@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}, doi = {10.2196/72165}, 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.

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.

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.

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.

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 & 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 & 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.

OBJECTIVE: To synthesize evidence evaluating changes in CM outcomes during the COVID-19 pandemic compared to pre-pandemic.

PARTICIPANTS AND SETTING: Individuals ≤18 years old living in member countries of the Organization for Economic Co-operation and Development.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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}, doi = {10.1002/nop2.70216}, 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.

DESIGN: A concept analysis paper.

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.

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.

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.

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.

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 = {}, number = {}, pages = {1-40}, doi = {10.1017/S1368980025101432}, pmid = {41199361}, issn = {1475-2727}, 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.

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.

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.

PARTICIPANTS: Healthy adults aged 18 years and older, living in a Mediterranean country.

RESULTS: A total of 37 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 socioeconomic status (SES), 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.

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.

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 < 24 h (standard) and ≥ 24 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.

RESULTS: Of 19,986 records, 9 (n = 1,045) were included in the qualitative and quantitative analysis. Four studies, including two small RCTs (n = 112) and two NRSIs (n = 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 = 641, HR 0.72; 95% CI 0.41-1.25). No heterogeneity was detected among studies (I² = 0%), but the confidence interval for I² was wide (95% CI: 0-89%), suggesting the possibility that substantial heterogeneity may exist. Similarly, no significant differences were found for secondary outcomes.

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 {pmid40140333, year = {2025}, author = {Wei, C and Jiang, W and Luo, M and Shao, F}, title = {BBB breakdown caused by plasma membrane pore formation.}, journal = {Trends in cell biology}, volume = {35}, number = {11}, pages = {933-943}, doi = {10.1016/j.tcb.2025.02.012}, pmid = {40140333}, issn = {1879-3088}, mesh = {Humans ; *Blood-Brain Barrier/metabolism/pathology ; *Cell Membrane/metabolism ; Animals ; Endothelial Cells/metabolism/pathology ; COVID-19/pathology ; Lipopolysaccharides ; Phosphate-Binding Proteins/metabolism ; Brain/metabolism ; Gasdermins ; }, abstract = {The blood-brain barrier, recently reintroduced as the blood-brain border (BBB), is a dynamic interface between the central nervous system (CNS) and the bloodstream. Disruption of the BBB exposes the CNS to peripheral pathogens and harmful substances, causing or worsening various CNS diseases. While traditional views attribute BBB failure to tight junction disruption or increased transcytosis, recent studies highlight the critical role of gasdermin D (GSDMD) pore formation in brain endothelial cells (bECs) during BBB disruption by lipopolysaccharide (LPS) or bacterial infections. This mechanism may also be involved in neurological complications like the 'brain fog' seen in long COVID. Pore formation in bECs may represent a prevalent mechanism causing BBB leakage. Investigating membrane-permeabilizing pores or channels and their effects on BBB integrity is a growing area of research. Further exploration of molecular processes that maintain, disrupt, and restore bEC membrane integrity will advance our understanding of brain vasculature and aid in developing new therapies for BBB-related diseases.}, } @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}, 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.

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.

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.

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.

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.

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.

METHOD: This umbrella review was conducted in accordance with 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.

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% 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.

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 = {}, doi = {10.1002/cpt.70120}, pmid = {41194530}, issn = {1532-6535}, 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 ; China/epidemiology ; *Physicians/psychology/statistics & numerical data ; Prevalence ; Risk Factors ; COVID-19/epidemiology ; }, abstract = {OBJECTIVES: The current study was performed to systemically examine the prevalence of burnout, risk factors among Chinese doctors, and possible treatment strategies.

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.

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).

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 {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.

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.

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 {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}, doi = {10.1161/JAHA.125.042670}, pmid = {41160032}, issn = {2047-9980}, mesh = {Humans ; *Cardiovascular Diseases/epidemiology ; *Virus Diseases/epidemiology/complications ; *COVID-19/epidemiology ; Risk Assessment ; Risk Factors ; SARS-CoV-2 ; }, 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.

METHODS: MEDLINE, Embase, Web of Science, African-Wide Information, and the Cochrane Library database were searched from inception to July 2024.

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 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.

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 {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.

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.

RESULTS: Of the 22 included economic evaluations, most were cost-utility analyses (n = 10) and cost-effectiveness analyses (n = 9). Most used a short-term decision tree with a long-term Markov model (n = 5), with time horizons between 28 days to a lifetime, and were from a healthcare system perspective (n = 7). Most conducted scenario analyses (n = 15) and/or sensitivity analyses (n = 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 = 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.

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.

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 {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 & 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.

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.

RESULTS: A total of 25 studies comprising of 5010 subjects were included. Mean SUV max of reactive nodes was 2.8 ± 1.2. Overall, RAL prevalence was 38.6% ± 17.6, higher in females (58.1% versus 41.9%, P  = 0.02) and younger individuals (mean age 63.3 versus 70.7 years, P  = 0.03). The RAL rate was not statistically different between mRNA (39.9% ± 16.9) and non-mRNA vaccines (26.3% ± 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 & 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 month.

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 {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}, doi = {10.2196/77331}, 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.

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.

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 (≥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.

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.

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 & dosage ; *COVID-19/prevention & 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.

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.

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.

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, İ}, 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 & numerical data ; *Pandemics ; *Vaccination/statistics & numerical data ; Health Services Accessibility ; *Vaccination Coverage ; *COVID-19/prevention & 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.

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.

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.

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 {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.

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.

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.

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 {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.

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.

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 {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}, doi = {10.3346/jkms.2025.40.e281}, pmid = {41185579}, issn = {1598-6357}, support = {101058094//European Commission/ ; }, mesh = {Humans ; *Helsinki Declaration ; *COVID-19/epidemiology ; Republic of Korea/epidemiology ; *Ethics, Research ; Informed Consent/ethics ; SARS-CoV-2 ; Pandemics ; Biomedical Research/ethics ; }, 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.

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.

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.

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 {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 & 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.

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.

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.

METHODS: Data from the CDC WONDER database were used to extract mortality information for individuals aged ≥65 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.

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 100 000 in 1999 to 6.26 per 100 000 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.

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.

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.

RESULTS: Key transmission sites were identified by chi-square test (χ [2] = 87.32, p < 0.001). Risk factors such as advanced age (OR = 3.15) and village clinic visits (OR = 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 = 0.91), and Apriori association rules revealed patterns such as "wedding banquet → family gathering" (confidence 0.86). A Python-based system improved intelligence extraction efficiency by 47.8%.

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 & dosage ; *COVID-19/prevention & control/epidemiology ; *Vaccination Hesitancy/statistics & numerical data/psychology ; *Vulnerable Populations/psychology ; Vaccination/psychology ; SARS-CoV-2/immunology ; Global Health ; Pandemics/prevention & 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 {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 & growth factor reviews}, volume = {86}, number = {}, pages = {167-180}, doi = {10.1016/j.cytogfr.2025.10.008}, pmid = {41176818}, issn = {1879-0305}, 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 & neonatal medicine}, volume = {}, number = {}, pages = {101680}, doi = {10.1016/j.siny.2025.101680}, pmid = {41176483}, issn = {1878-0946}, 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 {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}, doi = {10.5664/jcsm.11782}, 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.

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.

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.

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.

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 {pmid39404761, year = {2025}, author = {Choi, Y and Lee, JS and Choe, YJ and Lee, H and Yoon, Y and Shin, SH and Hwang, MJ and Choi, H and Na, S and Kim, JH and Kang, HM and Ahn, B and Seo, K and Park, S}, title = {Myocarditis and Pericarditis are Temporally Associated with BNT162b2 COVID-19 Vaccine in Adolescents: A Systematic Review and Meta-analysis.}, journal = {Pediatric cardiology}, volume = {46}, number = {8}, pages = {2193-2206}, pmid = {39404761}, issn = {1432-1971}, mesh = {Humans ; *Myocarditis/epidemiology/etiology ; *Pericarditis/epidemiology/etiology ; Adolescent ; *COVID-19/prevention & control ; *BNT162 Vaccine/adverse effects ; Incidence ; SARS-CoV-2 ; Male ; *COVID-19 Vaccines/adverse effects ; }, abstract = {The incidence of myocarditis and pericarditis has been documented in adolescents after COVID-19 vaccinations. This study aims to assess the risk of myopericarditis in adolescents following COVID-19 vaccination, using a meta-analysis of the published cases. We performed a comprehensive literature search of the following databases on July 5, 2023: MEDLINE, EMBASE, PubMed, and the Cochrane Library. We performed a meta-analysis using a random-effects model to estimate the incidence of myopericarditis per million of administered COVID-19 vaccine doses or COVID-19 infections. A total of 33 studies were included in the meta-analysis. The incidence of myopericarditis per million COVID-19 infections (1583.9 cases, 95% CI 751.8-2713.8) was approximately 42 times higher than that for COVID-19 vaccine administrations (37.6 cases, 95% CI 24.2-53.8). The risk of myopericarditis after COVID-19 vaccination was particularly high among the 16-19 age group (39.5 cases per million, 95% CI 25.8-56.0), males (43.1 cases per million, 95% CI 21.6-71.9), and those who received the second dose (47.7 cases per million, 95% CI 22.2-82.2). There were no significant differences in the incidence of myopericarditis per million COVID-19 vaccine administrations between Europe, the Western Pacific, and the Americas (p = 0.51). Adolescents faced a potential risk of myopericarditis after COVID-19 vaccination, but this risk is less harmful than that of myopericarditis following COVID-19 infection.}, } @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 & administration ; *Reproductive Health ; *Sexual Health ; Female ; *Delivery of Health Care, Integrated/organization & 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 = {}, number = {}, pages = {}, 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 = {}, number = {}, pages = {103295}, doi = {10.1016/j.ctim.2025.103295}, pmid = {41176175}, issn = {1873-6963}, 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 1,407 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 160-240mg/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 {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}, doi = {10.12659/AJCR.950045}, 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 ; North America/epidemiology ; Pandemics ; Health Services Accessibility ; *Healthcare Disparities ; 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.

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.

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.

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.

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.

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 = 0.415) and in hospital mortality (RR: 1.05, 95% CI: 0.95 to 1.16, P = 0.286), nor other secondary clinical outcomes.

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.

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 = {}, number = {}, pages = {106645}, doi = {10.1016/j.jinf.2025.106645}, pmid = {41173399}, issn = {1532-2742}, abstract = {OBJECTIVE: To assess whether GLP-1 RA treatment influences infection risk in randomized clinical trials (RCTs).

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.

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; I² = 0%), non-serious (RR, 0.90; 95% CI, 0.85-0.97; I² = 77%), and total infections (RR, 0.89; 95% CI, 0.84-0.94; I² = 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 I² = 0%. Meta-regression showed greater weight loss (β = -0.011; P =.045), hemoglobin A1c reduction (β = -0.229; P =.026), and higher GLP-1 RA doses (RR, 0.87; 95% CI, 0.83-0.92) were associated with lower risk.

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 = {2025}, 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}, 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.

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 ≥3 controlled studies.

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 ≤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.

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.

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.

RESULTS: The results of our analysis of 33 studies found long-COVID-19-related neurological signs/symptoms were predominantly: pain and sensory problems (N = 74,612/91,543; 81.5%), followed by sleep disturbances (N = 14,630/91,543; 15.9%), and cognitive difficulties (N = 2274/91,543; 2.4%). The global prevalence of long COVID-19 neurological signs/symptoms was estimated between 0.4% (20/5032; 95% CI = 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 =   -  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.

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 {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 & numerical data ; Child, Preschool ; Mood Disorders/epidemiology ; Suicide, Attempted/statistics & 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 {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 {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.

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.

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 μm) was most consistently associated with older age (n = 16), physical exercise (n = 6), and active infection (n = 6). No consistent associations were found for sex (n = 21), body mass index (BMI; n = 10), or smoking (n = 6). Viral presence-mainly influenza and SARS-CoV-2-was more strongly associated with time since symptom onset (n = 8) and lower respiratory symptoms (n = 3), based largely on genomic detection. Associations with other factors, including upper respiratory symptoms (n = 6), swab viral load (n = 11), age (n = 6), sex (n = 6), and BMI (n = 2), were inconsistent or absent. Physical exercise was not evaluated in relation to viral presence.

DISCUSSION: Fine respiratory particles (<5 μm) 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}, } @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 & ageing : I & 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.

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.

RESULTS: Among the 7 studies included (n = 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.

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 & 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 {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}, doi = {10.1111/aogs.70055}, 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 {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 {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}, doi = {10.1111/irv.70171}, 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.

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.

RESULTS: The mean incubation period was estimated at 3.5 days (95% credible interval: 3.0-4.0 days), with no clear differences based on vaccination status or age. This estimate aligned closely with the pooled mean of 3.7 days (3.3-4.0 days) for Omicron BA.1 and of 3.7 days (2.3-5.1 days) for all considered Omicron variants BA.1/2 and BA.5.

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 & 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 & 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 & 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 & 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 {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}, doi = {10.1002/jcla.70103}, 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 & 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.

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.

RESULTS: The patients received a combination therapy of molnupiravir and methylprednisolone; then their symptoms were relieved over the next 2 weeks-2 months.

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 {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 {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 = {3MS1093//University of Basel/ ; //Erasmus MC MRace Grant/ ; //ESCMID PK/PD of Anti-Infectives Study Group/ ; //Stichting de Merel/ ; K23AI143882//National Institute of Allergy and Infectious Diseases of the National Institutes of Health/ ; 848017008/ZONMW_/ZonMw/Netherlands ; }, mesh = {Humans ; Critical Illness/therapy ; *Anti-Bacterial Agents/administration & 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 {pmid40372391, year = {2025}, author = {Mukherjee, P and Beheshti, A and Kumar, SA and Wallace, G and Merrett, N and Clark, J and Kos, S and Rawstron, E and Yang, J and Grieve, S and Shetty, A and Singer, S}, title = {Traffic Light Coding System for Engaging With AI in Surgery.}, journal = {ANZ journal of surgery}, volume = {95}, number = {10}, pages = {1993-1998}, doi = {10.1111/ans.70172}, pmid = {40372391}, issn = {1445-2197}, mesh = {*Artificial Intelligence ; Humans ; COVID-19/epidemiology ; Pandemics ; SARS-CoV-2 ; *Surgical Procedures, Operative ; *General Surgery ; }, abstract = {Artificial Intelligence (AI) is generally defined as the development of computer systems or machines that can perform tasks typically requiring human intelligence and is increasingly being used in modern healthcare. While, various AI systems have existed for decades, its scale in healthcare has been escalated by global crises such as the COVID-19 pandemic and military conflicts, which has demanded rapid implementation of health system processes that improve efficiency in resource constrained environments. As AI-enabled technologies gain prominence, it is vital for surgeons to understand the various types of AI systems and their applications in medical practice.}, } @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}, 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 = {2025}, 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}, 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 {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 {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 = {}, pages = {32-37}, doi = {10.37201/req/s01.05.2025}, 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 & 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 & 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 = {}, doi = {10.3390/v17101353}, 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.

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.

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).

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 = {}, doi = {10.3390/v17101315}, 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 = {}, doi = {10.3390/v17101310}, pmid = {41157582}, issn = {1999-4915}, support = {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 = {}, doi = {10.3390/molecules30204130}, 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 = {}, doi = {10.3390/pathogens14101045}, 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 = {}, doi = {10.3390/pathogens14100975}, pmid = {41156587}, issn = {2076-0817}, mesh = {Humans ; *Mycobacterium tuberculosis/genetics/drug effects ; *Genomics/methods ; *Tuberculosis/prevention & control/epidemiology/microbiology ; COVID-19/epidemiology ; Genome, Bacterial ; Global Health ; Whole Genome Sequencing ; *Tuberculosis, Multidrug-Resistant/epidemiology/prevention & 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 = {}, doi = {10.3390/pathogens14100971}, 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 = {}, doi = {10.3390/jcm14207274}, 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 = {}, doi = {10.3390/jcm14207228}, 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 = {}, doi = {10.3390/pharmaceutics17101327}, 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 = {}, doi = {10.3390/medicina61101764}, 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 = {}, doi = {10.3390/ph18101581}, 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 = {}, doi = {10.3390/ph18101535}, 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 = {}, doi = {10.3390/ph18101461}, 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 = {}, doi = {10.3390/ph18101425}, pmid = {41155541}, issn = {1424-8247}, support = {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 = {}, doi = {10.3390/ijms262010230}, pmid = {41155520}, issn = {1422-0067}, support = {UNIN-BIOMED-25-1-2//University North/ ; }, mesh = {Humans ; *Anti-Infective Agents/pharmacology/chemistry ; *Mannose/pharmacology/chemistry/analogs & 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 = {}, doi = {10.3390/ijms262010120}, 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 = {}, doi = {10.3390/ijms26209885}, 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 = {}, doi = {10.3390/ijerph22101590}, pmid = {41154994}, issn = {1660-4601}, support = {N/A//The Conrad Prebys Foundation/ ; S21 MD010690/MD/NIMHD NIH HHS/United States ; }, mesh = {*Masks ; *COVID-19/prevention & 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 = {}, doi = {10.3390/ijerph22101574}, 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 = {}, doi = {10.3390/biom15101467}, pmid = {41154696}, issn = {2218-273X}, support = {CBF-2025-I-1331//SECIHTI/ ; R-2024-785-073//Fundación 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 = {}, doi = {10.3390/antiox14101193}, pmid = {41154502}, issn = {2076-3921}, support = {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 = {}, doi = {10.3390/healthcare13202623}, 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 = {}, doi = {10.3390/biomedicines13102450}, 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 = {}, doi = {10.3390/bs15101325}, 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 = {}, doi = {10.3390/bs15101313}, 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.

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.

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.

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 & 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.

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.

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.

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 {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}, doi = {10.1042/BST20253033}, 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 {pmid39410856, year = {2025}, author = {Perelmuter, S and Shin, JH}, title = {Enhancing endometriosis care with telehealth: Opportunities and challenges.}, journal = {Journal of telemedicine and telecare}, volume = {31}, number = {10}, pages = {1413-1417}, doi = {10.1177/1357633X241287969}, pmid = {39410856}, issn = {1758-1109}, mesh = {Humans ; *Endometriosis/therapy/diagnosis/psychology ; Female ; *Telemedicine/organization & administration ; COVID-19/epidemiology ; Quality of Life ; Health Services Accessibility ; Patient Care Team/organization & administration ; }, abstract = {Endometriosis affects a significant portion of women during their reproductive years, causing substantial pain and impacting their quality of life. Telehealth services have emerged as a promising avenue for enhancing endometriosis care, especially in the post-COVID-19 era. For endometriosis patients, who often require frequent appointments and specialized care, telehealth offers a convenient and accessible solution, particularly for addressing pain management and interdisciplinary concerns. Despite the challenges posed by the lack of physical examinations in telehealth, studies show that it can be a viable option for endometriosis care. Integrating telehealth with in-person visits for initial assessments can build trust and ensure comprehensive care delivery. Moreover, telehealth facilitates collaboration among multidisciplinary teams, including gynecologists, psychologists, and physiotherapists, to provide holistic treatment plans addressing physical, psychological, and interpersonal aspects of endometriosis. Here, we explore the potential benefits of telehealth in managing endometriosis, highlighting its role in providing comprehensive, multidisciplinary care while overcoming barriers like diagnostic delays and limited access to specialists. Further research and integration of telehealth into routine practice are warranted to maximize its benefits and address the complex challenges associated with endometriosis management.}, } @article {pmid41151085, year = {2025}, author = {González, L and Soriano, V}, title = {Human ecology: a bridge between medical ethics and the 2030 Agenda.}, journal = {AIDS reviews}, volume = {27}, number = {2}, pages = {55-62}, doi = {10.24875/AIDSRev.M25000085}, pmid = {41151085}, issn = {1698-6997}, mesh = {Humans ; COVID-19 ; *Ethics, Medical ; Pandemics ; *Ecology/ethics ; Sustainable Development ; SARS-CoV-2 ; United Nations ; *Pneumonia, Viral/epidemiology ; *Coronavirus Infections/epidemiology ; Animals ; One Health ; }, abstract = {The United Nations (UN) 2030 agenda is a developing program that aligns all human activities with the goodness and fullness of our planet. Sustainable development goals are grouped into categories, including planet, people, and partnership. Whereas ecology refers to caring for all elements of creation, human ecology points out that man specifically is part of it. It is at this point that medical ethics intersects with ecology. The responsibility of humans for the environment, living beings (animals and plants), and other men is needed for driving all creation to flourishing. Disregarding any of these elements would compromise the whole fulfillment by creatures on Earth, given their close interrelationship. Human abuse, instrumentalization, or exploitation of creatures-including one's own human being-would ultimately destroy our planet. Rather than empowering us with no limits, we should view creation as a gift and we, humans, as caregivers. Given the transformative power of human actions, concerns and regulations are required. This is why medical ethics should guide biotechnological advances, and the cautionary principle should prevail in human research. In this regard, ecology should be understood as the ethics of care. In a pyramidal way, caring should begin with human beings, followed by animals and plants, and finally consider the habitat we live in. In medicine, promoting "one health" underscores the need to expand caring beyond our own species, attending to the consequences of our actions on the environment and other living beings on our planet. The recent experience with the COVID-19 pandemic highlights the risk of zoonoses and the need for confronting human diseases globally.}, } @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 & control ; *Epidemiological Monitoring ; *Information Systems/organization & 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 = {}, doi = {10.3390/vaccines13101060}, 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 = {}, doi = {10.3390/vaccines13101059}, 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.

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.

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.

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 = {}, doi = {10.3390/vaccines13101002}, 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 = {}, doi = {10.3390/vaccines13100995}, 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 = {}, doi = {10.3390/jpm15100490}, 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 = {}, doi = {10.3390/bios15100660}, 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 = {}, doi = {10.3390/diseases13100333}, 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 = {}, pages = {CD015381}, pmid = {41147546}, issn = {1469-493X}, mesh = {Humans ; Randomized Controlled Trials as Topic ; *Cytidine/analogs & derivatives/therapeutic use/adverse effects ; *COVID-19 Drug Treatment ; *Antiviral Agents/therapeutic use/adverse effects ; *Hydroxylamines/therapeutic use/adverse effects/administration & dosage ; COVID-19/mortality ; SARS-CoV-2 ; Hospitalization/statistics & 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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

REGISTRATION: Protocol available at https://doi.org/10.1002/14651858.CD015381.}, } @article {pmid41147072, year = {2025}, author = {Huang, S and Wang, D and Wang, Y and Ma, Q and Zhu, Z and Liu, X and Shen, T and Wang, X and Yang, G and Ma, S and Guo, G and Zhu, F}, title = {Bibliometric Analysis of MSC-based Therapies for Non-COVID-19 ARDS.}, journal = {Current stem cell research & therapy}, volume = {20}, number = {6}, pages = {660-672}, doi = {10.2174/011574888X299848240529052619}, pmid = {41147072}, issn = {2212-3946}, mesh = {Humans ; *Bibliometrics ; *Respiratory Distress Syndrome/therapy ; *Mesenchymal Stem Cell Transplantation/methods ; *Mesenchymal Stem Cells/cytology ; COVID-19 ; SARS-CoV-2 ; Animals ; }, abstract = {BACKGROUND: Acute respiratory distress syndrome (ARDS) poses a significant challenge as it lacks specific treatments and can occur due to various etiologies. Mesenchymal stem cells (MSCs) have emerged as a promising cell-based therapy for ARDS due to their immunomodulatory, anti-inflammatory, and anti-fibrotic properties. Despite encouraging findings from preclinical studies, clinical evidence supporting the efficacy of MSCs in non-COVID-19 ARDS remains insufficient.

METHODS: We conducted a systematic search of three major databases (Web of Science Core Collection, Scopus, and PubMed) to identify original articles focusing on MSCs in non-COVID-19 ARDS. Subsequently, we employed the bibliometric package in R Studio to analyze and visualize bibliometric indicators derived from the retrieved articles.

RESULTS: Our analysis of 244 original studies revealed a notable trend in research on MSCs and non-COVID-19 ARDS. While the number of publications in this area saw an increase beginning in 2007, it exhibited a decline after 2019, with only 20 articles published in 2022. Notably, a significant proportion (131/244) of these studies originated from Chinese scholars. MSC derivatives emerged as a recent research focus due to their unique advantages as an alternative to MSCs. Specifically, umbilical cord/placental-derived MSCs have gained traction, surpassing the use of bone marrow-derived MSCs by 2022. The route of delivery is still mainly intravenous. Despite the potential advantages of the intratracheal route for lung-related diseases, the intravenous route remains the preferred mode of drug delivery.

CONCLUSION: Research on non-COVID-19 ARDS deserves further attention and investments. Existing studies have primarily focused on MSC derivatives that have shown clinical efficacy. Furthermore, umbilical cord/placental-derived MSCs are expected to replace traditional bone marrow- derived MSCs in research. Intratracheal delivery, which offers advantages for treating pulmonary diseases, still requires extensive experiments to validate.}, } @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.

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.

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.

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.

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.

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 {pmid39957693, year = {2025}, author = {Hussain, MS and Sultana, A and Bisht, AS and Gupta, G}, title = {Groundbreaking mRNA Lung Cancer Vaccine Trials: A New Dawn in Cancer Treatment.}, journal = {Current cancer drug targets}, volume = {25}, number = {8}, pages = {962-967}, pmid = {39957693}, issn = {1873-5576}, mesh = {Humans ; *Lung Neoplasms/immunology/therapy ; *Cancer Vaccines/immunology/therapeutic use/administration & dosage ; *Carcinoma, Non-Small-Cell Lung/immunology/therapy ; Clinical Trials as Topic ; *RNA, Messenger/immunology/genetics ; mRNA Vaccines ; Precision Medicine ; }, abstract = {The advent of mRNA vaccines has heralded a transformative era in oncology, exemplified by the BNT116 mRNA lung cancer vaccine. Leveraging the same groundbreaking technology as COVID-19 vaccines, BNT116 delivers tumor-specific genetic instructions to the immune system, targeting non-small cell lung cancer (NSCLC), the most prevalent lung cancer subtype. This approach contrasts with conventional therapies that lack precision and often damage healthy tissues. By encoding tumor antigens, BNT116 educates cytotoxic T cells to recognize and eradicate malignant cells, aligning with the principles of precision medicine. Early-phase clinical trials (e.g., NCT05142189) have demonstrated a favorable safety profile and promising antitumor activity, with ongoing research exploring its use in combination therapies, such as checkpoint inhibitors. Despite logistical challenges, such as mRNA instability and cold chain requirements, advances in lipid nanoparticle delivery systems are enhancing vaccine stability and efficacy. The adaptability of mRNA technology positions it as a cornerstone for personalized oncology, with potential applications extending to other cancers. Success in the BNT116 trials could redefine NSCLC treatment paradigms, offering a targeted, less cytotoxic alternative. This innovation can not only improve therapeutic outcomes, but also pave the way for preventive cancer vaccines, signaling a new dawn in cancer treatment.}, } @article {pmid39259221, year = {2025}, author = {Singh, M and Deokar, K and Sinha, BP and Doshi, J and Katoch, C}, title = {Infective pulmonary diseases and the eye: a narrative review.}, journal = {Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace}, volume = {95}, number = {3}, pages = {}, doi = {10.4081/monaldi.2024.2988}, pmid = {39259221}, issn = {2532-5264}, mesh = {Humans ; *Tuberculosis, Pulmonary/drug therapy/complications ; Antitubercular Agents/adverse effects/therapeutic use ; *Tuberculosis, Ocular/diagnosis/drug therapy/complications ; *Eye Diseases ; COVID-19 ; Linezolid/adverse effects ; }, abstract = {Several infectious pulmonary diseases affect the eye. An understanding of the association between infectious pulmonary and ocular diseases is pivotal to their successful management. We aimed to review the infections affecting both the lungs and the eye. The electronic database PubMed and the search engine Google Scholar were searched for relevant articles. Ocular tuberculosis (TB), usually not associated with clinical evidence of pulmonary TB, can affect almost all the ocular structures. Confirmation of the diagnosis of ocular TB requires demonstration of Mycobacterium tuberculosis in ocular fluids/tissues. Among the drugs used to treat TB, ethambutol, isoniazid, and linezolid may cause toxic optic neuropathy. The elderly, those with renal disease, diabetes mellitus, malnourished, alcoholics, and those who will receive ethambutol at doses greater than 15 mg/kg/day and for prolonged periods are at high risk of developing toxic optic neuropathy. These individuals should be referred to an ophthalmologist before initiating anti-tuberculous treatment for a baseline ophthalmic evaluation. Linezolid may also cause toxic retinal neuropathy. Rifampicin may cause yellowish-orange discoloration of tears and contact lenses. Adenovirus, coronavirus, influenza virus, respiratory syncytial virus, and rhinovirus exhibit both pulmonary and ocular tropism. Pneumocystis jirovecii choroiditis is rare and mainly seen when aerosolized pentamidine is used for pneumocystis pneumonia prophylaxis. Further research is needed to develop non-interventional strategies to diagnose ocular TB. Biomarkers for early detection of toxic optic neuropathy are a need of the hour. Genetic factors and mechanisms behind the development of ethambutol, isoniazid, and linezolid-induced toxic optic neuropathy need further study.}, } @article {pmid41145060, year = {2025}, 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 & bioelectronics}, volume = {293}, number = {}, pages = {118139}, doi = {10.1016/j.bios.2025.118139}, pmid = {41145060}, issn = {1873-4235}, 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 = {}, number = {}, pages = {e02659}, doi = {10.1002/chem.202502659}, pmid = {41144923}, issn = {1521-3765}, support = {101211395//HORIZON EUROPE Marie Sklodowska-Curie Actions/ ; J7-50041//Javna Agencija za 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.

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.

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 = -0.509, 95% CI: -0.680 to -0.338, p < 0.001). Similarly, a significant but weaker negative correlation was found between humidity and SARS-CoV-2 transmissibility (r = -0.426, 95% CI: -0.548 to -0.303, p < 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 < 0.001), while a unit increase in temperature in Celsius (°C) was associated with a reduction of transmissibility by 0.008 (95% CI: -0.030 to -0.030, p < 0.001).

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.

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.

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.

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 (≥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.

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.

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.

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.

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.

RESULTS: A total of 9 articles involving 1107 participants were included. The pooled mortality of acute heart failure was 16.36 % (95 % CI: 12.39, 20.33) with heterogeneity (I[2)] value of 85.86 %. Increased blood urea nitrogen (BUN), smoking, and hypotension were the factors significantly associated with the pooled mortality rate of acute heart failure.

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.

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).

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).

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 & numerical data ; Developing Countries/statistics & numerical data ; *Disease Outbreaks/statistics & 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.

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.

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.

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, & 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.

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.

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.

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.

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 = {}, number = {}, pages = {1-18}, doi = {10.3310/GJHG1331}, pmid = {41138066}, issn = {2755-0079}, 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.

OBJECTIVE: To identify evidence-based digital health intervention design and deployment features conducive to mitigating the digital divide.

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.

SETTING AND POPULATION: 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.

INTERVENTIONS: Any digital health intervention with features of design and/or deployment intended to enable access and engagement by the population of focus.

COMPARATORS: Any or none.

OUTCOME MEASURES: Any related to participants' access and/or use of digital health intervention and/or change in digital skills and confidence.

ANALYSIS: Data from studies that met the inclusion criteria were extracted, narratively synthesised and thematically analysed.

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.

DESIGN THEMES INCLUDE: 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.

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.

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.

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.

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 {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 {pmid41137964, year = {2025}, author = {Reis, J and Öztürk, Ş 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.

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 = {}, number = {}, pages = {}, pmid = {41136586}, issn = {1745-655X}, 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 {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 {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.

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.

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.

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.

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 {pmid40504242, year = {2025}, author = {Summerbell, R and Scott, J}, title = {Emerging Human Health Problems Caused by Pathogenic and Immuno-activating Fungi.}, journal = {Current topics in microbiology and immunology}, volume = {446}, number = {}, pages = {201-241}, pmid = {40504242}, issn = {0070-217X}, mesh = {Humans ; *Mycoses/microbiology/epidemiology/immunology ; Animals ; *Fungi/drug effects/pathogenicity/immunology/classification ; Drug Resistance, Fungal ; *Communicable Diseases, Emerging/microbiology/epidemiology ; Antifungal Agents/pharmacology/therapeutic use ; }, abstract = {In recent years, several types of novel fungal health problems have been emerging in parallel. Antifungal-drug-resistant opportunistic pathogens have emerged both in previously unknown lineages, notably Candida auris, and in traditional pathogens and opportunists such as the Trichophyton mentagrophytes species complex and Aspergillus fumigatus. Emergence of resistance in Aspergillus is clearly connected to agricultural use of fungicides related to medical antifungals, but is brought into further prominence by the simultaneous emergence of immunosuppressive viral effects connected to influenza and SARS CoV 2 infections. The sources of drug resistance phenotypes in Candida auris and Trichophyton indotineae are unclear, but neither climate change nor drug misuse can be clearly implicated. In Onygenalean endemic mycoses, however, climate change is under suspicion of causing range extension in Coccidioides immitis. Decimation of some North American bat species associated with Histoplasma hot spots has not had a perceptible effect on this fungus so far. Historical reading suggests that it may have survived a previous loss of conditioned habitat when the passenger pigeon became extinct. Emergence of Emergomyces and new Blastomyces species appears mainly to be related to enhanced recognition. Two separate sporotrichosis outbreaks in cats in South America and Southeast Asia suggest a little-discussed mechanism of pathogen emergence, opportunity trawling, i.e. ingress of new potential hosts into pathogen habitats leading to novel epizootics. In the investigations of non-pathogenic fungi connected to immunologically or toxicologically mediated symptomatology in indoor environments, the slow augmentation of difficult-to-obtain evidence has clarified that indoor dampness and mould can cause diverse health effects, ranging from novel advent of asthmatic conditions to eczema-like skin disturbances. The methodology used to evaluate indoor mould symptomatology shares some of the deficiencies that racked medical evaluations of causality during the SARS CoV 2 outbreak. Pertinent epidemiological connections may be obscured by an excessive positivistic demand for proof where the combination of valid evidence and judicious attention to the precautionary principle would better serve the community.}, } @article {pmid40388925, year = {2025}, author = {Wei, P and Wang, X and Han, J and Zhang, X}, title = {A bibliometric and visualized analysis of ischemic optic neuropathy from 2014 to 2024.}, journal = {European journal of ophthalmology}, volume = {35}, number = {6}, pages = {2259-2271}, doi = {10.1177/11206721251343653}, pmid = {40388925}, issn = {1724-6016}, mesh = {Humans ; *Optic Neuropathy, Ischemic/diagnosis/epidemiology ; *Bibliometrics ; Tomography, Optical Coherence ; SARS-CoV-2 ; }, abstract = {ObjectiveIschemic optic neuropathy (ION) is one of major causes of blindness or severe visual impairment. However, controversies persist regarding its pathogenesis, clinical features and management. This study aimed to conduct a bibliometric analysis to provide an assessment of current status and emerging trends in the field of ION.MethodsPublications spanning from January 2014 to Jun 2024 were retrieved, using the Web of Science Core Collection. Bibliometric and visualized analyses were performed employing the bibliometrix, CiteSpace and VOSviewer.ResultsA total of 776 papers met the inclusion criteria and a fluctuated publication trend was observed. The United States was the leading country. Research topics in ION field encompassed non-arteritic anterior ION (NAION), optical coherence tomography angiography, neuroprotection, optical coherence tomography, spine surgery, giant cell arteritis (GCA), optic disc diameter, peripapillary hyperreflective ovoid mass-like structures, vaccination, and branch retinal vein occlusion, based on the co-citation references analysis. The keywords "COVID-19", "oxidative stress", "inflammation" and "optic neuritis" experienced burst lasting until 2024.ConclusionDuring the past decade, advancements in in vivo imaging techniques are continually enhancing our understanding of the pathogenesis of ION and facilitating accurate diagnosis. NAION has been a prominent research topic, covering its pathogenesis, clinical features, and management. Studies on arteritic ION and GCA have garnered widespread attention, especially due to advances in treatments. Future research is warranted to identify standardized therapies for non-arteritic ION, potentially incorporating neuroprotective agents, and to formulate steroid-sparing treatment strategies aimed at preventing vision loss in arteritic ION, rather than merely addressing GCA.}, } @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}, abstract = {OBJECTIVE: Explore the impact of the COVID-19 pandemic on pediatric acute mastoiditis (AM).

DATA SOURCES: CINAHL, Cochrane Library, PubMed, Scopus.

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 (Δ), and relative risk (RR) with 95 % confidence intervals (CI).

RESULTS: There were seven included studies (N = 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 % greater risk of having an intracranial complication after the COVID pandemic than before (RR: 1.2 [95 % CI: 0.6-2.3], p = 0.0097). There was also a significant decrease in the proportion of cases treated conservatively with antibiotics after the pandemic (mean difference 10.8 % [95 % CI: 2.9 %-18.0 %], p < 0.01). Bacterial epidemiology also experienced a significant shift in composition following the pandemic.

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 {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 & control/epidemiology ; *Health Personnel/psychology/statistics & numerical data ; *Vaccination Hesitancy/statistics & 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.

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.

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.

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}, doi = {10.1111/irv.70172}, 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.

OBJECTIVES: To identify candidate markers of ARI severity suitable for use in primary care CMR-based surveillance.

METHODS: We undertook a systematic review of bibliographic databases and grey literature. Eligible studies reported characteristics for > 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.

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.

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.

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.

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 {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 & dosage/therapeutic use ; Aged ; Lenalidomide/therapeutic use/administration & dosage ; COVID-19/complications/therapy ; *Monoclonal Gammopathy of Undetermined Significance/complications/therapy/drug therapy ; Bortezomib/therapeutic use/administration & 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 {pmid41129928, year = {2025}, author = {Atlas, D}, title = {Targeting neurodegeneration and inflammation with thioredoxin-mimetic peptides.}, journal = {Redox biology}, volume = {87}, number = {}, pages = {103899}, doi = {10.1016/j.redox.2025.103899}, pmid = {41129928}, issn = {2213-2317}, 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 = {1-15}, 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.

SUMMARY: This review evaluates evidence on smoking's impact across eight conditions: endometrial carcinoma, rheumatoid arthritis, ulcerative colitis, Parkinson's disease, uterine leiomyoma, preeclampsia, 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.

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 & 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 Vaccines/adverse effects ; *COVID-19/prevention & control/immunology ; *SARS-CoV-2/immunology ; Vaccination/adverse effects ; *Eye Diseases/etiology ; *Uveitis/etiology/epidemiology ; Risk Factors ; }, 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.

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.

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.

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 {pmid40329717, year = {2025}, author = {Parwani, S and Upreti, S and Mishra, CK and Tripathi, A and Chakraborty, S and Tiwari, S}, title = {Navigating the COVID-19 Treatment Landscape: Efficacy and Side-Effects of Current Therapies against SARS-CoV-2.}, journal = {Current HIV research}, volume = {23}, number = {3}, pages = {145-160}, doi = {10.2174/011570162X338375250414114957}, pmid = {40329717}, issn = {1873-4251}, mesh = {Humans ; COVID-19/immunology ; *SARS-CoV-2/drug effects ; *Antiviral Agents/therapeutic use/adverse effects ; *COVID-19 Drug Treatment ; COVID-19 Vaccines/immunology ; *HIV Infections/complications/immunology/drug therapy ; Drug Repositioning ; }, abstract = {Coronavirus Disease 2019 (COVID-19), caused by the highly contagious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in late 2019 in Wuhan, China. Designated as an epidemic by the World Health Organization (WHO) on January 30, 2020, the virus quickly escalated to a global emergency, officially declared a pandemic in March 2020. With over 6 million recorded deaths and more than 200 identified symptoms in diverse individuals, the impact of COVID-19 is substantial. COVID-19 poses a greater risk to individuals with advanced HIV, while those with well-managed HIV are not at increased risk. Although COVID-19 vaccines are generally effective for people with HIV, some may experience reduced vaccine effectiveness and breakthrough infections due to suboptimal immune responses. Long COVID, affecting at least 65 million individuals, adds a layer of complexity. The virus's rapid mutation has led to diverse symptomatology, prompting adjustments in treatment guidelines. This review comprehensively examines repurposed antiviral drug candidates against COVID-19, explores immune responses across different age groups, delves into the mechanisms of COVID-19 vaccines, and discusses potential immunosuppressants. Additionally, the focus extends to Intravenous Immunoglobulin (IVIG), steroids, and anti-cytokine therapy as promising avenues to address cytokine release syndrome (CRS), a critical condition in COVID-19 patients.}, } @article {pmid40008994, year = {2025}, author = {Kitajima, M and Abe, H and Honda, R and Kobayashi, H and Kuroita, T and Nemoto, A and Shirakashi, R and Scott, R and Furuta, K}, title = {Biobanking: Possibilities for Wastewater-Based Epidemiology.}, journal = {Biopreservation and biobanking}, volume = {23}, number = {5}, pages = {387-395}, doi = {10.1089/bio.2024.0118}, pmid = {40008994}, issn = {1947-5543}, mesh = {Humans ; *Wastewater/virology/microbiology ; *Biological Specimen Banks/ethics ; *COVID-19/epidemiology/virology ; SARS-CoV-2/isolation & purification ; Public Health ; Pandemics ; *Wastewater-Based Epidemiological Monitoring ; }, abstract = {The COVID-19 pandemic, spanning from early 2020 to late 2022, posed unprecedented challenges for global public health. However, it also spurred innovative approaches to pandemic management, notably the development of pathogen detection in wastewater. It was successfully demonstrated that wastewater analysis can not only reflect ongoing COVID-19 infections but also serve as an early indicator of disease prevalence within communities. Recognizing the value of longitudinal analyses of various pathogens, we identified the need for wastewater biobanking. This practice allows for the retrospective analysis of samples, offering critical public health insights at the population level. Moreover, the potential to transport and store biobanked samples at ambient temperature or in a dry state could greatly enhance the utility of this technology, especially in resource-limited settings such as low- and middle-income countries. This article also addresses the ethical considerations and public health implications of wastewater-based epidemiology. While this approach holds significant potential beyond pathogen detection, it is essential to evaluate the benefits and potential risks carefully.}, } @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}, doi = {10.1126/sciadv.adx1576}, pmid = {41124269}, issn = {2375-2548}, mesh = {Humans ; *Nanomedicine/methods/trends ; *Neoplasms/therapy/drug therapy ; COVID-19/prevention & 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 = {}, number = {}, pages = {}, doi = {10.1002/phar.70070}, pmid = {41123220}, issn = {1875-9114}, 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.

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.

RESULTS: In less than 24 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.

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 = {2025}, 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 = {}, number = {}, pages = {120764}, doi = {10.1016/j.jep.2025.120764}, pmid = {41120028}, issn = {1872-7573}, 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.

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.

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.

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-κB 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.

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 & 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.

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.

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.

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 & dosage ; Female ; Child ; Methylprednisolone/administration & 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 & 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 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 {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 & 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.

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.

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.

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.

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 {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 & 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.

AIM: This project conducts a scoping review to describe the available evidence on the integration of COVID-19 into sentinel surveillance systems.

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.

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 (ρ = 0.78 and ρ = 0.82 respectively).

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 & 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 {pmid41110943, year = {2025}, author = {Thomas, C and Pearse, RM}, title = {Socioeconomic deprivation and health inequity: independently associated with postoperative outcomes, and does this matter?.}, journal = {British journal of anaesthesia}, volume = {135}, number = {5}, pages = {1141-1143}, doi = {10.1016/j.bja.2025.07.002}, pmid = {41110943}, issn = {1471-6771}, mesh = {Humans ; *COVID-19/epidemiology ; *Postoperative Complications/epidemiology ; United Kingdom/epidemiology ; Risk Factors ; *Health Inequities ; *Social Deprivation ; *Healthcare Disparities ; Socioeconomic Factors ; *Health Status Disparities ; }, abstract = {Health inequities are unjust disparities in health between groups of people, typically described in terms of sex, race and ethnicity, or socioeconomic position. The COVID-19 pandemic highlighted significant ongoing health inequities across the United Kingdom and worldwide. We believe that socioeconomic deprivation is the single most important driver of health inequity. For patients having surgical treatments, it is clear that socioeconomic deprivation is an important risk factor for poor patient outcomes. However, there is overlap with other important risk factors such as smoking and obesity. We discuss recent work that describes the associations between socioeconomic deprivation and short-term patient outcomes after surgery. We explore the difficulties in identifying risk factors for poor patient outcomes that can be modified by perioperative teams, and why it is important not to confuse modifiable risks with the underlying drivers of health inequity.}, } @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 {pmid40418063, year = {2025}, author = {Pascual-Mato, M and Gárate Viñas, G and Muñoz San Martín, M and González-Quintanilla, V and Crespo, J and Rivero Tirado, M and Pascual Gómez, J}, title = {Calcitonin gene-related peptide (CGRP) in the pathophysiology of gastrointestinal disorders - A key mediator in the gut-brain axis.}, journal = {Revista espanola de enfermedades digestivas}, volume = {117}, number = {10}, pages = {572-578}, doi = {10.17235/reed.2025.11310/2025}, pmid = {40418063}, issn = {1130-0108}, mesh = {Humans ; *Gastrointestinal Diseases/physiopathology ; *Calcitonin Gene-Related Peptide/physiology/metabolism ; *Brain-Gut Axis/physiology ; *Brain/physiopathology/physiology ; *Gastrointestinal Tract/physiopathology ; }, abstract = {The concept "gut-brain axis" means a bidirectional communication between the central nervous system and the gastrointestinal (GI) tract. This axis is key in keeping the physiological homeostasis of the GI tract and its dysfunction has been implicated in a number of neuropsychiatric and gut conditions. A number of neurotransmitters are known to be involved in the performance of gut-brain axis. Our objective has been to review and critically analyze the contribution of the calcitonin gene-related peptide (CGRP) in the physiology and pathophysiology of the gut-brain axis, with emphasis in the fresh, basic, and clinical evidence supporting an outstanding role of this neuropeptide. CGRP is considered the pivotal molecule and the first biomarker of migraine, a debilitating disease combining digestive and neurological symptoms. A number of recent experimental and clinical data support a relevant protective role for CGRP, and in particular for beta-CGRP, the isoform located in the enteric nervous system, in the gut-brain axis proper functioning and in the pathophysiology of several gut diseases, including conditions such as diverticular disease, acute infectious diarrhea or inflammatory bowel disease. As examples of its adaptable behavior, circulating beta-CGRP levels are increased in patients with acute diarrhea in COVID-19 infection or reduced already in the early phases of inflammatory bowel disease. In addition, beta-CGRP antagonism could explain the constipation seen with the new CGRP antagonists used in the preventive treatment of frequent migraine. These evidences indicate a relevant role of CGRP in gut-brain axis functioning and call for analyzing a potential role of CGRP in other common diseases of the GI tract, comorbid with brain conditions, such as irritable bowel syndrome or chronic constipation.}, } @article {pmid41110781, year = {2025}, author = {Borrow, R and Caugant, DA and Clark, SA and Dinleyici, EÇ and Hall, I and Harrison, LH and Hausdorff, WP and Ladhani, SN and Lucidarme, A and Sáfadi, MA 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 = {}, number = {}, pages = {106635}, doi = {10.1016/j.jinf.2025.106635}, pmid = {41110781}, issn = {1532-2742}, 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 {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 & 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 {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).

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.

RESULTS: Three RCTs were included in the main analysis (3882 statin-naive patients, 33.7 % female, average follow-up duration 37 days). Compared with control, statin therapy was associated with reduced all-cause death (20.9 % vs. 23.8 %; odds ratio [OR]: 0.82, 95 % confidence interval [CI] 0.70-0.96; P = 0.01), with a small but significant increase in myopathy (0.6 % vs. 0 %; risk difference: 0.00, 95 % CI -0.00; 0.01), and no significant difference in liver enzyme abnormalities (1.0 % vs. 1.4 %; OR 1.00, 95 % 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 = 0.38) or sex (males vs. females, P = 0.83).

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.

STUDY REGISTRATION: This study is registered in PROSPERO (CRD42023478764).}, } @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 & 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 {pmid41108463, year = {2025}, author = {Demongeot, J and Hillen, T and Ruan, S and Webb, G}, title = {The work of Pierre Magal on differential equations, functional analysis and mathematical biology.}, journal = {Journal of mathematical biology}, volume = {91}, number = {5}, pages = {59}, pmid = {41108463}, issn = {1432-1416}, mesh = {Humans ; Mathematical Concepts ; COVID-19/epidemiology ; *Models, Biological ; History, 20th Century ; History, 21st Century ; Population Dynamics/history ; SARS-CoV-2 ; }, abstract = {Pierre Magal (1967-2024) was a leading researcher at the interface of differential equations, functional analysis, and mathematical biology. He made substantial contributions to both theoretical and applied aspects of these subjects. He published a dozen monographs, proceedings, and special issues and more than 125 journal articles. In this article we provide an introduction to Pierre's contributions in some topics, including discrete population dynamics, integrated semigroup theory and abstract Cauchy problems with nondense domain, traveling waves in biological systems, uniform persistence and global attractors, cell-to-cell P-glycoprotein transfer in breast cancers, transfer problems in population dynamics and economics, and modeling of various epidemic problems, in particular his recent and extensive work on modeling COVID-19.}, } @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}, 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 = {}, number = {}, pages = {126287}, doi = {10.1016/j.ijpharm.2025.126287}, pmid = {41106514}, issn = {1873-3476}, 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}, doi = {10.1016/j.clinsp.2025.100807}, 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.

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.

METHODS: Cross-sectional study with two assessments: 30 days and one year after hospital discharge, in individuals ≥ 18 years of age, admitted to a referral hospital in São 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 ≤ 0.05 considered significant.

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.

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}, doi = {10.7189/jogh.15.04282}, 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.

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.

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).

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}, doi = {10.1111/jocd.70479}, pmid = {41104804}, issn = {1473-2165}, mesh = {Humans ; *Consumer Behavior/statistics & numerical data ; *COVID-19/epidemiology/prevention & 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.

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.

METHOD: The PRISMA & 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.

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.

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.

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 = {}, number = {}, pages = {}, doi = {10.1002/ame2.70099}, 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)/ ; }, 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.

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.

RESULTS: Age (≥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 (I²>50%, p>0.05).

CONCLUSION: This meta-analysis confirms that older age (≥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.

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}, doi = {10.1002/iid3.70289}, pmid = {41103058}, issn = {2050-4527}, mesh = {Humans ; *Adenosine Monophosphate/analogs & derivatives/therapeutic use/adverse effects ; *Alanine/analogs & derivatives/therapeutic use/adverse effects ; *Antiviral Agents/therapeutic use/adverse effects ; *Hydroxylamines/therapeutic use/adverse effects ; SARS-CoV-2 ; COVID-19/mortality ; *Cytidine/analogs & 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.

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.

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] = 2.54, 95% confidence interval [CI]: 0.67, 9.57), hospitalizations (OR = 2.43, 95% CI: 0.81, 7.24), viral clearance rates (OR = 1.49, 95% CI: 0.64, 3.46), or average time to viral clearance (standardized mean difference = 0.02, 95% CI: -0.40, 0.46). However, the incidence of adverse events was lower in the remdesivir group (OR = 0.49, 95% CI: 0.26, 0.93). The certainty of evidence for these findings was evaluated and determined to be low or moderate.

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 & 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.

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.

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.

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.

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}, doi = {10.1093/infdis/jiaf216}, pmid = {41102609}, issn = {1537-6613}, support = {//National Institute of Allergy and Infectious Diseases/ ; /NH/NIH HHS/United States ; }, mesh = {Humans ; *Influenza, Human/prevention & 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 & control ; *Pandemics/prevention & 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}, doi = {10.1093/infdis/jiaf218}, 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 {pmid41102602, year = {2025}, author = {Bright, RA}, title = {Optimizing Antiviral Stockpiles for Pandemic Response: A Strategic Framework.}, journal = {The Journal of infectious diseases}, volume = {232}, number = {Supplement_3}, pages = {S309-S313}, doi = {10.1093/infdis/jiaf264}, pmid = {41102602}, issn = {1537-6613}, mesh = {Humans ; *Antiviral Agents/supply & distribution/therapeutic use/economics ; *Influenza, Human/drug therapy/epidemiology/prevention & control ; *Pandemics/prevention & control ; *Strategic Stockpile/methods ; United States/epidemiology ; COVID-19 ; SARS-CoV-2 ; Influenza A Virus, H1N1 Subtype/drug effects ; }, abstract = {Influenza antiviral stockpiling represents a critical component of pandemic preparedness, yet evolving challenges demand new approaches to this strategic imperative. The Strategic National Stockpile's target of maintaining antiviral courses for 25% of the United States population reflects both economic modeling and practical experience from recent pandemics, including the 2009 influenza A(H1N1) and coronavirus disease-19 pandemics. This perspective examines the evolution of antiviral stockpiling strategies, highlighting key lessons from these events as well as challenges in supply chain resilience, resistance management, and rapid deployment. The increasing diversity of available antivirals, from traditional neuraminidase inhibitors to a newer cap-dependent endonuclease inhibitor and emerging host-targeted therapeutics, offers opportunities for more robust stockpiling strategies. However, this diversity also introduces complexities in decision-making, storage, and deployment. Recent advances in artificial intelligence and manufacturing technologies present promising solutions for enhancing stockpile management, potentially enabling more responsive just-in-time production capabilities. The integration of rapid diagnostics, streamlined distribution systems, and novel therapeutic approaches could transform traditional stockpiling paradigms. This analysis provides a framework for optimizing antiviral stockpiles that balances immediate pandemic response capabilities with long-term strategic considerations, while addressing critical challenges in resistance management, pediatric formulations, and supply chain resilience.}, } @article {pmid41102601, year = {2025}, author = {Waite, AAC and Peto, L and Gordon, AC and Horby, P}, title = {Platform Trials to Assess Therapeutics in Patients Hospitalized With Influenza.}, journal = {The Journal of infectious diseases}, volume = {232}, number = {Supplement_3}, pages = {S254-S261}, doi = {10.1093/infdis/jiaf276}, pmid = {41102601}, issn = {1537-6613}, support = {NIHR155209//NIHR Health Technology Assessment program/ ; //NIHR Imperial Biomedical Research Centre/ ; //Flu Lab Limited Liability Company/ ; //National Philanthropic Trust/ ; //Roche Products Ltd/ ; //F. Hoffmann-La Roche AG/ ; }, mesh = {Humans ; *Influenza, Human/drug therapy/therapy ; *Antiviral Agents/therapeutic use ; Hospitalization ; *Randomized Controlled Trials as Topic/methods ; SARS-CoV-2 ; COVID-19 ; COVID-19 Drug Treatment ; }, abstract = {Evidence-based effective treatments for hospitalized patients with influenza have yet to be identified. Traditional randomized controlled trials have struggled to provide definitive guidance due in part to small sample sizes and logistical challenges. Adaptive platform trials, such as REMAP-CAP (Randomised Embedded Multifactorial Adaptive Platform for Community-Acquired Pneumonia) and RECOVERY (Randomised Evaluation of COVID-19 Therapy), offer a transformative approach to evaluating influenza therapeutics. REMAP-CAP and RECOVERY utilize flexible, efficient designs that enable the simultaneous assessment of multiple interventions, adaptation to emerging data, and large-scale recruitment. Both platforms are currently evaluating antiviral and immunomodulatory therapies for severe influenza, building on their success in identifying effective treatments for COVID-19. Establishing global platform trials for influenza will facilitate the generation of high-quality evidence to guide seasonal influenza treatment and enhance pandemic preparedness. A coordinated international effort to sustain platform trials beyond pandemic periods is essential for improving clinical outcomes, optimizing resource utilization, and ensuring readiness for future pandemics.}, } @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}, doi = {10.2196/63984}, pmid = {41100177}, issn = {1438-8871}, mesh = {India ; *Telemedicine/trends/organization & 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.

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.

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.

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.

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 {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.

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.

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.

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 {pmid38548559, year = {2025}, author = {Katz, C and Cohen, N and Attrash-Najjar, A and Glucklich, T and Jacobson, M and Varela, N and Priolo-Filho, SR and Chang, OD and Haffejee, S and Kaawa-Mafigiri, D and Katz, I and Maguire-Jack, K and Massarweh, N and Tarabulsy, GM and Levine, DT and Wekerle, C}, title = {The remote work of child protection professionals during COVID-19: A scoping review and thematic analysis.}, journal = {Child abuse & neglect}, volume = {168}, number = {Pt 2}, pages = {106759}, doi = {10.1016/j.chiabu.2024.106759}, pmid = {38548559}, issn = {1873-7757}, mesh = {Humans ; *COVID-19/epidemiology ; Child ; *Child Protective Services/organization & administration ; *Child Abuse/prevention & control ; SARS-CoV-2 ; *Teleworking ; }, abstract = {BACKGROUND: The COVID-19 pandemic created new challenges and barriers for the work of child protection professionals (CPPs) and intensified existing hardships for families and children, increasing the risk of child maltreatment. As new restrictions and precautions were implemented by governments worldwide to stop the virus from spreading, CPPs had to adapt to a new reality of working remotely. However, limited research has investigated how remote work impacted CPPs and child protection work and how CPPs handled this alternative work style.

OBJECTIVE: This review aims to address gaps in the research to reveal the creative and effective approaches CPPs developed to overcome the challenges presented by COVID-19, defined as the 'positive legacy' of CPPs, particularly in adapting to remote work challenges.

METHOD: This review was conducted using a scoping review, followed by two rounds of thematic analysis. The scoping review was conducted in six languages: Hebrew, Arabic, French, Portuguese, Spanish, and English.

RESULTS: The first round of thematic analysis found 18 articles relevant to this review. The second round extracted two main themes: 1) the challenges of remote work and 2) overcoming the challenges of no contact.

CONCLUSIONS: The findings of this review may be used to inform future strategies for child protection during a pandemic. They also provide an opportunity to rethink the relationship child protection work has with technology to systematically reform current and future protection policies and practices, including outside of a pandemic.}, } @article {pmid38008657, year = {2025}, author = {Katz, C and Attrash-Najjar, A and Cohen, N and Glucklich, T and Jacobson, M and Varela, N and Priolo-Filho, SR and Bérubé, A and Chang, OD and Collin-Vézina, D and Fouché, A and Haffejee, S and Katz, I and Maguire-Jack, K and Massarweh, N and O'Reilly, M and Tiwari, A and Truter, E and de Andrade Vieira, RV and Walker-Williams, H and Zibetti, MR and Wekerle, C}, title = {Child protective services and out-of-home Care for Children during COVID-19: A scoping review and thematic analysis.}, journal = {Child abuse & neglect}, volume = {168}, number = {Pt 2}, pages = {106540}, doi = {10.1016/j.chiabu.2023.106540}, pmid = {38008657}, issn = {1873-7757}, mesh = {Humans ; *COVID-19/epidemiology ; Child ; *Child Protective Services/organization & administration ; *Child Abuse/prevention & control ; SARS-CoV-2 ; Child Welfare ; Foster Home Care ; }, abstract = {BACKGROUND: The COVID-19 pandemic challenged child protection and posed new risks for child maltreatment (CM). Moreover, governmental efforts worldwide prioritized mitigating the spread of the virus over ensuring the welfare and protection of families and children. This neglect caused hardship for many vulnerable children, including those in out-of-home care (OOHC), and challenged the functionality of child protective services (CPS). However, only limited research has investigated the impact of COVID-19 on OOHC and CPS and explored how CPS overcame the challenges of helping children in OOHC.

OBJECTIVE: This review aims to address this gap in the research to unveil the 'positive legacy' left by CPS in their work with children in OOHC during COVID-19.

METHOD: This review utilized three stages of analysis, including a scoping review followed by two rounds of thematic analysis. The scoping review was carried out in six languages: English, Hebrew, Arabic, French, Portuguese, and Spanish. The first round of thematic analysis found eight relevant articles for this review. The second round of thematic analysis found three themes related to this paper's aim in the context of COVID-19.

RESULTS: Three main themes were identified: 1) decision-making and OOHC, 2) difficulties in procedures related to OOHC placement, and 3) handling challenges of OOHC.

CONCLUSIONS: The discussion emphasizes the crucial role of preserving children's rights, hearing their voices and needs, and considering their safety and well-being when planning policies and practices to protect them. It also emphasizes society's responsibility to acknowledge contextual factors in child protection.}, } @article {pmid37479549, year = {2025}, author = {Katz, C and Glucklich, T and Attrash-Najjar, A and Jacobson, M and Cohen, N and Varela, N and Priolo-Filho, SR and Bérubé, A and Chang, OD and Collin-Vézina, D and Fouché, A and Haffejee, S and Katz, I and Maguire-Jack, K and Massarweh, N and O'Reilly, M and Tiwari, A and Truter, E and de Andrade Vieira, RV and Walker-Williams, H and Zibetti, MR and Wekerle, C}, title = {The global impact of COVID-19 on child protection professionals: A scoping review and thematic analysis.}, journal = {Child abuse & neglect}, volume = {168}, number = {Pt 2}, pages = {106347}, doi = {10.1016/j.chiabu.2023.106347}, pmid = {37479549}, issn = {1873-7757}, mesh = {Humans ; *COVID-19/epidemiology/psychology ; Child ; Adaptation, Psychological ; *Child Protective Services ; *Child Abuse/prevention & control ; Resilience, Psychological ; SARS-CoV-2 ; }, abstract = {BACKGROUND: The COVID-19 pandemic triggered new risks for child maltreatment (CM) and exacerbated existing challenges for families and children, elevating the importance of child protection professionals (CPPs) while also adding barriers to their work. During the pandemic, many CPPs experienced increased workloads, a disrupted work environment, and personal pandemic-related hardships. However, the scope of how COVID-19 impacted CPPs globally, as well as their adopted coping strategies, have not been well explored.

OBJECTIVE: This study addresses these gaps in the research by conducting an international scoping review to explore and analyze these topics.

METHOD: The scoping review was performed in six languages: English, Hebrew, Arabic, French, Spanish, and Portuguese, across 16 databases. Sixteen manuscripts were included in the final thematic analysis of this review.

RESULTS: Two main themes were identified: 1) the impact of COVID-19 on CPPs, and 2) the coping and adaptation strategies employed by CPPs during COVID-19. This review revealed and emphasized the importance of CPPs' resilience during COVID-19, underpinned by the theoretical framework of the social ecology of resilience.

CONCLUSIONS: This study highlights the responsibility of social ecologies and organizational structures to create readiness for a rapid response in times of crisis as well as valuable evidence to inform how CPPs, children, and families may be better supported in the event of a future crisis.}, } @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.

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.

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.

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 = {}, doi = {10.3390/nu17193125}, pmid = {41097203}, issn = {2072-6643}, support = {G075423N//Research Foundation - Flanders/ ; }, mesh = {Humans ; *Ketosis ; *Ketone Bodies/therapeutic use/administration & 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.

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).

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.

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 = {}, doi = {10.3390/ijms26199831}, 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 = {}, doi = {10.3390/ijms26199708}, 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 = {}, doi = {10.3390/ijms26199628}, 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 & 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 = {}, doi = {10.3390/jcm14197096}, 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, Ł 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 = {}, doi = {10.3390/jcm14197078}, 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 = {}, doi = {10.3390/jcm14197008}, 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 = {}, doi = {10.3390/jcm14196999}, 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 = {}, doi = {10.3390/plants14193053}, 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.

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.

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.

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 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.

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.

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.

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.

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.

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.

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}, doi = {10.35371/aoem.2025.37.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}, doi = {10.1136/bmjopen-2025-100024}, 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.

DESIGN: Scoping review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Review.

DATA SOURCES: Five databases including CINAHL Ultimate, Web of Science, Medline, Embase and Scopus were searched in August 2024.

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.

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.

RESULTS: A total of 13 563 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.

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 {pmid40189291, year = {2025}, author = {Tome, R and Arima, S and Akamine, M and Hashioka, H and Arakaki, W and Kami, W and Nabeya, D and Ideguchi, S and Nakamura, H and Kinjo, T and Nakamatsu, M and Furugen, M and Miyagi, K and Haranaga, S and Yamamoto, K}, title = {Varicella-zoster Virus Reactivation with Severe Pneumonia Following Convalescence from Coronavirus Disease: A Case Report and Literature Review.}, journal = {Internal medicine (Tokyo, Japan)}, volume = {64}, number = {20}, pages = {3051-3056}, doi = {10.2169/internalmedicine.4932-24}, pmid = {40189291}, issn = {1349-7235}, mesh = {Humans ; Male ; Aged ; *COVID-19/complications ; *Herpesvirus 3, Human/physiology ; *Virus Activation ; SARS-CoV-2 ; Convalescence ; Antiviral Agents/therapeutic use ; *Pneumonia, Viral/virology/diagnosis ; Tomography, X-Ray Computed ; Acyclovir/therapeutic use ; *Varicella Zoster Virus Infection/diagnosis/virology/complications/drug therapy ; }, abstract = {An association between coronavirus disease 2019 (COVID-19) and concomitant varicella-zoster virus (VZV) reactivation has been proposed. We herein report a case of severe VZV pneumonia in a 73-year-old man who underwent corticosteroid tapering after recovering from COVID-19 and presented with fever, vesicular rashes, and hypoxemia. Chest computed tomography revealed ground-glass opacities (GGOs) and multiple granular shadows. Varicella-zoster virus was detected in the skin and bronchoalveolar lavage fluid. The patient was diagnosed with disseminated VZV reactivation and thereafter successfully recovered with acyclovir treatment. Physicians should consider the possibility of VZV reactivation when GGOs or patchy nodular shadows appear during the course of patients with COVID-19.}, } @article {pmid39692910, year = {2025}, author = {Joyner, MJ and Carter, RE and Wright, RS and Senefeld, JW}, title = {The Safety Profile of COVID-19 Convalescent Plasma.}, journal = {Current topics in microbiology and immunology}, volume = {443}, number = {}, pages = {79-88}, pmid = {39692910}, issn = {0070-217X}, mesh = {Humans ; *COVID-19/therapy/immunology ; COVID-19 Serotherapy ; Immunization, Passive/adverse effects ; *SARS-CoV-2/immunology ; Plasma/immunology ; }, abstract = {Despite concerns about potential side effects, based both on historical experience with plasma products and more recent concerns about contemporary use of plasma, COVID-19 convalescent plasma has been shown to be a very safe product. Research early in the COVID-19 pandemic documented-among the very large population of convalescent plasma recipients in the US Convalescent Plasma Study component of the FDA-authorized Expanded Access Program-that the overall risk profile was no different than that seen for fresh frozen plasma, a product used routinely in medical practice. The safety of CCP was further demonstrated using real-world evidence, pragmatic trials, and formal randomized trials. The rates of all serious adverse events were very low, an especially impressive finding in light of the fact that nearly all safety data came from the use of COVID-19 convalescent plasma in patients who were hospitalized, were older, and/or had significant co-morbid cardiopulmonary and metabolic disorders. The well-known complications of blood and plasma transfusions-transfusion-associated circulatory overload and transfusion-related acute lung injury-were found with no higher incidence than with standard use of blood and plasma, nor was there evidence for antibody-dependent enhancement or increased incidence of thromboembolic events. The comprehensive safety profile derived from studies enrolling hundreds of thousands of recipients of COVID-19 convalescent plasma across the world should allay safety fears about the rapid deployment of convalescent plasma in future pandemics.}, } @article {pmid39692909, year = {2025}, author = {Paneth, N and Joyner, MJ and Casadevall, A}, title = {Using Passive Antibody Therapies in the Next Pandemic.}, journal = {Current topics in microbiology and immunology}, volume = {443}, number = {}, pages = {259-273}, pmid = {39692909}, issn = {0070-217X}, mesh = {Humans ; *Immunization, Passive/methods ; *COVID-19/therapy ; *Pandemics ; Antibodies, Monoclonal/therapeutic use ; COVID-19 Serotherapy ; SARS-CoV-2/immunology ; *Antibodies, Viral/therapeutic use ; }, abstract = {The twenty-first century has witnessed seven human viral pandemics. Approximately once every three to four years over the past quarter-century, the world has experienced a new viral epidemic that expanded well beyond its original national borders to become a pandemic. The probability that another pandemic caused by a previously unknown agent will occur in the near future is thus very high and public health agencies must prioritize mechanisms for detecting their first signals. At the onset of these recent pandemics, no specific therapeutic agent was available for any of the newly emergent pathogens. However, convalescent plasma therapy can be available as soon as there are survivors and is likely to be effective if used early and in sufficient strength. But for the three forms of passive antibody-convalescent plasma, monoclonal antibodies, and hyperimmune globulins-to be available and effective in a pandemic situation, careful strategic planning will be necessary. In the pre-pandemic period, we must reinforce the capacities of blood banks and plasma fractionating companies in the production and storage of their products; ensure that outpatient settings can provide intravenous products; educate providers in the proper use of plasma; and create a research infrastructure to examine the effectiveness of passive antibody products. Once a pandemic is underway, regulatory bodies should simplify the approval of research and emergency use protocols and develop treatment registries. Incentives for the rapid production of monoclonal antibodies and hyperimmune globulins will likely be required. A national resource to link providers with passive antibody products and national databases to monitor pandemic progress and pandemic treatment will permit the most effective allocation of pandemic-fighting resources. We cannot afford to wait until the next pandemic is upon us to respond. The time to strengthen clinical, research, and manufacturing infrastructure to permit us to be ready to confront the next new virulent pathogen is now.}, } @article {pmid39641791, year = {2025}, author = {Marks, PW}, title = {The Importance of Antibody Titer Determination to the Effective Use of Convalescent Plasma.}, journal = {Current topics in microbiology and immunology}, volume = {443}, number = {}, pages = {55-62}, pmid = {39641791}, issn = {0070-217X}, mesh = {Humans ; *COVID-19/therapy/immunology ; *Antibodies, Viral/blood/immunology ; COVID-19 Serotherapy ; Immunization, Passive ; *SARS-CoV-2/immunology ; Antibodies, Neutralizing/blood/immunology ; Neutralization Tests ; }, abstract = {Convalescent Plasma (CP) has been used prophylactically and therapeutically over the past century to address a variety of infectious threats. Two tenets of the use of CP were clear from prior experience in the setting of other infectious outbreaks: (1) best results are obtained when CP is given early in the course of the disease, and (2) plasma containing high-titer neutralizing capacity is necessary to achieve optimal results. The magnitude of the COVID-19 pandemic along with the initial lack of effective therapeutic alternatives, combined with the relative safety of the approach of administration of CP, led to the initiation of an expanded access program (EAP) that ultimately provided CP to tens of thousands of individuals. When the program was initiated, no high-throughput assay was available for the determination of antibody titers, so antibody positive units were administered without regard to titer. With foresight regarding the need to ultimately determine such titers, samples from the CP units administered were retained and titers were determined retrospectively. An automated live-virus neutralization assay was ultimately selected for this purpose based on an evaluation of its accuracy and precision. Ultimately, an analysis performed in 13,794 individuals from the EAP for which clinical outcomes were known following the administration of single units of COVID-19 CP between the period of April and August 2020 indicated that higher titer COVID-19 CP was associated with a modest reduction in absolute mortality. The benefit observed was confined to individuals who were not intubated, and there was a trend toward a greater reduction in mortality using the highest SARS-CoV-2 neutralizing antibody-containing CP units. This experience during the COVID-19 pandemic is instructive for the future. To facilitate the production of CP that is likely to be most effective, high-throughput assays to determine neutralizing antibody titers need to be developed and implemented early during an outbreak to facilitate the identification and early administration of high-titer units.}, } @article {pmid39207508, year = {2025}, author = {Paneth, N and Walsh, M and Kornatowski, B and Casadevall, A}, title = {A Brief History of Polyclonal Antibody Therapies Against Bacterial and Viral Diseases Before COVID-19.}, journal = {Current topics in microbiology and immunology}, volume = {443}, number = {}, pages = {15-39}, pmid = {39207508}, issn = {0070-217X}, mesh = {Humans ; *COVID-19/therapy/immunology ; History, 20th Century ; *Immunization, Passive/history ; History, 19th Century ; *Bacterial Infections/therapy/immunology/history ; SARS-CoV-2/immunology ; Animals ; *Virus Diseases/therapy/immunology ; COVID-19 Serotherapy ; History, 21st Century ; }, abstract = {The use of the serum or plasma of patients or animals who have recovered from an infectious disease, or had been immunized with a relevant antigen, to treat or prevent the same infection in others began in the late 1880s when French and German scientists uncovered, one step at a time, several of the elements of the immune system's response to infection. A key finding was that the damage caused by some bacteria depends upon their secreted toxins which can be neutralized by biologic agents. Antitoxins to diphtheria and tetanus began to be manufactured in large animals in France, Germany, and the US in the 1890s and were soon being used worldwide. The impact of diphtheria antitoxin on childhood mortality was profound. Shortly after the development of antitoxins, convalescent serum began to be used for its anti-bactericidal properties thus addressing serious infections caused by non-toxin-producing organisms. The effectiveness of antitoxins and antisera was demonstrated by examining mortality rates in hospitals before and after the introduction of antitoxins, by comparisons of treated and untreated patients, by comparing early and late treatment and dosage, by examining vital data mortality trends, and by several randomized and alternate assignment trials. Antitoxins continue to have a role in the rare cases of diphtheria and other conditions largely eradicated by immunization, but serum therapy nearly disappeared from the medical armamentarium with the development of antibiotics in the 1940s. Inasmuch as new human pathogens are now emerging with unprecedented regularity as seen in the recent COVID-19 pandemic, and because specific therapies are unlikely to be available for them, plasma-based antibody therapies are likely to again carve out a niche in infectious disease control.}, } @article {pmid39192049, year = {2025}, author = {Klassen, SA and Senefeld, JW}, title = {Evidence for the Efficacy of COVID-19 Convalescent Plasma.}, journal = {Current topics in microbiology and immunology}, volume = {443}, number = {}, pages = {99-117}, pmid = {39192049}, issn = {0070-217X}, mesh = {Humans ; *COVID-19/therapy/mortality/immunology ; COVID-19 Serotherapy ; Immunization, Passive ; *SARS-CoV-2/immunology ; Randomized Controlled Trials as Topic ; Treatment Outcome ; Pandemics ; }, abstract = {During the global health emergency caused by the coronavirus disease 2019 (COVID-19), evidence relating to the efficacy of convalescent plasma therapy-evidence critically needed for both public policy and clinical practice-came from multiple levels of the epistemic hierarchy. The challenges of conducting clinical research during a pandemic, combined with the biological complexities of convalescent plasma treatment, required the use of observational data to fully assess the impact of convalescent plasma therapy on COVID symptomatology, hospitalization rates, and mortality rates. Observational studies showing the mortality benefits of convalescent plasma emerged early during the COVID-19 pandemic from multiple continents and were substantiated by real-time pragmatic meta-analyses. Although many randomized clinical trials (RCTs) were initiated at the onset of the pandemic and were designed to provide high-quality evidence, the relative inflexibility in the design of clinical trials meant that findings generally lagged behind other forms of emerging information and ultimately provided inconsistent results on the efficacy of COVID-19 convalescent plasma. In the pandemic framework, it is necessary to emphasize more flexible analytic strategies in clinical trials, including secondary, subgroup, and exploratory analyses. We conclude that in totality, observational studies and clinical trials taken together provide strong evidence of a mortality benefit conferred by COVID-19 convalescent plasma, while acknowledging that some randomized clinical trials examined suboptimal uses of convalescent plasma.}, } @article {pmid39126485, year = {2025}, author = {Nierich, A and Bihariesingh, R and Bansie, R}, title = {HemoClear: A Practical and Cost-Effective Alternative to Conventional Convalescent Plasma Retrieval Methods.}, journal = {Current topics in microbiology and immunology}, volume = {443}, number = {}, pages = {185-201}, pmid = {39126485}, issn = {0070-217X}, mesh = {Humans ; *COVID-19/therapy ; COVID-19 Serotherapy ; Immunization, Passive/methods/economics ; SARS-CoV-2/immunology ; *Plasmapheresis/economics/instrumentation/methods ; Cost-Benefit Analysis ; Antibodies, Viral/blood ; Plasma ; }, abstract = {Convalescent plasma has increasingly been used to treat various viral infections and confer post-exposure prophylactic protection during the last decade and has demonstrated favorable clinical outcomes in patients infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) during the recent COVID-19 pandemic. The pandemic has highlighted the need for cost-effective, accessible, and easy-to-use alternatives to conventional blood plasmapheresis techniques, allowing hospitals to become more self-sufficient in harvesting and transfusing donor plasma into recipients in a single setting. To this end, the use of a membrane-based bedside plasmapheresis device (HemoClear) was evaluated in an open-label, non-randomized prospective trial in Suriname in 2021, demonstrating its practicality and efficacy in a low-to middle-income country. This paper will review the use of this method and its potential to expedite the process of obtaining convalescent plasma, especially during pandemics and in resource-constrained settings.}, } @article {pmid39126484, year = {2025}, author = {Focosi, D}, title = {Monoclonal Antibody Therapies Against SARS-CoV-2: Promises and Realities.}, journal = {Current topics in microbiology and immunology}, volume = {443}, number = {}, pages = {131-147}, pmid = {39126484}, issn = {0070-217X}, mesh = {Humans ; *SARS-CoV-2/immunology ; *Antibodies, Monoclonal/therapeutic use/immunology ; COVID-19/therapy/immunology ; Spike Glycoprotein, Coronavirus/immunology ; *COVID-19 Drug Treatment ; *Antibodies, Viral/therapeutic use/immunology ; Animals ; Antibodies, Neutralizing/therapeutic use/immunology ; }, abstract = {Monoclonal antibodies targeting the Spike protein of SARS-CoV-2 have been widely deployed in the ongoing COVID-19 pandemic. I review here the impact of those therapeutics in the early pandemic, ranging from structural classification to outcomes in clinical trials to in vitro and in vivo evidence of basal and treatment-emergent immune escape. Unfortunately, the Omicron variant of concern has completely reset all achievements so far in mAb therapy for COVID-19. Despite the intrinsic limitations of this strategy, future developments such as respiratory delivery of further engineered mAb cocktails could lead to improved outcomes.}, } @article {pmid39117848, year = {2025}, author = {Shoham, S}, title = {Convalescent Plasma for Immunocompromised Patients.}, journal = {Current topics in microbiology and immunology}, volume = {443}, number = {}, pages = {119-130}, pmid = {39117848}, issn = {0070-217X}, mesh = {Humans ; *Immunocompromised Host ; COVID-19 Serotherapy ; *COVID-19/therapy/immunology ; Immunization, Passive ; *SARS-CoV-2/immunology ; Antibodies, Viral/therapeutic use/immunology ; }, abstract = {COVID-19 convalescent plasma (CCP) is an important therapeutic option for immunocompromised patients with COVID-19. Such patients are at increased risk for serious complications of infection and may also develop a unique syndrome of persistent infection. This article reviews the rationale for CCP utilization in immunocompromised patients and the evidence for its value in immunosuppressed patients with both acute and persistent COVID-19. Both historical precedence and understanding of the mechanisms of action of antibody treatment support this use, as do several lines of evidence derived from case series, comparative studies, randomized trials, and systematic reviews of the literature. A summary of recommendations from multiple practice guidelines is also provided.}, } @article {pmid39117847, year = {2025}, author = {Yoon, H and Pirofski, LA}, title = {Generating the Evidence Base for Convalescent Plasma Use for a New Infectious Disease.}, journal = {Current topics in microbiology and immunology}, volume = {443}, number = {}, pages = {205-217}, pmid = {39117847}, issn = {0070-217X}, mesh = {Humans ; *COVID-19/therapy/immunology ; COVID-19 Serotherapy ; *Immunization, Passive/methods ; *SARS-CoV-2/immunology ; Antibodies, Viral/therapeutic use/immunology ; Randomized Controlled Trials as Topic ; }, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) swept across the world in the waning months of 2019 and emerged as the cause of the coronavirus disease 19 (COVID-19) pandemic in early 2020. The use of convalescent plasma (CP) for prior respiratory pandemics provided a strong biological rationale for the rapid deployment of COVID-19 convalescent plasma (CCP) in early 2020 when no validated treatments or prior immunity existed. CCP is an antiviral agent, with its activity against SARS-CoV-2 stemming from specific antibodies elicited by the virus. Early efforts to investigate the efficacy of CCP in randomized clinical trials (RCTs) that targeted hospitalized patients with COVID-19 did not demonstrate the overall efficacy of CCP despite signals of benefit in certain subgroups, such as those treated earlier in disease. In contrast, studies adhering to the principles of antibody therapy in their study design, choice of patient population, and product qualification, i.e., those that administered high levels of specific antibody during the viral phase of disease in immunocompromised or very early in immunocompetent individuals, demonstrated benefits. In this chapter, we leverage the knowledge gained from clinical studies of CCP for COVID-19 to propose a framework for future studies of CP for a new infectious disease. This framework includes obtaining high-quality CP and designing clinical studies that adhere to the principles of antibody therapy to generate a robust evidence base for using CP.}, } @article {pmid39117846, year = {2025}, author = {Sullivan, DJ}, title = {Convalescent Plasma and Other Antibody Therapies for Infectious Diseases-Lessons Learned from COVID-19 and Future Prospects.}, journal = {Current topics in microbiology and immunology}, volume = {443}, number = {}, pages = {219-242}, pmid = {39117846}, issn = {0070-217X}, support = {R01 AI152078/AI/NIAID NIH HHS/United States ; }, mesh = {Humans ; *COVID-19/therapy/immunology ; *Immunization, Passive/methods ; COVID-19 Serotherapy ; *SARS-CoV-2/immunology ; *Antibodies, Viral/therapeutic use/immunology ; Antibodies, Monoclonal/therapeutic use ; Antibodies, Neutralizing/therapeutic use/immunology ; }, abstract = {Antiviral passive antibody therapy includes convalescent plasma, hyperimmune globulin, and monoclonal antibodies. Passive antibodies have proven effective in reducing morbidity and mortality for SARS-CoV-2 and other infectious diseases when given early in the disease course with sufficiently high specific total and neutralizing antibody levels. Convalescent plasma can be delivered to patients before vaccination implementation or novel drug production. Carefully designed and executed randomized controlled trials near the pandemic outset are important for regulatory bodies, healthcare workers, guideline committees, the public, and the government. Unfortunately, many otherwise well-designed antibody-based clinical trials in COVID-19 were futile, either because they intervened too late in the disease or provided plasma with insufficient antibodies. The need for early treatment mandates outpatient clinical trials in parallel with inpatient trials. Early outpatient COVID-19 convalescent plasma transfusion with high antibody content within 9 days of symptom onset has proven effective in blunting disease progression and reducing hospitalization, thus reducing hospital overcrowding in a pandemic. Convalescent plasma offers the opportunity for hope by enabling community participation in outpatient curative therapy while monoclonal therapies, vaccines, and drugs are being developed. Maintaining the appropriate infrastructure for antibody infusion in both outpatient and inpatient facilities is critical for future pandemic readiness.}, } @article {pmid39117845, year = {2025}, author = {Kunze, KL and Johnson, PW}, title = {The Importance of Geographic Proximity of Convalescent Plasma Donors.}, journal = {Current topics in microbiology and immunology}, volume = {443}, number = {}, pages = {89-98}, pmid = {39117845}, issn = {0070-217X}, mesh = {Humans ; *COVID-19/therapy/mortality/immunology ; COVID-19 Serotherapy ; *Blood Donors ; Immunization, Passive ; SARS-CoV-2/immunology ; Pandemics ; Antibodies, Viral/blood ; }, abstract = {Donor-recipient proximity emerged as an important factor influencing the efficacy of COVID-19 convalescent plasma (CCP) treatment during the early stages of the COVID-19 pandemic. This relationship was uncovered while analyzing data collected in the collaborative Expanded Access Program (EAP) for CCP at Mayo Clinic, a project aimed to establish protocols for CCP use amid the uncertainty of the novel disease. Analysis of data from nearly 28,000 patients revealed a significant reduction in risk of 30-day mortality for those receiving near-sourced plasma when compared to those receiving distantly sourced plasma [pooled relative risk, 0.73 (95% CI 0.67-0.80)], prompting adjustments in treatment protocols at selected institutions, and highlighting the importance of proximity in optimizing CCP outcomes. Despite its significance, subsequent studies of CCP effectiveness in COVID-19 have often overlooked donor-recipient proximity. Our findings emphasize the importance of donor-recipient proximity in CCP treatment in the current pandemic, and we discuss potential methods for improving CCP efficacy in future pandemics. Our recommendations include prioritizing virus genotyping for vulnerable patients, establishing a robust testing infrastructure, and collecting additional donor data to enhance plasma selection. This chapter underscores the importance of comprehensive data collection and sharing to navigate the evolving landscape of newly emerging infectious diseases.}, } @article {pmid38877204, year = {2025}, author = {Joyner, MJ}, title = {Convalescent Plasma and the US Expanded Access Program: A Personal Narrative.}, journal = {Current topics in microbiology and immunology}, volume = {443}, number = {}, pages = {63-78}, pmid = {38877204}, issn = {0070-217X}, mesh = {Humans ; *COVID-19/therapy/immunology/epidemiology ; United States/epidemiology ; COVID-19 Serotherapy ; *SARS-CoV-2/immunology ; Immunization, Passive ; }, abstract = {Between early April 2020 and late August 2020, nearly 100,000 patients hospitalized with SARS-CoV2 infections were treated with COVID-19 convalescent plasma (CCP) in the US under the auspices of an FDA-authorized Expanded Access Program (EAP) housed at the Mayo Clinic. Clinicians wishing to provide CCP to their patients during that 5-month period early in the COVID pandemic had to register their patients and provide clinical information to the EAP program. This program was utilized by some 2,200 US hospitals located in every state ranging from academic medical centers to small rural hospitals and facilitated the treatment of an ethnically and socio-economically diverse cross section of patients. Within 6 weeks of program initiation, the first signals of safety were found in 5,000 recipients of CCP, supported by a later analysis of 20,000 recipients (Joyner et al. in J Clin Invest 130:4791-4797, 2020a; Joyner et al. in Mayo Clin Proc 95:1888-1897, 2020b). By mid-summer of 2020, strong evidence was produced showing that high-titer CCP given early in the course of hospitalization could lower mortality by as much as a third (Joyner et al. in N Engl J Med 384:1015-1027, 2021; Senefeld et al. in PLoS Med 18, 2021a). These data were used by the FDA in its August decision to grant Emergency Use Authorization for CCP use in hospitals. This chapter provides a personal narrative by the principal investigator of the EAP that describes the events leading up to the program, some of its key outcomes, and some lessons learned that may be applicable to the next pandemic. This vast effort was a complete team response to a crisis and included an exceptional level of collaboration both inside and outside of the Mayo Clinic. Writing just 4 years after the initiation of the EAP, this intense professional effort, comprising many moving parts, remains hard to completely understand or fully explain in this brief narrative. As Nelson Mandela said of the perception of time during his decades in prison, "the days seemed like years, and the years seemed like days."}, } @article {pmid38877203, year = {2025}, author = {Lebovits, C}, title = {The Role of the Patient Advocate During a Pandemic: The Case of Convalescent Plasma.}, journal = {Current topics in microbiology and immunology}, volume = {443}, number = {}, pages = {167-172}, doi = {10.1007/82_2024_271}, pmid = {38877203}, issn = {0070-217X}, mesh = {Humans ; *COVID-19/therapy/epidemiology ; COVID-19 Serotherapy ; Immunization, Passive ; SARS-CoV-2/immunology ; *Patient Advocacy ; Pandemics ; Antibodies, Viral ; }, abstract = {The onset of the COVID-19 pandemic confronted medicine with several difficulties, including a lack of specific therapeutic options, the absence of out-of-hospital testing facilities to diagnose the condition, and the sudden extraordinary need for intensive medical care that overwhelmed most hospitals. Early in the pandemic, many physicians recognized that using antibodies harvested from recovering patients was a treatment that had a proven track record for many diseases and that might be used to manage the disease at least as a stopgap until more specific medicines for COVID-19 were developed. But using convalescent plasma raised many additional complications, most especially the logistics that needed to be put in place to collect and distribute such plasma. Unlike drugs ordered from a pharmacy, plasma and other blood products are procured by a complex process that depends intensely on interaction with the public, the provider of all blood products that are directly provided to patients. Blood components such as convalescent plasma, intended to be used immediately without major processing, are entirely supplied by donations from the public. This form of treatment can therefore benefit from patient advocates, especially if they are experienced in solving problems of logistics and in the process of matching supply to demand that is more commonly encountered in the business world than in medicine. In this chapter, one patient advocate, Chaim Lebovits, describes the process of mobilizing the population, interacting with blood banks and hospitals, and successfully channeling thousands of units of plasma from volunteers recovering from COVID-19 to patients in hospitals. Starting in New York City in early 2020 and initially working with communities with which Mr. Lebovits was familiar, the efforts steadily spread across many parts of the US. The model described here, which uses patient advocates to serve as a link between patients, blood banks, and hospitals in the service of gathering and distributing high-titer convalescent plasma to patients is likely to be relevant to the next pandemic.}, } @article {pmid38877202, year = {2025}, author = {Franchini, M and Focosi, D}, title = {Monoclonal Antibodies and Hyperimmune Immunoglobulins in the Next Pandemic.}, journal = {Current topics in microbiology and immunology}, volume = {443}, number = {}, pages = {243-257}, pmid = {38877202}, issn = {0070-217X}, mesh = {Humans ; *Antibodies, Monoclonal/therapeutic use/immunology ; *COVID-19/therapy/immunology ; Immunization, Passive/methods ; SARS-CoV-2/immunology ; COVID-19 Serotherapy ; Pandemics ; COVID-19 Drug Treatment ; *Antibodies, Viral/therapeutic use/immunology ; Animals ; }, abstract = {Pandemics are highly unpredictable events that are generally caused by novel viruses. There is a high likelihood that such novel pathogens belong to entirely novel viral families for which no targeted small-molecule antivirals exist. In addition, small-molecule antivirals often have pharmacokinetic properties that make them contraindicated for the frail patients who are often the most susceptible to a novel virus. Passive immunotherapies-available from the first convalescent patients-can then play a key role in controlling pandemics. Convalescent plasma is immediately available, but if manufacturers have fast platforms to generate marketable drugs, other forms of passive antibody treatment can be produced. In this chapter, we will review the technological platforms for generating monoclonal antibodies and hyperimmune immunoglobulins, the current experience on their use for treatment of COVID-19, and the pipeline for pandemic candidates.}, } @article {pmid38877201, year = {2025}, author = {Maor, Y and Zimhony, O}, title = {Hyperimmune Globulins in COVID-19.}, journal = {Current topics in microbiology and immunology}, volume = {443}, number = {}, pages = {149-164}, pmid = {38877201}, issn = {0070-217X}, mesh = {Humans ; *COVID-19/therapy/immunology ; *SARS-CoV-2/immunology ; COVID-19 Serotherapy ; Immunization, Passive/methods ; Antibodies, Viral/therapeutic use/immunology ; Antibodies, Neutralizing/immunology ; }, abstract = {The COVID-19 pandemic, resulting from the emergence of the novel coronavirus SARS-CoV-2, posed unprecedented challenges to global health systems as no proven therapy was available. Initially, COVID-19 convalescent plasma (CCP) from recovered COVID-19 patients showed promise as a therapeutic option. However, the efficacy of this approach was closely correlated with the neutralizing antibody titer in the administered plasma and thus effectiveness was not always guaranteed. In response, hyperimmune immunoglobulins (hIG) derived from CCP obtained by apheresis from recovered or vaccinated individuals emerged as a potential alternative. hIG were purified through stringent chromatographic processing from CCP units and displayed varying results in clinical trials, although it seems likely that they improved outcomes compared to placebo or CCP at day 28, particularly in unvaccinated patients. The variability in the effect of hIG likely stems from factors such as the timing of outcome assessment, the administered dose of hIG, the patients' immunological background, and the matching between the variant infecting patients and the neutralization ability of the immunoglobulin batch, which depended on the timing of the CCP collection. Despite logistical challenges and high production costs, hIG showcase advantages over CCP, offering versatility in administration routes and eliminating the need for blood matching, thus facilitating administration in the community, and allowing for variant-specific preparations. hIG appear to be of particular importance in the treatment of immunocompromised patients and patients with persistent COVID-19, although studies in these populations are lacking. Non-human alternatives, such as equine-derived hIG and recombinant hIG, may provide a solution to the logistical challenges of large-scale hIG preparation. Further study is needed to explore these avenues. Establishing the infrastructure for large-scale hIG production independent of plasma donations emerges as a strategic approach for future pandemics, justifying exploration and promotion by health authorities.}, } @article {pmid38772970, year = {2025}, author = {Casadevall, A and Paneth, N}, title = {The Logic and History of Passive Immunity and Antibody Therapies.}, journal = {Current topics in microbiology and immunology}, volume = {443}, number = {}, pages = {41-52}, pmid = {38772970}, issn = {0070-217X}, mesh = {Humans ; COVID-19/therapy/immunology ; *Immunization, Passive/history/methods ; History, 20th Century ; SARS-CoV-2/immunology ; Pandemics/history ; Antibodies, Monoclonal/therapeutic use ; History, 19th Century ; History, 21st Century ; *Coronavirus Infections/therapy/immunology ; *Pneumonia, Viral/therapy/immunology ; COVID-19 Serotherapy ; Betacoronavirus/immunology ; Antibodies, Viral/therapeutic use ; }, abstract = {This volume takes a broad overview of antibody-based therapies prior to and during the COVID pandemic and examines their potential use in future pandemics. Passive antibody therapy was the first effective antimicrobial treatment and its development in the early twentieth century helped catalyze immunological and microbiological research. During the era of serum therapy (1890-1940) antibody-based therapies were developed against both viral and bacterial diseases. Effective treatment required an understanding of how to quantify antibodies, how to develop serotype-specific sera and recognition of the need to treat early in disease. Thus, although the era of serum therapy essentially ended with the development of small molecule antimicrobial therapy in the 1940s, antibody-based therapies led to important new scientific understanding, while remaining in use for some toxin and venom-caused diseases and in the prevention of outbreaks of viral hepatitis. A renewed interest in antibody-based therapies was seen in the widespread deployment of convalescent plasma and monoclonal antibodies during the COVID-19 pandemic. Convalescent plasma will likely be the first specific therapy during outbreaks with new pathogens for which there is no other therapy. For all forms of antibody-based therapies, effectiveness relies on the key principles of antibody therapy, namely, treatment early in disease with preparations containing sufficient antibody specific to the microbe in question.}, } @article {pmid38772969, year = {2025}, author = {Bloch, EM}, title = {Blood Banking Capacity in Low-and Middle-Income Countries: Covid-19 Convalescent Plasma in Context.}, journal = {Current topics in microbiology and immunology}, volume = {443}, number = {}, pages = {173-184}, pmid = {38772969}, issn = {0070-217X}, mesh = {Humans ; *COVID-19/therapy/epidemiology/blood ; Developing Countries ; COVID-19 Serotherapy ; *Blood Banks/supply & distribution ; Immunization, Passive ; SARS-CoV-2/immunology ; Blood Donors/supply & distribution ; Blood Transfusion ; *Blood Banking ; Donor Selection ; }, abstract = {Blood transfusion capacity in low- and middle-income countries (LMICs), encompassing both the safety and adequacy of the blood supply, is limited. The challenges facing blood banks in LMICs include regulatory oversight, blood donor selection, collection procedures, laboratory testing, and post-transfusion surveillance. A high proportion of LMICs are unable to fully meet clinical demands for blood products, and many do not meet even the minimum threshold of collection (10 units per 1000 population). Suboptimal clinical transfusion practices, in large part due to a lack of training in transfusion medicine, contribute to blood wastage. During the COVID-19 pandemic, high- and LMICs alike experienced blood shortages, in large part due to quarantine and containment measures that impeded donor mobility. COVID-19 convalescent plasma (CCP) was particularly appealing for the treatment of patients with COVID-19 in LMICs, as it is a relatively inexpensive intervention and makes use of the existing blood collection infrastructure. Nonetheless, the challenges of using CCP in LMICs need to be contextualized among broad concerns surrounding blood safety and availability. Specifically, reliance on first time, family replacement and paid donors, coupled with deficient infectious disease testing and quality oversight, increase the risk of transfusion transmitted infections from CCP in LMICs. Furthermore, many LMICs are unable to meet general transfusion needs; therefore, CCP collection also risked exacerbation of pervasive blood shortages.}, } @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}, doi = {10.1371/journal.pone.0321891}, pmid = {41091675}, issn = {1932-6203}, mesh = {Humans ; *COVID-19/rehabilitation/epidemiology ; *Return to Work ; SARS-CoV-2/isolation & purification ; }, 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.

OBJECTIVES: To synthesize evidence on RTW interventions for people living with Long COVID and to identify 'promising' interventions for enhancing work ability and RTW.

METHODS: We followed Arksey & 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 ≥ 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).

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.

CONCLUSION: Many uncertainties remain regarding which RTW interventions are effective or the optimal characteristics of these interventions.}, } @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 = {}, doi = {10.3390/cells14191511}, 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 & 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.

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.

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.

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.

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.

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.

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).

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 & 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 & numerical data ; *Contraception/statistics & 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.

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.

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.

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 {pmid40069950, year = {2025}, author = {Komura, T and Watanabe, M and Shioda, K}, title = {Exploring the application of target trial emulation in vaccine evaluation: scoping review.}, journal = {American journal of epidemiology}, volume = {194}, number = {10}, pages = {3028-3040}, doi = {10.1093/aje/kwaf053}, pmid = {40069950}, issn = {1476-6256}, support = {CDC-RFA-FT-23-0069//CDC's Center for Forecasting and Outbreak Analytics/ ; }, mesh = {Humans ; *COVID-19 Vaccines ; *COVID-19/prevention & control ; SARS-CoV-2 ; *Vaccines ; *Clinical Trials as Topic/methods ; }, abstract = {Target trial emulation (TTE) has gained popularity in evaluating treatments and health interventions. Its application to infectious disease outcomes requires careful consideration, as infectious disease transmission violates the assumption of no interference. Thus, we conducted a scoping review to understand how TTE approaches have been applied to vaccine evaluation. We searched literature published in PubMed, Embase, and Web of Science until May 2024, using keywords related to TTE, infectious diseases, and vaccines. Full-text articles meeting inclusion criteria were further assessed for eligibility. Our keyword-based search and citation search identified a total of 241 studies. Of these, 35 original research studies used TTE approaches to evaluate vaccines, predominantly published from 2022 to 2024. The majority (n = 32, 91%) evaluated the effect of COVID-19 vaccines, with 1 study each evaluating influenza, mpox, and rotavirus vaccines. Most studies did not define which of the 4 effects of vaccination they evaluated (direct, indirect, total, or overall effect), and none incorporated interference in vaccine evaluation. Our review highlights the increasing popularity of TTE in vaccine evaluation following the COVID-19 pandemic. Further discussions are needed to establish TTE approaches to estimating 4 effects of vaccination, using large, routinely collected data.}, } @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 = {}, number = {}, pages = {}, pmid = {41087797}, issn = {1538-2443}, 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 = {}, number = {}, pages = {}, doi = {10.1080/14787210.2025.2575044}, pmid = {41087378}, issn = {1744-8336}, abstract = {INTRODUCTION: There is growing recognition that SARS-CoV-2 can have long-term health consequences that persist beyond acute infection. While the long-term health impact of SARS-CoV-2 is evident in adults and the elderly, the impact on children and adolescents remains under recognized. In this paper, we navigate the second-order post-acute effects that the COVID-19 has had on the pediatric populations, with the exception of mental health implication of social restrictions, out of the scope of this review.

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.

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 = {2025}, 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 = {}, number = {}, pages = {107104}, doi = {10.1016/j.imlet.2025.107104}, pmid = {41086954}, issn = {1879-0542}, 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 = {}, number = {}, pages = {112942}, doi = {10.1016/j.diabres.2025.112942}, pmid = {41086951}, issn = {1872-8227}, 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 {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 & dosage ; Animals ; RNA, Messenger/administration & 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}, doi = {10.1371/journal.pone.0334290}, 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.

OBJECTIVE: This review aimed to assess healthcare waste management practices and associated factors among healthcare workers in Sub-Saharan Africa.

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.

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 = 96.8%, P < 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 = 0.00%, P < 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 = 97.9%, P < 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 = 96.8%, P < 0.000.

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 {pmid41082248, year = {2025}, author = {Marx, C and Piotrowiak, R and Schirrmann, T and Gebinoga, M and Bekeredjian-Ding, I and Schober, A}, title = {A comprehensive strategy for pandemic preparedness with neutralizing monoclonal antibodies.}, journal = {mAbs}, volume = {17}, number = {1}, pages = {2573180}, doi = {10.1080/19420862.2025.2573180}, pmid = {41082248}, issn = {1942-0870}, mesh = {Humans ; *Antibodies, Monoclonal/therapeutic use/immunology ; *COVID-19/immunology/prevention & control/epidemiology ; *SARS-CoV-2/immunology ; *Antibodies, Neutralizing/therapeutic use/immunology ; *Pandemics/prevention & control ; *Antibodies, Viral/immunology/therapeutic use ; Pandemic Preparedness ; }, abstract = {The success of nucleic acid-based vaccines during the COVID-19 pandemic positioned these technologies at the forefront of global preparedness. A retrospective analysis, however, demonstrates that while vaccines play a central role, they do not provide universal protection. Therapeutic interventions, such as monoclonal antibodies (mAbs), are also critical for an effective pandemic response, as they ensure both prophylaxis and treatment of vulnerable populations, prevent overload of healthcare systems, and safeguard the continuity of critical infrastructures. Despite the proven efficacy of antiviral mAbs, the rapid emergence of SARS-CoV-2 variants frequently diminished their effectiveness. Thus, innovative strategies are required to accelerate the development, manufacturing, and adaptation of mAbs to continuously evolving viral targets. Viable approaches consist of targeting conserved viral epitopes and producing multi-mAb formulations to maintain therapeutic efficacy. Notably, the development of prototype mAbs can help to protect high-risk groups and exposed medical personnel early in a pandemic. Here, we propose that a comprehensive mAb strategy - encompassing targeted support for research and development, expansion of resilient manufacturing capacities on a regional level, and collaborative networks integrating standardized procedures for development, production and distribution - should be considered a hallmark of pandemic preparedness, to ensure the rapid and effective deployment of mAbs in future pandemics.}, } @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 = {}, number = {}, pages = {}, pmid = {41082082}, issn = {1568-5608}, 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.

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), γ-glutamyl transferase (GGTP), bilirubin, total protein, albumin, and prothrombin (with INR).

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 ≥ 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).

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.

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.

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.

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.

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.

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.

DESIGN: Systematic review.

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.

DATA SOURCES: MEDLINE, EMBASE, Scopus, and Web of Science databases.

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.

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.

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.

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.

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 {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 & administration/trends ; Forecasting/methods ; *Health Policy ; *Health Planning/organization & 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 {pmid40623698, year = {2025}, author = {Lerner, A and Mainelis, G and Hallman, W and Kipen, H and Magalhaes, M and Buckley, B and Cedeño Laurent, JG and Eyal, N}, title = {Managing infectious aerosols to counter engineered pandemics: Current recommendations and future research.}, journal = {Risk analysis : an official publication of the Society for Risk Analysis}, volume = {45}, number = {10}, pages = {3045-3078}, doi = {10.1111/risa.70054}, pmid = {40623698}, issn = {1539-6924}, support = {P30 ES05022//National Institutes of Health / ; 2039320//Longview Philanthropy / ; }, mesh = {Humans ; Aerosols ; *Pandemics/prevention & control ; COVID-19/prevention & control ; SARS-CoV-2 ; Ultraviolet Rays ; }, abstract = {In the increasingly likely event of an engineered-virus outbreak or pandemic of catastrophic potential, managing infectious aerosols to reduce transmission will be crucial. Now is the time to start preparing our buildings, public opinion, and regulatory environments for the infectious aerosol management interventions necessary to protect the public. But which interventions should governments and institutions invest in the most? We review the leading candidate methods for infectious aerosol management and discuss their respective advantages, disadvantages, and suitable settings. There is strong emerging evidence that two recently explored technologies, direct exposure to far-ultraviolet-C (UVC) light and triethylene glycol, are particularly efficacious and safe, but there remain open questions about the long-term safety and efficacy of these interventions. In the meantime, we recommend other interventions-especially upper-room UVC and in-room air cleaners-for settings where most occupants regularly spend more than a small fraction of their day. We conclude by listing research questions about these interventions that still need to be researched in social science, product development, medicine, engineering, economics, and ethics.}, } @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 ; *Transcatheter Aortic Valve Replacement/methods ; *Aortic Valve Stenosis/surgery ; *Pacemaker, Artificial ; *Postoperative Complications ; }, 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 {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 = {}, number = {}, pages = {126263}, doi = {10.1016/j.ijpharm.2025.126263}, pmid = {41077088}, issn = {1873-3476}, 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 = {}, number = {}, pages = {}, doi = {10.1016/S0140-6736(25)01496-5}, pmid = {41077052}, issn = {1474-547X}, 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 {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, ÉG}, 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}, 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.

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.

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.

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}, 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 & communication disorders}, volume = {60}, number = {6}, pages = {e70136}, doi = {10.1111/1460-6984.70136}, 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.

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.

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).

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.

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 {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 & 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 {pmid41076270, year = {2025}, author = {Meier, RT and Kapur, R}, title = {Antibody-mediated multicellular pathophysiology of HIT and VITT: 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 thrombo-inflammatory 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 = {}, 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 ; *COVID-19/epidemiology/psychology ; *Students/psychology ; *Mental Health ; China/ethnology ; East Asian People ; }, 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?

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.

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.

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}, } @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.

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.

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] = 1.41; 95% confidence interval [CI]: 1.03, 1.93), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (OR = 1.88; 95% CI: 1.53, 2.32), hepatitis C virus (HCV) (OR = 1.39; 95% CI: 1.14, 1.69), and human herpesvirus (HHV) (OR = 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 = 1.18; 95% CI: 1.04, 1.35) and HCV (OR = 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.

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 = {2025}, author = {Kolarič, A and Jukič, M and Bren, U}, title = {Machine learning in antiviral drug design.}, journal = {Bioorganic & medicinal chemistry}, volume = {132}, number = {}, pages = {118426}, doi = {10.1016/j.bmc.2025.118426}, pmid = {41072100}, issn = {1464-3391}, 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 {pmid41071742, year = {2025}, author = {Jano, K and Babu, TM and Kottkamp, AC and Rebolledo, PA and Parameswaran, L and Wiley, Z and Branche, AR and Kotloff, K}, title = {Historical Advances in Clinical Trial Design and Expanding Representation as the New Frontier for Innovation.}, journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America}, volume = {81}, number = {Supplement_2}, pages = {S117-S124}, doi = {10.1093/cid/ciaf377}, pmid = {41071742}, issn = {1537-6591}, mesh = {Humans ; *Clinical Trials as Topic/history/methods ; COVID-19/prevention & control ; SARS-CoV-2 ; *Research Design ; COVID-19 Vaccines ; *Vaccine Development/history ; History, 20th Century ; History, 21st Century ; Pandemics ; }, abstract = {Since its establishment in 1962, the Vaccine and Treatment Evaluation Units (VTEUs) have employed cutting-edge technologies to develop novel vaccines and therapeutics to mitigate emerging public health threats in the United States and globally. Clinical trial innovation has been the hallmark of these efforts as novel approaches to testing countermeasures are investigated in pace with advances in technology and evolving public health needs. The spectrum of trials conducted by the VTEUs ranges from proof-of-concept or first-in-human phase 1 to late-phase trials that establish efficacy and inform licensure decisions or "real world" vaccine usage such as with the coronavirus disease 2019 (COVID-19) and rotavirus mix-and-match trials aimed to inform standard of care. The VTEUs have also been instrumental in developing experimental wild-type challenge studies to preliminarily assess vaccine immunogenicity against influenza, shigellosis, cholera, enterotoxigenic Escherichia coli, enteropathogenic E. coli, and malaria to help select promising vaccine candidates for further development. During the COVID-19 pandemic, novel strategies for recruitment and improved accessibility of vaccine clinical trials emerged. However, the pandemic also highlighted the need for improved representation in clinical trials and underscored the importance of community engagement. As we consider what challenges to address in the upcoming years, engagement of the population in clinical trials is critical to establishing safety and efficacy and community acceptance of vaccines and therapeutics. It is imperative to develop skills that engender community advocacy while staying on the cutting edge of science, henceforth serving as the guideposts for new frontiers in clinical trial innovation.}, } @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}, doi = {10.1093/cid/ciaf380}, pmid = {41071737}, issn = {1537-6591}, support = {//Infectious Diseases Clinical Research Consortium/ ; //Vaccine Treatment and Evaluation Units/ ; //National Institute of Allergy and Infectious Diseases/ ; UM1AI148574/NH/NIH HHS/United States ; UM1AI148575/NH/NIH HHS/United States ; UM1AI148576/NH/NIH HHS/United States ; UM1AI148684/NH/NIH HHS/United States ; UM1AI148685/NH/NIH HHS/United States ; UM1AI148689/NH/NIH HHS/United States ; }, mesh = {Humans ; *Pandemics/prevention & control ; *Communicable Diseases, Emerging/prevention & control/epidemiology ; COVID-19/prevention & 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}, doi = {10.5080/u27427}, pmid = {41070480}, issn = {2651-3463}, mesh = {Humans ; Lebanon/epidemiology ; *Health Personnel/psychology/statistics & 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.

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.

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.

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 {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.

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.

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.

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 {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 & 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 = {2025}, 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 = {}, number = {}, pages = {106131}, doi = {10.1016/j.bbi.2025.106131}, pmid = {41067656}, issn = {1090-2139}, } @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}, 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 = {2025}, 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}, 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.

AIM: The aim of this narrative review was to explore the literature regarding current pandemic preparedness and GBL simulation in nursing education.

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.

RESULTS: Screening and review identified 48 manuscripts that met inclusion criterion. Analysis revealed variation in duration of pandemic preparedness programs (n = 30 articles), theoretical versus practical content, and face-to-face or online modes of delivery. GBL simulation (n = 18 articles) was revealed as an emerging modality in nursing education curriculum.

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.

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 & immunotherapeutics}, volume = {21}, number = {1}, pages = {2572195}, doi = {10.1080/21645515.2025.2572195}, pmid = {41066388}, issn = {2164-554X}, mesh = {Humans ; Animals ; *Vaccine Efficacy ; *Iron Deficiencies/immunology ; *COVID-19 Vaccines/immunology ; *Iron ; COVID-19/prevention & 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 ; *Low-Level Light Therapy/methods ; Cardiovascular Diseases/radiotherapy ; *Blood/radiation effects ; Musculoskeletal Diseases/radiotherapy ; COVID-19 ; 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 = {}, number = {}, pages = {}, doi = {10.1021/acs.analchem.5c02331}, pmid = {41065710}, issn = {1520-6882}, 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 & dosage ; *COVID-19/prevention & control ; Young Adult ; *Vaccination/statistics & 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.

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.

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.

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, Ł 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 {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 & numerical data ; *Transients and Migrants/statistics & numerical data ; *COVID-19/prevention & control ; *COVID-19 Vaccines/administration & 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.

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.

RESULTS: A total of n = 11,825 unique studies were identified through database searches. Thirty-three (n = 33) studies were included in this review. Fifteen studies (n = 15) related to the COVID-19 vaccine and eighteen studies (n = 18) focused on other vaccines. Studies were mainly implemented in high-income countries with the majority from the United States (n = 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.

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 {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 & 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 {pmid39869829, year = {2025}, author = {Bachy, E and Linton, K}, title = {Frontline treatment of follicular lymphoma: what will it take to change current practice?.}, journal = {Blood}, volume = {146}, number = {15}, pages = {1770-1781}, doi = {10.1182/blood.2024026019}, pmid = {39869829}, issn = {1528-0020}, mesh = {Humans ; *Lymphoma, Follicular/therapy/diagnosis/drug therapy ; COVID-19/epidemiology ; Prognosis ; SARS-CoV-2 ; }, abstract = {Follicular lymphoma is the most common subtype of indolent lymphoma. Despite multiple trials over the past decades showing improved progression-free survival with new first-line therapeutic strategies, such as anti-CD20 maintenance therapy and new glycoengineered anti-CD20 antibodies, no standardized approach has been widely adopted in routine clinical practice. Several factors may explain this, including the increased incidence of infectious adverse events associated with these therapies, particularly during the COVID-19 pandemic, and the lack of overall survival benefit despite long-term follow-up. A consensus has emerged acknowledging the high prognostic variability of follicular lymphoma, which complicates the adoption of a one-size-fits-all first-line treatment strategy. A plethora of prognostic scores (Follicular Lymphoma International Prognostic Index [FLIPI], FLIPI2, PRIMA-Prognostic Index, m7-FLIPI, FLEX [Follicular Lymphoma Evaluation Index], 23-gene score, etc) has been proposed but none can reliably identify the ∼20% of patients who will die within 10 years of first-line immunochemotherapy and for whom a critical medical need remains despite recent therapeutic improvements. Consequently, current prognostic models mainly serve as tools to cross-compare and stratify clinical trials. In this review, we highlight current and future strategies aimed at reshaping frontline treatment paradigms to improve outcomes, including tailored approaches based on risk- or response-adapted designs, development of new predictive, rather than prognostic, tools, approaches to reduce adverse events to enhance health-related quality of life, and the potential use of T-cell-engaging therapies to improve survival in the highest risk patients.}, } @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, É 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 {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}, 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.

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.

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.

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}, 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.

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.

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.

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 {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}, 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.

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.

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.

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.

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 = {}, number = {}, pages = {}, pmid = {41062882}, issn = {2397-3358}, 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 = {2025}, 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 = {}, number = {}, pages = {}, doi = {10.1016/j.otc.2025.08.017}, pmid = {41062406}, issn = {1557-8259}, 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 = {}, doi = {10.1183/16000617.0070-2025}, pmid = {41062170}, issn = {1600-0617}, mesh = {Humans ; *COVID-19/epidemiology/immunology/virology ; *Air Pollution/adverse effects ; Severity of Illness Index ; SARS-CoV-2 ; Particulate Matter/adverse effects ; *Air Pollutants/adverse effects ; }, 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.

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.

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.

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}, doi = {10.1136/bmjopen-2025-101698}, pmid = {41062137}, issn = {2044-6055}, mesh = {Humans ; *Return to Work ; *COVID-19/rehabilitation ; SARS-CoV-2 ; Workplace ; }, 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.

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).

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.

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.

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.

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.

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.

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 = {}, number = {}, pages = {107312}, doi = {10.1016/j.ejps.2025.107312}, pmid = {41061826}, issn = {1879-0720}, 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.

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.

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.

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.

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.

RESULTS: The review revealed significant declines in TB incidence, detection, notification, and diagnosis during the pandemic, alongside reduced etiological confirmation of cases.

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}, doi = {10.1590/1516-3180.2024.0311R1.14072025}, pmid = {41059901}, issn = {1806-9460}, mesh = {Humans ; Dexmedetomidine/adverse effects ; *Intensive Care Units/statistics & 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.

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.

DESIGN AND SETTING: This systematic review was conducted using data from randomized clinical trials performed in various ICU settings.

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.

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.

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.

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 & Saúde Coletiva: time as king.}, journal = {Ciencia & saude coletiva}, volume = {30}, number = {9}, pages = {e12842025}, doi = {10.1590/1413-81232025309.12842025}, pmid = {41059883}, issn = {1678-4561}, mesh = {Humans ; *Periodicals as Topic/trends/statistics & numerical data ; *Mental Health ; COVID-19/epidemiology ; *Bibliometrics ; *Mental Disorders/epidemiology ; Primary Health Care/organization & administration ; Child ; *Publishing/statistics & numerical data/trends ; Adolescent ; }, abstract = {Systematic review of articles on mental health published between 2020 and 2025 in the journal Ciência & 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 = {*Machine Learning ; Humans ; COVID-19/epidemiology ; *Risk Management/methods/trends ; SARS-CoV-2 ; Bibliometrics ; }, abstract = {BACKGROUND: Currently, risk management is positioned as a key issue in industries, which is why machine learning technologies have been integrated for impact assessment, prevention, and decision making in different sectors. However, there are still important research gaps, so the aim is to investigate research trends related to the use of machine learning in risk management.

METHODS: A bibliometric analysis is proposed based on the PRISMA-2020 declaration in the Scopus and Web of Science databases.

RESULTS: The results show a growing interest in the use of machine learning for risk management in the scientific literature. China, South Korea and the United States lead the research. The thematic development reflects emerging topics such as urban trees and Covid-19. Key terms include random forest, SVM, and credit risk assessment, while others such as prediction, postpartum depression, big data, and security are considered emerging topics, reflecting the cross-cutting nature and applicability of the topic across different sectors of society. Deep learning and feature selection are also priorities for enhancing machine learning applications in risk management.

CONCLUSIONS: Machine learning in risk management has grown exponentially, shifting focus from stacking to urban trees and Covid-19. Key contributors, journals, and nations shape this evolving research landscape.}, } @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 = {}, number = {}, pages = {}, doi = {10.1111/aogs.70066}, pmid = {41058315}, issn = {1600-0412}, 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.

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 (≥70% or <70%) as moderators. The review was registered on PROSPERO (CRD42023447188).

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 = 0.004) for colposcopies (4 studies, I[2] = 60.97%, p = 0.075), -1.70 (95% CI -2.50 to -0.90, p < 0.001) for cervical treatments (5 studies, I[2] = 52.92%, p = 0.081), -4.61 (95% CI -7.90 to -1.33, p = 0.006) for pre-invasive lesion diagnoses (4 studies, I[2] = 92.45%, p < 0.001), and -0.85 (95% CI -1.52 to -0.19, p = 0.012) for cervical cancer diagnoses (9 studies, I[2] = 71.07%, p = 0.002). At meta-regression, further reductions for cervical treatments and pre-invasive lesion diagnoses were observed in the case of screening coverage <70%.

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 {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 {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 & dosage ; *Nanoparticles/chemistry/administration & dosage ; *Lipids/chemistry/administration & 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 {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 & 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 {pmid40000558, year = {2025}, author = {Idres, YM and Idris, A and Gao, W}, title = {Preclinical testing of antiviral siRNA therapeutics delivered in lipid nanoparticles in animal models - a comprehensive review.}, journal = {Drug delivery and translational research}, volume = {15}, number = {11}, pages = {3899-3916}, pmid = {40000558}, issn = {2190-3948}, mesh = {*RNA, Small Interfering/administration & dosage ; Animals ; *Nanoparticles/chemistry/administration & dosage ; *Antiviral Agents/administration & dosage ; Humans ; Disease Models, Animal ; COVID-19 ; *Lipids/chemistry ; SARS-CoV-2/drug effects ; RNA Interference ; COVID-19 Drug Treatment ; Liposomes ; }, abstract = {The advent of RNA interference (RNAi) technology through the use of short-interfering RNAs (siRNAs) represents a paradigm shift in the fight against viral infections. siRNAs, with their ability to directly target and silence specific posttranscriptional genes, offer a novel mechanism of action distinct from that of traditional pharmacotherapeutics. This review delves into the growing field of siRNA therapeutics against viral infections, highlighting their critical role in contemporary antiviral strategies. Importantly, this review will solely focus on the use of lipid nanoparticles (LNPs) as the ideal antiviral siRNA delivery agent for use in vivo. We discuss the challenges of siRNA delivery and how LNPs have emerged as a pivotal solution to enhance antiviral efficacy. Specifically, this review focuses on work that have preclinically tested LNP formulated siRNA on virus infection animal models. Since the COVID-19 pandemic, we have witnessed a resurgence in the field of RNA-based therapies, including siRNAs against viruses including, SARS-CoV-2. Notably, the critical importance of LNPs as the ideal carrier for precious 'RNA cargo' can no longer be ignored with the advent of mRNA-LNP based COVID-19 vaccines. siRNA-based therapeutics represents an emerging class of anti-infective drugs with a foreseeable future as suitable antiviral agents.}, } @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 {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/ ; }, 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.

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.

RESULTS: Out of 3539 references, 187 studies with 116,525 participants were analyzed. The majority (80.2%) used the EQ-5D-5 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 = 0.038) and geographic region (p < 0.001). Common predictors of lower HRQoL included older age, female gender, disease severity, comorbidities, and post-COVID-19 symptoms.

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}, 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.

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.

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.

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.

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.

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}, 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.

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.

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.

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 {pmid41057112, year = {2025}, author = {Viswanathan, V and Boulton, AJ}, title = {Introduction "global progress in diabetic foot care".}, journal = {Diabetes research and clinical practice}, volume = {}, 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}, 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.

STUDY DESIGN: Narrative-based analysis drawing on operational experience during the UK National Testing Programme's response to COVID-19.

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.

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.

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 = {}, number = {}, pages = {}, pmid = {41055867}, issn = {1535-1645}, 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.

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}, doi = {10.2196/66829}, pmid = {41055070}, issn = {2369-2960}, mesh = {Humans ; *Sports/statistics & numerical data ; *Terrorism/prevention & control/statistics & numerical data ; *Anniversaries and Special Events ; Athletic Injuries/epidemiology/prevention & 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.

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.

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.

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.

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}, doi = {10.2196/57626}, 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.

OBJECTIVE: This review aimed to determine the pooled effect of maternal anemia interventions and associated factors during the pandemic.

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.

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 (I²=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 (I²=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 (I²=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.

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 & 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.

METHOD: A systematic search was conducted across four databases, PsycINFO (n = 183), MEDLINE (n = 345), Web of Science (n = 382), and Embase (n = 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.

RESULTS: Thirty-five studies were included and grouped into the following themes: direct interventions (n = 16), policy approaches (n = 9), and population-specific approaches (n = 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.

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 {pmid40668160, year = {2025}, author = {Hidalgo, JL and Kumar, VK and Akech, SO and Myatra, SN and Jacob, ST and Kortz, T and Vasquez, AA and Jiménez Bazzano, MC and Diaz, M and Rio Rodríguez, JD and Garcia, ALN and Giron, R and Jacobi, J and Madden, MA and Nadkarni, V}, title = {The Sepsis Chain of Survival: A Comprehensive Framework for Improving Sepsis Outcomes.}, journal = {Critical care medicine}, volume = {53}, number = {10}, pages = {e1886-e1892}, pmid = {40668160}, issn = {1530-0293}, support = {K23 AI144029/AI/NIAID NIH HHS/United States ; }, mesh = {Humans ; *Sepsis/therapy/mortality/diagnosis ; *Critical Care/organization & administration/methods ; Fluid Therapy ; Emergency Medical Services/organization & administration ; Resuscitation/methods ; }, abstract = {The "Chain of Survival" concept, developed for cardiac arrest, emphasizes a seamless and interconnected set, of time-critical interventions that are not strictly linear, to improve survival. This paradigm of urgent recognition and response to life-threatening conditions has evolved to apply to acute medical conditions, including sepsis. The "Sepsis Chain of Survival" underscores the importance of early recognition, prompt emergency medical services activation, timely antimicrobial administration and appropriate fluid resuscitation, optimized critical care management, effective source control and infection management, and comprehensive post-sepsis care. By adopting this approach, healthcare systems can improve sepsis outcomes through a coordinated, multifaceted strategy. This model highlights the critical role of public and healthcare worker awareness, education, community response, and continuous monitoring. Addressing the importance and interdependence of each link, this framework aims to improve survival rates and patient recovery by ensuring timely and effective sepsis management across diverse resource settings in infants, children, and adults.}, } @article {pmid41053189, year = {2025}, author = {Ulaş, S and Seçer, İ}, 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 & numerical data ; *Stroke/epidemiology/therapy ; Risk Factors ; Patient Discharge/statistics & 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 & medicinal chemistry letters}, volume = {}, 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 & 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 & 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).

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.

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.

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.

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.

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.

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.

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.

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.

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.

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).

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).

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 = {}, number = {}, pages = {}, doi = {10.1080/14787210.2025.2569831}, pmid = {41048103}, issn = {1744-8336}, 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.

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 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.

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 {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 = {}, number = {}, pages = {105837}, doi = {10.1016/j.meegid.2025.105837}, pmid = {41046898}, issn = {1567-7257}, 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 = {}, number = {}, pages = {106920}, doi = {10.1016/j.fitote.2025.106920}, pmid = {41046876}, issn = {1873-6971}, 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 = {}, number = {}, pages = {104564}, doi = {10.1016/j.nepr.2025.104564}, pmid = {41046202}, issn = {1873-5223}, 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.

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.

DESIGN: An integrative systematic review and narrative synthesis.

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.

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.

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 = {}, number = {}, pages = {115700}, doi = {10.1016/j.addr.2025.115700}, pmid = {41046104}, issn = {1872-8294}, 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 {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 = {}, number = {}, pages = {}, doi = {10.1002/ajh.70074}, pmid = {41045051}, issn = {1096-8652}, 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 {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 {pmid41042962, year = {2025}, author = {Barański, J}, title = {Mobile Technologies in Infectious Disease Monitoring: Benefits and limitations.}, journal = {Przeglad epidemiologiczny}, volume = {79}, number = {2}, pages = {263-279}, doi = {10.32394/pe/207617}, pmid = {41042962}, issn = {0033-2100}, mesh = {Humans ; COVID-19/prevention & control ; *Mobile Applications ; *Communicable Disease Control/methods ; Zika Virus Infection/prevention & control ; *Communicable Diseases/epidemiology ; Pandemics ; Malaria/prevention & control ; Telemedicine ; SARS-CoV-2 ; Contact Tracing/methods ; }, abstract = {Infectious diseases, such as the COVID-19 pandemic, Zika virus, malaria, and Ebola, pose a serious threat to public health worldwide. Their impact on society can be significant, especially in the context of globalization, migration, and climate change. These diseases can spread quickly and efficiently, which requires the use of modern monitoring and control tools. In this context, mobile technologies can play a crucial role in preventing and controlling the spread of infectious diseases. This article will discuss both the benefits and limitations of using mobile technologies in monitoring and combating infectious diseases, such as contact-tracing apps, systems for collecting epidemiological data, and platforms supporting health education.}, } @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.

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.

DESIGN: The research team conducted qualitative, semi-structured interviews via telephone, Zoom, or in person between March 20th and April 12th, 2024.

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.

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 = 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.

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.

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 & control/epidemiology ; *Public Health ; *Communication ; *COVID-19 Vaccines/administration & 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 & control/immunology ; *COVID-19 Vaccines/immunology/adverse effects/administration & 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.

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.

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 ≥ 0.05). Among PWH, 22 studies reported significantly higher seroconversion rates in individuals with CD4[+] T cell counts >200 cells/mm³ compared to those with counts <200 cells/mm³. 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.

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.

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.

OBJECTIVES: The objective of this review was to systematically collect and assess evidence regarding the effectiveness of PSA.

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.

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.

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.

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.

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 {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 & 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 {pmid40705503, year = {2025}, author = {Marchetta, M and Golino, M and Markley, JD and Abbate, A}, title = {Rare but Severe Cardiovascular Complications of SARS-CoV-2 Vaccination: A Call for Awareness.}, journal = {Journal of cardiovascular pharmacology}, volume = {86}, number = {4}, pages = {317-320}, doi = {10.1097/FJC.0000000000001740}, pmid = {40705503}, issn = {1533-4023}, mesh = {Humans ; *COVID-19 Vaccines/adverse effects/administration & dosage ; *COVID-19/prevention & control/epidemiology ; *Cardiovascular Diseases/chemically induced/epidemiology/diagnosis ; *Vaccination/adverse effects ; Risk Assessment ; *SARS-CoV-2/immunology ; Male ; Risk Factors ; }, abstract = {The extensive use of severe acute respiratory syndrome coronavirus 2 vaccines has played a crucial role in controlling the coronavirus disease 2019 pandemic, underscoring the remarkable advantages and efficacy of novel vaccine technologies. However, rare but life-threatening cardiovascular complications such as myocarditis, pericarditis, and thrombosis have emerged, predominantly affecting young males after their second vaccine dose. These adverse events highlight the importance of continued pharmacovigilance and transparent communication about potential risks. Because the global epidemiologic context has shifted, now characterized by widespread natural, vaccine-induced, or hybrid immunity, it is important to re-evaluate the risk-benefit ratio of repeated vaccine administration in low-risk individuals. Data regarding severe acute respiratory syndrome coronavirus 2 vaccines complications are still largely based on the early phases of the pandemic (2020-2021), when population-level immunity was minimal and severe coronavirus disease 2019 outcomes more frequent. Today, such comparisons may no longer be appropriate. Updated real-world evidence is needed to better inform decision making and ensure that public health strategies remain aligned with the contemporary risk landscape.}, } @article {pmid38334977, year = {2025}, author = {Kapur, R and Okumura, K and Ohira, S and Isath, A and Gandhi, A and Keller, M and Nog, R and Gass, A and Spielvogel, D and Lansman, S and Dhand, A}, title = {Coronavirus Disease 2019 (COVID-19) in Heart Transplant Recipients and Anti-SARS-CoV-2 Monoclonal Antibodies: Experience, Lessons Learnt, and Future Challenges.}, journal = {Cardiology in review}, volume = {33}, number = {6}, pages = {522-530}, doi = {10.1097/CRD.0000000000000640}, pmid = {38334977}, issn = {1538-4683}, mesh = {Humans ; *Heart Transplantation ; *COVID-19/prevention & control/epidemiology ; SARS-CoV-2 ; Antibodies, Monoclonal, Humanized/therapeutic use ; Male ; Middle Aged ; Retrospective Studies ; Female ; *COVID-19 Drug Treatment ; *Antibodies, Monoclonal/therapeutic use ; Adult ; Aged ; Transplant Recipients ; Drug Combinations ; Antibodies, Neutralizing ; }, abstract = {Solid organ transplant recipients (SOTRs), including heart transplant (HT) recipients, infected with Coronavirus disease 2019 (COVID-19) are at higher risk of hospitalization, mechanical ventilation, or death when compared with general population. Advances in diagnosis and treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have reduced COVID-19-related mortality rates from ~30% in the early pandemic to <3% in 2022 among HT recipients. We performed a retrospective chart review including adult HT recipients at Westchester Medical Center from January 1, 2020 to December 10, 2022, who received anti-SARS-CoV-2 monoclonal antibodies (mAbs) for treatment of mild-to-moderate COVID-19, and those who received tixagevimab/cilgavimab for preexposure prophylaxis. Additionally, a comprehensive review of the literature involving SOTRs who received mAbs for COVID-19 was conducted. In this largest single-center study in this population, 42 adult HT recipients received casirivimab/imdevimab (36%), sotrovimab (31%), or bebtelovimab (29%) for treatment of mild-to-moderate COVID-19. Among these recipients, no infusion-associated adverse effects, progression of disease, COVID-19-associated hospitalizations, or death were noted. Preexposure prophylaxis with tixagevimab/cilgavimab was given to 63 HT recipients in a dedicated infusion center (40%), inpatient setting (33%), or at time of annual heart biopsy (27%). No immediate adverse events were noted. There were 11 breakthrough infections, all mild. Overall, the data suggests that HT recipients receiving mAbs have reduced rates of hospitalization, need for intensive care unit care, or death. Use of anti-SARS-CoV-2 mAbs in SOTRs is resource intensive and requires a programmatic team approach for optimal administration and to minimize any risk of disparities in their use.}, } @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?

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.

RESULTS: A total of 16 interventions were adapted or developed world wide during the COVID-19 pandemic between 2020 and 2023. Evidence of effectiveness exist in only six of the 16 interventions. Most of them were designed using digital approaches and were primarly delivered through iterative implementation cycles, whereas the implementation of face-to-face interventions focused on interactions with various stakeholders.

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 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/ ; }, } @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 = {}, number = {}, pages = {}, doi = {10.1016/j.yjmcc.2025.09.008}, pmid = {41038267}, issn = {1095-8584}, 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}, 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 = {2025}, 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 & 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}, abstract = {BACKGROUND: Artificial intelligence (AI) has emerged as a promising tool to improve the diagnosis and characterization of ARDS, including the identification of subphenotypes.

OBJECTIVES: To evaluate the diagnostic performance and methodological quality of AI models for identifying ARDS and its subphenotypes in adults.

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.

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 (I² > 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).

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 & numerical data ; *Physicians/psychology/statistics & 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 = {}, number = {}, pages = {}, doi = {10.1021/acs.jmedchem.5c01610}, pmid = {41037346}, issn = {1520-4804}, 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 & 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, E and Mulholland, D and Tricco, AC and Dinnes, J and Devane, D}, title = {Effectiveness of SARS-CoV-2 testing strategies inreducing COVID-19 cases, hospitalisations, and deaths.}, journal = {The Cochrane database of systematic reviews}, volume = {10}, number = {}, pages = {CD016192}, pmid = {41036688}, issn = {1469-493X}, mesh = {Humans ; *COVID-19/mortality/diagnosis ; *Hospitalization/statistics & numerical data ; *COVID-19 Testing/methods ; *SARS-CoV-2/isolation & purification ; Randomized Controlled Trials as Topic ; Asymptomatic Infections ; COVID-19 Nucleic Acid Testing/methods ; Controlled Before-After Studies ; Non-Randomized Controlled Trials as Topic ; }, 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.

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.

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.

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.

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.

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.

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.

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).

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.

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.

FUNDING: This Cochrane review was partially funded by the World Health Organization (WHO) and the Health Research Board of Ireland.

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 = {}, number = {}, pages = {}, doi = {10.1021/acs.jmedchem.5c02234}, pmid = {41036636}, issn = {1520-4804}, 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 & numerical data ; Africa/epidemiology ; *Patient Dropouts/statistics & 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.

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.

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 = 3.55, 95 CI (1.17-5.92). women who had no formal education (AOR = 3.88, 95 CI (- 0.24-8.00), inaccessible PHC facilities (AOR = 5.90, 95 CI (0.54-11.26), lack of support from family or husband (AOR = 4.91 CI (- 1.31-11.19), and women with poor economic status (AOR = 2.50, 95 CI (1.19-3.81) were determinant factors for maternal dropout from antenatal care service.

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 {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.

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.

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 {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 & 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 {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 & dosage ; COVID-19 Vaccines/administration & 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.

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.

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 {pmid41033372, year = {2025}, author = {Alshammari, A}, title = {Immunological Insights and Vaccine Advances Against Apicomplexan Parasites: Emerging Concepts and Innovations.}, journal = {Microbial pathogenesis}, volume = {}, number = {}, pages = {108074}, doi = {10.1016/j.micpath.2025.108074}, pmid = {41033372}, issn = {1096-1208}, 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}, 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}, 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.

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".

RESULTS: Eighteen patients were identified between 2021 and 2024 with ages ranging from 48 to 80 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) ≥ 75 mg/dl. Notably, 15 patients had a CRP blood test at least 48 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.

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.

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 < 0.05 was considered statistically significant.

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).

CONCLUSION: Neoadjuvant chemoimmunotherapy demonstrates clinical benefits for patients with stage III NSCLC.}, } @article {pmid39360539, year = {2025}, author = {Momani, A and Halimi, A and Nazari, SSH and Al-Marzouqi, Z and Jarrahi, AM and Al-Yateem, N and Rahman, SA and Al-Marzouqi, A}, title = {The Effect of COVID-19 Lockdown Among Adolescents with Type 1 Diabetes: A Systematic Review and Meta-Analysis.}, journal = {Current diabetes reviews}, volume = {21}, number = {10}, pages = {95-107}, pmid = {39360539}, issn = {1875-6417}, mesh = {Humans ; *Diabetes Mellitus, Type 1/blood/epidemiology ; *COVID-19/prevention & control/epidemiology ; Adolescent ; Blood Glucose/analysis/metabolism ; SARS-CoV-2 ; Glycated Hemoglobin/analysis/metabolism ; Child ; *Quarantine ; Glycemic Control ; }, abstract = {OBJECTIVE: The aim of this study was to assess how the lockdown of the COVID-19 pandemic had affected the glycaemic control of adolescents aged 10-19 with type 1 diabetes.

METHODS: A comprehensive search of literature was performed in PubMed, Scopus, Web of Science, and ProQuest. Published articles up to September 2022 were included. The Glucose Monitoring Index (GMI) and HbA1c level were defined as outcome variables. Average glucose level was found to be a common variable in both HbA1c levels and GMI; therefore, HbA1c and GMI were converted to average glucose (mg/dL) using appropriate formulas. Studies reported the outcomes in two or three periods (pre-lockdown, lockdown, and post-lockdown) were included in the analysis. A paired wise meta-analysis was performed among the studies that reported all three periods. Homogeneity across studies was assessed using I2 statistic.

RESULT: Fourteen studies were included in the study. The pooled average glucose during the lockdown decreased to 166.9 mg/dL (95% CI, 153.78, 180.02) from 205.793 mg/dL (95% CI, 188.412, 223.173) during the pre-lockdown period, then it increased to 204.23 mg/dL (95% CI, 186.17, 222.29) during the post-lockdown period. A paired wise meta-analysis indicated a reduction in average glucose levels. However, it was not statistically significant, possibly due to the small number of studies that reported data from all three periods.

CONCLUSION: Although the descriptive analysis of our study showed that the lockdown had affected (decreased) the average glucose level among adolescents with type 1 diabetes, this was not statistically significant in the pooled analysis.}, } @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 & 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 & 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.

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.

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.

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.

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}, doi = {10.1016/j.clinsp.2025.100793}, 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.

OBJECTIVE: To evaluate microbiological diagnostic data for severe pneumonia.

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.

RESULTS AND DISCUSSION: Diagnostic tests for pneumonia should be requested based on the severity of the disease, the patient´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.

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}, 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}, abstract = {BACKGROUND & 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.

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.

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}, doi = {10.1001/jamanetworkopen.2025.29659}, 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.

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.

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.

FINDINGS: Of 426 publications, 24 were analyzed; 9 studies (38%) used test-negative controls, while 15 studies (63%) did not (P < .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.

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 {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}, doi = {10.5501/wjv.v14.i3.107903}, 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}, doi = {10.5501/wjv.v14.i3.111912}, 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}, doi = {10.1177/17511437251374816}, 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}, doi = {10.5527/wjn.v14.i3.107582}, 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}, } @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.

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.

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.

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 = {}, number = {}, pages = {}, pmid = {41023525}, issn = {1179-1918}, 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.

OBJECTIVES: Our aim was to investigate the association between measured vaccine immunogenicity and vaccine effectiveness in clinically vulnerable populations.

DATA SOURCES: PubMed, MEDLINE, EMBASE, Cochrane Library.

STUDY ELIGIBILITY CRITERIA: Studies published between 03/2020 and 01/2025, which reported data on COVID-19 vaccine immunogenicity (antibody and T-cell) and subsequent infection outcomes.

PARTICIPANTS: Patients defined as clinically vulnerable by QCOVID criteria, who had received at least the primary course of COVID-19 vaccination.

ASSESSMENT OF RISK OF BIAS: The Newcastle-Ottawa quality assessment scale was used to assess risk of bias.

METHODS OF DATA SYNTHESIS: A random-effects meta-analysis model was used to pool relative risks of COVID-19 breakthrough infection (BTI), hospitalisation, and death. Unadjusted data was used for the primary analysis due to a lack of adjusted data available in individual studies.

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 [RR 1.82 (1.45-2.29), p<0.01, I[2]=84.03%], COVID-19 related hospitalisation [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 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.

CONCLUSIONS: Within the methodological limitations, this study has shown that lack of anti-spike 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 Fleichsmann-Struzek, C and Latronico, N and Cinotti, R}, title = {Post-Intensive Care Syndrome. What clinicians and researchers must know.}, journal = {Anaesthesia, critical care & pain medicine}, volume = {}, number = {}, 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 {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 & control/epidemiology ; *Laboratories/standards/organization & administration ; *Pandemics/prevention & 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.

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.

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 years of PD and at least 2 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.

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 & 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 & control ; Japan/epidemiology ; Measles Vaccine/administration & dosage ; Child ; Disease Outbreaks/prevention & 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 = {}, number = {}, pages = {178201}, doi = {10.1016/j.ejphar.2025.178201}, pmid = {41016568}, issn = {1879-0712}, 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: The physiological basis and current progress.}, journal = {Journal of controlled release : official journal of the Controlled Release Society}, volume = {}, number = {}, pages = {114275}, doi = {10.1016/j.jconrel.2025.114275}, pmid = {41016477}, issn = {1873-4995}, 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?"

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.

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.

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}, 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.

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.

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.

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.

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.

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.

METHODS: Embase, ISI Web of Science, PubMed, and Scopus were searched (up to July 2024) using terms related to IEI and mortality.

RESULTS: A total of 12,581 deceased IEI patients were included, with an overall reported mortality rate of 24.0 % (95 % confidence interval: 23.0-26.0 %) 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 % vs. 0.874 %). 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 %). 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 % (370 cases).

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.

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.

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.

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.

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.

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.

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 = {}, number = {}, pages = {}, pmid = {41015960}, issn = {1568-5608}, 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 & 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 = {}, number = {}, pages = {100625}, doi = {10.1016/j.jfp.2025.100625}, pmid = {41015338}, issn = {1944-9097}, 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 & medicine (1982)}, volume = {385}, number = {}, pages = {118556}, doi = {10.1016/j.socscimed.2025.118556}, pmid = {41014724}, issn = {1873-5347}, 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}, doi = {10.3310/DWKT1327}, 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.

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.

DESIGN: Systematic reviews; surveys; binary choice experiment; retrospective cohort studies using routine data; consensus meeting.

PARTICIPANTS: General practitioners; nurses; and surgeons managing pressure ulcers; people with incident pressure ulcers and hospitalised with severe pressure ulcers.

INTERVENTION: Surgical reconstruction.

COMPARATOR: No surgical reconstruction.

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.

RESULTS: Review 1 included three studies comparing different surgical reconstruction techniques. None reported wound-free time. Recurrence occurred in ≈ 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; > 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 < 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 > 70% of the surgical reconstructions. Comparing surgical reconstruction (n = 325) versus no surgical reconstruction (n = 1474) patients, time to next admission with a severe pressure ulcer was longer in patients having surgical reconstruction (hazard ratio = 0.79, 95% confidence interval 0.61 to 1.03; p = 0.07). Estimated pressure ulcer incidence in primary care was ≈ 5/10,000, but the true incidence was believed to be ≈ 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.

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.

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.

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.

STUDY REGISTRATION: This study is registered as PROSPERO 2019 CRD42019156436, 2019 CRD42019156450; ISRCTN13292620.

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.

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.

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.

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 & 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.

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.

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.

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 & 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&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 = {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.

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).

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.

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.

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".

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.

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 & 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 & 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.

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.

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.

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.

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//Direcció General de Ciència i Investigació, Generalitat Valenciana/ ; CEX2021-001165-S//Severo Ochoa" Program for Centers of Excellence in R&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 & 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 = {}, doi = {10.1136/bmjgh-2024-018342}, pmid = {41005811}, issn = {2059-7908}, mesh = {Humans ; *COVID-19/epidemiology/prevention & 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}, 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.

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.

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.

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}, 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}, 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 = {0260-1060}, 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 & dosage ; COVID-19/prevention & 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 & distribution ; *Drugs, Essential/supply & distribution ; SARS-CoV-2 ; Drugs, Generic/supply & distribution ; *Neoplasms/drug therapy ; Cisplatin/supply & distribution ; Methotrexate/supply & distribution ; Vincristine/supply & 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.

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.

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.

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.

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 & numerical data ; *Pregnancy Outcome/epidemiology ; SARS-CoV-2 ; Intensive Care Units, Neonatal/statistics & 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.

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.

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.

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}, 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 {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}, 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}, abstract = {AIM: To investigate the association of the COVID-19 virus with hemorrhagic and ischemic spinal strokes.

, 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.

MATERIALS AND METHODS: A PRISMA-based systematic review.

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 years old, respectively. Patients with cord ischemia had more severe COVID-19 pneumonia as compared to hemorrhagic (62 % vs 27 %). Lab results showed 75 % 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.

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 & numerical data ; *Return to Work/statistics & numerical data ; COVID-19/epidemiology ; *Teleworking/statistics & 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.

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.

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).

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.

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 = {}, number = {}, pages = {}, pmid = {40994423}, issn = {1473-0189}, support = {U54 EB027690/EB/NIBIB NIH HHS/United States ; UL1 TR002378/TR/NCATS NIH HHS/United States ; }, 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 {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 = {}, number = {}, pages = {}, 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.

OBJECTIVE: To map the scientific evidence related to cardiometabolic factors in long post-COVID-19 conditions.

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.

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.

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.

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.

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.

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 = 0.0071 and p = 0.0086 at multivariate analysis for SARS-CoV-2, hematological malignancies (p = 0.0035 at univariate analysis; p = 0.0083 at multivariate analysis), invasive mechanical ventilation (116 patients; 83.3%) p = 0.0060 at univariate analysis not confirmed in multivariate analysis (p = 0.0599). Corticosteroids were associated with reduced ICU mortality at univariate analysis (86 patients; 59.7% p = 0.0250) not confirmed at multivariate analysis (p = 0.7196).

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").

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.

DIAGNOSES: Both patients were diagnosed with persistent hiccups.

INTERVENTIONS: Both patients received combined treatment with acupuncture and TDP.

OUTCOMES: Following treatment, hiccups were alleviated to different degrees, and no recurrence was observed at follow-up.

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}, 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.

METHODS: We recorded clinical features and outcomes in patients with MIS-C admitted to our institution (February 2020-February 2022), focusing on the long-term outcome of those with a severe course.

RESULTS: A total of 50 MIS-C patients (mean age 8.8 ± 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 low white blood cells, lymphocytes, platelets, albumin, and sodium. In multivariate analysis, a more severe course of the disease was associated with sodium ≤133 or ferritin >684. In two months, the symptoms disappeared. No relapses occurred during four years of surveillance.

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 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}, 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.

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.

RESULTS: We included 20 studies that assessed costs (n = 16), disability-adjusted life years (DALYs) (n = 3), employment rates (n = 1), and school attendance (n = 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.

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 = {}, number = {}, pages = {}, doi = {10.1039/d5nr02301g}, pmid = {40984753}, issn = {2040-3372}, 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 & 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.

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.

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.

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 = {}, number = {}, pages = {}, doi = {10.1152/ajplung.00189.2025}, pmid = {40983473}, issn = {1522-1504}, 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 & dosage ; COVID-19 ; *Drug Overdose ; Fatal Outcome ; *Ivermectin/poisoning/administration & 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.

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.

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.

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.

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.

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.

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 {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 = {}, number = {}, pages = {e0243725}, doi = {10.1128/mbio.02437-25}, pmid = {40981424}, issn = {2150-7511}, 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.

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.

STUDY SELECTION: Studies with human participants aged ≥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.

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.

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.

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.

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.

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, Á 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 & 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 {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 Grégory Lemarchal/ ; RF20230503250//Association Grégory Lemarchal/ ; 101080462//HORIZON EUROPE Health/ ; 21402; AO 2021-2 CSS 11//Agence Nationale de Recherches sur le Sida et les Hépatites 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 Healthcare 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: Healthcare personnel (HCP) knowledge of isolation precautions (IPs) is essential for preventing healthcare-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.

METHODS: Following PRISMA guidelines, five databases were searched for studies published between 2007 and 2024. Eligible studies used instruments with more than 10 items covering CDC-recommended domains. Instruments were evaluated for content coverage, psychometric properties, and methodological quality.

RESULTS: Twenty-seven studies met inclusion criteria. All instruments assessed standard precautions, while transmission-based precautions and fundamental elements were underrepresented. 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.

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 healthcare settings.}, } @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 & pharmacotherapy = Biomedecine & pharmacotherapie}, volume = {192}, number = {}, pages = {118577}, doi = {10.1016/j.biopha.2025.118577}, pmid = {40974857}, issn = {1950-6007}, 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}, 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, T 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.

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.

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%.

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 {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 = {}, number = {}, pages = {1-16}, doi = {10.1080/03639045.2025.2563633}, pmid = {40971252}, issn = {1520-5762}, 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.

SIGNIFICANCE OF REVIEW: DT offers a human-centered, iterative alternative to the traditional linear R&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.

KEY FINDINGS: The application of design thinking 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®, ABRAXANE®, and mRNA-based COVID-19 vaccines illustrate established successes, while emerging examples, including CRISPR-based therapeutics and extracellular vesicle nanocarriers, underscore the forward-looking potential of this methodology. Together, these examples highlight how design thinking accelerates development timelines, mitigates risk, and enhances patient and regulatory alignment.

CONCLUSIONS: Integrating design thinking 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}, doi = {10.1192/j.eurpsy.2025.10084}, pmid = {40968401}, issn = {1778-3585}, mesh = {Humans ; *COVID-19/epidemiology/psychology ; *Occupational Stress/epidemiology ; *Physicians/psychology/statistics & 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.

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).

RESULTS: Based on 81 studies (N = 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 < 0.036). Studies employing brief screening tools (≤10 items) yielded significantly lower prevalence estimates (10.2%) than those using longer instruments (16.4%) (p < 0.027). No other significant moderators were identified.

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 {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}, 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.

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.

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.

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 & control/epidemiology ; *Typhoid-Paratyphoid Vaccines/immunology ; *Paratyphoid Fever/prevention & 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&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&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.

PURPOSE: This review aims to investigate and compile information on reported cases of SJS/TEN potentially linked to virus infections.

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.

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.

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.

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.

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.

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.

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.

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.

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).

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}, 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}, 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.

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 I² statistic, and subgroup and meta-regression analyses were performed to investigate potential moderators.

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.

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 & 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.

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 ≥ 60 to ≥ 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 ≥ 65 to ≥ 50 years. Recommendations for vaccination in RA patients (everyone age ≥ 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.

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.

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.

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 & control/veterinary/transmission/epidemiology ; Livestock ; Animals, Domestic ; *Coronavirus/immunology ; Poultry ; Poultry Diseases/prevention & 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.

PATIENT CONCERNS: A 27-year-old man with a history of left ear purulent otorrhea for > 20 years presented with neck swelling for 5 days during COVID-19 recovery.

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.

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.

OUTCOMES: The patient recovered well following surgical interventions and tailored wound management, with no further complications.

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 & control ; *Health Behavior ; }, abstract = {INTRODUCTION: This systematic review sought to understand barriers and enablers to hand hygiene in community settings.

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.

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).

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.

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}, 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}, 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}, 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}, doi = {10.2196/78417}, 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.

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.

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.

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.

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.

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 = {}, doi = {10.1146/annurev-pharmtox-071724-100739}, pmid = {40956864}, issn = {1545-4304}, 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 & 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, Á 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.

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.

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.

CONCLUSION: Thus, this review strengthens research into long COVID and provides new possibilities for future studies.}, } @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 & 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 & 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.

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.

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 (θ = 1.3, p < 0.0001). However, challenges, such as data underreporting, gaps and inconsistencies, were common, potentially affecting model accuracy and real-world applicability.

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 & 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 & 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.

AIMS: To synthesise a framework for the module-intensity-outcome of digitalised care during COVID-19.

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.

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.

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.

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.

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).

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 µs and 1400 µs. 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.

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.

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.

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.

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.

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 & 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 & ethics : a journal of the American Society of Law, Medicine & 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}, 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 = {2025}, 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}, 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 & molecular characterization of cytokine storm in COVID-19, association with disease severity & 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 & 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 & 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 & 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 {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}, 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.

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.

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.

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.

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 = {}, doi = {10.1136/bmjresp-2024-002722}, 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.

METHODS: Information sources: Trials were identified through a systematic search carried out on MEDLINE, Web of Science, Scopus and CINAHL until 17 March 2025.

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.

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.

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).

SYNTHESIS OF RESULTS: No difference was found in dyspnoea (8 studies, 224 participants; SMD 0.02, 95% CI -0.82 to 0.86, I[2]=88.2%), exercise capacity (5 studies, 183 participants; MD 3.62, 95% CI -19.39 to 26.63, I[2]=39.8%) and in HRQOL (4 studies, 127 participants; MD -11.81, 95% CI -42.95 to 19.33, I[2]=98.9%). The data available were insufficient to conduct a pooled analysis for muscle function.

CONCLUSIONS: Limitations of evidence: The evidence is very uncertain about virtual reality's effects on dyspnoea due to risk of bias, imprecision and heterogeneity.

INTERPRETATION: Further studies are needed and should explore various aspects of the application of immersive virtual reality.

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}, 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.

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.

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.

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.

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 = {}, number = {}, pages = {}, pmid = {40931272}, issn = {1590-3478}, 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 = {}, 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}, 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.

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.

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.

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}, doi = {10.62675/2965-2774.20250399}, pmid = {40929471}, issn = {2965-2774}, mesh = {Humans ; *Respiration, Artificial/methods ; *COVID-19/therapy ; *Biomedical Research/organization & 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 {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 & 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 = {}, number = {}, pages = {}, doi = {10.1016/j.ymthe.2025.09.011}, pmid = {40926412}, issn = {1525-0024}, 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 & 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 & numerical data/economics ; Pandemics/economics ; *Health Status Disparities ; Poverty/statistics & 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).

METHODS: Case report and literature review.

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.

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.

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.

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.

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.

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.

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.

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.

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 & control/immunology ; *COVID-19 Vaccines/administration & dosage ; *Nanoparticles ; SARS-CoV-2/immunology ; *mRNA Vaccines/administration & dosage ; Animals ; *RNA, Messenger/administration & dosage/immunology ; 2019-nCoV Vaccine mRNA-1273 ; Vaccines, Synthetic/administration & 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 & 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.

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.

RESULTS: Twenty RCTs were reviewed with 14 having a low risk of bias. For ICU LOS (18 studies) there was significant statistical heterogeneity (I2 = 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 = 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 = 0.298) or mean hospital LOS (p-value = 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 = 0.003); and patients with COVID-19 (hospital LOS -3.90 days, 95% CI: -6.28 to -1.51, p-value = 0.001).

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 & control ; *Health Services Accessibility ; COVID-19 Vaccines/supply & 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.

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).

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 κ (κ=0.82). We conducted this systematic review from April 20, 2025, to May 21, 2025.

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.

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 {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 & 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.

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.

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.

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.

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 non-pharmacological 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.

METHODS: This systematic review and meta-analysis followed the JBI methodology for RCTs. We included English-language randomized controlled trials that evaluated virtual reality (VR) for pain management in adult palliative care cancer patients. Due to COVID-19-related publication delays, our 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 non-randomized 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.

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.

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 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 & 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 & 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 {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 & 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).

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.

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.

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 & 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 & 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}, 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}, doi = {10.1097/MCC.0000000000001313}, pmid = {40910660}, issn = {1531-7072}, mesh = {Humans ; *Cross Infection/prevention & control ; *Intensive Care Units/organization & administration ; *Infection Control/methods/organization & 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.

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.

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 & 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.

OBJECTIVES: This systematic review aims to identify unmet needs and barriers in European dementia care, providing a framework to improve health strategies.

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.

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.

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 & 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.

METHODS: Systematic literature searches for preclinical and clinical studies involving Omicron infection and saline, bias assessment, and review of outcomes (benefits, risks).

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.

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.

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.

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.

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 = {}, number = {}, pages = {}, pmid = {40908304}, issn = {1759-507X}, abstract = {Long coronavirus disease (COVID) - commonly defined as symptoms and/or long-term effects that persist for at least 3 months after acute infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and cannot be explained by an alternative diagnosis - is a complex, multifaceted and heterogeneous disease that affects many organ systems, including the kidney. COVID-19 can cause acute kidney injury, and several studies have reported an increased risk of chronic kidney disease (CKD) following COVID-19, suggesting that CKD can be a manifestation of long COVID. Furthermore, patients with CKD are at an increased risk of severe COVID-19 and of long COVID. COVID-19 has also been associated with the development of COVID-19-associated nephropathy, which is a collapsing form of focal segmental glomerulosclerosis, and an increased incidence of new-onset vasculitis. Some early reports described associations of COVID-19 and/or SARS-CoV-2 vaccines with relapse or new-onset of other glomerular diseases, but this link was not confirmed in large population-based studies. SARS-CoV-2 vaccination reduces the risk of COVID-19 and long COVID and is particularly important for protecting vulnerable populations such as patients with CKD. Structured long-term follow-up of patients with COVID-19 and post-infectious sequelae is needed to provide further insight into the trajectory of long COVID and enable identification of those at risk of CKD.}, } @article {pmid40908027, year = {2025}, author = {Alvis-Zakzuk, NJ and Couto, P and Jara, JH and Descalzo, M and Rondy, M and Tempia, S and Vicari, A}, title = {Economic Burden of Respiratory Viruses in Latin America and the Caribbean (LAC): A Scoping Literature Review.}, journal = {Influenza and other respiratory viruses}, volume = {19}, number = {9}, pages = {e70148}, pmid = {40908027}, issn = {1750-2659}, support = {/WHO_/World Health Organization/International ; }, mesh = {Latin America/epidemiology ; Humans ; Caribbean Region/epidemiology ; *Cost of Illness ; *COVID-19/economics/epidemiology ; *Respiratory Tract Infections/economics/virology/epidemiology ; SARS-CoV-2 ; Influenza, Human/economics/epidemiology ; Respiratory Syncytial Virus Infections/economics/epidemiology ; }, abstract = {OBJECTIVE: The objective of this study is to summarize the state of knowledge on the economic burden and cost of illness due to influenza, SARS-CoV-2, respiratory syncytial virus (RSV), and other respiratory viruses (ORV) in Latin America and the Caribbean (LAC).

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

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

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

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.

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.

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.

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.

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

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

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

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

RR2-10.31219/osf.io/mfujb.}, } @article {pmid40906317, year = {2025}, author = {Rodríguez-Duarte, MA and Vedel, IM and Cetin-Sahin, D and Bousbiat, I and Godard-Sebillotte, C and Sourial, N and Maclagan, LC and Diong, C and Bronskill, SE and Seitz, D and Morgan, D and Rochette, L and Massamba, V and Quail, J and Arsenault-Lapierre, G and , }, title = {A Meta-Analysis of Sex-Based Differences in Health Service Use for Persons Living With Dementia Between 2018 and 2020 in Four Canadian Provinces.}, journal = {Journal of the American Geriatrics Society}, volume = {}, number = {}, pages = {}, doi = {10.1111/jgs.70066}, pmid = {40906317}, issn = {1532-5415}, support = {//Consortium canadien en neurodégénérescence associée au vieillissement/ ; 02005VR5-448197-CSH-CFAA-19228/CAPMC/CIHR/Canada ; }, abstract = {BACKGROUND: Ensuring equitable healthcare services for persons with dementia is of utmost importance. Recent evidence points to sex-based differences in healthcare use in this population. However, available evidence is based on data from limited geographic regions and predates the COVID-19 pandemic, which is said to have further magnified disparities. This study aims to estimate sex-based differences in ambulatory and acute care service use in persons with dementia in four Canadian provinces between 2018 and 2020.

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

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

CONCLUSION: Consistent sex differences in healthcare use by persons with dementia were observed before and during the pandemic in four Canadian provinces, especially in acute care. This emphasizes the need to address sex-based differences in dementia care, ultimately working toward ensuring equitable and tailored healthcare services to enhance the quality of care and experiences for all persons with dementia.}, } @article {pmid40906116, year = {2025}, author = {Kotsiri, I and Xanthi, M and Domazinaki, CM and Magiorkinis, E}, title = {The Role of Viral Infections in the Immunopathogenesis of Type 1 Diabetes Mellitus: A Narrative Review.}, journal = {Biology}, volume = {14}, number = {8}, pages = {}, pmid = {40906116}, issn = {2079-7737}, abstract = {Type 1 diabetes mellitus (T1DM) is a chronic autoimmune disorder characterized by the destruction of insulin-producing pancreatic beta cells, resulting in lifelong insulin dependence. While genetic susceptibility-particularly human leukocyte antigen (HLA) class II alleles-is a major risk factor, accumulating evidence implicates viral infections as potential environmental triggers in disease onset and progression. This narrative review synthesizes current findings on the role of viral pathogens in T1DM pathogenesis. Enteroviruses, especially Coxsackie B strains, are the most extensively studied and show strong epidemiological and mechanistic associations with beta-cell autoimmunity. Large prospective studies-including Diabetes Virus Detection (DiViD), The environmental determinans of diabetes in the young (TEDDY), Miljøfaktorer i utvikling av type 1 diabetes (MIDIA), and Diabetes Autoimmunity Study in the Young (DAISY)-consistently demonstrate correlations between enteroviral presence and the initiation or acceleration of islet autoimmunity. Other viruses-such as mumps, rubella, rotavirus, influenza A (H1N1), and SARS-CoV-2-have been investigated for their potential involvement through direct cytotoxic effects, immune activation, or molecular mimicry. Interestingly, certain viruses like varicella-zoster virus (VZV) and cytomegalovirus (CMV) may exert modulatory or even protective influences on disease progression. Proposed mechanisms include direct beta-cell infection, molecular mimicry, bystander immune activation, and dysregulation of innate and adaptive immunity. Although definitive causality remains unconfirmed, the complex interplay between genetic predisposition, immune responses, and viral exposure underscores the need for further mechanistic research. Elucidating these pathways may inform future strategies for targeted prevention, early detection, and vaccine or antiviral development in at-risk populations.}, } @article {pmid40905595, year = {2025}, author = {Débarre, F and Hensel, Z}, title = {Theories of the origin of SARS-CoV-2 in the light of its continuing evolution.}, journal = {Comptes rendus biologies}, volume = {348}, number = {}, pages = {189-209}, doi = {10.5802/crbiol.183}, pmid = {40905595}, issn = {1768-3238}, mesh = {*SARS-CoV-2/genetics ; Humans ; *COVID-19/virology/epidemiology/transmission ; Animals ; Spike Glycoprotein, Coronavirus/genetics ; Pandemics ; Evolution, Molecular ; China/epidemiology ; Animals, Wild/virology ; Biological Evolution ; }, abstract = {The exact details of the emergence of SARS-CoV-2, the virus causing Covid-19, remain unknown. Scientific publications using data available to date point to a natural origin linked to the wildlife trade at a market in Wuhan, China. Yet, theories postulating a research-related origin of SARS-CoV-2 abound, and currently dominate the public discussion of the origin of the Covid-19 pandemic. Here, we attempt to characterize the diversity of research-related origin scenarios, discuss their characteristics and evidence base, or the lack thereof, and highlight mutual incompatibilities between some scenarios. We then focus on a feature of SARS-CoV-2 that is central in today's leading research-related hypotheses, namely the insertion that led to the introduction of a polybasic cleavage site in the spike glycoprotein. We examine various scenarios put forward to explain this insertion in a research-related context, and we show how SARS-CoV-2's evolution in humans has provided examples demonstrating that such insertions happen naturally.}, } @article {pmid40905188, year = {2025}, author = {Bromfield, SG and Periyasamy, R and Babu, VR and Puenpatom, A and Hill, DD}, title = {Effectiveness of molnupiravir for the treatment of COVID-19: a systematic literature review of real-world observational studies.}, journal = {Current medical research and opinion}, volume = {}, number = {}, pages = {1-22}, doi = {10.1080/03007995.2025.2551227}, pmid = {40905188}, issn = {1473-4877}, abstract = {OBJECTIVE: Molnupiravir (MOV), an oral antiviral, is prescribed to treat adult patients with mild-to-moderate COVID-19 at risk of progressing to severe disease. Previous systematic literature reviews (SLRs) have evaluated the effectiveness of MOV in the general population; however, evidence on high-risk population is lacking. This SLR assessed the real-world effectiveness of MOV for reducing the progression to severe COVID-19 outcomes in clinical settings, including high-risk or special populations (such as patients with type 2 diabetes, chronic respiratory diseases, immunocompromised conditions, older adults, and nursing home residents) who have limited alternative COVID-19 treatment options.

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

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

CONCLUSIONS: Findings from this SLR suggest that MOV may reduce the risk of hospitalization, death, and hospitalization/death compared with untreated groups, including high-risk adults with underlying comorbidities. Further studies are needed to confirm the effectiveness of MOV in high-risk or special populations.}, } @article {pmid40904859, year = {2025}, author = {Klaudel, T and Pelczarski, M and Zaborska, M and Sadowski, J and Ostrowska, SA and Drzymała, A and Bułdak, RJ}, title = {The impact of diabetes and obesity on the severity and mortality of SARS-CoV-2 infection.}, journal = {Journal of diabetes and metabolic disorders}, volume = {24}, number = {2}, pages = {195}, pmid = {40904859}, issn = {2251-6581}, abstract = {PURPOSE OF REVIEW: The purpose of the study was to collect and summarise information available in the scientific literature on the probable reasons that lead to negative outcomes of COVID-19 in patients with pre-existing obesity and /or type 2 diabetes mellitus and influence on their treatment as also mortality.

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

SUMMARY: Diabetes and obesity have a multifactorial impact on the risk of SARS-CoV-2 virus infection, as well as on the nature and dynamics of the development of the infection. In turn, the presence of these diseases significantly increased the risk of requiring intensified treatment, complications and ultimately death. Limited access to medical care systems due to the pandemic and the impact on everyday activities made it even more difficult to control diabetes and obesity, leading to the deterioration of patient's condition and the occurrence of new cases of disease. Therefore, it is necessary not only to appropriately modify treatment of those already infected, but also to use appropriate prevention to reduce the number of potential high-risk patients.}, } @article {pmid40904653, year = {2025}, author = {Rzymski, P and Dobrowolska, K and Brzdęk, M and Zarębska-Michaluk, D and Flisiak, R}, title = {Hepatic involvement in major respiratory viral infections.}, journal = {Clinical and experimental hepatology}, volume = {11}, number = {2}, pages = {121-128}, pmid = {40904653}, issn = {2392-1099}, abstract = {Common respiratory viral pathogens, including SARS-CoV-2, influenza viruses, and respiratory syncytial virus (RSV), can lead to extrapulmonary manifestations, including clinically significant liver involvement. This review synthesizes current evidence on the epidemiology, mechanisms, and prognostic implications of hepatic injury associated with these viruses. We discuss the distinct mechanisms of liver dysfunction, ranging from the possibility of direct viral infection of hepatocytes to indirect effects of systemic inflammatory responses, hypoxic injury, preexisting liver disease, and drug-related hepatotoxicity. Liver involvement in COVID-19 has been explored to a much greater extent than in the case of influenza or RSV infections, highlighting the need for further studies. Clinically, recognizing liver involvement in respiratory viral infections is crucial, particularly in high-risk populations such as patients with chronic liver disease, transplant recipients, and children. We underscore the importance of integrating hepatic evaluation into the clinical approach to severe respiratory viral illnesses to improve patient outcomes.}, } @article {pmid40904575, year = {2025}, author = {Shen, S and Zhao, X and Pei, J and Wang, B and Hou, J and Chai, R and Guo, Y and Li, F and Hao, J and Wu, Z}, title = {Exploring the psychological impact of long COVID: symptoms, mechanisms, and treatments.}, journal = {Frontiers in psychiatry}, volume = {16}, number = {}, pages = {1555370}, pmid = {40904575}, issn = {1664-0640}, abstract = {Long COVID (LC) refers to a multisystem condition that persists after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19). In addition to physical symptoms, the psychological impact is particularly pronounced. This review summarizes the manifestations, potential mechanisms, epidemiological characteristics, and current interventions related to psychological disorders in LC. Drawing on domestic and international literature, it highlights anxiety, depression, cognitive dysfunction, and post-traumatic stress disorder (PTSD) as the primary psychological symptoms. These symptoms may be associated with neuroinflammation, immune abnormalities, vascular dysfunction, and psychosocial stress. Although research in this area is still developing, psychotherapy, pharmacotherapy, neuromodulation, and lifestyle interventions show promise as treatment approaches. This review aims to provide insights that can inform future research on clinical treatments and psychological care for individuals with LC.}, } @article {pmid40904531, year = {2025}, author = {Sentell, T and Berreman, JM and Reichhardt, L and Grace, A and Yamauchi, J and Marshall, J and Withy, K}, title = {Quantifying the Public Health Workforce for Hawai'i: Current Data, Measurement Complexities, and Conceptual Frameworks for Next Steps.}, journal = {Hawai'i journal of health & social welfare}, volume = {84}, number = {7}, pages = {87-95}, pmid = {40904531}, issn = {2641-5224}, mesh = {Hawaii ; Humans ; *Public Health/methods/statistics & numerical data/trends ; *Health Workforce/statistics & numerical data/trends/standards ; COVID-19/epidemiology ; }, abstract = {The public health workforce is critical to community well-being and too often overlooked. The goal of public health is to prevent disease, promote health, and protect the public from current and emerging health threats. This work is vital to the health, safety, security, and prosperity of all communities and requires an adequate workforce. Despite the well-articulated gaps in the clinical health care workforce, Hawai'i's public health workforce needs and capacities are not as well understood. Public health workforce enumeration is complex. The field lacks a consistent definition of its full workforce and agreed-upon mechanisms for measuring it. Resolving these issues is an active area of scholarship and action, particularly given the COVID-19 pandemic-induced workforce capacity strain. This article reviews existing literature on public health workforce enumeration as a step toward filling this knowledge gap for practical use in the state of Hawai'i. Specifically, using a critical literature review method, this article (1) consolidates existing data about Hawai'i's public health workforce, (2) summarizes public health workforce measurement challenges, (3) shares existing frameworks and models for quantifying the public health workforce, and (4) discusses next steps to provide actionable information for ensuring Hawai'i's public health workforce can fulfill its mission. The article confirms that core public health functions as articulated in the (a) updated 10 Essential Public Health Services framework and (b) Foundational Public Health Services framework provide useful guidance for public health workforce enumeration in Hawai'i. The article also concludes that the US Department of Health and Human Services (HHS) definition of public health workers provides comprehensive framing for this enumeration. Based on this literature synthesis, a descriptive figure of the public health workforce in Hawai'i was developed to guide future work and prioritization.}, } @article {pmid40903638, year = {2025}, author = {Resende, GG and Sousa, LP and Teixeira, MM}, title = {Bridging worlds: a narrative review of IL-17 at the crossroads of inflammation and thrombosis.}, journal = {Inflammation research : official journal of the European Histamine Research Society ... [et al.]}, volume = {74}, number = {1}, pages = {118}, pmid = {40903638}, issn = {1420-908X}, mesh = {Humans ; *Interleukin-17/immunology/physiology/antagonists & inhibitors ; *Thrombosis/immunology ; *Inflammation/immunology ; Animals ; COVID-19/immunology/complications ; Extracellular Traps/immunology ; Platelet Activation ; Autoimmune Diseases/immunology ; }, abstract = {Interleukin-17 (IL-17) has emerged as a key cytokine at the intersection of inflammation and thrombosis, potentially playing a pivotal role in thromboinflammation. This review explores the mechanistic contributions of IL-17 to endothelial dysfunction, platelet activation, monocytes activation, and neutrophil extracellular trap (NET) formation, which collectively promotes a pro-thrombotic state. We summarize findings from experimental models and clinical studies linking IL-17 to thrombosis in autoimmune diseases, atherosclerosis, and infectious diseases such sepsis and COVID-19. Additionally, we discuss the therapeutic implications of IL-17 inhibition in mitigating thromboinflammatory complications. Understanding the role of IL-17 in this process may provide new avenues for targeted interventions in thromboinflammatory disorders.}, } @article {pmid40903166, year = {2025}, author = {Abdelkader, S and Voladri, DR and Kennedy, JL}, title = {Beyond respiratory syncytial virus and rhinovirus: The other viral respiratory bandits.}, journal = {Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology}, volume = {135}, number = {3}, pages = {249-260}, doi = {10.1016/j.anai.2025.06.012}, pmid = {40903166}, issn = {1534-4436}, mesh = {Humans ; *Asthma/virology/epidemiology/immunology ; COVID-19/epidemiology ; SARS-CoV-2 ; Respiratory Syncytial Virus Infections/epidemiology ; Rhinovirus ; *Respiratory Tract Infections/virology/epidemiology ; Picornaviridae Infections/epidemiology ; Influenza, Human/epidemiology ; Respiratory Sounds ; }, abstract = {Asthma affects approximately 25 million people in the United States, with respiratory viruses playing a significant role in both the onset and exacerbations of the condition. Although rhinovirus and respiratory syncytial virus (RSV) are the most well-known triggers, other iratory viruses playing a significant role in both the on, human parainfluenza virus, human bocavirus, enterovirus D68, influenza, and SARS-CoV-2 are increasingly recognized for their significant impact on asthma. These viruses contribute to both the development of asthma and exacerbations by inducing airway inflammation, disrupting epithelial barriers, and skewing immune responses-particularly toward type 2 inflammation. Human metapneumovirus and human parainfluenza virus, members of the Paramyxoviridae family such as RSV, have been linked to early life wheezing and long-term airway changes. Although often co-detected with other viruses, human bocavirus has been associated with recurrent wheezing and asthma risk. Enterovirus D68, notably during the 2014 outbreak, caused severe exacerbations in children with asthma. Influenza and SARS-CoV-2 can cause significant morbidity in those with asthma, even if they are not the primary drivers of exacerbations or onset. As RSV vaccines become more widespread, shifts in viral ecology may lead to increased prevalence of these lesser known viruses due to viral interference and immunity gaps. Understanding their epidemiology and mechanisms is crucial for addressing the evolving asthma burden. Comprehensive surveillance, improved diagnostics, and mechanistic research are essential for developing effective preventive strategies. Broadening the focus beyond rhinovirus and RSV will be critical to fully understand and mitigate the impact of asthma on childrenng be critical to fth.}, } @article {pmid40903129, year = {2025}, author = {Nascimento, ED and de Almeida, SV and Dos Santos Araújo, S and da Silva, PRL and Santos, VS and Faria, RC}, title = {A review of magnetic particles as separation tools in electrochemical detection of Biomarkers: Insights from COVID-19.}, journal = {Analytica chimica acta}, volume = {1372}, number = {}, pages = {344371}, doi = {10.1016/j.aca.2025.344371}, pmid = {40903129}, issn = {1873-4324}, mesh = {Humans ; *Biomarkers/analysis ; *Electrochemical Techniques/methods ; *COVID-19/diagnosis ; *Biosensing Techniques/methods ; SARS-CoV-2/isolation & purification ; }, abstract = {BACKGROUND: Magnetic particles (MPs) are widely used in bioanalytical systems to quickly separate specific targets from complex samples using a magnetic field. MPs can be easily functionalized with bioreceptors to capture, separate, and concentrate biomarkers like proteins, oligonucleotides, and cells. Combining MPs-separation capabilities with electrochemical sensors can greatly enhance the sensitivity of these devices, helping achieve ultralow limits of detection for biomarkers. Thus, MPs-based electrochemical bioassays have led to the development of highly sensitive and selective detection platforms for biomedical applications, with promising results for early disease diagnosis.

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

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

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

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

DISCUSSION: The growing threat posed by natural disasters underscores the need to develop business continuity programs and define risk mitigation measures to ensure the uninterrupted provision of radiotherapy services. By drawing lessons from past disasters, we can better prepare for future hazards, supporting disaster management and planning efforts, particularly enhancing the resilience of radiotherapy practice. Additionally, our study can serve as a resource for shaping policy initiatives aimed at mitigating the impact of natural hazards.}, } @article {pmid40901740, year = {2025}, author = {Raza, A and Zhang, R and Lu, R and Wen, J and Wu, W}, title = {Emerging lipid nanoparticle systems capable of efficient intramuscular RNA delivery.}, journal = {Nanomedicine (London, England)}, volume = {}, number = {}, pages = {1-25}, doi = {10.1080/17435889.2025.2555507}, pmid = {40901740}, issn = {1748-6963}, abstract = {Lipid nanoparticles (LNPs) enable RNA delivery, primarily via intramuscular (IM) injection, catalyzing breakthroughs like the Pfizer-BioNTech and Moderna COVID-19 vaccines. LNPs encapsulate RNA, using ionizable lipids for endosomal escape and PEG-lipids for stability. IM administration leverages muscle tissue's immune-rich environment, enabling localized antigen production, reduced systemic toxicity, and scalability. Challenges include cold-chain dependence, RNA instability, and immunogenicity from PEG/lipids. Future advancements, driven by AI (e.g. AGILE platform), hybrid lipid-polymer systems, and stimuli-responsive formulations, aim to enhance controlled release and stability. Innovations like thermostable lyophilized LNPs and biodegradable materials promise improved accessibility and safety. Beyond pandemics, LNPs hold potential for accelerating vaccines against HIV and malaria, and advancing personalized medicine through CRISPR therapies and cancer neoantigen vaccines. Interdisciplinary efforts in chemistry, immunology, and AI are poised to expand RNA therapeutics for genetic disorders, infectious diseases, and precision oncology. Evolving from emergency tools to mainstream platforms, LNPs herald a paradigm shift toward equitable access and tailored treatments for unmet clinical needs.}, } @article {pmid40901683, year = {2025}, author = {Miteva, DG and Gulinac, M and Peruhova, M and Velikova, T}, title = {Exploring the oncogenic potential of SARS-CoV-2 in the gastrointestinal tract.}, journal = {World journal of gastroenterology}, volume = {31}, number = {31}, pages = {105665}, pmid = {40901683}, issn = {2219-2840}, mesh = {Humans ; *COVID-19/complications/virology ; *SARS-CoV-2/pathogenicity ; *Gastrointestinal Neoplasms/virology/pathology/etiology ; *Gastrointestinal Tract/virology/pathology ; *Carcinogenesis ; }, abstract = {Recent research has increasingly highlighted the potential oncogenic effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection within the gastrointestinal tract. Growing evidence suggests that SARS-CoV-2 may contribute to the development of gastrointestinal malignancies through several mechanisms, including sustained chronic inflammation, disruption of normal cellular homeostasis, and potential viral integration into host cells. These pathological processes have the potential to dysregulate critical cellular pathways, thereby promoting cancer development in vulnerable populations. A thorough understanding of how SARS-CoV-2 interacts with the development of gastrointestinal cancer is essential for optimizing patient care and establishing comprehensive, long-term monitoring protocols. This review highlighted the pressing need for ongoing research into the complex relationship between SARS-CoV-2 infection and the risk of gastrointestinal cancer.}, } @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.

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

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

CONCLUSION: To overcome these barriers, the study emphasizes the need for effective policy-making to improve the quality of life for cancer patients during their care transition. It also becomes crucial to implement measures to improve communication protocols, validate culturally sensitive interventions, and routinely integrate palliative care in oncological practice early. We also need to work towards culturally appropriate interventions and strive to incorporate appropriate communication techniques to eliminate disparity for access to equitable palliative care.}, } @article {pmid40901024, year = {2025}, author = {Chen, N and Li, L and Han, Y and Chen, Z}, title = {The Role of Gut Microbiota in the Modulation of Pulmonary Immune Response to Viral Infection Through the Gut-Lung Axis.}, journal = {Journal of inflammation research}, volume = {18}, number = {}, pages = {11755-11781}, pmid = {40901024}, issn = {1178-7031}, abstract = {Viral respiratory infections, including influenza, respiratory syncytial virus (RSV), and SARS-CoV-2, remain major global health challenges due to their high morbidity and mortality. Emerging evidence highlights the pivotal role of the gut-lung axis in regulating pulmonary immunity. The gut microbiota communicates with the lungs via endocrine, immune, and neuroimmune pathways-particularly through metabolites such as short-chain fatty acids (SCFAs) and vagus nerve-mediated signaling-which modulate immune cells including alveolar macrophages and dendritic cells. Disruption of gut microbial balance has been linked to impaired pulmonary immune responses and increased susceptibility to infection. This review synthesizes findings from animal models and clinical studies, demonstrating that interventions such as probiotics (eg, Lactobacillus gasseri), prebiotics (eg, galacto-oligosaccharides), fecal microbiota transplantation (FMT), and Traditional Chinese Medicine (eg, Astragalus, curcumin) can enhance antiviral cytokine production, restore gut-lung homeostasis, and reduce lung inflammation. For example, FMT from H7N9-survivor mice improved influenza resistance in recipients, and oral probiotics reduced respiratory failure risk in COVID-19 patients. These findings suggest that gut-lung axis modulation is a promising adjunctive approach for treating viral respiratory infections. Future research should prioritize personalized microbiome-based therapies and large-scale clinical trials to validate efficacy and safety.}, } @article {pmid40900166, year = {2025}, author = {Torlot, L and Fischer, MR and Zwißler, B and Schroeder, I}, title = {[Hospital surge capacity volunteers in an emergency: a scoping review].}, journal = {Die Anaesthesiologie}, volume = {}, number = {}, pages = {}, pmid = {40900166}, issn = {2731-6866}, abstract = {BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic was marked by increased patient surge in hospitals around the world as well as significant staff shortages due to illness and isolation. Hospital preparedness plans in Germany should plan for staff surge capacity in the event of a future pandemic or disaster.

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

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

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

CONCLUSION: An increasing body of evidence describes including volunteers in preparedness plans within the clinical setting. Especially medical students seem to be a well-established surge capacity workforce that could be systematically planned into preparedness plans in the event of another pandemic or significant disaster in Germany.}, } @article {pmid40899610, year = {2025}, author = {Liu, X and Chen, L and Niu, H and Chen, Y and Chen, P and Liu, L and Wu, R}, title = {The bittersweet link between glucose metabolism, cellular microenvironment and viral infection.}, journal = {Virulence}, volume = {16}, number = {1}, pages = {2554302}, 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.

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

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

CONCLUSION: Despite challenges, digital technologies continue to reshape dental education, with VR, AR, AI, and online learning playing increasingly important roles. Future research should focus on standardized implementation guidelines and technology refinement to maximize their effectiveness in dental training.}, } @article {pmid40898404, year = {2025}, author = {Raiisi, F and Ahmadi, K}, title = {COVID-19 Anxiety and Psychological Interventions in Iran: A Systematic Review and Meta-Analysis.}, journal = {Disaster medicine and public health preparedness}, volume = {19}, number = {}, pages = {e254}, doi = {10.1017/dmp.2025.10170}, pmid = {40898404}, issn = {1938-744X}, mesh = {Humans ; Iran/epidemiology ; *COVID-19/psychology/complications ; *Anxiety/therapy/psychology/etiology ; *Psychosocial Intervention/methods/standards/statistics & numerical data ; }, abstract = {OBJECTIVES: The symptoms of anxiety in the outbreak of COVID-19 were so severe that they entered the research literature as the term COVID-19 anxiety. This systematic review and meta-analysis study aimed to identify the variables related to COVID-19 anxiety and the effectiveness of psychological interventions on it.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

PROSPERO REGISTRATION NUMBER: CRD42022355213.}, } @article {pmid40897326, year = {2025}, author = {You, Y and Huang, J and Zhu, X and Sheng, H and Liu, Y}, title = {Cytochrome P450 (CYP) 1 enzymes in acute lung injury: from molecular insights to therapeutic implications.}, journal = {Redox report : communications in free radical research}, volume = {30}, number = {1}, pages = {2550807}, pmid = {40897326}, issn = {1743-2928}, mesh = {Humans ; *Acute Lung Injury/enzymology/metabolism ; *Cytochrome P-450 CYP1B1/metabolism/genetics ; COVID-19/enzymology ; Oxidative Stress ; Animals ; *Cytochrome P-450 CYP1A1/metabolism/genetics ; Receptors, Aryl Hydrocarbon/metabolism ; SARS-CoV-2 ; Sepsis ; }, abstract = {OBJECTIVE: This review aims to explore the roles and mechanisms of cytochrome P450 subfamily 1 (CYP1) enzymes in acute lung injury (ALI), and to discuss their potential as therapeutic targets.

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

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

CONCLUSION: The distinct functions of CYP1 isoforms in ALI suggest their clinical relevance, highlighting the potential for isoform-specific targeting in the treatment of acute respiratory conditions.}, } @article {pmid40895839, year = {2025}, author = {Nigatu, BZ and Dessie, NT}, title = {Prevalence of comorbidities and their association with disease severity and mortality in COVID-19 patients: A systematic review and meta-analysis.}, journal = {Journal of multimorbidity and comorbidity}, volume = {15}, number = {}, pages = {26335565251371256}, pmid = {40895839}, issn = {2633-5565}, abstract = {BACKGROUND: Comorbidity among coronavirus disease-19 (COVID-19) patients contributes to increasing their susceptibility to severe illness. The objectives of this systematic review and meta-analysis were to assess the prevalence of comorbidities and their association in increased severity of disease and mortality in COVID-19 patients.

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

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

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

PROTOCOL REGISTRATION: This systematic review and meta-analysis study was registered under the registration number CRD42023493170.}, } @article {pmid40895553, year = {2025}, author = {Xu, J and Chen, X and Guan, X and Zhang, H and Liu, Y and Zhang, M}, title = {Therapeutic frontiers in viral myocarditis: targeting inflammation, viruses, oxidative stress, and myocardial repair.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1643502}, pmid = {40895553}, issn = {1664-3224}, mesh = {Humans ; *Myocarditis/virology/therapy/drug therapy ; Oxidative Stress/drug effects ; Antiviral Agents/therapeutic use ; COVID-19/complications ; SARS-CoV-2 ; Inflammation ; Animals ; Myocardium/pathology ; *Virus Diseases/therapy ; Parvovirus B19, Human ; }, abstract = {Viral myocarditis (VMC) is a life-threatening inflammatory cardiomyopathy with a global incidence rate of 10-22 per 100,000 people. It is the most common clinical manifestation of myocardial inflammation. Myocardial cell injury and fibrosis are the pathological characteristics of VMC. Coxsackievirus B3 (CVB3), parvovirus B19 (PVB19), Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), and adenovirus (AdV) are the main causes that induce viral myocarditis. Among them, CVB3 has become the main pathogen, accounting for more than 50% of the confirmed cases of VMC. The clinical manifestations of this disease are extensive, ranging from asymptomatic carriers to sudden cardiac death caused by acute decompensated heart failure and arrhythmia. Current therapeutic strategies for VMC focus on four key approaches: (1) Anti-inflammatory interventions targeting inflammatory cells and mediators; (2) Antiviral therapies employing gene editing, viral protease inhibitors, and RNA polymerase inhibitors; (3) Myocardial protection through tissue repair promotion and nutritional support; (4) Oxidative stress mitigation using antioxidants. This article will systematically summarize the progress of VMC management in recent years and provide personal insights for VMC management.}, } @article {pmid40895341, year = {2025}, author = {Sun, J and Dong, S and Gong, J and Xie, J and Yan, H}, title = {Human papillomavirus vaccination willingness and influencing factors among women in China: A systematic review and meta-analysis.}, journal = {Preventive medicine reports}, volume = {58}, number = {}, pages = {103215}, pmid = {40895341}, issn = {2211-3355}, abstract = {OBJECTIVE: This study aims to comprehensively review the human papillomavirus (HPV) vaccination willingness among Chinese women and explore the factors influencing their vaccination intentions.

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

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

CONCLUSIONS: Chinese women's overall willingness to receive the HPV vaccine remains below the World Health Organization (WHO)'s 90 % target, with significant disparities across subpopulations. Targeted public health efforts are urgently needed to enhance vaccine awareness and acceptance, especially among women in rural or underdeveloped areas, with lower education, non-medical backgrounds, or no family history of cancer.}, } @article {pmid40895261, year = {2025}, author = {Samadani, AA and Vahidi, S and Babaei, K and Norollahi, SE and Delpasand, K and Gharakhyli, EA}, title = {Comprehensive and translational pathobiology of COVID-19 based on cellular and molecular techniques.}, journal = {Practical laboratory medicine}, volume = {46}, number = {}, pages = {e00497}, pmid = {40895261}, issn = {2352-5517}, abstract = {The biggest health issue in the world right now is the COVID-19 pandemic. This outbreak has caused a lot more people to be hospitalized for pneumonia and serious health problems, leading to many deaths. This report talks about many studies that showed the causes and how common COVID-19 is, as well as how to diagnose it in clinics and labs, and how to prevent and control it. These studies are very important and directly related to COVID-19 to help manage the current public emergency. Many parts of this dangerous disease, like how it spreads, how to diagnose it, how it infects people, and how to treat it, are still not well understood. It's important that to prevent, diagnose, and treat COVID-19 well, we need research at the molecular and clinical levels, along with public health measures and medical treatments. Clearly, new treatments like mesenchymal stem cell therapy have shown great promise in this area. Here, we will talk about and show the advanced lab methods used to understand how COVID-19 spreads, how it is diagnosed, and how it can be treated.}, } @article {pmid40894189, year = {2025}, author = {Ajibade, AA and Sethi, R and Lee, CJ and Post, ER and Meeks, SO and Alligood, T and Rainwater-Lovett, K and Kimball, MM and Leone, R and Zanker, M and Freeman, JD and Kirsch, TD}, title = {The Need to Incorporate Post-Acute Care Entities Into the National Disaster Medical System.}, journal = {Journal of the American College of Emergency Physicians open}, volume = {6}, number = {5}, pages = {100237}, pmid = {40894189}, issn = {2688-1152}, abstract = {The National Disaster Medical System (NDMS) is critical to healthcare preparedness and response in the United States but currently has limited capacity for handling large-scale mass-casualty surge events. Crises, such as the COVID-19 pandemic, have shown how quickly the US healthcare system can become overwhelmed, necessitating novel solutions for handling a large-scale influx of patients. This paper proposes the inclusion of post-acute care (PAC) entities, which provide long-term care rehabilitation and short-stay subacute rehabilitation support rather than acute or critical care, into the NDMS as one solution to increase its capacity during mass-casualty surges. By reviewing the unique capabilities and functions of PAC entities and considering evidence of their role in national emergencies, this paper demonstrates that PAC entities are well positioned to support the wider healthcare system in managing a mass influx of patients. We base this assertion on 4 points: (1) the support role PAC entities traditionally play for over-capacity hospitals by providing extra space for stabilized patients, (2) PAC entities' capacity to adapt their functions beyond PAC to support overall community response, (3) recent federal emergency preparedness requirement changes that increase PAC entities' disaster response capabilities, and (4) interim outcomes of NDMS efforts toward NDMS inclusion of PAC entities. We conclude by outlining challenges to integrate PAC entities into the NDMS and highlighting ongoing work by the congressionally directed NDMS Pilot Program, which is designed to increase capacity across the system. However, challenges such as limited staffed bed capacity at PAC entities, reduced availability of emergency medical service ambulances, and ongoing staffing shortages will need to be addressed.}, } @article {pmid40893900, year = {2025}, author = {Fama, F and Fattore, R and Raimondo, P and Brivio, F and Holmes, D and Muheberimana, T and Nayfeh, T and Bandera, A and Gori, A and Passerini, M and Colaneri, M}, title = {The impact of SARS-CoV-2 VOCs on clinical outcomes: an overview of reviews.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1624459}, pmid = {40893900}, issn = {2296-858X}, abstract = {BACKGROUND: Synthesizing data from existing literature is crucial for validating the robustness of associations, assessing data quality, and forming recommendations, especially given the vast amount of information available on SARS-CoV-2. This study aims to conduct an overview of reviews to evaluate the strength and validity of associations between VOCs and specific clinical outcomes in COVID-19 patients.

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

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

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

This overview of reviews was registered in PROSPERO, CRD42024500841; https://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42024500841.}, } @article {pmid40893194, year = {2025}, author = {Wister, A and Kim, B and Levasseur, M and Poulin, V and Qiu, S and Yuwono, E and Meynet, S and Beadle, J and Kadowaki, L and Klasa, K and Linkov, I}, title = {Resilience applications to social isolation and loneliness in older adults: a scoping review to develop a model and research agenda.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1589781}, pmid = {40893194}, issn = {2296-2565}, mesh = {Humans ; *Loneliness/psychology ; *Social Isolation/psychology ; *Resilience, Psychological ; *COVID-19/psychology/epidemiology ; Aged ; Social Support ; Adaptation, Psychological ; SARS-CoV-2 ; }, abstract = {BACKGROUND: The development of a theoretical model applied to social isolation and loneliness (SI/L) among older adults has not kept pace with the exponential growth in empirical research, especially since the COVID-19 pandemic. One promising but under-investigated area is the contribution of resilience models to this field. This paper provides a scoping review of the application of resilience theoretical models to social isolation and loneliness and suggests directions for the development of an integrated new model.

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

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

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

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

DESIGN: Critical discussion paper.

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

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

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

To support student nurses in UG professional preparation programmes which rely on SBE as well as clinical practice and universities, shared values between nurse educators and clinical nurses need to be enacted collaboratively. This could be achieved by reframing how students and nurses learn and rework knowledge across sites of learning.}, } @article {pmid40890766, year = {2025}, author = {Herdiana, H and Prameswari, HD and Puspadewi, RT and Fajariyani, SB and Diptyanusa, A and Theodora, M and Supriyanto, D and Hawley, WA}, title = {Shrinking the malaria map in Indonesia: progress of subnational control, elimination, and future strategies.}, journal = {BMC medicine}, volume = {23}, number = {1}, pages = {512}, pmid = {40890766}, issn = {1741-7015}, mesh = {Indonesia/epidemiology ; Humans ; *Malaria/epidemiology/prevention & control/transmission ; *Disease Eradication/methods ; COVID-19/epidemiology ; }, abstract = {BACKGROUND: Indonesia has a complex pattern of malaria transmission alongside a highly decentralized system of governance. Indonesia applies a subnational elimination strategy to achieve nationwide malaria elimination by 2030. This review describes Indonesia's subnational verification process, assesses progress towards subnational elimination over the past several decades, and explores strategies to accelerate achievement of elimination, including the challenges of high transmission in lowland Papua region and zoonotic malaria in Sumatra and Kalimantan islands.

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

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

CONCLUSIONS: Existing interventions will need to be well-managed, and new combinations of interventions implemented if Indonesia is to achieve its goal of malaria elimination by 2030, particularly in high-endemic Papua, which will remain a source of importation of malaria to other regions of Indonesia if malaria there is not eliminated.}, } @article {pmid40889099, year = {2025}, author = {Pfefferbaum, B}, title = {Mass Trauma in Children: Expanding the Concept of Exposure in the Context of the COVID-19 Pandemic.}, journal = {Current psychiatry reports}, volume = {}, number = {}, pages = {}, pmid = {40889099}, issn = {1535-1645}, abstract = {PURPOSE OF REVIEW: This review examined the concept of exposure in children in the context of the COVID-19 pandemic. Recognizing the varied effects of the pandemic on children across a range of experiences, the review departed from the frequently-used analytic framework based on the stressor criterion for a diagnosis of posttraumatic stress disorder (PTSD).

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

CONCLUSIONS: While many COVID-19 experiences would not qualify as exposure for a diagnosis of PTSD, the research recognizes the importance of these experiences and their influence on various outcomes in children.}, } @article {pmid40889005, year = {2025}, author = {Kumari, N and Raja, K}, title = {Potential Application of Carbon Dots for Sustainable Agriculture: Current Challenges and Future Prospects.}, journal = {Journal of fluorescence}, volume = {}, number = {}, pages = {}, pmid = {40889005}, issn = {1573-4994}, abstract = {The depletion of arable land, water scarcity, frequent climate fluctuations, the onset of the COVID-19 pandemic, inefficiencies in pesticide usage, and the Ukraine-Russia conflict, which disrupted global supplies of fertilisers, have collectively heightened crop strain and reduced agricultural productivity. In this regard, to overcome these agriculture problems, adopting a sustainable approach for agricultural production plays a significant role in ensuring global food security. Carbon dots, a novel member of the carbon-based nanomaterial's family with extraordinary properties such as chemical stability, water solubility, low cytotoxicity, small size, biocompatibility, and photoluminescence, have recently attracted attention in agriculture sectors. The abundant hydrophilic functional groups on the surface of carbon dots, together with their small size and structural features, provide several advantages, such as increased crop growth, improved photosynthesis, stress tolerance, and accelerated seed germination. Carbon dots have also shown impressive advantages in nutrient uptake, and acting as sensors for pesticides, herbicides, and nutrients. Furthermore, carbon dots facilitate precise gene delivery into plant cells creating opportunities for genetic improvement and also enhance post-harvest preservation. This review highlights the potential of carbon dots in the field of agriculture, covering their classification, source of synthesis, and their diverse applications in the field of agriculture. While their potential is vast, further research is essential to address toxicological concerns and environmental impacts to ensure their safe and effective integration into agricultural system. Lastly, the limitations and future perspectives are outlined, which need to be focused on promoting the potential application of carbon dots in the agricultural sector.}, } @article {pmid40887716, year = {2025}, author = {Miyashita, N}, title = {Contemporary Concise Review 2024: Respiratory Infections.}, journal = {Respirology (Carlton, Vic.)}, volume = {}, number = {}, pages = {}, doi = {10.1111/resp.70113}, pmid = {40887716}, issn = {1440-1843}, abstract = {Since public health measures against COVID-19 were relaxed, widespread outbreaks of respiratory infections such as influenza and respiratory syncytial virus (RSV), as well as infectious diseases transmitted by droplets and droplet nuclei, have been reported around the world. While there is evidence of antiviral drug efficacy against non-severe influenza, the emergence of two genetic mutations (I223V or S247N) that reduce susceptibility to neuraminidase inhibitors has been confirmed. Influenza vaccines are less effective in older people than in younger people; so high-dose influenza vaccines are recommended. RSV infection has a high disease burden among elderly people; however, vaccination is expected to limit or prevent severe disease. Macrolide-resistant strains of Mycoplasma species and Bordetella pertussis are common in East Asia, but an increase in resistant strains has also been observed in other Asian regions. Pneumonia in elderly people often leads to a decline in physical function. In a super-aging society, aspiration pneumonia occurs frequently. Hence, there is increasing awareness of the need for advance care planning discussions for pneumonia as well as malignant diseases. The use of inhaled steroids in bronchiectasis is not recommended because of the increased risk of infection; but in clinical practice, inhaled steroids are frequently used and are effective in some patients with bronchiectasis.}, } @article {pmid40886810, year = {2025}, author = {Bahrami, Y and Bolideei, M and Mohammadzadeh, S and Gahrouei, RB and Mohebbi, E and Haider, KH and Barzigar, R and Mehran, MJ}, title = {Applications of artificial intelligence and nanotechnology in vaccine development.}, journal = {International journal of pharmaceutics}, volume = {684}, number = {}, pages = {126096}, doi = {10.1016/j.ijpharm.2025.126096}, pmid = {40886810}, issn = {1873-3476}, abstract = {Vaccines have long been crucial in safeguarding public health by preventing and controlling infectious diseases. However, traditional vaccine development methods face challenges in efficiency, cost, and response time to emerging pathogens. Recent progress in art AI and nanotechnology is revolutionizing this landscape, offering innovative solutions for vaccine design, delivery, and optimization. This manuscript examines the transformative impact of AI and nanotechnology on advancing vaccine development, highlighting their synergistic effect in overcoming traditional limitations. AI, particularly machine learning (ML) and deep learning (DL) algorithms, facilitates rapid identification of immunogenic antigens and epitopes by analyzing vast genomic, proteomic, and immunological datasets. These computational tools optimize vaccine design by predicting antigen stability, immunogenicity, and efficacy, as exemplified by the expedited development of COVID-19 vaccines. Nanotechnology complements these advancements by providing engineered nanoparticles (NPs), including liposomes, polymeric NPs, and biomimetic systems, that enhance antigen delivery, stability, and immune activation. Innovations such as virus-like particles (VLPs) and immune-stimulating complexes (ISCOMs) further enhance vaccine safety and efficacy by mimicking natural infection processes to trigger robust, targeted immune responses. Integrating AI and nanotechnology presents remarkable opportunities for developing personalized immunization strategies. AI algorithms can assess individual immune profiles to design customized vaccines, while nanotechnology enables precise delivery and controlled release of antigens. This interdisciplinary approach accelerates vaccine development, ensuring both safety and efficacy, and lays the foundation for universal vaccines and cancer vaccines that target complex pathogens and non-infectious diseases. Together, AI and nanotechnology herald a new era in vaccinology, enabling the development of vaccines that are faster, more precise, and highly adaptable to emerging and complex health challenges.}, } @article {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, É and Kulcsár, A and Onozó, B and Pék, T and Tróbert-Sipos, D and Mészner, Z and Lakatos, B and Kassa, C and Bereczki, C and Decsi, T and Szabó, T and Szabó, JA}, title = {[RSV infections: characteristics and prevention strategies].}, journal = {Orvosi hetilap}, volume = {166}, number = {35}, pages = {1362-1373}, doi = {10.1556/650.2025.33364}, pmid = {40886308}, issn = {1788-6120}, mesh = {Humans ; *Respiratory Syncytial Virus Infections/prevention & control/epidemiology ; *Respiratory Syncytial Virus Vaccines/administration & dosage ; COVID-19 ; Vaccination ; Respiratory Syncytial Virus, Human/immunology ; }, 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 & dosage ; Influenza Vaccines/immunology ; SARS-CoV-2/immunology ; Hepatitis B Vaccines/immunology ; COVID-19/prevention & control/immunology ; }, abstract = {The gut microbiota has emerged as a key modulator of host immune responses, and growing evidence suggests it plays a role in shaping vaccine-induced immunity. While immunization remains vital for preventing infectious diseases, inter-individual variability in vaccine responses poses a persistent challenge. Traditional factors such as age, sex, genetics, and immune status do not fully account for this variability. Recent studies highlight the gut microbiome as a potential contributor. This review examines current evidence linking the gut microbiota to vaccine responses, with a focus on vaccines against SARS-CoV-2, hepatitis B virus, and influenza. Human studies show associations between microbial composition, particularly taxa like Bifidobacterium adolescentis, and immunogenicity. Microbial metabolites, such as short-chain fatty acids and bile acids, influence T-cell differentiation, antibody production, and cytokine responses. Factors that alter microbiota composition, including antibiotics, diet, and prebiotic or probiotic supplementation, can impact vaccine responses, highlighting a dynamic gut-immune relationship. Experimental models further support these observations, showing diminished responses in germ-free or antibiotic-treated animals and enhanced responses following microbial-based interventions. These findings also suggest the gut microbiota may be harnessed to improve vaccine efficacy. Future research should explore the potential for microbiota-targeted strategies to optimize vaccine efficacy, particularly in immunocompromised populations.}, } @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 & administration ; *Delivery of Health Care/organization & administration ; COVID-19/epidemiology ; Health Policy ; *Health Priorities ; }, abstract = {Health systems are under growing pressure from ageing populations, chronic diseases, and financial constraints, compounded by challenges, such as COVID-19 and climate change. In Greece, these pressures have converged in the past 15 years, exposing structural weaknesses and testing the health system's resilience. Despite successive reforms targeting funding, care delivery, and public health, persistent structural weaknesses, poor planning, and limited monitoring have undermined progress. Most policy responses have remained fragmented and are unable to fulfil their potential to address current public health challenges or prepare for future crises. Building health system sustainability and resilience requires more than enacting reforms. The reform process demands evidence-informed policy making, sustained political commitment, strong institutional capacity, and effective multisectoral coordination. Greece offers valuable lessons for countries facing similar pressures: resilience depends not only on policy adoption, but also on the institutions, resources, and accountability mechanisms that support implementation and translate policies into sustained action.}, } @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 & administration ; *Pandemics ; *Laboratories/organization & administration ; SARS-CoV-2 ; World Health Organization ; }, abstract = {BACKGROUND: Laboratory systems play a crucial role in managing diseases effectively, and the COVID-19 pandemic serves as a prime example. The pandemic underscored the need to make laboratory health systems more resilient and robust to respond to future pandemics.

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

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

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

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

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

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

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.

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.

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-γ) 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.

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 & 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 + SUBVENCIÓN A INSTALACIÓN EN LA ACADEMIA CONVOCATORIA AÑO 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.

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.

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.

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.

OBJECTIVES: The objective of this review was to assess the effects of various interventions designed to increase vaccination uptake among adults.

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.

SELECTION CRITERIA: Randomized trials were eligible for inclusion in this review, regardless of publication status or language.

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.

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).

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 & numerical data ; Alanine/analogs & derivatives/therapeutic use ; Adenosine Monophosphate/analogs & 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.

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.

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).

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 & derivatives/therapeutic use ; Alanine/analogs & 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 Américas, 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 & 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 & dosage/adverse effects ; *Chickenpox/epidemiology/prevention & 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 & 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.

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.

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.

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 = {№ 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 & 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.

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.

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.

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&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.

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.

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]).

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.

TRIAL REGISTRATION: PROSPERO, CRD42024587910.}, } @article {pmid40881746, year = {2025}, author = {Bozkurt, HB and Özdemir, Ö}, title = {Changes regarding solid organ transplantation during the COVID-19 pandemic.}, journal = {World journal of transplantation}, volume = {15}, number = {3}, pages = {100591}, pmid = {40881746}, issn = {2220-3230}, abstract = {Coronavirus disease 2019 is caused by severe acute respiratory syndrome coronavirus 2 and emerged in Wuhan, China. It affects millions of people all over the world and has caused the deaths of thousands of people. Mortality rates were higher in transplant recipients and patients awaiting transplantation due to social and psychological issues. It also affected candidates who would be transplant providers and caused the transplant chain to be broken worldwide. The coronavirus disease 2019 pandemic has significantly affected solid organ transplantation procedures and led to various changes in protocols and practices to ensure patient safety and increase transplant success. These include challenges in screening protocols, prioritization of cases, telemedicine and virtual consultations, modified surgical procedures, immunosuppression management, updated research and guidelines, post-transplantation process and difficulties to control side effects, difficulties in organ procurement, and patient education/support. It requires a multidisciplinary approach, close collaboration between transplant teams, and adherence to strict infection control measures to ensure the safety of both transplant recipients and healthcare providers. In this article, we compiled the most important points in an overview of this process.}, } @article {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 & control ; *SARS-CoV-2/immunology ; *Respiratory Syncytial Virus Infections/immunology/prevention & control ; Animals ; *COVID-19 Vaccines/immunology ; *Respiratory Tract Infections/immunology/prevention & control/virology ; *Influenza, Human/immunology/prevention & control ; *Viral Vaccines/immunology ; T-Lymphocytes/immunology ; Respiratory Syncytial Virus Vaccines/immunology ; }, abstract = {Respiratory tract infections, such as influenza, respiratory syncytial virus (RSV) infection, and COVID-19, remain a persistent threat to global public health due to their high transmissibility and disease burden. Vaccination, as a key preventive strategy, not only reduces the risk of infection but also blocks transmission by activating adaptive immunity. While traditional vaccine evaluations have primarily focused on humoral immunity, growing evidence highlights the critical role of T lymphocyte-mediated cellular immunity in clearing virus-infected cells, establishing long-term immune memory, and responding to viral mutations. This review systematically summarizes the cellular immune responses induced by vaccines against respiratory tract infections and their correlation with protective efficacy. It also outlines evaluation methodologies such as flow cytometry, providing a theoretical foundation for optimizing vaccine design and assessment, and advancing the development of effective, broad-spectrum vaccines.}, } @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.

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.

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.

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.

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.

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 = {}, number = {}, pages = {1-6}, doi = {10.1159/000548075}, pmid = {40875678}, issn = {2504-2106}, 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 = {}, number = {}, pages = {e0192125}, doi = {10.1128/mbio.01921-25}, pmid = {40874746}, issn = {2150-7511}, abstract = {Alphacoronaviruses are widespread but understudied in comparison to betacoronaviruses. Within the alphacoronaviruses is the species Alphacoronavirus-1, which comprises distinct viruses of cats, dogs, and pigs, along with a separate species that infects mustelids-as well as other related viruses of pigs and circulating human viruses. High-pathogenicity feline coronavirus (FCoV) is infamous as the cause of feline infectious peritonitis (FIP), existing as two distinct genotypes (types 1 and 2) and transmitted as a low-pathogenicity virus. The high-pathogenicity variants arise in cats infected with FCoV, and while the mutations responsible remain enigmatic, the main determinant is the spike glycoprotein. FCoV-1 disease outcome is driven by a combination of both within- and between-host evolution. Virulence can be largely explained by the "internal mutation hypothesis," which argues that high-pathogenicity-but poorly transmissible-variants are selected in individual cats. Canine coronaviruses are generally considered low pathogenicity but can cause severe enteritis and can be systemic. Notably, the canine coronavirus spike gene periodically recombines with FCoV-1 to generate FCoV-2, exemplified by FCoV-23, which has caused a widespread outbreak of FIP in Cyprus and has a notably truncated spike N-terminal domain (NTD). In pigs, coronaviruses often cause severe gastrointestinal disease but can become respiratory and have low pathogenicity based on what can also be considered an "internal deletion" of the spike NTD. These viruses may exist as a dynamic "metavirome" (the sum of all viral genomes present in a sample) that is in a constant state of flux, presenting notable challenges for disease surveillance and management.}, } @article {pmid40873776, year = {2025}, author = {Busis, NA and Alexander, CM and Castner, J and Singer, S and Smith, CD and Bernstein, CA and Hoyt, DB and Tran, TA and Cipriano, P}, title = {A Path to Improved Health Care Worker Well-being: Lessons from the COVID-19 Pandemic.}, journal = {NAM perspectives}, volume = {2025}, number = {}, pages = {}, pmid = {40873776}, issn = {2578-6865}, } @article {pmid40873637, year = {2025}, author = {Wang, L and Wang, L and Dong, C and Liu, J and Cui, G and Gao, S and Liu, Z}, title = {Exploring the Potential and Advancements of Circular RNA Therapeutics.}, journal = {Exploration (Beijing, China)}, volume = {5}, number = {4}, pages = {e20240044}, pmid = {40873637}, issn = {2766-2098}, abstract = {Messenger RNA (mRNA) technology is revolutionizing the pharmaceutical industry owing to its superior safety profile, manufacturing capabilities, and potential applications in previously undruggable therapeutic targets. In addition to linear mRNA, such as conventional mRNA, self-amplifying mRNA, and trans-amplifying mRNA, circular mRNA has emerged as a promising candidate. Circular RNA (circRNA) is a class of single-stranded RNA with a covalently closed loop structure that offers enhanced stability compared to linear RNA by resisting degradation from RNases. Recent studies have revolutionized our understanding of their biological functions, surpassing the notion that they are merely byproducts of aberrant splicing events. Given the remarkable success achieved in cancer and SARS-CoV-2/monkeypox virus (MPXV) vaccines, circRNA is being intensively investigated for gene and cell therapies. In this review, we provide an overview of circRNA biogenesis mechanisms in vivo, along with synthesis strategies in vitro, while discussing translation regulation mechanisms and quality control processes involved in circRNA production. Furthermore, we explore the potential application scenarios for circRNAs.}, } @article {pmid40873308, year = {2025}, author = {He, L and Liu, Z and Yang, H and Li, Y and Zhang, H}, title = {[Research progress in application of field effect transistor biosensors in virus detection].}, journal = {Sheng wu gong cheng xue bao = Chinese journal of biotechnology}, volume = {41}, number = {8}, pages = {3021-3035}, doi = {10.13345/j.cjb.240882}, pmid = {40873308}, issn = {1872-2075}, mesh = {*Biosensing Techniques/methods/instrumentation ; *Transistors, Electronic ; Humans ; SARS-CoV-2/isolation & purification ; *Viruses/isolation & purification ; Orthomyxoviridae/isolation & purification ; Hepatitis Viruses/isolation & purification ; *Virus Diseases/diagnosis/virology ; HIV/isolation & purification ; COVID-19/diagnosis ; }, abstract = {Viral infections are one of the main causes of deaths and economic losses around the globe, and effective virus detection methods are essential for epidemic prevention and control. Most existing detection methods have problems such as high false negative/positive rates, slow responses, high costs, and dependence on professional equipment and personnel, which are not conducive to the rapid and accurate detection of viruses. Field effect transistor (FET) biosensors have attracted widespread attention due to their advantages of label-free detection, high sensitivity, fast responses, real-time measurement, low power consumption, and small sizes for portability. This article first briefly describes the basic situation of viruses and the structure and detection principle of FET biosensors. Subsequently, it delves into the research achievements in the application of FET biosensors in the detection of influenza viruses, hepatitis viruses, human immunodeficiency virus, and severe acute respiratory syndrome coronavirus 2. Finally, we make a comprehensive summary and reasonable outlook on the role played by FET biosensors in biomedicine.}, } @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 & 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 & 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.

OBJECTIVE: To review the existing literature on CSB, for Long COVID, focusing on symptom outcomes, proposed mechanisms, and procedural considerations.

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.

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.

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.

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

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

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

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.

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 & numerical data ; Telemedicine ; Home Care Services/organization & 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.

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'.

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.

SETTING: The Netherlands.

Hospitals that initiated an early discharge programme for COVID-19 patients.

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.

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.

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.

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.

DATA SOURCES: PubMed, Scopus, Web of Science, Google Scholar and Scientific Information Database.

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.

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.

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.

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 & control ; *mRNA Vaccines/immunology ; Bacterial Infections/prevention & control ; Parasitic Diseases/prevention & 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}, doi = {10.7705/biomedica.7423}, pmid = {40865105}, issn = {2590-7379}, mesh = {Humans ; *COVID-19/epidemiology/prevention & control ; *Meningococcal Vaccines ; *Neisseria meningitidis, Serogroup B/immunology ; *Meningococcal Infections/prevention & control/epidemiology ; *Meningitis, Meningococcal/prevention & 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 {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 & 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 & 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.

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.

RESULTS: Twenty-eight studies were examined. The exposed population sampled 1 476 827, and the total sample was 23 819 822. 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.

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 & 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.

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.

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: -1.07%) before rising (APC: 6.41%). Non-metropolitan areas had an AAMR of 58.9, decreasing from 1999 to 2017 (APC: -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.

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.

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.

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.

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 & numerical data ; *Immunocompromised Host ; Intensive Care Units/statistics & 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.

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.

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.

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 & control/transmission/virology ; *Anti-Infective Agents/pharmacology ; *Filtration/instrumentation ; *SARS-CoV-2/isolation & 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 {pmid40848849, year = {2025}, author = {, }, title = {Rapid-sequence clinical research before and during a pandemic: Lessons learned and the way forward.}, journal = {Infectious diseases now}, volume = {55}, number = {7}, pages = {105135}, doi = {10.1016/j.idnow.2025.105135}, pmid = {40848849}, issn = {2666-9919}, abstract = {In the aftermath of the COVID-19 pandemic, the structuring of a nationwide research network for preparation and response to emerging infectious diseases (EID) with epidemic or pandemic potential has become increasingly essential. A nationwide EID operational research network (OPEN-ReMIE),is funded for five years through the France 2030 program and run by the French national research agency (ANR). Its primary missions are to accelerate hospital-based clinical research under epidemic or pandemic conditions with academic or industrial sponsors, and to pursue this effort in international research networks. OPEN-ReMIE governance is geared to steering this network and to guaranteeing its operability in inter- as well as crisis modes. It will be the point of entry for key international trial platforms, academic and private sponsors, regulatory agencies, associations of citizens and patients, and think tanks committed to promoting scientific integrity. OPEN-ReMIE encompasses six work packages: (i) regulatory affairs, sponsoring, fast-track procedures and contracts; (ii) clinical site network management; (iii) methodology and management centers to provide methodological expertise (generic master protocols, sets of core and extended variable catalogs, electronic case reports form templates, data management and interoperability, monitoring…); (iv) laboratory and biological resource center management; (v) drug supply and pharmacovigilance supervisory board; (vi) training programs and communication plans for various stakeholders: research teams, healthcare professionals, students, associations of citizens and patients and, increasingly, civil society actors. All in all, OPEN-ReMIE is a nationwide "preparedness task force" embedded in a large-scale European consortium for EID clinical research and working with other international EID clinical research platforms.}, } @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 & dosage ; Humans ; *COVID-19/prevention & 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.

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.

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.

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.

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.

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.

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 < 0.01), and recovery rates (HR 1.18; 95% CI [1.11;1.26]; p < 0.01) in patients with mild to moderate COVID-19. However, 3CL protease inhibitors significantly reduced viral load at 72 h (SMD − 0.95; 95% CI [-1.23; -0.66]; p < 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 = 0.147).

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.

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 = {}, number = {}, pages = {e70108}, doi = {10.1111/eci.70108}, pmid = {40844222}, issn = {1365-2362}, support = {//Gilead Sciences Srl Italy/ ; }, 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.

METHODS: Narrative review of current evidence regarding remdesivir in the treatment of COVID-19 in patients with hematologic malignancy.

RESULTS: Patients with non-severe COVID-19 should receive remdesivir as soon as possible after diagnosis, and within 7 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 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.

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.

OBJECTIVE & 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.

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.

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).

OBJECTIVE: To analyze the characteristics of tinnitus in subjects affected by COVID-19 while detailing the correlation between these two factors.

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.

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.

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.

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.

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.

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 & control ; *COVID-19/epidemiology/prevention & control ; Bordetella pertussis ; Infant ; Child ; Anti-Bacterial Agents/therapeutic use ; Pertussis Vaccine ; Global Health ; Infant, Newborn ; SARS-CoV-2 ; Vaccination Coverage/statistics & numerical data ; }, abstract = {PURPOSE OF REVIEW: Against the WHO's report of 84% diphtheria-pertussis-tetanus (DPT) primary vaccination coverage globally, the resurgence of pertussis (whooping cough), contributing factors and measures to control it are described.

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

SUMMARY: Pertussis maybe curtailed with public education, active clinical and microbiological surveillance, appropriate antimicrobial treatment and prophylaxis, public health reporting, infection control and optimized immunizations to reduce attributable morbidity and mortality.}, } @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 = {}, number = {}, pages = {}, doi = {10.1111/anae.16731}, pmid = {40842319}, issn = {1365-2044}, 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.

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.

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.

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}, 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}, 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.

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.

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.

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.

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 & control/statistics & numerical data ; *Emergency Nursing ; Emergency Service, Hospital/organization & 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.

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.

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.

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 {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 = {}, number = {}, pages = {}, doi = {10.1177/15305627251370936}, pmid = {40839011}, issn = {1556-3669}, 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 = {}, number = {}, pages = {}, doi = {10.1111/pace.70036}, pmid = {40838527}, issn = {1540-8159}, 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 & 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.

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.

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.

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.

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.

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.

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.

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.

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.

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 & control/epidemiology/immunology ; *Pertussis Vaccine/administration & dosage/immunology ; COVID-19/epidemiology/prevention & control ; Vaccines, Acellular/administration & dosage/immunology ; South America/epidemiology ; Female ; Central America/epidemiology ; Vaccination Coverage/statistics & numerical data ; Immunization, Secondary ; Vaccination ; Chile/epidemiology ; Immunization Programs ; Adolescent ; }, abstract = {INTRODUCTION: Pertussis remains a public health concern despite widespread vaccination, due to waning immunity and asymptomatic transmission. The shift to acellular pertussis (aP) vaccines, aimed at reducing side effects, has changed disease dynamics, requiring ongoing evaluation.

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

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

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.

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.

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 {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.

RESEARCH QUESTION: What is the recovery in lung function after COVID-19 during the first year after infection?

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.

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.

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 {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 & 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 McCormack, K 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 = {}, number = {}, pages = {}, doi = {10.1002/jad.70038}, pmid = {40834236}, issn = {1095-9254}, support = {//This work was funded by the European Association for Research on Adolescence (EARA)./ ; }, 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.

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.

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.

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 = {}, number = {}, pages = {e0092724}, doi = {10.1128/msphere.00927-24}, pmid = {40833114}, issn = {2379-5042}, 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 & numerical data ; *COVID-19 Vaccines/administration & dosage ; *COVID-19/prevention & 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.

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.

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.

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.

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 & 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 & 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).

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.

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.

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).

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 (≥18 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.

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 = 0.0002, n = 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 weeks of PR and ≥12 weeks of PR), with significant differences.

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.

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.

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.

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.

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 {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, É}, 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 & 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.

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 & 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 {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 & 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 & 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.

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.

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 & control/epidemiology ; *Pandemics/prevention & control ; SARS-CoV-2 ; *COVID-19 Vaccines/administration & 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 = {}, number = {}, pages = {333549251358665}, pmid = {40819231}, issn = {1468-2877}, 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 = {}, number = {}, pages = {333549251357825}, pmid = {40819227}, issn = {1468-2877}, 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 & 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.

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.

RESULTS: Overall, 26 articles met the inclusion criteria. The results indicated that the predominant objective of evaluations was to examine system performance (n = 8, 30.77%). Also, the methodology used in most evaluations was Qualitative and quantitative (non-integrated) (n = 18, 69.23%). In terms of evaluation period, most evaluations were summative (n = 12,46.15%), and the evaluator population in most systems was the healthcare team (n = 14, 53.85%).

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, ÉM 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 = {2025}, 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 & 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.

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.

DATA SOURCES: Data from PubMed, Embase and Web of Science were systematically searched for articles published between November 1, 2019 and March 31, 2024.

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.

PARTICIPANTS: COVID-19 patients without hematological disorders admitted in ICU and who were evaluated for invasive pulmonary aspergillosis by any specific published definitions.

INTERVENTIONS: No.

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).

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 % CI: 0.11-0.14, I[2] = 96.11 %, p-value<0.001). The incidence of CAPA varied significantly based on diagnostic definitions (p-value = 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 % CI: 0.52-0.64, I[2] = 83.31 %, p-value<0.001) and varied by NOS (p-value = 0.047). Furthermore, NOS and chronic liver diseases were positively associated with CAPA mortality.

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.

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.

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.

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.

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.

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 & 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.

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.

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 = 14, adjusted odds ratio, OR 1.25, 95% confidence interval, CI 1.07 to 1.47, I2 = 62%). This association was more pronounced among the youth (N = 4, adjusted OR 1.78, 95% CI 1.17 to 2.72, I2 = 75%) and current e-cigarette users (N = 14, adjusted OR 1.30, 95% CI 1.10 to 1.55, I2 = 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 = 3, adjusted OR 1.25, 95% CI 1.03 to 1.50, I2 = 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.

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 & administration ; SARS-CoV-2 ; *Midwifery ; Personal Protective Equipment/supply & 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.

METHODS: This scoping review adhered to the methodologies outlined by Arksey & 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.

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.

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.

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 {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 & 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 & jurisprudence/organization & administration ; *COVID-19/prevention & 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 & 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.

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.

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: Behçet's disease, spondyloarthritis, systemic sclerosis, systemic lupus erythematosus, polymyalgia rheumatica, psoriasis, rheumatoid arthritis, Sjögren'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 Behçet's disease. Guillain-Barré syndrome and type 1 diabetes (in the paediatric population) showed no evidence of association with SARS-CoV-2 infection.

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 & 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.

METHODS: This systematic review was registered in PROSPERO (CRD42024559951). Observational studies with ≥ 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.

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 = 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 = 3 studies) and females (n = 3 studies). Selective serotonin reuptake inhibitors were more common (73.9-90.9%; n = 3 studies) than other antidepressant classes.

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.

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 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).

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 < 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 < 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.

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.

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.

METHODS: We searched databases such as Medline, PsychINFO, Scopus, and Google Scholar using relevant keywords, and included 60 reports for narrative synthesis.

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.

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, Â 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 & 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.

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.

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.

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 Cercetării, Inovării şi Digitalizării/ ; }, 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 = {2025}, 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 = {}, number = {}, pages = {}, pmid = {40804538}, issn = {1740-1534}, 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.

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.

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.

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 & 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.

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.

RESULTS: A total of 12 studies were included, involving over 48 million participants. The risk of developing NODM was 41 % higher in patients following COVID-19 infection compared to the control group (RR 1.41; 95 % 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.

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 & research. Clinical obstetrics & 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 & 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 & 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 & administration ; *Tuberculosis/prevention & 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.

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

SUMMARY: The implications of the findings for clinical practice and research are that long COVID is not the same in CYP as adults; both their physical and mental health should be studied; and intervention trials are needed.}, } @article {pmid40802252, year = {2025}, author = {Alraddadi, A and Kumar, D}, title = {Management of diarrhea in solid organ transplantation.}, journal = {Current opinion in infectious diseases}, volume = {38}, number = {5}, pages = {403-410}, pmid = {40802252}, issn = {1473-6527}, mesh = {Humans ; *Diarrhea/etiology/diagnosis/drug therapy/therapy/microbiology ; *Organ Transplantation/adverse effects ; COVID-19/complications ; SARS-CoV-2 ; Transplant Recipients ; }, abstract = {PURPOSE OF REVIEW: Diarrhea is a common complaint in solid organ transplant recipients. We review both infectious and noninfectious causes of diarrhea and their management.

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

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

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.

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.

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.

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.

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.

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.

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 & control/epidemiology ; Adult ; *COVID-19 Vaccines/administration & dosage ; *Immunization Programs/organization & administration ; Anthropology, Cultural ; *Vaccination/statistics & 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 & dosage ; *Caregivers/psychology/statistics & numerical data ; *Malaria/prevention & control ; *Patient Acceptance of Health Care/statistics & numerical data ; COVID-19/epidemiology ; Child, Preschool ; Infant ; *Vaccination/statistics & 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.

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.

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] > 99%), and publication bias was indicated in the willingness outcome (Egger's test, P = 0.002).

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.

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.

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.

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.

DESIGN: A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses criteria.

DATA SOURCES: PubMed, Embase, Cochrane Library and Google Scholar were searched for relevant studies from 1 January 2015 to 1 June 2025.

ELIGIBILITY CRITERIA: This review examined studies focused on physician attire and its impact on patient perceptions.

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.

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.

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.

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.

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 & dosage ; *Adjuvants, Vaccine/administration & dosage/chemistry ; Humans ; COVID-19 Vaccines/administration & dosage/chemistry ; Animals ; *Liposomes/administration & dosage/chemistry ; *Nanoparticles/administration & 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.

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.

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.

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.

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.

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.

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.

METHOD: A narrative review of literature data from WHO publications, Google Scholar and PubMed. The review examines the impacts of climate change on agriculture, food supply systems, and the associated transmission of infectious disease - specifically zoonotic and food-borne diseases.

RESULTS: As temperatures increase, the germs multiply easily - and the risk of E. coli and Salmonella goes up. Waterborne diseases such as Norovirus and Hepatitis A are more likely to spread in typified extreme weather conditions such as floods. Ecosystem changes push humans and animals into a closer relationship that can lead to zoonotic spillovers, such as the Nipah virus and COVID-19. The growth of animal production and international trade exacerbates antimicrobial resistance (AMR) issues, imposing challenges to disease control.

CONCLUSION: Climate change is a critical public health 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 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.

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 = {}, number = {}, pages = {}, pmid = {40790389}, issn = {2676-8607}, 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//Fundação de Amparo à Ciência 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 = {}, number = {}, pages = {}, pmid = {40788370}, issn = {1573-9546}, support = {154/GR/UFFS/2024 and 73/GR/UFFS/2023//Universidade Federal da Fronteira Sul/ ; }, 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 & 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 & 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.

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.

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.

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 = {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.

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.

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.

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 = {}, number = {}, pages = {}, doi = {10.1111/jpc.70160}, pmid = {40781782}, issn = {1440-1754}, 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 {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 & numerical data ; *Bacterial Infections/ethnology/microbiology ; COVID-19/ethnology/epidemiology ; *Racial Groups/statistics & 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.

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.

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.

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 & 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.

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.

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 (≥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.

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.

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.

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}, 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.

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.

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.

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}, 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 & 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.

AIM:  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.

METHOD:  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.

RESULTS:  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.

CONCLUSION:  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: 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 = {}, number = {}, pages = {1-6}, doi = {10.1017/S002221512510296X}, pmid = {40776683}, issn = {1748-5460}, 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.

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.

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.

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 & 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 & safety in medicine}, volume = {}, number = {}, pages = {9246479251366836}, doi = {10.1177/09246479251366836}, pmid = {40773022}, issn = {1878-6847}, 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 & 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 & numerical data ; *COVID-19/epidemiology ; New Zealand ; Australia ; Censuses ; Male ; Female ; *Workforce/statistics & numerical data ; *Radiation Oncologists/statistics & 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.

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.

RESULTS: The census was sent to 591 radiation oncologists with an overall response rate of 52%. Almost half of respondents (n = 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 = 134/200; 67% and n = 112/194; 58% respectively). Five respondents (n = 5/270; 2%) currently practise in theranostics, with the majority treating thyroid cancers within the public sector. Just under half (n = 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 (> 98%).

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.

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.

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 & 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, Ł 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.

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.

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.

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.

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 I², and sensitivity analyses were restricted to high-quality studies (NOS ≥ 7).

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 = 0.81, 95% CI 0.75-0.86; I² = 98%). Mean age at diagnosis rose by 0.86 years (95% CI 0.58-1.14; I² = 45%). Tumors were thicker (MD = 0.24 mm, 95% CI 0.02-0.47; I² = 92%) and more frequently ulcerated (OR = 1.29, 95% CI 1.15-1.44; I² = 31%). Nodular melanoma, an aggressive subtype, became more common (OR = 1.34, 95% CI 1.08-1.67; I² = 81%), whereas superficial spreading, acral lentiginous, and lentigo-maligna subtypes showed no significant change. All the key findings persisted in good-quality-only analyses.

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.

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 & dosage ; *COVID-19/prevention & 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.

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.

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.

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 & New Zealand journal of obstetrics & 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.

AIMS: To explore women's qualitative experiences of pregnancy to the 12 postpartum months during the COVID-19 pandemic in Australia.

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.

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.

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 & 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.

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.).

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.

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 & numerical data ; Length of Stay/statistics & numerical data ; Aged ; Respiratory Insufficiency/epidemiology/etiology ; Severity of Illness Index ; Respiration, Artificial/statistics & numerical data ; Adult ; SARS-CoV-2 ; Hospitalization/statistics & 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.

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.

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).

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 & control ; *Antiviral Agents/pharmacology ; *Coronavirus Infections/veterinary/prevention & 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 & 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 & 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.

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.

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 = 0.361, 95 % 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 > rSMDS > rOthers), and assessment tools for ADHD (rASRS > rOthers). Additionally, the mean age of participants emerged as a significant moderator in the meta-regression analysis.

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

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

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

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.

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] > 90%). Mortality with eosinopenia showed low certainty of evidence for C. difficile (0 cells/mm³ cut-off: RR 2.35; 95% CI: 1.84-2.99) and very low for COVID-19 when considering different cut-offs (0 cells/mm³: RR 2.37; 95% CI: 1.86-3.01; 20 cells/mm³: RR 2.90; 95% CI: 1.59-5.28; 50 cells/mm³: 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.

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 & dosage ; *COVID-19/prevention & 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 = {}, number = {}, pages = {}, doi = {10.1111/bju.16881}, pmid = {40764711}, issn = {1464-410X}, 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.

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).

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 weeks and 3 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.

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 days, diagnostic cystoscopy, transurethral resection of bladder tumour and nephrectomy for cT2+ renal masses should be expedited to occur within 30 days. Treatment of cT1 renal masses, carcinoma invading bladder muscle, upper tract urothelial carcinoma and high-risk prostate cancer should commence within 90 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 & 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.

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.

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.

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.

OBJECTIVE: This study uncovers the organizational factors that may strengthen pandemic responses in high-income countries through a comparative analysis of four Canadian provinces.

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.

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.

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 & dosage/immunology/therapeutic use ; *COVID-19/prevention & 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 {pmid40759363, year = {2025}, author = {Qureshi, S and Khan, TM and Salim, H and Uddin, MS and Imran, Z and Ali, D and Sajid, M and Siddiqui, H and Waqas, SA}, title = {Trends and disparities in hypertension-related mortality among adults with obesity in the United States from 2000-2023.}, journal = {The American journal of the medical sciences}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.amjms.2025.08.003}, pmid = {40759363}, issn = {1538-2990}, abstract = {INTRODUCTION: Obesity and hypertension are major public health concerns in the United States (US), significantly contributing to mortality. Despite their well-established association, long-term trends and demographic disparities in hypertension-related mortality among individuals with obesity remain underexamined. This study evaluates these trends, focusing on variations by sex, race, geographic region, and urbanization level.

METHODS: Mortality data from individuals aged ≥25 years with obesity (ICD-10-CM: E66) and hypertension (ICD-10-CM: I10-I15) as underlying or contributing causes of death were extracted from the CDC WONDER database (2000-2023). Age-adjusted mortality rates (AAMRs) were calculated across demographic subgroups. Joinpoint regression estimated the average annual percentage change (AAPC). Sensitivity analyses assessed trends when hypertension was the primary cause of death.

RESULTS: Between 2000 and 2023, 410,416 hypertension-related deaths occurred in individuals with obesity. AAMR increased from 2.58 per 100,000 in 2000 to 13.23 in 2023 (AAPC: +7.16 %, 95 % CI: 6.66-8.52, p < 0.001). Males had higher AAMRs than females, with NH Black individuals experiencing the highest mortality rates. Nonmetropolitan areas and Southern US had significantly higher AAMRs. Mortality spiked between 2019 and 2021, likely due to COVID-19, before declining in 2023.

DISCUSSION: The rising hypertension-related mortality in individuals with obesity highlights the growing burden of cardiometabolic disease. The COVID-19 pandemic exacerbated these trends, but recent declines suggest potential benefits from improved public health measures.

CONCLUSIONS: Hypertension-related mortality in individuals with obesity has risen substantially, with significant disparities by sex, race, and geography. Targeted interventions are needed to address these disparities and reduce obesity-related hypertension mortality.}, } @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 & control/transmission ; Humans ; *Air Pollution, Indoor/prevention & 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.

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.

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.

STUDY SELECTION: English-language primary research articles evaluating engineering infection control interventions.

DATA EXTRACTION: Publication information, population characteristics, intervention details, and all relevant outcomes were abstracted by a reviewer and verified by a second, senior reviewer.

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.

LIMITATION: Exclusion of non-English-language publications and gray literature.

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.

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.

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.

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.

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 & purification ; *Biotechnology/methods ; Pandemics/prevention & 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 & 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&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 & 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.

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.

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.

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 & 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.

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).

RESULTS: We identified 8466 articles from database searches, of which 152 met our inclusion criteria and were qualitatively synthesised. Most included articles (n = 140) were published during the COVID-19 pandemic, with 131 articles specifically analysing COVID-19. Exploratory research (n = 77) investigated the spatiotemporal transmission characteristics of respiratory infectious diseases, focussing on transmission patterns (n = 16), and influencing factors (n = 61). Forecasting research (n = 75) aimed to predict the disease trends using either univariate (n = 57) or multivariate models (n = 18), predominantly using machine learning methods (n = 41). The application of advanced deep learning models (n = 20) in disease forecasting analysis was often constrained by the quality of the available disease data.

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 = {}, number = {}, pages = {169370}, doi = {10.1016/j.jmb.2025.169370}, pmid = {40754154}, issn = {1089-8638}, 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 = {}, number = {}, pages = {}, doi = {10.1016/j.cmi.2025.07.026}, pmid = {40754067}, issn = {1469-0691}, 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.

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.

METHODS DATA SOURCES: Studies were identified in Embase, MEDLINE, PreView, COVID-19 L.OVE repository, and Cochrane Library up to August 1, 2024.

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.

ASSESSMENT OF RISK OF BIAS: Risk of bias was assessed using the ''Risk Of Bias In Nonrandomized Studies-of Interventions'' tool.

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.

RESULTS: A total of 6423 records were screened, and 65 NRSI reporting adjusted estimates were included, comprising >5.7 mio.

PARTICIPANTS: VE for ≥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 ≥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.

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}, 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.

AIM: To identify the prevalence of these psychological conditions and their associated factors among nursing home caregivers across various countries.

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.

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.

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 {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}, 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 & control ; *COVID-19 Vaccines/supply & distribution/economics ; *Drug Industry/legislation & 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.

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.

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.

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 {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 & 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.

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.

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 & control/virology ; *Paramyxoviridae Infections/transmission/virology/prevention & 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}, doi = {10.1097/QCO.0000000000001139}, pmid = {40748012}, issn = {1473-6527}, mesh = {Humans ; *COVID-19/epidemiology/prevention & control ; Child ; *Data Science/methods ; SARS-CoV-2 ; Pediatrics ; Pandemics ; Public Health ; }, abstract = {PURPOSE OF REVIEW: During the COVID-19 pandemic, governments and public health agencies used data science tools and data sources in real time to evaluate pathogen transmissibility, disease burden, healthcare capacity, and evaluate treatment and preventive measures. The purpose of the review is to highlight the application of these data sources and methods during the COVID-19 response.

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

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

OBJECTIVE: To assess the efficacy of tenofovir in COVID-19 patients based on randomized controlled trials (RCTs).

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).

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] = 1.76; 95% CI: 0.52 to 5.91) or for the composite outcome of ICU admission, disease progression, and mortality (RR = 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 = 0.038) and ICU length of stay (3.3 days vs. 14.5 days; p = 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.

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.

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.

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.

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.

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.

METHOD: An integrative review method by Whittemore and Knafl (2005).

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.

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 = {}, number = {}, pages = {}, pmid = {40742669}, issn = {1179-1942}, 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 & 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.

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.

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: - 1.35; 95% CI - 1.58 to - 1.13; p < 0.01] and the incidence of lower cholesterol levels [RR: 8.83; 95% CI 4.05 to 19.27; p < 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.

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 & 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.

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.

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.

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 & administration ; *Disease Outbreaks/prevention & control ; *Civil Defense/organization & 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 & 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 & outcomes research}, volume = {}, number = {}, pages = {1-14}, doi = {10.1080/14737167.2025.2542294}, pmid = {40736451}, issn = {1744-8379}, 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.

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.

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.

METHODS: A systematic review was performed to estimate how often public health researchers accounted for diagnostic test performance in estimates of seroprevalence.

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.

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 & 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.

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.

RESULTS: Database searches yielded 812 unique articles; 68 met inclusion criteria. Most articles discussed interventions addressing opioid use (n = 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.

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.

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.

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.

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 & 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 & 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 & control/virology ; *Viral Zoonoses/prevention & control/immunology ; *Viral Vaccines/immunology ; COVID-19/prevention & control ; *Virus Diseases/prevention & control ; Vaccines, Synthetic/immunology ; SARS-CoV-2/immunology ; *RNA, Messenger/immunology/genetics ; mRNA Vaccines/immunology ; COVID-19 Vaccines/immunology ; Communicable Diseases, Emerging/prevention & 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 & derivatives/therapeutic use ; Alanine/analogs & 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 & 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 & control/immunology ; Vaccines, Synthetic/immunology ; *Bacteria/immunology/genetics ; Animals ; mRNA Vaccines/immunology ; COVID-19/prevention & 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 & dosage ; Randomized Controlled Trials as Topic/methods ; *COVID-19 Drug Treatment ; *COVID-19/mortality ; }, abstract = {INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has prompted global interest in potential adjunctive therapies. N-acetylcysteine (NAC), a mucolytic agent that enhances intracellular glutathione synthesis, has antioxidant properties and may indirectly modulate inflammation through redox regulation. While preclinical and observational data suggest potential mortality benefits, findings from randomized controlled trials (RCTs) have been inconsistent.

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

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

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

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

METHODS: We classify shocks into natural, anthropogenic and climate-related, and build on the literature to develop a 2×2 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 2×2 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 2×2 typology.

RESULTS: Based on the available literature, the proposed 2×2 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.

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 & 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 & 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 = {Dirección 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 & 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.

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.

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.

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.

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.

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.

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.

PURPOSE: This review aims to systematically decode the bioactive phytoconstituents of LJT driving ALI protection and establish their multi-target mechanisms through integrative pharmacology.

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."

RESULTS: LJT's bioactive matrix orchestrates ALI mitigation via: 1) TLR4/MyD88/NF-κB axis suppression, reducing TNF-α, IL-6, and NLRP3 inflammasome activation; 2) Nrf2/HO-1-mediated oxidative stress resolution; 3) direct antiviral effects against influenza.

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.

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.

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.

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 & dosage/therapeutic use/chemistry ; Humans ; SARS-CoV-2 ; COVID-19/prevention & 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 & control ; National Institute of Allergy and Infectious Diseases (U.S.) ; *Influenza, Human/prevention & control ; *Vaccine Development/methods ; SARS-CoV-2/immunology ; Pandemics/prevention & 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 & control/immunology ; SARS-CoV-2/immunology ; COVID-19 Vaccines/immunology/administration & dosage ; Pneumococcal Vaccines/administration & dosage/immunology/therapeutic use ; Influenza Vaccines/immunology/administration & 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.

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.

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.

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.

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 & dosage ; *SARS-CoV-2/immunology ; *Dysbiosis/immunology/microbiology ; Probiotics/therapeutic use ; Prebiotics/administration & 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 & 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.

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.

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 306 719 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=0·62 [p=0·0012] for hPIV-1 and r=0·53 [p=0·049] 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 <0·0001), whereas higher hPIV-3 activity was correlated with rising temperature (rs=0·61; p<0·0001). 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.

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.

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 & 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.

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.

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 & 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.

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.

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.

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.

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.

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.

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 & 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.

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.

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.

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 & 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.

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.

RESULTS: After removing studies that utilised the same data, 345 796 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) = 11.4-17.2). Among ICU patients, lower-middle-income countries had the lowest COVID-19 AKI prevalence (27.9%;95% CI = 19.4-38.4).

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.

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.

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] = 3.49, 95% confidence interval [CI]: 0.50-24.11, p = 0.20), hospitalization rate (OR = 2.11, 95% CI: 0.85-5.22, p = 0.10), emergency department visit (OR = 0.80, 95% CI: 0.11-5.62, p = 0.82), and intensive care unit (2.37, 95% CI: 0.18-29.90, p = 0.50). Moreover, comparable rates of adverse events were observed across both groups (OR = 0.98, 95% CI: 0.39-2.47, p = 0.97). The certainty of evidence for these findings was rated as low or moderate.

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 & jurisprudence ; COVID-19 ; *Health Policy/legislation & jurisprudence ; Japan ; *Mental Disorders/therapy ; *Mental Health Services/legislation & jurisprudence/organization & 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 & 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 & 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 & 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 & 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.

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).

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.

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 & control/transmission ; *Infection Control/methods ; *Cross Infection/prevention & 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.

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).

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.

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.

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 & 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 & 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 & 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.

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.

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 & inhibitors/genetics ; *Antitubercular Agents/pharmacology/therapeutic use ; *Tuberculosis, Multidrug-Resistant/drug therapy/microbiology ; *Bacterial Proteins/metabolism/antagonists & 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 & control/immunology/virology ; *Herpesvirus Vaccines/immunology/genetics/therapeutic use ; COVID-19/prevention & 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 & 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.

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 (≥75%), moderate (50-74%), or limited (<50%) consensus as essential on the basis of how many articles mentioned the procedure.

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.

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.

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 & numerical data ; *Measles Vaccine/administration & dosage ; *Measles/prevention & control ; *Pandemics ; SARS-CoV-2 ; *Vaccination/statistics & 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.

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.

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.

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 & numerical data ; *Anxiety/epidemiology ; *Internship and Residency/statistics & 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.

OBJECTIVE: This review aims to explore the prevalence and correlates of depression, anxiety, and burnout among physicians and residents in training.

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.

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).

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.

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 = 30 to 2507 participants) were included, with data collected from Europe and Asia.

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.

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.

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.

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.

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.

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.

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 & 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.

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.

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.

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 & numerical data ; Prevalence ; Global Health/statistics & 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.

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.

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.

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 I² statistics.

RESULTS: Eligible participants comprised adults (≥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≥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 (I² = 99.0%). A positive trend was noted for medication adherence (RR = 1.11, 95% CI: 0.89-1.38, p = 0.35).

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.

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.

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 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 weeks of gestation to under 24 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 years. 1990s: In 1991, the limit of viability was revised to 22 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 & Oceania Federation of Obstetrics & 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 & 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.

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 & 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 & 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.

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.

METHOD: An integrative review approach was used to analyse 12 peer-reviewed studies published between January 2020 and June 2023.

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.

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.

STUDY DESIGN: Systematic review.

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.

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.

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.

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.

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.

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.

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.

METHODS: A comprehensive review of experimental/clinical studies on AR was conducted, focusing on molecular mechanisms, biological implications, biophysical modeling, and translational applications.

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.

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 = {}, number = {}, pages = {333549251349417}, pmid = {40686451}, issn = {1468-2877}, 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.

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.

RESULTS: The literature search identified 26 467 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.

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 & control/statistics & 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 = {}, number = {}, pages = {e70099}, doi = {10.1111/cpr.70099}, pmid = {40685330}, issn = {1365-2184}, 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 = {}, number = {}, pages = {}, doi = {10.1016/j.chest.2025.06.028}, pmid = {40684905}, issn = {1931-3543}, 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 & 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 & 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.

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.

METHODS: Methods include systematic review and meta-analysis.

DATA SOURCES: Data sources include FDA website, Medline, Embase, and Google Scholar.

STUDY ELIGIBILITY CRITERIA: Study eligibility criteria include diagnostic test accuracy studies according to the instruction for use.

PARTICIPANTS: Participants include patients with symptoms of COVID-19.

TESTS: Test includes rapid antigen SARS-CoV-2 tests.

REFERENCE STANDARD: Reference standard includes RT-PCR.

ASSESSMENT OF RISK OF BIAS: Assessment of risk of bias was conducted using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool.

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.

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.

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 & 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}, } @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 & dosage/immunology ; *Breast Feeding ; *COVID-19/prevention & control ; SARS-CoV-2/immunology ; *Communicable Diseases, Emerging/prevention & control ; *Pregnancy Complications, Infectious/prevention & 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 & dosage/genetics/chemistry ; COVID-19/prevention & control ; *Lipids/chemistry ; SARS-CoV-2/genetics ; *Gene Transfer Techniques/trends ; COVID-19 Vaccines/administration & 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.

DATA SOURCES: MEDLINE, PubMed, Embase, Web of Science, and Cochrane databases.

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.

RESULTS: In 57 studies (222 patients), the mean reported symptom duration was 6.6 ± 5.0 weeks (n = 30) with nine outliers presenting after 6 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 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.

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 & administration ; *Armed Conflicts ; *Delivery of Health Care/organization & 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.

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.

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.

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.

CONCLUSION: Addressing expanded advanced practice nurse authorities before conflict starts will facilitate an improved health system response.

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 & 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 & derivatives/adverse effects ; *Antiviral Agents/adverse effects/therapeutic use ; *Alanine/analogs & 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.

DESIGN: Systematic review and meta-analysis.

DATA SOURCES: MEDLINE and Embase, searched from January 2020 to December 2023.

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.

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.

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.

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% 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).

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.

PROSPERO REGISTRATION NUMBER: CRD42022383647.}, } @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.

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.

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.

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.

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.

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

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

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

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.

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.

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 & 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.

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.

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.

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.

METHODS: Observational studies published prior to March 2022 were screened for data describing liver injury (defined per primary study) in patients with PACS.

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.

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

AIM: This study aimed to systematically review studies on sleep patterns among autistic children, adolescents, and their caregivers during the COVID-19 lockdown.

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.

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.

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&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).

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.

RESULTS: Ten RCTs involving 2401 patients were included. CHM showed a greater reduction in VAS scores compared to controls (MD = -1.03; 95% CI -2.10 to 0.03; P = 0.0577), with higher heterogeneity (I[2] = 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 = 1.40; 95% CI 1.21-1.61; P < 0.0001; I[2] = 0%) and insomnia (RR = 1.23; 95% CI 1.03-1.47; P = 0.0216; I[2] = 0%). A trend toward improvement was observed in fatigue (RR = 1.58, 95% CI 0.95-2.64; P = 0.0781) and dyspnea (RR = 1.39, 95% CI 0.99-1.95; P = 0.0554), although these results did not reach statistical significance. No significant difference was observed in terms of 6-min walking distance (MD = 13.95 m, 95% CI -11.64 to 39.55; P = 0.2853). Adverse event rates were comparable between the herbal and control groups (RR = 0.72, 95% CI 0.49-1.07; P = 0.1052).

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.

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 & control ; Antiviral Agents/administration & dosage ; *Pneumonia, Viral/diagnosis/prevention & control/drug therapy/therapy ; *Coronavirus Infections/diagnosis/prevention & 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.

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.

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.

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 = 24), exercise (n = 13), environmental triggers (n = 24), and prodromal symptoms (n = 9). The etiology of cardiac arrest initially assigned to cardiac or obvious non-cardiac classification may be precipitated by seizures (n = 8), trauma (n = 7), alcohol or drug intoxication (n = 6), Covid-19 infection (n = 5), myocardial infarction (n = 4), suicide (n = 4), antipsychotic medications (n = 4), and illicit drug use (n = 3). Exercise and environmental factors (e.g., particulate matter (PM) 2.5µ 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.

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.

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.

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 & 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.

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.

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.

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.

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.

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.

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.

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 & immunotherapeutics}, volume = {21}, number = {1}, pages = {2528409}, pmid = {40665593}, issn = {2164-554X}, mesh = {Adult ; Humans ; Asia, Southeastern/epidemiology ; Cost-Benefit Analysis ; *COVID-19/prevention & control/economics ; *COVID-19 Vaccines/economics/administration & dosage ; *Influenza Vaccines/economics/administration & dosage ; *Pneumococcal Vaccines/economics/administration & dosage ; *Respiratory Tract Infections/prevention & 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 & pharmacotherapy = Biomedecine & 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 & control ; SARS-CoV-2 ; *Vitamins/pharmacology/therapeutic use ; *Cytokines/metabolism ; Humans ; Dietary Supplements ; Animals ; Inflammation Mediators/antagonists & 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 = {//Coordenação de Aperfeiçoamento de Pessoal de Nível Superior/ ; //Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; }, 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.

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.

RESULTS: We identified 45 total studies examining transportation safety (n = 12), work-related injuries (n = 4), other physical health outcomes (n = 5), COVID-19 vulnerabilities (n = 10), mental health (n = 10), mental well-being (n = 18), and safety (n = 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.

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 {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.

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.

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.

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 {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.

AIM: To Synthesise nursing and midwifery faculty experiences of online teaching during the Covid-19 pandemic.

METHOD: A systematic review of qualitative evidence was completed to systematically synthesise nursing and midwifery faculty experiences of online teaching during Covid-19 pandemic.

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.

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, İ 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 & control ; SARS-CoV-2/immunology ; *Vaccine-Preventable Diseases/prevention & control ; COVID-19 Vaccines/administration & 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.

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.

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.

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.

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 {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 & purification ; Animals ; Humans ; COVID-19/immunology/prevention & 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 & control ; Infant ; Child, Preschool ; *Primary Health Care/statistics & 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.

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.

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 & 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 & control/epidemiology ; *Pandemics/prevention & control ; SARS-CoV-2 ; Animals ; *Henipavirus Infections/prevention & 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 & 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.

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.

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.

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 & 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.

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 (EDSS), and the number of patients with relapse after COVID.

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).

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.

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.

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 Université 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.

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.

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.

RESULTS: 1214 articles were retrieved and 108 were included in this analysis. The topics focused on: zoonoses (56 %), antimicrobial resistance (14 %), food safety/security (7 %), animal welfare (6 %), and governance (6 %). Most studies were conducted in African countries, the majority of studies (57 %) adopted a regional perspective, while 19 % employed a national and 13 % adopted a multi-country perspective. The most common economic approaches were mixed methods and CEA, regression analysis, as well as index methods.

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 & 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 & 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 & 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.

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.

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.

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.

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.

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 & control ; *COVID-19 Vaccines/administration & 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.

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.

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.

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.

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 & dosage ; *COVID-19 Vaccines/immunology/administration & dosage ; *Influenza, Human/prevention & control/immunology ; *COVID-19/prevention & control/immunology ; *SARS-CoV-2/immunology ; Animals ; Vaccines, Combined/immunology/administration & dosage ; *Coinfection/prevention & 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 & control/epidemiology/virology ; *Coinfection/immunology/virology ; SARS-CoV-2/immunology ; *Mpox, Monkeypox/immunology/transmission/prevention & 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.

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.

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.

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.

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.

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.

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.

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.

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 & control ; *Coronavirus Infections/diagnosis/virology/prevention & 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 & pharmacotherapy = Biomedecine & 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 & 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 = {}, number = {}, pages = {}, pmid = {40632470}, issn = {1439-0973}, 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.

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.

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.

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 & immunotherapeutics}, volume = {21}, number = {1}, pages = {2526964}, pmid = {40627495}, issn = {2164-554X}, mesh = {Humans ; *Brain Neoplasms/therapy/immunology ; *Neuroblastoma/therapy/immunology ; *Cancer Vaccines/administration & dosage/immunology/therapeutic use ; Blood-Brain Barrier/metabolism ; *Drug Delivery Systems/methods ; Nanoparticles/administration & dosage ; COVID-19 Vaccines ; Child ; Immunotherapy/methods ; SARS-CoV-2/immunology ; COVID-19/prevention & 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 & immunotherapeutics}, volume = {21}, number = {1}, pages = {2530291}, pmid = {40625176}, issn = {2164-554X}, mesh = {Humans ; Clinical Trials as Topic ; *COVID-19/prevention & control/immunology ; *COVID-19 Vaccines/immunology/administration & dosage ; Drug Approval ; Japan ; *Vaccination Hesitancy ; Vaccines, Synthetic/immunology/administration & 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.

AIMS/OBJECTIVES: This systematic review aimed to assess the effects of omega-3 supplementation on OD.

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.

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.

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 & care informatics}, volume = {32}, number = {1}, pages = {}, pmid = {40623772}, issn = {2632-1009}, mesh = {Humans ; Africa, Western/epidemiology ; *Population Surveillance/methods ; *Disease Outbreaks/prevention & control ; COVID-19/epidemiology ; Capacity Building ; *Communicable Disease Control/organization & 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 & 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 & 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 & purification ; COVID-19/epidemiology/virology ; *Molecular Epidemiology/methods ; *Viruses/genetics/isolation & 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.

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.

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.

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.

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.

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 I² test, while publication bias was evaluated through a funnel plot and Egger's and Begg's tests.

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 (I² = 57.86%, p < 0.001). The review also identified significant predictors of infection, including open fracture type, complex fracture patterns, surgery performed within 15 days of injury, the presence of a prophylactic drain, female gender, and procedures conducted by junior surgeons.

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 & 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.

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.

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.

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 = {}, number = {}, pages = {}, pmid = {40617907}, issn = {1573-742X}, support = {4022475//Mashhad University of Medical Sciences/ ; }, 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 & 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.

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.

RESULTS: We included 131 publications (85 quantitative, 27 qualitative, 6 mixed-/multi-methods studies, 12 systematic reviews, 1 discussion paper); 49 % 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 % did not provide information on funding. The Federal Ministry of Education and Research (21 %) was the most common funding body.

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 = {}, number = {}, pages = {}, doi = {10.1016/j.jpag.2025.06.010}, pmid = {40617558}, issn = {1873-4332}, 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.

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 I² 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).

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.

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 & 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 & 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 & 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 & 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.

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.

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.

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 & inhibitors ; Middle Aged ; }, abstract = {BACKGROUND: While COVID-19 has transitioned from a pandemic to an endemic state, the management of its persistent complications continues to present substantial clinical challenges. Tocilizumab, an interleukin-6 receptor antagonist endorsed by the World Health Organization (WHO) for severe COVID-19 management, remains a critical therapeutic intervention. This systematic evaluation provides a comprehensive assessment of tocilizumab's safety and efficacy profile to inform clinical decision-making.

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

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

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

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.

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.

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 = {}, number = {}, pages = {1-15}, doi = {10.1080/17476348.2025.2529540}, pmid = {40611647}, issn = {1747-6356}, 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).

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.

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 & 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.

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.

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.

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 ± 16.87 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 ± 12.63 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.

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.

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.

DESIGN: Rapid systematic review.

SEARCH STRATEGY: Keyword search of three databases; search and citation tracking of previous systematic reviews.

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.

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.

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.

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.

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.

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 & 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 & jurisprudence/organization & administration ; Telemedicine/legislation & 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 & 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 & 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 & dosage ; *Vaccination Hesitancy/psychology/statistics & numerical data ; Caribbean Region/epidemiology ; *COVID-19/prevention & control/epidemiology ; *Vaccination/psychology ; Communication ; Pandemics/prevention & 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.

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.

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?

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).

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.

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 & control/epidemiology ; Humans ; *Disease Eradication/methods/organization & 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.

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.

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 & numerical data ; COVID-19/epidemiology ; *Prisoners/statistics & 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 & 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 & dosage ; Herpes Zoster Vaccine/administration & dosage ; Influenza Vaccines/administration & dosage ; *Pharmacists/organization & administration ; Pneumococcal Vaccines/administration & dosage ; Professional Role ; Respiratory Syncytial Virus Vaccines/administration & dosage ; *Vaccination/statistics & 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.

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 % confidence interval (CI). Subgroup analyses were used to evaluated differences in effect sizes according to pharmacist roles.

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 % 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 % CI: 1.46-6.34).

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}, mesh = {*Influenza Vaccines/immunology ; Humans ; *Influenza, Human/prevention & control/immunology ; *Vaccine Development/methods ; Pandemics/prevention & 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&D) Roadmap (IVR) was published in 2021 to serve as a strategic planning tool to advance influenza vaccine R&D. Following IVR publication, a 3-year monitoring, evaluation, and adjustment (ME&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&A program provides a basis for ongoing critical review of progress in influenza vaccine R&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.

OBJECTIVE: This study aims to systematically review the existing literature on eHealth literacy levels and the associated outcomes among postsecondary students.

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.

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 (SD 6.8) to 31.4 (SD 4.4), and mean item scores ranged from 3.42 (SD 0.61) to 4.10 (SD 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.

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.

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.

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.

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.

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).

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.

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 & control/therapy ; *COVID-19 Vaccines/administration & 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 & 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 & 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.

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 m from a patient and another from the corridor leading to the positive section.

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 m from a patient and another collected from the corridor leading to the COVID-19 positive section.

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 & control ; SARS-CoV-2 ; *Pandemics/prevention & control ; *Disease Outbreaks/prevention & 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).

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.

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.

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.

REVIEW REGISTRATION: Open Science Framework https://osf.io/tqexa .

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.

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.

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.

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.

CASE PRESENTATION: We describe a 2-year-old child with MMA secondary to mutase deficiency, carrying the homozygous mutation c.2179 C > 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.

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 = {}, number = {}, pages = {}, doi = {10.1111/hiv.70069}, pmid = {40597327}, issn = {1468-1293}, 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.

OBJECTIVES: This review highlights reports on various infections and vaccines causing false-positive reactivity in fourth-generation HIV immunoassays.

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.

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.

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.

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.

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.

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 & 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.

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.

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).

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 & dosage ; *Bacterial Vaccines/administration & 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.

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 & 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 & dosage ; *COVID-19/prevention & 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 {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.

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.

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.

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.

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 & 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 & administration ; Humans ; *Electronic Health Records/organization & administration/statistics & 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}, mesh = {Humans ; *COVID-19/epidemiology/prevention & control ; *Patient Safety/standards ; Pandemics ; SARS-CoV-2 ; Cross Infection/prevention & control ; Accidental Falls/prevention & 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.

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 13 019 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.

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.

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 & control/epidemiology ; Hong Kong/epidemiology ; *Disease Eradication ; *Measles Vaccine/administration & 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 & 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, Ó 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 & 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 & control ; *Global Health ; World Health Organization ; *Pandemics/prevention & 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 & jurisprudence ; *Mental Health Services/legislation & jurisprudence/organization & 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.

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.

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.

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 & 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 & numerical data ; Canada/epidemiology ; *Telemedicine/statistics & 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.

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.

MATERIALS AND METHODS: A systematic literature review was conducted using PubMed and PMC, and the number of articles included was 19.

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.

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.

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.

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.

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.

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 APOEε4 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.

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 APOEε4 expression appears to increase susceptibility to Cpn and SARS-CoV-2 infections.

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 APOEε4. 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.

OBJECTIVES: To summarize the influence of vitamin D supplementation on ICU admissions and mortality among COVID-19 patients.

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 = 10.87, p = 0.33), while random-effects models were used for mortality outcomes (Q = 27.23, p = 0.006). Pooled odds ratios (OR) with 95% confidence intervals (CI) quantified the overall effects.

RESULTS: Vitamin D supplementation was associated with a significant 38% reduction in ICU admissions (OR = 0.62; 95% CI: 0.54-0.71) and a 33% reduction in mortality risk (OR = 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.

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 & 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 {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 = {}, number = {}, pages = {}, doi = {10.1111/medu.15760}, pmid = {40581875}, issn = {1365-2923}, 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).

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.

RESULTS: Of 3 930 unique studies identified, 245 were included, comprising 48 698 trainees. Impacts of the COVID-19 pandemic on burnout levels varied: although trainees' emotional exhaustion remained stable, reported levels of depersonalisation (from gw = 0.611 to 0.430, p = 0.045) and personal accomplishment fell (from gw = -0.348 to -0.626, p = 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.

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 & control ; *Vaccine Development/trends ; *COVID-19/prevention & control ; SARS-CoV-2/immunology ; COVID-19 Vaccines/immunology ; *Vaccines/immunology ; Pandemics/prevention & 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.

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.

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 & numerical data ; *Vaccination Hesitancy/statistics & numerical data/psychology ; *COVID-19 Vaccines/administration & dosage ; Africa, Western/epidemiology ; *COVID-19/prevention & control/epidemiology ; Cross-Sectional Studies ; SARS-CoV-2 ; Pandemics/prevention & control ; Pandemic Preparedness ; }, abstract = {BACKGROUND: Healthcare workers (HCWs) are at high risk of acquiring and transmitting infections, including COVID-19. Vaccination is a crucial method for preventing the spread of infectious diseases; however, vaccine non-acceptance can hinder optimal vaccine coverage. This research aims to evaluate the level of COVID-19 vaccine acceptance and the associated factors among HCWs in West Africa.

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

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

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

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.

RESULTS: Of the 240 articles pre-selected for study method analysis (κ = 0.84), the most common data collection methods were surveys (53.7 %), interviews (21.3 %), and mixed methods (13.9 %). 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.

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 & control/epidemiology ; *COVID-19 Vaccines/administration & dosage ; *Interferon-gamma Release Tests ; *Tuberculosis/diagnosis/prevention & control ; Vaccination ; }, abstract = {OBJECTIVESThe 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.METHODSNon-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.RESULTSA 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.CONCLUSIONSThe 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..}, } @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).

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.

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.

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.

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.

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 = -1.21, 95% CI: -1.44, 0.99) and positive (g = 0.68, 95% CI: 0.51, 0.84) mental health indicators, moderating by geographic region, intervention type, setting, and delivery modality.

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?

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.

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).

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 {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.

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.

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.

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.

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 = 18), perceived government performance (n = 14), and media/information (n = 8) were the most common determinants overall and for institutional trust. Three reports focused on trust repair (n = 2) or maintenance (n = 1).

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 & 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.

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.

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.

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 {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 & control ; *Immunization Programs/statistics & numerical data ; Africa, Western/epidemiology ; Child ; SARS-CoV-2 ; *Vaccination Coverage/statistics & numerical data ; }, abstract = {OBJECTIVES: To investigate the effects of the COVID-19 pandemic on childhood immunisation programmes in West African Countries.

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.

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.

PARTICIPANTS: All West African childhood immunisation programmes.

INTERVENTIONS: None.

MAIN OUTCOME MEASURES: Change in immunisation volumes during the COVID-19 pandemic.

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.

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.

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&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.

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.

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.

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 {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.

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).

SETTING: The study is based on the Ministry of Health and the National AIDS Commission in Maseru, Lesotho.

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.

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.

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.

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 {pmid40704343, year = {2024}, author = {Eslaminejad, T and Shojaeepour, S and Torabizadeh, SA and Mirzaie, V}, title = {Coronavirus in Recent Years: Characteristics, Outbreaks, and Treatments.}, journal = {Tanaffos}, volume = {23}, number = {3}, pages = {220-237}, pmid = {40704343}, issn = {1735-0344}, abstract = {BACKGROUND: Coronaviruses cause acute respiratory syndromes, e.g., SARS, MERS, and COVID-19, whose treatment depends on several factors, specifically the age of patients, adopted treatments, time of hospitalization, and timely diagnosis. The present study was conducted to investigate the interaction between the mentioned factors and treatment.

MATERIALS AND METHODS: Relevant full-text publications were indicated by searching in the five online databases MEDLINE, EMBASE, WOS, Science Direct, and Cochrane Library using MeSH terms during 2010-2024. Only original case reports (n=55) that worked on signs and treatments were selected and analysed according to age, gender, medical history, diagnostic methods, treatments, kind of respiratory syndrome, and transmission ways. Articles that met the inclusion criteria were evaluated by each of the reviewers independently, and non-agreements were solved by consulting with a fourth reviewer.

RESULTS: According to the results, the severe respiratory syndromes occurred more in the elderly than younger people and in males than females (58% and 42%, respectively). Medical history of diabetes and heart disease showed the maximum effect on the person to get involved with the severe respiratory syndrome. Clinical methods were used more for the diagnosis of the diseases because of easy access and less time consumption. Combination therapy was better than single therapy. The most common route of transmission was human to human and nosocomial.

CONCLUSION: It can be concluded that these types of fatal respiratory illnesses can be controlled if the health care workers become familiar with the type of illness and apply the early and effective treatments.}, } @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 {pmid40656089, year = {2024}, author = {Burkauskas, J and Branchi, I and Pallanti, S and Domschke, K}, title = {Anxiety in post-covid-19 syndrome - prevalence, mechanisms and treatment.}, journal = {Neuroscience applied}, volume = {3}, number = {}, pages = {103932}, pmid = {40656089}, issn = {2772-4085}, abstract = {In addition to the general impact of the COVID-19 pandemic on anxiety-related mental state, anxiety and anxiety disorders have also been implicated within 'post-COVID-19 syndrome', i.e. following a SARS-CoV-2 infection. The present narrative review provides an update on the current state of knowledge on anxiety and anxiety disorders in the context of post-COVID-19 syndrome, on epidemiological, psychological, and biological factors that may contribute to anxiety following a SARS-CoV-2 infection, as well as on therapy options available for anxiety in the context of post-COVID-19 syndrome. A multi-step systematic literature search of PubMed and Web of Science databases was performed applying the following broad search terms: ("anxiety" OR "anxiety disorder") AND ("COVID" OR "COVID-19" OR "corona" OR "pandemic" OR "Post-COVID" OR "Long-COVID"). Eligible articles published until November 15, 2022 were included. Meta-analyses identified anxiety prevalence rates ranging from 16.6% to 29.6% after a SARS-CoV-2 infection. Premorbid anxiety has not reliably been shown to be associated with post-COVID-19 syndrome. Female sex, older age, severity of COVID-19 infection, hospitalization, reduced mobility, uncertainty, loneliness and low social support, anxiety sensitivity and cognitive inflexibility as well as biological factors such as immune dysregulation, alterations in the angiotensin system and hypothalamus-pituitary-adrenal axis activation have been identified as potential anxiety risk factors in the context of post-COVID-19 syndrome. Treatment options comprise pharmacotherapy with selective serotonin/noradrenaline reuptake inhibitors and (internet-/computer-based) cognitive behavioral psychotherapy, possibly augmented by mindfulness-based techniques, physical exercise and non-invasive brain stimulation. Provided corroboration of the currently suggested increased risk of anxiety in the context of post-COVID-19 syndrome by future large-scale, prospective studies, a standardized screening for anxiety in patients with a SARS-CoV-2 infection - particularly in individuals with risk factors - and a psychiatric consultation and liaison service should be established to provide preventive and therapeutic interventions as early as possible.}, } @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 {pmid40703211, year = {2023}, author = {Park, IJ}, title = {Influence of the COVID-19 Pandemic on the Treatment Patterns and Outcomes of Colorectal Cancer.}, journal = {Ewha medical journal}, volume = {46}, number = {Suppl 1}, pages = {e28}, pmid = {40703211}, issn = {2234-2591}, abstract = {Over the past 3 years, the COVID-19 pandemic has posed significant challenges to the healthcare system, leading to delays in the diagnosis and treatment of various diseases due to the need for social distancing measures. Colorectal cancer has not been immune to these disruptions, and research in various countries has explored the impact of COVID-19 on the diagnosis and treatment of colorectal cancer. One notable consequence has been the postponement of colorectal cancer screenings, potentially resulting in disease progression, which can adversely affect surgical and oncological outcomes. Furthermore, the treatment approach for colorectal cancer may vary depending on the extent of disease progression and the healthcare policies implemented in response to the COVID-19 pandemic. In this systematic review, we examine treatment strategies, surgical outcomes, and oncological variables across multiple studies focusing on colorectal cancer treatment during the COVID-19 pandemic. The purpose of this analysis was to assess how medical policies enacted in response to the COVID-19 pandemic have influenced the outcomes of colorectal cancer treatment. We hope that this review will provide valuable insights and serve as a foundational resource for developing guidelines to address potential medical crises in the future.}, } @article {pmid40626086, year = {2023}, author = {Tang, Y and Ren, L and Liu, E}, title = {Current status and reflections on the diagnosis and treatment of respiratory tract infections in children in the COVID-19 pandemic and post-COVID-19 era.}, journal = {Pediatric discovery}, volume = {1}, number = {3}, pages = {e33}, pmid = {40626086}, issn = {2835-5598}, abstract = {Respiratory tract infections (RTIs) are common and frequently occurring diseases in children, posing a significant health threat to children worldwide. Viruses are the most important pathogens of childhood RTIs. Since the outbreak of Coronavirus Disease 2019 (COVID-19), a series of nonpharmaceutical interventions (NPIs) have been widely implemented around the globe, and important changes have taken place in the spectrum of respiratory diseases and viruses in children. However, with relaxation of NPIs, there has been a "virus resurgence" in some areas, with multiple viral infectious diseases appearing simultaneously. This review comprehensively summarizes the changes observed in the spectrum of respiratory diseases and viruses in children in the context of the COVID-19 pandemic, explores possible mechanisms, and presents reflections on the key points of diagnosis and treatment of RTIs in children in the post-COVID-19 era in light of recent advances in COVID-19 in children.}, } @article {pmid40729168, year = {2023}, author = {Vlasova-St Louis, I and Fang, D and Amer, Y and Mohei, H}, title = {COVID-19-Omics Report: From Individual Omics Approaches to Precision Medicine.}, journal = {Reports (MDPI)}, volume = {6}, number = {4}, pages = {}, pmid = {40729168}, issn = {2571-841X}, abstract = {During the COVID-19 pandemic, it became apparent that precision medicine relies heavily on biological multi-omics discoveries. High throughput omics technologies, such as host genomics, transcriptomics, proteomics, epigenomics, metabolomics/lipidomics, and microbiomics, have become an integral part of precision diagnostics. The large number of data generated by omics technologies allows for the identification of vulnerable demographic populations that are susceptible to poor disease outcomes. Additionally, these data help to pinpoint the omics-based biomarkers that are currently driving advancements in precision and preventive medicine, such as early diagnosis and disease prognosis, individualized treatments, and vaccination. This report summarizes COVID-19-omic studies, highlights the results of completed and ongoing omics investigations in individuals who have experienced severe disease outcomes, and examines the impact that repurposed/novel antiviral drugs, targeted immunotherapeutics, and vaccines have had on individual and public health.}, } @article {pmid40625713, year = {2023}, author = {Xia, W and Peng, Z}, title = {Maternal SARS-CoV-2 infection: The potential vertical transmission of SARS-CoV-2 and impact on neonates: A review.}, journal = {Pediatric discovery}, volume = {1}, number = {2}, pages = {e22}, pmid = {40625713}, issn = {2835-5598}, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a large, lipid-enveloped, single-stranded RNA virus, is a highly contagious virus that caused coronavirus disease 2019 (COVID-19), declared a pandemic by the World Health Organization on March 11, 2020. Pregnant women are usually considered at high risk for infectious diseases, including COVID-19. Maternal SARS-CoV-2 infection can adversely affect the pregnancy and birth outcomes, such as abortion, intrauterine growth restriction, and prematurity. Some meta-analysis suggested that the outcomes of newborns are different between symptomatic and asymptomatic pregnant women but similar in asymptomatic and SARS-CoV-2 negative group. Maternal infection increases the risk of vertical transmission; also the presence of SARS-CoV-2 or its RNA in maternal samples in some case reports raised the possibility of intrauterine transmission. Also, contact transmission during delivery and postnatal transmission are discussed. Although most infected newborns are asymptomatic or mildly symptomatic, there are case reports of severe neonatal SARS-CoV-2 infection, including cardiorespiratory failure and death. Otherwise, some studies suggested that the COVID-19 pandemic was associated with a reduction for preterm birth during the pandemic compared with the prepandemic period. We conduct this review to try to make a conclusion about the vertical transmission of SARS-CoV-2 and impact on neonates due to Maternal SARS-CoV-2 infection.}, } @article {pmid40741272, year = {2025}, author = {Zavalichi, MA and Ionescu, G and Arsenescu Georgescu, CM and Mihaescu, A and Cimpoesu, CD and Cimpoesu, G and Zavalichi, SD and Stătescu, C and Demiray, A and Kanbay, M and Covic, A and Nistor, I}, title = {The use of extracorporeal membrane oxygenation in COVID-19: a systematic review.}, journal = {Archives of medical science : AMS}, volume = {21}, number = {3}, pages = {897-918}, pmid = {40741272}, issn = {1734-1922}, abstract = {INTRODUCTION: The COVID-19 pandemic represents a major worldwide challenge, with a great impact on health systems and economic mechanisms. SARS-CoV-2, the pathogenic agent that generates COVID-19, creates a wide variety of organ dysfunctions, from acute respiratory distress syndrome (ARDS) to acute myocardial infarction or pulmonary embolism. Mechanical circulatory support devices such as extracorporeal membrane circulatory oxygenation (ECMO) have shown their efficacy in maintaining organ perfusion in respiratory and cardiac impairments. With this review, we aimed to assess the impact of ECMO use in COVID-19 patients with ARDS.

MATERIAL AND METHODS: We performed a systematic review to find studies using ECMO in COVID-19. Comorbidities, side effects, and survival rate to discharge were analysed. The literature search was done using PubMed/MEDLINE, Web of Science, Embase (Elsevier), the Cochrane Central Register of Controlled Trials (Wiley) and clinicaltrials.gov databases (inception (December 2019) to October 16, 2021), by 2 authors.

RESULTS: We included 33 studies from 10 countries with a total of 4760 patients receiving ECMO for COVID-19. The survival rate varied from 9% to 90.6% at discharge. The most serious adverse events were acute kidney injury (up to 87%), major bleeding (up to 92.1%), strokes or cerebral haemorrhage (up to 34%). Other complications such as pulmonary embolism, peripheral bleeding, or sepsis had a major impact on survival rates.

CONCLUSIONS: ECMO in COVID-19 patients may be a useful rescue therapy instrument, but due to the great variability of studies and still unknown mechanisms and effects of SARS-CoV-2, further studies need to be done.}, } @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}, 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 & numerical data ; Comorbidity ; SARS-CoV-2 ; Risk Factors ; Intensive Care Units/statistics & 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.

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.

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).

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 & 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 = {}, number = {}, pages = {10775587251345018}, doi = {10.1177/10775587251345018}, pmid = {40568792}, issn = {1552-6801}, 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-19 spurred innovation, increasing telehealth in carceral MOUD programs. Future research should explore MOUD program transition from early adoption to wide-scale implementation, considering external factors, sustainability, and evolving policies.}, } @article {pmid40568785, year = {2025}, author = {Arrè, V and De Luca, R and Mrmić, S and Marotta, S and Nardone, S and Incerpi, S and Giannelli, G and Negro, R and Trivedi, P and Anastasiadou, E}, title = {Gastrointestinal inflammation and cancer: viral and bacterial interplay.}, journal = {Gut microbes}, volume = {17}, number = {1}, pages = {2519703}, pmid = {40568785}, issn = {1949-0984}, mesh = {Humans ; Herpesvirus 4, Human/physiology/immunology ; *Helicobacter Infections/complications/microbiology/immunology/virology ; Helicobacter pylori/physiology/immunology/pathogenicity ; *Epstein-Barr Virus Infections/complications/virology/immunology ; *COVID-19/complications/virology/immunology ; SARS-CoV-2/physiology ; Gastrointestinal Microbiome ; Animals ; Inflammation/microbiology/virology ; Coinfection/microbiology/virology ; *Gastrointestinal Neoplasms/microbiology/virology/immunology ; Dysbiosis ; }, abstract = {Gastrointestinal (GI) inflammation and malignancies arise from complex interactions between the host's immune responses and microbial pathogens. Epstein-Barr virus (EBV), Helicobacter pylori (H. pylori), and Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) contribute to chronic GI inflammation, immune evasion, and tumorigenesis through distinct but interconnected mechanisms. EBV, a widespread herpesvirus, establishes a latent infection in B cells and epithelial cells. It promotes gastric carcinogenesis through immune modulation, epigenetic changes, and viral microRNAs (miRNAs). H. pylori, a gastric carcinogen, induces chronic gastritis and gastric cancer (GC) through Cytotoxin-associated gene A (CagA) and Vacuolating cytotoxin gene A (VacA) virulence factors. These factors disrupt host immune responses and enhance oncogenic signaling pathways. Recent evidence also links SARS-CoV-2 to gut dysbiosis and inflammatory responses. It worsens immune dysfunction and hence potentially impacting GI pathology. EBV and H. pylori co-infections may synergistically amplify inflammatory signaling, creating a tumor-promoting microenvironment. This review emphasizes the molecular mechanisms by which these pathogens contribute to GI diseases, focusing on their immune evasion strategies and potential therapeutic targets. Understanding these interactions is essential for developing targeted interventions for infection-driven GI malignancies.}, } @article {pmid40568634, year = {2025}, author = {Shitaye, G and Ventserova, N and D'Abrosca, G and Dragone, M and Maina, EW and Fattorusso, R and Iacovino, R and Russo, L and Isernia, C and Malgieri, G}, title = {The role of intrinsically disordered regions of SARS-CoV-2 nucleocapsid and non-structural protein 1 proteins.}, journal = {Frontiers in chemistry}, volume = {13}, number = {}, pages = {1597656}, pmid = {40568634}, issn = {2296-2646}, abstract = {Virus survival inside the host cell depends on the intricate mechanisms that recruit proteins involved in the arms race. Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) proteome exhibits important levels of structural order. However, some of the SARS-CoV-2 proteins, such as the Nucleocapsid (N) and Non-structural protein 1 (Nsp1), contain a considerably significant amount of intrinsically disordered regions (IDRs) that play indispensable roles in the intra-viral and virus-host interaction. Here, focusing on proteins that contain a relevant percentage of IDRs, we discuss experimental and computational studies sought to support IDRs as a key player in the interplay with ordered domains, the biological role as potential origin for variants of SARS-CoV-2, and their association with virus transmissibility. Furthermore, we also highlight the potential involvement of IDRs in the viral-host protein interaction and host cellular machinery. Thus, shading lights on the dark proteome of the virus and looking for therapeutic approaches beyond the classic structure-function paradigm may contribute to the efforts sparking the quest for therapeutics.}, } @article {pmid40567947, year = {2025}, author = {Yousufzai, W and Heo, A and Gu, K and Sun, E and Lopez, G and Balamurali, S and Adjei-Mosi, J and Shin, R and Stuart, DB and Edwards, P and Baronia, R and Amor, W and McMahon, T}, title = {First episode of psychiatric and neuropsychiatric disease among patients infected with COVID-19: A scoping review.}, journal = {PCN reports : psychiatry and clinical neurosciences}, volume = {4}, number = {2}, pages = {e70146}, pmid = {40567947}, issn = {2769-2558}, abstract = {This scoping review aims to examine the frequency and prevalence of neuropsychiatric disorders reported in patients infected with coronavirus disease 2019, and the mechanisms by which these develop during and post infection. A systematic search using relevant search terms and key words was done on six electronic databases of literature on neuropsychiatric conditions post-coronavirus disease 2019 infection from 2020 to 2023. Data were extracted following Joanna Briggs Institute guidelines, focusing on key findings, intervention details, and outcomes. We included 333 studies in the review. Studies indicated an elevated risk of neuropsychiatric disorders post-coronavirus disease 2019, with some risks remaining high 2 years after diagnosis. A significant prevalence of depressive, psychotic, and anxiety disorders, as well as post-traumatic stress symptoms were noted among coronavirus disease 2019 survivors. There was increased prevalence of insomnia and other sleep disturbances, mild to severe cognitive dysfunction, and eating disorders. Coronavirus disease 2019 infection is associated with a significant risk of developing various neuropsychiatric disorders, including schizophrenia, depressive disorders, anxiety, post-traumatic stress disorder, and cognitive dysfunction. Long-term monitoring and early interventions are essential to mitigate these risks and improve patient outcomes.}, } @article {pmid40566294, year = {2025}, author = {Rocha, DM and Pedroso, AO and Menegueti, MG and Silveira, RCCP and Sousa, LRM and Gir, E and Reis, RK}, title = {Predictors of Anxiety, Depression, and Stress in Long COVID: Systematic Review of Prevalence.}, journal = {International journal of environmental research and public health}, volume = {22}, number = {6}, pages = {}, pmid = {40566294}, issn = {1660-4601}, support = {88881.657963/2021-01//Coordenação de Aperfeicoamento de Pessoal de Nível Superior/ ; }, mesh = {Humans ; *COVID-19/psychology/epidemiology/complications ; *Anxiety/epidemiology/etiology ; *Depression/epidemiology/etiology ; Prevalence ; *Stress, Psychological/epidemiology/etiology ; Aged ; SARS-CoV-2 ; Adult ; }, abstract = {Anxiety, depression, and stress are prevalent psychosocial manifestations in Long COVID, and understanding their global impact can guide safe, effective, and evidence-based interventions. This study reviewed the literature to analyze the prevalence indicators and predictors of anxiety, depression, or stress experienced by adults and older adults with Long COVID. This systematic prevalence review was conducted using the databases MEDLINE via PubMed[®], CINAHL-EBSCO, Web of Science, Scopus, EMBASE, LILACS, and BDENF. Observational studies that assessed anxiety, depression, or perceived stress in adults and older adults with Long COVID were included, with no restrictions on time or language. Two reviewers independently conducted the selection process. Full texts were analyzed for their eligibility potential. Methodological quality was assessed using the JBI Critical Appraisal Checklist for Studies. Ten observational studies with moderate methodological quality were included. Anxiety and depression were the most prevalent psychosocial symptoms in Long COVID, reported in mild, moderate, and severe cases of COVID-19 infection. Prevalence rates reached up to 47.8% for anxiety, 37.3% for depression, and 23% for stress. The combined analysis revealed a pooled prevalence of 15.3% (95% CI: 10.8% to 20.2%). Being female, having pre-existing mental disorders or associated clinical comorbidities, experiencing severe infection in the acute phase, and receiving intensive care were predictors of greater mental burden. The experience of anxiety, depression, and stress in prolonged COVID-19 was reported in countries with different income levels and was disproportionately experienced, especially by women and individuals with associated clinical conditions or psychopathological comorbidities.}, } @article {pmid40566273, year = {2025}, author = {Bondanini, G and Giovanelli, C and Mucci, N and Giorgi, G}, title = {The Dual Impact of Digital Connectivity: Balancing Productivity and Well-Being in the Modern Workplace.}, journal = {International journal of environmental research and public health}, volume = {22}, number = {6}, pages = {}, pmid = {40566273}, issn = {1660-4601}, mesh = {Humans ; *Workplace/psychology ; *Efficiency ; *COVID-19 ; *Occupational Health ; Burnout, Professional ; }, abstract = {BACKGROUND: Digital connectivity is essential in modern work environments, enhancing productivity and communication. However, its rapid expansion post-COVID-19 raises concerns about burnout, digital fatigue, and work-related stress.

OBJECTIVE: This PRISMA-based systematic review examines the benefits and challenges of digital work, assessing its impact on occupational health and proposing mitigation strategies.

METHODS: A systematic search of PubMed, Google Scholar, Scopus, and Cochrane Library identified 40 peer-reviewed studies published since 2020, focusing on digital connectivity, remote work, and employee well-being. Studies on purely technological aspects were excluded.

RESULTS: While digital tools improve efficiency and flexibility, they also increase workload, cognitive overload, and stress. Prolonged screen exposure contributes to mental exhaustion and sleep disturbances. Limited digital infrastructure further exacerbates productivity barriers.

CONCLUSIONS: Digital connectivity offers both opportunities and risks. Organizations should implement structured policies such as offline hours, digital detox initiatives, and mental health support to sustain productivity and well-being. Future research should explore sector-specific interventions and long-term impacts of digital work practices.}, } @article {pmid40565889, year = {2025}, author = {Pálok, D and Kiss, B and Élő, LG and Dósa, Á and Zubek, L and Élő, G}, title = {Enhancing Safety and Quality of Cardiopulmonary Resuscitation During Coronavirus Pandemic.}, journal = {Journal of clinical medicine}, volume = {14}, number = {12}, pages = {}, pmid = {40565889}, issn = {2077-0383}, abstract = {Background: Professional knowledge and experience of healthcare organization went through continuous change and development with the progression of COVID-19 pandemic waves. However, carefully developed guidelines for cardiopulmonary resuscitation (CPR) remained largely unchanged regardless of the epidemic situation, with the largest change being a more prominent bioethical approach. It would be possible to further improve the quality of CPR by systematic data collection, the facilitation of prospective studies, and further development of the methodology based on this evidence, as well as by providing information and developing provisions on interventions with expected poor outcomes, and ultimately by refusing resuscitation. Methods: This study involved the critical collection and analysis of literary data originating from the Web of Science and PubMed databases concerning bioethical aspects and the efficacy of CPR during the COVID-19 pandemic. Results: According to the current professional recommendation of the European Resuscitation Council (ERC), CPR should be initiated immediately in case of cardiac arrest in the absence of an exclusionary circumstance. One such circumstance is explicit refusal of CPR by a well-informed patient, which in practice takes the form of a prior declaration. ERC prescribes the following conjunctive conditions for do-not-attempt CPR (DNACPR) declarations: present, real, and applicable. It is recommended to take the declaration as a part of complex end-of-life planning, with the corresponding documentation available in an electronic database. The pandemic has brought significant changes in resuscitation practice at both lay and professional levels as well. Incidence of out-of-hospital resuscitation (OHCA) did not differ compared to the previous period, while cardiac deaths in public places almost halved during the epidemic (p < 0.001) as did the use of AEDs (p = 0.037). The number of resuscitations performed by bystanders and by the emergency medical service (EMS) also showed a significant decrease (p = 0.001), and the most important interventions (defibrillation, first adrenaline time) suffered a significant delay. Secondary survival until hospital discharge thus decreased by 50% during the pandemic period. Conclusions: The COVID-19 pandemic provided a significant impetus to the revision of guidelines. While detailed methodology has changed only slightly compared to the previous procedures, the DNACPR declaration regarding self-determination is mentioned in the context of complex end-of-life planning. The issue of safe environment has come to the fore for both lay and trained resuscitators. Future Directions: Prospective evaluation of standardized methods can further improve the patient's autonomy and quality of life. Since clinical data are controversial, further prospective controlled studies are needed to evaluate the real hazards of aerosol-generating procedures.}, } @article {pmid40565471, year = {2025}, author = {Tsimtsiou, Z and Pagkozidis, I and Pappa, A and Triantafyllou, C and Vasileiou, C and Stridborg, M and Fonseca, VR and Breda, J}, title = {What Do We Know About Contemporary Quality Improvement and Patient Safety Training Curricula in Health Workers? A Rapid Scoping Review.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {12}, pages = {}, pmid = {40565471}, issn = {2227-9032}, support = {001/WHO_/World Health Organization/International ; REFORM/IM2023/001//European Union/ ; }, abstract = {BACKGROUND AND OBJECTIVE: Despite growing emphasis on quality and safety in healthcare, there remains a limited understanding of how Quality Improvement and Patient Safety (QI/PS) training for health workers has evolved in response to global events like the COVID-19 pandemic and the WHO Global Patient Safety Action Plan. This rapid scoping review aimed to not only identify existing curricula but also uncover trends, innovation gaps, and global inequities in QI/PS education-providing timely insights for reshaping future training strategies.

METHODS: We searched MEDLINE and Scopus for English-language studies published between January 2020 and April 2024, describing QI and/or PS curricula across graduate, postgraduate, and continuing education levels. All healthcare worker groups were eligible, with no geographic limitations. Two reviewers conducted independent screening and data extraction; a third verified the results.

RESULTS: Among 3290 records, 74 curricula met inclusion criteria, with a majority originating from the US (58, 78.4%) and targeting physicians-especially residents and fellows (43/46, 93.5%). Only 27% of curricula were multidisciplinary. While traditional didactic (66.2%) and interactive (73%) approaches remained prevalent, curricula launched after 2020 introduced novel formats such as Massive Open Online Courses and gamification, with long-term programs uniformly leveraging web-based platforms. Common thematic content included Root Cause Analysis, Plan-Do-Study-Act cycles, QI tools, communication skills, and incident reporting. English-language peer-reviewed published literature indicated a marked lack of structured QI/PS training in Europe, Asia, and Africa.

CONCLUSIONS: This review reveals both an uneven development and fragmentation in global QI/PS training efforts, alongside emerging opportunities catalyzed by digital transformation and pandemic-era innovation. The findings highlight a critical gap: while interest in QI/PS is growing, scalable, inclusive, and evidence-based curricula remain largely concentrated in a few high-income countries. By mapping these disparities and innovations, this review provides actionable direction for advancing more equitable and modern QI/PS education worldwide, whilst showcasing the need to systematically delve into QI/PS training in underrepresented regions.}, } @article {pmid40564973, year = {2025}, author = {Akher, SA and Wang, KY and Hall, K and Hunpatin, OS and Shan, M and Zhang, Z and Guo, Y}, title = {Harnessing Transient Expression Systems with Plant Viral Vectors for the Production of Biopharmaceuticals in Nicotiana benthamiana.}, journal = {International journal of molecular sciences}, volume = {26}, number = {12}, pages = {}, pmid = {40564973}, issn = {1422-0067}, support = {2022SFGC0102//Key R&D Program of Shandong Province/ ; ASTIP-TRIC02//the Agricultural Science and Technology Innovation Program/ ; P20GM103436-24 (KY INBRE)//the National Institute of General Medical Sciences, National Institutes of Health./ ; }, mesh = {*Nicotiana/genetics/metabolism/virology ; *Genetic Vectors/genetics ; *Recombinant Proteins/biosynthesis/genetics ; Plants, Genetically Modified/genetics/metabolism ; Molecular Farming/methods ; Humans ; COVID-19/virology ; SARS-CoV-2 ; Gene Editing ; Bioreactors ; }, abstract = {Plant Molecular Farming (PMF) capitalizes on the unique properties of plants as bioreactors to efficiently produce valuable proteins, pharmaceuticals, and enzymes. This review emphasizes the critical role of transient expression systems, particularly in Nicotiana benthamiana, due to its susceptibility to various pathogens. Viral vector-based transient expression has proven essential during health emergencies like COVID-19, enabling rapid recombinant protein production. The review also evaluates different transient expression platforms and highlights their applications in biopharmaceutical production, education, synthetic biology, and gene editing. Advances in viral vector modification, hydroponics, and Controlled Environment Agriculture (CEA) are presented as transformative innovations enhancing scalability and regulatory compliance. Furthermore, glycoengineering advancements broaden the range of producible biopharmaceuticals, improving global medication access. By exploring these advancements, this review underscores the vast potential of transient expression systems to meet dynamic scientific and market demands, positioning PMF as a vital component in modern biotechnology.}, } @article {pmid40564613, year = {2025}, author = {Daovisan, H and Sathiyamas, J and Choowan, P and Suwanwong, C}, title = {Rethinking Post-COVID-19 Behavioral Science: Old Questions, New Insights.}, journal = {Behavioral sciences (Basel, Switzerland)}, volume = {15}, number = {6}, pages = {}, pmid = {40564613}, issn = {2076-328X}, abstract = {The COVID-19 pandemic has radically transformed behavioral science research. While many disciplines have been shown increasing attention in the existing literature, behavioral science uniquely revisits old questions to develop new theoretical perspectives for the post-COVID-19 era. Our systematic search of the literature allowed us to map 505 records that met our criteria, found across 102 papers; from these, we chose 11 articles published between 2021 and 2024. The focus of this review is on examining old questions while providing fresh insights into social, psychological, cognitive, healthcare, and human behavior. The findings emphasize the relevance of the TPB, the HBM, SCT, and the COM-B model, which effectively provide new theoretical insights into post-COVID-19 research. This study shows that theory-informed practices have been integrated into behavioral science research since the COVID-19 pandemic. Practical applications depend on these insights, which can inform evidence-based practice of planned behavior in healthcare policy, academic research, and community practice.}, } @article {pmid40564201, year = {2025}, author = {Hemat Jouy, S and Tonchev, H and Mostafa, SM and Mahmoud, AM}, title = {Post-COVID Metabolic Fallout: A Growing Threat of New-Onset and Exacerbated Diabetes.}, journal = {Biomedicines}, volume = {13}, number = {6}, pages = {}, pmid = {40564201}, issn = {2227-9059}, support = {R00 HL140049/HL/NHLBI NIH HHS/United States ; R01 HL161386/HL/NHLBI NIH HHS/United States ; 1R00HL140049-03/NH/NIH HHS/United States ; 1R01HL161386-04/NH/NIH HHS/United States ; }, abstract = {Emerging evidence highlights the profound and lasting impact of severe illnesses such as COVID-19, particularly among individuals with underlying comorbidities. Patients with pre-existing conditions like diabetes mellitus (DM) are disproportionately affected, facing heightened risks of both disease exacerbation and the onset of new complications. Notably, the convergence of advanced age and DM has been consistently associated with poor COVID-19 outcomes. However, the long-term metabolic consequences of SARS-CoV-2 infection, especially its role in disrupting glucose homeostasis and potentially triggering or worsening DM, remain incompletely understood. This review synthesizes current clinical and experimental findings to clarify the bidirectional relationship between COVID-19 and diabetes. We critically examine literature reporting deterioration of glycemic control, onset of hyperglycemia in previously non-diabetic individuals, and worsening of metabolic parameters in diabetic patients after infection. Furthermore, we explore proposed mechanistic pathways, including pancreatic β-cell dysfunction, systemic inflammation, and immune-mediated damage, that may underpin the development or progression of DM in the post-COVID setting. Collectively, this work underscores the urgent need for continued research and clinical vigilance in managing metabolic health in COVID-19 survivors.}, } @article {pmid40564001, year = {2025}, author = {Zhu, Y and Zhang, Y and Shao, J and Jie, L}, title = {Glucocorticoid-Mediated Extracellular Matrix Regulation: Implications for Precision Therapy.}, journal = {Biomedicines}, volume = {13}, number = {6}, pages = {}, pmid = {40564001}, issn = {2227-9059}, support = {2024A1515012856//Natural Science Foundation of Guangdong Province/ ; 82474245//National Natural Science Foundation of China/ ; }, abstract = {Glucocorticoids (GCs) have revolutionized the treatment of multidisciplinary diseases. Recently, its role in severe infectious diseases has been revisited and discussed since the COVID-19 pandemic. Previous research and discussions have focused more on their anti-inflammatory effects and impact on the immune system, with limited study on other aspects of their action and mechanisms. In recent years, it has been discovered that glucocorticoids can regulate the extracellular matrix by influencing the cellular microenvironment and processes such as fibrosis, thereby exerting regulatory effects on diseases. This article summarizes current research on GC-mediated extracellular matrix (ECM) remodeling. It emphasizes the dual role of the ECM as a therapeutic target and a source of biomarkers, and identifies molecular mechanisms and potential biomarkers for precise glucocorticoid therapy, such as type I collagen (PRO-C1), type III collagen (PRO-C3), fibrillin-C (FBN-C), and type III collagen degradation (C3M). These findings may also contribute to the development of more precise new drugs.}, } @article {pmid40563736, year = {2025}, author = {Doskas, T and Vavougios, GD and Kormas, C and Kokkotis, C and Tsiptsios, D and Spiliopoulos, KC and Tsiakiri, A and Christidi, F and Aravidou, T and Dekavallas, L and Kazis, D and Dardiotis, E and Vadikolias, K}, title = {Neurocognitive Impairment After COVID-19: Mechanisms, Phenotypes, and Links to Alzheimer's Disease.}, journal = {Brain sciences}, volume = {15}, number = {6}, pages = {}, pmid = {40563736}, issn = {2076-3425}, abstract = {BACKGROUND/OBJECTIVES: SARS-CoV-2 can affect the central nervous system directly or indirectly. AD shares several similarities with long COVID cognitive impairment on a molecular and imaging level, as well as common risk factors. The objective of this review is to evaluate the incidence of post-acute COVID-19 cognitive impairment. Secondarily, we aim to determine if neuroinflammation in COVID-19 survivors may be associated with the onset of neurological disease, with a focus on Alzheimer's disease (AD).

METHODS: literature search up to March 2025 on the prevalence of cognitive deficits in COVID-19 survivors, underlying pathophysiology and associations with neurological disorders.

RESULTS: a wide array of neuropsychiatric manifestations is associated with COVID-19; executive function, memory, and attention are the most frequently reported neurocognitive deficits, regardless of COVID-19 severity. There are associations between the risks for cognitive deficits post-infection with the age of the patients and the severity of the disease. Increasing evidence suggests that neurocognitive deficits are associated with the onset of neurological and neuropsychiatric disease in COVID-19 survivors.

CONCLUSIONS: clinicians caring for COVID-19 survivors should actively investigate neurocognitive sequelae, particularly for patients with increased risk for cognitive deficits.}, } @article {pmid40563525, year = {2025}, author = {Ponce, A and Flores-Maldonado, C and Contreras, RG}, title = {Cardiac Glycosides: From Natural Defense Molecules to Emerging Therapeutic Agents.}, journal = {Biomolecules}, volume = {15}, number = {6}, pages = {}, pmid = {40563525}, issn = {2218-273X}, support = {CF-2019-7357//National Research Council of Mexico (CONAHCYT)/ ; }, mesh = {Humans ; *Cardiac Glycosides/pharmacology/therapeutic use/chemistry ; Animals ; Antiviral Agents/pharmacology/therapeutic use ; Signal Transduction/drug effects ; Neoplasms/drug therapy ; SARS-CoV-2/drug effects ; COVID-19 Drug Treatment ; }, abstract = {Cardiac glycosides (CGs), a class of plant- and animal-derived compounds historically used to treat heart failure, have garnered renewed interest for their diverse pharmacological properties beyond Na[+]/K[+]-ATPase (NKA) inhibition. Recent studies reveal that CGs modulate key signaling pathways-such as NF-κB, PI3K/Akt, JAK/STAT, and MAPK-affecting processes central to cancer, viral infections, immune regulation, and neurodegeneration. In cancer, CGs induce multiple forms of regulated cell death, including apoptosis, ferroptosis, pyroptosis, and immunogenic cell death, while also inhibiting angiogenesis, epithelial-mesenchymal transition, and cell cycle progression. They demonstrate broad-spectrum antiviral activity by disrupting viral entry, replication, and mRNA processing in viruses such as HSV, HIV, influenza, and SARS-CoV-2. Immunologically, CGs regulate Th17 differentiation via RORγ signaling, although both inhibitory and agonistic effects have been reported. In the nervous system, CGs modulate neuroinflammation, support synaptic plasticity, and improve cognitive function in models of Alzheimer's disease, epilepsy, and multiple sclerosis. Despite their therapeutic potential, clinical translation is hindered by narrow therapeutic indices and systemic toxicity. Advances in drug design and nanocarrier-based delivery are critical to unlocking CGs' full potential as multi-target agents for complex diseases. This review synthesizes the current knowledge on the emerging roles of CGs and highlights strategies for their safe and effective repurposing.}, } @article {pmid40562255, year = {2025}, author = {Argyrou, M and Pitsillou, E and Hung, A and El-Osta, A and Karagiannis, TC}, title = {Insights into the pathogenic mechanisms associated with the SARS-CoV-2 spike protein.}, journal = {Journal of structural biology}, volume = {217}, number = {3}, pages = {108229}, doi = {10.1016/j.jsb.2025.108229}, pmid = {40562255}, issn = {1095-8657}, mesh = {*Spike Glycoprotein, Coronavirus/chemistry/metabolism/genetics ; Humans ; *SARS-CoV-2/pathogenicity/metabolism ; *COVID-19/virology/metabolism ; Angiotensin-Converting Enzyme 2/metabolism/chemistry ; Protein Binding ; Furin/metabolism ; Virus Internalization ; }, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the pathogenic agent responsible for the coronavirus disease 2019 (COVID-19) pandemic, uses the trimeric spike protein to gain entry into the host cell. Structural studies have revealed that the spike protein is comprised of the S1 and S2 subunits. The S1 subunit of the spike protein contains the receptor-binding domain (RBD), which binds to the human angiotensin-converting enzyme 2 (ACE2) receptor. The interaction between the RBD and ACE2 facilitates membrane fusion and host cell infection. The SARS-CoV-2 spike protein also contains a unique insertion of four amino acids that results in the 682-RRAR↓S-686 polybasic furin cleavage motif at the boundary of the S1 and S2 subunits. The furin cleavage motif contributes to the high infectivity and transmissibility of SARS-CoV-2. This review provides a comprehensive analysis of the molecular interactions of the spike protein, with a specific focus on the RBD and furin cleavage site. In addition to examining the binding characteristics with ACE2, the interactions with alternative receptors, such as neuropilin-1 (NRP1) and the nicotinic acetylcholine receptors (nAChRs) are highlighted. The ability of the spike protein to bind alternative receptors and host factors has been linked to the pathophysiology of COVID-19 and the persistence of symptoms in the post COVID-19 condition. Furthermore, we examine the impact of spike protein mutations on receptor affinity and disease severity. SARS-CoV-2 continues to evolve, with variants remaining an ongoing threat to public health. Understanding these molecular interactions is critical for the development of novel therapeutic interventions.}, } @article {pmid40562174, year = {2025}, author = {Bartoletti, M and Azap, O and Barac, A and Ben Selma, M and Ergonul, O and Gkrania-Klotsas, E and Grossi, PA and Krause, R and Nagavci, B and Paño-Pardo, JR and Pierrotti, LC and Power, N and Rodríguez-Baño, J and Sibani, M and Slavin, MA and Szabo, BG and Tazza, B and Yung Tsang, NN and Tsiodras, S and Zollner-Schwetz, I and Chemaly, RF and , }, title = {Management of COVID-19 in immunocompromised patients: an European Society of Clinical Microbiology and Infectious Diseases consensus document.}, journal = {Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases}, volume = {31}, number = {10}, pages = {1655-1666}, doi = {10.1016/j.cmi.2025.05.032}, pmid = {40562174}, issn = {1469-0691}, mesh = {Humans ; *COVID-19/therapy ; COVID-19 Drug Treatment ; Europe ; *Immunocompromised Host ; Immunosuppressive Agents/therapeutic use ; }, abstract = {INTRODUCTION: Data on treatment of COVID-19 in immunocompromised patients emerged recently; however, published guidelines for the management of COVID-19 in immunocompromised patients are lacking.

AIM AND METHODS: To develop consensus statements derived from evidence and expert opinion on management of COVID-19 in immunocompromised patients, an expert panel was convened by European Society for Clinical Microbiology and Infectious Diseases. The expert panel developed a list of questions which are of general interest for clinicians and readers with backgrounds in clinical microbiology and infectious diseases. Six questions were selected. For each question, systematic literature searches were undertaken. We considered most study types, including clinical trials, observational studies with or without a control group, systematic reviews, case series, and case reports. Detailed inclusion criteria were defined for each research question using the Population Intervention Comparison Outcome format. Immunocompromised patients included patients with (a) primary immune deficiencies; (b) active malignancy or malignancy diagnosed or received cancer therapies within 1 year of COVID-19 diagnosis, (c) HIV with a CD4+ T-lymphocyte count <200 cells/mm[3] or percentage <14%; (d) receipt of solid organ transplant within 1 year of COVID-19 diagnosis; (e) receipt of haematopoietic cell transplant or chimeric antigen receptor T-cell therapy within 1 year of COVID-19 diagnosis; (f) receipt of systemic corticosteroid therapy with a dose of ≥20 mg prednisone or equivalent daily for ≥14 days or a cumulative dose of >600 mg of prednisone; (g) receipt of biological immune modulators; or (h) receipt of disease-modifying antirheumatic drugs or other immunosuppressive drugs. The panel's consensus statements were based on evidence, supplemented by experience and expert opinion, especially in cases when evidence was limited or scarce. This document is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standard.}, } @article {pmid40561878, year = {2025}, author = {Ali, SB and Gurnari, C}, title = {Infections in VEXAS syndrome: a systematic review of the literature.}, journal = {Current research in translational medicine}, volume = {73}, number = {4}, pages = {103524}, doi = {10.1016/j.retram.2025.103524}, pmid = {40561878}, issn = {2452-3186}, abstract = {Vacuolation, E1 enzyme, X-linked, autoinflammatory, somatic (VEXAS) syndrome is a multisystem disease for which chronic immunosuppression is needed. Opportunistic infections are common; however, a clear prophylaxis regimen is not defined. A systematic review of the literature was undertaken. Six publications with 123 patients were evaluated. Of 86 patients with demographic data; most were males (n = 85, 98.8 %) and median age was 73 years. UBA1 mutational status was reported in 80 patients: p.Met41Thr (n = 43, 53.8 %), p.Met41Val (n = 17, 21.3 %) and p.Met41Leu (n = 12, 15.0 %) were most common. In these patients, 48 (60 %) had underlying myelodysplastic syndrome. Many of the patients had multiple hospitalizations. Infections were reported as follows: COVID19 (n = 20), Pneumocystis jiroveci pneumonia (PJP) (n = 16), nontuberculous mycobacterium (NTM) species (n = 16), Enterobacteriaceae species (n = 14), Legionella species (n = 13), Varicella Zoster virus (n = 11) and Herpes Simplex Virus (n = 8) infections, respectively. Daily prednisolone dose was at, or greater than 10 mg and overall median long term steroid treatment duration was 3.1 years. Notably, for NTM the median daily prednisolone dose was 12.5 mg. Median prednisolone dosing for PJP was only reported in one of the publications, comprising six patients, at 17 mg per day. Where data was available, 45 of the 95 patients (47.3 %) were deceased at last follow-up. Of the 45 deaths, 32 (71.1 %) were attributed to the intercurrent infection. In summary, opportunistic infections are commonly reported in VEXAS syndrome. Prophylaxis for such infections remains paramount but no clear consensus on recommendations exists, highlighting the need for prospective studies. Moreover, furthering our understanding of pathophysiology of VEXAS syndrome and impairment in both innate and humoral immunity may clarify its contribution to infections in addition to high background immunosuppressive therapies.}, } @article {pmid40561741, year = {2025}, author = {Hosseini, H and Hosseini, F and Bolourian, S and Assadpour, E and Jafari, SM}, title = {Formulation of bioactive-loaded chewing gums; techno-functional and health-promoting attributes along with in-vitro and in-vivo release studies.}, journal = {Advances in colloid and interface science}, volume = {343}, number = {}, pages = {103583}, doi = {10.1016/j.cis.2025.103583}, pmid = {40561741}, issn = {1873-3727}, mesh = {Humans ; *Chewing Gum ; COVID-19/prevention & control ; Drug Liberation ; }, abstract = {The approved health and functional influences of the bioactive compounds has caused the development of many products delivering them to human body. Chewing gum (CWG) matrix could be one of the best novel delivering systems, as (i) it is a pleasant product for consumers, especially children, (ii) primarily protects the sensitive bioactives, (iii) originally provides positive effects on the memory, alertness, weight and stress, (iv) its application is easily possible at any time and place, (v) is commonly remained within oral cavity and chewed for a varied duration before throwing out, and (vi) it is possible to design a broad range of delivery profiles by controlling the type and content of the other ingredients, encapsulation of bioactives, and changing the production procedure. Therefore, this review is aimed to focus on the practical applications of the bioactive-containing CWG in improving our health (e.g., saliva stimulation, supplying mineral, vitamin, and antioxidant, improved cognitive function, smoking cessation, and preventing diseases e.g., oral infections, dental caries, enamel demineralization, formation of calculus, extrinsic tooth stain and plaque, gastrointestinal (GI) problems, cancer, Covid-19, etc.). The relevant studies confirmed that due to compliance with pharmaceutical standards, spontaneously providing both systemic and local delivery, fast onset of action, limited first pass metabolism, resistance to enzymes and acids, adequate stability, enhancing cognitive function and alertness and a lot more, it can be imagined for CWG to be much more popular to the market and patients in the near future. Nevertheless, more in-vivo and clinical studies should be established to monitor the release behavior of different bioactives from CWG into the biological media as affected by various factors. Finally, well-designed/documented studies for the optimized functional/medicinal CWG are commercially available, providing the desired health effects besides considering the consumer concerns, namely well organoleptic characteristics, practical efficiency, reasonable price and application of eco-friendly ingredients, especially gum base, as possible.}, } @article {pmid40561313, year = {2025}, author = {Viniegra, RFS and da Silva-Junior, AG}, title = {Resilience and vulnerability in women's health care during the COVID-19 pandemic: an integrative review.}, journal = {Ciencia & saude coletiva}, volume = {30}, number = {6}, pages = {e03792025}, doi = {10.1590/1413-81232025306.03792025}, pmid = {40561313}, issn = {1678-4561}, mesh = {Humans ; *COVID-19/epidemiology/psychology ; Female ; *Resilience, Psychological ; *Vulnerable Populations ; *Women's Health ; Health Services Accessibility ; Pandemics ; *Women's Health Services/organization & administration ; }, abstract = {This study seeks to identify the concept of resilience and reflect on factor that made women's heath vulnerable and protected (at personal level and in health services) during the COVID-19 pandemic. This is an integrative review of the literature, carried out in the SciELO, BVS, PubMed and LILACS databases, using the descriptors resilience, women's health, gynecology, obstetrics, COVID-19 and pandemic, covering the years 2020 to 2022, in Portuguese and English. 43 articles were included and analyzed in 4 thematic areas: concept of resilience, impacts of the pandemic on health services, stressors and personal resilience factors, and impacts of the pandemic on women' lives. Highlights difficulties in adapting the health network to the crisis stand out, as well as losses in access to services and information, leading to physical and mental harm, especially for the most vulnerable population. Factors that promote resilience were physical activity, interpersonal support, routine, education, income and maintenance of some services. Resilience in healthcare is a new, complex and promising field, which should be encouraged, as it contributes to strategies for improving and adapting healthcare systems and people's lives, preventively, during and after crises.}, } @article {pmid40560121, year = {2025}, author = {Torri, F and Schirinzi, E and Fontanelli, L and Ricci, G and Mancuso, M and Bochicchio, M and Siciliano, G}, title = {Telemedicine and remote monitoring in neuromuscular diseases: Challenges and opportunities.}, journal = {Journal of neuromuscular diseases}, volume = {}, number = {}, pages = {22143602251330436}, doi = {10.1177/22143602251330436}, pmid = {40560121}, issn = {2214-3602}, abstract = {BACKGROUND: Telemedicine, the application of those information technologies to remotely provide health services either for synchronously catching or asynchronous monitoring patient medical data, has shown a growing and widespread application in several chronic diseases, and, especially during and after COVID-19 pandemics, also in neuromuscular diseases.

OBJECTIVE: this review aims at providing an updated overview on the application of telemedicine and telemonitoring tools in neuromuscular diseases, in clinical practice, research and trials.

METHODS: a literature search was conducted on PubMed using keywords regarding telemedicine applications and several neuromuscular diseases, including papers up to May 2024.

CONCLUSIONS: several tools have been developed and tested in myopathies, motoneuron diseases, myasthenia gravis and peripheral neuropathies, providing monitoring, assistance, and rehabilitation protocols for such frail population, for which obtaining real life data remotely can represent a concrete advantage in clinical trials and clinical practice. Although several barriers in the implementation of telemedicine in NMD still need to be overcome, there is evidence for both clinicians and patients showing positive acceptance and satisfaction on the use of remote supports, regarding them as confident outcome measures of quality of life in view of a more general concept of e-health solutions in routine medical care.}, } @article {pmid40559719, year = {2025}, author = {Qian, Q and Fan, G and Yang, W and Shen, C and Yang, Y and Liu, Y and Xiao, W}, title = {Advances in Diagnostic Techniques for Influenza Virus Infection: A Comprehensive Review.}, journal = {Tropical medicine and infectious disease}, volume = {10}, number = {6}, pages = {}, pmid = {40559719}, issn = {2414-6366}, support = {2024YFC2309900，2022YFC2304400，2022B1515020075，XKJS-CRGRK-006，LCYSSQ20220823091203007，SZSM202311033//National Key R&D Program of China, National Key Research and Development Program of China , Guangdong Basic and Applied Basic Research Foundation , Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties , Shenzhen Clinical Research Cen/ ; }, abstract = {Influenza poses a significant global health burden due to its high transmissibility, antigenic variability, and substantial morbidity. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has further complicated influenza dynamics, highlighting the need for rapid, accurate, and accessible diagnostics. This review comprehensively summarized the advancements in influenza virus (IFV) detection, from conventional methods like viral culture and serology to modern molecular techniques, including CRISPR-based systems, next-generation sequencing (NGS), and biosensors. We analyze the sensitivity, specificity, and applicability of these methods and emphasize their roles in clinical and public health settings. While traditional techniques remain valuable for strain characterization, novel technologies like CRISPR and portable biosensors offer rapid, low-resource solutions. This review provides a comprehensive insight into the development of integrated diagnostic strategies for seasonal IFV epidemics and future pandemics.}, } @article {pmid40559673, year = {2025}, author = {Nash, C}, title = {Towards Optimal Health Through Boredom Aversion Based on Experiencing Psychological Flow in a Self-Directed Exercise Regime-A Scoping Review of Recent Research.}, journal = {Sports (Basel, Switzerland)}, volume = {13}, number = {6}, pages = {}, pmid = {40559673}, issn = {2075-4663}, abstract = {BACKGROUND: Optimal health requires self-direction for exercise regime consistency. Boredom may cause abandoning regular exercise. Experiencing psychological flow-a concept psychologist Csikszentmihalyi originated-may avert boredom.

METHOD: A search of post-2020 peer-reviewed publications following the PRISMA-ScR guidelines for scoping reviews investigates the range of research on this topic. The databases searched are OVID, ProQuest, PubMed, Scopus, Web of Science, and Google Scholar. The keywords are "Csikszentmihalyi AND flow AND exercise AND boredom". Included returns contain all the keywords. Those excluded are reviews, books, reports missing any keywords, non-English reports, reports not based on research studies, and research published before 2020.

RESULTS: Two databases returned the included results: OVID (n = 3) and Google Scholar (n = 8).

CONCLUSIONS: (1) Boredom is not evident when experiencing exercise-programme psychological flow. (2) Psychological flow evolves with self-directed changes in an exercise programme. (3) Successful exercise programme modifications during COVID-19 considered the imposed limitations. (4) Exercise regimes that are neither excessive nor extreme promote optimal health. And (5) optimal health accounts for exercise skill level and gender. Additionally, cognitive bias is avertable with a research team. Studies should include the research date and location and how flow reduces boredom, permitting accurate comparisons.}, } @article {pmid40559563, year = {2025}, author = {Stasi, C and Bellini, M}, title = {Digestive Manifestations of Post-COVID-19: A Focus on Therapeutic Strategies.}, journal = {Pathogens (Basel, Switzerland)}, volume = {14}, number = {6}, pages = {}, pmid = {40559563}, issn = {2076-0817}, mesh = {Humans ; *COVID-19/complications/virology ; SARS-CoV-2 ; Gastrointestinal Microbiome ; *Irritable Bowel Syndrome/etiology/virology ; Angiotensin-Converting Enzyme 2/metabolism ; Antiviral Agents/therapeutic use ; }, abstract = {Post-COVID-19 is a chronic infection-related syndrome, including exacerbations of pre-existing or newly diagnosed conditions that have been established after the acute phase of COVID-19 and have demonstrated a wide range of systemic effects beyond the lungs. SARS-CoV-2 attaches to its receptor, angiotensin-converting enzyme 2 (ACE-2). Transmembrane serine protease 2 (TMPRSS2) facilitates viral entry and spread. ACE-2 receptors are detectable in several tissues, including the respiratory mucosa, digestive tract, heart, kidney, and brain. Several investigations have demonstrated an increase in digestive manifestations post-acute COVID-19, likely related to an alteration in the intestinal microbiota following infection. These changes can lead to a loss of species diversity, resulting in an overgrowth of opportunistic pathogens and deprivation of commensal bacteria. In this context, post-infection irritable bowel syndrome shows an increased incidence compared to controls. Growing evidence also suggests the enduring presence of SARS-CoV-2 in the gut tissue. Studies are ongoing to investigate antiviral agents that counteract prolonged COVID-19 symptoms. Therefore, the objectives of this review were to summarize the digestive manifestations, focusing on irritable bowel syndrome and therapeutic strategies. This review gives an overview of studies published in English in the last two years on the PubMed database.}, } @article {pmid40559562, year = {2025}, author = {Hong, M and Wu, G and Ren, Y and Wu, S and Zhu, H and Chen, Z}, title = {Advancements in Pathogen Detection: Argonaute-Based Nucleic Acid Detection Technology.}, journal = {Pathogens (Basel, Switzerland)}, volume = {14}, number = {6}, pages = {}, pmid = {40559562}, issn = {2076-0817}, support = {2021YFF0600805//National Key Research and Development Program/ ; }, mesh = {*Argonaute Proteins/metabolism/chemistry/genetics ; Humans ; *Nucleic Acids/analysis/genetics ; }, abstract = {In recent years, global public health security has encountered significant challenges, with infectious diseases accounting for approximately 25% of global mortality annually. The worldwide pandemic instigated by the novel coronavirus, alongside the persistent threats posed by Ebola, influenza, and multidrug-resistant bacteria, has severely compromised human health, economic development, and social stability. Within this context, the development of rapid and precise pathogen detection technologies has emerged as a critical frontline defense for epidemic prevention and control, serving as a pivotal component in the implementation of the "early detection, early isolation, and early treatment" strategy. The Argonaute (Ago) protein, recognized as a programmable and target-specific activated nuclease, has demonstrated substantial potential in the realm of nucleic acid detection due to its distinctive biological properties, garnering considerable attention. In this study, we delineate the structural characteristics of Ago proteins and elucidate the mechanism underlying their nuclease activity. Furthermore, we review the principles of nucleic acid detection based on Argonaute and provide a comprehensive analysis of recent advancements in related detection systems. Additionally, we compare the advantages of detection based on Argonaute with other detection methodologies. Through a comprehensive analysis, we aim to provide a robust theoretical foundation and an advanced technical reference for the development of new-generation nucleic acid detection platforms with high sensitivity and high specificity.}, } @article {pmid40559430, year = {2025}, author = {Bosco, A and Fanos, V and Bosone, S and Incandela, V and La Ciacera, F and Dessì, A}, title = {SARS-CoV-2 in Asthmatic Children: Same Consequences in Different Endotypes?.}, journal = {Metabolites}, volume = {15}, number = {6}, pages = {}, pmid = {40559430}, issn = {2218-1989}, abstract = {During the early stages of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, concerns arose regarding the susceptibility of asthmatic children, one of the most common chronic conditions in childhood and a major cause of hospitalization in pediatric settings. Unexpectedly, evidences showed milder clinical courses and fewer asthma exacerbations in these patients, even if cases of critical and fatal infection, often related to specific clinical features of the patient, are not negligible. In this regard, obesity is considered not only an important comorbidity in patients with difficult-to-treat asthma but also a risk factor for more severe forms of COVID-19. These observations are of even greater concern in the context of an increase in childhood obesity that began even before the SARS-CoV-2 pandemic and has continued also as a consequence of it. Given asthma's heterogeneity, especially in children, an endotype-based approach is crucial. This is possible through a detailed analysis of the complex metabolic pathways that correlate asthma, COVID-19 infection and obesity thanks to new high-through-put technologies, especially metabolomics, which with minimally invasive sampling, including on exhaled breath condensate (EBC), can provide precise and unbiased evidence in support of existing endotypes, making it possible to identify not only the most vulnerable individuals and thus risk stratification through specific biomarkers, but also new molecular and therapeutic targets. This review explores asthma endotypes by highlighting their shared immunometabolic pathways with COVID-19. Findings suggest that metabolomics could enable more accurate risk stratification and guide personalized interventions during viral pandemics, especially in the presence of relevant comorbidities such as obesity.}, } @article {pmid40559389, year = {2025}, author = {Liu, H and Coarfa, C and Charania, AN and Larson-Casey, JL and Rosas, IO and He, C}, title = {Secreted Phosphoprotein 1 in Lung Diseases.}, journal = {Metabolites}, volume = {15}, number = {6}, pages = {}, pmid = {40559389}, issn = {2218-1989}, support = {K08 HL163406/HL/NHLBI NIH HHS/United States ; 5K08HL163406-02/NH/NIH HHS/United States ; }, abstract = {Secreted phosphoprotein 1 (SPP1), also known as osteopontin (OPN) or early T lymphocyte activation protein 1 (ETA-1), is a multifunctional protein involved in numerous biological processes, including immune modulation, stress response, and tissue remodeling. The role of SPP1 in interstitial lung diseases (ILDs) has become an area of increasing interest, given its elevated expression in various ILDs such as idiopathic pulmonary fibrosis (IPF), connective tissue disease-associated ILD (CTD-ILD), and pneumoconiosis, especially with recent data derived from single-cell RNA sequencing. In addition to ILDs, SPP1 has been implicated in infectious granulomatous lung diseases, lung and pleural malignancies, airway diseases, and COVID-19. In most cases, higher SPP1 levels in serum, bronchoalveolar lavage fluid, or lung tissue carry a poor prognosis. SPP1 is expressed in multiple cells critical for fibrogenesis, including macrophages, epithelial cells, and fibroblasts, and SPP1 has emerged as a potential target for therapeutic interventions. Here, we review the proposed mechanisms by which SPP1 contributes to the development of lung disease, with an emphasis on ILD.}, } @article {pmid40559367, year = {2025}, author = {Nyongesa, C and Majeed, T and Remond, M and Lewandowski, A and Dolja-Gore, X and Haysom, L and Sullivan, E}, title = {A Systematic Review of the Concepts of Efficacy, Effectiveness, and Efficiency as Applied and Measured for Virtual Health Care Delivery in Correctional Facilities.}, journal = {Telemedicine journal and e-health : the official journal of the American Telemedicine Association}, volume = {}, number = {}, pages = {}, doi = {10.1089/tmj.2024.0554}, pmid = {40559367}, issn = {1556-3669}, abstract = {Background: The use of virtual care interventions in correctional facilities has increased in recent years owing to the impacts of the COVID-19 pandemic. However, the literature shows variability in the application and measurement of efficacy, effectiveness, and efficiency of virtual care interventions. This systematic review addresses this gap in evidence and provides an overview and appraisal of the methods and measures used to evaluate these aspects of virtual care interventions in correctional facilities, using a modified conceptual framework by the World Health Organization (WHO). Methods: We conducted a systematic review using a narrative synthesis approach. Comprehensive searches were performed in PubMed, Scopus, and Web of Science for peer-reviewed studies published in English between 2014 and 2024. The Joanna Briggs Institute Meta-Analysis of Statistical Assessment and Review Instrument was used to assess the methodological quality of included studies. Results: Twenty-one studies were included, and most were conducted in the United States and focused on synchronous modality for adult males. None of the studies explicitly defined the efficacy, effectiveness, and efficiency of virtual care interventions. The concept of effectiveness was the most frequently explored, and aligned best with WHO's conceptual framework, whereas efficiency was the least explored. The most common evaluation measures were clinical effectiveness, user satisfaction, and interexaminer agreement. Conclusions: This review highlights the need for adopting a unified framework for evaluating virtual care in correctional facilities that can standardize evaluation metrics and improve resource allocation, ultimately enhancing patient outcomes by ensuring that virtual care interventions are efficacious, effective, and efficient.}, } @article {pmid40559088, year = {2025}, author = {Snopkowska Lesniak, SW and Maschio, D and Neria, F and Rey-Delgado, B and Moreno Cuerda, V and Henriquez-Camacho, C}, title = {Novel Biomarkers for SARS-CoV-2 Infection: A Systematic Review and Meta-Analysis.}, journal = {Journal of personalized medicine}, volume = {15}, number = {6}, pages = {}, pmid = {40559088}, issn = {2075-4426}, abstract = {Background: COVID-19, caused by SARS-CoV-2, has posed significant challenge to global healthcare systems, necessitating reliable biomarkers to predict disease severity and mortality. This systematic review and meta-analysis evaluated the prognostic value of novel biomarkers in COVID-19 patients. The aim of this study was to identify and prioritize the most prognostically relevant novel biomarkers associated with COVID-19 outcomes. Methods: We conducted a systematic review and meta-analysis of the available evidence. A systematic search of PubMed and Web of Science was performed to identify studies on the COVID-19 biomarkers. Observational studies that compared poor (severe disease/mortality) and good outcomes were included. For continuous measures, standard mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), and summary receiver operating characteristic (SROC) curve analyses for the biomarkers were used. The risk of bias was assessed using the Newcastle-Ottawa scale. Results: Of the 2907 screened studies, 38 were included (21 in the meta-analysis). MR-proADM showed higher levels of prediction for poor outcomes (SMD = 1.40, 95% CI: 1.11-1.69; AUC 0.74-0.96; sensitivity, 85%; specificity, 71%). The neutrophil-to-lymphocyte ratio (NLR) showed a high correlation with disease severity (SMD = 1.07, 95% CI: 0.79-1.35; AUC 0.73-0.98; sensitivity, 86%; specificity, 78%). Increased KL-6 levels were associated with lung injury (SMD = 1.22, 95% CI: 0.24-2.19; AUC 0.85-0.95). Other biomarkers (suPAR, miR-155, Galectin-3) showed promise but lacked sufficient data for pooled analysis. Heterogeneity was observed among the included studies in terms of diagnostic accuracy. These findings indicate that elevated levels of MR-proADM, NLR, and KL-6 are significantly associated with COVID-19 prognostic accuracy to guide patient management. Conclusions: MR-proADM, NLR, and KL-6 levels demonstrated strong prognostic value for COVID-19 severity and mortality. These biomarkers can enhance clinical decision-making.}, } @article {pmid40558086, year = {2025}, author = {Loperena González, PN and Karthigeyan, KP and Corry, J and Krishna, A and Hackenberg, B and Sierra, B and Kwiek, JJ}, title = {Mammalian fatty acid synthase: a commonly used viral host dependency factor and a putative target for host-targeted broad-spectrum antiviral therapeutic development.}, journal = {mBio}, volume = {16}, number = {8}, pages = {e0395424}, pmid = {40558086}, issn = {2150-7511}, support = {AI090644, AI141037//National Institute of Allergy and Infectious Diseases/ ; R21 AI141037/AI/NIAID NIH HHS/United States ; R01 AI090644/AI/NIAID NIH HHS/United States ; GM141955/GM/NIGMS NIH HHS/United States ; T32 GM141955/GM/NIGMS NIH HHS/United States ; }, mesh = {Humans ; Virus Replication/drug effects ; *Antiviral Agents/pharmacology ; *Fatty Acid Synthases/metabolism/antagonists & inhibitors/genetics ; Animals ; Fatty Acids/biosynthesis/metabolism ; *Host-Pathogen Interactions ; *Viruses/drug effects ; *Virus Diseases/drug therapy/virology ; }, abstract = {Viruses regulate host processes to create cellular environments favorable to viral replication. At least 27 viruses that infect humans require host fatty acid synthase (FASN)-dependent de novo fatty acid biosynthesis, including viruses from the Coronaviridae, Flaviviridae, Herpesviridae, Picornaviridae, Retroviridae, and Togaviridae families. How could FASN activity and subsequent de novo fatty acid production impact viral replication? FASN activity produces the fatty acid palmitate, which can be further metabolized into fatty acids that are used to form lipid droplets that can be used during viral assembly and budding, for beta-oxidation to generate ATP, and to create fatty acyl groups used for post-translational protein modification to change the subcellular localization of viral or host proteins. In this minireview, we outline the function of FASN, review the mechanisms linking virus replication and fatty acid biosynthesis, and consider the potential of FASN as a target for broad-spectrum antiviral drug development.}, } @article {pmid40557830, year = {2025}, author = {Byrne, AL and Pace, NL and Thomas, PS and Symons, RL and Chatterji, R and Bennett, M}, title = {Peripheral venous blood gas analysis for the diagnosis of respiratory failure, hypercarbia and metabolic disturbance in adults.}, journal = {The Cochrane database of systematic reviews}, volume = {6}, number = {6}, pages = {CD010841}, pmid = {40557830}, issn = {1469-493X}, mesh = {Humans ; *Blood Gas Analysis/methods ; Adult ; *Respiratory Insufficiency/diagnosis/blood ; *Hypercapnia/diagnosis/blood ; Carbon Dioxide/blood ; *Metabolic Diseases/diagnosis/blood ; Hydrogen-Ion Concentration ; Bicarbonates/blood ; Oxygen/blood ; }, abstract = {BACKGROUND: Arterial blood gas analysis (ABGA) is the reference standard for the diagnosis of respiratory failure (RF) and metabolic disturbance (MD), but peripheral venous blood gas analysis (PVBGA) is increasingly being used for the estimation of carbon dioxide, pH, and other variables in the context of acutely unwell adults presenting to hospitals and emergency departments.

OBJECTIVES: The primary objective of this review is to evaluate the performance of PVBGA by comparing it with the reference standard ABGA, which is assumed to be error-free for the diagnosis of (1) respiratory failure, (2) hypercarbia, and (3) metabolic disturbance (the three target conditions) in adults. The secondary objective is to evaluate the performance of the index test to diagnose nine specific subtypes of respiratory failure and metabolic disturbance. The definitions for these additional conditions are determined by changes to one or more of the following: pH (acidity), pO2 (partial pressure of oxygen), pCO2 (partial pressure of carbon dioxide), HCO3 (bicarbonate), as stated in the Methods section of this review (target conditions). We aimed to explore the following covariates: participant demographics (e.g. age, weight, and sex); participant comorbidities (e.g. chronic lung disease, chest wall deformity, and central nervous system disorder such as spinal cord injury); and the indication for blood gas sampling (e.g. shortness of breath, critical illness, resuscitation, trauma, or whilst under general anaesthesia).

SEARCH METHODS: On 10 July 2024, we searched the electronic databases MEDLINE, EMBASE, CINAHL, and LILACS. We also manually searched 19 respiratory and critical care journals, and we searched ClinicalTrials.gov for ongoing trials.

SELECTION CRITERIA: We considered consecutive series studies and case-control studies that directly compared the index test PVBGA to the reference standard ABGA for adults over the age of 16 years. The included studies contained data for any one of the target conditions of respiratory failure and metabolic disturbance, as determined by individual changes to pO2 (partial pressure of oxygen), pCO2 (partial pressure of carbon dioxide), pH (acidity), and HCO3 (bicarbonate) concentration. Studies that only provided mean values for summed data were ineligible for inclusion. However, we invited authors of such studies to provide individual patient data for inclusion in this systematic review. There are nine studies awaiting classification.

DATA COLLECTION AND ANALYSIS: Two authors independently evaluated the quality of the relevant studies and extracted data from them. We conducted a quality assessment using the QUADAS-2 tool. Our statistical analysis used 2 x 2 tables for the positive and negative results of each test. We estimated a bivariate meta-analysis of sensitivity and specificity.

MAIN RESULTS: We included six studies (919 participants) in our quantitative analysis. All studies were at high risk of bias due to one or more of the following factors: patient selection, since it was unclear if consecutive patients were included or where they were located; index test, with poor reporting of cut-offs; flow and timing domain because the fraction of inspired oxygen was frequently not stated and any difference between the collection of the VBGA and the ABGA could introduce bias. Respiratory failure For the diagnosis of respiratory failure of any type, when using PVBGA, the estimated summary sensitivity (Sn) was 97.6% (95% credible interval (CI) 94.1 to 99.4) and the estimated summary specificity (Sp) was 36.9% (95% CI 17.1 to 60.1) (6 studies, 805 participants of whom 291 (36%) were diagnosed with respiratory failure by ABGA; sensitivity: low-certainty evidence; specificity: very low certainty evidence). Isolated hypercarbia For the diagnosis of isolated hypercarbia (regardless of oxygen level), when using PVBGA, the estimated summary Sn was 97.1% (95% CI 93.3 to 99.2); the estimated summary Sp value was 53.9% (95% CI 39.8 to 66.7) (6 studies with 805 participants, 269 (33%) with ABGA confirmation; low-certainty evidence). Other findings Results for metabolic disturbance and our secondary target conditions are presented in the full review.

AUTHORS' CONCLUSIONS: Very limited data suggest PVBGA performs poorly as a diagnostic test for respiratory failure compared to the reference standard of ABGA. The index test PVBGA was highly sensitive for the diagnosis of respiratory failure and isolated hypercarbia, but its specificity was poor for these two primary target conditions. The high sensitivity means PVBGA may have a useful role as a "rule out test" for respiratory failure and isolated hypercarbia; however, the high false-positive rates make the clinical interpretation of a positive test difficult. Moreover, we are uncertain regarding these estimates because we have only low to very low certainty about the evidence. Further studies that use (ABGA) established thresholds for the diagnosis of each target condition are needed.}, } @article {pmid40557661, year = {2024}, author = {Bouchat, C and Blum, S and Fobé, E and Brans, M}, title = {Policy advisory bodies during crises: a scoping review of the COVID-19 literature in Europe.}, journal = {Evidence & policy : a journal of research, debate and practice}, volume = {21}, number = {3}, pages = {409-428}, doi = {10.1332/17442648Y2024D000000031}, pmid = {40557661}, issn = {1744-2656}, mesh = {Humans ; *Advisory Committees/organization & administration ; *COVID-19/epidemiology ; Europe/epidemiology ; *Health Policy ; Pandemics ; *Policy Making ; SARS-CoV-2 ; }, abstract = {BACKGROUND: The COVID-19 policy context was characterised by high levels of uncertainty, imperfect knowledge and the need for immediate action. Therefore, governments in Europe tended to rely on expertise provided by advisory bodies to design their crisis response. Advisory bodies played a fundamental part in policy making during the crisis to optimise policy formulation.

AIMS AND OBJECTIVES: During the COVID-19 crisis, the literature on policy advice grew considerably. To grasp the main research outcomes, we conduct a scoping review that interrogates the COVID-19 policy advice literature to answer the question 'How did policy advisory bodies operate in Europe during the COVID-19 crisis?' Our review builds on a strong theoretical and conceptual basis informed by the literature on policy advisory systems, while offering a new perspective by focusing on advice and policy making during crisis times specifically. We present a review of newly established knowledge and identify what merits further study.

METHODS: The scoping review follows a strict protocol informed by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to capture the literature published between 2020 and 2023. We searched two databases, Scopus and Web of Science. The grey literature was excluded.

FINDINGS: In total, 59 academic outputs inform this review. Overrepresented in our review were qualitative studies, studies about the UK and Sweden, and studies that examined the first half of 2020. Our review shows that the academic community has focused on advisory body composition, body structure and the advisory process.

DISCUSSION: Avenues for further research include the independence and influence of advisory bodies, and the fate of bodies set up during the crisis.}, } @article {pmid40556913, year = {2025}, author = {Magura, J and Nhari, SR and Nzimakwe, TI}, title = {Barriers to ART adherence in sub-Saharan Africa: a scoping review toward achieving UNAIDS 95-95-95 targets.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1609743}, pmid = {40556913}, issn = {2296-2565}, mesh = {Humans ; Africa South of the Sahara ; *HIV Infections/drug therapy ; *Medication Adherence/psychology ; Female ; Male ; *Anti-HIV Agents/therapeutic use ; Adult ; United Nations ; COVID-19/epidemiology ; }, abstract = {INTRODUCTION: With the 2025 UNAIDS 95-95-95 deadline upon us, significant gaps remain in achieving universal HIV care and treatment targets, particularly in Sub-Saharan Africa. Despite years of intensified global efforts, progress has lagged, partly driven by the multifaceted challenges of non-adherence to ART, shaped by social, economic, structural, and individual factors. These challenges have been compounded by the ever-changing landscape of global HIV funding, further undermining treatment outcomes. Addressing these interconnected barriers is essential to identify and implement targeted, evidence-based solutions.

METHODS: To explore these challenges and potential interventions, a scoping review was conducted, searching through PubMed and Dimensions databases for peer-reviewed articles published from 2020 through February 2025. Eligible studies focused on barriers to ART adherence in adult men and women ≥ 18 years old living with HIV, aligning with the UNAIDS 95-95-95 framework in sub-Saharan Africa.

RESULTS: Of the 4,928 articles screened, 21 were included in this scoping review. Although the search period was extended to February 2025, no eligible studies published in 2025 were identified. Barriers to ART adherence were multifaceted, spanning individual-level issues such as mental health issues and substance abuse; social barriers including stigma and intimate partner violence; and economic factors, including food insecurity, transport costs, and income instability. Structural barriers such as health system fragmentation, clinic accessibility, and drug stockouts were also common and often worsened by the COVID-19 pandemic, which disrupted service delivery and exacerbated socioeconomic vulnerabilities. While only peer-reviewed articles were included in the analysis, recent UNAIDS reports and reputable media sources, such as The Guardian, were referenced to contextualize the emerging impact of the 2025 HIV funding cuts, which have not yet been reflected in the academic literature.

CONCLUSION: Our findings emphasize the urgent need for targeted, multi-level interventions to address persistent economic, social, psychological, and policy barriers to ART adherence. A sustainable funding framework, combined with financial support, mental health services, and community-based care models, is crucial for improving retention and long-term adherence. These insights are essential for shaping policies, strengthening HIV service delivery, and sustaining momentum toward the 95-95-95 targets amid systematic challenges.}, } @article {pmid40555792, year = {2025}, author = {Lall, S and Vijayasarathy, M and Joshi, NV and Balaram, P}, title = {Resurrection of the Helical Hairpin Hypothesis for Understanding Coronavirus Fusion.}, journal = {The Journal of membrane biology}, volume = {258}, number = {5}, pages = {361-373}, pmid = {40555792}, issn = {1432-1424}, mesh = {*Spike Glycoprotein, Coronavirus/chemistry/metabolism ; *SARS-CoV-2/chemistry/physiology ; Humans ; *Virus Internalization ; Membrane Fusion ; COVID-19/virology ; }, abstract = {Coronaviruses use the spike protein (spike) to bind to target cells, and fuse the viral envelope with a host lipid membrane. Spike is a large trimeric surface glycoprotein, anchored to the viral membrane (envelope) by a single membrane-spanning polypeptide helix and a short intra-virion domain. In the SARS-CoV-2 virus, the spike is formed by three protomers of 1273 residues, each with two distinct domains separable by enzymatic proteolysis prior to infection. Thus far, enveloped virus surface glycoprotein structures have provided a detailed molecular view of the pre-fusion state, while structures of the post-fusion state have remained incomplete. The determination of the full-length structure of the SARS-CoV-2 spike in the post-fusion state is a landmark in furthering our understanding of the structural pre-requisites for membrane fusion. This perspective analyzes the fusion domain as revealed by the recent structure in the context of conserved sequences across diverse coronaviruses. We highlight the characterization of the membrane-embedded fusion peptide in a helical hairpin topology. This structure is discussed as a re-imagination of the helical hairpin hypothesis for polypeptide insertion into membranes, postulated by Engleman and Steitz over four decades ago.}, } @article {pmid40555044, year = {2025}, author = {Liao, J and Liang, Y and Liu, Z and Xie, Q and Zhang, JM and Song, SY and Huang, X and Cao, L and Wang, Y}, title = {Pyroptosis in acute respiratory distress syndrome and pulmonary fibrosis.}, journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie}, volume = {189}, number = {}, pages = {118286}, doi = {10.1016/j.biopha.2025.118286}, pmid = {40555044}, issn = {1950-6007}, mesh = {Humans ; *Pyroptosis/physiology ; *Respiratory Distress Syndrome/pathology/metabolism/drug therapy ; *Pulmonary Fibrosis/pathology/metabolism ; Animals ; Inflammasomes/metabolism ; COVID-19/pathology/complications ; NLR Family, Pyrin Domain-Containing 3 Protein/metabolism ; }, abstract = {ARDS (acute respiratory distress syndrome) and PF (pulmonary fibrosis) are severe pulmonary conditions with significant morbidity and mortality. This review focuses on the pyroptosis, a lytic, pro-inflammatory form of programmed cell death, as a central mechanism linking these two pathologies. We address how inflammasome activation stimulates the pyroptosis initiation and subsequently releases a cascade of inflammatory cytokines that drive the acute lung injury of ARDS. Subsequently, we elucidate how this sustained pyroptotic inflammation, combined with shifts in macrophage polarization, creates a pro-fibrotic microenvironment that promotes fibroblast activation and extracellular matrix deposition, thereby mechanistically driving the transition from ARDS to PF. The pathological landscape, from the early stage of ARDS to PF, is further shaped by a dynamic interaction between pyroptosis, necroptosis, and ferroptosis, with the temporal dominance of each pathway influencing the progression from acute inflammation to chronic fibrosis. Particularly, the clinical relevance of these mechanisms is also addressed in COVID-19-induced ARDS. Therefore, targeting key regulators of this axis, such as the NLRP3 inflammasome and the effector protein Gasdermin D, presents a promising therapeutic strategy to alleviate inflammatory responses upon tissue damage and halt fibrotic progression, offering new hope for these severe lung diseases.}, } @article {pmid40554438, year = {2025}, author = {Emery, K and Dhaliwal, J and Light, R and Eberl, M and Cruickshank, SM}, title = {Enabling Vaccine Uptake: Strategies for the Public Health Sector.}, journal = {British journal of hospital medicine (London, England : 2005)}, volume = {86}, number = {6}, pages = {1-14}, doi = {10.12968/hmed.2024.0669}, pmid = {40554438}, issn = {1750-8460}, mesh = {Humans ; *COVID-19/prevention & control ; United Kingdom ; *Public Health ; *Vaccination Hesitancy ; *Vaccination/statistics & numerical data ; SARS-CoV-2 ; COVID-19 Vaccines ; }, abstract = {Safe and effective vaccines have been instrumental in controlling and mitigating some of the most contagious and devastating diseases throughout history, ranging from smallpox, polio and diphtheria to measles, flu and coronavirus disease 2019 (COVID-19). Despite their proven success, vaccination rates often fall short of the World Health Organisation's recommendations, facing persistent challenges. This review explores strategies to enhance vaccine uptake, with a particular focus on the UK context, by examining potential barriers, effective interventions and the vital role of various stakeholders. Boosting vaccine uptake requires a comprehensive approach that tackles issues such as vaccine hesitancy, improves accessibility, builds public trust, and utilises effective communication. By implementing targeted strategies, public bodies, scientists and healthcare professionals can work together to improve vaccination rates and safeguard communities against preventable diseases. Continuous evaluation and adaptation of these strategies are crucial to ensure their effectiveness and relevance in addressing the evolving challenges of vaccine uptake.}, } @article {pmid40553348, year = {2025}, author = {Ramakrishnan, R and Washington, A and Suveena, S and Rani, JR and Oommen, OV}, title = {From DNA to Big Data: NGS Technologies and Their Applications.}, journal = {Methods in molecular biology (Clifton, N.J.)}, volume = {2952}, number = {}, pages = {459-482}, pmid = {40553348}, issn = {1940-6029}, mesh = {*High-Throughput Nucleotide Sequencing/methods ; *Big Data ; Humans ; *COVID-19/virology/epidemiology/genetics ; Genomics/methods ; SARS-CoV-2 ; Computational Biology/methods ; Sequence Analysis, DNA/methods ; *DNA/genetics ; }, abstract = {The last decade has witnessed an explosion in NGS data, which was the gift of advances in NGS technology as well as computing power. Along with AI, NGS is revolutionizing healthcare research. In this chapter, we briefly discuss the contribution of NGS in dealing with the COVID-19 pandemic and mention its application across various fields like oncology, agriculture, archaeogenetics, and space biology, followed by a historical perspective on sequencing, the evolution of NGS technologies and those currently in use. The chapter further outlines various NGS methods and workflows, detailing the key stages and the tools commonly employed for efficient analysis. Additionally, we highlight the surge and complexity of NGS data generated by genomics, transcriptomics, and microbiome studies, challenges and discusses their clinical applications. Toward the end, we explore the future directions of NGS. Given the rapid increase in data volume and complexity, there is an urgent need for efficient big data technologies, state-of-the-art tools, and techniques to manage, analyze, and derive actionable insights from these vast datasets, addressing the demands of the present-day scientific landscape.}, } @article {pmid40553266, year = {2025}, author = {Shukla, S and Vishwakarma, K and Singh, AK and Yadav, PK and Singh, SP and Jadaun, JS}, title = {Curdlan: a microbial biopolymer of multifarious applications for a sustainable environment.}, journal = {Protoplasma}, volume = {}, number = {}, pages = {}, pmid = {40553266}, issn = {1615-6102}, abstract = {Curdlan, an exopolysaccharide, has gained sufficient attention in recent years due to its potential health benefits. Its unique physico-chemical and rheological properties create an appropriate substitute for diverse applications in agriculture, food, and pharmaceutical industries. This review begins with an overview of bioactive properties, structural characteristics, curdlan biosynthesis, and its production technologies. Curdlan is useful in the modulation of immune responses and as an effective agent against diseases like malaria, cancer, dengue, and COVID-19. This review also expounds on the potential role of curdlan in the food industry as a thickener, texture modifier, stabilizer, and emulsifier. This biomolecule holds promise for functional food development due to its prebiotic properties. Research on curdlan has proved its potential role in the biomedical sector, and it acts positively in drug delivery and tissue engineering practices. Thus, curdlan offers a potential remedy in response to growing environmental concerns and the urgent demand for environment-friendly substitutes for synthetic polymers.}, } @article {pmid40553061, year = {2025}, author = {Tan, YJ and Lin, SZ}, title = {Isolated Abducens Nerve Palsies from COVID-19 Infections: Clinical Features and Outcomes.}, journal = {Neurology India}, volume = {73}, number = {3}, pages = {524-528}, doi = {10.4103/neurol-india.Neurol-India-D-24-00411}, pmid = {40553061}, issn = {1998-4022}, mesh = {Humans ; *Abducens Nerve Diseases/etiology/virology/therapy ; *COVID-19/complications ; Adult ; Male ; Child ; Female ; Middle Aged ; Adolescent ; Aged ; Young Adult ; Child, Preschool ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Isolated abducens nerve palsies from COVID-19 infections are rarely described in literature. Their clinical features are poorly understood, and guidance on their treatment is lacking.

OBJECTIVE: To describe the clinical features of isolated abducens nerve palsies from COVID-19 infection, and provide guidance on their management.

METHODS: We performed a literature review and analyzed the clinical features of patients with isolated abducens nerve palsy from COVID-19 infections reported in literature.

RESULTS: In total, 16 cases from 15 studies published between January 2020 and December 2023 were identified. Their median age was 44 years (range 3-71, including two children). Nearly two-thirds (10/16, 63%) were without medical history. Abducens nerve palsies mostly occurred early with COVID-19 symptoms (median of 5.5 days, range 0-21 days). They were all unilateral, and displayed neither clear gender nor left-right predilections. Brain magnetic resonance imaging scans were often unremarkable (9/13, 69%). More than half (9/16, 56%) received no treatment or symptomatic treatment only, while only two received steroids. Regardless, nearly all experienced clinical of diplopia (14/16, 88%), of which most recovery were either complete or near-complete (at least 10/14, 71%) within a median period of 26 days (range 5-240 days).

CONCLUSION: Isolated abducens nerve palsies are early but uncommon complications of COVID-19, mainly affecting patients with mild infections. Prognosis appears fair even when without corticosteroid treatment, and recovery is significant and early in most. Observation and early outpatient clinical review within a month are reasonable measures. Patients without significant improvement within a month should be re-assessed for other aetiologies.}, } @article {pmid40553025, year = {2025}, author = {Rahman, MH and Usmani, NG and Chandra, P and Manna, RM and Ahmed, A and Shomik, MS and Arifeen, SE and Hossain, AT and Rahman, AE}, title = {Mobile Apps to Prevent Violence Against Women and Girls (VAWG): Systematic App Research and Content Analysis.}, journal = {JMIR formative research}, volume = {9}, number = {}, pages = {e66247}, pmid = {40553025}, issn = {2561-326X}, mesh = {*Mobile Applications/statistics & numerical data ; Humans ; Female ; COVID-19/epidemiology ; *Violence/prevention & control ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Numerous reviews have explored specific aspects of violence prevention apps, but given the rapid development of new apps, increased violence during COVID-19, and gaps in understanding functionalities and geographical distribution, an updated review is needed.

OBJECTIVE: Therefore, we aimed to systematically evaluate the trends, geographical distribution, functional categories, available features, and feature evolution of mobile apps designed to prevent violence against women and girls (VAWG).

METHODS: We conducted a systematic search on app reselling platforms and search engines from April 24, 2024 to May 28, 2024, using terms related to VAWG in multiple languages. We included apps meeting our criteria for addressing VAWG, without restrictions on date or language. We conducted content analysis of app and apps were categorized by functionality and feature type. We performed descriptive analyses, trend analysis, co-occurrence network analysis, and geographical mapping.

RESULTS: Out of 432 apps initially identified, 178 were included in the final analysis. Of these, 99 apps were available on both Google Play and the App Store, and 64 were exclusive to Google Play. Most apps were implemented in North America (48/178, 27%), followed by South Asia (31/178, 17%) and Europe and Central Asia (31/178, 17%). Emergency and support apps were most prevalent across regions. Most apps (132/178, 74%) originated from the private sector and were designed for survivor (121/178, 68%), were free without in-app purchases (100/178, 56%), had a website (148/178, 83%), and offered GPS features (142/178, 80%), but only 15% (27/178) provided offline functionality. App releases peaked in 2020 (33/178, 19%), followed by a decline. Regression analysis indicated a significant trend (P=.01) increase in app release, with a 2.40 unit increase per year before 2020 and a 7.01 unit decrease after, showing a post-2020 decline of 4.61 units per year. Apps were primarily categorized as emergency (n=110) or support (n=81), with most emergency apps in the 10,000 to ≥100,000 downloads range. Network analysis showed that emergency services (degree=10, clustering coefficient=0.911), location sharing (degree=10, clustering coefficient=0.911), SOS (Save Our Souls) alerts (degree=10, clustering coefficient=0.911), and educational resources (degree=10, clustering coefficient=0.911) features highly co-occurred in the same app. We found a gradual shift towards more sophisticated and comprehensive safety tools, evolving from basic GPS tracking and SOS alerts to advanced features such as real-time communication, panic buttons, peer support, and group communication, culminating in multifunctional platforms offering personalized safety, community engagement, and proactive risk identification.

CONCLUSIONS: Most apps to prevent VAWG emphasize emergency and support functions, and although initial releases increased, there has been a recent decline, with a shift towards integrating more comprehensive safety solutions such as communication, reporting, and community engagement. Future app development should prioritize cross-platform availability, offline functionality, public sector collaboration, and the integration of advanced technologies like artificial intelligence.}, } @article {pmid40552782, year = {2025}, author = {Xu, Y and Xu, JW and Wu, Y and Rong, LJ and Ye, L and Franco, OH and Chien, CW and Feng, XR and Chen, JY and Tung, TH}, title = {Prevalence and prognosis of sarcopenia in acute COVID-19 and long COVID: a systematic review and meta-analysis.}, journal = {Annals of medicine}, volume = {57}, number = {1}, pages = {2519678}, doi = {10.1080/07853890.2025.2519678}, pmid = {40552782}, issn = {1365-2060}, mesh = {Humans ; *Sarcopenia/epidemiology ; *COVID-19/complications/epidemiology/mortality ; Prevalence ; Prognosis ; SARS-CoV-2 ; Length of Stay/statistics & numerical data ; Hospitalization/statistics & numerical data ; }, abstract = {BACKGROUND: A comprehensive investigation delineating the prevalence of sarcopenia across different infection phases, from acute COVID-19 to long COVID, is lacking. Meanwhile, the relationship between sarcopenia and adverse outcomes among COVID-19 patients remains inconsistent.

MATERIALS AND METHODS: A systematic search of MEDLINE/PubMed, Embase, Cochrane Library, Web of Science, and Scopus, before 22nd February 2025, was conducted to identify studies assessing sarcopenia prevalence in acute COVID-19 and long COVID. Random effects meta-analyses were performed to estimate the pooled prevalence of sarcopenia for acute COVID-19 and long COVID patients. Subgroup analyses stratified by assessment tool, region, income, hospitalization status, and age were performed. The associations between sarcopenia and COVID-19-related clinical outcomes were further quantified.

RESULTS: A total of 39 studies with 6,982 individuals were included. The pooled prevalence of sarcopenia was 48.7% (95% confidence interval (CI): 39.6-57.9%) in acute COVID-19 and 23.5% (95% CI: 12.7-39.4%) in long COVID. In acute COVID-19 patients, sarcopenia was not significantly associated with length of stay (mean difference = 2.215, 95% CI: -0.004 to 4.433), mechanical ventilation (Odds ratio (OR) = 1.80, 95% CI: 0.84-3.85), admission to the intensive care unit (OR = 1.05, 95% CI: 0.63-1.77), or mortality (OR = 1.41, 95% CI: 0.86-2.32), but was significantly associated with tracheostomy (OR = 2.48, 95% CI: 1.28-4.82).

CONCLUSION: In conclusion, our findings indicate that sarcopenia is highly prevalent in acute COVID-19 and persists in a substantial proportion of long COVID patients, suggesting prolonged muscle loss beyond the acute phase. Future well-designed studies are needed to further investigate the association between sarcopenia and short-term and long-term prognostic outcomes in both acute and long COVID patients.}, } @article {pmid40552605, year = {2025}, author = {Abdekhoda, M and Dehnad, A}, title = {Strategies to combat infodemics in public health.}, journal = {Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit}, volume = {31}, number = {5}, pages = {340-349}, doi = {10.26719/2025.31.5.340}, pmid = {40552605}, issn = {1687-1634}, mesh = {Humans ; *COVID-19/epidemiology ; *Public Health ; Health Literacy ; Pandemics ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Infodemic is an emerging concept in public health and effective strategies are required to combat it.

AIM: To identify documented strategies for combating infodemics in the health sector, particularly during the COVID-19 pandemic.

METHODS: In November 2022, we reviewed 87 articles on the management of infodemics in public health on PubMed and Web of Science using the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews.

RESULTS: The number of articles on infodemic more than doubled from 18 in 2020 to 37 in 2021 and decreased to 32 in 2022, indicating efforts at different levels to combat infodemics especially during the COVID-19 pandemic. Strategies to combat infodemics included health literacy and education, use of more effective information resources, content control, social networking and communication, restrictive laws, use of electronic platforms, awareness campaigns, and health care provider involvement.

CONCLUSION: Findings from this review indicate that infodemic, especially during a pandemic, is a serious challenge in public health and a multifaceted approach involving education, technology, policy and community engagement is essential to combat it.}, } @article {pmid40552499, year = {2025}, author = {Gschwend, A and Mach-Perrot, V and Sobral, G and Démolis, R and Serex, M and Ulukütük-Yavavli, S and Alexandre, K}, title = {[Factors influencing COVID-19 vaccine hesitancy among healthcare workers in Switzerland].}, journal = {Revue medicale suisse}, volume = {21}, number = {923}, pages = {1290-1294}, doi = {10.53738/REVMED.2025.21.923.46838}, pmid = {40552499}, issn = {1660-9379}, mesh = {Humans ; Switzerland/epidemiology ; *Health Personnel/psychology/statistics & numerical data ; *COVID-19 Vaccines/administration & dosage ; *Vaccination Hesitancy/psychology/statistics & numerical data ; *COVID-19/prevention & control/epidemiology ; Vaccination/psychology ; }, abstract = {During the COVID-19 pandemic, Switzerland adopted a strongly recommended but non-mandatory vaccination policy, respecting self-determination. Healthcare professionals (HCPs) were among the first to receive the vaccine. This literature review highlighted individual (gender, age, vaccination history, risk perception, social norms, and moral convictions) and contextual factors (trust in the government, recommendations from other HCPs, and media information) influencing HCPs' vaccination decisions in Switzerland. Understanding these factors offers opportunities to tailor vaccination measures during health crises.}, } @article {pmid40552445, year = {2025}, author = {Vora, V and Kanyal, S and Chauhan, A and Agarwal, P and Sethi, Y}, title = {Cultural perceptions and social determinants of health in perinatal mental health: An obstetric-psychiatric perspective.}, 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.70329}, pmid = {40552445}, issn = {1879-3479}, abstract = {BACKGROUND: Perinatal mental health is significantly influenced by social and cultural determinants, including socioeconomic status, education, cultural beliefs, and healthcare access. These factors shape the prevalence, presentation, and outcomes of mental health disorders during pregnancy and postpartum, as well as influencing help-seeking behaviors and treatment efficacy. The COVID-19 pandemic has exacerbated disparities, particularly among socioeconomically disadvantaged populations, emphasizing the need for culturally sensitive amd socially informed care.

OBJECTIVES: This narrative review aims to compile current evidence on the intersection of cultural perceptions, social determinants, and perinatal mental health outcomes. Additionally, it proposes culturally acceptable interventions to address disparities in perinatal mental healthcare.

METHODOLOGY: The review integrates the existing literature, focusing on the bidirectional relationship between maternal mental health and obstetric outcomes. It highlights the disproportionate concentration of research in high-income, western countries and emphasizes the need for interdisciplinary approaches, such as the integration of psychiatric and obstetric perspectives, to address gaps in low- and middle-income settings.

OBSERVATIONS AND INFERENCES: Key findings include the impact of economic instability, low maternal health literacy, limited healthcare access, and inadequate social support on perinatal mental health. Cultural factors, such as stigma, gender roles, and religious beliefs, further influence help-seeking behaviors and treatment outcomes.

CONCLUSIONS: The review underlines the lack of culturally attuned randomized controlled interventions aimed at perinatal mental health disorders and the need for culturally adapted measurement tools and methodologies. Recommendations include expanding mental health literacy campaigns, improving healthcare accessibility, and addressing systemic discrimination. Future research should focus on evaluating interventions for perinatal mental disorders, incorporating diverse populations, and addressing multimorbidity through holistic, interdisciplinary approaches.}, } @article {pmid40552388, year = {2025}, author = {Richter, A}, title = {Current experience with manual push subcutaneous immunoglobulin (SCIg) in patients with immune deficiencies.}, journal = {Immunological medicine}, volume = {}, number = {}, pages = {1-12}, doi = {10.1080/25785826.2025.2515333}, pmid = {40552388}, issn = {2578-5826}, abstract = {Immunoglobulin G replacement therapy prevents infections in patients with antibody deficiencies. Subcutaneous immunoglobulin (SCIg) has typically been administered via infusion pump, but the manual push technique offers a simple, convenient alternative method. The manual push technique is efficacious, well tolerated, quick to administer, offers increased dosing flexibility, and does not rely on a pump. Having various administration options available to patients provides greater treatment satisfaction and feelings of self-empowerment, which may improve compliance. Currently available literature published before 10 February 2022, that reported patient and healthcare professional experience with SCIg administered via manual push, were reviewed. Literature searches were performed using PubMed, Google and ClinicalTrials.gov using key words 'manual push', 'rapid push', 'immunoglobulin', 'subcutaneous immunoglobulin', 'SCIg', and 'primary immunodeficiency'. Real-world evidence demonstrates all delivery techniques provide similar efficacy, so treatment administration becomes about patient preference, hospital resources, cost-effectiveness/recovery and clinician attitude. To establish newer administration modalities such as manual push or prefilled syringes, there needs to be patient awareness of these options, then education and finally confidence in recommending these options. Adoption of newer administration modalities will help ensure patients receive the widest range of choice, thus improving compliance and their risk of recurrent and severe infection.}, } @article {pmid40552302, year = {2025}, author = {Bausch-Jurken, M and Alter, G}, title = {The immunological impact of revaccination in a hybrid-immune world.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1588259}, pmid = {40552302}, issn = {1664-3224}, mesh = {Humans ; *SARS-CoV-2/immunology ; *COVID-19/immunology/prevention & control ; *Immunization, Secondary ; *COVID-19 Vaccines/immunology/administration & dosage ; Antibodies, Viral/immunology ; Immunity, Cellular ; Immunity, Humoral ; }, abstract = {The global immune landscape of SARS-CoV-2 has progressively shifted from a naïve population several years ago to a population that possesses immunity to the virus through infection, vaccination, or a combination of both, known as hybrid immunity. Hybrid immunity offers a prolonged period of transmission-blocking activity, likely related to enhanced tissue-resident immunity, but also has been shown to be linked to broader humoral and cellular immune responses. Compared with vaccination or infection alone, the collective data have demonstrated that hybrid immunity offers enhanced protection against disease. Yet, despite the benefits of hybrid immunity, perpetual evolution of variants and the natural waning of immunity in vulnerable populations provides a strong rationale for revaccination. This article reviews the benefits of revaccination, including updating variant-specific immunity, bolstering humoral and cellular immune frequencies in those with hybrid immunity, and overcoming immune imprinting and enhancing effector mechanisms to raise surveillance and defense against the virus. As SARS-CoV-2 continues to evolve, updated booster vaccinations remain essential to enhance and sustain protection from disease by ensuring that the immune system is equipped to respond to contemporary strains, thereby reducing the impact of future outbreaks and mitigating the burden of COVID-19, especially among vulnerable populations.}, } @article {pmid40552181, year = {2025}, author = {Coyne, BM and Ito, D and Tariq, A and Lew, SQ and Kopp, J and Vinales, PC and Malik, F and Gipson, PE and Nobakht, E}, title = {Ascertaining the mechanistic etiology of COVID-associated glomerulonephritis: a systematic review.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1568943}, pmid = {40552181}, issn = {2296-858X}, abstract = {BACKGROUND: Since its first reported case in December 2019, COVID-19 disease, caused by severe acute respiratory coronavirus 2 (SARS-CoV-2), evolved into a major pandemic throughout the world. Although COVID-19 is most often characterized as a respiratory pathology, there are also extensive reports of renal complications, such as glomerulonephritis (GN). However, the precise nature of COVID-associated glomerulonephritis (COVID-GN) has yet to be fully understood. This review seeks to elucidate COVID-GN pathophysiology by conducting an exhaustive systematic review.

METHODS: Herein, we compare the different GN subtypes associated with COVID-19 in the literature. We also review the cytokines, antibodies, and genes most implicated in COVID-GN.

RESULTS: The GN subtype with the highest number of cases associated with COVID-19 infection was focal segmental glomerulosclerosis, specifically the collapsing morphology. Meanwhile, the highest number of cases associated with COVID-19 vaccination was IgA nephropathy. The most prevalent mechanism in the literature for COVID-GN involves a cytokine storm, which may be accompanied by immune complex deposition.

DISCUSSION: Both infection and vaccination from SARS-CoV-2 can induce robust CD4+ T cell responses promoted by an IL-6 amplifier loop of inflammation. This immune response is likely further enhanced by interactions with complement systems and the renin-angiotensin-aldosterone system (RAAS). SARS-CoV-2-mediated pathways of both direct cytotoxicity and stimulation of polyclonal immunoglobulin may converge to cause glomerular inflammation and injury. Further investigation of these inflammatory pathways may provide insight into COVID-19 pathophysiology, treatment, and long-term outcomes.}, } @article {pmid40552037, year = {2025}, author = {Nazir, M and Mir, IR and Lone, SA and Muteeb, G and Alam, R and Fomda, AB and Khan, N and Azhar, A and Fomda, BA and Khan, WH}, title = {Innate immunity, therapeutic targets and monoclonal antibodies in SARS-CoV-2 infection.}, journal = {PeerJ}, volume = {13}, number = {}, pages = {e19462}, pmid = {40552037}, issn = {2167-8359}, mesh = {Humans ; *Immunity, Innate/drug effects ; *SARS-CoV-2/immunology ; *COVID-19/immunology/therapy ; *Antibodies, Monoclonal/therapeutic use/immunology ; *COVID-19 Drug Treatment ; Antiviral Agents/therapeutic use ; }, abstract = {COVID-19 (coronavirus disease 2019), caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), stands as one of the most severe pandemics the world has ever faced in recent times. SARS-CoV-2 infection exhibits a wide range of symptoms, varying from severe manifestations to mild cases and even asymptomatic carriers. This diversity stems from a multitude of factors, including genetic predisposition, viral variants, and immune status. During SARS-CoV-2 infection, the immune system engages pattern recognition receptors, setting off a series of intricate signalling cascades. These cascades culminate in the activation of innate immune responses, including induction of type I and type III interferons. The emerging variants of SARS-CoV-2 pose challenges to the innate immune system defense. Therefore, investigating the innate immune response is crucial for effectively combating SARS-CoV-2 and its variants. The cyclic guanosine monophosphate-adenosine monophoshate synthase-stimulator of interferon genes (cGAS-STING) pathway, a critical innate immune mechanism, represents a promising target for intervention at multiple stages to reduce the severity and progression of SARS-CoV-2 infection. This review explores innate immunity in SARS-CoV-2 infection and other immune responses critical for SARS-CoV-2 defence. As part of the therapeutic approach, we extend our review to highlight monoclonal antibodies (mAbs) as emerging and effective therapeutics for controlling SARS-CoV-2 by targeting different stages of the innate immune system. A diverse range of mAbs has been explored to address specific targets within the innate immune pathways. A deep understanding of innate immunity and targeted monoclonal therapeutics will be instrumental in combating viruses and their variants, laying the foundation for enhanced treatment and therapeutic strategies.}, } @article {pmid40551543, year = {2025}, author = {Wu, J and Deng, X and Luo, J and Jiang, Z and Xie, F and Chen, B and Leung, HW and Zhang, G and To, KF and Kang, W}, title = {Update in the Treatment of Cirrhotic Patients with Portal Vein Thrombosis.}, journal = {Clinical and molecular hepatology}, volume = {}, number = {}, pages = {}, doi = {10.3350/cmh.2025.0411}, pmid = {40551543}, issn = {2287-285X}, abstract = {Portal vein thrombosis (PVT) is characterized by the formation of a thrombus (blood clot) within the portal vein system, including main portal vein and its intrahepatic portal vein branches, and may extend to the superior mesenteric vein or splenic vein. The emergence of PVT is linked to diverse risk factors, encompassing liver conditions with cirrhosis, abdominal infections, previous abdominal surgeries, malignancies, inherited or acquired thrombophilias, and systemic hypercoagulable conditions. Recent studies revealed a possible connection between the occurrence of PVT and either contracting COVID-19 or receiving a COVID-19 vaccination. Current treatment strategies were primarily based on symptom management, extent, and progression of thrombosis, but their efficacy was inconsistent and suboptimal. Untimely or inadequate treatment can lead to the progression of the thrombus and increase the risk of complications, such as portal hypertension, variceal bleeding, and hepatic decompensation, posing a significant risk to the patient's life. Thus, early, and appropriate initiation of pharmacologic and interventional treatments, as well as more aggressive strategies, are crucial for the management and prevention of PVT progression and recurrence. This review focuses on the literature on the recent advancements in the treatment of PVT using various therapeutic modalities, including anticoagulant therapy, thrombolysis, thrombectomy, interventional therapy and liver transplant in cirrhotic patients. In addition, we discuss pearls and pitfalls of these strategies for PVT, highlighting recent progress, identifying knowledge gaps, and proposing avenues towards precision management.}, } @article {pmid40551419, year = {2025}, author = {Burtscher, M and Strasser, B and Klimont, J and Leitner, B and Ulmer, H and Kopp, M and Burtscher, J}, title = {The Impact of Living at Moderate Altitude on Healthy Aging in Austria: Epidemiological Findings and Potential Underlying Mechanisms.}, journal = {Gerontology}, volume = {71}, number = {5}, pages = {351-364}, doi = {10.1159/000545228}, pmid = {40551419}, issn = {1423-0003}, mesh = {Humans ; Austria/epidemiology ; *Altitude ; Female ; Male ; Middle Aged ; Aged ; Aged, 80 and over ; *COVID-19/epidemiology/mortality ; *Healthy Aging/physiology ; Life Style ; Risk Factors ; Cardiovascular Diseases/mortality/epidemiology ; Exercise ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Epidemiological data of populations living at moderate altitudes between 1,000 and 2,000 m suggest healthier aging when compared to people living in lower regions. Besides social determinants of health, lifestyle and cardiovascular risk factors, environmental conditions such as ambient temperature, air pollution and aeroallergens, solar radiation and in particular hypobaric hypoxia may modify the risk of disease development and mortality. The present study was aimed at (1) evaluating altitude-dependent overall and age-specific mortality rates of the most prevalent diseases using mortality registries and (2) link them to differences in lifestyle and risk factors from a population-based survey in Austria. We analyzed altitude-dependent mortality data of the entire Austrian population over a 10-year period (2013-2022, including the COVID-19 pandemic) and the distribution of cardiovascular risk factors such as hypertension, hypercholesterolemia and diabetes, lifestyle factors such as the amount of regular physical activity and dietary habits based on a representative Austrian-wide survey from 2019.

SUMMARY: Mortality was reduced in both sexes when living between 1,000 and 2,000 m compared to those living lower: by 15% (13-18%) in men and by 22% (20-24%) in women (p < 0.05). People aged between 50 and 89 years, particularly benefited from living at higher altitudes. Women lived a healthier lifestyle than men, especially at an age of above 50 years, only women older than 74 benefited from a higher located residence regarding COVID-19 mortality.

KEY MESSAGES: The present study confirms mortality benefits at moderate altitudes. We propose that besides lifestyle and other environmental conditions, episodically occurring hypoxic periods and related hypoxia conditioning effects represent major underlying mechanisms.}, } @article {pmid40551274, year = {2025}, author = {Mousavi, A and Shojaei, S and Parhizkar, P and Bahri, RA and Alilou, S and Radkhah, H}, title = {Ischemic modified albumin and thiol levels in Coronavirus disease 19: a systematic review and meta-analysis.}, journal = {Diagnostic and prognostic research}, volume = {9}, number = {1}, pages = {13}, pmid = {40551274}, issn = {2397-7523}, abstract = {BACKGROUND: The COVID-19 pandemic has imposed a significant global health burden. Identifying prognostic markers for COVID-19 and its severity could contribute to improved patient outcomes by reducing morbidity and mortality. This systematic review and meta-analysis aimed to evaluate the relationship between ischemic-modified albumin (IMA) and thiol levels, both indicators of oxidative stress, in patients diagnosed with COVID-19.

METHOD: We conducted a comprehensive search across PubMed, Scopus, Embase, and Web of Science for eligible original studies. The study assessed IMA and thiol levels in COVID-19 patients, examining their association with both disease severity and mortality. A random effect analysis was conducted to estimate the standardized mean difference (SMD) and confidence intervals (CI).

RESULTS: Sixteen studies comprising 2010 COVID-19 patients and 982 controls were included. A diagnosis of COVID-19 was associated with significantly elevated IMA levels (Hedges's g = 1.02, 95% CI: 0.45 to 1.60) and reduced total thiol levels (Hedges's g = -1.08, 95% CI: -2.10 to -0.07). However, native thiol levels did not reveal a significant difference between infected patients and healthy participants. Subgroup analysis showed significantly lower total thiol levels in patients with critical and severe COVID-19, as well as lower native thiol levels specifically in critical COVID-19 patients. IMA levels were significantly higher across the critical, severe, and moderate COVID-19 groups.

CONCLUSION: Elevated IMA and reduced thiol levels may serve as novel markers for predicting COVID-19 severity and prognosis. Further research is needed to explore therapeutic interventions that target oxidative imbalance in COVID-19 patients.}, } @article {pmid40550575, year = {2025}, author = {Anderson, W and Lancaster, K and van Wichelen, S and Abimbola, S and Ankeny, RA and Engelmann, L and Fearnley, L and Giles-Vernick, T and Hegarty, B and Jephcott, FL and Ludovice, NP and Roitman, J and Steere-Williams, J and Stoove, M and Viaña, JN and Waldby, C and Yang, R}, title = {Epistemic preparedness.}, journal = {BMJ global health}, volume = {10}, number = {6}, pages = {}, pmid = {40550575}, issn = {2059-7908}, mesh = {Humans ; *COVID-19/epidemiology/prevention & control ; *Disease Outbreaks/prevention & control ; *Global Health ; SARS-CoV-2 ; *Knowledge ; Pandemics ; }, abstract = {Preparedness strategies for emergent infectious diseases have focused on microbial surveillance, medical stockpiling and healthcare infrastructure resilience. But what does it mean to be epistemically or cognitively prepared for the next disease outbreak? Taking stock of lessons for data practices and statistical modelling in the wake of COVID-19, we propose a reconceptualising of preparedness in global health, focusing on ecological and sociological configurations or framings rather than resorting to reductive 'crisis technologies'. We address three problem areas: data collection and sharing, outbreak modelling and the spatiotemporal structuring of analysis and intervention. We take these as illustrative of troubling effects of conceptual inflexibility. We inquire into alternative data practices and more complex epidemiological framings. This refiguring of our cognitive toolkit implies working through colonial legacies and national limitations embedded in governance of epidemiological reasoning. Epistemic preparedness-focusing on a more diverse, equitable and inclusive stocktaking as much as stockpiling-provides a reliable foundation for future disease outbreak management.}, } @article {pmid40550236, year = {2025}, author = {Liu, JW and Lai, CC and Hsueh, PR}, title = {Resurgence of human metapneumovirus in the post-COVID-19 era: pathogenesis, epidemiological shifts, clinical impact, and future challenges.}, journal = {The Lancet. Infectious diseases}, volume = {}, number = {}, pages = {}, doi = {10.1016/S1473-3099(25)00240-3}, pmid = {40550236}, issn = {1474-4457}, abstract = {Human metapneumovirus (hMPV), a respiratory pathogen identified in 2001, is a substantial cause of community-acquired respiratory infections across all age groups. This Review explores the impact of hMPV after the COVID-19 pandemic, emphasising its resurgence as a public health concern. Epidemiological shifts, as well as unusual seasonal patterns, increased co-infection rates, and altered age distributions, have been observed globally. Phylogenetic analysis has shown the variation across three distinct periods, especially before and after the COVID-19 pandemic, in terms of genotypic distribution. Clinical manifestations of hMPV infection range from asymptomatic to severe lower respiratory tract infections, particularly in vulnerable populations. Specific antivirals or vaccines are currently unavailable; consequently, treatment remains supportive. The development of monoclonal antibodies and vaccines leveraging cross-protective strategies against hMPV and related viruses is underway. This Review advocates prioritising research and public health measures to address the evolving epidemiological and clinical challenges associated with hMPV in the post-COVID-19 era.}, } @article {pmid40550065, year = {2025}, author = {Gao, P and Chen, X and Li, Y and Li, F and Zhang, H}, title = {Anti-CASPR2 meningoencephalitis with thickened dura mater induced by various infections: A case report and literature review.}, journal = {Medicine}, volume = {104}, number = {25}, pages = {e42873}, pmid = {40550065}, issn = {1536-5964}, mesh = {Humans ; Male ; *Meningoencephalitis/immunology/drug therapy/diagnostic imaging/etiology ; *Dura Mater/pathology/diagnostic imaging ; *Autoantibodies/blood ; *Membrane Proteins/immunology ; *Nerve Tissue Proteins/immunology ; Adult ; Magnetic Resonance Imaging ; COVID-19/complications ; Rituximab/therapeutic use ; }, abstract = {RATIONALE: With the update of novel autoantibodies and the expansion of the clinical spectrum, our understanding of autoimmune encephalitis (AE) is rapidly evolving. Anti-CASPR2 meningoencephalitis is a relatively rare condition that may be induced by infections.

PATIENT CONCERNS: A young man presented with 3 episodes of meningoencephalitis potentially triggered by possible viral, Salmonella, and severe acute respiratory syndrome coronavirus 2. Neuroimaging revealed a thickening of the cerebral dura mater. Laboratory tests found positive serum CASPR2 antibodies in the third episode.

DIAGNOSES: Across all 3 episodes, similar clinical manifestations and imaging features were observed. Although autoantibodies in the previous 2 phases were negative, the possibility of infection-related anti-CASPR2 meningoencephalitis remains highly suspected.

INTERVENTIONS: The treatment regimen comprised antimicrobial agents, corticosteroid therapy, intravenous immunoglobulin, and rituximab administration.

OUTCOMES: Following treatment, the patient's condition improved with no recurrence to date. Repeat testing showed undetectable anti-CASPR2 immunoglobulin G in both serum and cerebrospinal fluid. Post-treatment contrast-enhanced magnetic resonance imaging demonstrated the resolution of dural thickening.

LESSONS: We further reviewed the mechanism of various infection-related AE and characteristics of CASPR2-related disease. To our knowledge, this is the first report of CASPR2 meningoencephalitis with thickened dura mater, indicating the importance of paying attention to antibody-negative AE and monitor antibodies repeatedly when necessary. In addition to immunotherapy, we recommend comprehensive management throughout the disease process.}, } @article {pmid40549476, year = {2025}, author = {Luyt, D and Stiti, K and Valter, R and Josseran, L and Davido, B and Delarocque-Astagneau, E and Gautier, S}, title = {[Not Available].}, journal = {Sante publique (Vandoeuvre-les-Nancy, France)}, volume = {37}, number = {2}, pages = {57-71}, doi = {10.3917/spub.252.0057}, pmid = {40549476}, issn = {0995-3914}, mesh = {Humans ; *Vaccination Hesitancy/statistics & numerical data/psychology ; *Students, Health Occupations/psychology/statistics & numerical data ; *Vaccination/psychology ; COVID-19/prevention & control ; }, abstract = {INTRODUCTION: Vaccination of health professionals, including those in training, is crucial for population protection, especially in the face of emerging infectious risks. Health care students constitute a population that is potentially exposed to viruses and may pass them on, but also plays a major role as future prescribers. Despite the importance of this topic, there is little research on vaccine hesitancy within this population.

PURPOSE OF THE STUDY: The purpose of this literature review was to collect, organize, and analyze the existing data on vaccine hesitancy among health care students worldwide, and the factors associated with it.

RESULTS: Nineteen articles were included in the analysis. There was no consensus on the definition of vaccine hesitancy. Depending on the study, estimates of vaccine hesitancy among health care students for all vaccinations as a whole ranged from 6.7% to 80.2%. One of the main factors associated with vaccine hesitancy identified by the study was doubt, fear, anxiety, or expressed statements about a lack of vaccine safety, with concern about vaccine-induced adverse events. Vaccine hesitancy was higher for emerging infections (such as COVID-19 and H1N1). It also depended on the country and course of study.

CONCLUSIONS: To address the current challenge of vaccination among health care students, qualitative exploration of vaccine hesitancy is essential. This requires more detailed exploration of the sociocultural and professional contexts related to this hesitancy, as well as a more in-depth description of teaching on vaccination across disciplines.}, } @article {pmid40549427, year = {2025}, author = {Luo, X and Li, Y and Xu, J and Zheng, Z and Ying, F and Huang, G}, title = {AI in Medical Questionnaires: Scoping Review.}, journal = {Journal of medical Internet research}, volume = {27}, number = {}, pages = {e72398}, pmid = {40549427}, issn = {1438-8871}, mesh = {Humans ; *Artificial Intelligence ; Surveys and Questionnaires ; COVID-19/epidemiology ; *Mental Disorders/diagnosis ; SARS-CoV-2 ; }, abstract = {UNLABELLED: This systematic review aimed to explore the current applications, potential benefits, and issues of artificial intelligence (AI) in medical questionnaires, focusing on its role in 3 main functions: assessment, development, and prediction. The global mental health burden remains severe. The World Health Organization reports that >1 billion people worldwide experience mental disorders, with the prevalence of depression and anxiety among children and adolescents at 2.6% and 6.5%, respectively. However, commonly used clinical questionnaires such as the Hamilton Depression Rating Scale and the Beck Depression Inventory suffer from several problems, including the high degree of overlap of symptoms of depression with those of other psychiatric disorders and a lack of professional supervision during administration of the questionnaires, which often lead to inaccurate diagnoses. In the wake of the COVID-19 pandemic, the health care system is facing the dual challenges of a surge in patient numbers and the complexity of mental health issues. AI technology has now been shown to have great promise in improving diagnostic accuracy, assisting clinical decision-making, and simplifying questionnaire development and data analysis. To systematically assess the value of AI in medical questionnaires, this study searched 5 databases (PubMed, Embase, Cochrane Library, Web of Science, and China National Knowledge Infrastructure) for the period from database inception to September 2024. Of 49,091 publications, a total of 14 (0.03%) studies met the inclusion criteria. AI technologies showed significant advantages in assessment, such as distinguishing myalgic encephalomyelitis or chronic fatigue syndrome from long COVID-19 with 92.18% accuracy. In questionnaire development, natural language processing using generative models such as ChatGPT was used to construct culturally competent scales. In terms of disease prediction, one study had an area under the curve of 0.790 for cataract surgery risk prediction. Overall, 24 AI technologies were identified, covering traditional algorithms such as random forest, support vector machine, and k-nearest neighbor, as well as deep learning models such as convolutional neural networks, Bidirectional Encoder Representations From Transformers, and ChatGPT. Despite the positive findings, only 21% (3/14) of the studies had entered the clinical validation phase, whereas the remaining 79% (11/14) were still in the exploratory phase of research. Most of the studies (10/14, 71%) were rated as being of moderate methodological quality, with major limitations including lack of a control group, incomplete follow-up data, and inadequate validation systems. In summary, the integrated application of AI in medical questionnaires has significant potential to improve diagnostic efficiency, accelerate scale development, and promote early intervention. Future research should pay more attention to model interpretability, system compatibility, validation standardization, and ethical governance to effectively address key challenges such as data privacy, clinical integration, and transparency.

BACKGROUND: The World Health Organization reports that >1 billion people worldwide experience mental disorders, with the prevalence of depression and anxiety among children and adolescents at 2.6% and 6.5%, respectively. However, commonly used clinical questionnaires such as the Hamilton Depression Rating Scale and the Beck Depression Inventory suffer from several problems, including the high degree of overlap of symptoms of depression with those of other psychiatric disorders and a lack of professional supervision during administration of the questionnaires, which often lead to inaccurate diagnoses. In the wake of the COVID-19 pandemic, the health care system is facing the dual challenges of a surge in patient numbers and the complexity of mental health issues. Artificial Intelligence (AI) technology has now been shown to have great promise in improving diagnostic accuracy, assisting clinical decision-making, and simplifying questionnaire development and data analysis.

OBJECTIVE: This review aimed to explore the current applications, potential benefits, and issues of AI in medical questionnaires, focusing on its role in 3 main functions: assessment, development, and prediction. The global mental health burden remains severe.

METHODS: The review included peer-reviewed studies that applied AI technologies to medical, psychological, or physiological questionnaires and reported measurable outcomes; non–peer-reviewed, non-English/Chinese, ethically noncompliant, or AI-unrelated studies were excluded. Five databases (PubMed, Embase, Cochrane Library, Web of Science, and CNKI) were searched from inception through September 2024. Three independent reviewers conducted data extraction, quality appraisal using the Joanna Briggs Institute tools, and narrative synthesis of AI applications across questionnaire assessment, development, and prediction tasks.

RESULTS: Of 49,091 publications, a total of 14 (0.03%) studies met the inclusion criteria. AI technologies showed advantages in assessment, such as distinguishing myalgic encephalomyelitis or chronic fatigue syndrome from long COVID-19 with 92.18% accuracy. In questionnaire development, natural language processing using generative models such as ChatGPT was used to construct culturally competent scales. In terms of disease prediction, one study had an area under the curve of 0.790 for cataract surgery risk prediction. Overall, 24 AI technologies were identified, covering traditional algorithms such as random forest, support vector machine, and k-nearest neighbor, as well as deep learning models such as convolutional neural networks, Bidirectional Encoder Representations From Transformers, and ChatGPT. Despite the positive findings, only 21% (3/14) of the studies had entered the clinical validation phase, whereas the remaining 79% (11/14) were still in the exploratory phase of research. Most of the studies (10/14, 71%) were rated as being of moderate methodological quality, with major limitations including lack of a control group, incomplete follow-up data, and inadequate validation systems.

CONCLUSIONS: In summary, the integrated application of AI in medical questionnaires has significant potential to improve diagnostic efficiency, accelerate scale development, and promote early intervention. Future research should pay more attention to model interpretability, system compatibility, validation standardization, and ethical governance to effectively address key challenges such as data privacy, clinical integration, and transparency.}, } @article {pmid40548423, year = {2025}, author = {Samson, J and Gilbey, M and Taylor, N and Kneafsey, R}, title = {Virtual Simulated Placements in Health Care Education: Scoping Review.}, journal = {JMIR medical education}, volume = {11}, number = {}, pages = {e58794}, pmid = {40548423}, issn = {2369-3762}, mesh = {Humans ; COVID-19/epidemiology/prevention & control ; *Education, Medical/methods ; Pandemics/prevention & control ; SARS-CoV-2 ; *Simulation Training/methods ; *Virtual Reality ; }, abstract = {BACKGROUND: A virtual simulated placement (VSP) is a computer-based version of a practice placement. COVID-19 drove increased adoption of web-based technology in clinical education. Accordingly, the number of VSP publications increased from 2020. This review determines the scope of this literature to inform future research questions.

OBJECTIVE: This study aimed to assess the range and types of evidence related to VSPs across the health care professions.

METHODS: Studies that focussed on health care students participating in VSPs. Hybrid, augmented reality, and mixed reality placements were excluded. In total, 14 databases were searched, limited to English, and dated from January 1, 2020. Supplementary searches were employed, and an updated search was conducted on July 9, 2023. Themes were synthesized using the PAGER (patterns, advances, gaps, evidence for practice, and research recommendations) framework to highlight patterns, advances, gaps, evidence for practice, and research recommendations.

RESULTS: In total, 28 papers were reviewed. All VSPs were designed in response to pandemic restrictions. Students were primarily from medicine and nursing. Few publications were from low and middle-income countries. There was limited stakeholder involvement in the VSP designs and a lack of robust research designs, consistent outcome measures, conceptual underpinnings, and immersive technologies. Despite this, promising trends for student experience, knowledge, communication, and critical thinking skills using VSPs have emerged.

CONCLUSIONS: This review maps the VSP evidence across health care education. Allied health and midwifery research require greater representation, and based on the highlighted gaps, other areas for future research are suggested.}, } @article {pmid40547754, year = {2025}, author = {Vatsha, P and Vardhan, G and Kumari, T and Kanwar, N and Kanwal, A and Deshmukh, R}, title = {Efficacy and safety of remdesivir and favipiravir in COVID-19 patients - A systematic review and meta-analysis.}, journal = {Journal of family medicine and primary care}, volume = {14}, number = {5}, pages = {1604-1616}, pmid = {40547754}, issn = {2249-4863}, abstract = {Coronavirus-2019 (Covid-19) has led to a severe medical, social and economic crisis globally. The use of antivirals has given inconsistent results; thus, systematic summaries of available evidence may help us to understand its effectiveness. The current investigation was planned to conduct a systematic review and meta-analysis on the use of antivirals for Covid-19. Using 'MeSH' term databases were searched on Google Scholar, PubMed, Web of Science, SCOPUS, OVID, Cochrane Library, and Limits- English Language only. Title/abstract screening, full-text screening and data extraction were carried out by three authors. Pooled effect sizes and 95% confidence intervals (CI) were calculated using the Mantel-Haenszel method of random effects for meta-analysis. Ten studies were found eligible for inclusion: randomized controlled trials Moderate-quality evidence suggests a likely clinical benefit from the use of remdesivir in improving the number of recoveries (OR 1.46; 95% CI 1.23-1.74; I2=0%). A possibility of a higher mortality rate is also suggested by high-quality evidence with remdesivir (OR 0.78; 95% CI 0.57-1.05, I2=14%). Favipiravir also showed patient's higher mortality outcome (OR 0.69;95% CI 0.24-2.01, I2 = 0%). Although the need for oxygen therapy (OR 0.70 95% CI 0.40-1.23; I2= 72%) was highly significant p < 0.001** and Remdesivir/Favipiravir was determined to be beneficial overall for male gender data across all studies (OR 0.77; 95% CI;0.37-1.60;I2=90%) and highly significant P < 0.0001***. Worsening of comorbidities (OR 0.94; 95% CI 0.81-1.08; I2= 0%), Ferritin level measured (OR-19.80 95% CI -56.51-16.92; I2 = 0 %) and Transferred to ICU/ Mechanical Ventilation (OR 0.85 95% CI 0.25 -2.91; I2 = 52 %) were observed in both the anti-viral. This meta-analysis found mixed efficacy for Remdesivir and negative outcomes for Favipiravir.}, } @article {pmid40547733, year = {2025}, author = {Ravikoti, S and Bhatia, V and Mohanasundari, SK}, title = {Approaches for cessation and elimination of tobacco to atttain sustainable development goal.}, journal = {Journal of family medicine and primary care}, volume = {14}, number = {5}, pages = {1589-1596}, pmid = {40547733}, issn = {2249-4863}, abstract = {Tobacco use remains a pervasive global health challenge, particularly affecting low- and middle-income countries (LMICs) like India, where it contributes significantly to preventable deaths and economic burdens. This comprehensive review synthesizes current literature from 2010 to 2024 using prominent databases such as PubMed, ScienceDirect, UpToDate, and Embase and extracted 49 full text article focused on tobacco prevalence, health impacts, and control measures in India, emphasizing the urgency of tobacco elimination to achieve sustainable development goals (SDGs). The review includes data from the Global Adult Tobacco Survey (GATS 2), highlighting that 28.6% of Indian adults use tobacco, with variations by gender, urban-rural divide, and product preference. Tobacco use exacerbates health disparities, leading to chronic diseases such as cancer, respiratory conditions, and cardiovascular disorders. Moreover, tobacco compromises immune function, increasing susceptibility to infections like tuberculosis and COVID-19. Effective tobacco control strategies outlined include policy interventions, cessation programs integrating counseling and medication, international collaborations under the WHO Framework Convention on Tobacco Control (FCTC), and leveraging technological advancements like mobile apps and virtual reality for cessation support. This review highlights the importance of coordinated efforts to create a tobacco-free future in India and globally.}, } @article {pmid40547479, year = {2025}, author = {Seijas-Otero, N and Blanco-Pintos, T and Regueira-Iglesias, A and Suárez-Rodríguez, B and Sánchez-Barco, A and Balsa-Castro, C and Tomás, I}, title = {Antiseptics as effective virucidal agents against SARS-CoV-2: Systematic review and Bayesian network meta-analysis.}, journal = {The Japanese dental science review}, volume = {61}, number = {}, pages = {138-154}, pmid = {40547479}, issn = {1882-7616}, abstract = {This study represents the first Bayesian network meta-analysis (NMA), which aimed to determine the virucidal efficacy of oral and nasal antiseptics against SARS-CoV-2 in saliva. Eligible studies evaluated the antiseptics' effect on viral load in SARS-CoV-2-infected subjects. The search was performed in September 2024 through PubMed, World Health Organisation, Embase, Scopus, bioRxiv, and medRxiv. The methodological quality was evaluated using the Cochrane RoB-2 checklist. Twenty-six articles and 16 antiseptics were assessed. Bayesian NMA was possible for seven antiseptics, ranked by probability of best option for viral load reduction (SUCRA values): PVP-I (0.85); CPC and CHX (0.72); H2O2 (0.70); CHX (0.64); CPC (0.50); H2O2 and CHX (0.38); and HClO (0.34). Virucidal efficacy at baseline was significant for (viral load reduction): PVP-I (42 %), H2O2 (34 %), and CHX (31 %). Compared to the control group, PVP-I remained significant (34 %), whereas H2O2 and CHX approached significance (26 % and 22 %, respectively). In conclusion, a single application of PVP-I, H2O2 or CHX are the best options for reducing the SARS-CoV-2 viral load in saliva, which can be particularly relevant in high-risk settings. However, methodologically well-designed studies using more appropriate quantification techniques are needed to clarify better the clinical efficacy of antiseptics against SARS-CoV-2 and other respiratory viruses.}, } @article {pmid40546939, year = {2025}, author = {Xu, R and Zhang, G and Che, Y and Ren, N and Wang, S and Yang, C and Xue, Q and Tan, F and Zhao, L and He, J}, title = {Ablation combined with video-assisted thoracic surgery hybrid technique for multiple primary lung cancer.}, journal = {iScience}, volume = {28}, number = {6}, pages = {112703}, pmid = {40546939}, issn = {2589-0042}, abstract = {Increased public health awareness and expanded low-dose computed tomography (CT) utilization, accelerated by the COVID-19 pandemic, have elevated detection rates of pulmonary ground-glass nodules (GGNs). Patients with multiple primary lung cancer (MPLC) often present with multiple GGNs, posing challenges for precise treatment and prognostic assessment. Current therapies including stereotactic body radiation therapy (SBRT), chemotherapy, and immunotherapy face efficacy and safety limitations. While video-assisted thoracic surgery (VATS) is the primary treatment for high-risk GGNs, the sole reliance on surgery may cause excessive loss of lung function. Image-guided thermal ablation techniques can effectively treat smaller lesions with lung preservation. This review explores molecular mechanisms of ablation, VATS-ablation synergy, and the potential value of this approach in combination with immunotherapy. The clinical application prospects, including advancements in navigation techniques and equipment, are also discussed. Overall, this hybrid surgical strategy represents a promising option for patients with multiple lesions, minimizing lung function loss and the psychological burden.}, } @article {pmid40546647, year = {2025}, author = {Ibrahim, M and Ahmad, J and Abbas, M and Zainullah, and Umar, Z and Nasir, M and Zain, K and Ahmad, J and Arshad, S and Bashir, A and Ullah, S and Ahmad, Z and Safdar, S}, title = {The Role of N-terminal Pro-B-Type Natriuretic Peptide, Troponins, and D-dimer in Acute Cardio-Respiratory Syndromes: A Multi-specialty Systematic Review.}, journal = {Cureus}, volume = {17}, number = {5}, pages = {e84460}, pmid = {40546647}, issn = {2168-8184}, abstract = {This systematic review evaluates the diagnostic and prognostic utility of N-terminal pro-B-type natriuretic peptide (NT-proBNP), cardiac troponins, and D-dimer in acute cardio-respiratory syndromes, including heart failure (HF), acute coronary syndrome (ACS), pulmonary embolism (PE), acute respiratory distress syndrome (ARDS), and coronavirus disease 2019 (COVID-19)-related complications. These biomarkers play critical roles in assessing myocardial stress, injury, and thrombosis risk, offering a rapid and cost-effective alternative to traditional diagnostic tools. A comprehensive literature search from 2015 to 2024 identified 14 high-quality studies, demonstrating NT-proBNP's strong correlation with HF severity and mortality risk in severe COVID-19, while cardiac troponins were associated with myocardial injury in ARDS and ACS. D-dimer emerged as a predictor of thrombotic complications and poor outcomes in interstitial lung disease (ILD) and PE. The combined use of these biomarkers significantly improved risk stratification, enabling early intervention and reducing unnecessary imaging and invasive testing. A multi-marker approach provided superior predictive accuracy for mortality and recurrence risk in PE compared to single biomarker assessments. Despite some methodological limitations, including heterogeneity in biomarker thresholds, the findings support the integration of these markers into routine clinical practice to enhance early diagnosis and patient management. Future research should focus on standardizing biomarker cut-off values, conducting large-scale multi-center trials, and incorporating biomarker data into artificial intelligence (AI)-driven decision systems. This study highlights the potential of biomarker-driven risk assessment in cardio-respiratory medicine, paving the way for more precise, early, and effective intervention strategies to optimize patient outcomes and advance precision medicine in critical care settings.}, } @article {pmid40546533, year = {2025}, author = {Saxena, S and Mandrah, V and Tariq, W and Das, P and Sambhav, K and Devi, SH}, title = {The Future of mRNA Vaccines: Potential Beyond COVID-19.}, journal = {Cureus}, volume = {17}, number = {5}, pages = {e84529}, pmid = {40546533}, issn = {2168-8184}, abstract = {In recent years, mRNA therapeutics have emerged as a promising platform in treating a wide range of diseases, including cancers, infections, genetic disorders, and autoimmune diseases. This review focuses on the clinical impact of mRNA-based treatments and their transformative potential in modern medicine. mRNA therapeutics utilize the host's cellular machinery to produce target proteins, enabling highly specific and customizable treatments. In the case of cancer, mRNA vaccines to stimulate immune responses against such tumor-specific antigens are being developed in a personalized manner. Infectious diseases are also an indication for which mRNA vaccines have shown a significant effect on preventing viral infection, as the global success of mRNA COVID vaccines demonstrates. Among genetic disorders, mRNA therapy presents a new way to restore defective proteins and reverse the underlying pattern of genetic defects. Furthermore, mRNA treatment of autoimmune diseases aims to generate immune tolerance and avoid traditional immunosuppressive therapy. Advances are being driven by the discovery of new technologies to stabilize, deliver, and modulate the immune system around mRNAs. Recent advances in delivery systems and RNA stabilization have further expanded the potential of mRNA vaccines for viral diseases. mRNA therapeutics have the advantage of being rapidly developed and adaptable to a wide range. Research on further improvement of the delivery mechanisms and long-term safety will be necessary for extending the clinical applications of mRNA therapeutics.}, } @article {pmid40544799, year = {2025}, author = {Jwa, S and Imanishi, Y and Ascher, MT and Dudley, MZ}, title = {Communication interventions to reduce parental vaccine hesitancy: A systematic review.}, journal = {Vaccine}, volume = {61}, number = {}, pages = {127401}, doi = {10.1016/j.vaccine.2025.127401}, pmid = {40544799}, issn = {1873-2518}, mesh = {Humans ; *Vaccination Hesitancy/psychology ; *Parents/psychology ; *COVID-19/prevention & control ; *Communication ; *Vaccination/psychology ; *COVID-19 Vaccines/administration & dosage ; SARS-CoV-2 ; Child ; Vaccination Coverage ; Caregivers/psychology ; Adolescent ; }, abstract = {INTRODUCTION: Vaccine hesitancy among parents and caregivers is a growing issue that can lead to reduced vaccine coverage and corresponding outbreaks of disease. Different interventions to reduce vaccine hesitancy have been developed, including the use of remote online communication that has become more common during the COVID-19 pandemic, but their impacts and effectiveness are unclear. In this systematic review, we aimed to identify effective types of communication that reduce vaccine hesitancy.

METHODS: Multiple online databases were searched on April 1st, 2022 as well as March 18th, 2024. Included articles studied the impact of communication interventions aiming to reduce vaccine hesitancy among parents and caregivers of young children. Interventions targeting adolescent or adult vaccines were excluded. Potential biases or limitations that may affect the results of each study were evaluated.

RESULTS: Out of 3873 identified articles, 33 studies were included in this review, and 25 showed effectiveness. Among the 25 effective communication interventions, 11 were in-person and interactive, 11 were neither in-person nor interactive, 3 were interactive but not in-person, and 2 were in-person but not interactive.

DISCUSSION: Communication interventions can reduce vaccine hesitancy and increase childhood vaccine coverage. Although different types of interventions can reduce vaccine hesitancy and increase childhood vaccine coverage, especially by in-person and interactive communication interventions, further research is needed to elucidate the components that make such interventions impactful in different settings. These findings are particularly relevant for clinicians and public health officials striving to reduce vaccine hesitancy and increase vaccine uptake among children.}, } @article {pmid40544703, year = {2025}, author = {Mothae, SA and Chiliza, TE and Mvubu, NE}, title = {SARS-CoV-2 host-pathogen interactome: insights into more players during pathogenesis.}, journal = {Virology}, volume = {610}, number = {}, pages = {110607}, doi = {10.1016/j.virol.2025.110607}, pmid = {40544703}, issn = {1096-0341}, mesh = {Humans ; *SARS-CoV-2/pathogenicity/physiology ; *COVID-19/virology/metabolism/immunology ; *Host-Pathogen Interactions ; Virus Internalization ; Virus Replication ; }, abstract = {SARS-CoV-2, the virus responsible for COVID-19, emerged in December 2019 and was declared a global health emergency in January 2020. The pandemic has led to nearly 7 million deaths worldwide, prompting ongoing research into viral variants and potential future outbreaks. Like other viruses, SARS-CoV-2 relies on host proteins to complete its life cycle, hijacking cellular processes to enhance replication and evade immune responses. The virus primarily enters host cells through the angiotensin-converting enzyme 2 (ACE2) receptor, but additional co-receptors, including C-type lectins, neuropilin-1, basigin (CD147), and tyrosine-protein kinase receptors, may also facilitate entry. To evade immune detection, SARS-CoV-2 targets the type I interferon (IFN) pathway, disrupting antiviral responses. Viral replication is supported by interactions with host polymerase (Pol δ), lipid droplet regulators, and Ras-related proteins. Non-structural proteins (NSPs) further manipulate host ATP metabolism and stress response pathways in the endoplasmic reticulum (ER) and mitochondria. The membrane (M) protein plays a crucial role in viral trafficking, interacting with host proteins to direct assembly at the ER-Golgi intermediate compartment (ERGIC) or plasma membrane, promoting syncytia formation. For viral release, SARS-CoV-2 exploits tight junction proteins, enhancing its spread within the lungs. This narrative review unpacks the SARS-CoV-2 host-pathogen interactome, highlighting critical structural and non-structural protein interactions as well as crucial host proteins that are expressed during the pathogenesis process. Through an integrative perspective of essential "players" during pathogenesis, this review aims to uncover therapeutic and vaccine targets, offering insights into antiviral strategies against SARS-CoV-2 and future coronaviruses.}, } @article {pmid40543860, year = {2025}, author = {Cabral-Marques, O and Schimke, LF and Moll, G and Filgueiras, IS and Nóbile, AL and Adri, AS and do Vale, FYN and Usuda, JN and Corrêa, YLG and Albuquerque, D and Nava, RG and Santos, RS and Dias, HD and Silva, HF and Marconi, PB and Catar, R and Adu-Gyamfi, M and Wang, P and Khan, TA and Hackel, AM and Leheis, A and Stähle, A and Müller, A and Schmidt, C and Radunovic, C and Adjailia, EB and Grasshoff, H and Humrich, JY and Menz, J and Fourlakis, K and Winziers, M and Jäpel, M and Wegner, MV and Lamprecht, P and Nieberding, R and Akbarzadeh, R and Arnold, S and Jendrek, S and Klapa, S and Augustin, S and Biedermann, S and Schinke, S and Scheerer, P and Endres, M and Schulze-Forster, K and Paul, F and Yu, X and Sotzny, F and Sakmar, TP and Banasik, M and Haghikia, A and Hoffmann, MH and Veprintsev, D and Witte, T and Dalmolin, RJS and Ochs, HD and Heidecke, H and Scheibenbogen, C and Shoenfeld, Y and Riemekasten, G}, title = {Advancing research on regulatory autoantibodies targeting GPCRs: Insights from the 5th international symposium.}, journal = {Autoimmunity reviews}, volume = {24}, number = {9}, pages = {103855}, doi = {10.1016/j.autrev.2025.103855}, pmid = {40543860}, issn = {1873-0183}, mesh = {Humans ; *Receptors, G-Protein-Coupled/immunology ; *Autoantibodies/immunology ; *Autoimmune Diseases/immunology/therapy ; *COVID-19/immunology ; SARS-CoV-2/immunology ; Biomarkers ; Animals ; }, abstract = {The 5th International Symposium on Regulatory Autoantibodies Targeting GPCR (RAB-GPCRs) advanced the understanding of the significant role played by autoantibodies targeting G-protein-coupled receptors (GPCRs) in various human diseases. Once considered passive markers, RAB-GPCRs are now recognized as active modulators of cellular signaling, immune regulation, and inflammation. The symposium highlighted their involvement in multiple prominent pathologies, including autoimmune diseases, cardio- and cerebrovascular diseases, and neuroimmunologic disorders such as myalgic encephalomyelitis/chronic fatigue syndrome and post-COVID-19 syndrome (ME/CFS/PCS), as well as solid organ and hematopoietic stem cell transplantation (SOT/HSCT). Experts from rheumatology, immunology, and neurology presented interdisciplinary discussions on the potential of RAB-GPCRs as biomarkers and therapeutic targets. Advances in screening methods, biomarker identification, and therapeutic strategies were shared, emphasizing their diagnostic potential and application in novel therapeutic interventions. This report summarizes key insights from the symposium, particularly focusing on the modulatory properties of RAB-GPCRs and their relevance in both immune-mediated diseases and other pathologies (e.g., vascular, degenerative) that are traditionally not considered primarily immune-mediated. Ongoing research is expected to further establish these autoantibodies as crucial components in disease modulation and systems biology contexts, offering new opportunities for precision medicine and improved clinical outcomes in immune-related disorders.}, } @article {pmid40543387, year = {2025}, author = {Beuren, T and Ferrari, F and Franzoni, LT and Goulart, CDL and Val, F and Cipriano, G and Stein, R}, title = {Exploring the interplay between host genetics and acute and long COVID: A narrative review.}, journal = {Clinics (Sao Paulo, Brazil)}, volume = {80}, number = {}, pages = {100708}, pmid = {40543387}, issn = {1980-5322}, abstract = {Over the past four years, pivotal discoveries have deepened the understanding of the relationship between genetic factors and SARS-CoV-2 infection. Numerous genes associated with severe COVID-19 suggest a potential genetic predisposition, which may help explain why some individuals develop more serious illnesses. Emerging evidence highlights the role of genes involved in pulmonary immunity, such as Forkhead box Protein P4 (FOXP4), whose increased expression in lung tissue has been linked to more severe disease. Other genes - Transmembrane Protease Serine-2 (TMPRSS2), Leucine Zipper Transcription Factor Like-1 (LZTFL1), Solute Carrier family 6 member 20 (SLC6A20), Tyrosine Kinase-2 (TYK2), Angiotensin-Converting Enzyme (ACE), and FYVE and Coiled-Coil Domain-Containing-1 (FYCO1) - have also been implicated in COVID-19 severity. In contrast, certain genetic variants - such as the T-allele of rs12329760 in the TMPRSS2 gene and rs35705950-T in the Mucin-5B (MUC5B) gene - may confer protection against severe disease. Overall, the evidence suggests that genetic factors can influence both susceptibility to and protection from severe COVID-19, although these associations are likely shaped by complex interactions with environmental, behavioral, and other biological factors. This review summarizes current knowledge on genetic determinants linked to COVID-19 outcomes.}, } @article {pmid40543182, year = {2025}, author = {Smet, M and Berkell, M and Górska, A and Tacconelli, E and Kumar-Singh, S and Malhotra-Kumar, S}, title = {Drivers of quasispecies development in SARS-CoV-2 and implications for emergent variants and COVID-19.}, journal = {Virology}, volume = {610}, number = {}, pages = {110584}, doi = {10.1016/j.virol.2025.110584}, pmid = {40543182}, issn = {1096-0341}, mesh = {*SARS-CoV-2/genetics/pathogenicity ; Humans ; *COVID-19/virology/transmission ; Genome, Viral ; *Quasispecies/genetics ; Mutation ; Evolution, Molecular ; Pandemics ; Genetic Variation ; }, abstract = {Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 2019, significant research has focused on SARS-CoV-2 evolution and transmission. Most transmission studies rely on RT-qPCR and consensus sequencing for SARS-CoV-2 characterization, often overlooking the collection of viable genetically linked genomes characterized by one or more intra-host single nucleotide variants (iSNVs) within the same sample, defined as "quasispecies" (QS), which could influence disease outcomes. QS are highly variable in genomic position and frequency and have been proven to impact viral evolution substantially. Several de novo mutations were detected in QS before becoming lineage defining in variants of concern (VOCs). These mutations can also result from errors during replication and transcription leading to the development of defective viral genomes (DVGs) that are incapable of replicating, but important for propagating viral diversity during infection. In a continuously changing landscape of dominating VOCs and anti-SARS-CoV-2 therapy and vaccination strategies, this scoping review aims to summarize the current state-of-the-art and identify knowledge gaps in understanding QS development and their impact on intra-host SARS-CoV-2 evolution, virulence, and intra-host immunity. Finally, we explore the potential of studying inter-host transmission in households as a mirror for community transmission and evolution.}, } @article {pmid40542628, year = {2025}, author = {Fando, AA and Ilyichev, AA and Litvinova, VR and Rudometova, NB and Karpenko, LI and Rudometov, AP}, title = {[DNA Vaccine Technologies: Design and Delivery].}, journal = {Molekuliarnaia biologiia}, volume = {59}, number = {1}, pages = {3-21}, pmid = {40542628}, issn = {0026-8984}, mesh = {*Vaccines, DNA/genetics/immunology ; Humans ; *COVID-19/prevention & control/immunology/virology ; *SARS-CoV-2/immunology/genetics ; *COVID-19 Vaccines/immunology/genetics ; Plasmids/genetics/immunology ; *Vaccine Development/methods ; Pandemics/prevention & control ; }, abstract = {The COVID-19 pandemic has triggered the development of new directions in vaccine development, among which DNA- and mRNA-based technologies are particularly noteworthy. The platform based on DNA vaccines is developing particularly intensively due to their high stability at ambient temperature and the ability to activate both humoral and cellular immunity. The full cycle of DNA vaccine creation, which includes the construction of plasmid DNA, obtaining a producer strain, fermentation, and purification, takes 2-4 weeks. In addition, the production technology of such vaccines does not require working with dangerous pathogens, which significantly simplifies the process of their production and reduces the overall cost. Over more than 30 years of rapid development, DNA vaccine technology continues to undergo changes. Currently, there is a licensed DNA vaccine for the prevention of COVID-19, and many candidate prophylactic vaccines against viral and bacterial diseases are in clinical trials. This review covers not only the principles of constructing plasmid DNA vaccines, but also new technologies for obtaining DNA constructs, such as minicircular DNA, MIDGE DNA, and Doggybone^(™) DNA. New types of DNA vaccines are interesting because they consist only of the most essential elements for activating the immune response. Such constructs completely lack the sequences necessary for the production of plasmid DNA in bacterial cells, for example, the antibiotic resistance gene. One of the key problems in the development of a DNA vaccine is the method of its delivery to target cells. Currently, various delivery methods are used, both chemical and physical, which are rapidly developing and have already proven themselves to be reliable and effective. The characteristics of some of the most promising methods are also presented in this review.}, } @article {pmid40542514, year = {2025}, author = {Nakajima, K and Hirose, A and Yoshino, M and Watanuki, M and Nameda, T}, title = {Midwives' Support for Couples in Japanese Hospitals and Clinics During the COVID-19 Pandemic: A Cross-Sectional Survey.}, journal = {Nursing open}, volume = {12}, number = {6}, pages = {e70250}, pmid = {40542514}, issn = {2054-1058}, support = {21K10949//JSPS KAKENHI/ ; }, mesh = {Adult ; Female ; Humans ; Male ; Middle Aged ; Pregnancy ; *COVID-19/epidemiology ; Cross-Sectional Studies ; Japan/epidemiology ; *Midwifery/methods ; Pandemics ; Surveys and Questionnaires ; East Asian People ; }, abstract = {AIMS: Severe restrictions and changes in perinatal care, social isolation, and disruption of marital relationships due to the coronavirus disease COVID-19 pandemic have become problematic. This study aimed to clarify the status of the health guidance and group education provided by midwives in Japanese hospitals and clinics before and after the COVID-19 pandemic. Furthermore, this study clarifies the role of midwifery support in promoting marital relationships.

DESIGN: Cross-sectional questionnaire survey.

METHODS: The STROBE statement was used to guide this study. Overall, 890 midwives working in hospitals and clinics throughout Japan were recruited for this study, which yielded 216 valid questionnaires.

RESULTS: The COVID-19 pandemic has transformed Japanese midwifery into a flexible system that can provide non-face-to-face individualised support for couples. However, continuous midwifery care was not provided to couples prior to the COVID-19 pandemic. As a result, midwifery support for couples has been limited since the outbreak of COVID-19. During the COVID-19 pandemic, there was a significant association between midwifery practice and the importance of promoting marital relationships.

CONCLUSION: The challenge in providing midwifery support to couples is providing individualised and ongoing support in combination with direct and indirect support.}, } @article {pmid40541217, year = {2025}, author = {Pail, O and Lin, MJ and Anagnostou, T and Brown, BD and Brody, JD}, title = {Cancer vaccines and the future of immunotherapy.}, journal = {Lancet (London, England)}, volume = {406}, number = {10499}, pages = {189-202}, doi = {10.1016/S0140-6736(25)00553-7}, pmid = {40541217}, issn = {1474-547X}, mesh = {Humans ; *Cancer Vaccines/therapeutic use/immunology ; *Immunotherapy/trends/methods ; *Neoplasms/therapy/immunology/prevention & control ; }, abstract = {Vaccines have had a major impact on the control of infectious disease, most recently by helping to combat the COVID-19 pandemic. Prophylactic cancer vaccines have prevented several malignancies by protecting against cancer-causing pathogens. By contrast, therapeutic vaccines training the immune system to eliminate established tumours are now showing real promise in clinical settings. In the adjuvant setting, vaccines against melanoma and pancreatic cancer appear to be reducing minimal residual disease and relapse. In the macrometastatic setting, in-situ vaccines have induced systemic regressions in advanced-stage lung and breast cancers and lymphomas. More effective cancer vaccines are being developed through having a deeper understanding of crucial cellular factors in tumour immunology, the incorporation of newer vaccine components to effectively mobilise and activate cells, the use of omics and artificial intelligence in vaccine design, and addition of immune checkpoint blockade. In this Viewpoint, we analyse cancer vaccine trials, the strengths and limitations of different vaccine approaches, and we discuss how the next generation of cancer vaccines can help improve patient outcomes and quality of life.}, } @article {pmid40541216, year = {2025}, author = {Kantor, R and Pau, AK and Kozal, MJ and Hyle, EP}, title = {Do we need routine integrase resistance testing before starting antiretroviral therapy?.}, journal = {The lancet. HIV}, volume = {12}, number = {9}, pages = {e664-e668}, pmid = {40541216}, issn = {2352-3018}, support = {R01 AI042006/AI/NIAID NIH HHS/United States ; R01 AI186632/AI/NIAID NIH HHS/United States ; R01 AI147333/AI/NIAID NIH HHS/United States ; K24 AI134359/AI/NIAID NIH HHS/United States ; R01 AI136058/AI/NIAID NIH HHS/United States ; P30 AI042853/AI/NIAID NIH HHS/United States ; }, mesh = {Humans ; *HIV Infections/drug therapy/virology ; *Drug Resistance, Viral ; *HIV Integrase Inhibitors/therapeutic use/pharmacology ; *HIV Integrase/genetics ; *HIV-1/drug effects/genetics/enzymology ; *Anti-HIV Agents/therapeutic use ; }, abstract = {Oral second-generation integrase strand transfer inhibitors are now anchor drugs of antiretroviral therapy (ART) globally due to their high resistance barriers. In high-income settings, guidelines recommend routine protease and reverse transcriptase resistance testing before ART initiation but suggest routine integrase resistance testing only for individuals at elevated risk of integrase resistance. Improved characterisation of transmitted integrase resistance, its detection, and its clinical impact will guide future recommendations for clinical decision making. Balancing the need to protect this important drug class against concerns about resource allocation and care complexity presents a substantial challenge. Shifting the responsibility to providers to decide whether and when to test for integrase resistance before ART initiation can be problematic, particularly given the uncertainty around the need to reassess related available recommendations. As our understanding of integrase resistance evolves, prioritising this discussion is essential, and providers, researchers, and policy makers should engage in addressing this important issue.}, } @article {pmid40540317, year = {2025}, author = {Pangrazzi, L and Weinberger, B}, title = {Recent developments of vaccines for older adults: Adjuvants and beyond.}, journal = {Human vaccines & immunotherapeutics}, volume = {21}, number = {1}, pages = {2517931}, doi = {10.1080/21645515.2025.2517931}, pmid = {40540317}, issn = {2164-554X}, mesh = {Humans ; *Adjuvants, Immunologic/administration & dosage ; Aged ; COVID-19/prevention & control/immunology ; *Vaccine Development ; COVID-19 Vaccines/immunology ; Immunosenescence ; Influenza Vaccines/immunology ; *Vaccines/immunology/administration & dosage ; Vaccine Efficacy ; Pneumococcal Vaccines/immunology ; Aged, 80 and over ; Vaccination ; Herpes Zoster Vaccine/immunology ; *Aging/immunology ; }, abstract = {As the global population ages, the development of effective vaccines for older adults has become a public health priority. Immunosenescence, the gradual decline of immune function with age, reduces vaccine efficacy, necessitating novel strategies to enhance immune responses in this population. This review summarizes the current landscape of vaccines for older adults including vaccines against influenza, pneumococcal disease, COVID-19, RSV and herpes zoster and explores recent advancements in vaccines for older adults. Adjuvants can enhance immunogenicity and have played an important role in recent vaccine developments. This review underscores the need for continued innovation to improve existing vaccines, develop vaccines against additional infections including nosocomial pathogens, and to strengthen implementation of vaccination programs to ensure optimal protection against infectious diseases in aging populations.}, } @article {pmid40540167, year = {2025}, author = {Lang, SM and Schiffl, H}, title = {Long-term renal consequences of COVID-19. Emerging evidence and unanswered questions.}, journal = {International urology and nephrology}, volume = {}, number = {}, pages = {}, pmid = {40540167}, issn = {1573-2584}, abstract = {PURPOSE: COVID-19 infection is associated with a high burden of acute or acute on chronic kidney injury (AKI), particularly in critically ill patients. Given the large numbers of COVID-19 survivors, characterization of long-term adverse kidney effects of COVID-19 have important implications for post-COVID-19 care.

METHODS: This narrative review provides a summary of epidemiologic evidence for post-COVID kidney disorders.

RESULTS: Precise post-COVID renal data are scarce. The true burden of long-COVID chronic kidney disease (CKD) remains unknown owing to under-recognition, under-diagnosis, clinical heterogeneity of patients, incomplete follow-up, and temporal trends in critical COVID-19 disease across waves of the pandemic. Collectively, the few well-designed studies assessing the impact of long-COVID on kidney health found that the overwhelming majority of patients with normal renal function at admission and without AKI during acute COVID-19 disease preserved kidney function. Post-infection kidney function trajectories of patients who experience a loss of renal function vary. Kidney function may decline gradually even in non-hospitalized patients, hospitalized patients may experience a rapid loss of kidney function 6-12 months after COVID-19 diagnosis or hospital discharge resulting from AKI during the acute phase of the disease. End-stage renal disease may occur after non-recovery from AKI and rapid progression of pre-existing CKD. Multiple mechanisms may trigger post-COVID CKD including maladaptive repair after AKI, or progression of renal lesions of systemic co-morbidities, persistence of the virus and dysregulation of inflammatory cytokines.

CONCLUSIONS: The COVID-19 pandemic has significantly impacted and may continue to have an impact on kidney health. Patients at risk have a higher propensity to develop critical COVID-19 disease. Post-COVID-19 care must pay close attention to renal function in patients discharged from hospital.}, } @article {pmid40538568, year = {2025}, author = {Bhattacharya, S and Singh, A and Kashyap, A}, title = {Digital horizons in non-communicable disease care: a bibliometric exploration of intervention impact and innovation.}, journal = {Frontiers in digital health}, volume = {7}, number = {}, pages = {1528711}, pmid = {40538568}, issn = {2673-253X}, abstract = {INTRODUCTION: Digital interventions show considerable promise in managing non-communicable diseases (NCDs) within primary healthcare.

AIM: The aim of this study was to conduct a comprehensive bibliometric analysis of research on digital interventions for individuals living with NCDs.

METHODOLOGY: This study explores digital interventions in NCDs through a bibliometric analysis from 2014 to 2024. Carefully designed search queries targeted primary and combined terms to cover a wide range of NCDs, including cancer, diabetes, and hypertension. SCOPUS searches yielded 9,572 English-language articles, refined by excluding non-relevant works and duplicates. Metadata, including authorship, keywords, and citations, was extracted for analysis. Using Biblioshiny and VosViewer, the study examined publication trends, telemedicine applications, and the knowledge framework of the field. Conceptual themes were identified through co-occurrence mapping, intellectual structures via co-citation networks, and social structures through collaboration patterns among authors, institutions, and countries.

RESULTS: The upward trend in research on digital interventions and NCDs accelerated significantly after 2018, peaking in 2021, followed by a slight decline. Medicine dominates this field, with considerable contributions from biochemistry, health professions, and engineering. The most prolific authors, primarily from the United States, United Kingdom, and Australia, have significantly shaped this research area. Institutional contributions are led by Harvard Medical School and other global leaders, reflecting strong inter-institutional collaborations. The United States and the United Kingdom are the most productive countries, with the Journal of Medical Internet Research standing out as the leading publication. Keyword analysis reveals a focus on telemedicine, COVID-19, tele-health, and digital health. Co-citation analyses identify key intellectual frameworks, while co-authorship and institutional collaborations highlight robust global networks. Emerging trends emphasize AI, digital health tools, and patient self-management, underscoring a transformative shift in addressing NCDs through technology-driven interventions. The findings highlight the need for patient-centered applications, improved implementation strategies, and strengthened collaborations, especially in underrepresented regions, to enhance the global impact of digital interventions for NCDs.}, } @article {pmid40538540, year = {2025}, author = {Xu, Q and Lian, H and Zhou, R and Gu, Z and Wu, J and Wu, Y and Li, Z}, title = {Curcumin and multiple health outcomes: critical umbrella review of intervention meta-analyses.}, journal = {Frontiers in pharmacology}, volume = {16}, number = {}, pages = {1601204}, pmid = {40538540}, issn = {1663-9812}, abstract = {OBJECTIVE: This review aimed to determine the therapeutic effects and safety of oral curcumin compared with other comparators for human health and wellbeing outcomes.

METHODS: PubMed, Embase, and Cochrane Library were searched from their inception to 18 June 2024. The Assessment of Multiple Systematic Reviews-2 checklist, and Grading of Recommendations, Assessment, Development and Evaluation system were used to assess the methodological and evidence quality for each meta-analysis, respectively. The results are presented in a narrative review.

RESULTS: We included 25 studies. The overall methodological quality was relatively poor, and there is considerable room for improvement. The findings suggest that curcumin has potentially positive effects on lipid profiles, blood pressure, inflammatory markers and oxidative stress, musculoskeletal diseases, emotional and cognitive function, ulcerative colitis, liver and kidney function, primary dysmenorrhea or premenstrual syndrome, rheumatoid arthritis, COVID-19, painful statues, and HR-QOL. However, for many diseases, the conclusions remain uncertain.

CONCLUSION: The available evidence suggests that curcumin is a safe medicinal agent that improves multiple clinical outcomes; however, the scientific quality of published studies needs to be improved.}, } @article {pmid40538042, year = {2025}, author = {Abeykoon, AMH and Wilson, M and Subbarao, K and Geard, N and Zachreson, C and Sullivan, SG}, title = {Severe acute respiratory syndrome coronavirus-2 shedding in exhaled material: a systematic review.}, journal = {Epidemiology and infection}, volume = {153}, number = {}, pages = {e75}, pmid = {40538042}, issn = {1469-4409}, mesh = {Humans ; *Virus Shedding ; *COVID-19/virology ; *SARS-CoV-2/physiology/isolation & purification ; Viral Load ; Exhalation ; Breath Tests ; RNA, Viral ; }, abstract = {This systematic review synthesized evidence on the viral load of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) shedding in exhaled material to understand how the exhaled SARS-CoV-2 viral load of infected individuals varies with days since exposure. Medline, Scopus, and Web of Science databases were searched using a combination of search terms to identify articles that tested exhaled material from SARS-CoV-2 infected patients. Records were systematically screened and assessed for eligibility, following which reference lists of eligible articles were hand-searched to identify further relevant studies. Data extraction and quality assessment of individual studies were conducted prior to synthesizing the evidence. Forty-five articles that sampled exhaled breath, exhaled breath condensate, face masks, and cough samples were reviewed. The variation in the SARS-CoV-2 viral load in these materials was considerable with the detection of viral RNA shed during breathing as far as 43 days after symptom onset. The replication-competent virus was present in all four sample types, with the majority isolated during the first week of symptoms onset. Variations in the sample types and testing protocols precluded meta-analysis. High heterogeneity in exhaled SARS-CoV-2 viral load is likely due to host and viral factors as well as variations in sampling and diagnostic methodologies. Evidence on SARS-CoV-2 shedding in exhaled material is scarce and more controlled fundamental studies are needed to assess this important route of viral shedding.}, } @article {pmid40537540, year = {2025}, author = {Wang, N and Sun, L and Qian, G and Lv, H and Liu, Z}, title = {Neutrophil heterogeneity in Kawasaki disease and multisystem inflammatory syndrome in children.}, journal = {Pediatric research}, volume = {}, number = {}, pages = {}, pmid = {40537540}, issn = {1530-0447}, abstract = {Neutrophils, specialized cells of the early innate immune response, are important for maintaining the body's internal homeostasis. Upon invasion by foreign microbes, neutrophils are swiftly activated and recruited to the infection site, where they perform bactericidal functions through phagocytic clearance, degranulation-mediated toxin release, and NADPH oxidase-dependent killing. While their presence is crucial in the early stages of inflammation to combat infection, the prolonged engagement of neutrophils at the infection site can cause tissue damage due to apoptosis and the release of cytotoxic mediators. Neutrophils exhibit significant heterogeneity in response to allostatic conditions, with their phenotypic and functional properties undergoing distinct changes. Therefore, understanding the heterogeneity and diversity of neutrophils under physiological and pathological conditions is important. Multisystem inflammatory syndrome in children (MIS-C) is a pediatric inflammatory syndrome that emerges following exposure to SARS-CoV-2, while Kawasaki disease (KD) is a childhood systemic vasculitis with unknown etiology. Both conditions share clinical features, including neutrophilia and cardiovascular complications. This suggests the likelihood of overlapping underlying immunopathogenic mechanisms, and neutrophils may play a crucial role in these processes. This review focuses on the heterogeneity and function of neutrophils in KD and MIS-C, providing a comprehensive overview of the current research in this field. IMPACT: Neutrophils exhibit significant heterogeneity under physiological and pathological states. Different neutrophil subsets perform diverse functional characteristics. KD and MIS-C have apparent phenotypic similarities of systemic inflammation and cardiovascular complications. Neutrophil heterogeneity correlates with disease severity, and studies of neutrophil subsets reveal potential shared immunological drivers. Multi-omics analysis of neutrophil heterogeneity helps to better understand neutrophil subsets and discover new functions. Research into MIS-C and KD enhances our understanding of pediatric inflammatory diseases with cardiovascular involvement.}, } @article {pmid40536619, year = {2025}, author = {Bhattacharyya, D and Das Sarma, J}, title = {The pleiotropic anti-cancer, antiviral, and anti-neuro-immunomodulatory role of methanolic neem bark extract.}, journal = {Journal of natural medicines}, volume = {79}, number = {5}, pages = {951-966}, pmid = {40536619}, issn = {1861-0293}, mesh = {Humans ; *Plant Extracts/pharmacology/chemistry/therapeutic use ; Plant Bark/chemistry ; *Antiviral Agents/pharmacology/chemistry ; *Azadirachta/chemistry ; Animals ; *Antineoplastic Agents, Phytogenic/pharmacology/chemistry ; Methanol/chemistry ; }, abstract = {The miraculous golden tree of the century, neem or Azadirachta indica, has been used in ancient ayurvedic and traditional medicine since the inception of medicinal practices. The phytochemicals present in each part of this tree are known to possess the ability to cure a variety of diseases, from viral, bacterial, and fungal infections and associated pathogenesis to inflammatory diseases, different metabolic disorders, and cancers. Predominant phytochemicals from neem, azadirachtin, nimbin, nimbolide, quercetin, etc., are known to be potent anti-inflammatory, antiviral, and anti-cancer agents. These and many other bio-active compounds from neem restrict the viral spread and replication of β-coronaviruses, Human Immunodeficiency Virus, Herpes Simplex Virus, etc. Likewise, neem extracts and bio-active compounds from neem have been targeting cancer cells by restricting their proliferation, survival, and migration and inducing apoptosis, leading to the establishment of neem as a potent anti-cancer agent. Multiple studies have reported neem's efficiency in intervening with inflammatory pathways and oxidative stress pathways, which are known to be linked to viral infections and cancers. In this review, we discuss the role of methanolic neem bark extracts and their bio-active compounds in preventing β-coronavirus mouse hepatitis virus and SARS-CoV-2 replication and spread, and simultaneously the anti-cancer effects exerted by MNBE via activating pro-apoptotic markers, restricting the proliferation and migration of cervical cancer cells, inducing cell cycle arrest.}, } @article {pmid40536197, year = {2025}, author = {Yin, L and He, H and Zhang, H and Shang, Y and Fu, C and Wu, S and Jin, T}, title = {Revolution of AAV in Drug Discovery: From Delivery System to Clinical Application.}, journal = {Journal of medical virology}, volume = {97}, number = {6}, pages = {e70447}, pmid = {40536197}, issn = {1096-9071}, support = {//T.J. is supported by the National Key Research and Development Program of China (Grants No. 2022YFC2304102 and 2022YFC2303300), the Strategic Priority Research Program of the Chinese Academy of Sciences (Grant No. XDB0490000, XDB0940301), the National Natural Science Foundation of China (Grant No. 82272301), Anhui Provincial Key Research and Development Project (Grant No. 2022i01020025), USTC Research Funds of the Double First-Class Initiative (YD9100002056). H.Z. is supported by the National Natural Science Foundation of China (Grant No. 82402072)./ ; }, mesh = {Humans ; *Dependovirus/genetics ; *Genetic Vectors/genetics ; *Genetic Therapy/methods ; *Drug Discovery/methods ; *Gene Transfer Techniques ; Animals ; *Drug Delivery Systems/methods ; COVID-19/therapy ; SARS-CoV-2 ; }, abstract = {Adeno-associated virus (AAV) is a non-enveloped DNA virus infecting a wide variety of species, tissues, and cell types, which is recognized as a safe and effective method for delivering therapeutic transgenes. AAV vector is the most popular viral gene delivery system in clinical delivery systems with unique and multiple advantages, such as tissue tropism, transduction specificity, long-lasting gene expression, low immune responses, and without host chromosome incorporation. Till now, four AAV-based gene therapy drugs have already been approved by the US Food and Drug Administration (FDA) or European Medicines Agency (EMA). Despite the success of AAV vectors, there are still some remaining challenges that limit further usage, such as poor packaging capacity, low organ specificity, pre-existing humoral immunity, and vector dose-dependent toxicity. In the present review, we address the different approaches to optimize AAV vector delivery system with a focus on capsid engineering, packaging capacity, and immune response at the clinical level. The review further investigates the potential of manipulating AAV vectors in preclinical applications and clinical translation, which emphasizes the challenges and prospects in viral vector selection, drug delivery strategies, immune reactions in cancer, neurodegenerative disease, retinal disease, SARS-CoV-2, and monkeypox. Finally, it forecasts future directions and potential challenges of artificial intelligence (AI), vaccines, and nanobodies, which emphasizes the need for ethical and secure approaches in AAV application.}, } @article {pmid40536011, year = {2025}, author = {Moen, JK and Baker, CA and Iwasaki, A}, title = {Neuroimmune pathophysiology of long COVID.}, journal = {Psychiatry and clinical neurosciences}, volume = {79}, number = {9}, pages = {514-530}, pmid = {40536011}, issn = {1440-1819}, support = {/HHMI/Howard Hughes Medical Institute/United States ; R01 AI157488/AI/NIAID NIH HHS/United States ; R01AI157488//National Institute of Allergy and Infectious Diseases/ ; N/A/HHMI/Howard Hughes Medical Institute/United States ; }, mesh = {Humans ; *COVID-19/immunology/complications/physiopathology ; Post-Acute COVID-19 Syndrome ; *Neuroimmunomodulation/physiology ; *Nervous System Diseases/immunology/physiopathology/etiology ; SARS-CoV-2 ; Animals ; *Peripheral Nervous System Diseases/immunology/physiopathology/etiology ; Fatigue/physiopathology/immunology ; }, abstract = {Although COVID-19 was originally considered a respiratory illness, it is now well established that SARS-CoV-2 infection can have far-reaching impacts on the nervous system. Neurological symptoms such as chemosensory dysfunction are frequently observed during acute infection and approximately 10% of COVID-19 cases will go on to develop new or persistent long-term symptoms, a condition known in the literature as post-acute symptoms of COVID-19 (PASC) or by the patient-coined term Long COVID. Common neurological symptoms in Long COVID include new onset cognitive difficulties, dysautonomia, fatigue, and peripheral neuropathy. The emergence of Long COVID has prompted renewed interest in the study of post-acute infection syndromes (PAIS), particularly in the area of neuroimmune interactions. In this review we provide a comprehensive overview of the current body of literature on neurological manifestations of SARS-CoV-2 infection and Long COVID, with an emphasis on neuroimmune mechanisms drawn largely from autopsy studies and animal models. A more complete understanding of neuroimmune crosstalk in Long COVID will not only guide the development of therapies for this highly disabling condition but will also contribute to our general understanding of neuroimmune interactions in health and disease.}, } @article {pmid40535790, year = {2025}, author = {Macdonald, D and Bigelow-Talbert, K and Ross-White, A and Snelgrove-Clarke, E and Sookhoo, L}, title = {Understanding the experiences of birthing care during COVID-19: A qualitative systematic review.}, journal = {International journal of nursing studies advances}, volume = {8}, number = {}, pages = {100295}, pmid = {40535790}, issn = {2666-142X}, abstract = {BACKGROUND: The Covid-19 pandemic was a challenging time for people who sought health care and for health care providers. Throughout the pandemic women and birthing people, families, and health care providers adapted to ongoing changes, restrictions, and new information to ensure that babies were born safely. There was a strong policy focus on safety and the reduction of infection, however this focus did not account for how the changes to birthing care practice would influence the experiences of the people most continuously sharing space during birth - women and birthing people, midwives, and nurses.

OBJECTIVE: To explore and understand the birthing care experiences of women and birthing people, midwives, and nurses.

METHODS: We used the JBI methodology and methods to conduct our qualitative review. We included studies with participants who were women or birthing people, nurses, and midwives who received or provided birthing care during the Covid-19 global pandemic. Studies published between January 2020 and February 2023 were included. Studies had to report qualitative data.

RESULTS: A total of 5694 studies were identified for this review. After duplications were removed, screening and critical appraisal, 26 studies were included. Following meta-aggregation, 3 synthesized findings and 9 categories were created. The synthesized findings are 1) Navigating a pandemic and the chaos of constant changes 2) Striving for business as usual during a pandemic and 3) Amplifying variations in birthing care experiences.

CONCLUSIONS: The experiences and needs of people who provide and receive birthing care must be prioritized in all spaces. Midwives, nurses, women, and birthing people must be included in decision making for changes to practices and policies at all levels, especially during uncertain times. Birth experiences must be respected and supported to ensure that health and wellness outcomes are optimized for families at all stages of the intrapartum, postpartum and early parenting journeys.

REGISTRATION: Registered with Prospero CRD42021292832. An a priori protocol published, Macdonald, D., Snelgrove-Clarke, E., Ross-White, A., & Bigelow-Talbert, K. (2022). The experiences of birthing care during Covid-19: A systematic review protocol. JBI Evidence Synthesis. 20(5): 1353-1360.https://doi.org/10.11124/JBIES-21-00300.}, } @article {pmid40535522, year = {2025}, author = {Asghari, KM and Kakavand, N and Khosroshahi, MT and Alamdari, SJ and Karami, S and Jaberinezhad, M}, title = {Viral Etiologies and Histopathological Features of Olfactory Dysfunction: A Systematic Review.}, journal = {Health science reports}, volume = {8}, number = {6}, pages = {e70917}, pmid = {40535522}, issn = {2398-8835}, abstract = {BACKGROUND AND AIM: Olfactory dysfunction associated with viral infections, including the recent SARS-CoV-2 pandemic, has raised significant clinical interest. Understanding the viral etiologies and histopathological characteristics of permanent olfactory dysfunction is essential for optimizing diagnostic and therapeutic strategies. This systematic review aims to synthesize the available evidence on the histopathological features of viral-induced permanent olfactory dysfunction. By focusing on direct viral damage, inflammatory responses, and vascular changes, this study seeks to elucidate the underlying mechanisms of post-viral olfactory impairment.

METHODS: This systematic review adhered to PRISMA guidelines and was registered in PROSPERO (CRD42024520500). Searches were conducted in PubMed, EMBASE, Scopus, Web of Science, and Google Scholar up to February 14, 2024. Inclusion criteria encompassed observational studies investigating human subjects diagnosed with permanent olfactory dysfunction attributable to viral etiologies. Two reviewers independently screened studies, extracted data using predefined forms, and assessed study quality using NOS, STROBE, and JBI tools.

RESULTS: Eight studies met the inclusion criteria. Predominant viral etiologies included SARS-CoV-2 and common cold viruses (e.g., adenovirus). Diagnostic tools varied but commonly included clinical evaluations and validated olfactory tests. Histopathological findings revealed diverse nasal tissue alterations, such as mucosal atrophy, inflammatory infiltrates, and neuroepithelial degeneration. SARS-CoV-2 infections demonstrated distinctive neuroepithelial and endothelial pathology contributing to olfactory dysfunction.

CONCLUSION: Viral-induced permanent olfactory dysfunction involves multifaceted histopathological changes, including direct viral neuroinvasion and inflammatory responses. Understanding these pathophysiological mechanisms is crucial for developing targeted interventions and managing long-term sequelae of viral infections affecting olfaction. This systematic review, the first conducted on this topic, underscores the need for further research on viral etiologies beyond COVID-19, as they are currently understudied.}, } @article {pmid40535178, year = {2025}, author = {Cai, Y and Kamarudin, S and Nujaimi, S}, title = {Willingness to share information on social media: a systematic literature review (2020-2024).}, journal = {Frontiers in psychology}, volume = {16}, number = {}, pages = {1567506}, pmid = {40535178}, issn = {1664-1078}, abstract = {INTRODUCTION: The rapid advancement of Web 2.0 technologies, accelerated by the COVID-19 pandemic, has fundamentally transformed information sharing behaviors on social media. This transformation necessitates a comprehensive understanding of the factors influencing information sharing willingness in the digital era.

METHODS: This study systematically reviews 66 peer-reviewed journal articles published between 2020 and 2024, focusing on key research topics, theoretical frameworks, and methodologies used to examine information sharing willingness on social media. Following the PRISMA guidelines, articles were identified and analyzed using keyword matching, thematic categorization, and expert review.

RESULTS: Our findings reveal four core research themes: general information sharing, health-related information sharing, false information dissemination, and crisis information sharing. These themes are examined through three primary theoretical perspectives: motivational-driven theories, cognitive-processing theories, and social-relational theories. The study identifies key factors influencing information sharing willingness across motivational, cognitive, and social dimensions. Methodologically, survey-based studies dominate this field, with experimental designs providing supplementary insights.

DISCUSSION: This review contributes to the literature by providing a holistic synthesis of the current research landscape, identifying gaps in knowledge, and proposing potential directions for social media platform operators and policymakers to consider. Future research directions are proposed to address unresolved challenges and advance the theoretical and methodological understanding of information sharing behavior in the digital era.}, } @article {pmid40534870, year = {2025}, author = {Azzarone, B and Landolina, N and Mariotti, FR and Moretta, L and Maggi, E}, title = {Soluble SARS-CoV-2 Spike glycoprotein: considering some potential pathogenic effects.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1616106}, pmid = {40534870}, issn = {1664-3224}, mesh = {Humans ; *Spike Glycoprotein, Coronavirus/immunology/metabolism ; *COVID-19/immunology/virology ; *SARS-CoV-2/immunology ; *Killer Cells, Natural/immunology ; COVID-19 Vaccines/immunology ; Angiotensin-Converting Enzyme 2/metabolism ; }, abstract = {The soluble S1 subunit of Spike protein (SP) from the SARS-CoV-2 of different variants of concern (VOCs) may directly bind and activate human NK cells in vitro through the engagement of the toll-like receptor (TLR) 2 and TLR4. This mechanism revealed a novel pathogenic role played by NK cells not only in the different phases of disease but also in the post-acute sequelae of COVID-19 (PASC) and some post-vaccination side effects. In addition to its binding to angiotensin-converting enzyme 2 (ACE2), which mediates virus attachment and cell entry, soluble SP triggers several active receptors/molecules expressed by many cells, inducing, in turn, type I/III interferon decrease, altered autophagy and apoptosis, the release of inflammatory cytokines and chemokines, complement activation and endothelial damage, which favour clotting events. In this review, we discuss the hypothesis that circulating SP, exerting multiple biological activities, can explain the heterogeneity of the clinical outcomes of severe COVID-19, PASC and post-vaccine-related effects. Recent reports have clearly indicated that soluble SARS-CoV-2 and post-vaccination SP trigger the same cascade of events, acting on the immune response and promoting defined adverse events. Factors hindering the pathological activity of soluble SP are the SP plasma levels, the age of the infected/vaccinated people and the efficiency of protein synthesis of ectopic targets triggered by soluble SP, as well as the specificity, the titre and the affinity of anti-SP antibodies elicited by the infection. At present, the risk/benefit ratio is largely in favour of vaccination; however, the excessive and persistent ectopic production of synthetic SP should be systematically analysed. This would allow for the identification of subjects at risk for major adverse events and to answer the urgent need for efficient vaccines that provide long-lasting activity with minimal side effects.}, } @article {pmid40534826, year = {2025}, author = {Souissi, A and Prieto-González, P and Ben Saad, H}, title = {Widespread pain syndrome in long COVID-19: melatonin as an adjuvant treatment.}, journal = {Frontiers in pain research (Lausanne, Switzerland)}, volume = {6}, number = {}, pages = {1609095}, pmid = {40534826}, issn = {2673-561X}, abstract = {Long coronavirus disease 2019 (LC19) represents a complex global health challenge. Survivors frequently report persistent problems like widespread pain syndrome (WPS), cognitive dysfunction, cardiovascular complications, and sleep disturbances. These health problems, which are worsened by oxidative stress and inflammaging, open the prospect of treatment strategies targeting these mechanisms. Melatonin is a potential option for treating LC19 problems because of its anti-inflammatory, antioxidant, and pain-modulating properties. Melatonin targets shared pathological pathways, offering a promising approach to reducing inflammation, oxidative stress, and neuroendocrine dysfunction. The present mini-review explores the therapeutic potential of melatonin in the treatment of LC19, focusing on its effects on WPS and inflammation.}, } @article {pmid40534528, year = {2025}, author = {Ertural, B and Çiçek, BN and Kurnaz, IA}, title = {RNA Therapeutics: Focus on Antisense Oligonucleotides in the Nervous System.}, journal = {Biomolecules & therapeutics}, volume = {33}, number = {4}, pages = {572-581}, pmid = {40534528}, issn = {1976-9148}, abstract = {RNA therapeutics represent a disruptive technology that has transformed drug discovery and manufacturing, gaining significant prominence during the COVID-19 pandemic. RNA therapeutics encompass diverse molecules like antisense oligonucleotides (ASOs), small interfering RNAs (siRNAs), microRNAs (miRNAs), RNA aptamers, and messenger RNAs (mRNAs), which can function through different mechanisms. RNA therapeutics are increasingly used to treat various diseases, including neurological disorders. For example, ASO therapies such as nusinersen for spinal muscular atrophy and eteplirsen for Duchenne muscular dystrophy are successful applications of RNA-based treatment. Emerging ASO treatments for Huntington's disease and amyotrophic lateral sclerosis are also promising, with ongoing clinical trials demonstrating significant reductions in disease-associated proteins. Still, delivery of these molecules remains a pivotal challenge in RNA therapeutics, especially for ASOs in penetrating the blood-brain barrier to target neurological disorders effectively. Nanoparticle-based formulations have emerged as leading strategies to enhance RNA stability, reduce immunogenicity, and improve cellular uptake. Despite these advances, significant hurdles remain, including optimizing pharmacokinetics, minimizing off-target effects, and ensuring sustained therapeutic efficacy. Regulatory frameworks are evolving to accommodate the unique challenges of RNA-based therapies, including ASOs with efforts underway to establish comprehensive guidelines for RNA therapeutics, yet there are also sustainable manufacturing issues that need to be considered for long-term feasibility. By addressing these challenges, RNA therapeutics hold immense potential to revolutionize treatment paradigms for neurological disorders. Looking forward, the future of RNA therapeutics in neurology appears promising but requires continued interdisciplinary collaboration and technological innovation.}, } @article {pmid40533718, year = {2025}, author = {Trollman, H and Jagtap, S and Tamakloe, SD and Trollman, F}, title = {Foraging supply chains: Investigating disaster for improved food provisioning.}, journal = {Ambio}, volume = {}, number = {}, pages = {}, pmid = {40533718}, issn = {1654-7209}, support = {11155//Research England/ ; }, abstract = {Disasters such as COVID-19 and the Russia-Ukraine war are drawing attention to the provisioning of food during crises. The main concern has been quickly establishing a stable food supply. However, climate change and public health concerns are shifting attention to the critical gap in identifying the minimal considerations that would adequately address ecological disaster food provisioning. A meta-ethnography of 16 disasters in 12 different countries is employed to identify the activities and their supporting strategies that provide benefits to existing actors within food networks. Analysis suggests that public health, resilience, and sustainability stand to benefit from the identified practices. A conceptual model of an ecologically embedded minimum viable ecosystem for disaster food provisioning is proposed. Exemplar applications are provided for Tigray, Gaza, and Ukraine. The findings may be applied to disaster settings for the development of policy for culturally sensitive, equitable, and nutritious food provisioning strategies.}, } @article {pmid40532972, year = {2025}, author = {Orsel, LM and Severin, JA and Knoester, M and Lokate, M and Voss, A and Haanappel, CP and van Kampen, JJA and Haagmans, BL and Koopmans, MPG and Veldkamp, KE and van Mansfeld, R and de Jager, HJ and Voor In 't Holt, AF and Bowles, C}, title = {The role of gowns in preventing nosocomial transmission of respiratory viruses: a systematic review.}, journal = {The Journal of hospital infection}, volume = {163}, number = {}, pages = {57-71}, doi = {10.1016/j.jhin.2025.05.023}, pmid = {40532972}, issn = {1532-2939}, mesh = {Humans ; *Cross Infection/prevention & control/transmission/virology ; *COVID-19/prevention & control/transmission ; Health Personnel ; *Protective Clothing/virology ; SARS-CoV-2 ; *Personal Protective Equipment ; *Respiratory Tract Infections/prevention & control/transmission/virology ; Infectious Disease Transmission, Patient-to-Professional/prevention & control ; *Virus Diseases/transmission/prevention & control ; }, abstract = {BACKGROUND: During the COVID-19 pandemic, long-sleeved gowns were advocated as personal protective equipment for healthcare workers (HCWs). The purpose of gowns is preventing transmission of infectious agents via the uniform or arms during contact with patients and their surroundings. Gowns, however, entail a substantial burden; in costs, workload for HCWs, and generated waste.

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

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

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

CONCLUSION: Viral RNA can be found on clothing, but it is unclear whether viruses are transmitted to HCWs and/or patients. Evidence for the protective effect of long-sleeved gowns over alternatives is still insufficient. Therefore, well-controlled and adequately powered laboratory transmission experiments that simulate real-life conditions are necessary.}, } @article {pmid40532786, year = {2025}, author = {Szabó, D and Tod, P and Maácz, F and Gölöncsér, F and Iring-Varga, B and Török, B and Zsidei, G and Pályi, B and Kis, Z and Sperlágh, B}, title = {Targeting P2X7 mitigates neurobehavioural alterations in a mouse model of post-acute sequelae of SARS-CoV-2 infection.}, journal = {Neuropharmacology}, volume = {278}, number = {}, pages = {110566}, doi = {10.1016/j.neuropharm.2025.110566}, pmid = {40532786}, issn = {1873-7064}, mesh = {Animals ; *Receptors, Purinergic P2X7/metabolism ; Male ; Mice ; *Purinergic P2X Receptor Antagonists/pharmacology ; *COVID-19/psychology/complications/metabolism ; Disease Models, Animal ; Depression/metabolism/drug therapy ; Anxiety/metabolism/drug therapy ; SARS-CoV-2 ; Mice, Inbred C57BL ; Interferon-gamma/metabolism ; Behavior, Animal/drug effects ; Hippocampus/metabolism/drug effects ; Post-Acute COVID-19 Syndrome ; Prefrontal Cortex/metabolism/drug effects ; }, abstract = {The COVID-19 pandemic has imposed a significant global health burden, leading to various long-term consequences, including persistent neuropsychiatric symptoms in a substantial proportion of infected individuals. This study investigates the role of the purinergic receptor P2X7 in mediating behaviour changes in a mouse model of post-acute sequelae of SARS-CoV-2 infection (PASC). We show that infection with a mouse-adapted SARS-CoV-2 strain induces anxiety- and depression-like behaviours in male mice, associated with elevated P2X7 receptor expression in the prefrontal cortex and hippocampus, as well as increased IFN-γ levels in the striatum. To assess the therapeutic potential of P2X7 antagonism, we administered the selective P2X7 antagonist JNJ 47965567 in vivo. Pretreatment with JNJ 47965567 mitigated the behavioural changes and reduced IFN-γ levels, suggesting a potential therapeutic role for P2X7 antagonists in the management of post-COVID neuropsychiatric symptoms. Our findings support the involvement of neuroinflammation in the symptoms of PASC and highlight the P2X7 pathway as a potential innovative therapeutic target for alleviating anxiety and depression in affected individuals and in other sequelae of post-viral neuropsychiatric conditions.}, } @article {pmid40531916, year = {2025}, author = {Zha, R and Lu, J and Chen, J and Guo, C and Lu, J}, title = {Exploring one health-based strategies for rabies elimination: Overview and future prospects.}, journal = {PLoS neglected tropical diseases}, volume = {19}, number = {6}, pages = {e0013159}, pmid = {40531916}, issn = {1935-2735}, mesh = {*Rabies/prevention & control/epidemiology/veterinary ; Humans ; *Disease Eradication/methods ; Animals ; *One Health ; China/epidemiology ; COVID-19/epidemiology/prevention & control ; Global Health ; Dogs ; Prevalence ; }, abstract = {BACKGROUND: Establishing a comprehensive and coordinated mechanism for rabies management is essential for achieving the goal of eliminating the disease. It requires the involvement of multiple disciplines and departments, as well as the implementation of necessary policies and measures. The recent COVID-19 pandemic has added further challenges to the goal, particularly for developing countries like China. However, certain regions in China are leveraging local advantages and departmental strengths to actively explore effective strategies.

PRINCIPAL FINDINGS: This review provides an overview of the global prevalence of rabies, international cooperation efforts, and specific measures. Of particular significance is the analysis of the transformation of the rabies situation in China as well as an exemplar management of a rabies case in the Baiyun District of Guangzhou, Guangdong Province. We also discuss the hopeful action plan based on the One Health concept, aimed at achieving the goal of rabies elimination by 2030.

CONCLUSIONS: Rabies remains a significant threat to public health and economies across most countries worldwide. Despite this, eliminating rabies is increasingly feasible, with China showcasing notable progress, including the adoption of the One Health approach in disease prevention and control strategies.

SYNOPSIS: The distinction between disease eradication and elimination lies in their scope and permanence. Eradication involves globally reducing the incidence of infection caused by a specific agent to zero, requiring no further intervention measures once achieved. In contrast, disease elimination focuses on reducing the incidence of infection within a specific geographic area to zero, necessitating ongoing actions to prevent its transmission or re-emergence. In the long history of humans' battle against infectious diseases, the complete eradication of smallpox has undoubtedly been an inspiring achievement. However, emerging and re-emerging infectious diseases have remained in the forefront of people's minds, causing significant morbidity, mortality, and potential economic burdens in impoverished countries and regions worldwide. It is disappointing that rabies has not been eradicated globally. While high-income countries have achieved the elimination of canine-mediated rabies through dog vaccination and population management programs, there are fewer examples of successful large-scale elimination of canine rabies in low- and middle-income countries, primarily limited to Latin America.}, } @article {pmid40531392, year = {2025}, author = {da Silva, MD and da Silva, TS and Mendes, CG and Valbão, MCM and Badu-Tawiah, AK and Laurindo, LF and Barbalho, SM and Direito, R and Miglino, MA}, title = {Advances in Understanding Long COVID: Pathophysiological Mechanisms and the Role of Omics Technologies in Biomarker Identification.}, journal = {Molecular diagnosis & therapy}, volume = {29}, number = {5}, pages = {617-636}, pmid = {40531392}, issn = {1179-2000}, support = {200177/2022-2//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; }, mesh = {Humans ; *COVID-19/metabolism/virology/complications/physiopathology ; *Biomarkers/metabolism/analysis ; Metabolomics/methods ; *SARS-CoV-2 ; Proteomics/methods ; Lipidomics ; Post-Acute COVID-19 Syndrome ; Risk Factors ; }, abstract = {Long coronavirus disease (COVID) is a multisystem condition that affects a significant proportion of individuals following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, with persistent symptoms ranging from fatigue and cognitive dysfunction to cardiovascular disorders. It is estimated that 30-60% of infected individuals experience symptoms lasting more than 12 weeks. Despite advances in understanding acute infection, the pathophysiological mechanisms underlying long COVID remain unclear. Current hypotheses suggest that viral persistence, immune dysfunction, and metabolic alterations play central roles. Omics approaches, including metabolomics, proteomics, and lipidomics, have played a crucial role in investigating molecular changes, identifying biomarkers, and refining therapeutic strategies. This review discusses recent advances in understanding long COVID, addressing its mechanisms, risk factors, the impact of viral variants, and the role of vaccination, with an emphasis on the importance of omics technologies in elucidating this condition.}, } @article {pmid40530893, year = {2025}, author = {Dasari, D and Singhania, RR and Bhatia, SK and Dong, CD and Patel, AK}, title = {Squalene: A High-Value Compound for COVID-19 Vaccine Adjuvants and Beyond Pathways, Production Strategies, and Market Potential.}, journal = {IUBMB life}, volume = {77}, number = {6}, pages = {e70032}, doi = {10.1002/iub.70032}, pmid = {40530893}, issn = {1521-6551}, support = {113-2221-E-992-006//National Science and Technology Council/ ; }, mesh = {*Squalene/pharmacology/chemistry ; Humans ; *COVID-19 Vaccines/immunology ; SARS-CoV-2/immunology ; *COVID-19/prevention & control/immunology/virology ; *Adjuvants, Vaccine ; *Adjuvants, Immunologic ; Animals ; }, abstract = {Squalene, a naturally occurring triterpene, has gained significant attention due to its critical role as an adjuvant in COVID-19 vaccines and its broad applications in pharmaceuticals, cosmetics, and nutraceuticals. This review explores the potential of squalene production, prompting a shift toward sustainable and innovative approaches. Key biosynthetic pathways across various organisms, including plants, fungi, and microalgae, are analyzed to identify efficient production systems as compared to fast-growing heterotrophic thraustochytrids. Advanced strategies to enhance squalene yields are explored, including the use of chemical enhancers (methyl jasmonate), antioxidants (alpha-tocopherol), cofactor recycling, and squalene epoxidase inhibitors (terbinafine). Additionally, the global market potential of squalene is assessed, highlighting its economic importance and growing demand in the healthcare and cosmetic industries. The challenges of large-scale squalene production are addressed with a focus on sustainable alternatives to shark-derived sources as a high ethical concern. By aligning with Sustainable Development Goals (SDG-3: Good Health and Well-Being), squalene production supports advancements in vaccine development and biotechnological innovations. Future opportunities are highlighted, including novel applications in cancer therapy, functional foods, and anti-aging products, offering pathways to harness its full potential while contributing to a sustainable bioeconomy.}, } @article {pmid40530855, year = {2025}, author = {Powell, BH and Witwer, KW and Meffert, MK}, title = {Cellular miRNAs and viruses: trends in miRNA sequestering and target de-repression.}, journal = {Journal of virology}, volume = {99}, number = {7}, pages = {e0091425}, pmid = {40530855}, issn = {1098-5514}, support = {R01MH129292/MH/NIMH NIH HHS/United States ; GT16587/HHMI/Howard Hughes Medical Institute/United States ; T32 GM007445/GM/NIGMS NIH HHS/United States ; R01 DA047807/DA/NIDA NIH HHS/United States ; //The Braude Foundation/ ; Sontag DSA//Sontag Foundation/ ; 5R01DA047807-04/DA/NIDA NIH HHS/United States ; R01 MH129292/MH/NIMH NIH HHS/United States ; }, mesh = {*MicroRNAs/genetics/metabolism ; Humans ; SARS-CoV-2/genetics/physiology ; *Host-Pathogen Interactions/genetics ; Virus Replication/genetics ; COVID-19/genetics/virology ; RNA, Viral/genetics/metabolism ; Hepacivirus/genetics ; *Viruses/genetics ; Gene Expression Regulation ; Animals ; Virus Diseases/genetics/virology ; Gene Expression Regulation, Viral ; }, abstract = {Altered gene regulation downstream of infection has been linked to devastating cancers and neurological diseases, highlighting the importance of understanding viral:host gene interactions. Historically, approaches based on bioinformatic binding prediction showed that host microRNAs (miRNAs) can target and regulate viral genes to impact viral replication and pathogenesis. More recently, Argonaute cross-linking and immunoprecipitation (AGO-CLIP) and advancements incorporating a miRNA:target RNA ligation step (AGO-CLIP + ligation) enable a global view of miRNA interactions with target cellular and viral transcripts. These genome-wide approaches paired with RNA sequencing reveal that miRNA binding to viral transcripts can not only act conventionally to regulate viral replication but can also act to reduce miRNA targeting of host genes with resulting de-repression of host target genes and downstream biological impacts. Viruses with accumulated evidence of miRNA sequestration are selected as examples for review and include hepatitis C virus (HCV), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and respiratory syncytial virus (RSV). The significant impact of target de-repression on host cellular biology warrants a broader investigation of this mechanism. In this mini-review, we examine examples of crosstalk between host miRNAs and viral transcripts and highlight the advance and potential of analyses from AGO-CLIP + ligation with RNA-seq for expanding the identification of global miRNA:viral target interactions and interrogating the biological impacts of host miRNA sequestering and target de-repression. Host target de-repression by miRNA:viral target interactions could shed light on antiviral therapeutic candidates to aid in mitigating consequences such as malignancies and neurodegeneration.}, } @article {pmid40529997, year = {2025}, author = {Quinn, GA and Connolly, R and ÓhAiseadha, C and Hynds, P and Bagus, P and Brown, RB and Cáceres, CF and Craig, C and Connolly, M and Domingo, JL and Fenton, N and Frijters, P and Hatfill, S and Heymans, R and Joffe, AR and Jones, R and Lauc, G and Lawrie, T and Malone, RW and Mordue, A and Mushet, G and O'Connor, A and Orient, J and Peña-Ramos, JA and Risch, HA and Rose, J and Sánchez-Bayón, A and Savaris, RF and Schippers, MC and Simandan, D and Sikora, K and Soon, W and Shir-Raz, Y and Spandidos, DA and Spira, B and Tsatsakis, AM and Walach, H}, title = {What Lessons can Be Learned From the Management of the COVID-19 Pandemic?.}, journal = {International journal of public health}, volume = {70}, number = {}, pages = {1607727}, pmid = {40529997}, issn = {1661-8564}, mesh = {Humans ; *COVID-19/prevention & control/epidemiology ; SARS-CoV-2 ; COVID-19 Vaccines/administration & dosage ; *Pandemics/prevention & control ; Public Health ; Health Policy ; }, abstract = {During the COVID-19 pandemic (2020-2023), governments around the world implemented an unprecedented array of non-pharmaceutical interventions (NPIs) to control the spread of SARS-CoV-2. From early 2021, these were accompanied by major population-wide COVID-19 vaccination programmes-often using novel mRNA/DNA technology, although some countries used traditional vaccines. Both the NPIs and the vaccine programmes were apparently justified by highly concerning model projections of how the pandemic could progress in their absence. Efforts to reduce the spread of misinformation during the pandemic meant that differing scientific opinions on each of these aspects inevitably received unequal weighting. In this perspective review, based on an international multi-disciplinary collaboration, we identify major problems with many aspects of these COVID-19 policies as they were implemented. We show how this resulted in adverse impacts for public health, society, and scientific progress. Therefore, we propose seven recommendations to reduce such adverse consequences in the future.}, } @article {pmid40529717, year = {2025}, author = {Alsaleh, G and Balkhi, B and Alahmari, A and Khan, A}, title = {The Hajj legacy and Saudi Arabia's exemplary response to COVID-19.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1520179}, pmid = {40529717}, issn = {2296-2565}, mesh = {Saudi Arabia/epidemiology ; Humans ; *COVID-19/prevention & control/epidemiology ; *Islam ; *Mass Gatherings ; SARS-CoV-2 ; *Public Health ; *Travel ; Pandemics/prevention & control ; }, abstract = {The COVID-19 pandemic required strong public health measures globally. Saudi Arabia's effective pandemic management, leveraging its experience with mass gatherings such as the Hajj pilgrimage, has been lauded globally. This study was developed using a narrative synthesis approach, based on a structured review of peer-reviewed literature (PubMed and Scopus) and official sources (Saudi MoH and the WHO) covering March 2020-December 2024. This study examines Saudi Arabia's response to the COVID-19 pandemic, with particular emphasis on the strategies implemented to safeguard the Hajj pilgrimage. The analysis is framed within the context of the World Health Organization's (WHO) COVID-19 After Action Review pillars, providing a structured evaluation of the Kingdom's efforts to mitigate risks and protect both pilgrims and the broader population. Topics covered include country-level coordination, risk communication, surveillance, border health, national laboratory systems, infection prevention, case management, operational support, and essential health services. Findings show that preexisting infrastructure and mass-gathering expertise enabled rapid activation of multisectoral task forces, adaptive risk-communication campaigns, and scalable testing and isolation protocols. The Hajj legacy strengthened laboratory diagnostics and surge staffing, informed border screening algorithms, and guided large-event risk assessments. Integrating mass-gathering experience with WHO's framework fostered resilience to complex health emergencies. Saudi Arabia's model offers actionable insights for other nations seeking to harness cultural and organizational strengths in pandemic preparedness.}, } @article {pmid40529403, year = {2025}, author = {De Maio, M and Montenegro, S and Papale, O and Serafini, S and Prestanti, I and Izzicupo, P and Abalasei, BA and Alonso Del Hierro, T and Çalışkan, B and Di Baldassarre, A and Ege, H and Figueiredo, AJ and Ghinassi, B and González-García, H and Onose, I and Onose, RM and Perissinotto, M and Molinari, A and Ramírez-Muñoz, A and Sánchez-Pato, A and Stanković, N and Stojiljković, N and Abelkalns, I and Doupona, M and Capranica, L and Fusco, A}, title = {A scoping review of student Athletes' perspectives on dual career policies, provisions and challenges.}, journal = {Frontiers in sports and active living}, volume = {7}, number = {}, pages = {1566208}, pmid = {40529403}, issn = {2624-9367}, abstract = {Dual career (DC) athletes face significant challenges in balancing dual demands of academic and athletic commitments. A scoping review of 25 studies published between 2014 and 2024 included data from over 3,000 student-athletes across 23 countries, with 88.5% focused on European contexts. Most adopted qualitative (52%) or quantitative (44%) approaches, with one study (4%) using a mixed method. Findings, synthesized using PRISMA guidelines, addressed logistical, social, financial, tutorship, curricula, and policy aspects. Recurring barriers included a lack of flexible educational programs, insufficient financial aid, and limited access to proximate sports and facilities. Social support systems, such as mentorship and institutional committees, emerged as essential for engagement and reducing isolation. European athletes frequently cited the need for improved financial support, highlighting scholarships and fee waivers. During the COVID-19 pandemic, e-learning strategies supported educational adherence and reduced stress, emphasizing their potential as flexible tool for addressing DC demands. However, disparities in policy implementation and service provision persist, with studies identifying cohesive institutional strategies for DC athletes. These findings underscore the need to develop harmonized frameworks across Europe, prioritizing integrated logistical planning, expanded financial support and tailored curricula. Broader perspectives from stakeholders are needed to enable DC athletes to thrive academically and athletically.}, } @article {pmid40529374, year = {2025}, author = {Trautmann, A}, title = {Core features and inherent diversity of post-acute infection syndromes.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1509131}, pmid = {40529374}, issn = {1664-3224}, mesh = {Humans ; Post-Acute COVID-19 Syndrome ; Animals ; Fatigue/etiology ; *Infections/immunology/complications ; Critical Illness ; }, abstract = {Post-acute infection syndromes (PAIS), i.e., long-lasting pathologies subsequent to infections that do not properly resolve, have both a common core and a broad diversity of manifestations. PAIS include a group of core symptoms (pathological fatigue, cognitive problems, sleep disorders and pain) accompanied by a large set of diverse symptoms. Core and diverse additional symptoms, which can persist for years, exhibiting periods of relapses and remissions, usually start suddenly after an apparently common infection. PAIS display highly variable clinical features depending on the nature of the initial pathogen, and to an even larger extent, on the diversity of preexisting individual terrains in which PAIS are rooted. In a first part, I discuss biological issues related to the persistence of microbial antigens, dysregulated immune responses, reactivation of latent viruses, different potential self-sustained inflammatory loops, mitochondrial dysfunction, metabolic disorders in the tryptophan- kynurenin pathway (TKP) with impact on serotonin, and consequences of a dysfunctional bidirectional microbiota-gut-brain axis. The second part deals with the nervous system dependence of PAIS. I rely on the concept of interoception, the process by which the brain senses, integrates and interprets signals originating from within the body, and sends feebacks aimed at maintaining homeostasis. Interoception is central for understanding the origin of fatigue, dysautonomia, dysfunctioning of the hypothalamus-pituitary-adrenal (HPA) axis, and its relation with stress, inflammation or depression. I propose that all individual predispositions leading to self-sustained vicious circles constitute building blocks that can self-assemble in many possible ways, to give rise to both core and diverse features of PAIS. A useful discrimination between different PAIS subtypes should be obtained with a composite profiling including biomarkers, questionnaires and functional tests so as to take into account PAIS multidimensionality.}, } @article {pmid40529354, year = {2025}, author = {Xue, L and Wang, C and Liu, C}, title = {Immunomodulatory effects of gut microbiota on vaccine efficacy against respiratory pathogens.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1618921}, pmid = {40529354}, issn = {1664-3224}, mesh = {Humans ; *Gastrointestinal Microbiome/immunology ; *SARS-CoV-2/immunology ; *COVID-19/immunology/prevention & control/microbiology ; *Vaccine Efficacy ; Animals ; *Immunomodulation ; *COVID-19 Vaccines/immunology ; *Influenza, Human/immunology/prevention & control ; *Influenza Vaccines/immunology ; Vaccination ; }, abstract = {The outbreaks of respiratory pathogens like severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza virus (IV) have heightened the demand for highly effective vaccines that provide strong and durable immunity in human populations. However, immune responses to vaccination vary significantly among individuals and populations. Recent studies have demonstrated that the gut microbiota play an essential role in regulating respiratory pathogens vaccination-induced immune responses through the systemic effects of gut-lung axis on distant organs, the lungs. In this review, we first synthesize the changes in gut microbiota composition and immune responses that occur during respiratory pathogen infections and vaccination. Then, we discuss the underlying immunological mechanisms of bidirectional immunomodulatory effects between gut microbiota and vaccines. Finally, we explore the strategies for designing next-generation vaccines against respiratory pathogens in term of gut microbiota-mediated immunological pathway.}, } @article {pmid40529300, year = {2025}, author = {Maziec, K and Baliga-Gil, A and Kierzek, E}, title = {Delivery strategies for RNA-targeting therapeutic nucleic acids and RNA-based vaccines against respiratory RNA viruses: IAV, SARS-CoV-2, RSV.}, journal = {Molecular therapy. Nucleic acids}, volume = {36}, number = {3}, pages = {102572}, pmid = {40529300}, issn = {2162-2531}, abstract = {Therapeutic nucleic acids, including small interfering RNA (siRNA), and antisense oligonucleotides (ASOs), targeting RNA viruses such as influenza A virus (IAV), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and respiratory syncytial virus (RSV), play a crucial role in contemporary medicine. The primary goal of short oligonucleotide-based antivirals is to precisely inhibit viral mechanisms by interacting with viral RNA, thereby opening new avenues for infection treatment. RNA recently was also used to invent mRNA vaccine for different illness prevention. Therapeutic nucleic acids and mRNA vaccine attracted considerable attention during the COVID-19 pandemic due to the pressing necessity to develop an effective strategy to address this global threat. In addition to the advancement of therapeutic nucleic acids aimed at targeting respiratory viruses, the effective delivery of these molecules to infected cells is of paramount importance. Similarly, mRNA vaccine's effectiveness also depends on effective delivery. This article offers a comprehensive summary and analysis of various delivery strategies, along with the challenges encountered in their development. Representative studies conducted in cellular models, model organisms, and human are presented for examination. Furthermore, the article explores future perspectives regarding the delivery of therapeutic nucleic acids and mRNA vaccines aimed at combating IAV, SARS-CoV-2, and RSV.}, } @article {pmid40529146, year = {2025}, author = {de Vries, TJ and Crouwel, KL and Vogelzang, E and Levert, AI and Neels, E and de Wilde, A and Koopman, P and van Diermen, DE and Langenbach, GEJ and Verheijck, EE}, title = {Transforming dental education: interactive and student-centered learning with team-based learning in the undergraduate program.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1579237}, pmid = {40529146}, issn = {2296-858X}, abstract = {World-wide, educational curricula have made a transition toward (inter)active student-centered learning and teaching. To incorporate consistency within a curricular reform, it is important to make choices that are applied to all courses. Here we describe the implementation of team-based learning (TBL), an effective educational approach for activated learning at a dental school. TBL stimulates students to participate actively in their own learning process. This team-oriented method fosters problem solving, critical academic reasoning, clinical decision-making and communication skills among students, already early in their educational career. In the first year of the undergraduate program, TBL was introduced as a mandatory component, constituting 10% of the teaching activities and overall grade. To facilitate this transition, a dedicated team of teachers and educationalists (the TBL team) was formed to prepare the transition. The initial step involved establishing a TBL course and conducting training sessions for faculty to familiarize them with this new teaching methodology. Teachers received constructive feed-back on their own TBL application session. Due to the Covid-19 pandemic, TBL was introduced as an online variant, requiring close collaboration with IT-services. Halfway through the academic year, the implementation was evaluated through separate panel discussions with students and teachers separately. Overall, TBL was perceived favorably by both staff and students. Students appreciated the team work and noted that TBL added value to their learning process. This was also the outcome of the end of the academic years' student survey on TBL, where especially questions on collaborative teamwork scored 4.22 on average on a 1-5 Likert's Scale. TBL was inspiring for teachers, the student teams of TBL provided a safe environment for students to voice their thoughts. The activating nature of TBL was recognized as beneficial, though it requires continuous effort and motivation from instructors. Coaching and guiding were perceived as highly effective instructional methods. Some teachers acknowledged the challenge of transitioning from a traditional "one-person" show approach to a more collaborative teaching style. Both evaluations facilitated further refinement of the TBL approach. Particularly, during the social intercourse-deprived Covid-19 era, the fixed-groups format of TBL helped students to experience a sense of belonging.}, } @article {pmid40528936, year = {2025}, author = {Alp Meşe, E and Carrara, E and Tartari, E and Mutters, NT and Tsioutis, C and Birgand, G and Tacconelli, E}, title = {Prioritizing isolation precautions: a patient-centered approach to infection prevention and control.}, journal = {Antimicrobial stewardship & healthcare epidemiology : ASHE}, volume = {5}, number = {1}, pages = {e123}, pmid = {40528936}, issn = {2732-494X}, abstract = {Healthcare-associated infections (HAIs) and multidrug-resistant (MDR) pathogens present significant challenges to global health, exacerbated by emerging threats such as SARS-CoV-2 and the growing immunocompromised population. While isolation precautions are critical for infection prevention and control (IPC), their indiscriminate application can strain resources and impact patient well-being. This review proposes a patient-centered framework for optimizing isolation strategies by integrating pathogen-related factors, individual patient risks, and healthcare facility resources to optimize isolation precautions. By incorporating targeted risk assessments, advanced analytics (e.g., omics and machine learning), and infection preventionist leadership, this approach aligns isolation measures with clinical and operational realities. It aims to enhance IPC efficacy while balancing patient needs and resource efficiency. We highlight strategies to ensure isolation precautions remain evidence-based, adaptable, and sustainable within healthcare settings. A patient-focused approach to isolation improves both infection prevention and overall quality of patient care.}, } @article {pmid40528761, year = {2025}, author = {Oti, VB and Ranasinghe, V and Dyer, BP and Idris, A and McMillan, NAJ}, title = {Assessment of the effectiveness of intranasal antiviral therapies in preclinical SARS-CoV-2 infection mouse models: a systematic review.}, journal = {Expert opinion on drug delivery}, volume = {22}, number = {9}, pages = {1405-1429}, doi = {10.1080/17425247.2025.2522250}, pmid = {40528761}, issn = {1744-7593}, mesh = {Animals ; *Antiviral Agents/administration & dosage/pharmacology/adverse effects ; Mice ; Disease Models, Animal ; Administration, Intranasal ; *COVID-19 Drug Treatment ; Viral Load/drug effects ; *COVID-19/virology ; Humans ; SARS-CoV-2/drug effects ; }, abstract = {INTRODUCTION: Intranasally (IN) administered antiviral therapies have emerged as a promising approach to combating SARS-CoV-2 respiratory tract infections. This systematic review aims to examine published preclinical animal studies that report anti-SARS-CoV-2 effects due to IN-delivered antiviral drugs between 1 December 2019 and 1 March 2025.

METHODS: Our analysis revealed 37 relevant studies out of 792 identified studies. Importantly, 15 out of the 36 selected studies performed prophylactic and post-exposure IN treatments in preclinical animal models.

RESULTS: Our systematic analysis revealed six classes of IN-delivered antiviral therapeutics that significantly improved in vivo survival and reduced target organ viremia with minimal side effects in mice. Antiviral interventions resulted in animal body weight recovery (28 studies), better clinical survival (15 studies) and reduced organ viral loads (infectious viral titers (14 studies) and RNA viral loads (28 studies)). Out of these, one study reported negative outcomes of IN interventions, significant weight loss (one study) and poorer mouse survival (two studies).

CONCLUSIONS: Our systematic analysis revealed a moderate association between IN antiviral therapies and clinical and antiviral efficacy. Although the evidence supports the effectiveness of IN antiviral therapies in preclinical models, translation to clinical efficacy in humans remains uncertain.

PROSPERO REGISTRATION: CRD42024492039.}, } @article {pmid40528521, year = {2025}, author = {Sakurai, T and Sugimoto, T and Arai, H}, title = {Multidomain interventions for prevention of dementia: Achievements, challenges and future perspectives.}, journal = {Geriatrics & gerontology international}, volume = {25}, number = {8}, pages = {1015-1034}, pmid = {40528521}, issn = {1447-0594}, support = {22-2//National Center for Geriatrics and Gerontology/ ; 22-23//National Center for Geriatrics and Gerontology/ ; }, mesh = {Humans ; *Dementia/prevention & control ; Aged ; *COVID-19/epidemiology ; Risk Factors ; *Cognitive Dysfunction/prevention & control ; SARS-CoV-2 ; }, abstract = {With the aging of the population, the number of persons with dementia is expected to increase worldwide, making the establishment of preventive strategies for dementia an urgent issue. Several modifiable risk factors for dementia are known, and multidomain interventions that simultaneously intervene in multiple risks are becoming mainstream. This review aimed to overview multidomain intervention trials reported to date and ongoing trials regarding current challenges and future goals. Five multidomain intervention trials were published between 2015 and 2019, including the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), but consistent cognitive improvements were not evident. In the 2020s, seven of 10 trials reported the beneficial effects of multidomain interventions on cognitive outcomes in older adults. The other three trials failed to show significant cognitive improvement, partly due to the devastating impact of the coronavirus disease 2019 pandemic. Pre-specified subanalysis showed improvements in dementia risk factors, such as physical inactivity and nutritional status. These results suggest that multidomain interventions can protect against cognitive decline in older adults at risk for dementia. The World-Wide FINGERS Network was launched in 2017 to adapt and optimize findings to various geographic, cultural and economic settings, and to develop a global network of researchers working on preventing cognitive decline. Further development of the multidomain intervention is needed to enable social implementation considering the targets, delivery methods, scalability and cost-effectiveness. Hopefully, in the future, dementia will be treated similarly to cardiovascular disease in terms of early detection and early intervention. Geriatr Gerontol Int 2025; 25: 1015-1034.}, } @article {pmid40527588, year = {2025}, author = {García-Gimenez, JL and Ruiz-Rodríguez, JC and Ferrer, R and Durá, R and Artigas, A and Bajaña, I and de Andujar, DBL and Cánovas-Cervera, I and Ceccato, A and Chiscano-Camón, L and Climent-Martinez, E and García Fernández, G and Goma, G and Monforte, V and Quevedo-Sánchez, B and Ruiz-Sanmartín, A and Sierra-Rivera, A and Carbonell Monleón, N}, title = {Circulating histones as clinical biomarkers in critically ill conditions.}, journal = {FEBS letters}, volume = {}, number = {}, pages = {}, doi = {10.1002/1873-3468.70093}, pmid = {40527588}, issn = {1873-3468}, support = {DTS24/00094//Instituto de Salud Carlos III/ ; 190190813- Seal of Excellence-European Innovation//Centro para el Desarrollo Tecnológico Industrial/ ; CPP2021/008643//Ministerio de Ciencia, Innovación y Universidades. Spain/ ; }, abstract = {Extracellular histones, primarily nuclear proteins involved in chromatin organization, have emerged as key mediators in pathological processes in critically ill patients. When released into circulation due to cell death mechanisms such as NETosis, histones act as damage-associated molecular patterns (DAMPs), contributing to excessive inflammation, endothelial dysfunction, immune response dysregulation, coagulation activation, cell death, and multi-organ damage. Increasing evidence supports their role in the pathophysiology of sepsis, acute lung injury, cardiac injury, pancreatitis, and other life-threatening conditions. Given their strong association with disease severity and prognosis, circulating histones have gained attention as potential clinical biomarkers for early diagnosis, prognosis, and therapeutic monitoring in critically ill patients. This review discusses the biological roles of extracellular histones, their potential as biomarkers, different approaches to measure them, and emerging therapeutic strategies aimed at neutralizing or removing circulating histones to improve patient outcomes in severe medical conditions. Impact statement This review highlights extracellular histones as key mediators and biomarkers in sepsis, proposing their use in diagnosis, prognosis, and treatment monitoring. Integrating quantitative proteomics for the detection of circulating histones may enhance patient stratification and guide therapeutic strategies, advancing personalized medicine in critical care.}, } @article {pmid40527067, year = {2025}, author = {da Fonseca, RN and Maggioli, MF and de Oliveira Hübner, S and Bauermann, FV}, title = {Antiviral effects of flavonoids on animal viruses.}, journal = {Virology}, volume = {610}, number = {}, pages = {110596}, doi = {10.1016/j.virol.2025.110596}, pmid = {40527067}, issn = {1096-0341}, mesh = {*Flavonoids/pharmacology ; Animals ; *Antiviral Agents/pharmacology ; Virus Replication/drug effects ; *Virus Diseases/drug therapy/veterinary/virology ; Swine ; Virus Internalization/drug effects ; Porcine epidemic diarrhea virus/drug effects ; Infectious bronchitis virus/drug effects ; *Viruses/drug effects ; African Swine Fever Virus/drug effects ; }, abstract = {Flavonoids, plant-derived compounds widely recognized for their antioxidant, anti-inflammatory, and anticancer properties, also exhibit significant antiviral effects against various animal viruses. This review highlights the promising antiviral mechanisms of flavonoids, which include disrupting viral replication, blocking cell entry, and modulating immune responses. Notably, flavonoids like quercetin, kaempferol, and genistein have been shown to effectively inhibit viruses of veterinary importance, such as African Swine Fever Virus (ASFV), Porcine Epidemic Diarrhea Virus (PEDV), and Infectious Bronchitis Virus (IBV), among others. Although most studies demonstrate efficacy in vitro, the limited in vivo research underscores the need to further explore flavonoids' antiviral potential in real-world applications. The immunomodulatory effects observed in some cases, where flavonoids regulate cytokine expression and reduce inflammation, suggest a dual action that could benefit both antiviral and anti-inflammatory responses. This body of research suggests that flavonoids could provide an option for managing animal viral infections. Yet, standardized methodologies and more in vivo studies are needed to validate these findings for veterinary use.}, } @article {pmid40526902, year = {2025}, author = {Zhang, M and Yang, J and Li, Y and Li, Y and Li, T and Dong, Z and Gong, S and Wu, Y and Ren, M and Fan, C and Zhang, L and Wang, Y and Wang, Y and Ren, J and Sun, F and Shen, C and Li, K and Liu, Z and Zhan, S}, title = {Minimum Data Set and Metadata for Active Vaccine Safety Surveillance: Systematic Review.}, journal = {JMIR public health and surveillance}, volume = {11}, number = {}, pages = {e63161}, pmid = {40526902}, issn = {2369-2960}, mesh = {Humans ; COVID-19/prevention & control ; *COVID-19 Vaccines/adverse effects ; *Datasets as Topic ; *Metadata/standards ; *Vaccines/adverse effects ; World Health Organization ; }, abstract = {BACKGROUND: Active vaccine safety surveillance (AVSS) stands as a top priority for the World Health Organization (WHO), serving as a critical indicator of the fourth maturity level for national regulatory agencies.

OBJECTIVE: This review aims to define the minimal data scope for association studies in vaccine safety, providing a reference framework for implementing AVSS systems worldwide, especially in low- and middle-income countries.

METHODS: The study systematically searched PubMed, Embase, and Web of Science for cohort and case-control studies related to AVSS published between January 1, 2018, and September 7, 2022. Guided by the WHO and Council for International Organizations of Medical Sciences guidelines (CIOMS), we developed a 4D framework for Minimum Data Sets (MDSs), including "Vaccine," "Outcome," "Demographic Data," and "Covariate." Variables with a frequency of at least 5% were included in the MDS.

RESULTS: Of the 123 included studies, 102 (82.9%) were cohort studies and 98 (79.7%) originated from high-income countries, covering populations across the entire life course. The MDS for COVID-19 vaccines identified 54 variables, while the MDS for maternal populations included 96 variables. WHO guidelines were found to align better with practical applications compared to CIOMS guidelines, though both require further optimization based on the MDS findings. However, metadata for these essential variables were inadequately described across the studies.

CONCLUSIONS: The proposed MDS provides clear guidance and concise requirements for AVSS data scope. Establishing a globally standardized MDS and comprehensive metadata based on these findings is essential to enhancing the global vaccine safety ecosystem.}, } @article {pmid40526370, year = {2025}, author = {Sommers, T and Dockery, M and Burke, N and D'Souza, S and Troupe, B and Agbonyinma, T and Raghuram, H and Hopkins, KL and Kohlway, E and Stojicic, P and Bhan, A}, title = {Building trust and equity in vaccine communication through community engagement.}, journal = {Human vaccines & immunotherapeutics}, volume = {21}, number = {1}, pages = {2518636}, pmid = {40526370}, issn = {2164-554X}, mesh = {Humans ; *Trust ; *COVID-19/prevention & control/epidemiology ; *COVID-19 Vaccines/administration & dosage ; *Community Participation ; *Vaccination/psychology ; *Health Communication/methods ; *Health Equity ; Health Literacy ; *Immunization Programs ; SARS-CoV-2 ; Communication ; }, abstract = {That the COVID-19 pandemic has exacerbated inequities in health has been well studied in recent years, yet the ways in which the pandemic has also revealed existing inequities in communication, specifically health communication, is less well understood. Communities experience differing levels of basic literacy, health literacy, and access to information, as well as differing levels of trust in public health programs. Community engagement (CE) strategies are critical to support improved communication, trust, and equity in vaccination programs. This paper shares two real-world examples of impactful CE strategies from community-based programming to explore how well-designed community engagement strategies can support improved communication, trust, and equity in vaccination programming. Lessons learned from these programs highlight that vaccine communication programs should continuously engage communities to amplify community perspectives and voices to ensure sustained vaccine demand and uptake.}, } @article {pmid40526084, year = {2025}, author = {Mellett, M and Lawandi, A and Caya, C and Lee, TC and Babiker, A and Papenburg, J and Yansouni, CP and Cheng, MP}, title = {Antibiotic synergy against Staphylococcus aureus: a systematic review and meta-analysis.}, journal = {Antimicrobial agents and chemotherapy}, volume = {69}, number = {8}, pages = {e0119924}, pmid = {40526084}, issn = {1098-6596}, support = {UM1 AI104681/AI/NIAID NIH HHS/United States ; //Fonds de Recherche du Québec - Santé/ ; UM1AI104681//National Institute of Allergy and Infectious Diseases/ ; }, mesh = {*Anti-Bacterial Agents/pharmacology ; Drug Synergism ; Microbial Sensitivity Tests ; *Staphylococcus aureus/drug effects ; Methicillin-Resistant Staphylococcus aureus/drug effects ; Humans ; Staphylococcal Infections/drug therapy/microbiology ; }, abstract = {Antimicrobial combinations have been extensively evaluated in vitro to identify synergistic combinations for clinical use. Despite the available literature, no studies comprehensively summarize the findings for antimicrobial combinations against Staphylococcus aureus. We performed a systematic review to identify synergistic combinations that may be beneficial for clinical use against S. aureus. The PubMed, Cochrane, and Web of Science databases were queried from inception to February 2024 for studies of in vitro assays evaluating two antimicrobials in combination against isolates of S. aureus. Studies were included if they used common methods to determine synergy including time-kill assays, checkerboard assays, or the combined gradient diffusion method. The proportion of isolates for which synergy was identified was compared for different antimicrobial combinations. Two hundred sixty-five studies were included for analysis. One hundred forty-two studies evaluated synergy against methicillin-resistant S. aureus (MRSA), 31 against methicillin-susceptible S. aureus (MSSA), and 92 assessed synergy against both MRSA and MSSA, or did not define the methicillin susceptibility profile of the isolates studied. Time-kill assays (n = 176) and checkerboard assays (n = 158) were the most frequently used methods, with few studies evaluating synergy using the combined gradient diffusion method (n = 13). The proportion of synergy varied based on the antimicrobial combination and isolate being evaluated. Antimicrobial synergy has been extensively studied for S. aureus, with combinations of glycopeptides and cephalosporins being studied most frequently. Future evaluations of synergy for S. aureus should focus on antimicrobial combinations with strong rationales and robust potential for clinical use.}, } @article {pmid40526000, year = {2025}, author = {Zusman, SP and Paganelli, C}, title = {Interprofessional Dental Care: An International Perspective.}, journal = {JDR clinical and translational research}, volume = {10}, number = {1_suppl}, pages = {11S-16S}, doi = {10.1177/23800844251328661}, pmid = {40526000}, issn = {2380-0852}, mesh = {Humans ; *COVID-19/epidemiology ; *Dental Care/organization & administration ; *Interprofessional Relations ; SARS-CoV-2 ; *Patient Care Team/organization & administration ; Pandemics ; }, abstract = {The COVID-19 pandemic enhanced the known importance of good interprofessional communication and cooperation to ensure proper patient care. In dentistry, there is often no proper integration across teaching, research, and care. There is too little communication and cooperation among the members of the dental team and the health care team in general. There is a critical need to improve coordination and cooperation among dental professionals and with medical professionals in general. Health in all policies should include addressing interprofessional medical and dental care at all stages of professional human resource training and service planning. Dentists should play a leadership role since they are frontline professionals in the prevention, early detection, and treatment of oral and systemic diseases.Knowledge Transfer Statement:Postgraduate dental training programs can use the recommendations from this article to improve clinical teaching and ensure the education and competency of dental residents.}, } @article {pmid40525910, year = {2025}, author = {Aurer, I and Moss, P and Goldman, M and Tuthill, M and Einsele, H and Casañas I Comabella, C and James, S and Borkowska, K and Jah, F and Dube, S and Klein, S and Kandeil, W and Yokota, R and Pagliuca, A and Magiorkinis, G and Arnetorp, S and Lee, L}, title = {COVID-19 burden of illness in people who are immunocompromised due to cancer: an expert opinion review.}, journal = {The oncologist}, volume = {30}, number = {6}, pages = {}, pmid = {40525910}, issn = {1549-490X}, support = {//AstraZeneca/ ; }, mesh = {Humans ; *COVID-19/epidemiology/immunology/virology/complications ; *Neoplasms/immunology/epidemiology/complications ; Quality of Life ; *Cost of Illness ; *Immunocompromised Host ; SARS-CoV-2 ; Hospitalization/statistics & numerical data ; Mental Health ; Pandemics ; }, abstract = {From the beginning of the pandemic, people with cancer have experienced a high burden from COVID-19 compared with the general population, both in terms of severe COVID-19-related outcomes and reduced health-related quality of life and mental health. This review presents and discusses expert views on the burden of COVID-19 in individuals with cancer throughout the pandemic. The literature suggests that early in the pandemic, people with cancer had a disproportionately high risk of COVID-19-related hospitalization compared with the general population. This trend continued throughout the pandemic, even after the availability of vaccinations (including boosters) and the emergence of less virulent strains. Rates of hospitalization, intensive care unit admission, and mechanical ventilation varied across studies but were all seen to be higher in people with cancer and COVID-19 compared with the general population or those with cancer alone. Moreover, studies indicated worsened quality of life and mental health in these people during the pandemic and lockdown periods compared with prepandemic or postlockdown periods. Although COVID-19 has entered the endemic phase and is no longer a global health emergency, it remains a significant risk for people with cancer. Generally, COVID-19 continues to increase healthcare resource use, impair mental health, and reduce quality of life in this population, highlighting the need for continued real-world studies. Ongoing research is essential to evaluate the impact of COVID-19 on vaccinated people with cancer, particularly those undergoing systemic cancer therapy who may require continued guidance on preventive measures and treatments to mitigate the risk of severe COVID-19.}, } @article {pmid40525373, year = {2025}, author = {Karaboue, M and Cecannecchia, C and Dimauro, E and De Simone, S and Orsini, F and Cipolloni, L and Lacasella, GV and Cioffi, A}, title = {The Era of Pandemics and the Need for Readjustment of National Health Systems.}, journal = {La Clinica terapeutica}, volume = {176}, number = {3}, pages = {386-390}, doi = {10.7417/CT.2025.5238}, pmid = {40525373}, issn = {1972-6007}, mesh = {Humans ; *COVID-19/epidemiology ; *Pandemics ; *Delivery of Health Care/organization & administration/standards ; SARS-CoV-2 ; }, abstract = {The last few years have been marked by true upheavals in the organization of both public and private healthcare systems. These upheavals have had their epicenter in the impact that the COVID-19 pandemic has had on the organization of healthcare systems. Additionally, the management of healthcare resources, the methods of medical-scientific communication, medical professional responsibility, and the maintenance of adequate equity and equality have also been destabilized and questioned. It is crucial to understand how much our healthcare systems have benefited from recent events and how prepared they are for future, potential, and likely new challenges that may arise in the coming years. Unfortunately, many of the issues high-lighted during the pandemic phase have yet to be addressed, and new challenges have likely emerged. This situation inevitably exposes the healthcare systems to the creation of new vulnerabilities, which could lead to serious consequences concerning inequality, the professional responsibility of individual doctors and healthcare structures, and the overall sustainability of national healthcare systems.}, } @article {pmid40524715, year = {2025}, author = {Bushi, G and Gaidhane, AM and Vadia, N and Menon, SV and Chennakesavulu, K and Panigrahi, R and Shabil, M and Jena, D and Kumar, H and Rani, A and Sah, S and Rohilla, S and Singh, MP and Goh, KW}, title = {Impact of COVID-19 Vaccination on Menstrual Irregularities, Bleeding Patterns, and Cycle Duration: A Systematic Review and Meta-Analysis.}, journal = {Health science reports}, volume = {8}, number = {6}, pages = {e70882}, pmid = {40524715}, issn = {2398-8835}, abstract = {BACKGROUND: COVID-19 vaccination has raised concerns regarding its potential effects on women's reproductive health, particularly menstrual irregularities. This systematic review and meta-analysis aimed to assess the impact of COVID-19 vaccination on menstrual disturbances, bleeding patterns, and cycle duration among women of reproductive age.

METHODS: A systematic search of PubMed, Embase, and Web of Science was conducted up to April 11, 2025. The study protocol was registered with the PROSPERO (CRD42024500832). Studies reporting menstrual changes postvaccination in women aged 13-50 were included. Data extraction and quality assessment were performed independently by two reviewers. Meta-analyses using random-effects models were conducted in R (version 4.3), with heterogeneity assessed using the I² statistic.

RESULTS: Out of 586 records, 43 studies comprising 747,763 women met the inclusion criteria. The pooled RR for menstrual disturbances in vaccinated versus unvaccinated women was 1.03 (95% CI: 0.67-1.57; p = 0.88), indicating no significant association. Excluding one outlier increased the RR to 1.14 (95% CI: 0.97-1.34; p = 0.08). The overall pooled prevalence of menstrual disturbances postvaccination was 34% (95% CI: 26%-43%). Among vaccinated women, lighter bleeding was reported in 12.6%, heavier bleeding in 15.1%, irregular menstruation in 19.0%, and regular cycles in 56.6%. Shortened cycles occurred in 8.5%, longer cycles in 9.3%, amenorrhea (≥ 24 days) in 9.2%, and infrequent cycles (> 38 days) in 11.0%. All analyses showed high heterogeneity (I² = 98%-100%). Sensitivity analyses confirmed the robustness of findings, though Egger's test indicated potential publication bias (p = 0.0384).

CONCLUSION: COVID-19 vaccination was not significantly associated with an increased risk of menstrual disturbances. Although minor changes such as altered bleeding patterns and cycle length were observed in some women, the overall impact on menstrual health was minimal.}, } @article {pmid40524631, year = {2025}, author = {Jin, DL and Go, DS and Yoon, SJ}, title = {Longitudinal Perspectives on Health and Medical Research in Korea: Strengths and Limitations of Key Panel Datasets.}, journal = {Journal of Korean medical science}, volume = {40}, number = {23}, pages = {e194}, pmid = {40524631}, issn = {1598-6357}, mesh = {Humans ; Republic of Korea/epidemiology ; *COVID-19/epidemiology ; Longitudinal Studies ; Health Status ; SARS-CoV-2 ; *Biomedical Research ; Mental Health ; Female ; Chronic Disease/epidemiology ; Adult ; Pandemics ; Health Surveys ; Male ; }, abstract = {Rapid population ageing, the growing burden of chronic diseases, and evolving healthcare demands have heightened the need for robust longitudinal data to support evidence-based health policy and interventions. Longitudinal panel surveys, which repeatedly collect data from the same individuals over extended periods, offer detailed insights into dynamic health-related changes and their determinants. South Korea has established numerous national panel surveys over recent decades; however, systematic comparative assessments across these surveys-particularly concerning their health-related variables and adaptations during the coronavirus disease 2019 (COVID-19) pandemic-are lacking. We systematically reviewed eleven major Korean longitudinal panel surveys, focusing on health-related variables and COVID-19 modules. Key variables included health status, chronic diseases, lifestyle behaviors, healthcare utilization, and mental health measures. COVID-19 adaptations such as infection history, vaccination status, and socioeconomic impacts were also examined using official documentation. The findings revealed considerable variability among the surveys in the range and depth of health variables captured, reflecting distinct target populations and research objectives. Surveys focused on specific demographic groups (older adults, children, women, and people with disabilities) tended to provide more comprehensive coverage of health indicators and incorporated specialized instruments (e.g., CES-D, EQ-5D). Conversely, general population-based panels demonstrated substantial variability. COVID-19-specific adaptations varied significantly: while certain surveys (Korean Labor and Income Panel Study, Korea Health Panel Survey, Korean Longitudinal Survey of Women and Families, Korean Children and Youth Panel Survey) included explicit pandemic-related modules capturing infection histories, vaccinations, and changes in work and family dynamics, others relied on indirect reflections through existing measures. This comprehensive comparative analysis identifies notable strengths and gaps among Korea's major longitudinal panel surveys in health data collection and COVID-19 responsiveness. Enhanced standardization of survey instruments and targeted data harmonization efforts are recommended to optimize these resources for future health policy development, epidemiological research, and effective public health interventions.}, } @article {pmid40524626, year = {2025}, author = {Shinn, J and Jung, Y and Kim, JY and Seo, S and Lee, E and Kim, Y and Ko, MJ and Kim, HS}, title = {Evolving Regulations in Telemedicine Pilot Project: Insights Into Law, Practice, and Patient Care through International Case Studies.}, journal = {Journal of Korean medical science}, volume = {40}, number = {23}, pages = {e181}, pmid = {40524626}, issn = {1598-6357}, support = {NECA-A-23-016/NECA/National Evidence-based Healthcare Collaborating Agency/Korea ; NECA-A-24-005/NECA/National Evidence-based Healthcare Collaborating Agency/Korea ; }, mesh = {*Telemedicine/legislation & jurisprudence/economics ; Humans ; *COVID-19/epidemiology ; Pilot Projects ; Republic of Korea ; United States ; SARS-CoV-2 ; *Health Policy ; Canada ; Australia ; Japan ; Patient Care ; United Kingdom ; France ; }, abstract = {The primary focus of this research is the evolving landscape of telemedicine policies and practices across various countries, with particular attention to recent initiatives in South Korea. This study is crucial for understanding the implications of institutionalizing telemedicine, especially following the coronavirus disease 2019 (COVID-19) pandemic. It aims to ensure the delivery of quality medical services through remote healthcare systems. The objectives include analyzing changes in international telemedicine policies post-COVID-19, comparing these changes with South Korea's policies, and identifying best practices for the domestic institutionalization of telemedicine. The research examines telemedicine policies and practices in South Korea, the United States, Canada, the United Kingdom, France, Japan, and Australia. Key variables analyzed are eligibility for telemedicine, types of diseases treated, telemedicine platforms, drug prescriptions, drug delivery, responsibility for telemedicine, and cost. Data were collected from policy documents, legal frameworks, and pilot project outcomes and were analyzed to identify trends, differences, and potential areas for policy development. Telemedicine policies vary significantly among countries, with different approaches to patient eligibility, disease types treated, platforms used, prescription and delivery of drugs, legal responsibilities, and costs. South Korea's telemedicine policy is in its early stage, recently expanding to include all patients with prior face-to-face treatment within six months. The initial hypotheses that telemedicine policies are rapidly evolving and that there is no one-size-fits-all approach were supported. The findings suggest that telemedicine is a complex and multifaceted issue that requires careful consideration of various medical, legal, and technological aspects. South Korea's approach to telemedicine should be customized to its unique healthcare environment, focusing on patient health and alignment with national healthcare priorities. Future research should explore the development of a comprehensive system for telemedicine that addresses patient needs, provider capabilities, and regulatory requirements, with an emphasis on creating a global benchmark for personalized telemedicine.}, } @article {pmid40524170, year = {2025}, author = {Ragusa, MA and Tortosa, F and Monteiro, M and Saiso, SG and Reveiz, L}, title = {Health-related SDGs in the national science agendas of Latin America and the Caribbean: a scoping review.}, journal = {International journal for equity in health}, volume = {24}, number = {1}, pages = {177}, pmid = {40524170}, issn = {1475-9276}, support = {001/WHO_/World Health Organization/International ; }, mesh = {Latin America ; Humans ; Caribbean Region ; *Sustainable Development ; Public Health ; }, abstract = {BACKGROUND: The national science and technology agendas (NSTAs) of Latin America and the Caribbean (LAC) are crucial for formulating and implementing public policies by providing a strategic framework that guides state actions and priorities. The objective of this scoping review is to examine health-related targets from the national science and technology agendas (NSTA) of Latin America and the Caribbean (LAC), in accordance with the United Nations' third Sustainable Development Goal (SDG-3), as well as within the frameworks of innovation and risk management and emergencies.

METHODS: A scoping review was conducted, including policy documents issued between 2013 and 2023 by governmental science and technology authorities. The search strategy included government and international organization websites. A total of 108 documents were identified.

RESULTS: Sixteen NSTAs were selected. Health-related targets aligned with SDG-3 were highlighted, particularly in areas such as communicable diseases and drug and vaccine development, but there was limited representation in public health and health systems. Innovations in health science and technology included diagnostic technologies, health products and artificial intelligence. Risk management for health emergencies and disasters was present in a minority of the agendas, with a focus on natural disasters and the COVID-19 pandemic.

CONCLUSIONS: This analysis provides a comprehensive view of the representation of health in NSTAs in LACs, highlighting common objectives among countries to foster collaboration, optimize research and innovation, and identify gaps in components necessary to enhance population health, such as disaster management, public health, and health systems.

REGISTRATION: This scoping review was not registered.}, } @article {pmid40523710, year = {2025}, author = {Jim, J and Rigberg, DA}, title = {Interview format: Current state and future directions.}, journal = {Seminars in vascular surgery}, volume = {38}, number = {2}, pages = {202-206}, doi = {10.1053/j.semvascsurg.2025.03.002}, pmid = {40523710}, issn = {1558-4518}, mesh = {Humans ; *Education, Medical, Graduate/trends ; *Vascular Surgical Procedures/education ; COVID-19/epidemiology ; *Internship and Residency/trends ; *Interviews as Topic ; *Personnel Selection/trends/methods ; *Surgeons/education ; }, abstract = {Applicant interviews remain an integral part of the match process used in graduate medical education. In vascular surgery, in-person interviews of the applicant by program faculty at the institution have been the standard for decades. The COVID-19 pandemic forced a dramatic pivot to virtual interviews. With this unexpected change, there is now insight that interview format can affect equal and fair access, negatively impact the environment, as well as alter financial and administrative burden for both the applicants and programs. Future modifications to the match process will have to be explored to ensure both applicants and programs are able to mutually find their best match.}, } @article {pmid40522371, year = {2025}, author = {Telles-Araujo, GT and Cruz, KMD and Preto, KA and Araujo-Silva, G and Kraychete, DC and Santos, PSDS and Sarmento, VA and Lins-Kusterer, LEF}, title = {Photobiomodulation in the management of persistent olfactory and gustatory dysfunction post-COVID-19: a systematic review.}, journal = {Lasers in medical science}, volume = {40}, number = {1}, pages = {283}, pmid = {40522371}, issn = {1435-604X}, mesh = {Humans ; *Low-Level Light Therapy/methods ; *COVID-19/complications ; *Taste Disorders/radiotherapy/etiology/therapy ; *Olfaction Disorders/radiotherapy/etiology/therapy ; SARS-CoV-2 ; Quality of Life ; }, abstract = {Among the clinical manifestations associated with SARS-CoV-2 infection, olfactory and gustatory dysfunctions have emerged as significant symptoms that impact patients' quality of life, likely due to neural damage affecting the olfactory and gustatory pathways. Currently, there is no standardized protocol for managing these dysfunctions; however, photobiomodulation therapy (PBMT) has gained attention as a potential therapeutic approach due to its beneficial effects. This systematic review aimed to evaluate the current clinical evidence regarding the efficacy of PBMT in the management of persistent post-COVID-19 neurosensory dysfunctions. A comprehensive search was conducted in the PubMed, SciELO, LILACS, Embase, and Cochrane Central Register of Controlled Trials databases, from July 2023 to May 2025, identifying 465 records. The review of grey literature yielded eight additional eligible studies. Applying inclusion and exclusion criteria resulted in the selection of thirty-one studies for evaluation, with ten articles ultimately included in the qualitative analysis: one pilot clinical study, two case reports, three case series, and four randomized clinical trials. The efficacy of PBMT in treating neurosensory sequelae associated with SARS-CoV-2 infection was demonstrated with both red and infrared wavelengths, regardless of the therapeutic protocol adopted. Emerging evidence suggests that laser therapy-induced recovery of neurosensory dysfunction improves quality of life, especially in overall health perception and social well-being domains. However, to definitively establish its efficacy and optimize its clinical application, further high-quality research is necessary, including well-defined randomized clinical trials and standardized photobiomodulation protocols, to generate robust evidence capable of validating the clinical effectiveness of PBMT. CLINICAL TRIAL NUMBER: Not applicable.}, } @article {pmid40520382, year = {2025}, author = {Tang, Y and Liu, B and Ma, A and Wang, B and Xiong, H and Zhou, Y and Yang, J and Kang, Y}, title = {Lung microbiota: a new hope for treating acute respiratory distress syndrome?.}, journal = {Frontiers in microbiology}, volume = {16}, number = {}, pages = {1586949}, pmid = {40520382}, issn = {1664-302X}, abstract = {The lung microbiota, present in healthy individuals, undergoes alterations in different diseases and is closely linked to changes in both systemic and alveolar immunity. These interactions play a crucial role in the onset and progression of numerous diseases. Acute respiratory distress syndrome (ARDS), one of the most severe conditions encountered in intensive care units (ICU), is characterized by high incidence and mortality rates. The pathophysiology of ARDS involves complex mechanisms, including the activation and dysregulation of overlapping pathways related to injury, inflammation, and coagulation, both locally in the lungs and systemically. Notably, alterations in the microbiota may contribute to the pathogenesis of ARDS. Emerging evidence suggests that changes in the lung microbiota are associated with ARDS development, often marked by increased bacterial burden, reduced microbial diversity, and shifts in microbiota composition. In this review, we focus on the regulatory roles of the lung microbiota in ARDS and their therapeutic potential.}, } @article {pmid40519159, year = {2025}, author = {Novogrudsky, K and Treasure, J and Rø, Ø and Schmidt, U}, title = {A Scoping Review of Eating Disorder Clinicians' Experiences, Needs, Views and Wellbeing.}, journal = {Journal of clinical psychology}, volume = {81}, number = {10}, pages = {903-917}, pmid = {40519159}, issn = {1097-4679}, support = {//Maudsley Learning/ ; //National Institute of Health Research (NIHR) Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust, UK, and King's College London, UK./ ; //Social Research Council Adolescence, Mental Health and the Developing Mind initiative/ ; //Arts and Humanities Research Council/Economic/ ; /MRC_/Medical Research Council/United Kingdom ; }, mesh = {Humans ; *Attitude of Health Personnel ; COVID-19 ; *Feeding and Eating Disorders/therapy/psychology ; *Health Personnel/psychology ; *Job Satisfaction ; }, abstract = {BACKGROUND: Eating disorders (ED) are pervasive and severe mental illnesses affecting up to 15% of females and 5% of males internationally with rates sharply rising in recent decades, especially since the COVID-19 pandemic. As a result, workload pressures on ED services have surged. The impact of this on ED clinicians and their wellbeing has not recently been investigated. This scoping review examines recent literature on ED clinicians' experiences, needs, and wellbeing to identify areas for future research and intervention. The goal is to improve clinician support, quality of life, and patient outcomes.

METHODS: Following PRISMA guidelines, eight databases and gray literature sources were searched for studies published from 2014 to 2024. Papers were assessed for quality and risk of bias, and mixed-methods data were analyzed using narrative synthesis.

RESULTS: Sixty-three studies, encompassing 3,152 multidisciplinary ED clinicians, were included. Clinicians worked across diverse settings with patients of varied presentations. Analyzes suggest that whilst job satisfaction amongst ED clinicians is high and attitudes are generally positive, workplace demands and stressors have a negative impact on clinician wellbeing. Several areas require clearer guidance and further clinician training. Clinicians' affect is mixed, and an 'emotional rollercoaster' is experienced at work. Many clinicians mention a lack of resources as a frustrating obstacle to an optimally operating service.

CONCLUSIONS: Clinicians experience working with ED patients as emotionally challenging and occasionally fatiguing, but attitudes are generally positive. However, clinicians are hindered by organizational factors and a lack of resources, including those pertaining to staffing and training.}, } @article {pmid40518508, year = {2025}, author = {Huang, Z and Zhang, Y and Zou, P and Zong, X and Zhang, Q}, title = {Myelin dysfunction in aging and brain disorders: mechanisms and therapeutic opportunities.}, journal = {Molecular neurodegeneration}, volume = {20}, number = {1}, pages = {69}, pmid = {40518508}, issn = {1750-1326}, support = {RF1NS135548/NS/NINDS NIH HHS/United States ; R01AG082207/AG/NIA NIH HHS/United States ; R01 AG082207/AG/NIA NIH HHS/United States ; 24CDA1269588//American Heart Association/ ; RF1 NS135548/NS/NINDS NIH HHS/United States ; }, mesh = {Humans ; *Myelin Sheath/metabolism/pathology/physiology ; *Aging/pathology/physiology/metabolism ; *Brain Diseases/metabolism/pathology ; Brain/metabolism/pathology ; Animals ; COVID-19 ; }, abstract = {Myelin is a multilamellar membrane that surrounds axons in the vertebrate nervous system. Properly functioning myelin is essential for the rapid conduction of nerve impulses, and it metabolically supports axonal integrity. Emerging evidence indicates that myelin is also involved in various aspects of cognition, with adaptive myelination playing a critical role in memory consolidation and motor learning. However, these physiological processes can be disrupted in various diseases. Understanding the mechanisms underlying myelin pathology is therefore essential for the development of targeted therapies for associated medical conditions. This review provides a comprehensive overview of the role of myelin in neural function, with a particular focus on adaptive myelination in cognition. We also highlight myelin dysfunction and the underlying mechanisms in the aging brain, as well as in diverse brain disorders and neurological conditions, including neurodegenerative diseases, psychiatric conditions, brain injuries, chemotherapy-related cognitive impairment, and neurological symptoms associated with COVID-19. Furthermore, we discuss the therapeutic potential of recently identified pro-myelinating compounds in aging-associated cognitive decline and brain disorders, as well as the future of remyelination therapies. Current evidence suggests that restoring functional myelin may serve as a therapeutic strategy for various medical conditions associated with myelin dysfunction.}, } @article {pmid40518033, year = {2025}, author = {Ong, B and Conda, LE and Mendoza, TP and Hernandez, AV and Cho, SM}, title = {Sex differences on cerebrovascular complications in hospitalized COVID-19 patients: a meta-analysis.}, journal = {Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association}, volume = {34}, number = {8}, pages = {108377}, doi = {10.1016/j.jstrokecerebrovasdis.2025.108377}, pmid = {40518033}, issn = {1532-8511}, mesh = {Humans ; *COVID-19/epidemiology/diagnosis/therapy ; Male ; Female ; Sex Factors ; Risk Factors ; *Hospitalization ; Risk Assessment ; Middle Aged ; Incidence ; Aged ; *Hemorrhagic Stroke/epidemiology/diagnosis/therapy ; *Ischemic Stroke/epidemiology/diagnosis ; *Health Status Disparities ; *Intracranial Hemorrhages/epidemiology/diagnosis ; Sex Distribution ; }, abstract = {BACKGROUND: Although pre-pandemic data suggest a higher stroke incidence in females, recent evidence suggests COVID-19-related strokes disproportionately affect males. Prior studies often analyzed stroke as a composite outcome without stratifying by biologically distinct subtypes. This systematic review and meta-analysis evaluated sex differences in the risk of ischemic and hemorrhagic stroke among hospitalized patients with COVID-19.

METHODS: We searched MEDLINE and six additional databases from inception to December 2024. We included observational studies enrolling adults (≥18 years) with active COVID-19 infection, hospitalized, and reporting sex-stratified stroke outcomes. Pooled risk ratios (RRs) for each stroke subtype were calculated using random-effects models. We defined RR as the ratio of the cumulative incidence of type of stroke in males over the cumulative incidence of the same type of stroke in females.

RESULTS: Seventeen studies comprising 135,481 hospitalized COVID-19 patients (mean age 63.3 years; 48.7% male) met inclusion criteria. Stroke occurred in 1,509 patients (1.1%), with ischemic stroke accounting for 53.9% of cases, unspecified stroke for 30.1%, and hemorrhagic stroke for 16.1%. Males accounted for a greater proportion of stroke cases across all subtypes: 63.1% of ischemic, 69.0% of hemorrhagic, and 59.0% of unspecified strokes. The estimated prevalence of ischemic stroke was 17% in males (95% CI, 15%-20%) versus 9% in females (95% CI, 7%-11%), and hemorrhagic stroke occurred in 4% of males (95% CI, 2%-6%) versus 1% of females (95% CI, 0%-2%). Unspecified stroke occurred in 2% of both sexes (95% CI, 0%-3%). Pooled risk estimates showed that males had a significantly higher risk of any stroke (RR = 1.25; 95% CI,1.05-1.50), driven by an elevated risk of hemorrhagic stroke (RR = 1.64; 95% CI, 1.06-2.54). The increased risk of ischemic stroke in males did not reach statistical significance (RR = 1.18; 95% CI, 0.97-1.44).

CONCLUSIONS: This is the first meta-analysis to stratify stroke risk by sex and stroke subtype in hospitalized COVID-19 patients. Males were at significantly higher risk for hemorrhagic stroke, suggesting possible sex-specific vulnerability that warrants further studies.}, } @article {pmid40517598, year = {2025}, author = {Maharani, DA and Utaminingrum, F and Husnina, DNN and Sukmaningrum, B and Rahmania, FN and Handani, F and Chasanah, HN and Arrahman, A and Febrianto, F}, title = {A review: Lightweight architecture model in deep learning approach for lung disease identification.}, journal = {Computers in biology and medicine}, volume = {194}, number = {}, pages = {110425}, doi = {10.1016/j.compbiomed.2025.110425}, pmid = {40517598}, issn = {1879-0534}, mesh = {Humans ; *Deep Learning ; *COVID-19/diagnostic imaging ; SARS-CoV-2 ; Tomography, X-Ray Computed ; *Lung Diseases/diagnostic imaging ; }, abstract = {As one of the leading causes of death worldwide, early detection of lung disease is a very important step to improve the effectiveness of treatment. By using medical image data, such as X-ray or CT-scan, classification of lung disease can be done. Deep learning methods have been widely used to recognize complex patterns in medical images, but this approach has the constraints of requiring large data variations and high computing resources. In overcoming these constraints, the lightweight architecture in deep learning can provide a more efficient solution based on the number of parameters and computing time. This method can be applied to devices with low processor specifications on portable devices such as mobile phones. This article presents a comprehensive review of 23 research studies published between 2020 and 2025, focusing on various lightweight architectures and optimization techniques aimed at improving the accuracy of lung disease detection. The results show that these models are able to significantly reduce parameter sizes, resulting in faster computation times while maintaining competitive accuracy compared to traditional deep learning architectures. From the research that has been done, it can be seen that SqueezeNet applied on public COVID-19 datasets is the best basic architecture with high accuracy, and the number of parameters is 570 thousand, which is very low. On the other hand, UNet requires 31.07 million parameters, and SegNet requires 29.45 million parameters trained on CT scan images from Italian Society of Medical and Interventional Radiology and Radiopedia, so it is less efficient. For the combination method, EfficientNetV2 and Extreme Learning Machine (ELM) are able to achieve the highest accuracy of 98.20 % and can significantly reduce parameters. The worst performance is shown by VGG and UNet with a decrease in accuracy from 91.05 % to 87 % and an increase in the number of parameters. It can be concluded that the lightweight architecture can be applied to medical image classification in the diagnosis of lung disease quickly and efficiently on devices with limited specifications.}, } @article {pmid40517247, year = {2025}, author = {Almutawif, YA and Al-Kuraishy, HM and Al-Gareeb, AI and Albuhadily, AK and Eid, HMA and Alexiou, A and Papadakis, M and Abo-El Fetoh, ME and El-Saber Batiha, G}, title = {Monkeypox virus and type 1 diabetes: a molecular insight into inflammatory signaling and β-cell autoimmunity.}, journal = {Virology journal}, volume = {22}, number = {1}, pages = {195}, pmid = {40517247}, issn = {1743-422X}, mesh = {*Diabetes Mellitus, Type 1/immunology/virology ; Humans ; *Insulin-Secreting Cells/immunology ; *Autoimmunity ; Animals ; *Monkeypox virus/immunology ; *Mpox, Monkeypox/immunology/complications/virology ; Signal Transduction ; Inflammation/immunology/virology ; SARS-CoV-2/immunology ; }, abstract = {The current worldwide pandemic of monkeypox (MPXV) elicited apprehensions over its possible long-term health ramifications. Recent data indicate a potential association between MPXV infection and the onset of autoimmune disorders, such as type 1 diabetes (T1D). This article analyzes the possible methods for MPXV infection to induce autoimmune responses and damage pancreatic β-cells. We examine from published articles the possible MPXV-induced immune dysregulation and inflammation in the development of T1D. Utilizing insights from other diabetogenic viruses, such as enterovirus and SARS-CoV-2. Currently, the association between MPXV and the development of T1D is scarce. Therefore, additional studies are essential for establishing a conclusive causal link between MPXV and T1D.}, } @article {pmid40517043, year = {2025}, author = {Talmon, I and Pekarsky, S and Bartan, Y and Thie, N and Getz, WM and Kamath, PL and Bowie, RCK and Nathan, R}, title = {Using wild-animal tracking for detecting and managing disease outbreaks.}, journal = {Trends in ecology & evolution}, volume = {40}, number = {8}, pages = {760-771}, doi = {10.1016/j.tree.2025.05.004}, pmid = {40517043}, issn = {1872-8383}, mesh = {Animals ; *Animals, Wild ; *Disease Outbreaks/veterinary/prevention & control ; *COVID-19/epidemiology ; *Zoonoses/epidemiology ; Humans ; SARS-CoV-2 ; }, abstract = {Zoonotic diseases increasingly threaten human and wildlife populations, driving a global rise in mass-mortality outbreaks, including the ongoing avian influenza panzootic in wildlife and zoonotic spillovers such as the COVID-19 (SARS-CoV-2) pandemic in humans. We introduce a new general framework for detecting and managing pathogen outbreaks using animal movement and sensory biologging data to enhance early outbreak detection, provide near-real-time updates on sentinel host health and mortality, and reveal infection-induced behavioral changes. Integrating past and near-real-time biologging with disease surveillance data also enables prospective assessments of spatiotemporal outbreak dynamics, informs management decisions, helps to mitigate spillover risks, and supports both disease control and wildlife conservation.}, } @article {pmid40515956, year = {2025}, author = {Ghorbian, M and Ghorbian, S and Ghobaei-Arani, M}, title = {AI-driven techniques for detection and mitigation of SARS-CoV-2 spread: a review, taxonomy, and trends.}, journal = {Clinical and experimental medicine}, volume = {25}, number = {1}, pages = {204}, pmid = {40515956}, issn = {1591-9528}, mesh = {Humans ; *COVID-19/diagnosis/prevention & control/epidemiology ; *SARS-CoV-2/isolation & purification ; *Artificial Intelligence ; Machine Learning ; }, abstract = {The SARS-CoV-2 RNA virus, with its rapid spread and frequent genetic changes, has posed unparalleled obstacles for public health and treatment efforts. Early diagnosis of the disease and the development of effective treatment strategies are the main pillars of epidemic control. In this regard, machine learning (ML) methods, an advanced subset of artificial intelligence (AI), can play an effective role in improving the accuracy of diagnosis and the effectiveness of treatments related to SARS-CoV-2. However, the implementation of ML in clinical settings faces issues such as data heterogeneity, lack of training data, model interpretability challenges, patient privacy protection, and implementation limitations. This article provides a systematic review of the applications of federated learning (FL), deep learning (DL), reinforcement learning (RL), and hybrid approaches in the field of SARS-CoV-2 diagnosis and treatment. Based on the analysis of the results, the main focus of the research was on increasing privacy and security (P&S) with a share of 26%, improving detection accuracy and robustness (DAR) with 24%, and improving computational and communication efficiency (CCE) with 20%. These statistics indicate the importance of prioritizing patient information confidentiality and improving systems' accuracy and stability against data variability. In conclusion, the findings of this review can pave the way for the practical application of ML technologies in clinical decision-making and improving the quality of healthcare services related to SARS-CoV-2.}, } @article {pmid40515733, year = {2025}, author = {Xu, ZY and Ouyang, W and Liu, JL and Ye, WJ and Xu, F}, title = {Post-COVID-19 severe Pneumocystis jirovecii pneumonia in a non-HIV and immunocompetent patient: A case report and literature review.}, journal = {The Journal of international medical research}, volume = {53}, number = {6}, pages = {3000605251344140}, pmid = {40515733}, issn = {1473-2300}, mesh = {Humans ; Adrenal Cortex Hormones/therapeutic use ; *COVID-19/complications/virology ; Immunocompetence ; *Pneumocystis carinii/isolation & purification ; *Pneumonia, Pneumocystis/drug therapy/diagnosis/microbiology/etiology ; SARS-CoV-2 ; Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use ; }, abstract = {Pneumocystis jirovecii is a ubiquitous opportunistic fungus that can cause life-threatening pneumonia. The clinical manifestations of pneumonia caused by severe acute respiratory syndrome coronavirus 2 and P. jirovecii are similar, posing a significant challenge in the diagnosis of P. jirovecii pneumonia or coronavirus disease 2019. Herein, we report a case of P. jirovecii pneumonia diagnosed through bronchoalveolar lavage and sputum smear analyses. The patient recovered successfully and was discharged following combination therapy with trimethoprim/sulfamethoxazole and corticosteroids. Early diagnosis and prompt treatment are of vital importance in managing P. jirovecii pneumonia, particularly in individuals with related risk factors for P. jirovecii pneumonia development.}, } @article {pmid40515421, year = {2025}, author = {Portilho, AI and Silva, VO and Brigido, LFM and De Gaspari, E}, title = {Should We Advance Our Understanding of Immunoglobulin E in Viral Immunity?.}, journal = {Immunology}, volume = {}, number = {}, pages = {}, doi = {10.1111/imm.70007}, pmid = {40515421}, issn = {1365-2567}, support = {305301/2022-5//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; //Coordenação de Aperfeiçoamento de Pessoal de Nível Superior/ ; }, abstract = {Immunoglobulin E has been extensively studied in allergies and parasitic diseases. However, antigen-specific IgE has been identified as part of the humoral response to some viruses, including Respiratory syncytial virus (RSV), Human rhinovirus (HRV), Influenza, Hepatitis B virus (HBV), Human immunodeficiency virus (HIV), Herpes simplex virus (HSV), Dengue virus (DENV) and SARS-CoV-2. In this brief article, we have reviewed key aspects of IgE function and structure, and summarised the findings about this antibody in virus-specific immune response. To date, IgE effector mechanisms in the face of viruses have been almost unexplored through functional assays. We speculate on possible functionalities, such as neutralisation, cytotoxicity and immunopathology of viral diseases, and provide insights about gaps to fill in future research.}, } @article {pmid40514644, year = {2025}, author = {Elboraay, T and Ebada, MA and Elsayed, M and Aboeldahab, HA and Salamah, HM and Rageh, O and Elmallahy, M and AboElfarh, HE and Mansour, LS and Nabil, Y and Eltawab, AKA and Atwan, H and Alkanj, S}, title = {Long-term neurological and cognitive impact of COVID-19: a systematic review and meta-analysis in over 4 million patients.}, journal = {BMC neurology}, volume = {25}, number = {1}, pages = {250}, pmid = {40514644}, issn = {1471-2377}, mesh = {Humans ; *COVID-19/complications/psychology/epidemiology ; *Nervous System Diseases/epidemiology/etiology ; *Cognitive Dysfunction/epidemiology/etiology ; Prevalence ; Fatigue/epidemiology ; }, abstract = {BACKGROUND: Neuropsychiatric symptoms emerged early in the COVID-19 pandemic as a key feature of the virus, with research confirming a range of neuropsychiatric manifestations linked to acute SARS-CoV-2 infection. However, the persistence of neurological symptoms in the post-acute and chronic phases remains unclear. This meta-analysis assesses the long-term neurological effects of COVID-19 in recovered patients, providing insights for mental health service planning.

METHODS: A comprehensive literature search was conducted across five electronic databases: PubMed, Scopus, Web of Science, EBSCO, and CENTRAL, up to March 22, 2024. Studies evaluating the prevalence of long-term neurological symptoms in COVID-19 survivors with at least six months of follow-up were included. Pooled prevalence estimates, subgroup analyses, and meta-regression were performed, and publication bias was assessed.

RESULTS: The prevalence rates for the different symptoms were as follows: fatigue 43.3% (95% CI [36.1-50.9%]), memory disorders 27.8% (95% CI [20.1-37.1%]), cognitive impairment 27.1% (95% CI [20.4-34.9%]), sleep disorders 24.4% (95% CI [18.1-32.1%]), concentration impairment 23.8% (95% CI [17.2-31.9%]), headache 20.3% (95% CI [15-26.9%]), dizziness 16% (95% CI [9.5-25.7%]), stress 15.9% (95% CI [10.2-24%]), depression 14.0% (95% CI [10.1-19.2%]), anxiety 13.2% (95% CI [9.6-17.9%]), and migraine 13% (95% CI [2.2-49.8%]). Significant heterogeneity was observed across all symptoms. Meta-regression analysis showed higher stress, fatigue, and headache in females, and increased stress and concentration impairment with higher BMI.

CONCLUSIONS: Neurological symptoms are common and persistent in COVID-19 survivors. This meta-analysis highlights the significant burden these symptoms place on individuals, emphasizing the need for well-resourced multidisciplinary healthcare services to support post-COVID recovery.

REGISTRATION AND PROTOCOL: This meta-analysis was registered in PROSPERO with registration number CRD42024576237.}, } @article {pmid40514375, year = {2025}, author = {Deepika, and Kumari, A and Singh, S and Ahmad, MF and Chaki, D and Poria, V and Kumar, S and Saini, N and Yadav, N and Sangwan, N and BinMowyna, MN and Alsharari, ZD and Kambal, N and Min, JH and Raposo, A}, title = {Vitamin D: recent advances, associated factors, and its role in combating non-communicable diseases.}, journal = {NPJ science of food}, volume = {9}, number = {1}, pages = {100}, pmid = {40514375}, issn = {2396-8370}, abstract = {The field of nutrigenomics has produced numerous studies indicating the impact of vitamin D on various disease conditions. Trace elements of this vitamin in the body play a significant role in the regulation of body metabolism. This immunomodulatory vitamin plays a role in management of both communicable (viz. respiratory illness like COVID-19 and Respiratory tract infections) and non-communicable diseases e.g., cancer, osteomalacia, diabetes, and cardiovascular diseases. Deficient levels, i.e., vitamin D deficiency in body can lead to the onset of chronic non-communicable illnesses. Vitamin D plays a direct and sometimes indirect role in the progression (when deficient) and prevention (when sufficient) of non-communicable diseases. This essential nutrient may be obtained through dietary intake or supplements. However, the absorption of it relies on various factors, including the presence of complementary nutrients, chemical forms, and external stimuli such as UV-B and a healthy gastrointestinal tract. This review discusses vitamin D absorption and its role in non-communicable diseases with updates on methods for evaluating and fortifying this vitamin in varied diets. We also briefly highlight recommended dietary allowances by age group, absorption difficulties, and its significance in non-communicable disorders.}, } @article {pmid40514218, year = {2025}, author = {Pak, L and Rollison, J and Rabinowitz, M and Faherty, LJ}, title = {Human papillomavirus vaccine coverage surveys in low- and middle-income countries: current efforts and future considerations for very young adolescents.}, journal = {BMJ global health}, volume = {10}, number = {6}, pages = {}, pmid = {40514218}, issn = {2059-7908}, mesh = {Humans ; *Papillomavirus Vaccines/administration & dosage ; Adolescent ; *Developing Countries ; *Vaccination Coverage/statistics & numerical data ; *Papillomavirus Infections/prevention & control ; Child ; Female ; Male ; }, abstract = {With the recent accelerated rollout of the human papillomavirus (HPV) vaccine in low- and middle-income countries (LMICs), there is a growing need for high-quality vaccination coverage measurement. Vaccine coverage surveys are a key avenue for collecting coverage data, but little is known about the current state of HPV vaccination coverage surveys of very young adolescents (VYAs)-those 10-14 years of age-in LMICs and methodological considerations for these efforts. Through an analysis of peer-reviewed and grey literature and a series of expert discussions, we identify promising approaches for these coverage surveys, such as when to sample from schools versus households and how to reduce recall bias. We also draw attention to the significant methodological gaps, such as a lack of research comparing the validity of vaccination status self-report by the VYA to a caregiver's report. Next, we describe the status of coverage surveys, finding that most LMICs with the HPV vaccine included in their national programme have not conducted a nationally representative HPV vaccination coverage survey. We also describe four existing multi-country survey efforts that include HPV vaccination coverage questions. Finally, we discuss promising approaches to strengthen survey measurement of HPV vaccination coverage among VYAs. Our findings lay the groundwork for stakeholders to expand HPV vaccination coverage measurement for VYAs in LMICs, a necessary component for reducing global HPV and cervical cancer burdens.}, } @article {pmid40513718, year = {2025}, author = {Aram, C and Firuzpour, F and Barancheshmeh, M and Kamali, MJ}, title = {Unveiling the translational and therapeutic potential of small interfering RNA molecules in combating SARS-CoV-2: A review.}, journal = {International journal of biological macromolecules}, volume = {318}, number = {Pt 3}, pages = {145203}, doi = {10.1016/j.ijbiomac.2025.145203}, pmid = {40513718}, issn = {1879-0003}, mesh = {*RNA, Small Interfering/therapeutic use/genetics ; Humans ; *SARS-CoV-2/genetics/drug effects ; *COVID-19/virology/therapy/genetics ; RNA Interference ; Antiviral Agents/therapeutic use/pharmacology ; *COVID-19 Drug Treatment ; Virus Replication/drug effects ; Animals ; }, abstract = {The global COVID-19 pandemic, caused by SARS-CoV-2, has led to significant mortality, with over 6.5 million deaths worldwide. While vaccines have played a crucial role in reducing disease severity, the emergence of viral variants continues to undermine vaccine efficacy, highlighting the need for alternative antiviral strategies. This review explores the potential of RNA interference (RNAi), particularly small interfering RNAs (siRNAs), as a targeted therapeutic approach against SARS-CoV-2. siRNAs can silence specific viral genes with high precision, effectively inhibiting viral replication. We discuss the design and mechanism of siRNAs, their primary molecular targets such as the spike (S), membrane (M), and RNA-dependent RNA polymerase (RdRp) genes and summarize past and current research findings. Special emphasis is placed on delivery systems, especially lung-targeted strategies essential for respiratory infections. We also evaluate how siRNA therapeutics can overcome challenges posed by viral mutations and treatment resistance. The novelty of this work lies in its focused comparison of siRNAs with other non-coding RNAs and its integration of computational tools for siRNA design. This review presents a strategic overview of siRNA development and highlights its translational potential for the current pandemic and future coronavirus outbreaks.}, } @article {pmid40513291, year = {2025}, author = {Gritsok, D and Hedström, M and Montenegro, MCBSM and Amorim, CG}, title = {Electrochemical molecularly imprinted polymer sensors in viral diagnostics: Innovations, challenges and case studies.}, journal = {Biosensors & bioelectronics}, volume = {287}, number = {}, pages = {117678}, doi = {10.1016/j.bios.2025.117678}, pmid = {40513291}, issn = {1873-4235}, mesh = {Humans ; *Biosensing Techniques/methods/instrumentation ; *Electrochemical Techniques/methods/instrumentation ; *Virus Diseases/diagnosis/virology ; *Molecularly Imprinted Polymers/chemistry ; *Viruses/isolation & purification ; *Molecular Imprinting/methods ; }, abstract = {Molecularly imprinted polymers (MIPs) are synthetic equivalent of antibodies and have been widely used in electrochemical sensing as recognition elements. They offer advantages over traditional recognition elements such as antibodies, nucleic acids and aptamers due to their simple synthesis, lower production costs, greater chemical and physical stability, and robust performance in diverse environments. Improved detection techniques and combining MIPs with materials like metal nanoparticles, carbon nanotubes, aptamers, metal organic frameworks, quantum dots, and electrochemically active internal probes show increasing potential. These combinations could become a reliable method for detecting viruses quickly, with performance similar or better than standard techniques. In this review article we provide detailed case studies covering ten different viruses (Bean pod mottle virus, Dengue virus, Zika virus, Foot-and-mouth disease virus, Human papillomavirus, Hepatitis C virus, Human immunodeficiency virus, Influenza A virus, Norovirus, Severe acute respiratory syndrome coronavirus 2) and over forty specific examples. We summarize the recent advances in the development of electrochemical MIP-based sensors for the diagnostics of viral diseases and compare their performance. Additionally, challenges and future perspectives of MIPs as promising recognition elements are discussed.}, } @article {pmid40513184, year = {2025}, author = {Staller, DW and Gawargi, FI and Panigrahi, SS and Mishra, PK and Mahato, RI}, title = {Pharmaceutical perspectives on oligonucleotide therapeutics and delivery systems.}, journal = {Pharmacological reviews}, volume = {77}, number = {4}, pages = {100065}, doi = {10.1016/j.pharmr.2025.100065}, pmid = {40513184}, issn = {1521-0081}, mesh = {Humans ; *Genetic Therapy/methods ; Animals ; *Oligonucleotides/administration & dosage/therapeutic use/chemistry ; *Drug Delivery Systems ; COVID-19 ; }, abstract = {Gene therapy has a pivotal role in treating new diseases. In addition to the recent mRNA-based COVID-19 vaccines produced by Pfizer-BioNTech and Moderna against severe acute respiratory syndrome corona virus 2, several new gene therapies have recently been approved as effective treatments for fatal genetic disorders such as Duchenne's muscular dystrophy, familial transthyretin amyloidosis, hemophilia A, hemophilia B, spinal muscle atrophy, early cerebral autoleukodystrophy, and β-thalassemia. This review provides novel insights into RNA therapeutics focusing on endogenous RNA species, RNA structure and function, and chemical modifications that improve the stability and distribution of RNAs. Furthermore, it includes updated knowledge on clinically approved gene therapies rendering a comprehensive understanding of the biochemical basis and clinical application of gene therapies. SIGNIFICANCE STATEMENT: There have recently been significant advances in clinical translation of RNA therapeutics. This review discusses the diverse types of RNA species, RNA structure and function, backbone and chemical modifications to RNAs, and every RNA therapeutic approved for clinical use at the time of writing.}, } @article {pmid40512605, year = {2025}, author = {Lovatti-González, R and Gómez-Pavón, J and Bielza, R and Hernando, C and Martínez-Peromingo, J and Mateos-Nozal, J and Bermejo-Boixareu, C}, title = {[Recommendations on prevention and treatment of respiratory infections in institutionalised older people].}, journal = {Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia}, volume = {38}, number = {5}, pages = {361-385}, pmid = {40512605}, issn = {1988-9518}, mesh = {Humans ; Aged ; *Respiratory Tract Infections/prevention & control/epidemiology/therapy/drug therapy ; COVID-19/prevention & control/epidemiology ; *Nursing Homes ; Influenza, Human/prevention & control/epidemiology/therapy/drug therapy ; Aged, 80 and over ; Respiratory Syncytial Virus Infections/prevention & control/epidemiology/drug therapy/therapy ; Pneumococcal Infections/prevention & control/epidemiology/drug therapy/therapy ; Institutionalization ; Homes for the Aged ; Antiviral Agents/therapeutic use ; SARS-CoV-2 ; }, abstract = {Acute respiratory infections (ARIs) are one of the main causes of morbidity, functional impairment, and mortality in institutionalised older adults. This group is highly vulnerable due to factors such as advanced age, multimorbidity, frailty, and structural barriers to infection prevention and control. This article reviews, in a question-and-answer format, the most recent evidence on the epidemiology, prevention and treatment of the most relevant respiratory infections in nursing homes: influenza, SARS-CoV-2, respiratory syncytial virus, and Streptococcus pneumoniae. Epidemiological changes after the COVID-19 pandemic, current vaccination strategies, the efficacy and characteristics of newly vaccines available, as well as the updated therapeutic approach according to resistance profiles and the availability of antivirals, are analysed. In addition, the clinical and functional impact that these infections can have on residents is addressed, as well as the need to find a balance between preventive measures and the quality of life of this population group. The importance of effective coordination between health and social care professionals, and the implementation of protocols adapted to the residential context is highlighted. The article provides practical, evidence-based recommendations to improve the prevention and treatment of these infections in a particularly vulnerable environment.}, } @article {pmid40512320, year = {2025}, author = {Rose, W}, title = {Resurgence of Group A Streptococcal Infections.}, journal = {Indian journal of pediatrics}, volume = {92}, number = {7}, pages = {742-748}, pmid = {40512320}, issn = {0973-7693}, mesh = {Humans ; *Streptococcal Infections/epidemiology/prevention & control ; *Streptococcus pyogenes ; COVID-19/epidemiology ; Streptococcal Vaccines ; Anti-Bacterial Agents/therapeutic use ; SARS-CoV-2 ; Drug Resistance, Bacterial ; }, abstract = {Group A Streptococcus (GAS) causes considerable burden on the society with its varied disease manifestations than can range from asymptomatic infection to severe invasive disease which can lead to significant mortality. There was a decline in GAS infections over time with improved living conditions all over the world, however, with the COVID-19 pandemic, there has been a resurgence in the different types of GAS infections. This recent upsurge in the GAS cases worldwide and the increasing rates of antimicrobial resistance has brought the spotlight back on this organism. Many vaccines are under development, but face multiple challenges that hinder the availability of a safe and effective vaccine for widespread use.}, } @article {pmid40512228, year = {2025}, author = {Goldenberg, DL}, title = {The pivotal role of central sensitization in long COVID, fibromyalgia and myalgic encephalomyelitis/chronic fatigue syndrome.}, journal = {Expert review of neurotherapeutics}, volume = {25}, number = {8}, pages = {973-989}, doi = {10.1080/14737175.2025.2516097}, pmid = {40512228}, issn = {1744-8360}, mesh = {Humans ; *Fatigue Syndrome, Chronic/physiopathology/therapy ; *Fibromyalgia/physiopathology/therapy ; *COVID-19/physiopathology/complications/therapy ; *Central Nervous System Sensitization/physiology ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; }, abstract = {INTRODUCTION: Long COVID is a condition characterized by persistent unexplained symptoms following COVID-19 infection. These symptoms are not related to another disease or organ damage and are similar to those in fibromyalgia and myslgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

AREAS COVERED: The similar clinical and pathophysiological features and management of long COVID, fibromyalgia and ME/CFS are explored from the unifying framework of central sensitivity syndromes. The article is based on a literature search utilizing PubMed for content published between 2021 and 1 May 2025, using search terms: long COVID, long COVID syndrome, post-COVID-19, post-acute SARS-CoV-2, fibromyalgia, ME/CFS, post-exertional malaise and central sensitization.

EXPERT OPINION: Once long COVID is redefined to exclude patients with well-defined organ disease, it fits best as a model of central sensitization. Long COVID is a single syndrome, rather than many distinct diseases. Optimal management of long COVID and similar central sensitivity syndromes should include personalized care with a primary care led-multidisciplinary team.}, } @article {pmid40510680, year = {2025}, author = {Lin, J and Tong, Q and Huang, H and Liu, J and Kang, Y and Liu, S and Wang, W and Ren, T and Yuan, Y}, title = {Glucocorticoids and immunoglobulin alone or in combination in the treatment of multisystemic inflammatory syndrome in children: a systematic review and network meta-analysis.}, journal = {Frontiers in pediatrics}, volume = {13}, number = {}, pages = {1545788}, pmid = {40510680}, issn = {2296-2360}, abstract = {IMPORTANCE/BACKGROUND: Multisystem Inflammatory Syndrome in Children (MIS-C) has sparked the creation of diverse treatment guidelines by healthcare organizations globally. The initial management strategies for MIS-C differ among these guidelines. In developed nations, intravenous immunoglobulin (IVIG) is frequently advised as the first-line treatment. However, given its high cost and limited availability in numerous countries, there is a pressing need for evidence to validate alternative therapeutic options.

OBJECTIVE: To evaluate the efficacy of glucocorticoids (GCs), IVIG, and combination therapy for the treatment of Children with MIS-C.

DATA SOURCES: PubMed, Cochrane Library, EMBASE, Web of Science, and Medellín. The last search update was on April 8, 2025.

DATA EXTRACTION AND SYNTHESIS: Cohort studies that evaluated the efficacy of IVIG, GCs, and IVIG combined with GCs in children clinically diagnosed with MIS-C were included. Two authors independently screened the studies, extracted relevant data, and assessed the risk of bias.

PRIMARY OUTCOMES AND MEASURES: The primary outcomes of the Bayesian network meta-analysis were inotropic support requirements, treatment failure/persistent fever, left ventricular (LV) dysfunction, need for adjuvant immunotherapy, mortality and coronary artery dilatation/aneurysm. Secondary outcomes included length of stay in the intensive care unit (ICU), duration of fever, and duration of inotropic support.

RESULTS: The primary analysis included fourteen cohort studies with a total of 4,269 participants. According to moderate-quality evidence, combination therapy demonstrated the most significant reduction in the need for adjuvant immunotherapy compared to IVIG alone [OR 0.29, 95% CI (0.19, 0.45)]. Additionally, GCs monotherapy was found to be most effective in lowering the incidence of treatment failure [OR 0.23, 95% CI (0.14, 0.39)]. When compared to combination therapy, GCs monotherapy was associated with a reduction in ICU length of stay [SMD -0.25, 95% CI (-0.85, 0.36)], duration of fever (SMD [-0.42, 95% CI (-0.73, -0.11)], and duration of inotropic support [SMD -0.13, 95% CI (-0.46, 0.20)], as well as a decrease in the incidence of left ventricular (LV) dysfunction [OR 0.96, 95% CI (0.55, 1.68)]. Furthermore, GCs monotherapy had the lowest incidence of coronary artery dilation/aneurysm, while combination therapy required the least inotropic support. Patients receiving IVIG had the lowest mortality rate, but no statistically significant mortality differences existed across treatment groups.

CONCLUSIONS AND RELEVANCE: GCs monotherapy significantly reduces treatment failure rates and persistent fever duration, while combination therapy significantly reduces the need for adjunctive immunotherapy. For countries with limited access to IVIG, initiating GCs as first-line therapy may be a viable option.

https://www.crd.york.ac.uk/PROSPERO/, PROSPERO identifier CRD42023456156.}, } @article {pmid40510060, year = {2025}, author = {Ng, MK and Mont, MA and Bonutti, PM}, title = {Clinical and Environmental Harms of Quaternary Ammonium Disinfectants and the Promise of Ultraviolet-C (UV-C) Alternatives: A Narrative Review.}, journal = {Cureus}, volume = {17}, number = {5}, pages = {e84022}, pmid = {40510060}, issn = {2168-8184}, abstract = {Quaternary ammonium compounds (QACs) are widely used disinfectants whose application expanded dramatically during the COVID-19 pandemic, raising concerns about long-term safety and environmental impact. This narrative review begins by outlining the chemical structure, mechanisms of action, and widespread use of QACs across healthcare, consumer, and industrial settings. We examine toxicologic findings from in vitro and animal studies, highlighting mitochondrial dysfunction, oxidative stress, and reproductive toxicity at low-dose exposures. Clinical and public health data are reviewed, linking QAC exposure to respiratory symptoms, dermatitis, and potential reproductive risks among healthcare workers and other vulnerable populations. Environmental harms are also discussed, including QAC persistence in soil and water, ecotoxicity in aquatic species, and potential for bioaccumulation. We then explore ultraviolet-C (UV-C) disinfection as a non-chemical alternative, demonstrating comparable antimicrobial efficacy without the toxicological or ecological drawbacks of QACs. Despite the growing use of QACs, few studies have comprehensively reviewed their adverse effects or evaluated UV-C as a viable substitute. This narrative review fills a critical gap by synthesizing current evidence across disciplines and highlighting the need for safer disinfection practices. We advocate for the broader adoption of UV-C technologies to reduce chemical exposure, protect public health, and promote environmental sustainability.}, } @article {pmid40509781, year = {2025}, author = {Hayes, C and Bourke, S and Jacob, S and Joseph, B and Anish, L and Plummer, V and Abdelkader, A}, title = {Psychological Wellbeing and Predictors of Early Help-Seeking Behaviours of International Students of Undergraduate Nursing Programs: A Scoping Review.}, journal = {Nursing open}, volume = {12}, number = {6}, pages = {e70249}, pmid = {40509781}, issn = {2054-1058}, mesh = {Humans ; *Students, Nursing/psychology ; Australia ; *Help-Seeking Behavior ; Education, Nursing, Baccalaureate ; *Mental Health ; COVID-19/epidemiology ; }, abstract = {BACKGROUND: Australian Universities are the principal providers of nurse education for international students. While researchers have recognised the important issue of poor psychological well-being among nursing students, few have explored the factors which impact international nursing students.

AIM: This review aimed to map the reported factors impacting psychological health, wellness and early help-seeking behaviours of international students enrolled in Bachelor of Nursing programmes.

METHODS: A scoping review with a five-stage methodological framework to interpret and synthesise the available literature was utilised. The following databases were searched: CINAHL Complete, PsycINFO, MEDLINE, ERIC and Scopus for studies published in English from 2012 to 2022. Additional sources were also sought through a review of the references of included studies. Four studies met the inclusion criteria.

RESULTS: Results revealed that all included studies were from Australia and utilised a quantitative approach. Factors impacting psychological health and wellbeing, as well as help-seeking behaviours included but were not limited to migrating alone, language spoken, marginalisation and the COVID-19 pandemic. Published literature on this topic is limited, with a notable absence from other countries.

CONCLUSION: This review highlights a gap in evidence concerning ways to support international nursing students.

There were no patient or public contributions in the design, conduct, analysis or preparation of this manuscript.}, } @article {pmid40508918, year = {2025}, author = {Kusunoki, H}, title = {Unraveling Rising Mortality: Statistical Insights from Japan and International Comparisons.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {11}, pages = {}, pmid = {40508918}, issn = {2227-9032}, abstract = {Since the onset of the COVID-19 pandemic, Japan has experienced a significant rise in mortality, with excess deaths surpassing historical projections. Statistical data indicate a sharp increase in mortality rates from 2021 onward, attributed to COVID-19, aging demographics, cardiovascular diseases, and malignancies. Preliminary 2024 data suggest continued excess mortality, fueling public debate. This review analyzes national and municipal mortality trends using official Japanese statistics and comparative data from South Korea, the U.S., and the EU. Findings reveal a sharp mortality rise post-2021 in Japan and South Korea, while Western nations experienced peak deaths in 2020, followed by declines. The review explores contributing factors, including potential vaccine-related adverse effects, declining healthcare access, pandemic-induced stress, and demographic shifts. Notably, older adults' reluctance to seek medical care led to delayed diagnoses, treatment interruptions, and preventable deaths. Although some argue that declining COVID-19 vaccination rates in 2023 may have contributed to rising mortality in 2024, available data suggest a multifactorial causation. Japan's rapidly aging population, coupled with increasing mortality and declining birth rates, presents profound social and economic challenges. A nuanced approach, avoiding simplistic causal claims, is crucial for understanding these trends. This review highlights the need for a sustainable societal framework to address demographic shifts and improve healthcare resilience. Future pandemic strategies must balance infection control measures with mitigating unintended health consequences to ensure a more adaptive and effective public health response.}, } @article {pmid40508880, year = {2025}, author = {Tong, LK and Tam, HL and Mao, AM}, title = {A Bibliometric Review of Person-Centered Care Research 2010-2024.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {11}, pages = {}, pmid = {40508880}, issn = {2227-9032}, support = {0544/DGAF/2024-03//Macao Foundation/ ; }, abstract = {Background/Objectives: Person-centered care (PCC) has become a pivotal concept in healthcare. At present, no published studies have assessed the PCC field using bibliometric tools. This study aimed to identify hot spots, trends, and developmental trajectories within the PCC field. Methods: Publications related to PCC from 2010 to 2024 were extracted from the Web of Science core collection database and analyzed by the Bibliometrix package from RStudio. Results: A total of 5837 studies were analyzed. The analysis revealed steady growth in PCC research, with the United Kingdom, Australia, and the USA leading in publication numbers. Frequent keywords included patient-centered care, PCC, and qualitative research. The thematic shift from patient-centered care to PCC highlights a growing emphasis on individual healthcare needs and values. The evolution of research themes related to PCC has varied across different time periods, with communication, quality improvement, multimorbidity, and chronic disease remaining underdeveloped during 2020-2024, indicating that these themes are key focuses for future research. Emerging keywords over the past five years-value-based healthcare; deep learning; telehealth; and COVID-19-suggest new research directions. Conclusions: This study provides a detailed overview of the PCC research landscape, highlighting key areas of focus and identifying potential directions for future research. The findings suggest a dynamic field with a growing emphasis on individualized care and the integration of new methodologies and themes to address current healthcare challenges.}, } @article {pmid40508838, year = {2025}, author = {Richa, S and Praveen, S and Albariqi, AA and Abullais, SS and Mahmood, SE and Alsamghan, A and Bharti, RK and Bahamdan, GK}, title = {Global Trends and Emerging Frontiers in Smoking and Smokeless Tobacco Research: A Bibliometric Analysis over the Past Decade.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {11}, pages = {}, pmid = {40508838}, issn = {2227-9032}, support = {RGP-2/504/45//the Deanship of Scientific Research at King Khalid University for supporting this work through Large group Project/ ; }, abstract = {UNLABELLED: Tobacco use remains a critical global health issue, with extensive research focusing on its impact on public health, particularly its strong association with oral cavity cancer. It is a leading cause of preventable disease and death worldwide, affecting millions each year. Despite increased awareness and regulatory measures, tobacco continues to pose significant challenges, prompting ongoing investigations into its health effects and related behaviors.

OBJECTIVE: This study aims to conduct a bibliometric analysis of smoking and smokeless tobacco research from 2014 to 2024, focusing on identifying key research trends, influential contributors, emerging topics, and collaborative networks on a global scale.

METHODS: A dataset of 2694 research papers from PubMed was analyzed using bibliometric tools. Keyword co-occurrence, authorship patterns, and institutional collaborations were mapped to reveal dominant themes and trends. Additionally, country-specific publications were examined to assess geographical contributions and emerging research frontiers.

RESULTS: The analysis indicates a 7.3% annual increase in publications, with a peak in 2021 likely influenced by COVID-19. Research topics have shifted from traditional tobacco-related health impacts, such as lung cancer and cardiovascular diseases, to newer areas like e-cigarettes and social determinants of health. Strong international collaborations were noted, with the U.S., China, and Europe as dominant contributors. Emerging research frontiers include electronic nicotine delivery systems and strategies aimed at controlling tobacco-related health risks.

CONCLUSION: This bibliometric study highlights significant growth in tobacco-related research over the past decade. Evolving trends reflect a shift toward newer tobacco products and public health challenges. These findings provide valuable insights for shaping future research agendas and informing global tobacco control policies.}, } @article {pmid40508830, year = {2025}, author = {Miranda Gálvez, AL and Pacheco-Unguetti, AP}, title = {The Impact of the COVID-19 Pandemic on Young Adults with Autism Spectrum Disorder: A Systematic Review.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {11}, pages = {}, pmid = {40508830}, issn = {2227-9032}, abstract = {BACKGROUND/OBJECTIVES: The COVID-19 pandemic and related public health measures significantly disrupted daily life, with profound consequences for individuals with Autism Spectrum Disorder (ASD). Young adults with ASD faced unique challenges due to disruptions in routines, employment instability, limited access to essential services, and increased social isolation. While some individuals benefited from reduced social pressures and the adoption of remote work, many experienced heightened anxiety, behavioral difficulties, and declines in autonomy. This systematic review examines the impact of the pandemic on young adults with ASD, focusing on key domains such as autonomy, employment, service accessibility, socialization, emotional regulation, and overall well-being.

METHODS: This review followed the PRISMA 2020 guidelines, and its protocol was pre-registered in the PROSPERO database. A search was conducted in four databases-PubMed, Scous, Web of Science, and PsycInfo-as well as in specialized journals in the field.

RESULTS: Eight studies met the inclusion criteria and were included in the final synthesis. The findings highlight significant disruptions in daily life, increased dependence on caregivers, and difficulties in maintaining structured activities. However, technology-assisted interventions, including virtual therapies and remote work opportunities, played a role in mitigating some adverse effects.

CONCLUSIONS: Despite the heterogeneity in methodologies, this review underscores the urgent need for targeted interventions to support young adults with ASD during crises. Future research should focus on long-term consequences and developing inclusive policies that enhance resilience, access to services, and social integration.}, } @article {pmid40507911, year = {2025}, author = {Popa, E and Popa, AE and Poroch, M and Poroch, V and Ungureanu, MI and Slanina, AM and Bacusca, A and Coman, EA}, title = {The Molecular Mechanisms of Cognitive Dysfunction in Long COVID: A Narrative Review.}, journal = {International journal of molecular sciences}, volume = {26}, number = {11}, pages = {}, pmid = {40507911}, issn = {1422-0067}, mesh = {Humans ; *COVID-19/complications/metabolism ; *Cognitive Dysfunction/etiology/metabolism/virology ; SARS-CoV-2 ; Biomarkers/metabolism ; Blood-Brain Barrier/metabolism ; }, abstract = {Cognitive dysfunction represents one of the most persistent and disabling features of Long COVID, yet its molecular underpinnings remain incompletely understood. This narrative review synthesizes current evidence on the pathophysiological mechanisms linking SARS-CoV-2 infection to long-term neurocognitive sequelae. Key processes include persistent neuroinflammation, blood-brain barrier (BBB) disruption, endothelial dysfunction, immune dysregulation, and neuroendocrine imbalance. Microglial activation and cytokine release (e.g., IL-6, TNF-α) promote synaptic dysfunction and neuronal injury, while activation of inflammasomes such as NLRP3 amplifies CNS inflammation. Vascular abnormalities, including microthrombosis and BBB leakage, facilitate the infiltration of peripheral immune cells and neurotoxic mediators. Hypothalamic-pituitary-adrenal axis dysfunction and reduced vagal tone further exacerbate systemic inflammation and autonomic imbalance. Biomarkers such as GFAP, NFL, IL-6, and S100B have been associated with both neuroinflammation and cognitive symptoms. Notably, transcriptomic signatures in Long COVID overlap with those observed in Alzheimer's disease, highlighting shared pathways involving tau dysregulation, oxidative stress, and glial reactivity. Understanding these mechanisms is critical for identifying at-risk individuals and developing targeted therapeutic strategies. This review underscores the need for longitudinal research and integrative biomarker analysis to elucidate the molecular trajectory of cognitive impairment in Long COVID.}, } @article {pmid40507747, year = {2025}, author = {De Melo, LC and Rugna, MM and Durães, TA and Pereira, SS and Callado, GY and Pires, P and Traina, E and Araujo Júnior, E and Granese, R}, title = {Congenital Rubella Syndrome in the Post-Elimination Era: Why Vigilance Remains Essential.}, journal = {Journal of clinical medicine}, volume = {14}, number = {11}, pages = {}, pmid = {40507747}, issn = {2077-0383}, abstract = {Congenital Rubella Syndrome (CRS) results from maternal infection with the rubella virus during pregnancy, particularly in the first trimester, when the risk of vertical transmission and severe fetal damage is highest. CRS is characterized by a broad spectrum of congenital anomalies, including sensorineural hearing loss, congenital heart defects, cataracts, neurodevelopmental delay, and behavioral disorders. Despite the absence of specific antiviral therapies, active immunization remains the only effective strategy to prevent rubella infection and its congenital consequences. Global immunization efforts, particularly in the Americas, have led to the elimination of rubella and CRS in several countries. However, challenges persist in the post-elimination era, including declining vaccine coverage, vaccine hesitancy, and setbacks caused by the COVID-19 pandemic. Diagnosis relies on maternal serology, fetal imaging, postnatal antibody testing, and molecular techniques. Management requires long-term, multidisciplinary follow-up due to the complex and lifelong sequelae affecting sensory, motor, and cognitive development. This review highlights the clinical, epidemiological, and pathophysiological aspects of CRS, while emphasizing the urgent need to maintain high vaccination coverage and strengthen surveillance systems. Sustained public health commitment is essential to prevent the reemergence of rubella and protect future generations from this preventable syndrome.}, } @article {pmid40507642, year = {2025}, author = {Asseri, AA}, title = {Respiratory Syncytial Virus: A Narrative Review of Updates and Recent Advances in Epidemiology, Pathogenesis, Diagnosis, Management and Prevention.}, journal = {Journal of clinical medicine}, volume = {14}, number = {11}, pages = {}, pmid = {40507642}, issn = {2077-0383}, support = {RGP1/204/45//Deanship of Research and Graduate Studies at King Khalid University/ ; }, abstract = {Respiratory syncytial virus (RSV) continues as the major cause of acute lower respiratory tract infections in children around the world, and its substantial morbidity, particularly among infants and high-risk children, poses a significant burden on healthcare systems worldwide. RSV infections occur as a spectrum, ranging from mild upper respiratory symptoms to severe bronchiolitis and pneumonia, and the number of infections shows seasonal variations in different latitudes, as well as lasting impacts, reflecting the COVID-19 pandemic. The pathogenesis of the virus involves epithelial cell invasion and/or fusion to form syncytia, along with exaggerated immune-mediated responses. Disease severity is known to depend on viral load, strain variation, and host immune immaturity. Severe RSV infection during infancy is notably linked with long-term respiratory sequelae such as recurrent wheezing and asthma. Diagnosis is based on clinical suspicion and laboratory confirmation using rapid antigen testing or nucleic acid amplification tests, namely PCR. Non-pharmaceutical interventions, maternal vaccination, and prophylaxis with monoclonal antibodies, e.g., palivizumab and nirsevimab, a newly introduced long-acting agent, are efficient protective and preventive measures. Treatment is still, for the most part, supportive in nature and focuses on oxygen supplementation, hydration, and respiratory support for patients with more severe disease courses; however, the development of immunoprophylaxis and vaccine candidates shows promise for reducing the global burden of RSV.}, } @article {pmid40507506, year = {2025}, author = {Živković Zarić, R and Zarić, M and Protrka, S and Andrić, V and Arsenijević, N and Čanović, P and Mladenović, V and Jakovljević, S and Adamović, M and Glišić, M}, title = {Treatment and Outcomes of COVID-19 Infection in Pregnant Women: Systematic Review of Cases Reported in Europe.}, journal = {Journal of clinical medicine}, volume = {14}, number = {11}, pages = {}, pmid = {40507506}, issn = {2077-0383}, abstract = {Background/Objectives: The World Health Organization (WHO) declared a global pandemic of COVID-19 caused by SARS-CoV-2 in March 2020. May 2023 was the month that ended the global pandemic. Pregnant females with COVID-19 are less likely to be symptomatic than non-pregnant patients, with nearly three-quarters being without symptoms. According to previous studies, even if somebody develops symptoms, they are usually mild, most commonly coughing (41%), fever (40%), and dyspnea (21%). Our study aims to search the literature systematically, especially case series and case reports published in Europe, and to summarize results about the kind of COVID-19 therapy in pregnant women and about outcomes in mothers and newborns. Methods: Our systematic review was registered at the International Prospective Register of Systematic Reviews (PROSPERO) with CRD42024566838. We searched PubMed/MEDLINE, Google Scholar, Web of Science, Scopus, and Serbian Citation Index (SCIndeks). In this study, case reports or case series with open, complete text that included full clinical records of the individuals identified with infection in pregnancy, thought to be caused by COVID-19, were used. Case series or case reports were eliminated if they (1) did not contain a full clinical report for every patient, or (2) included an individual who suffered from another viral infection other than COVID-19, so the clinical course and the outcome could not be precisely defined. We evaluated reporting bias and attrition bias. Results: Our study included 32 published studies (eight case series and 24 case reports) that included 56 individual cases. The oldest patient was 50 years old, and the youngest was 19 years old. The most common symptom initially was dry cough (n = 23; 41%), followed by fever (n = 21; 37%) and dyspnea (n = 10; 17%). In three patients, a lower level of thrombocytes was reported, with the lowest level of 86 × 10[9]. The most frequently used drugs in pregnant women with COVID-19 infection were azithromycin, lopinavir/ritonavir, hydroxychloroquine, as well as corticosteroids. Twenty-two patients were on mechanical ventilation. After all this reported therapy, ten women died, as well as seven newborns. Conclusions: From our results, we can conclude that mechanical ventilation correlates with cesarean section performed more frequently, as well as with a higher mortality rate of neonates. There are no significant data related to transplacental transmission of the virus. Generally, mortality in our group of patients (mothers) was 17%, which is similar to the general population death from COVID-19 infection.}, } @article {pmid40507383, year = {2025}, author = {Milic, J and Vucurovic, M and Grego, E and Jovic, D and Sapic, R and Jovic, S and Jovanovic, V}, title = {From Fear to Hope: Understanding Preparatory and Anticipatory Grief in Women with Cancer-A Public Health Approach to Integrating Screening, Compassionate Communication, and Psychological Support Strategies.}, journal = {Journal of clinical medicine}, volume = {14}, number = {11}, pages = {}, pmid = {40507383}, issn = {2077-0383}, abstract = {Prolonged grief disorder, also known as post-loss grief, was officially recognized in the International Classification of Diseases (ICD-11) after years of debate within the mental health community. However, while post-loss grief gained recognition, anticipatory and preparatory grief, which occur before a loss, have remained underexplored. Preparatory grief affects individuals nearing the end of life, while anticipatory grief impacts the loved ones of those who are about to die. These grief types are particularly prevalent among women, who are more vulnerable to their emotional and psychological challenges. The primary aim of this study was to investigate preparatory grief in women diagnosed with cancer and anticipatory grief in their loved ones, with the goal of developing management guidelines. The secondary objective was to identify protective factors, such as psychotherapeutic interventions and systemic support, to alleviate grief-related distress. This review synthesized evidence from the PubMed and Cochrane databases, covering studies from 1968 to 2020 and after the COVID-19 pandemic in 2023. The results revealed that anticipatory grief was common among loved ones, leading to increased emotional distress, while cancer patients experienced preparatory grief, facing both emotional and practical challenges. Both types of grief were associated with altered stress responses, such as lower diurnal cortisol levels. Psychotherapeutic interventions, particularly early and systemic psychotherapy, were found to effectively reduce symptoms of both anticipatory and preparatory grief, improving coping strategies and emotional well-being. The study concluded that empowering coping strategies and social support played key roles in enhancing emotional outcomes for both patients and their families.}, } @article {pmid40507071, year = {2025}, author = {Bigman, G and Rusu, ME and Shelawala, N and Sorkin, JD and Beamer, BA and Ryan, AS}, title = {A Comprehensive Scoping Review on Diet and Nutrition in Relation to Long COVID-19 Symptoms and Recovery.}, journal = {Nutrients}, volume = {17}, number = {11}, pages = {}, pmid = {40507071}, issn = {2072-6643}, support = {IK6 RX003977/RX/RRD VA/United States ; K01 AG078545/AG/NIA NIH HHS/United States ; P30 AG028747/AG/NIA NIH HHS/United States ; R01 AG051752/AG/NIA NIH HHS/United States ; }, mesh = {Humans ; *COVID-19/complications/physiopathology/diet therapy ; *Nutritional Status ; *Diet ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Adult ; }, abstract = {Background/Objectives: Long COVID-19 is characterized by persistent symptoms lasting three months or more following SARS-CoV-2 infection. Nutrition has emerged as a modifiable factor influencing recovery trajectories and symptom burden; however, existing evidence remains fragmented across diverse study designs and populations. This scoping review synthesized global evidence on the role of diet and nutrition in managing long COVID-19 symptoms and supporting recovery. Methods: Following PRISMA-ScR and Joanna Briggs Institute guidelines for scoping reviews, we searched major biomedical databases for studies published between 2020 and 2025. Eligible studies examined dietary intake, nutritional status, or nutrition-related interventions in adults with long COVID-19. Results: After duplicates were removed, 1808 records were screened, resulting in 50 studies that met the inclusion criteria-27 intervention studies and 23 observational studies. Nutritional exposures included micronutrients (e.g., vitamins D, K2), amino acids (e.g., L-arginine), multinutrient formulations, microbiota-targeted therapies (e.g., probiotics, synbiotics), nutritional status, diet quality, and whole-diet patterns (e.g., the Mediterranean diet). Approximately 76% of studies reported improvements in long COVID-19-related symptoms such as fatigue, mood disturbances, physical function, and markers of inflammation. Conclusions: Diet and nutrition may support long COVID-19 recovery by targeting inflammation and the gut microbiome to alleviate symptoms and improve functional outcomes. Well-powered trials of whole-diet approaches, combined with targeted supplementation, are needed to confirm their potential as scalable, accessible tools for post-COVID-19 recovery and management.}, } @article {pmid40506676, year = {2025}, author = {Domenech, A and Kasujee, I and Koscielny, V and Griffiths, CEM}, title = {Systematic Review of the Use of the WHO-5 Well-Being Index Across Different Disease Areas.}, journal = {Advances in therapy}, volume = {42}, number = {8}, pages = {3657-3677}, pmid = {40506676}, issn = {1865-8652}, mesh = {Humans ; *COVID-19/psychology/epidemiology ; Mental Disorders/psychology ; *Mental Health ; *Quality of Life ; SARS-CoV-2 ; Surveys and Questionnaires ; World Health Organization ; }, abstract = {BACKGROUND: Since its first publication in 1998, the 5-item World Health Organization Well-being index, WHO-5, has become one of the most widely used questionnaires to assess subjective psychological well-being.

AIMS: To perform a systematic review of the WHO-5 questionnaire, with a focus on its use across various disease areas and patient populations.

METHODS: Studies reporting the use of the WHO-5 were searched on the PubMed and PsycINFO databases (search December 2024). The classification of the different diseases or disorders was used following the 11th version of the International Classification of Diseases.

RESULTS: A total of 552 studies met the predefined criteria for inclusion in the review. We provide an overview of the WHO-5 use in all different disease areas, the psychological burden of the patients, and if available, the impact of the treatments on their well-being. The groups with the most publications refer to the Coronavirus disease (COVID)-19 pandemic (n = 161, 29.2%) followed by the group of mental, behavioral, or neurodevelopmental disorders (n = 141, 25.6%), and the group of endocrine, nutritional, and metabolic diseases (n = 120, 21.7%).

CONCLUSIONS: The WHO-5 is a short questionnaire consisting of 5 positively formulated questions, which successfully detect when a disease impacts a person's subjective well-being. The scale proved to detect changes in well-being across various diseases around the world, and it should be considered in clinical practice and research.}, } @article {pmid40506276, year = {2025}, author = {Stormezand, GN and Doorduin, J and Glaudemans, AWJM and van der Hoorn, A and De Jong, BM}, title = {Current Developments on [[18]F]FDG PET/CT in Inflammatory Disorders of the Central Nervous System.}, journal = {Seminars in nuclear medicine}, volume = {55}, number = {4}, pages = {503-511}, doi = {10.1053/j.semnuclmed.2025.06.001}, pmid = {40506276}, issn = {1558-4623}, mesh = {Humans ; *Fluorodeoxyglucose F18 ; *Positron Emission Tomography Computed Tomography/methods ; *Central Nervous System Diseases/diagnostic imaging ; COVID-19/diagnostic imaging ; }, abstract = {2-Deoxy-2-[[18]F]fluoro-D-glucose positron emission tomography (FDG-PET) is widely used to study cerebral glucose metabolism and may be useful in several inflammatory disorders of the central nervous system. Emerging literature suggests that [[18]F]FDG may be more sensitive to detect abnormalities in auto-immune encephalitis (AIE) in comparison to MRI, especially in NDMA receptor encephalitis. Distinct patterns of regional abnormalities in AIE have been reported, depending on the auto-antibody involved. Predominant findings are hypermetabolism of the mediotemporal lobe and hypometabolism in parietal and occipital lobes. The possibility for whole body imaging in the setting of malignancy screening further strengthens the importance of [[18]F]FDG PET in AIE when associated with paraneoplastic syndromes. Other inflammatory conditions of the central nervous system where [[18]]FDG PET may facilitate diagnosis include neurosarcoidosis and potential neuropsychiatric manifestations of systemic lupus erythematodes. More recently, [[18]F]FDG PET has been used in patients to evaluate postacute sequelae of COVID-19, allowing assessment of specific neuronal impairments at the individual level and determination of time-dependent metabolic alterations.}, } @article {pmid40505671, year = {2025}, author = {Post, RM and Li, VW and Berk, M and Yatham, LN}, title = {Lithium as a disease-modifying drug for bipolar disorder.}, journal = {The lancet. Psychiatry}, volume = {}, number = {}, pages = {}, doi = {10.1016/S2215-0366(25)00097-5}, pmid = {40505671}, issn = {2215-0374}, abstract = {Lithium is a classic, primary treatment for bipolar disorder that has paradoxically been used less over time, especially in North America, which goes against the accumulating evidence for its efficacy. Bipolar disorder is increasingly conceptualised as a chronic, potentially progressive condition worsened and accelerated by each mood episode, which might resemble multiple sclerosis or rheumatoid arthritis as a condition that requires disease-modifying treatments to change illness trajectory. In this Personal View, we argue that lithium acts like a disease-modifying drug in bipolar disorder. Although the pathophysiology of bipolar disorder remains unclear, many of the mechanisms implicated in bipolar disorder, and the surrogate markers associated with this condition, are uniquely affected by lithium treatment from the DNA and cellular levels to the structure and function of the brain and other body systems. Clinical trial and cohort study evidence shows that lithium is effective and probably superior to other medications used to treat bipolar disorder, and that long-term outcomes are better with lithium than non-lithium regimens. Conceptualisation of lithium as a disease-modifying agent might help to increase clinical use by doctors, especially early in the disease course to better serve our patients.}, } @article {pmid40505559, year = {2025}, author = {Lukman, KM and Hastuti, LP and Oktavia, D and Pratiwi, D and Uchiyama, Y and Harding, D}, title = {Towards blue skies: A comprehensive review and regional mapping of ambient air quality in Indonesian cities.}, journal = {Journal of environmental management}, volume = {389}, number = {}, pages = {126132}, doi = {10.1016/j.jenvman.2025.126132}, pmid = {40505559}, issn = {1095-8630}, mesh = {Indonesia ; *Air Pollution/analysis ; Cities ; *Air Pollutants/analysis ; Particulate Matter/analysis ; *Environmental Monitoring ; Humans ; COVID-19/epidemiology ; SARS-CoV-2 ; }, abstract = {This study reviews the landscape of ambient air quality research in Indonesia, analyzing 74 articles published between 2014 and 2024. The analysis focuses on key pollutants-PM2.5, NOx, and SOx-in metropolitan cities like Jakarta, Surabaya, Bandung, and Semarang. Findings reveal that transportation, industrial activities, and forest fires are primary contributors to urban air pollution. The COVID-19 pandemic significantly impacted air quality, with marked reductions in PM2.5 and NOx levels in 2020 due to decreased human activities. However, pollutant concentrations rose again as economic activities resumed post-pandemic. Jakarta, the capital city, experienced notable changes, demonstrating the profound effects of emissions reduction strategies. This review highlights the urgent need for continuous monitoring, improved regulatory frameworks, and sustainable urban planning to mitigate air pollution in Indonesia's rapidly urbanizing cities.}, } @article {pmid40503878, year = {2025}, author = {Santamaria-Castro, I and Leiva-Rebollo, R and Marín-Wong, S and Jimenez-Guardeño, JM and Ortega-Prieto, AM}, title = {Molecular mechanisms of SARS-CoV-2 entry: implications for biomedical strategies.}, journal = {Microbiology and molecular biology reviews : MMBR}, volume = {89}, number = {3}, pages = {e0026024}, pmid = {40503878}, issn = {1098-5557}, mesh = {Humans ; *SARS-CoV-2/physiology/genetics/pathogenicity ; *Virus Internalization/drug effects ; *COVID-19/virology/prevention & control/transmission ; Spike Glycoprotein, Coronavirus/metabolism/genetics ; Angiotensin-Converting Enzyme 2/metabolism ; Cathepsin L/metabolism ; Serine Endopeptidases/metabolism ; Animals ; Receptors, Virus/metabolism ; Antiviral Agents/pharmacology/therapeutic use ; COVID-19 Drug Treatment ; }, abstract = {SUMMARYThe mechanisms by which viruses enter host cells are crucial for their ability to infect and cause disease, serving as major targets for both host immune responses and therapeutic strategies. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) entry process is primarily driven by the binding of the viral spike (S) protein to the angiotensin-converting enzyme 2 (ACE2) receptor, in conjunction with the activity of endosomal cathepsin L and the serine protease transmembrane protease serine 2 (TMPRSS2). Nevertheless, recent scientific advances have expanded our understanding of SARS-CoV-2 entry mechanisms, uncovering alternative receptors and novel cofactors that may enhance viral tropism and adaptability. Given the critical role of the SARS-CoV-2 S protein in mediating host cell entry, it has become a primary target for prevention and therapeutic strategies. However, the continuous spread of SARS-CoV-2 has led to the emergence of S protein variants that may potentially confer a fitness advantage or modify key aspects of SARS-CoV-2 biology, such as transmissibility, infectivity, antigenicity, and/or pathogenicity, posing significant challenges to the efficacy of current interventions. In this review, we provide an updated and comprehensive overview of the latest advances in SARS-CoV-2 entry pathways and molecular mechanisms, exploring their implications for antiviral drug discovery, vaccine design, and the development of other biomedical strategies while addressing the challenges posed by the ongoing evolution of the virus.}, } @article {pmid40503462, year = {2024}, author = {Jonah, JH and Samuel, G and Abdullahi, MI and Emmanuel, EA and Danladi, SS and Ekwuluo, CE}, title = {Nigeria's public health response to disease outbreaks: A review of strengths and weaknesses.}, journal = {Journal of public health in Africa}, volume = {15}, number = {1}, pages = {773}, pmid = {40503462}, issn = {2038-9922}, abstract = {BACKGROUND: In the past 20 years, Nigeria has confronted an array of six significant infectious disease outbreaks, including coronavirus disease 2019 (COVID-19), Lassa fever, meningitis, diphtheria, cholera and Ebola. Although the country has generally managed to address most of these infections effectively, there are still some shortcomings in the nation's public health response.

AIM: This review examined the six most significant outbreaks of infectious diseases and the corresponding public health responses, evaluating the strengths and limitations of the country's public health system.

SETTING: This study focused on Nigeria. Nigeria is regarded as a country with the largest population in Africa.

METHOD: A narrative review approach was employed, which entailed identifying pertinent literature using search terms with various Boolean combinations derived from multiple electronic databases, including PubMed, Google Scholar, the National Institutes of Health (NIH) database, the Web of Science and Africa Journals Online.

RESULTS: The key strengths of Nigeria's public health system include surveillance, workforce development, prevention at entry points, risk communication and establishment of national reference libraries. However, the study also identified several areas of weakness, such as inadequate funding, inadequate efforts at the subnational level, poor coordination between public health and security authorities, a lack of integration between the animal and human health sectors, inadequate biosafety and biosecurity policies and programmes and logistical complexities.

CONCLUSION: Despite the strengths, there are still weaknesses within Nigeria's public health system response to infectious diseases.

CONTRIBUTION: The study outlined the various strengths and weaknesses of the Nigeria Public health system in combating infectious disease. Therefore, it is recommended that funding be increased, poverty and inequalities are addressed, efforts at the subnational level be increased, and a Memorandum of Understanding (MOU) between the public health sector and security authorities be established.}, } @article {pmid40502935, year = {2025}, author = {Chen, K and Weng, R and Li, J and Wu, H and Tie, X and Li, H and Zhang, Y}, title = {Dual threat: Susceptibility mechanisms and treatment strategies for COVID-19 and bacterial co-infections.}, journal = {Computational and structural biotechnology journal}, volume = {27}, number = {}, pages = {2107-2122}, pmid = {40502935}, issn = {2001-0370}, abstract = {COVID-19 has rapidly spread worldwide, posing significant challenges to public health systems. This review offers an in-depth examination of the mechanisms underlying susceptibility and associated clinical features, and treatment strategies associated with bacterial co-infections in COVID-19 patients. A structured review of the literature revealed that the overall rate of bacterial co-infection among COVID-19 patients is relatively low (6.9 %). However, the rate increases significantly in severe cases (8.1 %) and reaches as high as 23.5 % among ICU patients. Common pathogens include Staphylococcus aureus, Streptococcus pneumoniae, and Klebsiella species. These co-infections contribute to increased disease severity, complicate treatment, and elevate the risk of mortality. Meanwhile, the widespread use of antibiotics has further intensified antimicrobial resistance. In terms of clinical management, we propose the "Four Antis and Two Balances" approach, which includes antiviral therapy, anti-shock treatment, prevention of hypoxia, control of secondary infections, as well as maintaining electrolyte/acid-base balance and microecological stability. Emerging therapeutic strategies include antiviral agents, immunomodulators, artificial liver support systems, and cell-based therapies. Public health policy recommendations focus on antimicrobial stewardship programs, biomarker-guided antibiotic use, and investment in rapid diagnostic technologies. Elucidating the immunological, cellular, and molecular mechanisms underlying these interactions will be essential for advancing more targeted intervention strategies. This review provides evidence-based guidance for clinicians in the management of COVID-19 cases complicated by bacterial co-infections, and provides valuable insights for public health policy in addressing the dual challenge of COVID-19 and antimicrobial resistance.}, } @article {pmid40501514, year = {2025}, author = {Yacoub, A and Atalla, M and Hasnaoui, A and Ramdass, PVAK}, title = {Evans Syndrome and COVID-19 Infection or Vaccination: A Systematic Review of Case Reports.}, journal = {Journal of hematology}, volume = {14}, number = {3}, pages = {109-123}, pmid = {40501514}, issn = {1927-1220}, abstract = {Evans syndrome (ES) is an autoimmune disorder of unknown etiology characterized by autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP). In this systematic review, we analyzed the reported cases of ES secondary to coronavirus disease 2019 (COVID-19) infection or COVID-19 vaccination. We examined their clinical presentation, temporality between events, diagnostics tests, and treatment regimens. Our search in four databases from December 2019 to September 2023 yielded 16 case reports that met eligibility criteria for inclusion. COVID-19 and ES symptoms were defined to assess the timeline between infection/vaccination and ES onset. Finally, treatment efficacy was categorized as complete, partial, or no response based on standard hematological criteria. Eleven cases of ES were associated with COVID-19 infection, and five cases of ES were associated with COVID-19 vaccination. All 16 cases presented with anemia, thrombocytopenia, and a positive Coombs test. Four of the five patients from the vaccination subset were found to have an additional autoimmune disease as a comorbidity on presentation. For cases of ES secondary to COVID-19 infection, six patients had concomitant symptoms of COVID-19 and ES on presentation, and four patients had ES symptoms occurring from 5 days to 3 weeks following COVID-19 infection. The remaining case presented a patient with a 3-week history of ES symptoms before a positive COVID-19 test and further ES workup on admission. For the five cases of ES post-COVID-19 vaccination, all five patients presented with ES with a mean presentation time of 9 days following vaccination. Regarding treatment, intravenous immunoglobulin (IVIG) emerged as the primary regimen, administered in 13 out of the 16 cases. Among the infection-related cases, the most frequent treatment outcome was a partial response in both AIHA and ITP, observed in five of the 11 patients. In the vaccination-related cases, a partial response for AIHA and a complete response for ITP were noted in three of the five patients. Overall, while the evidence points to a temporal association especially between COVID-19 vaccination and the onset of ES, larger studies are necessary to strengthen these findings. In terms of management, early initiation of corticosteroids and IVIG appears effective as first-line therapies; however, standardized treatment protocols are needed to help reduce complications associated with COVID-19-related ES.}, } @article {pmid40501312, year = {2025}, author = {Kim, CY and Holroyd, KB and Thakur, KT}, title = {Emerging neuroinfectious diseases: public health implications.}, journal = {Current opinion in neurology}, volume = {38}, number = {4}, pages = {436-442}, doi = {10.1097/WCO.0000000000001401}, pmid = {40501312}, issn = {1473-6551}, mesh = {Humans ; *Public Health ; *Communicable Diseases, Emerging/epidemiology/prevention & control ; COVID-19/epidemiology ; Animals ; Measles/epidemiology ; *Nervous System Diseases/epidemiology ; }, abstract = {PURPOSE OF REVIEW: Direct neurological consequences from emerging and re-emerging infectious diseases such as poliomyelitis, West Nile virus and Zika virus, and those with indirect neurological effects such as COVID-19 and Influenza, are major contributors to the profound impact of infectious diseases on global human health. Here, we highlight select infections of the nervous system of public health significance and discuss some of the key factors of emergence. We focus on vector-borne infections including Oropouche virus and West Nile virus, those transmitted by other nonvector animal species including Nipah and Hendra virus, and vaccine preventable infections including neurological effects of Measles virus.

RECENT FINDINGS: Currently, the emergence of Oropouche virus, Avian Influenza, and the re-emergence of Measles outbreaks across Europe and America, are examples of current emerging infectious disease outbreaks. As pathogens spread to new areas, we will continue to see a rise in populations at risk of severe neurological effects. The recent resurgence of measles virus cases exemplifies the importance of strong vaccination programs and preventive public health measures to mitigate the impact of preventable re-emerging infections in vulnerable populations.

SUMMARY: Neuroinfectious diseases will continue to drive significant morbidity and mortality on global populations as risk factors remain high, and global public health initiatives are hampered by inadequate governmental support.}, } @article {pmid40501150, year = {2025}, author = {Atraszkiewicz, D and Shakir, T and Harrington, C and Bassett, P and Soile, B and Mukhtar, H}, title = {Preoperative anastomotic evaluation prior to ileostomy closure: A 5-year UK survey, systematic review, and meta-analysis.}, journal = {Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland}, volume = {27}, number = {6}, pages = {e70137}, pmid = {40501150}, issn = {1463-1318}, mesh = {Humans ; *Ileostomy/methods/adverse effects ; United Kingdom ; *Anastomosis, Surgical/methods/adverse effects ; *Preoperative Care/methods/statistics & numerical data ; *Practice Patterns, Physicians'/statistics & numerical data ; COVID-19/epidemiology ; Adult ; Male ; Female ; Enema/statistics & numerical data ; Colorectal Surgery/statistics & numerical data ; }, abstract = {AIM: To compare current UK surgical practice against evidence-based anastomotic evaluation techniques prior to ileostomy closure.

METHODS: An online survey was distributed to UK consultant colorectal surgeons with Association of Coloproctology of Great Britain and Ireland affiliation to assess preoperative investigations. Data were collected at two timepoints: 2019 and 2024. A systematic review and meta-analysis were performed utilising PRISMA guidelines. MEDLINE (PubMed), Embase and Education Resources Information Center databases were evaluated from inception to 27 March 2024. Inclusion criteria were adult patients (≥18 years), distal colonic/pelvic anastomosis and defunctioning ileostomy reversal. ROBINS-I bias assessments were conducted. DerSimonian and Laird random-effects analyses were performed on eligible sensitivity and specificity data with forest plots generated.

PROSPERO ID: CRD42024520236.

RESULTS: The survey received 221 (41.0%) and 212 (40.7%) responses in 2019 and 2024 respectively. Pre- and post-pandemic practice was consistent. Water-soluble contrast enema (WCE) and digital rectal examination (DRE) were the most utilised, performed 'always' by 83.2% and 78.7% respectively. Thirty-seven studies (5061 patients) were included for systematic review; 12 studies (1385 patients) for meta-analysis. Studies were heterogeneous in methodology; no randomised controlled trials were identified. Endoscopy showed higher sensitivity (73.1%) compared to retrograde contrast studies (WCE and pouchography; 53.1%) in identifying anastomotic leaks. Specificity was similar: 100% and 98.0% respectively. Significant heterogeneity and a lack of eligible studies limited further interpretation. CT has a limited evidence base for anastomotic evaluation.

CONCLUSIONS: The most commonly performed anastomotic evaluation methods in the UK are WCE and DRE. Endoscopy, however, has a greater sensitivity and specificity for identifying anastomotic complications. WCE is an effective option to confirm suspected leaks. Endoscopy should be considered to evaluate anastomotic integrity prior to ileostomy closure.}, } @article {pmid40500571, year = {2025}, author = {Arévalo-Cañas, C and Arévalo-Serrano, J and de Mon-Soto, MÁ}, title = {First case of lupus induced by the Shingrix vaccine: a case report and literature review.}, journal = {Clinical rheumatology}, volume = {44}, number = {7}, pages = {3119-3125}, pmid = {40500571}, issn = {1434-9949}, mesh = {Humans ; Female ; *Lupus Erythematosus, Systemic/chemically induced/diagnosis/drug therapy ; Aged, 80 and over ; *Herpes Zoster Vaccine/adverse effects ; Antibodies, Antinuclear/blood ; Herpes Zoster/prevention & control ; Prednisone/therapeutic use ; }, abstract = {The recombinant zoster vaccine (Shingrix) was recently approved for the prevention of herpes zoster reactivation in adults aged ≥ 50 years. While its effectiveness has been widely demonstrated, its safety profile and potential adverse effects remain uncertain. We report the first case of lupus induced by the Shingrix vaccine. An 85-year-old woman was evaluated in the hospital due to a pleuropericarditis with pleural and pericardial effusion. Test for anti-nuclear antibody was positive at a titer of 1:640 with a homogeneous pattern, as well as for IgG anti-cardiolipin antibodies. Infectious or malignant etiologies were excluded. A diagnosis of Shingrix vaccine-induced lupus was suspected, and a short course of prednisone was initiated. The patient's symptoms resolved within the first two months, and after one year of follow-up, both the antinuclear and anti-cardiolipin IgG antibodies were negative. Although many drug categories have been associated with the development of drug-induced lupus erythematosus (DILE), it remains unclear whether vaccine-induced immune system upregulation could trigger the onset of systemic lupus. However, particularly after the introduction of the SARS-CoV2 vaccine, cases of cutaneous and systemic lupus induced by vaccines have been reported, and the serological pattern appears to be different from that observed in drug-induced lupus. Our case details a critical adverse effect observed in a patient who received the zoster vaccine. This finding is particularly relevant given the ongoing widespread vaccination campaigns and the global public health implications. Vaccine-induced lupus should be suspected following vaccination in the presence of cutaneous or systemic lupus symptoms, particularly serositis or renal involvement, when no other cause can be identified. The diagnosis is supported by positive antinuclear antibodies and other laboratory abnormalities, such as decreased complement levels or positivity for other antibodies, including antiphospholipid antibodies. Key Points • The varicella-zoster vaccine will be administered to a large percentage of the population, which could lead to an increase in adverse effects that have not yet been described. This article reports the first documented case of lupus induced by the varicella-zoster vaccine. • The diagnosis of Drug-induced lupus erythematosus (DILE) requires a low threshold of suspicion. • Clinical manifestations in DILE are usually milder, and it often presents with general symptoms, arthralgia, serositis, and hematologic abnormalities. • The autoimmune profile of vaccine-induced lupus appears to differ from that of drug-induced lupus, being characterized by a higher frequency of positive antinuclear antibodies (ANA), antiphospholipid antibodies, and hypocomplementemia, with a lower prevalence of anti-histone antibodies.}, } @article {pmid40498907, year = {2025}, author = {Sadigurschi, G and Kuschnir, MCC and Dos Santos, EAP and da Silva, BRA and Marques, CMC and de Andrade, RC and Vianna, CM and de Barros, DG and Mazzi, MT and Lago, EA and Dos Santos, EM and Maia, MLS}, title = {Challenges in developing new tuberculosis vaccines.}, journal = {Memorias do Instituto Oswaldo Cruz}, volume = {120}, number = {}, pages = {e240236}, pmid = {40498907}, issn = {1678-8060}, mesh = {Humans ; *Tuberculosis Vaccines/immunology ; *Vaccine Development ; *Tuberculosis/prevention & control/immunology ; BCG Vaccine/immunology ; *Mycobacterium tuberculosis/immunology ; }, abstract = {Tuberculosis (TB) is a preventable and curable disease caused by the bacillus Mycobacterium tuberculosis. In 2022, according to the World Health Organisation (WHO), TB was the second leading cause of death worldwide caused by a single infectious agent, after coronavirus disease (COVID-19). Brazil is ranked among the 30 countries with the highest TB burden. Currently, the neonatal Bacillus Calmette-Guérin (BCG) is the only vaccine against TB and offers significant efficacy against disseminated and meningeal disease in children. However, BCG has a limited efficacy in preventing adult-type cavitary TB, reinforcing the need for a new effective vaccine against pulmonary TB. There are currently over 22 TB vaccines under evaluation in clinical trials worldwide. Despite significant advancements, several challenges persist in developing and producing an effective TB vaccine. These include understanding the immune mechanisms that confer protection against M. tuberculosis, identifying immune correlates of protection, defining immune responses in BCG-vaccinated individuals, establishing efficacy endpoints for TB vaccine trials, and ensuring vaccine safety and effectiveness in individuals with human immunodeficiency virus (HIV), among other obstacles. Therefore, this study aims to explore the key obstacles in developing new TB vaccines and potential strategies to overcome them.}, } @article {pmid40497942, year = {2025}, author = {Webb, CE and Vautrinot, J and Hers, I}, title = {IL-6 as a Mediator of Platelet Hyper-Responsiveness.}, journal = {Cells}, volume = {14}, number = {11}, pages = {}, pmid = {40497942}, issn = {2073-4409}, support = {FS/4yPhD/F/21/34162/BHF_/British Heart Foundation/United Kingdom ; SP/F/21/150023/BHF_/British Heart Foundation/United Kingdom ; BB/X017176/1//Biotechnology and Biological Sciences Research Council (BBSRC)/ ; }, mesh = {Humans ; *Interleukin-6/metabolism ; *Blood Platelets/metabolism ; COVID-19 ; Signal Transduction ; Thrombopoiesis ; Animals ; Platelet Activation ; Megakaryocytes/metabolism ; Thrombosis ; SARS-CoV-2 ; }, abstract = {Interleukin-6 (IL-6) is a pleiotropic cytokine with critical roles in immune regulation, inflammation, and haematopoiesis. While its functions in host defence and tissue repair are well established, accumulating evidence suggests that IL-6 also can directly and indirectly modulate megakaryocyte and platelet biology. This review examines the mechanistic basis supporting IL-6-mediated platelet hyper-responsiveness, in addition to its effect on megakaryopoiesis and thrombopoiesis in thromboinflammatory disease states. We discuss how IL-6-mediated trans-signalling may sensitizes platelets to activation, and that this may be exclusive to glycoprotein VI (GPVI) stimulation due to Janus kinase (JAK)-signal transducer 2 crosstalk, in addition to other mechanisms that may contribute to priming platelets. We further highlight clinical evidence linking IL-6 to thrombotic complications in cardiovascular disease and infection (e.g., COVID-19 and sepsis). Given the emerging interest in IL-6-targeting therapies as anti-inflammatory and anti-thrombotic agents, a thorough understanding of how IL-6 can drive platelet responsiveness is crucial.}, } @article {pmid40497938, year = {2025}, author = {Batista, JC and DeAntonio, R and López-Vergès, S}, title = {Dynamics of Innate Immunity in SARS-CoV-2 Infections: Exploring the Impact of Natural Killer Cells, Inflammatory Responses, Viral Evasion Strategies, and Severity.}, journal = {Cells}, volume = {14}, number = {11}, pages = {}, pmid = {40497938}, issn = {2073-4409}, mesh = {Humans ; *COVID-19/immunology/virology/pathology ; *Immunity, Innate/immunology ; *Killer Cells, Natural/immunology ; *SARS-CoV-2/immunology ; *Inflammation/immunology ; *Immune Evasion ; Severity of Illness Index ; Cytokines/metabolism/immunology ; Cytokine Release Syndrome/immunology ; }, abstract = {The COVID-19 pandemic, caused by SARS-CoV-2, has had a profound impact on global health, with nearly 800 million cases reported in the Americas alone. The clinical presentation of the disease is highly variable, with approximately half of all patients experiencing severe symptoms. This variability confounds the complex interplay between immune responses and disease severity. Severe cases are often characterized by elevated levels of inflammatory cytokines. Over 88% of COVID-19 patients have multiple comorbidities; factors such as age and pre-existing conditions further modulate immune responses and contribute to the severity of the disease. While some studies have reported differences in cytokine profiles between severity groups, larger, well-designed cohorts are needed to clarify these relationships. Natural Killer cells, which are critical for the innate immune response against SARS-CoV-2, are often impaired and contribute to immune exhaustion. In addition, SARS-CoV-2 evades innate immune defenses through accessory proteins that inhibit interferon signaling and exacerbate cytokine storms and inflammation. This integrative review aims to synthesize findings from 2020 onward and provide insights into the innate immune responses induced by SARS-CoV-2 and their contributions to disease pathogenesis. Understanding cytokine dynamics, NK cell behaviors, and viral immune evasion strategies is critical for advancing therapeutic approaches.}, } @article {pmid40497110, year = {2025}, author = {Aporosa, SA and Itoga, D and Ioane, J and Prosser, J and Vaka, S and Grout, E and Atkins, MJ and Head, MA and Baker, JD and Blue, T and Sanday, DH and Owen, MW and Murray, C and Sivanathan, K and Cuthers, TW and Mesui-Henry, A and McCarthy, MJ and Bunn, J and Waqainabete, I and Turner, H}, title = {Innovating through tradition: kava-talanoa as a culturally aligned medico-behavioral therapeutic approach to amelioration of PTSD symptoms.}, journal = {Frontiers in psychology}, volume = {16}, number = {}, pages = {1460731}, pmid = {40497110}, issn = {1664-1078}, support = {R15 DA051749/DA/NIDA NIH HHS/United States ; }, abstract = {Levels of post-traumatic stress disorder (PTSD), trauma-related distress, and subsyndromal PTSD, (here "PTS") among combat soldiers and first responders are of international concern. In the broader population, a PTS global epidemic is attending trauma associated with the threatscape of the Anthropocene (increased extreme weather events, natural disasters, conflict, rising poverty, emerging infectious disease) as well as the legacy of the COVID-19 pandemic. PTS is also a health economic burden, with costs associated with treatment, long-term morbidity, and increased risk of mortality. In the Pacific region, rising PTS is associated with the existential threat of climate change and the economic and social legacy of colonization. There is an unmet therapeutic need for improved and culturally aligned PTS therapies in the Pacific and beyond. Medical standards of care for anxiety/PTS typically involve psychotropic interventions such as benzodiazepines (BDZ), tricyclic anti-depressants and anti-psychotic medications which have addictive potential, are only effective in the short term, are contraindicated for key populations such as the elderly and have significantly problematic track records in indigenous populations. Moreover, systemic racism both drives PTS in indigenous and other marginalized populations and limits the efficacy in such populations of conventional PTS therapies which are not culturally relevant or informed. Here, we describe the development of a novel, but traditionally grounded, approach to PTSD symptomatology in the context of Pacific populations. This approach has two elements: kava is a culturally significant Pacific drink used traditionally and in cultural practice, as a relaxant, to promote dialog in group settings, to aid in sleep and to manage anxiety. Its anxiolytic and sedative properties may link to the presence of kavalactones which are putative low potency γ-aminobutyric acid (GABA) ligands. Talanoa is a dialog practice common to most Pacific cultures. Our core hypothesis is that, combined, kava-talanoa will outperform current standards of care in PTSD symptom management as a culturally augmented cognitive-behavioral group therapy intervention. In this paper we review supporting literature, describe kava-talanoa pilot study findings and planned clinical trials, discuss important open questions, and present recommendations for broad-based transcultural applicability of this approach to global PTS burdens.}, } @article {pmid40496907, year = {2024}, author = {Gotum, T and Keeratisiroj, O and Jariya, W}, title = {Prevalence of musculoskeletal symptoms from online learning during the COVID-19 epidemic: a systematic review and meta-analysis.}, journal = {F1000Research}, volume = {13}, number = {}, pages = {790}, pmid = {40496907}, issn = {2046-1402}, mesh = {Humans ; *COVID-19/epidemiology ; *Education, Distance ; Prevalence ; SARS-CoV-2 ; *Musculoskeletal Pain/epidemiology ; Adolescent ; *Musculoskeletal Diseases/epidemiology ; Adult ; Young Adult ; Students ; Middle Aged ; }, abstract = {PURPOSE: The objective of this research was to assess the prevalence of musculoskeletal symptoms in online students.

MATERIALS AND METHODS: A systematic review and meta-analysis were performed by searching the PubMed, Cochrane Library, SCOPUS, Web of Science, ScienceDirect, ProQuest, CINAHL plus with full text, and Wiley InterScience databases. A total of 3,749 studies were identified between January 2020 and December 2023. The Joanna Briggs Tool for studies reporting prevalence was used to assess the quality of studies. Jamovi 2.4 was used in the meta-analysis.

RESULTS: Sixteen studies were included and used for the meta-analysis. The average age of participants was 22 years, with an age range of 17-45 years, Sample range 120-3,705. There were 6 studies of high quality, 9 studies of medium quality and 1 study of low quality. The areas with the highest prevalence of musculoskeletal pain were the neck (51%, 95% CI = 36-66%, I [2] = 99.96), lower back (51%, 95% CI = 42-59%, I [2] = 99.96) and shoulder (36%, 95% CI = 26-47%, I [2] = 99.61).

CONCLUSIONS: The shift to online learning during the COVID-19 pandemic has emerged as a potential factor influencing musculoskeletal pain in students. Educational institutions should study the duration of online learning that begins to impact student injury outcomes.}, } @article {pmid40496592, year = {2025}, author = {E-Fatima, J and Khan, FI and Lai, D}, title = {Exploring serum and glucocorticoid-regulated kinase 1: A promising target for COVID-19 and atrial fibrillation treatment.}, journal = {Heart rhythm O2}, volume = {6}, number = {5}, pages = {720-732}, pmid = {40496592}, issn = {2666-5018}, abstract = {Serum and glucocorticoid-regulated kinase 1 (SGK1) is a serine/threonine kinase that is involved in various cellular pathways, such as ion transport, cell survival, proliferation, and immune responses. Dysregulation of this enzyme is increasingly being associated with the progression of 2 prominent types of diseases, namely viral infections, such as COVID-19, and cardiovascular disorders, such as atrial fibrillation (AF), positioning it as a potential therapeutic target. With regard to coronavirus 2019 (COVID-19), SGK1 detrimentally affects inflammatory pathways and modulates the cytokine storm, leading to lung tissue damage. Considering this dysregulation, researchers are exploring SGK1 inhibition as a potential strategy for mitigating severe COVID-19 outcomes. SGK1 also regulates pumps and ion channels, significantly affecting cardiac performance in AF. This protein is responsible for promoting fibrosis and inflammation in the cardiac tissue, making it a potential target for reducing atrial fibrillation. SGK1 inhibition offers a new avenue for therapeutic targets against both COVID-19 and AF. This review is aimed at providing a comprehensive overview of SGK1 dysregulation in both diseases, underscoring the urgent need for more preclinical and clinical trials to evaluate effective SGK1 inhibitors for patients with coexisting COVID-19 and AF.}, } @article {pmid40496528, year = {2024}, author = {Akbari, B and Wang, JM and Baghaei-Yazdi, N and Lahooti, H and Sherman, JH}, title = {Systems Thinking, Causal Loop Diagram, and Systems Dynamic in Public Health Challenges: Navigating Long COVID Syndrome and Sense of Smell in LGBTQIA+ Communities.}, journal = {Public health challenges}, volume = {3}, number = {3}, pages = {e70004}, pmid = {40496528}, issn = {2769-2450}, abstract = {BACKGROUND: The coronavirus pandemic has profoundly affected global health, economic stability, and environmental sustainability. Despite these challenges, significant gaps in data remain, particularly in effectively assessing and engaging diverse communities such as color, LGBTQIA+ individuals, and low-income groups. This shortage of comprehensive research limits our capacity to undertake sensitive studies, specifically in dealing with the complexities of long COVID, which some individuals continue to suffer from after their initial recovery.

OBJECTIVE: This review delves into the ongoing repercussions of long-term COVID-19, a postinfectious syndrome marked by neurological symptoms such as cognitive deficits and sensory impairments, which may last well beyond the acute phase of the illness. These symptoms frequently overlap with mental health issues (e.g., anxiety and depression), which can aggravate the socioeconomic challenges faced by vulnerable populations, especially within the LGBTQA+ communities.

METHODS: To tackle these complex interactions, we have introduced a novel public health framework: model-based systems thinking (MBST), which incorporates System Dynamics and causal loop diagrams (CLD).

RESULTS AND DISCUSSION: The articles were selected on the basis of their discussion of COVID-19-associated anosmia, exploration of olfactory dysfunction alongside neurocognitive disorders, and the challenges experienced in LGBQA+ communities. This approach offers a robust framework for dissecting the intricate ties between socioeconomic factors, health outcomes, and the extended recovery trajectories associated with long-term COVID-19, with a particular focus on olfactory dysfunction. We also explore strategies to make our models more accessible to healthcare providers and the LGBTQA+ communities, encouraging its broader adoption.

CONCLUSION: Long COVID's impact on public health and marginalized communities highlights the urgent need for adopting systems thinking models. Additionally, this article calls for a concerted effort from all experts to foster multidisciplinary, team-based research and implement effective support measures for COVID-19 survivors across all communities, mainly focusing on the scientific, social, and behavioral challenges LGBTQIA+ and low-income individuals face.}, } @article {pmid40496119, year = {2025}, author = {Kunjavara, J and George, RJ and L, MK and Sam, ST and Mannethodi, K}, title = {Unbreakable in Crisis: A Systematic Review Exploring Nurse Resilience and Contributing Factors During the COVID-19 Pandemic.}, journal = {Public health challenges}, volume = {4}, number = {1}, pages = {e70015}, pmid = {40496119}, issn = {2769-2450}, abstract = {The coronavirus disease 2019 (COVID-19) placed an unprecedented burden on the global healthcare system, severely affecting the physical and mental health of healthcare workers, particularly nurses. Nurses faced immense workloads, increased infection risks, uncertainty, and public scrutiny. Despite these challenges, nurses were lauded for their dedication and resilience in confronting the pandemic. Many experienced mortality, morbidity, and post-COVID sequelae. This review integrates psychological resilience literature from 2020 to 2022, utilizing Whittemore and Knafl's integrative review method. A total of 22 studies met the inclusion criteria, focusing on how nurses demonstrated resilience during the COVID-19 crisis. Most studies reported a moderate level of resilience, with a mean score of 62.54. Factors such as positive acceptance of change, trust in personal judgment, perceived competence, and spiritual influences were positively associated with resilience, whereas burnout, anxiety, and depressive thoughts negatively impacted it. Resilience was found to mediate the relationships between variables like perceived stress, emotional exhaustion, and quality of life. The literature suggests that healthcare administrations should foster a healthy work environment, maintain an optimistic outlook, and establish strong connections with frontline staff to mitigate the pandemic's impact. Providing supportive environments, resilience training, and mental health interventions will be crucial in enhancing resilience for future crises.}, } @article {pmid40495805, year = {2025}, author = {Liu, Y}, title = {Is SARS-CoV-2 facing constraints in its adaptive evolution?.}, journal = {Biomolecules & biomedicine}, volume = {25}, number = {11}, pages = {2407-2415}, pmid = {40495805}, issn = {2831-090X}, mesh = {Humans ; *SARS-CoV-2/genetics/physiology/pathogenicity ; *COVID-19/virology/transmission ; Spike Glycoprotein, Coronavirus/genetics/metabolism ; *Evolution, Molecular ; Mutation ; Selection, Genetic ; Immune Evasion ; }, abstract = {The ultimate measure of viral fitness is the ability to maintain high prevalence within its host species. Effective transmission, efficient replication, and rapid immune evasion all contribute to this outcome. Over the past five years, SARS-CoV-2 has successfully adapted to humans, establishing long-term reservoirs and enabling sustained coexistence with the human population. We have observed innovative, synergistic mutations in the spike (S) protein that enhance receptor binding. Adaptation to the upper respiratory tract has shortened the incubation period, thereby facilitating viral spread. These improvements have also enabled immune escape mutations, even when such changes compromise replicative fitness. Adaptive mutations have driven intermittent selective sweeps by dominant variants. However, there are limits to functional enhancement. The receptor binding affinity of the S protein appears to have peaked between 2022 and 2023. The accumulation of fixed mutations plateaued following the emergence of BA.2.86/JN.1 around late 2023 and early 2024. Purifying selection has been the dominant evolutionary force acting on nonsynonymous mutations in the Omicron lineage, and the overall fitness impact of missense mutations in key viral proteins has declined. Additionally, due to weak selection pressure on synonymous mutations, the codon adaptation index in humans has been decreasing among Omicron subvariants. As a result, Omicron lineages have replicated less efficiently in cell cultures compared to the original virus, and recent variants show further attenuation in animal models. In the human population, this attenuation is reflected in declining COVID-19-related mortality, despite persistently high infection rates.}, } @article {pmid40495641, year = {2025}, author = {Stoevesandt, J and Schmalzing, M and Mohme, S and Goebeler, M}, title = {Vaccination in dermatology 2025: Update considering current recommendations of the German Standing Committee on Vaccination.}, journal = {Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG}, volume = {23}, number = {8}, pages = {925-930}, pmid = {40495641}, issn = {1610-0387}, mesh = {Adult ; Humans ; *COVID-19/prevention & control ; COVID-19 Vaccines/administration & dosage ; *Dermatology/standards ; Germany ; Immunocompromised Host ; *Practice Guidelines as Topic ; *Skin Diseases/immunology ; *Vaccination/standards ; }, abstract = {The immunosuppressive and immunomodulatory treatment of dermatological patients necessitates the regular review and updating of standard vaccinations and vaccines indicated for specific conditions. The German Standing Committee on Vaccination (STIKO) at the Robert Koch Institute regularly publishes evidence-based vaccination recommendations, which are adapted to the current epidemiological situation and availability of vaccines. Since 2020, several changes have been made that are relevant for patients with dermato(onco)logical diseases: (1) COVID-19 was defined as a new viral disease and several vaccines have been introduced; (2) in response to the global Mpox outbreak in 2022, a non-replicating live vaccine based on the modified Ankara vaccinia virus, which was approved in 2013 for the prevention of smallpox, was given an indication extension; (3) a new inactivated high-dose vaccine was approved for influenza vaccination of persons aged 60 years and older; (4) a new 20-valent conjugate vaccine is available for pneumococcal vaccination; (5) two recombinant vaccines against the respiratory syncytial virus (RSV) were recently approved. This article discusses the correspondingly adapted STIKO recommendations for adults, with particular emphasis on their implementation in immunocompromised patients in dermatology.}, } @article {pmid40494170, year = {2025}, author = {Alghadhban, A and Ramadan, RA and Alazmi, M}, title = {Advancing respiratory disease diagnosis: A deep learning and vision transformer-based approach with a novel X-ray dataset.}, journal = {Computers in biology and medicine}, volume = {194}, number = {}, pages = {110501}, doi = {10.1016/j.compbiomed.2025.110501}, pmid = {40494170}, issn = {1879-0534}, mesh = {Humans ; *COVID-19/diagnostic imaging ; *Deep Learning ; *Respiratory Tract Diseases/diagnostic imaging ; SARS-CoV-2 ; }, abstract = {With the increasing prevalence of respiratory diseases such as pneumonia and COVID-19, timely and accurate diagnosis is critical. This paper makes significant contributions to the field of respiratory disease classification by utilizing X-ray images and advanced machine learning techniques such as deep learning (DL) and Vision Transformers (ViT). First, the paper systematically reviews the current diagnostic methodologies, analyzing the recent advancement in DL and ViT techniques through a comprehensive analysis of the review articles published between 2017 and 2024, excluding short reviews and overviews. The review not only analyses the existing knowledge but also identifies the critical gaps in the field as well as the lack of diversity of the comprehensive and diverse datasets for training the machine learning models. To address such limitations, the paper extensively evaluates DL-based models on publicly available datasets, analyzing key performance metrics such as accuracy, precision, recall, and F1-score. Our evaluations reveal that the current datasets are mostly limited to the narrow subsets of pulmonary diseases, which might lead to some challenges, including overfitting, poor generalization, and reduced possibility of using advanced machine learning techniques in real-world applications. For instance, DL and ViT models require extensive data for effective learning. The primary contribution of this paper is not only the review of the most recent articles and surveys of respiratory diseases and DL models, including ViT, but also introduces a novel, diverse dataset comprising 7867 X-ray images from 5263 patients across three local hospitals, covering 49 distinct pulmonary diseases. The dataset is expected to enhance DL and ViT model training and improve the generalization of those models in various real-world medical image scenarios. By addressing the data scarcity issue, this paper paves the for more reliable and robust disease classification, improving clinical decision-making. Additionally, the article highlights the critical challenges that still need to be addressed, such as dataset bias and variations of X-ray image quality, as well as the need for further clinical validation. Furthermore, the study underscores the critical role of DL in medical diagnosis and highlights the necessity of comprehensive, well-annotated datasets to improve model robustness and clinical reliability. Through these contributions, the paper provides the basis and foundation of future research on respiratory disease diagnosis using AI-driven methodologies. Although the paper tries to cover all the work done between 2017 and 2024, this research might have some limitations of this research, including the review period before 2017 might have foundational work. At the same time, the rapid development of AI might make the earlier methods less relevant.}, } @article {pmid40493066, year = {2025}, author = {Chryssofos, S and Jeong, D and Yaeger, L and Badran, S}, title = {Surgical Care in the Era of Mpox Clade I: A Review and Call for Preparedness.}, journal = {The American surgeon}, volume = {}, number = {}, pages = {31348251351001}, doi = {10.1177/00031348251351001}, pmid = {40493066}, issn = {1555-9823}, abstract = {The Mpox virus, formerly known as Monkeypox, was declared a Public Health Emergency of International Concern in July 2022 due to its rapid global spread. By 2024, the more virulent and fatal Clade Ib variant had reached the United States. While Mpox typically presents with a self-limited rash, severe manifestations requiring surgical intervention have become increasingly prevalent, necessitating heightened awareness and preparedness among surgeons.This narrative review, specifically targeting surgeons, provides a comprehensive summary of the current data on the epidemiology, pathophysiology, perioperative considerations, and surgical management of Mpox-related conditions. It outlines essential hospital protocols and perioperative precautions to mitigate nosocomial spread, drawing useful parallels with measures established for COVID-19. It also addresses Mpox-related surgical pathologies, including colorectal abscesses, cutaneous scarring, facial lesions, and ocular complications, detailing management strategies for each.Our findings emphasize the need for rigorous infection control measures, early recognition of surgical indications, and interdisciplinary coordination to optimize patient outcomes, especially since Mpox is most readily transmitted among immunocompromised individuals, such as those who have undergone solid organ transplants. The virus primarily spreads through sexual transmission and contact with infected skin lesions, necessitating standardized hospital protocols to minimize its spread, particularly in operating rooms. Colorectal manifestations often require surgical drainage, with colostomy being necessary in severe cases, while ophthalmic manifestations demand prompt and aggressive management to preserve vision. Airway management and anesthetic planning are also critical considerations in cases involving oropharyngeal Mpox lesions.This review highlights the urgent need for ongoing documentation and research to refine surgical management protocols for Mpox, enhancing preparedness for future outbreaks. The complexity and severity of Mpox-related surgical pathologies underscore the necessity for further studies to refine management strategies, develop innovative treatments, and improve patient outcomes. Future research should aim to deepen our understanding of Mpox pathophysiology and optimize protocols to ensure safe and effective care for affected patients. This is essential in an era marked by the threat of emerging infectious diseases and the lessons learned from recent global health crises.}, } @article {pmid40492581, year = {2025}, author = {Vlaming-van Eijk, LE and Tang, G and Bourgonje, AR and den Dunnen, WFA and Hillebrands, JL and van Goor, H}, title = {Post-COVID-19 condition: clinical phenotypes, pathophysiological mechanisms, pathology, and management strategies.}, journal = {The Journal of pathology}, volume = {266}, number = {4-5}, pages = {369-389}, pmid = {40492581}, issn = {1096-9896}, mesh = {Humans ; *COVID-19/complications/therapy/physiopathology/pathology ; Phenotype ; SARS-CoV-2 ; Risk Factors ; Post-Acute COVID-19 Syndrome ; }, abstract = {Post-COVID-19 condition (PCC), also known as long COVID, is a complex multiple organ system condition that can develop and persist for months after acute COVID-19. PCC encompasses a wide range of symptoms, resulting in heterogeneous clinical manifestations. These manifestations likely arise from diverse underlying pathophysiological mechanisms, which, in turn, are influenced by risk factors such as age, sex, and comorbidities. To this end, characterising clinical phenotypes of PCC is essential for deepening our understanding of its (potentially) distinct pathophysiological mechanisms and for advancing diagnostic and patient-tailored management strategies. PCC is thought to result from a complex interaction of various pathophysiological mechanisms, leading to functional and structural pathological alterations across multiple organ systems. Investigating these alterations is critical to improving our currently incomplete understanding of PCC's complex pathophysiology. This review provides an overview of the main clinical phenotypes of PCC, characterises these phenotypes by examining symptoms and signs, as well as the associated risk factors. The main hypothesised pathophysiological mechanisms are discussed by outlining the current knowledge on PCC pathology, focussing on the most commonly affected organ systems. Current PCC management includes supportive care such as physiotherapy and the repurposing of existing drugs primarily targeting persistence of SARS-CoV-2 (e.g. antivirals, monoclonal antibodies) and immune dysfunction (e.g. antiinflammatory drugs, immunomodulators). To date, prevention of SARS-CoV-2 infection remains critical, which can be achieved through effective public health measures and vaccination strategies. Finally, this review highlights current knowledge gaps and proposes future research directions to advance the understanding and treatment of PCC. © 2025 The Author(s). The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.}, } @article {pmid40491997, year = {2025}, author = {Rosa, RJ and Andrade, RLP and Perticarrara Ferezin, L and de Campos, MCT and Moura, HSD and Berra, TZ and Ribeiro, NM and Teibo, TKA and Vinci, ALT and Mendes Delpino, F and Torres, MÁF and Arcêncio, RA}, title = {Risk perception of severity or death from COVID-19: a systematic review of the factors associated.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1543629}, pmid = {40491997}, issn = {2296-2565}, mesh = {Humans ; *COVID-19/mortality/psychology ; Severity of Illness Index ; SARS-CoV-2 ; Female ; Male ; Risk Factors ; Sex Factors ; }, abstract = {BACKGROUND: Health risk perception and factors associated with the severity or death from COVID-19 were key elements that influenced individuals' protective behaviors during the pandemic. Understanding these perceptions is crucial for public health guidelines that encourage preventive measures and improve an outbreak response strategy. Thus, this systematic review aimed to identify factors associated with the perception of risk of severity or death from COVID-19.

METHODS: A systematic review was conducted with an article search performed in March 2024 across five databases, utilizing both controlled and free vocabulary. Studies published from 2020 onward were included. Two reviewers independently selected articles, with disagreements resolved by a third reviewer. The data were extracted using a structured form, and the findings were synthesized narratively. The studies included in the review underwent a methodological quality assessment using tools proposed by the Joanna Briggs Institute.

RESULTS: Nineteen articles were included in the review. Among the factors most frequently associated with the perception of severe illness or death from COVID-19 were advanced age, female gender, personal experience or witnessing of adverse COVID-19 outcomes, the presence of chronic non-communicable diseases, and lower educational attainment.

CONCLUSION: The study highlights that the perception of risk for COVID-19 severity or death varied according to age, gender, and prior experiences with the disease. Such findings can guide healthcare practices and contribute to the formulation of public policies, strengthening responses to future public health crises.

identifier CRD42024444734, https://www.crd.york.ac.uk/PROSPERO/view/CRD42024444734.}, } @article {pmid40491910, year = {2025}, author = {Song, J and Wang, Y and Xie, Z and Wei, J and Wang, J}, title = {Review of the mechanism of infection induced cerebral small vessel disease.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1594891}, pmid = {40491910}, issn = {1664-3224}, mesh = {Humans ; *Cerebral Small Vessel Diseases/etiology/virology/immunology/pathology ; *COVID-19/complications/immunology/virology ; *SARS-CoV-2 ; Animals ; Blood-Brain Barrier ; Zika Virus Infection/complications/immunology ; HIV Infections/complications/immunology ; Hepatitis C/complications/immunology ; Zika Virus ; }, abstract = {Cerebral small vessel disease (CSVD) refers to a group of pathological syndromes that affect the brain's microcirculation. These conditions involve damage to small arteries, arterioles, capillaries, venules, and small veins. Cerebrovascular risk factors, immunosenescence, and inflammatory responses contribute to the pathogenesis of cerebral small vessel disease. The global impact of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has drawn significant attention to chronic inflammation caused by infections. Research into the mechanisms by which infections induce CSVD has made continual advancements. It is imperative to reassess the importance of managing infections and the chronic inflammatory phase that follows, highlighting their critical role in the pathogenesis. Our focus encompasses SARS-CoV-2, Human Immunodeficiency Virus (HIV), Hepatitis C Virus (HCV), Zika Virus(ZIKV), Treponema pallidum, as well as the microbial communities within the gut and oral cavity. These pathogen infections and chronic inflammation can contribute to CSVD through mechanisms such as neuroinflammation, blood-brain barrier disruption, microthrombosis, and endothelial cell damage, thereby promoting the occurrence and progression of the disease. This highlights the need for detailed mechanistic research on CSVD associated with these pathogens. Furthermore, we hope that in the future, we will be able to devise targeted prevention and treatment strategies for CSVD based on the unique characteristics of the pathogenic mechanisms associated with various infections.}, } @article {pmid40491760, year = {2025}, author = {Liu, L and Wu, L and Chen, Y and Deng, R and Hu, Y and Tu, Y and Fang, B}, title = {Clinical management of sepsis-associated acute respiratory distress syndrome: current evidence and future directions.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1531275}, pmid = {40491760}, issn = {2296-858X}, abstract = {Sepsis is a life-threatening condition characterized by organ dysfunction resulting from a dysregulated host response to infection. The lungs are among the first and most significantly affected organs in sepsis. Pulmonary infections or systemic inflammatory cascades triggered by various pathogens can lead to acute and diffuse pulmonary damage, often manifesting as persistent hypoxemia. The COVID-19 pandemic has highlighted critical knowledge gaps in SA-ARDS management, necessitating paradigm reevaluation under the new global definition of ARDS. This paper analyzes the pathomechanisms and subphenotype characteristics of SA-ARDS, reviews recent advances in clinical management, such as fluid resuscitation, antimicrobial therapy, immune modulation, respiratory support, microcirculatory improvement, and traditional Chinese medicine (TCM) therapies, and addresses controversial issues and areas requiring further investigation.}, } @article {pmid40491607, year = {2025}, author = {Schapira, K and Govind, A and Lakhi, N}, title = {The Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on Postgraduate Training in Obstetrics and Gynaecology: A Global Perspective.}, journal = {Cureus}, volume = {17}, number = {5}, pages = {e83783}, pmid = {40491607}, issn = {2168-8184}, abstract = {This paper reviews survey studies to assess the global impact of the coronavirus disease 2019 (COVID-19) pandemic on obstetrics and gynaecology (O&G) training from the perspectives of trainees and programme directors (PDs). An electronic literature review of the PubMed database was conducted from March 2020 to December 2024 for topics pertaining to the COVID-19 pandemic and trainee education to identify pertinent validated and non-validated survey studies. Ten studies were identified that analysed the impact of the COVID-19 pandemic on postgraduate training in O&G. All 10 studies utilised non-validated questionnaires. Two studies (total respondents: N=182) assessed the viewpoint of O&G PDs, and eight studies (total respondents: N=1416) solicited the perspectives of postgraduate trainees (PGTs) in O&G. Countries represented include Brazil, the European Union (EU) (encompassing 25 different countries), Germany, India, Italy, Sweden, Turkey, the United Kingdom, and the United States. The themes identified were as follows: (1) trainee reassignment, (2) restructuring of didactic and research activities, and (3) loss of clinical training opportunities within the specialty and its impact on trainees' mental health. Understanding this impact is key to enable better planning in similar pandemics in the future. The review suggests that there were both positive and negative impacts of the pandemic that may forever shape trainee education.}, } @article {pmid40491355, year = {2025}, author = {Gentry, MT and Beito, AH and Hilty, DM}, title = {Telehealth Competencies to Ensure Health Care Access, Quality, and Equity for Older Adults: A Scoping Review.}, journal = {Telemedicine journal and e-health : the official journal of the American Telemedicine Association}, volume = {}, number = {}, pages = {}, doi = {10.1089/tmj.2025.0080}, pmid = {40491355}, issn = {1556-3669}, abstract = {Background: During the COVID-19 pandemic, increased use of telehealth expanded access to health care for older adults. Many clinicians and health systems adjusted workflows and realized that certain competencies are needed to fully engage older adults in telehealth services. This scoping review evaluates the approaches needed to educate clinicians about providing telehealth services to older adults. Methods: We conducted a review of studies published from January 2000 through February 2024 by using the 6-stage scoping review process. Searches of PubMed/MEDLINE and five other databases included the concept areas of competencies, telehealth delivery of mental health services, and older adults. Results: We initially identified 813 articles, of which 89 were eligible for full-text review and 15 met our inclusion criteria. Most studies included training participants about the use of telehealth but without formal curricular interventions or evaluations and lacked details about topics, materials, methods, or outcomes. Telehealth training was general and focused primarily on the use of technology and telepresence, although not specifically for older adults. Three themes were identified from the studies: the role of teams and interprofessional education, the importance of training for clinicians and older patients, and adaptations to improve telehealth delivery for older adults. Conclusions: Individual and institutional competencies are needed to guide educational goals and outcome measures related to telehealth services for older adults. The use of telehealth specifically for older adults may require adaptation to clinical practice and delivery, adjustments to workflow, development of clinician skills, and promotion of interprofessional teamwork.}, } @article {pmid40491233, year = {2025}, author = {Ito, Y and Takazono, T and Namie, H and Tashiro, M and Kakeya, H and Miyazaki, Y and Mukae, H and Mikamo, H and Fukuda, T and Shibuya, K and Izumikawa, K}, title = {Incidence of Coronavirus Disease 2019-Associated Pulmonary Aspergillosis and Specialist Involvement in Its Diagnosis in Japan: A Nationwide Survey and Literature Review.}, journal = {Mycoses}, volume = {68}, number = {6}, pages = {e70077}, doi = {10.1111/myc.70077}, pmid = {40491233}, issn = {1439-0507}, support = {//Ministry of Health, Labour, and Welfare (MHLW) Research on Emerging and Re-emerging Infectious Diseases and Immunization/ ; }, mesh = {Humans ; *COVID-19/complications/epidemiology/diagnosis ; Japan/epidemiology ; Incidence ; *Pulmonary Aspergillosis/epidemiology/diagnosis ; Surveys and Questionnaires ; SARS-CoV-2 ; Galactose/analogs & derivatives ; Mannans/analysis ; Pulmonologists/statistics & numerical data ; }, abstract = {BACKGROUND: Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) has been reported worldwide. However, studies in Japan are limited, and no study has evaluated the relationship between the incidence of CAPA and specialist involvement in its diagnosis.

OBJECTIVES: We aimed to obtain new epidemiological data on CAPA in Japan and evaluate the relationship between the incidence of CAPA and specialist involvement in its diagnosis.

METHODS: A survey was conducted among chief physicians at 760 training hospitals with at least 100 beds and accredited by the Japanese Respiratory Society or the Japanese Association for Infectious Diseases. Critical patients with COVID-19 diagnosed with CAPA between 1 January 2020 and 31 August 2023 were analysed. A literature review was conducted to evaluate the correlations between the incidence of CAPA and galactomannan (GM) testing and positivity rates.

RESULTS: Responses were obtained from 221 of the 760 hospitals (29.1%). The incidence of CAPA was 0.67% (69/10,276). Hospitals with patients with CAPA had significantly more pulmonologists and infectious disease specialists than those without patients with CAPA. A strong positive correlation was observed between the incidence of CAPA and the number of pulmonologists per critical patient with COVID-19 (r = 0.824, p < 0.001). The literature review showed that bronchoalveolar lavage fluid GM testing rate was a strong positive correlation with the incidence of CAPA (r = 0.527, p = 0.014).

CONCLUSIONS: For the diagnosis of CAPA, its recognition by specialists primarily involved in managing critical patients with COVID-19 seems essential.}, } @article {pmid40491090, year = {2025}, author = {Wang, S and Zhang, S and Liu, J}, title = {Resurgence of pertussis: Epidemiological trends, contributing factors, challenges, and recommendations for vaccination and surveillance.}, journal = {Human vaccines & immunotherapeutics}, volume = {21}, number = {1}, pages = {2513729}, pmid = {40491090}, issn = {2164-554X}, mesh = {Humans ; *Whooping Cough/epidemiology/prevention & control ; *Pertussis Vaccine/administration & dosage/immunology ; *Vaccination ; Bordetella pertussis/immunology/genetics ; *COVID-19/epidemiology/prevention & control ; Global Health ; Immunization Programs ; Epidemiological Monitoring ; Incidence ; Infant ; World Health Organization ; }, abstract = {Pertussis, a respiratory disease caused by Bordetella pertussis, remains a global health challenge despite decades of vaccination. The inclusion of diphtheria, tetanus, and whole-cell pertussis (DTwP) vaccines in the World Health Organization (WHO) Expanded Program on Immunization (EPI) in 1974 significantly reduced incidence worldwide. However, since the 1980s, pertussis resurgence has been observed in both high-income and low- and middle-income nations. The COVID-19 pandemic further disrupted vaccination, exacerbating outbreaks. Contributing factors include genetic mutations in Bordetella pertussis, vaccine differences, waning immunity, inadequate immunization, disease cyclicity, and the impact of the COVID-19 pandemic, coupled with improved surveillance, diagnostics, and awareness. Pertussis continues to impose a substantial disease burden, with infants being the most vulnerable. This review examines pertussis epidemiology from 1980 to 2023, analyzing resurgence drivers and evaluating current progress and persistent challenges in vaccination strategies and surveillance efforts.}, } @article {pmid40490654, year = {2025}, author = {Tao, Y and Yang, Y and Luo, B and Lian, D and Weng, J and Li, F and Yan, J and Chen, Y}, title = {Did Economic Evaluations on Pharmaceuticals and Vaccination for COVID-19 Maintain Adequate Reporting Quality? A Systematic Review and Quantitative Analysis.}, journal = {Journal of evidence-based medicine}, volume = {18}, number = {2}, pages = {e70040}, doi = {10.1111/jebm.70040}, pmid = {40490654}, issn = {1756-5391}, mesh = {Humans ; *COVID-19/prevention & control/economics ; *COVID-19 Vaccines/economics ; *Cost-Benefit Analysis ; SARS-CoV-2 ; *COVID-19 Drug Treatment ; *Vaccination/economics ; }, abstract = {AIM: This study seeks to assess the reporting quality of published health economic evaluations (HEEs) on vaccination and pharmaceuticals for Coronavirus Disease 2019 (COVID-19), and identify potential predictors associated with reporting quality.

METHODS: A systematic literature search was performed in PubMed, Web of Science, Embase, the Cochrane Library, INAHTA, and Chinese databases (e.g., SinoMed, CNKI, and WANGFANG Database). HEEs published between January 1, 2020, and August 20, 2022, that considered both costs and outcomes of vaccination and pharmaceuticals for COVID-19 were included. The Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) statement scored the reporting quality for incorporated studies. A linear regression analysis was employed to characterize the impact of various features on reporting quality.

RESULTS: Fifty-two studies were included in the analysis. The average CHEERS score was 18.54±3.41, with the scoring rate of reporting quality was 67% (±12%). The most inadequately reported items included health economic analysis plan, time horizon, valuation of outcomes, heterogeneity, uncertainty, distributional effects, and stakeholder involvement. Higher reporting compliance was associated with articles applying a longer time horizon (no less than 1 year) and those using a societal perspective (p < 0.05). The investigations that did not specify a study perspective received the lowest scores among the subgroups.

CONCLUSION: Overall, the included HEEs on vaccination and pharmaceuticals for COVID-19 had moderate reporting quality. Future HEEs should be transparently and sufficiently reported in accordance with standard guidelines (e.g., the CHEERS 2022 statement), to increase the interpretability of results, improve the reporting quality, and better inform the decision-making.}, } @article {pmid40490389, year = {2025}, author = {Jeong, YI and Lee, HY and Lee, S and Jeong, GY and Kim, SH and Kim, S and Seo, SH and Shin, NR}, title = {Korea's National Action Plan on Antimicrobial Resistance: Focusing on the Appropriate Use of Antibiotics.}, journal = {Infection & chemotherapy}, volume = {57}, number = {2}, pages = {203-214}, pmid = {40490389}, issn = {2093-2340}, abstract = {Antimicrobial resistance (AMR) is recognized as one of the top ten global public health threats. Since the coronavirus disease 2019 pandemic, there has been a notable increase in global concern regarding AMR, leading to a strong call for a government-led response to address this issue. Since 2016, the Korean government has established and implemented a robust social foundation for managing AMR. This foundation encompasses several elements: enhancing the medical environment for infection prevention, providing support for the antimicrobial stewardship program in healthcare organizations, strengthening cooperation among multidisciplinary policy ministries, requiring veterinarians to prescribe antimicrobials in non-human fields, and enhancing food safety management in livestock and aquatic products. However, as the threat of AMR has intensified during the ongoing pandemic, the necessity for implementing a National Action Plan becomes even more critical. Therefore, the Third National Action Plan 2026-2030 is crucial to take into account several critical factors: raising awareness of AMR, strengthening of antimicrobial stewardship, halting the spread of antimicrobial-resistant bacteria, strengthening surveillance of antimicrobial use and AMR rates, strengthening internal and external collaborative efforts to combat AMR, and the final factor to consider is to enhance further antimicrobial development and diagnostic technologies to better manage and prevent AMR.}, } @article {pmid40490144, year = {2025}, author = {Sequeira, SB and Jones, LP and Goodman, SB and Mont, MA}, title = {Risk Factors, Pathogenesis, Diagnosis, and Treatment Options for COVID-Associated Osteonecrosis: A Systematic Review.}, journal = {The Journal of arthroplasty}, volume = {40}, number = {10S1}, pages = {S13-S20}, doi = {10.1016/j.arth.2025.06.015}, pmid = {40490144}, issn = {1532-8406}, mesh = {Humans ; *COVID-19/complications ; *Osteonecrosis/therapy/diagnosis/etiology/epidemiology ; Risk Factors ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Osteonecrosis associated with COVID-19 is a relatively rare clinical entity, but with a high incidence during the pandemic. There is a paucity of data regarding the characterization of this group of osteonecrosis patients. The purpose of this investigation was to systematically review the literature to identify: (1) clinical presentation/epidemiology, (2) pathophysiology, (3) diagnostic modalities, and (4) treatment guidelines/algorithms of COVID-19 osteonecrosis.

METHODS: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a systematic review across three databases, resulting in a total of 10 articles. Articles met the inclusion criteria if they provided data regarding: (1) clinical presentation/epidemiology, (2) pathophysiology, (3) diagnostic modalities, and/or (4) treatment guidelines/algorithms of COVID-19 osteonecrosis.

RESULTS: There was considerable variability in duration between COVID-19 infection and osteonecrosis symptoms. The clinical presentation of COVID-associated osteonecrosis is similar to standard symptoms, including joint pain and pain with weight-bearing. Corticosteroids tended to be the most identifiable associated risk factor for COVID-associated osteonecrosis. Diagnosis included radiographs and magnetic resonance imaging for definitive diagnosis. Treatment varied depending on the rapidity of osteonecrosis progression, ranging from bisphosphonates and analgesics to joint-preserving procedures and total joint arthroplasty.

CONCLUSIONS: Although COVID-associated osteonecrosis is a rare clinical condition, it is one that orthopaedic surgeons should be aware of and meticulously screen for in their patients. For patients inoculated with the COVID-19 virus, it is important for surgeons to use information regarding clinical presentation, pathophysiology, diagnosis, and treatment of COVID-associated osteonecrosis to screen and manage patients appropriately.}, } @article {pmid40489852, year = {2025}, author = {Obeagu, EI and Bolo, B}, title = {Climate change and medical laboratory operations: Impacts, challenges, and adaptation strategies: A narrative review.}, journal = {Medicine}, volume = {104}, number = {23}, pages = {e42718}, pmid = {40489852}, issn = {1536-5964}, mesh = {*Climate Change ; Humans ; COVID-19/epidemiology ; *Laboratories, Clinical/organization & administration ; SARS-CoV-2 ; }, abstract = {Climate change is increasingly disrupting medical laboratory operations worldwide, affecting diagnostic accuracy, infrastructure integrity, and supply chain stability. Hurricane Maria in 2017 devastated Puerto Rico, a major hub for medical supply manufacturing, leading to critical shortages of blood bags and reagents in U.S. hospitals. Rising global temperatures have also challenged the stability of temperature-sensitive reagents and biological samples, with studies indicating that a mere 2°C increase in ambient temperature can significantly reduce enzyme activity in diagnostic assays. Laboratories, particularly in low-resource settings, are struggling to maintain optimal storage conditions, raising concerns about the reliability of test results in disease diagnosis and monitoring. Extreme weather events and shifting disease patterns further compound these challenges. Flooding in South Asia has repeatedly disrupted microbiology laboratories, causing waterborne pathogen contamination and delays in infectious disease testing. In Sub-Saharan Africa, rising temperatures have expanded the range of malaria-carrying mosquitoes, increasing the demand for diagnostic services beyond the capacity of many laboratories. Supply chain disruptions due to climate-related disasters have led to prolonged shortages of essential testing materials, as seen during the COVID-19 pandemic when heatwaves affected the production and transportation of medical reagents. These disruptions highlight the urgent need for climate-adaptive strategies to ensure laboratory resilience and continuity in healthcare services. To mitigate these impacts, laboratories must adopt sustainable infrastructure and operational practices. Key recommendations include transitioning to solar-powered refrigeration to prevent sample degradation during power outages, investing in climate-resilient laboratory buildings, and enhancing digital diagnostic capabilities to reduce reliance on physical sample transportation.}, } @article {pmid40489594, year = {2025}, author = {Lucas Molitor, W and Feldhacker, DR and Li, Z and Kuhl, N and Jewell, VD}, title = {Occupational Therapy Telehealth Interventions Across Populations From 2019 to 2022: A Systematic Review.}, journal = {The American journal of occupational therapy : official publication of the American Occupational Therapy Association}, volume = {79}, number = {4}, pages = {}, doi = {10.5014/ajot.2025.050939}, pmid = {40489594}, issn = {0272-9490}, mesh = {Humans ; *Occupational Therapy/methods/trends ; *Telemedicine ; *COVID-19/epidemiology ; Chronic Disease/rehabilitation ; SARS-CoV-2 ; }, abstract = {IMPORTANCE: The utilization of telehealth to deliver occupational therapy services and research focusing on the effectiveness of these interventions has increased since 2020.

OBJECTIVE: To update systematic review findings since 2019 on the effectiveness of occupational therapy telehealth interventions for clients of all ages.

DATA SOURCES: Data were gathered from PubMed, CINAHL, PsycINFO, and the Cochrane Database of Systematic Reviews and hand searching relevant literature.

This systematic review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Articles selected included telehealth-delivered occupational therapy, peer-reviewed publications in English between 2019 and 2022, and Levels 1b, 2b, or 3b evidence.

FINDINGS: Forty-three studies were included. Strong strength of evidence supports telehealth interventions for lifestyle interventions to address chronic conditions. Moderate strength of evidence supports telehealth interventions for various outcomes to address chronic conditions, developmental disorders, neurological conditions, and people affected by COVID-19 isolation. Low strength of evidence supports telehealth interventions for various outcomes across identified subthemes.

CONCLUSIONS AND RELEVANCE: Telehealth use is rapidly increasing. Evidence supports occupational therapy-delivered telehealth for clients experiencing a chronic or musculoskeletal condition and may support interventions for other populations. Plain-Language Summary: This study provides a summary of 43 articles on the effectiveness of occupational therapy telehealth interventions for all ages and populations from 2019 to 2022. Telehealth occupational therapy interventions can effectively support clients with chronic conditions and shows promise for promoting outcomes to address developmental disorders, neurological conditions, musculoskeletal conditions, and those who were affected by isolation during the coronavirus disease 2019 (COVID-19) pandemic.}, } @article {pmid40488927, year = {2025}, author = {Keam, SJ}, title = {Sipavibart: First Approval.}, journal = {Drugs}, volume = {85}, number = {8}, pages = {1049-1054}, pmid = {40488927}, issn = {1179-1950}, mesh = {Humans ; *COVID-19/prevention & control/immunology ; Immunocompromised Host ; Drug Approval ; SARS-CoV-2 ; *Pre-Exposure Prophylaxis/methods ; Adolescent ; Adult ; *Antibodies, Monoclonal, Humanized/therapeutic use ; Child ; *Immunoglobulin G/therapeutic use/administration & dosage ; COVID-19 Drug Treatment ; }, abstract = {Sipavibart (KAVIGALE[®]), a recombinant human immunoglobulin (Ig)G1-based antibody, is being developed by AstraZeneca for the pre-exposure prophylaxis of COVID-19 in immunocompromised individuals. Sipavibart was approved in December 2024 in Japan to prevent the onset of infection caused by SARS-CoV-2 in adults and adolescents aged ≥ 12 years weighing ≥ 40 kg where vaccination against infection caused by SARS-CoV-2 is not recommended or may not achieve a sufficient immune response. Sipavibart was also approved in the EU for the pre-exposure prophylaxis of COVID-19 in adults and adolescents aged ≥ 12 years weighing ≥ 40 kg who are immunocompromised due to a medical condition or receipt of immunosuppressive treatments in January 2025 and in Canada in March 2025. This article summarizes the milestones in the development of sipavibart leading to this first approval for the pre-exposure prophylaxis of COVID-19 in immunocompromised adults and adolescents.}, } @article {pmid40488888, year = {2025}, author = {Ahmed, A and Cahn, B and Haber, R}, title = {Wells syndrome: emerging triggers and treatments- an updated systematic review.}, journal = {Archives of dermatological research}, volume = {317}, number = {1}, pages = {805}, pmid = {40488888}, issn = {1432-069X}, mesh = {Humans ; *Eosinophilia/diagnosis/etiology/therapy/immunology/drug therapy ; *Cellulitis/etiology/diagnosis/immunology/therapy/drug therapy ; *COVID-19/complications/immunology ; SARS-CoV-2/immunology ; Adrenal Cortex Hormones/therapeutic use ; Nitriles ; Pyrazoles ; Pyrimidines ; }, abstract = {IMPORTANCE: Wells syndrome (eosinophilic cellulitis) is a rare inflammatory dermatosis characterized by erythematous, edematous plaques and dermal eosinophilic infiltration. Understanding its evolving triggers and treatment options is critical for optimizing management, particularly in corticosteroid-refractory cases.

OBJECTIVE: To systematically review newly reported immunologic and iatrogenic triggers of Wells syndrome, as well as emerging therapies, with the goal of updating clinical guidance. This review focuses on diagnosis and therapy, emphasizing outcomes in patients with refractory or relapsing disease.

EVIDENCE REVIEW: A systematic literature search was conducted following PRISMA 2020 guidelines across six databases for English-language studies published between January 2016 and May 2025. Studies were eligible if they described new triggers or treatments for Wells syndrome. Article selection and data extraction were performed independently by two reviewers. Risk of bias was assessed using the Joanna Briggs Institute and Newcastle-Ottawa tools.

FINDINGS: Twenty-four studies met inclusion criteria: 21 case reports, 2 case series, and 1 retrospective cohort study. Newly identified triggers included COVID-19 infection, SARS-CoV-2 and influenza vaccines, aluminum- and gelatin-containing pediatric vaccines, and biologic therapies such as ustekinumab and tumor necrosis factor-alpha (TNF-α) inhibitors. In vaccine-related cases, causality was supported by positive patch testing. Novel therapies trialed in corticosteroid-refractory or relapsing patients included dupilumab, topical ruxolitinib, abrocitinib, and mepolizumab. Most patients experienced complete or near-complete resolution. However, recurrences were common, particularly in idiopathic cases or upon re-exposure to known triggers.

CONCLUSIONS AND RELEVANCE: Recent literature expands the clinical spectrum of Wells syndrome, highlighting new immunologic and iatrogenic triggers. Targeted treatments, especially biologics and Janus kinase inhibitors, demonstrate promising results and may offer steroid-sparing alternatives for patients with refractory disease. Clinicians should consider emerging triggers in differential diagnosis and evaluate newer therapies in recurrent or treatment-resistant cases. Further prospective and registry-based studies are warranted to validate efficacy and support development of evidence-based management guidelines.}, } @article {pmid40488703, year = {2025}, author = {Crump, J and Jackson, D and Algoso, M and Peters, K}, title = {Deployment of Perioperative Nurses From Their Clinical Specialty During the COVID-19 Pandemic: An Integrative Review.}, journal = {Journal of advanced nursing}, volume = {}, number = {}, pages = {}, doi = {10.1111/jan.17106}, pmid = {40488703}, issn = {1365-2648}, abstract = {AIM: To identify the available records surrounding the deployment of perioperative nurses into differing clinical settings during the COVID-19 pandemic.

DESIGN: Integrative review methodology.

METHODS: Quality appraisal of each record was conducted using a modified Critical Appraisal Skills Programme checklist. Data were extracted and presented based on outlined research objectives.

DATA SOURCES: Six electronic databases (CINAHL Plus, Google Scholar, MEDLINE, Pubmed, Scopus, and Web of Science) were searched, with relevant peer-reviewed records published after 2019 until February 2025 included to differentiate from other respiratory pandemics.

RESULTS: Ten records were included in the review. Opposing discourse exists between perioperative decision makers and those perioperative nurses who underwent deployment to differing clinical areas surrounding perceptions and experiences of deployment during the COVID-19 pandemic.

CONCLUSION: Few studies exist exploring experiences of perioperative nurse deployment to a different clinical area during the COVID-19 pandemic. Further research is vital to develop strategies that enhance the deployment process and ensure effective patient care across various clinical settings when cared for by deployed perioperative nurses.

Further research exploring transferable perioperative nursing skills and its subsequent influence on safe patient care may enhance and inform nurse deployment practices, enriching future staffing protocols in the event of a future pandemic.

REPORTING METHOD: PRISMA guidelines for reporting systematic reviews guided this review.

This study did not include patient or public involvement in its design, conduct, or reporting.}, } @article {pmid40488287, year = {2025}, author = {Hueto Madrid, JA and Hargreaves, J and Buchelt, B}, title = {Putting Patients at Risk: The Effect of Health Care Provider Burnout on Patient Care in the Operating Room-A Narrative Review.}, journal = {Journal of patient safety}, volume = {21}, number = {6}, pages = {424-436}, pmid = {40488287}, issn = {1549-8425}, support = {//Mölnlycke/ ; }, mesh = {Humans ; *Burnout, Professional/epidemiology/psychology ; *Operating Rooms/organization & administration ; *Patient Safety ; COVID-19/epidemiology ; *Health Personnel/psychology ; Quality of Health Care ; }, abstract = {OBJECTIVES: This review aimed to explore the prevalence of burnout among health care professionals working in the operating room (OR) and its impact on patient safety and care quality.

METHODS: A focused narrative review was conducted, utilizing PubMed, CINAHL, Semantic Scholar, WorldCat, Cochrane Library, and clinical trials registries. Full-text primary literature published in English between 2018 and 2024 was included. Studies specifically addressing burnout in the OR and its effects on patient safety and care quality were selected. Data extraction included prevalence rates, stress factors, and impacts on patient outcomes.

RESULTS: Burnout was found to be highly prevalent among OR health care professionals, particularly affecting surgeons, anesthesiologists, and OR nurses. Reported prevalence rates ranged from 10% to 83%, with the highest levels occurring during the COVID-19 pandemic. Burnout was linked to critical aspects of health care quality and safety, primarily through communication breakdowns and operational inefficiencies. Impaired communication contributed to safety incidents, while disruptions in OR scheduling and increased turnover times further exacerbated workflow challenges. Although studies directly connecting burnout to patient safety events were limited, burnout was consistently associated with poor decision-making, weakened teamwork, and higher staff turnover-factors that collectively undermine patient outcomes.

CONCLUSIONS: Burnout among OR health care professionals poses a significant threat to both staff well-being and patient safety, a challenge that was further intensified by the COVID-19 pandemic. Addressing burnout requires a multifaceted approach, including enhanced training, workload optimization, and robust support systems. Implementing comprehensive, context-specific interventions can improve staff resilience and patient safety.}, } @article {pmid40487789, year = {2025}, author = {Ahmed, SK and Ahmed, DR and Ibrahim, RH and Hussein, S and Blbas, HTA and Mahmood, KA and Qurbani, K and Saber, AF and Abdalla, AQ}, title = {Widespread Mental Health Impacts of COVID-19 on Iraq's General Population: A Systematic Review.}, journal = {SAGE open nursing}, volume = {11}, number = {}, pages = {23779608251347847}, pmid = {40487789}, issn = {2377-9608}, abstract = {BACKGROUND AND OBJECTIVE: Mental health has emerged as a critical public health priority during the COVID-19 pandemic. The purpose of this review was to analyze and summarize existing literature on the effects of the COVID-19 pandemic on the mental health of the general population in Iraq.

METHODS: The systematic reviews were conducted in accordance with the PRISMA 2020 guidelines. The review protocol was registered in PROSPERO with the unique identifier CRD42023423291. Searches were performed in PubMed, Scopus,Medline, and Google Scholar in May 2023 for studies published from January 2020 to January 2023. The researchers used the Joanna Briggs Institute to evaluate the quality of the studies. Data from all the included research in this review were collected and synthesized.

RESULTS: This review included data from 11 high-quality studies conducted in Iraq, involving a total of 8,917 participants. Of these participants, 4,860 (54.5%) were female and 4,057 (45.5%) were male. The aim of these studies was to investigate the impact of COVID-19 on mental health. The systematic review yielded important findings regarding the prevalence rates of anxiety, stress, depression, and post-traumatic stress disorder (PTSD). These rates were estimated to be 54.89%, 48.15%, 49.57%, and 31.35% respectively. It is worth noting that various demographic groups in Iraq exhibited elevated levels of stress, anxiety, depression, and PTSD, highlighting the significant burden experienced by individuals. These findings emphasize the wide-ranging effects on different segments of the population, including college students and individuals with a history of COVID-19 infection.

CONCLUSION: This review highlights the substantial impact of COVID-19 on mental health in Iraq, noting increased levels of stress, anxiety, depression, and PTSD among various groups. The findings consistently showed a significant mental health burden on Iraqis, urging healthcare authorities and policymakers to implement targeted interventions to address these challenges promptly.}, } @article {pmid40487254, year = {2025}, author = {Salehi, M and Salmanton-García, J and Abdollahi, A and Albaji, M and Davoudi-Monfared, E and Siami, Z and Mohammadi, S and Khodavaisy, S and Nazemi, P}, title = {The Value of the Galactomannan Test in Diagnosing COVID-19-Associated Pulmonary Aspergillosis: A Review.}, journal = {Iranian journal of pathology}, volume = {20}, number = {2}, pages = {142-151}, pmid = {40487254}, issn = {1735-5303}, abstract = {COVID-19-associated pulmonary aspergillosis (CAPA) is a complication of COVID-19. Galactomannan (GM) is a non-invasive test used to diagnose invasive aspergillosis. We collected the existing studies on the diagnostic value of GM to determine a GM level for predicting CAPA. All articles on the value of GM in CAPA diagnosis published until November 2023 were reviewed. The main databases were searched using the following keywords: "aspergillus", "aspergillosis", "SARS-CoV-2", "COVID", "2019 ncovnCOV", "novel coronavirus", "COVID-19", "galactomannan", and "CAPA". Studies with reported levels of serum or BAL GM were included. Patients were classified into two groups: non-confirmed and proven aspergillosis. Finally, the receiver operating characteristic (ROC) curve analysis was used to determine a GM level to predict the likelihood of CAPA. A total of 26 articles were selected, of which 239 patients were included. A count of 123 patients (50%) were in the non-confirmed group and 124 (50%) patients were proven. The median serum GM was 0.51 in the non-confirmed group and 0.47 in the proven group (p= 0.73). The level of GM in BAL fluid was 0.10 in the non-confirmed and 2.80 in the proven group, which was statistically different (p<0.001). With 81.3 % sensitivity and 79.5% specificity, the BAL GM cut-off was 1.01 ODI. The results showed that BAL GM ≥1.01 can be used to predict CAPA. Serum GM did not show any predictive value in diagnosing CAPA. However, BAL GM level can be a reliable diagnostic test in patients with CAPA.}, } @article {pmid40486850, year = {2025}, author = {Gu, X and Zheng, M and Gao, Y and Lin, S and Zhang, X and Chen, C and Zhu, H and Sun, W and Zhang, Y}, title = {Overview of host-directed antiviral targets for future research and drug development.}, journal = {Acta pharmaceutica Sinica. B}, volume = {15}, number = {4}, pages = {1723-1751}, pmid = {40486850}, issn = {2211-3835}, abstract = {Viruses constitute a significant group of pathogens that have caused numerous fatalities and substantial economic losses in recent years, particularly with the emergence of coronaviruses. While the impact of SARS-CoV-2 appears to be diminishing in daily life, only a limited number of drugs have received approval or emergency use authorization for its treatment. Given the high mutation rate of viral genomes, host-directed agents (HDAs) have emerged as a preferred choice due to their broad applicability and lasting effectiveness. In contrast to direct-acting antivirals (DAAs), HDAs offer several advantages, including broad-spectrum antiviral activities, potential efficacy against future emerging viruses, and a lower likelihood of inducing drug resistance. In our review article, we have synthesized known host-directed antiviral targets that span diverse cellular pathways and mechanisms, shedding light on the intricate interplay between host cells and viruses. Additionally, we have provided a brief overview of the development of HDAs based on these targets. We aim for this comprehensive analysis to offer valuable perspectives and insights that can guide future antiviral research and drug development efforts.}, } @article {pmid40486513, year = {2025}, author = {Chen, LZ and Cai, Q and Zheng, PF}, title = {Mitochondrial metabolic rescue in post-COVID-19 syndrome: MR spectroscopy insights and precision nutritional therapeutics.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1597370}, pmid = {40486513}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/metabolism/complications/diet therapy ; *Mitochondria/metabolism ; *SARS-CoV-2 ; Magnetic Resonance Spectroscopy/methods ; Precision Medicine ; *Nutrition Therapy/methods ; Energy Metabolism ; Oxidative Stress ; Ubiquinone/analogs & derivatives ; }, abstract = {Post-COVID-19 Condition (PCC), impacting 30-90% of survivors, is characterized by persistent fatigue and metabolic dysfunction, often linked to underlying mitochondrial impairment. This review examines current evidence on mitochondrial-targeted nutrition therapies, with a focus on magnetic resonance spectroscopy (MRS) as a tool for assessing metabolic recovery. Key findings highlight reduced adenosine triphosphate (ATP) production, heightened oxidative stress, and disrupted mitochondrial biogenesis- metabolic abnormalities that closely mirror those seen in chronic fatigue syndromes. While mitochondrial dysfunction is recognized as central, debate continues on whether systemic inflammation or direct viral damage primarily drives these abnormalities. Current evidence supports nutrients, such as, CoQ10, NAC, and creatine for restoring energy metabolism and reducing oxidative stress. MRS biomarkers (τPCr, Qmax), offer valuable tools for monitoring personalized intervention. However, several limitations persist, including variability in nutritional protocols, inconsistencies in MRS methodologies, and limited consideration of microbiome-psychosocial interactions. Most clinical trials focus on short-term outcomes, lacking data on long-term efficacy or stratification based on mitochondrial dysfunction severity. Future research priorities include multi-omics investigations into mitochondrial-epigenetic interactions, the development of targeted antioxidants, and exploration of engineered microbial metabolites. Standardizing MRS protocols, validating composite endpoints, and optimizing nutrient delivery systems require interdisciplinary collaboration. This review advocates for a precision medicine approach, combining MRS-based metabolic profiling with personalized nutritional strategies, to address the multifactorial nature of PCC and advance clinical translation.}, } @article {pmid40486510, year = {2025}, author = {Yang, P and Song, Y and Li, M}, title = {Biological mechanisms of pulmonary inflammation and its association with seropositive rheumatoid arthritis.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1530753}, pmid = {40486510}, issn = {1664-3224}, mesh = {Humans ; *Arthritis, Rheumatoid/immunology/complications ; Extracellular Traps/immunology ; *Pneumonia/immunology ; *COVID-19/immunology ; SARS-CoV-2/immunology ; Animals ; Lung/immunology/pathology ; Gastrointestinal Microbiome/immunology ; }, abstract = {Although the pathogenesis of seropositive rheumatoid arthritis (RA) remains unclear, studies suggest that pulmonary inflammation-related biological mechanisms play a significant role in its development. This review thoroughly explores the mechanisms underlying early pulmonary lesions in seropositive RA, focusing on the mucosal barrier hypothesis, neutrophil extracellular traps, pathogenic microbial infections like COVID-19, Vitamin D, the microbiome and gut-lung axis, inhalation exposures and chronic pulmonary diseases. This study seeks to provide novel insights and theoretical foundations for the prevention and treatment of seropositive rheumatoid arthritis.}, } @article {pmid40486342, year = {2025}, author = {Kunder, V and Harris, J and Moody, D}, title = {Comparative Effectiveness of High-Flow Nasal Cannula and Noninvasive Ventilation in Acute Hypoxemic Respiratory Failure: A Scoping Review.}, journal = {Cureus}, volume = {17}, number = {5}, pages = {e83752}, pmid = {40486342}, issn = {2168-8184}, abstract = {Acute hypoxemic respiratory failure (AHRF) is a leading cause of ICU admissions, and noninvasive respiratory support modalities such as high-flow nasal cannula (HFNC) and noninvasive ventilation (NIV) are frequently employed. However, the comparative effectiveness of these two interventions across different patient populations remains unclear. This scoping review aimed to synthesize current evidence comparing HFNC and NIV in the management of adult patients with AHRF, focusing on outcomes such as intubation rates, mortality, patient comfort, oxygenation, and complications. Studies were included if they: (1) were primary research articles, (2) involved human adults with AHRF, (3) directly compared HFNC with NIV, and (4) reported on clinical outcomes. Systematic reviews, case reports, editorials, and studies focused exclusively on immunocompromised or postoperative populations were excluded. A systematic search of PubMed, MEDLINE (via Ovid), and the Cochrane Library was conducted through February 2025. Three independent reviewers screened and selected studies using Rayyan. Data extraction was performed using a structured template capturing study design, sample size, population, intervention details, and relevant outcomes. Twelve studies met the inclusion criteria. HFNC and NIV demonstrated comparable effectiveness in reducing intubation rates across most patient populations. In COVID-19-associated AHRF, the two modalities yielded similar outcomes in terms of intubation and mortality. HFNC was consistently associated with greater patient comfort and fewer complications, particularly with respect to interface tolerance and skin breakdown. However, NIV remained more effective in clearing carbon dioxide, especially in patients with hypercapnic respiratory failure, such as those with COPD exacerbations. ORs were infrequently reported; however, one study reported an adjusted hazard ratio of 0.75 (95% CI: 0.58-0.98) favoring HFNC over oxygen masks for ICU mortality. HFNC may be preferable for patients who have difficulty tolerating masks or are at lower risk for hypercapnia, while NIV remains the standard of care in hypercapnic respiratory failure. Mortality outcomes were inconclusive. Future randomized controlled trials should target specific patient subgroups and examine long-term outcomes and hospital resource utilization to optimize noninvasive respiratory support strategies in AHRF.}, } @article {pmid40485649, year = {2025}, author = {Logothetis, G and Avramidis, K and Konstantaki, E and Matziou, V and Doupis, J}, title = {The Role of Remote Glucose Management Using Real-time Continuous Glucose Monitoring Systems in ICU-hospitalized Patients with COVID-19.}, journal = {TouchREVIEWS in endocrinology}, volume = {21}, number = {1}, pages = {9-13}, pmid = {40485649}, issn = {2752-5457}, abstract = {The recent coronavirus disease 2019 (COVID-19) pandemic has induced many challenges in the clinical environment worldwide. In a bid to reduce the exposure of healthcare providers to severe acute respiratory syndrome coronavirus 2 and the utilization of personal protective equipment (PPE), while maintaining optimal patient care, in April 2020, the US Food and Drug Administration issued a new policy, allowing the use of continuous glucose monitoring (CGM) systems in the intensive care unit (ICU) setting. This article aimed to explore the role of real-time continuous glucose monitoring systems in patients in the ICU with COVID-19. The hybrid protocols integrating real-time CGM and point of care seem to be a feasible and safe alternative for the glycaemic management of critically ill patients with COVID-1 9, including the reduction of healthcare providers' exposure and the preservation of PPE, whilst achieving and maintaining optimal glycaemic control.}, } @article {pmid40484894, year = {2025}, author = {Zahner, SJ and Gillespie, K and Merss, K and Bizot, P}, title = {Characteristics of Governmental Public Health Nurses With Recommendations for Public Health Nurse Workforce Planning.}, journal = {Public health nursing (Boston, Mass.)}, volume = {42}, number = {5}, pages = {1634-1643}, pmid = {40484894}, issn = {1525-1446}, mesh = {Humans ; Cross-Sectional Studies ; *COVID-19/epidemiology/nursing ; Female ; Adult ; Male ; *Public Health Nursing/statistics & numerical data ; *Nurses, Public Health/statistics & numerical data ; Middle Aged ; Surveys and Questionnaires ; Wisconsin/epidemiology ; Pandemics ; *Workforce/statistics & numerical data ; }, abstract = {OBJECTIVES: Characteristics and perceived impact of the COVID-19 pandemic on the health of governmental public health nurses were compared to all registered nurses.

DESIGN: Cross-sectional descriptive design using data from the 2022 Wisconsin RN Workforce Survey.

SAMPLE: The sample included 87,100 registered nurses, including 1350 governmental public health nurses.

MEASUREMENTS: The online survey was administered during February 2022. Responses to "Working as a nurse" and "Primary place of work" were used to classify governmental public health nurses. Data elements included demographics, employment, income, education, specialized knowledge, certifications, and COVID-19 pandemic measures.

RESULTS: Compared to all registered nurses, governmental public health nurses reported older age, greater race/ethnic diversity, and higher frequency of the baccalaureate as the highest degree. Most governmental public health nurses reported no plans for additional education. Income for governmental public health nurses lagged income for all registered nurses. The proportion of governmental public health nurses intending to remain in their present type of work for fewer than 10 years was higher than for all registered nurses, as was the proportion of governmental public health nurses who rated their overall health as "worse or much worse" than before the pandemic.

CONCLUSION: This analysis raises concerns about the size and preparation of the governmental public health nurse workforce given ongoing population health disparities and future health threats.}, } @article {pmid40484195, year = {2025}, author = {Bigley, AN and Raushel, FM}, title = {The use of phosphotriesterase in the synthesis of enantiomerically pure ProTide prodrugs.}, journal = {Chemico-biological interactions}, volume = {418}, number = {}, pages = {111597}, doi = {10.1016/j.cbi.2025.111597}, pmid = {40484195}, issn = {1872-7786}, mesh = {*Prodrugs/chemical synthesis/chemistry/metabolism ; Stereoisomerism ; *Antiviral Agents/chemistry/chemical synthesis/metabolism/pharmacology ; *Phosphoric Triester Hydrolases/metabolism/chemistry ; Humans ; SARS-CoV-2/drug effects ; ProTides ; }, abstract = {Outbreaks of viral diseases, such as COVID-19, and chronic viral diseases, such as HIV and hepatitis, have highlighted the need to develop antiviral medications. ProTide nucleotide analogs such as Remdesivir and Sofosbuvir have become an important class of antivirals. The ProTides are phosphonamidate prodrugs, which contain an alanine ester and a phenyl group esterified to a chiral phosphorus of a nucleotide analog. The resulting triester effectively masks the charge on the phosphate moiety to facilitate entry into the cell and are much more effective than the corresponding nucleoside analogs. Once in the cell, the ProTides require activation by cellular enzymes to remove the masking groups on the phosphorus. The activation in the cell is dependent on the stereochemistry of the phosphorus center with the effectiveness of a given isomer differing between tissue types. The ProTides are produced as single isomers at the phosphorus center by chiral chromatography or selective crystallization, but in many cases only a single isomer can be produced, potentially limiting the effectiveness of the ProTides. The phosphotriesterase (PTE) from Brevundimonas diminuta is well known for its ability to selectively hydrolyze chiral phosphotriesters. The extensive directed evolution of PTE has led to the identification of variants that can selectively hydrolyze the phosphonamidate precursor of the ProTides, allowing the preparation of optically pure ProTides. Importantly, the variant In1W-PTE allows the isolation of the pure RP-isomer while G60A-PTE and W131M-PTE allow the isolation of the pure SP-isomer, thereby facilitating the efficient preparation of either isomer of the final ProTide.}, } @article {pmid40484185, year = {2025}, author = {Hirota, Y and Okamoto, M and Baba, M and Suhara, Y}, title = {Potential of fat-soluble vitamins as a platform for antiviral drug development.}, journal = {Bioorganic & medicinal chemistry letters}, volume = {127}, number = {}, pages = {130292}, doi = {10.1016/j.bmcl.2025.130292}, pmid = {40484185}, issn = {1464-3405}, mesh = {*Antiviral Agents/pharmacology/chemistry ; Humans ; *Vitamins/chemistry/pharmacology ; *SARS-CoV-2/drug effects ; *COVID-19 Drug Treatment ; *Drug Development ; Vitamin D/pharmacology/chemistry/analogs & derivatives ; Virus Replication/drug effects ; Vitamin A/pharmacology/chemistry ; Vitamin E/pharmacology/chemistry ; Solubility ; Vitamin K/pharmacology/chemistry ; }, abstract = {Fat-soluble vitamins, including vitamins A, D, E, and K, exhibit antioxidative, anti-inflammatory, and immunomodulatory effects, making them promising candidates for antiviral drug development. This review highlights their structural features, biological roles, and antiviral potential. Vitamin A derivatives modulate immunity and inhibit viral replication, including SARS-CoV-2. Vitamin D analogs enhance immune responses and target viral enzymes, while vitamin E derivatives reduce oxidative stress and may directly inhibit viral replication. Emerging research on vitamin K derivatives suggests potential antiviral applications. These findings underscore the potential of fat-soluble vitamins as innovative antiviral agents, warranting further investigation to optimize efficacy and clinical use.}, } @article {pmid40483752, year = {2025}, author = {Li, L and Zou, X and Chen, H}, title = {Workload in ICU nurses: A systematic review and meta-analysis of the Nursing Activities Score.}, journal = {Intensive & critical care nursing}, volume = {91}, number = {}, pages = {104086}, doi = {10.1016/j.iccn.2025.104086}, pmid = {40483752}, issn = {1532-4036}, mesh = {Humans ; *Workload/statistics & numerical data/standards/psychology ; Intensive Care Units/organization & administration/statistics & numerical data ; *Critical Care Nursing/statistics & numerical data ; COVID-19/nursing ; *Nursing Staff, Hospital/statistics & numerical data ; }, abstract = {AIM: Intensive care units (ICUs) are high-demand environments where nurse workload management is critical for ensuring quality patient care and nurse well-being. The Nursing Activities Score (NAS) is widely used to quantify nursing workload, yet individual studies report heterogeneous findings. This systematic review and meta-analysis aimed to synthesize global data on ICU nursing workload using the NAS.

METHODS: A comprehensive literature search was conducted in multiple databases without language restrictions, identifying studies reporting mean NAS scores. Data were extracted by two independent reviewers, and a random-effects meta-analysis was performed to pool NAS values. Subgroup analyses and meta-regression were conducted to explore sources of heterogeneity.

RESULTS: A total of 70 observational studies, encompassing data from 56,042 ICU patients, were included. The meta-analysis revealed a pooled mean NAS of 66.2% (95% CI: 62.6-69.8%), indicating that, on average, ICU nurses spend nearly two-thirds of their shift on direct patient care for a single patient. Higher NAS values were observed during patient admission and the morning shift, with a significant increase during the COVID-19 period compared to pre-pandemic levels.

CONCLUSION: Our analysis revealed that ICU nurses spend a substantial part of their shift on direct patient care, especially during high-demand periods. These findings challenge traditional nurse-to-patient ratios, suggesting the need for flexible staffing models.

The current nursing staff level within ICU settings may not be adequate for the average nursing workload in some countries. Consideration should be given to dynamic staffing models that can consider increased nursing workload.}, } @article {pmid40483115, year = {2025}, author = {Jafari, B and Amiri, MR and Labecka, MK and Rajabi, R}, title = {The effect of home-based and remote exercises on low back pain during the COVID-19 pandemic: A systemic review.}, journal = {Journal of bodywork and movement therapies}, volume = {43}, number = {}, pages = {143-151}, doi = {10.1016/j.jbmt.2025.04.004}, pmid = {40483115}, issn = {1532-9283}, mesh = {Humans ; *Low Back Pain/rehabilitation/therapy ; *COVID-19/epidemiology ; *Exercise Therapy/methods ; SARS-CoV-2 ; Telemedicine ; Pandemics ; }, abstract = {BACKGROUND: The prevalence of low back pain (LBP) surged during the COVID-19 pandemic, posing challenges to face-to-face treatment.

OBJECTIVES: The systematic review aims to determine the effectiveness of various digital solutions for controlling and treatment of LBP during the COVID-19 pandemic.

METHODS: The systematic review was performed from January 1, 2019, to December 31, 2023 across databases, including Google Scholar, ScienceDirect, Scopus, and PubMed, according to the eligibility criteria. This review fulfilled the following criteria according to the PICO system: population (individuals using virtual exercises at home for LBP), interventions (distance rehabilitation and digital application), comparison (intervention group performing exercises virtually at home, and control group receiving in-person services), outcome (methods used in the diagnosis of LBP). Only randomized controlled trials with a PEDro score of 4 or above were included, indicating studies with moderate to good methodological quality. All the studies were assessed to be of high quality.

RESULTS: After the final review, 15 articles with 3789 subjects met the inclusion criteria. Digital tools such as video calls, Artificial Intelligence programs, Virtual Reality Exercises, and video-based programs were commonly used in studies addressing LBP management. The included article's scores ranged from 6.2 on the PEDro scale, which has a maximum of 10 points.

CONCLUSIONS: The COVID-19 pandemic prompted heightened attention to digital treatments, yielding relatively acceptable results for patients and therapists. However, recent technological advances indicate future expansion in this field. Key aspects of this method include training individuals in self-management of LBP and promoting adherence. Nonetheless, the high diversity in the use of digital methods poses limitations on conclusive outcomes.}, } @article {pmid40482741, year = {2025}, author = {Kang, H and Sun, Y and Fang, Z and Ding, W and Bai, T and Yang, K and Jiang, D}, title = {[Illuminating the shadows - perspectives on mRNA vaccine adverse events - mechanisms, risks and management]: A review.}, journal = {International journal of biological macromolecules}, volume = {318}, number = {Pt 1}, pages = {145010}, doi = {10.1016/j.ijbiomac.2025.145010}, pmid = {40482741}, issn = {1879-0003}, mesh = {Humans ; *COVID-19 Vaccines/adverse effects/immunology ; *COVID-19/prevention & control/immunology ; SARS-CoV-2/immunology ; *mRNA Vaccines/adverse effects ; *RNA, Messenger/immunology ; *Vaccines, Synthetic/adverse effects/immunology ; *Drug-Related Side Effects and Adverse Reactions ; }, abstract = {Apparently, mRNA vaccines have played a pivotal role in curbing the further spread of COVID-19. However, their deployment has been accompanied by reports of adverse events (AEs), including cardiovascular and neurological symptoms. The comprehensive review proposes a conceptual framework to better characterize AEs, elucidate the underlying mechanisms, and outline therapeutic strategies. It also profiles AEs into a three-axe mechanism classification: host susceptibility, delivery system interactions, and mRNA component immunogenicity, thereby advancing current understanding of their etiology. Finally, the analysis integrates these axes with critical perspectives - mRNA molecular design, platform-specific toxicity, and human nature - to provide a comprehensive roadmap for addressing above issues.}, } @article {pmid40482457, year = {2025}, author = {Tscherne, A and Krammer, F}, title = {A review of currently licensed mucosal COVID-19 vaccines.}, journal = {Vaccine}, volume = {61}, number = {}, pages = {127356}, doi = {10.1016/j.vaccine.2025.127356}, pmid = {40482457}, issn = {1873-2518}, mesh = {Humans ; *COVID-19 Vaccines/immunology/administration & dosage ; *COVID-19/prevention & control/immunology ; *Immunity, Mucosal ; *SARS-CoV-2/immunology ; Animals ; Antibodies, Viral/immunology ; Clinical Trials as Topic ; }, abstract = {The rapid development and deployment of injectable coronavirus disease 2019 (COVID-19) vaccines - in combination with non-pharmaceutical interventions and development of treatment options - significantly contributed to a decrease in both infection and mortality rates during the pandemic and saved millions of lives. However, injectable vaccines do not robustly and consistently induce a mucosal immune response, which is considered a key factor to prevent infection with and transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Hence, a tremendous effort is being made globally to develop next generation COVID-19 vaccines, which are capable of inducing a robust mucosal immune response in addition to a strong systemic cellular and humoral immune response. Mucosal COVID-19 vaccines have been evaluated successfully in preclinical and clinical trials, in which protection against SARS-CoV-2 infection has been demonstrated. This protective efficacy was associated with the upregulation of secretory IgA antibodies and the maturation of tissue-resident memory cells in the respiratory tract, which, together with an induced systemic immune response, significantly reduced viral replication and transmission in animal models. However, only five active mucosal vaccines (plus one 'passive' vaccine) have received approval for human use and robust data on their efficacy in inducing mucosal immune responses in humans and in blocking infection and transmission are missing. This highlights the importance of expanded research in this field. In this review, we aim to summarize what is known about these currently licensed vaccines, with an emphasis on the key findings obtained in both preclinical and clinical studies.}, } @article {pmid40481619, year = {2025}, author = {Linton, J and Carmichael, J and Newlands, F and Puri, A and Fox-Smith, L and Pinto Pereira, SM and Coughtrey, A and Shafran, R and Stephenson, T}, title = {Pre-Pandemic Prevalence of Post COVID-19 Condition Symptoms in Adolescents.}, journal = {Acta paediatrica (Oslo, Norway : 1992)}, volume = {114}, number = {9}, pages = {2116-2123}, pmid = {40481619}, issn = {1651-2227}, support = {COV-LT-0022//UK Research and Innovation/ ; 183885//Beryl Alexander Charity PhD Studentship/ ; MR/Y009398/1//UK Medical Research Council Senior Non-clinical Fellowship/ ; //NIHR Great Ormond Street Hospital Biomedical Research Centre/ ; }, mesh = {Humans ; Adolescent ; *COVID-19/complications/epidemiology ; Prevalence ; Child ; Young Adult ; *Adolescent Health ; }, abstract = {AIM: The emergence of post COVID-19 condition (PCC) within adolescents has been characterised by a wide range of symptoms, raising concerns for young people's health and quality of life. However, many symptoms are non-specific and there is considerable variation in symptom reporting. It is essential to understand how rates of these symptoms compare to the pre-pandemic health of adolescents.

METHODS: A systematic search of academic literature and websites, using traditional and automated search systems, was undertaken to identify symptoms described in adolescents aged 10-19 years in the 30 years up to and including 2019. Studies were reviewed and symptom prevalence data extracted.

RESULTS: Twenty-five sources (n = 483 097 participants) met the inclusion criteria, including longitudinal and cross-sectional study designs. The description and prevalence of symptoms varied widely, but there was a high pre-pandemic median prevalence of cough (13.6%), headache (30.0%), and fatigue (20.5%). These high prevalences highlight a gap in understanding of pre-pandemic adolescent health and the need for comprehensive, serial symptom profiling.

CONCLUSION: These findings provide a baseline of adolescent symptomatology prior to the emergence of PCC and provide important context for interpreting ongoing COVID symptoms. Data on PCC in adolescents should consider pre-pandemic symptom prevalence.}, } @article {pmid40481519, year = {2025}, author = {Jánosi, Á and Bódy, B and Nagy, R and Ocskay, K and Kói, T and Müller, K and Túri, I and Garami, M and Hegyi, P and Párniczky, A}, title = {Tumour necrosis factor-alpha inhibitors decrease mortality in COVID-19: a systematic review and meta-analysis.}, journal = {Critical care (London, England)}, volume = {29}, number = {1}, pages = {232}, pmid = {40481519}, issn = {1466-609X}, support = {FK 138929//National Research, Development and Innovation Fund (NRDI Fund)/ ; NU-000600//CF Trust Strategic Research Consortium Grant/ ; }, mesh = {Humans ; *COVID-19/mortality ; *Tumor Necrosis Factor-alpha/antagonists & inhibitors ; *COVID-19 Drug Treatment ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Despite widespread vaccination efforts, effective treatment strategies remain critical for severe SARS-CoV-2 infection. Tumour necrosis factor-alpha (TNF-α) plays a central role in the cytokine storm characteristic of severe COVID-19. This systematic review and meta-analysis evaluates the effectiveness, efficacy, and safety of TNF-α inhibitors in the management of COVID-19.

PATIENTS AND METHODS: A systematic review of PubMed, Embase, and CENTRAL was conducted, focusing on studies involving SARS-CoV-2-infected patients treated with TNF-α inhibitors compared with those receiving standard of care without prior TNF-α inhibitor use. Data from studies published up to August 12, 2024, were analysed. Outcomes assessed included mortality, invasive mechanical ventilation, and C-reactive protein (CRP) levels. Odds ratios (ORs) and mean differences (MD) were calculated with 95% confidence intervals (CI), and subgroup analyses were performed for randomised controlled trials (RCTs) and non-randomised studies.

RESULTS: Seven studies involving 1393 patients with moderate-to-critical COVID-19 were included. TNF-α inhibitor treatment was associated with a reduced odds of mortality (OR 0.67, 95% CI [0.44-1.00], P = 0.052), which was statistically significant in the RCT subgroup across three studies (OR 0.75, 95% CI [0.58-0.97], P = 0.042, certainty of evidence: very low). The number needed to treat for mortality was calculated to be 16 (95% CI 9.0-inf.), which indicates that one additional death could be avoided for every 16 patients treated with TNF-α inhibitors compared to standard of care. No significant reduction in the need for invasive mechanical ventilation was observed (OR 0.95 [95% CI 0.46-1.94]; P = 0.822). Additionally, TNF-α inhibitors resulted in a significant reduction in CRP levels (MD - 21.9 mg/L [95% CI - 38.46 to - 5.34]; P = 0.024) within three to seven days post-treatment.

CONCLUSION: Our study indicates a potential role for TNF-α inhibition in the treatment of COVID-19 as their use was associated with reduced mortality, but further studies are needed to provide robust evidence.}, } @article {pmid40480666, year = {2025}, author = {Imerlishvili, E and Gustafson, DR and Pashalishvili, M and Ompad, DC and Djibuti, M}, title = {Studies on cognitive performance among older people living with HIV in eastern Europe and central Asia: a scoping review.}, journal = {BMJ open}, volume = {15}, number = {6}, pages = {e094427}, pmid = {40480666}, issn = {2044-6055}, support = {D43 TW011532/TW/FIC NIH HHS/United States ; P30 DA011041/DA/NIDA NIH HHS/United States ; U01 HL146202/HL/NHLBI NIH HHS/United States ; }, mesh = {Humans ; *HIV Infections/psychology/complications/epidemiology ; Europe, Eastern/epidemiology ; Asia, Central/epidemiology ; Aged ; *Cognition ; *Cognitive Dysfunction/epidemiology ; Prevalence ; }, abstract = {BACKGROUND: Despite the growth of the population of older people living with HIV (PLWH), data on cognitive disorders among older PLWH, particularly in low- and middle-income countries, are scarce. These data are especially underrepresented in the literature from eastern Europe and central Asia (EECA).

OBJECTIVES: This scoping review aimed to describe the peer-reviewed literature on cognitive health among PLWH in the EECA region.

ELIGIBILITY CRITERIA: We selected articles from peer-reviewed journals that reported on cognitive assessments or the prevalence and characteristics of cognitive disorders among adult (≥18 years) PLWH in EECA countries (Armenia, Azerbaijan, Belarus, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Moldova, Russia, Tajikistan, Turkmenistan, Ukraine and Uzbekistan). Studies assessing cognition among PLWH related to traumatic brain injury, brain tumours, COVID-19, meningitis, neurosyphilis and/or other central nervous system infections were excluded.

SOURCE OF EVIDENCE: We searched for relevant data published up to March 2025 using four online databases (PubMed, CINAHL, Web of Science and PsycINFO).

CHARTING METHODS: Covidence, a web-based collaborative software platform, was used for data screening and extraction. Two independent reviewers screened abstracts and full texts, resolving disagreements through consensus. The data were extracted based on the predefined data extraction criteria.

RESULTS: A total of 1388 peer-reviewed articles were identified; 295 articles were removed due to duplication; and 1053 and 25 articles were excluded based on the abstract/title and full-text screenings, respectively. Finally, 15 articles met the inclusion criteria. All 15 studies used different neuropsychological assessments to measure cognitive performance by domain and/or cognitive disorders among various subgroups of PLWH. One cross-sectional study focused on older populations (≥40 years old), using standardised cognitive performance assessment tests. However, it neither provided information about the prevalence estimate of cognitive disorders nor identified risk factors.

CONCLUSION: Existing literature on cognitive disorders among older PLWH in the EECA region is limited and insufficient to estimate prevalence, or identify risk factors, and ultimately develop appropriate policy addressing the needs of older PLWH in this region. This scoping review underscores the urgent need for large-scale, longitudinal studies employing standardised, culturally adapted neuropsychological batteries and adherence to rigorous reporting standards.}, } @article {pmid40480638, year = {2025}, author = {Paiva, U and Cortese, S and Flor, M and Moncada-Parra, A and Lecumberri, A and Eudave, L and Magallón, S and García-González, S and Sobrino-Morras, Á and Piqué, I and Mestre-Bach, G and Solmi, M and Arrondo, G}, title = {Prevalence of mental disorder symptoms among university students: An umbrella review.}, journal = {Neuroscience and biobehavioral reviews}, volume = {175}, number = {}, pages = {106244}, doi = {10.1016/j.neubiorev.2025.106244}, pmid = {40480638}, issn = {1873-7528}, mesh = {Humans ; Anxiety/epidemiology ; *COVID-19/epidemiology ; Depression/epidemiology ; *Mental Disorders/epidemiology ; Prevalence ; Sleep Wake Disorders/epidemiology ; *Students/psychology/statistics & numerical data ; Universities ; Meta-Analysis as Topic ; Clinical Studies as Topic ; }, abstract = {This umbrella review synthesizes data on the prevalence of mental disorder symptoms among university students worldwide. A systematic search of seven databases (inception-July 23, 2023) followed PRISMA guidelines. We included meta-analyses assessing the prevalence of mental disorder symptoms, evaluating methodological quality with AMSTAR-2. A random-effects meta-analysis was conducted, along with meta-regression and subgroup analyses for moderators (percentage of females, publication date, healthcare-related degrees, COVID-19 pandemic). We included 1,655 primary studies from 62 meta-analyses, encompassing 8,706,185 participants. AMSTAR-2 ratings classified 35 % of meta-analyses as low quality and 65 % as critically low. Pooled prevalence estimates were: depression-mild (35.41 %, CI=33.9-36.93) and severe (13.42 %, CI=8.03-19.92; k=952; n=2,108,813); anxiety-mild (40.21 %, CI=37.39-43.07) and severe (16.79 %, CI=7.21-29.29; k=433; n=1,579,780); sleep disorders (41.09 %, CI=35.7-46.58); eating disorders (17.94 %, CI=15.79-20.20); gambling disorder (6.59 %, CI=5.52-7.75); post-traumatic stress disorder (25.13 %, CI=20.55-30.02); stress (36.34 %, CI=29.36-43.62); and suicide-related outcomes (ideation past 12 months: 10.76 %, CI=9.53-12.06; lifetime ideation: 20.33 %, CI=16.15-24.86; suicide attempt past 12 months: 1.37 %, CI=0.67-2.29; lifetime attempt: 3.44 %, CI=2.48-4.54). Meta-regression analyses identified statistically significant moderators of prevalence such as healthcare academic degrees and the pandemic in the case of depression and studies with more females in the case of sleep disorders. This is the most comprehensive synthesis on the prevalence of mental disorder symptoms in university students, providing crucial insights for clinicians, policymakers, and stakeholders.}, } @article {pmid40480210, year = {2025}, author = {Viswanathan, S and Galipeau, J}, title = {Hallmarks of MSCs: Key quality attributes for pharmacology and clinical use.}, journal = {Cell stem cell}, volume = {32}, number = {6}, pages = {878-894}, doi = {10.1016/j.stem.2025.05.008}, pmid = {40480210}, issn = {1875-9777}, mesh = {Humans ; *Mesenchymal Stem Cells/cytology ; *Mesenchymal Stem Cell Transplantation ; *COVID-19/therapy ; SARS-CoV-2 ; Respiratory Distress Syndrome/therapy ; }, abstract = {Marketing approval for allogenic mesenchymal stromal cells (MSCs) by international regulatory jurisdictions including the US have been granted. Notwithstanding, the long-heralded clinical and commercial breakthrough for MSC products has never fully manifested. The withdrawal of an allogenic MSC product in Europe, based on inefficacious phase 3 results along with setbacks in industry-sponsored, advanced clinical trials of MSCs for COVID-19-related acute respiratory distress syndrome (ARDS) have dampened enthusiasm for MSC products. In this perspective, we highlight the hallmarks of MSC identity and potency, and how these can inform surrogate, sensitive critical quality attributes that correlate with clinical effectiveness in a variety of indications. We further highlight host-dependent pharmacological attributes of MSCs, which together with their critical quality attributes drive the observed clinical responses and thus impact the translational utility of MSCs. We provide a rational pathway to additional MSC regulatory approval and deployment for disorders with unmet medical needs.}, } @article {pmid40479726, year = {2025}, author = {Costa, MP and Abdu, JOC and de Moura, MFCS and Silva, AC and Zacaron, TM and de Paiva, MRB and Fabri, RL and Pittella, F and Perrone, ÍT and Tavares, GD}, title = {Exploring the Potential of PLGA Nanoparticles for Enhancing Pulmonary Drug Delivery.}, journal = {Molecular pharmaceutics}, volume = {22}, number = {7}, pages = {3542-3562}, pmid = {40479726}, issn = {1543-8392}, mesh = {Humans ; *Polylactic Acid-Polyglycolic Acid Copolymer/chemistry ; *Nanoparticles/chemistry ; *Drug Delivery Systems/methods ; COVID-19 ; Administration, Inhalation ; SARS-CoV-2 ; COVID-19 Drug Treatment ; Drug Carriers/chemistry ; Animals ; Lung/drug effects/metabolism ; *Nanoparticle Drug Delivery System/chemistry ; }, abstract = {Lung diseases remain a leading cause of mortality globally, posing a substantial challenge to public health. Conditions such as asthma, tuberculosis, cystic fibrosis, pneumonia, chronic obstructive pulmonary disease (COPD), and lung cancer are highly prevalent and of increasing concern due to their rising incidence in recent years. The recent global outbreak of coronavirus disease 2019 (COVID-19) has further highlighted the urgent need for more effective therapeutic approaches to combat pulmonary diseases. In this context, growing interest in nanotechnology for pulmonary drug delivery has emerged, driven by its potential to enable localized treatment, reduce dosages, provide controlled release, enhance drug solubility, and improve bioavailability. Among the various nanomaterials explored, poly(lactic-co-glycolic acid) (PLGA)─a copolymer of lactic and glycolic acids─has gained regulatory approval as a safe, biodegradable, and biocompatible carrier, with an extended-release profile, making it an ideal candidate for the development of nanostructured drug delivery systems. Multiple methodologies are available for synthesizing PLGA nanoparticles tailored to pulmonary administration, supported by a wide array of devices designed to cater to individual patient needs. This review seeks to evaluate the advantages of PLGA-based nanoparticles for pulmonary drug delivery, with a focus on their potential to enhance inhalation therapy formulations.}, } @article {pmid40478540, year = {2025}, author = {McGraw, M and Morin, A and Tremblay Vaillancourt, V and Poitras, ME and Couturier, Y and Gaboury, I and Poirier, MD}, title = {Chronic Disease Patients' Engagement in Interprofessional Telehealth Collaboration in Primary Care: A Scoping Review.}, journal = {Journal of primary care & community health}, volume = {16}, number = {}, pages = {21501319251333858}, pmid = {40478540}, issn = {2150-1327}, mesh = {Humans ; *Telemedicine/organization & administration ; *Primary Health Care/organization & administration ; Chronic Disease/therapy ; *Interprofessional Relations ; *Patient Participation ; *Cooperative Behavior ; COVID-19 ; SARS-CoV-2 ; }, abstract = {With the rise of people being affected with chronic illness, now the leading cause of mortality worldwide, primary care is overwhelmed with the demand for healthcare services. Primary healthcare is the first resource for patients living with chronic illness, but in 2019, COVID-19 brought healthcare professionals to increase services through virtual care for patients living with chronic illness. In the workplace, such professionals often need to be sufficiently resourced to collaborate, to address collaborative care barriers in telehealth and to keep patients engaged in their health. We performed a scoping review to identify how patients living with chronic diseases actively engage and describe their involvement in the process of interprofessional collaboration within the context of telehealth in primary care settings. We followed Arksey and O'Malley's and the Joanna Briggs Institute's methodological guidelines to conduct this scoping review. The analysis of the retained twelve studies showed little distinction between the experience of interprofessional collaboration from the patient's perspective in a telehealth context compared to a face-to-face context. However, we were able to identify gaps (eg, limited insight onto engagement dynamic, lack of patient-centric research, and insufficient research on patient engagement) relating to the experiences of patients, patient engagement, and professionals who have used telehealth. In an era of digital innovations, this lack of literature regarding the patient experience may jeopardize the quality of the interprofessional collaboration services offered to patients and patient engagement. This gap in patient engagement integrated into interprofessional collaboration in a telehealth context needs to be addressed.}, } @article {pmid40476637, year = {2025}, author = {Rahmati, M and Udeh, R and Kang, J and Dolja-Gore, X and McEvoy, M and Kazemi, A and Soysal, P and Smith, L and Kenna, T and Fond, G and Boussat, B and Nguyen, DC and Do, H and Tran, BX and Veronese, N and Yon, DK and Boyer, L}, title = {Long-Term Sequelae of COVID-19: A Systematic Review and Meta-Analysis of Symptoms 3 Years Post-SARS-CoV-2 Infection.}, journal = {Journal of medical virology}, volume = {97}, number = {6}, pages = {e70429}, pmid = {40476637}, issn = {1096-9071}, support = {//The authors received no specific funding for this work./ ; }, mesh = {Humans ; *COVID-19/complications/epidemiology/physiopathology ; Fatigue/epidemiology ; Dyspnea/epidemiology ; SARS-CoV-2 ; Prevalence ; Sleep Wake Disorders/epidemiology ; Post-Acute COVID-19 Syndrome ; Survivors ; }, abstract = {The symptoms of long COVID are well-documented. However, the long-term effects beyond 2 years remain poorly understood due to a lack of data. This systematic review and meta-analysis examined the prevalence of persistent symptoms in COVID-19 survivors 3 years following initial SARS-CoV-2 infection. PubMed, MEDLINE (Ovid), CENTRAL, Web of Science, Scopus, and Embase were searched from inception of the databases up to July 20, 2024, by two independent researchers for articles reporting on the prevalence of persistent symptoms 3 years' post-infection of people who survived COVID-19 infection. We employed a random-effect model for the pooled analysis, and the meta-analytical effect size was prevalence for the applicable end-points, I[2] statistics, and quality assessment of included studies using the Newcastle-Ottawa Scale. Eleven articles were included after the literature search yielded 223 potentially relevant articles. We found that among patients with long COVID, fatigue, sleep disturbances, and dyspnea were the most common symptoms. Pooled analysis showed that the proportion of individuals experiencing at least one persistent symptom 3 years post-COVID-19 is 20% (95% confidence interval [CI]: 8-43). The prevalence of persistent symptoms was dyspnea (12%; 95% CI: 10-15), fatigue (11%; 95% CI: 6-20), insomnia (11%; 95% CI: 2-37), loss of smell (7%; 95% CI: 5-8), loss of taste (7%; 95% CI: 3-16), and anxiety (6%; 95% CI: 1-32). Prevalence of other findings include impaired diffusion capacity (42%; 95% CI: 34-50) and impaired forced expiratory volume in 1 s (10%; 95% CI: 8-12). Our findings confirm the persistence of unresolved symptoms 3 years post-COVID-19 infection, with implications for future research, healthcare policy, and patient care.}, } @article {pmid40475715, year = {2025}, author = {Caramoci, A and Smaranda, AM and Drăgoiu, TS and Bădărău, IA}, title = {ECG Screening in Athletes: A Systematic Review of Sport, Age, and Gender Variations.}, journal = {Reviews in cardiovascular medicine}, volume = {26}, number = {5}, pages = {38209}, pmid = {40475715}, issn = {2153-8174}, abstract = {BACKGROUND: The electrocardiogram (ECG) screening in athletes is essential due to the unique cardiac adaptations induced by intensive training. However, differentiating between physiological adaptations and pathological abnormalities remains a significant challenge, particularly when considering variations across different sports, ages, and genders.

METHODS: A systematic review of observational studies published between 2015 and 2025 was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were extracted from 20 studies examining ECG changes in athletes across endurance, strength, and mixed sports, encompassing both adolescent and adult populations.

RESULTS: Commonly observed ECG changes included increased QRS amplitude, T-wave inversions, and sinus bradycardia, particularly in endurance athletes, while strength-based athletes frequently exhibited left ventricular hypertrophy. Male athletes showed higher QRS voltages, longer QRS durations, and higher PR intervals, whereas female athletes demonstrated elevated resting heart rates and prolonged corrected QT interval (QTc) intervals. Adolescents who engaged in regular sports displayed fewer abnormal ECG findings than adults; however, high-intensity training in adolescent athletes was associated with right atrial enlargement and increased P-wave duration. Detraining effectively reversed certain ECG changes, including prolonged QT intervals and T-wave abnormalities, though these changes often reappeared upon resumption of intense training. Notably, de novo ECG abnormalities, such as T-wave inversions and ST-segment depression, were identified in athletes with post-COVID-19 infections. This review also highlights the financial burden of widespread ECG screening, but reinforces the importance of ECG screening in preventing sudden cardiac death (SCD) through comprehensive cardiac evaluations.

CONCLUSION: This review emphasizes the complexity of ECG interpretation in athletes, highlighting sport-specific, gender-based, and age-related variations. The persistent high false-positive rates underscore the need for refined, sport-specific ECG guidelines. Recent recognition of sports medicine as a primary specialty within the European Union (EU) reinforces the importance of comprehensive physician training. Integrating artificial intelligence (AI) technology into ECG screening can enhance diagnostic accuracy, reduce costs, and facilitate large-scale implementation. Meanwhile, collaborative efforts among clinicians, researchers, and policymakers are essential to developing cost-effective and standardized ECG screening protocols, ensuring improved athlete care, and advancing the field of sports cardiology.}, } @article {pmid40475275, year = {2025}, author = {Udoh, EE and Udoh, UA and Egwuenu, A and Esu, EB and Eteng, A and Ovat, FE and Okomo, U and Oduwole, O and Okebe, J and Meremikwu, M}, title = {Soap and water cleaning versus bleach-based cleaners for eliminating SARS-CoV-2 infection.}, journal = {Journal of public health in Africa}, volume = {16}, number = {2}, pages = {612}, pmid = {40475275}, issn = {2038-9922}, abstract = {BACKGROUND: Households and community settings are important hubs for the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As understanding of viral transmission improves, infection prevention and control (IPC) policies need to be updated.

AIM: To compare the effectiveness of soap and water alone to bleach-based cleaners in eliminating SARS-CoV-2 infection in households and community settings.

SETTING: We conducted a virtual search through the Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane database of systematic reviews, PubMed, EMBASE, and Effective Practice and Organisation of Care (EPOC).

METHODS: We assessed studies which compared the effect of soap and water cleaning on SARS-CoV-2 among humans to that of bleach-based cleaning, both in households and communities. We prioritised systematic reviews and randomised studies and only included other study designs, such as laboratory studies, which had interventions of relevant interest.

RESULTS: We retrieved 1192 articles from the search. We summarised evidence from three laboratory studies as there were no randomised controlled trials (RCTs) or comparative effectiveness studies that met our inclusion criteria. Indirect evidence suggests that soap and bleach-based cleaners were effective at different concentrations. Substantial heterogeneity between the cited studies precludes any inference on effectiveness in reducing risk of SARS-CoV-2 infection in humans. Both interventions remain important components of IPC measures.

CONCLUSION: There was no evidence for comparison of soap and water versus bleach-based cleaners against SARS-CoV-2 in humans in household and community settings. Indirect evidence shows both interventions to be effective against the virus.

CONTRIBUTIONS: Primary studies addressing this critical question are required to guide public health recommendations and policies.}, } @article {pmid40474772, year = {2025}, author = {Gupta, G and Buonsenso, D and Wood, J and Mohandas, S and Warburton, D}, title = {Mechanistic Insights Into Long Covid: Viral Persistence, Immune Dysregulation, and Multi-Organ Dysfunction.}, journal = {Comprehensive Physiology}, volume = {15}, number = {3}, pages = {e70019}, doi = {10.1002/cph4.70019}, pmid = {40474772}, issn = {2040-4603}, mesh = {Humans ; *COVID-19/immunology/complications/virology/physiopathology ; *SARS-CoV-2/physiology ; *Multiple Organ Failure/immunology/virology/etiology ; Post-Acute COVID-19 Syndrome ; Animals ; }, abstract = {Long Covid is a post-viral syndrome characterized by persistent symptoms targeting multiple organ systems after initial SARS-CoV-2 infection. Current literature suggests that the mechanisms causing Long Covid involve viral persistence, immune dysregulation, systemic inflammation, endothelial dysfunction, and metabolic disturbances. By forming reservoirs in the tissues of various organs, SARS-CoV-2 may evade immunological clearances while triggering immune responses and contributing to chronic symptoms through cytokine imbalances, T-cell exhaustion, and systemic inflammation. These symptoms parallel other post-viral syndromes such as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), suggesting similar mechanisms of pathology. The coronavirus has also been linked to neuroinflammation and endothelial dysfunction causing cognitive symptoms and cardiovascular complications. Furthermore, its ability to lower energy production links it to post-exertion malaise (PEM) and muscle pain. These symptoms may result from iron dysregulation and persistent oxidative stress due to Covid-impaired mitochondrial function. This review synthesizes current data on the mechanisms that drive Long Covid pathogenesis and explores potential therapeutic strategies to mitigate viral persistence, immune dysfunction, and metabolic disturbances. It is critical to understand these interactions to develop targeted interventions that address the long-term sequelae of SARS-CoV-2 infection and improve patient outcomes.}, } @article {pmid40473269, year = {2025}, author = {Andresen, K and Carreira, H and Jain, R and Forbes, H and Williamson, E and Quint, JK and Bhaskaran, K}, title = {Associations between cancer survivorship and subsequent respiratory disease: a systematic literature review.}, journal = {BMJ open respiratory research}, volume = {12}, number = {1}, pages = {}, pmid = {40473269}, issn = {2052-4439}, support = {/WT_/Wellcome Trust/United Kingdom ; }, mesh = {Humans ; *Cancer Survivors/statistics & numerical data ; *Survivorship ; *Respiratory Tract Diseases/epidemiology/etiology ; *Neoplasms/complications ; Respiratory Tract Infections/epidemiology ; Risk Factors ; }, abstract = {BACKGROUND: The population of cancer survivors is growing. Some cancers and their treatments may lead to long-term adverse respiratory issues. This systematic review aims to summarise the evidence on the association between cancer survivorship and long-term respiratory health, across a range of cancer types.

METHODS: We searched Cochrane, Embase and MEDLINE up until 23 February 2025 for cohort or nested case-control studies comparing incident respiratory outcomes in people with a history of cancer versus population-based cancer-free controls. We required studies to include follow-up time beyond the period of active cancer treatment. Outcomes included acute respiratory infections and chronic respiratory conditions. Study quality was assessed using The Scottish Intercollegiate Guidelines Network methodology checklists.

RESULTS: We identified 34 eligible cohort studies. Cancer survivors' cohort sizes ranged from 1325 to >8 million. Only 4 out of 34 studies adjusted for smoking, leading to most studies being rated as low quality. Four of the 21 studies of acute respiratory infections were rated as acceptable/high quality, and of these, all observed raised risks, notably among survivors of haematological, head and neck, lung and oesophageal cancers. Of 19 studies of chronic respiratory conditions, 1 was rated as high quality, finding increased risks of chronic obstructive pulmonary disease (COPD) and pneumonitis in survivors of head and neck cancer. The remaining studies found increased risks of adverse outcomes from acute respiratory infections in 17 of 21 cancer types for which data were available, and of COPD in cervical, head and neck, lung, oesophageal, oral, stomach, thyroid and vulva cancers.

DISCUSSION: These findings suggest increased risks of a range of respiratory conditions in survivors of some cancers. Much of the evidence is compromised by a lack of control for key potential confounders, like smoking. Future studies should address this limitation and investigate the drivers of respiratory risks in cancer survivors. Improved evidence could inform mitigation strategies and lead to better survivorship care plans.

PROSPERO REGISTRATION NUMBER: CRD42022311557.}, } @article {pmid40473220, year = {2025}, author = {Malune, P and Esposito, F and Tramontano, E}, title = {Unveiling SARS-CoV-2's heart: role, structure and inhibition of SARS-CoV-2 RNA-dependent RNA polymerase.}, journal = {Antiviral research}, volume = {240}, number = {}, pages = {106208}, doi = {10.1016/j.antiviral.2025.106208}, pmid = {40473220}, issn = {1872-9096}, mesh = {*SARS-CoV-2/drug effects/enzymology ; *Antiviral Agents/pharmacology/chemistry ; Humans ; Virus Replication/drug effects ; *RNA-Dependent RNA Polymerase/antagonists & inhibitors/chemistry/metabolism ; *Viral Nonstructural Proteins/antagonists & inhibitors/chemistry/metabolism ; Coronavirus RNA-Dependent RNA Polymerase/antagonists & inhibitors/chemistry ; COVID-19/virology ; RNA, Viral ; COVID-19 Drug Treatment ; *Betacoronavirus/enzymology/drug effects ; Pandemics ; }, abstract = {SARS-CoV-2 emergence in late 2019 represented an incredible challenge for virological research and the development of novel as well as repurposed antiviral agents. Among the targeted viral proteins, one is nsp12 that carries the RNA-dependent RNA polymerase (RdRp) activity, essential for the viral replication. Together with nsp7 and nsp8 cofactors, having an essential role in aiding processivity and associated with several other nonstructural proteins such as helicase, methyltransferase, endo- and exonuclease, nsp12 forms the large viral replication and transcription complex (RTC). Within such RTC, nsp12 catalyzes the synthesis of one of the longest RNA genomes in the viral world, requiring exceptional speed, processivity and fidelity compared to other viral RdRps. Moreover, the peculiar replication cycle of coronaviruses requires nsp12 to perform less conventional functions in backtracking on the viral genome for proof-reading activity and "jumping" during discontinuous synthesis of subgenomic mRNAs. The structure of the minimal RTC was resolved with a resolution <3 Å by cryo-electron microscopy in complex with RNA and with inhibitors, opening the doors to structural studies on its functions and drug development. Given its essential role in viral replication, extensive research was carried out over the last years to identify both nucleoside (NI) and non-nucleoside (NNI) inhibitors, resulting in two NIs reaching clinical use, although their efficacy in vivo is still under evaluation. This review aims at summarizing the currently known structural and functional aspects and the state-of-the art in drug discovery for SARS-CoV-2 RdRp.}, } @article {pmid40472669, year = {2025}, author = {Mohammadi, S and Sisay, MM and Saraswati, PW and Osman, AK and Zuithoff, NPA and Weibel, D and Sturkenboom, M and Ahmadizar, F}, title = {COVID-19 vaccine safety studies among special populations: A systematic review and meta-analysis of 120 observational studies and randomized clinical trials.}, journal = {Vaccine}, volume = {61}, number = {}, pages = {127342}, doi = {10.1016/j.vaccine.2025.127342}, pmid = {40472669}, issn = {1873-2518}, mesh = {Humans ; Observational Studies as Topic ; *COVID-19 Vaccines/adverse effects/administration & dosage ; *COVID-19/prevention & control ; Randomized Controlled Trials as Topic ; Pregnancy ; Female ; Child ; SARS-CoV-2/immunology ; Infant ; Vaccination/adverse effects ; Incidence ; }, abstract = {BACKGROUND: The COVID-19 vaccines were rapidly developed and tested, but concerns about vaccine-related adverse events remain, especially in special groups like pregnant women, children, and those with certain health conditions. This review aims to summarize rates of such adverse events in individuals often not included in randomized clinical trials (RCT).

METHOD: From December 2019 to February 2022, we searched Embase and Medline for observational studies and RCTs on adverse events post-COVID-19 vaccination in special populations. We examined severe and non-severe events in individuals with specific medical conditions, infants, children, pregnant individuals, and socioeconomically disadvantaged individuals. Cumulative risks for all events were calculated. The Incidence rate (IR) and 95% confidence intervals were reported for those studies that met the follow-up period criteria based on the referenced literature. For events with data on exposed and unexposed groups, we calculated the odds ratio (OR). Pooled incidence rates were calculated per 1000,000 person-days using a random-effects model. Sub-group analyses were conducted based on vaccine types and doses, with heterogeneity assessed using I[2].

RESULTS: Of the 4,254 papers, 235 met eligibility criteria, including 120 studies with 171,073 participants (113 observational, eight RCTs). We examined 17 severe and seven non-severe adverse event categories. Lymphadenopathy (IR: 1950[1200,3190]), autoimmune disease and multiple sclerosis flare-up (1130 [470,2680]), and cardiac symptoms (0.26[0.00,10.58]) were the most prevalent severe adverse events. Autoimmune disease flare-ups and cardiac symptoms were more common following the second dose compared to the first dose. The overall incidence of serious adverse events was low in children and adolescents, pregnant, autoimmune, and cancer patients.

DISCUSSION: This review highlights COVID-19 vaccine safety in special populations, enhancing vaccination strategies. Further real-world research is needed to validate and extend our findings, especially in addressing safety gaps among special groups.}, } @article {pmid40471123, year = {2025}, author = {Alves, MCS and Rego, MS and Silva, RCCD and Silva, RA and Arruda, IES and Paiva-Júnior, SSL and Balbino, VQ}, title = {Gut Microbiota and COVID-19: Unraveling the Gut-Lung Axis and Immunomodulatory Therapies.}, journal = {ACS infectious diseases}, volume = {11}, number = {7}, pages = {1844-1853}, pmid = {40471123}, issn = {2373-8227}, mesh = {Humans ; *Gastrointestinal Microbiome/immunology ; *COVID-19/immunology/microbiology/therapy ; SARS-CoV-2 ; Dysbiosis/microbiology/immunology ; Probiotics/therapeutic use ; *Lung/immunology/microbiology ; Prebiotics/administration & dosage ; Antiviral Agents/therapeutic use ; Immunomodulation ; }, abstract = {The gut flora modulates immune responses and influences COVID-19 severity. SARS-CoV-2 disrupts the gut microbiota, causing dysbiosis, increased intestinal permeability, and systemic inflammation and worsening clinical outcomes. Dysbiosis correlates with elevated inflammatory markers, such as CRP and PCT, contributing to severe complications. Studies show that COVID-19 patients have reduced beneficial bacteria, such as Faecalibacterium prausnitzii and Bifidobacterium spp., alongside increased opportunistic pathogens. This review explores how gut microbiota impacts COVID-19 through predictive microbial signatures and immunomodulatory mechanisms. Therapeutic strategies, including probiotics, prebiotics, and fiber-rich diets, may restore microbial balance, reduce inflammation, and support recovery. Additionally, we examine the effects of antiviral and immunomodulatory therapies on the gut microbiota and their role in post-COVID-19 rehabilitation. Understanding the gut-lung axis in SARS-CoV-2 pathogenesis may reveal microbiota-targeted treatments to improve outcomes and prevent complications. As the host organ with the highest microbial diversity, the gut plays a crucial role in viral infections and warrants further research.}, } @article {pmid40471062, year = {2025}, author = {Piñana, JL and Martino, R and Cesaro, S and Averbuch, D and Lujgman, P}, title = {To proceed or delay? The dilemma of community-acquired respiratory viruses in adults and pediatrics before allogeneic stem cell transplantation and chimeric-antigen-receptor T-cell therapy.}, journal = {Current opinion in infectious diseases}, volume = {38}, number = {4}, pages = {290-299}, doi = {10.1097/QCO.0000000000001120}, pmid = {40471062}, issn = {1473-6527}, mesh = {Humans ; *Hematopoietic Stem Cell Transplantation/adverse effects ; *Community-Acquired Infections/virology ; *Respiratory Tract Infections/virology ; Adult ; *Immunotherapy, Adoptive/adverse effects ; Child ; Transplantation, Homologous ; *Virus Diseases ; }, abstract = {PURPOSE OF REVIEW: This review explores the impact of community-acquired respiratory virus (CARV) infections on outcomes before proceeding with hematopoietic cell transplantation (HCT) and chimeric-antigen-receptor T-cell (CAR-T) therapy recipients and which conditions should be considered to delay or proceed with cell therapy. It aims to assess current practices, the risks associated with early CARV infections in cell therapy recipients, and potential modifications to reduce complications and improve clinical outcomes if delay is not an option.

RECENT FINDINGS: Studies have shown that pretransplant CARV infections, particularly those with symptomatic lower respiratory tract disease (LRTD), are linked to increased mortality and prolonged hospitalization after hematopoietic stem cell transplant. The timing of CARV infection regarding the transplant, the type of CARV, and the intensity of immunosuppressive conditioning, among others, are key factors influencing outcomes. Additionally, recent research highlights the potential benefits of delaying transplantation, optimizing immunosuppression, and reducing the duration of neutropenia and lymphopenia to mitigate the risk of severe infections.

SUMMARY: Key challenges include determining the optimal timing for transplant in CARV-positive patients, managing cell procedures, and minimizing risk factors to reduce the development of a severe course resulting in poor outcome. Current practices often prioritize timely transplant/CAR-T procedures but may need to be adjusted to account for CARV infections. Implementing strategies such as reduced-intensity conditioning, enhanced infection prevention measures, and antiviral therapy could significantly impact patient outcomes, particularly in preventing progression to LRTD and reducing the risk for fatal outcome.}, } @article {pmid40470564, year = {2025}, author = {Iannuccelli, C and Favretti, M and Dolcini, G and Di Carlo, M and Pellegrino, G and Bazzichi, L and Atzeni, F and Lucini, D and Varassi, G and Leoni, MLG and Fornasari, DMM and Conti, F and Salaffi, F and Sarzi-Puttini, P and Di Franco, M}, title = {Fibromyalgia: one year in review 2025.}, journal = {Clinical and experimental rheumatology}, volume = {43}, number = {6}, pages = {957-969}, doi = {10.55563/clinexprheumatol/buhd2z}, pmid = {40470564}, issn = {0392-856X}, mesh = {Humans ; *Fibromyalgia/therapy/physiopathology/diagnosis/epidemiology/psychology ; Quality of Life ; COVID-19/epidemiology ; }, abstract = {Fibromyalgia (FM) is a chronic syndrome characterised by widespread pain, high prevalence, and a significant impact on quality of life. Despite extensive research, its pathogenesis and treatment remain only partially understood, driving continued investigation throughout 2024. Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system has been linked to chronic stress responses and neuroinflammation, with neuroimaging and preclinical studies confirming altered pain and stress processing. Low-grade inflammation and metabolic disturbances, including cytokine imbalance and increased adipose tissue infiltration, further exacerbate symptoms. Alterations in the gut microbiota contribute to immune and emotional dysregulation. MRI studies continue to reveal brain changes that differentiate FM from other chronic pain disorders. Multi-omics approaches, including transcriptomic and metabolomic analyses, show promise as diagnostic biomarkers. Mitochondrial dysfunction also emerges as a key factor, since impaired energy metabolism seems to correlate with symptom severity. From a clinical perspective, recent studies have explored under-recognised aspects of FM, such as sexual and cognitive dysfunction, the role of gender, environmental exposures, and the disease's impact on relationships and family life. The differential diagnosis of FM and long COVID has ignited discussion about potential shared mechanisms. Conversely, residual pain in inflammatory diseases remains insufficiently addressed. Therapeutically, non-pharmacological strategies, particularly physical activity and psychosocial interventions, remain fundamental. Emerging areas such as non-invasive neuromodulation, psychedelic therapies, and the integration of technologies like virtual reality and artificial intelligence are opening new frontiers in treatment, patient care, and research. These advances underscore the multifactorial nature of FM and the need for personalised, interdisciplinary approaches.}, } @article {pmid40470521, year = {2025}, author = {Tan, JXR and Oshitani, H and Khanh, LP and Jitpeera, C and Ferretti, L and Cook, AR}, title = {Lessons for future outbreaks from successful contact tracing systems in Asia.}, journal = {The Lancet regional health. Western Pacific}, volume = {58}, number = {}, pages = {101563}, pmid = {40470521}, issn = {2666-6065}, abstract = {Countries around the world had utilized contact tracing to support public health responses to curb transmission during the COVID-19 pandemic. In particular, countries in East and Southeast Asia had been effective in their contact tracing responses. To understand their successes, the contact tracing systems of Japan, Thailand, Singapore and Vietnam were comparatively analyzed, including the technical aspects of contact tracing approaches, detection and response structures. Through the comparative analysis, we uncovered the key elements within these successful systems, namely speed, capture and accuracy, designed specific for the countries' settings. For the system to work efficiently, we found that maintaining the balance across speed, capture and accuracy while adapting to the disease epidemiology and environment was essential. Contact tracing will remain a vital strategy to control the next epidemic with a pandemic potential. The lessons learnt could provide guiding principles to help enhance contact tracing systems and prepare for future outbreaks.}, } @article {pmid40469441, year = {2025}, author = {Zhao, X and Jiang, L and Sun, W and Tang, S and Kang, X and Gao, Q and Li, Z and An, X and Lian, F}, title = {Understanding the interplay between COVID-19 and diabetes: insights for the post-pandemic era.}, journal = {Frontiers in endocrinology}, volume = {16}, number = {}, pages = {1599969}, pmid = {40469441}, issn = {1664-2392}, mesh = {Humans ; *COVID-19/complications/epidemiology ; *SARS-CoV-2 ; *Diabetes Mellitus/epidemiology/virology ; Pandemics ; Diabetes Complications/epidemiology ; Blood Glucose/metabolism ; Renin-Angiotensin System ; }, abstract = {The global pandemic caused by the SARS-CoV-2 virus has had a profound impact on the onset, progression, and management of diabetes, posing significant challenges to healthcare systems worldwide. This review elucidates the multifaceted impact of SARS-CoV-2 on diabetes mellitus, emphasizing the increased complexity of glycemic management in patients with SARS-CoV-2 infection following viral infection in the postpandemic era. In this study, we examined the diverse effects of the SARS-CoV-2 virus on individuals with diabetes. These effects included an elevated risk of morbidity, erratic fluctuations in blood glucose levels, the emergence of complications associated with diabetes, and the emergence of challenges related to self-management of the disease. From a mechanistic perspective, we investigated the following factors: SARS-CoV-2-mediated direct damage to islet beta cells, dysregulation of the RAAS system, impairment of islet function by oxidative stress, and the effects of the integrated stress response, stress response, and reduced adiponectin levels on insulin utilization efficiency and glucose metabolism. Furthermore, viral effects extend to diabetic complications and cardiovascular risk factors, such as coagulation abnormalities, hypertension, and lipid metabolism. This results in an exacerbation of the development of diabetic complications. This review highlights the urgent need for refined management strategies for patients with diabetes during the pandemic and in the later stages of COVID-19. Additionally, there is a need for integrated management strategies to mitigate the impact of COVID-19 on the long-term outcomes of patients with diabetes.}, } @article {pmid40469238, year = {2025}, author = {Harb, A and Souza-Talarico, JN and Willey, G and da Silva, FC and de Jesus, MCF and Deberg, J}, title = {Loneliness during the COVID-19 pandemic: A potential risk factor for post-pandemic cognitive decline in older adults without dementia.}, journal = {Dementia & neuropsychologia}, volume = {19}, number = {}, pages = {e20240256}, pmid = {40469238}, issn = {1980-5764}, abstract = {UNLABELLED: The COVID-19 pandemic has exacerbated loneliness and social isolation among older adults, raising concerns about their mental and physical well-being. While loneliness's adverse effects on health are well-documented, its specific impact on cognitive health during the pandemic remains under investigation.

OBJECTIVE: The aim of this study was to examine the association between loneliness during the COVID-19 pandemic and cognitive decline in cognitively unimpaired older adults by synthesizing evidence from primary studies.

METHODS: A comprehensive search strategy was employed across multiple databases, including MEDLINE (PubMed), CINAHL (EBSCO), PsycINFO (EBSCO), EMBASE, Scopus, AgeLine, and ProQuest, following PRISMA guidelines. Studies were selected to examine the association between loneliness and cognitive function in cognitively unimpaired older adults (aged ≥50 years) during the COVID-19 pandemic.

RESULTS: A total of eight studies were included from 1,384 search results, reviewing data from 10,449 cognitively unimpaired older adults. A total of six studies found significant associations between loneliness or social isolation and subjective cognitive decline (SCD). Only one study linked loneliness to lower objective cognitive performance. Notably, half of the studies considered key covariates, such as depression, which could mediate the relationship between loneliness and cognitive decline.

CONCLUSION: Loneliness during the COVID-19 pandemic is linked to SCD in older adults, though objective evidence is limited. The pandemic underscored the long-term impact of social isolation on cognition and mental health, highlighting the need for standardized neuropsychological tools and key covariates in studies to identify those at risk.}, } @article {pmid40469133, year = {2025}, author = {Zhang, Y and Hu, J and Xu, Q and Zhang, F and Sun, C and Liu, K}, title = {The efficacy and safety of corticosteroids in treating severe COVID-19 patients: A meta-analysis with trial sequential analysis.}, journal = {Pakistan journal of medical sciences}, volume = {41}, number = {5}, pages = {1517-1525}, pmid = {40469133}, issn = {1682-024X}, abstract = {BACKGROUND AND OBJECTIVE: Corticosteroids (CSs) are often administered for coronavirus disease 2019 (COVID-19); however, the advantages and disadvantages of CSs remain controversial. Accordingly, we performed a meta-analysis with trial sequential analysis (TSA) to ascertain the efficacy and safety of CSs in treating COVID-19.

METHODS: From their inception until April 2023, PubMed, Embase, The Cochrane Library, Web of Science, and China Biology Medicine(CBM) were searched to gather randomized controlled trials on the administration of CSs for COVID-19 treatment. Following the literature screening according to the inclusion criteria, data extraction and quality assessment were conducted by two reviewers, and then we conducted a meta-analysis with trial sequential analysis using RevMan 5.4 and TSA v0.9, respectively. This meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, and the study protocol was registered with PROSPERO (CRD42023458633).

RESULTS: A total of 6,077 literatures were obtained through the search, and 14 studies were finally included for quantitative meta-analysis. The meta-analysis revealed that the all-cause mortality in the group treated with CSs and standard treatment was significantly lower than that in the control group that received only standard treatment (RR 0.89, 95% CI: 0.82-0.96, P=0.002), with a statistically significant difference. However, the TSA analysis revealed that the cumulative Z value exceeded the traditional boundary value yet did not surpass the TSA boundary value, indicating a possibility of false positive outcomes in the meta-analysis. The incidence of adverse reactions in the group receiving CSs treatment was higher than that in the control group, but the distinction was not statistically significant (RR 1.02, 95% CI: 0.64-1.63, P=0.93).

CONCLUSION: CSs appear to be effective and safe in decreasing the overall mortality of patients who suffer from severe COVID-19; however, further assessment is required to determine adverse reactions and improvements in clinical symptoms associated with CS administration.}, } @article {pmid40469015, year = {2025}, author = {Zheng, L and Feng, H}, title = {Respiratory virus mRNA vaccines: mRNA Design, clinical studies, and future challenges.}, journal = {Animal models and experimental medicine}, volume = {}, number = {}, pages = {}, doi = {10.1002/ame2.70018}, pmid = {40469015}, issn = {2576-2095}, support = {2021YFA1300301//Grants from the Ministry of Science and Technology of the People's Republic of China/ ; 2018YFA0507101//Grants from the Ministry of Science and Technology of the People's Republic of China/ ; 31730054//National Natural Science Foundation of China/ ; 31770900//National Natural Science Foundation of China/ ; 5212016//Beijing Natural Science Foundation/ ; }, abstract = {Respiratory infectious diseases frequently erupt on a global scale, with RNA viruses, such as SARS-CoV-2, RSV, and influenza viruses, posing challenges to vaccine development due to their high mutation rates. Traditional vaccine development cycles are lengthy and struggle to keep pace with rapidly evolving viruses, whereas messenger RNA (mRNA) vaccines have demonstrated significant advantages due to their short development periods, straightforward production, and low costs. After the outbreak of the COVID-19 pandemic, multiple mRNA vaccines, including Pfizer-BioNTech and Moderna, rapidly received emergency use authorization, validating their feasibility. The Nobel Prize in Physiology or Medicine in 2023 was awarded to Katalin Karikó and Drew Weissman, underscoring the efficacy of mRNA vaccine technology. In 2024, the U.S. Food and Drug Administration (FDA) approval of Moderna's respiratory syncytial virus (RSV) mRNA vaccine marked the immense potential of mRNA technology in vaccine innovation. This review article summarizes the design, clinical research, and future challenges of mRNA vaccines for respiratory viruses, delving into antigen design, mRNA delivery systems, and advancements in vaccines for multiple respiratory viruses, including innovations in self-amplifying mRNA and circular mRNA vaccines. Additionally, the development of combination vaccines is underway, aiming to provide protection against multiple viruses through a single administration. Despite the significant progress in mRNA vaccine development, challenges remain regarding raw material costs, stability, and delivery efficiency. In the future, with technological advancements and the accumulation of clinical experience, the design strategies and delivery systems of mRNA vaccines are expected to be continuously optimized, thereby enhancing their safety and efficacy.}, } @article {pmid40468266, year = {2025}, author = {Conway-Moore, K and Birch, JM and McKinlay, AR and Graham, F and Oliver, E and Bambra, C and Kelly, MP and Bonell, C}, title = {How populist-aligned views affect receipt of non-COVID-19-related public health interventions: a systematic review of quantitative studies.}, journal = {BMC public health}, volume = {25}, number = {1}, pages = {2075}, pmid = {40468266}, issn = {1471-2458}, support = {PR-PRU-1217-20501//National Institute for Health and Care Research (NIHR) Policy Research Unit Behavioural and Social Sciences/ ; PR-PRU-1217-20501//National Institute for Health and Care Research (NIHR) Policy Research Unit Behavioural and Social Sciences/ ; PR-PRU-1217-20501//National Institute for Health and Care Research (NIHR) Policy Research Unit Behavioural and Social Sciences/ ; PR-PRU-1217-20501//National Institute for Health and Care Research (NIHR) Policy Research Unit Behavioural and Social Sciences/ ; PR-PRU-1217-20501//National Institute for Health and Care Research (NIHR) Policy Research Unit Behavioural and Social Sciences/ ; PR-PRU-1217-20501//National Institute for Health and Care Research (NIHR) Policy Research Unit Behavioural and Social Sciences/ ; PR-PRU-1217-20501//National Institute for Health and Care Research (NIHR) Policy Research Unit Behavioural and Social Sciences/ ; PR-PRU-1217-20501//National Institute for Health and Care Research (NIHR) Policy Research Unit Behavioural and Social Sciences/ ; }, mesh = {Humans ; *COVID-19/prevention & control ; *Public Health ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Globally, there is increasing evidence of resistance to government-led public health interventions in areas such as vaccination, climate change mitigation, sexual and reproductive healthcare, and the implementation of non-pharmaceutical infection control measures. One potential explanation for this could be the documented global rise in populist attitudes, characterised by distrust of scientific, government and other perceived 'elites.' While the effect of such attitudes on engagement with COVID-19-related interventions has been extensively considered and researched, their association with the receipt of other public health interventions is currently underexplored.

METHODS: To understand how populist-aligned views might influence the receipt of public health interventions addressing areas other than COVID-19, we systematically reviewed quantitative research published across thirteen bibliographic databases and relevant websites between 2008 and 2024. All studies were set in member countries of the Organisation for Economic Co-operation and Development (OECD).

RESULTS: Across 30 included studies, the vast majority of which were cross-sectional, we found evidence that populist-aligned attitudes have a negative impact on the receipt of public health interventions including vaccinations, sexual and reproductive health care and preventive health care. We also found preliminary evidence of the negative role of populist-aligned attitudes on the receipt of disease screening related to HIV/AIDS and adherence to non-pharmaceutical interventions during times of public health emergency, such as the 2009 H1N1 pandemic.

CONCLUSIONS: Although providing limited evidence of causality, the findings from this review suggest the need for future policy in many OECD countries to focus on trust-building between the public and political, scientific, and medical establishments. They also indicate the need for mitigation strategies to overcome the potentially negative impact of populist-style hostility towards out-groups on attitudes related to pressing public health issues such as abortion and family planning, for example by drawing on empathy-centred approaches.

PROSPERO registration number CRD42024513124.}, } @article {pmid40466480, year = {2025}, author = {Anastassopoulou, C and Panagiotopoulos, AP and Ferous, S and Poland, GA and Dodick, DW and Tsakris, A}, title = {RSV vaccines and Guillain-Barré syndrome: Insights into an emerging concern.}, journal = {Vaccine}, volume = {61}, number = {}, pages = {127338}, doi = {10.1016/j.vaccine.2025.127338}, pmid = {40466480}, issn = {1873-2518}, mesh = {Humans ; *Guillain-Barre Syndrome/epidemiology/etiology/chemically induced ; *Respiratory Syncytial Virus Infections/prevention & control ; *Respiratory Syncytial Virus Vaccines/adverse effects/administration & dosage ; Vaccination/adverse effects ; Incidence ; }, abstract = {Respiratory syncytial virus (RSV) is a common cause of serious lower respiratory tract infections (LTRI), disproportionately affecting infants and older adults. The recent approval of 3 different RSV vaccines marks a significant advancement in mitigating RSV-related morbidity and mortality. However, the increased incidence of Guillain-Barré syndrome (GBS) following RSV vaccination, confirmed by post-marketing surveillance, has raised concerns. Apart from the previously proposed mechanisms that primarily include molecular mimicry and host genetics, electrolytic hydroelectric disorders, particularly the syndrome of inappropriate secretion of antidiuretic hormone (SIADH)-induced hyponatremia, may be associated with GBS. Given that GBS is more common in individuals >65 years - the primary target group for RSV vaccination - this overlap warrants careful consideration. While the benefits of RSV vaccines have been demonstrated, continued safety monitoring and investigation into rare adverse events such as GBS are essential to ensure public health benefits and confidence while minimizing risks.}, } @article {pmid40466390, year = {2025}, author = {Movahed, F and Haji Hosseini, F and Heidari, A and Dehbozorgi, M and Ataei, M and Vahidi, F and Abyaneh, R and Bajelan, B and Bakhtiyari, M and Shafiee, A}, title = {COVID-19 vertical transmission from mothers to neonates: A systematic review and meta-analysis of 204 studies.}, journal = {Journal of infection and public health}, volume = {18}, number = {9}, pages = {102825}, doi = {10.1016/j.jiph.2025.102825}, pmid = {40466390}, issn = {1876-035X}, mesh = {Humans ; *Infectious Disease Transmission, Vertical/statistics & numerical data ; *COVID-19/transmission/epidemiology ; Infant, Newborn ; Female ; Pregnancy ; SARS-CoV-2 ; *Pregnancy Complications, Infectious/virology/epidemiology ; Risk Factors ; Milk, Human/virology ; Antibodies, Viral/blood ; Prevalence ; }, abstract = {This study estimates the prevalence of vertical transmission of SARS-CoV-2 and identifies risk factors for mother-to-neonate transmission. A comprehensive search of PubMed, Scopus, and Web of Science up to May 2024 identified 204 observational studies, out of 28,543 records, that included neonates with confirmed SARS-CoV-2 detection via RT-PCR. The overall vertical transmission rate was 4 % (95 % CI: 4 %-5 %), with notable heterogeneity (I[2] = 75 %). Transmission varied based on delivery method, income classification, and region, being higher in lower-income areas and cesarean deliveries. Maternal SARS-CoV-2 detection in breast milk was rare. Neonatal SARS-CoV-2-specific IgG antibodies were frequently detected, while IgM antibodies were less common. The findings highlight the infrequency of vertical transmission but underline disparities in healthcare practices. Further high-quality studies, especially in low-income regions, are essential for a deeper understanding of vertical transmission dynamics in diverse clinical settings.}, } @article {pmid40465915, year = {2025}, author = {Borges, LA and Silva, PHBD and Zara, ALSA and Oliveira, ESF}, title = {Health surveillance in tackling COVID-19 in Brazil: a scope review.}, journal = {Ciencia & saude coletiva}, volume = {30}, number = {5}, pages = {e02202025}, doi = {10.1590/1413-81232025305.02202025}, pmid = {40465915}, issn = {1678-4561}, mesh = {Brazil/epidemiology ; *COVID-19/prevention & control/epidemiology ; Humans ; *Pandemics/prevention & control ; Federal Government ; *Public Health Surveillance ; }, abstract = {The management of the COVID-19 pandemic in Brazil was marked by contradictory statements and controversial decisions by the head of the executive branch and the Ministry of Health, creating uncertainty about the effective implementation of federal actions to control the disease. This study aims to describe the main health surveillance strategies adopted by the federal government to combat COVID-19, with a focus on actions aimed at preventing SARS-CoV-2 infection. This is a scoping review conducted between November 2019 and January 2021, using DECS and MeSH descriptors in four databases, in addition to consulting 85 legislative documents available on the Brazilian government's legislation portal. The analysis included ten scientific articles and identified federal actions related to non-pharmacological and pharmacological measures, decisions on international borders, procurement of supplies, and essential services. The results point to the presence of sporadic strategies for pandemic containment but reveal insufficient surveillance in the face of the number of cases and deaths recorded. The study highlights the lack of robust federal support, which hindered the coordination and planning.}, } @article {pmid40465890, year = {2025}, author = {Santana, LADM and Oliveira, MKC and Carvalho, MVC and Moura, PHM and Barreto, MDS and Santos, MALD and Santos, PLD and Correia, D and Silva, VKDS and Gopalsamy, RG and Trento, CL and Borges, LP and Takeshita, WM}, title = {Cytogenetic Alterations Observed in Exfoliative Cells of the Tongue and Oral Mucosa of SARS-CoV-2-Vaccinated Patients: Report of Two Cases and a Brief Literature Review.}, journal = {Revista da Sociedade Brasileira de Medicina Tropical}, volume = {58}, number = {}, pages = {e008042025}, pmid = {40465890}, issn = {1678-9849}, mesh = {Humans ; *Mouth Mucosa/pathology/cytology ; *COVID-19/prevention & control ; *COVID-19 Vaccines/adverse effects ; *Tongue/pathology/cytology ; Male ; SARS-CoV-2 ; Female ; Adult ; Middle Aged ; *Chromosome Aberrations ; }, abstract = {The wide distribution of angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2) in oral tissues, especially in the salivary glands, which are natural reservoirs of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), contributes to the classification of the oral cavity as a potential target for the development of lesions. Despite the effective response produced by next-generation immunizers, the possibility of immune escape by new lineages of SARS-CoV-2 cannot be refuted. Therefore, we describe here the occurrence of cytogenetic alterations in orally exfoliated cells of immunized individuals and, based on the literature review, call attention to the need to monitor these cases in the post-pandemic period.}, } @article {pmid40465774, year = {2025}, author = {Salmam, I and Dubé, MO and Zahouani, I and Ramos, A and Desmeules, F and Best, KL and Roy, JS}, title = {The impact of long COVID on physical and cardiorespiratory parameters: A systematic review.}, journal = {PloS one}, volume = {20}, number = {6}, pages = {e0318707}, pmid = {40465774}, issn = {1932-6203}, mesh = {Humans ; *COVID-19/physiopathology/complications ; SARS-CoV-2 ; Respiratory Function Tests ; Adult ; Exercise Tolerance ; }, abstract = {BACKGROUND: Since the emergence of COVID-19, millions worldwide have continued to experience persistent symptoms months after infection. Among these, physical and cardiorespiratory impairments are frequently reported, but remain poorly understood. This systematic review aimed to identify and synthesize evidence regarding physical and cardiorespiratory impairments in individuals with long COVID, defined as symptoms persisting for at least three months post-infection.

METHODS AND FINDINGS: A structured search was conducted across the MEDLINE, Embase, CINAHL, and Web of Science databases to identify cross-sectional and longitudinal cohort studies on physical and cardiorespiratory deficits in adults with long COVID. Twenty-two studies involving 3,041 adults with long COVID were included. Critical appraisal using the JBI-APT indicated that most studies had clear inclusion criteria (17/22), well-defined study populations (17/22), and valid exposure measurements (16/22), though confounding factors were often unaddressed (9/22 unclear or not reported). Findings indicate that while adults with long COVID displayed normal pulmonary function at rest, including Forced Vital Capacity (FVC), Forced Expiratory Volume (FEV1), Total Lung Capacity (TLC), and resting Arterial oxygen saturation (SpO2), significant impairments in exercise capacity were identified. Notably, all studies assessing the 6-minute walk test (6MWT) reported reduced distances, consistently falling below the 50th percentile of normative values. Additionally, VO₂peak was decreased in most studies (7/10), falling below 80% of the predicted value, indicating impaired aerobic capacity. Lower Diffusing Capacity of the Lungs for Carbon Monoxide (DLCO) values were observed in three out of six studies, with values below 75% of predicted, suggesting impaired gas exchange efficiency during exertion.

CONCLUSION: Despite preserved resting lung function, these findings highlight significant physical deconditioning in Long COVID adults, with substantial reduction in exercise capacity. Routine assessments should include more sensitive measures, such as the 6MWT and VO₂peak, to detect subtle exercise limitations, even in patients with normal resting SpO₂, to better inform rehabilitation interventions.}, } @article {pmid40465208, year = {2025}, author = {Chen, CH and Shih, CF and Hummel, T and Chao, YT}, title = {Multidimensional benefits of olfactory training for chronic COVID-19-related olfactory dysfunction: a systematic review and meta-analysis.}, journal = {Rhinology}, volume = {63}, number = {4}, pages = {431-440}, doi = {10.4193/Rhin24.355}, pmid = {40465208}, issn = {0300-0729}, mesh = {Humans ; Chronic Disease ; *COVID-19/complications ; *Olfaction Disorders/physiopathology/rehabilitation/therapy/virology ; *Olfactory Training/methods ; Quality of Life ; SARS-CoV-2 ; Smell/physiology ; }, abstract = {BACKGROUND: Olfactory dysfunction is commonly observed in patients with COVID-19 infection. Chronic olfactory dysfunction can have a profound effect on one’s quality of life. Olfactory training (OT) is a rehabilitation therapy, which has emerged as a viable treatment for COVID-19-related olfactory dysfunction. Our primary objective was to assess the effectiveness of OT for individuals with chronic COVID-19-related olfactory dysfunction.

METHODS: A search was performed on the Cochrane Library, Embase, PubMed, Scopus, and Web of Science databases from their inception through Feb 24, 2024. Eligible studies included those with sufficient information for meta-analysis pertaining to the effectiveness of OT performed for more than 8 weeks in treating chronic (duration > 16 weeks) COVID-19-related olfactory dysfunction.

RESULTS: After a systematic review of all relevant articles, 9 studies qualified for inclusion. A total of 179 patients within 7 studies had eligible Sniffin' Sticks test data. The pooled results showed significant post-OT increases in TDI score, threshold, discrimination, and identification. Two studies documented qualified UPSIT scores in 63 patients. Pooled results of all identification tests revealed significant improvement.

CONCLUSIONS: OT demonstrates benefits in treating chronic COVID-19-related olfactory dysfunction, as evidenced by multidimensional evaluations. These findings suggest the involvement of both top-down and bottom-up mechanisms in the recovery process.}, } @article {pmid40465080, year = {2025}, author = {Wichmann, D and Hoenigl, M and Koehler, P and Koenig, C and Lund, F and Mang, S and Strauß, R and Weigand, MA and Hohmann, C and Kurzai, O and Heußel, C and Kochanek, M}, title = {Diagnosis and treatment of invasive pulmonary aspergillosis in critically ill intensive care patients: executive summary of the German national guideline (AWMF 113-005).}, journal = {Infection}, volume = {53}, number = {4}, pages = {1299-1310}, pmid = {40465080}, issn = {1439-0973}, mesh = {Humans ; *Invasive Pulmonary Aspergillosis/diagnosis/drug therapy/epidemiology ; Critical Illness ; *Antifungal Agents/therapeutic use ; Germany ; Risk Factors ; *Critical Care ; Intensive Care Units ; COVID-19 ; Voriconazole/therapeutic use ; }, abstract = {PURPOSE: The executive summary of the guideline aims to provide the most relevant recommendations on the diagnosis and treatment of invasive pulmonary aspergillosis in critically ill patients in the intensive care unit.

METHODS: The guideline's work included a systematic literature search, selection and assessment of the data relevant to the issues identified. Key questions included the areas of epidemiology, risk factors, diagnostics, and therapy. They were discussed analogous to a PICO scheme within the guideline committee, with subsequent working groups proposing recommendations for specific key questions, which were then again discussed and finalized by the entire guideline committee.

RESULTS: In addition to the classic risk factors (persistent neutropenia, allogeneic stem cell transplantation, congenital or acquired immunodeficiency, etc.), decompensated liver cirrhosis, COPD, solid tumours and viral pneumonia (influenza, COVID-19) have been established as risk factors for critically ill patients in need of intensive care. If there is no adequate improvement or even further clinical deterioration of the respiratory status in critically ill patients, the presence of IPA should be considered and appropriate diagnostic tests should be initiated. Diagnostics should include a CT scan of the chest and a broncho-alveolar lavage with culture for moulds, testing for galactomannan and PCR. Isavuconazole and voriconazole are recommended as first-line treatment, liposomal amphotericin B as an alternative, with posaconazole (PCZ) or the echinocandins (as an add-on to azole or polyene treatment) being additional options for salvage treatment.

CONCLUSION: Invasive aspergillosis in critically ill patients represents a diagnostic and therapeutic challenge. If indicated, invasive aspergillosis should be considered and appropriate diagnostic tests initiated. Isavuconazole and voriconazole are recommended as first-line treatment, liposomal amphotericin B as an alternative.}, } @article {pmid40465040, year = {2025}, author = {Ma, J and Paltin, D and Buch, KD and Miller-Perusse, M and Jaramillo, J and Horvath, KJ}, title = {Pre-Exposure Prophylaxis Care Engagement Among Men Who Have Sex with Men in the United States During the COVID-19 Pandemic: A Scoping Review.}, journal = {AIDS and behavior}, volume = {}, number = {}, pages = {}, pmid = {40465040}, issn = {1573-3254}, support = {T32 MH126772/MH/NIMH NIH HHS/United States ; }, abstract = {The COVID-19 pandemic substantially impacted the pre-exposure prophylaxis (PrEP) care continuum among men who have sex with men (MSM). While PrEP use during the pandemic has been studied, regional differences in PrEP regulations highlight the need for U.S.-specific reviews. This scoping review evaluates empirical literature on COVID-19's impact on PrEP engagement among U.S. MSM. A systematic search on August 29, 2024, identified articles from PubMed, PsycINFO, and Embase. Eligible studies (a) collected empirical data from U.S. MSM, (b) assessed COVID-19's impact on PrEP engagement, and (c) were peer-reviewed, English-language, full-text articles. Standardized forms were used to extract study information. Study quality was appraised using validated tools for qualitative and quantitative research. Findings were synthesized using descriptive statistics and narrative summaries, categorized by distinct pandemic phases. Of 438 records, 21 studies were included (15 quantitative, five qualitative, one mixed-method), mostly conducted during the lockdown phase. Results showed reduced PrEP use (5.9-35.6%), increased missed doses (8.3-14.2%), and higher discontinuation rates (9.0-33.3%) during COVID-19. Barriers included refill issues (9.0-20.0%), limited access to care (2.5-17.0%), disrupted lab testing (~ 25.5%), and changes in clinic procedures. College-aged youth reported confidentiality concerns after returning home. Qualitative evidence highlighted telehealth and injectable PrEP as promising alternatives. This review reveals significant disruptions to PrEP care for U.S. MSM during COVID-19, a lack of post-lockdown research, underrepresentation of MSM from Northeastern and Pacific regions, and limited use of objective PrEP adherence measures. These findings underscore the need for emergency-prepared PrEP services and expanded telehealth and home-delivery options for future crises.}, } @article {pmid40464778, year = {2025}, author = {Leite Barbosa, N and Rangel Agra Oliveira, T and Nóbrega, LD and Araújo, TTF and Dos Santos Bezerra, SR and Oliveira, GM and Do Nascimento, RM and de Miranda Silva Nogueira, PA and Tomaz, AF and Do Nascimento Sales Figueiredo Fernandes, AT}, title = {Prevalence and characteristics of respiratory and cardiovascular sequelae in post-COVID-19 syndromes: a scoping review.}, journal = {Expert review of respiratory medicine}, volume = {19}, number = {9}, pages = {935-953}, doi = {10.1080/17476348.2025.2515992}, pmid = {40464778}, issn = {1747-6356}, mesh = {Humans ; *COVID-19/complications/epidemiology/therapy ; Prevalence ; *Cardiovascular Diseases/epidemiology/etiology ; *Dyspnea/epidemiology/etiology ; Risk Factors ; Post-Acute COVID-19 Syndrome ; Cough/epidemiology ; SARS-CoV-2 ; }, abstract = {INTRODUCTION: Post acute and Long COVID-19 are public health issues, marked by persistent respiratory and cardiovascular symptoms such as dyspnea and palpitations. These complications often extend beyond the acute phase, affecting even individuals with mild or moderate COVID-19. This article reviews the clinical impact of long COVID-19 and emphasizes the need for a multidisciplinary approach to management.

AREAS COVERED: A comprehensive literature search was conducted through PubMed, Medline, CINAHL, SciELO, and LILACS to identify studies published up to 28 October 2024, reporting on respiratory and cardiovascular sequelae in long COVID-19. This review examines the prevalence and characteristics of persistent symptoms such as dyspnea, cough, and palpitations, as well as the associated risk factors and assessment methods.

EXPERT OPINION: Long COVID-19 represents a significant healthcare challenge, underscoring the need for standardized protocols for diagnosis and treatment. A multidisciplinary approach is crucial to address the diverse symptoms of affected patients. Future research should focus on understanding the underlying pathophysiology, and developing targeted therapeutic strategies to improve patient outcomes.}, } @article {pmid40464669, year = {2025}, author = {Polishchuk, H and Synowiec, A and Zubrzycka, N and Kantyka, T}, title = {Porphyromonas gingivalis: Multiple Tools of an Inflammatory Damage.}, journal = {Molecular oral microbiology}, volume = {40}, number = {5}, pages = {159-176}, doi = {10.1111/omi.12496}, pmid = {40464669}, issn = {2041-1014}, support = {2016/22/E/NZ5/00332//National Centre of Science SONATA Bis/ ; 2021/41/N/NZ6/03762//National Centre of Science Preludium/ ; }, mesh = {*Porphyromonas gingivalis/pathogenicity/metabolism ; Humans ; Virulence Factors/metabolism ; *Periodontitis/microbiology ; Gingipain Cysteine Endopeptidases/metabolism ; *Bacteroidaceae Infections/microbiology ; Lipopolysaccharides/metabolism ; Virulence ; COVID-19 ; Toll-Like Receptor 4/metabolism ; Inflammation/microbiology ; Animals ; Toll-Like Receptor 2/metabolism ; SARS-CoV-2 ; }, abstract = {Periodontitis (periodontal disease [PD]) is a complex inflammatory disease caused by a polymicrobial infection that facilitates the destruction of the connective tissue and bone that support the teeth. PD is highly correlated with cardiovascular disease, low birth weight, preterm osteoporosis, Alzheimer's disease, and rheumatoid arthritis. Porphyromonas gingivalis, a main causative agent of PD, is a non-motile, asaccharolytic, Gram-negative bacterium identified in subgingival, supragingival, and tongue sites in patients. P. gingivalis produces an arsenal of virulence factors, which include fimbriae, lipopolysaccharide (LPS), gingipains and other proteases, P. gingivalis peptidyl arginine deiminase (PPAD), and others. Recently, a number of reports highlighted novel aspects of P. gingivalis virulence. LPS signaling via Toll-like receptor 2 (TLR2) and Toll-like receptor 4 (TLR4) was elucidated; outer membrane vesicles (OMVs) were implicated as the shuttle for inflammatory induction and neurotoxicity, and gingipains were found to disrupt the integrity of blood-brain barrier (BBB). Further, Tpr protease substrate specificity was described in detail, a novel variant of PPAD was identified and correlated with the aggressive disease, and the role of C-terminal domain as the substrate for the Type IX secretion system (T9SS) transport has been unveiled, together with the identification of the first T9SS inhibitors. The impact of the COVID-19 pandemic prompted the novel research, expanding our understanding of the P. gingivalis correlation with viral infections. These recent findings implicate the need to update the current knowledge of the P. gingivalis virulence factors and provide a comprehensive review of the current trends in P. gingivalis research.}, } @article {pmid40464430, year = {2025}, author = {Alalawi, RA and Khriji, SA and Ambusaidi, MA and Al-Saadi, T}, title = {Reviewed Article: Stereotactic Radiosurgery for Brain Metastasis.}, journal = {The Gulf journal of oncology}, volume = {1}, number = {47}, pages = {14-23}, pmid = {40464430}, issn = {2078-2101}, mesh = {Humans ; *Radiosurgery/methods ; *Brain Neoplasms/secondary/radiotherapy/surgery ; }, abstract = {BACKGROUND: Brain metastases pose a significant challenge in oncology, contributing to morbidity and mortality rates. These metastases originates from primary tumors in the breast, lung, and melanoma tumors and has promoted the exploration of several treatment modalities, including stereotactic radiosurgery (SRS). SRS is considered to be one of the most effective treatments for brain metastases due to its precision in delivering high doses of radiation with low damage to the surrounding tissues.

METHOD: A search of Scopus database was conducted using key terms like "stereotactic," "radiosurgery," "brain metastasis," and "SRS". Relevant articles were screened based on title, abstract, and full text. The top 100 articles, ranked by citation frequency, were included, and analysed for various details including title, first author, publication year, journal name, journal impact factor, country of first author, country of study, first author institution, corresponding author institution, study design, patient involvement, number of patients studied, primary aim, source of metastasis, and study conclusion.

RESULTS: The top 100 cited articles on SRS for brain metastases were identified, with an average citation of 149 citations per article. The study found that the USA, followed by Japan and Switzerland, produced the highest number of publications on stereotactic radiosurgery for brain metastasis. The University of Pittsburgh was the leading institution in the USA. The analysis showed an increasing trend in publications from 2007 to 2017, with a peak in 2010, followed by a decline, potentially influenced by the COVID-19 pandemic.

CONCLUSION: Stereotactic radiosurgery (SRS) is an effective treatment for brain metastases, delivering precise high-dose radiation with rapid dose fall-off. This study revealed that the USA, particularly the University of Pittsburgh, has produced the most publications on this topic. This information can help clinicians and researchers identify valuable articles and journals related to SRS.}, } @article {pmid40462760, year = {2025}, author = {Fisman, D and Pérez-Rubio, A and Postma, M and Smith, DS and Mould-Quevedo, J}, title = {Maintaining the value of influenza vaccination - the shift from quadrivalent to trivalent vaccines: an expert review.}, journal = {Expert review of vaccines}, volume = {24}, number = {1}, pages = {499-508}, doi = {10.1080/14760584.2025.2515597}, pmid = {40462760}, issn = {1744-8395}, mesh = {Humans ; *Influenza Vaccines/administration & dosage/immunology ; *Influenza, Human/prevention & control/epidemiology/virology ; *Vaccination/methods ; COVID-19/prevention & control/epidemiology ; World Health Organization ; Vaccination Hesitancy ; }, abstract = {INTRODUCTION: This review provides an expert perspective on the sustained value of seasonal influenza vaccines as they transition from quadrivalent to trivalent formulations, based on apparent elimination of the B/Yamagata strain from circulation and subsequent advice from the World Health Organization (WHO) to remove the B/Yamagata antigen from influenza vaccines. Influenza has a high clinical and economic burden globally. However, coronavirus disease 2019 has created new challenges for managing seasonal influenza by amplifying vaccine hesitancy. Understanding why influenza virus circulation is monitored and vaccines subsequently updated is important for all relevant stakeholders to maintain confidence in the value of seasonal influenza vaccination.

AREAS COVERED: Discussion is provided on the dynamic nature of communicable diseases, influenza virus monitoring and WHO vaccine composition guidance, and maintaining the value of influenza vaccination to individuals, society, and healthcare systems.

EXPERT OPINION: The move from quadrivalent to trivalent influenza vaccines is a result of findings from strain surveillance. Continued surveillance and targeting of vaccines against strains most commonly in circulation to keep effectiveness high, and ensure the highest value of vaccination is vital to prevent influenza infection and severe illness, thus reducing pressure on healthcare systems and reducing the economic impact of influenza outbreaks.}, } @article {pmid40462133, year = {2025}, author = {Bertoni Maluf, VA and Herrmann, FR and Platon, A and Mendes, A and Dupertuis, YM and De Watteville, A and Heidegger, CP and Genton, L}, title = {Exploring the association between computed tomography (CT)-derived skeletal muscle mass and short- and long-term mortality in critically ill patients: a systematic review and meta-analysis.}, journal = {Critical care (London, England)}, volume = {29}, number = {1}, pages = {223}, pmid = {40462133}, issn = {1466-609X}, mesh = {Humans ; *Critical Illness/mortality ; Intensive Care Units/organization & administration/statistics & numerical data ; *Mortality/trends ; *Muscle, Skeletal/diagnostic imaging ; *Tomography, X-Ray Computed/methods ; }, abstract = {BACKGROUND: Low skeletal mass, often present at hospital admission, has been associated with poor prognoses.

AIM: To explore the association between computed tomography (CT)-derived skeletal muscle mass at the lumbar level and short- and long-term mortality in critically ill patients.

METHODS: Following PRISMA 2020 guidelines, we included studies on critically ill adults (≥ 18 years) hospitalized in intensive care units (ICU) that measured CT-derived skeletal muscle mass at the lumbar vertebral level within ± 7 days of ICU admission. The primary outcome was mortality, categorized as short-term (including ICU, hospital, 28- and 30-day mortality) and long-term (> 30 days) mortality. MEDLINE and Embase databases were searched without date restrictions. Study screening was performed using Rayyan, data extraction was guided by a custom-designed tool, and quality assessment was performed using the JBI Cohort Study Checklist. A meta-analysis was conducted, focusing on studies that reported short- and long-term mortality among patients with preserved and reduced skeletal muscle. A prevalence meta-analysis was also performed for studies that reported the size of subgroups with low muscle mass.

RESULTS: Out of 1248 unique records, 35 studies met the inclusion criteria, involving 9366 participants. The majority were retrospective, single-centre studies conducted on four continents and included heterogeneous populations such as patients with sepsis, COVID-19 and trauma. Sample sizes ranged from 36 to 939, with a wide age range, from 40 to 70 s, and a predominance of male patients (62%). Skeletal mass was most commonly reported as skeletal muscle index at the third lumbar vertebra. Studies reported mainly short-term mortality on day 28 or 30. Long-term mortality, measured at 90 days, 6 months, and 1 year, was evaluated in 11 studies. Meta-analyses revealed that low skeletal muscle mass area and index were significantly associated with increased risks of both short (OR = 2.33, CI 1.90-2.87, I[2] = 41.39%)-and long-term mortality (OR = 2.67, CI 1.45-4.92, I[2] = 62.24%). The overall prevalence of low muscle mass was 42% (CI 34-49%, I[2] = 98.2%).

CONCLUSIONS: CT-assessed skeletal muscle mass at the lumbar level on admission to ICU is associated with both short- and long-term mortality. It may serve as a prognostic marker in critically ill patients. Standardized protocols for measuring and defining low skeletal muscle mass in this population are essential to improve comparability across studies.}, } @article {pmid40460796, year = {2025}, author = {Eid, HMA and Al-Kuraishy, HM and Al-Gareeb, AI and Fawzy, MN and Papadakis, M and Almutawif, YA and Alexiou, A and Batiha, GE}, title = {GABA and GABAergic dysfunction in COVID-19: Piecing the puzzle with targeting immunity and several inflammatory pathways.}, journal = {Cytokine}, volume = {193}, number = {}, pages = {156976}, doi = {10.1016/j.cyto.2025.156976}, pmid = {40460796}, issn = {1096-0023}, mesh = {Humans ; COVID-19/immunology ; *gamma-Aminobutyric Acid/metabolism ; SARS-CoV-2 ; Inflammation/immunology/drug therapy ; Pandemics ; Cytokines/metabolism ; Inflammasomes/metabolism ; *Coronavirus Infections/immunology/drug therapy ; NLR Family, Pyrin Domain-Containing 3 Protein/metabolism ; *Pneumonia, Viral/immunology/drug therapy ; *Betacoronavirus ; COVID-19 Drug Treatment ; }, abstract = {Coronavirus disease 2019 (COVID-19) is a global pandemic disease caused by a new type of respiratory virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The primary factors contributing to inflammatory and immunological diseases in patients with severe COVID-19 are primarily attributed to the excessive activation of T cells and macrophages, resulting in the massive release of pro-inflammatory cytokines, including interleukins and chemokines. Studies have indicated that the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) possesses anti-inflammatory properties in mitigating certain inflammatory disorders. It has been shown that inflammation and oxidative stress caused by COVID-19 infection may lead to a disruption of GABAergic neurotransmission in COVID-19 patients. GABA and GABA agonists could be potential successful treatments for the management of COVID-19 by inhibiting the release of pro-inflammatory cytokines and inflammatory pathways such as nuclear factor kappa B (NF-κB) and the nod-like receptor pyrin 3 (NLRP3) inflammasome. Therefore, the purpose of this review was to discuss the potential role of GABA and GABA agonists in the alleviation of inflammatory disorders caused by COVID-19.}, } @article {pmid40460495, year = {2025}, author = {Zhang, Y and Yang, N and Li, Q and Tang, Y and Bai, B and Liu, G}, title = {Intestinal organoids: A novel and ideal in vitro platform for swine enteric coronavirus investigations.}, journal = {Virology}, volume = {610}, number = {}, pages = {110595}, doi = {10.1016/j.virol.2025.110595}, pmid = {40460495}, issn = {1096-0341}, mesh = {Animals ; *Organoids/virology ; Swine ; *Intestines/virology ; *Swine Diseases/virology ; *Coronavirus Infections/virology/veterinary ; Host-Pathogen Interactions ; }, abstract = {Swine enteric coronavirus-derived disease is an acute, highly contagious and infectious disease that causes symptoms such as diarrhea, vomiting, dehydration and high lethality in suckling piglets, posing a serious threat to the global pig farming industry. The main viral pathogens responsible for the disease include TGEV, PEDV, PDCoV, and SADS-CoV. The investigations of these viruses have been severely impeded by the lack of good in vitro culture systems and small animal models. Intestinal organoids are derived from crypt stem cells, which undergo growth, development and differentiation into structures resembling the intestinal tube morphology, thereby serving as an effective model for studying enteric pathogen‒host interactions in a manner that is as close as possible to in vivo conditions. This review outlines the establishment, regulation, and applications of intestinal organoids, with a particular focus on the advancements in research made possible by swine enteric coronaviruses using this model. The limitations of the intestinal organoids model and potential avenues for future improvement are also discussed. Finally, the findings emphasize the benefits of intestinal organoid models in investigating intestinal pathogen‒host interactions and how they will continue to offer a valuable platform for swine enteric coronavirus research with further developments in intestinal organoid technology.}, } @article {pmid40458900, year = {2025}, author = {Biagiola, S and Alfieri, N and Di Mario, S and Evangelista, G and Grima, D and Sodo, S and La Torre, G}, title = {The effect of workload on the development of burnout syndrome in Covid-19 intensive care nurses: a systematic review.}, journal = {Rivista di psichiatria}, volume = {60}, number = {3}, pages = {103-116}, doi = {10.1708/4509.45085}, pmid = {40458900}, issn = {2038-2502}, mesh = {Humans ; *COVID-19/nursing/epidemiology ; *Burnout, Professional/epidemiology/etiology ; *Workload/psychology ; *Critical Care Nursing ; SARS-CoV-2 ; Intensive Care Units ; Pandemics ; }, abstract = {BACKGROUND: Nowadays, it is well-known that burnout is a syndrome that mainly affects the helping professions. The nursing profession is obviously among those categories of workers that can develop burnout and, precisely because of its proximity to people who suffer associated with high workloads characterized by high emotional impacts.

AIM: The aim of this systematic review is, therefore, to highlight whether the high nursing workload during the pandemic has contributed to the onset of burnout syndrome in nurses who served in intensive care units (ICUs) dedicated to the care of Covid-19 patients.

METHODS: A systematic review was carried out. The main scientific databases were consulted, such as PubMed, Scopus, Web of Sciences and CINAHL analyzing all the papers present in literature. Using PRISMA guidelines, fifteen articles were included in the review. The protocol for this review has been registered on PROSPERO, the international prospective register of systematic reviews (PROSPERO ID: CRD42024502094). The quality assessment of the articles included in this review was conducted using the Newcastle-Ottawa Scale (NOS) for observational studies.

RESULTS: In accordance with the literature, all the 15 included studies documented high levels of burnout among ICU professionals, nevertheless those levels were greater than the ones registered in the pre-pandemic period. In Covid-19 era, nurses experienced higher levels of burnout compared to other professions and working as a nurse was identified as an independent risk factor for increased risk of burnout. As reported by all included studies, the overwhelming severity of Covid-19 patients entailed a significant increase in workload for health care providers, particularly nurses. Ultimately, this increase showed a significant correlation with increased burnout risk.

CONCLUSIONS: The review highlights the correlation between workload and burnout of nurses in Covid-19 intensive care units. It is expected that this and other studies will contribute to a better understanding of the importance of assigning the adequate workload to nurses.}, } @article {pmid40458684, year = {2025}, author = {Stolker, JM and Steg, PG and Rossini, R and Prabhakaran, D and Tokgözoğlu, L and Sattar, N}, title = {Could Acute COVID-19 Infection Ignite Thrombotic Risk?.}, journal = {European cardiology}, volume = {20}, number = {}, pages = {e14}, pmid = {40458684}, issn = {1758-3764}, abstract = {With the growing body of evidence of the ischaemic and thrombotic risks associated with recent COVID-19 infection, this expert commentary reviews the data on the cardiovascular risk implications of COVID-19 and considers potential management approaches for these patients. The authors' opinions were gauged against a global healthcare professional survey to measure current levels of agreement, lending support to their validity. While the need for ongoing research to improve the understanding of this disease is appreciated, the authors recognise that there is the potential to transform management approaches to reduce the health impact of COVID-19 infection among high-risk patients, especially those with established cardiovascular disease.}, } @article {pmid40458419, year = {2025}, author = {Tenkorang, PO and Awuah, WA and Mannan, KM and Roy, S and Nkrumah Boateng, PA and Asiedu, O and Tahiru, M and Ahluwalia, A and Owusu Bediako, NO and Darko, K}, title = {The transformative power of telemedicine in delivering effective neurosurgical care in low and middle-income countries: A review.}, journal = {Brain & spine}, volume = {5}, number = {}, pages = {104269}, pmid = {40458419}, issn = {2772-5294}, abstract = {INTRODUCTION: Telemedicine has been integrated into healthcare systems for over two decades, with the COVID-19 pandemic accelerating its adoption across various medical fields, including neurosurgery. Low- and middle-income countries (LMICs) face significant challenges such as a shortage of neurosurgeons and inadequate healthcare infrastructure. Teleneurosurgery offers a crucial solution to these challenges, improving access to specialized care and enhancing patient outcomes in resource-constrained settings.

RESEARCH QUESTION: How has teleneurosurgery been used to enhance access to specialized neurological care and improve patient outcomes in low- and middle-income countries?

METHODS: This narrative review employed a comprehensive search strategy to assess the role of telemedicine in neurosurgery within Low- and middle-income countries. Literature was searched across PubMed, EMBASE, and Scopus, using specific search terms related to teleneurosurgery, virtual consultations, and remote monitoring. Various study designs, including clinical trials, cohort studies, and case reports, were included, while isolated abstracts and unpublished studies were excluded. The review synthesizes the evidence to inform best practices in resource-limited environments.

RESULTS: Through remote consultations, pre-operative assessments and post-operative follow-up, telemedicine has become an essential tool to improve patient outcomes and increase access to neurosurgical care, particularly in underserved regions. The ability to conduct virtual assessments and provide specialized care remotely reduces the need for patients to travel long distances, thereby reducing the burden on already strained healthcare systems.

DISCUSSION AND CONCLUSION: Despite its growing adoption, low- and middle-income countries continue to face challenges such as limited internet connectivity, regulatory barriers, and infrastructure deficiencies. However, mobile health solutions, international collaborations, and capacity-building initiatives are helping to overcome these obstacles. The future of teleneurosurgery in low- and middle-income countries is promising, but sustained investment in technology, training, and regulatory frameworks is essential to maximize its impact and address disparities in neurosurgical care.}, } @article {pmid40458176, year = {2025}, author = {Anbardar, N and Dixon, SL and Munugoti, S and Gaddam, M and Kashfi, K and Kasulis, L and Messersmith, AL and Asadipooya, K}, title = {Thyroid disorders and COVID-19: a comprehensive review of literature.}, journal = {Frontiers in endocrinology}, volume = {16}, number = {}, pages = {1535169}, pmid = {40458176}, issn = {1664-2392}, mesh = {Humans ; *COVID-19/complications/epidemiology ; *Thyroid Diseases/epidemiology/virology/complications ; SARS-CoV-2 ; }, abstract = {BACKGROUND: The literature is rapidly evolving with regards to the endocrine consequences of coronavirus disease 2019 (COVID-19), including diabetes, thyroid dysfunction, adrenal and pituitary disorders. There is evidence suggesting that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can lead to thyroid dysfunction and long-term sequelae. We aimed to review the current evidence and propose a preventive approach based on the published data since the beginning of the COVID-19 pandemic.

METHODS: A comprehensive review of literature was conducted using electronic databases PubMed and Google Scholar. Two authors independently used the keywords "Thyroid, Hypothyroidism, Hyperthyroidism, Graves, Thyroid Eye Disease, or Thyroiditis" and "Coronavirus, SARS-CoV-2 or COVID-19" to search these databases. We screened titles and abstracts for initial selection and then reviewed the full text of relevant studies to report the outcomes of published data.

RESULTS: We selected 28 manuscripts. SARS-CoV-2 infection appears similar to other viruses. It affects thyroid function resulting in non-thyroidal illness syndrome, which usually resolves spontaneously. COVID-19 also causes subacute thyroiditis. It may also trigger autoimmunity against the thyroid that leads to autoimmune thyroiditis. Autoimmune thyroiditis or subacute thyroiditis may progress to clinical or subclinical hypothyroidism and clinical or subclinical hyperthyroidism. Patients with pre-existing thyroid dysfunction probably have similar risks of SARS-CoV-2 related adverse outcomes.

CONCLUSIONS: Evaluation of thyroid function is important in COVID-19 patients. Improving the efficacy of treatment against acute SARS-CoV-2 infection can reduce the risks of short-term and long-term complications.

https://www.crd.york.ac.uk/prospero, identifier CRD42023447994.}, } @article {pmid40457666, year = {2025}, author = {Katasonov, AB}, title = {[Therapeutic potential of quercetin and its derivatives against COVID-19].}, journal = {Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova}, volume = {125}, number = {5}, pages = {44-50}, doi = {10.17116/jnevro202512505144}, pmid = {40457666}, issn = {1997-7298}, mesh = {*Quercetin/therapeutic use/analogs & derivatives/pharmacology ; Humans ; *COVID-19 Drug Treatment ; Blood-Brain Barrier/drug effects ; COVID-19 ; *Neuroprotective Agents/therapeutic use/pharmacology ; SARS-CoV-2 ; Oxidative Stress/drug effects ; Virus Replication/drug effects ; *Antiviral Agents/therapeutic use/pharmacology ; Antioxidants/therapeutic use ; }, abstract = {Quercetin is a natural flavonoid with a wide range of biological activity. This compound does not penetrate the brain well, but under stress, it exhibits neuroprotective properties, probably associated with its effect on the blood-brain barrier (BBB). BBB disruption may be responsible for the invasion of the causative agent of the new coronavirus infection (COVID-19) into the brain with the development of neurological symptoms. Quercetin can suppress viral replication, oxidative stress, and inflammatory response, as well as prevent the formation of microthrombi. This potential of quercetin may help treat COVID-19 and its long-term sequelae.}, } @article {pmid40457567, year = {2025}, author = {Marc, A and Schiffer, JT and Mentré, F and Perelson, AS and Guedj, J}, title = {Viral Dynamic Models During COVID-19: Are We Ready for the Next Pandemic?.}, journal = {CPT: pharmacometrics & systems pharmacology}, volume = {14}, number = {8}, pages = {1289-1297}, pmid = {40457567}, issn = {2163-8306}, support = {R01 AI028433/AI/NIAID NIH HHS/United States ; R01 OD011095/OD/NIH HHS/United States ; R37 AI028433/AI/NIAID NIH HHS/United States ; }, mesh = {Humans ; *COVID-19/epidemiology/virology/transmission ; *SARS-CoV-2 ; Pandemics ; *Models, Theoretical ; Animals ; Antiviral Agents/therapeutic use ; *Models, Biological ; }, abstract = {Mathematical models have been used for about 30 years to improve our understanding of virus-host interaction, in particular during chronic infections. During the COVID-19 pandemic, these models have been used to provide insights into the natural history of acute SARS-CoV-2 infection, optimize antiviral treatment strategies, understand factors associated with transmission, and optimize surveillance systems. The impact of modeling has been accelerated by the availability of unprecedented multidimensional immune data from animal and human systems, which enhanced partnerships between experimentalists and theorists and led to exciting new modeling and statistical developments. In this mini review, we examine the lessons learned from the COVID-19 pandemic and discuss the main insights provided by mathematical models of viral dynamics at the different stages of the outbreak. Although we focus on respiratory infection, we also consider the new areas for development in anticipation of future acute infections from new or reemerging pathogens.}, } @article {pmid40457387, year = {2025}, author = {Moawad, MHED and Abbas, A and Sabet, H and Zanaty, MA and Hamad, AA and Rezkallah, A and Ballut, O and Fayad, T and Elsakka, MM and Eshun, F and Abdelgawad, HAH}, title = {Unveiling protection: a meta-analysis of tixagevimab-cilgavimab prophylaxis in 28,950 transplant recipients and immunocompromised patients against COVID-19.}, journal = {Virology journal}, volume = {22}, number = {1}, pages = {178}, pmid = {40457387}, issn = {1743-422X}, mesh = {Humans ; *COVID-19/prevention & control/mortality/immunology ; *Immunocompromised Host ; *Transplant Recipients ; SARS-CoV-2/drug effects ; *Antibodies, Monoclonal, Humanized/therapeutic use ; *Antiviral Agents/therapeutic use ; *Pre-Exposure Prophylaxis/methods ; *COVID-19 Drug Treatment ; Hospitalization/statistics & numerical data ; }, abstract = {BACKGROUND: This meta-analysis addresses the efficacy and safety of tixagevimab-cilgavimab as pre-exposure prophylaxis against COVID-19 in immunocompromised patients, particularly during the Omicron variant surge. Given the limited vaccine response in this population, alternative prophylactic strategies are critical.

METHODS: Following PRISMA guidelines, we comprehensively searched electronic databases, including PubMed, Scopus, Web of Science, and Embase, up to June 22, 2024. We included studies assessing tixagevimab-cilgavimab's impact on SARS-CoV-2 infection rates, hospitalization, ICU admissions, and/or mortality among immunocompromised patients. Data synthesis and analysis were conducted using RevMan and Open-Meta Analyst software.

RESULTS: Analyzing data from 36 studies involving 28,950 patients, tixagevimab-cilgavimab significantly reduced SARS-CoV-2 infection rates by 4.37%, hospitalization by 0.8%, and mortality by 0.5%. Compared to no prophylaxis, the drug combination showed a notable reduction in SARS-CoV-2 infection (OR = 0.33, 95% CI: 0.22-0.50), hospitalization (OR = 0.24, 95% CI: 0.15-0.39), and mortality (OR = 0.33, 95% CI: 0.16-0.66), exhibiting a favorable safety and efficacy profile. During the Omicron surge, tixagevimab-cilgavimab consistently reduced infection risk (OR = 0.32, 95% CI: 0.17-0.58).

CONCLUSION: Tixagevimab-cilgavimab offers a significant protective effect against COVID-19, including Omicron variants, in immunocompromised patients, underscoring its role as an effective pre-exposure prophylaxis. Future studies should further explore its efficacy across different SARS-CoV-2 variants and potential synergies with vaccination efforts.}, } @article {pmid40457282, year = {2025}, author = {Umemura, T and Kato, H and Mutoh, Y and Hagihara, M and Ikeda, Y and Mikamo, H}, title = {Safety evaluation of remdesivir administration in patients with severe renal impairment and coronavirus disease: a systematic review and meta-analysis.}, journal = {BMC infectious diseases}, volume = {25}, number = {1}, pages = {782}, pmid = {40457282}, issn = {1471-2334}, mesh = {Humans ; *Antiviral Agents/adverse effects/therapeutic use/administration & dosage ; COVID-19/complications/mortality ; *Adenosine Monophosphate/analogs & derivatives/adverse effects/administration & dosage/therapeutic use ; *Alanine/analogs & derivatives/adverse effects/administration & dosage/therapeutic use ; SARS-CoV-2 ; *COVID-19 Drug Treatment ; *Renal Insufficiency/drug therapy/complications ; Randomized Controlled Trials as Topic ; }, abstract = {BACKGROUND: We conducted a comprehensive systematic review and meta-analysis to evaluate whether remdesivir (RDV) is safe for patients with severe renal impairment (SRI) and COVID-19, compared to non-SRI patients or those not receiving RDV.

METHODS: This study was conducted according to the PRISMA guidelines for reporting systematic reviews and meta-analyses. We searched PubMed, Cohcrane, CINAHL, and Ichushi databases up to October 11, 2024. The outcomes assessed kidney injury, hepatic disorder and mortality. Randomized controlled trials and retrospective and cohort studies reporting kidney injury, hepatotoxicity, and mortality in (i) SRI patients treated with RDV versus without RDV or (ii) SRI patients versus non-SRI patients treated with RDV were included. Targeted patients were defined as adults with COVID-19 based on a positive reverse transcription polymerase chain reaction or rapid antigen test for SARS-CoV-2 from nasopharyngeal or salivary swabs regardless of symptoms.

RESULTS: One randomized controlled trial and 14 cohort studies met the inclusion criteria and were included in the final meta-analysis. Among SRI patients, RDV significantly reduced the incidence of kidney injury (risk ratio [RR] = 0.51, 95% confidence interval [CI] = 0.27-0.97) but had no significant difference in the development of hepatic disorder (RR = 0.88, 95% CI = 0.39-1.98) and mortality (RR = 0.79, 95% CI = 0.55-1.15). In the comparison between SRI and non-SRI patients treated with RDV, SRI patients demonstrated a significantly higher incidence of kidney injury (odds ratio [OR] = 2.51, 95% CI = 1.49-4.23), with no significant difference in the development of hepatic disorder (OR = 1.04, 95% CI = 0.43-2.53). Meanwhile, SRI patients treated with RDV exhibited significantly higher mortality than non-SRI patients treated with RDV (OR = 2.20, 95% CI = 1.51-3.22).

CONCLUSION: Our meta-analysis demonstrated that RDV administration in SRI patients with COVID-19 was safe compared to non-SRI or SRI patient treated without RDV. We suggest that the use of RDV should be actively considered for SRI patients.}, } @article {pmid40456838, year = {2025}, author = {Cesaro, S and Ljungman, P and Mikulska, M and Hirsch, HH and Navarro, D and Cordonnier, C and Mehra, V and Styczynski, J and Marchesi, F and Pinana, JL and Beutel, G and Einsele, H and Maertens, J and , and de la Camara, R}, title = {Post-pandemic recommendations for the management of COVID-19 in patients with haematological malignancies or undergoing cellular therapy, from the European Conference on Infections in Leukaemia (ECIL-10).}, journal = {Leukemia}, volume = {39}, number = {9}, pages = {2061-2071}, pmid = {40456838}, issn = {1476-5551}, mesh = {Humans ; *COVID-19/therapy/diagnosis/epidemiology/complications/prevention & control ; *Hematologic Neoplasms/therapy/complications ; *SARS-CoV-2 ; Immunization, Passive ; Antiviral Agents/therapeutic use ; Hematopoietic Stem Cell Transplantation ; Europe/epidemiology ; Pandemics ; *Cell- and Tissue-Based Therapy ; COVID-19 Serotherapy ; }, abstract = {In the post-pandemic years, SARS-CoV-2 morbidity and mortality declined due to less pathogenic variants, active and passive immunization, and antiviral therapies. However, patients with hematological malignancies and/or undergoing hematopoietic cell transplantation (HCT) remain at increased risk for poor outcomes. Therefore, adherence to contact and droplet precautions is essential to avoid transmission, especially during epidemic waves. Detection of viral RNA by nucleic acid testing of naso-oro-pharyngeal samples is the gold standard for diagnosis due to its high sensitivity and specificity. Direct antigen testing allows for rapid management decisions if positive, but has a low sensitivity, especially in asymptomatic patients. Active immunisation is the key to prevention and may require annual matching to circulating variants. Passive immunization with SARS-CoV-2 neutralizing anti-antibodies lost its indication due to the emergence of immune escape variants. Convalescent plasma has been proposed for passive immunization but is not readily available in most centres. For symptomatic patients, early antiviral treatment with nirmatrelvir/ritonavir or remdesivir may reduce the risk of progression to severe-critical COVID-19. Prolonged administration, repeated courses, and a combination of antivirals are considered for patients with clinical or virological failure to antiviral monotherapy. In severe-critical COVID-19, dexamethasone or drugs downregulating the inflammatory cytokine responses (anti-Il-6/anti-IL-2 agents, Janus kinase inhibitor) are recommended, together with the best supportive and intensive care, but care should be exercised in immunosuppressed patients. Deferral of intensive chemotherapy, HCT conditioning, T-cell-based immunotherapy, or T-cell engaging antibodies are considered for patients with COVID-19, whereas deferral decisions are taken on a case-by-case basis for asymptomatic patients with confirmed SARS-CoV-2 infection.}, } @article {pmid40454870, year = {2025}, author = {Hu, Z and Xu, YE and Li, JZ and Wang, YT and Song, H and Ao, DS}, title = {Three-dimensional cell culture models in respiratory virus research: technological advances and current applications.}, journal = {Journal of materials chemistry. B}, volume = {13}, number = {25}, pages = {7249-7268}, doi = {10.1039/d5tb00290g}, pmid = {40454870}, issn = {2050-7518}, mesh = {Humans ; Animals ; *Cell Culture Techniques, Three Dimensional/methods ; SARS-CoV-2 ; *Cell Culture Techniques ; COVID-19/virology ; }, abstract = {From the Spanish flu to the COVID-19 pandemic, respiratory viruses have inflicted significant damage on the global population. As research into these viruses progresses, so too does the methodology employed. Although traditional in vitro two-dimensional (2D) cell culture techniques and animal models have played crucial roles in our understanding of respiratory viruses and have made significant contributions to research on viral infection mechanisms, as well as the development of drugs and vaccines, they have limitations. Specifically, 2D cell culture models do not accurately simulate the in vivo micro-environment, and animal models may not share the same susceptibility and immune response as humans. Consequently, viral isolation and culture techniques are transitioning towards 3D cell culture technologies. Furthermore, the potential for multi-disciplinary collaborations using 3D cell culture opens new opportunities for personalized medicine. This review will explore the advancement and application of 3D cell culture in respiratory virus research, emphasising the most recent developments and trends in the field. By evaluating the current strengths and limitations of these technologies, we aim to provide insights that will inform future scientific exploration and clinical applications.}, } @article {pmid40454668, year = {2025}, author = {Sebastian, S and Nirghin, U and Rampersad, N}, title = {Impact of the COVID-19 pandemic on persons with visual impairment.}, journal = {Clinical & experimental optometry}, volume = {}, number = {}, pages = {1-11}, doi = {10.1080/08164622.2025.2509595}, pmid = {40454668}, issn = {1444-0938}, abstract = {Vision impairment is a global public health concern affecting 1.1 billion people worldwide. The coronavirus disease or COVID-19 outbreak caused by the SARS-CoV-2 virus in 2019 affected many aspects of everyday life and prompted various preventative health measures. Persons with visual impairment face multiple challenges daily, and with the onset of the COVID-19 pandemic, these challenges were likely worsened. With various studies conducted globally to explore the experiences of persons with visual impairment, this scoping review aims to provide an overview of the impact of the COVID-19 pandemic on persons with visual impairment within a global context. The five-step framework by Arksey and O'Malley was applied, involving a literature search across nine electronic databases, with specific search terms formulated from the research question. Data were screened for eligibility by the three reviewers using pre-decided study criteria. Of the 263 articles identified from December 2019 to October 2022, 49 were included in this review. More than 80% of the articles were published in the early years of the pandemic (2020 and 2021), and 77.5% of the studies had persons with visual impairment as participants. The themes identified included psychosocial, access to COVID-19 information and technology, healthcare, everyday activities, education, economic situation, adherence to regulations, and support. Overall, the COVID-19 pandemic worsened the challenges faced by persons with visual impairment, especially those affecting their independence and daily routines. Governments and stakeholders should make more efforts to address the challenges experienced by persons with visual impairment, as this will directly impact their quality of life.}, } @article {pmid40453691, year = {2025}, author = {Pourrazavi, S and Fathi, B and Fathifar, Z and Nadrian, H and Allahverdipour, H}, title = {Leveraging Ottawa Charter strategies to enhance COVID-19 vaccination: A systematic review of global health promotion approaches.}, journal = {Health promotion perspectives}, volume = {15}, number = {1}, pages = {9-22}, pmid = {40453691}, issn = {2228-6497}, abstract = {BACKGROUND: Despite global vaccination efforts, many countries struggled to achieve sufficient COVID-19 vaccination coverage. The use of Ottawa Charter health promotion strategies in vaccination programs not only enhances coverage but also fosters sustainable public health outcomes. This systematic review aims to identify actionable strategies to improve vaccination efforts.

METHODS: This systematic review involved a comprehensive literature search across PubMed, Scopus, Web of Science, and Embase, targeting studies published between January 2020 and August 2024. The search focused on government-led health promotion strategies for enhancing COVID-19 vaccination rates. Strategies were categorized five main areas of the Ottawa Charter for health promotion.

RESULTS: A total of 22 health promotion strategies were identified globally, categorized into five key areas based on the Ottawa Charter for health promotion. Notable strategies included engaging community, addressing misinformation, expanding vaccination sites, and providing culturally tailored communication.

CONCLUSION: The findings underscore the significance of utilizing the Ottawa Charter framework to design inclusive and adaptable public health strategies that ensure equitable vaccination coverage globally.}, } @article {pmid40453679, year = {2025}, author = {Elechi, KW and Oyepeju Nkem, O and Timothy Chibueze, N and Elechi, US and Franklin Chimaobi, K}, title = {Long-term Neurological Consequences of COVID-19 in Patients With Pre-existing Alzheimer's and Parkinson's Disease: A Comprehensive Review.}, journal = {Neuroscience insights}, volume = {20}, number = {}, pages = {26331055251342755}, pmid = {40453679}, issn = {2633-1055}, abstract = {SARS-CoV-2, the causative agent of COVID-19, has profound systemic effects, including significant impacts on the central nervous system (CNS). Emerging evidence suggests a potential link between SARS-CoV-2-induced neuroinflammation and the exacerbation or initiation of neurodegenerative diseases such as Alzheimer's disease (AD) and Parkinson's disease (PD). This review explores the mechanisms by which SARS-CoV-2 may contribute to neurodegenerative processes. We first discuss the pathways of viral entry into the CNS, including transneuronal and hematogenous routes, leading to blood-brain barrier (BBB) dysfunction. Neuroinflammation, mediated by the activation of microglia and astrocytes and the release of pro-inflammatory cytokines such as IL-6, TNF-α, and IL-1β, is highlighted as a critical factor exacerbating neuronal damage. Oxidative stress and vascular damage are further examined as complementary mechanisms promoting neurodegeneration. In addition, we review how SARS-CoV-2 infection influences proteinopathies by accelerating the aggregation of pathological proteins like alpha-synuclein, tau, and TDP-43, contributing to disease progression in PD, AD, and related disorders. Clinical studies reporting cognitive and motor dysfunctions in post-COVID-19 patients with pre-existing neurodegenerative diseases are also summarized. Finally, this review identifies knowledge gaps and emphasizes the need for further research to clarify the long-term neurological consequences of SARS-CoV-2 infection. Understanding these mechanisms is critical for developing targeted therapeutic strategies to mitigate the risk of neurodegeneration in vulnerable populations.}, } @article {pmid40453652, year = {2025}, author = {Pacheco, T and Coulombe, S and Kocovski, NL and Carbone, J}, title = {Workers' well-being during viral pandemics and epidemics: A scoping review.}, journal = {Comprehensive psychoneuroendocrinology}, volume = {22}, number = {}, pages = {100286}, pmid = {40453652}, issn = {2666-4976}, abstract = {Studies have documented workers' well-being during individual pandemics and epidemics. However, there lies a need to summarize worker well-being across crises. Moreover, there is a scarcity of reviews exploring precarious workers' well-being during these crises. Adopting a multidisciplinary perspective via positive psychology's third wave, this scoping review examines positive and negative well-being across diverse occupational groups and situations (e.g., precarious employment) and across crises. Inspired by Ecological Systems Theory, factors at different ecological levels (self, social, workplace, pandemic) relevant to workers' well-being are reviewed. The following questions are addressed: 1) How are virus-related public health crises (i.e., epidemics, pandemics) related to workers' well-being? 2) What resilience and risk factors are associated with workers' well-being in these crises? And 2a) How is the well-being of precarious workers impacted during virus-related public health crises? Of the 2,395 potentially relevant articles published before October 23rd, 2020, 187 were retained. Overall, more research has been conducted on negative than positive well-being. Workers experienced: 1) positive well-being frequently or at moderately high levels overall during pandemics and epidemics, 2) mild to moderate negative well-being during SARS and COVID-19's beginning and high negative well-being during other crises, and 3) high work-related well-being during such crises. Factors at self- (age, gender), social- (social support), workplace- (occupation, frontline status), and pandemic-related (risk/exposure, knowing someone infected/killed by the virus, PPE access) levels were associated with workers' well-being. Although explored infrequently, precarious employment was typically associated with greater negative well-being. Practice- and policy-related recommendations are discussed.}, } @article {pmid40453305, year = {2025}, author = {Okazaki, Y and Tsujimoto, Y and Yamada, K and Saka, N and Ariie, T and Taito, S and Banno, M and Kataoka, Y and Watanabe, N}, title = {The Impact of Government Lockdowns on the Mental Health of the General Population: A Systematic Review and Meta-analysis.}, journal = {Cureus}, volume = {17}, number = {4}, pages = {e83249}, pmid = {40453305}, issn = {2168-8184}, abstract = {Since December 2019, the COVID-19 pandemic has spread globally, prompting governments in many countries to implement lockdowns to control the transmission of the virus. Outbreaks of emerging infectious diseases, such as COVID-19, and the associated government lockdowns may have significant negative impacts on mental health. A comprehensive review of the available evidence on this topic can provide useful information for policymakers. This review aimed to assess the effects of government lockdowns on the mental health of the general population during emerging infectious disease outbreaks. On April 11, 2022, we conducted a systematic search of CENTRAL, MEDLINE, PsycINFO Ovid, and two clinical trial registries, supplemented by reference checking and citation searching. We included non-randomized studies of interventions (NRSIs) involving adults and adolescents, regardless of comorbidities, that examined the effects of government-imposed lockdowns compared to no lockdown during outbreaks of emerging infectious diseases, including SARS, MERS, COVID-19, H1N1, equine influenza, avian influenza, and Ebola virus disease. Critical outcomes assessed were depressive symptom severity and suicide, while important outcomes included anxiety symptom severity, post-traumatic stress disorder (PTSD) symptom severity, insomnia symptom severity, and substance use. We used the ROBINS-I tool to assess the risk of bias and conducted a meta-analysis using a random-effects model. The certainty of evidence was evaluated using the GRADE approach. We included 42 NRSIs, all conducted during the COVID-19 pandemic. Of the 27 studies reporting depressive symptoms, we pooled effect sizes from eight studies. The findings suggest that government lockdowns may have little to no effect on depressive symptom severity within the 12-month follow-up; however, the evidence was very uncertain (standardized mean difference (SMD) 0.00, 95% CI -0.08 to 0.09; I[2] = 70%; 11,278 participants). Two studies reported on suicide outcomes, but both had an overall critical risk of bias due to confounding; therefore, we did not synthesize results and judged the evidence as very low certainty. For anxiety symptom severity, we pooled data from five of 20 studies and found that government lockdowns may have little to no effect within the 12-month follow-up (SMD 0.08, 95% CI -0.10 to 0.26; I[2] = 91%; 11,006 participants). Regarding PTSD symptom severity, pooled data from one of two studies suggested that government lockdowns may increase the symptom severity within the 12-month follow-up (MD 0.18, 95% CI 0.08-0.28; 1,754 participants). We pooled data from two of eight studies on insomnia symptom severity and found that government lockdowns may increase the symptom severity within the 12-month follow-up (MD 1.28, 95% CI 0.62-1.94; I[2] = 91%; 5,142 participants). In terms of alcohol use, data pooled from five of nine studies on alcohol use showed that government lockdowns may have little to no effect on alcohol consumption within the 12-month follow-up (SMD 0.03, 95% CI -0.05 to 0.11; I[2] = 66%; 8,261 participants). Overall, the evidence regarding all important outcomes was of very low certainty. At present, the impact of government lockdowns during emerging infectious disease outbreaks on mental health in the general population remains very uncertain. Future research should prioritize well-designed studies to better assess the mental health effects of lockdown measures during novel outbreaks.}, } @article {pmid40453253, year = {2025}, author = {Boorle, NVLD and Kurra, NC and Gandrakota, N and Modi, K and Sudireddy, K and Irfan, SA and Jain, A and Parikh, PA and Jillella, D}, title = {Central Nervous System Manifestations of Long COVID: A Systematic Review.}, journal = {Cureus}, volume = {17}, number = {4}, pages = {e83247}, pmid = {40453253}, issn = {2168-8184}, abstract = {Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been one of the most widespread and devastating global pandemics, impacting hundreds of millions of people worldwide. After the cessation of active infection, the disease continues to have a disabling impact due to the persistence of fatigue, brain fog, anxiety, and depression - among the most common symptoms. This study explores the progression of neurological symptoms over 12 months and beyond following an initial diagnosis of COVID-19. Through an electronic search of eligible studies from PubMed, the Cochrane Trial Register, and Google Scholar, 10 studies were included for qualitative analysis. The systematic review highlights the similarities and differences in findings across the included studies. Olfactory dysfunction was prevalent in 0.9%-51% of individuals, and taste impairment was observed in 1.1%-21.3%. At 12 months, anxiety was more prevalent (3.5%-29%) than depression (3.5%-26%). Fatigue was the predominant neurocognitive complaint in 56% of individuals with severe COVID-19. Nearly half of individuals reported sleep difficulties. Memory impairment, followed by headaches and dizziness, also constitutes neurocognitive symptoms reported at 12 months. Our study found that there is a significant neurological burden one year following the diagnosis of COVID-19. Further studies exploring the pathological mechanisms of long-term COVID-19 are necessary to better delineate the mechanisms behind several long-term neurological manifestations of COVID-19.}, } @article {pmid40452530, year = {2025}, author = {Moghdam, Y and Arghavan, B and Kermani, F and Jeddi, SA and Khojasteh, S and Shokohi, T and Aslani, N and Ebrahimi, A and Javidnia, J}, title = {A fatal post-COVID-19 sino-orbital mucormycosis in an adult patient with diabetes mellitus: a case report and review of the literature.}, journal = {Journal of infection in developing countries}, volume = {19}, number = {5}, pages = {661-668}, doi = {10.3855/jidc.16526}, pmid = {40452530}, issn = {1972-2680}, mesh = {Humans ; *Mucormycosis/diagnosis/etiology/drug therapy/microbiology ; Female ; Middle Aged ; *COVID-19/complications ; Antifungal Agents/therapeutic use ; Fatal Outcome ; SARS-CoV-2 ; *Orbital Diseases/microbiology ; Amphotericin B/therapeutic use ; *Diabetes Complications ; COVID-19 Drug Treatment ; }, abstract = {INTRODUCTION: COVID-19 is associated with a broad spectrum of bacterial and fungal superinfections.

CASE PRESENTATION: We present a case of mucormycosis developing during post-COVID-19 therapeutic management. A 63-year-old diabetic female presented with COVID-19 and received combination therapy per institutional protocol, including dexamethasone, remdesivir, and ivermectin. Seven days post-discharge, the patient was readmitted with dyspnea and lethargy. On day 3 of readmission, the patient reported unilateral facial and orbital pain. Subsequent histopathological and mycological examination confirmed mucormycosis. Despite surgical debridement and treatment with amphotericin B (3 mg/kg/day), the patient succumbed to the infection.

RESULTS: Based on ITS rDNA sequencing, the fungus was identified as Rhizopus arrhizus. Antifungal susceptibility testing was performed according to the CLSI M38-A2 guideline, yielding minimum inhibitory concentration (MIC) values of 0.016 µg/mL for amphotericin B, 0.031 µg/mL for posaconazole, 0.25 µg/mL for isavuconazole, 1 µg/mL for itraconazole, and 8 µg/mL for voriconazole.

CONCLUSIONS: Early diagnosis, prompt antifungal therapy, and appropriate surgical intervention are critical for improving mucormycosis outcomes, especially in COVID-19 patients.}, } @article {pmid40451590, year = {2025}, author = {Jarallah, SJ and Almughem, FA and Alhumaid, NK and Fayez, NA and Alradwan, I and Alsulami, KA and Tawfik, EA and Alshehri, AA}, title = {Artificial intelligence revolution in drug discovery: A paradigm shift in pharmaceutical innovation.}, journal = {International journal of pharmaceutics}, volume = {680}, number = {}, pages = {125789}, doi = {10.1016/j.ijpharm.2025.125789}, pmid = {40451590}, issn = {1873-3476}, mesh = {*Drug Discovery/methods/trends ; *Artificial Intelligence ; Humans ; Drug Repositioning ; Drug Design ; COVID-19 Drug Treatment ; }, abstract = {Integrating artificial intelligence (AI) into drug discovery has revolutionized pharmaceutical innovation, addressing the challenges of traditional methods that are costly, time-consuming, and suffer from high failure rates. By utilizing machine learning (ML), deep learning (DL), and natural language processing (NLP), AI enhances various stages of drug development, including target identification, lead optimization, de novo drug design, and drug repurposing. AI tools, such as AlphaFold for protein structure prediction and AtomNet for structure-based drug design, have significantly accelerated the discovery process, improved efficiency and reduced costs. Success stories like Insilico Medicine's AI-designed molecule for idiopathic pulmonary fibrosis and BenevolentAI's identification of baricitinib for COVID-19 highlight AI's transformative potential. Additionally, AI enables the exploration of vast chemical spaces, optimization of clinical trials, and the identification of novel therapeutic targets, paving the way for precision medicine. However, challenges such as limited data accessibility, integration of diverse datasets, interpretability of AI models, and ethical concerns remain critical hurdles. Overcoming these limitations through enhanced algorithms, standardized databases, and interdisciplinary collaboration is essential. Overall, AI continues to reshape drug discovery, reducing timelines, increasing success rates, and driving the development of innovative and accessible therapies for unmet medical needs.}, } @article {pmid40450230, year = {2025}, author = {Leung, WKC and Yau, CYC and Lam, SC}, title = {Facilitators, barriers, and recommendations for mobile health applications among Chinese older populations: a scoping review.}, journal = {BMC geriatrics}, volume = {25}, number = {1}, pages = {396}, pmid = {40450230}, issn = {1471-2318}, support = {CRG2023/01//Tung Wah College/ ; CRG2023/01//Tung Wah College/ ; }, mesh = {Aged ; Aged, 80 and over ; Humans ; Middle Aged ; China ; *COVID-19/epidemiology ; *Mobile Applications ; *Telemedicine ; East Asian People ; }, abstract = {BACKGROUND: Mobile health (mHealth) applications have become indispensable in people's daily lives and are now incorporated into a multitude of healthcare services. However, due to inappropriate designs and ineffective promotional strategies, the rates of uptake and continued use of mHealth applications in older adults are usually low. Given that recent evidence has reported distinct mHealth adoption patterns between Chinese and non-Chinese populations, the aim of this scoping review was to map relevant evidence on the end-user perceptions and age-appropriate recommendations for interface design, persuasive features, and promotional strategies among Chinese older adults.

METHODS: All primary studies conducted in Chinese older people aged 60 + years, including quantitative, qualitative, and mixed methods research, examining end-user perceptions (e.g., motivators, barriers, and design) of mHealth applications were considered eligible for inclusion. Four electronic databases (PubMed, CINAHL, PsycINFO, and Medline) were searched from their inceptions through 31 May 2024. A narrative approach was adopted for data analyses relevant to the study aim.

RESULTS: A total of 23 studies (n = 8,203) were included. End-user perceptions (facilitators and barriers) of older people were narratively synthesized according to the socio-ecological model (individual/product, interpersonal, community, and societal). In Chinese deaf and hard-of-hearing older adults, the lack of proficiency in mastering operations of smartphone, Internet, and mHealth applications greatly jeopardized their communication with family or friends, accessibility to online medical consultations, and access to public places amidst COVID-19 pandemic. Recommended interface designs were categorized into various aspects of functional impairments (vision, manual dexterity, and cognition) of elderly users. Seven promotional strategies were also highlighted, whereas more than half of the studies recommended education measures (e.g., personalized family/peer- or health professional-led training program) and technical support (e.g., face-to-face instructions, detailed manual instructions, and timely consultation services). Other recommendations included increased publicity, co-creation, and supportive government policies.

CONCLUSION: This review synthesizes the existing relevant evidence and hence provides age-friendly recommendations for interface designs, persuasive features, and promotional strategies in Chinese older populations. Overall, this study empirically offers actionable guidelines for mHealth developers to meet the multifaceted needs of older people.}, } @article {pmid40450224, year = {2025}, author = {Skront, T and Sagan, J and Hyza, M}, title = {Neuroleptic malignant syndrome in a patient with COVID-19 and the possible role of SARS-CoV-2 in its manifestation: case report and overview of published cases.}, journal = {BMC psychiatry}, volume = {25}, number = {1}, pages = {557}, pmid = {40450224}, issn = {1471-244X}, mesh = {Adult ; Humans ; Male ; Antipsychotic Agents/therapeutic use/adverse effects ; *COVID-19/complications/virology ; *Neuroleptic Malignant Syndrome/diagnosis/drug therapy/virology ; Olanzapine/therapeutic use ; *SARS-CoV-2/pathogenicity ; *Schizophrenia/drug therapy/complications ; }, abstract = {BACKGROUND: The manifestation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is more complex than that of pulmonary infection, and neuropsychiatric symptoms play a role in this complexity. In this paper, we present the case of a 29-year-old schizophrenic patient who suffered from neuroleptic malignant syndrome (NMS) that developed during coronavirus disease 2019 (COVID-19) infection, with an emphasis on the possible connection between these two conditions. Additionally, we provide an overview of published NMS cases in patients with COVID-19 or after vaccination against SARS-CoV-2.

CASE PRESENTATION: A 29-year-old patient treated for schizophrenia, treated with paliperidone palmitate (150 mg every four weeks) and cariprazine (6 mg daily), was admitted to the hospital for agitation and aggressivity; shortly after arrival at the hospital, laryngospasm and hypoxia occurred. The patient tested positive for SARS-CoV-2, and later, he developed pneumonia. During hospitalization, olanzapine (20 mg daily) was added to his regimen. However, due to continuing restlessness, haloperidol was administered (20 mg over the course of one day). A few days later, neuroleptic malignant syndrome occurred. He was treated with bromocriptine (15 mg daily) and clonazepam (2 mg daily) and recovered.

CONCLUSIONS: As SARS-CoV-2 is known to interact with angiotensin-converting enzyme 2 and DOPA-decarboxylase is known to be coexpressed with this receptor, we hypothesized that COVID-19 infection might play a substantial role in the development of NMS.}, } @article {pmid40449975, year = {2025}, author = {Singh, AK and Goel, K and Dhanawat, M}, title = {Plasmid DNA and mRNA delivery: Approaches and challenges.}, journal = {Advances in immunology}, volume = {165}, number = {}, pages = {63-87}, doi = {10.1016/bs.ai.2024.12.001}, pmid = {40449975}, issn = {1557-8445}, mesh = {Humans ; *Plasmids/genetics/administration & dosage ; *RNA, Messenger/genetics/administration & dosage/immunology ; *COVID-19/prevention & control/immunology ; *SARS-CoV-2/immunology ; *Vaccines, DNA/immunology/genetics/administration & dosage ; Animals ; *COVID-19 Vaccines/immunology/genetics ; *Gene Transfer Techniques ; Genetic Therapy/methods ; *DNA/genetics/administration & dosage ; Nanoparticles ; }, abstract = {for delivery of plasmid DNA and mRNA transform biology and medicine, offering powerful tools for gene therapy, vaccine development, cancer immunotherapy, and regenerative medicine. Plasmid DNA provides a relatively stable and sustained expression of the genes which also provides the basic groundwork for long-lasting therapeutic. At the same time, mRNA has also demonstrated more appropriateness for dynamic and time-sensitive applications due to its short-lived and accurate translation capabilities, such as during the development of mRNA-based COVID-19 vaccines. Despite their unique advantages, however, the efficient delivery of these biomolecules poses challenges including immune system activation, enzymatic degradation, and limited cellular uptake. The structural and functional features of plasmid DNA and mRNA highlighted the positive functions that underpin their complementary roles in next-generation biomedical applications. In addition, it highlights the novel delivery routes across lipid nanoparticles, polymeric systems, biomimetic carriers, and hybrid applied sciences which can resolve long-standing challenges to efficient distribution. Emerging technologies such as CRISPR gene editing, self-amplifying RNA, and multiplexed nanoparticles are also increasing the utility of these systems. Significant advances in the delivery of plasmid DNA and mRNA molecules have revolutionized vaccine development, opened new avenues in personalized medicine, and have also inspired a future with engineerable tissues. As these innovations develop, they are predicted to go beyond current limitations and bring around a fresh era of accurate medication taking on one of the global healthcare's most complex challenges. Our revolutionary delivery methods provide stability and simplicity, transforming medical advances.}, } @article {pmid40449972, year = {2025}, author = {Prabhakar, PK and Upadhyay, TK and Sahu, SK}, title = {mRNA-based cancer vaccines: A novel approach to melanoma treatment.}, journal = {Advances in immunology}, volume = {165}, number = {}, pages = {117-162}, doi = {10.1016/bs.ai.2024.10.010}, pmid = {40449972}, issn = {1557-8445}, mesh = {Humans ; *Melanoma/therapy/immunology ; *Cancer Vaccines/immunology/therapeutic use/genetics ; *Immunotherapy/methods ; *Skin Neoplasms/therapy/immunology ; *RNA, Messenger/immunology/genetics ; Animals ; Antigens, Neoplasm/immunology/genetics ; COVID-19/immunology ; mRNA Vaccines/immunology ; SARS-CoV-2/immunology ; Vaccines, Synthetic/immunology ; }, abstract = {Malignant melanoma is one of the most aggressive forms of cancer and a leading cause of death from skin tumors. With the rising incidence of melanoma diagnoses, there is an urgent need to develop effective treatments. Among the most modern approaches are cancer vaccines, which aim to enhance cell-mediated immunity. Recently, mRNA-based cancer vaccines have gained significant attention due to their rapid production, low manufacturing costs, and ability to induce both humoral and cellular immune responses. These vaccines hold great potential in melanoma treatment, yet their application faces several challenges, including mRNA stabilization, delivery methods, and tumor heterogeneity. The recent success of mRNA vaccines in combating COVID-19 has renewed interest in their potential for cancer immunotherapy. In particular, mRNA cancer vaccines offer high specificity and better efficacy compared to traditional treatments. They can target tumor-specific neoantigens, prompting a robust immune response. This chapter reviews the mechanism of action of mRNA vaccines, advancements in adjuvant identification, and innovations in delivery systems such as lipid nanoparticles. It also discusses ongoing clinical trials evaluating the efficacy of mRNA-based vaccines in melanoma, highlighting promising early-phase results. Despite their potential, the development of mRNA cancer vaccines faces significant obstacles. Tumor heterogeneity, immunosuppressive tumor microenvironments, and practical issues like vaccine administration and clinical evaluation methods are major barriers to success. By addressing these challenges and advancing innovations, mRNA cancer vaccines hold promise for transforming melanoma treatment. A careful balance between the opportunities and challenges will be key to unlocking the full potential of mRNA vaccines in cancer immunotherapy.}, } @article {pmid40449348, year = {2025}, author = {Viviani, L and Vecchio, R and Pariani, E and Sandri, L and Binda, S and Ammoni, E and Cereda, D and Carducci, A and Pellegrinelli, L and Odone, A}, title = {Wastewater-based epidemiology of influenza viruses: a systematic review.}, journal = {The Science of the total environment}, volume = {986}, number = {}, pages = {179706}, doi = {10.1016/j.scitotenv.2025.179706}, pmid = {40449348}, issn = {1879-1026}, mesh = {*Wastewater/virology ; Humans ; *Influenza, Human/epidemiology/virology ; *Orthomyxoviridae/isolation & purification ; *Environmental Monitoring/methods ; *Wastewater-Based Epidemiological Monitoring ; }, abstract = {INTRODUCTION: Wastewater-based epidemiology (WBE) has emerged as a valuable public health tool for monitoring the circulation of many pathogens, including influenza viruses (IVs). The general aim of this study is to systematically retrieve and summarize evidence on the use of WBE for supporting influenza surveillance. Specific objectives are: (i) to map influenza monitoring activities using WBE; (ii) to assess the performance of viral recovery methods; (iii) to explore association with clinical data; (iv) to evaluate the feasibility of typing/subtyping IVs directly from wastewater.

METHODS: We conducted a systematic review following the PRISMA guidelines, focusing on original data from peer-reviewed studies identified through PubMed/Medline, Scopus, and Web of Science.

RESULTS: Of 882 identified citations, 42 studies were included in the review. IVs detection was reported in all but one study, although typically at lower concentration than SARS-CoV-2. Thirteen studies (38.09 %) performed comparative analysis of different protocols, with mostly inconclusive results. Detection of IVs in the solid fraction of wastewater samples generally outperformed detection in the supernatant/liquid. Additionally, we describe the findings from 22 studies (52.38 %) that examined the link between environmental viral concentrations and clinical data, and 14 studies (33.33 %) that described IVs subtyping in wastewater.

CONCLUSION: WBE has the potential to monitor influenza circulation in humans and animals, offering insights into outbreak size and circulating IVs subtypes. However, several key areas remain unexplored. Further research is needed to refine experimental techniques and standardize protocols, and to understand how to successfully integrate WBE data into public health strategies for influenza control.}, } @article {pmid40447511, year = {2025}, author = {Thibon, C and Vecellio, L and Dubus, JC and Reychler, G}, title = {[Does nebulization present a risk of viral transmission? A narrative review].}, journal = {Revue des maladies respiratoires}, volume = {42}, number = {6}, pages = {318-327}, doi = {10.1016/j.rmr.2025.04.005}, pmid = {40447511}, issn = {1776-2588}, mesh = {Humans ; *Nebulizers and Vaporizers ; *COVID-19/transmission/epidemiology ; SARS-CoV-2 ; *Infectious Disease Transmission, Patient-to-Professional/statistics & numerical data/prevention & control ; Occupational Exposure/adverse effects ; Air Microbiology ; *Virus Diseases/transmission ; }, abstract = {Nebulization is a commonly applied therapy for patients with respiratory conditions, encompassing those infected with respiratory viruses such as SARS-CoV-2, influenza and RSV. Since the COVID-19 pandemic occurred, concerns have arisen regarding the release into the environment of airborne particles during nebulization. While this treatment is known to expose healthcare workers to drug particles, the risk of viral dispersion remains poorly documented in the literature. The following narrative review explores this risk with the aim of fostering discussions and recommendations, the objectives being to minimize airborne contamination risk for healthcare workers during future epidemics, and in the management of seasonal viruses.}, } @article {pmid40447142, year = {2025}, author = {Vreeman, ECA and Pillay, J and Burgess, JK}, title = {Post-COVID pulmonary sequelae: Mechanisms and potential targets to reduce persistent fibrosis.}, journal = {Pharmacology & therapeutics}, volume = {272}, number = {}, pages = {108891}, doi = {10.1016/j.pharmthera.2025.108891}, pmid = {40447142}, issn = {1879-016X}, mesh = {Humans ; *COVID-19/complications ; *Pulmonary Fibrosis/etiology/drug therapy/virology ; SARS-CoV-2 ; Lung/pathology ; }, abstract = {After the severe acute respiratory syndrome (SARS) coronavirus 2 (SARS-CoV-2) pandemic, the emergence of long-term sequelae post-infection poses a new healthcare challenge. Following initial infection with SARS-CoV-2, approximately 1 in 10 people experience post-acute sequelae of COVID-19 (PASC), also known as long COVID. PASC can affect the entire body, with the airways and lungs being a primary target of the initial viral infection. Many post-COVID symptoms have been associated with fibrotic lung lesions and diminished respiratory function. The reversibility, persistence, or progression of post-COVID-19 pulmonary fibrosis is still a topic of debate. We aimed to compare current findings and examined similar viral infections from the past, to increase understanding of prevalence, persistence and possible pharmacological targets of post-COVID-19 pulmonary fibrosis. Recent studies have documented PASC symptoms persisting up to 3 years post-recovery, and lung impairments present after 15 years after infection with the similar SARS-CoV virus in 2003. These findings suggest the potential for long-term pulmonary fibrosis following SARS-CoV-2 infection, highlighting the need for new anti-fibrotic treatments capable of reversing pulmonary fibrosis. Besides the approved anti-fibrotics, pirfenidone and nintedanib, other promising treatments include histone deacetylase inhibitors, angiotensin receptor blockers and mesenchymal stem cells. The pathophysiological mechanisms underlying post-COVID-19 pulmonary fibrosis are still incompletely understood, necessitating future research to clarify the development of persistent post-COVID-19 pulmonary fibrosis following SARS-CoV-2 infection. Given the widespread transmission of SARS-CoV-2, even a low prevalence of persistent post-COVID-19 pulmonary fibrosis would represent a significant public health concern for which therapeutic strategies are essential to identify.}, } @article {pmid40446698, year = {2025}, author = {Gao, F and Wen, G}, title = {Strategies for combating FIPV infection: antiviral agents and vaccines.}, journal = {Research in veterinary science}, volume = {192}, number = {}, pages = {105709}, doi = {10.1016/j.rvsc.2025.105709}, pmid = {40446698}, issn = {1532-2661}, mesh = {Animals ; Cats ; *Antiviral Agents/therapeutic use/pharmacology ; *Viral Vaccines/immunology/therapeutic use ; *Feline Infectious Peritonitis/prevention & control/drug therapy/virology ; *Coronavirus, Feline/immunology/drug effects ; }, abstract = {Feline infectious peritonitis virus (FIPV) is a deadly virus that causes feline infectious peritonitis (FIP) in cats. FIP is a biotype of feline coronavirus (FCoV). Currently, the prevention and treatment of FIPV is challenged by the absence of adequate clinical treatment drugs and vaccines that offer strong immune protection complicated. In this review, we analyse and explain how small-molecule inhibitors function to protect against viral infections. Additionally, we highlight the challenges and future possibilities in developing FIPV vaccines, which are crucial for enhancing FIPV treatment and creating viable vaccine solution strategies.}, } @article {pmid40446293, year = {2025}, author = {Senek, M and Drummond, D and Pinnock, H and Hansen, K and Ankolekar, A and O'Connor, Ú and Gonsard, A and Mazulov, O and Sreter, KB and Thornton, C and Powell, P}, title = {Impact of Digital Health on Patient-Provider Relationships in Respiratory Secondary Care Based on Qualitative and Quantitative Evidence: Systematic Review.}, journal = {Journal of medical Internet research}, volume = {27}, number = {}, pages = {e70970}, pmid = {40446293}, issn = {1438-8871}, mesh = {Humans ; COVID-19/epidemiology ; *Telemedicine ; *Secondary Care ; *Professional-Patient Relations ; SARS-CoV-2 ; Qualitative Research ; Digital Health ; }, abstract = {BACKGROUND: Digital health technology adoption has accelerated in respiratory care, particularly since the COVID-19 pandemic, supporting various applications from self-management to telerehabilitation. While these technologies have transformed health care delivery, their impact on the patient-provider relationship in specialist respiratory care remains poorly understood.

OBJECTIVE: This study aims to systematically review the literature on the impact of digital health technology on the patient-provider relationship in respiratory secondary care settings and to understand the factors that enhance or diminish this relationship.

METHODS: In December 2023, we conducted a systematic review following Cochrane methodology, searching MEDLINE, Embase, CINAHL, Cochrane databases, and PsycINFO. We included qualitative, quantitative, and mixed methods studies examining digital health interventions in respiratory secondary care. Trained volunteers from the European Respiratory Society CONNECT Clinical Research Collaboration performed screening and data extraction. We conducted a qualitative meta-synthesis of findings, followed by an abductive quantitative data analysis. A total of 3 stakeholder workshops were held to interpret findings collaboratively with patients and health care professionals.

RESULTS: From 15,779 papers screened, 97 met the inclusion criteria (55 qualitative/mixed-methods studies, 42 quantitative studies). Studies covered various respiratory conditions, including COPD (32%), asthma (26%), and COVID-19 (13%). Four main themes emerged: trust (foundational to the relationship), adoption factors (including clinical context and implementation drivers), confidence in technology (based on functionality and the evidence base), and connection (encompassing communication and a caring presence). Digital health technology can either enhance or diminish trust between patients and clinicians, with patients' perceptions of the motivations behind its implementation being crucial. While technology facilitated access and communication, remote consultations risked depersonalisation, particularly when not balanced with in-person interactions. Self-monitoring and access to information empowered patients and promoted more equitable patient-provider relationships.

CONCLUSIONS: Digital health technology can either strengthen or weaken patient-provider relationships in respiratory care, with effects impacted by adoption factors, confidence in technology, connection, and patient empowerment. Maintaining trust in the era of digital care requires transparent implementation of motivations, consideration of individual circumstances, and reliable technology that supports rather than replaces the therapeutic relationship.

TRIAL REGISTRATION: PROSPERO CRD42024493664; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024493664.}, } @article {pmid40444574, year = {2025}, author = {Nakaike, T and Nguyen, DA and Makram, AM and Elsheikh, R and Hassani, M and Reda, A and Trieu, MDT and Huy, NT and Hirayama, K}, title = {The Impact of the COVID-19 on Physical Violence, Sexual Violence and Neglect Against Children: A Systematic Review and Meta-Analysis.}, journal = {Child: care, health and development}, volume = {51}, number = {4}, pages = {e70105}, doi = {10.1111/cch.70105}, pmid = {40444574}, issn = {1365-2214}, mesh = {Humans ; *COVID-19/epidemiology ; Child ; *Child Abuse/statistics & numerical data ; *Child Abuse, Sexual/statistics & numerical data ; SARS-CoV-2 ; *Physical Abuse/statistics & numerical data ; Prevalence ; *Sex Offenses/statistics & numerical data ; Male ; Female ; }, abstract = {BACKGROUND: COVID-19 caused the interruption of child protection services and economic/psychological burdens on parents. Therefore, in this systematic review and meta-analysis (SR/MA), we aimed to identify the impact of the worldwide COVID-19 pandemic on physical and sexual violence and neglect against children by investigating the change in the prevalence of these events before and during the COVID-19 pandemic.

METHODS: The protocol of this study was registered in PROSPERO with the registration number CRD42022377660. We included any studies eligible for meta-analysis comparing physical and sexual violence and neglect against children before and during the COVID-19 pandemic. Eleven electronic databases were systematically searched in March 2022. The meta-analysis was conducted using STATA, pooled odds ratios were calculated and subgroups by countries and sex of children (when possible) were analysed.

RESULTS: A total of 11 publications were included in the meta-analysis. Overall, we found no significant evidence to support that the COVID-19 pandemic impacted the prevalence or proportion of the three types of violence against children, even after segregating the data to the country or sex levels.

CONCLUSION: Overall, our analysis revealed no significant change in physical and sexual violence, as well as neglect against children before and during the COVID-19 pandemic, with the majority of data sources being hospital records and child protection services. More self-reported studies should be performed, especially in low- and middle-income countries, for a better understanding of child abuse and neglect around the world.}, } @article {pmid40443361, year = {2025}, author = {Spicuzza, L and Attinà, A and Bignamini, E and Cilla, M and De Bortoli, J and Di Michele, L and Foresi, A and Malorgio, E and Marino, L and Rocca, A and Toraldo, DM and Sanna, A}, title = {Telemedicine in the Management of Patients with Obstructive Sleep Apnea: Evidence from the Literature and Practical Issues. A Consensus Document from the Task Force for Telemedicine in Respiratory Diseases, Part of the Italian Society of Telemedicine.}, journal = {Telemedicine journal and e-health : the official journal of the American Telemedicine Association}, volume = {}, number = {}, pages = {}, doi = {10.1089/tmj.2024.0573}, pmid = {40443361}, issn = {1556-3669}, abstract = {Obstructive sleep apnea (OSA) is a high prevalent condition associated with relevant cardiovascular morbidity and mortality, determining the consume of a great amount of health care resources. Diagnosis and treatment of OSA are generally performed in OSA Units (OUs). However, although the large expansion of OUs in western countries, these still fail to cope with the increasing number of patients requiring care. Since long time, well before the COVID-19 pandemic, telemedicine (TM) has been explored as a tool to monitor both physiological parameters during sleep and treatment outcomes. Recently, the availability of wireless data transmission technology and new TM solutions has given an impetus to the spread of TM services. Nowadays, these find application throughout the diagnosis, treatment and follow-up of patients with OSA and the management of these patients is recognized as the most promising TM application among chronic disorders. A Task Force of experts in respiratory diseases, within the Italian Society of Telemedicine, has recently produced a document on distance management of OSA. Here, we present a revision of literature discussed by the TF and the document produced focusing on how to integrate TM services into the traditional routine care of patients with OSA.}, } @article {pmid40443291, year = {2025}, author = {Joseph, MM and P, S and Arya, JS and Nair, JB}, title = {Bridging pandemic and oncology challenges: Surface-enhanced Raman spectroscopy in the fight against COVID-19 and cancer.}, journal = {Science progress}, volume = {108}, number = {2}, pages = {368504251342977}, pmid = {40443291}, issn = {2047-7163}, mesh = {*Spectrum Analysis, Raman/methods ; Humans ; *COVID-19/diagnosis/virology/epidemiology ; *Neoplasms/diagnosis/therapy/drug therapy ; SARS-CoV-2/isolation & purification ; Pandemics ; Antiviral Agents/therapeutic use ; Drug Delivery Systems/methods ; COVID-19 Drug Treatment ; Metal Nanoparticles/chemistry ; }, abstract = {While Raman spectroscopy itself stands on the principle of inelastic scattering of light, surface-enhanced Raman spectroscopy (SERS) amplifies those normally rather weak Raman signals by way of interactions between molecules and nanostructured metal surfaces. The technique has rapidly evolved into a very powerful analytical tool with enormous potential in combating cancer and COVID-19. SERS is a useful tool for diagnostics and treatment monitoring because of its remarkable sensitivity and ability to detect low-abundance molecules; nevertheless, standardizing techniques, guaranteeing reproducibility across several platforms, and overcoming problems related to signal enhancement and sensitivity under different experimental conditions remain challenges. SERS is also being explored about the COVID-19 pandemic, where its high sensitivity and specificity hold a promise in diagnostics, treatment monitoring, and even environmental tracing of the virus. When it comes to treatment, SERS-based theragnostic applications offer a two-pronged approach by combining therapeutic interventions with diagnostic capabilities that would make different therapies more accurate and effective. Approaches to SERS-guided drug delivery systems are discussed that would allow the drug to reach exactly where the antiviral agent is wanted, hence reducing side effects and enhancing treatment outcomes. Other approaches examined, including nanoparticle-based SERS for targeted therapy and the design of SERS tags, allow therapy and develop new ways of treatment against this virus. Finally, potential future developments of SERS technology and its wider applications in cancer and virology are discussed, with a specific view on the impact SERS might have on how infectious diseases are treated. In addition to discussing its present and potential uses, this narrative review emphasizes the critical role that SERS plays in developing and tracking cancer and COVID-19 treatments.}, } @article {pmid40443190, year = {2025}, author = {Ravichandran, N and Dillon, E and McCombe, G and Sietins, E and Broughan, J and O' Connor, K and Gulati, G and Frawley, T and Kelly, BD and Guérandel, A and Osborne, B and Cullen, W}, title = {Prevalence of Mental Health Disorders in General Practice from 2014 to 2024: A literature review and discussion paper.}, journal = {Irish journal of psychological medicine}, volume = {}, number = {}, pages = {1-8}, doi = {10.1017/ipm.2025.24}, pmid = {40443190}, issn = {2051-6967}, abstract = {BACKGROUND: Many consultations in primary care involve patients with mental health problems, and primary care is typically the place where many such patients initially seek help. While considerable research has examined the prevalence of mental health disorders in primary care, relatively few papers have examined this issue in recent years. This study aims to address this gap by reviewing contemporary literature from 2014 to 2024 on the prevalence of mental health disorders among general practice patients.

METHODS: A comprehensive search across PubMed, PsycINFO, and Google Scholar was conducted, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for article selection and assessment, examining the prevalence of mental health disorders in general practice.

RESULTS: Studies varied in methodologies and healthcare settings, with reported prevalence rates of mental health disorders ranging from 2.4% to 56.3%. Demographic characteristics (female gender, older age) were associated with a higher prevalence of mental health disorders in the studies identified. Studies based on patient interviews reported broader prevalence (2.4-56.3%) compared to studies using electronic medical record reviews (12-38%). Prevalence also varied between countries. Notably, there has been a lack of post-COVID-19 studies, especially within Europe, examining the prevalence of mental health prevalence in primary care.

CONCLUSIONS: Mental health problems are still common among patients attending general practice; the approach to data collection (i.e., prospective interviews with patients), female gender and older age appear to be correlates of higher estimates. Further research involving a large-scale study with multiple sites is a priority.}, } @article {pmid40442421, year = {2025}, author = {Singh, BP}, title = {Analyzing the Interplay of Air Pollution and COVID-19: A Review on Health Implications.}, journal = {EcoHealth}, volume = {22}, number = {3}, pages = {486-499}, pmid = {40442421}, issn = {1612-9210}, mesh = {*COVID-19/epidemiology/mortality/transmission ; Humans ; *Air Pollution/adverse effects/analysis ; *Air Pollutants/analysis/adverse effects ; Particulate Matter/analysis/adverse effects ; SARS-CoV-2 ; *Environmental Exposure/adverse effects ; Pandemics ; Public Health ; }, abstract = {The COVID-19 pandemic has had a profound impact on global public health, highlighting the complex relationship between air pollution and disease transmission. Approximately 2.3 billion people live in regions with high levels of air pollution, particularly in the Asia-Pacific region, with countries like India facing severe challenges. This review examines the association between various pollutants, including PM2.5, PM10, NO2, SO2, and CO, and the spread, severity, and mortality of COVID-19. Particulate matter, particularly fine particles, serves as a carrier for viral particles, facilitating faster transmission and increasing respiratory vulnerability. Studies have shown that long-term exposure to air pollutants exacerbates the severity of COVID-19 symptoms, especially in densely populated urban areas. During the lockdown phases, significant reductions in air pollution were observed, including decreases in PM2.5 by up to 93%, PM10 by 83%, and NO2 levels, which contributed to improved air quality and potentially mitigated COVID-19 mortality rates. The review also underscores regional disparities, with marginalized populations bearing a disproportionate burden of pollution exposure and health impacts. Gaseous pollutants such as NO2 were found to contribute to respiratory inflammation, increasing the susceptibility to severe COVID-19 outcomes. Additionally, the review explores the influence of meteorological and climatic factors on COVID-19 outcomes, noting the varying impact of temperature, humidity, and other factors depending on the season, geographical location, and latitude. These findings offer critical insights for policymakers and public health authorities in developing strategies for mitigating both air pollution and COVID-19 transmission.}, } @article {pmid40442046, year = {2025}, author = {Bansal, AK and Kumar, D}, title = {Solid-State Pharmaceutics Research in India: Present and Future.}, journal = {Molecular pharmaceutics}, volume = {22}, number = {7}, pages = {3523-3529}, doi = {10.1021/acs.molpharmaceut.5c00534}, pmid = {40442046}, issn = {1543-8392}, mesh = {India ; *Drug Industry/economics/trends ; Humans ; COVID-19/epidemiology ; *Pharmaceutical Research/trends/economics ; Drugs, Generic/economics ; SARS-CoV-2 ; }, abstract = {The pharmaceutical industry not only plays a crucial role in the healthcare system but also contributes significantly to the economy of a country. It is interesting to note that in 2024, a Danish pharmaceutical company held the title of Europe's most valuable company. Novo Nordisk, riding on popularity of a weight-loss drug, had a valuation of $600 billion in 2024, outweighing the GDP of Denmark Nat Med 2024, 30, 2049. Indian companies have achieved global recognition in generics, thus earning India the title of the "pharmacy of the world". This position was further strengthened during the COVID-19 pandemic when India supported the global needs with its high-capacity manufacturing and efficient supply chain management. However, despite these awards, the total valuation of the Indian pharmaceutical market, including its export values, is less than $100 billion. This highlights the focus of Indian pharmaceutical companies on generics, which generally generates less revenue with high volumes Journal of Positive School Psychology 2022, 9285. In contrast, innovative products can generate a high revenue and accelerate economic growth. Innovative companies spend a good amount of their funds on research and development. It is well-recognized that a synergy between academic research institutions and pharmaceutical companies supports innovative outcomes Res. Policy 1991, 20, 1-12. In this perspective, we discuss the prominent areas of pharmaceutical research in Indian academia and also analyze the status of solid-state pharmaceutics (SSP) and pharmaceutical crystal engineering research. The article discusses the evolution of research in SSP, its status, and future prospects. Authors emphasize the need for improvement of the research ecosystem for SSP, thus ensuring availability of optimal human resources for this critical component of the pharmaceutical industry. There is a need to create a "solid-state pharmaceutics research cluster" in India to accelerate the research and support the growth of the Indian pharmaceutical industry.}, } @article {pmid40441732, year = {2025}, author = {Ibrahim, S and Siemieniuk, RAC and Oliveros, MJ and Islam, N and Díaz Martinez, JP and Izcovich, A and Qasim, A and Zhao, Y and Zaror, C and Yao, L and Wang, Y and Vandvik, PO and Roldan, Y and Rochwerg, B and Rada, G and Prasad, M and Pardo-Hernandez, H and Mustafa, RA and Fashami, FM and Miroshnychenko, A and McLeod, SL and Mansilla, C and Lamontagne, F and Khosravirad, A and Honarmand, K and Ghadimi, M and Gao, Y and Foroutan, F and Devji, T and Couban, R and Chu, DK and Chowdhury, SR and Chang, Y and Bravo-Soto, G and Bosio, C and Biscay, D and Bhogal, G and Azab, M and Agoritsas, T and Agarwal, A and Guyatt, GH and Brignardello-Petersen, R}, title = {Drug treatments for mild or moderate covid-19: systematic review and network meta-analysis.}, journal = {BMJ (Clinical research ed.)}, volume = {389}, number = {}, pages = {e081165}, pmid = {40441732}, issn = {1756-1833}, mesh = {Humans ; Adenosine Monophosphate/analogs & derivatives/therapeutic use/analogs & derivatives ; Alanine/analogs & derivatives/therapeutic use/analogs & derivatives ; Amides/therapeutic use ; *Antiviral Agents/therapeutic use ; COVID-19 ; *COVID-19 Drug Treatment ; Lopinavir/therapeutic use ; Pyrazines/therapeutic use ; Randomized Controlled Trials as Topic ; Ritonavir/therapeutic use ; Severity of Illness Index ; }, abstract = {OBJECTIVE: To compare the effects of treatments for mild or moderate (that is, non-severe) coronavirus disease 2019 (covid-19).

DESIGN: Systematic review and network meta-analysis.

DATA SOURCES: Covid-19 Living Overview of Evidence Repository (covid-19 L-OVE) by the Epistemonikos Foundation, a public, living repository of covid-19 articles, from 1 January 2023 to 19 May 2024. The search also included the WHO covid-19 database (up to 17 February 2023) and six Chinese databases (up to 20 February 2021). The analysis included studies identified between 1 December 2019 and 28 June 2023.

STUDY SELECTION: Randomised clinical trials in which people with suspected, probable, or confirmed mild or moderate covid-19 were allocated to drug treatment or to standard care or placebo. Pairs of reviewers independently screened potentially eligible articles.

METHODS: After duplicate data abstraction, a bayesian network meta-analysis was conducted. Risk of bias was assessed by use of a modification of the Cochrane risk of bias 2.0 tool, and the certainty of the evidence using the grading of recommendations assessment, development, and evaluation (GRADE) approach. For each outcome, following GRADE guidance, drug treatments were classified in groups from the most to the least beneficial or harmful.

RESULTS: Of 259 trials enrolling 166 230 patients, 187 (72%) were included in the analysis. Compared with standard care, two drugs probably reduce hospital admission: nirmatrelvir-ritonavir (25 fewer per 1000 (95% confidence interval 28 fewer to 20 fewer), moderate certainty) and remdesivir (21 fewer per 1000 (28 fewer to 7 fewer), moderate certainty). Molnupiravir and systemic corticosteroids may reduce hospital admission (low certainty). Compared with standard care, azithromycin probably reduces time to symptom resolution (mean difference 4 days fewer (5 fewer to 3 fewer), moderate certainty) and systemic corticosteroids, favipiravir, molnupiravir, and umifenovir probably also reduce duration of symptoms (moderate to high certainty). Compared with standard care, only lopinavir-ritonavir increased adverse effects leading to discontinuation.

CONCLUSION: Nirmatrelvir-ritonavir and remdesivir probably reduce admission to hospital, and systemic corticosteroids and molnupiravir may reduce admission to hospital. Several medications including systemic corticosteroids and molnupiravir probably reduce time to symptom resolution.

This review was not registered. The protocol is publicly available in the supplementary material.}, } @article {pmid40441594, year = {2025}, author = {Forsdyke, DR}, title = {Mechanism and biological significance of erythrocyte homoaggregation (rouleaux formation): temperature-dependent entropic liberation of water from cells and macromolecules.}, journal = {Bio Systems}, volume = {254}, number = {}, pages = {105504}, doi = {10.1016/j.biosystems.2025.105504}, pmid = {40441594}, issn = {1872-8324}, mesh = {Humans ; *Erythrocyte Aggregation/physiology ; *Erythrocytes/physiology/metabolism ; Temperature ; *Water/metabolism ; Entropy ; *Macromolecular Substances/metabolism ; }, abstract = {In the pre-antibiotic era, infections were usually more frequent and serious than today. Robin Fåhraeus (1888-1958) examined the erythrocyte sedimentation rate (ESR) test for infections, which was normally carried out in vitro with freshly drawn blood. His extensive studies on the mechanism and physiological significance of the enhanced sedimentation of erythrocyte aggregates (rouleaux) in disease included in vivo simulation. This led him to propose an explanation for the finding of long white strips ("fibrin coagula") within the blood vessels of those who had died from infections. The surge of serious infections in pandemic times has likely kindled a reemergence. He further speculated that (i) the weak aggregation of red blood cells (RBCs) followed the liberation of water molecules from their surfaces, and (ii) the importance of their aggregation, which was induced by changes in serum proteins (not necessarily antibodies), extended beyond the clinic. In modern times these changes have led to immunologically significant entropic interpretations of infection-associated aggregations, whether cellular (e.g., RBC) or molecular (i.e., macromolecular polymerizations). Thus, rouleaux formation displays a process at the cellular level that can proceed in parallel at a less visible macromolecular level. It has been proposed that, when intracellular, aggregations would discriminate between self and not-self proteins in the crowded cytosol. Favoured by an associated pyrexia, this could lead, by mechanisms to be determined, to the preferential loading of peptides from proteins deemed "foreign" for presentation as major histocompatibility complexes (MHCs) to specific clones of immune cells.}, } @article {pmid40440696, year = {2025}, author = {Sylla, B and Ismaila, O and Diallo, G}, title = {25 Years of Digital Health Toward Universal Health Coverage in Low- and Middle-Income Countries: Rapid Systematic Review.}, journal = {Journal of medical Internet research}, volume = {27}, number = {}, pages = {e59042}, pmid = {40440696}, issn = {1438-8871}, mesh = {Humans ; COVID-19/epidemiology ; *Developing Countries ; Digital Health ; Health Services Accessibility ; Mobile Applications ; Retrospective Studies ; *Telemedicine ; *Universal Health Insurance ; }, abstract = {BACKGROUND: Over the last 25 years, digital health interventions in low- and middle-income countries have undergone substantial transformations propelled by technological advancements, increased internet accessibility, and a deeper appreciation of the benefits of digital tools in enhancing health care availability.

OBJECTIVE: This study aims to examine the evolution, impact, and prospects of digital health interventions in low- and middle-income countries, highlighting their role in improving health care accessibility and equity.

METHODS: A retrospective analysis of digital health initiatives scanning the past two and a half decades focused on the progression from basic SMS platforms to sophisticated mobile health apps and other health digital interventions. Relevant literature and case studies were reviewed to elucidate key milestones, successes, challenges, and opportunities in advancing digital health initiatives in low- and middle-income regions.

RESULTS: Digital health initiatives in low- and middle-income countries initially targeted specific health concerns, such as malaria diagnosis and treatment, through text-based platforms, demonstrating their efficacy in reaching remote and marginalized communities. With the proliferation of mobile phone ownership and internet access, these interventions evolved into comprehensive mobile health apps, facilitating self-care support, patient education, chronic disease monitoring, and remote consultations. The COVID-19 pandemic further accelerated the adoption of digital health interventions, particularly in disseminating health information, supporting contact tracing efforts, and enabling virtual consultations to alleviate strain on health care systems.

CONCLUSIONS: The future of digital health interventions in low- and middle-income countries holds immense promise, fueled by emerging technologies such as artificial intelligence, machine learning, and blockchain. However, challenges persist in ensuring equitable access to digital health technologies, addressing disparities in digital literacy, and establishing robust health care infrastructure. Collaboration among governments, health care providers, technology innovators, and communities is essential to overcome these challenges and harness the full potential of digital health to improve health care outcomes in low- and middle-income countries.}, } @article {pmid40439840, year = {2025}, author = {Liu, X}, title = {ACE2, a therapeutic target of COVID-19, needs to be treated with caution.}, journal = {Archives of virology}, volume = {170}, number = {7}, pages = {143}, pmid = {40439840}, issn = {1432-8798}, support = {2015647//Ministère de l'Education Nationale, de la Formation professionnelle, de l'Enseignement Supérieur et de la Recherche Scientifique/ ; }, mesh = {*Angiotensin-Converting Enzyme 2/metabolism/antagonists & inhibitors/genetics ; Humans ; *SARS-CoV-2/drug effects/physiology ; COVID-19/virology ; *COVID-19 Drug Treatment ; Spike Glycoprotein, Coronavirus/metabolism ; *Antiviral Agents/therapeutic use/pharmacology ; Virus Internalization/drug effects ; }, abstract = {Angiotensin-converting enzyme 2 (ACE2) has garnered significant attention for its crucial role in infection by both SARS-CoV and SARS-CoV-2. Consequently, it has emerged as a potential therapeutic target for treatment of COVID-19. It is therefore important to understand the mechanisms and modes of action of current and future treatments involving ACE2. Three important strategies have been explored in previous studies: (1) interruption of the interaction between ACE2 and the coronavirus spike protein using compounds or monoclonal antibodies, (2) capturing the extracellular virus by employing soluble ACE2 as a decoy, and (3) reducing the expression or inhibiting the activity of ACE2 through genetic approaches or drug intervention. However, the third strategy of inhibiting ACE2 activity as a means of treating COVID-19 is potentially risky, and the wisdom of pursuing this approach is subject to debate. Here, the advisability of using anti-ACE2 treatment in the context of SARS-CoV and SARS-CoV-2 infections is challenged by reviewing the physiological function of ACE2 and the mechanism of viral entry, emphasizing the pathological impairment of ACE2 that occurs during SARS-CoV and SARS-CoV-2 infection and arguing that the potential hazards associated with ACE2 impairment should be given more attention. Because of the important concerns regarding the potential side effects of ACE2 inhibition, researchers are strongly urged to approach this issue with caution.}, } @article {pmid40438846, year = {2025}, author = {Idris Fadul, AA and Osman Mohamed, AA and Mohammed Ahmed, AAS and Elmobark, S and Merghani Hammour, AS and Elgaleel Khir Elsiad, NMN and Mohammed Elhaj, EA}, title = {Post-coronavirus Disease 2019 (COVID-19) Cardiovascular Manifestations: A Systematic Review of Long-Term Risks and Outcomes.}, journal = {Cureus}, volume = {17}, number = {4}, pages = {e83083}, pmid = {40438846}, issn = {2168-8184}, abstract = {Emerging evidence suggests that coronavirus disease 2019 (COVID-19) survivors face increased risks of cardiovascular complications, but the long-term risks, underlying mechanisms, and clinical implications remain incompletely characterized. This systematic review synthesizes current evidence on post-COVID-19 cardiovascular manifestations, evaluating their incidence, pathophysiology, and outcomes. A comprehensive literature search was conducted across PubMed/MEDLINE, Embase, Scopus, Web of Science, and the Cochrane Library, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Fifteen observational studies (cohort, case-control, cross-sectional) meeting predefined eligibility criteria, confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, cardiovascular outcomes assessed ≥4 weeks post-infection, sample sizes >10, and peer-reviewed publication, were included. The risk of bias was assessed using the Newcastle-Ottawa Scale. The multinational studies (United States, Europe, Asia, South America) involved diverse populations (n=80-8,126,462), with follow-up durations ranging from three to 24 months. Mechanisms such as endothelial dysfunction, myocardial inflammation, and autonomic dysregulation were consistently supported across studies via imaging (e.g., cardiac MRI) and biomarkers (e.g., troponin, C-reactive protein (CRP)). Persistent arrhythmias and subclinical myocardial injury were directly demonstrated in 40-60% of patients. Worse outcomes were associated with hospitalization during acute infection, preexisting cardiovascular disease, and metabolic syndrome. Heterogeneity in follow-up durations may limit the detection of very-late-onset complications, though risks remained elevated across all intervals. Individualized management strategies should include cardiovascular imaging (echocardiography, MRI), biomarker profiling, and tailored pharmacotherapy (anti-inflammatory agents, anticoagulants). The ethical rationale for randomized trials is now strengthened by the clear evidence of long-term risks; ongoing trials are testing targeted anti-inflammatory and anticoagulant regimens. These findings underscore the necessity of systematic cardiovascular surveillance and risk-stratified care for COVID-19 survivors. Future research should prioritize extended follow-up studies and randomized controlled trials (RCTs) to optimize interventions for this growing population.}, } @article {pmid40438117, year = {2025}, author = {Li, Z and Qin, L and Xu, X and Chen, R and Zhang, G and Wang, B and Li, B and Chu, XM}, title = {Immune modulation: the key to combat SARS-CoV-2 induced myocardial injury.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1561946}, pmid = {40438117}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/immunology/complications ; *SARS-CoV-2/immunology ; Animals ; *Cardiomyopathies/immunology ; Myocardium/immunology/pathology ; *Immunomodulation ; }, abstract = {The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which caused the Coronavirus disease 2019 (COVID-19) pandemic, has posed significant healthcare challenges. In addition to respiratory complications, it has led to severe damage in other organs, particularly the cardiovascular system. Of which, myocardial injury is increasingly recognized as a most significant complication, contributing to the high mortality. Recent research indicates the pivotal role of immune dysregulation in mediating myocardial injury in patients infected with SARS-CoV-2. In this review, we provide a comprehensive analysis of the immune mechanisms involved in SARS-CoV-2-induced myocardial damage, focusing on the roles of key immune cells and molecules that contribute to this pathological process. Aiming at mitigating the myocardial injury of COVID-19, we review immune-based treatments under evaluation in preclinical and clinical trials. Along with talking about the similarities and differences in myocardial injury resulting from SARS-CoV-2, the Middle East respiratory syndrome coronavirus (MERS-CoV) and the severe acute respiratory syndrome coronavirus (SARS-CoV). This article provides a unique perspective on using past experiences to prevent myocardial injury in the face of ongoing virus mutations.}, } @article {pmid40438110, year = {2025}, author = {Konopka, EN and Edgerton, AO and Kutzler, MA}, title = {Nucleic acid vaccines: innovations, efficacy, and applications in at-risk populations.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1584876}, pmid = {40438110}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/prevention & control/immunology ; *Vaccines, DNA/immunology ; *SARS-CoV-2/immunology ; *COVID-19 Vaccines/immunology ; Animals ; Vaccine Efficacy ; *Nucleic Acid-Based Vaccines/immunology ; Vaccine Development ; mRNA Vaccines/immunology ; Aging/immunology ; }, abstract = {For more than two centuries, the field of vaccine development has progressed through the adaptation of novel platforms in parallel with technological developments. Building off the advantages and shortcomings of first and second-generation vaccine platforms, the advent of third-generation nucleic acid vaccines has enabled new approaches to tackle emerging infectious diseases, cancers, and pathogens where vaccines remain unavailable. Unlike traditional vaccine platforms, nucleic acid vaccines offer several new advantages, including their lower cost and rapid production, which was widely demonstrated during the COVID-19 pandemic. Beyond production, DNA and mRNA vaccines can elicit unique and targeted responses through specialized design and delivery approaches. Considering the growth of nucleic acid vaccine research over the past two decades, the evaluation of their efficacy in at-risk populations is paramount for refining and improving vaccine design. Importantly, the aging population represents a significant portion of individuals highly susceptible to infection and disease. This review seeks to outline the major impairments in vaccine-induced responses due to aging that may be targeted for improvement with design and delivery components encompassing mRNA and DNA vaccine formulations. Results of pre-clinical and clinical applications of these vaccines in aged animal models and humans will also be evaluated to outline current successes and limitations observed in these platforms.}, } @article {pmid40438065, year = {2025}, author = {Blackberry, I and Boak, J and Barclay, K and Khalil, H}, title = {What is the care economy? A scoping review on current evidence, challenges, facilitators and future opportunities.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1540009}, pmid = {40438065}, issn = {2296-2565}, mesh = {Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; *Caregivers/economics ; *COVID-19/economics/epidemiology ; }, abstract = {BACKGROUND: The care economy gained its prominence during the COVID-19 pandemic. The value and impact of caregiving, mostly shouldered by women, was not as visible until such crisis point. Health care and social support sectors represent the largest and fastest growing industry globally. This scoping review aims to elucidate the current state of play in the care economy, where there is a great reliance on informal and formal care workforce to deliver care for populations across all age groups and abilities.

METHODS: Following Joanna Briggs Institute (JBI) methodology and PRISMA-SCR reporting guidance, we searched MEDLINE, Embase, CINAHL, PsycINFO, Campbell collaboration database, Social Science Abstracts, Library and Information Science Abstracts (LISA) and Scopus. Quantitative and qualitative original research on disability, aged care, early childhood education and care, rural, veterans, migrants and informal and formal care workforce from January 2018 until November 2023 were examined.

RESULTS: Of 354 studies selected, 20% were from the United States of America, 11% each were from China and the United Kingdom. Most studies employed cross-sectional design. A quarter of the studies included adults aged 65 years and above while 6% were adults aged 18 to 64 years. These age groups combined were included in an additional 27% of studies. Women were overrepresented in 70% of the studies. Nearly two-thirds of caregivers were spouses or partners. Barriers to providing care were lack of education, support and monitoring of caregiver well-being, loss of income or ability to earn money, reduced social life and increased out-of-pocket costs. Gaps in research included migrant populations' contribution to the care economy, gender and diversity inequality in the care economy. The care economy could be improved through providing education for caregivers, care workforce engaging with caregivers in the care plan, and governments' overhaul of compensation for caregivers through direct financial support and employment benefits.

CONCLUSION: The care economy is an emerging research area. There continues to be a paucity of research evidence across some geographical areas. Studies are mostly short term or small scale with very little evidence around the value of care. Given the growing aging population, more research is needed to elucidate the positive aspects of caring by formal and informal care workforce to the population, society and economy.

PROTOCOL REGISTRATION: The protocol is registered with Open Science Framework (10.17605). "Definitions, key themes and aspects of the care economy-a scoping review protocol," https://osf.io/ypmuh.}, } @article {pmid40438050, year = {2025}, author = {Moreira da Cunha, N and Tzirita, S and Gobbo, E and Herzig van Wees, S}, title = {Factors influencing adolescents' decision-making about COVID-19 vaccination: a systematic review with qualitative synthesis.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1563677}, pmid = {40438050}, issn = {2296-2565}, mesh = {Humans ; Adolescent ; *Decision Making ; *COVID-19/prevention & control ; *COVID-19 Vaccines/administration & dosage ; *Vaccination/psychology ; *Health Knowledge, Attitudes, Practice ; Health Literacy ; Qualitative Research ; }, abstract = {INTRODUCTION: Attitudes towards vaccination are influenced by a broad range of factors, yet little is known about the drivers shaping adolescents' vaccination beliefs. The aim of this study was to qualitatively explore the factors influencing adolescents' individual decision-making towards COVID-19 vaccination.

METHODS: A systematic review was conducted using Medline, Web of Science, Sociological Abstracts, and Publicly Available Content Database. Studies on attitudes, beliefs, and perceptions of adolescents regarding COVID-19 vaccines were included. The JBI Critical Appraisal Checklist was used for quality assessment, followed by thematic synthesis of the included studies.

RESULTS: In total, 13 studies were included, revealing 5 key themes: (1) Limited vaccine literacy influences adolescents' attitudes towards COVID-19 vaccines; (2) Family, peers, and community strongly influence adolescents' COVID-19 vaccine decision-making; (3) Different levels of trust in vaccine providers and governments influence adolescents' attitudes towards COVID-19 vaccines; (4) Desire to go back to normality influences adolescents' COVID-19 vaccine attitudes towards vaccine acceptancy; (5) Autonomy influences adolescents' COVID-19 vaccine decision-making.

DISCUSSION: The review findings suggest that vaccine acceptance among adolescents could be improved through tailored and accessible vaccine literacy messaging, addressing structural mistrust, and empowering adolescents to make autonomous health decisions that take into account diverse contexts and populations.

https://www.crd.york.ac.uk/PROSPERO/view/CRD42024512197, identifier CRD42024512197.}, } @article {pmid40437478, year = {2025}, author = {Mann, C and Reuben, E and Baker, S and Hijazi, M and Nandakumar, AK and Shetty, P and Stanley, R and Igboelina, O and Nyombi, G and Nzoya, D and Oli, S and Kena, G and Piña, C and Tuchman, J and Sklaw, K and Kola-Jebutu, A and Lohar, I and Cam, ANT and Kamdem, ST and Kouadio Kouadio, YM}, title = {Addressing the HIV/AIDS investment gap through stronger public financial management systems: a human-centered approach.}, journal = {BMC health services research}, volume = {24}, number = {Suppl 1}, pages = {1670}, doi = {10.1186/s12913-024-11324-1}, pmid = {40437478}, issn = {1472-6963}, mesh = {Humans ; *HIV Infections/economics ; *Financial Management/organization & administration ; Acquired Immunodeficiency Syndrome/economics ; Budgets ; COVID-19 ; *Financing, Government/organization & administration ; Capacity Building ; *Investments ; }, abstract = {BACKGROUND: UNAIDS estimated that US$29 billion will be required by 2025 to meet HIV/AIDS service demands, with 53 percent expected to come from domestic sources. The PEPFAR-funded, USAID-implemented Sustainable Financing Initiative for HIV/AIDS (SFI), starting in 2014, supported domestic resources mobilization efforts and activities to strengthen countries' public financial management (PFM) systems, positively contributing to much-needed increase in domestic resources for health and HIV.

PROGRAM APPROACH: SFI was implemented in 12 countries, supporting activities to build the capacity of governments to mobilize domestic resources for HIV, improve budget absorption, and maximize resource use and develop and use evidence for advocacy to increase domestic government funds for HIV/AIDS. SFI measured impact by agreed upon indicators and estimated return on investment (ROI).

RESULTS: Eight countries focused on building capacity to improve budgeting and execution of health and HIV/AIDS funds; five experienced increases in budget allocation and spending. Kenya country governments spent an additional US$180 million and US$8.7 million on health and HIV, respectively. This contributed to US$60 mobilized and spent for every SFI dollar invested. Eight countries focused on using evidence to advocate for more domestic resources for health and HIV/AIDS from government budgets, increase budget execution, and identify areas for efficiency. Cambodia saw an increase in government commitments for ARVs from US$1.5 million annually from 2018-2020 to US$5 million by 2023.

LESSONS LEARNED: Robust data are needed for evidence-based advocacy to increase domestic government funding for HIV/AIDS and to strengthen PFM systems for more efficient and effective resource use; institutionalizing capacity building efforts allows for locally-led technical assistance; policy-related work is a multi-year endeavor; PFM success can be stymied by political transitions, political will, and donor commitments; COVID-19 brought new challenges and new opportunities; measurable results can lead to greater impact; and results are not necessarily solely project attributions with possible inflation of ROI estimates given there was no counterfactual.

CONCLUSION: Strengthening PFM systems can increase domestic resources for health and HIV through increased revenue and improved efficiency; closing the investment gap to end the HIV/AIDS epidemic by 2030.}, } @article {pmid40436612, year = {2025}, author = {Daynes, E and Barker, RE and Jones, AV and Walsh, JA and Nolan, CM and Man, WD and Singh, SJ and Greening, NJ and Houchen-Wolloff, L and Evans, RA}, title = {Determining the minimum important differences for field walking tests in adults with long-term conditions: a systematic review and meta-analysis.}, journal = {European respiratory review : an official journal of the European Respiratory Society}, volume = {34}, number = {176}, pages = {}, pmid = {40436612}, issn = {1600-0617}, support = {/WT_/Wellcome Trust/United Kingdom ; }, mesh = {Humans ; *Walk Test ; *Exercise Tolerance ; Time Factors ; Predictive Value of Tests ; Male ; Female ; *Minimal Clinically Important Difference ; Reproducibility of Results ; Adult ; Middle Aged ; *Lung/physiopathology ; *Walking ; Aged ; *Respiratory Tract Diseases/diagnosis/physiopathology/therapy ; *Heart Diseases/diagnosis/physiopathology ; Prognosis ; *Exercise Test ; *Nervous System Diseases/diagnosis/physiopathology ; Chronic Disease ; }, abstract = {IMPORTANCE: The minimum important difference (MID) for field walking tests aims to improve interpretation of outcomes, but the volume and heterogeneity of MIDs for these tests is challenging. We aimed to determine the MID for the 6-min walk distance (6MWD), incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT) in adults with long-term conditions.

METHODS: This systematic review included studies that generated a MID using an anchor-based approach in patients with long-term conditions for the 6MWD, ISWT or ESWT field walking tests. Studies were screened and data extracted by independent reviewers. Meta-analyses were performed using RevMan.

RESULTS: 42 studies were included in the analyses, involving n=13 949 participants. Of these, 12 studies involving exercise as an intervention were included in the meta-analyses to produce MIDs, presented as mean (95% confidence interval). The MID for the 6MWD was 25 m (24-26 m) for respiratory conditions, 23 m (8-37 m) for cardiac conditions and 37 m (26-49 m) for neurological/musculoskeletal conditions. The MID for the ISWT was 48 m (39-57 m) for respiratory conditions and 70 m (55-85 m) for cardiac conditions. The MID for ESWT in COPD was 159 s (94-224 s). The pooled MID across conditions within exercise interventions was 26 m (22-40 m) for the 6MWD and 53 m (44-62 m) for the ISWT, with reasonable heterogeneity (I[2]=48% and I[2]=47%, respectively).

CONCLUSION: We propose new MIDs for exercise interventions using anchor-based methodology in long‑term conditions for the 6MWD, ISWT and ESWT. These can be used internationally for meta‑analyses where studies have used different field walking tests, to optimise trial sample size calculations, and for clinical service benchmarking.}, } @article {pmid40435404, year = {2025}, author = {Machtinger, AN and Machkovech, HM and O'Connor, SL and Johnson, MC and Shafer, MM and Friedrich, TC and O'Connor, DH}, title = {Community-Scale Molecular Surveillance for Human Viruses.}, journal = {Annual review of virology}, volume = {12}, number = {1}, pages = {115-134}, doi = {10.1146/annurev-virology-092623-102821}, pmid = {40435404}, issn = {2327-0578}, mesh = {Humans ; *Viruses/genetics/isolation & purification/classification ; *Environmental Monitoring/methods ; *Virus Diseases/virology/epidemiology ; *COVID-19/epidemiology/virology ; SARS-CoV-2/genetics/isolation & purification ; Animals ; Wastewater/virology ; }, abstract = {Environmental surveillance, including wastewater and air sampling, has emerged as a powerful complement to traditional clinical surveillance for monitoring viral circulation. Advances in sampling and detection technologies, many spurred by the COVID-19 pandemic, have enabled more sensitive and comprehensive characterization of viruses in diverse types of commingled samples from multiple individuals. Expanding environmental monitoring globally presents challenges and opportunities, particularly in low- and middle-income countries where centralized sewage infrastructure may be limited. Ethical implementation will require balancing privacy and transparency through community engagement. Future directions include using environmental surveillance to detect emerging zoonoses, fill gaps when clinical testing wanes, and inform public health actions. While logistical, regulatory, and ethical challenges remain, coordination across scientific and public health stakeholders can enable environmental monitoring to transform epidemic intelligence. This review summarizes recent developments in environmental surveillance systems and discusses how they can mitigate the introduction and spread of viruses in communities.}, } @article {pmid40435229, year = {2025}, author = {Hamilton, F and Butler-Laporte, G and Davey Smith, G}, title = {Mendelian Randomization and Infection: Pitfalls and Promises.}, journal = {The Journal of infectious diseases}, volume = {232}, number = {3}, pages = {525-533}, pmid = {40435229}, issn = {1537-6613}, support = {//National Institute for Health and Care Research/ ; MC_UU_00032/1/MRC_/Medical Research Council/United Kingdom ; }, mesh = {*Mendelian Randomization Analysis/methods ; Humans ; COVID-19/genetics ; SARS-CoV-2 ; *Communicable Diseases/genetics/epidemiology ; Research Design ; }, abstract = {Mendelian randomization (MR) is an increasingly common study design in infectious diseases (ID). It holds promise for identifying causes and consequences of infections where conventional epidemiology has struggled, and can highlight plausible drug targets, as shown in successful coronavirus disease 2019 (COVID-19) trials (baricitinib, tocilizumab). However, many current applications provide limited insight due to violations of core assumptions, yielding uninterpretable results. This article reviews MR principles, assumptions, and specific challenges in ID. We highlight examples violating key assumptions, noting that MR studies using infection as an exposure are particularly prone to bias compared to using infection as an outcome. We discuss the future of MR in ID, emphasizing appropriate application to address causal questions unanswerable by other methods and capitalize on emerging opportunities where MR can provide unique insights.}, } @article {pmid40434925, year = {2025}, author = {Cheuiche, AV and Teixeira, MG and Moro, C and Guimarães, G and Salvador, L and Czepielewski, MA and de, LCP and Silveiro, SP}, title = {Impact of the COVID-19 pandemic on the incidence of central precocious puberty: A PRISMA-ScR-COMPLIANT scoping review.}, journal = {Archives of endocrinology and metabolism}, volume = {69}, number = {2}, pages = {e240300}, pmid = {40434925}, issn = {2359-4292}, mesh = {Humans ; *Puberty, Precocious/epidemiology ; *COVID-19/epidemiology ; Incidence ; Male ; Female ; Child ; SARS-CoV-2 ; Pandemics ; }, abstract = {Puberty is a biological maturation process that involves genetic, nutritional, environmental, ethnic, and lifestyle factors. During the coronavirus 2019 (COVID-19) pandemic, an increase in referrals for central precocious puberty (CPP) assessment was observed in clinical practice. The aim of this review was to evaluate the incidence of CPP in different countries before and during the COVID-19 pandemic. A PRISMA-ScR-compliant scoping review was performed in the MEDLINE and Embase databases using "puberty" and "COVID-19" as search terms. Exclusion criteria were an identifiable organic cause of CPP, genetic disorders or peripheral precocious puberty. The study was registered in OSF. A total of 26 studies with participants from 11 countries were included. Twenty-five studies found a 1.3- to 5-fold increase in the incidence of CPP in girls. In boys, 4 studies found no significant difference in the number of cases, 3 studies found a 2.8- to 3.4-fold increase, and 1 study detected a 75% decrease. Twelve studies reported an increase in the use of electronic devices, sedentary lifestyles, higher Z-scores for weight and body mass index, increased sleep disturbances, and a lower age at the onset of puberty. Seven studies found no significant differences in clinical and laboratory parameters between the pandemic and pre-pandemic periods. There was an increase in the incidence of precocious puberty among girls during the COVID-19 pandemic. This finding was not consistently observed in boys. Increased screen time, reduced physical activity, psychological stress, changes in diet and sleep habits, and the direct effects of SARS-CoV-2 may have caused these results.}, } @article {pmid40434829, year = {2025}, author = {Baird, S and Holmes, EC and Ashley, CL and Triccas, JA and Steain, M}, title = {The Batalogue: an overview of betacoronaviruses with future pandemic potential.}, journal = {FEMS microbiology reviews}, volume = {49}, number = {}, pages = {}, pmid = {40434829}, issn = {1574-6976}, support = {//Coalition for Epidemic Preparedness Innovations/ ; }, mesh = {Humans ; Animals ; *Betacoronavirus/genetics/classification/immunology/physiology ; COVID-19 ; *Pandemics/prevention & control ; *Coronavirus Infections/epidemiology/virology/transmission/prevention & control ; Chiroptera/virology ; SARS-CoV-2 ; }, abstract = {The coronavirus disease-19 pandemic has intensified interest in the global diversity of RNA viruses and their ability to jump hosts, with a notable expansion in the number of known betacoronaviruses in wild mammalian species, particularly bats. This has enabled vaccine development research to shift its focus to include a range of severe acute respiratory syndrome coronavirus-1 and severe acute respiratory syndrome coronavirus-2 related viruses from animal species, with the intention of developing broadly protective coronavirus vaccines and therapeutics. However, there is currently a lack of synthesis of this expanding knowledge base of viruses with potential to cause another severe disease outbreak. This has led to many vaccine trials considering protection against a small subset of known betacoronaviruses that poorly approximate the true diversity of this group of viruses. This review aims to synthesize information gained from the recent surge in betacoronavirus characterization, providing a catalogue of viruses exhibiting features that pose a risk to public health, together with a framework for assessing their likelihood of emergence and subsequent transmission through human populations. This information will help inform global pandemic preparedness measures before a novel betacoronavirus outbreak occurs.}, } @article {pmid40434505, year = {2025}, author = {Gupta, MK and Srivastava, R}, title = {Gut Microbiome Interventions: From Dysbiosis to Next-Generation Probiotics (NGPs) for Disease Management.}, journal = {Probiotics and antimicrobial proteins}, volume = {17}, number = {4}, pages = {2629-2652}, pmid = {40434505}, issn = {1867-1314}, mesh = {Humans ; *Probiotics/therapeutic use ; *Gastrointestinal Microbiome ; *Dysbiosis/therapy/microbiology ; COVID-19/therapy/microbiology ; Animals ; Prebiotics ; }, abstract = {The gut microbiome, sometimes referred to as the "second brain," the "lost organ," the "identification card of the individual," and the "fingerprint of the host," possesses diverse traits and functions that influence health. The impact of gut commensal bacteria on health, as opposed to environmental pathogenic factors, has generated increasing interest in recent years, culminating in a substantial body of study. Research indicates that dysbiosis of the intestinal microbiota is commonly observed in chronic inflammatory diseases, including colitis, obesity/metabolic syndrome, diabetes mellitus, liver infections, allergic conditions, cardiovascular diseases, COVID-19, cancers, and neurodegenerative disorders. The International Scientific Association for Probiotics and Prebiotics has recently refined the theory of complementary and synergistic synbiotics. In recent years, the field of microbiome research has been significantly advanced by technological developments such as massive culturomics, gnotobiotics, metabolomics, parallel DNA sequencing, and RNA sequencing. This review article examined the potential next generation probiotics (NGPs) and explored some of them, Faecalibacterium prausnitzii, Bacteroides thetaiotaomicron, Akkermansia muciniphila, Parabacteroides goldsteinii, Bacteroides fragilis, Eubacterium hallii, Roseburia intestinalis, Christensenella minuta, Prevotella copri, and Oscillospira guilliermondii. In addition to these useful probiotic strains, psychobiotics, members of the families of Lactobacilli, Streptococci, Bifidobacteria, Escherichia, and Enterococci, have extended applicability in the use for neurodevelopmental and neurodegenerative disorders. The article also reviewed current trends and limitations in NGPs to enhance our comprehensive understanding of key concepts associated with the consumption of probiotics and proposed necessary initiatives for researchers to engage in collaborative translational research as future therapeutic solutions.}, } @article {pmid40434501, year = {2025}, author = {Rajkumar, T and Hennessy, A and Makris, A}, title = {Remote Blood Pressure Monitoring in Pregnancies at Risk of Developing Preeclampsia.}, journal = {Current hypertension reports}, volume = {27}, number = {1}, pages = {15}, pmid = {40434501}, issn = {1534-3111}, mesh = {Humans ; Pregnancy ; Female ; *Pre-Eclampsia/diagnosis/physiopathology/prevention & control ; COVID-19/epidemiology ; *Blood Pressure Monitoring, Ambulatory/methods ; *Blood Pressure/physiology ; *Blood Pressure Determination/methods ; Telemedicine ; SARS-CoV-2 ; }, abstract = {PURPOSE OF REVIEW: This review examines the literature on remote blood pressure monitoring (RBPM) for pregnant women at high risk of hypertensive disorders of pregnancy (HDP).

RECENT FINDINGS: Hypertensive disorders of pregnancy are a leading cause of maternal and perinatal morbidity. High risk women often require frequent outpatient review for blood pressure monitoring which can be resource-intensive. RBPM is an organised framework which allows patients to monitor their own blood pressure with clinician guidance, improving healthcare utilisation and potentially saving healthcare costs without worsening maternal and fetal outcomes. Following the COVID-19 pandemic and the growing research interest in mobile health, RBPM has been integrated into international guidelines for managing high-risk pregnancies. Yet there is significant heterogeneity across RBPM frameworks described in the literature, and a lack of clear guidance on the development and implementation of this strategy. RBPM offers promising additional surveillance for high-risk pregnant women. However, challenges remain in its safe implementation, including patient selection, technology, costs, and adequate training to ensure accuracy in blood pressure readings.}, } @article {pmid40434418, year = {2025}, author = {Voderholzer, U and Naab, S and Cuntz, U and Schlegl, S}, title = {Anorexia nervosa-an update.}, journal = {Der Nervenarzt}, volume = {}, number = {}, pages = {}, pmid = {40434418}, issn = {1433-0407}, abstract = {Anorexia nervosa (AN) is a severe psychiatric disorder with the highest mortality rate among eating disorders. It predominantly affects adolescents and young adults, with a significant increase in prevalence among adolescents observed since the coronavirus disease 2019 (COVID-19) pandemic. It is frequently associated with other psychiatric disorders, such as depression, anxiety and obsessive-compulsive disorders as well as numerous physical complications. An early diagnosis and treatment are associated with better outcomes. The treatment of choice for AN includes cognitive behavioral therapy and family-based therapy for children and adolescents. Innovative treatment approaches, such as home treatment and technology-based interventions, have shown promising preliminary results. With the exception of moderate evidence supporting the use of olanzapine regarding weight gain, there is currently no evidence for the efficacy of psychopharmacotherapy in AN. Future research should focus on prevention, early detection and intervention, relapse prevention, personalized treatment approaches, management of comorbid disorders, long-term studies and the influence of psychosocial factors.}, } @article {pmid40433624, year = {2025}, author = {Njiriri, F and Nyanchoka, M and Nzinga, J and Tsofa, B}, title = {Experiences and Outcomes of the Implementation of Cuban Health Cooperation Programs in Low and Middle-Income Countries: A Scoping Review.}, journal = {Wellcome open research}, volume = {10}, number = {}, pages = {167}, pmid = {40433624}, issn = {2398-502X}, support = {/WT_/Wellcome Trust/United Kingdom ; }, abstract = {BACKGROUND: Health systems in low-and middle-income countries (LMICs) face chronic Human Resources for Health (HRH) shortages. This is especially worse in rural and primary healthcare settings. The Cuban government since 1960s has been implementing a policy strategy for producing healthcare workers for export, to boost their economy, support humanitarian efforts and boost their global diplomatic influence. Several LMICs have since established health cooperation programs with Cuba to import health workers to address their shortages. This review aimed to examine the emergence, design, utility, outcomes, and lessons learned from the implementation of these programs.

METHODS: We conducted a scoping review using the Joanna Briggs Institute (JBI) methodology and searched for literature across four databases. Two independent reviewers screened and selected relevant articles based on pre-defined criteria. We extracted data and synthesized findings using thematic analysis.

RESULTS: We included 71 articles after screening 3509 articles. Cuban health cooperation programs have been implemented in many LMICs in South America, Africa, Southeast Asia, and the Pacific region. These programs are formalized primarily through bilateral agreements and implemented as exchange initiatives. This involves importing Cuban healthcare workers and sending collaborating country students to study in Cuba. These programs aimed to address HRH shortages, maldistribution, inadequate training capacity, and respond to medical emergencies in the host countries. Cuban healthcare workers, primarily family physicians, within the host countries; are deployed in primary healthcare settings, increasing the rural health workforce, and improving healthcare access and outcomes. Challenges included opposition from local medical professionals, underutilization due to poorly coordinated recruitment, and language barrier in non-Spanish speaking countries.

CONCLUSION: Cuban health cooperations in LMICs have shown diverse results based on their structures. Long-term comprehensive programs have proven to be more successful in boosting the healthcare workforce and enhancing health outcomes. Key factors for optimizing HRH health cooperation include effective collaborative decision-making and need-based deployment in alignment with national health system goals.}, } @article {pmid40433610, year = {2025}, author = {Yang, X and Zhu, W}, title = {Effects of coronavirus disease 2019 on the incidence, mortality, and prognosis of ischemic stroke: a systematic review and meta-analysis.}, journal = {Frontiers in neurology}, volume = {16}, number = {}, pages = {1486887}, pmid = {40433610}, issn = {1664-2295}, abstract = {OBJECTIVE: The objective of this study was to conduct a systematic review on the effect of coronavirus disease 2019 (COVID-19) on the incidence, mortality, and prognosis of ischemic stroke. The systematic review also ascertained the relationship between COVID-19 and the Trial of Org 10,172 in Acute Stroke Treatment (TOAST) typing of ischemic stroke, as well as the risk factors for ischemic stroke in patients with COVID-19.

METHODS: The relevant literature between COVID-19 and ischemic stroke incidence, mortality, and prognosis up to January 2024 were systematically reviewed. Searches were carried out PubMed, Embase, Web of Science, and Cochrane databases. Utilizing the Meta-analysis of observational studies in epidemiology (MOOSE) declaration list, a systematic review and meta-analysis were carried out. Heterogeneity and publication bias were assessed.

RESULTS: Twenty-one studies encompassed 505,864 participants across 13 countries. In total, 1.1% of patients with COVID-19 infection had an ischemic stroke (odds ratio [OR], 0.011; 95% confidence interval [CI], 0.007-0.017; p < 0.001). COVID-19 was related to in-hospital mortality (OR, 2.76; 95% CI, 1.90-4.02; p < 0.001), mortality 3 months following the beginning of an ischemic stroke (OR, 2.54; 95% CI, 1.80-3.58; p < 0.001), and modified Rankin scale (mRS) score ≤2 at hospital discharge (OR, 0.62; 95% CI, 0.54-0.72; p < 0.001). mRS ≤ 2 at 3 months after the onset of ischemic stroke did not show any correlation significantly with COVID-19 (OR, 0.67; 95% CI, 0.43-1.06; p = 0.086). Longer hospital stays (OR, 0.13; 95% CI, 0.06-0.20; p < 0.001) and increased incidence of large-artery atherosclerosis and small-vessel disease phenotypes of ischemic stroke were observed in patients with both COVID-19 and ischemic stroke (p < 0.05). In patients with COVID-19, ischemic stroke was substantially linked with hypertension, diabetes, hyperlipidemia, smoking, atrial fibrillation, coronary artery disease, chronic kidney disease, and chronic obstructive pulmonary disease (p < 0.05).

CONCLUSION: COVID-19 is linked with increased incidence and mortality rates for ischemic stroke, as well as a worsening prognosis for the condition. With the data obtained from this study, targeted strategies to prevent and treat ischemic stroke in the context of the COVID-19 can be developed.

https://www.crd.york.ac.uk/PROSPERO/view/CRD42024524016, identifier: CRD42024524016.}, } @article {pmid40433474, year = {2025}, author = {Mousavi, T and Moosazadeh, M}, title = {Vitamin D status in children with mild, moderate, or severe confirmed COVID-19: systematic-review and meta-analysis.}, journal = {Frontiers in pediatrics}, volume = {13}, number = {}, pages = {1436633}, pmid = {40433474}, issn = {2296-2360}, abstract = {BACKGROUND: Vitamin D acts as a pro-hormone with a wide range of beneficial effects. It is reported that vitamin D deficiency is a risk factor for COVID-19 severity in children. In the present study, we decided to assess 25 hydroxy (OH) vitamin D status in children with mild, moderate, or severe confirmed COVID-19 and also compare them with those of a healthy control group using existing data.

METHODS: Relevant studies were extracted using online international databases including Scopus, Science Direct, PubMed, Web of Science, ProQuest, and Google Scholar search engine between Jan 2019 and 2024. The quality of all papers is determined by the NOS checklist. Heterogeneity between the results of primary studies was evaluated with the I-square index. Egger's test, funnel plot, and sensitivity analysis were applied. The statistical analysis was done using Stata version 17.

RESULTS: In 12 documents, the status of vitamin D was examined between case and control groups. By combining the results of these studies using random effect model, the standardized mean difference (SMD) vitamin D level in the COVID-19 children compared to the control group was estimated to be -0.88 (98% CI: -1.24, -0.51), which was statistically significant. In the present study, the odd ratio of vitamin D deficiency and vitamin D disorder (insufficiency and deficiency) in children with moderate COVID-19 compared to asymptomatic children with COVID-19 were estimated to be 3.58 (1.10, 11.63) and 2.52 (0.99, 6.41) respectively which was higher than in asymptomatic children with COVID-19. In addition, vitamin D deficiency and vitamin D disorder in children with moderate COVID-19 compared to the children with mild COVID-19 were estimated to be 2.12 (0.90, 4.98) and 1.82 (0.78, 4.22) respectively, which was higher than in children with mild COVID-19. Also, vitamin D deficiency and vitamin D disorder in children with mild COVID-19 compared to asymptomatic children with COVID-19 were estimated to be 2.02 (0.60, 6.78) and 1.64 (0.53, 5.07) respectively, which was higher than in asymptomatic children.

CONCLUSIONS: Combining the results of these studies, the effect size of the relationship between vitamin D and COVID-19 in children is significant. During the COVID-19 pandemic (except for the Omicron peak), children were less affected by the severity of COVID-19. The standardized mean difference (SMD) vitamin D level in children with COVID-19 was significantly 0.88 units lower than the control group. Also, the odds ratio of moderate COVID-19 in children with vitamin D deficiency was significantly 3.58 times higher than in asymptomatic children with COVID-19.}, } @article {pmid40433383, year = {2025}, author = {Xing, J and Zhao, X and Li, X and Fang, R and Sun, M and Zhang, Y and Song, N}, title = {The recent advances in vaccine adjuvants.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1557415}, pmid = {40433383}, issn = {1664-3224}, mesh = {Humans ; *Adjuvants, Vaccine/pharmacology ; *Adjuvants, Immunologic/pharmacology ; *SARS-CoV-2/immunology ; Animals ; COVID-19 Vaccines/immunology ; *COVID-19/prevention & control/immunology ; Immunogenicity, Vaccine ; *Vaccines/immunology ; Oligodeoxyribonucleotides ; }, abstract = {Vaccine adjuvants, as key components in enhancing vaccine immunogenicity, play a vital role in modern vaccinology. This review systematically examines the historical evolution and mechanisms of vaccine adjuvants, with particular emphasis on innovative advancements in aluminum-based adjuvants, emulsion-based adjuvants, and nucleic acid adjuvants (e.g., CpG oligonucleotides). Specifically, aluminum adjuvants enhance immune responses through particle formation/antigen adsorption, inflammatory cascade activation, and T-cell stimulation. Emulsion adjuvants amplify immunogenicity via antigen depot effects and localized inflammation, while nucleic acid adjuvants like CpG oligonucleotides directly activate B cells and dendritic cells to promote Th1-type immune responses and memory T-cell generation. The article further explores the prospective applications of these novel adjuvants in combating emerging pathogens (including influenza and SARS-CoV-2), particularly highlighting their significance in improving vaccine potency and durability. Moreover, this review underscores the critical importance of adjuvant development in next-generation vaccine design and provides theoretical foundations for creating safer, effective adjuvant.}, } @article {pmid40432602, year = {2025}, author = {Mikkelsen, K and Zaccagnini, M and Brunton, G and Hosseini, A and Tan, MC and Nonoyama, ML}, title = {Characteristics of Rapidly Manufactured Ventilators: A Scoping Review.}, journal = {Respiratory care}, volume = {}, number = {}, pages = {}, doi = {10.1089/respcare.12549}, pmid = {40432602}, issn = {1943-3654}, abstract = {Many health care systems worldwide were ill-prepared for the mass-casualty surge caused by the COVID-19 pandemic. Mechanical ventilator shortages prompted the production of rapidly manufactured ventilators (RMVs). However, without standards to develop them, the effectiveness and safety of RMVs remain uncertain. The purpose of this study was to map the breadth and depth of the literature on RMVs and provide suggestions for effective and safe designs. A scoping review, following the Joanna Briggs Institute guidelines, was completed. A search of 9 electronic databases and Google Scholar was completed in April 2022 and updated in 2024. Dual screening and data extraction were conducted using predefined criteria based on 6 previously published RMV guidance documents. Results were collated into descriptive summaries and tables and used to develop the suggested standards. There were 66 RMVs described within 66 articles. The majority (60, 91%) of articles were published post-COVID-19 (2020), with 24 (36%) from the United States. Four designs were identified: 18 (27%) electro-pneumatic (E-P), 27 (41%) automatic compression of manual resuscitator (MR), 6 (9%) automatic compression of MR with E-P components (E-P and MR), and 15 (23%) "other." The E-P designs mimicked conventional ventilators and MR designs incorporated an MR with a motor and arm. Four RMV characteristic categories emerged from the data: operating features, performance features, other features outside routine use, and engineering features. There was significant variability in the RMV designs. Eleven suggestions regarding RMV design, performance, and testing were developed. This study provides preliminary information to inform the standardization of RMV designs to guide future manufacturing for effective and safe use. Although pandemic urgency has waned, RMV utility may extend to future mass-casualty scenarios (eg, natural disasters, wars) and in low- and middle-income countries, which often lack sufficient resources even under normal conditions.}, } @article {pmid40432133, year = {2025}, author = {Tang, J and Amin, MA and Campian, JL}, title = {Past, Present, and Future of Viral Vector Vaccine Platforms: A Comprehensive Review.}, journal = {Vaccines}, volume = {13}, number = {5}, pages = {}, pmid = {40432133}, issn = {2076-393X}, abstract = {Over the past several decades, viral vector-based vaccines have emerged as some of the most versatile and potent platforms in modern vaccinology. Their capacity to deliver genetic material encoding target antigens directly into host cells enables strong cellular and humoral immune responses, often superior to what traditional inactivated or subunit vaccines can achieve. This has accelerated their application to a wide array of pathogens and disease targets, from well-established threats like HIV and malaria to emerging infections such as Ebola, Zika, and SARS-CoV-2. The COVID-19 pandemic further highlighted the agility of viral vector platforms, with several adenovirus-based vaccines quickly authorized and deployed on a global scale. Despite these advances, significant challenges remain. One major hurdle is pre-existing immunity against commonly used vector backbones, which can blunt vaccine immunogenicity. Rare but serious adverse events, including vector-associated inflammatory responses and conditions like vaccine-induced immune thrombotic thrombocytopenia (VITT), have raised important safety considerations. Additionally, scaling up manufacturing, ensuring consistency in large-scale production, meeting rigorous regulatory standards, and maintaining equitable global access to these vaccines present profound logistical and ethical dilemmas. In response to these challenges, the field is evolving rapidly. Sophisticated engineering strategies, such as integrase-defective lentiviral vectors, insect-specific flaviviruses, chimeric capsids to evade neutralizing antibodies, and plug-and-play self-amplifying RNA approaches, seek to bolster safety, enhance immunogenicity, circumvent pre-existing immunity, and streamline production. Lessons learned from the COVID-19 pandemic and prior outbreaks are guiding the development of platform-based approaches designed for rapid deployment during future public health emergencies. This review provides an exhaustive, in-depth examination of the historical evolution, immunobiological principles, current platforms, manufacturing complexities, regulatory frameworks, known safety issues, and future directions for viral vector-based vaccines.}, } @article {pmid40432119, year = {2025}, author = {Iwu-Jaja, C and Ndwandwe, D and Malinga, T and Mathebula, L and Mazingisa, A and Wiysonge, CS}, title = {Vaccine Research Trends in Africa from 2016 to Mid-2024: A Bibliometric Analysis.}, journal = {Vaccines}, volume = {13}, number = {5}, pages = {}, pmid = {40432119}, issn = {2076-393X}, support = {001/WHO_/World Health Organization/International ; }, abstract = {BACKGROUND: Vaccine research publications play a crucial role in the scientific process by strategically linking the generation of knowledge with its translation into vaccine policy and practice. This study was designed to understand vaccine and immunization research publication trends in Africa to inform strategic directions for vaccine research and innovation efforts in the continent.

METHODS: We searched PubMed only for vaccine and immunization-related publications from Africa between 1 January 2016 and 8 August 2024. Metrics such as annual growth rates, geographical distribution, international collaboration, and trend topics were analyzed. We conducted separate analyses for general vaccine research, vaccine clinical trials, and vaccine evidence syntheses (systematic reviews and meta-analyses).

RESULTS: Vaccine research in Africa demonstrated an annual growth rate of 55.4% (based on the 10,000 records retrieved due to PubMed's export limit), while vaccine trials saw a decline of 6.08% during the study period. The trend topics analysis across vaccine research, trials, and reviews showed that topics shifted from a focus on general vaccine development, immunization, and malaria pre-2020 to COVID-19-related topics in 2020, with post-2020 research returning to traditional topics like immunization schedules, vaccine safety, and pediatric and maternal vaccines. Additionally, the COVID-19 pandemic had a profound impact on vaccine research, leading to a surge in publications for vaccine research, trials, and reviews. About 65.8% of vaccine research featured international co-authorship. Vaccine trials had a higher rate of international co-authorship at 79.8%.

CONCLUSION: While vaccine research in general in Africa has increased, vaccine trials do not match this increase. The number of clinical trials remained relatively stagnant, reflecting ongoing challenges in the vaccine research ecosystem, particularly in building and sustaining clinical trial capacity across the region. In addition, disparities in research productivity exist between countries. Research prioritization, strategic collaborations, capacity building for research, and improved research infrastructure require critical consideration.}, } @article {pmid40432106, year = {2025}, author = {Sayedahmed, EE and Gairola, V and Murala, MST and Mittal, SK}, title = {Bovine Adenoviral Vector-Based Platform for Vaccine Development.}, journal = {Vaccines}, volume = {13}, number = {5}, pages = {}, pmid = {40432106}, issn = {2076-393X}, support = {AI059374/AI/NIAID NIH HHS/United States ; R01 AI059374/AI/NIAID NIH HHS/United States ; Hatch#1014146//USDA/ ; AI158177/AI/NIAID NIH HHS/United States ; R01 AI158177/AI/NIAID NIH HHS/United States ; }, abstract = {Adenoviral (AdV) vector-based vaccines employing the human AdV (HAdV) and chimpanzee AdV (ChAdV) vector platforms played a crucial role in combating the COVID-19 pandemic. However, the widespread use of these platforms, the prevalence of various HAdV types, and the resulting preexisting immunity have significantly impacted the vaccines utilizing these vector platforms. Considering these challenges, the bovine AdV type 3 (BAdV-3) vector system has emerged as a versatile and innovative platform for developing next-generation vaccines against infectious diseases. Inherent attributes like a high transduction efficiency, large transgene insertion capacity, broad tissue tropism, and robust induction of innate immunity add significant value to the BAdV vector platform for vaccine design. BAdV-3 vectors effectively elude HAdV-specific preexisting humoral and cellular immune responses. Additionally, BAdV-3 is low in pathogenicity for its host and is anticipated to be safe as a vaccine platform. This systematic review provides an overview of the development of BAdV-3 as a vaccine delivery platform and its application in designing vaccines for infectious agents of human and veterinary importance.}, } @article {pmid40432093, year = {2025}, author = {Lino, MM and Mather, S and Trani, M and Chen, Y and Caubel, P and De Bernardi, B}, title = {Challenges and Innovations in Pharmacovigilance and Signal Management During the COVID-19 Pandemic: An Industry Perspective.}, journal = {Vaccines}, volume = {13}, number = {5}, pages = {}, pmid = {40432093}, issn = {2076-393X}, abstract = {Vaccine marketing authorization holders (MAHs) are responsible for the conduction of global vaccine pharmacovigilance on their vaccine products. A safety signal is detected when a new adverse event (AE) or aspect of an AE occurs after exposure to the vaccine and warrants further investigation to determine whether a causal association may exist. Signal detection and evaluation (signal management) begins at the start of vaccine development, before an MAH submits an application for authorization to regulatory authorities, continues through the course of all clinical trials, and carries on beyond development into the post-marketing phase. As long as the vaccine remains authorized anywhere in the world, pharmacovigilance continues. During the time that the COVID-19 vaccine became widely available after authorization and approval, clinical trials were also ongoing, and therefore all clinical development and post-authorization safety information was closely monitored for safety by the MAH. MAH pharmacovigilance activities were adapted to manage the unprecedented volume of safety information that became available within a very short timeframe following worldwide vaccination campaigns. No vaccine had previously been administered to such a large number of individuals in such a short time, nor had there previously been a public health vaccine experience that was the subject of so many medical and non-medical writings. The MAH's COVID-19 vaccine signal detection methods included the continuous review of accruing clinical trial data and the quantitative and qualitative analyses of spontaneously reported experiences. Review of published and unpublished medical literature and epidemiology-based analyses such as observed vs. expected analysis based on reported adverse events following immunization (AEFIs) played key roles in pharmacovigilance and signal management. All methods of signal detection and evaluation have caveats, but when considered in totality, can advance our understanding of a vaccine's safety profile and therefore the risk-benefit considerations for vaccinating both individuals and large populations of people. All COVID-19 vaccines authorized for use were subject to an unprecedented level of pharmacovigilance by their individual MAHs, national regulatory authorities, public health organizations, and others during the years immediately following regulatory authorization and full approval. The intense worldwide focus on pharmacovigilance and the need for MAHs and regulatory/health authorities to quickly evaluate incoming safety information, spurred frequent and timely communications between national and regional health authorities and between MAHs and regulatory/health authorities, spotlighting a unique opportunity for individuals committed to patient safety to share important accruing safety information in a collegial and less traditionally formal manner than usual. The global pandemic precipitated by the SARS-CoV-2 virus created a significant impetus for MAHs to develop innovative vaccines to change the course of the COVID-19 pandemic. Pharmacovigilance also had to meet unprecedented needs. In this article, unique aspects of COVID-19 vaccine pharmacovigilance encountered by one MAH will be summarized.}, } @article {pmid40432085, year = {2025}, author = {Skerritt, JH}, title = {Considerations for mRNA Product Development, Regulation and Deployment Across the Lifecycle.}, journal = {Vaccines}, volume = {13}, number = {5}, pages = {}, pmid = {40432085}, issn = {2076-393X}, abstract = {With the successful deployment of several mRNA vaccines against SARS-CoV-2, an mRNA vaccine against RSV (respiratory syncytial virus) and a large pipeline of mRNA products against other infectious diseases, cancers and rare diseases, it is important to examine the whole product lifecycle. mRNA technology enables product design, testing and manufacturing systems to be rapidly developed, but these advantages can be lost if other factors that determine public access are not closely considered. This review analyzes key aspects of the mRNA product lifecycle including candidate design, manufacturing, quality systems and product safety and storage. Regulatory thinking is well advanced in some countries but not others, but more thought on the regulation of mRNA vaccines outside of a pandemic situation as well as mRNA therapeutics including individual neoantigen therapies and rare disease treatments is needed. Consumer acceptance-the "social license to operate" around mRNA products-is critical for their uptake, particularly outside of a pandemic.}, } @article {pmid40432077, year = {2025}, author = {Franchini, M and Maggi, F and Focosi, D}, title = {COVID-19 Vaccination in Patients with Hematological Malignances.}, journal = {Vaccines}, volume = {13}, number = {5}, pages = {}, pmid = {40432077}, issn = {2076-393X}, support = {Programme CCM 2020 Ricerca Corrente-Linea 1 on emerging and re-emerging infections//italian ministry of health/ ; }, abstract = {Patients with hematologic malignancies (HM) represent a population particularly vulnerable to infections due to their cancer-related immune deficiency and the immunosuppressive treatment they are administered. Accordingly, a high hospitalization and mortality rate has been consistently reported in such a frail population during the first COVID-19 pandemic waves. After a brief description of the clinical impact of SARS-CoV-2 infection in patients with blood cancers, this narrative review is focused on the protective effect of COVID-19 vaccines in patients with HM. All in all, the results from the literature analysis indicate that booster shots in fully vaccinated HM patients are significantly able to increase seroconversion rates, which represent the best surrogate of vaccine efficacy. Despite these encouraging data, concerns still remain regarding the lower immune responses to COVID-19 vaccines, even to booster doses, in severely immunosuppressed HM patients, such as those receiving anti-CD20 monoclonal antibody therapies and hematopoietic stem cell transplants.}, } @article {pmid40432073, year = {2025}, author = {Min Htike, WY and Zhang, M and Wu, Z and Zhou, X and Lyu, S and Kam, YW}, title = {Addressing Vaccine Hesitancy in College Students Post COVID-19 Pandemic: A Systematic Review Using COVID-19 as a Case Study.}, journal = {Vaccines}, volume = {13}, number = {5}, pages = {}, pmid = {40432073}, issn = {2076-393X}, support = {00AKUG0130//Division of Natural and Applied Sciences, Duke Kunshan University/ ; }, abstract = {Background: Resistance to vaccinations continues to pose a considerable challenge to attaining widespread vaccination, especially among the college student demographic, who are pivotal in championing public health initiatives. This systematic review investigates the elements that influence reluctance to receive the COVID-19 vaccine among university students globally. Utilizing the WHO's 3C model, which encompasses confidence, complacency, and convenience, this review seeks to pinpoint the main factors and suggest focused strategies to address them. Methods: Following the PRISMA guidelines, we conducted a systematic search in PubMed, Medline, Web of Science, Scopus, Embase, and Global Health. Eligible studies were cross-sectional, peer-reviewed, and examined COVID-19 vaccine hesitancy among college students. Covidence was used for screening, and data were synthesized narratively using the 3C model. Results: Sixty-seven studies (n = 88,345 participants) from 25 countries were included in this study. Confidence factors were the most influential, with fear of side effects (87.18%) and doubts about efficacy (72.4%) as primary concerns. Complacency factors included a low perceived risk of infection (34.9%) and a preference for alternative preventive measures (52.3%). Convenience barriers involved financial costs (58.1%) and difficulty accessing vaccination centers (40.3%). Subgroup analyses revealed variations by academic discipline and geographic region, with medical students showing hesitancy despite their health knowledge. Conclusions: COVID-19 vaccine hesitancy among college students is primarily driven by safety concerns, misinformation, and accessibility barriers. Addressing hesitancy requires transparent risk communication, policy-driven accessibility improvements, and tailored educational interventions. These findings can inform strategies to enhance vaccine uptake among young adults and contribute to broader efforts in pandemic preparedness.}, } @article {pmid40432062, year = {2025}, author = {Santilli, V and Sgrulletti, M and Costagliola, G and Beni, A and Mastrototaro, MF and Montin, D and Rizzo, C and Martire, B and Miraglia Del Giudice, M and Moschese, V and , }, title = {Maternal Immunization: Current Evidence, Progress, and Challenges.}, journal = {Vaccines}, volume = {13}, number = {5}, pages = {}, pmid = {40432062}, issn = {2076-393X}, abstract = {Maternal immunization is a key strategy for protecting pregnant individuals and newborns from infectious diseases. This review examines the mechanisms and benefits of maternal immunization, with a focus on transplacental IgG transfer and immune system interactions. We provide an overview of current recommendations and the safety and efficacy profiles of maternal vaccines, including influenza, tetanus-diphtheria-acellular pertussis (Tdap), respiratory syncytial virus (RSV), COVID-19, and hepatitis B. Additionally, we analyze the barriers to maternal immunization, such as misinformation, vaccine hesitancy, and disparities in healthcare access, while exploring potential strategies to overcome these challenges through targeted educational initiatives, improved provider communication, and policy-driven interventions aimed at increasing vaccine confidence and accessibility. Finally, this review highlights recent innovations and future directions in maternal immunization, including emerging vaccines for Group B Streptococcus and cytomegalovirus. Expanding immunization programs and advancing research on maternal-fetal immunity are essential to optimizing vaccination strategies, improving public health outcomes, and reducing the global burden of infectious diseases.}, } @article {pmid40432048, year = {2025}, author = {Nembot Fogang, BA and Debrah, LB and Owusu, M and Agyei, G and Meyer, J and Gmanyami, JM and Ritter, M and Arndts, K and Adu Mensah, D and Adjobimey, T and Hörauf, A and Debrah, AY}, title = {Helminth Coinfections Modulate Disease Dynamics and Vaccination Success in the Era of Emerging Infectious Diseases.}, journal = {Vaccines}, volume = {13}, number = {5}, pages = {}, pmid = {40432048}, issn = {2076-393X}, support = {81204851//Federal Ministry of Education and Research/ ; 2021//German West African Center for Global Health and Pandemic Prevention (GWAC)/ ; }, abstract = {Background/Objectives: Helminth infections, particularly prevalent in low- and middle-income countries, have been extensively studied for their effects on human health. With the emergence of new infectious diseases like SARS-CoV-2 and Ebola, their impact on disease outcomes become more apparent. While individual studies have explored the impact of helminth co-infections on disease severity and vaccine efficacy, the findings are often inconsistent and context-dependent. Furthermore, the long-term effects of helminth-mediated immunosuppression on vaccine efficacy and its broader implications for co-infections in endemic regions remain not fully understood. Methods: This systematic review conducted in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020 guidelines synthesizes the current evidence, identifies patterns, and highlights areas needing further research, offering a cohesive understanding of the topic. PubMed, Scopus, Google Scholar, and Cochrane Library were searched to include studies published from 2003 to February 2025. Results: Co-infection reveals a dual role of helminths in modulating immune responses, with both beneficial and detrimental interactions reported across studies. It may confer benefits against respiratory viral infections by muting hyper-inflammation associated with the severity of conditions like COVID-19, Influenza, and RSV. However, they can exacerbate disease outcomes in most bacteria and blood-borne viral conditions by impairing immune functions, such as neutrophil recruitment and antibody response, leading to more severe infections and higher viral loads. The stage of helminth infection also appears critical, with early-stage infections sometimes offering protection, while late-stage infections may worsen disease outcomes. Helminth infection can also negatively impact vaccine efficacy by suppressing B cell activity, reducing antibody levels, and decreasing vaccine effectiveness against infectious diseases. This immunosuppressive effect may persist after deworming, complicating efforts to restore vaccine efficacy. Maternal helminth infections also significantly influence neonatal immunity, affecting newborn vaccine responses. Conclusions: There is a need for targeted interventions and further research in helminth-endemic regions to mitigate the adverse effects on vaccine efficacy and improve public health outcomes.}, } @article {pmid40431734, year = {2025}, author = {Kim, DH and Kim, JH and Jeon, MT and Kim, KS and Kim, DG and Choi, IS}, title = {The Role of TDP-43 in SARS-CoV-2-Related Neurodegenerative Changes.}, journal = {Viruses}, volume = {17}, number = {5}, pages = {}, pmid = {40431734}, issn = {1999-4915}, support = {25-BR-02-03//Korea Brain Research Institute/ ; }, mesh = {Humans ; *DNA-Binding Proteins/metabolism/genetics ; *COVID-19/complications/metabolism/virology/pathology ; *SARS-CoV-2/physiology ; *Neurodegenerative Diseases/metabolism/virology/pathology/etiology ; Virus Replication ; Animals ; }, abstract = {The coronavirus disease 2019 (COVID-19) pandemic has been linked to long-term neurological effects with multifaceted complications of neurodegenerative diseases. Several studies have found that pathological changes in transactive response DNA-binding protein of 43 kDa (TDP-43) are involved in these cases. This review explores the causal interactions between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and TDP-43 from multiple perspectives. Some viral proteins of SARS-CoV-2 have been shown to induce pathological changes in TDP-43 through its cleavage, aggregation, and mislocalization. SARS-CoV-2 infection can cause liquid-liquid phase separation and stress granule formation, which accelerate the condensation of TDP-43, resulting in host RNA metabolism disruption. TDP-43 has been proposed to interact with SARS-CoV-2 RNA, though its role in viral replication remains to be fully elucidated. This interaction potentially facilitates viral replication, while viral-induced oxidative stress and protease activity accelerate TDP-43 pathology. Evidence from both clinical and experimental studies indicates that SARS-CoV-2 infection may contribute to long-term neurological sequelae, including amyotrophic lateral sclerosis-like and frontotemporal dementia-like features, as well as increased phosphorylated TDP-43 deposition in the central nervous system. Biomarker studies further support the link between TDP-43 dysregulation and neurological complications of long-term effects of COVID-19 (long COVID). In this review, we presented a novel integrative framework of TDP-43 pathology, bridging a gap between SARS-CoV-2 infection and mechanisms of neurodegeneration. These findings underscore the need for further research to clarify the TDP-43-related neurodegeneration underlying SARS-CoV-2 infection and to develop therapeutic strategies aimed at mitigating long-term neurological effects in patients with long COVID.}, } @article {pmid40431733, year = {2025}, author = {Dinata, R and Baindara, P and Mandal, SM}, title = {Evolution of Antiviral Drug Resistance in SARS-CoV-2.}, journal = {Viruses}, volume = {17}, number = {5}, pages = {}, pmid = {40431733}, issn = {1999-4915}, mesh = {*Antiviral Agents/pharmacology/therapeutic use ; *SARS-CoV-2/drug effects/genetics ; *Drug Resistance, Viral/genetics ; Humans ; *COVID-19 Drug Treatment ; COVID-19/virology ; Drug Repositioning ; Mutation ; Evolution, Molecular ; }, abstract = {The COVID-19 pandemic has had a significant impact and continues to alarm the entire world due to the rapid emergence of new variants, even after mass vaccinations. There is still an urgent need for new antivirals or strategies to combat the SARS-CoV-2 infections; however, we have success stories with nirmatrelvir. Drug repurposing and drug discovery may lead to a successful SARS-CoV-2 antiviral; however, rapid drug use may cause unexpected mutations and antiviral drug resistance. Conversely, novel variants of the SARS-CoV-2 can diminish the neutralizing efficacy of vaccines, thereby enhancing viral fitness and increasing the likelihood of drug resistance emergence. Additionally, the disposal of antivirals in wastewater also contributes to drug resistance. Overall, the present review summarizes the strategies and mechanisms involved in the development of drug resistance in SARS-CoV-2. Understanding the mechanism of antiviral resistance is crucial to mitigate the significant healthcare threat and to develop effective therapeutics against drug resistance.}, } @article {pmid40431702, year = {2025}, author = {Mahdi, M and Kiarie, IW and Mótyán, JA and Hoffka, G and Al-Muffti, AS and Tóth, A and Tőzsér, J}, title = {Receptor Binding for the Entry Mechanisms of SARS-CoV-2: Insights from the Original Strain and Emerging Variants.}, journal = {Viruses}, volume = {17}, number = {5}, pages = {}, pmid = {40431702}, issn = {1999-4915}, support = {TKP2021-EGA-20//National Research, Development and Innovation Office/ ; NKFIH K132623//National Research, Development and Innovation Office/ ; POST-COVID2021-33//National Research, Development and Innovation Office/ ; NKFIH Advanced Grant 150532//National Research, Development and Innovation Office/ ; BO/00110/23/5//János Bolyai Research Scholarship of the Hungarian Academy of Sciences/ ; EKÖP-24-4-I-DE-435//National Research, Development and Innovation Office/ ; }, mesh = {Humans ; *SARS-CoV-2/genetics/physiology ; *Virus Internalization ; *Spike Glycoprotein, Coronavirus/metabolism/genetics ; *COVID-19/virology/transmission/metabolism ; *Receptors, Virus/metabolism ; Angiotensin-Converting Enzyme 2/metabolism ; Mutation ; Serine Endopeptidases/metabolism ; Protein Binding ; }, abstract = {Since its emergence in late 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has continuously evolved, giving rise to multiple variants that have significantly altered the trajectory of the COVID-19 pandemic. These variants have resulted in multiple waves of the pandemic, exhibiting characteristic mutations in the spike (S) protein that may have affected receptor interaction, tissue tropism, and cell entry mechanisms. While the virus was shown to primarily utilize the angiotensin-converting enzyme 2 (ACE2) receptor and host proteases such as transmembrane serine protease 2 (TMPRSS2) for entry into host cells, alterations in the S protein have resulted in changes to receptor binding affinity and use of alternative receptors, potentially expanding the virus's ability to infect different cell types or tissues, contributing to shifts in clinical presentation. These changes have been linked to variations in disease severity, the emergence of new clinical manifestations, and altered transmission dynamics. In this paper, we overview the evolving receptor utilization strategies of SARS-CoV-2, focusing on how mutations in the S protein may have influenced viral entry mechanisms and clinical outcomes across the ongoing pandemic waves.}, } @article {pmid40431631, year = {2025}, author = {de Melo, BP and da Silva, JAM and Rodrigues, MA and Palmeira, JDF and Amato, AA and Argañaraz, GA and Argañaraz, ER}, title = {SARS-CoV-2 Spike Protein and Long COVID-Part 2: Understanding the Impact of Spike Protein and Cellular Receptor Interactions on the Pathophysiology of Long COVID Syndrome.}, journal = {Viruses}, volume = {17}, number = {5}, pages = {}, pmid = {40431631}, issn = {1999-4915}, mesh = {*Spike Glycoprotein, Coronavirus/metabolism/genetics ; Humans ; *COVID-19/virology/physiopathology/complications/metabolism ; *SARS-CoV-2/metabolism/genetics/physiology ; *Receptors, Virus/metabolism ; Protein Binding ; Post-Acute COVID-19 Syndrome ; }, abstract = {SARS-CoV-2 infection has had a significant impact on global health through both acute illness, referred to as coronavirus disease 2019 (COVID-19), and chronic conditions (long COVID or post-acute sequelae of COVID-19, PASC). Despite substantial advancements in preventing severe COVID-19 cases through vaccination, the rise in the prevalence of long COVID syndrome and a notable degree of genomic mutation, primarily in the S protein, underscores the necessity for a deeper understanding of the underlying pathophysiological mechanisms related to the S protein of SARS-CoV-2. In this review, the latest part of this series, we investigate the potential pathophysiological molecular mechanisms triggered by the interaction between the spike protein and cellular receptors. Therefore, this review aims to provide a differential and focused view on the mechanisms potentially activated by the binding of the spike protein to canonical and non-canonical receptors for SARS-CoV-2, together with their possible interactions and effects on the pathogenesis of long COVID.}, } @article {pmid40431629, year = {2025}, author = {de Melo, BP and da Silva, JAM and Rodrigues, MA and Palmeira, JDF and Saldanha-Araujo, F and Argañaraz, GA and Argañaraz, ER}, title = {SARS-CoV-2 Spike Protein and Long COVID-Part 1: Impact of Spike Protein in Pathophysiological Mechanisms of Long COVID Syndrome.}, journal = {Viruses}, volume = {17}, number = {5}, pages = {}, pmid = {40431629}, issn = {1999-4915}, mesh = {Humans ; *Spike Glycoprotein, Coronavirus/metabolism ; *COVID-19/complications/virology/physiopathology/pathology ; *SARS-CoV-2/pathogenicity ; Post-Acute COVID-19 Syndrome ; }, abstract = {SARS-CoV-2 infection has resulted in more than 700 million cases and nearly 7 million deaths worldwide. Although vaccination efforts have effectively reduced mortality and transmission rates, a significant proportion of recovered patients-up to 40%-develop long COVID syndrome (LC) or post-acute sequelae of COVID-19 infection (PASC). LC is characterized by the persistence or emergence of new symptoms following initial SARS-CoV-2 infection, affecting the cardiovascular, neurological, respiratory, gastrointestinal, reproductive, and immune systems. Despite the broad range of clinical symptoms that have been described, the risk factors and pathogenic mechanisms behind LC remain unclear. This review, the first of a two-part series, is distinguished by the discussion of the role of the SARS-CoV-2 spike protein in the primary mechanisms underlying the pathophysiology of LC.}, } @article {pmid40431528, year = {2025}, author = {Lunge, VR and Kipper, D and Streck, AF and Fonseca, ASK and Ikuta, N}, title = {Emergence and Dissemination of the Avian Infectious Bronchitis Virus Lineages in Poultry Farms in South America.}, journal = {Veterinary sciences}, volume = {12}, number = {5}, pages = {}, pmid = {40431528}, issn = {2306-7381}, support = {350153/2025-6//CNPq/ ; 303647/2023-0//CNPq/ ; }, abstract = {Infectious bronchitis virus (IBV) is a chicken pathogen present in commercial poultry farms worldwide. It is classified within the species Avian coronavirus, genus Gammacoronavirus. As with other members of the family Coronaviridae, it has a single positive-sense RNA genome with 27.6 Kb and presents viral particles with a typical crown-like aspect due to the spike (S) transmembrane glycoprotein. IBV has a remarkable capacity for genetic recombination and mutation, resulting in many genotypes and antigenic variants over evolutionary time. Currently, it is classified into nine genetic types (GI to GIX) and 41 (1 to 41) lineages disseminated worldwide. In South America, IBV was first identified in early commercial poultry production ventures in Brazil in the 1950s. Since then, this virus has been frequently detected in commercial South American poultry farms, being classified into serotypes in the first decades and genotypes more recently. IBVs of the Massachusetts (Mass) serotype were initially detected and vaccine strains of this serotype were used extensively on commercial poultry farms. Other serotypes/genotypes were identified later, with almost all of them classified in the current genetic type I (GI). In addition, five GI lineages (GI-1, -11, -13, -16, and -23) have been associated with the main infectious bronchitis outbreaks in the continent, with some variations in the occurrence according to the countries and the period of time. Molecular epidemiological surveillance of IBV genetic types and lineages is necessary to anticipate potential outbreaks, revealing patterns of viral evolution and dissemination, as well as to guide the selection of appropriate vaccine strains and immunization programs.}, } @article {pmid40431497, year = {2025}, author = {Rubini, A and Di Via, R and Pastore, VP and Del Signore, F and Rosto, M and De Bonis, A and Odone, F and Vignoli, M}, title = {Artificial Intelligence in Chest Radiography-A Comparative Review of Human and Veterinary Medicine.}, journal = {Veterinary sciences}, volume = {12}, number = {5}, pages = {}, pmid = {40431497}, issn = {2306-7381}, abstract = {The integration of artificial intelligence (AI) into chest radiography (CXR) has greatly impacted both human and veterinary medicine, enhancing diagnostic speed, accuracy, and efficiency. In human medicine, AI has been extensively studied, improving the identification of thoracic abnormalities, diagnostic precision in emergencies, and the classification of complex conditions such as tuberculosis, pneumonia, and COVID-19. Deep learning-based models assist radiologists by detecting patterns, generating probability maps, and predicting outcomes like heart failure. However, AI is still supplementary to clinical expertise due to challenges such as data limitations, algorithmic biases, and the need for extensive validation. Ethical concerns and regulatory constraints also hinder full implementation. In veterinary medicine, AI is still in its early stages and is rarely used; however, it has the potential to become a valuable tool for supporting radiologists in the future. However, challenges include smaller datasets, breed variability, and limited research. Addressing these through focused research on species with less phenotypic variability (like cats) and cross-sector collaborations could advance AI in veterinary medicine. Both fields demonstrate AI's potential to enhance diagnostics but emphasize the ongoing need for human expertise in clinical decision making. Differences in anatomy structure between the two fields must be considered for effective AI adaptation.}, } @article {pmid40431340, year = {2025}, author = {Zhu, W and Wang, D and Li, P and Deng, H and Deng, Z}, title = {Advances in Wastewater-Based Epidemiology for Pandemic Surveillance: Methodological Frameworks and Future Perspectives.}, journal = {Microorganisms}, volume = {13}, number = {5}, pages = {}, pmid = {40431340}, issn = {2076-2607}, support = {8252030//Beijing Natural Science Foundation/ ; }, abstract = {Wastewater-based epidemiology (WBE) has emerged as a transformative approach for community-level health monitoring, particularly during the COVID-19 pandemic. This review critically examines the methodological framework of WBE systems through the following three core components: (1) sampling strategies that address spatial-temporal variability in wastewater systems, (2) comparative performance of different platforms in pathogen detection, and (3) predictive modeling integrating machine learning approaches. We systematically analyze how these components collectively overcome the limitations of conventional surveillance methods through early outbreak detection, asymptomatic case identification, and population-level trend monitoring. While highlighting technical breakthroughs in viral concentration methods and variant tracking through sequencing, the review also identifies persistent challenges, including data standardization, cost-effectiveness concerns in resource-limited settings, and ethical considerations in public health surveillance. Drawing insights from global implementation cases, we propose recommendations for optimizing each operational phase and discuss emerging applications beyond pandemic response. This review highlights WBE as an indispensable tool for modern public health, whose methodological refinements and cross-disciplinary integration are critical for transforming pandemic surveillance from reactive containment to proactive population health management.}, } @article {pmid40431202, year = {2025}, author = {Rampelotto, PH and Taufer, CR and da Silva, J}, title = {The Role of Beneficial Microbiota in COVID-19: Insights from Key Bacterial Genera.}, journal = {Microorganisms}, volume = {13}, number = {5}, pages = {}, pmid = {40431202}, issn = {2076-2607}, support = {88887.513461/2020-00//Coordenação de Aperfeiçoamento de Pessoal de Nível Superior/ ; 88887.798411/2022-00//Coordenação de Aperfeiçoamento de Pessoal de Nível Superior/ ; }, abstract = {The COVID-19 pandemic has highlighted the need for a comprehensive understanding of the factors influencing disease severity and progression. Emerging research indicates that the human microbiota, particularly beneficial bacteria, significantly impacts immune responses and health outcomes in COVID-19 patients. While existing studies provide general insights into the relationship between the microbiota and probiotics with COVID-19, they often lack a detailed exploration of how specific bacterial taxa might be used as adjunctive treatments. This review aims to address this gap by focusing on ten key genera of beneficial bacteria, discussing their roles in COVID-19 and evaluating their potential as probiotics for prevention and treatment. The review covers the impact of these microbes on human health, their population alterations in COVID-19 patients, and their interactions with other viral infections. Among these microbes, several exhibit distinct patterns of abundance in COVID-19 patients, influencing disease outcomes and highlighting their potential roles in infection dynamics. In COVID-19 patients, populations of Akkermansia, Ruminococcus, and Roseburia are consistently reduced, while those of Faecalibacterium show a significant decline in more severe cases. Bacteroides presents varying effects depending on the species involved. Alterations in the abundance of Blautia and Lachnospiraceae are associated with increased inflammation and disease severity. Likewise, the depletion of Lachnospira and Coprococcus populations, both linked to anti-inflammatory effects, may exacerbate symptom severity. Oscillospira, though less studied, is connected to overall health and could have implications for viral infections. This review synthesizes the current understanding of these beneficial microbes to highlight the importance of maintaining a healthy microbiota to alleviate the impact of COVID-19 and contribute to the development of novel therapeutic strategies involving microbiota modulation.}, } @article {pmid40430901, year = {2025}, author = {Spagnolo, F and Brugiapaglia, S and Perin, M and Intonti, S and Curcio, C}, title = {Anti-Cancer Drugs: Trends and Insights from PubMed Records.}, journal = {Pharmaceutics}, volume = {17}, number = {5}, pages = {}, pmid = {40430901}, issn = {1999-4923}, support = {2022TRSH52//Progetti di Rilevante Interesse Nazionale-PRIN/ ; }, abstract = {Background: In recent years, there has been an exponential growth in global anti-cancer drug research, prompting the necessity for comprehensive analyses of publication output and thematic shifts. Methods: This study utilized a comprehensive set of PubMed records from 1962 to 2024 and examined growth patterns, content classification, and co-occurrence of key pharmacological and molecular terms. Results: Our results highlight an exponential rise in publications, with an annual compound growth rate of over 14%, influenced by advancements in digital knowledge sharing and novel therapeutic breakthroughs. A pronounced surge occurred during the COVID-19 pandemic, suggesting a sustained shift in research dynamics. The content analyses revealed a strong emphasis on classical chemotherapeutic agents-often studied in combination with targeted therapies or immunotherapies-and a growing focus on immune checkpoint inhibitors and vaccine platforms. Furthermore, co-occurrence networks indicated robust links between chemotherapy and supportive care, as well as emerging synergies between immuno-oncology, precision medicine approaches. Conclusions: Our study suggests that while novel modalities are reshaping treatment paradigms, chemotherapy remains central, underscoring the value of integrative regimens. This trend toward personalized, combination-based strategies indicates a transformative era in oncology research, where multidimensional data assessment is instrumental in guiding future therapeutic innovations.}, } @article {pmid40430786, year = {2025}, author = {Valencia-Ledezma, OE and Reyes-Montes, MDR and Acosta-Altamirano, G and Frías-De-León, MG and García-Salazar, E and Duarte-Escalante, E and Santiago-Abundio, J and González-Miguel, Z and García-Hernández, ML and Martínez-Quezada, R and Torres-Páez, OU and Galindo-Oseguera, E and Meza-Meneses, P and Santiago-González, N}, title = {Invasive Candidiasis Coinfection in Patients with Severe COVID-19 Disease: Scoping Review.}, journal = {Pathogens (Basel, Switzerland)}, volume = {14}, number = {5}, pages = {}, pmid = {40430786}, issn = {2076-0817}, mesh = {Humans ; *COVID-19/complications/epidemiology/microbiology ; *Coinfection/epidemiology/microbiology ; *Candidiasis, Invasive/epidemiology/microbiology/complications ; SARS-CoV-2 ; Intensive Care Units ; Candida/isolation & purification/classification ; }, abstract = {Coinfection rates of candidiasis in patients affected by COVID-19 had a significantly increase during the sanitary contingency. The objective of this scoping review is to analyze the available scientific evidence around the coinfection of invasive candidiasis in hospitalized patients with severe COVID-19 disease. Online databases such as PubMed, EBSCO, SciFinder, Scopus, and SciELO were used to analyze the different scientific studies published from January 2020 to December 2022, selecting 48 publications that reported comorbidity between invasive candidiasis and COVID-19 as a study variable. Based on the PRISMA-ScR extension for scoping reviews, we identified more than half of the publications (57%) as observational, descriptive, and analytic studies, while 43% were systematic reviews. Overall, up to 169,468 adult patients admitted to the intensive care unit were examined. Coinfection was due mainly to Candida albicans (75%), but some more species were reported such as Meyerozyma parapsilosis (formerly Candida parapsilosis); Meyerozyma guilliermondii (formerly Candida guilliermondii); Nakaseomyces glabratus (formerly Candida glabrata); Candida tropicalis; Candida dubliniensis; Clavispora lusitaniae (formerly Candida lusitaniae); and Pichia kudriavzevii (formerly Candida krusei). We concluded that patients infected by SARS-CoV-2 had a higher incidence of fungal coinfections, thus increasing the mortality rate, disease severity, and length of hospital stay in the intensive care unit.}, } @article {pmid40430385, year = {2025}, author = {Ortega, Á and Duran, P and Garrido, B and Manzano, A and Navarro, C and Silva, A and Rojas, M and De Sanctis, JB and Radzioch, D and Rivera-Porras, D and Paredes, CS and Bermúdez, V}, title = {Specialized Pro-Resolving Lipid Mediators in Pulmonary Diseases: Molecular and Therapeutic Implications.}, journal = {Molecules (Basel, Switzerland)}, volume = {30}, number = {10}, pages = {}, pmid = {40430385}, issn = {1420-3049}, mesh = {Humans ; Animals ; COVID-19/metabolism ; *Lung Diseases/drug therapy/metabolism ; Docosahexaenoic Acids/therapeutic use/metabolism ; SARS-CoV-2 ; Pulmonary Disease, Chronic Obstructive/drug therapy/metabolism ; }, abstract = {Inflammatory lung diseases (ILDs) represent a global public health crisis characterized by escalating prevalence, significant morbidity, and substantial mortality. In response to the complex immunopathogenic mechanisms driving these conditions, novel pharmacological strategies targeting resolution pathways have emerged throughout the discovery of specialized pro-resolving lipid mediator (SPM; resolvins, maresins, and protectins) dysregulation across the ILD spectra, positioning these endogenous molecules as promising therapeutic candidates for modulating maladaptive inflammation and promoting tissue repair. Over the past decade, this paradigm has catalyzed extensive translational research into SPM-based interventions as precision therapeutics for respiratory inflammation. In asthma, they reduce mucus hypersecretion, bronchial hyperreactivity, and airway inflammation, with prenatal SPM exposure potentially lowering offspring disease risk. In COPD, SPMs attenuate amyloid A-driven inflammation, normalizing cytokine/chemokine imbalances and oxidative stress and mitigating COVID-19-associated cytokine storm, enhancing survival. This review synthesizes SPMs' pharmacotherapeutic mechanisms in ILDs and evaluates current preclinical and clinical evidence.}, } @article {pmid40430296, year = {2025}, author = {Kubryń, N and Fijałkowski, Ł and Nowaczyk, J and Jamil, A and Nowaczyk, A}, title = {PROTAC Technology as a New Tool for Modern Pharmacotherapy.}, journal = {Molecules (Basel, Switzerland)}, volume = {30}, number = {10}, pages = {}, pmid = {40430296}, issn = {1420-3049}, mesh = {Humans ; Neoplasms/drug therapy/metabolism ; *Proteolysis/drug effects ; Antineoplastic Agents/therapeutic use/pharmacology ; SARS-CoV-2 ; Drug Design ; COVID-19 Drug Treatment ; }, abstract = {The publication focuses on the innovative applications of PROTAC (proteolysis-targeting chimera) technology in modern pharmacotherapy, with particular emphasis on cancer treatment. PROTACs represent an advanced therapeutic strategy that enables selective protein degradation, opening new possibilities in drug design. This technology shows potential in the treatment of cancers, viral infections (such as HIV and COVID-19), and chronic diseases including atherosclerosis, Alzheimer's disease, atopic dermatitis, and Huntington's disease. Promising results from clinical studies on the compound ARV-471 confirm the effectiveness of this approach. New types of PROTACs, like TF-PROTAC and PhosphoTAC, are designed to enhance the effectiveness, stability, and absorption of treatment drugs. The conclusions of the review highlight the broad therapeutic potential of PROTACs in various diseases and their relevance for the future of therapies, particularly in oncology.}, } @article {pmid40430232, year = {2025}, author = {Ciortea, DA and Matei, MN and Debita, M and Lupu, A and Mătăsaru, M and Verga Răuță, GI and Fotea, S}, title = {Cardiac Manifestations and Emerging Biomarkers in Multisystem Inflammatory Syndrome in Children (MIS-C): A Systematic Review and Meta-Analysis.}, journal = {Life (Basel, Switzerland)}, volume = {15}, number = {5}, pages = {}, pmid = {40430232}, issn = {2075-1729}, abstract = {BACKGROUND: Cardiac involvement is a key prognostic factor in multisystem inflammatory syndrome in children (MIS-C), a rare but serious inflammatory condition that typically occurs 2-6 weeks after SARS-CoV-2 infection and is characterized by fever, systemic inflammation, and multiorgan involvement. Biomarkers may aid in early detection, severity assessment, and treatment stratification.

OBJECTIVE: To evaluate the diagnostic utility of established and emerging serum biomarkers in MIS-C, with an emphasis on cardiac dysfunction and disease severity.

METHODS: A systematic search was conducted in PubMed, Scopus, and Web of Science up to April 2025. Eligible studies included pediatric MIS-C cases with reported serum biomarkers. Meta-analyses were performed for NT-proBNP and troponin using random-effects models. Descriptive profiling was applied to emerging biomarkers. Subgroup comparisons were explored between severe and moderate MIS-C. Quality assessment followed the Newcastle-Ottawa Scale, and publication bias was assessed via funnel plots and Egger's test.

RESULTS: A total of 67 studies were included, comprising >4000 pediatric MIS-C cases. NT-proBNP and troponin were consistently elevated (pooled means: 9697 pg/mL and 0.384 ng/mL, respectively), with a low risk of publication bias. Emerging biomarkers such as CXCL9, angiopoietin-2, and vitamin D revealed high inter-study variability but potential prognostic value. Subgroup analyses for selected studies (n = 5) suggested higher biomarker levels in severe MIS-C.

CONCLUSIONS: NT-proBNP and troponin are robust indicators of cardiac injury in MIS-C. Emerging biomarkers show promise but require validation. Future studies should include copeptin and adopt standardized reporting to refine biomarker-guided management.}, } @article {pmid40430210, year = {2025}, author = {Gherman, A and Andrei, D and Popoiu, CM and Stoicescu, ER and Levai, MC and Stoian, II and Bloancă, V}, title = {Multidisciplinary Telemedicine in Healthcare During and After the COVID-19 Pandemic: A Narrative Review.}, journal = {Life (Basel, Switzerland)}, volume = {15}, number = {5}, pages = {}, pmid = {40430210}, issn = {2075-1729}, abstract = {The COVID-19 pandemic accelerated the adoption of virtual multidisciplinary teams (MDTs), transforming healthcare delivery through telemedicine. This review examines the integration of telemedicine into multidisciplinary care across various medical specialties, highlighting its benefits and challenges. A comprehensive literature search was conducted across PubMed, Google Scholar, Scopus, and Web of Science, using keywords related to telemedicine and MDTs. Inclusion criteria focused on studies discussing telemedicine implementation in multidisciplinary care, as well as its effectiveness and impact on patient outcomes, while non-English studies, single-case reports, and articles lacking explicit discussions on MDT integration were excluded. Data extraction covered telemedicine platforms, specialties involved, patient satisfaction, and clinical outcomes. Our findings suggest that virtual MDTs enhance efficiency, accessibility, and patient satisfaction, particularly in remote and underserved areas. However, challenges, such as technological barriers, disparities in digital access, and maintaining effective team communication, persist. Despite these limitations, telemedicine has demonstrated significant potential in improving diagnostic accuracy and treatment coordination. Future efforts should focus on optimizing infrastructure, digital training for healthcare providers, and regulatory frameworks to guarantee long-term sustainability.}, } @article {pmid40430160, year = {2025}, author = {Caliman-Sturdza, OA and Gheorghita, RE and Soldanescu, I}, title = {Vitamin D and COVID-19: Clinical Evidence and Immunological Insights.}, journal = {Life (Basel, Switzerland)}, volume = {15}, number = {5}, pages = {}, pmid = {40430160}, issn = {2075-1729}, abstract = {Vitamin D has emerged as a potential modulator of immune responses, sparking interest in its role in COVID-19 susceptibility and clinical outcomes. This review synthesizes current clinical evidence and explores immunological insights into the relationship between vitamin D levels and COVID-19 infection severity. Epidemiological studies indicate an inverse correlation between vitamin D deficiency and an increased risk of severe disease, hospitalization, and mortality in COVID-19 patients. Immunologically, vitamin D exerts regulatory effects on both innate and adaptive immunity, enhancing antimicrobial defense mechanisms, reducing excessive inflammatory responses, and potentially mitigating cytokine storm events observed in severe COVID-19 cases. Despite promising observational data, clinical trials evaluating vitamin D supplementation have shown mixed results, underscoring the need for standardized dosing regimens and patient stratification. Future research should focus on large-scale randomized controlled trials to conclusively determine the therapeutic potential and optimal supplementation strategies for vitamin D in managing COVID-19.}, } @article {pmid40430154, year = {2025}, author = {Huang, TS and Chao, JY and Chang, HH and Lin, WR and Lin, WH}, title = {COVID-19 and Diabetes: Persistent Cardiovascular and Renal Risks in the Post-Pandemic Landscape.}, journal = {Life (Basel, Switzerland)}, volume = {15}, number = {5}, pages = {}, pmid = {40430154}, issn = {2075-1729}, abstract = {The Coronavirus Disease 2019 (COVID-19) pandemic, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), disproportionately affects individuals with diabetes mellitus (DM) by exacerbating cardiovascular and renal complications. This increased risk is mediated through immune dysfunction, chronic inflammation, hyperglycemia, dysregulation of renin-angiotensin system dysregulation, endothelial dysfunction, and hypercoagulability. Epidemiological studies indicate a two-fold increased risk of stroke and end-stage renal disease in SARS-CoV-2-infected individuals with diabetes, along with a 60% higher risk of cardiovascular disease. While antidiabetic therapies like sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists show potential protective effects, insulin use in hospitalized patients is linked to higher mortality. Vaccination is crucial in reducing severe COVID-19 outcomes and mitigating post-infection complications, including new-onset diabetes. While concerns exist regarding vaccine-associated nephropathy and thromboembolic events, these risks are thought to be minimal compared to the benefits. As COVID-19 shifts to an endemic phase, the long-term renal and cardiovascular outcomes in patients with DM remain uncertain, highlighting the urgent need for continued research and targeted management strategies.}, } @article {pmid40430138, year = {2025}, author = {Modiga, A and Butiurca, VO and Boeriu, CM and Truta, TS and Turucz, E and Halațiu, VB and Rodean, IP and Russu, PC and Gherghinescu, MC and Molnar, C}, title = {Pathophysiological Mechanisms Linking COVID-19 and Acute Surgical Abdomen: A Literature Review.}, journal = {Life (Basel, Switzerland)}, volume = {15}, number = {5}, pages = {}, pmid = {40430138}, issn = {2075-1729}, abstract = {Acute surgical abdomen is characterized by intense, sudden abdominal pain due to intra-abdominal conditions requiring prompt surgical intervention. The coronavirus disease 2019 (COVID-19) pandemic has led to various complications related to the disease's complex pathophysiological mechanisms, hence the hypothesis of COVID-19-induced acute abdominal surgical pathologies. The connection between acute surgical abdomen and COVID-19 involves two primary mechanisms. First, there is the presence of angiotensin-converting enzyme 2 (ACE2) receptors in multiple abdominal organs. This facilitates the cytokine storm through direct viral injury and inflammation. Second, the hypercoagulable state induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) increases the thrombotic risk within abdominal vessels, which can subsequently lead to ischemia. ACE2 receptors are notably expressed in the gastric, duodenal, and rectal epithelium, with SARS-CoV-2 viral RNA and nucleocapsid proteins detected in these tissues. The inflammatory response results in significant endothelial damage, activating coagulation pathways that cause monocellular infiltration, lymphocytic inflammation, and uncontrolled coagulation. These findings highlight the need for further research to clarify how COVID-19 leads to acute abdominal pathologies. Understanding these mechanisms is vital for improving clinical management and patient outcomes during future health crises and in the aftermath of the pandemic.}, } @article {pmid40430032, year = {2025}, author = {Park, PG and Lee, SY and Youn, H and Hong, KJ}, title = {Promising Vaccine Formulations for Emerging Infectious Diseases.}, journal = {International journal of molecular sciences}, volume = {26}, number = {10}, pages = {}, pmid = {40430032}, issn = {1422-0067}, support = {NRF-2020R1A2C2011695//National Research Foundation of Korea/ ; 22213MFDS421//Ministry of Food and Drug Safety/ ; RS-2023-00217026//Ministry of Food and Drug Safety/ ; RS-2024-00331833//Ministry of Food and Drug Safety/ ; HI22C0009//Ministry of Food and Drug Safety/ ; HV22C0004//Ministry of Food and Drug Safety/ ; }, mesh = {Humans ; *Communicable Diseases, Emerging/prevention & control/immunology ; *COVID-19/prevention & control/immunology ; *COVID-19 Vaccines/immunology ; SARS-CoV-2/immunology ; }, abstract = {Emerging infectious diseases (EIDs) are one of the greatest threats to human health today, thus requiring an urgent response. Vaccines are one of the most effective means of preventing the spread of infectious diseases, and their usefulness in responding to EIDs has been clearly proven through the process of overcoming the global COVID-19 pandemic. As the characteristics of various vaccine formulations differ, it is necessary to apply the most appropriate one according to the EID response strategy. In this review, we first consider which vaccine formulation is the most suitable for EID vaccines by comparing the pros and cons of different vaccine formulations, and then we discuss the utility of mRNA vaccine formulations, which are considered the most promising for EID vaccines.}, } @article {pmid40428732, year = {2025}, author = {Hărșan, ST and Sin, AI}, title = {The Involvement and Manifestations of SARS-CoV-2 Virus in Cardiovascular Pathology.}, journal = {Medicina (Kaunas, Lithuania)}, volume = {61}, number = {5}, pages = {}, pmid = {40428732}, issn = {1648-9144}, mesh = {Humans ; *COVID-19/complications/physiopathology ; *Cardiovascular Diseases/virology/physiopathology/etiology ; SARS-CoV-2 ; }, abstract = {Although the acute phase of the COVID-19 pandemic has subsided, the emergence of the post-COVID-19 condition presents a new and complex public health challenge, characterized by persistent, multisystem symptoms that can endure for weeks or months after the initial infection with the SARS-CoV-2 virus, significantly affecting survivors' quality of life. Among the most concerning sequelae are cardiovascular complications, which encompass a broad spectrum of conditions, including arrhythmias, myocardial damage, or postural orthostatic tachycardia syndrome. This narrative review explores the burden of the SARS-CoV-2 infection on cardiovascular health by reviewing the latest and most relevant findings in the literature and highlighting different aspects of COVID-19's cardiovascular involvement. This review investigates the pathophysiological mechanisms underlying cardiovascular involvement in the post-COVID-19 condition, with a focus on direct viral invasion via ACE2 receptors, immune-mediated cardiovascular injury, cytokine storm, systemic inflammation, endothelial dysfunction, and mitochondrial injury. The interplay between pre-existing cardiovascular diseases, such as hypertension, atherosclerosis, diabetes, and atrial fibrillation, and COVID-19 is also explored, revealing that individuals with such conditions are at heightened risk for both severe acute illness and long-term complications. Long-term immune activation and the persistence of viral antigens are increasingly recognized as contributors to ongoing cardiovascular damage, even in individuals with mild or asymptomatic initial infections. As the healthcare system continues to adapt to the long-term consequences of the SARS-CoV-2 pandemic, a deeper understanding of these cardiovascular manifestations is essential. This knowledge will inform the development of targeted strategies for prevention, clinical management, and rehabilitation of affected patients. Furthermore, the insights gained from the intersection of COVID-19 and cardiovascular health will be instrumental in shaping responses to future viral epidemics, highlighting the necessity for multidisciplinary approaches to patient care and public health preparedness.}, } @article {pmid40428193, year = {2025}, author = {Hsu, NC and Lin, YF and Tsai, HB and Liao, C and Hsu, CH}, title = {Ten Questions on Using Lung Ultrasonography to Diagnose and Manage Pneumonia in Hospital-at-Home Model: Part II-Confounders and Mimickers.}, journal = {Diagnostics (Basel, Switzerland)}, volume = {15}, number = {10}, pages = {}, pmid = {40428193}, issn = {2075-4418}, abstract = {The hospital-at-home (HaH) model offers hospital-level care within patients' homes and has proven effective for managing conditions such as pneumonia. The point-of-care ultrasonography (PoCUS) is a key diagnostic tool in this model, especially when traditional imaging modalities are unavailable. This review explores how PoCUS can be optimized to manage pneumonia in HaH settings, focusing on its diagnostic accuracy in patients with comorbidities, differentiation from mimickers, and role in assessing disease severity. Pulmonary comorbidities, such as heart failure and interstitial lung disease (ILD), can complicate lung ultrasound (LUS) interpretation. In heart failure, combining lung, cardiac, and venous assessments (e.g., IVC collapsibility, VExUS score) improves diagnostic clarity. In ILD, distinguishing chronic changes from acute infections requires attention to B-line patterns and pleural abnormalities. PoCUS must differentiate pneumonia from conditions such as atelectasis, lung contusion, cryptogenic organizing pneumonia, eosinophilic pneumonia, and neoplastic lesions-many of which present with similar sonographic features. Serial LUS scoring provides useful information on pneumonia severity and disease progression. Studies, particularly during the COVID-19 pandemic, show correlations between worsening LUS scores and poor outcomes, including increased ventilator dependency and mortality. Furthermore, LUS scores correlate with inflammatory markers and gas exchange metrics, supporting their prognostic value. In conclusion, PoCUS in HaH care requires clinicians to integrate multi-organ ultrasound findings, clinical context, and serial monitoring to enhance diagnostic accuracy and patient outcomes. Mastery of LUS interpretation in complex scenarios is crucial to delivering personalized, high-quality care in the home setting.}, } @article {pmid40428133, year = {2025}, author = {Cheng, Y and Cheng, R and Xu, T and Tan, X and Bai, Y}, title = {Machine Learning Techniques Applied to COVID-19 Prediction: A Systematic Literature Review.}, journal = {Bioengineering (Basel, Switzerland)}, volume = {12}, number = {5}, pages = {}, pmid = {40428133}, issn = {2306-5354}, support = {202103021224195//Fundamental Research Program of Shanxi Province, China/ ; 202103021223189//Fundamental Research Program of Shanxi Province, China/ ; 202103021224212//Fundamental Research Program of Shanxi Province, China/ ; 20210302123019//Fundamental Research Program of Shanxi Province, China/ ; 61774137//National Science Foundation of China, China/ ; }, abstract = {COVID-19 was one of the most serious global public health emergencies in recent years, and its extremely fast spreading speed had a profound negative impact on society. A comprehensive analysis and prediction of COVID-19 could lay a theoretical foundation for monitoring and early warning systems. Since the outbreak of COVID-19, there has been an influx of research on predictive modelling, with artificial intelligence (AI) techniques, particularly machine learning (ML) methods, becoming the dominant research direction due to their superior capability in processing multidimensional datasets and capturing complex nonlinear transmission patterns. We systematically reviewed COVID-19 ML prediction models developed under the background of the epidemic using the PRISMA method. We used the selected keywords to screen the relevant literature of COVID-19 prediction using ML technology from 2020 to 2023 in the Web of Science, Springer and Elsevier databases. Based on predetermined inclusion and exclusion criteria, 136 eligible studies were ultimately selected from 5731 preliminarily screened publications, and the datasets, data preprocessing, ML models, and evaluation metrics used in these studies were assessed. By establishing a multi-level classification framework that included traditional statistical models (such as ARIMA), ML models (such as SVM), deep learning (DL) models (such as CNN, LSTM), ensemble learning methods (such as AdaBoost), and hybrid models (such as the fusion architecture of intelligent optimization algorithms and neural networks), it revealed that the hybrid modelling strategy effectively improved the prediction accuracy of the model through feature combination optimization and model cascade integration. In addition, we compared the performance of ML models with other models in the COVID-19 prediction task. The results showed that the propagation of COVID-19 is affected by multiple factors, including meteorological and socio-economic conditions. Compared to traditional methods, ML methods demonstrated significant advantages in COVID-19 prediction, especially hybrid modelling strategies, which showed great potential in optimizing accuracy. However, these techniques face challenges and limitations despite their strong performance. By reviewing existing research on COVID-19 prediction, this study provided systematic theoretical support for AI applications in infectious disease prediction and promoted technological innovation in public health.}, } @article {pmid40428099, year = {2025}, author = {Jadhav, K and Abhang, A and Kole, EB and Gadade, D and Dusane, A and Iyer, A and Sharma, A and Rout, SK and Gholap, AD and Naik, J and Verma, RK and Rojekar, S}, title = {Peptide-Drug Conjugates as Next-Generation Therapeutics: Exploring the Potential and Clinical Progress.}, journal = {Bioengineering (Basel, Switzerland)}, volume = {12}, number = {5}, pages = {}, pmid = {40428099}, issn = {2306-5354}, abstract = {Peptide-drug conjugates (PDCs) have emerged as a next-generation therapeutic platform, combining the target specificity of peptides with the pharmacological potency of small-molecule drugs. As an evolution beyond antibody-drug conjugates (ADCs), PDCs offer distinct advantages, including enhanced cellular permeability, improved drug selectivity, and versatile design flexibility. This review provides a comprehensive analysis of the fundamental components of PDCs, including homing peptide selection, linker engineering, and payload optimization, alongside strategies to address their inherent challenges, such as stability, bioactivity, and clinical translation barriers. Therapeutic applications of PDCs span oncology, infectious diseases, metabolic disorders, and emerging areas like COVID-19, with several conjugates advancing in clinical trials and achieving regulatory milestones. Innovations, including bicyclic peptides, supramolecular architectures, and novel linker technologies, are explored as promising avenues to enhance PDC design. Additionally, this review examines the clinical trajectory of PDCs, emphasizing their therapeutic potential and highlighting ongoing trials that exemplify their efficacy. By addressing limitations and leveraging emerging advancements, PDCs hold immense promise as targeted therapeutics capable of addressing complex disease states and driving progress in precision medicine.}, } @article {pmid40427985, year = {2025}, author = {Bernuzzi, C and Piccardo, MA and Guglielmetti, C}, title = {Mapping Research Trends on the Implications of Telemedicine for Healthcare Professionals: A Comprehensive Bibliometric Analysis.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {10}, pages = {}, pmid = {40427985}, issn = {2227-9032}, support = {//MUSA-Multilayered Urban Sustainability Action-project, funded by the European Un-ion-NextGenerationEU, under the National Recovery and Resilience Plan (NRRP)/ ; }, abstract = {Background/Objectives: The digital transformation in healthcare is reshaping care delivery by enhancing patient care and flexibility. However, it also poses potential challenges to healthcare professionals' wellbeing and work practices. To date, research on the implications of telemedicine for healthcare professionals remains limited and inconclusive. This study aims to provide a comprehensive overview of this research field using a quantitative, bibliometric approach. Methods: Articles were systematically selected from Web of Science and Scopus databases, focusing on empirical, peer-reviewed articles written in English, involving healthcare professionals and focusing on telemedicine. Results: The dataset consists of 160 papers. The analysis reveals a significant increase in publications starting from 2012, with a notable surge in 2020, reflecting the impact of the COVID-19 pandemic. The University of New Mexico and the Cleveland Clinic Foundation, both in the United States, were identified as the institutions with the highest number of published articles. Most studies were published in clinical-focused journals (e.g., Journal of Medical Internet Research and BMC Health Services Research), emphasizing the field's dominant orientation. The intellectual structure reveals that wellbeing, work practices, and communications between patients and professionals are central themes. Conclusions: This bibliometric analysis provides scholars with a clearer understanding of the intellectual structure of research on the implications of telemedicine for healthcare professionals, addressing key gaps left by previous reviews. While telemedicine offers numerous advantages, such as enhanced access to care and greater flexibility, it also raises challenges related to healthcare professionals' wellbeing, work practices, and communication with patients. Both contextual factors (e.g., digital skills training) and individual characteristics (e.g., attitudes toward telemedicine) play a significant role in shaping healthcare professionals' experiences with telemedicine. By identifying influential contributors and thematic patterns, this study offers a foundation for future research and informs the development of targeted interventions to sustain healthcare professionals in digitally mediated care environments.}, } @article {pmid40427984, year = {2025}, author = {D'Ardes, D and Deana, C and Boccatonda, A and Biasucci, DG and Cipollone, F and Castro-Sayat, M and Colaianni-Alfonso, N and Gallardo, A and Vetrugno, L}, title = {Lung Ultrasound After COVID-19: A Pivotal Moment for Clinical Integration-Navigating Challenges and Seizing Opportunities.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {10}, pages = {}, pmid = {40427984}, issn = {2227-9032}, abstract = {Lung ultrasound (LUS) has emerged as a valuable bedside decision-making tool, particularly since the COVID-19 pandemic, with applications in diagnosing pneumonia, managing fluid, and monitoring interstitial lung diseases (ILDs) and acute respiratory distress syndrome (ARDS), ultimately improving patient outcomes. Its repeatability, environmental safety, and reduced radiation exposure make it ideal for vulnerable populations and resource-limited settings. However, challenges such as inadequate documentation and a lack of standardized reporting formats limit its widespread adoption. The evolution of technology offers different possibilities, and improvements in software open up a range of possibilities, but this contrasts with the lack of postgraduate and undergraduate training and formal accreditation. This review addresses the impact of lung ultrasound through the course of air-liquid ratio impairment, crossing different clinical scenarios and exploring the challenges and opportunities for the implementation of lung ultrasound in the post-COVID era.}, } @article {pmid40427812, year = {2025}, author = {Santalucia, I and Sorrentino, M and Fiorilla, C and Tranquilli, S and Strazza, G and Montuori, P and Palladino, R and Fiore, M and Ferrante, M and Triassi, M}, title = {Learning from COVID-19: A Systematic Review of the IHR-SPAR Framework's Role in the Pandemic Response.}, journal = {International journal of environmental research and public health}, volume = {22}, number = {5}, pages = {}, pmid = {40427812}, issn = {1660-4601}, mesh = {Humans ; *COVID-19/epidemiology/prevention & control ; *Global Health ; *International Health Regulations ; *Pandemics/prevention & control ; SARS-CoV-2 ; }, abstract = {The International Health Regulations (IHR) provide a global framework for health security, requiring annual reporting on 35 indicators across 15 core capacities via the State Parties Annual Reporting (SPAR) tool. The COVID-19 pandemic exposed gaps in the IHR framework and monitoring systems, prompting calls for reform. This systematic review analyzed the correlations between IHR-SPAR scores and pandemic outcomes across nine studies (2020-2024), selected using the PRISMA guidelines. The study quality was assessed using the Joanna Briggs Institute's tool for cross-sectional studies. Of 1019 screened studies, nine met the inclusion criteria. Higher SPAR scores generally correlated with lower COVID-19 incidence and mortality, although some high-scoring countries experienced severe outbreaks. Middle-income countries showed the greatest improvement, particularly in risk communication and emergency response, while zoonotic disease capacities saw little progress. While the SPAR tool aids monitoring, it requires revisions to better reflect real-world pandemic responses. High SPAR scores do not always indicate effective crisis management. This study recommends integrating more dynamic, operational, and context-sensitive indicators to enhance the global preparedness for future health emergencies.}, } @article {pmid40427786, year = {2025}, author = {Espinola, N and Loudet, CI and Luxardo, R and Moreno, C and Kyaw, MH and Spinardi, J and Mendoza, CF and Carballo, CM and Dantas, AC and Abalos, MG and Ballivian, J and Navarro, E and Bardach, A}, title = {COVID-19 Disease and Economic Burden to Healthcare Systems in Adults in Six Latin American Countries Before Nationwide Vaccination Program: Ministry of Health Database Assessment and Literature Review.}, journal = {International journal of environmental research and public health}, volume = {22}, number = {5}, pages = {}, pmid = {40427786}, issn = {1660-4601}, support = {NA//Pfizer/ ; }, mesh = {Humans ; *COVID-19/economics/epidemiology/mortality ; Adult ; Latin America/epidemiology ; *Cost of Illness ; *Health Care Costs/statistics & numerical data ; SARS-CoV-2 ; Middle Aged ; Databases, Factual ; Aged ; Young Adult ; Hospitalization/statistics & numerical data ; }, abstract = {The COVID-19 pandemic imposed a substantial burden on healthcare systems worldwide, yet reliable data on COVID-19 morbidity, mortality, and healthcare costs in Latin America remain limited. This study explored the disease and economic burden of COVID-19 in Argentina, Brazil, Chile, Colombia, Mexico, and Peru during the pre-vaccination period. Using national databases and a systematic review of the literature, we analyzed data on adults aged 18 and older, reporting cases, death rates, years of life lost, excess mortality, and direct medical costs. Before vaccination programs began, the average COVID-19 incidence rate was 6741 per 100,000 adults. Of these, 91% were mild cases, 7% moderate/severe, and 2% critical. Among 2,201,816 hospitalizations, 27.8% required intensive care, and 17.5% required mechanical ventilation. Excess mortality ranged from 76 to 557 per 100,000, and years of life lost spanned 241,089 to 3,312,346. Direct medical costs ranged from USD 258 million to USD 10,437 million, representing 2-5% of national health expenditures. The findings highlight significant variability across countries and provide crucial insights to help policymakers to make informed decisions and allocate resources effectively to improve national strategies around surveillance, preventive and treatment strategies to control the spread of COVID-19 disease in the future.}, } @article {pmid40426590, year = {2025}, author = {Andreev, DN and Khurmatullina, AR and Maev, IV and Bordin, DS and Zaborovskiy, AV and Abdulkhakov, SR and Kucheryavyy, YA and Sokolov, FS and Beliy, PA}, title = {Helicobacter pylori Antibiotic Resistance in Russia: A Systematic Review and Meta-Analysis.}, journal = {Antibiotics (Basel, Switzerland)}, volume = {14}, number = {5}, pages = {}, pmid = {40426590}, issn = {2079-6382}, abstract = {Objective: This systematic review and meta-analysis aims to evaluate the temporal changes in Helicobacter pylori antibiotic resistance in Russia based on studies published over the past 15 years. Materials and Methods: We conducted a comprehensive literature search in MEDLINE/PubMed, EMBASE, the Russian Science Citation Index, and Google Scholar, following the PRISMA 2020 guidelines. Our meta-analysis was pre-registered in PROSPERO (CRD 420251025636). The inclusion criteria included original research, published in English or Russian in 2011-2024, involving antibiotic susceptibility testing in treatment-naive Russian adults using validated diagnostic methods. Two independent researchers selected studies and extracted data using standardized procedures, with methodological quality assessed via the Newcastle-Ottawa Scale. Pooled resistance rates were calculated using fixed/random-effects models in MedCalc 23.1.5 and Python 3.9.21, with meta-regression investigating temporal trends and subgroup analyses examining regional and methodological variations. Results: We identified 16 studies comprising 1206 H. pylori isolates. The pooled analysis of studies (2011-2025) revealed an overall clarithromycin resistance rate of 15.236%, with a significant temporal increase from 11.903% pre-2015 to 21.024% in 2020-2024 (p = 0.0049). Metronidazole showed consistently high pooled resistance (33.309%), while amoxicillin (1.828%), levofloxacin (19.014%), tetracycline (1.328%), and rifampicin (5.803%) maintained low resistance rates, and dual clarithromycin-metronidazole resistance was observed in 2.793% of isolates. Regional disparities were notable in the two largest cities of Russia, with 18.763% clarithromycin resistance in Moscow versus 28.540% in Saint-Petersburg. Conclusions: Russia surpasses the Maastricht VI Consensus resistance threshold for clarithromycin (15%), necessitating revision of empirical treatment strategies. The significant increase in clarithromycin resistance, potentially exacerbated by antibiotic use during the COVID-19 pandemic, underscores the urgent need for resistance-guided therapies and ongoing national surveillance programs to optimize H. pylori management.}, } @article {pmid40426524, year = {2025}, author = {Satyam, SM and El-Tanani, M and Patni, MA and Rehman, A and Wali, AF and Rangraze, IR and Babiker, R and Rabbani, SA and El-Tanani, Y and Rizzo, M}, title = {Repurposing Anthelmintic Drugs for COVID-19 Treatment: A Comprehensive Meta-Analysis of Randomized Clinical Trials on Ivermectin and Mebendazole.}, journal = {Antibiotics (Basel, Switzerland)}, volume = {14}, number = {5}, pages = {}, pmid = {40426524}, issn = {2079-6382}, abstract = {Background: The COVID-19 pandemic necessitated the urgent exploration of therapeutic options, including drug repurposing. Anthelmintic drugs such as ivermectin and mebendazole have garnered interest due to their potential antiviral and immunomodulatory properties. However, conflicting evidence from randomized clinical trials (RCTs) necessitates a comprehensive meta-analysis to determine their efficacy and safety in COVID-19 management. Objective: This meta-analysis evaluates the clinical efficacy of ivermectin and mebendazole in treating COVID-19 by analyzing their impact on viral clearance, symptom resolution, hospitalization duration, and safety profiles. Methods: A systematic search of Scopus, PubMed, Embase, and the Cochrane Library was conducted following PRISMA guidelines to identify RCTs published up to February 2025. Eligible studies included adult patients with confirmed COVID-19 who received ivermectin or mebendazole compared with a placebo or standard of care. Data extraction and risk of bias assessment were performed using the Cochrane Risk of Bias Tool. Statistical heterogeneity was evaluated using the I[2] statistic, and pooled effect sizes were calculated for primary clinical outcomes. Results: Twenty-three RCTs (n = 12,345) were included, with twenty-one studies on ivermectin and two on mebendazole. The pooled analysis suggested no statistically significant improvement in viral clearance (p = 0.39), hospitalization duration (p = 0.15), or symptom resolution (p = 0.08) with ivermectin or mebendazole. However, individual studies indicated potential benefits, particularly for mebendazole, in reducing viral load and inflammation. Both drugs exhibited favorable safety profiles, with no significant increase in adverse events. Conclusions: The promising propensities observed in selected studies underscore the potential of ivermectin and mebendazole as adjunct therapies for COVID-19. With well-established safety profiles, immunomodulatory effects, and affordability, these drugs present strong candidates for further exploration. Advancing research through well-designed, large-scale RCTs will help unlock their full therapeutic potential and expand treatment options in the fight against COVID-19.}, } @article {pmid40426384, year = {2025}, author = {Fernández-Vilas, E and Coca, JR and Labora González, JJ and Iglesias Carrera, M}, title = {The Sociology of Suicide After COVID-19: Assessment of the Spanish Case.}, journal = {Behavioral sciences (Basel, Switzerland)}, volume = {15}, number = {5}, pages = {}, pmid = {40426384}, issn = {2076-328X}, support = {2024-3608//Banco Santander (Spain)/ ; }, abstract = {The phenomenon of suicide has become a significant global concern, claiming over 800,000 lives annually and resulting in millions of suicide attempts worldwide. In the aftermath of the COVID-19 pandemic, these troubling statistics have worsened, with notable increases in suicidal behavior, especially among vulnerable populations such as the youth, the elderly, and those in socioeconomically disadvantaged groups. This paper aims to explore the impact of the COVID-19 pandemic on suicide rates in Spain, using a theoretical ex post facto analysis. Spain has witnessed an alarming rise in suicide rates, particularly among young people, and a disturbing trend of increased suicidal ideation and self-harm behaviors. While some studies report no significant change in suicide rates during the pandemic, others point to the exacerbating effects of social isolation, economic instability, and public health measures. This study provides an in-depth examination of the psychosocial consequences of the pandemic on mental health in Spain, emphasizing the urgency of the need to address pre-existing inequalities and implement effective suicide prevention measures. Furthermore, it highlights the importance of gender-sensitive strategies and the need for systemic reforms to ensure better mental healthcare access for all segments of society. To achieve this goal, this paper uses a narrative literature review combined with a theoretical ex post facto analysis to assess the influence of the COVID-19 pandemic on suicide patterns in Spain.}, } @article {pmid40426351, year = {2025}, author = {Agyapong-Opoku, N and Agyapong-Opoku, F and Greenshaw, AJ}, title = {Effects of Social Media Use on Youth and Adolescent Mental Health: A Scoping Review of Reviews.}, journal = {Behavioral sciences (Basel, Switzerland)}, volume = {15}, number = {5}, pages = {}, pmid = {40426351}, issn = {2076-328X}, support = {N/A//Alberta Mental Health Foundation/ ; }, abstract = {Background: The impact of social media on adolescent mental health has become a critical area of research as social media usage has surged among youth. Despite extensive research, findings on this relationship remain inconsistent, with various studies reporting both negative and positive effects. This scoping review aims to clarify the multifaceted nature of this relationship by analyzing the recent literature. Objective: This review aims to analyze the current evidence regarding the effects of social media use on adolescent mental health, identify consistent patterns and discrepancies in the findings, identify gaps in our knowledge, and highlight opportunities for further research. Methods: A scoping review was conducted following Arksey and O'Malley's five-stage approach. Searches were performed in PubMed, MEDLINE, Web of Science, and Scopus for articles published between July 2020 and July 2024. Inclusion criteria were systematic reviews, umbrella reviews, narrative reviews, and meta-analyses written in English focusing on youth/adolescents' mental health and social media. The search strategy identified 1005 articles, of which 43 relevant articles survived the reviewer selection process, from which data were extracted and analyzed to inform this review. Results: The majority of studies linked social media use to adverse mental health outcomes, particularly depression and anxiety. However, the relationship was complex, with evidence suggesting that problematic use and passive consumption of social media were most strongly associated with adverse effects. In contrast, some studies highlighted positive aspects, including enhanced social support and reduced isolation. The mental health impact of social media use, specifically during the COVID-19 pandemic, was mixed, with the full range of neutral, negative, and positive effects reported. Conclusions: The nature of social media's impact on adolescent mental health is highly individualistic and influenced by moderating factors. This review supports the notion that social media's effects on adolescent mental health can be context specific and may be shaped by patterns of usage. A focus on longitudinal studies in future research will be useful for us to understand long-term effects and develop targeted interventions in this context. Enhancing digital literacy and creating supportive online environments are essential to maximizing the benefits of social media while mitigating its risks.}, } @article {pmid40426138, year = {2025}, author = {Abbasi, AF and Karimi Dehkordi, N and SoleimanvandiAzar, N and Roohravan Benis, M and Nojomi, M}, title = {Gini coefficient, GDP per capita and COVID-19 mortality: a systematic review of ecologic studies.}, journal = {BMC public health}, volume = {25}, number = {1}, pages = {1960}, pmid = {40426138}, issn = {1471-2458}, support = {1401-4-90-24758//Iran University of Medical Sciences/ ; }, mesh = {Humans ; *COVID-19/mortality ; *Gross Domestic Product/statistics & numerical data ; Socioeconomic Factors ; Global Health ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Since December 2019, when Wuhan officially reported COVID-19, the disease has spread globally, revealing significant variations in mortality rates influenced by socio-economic factors and health policies. This study aims to identify two predictors of COVID-19 mortality differences-GDP (Gross Domestic Product), and Gini Coefficient index-across various countries through a systematic review.

METHODS: The study was a systematic review conducted according to PRISMA guidelines. The search strategy was searched in the titles and abstracts of the articles in three main databases: PubMed, Scopus, and Web of Science. Gini Coefficients and the Gross Domestic Product (GDP) of the countries were used as mortality predictors. The initial search yielded 331 articles, which were assessed for quality using the Newcastle Ottawa Scale (NOS). Ultimately, 31 articles were included in the final synthesis.

RESULTS: Most studies analyzed data from multiple countries, with only ten of the thirty-one articles focusing on a single nation. Initial research in 2020 aimed to understand the immediate socioeconomic factors affecting COVID-19 outcomes. Later studies in 2021 and 2022 explored more complex interactions between the pandemic and socioeconomic factors, while long-term outcomes were published in 2023 and 2024. Some studies found a paradoxical relationship between GDP and COVID-19 mortality rates, whereas most indicated a positive correlation between COVID-19 mortality rates and the Gini index.

CONCLUSION: Both income inequality and GDP significantly influence COVID-19 mortality rates. While a higher GDP can provide some protective benefits, it does not completely shield countries from high mortality, especially when considering economic activity and demographics. Researchers consistently identify income inequality as a predictor of poorer health outcomes, highlighting the need for equitable health and social policies to mitigate vulnerabilities in future pandemics.}, } @article {pmid40425603, year = {2025}, author = {Gonete, AT and Tamir, TT and Techane, MA and Workneh, BS and Mekonen, EG and Ali, MS and Zegeye, AF and Wassie, M and Kassie, AT and Tsega, SS and Wassie, YA and Tekeba, B and Ahmed, MA}, title = {Practice and associated factors of Covid-19 prevention among health professionals in Ethiopia: a systematic review and meta-analysis.}, journal = {Scientific reports}, volume = {15}, number = {1}, pages = {18462}, pmid = {40425603}, issn = {2045-2322}, mesh = {Humans ; *COVID-19/prevention & control/epidemiology ; Ethiopia/epidemiology ; *Health Personnel ; SARS-CoV-2/isolation & purification ; Health Knowledge, Attitudes, Practice ; }, abstract = {Health professionals (HPs) who work on the front lines are more likely to contract COVID-19.Healthmanners of HPs impact control and prevention activities employed in answer to the contagion crisis. Therefore, this systematic review and meta-analysis aimed to assess the pooled level of practice and associated factors toward COVID-19 prevention among HPs in Ethiopia. PubMed, Scoups, Web of Science, Google Scholar (search engine), Google Advance, and Cochrane Library were searched from December 20, 2023 -January 30, 2024. Data was dugout using Microsoft Excel (version 10) and analysis was computed using STATA version 11. Funnel plot and quantitatively further through Egger's regression test, with P < 0.05 was used to check publication bias. I[2] statistics were used to check the heterogeneity of the studies. Pooled analysis was used using a weighted inverse variance random-effects model. A subgroup analysis was conducted based on publication year and region. Meta-regression and sensitivity analysis were used. Eighteen studies with 7,775 Health professionals were included in the review process. Among them, 57.03% (95% CI; 48.41, 65.65%) of HPs practice correctly. Although the risk factors reported were inconsistent between studies, access to infection prevention training (IP) (AOR = 1.79; 95% CI 1.54, 2.08), good knowledge (AOR = 1.92; 95% CI 1.38, 2.66), MSc degree and above (AOR = 3.53; 95% CI 2.64, 4.71), and positive attitude (AOR = 2.19; 95% CI 1.50, 3.19) were significant predictors of good practice. Nearly 43% of health professionals had poor practice. Good knowledge, positive attitude, level of education, and infection prevention training were the main determinants of good practice. The responsible authorities do emphases to halt barriers and improving the zero infection principles of health professionals during the pandemic.}, } @article {pmid40424828, year = {2025}, author = {Li, L and Shi, X and Wang, R and Fan, Y and Xu, Z and Mirzaei, H and Wei, W}, title = {Cardiovascular impact of emerging and Re-emerging Viruses: Pathophysiological mechanisms, diagnosis, and management with a pediatric focus.}, journal = {Molecular aspects of medicine}, volume = {104}, number = {}, pages = {101371}, doi = {10.1016/j.mam.2025.101371}, pmid = {40424828}, issn = {1872-9452}, mesh = {Humans ; *Cardiovascular Diseases/diagnosis/therapy/virology/etiology/physiopathology ; *COVID-19/complications/virology ; Child ; SARS-CoV-2/pathogenicity ; Zika Virus Infection/complications/diagnosis ; *Communicable Diseases, Emerging/virology/complications ; Zika Virus/pathogenicity ; Dengue Virus/pathogenicity ; }, abstract = {Emerging and re-emerging viruses are currently known as a major public health issue. These viruses can cause various human complications such as cardiovascular diseases (CVDs), both in adults and pediatric populations. Although various CVDs have been previously reported for emerging and re-emerging viruses, the mechanisms underlying these complications remain relatively unknown. Children and infants, while commonly developing less severe symptoms, may experience notable cardiovascular manifestations during infections caused by emerging and re-emerging viral infections, which can result in both acute and long-term complications. The present review aims to discuss various cardiovascular complications linked to emerging and re-emerging viral pathogens (including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), dengue virus (DENV), Zika virus (ZIKV), and chikungunya virus (CHIKV)) such as arrhythmias, myocarditis, vascular disorders, and thromboembolic conditions, particularly among the pediatric population. This review also addresses the potential mechanisms by which SARS-CoV-2, DENV, ZIKV, and CHIKV may impact the cardiovascular system and their clinical implications. Moreover, it discusses the diagnostic challenges for viral-caused cardiovascular disorders in children, owing to their common subtle or atypical manifestations. Finally, it addresses the present therapeutic specifically used for pediatric cases.}, } @article {pmid40423359, year = {2025}, author = {Ochola, R}, title = {The Case for Genomic Surveillance in Africa.}, journal = {Tropical medicine and infectious disease}, volume = {10}, number = {5}, pages = {}, pmid = {40423359}, issn = {2414-6366}, abstract = {Sub-Saharan Africa has made remarkable strides in genomic surveillance, with more than 50% of countries now equipped with an in-country sequencing capacity and 98% actively contributing data to public genomic repositories. Catalyzed by the momentum of the COVID-19 pandemic, these advancements have extended far beyond SARS-CoV-2 to address a broader spectrum of public health threats, including antimicrobial resistance (AMR) and other emerging infectious diseases. This review explores these transformative achievements, identifies remaining gaps, and outlines strategic priorities for embedding genomics into the continent's health systems. With a focus on sustainability, equity, and cross-sector collaboration, it positions Africa as a driver of global innovation in pathogen surveillance, uniquely leveraging its genetic and epidemiological diversity.}, } @article {pmid40423350, year = {2025}, author = {Leung, V and Ritchie, G and Stefanovic, A and Lee, C and Chorlton, S and Matic, N and Romney, MG and Hayden, A and Lowe, CF}, title = {An Outbreak of Multidrug-Resistant Shigella flexneri Serotype 2a Among People Experiencing Homelessness in Vancouver.}, journal = {Tropical medicine and infectious disease}, volume = {10}, number = {5}, pages = {}, pmid = {40423350}, issn = {2414-6366}, abstract = {Background: We describe a community-based outbreak of multidrug-resistant Shigella flexneri serotype 2a among people experiencing homelessness (PEH) in Vancouver's Downtown Eastside during the COVID-19 pandemic. Methods: In this observational cohort study, we followed the Outbreak Reports and Intervention Studies of Nosocomial Infection (ORION) reporting guidelines. We identified cases by laboratory surveillance and collected demographic and clinical data from the medical charts or patient interviews. We implemented enhanced surveillance and disseminated testing and management guidelines. Shigella flexneri isolates were serotyped, and whole-genome sequencing was performed. Results: We identified 101 confirmed cases of Shigella flexneri 2a (80% male; median age 43) between 31 January and 16 December 2021. All the affected individuals experienced homelessness, and substance use disorder was the most common comorbidity (88%). Five patients required ICU hospitalization, and one death occurred within 30 days. Core-genome multilocus sequence typing analysis confirmed a clonal outbreak. All S. flexneri isolates were phenotypically and genotypically multidrug-resistant. Conclusions: COVID-19 exacerbated longstanding public health concerns around the dearth of hygiene and sanitation resources available to PEH. Preventing similar outbreaks will require addressing these risks and finding solutions to the crisis of homelessness in Canada.}, } @article {pmid40422702, year = {2025}, author = {Landré, V and Klingebiel, FK and van Niftrik, CHB and Goetze, E and Speck, RF and Hübner, CT and Pape, HC and Schäfer, FP}, title = {Mucormycosis Caused by Apophysomyces elegans-A Case Report and Systematic Review of the Literature of Rhino-Orbito-Cerebral Cases of the Genus Apophysomyces.}, journal = {Journal of fungi (Basel, Switzerland)}, volume = {11}, number = {5}, pages = {}, pmid = {40422702}, issn = {2309-608X}, abstract = {INTRODUCTION: Orbitocerebral mucormycosis, caused by Apophysomyces, is a rare infection, usually occurring in tropical and subtropical climates, with a high mortality rate. We report a case of orbitocerebral mucormycosis caused by A. elegans in a person living with HIV (PLWHIV) from Africa alongside a systematic literature review updating current diagnostic and treatment strategies for orbitocerebral mucormycosis caused by Apophysomyces.

METHODS: The presented case was treated in our hospital for polytrauma following a motor vehicle accident (MVA) with aggressive surgical debridement and therapy with liposomal Amphotericin B (AMB). We evaluated clinical presentation, imaging, surgery, and postoperative outcomes. A systematic review of English or German language articles (published between 1985 and 2025) was performed according to PRISMA guidelines. Articles describing patients with mucormycosis due to Apophysomyces were summarized. Quantitative values for relevant parameters that indicated a reduction in mortality and morbidity were obtained.

RESULTS: The systematic search initially identified 452 publications, from which 79 studies were retrieved. Seventeen publications comprising 21 cases were included, along with one additional case from our institution, for a total of 22 rhino-orbito-cerebral infections caused by the genus Apophysomyces. Apophysomyces elegans (A. elegans) was the most frequently isolated species (n = 17), followed by A. variabilis (n = 4) and A. ossiformis (n = 1); A. trapeziformis was not reported. The majority of patients were male (72.7%), with a mean age of 40.7 ± 15.9 years. Trauma (27.3%) and diabetes mellitus (18.2%) were the most common underlying risk factors, with SARS-CoV-2 infection identified in 13.6% of cases.

CONCLUSION: Mucormycosis due to Apophysomyces is a rare but potentially devastating condition. Based on our experience and the literature, we suggest that the early diagnosis of Apophysomyces treated with liposomal AMB and aggressive surgical debridement is essential to reduce morbidity and mortality.}, } @article {pmid40422292, year = {2025}, author = {Neto, GEF and Prudente, GD and de Oliveira, HL and de Lima, KBA and da Silva Menezes Junior, A}, title = {Telerehabilitation as an innovative strategy for the management of anxiety and dyspnea in post-COVID-19: A scoping review.}, journal = {PM & R : the journal of injury, function, and rehabilitation}, volume = {}, number = {}, pages = {}, doi = {10.1002/pmrj.13403}, pmid = {40422292}, issn = {1934-1563}, abstract = {The COVID-19 pandemic brought challenges for everyone, especially for patients with persistent sequelae, driving interest in telerehabilitation as an alternative treatment. Additional evidence may be useful to better assess its efficacy and applicability in managing post-COVID-19 symptoms. This study aimed to enhance the understanding of telerehabilitation in the post-COVID-19 context, facilitating its integration into clinical settings and patient management. Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines, we reviewed PubMed, Excerpta Medica, and Scopus databases until January 2024. The study included primary and secondary research evaluating the benefits and drawbacks of telerehabilitation for patients with persistent COVID sequelae. This review analyzed 19 studies on telerehabilitation for long-term COVID-19 patients. Key findings included the comparison between hospital-based and telerehabilitation and synchronous versus asynchronous telerehabilitation. The main sequelae addressed were dyspnea, quality of life, and anxiety. Limitations, particularly regarding costs, were also examined. Telerehabilitation provides psychological and social support, which is essential for managing post-COVID-19. Despite initial costs, long-term benefits include reduced anxiety and improved quality of life. More long-term research is needed to better understand the limitations and potential implications of telerehabilitation for integration into post-COVID-19 care to optimize outcomes and provide continuous support to patients and caregivers during recovery.}, } @article {pmid40420966, year = {2025}, author = {Muodiaju, JC and Madu, CS}, title = {Messenger Ribonucleic Acid (mRNA)-Based Universal Vaccines: Engineering Broad-Spectrum Immunity Against Future Pandemics.}, journal = {Cureus}, volume = {17}, number = {5}, pages = {e84821}, pmid = {40420966}, issn = {2168-8184}, abstract = {The rapid emergence and evolution of infectious pathogens, including the COVID-19 pandemic and recurring influenza outbreaks, underscore the need for universal vaccines capable of providing broad-spectrum immunity. Messenger ribonucleic acid (mRNA) vaccine technology has emerged as a transformative platform due to its rapid development, high immunogenicity, and adaptability to new variants. Unlike conventional vaccines, which rely on weakened or inactivated pathogens, mRNA vaccines instruct host cells to produce antigens that elicit robust immune responses. This paper explores the design principles, mechanisms of action, and advancements in mRNA-based universal vaccines, emphasizing their potential against influenza, coronaviruses, and antimicrobial-resistant pathogens. We discuss innovations such as self-amplifying mRNA (saRNA), nanoparticle-based delivery systems, and artificial intelligence (AI)-driven antigen selection. Additionally, challenges such as antigenic variability, immune evasion, stability issues, and global distribution barriers are addressed. With continued research and development, mRNA-based universal vaccines could play a critical role in pandemic preparedness and global health security.}, } @article {pmid40420959, year = {2025}, author = {Okusanya, BO and Gadanya, M and Nlemadim, A and Adaramoye, V and Akeju, DO and Ehiri, J and Meremiku, MM}, title = {Systematic review of surface disinfection: Spraying versus wiping for COVID-19 prevention.}, journal = {Journal of public health in Africa}, volume = {16}, number = {2}, pages = {597}, pmid = {40420959}, issn = {2038-9922}, abstract = {BACKGROUND: Within countries, community spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) propagated the infection despite the use of non-pharmaceutical interventions.

AIM: To evaluate the effectiveness of disinfecting surfaces and materials in the community by spraying compared with wiping (mechanical cleaning) or nothing for SARS-CoV-2 infection prevention.

SETTING: This research was conducted in a global context.

METHOD: We searched six databases for eligible studies from 01 January 2020 to 06 September 2022. Spraying disinfectants was the intervention, while wiping or nothing was the comparison. Review outcomes include SARS-CoV-2 infection, the incidence of adverse effects and operator satisfaction. The review was registered on Prospero: CRD42022356276.

RESULTS: We found no studies that compared spraying with wiping or had human participants. Three studies with indirect evidence, published between 2021 and 2022 in Japan, South Korea and Spain, were included. Dry fog spraying of 8 700 parts per million (ppm) of hypochlorous acid solution or 56 400 ppm of hydrogen peroxide solution reduced the infectious viral titre. Wiping with 1000 ppm of sodium hypochlorite for 1 min completely reduces SARS-CoV-2 viruses on stainless steel. Also, wiping with 500 ppm of bleach for 5 min completely reduces the virus on kraft paper and polypropylene. No viruses were detected on any surface after wiping with 1000 ppm of bleach for 5 min.

CONCLUSION: This review provides basic scientific evidence that either spraying disinfectants as dry fog or wiping has some disinfectant effects on surfaces and materials.

CONTRIBUTION: Although the review included no human studies, both methods of disinfection can be practiced in the community for SARS-CoV-2 infection prevention.}, } @article {pmid40420061, year = {2025}, author = {Eslami, A and Allami, P and KamaliZonouzi, S and Ravanbakhsh, M and Razi, S and Yazdanpanah, N and Rezaei, N}, title = {Prevalence of anxiety, depression, and post-traumatic stress disorder during the COVID-19 lockdown in patients with rheumatoid arthritis or systemic lupus erythematosus: a systematic review.}, journal = {BMC psychiatry}, volume = {25}, number = {1}, pages = {546}, pmid = {40420061}, issn = {1471-244X}, mesh = {Humans ; *Arthritis, Rheumatoid/psychology/epidemiology ; *COVID-19/psychology/epidemiology/prevention & control ; *Stress Disorders, Post-Traumatic/epidemiology/psychology ; *Lupus Erythematosus, Systemic/psychology/epidemiology ; Prevalence ; *Anxiety/epidemiology ; *Depression/epidemiology ; }, abstract = {The COVID-19 pandemic and its associated lockdown measures had a profound impact on mental health, particularly among individuals with chronic illnesses. Patients with autoimmune arthritis, such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), are already at increased risk for psychological disorders due to the chronic nature of their disease, physical disability, and long-term medication use. The added stress of the pandemic, including fear of infection, limited access to healthcare, and social isolation, may have further exacerbated mental health issues in this population. This systematic review aims to evaluate the prevalence of anxiety, depression, and post-traumatic stress disorder (PTSD) among individuals with autoimmune arthritis during the pandemic. A comprehensive search of major medical databases identified 18 relevant studies, encompassing 9,666 participants from various geographic regions. By synthesizing findings across diverse populations, this review examines the extent of the mental health burden in this vulnerable group and highlights the importance of mental health support during public health crises. Understanding these impacts can help guide future research and inform healthcare policies to better support autoimmune arthritis patients in times of crisis.}, } @article {pmid40419326, year = {2025}, author = {Belmonte, M and Albiero, A and Callewaert, F and Patris, J and Whittal, A}, title = {Understanding supply sustainability of plasma-derived medicinal products: Drivers and consequences of shortages.}, journal = {Vox sanguinis}, volume = {120}, number = {8}, pages = {754-764}, pmid = {40419326}, issn = {1423-0410}, support = {//argenx/ ; }, mesh = {Humans ; *Plasma ; *COVID-19/epidemiology/therapy ; SARS-CoV-2 ; United States ; *Immunoglobulins/therapeutic use ; Europe ; *Biological Products/supply & distribution ; }, abstract = {Plasma-derived medicinal products (PDMPs), particularly immunoglobulins (Igs), are essential treatments for numerous diseases, often serving as the primary therapeutic option and playing a critical role in patient care. The human origin of these products, however, can lead to supply constraints due to a lack of plasma collection, market dynamics, regulatory challenges and manufacturing complexities. Many nations lack plasma self-sufficiency and often rely on the United States, which supplies approximately 70% of the world's plasma. This supply chain is vulnerable to disruptions, such as those caused by COVID-19. Additionally, plasma processing timelines are lengthy-Ig manufacturing takes 7-12 months compared with 2-3 months for biologics. Despite the global Ig market's projected growth from $13.36 billion to $24.98 billion between 2023 and 2032, plasma shortages persist. The European Medicines Agency anticipated shortages to affect 14 European countries in 2024. These factors can have significant implications for patients, with growing demand likely leading to supply challenges and forcing countries to prioritize certain indications in the face of shortages. Policy interventions may be needed to ensure the sustainable use of these products in treating immune-mediated disorders and related conditions. Exploring alternative treatments where possible could also mitigate the risk of shortages and maintain access to these life-saving therapies. This review examines the sustainability of PDMPs, focusing on drivers and consequences of shortages, insufficient plasma collection, vulnerability of the plasma supply chain and impacts on patients. A scoping literature research was conducted in PubMed, supplemented by internal knowledge and targeted web searches.}, } @article {pmid40419200, year = {2025}, author = {Bhat, AA and Singh, I and Farid, A and Wani, AW and Khanday, F and Wani, AK and Shah, N and Hassan, A and Kabrah, A and Qusty, NF and Babalghith, AO and Alghamdi, S}, title = {Repositioning antivirals against COVID-19: Synthetic pathways, mechanisms, and therapeutic insights.}, journal = {Microbial pathogenesis}, volume = {206}, number = {}, pages = {107724}, doi = {10.1016/j.micpath.2025.107724}, pmid = {40419200}, issn = {1096-1208}, mesh = {*Antiviral Agents/pharmacology/therapeutic use/chemical synthesis/chemistry ; Humans ; *Drug Repositioning/methods ; SARS-CoV-2/drug effects ; COVID-19 ; COVID-19 Drug Treatment ; Pyrazines/pharmacology/therapeutic use ; Hydroxychloroquine/pharmacology/therapeutic use ; Alanine/analogs & derivatives/pharmacology/therapeutic use ; Chloroquine/pharmacology/therapeutic use ; Pandemics ; Amides/pharmacology/therapeutic use ; Virus Replication/drug effects ; Adenosine Monophosphate/analogs & derivatives/pharmacology/therapeutic use ; *Betacoronavirus/drug effects ; *Pneumonia, Viral/drug therapy/virology ; *Coronavirus Infections/drug therapy/virology ; }, abstract = {The pandemic of COVID-19 has ignited a global race to locate effective therapies with drug repositioning emerging as a leading strategy due to its cost-effectiveness and established safety profiles. Remdesivir, Favipiravir, Hydroxychloroquine, and Chloroquine have been the focus of rigorous clinical trials to determine their therapeutic potential against SARS-CoV-2. This article delves into the innovative synthetic strategies behind these drugs, providing a blueprint for researchers navigating the complex landscape of antiviral development. Beyond synthesis, we explore the fascinating mechanisms of action: hydroxychloroquine and chloroquine elevate lysosomal pH to impede autophagy and viral replication; favipiravir, a nucleoside analogue, induces lethal mutagenesis or RNA chain termination and remdesivir disrupts viral RNA synthesis through delayed chain termination. By merging synthetic methodologies with mechanistic insights, this article offers a comprehensive resource aimed at accelerating the development of potent COVID-19 therapies and underscores the crucial part that chemistry in addressing global health emergencies. It also underscores the vital function of chemistry in addressing global health emergencies and highlights how innovative drug design and repurposing can provide rapid responses to emerging infectious diseases. This fusion of chemistry and virology not only advances our understanding of drug action but also paves the way for the discovery of new therapeutic agents crucial in future pandemics.}, } @article {pmid40418749, year = {2025}, author = {Rumfelt, KE and Englund, JA and Kachikis, A}, title = {The burden, pathogenesis, clinical outcomes, and treatment of common respiratory virus infections during pregnancy.}, journal = {Women's health (London, England)}, volume = {21}, number = {}, pages = {17455057251338501}, pmid = {40418749}, issn = {1745-5065}, support = {K23 AI153390/AI/NIAID NIH HHS/United States ; }, mesh = {Humans ; Pregnancy ; Female ; *Pregnancy Complications, Infectious/epidemiology/virology/therapy ; *Respiratory Tract Infections/epidemiology/virology/therapy ; COVID-19/epidemiology ; Influenza, Human/epidemiology ; SARS-CoV-2 ; Pregnancy Outcome ; }, abstract = {Respiratory illnesses due to respiratory virus infections disproportionately impact pregnant individuals and their infants, leading to significant morbidity and mortality globally. Data describing the incidence and impact of these infections in pregnancy is sparse and more common for influenza and now severe acute respiratory syndrome coronavirus 2 with less data available on other respiratory virus infections in pregnancy. This lack of data is a result of limited prospective surveillance and issues surrounding the calculations of seroprevalence, as well as disproportionately low funding for reproductive health research. In this review article, we aimed to summarize available data on respiratory virus infections in pregnancy and identify gaps in the published literature.}, } @article {pmid40418682, year = {2025}, author = {Alkharaan, H}, title = {Infectious and Immunological Links Between Periodontitis and COVID-19: A Review.}, journal = {Medical science monitor : international medical journal of experimental and clinical research}, volume = {31}, number = {}, pages = {e948069}, pmid = {40418682}, issn = {1643-3750}, mesh = {Humans ; *COVID-19/immunology/complications/virology ; *Periodontitis/immunology/complications/virology ; SARS-CoV-2/immunology ; Cytokines/immunology/metabolism ; Angiotensin-Converting Enzyme 2/metabolism ; Risk Factors ; Inflammation/immunology ; Cytokine Release Syndrome/immunology ; }, abstract = {Emerging evidence suggests a potential association between periodontitis and adverse outcomes in COVID-19. Both conditions share risk factors and exhibit similar immune dysregulation, including elevated pro-inflammatory cytokines, altered myeloid compartments, and T-cell dysfunction. SARS-CoV-2 uses angiotensin-converting enzyme type 2 and transmembrane protease serine 2 membrane proteins, highly expressed in the oral cavity, for cellular entry. Periodontitis may exacerbate COVID-19 through mechanisms such as oral microbe aspiration, increased viral receptor expression, and systemic inflammation. The shared immunopathogenesis, characterized by cytokine storms and perturbed immune profiles, suggests periodontitis can predispose patients to more severe COVID-19 outcomes. This article aims to review the associations between periodontitis and the severity of COVID-19 and the possible immune mechanisms involved.}, } @article {pmid40418574, year = {2025}, author = {Osimitz, TG and Droege, W}, title = {Perspectives on safety of quaternary ammonium compounds (QACs).}, journal = {Journal of toxicology and environmental health. Part B, Critical reviews}, volume = {28}, number = {7}, pages = {535-560}, doi = {10.1080/10937404.2025.2503784}, pmid = {40418574}, issn = {1521-6950}, mesh = {Humans ; *Quaternary Ammonium Compounds/toxicity/adverse effects ; Animals ; Risk Assessment ; SARS-CoV-2/drug effects ; }, abstract = {Quaternary ammonium compounds (QACs) are widely used to kill pathogenic microbes (including COVID-19), providing a substantial public health benefit. This review is an update to our previous publications that summarized and interpreted the current knowledge of the safety of the two most widely used QACs, alkyl dimethyl benzyl ammonium chloride (ADBAC) and didecyl dimethyl ammonium chloride (DDAC). A literature search was conducted for studies published since 2000 that addressed possible toxicity of ADBAC and DDAC as well as investigations into human exposure. The current database of high-quality animal toxicology studies with ADBAC/DDAC showed that adverse cellular changes are limited to effects at the point of contact. (1) Non-guideline animal toxicology investigations, (2) studies of the effect of QACs on subcellular functions, and (3) the sole report of systemic effects in humans might not be informative for human health risk assessment. Because of their widespread use, human exposure to QACs is frequent. Various reports measured QACs in media in the home and workplaces. Risk calculations performed based upon these exposure estimates performed as part of this review demonstrated that none of the exposure scenarios examined are predicted to pose adverse health risks to exposed individuals.}, } @article {pmid40418545, year = {2025}, author = {Varikasuvu, SR and Manne, M and Kumar, S and Mudgal, SK and Raj, V and Varshney, S and Gupta, P and Grover, A and Goyal, C and Lal, V and Singh, H and Lisa, M and Saransh Workshop Members, }, title = {COVID-19 clinical outcomes and N-acetylcysteine (CoViNAC study): a GRADE compliant meta-analysis of randomized controlled trials with molecular docking and dynamics simulation studies with Mpro of SARS-CoV-2.}, journal = {Cellular and molecular biology (Noisy-le-Grand, France)}, volume = {71}, number = {5}, pages = {95-102}, doi = {10.14715/cmb/2025.71.5.13}, pmid = {40418545}, issn = {1165-158X}, mesh = {Humans ; *Acetylcysteine/therapeutic use ; Molecular Docking Simulation ; *SARS-CoV-2/enzymology/drug effects ; Randomized Controlled Trials as Topic ; *Coronavirus 3C Proteases/metabolism/chemistry ; *COVID-19 Drug Treatment ; Molecular Dynamics Simulation ; COVID-19/mortality/virology ; Treatment Outcome ; Antiviral Agents/therapeutic use ; }, abstract = {N-acetylcysteine (NAC) has been proposed as an adjuvant therapy for COVID-19, but evidence from randomized controlled trials (RCTs) remains inconclusive. This systematic review and meta-analysis evaluated NAC's efficacy in improving mortality and recovery/discharge rates. Additionally, molecular docking and molecular dynamics simulation (MDMS) studies were conducted to assess NAC's interaction with the SARS-CoV-2 main protease (Mpro), a key enzyme for viral replication. A systematic search identified 12 RCTs, with 11 trials (1125 patients) included in the mortality analysis. NAC significantly reduced mortality (RR=0.59, 95% CI 0.39-0.88, p=0.01; I[2]=62%), indicating a 41% decreased risk of death. Six RCTs (656 patients) showed improved recovery/discharge rates (RR=1.09, 95% CI 1.03-1.14, p=0.003; I[2]=0%). MDMS studies demonstrated stable NAC binding at the Mpro catalytic site, interacting with His41 and Cys145, crucial for enzymatic activity. These findings suggest NAC significantly improves clinical outcomes in COVID-19 and may inhibit viral replication by targeting Mpro. This integrated evidence substantiates NAC's potential as a critical adjuvant therapy.}, } @article {pmid40418401, year = {2025}, author = {Zou, H and Wang, Y and Luo, G and Huang, S}, title = {The biomechanical phenomena observed in the cell invasion pathway of porcine epidemic diarrhea virus: a review.}, journal = {Archives of virology}, volume = {170}, number = {7}, pages = {139}, pmid = {40418401}, issn = {1432-8798}, support = {cqsx2021001//Chongqing Three Gouges Vocational College/ ; KJQN202203513//Chongqing Municipal Education Commission/ ; }, mesh = {*Porcine epidemic diarrhea virus/physiology ; Animals ; Swine ; *Virus Internalization ; Endocytosis ; *Swine Diseases/virology ; *Coronavirus Infections/virology/veterinary ; Biomechanical Phenomena ; Cell Membrane/virology ; }, abstract = {Porcine epidemic diarrhea virus (PEDV) is the primary pathogen responsible for highly contagious intestinal infections in pigs, which results in significant economic losses to the global animal husbandry industry. PEDV is an enveloped virus that enters cells via endocytosis, a process that is dependent on the binding of the viral surface S protein to a receptor on the host cell membrane. This results in a series of biomechanical alterations that drive the fusion of the viral and host cell membranes. These alterations stabilise the binding of the virus to the receptor and also affect the tension and the curvature of the plasma membrane and the formation of endocytic vesicles. A comprehensive understanding of the mechanism by which PEDV enters cells and the biomechanical changes that accompany this process is of paramount importance for the development of PEDV inhibitors, vaccines, and disease prevention and control strategies. Here, we review the general mechanism of PEDV entry, the biomechanical phenomena that occur during endocytosis, and the potential applications of biomechanics in antiviral therapy. It is anticipated that by gaining insight into these mechanisms, novel approaches to regulating viral entry pathways through mechanical interference, vaccine development, and antiviral drug design can be explored.}, } @article {pmid40418273, year = {2025}, author = {Caldwell, JM and Espinosa, CM and Banerjee, R and Domachowske, JB}, title = {Rapid diagnosis of acute pediatric respiratory infections with Point-of-Care and multiplex molecular testing.}, journal = {Infection}, volume = {53}, number = {Suppl 1}, pages = {1-14}, pmid = {40418273}, issn = {1439-0973}, mesh = {Humans ; *Respiratory Tract Infections/diagnosis ; Child ; *Molecular Diagnostic Techniques/methods ; *Multiplex Polymerase Chain Reaction/methods ; *Point-of-Care Testing ; *Point-of-Care Systems ; Acute Disease ; }, abstract = {Acute infections of the respiratory tract are very common in pediatric patients, with an estimated global incidence of 17.2 billion cases in 2019. Accurate and timely diagnosis and treatment of acute respiratory infections can prevent progression to more serious pathologies, especially in the young, elderly, immunocompromised, and other high-risk groups. Due to the significant increase in the number of multiplex molecular tests available, there are now many diagnostic options which generate results within minutes or hours, many of which can be performed at point-of-care or near-patient rather than being sent out to a centralized laboratory. Rapid molecular single- or multiplex testing conducted at point-of-care or near-patient offers the potential to improve timely and accurate diagnosis, decrease inappropriate antibiotic use, decrease reliance on chest radiographs, improve timely antiviral administration, reduce the length of hospital stay, reduce the number of clinical visits, and, ultimately, improve patient outcomes. Optimal use of user-friendly multiplex molecular panels also has the potential to improve regional and global disease surveillance and to fill gaps that exist in our understanding of the epidemiology of respiratory infections. These potential benefits, however, come with limitations. For example, use of multiplex PCR assays is not always a cost effective approach. Despite their potential, there are clinical and/or laboratory circumstances where their use becomes cost prohibitive. Another recognized limitation of multiplex PCR assays is that the pathogen detected may not be the cause of a patient's current symptom complex. Such false positive results may occur because the assays are designed to detect pathogen-specific nucleic acid (which may be residual from a prior illness), rather than replication competent pathogens, or because some pathogens can be present without causing symptomatic infection. Further study is needed to determine optimal use of these tests across different patient groups and settings. Incorporating recommendations for best practice use of multiplex molecular assays into clinical guidelines helps offer a framework for their most appropriate use in the diagnosis of pediatric acute respiratory infections.}, } @article {pmid40418237, year = {2025}, author = {Sato, K and Ishii, K and Nagai, S and Ogata, Y}, title = {Factors related to nurses' posttraumatic growth during the early stage of the coronavirus disease 2019 pandemic: a scoping review.}, journal = {Journal of occupational health}, volume = {67}, number = {1}, pages = {}, pmid = {40418237}, issn = {1348-9585}, support = {//JSPS KAKENHI/ ; }, mesh = {Humans ; *COVID-19/nursing/psychology/epidemiology ; *Posttraumatic Growth, Psychological ; SARS-CoV-2 ; Pandemics ; *Nurses/psychology ; Adult ; *Nursing Staff, Hospital/psychology ; }, abstract = {OBJECTIVES: This study aimed to identify the factors influencing nurses' posttraumatic growth (PTG) during the early stages of the coronavirus disease 2019 (COVID-19) pandemic.

METHODS: A literature search was conducted in February 2023 across databases, including Medline, CINAHL, APA PsycINFO, Web of Science, and Google Scholar, for articles published between January 2020 and February 2023 related to PTG in nurses during the COVID-19 pandemic. Inclusion criteria were English-language articles, original research on nurses' PTG, and studies conducted after January 2020. Of 1089 identified articles, 142 were screened, and 27 were selected for final analysis. Data extracted from the articles included the author(s) name(s), the study's geographic location, publication year, study purpose, study design, participants, methods, measurement scales, results, and notes. PTG factors were extracted and grouped into 4 broad categories: COVID-related factors, nursing-related factors, factors in Tedeschi's PTG conceptual model, and other factors. Smaller categories were then created by inductively categorizing the factors based on similarities and differences.

RESULTS: As factors of nurses' PTG during the early stage of the COVID-19 pandemic, 16 subcategories were organized under 4 categories. In addition to all factors from Tedeschi's PTG model, some COVID-related factors (eg, care context, organizational training), and some nursing-related factors (eg, work environment) were shown to be related to PTG. No significant relationships were found between almost all of the other factors, including sociodemographic attributes, and PTG.

CONCLUSIONS: Factors found in this study can help identify nurses' PTG facilitators and guide the development of interventions for future crises.}, } @article {pmid40417997, year = {2025}, author = {Evans, C and Clancy, G and Evans, K and Booth, A and Nazmeen, B and Sunney, C and Clowes, M and Jones, NW and Timmons, S and Spiby, H}, title = {How to Implement Digital Clinical Consultations in UK Maternity Care: the ARM@DA Realist Review.}, journal = {Health and social care delivery research}, volume = {13}, number = {22}, pages = {1-77}, doi = {10.3310/WQFV7425}, pmid = {40417997}, issn = {2755-0079}, mesh = {Humans ; United Kingdom ; COVID-19/epidemiology ; Female ; *Maternal Health Services/organization & administration ; Pregnancy ; SARS-CoV-2 ; *Remote Consultation ; State Medicine/organization & administration ; Telemedicine ; }, abstract = {BACKGROUND: Digital transformation is a key component within the National Health Service Maternity Transformation Programme. The COVID-19 pandemic led to an acceleration of digital innovation, in particular, the use of digital clinical consultations (telephone/video consultations). The ways in which digital clinical consultations can be optimised and utilised alongside the traditional maternity care pathway remains unclear, however, with particular concerns about the potential for digital care to exacerbate inequalities.

OBJECTIVE: To explore how digital clinical consultations can be implemented in a clinically safe, appropriate and acceptable way within UK maternity services? For whom? In what settings? And for what purposes?

DESIGN: A realist synthesis combining an evidence review of diverse sources (2010 to the present) from Organisation for Economic Co-operation and Development countries with insights from key stakeholder groups (healthcare professionals, service users and community organisations).

DATA SOURCES: There were three main sources: (1) published primary and secondary research; (2) grey literature (such as policy documents and maternity safety reports); and (3) stakeholder insights.

METHODS: A realist synthesis adopts a theory-driven approach which seeks to understand how a complex programme works, for whom and under what circumstances. The review had three iterative phases: (1) refining the review focus and developing initial programme theories; (2) retrieval of evidence for data extraction and analysis (using on a realist logic to identify key contexts, mechanisms and outcomes); and (3) testing and refining the programme theories.

RESULTS: The final synthesis included 93 evidence sources (reviews, reports and 77 primary studies), with priority given to UK-focused studies. Study samples included a focus on healthcare professionals (n = 17), women (n = 45, of which 14 focused on vulnerable groups) or both (n = 15). Clinical and safety-related outcomes were reported in 12 studies. Fifteen programme theories were developed. A conceptual framework was produced that illustrates the inter-relationship between key contexts in maternity care through which different interactions activate mechanisms to produce outcomes of interest. The findings suggest that digital clinical consultations can be acceptable and appropriate if implementation includes personalisation and informed choice for women, as well as support and autonomy for staff. The relationship and connection between women and their healthcare professional are proposed as key mechanisms that support safety and engagement in care.

LIMITATIONS: Some of the evidence lacked details regarding specific settings, interventions or sample characteristics. This limits the extent to which findings can be applied to micro-level contexts. Stakeholder groups contributed key insights to the review at all stages. In spite of efforts to achieve diversity within these groups, there may have been experiences or identities that were missed.

CONCLUSIONS: Four 'CORE' implementation principles were identified to guide future practice and research: C - Creating the right environment, infrastructure and support for staff; O - Optimising consultations to be responsive, flexible and personalised to different needs and preferences; R - Recognising the importance of access and inclusion; and E - Enabling quality and safety through relationship-focused connections.

FUTURE WORK: Future research should embed equity considerations and should focus on understanding digital clinical consultation within specific maternity systems (like triage/helplines), services (such as specialist outpatient clinics) or groups of women (e.g. with digital literacy or communication needs).

FUNDING: This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research as award number NIHR134535.}, } @article {pmid40416841, year = {2025}, author = {Mahendran, R and Ju, K and Yang, Z and Gao, Y and Huang, W and Yu, W and Liu, Y and Hundessa, S and Yu, P and Xu, R and Zhang, L and Li, S and Guo, Y}, title = {Wildfire-Related Air Pollution and Infectious Diseases: Systematic Review and Meta-Analysis.}, journal = {ACS environmental Au}, volume = {5}, number = {3}, pages = {253-266}, pmid = {40416841}, issn = {2694-2518}, abstract = {Amid the global rise in wildfire events, the health impacts of wildfire-related air pollution are increasingly scrutinized. While numerous reviews have examined the link between air pollution and infectious diseases, reviews specifically focusing on wildfire-related air pollution and infectious diseases remain scarce. To address this gap, we conducted a comprehensive search in MEDLINE, EMBASE, Scopus and Web of Science databases up to December 31, 2023, using PRISMA (Preferred Reporting Items for Systematic Reviews & Meta-Analyses) guidelines. Search terms included synonyms of wildfire and infectious diseases. Peer-reviewed epidemiological studies that reported any association or trend between wildfire air pollution and infectious diseases were selected against eligibility criteria. Risk of bias and quality of included studies were assessed using modified risk of bias and quality assessment tools. Our review included 30 studies, predominantly from developed countries including the United States (USA), Australia, and Canada. Most focused on respiratory infectious diseases (n = 29), including 9 specifically on the coronavirus disease 2019 (COVID-19). The majority examined short-term wildfire air pollution (n = 27) (exposure of one month or less). Twenty-three studies reported effect estimates for the meta-analysis. We found that a 10 μg/m[3] increase in short-term wildfire PM2.5 (particulate matter with a diameter of 2.5 micrometer of less) exposure was associated with a 15% increase in COVID-19 infections (relative risk [RR] = 1.15; 95% confidence interval [CI]: 1.09-1.21; heterogeneity (I [2]): 83%), a 3% increase in respiratory diseases (RR = 1.03; 95% CI: 1.01-1.05; I [2]: 0%) and a 3% increase in acute upper respiratory infection combined with acute bronchitis (RR = 1.03; 95% CI: 1.02-1.05; I [2]: 62%). Medium-term exposure (more than a month but less than a year) to wildfire smoke was associated with 20% rising hospitalization for systemic fungal infections like coccidioidomycosis (95% CI: 5-38%). The current research exclusively examines respiratory infections in developed countries. Future high-quality primary studies should prioritize understanding the impact of wildfire-related air pollution on various infectious diseases.}, } @article {pmid40416618, year = {2025}, author = {Eltayeb, A and Adilović, M and Golzardi, M and Hromić-Jahjefendić, A and Rubio-Casillas, A and Uversky, VN and Redwan, EM}, title = {Intrinsic factors behind long COVID: exploring the role of nucleocapsid protein in thrombosis.}, journal = {PeerJ}, volume = {13}, number = {}, pages = {e19429}, pmid = {40416618}, issn = {2167-8359}, mesh = {Humans ; *COVID-19/complications ; *Thrombosis/virology/metabolism/etiology ; *SARS-CoV-2 ; *Coronavirus Nucleocapsid Proteins/metabolism ; }, abstract = {COVID-19, caused by the SARS-CoV-2, poses significant global health challenges. A key player in its pathogenesis is the nucleocapsid protein (NP), which is crucial for viral replication and assembly. While NPs from other coronaviruses, such as SARS-CoV and MERS-CoV, are known to increase inflammation and cause acute lung injury, the specific effects of the SARS-CoV-2 NP on host cells remain largely unexplored. Recent findings suggest that the NP acts as a pathogen-associated molecular pattern (PAMP) that binds to Toll-like receptor 2 (TLR2), activating NF-κB (nuclear factor kappa-light-chain-enhancer of activated B cells) and MAPK (mitogen-activated protein kinase) signaling pathways. This activation is particularly pronounced in severe COVID-19 cases, leading to elevated levels of soluble ICAM-1 (intercellular adhesion molecule 1) and VCAM-1 (vascular cell adhesion molecule 1), which contribute to endothelial dysfunction and multiorgan damage. Furthermore, the NP is implicated in hyperinflammation and thrombosis-key factors in COVID-19 severity and long COVID. Its potential to bind with MASP-2 (mannan-binding lectin serine protease 2) may also be linked to persistent symptoms in long COVID patients. Understanding these mechanisms, particularly the role of the NP in thrombosis, is essential for developing targeted therapies to manage both acute and chronic effects of COVID-19 effectively. This comprehensive review aims to elucidate the multifaceted roles of the NP, highlighting its contributions to viral pathogenesis, immune evasion, and the exacerbation of thrombotic events, thereby providing insights into potential therapeutic targets for mitigating the severe and long-term impacts of COVID-19.}, } @article {pmid40416616, year = {2025}, author = {Xue, L and Qi, Y and Zou, Y}, title = {Short-term safety and efficacy of aspirin in patients with COVID-19: a systematic review and meta-analysis of randomized controlled trials.}, journal = {PeerJ}, volume = {13}, number = {}, pages = {e19466}, pmid = {40416616}, issn = {2167-8359}, mesh = {Humans ; *Aspirin/therapeutic use/adverse effects ; Randomized Controlled Trials as Topic ; *COVID-19 Drug Treatment ; COVID-19/mortality/complications ; Hemorrhage/chemically induced ; SARS-CoV-2 ; Thrombosis/prevention & control ; Treatment Outcome ; }, abstract = {OBJECTIVE: Coagulation activation and inflammatory derangements are key characteristics of coronavirus disease 2019 (COVID-19). Aspirin therapy in patients with COVID-19 remains uncertain due to conflicting evidence regarding its ability to balance anti-inflammatory and antithrombotic benefits against potential bleeding risks in the context of COVID-19-associated coagulopathy. This study aimed to compare the clinical safety and efficacy of aspirin in patients with COVID-19 in randomized controlled trials (RCTs).

METHODS: In the present systematic review and meta-analysis, the Medline, Embase, and Cochrane Library databases were searched for RCTs from database inception to January 13, 2023. Data were independently extracted and screened by two authors using structured data collection forms based on published reports. Results were calculated using odds ratios (ORs) and 95% confidence intervals (CIs) with the Mantel-Haenszel method. Quality was assessed using the Cochrane Risk of Bias tool. The main outcomes were short-term all-cause mortality, bleeding events and any thrombosis events. This meta-analysis was registered on PROSPERO.

RESULTS: A total of 922 studies were identified. Finally, six RCTs with low risk of bias were pooled in the analysis. The results showed that aspirin use was not associated with a reduction in all-cause mortality (OR = 0.95, 95% CI [0.88-1.03], I[2] = 0%) or the risk of any thrombosis (RR 0.88, 95% CI [0.77-1.01], I[2] = 0%), but aspirin use was associated with a higher risk of bleeding (OR 1.72, 95% CI [1.32-2.24], I[2] = 0%). No obvious risk of bias was found among the included RCTs for the primary outcome.

CONCLUSION: Routine low-dose aspirin use does not reduce the risk of short-term mortality and risk of any thrombosis but increases the risk of bleeding. The data does not support the use of low-dose aspirin in patients with COVID-19.}, } @article {pmid40416015, year = {2025}, author = {Harabuchi, Y and Kumai, T and Nishi, K and Tanaka, A and Hotta, O and Hagino, H and Kusuyama, T and Mogitate, M and Ohno, Y and Sakakibara, A and Araki, S and Nishida, Y and Shintani, T and Takezawa, H and Ito, H and Komazawa, D and Nishiwaki, N and Toritani, R and Hirahata, K and Marumo, S}, title = {Retracted: Chronic Epipharyngitis Treated with Epipharyngeal Abrasion Therapy: Symptoms, Diagnosis, Pathogenesis, and Treatment Outcomes.}, journal = {JMA journal}, volume = {8}, number = {2}, pages = {371-384}, pmid = {40416015}, issn = {2433-3298}, abstract = {Chronic epipharyngitis is associated with a wide variety of symptoms, including local symptoms such as postnasal drip, sore throat, lump sensation of the pharynx, headache, chronic cough, nasal obstruction, tinnitus/ear fullness, chronic phlegm and dysphonia due to inflammation of the epipharynx, functional somatic symptoms such as chronic fatigue, dizziness, insomnia, brain fog, abdominal discomfort, and depression caused by dysfunction of the hypothalamus-limbic system via disturbances of vagal response and cerebrospinal fluid outflow, and distant organ symptoms such as immunoglobulin A nephropathy and palmoplantar pustulosis caused by the epipharyngeal lymphoid tissue as an etiologic organ. In the past, chronic inflammation in the epipharynx was difficult to prove by gross findings, now, direct observation of the epipharyngeal inflammation by endoscopy has become easier for the diagnosis. For the treatment of chronic epipharyngitis, epipharyngeal abrasive therapy (EAT), epipharyngeal application of a 1% zinc chloride solution intranasally or orally was popular since the 1960s, recently, endoscopic EAT (E-EAT), in which epipharynx is safely and accurately observed and abraded under clear vision using an endoscope, has been developed. The mechanisms of EAT effects can be classified into anti-inflammatory/antiviral effect, bloodletting effect, and vagus nerve stimulation effect. Recently, the effectiveness of EAT for post-acute sequelae of coronavirus disease 2019 (COVID-19), known as long COVID, has come into the limelight, and the number of patients for whom EAT is expected to increase. In 2019, the Japan Society of Stomato-pharyngology established the EAT Review Committee to accumulate evidence on the efficacy of EAT and to establish indications and techniques for its use. In this article, the EAT Review Committee outlines its symptoms, pathogenesis, and diagnosis of chronic epipharyngitis, technique of E-EAT, mechanisms of EAT effects, past reports for the efficacy of EAT, and a multicenter prospective study.}, } @article {pmid40415711, year = {2025}, author = {Schürmann, PJL and van Breda Vriesman, SPE and Castro-Alpízar, JA and Kooijmans, SAA and Nieuwenhuis, EES and Schiffelers, RM and Fuchs, SA}, title = {Therapeutic Application of mRNA for Genetic Diseases.}, journal = {Wiley interdisciplinary reviews. Nanomedicine and nanobiotechnology}, volume = {17}, number = {3}, pages = {e70019}, pmid = {40415711}, issn = {1939-0041}, support = {10104161//European Research Council, ERC-2021-STG PRIME/ ; //Stichting Metakids, mRNA-research/ ; //Koninklijke Nederlandse Akademie van Wetenschappen, KNAW Ammodo Science Award for Groundbreaking Research 2022/ ; 09150182310045//Nederlandse Organisatie voor Wetenschappelijk Onderzoek, NWA-ORC Research along Routes by Consortia, Netherlands Science Agenda - Research along Routes/ ; }, mesh = {Humans ; *Genetic Therapy/methods ; *RNA, Messenger/genetics/therapeutic use ; *Genetic Diseases, Inborn/therapy/genetics ; COVID-19/prevention & control ; Animals ; Gene Editing ; SARS-CoV-2 ; COVID-19 Vaccines ; Nanoparticles/chemistry ; }, abstract = {While gene therapy has been at the center of an active research field for decades, messenger RNA (mRNA) has long been considered unsuited for therapeutic application due to challenges with stability, immunogenicity, and delivery. Where gene therapy focuses on providing the desired genetic code, mRNA can directly provide the instructions encoded in the corresponding gene. This review aims to explore recent advances in mRNA therapies, building on the success of mRNA COVID-19 vaccines, and extend these insights to the potential treatment of rare genetic diseases. We follow the "outside-in" trajectory of mRNA therapies from administration to intracellular function, focusing on carrier systems such as lipid nanoparticles and virus-like particles, mRNA modifications, and the potential and challenges for clinical applications. To treat rare diseases, different approaches can be envisioned, including chronic or acute delivery of mRNAs encoding functional enzymes for enzyme deficiencies and delivery of CRISPR/Cas9-based gene-editing tools for gene correction. These different approaches determine safety and immunological considerations. By exploring genetic, technical, and therapeutic aspects, this review highlights the potential and current challenges of mRNA therapies to address the large unmet needs in rare genetic disorders.}, } @article {pmid40415355, year = {2025}, author = {Focosi, D and Alfonsi, T and Bernasconi, A}, title = {Is SARS-CoV-2 Spike Evolution Being Retargeted at the N-Terminal Domain?.}, journal = {Discovery medicine}, volume = {37}, number = {196}, pages = {801-807}, doi = {10.24976/Discov.Med.202537196.70}, pmid = {40415355}, issn = {1944-7930}, mesh = {*Spike Glycoprotein, Coronavirus/genetics/immunology/chemistry ; *SARS-CoV-2/genetics/immunology ; Humans ; *COVID-19/virology/immunology ; *Evolution, Molecular ; Protein Domains ; Mutation ; Antibodies, Neutralizing/immunology ; }, abstract = {Since 2020, most of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) evolution has been focused on the receptor-binding domain (RBD) of the Spike protein. Nevertheless, the N-terminal domain (NTD) of Spike has been shown to represent the target for neutralizing antibodies, and accordingly, NTD mutations are relevant for immune escape. In 2024, after the introduction of the BA.2.86 saltation variant (heavily mutated at the NTD antigenic supersite), its descendant JN.1 has further explored NTD evolution in its progeny, largely focused on positions 22, 31, 59 and 60. In this review, we explore such convergent evolution in detail and hypothesize the underlying mechanisms.}, } @article {pmid40415285, year = {2025}, author = {Eltayeb, A and Rubio-Casillas, A and Uversky, VN and Redwan, EM}, title = {Intrinsic Factors Behind Long COVID: VI. Combined Impact of G3BPs and SARS-CoV-2 Nucleocapsid Protein on the Viral Persistence and Long COVID.}, journal = {Journal of cellular biochemistry}, volume = {126}, number = {5}, pages = {e70038}, doi = {10.1002/jcb.70038}, pmid = {40415285}, issn = {1097-4644}, support = {//The authors received no specific funding for this work./ ; }, mesh = {Humans ; *COVID-19/virology/metabolism/immunology/pathology ; *SARS-CoV-2/metabolism/physiology ; *Coronavirus Nucleocapsid Proteins/metabolism ; *RNA Recognition Motif Proteins/metabolism/immunology ; *Poly-ADP-Ribose Binding Proteins/metabolism/immunology ; *DNA Helicases/metabolism ; *Phosphoproteins/metabolism ; *RNA Helicases/metabolism ; Virus Replication ; Stress Granules/metabolism/virology ; Host-Pathogen Interactions ; }, abstract = {The efficient transmission of SARS-CoV-2 caused the COVID-19 pandemic, which affected millions of people around the globe. Despite extensive efforts, specific therapeutic interventions and preventive measures against COVID-19 and its consequences, such as long COVID, have not yet been identified due to the lack of a comprehensive knowledge of the SARS-CoV-2 biology. Therefore, a deeper understanding of the sophisticated strategies employed by SARS-CoV-2 to bypass the host antiviral defense systems is needed. One of these strategies is the inhibition of the Ras GTPase-activating protein-binding protein (GAP SH3-binding protein or G3BP)-dependent host immune response by the SARS-CoV-2 nucleocapsid (N) protein. This inhibition disrupts the formation of stress granules (SGs), which are crucial for antiviral defense. By preventing SG formation, the virus enhances its replication and evades the host's immune response, leading to increased disease severity. Given the involvement of G3BP1 in SG formation and its ability to interact with viral proteins, along with the crucial role of the N protein in the replication of the virus, we hypothesize that these proteins may have a potential role in the pathogenesis of long COVID. Despite the current lack of direct evidence linking these proteins to long COVID, their interactions and functions suggest a possible connection that warrants further investigation.}, } @article {pmid40415212, year = {2025}, author = {Moirangthem, R and Bar-On, Y}, title = {Passive Immunization in the Prevention and Treatment of Viral Infections.}, journal = {European journal of immunology}, volume = {55}, number = {5}, pages = {e202451606}, pmid = {40415212}, issn = {1521-4141}, mesh = {Humans ; *Immunization, Passive/methods ; *COVID-19/immunology/therapy/prevention & control ; *SARS-CoV-2/immunology ; *Respiratory Syncytial Virus Infections/immunology/therapy/prevention & control ; Antibodies, Monoclonal/therapeutic use/immunology ; Animals ; *Antibodies, Viral/therapeutic use/immunology ; Antibodies, Neutralizing/therapeutic use/immunology ; HIV-1/immunology ; }, abstract = {The basic concepts of passive immunization and the potential of antibody therapy to confer immunity against infectious diseases were introduced already in the late 19th century. This approach was also later implemented to extensively treat and prevent infections, but with the development of effective vaccines, it became restricted to only a few medical conditions such as snake bites, neutralization of toxins, and prevention of rabies infection. This has dramatically changed in the last decade, as antibodies have been widely used in the clinic for the treatment of COVID-19 and the prevention of respiratory syncytial virus (RSV) infections. A stepping-stone for the progress in monoclonal antibody generation was the development of single-cell antibody cloning techniques that made it possible to develop effective neutralizing antibodies against highly mutable viruses such as influenza virus and HIV-1. Here, we review the use of passive immunotherapy in the clinic for treating and controlling SARS-CoV-2 and RSV infections. We further discuss key developments that have made it possible to use monoclonal antibodies against the highly mutable HIV-1 and influenza virus and advanced clinical trials designed to evaluate the efficacy of such an approach. Finally, we present recent findings that demonstrate that passive immunization can elicit long-term immunity in the host.}, } @article {pmid40414639, year = {2025}, author = {Singh, AK and Sudhan, YG and Ramakrishna, R and Durairajan, SSK}, title = {Viral agents in neuromuscular pathology.}, journal = {International review of neurobiology}, volume = {180}, number = {}, pages = {397-434}, doi = {10.1016/bs.irn.2025.04.007}, pmid = {40414639}, issn = {2162-5514}, mesh = {Humans ; *Neuromuscular Diseases/virology/therapy/diagnosis ; *COVID-19/complications ; *Virus Diseases/complications/therapy ; SARS-CoV-2 ; }, abstract = {In recent years, viral infections have been increasingly identified as major players in neuromuscular pathologies. This chapter presents an overview of the evidence and future directions for virus-induced neuromuscular disorders. Information is integrated on the global burden of these diseases related to epidemiology, clinical features, diagnosis, treatment, and preventive strategies was integrated. Responsible viruses include enteroviruses, flaviviruses, herpesviruses, and emerging pathogens such as SARS-CoV-2. It represents a broad spectrum of neuromuscular disorders, including Guillain-Barré syndrome, viral myositis, and critical illness neuropathy/myopathy. The book chapter discusses different diagnostic approaches, therapy strategies, and rehabilitation methods, in addition to early intervention and preventive measures. This has led to new insights into novel therapies, unmet research needs, and future perspectives on viral neuromuscular disorders. This chapter demonstrates that supporting both clinical care and patient management with clinical research entails a profound understanding of the difficult interactions between the viruses concerned and the neuromuscular system.}, } @article {pmid40413978, year = {2025}, author = {Braconi, L and Sosic, A and Crocetti, L}, title = {Recent breakthroughs in synthetic small molecules targeting SARS-CoV-2 M[pro] from 2022 to 2024.}, journal = {Bioorganic & medicinal chemistry}, volume = {128}, number = {}, pages = {118247}, doi = {10.1016/j.bmc.2025.118247}, pmid = {40413978}, issn = {1464-3391}, mesh = {*SARS-CoV-2/drug effects/enzymology ; Humans ; *Antiviral Agents/pharmacology/chemistry/chemical synthesis ; *COVID-19 Drug Treatment ; *Coronavirus 3C Proteases/antagonists & inhibitors/metabolism ; *Small Molecule Libraries/pharmacology/chemistry/chemical synthesis ; COVID-19/virology ; }, abstract = {Among the identified targets for developing anti-coronavirus therapies, SARS-CoV-2 M[pro] stands out as one of the most promising due to its crucial role in viral replication and its low mutability across various coronaviruses, making it a potential broad-spectrum target. Currently, although the approved drugs targeting M[pro] are peptidomimetic inhibitors with an adequate efficacy, they exhibit relatively poor pharmacokinetic properties commonly associated with peptide-based compounds. On the contrary, using non-peptidic small-molecules M[pro] inhibitors can offer many advantages, including reduced off-target toxicity, improved metabolic stability and drug-like properties more appropriate for oral administration. This topic has sparked interest in the scientific community, leading to the publication of numerous studies in recent years. In this review, we summarize the most recent progress over the past two years in the identification and development of synthetic small-molecule inhibitors of SARS-CoV-2 M[pro].}, } @article {pmid40413366, year = {2025}, author = {Nair, AS and Tauro, L and Joshi, HB and Makhal, A and Sobczak, T and Goret, J and Dewitte, A and Kaveri, S and Chakrapani, H and Matsuda, MM and Joshi, MB}, title = {Influence of homocysteine on regulating immunothrombosis: mechanisms and therapeutic potential in management of infections.}, journal = {Inflammation research : official journal of the European Histamine Research Society ... [et al.]}, volume = {74}, number = {1}, pages = {86}, pmid = {40413366}, issn = {1420-908X}, mesh = {Humans ; *Homocysteine/metabolism/immunology ; COVID-19/immunology ; Animals ; *Thrombosis/immunology ; Immunity, Innate ; Sepsis/immunology ; }, abstract = {Mechanisms controlling innate immune responses and coagulation are interdependent, evolutionarily entangled and make a complex network to form immuno-thrombosis axis which is an integral part of host-defence response. During infections, immunothrombosis generates intravascular scaffold enabling recognition, trap and destruction of pathogens facilitating tissue integrity. However, the accompanying dysregulation fosters into pathologies associated with thrombosis and regulates severity, morbidity and mortality in infections. Several extrinsic and intrinsic factors such as (epi)genetic mechanisms, age, metabolism and lifestyle regulate immunothrombosis during infections. Mounting evidence demonstrates that homocysteine, a metabolic intermediate of methionine synthesis pathway activate cells participating in immuno-thrombosis such as neutrophils, platelets, monocytes and endothelial cells. Interestingly, multiple infections are significantly associated with perturbed homocysteine metabolism. In the present review, we describe mechanistic insights into how homocysteine drives immuno-thrombotic crosstalk that generate a vicious cycle of inflammation and coagulation that fuels organ failure during infections with an emphasis on sepsis, COVID-19, and other infectious diseases caused by parasites, viral, and bacterial pathogens. Subsequently, we discuss therapeutic strategies targeting homocysteine metabolism that may improve clinical outcomes in infections.}, } @article {pmid40413212, year = {2025}, author = {Akingbola, A and Adegbesan, A and Adegoke, K and Idahor, C and Mariaria, P and Peters, F and Salami, RA and Ojo, O and Nwaeze, E and Abdullahi, O and Chuku, J}, title = {Comparing Moderna's mRNA-1083 and Pfizer's dual-target mRNA vaccines for influenza and COVID-19.}, journal = {NPJ vaccines}, volume = {10}, number = {1}, pages = {105}, pmid = {40413212}, issn = {2059-0105}, abstract = {This review examines Moderna's mRNA-1083 and Pfizer/BioNTech's mRNA-1020/1030 dual-target vaccines for COVID-19 and influenza. Both utilize mRNA technology, demonstrating strong immunogenicity and favorable safety profiles. Moderna's mRNA-1083 showed superior immune responses, while Pfizer's mRNA-1020/1030 performed well but was slightly less effective against influenza B. These vaccines simplify immunization strategies, enhance protection, and emphasize the need for global vaccine equity to prevent future outbreaks.}, } @article {pmid40412913, year = {2025}, author = {DeMasi, M and Bujold, L}, title = {Effect of the Covid Pandemic on Women's Health.}, journal = {Primary care}, volume = {52}, number = {2}, pages = {371-382}, doi = {10.1016/j.pop.2025.01.009}, pmid = {40412913}, issn = {1558-299X}, mesh = {Humans ; *COVID-19/epidemiology ; Female ; *Women's Health ; United States/epidemiology ; SARS-CoV-2 ; Pandemics ; }, abstract = {The corona virus disease 2019 (COVID-19) pandemic impacted all spheres of the lives of women. This article focuses on the impact on the health, careers, and family lives of women in the United States. There is a lasting impact from COVID-19 on the lives and health of women. Preventative care and chronic care were disrupted. Long covid seems to impact premenopausal women at much higher rates than men. Time spent between work and home changed for many during the pandemic. Women shifted to more time spent on home duties. The long-term outcome of career advancement and economic success is unknown.}, } @article {pmid40412334, year = {2025}, author = {Rahimi, HK and Jasim, AA and Rezahosseini, O and Harboe, ZB}, title = {Immunogenicity and adverse effects of pneumococcal vaccines co-administered with influenza or SARS-CoV-2 vaccines in adults: A systematic review and Meta-analysis.}, journal = {Vaccine}, volume = {59}, number = {}, pages = {127293}, doi = {10.1016/j.vaccine.2025.127293}, pmid = {40412334}, issn = {1873-2518}, mesh = {Humans ; *Pneumococcal Vaccines/adverse effects/immunology/administration & dosage ; *Influenza Vaccines/adverse effects/administration & dosage/immunology ; Adult ; *COVID-19 Vaccines/administration & dosage/adverse effects/immunology ; *Immunogenicity, Vaccine ; *COVID-19/prevention & control/immunology ; Influenza, Human/prevention & control ; Pneumococcal Infections/prevention & control ; SARS-CoV-2/immunology ; }, abstract = {BACKGROUND: This systematic review and meta-analysis aimed to investigate the immunogenicity and adverse effects (AEs) of co-administration of pneumococcal vaccines with influenza or SARS-CoV-2 vaccines.

METHODS: Following PRISMA 2020 guidelines, we searched MEDLINE, EMBASE, Web of Science, Scopus, and Google for studies published from January 1, 1950, to October 20, 2024. Randomized controlled trials (RCTs) and non-randomized studies were included. Pooled geometric mean titer (GMT) ratios per serotype and risk ratios (RR) for AEs were calculated in the meta-analyses.

RESULTS: Of 752 search hits, 17 studies were included, consisting of 14 RCTs and three non-randomized studies. One study investigated PCV20 and SARS-CoV-2 vaccine co-administration and found it safe and immunogenic. Six studies examined PPV23 and influenza vaccine co-administration, showing lower immunogenicity for some serotypes but non-inferior to single administration. A meta-analysis of studies on PCV and influenza vaccines showed significantly reduced pooled GMT ratios for several serotypes, with serotype 1 (pooled GMT ratio = 0.74, 95 % CI: [0.63, 0.87]) and 6 A (pooled GMT ratio = 0.78, 95 % CI: [0.71, 0.85]) having the lowest ratios. For AEs, PCV co-administration resulted in a 15 % increase in risk for myalgia/arthralgia (RR: 1.15, 95 % CI: 1.04-1.27) and a 34 % increase for headache (RR: 1.34, 95 % CI: 1.14-1.57). Eight studies were rated as having a moderate or severe risk of bias.

CONCLUSIONS: In adults, co-administration of pneumococcal vaccines with influenza or SARS-CoV-2 vaccines is non-inferior to single-administration; however, it can increase mild-moderate systemic AEs. Data is scarce, and further studies are needed on immunocompromised adults.}, } @article {pmid40412331, year = {2025}, author = {Gandhi, K and Vijay, Y and Page, K and Dahari, H and Gutfraind, A}, title = {Challenges in coverage of future hepatitis C vaccines: Review and potential solutions.}, journal = {Vaccine}, volume = {59}, number = {}, pages = {127256}, doi = {10.1016/j.vaccine.2025.127256}, pmid = {40412331}, issn = {1873-2518}, support = {R01 AI158666/AI/NIAID NIH HHS/United States ; }, mesh = {Humans ; *Hepatitis C/prevention & control/epidemiology ; *Viral Hepatitis Vaccines/administration & dosage/immunology ; *Vaccination Coverage ; Hepacivirus/immunology ; Vaccination Hesitancy ; COVID-19/prevention & control ; Substance Abuse, Intravenous ; Patient Acceptance of Health Care ; Vaccination ; }, abstract = {BACKGROUND: Motivated by the high mortality burden of hepatitis C virus (HCV) and the unprecedented rapid development of the COVID-19 and respiratory syncytial virus (RSV) vaccines, we note that a prompt HCV vaccine rollout may streamline the World Health Organization's goal to eliminate HCV before 2030. While progress in the development of HCV vaccine candidates has rapidly flourished, vaccine hesitancy and HCV incidence are both particularly prevalent in people who inject drugs (PWID). The aim of this paper is to document several potential challenges in HCV vaccine uptake and provide a set of preliminary recommendations for public and community health professionals to improve acceptance.

METHODS: We conducted a forward-looking integrative narrative review and identified relevant articles from PubMed. We survey literature discussing barriers to vaccine acceptance in past rollouts (e.g., COVID-19, hepatitis B) and barriers to HCV management, particularly in PWID.

RESULTS: Six key challenges were identified: (1) structural and social barriers affecting PWID, (2) vaccine safety, efficacy, and relevance concerns, (3) multiple-dose attrition and vaccine fatigue, (4) media presentation and misinformation, (5) awareness and attitude towards infection, and (6) information framing and primary care linkage. Four possible recommendations were also identified: (1) vaccine promotion in targeted educational and outreach campaigns, (2) community-level support programs integrated with vaccine rollout, (3) rollout of a pan-genotypic, multivalent, or combination vaccine, and (4) cost-benefit analysis supporting the vaccine.

CONCLUSION: This forward-looking paper offers several recommendations to address potential gaps in HCV vaccination-from linkage with syringe exchange programs to economic analysis of vaccination program costs.}, } @article {pmid40412200, year = {2025}, author = {Tonutti, A and Motta, F and Isailovic, N and Selmi, C and Timilsina, S and Eric Gershwin, M and De Santis, M}, title = {Mechanistic considerations linking SARS-CoV-2 infection, inflammation, and the loss of immune tolerance.}, journal = {Current opinion in immunology}, volume = {95}, number = {}, pages = {102567}, doi = {10.1016/j.coi.2025.102567}, pmid = {40412200}, issn = {1879-0372}, mesh = {Humans ; *COVID-19/immunology ; *SARS-CoV-2/immunology ; *Immune Tolerance ; *Inflammation/immunology ; Animals ; Autoantibodies/immunology ; }, abstract = {The immune response to SARS-CoV-2 has been implicated in the onset of multiple, seemingly unrelated, autoimmune diseases. The immune response to SARS-CoV-2 has also been implicated in the unmasking and/or production of multiple autoantibodies, even in the absence of clinical disease. Despite such data, it remains unclear whether antibodies targeting antiviral signaling proteins and mitochondrial antigens reflect bystander activation or alternatively contribute to de novo viral immune escape mechanisms. With these comments in mind, a variety of professional antibody presenting cells and including lung resident macrophages of COVID-19 infected patients are impacted and dependent on the uptake of antibody-opsonized virus by Fcγ receptors; yet infection is aborted via antibody-dependent effector mechanisms or pyroptosis, possibly leading to autoantibody production, and autoinflammatory manifestations, respectively. TRIM21/Ro52, a cytosolic E3-ubiquitin ligase with an Fc-gamma receptor domain, functions as an intracytoplasmic antibody receptor, directs immune complexes binding virions but also autoantigens to autophagy. During autophagy, Ig-virions-TRIM21/Ro52-autoantigens complexes bind directly to class II human leukocyte antigen in lysosomal compartment, leading to subsequent presentation on the cell surface. This process favors the development of a specific humoral immune response but has the potential to lead to loss of tolerance. Interestingly, TRIM21/Ro52 can also contribute to pyroptosis. We propose that TRIM21/Ro52 is well-placed at the crossroad between the inflammatory response and clinical autoimmunity.}, } @article {pmid40411467, year = {2025}, author = {Wang, X and Zhong, L and Zhang, W and Wu, P and Wang, M and Li, D and Dong, L and Wang, G}, title = {CRISPR Digital Sensing: From Micronano-Collaborative Chip to Biomolecular Detection.}, journal = {ACS nano}, volume = {19}, number = {22}, pages = {20427-20451}, doi = {10.1021/acsnano.5c03474}, pmid = {40411467}, issn = {1936-086X}, mesh = {Humans ; *COVID-19/diagnosis/genetics/virology ; *CRISPR-Cas Systems/genetics ; SARS-CoV-2/genetics/isolation & purification ; *Clustered Regularly Interspaced Short Palindromic Repeats/genetics ; *Biosensing Techniques/methods ; *Lab-On-A-Chip Devices ; }, abstract = {The Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) sensing technology proved to be valuable during the COVID-19 pandemic through its sensitivity, specificity, robustness, and versatility. However, issues such as overreliance on amplification, susceptibility to false positives, lack of quantification strategies, and complex operation procedures have hindered its broader application in bioanalysis and clinical diagnostics. The collision between micronano-collaborative chips and CRISPR technology has effectively addressed these bottlenecks, offering innovative solutions for diagnosis and treatment. Unlike conventional micronano chips, micronano digital chips enhance CRISPR's response to trace amounts of target molecules by leveraging highly controllable local environments and compartmentalized microreactors. This advancement improves detection efficiency and revolutionizes traditional in vitro bioanalytical processes. First, the working principles, fabrication techniques, and performance metrics of CRISPR-based digital droplet microfluidics and microarray chips are examined. Then, the applications of CRISPR digital sensing chips in bioassays are reviewed, emphasizing their importance in advancing in vitro detection systems for gene editing. Finally, the prospects of CRISPR digital sensing technology are explored, particularly its potential for body surface biomonitoring and its broader development opportunities in the biomedical field.}, } @article {pmid40411153, year = {2025}, author = {Patel, V and Korsun, M and Cervia, J}, title = {Protective effects of booster dose of SARS-COV-2 vaccination against post-acute COVID-19 syndrome: A systematic review.}, journal = {Journal of investigative medicine : the official publication of the American Federation for Clinical Research}, volume = {}, number = {}, pages = {10815589251346963}, doi = {10.1177/10815589251346963}, pmid = {40411153}, issn = {1708-8267}, abstract = {The global impact of COVID-19, caused by SARS-CoV-2, has extended beyond acute infection, with post-acute COVID-19 syndrome (PACS) affecting an estimated 10% of recovered individuals. PACS manifests a range of debilitating symptoms, including fatigue, cognitive impairment, and gastrointestinal issues. While vaccination has proven effective in mitigating severe COVID-19 outcomes, the role of booster doses in preventing PACS remains unclear. This study aimed to evaluate whether COVID-19 booster vaccinations reduce the incidence and severity of PACS in individuals with prior SARS-CoV-2 infection. A systematic review and meta-analysis were conducted, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Databases PubMed, Embase, and Cochrane were searched for peer-reviewed studies published in English from January 2020 to August 2023. Inclusion criteria encompassed randomized controlled trials, prospective cohort studies, and case-control studies comparing PACS prevalence between booster recipients and non-recipients. The risk of bias was assessed using the Joanna Briggs Institute appraisal tool. Data synthesis included pooled prevalence estimates and narrative analyses. Of 849 identified studies, 22 met inclusion criteria, with 12 providing complete data for meta-analysis. Among 38,718 participants, a trend toward lower PACS prevalence was observed in booster recipients (RR: 0.66; 95% CI: 0.41-1.09), though heterogeneity (I[2] = 98%) limited statistical significance. Risk of bias analysis classified most studies as low or moderate risk, with two high-risk studies reporting higher PACS rates in boosted individuals. This study suggests a potential protective effect of booster vaccinations against PACS, though findings were not statistically significant. Further research with larger, standardized cohorts is essential to validate these observations and guide vaccination strategies.Prospero Record Number: CRD42023461326.}, } @article {pmid40410684, year = {2025}, author = {Kumar, N and Segovia, D and Kumar, P and Atti, HB and Kumar, S and Mishra, J}, title = {Mucosal implications of oral Jak3-targeted drugs in COVID patients.}, journal = {Molecular medicine (Cambridge, Mass.)}, volume = {31}, number = {1}, pages = {203}, pmid = {40410684}, issn = {1528-3658}, mesh = {Humans ; *Janus Kinase 3/antagonists & inhibitors/metabolism ; *COVID-19 Drug Treatment ; COVID-19/virology ; SARS-CoV-2/drug effects ; *Janus Kinase Inhibitors/administration & dosage/therapeutic use/adverse effects ; Administration, Oral ; *Antiviral Agents/therapeutic use/administration & dosage/adverse effects ; }, abstract = {The JAK family, particularly JAK3, plays a crucial role in immune signaling and inflammatory responses. Dysregulated JAK3 activation in SARS-CoV-2 infections has been associated with severe inflammation and respiratory complications, making JAK inhibitors a viable therapeutic option. However, their use raises concerns regarding immunosuppression, which could increase susceptibility to secondary infections. While long-term adverse effects are less of a concern in acute COVID-19 treatment, patient selection and monitoring remain critical. Furthermore, adverse effects associated with oral JAK3 inhibitors necessitate the exploration of alternative strategies to optimize therapeutic efficacy while minimizing risks. This review highlights the role of JAK3 in immune and epithelial cells, examines the adverse effects of oral JAK3 inhibitors in COVID-19 and other treatments, and discusses alternative therapeutic strategies for improving patient outcomes.}, } @article {pmid40409874, year = {2025}, author = {, and Batra, K and Walker, CM and Little, BP and Bang, TJ and Bartel, TB and Brixey, AG and Christensen, JD and Cox, CW and Hanak, M and Khurana, S and Madan, R and Merchant, N and Moore, WH and Pandya, S and Sanchez, LD and Shroff, GS and Zagurovskaya, M and Chung, JH}, title = {ACR Appropriateness Criteria® Acute Respiratory Illness in Immunocompetent Patients: 2024 Update.}, journal = {Journal of the American College of Radiology : JACR}, volume = {22}, number = {5S}, pages = {S14-S35}, doi = {10.1016/j.jacr.2025.02.014}, pmid = {40409874}, issn = {1558-349X}, mesh = {Humans ; Acute Disease ; Evidence-Based Medicine/standards ; *Immunocompetence ; *Respiratory Tract Infections/diagnostic imaging ; Societies, Medical/standards ; United States ; }, abstract = {Acute respiratory illness is one of the leading causes of morbidity and mortality amongst infectious diseases worldwide and a major public health issue. Even though most cases are due to self-limited viral infections, a significant number of cases are due to more serious respiratory infections where delay in diagnosis can lead to morbidity and mortality. Imaging plays a key role in the initial diagnosis and management of acute respiratory illness. This document reviews the current literature concerning the appropriate role of imaging in the diagnosis and management of the immunocompetent adult patient initially presenting with acute respiratory illness. Imaging recommendations for adults presenting with asthma or chronic obstructive pulmonary disease exacerbations are discussed. Finally, guidelines for follow-up imaging in suspected pneumonia cases to ensure occult malignancy is not overlooked. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or intermediate, experts may be the primary evidentiary source available to formulate a recommendation.}, } @article {pmid40409813, year = {2025}, author = {Pomin, VH and Zhang, F and Dordick, JS}, title = {Role, binding properties, and potential therapeutical use of glycosaminoglycans and mimetics in SARS-CoV-2 infection. In memory of Dr. Robert Linhardt (1953-2025).}, journal = {Carbohydrate polymers}, volume = {362}, number = {}, pages = {123703}, doi = {10.1016/j.carbpol.2025.123703}, pmid = {40409813}, issn = {1879-1344}, mesh = {*Glycosaminoglycans/therapeutic use/pharmacology/chemistry/metabolism ; Humans ; SARS-CoV-2/drug effects ; COVID-19/virology ; *Antiviral Agents/therapeutic use/pharmacology/chemistry ; History, 20th Century ; *COVID-19 Drug Treatment ; History, 21st Century ; Pandemics ; }, abstract = {Dr. Robert Linhardt was a prolific scientist who paved the way for understanding the key aspects of structure, function, synthesis, mechanisms of action, and potential therapeutic use of glycosaminoglycans (GAGs). His contribution to the field of Glycobiology for over 40 years led to an incredible legacy in terms of mentorship, publication, and research accomplishment. Sorrowfully, he succumbed to a rare case of spinal cancer aggravated by a SARS-CoV-2 infection at the beginning of 2025. Since the COVID-19 pandemic, Dr. Linhardt published approximately 20 groundbreaking scientific articles unraveling the role, mechanism of action, virus binding properties, and potential anti-SARS-CoV-2 use of GAGs. In honor of the extraordinary contribution of Dr. Robert Linhardt in the fields of GAGs and SARS-CoV2, we review herein the main scientific achievements of his set of published works on the topic, after presenting a biography of this renowned glycoscientist.}, } @article {pmid40409475, year = {2025}, author = {Dermitzakis, I and Theotokis, P and Delilampou, E and Axarloglou, E and Gouta, C and Manthou, ME and Meditskou, S and Miliaras, D}, title = {The impact of infections and genetics on secondary sex ratio.}, journal = {Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases}, volume = {132}, number = {}, pages = {105770}, doi = {10.1016/j.meegid.2025.105770}, pmid = {40409475}, issn = {1567-7257}, mesh = {Humans ; Female ; Male ; *Sex Ratio ; *Communicable Diseases/genetics/epidemiology ; COVID-19 ; }, abstract = {The secondary sex ratio (SSR), which reflects the proportion of male to female offspring at birth, is influenced by a complex interplay of multiple factors. This review delves into the current understanding of how infections and genetics contribute to variations in the SSR. The effects of infections on the SSR represent an intriguing intersection of biology and epidemiology. Research indicates that several infectious diseases, such as toxoplasmosis, coronavirus disease 2019, Spanish flu, acquired immunodeficiency syndrome and tuberculosis, can impact the SSR through mechanisms that are only partially understood. Genetics are also scrutinized in this review. Although their involvement in determining the SSR is debatable, various genetic factors have been studied. The influences of the Rhesus D heterozygous phenotype, major histocompatibility complex, corticosteroid-binding globulin deficiency, ethnicity, and consanguinity on SSR have been delineated. By amalgamating findings from diverse disciplines, this review aims to offer a comprehensive overview of the multifaceted impact of infections and genetics on SSR, pinpointing potential implications for reproductive biology and public health.}, } @article {pmid40407658, year = {2025}, author = {Park, SO and Nanda, N}, title = {Long COVID: A Systematic Review of Preventive Strategies.}, journal = {Infectious disease reports}, volume = {17}, number = {3}, pages = {}, pmid = {40407658}, issn = {2036-7430}, abstract = {Background: Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019, long COVID (LC) has become a significant global health burden. While knowledge about LC is accumulating, studies on its prevention are still lacking. Methods: We conducted a systematic review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to investigate prevention options for LC. We identified fifteen articles on vaccines, seven on antivirals, and six on other interventions after searching for articles in the PubMed/MEDLINE database using the MeSH terms. Results: Most vaccine-related studies demonstrated a protective effect of COVID-19 vaccines against developing LC. Our review found an equivocal effect of antivirals, while metformin had a protective effect in outpatients and corticosteroids were protective in hospitalized patients against LC. Conversely, COVID-19 convalescent plasma and multiple micronutrient supplement did not confer any protection against LC. Conclusions: COVID-19 vaccination is vital as it not only prevents COVID-19 but also reduces the severity of illness and may help prevent LC. Further studies are warranted to shed light on preventive strategies for long COVID.}, } @article {pmid40407551, year = {2025}, author = {Alexatou, O and Papadopoulou, SK and Mentzelou, M and Deligiannidou, GE and Dakanalis, A and Giaginis, C}, title = {Exploring the Impact of Emotional Eating Among University Students: A Literature Review.}, journal = {Medical sciences (Basel, Switzerland)}, volume = {13}, number = {2}, pages = {}, pmid = {40407551}, issn = {2076-3271}, mesh = {Humans ; *Students/psychology ; Universities ; *Emotions ; COVID-19/psychology/epidemiology ; *Feeding Behavior/psychology ; Quality of Life ; *Eating/psychology ; Mental Health ; Anxiety/psychology ; Stress, Psychological/psychology ; SARS-CoV-2 ; Depression/psychology ; Emotional Eating ; }, abstract = {BACKGROUND/OBJECTIVES: Emotional eating has been considered as a trend to consume energy concentrated and tasty foods in response to adverse emotions. Emotional eating may harmfully influence physical and mental health among university students, worsening their daily quality of life and their academic performance. The aim of the present study is to critically summarize and analyze the currently available clinical data concerning the impact of emotional eating among university students.

METHODS: Comprehensive exploration of the currently available scientific literature was performed in the most precise scientific databases, utilizing relevant and representative keywords.

RESULTS: More than a few interrelationships were found between emotional eating and body mass index, physical activity, depression, anxiety, stress, social media overuse, nutritional behaviors, and COVID-19 lockdown concerning university students.

CONCLUSIONS: The currently available clinical studies support evidence that there are significant intercorrelations between emotional eating and several aspects of physical and mental health of university students. However, most of them have a cross-sectional design that cannot establish causality effects. In this respect, prospective surveys are strongly required to delineate the impact of emotional eating in the daily life of university students.}, } @article {pmid40406976, year = {2025}, author = {Agyei-Manu, E and Atkins, N and Nundy, M and St-Jean, C and Gornall-Wick, A and Birley, E and De Silva, U and Krishan, P and Vokey, L and Dozier, MF and McSwiggan, E and McQuillan, R and Theodoratou, E and Shi, T and , }, title = {Characteristics of influenza, SARS-CoV-2, and RSV surveillance systems that utilise ICD-coded data: a systematic review.}, journal = {Journal of global health}, volume = {15}, number = {}, pages = {04177}, pmid = {40406976}, issn = {2047-2986}, mesh = {Humans ; *COVID-19/epidemiology ; *Influenza, Human/epidemiology ; *International Classification of Diseases ; *Respiratory Syncytial Virus Infections/epidemiology ; *Population Surveillance/methods ; Global Health ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Some surveillance systems for influenza, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and respiratory syncytial virus (RSV) utilise International Classification of Diseases (ICD)-coded data and are useful for analysing trends and enhancing quick, evidence-based decisions against the epidemic potential that threatens global health security. With variations in the design of systems globally, the World Health Organization requested a systematic review to identify key characteristics of influenza, SARS-CoV-2, and RSV surveillance systems that utilise ICD-coded data, and to assess their performance.

METHODS: We searched EMBASE, MEDLINE, and Global Health to identify relevant studies reporting on influenza, SARS-CoV-2, and RSV surveillance systems that use ICD-coded data. We independently assessed studies for the ICD codes used, their statistical estimates and limitations. We appraised included studies using Joana Briggs Institute's critical appraisal tools and synthesised using narrative synthesis.

RESULTS: We identified 77 studies, reporting on 71 surveillance systems - 33 systems recorded surveillance data only, 15 systems recorded burden of disease data only, and 23 systems recorded both surveillance and burden of disease data. Surveillance systems utilised ICD-10 codes (75%), ICD-9 codes (22%), or both (3%). ICD-10 codes J09 and J10 were frequently used for influenza, U07.1 for COVID-19, and B97.4, J12.1, J20.5, and J21.0 for RSV. ICD-9 codes 487 and 488 were mostly used for influenza, and codes 466.11 and 480.1 for RSV. ICD-10 codes had low-to-moderate sensitivity (6.60-79.87%) and high specificity (97.40-99.72%) for influenza, low-to-high sensitivity (30.00-98.4%) and specificity (39.50-99.80%) for COVID-19, and low-to-high sensitivity (6.00-99.80%) and specificity (12.10-100.00%) for RSV. ICD-9 codes had low sensitivity (45.60%) and high specificity (97.90%) for influenza. Underestimation of infections or mortality attributable to influenza, SARS-CoV-2, or RSV is a major limitation to using ICD-coded data across surveillance systems.

CONCLUSIONS: The performance of ICD codes for syndromic- or disease-specific surveillance remains inconclusive, although using only ICD-coded data within these systems may underestimate influenza, SARS-CoV-2, or RSV-attributable morbidity and mortality. Future studies should assess the accuracy of ICD code combinations for surveillance of influenza, SARS-CoV-2, and RSV.}, } @article {pmid40406515, year = {2025}, author = {Muñoz-Carrillo, JL and Palomeque-Molina, PI and Villacis-Valencia, MS and Gutiérrez-Coronado, O and Chávez-Ruvalcaba, F and Vázquez-Alcaraz, SJ and Villalobos-Gutiérrez, PT and Palomeque-Molina, J}, title = {Relationship between periodontitis, type 2 diabetes mellitus and COVID-19 disease: a narrative review.}, journal = {Frontiers in cellular and infection microbiology}, volume = {15}, number = {}, pages = {1527217}, pmid = {40406515}, issn = {2235-2988}, mesh = {Humans ; *Diabetes Mellitus, Type 2/complications/epidemiology ; *COVID-19/epidemiology/complications/immunology ; *Periodontitis/complications/epidemiology ; Comorbidity ; SARS-CoV-2 ; Inflammation ; }, abstract = {Inflammation plays a fundamental role in the development and bidirectional association of di-verse diseases, such as periodontitis and type 2 diabetes mellitus (T2DM), which generates important clinical complications, where chronic exposure to high levels of blood glucose affects the repair process of periodontal tissues. Likewise, it has been observed that comorbidity, between these two diseases, influences the development of the COVID-19 disease towards a more severe course. However, there is currently very little scientific evidence on the relationship between periodontitis, T2DM and COVID-19 disease. This narrative review aims to provide an understanding of the current and most relevant aspects of the relationship between periodontitis, T2DM and COVID-19 disease. A narrative review was performed through a systematic search of published studies, without date restrictions, indexed in the electronic databases of PubMed, for the inclusion of articles in English, and LILACS for the inclusion of articles in Spanish. This review included different articles, which addressed the most important aspects to present a current perspective on the relationship and influence between periodontitis, T2DM and COVID-19 disease. Comorbidity between periodontitis and T2DM represents a greater risk of developing a more severe course of COVID-19 disease, because these three diseases share three important axes: a clinicopathological axis; an axis associated with glycemia, and an immunological axis associated with inflammation.}, } @article {pmid40406494, year = {2025}, author = {Yin, C and Xu, M and Zong, Z}, title = {Advances in the prevalence and treatment of depression for adolescents: a review.}, journal = {Frontiers in pharmacology}, volume = {16}, number = {}, pages = {1574574}, pmid = {40406494}, issn = {1663-9812}, abstract = {BACKGROUND: Depression is a psychological condition in adolescents caused by various factors. Many serious consequences can be associated with depression, such as irritability, emotional instability, and suicide. Meanwhile, the incidence of depression and suicide among adolescents was also affected during the pandemic of COVID-19 in 2019. This phenomenon of adolescent depression should be drawn extensive concern by the community, which affects their physical and mental health.

MAIN BODY: This review describes the epidemiology, high-risk factors, and treatment of adolescent depression. The onset of depression is probably attributable to preterm birth, growth environment, genetic. We also identify that the COVID-19 pandemic, initiated in late 2019,affects adolescent mental health. Antidepressants and psychotherapy are conventional treatments for depressive disorders. However, it is controversial whether antidepressants are as effective and safer as psychotherapy, and a combination of the two could provide more benefit to this population than antidepressants alone. We also summarize some antidepressants developed for novel targets. Improving the efficacy and safety of treatment to reduce the suicide rate among adolescents is the primary goal of clinical research. Existing treatment modalities and drugs are not sufficient to achieve clinical demands, so that new therapeutic targets will be promising for such patients.

CONCLUSION: A variety of factors can contribute to depression in adolescents. Adolescent depression should be mainly treated with non-pharmacological. A combination of guideline-recommended antidepressants should be used if uncontrolled with non-pharmacological, but adverse drug reactions and suicidal ideation should be closely monitored.}, } @article {pmid40406131, year = {2025}, author = {El Arab, RA and Alkhunaizi, M and Alhashem, YN and Al Khatib, A and Bubsheet, M and Hassanein, S}, title = {Artificial intelligence in vaccine research and development: an umbrella review.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1567116}, pmid = {40406131}, issn = {1664-3224}, mesh = {Humans ; *Artificial Intelligence ; *COVID-19 Vaccines/immunology ; *Vaccine Development/methods ; *COVID-19/prevention & control/immunology ; *SARS-CoV-2/immunology ; Vaccinology/methods ; }, abstract = {BACKGROUND: The rapid development of COVID-19 vaccines highlighted the transformative potential of artificial intelligence (AI) in modern vaccinology, accelerating timelines from years to months. Nevertheless, the specific roles and effectiveness of AI in accelerating and enhancing vaccine research, development, distribution, and acceptance remain dispersed across various reviews, underscoring the need for a unified synthesis.

METHODS: We conducted an umbrella review to consolidate evidence on AI's contributions to vaccine discovery, optimization, clinical testing, supply-chain logistics, and public acceptance. Five databases were systematically searched up to January 2025 for systematic, scoping, narrative, and rapid reviews, as well as meta-analyses explicitly focusing on AI in vaccine contexts. Quality assessments were performed using the ROBIS and AMSTAR 2 tools to evaluate risk of bias and methodological rigor.

RESULTS: Among the 27 reviews, traditional machine learning approaches-random forests, support vector machines, gradient boosting, and logistic regression-dominated tasks from antigen discovery and epitope prediction to supply‑chain optimization. Deep learning architectures, including convolutional and recurrent neural networks, generative adversarial networks, and variational autoencoders, proved instrumental in multiepitope vaccine design and adaptive clinical trial simulations. AI‑driven multi‑omic integration accelerated epitope mapping, shrinking discovery timelines by months, while predictive analytics optimized manufacturing workflows and supply‑chain operations (including temperature‑controlled, "cold‑chain" logistics). Sentiment analysis and conversational AI tools demonstrated promising capabilities for real‑time monitoring of public attitudes and tailored communication to address vaccine hesitancy. Nonetheless, persistent challenges emerged-data heterogeneity, algorithmic bias, limited regulatory frameworks, and ethical concerns over transparency and equity.

DISCUSSION AND IMPLICATIONS: These findings illustrate AI's transformative potential across the vaccine lifecycle but underscore that translating promise into practice demands five targeted action areas: robust data governance and multi‑omics consortia to harmonize and share high‑quality datasets; comprehensive regulatory and ethical frameworks featuring transparent model explainability, standardized performance metrics, and interdisciplinary ethics committees for ongoing oversight; the adoption of adaptive trial designs and manufacturing simulations that enable real‑time safety monitoring and in silico process modeling; AI‑enhanced public engagement strategies-such as routinely audited chatbots, real‑time sentiment dashboards, and culturally tailored messaging-to mitigate vaccine hesitancy; and a concerted focus on global equity and pandemic preparedness through capacity building, digital infrastructure expansion, routine bias audits, and sustained funding in low‑resource settings.

CONCLUSION: This umbrella review confirms AI's pivotal role in accelerating vaccine development, enhancing efficacy and safety, and bolstering public acceptance. Realizing these benefits requires not only investments in infrastructure and stakeholder engagement but also transparent model documentation, interdisciplinary ethics oversight, and routine algorithmic bias audits. Moreover, bridging the gap from in silico promise to real‑world impact demands large‑scale validation studies and methods that can accommodate heterogeneous evidence, ensuring AI‑driven innovations deliver equitable global health outcomes and reinforce pandemic preparedness.}, } @article {pmid40406115, year = {2025}, author = {Tscherne, A and Guardado-Calvo, P and Clark, JJ and Krause, R and Krammer, F}, title = {Puumala orthohantavirus: prevalence, biology, disease, animal models and recent advances in therapeutics development and structural biology.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1575112}, pmid = {40406115}, issn = {1664-3224}, mesh = {Animals ; *Puumala virus/immunology/physiology ; Humans ; *Hemorrhagic Fever with Renal Syndrome/epidemiology/virology/therapy/immunology ; Disease Models, Animal ; Prevalence ; Antiviral Agents/therapeutic use ; Viral Vaccines/immunology ; }, abstract = {Puumala orthohantavirus (PUUV) is an emerging zoonotic virus that was first discovered in the Puumala region of Finland in the early 1980s and is the primary etiological agent of nephropathia epidemica (NE), a milder form of a life-threatening disease known as hemorrhagic fever with renal syndrome (HFRS). PUUV and other members of the Old World hantaviruses (OWHVs) predominantly circulate in rodents or insectivores across Eurasia, accounting for several thousand of reported HFRS cases every year (with many more unreported/misdiagnosed cases suspected). The rodent reservoir of PUUV is the common bank vole (Myodes (M.) glareolus), and transmission of the virus to humans occurs via inhalation of contagious aerosols and through contact with contaminated droppings or urine. Although PUUV is the subject of extensive research, due to its potential to cause severe disease outcomes in humans and its considerable economic and social impact, neither licensed vaccines nor specific antiviral treatments are available against PUUV. However, many important advancements have been made in terms of PUUV research over the last years. This included the elucidation of its glycoproteins, the discovery of broadly neutralizing hantavirus antibodies as therapeutic candidates and expanded research on the mRNA vaccine technology which will likely enable the development of strong PUUV vaccine candidates in the near future. Currently, there is still a lack of suitable animal models for the preclinical evaluation of experimental vaccines and antivirals, which hampers vaccine and antiviral development. Current attempts to decrease hantavirus-associated human infections rely primarily on prevention and countermeasures for rodent control, including reduced contact to droppings, saliva and urine, and disinfection of areas that are contaminated with rodent excreta. Here, we review these recent advances and other aspects including PUUV prevalence, virus biology, diagnosis and clinical features, and current animal models for vaccine and treatment development.}, } @article {pmid40406036, year = {2025}, author = {Nwaudo, D and Egbe, S and Litvak, A and Strelzow, J}, title = {Impact of Transitioning to a Level 1 Trauma Center on Orthopaedic Surgical Volume and Resident Education: Case Report in Orthopaedic Education.}, journal = {JB & JS open access}, volume = {10}, number = {2}, pages = {}, pmid = {40406036}, issn = {2472-7245}, abstract = {BACKGROUND: Orthopaedic residents are required to complete at least 1,000 surgical cases over their 5-year training, including specific procedural categories mandated by the Accreditation Council for Graduate Medical Education (ACGME). This study evaluates the effects of upgrading a major academic center to an adult Level 1 trauma center (L1TC) on orthopaedic case volume, complexity, and residents' training experience. In 2018, our institution transitioned from a Level 3 to a L1TC. We retrospectively analyzed surgical records and resident case logs spanning from 2013 to 2023.

METHODS: ACGME case logs and electronic medical records (EMRs) from a single urban institution were reviewed from July 2013 to June 2023. Data were divided into pre-L1TC (2013-2018) and post-L1TC (2018-2023) periods. Trauma cases were defined by ACGME Current Procedural Terminology (CPT) codes in the "fracture/dislocation" and "manipulation" categories and further identified by criteria such as treatment by orthopaedic trauma surgeons, emergent scheduling, or occurrence on weekends or holidays. All other cases were categorized as elective. Linear regression analyses assessed trends in case volumes over time.

RESULTS: Total ACGME cases logged ranged from 6,172 in 2015 to 10,541 in 2018, without a significant trend over time (p = 0.17). Trauma logs increased significantly post-L1TC (p < 0.001), with an average of 2,586 (31% of all cases) compared with 1,467 (22%) pre-L1TC. Trauma case volume saw a near 12-fold increase post-L1TC (p < 0.001). Elective cases remained stable (p = 0.48) but decreased significantly during the COVID-19 pandemic (p = 0.0035).

CONCLUSIONS: The shift to L1TC status significantly boosted trauma case exposure for residents without an observed displacement of elective cases in favor of trauma cases. Elective cases declined during the pandemic, emphasizing the role of L1TC access in sustaining training. Future studies should investigate the impact of the L1TC experience on early career proficiency in orthopaedic practice. These findings underscore the value of trauma center access in resident training and support further exploration into optimizing orthopaedic education.

LEVEL OF EVIDENCE: Level V, Case report. See Instructions for Authors for a complete description of levels of evidence.}, } @article {pmid40405833, year = {2025}, author = {Phuong, NTT and Nguyen, HA and Trinh, TND and Trinh, KTL}, title = {A gold nanoparticle-based colorimetric strategy for DNA detection: principles and novel approaches.}, journal = {Analytical methods : advancing methods and applications}, volume = {17}, number = {22}, pages = {4496-4509}, doi = {10.1039/d5ay00148j}, pmid = {40405833}, issn = {1759-9679}, mesh = {*Gold/chemistry ; *Metal Nanoparticles/chemistry ; *Colorimetry/methods ; Humans ; COVID-19/diagnosis/virology ; SARS-CoV-2/isolation & purification/genetics ; Surface Plasmon Resonance/methods ; *Biosensing Techniques/methods ; *DNA/analysis ; *DNA, Viral/analysis ; }, abstract = {The development of nanotechnology has led to the rapid growth of many different fields, including sensors. Bulky and complex sensor systems are gradually being replaced by streamlined sensor devices with advantages in size, simplicity, cost-effectiveness, and fast response, allowing qualitative detection of target analyte on-site application for clinical diagnosis. Significantly, since the COVID-19 pandemic, research on developing test kits for detecting biological molecules has grown rapidly, with an increasing number of publications. The number of studies developing colorimetric sensors based on gold nanoparticles (AuNPs) has increased continuously over the years, demonstrating the potential application of this material. The surface plasmon resonance (SPR) effect and high biocompatibility of AuNPs make them different from many other metal nanomaterials. In addition, the peroxidase activity properties of AuNPs have also received much attention in colorimetric sensors. In this review, the colorimetric sensors developed based on the AuNP material platform for DNA detection will be discussed in detail. Among them, the commonly used synthesis methods of AuNPs based on their applications and the primary mechanism of AuNP-based colorimetric sensors for DNA detection will be discussed. In addition, AuNP-based colorimetric applications in POCT for pathogenic bacteria and viruses are also mentioned in this review to provide a broader perspective on the potential and developmental direction of AuNP-based colorimetric sensors. Another aspect this review provides is development strategies that allow simple readout using the naked eye, a spectrophotometer, or a smartphone camera, which present many opportunities for integration into other electronic devices.}, } @article {pmid40405557, year = {2025}, author = {Gasmi, M and Hejazi, M and Muscella, A and Marsigliante, S and Sharma, A}, title = {Aging-associated changes in immunological parameters: Implications for COVID-19 immune response in the elderly.}, journal = {Physiological reports}, volume = {13}, number = {10}, pages = {e70364}, pmid = {40405557}, issn = {2051-817X}, mesh = {Humans ; *COVID-19/immunology ; *Aging/immunology ; Aged ; *Immunosenescence ; Immunity, Innate ; SARS-CoV-2/immunology ; Cytokines/immunology ; }, abstract = {Aging has a profound impact on the immune system, leading to a gradual decline in its function and increased systemic inflammation, collectively known as immunosenescence and inflammaging. These changes make older adults more susceptible to infections, including COVID-19, and contribute to worse clinical outcomes, such as higher morbidity and mortality rates. This review explores immunological changes associated with aging, including impaired innate immune responses, reduced T- and B-cell function, and altered cytokine profiles. A comprehensive literature search identified relevant studies on the topic, and inclusion criteria focused on studies addressing age-related immune changes and their impact on responses to COVID-19. The findings underscore the need for targeted healthcare strategies to mitigate the negative effects of aging on immunity and improve immune resilience, and ultimately clinical outcomes and quality of life for this vulnerable population.}, } @article {pmid40405251, year = {2025}, author = {Lüdecke, LT and Ekman, B and Arunda, MO and Bulamba, R and Daama, A and Ekström, AM and Kyasanku, E and Larsson, EC and Nkale, J and Sundewall, J}, title = {Effects of COVID-19 lockdowns on unintended pregnancies among adolescent girls and young women in low- and middle-income countries: a scoping review.}, journal = {Reproductive health}, volume = {22}, number = {1}, pages = {89}, pmid = {40405251}, issn = {1742-4755}, mesh = {Humans ; Female ; *COVID-19/epidemiology/prevention & control ; Adolescent ; Pregnancy ; *Pregnancy, Unplanned ; Developing Countries ; Young Adult ; SARS-CoV-2 ; Child ; *Pregnancy in Adolescence ; }, abstract = {BACKGROUND: The response to the COVID-19 pandemic involved various lockdown measures, including school closures, which significantly impacted young populations, particularly in low-and middle-income countries (LMICs). Given the well-known protective effect of regular school attendance on sexual and reproductive health and rights (SRHR), reports of disrupted education, compromised SRHR, and an increase in unintended pregnancies among adolescent girls and young women (AGYW 10-24 years) have caused major concerns. We conducted a scoping review to compile the available evidence of the impact of COVID-19 lockdown measures on unintended pregnancies among AGYW aged 10-24 in LMICs.

METHODS: The scoping review followed the five-stage framework by Arksey and O´Malley. A systematic search on two comprehensive databases, using search terms related to COVID-19 and unintended pregnancies, was conducted along with grey literature searches of articles in English language published between 2019 and 2024. The systematic review software Covidence was used for publication screening, selection and data extraction.

RESULTS: After deduplication, 241 publications were screened, and 72 full-text publications were assessed for eligibility. 13 publications from the database searches, citation searching and grey literature, were included. The scoping review included seven studies that applied quantitative methods, four that used qualitative approaches and the remaining two mixed methods. Five out of 13 publications were set in Uganda, two in Kenya and two in Nigeria, while six other countries were represented once. All included studies reported increases in pregnancies among AGYW during the COVID-19 period. School dropout among girls following a pregnancy was reported to have increased. Factors associated with unintended pregnancy were school closures, limited access to SRHR services including contraceptives, and increasing sexual encounters.

CONCLUSION: School closures and other lockdown measures during the COVID-19 pandemic led to an increase in unintended pregnancies among AGYW in LMICs. The long-term consequences for these young individuals, their communities and to the broader society are still to be measured and available evidence is limited, few studies have applied robust study designs, and several relied on small sample sizes. Further research is needed to build a stronger evidence base for health and socio-economic impacts of school closures and lockdowns among young people.}, } @article {pmid40405221, year = {2025}, author = {Gabriel, KMA and Schröder, C and Wolf, R and Bolm-Audorff, U and Kienast, C and Smolinska, J and Petereit-Haack, G and Seidler, A}, title = {SARS-CoV-2 infection risk by non-healthcare occupations: a systematic review and meta-analysis.}, journal = {Journal of occupational medicine and toxicology (London, England)}, volume = {20}, number = {1}, pages = {17}, pmid = {40405221}, issn = {1745-6673}, abstract = {BACKGROUND: During the COVID-19 pandemic, several industries were deemed essential. However, information on infection risk in occupational settings outside of healthcare workers and medical staff (HCWs) remain scarce. Thus, a systematic review with meta-analysis was conducted to compile the risk of infection to SARS-CoV-2 in non-healthcare workers (non-HCWs).

METHODS: We screened three databases (EMBASE, PubMed, medRχiv) for studies on SARS-CoV-2 infection risk in working population. Several stages of severity (infection, hospitalisation, admission to intensive care unit (ICU), mortality) were eligible. Occupational specifications were harmonised according to the German classification of professions (KldB). All reported risk estimators were considered. Studies were analysed for their risk of bias. Results of random-effects meta-analyses were assessed for their evidence according to GRADE. Subgroup analyses were run for 'outcome', 'comparison group', and 'risk of bias'.

RESULTS: Of 9,081 publications identified, 25 were recognised as eligible, mainly describing the first year of the pandemic. For 20 occupations, we were able to carry out meta-analyses on KldB-4-level by integrating all stages of severity. Nine occupations were identified with a statistically significantly increased risk of infection for SARS-CoV-2, four of which had a relative risk (RR) of > 2: Occupations in meat processing (RR = 3.58 [95%-CI 1.46; 8.77]), occupations in building cleaning services (RR = 2.55 [95%-CI 1.51; 4.31]), occupations in cargo handling (RR = 2.52 [95%-CI 2.27; 2.79]) and cooks (RR = 2.53 [95%-CI 1.75; 3.67]). The certainty of evidence of eight results was found moderate or high.

CONCLUSIONS: The first systematic review and meta-analysis of occupational SARS-CoV-2 infection risk in occupations other than HCWs revealed a considerably elevated risk in individual related services as well as in commercial services.

TRIAL REGISTRATION: PROSPERO CRD42021297572.}, } @article {pmid40405092, year = {2025}, author = {Seo, YB and Choi, YJ and Seo, JW and Kim, EJ and Lee, J and Song, JY}, title = {Therapeutic options for the treatment of post-acute sequelae of COVID-19: a scoping review.}, journal = {BMC infectious diseases}, volume = {25}, number = {1}, pages = {731}, pmid = {40405092}, issn = {1471-2334}, support = {HD22C2045//Korea Health Industry Development Institute/Republic of Korea ; }, mesh = {Humans ; Antiviral Agents/therapeutic use ; *COVID-19/complications/therapy ; *COVID-19 Drug Treatment ; Hyperbaric Oxygenation ; *Post-Acute COVID-19 Syndrome/therapy ; }, abstract = {OBJECTIVES: This scoping review aimed to summarize the available studies to address the question of which therapeutic agents can be utilized for patients with post-acute sequelae of COVID-19 (PASC).

METHODS: We conducted a systematic search in medical databases, including PubMed and Embase, for studies aligned with our objectives published between January 1, 2020, and July 22, 2024. For each study, we summarized the main symptoms targeted, study design, therapeutic regimens, evaluation tools, and clinical outcomes.

RESULTS: A total of 413 studies were identified, and 39 studies were included in this review based on relevance to the research objectives. We primarily focused on high-level evidence studies, such as meta-analyses and randomized controlled trials, but observational studies were included when evidence was scarce. Therapeutic agents evaluated included hyperbaric oxygen, ivermectin, metformin, naltrexone, micronutrient supplements, antifibrotic agents, antiviral agents, and selective serotonin reuptake inhibitors (SSRIs). Among these, hyperbaric oxygen, antifibrotic agents, antiviral agents, and SSRIs demonstrated promising results. However, the heterogeneity of PASC symptoms posed challenges in synthesizing findings for specific symptom-based outcomes.

CONCLUSION: Given the heterogeneity of symptoms, this review highlights the need for standardized and targeted research to better address the diverse therapeutic needs of patients with PASC.

CLINICAL TRIAL: Not applicable.}, } @article {pmid40404571, year = {2025}, author = {Pagani, W and Buysse, T and Dua, KS}, title = {Digital platforms, virtual reality, and augmented reality in gastrointestinal endoscopy training.}, journal = {Clinical endoscopy}, volume = {58}, number = {5}, pages = {653-661}, doi = {10.5946/ce.2024.354}, pmid = {40404571}, issn = {2234-2400}, abstract = {Remote training in procedural tasks has experienced robust growth in recent years, spurred by the coronavirus disease 2019 pandemic to meet the need for basic and continued skills development, including in gastrointestinal endoscopy. Remote endoscopy training offers learners the opportunity for skill acquisition, real-time feedback, and access to experts from around the world, and gives mentors the ability to educate trainees without the need to travel themselves. Remote training can be cost-effective but requires reliable technology and continuous assessment to ensure training quality. Ethical and legal issues related to patient safety may also exist. Training using virtual or augmented reality, on the other hand, does not involve patients and, hence, has no patient safety, legal, or ethical issues. Multiple endoscopic scenarios, from basic to advanced, can be practiced multiple times with immediate feedback on performance. These innovations are expected to not only increase individual endoscopy skills but also expand access to specialized care in remote areas, either in the same country or in underserved regions of the world. This review describes various techniques in remote endoscopy training with associated advantages and drawbacks and analyzes research outcomes on the effectiveness of remote endoscopy training.}, } @article {pmid40402473, year = {2025}, author = {de Andrade, ML and do Monte, AL and Gerage, AM and Galliano, LM and Costa, EC and Ritti Dias, RM and Corrêa, FI}, title = {Effects of Physical Exercise on Functional Physical Performance in Individuals With Long COVID: A Systematic Review.}, journal = {Journal of cardiopulmonary rehabilitation and prevention}, volume = {45}, number = {4}, pages = {239-246}, pmid = {40402473}, issn = {1932-751X}, mesh = {Humans ; *COVID-19/rehabilitation/physiopathology/complications/psychology ; *Physical Functional Performance ; Quality of Life ; *Exercise Therapy/methods ; *Exercise/physiology ; SARS-CoV-2 ; Cardiorespiratory Fitness ; Post-Acute COVID-19 Syndrome ; }, abstract = {PURPOSE: To analyze the effect of physical exercise on functional parameters in individuals with long coronavirus disease-2019 (COVID-19).

REVIEW METHODS: A search in MEDLINE, EMBASE, Web of Science, Scielo, and EBSCO was carried out in October 2022, and it was updated in June 2024. For inclusion, studies should have involved physical training without pulmonary rehabilitation, have involved individuals who had long COVID-19, and were prospective trials, clinical trials, or controlled trials. Two reviewers independently performed data extraction and assessed the risk of bias. Seven studies were reviewed, three of high methodological quality. Participants with long COVID-19 were hospitalized in two studies. Interventions lasted 2 to 16 weeks, with frequencies of 2 to 7 days per week, often involving resistance exercise. Strength improved in 67% of studies, cardiorespiratory fitness in 50%, and agility/mobility in 60%. Anxiety improved in 25% of studies, while depression improved in 75%. Quality of life improved across all studies, with dyspnea and fatigue improving in 40% and 80%, respectively.

SUMMARY: Results suggest potential benefits of exercise training for subjects with long COVID-19 in several outcomes, mainly in functional capacity, depression symptoms, quality of life, and fatigue.}, } @article {pmid40402366, year = {2025}, author = {Ramzan, N and Butt, H and Azeem, M and Hanif, M and Mahmood, K and Rehman, S and Shahwar, D and Zeeshan, M and Ahmad, QU and Jabeen, M}, title = {Therapeutic applications of quercetin-metallic complexes: a review.}, journal = {Biometals : an international journal on the role of metal ions in biology, biochemistry, and medicine}, volume = {38}, number = {4}, pages = {1027-1048}, doi = {10.1007/s10534-025-00696-4}, pmid = {40402366}, issn = {1572-8773}, mesh = {*Quercetin/chemistry/therapeutic use/pharmacology ; Humans ; *Coordination Complexes/chemistry/therapeutic use/pharmacology ; Copper/chemistry ; COVID-19 Drug Treatment ; Animals ; Zinc/chemistry ; SARS-CoV-2/drug effects ; COVID-19 ; Antioxidants/chemistry/therapeutic use ; Antineoplastic Agents/chemistry/therapeutic use/pharmacology ; Iron/chemistry ; }, abstract = {Flavonoids, especially quercetin, are widely recognized for their antioxidant, anti-inflammatory, anti-microbial, anti-diabetic, and anti-tumor properties, but their clinical application is limited by poor permeability. Different techniques of permeability enhancement of quercetin, i.e., preparation of phytosomes, conjugation with glucose, and interaction of piperine, are reported extensively, but formation of metal complexes is considered more precise and reliable. This review focuses on research conducted on the chelation of quercetin with metals, i.e., copper (II), zinc (II), iron and ruthenium. In-vitro and in-vivo therapeutic activities, biomedical applications of metal/quercetin inclusion complexes and discussions of stability concerns of quercetin alone and its metallic complexes. Conjugation of metals with quercetin augments its potential to the next level. Numerous studies revealed that quercetin/copper (Q/Cu) and quercetin/zinc (Q/Zn) can become efficacious candidates in acute myeloid leukaemia, orthopaedics and severe acute respiratory syndrome coronavirus (SARS-CoV) infection.}, } @article {pmid40402311, year = {2025}, author = {Omidi, A and Zolfaghari, A and Mirab, SM and Bafghi, MH and Khosravi, M and Safdari, F and Shirani, K}, title = {Mapping the complexity of multiple sclerosis: a novel perspective on genetic, environmental, and neurobiological insights.}, journal = {Molecular biology reports}, volume = {52}, number = {1}, pages = {484}, pmid = {40402311}, issn = {1573-4978}, mesh = {Humans ; *Multiple Sclerosis/genetics/etiology/pathology ; Risk Factors ; Blood-Brain Barrier/metabolism ; COVID-19/complications ; Genetic Predisposition to Disease ; Dysbiosis/complications ; }, abstract = {Multiple sclerosis (MS) is the most common chronic demyelinating disease of the central nervous system (CNS) that mainly affects young adults. MS is a neuroinflammatory disease traditionally classified as an autoimmune disorder; however, its exact cause remains unknown. A wide variety of etiology and risk factors have been proposed to contribute, among which genetics and environment are the leading ones. The heterogeneity of MS can be attributed to a variety of factors, including diverse pathobiological mechanisms. In this narrative review, before discussing the most prevalent etiologies of MS and risk factors, we look at the main neurobiological pathways, blood-brain barrier (BBB) breakdown, and glymphatic system dysfunction. Several intrinsic factors, including genetics and epigenetic implications, hormones, immune system dysregulation, age, and microbiome, have definite roles in developing and worsening MS severity. However, external factors like viruses, bacteria, bioclimate impacts, environmental toxins, lifestyle factors, stress, and psychological factors revealed different or controversial impacts on MS disease. On the other hand, some nascent ones, such as intestinal dysbiosis and COVID-19, need to be further experimentally and clinically investigated. Both may contribute to MS by promoting inflammation and triggering autoimmune responses. Although it assumes that more than one factor contributes to MS development, finding the leading underlying cause and, consequently, the probable involvement mechanisms certainly could help take appropriate, efficient, and personalized therapeutic strategies.}, } @article {pmid40402161, year = {2025}, author = {Zambianchi, JK and Benegra, M}, title = {GABAergic receptors and essential oils in anxiety and depression: a scientometric analysis.}, journal = {Natural product research}, volume = {}, number = {}, pages = {1-12}, doi = {10.1080/14786419.2025.2505610}, pmid = {40402161}, issn = {1478-6427}, abstract = {This review aims to map and analyse scientific production on the effect of essential oils and their isolated compounds on GABAergic receptors with a focus on the treatment of anxiety and depression. Publications were selected from the Web of Science following the PRISMA guidelines from October 1945 to March 2024. Analysis of publication trends, geographic distribution, keywords, and influential articles was carried out using the CiteSpace and Bibliometrix tools. The results indicate that research on the topic is a recent trend, with only eight articles published before 2003 and a significant increase in publications during the SARS-CoV-2 pandemic. The main areas of interest were Medicinal Chemistry, Plant Sciences, and Integrative and Complementary Medicine, with Brazil and China leading the publications. The study also highlights a growing interest in scientifically validating natural therapies for safer and more effective treatment options.}, } @article {pmid40402076, year = {2025}, author = {Kohake, K and Henning, L and Dahl, S and Neuber, N and Dreiskämper, D}, title = {Associations between physical activity and health-related factors in childhood and adolescence during COVID-19 pandemic: A systematic review.}, journal = {Journal of sports sciences}, volume = {43}, number = {15}, pages = {1499-1522}, doi = {10.1080/02640414.2025.2508041}, pmid = {40402076}, issn = {1466-447X}, mesh = {Humans ; *COVID-19/epidemiology ; Child ; Adolescent ; *Exercise/psychology ; Screen Time ; Mental Health ; *Health Behavior ; Sleep ; Pandemics ; *Health Status ; }, abstract = {Today, there is clear evidence that the restrictions of the COVID-19 pandemic influenced not only the physical activity (PA) behaviour of children and adolescents but also different health parameters. This study aimed at analysing the relationship between PA and health in children and adolescents during the COVID-19 pandemic. A systematic review in accordance with PRISMA was conducted. In April 2022, studies were searched for in nine electronic databases. Overall, 58 papers investigating more than 80,000 children and adolescents from 26 countries met full inclusion criteria. Studies examined the associations between PA and psychological health (n = 45), physical health (n = 13), social health (n = 12), general health (n = 1), and health-related habits (i.e. sleep, nutrition, screen time; n = 17). Most studies demonstrated strong evidence for relationships between PA and psychological health. Mostly positive correlations also emerged regarding the relation of PA and physical as well as social health. PA is also associated with other health-related behaviours, with screen time having an exceptional role during the pandemic. This review indicates that PA and health are associated largely even during the changed conditions of the COVID-19 pandemic. Future studies are needed that focus on the causality of these relationship between PA and health by including studies with longitudinal designs.}, } @article {pmid40401810, year = {2025}, author = {Mora, AC and Mace, CR}, title = {Standardization of Microsampling Technologies for Accurate Sensing and Reliable Diagnostics.}, journal = {ACS sensors}, volume = {10}, number = {6}, pages = {3795-3805}, doi = {10.1021/acssensors.5c00667}, pmid = {40401810}, issn = {2379-3694}, mesh = {Humans ; *COVID-19/diagnosis/virology ; SARS-CoV-2/isolation & purification ; *Specimen Handling/standards/methods ; *COVID-19 Testing/methods ; Point-of-Care Systems ; *Blood Specimen Collection/standards/methods ; }, abstract = {The COVID-19 pandemic demonstrated the debilitating effect of overreliance on centralized sampling and testing, and generated significant momentum to investigate and validate sample types that are alternatives to the gold standard (e.g., anterior nasal vs nasopharyngeal swabs). As a result, sample collection is trending away from traditional methods at centralized health care facilities and toward at-home or point-of-care settings with devices that enable self-collection. With shifts away from regulated environments and trained personnel, it is important to remember that reliable measurements begin with standardized sample collection. To develop microsampling technologies for applications where the outcome can impact health care decisions, it is critical to (i) fully understand the sample collected (e.g., volume, composition, biological factors) and (ii) implement engineering controls for users and clinical workflow integration (e.g., usability, volume metering) to ensure precision and accuracy of a measurement. Blood sampling, once exclusively performed via venipuncture, has made the greatest strides toward remote collection with the introduction of lancet- and microneedle-based, capillary microsampling devices. However, challenges remain toward standardizing these methods, such as ensuring that measurements are hematocrit-independent. Other sample types (e.g., nasal fluid, saliva) face similar hurdles. In this Perspective, we review the current state of self-collection microsampling technologies and highlight the need to develop tools that can (i) standardize sample collection and (ii) seamlessly integrate with current clinical workflows. Ultimately, we advocate for continued innovation as technologies that support self-collection have the potential to greatly improve the diagnostic process for patients, reduce the burden on health care workers, and advance the shift toward decentralized testing.}, } @article {pmid40401130, year = {2025}, author = {Ray, H and Khatum, J and Haldar, S and Bhowmik, P}, title = {Second brain: reviewing the gut microbiome's role in lifestyle diseases.}, journal = {Biotechnologia}, volume = {106}, number = {1}, pages = {103-122}, pmid = {40401130}, issn = {2353-9461}, abstract = {The recent COVID-19 pandemic has highlighted another silent pandemic: lifestyle diseases. Conditions, such as cardiovascular diseases, anxiety, and type 2 diabetes (T2D), are increasingly becoming public health threats, affecting even younger populations worldwide. In recent years, extensive research has uncovered the pivotal role of the human gut microbiome in various aspects of human physiology, including metabolism, cellular homeostasis, immune defense, and disease development. The gut microbiome, often referred to as the "second brain," is now recognized as a key player in health and disease. Lifestyle factors such as diet, mental health, stress, exercise, and others significantly influence the composition of the gut microbiome. Imbalances in this composition, termed "dysbiosis," have been linked to a wide range of diseases, including cancer, cardiovascular diseases, obesity, T2D, asthma, and neurological disorders like Alzheimer's and Parkinson's disease. These findings underscore the profound influence of gut microbiome health on overall well-being. A working understanding of the gut microbiome's composition and its impact on disease processes is crucial for the advancement of personalized or precision medicine. This review article aims to explore recent advancements in the field, shedding light on how the gut microbiome contributes to the development and prognosis of lifestyle diseases.}, } @article {pmid40400892, year = {2025}, author = {Ferrer, G and Valerio-Pascua, F and Alas-Pineda, C and Gaitán-Zambrano, K and Pavón-Varela, DJ}, title = {Intranasal Chlorpheniramine for Early Symptomatic Treatment of COVID-19 and the Impact on Long-COVID.}, journal = {Cureus}, volume = {17}, number = {4}, pages = {e82736}, pmid = {40400892}, issn = {2168-8184}, abstract = {This review explores the therapeutic potential of intranasal chlorpheniramine maleate (iCPM) in managing both acute COVID-19 and Long COVID by integrating histamine H1 receptor antagonism and bitter taste receptor (T2R) activation. Current literature on histamine-mediated inflammation, T2R activation, and the dual-action mechanisms of iCPM were analyzed. Emphasis was placed on its antiviral, anti-inflammatory, and mucosal immunity-enhancing properties. iCPM demonstrates significant efficacy in addressing acute COVID-19 symptoms by inhibiting histamine-mediated inflammatory pathways and reducing cytokine storms. As a T2R agonist, it enhances mucosal immunity through nitric oxide production, mucociliary clearance, and antimicrobial peptide synthesis, reducing viral replication and supporting respiratory health. Additionally, iCPM shows promise in mitigating persistent symptoms of long COVID, including fatigue, brain fog, and respiratory dysfunction, by addressing chronic inflammation and residual viral activity. The integration of H1 receptor antagonism and T2R activation positions iCPM as a novel dual-target therapy for respiratory infections. Its localized delivery and broad mechanism of action make it a promising candidate for managing both the acute and chronic phases of COVID-19. Future research should focus on large-scale clinical trials and personalized approaches based on genetic variations in T2R pathways.}, } @article {pmid40400658, year = {2025}, author = {Moteki, Y}, title = {Research Trends and Structural Characteristics of Healthcare Research in Japan, Including the First Half of the New Coronavirus Spread Period: A Bibliometric Analysis.}, journal = {Cureus}, volume = {17}, number = {5}, pages = {e84197}, pmid = {40400658}, issn = {2168-8184}, abstract = {This study aims to conduct a bibliometric analysis to characterize the trends and research features of health administration in Japan, in terms of themes and structural aspects, such as institutional affiliations, up to the early stages of the spread of the new coronavirus. Literature data were obtained from the United States National Institutes of Health (NIH) database, using the search formula (Healthcare[Title/Abstract] AND Japan[Title]), and the dataset was obtained on March 15, 2025. The total number of data points analyzed was 1066. Research trends, such as the characteristics of themes based on KeyWords Plus (Clarivate, Philadelphia, USA) and their changes, and the academic structure focusing on the country of origin, institutional affiliations, and publication journals, were quantitatively analyzed using the bibliometrics tools in the R package (Biblioshiney interface) for literature up to 2021, when the impact of coronavirus disease of 2019 (COVID-19) became pronounced in Japan. The KeyWords Plus analysis revealed a substantial research emphasis on healthcare human resources, and confirmed an increase in COVID-19-related research around 2020, when the impact of the novel coronavirus infection spread in Japan. Notably, the results of the bibliometric analysis highlight the aspect that healthcare human resources was one of the main focuses of the study area. However, limitations of textmining methods were observed in the export function of the CiNii database (National Institute of Informatics, Tokyo, Japan), which comprehensively collects articles written in Japanese. In order to grasp research trends in the field of healthcare in Japan, regardless of language, it is necessary to enhance multilingual support in Japanese academic information databases and develop an international academic information database (such as Web of Science, Scopus, OpenAlex, etc.) to expand the scope of collection.}, } @article {pmid40398650, year = {2025}, author = {Targa, ADS and Henríquez-Beltrán, M and Galan-Gonzalez, A and Barbé, F}, title = {Life After COVID-19: Alterations Related to Sleep and Circadian Rhythms.}, journal = {Seminars in respiratory and critical care medicine}, volume = {46}, number = {2}, pages = {158-169}, doi = {10.1055/a-2591-5627}, pmid = {40398650}, issn = {1098-9048}, mesh = {Humans ; *COVID-19/complications/physiopathology ; *Circadian Rhythm/physiology ; SARS-CoV-2 ; *Sleep/physiology ; *Sleep Wake Disorders/physiopathology/epidemiology ; Post-Acute COVID-19 Syndrome ; }, abstract = {World Health Organization (WHO) estimates reveal that over 777 million people were reportedly infected by SARS-CoV-2, with approximately 7 million deaths and 770 million surviving the disease up to April 2025. Beyond the immediate social and economic impact, an additional challenge arises as a large percentage of COVID-19 survivors report a wide range of symptoms after the acute phase, including fatigue, shortness of breath, cognitive difficulties, joint and muscle pain, chest pain, heart palpitations, loss of taste or smell, headaches, depression, anxiety, and sleep and circadian alterations. In this chapter, we will specifically address the sleep- and circadian rhythm-related alterations within this context. First, we will focus on sleep-related changes following the acute phase of the disease, detailing their manifestations, prevalence, and associated factors. We will then discuss the potential impact of these sleep-related aspects on the risk of SARS-CoV-2 infection, the severity of COVID-19, and the presence of post-COVID-19 conditions. A similar approach will be applied to address the circadian-related alterations. Finally, we will provide a comprehensive discussion on the overall limitations of available knowledge and its applicability, highlighting the relevance of these findings for the present and future.}, } @article {pmid40398621, year = {2025}, author = {Spellman, SR and Xu, K and Oloyede, T and Ahn, KW and Akhtar, O and Bolon, YT and Broglie, L and Bloomquist, J and Bupp, C and Chen, M and Devine, SM and El-Jurdi, N and Hamadani, M and Hengen, M and Huppler, AH and Jaglowski, S and Kuxhausen, M and Lee, SJ and Moskop, A and Page, KM and Pasquini, MC and Perez, W and Phelan, R and Rizzo, D and Saber, W and Stefanski, HE and Steinert, P and Tuschl, E and Visotcky, A and Vogel, R and Auletta, JJ and Shaw, BE and Allbee-Johnson, M}, title = {Current Activity Trends and Outcomes in Hematopoietic Cell Transplantation and Cellular Therapy - A Report from the CIBMTR.}, journal = {Transplantation and cellular therapy}, volume = {31}, number = {8}, pages = {505-532}, pmid = {40398621}, issn = {2666-6367}, support = {27305C0011/ES/NIEHS NIH HHS/United States ; 27307C0011/ES/NIEHS NIH HHS/United States ; 27398C0011/ES/NIEHS NIH HHS/United States ; U24 CA076518/CA/NCI NIH HHS/United States ; }, mesh = {Humans ; *Hematopoietic Stem Cell Transplantation/trends/methods/adverse effects ; Middle Aged ; Aged ; Adult ; Male ; Graft vs Host Disease/prevention & control ; Female ; Adolescent ; COVID-19/epidemiology ; Child ; United States/epidemiology ; Young Adult ; Transplantation, Homologous ; Child, Preschool ; Treatment Outcome ; Myelodysplastic Syndromes/therapy ; *Cell- and Tissue-Based Therapy/trends ; SARS-CoV-2 ; Infant ; Transplantation, Autologous ; Unrelated Donors ; Leukemia, Myeloid, Acute/therapy ; }, abstract = {The Center for International Blood and Marrow Transplant Research (CIBMTR) compiles annual summary slides describing trends in hematopoietic cell transplantation (HCT) and cellular therapy (CT) practice and outcomes. This year's report includes all patients receiving their first autologous and/or allogeneic HCT/CT in the United States between 2013 and 2023 or chimeric antigen receptor T-cell (CAR-T) therapy from 2016 and 2023, reported to the CIBMTR. A relative proportion of allogeneic and autologous HCT/CT was generated as percentage of total for donor type and for patient age, disease indication, graft-versus-host disease (GVHD) prophylaxis, and race and ethnicity. Causes of death were summarized using frequencies, and the Kaplan-Meier estimator was used for estimating overall survival. New for this year, disease risk stratification reflects the European LeukemiaNet cytogenetic risk score for acute myeloid leukemia (AML) and the Revised International Prognostic Scoring System for myelodysplastic syndromes (MDS). Use of allogeneic HCT increased substantially in 2023, recovering from a decline in activity during the COVID-19 pandemic, with growth predominately in the 65- to 74-year-old age group. Overall, matched unrelated donors (MUDs) continue to be the most common allogeneic donor source (45%) followed by haploidentical related donors (Haplo; 21%), matched related donors (MRDs; 18%), mismatched unrelated donors (MMUDs; (12%), and cord blood (Cord; 3%). These trends hold in the adult patient population, with a notable doubling of MMUD utilization since 2020 driven by the rapid shift to post-transplantation cyclophosphamide-based GVHD prophylaxis (PTCy) in this setting. In the pediatric setting, Haplo was the most common donor source, surpassing MRD use in 2023 followed by MUD, Cord, and MMUD use. Autologous HCT continued to decline slightly, whereas use of CAR-T therapy has rapidly increased since commercial approval in 2017, with lymphoma and multiple myeloma reaching 45% and 16%, respectively, in 2023. Significant recent changes in GVHD prophylaxis in the adult allogeneic HCT setting have occurred. PTCy is most common in Haplo HCT with >90% since 2016. Among other donor sources, the most rapid adoption is in MMUD HCT at 82% in 2023. In MRDs and MUDs, PTCy use differs by conditioning intensity, with non-myeloablative/reduced-intensity conditioning (NMA/RIC) higher (58% and 64%, respectively), reflecting the standard of care established by BMT CTN 1703, compared with myeloablative (MAC; 43% and 46%, respectively). In pediatrics, calcineurin inhibitor ± others remains the most common GVHD prevention strategy for use of MRDs (88%) and MUDs (68%). Although common in the pediatric Haplo HCT setting at 68% in 2023, use of PTCy is less common across other mismatched donor types in which use of abatacept or ex-vivo T-cell depletion/CD34 selection accounts for 28% and 17% in MMUDs, respectively. Three-year overall survival continues to significantly improve among patients receiving allogeneic (62.1% vs. 55.8%) and autologous (82.6% vs. 79.6%) HCT when comparing HCT from 2017 to 2022 versus 2012 to 2016 (P < .001), respectively. In both the adult and pediatric settings, primary cause of mortality after 100 days post-HCT remains primary disease in both allogeneic (47% and 45%, respectively) and autologous (60% and 79%, respectively). HCT/CT and CAR-T use continues to grow. Relapse remains the primary cause of death in the malignant setting, supporting further efforts to mitigate risk.}, } @article {pmid40398109, year = {2025}, author = {Sekar, P and Ashok Kumar, A and Hughes, I and Mason, R and Dzienis, M}, title = {The safety of extended dosing pembrolizumab when compared to traditional dosing: A review and meta-analysis of retrospective studies.}, journal = {Lung cancer (Amsterdam, Netherlands)}, volume = {204}, number = {}, pages = {108585}, doi = {10.1016/j.lungcan.2025.108585}, pmid = {40398109}, issn = {1872-8332}, mesh = {Humans ; *Antibodies, Monoclonal, Humanized/administration & dosage/adverse effects/therapeutic use ; *Antineoplastic Agents, Immunological/administration & dosage/adverse effects ; Retrospective Studies ; *Neoplasms/drug therapy ; Drug Administration Schedule ; COVID-19 ; SARS-CoV-2 ; }, abstract = {BACKGROUND: To minimise healthcare exposure in the COVID 19 era, 6-weekly extended dosing pembrolizumab became widely accepted as an alternative to 3-weekly dosing based on modelling studies. A review and meta-analysis were performed to assess the real-world safety of 6-weekly pembrolizumab in relation to 3-weekly dosing.

METHODS: Following PRISMA guidelines, we conducted a meta-analysis encompassing retrospective studies of solid organ malignancies comparing 6-weekly pembrolizumab with 3-weekly pembrolizumab including patients switched to 6-weekly from 3-weekly pembrolizumab ("switched"). Primary outcomes were relative risk estimates (RR) of grade 3-5 immune related adverse events (irAEs) for 6-weekly and "switched" pembrolizumab in relation to 3-weekly dosing. Secondary outcomes were pooled proportions of grade 3-5 irAEs for 6-weekly, 3-weekly and "switched" patients. A random effects logistic regression was used to estimate RR and the results were depicted in forest plots.

RESULTS: 10 studies were included with a total of 592 3-weekly, 520 6-weekly and 273 "switched" patients. 6-weekly pembrolizumab was not associated with increased rates of grade 3-5 irAEs when compared to 3-weekly dosing (RR 1.16; CI 0.85-1.58, p = 0.35). "Switched" 6-weekly patients had no significant difference in rates of grade 3-5 irAEs when compared to 3-weekly patients (RR 1.30; CI 0.87-2.07, p = 0.28). Total grade 3-5 irAEs for 6-weekly, 3-weekly and "switched" pembrolizumab patients were 15 %, 13 % and 16 %, respectively.

CONCLUSION: 6-weekly pembrolizumab is not associated with increased grade 3-5 irAEs compared to 3-weekly pembrolizumab. Switching patients to 6-weekly pembrolizumab from 3-weekly dosing was not associated with an increased risk of grade 3-5 irAEs.}, } @article {pmid40397507, year = {2025}, author = {Karp-Tatham, E and Knight, JC and Bolze, A}, title = {Human genetics of responses to vaccines.}, journal = {Clinical and experimental immunology}, volume = {219}, number = {1}, pages = {}, pmid = {40397507}, issn = {1365-2249}, mesh = {Humans ; *COVID-19 Vaccines/immunology ; *COVID-19/immunology/prevention & control/genetics ; *SARS-CoV-2/immunology ; *HLA Antigens/genetics/immunology ; *Immunogenicity, Vaccine/genetics ; Vaccination ; }, abstract = {The human response to vaccination exhibits considerable variability due to a complex interplay of heritable and environmental factors. This review examines the current understanding of the role of human genetics in vaccine responses, encompassing both rare adverse events following immunization as well as immunogenicity and efficacy. We highlight recent studies including from the coronavirus disease 2019 (COVID-19) pandemic, which provided a unique opportunity to study vaccine genetics at scale for a newly emerging infection and revealed significant associations between HLA alleles and responses to SARS-CoV-2 vaccines. Understanding genetic contributions to vaccine responses holds promise for enhancing vaccine safety and efficacy, and the development of personalized vaccination strategies.}, } @article {pmid40397375, year = {2025}, author = {Sansone, NMS and Mello, LS and Martins, JP and Marson, FAL}, title = {Impact of Coronavirus Disease (COVID)-19 on the Indigenous Population of Brazil: A Systematic Review.}, journal = {Journal of racial and ethnic health disparities}, volume = {}, number = {}, pages = {}, pmid = {40397375}, issn = {2196-8837}, support = {88887.892875/2023-00//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; 88887.823904/2023-00//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; 122407/2024-5//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; }, abstract = {BACKGROUND: Indigenous peoples in Brazil were severely impacted by coronavirus disease (COVID)-19 pandemic, experiencing high rates of infection and mortality. Geographic isolation, limited access to healthcare, socio-economic disparities, and cultural factors, such as communal living and mistrust of state-led initiatives, heightened their vulnerability. Territorial invasions and oxygen shortages further exacerbated the crisis. Therefore, this systematic review aimed to explore the progression of COVID-19 in this population.

METHODS: A systematic review was conducted in PubMed-MEDLINE, SciELO (Scientific Electronic Library Online), and LILACS (Latin America and the Caribbean Health Sciences Literature) from the beginning of the pandemic in Brazil (2020) to March 2025. Studies addressing COVID-19 vaccination and epidemiological, social, and economic aspects among Indigenous populations in Brazil were included. Reviews and irrelevant studies were excluded. The quality of eligible studies was assessed using the Newcastle-Ottawa Scale.

RESULTS: A total of 50 relevant studies were included, grouped into thematic blocks: mortality/infection, symptoms, vaccination/testing, social impacts, and birth outcomes. Several studies highlighted that being male, of Indigenous or other racial minority background, and having comorbidities increased mortality risk. In contrast, asthma was associated with reduced mortality. Pregnant Indigenous women in rural areas had 33 times higher odds of dying than their urban counterparts. Furthermore, there is a higher likelihood of very low birth weight and inadequate prenatal care among Indigenous mothers. Vaccination reduced the risk of death, particularly after full immunization, though it did not prevent hospitalization. A cohort study of 389,753 Indigenous people showed a lower full vaccination rate (48.7%) compared to the general population (74.8%). Complete vaccination reduced the risk of death by 96% among hospitalized patients. Regarding seroprevalence, Indigenous people had a 5.4% positivity rate, much higher than other racial groups, and were 4.71 times more likely to test positive than White, Black, or Mixed Individuals. Socioeconomic disparities also correlated with increased infection risk.

CONCLUSIONS: The COVID-19 pandemic worsened health disparities among Indigenous peoples in Brazil, revealing systemic inequalities, weak public policies, and limited healthcare access. This review urges culturally sensitive, community-led responses and highlights the need for disaggregated data and equitable, inclusive health strategies.}, } @article {pmid40397294, year = {2025}, author = {Hingole, P and Saha, P and Das, S and Gundu, C and Kumar, A}, title = {Exploring the role of mitochondrial dysfunction and aging in COVID-19-Related neurological complications.}, journal = {Molecular biology reports}, volume = {52}, number = {1}, pages = {479}, pmid = {40397294}, issn = {1573-4978}, mesh = {Humans ; *COVID-19/complications/metabolism ; *Aging/metabolism ; *Mitochondria/metabolism/pathology ; SARS-CoV-2 ; *Nervous System Diseases/etiology/metabolism/virology ; Pandemics ; Mitochondrial Dynamics ; *Mitochondrial Diseases ; }, abstract = {The COVID-19 pandemic, caused by SARS-CoV-2, posed a tremendous challenge to healthcare systems globally. Severe COVID-19 infection was reported to be associated with altered immunometabolism and cytokine storms, contributing to poor clinical outcomes and in many cases resulting in mortality. Despite promising preclinical results, many drugs have failed to show efficacy in clinical trials, highlighting the need for novel approaches to combat the virus and its severe manifestations. Mitochondria, crucial for aerobic respiration, play a pivotal role in modulating immunometabolism and neuronal function, making their compromised capability as central pathological mechanism contributing to the development of neurological complications in COVID-19. Dysregulated mitochondrial dynamics can lead to uncontrolled immune responses, underscoring the importance of mitochondrial regulation in shaping clinical outcomes. Aging further accelerates mitochondrial dysfunction, compounding immune dysregulation and neurodegeneration, making older adults particularly vulnerable to severe COVID-19 and its neurological sequelae. COVID-19 infection impairs mitochondrial oxidative phosphorylation, contributing to the long-term neurological complications associated with the disease. Additionally, recent reports also suggest that up to 30% of COVID-19 patients experience lingering neurological issues, thereby highlighting the critical need for further research into mitochondrial pathways to mitigate long-tern neurological consequences of Covid-19. This review examines the role of mitochondrial dysfunction in COVID-19-induced neurological complications, its connection to aging, and potential biomarkers for clinical diagnostics. It also discusses therapeutic strategies aimed at maintaining mitochondrial integrity to improve COVID-19 outcomes.}, } @article {pmid40396597, year = {2025}, author = {Head, RJ and Buckley, JD and Martin, JH}, title = {Exploiting the vulnerability of SARS-CoV-2 with a partnership of mucosal immune function and nutrition: a narrative review.}, journal = {Nutrition research reviews}, volume = {}, number = {}, pages = {1-19}, doi = {10.1017/S0954422425100061}, pmid = {40396597}, issn = {1475-2700}, abstract = {To achieve infectivity, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for COVID-19, must first traverse the upper respiratory tract mucosal barrier. Once infection is established, the cascading complexities of the pathophysiology of COVID-19 makes intervention extremely difficult. Thus, enhancing the defensive properties of the mucosal linings of the upper respiratory tract may reduce infection by SARS-CoV-2 and indeed by other viruses such as influenza, which have been responsible for the two major pandemics of the last century. In this review we summarise potential opportunities for foods and nutrients to promote an adequate mucosal immune preparedness with an aim to assist protection against infection by SARS-CoV-2, to maximise the mucosal vaccination (IgA inducing) response to existing systemic vaccines, and to play a role as adjuvants to intranasal vaccines. We identify opportunities for vitamins A and D, zinc, probiotics, bovine colostrum and resistant starch to promote mucosal immunity and enhance the mucosal response to systemic vaccines, and for vitamin A to also improve the mucosal response to intranasal vaccination. It is possible that an entirely different virus may in the future, by way of convergent evolution, utilise a similar upper respiratory tract infection pathway. A greater research focus on mucosal lymphoid immune protection in partnership with nutrition would result in greater preparedness for such an event.}, } @article {pmid40396505, year = {2025}, author = {Zorger, AM and Hirsch, C and Baumann, M and Feldmann, M and Bröckelmann, PJ and Mellinghoff, S and Monsef, I and Skoetz, N and Kreuzberger, N}, title = {Vaccines for preventing infections in adults with haematological malignancies.}, journal = {The Cochrane database of systematic reviews}, volume = {5}, number = {5}, pages = {CD015530}, pmid = {40396505}, issn = {1469-493X}, mesh = {Humans ; *Hematologic Neoplasms/immunology/complications ; Randomized Controlled Trials as Topic ; Adult ; *COVID-19/prevention & control ; *Immunocompromised Host ; Bias ; COVID-19 Vaccines/adverse effects ; Influenza Vaccines/adverse effects ; Influenza, Human/prevention & control ; Quality of Life ; Herpes Zoster Vaccine/adverse effects ; Pneumococcal Vaccines ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Vaccination aims to prevent infections. People who are immunocompromised, such as those with haematological malignancies, often experience higher immunosuppression, increasing their vulnerability to infections compared to individuals with solid tumours or healthy individuals.

OBJECTIVES: The aim of this review is to summarise and evaluate the benefits and risks of vaccines for preventing infections in adults with haematological malignancies.

SEARCH METHODS: We conducted a comprehensive systematic search in CENTRAL, MEDLINE, Embase, LILACS, and Web of Science on 2 December 2024 for randomised controlled trials (RCTs) and for controlled non-randomised studies of interventions (NRSIs). We also searched ClinicalTrials.gov, WHO (World Health Organization) International Clinical Trials Registry Platform (ICTRP), and the Cochrane COVID-19 Study Register.

SELECTION CRITERIA: We included RCTs and controlled NRSIs evaluating the preventive effect of vaccines on outcomes prioritised by clinical experts, patients, and patient representatives. The prioritised outcomes for adults (≥ 18 years) with haematological malignancies (excluding those receiving cellular therapies) were infection incidence, all-cause mortality, quality of life, adverse events of any grade, serious adverse events, and adverse events of special interest. We looked for studies that evaluated a broad range of vaccine types (e.g. COVID-19, diphtheria, Haemophilus influenzae type b, hepatitis B, herpes zoster, influenza, Neisseria meningitidis, pertussis, polio, Streptococcus pneumoniae, or tetanus), but we excluded live-attenuated vaccines.

DATA COLLECTION AND ANALYSIS: We followed current Cochrane methodological standards in the conduct of this review. We assessed the risk of bias using the Cochrane risk of bias 2 tool (RoB 2) for RCTs and Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) for controlled NRSIs.

MAIN RESULTS: We included six studies (four RCTs, two controlled NRSIs) with a total of 25,886 participants. We present the RCT results here and the NRSI findings from NRSIs in the full review. We judged one RCT on herpes zoster to be at low risk of bias overall, and we had 'some concerns' about bias in the other RCT on herpes zoster. We had 'some concerns' about bias in the RCTs on COVID-19 and influenza vaccines. Herpes zoster vaccines Two RCTs, involving 3067 participants with a range of haematological malignancies, evaluated vaccines for preventing herpes zoster compared to placebo or no vaccine. Vaccines may reduce herpes zoster incidence up to 21 months post-vaccination, although the 95% CI includes the possibility of no effect (4% versus 6%; RR 0.40, 95% CI 0.07 to 2.23; 2 RCTs, 3067 participants; low-certainty evidence). Vaccines probably have little to no effect on all-cause mortality up to 28 days post-vaccination (2.7% versus 2.6%; RR 1.03, 95% CI 0.65 to 1.64; 2548 participants; moderate-certainty evidence). Vaccines slightly increase any-grade adverse events within 30 days (RR 1.12, 95% CI 1.07 to 1.18; 3110 participants; high-certainty evidence), but probably do not increase serious adverse events within 12 months (23% versus 29%; RR 0.79, 95% CI 0.60 to 1.05; 562 participants; moderate-certainty evidence) after vaccination. Vaccines increase injection site adverse events substantially (40% versus 13%; RR 3.07, 95% CI 2.62 to 3.59; high-certainty evidence) and also increase systemic adverse events (10% versus 6%; RR 1.82, 95% CI 1.38 to 2.40; high-certainty evidence), as measured in 2548 participants within 28 days post-vaccination. Neither RCT reported quality of life. COVID-19 vaccines One RCT, involving 95 participants with lymphoma, leukaemia or myeloma, evaluated the BNT162b2 COVID-19 vaccine compared to placebo or no vaccine. Evidence about the effect of BNT162b2 vaccine on the incidence of COVID-19 up to six months after the second dose compared to placebo or no vaccine remains very uncertain (2.2% versus 2%; RR 1.11, 95% CI 0.07 to 17.25; 1 RCT, 95 participants; very low certainty evidence). Regarding safety data (mixed population including both solid tumours and haematological malignancies), BNT162b2 vaccine probably increases the number of participants with any grade adverse events (35% versus 17.5%; RR 1.99, 95% CI 1.71 to 2.30; 1 RCT, 2328 participants; moderate-certainty evidence) and there may be little to no difference concerning the number of participants experiencing serious adverse events (2.4% versus 1.7%; RR 1.43, 95% CI 0.80 to 2.54; 1 RCT, 2328 participants; low-certainty evidence). The RCT did not report all-cause mortality, quality of life, injection site adverse events or systemic adverse events. Influenza vaccines No RCTs evaluated an influenza vaccine versus placebo or no vaccine. One RCT, involving 122 participants with plasma cell disorders, evaluated different dosing regimens for an influenza vaccine on the incidence of influenza infection. Evidence is very uncertain regarding the effect of two doses of high-dose trivalent inactivated influenza vaccine compared to one dose (with strength based on age) of influenza vaccination on the incidence of infection within the 2015 to 2016 flu season (4% versus 8%; RR 0.49, 95% CI 0.11 to 2.08; very low-certainty evidence). The RCT did not report all-cause mortality, quality of life, any-grade or serious adverse events, or injection site or systemic adverse events.

AUTHORS' CONCLUSIONS: The evidence on vaccines for preventing infections in adults with haematological malignancies is limited and uncertain. Herpes zoster vaccines may reduce infection risk for up to 21 months, but the certainty of the evidence is low. While there is a considerable increase in short-term adverse events (high-certainty evidence), no increase in serious adverse events was observed at up to 12 months (moderate-certainty evidence). Data on long-term impacts on other outcomes are lacking. For COVID-19 and influenza vaccines, the evidence is very uncertain. We found no studies that could be included in the review of vaccines for our other infectious diseases of interest: diphtheria, Haemophilus influenzae type b (Hib), hepatitis B, Neisseria meningitidis, pertussis, polio, Streptococcus pneumoniae, or tetanus. Our review underscores the need for high-quality RCTs and controlled NRSIs with better reporting, larger samples, longer follow-ups, and a focus on patient-relevant outcomes, such as quality of life and long-term safety. A robust and continuously updated evidence base is essential to guide clinical and public health decisions.}, } @article {pmid40396498, year = {2025}, author = {Meza, N and Franco, JV and Sguassero, Y and Núñez, V and Escobar Liquitay, CM and Rees, R and Williams, K and Rojas, V and Rojas, F and Pringsheim, T and Madrid, E}, title = {Atypical antipsychotics for autism spectrum disorder: a network meta-analysis.}, journal = {The Cochrane database of systematic reviews}, volume = {5}, number = {5}, pages = {CD014965}, pmid = {40396498}, issn = {1469-493X}, mesh = {Humans ; *Antipsychotic Agents/therapeutic use/adverse effects ; *Autism Spectrum Disorder/drug therapy/psychology ; Randomized Controlled Trials as Topic ; Child ; Adult ; Risperidone/therapeutic use/adverse effects ; Bias ; Irritable Mood/drug effects ; Olanzapine/therapeutic use/adverse effects ; Aggression/drug effects ; Aripiprazole/therapeutic use/adverse effects ; Placebos/therapeutic use ; Weight Gain/drug effects ; }, abstract = {RATIONALE: Individuals with autism spectrum disorder (ASD) exhibit a wide variety of symptoms related to social interaction and behaviour. Atypical antipsychotics have been widely evaluated and prescribed to treat distressing symptoms (e.g. irritability, aggression, obsessions, repetitive behaviours, etc.) in children and adults with ASD. Still, their effects and relative efficacy remain unclear.

OBJECTIVES: Primary: to assess the comparative benefits of atypical antipsychotics for irritability through network meta-analyses in children and adults with ASD at short-term follow-up. Secondary: to assess the benefits and harms of atypical antipsychotics, compared to placebo or any other atypical antipsychotic, for different symptoms (e.g. aggression, obsessive-compulsive behaviours, inappropriate speech) and side effects (e.g. extrapyramidal symptoms, weight gain, metabolic side effects) in children and adults with ASD at short-, medium- and long-term follow-up.

SEARCH METHODS: We searched CENTRAL, MEDLINE, 10 other databases, and two trial registers, together with reference checking, citation searching and contact with study authors to identify studies for inclusion. The latest search was 3 January 2024.

ELIGIBILITY CRITERIA: Randomised controlled trials (RCTs) comparing any atypical antipsychotic drug with placebo or another atypical antipsychotic drug for adults and children with a clinical diagnosis of ASD.

OUTCOMES: Critical outcomes included irritability, aggression, weight gain, extrapyramidal side effects, obsessive-compulsive behaviours and inappropriate speech.

RISK OF BIAS: We used the Cochrane RoB 2 tool to assess risk of bias in the included studies.

SYNTHESIS METHODS: We performed statistical analyses using a frequentist network meta-analysis for combined estimates for the outcome irritability and a random-effects model for pairwise comparisons for other outcomes. We rated the certainty of the evidence using GRADE.

INCLUDED STUDIES: We included 17 studies with 1027 randomised participants. One study evaluated adults (31 participants); the remaining 16 studies evaluated children (996 participants). The interventions were risperidone, aripiprazole, lurasidone and olanzapine.

SYNTHESIS OF RESULTS: Comparative efficacy on irritability Based on the network meta-analysis, risperidone and aripiprazole may reduce symptoms of irritability compared to placebo in the short term in children with ASD (risperidone: mean difference (MD) -7.89, 95% confidence interval (CI) -9.37 to -6.42; 13 studies, 906 participants; low-certainty evidence; aripiprazole: MD -6.26, 95% CI -7.62 to -4.91; 13 studies, 906 participants; low-certainty evidence). Lurasidone probably results in little to no difference in irritability compared to placebo in the short term (MD -1.30, 95% CI -5.46 to 2.86; 13 studies, 906 participants; moderate-certainty evidence). Efficacy and safety on other outcomes We are very uncertain about the effects of atypical antipsychotics on aggression compared to placebo at short-term follow-up in children with ASD (risk ratio (RR) 1.06, 95% CI 0.96 to 1.17; 1 study, 66 participants; very low-certainty evidence). The certainty of the evidence was very low due to concerns about risk of bias and serious imprecision. We are very uncertain about the effects of atypical antipsychotics on the occurrence of weight gain (above predefined levels) compared to placebo in the short term in children with ASD (RR 2.40, 95% CI 1.25 to 4.60; 7 studies, 434 participants; very low-certainty evidence). We are also very uncertain about the effects of atypical antipsychotics on weight gain (in kilograms) compared to placebo in the short term in children with ASD (MD 1.22 kg, 95% CI 0.55 to 1.88; 3 studies, 297 participants; very low-certainty evidence). In both, the certainty of the evidence was very low due to concerns about risk of bias and serious imprecision. We are very uncertain about the effects of atypical antipsychotics on the occurrence of extrapyramidal side effects compared to placebo in the short term in children with ASD (RR 2.36, 95% CI 1.22 to 4.59; 6 studies, 511 participants; very low-certainty evidence). The certainty of the evidence was very low due to concerns about risk of bias and serious imprecision. Atypical antipsychotics may improve obsessive-compulsive behaviours compared to placebo in the short term in children with ASD (MD -1.36, 95% CI -2.45 to -0.27; 5 studies, 467 participants; low-certainty evidence). The certainty of the evidence was low due to concerns about risk of bias and heterogeneity. Atypical antipsychotics may reduce inappropriate speech compared to placebo in the short term in children with ASD (MD -1.44, 95% CI -2.11 to -0.77; 8 studies, 676 participants; low-certainty evidence). The certainty of the evidence was low due to concerns about risk of bias and heterogeneity. We were unable to evaluate the effects of other atypical antipsychotics. Furthermore, our findings on adults with autism were scarce due to the lack of available studies.

AUTHORS' CONCLUSIONS: Risperidone and aripiprazole may reduce symptoms of irritability compared to placebo in children with ASD in the short term, but lurasidone probably has little to no effect on irritability compared to placebo. Other benefits and potential harms observed ranged from moderate- to very low-certainty evidence. The available data did not allow comprehensive subgroup analyses. New randomised controlled trials with larger sample sizes are needed to balance the efficacy and safety of interventions with enough certainty, which are currently scarce (or even absent in the case of the adult population). Authors should report population and intervention characteristics transparently, providing disaggregated or individual patient data when possible. Furthermore, consistent measurement methods for each outcome should be reported to avoid problems during the data synthesis process.

FUNDING: This Cochrane review had no dedicated funding.

REGISTRATION: Protocol available via 10.1002/14651858.CD014965.}, } @article {pmid40396160, year = {2025}, author = {Tisdale, RL and Burnett, K and Rogers, M and Nelson, K and Heyworth, L and Zulman, DM}, title = {An approach to evaluating the impact of virtual specialty care: the Veterans Health Administration's clinical resource hub as case study.}, journal = {JAMIA open}, volume = {8}, number = {3}, pages = {ooaf038}, pmid = {40396160}, issn = {2574-2531}, abstract = {OBJECTIVES: Telemedicine for specialty medical care is evolving from a COVID-19 pandemic-era requirement to an option for patients and clinicians alike, requiring evidence to guide optimal use of virtual specialty care. Heterogeneity across medical specialties complicates this evidence generation. To address this gap in the literature, we present an approach to evaluation of telehealth across specialties with the potential to generate findings generalizable across specialties and health systems.

MATERIALS AND METHODS: We describe an approach to evaluation of virtual specialty care that balances widely generalizable metrics, such as patient and clinician satisfaction and avoided travel or cost, and those that are specialty-specific. We use the Veterans Health Administration (VA)'s Clinical Resource Hub program to illustrate potential applications of this approach.

RESULTS: Clinical Resource Hub clinics leverage a hub-and-spoke model to deliver virtual care across many specialties, compensating for staffing shortages and expanding access to more specialized services not available at every VA site. Use cases for these clinics span the spectrum of short-term, episodic care to long-term substitution for a usual source of specialty care and offer opportunities to apply a range of evaluation metrics that generalize across telehealth use cases.

DISCUSSION: Clinical Resource Hub clinics provide a variety of examples for this approach, demonstrating a path forward for virtual specialty care evaluation.

CONCLUSION: As the Clinical Resource Hub case illustrates, combining universal and specialty- or use case-specific metrics has the potential to build the evidence base for virtual specialty care.}, } @article {pmid40395715, year = {2025}, author = {Hompas, T and Liang, Z}, title = {Understanding competency development of the management workforce in veterinary clinical practice: A scoping review.}, journal = {Veterinary record open}, volume = {12}, number = {1}, pages = {e70011}, pmid = {40395715}, issn = {2052-6113}, abstract = {BACKGROUND: The historical challenges facing veterinary care have been exacerbated by the surge in pet ownership and demand for services following the COVID-19 pandemic. Managers in veterinary services are essential in navigating these challenges while ensuring the provision of quality animal care. Evidence from human healthcare highlights the importance of developing and supporting managers to thrive in their management roles. However, there is currently no established management competency framework to guide development of managers working in veterinary care.

METHODS: A two-step approach was used to explore the existing efforts to develop a competent veterinary management workforce. A scoping review of Web of Science, PubMed and Scopus databases was conducted using the Arksey and O'Malley framework. This review aimed to identify both the key management challenges in veterinary services and specific competencies required by veterinary managers. A supplementary web-based search of professional institutions and postgraduate programmes relevant to veterinary leadership and management was also completed.

RESULTS: Fourteen articles met the inclusion criteria with only five of them published after 2011. The literature identified key challenges in managing veterinary services and revealed a limited recognition of skills and competencies for veterinary managers, especially when compared with the human healthcare sector. Several professional institutions and educational programmes supporting veterinary leaders were identified.

CONCLUSION: Findings confirm that current approaches to management competency identification and development in veterinary care are insufficient. A validated, comprehensive framework to build management capability in veterinary care is urgently needed to support managers in fulfilling their roles and to promote sustainable veterinary service delivery.}, } @article {pmid40394759, year = {2025}, author = {Christofferson, RC and Giovanni, JE and Koumans, EH and Ategbole, M and Clark, SD and Godfred-Cato, S and Menon, MP and Sastalla, I and Schweitzer, BK and Uyeki, TM}, title = {A Systematic Review of Prolonged SARS-CoV-2 Shedding in Immunocompromised Persons.}, journal = {Influenza and other respiratory viruses}, volume = {19}, number = {5}, pages = {e70121}, pmid = {40394759}, issn = {1750-2659}, mesh = {Humans ; *Immunocompromised Host ; *COVID-19/virology/immunology ; *SARS-CoV-2/physiology/isolation & purification/genetics ; *Virus Shedding ; RNA, Viral ; }, abstract = {BACKGROUND: Although reports have documented prolonged SARS-CoV-2 RNA detection in immunocompromised patients, few studies have systematically analyzed data on duration of SARS-CoV-2 in respiratory specimens of immunocompromised patients.

METHODS: A systematic review was undertaken to describe SARS-CoV-2 RNA and infectious virus detection in immunocompromised patients from published data between January 1, 2020 and July 1, 2022. Patients were included if there was ≥ 1 positive SARS-CoV-2 RNA result in respiratory specimens collected > 20 days since symptom onset or first positive SARS-CoV-2 RT-PCR result.

RESULTS: Of the 183 patients, 175 were symptomatic with 83 (47.4%) that experienced intermittent relapsing symptoms, while pneumonia was reported in 122 (66.7%). Immunocompromising conditions represented were hematologic malignancy treatment (89, 48.6%), solid organ transplant (47, 25.7%), autoimmune disease treatment (14, 7.7%), solid tumor treatment (3, 1.6%), HIV infection (15, 8.2%), and primary immunodeficiency (15, 8.2%). Median duration from the first to the last positive SARS-CoV-2 RT-PCR result was 56 days in upper respiratory and 60 days in lower respiratory tract specimens. Significant differences in median duration of SARS-CoV-2 RNA detection were observed between patients with and without pneumonia and for patients with hematologic malignancies compared to solid organ transplant patients. Among patients with viral culture performed, median duration of replication-competent SARS-CoV-2 was 60.5 days from symptom onset (maximum 238 days) and 59 days from first RT-PCR positive result (maximum 268 days).

CONCLUSIONS: Immunocompromised persons can have replication-competent SARS-CoV-2 in respiratory tissues for months, including while asymptomatic. Serial SARS-CoV-2 testing can inform the duration of isolation for immunocompromised patients with SARS-CoV-2 infection.}, } @article {pmid40394641, year = {2025}, author = {Mohammadi, K and Faramarzi, S and Yaribash, S and Valizadeh, Z and Rajabi, E and Ghavam, M and Samiee, R and Karim, B and Salehi, M and Seifi, A and Shafaati, M}, title = {Human metapneumovirus (hMPV) in 2025: emerging trends and insights from community and hospital-based respiratory panel analyses-a comprehensive review.}, journal = {Virology journal}, volume = {22}, number = {1}, pages = {150}, pmid = {40394641}, issn = {1743-422X}, mesh = {Humans ; *Metapneumovirus/genetics/isolation & purification ; *Paramyxoviridae Infections/epidemiology/diagnosis/virology/transmission ; *Respiratory Tract Infections/virology/epidemiology/diagnosis ; Seasons ; Hospitals ; }, abstract = {Human metapneumovirus (hMPV) is a significant respiratory pathogen, primarily impacting young, elderly, and immunocompromised populations. While the clinical presentations are similar to those of other respiratory viruses such as respiratory syncytial virus (RSV), influenza, and SARS-CoV-2, they can still lead to serious complications. The virus primarily transmits via respiratory droplets, with outbreaks peaking during winter and spring. In resource-limited settings, administration of multiplex PCR assays is essential for precise diagnosis, yet it presents significant challenges. Recent studies indicate a 6.24% infection rate in hospitalized patients presenting with acute respiratory infections (ARIs). Enhanced surveillance and prevention are essential given the morbidity and mortality rates of hMPV, which are comparable to those of influenza and RSV. Effective management requires enhanced diagnostic tools, improved public health strategies, and continuous research into antiviral therapies and vaccines. This study highlighted the growing importance of hMPV as a respiratory pathogen, focusing on its seasonal patterns, clinical manifestations in at-risk populations, transmission dynamics, and diagnostic challenges compared to other respiratory viruses.}, } @article {pmid40394626, year = {2025}, author = {Belita, E and Neil-Sztramko, SE and Seale, C and Zhou, F and Zogo, CO and Boamah, S and Cabaj, J and Jack, SM and Banfield, L and Neudorf, C and Watson-Creed, G and Dobbins, M}, title = {Organizational interventions to support and promote the mental health of healthcare workers during pandemics and epidemics: a systematic review.}, journal = {BMC health services research}, volume = {25}, number = {1}, pages = {731}, pmid = {40394626}, issn = {1472-6963}, support = {#WI2 179945/CAPMC/CIHR/Canada ; #WI2 179945/CAPMC/CIHR/Canada ; #WI2 179945/CAPMC/CIHR/Canada ; }, mesh = {Humans ; *Health Personnel/psychology ; *Pandemics ; *Mental Health ; *COVID-19/epidemiology/psychology ; *Epidemics ; Workload/psychology ; Burnout, Professional ; }, abstract = {BACKGROUND: Understanding organizational mechanisms that protect the mental health of the healthcare workforce during pandemics and epidemics is critical to support decision-making related to worker health and safety. This systematic review aimed to identify organizational-level factors, strategies or interventions that support the mental health of healthcare workers during pandemics or epidemics.

METHODS: A comprehensive search was used, including online databases, a grey literature review, and handsearching of reference lists. Studies were eligible for inclusion if they described implementing or testing organizational-level factors, strategies or interventions to support healthcare workers' mental health during pandemics or epidemics. There were no limitations by language, publication status, or publication date. Two reviewers independently conducted screening, data extraction, data analysis and quality appraisal, with conflicts resolved through discussion or third-party arbitration. Data analysis was guided by the Job Demands-Resources Model. A narrative synthesis is presented, given the high degree of heterogeneity across studies.

RESULTS: A total of 10,805 articles from database searches and 190 records from other sources were screened. The final review included 86 articles. Studies were of low (n = 11), moderate (n = 39), and high quality (n = 36). Regarding job demands, 40 studies explored high work pressure or heavy workload factors, with the majority investigating working hours (n = 32). Increased working hours may be associated with an increased risk of diverse mental health outcomes. Regarding job resources, leadership factors, strategies (support, appreciation, responsiveness; n = 19) and leadership interventions (n = 3) may be associated with decreased burnout, anxiety, stress, and increased well-being. The availability and adequacy of personal protective equipment (n = 20) may be associated with decreased burnout, anxiety, depression, and stress. Mixed findings were reported on associations between diverse mental health outcomes and training and education (n = 28) or peer support (n = 3). Results should be interpreted cautiously given the high heterogeneity among factors, strategies, and interventions assessed and outcomes measured.

CONCLUSIONS: Organizational-level mechanisms can critically influence the mental health of healthcare workers' during pandemics and epidemics. More focused attention is needed to explore and act on the integral role of leadership and the availability of protective equipment to support healthcare workers' mental health.}, } @article {pmid40394244, year = {2025}, author = {Luo, N and Huang, Q and Zhang, M and Yi, C}, title = {Functions and therapeutic applications of pseudouridylation.}, journal = {Nature reviews. Molecular cell biology}, volume = {26}, number = {9}, pages = {691-705}, pmid = {40394244}, issn = {1471-0080}, mesh = {*Pseudouridine/metabolism/genetics/therapeutic use ; Humans ; SARS-CoV-2/genetics/immunology ; RNA, Messenger/genetics/metabolism ; RNA, Transfer/genetics/metabolism ; *COVID-19/prevention & control/virology/genetics ; RNA, Ribosomal/genetics/metabolism ; Animals ; RNA Processing, Post-Transcriptional ; COVID-19 Vaccines/genetics/immunology ; Gene Expression Regulation ; }, abstract = {The success of using pseudouridine (Ψ) and its methylation derivative in mRNA vaccines against SARS-CoV-2 has sparked a renewed interest in this RNA modification, known as the 'fifth nucleotide' of RNA. In this Review, we discuss the emerging functions of pseudouridylation in gene regulation, focusing on how pseudouridine in mRNA, tRNA and ribosomal RNA (rRNA) regulates translation. We also discuss the effects of pseudouridylation on RNA secondary structure, pre-mRNA splicing, and in vitro mRNA stability. In addition to nuclear-genome-encoded RNAs, pseudouridine is also present in mitochondria-encoded rRNA, mRNA and tRNA, where it has different distributions and functions compared with their nuclear counterparts. We then discuss the therapeutic potential of programmable pseudouridylation and mRNA vaccine optimization through pseudouridylation. Lastly, we briefly describe the latest quantitative pseudouridine detection methods. We posit that pseudouridine is a highly promising modification that merits further epitranscriptomics investigation and therapeutic application.}, } @article {pmid40393551, year = {2025}, author = {Martin, AF and Rubin, GJ and Rogers, MB and Wessely, S and Greenberg, N and Hall, CE and Pitt, A and Logan, PE and Lucas, R and Brooks, SK}, title = {The changing prevalence of ADHD? A systematic review.}, journal = {Journal of affective disorders}, volume = {388}, number = {}, pages = {119427}, doi = {10.1016/j.jad.2025.119427}, pmid = {40393551}, issn = {1573-2517}, mesh = {Humans ; *Attention Deficit Disorder with Hyperactivity/epidemiology ; Prevalence ; *COVID-19/epidemiology ; Incidence ; Global Health ; }, abstract = {INTRODUCTION: Understanding the prevalence of Attention Deficit Hyperactivity Disorder (ADHD) and changes in demand for related healthcare services is crucial for effective healthcare policy and resource allocation. Clinicians, teachers and charities have reported increasing demand for ADHD assessments in recent years, overwhelming support systems. This review synthesises post-2020 studies of ADHD prevalence and incidence.

METHODS: We conducted systematic searches in Web of Science, Embase, Medline, Global Health, and PsycInfo using terms relating to ADHD and prevalence. Additional sources included public health databases, Google, and study reference lists. Studies were included if they contained original data relating to general population rates of ADHD and we extracted data relating to methods of assessment and measures of prevalence and incidence. We followed PRISMA and synthesis without meta-analysis (SWiM) guidelines.

RESULTS: Forty studies across 17 countries, with one study spanning 42 countries, were reviewed. No significant rise in ADHD prevalence was found, although incidence was found to vary during the COVID-19 pandemic. Only four of the included studies were at low risk of bias.

LIMITATIONS: There are substantial limitations in the quality of the literature included in this review. Due to significant delays in reporting prevalence data, estimates from previous reviews may be inaccurate. There is a lack of healthcare data and no school-level data.

CONCLUSIONS: Significant research gaps exist in determining ADHD prevalence and incidence. The highest quality findings do not suggest an increase in prevalence since 2020 but indicate some variability in incidence during the COVID-19 pandemic. Further research is urgently needed to guide clinical practice and public health policy.}, } @article {pmid40393269, year = {2025}, author = {Struhal, W and Almamoori, D}, title = {A review of the sequelae of post Covid-19 with neurological implications (post-viral syndrome).}, journal = {Journal of the neurological sciences}, volume = {474}, number = {}, pages = {123532}, doi = {10.1016/j.jns.2025.123532}, pmid = {40393269}, issn = {1878-5883}, mesh = {Humans ; *COVID-19/complications ; *Nervous System Diseases/etiology/epidemiology ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; }, abstract = {Post Covid-19 conditions represent a medical challenge; a unified definition is not achieved after 5 years of the Pandemic. The incidence of Post Covid-19 conditions varies, nevertheless the neurological complications represent an important aspect in the spectrums of fields involved. The current perception is that varied manifestations and long-term complications of COVID-19 reflect underlying pathophysiological processes, including inflammatory, immune-mediated, and vascular mechanisms. These mechanisms underscore the complexity of COVID-19's impact including the nervous system and its potential for lasting effects. A number of symptoms are extremely severe and may also need neurologic attention including fatigue, cognitive disturbances, autonomic symptoms, headache, and sleep disorders. Post Covid-19 conditions are often of chronic nature. Management as in other chronic conditions should rely on the conventional diagnostic measures and management of symptoms irrespective of the temporal relation to the viral infection. To date Post Covid-19 conditions is only accepted as an additional or explanatory diagnosis.}, } @article {pmid40393170, year = {2025}, author = {Pei, T and Li, W and Zhou, Z and Zhang, Q and Yu, G and Yin, S and Chen, H and Tang, J}, title = {The relationship between tryptophan metabolism and gut microbiota: Interaction mechanism and potential effects in infection treatment.}, journal = {Microbiological research}, volume = {298}, number = {}, pages = {128211}, doi = {10.1016/j.micres.2025.128211}, pmid = {40393170}, issn = {1618-0623}, mesh = {*Tryptophan/metabolism ; *Gastrointestinal Microbiome/physiology ; Humans ; *Bacteria/metabolism ; Receptors, Aryl Hydrocarbon/metabolism ; Animals ; Fungi/metabolism ; Kynurenine/metabolism ; }, abstract = {Human health is influenced by the gut microbiota, particularly in aspects of host immune homeostasis and intestinal immune response. Tryptophan (Trp) not only acts as a nutrient enhancer but also plays a critical role in the balance between host immune tolerance and gut microbiota maintenance. Both endogenous and bacterial metabolites of Trp, exert significant effects on gut microbial composition, microbial metabolism, the host immunity and the host-microbiome interface. Trp metabolites regulate host immunity by activating aryl hydrocarbon receptor (AhR), thereby contributing to immune homeostasis. Among Trp metabolites, AhR ligands include endogenous metabolites (such as kynurenine), and bacterial metabolites (such as indole and its derivatives). Here, we present a comprehensive analysis of the relationships between Trp metabolism and 14 key microbiota, encompassing fungi (e.g., Candida albicans, Aspergillus), bacteria (e.g., Ruminococcus gnavus, Bacteroides, Prevotella copri, Clostridium difficile, Escherichia coli, lactobacilli, Mycobacterium tuberculosis, Pseudomonas aeruginosa, Staphylococcus aureus, Helicobacter. Pylori), and viruses (e.g., SARS-CoV-2, influenza virus). This review clarifies how the gut microbiota regulates Trp metabolism and uncovers the underlying mechanisms of these interactions. And increased mechanistic insight into how the microbiota modulate the host immune system through Trp metabolism may allow for the identification of innovative therapies that are specifically designed to target Trp absorption, Trp metabolites, the gut microbiota, or interactions between Trp and gut microbiota to treat both intestinal and extra-intestinal inflammation as well as microbial infections.}, } @article {pmid40392201, year = {2025}, author = {Hagberg, L and Zetterberg, H and Gisslén, M}, title = {Neurofilament light chain as a biomarker for neuronal injury in CNS infections.}, journal = {Expert review of molecular diagnostics}, volume = {25}, number = {8}, pages = {419-424}, doi = {10.1080/14737159.2025.2509023}, pmid = {40392201}, issn = {1744-8352}, mesh = {Humans ; *Biomarkers/blood/cerebrospinal fluid ; *Neurofilament Proteins/cerebrospinal fluid/blood/metabolism ; *Central Nervous System Infections/diagnosis/blood/cerebrospinal fluid ; COVID-19 ; }, abstract = {INTRODUCTION: In this special report, we summarize studies of cerebrospinal fluid and plasma/serum biomarker neurofilament light chain (NfL) concentrations, a key structural component of myelinated axons in neuroinfections.

AREAS COVERED: The following infections were searched for in PubMed; Neuroinfection and biomarkers, herpes simplex encephalitis and neurofilament light chain, tick-borne encephalitis and neurofilament light chain, Lyme neuroborreliosis and neurofilament light chain, bacterial meningitis and neurofilament light chain, malaria and neurofilament light chain, COVID-19 and neurofilament light chain, HIV infection and neurofilament light chain.

EXPERT OPINION: NfL can serve as a valuable biomarker for assessing disease severity and neurological complications in the acute stage of neuroinfections and can also be useful in evaluating patients with residual symptoms following acute illness.}, } @article {pmid40392198, year = {2025}, author = {Hojeij, B and Koc, GH and Luime, JJ and Vis, M and Coates, LC and Kok, MR and Tchetverikov, I}, title = {Psoriatic arthritis flare incidence, definition and risk factors: a systematic review.}, journal = {Rheumatology (Oxford, England)}, volume = {64}, number = {9}, pages = {4886-4901}, doi = {10.1093/rheumatology/keaf247}, pmid = {40392198}, issn = {1462-0332}, support = {//Department of Rheumatology of the Erasmus MC/ ; }, mesh = {Humans ; Risk Factors ; Incidence ; *Arthritis, Psoriatic/epidemiology/diagnosis ; *Symptom Flare Up ; }, abstract = {OBJECTIVES: We systematically reviewed the literature to identify the incidence of PsA flare, criteria used to define it and associated risk factors.

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

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

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

PROSPERO REGISTRATION: CRD42024482657.}, } @article {pmid40391396, year = {2025}, author = {Vasquez, I and Xue, R and Srivastava, I}, title = {Surface-Enhanced Raman Scattering Nanotags: Design Strategies, Biomedical Applications, and Integration of Machine Learning.}, journal = {Wiley interdisciplinary reviews. Nanomedicine and nanobiotechnology}, volume = {17}, number = {3}, pages = {e70015}, doi = {10.1002/wnan.70015}, pmid = {40391396}, issn = {1939-0041}, mesh = {*Spectrum Analysis, Raman/methods ; Humans ; *Machine Learning ; Animals ; COVID-19/diagnosis ; SARS-CoV-2 ; Neoplasms/diagnosis ; Metal Nanoparticles/chemistry ; }, abstract = {Surface-enhanced Raman scattering (SERS) is a transformative technique for molecular identification, offering exceptional sensitivity, signal specificity, and resistance to photobleaching, making it invaluable for disease diagnosis, monitoring, and spectroscopy-guided surgeries. Unlike traditional Raman spectroscopy, which relies on weak scattering signals, SERS amplifies Raman signals using plasmonic nanoparticles, enabling highly sensitive molecular detection. This technological advancement has led to the development of SERS nanotags with remarkable multiplexing capabilities for biosensing applications. Recent progress has expanded the use of SERS nanotags in bioimaging, theranostics, and more recently, liquid biopsy. The distinction between SERS and conventional Raman spectroscopy is highlighted, followed by an exploration of the molecular assembly of SERS nanotags. Significant progress in bioimaging is summarized, including in vitro studies on 2D/3D cell cultures, ex vivo tissue imaging, in vivo diagnostics, spectroscopic-guided surgery for tumor margin delineation, and liquid biopsy tools for detecting cancer and SARS-CoV-2. A particular focus is the integration of machine learning (ML) and deep learning algorithms to boost SERS nanotag efficacy in liquid biopsies. Finally, it addresses the challenges in the clinical translation of SERS nanotags and offers strategies to overcome these obstacles.}, } @article {pmid40391312, year = {2025}, author = {Atarodi, A and Kalankesh, LR and Ghaderi Nansa, L and Vaziri, MH and Hajighasemkhan, A}, title = {Association between COVID-19 Mortality and Underlying Disease; Tehran, Iran.}, journal = {Journal of caring sciences}, volume = {14}, number = {1}, pages = {37-41}, pmid = {40391312}, issn = {2251-9920}, abstract = {INTRODUCTION: Coronavirus disease has emerged as one of the major health challenges in the 21st century. This study aimed to investigate the association between COVID-19 mortality and underlying disease in Tehran.

METHODS: The retrospective, epidemiological study was conducted from January 1, 2019, to May 31, 2021, in hospitals in Tehran, Iran based on the International Classification of Diseases (ICD-11). Data concerning coronary cases with underlying disease (8018) and related demographic and clinical characteristics are collected by hospitals. Additionally, logistic regression was examined to determine the association between COVID-19 mortality and underlying disease.

RESULTS: The result shows that incurable diseases (47.3%) and cancer (67.7%) had the lowest while; pulmonary disease showed the highest recovery day (80.7%) between various underlying conditions. In addition, cancer and pulmonary disease show 10.41 and 7.3 hospitalization days, respectively. The logistic regression analysis revealed that mortality in cases with cancer as an underlying disease is 4.72 times higher than in cases without cancer (95% CI: 4.08-5.46). Moreover, the adjusted regression analysis showed that the mortality in multiple underlying conditions such as cancer, respiratory issues, cardiovascular problems, and diabetes are 5.48, 2.75, 4.081, and 3.162 times higher, respectively (P<0.05).

CONCLUSION: The findings of this study provide valuable insights into how specific underlying health conditions can increase the risk of COVID-19 mortality, hospitalization, and recovery time.}, } @article {pmid40391308, year = {2025}, author = {Namdar Areshtanab, H and Hosseinzadeh, M and Ebrahimi, H and Arshadi Bostanabad, M and Sepehrnia, N}, title = {Health Anxiety and Its Relationship with Academic Performance and Learning Styles among Nursing Students during COVID-19 Pandemic.}, journal = {Journal of caring sciences}, volume = {14}, number = {1}, pages = {52-57}, pmid = {40391308}, issn = {2251-9920}, abstract = {INTRODUCTION: This study aimed to investigate health anxiety and its relationships with academic performance and learning styles among nursing students during the COVID-19 pandemic.

METHODS: A cross-sectional design was employed, involving 365 participants selected through stratified random sampling in Iran in 2021. Data were collected using Health Anxiety Inventory, Visual, Aural, Reading/Writing, and Kinesthetic Learning Styles Questionnaire and students' self-reported grade point average (GPA). Data were analyzed using descriptive and inferential statistics (independent samples t-test, one-way ANOVA, Pearson correlation coefficient and chi-square test) by SPSS version 13.

RESULTS: The mean (SD) health anxiety score among nursing students was 24.33(9.79) on a range of 0-54; and the mean (SD) of GPA was 15.60 (1.51) on a range of 0-20. The majority of students (85.8%) had a unimodal learning style, with the dominant pattern being kinetic-motor (39.7%). The study found a negative correlation between health anxiety and academic performance (r=-0.19, P≤0.05). However, no significant association was identified between health anxiety and learning style (r=-0.27, P=0.42). The analysis of health anxiety among participants indicated notable differences based on demographic factors such as sex, interest in nursing, and education level (P<0.001).

CONCLUSION: This study revealed a moderate level of health anxiety among Iranian nursing students during the COVID-19 pandemic and identified a significant negative correlation between health anxiety and academic performance. These findings underscore the need for interventions targeting health anxiety to potentially improve academic outcomes for nursing students, as reducing anxiety levels can enhance focus, learning capacity, and overall academic performance.}, } @article {pmid40391044, year = {2025}, author = {Duenas, K and Chwa, WJ and Hoque, F}, title = {Overview of Long COVID: Navigating the Aftermath.}, journal = {Journal of Brown hospital medicine}, volume = {4}, number = {2}, pages = {133879}, pmid = {40391044}, issn = {2994-5593}, abstract = {The coronavirus disease (COVID-19) pandemic was a global health crisis with far-reaching consequences. Among these were physical and mental health complications that emerged weeks or even months after the initial COVID-19 infection, collectively termed "long COVID" or "post-COVID syndrome." Identifying the epidemiology, risk factors, clinical manifestations, and management strategies for long COVID is crucial for both clinicians and patients, which is the focus of this review. The prevalence of long COVID varies across studies, generally ranging from 5% to 20%. Prominent risk factors include female sex, older age, a high number of acute symptoms, lower socioeconomic status, and underlying comorbidities such as diabetes, asthma, or chronic obstructive pulmonary disease. The clinical manifestations of long COVID are diverse; beyond the commonly reported symptoms of fatigue, malaise, ageusia, and anosmia, neuropsychiatric complications such as headache, cognitive deficits, and depression are also potential outcomes. Although there is currently no consensus on the management of long COVID, multidisciplinary care teams with appropriate referrals and follow-up diagnostic studies are essential in evaluating the clinical course of long COVID patients.}, } @article {pmid40390594, year = {2025}, author = {Imazio, M and Basso, C and Brucato, A and Klingel, K and Kuchynka, P and Lazaros, G and Merlo, M and Sinagra, G and Adler, Y and Bucciarelli Ducci, C and Cameli, M and Castelletti, S and Caforio, AL and Crotti, L and Dagna, L and Frustaci, A and Klein, A and Kuusisto, J and Lopez Sainz, A and Marcolongo, R and Pantazis, A and Rigopoulos, AG and Ristic, A and Seferovic, P and Sheppard, M and Tschöpe, C and Lüscher, T}, title = {Myopericardial complications following COVID-19 disease and vaccination: a clinical consensus statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases.}, journal = {European heart journal}, volume = {46}, number = {34}, pages = {3328-3338}, doi = {10.1093/eurheartj/ehaf222}, pmid = {40390594}, issn = {1522-9645}, mesh = {Humans ; Cardiology ; Consensus ; *COVID-19/complications/prevention & control ; *COVID-19 Vaccines/adverse effects ; Europe ; *Myocarditis/etiology/therapy/diagnosis/epidemiology ; Pericarditis/etiology/therapy ; SARS-CoV-2 ; *Vaccination/adverse effects ; }, abstract = {The aim of the present clinical consensus statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases is to review the current knowledge on the epidemiology, pathogenesis, diagnosis, therapy, and outcomes of myocardial and pericardial complications of coronavirus disease 2019 (COVID-19) and vaccination in order to improve the awareness and clinical confidence on the management of patients with these complications. The risk of myopericardial complications is especially higher within 1 month of COVID-19 disease and vaccination. Forms related to the disease are generally more common and severe than those related to vaccination. Even if vaccination against COVID-19 increases myocarditis risk, this risk is lower in vaccinated than non-vaccinated COVID-19 individuals, supporting the vaccine use. Overall, COVID-19 related complications, especially myocarditis, are relatively rare.}, } @article {pmid40389865, year = {2025}, author = {Fatoke, B and Hui, AL and Saqib, M and Vashisth, M and Aremu, SO and Aremu, DO and Aremu, DB}, title = {Type 2 diabetes mellitus as a predictor of severe outcomes in COVID-19 - a systematic review and meta-analyses.}, journal = {BMC infectious diseases}, volume = {25}, number = {1}, pages = {719}, pmid = {40389865}, issn = {1471-2334}, mesh = {Humans ; *COVID-19/mortality/complications/therapy ; *Diabetes Mellitus, Type 2/complications/mortality ; Respiration, Artificial/statistics & numerical data ; SARS-CoV-2 ; Severity of Illness Index ; Risk Factors ; }, abstract = {BACKGROUND: The COVID-19 pandemic has posed significant challenges to global health, with type 2 diabetes mellitus (T2DM) emerging as a key risk factor for adverse outcomes. This study systematically reviews and quantifies the association between T2DM and COVID-19 outcomes, including mortality, severity, and need for mechanical ventilation.

METHODS: A systematic review and meta-analysis were conducted that adhered to PRISMA guidelines. We searched PubMed, Scopus, Web of Science and Embase for studies published from december 2019 to march 2024. Eligible studies reported on the impact of T2DM on COVID-19 outcomes in the adult population. Data were extracted and analyzed using a random-effects model, and heterogeneity was assessed using the I[2] statistic. Publication bias was assessed using Egger regression, Kendall's Tau, and the Fail-safe N calculation.

RESULTS: Eighteen studies were included in the meta-analysis for mortality, six for severity and five for mechanical ventilation. T2DM was significantly associated with higher mortality (OR = 3.66, 95% CI: 2.20-5.11, p < 0.001), higher severity (OR = 1.97, 95% CI: 1.02-2.92, p < 0.001), and higher need for mechanical ventilation (OR = 2.34, 95% CI: 1.18-3.49, p < 0.001). Heterogeneity was high for mortality (I[2] = 83.83%) but low for severity and mechanical ventilation (I[2] = 0%). No significant publication bias was found.

CONCLUSIONS: T2DM is associated with significantly worse outcomes in COVID-19 patients, including higher mortality, higher severity and a greater likelihood of needing mechanical ventilation. These findings emphasize the need for targeted interventions and management strategies for individuals with T2DM during the ongoing pandemic. Future research should focus on understanding the underlying mechanisms and exploring strategies to mitigate these risks.}, } @article {pmid40389321, year = {2025}, author = {Nagappan, PG and Tan, SRX and Absar, S and Brown, S and Sayers, S and McManus, A and Arora, A and Kuhn, I and Khan, F and Lau, E and Tulinius, C}, title = {Changes in medical student attendance at in-person teaching sessions: a systematic review.}, journal = {BMJ open}, volume = {15}, number = {5}, pages = {e091768}, pmid = {40389321}, issn = {2044-6055}, mesh = {Humans ; *Students, Medical/statistics & numerical data ; *COVID-19/epidemiology ; SARS-CoV-2 ; *Education, Distance ; *Teaching ; *Education, Medical, Undergraduate ; *Education, Medical ; United Kingdom ; Schools, Medical ; Pandemics ; }, abstract = {INTRODUCTION: The COVID-19 pandemic has had a significant impact on medical education, with many institutions shifting to online learning to ensure the safety of students and staff. However, there appears to be a decline in in-person attendance at medical schools across the UK and worldwide following the relaxation of social distancing rules and the reinstatement of in-person teaching. Importantly, this trend was also observed before the pandemic. While reflected within the literature, there is currently no systematic review describing these changes. We aim to find out how medical students' attendance is changing as documented within the literature and its impact on their educational outcomes.

METHODS: This systematic review followed the guidelines of the Centre of Research and Dissemination, Moose and Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We searched the major databases of Medline via Ovid, Embase via Ovid, Scopus, Web of Science, British Education Index via EBSCOhost and ERIC via EBSCOhost in September 2023. Two reviewers independently screened each paper and extracted the data, with a third reviewer for dispute resolution. All studies reporting on medical students from various universities, both graduate and undergraduate, and describing changes in attendance and/or students' educational outcomes were included. Risk of bias in individual studies was assessed using the Agency for Healthcare Research and Quality tool. A narrative synthesis of the findings from all included studies was done.

RESULTS: 12 papers were included in the analysis.

PRIMARY AIM: Of the eight papers that measured attendance data over more than one academic year, only one paper demonstrated a statistically significant decrease while one paper demonstrated a statistically significant increase in attendance over the observational period. Other papers either did not perform statistical tests or did not demonstrate statistical significance. Secondary aims: Most papers showed a general positive correlation between attendance and educational outcomes. No studies explicitly explored reasons for changes in attendance seen. Only one paper outlined a possible strategy to address changes in attendance, a mandatory attendance policy, which has mixed outcomes.

DISCUSSION: Despite widespread anecdotally reported attendance decline post-COVID-19, overall, there was no consistent change in attendance noted. However, there was a large heterogeneity in the studies included. Further research is required to elucidate trends in attendance and its impact on medical education.}, } @article {pmid40389117, year = {2025}, author = {Rudroff, T}, title = {Climate crossroads: How global warming drives coronavirus emergence, the long COVID crisis of tomorrow, and AI's role in navigating our future.}, journal = {Infectious diseases now}, volume = {55}, number = {6}, pages = {105091}, doi = {10.1016/j.idnow.2025.105091}, pmid = {40389117}, issn = {2666-9919}, mesh = {Humans ; *COVID-19/epidemiology/transmission/virology ; *Global Warming ; SARS-CoV-2 ; Animals ; *Artificial Intelligence ; Climate Change ; Pandemics ; *Coronavirus Infections/epidemiology/transmission ; }, abstract = {This narrative review examines the critical nexus between climate change, coronavirus emergence, and Long COVID-a triad that may shape public health outcomes for generations. Climate change disrupts ecological balances that have historically limited viral spillover events, creating novel interfaces between wildlife reservoirs and human populations. The coronavirus family presents particular concern due to its diversity, adaptability, and demonstrated capacity for cross-species transmission. With over 200 coronaviruses identified in bat populations alone, this vast reservoir of genetic diversity, combined with the family's propensity for recombination, creates substantial pandemic potential that climate disruption may further amplify. Long COVID has revealed another dimension of the coronavirus threat: the potential for significant chronic disease burden following acute infection. This complex multisystem condition affects a substantial portion of SARS-CoV-2 infected individuals, with mechanisms including viral persistence, autoimmunity, microclot formation, and mitochondrial dysfunction. Future projections suggest that climate change could increase global viral spillover risk by 30-45% by 2070, particularly in Southeast Asia, Central Africa, and parts of South America. Artificial intelligence offers promising tools for addressing these interconnected challenges through enhanced surveillance, accelerated therapeutic development, and optimized healthcare delivery. Understanding the climate-coronavirus-chronic illness nexus has become essential to the development of resilient health systems and effective planetary health policies face to an uncertain future.}, } @article {pmid40388534, year = {2025}, author = {Park, T and Brickwood, S and Buss, K and Tran, V and Parsons, D and Wisely, K and Gillett, K and Lavis, H and Heaney, S}, title = {Virtually delivered lifestyle interventions for overweight and obese pregnant people: A systematic review.}, journal = {Women's health (London, England)}, volume = {21}, number = {}, pages = {17455057251336292}, pmid = {40388534}, issn = {1745-5065}, mesh = {Humans ; Pregnancy ; Female ; Telemedicine ; *Overweight/therapy ; *Obesity/therapy ; *Pregnancy Complications/prevention & control/therapy ; Gestational Weight Gain ; Exercise ; COVID-19/epidemiology ; *Life Style ; *Pregnant People ; Adult ; Prenatal Care/methods ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Gestational weight gain (GWG) impacts both foetal and maternal health outcomes, with excessive GWG in overweight and obese people further increasing the risk of complications for this population. Lifestyle changes including consuming a healthy diet and physical activity are core strategies for management. Since 2020 and the emergence of the COVID-19 pandemic, use of telehealth has increased; however, little is known about the effectiveness of virtually delivered strategies for maintaining healthy gestational weight during pregnancy.

OBJECTIVES: To describe the effect of virtually delivered lifestyle interventions on promoting healthy GWG and reducing maternal and foetal complications associated with excessive GWG, with the view to inform future clinical practice.

DESIGN: This systematic review followed preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines and targeted quantitative studies assessing virtually delivered lifestyle interventions for maintaining healthy gestational weight for overweight and obese pregnant individuals aged 18 and older.

DATA SOURCES AND METHODS: Six databases (MEDLINE, CINHAL, EMBASE, EMCARE, MIDIRS and APA PsycINFO) were searched using a rigorous search strategy. Data extraction investigated mode of telehealth delivery, intervention type and GWG outcomes. Quality appraisal was conducted using the Critical Appraisal Skills Programme tool and risk of bias was assessed using the Risk of Bias assessment (RoB-2).

RESULTS: Nine studies met inclusion criteria and within those studies, six different telehealth modalities were identified. Interventions varied and included GWG tracking, step counts, diet and exercise goal setting. Effectiveness of studies was inconsistent, with five studies demonstrating lower GWG.

CONCLUSION: Results suggest that lifestyle interventions delivered via telehealth may be effective at reducing excessive GWG. The development of targeted interventions integrated into obstetric guidelines aimed at reducing excessive GWG via telehealth platforms should be considered as a strategy not only for pandemic situations, but to increase antenatal care and service access.

REGISTRATION: PROSPERO International Prospective Register on 26 January 2023 (CRD42023392095).}, } @article {pmid40387617, year = {2025}, author = {Ogini, F and Elesho, R and Awuonda, M}, title = {Assessment of Patients' Postpandemic Perception of Telehealth Utilization: A Scoping Review.}, journal = {Telemedicine journal and e-health : the official journal of the American Telemedicine Association}, volume = {}, number = {}, pages = {}, doi = {10.1089/tmj.2024.0604}, pmid = {40387617}, issn = {1556-3669}, abstract = {Background: Studies have reported telehealth benefits, focusing on telehealth performance during the pandemic. However, there is a need to assess the persistence of patients' satisfaction beyond the pandemic. The objective of this work was to evaluate patient satisfaction, acceptance, and utilization of telehealth in the postpandemic years, highlighting significant barriers and potential areas for future studies. Methods: Published studies were identified from PubMed and Scopus databases from January 2022 to January 2024. Predesigned inclusion/exclusion criteria and Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram were applied. Search terms related to "Post-pandemic," "Patient satisfaction," and "Telehealth" were used, and the primary outcomes of interest (patients' perception and satisfaction) were extracted from the articles. Results: A total of 228 articles were obtained from the literature search. After screening, 17 articles were included in the study. Most studies recorded sustained satisfaction and a decrease in utilization early postpandemic. Recurring areas of concern reported by patients were barriers related to patient-physician communication, the ineffectiveness of telehealth due to a lack of physical examination, and the preference for telehealth for less severe conditions. Individuals without prior telehealth experience had the lowest tendency to utilize telehealth. Treatment time, reduced trust in specialist competency, and lack of familiarity with telehealth modality were identified as nonconventional factors influencing telehealth utilization. Conclusion: Telehealth remains an essential form of care delivery in the postpandemic years. This review emphasizes the need for more up-to-date research on patients' telehealth perceptions. The recurring barriers, emerging nonconventional factors, and telehealth optimization for less preferred visit types are areas for future research.}, } @article {pmid40386870, year = {2024}, author = {Milevska Kostova, N and Atanasova, S and Dimkovski, V and Stevanovski, G and Stæhr Johansen, A and Winkelmann, J and Rechel, B}, title = {North Macedonia: Health System Review.}, journal = {Health systems in transition}, volume = {26}, number = {6}, pages = {1-164}, pmid = {40386870}, issn = {1817-6127}, support = {001/WHO_/World Health Organization/International ; }, mesh = {Humans ; Republic of North Macedonia/epidemiology ; *COVID-19/epidemiology ; *Health Care Reform/organization & administration ; *Delivery of Health Care/organization & administration/economics ; Health Services Accessibility/organization & administration ; SARS-CoV-2 ; Health Expenditures ; Healthcare Financing ; Universal Health Insurance ; }, abstract = {This analysis of North Macedonia's health system reviews developments in its organization and governance, financing, provision of services, health reforms and health system performance. Life expectancy improved prior to the COVID-19 pandemic, but remains far below the EU average, and the country still struggles with comparatively high levels of morbidity and mor¬tality. The social health insurance system covers almost the entire population and progress has been achieved in providing access to publicly covered essential health services. However, challenges remain for patients in access¬ing health services and in financial protection. Geographical accessibility of services varies, with better access in the capital and major cities compared to smaller towns and rural areas. In terms of health financing, the health system offers universal population coverage for a wide range of benefits and services, which are free at the point of delivery or require only minimal co-payments to prevent overuse. Yet the share of private spending on health as a percentage of current health expenditure is high, which undermines the achievement of key health system goals, such as financial protection, equity and efficiency. The health workforce has been a focus of health reforms and efforts are underway to strengthen education and training to improve the skill mix and competences of the health workforce to respond to new challenges and an ageing population. The ratio of physicians per population has increased markedly in recent years, but remains below the EU average. The priorities for the country in the National Health Strategy 2021-2030 are restructuring the hospital system, continuing the country's primary care reform, and improving quality of care while increasing the efficiency of resource use. Access to medicines has improved, but further efforts are needed to ensure access to innovative medicines and treatments. Overall, the Macedonian health system has made important progress, especially in terms of digitalization of health care and access to e-services and telemedicine, but unmet needs remain an issue. The main outstanding challenges include increasing the responsiveness of the health system to population needs; redistributing resources and activities from hospitals to primary care; ensuring access to medicines; and safeguarding the financial sustainability of the health system.}, } @article {pmid40386630, year = {2025}, author = {Poddar, A and Rao, SR}, title = {Innovation landscape in nanobiosensors for COVID-19 detection and future implications for a resilient Global Health Security.}, journal = {3 Biotech}, volume = {15}, number = {6}, pages = {170}, pmid = {40386630}, issn = {2190-572X}, abstract = {This review presents a comprehensive analysis of nanobiosensors (NBSs) advancements for COVID-19 detection, highlighting their repurposing potential to enhance global health security against emerging threats. It outlines the use of various nanomaterials like gold and magnetic nanoparticles in developing NBSs for detecting SARS-CoV-2, emphasizing their adaptability and rapid detection capabilities. Gold nanoparticles are highlighted for their superior surface chemistries and stability, making them ideal for label-free COVID-19 detection and other diagnostic applications. Magnetic nanoparticles, particularly superparamagnetic iron oxides, offer alternative detection mechanisms based on magnetism, providing high sensitivity and reliability in pathogen detection. The document also discusses nonmetallic nanomaterials, such as single-walled carbon nanotubes and selenium nanoparticles, which have been used to develop optical and electrochemical NBSs for COVID-19 detection. Breathalyzers are recognized for their noninvasive, rapid detection of volatile organic compounds specific to COVID-19. Such advancements in NBSs have significantly contributed to global health security by providing reliable, portable, and affordable diagnostic solutions, especially in resource-limited settings. However, despite technological advancements, commercialization and market adoption challenges persist, necessitating improvements in manufacturing scalability, cost reduction, and clinical validation. The document emphasizes the need for transparent and efficient regulatory strategies to address concerns related to nanomaterial toxicity, health effects, and environmental impact during the R&D phase. While presenting a comprehensive framework for successful research to market translation, this review highlights the need for cross-sectoral collaboration to tailor country-specific nanotechnology roadmaps for optimized resource allocation, navigating diverse regulations, and addressing unique societal needs.}, } @article {pmid40386461, year = {2025}, author = {Nain, A and Bohra, NS and Singh, A and Verma, R and Kumar, R and Kumar, R}, title = {Mapping the landscape: A bibliometric analysis of AI and teacher collaboration in educational research.}, journal = {F1000Research}, volume = {14}, number = {}, pages = {201}, pmid = {40386461}, issn = {2046-1402}, mesh = {*Bibliometrics ; Humans ; *Artificial Intelligence ; *Cooperative Behavior ; COVID-19 ; *Research ; }, abstract = {BACKGROUND: This study intends to investigate the relationship between artificial intelligence and teachers' collaboration in educational research in response to the growing use of technologies and the current status of the field.

METHODS: A total of 62 publications were looked at through a systematic review that included data mining, analytics, and bibliometric methods.

RESULT: The study shows a steady increase in the field of artificial intelligence and teacher collaboration in educational research, especially in the last few years with the involvement of the USA, China, and India. Education and information technology are the main contributors to this field of study, followed by an international review of open and distance learning research. The Scopus database was chosen for this study because of its extensive coverage of high-quality, peer-reviewed literature and robust indexing system, making it a dependable source for conducting bibliometric analyses. Scopus offers substantial information, citations tracking, and multidisciplinary coverage, which are critical for spotting publication trends, significant articles, major themes, and keywords in the area. The findings show that education and information technology make the most significant contributions to this sector, followed by international studies on open and distance learning.

CONCLUSIONS: Over a three-year period, the average citation value is 12.44%. The education system, learning, e-learning, sustainability, COVID-19 issues, team challenges, organizational conflicts, and digital transformation are just a few of the topics it significantly contributes to. The study acknowledges its limitations and considers potential avenues for additional research. The results also emphasize important gaps in the literature, highlighting the necessity for more research. This information can help develop strategic approaches to address issues and take advantage of opportunities relating to artificial intelligence and teacher collaboration in higher education and research. The study's ultimate goal is to offer guidance for tactics that promote teachers' cooperation in educational research and the development of artificial intelligence.}, } @article {pmid40385980, year = {2025}, author = {Sklienka, P and Burša, F and Frelich, M and Máca, J and Romanová, T and Vodička, V and Straková, H and Bílená, M and Jor, O and Neiser, J and Tomášková, H}, title = {Lessons Learned From Awake ECMO Approach in Covid-19-Related Acute Respiratory Distress Syndrome - a Scoping Review.}, journal = {Therapeutics and clinical risk management}, volume = {21}, number = {}, pages = {655-668}, pmid = {40385980}, issn = {1176-6336}, abstract = {During the COVID-19 pandemic, specific COVID-19-related conditions renewed interest in the full-awake venovenous extracorporeal membrane oxygenation ([fa] V-V ECMO) approach, in which ECMO is applied to awake, cooperative, and non-intubated patients. This scoping review aims to provide a descriptive overview of [fa] V-V ECMO in patients with COVID-19-related acute respiratory distress syndrome (CARDS). We searched the PubMed, Web of Science, and Scopus databases using the keywords "awake ECMO" or "spontaneous breathing AND ECMO", combined with "COVID-19", "SARS-CoV-2" or "coronavirus", utilizing the Boolean operator "AND". The search included papers published from November 1, 2019, to December 31, 2024. Sixty-four papers were assessed for eligibility at the abstract level, and fourteen articles (seven small-sample cohort studies and seven case reports) comprising 95 patients were included in the final analysis. The most frequent reasons for preferring [fa] V-V ECMO over mechanical ventilation were barotrauma and patient refusal of intubation and mechanical ventilation. The [fa] V-V ECMO strategy was successful (ie, patients not intubated, disconnected from ECMO, and discharged from the hospital) in 36.4% of cases (cohort studies only). The incidence of defined severe adverse events (bleeding, thrombosis, cannula malposition, delirium, and progression of barotrauma) was considered low. The mortality rate for CARDS patients treated with [fa] V-V ECMO (including only patients from cohort studies) reached 33.0%, notably lower than the 48% reported for CARDS patients treated with V-V ECMO in the ELSO registry. Patients who were intubated due to worsening respiratory failure during [fa] V-V ECMO had significantly higher mortality. Infectious complications, sepsis, and multiorgan failure were the most frequent causes of death. However, significant heterogeneity in the definitions and reporting of management, ECMO-related complications, and outcomes was observed across the papers. Despite the heterogeneity of the data, [fa] V-V ECMO in CARDS patients can be considered a safe approach associated with a lower mortality rate than that reported in the overall V-V ECMO CARDS population.}, } @article {pmid40385903, year = {2025}, author = {Saran, E and Brenna, CT and Brar, A and Lee, J and Thomas, D and Huszti, E and Sharma, S and Ladha, KS}, title = {Academic Output of Anesthesiology Departments in Canada From 2014 to 2023: A Bibliometric Analysis Study.}, journal = {Cureus}, volume = {17}, number = {4}, pages = {e82452}, pmid = {40385903}, issn = {2168-8184}, abstract = {Anesthesia research is essential for advancing clinical practice and patient care. The purpose of this study was to analyze research productivity in Canadian anesthesiology departments from 2014 to 2023, focusing on trends in publication volume, methodology, and the impact of the COVID-19 pandemic. A bibliometric analysis was conducted following a pre-registered protocol to identify articles in the PubMed database, which were published between 2014 and 2023 (inclusive) with corresponding authors from Canadian anesthesiology departments. Data extracted for each article included the year of publication, journal, and study design. Descriptive statistics and Pearson correlation coefficient were used to compare trends, while annual publication rates were assessed with linear regression. An interaction term captured differences between pre-pandemic (2014-2020) and post-pandemic (2021-2023) periods. A total of 3,490 articles met the inclusion criteria. From 2014 to 2020 (pre-pandemic period), publication volume increased significantly by 28.7 studies/year (95% CI: 19.2-38.2, p < 0.001). In contrast, 2021-2023 (post-pandemic period) showed a non-significant decline of 13.0 studies/year (95% CI: -48.6-22.6, p = 0.405). Pre-pandemic trends showed significant growth in reviews, case-control/cohort studies, and surveys, while publication rates declined across most categories after 2020. Our findings illustrate an increase in research productivity among Canadian anesthesiology departments from 2014 to 2020, followed by a plateau in publication volume after the onset of the COVID-19 pandemic. This stagnation highlights a critical area for future exploration, including examining how pandemic-related factors, such as shifts in clinical priorities, resource allocation, and adoption of telemedicine in pre-operative clinics, have influenced research productivity. As the field of anesthesiology adapts to post-pandemic realities, ongoing bibliometric studies will be essential to monitor these trends and guide the trajectory of Canadian anesthesia research amid emerging clinical challenges and evolving academic priorities.}, } @article {pmid40385745, year = {2025}, author = {Puia, D and Ivanuta, M and Pricop, C}, title = {A Bibliometric Analysis of COVID-19 Publications Between January 2019 and February 2025 by Romanian Authors.}, journal = {Cureus}, volume = {17}, number = {4}, pages = {e82339}, pmid = {40385745}, issn = {2168-8184}, abstract = {The coronavirus disease 2019 (COVID-19) pandemic, declared by the World Health Organization (WHO) on March 11, 2020, had profound global consequences, including significant mortality, economic disruption, and strain on healthcare systems. Romania was also severely affected, with Suceava County being dubbed the "Romanian Lombardy" due to its high infection rates. In response, Romanian researchers actively contributed to scientific literature on COVID-19, producing numerous publications addressing epidemiology, public health policies, and medical treatments. This study aims to analyze Romanian scientific contributions related to COVID-19 using bibliometric methods. A bibliometric analysis was conducted using Web of Science, focusing on publications from Romanian universities, hospitals, and medical organizations. Articles were selected based on relevance to medicine, while non-research publications such as editorials and book reviews were excluded. The study employed VOSviewer (available at https://www.vosviewer.com/) for co-authorship and keyword analysis, alongside CiteSpace (available at https://citespace.podia.com/) for citation burst analysis. Between January 2019 and March 2025, 4,720 COVID-19-related articles with at least one Romanian author were indexed in Web of Science. After applying the inclusion criteria, 336 articles remained. The most productive authors were from Dunărea de Jos University, Galați, and the University of Oradea. Most studies were published in MDPI journals, with predominant research areas including internal medicine, pharmacology, and experimental medicine. Keyword analysis highlighted major research themes such as COVID-19 impact, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and pandemic response. Romanian research significantly influenced public health policies, guiding pandemic management strategies. The crisis accelerated digital healthcare adoption, including telemedicine services. Biomarkers such as C-reactive protein (CRP), interleukin-6 (IL-6), and lactate dehydrogenase (LDH) were identified as predictors of COVID-19 severity. Additionally, the pandemic had severe psychological and social consequences, particularly among vulnerable populations. This bibliometric analysis underscores the substantial role of Romanian researchers in the global fight against COVID-19 and the lasting impact of their contributions. Understanding Romania's scientific contribution to COVID-19 literature helps assess the country's research impact, identify strengths in key areas, and highlight opportunities for international collaboration in pandemic-related studies.}, } @article {pmid40385588, year = {2025}, author = {Ranque, B and Cogan, E}, title = {Internal medicine at the crossroads of long COVID diagnosis and management.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1521472}, pmid = {40385588}, issn = {2296-858X}, abstract = {The lack of specificity in its definition is a major obstacle to both explanatory and therapeutic research in long COVID. It brings together, on the one hand, patients with severe COVID-19 who suffer the classic complications of prolonged hospitalization and decompensation of comorbidities and, on the other hand, patients with non-severe acute COVID-19 who report multiple symptoms that cannot be fully explained by a biomechanical model. Indeed, despite numerous studies, it remains unclear how persistent viral infection, immunological or coagulation disturbances may contribute mechanistically to long COVID. Nevertheless, internal medicine should be in good place to manage these patients. Indeed, the diversity of symptoms may evoke a broad spectrum of differential diagnoses that are familiar to internists. Their experience in the exploration of unexplained symptoms is also valuable. It can reduce the need for multiple consultations with specialists and unnecessary laboratory or imaging tests. However, long COVID diagnosis cannot be limited to the exclusion of all other conditions one by one. An open and non-dualistic approach is required to identify other mechanisms that may explain the symptoms. Based on their clinical experience, most French internists who responded to an opinion survey consider that long COVID corresponds most closely to a functional somatic disorder (FSD) and seek the help of specialists in mental health care to assist in the management of the patients in a multi-disciplinary approach. However, as with other FSDs, patients with long COVID are usually reluctant to be managed by mental health care specialists, given the very physical nature of their presentation. Unfortunately, most physicians are in turn reluctant to take care of them, due to poor knowledge about FSD, leading to management failure. Alternatively, a comprehensive multidisciplinary care orchestrated by an experienced internist is generally well-accepted. It includes providing rational cognitive explanations for the symptoms and support for behavioral changes tailored to the patient. While waiting for hypothetical randomized controlled trials assessing drugs with positive results, such a holistic approach has been successfully applied in many individuals with severe long COVID. However, its generalization would require a much broader training for FSD of all health care providers.}, } @article {pmid40384881, year = {2025}, author = {Oehler, JB and Burns, K and Warner, J and Schmitz, U}, title = {Long-Read Sequencing for the Rapid Response to Infectious Diseases Outbreaks.}, journal = {Current clinical microbiology reports}, volume = {12}, number = {1}, pages = {10}, pmid = {40384881}, issn = {2196-5471}, abstract = {PURPOSE OF REVIEW: Long-read sequencing (LRS) has revolutionized pathogen surveillance by enabling real-time, high-fidelity genomic analysis critical for outbreak response. This review synthesizes recent breakthroughs in LRS, evaluating its impact on genomic epidemiology, metagenomics, and public health decision-making while addressing limitations and prospects for integrating LRS into global outbreak surveillance.

RECENT FINDINGS: Unlike short-read sequencing, LRS-pioneered by Oxford Nanopore Technologies (ONT) and Pacific Biosciences (PacBio)-resolves complex genomic structures, antimicrobial resistance determinants, and transmission dynamics with unprecedented accuracy. The portability of some LRS devices has facilitated rapid pathogen identification in field settings, notably during the Ebola and COVID-19 pandemics. Despite advancements in basecalling algorithms and target enrichment, challenges including sequencing errors, computational bottlenecks, and cost barriers remain.

SUMMARY: By critically evaluating recent findings and discussing future directions, this review highlights the importance of leveraging LRS for outbreak preparedness and response, equipping researchers and public health professionals with the knowledge necessary to navigate the complexities of modern infectious disease challenges.}, } @article {pmid40384749, year = {2025}, author = {Coller, BS}, title = {Embedding a commitment to equitable global access into basic and early-phase translational research.}, journal = {Journal of clinical and translational science}, volume = {9}, number = {1}, pages = {e88}, pmid = {40384749}, issn = {2059-8661}, abstract = {The COVID-19 pandemic laid bare the inequities in U.S. healthcare in ways that captured public attention and reinforced the need to view all of healthcare through an equity lens. It also exposed global inequities in access to healthcare technologies. At Rockefeller University, we participate in the entire spectrum of translational research, but our focus is in the areas of basic research and new methods to prevent, diagnose, and treat disease, extending to proof of concept preclinical and Phase 1 studies. Since we believe that all phases of translational research should have an equity lens, we have instituted an initiative to encourage thought and planning about global equitable access to discoveries made by our trainee Clinical Scholars and faculty, even at the earliest phases of basic research. Assuring global equitable access to new technologies requires addressing at least 3 different aspects of new technology: 1. Patenting and licensing, 2. Manufacturing, and 3. Dissemination and implementation in low- and middle-income countries. In this review, I focus on patenting and licensing and offer ten questions for inventors to consider in discussing licensing their technologies with technology transfer officers to maximize equitable global access to the technologies they create.}, } @article {pmid40384465, year = {2025}, author = {Liang, J and Liu, C and Xu, T}, title = {Innovative biosensing smart masks: unveiling the future of respiratory monitoring.}, journal = {Materials horizons}, volume = {12}, number = {16}, pages = {5975-5993}, doi = {10.1039/d5mh00279f}, pmid = {40384465}, issn = {2051-6355}, mesh = {Humans ; *Biosensing Techniques/methods/instrumentation ; *Masks ; *COVID-19/prevention & control/diagnosis ; SARS-CoV-2/isolation & purification ; Monitoring, Physiologic/instrumentation/methods ; Equipment Design ; }, abstract = {Real-time monitoring of respiratory health is increasingly critical, particularly in addressing global health challenges such as Corona Virus Disease 2019 (COVID-19). Smart masks equipped with biosensing mechanisms revolutionize respiratory health monitoring by enabling real-time detection of respiratory parameters and biomarkers. In recent years, significant advancements have been achieved in the development of smart masks based on different sensor types with high sensitivity and accuracy, flexible functionality, and portability, providing new approaches for remote and real-time monitoring of respiratory parameters and biomarkers. In this review, we aim to provide a comprehensive overview of the current state of development and future potential of biosensing smart masks in various domains. This review outlines a systematic categorization of smart masks according to diverse sensing principles, classifying them into six categories: electrochemical sensors, optical sensors, piezoelectric sensors, and others. This review discusses the basic sensing principles and mechanisms of smart masks and describes the existing research developments of their different biosensors. Additionally, it explores the innovative applications of smart masks in health monitoring, protective functions, and expanding application scenarios. This review also identifies the current challenges faced by smart masks, including issues with sensor accuracy, environmental interference, and the need for better integration of multifunctional features. Proposed solutions to these challenges are discussed, along with the anticipated role of smart masks in early disease detection, personalized medicine, and environmental protection.}, } @article {pmid40384192, year = {2025}, author = {Cercel, RA and Buibaş, FI and Şerbănescu, MS and Mirea, AA and Dumitrescu, F and Pirici, I and Badea-Voiculescu, O and Mogoantă, L and Botezat, MM}, title = {COVID-19 - multisystem disease.}, journal = {Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie}, volume = {66}, number = {1}, pages = {61-67}, pmid = {40384192}, issn = {2066-8279}, mesh = {Humans ; *COVID-19/complications ; SARS-CoV-2 ; *Systemic Inflammatory Response Syndrome ; }, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19), caused a global public health crisis, with a significant impact on multiple body systems. This virus, a member of the Coronaviridae family, shows ~80% genomic similarity to SARS-CoV and ~50% genomic similarity to Middle East respiratory syndrome coronavirus (MERS-CoV). The spike (S) protein plays an essential role in the pathogenesis of the virus, as it facilitates its entry into host cells by binding to the angiotensin-converting enzyme 2 (ACE2) receptor. In addition to the respiratory system damage, SARS-CoV-2 infection causes a variety of gastrointestinal (GI), neurological, cardiovascular (CV), ocular, renal, etc. clinical manifestations. Neurological complications, such as anosmia, ague, headache, encephalitis and cerebrovascular events, were frequently observed, being attributed to both direct viral invasion and a very strong systemic inflammatory response. GI symptoms such as diarrhea, nausea and vomiting are common and may occur independently of respiratory symptoms, and the presence of viral ribonucleic acid (RNA) detected in fecal samples suggests possible fecal-oral transmission. The CV system is affected by myocardial damage, inflammation and coagulation disorders, with an increased risk of thromboembolic events. At the ocular level, the virus was identified in ocular secretions, and conjunctivitis, uveitis and episcleritis were observed in about 11% of patients. Renal involvement, manifested by acute kidney injury, was detected in 0.5-7% of cases. In conclusion, SARS-CoV-2 infection is not limited to respiratory tract involvement but also has significant systemic implications.}, } @article {pmid40384184, year = {2025}, author = {Rejinold N, S and Choi, G and Jin, GW and Choy, JH}, title = {Transforming Niclosamide through Nanotechnology: A Promising Approach for Long COVID Management.}, journal = {Small (Weinheim an der Bergstrasse, Germany)}, volume = {21}, number = {27}, pages = {e2410345}, pmid = {40384184}, issn = {1613-6829}, support = {//National Academy of Sciences, Republic of Korea/ ; }, mesh = {*Niclosamide/therapeutic use/chemistry ; Humans ; COVID-19/complications ; *Nanotechnology/methods ; SARS-CoV-2 ; Pandemics ; COVID-19 Drug Treatment ; Post-Acute COVID-19 Syndrome ; Betacoronavirus ; *Coronavirus Infections/drug therapy ; }, abstract = {Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has infected over 770 million people worldwide. The long-term effects of COVID-19 and their management have become important issues. Accumulating evidence indicates that post-COVID-19 syndrome, also known as long COVID, is not limited to respiratory symptoms but affects a wide range of systems, including neurological, cardiovascular, gastrointestinal, musculoskeletal, and reproductive systems etc. The social and economic losses associated with these effects are estimated to reach 3·7 trillion dollars in the United States alone. However, no treatment for long COVID has been developed. Herein, the literature on long COVID is comprehensively reviewed to examine the underlying causes. Additionally, evidence supporting the efficacy of nanoengineered niclosamide is presented, given its ability to counteract the underlying causes. Niclosamide is already Food and Drug Administration (FDA)-approved, and the nanoengineered one is a viable candidate for clinical trials for long COVID.}, } @article {pmid40383645, year = {2025}, author = {Ntontis, E and Williams, R and Luzynska, K and Wright, A and Rousaki, A}, title = {Secondary stressors and their psychosocial impacts on healthcare staff: lessons from a qualitative systematic review from the COVID-19 pandemic in the UK.}, journal = {BJPsych open}, volume = {11}, number = {3}, pages = {e110}, pmid = {40383645}, issn = {2056-4724}, abstract = {BACKGROUND: Extreme events (e.g. floods and disease outbreaks) can overwhelm healthcare workers (HCWs) and healthcare systems. During the COVID-19 pandemic, high levels of distress and mental ill health were reported by HCWs.

AIMS: To examine and synthesise research findings reported in the qualitative literature regarding the stressors, and their psychosocial impacts, faced by HCWs in the UK during the COVID-19 pandemic, and to provide lessons for future support.

METHOD: Qualitative articles were identified in EMBASE and OVID (preregistered on PROSPERO: CRD42022304235). Studies were required to have been published between January 2021 and January 2022 and to have examined the impact of COVID-19 on UK HCWs. We included 27 articles that represented the experiences of 2640 HCWs, assessed their quality using National Institute for Health and Care Excellence criteria and integrated their findings using thematic synthesis.

RESULTS: Several secondary stressors were identified, including lack of personal protective equipment, ineffective leadership and communication, high workloads and problems stemming from uncertainty and a lack of knowledge. Stressors were related to adverse psychosocial outcomes including worry, fatigue, lack of confidence in oneself and senior managers, impacts on teamwork and feeling unappreciated or that one's needs are not recognised.

CONCLUSIONS: Our thematic synthesis moves beyond simply mapping stressors faced by HCWs by considering their antecedents, origins and psychosocial impacts. Utilising a theoretical framework that points towards systemic deficiencies, we argue that secondary stressors can be modified to remove their negative effects. Consequently, workforce planning should shift from focusing on individual change towards amending psychosocial environments in which HCWs work.}, } @article {pmid40382241, year = {2025}, author = {Li, Q and Wang, Q and Wang, R and Zhang, L and Liu, Z}, title = {The frameshifting element in coronaviruses: structure, function, and potential as a therapeutic target.}, journal = {Trends in pharmacological sciences}, volume = {46}, number = {6}, pages = {535-550}, doi = {10.1016/j.tips.2025.04.003}, pmid = {40382241}, issn = {1873-3735}, mesh = {Antiviral Agents/pharmacology/therapeutic use ; Base Sequence ; *Coronavirus/genetics ; Coronavirus Infections/drug therapy ; *Frameshifting, Ribosomal ; *Molecular Targeted Therapy ; *RNA, Viral/genetics/ultrastructure ; }, abstract = {The frameshifting element (FSE) comprises a slippery heptanucleotide sequence followed by a downstream RNA structure, such as a pseudoknot or stem-loop. Found in various RNA viruses, FSE regulates viral replication via programmed -1 ribosomal frameshifting (-1 PRF), making it a potential broad-spectrum antiviral target. Advances in RNA structural analysis have elucidated the dynamic conformations and cross-viral diversity of FSE, with the SARS-CoV-2 outbreak further highlighting its role in viral replication. Efforts to develop antiviral drugs targeting FSE have progressed through virtual and phenotypic screening. In this review, we explore the evolution, structure, and function of FSE in coronaviruses, evaluate recent advances in FSE-targeted drug development, and discuss their design advantages, efficacy, and challenges, providing insights for future antiviral strategies.}, } @article {pmid40381561, year = {2025}, author = {Mohan, A and Dummi Mahadevan, G and Anand Iyer, V and Mukherjee, TK and Haribhai Patel, V and Kumar, R and Siddiqui, N and Nayak, M and Maurya, PK and Kumar, P}, title = {Dietary flavonoids in health and diseases: A concise review of their role in homeostasis and therapeutics.}, journal = {Food chemistry}, volume = {487}, number = {}, pages = {144674}, doi = {10.1016/j.foodchem.2025.144674}, pmid = {40381561}, issn = {1873-7072}, mesh = {Humans ; *Flavonoids/metabolism/chemistry/administration & dosage ; Animals ; Homeostasis/drug effects ; Cardiovascular Diseases/drug therapy/metabolism ; Anti-Inflammatory Agents ; Diet ; }, abstract = {Over the past few decades, extensive research has delved into the health advantages of flavonoids, exploring their physiological effects through cell-based assays, epidemiological studies, and human intervention trials. The regular intake of plant-derived flavonoids has shown therapeutic potential against noncommunicable pathophysiological conditions, including carcinoma and various inflammatory disorders. Among the myriads of flavonoids, many have been shown to inhibit the aggregation of amyloid-beta peptides in Alzheimer's disease, while anthocyanins exhibit cardioprotective effects by improving endothelial function and lowering blood pressure. In addition, their efficacy is known to manage infectious communicable diseases caused by various bacteria and viruses, such as S. pneumoniae and SARS-CoV-2. Currently, flavonoids are being used to develop new drugs for both communicable and noncommunicable diseases because of their intricate metabolism and bioavailability, leveraging their anti-inflammatory and antioxidant properties. This concise review provides insights into the potential of flavonoids for therapeutics and disease management, particularly with respect to cardiovascular health, neuroprotection, and antimicrobial action. The implications of these findings underscore the necessity for further exploration of flavonoid-rich diets and their incorporation into therapeutic practices to harness their full health benefits.}, } @article {pmid40380990, year = {2025}, author = {Ghosh, S and Das Sarma, J}, title = {The age-dependent neuroglial interaction with peripheral immune cells in coronavirus-induced neuroinflammation with a special emphasis on COVID-19.}, journal = {Biogerontology}, volume = {26}, number = {3}, pages = {111}, pmid = {40380990}, issn = {1573-6768}, mesh = {Humans ; *COVID-19/immunology/complications ; *Neuroinflammatory Diseases/immunology/virology ; *Aging/immunology ; SARS-CoV-2 ; *Neuroglia/immunology ; Blood-Brain Barrier/immunology ; Animals ; Age Factors ; }, abstract = {Neurodegenerative diseases are chronic progressive disorders that impair memory, cognition, and motor functions, leading to conditions such as dementia, muscle weakness, and speech difficulties. Aging disrupts the stringent balance between pro- and anti-inflammatory cytokines, increasing neuroinflammation, which contributes to neurodegenerative diseases. The aging brain is particularly vulnerable to infections due to a weakened and compromised immune response and impaired integrity of the blood-brain barrier, allowing pathogens like viruses to trigger neurodegeneration. Coronaviruses have been linked to both acute and long-term neurological complications, including cognitive impairments, psychiatric disorders, and neuroinflammation. The virus can induce a cytokine storm, damaging the central nervous system (CNS) and worsening existing neurological conditions. Though its exact mechanism of neuroinvasion remains elusive, evidence suggests it disrupts the blood-brain barrier and triggers immune dysregulation, leading to persistent neurological sequelae in elderly individuals. This review aims to understand the interaction between the peripheral immune system and CNS glial cells in aged individuals, which is imperative in addressing coronavirus-induced neuroinflammation and concomitant neurodegeneration.}, } @article {pmid40380599, year = {2025}, author = {Rajasekar, SJS and Saleem M, and Kannan N, and Narayanasamy K, and Varalakshmi P, }, title = {Artificial Intelligence Powered Audiomics: The Futuristic Biomarker in Pulmonary Medicine - A State-of-the-Art Review.}, journal = {Studies in health technology and informatics}, volume = {327}, number = {}, pages = {884-885}, doi = {10.3233/SHTI250491}, pmid = {40380599}, issn = {1879-8365}, mesh = {Humans ; *Artificial Intelligence ; *COVID-19/diagnosis ; Biomarkers ; *Lung Diseases/diagnosis ; *Respiratory Sounds ; SARS-CoV-2 ; *Pulmonary Medicine/methods ; }, abstract = {AI-driven "audiomics" leverages voice and respiratory sounds as non-invasive biomarkers to diagnose and manage pulmonary conditions, including COVID-19, tuberculosis, ILD, asthma, and COPD. By analyzing acoustic features, machine and deep learning enhance diagnostic accuracy and track disease progression. Key applications include cough-based TB detection, smartphone COVID-19 screening, and speech analysis for asthma and COPD monitoring. Ethical challenges like data privacy and standardization remain barriers to clinical adoption. With ongoing research, audiomics holds promise for transforming respiratory diagnostics and personalized care.}, } @article {pmid40380415, year = {2025}, author = {Tsirintani, M}, title = {Pros, Cons and Limits of AI in Public Health.}, journal = {Studies in health technology and informatics}, volume = {327}, number = {}, pages = {208-212}, doi = {10.3233/SHTI250303}, pmid = {40380415}, issn = {1879-8365}, mesh = {*Artificial Intelligence/ethics ; Humans ; *Public Health/ethics ; *COVID-19/epidemiology ; Pandemics ; SARS-CoV-2 ; }, abstract = {This paper explores the role of Artificial Intelligence (AI) in Public Health (PH), examining its benefits, challenges, and ethical considerations. AI has become an essential tool in healthcare, improving diagnosis, treatment, and health system management. Its applications range from disease surveillance to personalized patient care, offering transformative potential in addressing public health crises such as the COVID-19 pandemic. However, the rapid adoption of AI technologies also raises concerns related to accuracy, bias, ethical dilemmas, and the safety of AI-driven decisions in healthcare. The paper presents a systematic review of the literature, identifying key areas where AI is used in public health, alongside the advantages and potential risks. Additionally, it highlights the importance of the EU AI Act, which categorizes public health AI systems as high-risk, requiring strict oversight to ensure transparency, accountability, and the protection of individual rights. The Act serves as a critical framework to foster trust and safety in AI applications, ensuring their responsible and ethical use in public health while enhancing Europe's preparedness for future health challenges. Further research is needed to address the limitations and ethical issues associated with AI in public health, including its impact on workforce dynamics and equitable healthcare access.}, } @article {pmid40380300, year = {2025}, author = {Polspoel, M and Mullie, P and Reilly, T and Van Tiggelen, D and Calders, P}, title = {Comparison of physical activity and sedentary behavior between telework and office work in a working population during the COVID-19 pandemic: a systematic review and meta-analysis of observational studies.}, journal = {BMC public health}, volume = {25}, number = {1}, pages = {1805}, pmid = {40380300}, issn = {1471-2458}, mesh = {Humans ; *COVID-19/epidemiology ; *Sedentary Behavior ; *Exercise ; Observational Studies as Topic ; *Teleworking/statistics & numerical data ; Pandemics ; *Workplace ; SARS-CoV-2 ; Accelerometry ; }, abstract = {BACKGROUND: The surge in telework due to technological advances and confinement during the coronavirus disease pandemic of 2019 (COVID-19) has drawn attention to its effects on physical activity (PA) and sedentary behavior (SB). This review aimed to analyze the impact of telework compared to office work in PA and SB, assessed by validated questionnaires and accelerometers during the COVID-19 pandemic.

METHODS: Observational studies that evaluated the effect of telework in PA and SB compared to office work were identified by literature searches in three electronic databases (PubMed, Web of Science, and Scopus) published up to January 2023. Studies were included when written in English, including observational design, evaluating the effect of telework on PA and/or SB compared to office work, and using validated questionnaires and accelerometers to assess PA and/or SB. The meta-analysis evaluated continuous outcomes with a random-effect model using Review Manager Web 5 (Cochrane Collaboration, Oxford, UK). The risk of bias was assessed using the National Heart, Lung, and Blood Institute quality assessment tool for Observational studies.

RESULTS: Twelve observational studies, with a total of 9,059 participants, were included in this study. Ten studies assessed PA and SB with questionnaires and two with accelerometers. A significant decrease of -0.33 (95% CI -0.59, -0.08) in light PA was observed, while no significant changes were observed for total PA (-0.19 [-0.42, 0.04]), moderate to vigorous PA (-0.44 [-1.32, 0.44]) and SB (0.12 [-0.20, 0.44]).

CONCLUSIONS: Telework significantly decreases light PA in a working population during the COVID-19 pandemic. More research using validated measurement tools to assess PA and SB is needed to confirm this result. Given the extensive health benefits of physical activity and reduced sedentary behavior, public health resources must focus on encouraging PA and minimizing SB, especially among teleworkers.

TRAIL REGISTRATION: The review protocol was registered in the Prospero database (CRD42024502374).}, } @article {pmid40380268, year = {2025}, author = {Frentzen, E and Fegert, JM and Martin, A and Witt, A}, title = {Child and adolescent mental health during the Covid-19 pandemic: an overview of key findings from a thematic series.}, journal = {Child and adolescent psychiatry and mental health}, volume = {19}, number = {1}, pages = {57}, pmid = {40380268}, issn = {1753-2000}, abstract = {BACKGROUND: The 2019 outbreak of COVID-19, a severe acute respiratory infection caused by the SARS-CoV-2 virus, triggered a global pandemic with far-reaching consequences. Societies worldwide felt the effects of the virus and pandemic related restrictive measures on their economies, healthcare systems, and social fabric. To curb the spread of COVID-19, numerous restrictive measures were implemented. This manuscript summarizes the findings published within the thematic series on Child Mental Health during the Covid-19 pandemic.

METHODS: Between May 2020 and June 2024 Child and Adolescent Psychiatry and Mental Health (CAPMH) issued a thematic series on "Child Mental Health during the Covid-19 pandemic." All manuscripts underwent a prescreening process by the Editor-in-Chief, including checks regarding the compliance with ethical standards compliance with the scope of the journal and the thematic series. Suitable manuscripts were then handled by one of the editors of the thematic series. All suitable manuscripts then underwent a peer review process that included at least two reviews. Different aspects of child and adolescent mental health as well as various aspects of the pandemic - in addition to their findings -were investigated, defined and discussed throughout the manuscripts within the series.

RESULTS: A total of 327 manuscripts were submitted and 85 manuscripts were published within the series. Manuscripts included qualitative and quantitative studies as well as systematic reviews. The manuscripts reported findings from 22 countries from all over the world and various populations. The studies covered the somatic and psychological impacts of the pandemic, including emotional and behavioral consequences, non-suicidal self-injury and suicidal behavior, threat and trauma, parent child separation, school closure and home schooling, physical activity and media use, psychiatric care, as well as digital resources and online therapy. Through its findings, the research also highlighted the multilayered impact the pandemic had, as well as the need to make targeted interventions and evidence-based interventions available to a large audience.

CONCLUSION: A broad range of literature in the series submitted from various countries around the world documented the profound impact of COVID-19 on child mental health. The findings can be used as a foundation for conceptualizing targeted programs to counteract the consequences, in addition to helping prepare systems in the event of similar incidents in the future.}, } @article {pmid40379394, year = {2025}, author = {Boloré, S and Spielmann, V and Massebiaux, C}, title = {[Clinical nursing assessment of Covid-19 patients: a comparison of home-hospital practices].}, journal = {Soins; la revue de reference infirmiere}, volume = {70}, number = {895}, pages = {10-14}, doi = {10.1016/j.soin.2025.03.002}, pmid = {40379394}, issn = {0038-0814}, mesh = {Humans ; *COVID-19/nursing ; *Nursing Assessment/methods ; Switzerland/epidemiology ; SARS-CoV-2 ; Pandemics ; }, abstract = {This study examines the impact of clinical assessment training on nurses' practices in Geneva during the Covid-19 pandemic. The results reveal that trained professionals, mainly in hospital settings, adopted more advanced techniques, such as auscultation and palpation. Practices varied significantly according to practice location and training received, underlining the importance of ongoing training to improve quality of care.}, } @article {pmid40379315, year = {2025}, author = {Iannizzi, C and Andreas, M and Bohndorf, E and Hirsch, C and Zorger, AM and Brinkmann-Paulukat, J and Bormann, B and Kaufman, J and Lischetzki, T and Monsef, I and Neufeind, J and Schmid-Küpke, N and Thole, S and Worbes, K and Skoetz, N}, title = {Communication-based interventions to increase COVID-19 vaccine willingness and uptake: a systematic review with meta-analysis.}, journal = {BMJ open}, volume = {15}, number = {5}, pages = {e072942}, pmid = {40379315}, issn = {2044-6055}, mesh = {Humans ; *COVID-19 Vaccines/administration & dosage ; *COVID-19/prevention & control ; SARS-CoV-2 ; *Communication ; *Vaccination Hesitancy ; Randomized Controlled Trials as Topic ; *Vaccination/psychology ; *Patient Acceptance of Health Care ; }, abstract = {OBJECTIVE: This systematic review investigates the effectiveness of different communication strategies to increase COVID-19 vaccine uptake and willingness.

DESIGN: Systematic review and meta-analysis of randomised controlled trials (RCTs), following recommendations from the Cochrane Handbook and reporting according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline.

DATA SOURCES: We searched the following databases until 27 July 2022: Cochrane COVID-19 Study Register, PsycINFO, CINAHL, Web of Science Core Collection and WHO COVID-19 Global literature.

We included RCTs investigating, any population, communication-based interventions to increase COVID-19 vaccine uptake and comparing these with no intervention (with or without placebo), another communication strategy or another type of intervention.

METHODS: Screening, data extraction and bias assessment, using the Cochrane ROB 1.0 tool, were conducted by two authors independently. We performed meta-analyses if studies were homogeneous using the Review Manager (RevMan 5) software, synthesised the remaining results narratively and assessed the certainty in the evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach.

RESULTS: We identified 49 studies reporting on the predefined four categories of communication interventions. Evidence from our meta-analyses shows that COVID-19 vaccine uptake may increase when education and information strategies are applied (risk ratio (RR) 1.23, 95% CI 1.17 to 1.28; high-certainty evidence) or social norms are communicated (RR 1.28, 95% CI 1.23 to 1.33; high-certainty evidence) compared with no intervention. The different communication strategies mostly have little to no impact on vaccine intention; however, there may be a slight increase in vaccine confidence when gain framing is applied compared with no intervention.

CONCLUSION: Overall, we found that education and information-based interventions or social norm-framing strategies are most effective compared with no intervention given. Our findings show that some of the investigated communication strategies might influence policy decision-making, and our results could be useful for future pandemics as well.

PROSPERO REGISTRATION NUMBER: PROSPERO (CRD42021296618).}, } @article {pmid40379243, year = {2025}, author = {Devonshire, AL and Guilbert, T and Bauer, CS and Schmidt, H and Davis, S and Hernandez, M and Fitzpatrick, AM and Gaffin, JM and Kattan, M and De, A and Jackson, DJ and Mauger, D and Phipatanakul, W and Schwartz, JT and Sheehan, W and Long, D and Juarez, L and Bacharier, LB and Stokes, JR and Teach, SJ and Morgan, WJ and Martinez, FD and , }, title = {Evaluating the Impact of the COVID-19 Pandemic on Pediatric Asthma Incidence.}, journal = {The journal of allergy and clinical immunology. In practice}, volume = {13}, number = {8}, pages = {1952-1959}, pmid = {40379243}, issn = {2213-2201}, support = {U01 HL130045/HL/NHLBI NIH HHS/United States ; UL1 TR001425/TR/NCATS NIH HHS/United States ; }, mesh = {Humans ; *COVID-19/epidemiology/prevention & control ; *Asthma/epidemiology ; Incidence ; Child ; SARS-CoV-2 ; Child, Preschool ; Infant ; Pandemics ; Environmental Exposure/adverse effects ; }, abstract = {Multiple early life environmental exposures are thought to influence childhood asthma incidence. The coronavirus disease 2019 (COVID-19) pandemic resulted in changes in air pollution levels and a marked disruption in the circulation of childhood respiratory viruses. Both air pollution and respiratory viruses have been implicated in the development of asthma and early childhood wheeze. Human behavior and daily routine practices, including family gatherings and daycare attendance, were impacted profoundly by the COVID-19 pandemic and the associated mitigation measures. The changes to human behavior and social interactions that occurred during the pandemic have and will likely continue to impact chronic diseases, including the development of asthma. This rostrum explores how childhood asthma incidence might be affected by the COVID-19 pandemic and its associated public health mitigation measures. Recently completed and ongoing clinical trials being conducted in the infant and toddler population and assessing allergic outcomes may be well positioned to examine the impact of the pandemic on asthma incidence and time to asthma onset.}, } @article {pmid40378861, year = {2025}, author = {Amstutz, A and Schandelmaier, S and Ewald, H and Speich, B and Schwenke, JM and Schönenberger, CM and Schobinger, S and Agoritsas, T and Tomashek, KM and Nayak, S and Makowski, M and Morales-Ortega, A and Bernal-Bello, D and Pomponio, G and Ferrarini, A and Ghazaeian, M and Hall, F and Bond, S and García-Morales, MT and Jiménez-González, M and Arribas, JR and Guimaraães, PO and Tavares, CAM and Berwanger, O and Yazdanpanah, Y and Simensen, VC and Lacombe, K and Hites, M and Ader, F and Tacconelli, E and Mentré, F and Belhadi, D and Massonnaud, CR and Laouénan, C and Diallo, A and Baldé, A and Assoumou, L and Costagliola, D and Ponzi, E and Rueegg, CS and Olsen, IC and Trøseid, M and Briel, M}, title = {Effects of Janus kinase inhibitors in adults admitted to hospital due to COVID-19: a systematic review and individual participant data meta-analysis of randomised clinical trials.}, journal = {The Lancet. Respiratory medicine}, volume = {13}, number = {6}, pages = {530-544}, doi = {10.1016/S2213-2600(25)00055-4}, pmid = {40378861}, issn = {2213-2619}, mesh = {Humans ; *Janus Kinase Inhibitors/therapeutic use/adverse effects ; Randomized Controlled Trials as Topic ; *COVID-19 Drug Treatment ; COVID-19/mortality ; Hospitalization ; SARS-CoV-2 ; Pyrimidines/therapeutic use ; Adult ; Purines/therapeutic use ; Sulfonamides/therapeutic use ; Nitriles ; Azetidines/therapeutic use ; Piperidines/therapeutic use ; Pyrazoles/therapeutic use ; Male ; Female ; Middle Aged ; }, abstract = {BACKGROUND: Evidence from randomised clinical trials (RCTs) of Janus kinase (JAK) inhibitors-compared with usual care or placebo-in adults treated in hospital for COVID-19 is conflicting. We aimed to evaluate the benefits and harms of JAK inhibitors compared with placebo or usual care and whether treatment effects differed between prespecified participant subgroups.

METHODS: For this systematic review and individual participant data meta-analysis (IPDMA), we searched Medline via Ovid, Embase via Elsevier, the Cochrane Central Register of Controlled Trials, the Cochrane COVID-19 Study Register, and the COVID-19 L·OVE Platform, including backward and forward citation searching (last search Nov 28, 2024), for RCTs (unpublished or published in any format and any language) that randomly assigned adults (aged ≥16 years) admitted to a hospital due to COVID-19 to receive either a JAK inhibitor (any type) or no JAK inhibitor (ie, received site-specific standard of care with or without placebo), and requested individual participant data (IPD) from the original trial teams. The primary outcome was all-cause mortality at day 28 after random assignment. We used two-stage meta-analyses adjusting for age and respiratory support, and pooled estimates using random-effects models. The assessment of individual-level effect modifiers was based solely on within-trial information and continuous modifiers were investigated as both linear and non-linear interactions. We used the Instrument for Assessing the Credibility of Effect Modification Analyses to appraise the subgroup analyses and the Grading of Recommendations Assessment, Development, and Evaluation approach to adjudicate the certainty of evidence. Grade 3 or 4 adverse events and serious adverse events by day 28, and adverse events of special interest within 28 days, were assessed among secondary outcomes. This study was registered with PROSPERO (CRD42023431817).

FINDINGS: We identified 16 eligible trials. IPD were obtained from 12 trials, corresponding to 12 902 adults admitted to hospital between May, 2020, and March, 2022. These trials represented 12 902 [96·1%] of 13 423 participants from all eligible trials worldwide. Seven trials evaluated baricitinib, three evaluated tofacitinib, and two evaluated ruxolitinib. Overall, 755 (11·7%) of 6465 participants in the JAK inhibitor group died by day 28 compared with 805 (13·2%) of 6108 participants in the no JAK inhibitor group (adjusted odds ratio [aOR] 0·67 [95% CI 0·55-0·82]; high-certainty evidence; 39 fewer per 1000 [95% CI 55 fewer to 21 fewer]). JAK inhibitors decreased the need for new mechanical ventilation or other respiratory support and allowed for faster discharge from hospital by about 1 day. We observed fewer grade 3 and 4 adverse events and serious adverse events in the JAK inhibitor group (14 fewer per 1000 [95% CI 24 fewer to 4 fewer]; moderate-certainty evidence). The rates of adverse events of special interest were similar across both groups. No credible subgroup effect on mortality at day 28 was found for ventilation status, type of JAK inhibitor, presence of comorbidities, timing of treatment initiation after symptom onset, C-reactive protein concentration, or concomitant use of dexamethasone or tocilizumab. We found a moderately credible effect modification by age, with younger participants showing larger relative treatment effects than older participants, but similar absolute treatment effects due to higher baseline risk for older participants.

INTERPRETATION: This IPDMA of RCTs in adults admitted to hospital due to COVID-19 found that JAK inhibitors reduced mortality across all levels of respiratory support, independent of dexamethasone or tocilizumab, and probably decreased serious and severe adverse events compared with no JAK inhibitors.

FUNDING: This project has received funding from the EU's Horizon 2020 research and innovation programme under grant agreement number 101015736.}, } @article {pmid40378522, year = {2025}, author = {Tang, W and Kim, J and Lee, RT and Maurer-Stroh, S and Renia, L and Tay, MZ}, title = {SARS-CoV-2: lessons in virus mutation prediction and pandemic preparedness.}, journal = {Current opinion in immunology}, volume = {95}, number = {}, pages = {102560}, doi = {10.1016/j.coi.2025.102560}, pmid = {40378522}, issn = {1879-0372}, mesh = {*SARS-CoV-2/genetics ; Humans ; *COVID-19/virology/epidemiology/prevention & control ; *Mutation ; Pandemics/prevention & control ; Machine Learning ; Evolution, Molecular ; Computational Biology/methods ; Pandemic Preparedness ; }, abstract = {The COVID-19 pandemic has prompted an unprecedented global response. In particular, extraordinary efforts have been dedicated toward monitoring and predicting variant emergence due to its huge impact, particularly for vaccine escape. Broadly, we classify such methods into two categories: forward mutation prediction, where phenotypes are first observed and the responsible genotypes traced, and reverse mutation prediction, which starts with selected pathogen genetic profiles and characterizes their associated phenotypes. Reverse mutation prediction strategies have advantages in being able to sample a more complete evolutionary space since sequences that do not yet exist can be sampled. The rapid improvement in the maturity and scale of reverse mutation prediction strategies, such as deep mutational scanning, has led to significant amounts of data for machine learning, with concomitant improvement in the prediction results from computational tools. Such integrated prediction approaches are generalizable and offer significant opportunities for anticipating viral evolution and for pandemic preparedness.}, } @article {pmid40378132, year = {2025}, author = {Dorjee, K and Sadoff, RC and Mansour, FR and Dorjee, S and Binder, EM and Stetson, M and Yuen, R and Kim, H}, title = {Menstrual disturbance associated with COVID-19 vaccines: A comprehensive systematic review and meta-analysis.}, journal = {PloS one}, volume = {20}, number = {5}, pages = {e0320162}, pmid = {40378132}, issn = {1932-6203}, mesh = {Humans ; *COVID-19 Vaccines/adverse effects ; Female ; *COVID-19/prevention & control ; *Menstruation Disturbances/chemically induced/etiology ; SARS-CoV-2 ; Vaccination/adverse effects ; Menstrual Cycle/drug effects ; }, abstract = {BACKGROUND: The relationship between COVID-19 vaccines and menstrual disturbance is unclear, in part because researchers have measured different outcomes (e.g., delays vs. changes to cycle length) with various study designs. Menstrual disruption could be a decisive factor in people's willingness to accept the COVID-19 vaccine.

METHODS: We searched Medline, Embase, and Web of Science for studies investigating menstrual cycle length, flow volume, post-menopausal bleeding, and unexpected or intermenstrual bleeding. Data were analyzed using fixed-effects meta-analysis with Shore's adjusted confidence intervals for heterogeneity.

FINDINGS: Seventeen studies with >1·9 million participants were analyzed. We found a 19% greater risk of increase in menstrual cycle length as compared to unvaccinated people or pre-vaccination time-periods (summary relative risk (sRR): 1·19; 95% CI: 1·11-1·26; n = 23,718 participants). The increase in risk was the same for Pfizer-BioNTech (sRR: 1·15; 1·05-1·27; n = 16,595) and Moderna vaccines (sRR: 1·15; 1·05-1·25; n = 7,523), similar for AstraZeneca (sRR: 1·27; 1·02-1·59; n = 532), and higher for the Janssen (sRR: 1·69; 1·14-2·52; n = 751) vaccine. In the first cycle after vaccination, length increased by
INTERPRETATION: We observed a mild increase in the risk of menstrual disturbance associated with COVID-19 vaccines. Such risks are likely clinically unmeaningful. Vaccine recipients should be appropriately counseled.}, } @article {pmid40377682, year = {2025}, author = {Yin, J and Huang, J and Zhou, P and Li, L and Zheng, Q and Fu, H}, title = {The role of TLR4/NF-kB signaling axis in pneumonia: from molecular mechanisms to regulation by phytochemicals.}, journal = {Naunyn-Schmiedeberg's archives of pharmacology}, volume = {}, number = {}, pages = {}, pmid = {40377682}, issn = {1432-1912}, support = {2024qdjfxm002//Doctoral Research Initiation Fund/ ; 2024qdjfxm002//Doctoral Research Initiation Fund/ ; 2024qdjfxm002//Doctoral Research Initiation Fund/ ; 2024qdjfxm002//Doctoral Research Initiation Fund/ ; 2024qdjfxm002//Doctoral Research Initiation Fund/ ; 2024qdjfxm002//Doctoral Research Initiation Fund/ ; }, abstract = {Pneumonia, a leading global health challenge, is characterized by inflammation driven by dysregulated immune responses. Central to its pathogenesis is the Toll-like receptor 4 (TLR4)/nuclear factor-κB (NF-κB) signaling axis, which orchestrates the recognition of pathogen-associated molecular patterns (PAMPs) and initiates cascades that mediate innate immunity. While this pathway is essential for bacterial clearance, its overactivation can lead to excessive inflammation, tissue damage, and severe complications, including acute respiratory distress syndrome (ARDS) and sepsis. This review examines the role of the TLR4/NF-κB axis in pneumonia caused by various pathogens, including Streptococcus pneumoniae, Staphylococcus aureus, and SARS-CoV- 2, and highlights its dual role in immune defense and pathological inflammation. Furthermore, we explore molecular regulators and phytochemicals that modulate this axis, including baicalin, resveratrol, and sodium houttuyfonate, which exhibit promising therapeutic potential. By elucidating these mechanisms, this study provides insights into targeted interventions to balance immune responses and mitigate inflammation, paving the way for innovative treatments in pneumonia management.}, } @article {pmid40377563, year = {2024}, author = {Kamalov A, A and Gabbasova L, A and Nesterova O, Y and Bozhedomov V, A and Drapkina O, M}, title = {[Mens health preservation: gender-specific features of disease prevention and choice of program solution].}, journal = {Urologiia (Moscow, Russia : 1999)}, volume = {}, number = {6}, pages = {125-132}, pmid = {40377563}, issn = {1728-2985}, mesh = {Humans ; Female ; Male ; Life Expectancy ; Sex Factors ; }, abstract = {The protection of mens health as a concept is currently only beginning to emerge in most countries, but the belief about the need to develop this area is being discussed more and more often by leading representatives of the medical community. Interest in the issues of mens health protection and gender approaches to health assessment in the health system has increased significantly, primarily due to the higher mortality rate of the male population, as well as lower life expectancy at birth (LEB). Compared to women, men are more vulnerable to many diseases that affect the quality and duration of life, but they are poorly motivated to maintain health, rarely turn to doctors for prevention. Many important steps have already been taken in this direction: pilot projects are being created all over the world, interdisciplinary platforms are being developed, specialists are being trained and legislative regulation is changing. The joint work of doctors in the field, as well as the development of national programs, will help to overcome the gender gap in life expectancy between men and women by promoting a holistic and orderly approach to mens health.}, } @article {pmid40376900, year = {2025}, author = {Cagliano, S and Coen, D}, title = {[Emergency Room, a strategic resource for population health].}, journal = {Recenti progressi in medicina}, volume = {116}, number = {5}, pages = {285-290}, doi = {10.1701/4495.44948}, pmid = {40376900}, issn = {2038-1840}, mesh = {Humans ; *Emergency Service, Hospital/organization & administration/statistics & numerical data ; Italy/epidemiology ; *COVID-19/epidemiology ; *Population Health ; Workload ; Pandemics ; }, abstract = {In Italy, 609 active hospitals with Emergency Rooms or first and second-level Emergency Departments (DEA) see attend to approximately 20 million people annually. The number of visits to the Emergency Department per 1,000 inhabitants varies significantly from region to region, as do the main indicators of functioning and outcome. After several decades of organizational and professional growth, culminating in the activation of the Schools of specialization in emergency medicine, the Italian emergency departments are currently going through a period of crisis that has worsened following the Covid-19 pandemic. The demanding and risky characteristics of this work environment along with the impossibility of carrying out freelance activities have pushed young doctors to prefer other disciplines, leaving approximately 75% of the specialization grants unfilled. The workload of the Emergency departments is directly related to the crisis of territorial medicine which is proving increasingly unsuitable to respond to the health needs of citizens in an era of tumultuous epidemiological and technological changes, and to the heavy reduction in hospital staff and bed capacity number of beds throughout the country. This review aims to briefly retrace the recent history of the Italian PS, underline the importance of its performances, both in response to the most serious conditions of clinical emergency and in support of the most fragile segments of the population, and propose some lines of intervention that could support a health institution of fundamental public interest.}, } @article {pmid40376818, year = {2025}, author = {Song, Y and Bracchiglione, J and Meneses-Echávez, JF and de Carvalho Gomes, H and Albiger, B and Solà, I and Rigau, D and Alonso-Coello, P}, title = {Frameworks to support evidence-informed decision-making in public health and infectious disease prevention and control: a scoping review.}, journal = {Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin}, volume = {30}, number = {19}, pages = {}, pmid = {40376818}, issn = {1560-7917}, mesh = {Humans ; *Public Health/methods ; *Decision Making ; COVID-19/prevention & control ; *Communicable Diseases ; *Communicable Disease Control/methods ; SARS-CoV-2 ; }, abstract = {BackgroundEvidence-informed public health decision-making (EIDM) is a complex process that must consider multiple factors.AimWe aimed to identify and describe existing frameworks supporting evidence-informed public health decision-making and their application to infectious disease.MethodsWe conducted a scoping review to describe current EIDM framework use in public health. We included decision-making frameworks in public health and examples of their use in infectious diseases. We searched MEDLINE and Health Systems Evidence from inception to December 2022. We also hand searched websites of relevant organisations and conducted a forward citation search of the included frameworks. Two reviewers selected studies independently, one reviewer extracted data and one cross-checked for accuracy. We presented the results narratively.ResultsWe included 15 frameworks. Seven had a generic scope and eight were focused on specific topics (immunisation, COVID-19 or other, non-infectious diseases). From the included frameworks, we identified a total of 18 criteria with each framework assessing a median of eight, the most frequent being 'desirable effects', 'resources considerations' and 'feasibility'. We identified infectious disease examples for four frameworks: 'Grading of Recommendations, Assessment, Development, and Evaluation' (GRADE), WHO-INTEGRATe Evidence (WHO-INTEGRATE), 'Ethics, Equity, Feasibility, and Acceptability' (EEFA) and 'Community Preventive Services Task Force' (CPSTF) evidence-to-decision frameworks.ConclusionAlthough several EIDM frameworks exist for public health decision-making, most have not been widely applied to infectious diseases. Current EIDM frameworks inconsistently address factors for public health decision-making. Further application and evaluation, and possibly adaptation of existing frameworks, is required to optimise decision-making in public health and infectious diseases.}, } @article {pmid40376436, year = {2025}, author = {Nwabueze, KK and Akubue, N and Onakoya, A and Okolieze, SC and Otaniyen-Igbinoba, IJ and Chukwunonye, C and Okengwu, CG and Ige, T and Alao, OJ and Adindu, KN}, title = {Exploring the prevalence and risk factors of adolescent mental health issues in the COVID and post-COVID era in the U.K.: A systematic review.}, journal = {EXCLI journal}, volume = {24}, number = {}, pages = {508-523}, pmid = {40376436}, issn = {1611-2156}, abstract = {Adolescence is a developmental phase largely characterized by rapid biological and non-biological transformations, with a heightened susceptibility to social and environmental influences. Hence, adolescents are particularly vulnerable to external stressors, underscoring the need to safeguard their well-being and prioritize mental health interventions. The coronavirus disease (COVID-19) pandemic caused a global crisis with profound societal disruptions, and led to lasting impact on global public health, disproportionately affecting vulnerable populations, including adolescents. In view of the unique developmental challenges faced by adolescents, it is imperative to assess the growing burden of mental health issues exacerbated by the pandemic. This review synthesizes existing evidence on the emerging mental health challenges faced by adolescents in the United Kingdom (UK) as exacerbated by the COVID-19 pandemic. A systematic literature search was conducted using PubMed, ScienceDirect, MEDLINE, and SpringerNature databases, resulting in the selection of ten high-quality studies. A thematic analysis of the collected data revealed that depression and anxiety were the most frequently reported mental health conditions among adolescents. These conditions were particularly prevalent among adolescents who were from low-income households, those with pre-existing mental health disorders, adolescents experiencing household conflicts, females, and those who provided self-reported data. Several key risk factors were identified, including family and peer relationships, academic pressures such as examinations and grades, financial constraints within households, and the corruptive influence of social media. The findings underscore the urgency of targeted mental health interventions tailored to the specific needs of adolescents in the U.K. By addressing the identified risk factors, mental health professionals, policymakers, and educators can develop more effective strategies to mitigate the psychological impact of the pandemic on this vulnerable population. This study contributes to the evolving body of literature and emphasizes the need for evidence-based policies to foster overall well-being and resilience in adolescents navigating post-pandemic challenges.}, } @article {pmid40376405, year = {2025}, author = {Barroso da Silva, FL and Paco, K and Laaksonen, A and Ray, A}, title = {Biophysics of SARS-CoV-2 spike protein's receptor-binding domain interaction with ACE2 and neutralizing antibodies: from computation to functional insights.}, journal = {Biophysical reviews}, volume = {17}, number = {2}, pages = {309-333}, pmid = {40376405}, issn = {1867-2450}, abstract = {The spike protein encoded by the SARS-CoV-2 has become one of the most studied macromolecules in recent years due to its central role in COVID-19 pathogenesis. The spike protein's receptor-binding domain (RBD) directly interacts with the host-encoded receptor protein, ACE2. This review critically examines computational insights into RBD's interaction with ACE2 and with therapeutic antibodies designed to interfere with this interaction. We begin by summarizing insights from early computational studies on pre-pandemic SARS-CoV-1 RBD interactions and how these early studies shaped the understanding of SARS-CoV-2. Next, we highlight key theoretical contributions that revealed the molecular mechanisms behind the binding affinity of SARS-CoV-2 RBD against ACE2, and the structural changes that have enhanced the infectivity of emerging variants. Special attention is given to the "RBD charge rule", a predictive framework for determining variant infectivity based on the electrostatic properties of the RBD. Towards applying the computational insights to therapy, we discuss a multiscale computational protocol for optimizing monoclonal antibodies to improve binding affinity across multiple spike protein variants, including representatives from the Omicron family. Finally, we explore how these insights can inform the development of future vaccines and therapeutic interventions for combating future coronavirus diseases.}, } @article {pmid40376360, year = {2025}, author = {Siddiqui, SL and Manzoor, ZU and Schwartz, G and Laloo, A}, title = {Exploring the COVID-19 Vaccine: New Onset and Exacerbations in Rheumatic Diseases.}, journal = {Cureus}, volume = {17}, number = {4}, pages = {e82249}, pmid = {40376360}, issn = {2168-8184}, abstract = {The COVID-19 vaccine has been substantial in mitigating the risk of SARS-CoV-2 infection, transmission, and adverse outcomes on a global scale. While the vaccine has been crucial in reducing COVID-19 risks, rheumatological manifestations are rare. These include new-onset conditions and exacerbations of pre-existing disease, which raise important clinical questions. This narrative literature review aims to synthesize findings from 21 studies on the rheumatological outcomes of COVID-19 vaccination, focusing on clinical presentations, risk factors, pathogenesis, laboratory findings, and treatment outcomes. The patients may present with various symptoms, and there can be certain determinants that may predispose the patients to developing these symptoms. The pathogenesis is postulated to be complex, with proposed mechanisms including molecular mimicry and immune dysregulation to explain the onset of rheumatic disease. Both new-onset rheumatological disease and exacerbated rheumatological conditions post-vaccination typically respond well to first-line treatment with glucocorticoids and immunosuppressive agents. Understanding these findings will help clinicians diagnose, manage, and treat post-vaccination rheumatological conditions more effectively.}, } @article {pmid40375347, year = {2025}, author = {Bose, B and Siva Kumar, S}, title = {Economic burden of zoonotic and infectious diseases on livestock farmers: a narrative review.}, journal = {Journal of health, population, and nutrition}, volume = {44}, number = {1}, pages = {158}, pmid = {40375347}, issn = {2072-1315}, mesh = {*Zoonoses/economics/epidemiology ; Animals ; Humans ; *Farmers/statistics & numerical data ; *Livestock ; *Communicable Diseases/economics ; Cattle ; *Cost of Illness ; Dairying/economics ; Developing Countries ; Agriculture/economics ; }, abstract = {BACKGROUND: Zoonoses significantly impact human health and agricultural productivity, particularly affecting livestock farmers. In this review, the primary objective was to understand the economic impact of both zoonotic and potential zoonotic diseases.

METHODS: This narrative review synthesises literature from SCOPUS, Web of Science, PUBMED, and Reports, covering articles published between 1970 and 2024. Inclusion criteria focused on articles discussing economic losses due to zoonotic diseases in livestock, while exclusion criteria eliminated non-peer-reviewed works and studies not in English.

RESULTS: A total of 37 articles were analysed, revealing substantial economic impacts from various zoonotic diseases. The study uncovers a dramatic decrease in milk consumption, with some areas experiencing a reduction of up to 64 per cent, causing financial hardship for dairy farmers. Moreover, animal-to-human transmissible diseases like bovine tuberculosis, Rift Valley Fever and mastitis result in significant economic setbacks, especially in developing countries.

CONCLUSION: Addressing economic challenges caused by zoonotic and potential diseases is vital for dairy sector sustainability, particularly in developing nations like India. The study emphasises the need for collaborative efforts from stakeholders, including government officials and researchers. It underlines key challenges and compares economic contexts between countries, advocating increased livestock farmers' awareness of these diseases, improved farming techniques, and training programmes to alleviate the problem.}, } @article {pmid40375274, year = {2025}, author = {Lesnik, T and Hauser-Oppelmayer, A}, title = {Turnover intention among intensive care nurses and the influence of the COVID-19 pandemic: a scoping review.}, journal = {Human resources for health}, volume = {23}, number = {1}, pages = {23}, pmid = {40375274}, issn = {1478-4491}, mesh = {Humans ; *COVID-19 ; *Personnel Turnover/statistics & numerical data ; *Intention ; *Intensive Care Units ; SARS-CoV-2 ; *Nursing Staff, Hospital/psychology ; Job Satisfaction ; *Critical Care Nursing ; Pandemics ; }, abstract = {BACKGROUND: The shortage of nurses has been an ongoing issue for many decades. An important contributing factor is voluntary turnover. Especially in intensive care (ICU) and critical care units (CCU) with high workloads, high mortality rates and stressful working conditions, the phenomenon has serious consequences. In addition, the COVID-19 pandemic has exacerbated the problem. This review examines the factors influencing the intention to leave (ITL) and intention to stay (ITS) among intensive care and critical care nurses and the influence of the COVID-19 pandemic.

METHODS: A scoping review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The databases PubMed, Wiley, Scopus, APA PsycNet and Web of Science were searched. In addition, a forward search using Google Scholar was carried out. Empirical studies reporting on factors influencing the intention to stay or leave among ICU nurses published from 2000 to 2022 were included. The factors were qualitatively coded in MAXQDA, resulting in an inductive coding frame.

RESULTS: Fifty-four studies, including 51 quantitative, one qualitative, and two mixed methods studies, were included in the review. The analysis of factors influencing the intention to either leave or stay in intensive care can be systematically classified into two categories: organisational factors and individual factors. The category of organisational factors encompasses factors, such as commitment and integration, leadership, professional collaboration and communication. Conversely, the category of individual factors comprises factors, such as professionalism, job satisfaction, mental health and social reasons. The pandemic has exacerbated certain aspects within individual and organisational factors, influencing the intention to leave intensive care. Notably, despite the significant impact of COVID-19, no "new" themes are directly attributable to it.

CONCLUSIONS: The results can help practitioners meet future challenges (maintaining adequate staffing levels in view of the existing shortage of nurses). It is the responsibility of nursing and hospital management to capitalise on the insights of this review. Future research should focus on longitudinal, interventional and qualitative study designs to understand voluntary turnover among ICU nurses.}, } @article {pmid40375203, year = {2025}, author = {Vallée, A and Arutkin, M and Ceccaldi, PF and Feki, A and Ayoubi, JM}, title = {Long COVID and endometriosis: a systematic review and meta-analysis.}, journal = {BMC women's health}, volume = {25}, number = {1}, pages = {229}, pmid = {40375203}, issn = {1472-6874}, mesh = {Humans ; *Endometriosis/epidemiology/complications ; Female ; *COVID-19/epidemiology/complications ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Prevalence ; }, abstract = {Long COVID conditions entail the persistence of COVID-19-related symptoms for at least eight weeks following SARS-CoV-2 infection. The prevalence of long COVID is estimated to range from 10 to 30% among individuals infected with SARS-CoV-2. Despite its growing impact on healthcare systems, long COVID remains poorly understood. In parallel, endometriosis, a chronic inflammatory condition affecting around 10% of reproductive-age women, is marked by symptoms such as pelvic pain and infertility. The aim of this study was to assess the association between endometriosis and long COVID. We performed a systematic review of long COVID among endometriosis patients in Pubmed/Medline, Cochran Library and Science Direct databases from inception to August 2023. We independently selected studies, extracted data, assessed risk of bias, and compared endometriosis versus non endometriosis patients for long. Pooled analyses were based on random-effect models, and the I[2] statistic was used to quantify heterogeneity across studies. A total of 2 cross-sectional studies (N = 216,095 participants) were included. The pooled analysis comparing endometriosis to non-endometriosis patients significantly showed association for long COVID (pooled RR = 1.41 [1.31-1.52], I[2] = 29%, p < 0.001). Women, who are disproportionately affected by long COVID, particularly those with endometriosis, may face compounded health challenges. While our findings suggest a possible association between endometriosis and long COVID, the evidence is currently limited to two observational studies. Further research involving diverse populations and robust study designs is needed to confirm this relationship and clarify underlying mechanisms.}, } @article {pmid40374879, year = {2025}, author = {Wang, A and Xie, W and Zhang, J}, title = {The synergistic role of viral infection and immune response in the pathogenesis of facial palsy.}, journal = {Journal of neurovirology}, volume = {31}, number = {3}, pages = {208-218}, pmid = {40374879}, issn = {1538-2443}, support = {2022K126//Quzhou Municipal Science and Technology Bureau/ ; }, mesh = {Humans ; *Facial Paralysis/immunology/virology/pathology ; SARS-CoV-2/immunology/pathogenicity ; *COVID-19/immunology/virology/pathology/complications ; Herpesvirus 3, Human/immunology/pathogenicity ; Herpesvirus 1, Human/immunology/pathogenicity ; Facial Nerve/virology/immunology/pathology ; T-Lymphocytes/immunology/virology ; B-Lymphocytes/immunology/virology ; Immunity, Innate ; }, abstract = {Facial palsy refers to facial muscle paralysis and is typically brought about by viral infections, such as herpes simplex virus type 1 (HSV-1), herpes zoster virus (VZV), and SARS-CoV-2. While significant progress has been achieved in viral facial palsy pathogenesis, mechanisms of viral infection-immunity synergy are yet to be revealed. The authors of this article made an attempt to fill this gap by critically summarizing how viral infection causes inflammation and damage to the facial nerve through an immune response mechanism in the facial palsy pathogenesis. We also summarize the current treatment modalities and their respective efficacies. The article set the conditions under which viral infections caused by HSV-1, VZV, SARS-CoV-2, HIV, and EBV lead to facial paralysis and how the viruses infect the facial nerve, initiate an immune response, and cause nerve death. The impact involved direct viral invasion of neurons, immune evasion and induction of neuroinflammation. The review also discusses the primary role of T cells, B cells and innate immune cells in inducing or relieving the condition. The study emphasizes the need to understand the synergic effect of viral infection and immuneresponse of facial palsy as the foundation of the creation of more potent therapeutic strategies. The paper provides a detailed overview of complex interaction of immuneresponse and viral infection of facial palsy with significant level of importance regarding future research and clinical application.}, } @article {pmid40374417, year = {2025}, author = {Cabral, JE and Wu, A and Zhou, H and Pham, MA and Lin, S and McNulty, R}, title = {Targeting the NLRP3 inflammasome for inflammatory disease therapy.}, journal = {Trends in pharmacological sciences}, volume = {46}, number = {6}, pages = {503-519}, doi = {10.1016/j.tips.2025.04.007}, pmid = {40374417}, issn = {1873-3735}, support = {K22 AI139444/AI/NIAID NIH HHS/United States ; T32 AI177324/AI/NIAID NIH HHS/United States ; }, mesh = {*NLR Family, Pyrin Domain-Containing 3 Protein/antagonists & inhibitors/metabolism ; Humans ; *Inflammasomes/metabolism/antagonists & inhibitors ; *Inflammation/drug therapy/immunology ; Animals ; COVID-19 Drug Treatment ; COVID-19 ; *Anti-Inflammatory Agents/pharmacology ; }, abstract = {The NOD-like receptor pyrin domain-containing 3 (NLRP3) inflammasome is a megadalton complex implicated in numerous inflammation-driven diseases including COVID-19, Alzheimer's disease, and gout. Although past efforts have focused on inhibiting IL-1β downstream of NLRP3 activation using drugs such as canakinumab, no FDA-approved NLRP3-targeted inhibitors are currently available. MCC950, a direct NLRP3 inhibitor, showed promise but exhibited off-target effects. Recent research has focused on optimizing the sulfonylurea-based MCC950 scaffold by leveraging recent structural and medicinal chemistry insights into the NLRP3 nucleotide-binding and oligomerization (NACHT) domain to improve solubility and clinical efficacy. In addition, oxidized DNA (oxDNA) has emerged as a key inflammasome trigger, and molecules targeting the pyrin domain have shown promise in inhibiting NLRP3 activation. This review discusses the role of NLRP3 in inflammation-related diseases, the status of ongoing clinical trials, and emerging small-molecule therapeutics targeting NLRP3.}, } @article {pmid40374219, year = {2025}, author = {Hall Dykgraaf, S and Sunjaya, AP and James, D and Kidd, M}, title = {Access to dental services for children: a scoping review on the impact of COVID-19 and implications for future models of care.}, journal = {BMJ open}, volume = {15}, number = {5}, pages = {e097256}, pmid = {40374219}, issn = {2044-6055}, mesh = {Humans ; *COVID-19/epidemiology ; *Health Services Accessibility ; Child ; *Dental Care for Children/organization & administration ; SARS-CoV-2 ; Australia/epidemiology ; Oral Health ; }, abstract = {BACKGROUND: The COVID-19 pandemic had detrimental effects on routine health and social care as countries instituted widespread public health measures to control transmission of SARS-CoV-2. This affected care delivery for many chronic and non-communicable diseases, including oral health and dental diseases with implications in the postpandemic period.

OBJECTIVES: This scoping review, conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Scoping Review guidelines, aims to synthesise evidence regarding the impact of COVID-19 on access to dental services among children and their implications for future models of care, especially for children from low-income families, to inform policy decision making around subsidised dental services in Australia.

DATA SOURCES: PubMed, Web of Science, Embase, Cochrane Library of Systematic Reviews and Cochrane Central Register of Controlled Trials.

ELIGIBILITY CRITERIA: Primary studies of any design published between 1 January 2020 and 31 July 2024. Included studies described provision of paediatric dental services, considered components of access or utilisation and were published in English. Excluded studies were those that only evaluated maxillofacial services.

DATA EXTRACTION AND SYNTHESIS: Data were extracted using a standardised template in MS Excel then analysed to thematically classify findings based on key areas of impact. Quality assessment of studies was not conducted.

RESULTS: 54 articles from 17 countries were included. Studies identified reductions in service availability and utilisation, including patient and parent-driven demand. Changes to the configuration of services included greater rates of emergency treatment, reductions in use of aerosol-generating procedures and more use of teledentistry, as well as self-management and prevention approaches. Substantial delays to routine dental care, leading to more dental problems and ongoing need, especially untreated dental caries, were observed with a disproportionate impact on socioeconomically disadvantaged and vulnerable children and families.

CONCLUSION: The COVID-19 pandemic has had pronounced negative effects on the provision of primary and secondary dental care for children around the world. Access to care was affected by disruptions to service availability and by changes in demand for services related to parental anxiety around the risk of COVID-19 transmission. Delays in receipt of routine dental care and changes to oral health behaviours are likely to lead to an increased need for oral health services, with service adaptations needed to ensure this increased demand can be met.}, } @article {pmid40373391, year = {2025}, author = {Zhang, X and Li, F and Hobbelen, HS and van Munster, BC and Lamoth, CJ}, title = {Gait parameters and daily physical activity for distinguishing pre-frail, frail, and non-frail older adults: A scoping review.}, journal = {The journal of nutrition, health & aging}, volume = {29}, number = {7}, pages = {100580}, pmid = {40373391}, issn = {1760-4788}, mesh = {Humans ; Aged ; *Frail Elderly ; *Gait/physiology ; *Exercise/physiology ; *Frailty/diagnosis/physiopathology ; *Geriatric Assessment/methods ; Activities of Daily Living ; Walking/physiology ; Aged, 80 and over ; *Gait Analysis ; Male ; Female ; Cross-Sectional Studies ; }, abstract = {OBJECTIVE: This scoping review aimed to gather current knowledge on accurately identifying and distinguishing between non-frail, pre-frail, and frail older adults using gait and daily physical activity (DPA) parameters and/or models that combine gait with DPA parameters in both controlled and daily life environments.

METHODS: Following PRISMA-ScR guidelines, a systematic search was conducted across seven databases using key terms: "frail", "gait or walk", "IMU", and "age". Studies were included if they focused on gait analysis using Inertial Measurement Units (IMUs) for walking distances greater than 10 meters. Extracted data included study design, gait and DPA outcomes, walking conditions, and classification model performance. Gait parameters were grouped into four domains: spatio-temporal, frequency, amplitude, and dynamic gait. DPA parameters were synthesized into three categories: postural and transition, variability, and physical activity pattern.

RESULTS: A total of 15 cross-sectional studies involving 2,366 participants met the inclusion criteria. Gait analysis showed (pre)frail individuals had slower, shorter steps with longer stride times compared to non-frail individuals. Pre-frail individuals showed distinct gait patterns in periodicity, magnitude range, and variability. In daily activities, (pre)frail individuals displayed shorter, fragmented walking periods and longer transitions between positions. Walking variation identified pre-frail status, showing progressive decreases from non-frail to frail states. Combined gait and daily physical activity models achieved over 97% accuracy, sensitivity and specificity in distinguishing between groups.

DISCUSSION: This review provides an updated synthesis of the relationship between various gait and/or DPA parameters and physical frailty, highlighting gaps in pre-frailty detection and the variability in measurement protocols. It underscores the potential of long-term, sensor-based monitoring of daily physical activity for advancing pre-frailty screening and guiding future clinical trials. Structured Abstract BACKGROUND: Changes in gait and physical activity are critical indicators of frailty. With advancements in wearable sensor technology, long-term gait analysis using acceleration data has become more feasible. However, the contribution of parameters beyond gait speed, such as gait dynamics and daily physical activity (DPA), in identifying frail and pre-frail individuals remains unclear.

OBJECTIVE: This scoping review aimed to gather knowledge on accurately identifying and differentiating physical pre-frail and frail individuals from non-frail individuals using gait parameters alone or models that combine gait and DPA parameters, both in controlled settings and daily life environments.

METHODS: The review followed PRISMA-ScR guidelines. A search strategy incorporating key terms-"frail", "gait or walk", "IMU", and "age"-was applied across seven databases from inception to March 1, 2024. Studies were included if they focused on gait analysis in controlled or daily environments using Inertial Measurement Units (IMUs) and involved walking distances longer than 10 meters. Data on walking conditions, gait outcomes, classification methods, and results were extracted. Gait parameters were categorized into four domains: spatio-temporal, frequency, amplitude, and dynamic gait. DPA parameters were synthesized into three categories: postural and transition, variability, physical activity pattern.

RESULTS: A total of 15 cross-sectional observational studies met the eligibility criteria, covering 2,366 participants, with females representing 27%-80% of the sample and ages ranging from 60 to 92 years. Regarding gait parameters, (pre)frail individuals exhibited longer stride times, slower walking speeds, shorter steps, and reduced cadence compared to non-frail individuals. In three studies, pre-frail could be distinguished from the non-frail and frail group through gait periodicity, range of magnitude, and gait variability. DPA patterns differed between groups, with (pre)frail individuals showing shorter and more fragmented walking periods, brief walking bouts and longer postural transitions. Walking bout variation (CoV) effectively identified pre-frail status, decreasing 53.73% from non-frail to pre-frail, and another 30.87% from pre-frail to frail. Models combining both gait and DPA parameters achieved the highest accuracy (97.25%), sensitivity (98.25%), and specificity (98.25%) in distinguishing between groups.

DISCUSSION: This scoping review provides an updated overview of the current knowledge and gaps in understanding the relationship between gait parameters across different domains and DPA parameters along with physical frailty. Significant variability in gait measurement methods and protocols complicates direct comparisons between studies. The review emphasizes the need for further research, particularly in pre-frailty screening, and underscores the potential of inertial sensor-based long-term monitoring of daily physical activity for future clinical trials.}, } @article {pmid40373033, year = {2025}, author = {Wang, L and Bhanushali, T and Huang, Z and Yang, J and Badami, S and Hightow-Weidman, L}, title = {Evaluating Generative AI in Mental Health: Systematic Review of Capabilities and Limitations.}, journal = {JMIR mental health}, volume = {12}, number = {}, pages = {e70014}, pmid = {40373033}, issn = {2368-7959}, mesh = {Humans ; *Artificial Intelligence ; *COVID-19/psychology ; *Mental Disorders/therapy ; *Mental Health ; }, abstract = {BACKGROUND: The global shortage of mental health professionals, exacerbated by increasing mental health needs post COVID-19, has stimulated growing interest in leveraging large language models to address these challenges.

OBJECTIVES: This systematic review aims to evaluate the current capabilities of generative artificial intelligence (GenAI) models in the context of mental health applications.

METHODS: A comprehensive search across 5 databases yielded 1046 references, of which 8 studies met the inclusion criteria. The included studies were original research with experimental designs (eg, Turing tests, sociocognitive tasks, trials, or qualitative methods); a focus on GenAI models; and explicit measurement of sociocognitive abilities (eg, empathy and emotional awareness), mental health outcomes, and user experience (eg, perceived trust and empathy).

RESULTS: The studies, published between 2023 and 2024, primarily evaluated models such as ChatGPT-3.5 and 4.0, Bard, and Claude in tasks such as psychoeducation, diagnosis, emotional awareness, and clinical interventions. Most studies used zero-shot prompting and human evaluators to assess the AI responses, using standardized rating scales or qualitative analysis. However, these methods were often insufficient to fully capture the complexity of GenAI capabilities. The reliance on single-shot prompting techniques, limited comparisons, and task-based assessments isolated from a context may oversimplify GenAI's abilities and overlook the nuances of human-artificial intelligence interaction, especially in clinical applications that require contextual reasoning and cultural sensitivity. The findings suggest that while GenAI models demonstrate strengths in psychoeducation and emotional awareness, their diagnostic accuracy, cultural competence, and ability to engage users emotionally remain limited. Users frequently reported concerns about trustworthiness, accuracy, and the lack of emotional engagement.

CONCLUSIONS: Future research could use more sophisticated evaluation methods, such as few-shot and chain-of-thought prompting to fully uncover GenAI's potential. Longitudinal studies and broader comparisons with human benchmarks are needed to explore the effects of GenAI-integrated mental health care.}, } @article {pmid40372276, year = {2025}, author = {Wood, C and Salter, WZ and Garcia, I and Nguyen, M and Rios, A and Oropeza, J and Ugwa, D and Mukherjee, U and Sehar, U and Reddy, PH}, title = {Age-associated changes in the heart: implications for COVID-19 therapies.}, journal = {Aging}, volume = {17}, number = {5}, pages = {1340-1367}, pmid = {40372276}, issn = {1945-4589}, mesh = {Humans ; *COVID-19/therapy/complications ; *Aging/physiology/pathology ; SARS-CoV-2 ; *Heart/physiopathology/physiology ; Oxidative Stress ; Female ; Male ; }, abstract = {Cardiac aging involves progressive structural, functional, cellular, and molecular changes that impair heart function. This review explores key mechanisms, including oxidative stress, mitochondrial dysfunction, impaired autophagy, and chronic low-grade inflammation. Excess reactive oxygen species (ROS) damage heart muscle cells, contributing to fibrosis and cellular aging. Mitochondrial dysfunction reduces energy production and increases oxidative stress, accelerating cardiac decline. Impaired autophagy limits the removal of damaged proteins and organelles, while inflammation activates signaling molecules that drive tissue remodeling. Gender differences reveal estrogen's protective role in premenopausal women, with men showing greater susceptibility to heart muscle dysfunction and injury. After menopause, women lose this hormonal protection, increasing their risk of cardiovascular conditions. Ethnic disparities, particularly among underserved minority populations, emphasize how social factors such as access to care, environment, and chronic stress contribute to worsening cardiovascular outcomes. The coronavirus disease pandemic has introduced further challenges by increasing the incidence of heart damage through inflammation, blood clots, and long-term heart failure, especially in older adults with existing metabolic conditions like diabetes and high blood pressure. The virus's interaction with receptors on heart and blood vessel cells, along with a weakened immune response in older adults, intensifies cardiac aging. Emerging therapies include delivery of therapeutic extracellular vesicles, immune cell modulation, and treatments targeting mitochondria. In addition, lifestyle strategies such as regular physical activity, nutritional improvements, and stress reduction remain vital to maintaining cardiac health. Understanding how these biological and social factors intersect is critical to developing targeted strategies that promote healthy aging of the heart.}, } @article {pmid40372206, year = {2025}, author = {Ortiz-Prado, E and Izquierdo-Condoy, JS and Vasconez-Gonzalez, J and López-Cortés, A and Salazar-Santoliva, C and Vargas Michay, AR and Vélez-Paéz, JL and Unigarro, L}, title = {From pandemic onset to present: five years of insights into ARDS caused by COVID-19.}, journal = {Expert review of respiratory medicine}, volume = {19}, number = {8}, pages = {843-862}, doi = {10.1080/17476348.2025.2507207}, pmid = {40372206}, issn = {1747-6356}, mesh = {Humans ; *COVID-19/therapy/complications/epidemiology ; *Respiratory Distress Syndrome/therapy/epidemiology/physiopathology/etiology/virology ; Extracorporeal Membrane Oxygenation ; SARS-CoV-2 ; Pandemics ; }, abstract = {INTRODUCTION: COVID-19-associated acute respiratory distress syndrome (ARDS) has challenged healthcare systems, initially resembling classical ARDS but later recognized as distinct. Unique features such as endothelial injury, microthrombosis, and dysregulated inflammation influenced treatment efficacy. Understanding its evolution is key to optimizing therapy and improving outcomes.

AREAS COVERED: This review synthesizes current evidence on COVID-19-associated ARDS, covering epidemiology, pathophysiology, clinical phenotypes, and treatments. It explores the shift from L and H phenotypes to a refined disease model and highlights key therapies, including corticosteroids, immunomodulators, prone positioning, ECMO, and vaccination's impact on severity and ARDS incidence.

EXPERT OPINION: At the onset of the COVID-19 pandemic in December 2019, uncertainty was overwhelming. Early clinical guidelines relied on case reports and small case series, offering only preliminary insights into disease progression and management. Despite the initial chaos, the scientific community launched an unprecedented research effort, with over 11,000 clinical trials registered on ClinicalTrials.gov investigating COVID-19 treatments. Several evidence-based strategies emerged as gold standards for managing COVID-19-associated acute respiratory distress syndrome, surpassing prior approaches. The pandemic exposed vulnerabilities in global healthcare, reshaped modern medicine, accelerated innovation, and reinforced the essential role of evidence-based practice in critical care and public health policy.}, } @article {pmid40372091, year = {2025}, author = {Schentag, J and Penz, K and Vandenberg, H}, title = {Exploring the Impact of COVID-19 on Acute Care Nurses: An Integrative Review.}, journal = {Journal of advanced nursing}, volume = {}, number = {}, pages = {}, doi = {10.1111/jan.17057}, pmid = {40372091}, issn = {1365-2648}, abstract = {AIM: To analyse, critique, and synthesise available research to create a unique framework of the impacts of COVID-19 on acute care nurses.

METHODS: Whittemore and Knafl's framework was used to organise this review. The Mixed Methods Appraisal Tool was used for quality analysis.

DATA SOURCES: CINAHL, MEDLINE, Web of Science, Scopus and the National Institute of Health COVID-19 database were searched.

RESULTS: Twenty-five articles were included. Impacts on acute care nurses came from changes, access to resources, interrupted relationships, and the virus itself. The outcomes from nurses were categorised as positive, physical, emotional responses, leaving and mental disorders. These outcomes were mediated by making connections, coping, learning and experience, and finding meaning.

CONCLUSION: Nurses working in acute care during COVID-19 were faced with immense stressors in a tumultuous and dangerous time. The vastly negative outcomes were less surprising than the fact nurses were left to find mitigating factors on their own. Given the large attrition from nursing that occurred and is still occurring, health systems that can both lessen the impacts and strengthen the buffering effects of mediating factors may fare better when the next pandemic comes.

IMPLICATIONS: Lessons learned can be used to prepare for future pandemics. Nurses should be at the forefront of all planning whether through education, policy, or research. Having a framework allows for a more comprehensive understanding and provides an underpinning for future action. The possibility for impact spans nurses across the globe who have worked, and who may work, during a pandemic. This framework provides a basis for changes related to pandemic planning throughout nursing domains.

REPORTING METHOD: The researcher has adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. No Patient or Public Contribution.}, } @article {pmid40371028, year = {2025}, author = {Devi, S and Yadav, N and Yadav, R}, title = {Nanotechnology-Based Modern Biosensors for the Detection of SARS-CoV-2 Virus.}, journal = {Indian journal of microbiology}, volume = {65}, number = {1}, pages = {177-188}, pmid = {40371028}, issn = {0046-8991}, abstract = {The emergence of the COVID-19 pandemic has pointed out the urgent need for rapid and accurate diagnostic tools to detect the SARS-CoV-2 virus. Nanotechnology-based biosensors have emerged as a promising solution due to their high sensitivity, specificity, and speed in detecting biological molecules. This article focuses on the advancements in using nanotechnology for the development of modern biosensors tailored for the detection of the SARS-CoV-2 virus. Various nanomaterials, such as quantum dots, metallic nanoparticles, and nanowires, have been harnessed to enhance the performance of biosensors, offering improved detection limits and specificity. Besides this, innovative detection platforms, such as field-effect transistors, surface plasmon resonance, and electrochemical sensors, have revolutionized the landscape of SARS-CoV-2 diagnostics. These nanotechnology-based biosensors demonstrate the potential for point-of-care testing, enabling rapid and on-site detection with minimal sample preparation. The scalability, cost-effectiveness, and portability of these biosensors make them suitable for mass screening efforts in various healthcare settings, including hospitals, clinics, and community centers. The development of reliable biosensors for SARS-CoV-2 detection aligns with global efforts to curb the spread of the virus through early identification and containment strategies.}, } @article {pmid40370972, year = {2025}, author = {La Torre, F and Meliota, G and Civino, A and Campanozzi, A and Cecinati, V and Rosati, E and Sacco, E and Santoro, N and Vairo, U and Cardinale, F}, title = {Advancing multidisciplinary management of pediatric hyperinflammatory disorders.}, journal = {Frontiers in pediatrics}, volume = {13}, number = {}, pages = {1553861}, pmid = {40370972}, issn = {2296-2360}, abstract = {Pediatric hyperinflammatory diseases, including Still's disease, Kawasaki disease (KD), multisystem inflammatory syndrome in children (MIS-C), and recurrent pericarditis (RP), represent a spectrum of conditions characterized by immune dysregulation and systemic inflammation. Each disorder exhibits distinct pathophysiological mechanisms and clinical features, yet their overlapping presentations often pose diagnostic challenges. Early and accurate differentiation is critical to mitigate complications such as macrophage activation syndrome (MAS), coronary artery aneurysms, and myocardial dysfunction. This narrative review explores the pathophysiology, diagnostic criteria, and management of these conditions, emphasizing the utility of advanced biomarkers, imaging modalities, and genetic testing. For Still's disease, the review highlights the transformative role of biologic therapies targeting IL-1 and IL-6 in reducing systemic inflammation and improving outcomes. In KD, timely administration of intravenous immunoglobulin (IVIG) and combination with high-dose steroids in high-risk patients is pivotal for preventing coronary complications. MIS-C, associated with SARS-CoV-2 infection, requires tailored immunomodulatory approaches, including corticosteroids and biologics, to address severe hyperinflammation and multiorgan involvement. RP management prioritizes NSAIDs, colchicine, and IL-1 inhibitors to reduce recurrence and corticosteroid dependence. The review advocates for a multidisciplinary approach, integrating standardized diagnostic algorithms and disease-specific expertise to optimize patient care. Future research directions include the identification of predictive biomarkers, exploration of novel therapeutic targets, and development of evidence-based treatment protocols to enhance long-term outcomes in pediatric inflammatory diseases.}, } @article {pmid40370518, year = {2025}, author = {Jafari, AS and Mozaffari Nejad, AS and Faraji, H and Abdel-Moneim, AS and Asgari, S and Karami, H and Kamali, A and Kheirkhah Vakilabad, AA and Habibi, A and Faramarzpour, M}, title = {Diagnostic Challenges in Fungal Coinfections Associated With Global COVID-19.}, journal = {Scientifica}, volume = {2025}, number = {}, pages = {6840605}, pmid = {40370518}, issn = {2090-908X}, abstract = {The early diagnosis of opportunistic infections is a critical concern for patient care worldwide, particularly in the context of the COVID-19 pandemic. This review examines the challenges and advancements in the management and early diagnosis of opportunistic fungal infections, which have become increasingly prominent during the pandemic. Using multiple sources, including curated databases such as PubMed and Scopus, as well as Google Scholar for broader literature searches, we systematically reviewed studies on COVID-19-associated fungal infections, with a focus on candidiasis, mucormycosis, and aspergillosis. The inclusion criteria encompassed peer-reviewed articles, clinical case reports, and cohort studies that discussed diagnostic methods, clinical outcomes, and treatment responses. Data were systematically extracted and analyzed to identify key trends and gaps in current diagnostic practices. Given the significance of opportunistic fungal infections-particularly the selected species-this review provides a comprehensive analysis of diagnostic challenges and advancements in the context of COVID-19 and beyond. Currently, there is no definitive strategy for effectively addressing these opportunistic pathogens, highlighting the need for continued research and innovation. Despite advancements in medical technology, opportunistic fungal infections continue to pose significant challenges to early and accurate diagnosis. The COVID-19 pandemic has exacerbated these challenges, with secondary fungal infections contributing to increased morbidity and mortality rates. This review highlights the complexities of diagnosing fungal coinfections and emphasizes the urgent need for improved diagnostic strategies. Enhancing the early and accurate detection of these infections is critical for effective patient management, particularly during viral pandemics. Addressing the challenges outlined in this review requires innovative diagnostic approaches to improve patient outcomes and reduce the burden of opportunistic infections on global healthcare systems.}, } @article {pmid40370452, year = {2025}, author = {Shang, Z and Huang, L and Qin, S}, title = {The underlying mechanism behind the different outcomes of COVID-19 in children and adults.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1440169}, pmid = {40370452}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/immunology/prevention & control ; Child ; *SARS-CoV-2/immunology ; Adult ; Angiotensin-Converting Enzyme 2/metabolism ; Age Factors ; Serine Endopeptidases/metabolism ; COVID-19 Vaccines/immunology ; Cytokines/immunology ; }, abstract = {Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has affected hundreds of millions of people globally, resulting in millions of deaths. During this pandemic, children have demonstrated greater resistance than adults, exhibiting lower infection rates, reduced mortality, and milder symptoms. Summarizing the differences in resistance between children and adults during COVID-19 can provide insights into protective mechanisms and potential implications for future treatments. In this review, we focused on summarizing and discussing the mechanisms for better protection of children in COVID-19. These protective mechanisms encompass several factors: the baseline expression of cell surface receptor ACE2 and hydrolase TMPRSS2, the impact of complications on COVID-19, and age-related cytokine profiles. Additionally, differences in local and systemic immune responses between children and adults also contribute significantly, particularly interferon responses, heterologous protection from non-COVID-19 vaccinations, and immune status variations influenced by micronutrient levels. The advantageous protection mechanisms of these children may provide insights into the prevention and treatment of COVID-19. Importantly, while age-related metabolic profiles and differential COVID-19 vaccine responses may contribute to protection in children, current comparative research remains limited and requires further investigation.}, } @article {pmid40369626, year = {2025}, author = {Batisani, K}, title = {The role of mRNA vaccines in infectious diseases: a new era of immunization.}, journal = {Tropical diseases, travel medicine and vaccines}, volume = {11}, number = {1}, pages = {12}, pmid = {40369626}, issn = {2055-0936}, abstract = {The emergence of messenger RNA (mRNA) vaccines has marked a seminal shift in the field of immunization, heralding an era characterized by unprecedented speed and efficacy in the face of infectious diseases. The global crisis caused by the COVID-19 pandemic catalyzed the rapid development and deployment of two leading mRNA vaccines, Comirnaty and SpikeVax, showcasing not only the technological promise of mRNA, but also its transformative potential in public health strategies. This study seeks to provide an in-depth exploration of the foundational elements of mRNA vaccine technology, elucidate its unique advantages over traditional vaccine platforms, analyze the existing challenges that public health officials face, and envision future applications that extend far beyond current expectations. Through this exploration, we advocate for the integration of mRNA technology into existing public health frameworks to enhance global health security and adaptability in the face of emerging infectious threats.}, } @article {pmid40369424, year = {2025}, author = {Xu, T and Liang, T and Zhang, J and Yan, Y and Lu, L and Kuang, L and Wang, C and Xiao, M and Chen, Y and Zhu, B}, title = {Case report of brain death in a child due to COVID-19 and literature review.}, journal = {BMC infectious diseases}, volume = {25}, number = {1}, pages = {700}, pmid = {40369424}, issn = {1471-2334}, support = {202201020628//Guangzhou Municipal Science and Technology Project/ ; }, mesh = {Humans ; *COVID-19/complications ; Female ; Child ; SARS-CoV-2 ; *Brain Death ; Tomography, X-Ray Computed ; Electroencephalography ; }, abstract = {PURPOSE: Although COVID-19 typically presents with respiratory symptoms, it can also lead to severe neurological manifestations in children. While case reports of COVID-19-associated encephalopathy (including acute necrotizing encephalopathy) have increasingly appeared, gaps remain regarding optimal management strategies and outcome predictors for children with rapid-onset neurological decline. This report aims to underscore the critical need for standardized clinical approaches to severe pediatric COVID-19-related encephalopathy.

METHODS: In this case report, We detail the case of an 8-year-old girl who presented with fever, rash, headache, and recurrent seizures. Her diagnostic workup included polymerase chain reaction (PCR) testing for SARS-CoV-2 and a range of neurological assessments: contrast-enhanced computed tomography (CT) to evaluate structural changes, transcranial Doppler ultrasound to assess intracranial hemodynamics, and electroencephalography (EEG) to monitor electrical activity. Intensive therapeutic measures-encompassing mechanical ventilation, hemodynamic support, antimicrobial agents, and corticosteroids-were initiated. In addition, a targeted narrative literature review of pediatric COVID-19-associated neurological complications was conducted to contextualize this presentation.

RESULTS: The patient tested positive for COVID-19;imaging revealed brain edem, and EEG suggested brain death. Despite aggressive critical care interventions, her condition did not improve, ultimately resulting in brain death. Our review of current literature revealed several reported instances of acute necrotizing encephalopathy in pediatric COVID-19, highlighting a growing body of evidence on the potential for severe central nervous system sequelae.

CONCLUSION: This case highlights the importance of early recognition and close neurological surveillance in pediatric patients with COVID-19. Although accumulating evidence describes COVID-19-related neurological complications such as acute necrotizing encephalopathy, uncertainties persist regarding definitive treatment protocols and long-term outcomes. Greater understanding of the underlying mechanisms and standardized management pathways is imperative to improve prognosis in this vulnerable population.

CLINICAL TRIAL: Not applicable.}, } @article {pmid40369415, year = {2025}, author = {Zulu, JM and Silumbwe, A and Munakampe, M and Chavula, MP and Mulubwa, C and Sirili, N and Zulu, W and Michelo, C and Tetui, M}, title = {A scoping review of the roles, challenges, and strategies for enhancing the performance of community health workers in the response against COVID-19 in low- and middle-income countries.}, journal = {BMC primary care}, volume = {26}, number = {1}, pages = {163}, pmid = {40369415}, issn = {2731-4553}, mesh = {Humans ; *COVID-19/prevention & control/epidemiology ; *Community Health Workers/standards/organization & administration ; *Developing Countries ; *Professional Role ; SARS-CoV-2 ; Pandemics ; }, abstract = {BACKGROUND: Global concerns regarding effective response strategies to the COVID-19 pandemic arose amid the swift spread of the virus to low- and middle-income country (LMIC) settings. Although LMICs instituted several measures to mitigate spread of the virus in low resource settings, including task shifting certain demand and supply functions to community actors such as community health workers (CHWs), there remains a lack of synthesized evidence on these experiences and lessons. This scoping review sought to synthesize evidence regarding the roles and challenges faced by CHWs during the fight against COVID-19, along with strategies to address these challenges.

METHODOLOGY: We systematically searched several major electronic databases including PubMed, HINARI, Cochrane Library (Reviews and Trials), Science Direct and Google Scholar for relevant literature. The search strategy was designed to capture literature published in LMICs on CHWs roles during COVID-19 period spanning 2019-2023. Two researchers were responsible for retrieving these studies, and critically reviewed them in accordance with Arksey and O'Malley scoping review approach. In total, 22 articles were included and analysed using Clarke and Braun thematic analysis in NVivo 12 Pro Software.

RESULTS: Community health workers (CHWs) played a vital role during the COVID-19 pandemic. They engaged in health promotion and education, conducted surveillance and contact tracing, supported quarantine efforts, and maintained essential primary health services. They also facilitated referrals, advocated for clients and communities, and contributed to vaccination planning and coordination, including tracking and follow-up. However, CHWs faced significant challenges, including a lack of supplies, inadequate infection prevention and control measures, and stigma from community members. Additionally, they encountered limited supportive policies, insufficient remuneration and incentives. To enhance CHWs' performance, regular training on preventive measures is essential. Utilizing digital technology, such as mobile health, can be beneficial. Establishing collaborative groups through messaging platforms and prioritizing access to COVID-19 vaccines are important steps. Additionally, delivering wellness programs and providing quality protective equipment for CHWs are crucial for their effectiveness.

CONCLUSION: The study found that CHWs are vital actors within the health system during global pandemics like COVID-19. This entails the need for increased support and investment to better integrate CHWs into health systems during such crises, which could ultimately contribute to sustaining the credibility of CHWs programs and foster more inclusive community health systems (CHSs).}, } @article {pmid40368635, year = {2025}, author = {Flores, CV and Chan, SY}, title = {Therapeutic targets for pulmonary arterial hypertension: insights into the emerging landscape.}, journal = {Expert opinion on therapeutic targets}, volume = {29}, number = {6}, pages = {327-343}, pmid = {40368635}, issn = {1744-7631}, support = {R01 HL124021/HL/NHLBI NIH HHS/United States ; R01 HL151228/HL/NHLBI NIH HHS/United States ; }, mesh = {Humans ; *Pulmonary Arterial Hypertension/drug therapy/physiopathology ; Animals ; *Molecular Targeted Therapy ; Vascular Remodeling/drug effects ; Drug Development ; Disease Progression ; Signal Transduction/drug effects ; Ventricular Dysfunction, Right/physiopathology/etiology/drug therapy ; }, abstract = {BACKGROUND: Pulmonary arterial hypertension (PAH) is a progressive, life-threatening disease driven by vascular remodeling, right ventricular (RV) dysfunction, and metabolic and inflammatory dysregulation. Current therapies primarily target vasodilation to relieve symptoms but do not reverse disease progression. The recent approval of sotatercept, which modulates BMP/TGF-β signaling, marks a shift toward anti-remodeling therapies. Building on this, recent preclinical advances have identified promising therapeutic targets and potentially disease-modifying treatments.

AREAS COVERED: This review synthesizes the evolving preclinical landscape of emerging PAH therapeutic targets and drugs, highlighting innovative approaches aimed at addressing the underlying mechanisms of disease progression. Additionally, we discuss novel therapeutic strategies under development.

EXPERT OPINION: Recent advances in PAH research have identified novel therapeutic targets beyond vasodilators, including modulation of BMP/TGF-β signaling, metabolic programs, epigenetics, cancer-related signaling, the extracellular matrix, and immune pathways, among others. Sotatercept represents a significant advance in therapies that go beyond vasodilation, and long-term safety, efficacy, and durability are being assessed. Future treatment strategies will focus on precision approaches, noninvasive technologies, and regenerative biology to improve outcomes and reverse vascular remodeling.}, } @article {pmid40368586, year = {2025}, author = {Isaia, HA and Clerici, NJ and Brandelli, A}, title = {Bacillus lipopeptides as versatile antimicrobial weapons: looking toward antiviral activity.}, journal = {Critical reviews in biotechnology}, volume = {}, number = {}, pages = {1-17}, doi = {10.1080/07388551.2025.2499152}, pmid = {40368586}, issn = {1549-7801}, abstract = {Viral outbreaks are a topic of worldwide concern, resulting in a significant impact in health systems, a large number of deaths, and huge economical losses. The damage caused by Covid-19 has further highlighted the importance of prospecting for new molecules that can be applied in the prevention and treatment of viral infections. Many studies describe the remarkable antimicrobial activity of lipopeptides produced by Bacillus spp., especially against fungi and bacteria. However, research regarding the antagonistic effects on viruses is less frequent. Despite that, the antiviral activity of lipopeptides produced by Bacillus spp. has been demonstrated, indicating that these molecules could be potential candidates to control viral diseases. In this article, a compilation of reports with consistent data regarding the antiviral effect of Bacillus lipopeptides and the mechanisms involved in this process are presented. Moreover, the immunomodulatory role and toxicity profile of these molecules are discussed. Bacillus lipopeptides may exert an indirect antiviral effect, since they are able to positively induce humoral and cell-mediated immune responses. Moreover, their antiviral effect was observed in vitro and in vivo at nontoxic concentrations, offering a safe perspective for possible clinical application of these molecules. Finally, the challenges related to optimization and increasing production yield are addressed. This is the first critical review dedicated exclusively to antiviral activity of Bacillus lipopeptides.}, } @article {pmid40368428, year = {2025}, author = {Landry, V and Matschek, J and Pang, R and Munipalle, M and Tan, K and Boruff, J and Li-Jessen, NYK}, title = {Audio-based digital biomarkers in diagnosing and managing respiratory diseases: a systematic review and bibliometric analysis.}, journal = {European respiratory review : an official journal of the European Respiratory Society}, volume = {34}, number = {176}, pages = {}, pmid = {40368428}, issn = {1600-0617}, mesh = {Humans ; Bibliometrics ; Biomarkers ; *Respiratory Tract Diseases/diagnosis/therapy/physiopathology ; Asthma/diagnosis/therapy/physiopathology ; *Wearable Electronic Devices ; }, abstract = {Advances in wearable sensors and artificial intelligence have greatly enhanced the potential of digitised audio biomarkers for disease diagnostics and monitoring. In respiratory care, evidence supporting their clinical use remains fragmented and inconclusive. This study aimed to assess the current research landscape of digital audio biomarkers in respiratory medicine through a bibliometric analysis and systematic review (PROSPERO CRD 42022336730). MEDLINE, Embase, Cochrane Library and CINAHL were searched for references indexed up to 9 April 2024. Eligible studies evaluated the accuracy of sound analysis for diagnosing and managing obstructive (asthma and COPD) or infectious respiratory diseases, excluding COVID-19. A narrative synthesis was conducted, and the QUADAS-2 tool was used to assess study quality and risk of bias. Of 14 180 studies, 81 were included. Bibliometric analysis identified fundamental (e.g. "diagnostic accuracy"+"machine learning") and emerging (e.g. "developing countries") themes. Despite methodological heterogeneity, audio biomarkers generally achieved moderate (60-79%) to high (80-100%) accuracies. 80% of studies (eight out of ten) reported high sensitivities and specificities for asthma diagnosis, 78% (seven out of nine) reported high sensitivities and 56% (five out of nine) reported high specificities for COPD, and 64% (seven out of eleven) reported high sensitivity or specificity values for pneumonia diagnosis. Breathing and coughing were the most common biomarkers, with artificial neural networks being the most common analysis technique. Future research on audio biomarkers should focus on testing their validity in clinically diverse populations and resolving algorithmic bias. If successful, digital audio biomarkers hold promise for complementing existing clinical tools in enabling more accessible applications in telemedicine, communicable disease monitoring, and chronic condition management.}, } @article {pmid40368188, year = {2025}, author = {Cao, D and Tian, M and Liu, Z and Guo, K and Peng, J and Ravichandra, A and Ferrell, C and Dong, Y}, title = {Unlock the sustained therapeutic efficacy of mRNA.}, journal = {Journal of controlled release : official journal of the Controlled Release Society}, volume = {383}, number = {}, pages = {113837}, pmid = {40368188}, issn = {1873-4995}, support = {R35 GM144117/GM/NIGMS NIH HHS/United States ; }, mesh = {Humans ; *RNA, Messenger/administration & dosage/therapeutic use/genetics ; Animals ; Nanoparticles/administration & dosage/chemistry ; Lipids/chemistry ; COVID-19 ; SARS-CoV-2 ; *COVID-19 Vaccines/administration & dosage ; Drug Delivery Systems ; mRNA Vaccines/administration & dosage ; Delayed-Action Preparations ; Liposomes ; }, abstract = {mRNA therapies have emerged as a transformative class of medicines, offering immense potential across a diverse array of applications. This progress has been particularly evident in the wake of the success of lipid nanoparticle (LNP)-based mRNA vaccines during the COVID-19 pandemic. As these applications expand, the demand for sustained protein production has become increasingly critical. However, conventional mRNA therapies face significant challenges, including inherent RNA instability and suboptimal expression efficiency, often requiring repeated dosing to maintain therapeutic efficacy over time. This review highlights recent advances in strategies to prolong the therapeutic efficacy of LNP-mRNA systems. We focus on preclinical and emerging approaches aimed at extending the period of protein translation by engineering both the mRNA molecule and the LNP delivery system. Sustained protein expression is a cornerstone of mRNA-based therapeutics, and addressing this challenge is vital for unlocking their therapeutic potential. We hope this review provides valuable insights to guide the development of optimized delivery platforms for LNP-mRNA therapeutics.}, } @article {pmid40367933, year = {2025}, author = {Shang, S and Zhang, B and Wu, B and Dou, Y and Zhang, L and Sun, W and Sun, W}, title = {The Efficacy of Hemoperfusion in Severe COVID-19 Patients: A Systematic Review and Meta-Analysis.}, journal = {Blood purification}, volume = {54}, number = {7}, pages = {384-403}, doi = {10.1159/000546256}, pmid = {40367933}, issn = {1421-9735}, mesh = {Humans ; *COVID-19/therapy/mortality/blood ; *Hemoperfusion/methods ; *SARS-CoV-2 ; Length of Stay ; Intensive Care Units ; Treatment Outcome ; C-Reactive Protein/analysis ; }, abstract = {INTRODUCTION: This study aimed to conduct a meta-analysis and systematic review to assess the efficacy of hemoperfusion (HP) in patients with severe coronavirus disease 2019 (COVID-19).

METHODS: A comprehensive search for candidate publications was performed using PubMed, Cochrane Library, and Embase. Studies investigating the effect of HP on mortality among severe COVID-19 patients were selected, including randomized controlled trials (RCTs), non-RCTs, and observational studies with control groups. The primary endpoint was the longest reported mortality, while the secondary endpoints were the length of stay, intensive care unit (ICU) stay, P/F ratio, and C-reactive protein (CRP). The Cochrane test (Q) and I2 test were used to quantify heterogeneity among the studies. The fixed-effect model (Mantel-Haenszel method) would be selected when there is no heterogeneity (p > 0.10 and I2 <50%), whereas the random-effect model (DerSimonian-Laird method) was used in obvious heterogeneity (p ≤ 0.10 and I2 ≥50%). Data are presented as risk ratio (RR), 95% confidence intervals (CIs), p values, and I2.

RESULTS: Of the 127 articles retrieved, 14 were selected for this study, including 405 patients in the HP group and 518 patients in the control group. There was no statistically significant difference in mortality between the HP and the control groups (RR 0.81 95% CI: [0.71, 0.93]; p = 0.15 > 0.05; I2 = 68.2%). The results of the subgroup analysis of HP with HA series indicated a reduction in the mortality of patients with COVID-19 (RR 0.60 [0.46, 0.78]; p < 0.0001; I2 = 0.0%). The HP group had a longer hospital stay compared with the control group (weighted mean difference; WMD 5.25 [2.53, 7.97] days; p < 0.05; I2 = 28.0%), but not the ICU stay (ES 1.33 [-2.86, 5.53] days; p = 0.53; I2 = 85.5%). After HP, the P/F ratio (WMD 95.79 [74.46, 117.12] mm Hg; p < 0.05; I2 = 5.8%) increased, while CRP (WMD -44.03 [-68.97, -19.09] mg/L; p < 0.05; I2 = 86.9%) decreased.

CONCLUSION: This study found that HP did not significantly reduce mortality in COVID-19 patients; however, the HA series showed potential mortality benefits, suggesting its clinical applicability. While the HP group had longer hospital stays, ICU stay durations did not differ significantly. Notably, HP improved the P/F ratio and reduced CRP levels post-treatment.}, } @article {pmid40366930, year = {2025}, author = {Mateus, LCO and Correa, JR and Almeida, PE}, title = {Extracellular Vesicles in COVID-19: Mechanistic insights and emerging therapeutic strategies.}, journal = {Anais da Academia Brasileira de Ciencias}, volume = {97}, number = {2}, pages = {e20241216}, doi = {10.1590/0001-3765202520241216}, pmid = {40366930}, issn = {1678-2690}, mesh = {Humans ; *Extracellular Vesicles/virology/immunology/physiology ; *COVID-19/therapy/immunology ; *SARS-CoV-2/immunology ; COVID-19 Drug Treatment ; Exosomes ; }, abstract = {The COVID-19 pandemic has profoundly impacted global health, driven in part by the high mutation rate of SARS-CoV-2, which has resulted in the emergence of variants with enhanced transmissibility, virulence, and immune evasion capabilities. This evolving threat highlights the urgent need for innovative therapeutic strategies, as current treatments have shown limited efficacy. In this context, Extracellular Vesicles (EVs) present a promising alternative. EVs play a crucial role in intercellular communication and offer advantages due to their biocompatibility and mechanisms of cellular entry as viruses, making them an important tool against SARS-CoV-2. One of the principal immune evasion strategies employed by SARS-CoV-2 involves the release of EVs capable of transporting viral antigens. Numerous studies have suggested the role of exosomes and microvesicles as carriers of viral components, indicating that EVs can be targets in the progression of infection. Exosomes derived from infected cells could function as biomarkers and as potential drug delivery vehicles. Furthermore, EVs play a regulatory role in immune responses, facilitating cytokine production and antigen presentation. This review aims to elucidate the molecular mechanisms underlying the involvement of EVs in SARS-CoV-2 infection, examine their implications for biomarker development and explore their potential therapeutic applications in COVID-19.}, } @article {pmid40366711, year = {2025}, author = {Vu, PD and Abdi, S}, title = {Post-acute sequelae SARS-CoV-2 infection and neuropathic pain: a narrative review of the literature and future directions.}, journal = {Pain management}, volume = {15}, number = {6}, pages = {333-343}, pmid = {40366711}, issn = {1758-1877}, mesh = {Humans ; *Neuralgia/etiology/therapy/epidemiology/physiopathology ; *COVID-19/complications ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; }, abstract = {PURPOSE OF REVIEW: Neuropathic pain is a recognized and debilitating symptom of SARS-CoV-2 infection across acute, post-acute, and long-COVID phases. Initially emerging as acute or subacute symptoms, these neuropathic manifestations can evolve into chronic conditions, with approximately 10% of all SARS-CoV-2 cases (estimated 65 million individuals globally) developing post-acute SARS-CoV-2 (PASC) neuropathic sequalae. Given the limited literature specifically addressing neuropathic pain related to PASC, a deeper understanding is needed to improve management and reduce patient burden.

RECENT FINDINGS: PASC symptoms are associated with disease severity, elevated body mass indexes, preexisting psychological conditions, and addiction history. Sex differences appear to influence prevalence, and the multisystem nature of PASC complicates symptom presentation, with mood disorders, fatigue, and cognitive dysfunction contributing to altered pain perception. Proposed mechanisms include immune dysregulation, persistent viral protein effects, and neuroanatomical changes. Management typically involves a multimodal approach.

SUMMARY: This review examines SARS-CoV-2 neuropathic pain across the illness trajectory, examining its pathophysiology, prevalence, and treatment. It highlights the potential for subacute neuropathic symptoms to become chronic and calls for future research to refine long-term management strategies and assess broader healthcare implications.}, } @article {pmid40366294, year = {2025}, author = {Sheikhi, RA and Heidari, M and Noorbakhsh, S and Sarpiri, MR}, title = {The COVID-19 Pandemic and the Role of Tele-Nursing in Reducing Bed Occupancy: A Systematic Review.}, journal = {Florence Nightingale journal of nursing}, volume = {33}, number = {}, pages = {1-10}, pmid = {40366294}, issn = {2687-6442}, abstract = {AIM: This systematic review examines the tele-nursing methods used during the coronavirus disease-2019 outbreak to manage the increase in patient numbers and investigates strategies for reducing hospital bed occupancy.

METHOD: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The primary databases used to search the literature were PubMed, Web of Science, Scopus, ProQuest, ScienceDirect, and Google Scholar. One hundred sixty eight articles have been reviewed. The keywords for this review included "Coronavirus Disease 2019," "tele-nursing," and "bed occupancy." Equivalent terms were derived from Medical Subject Headings and expert opinions and extracted from related articles.

RESULTS: Out of the 168 records identified through the initial database search, seven articles were ultimately included in the final stage of this review after a thorough analysis of their features and content to address the study questions. The results of this systematic review, based on the content analysis of the selected studies, reveal various approaches used worldwide to manage the influx of patients in hospitals due to COVID-19 infection. The findings also highlight strategies employed to reduce bed occupancy, along with the challenges faced in implementing telenursing. The results are summarized into three main themes: current care models, challenges in establishing telenursing, and strategies to decrease bed occupancy.

CONCLUSION: Tele-nursing and virtual care are crucial for reducing bed occupancy during disasters like coronavirus disease 2019. Creating communication infrastructure, developing distance education through virtual space, licensing the private sector to run tele-nursing, clarifying the medical and legal responsibilities of telehealth, developing protocols of care, community education, and using new technology for remote consultation are ways to facilitate tele-nursing and reduce hospital bed occupancy.}, } @article {pmid40365983, year = {2025}, author = {Romantowski, J and Gawinowska, M and Trzonkowski, P and Niedoszytko, M}, title = {Can Labs Help With Vaccination? In Vitro Tests in Diagnosis of Allergy to COVID-19 Vaccines-A Systematic Review.}, journal = {Immunity, inflammation and disease}, volume = {13}, number = {5}, pages = {e70206}, pmid = {40365983}, issn = {2050-4527}, support = {//The article was prepared as part of the course Clinical Research Scholars Programme conducted by Harvard Medical School in 2023/2024 funded by Medical Research Agency (Poland, Warsaw)./ ; }, mesh = {Humans ; *COVID-19/prevention & control/immunology ; *COVID-19 Vaccines/adverse effects/immunology ; *Drug Hypersensitivity/diagnosis/immunology ; Immunoglobulin E/blood/immunology ; *SARS-CoV-2/immunology ; *Vaccination/adverse effects ; }, abstract = {INTRODUCTION: Since the outbreak of the coronavirus pandemic in 2019, vaccinations have proven to be a key strategy in disease prophylaxis. Although vaccines are safe from the perspective of the general population, hypersensitivity reactions have still been described, causing individuals to be reluctant in their vaccination decision. Since the description of first reports of COVID-19 vaccine allergy, many protocols of allergy work-up have been developed, including In Vitro and In Vivo tests. Although In Vivo tests were more accessible, many patients preferred In Vitro tests that would not involve contact with the allergen and be safe. This applied in particular to patients that had experienced a severe delayed hypersensitivity reaction in which In Vivo tests were highly limited and provocations were deemed high risk. Taking into account these circumstances, In Vitro tests might significantly enhance allergy work-up.

METHODS: National Center for Biotechnology Information (Pubmed) database was searched in May 2024 for articles on In Vitro diagnostic methods for COVID-19 vaccine allergy and hypersensitivity.

RESULTS: This article describes the In Vitro tests developed to date in the diagnosis of COVID-19 vaccine hypersensitivity: (1) analysis of specific IgE and IgG, (2) Basophil Activation Test, (3) Histamine Release Test, (4) IgM-dependent complement activation, (5) Lymphocyte Transformation Test, (6) Flow cytometry T-Cell markers, (7) Th1/Th2 cytokines concentration in cell culture.

CONCLUSIONS: The article highlights the tests' advantages, flaws and possible clinical applications.}, } @article {pmid40365256, year = {2025}, author = {Olson, KO and Patel, S and Pathak, P and Kelly, LP and Antony, MA and Thiriveedi, M}, title = {Cutaneous small vessel vasculitis in the COVID-19 era: a systematic review.}, journal = {Skin health and disease}, volume = {5}, number = {2}, pages = {114-123}, pmid = {40365256}, issn = {2690-442X}, abstract = {BACKGROUND: Dermatological adverse effects may occur after COVID-19 infection or vaccine administration. Since the beginning of the pandemic, several case reports and systematic reviews have been published on vasculitis associated with both COVID-19 infection and vaccination. Fever, malaise, urticaria, and rash are common symptoms of COVID-19. These symptoms can also occur as adverse reactions to COVID-19 vaccines. However, the occurrence of serious autoimmune reactions due to COVID-19 infection or its vaccine is rare. Cutaneous small vessel vasculitis (CSVV) is an autoimmune disorder that manifests with palpable purpura and petechiae involving the extremities. It results from neutrophilic inflammation within and around dermal vessels and is usually self-limited.

OBJECTIVE: We provide a thorough systematic review on CSVV occurring in the COVID-19 era.

METHODS: We followed the PRISMA 2020 checklist for systematic review, searching PubMed, Google Scholar, Cochrane, and Embase. We included case reports, case series, correspondence articles, and letters to the editor written in English. Characteristics of each were then summarized and analyzed.

RESULTS: 39 cases were included in our review - 27 due to the COVID-19 vaccine and 12 due to COVID-19 infection. Mean age of onset was similar, but mean time to onset was sooner in the vaccination group. Common treatments included systemic steroids, and almost all patients experienced complete recovery with the exception of a few patients in the COVID-19 infection cohort.

CONCLUSION: While most cases are self-limiting and resolve with no long-term sequalae, the occurrence of more severe reactions appears to be associated with COVID-19 infection rather than with vaccination.}, } @article {pmid40364089, year = {2025}, author = {Moustakli, E and Stavros, S and Michaelidis, TM and Potiris, A and Christodoulaki, C and Zachariou, A and Drakakis, P and Zikopoulos, K and Domali, E and Zikopoulos, A}, title = {Long-Term Effects of COVID-19 on Women's Reproductive Health and Its Association with Autoimmune Diseases, Including Multiple Sclerosis.}, journal = {Journal of clinical medicine}, volume = {14}, number = {9}, pages = {}, pmid = {40364089}, issn = {2077-0383}, abstract = {Concern over COVID-19's long-term influence on women's reproductive health is growing, with emerging research suggesting potential links to ovarian dysfunction, menstrual irregularities, fertility challenges, and adverse pregnancy outcomes. Post-viral immune dysregulation is linked to both the development and exacerbation of autoimmune diseases, including multiple sclerosis (MS). Long COVID has been associated with immunological dysfunction, hormonal imbalances, and chronic inflammation, all of which may worsen autoimmune disorders and reproductive health issues. Long COVID is characterized by symptoms persisting for weeks or months beyond the acute infection phase. There are indications that prolonged COVID may contribute to autoimmune disease development through mechanisms such as immune hyperactivation, molecular mimicry, and dysregulated cytokine responses. Although this research field is still emerging, growing evidence suggests that SARS-CoV-2 infection may have lasting effects on women's health, highlighting the need for further studies into its underlying mechanisms and long-term clinical outcomes. This review compiles recent findings on the long-term impact of COVID-19 on women's reproductive health and its potential association with autoimmune disorders, particularly MS.}, } @article {pmid40363817, year = {2025}, author = {He, W and Cui, J and Wang, XY and Siu, RHP and Tanner, JA}, title = {Early-Stage Pancreatic Cancer Diagnosis: Serum Biomarkers and the Potential for Aptamer-Based Biosensors.}, journal = {Molecules (Basel, Switzerland)}, volume = {30}, number = {9}, pages = {}, pmid = {40363817}, issn = {1420-3049}, support = {17163416//General Research Fund (GRF) grants/ ; 17127515//General Research Fund (GRF) grants/ ; 17102318//General Research Fund (GRF) grants/ ; SST/118/20GP//Innovation and Technology Commission Public Sector Trial Scheme for the Prevention and Con-trol of COVID-19 in Hong Kong "COVID-19 Point-of-Care Diagnostics in Saliva: an Ap-tamer-Mediated Approach"/ ; 104006067//HKU Seed Funding for Translational and Applied Research 2020/21 "Digital Diagnostics Using CRISPR-Enabled Nucleic Acid Probe Platform"/ ; 109001358//HKU Seed Funding for Translational and Applied Research 2023/24 "Development of an organic electrochemical transistor-based electrochemical aptamer biosensor"/ ; T12-201/20-R//Hong Kong University Grants Council Theme-based Research Scheme/ ; }, mesh = {Humans ; *Pancreatic Neoplasms/diagnosis/blood ; *Biomarkers, Tumor/blood ; *Biosensing Techniques/methods ; *Aptamers, Nucleotide/chemistry ; *Early Detection of Cancer/methods ; }, abstract = {Pancreatic cancer has a high mortality rate, and both the incidence and mortality are continuing to increase in many countries globally. The poor prognosis of pancreatic cancer is in part due to the challenges in early diagnosis. Improving early-stage pancreatic cancer diagnosis would improve survival outcomes. Aptamer-based biosensors provide an alternative technological approach for the analysis of serum biomarkers with several potential advantages. This review summarizes the major pancreatic cancer serum biomarkers, as well as discusses recent progress in biomarker exploration and aptasensor development. Here, we review both established and novel serum biomarkers identified recently, emphasizing their potential for early-stage pancreatic cancer diagnosis. We also propose strategies for further expanding multiplex biomarker panels beyond the established CA19-9 biomarker to enhance diagnostic performance. We discuss technological advancements in aptamer-based sensors for pancreatic cancer-related biomarkers over the last decade. Optical and electrochemical sensors are highlighted as two primary modalities in aptasensor design, each offering unique advantages. Finally, we propose steps towards clinical application using aptamer-based sensors with multiplexed biomarker detection for improved pancreatic cancer diagnostics.}, } @article {pmid40362439, year = {2025}, author = {da Silva, FPG and Matte, R and Wiedmer, DB and da Silva, APG and Menin, RM and Barbosa, FB and Meneguzzi, TAM and Pereira, SB and Fausto, AT and Klug, L and Melim, BP and Beltrão, CJ}, title = {HIF-1α Pathway in COVID-19: A Scoping Review of Its Modulation and Related Treatments.}, journal = {International journal of molecular sciences}, volume = {26}, number = {9}, pages = {}, pmid = {40362439}, issn = {1422-0067}, mesh = {*Hypoxia-Inducible Factor 1, alpha Subunit/metabolism/antagonists & inhibitors ; Humans ; *COVID-19/metabolism ; SARS-CoV-2 ; Signal Transduction ; Pandemics ; COVID-19 Drug Treatment ; Inflammation/metabolism ; *Coronavirus Infections/metabolism/drug therapy ; }, abstract = {The COVID-19 pandemic, driven by SARS-CoV-2, has led to a global health crisis, highlighting the virus's unique molecular mechanisms that distinguish it from other respiratory pathogens. It is known that the Hypoxia-Inducible Factor 1α (HIF-1α) activates a complex network of intracellular signaling pathways regulating cellular energy metabolism, angiogenesis, and cell survival, contributing to the wide range of clinical manifestations of COVID-19, including Post-Acute COVID-19 Syndrome (PACS). Emerging evidence suggests that dysregulation of HIF-1α is a key driver of systemic inflammation, silent hypoxia, and pathological tissue remodeling in both the acute and post-acute phases of the disease. This scoping review was conducted following PRISMA-ScR guidelines and registered in INPLASY. It involved a literature search in Scopus and PubMed, supplemented by manual reference screening, with study selection facilitated by Rayyan software. Our analysis clarifies the dual role of HIF-1α, which may either worsen inflammatory responses and viral persistence or support adaptive mechanisms that reduce cellular damage. The potential for targeting HIF-1α therapeutically in COVID-19 is complex, requiring further investigation to clarify its precise role and translational applications. This review deepens the molecular understanding of SARS-CoV-2-induced cellular and tissue dysfunction in hypoxia, offering insights for improving clinical management strategies and addressing long-term sequelae.}, } @article {pmid40362357, year = {2025}, author = {Zajac, D and Jampolska, M and Wojciechowski, P}, title = {Molecular Hydrogen in the Treatment of Respiratory Diseases.}, journal = {International journal of molecular sciences}, volume = {26}, number = {9}, pages = {}, pmid = {40362357}, issn = {1422-0067}, mesh = {Humans ; *Hydrogen/therapeutic use/pharmacology ; *Respiratory Tract Diseases/drug therapy ; Animals ; Antioxidants/therapeutic use/pharmacology ; Anti-Inflammatory Agents/therapeutic use/pharmacology ; Pulmonary Disease, Chronic Obstructive/drug therapy ; }, abstract = {Molecular hydrogen is gaining increasing attention as an antioxidant, anti-inflammatory, and antiapoptotic agent. Once considered an inert gas, it reveals current therapeutic potential among others in inflammatory diseases, cancer, and sports medicine, among others. The present review aims to provide a consistent summary of the findings of the last twenty years on the use of molecular hydrogen in major respiratory diseases, including allergies, asthma, COPD, pulmonary fibrosis, lung injury of various origins, as well as cancer and infections of the respiratory tract. In addition, the basic mechanisms through which molecular hydrogen exercises its biological activity on the respiratory system are described.}, } @article {pmid40362344, year = {2025}, author = {Naidoo, P and Naicker, T}, title = {A Disintegrin and Metalloprotease with Thrombospondin Motif, Member 13, and Von Willebrand Factor in Relation to the Duality of Preeclampsia and HIV Infection.}, journal = {International journal of molecular sciences}, volume = {26}, number = {9}, pages = {}, pmid = {40362344}, issn = {1422-0067}, mesh = {Humans ; *ADAMTS13 Protein/metabolism/genetics/blood ; *Pre-Eclampsia/metabolism/blood ; *von Willebrand Factor/metabolism/genetics ; Pregnancy ; Female ; *HIV Infections/metabolism/blood ; COVID-19/metabolism/complications ; Thrombosis ; SARS-CoV-2 ; }, abstract = {Normal pregnancy is associated with multiple changes in the coagulation and the fibrinolytic system. In contrast to a non-pregnant state, pregnancy is a hypercoagulable state where the level of VWF increases by 200-375%, affecting coagulation activity. Moreover, in this hypercoagulable state of pregnancy, preeclampsia is exacerbated. ADAMTS13 cleaves the bond between Tyr1605 and Met1606 in the A2 domain of VWF, thereby reducing its molecular weight. A deficiency of ADAMTS13 originates from mutations in gene or autoantibodies formed against the protease, leading to defective enzyme production. Von Willebrand protein is critical for hemostasis and thrombosis, promoting thrombus formation by mediating the adhesion of platelets and aggregation at high shear stress conditions within the vessel wall. Mutations in VWF disrupts multimer assembly, secretion and/or catabolism, thereby influencing bleeding. VWF is the primary regulator of plasma ADAMTS13 levels since even minute amounts of active ADAMTS13 protease have a significant inhibitory effect on inflammation and thrombosis. VWF is released as a result of endothelial activation brought on by HIV infection. The SARS-CoV-2 infection promotes circulating proinflammatory cytokines, increasing endothelial secretion of ultra large VWF that causes an imbalance in VWF/ADAMTS13. Raised VWF levels corresponds with greater platelet adhesiveness, promoting a thrombotic tendency in stenotic vessels, leading to increased shear stress conditions.}, } @article {pmid40361168, year = {2025}, author = {Laudański, P and Zyguła, A and Czyżyk, A and Olszak-Wasik, K and Warzecha, D and Wojtyła, C and Kurzawa, R}, title = {Viral infection and its impact on fertility, medically assisted reproduction and early pregnancy - a narrative review.}, journal = {Reproductive biology and endocrinology : RB&E}, volume = {23}, number = {1}, pages = {68}, pmid = {40361168}, issn = {1477-7827}, mesh = {Humans ; Pregnancy ; Female ; *Reproductive Techniques, Assisted/trends ; *Fertility/physiology ; *Virus Diseases/complications ; *Pregnancy Complications, Infectious/virology ; Male ; COVID-19/complications ; Pregnancy Outcome ; *Infertility/virology/therapy/etiology ; }, abstract = {Viral infections can significantly affect the physiopathology of reproductive organs, leading to fertility problems, reducing the success rates of assisted reproductive technologies, and negatively impacting pregnancy. This review aims to summarize the current evidence on viral pathogens that are either suspected or confirmed to play a role in reproductive medicine and their effects on early pregnancy. For instance, viral hepatitis and human immunodeficiency virus can decrease sperm quality. Human papilloma virus infection in men appears to cause infertility, while herpesviruses pose a greater risk to fetuses rather than to fertility. The Zika virus disrupts early embryo development, necessitating a delay in conception for those suspected or confirmed to be infected. The effects of SARS-CoV-2 on reproduction are still unclear. Rubella and cytomegalovirus can cause serious congenital defects, making pre-conception screening essential, and a Rubella vaccine is recommended. More rigorous studies are needed to clarify the roles of various infectious agents, enhance fertility treatments, and improve pregnancy outcomes while reducing complications.}, } @article {pmid40361091, year = {2025}, author = {Khoshmaram, N and Gholipour, K and Farahbakhsh, M and Tabrizi, JS}, title = {Strategies and challenges for maintaining the continuity of essential health services during a pandemic: a scoping review.}, journal = {BMC health services research}, volume = {25}, number = {1}, pages = {691}, pmid = {40361091}, issn = {1472-6963}, mesh = {Humans ; *COVID-19/epidemiology ; SARS-CoV-2 ; Pandemics ; *Delivery of Health Care/organization & administration ; *Continuity of Patient Care/organization & administration ; Leadership ; }, abstract = {BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on health systems worldwide, resulting in disruptions to essential health service delivery, such as routine immunizations, maternal and child health, and treatment for communicable and noncommunicable diseases. These services have been disrupted due to the diversion of resources towards the COVID-19 response. Therefore, the objective of this scoping review was to identify the strategies and challenges associated with maintaining the continuity of essential health services during a pandemic.

METHODS: This scoping review study was conducted in 2023 using the proposed Arksey and O'Malley framework. We conducted searches on PubMed, Scopus, ProQuest, and Web of Science using relevant keywords. Additionally, we searched Google Scholar, hand-searched reference lists of included studies, and reviewed organizational reports, websites, and other sources of information. Content analysis was employed to summarize the themes from the selected articles.

RESULTS: Our search of major databases yielded 3,732 results. After the screening process, 47 articles were included in the scoping review. The extracted interventions were classified into six groups based on the building blocks of the World Health Organization health system: leadership and governance, access to essential medicines, health systems financing, the health workforce, health service delivery, and health information systems.

CONCLUSIONS: The implementation of effective strategies and interventions can help ensure the provision of essential health services during a pandemic. These strategies include leveraging technology for remote care, ensuring the safety of healthcare workers and patients, strengthening supply chains, and establishing flexible and adaptive healthcare systems.}, } @article {pmid40360908, year = {2025}, author = {Vidiyala, N and Sunkishala, P and Parupathi, P and Nyavanandi, D}, title = {The Role of Artificial Intelligence in Drug Discovery and Pharmaceutical Development: A Paradigm Shift in the History of Pharmaceutical Industries.}, journal = {AAPS PharmSciTech}, volume = {26}, number = {5}, pages = {133}, pmid = {40360908}, issn = {1530-9932}, mesh = {*Artificial Intelligence/trends ; *Drug Industry/methods/trends ; *Drug Discovery/methods/trends ; Humans ; *Drug Development/methods/trends ; COVID-19 ; History, 20th Century ; History, 21st Century ; }, abstract = {In today's world, with an increasing patient population, the need for medications is increasing rapidly. However, the current practice of drug development is time-consuming and requires a lot of investment by the pharmaceutical industries. Currently, it takes around 8-10 years and $3 billion of investment to develop a medication. Pharmaceutical industries and regulatory authorities are continuing to adopt new technologies to improve the efficiency of the drug development process. However, over the decades the pharmaceutical industries were not able to accelerate the drug development process. The pandemic (COVID-19) has taught the pharmaceutical industries and regulatory agencies an expensive lesson showing the need for emergency preparedness by accelerating the drug development process. Over the last few years, the pharmaceutical industries have been collaborating with artificial intelligence (AI) companies to develop algorithms and models that can be implemented at various stages of the drug development process to improve efficiency and reduce the developmental timelines significantly. In recent years, AI-screened drug candidates have entered clinical testing in human subjects which shows the interest of pharmaceutical companies and regulatory agencies. End-end integration of AI within the drug development process will benefit the industries for predicting the pharmacokinetic and pharmacodynamic profiles, toxicity, acceleration of clinical trials, study design, virtual monitoring of subjects, optimization of manufacturing process, analyzing and real-time monitoring of product quality, and regulatory preparedness. This review article discusses in detail the role of AI in various avenues of the pharmaceutical drug development process, its limitations, regulatory and future perspectives.}, } @article {pmid40360101, year = {2025}, author = {Aldaais, EA}, title = {Cellulose-based and polysaccharide delivery systems for phytochemicals in MERS-CoV and SARS-CoV-2 treatment: A systematic review of therapeutic potential.}, journal = {International journal of biological macromolecules}, volume = {313}, number = {}, pages = {143985}, doi = {10.1016/j.ijbiomac.2025.143985}, pmid = {40360101}, issn = {1879-0003}, mesh = {Humans ; *Middle East Respiratory Syndrome Coronavirus/drug effects ; *Polysaccharides/chemistry ; SARS-CoV-2/drug effects ; *Cellulose/chemistry ; *Phytochemicals/chemistry/therapeutic use/administration & dosage/pharmacology ; *Drug Delivery Systems ; *Antiviral Agents/chemistry ; COVID-19 ; *Coronavirus Infections/drug therapy ; Chitosan/chemistry ; Drug Carriers/chemistry ; *COVID-19 Drug Treatment ; Nanoparticles/chemistry ; }, abstract = {Phytochemical delivery systems often suffer from poor bioavailability and stability, limiting their therapeutic impact against coronaviruses. Polysaccharide-based carriers offer promising alternatives due to their biocompatibility, biodegradability, and potential for functionalization. This systematic review and meta-analysis evaluated the effectiveness of cellulose-based and other polysaccharide delivery systems in enhancing phytochemical delivery for MERS-CoV and SARS-CoV-2 treatment. Following PRISMA guidelines, six databases were searched for studies published between 2019 and 2024. Twenty studies meeting inclusion criteria were analyzed for delivery system performance, including particle characterization, drug loading efficiency, and therapeutic outcomes. Chitosan-based systems exhibited the highest encapsulation efficiency (86.8 %) and bioavailability enhancement (10.04-fold). Cellulose nanocrystals showed favorable particle size (100-250 nm) and drug loading capacity (72.5 %). Hybrid systems offered sustained stability up to 72 h under physiological conditions. All systems demonstrated good safety profiles, with cell viability exceeding 85 %. Statistical analyses confirmed significant differences between carrier types (p < 0.05), with chitosan systems performing best overall. These findings underscore the therapeutic potential of polysaccharide-based delivery systems for coronavirus treatment. Future research should address the limited data on MERS-CoV-specific systems and standardize methodologies to enhance cross-study comparability.}, } @article {pmid40359841, year = {2025}, author = {Chahat, and Kumar, B and Gupta, S and Wahajuddin, M and Joshi, G}, title = {Reconnecting the roots of hydrogen sulfide (H2S) with medicinal chemistry: Lessons accomplished and challenges so far.}, journal = {Bioorganic chemistry}, volume = {161}, number = {}, pages = {108569}, doi = {10.1016/j.bioorg.2025.108569}, pmid = {40359841}, issn = {1090-2120}, mesh = {*Hydrogen Sulfide/metabolism/chemistry/pharmacology/therapeutic use ; Humans ; Animals ; Chemistry, Pharmaceutical ; Neoplasms/drug therapy/metabolism ; SARS-CoV-2 ; COVID-19 Drug Treatment ; }, abstract = {Previously known for its unpleasant odour and mortality in elevated concentrations, hydrogen sulfide (H2S) is currently considered a complex molecule having significant physiological advantages. After nitric oxide (NO) and carbon monoxide (CO), H2S is regarded as the third endogenous gasotransmitter, performing many biological functions in the human body. The essential functions include but are not limited to regulating inflammation, maintaining the redox potential, cellular signalling, and metabolic processes. Moreover, an imbalance in its expression or dysfunction of its precursors and associated enzymes in its biosynthesis leads to multiple pathological conditions, including cancer, diabetes, neurodegenerative disorders, COVID-19, etc. Nonetheless, its upregulation is also reported to dysregulate normal physiological conditions and precipitate different diseases and cancer, thus acting as a "Double-edged sword." Despite this, H2S is still being widely explored for its therapeutic potential in various disease states. The present review is put forth to focus on hydrogen sulfide's dichotomous properties, emphasising its critical functions and therapeutic applications. This compilation provides a state-of-the-art analysis of the broad application of H2S donors in developing therapeutic interventions, release mechanisms, and their use in numerous diseases and disorders. Furthermore, various analytical techniques for detecting and quantifying the H2S release in biological samples via the hybrid donors are also discussed. We herein expect that an in-depth comprehension of the multiple activities of H2S can aid in discovering novel therapeutic interventions critical for holistic disease management measures in the future.}, } @article {pmid40359650, year = {2025}, author = {Acharya, A and Byrareddy, SN}, title = {Immunological insights into the re-emergence of human metapneumovirus.}, journal = {Current opinion in immunology}, volume = {94}, number = {}, pages = {102562}, pmid = {40359650}, issn = {1879-0372}, support = {R01 DA052845/DA/NIDA NIH HHS/United States ; R01 DA061678/DA/NIDA NIH HHS/United States ; R01 MH130177/MH/NIMH NIH HHS/United States ; R21 OD037751/OD/NIH HHS/United States ; }, mesh = {Humans ; *Metapneumovirus/immunology/genetics/physiology ; *Paramyxoviridae Infections/immunology/epidemiology/virology ; Animals ; }, abstract = {Human metapneumovirus (hMPV) is a seasonal respiratory virus that typically causes mild, flu-like symptoms. In some cases, it can lead to severe respiratory complications, such as pneumonia, bronchitis, and bronchiolitis, often requiring hospitalization. Recently, a surge in hMPV cases has been reported in China and other countries, raising concerns about a potential pandemic scenario reminiscent of COVID-19. This review explores the genomic structure, replication cycle, genetic diversity, and evolutionary trajectory of hMPV. It also discusses host immune responses and the available animal models to study pathogenesis and to screen for potential vaccines and antivirals. Additionally, we examine the shifting seasonal trends in hMPV circulation, evaluate the low pandemic risk posed by existing hMPV clades, and underscore the need for continued vaccine and antiviral development. Finally, we advocate for strengthened global surveillance, especially in low- and middle-income countries, as a critical strategy to mitigate the risks posed by emerging hMPV clades.}, } @article {pmid40358208, year = {2025}, author = {Broadbent, A}, title = {A veterinary virapalooza: a summary of the 2024 American Society for Virology (ASV) Veterinary/Zoonotic Virology Satellite Symposium and online H5N1 panel discussion.}, journal = {Journal of virology}, volume = {99}, number = {6}, pages = {e0049925}, pmid = {40358208}, issn = {1098-5514}, support = {20246701542141//U.S. Department of Agriculture/ ; }, mesh = {Animals ; Humans ; *Virology ; *Virus Diseases/veterinary/virology/epidemiology/prevention & control ; *Zoonoses/virology/epidemiology ; *Veterinary Medicine ; Congresses as Topic ; United States ; Influenza A Virus, H5N1 Subtype ; }, abstract = {The year 2024 saw veterinary/zoonotic virology take center stage once more as the American Society for Virology (ASV) hosted a satellite symposium on the subject in June and an online panel discussion in December. The symposium comprised six talks from experts on viruses of economic importance to agriculture and of public health importance. The viruses in question spanned foot and mouth disease virus (FMDV), African swine fever virus (ASFV), Marek's disease virus (MDV), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and influenza A viruses (IAVs), and topics covered fundamental virology, applied virology, epidemiology, and surveillance. The goal was to emphasize that improving the control of animal viral diseases requires an integrated, holistic approach involving academia, government, and industry labs undertaking research on basic virology, vaccinology, epidemiology, and surveillance. Moreover, the symposium aimed to highlight career opportunities in the agricultural/veterinary sector for those with virology training. Six months following the symposium, the ASV held an online panel discussion on the ongoing H5N1 IAV situation in poultry, cattle, and people to provide more up-to-date information to its membership. A summary of the talks and discussions is presented here.}, } @article {pmid40358108, year = {2025}, author = {Ratliff, HC and Lee, KA and Buchbinder, M and Kelly, LA and Yakusheva, O and Costa, DK}, title = {Organizational Resilience in Healthcare: A Scoping Review.}, journal = {Journal of healthcare management / American College of Healthcare Executives}, volume = {70}, number = {3}, pages = {165-188}, pmid = {40358108}, issn = {1096-9012}, mesh = {Humans ; *Delivery of Health Care/organization & administration ; *Resilience, Psychological ; COVID-19/epidemiology ; *Organizational Culture ; }, abstract = {GOAL: Healthcare organizations have always faced challenges, yet the past decade has been particularly difficult due to workforce shortages, the COVID-19 pandemic, and economic demands, all of which can impact quality of care. While some healthcare organizations have demonstrated the ability to adapt to such stressors-which has been termed "organizational resilience"-others have not. Most of the research on resilience in healthcare has been on individual clinicians; less is known about how extra-individual groups such as teams, units, and systems develop resilience. Understanding what organizational resilience is, how to measure it, and how healthcare organizations can develop it is essential to responding effectively to future acute and chronic stressors in the healthcare industry. The purpose of this scoping review is to synthesize how organizational resilience is defined and measured in the current healthcare literature and to inform future interventions to improve organizational resilience.

METHODS: We searched PubMed and Scopus databases for articles mentioning organizational resilience in healthcare. Eligible sources were those published in English through December 2023 in any format, and that described or measured organizational resilience in healthcare. Titles and abstracts were screened, and information was extracted from eligible articles.

PRINCIPAL FINDINGS: We screened 243 articles and included 97 in our review. Across these studies, organizational resilience was described as a healthcare system's ability to continue functioning and meet its objectives when exposed to stressful stimuli. Reactive and proactive strategies, as well as reflection, were identified as key components of organizational resilience. Four measures of organizational resilience were developed for use in healthcare, but only two have been validated.

PRACTICAL APPLICATIONS: Future studies should focus on validating and comparing existing measures of organizational resilience and using them to investigate how organizational resilience may impact quality of care and clinician well-being, allowing the field to move beyond the focus on individual clinician resilience.}, } @article {pmid40357526, year = {2025}, author = {Fahrbach, K and Cichewicz, A and Chu, H and Di Fusco, M and Burnett, H and Volkman, HR and Akin-Fajiye, M and Mendoza, CF and Cappelleri, JC}, title = {Comparative effectiveness of Omicron XBB 1.5-adapted COVID-19 vaccines: a systematic literature review and network meta-analysis.}, journal = {Expert review of vaccines}, volume = {24}, number = {1}, pages = {416-432}, doi = {10.1080/14760584.2025.2505754}, pmid = {40357526}, issn = {1744-8395}, mesh = {Humans ; BNT162 Vaccine/immunology ; *COVID-19/prevention & control/immunology ; *COVID-19 Vaccines/immunology/administration & dosage ; *SARS-CoV-2/immunology ; *Vaccine Efficacy ; Observational Studies as Topic ; }, abstract = {INTRODUCTION: Comparative effectiveness data of COVID-19 vaccines remain limited. We conducted a systematic review and network meta-analysis (NMA) feasibility assessment of effectiveness studies of Omicron-adapted COVID-19 vaccines.

RESEARCH DESIGN AND METHODS: Searches in MEDLINE and Embase up to February 2025 identified studies comparing the effectiveness of Omicron-adapted COVID-19 vaccines, either directly or against no recent vaccine. Two investigators independently selected articles reporting adjusted vaccine effectiveness (VE). A feasibility assessment determined the appropriateness of a common comparator and evaluated effect modifiers (EMs). Data extraction and risk-of-bias assessment were performed by one investigator and validated by a second investigator. Bayesian NMAs using random-effects models were performed for base-case analyses, data permitting.

RESULTS: The review identified 25 studies for Omicron-adapted COVID-19 vaccines: 16 for XBB formulations, eight of which were included in NMAs, all for mRNA formulations, representing 29.9 million participants. BNT162b2 had the largest evidence base. Comparisons between XBB.1.5-adapted BNT162b2 (Comirnaty) and mRNA-1273 (Spikevax) found that both vaccines are effective and comparable against XBB-related hospitalizations, infections, and medically attended visits in adults Among elderly, the estimated effectiveness against XBB-related hospitalizations favored BNT162b2.

CONCLUSIONS: Findings of this NMA of observational studies support the effectiveness of XBB.1.5-adapted mRNA vaccines. Limitations included assumptions on EMs and sparse evidence networks.}, } @article {pmid40357242, year = {2025}, author = {Gontse, KS and Kovane, GP and Mokgaola, IO and Moloko-Phiri, SS}, title = {Experiences of nurse educators regarding teaching and learning during the COVID-19 pandemic.}, journal = {Health SA = SA Gesondheid}, volume = {30}, number = {}, pages = {2882}, pmid = {40357242}, issn = {2071-9736}, abstract = {BACKGROUND: The abrupt start of the coronavirus disease 2019 (COVID-19) pandemic impacted educational systems globally, including nursing education institutions (NEIs). Teaching and learning in academic institutions were disturbed because of strict legislation measures, like lockdowns, that were implemented to curb the spread of COVID-19. These measures affected the quality of teaching and academic attainment.

AIM: This study aimed to explore and describe the experiences of nurse educators regarding teaching and learning during the COVID-19 pandemic at a NEI in the North West province (NWP). The study was conducted at a selected NEI, which comprises two campuses that are 178.1 km apart.

METHOD: A qualitative descriptive phenomenology approach was used. The nurse educators were purposively sampled, and 25 nurse educators participated in this study. Four focus group discussions (FGDs) were held to collect data through face-to-face semi-structured interviews. The data analysis followed Colaizzi's seven-stage process.

RESULTS: Three themes emerged from data analysis: positive experiences and negative experiences regarding teaching and learning during the COVID-19 pandemic, and strategies for overcoming the challenges experienced by nurse educators during the COVID-19 pandemic.

CONCLUSION: The study findings revealed that nurse educators experienced positive and negative challenges regarding teaching and learning during the COVID-19 pandemic. Furthermore, there is a need for NEIs to employ teaching and learning innovations, including the use of technology, to be able to divert to online teaching and learning during future pandemics where face-to-face teaching is halted.

CONTRIBUTION: The study findings may provide valuable insights for policymakers in higher education institutions (HEIs) to develop policies that incorporate innovative teaching methods. These methods will be relevant for future pandemics that may disrupt traditional face-to-face teaching and learning. As an enhancement of existing teaching practices, innovative approaches have proven to be effective and contribute to more inclusive education. By adopting these methods, HEIs can better support the achievement of Sustainable Development Goal 4, which aims to ensure quality and equitable education for all.}, } @article {pmid40357185, year = {2025}, author = {Arikpo, DI and Oku, AO and Onyema, OA and Odey, EO and Hamilton-Hurwitz, H and Toledo, JP and Dunn, K and Baller, A and Smith, HJ and Meremikwu, MM}, title = {Health and care workers' perceptions of PPE and physical distancing for COVID-19: A qualitative evidence synthesis.}, journal = {Journal of public health in Africa}, volume = {16}, number = {2}, pages = {621}, pmid = {40357185}, issn = {2038-9922}, support = {001/WHO_/World Health Organization/International ; }, abstract = {BACKGROUND: Despite the effectiveness of personal protective equipment (PPE) and physical distancing interventions for COVID-19 infection prevention and control (IPC), low uptake among health and care workers persists.

AIM: To synthesise evidence from primary qualitative research exploring the perceptions and experiences of health and care workers on the use of PPE and physical distancing in the context of COVID-19.

SETTING: Healthcare settings including care homes.

METHOD: An electronic database search was conducted using search terms based on the inclusion criteria, and the search strategy was peer-reviewed by a team of information scientists. Thirty qualitative studies were sampled after eligibility screening independently by two review authors. Synthesis was performed using the thematic synthesis approach. The confidence in each review finding was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations; Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQual) approach.

RESULTS: Fifteen analytical themes were identified. Health and care workers valued the use of PPE in patient care. The sense of value was heightened by perceived susceptibility to infection with COVID-19, the need to deliver optimal patient care and the desire to protect family members. Service delivery, clinical workflows, the absence of visual cues for spatial separation and physical infrastructure hindered adherence to physical distancing guidelines.

CONCLUSION: The gap between IPC guidelines and their implementation is an important health system barrier to PPE use and physical distancing in healthcare settings.

CONTRIBUTION: This review provides useful insights on key considerations for planning and implementing IPC in healthcare settings.}, } @article {pmid40357184, year = {2025}, author = {Arikpo, DI and Onyema, OA and Oku, AO and Meremikwu, C and Hamilton-Hurwitz, H and Toledo, JP and Dunn, K and Baller, A and Smith, HJ and Meremikwu, MM}, title = {Factors influencing mask use and physical distancing for COVID-19: A qualitative evidence synthesis.}, journal = {Journal of public health in Africa}, volume = {16}, number = {2}, pages = {614}, pmid = {40357184}, issn = {2038-9922}, support = {001/WHO_/World Health Organization/International ; }, abstract = {BACKGROUND: The World Health Organization (WHO) recommends a bundle of precautions to reduce community transmission of COVID-19, including mask use and physical distancing. However, there is evidence that suggests poor adherence to these health measures community settings.

AIM: To summarise qualitative research evidence on the perceptions and factors influencing masks use and physical distancing in the context of the COVID-19 pandemic.

SETTING: We included studies conducted in community settings.

METHOD: An electronic database search was conducted using search terms derived from the inclusion criteria and combined in a peer-reviewed search strategy. Thirty studies were sampled. Qualitative data analysis was performed using the thematic synthesis approach. The confidence in each review finding was ascertained using the Grading of Recommendations, Assessment, Development and Evaluations - Confidence in the evidence from Reviews of Qualitative Research (GRADE-CERQual) approach.

RESULTS: Ten analytical themes of low to high confidence were identified. Values, belief systems and cultural norms shaped the perception and uptake of mask use and physical distancing. Key barriers included the cost of masks, limited infrastructure for spatial separation and inconsistent political or government messaging, while visual cues and social responsibility facilitated adherence.

CONCLUSION: Personal values and preferences influenced individuals' adherence to these public health measures. Political or government messaging is important to aid understanding and adherence.

CONTRIBUTION: Insights provided by this synthesis can support future emergency preparedness and response to outbreaks of acute respiratory infections by providing policy makers with information needed to make contextually relevant recommendations to enhance adherence.}, } @article {pmid40357183, year = {2025}, author = {Nwachuku, NS and Arikpo, DI and Agbor, UJ and Onyenemerem, PN and Ochodo, EA and Smith, H and Meremikwu, M}, title = {Factors influencing uptake of diagnostic test interventions for SARS-CoV-2: A qualitative review.}, journal = {Journal of public health in Africa}, volume = {16}, number = {2}, pages = {619}, pmid = {40357183}, issn = {2038-9922}, abstract = {BACKGROUND: Diagnostic tests for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) may be performed based on symptomatic presentation or for screening of asymptomatic persons. Testing can limit spread by enabling rapid identification of cases leading to containment measures. However, views regarding diagnostic test as a containment intervention vary across different settings.

AIM: To synthesise the findings of qualitative studies on the perceptions and factors influencing the uptake of diagnostic test interventions for SARS-CoV-2.

SETTING: Healthcare facilities, care homes, communities including households.

METHOD: We searched MEDLINE database and the (WHO) SARS-CoV-2 Research database from 01 January 2020 to 06 September 2022. Qualitative data were synthesised thematically while data for barriers and facilitators were synthesised using the SURE framework. The GRADE-CERQual approach was used to assess the confidence in each review finding, while the ENTREQ checklist was used to report the QES. The quality of included studies was assessed with the CASP tool.

RESULTS: Twenty two studies were included for QES. Two were conducted in the health facility setting, 2 in care homes, and 18 in the community. Twenty of the studies came from high-income countries, 2 from low- and middle-income countries. In all, 13 analytical and 31 descriptive themes of low to moderate quality evidence emerged; mainly around fear of contracting COVID-19, test procedure and socio-economic implications of a positive test result.

CONCLUSION: Low to moderate quality evidence of barriers to uptake of diagnostic test were largely due to misconceptions about the interventions.

CONTRIBUTION: Sensitising and engaging communities and stakeholders in the healthcare system, will help mitigate the fear barrier and enhance policy coordination.}, } @article {pmid40356629, year = {2025}, author = {Liu, W and Zhao, Y and Rao, Y and Wu, Z and Peng, Y and Gong, L}, title = {Frontiers and hotspot evolution in research on Alzheimer's disease and hypertension: a bibliometric analysis from 2004 to 2023.}, journal = {Frontiers in neurology}, volume = {16}, number = {}, pages = {1514054}, pmid = {40356629}, issn = {1664-2295}, abstract = {BACKGROUND: Alzheimer's disease (AD) is a neurodegenerative disease that imposes a heavy burden on patients and their families. Hypertension is an important risk factor for AD, but the specific mechanism of its impact is still unclear. This study thus aimed to analyze the relationship and trend changes between AD and hypertension through bibliometric methods.

METHODS: Literature on AD and hypertension was retrieved from the Web of Science Core Collection (WoSCC) database between 2004 and 2023. Data regarding countries, institutions, authors and journals were sourced from WoSCC. CiteSpace and VOSviewer were used for data visualization, including author collaboration, timelines view of references, reference bursts and overlay visualization maps of keywords. Excel 2018 software was used for the statistical analysis.

RESULTS: A total of 1,833 publications were ultimately included. From 2004 to 2023, the number of publications per year basically showed an increasing trend. The United States (United States) not only had the largest output of publications and the highest H-index but also had the seven highest frequencies of publication institutions. Kehoe, Patrick ranked first with the most articles among 9,330 authors. The journal with the most published articles was the Journal of Alzheimer's Disease. Reference analysis revealed a hotspot in the exploration of the pathophysiological association between AD and hypertension. Second, the treatment effects and potential risks of antihypertensive drugs (AHDs) on AD are also the focus of research. Researchers have carried out a series of studies ranging from basic research to clinical research on AHDs for the treatment of AD. Finally, personalized treatment strategies will also become one of the hotspots of future research. Controlling hypertension through lifestyle changes and medication interventions in AD patients is a promising strategy. The analysis of keywords revealed that "amyloid deposition," "preeclampsia," "Corona Virus Disease 2019 (COVID-19)" and "biomarkers" have been research hotspots in recent years.

CONCLUSION: By analyzing the references and keywords, we summarized the hot topics and research trends in this field. These findings provide useful information for researchers to explore the relationship between hypertension and AD further, with the hope of providing more effective treatments for AD patients to delay disease progression and improve quality of life.}, } @article {pmid40355732, year = {2025}, author = {Dumke, R}, title = {[Infections with the human pathogenic Mycoplasma species M. genitalium and M. pneumoniae : Current epidemiological aspects].}, journal = {Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz}, volume = {68}, number = {8}, pages = {932-939}, pmid = {40355732}, issn = {1437-1588}, mesh = {Humans ; *Mycoplasma genitalium/pathogenicity ; *Mycoplasma Infections/epidemiology/drug therapy/diagnosis/microbiology ; Male ; *Mycoplasma pneumoniae/pathogenicity ; Germany/epidemiology ; Female ; COVID-19/epidemiology ; Anti-Bacterial Agents/therapeutic use ; *Pneumonia, Mycoplasma/epidemiology/drug therapy/diagnosis/microbiology ; Risk Factors ; }, abstract = {Two human pathogenic mycoplasma species, Mycoplasma pneumoniae and M. genitalium currently pose challenges for the clinical practice.M. pneumoniae is a common cause of community-acquired respiratory infections, which can lead to asymptomatic courses as well as severe atypical pneumonia. Extrapulmonary manifestations also occur. Since December 2023, a strong increase of reported cases has been registered in the federal state of Saxony, where reporting is mandatory. These numbers far exceed those from the previous ten years and are assumed to generally translate to the other federal states. The reason for this development is likely the reduced contact with the pathogen during the COVID-19 pandemic combined with a waning immunity in the population. Although there are no reliable data on an increase in the rate of severe cases, diagnostics and treatment must be adapted. The resistance rate to macrolides (which are primarily used in Germany) remains favorable at approximately 3%.M. genitalium is a sexually transmitted bacterium and is only causally relevant in a portion of male urethritis cases. While its epidemiological significance is limited, resistance to the guideline-recommended antibiotics azithromycin and moxifloxacin is increasing, reaching 69% and 25%, respectively, in samples tested in the German consulting laboratory in recent years. Even higher rates are to be expected in high-risk groups (e.g., men who have sex with men), where M. genitalium is relatively frequent. Under these conditions, therapy can only be successful with a resistance-guided treatment concept.This review summarizes the current state of knowledge on both pathogens.}, } @article {pmid40355215, year = {2025}, author = {Wang, J and Ji, X and Yang, C and Xu, J}, title = {Susceptibility from the immunological perspective of COVID-19-associated pulmonary aspergillosis: A literature review.}, journal = {Medicine}, volume = {104}, number = {19}, pages = {e42363}, pmid = {40355215}, issn = {1536-5964}, support = {20200404171YY//Jilin Science and Technology Development Program/ ; }, mesh = {Humans ; *COVID-19/immunology/complications ; Disease Susceptibility/immunology ; *Pulmonary Aspergillosis/immunology ; Immunity, Innate ; SARS-CoV-2 ; *Invasive Pulmonary Aspergillosis/immunology ; Adaptive Immunity ; }, abstract = {The incidence rate of COVID-19-associated pulmonary aspergillosis (CAPA) is rising. However, the pathogenesis of CAPA remains unclear. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection disrupts pathways related to type I interferon and Toll-like receptors, key components in innate immunity, thereby elevating the incidence of CAPA. Additionally, SARS-CoV-2 infection results in T and B cell functional deficiencies or exhaustion within adaptive immunity, weakening the defense against invasive Aspergillus. Furthermore, SARS-CoV-2 infection enhances the replication of cytomegalovirus and alters the gut microbiota, factors that may aid in diagnosing CAPA. Immunosuppressive therapy in COVID-19 patients is also believed to heighten the risk of invasive aspergillosis. Therefore, this review, examines the immune response to SARS-CoV-2 infection combined with invasive aspergillosis, and explores the pathogenesis and susceptibility factors of CAPA. We propose that variations in an individual's immune response significantly determine susceptibility to CAPA. The aim of this paper is to deepen clinical understanding of CAPA's pathogenesis, thereby aiding in mitigating susceptibility risk and advancing novel treatment approaches.}, } @article {pmid40354666, year = {2025}, author = {Jacobs, JW and Booth, GS and Lewis-Newby, M and Saifee, NH and Ferguson, E and Cohn, CS and Delaney, M and Morley, S and Thomas, S and Thorpe, R and Raza, S and Weaver, MS and Woo, JS and Sharma, D and So-Osman, C and Yurtsever, N and Tormey, CA and Waters, A and Goldman, M and Yan, MTS and Fasano, RM and Stephens, LD and Allen, ES and Erikstrup, C and Infanti, L and Schlafer, TD and Warner, MA and Winters, JL and Tobian, AAR and Bloch, EM}, title = {Medical, Societal, and Ethical Considerations for Directed Blood Donation in 2025.}, journal = {Annals of internal medicine}, volume = {178}, number = {7}, pages = {1021-1026}, doi = {10.7326/ANNALS-25-00815}, pmid = {40354666}, issn = {1539-3704}, mesh = {Humans ; *Blood Donors/ethics/psychology/legislation & jurisprudence ; COVID-19/prevention & control ; *Blood Safety ; United States ; COVID-19 Vaccines ; SARS-CoV-2 ; Blood Donation ; }, abstract = {In the United States and other high-income countries, blood donation primarily relies on anonymous, voluntary donors. However, directed blood donation-where people donate for a specific recipient-has resurged, particularly due to misinformation surrounding COVID-19 vaccination. Requests for "nonvaccinated" blood, driven by misconceptions about vaccine safety, have led to legislative attempts to mandate compliance. Historically, directed donation was used to mitigate the risk for transfusion-related infections before modern screening techniques rendered it largely unnecessary. Today, it presents important patient safety risks, including increased infectious disease transmission, immunologic complications, and logistic burdens. Directed donations also introduce inefficiencies, diverting resources from the community blood supply and exacerbating shortages. Moreover, directed donation for nonmedical indications lacks scientific justification. Blood safety is ensured through rigorous donor screening, pathogen testing, and processing measures. There is no evidence that blood from vaccinated donors poses risk. Requests for nonvaccinated blood, as well as other directed donation preferences based on personal beliefs, introduce biases that are not grounded in medical necessity. Accommodating such requests undermines public trust in blood safety protocols and legitimizes unfounded fears. Ethical concerns arise as non-medically justified requests reinforce discriminatory practices, such as selecting donors based on race or gender. Allowing such preferences risks politicizing blood donation, spreading misinformation, and straining health care systems. Although autonomy is a core ethical principle in medicine, it does not justify non-evidence-based interventions. Given the potential harm and societal impact, directed blood donations should be limited to rare, medically necessary cases. Ongoing legislative efforts to mandate these requests require unified opposition from the medical and scientific community to uphold ethical, evidence-based, blood allocation practices.}, } @article {pmid40354157, year = {2025}, author = {Gujral, K and Illarmo, S and Jacobs, JC and Wagner, TH}, title = {The Economics of Telehealth: An Overview.}, journal = {Telemedicine journal and e-health : the official journal of the American Telemedicine Association}, volume = {31}, number = {9}, pages = {1074-1095}, doi = {10.1089/tmj.2025.0073}, pmid = {40354157}, issn = {1556-3669}, support = {IK2 HX003723/HX/HSRD VA/United States ; }, mesh = {*Telemedicine/economics/organization & administration ; Humans ; *COVID-19/epidemiology ; SARS-CoV-2 ; Health Services Accessibility/economics ; Pandemics ; Cost-Benefit Analysis ; }, abstract = {Background: Telehealth has long offered promise for improving health care access, but due to restrictive regulations and technology limitations, historic use has been low. Despite telehealth's unprecedented expansion during the COVID-19 pandemic, economic questions remain, raising uncertainty about telehealth's future. Methods: We used an economics lens to conduct a narrative review of the vast medical literature and nascent economic literature on telehealth. We reviewed evidence on demand-side and supply-side forces influencing telehealth adoption and evidence on telehealth's impact on health care use, costs, effectiveness, and equity. Results: Current evidence is sparsely distributed across care types, telehealth modalities (e.g., phone, video, secure messaging), models of telehealth delivery, and pre- and post-pandemic periods. While the literature provides some signals that patients and clinicians are responsive to monetary costs of telehealth, more robust studies are needed, including studies on patient and provider time costs. Telehealth adoption appears to modestly increase outpatient care use, but evidence of its impact on costlier emergency or inpatient care use is needed. There is a lack of studies on monetary costs of telehealth, particularly the impact of telehealth on production costs. Importantly, there is a lack of high-quality studies on the comparative effectiveness of modalities. While there is a growing literature on disparities, studies that address confounders are needed to assess if telehealth can deliver on its promise to improve access for underserved populations. Conclusion: Our review paves the way for a stronger economics literature on telehealth, highlighting areas of future research.}, } @article {pmid40352986, year = {2025}, author = {Park, GL and Hegazy, SA and Sepe, J and Swigart, J and Burnette, M and Beltran, J and Hernandez, C}, title = {Fostering Competencies: A Scoping Review of Escape Rooms in Medical Education.}, journal = {Medical science educator}, volume = {35}, number = {2}, pages = {1111-1121}, pmid = {40352986}, issn = {2156-8650}, abstract = {Escape rooms are used in medical education to encourage teaming and communication skills, but their effectiveness beyond learner satisfaction remains unexplored. This review evaluated their educational value, focusing on alignment with ACGME core competencies. Following the PRISMA framework, a scoping review was conducted in PubMed, Scopus, and ERIC through mid-September 2023, excluding commentaries, editorials, and letters. The review included 35 studies, mostly single-institution studies, with various methodologies. Most aligned with competencies in interpersonal and communication skills and systems-based practice, with increased virtual formats during COVID-19 pandemic. High learner satisfaction was noted. Escape rooms effectively foster teamwork and communication in medical education. Further research is needed on knowledge retention and application.}, } @article {pmid40352672, year = {2025}, author = {Singh, R and Bansal, R}, title = {Revisiting the role of steroidal therapeutics in the 21st century: an update on FDA approved steroidal drugs (2000-2024).}, journal = {RSC medicinal chemistry}, volume = {}, number = {}, pages = {}, pmid = {40352672}, issn = {2632-8682}, abstract = {Steroids are biologically active polycyclic compounds that have garnered significant scientific attention due to their distinct physiochemical properties and diverse medical applications. Since their invention more than 90 years ago, steroids have remained the most important and necessary class of regulatory molecules in the evolution process of living creatures and have fascinated scientists due to their broad-spectrum biological activities. Over time, scientific innovations and expanded understanding of mechanisms related to diversified biological activities of steroids have made them cheaper, efficient and more specific therapeutic agents which could be effective in the prevention and cure of numerous diseases like cancer, inflammation, asthma, microbial infection, and many more. However, steroidal drugs remain a double-edged sword having significant therapeutic benefits but with incidence of several adverse effects if used for a longer duration and/or with incorrect dose. Nevertheless, novel treatment approaches such as nanoparticles or liposomal drug delivery, real-time monitoring and the use of artificial intelligence in steroidal therapy outweigh their risk factors and provide an effective and safe treatment with minimum adverse effects. Furthermore, the repurposing of steroids in different diseases, e.g. successful use of dexamethasone or hydrocortisone during COVID-19 pandemic has renewed the interest in steroidal therapeutics. The present review provides an update on FDA approved steroidal drugs during the years 2000-2024, the status of their clinical studies, the challenges offered by steroidal therapy and the future perspectives to counterbalance all these challenges. Moreover, this review also delivers useful data on the repurposing of steroidal drugs against various diseases along with the novel techniques used for improved steroid delivery.}, } @article {pmid40352244, year = {2025}, author = {Shah, HP and Naqvi, AS and Rajput, P and Ambra, H and Venkatesh, H and Saleem, J and Saravanan, S and Wanjari, M and Mittal, G}, title = {Artificial intelligence-based deep learning algorithms for ground-glass opacity nodule detection: A review.}, journal = {Narra J}, volume = {5}, number = {1}, pages = {e1361}, pmid = {40352244}, issn = {2807-2618}, mesh = {Humans ; *Deep Learning ; *Tomography, X-Ray Computed/methods ; Algorithms ; *Artificial Intelligence ; COVID-19/diagnostic imaging ; *Lung Neoplasms/diagnostic imaging ; Sensitivity and Specificity ; }, abstract = {Ground-glass opacities (GGOs) are hazy opacities on chest computed tomography (CT) scans that can indicate various lung diseases, including early COVID-19, pneumonia, and lung cancer. Artificial intelligence (AI) is a promising tool for analyzing medical images, such as chest CT scans. The aim of this study was to evaluate AI models' performance in detecting GGO nodules using metrics like accuracy, sensitivity, specificity, F1 score, area under the curve (AUC) and precision. We designed a search strategy to include reports focusing on deep learning algorithms applied to high-resolution CT scans. The search was performed on PubMed, Google Scholar, Scopus, and ScienceDirect to identify studies published between 2016 and 2024. Quality appraisal of included studies was conducted using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool, assessing the risk of bias and applicability concerns across four domains. Two reviewers independently screened studies reporting the diagnostic ability of AI-assisted CT scans in early GGO detection, where the review results were synthesized qualitatively. Out of 5,247 initially identified records, we found 18 studies matching the inclusion criteria of this study. Among evaluated models, DenseNet achieved the highest accuracy of 99.48%, though its sensitivity and specificity were not reported. WOANet showed an accuracy of 98.78%, with a sensitivity of 98.37% and high specificity of 99.19%, excelling particularly in specificity without compromising sensitivity. In conclusion, AI models can potentially detect GGO on chest CT scans. Future research should focus on developing hybrid models that integrate various AI approaches to improve clinical applicability.}, } @article {pmid40352079, year = {2025}, author = {Wang, J and Zhang, X and Deng, H and Tan, Y}, title = {The Effect of the COVID-19 Pandemic Lockdown on Self-Harm: A Meta-Analysis.}, journal = {Alpha psychiatry}, volume = {26}, number = {2}, pages = {39868}, pmid = {40352079}, issn = {2757-8038}, abstract = {OBJECTIVE: The Coronavirus disease 2019 (COVID-19) pandemic caused a range of mental health problems, particularly self-harm. Lockdowns are the usual methods of responding to these public health emergencies. However, the effect of the COVID-19 lockdown on self-harm remains poorly characterized. This study aimed to investigate the influence of the COVID-19 pandemic on the incidence of self-harm. The findings may inform future policy development and strategies for managing pandemic-related mental health challenges.

METHODS: A meta-analysis was conducted using several database searches: APA PsycINFO, Embase, PubMed, Web of Science, CNKI, and Wan Fang. Published studies with data on the incidence of self-harm during visits to medical institutions, before and during the COVID-19 pandemic, were included. The pooled risk ratio (RR) value of self-harm incidence variation before and during the COVID-19 lockdown period, expressed as the comparison of clinical institution visits before and during the pandemic, was calculated.

RESULTS: Fifteen retrospective cohort studies with observational designs involving 253,600 participants were included. The pooled RR value of self-harm incidence variation was 1.386 (95% confidence interval (CI), 1.205-1.595, I[2] = 58.9%, p = 0.002). The subgroup analysis showed that "emergency department type" (p = 0.004) and "mean age of the sample" were the sources of the RR values' heterogeneity (p = 0.026).

CONCLUSIONS: Our findings suggest that the lockdown during the COVID-19 pandemic was a risk factor for self-harm. Therefore, special attention should be paid to individuals visiting the emergency department and the middle-aged and elderly populations.

THE PROSPERO REGISTRATION: This study was registered in PROSPERO (CRD42023373026), https://www.crd.york.ac.uk/PROSPERO/view/CRD42023373026.}, } @article {pmid40352018, year = {2025}, author = {Ahmed, AE and Alsunusi, OA and Alamer, HA and Shubayli, EA and Alqahtani, HA and Juraybi, RK and Aboud, AM and Alshihri, MS and Almaghrabi, AH and Aljohani, WF and Almudawi, AM}, title = {Effectiveness of Telemedicine Interventions for Infection Prevention and Control: A Systematic Review.}, journal = {Cureus}, volume = {17}, number = {4}, pages = {e82075}, pmid = {40352018}, issn = {2168-8184}, abstract = {Infection prevention and control is a critical aspect of healthcare delivery, especially during the ongoing challenges posed by the coronavirus pandemic. Telemedicine has emerged as a valuable strategy for reducing the risk of infection transmission while maintaining the continuity of care. This systematic review evaluates the effectiveness, benefits, and challenges of telemedicine interventions aimed at improving infection prevention and control across various healthcare settings. A comprehensive literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines using databases including PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, and the Virtual Health Library, covering studies published up to November 2024. Studies eligible for inclusion comprised randomized trials, observational studies, and mixed-methods research assessing telemedicine applications for infection control. The methodological quality of studies was assessed using established tools for qualitative and quantitative research appraisal. Five studies met the inclusion criteria and highlighted several positive outcomes. Telemedicine interventions such as mobile applications, remote video assessments of infection control practices, and virtual infection control consultations were associated with reduced infection rates, improved compliance with preventive protocols, and timely identification of procedural gaps. In inpatient settings, telemedicine also helped conserve protective equipment and reduce staff exposure. High patient satisfaction and maintained quality of care were commonly reported. However, several challenges were identified, including technical barriers, increased workload for healthcare workers, and concerns regarding data security. These findings suggest that telemedicine is a promising and adaptable solution for enhancing infection prevention efforts, but successful implementation depends on addressing operational barriers, ensuring adequate training, and strengthening infrastructure. Further rigorous research is needed to evaluate the long-term impact and cost-effectiveness of telemedicine in infection control.}, } @article {pmid40351947, year = {2025}, author = {Nitz, JN and Ruprecht, KK and Henjum, LJ and Matta, AY and Shiferaw, BT and Weber, ZL and Jones, JM and May, R and Baio, CJ and Fiala, KJ and Abd-Elsayed, AA}, title = {Cardiovascular Sequelae of the COVID-19 Vaccines.}, journal = {Cureus}, volume = {17}, number = {4}, pages = {e82041}, pmid = {40351947}, issn = {2168-8184}, abstract = {Vaccines against COVID-19 present a key tool in lowering the morbidity, mortality, and transmission of the disease, but they also present a strongly controversial topic. As a result, the adverse effects of the vaccine have been under scrutiny by the public eye. A comprehensive summary of the cardiovascular (CV) adverse effects of COVID-19 vaccines is vital for clinical recognition of rare adverse events, determining the public health implications, and creating a base for future research. In May 2023, a search was conducted in the PubMed and Cochrane databases to identify literature on CV complications resulting from the COVID-19 vaccine. All articles with relevant data and discussion regarding adverse effects of the COVID-19 vaccines were included in the review. In total, 4419 articles were screened, and 166 articles were included in the review. The vaccine-associated CV adverse events encompassed the following conditions: myocarditis, pericarditis, acute coronary syndrome, stress cardiomyopathy, hypertension, isolated tachycardia, myocardial infarction (MI) with nonobstructive coronary arteries (MINOCA), cardiac arrest, vaccine-induced thrombotic thrombocytopenia (VITT), MI, cerebral venous thrombosis (CVT), deep vein thrombosis (DVT), pulmonary embolism (PE), and other venous thrombotic disorders. Among these, myocarditis and thrombosis, especially VITT, emerged as the most frequently cited complications in the reviewed literature. Ranges of incidences for the following were recorded among the reviewed articles: myocarditis: 2 to 17 per million, VITT: 3-10 per million, CVST: 2.6-10 per million, MI: 3-4 per million. COVID-19 vaccines entail the potential for adverse events, although at low incidence, some of which exhibit notable severity. These adverse events exhibit demographic specificity and vaccine-specific profiles. The adverse events reviewed are uniformly acute in nature. The existing body of evidence offers limited support for the assertion that COVID-19 vaccines may elevate the baseline risk of CV events in the long term. However, the available research on effects greater than six months is scarce.}, } @article {pmid40351791, year = {2025}, author = {Stein, MJ and Rohrich, R}, title = {Artificial Intelligence and Postoperative Monitoring in Plastic Surgery.}, journal = {Plastic surgery (Oakville, Ont.)}, volume = {33}, number = {2}, pages = {312-317}, pmid = {40351791}, issn = {2292-5503}, abstract = {Technological innovation has fueled an evolving landscape in plastic surgery. Recently, artificial intelligence (AI) has demonstrated tremendous potential in enhancing our diagnostic ability, automating data acquisition for research purposes, and supplementing our intraoperative decision-making. Over the last two decades, advancements in AI enhanced pre- and intraoperative management of plastic surgery patients. However, the demand to keep plastic surgery patients out of hospital during the COVID-19 pandemic has recently inspired important AI innovations in postoperative care, such as telemedicine and remote patient monitoring. As we transition into the post-COVID era of medicine, these novel technologies will be critical in enhancing patient safety and satisfaction, while reducing rising healthcare costs. Herein, we review the basic principles of AI in plastic surgery and illustrate its significance in remote postoperative monitoring.}, } @article {pmid40351412, year = {2025}, author = {Li, J and Zhu, B and Lu, J and Dong, Z and Li, P and Li, W and Zheng, C and Chang, J and Shang, S}, title = {Advances in the effectiveness and safety of azvudine treatment: a comprehensive review.}, journal = {Frontiers in pharmacology}, volume = {16}, number = {}, pages = {1524072}, pmid = {40351412}, issn = {1663-9812}, abstract = {The global impact of COVID-19 has highlighted the urgent need for effective therapeutic interventions against SARS-CoV-2. Azvudine, a dual-target nucleoside drug initially developed for human immunodeficiency virus (HIV), has gained attention for its potential in treating COVID-19. On 25 July 2022, Azvudine received conditional approval from the National Medical Products Administration (NMPA) of China, making it the first oral SARS-CoV-2 RNA-dependent RNA polymerase (RdRp) inhibitor for COVID-19 treatment. This review explores the pharmacological activity, antiviral mechanisms, and clinical effectiveness of azvudine in the context of COVID-19. Clinical trials have demonstrated its ability to reduce the viral load, shorten the time to nucleic acid negativity, and improve clinical outcomes in patients. Additionally, azvudine has shown excellent pharmacokinetic properties and a favorable safety profile with mild side effects. The review also addresses the importance of drug interactions and safety considerations, particularly in high-risk populations. Research should focus on optimizing second-generation inhibitors with enhanced effectiveness against SARS-CoV-2 variants, improving oral bioavailability, and minimizing adverse effects, ensuring more robust treatment options for COVID-19.}, } @article {pmid40350816, year = {2025}, author = {Sun, FY and Jing, ZW and Ge, JW and Mei, ZG}, title = {[Exploration of biological essence of blood heat syndrome and mechanism of blood-cooling traditional Chinese medicine from combination of disease and syndrome].}, journal = {Zhongguo Zhong yao za zhi = Zhongguo zhongyao zazhi = China journal of Chinese materia medica}, volume = {50}, number = {4}, pages = {985-993}, doi = {10.19540/j.cnki.cjcmm.20241108.502}, pmid = {40350816}, issn = {1001-5302}, mesh = {Humans ; *Medicine, Chinese Traditional/methods ; *Hyperthermia/therapy/diagnosis ; *Drugs, Chinese Herbal/therapeutic use ; Syndrome ; }, abstract = {Blood heat syndrome, one of the main subtypes of blood syndrome in traditional Chinese medicine(TCM), is mainly diagnosed by bleeding and heat manifestations and treated by the blood-cooling method. The biological essence of blood heat syndrome has not been elucidated yet, and there is a lack of systematic research on the potential mechanisms underlying the blood-cooling method. The biological essence of blood heat syndrome is closely related to abnormal immune response, oxidative stress, coagulation dysfunction, endocrine disorders, abnormalities in energy metabolism and so on. Blood heat syndrome is common in autoimmune skin diseases(such as systemic lupus erythematosus, psoriasis, and purpura), central hyperthermia, infectious diseases(such as infectious mononucleosis and COVID-19), and hemorrhagic diseases in gynecology. As the primary clinical therapy for blood heat syndrome, blood-cooling TCM is usually combined with the TCM with effects of activating blood and resolving stasis, nourishing Yin,and extinguishing wind to play the role of cooling blood. The mechanisms of above therapies may be attributed to reducing inflammation, inhibiting oxidative stress, restoring the balance of blood coagulation and metabolism, regulating the secretion of sex hormones, and alleviating allergic reactions. This article systematically explores the biological essence of blood heat syndrome and elucidates the targets and underlying mechanism of the blood-cooling method, laying a scientific foundation for the clinical application of TCM in the prevention and treatment of diseases associated with blood heat syndrome.}, } @article {pmid40350728, year = {2025}, author = {Nemkova, SA}, title = {[Modern approaches to diagnosis and treatment of postinfectious asthenic syndrome in children].}, journal = {Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova}, volume = {125}, number = {4}, pages = {42-52}, doi = {10.17116/jnevro202512504142}, pmid = {40350728}, issn = {1997-7298}, mesh = {Humans ; Child ; Adolescent ; *Asthenia/diagnosis/etiology/drug therapy/therapy ; *Picolines/therapeutic use ; Influenza, Human/complications ; *Respiratory Tract Infections/complications ; Syndrome ; COVID-19/complications ; }, abstract = {The article is devoted to an urgent problem - the diagnosis and treatment of Postinfectious asthenic syndrome in children and adolescents. The issues of etiology and pathogenesis, classification and clinical manifestations of postinfectious asthenia in children are considered in detail. Special attention is paid to the asthenic syndrome after acute respiratory viral infections and influenza, neuroinfections, and coronavirus infection. The high efficacy of the drug Mexidol in the prevention and comprehensive correction of postinfectious asthenic disorders, as well as concomitant autonomic, cognitive and emotional disorders in children and adolescents has been shown.}, } @article {pmid40350570, year = {2025}, author = {Loh, CTI and Lee, ZY and Yunos, NM and Atan, R and Heyland, DK and Stoppe, C and Hasan, MS}, title = {Association of muscularity status with clinical and physical function outcomes in critically ill patients with COVID-19: A systematic review and meta-analysis.}, journal = {JPEN. Journal of parenteral and enteral nutrition}, volume = {49}, number = {6}, pages = {692-706}, doi = {10.1002/jpen.2767}, pmid = {40350570}, issn = {1941-2444}, mesh = {Humans ; *Critical Illness/mortality ; *COVID-19/mortality/physiopathology/complications ; *Muscle Strength ; *Muscle, Skeletal/physiopathology ; SARS-CoV-2 ; }, abstract = {Pre-coronavirus disease 2019 (COVID-19) critical care research underscored the importance of muscularity on patient outcomes. This study investigates the association between skeletal muscle mass and quality with clinical and physical function outcomes in critically ill patients with COVID-19. We systematically searched MEDLINE, EMBASE, and CINAHL from database inception to April 24, 2024, for studies using objective methods to evaluate muscularity in critically ill adults with COVID-19, without language restrictions. Co-primary outcomes were overall mortality and muscle strength. Random-effect meta-analyses were performed in RevMan 5.4.1. We included 20 studies (N = 1818), assessing muscularity via computed tomography (twelve studies), ultrasound (seven studies), and bioelectrical impedance analysis (one study); none had low risk of bias. In analyses of high vs low muscularity, high muscle mass was significantly associated with lower overall mortality (nine studies; risk ratio = 0.74; 95% CI, 0.57-0.98; P = 0.03). When muscularity was analyzed as a continuous variable, COVID-19 survivors had higher skeletal muscle area (SMA) (13 studies; mean difference [MD] = 1.18; 95% CI, 0.03-2.33; P = 0.05) confirmed by sensitivity analysis using standardized MD (0.23, 95% CI 0.05-0.42, P = 0.01) and significantly higher muscle quality (five studies; standardized MD = 0.45; 95% CI, 0.20-0.70; P = 0.0004). Muscle strength findings were inconsistent: one study showed significant correlations between muscle strength with muscle mass parameters (r = 0.365-0.375, P < 0.001) whereas another found no association. In critically ill adults with COVID-19, high muscle mass was associated with lower mortality risk. Survivors had significantly higher SMA and muscle quality. Findings on physical function outcomes remain inconclusive (PROSPERO ID: CRD42022384155).}, } @article {pmid40350558, year = {2025}, author = {Uzzell, J and Divin, C and Zinn, K}, title = {Integration of Student Well-Being in Undergraduate Nursing Curricula: A Scoping Review.}, journal = {Worldviews on evidence-based nursing}, volume = {22}, number = {3}, pages = {e70029}, doi = {10.1111/wvn.70029}, pmid = {40350558}, issn = {1741-6787}, mesh = {Humans ; *Curriculum/trends/standards ; *Education, Nursing, Baccalaureate/methods/standards ; *Students, Nursing/psychology ; }, abstract = {BACKGROUND: Nursing school causes immense stress for students, and the attrition rate is high. Nurse educators have long been aware of the documented relationship between well-being and academic success, as well as the anxiety, depression, insomnia, fear, and exhaustion that result in student burnout. However, there has been little change in the nursing curriculum, and few nursing curricula include student well-being education.

AIM: This scoping review aimed to search the literature for student well-being education concepts integrated into the nursing curriculum.

METHODS: This scoping review was performed on Scopus 20, American Psychological Association's (APA) PsychNet database, and CINAHL database using Arksey and O'Malley's 6-step methodology. Search terms included nursing AND student AND well-being AND curricula OR education OR curriculum. Articles were excluded if they were graduate-level education, not faculty or student-focused, not in an academic setting, or if the study was completed in a foreign country or was COVID-19 pandemic-related. Other limitations were the years 2020-2024 and in the English language.

RESULTS: A total of 19 articles were chosen for inclusion in the scoping review. Ninety-nine articles were found on Scopus 20 and limited by careful analysis to 16. No eligible articles were found on APA PsychNet. The CINAHL database produced four articles, with two chosen for inclusion after a full-text review. One article was found through hand-searching during the literature search process. Articles discussed using one well-being course, integrating a specific well-being program, utilizing multiple well-being activities, developing faculty training skills for the integration of well-being, and creating a shared agenda for the design of well-being activities within the nursing curriculum.

LINKING EVIDENCE TO ACTION: The nursing curriculum should include well-being activities in each nursing course. Supporting nursing students' well-being will enhance their academic success and decrease burnout.}, } @article {pmid40350182, year = {2025}, author = {Matsumoto, K and Prowle, JR and Puthucheary, Z and Cecconi, M and Fazzini, B and Malcolm, H and Nydahl, P and Osman, M and Santini, A and Schaller, SJ and Thomson, W and van den Berke, D and Poll, M and Stephens, T}, title = {Uncertainty and decision-making in critical care: lessons from managing COVID-19 ARDS in preparation for the next pandemic.}, journal = {BMJ open respiratory research}, volume = {12}, number = {1}, pages = {}, pmid = {40350182}, issn = {2052-4439}, mesh = {Humans ; *COVID-19/therapy/epidemiology ; *Critical Care/methods ; Uncertainty ; *Respiration, Artificial/methods ; *Respiratory Distress Syndrome/therapy ; *Clinical Decision-Making ; SARS-CoV-2 ; *Decision Making ; Surveys and Questionnaires ; Pandemics ; }, abstract = {PURPOSE: Coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS) was an emergent syndrome that led to high volumes of critically ill ventilated patients. We explored influences on decision-making regarding management of COVID-19 ARDS mechanical ventilation to identify modifiable factors to improve preparedness for future pandemics.

METHODS: A systematic review and small group interviews informed the development of an international questionnaire (UK, Italy, Germany and Netherlands) on factors influencing COVID-19 ARDS ventilation decision-making in critical care professionals. Participants ranked four themes in order of importance: disease (uncertainties around COVID-19 ARDS), contextual (cognitive strain), environmental (structural logistics) and team factors. Participants also ranked the subthemes within each theme. Thematic analysis was used to derive findings from qualitative data. Kruskal-Wallis, Mann-Whitney U and Kendall's tau were used for quantitative data analysis.

RESULTS: Patient factors (comorbidities, clinical/biochemical parameters) were the most studied influences in the extant literature on decision-making; uncertainty was one of the least studied. 371 critical care professionals responded to the questionnaire. Disease uncertainty (lack of applicable guidelines, unfamiliarity with pathophysiology) was ranked as the most important influence on ventilation decision-making for COVID-19 ARDS across regions, professions and experience levels (p<0.001). Participants expressed underconfidence in their decision-making (median score: 9/20); this was unaffected by experience (p=0.79) or profession (p=0.58). Qualitative findings supported and extended the initial proposed influences, including the impact of team factors (+ve) and resource limitations (-ve) on disease uncertainty.

CONCLUSION: Future pandemic preparedness programmes should target modifiable influences such as information sharing, teamworking and resource limitations to mitigate against the negative influence of uncertainty and thereby improve decision-making overall.}, } @article {pmid40350153, year = {2025}, author = {Lee, J}, title = {Introduction to burnout and well-being for anesthesiologists in South Korea: narrative and brief review.}, journal = {Anesthesia and pain medicine}, volume = {20}, number = {2}, pages = {121-126}, pmid = {40350153}, issn = {2383-7977}, abstract = {Burnout is a widespread occupational issue in the medical field, posing significant risks to both physician health and patient care worldwide. While the COVID-19 pandemic highlighted the impact of systemic factors-such as excessive workloads, administrative burdens, and inefficiencies-in exacerbating physician burnout, discussions about well-being remain limited in South Korea. Given the recent challenges faced by healthcare professionals in Korea, addressing burnout has become urgent to prevent further negative outcomes. Although individual efforts toward wellness are important, they are insufficient without systemic support. Distinguishing between burnout and well-being is crucial for developing targeted interventions. Drawing on global examples, comprehensive strategies-including policy reforms, organizational support, mental health resources, and cultural shifts-are recommended to create a sustainable and supportive environment for anesthesiologists in Korea.}, } @article {pmid40349995, year = {2025}, author = {Pita Dos Santos, LG and da Silva Coutinho, G and Rodrigues Guimarães, JM and Miranda da Silva, M and Francisco da Silva, A and Marcelino Neto, PP and Coral Rodrigues, BC and Aaron de Almeida, W and Carlos Alves Dos Santos, AJ and Napoleão, TH and Pontual, EV}, title = {Advances in COVID-19 Therapeutics: Exploring the role of lectins and protease inhibitors.}, journal = {Microbial pathogenesis}, volume = {205}, number = {}, pages = {107687}, doi = {10.1016/j.micpath.2025.107687}, pmid = {40349995}, issn = {1096-1208}, mesh = {Humans ; *COVID-19 Drug Treatment ; *Antiviral Agents/therapeutic use/pharmacology ; *SARS-CoV-2/drug effects ; *Lectins/therapeutic use/pharmacology ; COVID-19/prevention & control ; *Protease Inhibitors/therapeutic use/pharmacology ; Virus Internalization/drug effects ; COVID-19 Vaccines ; }, abstract = {The rapid global spread of SARS-CoV-2 has demanded innovative approaches to treatment and prevention. This article reviews the current landscape of COVID-19 therapeutics and vaccines, emphasizing the role of biotechnological products, particularly lectins and protease inhibitors. SARS-CoV-2, a single-stranded RNA virus, infects host cells via its spike (S) protein, which binds to the angiotensin-converting enzyme 2 (ACE2) receptor. This interaction is facilitated by host proteases like TMPRSS2, which are critical for viral entry. Treatments for COVID-19 primarily focus on antiviral drugs, anti-inflammatory agents, and monoclonal antibodies. Protease inhibitors that target viral enzymes like Mpro and PLpro have demonstrated potential. Additionally, vaccines, including mRNA-based, DNA-based, and those using viral vectors or inactivated viruses, are essential for preventing new infections. Lectins, proteins that bind specifically to carbohydrates, have emerged as potential antiviral agents. They can impede viral entry by binding to glycoproteins on the virus's surface or modulate immune responses. Studies indicate that lectins like cyanovirin-N and griffithsin exhibit significant antiviral activity against SARS-CoV-2. While most of the research on these biotechnological products is still in preclinical or early stages, their potential for treating and preventing COVID-19 is substantial. Further investigation and clinical trials are crucial to validate their efficacy and safety. This article underscores the need for continued exploration of novel therapeutic strategies to combat the evolving COVID-19 pandemic. However, the review is limited by the scarcity of clinical data on these products, highlighting the need for translational research.}, } @article {pmid40349784, year = {2025}, author = {Xu, S and Sun, C and Qian, T and Chen, Y and Dong, X and Wang, A and Zhang, Q and Ji, Y and Jin, Z and Liu, C and Zhao, K}, title = {Animal vaccine revolution: Nanoparticle adjuvants open the future of vaccinology.}, journal = {Journal of controlled release : official journal of the Controlled Release Society}, volume = {383}, number = {}, pages = {113827}, doi = {10.1016/j.jconrel.2025.113827}, pmid = {40349784}, issn = {1873-4995}, mesh = {Animals ; *Nanoparticles/administration & dosage ; *Adjuvants, Immunologic/administration & dosage ; *Vaccinology/trends ; Humans ; *Vaccines/administration & dosage/immunology ; COVID-19 Vaccines/administration & dosage ; COVID-19/prevention & control ; *Adjuvants, Vaccine/administration & dosage ; }, abstract = {In recent years, the rapid development of nanoparticle adjuvants has greatly facilitated the treatment and prevention of infectious diseases in humans and animals. The remarkable success of mRNA nanovaccines against SARS-CoV-2 has accelerated the advancement of nanoparticle adjuvant technologies in the era of precision medicine. Significant progress has been made in researching nanovaccines for major animal infectious diseases, such as porcine epidemic diarrhea, avian influenza, porcine reproductive and respiratory syndrome, bovine viral diarrhea, foot-and-mouth disease, African swine fever, and Newcastle disease. This article reviews the nanoparticle adjuvants under investigation for animal use, emphasizing their diverse mechanisms of action and immunological properties, and analyzes the physicochemical factors influencing their immune-enhancing effects. On this basis, we discuss future prospects and key challenges that need to be addressed, aiming to provide valuable references for the development of novel animal vaccine adjuvants.}, } @article {pmid40349734, year = {2025}, author = {Massonnaud, CR and Schönenberger, CM and Chiaborelli, M and Ehrenzeller, S and Griessbach, A and Gillibert, A and Briel, M and Laouénan, C}, title = {Characteristics, design, and statistical methods in platform trials: a systematic review.}, journal = {Journal of clinical epidemiology}, volume = {184}, number = {}, pages = {111827}, doi = {10.1016/j.jclinepi.2025.111827}, pmid = {40349734}, issn = {1878-5921}, mesh = {Humans ; *Research Design ; *Randomized Controlled Trials as Topic/methods/statistics & numerical data ; COVID-19/epidemiology ; SARS-CoV-2 ; Bayes Theorem ; }, abstract = {BACKGROUND AND OBJECTIVE: Platform trials (PTs) are gaining popularity in clinical research due to their innovative and flexible methodologies. The objective was to determine the characteristics, methodological, and statistical practices in PTs.

METHODS: We identified PTs from trial registries and bibliographic databases up to August 2024. Eligible PTs were randomized controlled trials studying multiple interventions within a single population, with flexibility to add or drop arms. Data were extracted on trial status, design, statistical methods, and reporting practices.

RESULTS: We identified 189 PTs. Most focused on infectious diseases (77, including 57 for COVID-19) and oncology (68). PT initiation peaked during the COVID-19 pandemic but has since stabilized at 84 active PTs, with 25 in planning. A complete master protocol was available for 47% (89/189) of PTs. Bayesian designs featured in 58/189 PTs vs. 56/189 frequentist trials, 20/189 trials utilizing both (unclear in 55/189 PTs). Overall, 25/111 trials (23%) were designed without a predetermined target sample size, all of which were Bayesian. Among these, 16 were explicitly reported as "perpetual" trials. The number of interim analyses was predetermined in 18% (10/57) of Bayesian trials vs. 58% (28/48) of frequentist trials. Simulations to evaluate operating characteristics were used in 93% (39/42) of Bayesian trials. Simulation reports were available in 67% (26/39) of cases, and the procedures were detailed for 62% (24/39) of trials. Only two trials shared the simulation code.

CONCLUSION: PTs remain popular and increasingly diverse. Efforts to enhance transparency and reporting, especially in complex Bayesian PTs, are essential to ensure reliability and broader acceptance.}, } @article {pmid40349479, year = {2025}, author = {Walsh, A and McCarthy, J and Bradshaw, C}, title = {Impact of the Covid-19 pandemic on bereavement care provided within maternity services: A focused mapping review and synthesis.}, journal = {Midwifery}, volume = {147}, number = {}, pages = {104445}, doi = {10.1016/j.midw.2025.104445}, pmid = {40349479}, issn = {1532-3099}, mesh = {Humans ; *COVID-19/psychology ; Female ; *Bereavement ; Pregnancy ; *Maternal Health Services/organization & administration ; *Parents/psychology ; Pandemics ; SARS-CoV-2 ; Infant, Newborn ; }, abstract = {BACKGROUND: Perinatal bereavement is the experience of parents after the death of an infant due to miscarriage, stillbirth, neonatal death, or elective termination of pregnancy for fetal anomaly. Perinatal loss is a traumatic event for parents and the quality of care provided by healthcare professionals (HCPs) can impact their grieving process. In March 2020, Covid-19 was declared a global pandemic, with significant consequences on perinatal bereavement services.

AIM: To explore parents and HCPs experiences of perinatal bereavement care during the Covid-19 pandemic.

METHODS: A focused mapping review and synthesis was used to identify papers which concentrated on perinatal bereavement care within maternity services during the Covid-19 pandemic. Studies meeting the criteria in peer reviewed midwifery, obstetric and healthcare journals (n = 6), published between Jan 2020-Feb 2025 were descriptively analysed, providing a topography and synthesis of the key trends identified.

FINDINGS: Fourteen relevant studies were identified in the review period, six of which met the inclusion criteria, with two themes identified: Maternity service reconfiguration due to Covid-19 restrictions and Loneliness and anxiety inducing experiences among parents.

CONCLUSION: The Covid-19 pandemic negatively impacted bereavement care within maternity services. Maternity reconfiguration because of the pandemic was a major contributor to dissatisfaction and frustration amongst bereaved parents and HCPs. Exclusion of partners had a negative effect on parents' experiences of care, augmenting the loneliness and anxiety felt by parents when dealing with loss. Perinatal bereavement guidelines need to accentuate the importance of partner inclusion in any context but particularly when providing care to women requiring isolation or barrier nursing. Guidelines must be reviewed to clearly outline when the use of virtual care is appropriate within the maternity setting. Additional research is needed to assess the long-term impacts of Covid 19 on HCPs. Such research includes identifying effective mechanisms to help staff deal with the stress and emotional impact of future public health emergencies.}, } @article {pmid40349297, year = {2025}, author = {Arries-Kleyenstuber, E and Dierckx de Casterlé, B and Kynoch, K and Ramis, MA and Suhonen, R and Ventura, C and Morley, G}, title = {Ethical challenges nurses faced during the COVID-19 pandemic: Scoping review.}, journal = {Nursing ethics}, volume = {}, number = {}, pages = {9697330251339417}, doi = {10.1177/09697330251339417}, pmid = {40349297}, issn = {1477-0989}, abstract = {Nurses encountered a myriad of ethical challenges during the height of the COVID-19 pandemic, such as allocation of scarce resources, the need to balance duty of care with safety of self as well as visitation restrictions. The impact of these challenges on the nursing workforce requires investigation. The aim of this review was to scope and describe the reported literature on ethical challenges faced by nurses during the COVID-19 pandemic, including contextual characteristics and strategies reported to address these challenges. The review was conducted in accordance with JBI methods for scoping reviews and reported using PRISMA-ScR guidance. A published protocol guided conduct of the review. The following databases were searched for eligible studies from November 2019 to January 2023: PubMed, CINAHL, Ovid, PsycINFO, the Cochrane Library, and Scopus. No language restrictions were applied. Studies were reviewed for inclusion by two independent reviewers, and a data extraction form was developed to extract data relevant to the review questions. Results were analyzed and presented according to the concepts of interest, using tables, figures, and supporting narrative synthesis. After searching the databases, 2150 citations were retrieved with 47 studies included in the review. Studies represented 23 countries across five continents. Most of the studies used qualitative designs. Ethical challenges were described in several ways, often without appealing to common ethics language or terms. Few studies reported on strategies to address the specific challenges, which may reflect the dynamic nature of the pandemic. The scoping review highlights the complex and, at times, overwhelming impact of ethical challenges faced by nurses across the globe during the COVID-19 pandemic. Findings from the review can be used as a basis for further research to explore, develop, and implement strategies to address ethical challenges faced by nurses during future public health crises.}, } @article {pmid40348572, year = {2025}, author = {Garcia, JF and Reid, MW and Raymond, JK}, title = {Designing, Implementing, and Adapting Virtual Care Models for Marginalized Communities.}, journal = {Endocrinology and metabolism clinics of North America}, volume = {54}, number = {2}, pages = {315-328}, doi = {10.1016/j.ecl.2025.02.018}, pmid = {40348572}, issn = {1558-4410}, mesh = {Humans ; *Telemedicine/organization & administration ; *COVID-19/epidemiology ; Child ; *Endocrine System Diseases/therapy ; SARS-CoV-2 ; Healthcare Disparities ; }, abstract = {Telehealth and virtual care models are viable solutions to disparities impacting diverse or marginalized communities with endocrine disorders. Racially and ethnically diverse children with endocrine disorders and their families have not been adequately represented in research or granted equal access to these innovative models. The coronavirus disease 2019 pandemic highlighted disparities but also provided an opportunity to adapt telehealth and virtual care models across institutions. To ensure the success of these care models, diverse children and their families must be included in their development, implementation, and adaptation.}, } @article {pmid40348543, year = {2025}, author = {Razzaq, A and Prager, KM and Garan, AR and Hastie, J and Brodie, D and Abrams, D}, title = {Ethical Considerations for Mechanical Support.}, journal = {Anesthesiology clinics}, volume = {43}, number = {2}, pages = {267-282}, doi = {10.1016/j.anclin.2025.02.003}, pmid = {40348543}, issn = {1932-2275}, mesh = {Humans ; *Extracorporeal Membrane Oxygenation/ethics/methods ; Heart Failure/therapy ; Respiratory Insufficiency/therapy ; }, abstract = {Extracorporeal life support (ECLS) has the ability to support patients with severe forms of cardiac and respiratory failure. Rapid expansion of ECLS, its resource-intensive and invasive nature, and the high acuity illness of supported patients have raised important questions. Specific issues include identification of patients most likely to benefit, the appropriate duration of support amid uncertain prognosis, and what to do when patients become dependent on ECLS but no longer have hope for recovery or transplantation. Careful deliberation of ethical principles and potential dilemmas should be made when considering the use of ECLS in advanced cardiopulmonary failure.}, } @article {pmid40348041, year = {2025}, author = {Ayyad, M and Abu Alya, W and Barabrah, AM and Darawish, SM and AlHabil, Y and MohammedAli, M and Nabilsi, MZ and Asad, D and Ayasa, LA and Matassa, D}, title = {Autoimmune hemolytic anemia in COVID-19 patients: A systematic review of 105 cases on clinical characteristics and outcomes.}, journal = {Clinical immunology (Orlando, Fla.)}, volume = {277}, number = {}, pages = {110512}, doi = {10.1016/j.clim.2025.110512}, pmid = {40348041}, issn = {1521-7035}, mesh = {Humans ; *Anemia, Hemolytic, Autoimmune/drug therapy/mortality ; *COVID-19/complications/mortality ; SARS-CoV-2 ; Male ; Female ; Middle Aged ; Treatment Outcome ; Steroids/therapeutic use ; Adult ; }, abstract = {BACKGROUND: COVID-19 has been linked to autoimmune hemolytic anemia (AIHA), a rare but serious condition causing red blood cell destruction. This systematic review examines the clinical characteristics, management, and outcomes of AIHA in COVID-19 patients.

METHODS: A systematic search of PubMed, CINAHL, and Scopus identified 85 studies encompassing 105 patients. Data on demographics, clinical features, and treatment outcomes were extracted.

RESULTS: Of 1402 articles, 85 met inclusion criteria. Most patients were male (54.3 %) with a mean age of 50.6 years, predominantly from Asia (83.5 %). Cold agglutinin AIHA was most common (48.2 %). Presenting symptoms included fatigue, dyspnea, and fever. Steroids were the most effective treatment, used in 95 % of recovered cases. Mortality was 14.3 %, with 26.7 % of deaths directly related to AIHA.

CONCLUSIONS: COVID-19 is associated with AIHA, often presenting with non-specific symptoms. Early recognition and prompt steroid therapy are critical for improving outcomes. Further research is needed to guide management.}, } @article {pmid40347741, year = {2025}, author = {J, P and Lavanya, P and A, M and Kumar C, N}, title = {Recent advances in the diagnosis of fungal zoonoses in India: A comprehensive overview.}, journal = {Molecular aspects of medicine}, volume = {103}, number = {}, pages = {101366}, doi = {10.1016/j.mam.2025.101366}, pmid = {40347741}, issn = {1872-9452}, mesh = {Humans ; India/epidemiology ; *Mycoses/diagnosis/epidemiology/microbiology ; Animals ; *Zoonoses/diagnosis/epidemiology/microbiology ; COVID-19/epidemiology ; SARS-CoV-2 ; Mucormycosis/diagnosis ; Prevalence ; }, abstract = {Fungal infections are most common in integumentary and systemic parts of the body. The outbreak of fungal infections was observed in several disease conditions like Pulmonary tuberculosis (PTB), chronic obstructive disease (COPD), malignancies and others like COVID-19 associated Mucormycosis (Black fungus) among Indian population. The main objective of the study is to examine the recent advanced techniques available in India for the diagnosis of fungal infections. We conclude that the study has mainly focuses on the recent advances on the diagnosis of fungal infections in India. The prevalence of zoonotic fungal infections among humans is alarming, and global health is moving towards the existence of a one-health approach.}, } @article {pmid40346732, year = {2025}, author = {Helmold, M and Amann, R}, title = {Advancing ORFV-Based Therapeutics to the Clinical Stage.}, journal = {Reviews in medical virology}, volume = {35}, number = {3}, pages = {e70038}, pmid = {40346732}, issn = {1099-1654}, support = {//Bundesministerium für Wirtschaft und Klimaschutz/ ; ZUK63//Deutsche Forschungsgemeinschaft/ ; }, mesh = {Humans ; *Oncolytic Virotherapy/methods ; *COVID-19/prevention & control/immunology ; Animals ; SARS-CoV-2/immunology ; Clinical Trials as Topic ; *COVID-19 Vaccines/immunology ; Oncolytic Viruses/immunology/genetics ; }, abstract = {The Orf virus (ORFV) is the prototype member of the parapoxvirus family and has long been recognized for its robust immunogenicity, favourable safety profile and its ability to stimulate both cellular and humoural immune responses without inducing significant anti-vector immunity. Despite these inherent advantages, early applications of ORFV-based technologies were limited by challenges in manufacturing scalability and uncertainties regarding clinical safety in humans. However, recent breakthroughs have transformed this therapeutic landscape. A landmark achievement is the development of Prime-2-CoV, an ORFV-based anti-COVID-19 vaccine that has advanced into human clinical trials, providing the first clinical evidence of live ORFV's feasibility, safety and immunogenicity. This milestone, together with the establishment of a good manufacturing practice (GMP)-compliant production process and comprehensive preclinical evaluations, has laid a robust foundation for broader clinical applications of ORFV-based therapeutics. Moreover, the use of ORFV as an oncolytic virus therapy has shown promising results, effectively converting immunologically 'cold' tumours into 'hot' ones, underscoring its versatility as a therapeutic platform. In this review, we critically assess recent advances in ORFV-based therapeutics, with a particular focus on vaccine development and oncolytic virotherapy (OVT). We thoroughly discuss the milestones and impact of the first ORFV-based clinical trial, outline strategies for optimizing the technology and provide insights into overcoming remaining challenges. Collectively, these advancements position ORFV as a highly promising and versatile platform for next-generation prophylactic and therapeutic interventions in both human and veterinary medicine, while also providing a roadmap for future innovations.}, } @article {pmid40346621, year = {2025}, author = {Kenney, M and Mamo, L}, title = {Precision public health after Covid-19: a scoping review.}, journal = {International journal for equity in health}, volume = {24}, number = {1}, pages = {129}, pmid = {40346621}, issn = {1475-9276}, support = {2218494//U.S. National Science Foundation/ ; 2218494//U.S. National Science Foundation/ ; }, mesh = {Humans ; *COVID-19/epidemiology ; *Public Health/methods ; *Health Equity ; SARS-CoV-2 ; Pandemics ; *Precision Medicine ; }, abstract = {"Precision public health" (PPH) emerged in 2015 as a charismatic vision to revolutionize traditional public health with data-driven solutions to the world's most challenging public health problems. A central goal of PPH is to use population-level data to improve health equity by targeting geographically localized at-risk populations. For this article, we conducted a scoping review to investigate whether and how PPH approaches were used for Covid-19 pandemic response and how they incorporated health equity goals in their approaches. We found that during the Covid-19 pandemic, discussions of PPH in the academic literature mostly focused on potential future implementation of PPH rather than on-the-ground Covid-19 pandemic response. In the few articles that described a research project and/or public health intervention at the intersection of PPH and Covid-19, researchers articulated PPH together with three sets of Covid-19 era public health practices: 1) vulnerability indexes; 2) near real-time surveillance; 3) pathogen sequencing. In each of these articulations, the most common method for achieving health equity was using epidemiological surveillance data to create risk stratification to direct resources to the most vulnerable. As these new articulations are tentative and have not yet become common in public health literature and policy, the article ends with a critical call to interrogate which versions of health equity are enacted and foreclosed in data-driven approaches to public health and how PPH can best serve vulnerable populations.}, } @article {pmid40346581, year = {2025}, author = {Kuandyk, A and Toleukhanova, N and Dmitriyeva, M and Suleimenov, T and Sarssenov, D and Mamytkhan, R and Sakhayev, M and Tleubergenov, A and Toleubayev, M}, title = {Indicators associated with job morale of physicians in low- and middle-income countries during the COVID- 19 pandemic: a systematic review and meta-analysis.}, journal = {BMC health services research}, volume = {25}, number = {1}, pages = {669}, pmid = {40346581}, issn = {1472-6963}, mesh = {Humans ; *COVID-19/epidemiology/psychology ; *Morale ; *Job Satisfaction ; *Developing Countries ; Burnout, Professional/epidemiology/psychology ; *Physicians/psychology ; SARS-CoV-2 ; Pandemics ; Motivation ; Depression/epidemiology ; }, abstract = {BACKGROUND: The COVID- 19 pandemic has placed immense strain on healthcare systems around the globe, with low- and middle-income countries facing unique challenges due to limited resources and fragile healthcare infrastructures. This systematic review and meta-analysis aims to define the levels of four indicators of job morale (job motivation, job satisfaction, burnout, and depression symptoms) among physicians working in public healthcare settings in low- and middle-income countries.

METHODS: A comprehensive search of Scopus, PubMed, Embase, Web of Science, the Cochrane Library, and grey literature was performed. Studies were eligible if at least one job morale indicator (job motivation, job satisfaction, burnout, or depression symptoms) was assessed using quantitative methods, and at least 50% of the sample were qualified physicians working in low- and middle-income countries during the COVID- 19 pandemic. Random effects meta-analyses, planned sub-group analyses, and meta-regression were performed.

RESULTS: Overall, 82 studies involving 65,431 participants across 26 middle-income countries met the inclusion criteria for the review. The pooled random effect estimates of the prevalence of burnout suggest that 49% of physicians working in middle-income countries during the COVID- 19 pandemic suffered from professional burnout. The overall estimate of the mean was 24.64, which also indicated a high level of burnout. The pooled random effect estimates of the prevalence of depression symptoms varied from 41 to 58%, depending on the adopted scale. Sufficient data were not available for meta-analyses of job motivation and job satisfaction.

CONCLUSIONS: The findings suggest that job morale among physicians working in middle-income countries was generally low during the COVID- 19 pandemic. However, due to substantial variation and limited methodological quality among the studies included, any conclusions offered should be approached with caution. Future research should focus on assessing job morale in low-income regions and identifying effective resilience strategies to support interventions aimed at improving job morale.}, } @article {pmid40344415, year = {2025}, author = {Bruno Ortiz, TN and DeChristofaro, SC and Cheng, M and Alegría, M}, title = {Community Health Workers Research: Where Are We Now? A Narrative Review of an Expanding Workforce for Mental Health.}, journal = {Harvard review of psychiatry}, volume = {33}, number = {3}, pages = {103-113}, doi = {10.1097/HRP.0000000000000427}, pmid = {40344415}, issn = {1465-7309}, mesh = {Humans ; *Community Health Workers/education ; *COVID-19 ; *Mental Health Services ; }, abstract = {In an evolving health care landscape, community health workers (CHWs) have emerged as invaluable assets, bridging gaps to mental health service access and fostering community resilience. In this article, we explore the multifaceted responsibilities shouldered by CHWs, encompassing outreach, education, and support, and underscore their unique abilities to establish trust within diverse communities. We also highlight evolving recognition of CHWs as integral health care team members and examine the growing body of evidence on CHW effectiveness in enhancing mental health outcomes, reducing disparities, and promoting preventative measures. Additionally, we review how, in the wake of the COVID-19 pandemic, the CHW role has shifted with increased demand for their services within the mental health care landscape. The pandemic laid bare the vulnerabilities in existing health care structures, disproportionately affecting communities with limited resource access, including mental health support. Furthermore, we review six primary research domains that could potentially help expand the CHW workforce: standardization and training, sustainability and retention, integration into health systems, impact measurement, cost-effectiveness and financing, and scaling up and adaptation. Last, we examine the pandemic's transformative effects on CHWs; we shed light on their resilience and adaptability in the face of unprecedented challenges and underscore their heightened relevance within the evolving health care response paradigm post-COVID.}, } @article {pmid40343622, year = {2025}, author = {Trigg, LA and Farmer, C and Muthukumar, M and Wilson, ECF and Lovell, A and Lee, D}, title = {The Cost Effectiveness of Elective Surgical Procedures with Longer NHS Waiting Lists: A Targeted Review.}, journal = {Applied health economics and health policy}, volume = {23}, number = {5}, pages = {779-796}, pmid = {40343622}, issn = {1179-1896}, mesh = {*Elective Surgical Procedures/economics ; Humans ; *Cost-Benefit Analysis ; *Waiting Lists ; *State Medicine/economics ; COVID-19/epidemiology ; England ; Quality-Adjusted Life Years ; Cost-Effectiveness Analysis ; }, abstract = {OBJECTIVES: Our aim was to review the evidence for the cost effectiveness of elective surgeries with long waiting lists within the NHS in England. This is to inform understanding of national spending priorities in the context of significant demand for elective surgeries and to inform the debate on appropriate cost-effectiveness thresholds across healthcare decision making.

METHODS: We conducted a targeted literature review to identify published cost-effectiveness analyses for nine elective procedures with long waiting lists in the NHS, selected based on previous reviews. These were percutaneous coronary intervention (PCI), coronary artery bypass graft surgery (CABG), hysterectomy, cholecystectomy, knee replacement, groin hernia repair, hip replacement, prostatectomy, and cataract surgery. We made comparisons adjusted for currency and price year (2024).

RESULTS: We identified 21 evaluations; in these, the cost effectiveness of surgeries was compared with no surgery (n = 9), medical management (n = 5), and between early and delayed surgery (n = 10). The evaluations reported that almost all procedures would be considered cost effective yielding incremental cost-effectiveness ratios (ICERs) below £20,000 per quality-adjusted life-year gained. Cholecystectomy, prostatectomy, hip and knee replacement surgeries were associated with ICERs of between £5,000 and £10,000.

CONCLUSIONS: These findings offer insights for policymakers on optimising finite healthcare resources, particularly post-COVID-19, with surgical waiting lists a priority for the NHS. Prioritising these elective procedures is likely to be a highly cost-effective use of NHS resources. Allocation of investment to areas that are more cost effective than others is likely to increase the efficiency of the NHS, resulting in a net health gain compared with the reimbursement of less cost-effective interventions.}, } @article {pmid40343424, year = {2025}, author = {Bhattacharya, S and Bhattacharjee, S and Singh, A}, title = {Human Metapneumovirus: A Comprehensive Epidemiological Analysis of a Global Respiratory Threat.}, journal = {Infection & chemotherapy}, volume = {57}, number = {2}, pages = {194-202}, pmid = {40343424}, issn = {2093-2340}, abstract = {Human metapneumovirus (HMPV) is a significant respiratory pathogen that contributes to acute respiratory infections, particularly in vulnerable populations such as children, the elderly, and immunocompromised individuals. Since its discovery in 2001, HMPV has become a global health concern, with epidemiological data revealing seasonal peaks and notable genetic diversity. The virus is associated with a wide range of respiratory illnesses, including bronchiolitis, pneumonia, and asthma exacerbations, leading to substantial hospitalization rates and healthcare costs. This review examines the epidemiology of HMPV, focusing on pre- and post-coronavirus disease 2019 (COVID-19) trends, transmission patterns, and the impact on at-risk populations. Notably, the COVID-19 pandemic has influenced the seasonality of HMPV, with altered patterns of viral circulation and co-infection with other respiratory pathogens, such as respiratory syncytial virus and influenza. Despite its considerable impact, HMPV remains under-recognized and lacks specific antivirals or vaccines, leaving management largely supportive. Advances in molecular diagnostics, including RT-PCR and potential serological methods, offer hope for improved detection and epidemiological tracking. Moreover, research into monoclonal antibodies, antiviral treatments, and vaccines is ongoing, with promising results in preclinical models. Enhanced surveillance systems and integrated approaches to monitor co-circulating viruses are essential for mitigating the burden of HMPV. This review underscores the need for continued research, public health strategies, and global collaboration to address the challenges posed by HMPV, particularly in high-risk populations and regions with limited healthcare infrastructure.}, } @article {pmid40343212, year = {2025}, author = {Ofori, MA and Lartey, S and Durneva, P and Jha, N and Mittal, N and Roy, S and Zeba, Z and Chirwa, S and Saulsberry-Scarboro, N and Taylor, M and Joshi, A}, title = {Visual communication of public health data: a scoping review.}, journal = {Frontiers in digital health}, volume = {7}, number = {}, pages = {1555231}, pmid = {40343212}, issn = {2673-253X}, abstract = {INTRODUCTION: Visual communications (VC) play a crucial role in effectively conveying public health data to diverse audiences, including policymakers, healthcare professionals, and the general public. Although the U.S. government invests heavily in health data and data accessibility, health data are not entirely accessible or easily understood. This can be attributed to data sharing and visualization challenges. VC challenges have created public health information gaps which are compounded in emergencies such as the COVID-19 pandemic, potentially impacting poor health outcomes and increasing health inequities.

OBJECTIVE: To examine visualization tools and techniques effective for public health visual data communication.

METHODS: A scoping review was conducted to summarize the available evidence related to visualization techniques and tools for public health visual data communication as well as related principles and best practices. Original peer-reviewed articles published in English that involve visualization, user-centered design of visual public health applications/interfaces, visual analytics, infographics, or dashboards from PubMed database from 2020 to 2024 were included. Also, review articles, commentaries, editorials, posters, systematic and scoping articles were excluded from this review. In all, twenty-eight (28) studies were included.

RESULTS: There were 25 different visualization techniques identified which included charts and graphs (e.g., bar charts, line charts, pie charts, bubble charts, box plots, scatter plots), maps (e.g., choropleth maps, hotspot maps, and heatmaps), and specialized visualizations (e.g., sunburst diagrams, alluvial plots, upset plots, circos). These visuals were displayed employing different programming and statistical tools and libraries like R, Python, Power BI, Tableau, ArcGIS, and custom web-based applications. The visuals measured different types of data accessibility, pattern and trends identification, association and relationships of univariate and bivariate data, as well as exploring multidimensional forms of health data. The visualizations were applied in different public health domains, such as HIV prevention and care, public health communication, interventions, surveillance, policy measures and decision-making, and improving health education.

CONCLUSION: Dashboards and web-based tools combined with static visualizations like charts, maps, or specialized plots can help with data exploration, pattern recognition, and dissemination of health information. Effective communication of public health data promotes informed decision-making, creates awareness, and leads to improved and better health outcomes.}, } @article {pmid40343137, year = {2025}, author = {Foley, DA and Phuong, LK}, title = {RSV: an update on prevention and management.}, journal = {Australian prescriber}, volume = {48}, number = {2}, pages = {34-39}, pmid = {40343137}, issn = {0312-8008}, abstract = {Respiratory syncytial virus (RSV) is a common cause of respiratory tract infections in infants and young children, and adults over 60 years of age. Infants born prematurely, adults aged over 75 years, individuals with medical conditions such as chronic cardiac or respiratory disease, or obesity, and Aboriginal and Torres Strait Islander people are at increased risk of severe RSV disease. As the management of RSV disease is mainly supportive, routine testing for RSV in people with a respiratory illness is not recommended. In high-risk populations and individuals presenting with severe illness, respiratory virus testing should prioritise influenza and COVID-19, as there are specific antiviral drugs for these diseases. Recent approval of RSV vaccines and a new long-acting RSV monoclonal antibody has created opportunities to minimise adverse outcomes associated with RSV infection. Protection against severe RSV disease in infants can be achieved through vaccination of their mother between weeks 28 and 36 of pregnancy, or by administering an RSV monoclonal antibody after delivery. There is currently no RSV vaccine approved for neonates or infants. For older adults, at the time of writing there are 2 approved RSV vaccines available.}, } @article {pmid40342869, year = {2025}, author = {Zhang, D and Hua, W and Sun, F and Wen, C and Cheong, LY and Xie, R and Chan, KH and Chan, SCW and Li, X and Ye, S and Yap, DYH}, title = {The changes in global burden of autoimmune diseases two years after the COVID-19 pandemic: a trend analysis based on the Global Burden of Disease Study 2021.}, journal = {Journal of translational autoimmunity}, volume = {10}, number = {}, pages = {100289}, pmid = {40342869}, issn = {2589-9090}, abstract = {BACKGROUND: Data on the epidemiological changes in the global burden of autoimmune diseases (ADs) after the Coronavirus disease 2019 (COVID-19) pandemic is lacking. This study investigated the impact of the COVID-19 pandemic on the global burden of ADs, including psoriasis (PsO), inflammatory bowel disease (IBD), type 1 diabetes (T1DM), rheumatoid arthritis (RA), and multiple sclerosis (MS).

METHODS: Age-standardized rates (ASR), including incidence (ASIR), prevalence (ASPR), disability-adjusted life years (DALYs), and death (ASDR), were extracted from the Global Burden of Disease Study 2021 from 1990 to 2021. The changes in number and ASR of ADs burden were assessed by absolute and relative increases comparing 2021 to 2019. Joinpoint regression analysis was used to determine whether the year 2019 marked the substantial changes in trends of ASR across global, 21 geographical regions, and 204 countries. The correlations between COVID-19 incidence, vaccination and the relative increased ASIR/ASPR of ADs were also evaluated.

RESULTS: Joinpoint regression analysis identified 2019 as a pivotal year, marking a global increase in the burden of PsO. The global ASR of PsO in 2021 showed an increased incidence, prevalence, and DALYs of 0.78, 5, and 0.33 DALYs per 100,000, respectively, compared to 2019 (194.1 × 10[3] cases, 1651.3 × 10[3] cases, and 131.4 × 10[3] DALYs, respectively). Notable absolute increases in PsO incidence rates in 2021 were observed in regions with a high socio-demographic index, particularly among individuals aged 50 to 54 and among males. Furthermore, 2019 marked a joinpoint with increased ASIR or ASPR of ADs in various regions, notably PsO in High-income North America, Southern Latin America, and South Asia, as well as IBD in Southern and Eastern Sub-Saharan Africa, Central Europe, and East Asia. Regional data from the USA, England, and Japan indicated a positive correlation between COVID-19 incidence and relative increases in the burden of PsO in 2020 (Spearman R 0.35, 0.24, and 0.36, respectively, for incidence; R 0.35, 0.2, and 0.36, respectively, for prevalence; all p < 0.05). Additionally, 2021 state-level vaccination rates in the USA were negatively correlated with the relative increases in the ASIR of PsO and RA (R: 0.27 and -0.54, respectively; p < 0.001 for all), as well as the ASPR of PsO, RA, and MS (R: 0.45, -0.49, and -0.41, respectively; p < 0.01 for all) in 2021.

CONCLUSIONS: The year 2019 marked a pivotal point for increased global burden of PsO and regional burdens of other ADs. These observations have important implications for subsequent healthcare planning and resource allocation.}, } @article {pmid40341792, year = {2025}, author = {Madiha, and Shahzadi, A and Ashiq, Z}, title = {Community engagement: the missing piece in solving the puzzle of XDR-typhoid spread in Pakistan.}, journal = {Journal of public health policy}, volume = {46}, number = {3}, pages = {645-652}, pmid = {40341792}, issn = {1745-655X}, mesh = {Pakistan/epidemiology ; Humans ; *Typhoid Fever/epidemiology/prevention & control/drug therapy ; COVID-19/epidemiology ; *Community Participation ; Health Policy ; Typhoid-Paratyphoid Vaccines/administration & dosage ; Drug Resistance, Multiple, Bacterial ; Public Health ; }, abstract = {Typhoid has been a major infectious health threat for the masses in Pakistan with increasing antimicrobial resistance, socio-economic decline, and environmental challenges. Since 2019, the percentage of cases has reduced with the implementation of Typhoid Conjugate Vaccine (TCV) program but reports of widened geographical spread particularly as aftermath of flooding in 2022 and resistance to Azithromycin or Meropenem in adult population are a matter of serious concern. Now is the right time to reconsider whether strategies like mass immunization or health infrastructure development solely can combat the hazards of Extensively Drug-Resistant (XDR)-Typhoid. Public health policies developed due to COVID-19, such as incorporating all stakeholders especially the public through community engagement, may provide a collaborative effort to lessen the prevailing threat of antibiotic resistance.}, } @article {pmid40341155, year = {2025}, author = {Brown, MEL and Finn, G and Burford, B and Vance, G}, title = {Changes to national postgraduate medical education during COVID-19: a scoping review of practice and impact within the UK.}, journal = {BMJ open}, volume = {15}, number = {5}, pages = {e099766}, pmid = {40341155}, issn = {2044-6055}, mesh = {*COVID-19/epidemiology ; Humans ; United Kingdom/epidemiology ; *Education, Medical, Graduate/organization & administration ; SARS-CoV-2 ; Curriculum ; Pandemics ; }, abstract = {OBJECTIVES: Explore what is known about the impact of changes made at a national level to UK postgraduate medical education during COVID-19.

DESIGN: A scoping review, following Arksey and O'Malley's framework, reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews Checklist.

DATA SOURCES: Ovid MEDLINE, Ovid Embase and ERIC were searched for peer-reviewed literature, and grey literature was searched via DuckDuckGo. The initial search was conducted on 17 January 2023 and updated on 5 June 2024. Forward citation tracking was performed.

ELIGIBILITY CRITERIA: English-language studies of any design examining national-level adaptations to postgraduate medical education (eg, curricula, examinations and Annual Review of Competency Panels (ARCPs)) within the UK during the COVID-19 pandemic. Studies were excluded, which focused solely on undergraduate education, international settings, grassroots-level changes (eg, to individual teaching sessions), or where full text was unobtainable.

DATA EXTRACTION AND SYNTHESIS: Data were extracted using a piloted charting form and analysed thematically to identify recurring patterns across studies. Basic numerical data were collected to describe study characteristics.

RESULTS: Of 1067 records screened, 30 studies met inclusion criteria. Most were cross-sectional surveys, with a strong representation from surgical and craft specialties. Four themes were identified: (1) impact on career development (including concerns about career delays and shifts in aspirations); (2) impact on trainee progression (highlighting delays due to ARCP outcomes 10.1/10.2 and reduced procedure accreditation); (3) changes in teaching and learning (such as a shift to online learning and cancelled rotations) and (4) supervision and support (revealing mixed experiences, with reports of burnout and inadequate organisational guidance). The systemic impact was uneven across specialties and training stages.

CONCLUSIONS: National-level changes mitigated immediate educational disruptions but are beginning to reveal long-term consequences for career development, workforce planning and trainee well-being, highlighting the need for resilient and equitable future frameworks.}, } @article {pmid40341071, year = {2025}, author = {Jafari, M and Khani, M and Akbari, T and Farahani, E and Bayat, F and Bagheri, A and Nasrollahizadeh, A and Ramezani, P and Ebrahimi, P and Mandegar, MH}, title = {Presentation of a residual post-myocardial infarction ventricular septal defect; a literature review based on a case report.}, journal = {Journal of cardiothoracic surgery}, volume = {20}, number = {1}, pages = {230}, pmid = {40341071}, issn = {1749-8090}, mesh = {Humans ; Male ; Middle Aged ; *Myocardial Infarction/complications ; *Heart Septal Defects, Ventricular/etiology/surgery/diagnosis/diagnostic imaging ; Echocardiography ; COVID-19/complications ; SARS-CoV-2 ; }, abstract = {INTRODUCTION: In the era of modern techniques for the early diagnosis and revascularization of myocardial infarction, post-myocardial infarction ventricular septal defect is rarely seen. However, this potentially fatal complication of ischemic cardiac events cannot always be detected and diagnosed in a straightforward pattern of practice. This study presents an initially delayed-presented post-infarction ventricular septal defect.

CASE PRESENTATION: The patient was a 58-year-old white man who presented to the cardiology clinic complaining of moderate exertional dyspnea initiated two months ago and exacerbated by the time. His medical history includes an admission three years prior, where he was diagnosed with COVID-19 pneumonia and a myocardial infarction that was complicated by a ventricular septal defect (VSD) and hemodynamic instability. This condition was managed through urgent surgical revascularization and closure of the defect. Due to his current symptoms, further cardiac investigations were planned. A transthoracic echocardiogram was recommended after detecting a grade 3/6 systolic murmur during the physical examination. The initial assessment using an apical four-chamber TTE appeared normal. However, when performing a modified view with a posterior tilt, a bulging septum was observed, leaning toward the right ventricle. This bulging contained a defect with a left-to-right shunt, identified as a residual defect in the area of the repaired patch, along with a myocardial aneurysm. Due to the inconsequential findings from the echocardiogram study, the patient was scheduled for a follow-up echocardiogram, which showed no changes after six months. Additionally, the patient underwent therapeutic management addressing chronic obstructive pulmonary disease.

CONCLUSION: Although post-infarction ventricular septal defects are rarely seen in the revascularization era, the COVID-19 era was associated with an increase in the prevalence of this complication. It is important to be vigilant for patients who experienced an index event during that time. This potentially fatal complication can present with new issues following the initial event, such as residual defects. Comprehensive imaging studies are necessary to detect the underlying pathology.

KEY CLINICAL MESSAGE: Diagnosing post-infarction ventricular septal defect requires the hypervigilance and precision of the cardiologist, who examines the patient and performs the cardiac imaging. Therefore, comprehensive investigations are crucial in patients with a suspicious history of ischemic cardiac events.}, } @article {pmid40341010, year = {2025}, author = {Ogungbe, O and Jabakhanji, SB and Mehta, R and McCaffrey, J and Byrne, D and Hurley, S and Rosman, L and Bansah, EC and Ibukun, F and Quarshie, IA and Lord, K and Lu, Y and Wang, Y and Rayani, A and Liu, H and Joseph, A and Escobosa, A and Nyamuame, I and Lee, J and Meng, N and Jehanzeb, I and Akinyemi, T and Nohara, S and Mediano, MFF and Yeboah-Kordieh, Y and de Sousa, C and Farhat, J and de Mello, RB and Taeed, T and Appel, LJ and Angell, SY and Gregg, EW and Matsushita, K}, title = {Disruption to diabetes and hypertension care during the COVID-19 pandemic in Latin America and the Caribbean and mitigation approaches: a scoping review.}, journal = {BMC health services research}, volume = {25}, number = {1}, pages = {660}, pmid = {40341010}, issn = {1472-6963}, support = {22/RP/10091//RCSI was provided by Science Foundation Ireland, Converge Programme/ ; 22/RP/10091//RCSI was provided by Science Foundation Ireland, Converge Programme/ ; 22/RP/10091//RCSI was provided by Science Foundation Ireland, Converge Programme/ ; 22/RP/10091//RCSI was provided by Science Foundation Ireland, Converge Programme/ ; 22/RP/10091//RCSI was provided by Science Foundation Ireland, Converge Programme/ ; }, mesh = {Humans ; *COVID-19/epidemiology ; Latin America/epidemiology ; *Hypertension/therapy/epidemiology ; *Diabetes Mellitus/therapy/epidemiology ; Caribbean Region/epidemiology ; *Primary Health Care/organization & administration ; SARS-CoV-2 ; Pandemics ; Telemedicine ; }, abstract = {BACKGROUND: The COVID-19 pandemic disrupted care for non-communicable diseases globally. This study synthesizes evidence on disruptions to primary care, focusing on hypertension and diabetes care and mitigation approaches taken during the pandemic in Latin America and the Caribbean (LAC).

METHODS: We conducted a scoping review, searching nine electronic databases for studies from January 2020 to December 2022 on COVID-19-related primary care disruptions and interventions, including studies on hospital-based interventions given their relevance to the pandemic response in LAC. We adapted the Primary Health Care Performance Initiative framework to develop our search strategy and synthesize data. For studies reporting interventions, we included studies conducted outside of LAC.

RESULTS: Of 33,510 references screened, 388 studies were included (259 reported disruptions in LAC, 61 interventions in LAC, 63 interventions outside LAC, and five interventions from countries within and outside LAC), with three-quarters presenting data from Brazil, Argentina, Mexico, and Peru; few studies focused on rural areas. Additionally, the few studies that adequately quantified care disruptions reported a reduction in hypertension and diabetes control during the pandemic (e.g., hypertension control rate decreased from 68 to 55% in Mexico). Frequently reported causes of disruption included burnout and mental health challenges among healthcare workers (with disproportionate effects by type of worker), reduced medication supplies, and reduced frequency of clinic visits by patients (e.g., due to financial constraints). The most reported interventions included remote care strategies (e.g., smartphone applications, virtual meeting platforms) and mental health programs for healthcare workers. Remote care strategies were deemed feasible for care delivery, triaging, and clinical support for non-physicians. Patients were generally satisfied with telemedicine, whereas providers had mixed perceptions. Robust evidence on the effectiveness of remote care strategies for diabetes and hypertension care was unavailable in LAC.

CONCLUSION: Hypertension and diabetes control appeared to worsen in LAC during the pandemic. Major reported causes of care disruptions were workforce issues, reduced medication supply, and changes in patient perceptions of seeking and receiving primary healthcare. Remote care strategies were feasible for various purposes and were well received by patients. However, the lack of data on intervention effectiveness underscores the importance of strengthening research capacity to generate robust evidence during future pandemics. Developing resilient healthcare systems able to provide care for hypertension and diabetes during future pandemics will depend on investment in the healthcare workforce, medical supply chain, health data and research infrastructure, and technology readiness.}, } @article {pmid40340966, year = {2025}, author = {Greenup, EP and Best, D}, title = {Systematic review and meta-analysis of no show or non-attendance rates among telehealth and in-person models of care.}, journal = {BMC health services research}, volume = {25}, number = {1}, pages = {663}, pmid = {40340966}, issn = {1472-6963}, mesh = {Humans ; *Telemedicine/statistics & numerical data ; *COVID-19/epidemiology ; *No-Show Patients/statistics & numerical data ; SARS-CoV-2 ; Retrospective Studies ; }, abstract = {OBJECTIVES: Comparisons of no-show rates between virtual and in-person models of care are commonly reported during evaluation, indicating how coveted improvements in attendance are to health service providers. This study seeks to synthesise the data from studies that make these comparisons, providing a more accurate indication of what may expected from the use of virtual care models for clinicians and administrators.

STUDY DESIGN: Systematic review and meta-analysis of 45 retrospective cohort studies.

METHODS: A literature review involving five databases was conducted, identifying 441 articles for screening. 45 were included for further analysis. A Random effects model was used to calculate the effect size, with further analysis conducted to determine heterogeneity and publication bias.

RESULTS: The Random effects model estimated a reduced likelihood non-attendance in patients receiving virtual care compared to in-person groups (OR = 0.61). An I[2] indicated a high degree of heterogeneity among the studies analysed. The Fail-Safe N suggested that the results are robust and not significantly influenced by publication bias.

CONCLUSIONS: The meta-analysis indicated that on average, telehealth models of care implemented since COVID-19 provide a moderate reduction in risk of patient non-attendance when compared to in-person alternatives.}, } @article {pmid40340891, year = {2025}, author = {Wu, K and Van Name, J and Xi, L}, title = {D-Dimer as Biomarker for Prognosis of Coronary Artery Disease and Heart Failure: Reappraisal of Its Central Role.}, journal = {Cardiology}, volume = {}, number = {}, pages = {1-11}, doi = {10.1159/000546154}, pmid = {40340891}, issn = {1421-9751}, abstract = {BACKGROUND: D-dimer is a fibrinogen degradation product formed by the breakdown of cross-linked fibrin in a series of enzyme-mediated steps. Since the D-dimer assay allows for detection of thrombin production and endogenous fibrinolysis, it has been increasingly used in clinics as a screening test to exclude venous thromboembolism and disseminated intravascular coagulation. Additionally, D-dimer has been evaluated for determining the initiation of anticoagulation therapy in patients with selected cardiovascular disease.

SUMMARY: This narrative review has evaluated the updated evidence from several recent clinical studies/trials and provides a reappraisal of the utility of D-dimer assay for disease prognosis and clinical management decisions in patients with stable coronary artery disease, acute coronary syndrome, and heart failure. We further discussed several confounding factors that may affect circulating levels of D-dimer, including those observed during the COVID-19 pandemic.

KEY MESSAGES: Better understanding of the pathophysiologic mechanisms underlying D-dimer formation would improve accuracy and specificity of D-dimer as biomarker for predicting long-term outcome of the severity of coronary artery disease and heart failure.}, } @article {pmid40340080, year = {2025}, author = {Kakehi, S and Cooblall, C and Pizzi, L and Devlin, N and Reed, SD and Slejko, JF and Wu, O}, title = {How Well Are Women Represented in Authorship in HEOR? An Analysis of Value in Health: An ISPOR Report.}, journal = {Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research}, volume = {28}, number = {5}, pages = {671-675}, doi = {10.1016/j.jval.2025.02.006}, pmid = {40340080}, issn = {1524-4733}, mesh = {*Authorship ; Humans ; Female ; *COVID-19/epidemiology ; Developing Countries ; *Periodicals as Topic/statistics & numerical data ; *Publishing/statistics & numerical data ; Pandemics ; SARS-CoV-2 ; }, abstract = {OBJECTIVES: The aim of this study was to report women's authorship in Value in Health in terms of articles submitted to and accepted for publication before and during the COVID-19 pandemic to evaluate its potential impact on women's research productivity.

METHODS: The proportion of women corresponding and first authors among submitted and accepted articles were analyzed and compared between the 2 periods: before (2018-2019) and during the COVID pandemic (2020-2021). The proportion of women corresponding authors from low- and middle-income countries (LMIC) was compared with the proportion from the rest of world (ROW).

RESULTS: A total of 4910 Value in Health submissions were identified from 2018 to 2021. The proportion of women's first and corresponding authorship of articles submitted to and accepted for publication in Value in Health slightly increased from before the pandemic to during the pandemic, although not statistically significantly. The difference in proportions of women corresponding authors between LMIC and ROW countries was statistically significant for both periods: before and during the pandemic. Logistic regression models determined that submissions from ROW countries have an increased odds of women corresponding authorship than submissions from LMIC countries (OR 1.28; 95% CI 1.11-1.46).

CONCLUSIONS: Findings from this study suggest that the pandemic did not exert an adverse effect on women submitting to or publishing articles in Value in Health. Additional studies are needed to explore whether the proportions are representative of the workforce and investigate whether these distributions change in the future.}, } @article {pmid40340037, year = {2025}, author = {Delgado-Fernández, M and Ruiz-Mesa, JD and Rojas-González, A and García-Gemar, GM and Fuentes-López, A and de Salazar-González, A and García-García, F}, title = {Fresh frozen plasma for neutralizing SARS-CoV-2: "An exploratory cross-sectional study and review of the state of the art".}, journal = {Enfermedades infecciosas y microbiologia clinica (English ed.)}, volume = {43}, number = {5}, pages = {282-290}, doi = {10.1016/j.eimce.2025.03.014}, pmid = {40340037}, issn = {2529-993X}, mesh = {Humans ; *SARS-CoV-2/immunology ; *COVID-19/therapy/immunology ; *Plasma/immunology ; Cross-Sectional Studies ; *Antibodies, Neutralizing/blood ; Antibodies, Viral/blood ; Blood Donors ; Male ; Middle Aged ; Female ; Adult ; Spain ; Immunization, Passive ; Immunoglobulin G/blood ; COVID-19 Serotherapy ; }, abstract = {Restitution of humoral immunodeficiency is essential to clear SARS-CoV-2. Intravenous unspecific immunoglobulins are expensive and restricted. So recently donated fresh frozen plasma (FFP) could be useful in this scenario but, are all units neutralizing against SARS-CoV-2? We explored this on 52 donations obtained from "Centro de Transfusión, Tejidos y Células de Málaga, Spain", from April to June 2022. Donors status about SARS-CoV-2 previous infection or vaccination was unknown. Neutralizing activity (at dilutions≥1/160) against real Delta (not circulating), BA.2 (dominant circulating variant), BA.5 (irrupting variant), and BQ.1.1 and XBB.1.5 (not circulating yet) was determined. Higher anti-Spike IgG antibodies cut-offs predicted efficacy of FFP. Different cut-offs have been reported in the literature, but all papers have in common that levels over the higher range of quantification can predict neutralizing activity of recently donated FFP against circulating variants of concern, if used early after donation, not requiring clinical data from donors.}, } @article {pmid40338681, year = {2025}, author = {Aslam, AM and Shinozuka, K and Muir, O and Tabaac, BJ}, title = {Mapping the Use of Ketamine in Treatment-Resistant Depression and Other Psychiatric Disorders: A Scoping Review of Practice Patterns, Efficacy, and Patient Demographic Trends.}, journal = {American journal of therapeutics}, volume = {32}, number = {3}, pages = {e242-e246}, pmid = {40338681}, issn = {1536-3686}, mesh = {Humans ; *Ketamine/therapeutic use/administration & dosage ; *Depressive Disorder, Treatment-Resistant/drug therapy ; United States ; *Practice Patterns, Physicians'/statistics & numerical data/trends ; COVID-19/epidemiology ; *Antidepressive Agents/therapeutic use/administration & dosage ; Off-Label Use ; Health Services Accessibility ; Adult ; }, abstract = {BACKGROUND: Ketamine has emerged as a novel treatment for psychiatric disorders, particularly treatment-resistant depression (TRD). Although intravenous (IV) ketamine is not approved by the Food and Drug Administration (FDA) for TRD, esketamine, an FDA-approved therapeutic, has contributed to the widespread clinical use of off-label IV ketamine across the United States. This scoping review highlights significant shifts in ketamine therapy, particularly after FDA approval of esketamine, the impact of COVID-19 on treatment accessibility, and increased regulatory scrutiny from the Drug Enforcement Administration (DEA) and FDA.

AREAS OF UNCERTAINTY: What are the current practice patterns, patient demographics, and barriers to accessing ketamine for psychiatric disorders, particularly TRD?

DATA SOURCES: This scoping review focused on provider utilization patterns (including frequency of ketamine administration, provider roles, and treatment settings), preferred administration methods (IV infusions, intramuscular injections, and other routes), and patient characteristics (age, sex, socioeconomic status, and primary psychiatric diagnoses treated). The Web of Science, PubMed, CBM, MEDLINE, Cochrane Library, University Theses, and Embase databases were searched.

RESULTS: Two survey-based studies were included. IV administration was the most common method of administration reported in both studies, with alternative methods such as intramuscular and sublingual routes emerging in limited use. Patients receiving ketamine therapy were predominantly middle aged (36-64 years old), with financial barriers identified as a notable obstacle because of limited insurance coverage. Access to ketamine was limited in rural areas, illustrating the need for expanded provider networks. Private clinics exhibited greater flexibility in treatment approaches than hospital settings, which adhered to standardized protocols. The absence of long-term outcome data and variability in treatment protocols emphasize the need for standardized practices and further research.

CONCLUSIONS: This scoping review highlights the widespread use of ketamine for TRD, but reveals significant variability in practice patterns and accessibility barriers. Findings emphasize the need for standardized protocols, expanded insurance coverage, and further research to optimize the role of ketamine in psychiatric care.}, } @article {pmid40338485, year = {2025}, author = {Alves, MCS and da Silva, RCC and de Leitão-Júnior, SSP and de Balbino, VQ}, title = {Therapeutic Approaches for COVID-19: A Review of Antiviral Treatments, Immunotherapies, and Emerging Interventions.}, journal = {Advances in therapy}, volume = {42}, number = {7}, pages = {3045-3058}, pmid = {40338485}, issn = {1865-8652}, support = {001//Coordenação de Aperfeiçoamento de Pessoal de Nível Superior/ ; }, mesh = {Humans ; *Antiviral Agents/therapeutic use ; *COVID-19 Drug Treatment ; COVID-19/therapy ; *Immunotherapy/methods ; SARS-CoV-2 ; Anticoagulants/therapeutic use ; Immunomodulating Agents/therapeutic use ; }, abstract = {The coronavirus disease 2019 (COVID-19) global health crisis, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has presented unprecedented challenges to global healthcare systems, leading to rapid advances in treatment development. This review comprehensively examines the current therapeutic approaches for managing COVID-19, including direct-acting antivirals, immunomodulators, anticoagulants, and adjuvant therapies, as well as emerging and experimental approaches. Direct-acting antivirals target various stages of the viral life cycle, offering specific intervention points, while immunomodulators aim to modulate the host's immune response, reducing disease severity. Anticoagulant therapies address the coagulopathy frequently observed in severe cases, and adjuvant treatments provide supportive care to improve overall outcomes. We also explore the challenges and limitations of implementing these treatments, such as drug resistance, variable patient responses, and access to therapies, especially in resource-limited settings. The review also discusses future perspectives, including the potential of next-generation vaccines, personalized medicine, and global collaboration in shaping future COVID-19 treatment paradigms. Continuous innovation, combined with an integrated and adaptable approach, will be crucial to effectively managing COVID-19 and mitigating the impact of future pandemics.}, } @article {pmid40337590, year = {2025}, author = {Lal, P and Gupta, S}, title = {Psychological Impact of COVID-19 on Children and Adolescents: A Narrative Review of Mental Health Challenges, Interventions, and Long-Term Trajectories.}, journal = {Cureus}, volume = {17}, number = {4}, pages = {e81840}, pmid = {40337590}, issn = {2168-8184}, abstract = {The COVID-19 pandemic has significantly impacted the mental health and well-being of children and adolescents globally. This comprehensive narrative review synthesizes current research on the pandemic's psychological effects on young people, examining emotional distress, behavioral changes, sleep disturbances, educational disruptions, and the exacerbation of pre-existing mental health conditions. A systematic literature search was conducted using PubMed, MEDLINE, PsycINFO, CINAHL, and Web of Science, covering articles published from January 2020 to December 2024. Studies focusing on children and adolescents (aged 0-18 years) that examined mental health outcomes related to the COVID-19 pandemic were included. Data extraction was performed using a standardized form, and a narrative synthesis approach was employed to analyze and integrate the findings. Key findings reveal a substantial increase in anxiety, depression, and post-traumatic stress disorder among children and adolescents during the pandemic. School closures, social isolation, and disrupted routines have contributed to these mental health challenges. Sleep patterns have been notably affected, with delayed bedtimes, increased sleep disturbances, and a higher prevalence of insomnia and nightmares. The pandemic has widened educational disparities, particularly affecting children from disadvantaged backgrounds. Individuals with pre-existing mental health conditions have experienced exacerbated symptoms and faced challenges in accessing care. Various interventions, including cognitive behavioral therapy, social-emotional learning programs, and digital mental health support, have shown promise in mitigating the pandemic's psychological impact on young people. Children were more affected, as they faced a global crisis for the first time with limited coping skills. Disruptions in routine, social isolation, and family stressors heightened anxiety, depression, and behavioral issues, making them more affected. This review emphasizes the need for continued research, targeted interventions, and policy development to address the long-term mental health consequences of the COVID-19 pandemic on children and adolescents.}, } @article {pmid40336572, year = {2025}, author = {Spunde, K and Korotkaja, K and Sominskaya, I and Zajakina, A}, title = {Genetic adjuvants: A paradigm shift in vaccine development and immune modulation.}, journal = {Molecular therapy. Nucleic acids}, volume = {36}, number = {2}, pages = {102536}, pmid = {40336572}, issn = {2162-2531}, abstract = {The COVID-19 pandemic underscored the urgency of developing effective vaccines to combat infectious diseases, especially in vulnerable populations such as the elderly and immunocompromised. While recombinant protein vaccines offer safety, their poor immunogenicity highlights the need for advanced vaccination platforms. New genetic/nucleic acid vaccine formulations like plasmid DNA and mRNA showed efficiency and safety in preclinical and clinical studies; however, they demand innovative adjuvants because their mechanism of action differs from traditional protein vaccines. Genetic adjuvants-encoded by nucleic acids within DNA, RNA, or viral vectors-emerge as a promising solution by targeting and modulating specific immune pathways, including antigen presentation, T cell activation, and memory formation. These innovative adjuvants enhance vaccine efficacy by fine-tuning innate and adaptive immune responses, overcoming immune senescence, and addressing the challenges of CD8[+] T cell activation in immunocompromised populations. This review explores the potential of genetically encoded adjuvants, including cytokines, chemokines, and other immune modulators. By comparing these adjuvants to traditional formulations, we highlight their capacity to address the limitations of modern vaccines while discussing their integration with emerging technologies like RNA-based vaccines. As genetic adjuvants advance toward clinical application, understanding their mechanisms and optimizing their delivery is pivotal to unlocking next-generation immunization strategies.}, } @article {pmid40335714, year = {2025}, author = {Kiyono, H and Ernst, PB}, title = {Nasal vaccines for respiratory infections.}, journal = {Nature}, volume = {641}, number = {8062}, pages = {321-330}, pmid = {40335714}, issn = {1476-4687}, mesh = {Animals ; Humans ; *Administration, Intranasal ; Antibodies, Neutralizing/immunology ; COVID-19/prevention & control/immunology ; COVID-19 Vaccines/immunology/administration & dosage ; Immunoglobulin G/immunology ; *Respiratory Tract Infections/prevention & control/immunology/virology ; SARS-CoV-2/immunology ; *Vaccines/administration & dosage ; }, abstract = {Beginning with Edward Jenner's discovery of the smallpox vaccine, the ever-expanding repertoire of vaccines against pathogens has saved many lives. During the COVID-19 pandemic, a revolutionary mRNA injectable vaccine emerged that effectively controlled the severity of disease caused by SARS-CoV-2. This vaccine induced potent antigen-specific neutralizing serum IgG antibodies, but was limited in its ability to prevent viral invasion at the respiratory surfaces. Nasal vaccines have attracted attention as a potential strategy to combat respiratory infections and prepare for future pandemics. Input from disciplines such as microbiology, biomaterials, bioengineering and chemistry have complemented the immunology to create innovative delivery systems. This approach to vaccine delivery has yielded nasal vaccines that induce secretory IgA as well as serum IgG antibodies, which are expected to prevent pathogen invasion, thereby diminishing transmission and disease severity. For a nasal vaccine to be successful, the complexity of the relevant anatomical, physiological and immunological properties, including the proximity of the central nervous system to the nasal cavity, must be considered. In this Review, we discuss past and current efforts as well as future directions for developing safe and effective nasal vaccines for the prevention of respiratory infections.}, } @article {pmid40335476, year = {2025}, author = {O'Mahoney, LL and Routen, A and Gillies, C and Jenkins, SA and Almaqhawi, A and Ayoubkhani, D and Banerjee, A and Brightling, C and Calvert, M and Cassambai, S and Ekezie, W and Funnell, MP and Welford, A and Peace, A and Evans, RA and Jeffers, S and Kingsnorth, AP and Pareek, M and Seidu, S and Wilkinson, TJ and Willis, A and Shafran, R and Stephenson, T and Sterne, J and Ward, H and Ward, T and Khunti, K}, title = {The risk of Long Covid symptoms: a systematic review and meta-analysis of controlled studies.}, journal = {Nature communications}, volume = {16}, number = {1}, pages = {4249}, pmid = {40335476}, issn = {2041-1723}, mesh = {Humans ; *COVID-19/epidemiology/complications/physiopathology/virology ; *Post-Acute COVID-19 Syndrome/epidemiology/physiopathology/virology ; Risk Factors ; SARS-CoV-2/pathogenicity ; }, abstract = {The global evidence on the risk of symptoms of Long Covid in general populations infected with SARS-CoV-2 compared to uninfected comparator/control populations remains unknown. We conducted a systematic literature search using multiple electronic databases from January 1, 2022, to August 1, 2024. Included studies had ≥100 people with confirmed or self-reported COVID-19 at ≥28 days following infection onset, and an uninfected comparator/control group. Results were summarised descriptively and meta-analyses were conducted to derive pooled risk ratio estimates. 50 studies totaling 14,661,595 people were included. In all populations combined, there was an increased risk of a wide range of 39 out of 40 symptoms in those infected with SARS‑CoV‑2 compared to uninfected controls. The symptoms with the highest pooled relative risks were loss of smell (RR 4.31; 95% CI 2.66, 6.99), loss of taste (RR 3.71; 95% CI 2.22, 7.26), poor concentration (RR 2.68; 95% CI 1.66, 4.33), impaired memory (RR 2.53; 95% CI 1.82, 3.52), and hair loss/alopecia (RR 2.38; 95% CI 1.69, 3.33). This evidence synthesis, of 50 controlled studies with a cumulative participant count exceeding 14 million people, highlights a significant risk of diverse long-term symptoms in individuals infected with SARS-CoV-2, especially among those who were hospitalised.}, } @article {pmid40334268, year = {2025}, author = {Chong, RLK and Chan, ASE and Chua, CMS and Lai, YF}, title = {Telehealth Interventions in Pharmacy Practice: Systematic Review of Reviews and Recommendations.}, journal = {Journal of medical Internet research}, volume = {27}, number = {}, pages = {e57129}, pmid = {40334268}, issn = {1438-8871}, mesh = {Humans ; *Pharmaceutical Services/organization & administration ; *Telemedicine ; Review Literature as Topic ; }, abstract = {BACKGROUND: Pharmaceutical care has expanded, with telehealth playing a key role, especially during the COVID-19 pandemic. Despite global growth, existing reviews focus on specific settings or conditions, highlighting the need for broader research on public health topics and comparative studies to evaluate the effectiveness, preferences, and cost of telehealth interventions in pharmacy practice.

OBJECTIVE: The aim of this study was to unify existing literature on the impact of telehealth on future pharmacy practice and to analyze those already implemented in current pharmacy practice, with the objective of providing recommendations.

METHODS: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework was used to guide this review. In total, 4 databases were searched for relevant studies: PubMed, CINAHL, Web of Science, and Cochrane Library. Title, abstract, and full-text screening was performed, and 18 reviews met the selection criteria. The search period was from August 1, 2012, to December 22, 2024. The quality of the reviews was assessed using a 5-point Likert scale and a GRADE-CERQual scale.

RESULTS: Based on the identified reviews, telehealth interventions were categorized into teleconsultation, telemonitoring, telecollaboration, and telesupport. Teleconsultation was the most frequently used. Telephones were most common in teleconsultations and telemonitoring, while mobile, web, or computer applications were most frequent in telesupport. A combination of methods was most used to facilitate telecollaboration, such as telephone, fax, electronic messaging, shared electronic records, and videoconferencing. The identified reviews were evaluated by health outcomes, hospital readmission rates, patient safety, adherence, satisfaction, pharmacist shortage, and quality and access to care. The use of telehealth in pharmacy has generally seen an improvement in overall outcomes compared to traditional pharmacy practice. Our results show a strong push to integrate telehealth into future pharmacy practice, with the United States leading the way in adoption, demonstrating increased care access, quality, and patient safety. In Singapore, telephone consultations have been commonly used in hospitals, though community settings lack widespread adoption. However, the growing digital literacy of older adults and innovations like chatbots and telemonitoring present opportunities to expand telehealth services. To align with this shift, pharmacy education should invest in enhancing formative training by incorporating telehealth training, ensuring future pharmacists are prepared for this evolving practice, applicable to regions with similar contexts.

CONCLUSIONS: Telehealth has shown promise in improving overall outcomes in pharmacy practice. While many countries have made strides, particularly in hospital settings, there remains an opportunity for greater adoption in community health care, driven by innovations like telemonitoring and digital literacy among older adults. The findings from this study can be used to inform future implementation of telehealth interventions in pharmacy in Singapore and other regions or cities with similar contexts.}, } @article {pmid40334075, year = {2025}, author = {García-Valdés, L and Al Wattar, BH and García-Valdés, M and Amezcua-Prieto, C}, title = {Quality of clinical practice guidelines on the COVID-19 management in pregnancy during the pandemic: a systematic review.}, journal = {European journal of public health}, volume = {35}, number = {3}, pages = {423-433}, pmid = {40334075}, issn = {1464-360X}, mesh = {Humans ; Pregnancy ; Female ; *COVID-19/prevention & control/therapy/epidemiology ; *Practice Guidelines as Topic/standards ; *Pregnancy Complications, Infectious/therapy ; SARS-CoV-2 ; Pandemics ; }, abstract = {The Coronavirus Disease 2019 (COVID-19) pandemic disrupted maternity care, highlighting the need for rapid, high-quality clinical practice guidelines (CPGs) to ensure safe care for pregnant women. We assessed the quality and recommendations of CPGs related to COVID-19 in pregnancy. Following prospective registration (PROSPERO number: CRD42022346031) we searched Medline, Web of Science, and UpToDate from inception until July 2024. The methodological quality was appraised using the Appraisal of Guidelines for Research and Evaluation II (AGREE II). A total of 27 CPGs were included. High scores were achieved in scope and purpose (21/27, 78%) and clarity (17/27, 63%). The most poorly addressed domains were rigour of development and applicability to clinical practice (18/27, 67% and 19/27, 70% scored low quality, respectively). Overall, only four (15%) guidelines were recommended. Most CPGs (25/27, 93%) addressed COVID-19 screening and transmission prevention, but few covered psychological care (3/27, 11%) or maternal delivery preferences (4/21, 19%). Consensus was found on timing and mode of delivery (16/17, 94%), but there was disagreement on delayed cord clamping and virus transmission interventions. Evidence-based practice requires health care providers, patients and stakeholders to be aware of variations in both the quality and recommendations of CPGs, especially during times of uncertainty.}, } @article {pmid40333653, year = {2025}, author = {Checconi, P and Mariconda, A and Catalano, A and Ceramella, J and Pellegrino, M and Aquaro, S and Sinicropi, MS and Longo, P}, title = {Searching for New Gold(I)-Based Complexes as Anticancer and/or Antiviral Agents.}, journal = {Molecules (Basel, Switzerland)}, volume = {30}, number = {8}, pages = {}, pmid = {40333653}, issn = {1420-3049}, mesh = {*Antiviral Agents/chemistry/pharmacology/therapeutic use ; Humans ; *Antineoplastic Agents/chemistry/pharmacology/therapeutic use ; *Gold/chemistry ; *Coordination Complexes/chemistry/pharmacology/therapeutic use ; SARS-CoV-2/drug effects ; COVID-19 Drug Treatment ; Neoplasms/drug therapy ; Methane/analogs & derivatives/chemistry ; Heterocyclic Compounds/chemistry ; Animals ; }, abstract = {Approaches capable of simultaneously treating cancer and protecting susceptible patients from lethal infections are highly desirable, although they prove challenging. Taking inspiration from the well-known anticancer platinum complexes, successive studies about the complexation of organic compounds with other late transition metals, such as silver, gold, palladium, rhodium, ruthenium, iridium, and osmium, have led to remarkable anticancer activities. Among the numerous chemical moieties studied, N-heterocyclic carbenes (NHCs) have revealed very attractive activities due to their favorable chemical properties. Specifically, gold-NHC complexes emerged as some of the most active complexes acting as antitumor agents. On the other hand, some recent studies have highlighted the involvement of these complexes in antiviral research as well. The well-known gold-based, orally available complex auranofin approved by the Food and Drug Administration (FDA) for the treatment of rheumatoid arthritis has been suggested as a repositioned drug for both cancer and viral infections. In the era of the COVID-19 pandemic, the most interesting goal could be the discovery of gold-NHC complexes as dual antiviral and anticancer agents. In this review, the most recent studies regarding the anticancer and antiviral activities of gold(I)-NHC complexes will be analyzed and discussed, offering an interesting insight into the research in this field.}, } @article {pmid40333633, year = {2025}, author = {Ronca, DB and Mesquita, LO and Oliveira, D and Figueiredo, ACMG and Wen, J and Song, M and de Carvalho, KMB}, title = {Excess weight is associated with neurological and neuropsychiatric symptoms in post-COVID-19 condition: A systematic review and meta-analysis.}, journal = {PloS one}, volume = {20}, number = {5}, pages = {e0314892}, pmid = {40333633}, issn = {1932-6203}, mesh = {Humans ; *COVID-19/complications/psychology ; *Obesity/complications ; SARS-CoV-2 ; *Nervous System Diseases/etiology ; *Overweight/complications ; Risk Factors ; *Mental Disorders/etiology ; Depression ; }, abstract = {BACKGROUND/PURPOSE: Excess weight has been identified as a potential risk factor for post-COVID-19 condition (PCC). This systematic review and meta-analysis aimed to investigate whether excess weight is associated with the development or experience of neurological and neuropsychiatric symptoms in PCC.

METHODS: We conducted a comprehensive search of eight databases (PubMed, Embase, Scopus, Web of Science, VHL, Google Scholar, ProQuest, and medRxiv) for studies published up to July 2023. Studies were included if they assessed PCC symptoms in relation to nutritional status, specifically the development of neurological and neuropsychiatric symptoms more than 12 weeks post-infection. The analysis compared exposure and controls groups (excess weight vs. normal weight; obesity vs. non-obesity). Data were synthesized using a random-effects model.

RESULTS: Of the 10,122 abstracts screened, 18 studies (n = 139,091 adults) were included. These studies included 79,050 individuals with excess weight vs 57,926 normal-weight individuals and 30,694 individuals with obesity vs 107,612 non-obese individuals. The presence of excess weight in PCC was significantly associated with persistent depression (RR = 1.21; 95% CI: 1.03-1.42), headache (OR = 1.23; 95% CI: 1.10-1.37), memory issues (RR = 1.43; 95% CI: 1.24-1.65), sleep disturbance (RR = 1.31; 95% CI: 1.16-1.48), and vertigo (RR = 1.21; 95% CI: 1.04-1.41). Obesity was significantly associated with persistent headache (OR = 1.45; 95% CI: 1.37-1.53), numbness (RR = 1.61; 95% CI: 1.46-1.78), smell disorder (OR = 1.16; 95% CI: 1.11-1.22), taste disorder (OR = 1.22; 95% CI: 1.08-1.38), and vertigo (RR = 1.44; 95% CI: 1.35-1.53).

CONCLUSIONS: Excess weight, including overweight and obesity, is associated with experiencing neuro-symptoms related to PCC. Individuals with these conditions urgently need enhanced personalized care management in current post-pandemic context.}, } @article {pmid40333566, year = {2025}, author = {Davis, MD}, title = {2024 Year in Review: Fugitive Aerosols-Keeping the Air Clear for Patients and Staff.}, journal = {Respiratory care}, volume = {70}, number = {7}, pages = {908-913}, pmid = {40333566}, issn = {1943-3654}, support = {P01 HL158507/HL/NHLBI NIH HHS/United States ; R01 HL149693/HL/NHLBI NIH HHS/United States ; R01 HL177812/HL/NHLBI NIH HHS/United States ; }, mesh = {Humans ; *COVID-19/transmission/prevention & control/epidemiology ; Aerosols ; SARS-CoV-2 ; *Infection Control/methods ; *Infectious Disease Transmission, Patient-to-Professional/prevention & control ; Air Microbiology ; }, abstract = {Although concerns about and precautions to prevent transmission of diseases through the air have existed since Hippocrates, renewed interest in risks and prevention strategies grew significantly since the onset of the COVID-19 pandemic. This altered respiratory care practice globally owing to concerns that some respiratory care procedures may generate or disperse aerosols that could spread pathogens. A paucity of evidence, as well as a lack of general consensus, existed at the pandemic onset to determine the associated risks of these procedures and best practices for mitigating those risks. This is a review of key peer-reviewed manuscripts from 2023 to 2024 discussing aerosol generation and dispersion from respiratory care procedures, as well as the mitigation of associated risks. A brief discussion of different forms of aerosols, and the risks associated with each, is also included.}, } @article {pmid40333520, year = {2025}, author = {Uwamahoro, H and Collier, WE and Nashar, TO and Jaynes, JM and Mortley, DG and Davis, CG and Kanyairita, GG and Abdelazim, EF and Igiramaboko, JFR and Habineza, C and Tumushimiyimana, D and Rutayisire, UN and Davis, YA and Renard, KL}, title = {Natural and Designed Cyclic Peptides as Potential Antiviral Drugs to Combat Future Coronavirus Outbreaks.}, journal = {Molecules (Basel, Switzerland)}, volume = {30}, number = {8}, pages = {}, pmid = {40333520}, issn = {1420-3049}, support = {2U54MD007585-34A34/NH/NIH HHS/United States ; 5454MD007585//Tuskegee University Center for Biomedical Research/RCMI/ ; }, mesh = {*Antiviral Agents/therapeutic use/pharmacology/chemistry ; Humans ; *COVID-19 Drug Treatment ; *Peptides, Cyclic/therapeutic use/pharmacology/chemistry ; SARS-CoV-2/drug effects ; Animals ; COVID-19/epidemiology/virology ; }, abstract = {The COVID-19 pandemic has underscored the need for effective and affordable antiviral drugs. Anthropogenic activities have increased interactions among humans, animals, and wildlife, contributing to the emergence of new and re-emerging viral diseases. RNA viruses pose significant challenges due to their rapid mutation rates, high transmissibility, and ability to adapt to host immune responses and antiviral treatments. The World Health Organization has identified several diseases (COVID-19, Ebola, Marburg, Zika, and others), all caused by RNA viruses, designated as being of priority concern as potential causes of future pandemics. Despite advances in antiviral treatments, many viruses lack specific therapeutic options, and more importantly, there is a paucity of broad-spectrum antiviral drugs. Additionally, the high costs of current treatments such as Remdesivir and Paxlovid highlight the need for more affordable antiviral drugs. Cyclic peptides from natural sources or designed through molecular modeling have shown promise as antiviral drugs with stability, low toxicity, high target specificity, and low antiviral resistance properties. This review emphasizes the urgent need to develop specific and broad-spectrum antiviral drugs and highlights cyclic peptides as a sustainable solution to combat future pandemics. Further research into these compounds could provide a new weapon to combat RNA viruses and address the gaps in current antiviral drug development.}, } @article {pmid40333344, year = {2025}, author = {Huang, Y and Li, S and Ye, W and Wang, H and Su, J and Gao, L and Shi, R and Mou, X and Leng, SX and Xiao, C and Chen, G}, title = {Viral Infections in Elderly Individuals: A Comprehensive Overview of SARS-CoV-2 and Influenza Susceptibility, Pathogenesis, and Clinical Treatment Strategies.}, journal = {Vaccines}, volume = {13}, number = {4}, pages = {}, pmid = {40333344}, issn = {2076-393X}, support = {2023YFE0118700//the Key R&D Program Key Special Projects for International Science and Technology Innovation Cooperation between Governments/ ; }, abstract = {As age increases, the immune function of elderly individuals gradually decreases, increasing their susceptibility to infectious diseases. Therefore, further research on common viral infections in the elderly population, especially severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza viruses, is crucial for scientific progress. This review delves into the genetic structure, infection mechanisms, and impact of coinfections with these two viruses and provides a detailed analysis of the reasons for the increased susceptibility of elderly individuals to dual viral infections. We evaluated the clinical manifestations in elderly individuals following coinfections, including complications in the respiratory, gastrointestinal, nervous, and cardiovascular systems. Ultimately, we have summarized the current strategies for the prevention, diagnosis, and treatment of SARS-CoV-2 and influenza coinfections in older adults. Through these studies, we aim to reduce the risk of dual infections in elderly individuals and provide a scientific basis for the prevention, diagnosis, and treatment of age-related viral diseases, thereby improving their health status.}, } @article {pmid40333310, year = {2025}, author = {Kumar, P and Ray, A and Kumari, A and Sultana, A and Hora, R and Singh, K and Mehra, R and Kaur, A and Koshal, SS and Quadri, SF and Singh, SK and Roy, AD}, title = {Chronicling the Journey of Pneumococcal Conjugate Vaccine Introduction in India.}, journal = {Vaccines}, volume = {13}, number = {4}, pages = {}, pmid = {40333310}, issn = {2076-393X}, support = {INV-030655/GATES/Gates Foundation/United States ; }, abstract = {BACKGROUND: Globally, pneumonia claims the lives of about 700,000 children under the age of 5 every year. Pneumococcal conjugate vaccine (PCV) was introduced in India phase-wise, beginning in high-burden states, and the rollout was completed nationwide by 2021-representing a major initiative by the Ministry of Health and Family Welfare (MoHFW). Despite the challenges posed by the COVID-19 pandemic, the campaign succeeded in maintaining progress and achieving nationwide coverage. This narrative review highlights the significant decisions, processes, and coordinated efforts of the various stakeholders involved that led to this successful PCV rollout.

METHODOLOGY: A comprehensive desk review of both published and unpublished literature relevant to pneumonia burden and the efficacy and effectiveness of PCVs, along with documentation of PCV introduction and the scale-up was carried out.

RESULTS: The documentation of the PCV journey has been broken down into four sections: pre-introduction, PCV Phase-I introduction, pan-India rapid expansion, and the period post-introduction. Since the nationwide rollout in 2021, PCV coverage in India has steadily increased, reflecting successful immunization efforts. WUENIC, which is an annual WHO, and UNICEF estimates of national immunization coverage also show a positive trend in vaccination coverage (PCV booster coverage = 25% (2021), rising to 83% (2023), aligning with the goals of the WHO and UNICEF's Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD).

CONCLUSIONS: The phased rollout was an ambitious effort by the MoHFW, which was particularly challenging given the overlap with the COVID-19 pandemic. Despite these hurdles, the MoHFW, along with strong collaboration from development partners and stakeholders, successfully navigated the complex rollout. Future studies on the role of PCVs in reducing antibiotic resistance and the economic benefits of PCV introduction could help policymakers sustain funding and prioritize vaccine procurement decisions.}, } @article {pmid40333307, year = {2025}, author = {Murala, MST and Gairola, V and Sayedahmed, EE and Mittal, SK}, title = {Next-Generation Adenoviral Vector-Based Vaccines for Severe Acute Respiratory Syndrome Coronavirus-2.}, journal = {Vaccines}, volume = {13}, number = {4}, pages = {}, pmid = {40333307}, issn = {2076-393X}, support = {R01 AI158177/AI/NIAID NIH HHS/United States ; AI158177/AI/NIAID NIH HHS/United States ; }, abstract = {This review systematically revises adenovirus (Ad) biology, vector structure, immune responses, and currently available Ad vector COVID-19 vaccines. It analyzes the challenges associated with the Ad vector-based vaccines, including preexisting vector immunity and other side effects. Moreover, this review explores novel and innovative strategies to overcome these constraints for developing next-generation vaccines for broad protection to cover emerging SARS-CoV-2 variants. The future refinement of Ad vaccine platforms will be pivotal in achieving durable immunity against emerging variants for global preparedness.}, } @article {pmid40333293, year = {2025}, author = {Saha, A and Ghosh Roy, S and Dwivedi, R and Tripathi, P and Kumar, K and Nambiar, SM and Pathak, R}, title = {Beyond the Pandemic Era: Recent Advances and Efficacy of SARS-CoV-2 Vaccines Against Emerging Variants of Concern.}, journal = {Vaccines}, volume = {13}, number = {4}, pages = {}, pmid = {40333293}, issn = {2076-393X}, abstract = {Vaccination has been instrumental in curbing the transmission of SARS-CoV-2 and mitigating the severity of clinical manifestations associated with COVID-19. Numerous COVID-19 vaccines have been developed to this effect, including BioNTech-Pfizer and Moderna's mRNA vaccines, as well as adenovirus vector-based vaccines such as Oxford-AstraZeneca. However, the emergence of new variants and subvariants of SARS-CoV-2, characterized by enhanced transmissibility and immune evasion, poses significant challenges to the efficacy of current vaccination strategies. In this review, we aim to comprehensively outline the landscape of emerging SARS-CoV-2 variants of concern (VOCs) and sub-lineages that have recently surfaced in the post-pandemic years. We assess the effectiveness of existing vaccines, including their booster doses, against these emerging variants and subvariants, such as BA.2-derived sub-lineages, XBB sub-lineages, and BA.2.86 (Pirola). Furthermore, we discuss the latest advancements in vaccine technology, including multivalent and pan-coronavirus approaches, along with the development of several next-generation coronavirus vaccines, such as exosome-based, virus-like particle (VLP), mucosal, and nanomaterial-based vaccines. Finally, we highlight the key challenges and critical areas for future research to address the evolving threat of SARS-CoV-2 subvariants and to develop strategies for combating the emergence of new viral threats, thereby improving preparedness for future pandemics.}, } @article {pmid40333251, year = {2025}, author = {Paczkowska, A and Hoffmann, K and Andrzejczak, A and Pucek, WF and Kopciuch, D and Bryl, W and Nowakowska, E and Kus, K}, title = {The Application of mRNA Technology for Vaccine Production-Current State of Knowledge.}, journal = {Vaccines}, volume = {13}, number = {4}, pages = {}, pmid = {40333251}, issn = {2076-393X}, abstract = {Over the past 20 years, intensive research has been conducted on the development of therapeutic mRNA, leading to numerous discoveries that have enabled its use in therapy. The main achievements in this field include increasing mRNA stability, reducing its immunogenicity (i.e., its ability to trigger an immune response), and solving the challenge of delivering mRNA into cells-all to achieve a therapeutic effect. The aim of this study was to review the scientific literature on the use of mRNA technology in the production of vaccines. Various methods of applying mRNA technology that could potentially be introduced into clinical practice in the future are described. A detailed analysis was conducted on the approved COVID-19 vaccines developed by Pfizer/BioNTech (New York, NY, USA) and Moderna (Kirkland, QC, Canada), as their introduction marked a groundbreaking moment in the advancement of mRNA technology. This study was based on the latest scientific literature from reputable publishers and medical databases such as PubMed and ClinicalTrials. In conclusion, mRNA technology is currently experiencing rapid development, significantly driven by the ongoing COVID-19 pandemic. The application of this technology holds great potential not only for vaccines against infectious diseases but also for cancer treatment. However, further research is necessary to facilitate its broader clinical implementation.}, } @article {pmid40333241, year = {2025}, author = {Boikos, C and Schaible, K and Nunez-Gonzalez, S and Welch, V and Hu, T and Kyaw, MH and Choi, LE and Kamar, J and Goebe, H and McLaughlin, J}, title = {Co-Administration of BNT162b2 COVID-19 and Influenza Vaccines in Adults: A Global Systematic Review.}, journal = {Vaccines}, volume = {13}, number = {4}, pages = {}, pmid = {40333241}, issn = {2076-393X}, support = {N/A//This research was sponsored by Pfizer/ ; }, abstract = {BACKGROUND/OBJECTIVES: Co-administration of BNT162b2 with licensed seasonal influenza vaccines (SIVs) is recommended by health authorities. We provide a comprehensive summary of the data supporting this practice in adults.

METHODS: This systematic review consolidates available evidence on the prevalence, safety, immunogenicity, efficacy, and effectiveness of co-administering BNT162b2 and SIVs. Searches were conducted for English studies in adults ≥ 18 years of age between January 2021 and August 2024, with no geographic restriction. Study quality was assessed using Cochrane RoB 2.0 and the Newcastle-Ottawa Scale.

RESULTS: Twenty studies (15 observational and 5 clinical trials) were included, mainly conducted in seven countries in Europe and North America. Eight observational studies reported prevalence, twelve reported safety/reactogenicity, six reported immunogenicity, and three evaluated efficacy/effectiveness. Reported co-administration of BNT162b2 vaccines with SIVs increased over time. Of persons receiving BNT162b2, the proportion that reported co-administered SIVs increased from 2.7% in 2021 to 34.1% in 2023. Although variability in outcomes was observed, no consistent pattern indicating a negative impact on immunogenicity from same-day co-administration was identified. Effectiveness was not observed to change when BNT162B2 was co-administered with SIVs. The incidence of systemic and local adverse events was comparable between individuals receiving the vaccines separately and those receiving them co-administered.

CONCLUSIONS: The findings from this review indicate that the co-administration of BNT162B2 with SIVs is both safe and effective. This highlights the value of co-administration, which could enhance vaccine uptake by streamlining immunization protocols and reducing health visits.}, } @article {pmid40333234, year = {2025}, author = {Fatima, M and Hong, KJ}, title = {Innovations, Challenges, and Future Prospects for Combination Vaccines Against Human Infections.}, journal = {Vaccines}, volume = {13}, number = {4}, pages = {}, pmid = {40333234}, issn = {2076-393X}, support = {RS-2024-00331833//Ministry of Food and Drug Safety/ ; }, abstract = {Combination vaccines provide the versatile benefits of addressing different pathogens simultaneously using a combined formulation. This approach can be regarded as a substantial modernization in immunization. In this review, we highlight various advancements in combination vaccines based on mRNA, viral vectors, live attenuated, and recombinant vaccines. Recent success in clinical trials of mRNA platforms for combination vaccines has particularly accelerated research in this direction. The advantages of combination vaccines in terms of patient adherence, cost effectiveness, and streamlined immunization schedule are discussed. The existing challenges of antigenic interference, logistical hurdles, and the complications of regulatory standards are analyzed. Research trends to make combination vaccines viable for emerging infections have been summarized. The current work provides a critical overview, the existing opportunities, and the future prospects of combination vaccines.}, } @article {pmid40333208, year = {2025}, author = {Mulleners, SJ and Juncker, HG and Zuiderveld, J and Ziesemer, KA and van Goudoever, JB and van Keulen, BJ}, title = {Safety and Efficacy of Vaccination During Lactation: A Comprehensive Review of Vaccines for Maternal and Infant Health Utilizing a Large Language Model Citation Screening System.}, journal = {Vaccines}, volume = {13}, number = {4}, pages = {}, pmid = {40333208}, issn = {2076-393X}, abstract = {Newborns are born with an immature immune system, making them susceptible to infections early in life. Human milk provides essential nutrients and immunological factors that support infant immunity. Maternal vaccination during lactation has the potential to enhance these benefits by triggering an immune response in the mother, potentially extending protection to her child. However, lactating individuals are often excluded from vaccine trials, leading to uncertainties about vaccine safety and efficacy during the postpartum period. This study critically evaluates the effectiveness of vaccines in enhancing the immune-supporting properties of human milk and assesses their safety and efficacy for lactating mothers and their infants. By examining potential benefits alongside safety concerns, we aim to provide a comprehensive understanding of postpartum vaccination's impact on maternal and infant health. We utilized large-language models (LLMs) to enhance the review process and performed a structured literature search across Ovid/Medline, Embase, and Clarivate Analytics using terms like "breastfeeding", "postpartum", and "vaccination". A three-stage screening process involving human and LLM-assisted evaluation focused on postpartum vaccines and their implications for maternal and infant health. We identified 73 studies covering vaccines against COVID-19, cholera, influenza, pertussis, pneumococcal, rabies, polio, rotavirus, rubella, varicella, typhoid, smallpox, and yellow fever. Most vaccines, such as those for COVID-19 and influenza, appear safe and effective for postpartum use without requiring precautionary measures. However, caution is advised with vaccines such as the yellow fever vaccine, where temporary breastfeeding cessation is recommended. Overall, this review underscores the compatibility of most vaccines with lactation and suggests its benefits for both mother and infant.}, } @article {pmid40333142, year = {2025}, author = {Astroth, C and Shah, KS and Agrawal, S and Agrawal, A}, title = {Weathering the Storm: How Age and Biologics Influence the COVID-19 Cytokine Surge.}, journal = {Pathogens (Basel, Switzerland)}, volume = {14}, number = {4}, pages = {}, pmid = {40333142}, issn = {2076-0817}, mesh = {Humans ; *COVID-19/immunology ; *Biological Products/therapeutic use ; *Cytokines/immunology ; *Cytokine Release Syndrome/immunology ; *SARS-CoV-2/immunology ; Age Factors ; Aged ; *Aging/immunology ; Risk Factors ; }, abstract = {SARS-CoV-2, first identified in December 2019, caused a global pandemic, resulting in over 6.8 million deaths by March 2023. The elderly, or individuals over 65, accounted for the majority of COVID-19 deaths, with 81% of fatalities in the US in 2020 occurring in this group. Beyond mortality, aging populations are also at higher risk of long-term cardiovascular complications and acute respiratory distress syndrome (ARDS). Although these outcomes may be influenced by comorbidities common in the elderly, age has been found to be a standalone risk factor for severe COVID-19 infection. Therefore, investigating age-related factors in COVID-19 outcomes is crucial in protecting this vulnerable group. Of particular interest is the cytokine storm phenomenon, an excessive inflammatory response that contributes to severe COVID-19 symptoms, including ARDS and cardiovascular damage. Elevated levels of multiple cytokines are common in severe cases of COVID-19. We propose that changes that occur to cytokine profiles as we age may contribute to these aberrant inflammatory responses. This review specifically explored the interleukin class cytokines IL-1, IL-6, IL-17, and IL-23 and considered the potential of biologics targeting these cytokines to alleviate severe outcomes in both COVID-19 and aging individuals.}, } @article {pmid40333091, year = {2025}, author = {Jarneborn, A and Kopparapu, PK and Jin, T}, title = {The Dual-Edged Sword: Risks and Benefits of JAK Inhibitors in Infections.}, journal = {Pathogens (Basel, Switzerland)}, volume = {14}, number = {4}, pages = {}, pmid = {40333091}, issn = {2076-0817}, support = {ALFGBG-823941 and ALFGBG-933787 to T.J.; ALFGBG-770411 to A.J.//Swedish state under the agreement between the Swedish Government and the county councils, the ALF agreement/ ; 523-2013-2750 and 2019-01135 to T.J.//Swedish Medical Research Council/ ; 2023-419 to A.J, 2021-283 to PKK//Rune och Ulla Amlövs Stiftelse för Neurologisk och Reumatologisk Forskning/ ; SU-984331 and SU-998149 to A.J., SU-984446 to PKK.//Sahlgrenska University Hospitals Research Foundations/ ; }, mesh = {Humans ; *Janus Kinase Inhibitors/therapeutic use/adverse effects ; Animals ; Piperidines/therapeutic use/adverse effects ; Pyrimidines/therapeutic use ; SARS-CoV-2/drug effects ; Purines/therapeutic use ; COVID-19/immunology ; Mice ; Azetidines/therapeutic use ; Pyrazoles ; Sulfonamides ; }, abstract = {Janus kinase inhibitors (JAKis) represent a relatively new class of immunomodulatory drugs with potent effects on various cytokine signalling pathways. They have revolutionized the treatment landscape for autoimmune diseases such as rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis. However, their ability to modulate immune responses presents a dual-edged nature, influencing both protective immunity and pathological inflammation. This review explores the complex role of JAKis in infectious settings, highlighting both beneficial and detrimental effects. On the one hand, experimental models suggest that JAK inhibition can impair host defence mechanisms, increasing susceptibility to certain bacterial and viral infections. For example, tofacitinib-treated mice exhibited more severe joint erosions in Staphylococcus aureus (S. aureus) septic arthritis and showed impaired viral clearance in herpes simplex encephalitis. Additionally, clinical data confirm an increased risk of herpes zoster in patients receiving JAKis, underscoring the need for rigorous monitoring. On the other hand, JAK inhibition has demonstrated protective effects in certain infectious and hyperinflammatory conditions. In sepsis models, including cecal ligation and puncture (CLP) and S. aureus bacteraemia, tofacitinib improved survival by attenuating excessive inflammation. Furthermore, JAKis, particularly baricitinib, have shown substantial efficacy in mitigating cytokine storms during severe COVID-19 infections, leading to improved clinical outcomes and reduced mortality. These observations suggest that JAKis have a role in modulating hyperinflammatory responses in select infectious contexts. In conclusion, JAKis present a complex interplay between immunosuppression and immunomodulation. While they increase the risk of certain infections, they also show potential in managing hyperinflammatory conditions such as cytokine storms. The key challenge is determining which patients and situations benefit most from JAKis while minimizing risks, requiring a careful and personalized treatment approach.}, } @article {pmid40332501, year = {2025}, author = {Verbeeck Mendez, S and Do Orozco, IL and Gavilanez-Chavez, GE and Nava-Zavala, AH and Zavala-Cerna, MG}, title = {Challenges and Opportunities for Post-COVID Pulmonary Disease: A Focused Review of Immunomodulation.}, journal = {International journal of molecular sciences}, volume = {26}, number = {8}, pages = {}, pmid = {40332501}, issn = {1422-0067}, mesh = {Humans ; *COVID-19/complications/immunology ; *Immunomodulation ; SARS-CoV-2 ; *Immunomodulating Agents/therapeutic use ; COVID-19 Drug Treatment ; *Immunologic Factors/therapeutic use ; *Pulmonary Fibrosis/drug therapy/immunology/etiology ; Idiopathic Pulmonary Fibrosis/drug therapy/immunology ; }, abstract = {The resolution of the recent COVID-19 pandemic still requires attention, since the consequences of having suffered the infection, even in mild cases, are associated with several acute and chronic pathological conditions referred to as post-COVID syndrome (PCS). PCS often manifests with pulmonary disease and, in up to 9% of cases, a more serious complication known as post-COVID-19 pulmonary fibrosis (PC19-PF), which has a similar clinical course as idiopathic pulmonary fibrosis (IPF). Generating knowledge to provide robust evidence about the clinical benefits of different therapeutic strategies to treat the pulmonary effects of PCS can provide new insights to amplify therapeutic options for these patients. We present evidence found after a scoping review, following extended PRIMSA guidelines, for the use of immunomodulators in pulmonary PCS. We start with a brief description of the immunomodulatory properties of the relevant drugs, their clinically proven efficacy for viral infections and chronic inflammatory conditions, and their use during the COVID-19 pandemic. We emphasize the need for well-designed clinical trials to improve our understanding the physiopathology of pulmonary PCS and PC19-PF and also to determine the efficacy and safety of candidate treatments.}, } @article {pmid40330766, year = {2025}, author = {Khoshsirat, S and Soleimanpour, H and Rezaei-Hachesu, P}, title = {Strengths, Weaknesses, Opportunities, and Threats (SWOT) of Implementing Teleconsultation: A Systematic Review.}, journal = {Health science reports}, volume = {8}, number = {5}, pages = {e70645}, pmid = {40330766}, issn = {2398-8835}, abstract = {BACKGROUND AND AIMS: The COVID-19 pandemic has changed the traditional models of providing services in health systems. One of the recommended ways to provide healthcare services in this era is teleconsultation. This study aimed to determine the strengths, weaknesses, opportunities, and threats (SWOTs) of teleconsultation from the general practitioner's point of view and to implement it in the COVID-19 era.

METHODS: A systematic review was conducted by searching online databases, including the PubMed, Scopus, and WOS databases, from the beginning to January 1, 2024, without restrictions and using relevant keywords. All studies that mentioned at least one of the areas of strength, weakness, opportunities, or threats related to teleconsultation were included in the study. We used content analysis to combine the results.

RESULTS: Ultimately, 32 studies were included in this review. The most important factors were determined in four domains. Strengths included ease of use of technology, reduction of time and cost, and facilitating documentation. Weaknesses included a lack of physical exams, less direct communication, and internet-related problems. The opportunities included the increasing progress of medical technologies worldwide, continuity of care, and people's interest in the daily use of new technologies. Threats included sociocultural barriers, the need for continuous training, and competing interests.

CONCLUSION: Examining internal and external factors is important for formulating a plan. Identifying these factors and using them can lead to the formulation of effective and efficient programs in the field of teleconsultation for general practitioners in the era of COVID-19. Without paying attention to these issues, adopting appropriate plans to minimize weaknesses and threats, and effectively using strengths and opportunities to implement telemedicine projects, there is a possibility of failure and waste of time, effort, and credit in the health sector.}, } @article {pmid40330746, year = {2025}, author = {Kovačić Petrović, Z and Peraica, T and Blažev, M and Barac Furtinger, V and Kozarić-Kovačić, D}, title = {Depression and Anxiety Among Dentists: A Systematic Review and Meta-Analysis.}, journal = {Health science reports}, volume = {8}, number = {5}, pages = {e70786}, pmid = {40330746}, issn = {2398-8835}, abstract = {BACKGROUND AND AIMS: Many studies investigated the prevalence and severity of depression and anxiety among dentists. This systematic review aimed to determine: (i) the prevalence and severity of depression and anxiety symptoms, (ii) the prevalence rates of depression and anxiety before and during the COVID-19 pandemic, and (iii) gender difference in prevalence of depression and anxiety among dentists.

METHODS: Eligible articles on depression and anxiety in dentists were systematically searched for in PubMed and Scopus databases from September 2023 to October 2023 according to the Preferred Reporting Items for Systematic Review and Meta-Analysis protocol. We assessed the methodological quality of the studies using the Newcastle-Ottawa Quality Assessment checklist adapted for cross-sectional studies. Statistical heterogeneity across the studies was evaluated using Cochran's Q test and I [2] statistic. The prevalence rates of depression and anxiety were calculated using the random-effect model with the Restricted Maximum-Likelihood estimator. Of 3762 searched articles, 33 articles were analyzed.

RESULTS: The prevalence rates of depression and anxiety symptoms among dentists were 42% and 44%, respectively. The prevalence rates of mild, moderate, and severe or extremely severe depression were 20%, 18%, and 8%, respectively. For mild, moderate, and severe or extremely severe anxiety, the respective prevalence rates were 21%, 18%, and 11%. We did not find evidence to suggest differences in depression or anxiety prevalence rates between the periods before and during COVID-19. In comparison with men, women showed approximately 27% higher risk of experiencing depression and 24% higher risk of experiencing anxiety.

CONCLUSION: Equally high levels of depression and anxiety in dentists were found both before and during the COVID-19 pandemic, with a significant percentage of moderate to severe depression and anxiety. Female dentists reported a higher prevalence of depression and anxiety symptoms than their male colleagues.}, } @article {pmid40330066, year = {2025}, author = {Doroud, D and Daneshi, M and Kazemi-Lomedash, F and Eftekhari, Z}, title = {Comprehensive review of preclinical evaluation strategies for COVID-19 vaccine candidates: assessing immunogenicity, toxicology, and safety profiles.}, journal = {Iranian journal of microbiology}, volume = {17}, number = {1}, pages = {1-18}, pmid = {40330066}, issn = {2008-3289}, abstract = {Following the worldwide spread of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), there is a vital requirement for safe and effective vaccines against Coronavirus disease 2019 (COVID-19). Therefore, several vaccine-candidate platforms have been designed, tested, and developed. Based on guidelines, preclinical studies are recommended to assess the safety and potency of COVID-19 vaccines in appropriate in vitro and in vivo settings. These studies provide essential information to describe the potential toxic properties of a vaccine and the formulation of vaccine agents during the preclinical trial phase. In toxicology studies, several factors must be considered, such as the appropriate animal species and strains, dosing timetable, mode of administration, time of sampling for biochemistry and antibody evaluation, and necropsy. Pharmacokinetic/ biodistribution studies are not usually required for infectious disease prophylaxis vaccines unless the vaccine contains a novel substance. Evaluating their biodistribution is crucial for newly developed vaccines, such as lipid nanoparticles -messenger RNA (LNP-mRNA), DNA, and Viral vectors in non-replicated (VVnr), or recombinant virus vaccines. The review highlights the importance of preclinical studies in assessing the safety and efficacy of vaccine candidates. This guidance is essential for researchers and manufacturers to design effective vaccines that can progress to clinical trials safely.}, } @article {pmid40330025, year = {2025}, author = {Smail, SW and Albarzinji, N and Salih, RH and Taha, KO and Hirmiz, SM and Ismael, HM and Noori, MF and Azeez, SS and Janson, C}, title = {Microbiome dysbiosis in SARS-CoV-2 infection: implication for pathophysiology and management strategies of COVID-19.}, journal = {Frontiers in cellular and infection microbiology}, volume = {15}, number = {}, pages = {1537456}, pmid = {40330025}, issn = {2235-2988}, mesh = {Humans ; *Dysbiosis/microbiology/therapy ; *COVID-19/microbiology/physiopathology/therapy/complications ; *SARS-CoV-2 ; *Gastrointestinal Microbiome ; }, abstract = {The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiological agent of coronavirus disease 2019 (COVID-19), in late 2019 initiated a global health crisis marked by widespread infection, significant mortality, and long-term health implications. While SARS-CoV-2 primarily targets the respiratory system, recent findings indicate that it also significantly disrupts the human microbiome, particularly the gut microbiota, contributing to disease severity, systemic inflammation, immune dysregulation, and increased susceptibility to secondary infections and chronic conditions. Dysbiosis, or microbial imbalance, exacerbates the clinical outcomes of COVID-19 and has been linked to long-COVID, a condition affecting a significant proportion of survivors and manifesting with over 200 symptoms across multiple organ systems. Despite the growing recognition of microbiome alterations in COVID-19, the precise mechanisms by which SARS-CoV-2 interacts with the microbiome and influences disease progression remain poorly understood. This narrative review investigates the impact of SARS-CoV-2 on host-microbiota dynamics and evaluates its implications in disease severity and for developing personalized therapeutic strategies for COVID-19. Furthermore, it highlights the dual role of the microbiome in modulating disease progression, and as a promising target for advancing diagnostic, prognostic, and therapeutic approaches in managing COVID-19.}, } @article {pmid40328900, year = {2025}, author = {Chen, B and Farzan, M and Choe, H}, title = {SARS-CoV-2 spike protein: structure, viral entry and variants.}, journal = {Nature reviews. Microbiology}, volume = {23}, number = {7}, pages = {455-468}, pmid = {40328900}, issn = {1740-1534}, support = {R01 AI127193/AI/NIAID NIH HHS/United States ; }, mesh = {*Spike Glycoprotein, Coronavirus/chemistry/genetics/metabolism ; *Virus Internalization ; *SARS-CoV-2/physiology/genetics/chemistry ; Humans ; *COVID-19/virology ; }, abstract = {Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been a devastating global pandemic for 4 years and is now an endemic disease. With the emergence of new viral variants, COVID-19 is a continuing threat to public health despite the wide availability of vaccines. The virus-encoded trimeric spike protein (S protein) mediates SARS-CoV-2 entry into host cells and also induces strong immune responses, making it an important target for development of therapeutics and vaccines. In this Review, we summarize our latest understanding of the structure and function of the SARS-CoV-2 S protein, the molecular mechanism of viral entry and the emergence of new variants, and we discuss their implications for development of S protein-related intervention strategies.}, } @article {pmid40327531, year = {2025}, author = {Sylvester, PA and Heise, MT}, title = {The Collaborative Cross as a Model for Studying Viral Infections.}, journal = {Annual review of virology}, volume = {12}, number = {1}, pages = {401-419}, doi = {10.1146/annurev-virology-100422-031014}, pmid = {40327531}, issn = {2327-0578}, mesh = {Animals ; *Virus Diseases/virology/genetics ; Mice ; Humans ; *Disease Models, Animal ; *Collaborative Cross Mice ; *Host-Pathogen Interactions/genetics ; Genetic Variation ; *Viruses/pathogenicity/genetics ; Genetic Predisposition to Disease ; }, abstract = {Inbred mouse strains are an invaluable resource for modeling virus-host interactions and studying how specific host genes affect virus-induced disease. However, many viruses cause a spectrum of disease outcomes in humans ranging from asymptomatic infection to severe disease or death. Conventional mouse strains do not recapitulate human genetic diversity and often fail to reproduce the full spectrum of virus-induced disease phenotypes seen in humans. The Collaborative Cross (CC) recombinant inbred mouse population is a genetically diverse set of mouse strains designed to model the genetic and phenotypic diversity seen in human populations. The CC has been used to study the effect of host genetic variation on the pathogenesis of several human viruses, and we review the utility of the CC as a resource both for developing new models of virus-induced disease and for the identification and study of host gene variants that affect susceptibility to virus-induced disease.}, } @article {pmid40327249, year = {2025}, author = {Li, JY and Jiang, RY and Wang, J and Wang, XJ}, title = {Advances in mRNA vaccine therapy for breast cancer research.}, journal = {Discover oncology}, volume = {16}, number = {1}, pages = {673}, pmid = {40327249}, issn = {2730-6011}, support = {TGD23H160004//Natural Science Foundation of Zhejiang Province, China/ ; }, abstract = {Breast cancer represents the most prevalent cancer among women globally, constituting approximately 30% of newly diagnosed female malignancies and serving as the second leading cause of cancer-related mortality, accounting for 11.6% of deaths. Despite notable advancements in survival rates and quality of life for breast cancer patients over recent decades-achieved through interventions such as surgery, chemotherapy, radiotherapy, and endocrine therapy-there remains an urgent need for novel therapeutic strategies. This necessity arises from challenges associated with recurrence, metastasis, and drug resistance. The COVID-19 pandemic has accelerated the development of Messenger RNA (mRNA) vaccines at an unprecedented pace, and as a novel form of precision immunotherapy, mRNA vaccines are increasingly being recognized for their potential in cancer treatment. mRNA vaccines efficiently produce antigens within the cytoplasm, specifically activating the immune system to target tumor cells while minimizing the risk of T-cell tolerance. Therefore, mRNA vaccines have emerged as a promising approach in cancer immunotherapy. This review systematically examines the principles, mechanisms, advantages, key targets, and recent progress in mRNA vaccine therapy for breast cancer. Furthermore, it discusses current challenges and suggests potential directions for future research.}, } @article {pmid40327103, year = {2025}, author = {Bereczki, D and Dénes, Á and Boneschi, FM and Akhvlediani, T and Cavallieri, F and Fanciulli, A and Filipović, SR and Guekht, A and Helbok, R and Hochmeister, S and von Oertzen, TJ and Özturk, S and Priori, A and Rakusa, M and Willekens, B and Moro, E and Sellner, J and , }, title = {Need for awareness and surveillance of long-term post-COVID neurodegenerative disorders. A position paper from the neuroCOVID-19 task force of the European Academy of Neurology.}, journal = {Journal of neurology}, volume = {272}, number = {6}, pages = {380}, pmid = {40327103}, issn = {1432-1459}, mesh = {Humans ; *COVID-19/complications/epidemiology ; *Neurodegenerative Diseases/epidemiology/etiology/pathology ; Europe/epidemiology ; Neurology/standards ; Advisory Committees ; }, abstract = {BACKGROUND: Neuropathological and clinical studies suggest that infection with SARS-CoV-2 may increase the long-term risk of neurodegeneration.

METHODS: We provide a narrative overview of pathological and clinical observations justifying the implementation of a surveillance program to monitor changes in the incidence of neurodegenerative disorders in the years after COVID-19.

RESULTS: Autopsy studies revealed diverse changes in the brain, including loss of vascular integrity, microthromboses, gliosis, demyelination, and neuronal- and glial injury and cell death, in both unvaccinated and vaccinated individuals irrespective of the severity of COVID-19. Recent data suggest that microglia play an important role in sustained COVID-19-related inflammation, which contributes to the etiology initiating a neurodegenerative cascade, to the worsening of pre-existing neurodegenerative disease or to the acceleration of neurodegenerative processes. Histopathological data have been supported by neuroimaging, and epidemiological studies also suggested a higher risk for neurodegenerative diseases after COVID-19.

CONCLUSIONS: Due to the high prevalence of COVID-19 during the pandemic, healthcare systems should be aware of, and be prepared for a potential increase in the incidence of neurodegenerative diseases in the upcoming years. Strategies may include follow-up of well-described cohorts, analyses of outcomes in COVID-19-registries, nationwide surveillance programs using record-linkage of ICD-10 diagnoses, and comparing the incidence of neurodegenerative disorders in the post-pandemic periods to values of the pre-pandemic years. Awareness and active surveillance are particularly needed, because diverse clinical manifestations due to earlier SARS-CoV-2 infections may no longer be quoted as post-COVID-19 symptoms, and hence, increasing incidence of neurodegenerative pathologies at the community level may remain unnoticed.}, } @article {pmid40326310, year = {2025}, author = {El-Naas, A and Hamad, O and Nair, S and Alfakhri, B and Mahmoud, S and Haji, A and Ahmed, L and Lebbe, A and Aboulwafa, A and Shaikh, F and Bouhali, I and Zakaria, D}, title = {New onset of type 1 and type 2 diabetes post-COVID-19 infection: a systematic review.}, journal = {Emerging microbes & infections}, volume = {14}, number = {1}, pages = {2492211}, pmid = {40326310}, issn = {2222-1751}, mesh = {Humans ; *COVID-19/complications/epidemiology ; *Diabetes Mellitus, Type 1/epidemiology/etiology ; *Diabetes Mellitus, Type 2/epidemiology/etiology ; Prevalence ; Risk Factors ; SARS-CoV-2 ; }, abstract = {COVID-19 may primarily cause respiratory symptoms but can lead to long-term effects known as long COVID. COVID-19-induced diabetes mellitus was reported in many patients which shares characteristics of types 1 and 2 (T1DM and T2DM). This study aims to identify and analyse the reported cases of new onset diabetes post-COVID-19 infection. Several databases were used to conduct a comprehensive literature search to target studies reporting cases of T1DM or T2DM post-COVID-19 infection. Screening, data extraction, and cross-checking were performed by two independent reviewers. Only 43 studies met our inclusion criteria. Our results revealed that the overall prevalence of new onset diabetes post-COVID-19 was 1.37% with higher prevalence for T2DM (0.84%) as compared to T1DM (0.017%) while the type of diabetes was not reported in 0.51% of the cases. Several risk factors for developing diabetes post-COVID-19 infection were identified including the type of SARS-CoV-2 variant, age, comorbidities, and the vaccination status. The direct viral attack of the pancreatic beta cells as well as inflammation and the anti-inflammatory corticosteroids were proposed as possible mechanisms of the COVID-19 induced diabetes. A multidisciplinary approach involving endocrinologists, primary care physicians, and infectious disease specialists should be implemented in the management of post-COVID patients to address both the acute and long-term complications, including metabolic changes and risk of diabetes.}, } @article {pmid40325547, year = {2025}, author = {Srikumar, G and Finlayson, C and Bissett, I and Harmston, C}, title = {Remote Follow-Up After Colorectal Cancer Surgery: A Systematic Review.}, journal = {ANZ journal of surgery}, volume = {}, number = {}, pages = {}, doi = {10.1111/ans.70141}, pmid = {40325547}, issn = {1445-2197}, abstract = {BACKGROUND: Remote consultations are increasingly being utilized in colorectal cancer follow-up, especially since the COVID-19 pandemic, with benefits continuing beyond the pandemic. It is not clear how remote modalities affect patient satisfaction, quality of life (QoL) and safety of colorectal cancer follow-up.

OBJECTIVES: To investigate the impact of remote follow-up on patient satisfaction, QoL, clinician satisfaction, adherence to investigations, readmission rates, recurrence rates, and mortality rates for colorectal cancer.

METHODS: A systematic review was performed using three electronic databases: MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials, along with grey literature. Eligible studies included remote techniques such as telephone, video, or patient-initiated follow-up (PIFU) compared with standard face-to-face follow-up in patients who have undergone colorectal cancer resection. Two independent reviewers screened studies and assessed the risk of bias.

RESULTS: A total of 4417 records were identified with seven studies included. Six studies showed high levels of patient satisfaction in remote follow-up, with two studies showing significantly better satisfaction than standard follow-up. Two studies evaluated QoL, with one showing significantly better QoL in the remote follow-up group than the standard, and the other study showing comparable levels. Safety outcomes were minimally reported, but there were no adverse outcomes. There was at least moderate risk of bias in the four nonrandomized interventions due to confounding from patient selection into intervention groups.

CONCLUSIONS: Remote follow-up in colorectal cancer appears to be comparable to face-to-face follow-up with high levels of patient satisfaction and QoL. While adherence to follow-up investigations was not compromised, the evidence on oncological impact is limited, and further studies on mortality and recurrence rates are required to ensure overall safety.}, } @article {pmid40324776, year = {2025}, author = {Ma, C and Fang, Y and Zhang, H and Zheng, Y and Zhang, Y and Zhao, W and Yan, G and Zeng, Y and Zhang, Y and Ning, X and Jia, Z and Guo, N}, title = {Nurse-Delivered Telehealth in Home-Based Palliative Care: Integrative Systematic Review.}, journal = {Journal of medical Internet research}, volume = {27}, number = {}, pages = {e73024}, pmid = {40324776}, issn = {1438-8871}, mesh = {*Telemedicine/organization & administration ; Humans ; *Palliative Care/methods ; *Home Care Services/organization & administration ; COVID-19/epidemiology ; Nurse's Role ; }, abstract = {BACKGROUND: Telehealth technologies can enhance patients' and their families' access to high-quality resources in home-based palliative care. Nurses are deeply involved in delivering telehealth in home-based palliative care. However, no previous integrative systematic reviews have synthesized evidence on nurses' roles, facilitators, and barriers to implementing nurse-delivered telehealth in home-based palliative care.

OBJECTIVE: This integrative systematic review aimed to provide a comprehensive understanding of the roles of nurses and the multilevel facilitators and barriers to implementing nurse-delivered telehealth in home-based palliative care, which could inform future policy development, research, and clinical practice.

METHODS: This integrative systematic review was conducted using Joanna Briggs Institute methodological guidance. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We systematically searched articles published from January 1, 2014, to May 2024 in PubMed, Embase, Web of Science, CINAHL, and Cochrane Library. We included English-language; peer-reviewed; original; and qualitative, quantitative, and mixed methods studies that centered on nurse-delivered telehealth in home-based palliative care. We used the Mixed Methods Appraisal Tool to assess the quality of the included articles. Furthermore, 3 authors independently assessed eligibility, extracted data, and assessed the quality of articles. The entities to extract were identified by research questions of interest regardless of the type of study. We applied a convergent synthesis approach to integrate quantitative and qualitative data. Guided by the updated Consolidated Framework for Implementation Research (CFIR) 2.0, we synthesized the facilitators and barriers to implementing nurse-delivered telehealth in home-based palliative care.

RESULTS: This integrative systematic review identified 4819 unique articles, including 34 papers encompassing 29 unique primary research studies. Innovations were mainly delivered by nurses (n=8) and nurse-involved multiprofessional teams (n=18). The roles of nurses in telehealth home-based palliative care involve palliative care nurses, community nurses, nurse coordinators, nurse coaches or nurse navigators, and nurse case managers. Guided by CFIR 2.0, facilitators and barriers to implementing nurse-delivered, telehealth, home-based palliative care were identified to 6 implementation levels and 20 constructs. The key facilitators included the COVID-19 pandemic, cost avoidance to the health care system, engagement of patients and their family caregivers, and so on. The barriers included a lack of reimbursement and payment mechanisms, technical problems, insufficiently trained health care providers, and so on.

CONCLUSIONS: This integrative systematic review synthesizes evidence on nurses' evolving roles in telehealth home-based palliative care and identifies multilevel facilitators and barriers to nurse-delivered, home-based palliative care implementation. With the empowerment of telehealth technologies, nurses could establish a stronger professional identity and develop leadership in home-based palliative care. Nurses should leverage influence to promote nursing practice, clinical management, and policy support in the implementation of telehealth home-based palliative care.

TRIAL REGISTRATION: PROSPERO CRD42024541038; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024541038.}, } @article {pmid40324661, year = {2025}, author = {Raju, V and Reddy, R and Javan, AC and Hajihossainlou, B and Weissleder, R and Guiseppi-Elie, A and Kurabayashi, K and Jones, SA and Faghih, RT}, title = {Tracking inflammation status for improving patient prognosis: A review of current methods, unmet clinical needs and opportunities.}, journal = {Biotechnology advances}, volume = {82}, number = {}, pages = {108592}, pmid = {40324661}, issn = {1873-1899}, support = {R35 GM151353/GM/NIGMS NIH HHS/United States ; }, mesh = {Humans ; *Inflammation/diagnosis/metabolism ; COVID-19/diagnosis/immunology ; Prognosis ; Biomarkers/metabolism ; SARS-CoV-2 ; Cytokines/metabolism ; Neoplasms/diagnosis ; Autoimmune Diseases/diagnosis ; }, abstract = {Inflammation is the body's response to infection, trauma or injury and is activated in a coordinated fashion to ensure the restoration of tissue homeostasis and healthy physiology. This process requires communication between stromal cells resident to the tissue compartment and infiltrating immune cells which is dysregulated in disease. Clinical innovations in patient diagnosis and stratification include measures of inflammatory activation that support the assessment of patient prognosis and response to therapy. We propose that (i) the recent advances in fast, dynamic monitoring of inflammatory markers (e.g., cytokines) and (ii) data-dependent theoretical and computational modeling of inflammatory marker dynamics will enable the quantification of the inflammatory response, identification of optimal, disease-specific biomarkers and the design of personalized interventions to improve patient outcomes - multidisciplinary efforts in which biomedical engineers may potentially contribute. To illustrate these ideas, we describe the actions of cytokines, acute phase proteins and hormones in the inflammatory response and discuss their role in local wounds, COVID-19, cancer, autoimmune diseases, neurodegenerative diseases and aging, with a central focus on cardiac surgery. We also discuss the challenges and opportunities involved in tracking and modulating inflammation in clinical settings.}, } @article {pmid40324574, year = {2025}, author = {Li, M and Gu, X and Yang, J and Zhang, C and Zhou, Y and Huang, P and Wang, X and Zhang, L and Jiang, L and Zhai, L and Yu, M and Cheng, G and Yang, L}, title = {Luteolin: A potential therapeutic agent for respiratory diseases.}, journal = {European journal of pharmacology}, volume = {999}, number = {}, pages = {177699}, doi = {10.1016/j.ejphar.2025.177699}, pmid = {40324574}, issn = {1879-0712}, mesh = {Humans ; *Luteolin/therapeutic use/pharmacology/adverse effects ; Animals ; COVID-19 Drug Treatment ; COVID-19 ; Signal Transduction/drug effects ; Anti-Inflammatory Agents/therapeutic use/pharmacology ; *Respiratory Tract Diseases/drug therapy/metabolism ; }, abstract = {Acute lung injury, COVID-19, lung cancer, and asthma are a few of the respiratory conditions that are the main causes of morbidity and mortality worldwide. The increasing incidence and mortality rates have attracted significant attention to the prevention and treatment of these conditions. In recent years, there has been a renewed interest in utilizing naturally derived compounds as therapeutic agents for respiratory diseases. Luteolin (Lut), a flavonoid compound, possesses an extensive range of pharmacological characteristics, encompassing anti-inflammatory, antioxidative, antineoplastic, and antimicrobial activities. However, a comprehensive summary of Lut's therapeutic effects and mechanisms in respiratory diseases remains lacking. This review examines the physicochemical properties, toxicity, and avenues of Lut's action in respiratory ailments. Lut exerts therapeutic effects through pathways such as nuclear factor kappa-B (NF-κB), nuclear factor erythroid 2-related factor 2 (Nrf2), mitogen-activated protein kinase (MAPK), janus kinase 1 (JAK1)/signal transducer and activator of transcription 3 (STAT3), phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT), and pyroptosis, modulating key processes such as the suppression of inflammatory mediators, attenuation of oxidative assault, and induction of apoptosis in lung cancer cells. This review strives to provide critical realizations into respiratory disease therapeutics and contribute to the foundation for drug development.}, } @article {pmid40322881, year = {2025}, author = {Vieira Junior, JCA and Sander, MRL and Matos, JAO and Medeiros, AM and Silva, FSD and Aires, CAM}, title = {Neurological Post-Acute Sequelae of COVID-19 in Non-Hospitalized Patients: An Integrative Review.}, journal = {Biological research for nursing}, volume = {27}, number = {4}, pages = {652-665}, doi = {10.1177/10998004251335968}, pmid = {40322881}, issn = {1552-4175}, mesh = {Humans ; *COVID-19/complications ; *Nervous System Diseases/etiology ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; }, abstract = {The COVID-19 pandemic has had a significant impact on the global population. The infection, caused by SARS-CoV-2, presents with a variety of clinical manifestations, from asymptomatic cases to more severe forms, including a variety of neurological symptoms, such as fatigue, weakness, brain fog, paresthesias, dysautonomia, anosmia, and dysgeusia. Additionally, the disease is associated with the long COVID syndrome, in which there is persistence of the effects and symptoms of the acute phase. In recent years the literature has shown relevant data on long COVID, but there is still a need to deepen the knowledge about these long term manifestations. Thus, the present study aimed to describe the main neurological sequelae resulting from SARS-CoV-2 infection in non-hospitalized population during the long phase of the disease, gathering scientific evidence through an integrative review of the prevalence of symptoms, patient profile, duration and severity of sequelae, risk factors, comorbidities, and possible nervous system structural damage. The PubMed/Medline database was used with descriptors and, at the end of the screening process with predefined inclusion and exclusion criteria, 22 studies were included. A group of neurological symptoms associated with long COVID was identified: myalgia, dysgeusia, memory alterations, olfactory dysfunction, dizziness, and pain. Most patients presented multiple symptoms that lasted for more than one year with a significant impact on quality of life. The main risk factors were dyslipidemia, age, ethnicity, muscle/ joint pain, and sex. This review highlights the importance of further studies on the syndrome, its etiology, diagnosis, follow-up, and treatments.}, } @article {pmid40322752, year = {2025}, author = {Stanicki, B and Criscione, JX and Shaari, AL and Thompson, K and Galdi, B}, title = {An Analysis of Fencing Injuries in the United States: A 10-Year Database Review.}, journal = {Orthopaedic journal of sports medicine}, volume = {13}, number = {4}, pages = {23259671251334774}, pmid = {40322752}, issn = {2325-9671}, abstract = {BACKGROUND: Fencing has maintained sustained popularity in the United States and internationally. However, there is limited information regarding acute injury patterns among fencing athletes.

PURPOSE: To determine the prevalence of fencing injuries evaluated at emergency departments in the United States from 2013 to 2023 and analyze trends in diagnosis by demographics, mechanism of action, and disposition status.

STUDY DESIGN: Descriptive epidemiological study.

METHODS: The US Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS) database was queried in June of 2024 using the product code 3260-Fencing (activity/apparel/equipment). The analysis included descriptive statistics for diagnosis prevalence and demographics, univariate analysis utilizing diagnosis and demographic data, and a text analysis of the narrative descriptions.

RESULTS: From 2013 to 2023, 129 fencing-related injuries were reported from US emergency departments, representing an NEISS national estimate of 3418 (95% CI, 2200-4636). The most common age group affected was 11 to 15 years (35.7%), followed by 16 to 20 years (29.5%), with a median age of 16 years. Most injured individuals were White (49.65%) and male (56.5%). However, there was an upward trend in injuries among female athletes throughout the study. The most frequent injuries were strains or sprains (26.4%), lacerations (15.5%), fractures (11.6%), and contusions/abrasions (10.9%). Fracture prevalence was higher in females than males (14.4% vs 9.6%; P1 = .04). Males experienced a higher laceration prevalence (21.9% vs 7.1%; P = .02). The most affected body part was the finger (14%), followed by the wrist (8.5%), leg (8.5%), and head (7.8%). Most injuries occurred in sports-specific facilities (70%), followed by personal homes. Regarding disposition, 97.7% of all patients were treated and released. Fencing injuries rose steadily until the COVID-19 pandemic caused a decline, but they have since rebounded.

CONCLUSION: Fencing injuries decreased significantly during the COVID-19 pandemic but have since become more prevalent. Fractures were more prevalent among females, whereas males had a higher prevalence of lacerations. Understanding the epidemiology and nature of fencing injuries can help inform coaches, athletes, and health care providers about potential risks and injury prevention strategies.}, } @article {pmid40322032, year = {2025}, author = {Zhou, F and Pang, Z and Chen, Z and Hu, K and Luo, J and Huang, S and Qu, Q}, title = {Bibliometric Analysis of Non-Vitamin K Antagonist Oral Anticoagulants (NOACS) in the Prevention of Venous Thrombosis and Pulmonary Embolism.}, journal = {Drug design, development and therapy}, volume = {19}, number = {}, pages = {3589-3610}, pmid = {40322032}, issn = {1177-8881}, mesh = {Humans ; *Pulmonary Embolism/prevention & control ; *Anticoagulants/administration & dosage/therapeutic use ; *Bibliometrics ; Administration, Oral ; *Venous Thrombosis/prevention & control ; }, abstract = {INTRODUCTION: Venous thromboembolism (VTE) is a leading cause of cardiovascular-related deaths. Non-vitamin K antagonist oral anticoagulants (NOACs) offer effective therapy without injections or blood monitoring. This bibliometric analysis explores the research on NOACs for preventing VTE and pulmonary embolism.

METHODS: Literature up to July 20, 2024, was searched in Web of Science Core Collection. Citespace software was used for screening and analysis.

RESULTS: In this study, we analyzed 2124 articles and 767 reviews from 11,282 institutions across 528 countries and regions, encompassing 830 publications and 60 research directions. The USA led in publication count, followed by Germany and Canada. Cardiovascular System Cardiology, Hematology, and General Internal Medicine were the top research areas, while THROMBOSIS AND HAEMOSTASIS was the leading journal. From 2004 to 2024, we observed accelerated publication growth, particularly from 2008, highlighting the emergence of NOACs as a major research focus. Key contributors, including Bengt I. Eriksson, and major institutions like Harvard Medical School and University of Amsterdam, played pivotal roles in advancing anticoagulant research. Co-citation and keyword clustering analyses revealed research hotspots in NOACs, cancer-associated venous thromboembolism, stroke prevention, and COVID-19-related thrombotic events, reflecting a shift towards individualized anticoagulation therapy and the growing importance of NOACs in various clinical contexts.

CONCLUSION: The development of NOACs has progressed rapidly, with an increasing number of publications, indicating the lead research in the United States and other Western nations. Comparative studies on the safety and efficacy of NOACs have become a significant focus, shifting from traditional anticoagulants. Pharmacogenetics-guided use of NOACS shows new hope of precision medicine.}, } @article {pmid40321932, year = {2025}, author = {Rehman, S and Ghazali, SR and Elklit, A}, title = {COVID-19 and Psychopathologies in Children-A Single Session Intervention Plan to Promote Mental Health during Crises Management: A Systematic Review.}, journal = {Iranian journal of public health}, volume = {54}, number = {4}, pages = {688-700}, pmid = {40321932}, issn = {2251-6093}, abstract = {BACKGROUND: The world has experienced numerous natural and man-made disasters throughout history. Due to these unforeseen circumstances, children and adolescents have reported significant psychopathologies in response to traumatic experiences. We aimed to investigate the surge of internalizing and externalizing psychopathologies during COVID-19 and to assess the efficacy of single-session therapies used to treat mental health issues during this period.

METHODS: Overall, 270 articles were retrieved across both phases of the study, with 250 articles identified in Phase I and 20 in Phase II. Following the PRISMA flowchart guidelines, approximately 30 studies were selected to meet the objective of Phase I, while 10 studies were chosen to address the objective of Phase II. The articles were retrieved from various databases, including PubMed, Google Scholar, Scopus, Ovid, CENTRAL, JSTOR, NCBI, and Science Direct. Only articles published between 2019 and 2022 were included in the study.

RESULTS: The findings of first phase of study indicated a surge in internalizing psychopathologies (such as anxiety, depression, loneliness, and somatic problems) and externalizing psychopathologies (including conduct/oppositional disorders, sleep disturbances, suicidal ideation, ADHD, and substance abuse) over the past four years. Additionally, according to the findings of the second phase of the study, single-session therapies were found to be effective in mitigating symptoms of depression and anxiety.

CONCLUSION: The study's findings are discussed in the context of counseling adolescents, highlighting the importance of addressing mental health issues in this demographic.}, } @article {pmid40321796, year = {2025}, author = {Walewangko, OC and Purnomo, JS and Jo, PA and Vidian, V and Jo, J}, title = {Prophylactic vaccination strategies for adult patients with diabetes: a narrative review of safety profiles and clinical effectiveness.}, journal = {Clinical and experimental vaccine research}, volume = {14}, number = {2}, pages = {101-115}, pmid = {40321796}, issn = {2287-3651}, abstract = {This narrative review analyzed roles of several prophylactic vaccinations in adult patients with diabetes, focusing on their safety profiles and clinical effectiveness. Individuals with diabetes mellitus are at increased risk for infections, making vaccination a critical component of their healthcare. The review assessed various vaccines that are particularly relevant for this population, i.e., vaccines for pneumococcus, meningococcus, severe acute respiratory syndrome coronavirus 2, influenza, herpes zoster, human papillomavirus, and dengue. It highlighted the safety profiles and clinical effectiveness of these vaccines in preventing serious infections and improving long-term health outcomes in diabetic patients. Taken together, this review emphasized the importance of prophylactic vaccinations in reducing infection-related morbidity and mortality as well as encouraged fostering greater adoption and advocacy for immunization programs among diabetic adults.}, } @article {pmid40321651, year = {2025}, author = {Mosley, TJ and Zajdel, RA and Alderete, E and Clayton, JA and Heidari, S and Pérez-Stable, EJ and Salt, K and Bernard, MA}, title = {Intersectionality and diversity, equity, and inclusion in the healthcare and scientific workforces.}, journal = {Lancet regional health. Americas}, volume = {41}, number = {}, pages = {100973}, pmid = {40321651}, issn = {2667-193X}, abstract = {Enhancing diversity, equity, and inclusion (DEI) in the scientific and healthcare workforces∗ promotes research innovation and equitable access to quality healthcare. Efforts to advance DEI within the global scientific and healthcare workforces have assumed a new urgency given the strain caused by the COVID-19 pandemic, the aging of the global population, and the persistent shortages in the healthcare workforce, particularly in low- and middle-income countries. Yet, these fields continue to struggle to promote DEI. Considering the impact of intersectionality-how multiple identities interact to create unique experiences of privilege and power-within these workforces will enhance efforts to promote DEI. This series explores the impact of intersectionality on scientific and healthcare workforce DEI and how prominent institutional and structural factors (e.g., sexism and racism), as well as their interpersonal manifestations, can create barriers for workers with multiple intersecting marginalised identities. This paper, the first in a three-part series, describes how intersecting identities interact with workplace inequities and suggests ways to incorporate intersectionality into DEI efforts within the scientific and healthcare workforces. ∗We use the phrase scientific and healthcare workforces throughout this article to broadly encompass individuals associated with the biomedical, clinical, behavioral, and population science workforce.}, } @article {pmid40321580, year = {2025}, author = {Zheng, J and Pang, Q and Fu, Z}, title = {Replication Features of SARS-CoV-2 and Advantages of Targeting S Protein with Aptamers to Block Viral Entry.}, journal = {ACS omega}, volume = {10}, number = {16}, pages = {15840-15851}, pmid = {40321580}, issn = {2470-1343}, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a virus of the coronaviridae family. The virus enters the cell through binding to the corresponding receptor angiotensin-converting enzyme 2 (ACE2) on host cell membrane with the spike protein (S protein) on its envelope; thus, we can design inhibitors that bind the S protein to block the entry of the virus into cells. Aptamers are single stranded DNA or RNA molecules that can form specific three-dimensional structures and bind their target molecules with high affinity and specificity and thus are promising candidates for S protein inhibitors. This paper reviews the replication cycle and cell entry mechanisms of SARS-CoV-2 as well as the preparation principle and characteristics of aptamers, features a discussion of the advantages of using aptamers to target the S protein to prevent SARS-CoV-2 from infecting cells, and finally summarizes the research progress in S protein-blocking aptamers.}, } @article {pmid40321454, year = {2025}, author = {Miyamoto, T and Fujita, M and Hachiya, M and Yokobori, Y and Komada, K and Murakami, H}, title = {Overview of global governance, capacity, and health systems implication of pandemic prevention, preparedness, and response: A narrative review and descriptive analysis of open-source data.}, journal = {Global health & medicine}, volume = {7}, number = {2}, pages = {112-126}, pmid = {40321454}, issn = {2434-9194}, abstract = {The COVID-19 pandemic has highlighted the importance of pandemic prevention, preparedness, and response (PPPR) in global health. This review first examined global health governance (GHG) for PPPR, identifying its core-satellite structure. Key GHG functions include rule-setting, resource mobilization, medical countermeasures (MCMs) supply, surveillance and data/pathogen sharing with rapid response, and One Health. Major gaps exist in global collaboration, enforcement of the International Health Regulations (IHR), and the World Health Organization's (WHO) capacity. The most urgent issue is pathogen access and benefit-sharing (PABS). Second, the PPPR capacity across world regions were assessed using two public datasets: eSPAR and GHS Index. Sub-Saharan Africa requires urgent support to strengthen most PPPR aspects, while epidemiological and laboratory surveillance, infection prevention and control (IPC), and regulatory functions need improvement in low- and middle-income countries (LMICs) in various regions outside Europe. Japan, with its strong PPPR capacity, is well-positioned to assist. Lastly, the review explored the link between PPPR and health systems strengthening (HSS). PPPR must be firmly integrated into HSS to ensure resilience, equity, inclusiveness, continuity of care, and sustainability. Core health system components - service delivery, workforce, health information systems, MCMs access, and governance - along with communication and trust-building, effectively contribute to PPPR. However, pandemic exceptionalism and the over-securitization of PPPR and health security may hinder coordination. The enhanced GHG for PPPR, led by the empowered WHO, should effectively facilitate and coordinate technical assistance to LMICs to strengthen their PPPR capacities and promote PPPR-HSS integration by bringing together the often-divided health security and HSS communities.}, } @article {pmid40321452, year = {2025}, author = {Saito, T and Sunagawa, T and Suzuki, M and Matano, T and Wakita, T}, title = {Enhancing health security against infectious diseases: Perspectives on the emergency operations capabilities of the Japan Institute for Health Security.}, journal = {Global health & medicine}, volume = {7}, number = {2}, pages = {82-89}, pmid = {40321452}, issn = {2434-9194}, abstract = {The Japan Institute for Health Security (JIHS) will be established in April 2025 by merging the National Institute of Infectious Diseases (NIID) and the National Center for Global Health and Medicine (NCGM). JIHS aims to enhance health security against infectious disease crises by integrating NIID's surveillance, epidemiologic investigation, and research expertise with NCGM's clinical care and research capabilities. An effective response to an infectious disease crisis depends on robust intelligence, systematic data analysis, and surge capacity - the ability to rapidly scale responses through mobilization of resources and an established infrastructure. An Emergency Operations Center (EOC), which centralizes emergency response coordination, is critical to harmonizing these diverse capabilities, enabling technical experts to focus effectively on specialized tasks. NIID has contributed to disease prevention through surveillance, laboratory reference services, and devising medical countermeasures. The establishment of NIID's Center for Emergency Preparedness and Response (CEPR) in 2020 and the EOC in 2021 markedly improved crisis management in the NIID, as demonstrated during events like Tokyo 2020 and the SARS-CoV-2 Omicron variant outbreak. These experiences highlight the importance of centralized coordination, which is being incorporated in the operational framework of the newly established JIHS. This article reviews NIID EOC's evolution and its crucial role in enhancing Japan's health security by consolidating lessons learned from recent public health crises.}, } @article {pmid40321451, year = {2025}, author = {Chu, C}, title = {Effect of the establishment of the Korea Centers for Disease Control and Prevention/Korea Disease Control and Prevention Agency from the perspective of global health security.}, journal = {Global health & medicine}, volume = {7}, number = {2}, pages = {141-150}, pmid = {40321451}, issn = {2434-9194}, abstract = {The Korea Centers for Disease Control and Prevention (KCDC) was established in 2004 after the SARS epidemic. As a national disease control agency, KCDC strengthened its capacities for global health security based on experiences from some important issues such as the Influenza A/H1N1 pandemic (2009), the Middle East Respiratory Syndrome outbreak in Korea (2015), the Zika epidemic (2016), and COVID-19 pandemic (2020-2024). KCDC can make or revise infectious disease prevention and control related law, and collect, manage and analyze disease data from all the local public health centers and medical institutions in Korea. Based on the indicator-based surveillance, event-based surveillance and laboratory-based surveillance, KCDC conducts risk assessment for public health threats and has full responsibility as a competing authority in responding to outbreaks on a legal basis, which is specified in the national disaster framework. All quarantine stations in airports and sea ports belong to KCDC, and individual international travel history data at point of entries are linked to the National Health Insurance Services Database and medical doctors can access the database when the symptomatic individual visits the clinics/hospitals to check his/her travel history in the affected countries. This is a backbone to identify and notify imported infectious diseases from local clinic/hospitals to KCDC. Based on risk assessment in KCDC, KCDC triggers the Emergency Operations Center to respond. This KCDC-centered public health governance with centralized, comprehensive surveillance and response is one of the model cases from the health security perspective to consider for countries that are to establish new national public health institutes in the post-COVID-19 era.}, } @article {pmid40321449, year = {2025}, author = {Saito, H and Jindai, K and Shibata, T and Sonoda, M and Iiyama, T}, title = {How to build a better clinical trial ecosystem for future infectious disease emergencies in Japan: Findings from a narrative review and stakeholder meetings.}, journal = {Global health & medicine}, volume = {7}, number = {2}, pages = {96-105}, pmid = {40321449}, issn = {2434-9194}, abstract = {The COVID-19 pandemic posed a serious challenge to national and global pandemic preparedness and response (PPR). Timely identification and development of diagnostics, therapeutics and vaccines through prompt evidence generation from clinical trials was recognized as an important health security agenda. In 2022, under the guidance of Japan Ministry of Health, Labour and Welfare (MHLW), a health policy research team was convened to analyze the COVID-19 related clinical trial ecosystem in the context of PPR in Japan and abroad with a focus on clinical trials for therapeutics. The research mainly composed of the following: a narrative review of relevant peer reviewed journals and grey literature, interview of global experts and stakeholders including those from the United States and the United Kingdom, and a culminating meeting in Japan with various stakeholders. Based on the outcomes of this research, the team makes the following three recommendations: (1) Strengthen the leadership group's role in infectious disease clinical trials, (2) Promote sustained coordination and collaboration among stakeholders, and (3) Apply innovative clinical trial designs and create an enabling research environment. Clinical trials, as a public health good, must be further integrated into healthcare. The team advocates for the implementation of these recommendations at the policy level to help improve the clinical trial ecosystem for future health emergencies in Japan.}, } @article {pmid40321448, year = {2025}, author = {Kokudo, N and Wada, K and Takei, T and Matano, T and Wakita, T}, title = {The establishment of the Japan Institute for Health Security (JIHS): A new era in infectious disease response and research.}, journal = {Global health & medicine}, volume = {7}, number = {2}, pages = {77-81}, pmid = {40321448}, issn = {2434-9194}, abstract = {On April 1, 2025, the National Center for Global Health and Medicine (NCGM) and the National Institute of Infectious Diseases (NIID) will be merged to establish the Japan Institute for Health Security (JIHS). This merger strengthens Japan's capacity to address infectious diseases and health threats, aiming for a resilient and secure society. This paper highlights the establishment of JIHS, its alignment with government reforms, and its strategic priorities for the future. The initiative originated on October 6, 2020, when the Liberal Democratic Party's Policy Research Council proposed measures to address vulnerabilities exposed by COVID-19. In 2022, the Japanese government called for formulating a central control tower, the Cabinet Agency for Infectious Disease Crisis Management (CAICM), upgrading the divisions related to infectious diseases to the Department of Infectious Disease Prevention and Control in the Ministry of Health, Labour and Welfare (MHLW), and establishing the JIHS. JIHS will serve as a scientific advisory body during infectious disease crises, guiding the Prime Minister and the MHLW. It focuses on four key areas: i) Disease intelligence: risk assessment and data analysis; ii) Research, development, and innovation: advancing medical science; iii) Comprehensive medical services: strengthening clinical response capacity; and iv) Human resource development and international cooperation: building expertise and partnerships. Through integration, JIHS aims to improve existing systems and create synergy between basic and clinical research. As a hub for domestic and international collaboration, JIHS will consolidate critical information, catalyze innovative research, and deliver transformative solutions to address domestic and global infectious disease challenges.}, } @article {pmid40321447, year = {2025}, author = {Kayama, M and Sudo, K and Kamata, K and Igarashi, K and Nakao, T and Watanuki, S}, title = {Capacity development of nursing professionals for the next pandemic: Nursing education, on-the-job training, and networking.}, journal = {Global health & medicine}, volume = {7}, number = {2}, pages = {90-95}, pmid = {40321447}, issn = {2434-9194}, abstract = {The COVID-19 pandemic highlighted the essential role of nursing professionals in infection control and patient care across various healthcare settings in Japan. Despite their dedication, the crisis exposed significant gaps in preparedness, training, and leadership development. This paper examines the challenges nurses and public health nurses faced during the pandemic and proposes a framework for strengthening capacity development to enhance future public health emergency responses. Fundamental infection control education must be systematically incorporated into basic nursing curricula, equipping nurses with essential skills such as proper use of personal protective equipment, zoning principles, and infection prevention strategies. Simulation-based training should complement theoretical instruction to ensure practical application. Continuous professional development through structured on-the-job training is crucial, particularly for smaller hospitals and elderly care facilities where infection control expertise remains limited. Public health nurses require specialized training in epidemiological investigations and outbreak management to coordinate community health responses effectively. Leadership in clinical settings and public health must be reinforced. The Infectious Disease Health Emergency Assistance Team (IHEAT) and supervisory public health nurses played key roles in the pandemic response. Still, challenges in rapid deployment and infrastructure readiness hindered their effectiveness. Strengthening managerial education and crisis response training will be critical to improving future outcomes. Additionally, networking and knowledge-sharing systems should be expanded to enhance communication and coordination. Mental health support for nursing professionals engaged in infection control must also be prioritized. This paper advocates a comprehensive approach to nursing education, training, and leadership development to fortify Japan's healthcare system against future pandemics.}, } @article {pmid40321006, year = {2025}, author = {Li, S and Zheng, L and Zhong, J and Gao, X}, title = {Advancing mRNA vaccines for infectious diseases: key components, innovations, and clinical progress.}, journal = {Essays in biochemistry}, volume = {69}, number = {2}, pages = {}, pmid = {40321006}, issn = {1744-1358}, mesh = {Humans ; *COVID-19/prevention & control/immunology ; *COVID-19 Vaccines/immunology ; SARS-CoV-2/immunology ; *Vaccines, Synthetic/immunology ; *RNA, Messenger/immunology/genetics ; *mRNA Vaccines/immunology ; Vaccine Development/methods ; Nanoparticles/chemistry ; }, abstract = {Vaccination remains a cornerstone in preventing infectious diseases and managing outbreaks. The COVID-19 pandemic has underscored the revolutionary impact of mRNA vaccine technology, which utilizes pathogenderived genomic sequences to generate specific antigens. This process involves in vitro transcription of mRNA, encoding target antigens that are subsequently encapsulated within lipid nanoparticles (LNPs) for efficient delivery into host cells. Once internalized, the mRNA enables antigen expression, triggering a robust immune response. This platform dramatically accelerates vaccine development timelines and offers unparalleled adaptability, making mRNA vaccines particularly advantageous in addressing emerging infectious diseases. The clinical success of BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) has fueled broader applications, including influenza, respiratory syncytial virus (RSV), Zika, and HIV. Notably, mRNA-1345 became the first FDA-approved RSV mRNA vaccine, while self-amplifying RNA and multivalent vaccines are advancing in trials. However, CureVac's CVnCoV failed due to lack of nucleoside modifications, and mRNA-1325 (Zika) showed poor immunogenicity. Additionally, mRNA-1365 (RSV) faced an FDA clinical hold due to safety concerns. These cases highlight the need for continued optimization in sequence design, delivery, and safety assessment. Despite advancements, a key hurdle persists, including mRNA instability, ultra-low storage requirements, and LNP liver accumulation. Innovations such as lyophilization and selective organ targeting technology are being explored to improve stability extrahepatic delivery. This review examines mRNA vaccine optimization strategies, clinical progress, and challenges, providing insights into future developments in this evolving field.}, } @article {pmid40320267, year = {2025}, author = {Nádas, M and Becker, O and Mallow, M and Rand, S}, title = {Medication Abortion: Out of the Clinic and into the Mail.}, journal = {Obstetrics and gynecology clinics of North America}, volume = {52}, number = {2}, pages = {219-237}, doi = {10.1016/j.ogc.2024.12.014}, pmid = {40320267}, issn = {1558-0474}, mesh = {Humans ; Female ; *COVID-19/epidemiology/prevention & control ; *Telemedicine/organization & administration ; Pregnancy ; *Abortion, Induced/methods ; *Health Services Accessibility ; SARS-CoV-2 ; *Abortifacient Agents ; United States ; }, abstract = {Abortion access is a critical component of comprehensive reproductive health care. During the coronavirus disease 2019 (COVID -19) pandemic, telehealth emerged as a promising solution to expand abortion access, which has continued in the wake of significant policy shifts and clinical updates. Several early programs paved the way for broader adoption; however, the pandemic forced existing telehealth abortion programs to alter their models and made way for new virtual clinics dedicated to abortion care as well as the integration of telehealth abortion care into established health systems and brick-and-mortar clinics. Published protocols can be used to expand practice.}, } @article {pmid40319833, year = {2025}, author = {Suleiman, AS and Bhattacharya, P and Islam, MA}, title = {Global prevalence and dynamics of mecA and mecC genes in MRSA: Meta-meta-analysis, meta-regression, and temporal investigation.}, journal = {Journal of infection and public health}, volume = {18}, number = {7}, pages = {102802}, doi = {10.1016/j.jiph.2025.102802}, pmid = {40319833}, issn = {1876-035X}, mesh = {*Methicillin-Resistant Staphylococcus aureus/genetics/isolation & purification ; Humans ; *Staphylococcal Infections/epidemiology/microbiology/veterinary ; Prevalence ; *Penicillin-Binding Proteins/genetics ; *Bacterial Proteins/genetics ; Global Health ; Animals ; Carrier State/microbiology/epidemiology ; }, abstract = {This study aimed to conduct first robust meta-meta-analysis on mecC and mecA-positive MRSA strains, determining their overall prevalence and temporal trends. It encompassed 14 meta-analyses, involving 322,269 samples from 553 index studies. MRSA strains exhibited mecA / mecC positivity ranging from 0.90 % to 69.98 %. Varied AMSTAR and QUOROM scores were observed. mecC-positive MRSA prevalence was 2.41 % (95 % CI: 0.72-7.78 %). Human mecA-positive MRSA had 21.77 % prevalence (95 % CI: 9.08-43.67 %), animal samples had 7.08 % prevalence (95 % CI: 3.93-12.42 %), and worldwide prevalence was 14.58 % (95 % CI: 6.61-29.14 %). Temporal trends reveal fluctuations, mecA prevalence spiked to 52.68 % in 2012 and decreased to 7.11 % in 2022. For mecC gene, the year 2015 marked a low incidence of 0.41 % (95 % CI: 0.05-3.54 %). Overall, mecA gene carriage surpassed mecC in MRSA strains, especially in humans.}, } @article {pmid40319254, year = {2025}, author = {Bizuneh, FK and Biwota, GT and Tsheten, T and Bizuneh, TK}, title = {Incidence of recovery rate and predictors among hospitalized COVID- 19 infected patients in Ethiopia; a systemic review and meta-analysis.}, journal = {BMC public health}, volume = {25}, number = {1}, pages = {1644}, pmid = {40319254}, issn = {1471-2458}, mesh = {Humans ; Ethiopia/epidemiology ; *COVID-19/epidemiology/therapy ; Incidence ; *Hospitalization/statistics & numerical data ; Male ; SARS-CoV-2 ; Female ; }, abstract = {BACKGROUND: Despite global efforts to mitigate COVID-19 infection through vaccination and therapeutic interventions, morbidity and mortality rates continued at variable rates. Although mortality risk and clinical features of COVID-19 are well-documented, recovery patterns and prognostic factors post-admission remain inconclusive, particularly in resource-limited settings like Ethiopia. This systematic review and meta-analysis (SRM) aimed to estimate the pooled incidence rate of recovery and predictors among hospitalized COVID-19 patients in Ethiopia.

METHODS: We searched (N = 1,191) articles using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline from PubMed/MEDLINE (N = 755), Scopus (N = 137), Web of Science (N = 84), Science Direct (N = 148), Cochran (N = 25), and Google Scholar searching (N = 42) from December 2019 to February 2024. The data were extracted using a Microsoft Excel spreadsheet and exported to Stata TM version 17.0 for further analysis. The Article quality was assessed using the Joanna Briggs Institute checklist. The pooled incidence rate of recovery was estimated using a weighted inverse variance random-effects meta-regression. Heterogeneity among studies was evaluated using the I[2] statistic. Subgroup analyses and sensitivity tests were also conducted to explore publication bias. This file is registered in international Prospero with ID (CRD42024518569).

RESULT: Sixteen (N = 16) published studies with 7,676 hospitalized COVID-19 patients were included in the final report. The mean age of participants ranged from 29 (± 17) to 57.5 (± 3) years, with male patients constituting the largest proportion of participants, 4,491(58.5%). During recovery screening, 6,304(82.21%) cases were discharged as improved, 159 (2.1%) attriters, and 818 (10.6%) died during inpatient treatment. The pooled incidence of recovery, mortality, and attrition rates were found to be 82.32% (95% CI: 78.81-85.83; I[2] = 94.8%), 14.3% (I[2] = 98.45%), and 2.7% (I[2] = 81.34%), respectively. Incidence of recovery rate varied across regions and epidemic phases, with the highest rate observed in Addis Ababa (89.94%, I[2] = 78.33%) and the lowest reported in the Tigray region (59.7%, I[2] = 0.0%). Across epidemic phases, the recovery rate was 88.05% (I[2] = 29.56%) in Phase II, 84.09% (I[2] = 97.57%) in Phase I, and 78.92% (I[2] = 96.9%) in Phase III, respectively. Factors included being aged 15-30 years (pooled OR = 2.01), male sex (pooled OR = 1.46), no dyspnea (pooled OR = 2.4; I[2] = 79%), and no baseline comorbidities (pooled OR = 1.15; I[2] = 89.3%) were predictors for recovery. CONCLUSION AND RECOMMENDATION: In Ethiopia, more than eight out of ten hospitalized COVID-19 patients recovered after inpatient treatment. However, the incidence of recovery rates varied significantly across epidemic phases, study settings, and regions. Factors including younger age, male sex, no dyspnea (shortness of breathing), and no underlying comorbidity heightened recovery. It is highly recommended those inpatients cares should focus on high-risk groups (older adults) and implement standardized treatment protocols in each study setting. Regions with lower recovery rates need aid in logistical support and training for healthcare providers.}, } @article {pmid40319249, year = {2025}, author = {Stevenson, H and Alzyood, M}, title = {Healing through art: a thematic synthesis within a quasi-systematic review of art's impact on adult mental well-being during the COVID-19 pandemic.}, journal = {BMC public health}, volume = {25}, number = {1}, pages = {1641}, pmid = {40319249}, issn = {1471-2458}, mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Art Therapy/methods ; *Mental Health ; Adult ; Social Isolation/psychology ; Pandemics ; Qualitative Research ; SARS-CoV-2 ; }, abstract = {AIM: To synthesise evidence on how both structured art therapy and informal creative engagement supported adult mental well-being during COVID-19-related isolation, and to evaluate their applicability across diverse populations and contexts.

METHOD: A quasi-systematic review of qualitative studies from CINAHL, PsycInfo, and PubMed (2020-2024), analysed through thematic synthesis.

RESULTS: Analysis of seven studies identified five key themes: (1) emotional processing and expression through symbolic creation, (2) adaptive communication and nonverbal connection, (3) communal support and collective meaning-making, (4) empowerment and regaining agency, and (5) transformation of trauma into post-traumatic growth. Marginalised groups-including isolated elderly individuals, disabled adults, and low-income families-benefited significantly from both formal art therapy and informal artistic activities, which addressed barriers such as limited mobility, communication challenges, and social disconnection.

DISCUSSION: Art-based interventions demonstrate potential as scalable, low-resource tools for mental health support, particularly for individuals experiencing isolation or other forms of vulnerability, such as disability or displacement. However, equitable implementation requires hybrid delivery models and cultural adaptation. While qualitative findings highlight art's capacity to externalise distress and sustain connection, methodological constraints (small homogenous samples) necessitate mixed-methods validation of long-term outcomes.

CONCLUSION: Integrating art into public health frameworks could mitigate isolation-related psychological harm, particularly for marginalised groups. Future research should prioritise cross-cultural adaptation of interventions, community-led co-design, and studies that examine how social factors like disability, income, and cultural context intersect to shape the effectiveness of art-based mental health support.

CLINICAL TRIAL NUMBER: Not applicable.}, } @article {pmid40318913, year = {2025}, author = {Pittao, MLV and Nava, S and Hill, NS and Pisani, L}, title = {Tailoring non-invasive respiratory supports in acute hypoxemic respiratory failure: A practical approach for clinicians.}, journal = {European journal of internal medicine}, volume = {137}, number = {}, pages = {21-32}, doi = {10.1016/j.ejim.2025.04.018}, pmid = {40318913}, issn = {1879-0828}, mesh = {Humans ; *Noninvasive Ventilation/methods ; *COVID-19/complications/therapy ; *Respiratory Insufficiency/therapy ; *Hypoxia/therapy ; SARS-CoV-2 ; Continuous Positive Airway Pressure/methods ; Acute Disease ; }, abstract = {The use of non-invasive respiratory support (NIRS) for acute respiratory failure (ARF), particularly hypoxemic respiratory failure, has advanced in recent years, especially during the COVID-19 pandemic. NIRS modalities like high-flow nasal cannula (HFNC), continuous positive airway pressure (CPAP), and non-invasive ventilation (NIV) have shown efficacy, though evidence is inconsistent, especially for "de novo" acute hypoxemic respiratory failure (AHRF). This review outlines the physiological rationale for NIRS and offers practical guidance on tailoring treatment to individual patients. Successful AHRF management with NIRS requires a personalized approach, guided by clinical expertise. Further research is needed to refine patient selection and optimize NIRS application.}, } @article {pmid40318375, year = {2025}, author = {Kumar, P and Hama, S and Cheung, HYW and Hadjichristodoulou, C and Mouchtouri, VA and Anagnostopoulos, L and Kourentis, L and Wang, Z and Galea, ER and Ewer, J and Grandison, A and Jia, F and Siilin, N}, title = {Airborne pathogen monitoring and dispersion modelling on passenger ships: A review.}, journal = {The Science of the total environment}, volume = {980}, number = {}, pages = {179571}, doi = {10.1016/j.scitotenv.2025.179571}, pmid = {40318375}, issn = {1879-1026}, mesh = {*Ships ; *Air Microbiology ; *COVID-19/transmission/epidemiology ; Humans ; Aerosols/analysis ; Ventilation ; *Environmental Monitoring ; SARS-CoV-2 ; Models, Theoretical ; }, abstract = {The COVID-19 pandemic demonstrated a profound inability of pre-pandemic passenger ship policies implemented by both ship operators and governmental authorities to detect and address newly emerging diseases. The essentiality of maritime transport puts into focus the risk of approach to address known and new emerging airborne infectious diseases that, due to increasing capacity, are likely to occur on passenger ships. In order to enhance the passenger experience, prepare shipping for pandemics like COVID-19, and improve the resilience and safety of the industry, this review critically synthesises existing literature on (1) monitoring ventilation conditions and aerosol dispersion, linking them to airborne transmission risk using airborne aerosols and ventilation performance as input parameters for computational fluid dynamics (CFD) simulations, and (2) modelling airborne disease transmission risk in controlled passenger ship environments. This review analysed 39 studies on aerosol monitoring, thermal comfort, and infection risk modelling on passenger ships (2000-2023). Additionally, 55 papers on CFD modelling of airborne pathogen dispersion were reviewed: 22 included validation, with most focused on built environments and only four specifically addressing ship environments. Two major challenges relate to the complexity and poorly characterised ventilation boundary conditions on passenger ships, and the other is the lack of suitable validation data. For this reason, ship experimental studies are required for CFD model validation. Only a handful of studies were found that have measured aerosol concentrations on board passenger ships. To the best of our knowledge, there have been no studies conducted on aerosol mass or airborne transmission sampling on board passenger ships or other types of vessels. The results of this review have the potential to create synergistic connections between experimental and modelling studies to inform, characterise and improve the development of numerical models that can accurately estimate infection risk on ships for prevention, mitigation and management of outbreaks.}, } @article {pmid40317651, year = {2025}, author = {Kim, SR and Kim, SK and Asai, A and Nishikawa, H}, title = {Comparison between Japan and Korea in liver transplantation: Focusing on a higher deceased donation rate in Korea.}, journal = {Hepatology research : the official journal of the Japan Society of Hepatology}, volume = {55}, number = {9}, pages = {1220-1227}, doi = {10.1111/hepr.14177}, pmid = {40317651}, issn = {1386-6346}, abstract = {Over the past 30 years, liver transplantations (LTs) and deceased-donor LTs (DDLTs) have been higher in Korea than in Japan. In 2019, the number of DDLT reached 88 (22.3% of LTs) in Japan and 391 (24.7% of LTs) in Korea. The deceased-donor rate (per million population) was 0.70 in Japan and 7.56 in Korea. Presently, Korea is one of the Asian countries with the highest rate of DDLT. Factors conducive to the deceased donation rate in Korea encompass the socio-legal system, including the Korean Network for Organ Sharing, Korean Organ Donation Agency, the healthcare system and public awareness. During 2009-2019, two major indications of DDLT were hepatitis B cirrhosis and alcoholic liver disease in Korea, and acute liver failure and metabolic diseases in Japan. For living-donor LT, two major indications were hepatitis B cirrhosis and neoplastic diseases in Korea, and biliary atresia and neoplastic diseases in Japan. During the COVID-19 pandemic, the indications for DDLT in Korea were alcoholic liver disease and hepatitis B cirrhosis with a higher rate of alcoholic liver disease than during the pre-pandemic period. In 2021, the 5-year survival rate of DDLT was 66.5% in Korea compared with 82.6% in Japan, whereas that rate of living-donor LT in Korea reached 80.8% compared with 79.4% in Japan. To promote LT in Japan and Korea, mutual understanding and intercommunication between the two countries is crucial.}, } @article {pmid40315803, year = {2025}, author = {Boniek, D and Malamut, C}, title = {A mini-review: Application of the radiopharmaceutical [[18]F]DPA-714 in neuroinflammation research in post-SARS-CoV-2 patients.}, journal = {Journal of the neurological sciences}, volume = {473}, number = {}, pages = {123518}, doi = {10.1016/j.jns.2025.123518}, pmid = {40315803}, issn = {1878-5883}, mesh = {Humans ; *Pyrimidines ; *COVID-19/diagnostic imaging/complications ; *Radiopharmaceuticals ; *Neuroinflammatory Diseases/diagnostic imaging/metabolism/etiology ; *Pyrazoles ; Positron Emission Tomography Computed Tomography/methods ; *Brain/diagnostic imaging/metabolism ; SARS-CoV-2 ; }, abstract = {The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has been linked to significant neurological complications, including neuroinflammation. This mini review explores the application of the radiopharmaceutical [[18]F]DPA-714 in neuroinflammation studies in post-SARS-CoV-2 patients using Positron Emission Tomography - Computed Tomography (PET-CT) imaging technology. [[18]F]DPA-714, a specific ligand for the translocator protein (TSPO), enables precise visualization and quantification of microglial activation, a key marker of neuroinflammation. Recent studies demonstrate that post-COVID-19 patients exhibit increased uptake of [[18]F]DPA-714 in various brain regions, correlating with persistent symptoms such as fatigue, cognitive dysfunction, and mood alterations. The application of [[18]F]DPA-714 in longitudinal studies can monitor the progression of neuroinflammation and evaluate the efficacy of therapeutic interventions, allowing personalized treatment adjustments. Additionally, exploring new TSPO ligands can complement data obtained with [[18]F]DPA-714, offering a more comprehensive view of neuroinflammatory processes. This article discusses the technical challenges in synthesizing and applying [[18]F]DPA-714, including the need for standardized imaging protocols and variability in binding due to genetic polymorphisms in TSPO. As a conclusion that [[18]F]DPA-714 is a valuable tool for research and treatment of neuroinflammation in post-SARS-CoV-2 patients, with significant implications for the development of personalized therapies and clinical monitoring.}, } @article {pmid40314667, year = {2025}, author = {Gannamaneni, K and Mian, SI}, title = {Corneal complications of common vaccinations.}, journal = {Current opinion in ophthalmology}, volume = {36}, number = {4}, pages = {288-293}, doi = {10.1097/ICU.0000000000001146}, pmid = {40314667}, issn = {1531-7021}, mesh = {Humans ; *Vaccination/adverse effects ; *Corneal Diseases/etiology ; *COVID-19 Vaccines/adverse effects ; Graft Rejection/etiology ; *Influenza Vaccines/adverse effects ; SARS-CoV-2 ; Risk Factors ; COVID-19/prevention & control ; *Keratitis/etiology ; Influenza, Human/prevention & control ; }, abstract = {PURPOSE OF REVIEW: To summarize and evaluate the current literature concerning corneal complications associated with common vaccinations, particularly keratitis and corneal graft rejection following vaccination against SARS-CoV-2, Varicella-Zoster, and Influenza.

RECENT FINDINGS: Small case series and reports have documented keratitis/herpesvirus reactivation and corneal graft rejection following vaccination, prompting concern from ophthalmologists regarding vaccination timing and management of patients. Recent population-based studies have reported higher risks of herpesvirus keratitis and herpes zoster ophthalmicus recurrence associated with the COVID-19 and varicella zoster vaccinations in rare cases, often in patients with identified risk factors. Similarly, corneal graft rejection rates appear to be stable following vaccination when compared with unvaccinated individuals, with the bulk of vaccine-associated rejection noted to occur with penetrating keratoplasties and in patients at a higher risk for rejection.

SUMMARY: While the benefits of vaccination continue to outweigh the risks, clinicians must identify and balance patient-specific risk factors for corneal complications to inform individual management and counseling, potentially with heightened steroid use in the postvaccination period and more stringent follow up for signs of keratitis or graft rejection.}, } @article {pmid40314496, year = {2025}, author = {Ward, EJ and Webster, CS}, title = {The Conceptualization of Health Care Resilience: A Scoping Review.}, journal = {Journal of patient safety}, volume = {21}, number = {6}, pages = {e100-e109}, pmid = {40314496}, issn = {1549-8425}, mesh = {Humans ; *Resilience, Psychological ; *COVID-19 ; *Delivery of Health Care/organization & administration ; SARS-CoV-2 ; *Health Personnel/psychology ; }, abstract = {OBJECTIVES: In recent years, health care resilience has garnered increased attention, particularly since COVID-19. Resilience in health care is commonly framed across four interconnected levels: individual, team, organisational, and systemic. While individual-level resilience is relatively well explored, conceptualisations at other levels remain poorly defined.

METHODS: To address this gap, we conducted a scoping review exploring conceptualisations of health care resilience outside of the individual-level using systematic searches of MEDLINE, EMBASE, PsycINFO, and Google Scholar.

RESULTS: From 3734 initial records, 58 met our criteria. Of these, 7 (12.1%) articles did not explicitly define resilience. System-level resilience was the most explored (n=38, 65.5%), followed by organisational (n=12, 20.7%), and cross-level studies (n=8, 13.8%), with no studies exclusively focusing on team-level resilience. Conceptualisations of resilience revealed 5 themes: the goal of resilience; what systems are resilient to; resilience characteristics; its classification as ability, capacity, or capability; and the temporal dimension of resilience. Notably, no distinct patterns emerged specific to a conceptual level, suggesting resilience can be conceptualised across team, organisation, and system levels.

CONCLUSIONS: Our findings underscore significant diversity in resilience definitions, indicating an evolving health care resilience paradigm. On the basis of these insights, we propose the following definition, applicable across all levels: health care resilience is the ability to anticipate, absorb, adapt or transform in response to everyday pressures, threats and opportunities to maintain efficient, high quality, and safe performance. A shared understanding of health care resilience would promote the critical imperative for research to bolster health care recovery post-COVID-19 and to prepare for future disruptive events.}, } @article {pmid40314314, year = {2025}, author = {Zanella, MC and Rhee, C and Klompas, M}, title = {Preventing respiratory viral transmission in healthcare settings.}, journal = {Current opinion in infectious diseases}, volume = {38}, number = {4}, pages = {339-346}, pmid = {40314314}, issn = {1473-6527}, mesh = {Humans ; *COVID-19/prevention & control/transmission ; *Cross Infection/prevention & control/transmission/virology ; SARS-CoV-2 ; *Infection Control/methods ; *Respiratory Tract Infections/prevention & control/virology/transmission ; Health Personnel ; *Virus Diseases/transmission/prevention & control ; }, abstract = {PURPOSE OF REVIEW: The COVID-19 pandemic catalyzed new insights into respiratory viral transmission mechanisms and prevention. We review the most practical and impactful measures to prevent SARS-CoV-2 and other nosocomial respiratory viral infections in healthcare.

RECENT FINDINGS: Nosocomial respiratory viral infection rates mirror viral activity levels in the surrounding community. During peak periods ∼15-20% of hospitalized patients with respiratory viral infections may have acquired their virus in the hospital. Nosocomial respiratory viral infections are associated with increased lengths-of-stay, risk of respiratory failure, and hospital death. Most procedures contribute minimally to aerosol production compared to labored breathing, coughing, and forced expiration. Masking for source control and exposure control both decrease transmission risk, respirators more so than masks. Likewise, vaccinating healthcare workers decreases transmission risk and is associated with lower patient mortality rates, particularly in long-term care facilities. Increasing air changes, ultraviolet irradiation, and portable HEPA filtration units may also decrease transmission rates but their marginal benefit relative to current healthcare ventilation standards has yet to be established.

SUMMARY: Practical strategies to prevent nosocomial respiratory viral infections include maximizing staff and patient influenza and SARS-CoV-2 vaccination rates and implementing routine masking during patient interactions when community incidence is high.}, } @article {pmid40313948, year = {2025}, author = {Michalak, KP and Michalak, AZ and Brenk-Krakowska, A}, title = {Acute COVID-19 and LongCOVID syndrome - molecular implications for therapeutic strategies - review.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1582783}, pmid = {40313948}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/immunology/complications/virology/therapy ; *SARS-CoV-2/immunology/physiology ; Autophagy ; Post-Acute COVID-19 Syndrome ; Animals ; }, abstract = {Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been recognized not only for its acute effects but also for its ability to cause LongCOVID Syndrome (LCS), a condition characterized by persistent symptoms affecting multiple organ systems. This review examines the molecular and immunological mechanisms underlying LCS, with a particular focus on autophagy inhibition, chronic inflammation, oxidative, nitrosative and calcium stress, viral persistence and autoimmunology. Potential pathophysiological mechanisms involved in LCS include (1) autoimmune activation, (2) latent viral persistence, where SARS-CoV-2 continues to influence host metabolism, (3) reactivation of latent pathogens such as Epstein-Barr virus (EBV) or cytomegalovirus (CMV), exacerbating immune and metabolic dysregulation, and (4) possible persistent metabolic and inflammatory dysregulation, where the body fails to restore post-infection homeostasis. The manipulation of cellular pathways by SARS-CoV-2 proteins is a critical aspect of the virus' ability to evade immune clearance and establish long-term dysfunction. Viral proteins such as NSP13, ORF3a and ORF8 have been shown to disrupt autophagy, thereby impairing viral clearance and promoting immune evasion. In addition, mitochondrial dysfunction, dysregulated calcium signaling, oxidative stress, chronic HIF-1α activation and Nrf2 inhibition create a self-sustaining inflammatory feedback loop that contributes to tissue damage and persistent symptoms. Therefore understanding the molecular basis of LCS is critical for the development of effective therapeutic strategies. Targeting autophagy and Nrf2 activation, glycolysis inhibition, and restoration calcium homeostasis may provide novel strategies to mitigate the long-term consequences of SARS-CoV-2 infection. Future research should focus on personalized therapeutic interventions based on the dominant molecular perturbations in individual patients.}, } @article {pmid40313858, year = {2025}, author = {Gan, S and Qu, S and Zhu, H and Gong, M and Xiang, Y and Ye, D}, title = {Role and Mechanism of Olfactory Stem Cells in the Treatment of Olfactory Disorders.}, journal = {Stem cells international}, volume = {2025}, number = {}, pages = {6631857}, pmid = {40313858}, issn = {1687-966X}, abstract = {Olfactory dysfunction is one of the most prevalent diseases in otorhinolaryngology, particularly since the coronavirus 2019 (COVID-19) pandemic, with a potential impact on daily life. Several etiological factors can contribute to olfactory dysfunction owing to the complexity and specificity of the olfactory transmission pathway. However, current treatments for olfactory dysfunction are limited and their efficacy is unsatisfactory. Olfactory stem cells are multifunctional stem cells in the olfactory mucosa that comprise both horizontal and global basal stem cells (HBCs and GBCs, respectively). These cells can differentiate into various cell types in response to different stimuli with distinct characteristics. The aim of the study was to discuss the mechanisms and functions of stem cells and their application in the treatment of olfactory dysfunction.}, } @article {pmid40313573, year = {2025}, author = {Cheng, M and Chai, Y and Rong, G and Xin, C and Gu, L and Zhou, X and Hong, J}, title = {Nanotechnology-based strategies for vaccine development: accelerating innovation and delivery.}, journal = {Biomaterials translational}, volume = {6}, number = {1}, pages = {55-72}, pmid = {40313573}, issn = {2096-112X}, abstract = {The key role and impact of nanotechnology in vaccine development became particularly prominent following the outbreak of the coronavirus disease 2019 (COVID-19) pandemic in 2019. Especially in the process of designing and optimising COVID-19 vaccines, the application of nanomaterials significantly accelerated vaccine development and efficient delivery. In this review, we categorised and evaluated conventional vaccines, including attenuated live vaccines, inactivated vaccines, and subunit vaccines, highlighting their advantages and limitations. We summarised the development history, mechanisms, and latest technologies of vaccine adjuvants, emphasising their critical role in immune responses. Furthermore, we focused on the application of nanotechnology in the vaccine field, detailing the characteristics of nanoparticle vaccines, including virus-like particles, lipid-based carriers, inorganic nanoparticles, and polymer-based carriers. We emphasised their potential advantages in enhancing vaccine stability and immunogenicity, as well as their ability to deliver vaccines and present antigens through various routes. Despite facing challenges such as low drug loading efficiency, issues with long-term storage, high costs, and difficulties in large-scale production, nano-vaccines hold promise for the future. This review underscores the pivotal role and prospects of nanotechnology in vaccine development, offering new pathways and strategies to address current and future disease challenges.}, } @article {pmid40312748, year = {2025}, author = {Nayak, SS and Ameen, D and Nobakht, S and Nayak, R and Prabhu, SV and Keivanlou, MH and Hassanipour, S and Amini-Salehi, E and Thakker, N}, title = {The predictive value of endocan as a novel biomarker: an umbrella study on meta-analyses.}, journal = {Systematic reviews}, volume = {14}, number = {1}, pages = {98}, pmid = {40312748}, issn = {2046-4053}, mesh = {Humans ; *Proteoglycans/blood/metabolism ; Biomarkers/blood ; *COVID-19/blood/diagnosis ; *Neoplasm Proteins/blood/metabolism ; Meta-Analysis as Topic ; Predictive Value of Tests ; SARS-CoV-2 ; }, abstract = {BACKGROUND AND AIM: In recent years, endocan has emerged as a potential biomarker in various medical conditions. This multifaceted molecule, involved in key processes such as inflammation and endothelial dysfunction, has shown promise in predicting disease progression and therapeutic response across a spectrum of pathologies. However, the heterogeneity of studies and the complexity of endocan's role in different diseases necessitate a comprehensive review. This umbrella review aimed to systematically synthesize and evaluate the evidence from multiple meta-analyses, offering a view of endocan's effectiveness as a predictive biomarker in medical diseases.

METHODS: An extensive search was carried out on March 12, 2024, using the following four databases: PubMed, Scopus, Web of Science, and Cochrane Library. The goal was to identify meta-analyses that assess endocan's predictive efficacy. The pooled effect size and its 95% confidence interval were taken out of each discovered meta-analysis. Furthermore, power analyses were performed to assess the robustness and dependability of the results. An additional GRADE assessment was carried out to gauge the epidemiological reliability of the findings.

RESULTS: In the final analysis, 12 meta-analyses were included in the current umbrella review. The results showed that there is a significant correlation between a higher endocan level and COVID-19 (SMD: 1.40, 95% CI 0.21-2.58, P = 0.02), followed by chronic kidney disease (SMD: 1.34, 95% CI 0.20 to 2.48, P < 0.01), obstructive sleep apnea (SMD: 1.30, 95% CI 1.06-1.54, P < 0.01), diabetes mellitus (SMD: 1.00, 95% CI 0.81 to 1.19, P < 0.01), coronary artery disease (SMD: 0.99, 95% CI 0.58-1.39, P < 0.01), hypertension (SMD: 0.91, 95% CI 0.44-1.38, P < 0.01), and preeclampsia (SMD: 0.37, 95% CI 0.13-0.62, P < 0.01).

CONCLUSION: Endocan has emerged as a highly promising biomarker with considerable potential across various medical conditions. Its relevance spans critical areas such as COVID-19, chronic kidney disease, obstructive sleep apnea, diabetes mellitus, coronary artery disease, and preeclampsia. The broad applicability of endocan highlights its value in improving diagnostic accuracy and enhancing our understanding of these diseases. Clinically, incorporating endocan testing could aid in early detection, monitoring disease progression, and refining patient management, particularly for high-risk populations. However, additional research is needed to fully assess its specificity, sensitivity, and overall clinical utility, paving the way for its integration into routine healthcare practices and enabling more precise, individualized treatment strategies.}, } @article {pmid40312682, year = {2025}, author = {Faske, A and Reis, S and Pscheidl, T and Saal-Bauernschubert, L and Meybohm, P and Weibel, S}, title = {An urgent call to publish COVID-19 trials: a systematic search revealed ZERO studies regarding the incidence of thromboembolic events in SARS-CoV-2 Omicron-infected COVID-19 patients.}, journal = {Critical care (London, England)}, volume = {29}, number = {1}, pages = {173}, pmid = {40312682}, issn = {1466-609X}, mesh = {Humans ; *COVID-19/complications/epidemiology ; Incidence ; *Thromboembolism/epidemiology/etiology ; SARS-CoV-2 ; *Clinical Trials as Topic ; }, abstract = {BACKGROUND: COVID-19 has been associated with an increased risk of thromboembolic complications, particularly in hospitalized patients. While early research focused on pre-Omicron variants, the thrombotic risk associated with SARS-CoV-2 Omicron infections remains unclear. Given the evolving nature of the pandemic, it is critical to assess whether current anticoagulation recommendations remain appropriate.

METHODS: We conducted a systematic review of clinical studies to determine the incidence of thromboembolic events in COVID-19 patients infected with SARS-CoV-2 Omicron variants. The main outcome was thromboembolic events within 28 days of infection, using objective diagnostic criteria. We systematically searched the Cochrane COVID-19 Study Register, covering multiple databases, for studies published between November 30, 2021, and January 31, 2024. Studies were screened independently by two reviewers, and missing data were requested from study authors.

RESULTS: Our search identified 7843 records, of which 238 underwent full-text screening. Ultimately, no study met our inclusion criteria due to issues such as lack of Omicron-specific data, inadequate reporting of diagnostic methods, and failure to specify the timing of outcome assessment. Despite contacting study authors, no additional eligible data were obtained.

CONCLUSION: There is currently no high-quality evidence on the incidence of thromboembolic events in Omicron-infected COVID-19 patients. The absence of relevant studies highlights a critical research gap and raises concerns about the applicability of current anticoagulation guidelines. Future studies should stratify outcomes by SARS-CoV-2 variant, ensure transparent reporting, and provide rigorous diagnostic confirmation to guide clinical decision-making.}, } @article {pmid40312598, year = {2025}, author = {de Assis Carvalho, EM and Ozanic, K and Machado, AFB and Dias, VC and Diniz, CG and da Silva, VL and Bellei, N and Watanabe, A}, title = {Respiratory virus circulation during pandemic: Why were some viruses still circulating?.}, journal = {Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology]}, volume = {56}, number = {3}, pages = {1913-1928}, pmid = {40312598}, issn = {1678-4405}, mesh = {Humans ; *COVID-19/epidemiology/virology/prevention & control ; SARS-CoV-2 ; Pandemics ; *Respiratory Tract Infections/virology/epidemiology ; *Viruses/classification/isolation & purification/genetics ; }, abstract = {A few months after the beginning of the coronavirus disease 2019 (COVID-19) pandemic in March 2020, several non-pharmacological measures were adopted worldwide, with varying degrees of strictness, to contain the transmission of the virus and mitigate its impacts. These measures, in addition to effectively reducing the circulation of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2), these measures also appeared to impact the circulation of other respiratory viruses. Therefore, this study aims to discuss the most relevant data available regarding the circulation of the major respiratory viruses during the COVID-19 pandemic, exploring the factors that allowed some viruses to continue circulating while others experienced a decline. Several authors report that the detection of influenza, respiratory syncytial virus (RSV), human coronaviruses (hCoVs), human parainfluenza viruses (HPIVs), and human metapneumovirus (hMPV) dropped significantly. However, non-enveloped viruses such as adenovirus, and especially human rhinovirus (HRV), did not seem to be as affected. Hypotheses for this scenario include adopting of non-pharmacological measures to curb the spread of COVID-19, behavioral changes in hygiene habits, intrinsic characteristics of each virus such as transmission mode, the presence or absence of a viral envelope and viral interference. Rhinovirus is particularly intriguing, as it maintained a high prevalence during the years of the pandemic. Further investigation into the possible explanations for this phenomenon may be worthwhile.}, } @article {pmid40311684, year = {2025}, author = {Cheng, VC and Wong, SC and Ma, ES and Chen, H and Chiu, KH and Chen, JH and So, SY and Lung, DC and Ho, PL and Yuen, KY}, title = {Antimicrobial resistance situation and control measures in Hong Kong: from a One Health perspective.}, journal = {The Journal of hospital infection}, volume = {162}, number = {}, pages = {174-185}, doi = {10.1016/j.jhin.2025.01.019}, pmid = {40311684}, issn = {1532-2939}, mesh = {Hong Kong/epidemiology ; Animals ; Humans ; *One Health ; Swine ; Chickens/microbiology ; *Anti-Bacterial Agents/pharmacology ; *Drug Resistance, Multiple, Bacterial ; Prevalence ; Methicillin-Resistant Staphylococcus aureus ; COVID-19/epidemiology ; Food Microbiology ; *Infection Control/methods ; Escherichia coli/drug effects ; }, abstract = {Multi-drug-resistant organisms pose a critical public health challenge globally, particularly in densely populated Hong Kong with a rapidly aging population, where over 90% of food is imported. This review examines the targeted surveillance and control efforts implemented under the One Health framework to combat antimicrobial resistance. Between 2010 and 2023, surveillance revealed the prevalence rates of extended-spectrum-beta-lactamase (ESBL)-producing Escherichia coli in tested pigs (51.5%) and chickens (86.3%). Alarmingly, carbapenemase-producing E. coli was increasingly detected in pigs (<5-19.2% from 2017 to 2023). For other food items, ESBL-producing Enterobacterales were found in sashimi (11.5%), sushi (4.8%), ready-to-eat (RTE) vegetables (26.9%), RTE cut fruits (5.6%), braised dishes (19.8%) and roast meat (2.4%). Mean antimicrobial consumption in food animals was 113.4 mg/kg target animal biomass for pigs from 2019 to 2022. Antimicrobial consumption in hospitals and the community, expressed as defined daily doses per 1000 inhabitants per day, declined from 20.4 to 13.8 during the coronavirus disease 2019 pandemic, and gradually rebounded to 17.1 in 2023. In residential care homes for the elderly (RCHEs), the prevalence of meticillin-resistant Staphylococcus aureus (MRSA) escalated rapidly from 2.8% to 48.7% between 2005 and 2021, triggering a pilot MRSA decolonization programme in 257 RCHEs, which led to a significant reduction in community-onset MRSA infections (from 3.526 to 2.632 per 1000 resident-days; P<0.005) and MRSA bacteraemia (from 0.322 to 0.197 per 1000 resident-days; P=0.025). These findings highlight the challenges in the control of ESBL and carbapenemase-producing E. coli in animals, compliance with food hygiene measures, and infection control in overcrowded and understaffed RCHEs or hospitals in perpetuating MRSA infections in healthcare settings.}, } @article {pmid40311676, year = {2025}, author = {Martinuka, O and le Cessie, S and Wolkewitz, M}, title = {Target trial emulation framework: mitigating methodological challenges and application in COVID-19 treatment evaluation studies.}, journal = {Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases}, volume = {31}, number = {9}, pages = {1475-1483}, doi = {10.1016/j.cmi.2025.04.027}, pmid = {40311676}, issn = {1469-0691}, mesh = {Humans ; *COVID-19 Drug Treatment ; SARS-CoV-2 ; COVID-19 ; *Observational Studies as Topic/methods ; Hydroxychloroquine/therapeutic use ; Bias ; Research Design ; Treatment Outcome ; Antiviral Agents/therapeutic use ; }, abstract = {BACKGROUND: During the COVID-19 pandemic, real-world data and observational studies played an important role in assessing treatment effectiveness. Methodological challenges such as confounding, immortal time bias, and competing risks were observed. Target trial emulation provides a structured framework for evaluating treatment effectiveness using observational data while mitigating these biases.

OBJECTIVES: To describe common biases in observational COVID-19 research, introduce the target trial emulation framework, and discuss how these biases can be addressed in this framework. Specifically, we discuss the clone-censor-weight approach and provide real-world study examples demonstrating its application in COVID-19 research.

SOURCES: We summarise key principles of target trial emulation and the clone-censor-weight approach using published methodological articles. Additionally, we demonstrate the practical implementation by reviewing three studies that emulated a target trial to evaluate the effects of treatments in patients with COVID-19. These studies were selected without a predefined search strategy.

CONTENT: We define and discuss confounding, immortal time bias, and competing risks in studies using observational data. To facilitate the understanding of these biases, we use a hypothetical example evaluating the effects of hydroxychloroquine in hospitalised patients with COVID-19. We provide an overview of the target trial emulation framework and its core elements, explaining how it can mitigate these challenges. To illustrate the clone-censor-weight approach, we describe published examples demonstrating its application during the COVID-19 pandemic.

IMPLICATIONS: Target trial emulation is an important framework for evaluating treatment effects using observational data, but it requires careful implementation to mitigate methodological biases. Identifying and addressing confounding, immortal time bias, and competing risks during study design and analysis are important in any causal study evaluating treatment effects. This framework can improve the quality of observational studies and complement evidence from clinical trials, particularly when evidence is urgently needed, as during the first waves of the COVID-19 pandemic.}, } @article {pmid40311049, year = {2025}, author = {Mombo, N and Le Nguyen, KN}, title = {Practices for collecting, analyzing and disseminating data on health and its social determinants among Black populations in Quebec: a scoping review.}, journal = {Health promotion and chronic disease prevention in Canada : research, policy and practice}, volume = {45}, number = {4}, pages = {165-189}, pmid = {40311049}, issn = {2368-738X}, mesh = {Humans ; Quebec/epidemiology ; *Social Determinants of Health/ethnology ; *COVID-19/epidemiology/ethnology ; *Black People/statistics & numerical data ; *Data Collection/methods ; Health Status Disparities ; }, abstract = {INTRODUCTION: The COVID-19 pandemic highlighted the deficiencies in healthcare systems both within and outside of Canada, affecting racialized populations, particularly Black communities, who face an increased risk of infection and mortality from the disease. Although Black populations in Quebec make up more than 25% of the Black population in Canada, detailed data on the impact of COVID-19 on these communities are only available at the national level. This scoping review documents the methods and issues related to the collection, analysis and dissemination of data on the health of Black populations in Quebec, and its social determinants.

METHODS: We conducted a review of studies published in English and French from January 2010 to June 2024 by consulting six databases. This review exclusively comprised studies involving data collection from racialized populations, including Black populations in Quebec, and excluded Canada-wide studies involving only a subsample of Black populations in Quebec. The main keywords used were: "data on race", "ethnic data collection", "race data collection", "culturally appropriate", "health", "survey", "questionnaire", "racial groups", "racialized groups", "Black and minority ethnic people", "people of colour", "migrants", "Quebec", "collecte de données", "minorité", "noir" and "ethnicité".

RESULTS: We selected 43 studies covering four sectors: health, social services, education and employment. We identified the main issues, methods and strategies used to recruit members of Black communities and to collect and analyze data according to ethnoracial categories while minimizing bias to better understand the sociocultural and socioeconomic context of the target populations.

CONCLUSION: Our review highlights the importance of collecting data on racialized groups, particularly Black communities in Quebec, to support public policies aimed at promoting health equity.}, } @article {pmid40310895, year = {2025}, author = {Russell, NG and Rodney, T and Peterson, JK and Baker, A and Francis, L}, title = {Nurse-Led Mental Health Interventions for College Students: A Systematic Review.}, journal = {Preventing chronic disease}, volume = {22}, number = {}, pages = {E17}, pmid = {40310895}, issn = {1545-1151}, mesh = {Humans ; *Mental Disorders/nursing ; *Mental Health ; *Mental Health Services/organization & administration ; *Nurse's Role ; *Students/psychology ; Universities ; }, abstract = {INTRODUCTION: Mental health conditions such as anxiety, depression, and suicidal ideation or suicide are prevalent among college students and are a growing public health concern. The COVID-19 pandemic exacerbated this crisis. Nurses are a vital component of college health services and may be the first or only health care provider to evaluate college students experiencing a mental health condition. However, the literature has limited evidence on the nurse's role and its impact on college mental health. Our systematic review examines nurse-led mental health interventions for college students.

METHODS: We conducted a comprehensive search for nurse-led interventions in college mental health by using PubMed, Embase, CINAHL, PsycInfo, and ERIC databases. A total of 2,814 articles were identified, and 2,290 were screened after removal of 524 duplicates. Thirty-five studies were reviewed for eligibility, and 16 were included in this review. The Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Hierarchy of Evidence Guide and Appraisal Tools were used to rate the strength and quality of the evidence, and the selected articles were generally of good quality.

RESULTS: The 16 articles came from institutions in North America (n = 5), southeastern Europe (n = 3), and Asia (n = 8). The studies focused on samples with a pre-existing mental health diagnosis or on mental health symptoms and interventions aimed at addressing mental health concerns. The interventions were facilitated by nurses and included various approaches, including experimental, quality improvement, and educational strategies.

CONCLUSION: This review underscores the crucial role of nurses in addressing mental health issues among college students. Despite variability in approaches, nurse-led interventions offer promise in enhancing student well-being. Further studies are essential to gauge effectiveness and shape policies for supporting the nurse's unique role in higher education. Integrating these findings into practice and policy will equip college health services to meet students' evolving needs. Leveraging the expertise of nurses can enhance student mental well-being, leading to improved academic outcomes and overall quality of life.}, } @article {pmid40310051, year = {2025}, author = {Grilli, S and Perrotta, G and Eleuteri, S and Petruccelli, I}, title = {Critical Issues in Psychological Services Within Italian Schools: Definition, Contexts, Interventions, and Legislation for Vulnerable Populations.}, journal = {Children (Basel, Switzerland)}, volume = {12}, number = {4}, pages = {}, pmid = {40310051}, issn = {2227-9067}, abstract = {BACKGROUND: This paper presents a comprehensive literature review that investigates the pivotal role of school psychologists within the Italian educational context, highlighting their importance in promoting mental health and students' well-being, emphasizing the importance of a comprehensive school psychology evidence-based service to facilitate the personal and professional development of both students and staff.

METHODS: To conduct this review, we utilized databases such as Scopus, ResearchGate, PsycINFO, and PubMed to access recent scientific literature related to school psychologists in Italy, focusing primarily on studies published between 2018 and 2025. We employed keywords including "school psychologist in Italy", "mental health", "COVID-19", "COVID-19 and school psychologists", and "school psychologist legislation in Italy" to guide our search.

RESULTS: By synthesizing the existing literature, this study aims to explore the integration and effectiveness of psychological services in Italian schools, particularly in light of the challenges posed by the COVID-19 pandemic. This review provides an overview of the current state of school psychology evidence-based services in Italy, with particular attention to the emotional and psychological challenges exacerbated by the pandemic. This event that has profoundly impacted community life highlighted the importance of mental health, prompting Italy to enhance the presence of psychologists within schools. Furthermore, this review critically analyzes the existing laws and psychological frameworks, drawing on data from an extensive examination of legislative documents and the previous literature regarding the implementation of school psychology services. The findings reveal that 69.2% of Italian schools adopted a school psychology service following legislative initiatives, aimed at addressing the trauma and discomfort caused by the pandemic.

CONCLUSIONS: Despite this progress, the presence of this figure is still rare and while significant steps have been taken, a shift towards a more preventative and holistic model is currently essential.}, } @article {pmid40310013, year = {2025}, author = {Becerra, JA and Roohani, I and Parikh, NU and Jolibois, MI and Kondra, K and Swerdlow, M and Nicholson, LT and Carey, JN}, title = {A Systematic Review of Hand Surgery Simulation.}, journal = {Annals of plastic surgery}, volume = {94}, number = {5S Suppl 3}, pages = {S474-S483}, pmid = {40310013}, issn = {1536-3708}, mesh = {Humans ; *Hand/surgery ; *Simulation Training/methods ; COVID-19/epidemiology ; Clinical Competence ; Animals ; SARS-CoV-2 ; }, abstract = {BACKGROUND: The COVID-19 pandemic and duty hour restrictions illuminated a role for surgical simulation in hand surgery training that permits meaningful technical experience outside the operating room. Implementation of surgical simulation infrastructure alongside clinical training accounting for complexity and cost should be considered. This systematic review analyzes cadaveric, benchtop, 3D-printed, augmented/virtual reality, and animal models that may effectively simulate hand surgical techniques and procedures with subjective or objective competence assessment.

METHODS: A systematic review was conducted according to PRISMA-P guidelines using the following databases: PubMed, Medline, Scopus, Embase, Web of Science, and Cochrane. Selected search terms included procedures relevant to hand surgery and various simulation training modalities. Inclusion criteria were English-language peer-reviewed articles about surgical simulation techniques or hand surgery-related training. Abstracts, conference proceedings, non-English literature, and reviews were excluded. Data, including skills and techniques taught and assessed, model type, equipment, cost, and emphasis placed in training for each article, were entered into an electronic database. Additional articles were identified through references from the initial search.

RESULTS: Our search criteria identified 2745 articles, 39 of which met the inclusion criteria. Models were described with the following frequency: synthetic benchtop/3D printed (41.0%), animal (25.6%), cadaveric (17.9%), augmented and virtual reality (AR/VR; 10.3%), and other computer simulation (10.3%). Three models incorporated both a physical benchtop and AR/VR components. The procedures most represented by the simulation tools assessed include tendon repair (30.8%), fracture fixation (25.6%), wrist arthroscopy (15.4%), and carpal tunnel release (15.4%). Of all articles, 51.3% evaluated the efficacy of the educational tool. Of these, 40.0% were evaluated via subjective methods only, 10.0% via objective methods, and 50% via both. Eighty-seven percent of articles emphasized the importance of surgical simulation in a surgeon's training.

CONCLUSIONS: A diverse collection of hand surgical simulation models exists for the practice of various aspects of hand surgery. The existing literature demonstrates their utility for increasing expertise with surgical techniques and procedures in a low-risk setting. Integration into surgical training will depend on program time and budget constraints.}, } @article {pmid40309618, year = {2025}, author = {Ahmadnia, E and Haseli, A and Davoudian, A and Abbasi, M}, title = {Adolescents' Sexual Health During the COVID-19 Outbreak: A Systematic Review.}, journal = {Health science reports}, volume = {8}, number = {5}, pages = {e70774}, pmid = {40309618}, issn = {2398-8835}, abstract = {BACKGROUND AND AIMS: The COVID-19 pandemic has greatly disrupted adolescents' access to sexual health services, resulting in a decline in their overall sexual well-being. This systematic review explored adolescent sexual health during the COVID-19 pandemic.

METHODS: A systematic review of quantitative studies-including observational research, clinical trials, and quasi-experimental interventions-examined English-language articles published between January 2020 and February 10, 2025, sourced from databases such as PubMed, Web of Science, Scopus, and Google Scholar. Study quality was evaluated using the Newcastle-Ottawa Scale (NOS) for observational studies, Cochrane RoB 2 for clinical trials, and ROBINS-1 for quasi-experimental designs. Due to the heterogeneity of the data.

RESULTS: After identifying 781 articles, 10 studies with a total sample size of 636,873 participants were included in the final systematic review. Observational studies during the COVID-19 pandemic revealed diminished access to sexual and reproductive health (SRH) services, greater dependence on informal information sources, widening health inequalities, and negative impacts on adolescent sexual behavior. Intervention studies on online SRH education demonstrate significant positive impacts across key areas: access to SRH services, safe sex practices, communication with parents about sexual health, lower acceptance of dating violence, normative beliefs regarding adolescent sexuality, HIV/STI awareness, and condom use. The findings emphasize notable improvements in communication, knowledge, and attitudes toward sexual health, driven by these targeted interventions.

CONCLUSION: The COVID-19 pandemic disrupted adolescent SRH globally, reducing service access and amplifying inequities. While some behaviors (e.g., sexual activity) showed resilience, systemic gaps in education and healthcare persist. Multisectoral efforts are needed to ensure adolescents' SRH rights are upheld during crises. However, the interventional studies underscore the viability of digital, media-literate interventions in improving adolescent sexual health.

TRIAL REGISTRATION: The review study was officially registered on the PROSPERO website on 02/08/2023 under the code CRD42023438631 and received approval from the jury.}, } @article {pmid40308622, year = {2025}, author = {Parizad, R and Batta, A and Hatwal, J and Taban-Sadeghi, M and Mohan, B}, title = {Emerging risk factors for heart failure in younger populations: A growing public health concern.}, journal = {World journal of cardiology}, volume = {17}, number = {4}, pages = {104717}, pmid = {40308622}, issn = {1949-8462}, abstract = {Heart failure (HF) is a growing public health concern, with an increasing incidence among younger populations. Traditionally, HF was considered a condition primarily affecting the elderly, but of late, emerging evidence hints at a rapidly rising HF incidence in youth in the past 2 decades. HF in youth has been linked to a complex interaction between emerging risk factors, such as metabolic syndrome, environmental exposures, genetic predispositions, and lifestyle behaviors. This review examines these evolving determinants, including substance abuse, autoimmune diseases, and the long-term cardiovascular effects of coronavirus disease 2019, which disproportionately affect younger individuals. Through a comprehensive analysis, the study highlights the importance of early detection, targeted prevention strategies, and multidisciplinary management approaches to address this alarming trend. Promoting awareness and integrating age-specific interventions could significantly reduce the burden of HF and improve long-term outcomes among younger populations.}, } @article {pmid40307795, year = {2025}, author = {Garza, M and Abascal Miguel, L}, title = {Health disparities among indigenous populations in Latin America: a scoping review.}, journal = {International journal for equity in health}, volume = {24}, number = {1}, pages = {119}, pmid = {40307795}, issn = {1475-9276}, mesh = {Humans ; *Health Status Disparities ; *Healthcare Disparities/ethnology ; Latin America/epidemiology ; *Indigenous Peoples ; }, abstract = {BACKGROUND: Health disparities persist among Indigenous populations in Latin America, reflecting systemic inequities and historical marginalization. These disparities span infectious diseases, malnutrition, and chronic conditions, necessitating a comprehensive understanding to inform equitable public health strategies. This scoping review aims to map health disparities affecting Indigenous populations in Latin America, identify research gaps, and inform policy recommendations.

METHODS: Following PRISMA-ScR guidelines, we systematically searched PubMed, Embase, and Scielo for studies with data collected between May 2014 and May 2024. Studies were included if they examined health disparities among Indigenous populations in Latin America, contained a comparator related to disparities, and presented quantitative data. We excluded studies on oral health, risk factors, genetic disparities, health system access, and ecological studies, as well as non-research articles such as commentaries and letters to the editor. Data were synthesized narratively, summarizing key themes.

RESULTS: Of 1,116 identified articles, 35 met inclusion criteria, spanning nine Latin American countries. Most studies were cross-sectional (n = 18) or cohort-based (n = 16). Infectious diseases and malnutrition were the most studied topics, consistently showing higher incidence and mortality rates among Indigenous populations. Many papers highlighted COVID-19 disparities, with Indigenous groups experiencing higher incidence and mortality. Malnutrition, particularly stunting and anemia, was significantly more prevalent among Indigenous children and women. Studies on overweight and obesity showed mixed results. Chronic diseases, including chronic kidney disease and cardiovascular issues, showed notable disparities, while mental health and cancer were underrepresented.

CONCLUSION: Indigenous populations in Latin America face a dual burden of infectious and chronic diseases, compounded by structural barriers such as poverty, geographic isolation, and systemic discrimination. Addressing these disparities requires culturally tailored interventions, structural reforms, and policy prioritization. This scoping review is limited by database restrictions, search term variability, language and time frame constraints, the absence of a methodological quality assessment, inconsistencies in defining Indigenous status, exclusion of grey literature, and a focus on disease prevalence rather than disparities in risk factors, diagnosis, and treatment, which may result in an incomplete representation of Indigenous health disparities in Latin America. Future research should incorporate mental health outcomes to provide a more comprehensive understanding of Indigenous health disparities.}, } @article {pmid40307505, year = {2025}, author = {Rolin, SA and Appelbaum, PS}, title = {Expansion of Colleges' Legal Responsibilities Regarding Student Mental Health.}, journal = {Current psychiatry reports}, volume = {27}, number = {7}, pages = {450-455}, pmid = {40307505}, issn = {1535-1645}, support = {K23 MH126312/MH/NIMH NIH HHS/United States ; }, mesh = {Humans ; *Students/psychology/legislation & jurisprudence ; Universities/legislation & jurisprudence ; *Mental Health/legislation & jurisprudence ; *COVID-19/psychology ; *Liability, Legal ; }, abstract = {PURPOSE OF THE REVIEW: We review recently published literature about the mental health of college students, as well as current court cases litigating colleges' liability for student mental health and safety.

RECENT FINDINGS: College students experienced a dramatic increase in mental health symptoms during the early phase of the COVID-19 pandemic, with clinically significant increases in anxiety and depression. Meanwhile, in contrast to the past when colleges were mostly immune to liability for harm to students, a major shift occurred with the courts beginning to recognize colleges as having a legally defined "special relationship" to protect students from foreseeable harm. Recently, court cases in many states have expanded the circumstances under which colleges have a responsibility to protect students from themselves and from each other, and to foster students' mental health. The past few years have constituted a changing landscape for colleges with regard to their legal responsibilities related to student mental health. As college students experienced worsening mental health distress, recent court cases increased colleges' liability to ensure safety and create a supportive environment for students' mental health.}, } @article {pmid40307433, year = {2025}, author = {Hindes, I and Sarwar, HN and Gravesteijn, BY and Jardine, J and Burgos-Ochoa, L and Been, JV and Zenner, D and Iliodromiti, S}, title = {The association of COVID-19 lockdowns with adverse birth and pregnancy outcomes in 28 high-income countries: a systematic review and meta-analysis.}, journal = {Nature human behaviour}, volume = {9}, number = {7}, pages = {1420-1430}, pmid = {40307433}, issn = {2397-3374}, support = {C007//DH | National Institute for Health Research (NIHR)/ ; }, mesh = {Humans ; Pregnancy ; *COVID-19/prevention & control/epidemiology ; Female ; *Pregnancy Outcome/epidemiology ; *Premature Birth/epidemiology ; *Developed Countries/statistics & numerical data ; SARS-CoV-2 ; *Quarantine ; }, abstract = {We conducted a systematic review and meta-analysis to review the association of lockdowns with adverse birth and pregnancy outcomes (ABPOs) and related inequalities, in high-income countries (HICs). Databases (EMBASE, MEDLINE/PubMed and Web of Science) were searched from 1 January 2019 to 22 June 2023 for original observational studies based in HICs that compared the rates of ABPOs, before and during lockdowns. The risk of bias was assessed using the Newcastle-Ottawa tool for cohort studies. We ran random-effects meta-analyses and subgroup analyses per region, lockdown period, ethnicity group and deprivation level and adjusted for underlying temporal trends. A total of 132 studies were meta-analysed from 28 HICs. Reduced rates of preterm birth (reported by 26 studies) were associated with the first lockdown (relative risk 0.96, 95% confidence interval 0.93-0.99), 11 studies adjusted for long-term trends and the association remained (0.97, 0.95-0.99), and subgroup analysis found that this association varied by continental region. Ten studies reported positive screening rates for possible depression antenatally, and lockdown was associated with increases in positive screening rates (1.37, 1.06-1.78). No other ABPOs were associated with lockdowns. Investigation of inequalities was limited due to data availability and heterogeneity; further research is warranted on the effect of lockdowns on health inequalities. This study was funded by the National Institute of Health Research, School of Primary Care Research and registered on PROSPERO (CRD42022327448).}, } @article {pmid40306545, year = {2025}, author = {Li, H and Min, L and Du, H and Wei, X and Tong, A}, title = {Cancer mRNA vaccines: clinical application progress and challenges.}, journal = {Cancer letters}, volume = {625}, number = {}, pages = {217752}, doi = {10.1016/j.canlet.2025.217752}, pmid = {40306545}, issn = {1872-7980}, mesh = {Humans ; *Cancer Vaccines/immunology/therapeutic use/administration & dosage ; *Neoplasms/immunology/therapy ; COVID-19/immunology/epidemiology/virology ; *mRNA Vaccines/immunology ; *RNA, Messenger/immunology/genetics ; Immunotherapy/methods ; SARS-CoV-2/immunology ; Antigens, Neoplasm/immunology/genetics ; Animals ; Clinical Trials as Topic ; Vaccines, Synthetic/immunology ; }, abstract = {Messenger RNA (mRNA) vaccines have emerged as one of the most promising and rapidly evolving immunotherapeutic approaches due to their ease of production, demonstrated clinical efficacy, and high safety. The coronavirus disease 2019(COVID-19) pandemic has showcased the remarkable therapeutic potential of mRNA vaccines, prompting researchers to explore their use for cancer treatment. Preclinical studies and human clinical trials have indicated their substantial clinical applicability. However, current research faces several challenges, including the complexity of tumor antigen selection, vaccine stability, and the development of resistance. This review summarizes the optimization strategies for cancer mRNA vaccines in preclinical settings, the progress of clinical trials, and the challenges encountered while analyzing various delivery vehicle types, infusion methods, and application cases across different cancer types, highlighting key factors in vaccine design. The findings demonstrate that mRNA vaccines elicit specific immune responses and exhibit favorable safety and tolerability in clinical trials. Moreover, developing personalized neoantigen vaccines offers a novel direction for cancer immunotherapy. The unique contribution of this review lies in its comprehensive overview of the latest advancements in therapeutic mRNA vaccines for cancer treatment while identifying critical areas for future research to propel the field forward.}, } @article {pmid40306115, year = {2025}, author = {Aghaali, Z and Zargar, M and Naghavi, MR}, title = {Encapsulation of Ferula-derived bioactive compounds in nanoparticles: A promising therapeutic route for cancers and infectious diseases.}, journal = {International immunopharmacology}, volume = {157}, number = {}, pages = {114705}, doi = {10.1016/j.intimp.2025.114705}, pmid = {40306115}, issn = {1878-1705}, mesh = {Humans ; *Ferula/chemistry ; *Neoplasms/drug therapy ; *Nanoparticles/chemistry ; Animals ; *Communicable Diseases/drug therapy ; *Antineoplastic Agents/administration & dosage ; Drug Delivery Systems ; Nanomedicine ; SARS-CoV-2/drug effects ; }, abstract = {The biomedical sector is constantly searching for new drugs that efficiently improve human health and well-being with minimum side effects. Bio-inspired nanomedicine has emerged as a feasible alternative to chemotherapeutic agents for diagnosis and therapy due to its safety, biocompatibility, affordability, and sustainability. Among biological sources available for green nanomedicine are plants offering the avoidance of the labor-intensive and time-consuming processes of cultivation and maintenance compared to microorganisms. With a long history of treating over a hundred health-related issues, Ferula-derived metabolites have received special consideration for combining with nanoparticles (NPs) since they have been reported to enhance the therapeutic efficiency of NPs, enable targeted drug delivery, and ensure controlled release, which make them elusive candidates for green nanotechnology. This review aimed to provide comprehensive information about the inhibitory effects of NPs carrying Ferula-originated bioactive compounds on several cancers and pathogenic bacteria. Plus, it explores the potential of these NPs in addressing different viral diseases, such as HIV, SARS-CoV2, and hepatitis. The anticancer, antibacterial, and antiviral mechanisms of action are also briefed. The valuable insights provided by this article may result in the development of designer Ferula-based NPs that satisfy the growing needs of the pharmaceutical industry for innovative and effective medications.}, } @article {pmid40305976, year = {2025}, author = {Dakiniewich, A and Graham, S and Dyda, A and McHugh, L}, title = {Pregnancy loss <28 weeks gestation in maternal influenza and COVID-19 vaccination studies: a review of data sources, 2009-2024.}, journal = {Public health}, volume = {243}, number = {}, pages = {105733}, doi = {10.1016/j.puhe.2025.105733}, pmid = {40305976}, issn = {1476-5616}, mesh = {Humans ; Female ; Pregnancy ; *Influenza, Human/prevention & control ; *Influenza Vaccines/adverse effects/administration & dosage ; *Abortion, Spontaneous/epidemiology ; *COVID-19 Vaccines/adverse effects/administration & dosage ; *COVID-19/prevention & control ; *Vaccination/adverse effects ; Pregnancy Complications, Infectious/prevention & control ; Data Collection ; Information Sources ; }, abstract = {OBJECTIVES: To address gaps in maternal vaccination and pregnancy loss research, large, complex datasets are needed. We aimed to identify and evaluate data sources and data collection methods currently used to capture pregnancy losses <28 weeks following maternal influenza and COVID-19 vaccination research.

STUDY DESIGN: Narrative Review.

METHODS: PubMed, CINAHL, Scopus, and Web of Science were used to identify studies that investigated pregnancy loss <28 gestational weeks following influenza and COVID-19 vaccinations from January 1st[,] 2009, to March 19th[,] 2024. Within the resulting studies, the data source(s) used to capture exposure and outcome data were identified and categorised. The capacity to capture and measure exposures, outcomes, and missing data within categories was investigated.

RESULTS: 28 articles met the inclusion criteria, representing 1,113,878 participants. Most articles (n = 19) used multiple data sources within the one study, often obtaining exposure and outcome data from separate data sources. Categories of data sources included: registries, adverse reporting systems, medical records, and survey or interview methods.

CONCLUSION: Current data collection practices and existing data sources are adversely impacting data quality, and the ability to combine large datasets necessary for analysing early pregnancy loss risk factors. This also hinders our ability to evaluate the safety of early maternal vaccination and subsequent miscarriage. Establishing pregnancy loss registries using standardised data collection and coding practices, consistent terminology, and accurate exposure and outcome timing is critical. In the absence of registries, we propose an alternative source to capture both pregnancy loss and maternal vaccination data.}, } @article {pmid40305821, year = {2025}, author = {Kawabata, M and Mori, E and Yanagi, N and Tei, M and Otori, N}, title = {Olfactory disorder after COVID-19 vaccination.}, journal = {Rhinology}, volume = {63}, number = {4}, pages = {441-447}, doi = {10.4193/Rhin23.499}, pmid = {40305821}, issn = {0300-0729}, mesh = {Humans ; *Olfaction Disorders/etiology/diagnosis ; *COVID-19 Vaccines/adverse effects ; *COVID-19/prevention & control ; Female ; Adult ; Male ; SARS-CoV-2 ; *Vaccination/adverse effects ; }, abstract = {This systematic review examines 16 reported cases of olfactory disorders occurring after COVID-19 vaccination. Symptoms such as anosmia, parosmia, hyposmia, ageusia, and dysgeusia appeared within one week of vaccination. Among the 16 patients (12 women, 4 men; mean age 38 years), 9 received the Pfizer mRNA vaccine, 6 received the AstraZeneca viral vector vaccine, and 1 received the Moderna mRNA vaccine. Symptoms persisted from 4 days to 18 months, with varying degrees of severity. Diagnoses were made using Sniffin’ Sticks tests and T&T olfactometry, mosty revealing mild hyposmia. Treatment included vitamin B12, multivitamins, olfactory training, Kampo formula, and, in some cases, corticosteroids. The hypothesized mechanism involves inflammatory responses triggered by spike protein interaction with the α7 nicotinic acetylcholine receptor on macrophages. Given the lack of definitive diagnostic methods, careful clinical evaluation is essential to rule out other causes such as subclinical COVID-19 infection. While olfactory disorders have been reported after vaccination, no direct causal relationship has been established.Further research is needed to clarify underlying mechanisms and contributing factors.}, } @article {pmid40305634, year = {2025}, author = {Gilliland, K and Kilinsky, A}, title = {Vaccine Hesitancy: Where Are We Now?.}, journal = {Pediatric annals}, volume = {54}, number = {5}, pages = {e154-e159}, doi = {10.3928/19382359-20250307-01}, pmid = {40305634}, issn = {1938-2359}, mesh = {Child ; Humans ; *COVID-19/prevention & control/epidemiology ; *COVID-19 Vaccines/adverse effects ; *Patient Acceptance of Health Care/psychology ; Social Media ; *Vaccination/psychology ; *Vaccination Hesitancy/psychology ; *Vaccination Refusal/psychology ; }, abstract = {Vaccine hesitancy is the delay in acceptance or outright refusal of immunizations, which has evolved into a growing public health threat. In this article, we explore recent trends in vaccine hesitancy in the setting of the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic, vaccine-specific variations, social media influence, and sociodemographic factors. During the coronavirus disease 2019 pandemic, the antivaccine movement gained increasing support and generated widespread conspiracy theories and mistrust. This highlighted the importance of enhancing communication between the health care field and general public. While the impact of antivaccine social media is widespread, physicians have also begun to use technology to spread factual information and increase vaccination uptake. There is a growing body of evidence regarding sociodemographic data, including the pervasive impact of medical racism on vaccine hesitancy, with additional studies on age, education, income, and more. Providers must serve as communicators and focus on presumptive language, strong recommendations, and tailored conversations with families who are hesitant about vaccines. [Pediatr Ann. 2025;54(5):e154-e159.].}, } @article {pmid40305533, year = {2025}, author = {Wang, R and Lin, M and Yu, S and Xue, X and Hu, X and Wang, Z}, title = {Predictors of post-COVID-19 syndrome: a meta-analysis.}, journal = {Journal of infection in developing countries}, volume = {19}, number = {4}, pages = {490-497}, doi = {10.3855/jidc.18574}, pmid = {40305533}, issn = {1972-2680}, mesh = {Female ; Humans ; Male ; Comorbidity ; *COVID-19/complications/diagnosis/epidemiology/virology ; Dyspnea/diagnosis/epidemiology/virology ; *Post-Acute COVID-19 Syndrome/diagnosis/epidemiology/virology ; Prognosis ; Risk Factors ; SARS-CoV-2 ; Severity of Illness Index ; Sex Factors ; }, abstract = {INTRODUCTION: Post Coronavirus Disease 2019 (COVID-19) Syndrome also known as long COVID-19 would affect survivors of various patients. At present, the evidence for predicting a poor prognosis of COVID-19 remains insufficient. This study aims to explore potential predictors of post-COVID-19 syndrome.

METHODOLOGY: A systematic review process and meta-analysis method are applied to identify the predictors. Systematic searches were conducted without language restrictions from December 1, 2019, to February 28, 2022, on PubMed, Embase, Google Scholar, Web of Science, and Cochrane Library using specific keywords relevant to our targets. The Newcastle Ottawa Scale observational research tool was used to assess study quality and the R (4.1.1) package meta was used for statistical analysis.

RESULTS: Our meta-analysis of 14 studies showed that females (OR = 1.42, 95% CI: 1.19-1.70), the severity of patients (OR = 2.43, 95% CI: 1.26-4.68), comorbidity (OR = 2.08, 95% CI: 1.29-3.35), dyspnea (OR = 2.02, 95% CI: 1.34-3.04) associated with a higher risk of post-COVID-19 syndrome.

CONCLUSIONS: Our study showed that females, the severity of COVID-19, comorbidity, and dyspnea were associated with a higher risk of post-COVID-19 syndrome. More attention should be paid to these factors to prevent and treat post-COVID-19 syndrome.}, } @article {pmid40303414, year = {2025}, author = {Lupu, A and Gavrilovici, C and Mihai, CM and Tonco, DC and Nedelcu, AH and Pertea, L and Chisnoiu, T and Baciu, G and Stoicescu, RM and Salaru, DL and Badescu, MC and Cuciureanu, M and Cirstea, O and Lupu, VV}, title = {Multisystem inflammatory syndrome in children and Kawasaki disease.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1554787}, pmid = {40303414}, issn = {1664-3224}, mesh = {Humans ; *Mucocutaneous Lymph Node Syndrome/diagnosis/therapy/epidemiology/immunology ; *Systemic Inflammatory Response Syndrome/diagnosis/therapy/epidemiology/immunology ; Child ; Child, Preschool ; *COVID-19/diagnosis/therapy/complications ; Diagnosis, Differential ; Infant ; }, abstract = {This narrative review aims to analyze and compare the current literature on multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease (KD), with a focus on case definitions, clinical features, diagnostic approaches, treatment strategies, and outcomes. Through a comprehensive review of relevant studies, including screening titles, abstracts, and full-text articles, key similarities and differences were identified. Both MIS-C and KD involve immune system dysregulation and share clinical manifestations such as rash, gastrointestinal symptoms, and cardiovascular involvement, with treatments often centered around immunomodulatory therapies. However, significant differences were observed, particularly in terms of age distribution, demographic prevalence, clinical presentation, and diagnostic criteria, with KD primarily affecting younger children and being associated more prominently with coronary artery abnormalities. While both diseases raise concerns about severe cardiac involvement and the need for intensive care, their pathogenic mechanisms have not been fully understood. Ongoing research is critical to elucidating these mechanisms, refining diagnostic criteria, and optimizing therapeutic approaches to improve outcomes for affected children. This comparative analysis is essential for advancing the understanding of both conditions, as accurately distinguishing between MIS-C and KD has significant implications for clinical decision-making and patient management. Given their overlapping yet distinct clinical features, precise differentiation is critical for ensuring timely diagnosis, optimizing therapeutic strategies, and improving patient outcomes. The concern among pediatric patients stems from the potential for severe complications, particularly cardiac involvement, which underscores the need for heightened awareness, early recognition, and evidence-based treatment strategies to minimize long-term morbidity and mortality.}, } @article {pmid40302570, year = {2025}, author = {Feng, SS and Zhang, S}, title = {[Advances in pulmonary pathology in China over the past ten years: retrospect and prospect].}, journal = {Zhonghua bing li xue za zhi = Chinese journal of pathology}, volume = {54}, number = {5}, pages = {425-434}, doi = {10.3760/cma.j.cn112151-20241024-00697}, pmid = {40302570}, issn = {0529-5807}, mesh = {Humans ; China ; *COVID-19/pathology/diagnosis ; *Lung Neoplasms/pathology/diagnosis ; SARS-CoV-2 ; *Lung/pathology ; Lung Diseases, Interstitial/pathology/diagnosis ; Artificial Intelligence ; Liquid Biopsy ; }, abstract = {Over the past decade, China has made remarkable achievements in the updating of molecular characteristics and diagnostic criteria of lung cancer, pathological characteristics of COVID-19, classification scheme of interstitial lung disease, application of artificial intelligence in pulmonary pathological diagnosis, and clinical application of new biomarkers such as liquid biopsy. The Chinese Journal of Pathology has witnessed a revolution in this field. On the occasion of the 70th anniversary of the journal, this article reviews the development of pulmonary pathology over the past decade and looks forward to the future trend.}, } @article {pmid40302466, year = {2025}, author = {Facio, F and Colonnello, E and Alzweri, L and Citrin, E and Dubinskaya, A and Falsetta, M and Fregonesi, A and Kellogg-Spadt, S and Lopes, LS and Jannini, EA}, title = {Infection, inflammation, and sexual function in male and female patients-recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024).}, journal = {Sexual medicine reviews}, volume = {13}, number = {3}, pages = {301-317}, doi = {10.1093/sxmrev/qeaf021}, pmid = {40302466}, issn = {2050-0521}, mesh = {Female ; Humans ; Male ; *Inflammation/complications ; *Sexual Dysfunction, Physiological/etiology ; *Sexual Dysfunctions, Psychological/etiology ; Sexual Health ; *Sexually Transmitted Diseases/complications ; Practice Guidelines as Topic ; }, abstract = {INTRODUCTION: Sexual dysfunction in men and women is an important clinical issue; infection and inflammation can cause social, medical, and psychological problems that have a profound impact on sexual and reproductive health worldwide.

OBJECTIVES: We set out to identify sexual dysfunctions in men and women that arise from infection and inflammation and propose meaningful interventions, as evaluated by the Fifth International Consultation on Sexual Medicine (ICSM) held in June 2024 in Madrid (Spain).

METHODS: We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) for published peer-reviewed journal articles and ClinicalTrials.gov and the World Health Organization's (WHO's) International Clinical Trials Registry Platform for prospective trials. This manuscript represents the opinions of 10 experts from 6 countries developed in a consensus process after completing the literature review, which produced a list of recommendations graded as weak or strong. This document was presented for peer review and debate in a public forum, and revisions were made based on the recommendations of chairpersons of the 5th ICSM.

RESULTS: Infections, and in particular sexually transmitted infections (STIs), dramatically affect the sexual and reproductive health of individuals and couples, irrespective of sexual orientation and gender. Similarly, non-communicable chronic diseases (NCDs), through the common pathogenetic mechanism of inflammation, can directly impair the ability to copulate, reproduce, and enjoy sexual life.

CONCLUSIONS: This expert consensus recommends prioritizing early detection, comprehensive treatment approaches, and preventive measures to mitigate the effects of infection and inflammation on sexual health, both for the patient and the couple. These insights provide a foundation for improving patient outcomes and fostering global awareness of the interconnections between infection, inflammation, and sexual dysfunction.}, } @article {pmid40302322, year = {2025}, author = {Xi, Y and Zhou, Z and Chang, T and Dou, G and Chu, Z}, title = {Acute Macular Neuroretinopathy Mediated by COVID-19 Infection: Insights into its Clinical Features and Pathogenesis.}, journal = {Frontiers in bioscience (Landmark edition)}, volume = {30}, number = {4}, pages = {26412}, doi = {10.31083/FBL26412}, pmid = {40302322}, issn = {2768-6698}, support = {82371071//National Natural Science Foundation of China/ ; 81970814//National Natural Science Foundation of China/ ; 82000905//National Natural Science Foundation of China/ ; 2021JSTS28//Clinical AFFMU foundation support/ ; 22YXYJ0053//Science and Technology Project of Xi'an/ ; }, mesh = {Humans ; *COVID-19/complications ; *Retinal Diseases/etiology/pathology/virology ; SARS-CoV-2 ; Adult ; Female ; Male ; Middle Aged ; Aged ; Adolescent ; Young Adult ; Acute Disease ; Blood-Retinal Barrier/pathology ; Macula Lutea/pathology ; }, abstract = {Acute macular neuroretinopathy (AMN) is a rare retinal condition that predominantly affects young females. The incidence of AMN increased significantly during the COVID-19 pandemic, thereby providing a unique opportunity to elucidate the etiology of this disease. In the present study, 24 articles reporting 59 patients were reviewed. The average age of the patients was 33.51 ± 14.02 years, ranging from 16 to 75 years, with females comprising 71.19% of the cases. The average duration of ocular symptoms post-infection was 8.22 ± 10.69 days, ranging from 4 to 150 days. This study investigated the potential pathogenesis of AMN, including the impact of COVID-19 on retinal neurovascular structure and function, immune-mediated inflammatory factor production, blood-retinal barrier disruption, and retinal microvascular damage, as well as potential clinical therapeutic interventions. This research provides a theoretical framework that can inform further investigations of AMN.}, } @article {pmid40301951, year = {2025}, author = {Jafari-Vayghan, H and Rahimlou, M and Almasi-Hashiani, A and Aframehr, E and Saleh-Ghadimi, S}, title = {Effect of the vitamin D supplementation on clinical outcomes and inflammatory status in COVID-19 patients: an umbrella review.}, journal = {BMC nutrition}, volume = {11}, number = {1}, pages = {86}, pmid = {40301951}, issn = {2055-0928}, abstract = {INTRODUCTION: The role of vitamin D supplementation in modulating clinical outcomes and inflammatory responses in COVID- 19 patients has garnered significant interest. This umbrella review consolidates current evidence to evaluate the association between vitamin D supplementation and COVID- 19-related outcomes.

METHODS: A comprehensive search was conducted across multiple databases to identify relevant systematic reviews and meta-analyses. Studies assessing the impact of vitamin D supplementation on disease severity, mortality, hospitalization, and inflammatory markers in COVID- 19 patients were included. Methodological quality was assessed using standardized tools.

RESULTS: The findings suggest that vitamin D supplementation may be associated with reduced mortality and improved clinical outcomes in COVID- 19 patients. Several studies reported a decrease in inflammatory markers, such as C-reactive protein and interleukin- 6, following supplementation. However, variations in study design, dosage regimens, and baseline vitamin D status limit the generalizability of results.

CONCLUSION: Vitamin D supplementation appears to have a potential role in improving clinical outcomes and modulating inflammatory responses in COVID- 19 patients. Nevertheless, due to heterogeneity among studies, further high-quality randomized controlled trials are warranted to confirm these findings.}, } @article {pmid40301825, year = {2025}, author = {Khanlari, P and NoorbalaTafti, A and Ghasemi, F and Ghiyasvandian, S and Azam, K and Zakerian, SA}, title = {Identification and classification of risk factors for mental health problems in healthcare workers using a systemic framework: an umbrella review.}, journal = {BMC public health}, volume = {25}, number = {1}, pages = {1581}, pmid = {40301825}, issn = {1471-2458}, mesh = {Humans ; *Health Personnel/psychology/statistics & numerical data ; Risk Factors ; *Depression/epidemiology ; COVID-19/epidemiology/psychology ; *Anxiety/epidemiology ; Prevalence ; Mental Disorders/epidemiology ; }, abstract = {BACKGROUND: Mental health problems are high among healthcare workers (HCWs) due to difficult and complex working conditions. This study aims to investigate the prevalence of depression and anxiety through existing meta-analyses and identify risk factors related to these mental health issues at different levels of the work system.

METHODS: We conducted an umbrella review with a scoping approach to identify and select studies related to depression and anxiety among HCWs. This study was conducted according to a five-step scoping approach. The search included only studies published before January 2024. The final studies were reviewed and selected using EndNote X9, with information extracted according to specific criteria.

RESULTS: Sixty-one studies were included in the final stage and necessary information was extracted from them, 47 articles reported prevalence and risk factors were extracted from 29 articles. Most of the studies were conducted in the context of Covid-19. prevalence of depression varied between 20.5% and 46.2% and for anxiety, it was between 21.9 and 47%. Factors related to depression and anxiety were divided into four levels of the work system, including individual factors, work and unit factors, organizational factors, and external factors.

CONCLUSIONS: Numerous secondary studies indicate a high prevalence of depression and anxiety among HCWs, especially during the COVID-19 pandemic. This study introduces a framework for systematically identifying mental health problems. Future research is encouraged to utilize this framework to identify risk factors contributing to mental health challenges. It is recommended to use a systemic approach to managing mental health problems.}, } @article {pmid40301746, year = {2025}, author = {Han, Y and Wang, Z and Li, X and Zhong, Z}, title = {Differences in chest imaging between Omicron and non-Omicron coronavirus disease 2019 (COVID-19) patients: a systematic review and meta-analysis.}, journal = {BMC infectious diseases}, volume = {25}, number = {1}, pages = {631}, pmid = {40301746}, issn = {1471-2334}, support = {No. JJKH20221045KJ//Scientific and technological research program of Jilin provincial education department/ ; No. JJKH20221045KJ//Scientific and technological research program of Jilin provincial education department/ ; }, mesh = {Humans ; *COVID-19/diagnostic imaging/virology ; Tomography, X-Ray Computed ; *SARS-CoV-2/genetics ; *Lung/diagnostic imaging/virology/pathology ; }, abstract = {BACKGROUND: Coronavirus disease 2019 (COVID-19) have posed a great threat to human health. We carried out this systematic review and meta-analysis for two objectives. First, to evaluate the differences in lung infection between the Omicron variants and the non-Omicron strains by chest computed tomography (CT); second, to evaluate the differences in chest CT features between COVID-19 patients with the Omicron variants and those with non-Omicron strains in CT-positive cases.

METHODS: We searched PubMed, Embase, Web of Science and China National Knowledge Infrastructure for articles and performed a meta-analysis using Stata 14.0 with a random effects model.

RESULTS: Our study included a total of 8126 patients with COVID-19, 4113 with the Omicron variants, and 4013 with non-Omicron strains. Patients with the Omicron variants were less likely to be CT-positive (OR = 0.14, 95% CI: 0.08-0.25), and further analysis among CT-positive patients was performed. Compared with the CT images of patients with non-Omicron strains, those of patients with the Omicron variants showed atypical pulmonary features (OR = 4.02, 95% CI: 2.31-6.98). Moreover, patients with the Omicron variants typically had lesions that were mainly located in the center of the lung (OR = 4.51, 95% CI: 1.38-14.76) and in a single lobe (OR = 1.72, 95% CI: 1.10-2.70). The patients with the Omicron variants were less likely to have lesions in both lungs (OR = 0.33, 95% CI: 0.15-0.69), more likely to have bronchial wall thickening (OR = 1.99, 95% CI: 1.05-3.77) and less likely to have the crazy-paving pattern (OR = 0.51, 95% CI: 0.33-0.81), linear opacity (OR = 0.26, 95% CI: 0.12-0.60), and vascular enlargement (OR = 0.54, 95% CI: 0.35-0.84).

CONCLUSIONS: Through meta-analysis, which yields the highest level of evidence for evidence-based medicine, we further confirmed that there were significant differences in the distribution and manifestations of lesions between patients with non-Omicron strains and those with the Omicron variants on chest CT. The variation in SARS-CoV-2 has never stopped. Our findings are useful for the diagnosis and treatment of new SARS-CoV-2 variants that may appear in the future and provide a basis for public health decision-making.

PROSPERO REGISTRATION NUMBER: CRD42024581869.}, } @article {pmid40300883, year = {2025}, author = {Wang, P and Huang, Q and Liu, B and Xu, Q and Li, X and Feng, G and Liu, Y}, title = {Oxygen therapy in the intensive care unit.}, journal = {Medical gas research}, volume = {15}, number = {4}, pages = {478-487}, pmid = {40300883}, issn = {2045-9912}, mesh = {Humans ; *Intensive Care Units ; *Oxygen Inhalation Therapy/methods ; COVID-19/therapy ; Respiration, Artificial ; Oxygen ; Extracorporeal Membrane Oxygenation ; SARS-CoV-2 ; }, abstract = {Oxygen therapy is a crucial treatment method for maintaining vital signs in patients in the intensive care unit. However, several controversial issues have emerged regarding its clinical application. This article analyzes current research trends in oxygen therapy in the intensive care unit and provides guidance and recommendations. Relevant literature was retrieved from the Web of Science Core Collection, and keyword co-occurrence and highly cited literature hotspot analyses were conducted using VOSviewer 1.6.19 software. The key topics related to oxygen therapy in the intensive care unit primarily focus on four areas: oxygen therapy and mechanical ventilation in the intensive care unit, extracorporeal membrane oxygenation therapy for coronavirus disease 2019 and its role in reducing mortality, research on hypoxia and oxygen saturation monitoring, and oxygen inhalation therapy in the intensive care unit. The analysis of highly cited literature indicates that the main research hotspots regarding oxygen therapy used in the intensive care unit focus primarily on conservative oxygen therapy, high-flow nasal oxygen therapy, comparisons of high- and low-oxygenation strategies, and research on hyperbaric oxygen therapy. First, the potential of conservative oxygen therapy to reduce mortality rates in the intensive care unit has attracted considerable attention; however, further clinical studies are needed to validate its optimal parameters and suitable patient populations. Second, high-flow nasal oxygen therapy has been shown to be effective in alleviating respiratory distress and reducing the need for intubation. This therapy can deliver oxygen flows of up to 60 L/min, effectively improving respiratory distress and decreasing intubation demands. In patients subjected to high-risk extubation, the combination of high-flow nasal oxygen therapy and noninvasive ventilation significantly lowers the rate of reintubation, making the combined approach one of the best strategies to prevent respiratory failure after extubation in the intensive care unit. Third, there are differences between lower and higher oxygenation strategies regarding their effects on patient mortality, long-term outcomes, and clinician preferences; however, there is currently no clear evidence indicating which strategy is superior. Clinicians' preferences regarding various oxygenation targets may impact the design of future studies. Finally, hyperbaric oxygen therapy is recognized as an effective supportive treatment for various critical conditions and has significant application value in acute severe traumatic brain injury, cerebral resuscitation, and cardiopulmonary resuscitation. Currently, researchers are continually exploring the latest oxygen therapies in the intensive care unit. Several randomized controlled clinical trials investigating automated oxygen control, novel high-flow nasal oxygen therapy, and combined oxygen therapy are underway. The results of these trials should be closely observed. Overall, this article provides a systematic review and valuable reference for the scientific and rational application of oxygen therapy in the intensive care unit. Future research should focus on verifying the optimal parameters of conservative oxygen therapy, assessing oxygen needs in different patient populations, evaluating the long-term effects of oxygen treatment, and developing novel oxygen therapy technologies and devices.}, } @article {pmid40300093, year = {2025}, author = {Rane Levendovszky, S and Patel, P and Zhu, C and Rutman, AM and Basha, MM}, title = {Neuroimaging biomarkers of post-acute sequelae of Coronavirus Disease 2019.}, journal = {The British journal of radiology}, volume = {98}, number = {1172}, pages = {1165-1175}, doi = {10.1093/bjr/tqaf090}, pmid = {40300093}, issn = {1748-880X}, support = {R01 HL162743/HL/NHLBI NIH HHS/United States ; //Chronic Post COVID-19 Infection Neuroimaging and Cerebrovascular Imaging/ ; //Bayer Healthcare LLC/ ; //Long terms effects of COVID-19/ ; }, mesh = {Humans ; *COVID-19/complications/diagnostic imaging ; *Neuroimaging/methods ; *Brain/diagnostic imaging/pathology ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; Biomarkers ; Magnetic Resonance Imaging/methods ; Diffusion Tensor Imaging ; }, abstract = {COVID-19, caused by SARS-CoV-2, has led to the condition known as Long COVID or post-acute sequelae of COVID-19 (PASC), where individuals experience persistent debilitating symptoms long after the initial infection. We provide here a comprehensive review of findings in the central nervous system associated with PASC. Neuroimaging has been instrumental in identifying brain changes associated with PASC. Structural MRI studies consistently reveal grey matter volume reductions in the frontal and temporal lobes and white matter hyperintensities, particularly in the periventricular regions. Studies especially found these changes to correlate strongly with cognitive deficits. Diffusion tensor imaging has shown increased tissue damage and oedema in the brain's white matter tracts, particularly in the sagittal stratum and thalamic radiation. Resting-state functional MRI studies indicate altered brain connectivity in PASC patients, especially in those with post-traumatic stress symptoms. Reduced connectivity within and between critical networks, such as the default mode network and the executive control network, has been observed. These changes correlate with cognitive impairments, such as attention and memory deficits. Dynamic functional connectivity analyses further reveal that PASC patients spend less time in states with rich inter-regional connectivity, and transitions between connectivity states were linked to post-traumatic stress disorder symptoms. Positron emission tomography scans have shown hypometabolism in the frontal and temporal lobes, particularly in regions associated with memory and executive functions. Hypometabolism in the hippocampus and thalamus is linked to symptoms like anosmia and fatigue. Despite the heterogeneity in clinical presentations and diagnostic criteria, these neuroimaging findings underscore the significant impact of COVID-19 on brain structure and function. Continued research using advanced imaging techniques is essential for a deeper understanding of PASC's neurological effects. This will aid in developing targeted interventions and improving outcomes for those affected by Long COVID and inform studies investigating downstream effects of viral infections on the brain.}, } @article {pmid40299886, year = {2025}, author = {Okmi, M and Ang, TF and Mohd Zaki, MF and Ku, CS and Phan, KY and Wahyudi, I and Por, LY}, title = {Mobile Phone Network Data in the COVID-19 era: A systematic review of applications, socioeconomic factors affecting compliance to non-pharmaceutical interventions, privacy implications, and post-pandemic economic recovery strategies.}, journal = {PloS one}, volume = {20}, number = {4}, pages = {e0322520}, pmid = {40299886}, issn = {1932-6203}, mesh = {Humans ; *COVID-19/epidemiology/prevention & control/economics ; *Cell Phone/statistics & numerical data ; Pandemics ; Privacy ; Socioeconomic Factors ; SARS-CoV-2 ; Smartphone ; }, abstract = {BACKGROUND: The use of traditional mobility datasets, such as travel surveys and census data, has significantly impacted various disciplines, including transportation, urban sensing, criminology, and healthcare. However, because these datasets represent only discrete instances of measurement, they miss continuous temporal shifts in human activities, failing to record the majority of human mobility patterns in real-time. Bolstered by the rapid expansion of telecommunication networks and the ubiquitous use of smartphones, mobile phone network data (MPND) played a pivotal role in fighting and controlling the spread of COVID-19.

METHODS: We conduct an extensive review of the state-of-the-art and recent advancements in the application of MPND for analyzing the early and post-stages of the COVID-19 pandemic, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Additionally, we evaluate and assess the included studies using the Mixed Methods Appraisal Tool (MMAT) and the Critical Appraisal Skills Programme (CASP). Furthermore, we apply bibliometric analysis to visualize publication structures, co-authorship networks, and keyword co-occurrence networks.

RESULTS: After the full-text screening process against the inclusion and exclusion criteria, our systematic literature review identified 55 studies that utilized MPND in the context of the COVID-19 pandemic: 46 (83.6%) were quantitative, and 9 (16.4%) were qualitative. These quantitative studies can be classified into five main groups: monitoring and tracking of human mobility patterns (n = 11), investigating the correlation between mobility patterns and the spread of COVID-19 (n = 7), analyzing the recovery of economic activities and travel patterns (n = 5), assessing factors associated with NPI compliance (n = 5), and investigating the impact of COVID-19 lockdowns and non-pharmaceutical interventions (NPI) measures on human behaviors, urban dynamics, and economic activity (n = 18). In addition, our findings indicate that NPI measures had a significant impact on reducing human movement and dynamics. However, demographics, political party affiliation, socioeconomic inequality, and racial inequality had a significant impact on population adherence to NPI measures, which could increase disease spread and delay social and economic recovery.

CONCLUSION: The usage of MPND for monitoring and tracking human activities and mobility patterns during the COVID-19 pandemic raises privacy implications and ethical concerns. Thus, striking a balance between meeting the ethical requirements and maintaining privacy risks should be further discovered and investigated in the future.}, } @article {pmid40299497, year = {2025}, author = {Galindo-Méndez, M and Galindo-Ruiz, M and Concheso-Venegas, MF and Mendoza-Molina, SU and Orozco-Cruz, D and Weintraub-Benzion, E}, title = {The Impact of Vitamin D in the Prevention of Influenza, COVID-19, and Dengue: A Review.}, journal = {Biomedicines}, volume = {13}, number = {4}, pages = {}, pmid = {40299497}, issn = {2227-9059}, abstract = {Since its discovery, vitamin D (VD) has been known for its implications in maintaining bone homeostasis. However, in recent years it has been discovered that the vitamin D receptor is expressed on different cells of the immune system and that these cells can locally produce the active form of this molecule, calcitriol, strongly suggesting that this vitamin might play a key role in both branches of the immune system, innate and adaptive. Recent evidence has demonstrated that VD participates in the different protective phases of the immune system against invading microorganisms, including in the activation and production of antimicrobial peptides, in the inactivation of replication of infectious agents, in the prevention of the exposure of cellular receptors to microbial adhesion, and, more importantly, in the modulation of the inflammatory response. In recent years, the world has witnessed major outbreaks of an ancient infectious disease, dengue fever; the emergence of a pandemic caused by an unknown virus, SARS-CoV-2; and the resurgence of a common respiratory infection, influenza. Despite belonging to different viral families, the etiological agents of these infections present a common trait: their capacity to cause complications not only through their cytopathic effect on target tissues but also through the excessive inflammatory response produced by the human host against an infection. This review outlines the current understanding of the role that vitamin D plays in the prevention of the aforementioned diseases and in the development of their complications through its active participation as a major modulator of the immune response.}, } @article {pmid40298974, year = {2025}, author = {Pettenuzzo, T and Balzani, E and Sella, N and Giani, M and Bassi, M and Fincati, V and Cescon, R and Pacchiarini, G and Pandolfo, G and Ceccato, R and Grønlykke, L and Staudacher, DL and Nesseler, N and Raasveld, SJ and Carron, M and Pistollato, E and Mormando, G and Zarantonello, F and De Cassai, A and Boscolo, A and Rezoagli, E and Foti, G and Navalesi, P}, title = {Prone positioning during veno-venous extracorporeal membrane oxygenation: a systematic review and meta-analysis.}, journal = {Intensive care medicine}, volume = {51}, number = {5}, pages = {930-941}, pmid = {40298974}, issn = {1432-1238}, mesh = {Humans ; Prone Position/physiology ; *Extracorporeal Membrane Oxygenation/methods ; *Respiratory Insufficiency/therapy/mortality ; *Patient Positioning/methods ; Hospital Mortality ; }, abstract = {PURPOSE: The evidence supporting the benefit on clinical outcomes of prone positioning during veno-venous extracorporeal membrane oxygenation (V-V ECMO) for acute hypoxemic respiratory failure remains inconclusive. We aimed to assess the association of prone positioning, compared to no prone positioning, with 28-day mortality and other clinical outcomes in different patient subgroups.

METHODS: A systematic review and meta-analysis of randomized and non-randomized controlled trials (RCTs) using a random-effects model was conducted. An electronic database search up to September 1st, 2024 was performed (PROSPERO CRD42024517602). The RoB 2 and ROBINS-I tools were used for risk of bias assessments.

RESULTS: We analyzed two RCTs and 20 non-RCTs (3,465 patients). Compared to no prone positioning, the use of prone positioning was associated with lower 28-day (odds ratio [OR] 0.64, 95% confidence interval [CI] 0.42-0.98, p = 0.040, I[2] = 66%, low certainty of evidence [CoE]) and hospital mortality (OR 0.67, 95% CI 0.54-0.83, p < 0.001, I[2] = 39%, low CoE), despite fewer 28-day ventilator-free days and longer ECMO duration. Younger age (p = 0.005), a higher sequential organ failure assessment (SOFA) score (p = 0.022), non-Covid-19 etiology (p = 0.003), and lower rates of prone positioning before cannulation (p = 0.049) were associated with a greater benefit from prone positioning.

CONCLUSION: In this analysis, among patients supported with V-V ECMO for acute hypoxemic respiratory failure, we observed improved 28-day and hospital mortality in those who received prone positioning, compared to those who did not. However, these findings do not imply causation. Further research is needed to clarify the role of prone positioning in this population.}, } @article {pmid40298723, year = {2025}, author = {Carbonera, JB and Silva, SMD and Cunha, CJCA}, title = {Leading a hospital in the COVID-19 pandemic: an integrative review.}, journal = {Ciencia & saude coletiva}, volume = {30}, number = {4}, pages = {e14682023}, doi = {10.1590/1413-81232025304.14682023}, pmid = {40298723}, issn = {1678-4561}, mesh = {Humans ; *COVID-19/epidemiology ; *Leadership ; Pandemics ; *Hospital Administration ; }, abstract = {The objective of this review was to investigate the experiences lived by leaders during the pandemic period and their potential contributions. It is an integrative review based on the methodology proposed by Whittemore and Knafl (2005). The search was conducted in the following databases: PubMed/Medline, Embase, Scopus, Web of Science, PsycINFO, LILACS, SciELO, and CINAHL, resulting in the retrieval of 1,538 articles. In the analysis of the included articles, the difficulties faced by identified leaderships were: fear, stress, burnout syndrome, insecurity, prejudice, anger, communication problems, external challenges related to lockdown, school and daycare closures, Personal Protective Equipment, budget and funding, separation of family members from the hospital, overload, and difficulties in leading the team and leading individually. In cases where the leader managed to deal with the difficulties and shifted their focus to people-focused leadership, it was possible to confront one of the greatest health crises in history. Leadership produced positive outcomes such as streamlining, a sense of professional appreciation, improvement in continuous education, strengthening of team spirit, knowledge sharing, and development of health services.}, } @article {pmid40298344, year = {2025}, author = {Collà Ruvolo, C and Morra, S and Di Bello, F and Cilio, S and Fraia, A and Polverino, F and Creta, M and Longo, N and Imbimbo, C and Checcucci, E and Puliatti, S and Dell'oglio, P and Califano, G}, title = {A systematic review assessing the reliability of studies focusing on urological content on YouTube.}, journal = {Minerva urology and nephrology}, volume = {77}, number = {2}, pages = {192-201}, doi = {10.23736/S2724-6051.24.05994-9}, pmid = {40298344}, issn = {2724-6442}, mesh = {*Social Media/standards ; Humans ; *Urology ; COVID-19/epidemiology ; Reproducibility of Results ; *Video Recording ; }, abstract = {INTRODUCTION: In recent years, several publications have focused on analyzing the quality of medical content on YouTube. The current systematic review aimed to summarize and analyze the available studies examining YouTube video content in the urological field.

EVIDENCE ACQUISITION: This is a systematic review including studies examining urological content uploaded on the YouTube platform published before November 2023. The following keywords were combined to capture relevant publications with a title/abstract search: ("Urology" OR "Andrology") AND ("YouTube" OR "Social media").

EVIDENCE SYNTHESIS: According to the inclusion criteria, 84 studies were included. Of all, 74 (88%) studies were published after the COVID-19 pandemic outbreak. A total of 52 (62%) studies used the DISCERN score, 29 (35%) the PEMAT A/V score, 30 (36%) the GQS, 23 (27%) the Misinformation score, 14 (17%) the Likert scale, and 13 (15%) the JAMA score. According to the conclusion, 62 (74%) studies reported poor quality results. Among all, only 10 (12%) studies respected our criteria of best quality methodology, defined as: 1) description of the research time frame; 2) use of incognito status; 3) the description of the inter-rater variability between reviewers; 4) use of at least one quality assessment tool.

CONCLUSIONS: The systematic review highlights significant variability in results and methodologies across studies on the quality analysis of urological content on YouTube. The official urological community should establish guidelines for authors, aiming to enhance the reliability and importance of such publications as valuable resources for daily clinical practice.}, } @article {pmid40298141, year = {2025}, author = {Taylor, BD and Haggerty, CL and Amabebe, E and Richardson, LS}, title = {Current Evidence of Maternal Infection With Chlamydia trachomatis and Preeclampsia Risk.}, journal = {American journal of reproductive immunology (New York, N.Y. : 1989)}, volume = {93}, number = {5}, pages = {e70080}, pmid = {40298141}, issn = {1600-0897}, support = {R01 AI141501/AI/NIAID NIH HHS/United States ; R01 AI143653/AI/NIAID NIH HHS/United States ; 1R01AI143653//National Institute of Allergy and Infectious Diseases/ ; 1R01AI141501//National Institute of Allergy and Infectious Diseases/ ; }, mesh = {Humans ; Female ; Pregnancy ; *Pre-Eclampsia/epidemiology ; *Chlamydia trachomatis/physiology ; *Chlamydia Infections/epidemiology/complications/immunology ; *Pregnancy Complications, Infectious/epidemiology ; Animals ; COVID-19 ; SARS-CoV-2 ; }, abstract = {Chlamydia trachomatis is the most common bacterial sexually transmitted infection (STI) in the United States. Ascending C. trachomatis can cause pelvic inflammatory disease (PID), potentially leading to subsequent infertility, ectopic pregnancy, and adverse pregnancy outcomes. There is growing evidence implicating infections (e.g., COVID-19, cytomegalovirus) in preeclampsia etiology, a maternal hypertensive disorder and leading cause of maternal morbidity and mortality. However, few studies have investigated the impact of STIs on preeclampsia risk. In this review, we provide an overview of the potential association between C. trachomatis and preeclampsia and identify future research needs through a critical evaluation of epidemiologic, in vitro, and in vivo studies. Unfortunately, current methodological limitations such as lower-quality study designs, selection bias, confounding bias, and variations in chlamydia diagnostic methods inhibit our understanding of the impact of C. trachomatis on preeclampsia. In addition, bench-side approaches such as animal models and in vitro studies have not elucidated the mechanisms linking C. trachomatis to preeclampsia. Understanding the biological pathways that could be disrupted by chlamydia is important as it may ultimately guide the development and use of novel therapeutics to augment standard antibiotic therapy to reduce pathology.}, } @article {pmid40297833, year = {2025}, author = {Baby, K and Vithalkar, MP and Dastidar, SG and Mukhopadhyay, C and Hamdy, R and Soliman, SSM and Nayak, Y}, title = {Exploring TMPRSS2 Drug Target to Combat Influenza and Coronavirus Infection.}, journal = {Scientifica}, volume = {2025}, number = {}, pages = {3687892}, pmid = {40297833}, issn = {2090-908X}, abstract = {Respiratory viral infections, including influenza and coronaviruses, present significant health risks worldwide. The recent COVID-19 pandemic highlights the urgent need for novel and effective antiviral agents. The host cell protease, transmembrane serine protease 2 (TMPRSS2), facilitates viral pathogenesis by playing a critical role in viral invasion and disease progression. This protease is coexpressed with the viral receptors of angiotensin-converting enzyme 2 (ACE2) for SARS-CoV-2 in the human respiratory tract and plays a significant role in activating viral proteins and spreading. TMPRSS2 activates the coronavirus spike (S) protein and permits membrane fusion and viral entry by cleaving the virus surface glycoproteins. It also activates the hemagglutinin (HA) protein, an enzyme necessary for the spread of influenza virus. TMPRSS2 inhibitors can reduce viral propagation and morbidity by blocking viral entry into respiratory cells and reducing viral spread, inflammation, and disease severity. This review examines the role of TMPRSS2 in viral replication and pathogenicity. It also offers potential avenues to develop targeted antivirals to inhibit TMPRSS2 function, suggesting a possible focus on targeted antiviral development. Ultimately, the review seeks to contribute to improving public health outcomes related to these viral infections.}, } @article {pmid40297655, year = {2025}, author = {Appiah, PO and Odoom, A and Tetteh-Quarcoo, PB and Kotey, FCN and Donkor, ES}, title = {Microbial Contamination of Door Handles: A Global Systematic Review and Meta-Analysis of Public and Healthcare Settings.}, journal = {Environmental health insights}, volume = {19}, number = {}, pages = {11786302251328550}, pmid = {40297655}, issn = {1178-6302}, abstract = {BACKGROUND: The public health risk of microbial contamination of fomites is evident from the numerous fomite-associated outbreaks that have occurred in several countries. Despite the high-touch nature of door handles across various settings, no comprehensive synthesis of contamination rates and microbial profiles has been performed.

AIM: The aim of this work was to assess the prevalence and types of microbial contamination on door handles in public and healthcare settings.

METHODS: We systematically searched PubMed, Web of Science, and Scopus for studies published up to July 2024. A systematic review and meta-analysis were conducted according to the PRISMA guidelines. Pooled prevalence estimates were calculated via a random-effects model, and subgroup analyses were performed to assess differences on the basis of pathogen type, handle location, and setting.

RESULTS: A total of 27 studies met the eligibility criteria. The overall estimation of microbial contamination of door handles revealed a prevalence of 9.96% (95% CI: 5.87‒14.11). Compared with viral contamination which was observed to be 17.73% (95% CI: 9.24‒27.81), bacterial contamination was less common at 6.20% (95% CI: 2.90‒10.42). The most predominant bacterial agent was Bacillus spp. (55.74%), followed by Acinetobacter baumannii (25.00%); the most prevalent virus was rotavirus (62.50%). The rate of contamination was higher for toilet door handles (23.04%) than for other public and healthcare handles (7.75%). Hospitals presented slightly higher contamination rates (10.82%) than did public settings (8.97%).

CONCLUSION: This systematic review highlights the widespread microbial contamination of door handles, particularly in public and healthcare environments. While bacterial contamination is predominant, the finding of viruses such as rotavirus, norovirus and even SARS-CoV-2 highlights the stringency of cleaning that has to be applied. These findings emphasise the need for targeted hygiene interventions to reduce the risk of pathogen transmission via door handles, particularly in high-traffic areas.}, } @article {pmid40295963, year = {2025}, author = {Rotundo, S and Serapide, F and Berardelli, L and Gullì, SP and Mongiardi, S and Tassone, MT and Trecarichi, EM and Russo, A}, title = {Early combined therapy for COVID-19 in immunocompromised patients: a promising approach against viral persistence and drug resistance.}, journal = {BMC infectious diseases}, volume = {25}, number = {1}, pages = {616}, pmid = {40295963}, issn = {1471-2334}, mesh = {Humans ; *Immunocompromised Host ; *COVID-19/therapy/immunology/virology ; *SARS-CoV-2/drug effects/immunology ; *Antiviral Agents/therapeutic use ; *Drug Resistance, Viral ; *COVID-19 Drug Treatment ; Antibodies, Monoclonal/therapeutic use ; Antibodies, Neutralizing/therapeutic use ; Drug Therapy, Combination ; }, abstract = {Immunocompromised (IC) patients face significant challenges in managing COVID-19 due to their heightened susceptibility to severe illness, persistent infections, and the potential development of drug resistance. Studies indicate that IC patients, particularly those with hematologic malignancies (HM), hematopoietic stem cell transplants (HSCTR), or solid organ transplants (SOTR), experience higher mortality rates and worse outcomes compared to the general population, even post-vaccination. The persistence of the virus in these patients, combined with its rapid mutation, further complicates treatment. Recent evidence supports the use of combined neutralizing monoclonal antibodies (mAbs) and direct-acting antivirals (DAAs) as a more effective approach to viral clearance, reducing mortality, and preventing relapses. However, the rise of resistant variants, especially to mAbs, and concerns about the safety of prolonged or intensive therapies pose ongoing challenges. Monotherapies often fail short to address these issues, highlighting the need for early combined therapy (ECT) with mAbs and DAAs. ECT has shown promise in managing COVID-19 in IC individuals by targeting multiple stages of the viral lifecycle, reducing viral load, and clearing infections at earlier stages, which helps mitigate the risks of severe disease and drug resistance. Continued research is essential to refine these treatment protocols, especially as the virus evolves. Although further studies are needed, current findings suggest that ECT may become the standard of care for managing COVID-19 in severely IC patients, offering better clinical outcomes and hindering viral persistence.}, } @article {pmid40295886, year = {2024}, author = {Marano, V and Vlachová, Š and Tiano, SML and Cortese, M}, title = {A portrait of the infected cell: how SARS-CoV-2 infection reshapes cellular processes and pathways.}, journal = {Npj viruses}, volume = {2}, number = {1}, pages = {66}, pmid = {40295886}, issn = {2948-1767}, support = {HT-ECF 763//Human Technopole/ ; }, abstract = {Positive-sense single-stranded RNA (+ssRNA) viruses exert a profound influence on cellular organelles and metabolic pathway by usurping host processes to promote their replication. In this review, we present a portrait of selected cellular pathways perturbed in SARS-CoV-2 infection: the effect of viral translation, replication and assembly on the morphology and function of the ER, the remodelling of degradative pathways with a focus on the autophagic processes, and the alterations affecting cellular membranes and lipid metabolism. For each of these cellular processes, we highlight the specific viral and host factors involved and their interplay in this microscopic tug-of-war between pro-viral and anti-viral effects that ultimately tip the scale toward the propagation or the resolution of the infection.}, } @article {pmid40295852, year = {2025}, author = {Kayesh, MEH and Kohara, M and Tsukiyama-Kohara, K}, title = {Effects of oxidative stress on viral infections: an overview.}, journal = {Npj viruses}, volume = {3}, number = {1}, pages = {27}, pmid = {40295852}, issn = {2948-1767}, abstract = {Viral infections can trigger increased reactive oxygen species (ROS) production and a reduced antioxidant response in the host, leading to redox stress, inflammation, apoptosis, and ultimately, cell and tissue damage, which contribute to disease development. A better understanding of how ROS contributes to viral pathogenesis is critical for the development of novel therapeutic interventions. In this review, we discuss the current knowledge on ROS production and its effects across various viral infections, including severe acute respiratory syndrome-coronavirus-2, influenza A virus, dengue virus, Zika virus, hepatitis B virus, hepatitis C virus, and human immunodeficiency virus infections, to improve future therapeutic and preventive strategies for these infections.}, } @article {pmid40295844, year = {2025}, author = {Lauster, D and Haag, R and Ballauff, M and Herrmann, A}, title = {Balancing stability and function: impact of the surface charge of SARS-CoV-2 Omicron spike protein.}, journal = {Npj viruses}, volume = {3}, number = {1}, pages = {23}, pmid = {40295844}, issn = {2948-1767}, support = {431232613//Deutsche Forschungsgemeinschaft/ ; 431232613//Deutsche Forschungsgemeinschaft/ ; 434130070//Deutsche Forschungsgemeinschaft/ ; 431232613//Deutsche Forschungsgemeinschaft/ ; }, abstract = {The ectodomain of the Omicron SARS-CoV-2 spike has an increased positive surface charge, favoring binding to the host cell surface, but may affect the stability of the ectodomain. Thermal stability studies identified two transitions associated with the flexibility of the receptor binding domain and the unfolding of the whole ectodomain, respectively. Despite destabilizing effects of some mutations, compensatory mutations maintain ECD stability and functional advantages thus supporting viral fitness.}, } @article {pmid40295787, year = {2025}, author = {Cabrera, A and Mason, E and Mullins, LP and Sadarangani, M}, title = {Antimicrobial resistance and vaccines in Enterobacteriaceae including extraintestinal pathogenic Escherichia coli and Klebsiella pneumoniae.}, journal = {npj antimicrobials and resistance}, volume = {3}, number = {1}, pages = {34}, pmid = {40295787}, issn = {2731-8745}, abstract = {Antimicrobial-resistant Enterobacteriaceae are increasingly a clinical challenge. In particular, extraintestinal pathogenic Escherichia coli and Klebsiella pneumoniae threaten public health. Vaccination presents a long-term strategy to reduce both drug-susceptible and resistant infections while maintaining current clinical therapies. The review aims to emphasize the need for vaccines targeting extraintestinal pathogenic E. coli and K. pneumoniae by providing an overview of disease burden, antimicrobial resistance, therapeutics, and vaccine development.}, } @article {pmid40295763, year = {2024}, author = {Koolaparambil Mukesh, R and Yinda, CK and Munster, VJ and van Doremalen, N}, title = {Beyond COVID-19: the promise of next-generation coronavirus vaccines.}, journal = {Npj viruses}, volume = {2}, number = {1}, pages = {39}, pmid = {40295763}, issn = {2948-1767}, abstract = {Coronaviruses (CoVs) have caused three global outbreaks: severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1) in 2003, Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012, and SARS-CoV-2 in 2019, with significant mortality and morbidity. The impact of coronavirus disease 2019 (COVID-19) raised serious concerns about the global preparedness for a pandemic. Furthermore, the changing antigenic landscape of SARS-CoV-2 led to new variants with increased transmissibility and immune evasion. Thus, the development of broad-spectrum vaccines against current and future emerging variants of CoVs will be an essential tool in pandemic preparedness. Distinct phylogenetic features within CoVs complicate and limit the process of generating a pan-CoV vaccine capable of targeting the entire Coronaviridae family. In this review, we aim to provide a detailed overview of the features of CoVs, their phylogeny, current vaccines against various CoVs, the efforts in developing broad-spectrum coronavirus vaccines, and the future.}, } @article {pmid40295300, year = {2025}, author = {Qi, Y and Li, JY and Wang, J and Mu, J and Deng, Q and Cui, R}, title = {De novo AML spontaneously achieved PR after COVID-19 infection, and CR after reduced dose of azacytidine combined with venetoclax: A case report and literature review.}, journal = {Medicine}, volume = {104}, number = {17}, pages = {e42039}, pmid = {40295300}, issn = {1536-5964}, support = {TJWJ2022XK021//Tianjin Health Research Project/ ; Y-SY2021QN-0184//Chinese Society of Clinical Oncology Beijing Xisike Clinical Oncology Research Foundation/ ; Y-NCJH202201-0027//Chinese Society of Clinical Oncology Beijing Xisike Clinical Oncology Research Foundation/ ; }, mesh = {Female ; Humans ; Middle Aged ; Antimetabolites, Antineoplastic/administration & dosage ; *Azacitidine/administration & dosage/therapeutic use ; *Bridged Bicyclo Compounds, Heterocyclic/administration & dosage/therapeutic use ; *COVID-19/complications ; *COVID-19 Drug Treatment ; *Leukemia, Myeloid, Acute/complications/drug therapy/immunology ; Remission Induction ; SARS-CoV-2/immunology ; *Sulfonamides/administration & dosage/therapeutic use ; }, abstract = {RATIONALE: Coronavirus disease (COVID-19) infection increases the mortality of patients with hematological malignancies. The optimal treatment for de novo acute myeloid leukemia (AML) patients with severe pneumonia caused by COVID-19 is not clear.

PATIENT CONCERNS: A 59-year-old woman was admitted to our department with fever, cough dyspnea, and thrombocytopenia for 1 week.

DIAGNOSES: The patient was diagnosed with AML associated with a TP53 mutation and complex chromosomal abnormalities by bone marrow examination. In addition, she had severe COVID-19 pneumonia when her AML was diagnosed.

INTERVENTIONS: We delayed leukemia therapy to adequately treat her severe COVID-19 pneumonia. In the therapy for COVID-19 pneumonia, the patient presented with high levels of tumor necrosis factor-α and interleukin 6. Surprisingly, after being treated for severe COVID-19 pneumonia, she obtained partial remission in the absence of leukemia therapy. When the severe COVID-19 pneumonia was under control, the patient achieved complete remission after she received a reduced dose of azacytidine combined with venetoclax for only 1 cycle.

OUTCOMES: After a standard dose of azacytidine combined with venetoclax for 2 cycles, the patient achieved a deep molecular remission. The results of next-generation sequencing analysis indicated that the TP53 mutation turned negative.

LESSONS: This case suggests that azacytidine combined with venetoclax could be a safe and valid option compared with intensive chemotherapy in newly diagnosed AML patients with severe COVID-19 pneumonia. Whether the increased cytokine levels could indicate that COVID-19 infection might have an anti-tumor effect on AML patients remains to be further observed.}, } @article {pmid40295228, year = {2025}, author = {Yao, YT and Xie, CM and Wang, HB and Yu, SC and , }, title = {Acute type A aortic dissection patients undergoing surgical repair during the COVID-19 pandemic.}, journal = {Medicine}, volume = {104}, number = {17}, pages = {e42249}, pmid = {40295228}, issn = {1536-5964}, support = {2021-I2M-C&T-B-038//the Youth Teacher Training Program of Peking Union Medical College/ ; 2024RCTJ-QN002//Talent Trusteeship Program of Fuwai Yunnan Hospital Chinese Academy of Medical Sciences/ ; }, mesh = {Humans ; *Aortic Aneurysm/complications/mortality/surgery ; *Aortic Dissection/etiology/mortality/surgery ; *COVID-19/epidemiology/prevention & control ; Pandemics/prevention & control ; Postoperative Complications/epidemiology ; Risk Factors ; }, abstract = {BACKGROUND: Acute type A aortic dissection (ATAAD) is a deadly form of acute aortic syndrome which necessitates emergency surgical repair. Coronavirus disease-19 (COVID-19) pandemic has caused a significant impact on surgery globally. The influence of the COVID-19 pandemic on ATAAD patients undergoing surgical repair remains undetermined.

METHODS: We conducted a systematic review and meta-analysis of studies comparing ATAAD patients undergoing aortic surgery before versus during the COVID-19 pandemic and literature review of published cases reporting COVID-19 patients undergoing surgical repair for ATAAD. PubMed, China National Knowledge Infrastructure, VIP, WANFANG, and SinoMed databases were searched for relevant studies and case reports till January 21st, 2023, and the database search was updated on January 3rd, 2024. Meta-analysis was performed by utilizing RevMan. Pooled odds ratio (OR) and 95% confidence interval (CI) were estimated for dichotomous data, and weighted mean difference (WMD) and 95% CI for continuous data, respectively. All P-values were 2-sided and statistical significance was defined as P < .05.

RESULTS: Meta-analysis of 5 included studies comparing ATAAD patients undergoing aortic surgery before versus during the COVID-19 pandemic demonstrated that, the patients in Group During-Pandemic (DP) were older than those in Group Before-Pandemic (BP; P = .005), and the body mass index of the patients in Group DP was lower than that of the patients in Group BP (P = .002), more patients in Group DP were smokers (P = .02). Meta-analysis also showed that, either the composite incidence of mortality and morbidities or individual morbidity was comparable between 2 groups, except that more patients in Group DP developed pneumonia (P = .05). Literature reviews of 24 published cases reporting COVID-19 patients undergoing surgical repair for ATAAD demonstrated that, twenty (83.3%) patients recovered well after aortic surgery and were finally discharged from hospital. Unfortunately, 4 patients died postoperatively, 3 due to multiple organ failure and one due to respiratory failure (RF). Reported postoperative complications included hypoxia, endotracheal re-intubation, RF, renal failure, coagulopathy, fever, multi-organ failure and shock.

CONCLUSION: The hospitalized outcomes of ATAAD patients undergoing surgical repair before versus during the COVID-19 were mostly comparable. ATAAD patients with concomitant COVID-19 infection who underwent emergent surgical repair had a high risk of mortality and morbidities.}, } @article {pmid40294421, year = {2025}, author = {Bilinski, A and Emanuel, N and Ciaranello, A}, title = {Sins of Omission: Model-Based Estimates of the Health Effects of Excluding Pregnant Participants From Randomized Controlled Trials.}, journal = {Annals of internal medicine}, volume = {178}, number = {6}, pages = {868-877}, doi = {10.7326/ANNALS-24-00689}, pmid = {40294421}, issn = {1539-3704}, mesh = {Humans ; Female ; Pregnancy ; *Randomized Controlled Trials as Topic ; Pyridones/adverse effects ; COVID-19 Vaccines/adverse effects ; Thalidomide/adverse effects ; Heterocyclic Compounds, 3-Ring/adverse effects ; *Patient Selection ; COVID-19/prevention & control ; United States ; Decision Support Techniques ; Abnormalities, Drug-Induced/prevention & control ; Oxazines ; Piperazines ; }, abstract = {BACKGROUND: More than 90 million women in the United States have given birth. Randomized controlled trials (RCTs) of medications almost always exclude pregnant participants.

OBJECTIVE: To quantify the health effects of excluding pregnant participants from RCTs.

DESIGN: Decision analytic framework applied to case studies of thalidomide, COVID-19 vaccines, and dolutegravir.

SETTING: Varied.

PARTICIPANTS: Pregnant people and their children.

MEASUREMENTS: The authors modeled the ex post facto health effects of RCTs, comparing projected health effects of medication uptake had an RCT been conducted versus historically observed outcomes. They also modeled the a priori health effects that could have been anticipated in trial planning. They converted health effect estimates to monetary value using standard benchmarks.

RESULTS: Across case studies, health benefits from conducting RCTs during pregnancy were projected to far exceed expected adverse effects (AEs) from RCTs. For example, had thalidomide been tested in a completed RCT with 200 treated participants, about 33 children would have experienced severe AEs, whereas knowledge from the RCT would have prevented 8000 thalidomide-related birth defects, 99.6% of all thalidomide-related birth defects from 1956 to 1962. Likewise, if RCTs for COVID-19 vaccines had included pregnant participants and if posttrial pregnant uptake were conservatively assumed to mirror that of age- and state-matched nonpregnant women, a projected 20% of COVID-19-related maternal deaths and stillbirths (8% of all maternal deaths and 1% of all stillbirths) in the United States would have been prevented from March to November 2021. Across case studies, the a priori value of RCT data would have exceeded the approximately $100 million cost of phase 1 to 3 RCTs.

LIMITATION: Parameter uncertainty.

CONCLUSION: Systematic inclusion in RCTs could benefit both pregnant people and their children by both speeding AE detection and increasing uptake of beneficial medications.

PRIMARY FUNDING SOURCE: None.}, } @article {pmid40293968, year = {2025}, author = {Thiriveedi, M and Sto Domingo, FG and Longley, S and Patel, S and Baddam, S and Chimakurthy, A}, title = {Post-COVID-19 Guillain-Barré Syndrome with GM1 and GD1b Antibodies: A Case Study and Literature Review.}, journal = {The American journal of case reports}, volume = {26}, number = {}, pages = {e947416}, pmid = {40293968}, issn = {1941-5923}, mesh = {Humans ; *Guillain-Barre Syndrome/immunology/diagnosis/therapy/etiology ; Male ; *COVID-19/complications ; *G(M1) Ganglioside/immunology ; Aged, 80 and over ; *Gangliosides/immunology ; *Autoantibodies/blood ; Pandemics ; SARS-CoV-2 ; Immunoglobulins, Intravenous/therapeutic use ; }, abstract = {BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to the emergence of various neurological complications, including Guillain-Barre syndrome (GBS). GBS is an acute, immune-mediated disorder characterized by progressive weakness, sensory deficits, and autonomic dysfunction. Anti-ganglioside antibodies are often seen in GBS; however, they are rarely reported in the setting of COVID-19-related GBS. We present a case of post-COVID-19 GBS with positive GM1 and GD1b antibodies. CASE REPORT An 86-year-old man presented with progressive quadriparesis, sensory deficits, and hyporeflexia 4 weeks after COVID-19 infection. Brain and spine imaging were unremarkable. Cerebrospinal fluid (CSF) analysis revealed albuminocytological dissociation, consistent with acute inflammatory demyelinating polyneuropathy (AIDP). Despite 2 courses of intravenous immunoglobulin (IVIG), the patient showed minimal improvement in muscle strength. Nerve conduction studies (NCS) revealed severe sensorimotor polyneuropathy, with axonal and demyelinating features. Serum testing showed elevated GM1 and GD1b anti-ganglioside antibody titers. CONCLUSIONS Although numerous cases of COVID-19-related GBS have been reported, anti-ganglioside antibody positivity, particularly GM1 and GD1b, is uncommon. The underlying mechanism is presumed to be autoimmune, likely triggered by molecular mimicry. Our case contributes to the evolving understanding of GBS immunology in the context of COVID-19. Although this case report may not alter current GBS management, the co-occurrence of GM1 and GD1b antibodies in post-COVID-19 GBS underscores the need for continued vigilance, immunological profiling, and research into potential prognostic and therapeutic implications.}, } @article {pmid40293964, year = {2025}, author = {Li, Y and Meagher, RB and Lin, X}, title = {Tailoring mRNA lipid nanoparticles for antifungal vaccines.}, journal = {PLoS pathogens}, volume = {21}, number = {4}, pages = {e1013091}, pmid = {40293964}, issn = {1553-7374}, mesh = {Humans ; *Fungal Vaccines/immunology ; *Nanoparticles/chemistry ; SARS-CoV-2/immunology ; COVID-19/prevention & control/immunology ; *RNA, Messenger/immunology ; *Lipids/chemistry/immunology ; *Mycoses/prevention & control/immunology ; Animals ; Liposomes ; }, abstract = {Vaccination is one of the most effective public health measures for preventing and managing infectious diseases. Despite intensive efforts from the relatively small medical mycology community, developing effective vaccines against invasive fungal infections remains a scientific challenge. This is predominantly due to large antigenic repertoires, complicated life cycles, and the capacity of fungal pathogens to evade the host immune system. Additionally, antifungal vaccines often need to work for at-risk individuals who are immunodeficient. We anticipate that the success of mRNA vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its exploration for various infectious diseases and cancers will usher a new wave of antifungal vaccine research. Herein, we discuss recent advancements and key scientific areas that need to be explored to actualize the development of effective antifungal mRNA vaccines.}, } @article {pmid40293510, year = {2025}, author = {Abraham, JN and Rawat, D and Srikanth, P and Sunny, LP and Abraham, NM}, title = {Alpha-synuclein pathology and Parkinson's disease-related olfactory dysfunctions: an update on preclinical models and therapeutic approaches.}, journal = {Mammalian genome : official journal of the International Mammalian Genome Society}, volume = {36}, number = {2}, pages = {444-464}, pmid = {40293510}, issn = {1432-1777}, support = {/WT_/Wellcome Trust/United Kingdom ; BT/RLF/Re-entry/45/2014//Department of Biotechnology, Ministry of Science and Technology, India/ ; IA/S/22/2/506517//Wellcome Trust DBT India Alliance/ ; }, mesh = {*alpha-Synuclein/metabolism/genetics ; *Parkinson Disease/therapy/pathology/complications/metabolism/genetics ; Humans ; Animals ; Disease Models, Animal ; *Olfaction Disorders/therapy/pathology/etiology/metabolism ; COVID-19/complications ; SARS-CoV-2 ; }, abstract = {Olfactory dysfunction (OD) is considered one of the early signs of Parkinson's disease (PD), affecting over 90% of PD patients. OD often appears several years before the onset of motor symptoms and is therefore considered an early biomarker of PD. Recent studies have shown that COVID-19 infection might lead to worsening of symptoms and acceleration of disease progression in neurodegenerative disorders, where OD is a common symptom to both. Hence, it is essential to accurately monitor olfactory fitness in clinical settings using any of the currently available olfactory function tests. Even after a quarter of a century of the discovery of α-synuclein (α-syn) pathogenesis in PD, many aspects related to the α-syn pathogenesis in OD remain unknown. Currently, there is no definitive cure for PD; the disease management options include dopaminergic medications, deep brain stimulations, stem cells, and immunotherapy. Generating reliable PD animal models is critical for understanding the molecular pathways and neural circuits affected by disease conditions. This might contribute to the development and validation of new therapeutic approaches. This review discusses the known mechanisms of α-syn aggregated forms causing neuronal death, the recent developments in the PD preclinical models with ODs, and the treatment strategies employed.}, } @article {pmid40293430, year = {2025}, author = {Tian, E and Ho, MK and Chou, OHI and Chong, S and Kwan, CT and Lam, AH and Chan, KT}, title = {Effectiveness of telepsychiatry interventions for youth with depressive and/or anxiety disorders: A systematic review with meta-analysis.}, journal = {Clinical child psychology and psychiatry}, volume = {30}, number = {3}, pages = {537-561}, doi = {10.1177/13591045251338475}, pmid = {40293430}, issn = {1461-7021}, mesh = {Humans ; *Telemedicine ; *Anxiety Disorders/therapy ; *Depressive Disorder/therapy ; Adolescent ; COVID-19 ; Child ; }, abstract = {ObjectiveSince the onset of the COVID-19 pandemic, rates of anxiety and depression in youth have risen. Telepsychiatry is a potential mode of intervention for such digital natives. This systematic review aims to examine the effectiveness of telepsychiatry for youth with depression and/or anxiety.MethodsFour electronic databases, PubMed, MEDLINE, Embase, PsycINFO, were searched from their inception to May 12, 2024. Included studies were assessed for study quality and risk of bias.ResultsA search returning 29,944 records yielded 26 included studies, comprising 1,558 youths. Of 13 studies comparing depressive symptoms pre- and post-telepsychiatry intervention, symptom severity was significantly lower post-intervention compared to baseline (Hedges' g: 0.83; 95% CI: 0.59, 1.08). Similarly, of six studies comparing pre- and post-telepsychiatry intervention anxiety symptoms, anxiety scores were significantly lower post-intervention (Hedges' g: 1.15; 95% CI: 0.79, 1.50). Patients undergoing telepsychiatry also had superior outcomes when compared to waitlist control groups for depression (Hedges' g: 0.54; 95% CI: 0.23, 0.85) but not anxiety (Hedges' g: 0.50; 95% CI: -0.09, 1.10). Certainty of these estimates ranged from moderate to very low. Qualitative feedback noted subjective improvement in symptoms and high levels of satisfaction.ConclusionTelepsychiatry has potential as a therapeutic intervention for youth anxiety and depression. Further research with more controlled methodology is needed for development of recommendations that can guide growing use of this technology.}, } @article {pmid40292087, year = {2025}, author = {Mukae, H and Yotsuyanagi, H and Ohmagari, N and Doi, Y and Yamato, M and Imamura, T and Sakaguchi, H and Sanaki, T and Sonoyama, T and Tsuge, Y and Uehara, T}, title = {Ensitrelvir as a novel treatment option for mild-to-moderate COVID-19: a narrative literature review.}, journal = {Therapeutic advances in infectious disease}, volume = {12}, number = {}, pages = {20499361251321724}, pmid = {40292087}, issn = {2049-9361}, abstract = {To address the coronavirus disease 2019 (COVID-19) pandemic, several antiviral agents targeting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been developed for clinical use. However, antivirals that can be administered irrespective of risk factors were lacking until the approval of ensitrelvir fumaric acid (hereafter, ensitrelvir) in Japan, which took effect in November 2022. Ensitrelvir is an oral SARS-CoV-2 3C-like protease inhibitor currently approved in Japan and Singapore. This narrative review summarizes preclinical, clinical trial, and real-world data on ensitrelvir. The efficacy and safety of ensitrelvir were assessed in a seamless, randomized, double-blind, placebo-controlled, phase II/III study conducted in Japan, South Korea, and Vietnam (Japan Registry of Clinical Trials identifier, jRCT2031210350). This study enrolled patients with mild-to-moderate COVID-19 symptoms or asymptomatic individuals irrespective of the presence of risk factors for severe illness. Overall, ensitrelvir demonstrated favorable antiviral efficacy and symptom improvement, with an acceptable safety profile. In the phase III part, the time to resolution of the composite of five typical COVID-19 symptoms showed a difference between the ensitrelvir 125 mg and placebo groups, and the difference in median was approximately 1 day when the patients were randomized in less than 72 h of disease onset. This study is one of the clinical trials that used patient symptoms as a clinical efficacy endpoint. Additional clinical trials are currently underway to investigate the efficacy and safety of ensitrelvir in various patient populations. Moreover, published evidence generally supports the effectiveness of ensitrelvir in routine clinical practice and its antiviral activity against various SARS-CoV-2 variants of concern. Further research is granted to establish ensitrelvir as a novel antiviral treatment. Royalty-free licensing agreements concluded between drug manufacturers and the Medicines Patent Pool will facilitate access to COVID-19 therapeutics, including ensitrelvir, in low- and middle-income countries.}, } @article {pmid40291986, year = {2024}, author = {Alibudbud, R}, title = {Navigating the Philippine mental health system for the nation's youth: challenges and opportunities.}, journal = {BJPsych international}, volume = {21}, number = {3}, pages = {56-58}, pmid = {40291986}, issn = {2056-4740}, abstract = {The challenges besetting the Philippine mental health system demand multifaceted, strategic responses to ensure the holistic well-being of Filipino youth. Through the integration of mental health into primary care, augmentation of the professional workforce, bolstering information infrastructure, reforming medication accessibility, augmenting budgetary allocations and invigorating governance, the Philippines can pave the way for an inclusive mental health system that adequately addresses the exigencies of its younger demographic. In doing so, the nation can make substantial strides towards alleviating the negative impacts of adverse social conditions, such as the COVID-19 pandemic, on the mental well-being of its youth.}, } @article {pmid40291378, year = {2025}, author = {Chakraborty, C and Lo, YH and Bhattacharya, M and Das, A and Wen, ZH}, title = {Looking beyond the origin of SARS-CoV-2: Significant strategic aspects during the five-year journey of COVID-19 vaccine development.}, journal = {Molecular therapy. Nucleic acids}, volume = {36}, number = {2}, pages = {102527}, pmid = {40291378}, issn = {2162-2531}, abstract = {It has been five years since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and we are also approaching the five-year mark of the COVID-19 pandemic. The vaccine is a significant weapon in combating infectious diseases like SARS-CoV-2. Several vaccines were developed against SARS-CoV-2, and they demonstrated efficacy and safety during these five years. The rapid development of multiple next-generation vaccine candidates in different platforms with very little time is the success story of the vaccine development endeavor. This remarkable success of rapid vaccine development is a new paradigm for fast vaccine development that might help develop infectious diseases and fight against the pandemic. With the completion of five years since the beginning of SARS-CoV-2 origin, we are looking back on the five years and reviewing the milestones, vaccine platforms, animal models, clinical trials, successful collaborations, vaccine safety, real-world effectiveness, and challenges. Lessons learned during these five years will help us respond to public health emergencies and to fight the battle against future pandemics.}, } @article {pmid40290510, year = {2025}, author = {Othman, M and Selnow, GW}, title = {Community health workers: a narrative review of a curriculum and training program for low-income communities facing limited access to healthcare.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1504490}, pmid = {40290510}, issn = {2296-2565}, mesh = {*Community Health Workers/education ; Humans ; *Curriculum ; *Health Services Accessibility ; COVID-19/epidemiology ; *Poverty ; SARS-CoV-2 ; }, abstract = {BACKGROUND: The aim of this narrative review is to examine a WHO-compliant program that prepares Community Health Workers (CHWs) in low-resource environments. The intended outcome of the training is to enhance healthcare access and address health equity disparities. We examined the program's curriculum, instructional methods, and a complementary continuing medical education (CME) program designed to sustain CHWs' knowledge and skills.

METHODOLOGY: We review, in detail, the CHW training program-its curriculum, delivery, and implementation-launched prior to the COVID-19 pandemic and continuing today. This program develops critical human resources to expand the reach of overburdened healthcare professionals in disproportionately affected regions.

RESULTS: Our review highlights the positive impact of this program on marginalized communities. We propose the adoption of its curriculum and pedagogical framework by local leaders seeking to train teams of well-prepared CHWs to improve healthcare and bridge the gap between communities and medical professionals. This no-cost program is accessible even to the most under-resourced settings.

CONCLUSION: The program examined in this paper offers small, disproportionately affected communities a valuable opportunity to implement a program that equips CHWs to provide essential clinical services and conduct community-wide health education initiatives. These CHWs serve as vital bridges between their communities and the professional medical system. Their demonstrated effectiveness in serving the health needs of their communities, even during the challenging COVID-19 pandemic, is noteworthy. When called for, they can support refugees fleeing war and climate pressures by offering basic clinical care and prevention training.}, } @article {pmid40290477, year = {2025}, author = {Nagai, Y and Kartar, A and Pfaff, M and Elkholy, H}, title = {The paradox of hikikomori through a transcultural lens.}, journal = {BJPsych international}, volume = {22}, number = {1}, pages = {22-24}, pmid = {40290477}, issn = {2056-4740}, abstract = {This article appraises cultural understanding and controversies regarding hikikomori (prolonged social withdrawal), with reference to research over the past 20 years. Initially viewed as a uniquely Japanese phenomenon, hikikomori is now recognised globally, prompting a re-evaluation of its cultural, psychological and socioeconomic demographics. A revision in lifestyle after the COVID-19 pandemic and ongoing technological advancements - particularly the rise of social media, gaming and the internet - have paradoxically both exacerbated isolation and provided new forms of social interaction for young adults who confine themselves at home. This phenomenon underlines the complex interplay between putative individual psychopathology, neurodiversity and broader societal shifts across the globe.}, } @article {pmid40289185, year = {2025}, author = {Zhang, J and Wang, D and Kwok, C and Xu, L and Famulok, M}, title = {Aptamer-engaged nanotherapeutics against SARS-CoV-2.}, journal = {Discover nano}, volume = {20}, number = {1}, pages = {71}, pmid = {40289185}, issn = {2731-9229}, support = {CHN-1228220-HFST-P//Alexander von Humboldt-Stiftung/ ; 2023T160653//China Postdoctoral Science Foundation/ ; 2022M723202//China Postdoctoral Science Foundation/ ; }, abstract = {The COVID-19 pandemic, caused by the virus SARS-CoV-2 infection, has underscored the critical importance of rapid and accurate therapeutics. The neutralization of SARS-CoV-2 is paramount in controlling the spread and impact of COVID-19. In this context, the integration of aptamers and aptamer-related nanotherapeutics presents a valuable and scientifically significant approach. Despite the potential, current reviews in this area are often not comprehensive and specific enough to encapsulate the full scope of therapeutic principles, strategies, advancements, and challenges. This review aims to fill that gap by providing an in-depth examination of the role of aptamers and their related molecular medicine in COVID-19 therapeutics. We first introduce the unique properties, selection, and recognition mechanism of aptamers to bind with high affinity to various targets. Next, we delve into the therapeutic potential of aptamers, focusing on their ability to inhibit viral entry and replication, as well as modulate the host immune response. The integration of aptamers with nucleic acid nanomedicine is explored. Finally, we address the challenges and future perspectives of aptamer and nucleic acid nanomedicine in COVID-19 therapeutics, including issues of stability, delivery, and manufacturing scalability. We conclude by underscoring the importance of continued research and development in this field to meet the ongoing challenges posed by COVID-19 and potential future pandemics. Our review will be a valuable resource for researchers and clinicians interested in the latest developments at the intersection of molecular biology, nanotechnology, and infectious disease management.}, } @article {pmid40288999, year = {2025}, author = {Ahmed, R and Ahmed, S}, title = {Exploring the Efficacy of Hypochlorous Acid as a Cost Effective Environmental Decontaminant in Dentistry: A Scoping Review.}, journal = {Nigerian journal of clinical practice}, volume = {28}, number = {4}, pages = {425-445}, doi = {10.4103/njcp.njcp_674_24}, pmid = {40288999}, issn = {1119-3077}, mesh = {*Hypochlorous Acid/pharmacology/economics ; Humans ; Cost-Benefit Analysis ; *Decontamination/methods/economics ; Disinfection/methods ; *Infection Control, Dental/methods ; *Dental Disinfectants/pharmacology ; COVID-19/prevention & control ; }, abstract = {Dental procedures result in the production of bioaerosols that contaminate various environmental surfaces in the dental clinic. In order to maintain a safe environment in the dental clinic and prevent cross contamination, it is important to find alternative disinfection methods and agents to ensure effective decontamination. Hypochlorous acid (HOCl) is a cost-effective antimicrobial agent that can be used for infection control. The purpose of this scoping review is to provide evidence from the literature supporting the routine use of HOCl as a biodecontamination and disinfection agent in dental clinics. An electronic search was completed on the following databases: PubMed, Web of Science, Scopus, Wiley, and Science Direct. The studies were included based on their titles, abstract, and relevance to HOCl and the ability to render pathogens deactivated after exposure to HOCl vapor. The search focused on studies in the past 5 years. The search resulted in a total of 15 articles being selected after exclusions based on duplications, title, and abstract assessment. The articles included studies that used various HOCl concentrations and expanded on the inactivation of several pathogens. The reviewed studies highlight HOCl's broad-spectrum antimicrobial efficacy, with significant reductions in severe acute respiratory syndrome coronavirus 2, methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and Clostridioides difficile, reinforcing its role in optimizing disinfection protocols across healthcare and occupational settings. The articles selected provided clear evidence that under correct and established parameters, HOCl can provide a cheaper safer alternative to most disinfectants. Further studies are recommended on applications methods in clinical settings.}, } @article {pmid40288953, year = {2025}, author = {Ninot, G and Minet, M and Larché, J and Ribstein, J and Chiche, L}, title = {[Non-pharmacological interventions: A new paradigm and opportunities for internists].}, journal = {La Revue de medecine interne}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.revmed.2025.04.004}, pmid = {40288953}, issn = {1768-3122}, abstract = {The notion of non-pharmacological interventions (NPI) has been used by healthcare researchers since 1975, and is cited in numerous reports by French, European and international healthcare authorities, such as the WHO since 2003 and the HAS since 2011. However, it was only recently that a collaborative initiative of consensus was launched to address the lack of consensus on how to define and evaluate these health practices, amplified by the media controversy surrounding these practices during the COVID-19 episode. Indeed, in 2021, the launch of a collaborative and open research program responding to international scientific expectations in the healthcare field and to the specificities of these immaterial, personalized and targeted healthcare solutions has finally been initiated. The first part of this article, intended for specialists in internal medicine, describes the consensus-building work carried out under the guidance of a multidisciplinary committee, with the support of Inserm and the logistics of the international Non-Pharmacological Intervention Society (NPIS). Over a period of three years, this work, involving more than 1000 participants, established a definition, a characterization and an evaluative framework including 77 ethical and methodological recommendations for these practices. This NPIS Model framework has received the support of 30 French scientific and medical societies, two European societies and three French health authorities. The second part of the article presents the collaborative tools that have emerged from this work. Finally, the third part of the article looks at the implications of NPI for research and practice in the field of internal medicine.}, } @article {pmid40288658, year = {2025}, author = {Tang, Y and Yi, X and Ai, J}, title = {mRNA vaccines for prostate cancer: A novel promising immunotherapy.}, journal = {Biochimica et biophysica acta. Reviews on cancer}, volume = {1880}, number = {3}, pages = {189333}, doi = {10.1016/j.bbcan.2025.189333}, pmid = {40288658}, issn = {1879-2561}, mesh = {Humans ; Male ; *Cancer Vaccines/immunology/therapeutic use ; *Immunotherapy/methods ; *Prostatic Neoplasms/immunology/therapy ; *Prostatic Neoplasms, Castration-Resistant/immunology/therapy ; COVID-19/prevention & control/immunology/virology ; *mRNA Vaccines/immunology/therapeutic use ; SARS-CoV-2/immunology ; Vaccines, Synthetic/immunology/therapeutic use ; }, abstract = {The treatment of advanced prostate cancer (PCa) primarily based on androgen deprivation therapy (ADT); however, patients inevitably progress to the castration-resistant prostate cancer (CRPC) stage. Despite the recent advancements in CRPC treatment with novel endocrine drugs that further inhibit androgen receptor signaling, resistance ultimately develops, underscoring the urgent need for new effective therapeutic strategies. Therapeutic cancer vaccines, a form of immunotherapy, exert anti-cancer effects by activating the host's immune system. Over the past few decades, various conventional therapeutic PCa vaccines based on cells, microbes, proteins, peptides, or DNA have been developed and tested in patients with advanced PCa. These attempts have largely failed to improve survival, with the sole exception of sipuleucel-T, which extended the median overall survival of asymptomatic or minimally symptomatic metastatic CRPC (mCRPC) patients by four months. The rapid development and high efficacy of mRNA vaccines during the COVID-19 pandemic have garnered worldwide attention. Compared to conventional vaccines, mRNA vaccines offer several unique advantages, including high production efficiency, low cost, high safety, strong immune response induction, and high adaptability and precision. These attributes make mRNA vaccines a promising frontier in the treatment of advanced PCa.}, } @article {pmid40287959, year = {2025}, author = {Nor, N and Zahm, S and El Alaoui El Abdallaoui, H and Kerraj, S and Naji, N and Mazoir, N and Komiha, N and Marakchi, K and Salah, M}, title = {Designing highly efficient heterocyclic inhibitors for SARS-CoV-2 3C-like proteinase: a comprehensive in silico study.}, journal = {Journal of biomolecular structure & dynamics}, volume = {}, number = {}, pages = {1-9}, doi = {10.1080/07391102.2025.2494842}, pmid = {40287959}, issn = {1538-0254}, abstract = {To address the limitations of current COVID-19 treatments, we conducted an integrated in-silico investigation to design potential drugs with proven efficacy against the virus. We developed Quantitative Structure-Activity Relationship (QSAR) models using a database of 63 Aromatic heterocyclic compounds, focusing on key parameters Effective Diameter (ED) and Diameter Maximum (DM). Our models, utilizing multi-linear regression (MLR) and Artificial Neural Network (ANN), were validated according to OECD principles and successfully used to predict unexplored aromatic heterocyclic compounds with Pyridine Cores. Compound 4 (Dexbrompheniramine) exhibited high inhibition against the SARS coronavirus 3 C-like protease, leading to the design of two new molecules (compounds 15 and 16) with enhanced activity based on structural enhancements from the QSAR model. Docking studies and molecular dynamics simulations confirmed the improved binding energies and stability of compounds 15 and 16, with compound 15 showing remarkable stability and strong binding affinity with the 3 C-like proteinase (1P9U). This comprehensive in-silico review identifies compound 15 as a promising candidate for experimental evaluation as a potential COVID-19 drug, highlighting a significant advancement in our battle against the pandemic.}, } @article {pmid40287714, year = {2025}, author = {Alves, VP and Souto-Souza, D and Fernandes, IA and Falci, SGM and de Souza, GM}, title = {Impact of the COVID-19 pandemic on the prevalence of the fractures and etiology of orofacial trauma: a systematic review and meta-analysis.}, journal = {BMC oral health}, volume = {25}, number = {1}, pages = {643}, pmid = {40287714}, issn = {1472-6831}, mesh = {Humans ; *COVID-19/epidemiology ; Prevalence ; *Maxillofacial Injuries/epidemiology/etiology ; Mandibular Fractures/epidemiology ; Pandemics ; SARS-CoV-2 ; }, abstract = {BACKGROUND: To assess the impact of the COVID-19 pandemic on the prevalence of oral and maxillofacial fractures (OMFs) by comparing current data with pre-pandemic trends.

METHODS: Eligibility criteria: Observational studies comparing current data from OMFs with pre-pandemic trends were eligible for inclusion.

INFORMATION SOURCES: An electronic search was conducted in six databases up to January 15, 2024 and gray literature and reference lists. Risk of bias: The risk of bias in the included studies was assessed using the Joanna Briggs Institute's critical appraisal tool for analytical cross-sectional studies.

SYNTHESIS OF RESULTS: Results were presented as both qualitative and quantitative syntheses. Prevalence and Comparative meta-analysis were performed to evaluate the location and etiology of OMFs in the pre-pandemic and pandemic periods using R version 4.4.1.

RESULTS: Included studies: Fifty-one studies with 104,960 patients and 23,514 cases of OMFs met the inclusion criteria and were included in the systematic review.

SYNTHESIS OF RESULTS: Mandibular fractures showed a decrease in prevalence from 24% in the pre-pandemic period to 20% during the pandemic (OR 0.73 [0.59-0.90], I[2] = 62%). OMFs caused by falls and violence increased significantly, from 23% for 30% (OR 1.29 [1.06-1.57], I[2] = 76%) and from 22% for 31% (OR 1.43 [1.04-1.98], I[2] = 45%), respectively.

CONCLUSION: The COVID-19 pandemic has led to significant changes in the prevalence of OMFs, including an increase in cases caused by falls and interpersonal violence, as well as a decrease in mandibular fractures. The results should be interpreted with caution due to the heterogeneity and inconsistency found in the studies included in the review. The data presented here may inform public health policies and emergency response protocols for managing OMFTs in future global health crises like pandemics. TRIAL REGISTRATION: CRD42023431119.}, } @article {pmid40287707, year = {2025}, author = {Ban, J and Qian, J and Zhang, C and Li, J}, title = {Recent advances in TAM mechanisms in lung diseases.}, journal = {Journal of translational medicine}, volume = {23}, number = {1}, pages = {479}, pmid = {40287707}, issn = {1479-5876}, mesh = {Humans ; *Receptor Protein-Tyrosine Kinases/metabolism ; COVID-19/complications/pathology ; *Lung Diseases/metabolism/pathology ; c-Mer Tyrosine Kinase/metabolism ; Axl Receptor Tyrosine Kinase ; Animals ; SARS-CoV-2 ; Signal Transduction ; *Proto-Oncogene Proteins/metabolism ; }, abstract = {TYRO3, MERTK, and AXL receptor tyrosine kinases, collectively known as TAM receptors, play a vital role in maintaining lung tissue homeostasis by regulating integrity and self-renewal. These receptors activate signalling pathways that inhibit apoptosis, promote cell proliferation and differentiation, mediate cell adhesion and migration, and perform other essential biological functions. Additionally, TAM receptors are implicated in mechanisms that suppress anti-tumor immunity and confer resistance to immune checkpoint inhibitors. Disruption of the homeostatic balances can lead to pathological conditions such as lung inflammation, fibrosis, or tumors. Recent studies highlight their significant role in COVID-19-induced lung injury. However, the exact mechanisms by which TAM receptors contribute to lung diseases remain unclear. This article reviews the potential mechanisms of TAM receptor involvement in disease progression, focusing on lung inflammation, fibrosis, cancer, and COVID-19-induced lung injury. It also explores future research aspects and the therapeutic potentials of targeting TAM receptors, providing a theoretical foundation for understanding lung disease mechanisms and identifying treatment targets.}, } @article {pmid40286229, year = {2025}, author = {Camperi, J and Chatla, K and Freund, E and Galan, C and Lippold, S and Guilbaud, A}, title = {Current Analytical Strategies for mRNA-Based Therapeutics.}, journal = {Molecules (Basel, Switzerland)}, volume = {30}, number = {7}, pages = {}, pmid = {40286229}, issn = {1420-3049}, mesh = {*RNA, Messenger/therapeutic use/genetics/chemistry/analysis ; Humans ; SARS-CoV-2 ; COVID-19/virology ; COVID-19 Drug Treatment ; Mass Spectrometry ; }, abstract = {Recent advancements in mRNA technology, utilized in vaccines, immunotherapies, protein replacement therapies, and genome editing, have emerged as promising and increasingly viable treatments. The rapid, potent, and transient properties of mRNA-encoded proteins make them attractive tools for the effective treatment of a variety of conditions, ranging from infectious diseases to cancer and single-gene disorders. The capability for rapid and large-scale production of mRNA therapeutics fueled the global response to the COVID-19 pandemic. For effective clinical implementation, it is crucial to deeply characterize and control important mRNA attributes such as purity/integrity, identity, structural quality features, and functionality. This implies the use of powerful and advanced analytical techniques for quality control and characterization of mRNA. Improvements in analytical techniques such as electrophoresis, chromatography, mass spectrometry, sequencing, and functionality assessments have significantly enhanced the quality and detail of information available for product and process characterization, as well as for routine stability and release testing. Here, we review the latest advancements in analytical techniques for the characterization of mRNA-based therapeutics, typically employed by the biopharmaceutical industry for eventual market release.}, } @article {pmid40284936, year = {2025}, author = {Olech, M and Antas, M}, title = {Transmissible Gastroenteritis Virus (TGEV) and Porcine Respiratory Coronavirus (PRCV): Epidemiology and Molecular Characteristics-An Updated Overview.}, journal = {Viruses}, volume = {17}, number = {4}, pages = {}, pmid = {40284936}, issn = {1999-4915}, mesh = {Animals ; Swine ; *Transmissible gastroenteritis virus/genetics/classification/physiology/pathogenicity ; *Gastroenteritis, Transmissible, of Swine/epidemiology/virology ; Phylogeny ; *Porcine Respiratory Coronavirus/genetics/classification/pathogenicity/physiology ; *Swine Diseases/epidemiology/virology ; *Coronavirus Infections/epidemiology/veterinary/virology ; Viral Tropism ; Virulence ; Mutation ; Genome, Viral ; }, abstract = {Transmissible gastroenteritis virus (TGEV) and porcine respiratory coronavirus (PRCV) are enveloped, single-stranded RNA viruses belonging to the genus Alphacoronavirus in the family Coronaviridae. PRCV, a TGEV mutant with a spike(S) gene deletion, exhibits altered tissue tropism. TGEV replicates mainly in the intestines and causes severe diarrhea and high mortality in piglets, whereas PRCV replicates mainly in the respiratory tract. PRCV causes mild or subclinical respiratory infections but may contribute to respiratory disease syndrome in pigs infected with other respiratory pathogens. As PRCV and TGEV continuously evolve, monitoring these viruses is important for disease prevention and control. In this review, we provide updated information on the prevalence and genetic characteristics of TGEV/PRCV and their phylogenetic relationships. We also discuss the impact of mutations, deletions and recombination on the virulence and tissue tropism of TGEV/PRCV and highlight the possible zoonotic potential of these viruses.}, } @article {pmid40284927, year = {2025}, author = {Nappi, F}, title = {Myocarditis and Inflammatory Cardiomyopathy in Dilated Heart Failure.}, journal = {Viruses}, volume = {17}, number = {4}, pages = {}, pmid = {40284927}, issn = {1999-4915}, mesh = {Humans ; *Myocarditis/virology/pathology/etiology/diagnosis/complications ; *Cardiomyopathy, Dilated/virology/pathology/etiology ; COVID-19/complications ; *Heart Failure/virology ; Animals ; SARS-CoV-2 ; *Cardiomyopathies/virology ; Inflammation ; }, abstract = {Inflammatory cardiomyopathy is a condition that is characterised by the presence of inflammatory cells in the myocardium, which can lead to a significant deterioration in cardiac function. The etiology of this condition involves multiple factors, both infectious and non-infectious causes. While it is primarily associated with viral infections, other potential causes include bacterial, protozoal, or fungal infections, as well as a wide variety of toxic substances and drugs, and systemic immune-mediated pathological conditions. In spite of comprehensive investigation, the presence of inflammatory cardiomyopathy accompanied by left ventricular dysfunction, heart failure or arrhythmia is indicative of an unfavourable outcome. The reasons for the occurrence of either favourable outcomes, characterised by the absence of residual myocardial injury, or unfavourable outcomes, marked by the development of dilated cardiomyopathy, in patients afflicted by the condition remain to be elucidated. The relative contributions of pathogenic agents, genomic profiles of the host, and environmental factors in disease progression and resolution remain subjects of ongoing discourse. This includes the determination of which viruses function as active inducers and which merely play a bystander role. It remains unknown which changes in the host immune profile are critical in determining the outcome of myocarditis caused by various viruses, including coxsackievirus B3 (CVB3), adenoviruses, parvoviruses B19 and SARS-CoV-2. The objective of this review is unambiguous: to provide a concise summary and comprehensive assessment of the extant evidence on the pathogenesis, diagnosis and treatment of myocarditis and inflammatory cardiomyopathy. Its focus is exclusively on virus-induced and virus-associated myocarditis. In addition, the extant lacunae of knowledge in this field are identified and the extant experimental models are evaluated, with the aim of proposing future directions for the research domain. This includes differential gene expression that regulates iron and lipid and metabolic remodelling. Furthermore, the current state of knowledge regarding the cardiovascular implications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is also discussed, along with the open questions that remain to be addressed.}, } @article {pmid40284780, year = {2025}, author = {Bertola, B and Cotolí-Crespo, A and San Onofre, N and Soriano, JM}, title = {The Mystery of Certain Lactobacillus acidophilus Strains in the Treatment of Gastrointestinal Symptoms of COVID-19: A Review.}, journal = {Microorganisms}, volume = {13}, number = {4}, pages = {}, pmid = {40284780}, issn = {2076-2607}, abstract = {COVID-19 presents a wide range of symptoms, including gastrointestinal manifestations such as diarrhea, nausea, and abdominal pain. Lactobacillus acidophilus has been proposed as a potential adjunct therapy to alleviate these symptoms due to its probiotic properties, which help restore gut microbiota balance and modulate immune responses. This review systematically analyzed studies assessing the effects of L. acidophilus in COVID-19 patients with gastrointestinal symptoms. The literature search was conducted through PubMed and the WHO COVID-19 database using keywords such as "Lactobacillus acidophilus", "COVID-19", "gastrointestinal symptoms", and "inflammation markers". The search covered studies published until February 2025. Inclusion criteria: observational and clinical trials with L. acidophilus for symptom relief. Exclusion: animal studies and non-ethical approvals. The findings suggest that L. acidophilus supplementation may contribute to faster resolution of diarrhea, improved gut microbiota balance, and reduced inflammatory markers. However, some studies have found no significant impact on hospitalization rates or disease progression. The probiotic's mechanisms of action appear to involve microbiota modulation, intestinal barrier reinforcement, and anti-inflammatory effects rather than direct viral inhibition in COVID-19 after progression. Some L. acidophilus strains show promise, and clinical validation should follow careful preclinical studies (in vitro, cell lines, and animal models), especially in vulnerable populations such as immunocompromised individuals. Understanding the gut-lung axis and its role in immune response regulation, together with the need for a thorough characterization of the specific strains, including biochemical, genomic, and functional properties, before testing in humans, may provide deeper insights into the therapeutic potential of probiotics in viral infections.}, } @article {pmid40284540, year = {2025}, author = {Jason, LA and Katz, BZ}, title = {Predisposing and Precipitating Factors in Epstein-Barr Virus-Caused Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.}, journal = {Microorganisms}, volume = {13}, number = {4}, pages = {}, pmid = {40284540}, issn = {2076-2607}, abstract = {Long COVID following SARS-CoV-2 and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) following infectious mononucleosis (IM) are two examples of post-viral syndromes. The identification of risk factors predisposing patients to developing and maintaining post-infectious syndromes may help uncover their underlying mechanisms. The majority of patients with ME/CFS report infectious illnesses before the onset of ME/CFS, with 30% of cases of ME/CFS due to IM caused by the Epstein-Barr virus. After developing IM, one study found 11% of adults had ME/CFS at 6 months and 9% had ME/CFS at 1 year. Another study of adolescents found 13% and 7% with ME/CFS at 6 and 12 months following IM, respectively. However, it is unclear which variables are potential risk factors contributing to the development and maintenance of ME/CFS following IM, because few prospective studies have collected baseline data before the onset of the triggering illness. The current article provides an overview of a study that included pre-illness predictors of ME/CFS development following IM in a diverse group of college students who were enrolled before the onset of IM. Our data set included an ethnically and sociodemographically diverse group of young adult students, and we were able to longitudinally follow these youths over time to better understand the risk factors associated with the pathophysiology of ME/CFS. General screens of health and psychological well-being, as well as blood samples, were obtained at three stages of the study (Stage 1-Baseline-when the students were well, at least 6 weeks before the student developed IM; Stage 2-within 6 weeks following the diagnosis of IM, and Stage 3-six months after IM, when they had either developed ME/CFS or recovered). We focused on the risk factors for new cases of ME/CFS following IM and found factors both at baseline (Stage 1) and at the time of IM (Stage 2) that predicted nonrecovery. We are now collecting seven-year follow-up data on this sample, as well as including cases of long COVID. The lessons learned in this prospective study are reviewed.}, } @article {pmid40284499, year = {2025}, author = {Patriarca, EJ and D'Aniello, C and De Cesare, D and Cobellis, G and Minchiotti, G}, title = {The Modulation of Cell Plasticity by Budesonide: Beyond the Metabolic and Anti-Inflammatory Actions of Glucocorticoids.}, journal = {Pharmaceutics}, volume = {17}, number = {4}, pages = {}, pmid = {40284499}, issn = {1999-4923}, support = {IG20736//Italian Foundation for Cancer Research (AIRC)/ ; 2022KME7RY//Italian Ministry of University and Research (MUR-PRIN)/ ; P20224ZY5P//Italian Ministry of University and Research (MUR-PRIN)/ ; PNC 0000001 D34Health//Next Generation EU, in the context of the National Plan for Complementary Investments (PNC) to the National Recovery and Resilience Plan (PNRR)/ ; }, abstract = {The synthetic cortisol analog budesonide (BUD) is an essential drug employed to manage chronic inflammatory diseases in humans, mainly those involving gastroenteric and airway mucosa, such as rhinitis, laryngitis, bronchitis, esophagitis, gastritis, and colitis, with high levels of success. As a glucocorticoid, BUD prevents the expression of pro-inflammatory cytokines/chemokines and the recruitment of immune cells into the inflamed mucosa. However, emerging evidence indicates that BUD, unlike classical glucocorticoids, is also a potent modulator of stem and cancer cell behavior/plasticity. Certainly, BUD stabilizes cell-cell adhesions, preventing embryonic stem cell differentiation and inhibiting the development of 3D gastruloids. In addition, BUD inhibits the motile/invasive propensity of different cancer cells, including breast, lung, and pancreatic cancer. Finally, it prevents the infection of positive single-stranded human-infecting RNA viruses such as SARS-CoV-2. At a molecular level, BUD induces epigenetic changes and modifies the transcriptome of epithelial, stem, and cancer cells, providing molecular support to the immune cell-independent activity of BUD. Here, we performed an in-depth review of these unexpected activities of BUD, identified by unbiased drug screening programs, and we emphasize the molecular mechanisms modulated by this efficacious drug that deserve further research.}, } @article {pmid40284445, year = {2025}, author = {Szebeni, J}, title = {Expanded Spectrum and Increased Incidence of Adverse Events Linked to COVID-19 Genetic Vaccines: New Concepts on Prophylactic Immuno-Gene Therapy, Iatrogenic Orphan Disease, and Platform-Inherent Challenges.}, journal = {Pharmaceutics}, volume = {17}, number = {4}, pages = {}, pmid = {40284445}, issn = {1999-4923}, abstract = {The mRNA- and DNA-based "genetic" COVID-19 vaccines can induce a broad range of adverse events (AEs), with statistics showing significant variation depending on the timing and data analysis methods used. Focusing only on lipid nanoparticle-enclosed mRNA (mRNA-LNP) vaccines, this review traces the evolution of statistical conclusions on the prevalence of AEs and incidents associated with these vaccines, from initial underestimation of atypical, severe toxicities to recent claims suggesting the possible contribution of COVID-19 vaccinations to the excess deaths observed in many countries over the past few years. Among hundreds of different AEs listed in Pfizer's pharmacovigilance survey, the present analysis categorizes the main symptoms according to organ systems, with nearly all of them being affected. Using data from the US Vaccine Adverse Event Reporting System and a global vaccination dataset, a comparison of the prevalence and incidence rates of AEs induced by genetic versus flu vaccines revealed an average 26-fold increase in AEs with the use of genetic vaccines. The difference is especially pronounced in the case of severe 'Brighton-listed' AEs, which are also observed in COVID-19 and post-COVID conditions. Among these, the increases in incidence rates relative to flu vaccines, given as x-fold rises, were 1152x, 455x, 226x, 218x, 162x, 152x, and 131x for myocarditis, thrombosis, death, myocardial infarction, tachycardia, dyspnea, and hypertension, respectively. The review delineates the concept that genetic vaccines can be regarded as prophylactic immuno-gene therapies and that the observed chronic disabling AEs might be categorized as iatrogenic orphan diseases. It also examines the unique vaccine characteristics that could be causally related to abnormal immune responses which potentially lead to adverse events and complications. These new insights may contribute to improving the safety of this platform technology and assessing the risk/benefit balance of various products.}, } @article {pmid40284278, year = {2025}, author = {Fang, Z and Wang, J and Xie, S and Lian, Z and Luo, Z and Du, Y and Zhang, X}, title = {Advancements in Research and Applications of PP-Based Materials Utilizing Melt-Blown Nonwoven Technology.}, journal = {Polymers}, volume = {17}, number = {8}, pages = {}, pmid = {40284278}, issn = {2073-4360}, support = {2024zdyf0009//Key Research and Development Program of Karamay/ ; }, abstract = {Melt-blown nonwoven materials have demonstrated significant advancements in a multitude of industrial sectors, mainly due to their high production efficiency, extensive specific surface area, and narrow aperture. The demand for melt-blown nonwoven materials has increased further in recent time, particularly in the wake of the novel coronavirus (COVID-19) pandemic. Polypropylene (PP) is extensively used in production and research due to its low cost, low weight, and easy processing, and the melt-blown materials made from it share similar characteristics. We systematically summarize the research advancements of melt-blown nonwoven technology and applications of PP-based melt-blown materials over the last few years. First, the principles and processes of melt-blown nonwoven that govern the production of micro/nano fibers are described. Then the raw materials and process technology of melt-blown are reviewed. After these, we highlight the use of PP-based melt-blown materials in key fields, including media filtration, oil-water separation, heavy metal ions removal, organic pollutants removal and battery separator. Finally, we summary and suggest some potential future research directions of melt-blown nonwoven technology and PP-based melt-blown materials.}, } @article {pmid40283797, year = {2025}, author = {Peultier-Celli, L and Gérard, A and Letourneur, F and Inghels, C and Duclos, A and Perrin, P}, title = {Methodology of Epidemic Risk Analysis in the Naval Military.}, journal = {International journal of environmental research and public health}, volume = {22}, number = {4}, pages = {}, pmid = {40283797}, issn = {1660-4601}, mesh = {Humans ; Risk Assessment/methods ; *Military Personnel ; COVID-19/epidemiology ; *Communicable Diseases/epidemiology ; Ships ; }, abstract = {This review of the literature examines diseases and pathogen characteristics on military vessels, in order to improve the success of missions on a boat. Our aim is to understand the spread of disease, aiming to maximize biological resilience and hopefully eliminate outbreaks. Keyword research was conducted from various sources of information, including scientific publications, theses, public health organization websites, and clinical trials. A synthesis of bacterial, viral, fungal, and parasitosis characteristics was established, and a risk prioritization index was defined, based on contagiousness (basic reproduction number (R0)) and clinical severity. For instance, COVID-19 was assessed as moderately contagious, with critical severity, and Influenza A H1N1 as having a minor level of contagiousness with critical severity, resulting in a level two out of three risk prioritization index. This approach demonstrates that while diseases have numerous characteristics, a method for classifying them by isolating specific criteria and prioritizing them could be proposed. In conclusion, further work is needed to analyze onboard operator activities and develop simulation models related to pathogen characteristics.}, } @article {pmid40283707, year = {2025}, author = {Höhn, AM and Ascone, L and Lohse, L and Kugler, D and Lambert, M and Wege, N and Wittmann, F and Riedel-Heller, S and Luppa, M and Elsayed, MEG and Hurlemann, R}, title = {Mental Health in the Time of the COVID-19 Pandemic: A Scoping Review of Collateral Effects on Common Mental Disorders (CMDs).}, journal = {International journal of environmental research and public health}, volume = {22}, number = {4}, pages = {}, pmid = {40283707}, issn = {1660-4601}, support = {01KX2021//Federal Ministry of Education and Research/ ; }, mesh = {*COVID-19/psychology/epidemiology ; Humans ; *Mental Disorders/epidemiology/etiology/psychology ; *Mental Health ; Pandemics ; SARS-CoV-2 ; Social Isolation ; }, abstract = {It is unclear whether the COVID-19 pandemic has had consequences for common mental disorders (CMDs). This scoping review aims to examine direct infection-related (e.g., severe COVID-19 illness), psychosocial (e.g., social isolation), and indirect outcomes (e.g., changes in incidence) that have been particularly discussed so far. A literature search for clinically diagnosed adult CMDs was conducted using Pubmed, Web of Science, and PsycInfo (n = 5325). After completion of the screening process, 26 included studies remained for extraction. None of the included studies reported post-pandemic data. The effects appeared to be particularly pronounced for anxiety and obsessive-compulsive disorders in the first year of the pandemic. This was followed by a period of adjustment, during which rates of mental disease and its symptoms largely returned to pre-pandemic levels. Fluctuating rates of CMDs may have had COVID-related causes. Preventive temporary inpatient care could be a protective approach for those at risk or vulnerable, as well as establishing pandemic consultation and building resilience. A gap in the research is the lack of comparisons of CMD data before, during, and after the pandemic to distinguish transient disease rates from chronic disease requiring treatment.}, } @article {pmid40283596, year = {2025}, author = {Mara, G and Nini, G and Cotoraci, C}, title = {Chronic Obstructive Pulmonary Disease and COVID-19: The Impact of Hematological Biomarkers on Disease Severity and Outcomes.}, journal = {Journal of clinical medicine}, volume = {14}, number = {8}, pages = {}, pmid = {40283596}, issn = {2077-0383}, abstract = {Background/Objectives: Chronic obstructive pulmonary disease (COPD) patients are at heightened risk of severe COVID-19 due to underlying respiratory impairment, systemic inflammation, and immune dysregulation. This review explores the hematological changes that occur in COPD patients with COVID-19 and their implications for disease progression, prognosis, and clinical management. Methods: We conducted a comprehensive analysis of recent peer-reviewed studies from medical databases including Clarivate Analytics, PubMed, and Google Scholar. Results: Hematological alterations, such as lymphopenia, elevated neutrophil-to-lymphocyte ratio (NLR), increased D-dimer and fibrinogen levels, inflammatory anemia, and erythrocyte dysfunction, are commonly observed in COPD patients with COVID-19. These changes are linked to immune suppression, hyperinflammation, oxidative stress, and thromboembolic complications. Conclusions: Hematological biomarkers are valuable tools for early risk assessments and guiding treatment strategies in this high-risk population. The regular monitoring of D-dimer, fibrinogen, and NLR is advisable. Prophylactic anticoagulation and immunomodulatory therapies, such as corticosteroids and IL-6 and IL-1 inhibitors, may improve clinical outcomes. Further clinical studies are needed to validate personalized approaches and explore antioxidant-based interventions.}, } @article {pmid40283075, year = {2025}, author = {Loboda, D and Golba, KS and Gurowiec, P and Bredelytė, A and Razbadauskas, A and Sarecka-Hujar, B}, title = {Variability in Arterial Stiffness and Vascular Endothelial Function After COVID-19 During 1.5 Years of Follow-Up-Systematic Review and Meta-Analysis.}, journal = {Life (Basel, Switzerland)}, volume = {15}, number = {4}, pages = {}, pmid = {40283075}, issn = {2075-1729}, support = {BNW-2-016/N/4/K//Medical University of Silesia/ ; }, abstract = {Increasing long-term observations suggest that coronavirus disease 2019 (COVID-19) vasculopathy may persist even 1.5 years after the acute phase, potentially accelerating the development of atherosclerotic cardiovascular diseases. This study systematically reviewed the variability of brachial flow-mediated dilation (FMD) and carotid-femoral pulse wave velocity (cfPWV) from the acute phase of COVID-19 through 16 months of follow-up (F/U). Databases including PubMed, Web of Science, MEDLINE, and Embase were screened for a meta-analysis without language or date restrictions (PROSPERO reference CRD42025642888, last search conducted on 1 February 2025). The quality of the included studies was assessed using the Newcastle-Ottawa Quality Scale. We considered all studies (interventional pre-post studies, prospective observational studies, prospective randomized, and non-randomized trials) that assessed FMD or cfPWV in adults (aged ≥ 18 years) with or after laboratory-confirmed COVID-19 compared with non-COVID-19 controls or that assessed changes in these parameters during the F/U. Twenty-one studies reported differences in FMD, and 18 studies examined cfPWV between COVID-19 patients and control groups during various stages: acute/subacute COVID-19 (≤30 days from disease onset), early (>30-90 days), mid-term (>90-180 days), late (>180-270 days), and very late (>270 days) post-COVID-19 recovery. Six studies assessed variability in FMD, while nine did so for cfPWV during the F/U. Data from 14 FMD studies (627 cases and 694 controls) and 15 cfPWV studies (578 cases and 703 controls) were included in our meta-analysis. FMD showed a significant decrease compared to controls during the acute/subacute phase (standardized mean difference [SMD]= -2.02, p < 0.001), with partial improvements noted from the acute/subacute phase to early recovery (SMD = 0.95, p < 0.001) and from early to mid-term recovery (SMD = 0.92, p = 0.006). Normalization compared to controls was observed in late recovery (SMD = 0.12, p = 0.69). In contrast, cfPWV values, which were higher than controls in the acute/subacute phase (SMD = 1.27, p < 0.001), remained elevated throughout the F/U, with no significant changes except for a decrease from mid-term to very late recovery (SMD= -0.39, p < 0.001). In the very late recovery, cfPWV values remained higher than those of controls (SMD = 0.45, p = 0.010). In the manuscript, we discuss how various factors, including the severity of acute COVID-19, the persistence of long-term COVID-19 syndrome, and the patient's initial vascular age, depending on metrics age and cardiovascular risk factors, influenced the time and degree of FMD and cfPWV improvement.}, } @article {pmid40282917, year = {2025}, author = {Patricia, S and Kartika, A and Puspitasari, IM}, title = {COVID-19-Related Diplopia and Its Treatment.}, journal = {Medicina (Kaunas, Lithuania)}, volume = {61}, number = {4}, pages = {}, pmid = {40282917}, issn = {1648-9144}, mesh = {Humans ; *COVID-19/complications ; *Diplopia/etiology/drug therapy/therapy ; SARS-CoV-2 ; COVID-19 Vaccines/adverse effects ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Male ; }, abstract = {Background and Objectives: The effects of COVID-19 disease can manifest and cause eye complications, one of which is diplopia. Diplopia is a medical condition that makes one object appear like two images. People may also experience diplopia after receiving the COVID-19 vaccine, after contracting COVID-19, or following a COVID-19 infection. Materials and Methods: This review aims to summarize the cases of COVID-19 that can cause diplopia and its treatment in the past 5 years. The literature search databases used for this review were PubMed and Scopus. The keywords used were "diplopia," "COVID-19," and "treatment." Sixteen articles were reviewed after screening and applying the inclusion criteria. Results: The results show that over the past 5 years, cases of diplopia related to COVID-19 have occurred in America, Europe, Asia, and Africa. Most studies are case reports, and the total number of patients was 26, with an age range of 14 to 81. Conclusions: The diplopia cases recovered within 1 day to 8 months. Patients who experienced diplopia after receiving the COVID-19 vaccine, during COVID-19 infection, or after COVID-19 infection exhibited different symptoms. Nasopharyngeal swabs, magnetic resonance imaging (MRI), computerized tomography (CT) scans, visual acuity tests, slit lamp biomicroscope examinations, eye movement tests, funduscopic examinations, and blood tests were the most commonly performed tests. Corticosteroids such as prednisone, methylprednisolone, and prednisolone were the most commonly used drugs to treat diplopia. In addition to corticosteroids, antibiotics, antivirals, antiplatelets, and vitamins were also given. An eye patch was considered to alleviate the diplopia.}, } @article {pmid40282903, year = {2025}, author = {Špiljak, B and Sauerborn, D and Tomas, M and Gregorić Butina, B and Mahovne, I and Erić, S and Vidaković, B and Lešić, S}, title = {Aggressive Squamoid Eccrine Ductal Carcinoma of the Face: A Rare and Challenging Diagnosis-Case Report and Literature Review.}, journal = {Medicina (Kaunas, Lithuania)}, volume = {61}, number = {4}, pages = {}, pmid = {40282903}, issn = {1648-9144}, mesh = {Humans ; Female ; Aged, 80 and over ; *Carcinoma, Squamous Cell/diagnosis/pathology ; *Carcinoma, Ductal/diagnosis/pathology ; Face/pathology ; *Sweat Gland Neoplasms/diagnosis/pathology ; }, abstract = {Background: Squamoid eccrine ductal carcinoma (SEDC) is an exceedingly rare and aggressive cutaneous adnexal malignancy, with fewer than 100 reported cases. Its histopathologic overlap with squamous cell carcinoma (SCC) frequently leads to misdiagnosis, delaying appropriate management. Unlike SCC, SEDC exhibits biphasic differentiation, deep infiltration, and a high rate of perineural invasion, contributing to significant morbidity and poor long-term outcomes. Given the absence of standardized treatment protocols, managing SEDC remains a challenge. Case Presentation: We report an unusual case of an 80-year-old female presenting with progressive numbness, nasal deviation, and a subcutaneous indurated lesion in the left nasofacial region. The early neurological symptoms were an atypical feature, suggesting perineural invasion (PNI) before visible tumor progression. Initial histopathologic evaluation was inconclusive, raising suspicion of SCC, necessitating immunohistochemical analysis, which confirmed ductal differentiation, leading to the final diagnosis of SEDC. The patient underwent radical resection with intraoperative margin assessment (Mohs micrographic surgery; MMS) followed by adjuvant radiotherapy (62 Gy/31 fractions) due to high-risk features, including perineural and perivascular invasion. Despite initial disease control, a local recurrence involving the left orbit and nasal bone occurred 20 months postoperatively, demonstrating the aggressive nature of SEDC despite clear surgical margins and adjuvant therapy. Due to disease progression and refusal of further surgery, only palliative care was provided. During follow-up, the patient contracted COVID-19, further complicating her clinical status and contributing to her demise. While COVID-19 was not directly linked to SEDC progression, its impact on patient management was significant. Conclusions: This case underscores the diagnostic and therapeutic challenges of SEDC, emphasizing the need for early suspicion, extensive histopathologic assessment, and aggressive multimodal treatment. The importance of multidisciplinary management-particularly in elderly and immunocompromised patients-and long-term surveillance due to high recurrence risk and PNI is crucial.}, } @article {pmid40282336, year = {2025}, author = {Vélez, DE and Torres, BL and Hernández, G}, title = {The Bright Future of mRNA as a Therapeutic Molecule.}, journal = {Genes}, volume = {16}, number = {4}, pages = {}, pmid = {40282336}, issn = {2073-4425}, support = {Intramural funding program//Instituto Nacional de Cancerología/ ; Program Estancias posdoctorales por México para la Formación y Consolidación de las y los Investigadores por México, 2022.//Consejo Nacional de Humanidades, Ciencia y Tecnología (CONHACyT)/ ; PhD Fellowship//CONHACyT/ ; }, mesh = {Humans ; *RNA, Messenger/therapeutic use/genetics ; SARS-CoV-2 ; COVID-19 ; COVID-19 Vaccines/therapeutic use ; COVID-19 Drug Treatment ; Neoplasms/therapy ; Animals ; }, abstract = {The rapid success of messenger (m) RNA vaccines against COVID-19 has pushed the mRNA to the forefront of drug research. The promise of mRNA-based therapeutics and vaccines in other areas is not new but is now emerging stronger. We review basic concepts, key historical aspects, and recent research on mRNA as a therapeutic molecule to fight infectious diseases and cancer. We also show a current patent perspective of this field. Altogether, we describe that the technology of mRNA as a therapeutic molecule is a rapidly moving field aiming for a bright future.}, } @article {pmid40282092, year = {2025}, author = {McMichael, SL and Kwan, VSY}, title = {A Review of Temporal Self-Perceptions Among Emerging Adults: The Significance of Demographics and a Global Crisis on Psychological and Achievement Benefits.}, journal = {Behavioral sciences (Basel, Switzerland)}, volume = {15}, number = {4}, pages = {}, pmid = {40282092}, issn = {2076-328X}, abstract = {In industrialized societies, emerging adulthood is a unique developmental stage between adolescence and adulthood (i.e., 18 to 29 years old), where individuals continuously encounter decisions that have important consequences that unfold over time (i.e., intertemporal decisions). The present review paper had three aims. The first aim was to provide a brief overview of emerging adulthood as a developmental stage and present a rationale for the importance of understanding the relationship between temporal self-perceptions and longitudinal outcomes in emerging adults. The second aim was to review evidence for a proposed model demonstrating the connection between three domains of temporal self-perceptions-future self-perceptions, longitudinal changes in future self-perceptions, and continuity between temporal selves (i.e., past-to-future)-, self-regulatory processes, and positive downstream consequences (e.g., psychological well-being and academic success) in emerging adults. Specifically, this targeted review sought to highlight research exploring the longitudinal processes in these relationships (e.g., changes in temporal self-perceptions over time and the relationship between temporal self-perceptions and longitudinal outcomes) and testing how these relationships function amidst a large-scale challenge (i.e., the COVID-19 pandemic). Given the heterogeneity of emerging adults as a demographic group, the third aim was to review research exploring demographic factors (e.g., gender and socioeconomic status) as a potential moderator of these relationships. The review provided support for the proposed model, highlighting the importance of perceptions of temporal selves in predicting a range of positive long-term outcomes, including self-regulatory processes, psychological well-being, and achievement. Additionally, the review demonstrated preliminary support for the significance of crucial demographic factors (e.g., gender and socioeconomic status) in understanding the nature of these relationships in emerging adults. Finally, the review suggests future directions to extend this growing literature and broaden the understanding of these relationships.}, } @article {pmid40281884, year = {2025}, author = {Ocagli, H and Brigiari, G and Marcolin, E and Mongillo, M and Tonon, M and Da Re, F and Gentili, D and Michieletto, F and Russo, F and Gregori, D}, title = {Mathematical Contact Tracing Models for the COVID-19 Pandemic: A Systematic Review of the Literature.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {8}, pages = {}, pmid = {40281884}, issn = {2227-9032}, support = {The study was conducted under the scope of the CCM (Centre for Diseases Control) 2020 Project "Modelli organizzativi per l'efficientamento delle attività di contact tracing" (Organizational models to improve the efficiency of contact tracing activities)//Italian Ministry of Health./ ; }, abstract = {Background: Contact tracing (CT) is a primary means of controlling infectious diseases, such as coronavirus disease 2019 (COVID-19), especially in the early months of the pandemic. Objectives: This work is a systematic review of mathematical models used during the COVID-19 pandemic that explicitly parameterise CT as a potential mitigator of the effects of the pandemic. Methods: This review is registered in PROSPERO. A comprehensive literature search was conducted using the PubMed, EMBASE, Cochrane Library, CINAHL, and Scopus databases. Two reviewers independently selected the title/abstract, full text, data extraction, and risk of bias. Disagreements were resolved through discussion. The characteristics of the studies and mathematical models were collected from each study. Results: A total of 53 articles out of 2101 were included. The modelling of the COVID-19 pandemic was the main objective of 23 studies, while the remaining articles evaluated the forecast transmission of COVID-19. Most studies used compartmental models to simulate COVID-19 transmission (26, 49.1%), while others used agent-based (16, 34%), branching processes (5, 9.4%), or other mathematical models (6). Most studies applying compartmental models consider CT in a separate compartment. Quarantine and basic reproduction numbers were also considered in the models. The quality assessment scores ranged from 13 to 26 of 28. Conclusions: Despite the significant heterogeneity in the models and the assumptions on the relevant model parameters, this systematic review provides a comprehensive overview of the models proposed to evaluate the COVID-19 pandemic, including non-pharmaceutical public health interventions such as CT. Prospero Registration: CRD42022359060.}, } @article {pmid40281841, year = {2025}, author = {Dalky, A and Altawalbih, M and Alshanik, F and Khasawneh, RA and Tawalbeh, R and Al-Dekah, AM and Alrawashdeh, A and Quran, TO and ALBashtawy, M}, title = {Global Research Trends, Hotspots, Impacts, and Emergence of Artificial Intelligence and Machine Learning in Health and Medicine: A 25-Year Bibliometric Analysis.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {8}, pages = {}, pmid = {40281841}, issn = {2227-9032}, support = {20240512//Deanship of Research at Jordan University of Science and Technology/ ; }, abstract = {Background/Objectives: The increasing application of artificial intelligence (AI) and machine learning (ML) in health and medicine has attracted a great deal of research interest in recent decades. This study aims to provide a global and historical picture of research concerning AI and ML in health and medicine. Methods: We used the Scopus database for searching and extracted articles published between 2000 and 2024. Then, we generated information about productivity, citations, collaboration, most impactful research topics, emerging research topics, and author keywords using Microsoft Excel 365 and VOSviewer software (version 1.6.20). Results: We retrieved a total of 22,113 research articles, with a notable surge in research activity in recent years. Core journals were Scientific Reports and IEEE Access, and core institutions included Harvard Medical School and the Ministry of Education of the People's Republic of China, while core countries comprised the United States, China, India, the United Kingdom, and Saudi Arabia. Citation trends indicated substantial growth and recognition of AI's and ML impact on health and medicine. Frequent author keywords identified key research hotspots, including specific diseases like Alzheimer's disease, Parkinson's diseases, COVID-19, and diabetes. The author keyword analysis identified "deep learning", "convolutional neural network", and "classification" as dominant research themes. Conclusions: AI's transformative potential in AI and ML in health and medicine holds promise for improving global health outcomes.}, } @article {pmid40281838, year = {2025}, author = {Anastasiadou, O and Tsipouras, M and Mpogiatzidis, P and Angelidis, P}, title = {Digital Healthcare Innovative Services in Times of Crisis: A Literature Review.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {8}, pages = {}, pmid = {40281838}, issn = {2227-9032}, abstract = {Objectives: The transformation of healthcare systems during crises, particularly demonstrated during the COVID-19 pandemic, emphasizes the urgent need for effective research methodologies to evaluate digital healthcare innovations. These methodologies are essential in addressing the rapid shift in healthcare service delivery modalities, responding to unprecedented challenges that have revealed both opportunities and barriers within the digital ecosystem. Methods: For this review, research was carried out on the Medline/PubMed, Scopus, and Google Scholar databases to locate articles published from 2015 to 2024, using the search terms digital health, digital technologies, management implications, and digital platforms. The inclusion criteria referred to studies that were directly related to the topic, available in the English language, and published in peer-reviewed scientific journals. The exclusion parameters were as follows: (a) articles not relevant to the topic as defined in the purpose of the review, (b) systematic reviews and meta-analyses, and (c) articles published in a language other than English. Results: Key findings indicate that, while digital health technologies have the potential to mitigate healthcare disparities, they often exacerbate existing inequities, especially among vulnerable populations lacking consistent access to technology. Furthermore, the shift towards digital platforms has revealed significant gaps in workforce training and support, which are essential for effective implementation. Conclusions: This review underscores the financial implications, with expenditures rising significantly due to the increased use of digital services, reflecting a broader trend noted in studies of related health conditions. Moreover, discussions on public health governance suggest a critical need for democratic frameworks to support such digital transformations effectively.}, } @article {pmid40281723, year = {2025}, author = {Kumar, P and Chaudhary, B and Arya, P and Chauhan, R and Devi, S and Parejiya, PB and Gupta, MM}, title = {Advanced Artificial Intelligence Technologies Transforming Contemporary Pharmaceutical Research.}, journal = {Bioengineering (Basel, Switzerland)}, volume = {12}, number = {4}, pages = {}, pmid = {40281723}, issn = {2306-5354}, abstract = {One area of study within machine learning and artificial intelligence (AI) seeks to create computer programs with intelligence that can mimic human focal processes in order to produce results. This technique includes data collection, effective data usage system development, conclusion illustration, and arrangements. Analysis algorithms that are learning to mimic human cognitive activities are the most widespread application of AI. Artificial intelligence (AI) studies have proliferated, and the field is quickly beginning to understand its potential impact on medical services and investigation. This review delves deeper into the pros and cons of AI across the healthcare and pharmaceutical research industries. Research and review articles published throughout the last few years were selected from PubMed, Google Scholar, and Science Direct, using search terms like 'artificial intelligence', 'drug discovery', 'pharmacy research', 'clinical trial', etc. This article provides a comprehensive overview of how artificial intelligence (AI) is being used to diagnose diseases, treat patients digitally, find new drugs, and predict when outbreaks or pandemics may occur. In artificial intelligence, neural networks and deep learning are some of the most popular tools; in clinical research, Bayesian non-parametric approaches hold promise for better results, while smartphones and the processing of natural languages are employed in recognizing patients and trial monitoring. Seasonal flu, Ebola, Zika, COVID-19, tuberculosis, and outbreak predictions were made using deep computation and artificial intelligence. The academic world is hopeful that AI development will lead to more efficient and less expensive medical and pharmaceutical investigations and better public services.}, } @article {pmid40280238, year = {2025}, author = {Nguyen, CTG and Meng, F}, title = {Unleashing the power of nucleic acid therapeutics through efficient cytosolic delivery.}, journal = {Journal of controlled release : official journal of the Controlled Release Society}, volume = {383}, number = {}, pages = {113774}, doi = {10.1016/j.jconrel.2025.113774}, pmid = {40280238}, issn = {1873-4995}, mesh = {Humans ; Endosomes/metabolism ; *Nucleic Acids/administration & dosage ; Animals ; Cytosol/metabolism ; *Drug Delivery Systems ; COVID-19 ; Gene Transfer Techniques ; *RNA, Small Interfering/administration & dosage ; SARS-CoV-2 ; }, abstract = {The approval of siRNA-based therapy for liver disease in 2018 and the subsequent success of mRNA-based SARS-CoV-2 vaccines have inaugurated a new era in nucleic acid-based therapeutics. These breakthroughs underscore the transformative potential of nucleic acid-based therapeutics, which modulate gene function, correct genetic defects, or disrupt pathological molecular processes. Such advances represent a paradigm shift in modern medicine. Despite their immense promise, the clinical realization of nucleic acid-based therapies is fundamentally constrained by endosomal entrapment, a critical barrier that significantly limits therapeutic efficacy. Overcoming this obstacle is imperative to fully unlock the potential of these therapies. Designing effective strategies to facilitate the escape of nucleic acids from endosomes-or bypassing endosomal pathways altogether-remains a central challenge in the field. In this review, we provide a comprehensive and critical analysis of current approaches aimed at enhancing endosomal escape or circumventing endosomal entrapment. By highlighting both the successes and limitations of these strategies, we aim to offer valuable insights to inform the development of more efficient and clinically viable nucleic acid delivery systems, advancing the future of molecular medicine.}, } @article {pmid40280144, year = {2025}, author = {Ray, STJ and Fuller, CE and Boubour, A and Tshimangani, T and Kafoteka, E and Muiruri-Liomba, A and Malenga, A and Tebulo, A and Pensulo, P and Gushu, MB and Nielsen, M and Raees, M and Stockdale, E and Langton, J and Birbeck, GL and Waithira, N and Bonnett, LJ and Henrion, MY and Fink, EL and Postels, DG and O'Brien, N and Page, AL and Baron, E and Gordon, SB and Molyneux, E and Dondorp, A and George, EC and Maitland, K and Michael, BD and Solomon, T and Chimalizeni, Y and Lalloo, DG and Moxon, CA and Taylor, T and Mallewa, M and Idro, R and Seydel, K and Griffiths, MJ}, title = {The aetiologies, mortality, and disability of non-traumatic coma in African children: a systematic review and meta-analysis.}, journal = {The Lancet. Global health}, volume = {13}, number = {6}, pages = {e1043-e1056}, doi = {10.1016/S2214-109X(25)00055-5}, pmid = {40280144}, issn = {2214-109X}, mesh = {Humans ; *Coma/etiology/mortality/epidemiology ; Child ; Africa/epidemiology ; Child, Preschool ; Adolescent ; Infant ; Prevalence ; }, abstract = {BACKGROUND: Non-traumatic coma in African children is a common life-threatening presentation often leading to hospital attendance. We aimed to estimate the distribution of non-traumatic coma causes and outcomes, including disease-specific outcomes, for which evidence is scarce.

METHODS: We systematically reviewed MEDLINE, Embase, and Scopus databases from inception to Feb 6, 2024. We included studies recruiting children (aged 1 month to 16 years) with non-traumatic coma (Blantyre Coma Scale score ≤2, ie deep coma or comparable alternative) from any African country. Disease-specific studies were included if outcomes were reported. Primary data were requested where required. We used a DerSimonian-Laird random effects model to calculate pooled estimates for prevalence of causes, mortality, and morbidity (in-hospital and post-discharge), including analysis of mortality by temporality. This study was registered with PROSPERO (CRD4202014193).

FINDINGS: We screened 16 666 articles. 138 studies were eligible for analysis, reporting causes, outcome data, or both from 35 027 children with non-traumatic coma in 30 African countries. 114 (89%) of 128 studies were determined to be high quality. Among the causes, cerebral malaria had highest pooled prevalence at 58% (95% CI 48-69), encephalopathy of unknown cause was associated with 23% (9-36) of cases, and acute bacterial meningitis was the cause of 10% (8-12) of cases, with all other causes representing lower proportions of cases. Pooled overall case-fatality rates were 17% (16-19) for cerebral malaria, 37% (20-55) for unknown encephalopathy, and 45% (34-55) for acute bacterial meningitis. By meta-regression, there was no significant difference in cerebral malaria (p=0·98), acute bacterial meningitis (p=0·99), or all-cause coma (p=0·081) mortality by year of study. There was no substantial difference in deaths associated with cerebral malaria in-hospital compared with post-discharge (17% [16-19] vs (18% [16-20]). Mortality was higher post-discharge than in-hospital in most non-malarial comas, including acute bacterial meningitis (39% [26-52]) vs 53% [38-69]). Disability associated with cerebral malaria was 11% (9-12). Pooled disability outcomes associated with other non-malarial diseases were largely absent.

INTERPRETATION: The prevalence and outcomes of cerebral malaria and meningitis associated with non-traumatic coma were strikingly static across five decades. Enhanced molecular and radiological diagnostics, investment, policy making, community awareness, and health service provision are all required to facilitate earlier referral to specialist centres, to drive a step-change in diagnostic yield and treatment options to improve these outcomes.

FUNDING: Wellcome Trust.

TRANSLATIONS: For the Chichewa, French and Portuguese translations of the abstract see Supplementary Materials section.}, } @article {pmid40280022, year = {2025}, author = {Sahni, S and Kaushal, LA and Gupta, P}, title = {Gendered differences and strategies for work-life balance: Systematic review based on social ecological framework perspective.}, journal = {Acta psychologica}, volume = {256}, number = {}, pages = {105019}, doi = {10.1016/j.actpsy.2025.105019}, pmid = {40280022}, issn = {1873-6297}, mesh = {Humans ; *Work-Life Balance ; Female ; Male ; Sex Factors ; *COVID-19 ; *Gender Role ; }, abstract = {This paper systematically reviews gender-based work-life balance (WLB) studies conducted during pandemic times. It outlines potential problems and solutions for effectively managing work and non-work commitments. Using the Socio-ecological system theory, the study makes a significant contribution by identifying the root causes of gender disparities across four levels of inquiry: the micro, meso, exo, and macro system, based on themes that directly emerge from analysing the previous 109 articles published between till 2024. A conceptual framework is developed to understand various factors that explain why women are at high risk of experiencing gender disparity. However, we complement and populate the model with pioneering and insightful instances of gender inequalities from the literature to provide richer insights into gender-based WLB. Drawing from our research findings, we propose specific strategies to achieve WLB without reinforcing traditional gender roles. These strategies have practical implications for policymakers and human resources departments, providing them with a roadmap to design and implement work-life-friendly policies differentiated by gender to generate overall well-being.}, } @article {pmid40279858, year = {2025}, author = {Patel, PA and Ripp, AT and Nguyen, SA and Duffy, AN and Soler, ZM and Eskandari, R and White, DR and Schlosser, RJ}, title = {Increased incidence of intracranial complications following pediatric sinogenic and otogenic infections in the post-COVID-19 Era: A systematic review and meta-analysis.}, journal = {International journal of pediatric otorhinolaryngology}, volume = {193}, number = {}, pages = {112364}, doi = {10.1016/j.ijporl.2025.112364}, pmid = {40279858}, issn = {1872-8464}, mesh = {Humans ; *COVID-19/epidemiology/complications ; Child ; Incidence ; SARS-CoV-2 ; Adolescent ; *Sinusitis/complications/epidemiology ; Sinus Thrombosis, Intracranial/epidemiology ; }, abstract = {BACKGROUND: This systematic-review and meta-analysis aims to evaluate and summarize the prevalence of pediatric intracranial complications following sinogenic or otogenic infections before and after the COVID-19 pandemic.

METHODS: A literature search was performed using the PubMed, Scopus, and CINAHL databases to answer the question: In pediatric patients, was there an increase in the prevalence or severity of intracranial complications due to sinogenic or otogenic infections during and after the COVID-19 pandemic? Publications which included primary data on patients under the age of 18 years old, focusing on intracranial complications following otogenic and sinogenic infections were included.

RESULTS: Of 1025 abstracts screened, 18 studies were included. There were no significant differences in age or sex between the two cohorts. Compared to the pre-COVID era, post-COVID infections were more likely to have neurologic complications upon presentation [11.4 % (1.6-53.0) vs 50.1 % (13.9-86.2), p < 0.01], cerebral venous sinus thrombosis (CVST) [14.1 % (10.6-18.2) vs 40.5 % (25.2-56.9), p < 0.01], intraparenchymal abscess [40.3 % (43.9-72.2) vs 54.9 % (25.2-87.1), p < 0.01], and meningitis [10.6 % (0.0-39.4) vs 40.2 % (13.4-70.8), p < 0.01]. Metronidazole use [38.7 % (31.8-46.0) vs 71.9 % (51.3-88.6), p < 0.01], craniectomy [16.1 % (1.3-42.8) vs 37.4 % (2.9-83.0), p = 0.02], and burr holes [16.8 % (11.5-23.3) vs 26.6 % (12.7-43.3), p = 0.02] were increased in the post-COVID cohort.

CONCLUSION: There are considerable differences in neurologic deficits, CVST, intraparenchymal abscesses, meningitis, and treatment modalities in pre- and post-COVID cohorts of children with intracranial complications of otorhinogenic origin. Further research is required to determine the underlying mechanism for these differences.}, } @article {pmid40279527, year = {2025}, author = {Monschein, T and Zrzavy, T and Rommer, PS and Meuth, SG and Chan, A and Berger, T and Hartung, HP}, title = {SARS-CoV-2 Vaccines and Multiple Sclerosis: An Update.}, journal = {Neurology(R) neuroimmunology & neuroinflammation}, volume = {12}, number = {3}, pages = {e200393}, pmid = {40279527}, issn = {2332-7812}, mesh = {Humans ; *COVID-19 Vaccines/immunology ; *Multiple Sclerosis/drug therapy/immunology ; *COVID-19/prevention & control/immunology ; SARS-CoV-2/immunology ; }, abstract = {The highly contagious zoonosis coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a pandemic by the World Health Organization on March 11, 2020, and has led to a global health crisis with nearly 777 million confirmed infections and over 7 million deaths worldwide by November 10, 2024.[1-3] Over time, various variants emerged, with Omicron and its sublines dominating the world over the past 3 years.[4] In addition, there is increasing evidence regarding the immune response of SARS-CoV-2 vaccines, especially for people with multiple sclerosis (MS) receiving disease-modifying therapies. Hence, with this review, we aim to provide an updated overview and recommendations for clinical practice regarding MS and SARS-CoV-2 vaccines, including efficacy and safety, SARS-CoV-2 variants, vaccine hesitancy, and the immune response under treatment with respective disease-modifying therapies.}, } @article {pmid40278579, year = {2025}, author = {Lan, L and Wang, Y and Chen, Y and Wang, T and Zhang, J and Tan, B}, title = {A Review on the Prevalence and Treatment of Antibiotic Resistance Genes in Hospital Wastewater.}, journal = {Toxics}, volume = {13}, number = {4}, pages = {}, pmid = {40278579}, issn = {2305-6304}, abstract = {Antibiotic resistance is a global environmental and health threat. Approximately 4.95 million deaths were associated with antibiotic resistance in 2019, including 1.27 million deaths that were directly attributable to bacterial antimicrobial resistance. Hospital wastewater is one of the key sources for the spread of clinically relevant antibiotic resistance genes (ARGs) into the environment. Understanding the current situation of ARGs in hospital wastewater is of great significance. Here, we review the prevalence of ARGs and antibiotic-resistant bacteria (ARB) in hospital wastewater and wastewater from other places and the treatment methods used. We further discuss the intersection between ARGs and COVID-19 during the pandemic. This review highlights the issues associated with the dissemination of critical ARGs from hospital wastewater into the environment. It is imperative to implement more effective processes for hospital wastewater treatment to eliminate ARGs, particularly during the current long COVID-19 period.}, } @article {pmid40278560, year = {2025}, author = {Everaert, S and Godderis, L and Raquez, JM and Schoeters, G and Spanoghe, P and Moens, J and Hens, L and Michel, O and Adang, D and Fraeyman, N}, title = {Do We Need Titanium Dioxide (TiO2) Nanoparticles in Face Masks?.}, journal = {Toxics}, volume = {13}, number = {4}, pages = {}, pmid = {40278560}, issn = {2305-6304}, abstract = {The use of face masks has proven to be an effective preventive measure during the COVID-19 pandemic. However, concerns have emerged regarding the safety of metal (nano)particles incorporated into face masks for antimicrobial purposes. Specifically, this review examines the risks associated with TiO2 nanoparticles (NPs), which are classified as a possible human carcinogen. The inhalation of TiO2 NPs can cause multiple adverse effects, including oxidative stress, pulmonary inflammation, histopathological changes, and (secondary) genotoxicity. Different aspects are discussed, such as the composition and filtration efficiency of face masks, the antimicrobial mode of action and effectiveness of various metals, and the hazards of TiO2 NPs to human health, including exposure limits. A conservative risk assessment was conducted using different worst-case scenarios of potential (sub)chronic TiO2 exposure, derived from published leaching experiments. Most face masks are considered safe, especially for occasional or single use. However, the nanosafety of a minority of face masks on the European market may be inadequate for prolonged and intensive use. Important uncertainties remain, including the risks of combined exposure to TiO2 NPs and silver biocides, and the lack of direct exposure measurements. Considering the potential safety issues and the limited added protective value of TiO2 NPs, it is recommended to ban all applications of TiO2 in face masks based on the precautionary principle.}, } @article {pmid40276849, year = {2025}, author = {Kim, DH and Wang, M and Kim, S and Jang, DW and Ko, T and Goldstein, BJ}, title = {Strategies to Develop Regenerative Medicine Approaches for Olfactory Disorders.}, journal = {Clinical and experimental otorhinolaryngology}, volume = {18}, number = {3}, pages = {204-209}, pmid = {40276849}, issn = {1976-8710}, support = {//Duke University School of Medicine/ ; //Seoul St. Mary's Hospital, The Catholic University of Korea/ ; RS-2023-00209494//National Research Foundation of Korea/ ; //Ministry of Science and ICT/ ; 23C0121L1//Korean Fund for Regenerative Medicine/ ; }, abstract = {Olfactory loss affects more than 12% of the population, with prevalence increasing in aging individuals. Multiple conditions can lead to a loss of smell (hyposmia or anosmia), including post-viral damage from coronavirus disease 2019 (COVID-19) or influenza, head injuries, sinusitis, or neurodegenerative conditions such as Alzheimer or Parkinson disease. Although treatments like surgery, anti-inflammatory medications, or olfactory training can be beneficial in certain cases, there remains an unmet need for effective therapies addressing many common causes of olfactory dysfunction. This is particularly true for cases attributed to damage of olfactory neurons that fail to spontaneously recover. Regenerative medicine approaches, aimed at either stimulating the regrowth of sensory neural structures or replacing them through cell-based therapies, have attracted considerable interest for treating various neurological disorders, including olfactory loss. Here, we summarize the intrinsic regenerative capabilities of the peripheral olfactory system, focusing on current research strategies and the existing barriers that must be overcome for successful translational applications. A major unmet need in this field involves the establishment of reliable and widely accepted culture models for expanding and differentiating olfactory stem or progenitor cells from rodents and humans, both for use in vitro assays and as potential material for cell-based therapies.}, } @article {pmid40275994, year = {2025}, author = {Leong, TD and Hohlfeld, AS and Bango, F and Mabetha, D and Blose, N and Oliver, J and Engel, ME and Kredo, T}, title = {Assessing the evidence for antibiotic management of laboratory-confirmed Streptococcus A skin infections to prevent acute rheumatic fever and rheumatic heart disease: a systematic review.}, journal = {IJID regions}, volume = {15}, number = {}, pages = {100642}, pmid = {40275994}, issn = {2772-7076}, abstract = {OBJECTIVES: Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are potential sequelae of untreated group A streptococcal (Strep A) infections. Guidelines focus on treating Strep A pharyngitis but seldom on skin infections. This systematic review explored whether directed antibiotic therapy for superficial Strep A skin infections prevents ARF/RHD.

METHODS: We searched PubMed, Scopus, Cochrane Library, and clinical trial registries for published and ongoing trials measuring the eradication of Strep A and clinical resolution of polymicrobial infections with antibiotics through December 13, 2024. We calculated risk ratios and absolute risk differences, using the grading of recommendations, assessment, development, and evaluation (GRADE) to assess the certainty of evidence.

RESULTS: No trials were reported on ARF/RHD outcomes. However, we identified 12 trials and pooled data comparing penicillin, cotrimoxazole, macrolides, and cephalosporins. There was probably no difference between interventions for eradicating Strep A (very low certainty evidence). For clinical resolution, cotrimoxazole was comparable to intramuscular benzathine benzylpenicillin and macrolides to penicillin (moderate certainty evidence). First- and second-generation cephalosporins showed no difference (low certainty evidence), whereas third-generation cephalosporins demonstrated improved clinical response (moderate certainty evidence). Benzathine benzylpenicillin-associated injection-site pain and oral antibiotic-associated gastrointestinal disorders were commonly reported.

CONCLUSIONS: The available evidence for directed treatment of Strep A skin infections to prevent ARF/RHD is uncertain, requiring further research, with consideration of antimicrobial resistance and the limited antibiotic pipeline.}, } @article {pmid40275360, year = {2025}, author = {Pelizzari, N and Covolo, L and Ceretti, E and Fiammenghi, C and Gelatti, U}, title = {Defining, assessing, and implementing organizational health literacy: barriers, facilitators, and tools - a systematic review.}, journal = {BMC health services research}, volume = {25}, number = {1}, pages = {599}, pmid = {40275360}, issn = {1472-6963}, mesh = {*Health Literacy/organization & administration ; Humans ; *Delivery of Health Care/organization & administration ; COVID-19/epidemiology ; }, abstract = {BACKGROUND: Organizational health literacy (OHL) is increasingly recognized as a fundamental aspect of high-quality healthcare delivery, focusing on organizations' roles in enabling patients to access, understand, and use health information effectively. This systematic review synthesizes current research on OHL, focusing on its definitions, assessment tools, implemented practices, outcomes, and the factors influencing successful OHL integration within healthcare settings.

METHODS: Guided by PRISMA and following a predefined registered protocol (PROSPERO 2024:CRD42024537425), this systematic review analyzed studies from six key databases, using targeted keywords associated with OHL. Eligibility criteria isolated research on OHL tools, practices, and outcomes in healthcare settings. Independent reviewers conducted study selection, data extraction, and bias risk analysis. Systematic quality assessment and data extraction were performed to thoroughly evaluate OHL's impact on healthcare.

RESULTS: This systematic review identified 62 articles, published between 2010 and 2024, from 15 different countries. A notable share (30.6%) aimed to develop, validate, and pilot context-sensitive OHL assessment tools. Other studies included qualitative (24.1%), descriptive (14.6%), case studies (11.29%), cross-sectional (8.06%), mixed methods (8.06%), and quantitative (3.25%) approaches, investigating factors promoting and impeding OHL outcomes. The results highlight a 54.1% increase in studies during the COVID-19 pandemic compared to the pre-pandemic period.

CONCLUSION: OHL is instrumental in advancing healthcare systems towards greater accessibility and patient-centeredness. Nevertheless, overcoming the identified implementation barriers is crucial for realizing OHL's full potential in enhancing healthcare equity and efficiency. Strategic efforts are needed to foster organizational support, adapt structural practices, and allocate necessary resources for OHL initiatives to enhance healthcare.}, } @article {pmid40274383, year = {2025}, author = {Yao, C and Dong, Y and Zhou, H and Zou, X and Alhaskawi, A and Ezzi, SHA and Wang, Z and Lai, J and Kota, VG and Abdulla, MHAH and Liu, Z and Abdalbary, SA and Alenikova, O and Lu, H}, title = {COVID-19 and acute limb ischemia: latest hypotheses of pathophysiology and molecular mechanisms.}, journal = {Journal of Zhejiang University. Science. B}, volume = {26}, number = {4}, pages = {333-352}, pmid = {40274383}, issn = {1862-1783}, support = {2022RC136//the Zhejiang Provincial Medical Scientific Research Program/ ; }, mesh = {Humans ; *COVID-19/complications/physiopathology ; *Ischemia/physiopathology/etiology ; SARS-CoV-2 ; *Extremities/blood supply ; Risk Factors ; Interleukin-6/antagonists & inhibitors ; Acute Disease ; Angiotensin-Converting Enzyme 2 ; }, abstract = {Coronavirus disease 2019 (COVID-19) is a multi-system disease that can lead to various severe complications. Acute limb ischemia (ALI) has been increasingly recognized as a COVID-19-associated complication that often predicts a poor prognosis. However, the pathophysiology and molecular mechanisms underlying COVID-19-associated ALI remain poorly understood. Hypercoagulability and thrombosis are considered important mechanisms, but we also emphasize the roles of vasospasm, hypoxia, and acidosis in the pathogenesis of the disease. The angiotensin-converting enzyme 2 (ACE2) pathway, inflammation, and platelet activation may be important molecular mechanisms underlying these pathological changes induced by COVID-19. Furthermore, we discuss the hypotheses of risk factors for COVID-19-associated ALI from genetic, age, and gender perspectives based on our analysis of molecular mechanisms. Additionally, we summarize therapeutic approaches such as use of the interleukin-6 (IL-6) blocker tocilizumab, calcium channel blockers, and angiotensin-converting enzyme inhibitors, providing insights for the future treatment of coronavirus-associated limb ischemic diseases.}, } @article {pmid40273323, year = {2025}, author = {Li, Y and Liu, Y and Liu, X and Zhang, T and Guo, Z and Lai, L and Zhao, J and Cheng, Y and Ren, Z}, title = {Digital Psychological Interventions for Adults in the COVID-19 Pandemic: A Systematic Review and Meta-Analysis.}, journal = {Health psychology review}, volume = {19}, number = {3}, pages = {598-614}, doi = {10.1080/17437199.2025.2493903}, pmid = {40273323}, issn = {1743-7202}, mesh = {Humans ; *COVID-19/psychology ; *Anxiety/therapy ; *Stress, Psychological/therapy ; *Depression/therapy ; Adult ; *Psychosocial Intervention/methods ; SARS-CoV-2 ; Pandemics ; }, abstract = {This study evaluates the effect of digital psychological interventions on anxiety, depression, and stress symptoms in adults affected by the pandemic. A systematic search across five digital databases, from 1 January 2020 to 6 March 2024, identified 36 studies encompassing 8,662 participants. Compared with all control conditions, random-effects meta-analyses indicated that digital psychological interventions significantly reduced anxiety (g = -0.374; 95% CI, -0.529 to -0.218), depression (g = -0.568; 95% CI, -0.776 to -0.360), and stress (g = -0.452; 95% CI, -0.608 to -0.295). Smaller effect sizes were observed when compared with active controls than with inactive controls. Notable heterogeneity across three outcomes was observed. Publication bias was noted in depression symptoms. Several moderators were identified compared with inactive controls, including participant type for anxiety (psubgroup = 0.005), and region for depression symptoms (psubgroup = 0.000). Larger sample sizes (b = 0.0004; p = 0.028) related to stronger effects on depression symptoms. Publication year positively correlated with effects on stress (b = 0.1573; p = 0.032). This study supports the efficacy of digital psychological interventions in alleviating anxiety, depression, and stress symptoms for adults during the pandemic, offering insights for developing targeted mental health strategies in future public health crises.}, } @article {pmid40273148, year = {2025}, author = {Dickinson, R and Makowski, D and van Marwijk, H and Ford, E}, title = {Interventions for combating COVID-19 misinformation: A systematic realist review.}, journal = {PloS one}, volume = {20}, number = {4}, pages = {e0321818}, pmid = {40273148}, issn = {1932-6203}, mesh = {*COVID-19/epidemiology/psychology ; Humans ; *Communication ; SARS-CoV-2/isolation & purification ; Pandemics ; Public Health ; }, abstract = {Misinformation is a growing concern worldwide, particularly in public health following the COVID-19 pandemic in which misinformation has been attributed to tens of thousands of unnecessary deaths. Therefore a search for effective interventions against misinformation is underway, with widely varying proposed interventions, measures of efficacy, and groups targeted for intervention. This realist systematic review of proposed interventions against COVID-19 misinformation assesses the studies themselves, the characteristics and effectiveness of the interventions proposed, the durability of effect, and the circumstances and contexts within which these interventions function. We searched several databases for studies testing interventions published from 2020 onwards. The search results were sorted by eligibility, with eligible studies then being coded by themes and assessed for quality. Thirty-five studies were included, representing eight types of intervention. The results are promising to the advantages of game-type interventions, with other types scoring poorly on either scalability or impact. Backfire effects and effects on subgroups were reported on intermittently in the included studies, showing the advantages of certain interventions for subgroups or contexts. No one intervention appears sufficient by itself, therefore this study recommends the creation of packages of interventions by policymakers, who can tailor the package for contexts and targeted groups. There was high heterogeneity in outcome measures and methods, making comparisons between studies difficult; this should be a focus in future studies. Additionally, the theoretical and intervention literatures need connecting for greater understanding of the mechanisms at work in the interventions. Lastly, there is a need for work more explicitly addressing political polarisation and its role in the belief and spread of misinformation. This study contributes toward the expansion of realist review approaches, understandings of COVID-19 misinformation interventions, and broader debates around the nature of politicisation in contemporary misinformation.}, } @article {pmid40272376, year = {2025}, author = {Nguyen, THV and Ferron, F and Murakami, K}, title = {Neurotoxic Implications of Human Coronaviruses in Neurodegenerative Diseases: A Perspective from Amyloid Aggregation.}, journal = {ACS chemical biology}, volume = {20}, number = {5}, pages = {983-992}, doi = {10.1021/acschembio.5c00153}, pmid = {40272376}, issn = {1554-8937}, mesh = {Humans ; *Neurodegenerative Diseases/virology/metabolism ; *Amyloid/metabolism/chemistry ; *Coronavirus/metabolism/pathogenicity ; *Coronavirus Infections/complications/virology ; }, abstract = {Human coronaviruses (HCoVs) include seven species: HCoV-229E, HCoV-NL63, HCoV-OC43, HCoV-HKU1, MERS-CoV, SARS-CoV-1, and SARS-CoV-2. The last three, classified as Betacoronaviruses, are highly transmissible and have caused severe pandemics. HCoV infections primarily affect the respiratory system, leading to symptoms such as dry cough, fever, and breath shortness, which can progress to acute respiratory failure and death. Beyond respiratory effects, increasing evidence links HCoVs to neurological dysfunction. However, distinguishing direct neural complications from preexisting disorders, particularly in the elderly, remains challenging. This study examines the association between HCoVs and neurodegenerative diseases like Alzheimer disease, Parkinson disease, Lewy body dementia, amyotrophic lateral sclerosis, and Creutzfeldt-Jakob disease. It also presents the long-term neurological effects of HCoV infections and their differential impact across age groups and sexes. A key aspect of this study is the investigation of the sequence and structural similarities between amyloidogenic and HCoV spike proteins, which can provide insights into potential neuropathomechanisms.}, } @article {pmid40272168, year = {2025}, author = {Couch, J and Li, C and Thomas, K and Card, T and Humes, D}, title = {The impact of COVID-19 on inflammatory bowel disease surgery: a systematic review.}, journal = {Annals of the Royal College of Surgeons of England}, volume = {}, number = {}, pages = {}, doi = {10.1308/rcsann.2025.0016}, pmid = {40272168}, issn = {1478-7083}, abstract = {INTRODUCTION: The COVID-19 pandemic caused a significant disruption to the delivery of surgical services. Guidance prioritising life-saving and cancer surgery was issued. Inflammatory bowel disease (IBD) often requires considered, timely surgery, which may have not been feasible under the conditions imposed by the pandemic. This systematic review aims to quantify the impact of COVID-19 on IBD surgery and assess the safety of performing such surgery.

METHODS: A systematic review of MEDLINE, Embase and Web of Science was performed. Studies that included a prepandemic and a pandemic cohort for comparison and reported on numbers of IBD surgeries or postoperative outcomes following IBD surgery were included. Heterogeneity of included studies precluded any meta-analyses.

FINDINGS: In total, 1,220 titles were screened and 13 were included in the final review. All were cohort studies other than one case-control study. A total of 1,673,282 and 1,445,971 patients were included in the prepandemic and pandemic cohorts, respectively. Rates of elective surgery during the pandemic varied from a 66% reduction to a 9.66% increase and emergency surgery varied from no difference to an 18% reduction. Urgent surgery in IBD inpatients appears to be unaffected. Postoperative outcomes were not shown to be negatively impacted by resource limitations.

CONCLUSIONS: The COVID-19 pandemic affected IBD surgical services considerably; however, those who did undergo surgery during this period do not appear to have been at an increased risk of adverse outcomes. Further work is required to describe the long-term impacts of these cancellations on IBD services and patient morbidity.}, } @article {pmid40271530, year = {2025}, author = {Osunla, A and Oloye, F and Kayode, A and Femi-Oloye, O and Okiti, A and Servos, M and Giesy, J}, title = {The Slow Pandemic: Emergence of Antimicrobial Resistance in the Postadvent of SARS-CoV-2 Pandemic.}, journal = {Global health, epidemiology and genomics}, volume = {2025}, number = {}, pages = {3172234}, pmid = {40271530}, issn = {2054-4200}, mesh = {Humans ; *COVID-19/epidemiology ; *Pandemics/prevention & control ; SARS-CoV-2 ; Quaternary Ammonium Compounds/pharmacology ; Benzalkonium Compounds ; *Drug Resistance, Bacterial ; Disinfectants ; *Pneumonia, Viral/epidemiology/virology ; Wastewater/microbiology ; Betacoronavirus ; }, abstract = {Background: The unprecedented outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has dramatically changed the global approach to public health, emphasizing the importance of measures to control and prevent infections. In response to the COVID-19 crisis, stringent hygiene practices and surface disinfection have become the norm, with an unprecedented surge in the use of disinfectants and antiseptics (DAs). Main Text: While these measures have been crucial in curbing the spread of the virus, an emerging concern has taken center stage: the potential impact of the prolonged and widespread use of antimicrobial compounds in these products on the development of antibiotic resistance. Antimicrobial resistance (AMR) has long been recognized as one of the most pressing global health threats. Quaternary ammonium compounds (QAC) such as benzalkonium chloride, benzethonium chloride, and cetylpyridinium chloride, which are extensively used in DAs formulations, have gained less attention in the context of AMR. Conclusion: A high abundance of QACs was detected in wastewater, and certain bacteria such as Pseudomonas aeruginosa, Acinetobacter baumannii, and Enterococcus species developed resistance to these compounds over time. We analyzed the available evidence from the scientific literature, examining the presence and concentrations of QACs in different water sources, and their resistance mechanisms. This review aimed to shed light on the multifaceted challenges that arise from the dual battle against the COVID-19 pandemic and the ongoing global fight against AMR.}, } @article {pmid40270160, year = {2025}, author = {Gavazova, E and Staynova, R and Grekova-Kafalova, D}, title = {Inappropriate polypharmacy during the COVID-19 pandemic: impact, challenges, and solutions - a narrative review.}, journal = {Folia medica}, volume = {67}, number = {1}, pages = {}, doi = {10.3897/folmed.67.e144169}, pmid = {40270160}, issn = {1314-2143}, mesh = {Humans ; *Polypharmacy ; *COVID-19/epidemiology ; SARS-CoV-2 ; *Inappropriate Prescribing/prevention & control ; *COVID-19 Drug Treatment ; Pandemics ; }, abstract = {The COVID-19 pandemic has brought unprecedented challenges to healthcare systems worldwide, impacting various aspects of patient care. Polypharmacy, the concurrent use of multiple medications by a single patient, is a significant concern exacerbated by the pandemic. The dual threat of COVID-19 infection and polypharmacy for the same vulnerable group - the elderly and those with pre-existing multimorbidity - is particularly problematic, as polypharmacy has been shown to lead to suboptimal treatment outcomes in many chronic diseases. This comprehensive review explores the multifaceted issues surrounding polypharmacy during the COVID-19 pandemic, addressing its causes, consequences, and potential solutions.}, } @article {pmid40269971, year = {2025}, author = {Pohl, R and Wolff, D and Özkan, E and Sprenger, AA and Hasenpusch, C and Wesenberg, J and Düzel, E and Apfelbacher, C}, title = {Prevalence and incidence of cognitive impairment following acute respiratory distress syndrome of any cause: a systematic review and meta-analysis.}, journal = {Critical care (London, England)}, volume = {29}, number = {1}, pages = {164}, pmid = {40269971}, issn = {1466-609X}, mesh = {Humans ; *Respiratory Distress Syndrome/complications/epidemiology/psychology ; *Cognitive Dysfunction/epidemiology/etiology ; Prevalence ; Incidence ; }, abstract = {OBJECTIVES: The aim of this systematic review and meta-analysis is to synthesize and appraise the evidence on prevalence of cognitive impairment following acute respiratory distress syndrome (ARDS) of any cause.

METHODS: We systematically searched PubMed, Scopus, and Web of Science for observational studies focused on cognitive impairment in adult survivors of ARDS. Risk of bias and certainty of evidence (GRADE) were assessed. A meta-analysis using a random effects model was performed to estimate the overall prevalence of cognitive impairment after ARDS, with subgroup analyses for COVID-19-related ARDS (C-ARDS). Additionally, a meta-regression was conducted to assess the influence of demographic and clinical predictors on cognitive outcomes. Heterogeneity was assessed using τ[2] and the I[2] statistic.

RESULTS: We identified 14 studies with 1451 participants, with 650 participants (range: 13-98) included in the analyses. In the subgroup of C-ARDS, 12 studies with 563 participants (range: 13-98) were considered. The pooled prevalence of cognitive impairment following ARDS was 36% (95% CI 26-46%), with high heterogeneity between studies (I[2] = 92%, τ[2] = 0.03). In C-ARDS cohorts, the prevalence was 34% (95% CI 22-45%), with similar levels of heterogeneity (I[2] = 92.7%, τ[2] = 0.03). Meta-regression analysis showed  that older age predicted a higher prevalence of cognitive impairment following ARDS (b = 0.02, p = 0.033), reducing between-study heterogeneity (I² = 60.04%, τ² = 0.01). ICU stay, sex, and time from ICU discharge to cognitive assessment showed no significant associations (p > 0.05).

CONCLUSIONS: This meta-analysis corroborates previous findings that cognitive impairment remains a persistent issue for ARDS survivors. The prevalence of cognitive impairments following ARDS highlights the importance of future research to unravel the complex underlying mechanisms contributing to these deficits and to develop targeted strategies for prevention and rehabilitation in survivors.}, } @article {pmid40269273, year = {2025}, author = {Male, V and Jones, CE}, title = {Vaccination in pregnancy to protect the newborn.}, journal = {Nature reviews. Immunology}, volume = {25}, number = {9}, pages = {649-661}, pmid = {40269273}, issn = {1474-1741}, mesh = {Humans ; Pregnancy ; Female ; Infant, Newborn ; *Vaccination/methods ; *Pregnancy Complications, Infectious/prevention & control/immunology ; COVID-19 Vaccines/immunology ; COVID-19/prevention & control ; }, abstract = {Infectious diseases pose a particular risk to newborns and there is a global need to protect this vulnerable group. Because of the challenges of developing vaccines that are effective in newborns, only the hepatitis B and tuberculosis vaccines are given in the first 28 days of life, and even those vaccines are mainly only offered to high-risk groups. Maternal antibodies cross the placenta and can afford some protection to the newborn, so an alternative strategy is vaccination in pregnancy. This approach has been successfully used to protect newborns against tetanus and pertussis, and vaccines that are primarily offered to protect the mother during pregnancy, such as influenza and COVID-19 vaccines, also provide some protection to newborns. A respiratory syncytial virus vaccine has recently been approved for use in pregnancy to protect newborns, and a new vaccine that will be offered during pregnancy to prevent Group B Streptococcus infection in infants is on the horizon. Here, we discuss the current vaccines that are offered during pregnancy and to newborns, the vaccines in development for future use in these groups and the challenges that remain concerning the delivery and uptake of such vaccines.}, } @article {pmid40268787, year = {2025}, author = {Karaçam, Z and Ekin, P and Şaraldı, HB}, title = {Comparison of the prevalence of probably postpartum depression before and during the covid-19 pandemic in Turkey: a systematic review and meta-analysis.}, journal = {Social psychiatry and psychiatric epidemiology}, volume = {60}, number = {10}, pages = {2469-2485}, pmid = {40268787}, issn = {1433-9285}, mesh = {Humans ; *Depression, Postpartum/epidemiology ; *COVID-19/psychology/epidemiology ; Turkey/epidemiology ; Female ; Prevalence ; SARS-CoV-2 ; Cross-Sectional Studies ; Pandemics ; Pregnancy ; }, abstract = {PURPOSE: To determine the prevalence of probably postpartum depression and the effect of COVID-19 pandemic on the prevalence of probably postpartum depression based on the results of the studies in Turkey.

METHODS: Systematic review and meta-analysis of cross-sectional studies. The key words postpartum depression or postnatal depression and Turkey were searched in the electronic databases of PubMed, EbscoHost, OVID Journals, Science Direct, Web of Science, ULAKBIM Databases, DergiPARK, TR Dizin, YÖK-Natural Thesis Centre. The systematic review was performed by following PRISMA and COSMOS-E. Data were collected by using a data extraction tool developed by the researchers. The quality of the studies was evaluated by utilizing The Joanna Briggs Institute's Critical Appraisal Checklist for Analytical Cross Sectional Studies. Obtained data were synthesized with meta-analysis, narrative synthesis, subgroup analysis and meta-regression.

RESULTS: The total sample size of 34 studies included in this meta-analysis was 10 236. The cut-off score for the EPDS was considered as ≥ 13 in 30 studies and ≥ 12 in four studies. The pooled probably postpartum depression prevalence was 17.8% (95% CI: 0.153-0.206; 95% Prediction Interval: 0.070-0.383). It was found to be 16.3% before the pandemic (95% CI: 0.065-0.358; 95% Prediction Interval: 0.065-0.358) and increased to 20.2% during the pandemic (95% CI: 0.068-0.468; 95% Prediction Interval: 0.068-0.468), though the difference was not significant (Q = 1.77; df: 1; p = 0.184). The meta-regression analysis showed that the prevalence of probably postpartum depression did not change depending on the geographical region where the studies were performed, the time of data collection and the cut-off point of the EPDS. However, the studies reported many factors related to women, their infants and families that affected the prevalence of probably postpartum depression.

OUTCOMES: This meta-analysis revealed that the prevalence of probably postpartum depression was very high, increased during the pandemic and was affected by many risk factors. It may be recommended that healthcare professionals take protective and improving measures for the mental health of women at high risk during the perinatal period and provide early diagnosis, treatment, monitoring and care services.}, } @article {pmid40268657, year = {2025}, author = {Brook, B and Goetz, M and Duval, V and Micol, R and Dowling, DJ}, title = {mRNA vaccines: miRNA-based controlled biodistribution and directed adjuvantation.}, journal = {Trends in immunology}, volume = {46}, number = {5}, pages = {357-360}, pmid = {40268657}, issn = {1471-4981}, support = {75N93019C00044/AI/NIAID NIH HHS/United States ; 75N93024C00020/AI/NIAID NIH HHS/United States ; }, mesh = {*MicroRNAs/genetics/immunology ; Humans ; *SARS-CoV-2/immunology ; *COVID-19/immunology/prevention & control ; *COVID-19 Vaccines/immunology ; Animals ; Nanoparticles/chemistry ; Tissue Distribution ; *mRNA Vaccines/immunology ; Adjuvants, Immunologic ; BNT162 Vaccine ; *RNA, Messenger/immunology ; 2019-nCoV Vaccine mRNA-1273 ; Lipids/chemistry ; Liposomes ; }, abstract = {The development of ionizable mRNA-lipid nanoparticle (mRNA-LNP) nucleic acid carriers facilitated the clinical translation of the Coronavirus 2019 (COVID-19) mRNA vaccines BNT162b2 and mRNA-1273. Here, we discuss insights into rational improvements to mRNA vaccines, focusing on LNP modifications for mRNA-LNP biodistribution control, miRNA-based biodistribution control of encoded transcripts, and precision adjuvantation strategies.}, } @article {pmid40268602, year = {2025}, author = {Rubin, BK}, title = {Pediatric pulmonary and sleep medicine - Best recent articles to read in 2025.}, journal = {Paediatric respiratory reviews}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.prrv.2025.04.002}, pmid = {40268602}, issn = {1526-0550}, abstract = {It is a challenge to select the "best" recent publications in a field. This is especially so when faced with a feast of outstanding manuscripts across a broad range of topics. I therefore reached out to a Who's Who of friends and colleagues in pediatric pulmonary and sleep medicine for suggestions, and I was delighted and overwhelmed by the response - please see the Acknowledgements for those who contributed ideas. Overwhelmed, by having to read 77 publications suggested by one or more colleagues and having to winnow the list down to a somewhat reasonable number. I chose to include all papers mentioned by two or more of my colleagues and I then selected the remainder to cover the broad range of our field, based upon my belief that a manuscript represented an important contribution to our understanding and clinical care. What follows are the chosen papers organized by topic area. Given the number of papers that made the final cut, I have briefly summarized each of these manuscripts. I hope that you will find something new and exciting in these publications and that you will have as much fun in reading them as I did.}, } @article {pmid40267760, year = {2025}, author = {Freund, R and Favara, M and Porter, C and Scott, D and Duc, LT}, title = {Under pressure: Assessing the relationship between job loss and mental health of young adults in Vietnam.}, journal = {Social science & medicine (1982)}, volume = {375}, number = {}, pages = {118073}, doi = {10.1016/j.socscimed.2025.118073}, pmid = {40267760}, issn = {1873-5347}, mesh = {Humans ; Male ; Female ; Vietnam/epidemiology ; Young Adult ; Anxiety/epidemiology/etiology ; Longitudinal Studies ; COVID-19/epidemiology/psychology ; *Mental Health/statistics & numerical data ; *Unemployment/psychology/statistics & numerical data ; Adolescent ; Adult ; Depression/epidemiology ; Surveys and Questionnaires ; }, abstract = {We examine the association between job loss and mental health among young people in Vietnam using longitudinal data from the Young Lives survey. We exploit the timing of the first severe wave of COVID-19 which occurred between rounds of a phone survey, allowing comparison of pre- and post-wave job status and mental health for the same individuals. Using fixed effects regressions, our findings suggest that job loss is associated with increased levels of anxiety but not depression, in the short run. Specifically, job loss is linked to a 5.9 percentage point (pp) rise in the probability of experiencing symptoms of mild or severe anxiety, nearly double the pre-wave baseline. This association is particularly evident among individuals in the top earnings tercile who no longer live in their natal household, who experience nearly a 17pp increase in the probability of at least mild anxiety. Additional analysis suggests that financial strain and food insecurity may explain just over 20% of the observed associations. These findings highlight the need for targeted mental health and psychosocial support interventions for young people experiencing job loss, particularly among those who are under financial pressure as primary earners in their household.}, } @article {pmid40266896, year = {2025}, author = {Plebani, M and Scott, S and Simundic, AM and Cornes, M and Padoan, A and Cadamuro, J and Vermeersch, P and Çubukçu, HC and González, Á and Nybo, M and Salvagno, GL and Costelloe, SJ and Falbo, R and von Meyer, A and Iaccino, E and Botrè, F and Banfi, G and Lippi, G}, title = {New insights in preanalytical quality.}, journal = {Clinical chemistry and laboratory medicine}, volume = {63}, number = {9}, pages = {1682-1692}, pmid = {40266896}, issn = {1437-4331}, mesh = {Humans ; *COVID-19/diagnosis ; *Pre-Analytical Phase/standards ; SARS-CoV-2/isolation & purification ; Quality Control ; Laboratories, Clinical/standards ; *Clinical Laboratory Techniques/standards ; Artificial Intelligence ; }, abstract = {The negative impact of preanalytical errors on the quality of laboratory testing is now universally recognized. Nonetheless, recent technological advancements and organizational transformations in healthcare - catalyzed by the still ongoing coronavirus disease 2019 (COVID-19 pandemic) - have introduced new challenges and promising opportunities for improvement. The integration of value-based scoring systems for clinical laboratories and growing evidence linking preanalytical errors to patient outcomes and healthcare costs underscore the critical importance of this phase. Emerging topics in the preanalytical phase include the pursuit of a "greener" and more sustainable environment, innovations in self-sampling and automated blood collection, and strategies to minimize patient blood loss. Additionally, efforts to reduce costs and enhance sustainability through patient blood management have gained momentum. Digitalization and artificial intelligence (AI) offer transformative potential, with applications in sample labeling, recording collection events, and monitoring sample conditions during transportation. AI-driven tools can also streamline the preanalytical workflow and mitigate errors. Specific challenges include managing hemolysis and developing strategies to minimize its impact, addressing issues related to urine collection, and designing robust protocols for sample stability studies. The rise of decentralized laboratory testing presents unique preanalytical hurdles, while emerging areas such as liquid biopsy and anti-doping testing introduce novel complexities. Altogether, these advancements and challenges highlight the dynamic evolution of the preanalytical phase and the critical need for continuous innovation and standardization. This collective opinion paper, which summarizes the abstracts of lectures delivered at the two-day European Federation of Laboratory Medicine (EFLM) Preanalytical Conference entitled "New Insight in Preanalytical Quality" (Padova, Italy; December 12-13, 2025), provides a comprehensive overview of preanalytical errors, offers some important insights into less obvious sources of preanalytical vulnerability and proposes efficient opportunities of improvement.}, } @article {pmid40266540, year = {2025}, author = {Gallo, M and Lasagna, A and Renzelli, V and Morviducci, L and Cortellini, A and Monami, M and Marino, G and Gori, S and Verzé, M and Ragni, A and Tuveri, E and Sciacca, L and D'Oronzo, S and Giuffrida, D and Natalicchio, A and Giorgino, F and Marrano, N and Zatelli, MC and Montagnani, M and Felicetti, F and Mazzilli, R and Fogli, S and Franchina, T and Argentiero, A and Candido, R and Perrone, F and Aimaretti, G and Avogaro, A and Silvestris, N and Faggiano, A}, title = {Vaccination of people with solid tumors and diabetes: existing evidence and recommendations. A position statement from a multidisciplinary panel of scientific societies.}, journal = {Journal of endocrinological investigation}, volume = {48}, number = {8}, pages = {1717-1738}, pmid = {40266540}, issn = {1720-8386}, mesh = {Humans ; COVID-19/prevention & control ; *Diabetes Mellitus/epidemiology/immunology ; *Neoplasms/complications/immunology/epidemiology/prevention & control ; Societies, Medical/standards ; Societies, Scientific/standards ; *Vaccination/standards/methods ; }, abstract = {Diabetes and cancer are two of the most common public health concerns worldwide. The complex interplay of these two conditions is a growing area of research, as patients with diabetes are at increased risk for developing cancer, and vice versa. Furthermore, both patient populations show increased risk of many communicable infectious diseases and their adverse consequences, while vaccination can play a crucial role in their prevention, improving patient outcomes. Vaccination should represent a standard part of care for patients with cancer, diabetes, and both the diseases simultaneously, including people undergoing cancer treatment or in remission. Several international guidelines provide recommendations for vaccinating people with cancer or diabetes, but the two conditions have not been specifically evaluated together. Here we present a multidisciplinary consensus position paper on vaccination in patients with cancer and diabetes. The position paper is the result of a collaborative effort between experts from the Italian Association of Medical Oncology (AIOM), Italian Association of Medical Diabetologists (AMD), Italian Society of Diabetology (SID), Italian Society of Endocrinology (SIE), and Italian Society of Pharmacology (SIF). The paper provides a comprehensive overview of the current state-of-the-art knowledge on vaccination in patients with cancer and diabetes. It discusses the importance of vaccination in preventing infections, focuses attention on the need to consider the unique challenges faced by patients with cancer and diabetes when it comes to vaccine administration, and highlights the need for coordinated care to optimize treatment outcomes. Overall, the consensus position paper provides healthcare professionals caring for patients with cancer and diabetes recommendations on the use of various vaccines, including influenza, COVID-19, HZV, and HPV vaccines, as well as guidance on how to address common concerns and challenges related to vaccine administration.}, } @article {pmid40266515, year = {2025}, author = {Krasnova, L and Wong, CH}, title = {Making Universal Vaccines and Antibodies Through Glycoengineering.}, journal = {Methods in molecular biology (Clifton, N.J.)}, volume = {2926}, number = {}, pages = {35-50}, pmid = {40266515}, issn = {1940-6029}, mesh = {Humans ; Glycosylation ; *Antibodies, Viral/immunology ; *Protein Engineering/methods ; Animals ; Influenza Vaccines/immunology ; Vaccine Development/methods ; SARS-CoV-2/immunology ; Polysaccharides/immunology ; Epitopes/immunology ; }, abstract = {Biological glycosylation is a process used by nature to modulate the structure and function of biomolecules, particularly the glycoproteins on the surface of cells. Most human viruses, for example, depend on the host glycosylation machinery to create a sugar coat on the viral surface to facilitate infection and escape immune surveillance. The main immunogens of influenza and COVID viruses are mostly shielded by the sugar coat from immune response, so deletion of the sugar coat would expose the highly conserved epitopes and elicit broadly protective antibody and T cell responses against the virus and different variants. In addition to increased memory T cell response, the antibodies induced by such low-sugar vaccines are more diverse with higher titers against the immunogen, especially the highly conserved epitopes, thus broadening the scope of protection. Furthermore, the Fc-glycans on the antibody can be engineered to improve antibody-mediated killing. This review highlights the impact of glycosylation engineering on the development of universal vaccines and antibodies with improved Fc-mediated killing.}, } @article {pmid40266228, year = {2025}, author = {Pilewskie, M and Prosperi, C and Bernasconi, A and Esteban, I and Niehaus, L and Ross, C and Carcelen, AC and Moss, WJ and Winter, AK}, title = {The Use of Residual Blood Specimens in Seroprevalence Studies for Vaccine-Preventable Diseases: A Scoping Review.}, journal = {Vaccines}, volume = {13}, number = {3}, pages = {}, pmid = {40266228}, issn = {2076-393X}, support = {OPP1094816//The Bill and Melinda Gates Foundation/ ; }, abstract = {Background: Residual blood specimens offer a cost- and time-efficient alternative for conducting serological surveys. However, their use is often criticized due to potential issues with the representativeness of the target population and/or limited availability of associated metadata. We conducted a scoping review to examine where, when, how, and why residual blood specimens have been used in serological surveys for vaccine-preventable diseases (VPDs) and how potential selection biases are addressed. Methods: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines and identified relevant papers published in 1990-2022. Results: A total of 601 articles met the inclusion criteria after title, abstract screening, and full-text review. The most studied VPDs using residual blood specimens were COVID-19 (27%), hepatitis E (16%), hepatitis B (10%), influenza (9%), HPV (7%), and measles (7%). Residual blood specimens were primarily sourced from diagnostic specimens (61%) or blood and plasma donations (37%). Almost all articles used specimens linked to basic demographic data (e.g., age and sex), with 47% having access to extended demographic data (e.g., geographic location). Common strategies to address potential biases included comparing results with published estimates (78%) and performing stratified analyses (71%). Conclusions: Residual blood specimens are widely used in seroprevalence studies, particularly during emerging disease outbreaks when rapid estimates are critical. However, this review highlighted inconsistencies in how researchers analyze and report the use of residual specimens. We propose a set of recommendations to improve the analysis, reporting, and ethical considerations of serological surveys using residual specimens.}, } @article {pmid40266208, year = {2025}, author = {Loddo, F and Laganà, P and Rizzo, CE and Calderone, SM and Romeo, B and Venuto, R and Maisano, D and Fedele, F and Squeri, R and Nicita, A and Nirta, A and Genovese, G and Bartucciotto, L and Genovese, C}, title = {Intestinal Microbiota and Vaccinations: A Systematic Review of the Literature.}, journal = {Vaccines}, volume = {13}, number = {3}, pages = {}, pmid = {40266208}, issn = {2076-393X}, abstract = {Background: Vaccination constitutes a low-cost, safe, and efficient public health measure that can help prevent the spread of infectious diseases and benefit the community. The fact that vaccination effectiveness varies among populations, and that the causes of this are still unclear, indicates that several factors are involved and should be thoroughly examined. The "intestinal microbiota" is the most crucial of these elements. Numerous clinical studies demonstrate the intestinal microbiota's significance in determining the alleged "immunogenicity" and efficacy of vaccines. This systematic review aimed to review all relevant scientific literature and highlight the role of intestinal microbiota in COVID-19, Salmonella typhi, Vibrio cholerae, and rotavirus vaccinations. Materials and Methods: The MESH terms "vaccines" and "microbiota" were used to search the major scientific databases PubMed, SciVerse Scopus, Web of Knowledge, and the Cochrane Central Register of Controlled Clinical Trials. Results: Between February 2024 and October 2024, the analysis was conducted using electronic databases, yielding a total of 235 references. Finally, 24 RCTs were chosen after meeting all inclusion criteria: eight studies of COVID-19, two studies of Salmonella typhi, three studies of Vibrio cholerae, and eleven studies of rotavirus. Only six of these demonstrated good study quality with a Jadad score of three or four. Conclusions: According to the review's results, the intestinal microbiota surely plays a role in vaccinations' enhanced immunogenicity, especially in younger people. As it is still unclear what mechanisms underlie this effect, more research is needed to better understand the role of the intestinal microbiota.}, } @article {pmid40266207, year = {2025}, author = {Livieratos, A and Gogos, C and Thomas, I and Akinosoglou, K}, title = {Vaccination Strategies: Mixing Paths Versus Matching Tracks.}, journal = {Vaccines}, volume = {13}, number = {3}, pages = {}, pmid = {40266207}, issn = {2076-393X}, abstract = {Vaccination strategies play a pivotal role in achieving broad and robust immune protection. With the advent of new technologies and challenges posed by emerging infectious diseases such as SARS-CoV-2, evaluating the efficacy of homologous (matching tracks) and heterologous (mixing paths) vaccination regimens is critical. This article explores mechanistic insights and empirical evidence on the benefits and limitations of these approaches.}, } @article {pmid40266155, year = {2025}, author = {Leontari, K and Lianou, A and Tsantes, AG and Filippatos, F and Iliodromiti, Z and Boutsikou, T and Paliatsou, S and Chaldoupis, AE and Ioannou, P and Mpakosi, A and Iacovidou, N and Sokou, R}, title = {Pertussis in Early Infancy: Diagnostic Challenges, Disease Burden, and Public Health Implications Amidst the 2024 Resurgence, with Emphasis on Maternal Vaccination Strategies.}, journal = {Vaccines}, volume = {13}, number = {3}, pages = {}, pmid = {40266155}, issn = {2076-393X}, abstract = {Bordetella pertussis is the causative agent of pertussis or whooping cough, an acute and highly contagious respiratory infection that can have serious and fatal complications such as pneumonia, encephalopathy, and seizures, especially for newborns. The disease is endemic not only in the European Union (EU)/European Economic Area (EEA) but also globally. Larger outbreaks are anticipated every three to five years, even in countries where vaccination rates are high. Despite the high pertussis vaccination coverage in developed countries and a low rate of pertussis incidence for many years, especially during the COVID-19 pandemic, the incidence of pertussis has been on the rise again, with outbreaks in some places, which is referred to as "re-emergence of pertussis". The aim of this review is to underscore the critical importance of achieving high vaccination coverage, particularly among pregnant women, to safeguard vulnerable neonates from pertussis during their early months, before they are eligible for vaccination. This aligns with the need to address diagnostic challenges, mitigate disease severity, and strengthen public health strategies in light of the ongoing 2024 Bordetella pertussis resurgence.}, } @article {pmid40266118, year = {2025}, author = {Parodi, JF and Runzer-Colmenares, F and Cano-Gutiérrez, C and Dinamarca-Montecinos, JL and Torre, PB and Villas Boas, PF and Flores-Cohaila, J and Urrunaga-Pastor, D and Gutiérrez-Robledo, LM}, title = {Respiratory Vaccines in Older Adults: A Bibliometric Analysis and Future Research Agenda.}, journal = {Vaccines}, volume = {13}, number = {3}, pages = {}, pmid = {40266118}, issn = {2076-393X}, abstract = {BACKGROUND/OBJECTIVES: Respiratory infections impact older adults due to immunosenescence and comorbidities, resulting in increased healthcare costs and mortality. While vaccination is a critical preventive measure, research on respiratory vaccines in older adults in Latin America and the Caribbean (LAC) remains underexplored. This study aims to map the research landscape and identify emerging themes to guide future studies.

METHODS: A bibliometric analysis was conducted using the Web of Science database, focusing on publications up to 2023 related to respiratory vaccines in LAC's older adult population. PRISMA-ScR guidelines were followed for data extraction and analysis, with performance metrics and scientometric mapping conducted using Biblioshiny 4.1 and VOSviewer.

RESULTS: Ninety-nine studies spanning forty-one journals and 575 authors were included. Brazil contributed 70% of publications, followed by Mexico and Argentina. Influenza and pneumococcal vaccines were the most studied, focusing on coverage, acceptance, and cost-effectiveness. Emerging themes included COVID-19 vaccine effectiveness and vaccination-associated factors. Brazil was identified as the primary hub for collaboration across the region, while other countries made limited contributions.

CONCLUSIONS: The findings highlight disparities in research output, with Brazil dominating and significant gaps in other LAC countries. Future research should prioritize genomic studies, vaccine efficacy in comorbid populations, and adaptive immunization strategies. Building research capacity and fostering international collaborations are essential for improving vaccination outcomes in older adults across LAC.}, } @article {pmid40266112, year = {2025}, author = {Wong, J and Gill, C and Abdo, A and Eisa, A}, title = {The Influence of Financial Incentives on Vaccination Hesitancy: A Narrative Review of Recent Research.}, journal = {Vaccines}, volume = {13}, number = {3}, pages = {}, pmid = {40266112}, issn = {2076-393X}, abstract = {BACKGROUND: Vaccine hesitancy represents a significant global health challenge that greatly hinders public health efforts focused on managing the transmission of infectious diseases. A wealth of original research conducted worldwide has examined various incentives that could help alleviate vaccine hesitancy and increase vaccination rates. Although some findings are conflicting, no comprehensive review has yet assessed the overall effectiveness of these strategies. This study aims to bridge this knowledge gap by examining how financial incentives influence people's willingness to undergo vaccination.

METHODS: In August 2024, we extensively searched four databases for studies focusing on financial incentives and vaccination rates. Examples of financial incentives included lottery tickets and hypothetical or physical monetary rewards ranging in various amounts depending on the study. We selected nineteen relevant articles from a larger pool and evaluated them for validity and bias.

RESULTS: Around eighty percent of the research focused on COVID-19 vaccines, driven by the ongoing pandemic and the debates surrounding their use. Most of the studies indicated a positive influence of financial incentives on vaccination rates, although they often came with a higher risk of bias. Conversely, several studies suggest that financial incentives do not result in benefits. Instead, they highlight other factors that have a more profound effect on influencing people to undergo vaccination. The remaining studies are inconclusive regarding the effectiveness of financial incentives, concluding the need for further research. The strategies to mitigate these concerns included a combination of legal and monetary incentives.

SUMMARY: The effectiveness of financial incentives in boosting vaccination rates seems to differ significantly based on the region and context. They tend to be more effective in economically disadvantaged developing countries. In contrast, in developed nations, they may be ineffective or counterproductive due to various confounding factors such as financial background, lack of trust in the healthcare system, and/or lack of patient education. In resource-rich areas, educational programs often yield better results, and addressing widespread mistrust in healthcare systems and governmental policies through transparency is essential. Ultimately, employing tailored incentives alongside public education could enhance vaccination acceptance, particularly in culturally diverse countries like the United States, where understanding community preferences is crucial.}, } @article {pmid40266109, year = {2025}, author = {Inauen, J and LaBroome, S and Maldari, A and Stevens, NE and Geake, JB and Lynn, DJ and Barry, S}, title = {Efficacy of Bacille Calmette-Guérin Against COVID-19 Hospitalisation: A Meta-Analysis and Systematic Review of Randomised Control Trials.}, journal = {Vaccines}, volume = {13}, number = {3}, pages = {}, pmid = {40266109}, issn = {2076-393X}, abstract = {BACKGROUND: The BCG vaccine has long been hypothesised to have non-specific protective effects, and early epidemiological studies on COVID-19 suggested a possible protective effect against SARS-CoV-2 infection and COVID-19 severity. This systematic review and meta-analysis assesses the effect of the BCG vaccine on preventing severe COVID-19 disease, based on the rate of hospitalisation for COVID-19 related disease.

METHODS: We performed a literature search of randomised control trials comparing BCG vaccine to placebo in adult participants using EMBASE, MEDLINE, and Web of Science. A random effects model was used to generate summary estimates. Risk of bias was assessed regarding randomisation, allocation sequence concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases.

RESULTS: We included 11 studies involving 18,412 participants, reporting COVID-19 incidence. The hospitalisation rate was sought from the authors of papers that did not report on this statistic. There was no significant reduction in COVID-19-related hospitalisation across all studies (relative risk 0.85, 0.51-1.40, p = 0.335), COVID-19 incidence across all studies (relative risk 1.07, 0.94-1.21, p = 0.264), deaths reported in six studies (relative risk 0.67, 0.36-1.26, p = 0.733), and COVID-19-related critical care admissions reported in four studies (relative risk 0.43, 0.13-1.46, p = 0.746).

CONCLUSIONS: The findings from this meta-analysis, involving a large number of participants, suggest no protective effect of BCG vaccination against severe COVID-19 outcomes or overall SARS-CoV-2 incidence. Further research may be needed to explore the potential non-specific effects of BCG vaccination in other specific populations and against other infections.}, } @article {pmid40266105, year = {2025}, author = {Fousseni, S and Ngangue, P and Barro, A and Ramde, SW and Bihina, LT and Ngoufack, MN and Bayoulou, S and Kiki, GM and Salfo, O}, title = {Navigating the Road to Immunization Equity: Systematic Review of Challenges in Introducing New Vaccines into Sub-Saharan Africa's Health Systems.}, journal = {Vaccines}, volume = {13}, number = {3}, pages = {}, pmid = {40266105}, issn = {2076-393X}, abstract = {Background/Objectives: Over the past 50 years, developing new vaccines has been pivotal in responding to emerging and re-emerging diseases globally. However, despite substantial partner support, introducing new vaccines in sub-Saharan Africa remains challenging. This systematic review documents the barriers to new vaccine introduction in sub-Saharan Africa by distinguishing between vaccines integrated into routine immunization programs and those introduced primarily for outbreak response. Methods: A comprehensive electronic search was conducted across five databases for articles published in English or French on the challenges of new vaccine introduction in sub-Saharan Africa. Three reviewers screened articles independently based on the titles and abstracts, with full-text assessments conducted for inclusion. Data were analyzed thematically and synthesized narratively. Results: A total of 796 articles were retrieved from the five databases. Following the screening, 33 articles were finally retained and included in the review. These articles concerned the introduction of eight new vaccines (malaria vaccine, COVID-19 vaccine, HPV vaccine, Ebola vaccine, cholera vaccine, hepatitis B vaccine, rotavirus vaccine, and typhoid vaccine). The analyses revealed coordination and financing challenges for six vaccines in seventeen countries, acceptability challenges for five vaccines in ten countries, logistical challenges for two vaccines in six countries, and quality service delivery challenges for three vaccines in thirteen countries. Conclusions: Addressing the challenges of introducing new vaccines in sub-Saharan Africa requires targeted, evidence-based strategies. Prioritizing political commitment, innovative funding, public education, workforce development, and infrastructure improvements will strengthen immunization systems and enable timely vaccine delivery. Collaborative efforts and a focus on local context can advance equitable health outcomes, safeguard public health, and support global immunization goals.}, } @article {pmid40266071, year = {2025}, author = {Kwok, WC and Wong, JC and Cheung, A and Tam, TC}, title = {Vaccination in Chronic Obstructive Pulmonary Disease.}, journal = {Vaccines}, volume = {13}, number = {3}, pages = {}, pmid = {40266071}, issn = {2076-393X}, abstract = {Chronic obstructive pulmonary disease (COPD) is often exacerbated by various viruses and bacteria, leading to acute episodes of worsening respiratory symptoms, which contribute significantly to the morbidity and mortality associated with COPD. Consequently, vaccination against these pathogens is recommended by numerous guidelines to safeguard COPD patients from adverse health outcomes. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendation advocates for vaccination against influenza, Streptococcus pneumoniae, respiratory syncytial virus (RSV), severe acute respiratory syndrome coronavirus (SARS-CoV2), pertussis, and varicella zoster. This review article will examine the current vaccination strategies recommended for adult COPD patients and will discuss the clinical benefits associated with these vaccines.}, } @article {pmid40265842, year = {2025}, author = {Matthews, L and Cook, J and Stephan, R and Milacic, M and Rothfels, K and Shamovsky, V and Jassal, B and Haw, R and Sevilla, C and Gong, C and Ragueneau, E and May, B and Wright, A and Weiser, J and Beavers, D and Tiwari, K and Senff-Ribeiro, A and Varusai, T and Hermjakob, H and D'Eustachio, P and Wu, G and Stein, L and Gillespie, ME}, title = {Advancing curation of viral life cycles, host interactions, and therapeutics in Reactome.}, journal = {Journal of virology}, volume = {99}, number = {5}, pages = {e0202424}, pmid = {40265842}, issn = {1098-5514}, mesh = {Humans ; *Virus Diseases/virology/drug therapy ; *Viruses/growth & development ; *Host-Pathogen Interactions ; *Virus Physiological Phenomena ; *Data Curation/methods ; *Host Microbial Interactions ; Databases, Factual ; }, abstract = {Reactome (reactome.org) is a manually curated, peer-reviewed, open-source, open-access pathway knowledgebase of essential human cellular functions. Reactome includes viral life cycles that capture a broad range of virus-induced human pathology. Here, we describe a workflow using collaborative curation strategies, orthoinference procedures, and literature triage to rapidly create reliable molecular models of emergent viruses. The resulting pathway data set rigorously details viral infection pathways, interactions with normal human biological processes, and potential therapeutic compounds.}, } @article {pmid40265383, year = {2025}, author = {Contractor, JB and Radha, V and Shah, K and Singh, P and Tadepalli, S and Nimbalkar, S and Mohan, V and Shah, P}, title = {Congenital Hyperinsulinism India Association: An Approach to Address the Challenges and Opportunities of a Rare Disease.}, journal = {Medical sciences (Basel, Switzerland)}, volume = {13}, number = {2}, pages = {}, pmid = {40265383}, issn = {2076-3271}, mesh = {Humans ; India/epidemiology ; *Congenital Hyperinsulinism/genetics/epidemiology/diagnosis/therapy ; *Rare Diseases/epidemiology/genetics/therapy/diagnosis ; }, abstract = {India's population complexity presents varied challenges in genetic research, and while facilities have gained traction in tier-1 and -2 cities, reliance on international collaborations often delays such investigations. COVID-19 further exacerbated the issues with such sample sharing. Congenital Hyperinsulinism (CHI) is a rare genetic disorder of pancreatic β-cells causing hypoglycaemia in children due to abnormal insulin secretion. Given India's high birth rate and consanguineous populations, annual CHI cases are estimated to be around up to 10,000, with up to 50% having unexplained genetic causes. Diffuse or atypical lesions in such patients often necessitate near-total-pancreatectomy, risking pancreatic exocrine insufficiency and diabetes, requiring lifelong therapy. Also, novel genetic variations complicate accurate diagnosis, risk assessment, and counselling, emphasising the need for rapid genetic assessment to prevent neurological injuries and inform treatment decisions. Despite significant efforts at many institutes, there are no dedicated organisations for CHI in India. With the implementation of the National Policy for Rare Diseases 2021, we plan to form a non-profit organisation, "Congenital Hyperinsulinism India Association (CHIA)", comprising paediatric endocrinologists, paediatricians, geneticists, and independent researchers. The aims of this association are to generate a national database registry of patients, formulate a parent support group and CHIA consortium, design patient information leaflets, as well as foster genomic collaborations and promote clinical trials. Such steps will help sensitise the health authorities and policy makers, urging them to improve the allocation of health budgets for rare diseases, as well as empower patients and their families, contributing towards a better quality of life.}, } @article {pmid40265202, year = {2025}, author = {Lau, MPXL and Ling, RR and Ong, BJA and Cho, HJ and Jeong, IS and Sahoo, TK and Chua, HR and Shekar, K and Ramanathan, K}, title = {Kidney replacement therapy during extracorporeal membrane oxygenation: pathophysiology, technical considerations, and outcomes.}, journal = {Renal failure}, volume = {47}, number = {1}, pages = {2486557}, pmid = {40265202}, issn = {1525-6049}, mesh = {Humans ; *Extracorporeal Membrane Oxygenation/methods/adverse effects ; *Acute Kidney Injury/therapy/physiopathology/etiology ; *Renal Replacement Therapy/methods ; *COVID-19/epidemiology/therapy ; SARS-CoV-2 ; Treatment Outcome ; }, abstract = {The use of extracorporeal membrane oxygenation has been increasing over time, in part due to the COVID-19 pandemic. Whilst lifesaving, complications that must be managed are also associated with its use. AKI and fluid overload are complications of concern due to their associations with poor outcomes, and ability to be managed by additional interventions such as the use of kidney replacement therapy. Various modalities, timings, and types of kidney replacement therapy are currently being used and outcomes regarding its concurrent use with extracorporeal membranous oxygenation across centers may be mixed. In this review, we discuss the pathophysiology of AKI, methods, modalities and impact of concurrent extracorporeal membrane oxygenation and kidney replacement therapy.}, } @article {pmid40265016, year = {2025}, author = {Zhang, D and Peng, J and Zhu, Y and Gong, Q and Wang, Q and Xiang, C and Du, H and Hu, X}, title = {Mapping the research landscape of PET/CT in lymphoma: insights from a bibliometric analysis.}, journal = {Frontiers in oncology}, volume = {15}, number = {}, pages = {1513296}, pmid = {40265016}, issn = {2234-943X}, abstract = {OBJECTIVE: This study provides a comprehensive bibliometric analysis of research trends in Positron Emission Tomography/Computed Tomography (PET/CT) applications for lymphoma, aiming to identify key contributors, emerging topics, and collaboration patterns within the field.

METHODS: Data from the Web of Science Core Collection (2004-2024) were analyzed. Original articles and reviews in English on PET/CT in lymphoma staging, response assessment, or prognosis were included, while case reports, meeting abstracts, and editorials were excluded. Using CiteSpace, VOSviewer, and Bibliometrix R, we evaluated country/institutional contributions, co-citation networks, keyword trends, and employed linear regression for trend forecasting.

RESULTS: A total of 2,962 papers related to PET/CT and lymphoma were published during the study period. The annual publication volume increased significantly, peaking in 2021 with 281 papers, followed by a decline to 260 in 2023, potentially linked to COVID-19-related research disruptions. The United States and China led in publication volume, contributing over 40% of global publications. Leading institutions included UNICANCER and Assistance Publique Hôpitaux de Paris. Influential authors such as Sally F. Barrington and Michel Meignan were identified. The European Journal of Nuclear Medicine and Molecular Imaging and the Journal of Nuclear Medicine were the top journals in this field. Key research themes included staging, response assessment, prognosis, and the role of PET/CT in personalized treatment approaches.

CONCLUSION: This bibliometric analysis highlights the significant growth and evolving trends in PET/CT research for lymphoma. The findings underscore the critical role of PET/CT in advancing precision medicine, informing future research directions, and optimizing clinical practices in lymphoma management.}, } @article {pmid40264303, year = {2025}, author = {Healy, L and Seto, BY and Cui, H and Li, B}, title = {Non-viral mRNA delivery to the lungs.}, journal = {Biomaterials science}, volume = {13}, number = {11}, pages = {2871-2882}, doi = {10.1039/d5bm00322a}, pmid = {40264303}, issn = {2047-4849}, mesh = {Humans ; *Lung/metabolism ; *RNA, Messenger/administration & dosage/chemistry/genetics ; Nanoparticles/chemistry ; COVID-19 ; Animals ; Polymers/chemistry ; Lipids/chemistry ; SARS-CoV-2 ; *Drug Delivery Systems/methods ; }, abstract = {The rapid advancement of mRNA therapeutics, exemplified by COVID-19 vaccines, underscores the transformative potential of non-viral delivery systems. However, achieving efficient and targeted mRNA delivery to the lungs remains a critical challenge due to biological barriers such as pulmonary mucus, nanoparticle instability, and off-target accumulation particularly in the liver. Addressing these challenges is crucial for advancing treatments for respiratory diseases, including cystic fibrosis, primary ciliary dyskinesia, and lung cancers. This review highlights emerging strategies to enhance lung-targeted mRNA delivery, focusing on lipid nanoparticles, polymeric nanoparticles, lipid-polymer hybrids, and peptide/protein conjugates. By discussing advances in bioinspired design and nanoparticle reformulation, this review provides a roadmap for overcoming current delivery limitations and accelerating the clinical translation of lung-targeted mRNA therapies.}, } @article {pmid40263685, year = {2025}, author = {Poudineh, M and Amirbeik, A and Firouzabadi, MD and Hajizadeh, M and Kahe, F and Babaniamansour, S and Poopak, A and Tajrishi, FZ and Deravi, N and Rahmanian, M and Ghasemirad, H and Malek, M and Noroozi, M and Fathi, M and Keylani, K and Firouzabadi, AD and Abbasabad, GD and Yazdanian, F and Ramezanpour, S and Babaniamansour, A and Tajrishi, FZ and Mohammadi, S and Ansari, G and Firouzabadi, FD and Yousem, DM}, title = {Olfactory and Gustatory Recovery Time Evaluation of COVID-19: A Systematic Review and Meta-Analysis.}, journal = {Acta medica Indonesiana}, volume = {57}, number = {1}, pages = {18-43}, pmid = {40263685}, issn = {2338-2732}, mesh = {Humans ; *COVID-19/complications ; *Olfaction Disorders/virology/etiology ; *Taste Disorders/virology/etiology ; SARS-CoV-2 ; Recovery of Function ; Pandemics ; Time Factors ; }, abstract = {BACKGROUND: Olfactory dysfunction is a common symptom of Coronavirus disease 2019 (COVID-19). In this study, we aimed to evaluate the recovery rate and duration of these symptoms in COVID-19patients.

METHODS: This systematic review was conducted by searching PubMed and Google Scholar from April 1st, 2020, until October 1st, 2022, using the terms ''COVID-19'' OR ''COV-2,'' OR ''Coronavirus 2'' OR coronavirus AND ''loss of smell'' OR Anosmia OR Hyposmia OR olfaction OR ''olfactory loss'' AND ageusia OR Hypogeusia OR dysgeusia OR ''gustatory loss'' OR gustation OR ''loss of taste''. The references of included studies were also manually screened. Random-effects meta-analysis was performed.

RESULTS: One hundred and twenty-five studies with test-confirmed COVID-19 infection from 31 countries were included. 62 publications which reported data on loss of taste were used to estimate patients' recovery rate in 13700 COVID-19 patients. Accordingly, the time to recovery of loss of taste among COVID-19 patients ranged from 2±0.352 to 43.6 ± 28.5 days. The estimated overall pooled recovery rate of loss of taste among COVID-19 patients was 74%. The estimated overall pooled time to recover loss of taste among COVID-19 patients was 11.44 days [95% CI 8.11, 14.77(]. 90 publications which reported data on loss of smell were used to estimate patients' recovery rate in 20027 COVID-19 patients. Accordingly, the time to recover the loss of smell among COVID-19 patients ranged from 2.44±0.352 to 31.9 ± 30.7 days The estimated overall pooled recovery rate of loss of smell among COVID-19 patients was 72%. The estimated overall pooled time to recover loss of smell among COVID-19 patients was 12.87 days [95% CI)1011, 15.64(].

CONCLUSION: The recovery rate of loss of smell and taste among COVID-19 patients was high globally, and time to recovery of loss of smell and taste among COVID-19 patients usually was less than 2 weeks; regional differences supported the relevance of these symptoms as important markers. Health workers must consider smell and taste symptoms as suspicion indices for the empirical diagnosis of COVID-19 infection and reassure patients with their high recovery rate in a short period of time.}, } @article {pmid40261365, year = {2025}, author = {Voderholzer, U and Naab, S and Cuntz, U and Schlegl, S}, title = {[Anorexia nervosa-An update. German version].}, journal = {Der Nervenarzt}, volume = {96}, number = {3}, pages = {220-229}, pmid = {40261365}, issn = {1433-0407}, mesh = {Humans ; *Anorexia Nervosa/therapy/diagnosis/psychology/epidemiology ; Adolescent ; *Cognitive Behavioral Therapy/methods ; Germany ; Family Therapy/methods ; Child ; COVID-19/epidemiology ; Young Adult ; Female ; }, abstract = {Anorexia nervosa (AN) is a severe psychiatric disorder with the highest mortality rate among eating disorders. It predominantly affects adolescents and young adults, with a significant increase in prevalence among adolescents observed since the coronavirus disease 2019 (COVID-19) pandemic. It is frequently associated with other psychiatric disorders, such as depression, anxiety and obsessive-compulsive disorders as well as numerous physical complications. An early diagnosis and treatment are associated with better outcomes. The treatment of choice for AN includes cognitive behavioral therapy and family-based therapy for children and adolescents. Innovative treatment approaches, such as home treatment and technology-based interventions, have shown promising preliminary results. With the exception of moderate evidence supporting the use of olanzapine regarding weight gain, there is currently no evidence for the efficacy of psychopharmacotherapy in AN. Future research should focus on prevention, early detection and intervention, relapse prevention, personalized treatment approaches, management of comorbid disorders, long-term studies and the influence of psychosocial factors.}, } @article {pmid40260163, year = {2025}, author = {Vink, K and Kusters, J and Wallinga, J}, title = {Chrono-optimizing vaccine administration: a systematic review and meta-analysis.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1516523}, pmid = {40260163}, issn = {2296-2565}, mesh = {Humans ; *Immunization Schedule ; *Vaccination/methods ; COVID-19/prevention & control ; Male ; Middle Aged ; Time Factors ; Female ; Aged ; *COVID-19 Vaccines/administration & dosage ; }, abstract = {BACKGROUND: Increasing evidence suggests that vaccine responses may vary based on the time of day of administration. This systematic review provides a comprehensive overview of the impact of vaccination timing on immune responses, to assess its potential role in optimizing vaccination programs.

METHODS: A systematic literature search was performed in Embase, Medline and Scopus to identify eligible observational studies and clinical trials that assessed immune responses following vaccination at different times of the day in humans. A meta-analysis of clinical trials was conducted to quantify the effect size of vaccination timing on antibody responses.

RESULTS: The search identified 17 studies that compared vaccine responses at different times of the day, covering vaccinations against COVID-19 (9), influenza (5), hepatitis B (2), hepatitis A (1), and pneumococcal infection (1). Eleven out of these 17 studies demonstrated statistically significant effects of vaccination timing on the antibody response, with 10 reporting stronger antibody responses following morning compared to afternoon vaccination. Of the six subgroups with an average age of 60 years and older, five showed significantly stronger antibody responses following morning vaccination, while the sixth showed a significant effect only in men. In contrast, only five out of 16 subgroups with an average age younger than 60 years showed a statistically significant effect of vaccination timing on antibody titers. Similarly, the meta-analysis indicated that receiving influenza vaccination in the morning elicited a stronger antibody response than in the afternoon (SMD = 0.24, 95% CI = 0.01-0.47), with subgroup analyses revealing a larger effect in adults aged 65 and older (SMD = 0.32, 95% CI = 0.21-0.43) compared to those aged 60 or younger (SMD = 0.00, 95% CI = -0.17-0.17).

CONCLUSION: Morning vaccination enhanced antibody responses in adults aged 60 years and older, a key demographic for influenza and COVID-19 vaccination. Chrono-optimizing vaccine administration may offer a low-risk, low-cost strategy to boost vaccine effectiveness in this age group.

https://inplasy.com/inplasy-2025-1-0060/.}, } @article {pmid40260091, year = {2025}, author = {Liu, W and Liu, X and Kang, S and Yuan, Y}, title = {Low vitamin K status is a potential risk factor for COVID-19 infected patients: a systematic review and meta-analysis.}, journal = {Frontiers in nutrition}, volume = {12}, number = {}, pages = {1476622}, pmid = {40260091}, issn = {2296-861X}, abstract = {OBJECTIVE: To provide further data support for the treatment of COVID-19 by conducting a comprehensive analysis of reports on dephosphorylated-uncarboxylated Matrix Gla Protein (dp-ucMGP), which detects the functional vitamin K status post COVID-19 infection, using meta-analysis.

METHODS: This study conducted a comprehensive review and analysis of relevant research on dp-ucMGP detection in patients infected with COVID-19 through meta-analysis. The article collection period ranged from January 2024 to April 2024.

RESULTS: A total of 6 articles were included in this study. Baseline data analysis showed that the age of patients in the COVID-19 infected group was greater than that of the non-infected control group (p = 0.030); similarly, the age of patients in the severe infection group was also greater than that of the mild infection group (p = 0.003). In the analysis of underlying diseases, statistical differences were found between the Severe group and Mild group in the presence of CVD (p = 0.010). A total of 5 studies conducted dp-ucMGP detection in both the COVID-19 infected group and the control group. The results showed that the expression of dp-ucMGP was higher in the infected group than in the control group (p < 0.001). Subgroup analysis revealed that the expression of dp-ucMGP in the severe infection group was also higher than that in the mild infection group (p < 0.001).

CONCLUSION: COVID-19 infected patients exhibit Low Vitamin K Status, which correlates positively with the severity of infection. Supplementation of vitamin K during COVID-19 infection may potentially mitigate the progression toward severe infection, necessitating further support from clinical data.}, } @article {pmid40259889, year = {2025}, author = {Fonseca, WT and Parra Vello, T and Lelis, GC and Ferreira Deleigo, AV and Takahira, RK and Martinez, DST and de Oliveira, RF}, title = {Chemical Sensors and Biosensors for Point-of-Care Testing of Pets: Opportunities for Individualized Diagnostics of Companion Animals.}, journal = {ACS sensors}, volume = {10}, number = {5}, pages = {3222-3238}, pmid = {40259889}, issn = {2379-3694}, mesh = {Animals ; *Point-of-Care Testing ; *Pets ; *Biosensing Techniques/methods/instrumentation ; Dogs ; Cats ; Humans ; Biomarkers/analysis ; COVID-19/diagnosis ; SARS-CoV-2/isolation & purification ; }, abstract = {Point-of-care testing (POCT) is recognized as one of the most disruptive medical technologies for rapid and decentralized diagnostics. Successful commercial examples include portable glucose meters, pregnancy tests, and COVID-19 self-tests. However, compared to advancements in human healthcare, POCT technologies for companion animals (pets) remain significantly underdeveloped. This Review explores the latest advancements in pet POCT and examines the challenges and opportunities in the field for individualized diagnostics of cats and dogs. The most frequent diseases and their respective biomarkers in blood, urine, and saliva are discussed. We examine key strategies for developing the next-generation POCT devices by harnessing the potential of selective (bio)receptors and high-performing transducers such as lateral flow tests and electrochemical (bio)sensors. We also present the most recent research initiatives and the successful commercial pet POCT technologies. We discuss future trends in the field, such the role of biomarker discovery and development of wearable, implantable, and breath sensors. We believe that advancing pet POCT technologies benefits not only animals but also humans and the environment, supporting the One Health approach.}, } @article {pmid40259874, year = {2025}, author = {Huang, X and Gao, H and Zhang, J and Zhan, P and Liu, X}, title = {A patent review of anti-coronavirus agents targeting the spike-ACE2 interaction (2019-present).}, journal = {Expert opinion on therapeutic patents}, volume = {35}, number = {7}, pages = {735-746}, doi = {10.1080/13543776.2025.2494860}, pmid = {40259874}, issn = {1744-7674}, mesh = {Humans ; *Angiotensin-Converting Enzyme 2/metabolism ; *Spike Glycoprotein, Coronavirus/metabolism/drug effects ; Patents as Topic ; *Antiviral Agents/pharmacology ; *COVID-19 Drug Treatment ; SARS-CoV-2/drug effects ; Animals ; Virus Internalization/drug effects ; Drug Design ; Drug Development ; COVID-19/virology ; }, abstract = {INTRODUCTION: The Angiotensin-converting enzyme 2 (ACE2) receptor, crucial for coronavirus recognition of host cells, is a key target for therapeutic intervention against SARS-CoV-2 and related coronaviruses. Therefore, thoroughly investigating the interaction mechanism between ACE2 and the Spike protein (S protein), as well as developing targeted inhibitors based on this mechanism, is vital for effectively controlling the spread of SARS-CoV-2 and preventing potential future pandemics caused by other coronaviruses.

AREAS COVERED: This article comprehensively reviews the mechanisms underlying ACE2-S protein interaction that facilitate SARS-CoV-2 entry into host cells. It also analyzes the patent landscape regarding inhibitors targeting the ACE2-S interface since 2019.

EXPERT OPINION: In the 5 years since the outbreak of SARS-CoV-2, numerous methods and design strategies have been employed to develop innovative therapeutics against coronaviruses. Among these approaches, inhibitors targeting both the ACE2 receptor and the S protein have gained significant interest due to their potential in blocking various coronaviruses. Despite facing challenges similar to other protein-protein interaction inhibitors, progress has been made in developing these inhibitors through virtual screening, covalent protein binding, and peptide modification strategies. However, obstacles persist in clinical translation, necessitating a multidisciplinary strategy that integrates state-of-the-art methodologies to optimize S-ACE2 interface-targeted drug discovery.}, } @article {pmid40259865, year = {2025}, author = {Bjorvatn, B and Merikanto, I and Chung, F and Holzinger, B and Morin, CM and Penzel, T and De Gennaro, L and Dauvilliers, Y and Wing, YK and Benedict, C and Xue, P and Reis, C and Korman, M and Landtblom, AM and Matsui, K and Hrubos-Strøm, H and Mota-Rolim, S and Nadorff, MR and Berezin, L and Sarkanen, T and Liu, Y and Scarpelli, S and Brandao, LEM and Cedernaes, J and Fränkl, EC and Partinen, E and Bolstad, CJ and Plazzi, G and Partinen, M and Espie, CA}, title = {Sleep During Pandemic Times: Summary of Findings and Future Outlook Through the Lens of the International COVID Sleep Study (ICOSS).}, journal = {Journal of sleep research}, volume = {34}, number = {5}, pages = {e70076}, doi = {10.1111/jsr.70076}, pmid = {40259865}, issn = {1365-2869}, mesh = {Humans ; *COVID-19/epidemiology ; *Sleep Wake Disorders/epidemiology ; *Sleep/physiology ; Pandemics ; Circadian Rhythm/physiology ; Surveys and Questionnaires ; SARS-CoV-2 ; }, abstract = {To study the impact of the COVID-19 pandemic on sleep and circadian rhythms-two fundamental pillars for health-the collaboration International COVID-19 Sleep Study (ICOSS) was established. The present overview comprehensively discusses the findings from this collaboration. Involving sleep researchers across the globe, ICOSS used a harmonised questionnaire to cover changes in sleep and sleep disorders, as well as physical and mental health. Two survey waves were conducted, one in 2020 and another one in 2021. In ICOSS-1, a total of 26,539 people from 14 countries across four continents (Europe, Asia, North and South America) participated. In ICOSS-2, two more countries joined ICOSS, and 15,813 people participated. The focus in ICOSS-2 was on Long COVID. Participants accessed the widely disseminated online surveys in their native language. In the 20 papers published so far, the surveys have uncovered several novel findings, including how the pandemic impacted sleep patterns, the prevalence of sleep disorders, chronotype-based differences and sleep-immune system interactions. To the best of our knowledge, there is no other large-scale multinational study targeting the general population investigating the role of sleep and sleep disorders alongside a variety of psychological, biological, social and economic factors during the recent COVID-19 pandemic.}, } @article {pmid40259707, year = {2025}, author = {Sajid, M and Ali, D and Qureshi, S and Ahmad, R and Sajjad, A and Waqas, SA and Ahmed, R and Collins, P}, title = {Trends and Disparities in Acute Myocardial Infarction-Related Mortality Among U.S. Adults With Hypertension, 2000-2023.}, journal = {Clinical cardiology}, volume = {48}, number = {4}, pages = {e70129}, pmid = {40259707}, issn = {1932-8737}, support = {//The authors received no specific funding for this work./ ; }, mesh = {Humans ; *Hypertension/mortality/complications/ethnology/diagnosis ; Male ; United States/epidemiology ; Female ; *Myocardial Infarction/mortality/ethnology ; Middle Aged ; Aged ; Adult ; Risk Factors ; COVID-19/epidemiology ; *Health Status Disparities ; *Healthcare Disparities ; }, abstract = {BACKGROUND: Hypertension is a major public health concern and a key risk factor for acute myocardial infarction (AMI), significantly contributing to cardiovascular mortality. Despite advancements in management and treatment, trends in associated mortality remain underexplored.

OBJECTIVE: This study examines U.S. national trends in hypertension- and AMI-associated mortality from 2000 to 2023, focusing on demographics and regions.

METHODS: Age-adjusted mortality rates (AAMRs) per 100,000 for adults aged ≥ 25 with hypertension and AMI were extracted from the CDC WONDER database. Annual percent changes (APCs) and average APCs (AAPCs) with 95% confidence intervals (CIs) were calculated, stratified by year, sex, race/ethnicity, age, urbanization, and Census region.

RESULTS: From 2000 to 2023, 933,024 hypertension- and AMI-related deaths were recorded. Overall, AAMR declined from 19.84 per 100,000 in 2000 to 16.26 in 2023 (AAPC: -0.93%, 95% CI: -1.18% to -0.76%). However, a sharp rise in mortality occurred between 2018 and 2021, coinciding with the COVID-19 pandemic. Stratified analyses revealed persistently higher mortality rates among menmen, non-Hispanic BlackBlack individuals, and residents of the Southern and rural U.S. regions. Younger adults showed an increasing AAMR trend, indicating a growing burden of hypertension and AMI-associated disease.

CONCLUSION: While long-term mortality trends show a decline, recent years have seen a rise, particularly among high-risk groups. Targeted public health interventions addressing hypertension management, cardiovascular risk reduction, and healthcare disparities are essential to mitigate the ongoing burden of hypertension and AMI mortality in the U.S.}, } @article {pmid40259563, year = {2025}, author = {Cornish, F and Sabaine, B and Soares, L and Caldas, B and Portela, MC and Bousquat, A and Aveling, EL}, title = {The erasure of infection-associated chronic conditions: Critical interpretive synthesis of literature on healthcare for long COVID and related conditions in Brazil.}, journal = {Global public health}, volume = {20}, number = {1}, pages = {2490720}, doi = {10.1080/17441692.2025.2490720}, pmid = {40259563}, issn = {1744-1706}, mesh = {Humans ; Brazil/epidemiology ; *COVID-19/epidemiology/therapy/complications ; Chronic Disease/epidemiology/therapy ; SARS-CoV-2 ; *Delivery of Health Care ; Post-Acute COVID-19 Syndrome ; }, abstract = {Evidence is emerging that long COVID is at least as prevalent in the Global South as the Global North, but literature on long COVID healthcare in the Global South is in its infancy. Brazil is seeing significant levels of debility due to long COVID but a limited national evidence-base. long COVID shares symptomatology and appropriate care with a wider category of infection-associated chronic conditions (IACCs). This article reviews literature published between 2000 and 2023 addressing healthcare for long COVID and IACCs in Brazil, in the interest of exploring challenges and opportunities for the SUS (Brazil's universal health system) to offer appropriate long COVID healthcare. We find that long COVID and IACCs collectively are subject to erasure from Brazilian healthcare knowledge, through lack of expertise, a resource-limited health system prioritising urgent care, and the concentration of poor health in marginalised populations with limited decision-making power. A nascent intellectual will to address long COVID, and a tradition of social participation in healthcare governance present potential opportunities. We call for ignition of a global step-change in tackling healthcare for long COVID and IACCs. Global equity in long COVID healthcare requires the development and sharing of expertise regarding its universal and context-specific features.}, } @article {pmid40258740, year = {2025}, author = {Semnani, K and Esmaeili, S}, title = {Nuances in the global impact of COVID-19 on tuberculosis control efforts: An updated review.}, journal = {Medicine}, volume = {104}, number = {16}, pages = {e42195}, pmid = {40258740}, issn = {1536-5964}, mesh = {Humans ; *COVID-19/epidemiology ; *Tuberculosis/epidemiology/prevention & control/diagnosis ; Global Health ; SARS-CoV-2 ; Pandemics ; }, abstract = {The COVID-19 pandemic has affected public health systems in an unprecedented manner. There has been an abundance of discussion regarding the possible effects of the pandemic in disruption of health services aiming at tuberculosis (TB) infection control - including hindered screening efforts and delays in diagnosis and treatment. The pandemic has also been proposed to affect TB transmission via lifestyle modifications. Moreover, some research has suggested a more direct link between COVID-19 infection and increased TB morbidity and mortality. The authors conducted a narrative review of the relevant literature. Searches were performed in the MEDLINE, Scopus, and Web of Science databases. Reports of impaired TB case-notification were ubiquitous during the early stages of the pandemic. Subsequently, divergent patterns emerged: recovery and decreased TB incidence in countries with stringent public health measures, low local transmission of TB, and resilient health systems; or devastating results from TB underdiagnosis and delayed treatment in countries with high TB burden, limited COVID-19 control measures, and public health funding. Few studies quantified the effects of TB and COVID-19 co-infection - and the possible role of COVID-19 infection in reactivation of latent tuberculosis infection (LTBI) remains ambiguous. Despite the lapse of the COVID-19 pandemic, its effects on TB control efforts perseverate. Particularly, great care is warranted for recovery of impacted healthcare systems in low-income countries.}, } @article {pmid40258634, year = {2025}, author = {Barry, K and Fernández-García, S and Khashaba, A and Ruiz-Calvo, G and Roncal Redin, M and Mahmoud, G and Yap, M and King, Y and Zhou, D and Mamey, M and Shepherd-Evans, I and Sheikh, J and Lawson, H and Kew, T and Ansari, K and Attarde, S and Banjoko, A and Fraser, H and Littmoden, M and Rajah, T and Walker, K and O'Donoghue, K and van Wely, M and van Leeuwen, E and Kostova, E and Kunst, H and Khalil, A and Brizuela, V and Kara, E and Kim, CR and Thorson, A and Oladapo, OT and Mofenson, L and Bonet, M and Zamora, J and Allotey, J and Thangaratinam, S and , }, title = {Global maternal mortality associated with SARS-CoV-2 infection: a systematic review and meta-analysis.}, journal = {BMJ global health}, volume = {10}, number = {4}, pages = {}, pmid = {40258634}, issn = {2059-7908}, support = {001/WHO_/World Health Organization/International ; }, mesh = {Humans ; *COVID-19/mortality ; Female ; *Maternal Mortality ; Pregnancy ; *Pregnancy Complications, Infectious/mortality ; *Global Health/statistics & numerical data ; SARS-CoV-2 ; Cause of Death ; }, abstract = {BACKGROUND: Pregnant and recently pregnant women infected with SARS-CoV-2 are at increased risk of death and serious complications than those without the infection. The extent of variation in mortality rates in pregnant women with SARS-CoV-2 infection across regions, and the causes of death are not known. We systematically reviewed all available evidence on the variation in mortality rates in pregnant women with SARS-CoV-2 infection across geographical and country income groups, and the reported cause of death.

METHODS: We searched major databases (December 2019-January 2023) including Medline, LILACS, BIREME and Embase. We included studies that reported deaths in at least 10 consecutive pregnant or recently pregnant women with confirmed SARS-CoV-2 infection and assessed the studies' risk of bias. We calculated the summary estimates of any cause of death as proportions with 95% CIs using a multilevel random-effects logistic regression model. Subgroup analyses were performed by geographical region and country income groups. We used International Statistical Classification of Diseases and Related Health Problems-Maternal Mortality to categorise the reported cause of death.

FINDINGS: From 1 326 315 citations, we included 169 studies (319 172 women with confirmed SARS-CoV-2 infection; 4253 women died). The overall rate of unspecified maternal death was 0.87% (95% CI 0.64% to 1.16%). There were significant differences between geographical regions in rates of maternal mortality, with the highest rates in Sub-Saharan Africa (3.48%; 95% CI 0.66% to 16.42%) and Latin America and the Caribbean (3.16%, 95% CI 1.53% to 6.43%). Rates of maternal mortality varied by country income groups, with the highest rates in low-income countries (4.66%, 95% CI 0.75% to 24.07%). Among women with reported cause of death, 98.6% (2,390/2,423) of deaths were attributable to COVID-19.

INTERPRETATION: Rates of deaths in pregnant and recently pregnant women with SARS-CoV-2 infection vary significantly across regions and by country income groups, with the highest burden in Sub-Saharan Africa and low-income countries. COVID-19 is the main reported cause of death.

PROSPERO REGISTRATION NUMBER: CRD42020224120.}, } @article {pmid40254504, year = {2025}, author = {Aboelzahab, YH and McCracken, A and Abdoulrezzak, R and Naguib, S and McLean, M and Tricco, AC and Pinto, AD and McCarthy, LM and Dolovich, L}, title = {Virtual care in community pharmacy services: a scoping review.}, journal = {Research in social & administrative pharmacy : RSAP}, volume = {21}, number = {9}, pages = {653-666}, doi = {10.1016/j.sapharm.2025.03.066}, pmid = {40254504}, issn = {1934-8150}, mesh = {Humans ; *Community Pharmacy Services/organization & administration ; *Telemedicine/organization & administration ; *Pharmacists/organization & administration ; COVID-19 ; }, abstract = {BACKGROUND: The integration of virtual care has been essential for maintaining continuity of patient care during and after the COVID-19 pandemic. Community pharmacists were among the healthcare professionals who used virtual care to provide remote pharmacy services. However, the use of virtual care in community pharmacy has not been comprehensively reviewed.

OBJECTIVE: To provide an overview of the types of virtual care platforms used in community pharmacy, their purposes, barriers, and facilitators, and to identify strategies for optimizing virtual care in this setting.

METHODS: The scoping review followed Joanna Briggs Institute (JBI) methodology for scoping reviews. A comprehensive search strategy was employed to identify studies across MEDLINE, Embase, CINAHL, Scopus, and grey literature sources. Two levels of screening were performed, and data were extracted using a pre-specified form. The data were analyzed through qualitative content analysis, and the PRISMA-ScR was used to report the results.

RESULTS: A total of 3580 citations were assessed and 32 studies were included in the review. The qualitative data were summarized into five categories: (1) virtual care tools and technologies used in community pharmacy, (2) purpose of virtual care, (3) barriers to using virtual care, (4) facilitators of virtual care adoption, and (5) strategies to optimize virtual care use.

CONCLUSION: Virtual care in community pharmacy showed promise in enhancing pharmacy services. Despite operational barriers and inequities in access, facilitators such as adequate training and technological advancements supported its implementation. Future efforts should address these challenges and refine virtual care for broader and equitable integration.}, } @article {pmid40254311, year = {2025}, author = {Andersen-Waine, B and Keene, CM and Dickinson, S and Naidoo, R and Ferguson-Lewis, A and Polner, A and Amswych, M and White, L and Molyneux, S and Wanat, M and , }, title = {Influence of context on engagement with COVID-19 testing: a scoping review of barriers and facilitators to testing for healthcare workers, care homes and schools in the UK.}, journal = {BMJ open}, volume = {15}, number = {4}, pages = {e089062}, pmid = {40254311}, issn = {2044-6055}, mesh = {Humans ; *COVID-19/diagnosis/epidemiology ; United Kingdom/epidemiology ; *Health Personnel ; SARS-CoV-2 ; *COVID-19 Testing ; *Schools ; *Nursing Homes ; }, abstract = {OBJECTIVE: The UK government's response to the COVID-19 pandemic included a 'test, trace and isolate' strategy. Testing services for healthcare workers, care homes and schools accounted for the greatest spend and volume of tests. We reviewed relevant literature to identify common and unique barriers and facilitators to engaging with each of these testing services.

DESIGN: Scoping review.

SEARCH STRATEGY: PubMed, Scopus and the WHO COVID-19 Research Database were searched for evidence published between 1 January 2020 and 7 November 2022. This was supplemented by evidence identified via free-text searches on Google Scholar and provided by the UK Health Security Agency (UKHSA).

DATA EXTRACTION AND SYNTHESIS: Data were extracted by a team of reviewers and synthesised thematically under the broad headings of perceptions, experiences, barriers and facilitators to engaging with the COVID-19 testing programme.

RESULTS: This study included 40 sources, including 17 from projects that informed UKHSA's decisions during the pandemic. Eight themes emerged and were used to categorise barriers and facilitators to engaging with the testing services for healthcare workers, care homes and schools: (1) perceived value, (2) trust in the tests and public bodies, (3) importance of infrastructure, (4) impact of media and social networks, (5) physical burden of the test, (6) perceived capability to undertake testing, (7) importance of relevant information and 8) consequences of testing.

CONCLUSIONS: Universal barriers and facilitators to engagement with the testing programme related to the core elements of each testing service, such as uncomfortable specimen collection and the influence of media and peers; these could be mitigated or leveraged to increase engagement across settings. However, the individuals involved, perceptions of value and available resources differed across services, leading to unique experiences between settings. Thus, consideration of context is crucial when designing and implementing a testing programme in response to a pandemic.}, } @article {pmid40254264, year = {2025}, author = {Posa, A}, title = {Spike protein-related proteinopathies: A focus on the neurological side of spikeopathies.}, journal = {Annals of anatomy = Anatomischer Anzeiger : official organ of the Anatomische Gesellschaft}, volume = {260}, number = {}, pages = {152662}, doi = {10.1016/j.aanat.2025.152662}, pmid = {40254264}, issn = {1618-0402}, mesh = {Humans ; *Spike Glycoprotein, Coronavirus/metabolism ; COVID-19 ; SARS-CoV-2 ; *Nervous System Diseases/etiology ; Angiotensin-Converting Enzyme 2/metabolism ; Pandemics ; Blood-Brain Barrier/metabolism ; }, abstract = {BACKGROUND: The spike protein (SP) is an outward-projecting transmembrane glycoprotein on viral surfaces. SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2), responsible for COVID-19 (Coronavirus Disease 2019), uses SP to infect cells that express angiotensin converting enzyme 2 (ACE2) on their membrane. Remarkably, SP has the ability to cross the blood-brain barrier (BBB) into the brain and cause cerebral damage through various pathomechanisms. To combat the COVID-19 pandemic, novel gene-based products have been used worldwide to induce human body cells to produce SP to stimulate the immune system. This artificial SP also has a harmful effect on the human nervous system.

STUDY DESIGN: Narrative review.

OBJECTIVE: This narrative review presents the crucial role of SP in neurological complaints after SARS-CoV-2 infection, but also of SP derived from novel gene-based anti-SARS-CoV-2 products (ASP).

METHODS: Literature searches using broad terms such as "SARS-CoV-2", "spike protein", "COVID-19", "COVID-19 pandemic", "vaccines", "COVID-19 vaccines", "post-vaccination syndrome", "post-COVID-19 vaccination syndrome" and "proteinopathy" were performed using PubMed. Google Scholar was used to search for topic-specific full-text keywords.

CONCLUSIONS: The toxic properties of SP presented in this review provide a good explanation for many of the neurological symptoms following SARS-CoV-2 infection and after injection of SP-producing ASP. Both SP entities (from infection and injection) interfere, among others, with ACE2 and act on different cells, tissues and organs. Both SPs are able to cross the BBB and can trigger acute and chronic neurological complaints. Such SP-associated pathologies (spikeopathies) are further neurological proteinopathies with thrombogenic, neurotoxic, neuroinflammatory and neurodegenerative potential for the human nervous system, particularly the central nervous system. The potential neurotoxicity of SP from ASP needs to be critically examined, as ASPs have been administered to millions of people worldwide.}, } @article {pmid40254131, year = {2025}, author = {Mayer, MG and Fischer, T}, title = {Shared Mechanisms of Blood-Brain Barrier Dysfunction and Neuroinflammation in Coronavirus Disease 2019 and Alzheimer Disease.}, journal = {The American journal of pathology}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.ajpath.2025.03.011}, pmid = {40254131}, issn = {1525-2191}, abstract = {The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has highlighted the virus's impact on the central nervous system and its potential to exacerbate neurodegenerative diseases, like Alzheimer disease (AD). Emerging evidence suggests that SARS-CoV-2 infection contributes to chronic neuroinflammation, a key driver in the etiopathogenesis of AD. Shared mechanisms, including blood-brain barrier (BBB) dysfunction, systemic inflammation, and activation of immune pathways, may link SARS-CoV-2 infection to AD onset and/or progression, particularly among vulnerable individuals, such as those of advanced age. This review explores convergent pathways involving the renin-angiotensin-aldosterone system, Wnt/β-catenin signaling, NF-κB activation, and interferon signaling, focusing on their roles in BBB integrity and neuroinflammation. SARS-CoV-2-mediated angiotensin-converting enzyme 2 depletion disrupts renin-angiotensin-aldosterone system homeostasis, favoring proinflammatory signaling that parallels vascular dysfunction in AD. Dysregulation of Wnt/β-catenin signaling exacerbates BBB permeability, whereas NF-κB and interferon pathways contribute to BBB breakdown and propagate central nervous system inflammation via endothelial and immune cell activation. These interactions may amplify prodromal AD pathology and/or initiate AD pathogenesis. By identifying mechanistic overlaps between COVID-19 and AD, this review underlines the need for therapeutic strategies targeting shared pathways of inflammation and BBB dysfunction. Understanding these connections is critical for mitigating the long-term neurologic sequelae of COVID-19 and reducing the burden of AD.}, } @article {pmid40250816, year = {2025}, author = {Zheng, P and Li, G and Chen, Y and Li, S and Yang, S and Guo, D and Zhou, Q and Zhang, X}, title = {Mini review: SHEN26, a novel oral antiviral drug for COVID-19 treatment.}, journal = {Bioorganic & medicinal chemistry letters}, volume = {124}, number = {}, pages = {130243}, doi = {10.1016/j.bmcl.2025.130243}, pmid = {40250816}, issn = {1464-3405}, mesh = {*Antiviral Agents/therapeutic use/administration & dosage/chemistry/pharmacology ; *COVID-19 Drug Treatment ; Humans ; *SARS-CoV-2/drug effects ; Administration, Oral ; Animals ; COVID-19 ; }, abstract = {Over two years into the pandemic, global collaboration led to effective antiviral drugs targeting SARS-CoV-2's RdRp and 3CL protease. However, the virus continues to evolve, and certain low-virulence variants still circulate. Despite reduced virulence, ongoing transmission raises the risk of new mutations, underscoring the need for continued vigilance, research, and expansion of our antiviral and vaccine strategies. Our research team has developed SHEN26, a promising small-molecule antiviral drug for the treatment of COVID-19. This mini-review explores its development, including history, synthesis, preclinical evaluations, and findings from Phase I and II clinical trials. Data from each research phase further underscores SHEN26's potential as a safe and effective oral antiviral treatment for COVID-19, while also emphasizing its broader relevance in combating emerging RNA viral infections.}, } @article {pmid40249720, year = {2025}, author = {van Ooij, PJ and van Hulst, RA}, title = {Respiratory fitness for occupational diving, what is new?.}, journal = {Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc}, volume = {52}, number = {1}, pages = {33-40}, pmid = {40249720}, issn = {1066-2936}, mesh = {Humans ; *Diving/adverse effects/physiology/standards ; Practice Guidelines as Topic ; COVID-19 ; *Occupational Diseases/prevention & control/diagnosis ; Asthma/complications ; Spirometry ; Pulmonary Edema/diagnosis ; }, abstract = {Diving diseases originating from lung-related pathology are not the most prominent but are considered the most severe. To minimize this risk, a good respiratory tract assessment is important. Organizations like the British Thoracic Society (2003) and the European Diving Technology Committee (EDTC) (2004) have provided guidelines regarding this assessment. However, most of the guidelines are 20 years old. The EDTC has revised its guidelines based on the present literature and published it last year. This review discusses a few topics that have changed or are newly introduced in the new EDTC guidelines. Importantly, additional tests might be necessary when assessing the respiratory tract based on history taking and spirometry, leading to a case-by-case decision regarding the fitness to dive. Particular attention should be paid to individuals with large lungs or cysts, those who have undergone thoracic surgery, and those with a history of asthma, immersion pulmonary edema, COVID-19 infection, or sleep apnea.}, } @article {pmid40249463, year = {2025}, author = {Papapetrou, I and Swiecicka, A}, title = {The impact of COVID-19 pandemic on the incidence, presentation, and management of type 1 diabetes in children and adolescents: a narrative review.}, journal = {Hormones (Athens, Greece)}, volume = {}, number = {}, pages = {}, pmid = {40249463}, issn = {2520-8721}, abstract = {Type 1 diabetes (T1D) is an autoimmune condition affecting approximately 1.5 million children and adolescents worldwide, with an incidence of approximately 2-3% each year and rising. During the recent COVID-19 pandemic, a significant increase in incidence of T1D in children and adolescents was observed in numerous countries worldwide, with an increased number of newly-diagnosed cases presenting with diabetic ketoacidosis. The increased frequency of T1D presenting with diabetic ketoacidosis has been attributed not only to the SARS-CoV-2 virus itself but also to the restrictions imposed by the pandemic. The shift to telemedicine and unwillingness to seek medical care due to fear of infection contributed to delayed diagnosis and more severe disease presentation. Furthermore, the periods of lockdown that were implemented during the pandemic presented multiple challenges for children and adolescents living with T1D and disrupted the management of their condition. Changes in physical activity and diet as well as shortage of medical supplies during that period have been linked to worsening of glycemic control, which were at least partly offset by increased parental involvement and use of telemedicine.}, } @article {pmid40248759, year = {2025}, author = {Gomes Costa, RR and Ramos, BL and Ribeiro Neto, F and Winckler, C}, title = {Tele-exercise in individuals with spinal cord injury: a systematic review.}, journal = {mHealth}, volume = {11}, number = {}, pages = {19}, pmid = {40248759}, issn = {2306-9740}, abstract = {BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has seen the emergence of tele-exercise as a mean of remotely providing physical activity. This is particularly crucial given that individuals with spinal cord injury (SCI), often engage in lower levels of physical activity due to barriers such as transportation issues and financial limitations. Given the potential the tele-exercise for individuals with SCI, this study aims to characterize research on tele-exercise interventions in this population focusing on the approach (synchronous, asynchronous, or hybrid), platform, intervention details, duration, adherence, outcomes, and improvements.

METHODS: A review was conducted using the Embase, Scopus, and PubMed databases, adhering to the PRISMA reporting checklist. Studies on "tele-exercise" and "teleexercise", without specifying SCI in the search terms were screened. Inclusion criteria were limited to English-language articles published up to April 2024. Articles in poster or editorial format and grey literature were excluded. The decision was made to exclude gray literature and focus solely on studies published in peer-reviewed scientific journals. Two reviewers (B.L.R. and R.R.G.C.) independently screened the titles and abstracts of the initially retrieved articles, and then discussed them to ensure agreement.

RESULTS: The review identified twelve articles (seven studies with intervention, three studies as projects, one study as cross-sectional analysis and 1 study as theorical framework). Most studies (58.3%) employed synchronous tele-exercise interventions, with Zoom software being the most prevalent platform (41.7%). Interventions primarily focused on muscle strength (75.0%) and aerobic training (75.0%), with a median duration of 8.0 weeks. The mean (standard deviation) adherence was 67.3% (18.7), with variations observed between sex and approaches (synchronous, asynchronous, or hybrid). The most commonly assessed outcomes included physical activity levels (58.3%), adherence (33.3%), pain (25.0%), and physical activity behavior (25.0%). Significant improvements were noted in health status, physical capacity, and tele-exercise implementation.

CONCLUSIONS: Tele-exercise interventions, predominantly utilizing synchronous methods and emphasizing muscle strength and aerobic training, are effective and feasible for individuals with SCI. These interventions contribute to improved health outcomes and increased exercise adherence, establishing them as a viable option for promoting physical activity among individuals with SCI. However, the results should be interpreted with caution as the quality of the studies was not considered in this review.}, } @article {pmid40248758, year = {2025}, author = {Lew, SQ and Sikka, N and Erickson, KF}, title = {Telehealth in the US for patients with end-stage kidney disease: its utilization and impact on social, economic and health outcomes.}, journal = {mHealth}, volume = {11}, number = {}, pages = {22}, pmid = {40248758}, issn = {2306-9740}, abstract = {The use of telehealth in the United States accelerated in 2020 when a coronavirus disease of 2019 (COVID-19) related public health emergency (PHE) was declared. Centers for Medicare and Medicaid Services issued emergency waivers that relaxed restrictions imposed by regulations on geographic locations, originating and distant sites, audio-video-conferencing technology and re-imbursement. This review focuses on the history of telehealth usage for patients with end-stage kidney disease. Patients who receive home dialysis gained widespread access to telehealth in 2019, following passage of the Bipartisan Budget Act of 2018, Sec 50302 by the US Congress. For the first time in telehealth application, the patient's home could be an originating site without geographic restrictions for telemedicine. These earlier regulations will continue even after the PHE expires. While they made telemedicine possible for many patients receiving home dialysis, in practice, the uptake of telemedicine in the home setting may have been sluggish following the 2018 law. Rules governing the frequency of telemedicine visits and other stipulations for home dialysis that were specified in the 2018 law were relaxed in the setting of the COVID-19 waivers, further facilitating the use of telemedicine for home dialysis care. Meanwhile, the in-center dialysis unit became an originating site for the first time during the COVID-19 PHE, with a corresponding sharp increase in the use of telemedicine for in-center hemodialysis care. The waivers enabling the use of telemedicine for patients who receive in-center hemodialysis and further facilitating the use of telemedicine in home dialysis, expire with the end of the COVID-19 PHE unless Congress passes new legislation. Comparisons among the periods before, during and after the PHE can illustrate telehealth's impact and some of its challenges. Most of the literature on telehealth represents observational data. Future studies on telehealth, including clinical trials, could provide information on outcomes and cost savings.}, } @article {pmid40248364, year = {2025}, author = {Yang, AX and Norbrun, C and Sorkhdini, P and Zhou, Y}, title = {Phospholipid scramblase 1: a frontline defense against viral infections.}, journal = {Frontiers in cellular and infection microbiology}, volume = {15}, number = {}, pages = {1573373}, pmid = {40248364}, issn = {2235-2988}, mesh = {Humans ; *Phospholipid Transfer Proteins/metabolism/genetics/immunology ; *Virus Diseases/immunology/virology ; SARS-CoV-2 ; Virus Replication ; Interferons/metabolism ; Animals ; Antiviral Agents ; Signal Transduction ; Viruses/immunology ; }, abstract = {Phospholipid scramblase 1 (PLSCR1) is the most studied member of the phospholipid scramblase protein family. Its main function is to catalyze calcium (Ca[2+])-dependent, ATP-independent, bidirectional and non-specific translocation of phospholipids between inner and outer leaflets of plasma membrane. Additionally, PLSCR1 is identified as an interferon-stimulated gene (ISG) with antiviral activities, and its expression can be highly induced by all types of interferons in various viral infections. Indeed, numerous studies have reported the direct antiviral activities of PLSCR1 through interrupting the replication processes of a variety of viruses, including entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), nuclear localization of influenza A virus (IAV), and transactivation of human immunodeficiency virus (HIV), Epstein-Barr virus (EBV), human T-cell leukemia virus type-1 (HTLV1), human cytomegalovirus (HCMV) and hepatitis B virus (HBV). In addition to these direct antiviral activities, PLSCR1 also regulates endogenous immune components to defend against viruses in both nonimmune and immune cells. Such activities include potentiation of ISG transcription, activation of JAK/STAT pathway, upregulation of type 3 interferon receptor (IFN-λR1) and recruitment of Toll-like receptor 9 (TLR9). This review aims to summarize the current understanding of PLSCR1's multiple roles as a frontline defense against viral infections.}, } @article {pmid40248034, year = {2025}, author = {Lang, L and Ma, M and Zhao, H and Zhang, J and Liu, S and Liu, H}, title = {Global research trends in obesity-related asthma (2004-2023): a bibliometric analysis.}, journal = {Frontiers in nutrition}, volume = {12}, number = {}, pages = {1528366}, pmid = {40248034}, issn = {2296-861X}, abstract = {BACKGROUND: In recent years, an increasing body of evidence has revealed a complex interplay between obesity and asthma, prompting academic and medical communities to intensify their focus on this area of research. The objective of this study is to undertake a comprehensive bibliometric analysis of the research literature pertaining to obesity-related asthma from 2004 to 2023. This analysis aims to provide precise and valuable insights, as well as to systematically reflect upon the current status and emerging trends within the field.

METHODS: Literature data on obesity and asthma research was sourced from the Web of Science Core Collection database. CiteSpace and VOSviewer were utilized to visually analyze bibliometric indicators such as co-authorship, citation networks, and publication frequency of the data to facilitate the identification of patterns and trends.

RESULTS: A total of 3,118 papers were included in the analysis, encompassing 2,539 articles and 579 reviews. Throughout the last 20 years, the volume of publications has shown a consistent upward trend. The United States and Harvard University are at the forefront of this research field. Professor Dixon Anne E. is recognized as a pioneer and leading figure in the cultivation of obesity-related asthma research. Keyword analysis identified topics such as "childhood asthma," "bariatric surgery," "physical activity," "gut microbiota," "COVID-19," "food allergy," "asthma control," "nutrition examination," and "severe asthma."

CONCLUSION: The research domain of obesity-related asthma has experienced a substantial growth, with the United States, the United Kingdom, and China leading the global landscape. The focus on asthma in obese adolescents and children, the role of bariatric surgery, and lifestyle interventions remains a consistent area of interest, with considerable potential for further study. These findings provide a scientific basis for the development of personalized treatment programs for obese asthma patients. In addition, this study highlights the importance of further research in the fields of gut microbiota, COVID-19, and food allergy, providing directions for future policymaking.}, } @article {pmid40246793, year = {2025}, author = {Salvatori, P and Amoushahi, A and Venuti, A and Paolini, F}, title = {Ethanol Inhalation for Respiratory Infections due to Enveloped Viruses.}, journal = {Infectious diseases and therapy}, volume = {14}, number = {6}, pages = {1143-1156}, pmid = {40246793}, issn = {2193-8229}, support = {21/18/R/53//Agenzia Nazionale per le Nuove Tecnologie, l'Energia e lo Sviluppo Economico Sostenibile/ ; }, abstract = {Ethanol has demonstrated high efficacy in inactivating enveloped viruses in vitro and in vivo (in animal and human studies). The inhalation route has been a significant method of drug administration for respiratory disorders since ancient times. Infections with enveloped viruses cause many respiratory diseases. This concise review explores the general structural characteristics of enveloped viruses and examines the potential role of inhaled ethanol as a low-cost therapy for respiratory diseases. Current literature data suggest that ethanol inhalation could be beneficial in treating respiratory infections caused by enveloped viruses. However, there is a clear gap in well-designed clinical trials assessing the safety and efficacy of ethanol inhalation in treating respiratory infections from enveloped viruses. This low-cost therapy could become an important therapeutic option, especially for large numbers of patients simultaneously infected, as was the case during the coronavirus disease 2019 (COVID-19) pandemic. In addition, inhaled ethanol could be a successful approach for vulnerable patients such as patients with cancer because it is likely to have no or minimal effects on already established life-saving treatments. Further investigation by national and international institutions is urgently needed to validate these findings and refine treatment protocols.}, } @article {pmid40246352, year = {2025}, author = {Lundstrom, K}, title = {Immunobiology and immunotherapy of COVID-19.}, journal = {Progress in molecular biology and translational science}, volume = {213}, number = {}, pages = {73-133}, doi = {10.1016/bs.pmbts.2024.12.002}, pmid = {40246352}, issn = {1878-0814}, mesh = {Humans ; *COVID-19/immunology/therapy ; SARS-CoV-2/immunology ; *Immunotherapy/methods ; COVID-19 Vaccines/immunology ; Pandemics/prevention & control ; Antiviral Agents/therapeutic use ; *Coronavirus Infections/immunology/therapy ; *Pneumonia, Viral/immunology/therapy ; COVID-19 Drug Treatment ; Antibodies, Monoclonal/therapeutic use ; }, abstract = {The SARS-CoV-2 outbreak in late 2019 triggered a major increase in activities related to immunobiology and immunotherapy to cope with and find solutions to end the COVID-19 pandemic. The unprecedented approach to research and development of drugs and vaccines against SARS-CoV-2 has substantially improved the understanding of immunobiology for COVID-19, which can also be applied to other infectious diseases. Major efforts were dedicated to the repurposing of existing antiviral drugs and the development of novel ones. For this reason, numerous approaches to evaluating interferons, immunoglobulins, and cytokine inhibitors have been conducted. Antibody-based therapies, especially employing monoclonal antibodies have also been on the agenda. Cell-based therapies involving dendritic cells, macrophages, and CAR T-cell approaches have been evaluated. Many existing antiviral drugs have been repurposed for COVID-19 and novel formulations have been tested. The extraordinarily rapid development of efficient vaccines led to the breakthrough of novel vaccine approaches such as mRNA-based vaccines saving millions of lives. Waning immunity of existing vaccines and emerging SARS-CoV-2 variants have required additional booster vaccinations and re-engineering of new versions of COVID-19 vaccines.}, } @article {pmid40246351, year = {2025}, author = {Rubio-Casillas, A and Redwan, EM and Uversky, VN}, title = {More antibodies are not always better: Fc effector functions play a critical role in SARS-CoV-2 infection and protection.}, journal = {Progress in molecular biology and translational science}, volume = {213}, number = {}, pages = {413-447}, doi = {10.1016/bs.pmbts.2025.02.001}, pmid = {40246351}, issn = {1878-0814}, mesh = {Humans ; *COVID-19/immunology/prevention & control/virology ; *SARS-CoV-2/immunology ; *Antibodies, Viral/immunology ; Antibodies, Neutralizing/immunology ; *Immunoglobulin Fc Fragments/immunology ; COVID-19 Vaccines/immunology ; Antibodies, Monoclonal/immunology ; Spike Glycoprotein, Coronavirus/immunology ; Animals ; }, abstract = {Traditional vaccinology has primarily focused on neutralizing antibody titers as the main correlate of vaccine efficacy, often overlooking the multifaceted roles of antibody Fc effector functions in orchestrating protective immune responses. Fc-mediated immune responses play a pivotal role in immune modulation and pathogen clearance. Emerging evidence from natural infections and vaccine studies highlights the critical contribution of Fc effector functions in determining the quality and durability of immunity. This work explores the limitations of current vaccine evaluation paradigms that prioritize neutralization over Fc effector mechanisms. It also describes findings from a study showing an unexpected role for SARS-CoV-2 anti-spike antibodies: both convalescent plasma and patient-derived monoclonal antibodies (mAbs) lead to maximum phagocytic capacity by monocytes at low concentrations, whereas at higher concentrations the phagocytic capacity was reduced. Given that the severity of COVID-19 disease and antibody titers are strongly positively correlated, this work challenges the paradigm that high antibodies offer better protection against severe disease. It is proposed that humoral and cellular responses elicited by vaccination should never be higher than those produced by natural infection. By integrating antibody Fc effector functions into vaccine development, a paradigm shift is proposed that emphasizes synergic antibody responses. Such an approach could transform vaccine efficacy assessment, enhance protection against dangerous pathogens, and drive innovation in vaccine design.}, } @article {pmid40246350, year = {2025}, author = {Rubio-Casillas, A and Rodríguez-Quintero, CM and Hromić-Jahjefendić, A and Uversky, VN and Redwan, EM and Brogna, C}, title = {The essential role of prebiotics in restoring gut health in long COVID.}, journal = {Progress in molecular biology and translational science}, volume = {213}, number = {}, pages = {385-411}, doi = {10.1016/bs.pmbts.2025.01.004}, pmid = {40246350}, issn = {1878-0814}, mesh = {Humans ; *Prebiotics/administration & dosage ; *COVID-19/microbiology/immunology ; *Gastrointestinal Microbiome/drug effects ; SARS-CoV-2 ; Dysbiosis/microbiology ; Probiotics ; Pandemics ; }, abstract = {The gut microbiota (GM) plays an essential role in human health, influencing not only digestive processes but also the immune system´s functionality. The COVID-19 pandemic has highlighted the complex interaction between viral infections and the GM. Emerging evidence has demonstrated that SARS-CoV-2 can disrupt microbial homeostasis, leading to dysbiosis and compromised immune responses. The severity of COVID-19 has been associated with a reduction in the abundance of several beneficial bacteria in the gut. It has been proposed that consuming probiotics may help to re-colonize the GM. Although probiotics are important, prebiotics are essential for their metabolism, growth, and re-colonization capabilities. This chapter delves into the critical role of prebiotics in restoring GM after COVID-19 disease. The mechanisms by which prebiotics enhance the metabolism of beneficial bacteria will be described, and how prebiotics mediate the re-colonization of the gut with beneficial bacteria, thereby restoring microbial diversity and promoting the resilience of the gut-associated immune system. The benefits of consuming prebiotics from natural sources are superior to those from chemically purified commercial products.}, } @article {pmid40246349, year = {2025}, author = {Šutković, J}, title = {Neutrophils and COVID-19.}, journal = {Progress in molecular biology and translational science}, volume = {213}, number = {}, pages = {347-384}, doi = {10.1016/bs.pmbts.2025.02.003}, pmid = {40246349}, issn = {1878-0814}, mesh = {Humans ; *COVID-19/immunology/virology/pathology ; *Neutrophils/immunology ; Extracellular Traps/immunology ; *SARS-CoV-2/immunology ; Cytokines/antagonists & inhibitors ; COVID-19 Drug Treatment ; Animals ; Cytokine Release Syndrome/immunology ; }, abstract = {Neutrophils are the first line of defense against pathogens, most effectively by forming Neutrophil Extracellular Traps (NETs). Neutrophiles are further classified into several subpopulations during their development, eliminating pathogens through various mechanisms. However, due to the chaotic and uncontrolled immune response, NETs are often severely resulting in tissue damage and lung infections. The uncontrolled and poorly acknowledged host response regarding the cytokine storm is one of the major causes of severe COVID-19 conditions. Specifically, the increased formation of low-density neutrophils (LDNs), together with neutrophil extracellular traps (NETs) is closely linked with the severity and poor prognosis in patients with COVID-19. In this review, we discuss in detail the ontogeny of neutrophils at different stages and their recruitment and activation after infections, focusing on SARS-CoV-2. In addition, this chapter summarized the research progress on potential targeted drugs (NETs and Cytokine inhibitors) for neutrophil medical therapy and hoped to provide reference for the development of related therapeutic drugs for critically ill COVID-19 patients.}, } @article {pmid40246348, year = {2025}, author = {Hromić-Jahjefendić, A and Sezer, A and Mahmuljin, I}, title = {The impact of COVID-19 on autoimmune diseases.}, journal = {Progress in molecular biology and translational science}, volume = {213}, number = {}, pages = {315-345}, doi = {10.1016/bs.pmbts.2025.01.007}, pmid = {40246348}, issn = {1878-0814}, mesh = {Humans ; *COVID-19/immunology/complications ; *Autoimmune Diseases/immunology/etiology ; *SARS-CoV-2/immunology ; COVID-19 Vaccines/immunology/adverse effects ; Autoimmunity ; Autoantibodies/immunology ; Extracellular Traps/immunology ; }, abstract = {Various autoantibodies, such as antinuclear antibodies (ANA), anti-Ro/SSA, rheumatoid factor, lupus anticoagulant, and antibodies against interferon type I (IFN-I), have been frequently detected in COVID-19 patients, indicating a significant prevalence of autoimmune reactions following viral exposure. Additionally, the identification of human proteins with structural similarities to SARS-CoV-2 peptides as potential autoantigens underscores the complex interplay between the virus and the immune system in triggering autoimmunity. The chapter discusses probable pathways contributing to COVID-19-related autoimmunity, including bystander activation due to hyperinflammatory states, viral persistence, and the formation of neutrophil extracellular traps. These mechanisms illuminate a spectrum of autoimmune-related symptoms that can manifest, ranging from organ-specific to systemic autoimmune and inflammatory diseases. Importantly, there is emerging evidence of de novo autoimmunity arising after COVID-19 infection or vaccination, where new autoimmune conditions develop in previously healthy individuals. While various COVID-19 vaccines have received emergency use authorization, concerns regarding potential autoimmune side effects persist. Ongoing research is crucial to clarify these relationships and enhance our understanding of the risks associated with COVID-19 infections and vaccinations.}, } @article {pmid40246347, year = {2025}, author = {Hromić-Jahjefendić, A and Aljabali, AAA}, title = {Analysis of the immune response in COVID-19.}, journal = {Progress in molecular biology and translational science}, volume = {213}, number = {}, pages = {31-71}, doi = {10.1016/bs.pmbts.2024.10.004}, pmid = {40246347}, issn = {1878-0814}, mesh = {Humans ; *COVID-19/immunology/virology ; *SARS-CoV-2/immunology ; *Immunity, Innate ; Pandemics ; Toll-Like Receptors/immunology/metabolism ; Receptors, Pattern Recognition ; }, abstract = {The COVID-19 pandemic, instigated by the novel coronavirus SARS-CoV-2, has emerged as a significant global health challenge, demanding a profound grasp of the immune response. The innate immune system, a multifaceted network encompassing pattern recognition receptors (PRRs) and effector cells, assumes a pivotal function in detecting and countering this viral assailant. Toll-like receptors (TLRs), situated on immune cell surfaces and within endosomes, play a central role in recognizing SARS-CoV-2. TLR-2 and TLR-4 discern specific viral constituents, such as the spike (S) protein, setting off inflammatory signaling cascades and catalyzing the generation of type I interferons. Intracellular PRRs, including the RIG-I-like receptors (RLRs), RIG-I and MDA5, detect viral RNA within the cytoplasm of infected cells, provoking antiviral responses by initiating the synthesis of type I interferons. The equilibrium between interferons and pro-inflammatory cytokines dictates the outcomes of the disease. Interferons play an indispensable role in governing viral replication, while unregulated cytokine production can result in tissue harm and inflammation. This intricate dynamic underpins therapeutic strategies aimed at regulating immune responses in individuals grappling with COVID-19. Natural killer (NK) cells, with their capacity to recognize infected cells through the "missing self" phenomenon and activating receptors, make significant contributions to the defense against SARS-CoV-2. NK cells play a pivotal role in eliminating infected cells and boosting immune responses through antibody-dependent cell-mediated cytotoxicity (ADCC). In conclusion, comprehending the interplay among PRRs, interferons, and NK cells within innate immunity is paramount for discerning and combatting SARS-CoV-2. This comprehension illuminates therapeutic interventions and vaccine development, casting light on our endeavors to confront this worldwide health crisis.}, } @article {pmid40246346, year = {2025}, author = {Adilović, M}, title = {COVID-19 related complications.}, journal = {Progress in molecular biology and translational science}, volume = {213}, number = {}, pages = {259-314}, doi = {10.1016/bs.pmbts.2025.02.002}, pmid = {40246346}, issn = {1878-0814}, mesh = {Humans ; *COVID-19/complications ; *SARS-CoV-2 ; Pregnancy ; Pandemics ; Female ; }, abstract = {The COVID-19 pandemic has significantly impacted global healthcare systems, revealed vulnerabilities and prompted a re-evaluation of medical practices. Acute complications from the virus, including cardiovascular and neurological issues, have underscored the necessity for timely medical interventions. Advances in diagnostic methods and personalized therapies have been pivotal in mitigating severe outcomes. Additionally, Long COVID has emerged as a complex challenge, affecting various body systems and leading to respiratory, cardiovascular, neurological, psychological, and musculoskeletal problems. This broad spectrum of complications highlights the importance of multidisciplinary management approaches that prioritize therapy, rehabilitation, and patient-centered care. Vulnerable populations such as paediatric patients, pregnant women, and immunocompromised individuals face unique risks and complications, necessitating continuous monitoring and tailored management strategies to reduce morbidity and mortality associated with COVID-19.}, } @article {pmid40246345, year = {2025}, author = {Ashmawy, R and Hamouda, EA and Zeina, S and Sharaf, S and Erfan, S and Redwan, EM}, title = {Impact of COVID-19 on preexisting comorbidities.}, journal = {Progress in molecular biology and translational science}, volume = {213}, number = {}, pages = {215-258}, doi = {10.1016/bs.pmbts.2024.10.002}, pmid = {40246345}, issn = {1878-0814}, mesh = {Humans ; *COVID-19/epidemiology/complications ; Comorbidity ; SARS-CoV-2 ; Diabetes Mellitus/epidemiology ; Cardiovascular Diseases/epidemiology ; Pandemics ; Risk Factors ; United States/epidemiology ; }, abstract = {COVID-19 is a highly contagious viral disease caused by SARS-CoV-2, leading to a tragic global pandemic, where it was ranked in 2020 as the third leading cause of death in the USA, causing approximately 375,000 deaths, following heart disease and cancer. The CDC reports that the risk of death increases with age and preexisting comorbidities such as such as hypertension, diabetes, respiratory system disease, and cardiovascular disease. this report will delineate and analyze the paramount comorbidities and their repercussions on individuals infected with SARS-CoV-2.}, } @article {pmid40246344, year = {2025}, author = {Aljabali, AAA and El-Tanani, M and Barh, D and Tambuwala, MM}, title = {COVID-19: Perspectives on innate immune evasion.}, journal = {Progress in molecular biology and translational science}, volume = {213}, number = {}, pages = {171-214}, doi = {10.1016/bs.pmbts.2024.03.002}, pmid = {40246344}, issn = {1878-0814}, mesh = {Humans ; COVID-19/immunology ; *Immunity, Innate ; *SARS-CoV-2/immunology ; *Immune Evasion/immunology ; Pandemics ; Toll-Like Receptors/immunology/metabolism ; *Pneumonia, Viral/immunology/virology ; *Coronavirus Infections/immunology/virology ; *Betacoronavirus/immunology ; Receptors, Pattern Recognition/immunology/metabolism ; Spike Glycoprotein, Coronavirus/immunology/metabolism ; Animals ; }, abstract = {The ongoing global health challenges posed by the SARS-CoV-2, the virus responsible for the COVID-19 pandemic, necessitate a deep understanding of its intricate strategies to evade the innate immune system. This chapter aims to provide insights into the sophisticated mechanisms employed by SARS-CoV-2 in its interaction with pattern recognition receptors (PRRs), with particular emphasis on Toll-like receptors (TLRs) and RIG-I-like receptors (RLRs). By skillfully circumventing these pivotal components, the virus manages to elude detection and impairs the initiation of crucial antiviral immune responses. A notable aspect of SARS-CoV-2's immune evasion tactics lies in its strategic manipulation of cytokine production. This orchestrated modulation disrupts the delicate balance of inflammation, potentially leading to severe complications, including the notorious cytokine storm. In this regard, key viral proteins, such as the spike protein and nucleocapsid protein, emerge as pivotal players in the immune evasion process, further highlighting their significance in the context of COVID-19 pathogenesis. Acquiring a comprehensive understanding of these intricate immune evasion mechanisms holds immense promise for the development of effective treatments against COVID-19. Moreover, it is imperative for vaccine development to consider these evasion strategies to maximize vaccine efficacy. Future therapeutic interventions may involve targeting alternative pathways or augmenting the antiviral immune responses, thereby mitigating the impact of immune evasion, and fostering successful outcomes. By unraveling the underlying mechanisms of innate immune evasion, we advance our comprehension of COVID-19 pathogenesis and pave the way for the development of innovative therapeutic strategies. This comprehensive understanding catalyzes progress, enabling researchers and clinicians to devise novel approaches that combat the challenges posed by SARS-CoV-2 and ultimately improve patient outcomes.}, } @article {pmid40246343, year = {2025}, author = {Aljabali, AAA and Obeid, M and Gammoh, O and El-Tanani, M and Tambuwala, MM}, title = {Guardians at the gate: Unraveling Type I interferon's role and challenges posed by anti-interferon antibodies in COVID-19.}, journal = {Progress in molecular biology and translational science}, volume = {213}, number = {}, pages = {135-169}, doi = {10.1016/bs.pmbts.2025.01.005}, pmid = {40246343}, issn = {1878-0814}, mesh = {Humans ; *Interferon Type I/immunology ; *COVID-19/immunology/diagnosis ; *SARS-CoV-2/immunology ; *Antibodies/immunology ; Signal Transduction ; }, abstract = {The intricate interplay involving Type I interferon (IFN), anti-interferon antibodies, and COVID-19 elucidates a complex symphony within the immune system. This chapter thoroughly explores the dynamic landscape of Type I IFN, delineating its pivotal role as the guardian of the immune response. As SARS-CoV-2 engages the host, the delicate balance of IFN induction and signaling pathways is disrupted, resulting in a nuanced impact on the severity and pathogenesis of COVID-19. Clinical studies illuminate a critical link between impaired IFN response and severe outcomes, uncovering genetic factors contributing to susceptibility. Furthermore, the emergence of anti-interferon antibodies proves to be a disruptive force, compromising the immune arsenal and correlating with disease severity. Our chapter encompasses diagnostic and prognostic implications, highlighting the importance of assays in identifying levels of IFN and anti-interferon antibodies. This chapter examines the possible incorporation of interferon-related biomarkers in COVID-19 diagnostics, offering predictive insights into disease progression. On the therapeutic front, efforts to manipulate the IFN pathway undergo scrutiny, encountering complexities in light of anti-interferon antibodies. This chapter concludes by outlining prospective avenues for precision medicine, emphasizing the imperative need for a comprehensive comprehension of the IFN landscape and its intricate interaction with COVID-19.}, } @article {pmid40246342, year = {2025}, author = {Eltayeb, A and Redwan, EM}, title = {T-cell immunobiology and cytokine storm of COVID-19.}, journal = {Progress in molecular biology and translational science}, volume = {213}, number = {}, pages = {1-30}, doi = {10.1016/bs.pmbts.2024.10.003}, pmid = {40246342}, issn = {1878-0814}, mesh = {Humans ; COVID-19/immunology ; SARS-CoV-2 ; *T-Lymphocytes/immunology ; *Cytokine Release Syndrome/immunology ; Pandemics ; Cytokines/immunology/metabolism ; *Coronavirus Infections/immunology/therapy ; *Pneumonia, Viral/immunology/therapy ; *Betacoronavirus/immunology ; }, abstract = {The 2019 coronavirus illness (COVID 2019) first manifests as a newly identified pneumonia and may quickly escalate to acute respiratory distress syndrome, which has caused a global pandemic. Except for individualized supportive care, no curative therapy has been steadfastly advised for COVID-19 up until this point. T cells and virus-specific T lymphocytes are required to guard against viral infection, particularly COVID-19. Delayed immunological reconstitution (IR) and cytokine storm (CS) continue to be significant barriers to COVID-19 cure. While severe COVID-19 patients who survived the disease had considerable lymphopenia and increased neutrophils, especially in the elderly, their T cell numbers gradually recovered. Exhausted T lymphocytes and elevated levels of pro-inflammatory cytokines, including IL6, IL10, IL2, and IL17, are observed in peripheral blood and the lungs. It implies that while convalescent plasma, IL-6 blocking, mesenchymal stem cells, and corticosteroids might decrease CS, Thymosin α1 and adaptive COVID-19-specific T cells could enhance IR. There is an urgent need for more clinical research in this area throughout the world to open the door to COVID-19 treatment in the future.}, } @article {pmid40245664, year = {2025}, author = {Kalagy, T and Braun-Lewensohn, O and Abu-Kaf, S}, title = {Psychological distress among Israelis during crisis: A comparison between COVID-19 and the Iron Swords War.}, journal = {Psychiatry research}, volume = {348}, number = {}, pages = {116491}, doi = {10.1016/j.psychres.2025.116491}, pmid = {40245664}, issn = {1872-7123}, mesh = {Humans ; Israel/epidemiology ; *COVID-19/psychology ; Male ; Female ; *Adaptation, Psychological ; Adult ; *Psychological Distress ; Middle Aged ; *Sense of Coherence ; Resilience, Psychological ; *Jews/psychology ; Hope ; *Stress, Psychological/psychology ; Young Adult ; Aged ; Surveys and Questionnaires ; }, abstract = {This study aimed to compare stress reactions and coping resources among the Jewish population in Israel during two different crises: the COVID-19 pandemic and the current Iron Swords War. The study included 421 respondents during the COVID-19 period and 604 respondents during the Iron Swords War. Participants completed self-report questionnaires designed to evaluate sense of coherence, hope, and Community resilience as indicators of coping resources and the Brief Symptom Inventory as a measure of psychological distress. Overall, the mental state of the entire population was more severe during the Iron Swords War than it was during the COVID-19 period (p0.001> (. Sense of coherence and hope were both strongly negatively correlated with psychological distress (p<.001). Moreover, hope, sense of coherence, gender, and age were significant predictors of psychological distress (p< .01). These findings indicate the importance of personal coping resources, such as sense of coherence, during times of crisis. This is particularly important for vulnerable groups. Policymakers should prioritize mental-health services and targeted interventions in emergency response plans.}, } @article {pmid40245580, year = {2025}, author = {Nakajima, M and Yamazaki, H and Yoshinari, K and Kobayashi, K and Ishii, Y and Nakai, D and Kamimura, H and Kume, T and Saito, Y and Maeda, K and Kusuhara, H and Tamai, I}, title = {Contribution of Japanese scientists to drug metabolism and disposition.}, journal = {Drug metabolism and disposition: the biological fate of chemicals}, volume = {53}, number = {5}, pages = {100071}, doi = {10.1016/j.dmd.2025.100071}, pmid = {40245580}, issn = {1521-009X}, mesh = {Animals ; Humans ; Cytochrome P-450 Enzyme System/metabolism ; Japan ; Periodicals as Topic ; *Pharmaceutical Preparations/metabolism ; Pharmacokinetics ; *Research Personnel ; East Asian People ; }, abstract = {Japanese researchers have played a pivotal role in advancing the field of drug metabolism and disposition, as demonstrated by their substantial contributions to the journal Drug Metabolism and Disposition (DMD) over the past 5 decades. This review highlights the historical and ongoing impact of Japanese scientists on DMD, celebrating their achievements in elucidating drug metabolism, membrane transport, pharmacokinetics, and toxicology. From the discovery of cytochrome P450 by Tsuneo Omura and Ryo Sato in 1962 to subsequent advances in drug transport research, Japan has maintained a leading position in the field. A geographical analysis of DMD publications reveals a notable increase in contributions from Japan during the 1980s, ranking second globally and maintaining this position through the 2000s. However, recent years have seen a slight decline in output, likely influenced by the COVID-19 pandemic and increased online journals as well as structural changes within academia and industry. Importantly, this trend is not unique to Japan. To sustain excellence and innovation in this field, it is crucial to strengthen funding for absorption, distribution, metabolism, excretion, and toxicity research and promote collaborations between academia, industry, and regulatory agencies. By prioritizing the translation of fundamental discoveries into drug development and clinical applications, scientists in this area can further advance global efforts toward achieving optimal drug efficacy and safety. This review underscores the enduring contributions of Japanese researchers to DMD and calls for renewed efforts to drive innovation and progress in this vital area of science. SIGNIFICANCE STATEMENT: Over the past 5 decades, Japanese scientists have made significant contributions to Drug Metabolism and Disposition through groundbreaking discoveries and advancements in the study of drug-metabolizing enzymes, transporters, pharmacokinetics analysis, and related areas. These contributions continue to shape the field, offering a foundation for future innovation in this area. We hope that the next generation of Japanese scientists will further solidify their global leadership in this area to advance drug development and proper pharmacotherapy.}, } @article {pmid40244866, year = {2025}, author = {Ladetto, MF and Gantner, ME and Rodenak-Kladniew, BE and Rodriguez, S and Cuestas, ML and Talevi, A and Castro, GR}, title = {Promising Prodiginins Biological Activities.}, journal = {Chemistry & biodiversity}, volume = {22}, number = {9}, pages = {e202402940}, pmid = {40244866}, issn = {1612-1880}, mesh = {Humans ; *Prodigiosin/pharmacology/chemistry/therapeutic use/analogs & derivatives ; *COVID-19 Drug Treatment ; *Antiviral Agents/pharmacology/chemistry/therapeutic use ; Anti-Infective Agents/pharmacology/chemistry/therapeutic use ; SARS-CoV-2/drug effects ; Animals ; COVID-19/virology ; }, abstract = {Prodiginins are a large family of at least 34 pyrrolic compounds, including the well-studied red pigment prodigiosin. Prodiginins are produced by several microorganisms displaying broad biological activities, including antimicrobial, antiviral, antiparasitic, antiproliferative, and immunosuppressive activities. The present review aims to compile and analyze the main physicochemical and biological properties and mechanisms of action of prodiginins for microbial disease treatment, particularly SARS-CoV-2 disease and opportunistic infections related to COVID-19. The interaction of prodigiosin, as a model molecule, with cellular membranes, potential drug delivery devices, and toxicological studies, and in silico studies using molecular dynamics showed that the prodigiosin motif, which interacts with lipids, opens a new door for the potential therapeutic use of prodiginins.}, } @article {pmid40244526, year = {2025}, author = {Taha, MS and Akram, A and Abdelbary, GA}, title = {Unlocking the potential of remdesivir: innovative approaches to drug delivery.}, journal = {Drug delivery and translational research}, volume = {15}, number = {10}, pages = {3390-3413}, pmid = {40244526}, issn = {2190-3948}, mesh = {Humans ; *Adenosine Monophosphate/analogs & derivatives/administration & dosage/pharmacokinetics/therapeutic use ; *Alanine/analogs & derivatives/administration & dosage/pharmacokinetics/therapeutic use ; *Antiviral Agents/administration & dosage/pharmacokinetics/therapeutic use ; *Drug Delivery Systems/methods ; COVID-19 Drug Treatment ; SARS-CoV-2 ; COVID-19 ; *Coronavirus Infections/drug therapy ; Pandemics ; Animals ; *Pneumonia, Viral/drug therapy ; }, abstract = {Given the recurrent waves of COVID-19 and the emergence of new viral infections, optimizing the potential of remdesivir as an antiviral agent is critical. While several reviews have explored the efficacy of remdesivir, few have comprehensively addressed its challenges, such as the necessity for intravenous infusion, suboptimal lung accumulation, and safety concerns related to its formulation. This review critically examines these challenges while proposing innovative solutions and effective combinations with other antiviral agents and repurposed drugs. By highlighting the role of complex generics, we aim to enhance therapeutic efficacy in ways not previously discussed in existing literature. Furthermore, we address the development of novel drug delivery systems which specifically aim to improve remdesivir's pharmacological profile. By analyzing recent findings, we assess both the successes and limitations of current approaches, providing insights into ongoing challenges and strategies for further optimization. This review uniquely focuses on targeted drug delivery systems and innovative formulations, thereby maximizing remdesivir's therapeutic benefits and broadening its application in combating emerging viral threats. In doing so, we fill a critical gap in literature, offering a comprehensive overview that informs future research and clinical strategies.}, } @article {pmid40244315, year = {2025}, author = {Aderinto, N and Olatunji, G and Kokori, E and Ogieuhi, IJ and Yusuf, IA and Egbunu, E and Ukoaka, BM and Babalola, AE and Adefusi, TO and Aboje, JE and Moradeyo, A}, title = {COVID-19 and cognitive impairment: a review of the emerging evidence.}, journal = {Discover mental health}, volume = {5}, number = {1}, pages = {56}, pmid = {40244315}, issn = {2731-4383}, abstract = {The recent surge of COVID-19 cases has raised concerns about its potential long-term effects on cognitive function. This review explores the growing body of research investigating the link between COVID-19 infection and cognitive impairment. Studies employing observational, longitudinal, and case-control designs reveal a concerning prevalence of cognitive impairment in survivors, affecting domains like attention, memory, executive function, and processing speed. The persistence of these deficits for months after the initial infection highlights the potential for long-term consequences. While the precise mechanisms remain under investigation, potential contributing factors include neuroinflammation, hypoxia, and psychological effects. Limitations within the current research landscape necessitate further investigation into the long-term trajectory of cognitive decline, the potential for intervention and recovery, and the role of vaccination in mitigating these effects. Understanding the multifaceted nature of this issue is crucial for developing effective strategies to ensure optimal cognitive health outcomes for COVID-19 survivors.}, } @article {pmid40244031, year = {2025}, author = {Alves, MI and Dias Junior, SA and Martins, T and Felipe, AOB and Freitas, PS and Moreira, DDS}, title = {The Relationship Between Excessive Screen Time, Self-Harm, and Suicidal Behavior in Adolescents During the COVID-19 Pandemic: An Integrative Literature Review.}, journal = {Journal of child and adolescent psychiatric nursing : official publication of the Association of Child and Adolescent Psychiatric Nurses, Inc}, volume = {38}, number = {2}, pages = {e70015}, pmid = {40244031}, issn = {1744-6171}, support = {//This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001./ ; }, mesh = {Humans ; *COVID-19/psychology ; *Self-Injurious Behavior/epidemiology/psychology ; Adolescent ; *Screen Time ; *Adolescent Behavior/psychology ; *Suicidal Ideation ; }, abstract = {INTRODUCTION: Adolescents are being increasingly exposed to digital media, especially in the aftermath of the COVID-19 pandemic. This reality raises concerns over the effects of this exposure, in addition to an increase in suicidal behavior and self-harm.

AIM/QUESTION: This study aims to analyze the relationship between excessive screen time, self-harm, and suicidal behavior in adolescents during the COVID-19 pandemic.

METHODS: This is an integrative literature review. The research question was structured using the PICOT strategy (P-adolescents; I-intensive screen and internet time; O-suicidal behavior and self-harm; and T-pandemic timeframe). The databases included were: Embase, LILACS, PubMed, Scopus, Cinahl, Web of Science, and Google Scholar. Initially, 1645 studies were found; after reviewing their titles and abstracts, 18 studies met the eligibility criteria.

FINDINGS: The results revealed concerning associations between prolonged exposure and behaviors such as self-harm and suicidal behavior.

IMPLICATIONS FOR PRACTICE: These findings can assist nurses in identifying young individuals at risk due to inappropriate technology use, enabling the development of tailored interventions, the implementation of educational programs for healthy digital habits, and the promotion of mental well-being.

RECOMMENDATION: In light of the above, measures to mitigate this problem and the risks stemming from prolonged exposure are needed, considering that the adverse effects go beyond the pandemic context.}, } @article {pmid40243795, year = {2025}, author = {Neil, JA}, title = {PREGNANCY DISORDERS AND MATERNAL CONSEQUENCES: Emerging viral infections during pregnancy: understanding the risks to maternal and fetal health.}, journal = {Reproduction (Cambridge, England)}, volume = {169}, number = {5}, pages = {}, doi = {10.1530/REP-25-0043}, pmid = {40243795}, issn = {1741-7899}, mesh = {Pregnancy ; Humans ; Female ; *Pregnancy Complications, Infectious/virology/epidemiology ; *Communicable Diseases, Emerging/virology/epidemiology/complications ; *Virus Diseases/complications/epidemiology/virology ; COVID-19 ; Zika Virus Infection/complications ; *Maternal Health ; Pregnancy Outcome ; SARS-CoV-2 ; }, abstract = {IN BRIEF: Emerging viral infections pose a significant risk to pregnant women and their offspring. This review summarizes what is known about maternal and fetal outcomes following infection with emerging viruses and discusses how we can prepare for the next outbreak.

ABSTRACT: Viral infections during pregnancy pose significant risks to both maternal and fetal health. While several viruses are well known to cause adverse pregnancy outcomes, often little is known about emerging viruses. This review summarizes the known maternal and fetal consequences of infection during pregnancy with novel and re-emerging viruses. Focus is placed on viruses such as Zika and SARS-CoV-2, among others, discussing the mechanisms by which these viruses may disrupt fetal development at the maternal-fetal interface. The review also addresses the challenges that need to be overcome, such as the need for ongoing disease surveillance, prioritization of pregnant women for clinical trials and the importance of pre-clinical models of placenta infection, to adequately prepare for the next virus outbreak.}, } @article {pmid40243788, year = {2025}, author = {Melo, EP and Mendes, EFDS and Rodrigues, RCR and Nogueira, DL and Tabosa, TA and Castro, MC and Machado, MMT}, title = {Maternal care for preterm infants in the context of the COVID-19 pandemic: a qualitative systematic review.}, journal = {Cadernos de saude publica}, volume = {41}, number = {3}, pages = {e00134924}, pmid = {40243788}, issn = {1678-4464}, mesh = {Humans ; *COVID-19/psychology/epidemiology ; Infant, Newborn ; *Infant, Premature ; Female ; Pregnancy ; *Mothers/psychology ; Qualitative Research ; SARS-CoV-2 ; Pandemics ; Premature Birth ; Adaptation, Psychological ; }, abstract = {Preterm birth and hospitalization of the newborn are potentially traumatic events for mothers and children. The COVID-19 pandemic, along with its social impacts and additional concerns, has exacerbated maternal distress and anxiety, adversely impacting the development of premature babies. This study conducted a qualitative systematic review to understand maternal care for preterm infants during the COVID-19 pandemic. Following the Joanna Briggs Institute methodology and PRISMA guidelines, the databases CINAHL, Embase, PsycINFO, Scopus, Web of Science, and the portals Virtual Health Library and CAPES Periodicals were consulted. From the 1,449 identified publications, 14 articles were included in the review, resulting in 172 primary findings. The findings were grouped using the meta-aggregative approach, with confidence assessed via the ConQual approach, resulting in four meta-aggregated findings: (1) the impact of the pandemic on health services for preterm infants; (2) the impact of the pandemic and prematurity on maternal mental health; (3) challenges to the maternal care of preterm infants imposed by COVID-19; and (4) maternal coping strategies during the pandemic. The review revealed that the pandemic and associated sanitary measures negatively impacted maternal proximity to hospitalized premature infants, reduced the support networks, worsened financial situations, and increased mothers' emotional burden. Public policies are recommended to provide support to mothers, offer resources to deal with adverse experiences, and promote parental skills in caring for preterm infants.}, } @article {pmid40243757, year = {2025}, author = {Meng, S and Hara, T and Miura, Y and Arao, Y and Saito, Y and Inoue, K and Hirotsu, T and Vecchione, A and Satoh, T and Ishii, H}, title = {In Vivo Engineered CAR-T Cell Therapy: Lessons Built from COVID-19 mRNA Vaccines.}, journal = {International journal of molecular sciences}, volume = {26}, number = {7}, pages = {}, pmid = {40243757}, issn = {1422-0067}, support = {grant nos. 19K22658, 20H00541, 21K19526, 22H03146, 22K19559, 23K19505, 23K18313, 23KK0153, 24K22144, and 16H06279 (PAGS)//Ministry of Education, Culture, Sports, Science and Technology/ ; grant nos. JP23ym0126809 and JP24ym0126809//Japan Agency for Medical Research and Development/ ; 23-255001//Princess Takamatsu Cancer Research Fund/ ; G-2024-3-00//IFO Research Communications/ ; 2024//Oceanic Wellness Foundation/ ; 2024//Suzuken Memorial Foundation/ ; }, mesh = {Humans ; *Immunotherapy, Adoptive/methods ; *COVID-19 Vaccines/immunology/genetics ; *COVID-19/prevention & control/immunology ; *Receptors, Chimeric Antigen/immunology/genetics ; SARS-CoV-2/immunology ; *Neoplasms/therapy/immunology ; Nanoparticles/chemistry ; RNA, Messenger/immunology/genetics ; mRNA Vaccines/immunology ; Animals ; Vaccines, Synthetic/immunology ; Lipids/chemistry ; Liposomes ; }, abstract = {Chimeric antigen receptor T cell (CAR-T) therapy has revolutionized cancer immunotherapy but continues to face significant challenges that limit its broader application, such as antigen targeting, the tumor microenvironment, and cell persistence, especially in solid tumors. Meanwhile, the global implementation of mRNA vaccines during the COVID-19 pandemic has highlighted the transformative potential of mRNA and lipid nanoparticle (LNP) technologies. These innovations, characterized by their swift development timelines, precise antigen design, and efficient delivery mechanisms, provide a promising framework to address some limitations of CAR-T therapy. Recent advancements, including mRNA-based CAR engineering and optimized LNP delivery, have demonstrated the capacity to enhance CAR-T efficacy, particularly in the context of solid tumors. This review explores how mRNA-LNP technology can drive the development of in vivo engineered CAR-T therapies to address current limitations and discusses future directions, including advancements in mRNA design, LNP optimization, and strategies for improving in vivo CAR-T functionality and safety. By bridging these technological insights, CAR-T therapy may evolve into a versatile and accessible treatment paradigm across diverse oncological landscapes.}, } @article {pmid40243562, year = {2025}, author = {Jellinger, KA}, title = {Concomitant Pathologies and Their Impact on Parkinson Disease: A Narrative Overview of Current Evidence.}, journal = {International journal of molecular sciences}, volume = {26}, number = {7}, pages = {}, pmid = {40243562}, issn = {1422-0067}, support = {2025-02//Society for the Promotion of Research in Experimental Neurology, Vienna, Austria/ ; }, mesh = {Humans ; *Parkinson Disease/pathology/epidemiology/complications/metabolism ; COVID-19/epidemiology/complications/pathology ; Comorbidity ; alpha-Synuclein/metabolism ; Neoplasms/epidemiology/pathology ; SARS-CoV-2 ; }, abstract = {Many clinico-pathological studies point to the presence of multiple comorbidities/co-pathologies in the course of Parkinson disease (PD). Lewy body pathology, the morphological hallmark of PD, rarely exists in isolation, but is usually associated with other concomitant pathologies, in particular Alzheimer disease-related changes (ADNC), cerebrovascular pathologies (macro- and microinfarcts, cerebral small vessel disease, cerebral amyloid angiopathy), TDP-43 pathology as well as multiple pathological combinations. These include cardiovascular disorders, metabolic syndrome, diabetes mellitus, autoimmune and rheumatic diseases, myasthenia gravis, Sjögren's syndrome, restless leg syndrome or other rare disorders, like Fabry disease. A combination of PD and multiple sclerosis (MS) may be due to the immune function of LRRK2 and its interrelation with α-synuclein. COVID-19 and HIV posed considerable impacts on patients with PD. Epidemiological evidence points to a decreased risk for the majority of neoplasms, except melanoma and other skin cancers, while some tumors (breast, brain) are increased. On the other hand, a lower frequency of malignancies preceding early PD markers may argue for their protective effect on PD risk. Possible pathogenetic factors for the association between PD and cancer are discussed. The tremendous heterogeneity of concomitant pathologies and comorbidities observed across the PD spectrum is most likely caused by the complex interplay between genetic, pathogenic and other risk factors, and further research should provide increasing insight into their relationship with idiopathic PD (and other parkinsonian disorders) in order to find better diagnostic tools and probable disease-modifying therapies.}, } @article {pmid40243121, year = {2025}, author = {Wong, SK}, title = {Effects of chloroquine and hydroxychloroquine on bone health (Review).}, journal = {Molecular medicine reports}, volume = {31}, number = {6}, pages = {}, pmid = {40243121}, issn = {1791-3004}, mesh = {*Hydroxychloroquine/pharmacology/therapeutic use/adverse effects ; Humans ; *Chloroquine/pharmacology/therapeutic use/adverse effects ; *Bone and Bones/drug effects/metabolism ; Animals ; Osteoclasts/drug effects/metabolism ; COVID-19 Drug Treatment ; Apoptosis/drug effects ; Autophagy/drug effects ; Osteoblasts/drug effects/metabolism ; Osteogenesis/drug effects ; }, abstract = {Chloroquine (CQ) and hydroxychloroquine (HCQ), which were initially used to treat malaria, are now also used to treat autoimmune and inflammatory diseases, which have gained notoriety during the coronavirus‑19 pandemic. The emerging uses of CQ and HCQ in cancer therapy, metabolic syndrome and bone disorders highlight their broad clinical potential. Patients with autoimmune and inflammatory conditions have a higher risk of suboptimal bone health because of chronic inflammation, immune dysregulation and medication use. In the present review, the use of CQ and HCQ in bone research was explored, particularly in terms of their effectiveness and mechanism in modulating bone homeostasis. CQ and HCQ inhibit osteoblastic activity by suppressing autophagy, inducing oxidative stress and promoting osteoblast apoptosis. CQ suppresses osteoclastic activity by blocking the receptor activator of nuclear factor κ‑β/receptor activator of nuclear factor κ‑β ligand interaction, autophagy and inflammation. HCQ inhibits osteoclastogenesis by increasing the expression levels of osteoprotegerin, inducing osteoclast apoptosis and reducing cytokines without affecting autophagy. With regard to the molecular machineries, CQ and HCQ inhibit bone formation and bone resorption. Variations in dose, frequency and duration of CQ and HCQ treatment result in heterogenous outcomes. Further research is necessary to clarify the net effects of CQ and HCQ on bone through studies specifically designed to explore their direct impact as the primary objective. The use of these medications is broadening particularly in patients with autoimmune diseases who are at risk of skeletal disorders. However, their safety profiles, adverse effects and contraindications must be carefully monitored when administered for long‑term use and in combination.}, } @article {pmid40242974, year = {2025}, author = {Nouari, W and Aribi, M}, title = {Innate lymphoid cells, immune functional dynamics, epithelial parallels, and therapeutic frontiers in infections.}, journal = {International reviews of immunology}, volume = {44}, number = {5}, pages = {245-272}, doi = {10.1080/08830185.2025.2490233}, pmid = {40242974}, issn = {1563-5244}, mesh = {Humans ; *Immunity, Innate ; Animals ; *Lymphocytes/immunology/metabolism ; *Epithelial Cells/immunology ; *Infections/immunology/therapy ; Host-Pathogen Interactions/immunology ; }, abstract = {Innate lymphoid cells (ILCs) have emerged as pivotal players in the field of immunology, expanding our understanding of innate immunity beyond conventional paradigms. This comprehensive review delves into the multifaceted world of ILCs, beginning with their serendipitous discovery and traversing their ontogeny and heterogeneity. We explore the distinct subsets of ILCs unraveling their intriguing plasticity, which adds a layer of complexity to their functional repertoire. As we journey through the functional activities of ILCs, we address their role in immune responses against various infections, categorizing their interactions with helminthic parasites, bacterial pathogens, fungal infections, and viral invaders. Notably, this review offers a detailed examination of ILCs in the context of specific infections, such as Mycobacterium tuberculosis, Citrobacter rodentium, Clostridium difficile, Salmonella typhimurium, Helicobacter pylori, Listeria monocytogenes, Staphylococcus aureus, Pseudomonas aeruginosa, Influenza virus, Cytomegalovirus, Herpes simplex virus, and severe acute respiratory syndrome coronavirus 2. This selection aimed for a comprehensive exploration of ILCs in various infectious contexts, opting for microorganisms based on extensive research findings rather than considerations of virulence or emergence. Furthermore, we raise intriguing questions about the potential immune functional resemblances between ILCs and epithelial cells, shedding light on their interconnectedness within the mucosal microenvironment. The review culminates in a critical assessment of the therapeutic prospects of targeting ILCs during infection, emphasizing their promise as novel immunotherapeutic targets. Nevertheless, due to their recent discovery and evolving understanding, effectively manipulating ILCs is challenging. Ensuring specificity and safety while evaluating long-term effects in clinical settings will be crucial.}, } @article {pmid40242829, year = {2025}, author = {Jung, Y and Baldeo, S and Pahuta, M and Sharma, S and Guha, D}, title = {The legal and socioeconomic considerations of spine telemedicine in Canada.}, journal = {Journal of spine surgery (Hong Kong)}, volume = {11}, number = {1}, pages = {166-177}, pmid = {40242829}, issn = {2414-469X}, abstract = {Telemedicine, or virtual care offers a platform for remote assessments, for either initial consultations or follow-up care. Telemedicine is a broad term and may refer to video conferences/assessments, telephone visits, messages through online platforms, and remote monitoring applications. The restrictions during the coronavirus disease 2019 (COVID-19) crisis had accelerated the use of telemedicine in Canadian healthcare. Several years after the pandemic, after this initial trial of widespread telemedicine, there remains significant uncertainty as to its efficacy and future directions. There are inherent challenges to telemedicine, including questions of clinical reliability and privacy, balanced against the possibility of efficiency and increased access to specialists. The Canadian healthcare system also poses significant challenges in the evaluation and systemic implementation of telemedicine, given the lack of a national legal framework and separate provincial or territorial regulation systems across the country. Telemedicine is of a particular interest to spinal surgeons, given the prevalence, morbidity, and economic costs associated with spinal pathologies. Prior to the COVID-19 pandemic, few spine surgeons offered telemedicine, due to the perceived challenges of remote assessment and diagnosis with spine pathologies. There has been little subsequent data to examine the role and suitability for remote acre in spine surgery. Herein, we review the current landscape of telemedicine in Canadian healthcare, with applications to spine surgery.}, } @article {pmid40242541, year = {2025}, author = {Guo, Y and Liu, F and Song, JS and Wang, S}, title = {Supply chain resilience: A review from the inventory management perspective.}, journal = {Fundamental research}, volume = {5}, number = {2}, pages = {450-463}, pmid = {40242541}, issn = {2667-3258}, abstract = {The COVID-19 pandemic has exposed vulnerabilities in global supply chains, leading to economic damage and product shortages caused by demand surges and supply disruptions. Concurrently, geopolitical conflicts and the rising frequency of natural disasters due to climate change have amplified the urgency to develop strategies for building resilient supply chains. This article presents a comprehensive literature review on inventory management strategies for enhancing supply chain resilience, such as stockpiling, multi-sourcing, capacity reservation, and flexible supply contracts. We classify these strategies into two categories: one deals with supply-side disruption risks, and the other deals with demand-side disruption risks. For each category, we summarize the practical challenges, the state-of-art research, and potential avenues for future research.}, } @article {pmid40242230, year = {2025}, author = {Tyagi, S and Upadhyay, S and Bharara, T and Sahai, S}, title = {Nipah virus: Preventing the next outbreak.}, journal = {World journal of clinical cases}, volume = {13}, number = {11}, pages = {99748}, pmid = {40242230}, issn = {2307-8960}, abstract = {Nipah is a deadly viral infection which has come to the news highlight recently, due to its fresh onslaught in Southern India. As the world continues to recover from coronavirus disease 2019, the World Health Organization has identified a list of high-priority pathogens with the potential to cause future pandemics. Among them is the Nipah virus (NiV), which poses a significant threat. Even a small outbreak could trigger widespread panic among the public. The emergence and re-emergence of NiV among other zoonotic infections is a stern reminder of the importance of One health concept.}, } @article {pmid40241147, year = {2025}, author = {Morello, R and De Rose, C and Martino, L and Raffaelli, F and Zampino, G and Valentini, P and Buonsenso, D}, title = {Role of nutrient supplements in children with post-COVID condition: a retrospective preliminary observation and narrative review.}, journal = {Italian journal of pediatrics}, volume = {51}, number = {1}, pages = {119}, pmid = {40241147}, issn = {1824-7288}, mesh = {Humans ; *Dietary Supplements ; Retrospective Studies ; *COVID-19/complications ; Child ; Male ; Female ; Child, Preschool ; Adolescent ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Post-COVID Condition (PCC), emerging as a significant long-term consequence of SARS-CoV-2 infection, affects not only adults but also the pediatric population. Despite ongoing research, the precise pathophysiology of PCC remains elusive. However, several putative mechanisms have been identified, leading to the exploration of various therapeutic strategies. Notably, in the adult population, there has been substantial interest in the potential efficacy of nutritional supplements. Regrettably, information regarding the use of such supplements in the pediatric population is currently lacking.

METHODS: The present study was conducted to assess the impact of nutritional supplements on alleviating long COVID symptoms in children. To achieve this, we conducted a retrospective analysis of nutrient supplements administered by parents to children with Post-COVID Condition (PCC) between February 2020 and October 2022. Statistical analyses were employed to determine associations between categorical variables.

RESULTS: A total of 1243 children were enrolled following documented SARS-CoV-2 infection, with 940 (76.2%) diagnosed as recovered and 294 (23.8%) diagnosed with Long COVID. Among Long COVID patients experiencing disabling symptoms, treatment with oral lactoferrin and/or a Multi-Element Product (MEP) with antioxidant and anti-inflammatory properties was initiated. The correlation analysis between the use of supplements and persistence of long COVID at the next follow-up showed that the use of MEP alone (OR 5.7, 95% CI 3.8-8.5), or the combination of MEP and lactoferrin (OR 5.06, 95% CI 3.3-7.6) three months after the initial infection and for the following three months, were associated with a lower risk having long covid at six months following initial infection, when compared with the use of lactoferrin alone (OR 7.6 95% CI 5.1-11.4).

CONCLUSIONS: This proof-of-concept study revealed that MEP and lactoferrin, when administered three months after initial infection in patients with a new diagnosis of long covid, may have a positive impact on improving Long COVID symptoms in children during follow-up evaluations. This positive trend toward reducing Post-COVID Condition (PCC) exhibited by MEP and lactoferrin suggested a potential benefit worthy of exploration in future randomized controlled trials.}, } @article {pmid40240055, year = {2025}, author = {Ajumobi, O and Davis, M and George, CM and Rosman, L and Von Dobschuetz, S and Watson, C and Nuzzo, JB}, title = {Improving risk analysis of the environmental drivers of the spillover, emergence/re-emergence and spread of Crimean-Congo haemorrhagic fever virus, Marburg virus and Middle East respiratory syndrome coronavirus in the East Africa Region.}, journal = {BMJ global health}, volume = {10}, number = {4}, pages = {}, pmid = {40240055}, issn = {2059-7908}, support = {001/WHO_/World Health Organization/International ; }, mesh = {Humans ; *Hemorrhagic Fever, Crimean/epidemiology/transmission ; Risk Assessment ; Animals ; Africa, Eastern/epidemiology ; *Communicable Diseases, Emerging/epidemiology ; Middle East Respiratory Syndrome Coronavirus ; Hemorrhagic Fever Virus, Crimean-Congo ; *Marburg Virus Disease/epidemiology/transmission ; *Coronavirus Infections/epidemiology/transmission ; Climate Change ; }, abstract = {INTRODUCTION: Emerging and/or re-emerging infectious diseases (EIDs) in the East Africa region are associated with climate change-induced environmental drivers. There is a need for a comprehensive understanding of these environmental drivers and to adopt an integrated risk analysis (IRA) framework for addressing a combination of the biological, environmental and socioeconomic factors that increase population vulnerabilities to EID risks to inform biological risk mitigation and cross-sectoral decision-making. The aim of this integrative review was to identify knowledge gaps and contribute to a holistic understanding about the environmental drivers of Crimean-Congo haemorrhagic fever virus (CCHFV), Marburg virus (MARV) and Middle East respiratory syndrome coronavirus (MERS-CoV) infections in the East Africa Region to improve IRA processes at the environment-animal-human exposure interface.

METHODS: An integrative review search was carried out to identify relevant studies and reports from 2000 to 2024. Searches were conducted in bibliographic databases and global institutional websites. Inclusion criteria were studies and reports (in English) addressing environmental drivers of CCHFV, MARV and MERS-CoV infections across countries in the East Africa region, existing risk frameworks/methodological tools and/or One Health policy recommendations for risk analysis of environmentally driven biological threats.

RESULTS: Of the total number of studies retrieved from database searches (n=18 075) and website searches (n=44), 242 studies and reports combined were included in the review with the majority covering the environmental drivers (n=137), the risk frameworks/methodological tools (n=73) and the policy recommendations (n=32). We identified 10 categories of environmental drivers, four thematic groups of risk frameworks and three categories of policy recommendations. Overall, many of the included records on the risk frameworks/methodological tools expounded on the adoption of ecological niche modelling (ENM) for environmental monitoring of potential transmission pathways of EIDs and other biological threats.

CONCLUSION: This integrative review recommends the adoption of specialised risk mapping approaches such as ENM for environmental monitoring of EIDs under IRA processes. Findings from the review were used for the conceptualisation of an IRA framework for addressing environmentally driven EIDs.}, } @article {pmid40239606, year = {2025}, author = {Perozziello, A and Sta, A and Aubriot, B and Barruel, D and Dauriac-Le Masson, V}, title = {Transitions in mental health care utilisation at GHU Paris between 2019 and 2024: A post-pandemic perspective.}, journal = {Psychiatry research}, volume = {348}, number = {}, pages = {116482}, doi = {10.1016/j.psychres.2025.116482}, pmid = {40239606}, issn = {1872-7123}, mesh = {Humans ; Female ; Male ; *COVID-19/epidemiology ; Paris/epidemiology ; Adult ; Retrospective Studies ; Adolescent ; Middle Aged ; Young Adult ; *Patient Acceptance of Health Care/statistics & numerical data ; *Mental Health Services/statistics & numerical data/trends ; *Hospitalization/statistics & numerical data/trends ; *Mental Disorders/therapy/epidemiology ; Aged ; *Emergency Service, Hospital/statistics & numerical data/trends ; }, abstract = {OBJECTIVE: This study aimed to analyse the long-term evolution of mental health services use following the COVID-19 pandemic.

DESIGN: This was a retrospective study, conducted from 2019 to 2024, using the Groupe Hospitalier Universitaire Paris Psychiatry and Neurosciences (GHU Paris) databases.

METHODS: We considered the number of patients consulting at GHU Paris clinics, number of patients presenting at the emergency department (ED), and number of hospital admissions per week, by sex and age group. We performed a piecewise linear regression, using a threshold approach to identify time patterns between 2019 and 2024: pre-pandemic period (T1), short-term (T2) and long-term post-pandemic period (T3). Temporal changes in mental healthcare service use were then analysed.

RESULTS: No significant overall changes were observed in the number of outpatients after the COVID-19 pandemic, except for a slight increase among patients aged 15-24 years. The number of hospital admissions remained lower in 2024 compared with 2019, with a decreasing trend in T3 for all subgroups. In contrast, the number of ED visits increased over time, with higher use of emergency services by women and young people in 2024 compared with 2019. The overall long-term trend (T3) continued to show an increasing pattern. Additionally, a reduction in schizophrenia presentations was observed, while there was an overall increase in patients with substance use or neurotic disorders.

CONCLUSIONS: Our results described transitions in mental health service use at GHU Paris between 2019 and 2024, highlighting reduced hospital admissions, increased psychiatric emergencies, and changes in the reasons for seeking care.}, } @article {pmid40238569, year = {2025}, author = {Buceta-Albillos, N and Ayuga-Téllez, E}, title = {The Beneficial Interaction Between Human Well-Being and Natural Healthy Ecosystems: An Integrative Narrative Approach.}, journal = {International journal of environmental research and public health}, volume = {22}, number = {3}, pages = {}, pmid = {40238569}, issn = {1660-4601}, mesh = {Humans ; *Ecosystem ; *COVID-19/epidemiology ; *Conservation of Natural Resources ; Climate Change ; SARS-CoV-2 ; }, abstract = {This study highlights the lack of research on the relationship between ecosystem services, climate change, and human well-being. The experiences with the COVID-19 pandemic show the value of the natural environment for people's well-being. We propose a framework that fosters an integrative approach to enhance our connection with nature, which is vital for tackling current environmental challenges. We reviewed over 70 articles and 160 references from databases such as Elsevier, ScienceDirect, Dialnet, MDPI, and Taylor & Francis, focusing on the correlation between pro-environmental behavior and emotional bonds with nature. Increasing our awareness of nature is crucial for fostering sustainable ecosystems. To deepen our understanding of how this connection influences human well-being and ecosystem health, we advocate for the application of specific neuroscience and artificial intelligence techniques. The study presents a compendium of prospective research topics for future investigation and analysis. In particular, it underscores the significance of this research for the development of effective policy and practical applications in the realm of conservation efforts.}, } @article {pmid40238403, year = {2025}, author = {Bauer, KL and Johnson-Koenke, R and Fort, MP}, title = {What Is Social Connection in the Context of Human Need: An Interdisciplinary Literature Review.}, journal = {International journal of environmental research and public health}, volume = {22}, number = {3}, pages = {}, pmid = {40238403}, issn = {1660-4601}, mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Social Isolation ; Loneliness ; SARS-CoV-2 ; Public Health ; }, abstract = {The U.S. Surgeon General made an impactful declaration in the 2023 advisory on America's loneliness and social isolation epidemic that social connection, or human relationships, is a human need equivalent to water, food, and shelter. After witnessing the impact of social isolation measures during the COVID-19 pandemic, there is a global urgency to better understand social connection in public health responses. However, meaningfully effective interventions for social isolation or loneliness have yet to be identified, and the consensus that social connection is an equivalent human need is unclear. To understand what social connection, oxygen, water, food, and shelter have in common regarding population health, we conducted an interdisciplinary literature review between September 2021 and October 2024, seeking to find commonalities between research literature advocating social connection as a human need critical to survival and key concepts across population health disciplines that explain how oxygen, water, food, and shelter function as human needs. We integrated the concepts of evolution, resource, environment, ecosystem, exposure science, embodiment, homeostasis, allostatic load theory, and interdisciplinary from 44 core publications to develop a unified conceptual model and definition for social connection as a human need. We believe a holistic understanding of social connection within the shared context of oxygen, water, food, and shelter can better support health researchers across a variety of disciplines to find common ground in developing evidence-based interventions within public health.}, } @article {pmid40237465, year = {2025}, author = {Denz, PJ and Yount, JS}, title = {IFITM3 variants point to a critical role in emergent virus infections.}, journal = {mBio}, volume = {16}, number = {5}, pages = {e0334724}, pmid = {40237465}, issn = {2150-7511}, support = {AI130110, HL168501, HL157215, HL154001/NH/NIH HHS/United States ; R01 HL168501/HL/NHLBI NIH HHS/United States ; R01 HL154001/HL/NHLBI NIH HHS/United States ; R01 AI130110/AI/NIAID NIH HHS/United States ; R01 HL157215/HL/NHLBI NIH HHS/United States ; }, mesh = {Humans ; *RNA-Binding Proteins/genetics/immunology ; Polymorphism, Single Nucleotide ; Animals ; *Membrane Proteins/genetics/immunology ; Mice ; Influenza, Human/genetics/immunology/virology ; SARS-CoV-2 ; COVID-19/genetics ; *Virus Diseases/genetics/immunology/virology ; }, abstract = {Interferon-induced transmembrane protein 3 (IFITM3) is a cellular protein that restricts numerous viral infections by blocking virus-host membrane fusion. In humans, there are two IFITM3 single nucleotide polymorphisms (SNPs), rs12252-C and rs34481144-A, that decrease IFITM3 activity and have been associated with severe illness following influenza virus infections. Mice lacking IFITM3 show increased influenza severity, supporting this association. However, some studies do not find a consistent link between IFITM3 SNPs and infection severity, causing uncertainty about its role in vivo. Review of the literature indicates that IFITM3 SNPs are primarily associated with increased viral disease in infections with emergent influenza viruses, such as the 2009 H1N1 pandemic virus and zoonotic H7N9 virus. Similarly, IFITM3 SNPs are reported to be risk factors for increased severity in other emergent infections, including SARS-CoV-2, Hantaan virus, and HIV. In contrast, most studies that failed to find an association examined seasonal influenza. We posit that adaptive immune mechanisms, including pre-existing antibodies and memory T cells against seasonally circulating viruses, compensate for IFITM3 deficiencies, therefore masking its role in seasonal influenza. We propose that IFITM3 is most critical in defending against emergent viruses and should be a key focus of public health strategies to prevent the emergence and spread of novel pathogens, with individuals carrying IFITM3 SNPs potentially benefiting from broadened vaccine coverage, avoidance of animal reservoirs, or enhanced masking to protect themselves and the wider population.}, } @article {pmid40237463, year = {2025}, author = {Hirsch, C and Zorger, AM and Baumann, M and Park, YS and Bröckelmann, PJ and Mellinghoff, S and Monsef, I and Skoetz, N and Kreuzberger, N}, title = {Vaccines for preventing infections in adults with solid tumours.}, journal = {The Cochrane database of systematic reviews}, volume = {4}, number = {4}, pages = {CD015551}, pmid = {40237463}, issn = {1469-493X}, mesh = {Humans ; *Neoplasms/complications/immunology ; Randomized Controlled Trials as Topic ; Adult ; Influenza Vaccines/therapeutic use ; Pneumococcal Vaccines ; Bias ; Influenza, Human/prevention & control ; Pneumococcal Infections/prevention & control ; COVID-19/prevention & control ; COVID-19 Vaccines/adverse effects ; Meningococcal Infections/prevention & control ; Placebos/therapeutic use ; }, abstract = {BACKGROUND: Infections are one of the most frequent complications seen in adults with cancer, often arising from the underlying condition or as a result of immunosuppressive treatments. Certain infections (e.g. influenza, pneumococcal disease, and meningococcal disease) may be prevented through vaccination. However, adults with solid tumours may elicit varying immune responses compared to healthy individuals.

OBJECTIVES: To assess the benefits and risks of vaccines for the prevention of infectious diseases in adults with solid tumours.

SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, two further databases, and two study registries from inception to 2 December 2024 for randomised controlled trials (RCTs) and controlled non-randomised studies of interventions (NRSIs).

SELECTION CRITERIA: We included RCTs evaluating vaccines against the following infectious diseases in adults (≥ 18 years of age) with any diagnosis of solid tumour cancer compared to placebo or no vaccine: pneumococcal disease, Haemophilus influenzae type b disease, meningococcal disease, pertussis, hepatitis B, tetanus, polio, diphtheria, influenza, herpes zoster, and COVID-19. In cases where RCTs were unavailable, we included prospective controlled NRSIs. We excluded live-attenuated vaccines.

DATA COLLECTION AND ANALYSIS: We followed standard Cochrane methodology. Two review authors independently screened search results, extracted data, and assessed the risk of bias (RoB) in the included studies using the Cochrane RoB 2 tool for RCTs and ROBINS-I for NRSIs. We rated the certainty in the evidence using the GRADE approach for the following prioritised outcomes: incidence of infection concerned, all-cause mortality, quality of life, adverse events (AEs) of any grade, serious adverse events (SAEs), localised events at the injection site, and systemic events.

MAIN RESULTS: We included 10 studies (five RCTs and five NRSIs) involving 81,823 adults with solid tumours receiving vaccines to prevent infections with herpes zoster, influenza, or COVID-19. Six studies included participants with varied solid tumours, while two focused on neck and oesophageal cancer or lung cancer. We assessed the RCTs to be at low or moderate risk of bias, whereas most NRSIs were at critical risk of bias due to concerns about confounding. We identified two ongoing studies: one RCT evaluating an influenza vaccine, and one NRSI evaluating COVID-19 vaccines. Twelve studies are awaiting assessment. We did not identify RCTs or NRSIs of vaccines for preventing pneumococcal disease, Haemophilus influenzae type b disease, meningococcal disease, pertussis, hepatitis B, tetanus, polio, or diphtheria compared to placebo or no vaccine. The results from the RCTs are presented below. The results from the NRSIs are detailed in the main text of the review. No study reported quality of life. Vaccines for preventing herpes zoster compared to placebo or no vaccine Three RCTs (3054 participants) evaluated vaccines to prevent herpes zoster. Herpes zoster vaccines decrease the incidence of herpes zoster up to 29.4 months after the final dose (RR 0.37, 95% CI 0.23 to 0.59; 1 RCT, 2678 participants; high-certainty evidence). Herpes zoster vaccines probably make little or no difference to all-cause mortality up to 28 days after the final dose (RR 1.17, 95% CI 0.91 to 1.50; 2 RCTs, 2744 participants; moderate-certainty evidence); make little or no difference to any-grade AEs up to 30 days after final dose (RR 1.02, 95% CI 0.98 to 1.05; 3 RCTs, 2976 participants; high-certainty evidence), and probably make little or no difference in SAEs up to 30 days (RR 1.08, 95% CI 0.93 to 1.24; I² = 0%; 3 RCTs, 2976 participants; moderate-certainty evidence). Vaccines to prevent herpes zoster increase the number of participants with localised events at the injection site compared to placebo or no vaccine (RR 6.81, 95% CI 2.52 to 18.40; 3 RCTs, 2966 participants; high-certainty evidence) and may make little or no difference to the number of participants with systemic events up to 30 days after final dose (RR 1.08, 95% CI 0.77 to 1.50; 3 RCTs, 2966 participants; low-certainty evidence). Vaccines for preventing influenza compared to placebo or no vaccine One RCT (75 participants) evaluated vaccines to prevent influenza. We are uncertain about the effects of influenza vaccines administered prior to surgery on all-cause mortality (RR 1.00, 95% CI 0.07 to 15.33; 1 RCT, 66 participants; very low-certainty evidence), any-grade AEs (RR 1.17, 95% CI 0.89 to 1.54; 1 RCT, 75 participants; very low-certainty evidence), and SAEs (RR 1.46, 95% CI 0.76 to 2.83; 1 RCT, 75 participants; very low-certainty evidence) up to 15 days post-surgery. The RCT did not report the incidence of influenza, localised events at the injection site, or systemic events. Vaccines for preventing COVID-19 compared to placebo or no vaccine One RCT (2256 participants) evaluated vaccines to prevent COVID-19. Participants may have been exposed to the SARS-CoV-2 variants alpha, beta, and gamma. Vaccines to prevent COVID-19 probably decrease the incidence of COVID-19 in participants without previous COVID-19 infection up to six months after the second dose (RR 0.08, 95% CI 0.02 to 0.25; 1 RCT, 2100 participants; moderate-certainty evidence). The COVID-19 vaccines probably increase any-grade AEs (RR 1.99, 95% CI 1.71 to 2.30; 1 RCT, 2328 participants; moderate-certainty evidence). They may have little or no effect on SAEs up to 6 months after the second dose (RR 1.43, 95% CI 0.80 to 2.54; 1 RCT, 2328 participants; low-certainty evidence). The RCT did not report localised events at the injection site or systemic events.

AUTHORS' CONCLUSIONS: In adults with solid tumours, herpes zoster vaccines reduced the incidence of herpes zoster (high-certainty evidence), although localised events at the injection site were more likely to occur (high-certainty evidence). The evidence is very uncertain about the effects of influenza vaccines on all-cause mortality, any-grade AEs, and SAEs (very low-certainty evidence); the incidence of influenza was not measured in the studies. COVID-19 vaccines probably decrease the incidence of COVID-19 in those without prior infection (moderate-certainty evidence) but probably increase any-grade AEs (moderate-certainty evidence). We found no RCTs or NRSIs investigating vaccines for preventing pneumococcal disease, Haemophilus influenzae type b disease, meningococcal disease, pertussis, hepatitis B, tetanus, polio, diphtheria compared to placebo or no vaccine, in adults with solid tumours. Additional research, preferably of RCT design, is necessary to resolve uncertainties.}, } @article {pmid40237012, year = {2025}, author = {Mateu-Arrom, L and Puig, L}, title = {Infection Risk and Vaccination in the Management of Psoriasis: Considerations for Biologic Therapy.}, journal = {Psoriasis (Auckland, N.Z.)}, volume = {15}, number = {}, pages = {127-144}, pmid = {40237012}, issn = {2230-326X}, abstract = {This narrative review examines critical considerations for biologic treatment in psoriasis patients, with a focus on infection risks, providing current recommendations and practical considerations for prevention, including vaccination, screening, and management strategies. Since type I (Th1) inflammation and type III (Th17) inflammation protect against intracellular and extracellular infections, respectively, it is logical that biologic treatments blocking these pathways may be associated with an increased risk of infection. It has been proven that TNF inhibitors are associated with an increased risk of latent tuberculosis (LTBI) and hepatitis B virus reactivation. However, not all biologics exert the same immunosuppressive effect, as IL-17 and IL-23 inhibitors may be associated with a lower risk of infection. In general, pre-treatment screening for reactivable infectious diseases is advised for all patients initiating biologic therapy. Vaccination schedules for patients with psoriasis under biologic treatment should mirror those of the general population, including annual influenza and COVID-19 vaccines. Live-attenuated vaccines are generally advised against in patients undergoing biologic treatment. However, some live-attenuated vaccines may be safely administered under specific circumstances with IL-17 or IL-23 inhibitors. Current guidelines and recommendations on this topic were initially designed for TNF inhibitors and later extrapolated to other classes of biologic agents. Thus, they should be revised to better align with the specific pathogenic mechanisms of drugs and clinical evidence, emphasizing individualized treatment approaches.}, } @article {pmid40236285, year = {2025}, author = {Müller, L and Wang, JJ and Dabbiru, VAS and Thiele, T and Schönborn, L}, title = {Anti-Platelet factor 4 immunothrombosis-not just heparin and vaccine triggers.}, journal = {Research and practice in thrombosis and haemostasis}, volume = {9}, number = {2}, pages = {102729}, pmid = {40236285}, issn = {2475-0379}, abstract = {Derailments at the tightly regulated interface of blood coagulation and innate inflammatory immune responses can lead to pathologic immunothrombosis. A special subset of immunothrombosis is caused by antibodies against platelet-factor 4 (PF4). Anti-PF4 antibodies triggered by heparin treatment in heparin-induced thrombocytopenia (HIT) are known for more than 50 years. Interest in anti-PF4 disorders rekindled when first cases of vaccine-induced immune thrombocytopenia and thrombosis (VITT) occurred during the worldwide COVID-19 vaccination campaign. During this time new diagnostic procedures were established to identify affected patients and to differentiate between different kinds of anti-PF4 antibodies. This review article gives an overview about the current knowledge of HIT and VITT with concepts of the underlying pathogenesis. In addition to heparin and vaccination as known triggers for HIT and VITT, concepts for other clinical cases with anti-PF4 antibodies are described in more detail. Anti-PF4 antibodies in atypical HIT-like syndromes could be triggered by presentation of various polyanions, eg, in settings of orthopedic surgery or bacterial infections. Anti-PF4 antibodies in acute VITT-like disorders can occur after viral infections. Chronic VITT-like anti-PF4 antibodies causing recurrent thrombosis and thrombocytopenia are often linked to monoclonal gammopathies. For all disorders with anti-PF4 antibodies, timely identification in patients with thrombocytopenia with or without thrombosis is crucial for successful therapy.}, } @article {pmid40235636, year = {2025}, author = {Hamelin, DJ and Scicluna, M and Saadie, I and Mostefai, F and Grenier, JC and Baron, C and Caron, E and Hussin, JG}, title = {Predicting pathogen evolution and immune evasion in the age of artificial intelligence.}, journal = {Computational and structural biotechnology journal}, volume = {27}, number = {}, pages = {1370-1382}, pmid = {40235636}, issn = {2001-0370}, abstract = {The genomic diversification of viral pathogens during viral epidemics and pandemics represents a major adaptive route for infectious agents to circumvent therapeutic and public health initiatives. Historically, strategies to address viral evolution have relied on responding to emerging variants after their detection, leading to delays in effective public health responses. Because of this, a long-standing yet challenging objective has been to forecast viral evolution by predicting potentially harmful viral mutations prior to their emergence. The promises of artificial intelligence (AI) coupled with the exponential growth of viral data collection infrastructures spurred by the COVID-19 pandemic, have resulted in a research ecosystem highly conducive to this objective. Due to the COVID-19 pandemic accelerating the development of pandemic mitigation and preparedness strategies, many of the methods discussed here were designed in the context of SARS-CoV-2 evolution. However, most of these pipelines were intentionally designed to be adaptable across RNA viruses, with several strategies already applied to multiple viral species. In this review, we explore recent breakthroughs that have facilitated the forecasting of viral evolution in the context of an ongoing pandemic, with particular emphasis on deep learning architectures, including the promising potential of language models (LM). The approaches discussed here employ strategies that leverage genomic, epidemiologic, immunologic and biological information.}, } @article {pmid40235384, year = {2025}, author = {Li, C and Chen, F and Lü, S}, title = {[Current status and challenges of zoonosis prevention and control: a One Health perspective].}, journal = {Zhongguo xue xi chong bing fang zhi za zhi = Chinese journal of schistosomiasis control}, volume = {37}, number = {1}, pages = {98-103}, doi = {10.16250/j.32.1915.2024105}, pmid = {40235384}, issn = {1005-6661}, support = {NPRC-2019-194-30//National Parasite Resource Center/ ; H-2018072//Special Fund for the Training of High-Level Health and Medical Science and Technology Talents in Yunnan Province/ ; }, mesh = {*Zoonoses/prevention & control ; *One Health ; Humans ; Animals ; COVID-19/prevention & control ; Echinococcosis/prevention & control ; Rabies/prevention & control ; Schistosomiasis/prevention & control ; }, abstract = {Zoonosis prevention and control is a complex public health concern, which requires the collaboration of multiple regions, disciplines, and departments to enhance the effectiveness. The One Health concept aims to achieve the joint health security of humans, animals and environments through cross-disciplinary, cross-sector and cross-field collaborations. This review summarizes the development of One Health and the successful practices in the prevention and control of echinococcosis, rabies, COVID-19 and schistosomiasis, as well as explores the challenges faced in applying this concept to the prevention and control of zoonoses, so as to provide insights into formulation of the integrated zoonoses control strategy and implementation of zoonoses control interventions at the human-animal-environment interface.}, } @article {pmid40235373, year = {2025}, author = {Wei, C and Lin, Z and Yang, Z and Zhou, H and Zhou, X and Yang, R}, title = {[Malaria elimination strategy and joint prevention and control of malaria across China-Myanmar border areas: an overview].}, journal = {Zhongguo xue xi chong bing fang zhi za zhi = Chinese journal of schistosomiasis control}, volume = {37}, number = {1}, pages = {19-23}, doi = {10.16250/j.32.1915.2024281}, pmid = {40235373}, issn = {1005-6661}, mesh = {*Malaria/prevention & control/epidemiology ; Humans ; Myanmar/epidemiology ; China/epidemiology ; *Disease Eradication/methods ; }, abstract = {Yunnan Province borders with Myanmar, Vietnam, and Laos, the China-Myanmar border area is the key area for prevention of re-establishment from imported malaria after the disease was eliminated in China. Since the malaria elimination action plan was launched in Yunnan Province in 2011, 129 counties (cities, districts) were classified into three categories according to malaria incidence and transmission risk, and different technical strategies and measures were implemented with adaptations to local circumstances. A total of 68 malaria consultation service stations were established on the Chinese side of the China-Myanmar border and 80 malaria prevention and control stations were established on the Myanmar side by Yunnan Province in 2014. Then, the "Three Lines of Defense" strategy was implemented for malaria elimination in the China-Myanmar border area in Yunnan Province during the period from 2015 to 2018, and this strategy was further refined and adjusted to the "3 + 1" strategy for prevention of re-establishment from imported malaria in 2019. Through decades of multifaceted efforts, the malaria elimination goal was achieved in Yunnan Province in June 2021. However, the number of imported malaria cases appeared a tendency towards a rise in Yunnan Province in 2023 and 2024, due to changes in the situation in Myanmar and the gradual resumption of international travel and border crossings following the adjustment of the COVID-19 prevention and control policy in China. The joint malaria prevention and control cooperation between China and Myanmar was initiated with the pilot project for joint malaria prevention and control in the China-Myanmar border area in 2005, and this project was progressed into the joint malaria and dengue fever prevention and control project in parts of the Greater Mekong Subregion border areas in 2010. The threat of overseas malaria epidemics to border areas in Yunnan Province was effectively reduced through implementation of coordination meetings with Myanmar health departments, establishment of efficient information exchange mechanisms, establishment of overseas surveillance sentinel sites, technical training, provision of material supports, joint propagation activities and joint responses to malaria epidemics. This project was incorporated into the Five-Year Plan of Action on Lancang-Mekong Cooperation (2018-2022) in China in 2018, with 5 liaison offices and 20 liaison workstations established in Myanmar, Laos, Vietnam, Cambodia, and Thailand, and 21 cross-border malaria surveillance sites assigned in border areas of Myanmar, Laos and Vietnam, and a long-term malaria prevention and control cooperation mechanisms was established through meetings, training, propagation, and joint investigations. Currently, Yunnan Province is poised to engage in more extensive and in-depth cooperation with neighboring countries, including malaria diagnosis and treatment techniques, drug and vaccine research and development, talent cultivation, information sharing, cross-border human health services, and health promotion, under the guidance of the Five-Year Plan of Action on Lancang-Mekong Cooperation (2023-2027).}, } @article {pmid40234876, year = {2025}, author = {Ren, X and Liu, G and Zhou, J}, title = {Nuclear-activating miRNAs: unveiling the intricacies of subcellular miRNA function and regulation in cancer and immunity disease.}, journal = {Cancer cell international}, volume = {25}, number = {1}, pages = {147}, pmid = {40234876}, issn = {1475-2867}, support = {20-205-4-096//Shenyang Science and Technology Project of China/ ; }, abstract = {MicroRNAs (miRNAs) are small non-coding RNAs that traditionally recognized as negative regulators of gene expression through post-transcriptional regulation in the cytoplasm. However, recent discoveries have unveiled some novel miRNA functions in the cell nucleus, where a subset of miRNAs, termed nuclear-activating miRNAs (NamiRNAs), play pivotal roles in gene activation and transcriptional regulation for cancer and immunity disease. The discovery of NamiRNAs demonstrated a complementary regulatory function of miRNA, showing their differential activities in the nucleus and cytoplasm. This review aims to explore the biogenesis, mechanisms, and regulatory functions of NamiRNAs, deciphering their involvement in NamiRNA-gene network for gene expression modulation, and emerging significance as drug targets against cancer.}, } @article {pmid40234831, year = {2025}, author = {Cheuyem, FZL and Amani, A and Achangwa, C and Ajong, BN and Minkandi, CA and Zeh, MMMK and Ntsek, LLE and Essomba, JP and Jiogue, RC and Ndagijimana, O and Nchanji, NE and Danwang, C}, title = {COVID- 19 vaccine uptake and its determinants in Cameroon: a systematic review and meta-analysis (2021-2024).}, journal = {BMC infectious diseases}, volume = {25}, number = {1}, pages = {525}, pmid = {40234831}, issn = {1471-2334}, support = {001/WHO_/World Health Organization/International ; }, mesh = {Humans ; Cameroon/epidemiology ; *COVID-19/prevention & control/epidemiology ; *COVID-19 Vaccines/administration & dosage ; SARS-CoV-2/immunology ; *Vaccination Hesitancy/statistics & numerical data ; *Vaccination/statistics & numerical data ; Adult ; }, abstract = {BACKGROUND: COVID-19 vaccination is crucial for mitigating the pandemic's impact. However, vaccine hesitancy and access challenges have hindered global vaccination efforts. This meta-analysis aimed to estimate the pooled COVID-19 vaccine uptake proportion and identify associated determinants in Cameroon.

METHODS: This review, conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, identified articles through searches of electronic databases, including PubMed, ScienceDirect, and Google Scholar, as well as through gray literature. The search encompassed published and unpublished studies from 2021 to 2024 reporting on COVID-19 vaccine uptake and/or acceptance in Cameroon. Extracted data were compiled in a Microsoft Excel spreadsheet and analyzed using R statistical software (version 4.4.2). A random-effects model was employed when heterogeneity exceeded 50%. Publication bias was assessed using funnel plots, Egger's and Begg's tests. Meta-regression was used to explore the influence of study characteristics.

RESULTS: Twenty-two studies, encompassing 24,130 participants, were included. The pooled vaccine uptake proportion was 37.14% (95% CI: 29.24-45.05) with substantial heterogeneity (I[2] = 98.2%, p < 0.001). Subgroup analyses revealed lower uptake among the general population (23.18%; 95% CI: 10.11-36.25) and in community settings (16.0%; 95% CI: 0.97-31.04) compared with healthcare workers (42.12%; 95% CI: 34.14-50.09). Younger age (OR = 0.53; 95% CI: 0.42-0.67) was inversely associated with vaccine uptake, while being in a partnership (OR = 1.59; 95% CI: 1.11-2.27) was positively associated. Higher levels of education (OR = 1.75; 95% CI: 1.56-1.97), urban residence (OR = 1.66; 95% CI: 1.21-2.29) were positively associated with vaccine acceptance.

CONCLUSION: This meta-analysis revealed a suboptimal pooled COVID-19 vaccine uptake required to ensure a herd immunity. The results of this meta-analysis underline the crucial need to step up efforts to improve vaccination coverage, particularly among the most vulnerable populations. Identifying and addressing the factors underlying this low coverage is imperative if public health objectives are to be met. Public health interventions should be tailored to address the specific concerns and needs of different age groups and marital statuses.}, } @article {pmid40234308, year = {2025}, author = {Suhr, M and Keese, M}, title = {The Role of Virtual Physical Therapy in the Management of Musculoskeletal Patients: Current Practices and Future Implications.}, journal = {Current reviews in musculoskeletal medicine}, volume = {18}, number = {8}, pages = {289-301}, pmid = {40234308}, issn = {1935-973X}, abstract = {PURPOSE OF REVIEW: The rapid evolution of virtual technology and artificial intelligence (AI), combined with physical distancing limitations imparted by the COVID- 19 pandemic, has hastened the shift of healthcare toward digitally enabled practitioners. As physical therapy embraces virtual care, its impact is far-reaching across stakeholders, affecting patients, providers, and payors. This article seeks to explore the role of virtual physical therapy (VPT) in managing patients with musculoskeletal (MSK) conditions and its impact on healthcare and patient outcomes.

RECENT FINDINGS: While research on VPT is growing, high-quality studies remain limited due to challenges in conducting blinded, randomized controlled trials, sponsor bias, and the diversity of digital solutions that complicate comparative studies. Nevertheless, general literature trends show that VPT, particularly when guided by a physical therapist, can yield improvements in pain and function comparable to in-person therapy. VPT demonstrates fair to excellent reliability and validity across key assessment areas, successfully identifying MSK diagnoses and delivering outcomes similar to conventional treatment for pain, function, and quality of life across multiple MSK disorders. Additionally, VPT addresses adherence issues by reducing travel, costs, and exposure risks, while technology enhancements foster patient engagement and communication with therapists. By increasing access and adherence to PT, VPT has the potential to optimize outcomes and curb long-term healthcare costs by preventing progression to more expensive interventions. Virtual care harnesses technology to advance musculoskeletal care by improving access, enhancing patient-provider communication and connection, and optimizing patient engagement and outcomes. VPT moves beyond replication of the in-person experience to an enhanced patient journey. This journey taps into technological advancements to deliver a more integrated experience that engages and supports the patient. VPT offers a sophisticated model of care from the therapist, emphasizing evidence-based practice and critical thinking.}, } @article {pmid40234304, year = {2025}, author = {Boulton, AJM and Jenkins, AJ and Makkar, B and Mankovsky, B and Abera, MA and Tesfaye, S}, title = {Diabetes and natural and man-made disasters: prevention, preparation, response and recovery.}, journal = {Diabetologia}, volume = {}, number = {}, pages = {}, pmid = {40234304}, issn = {1432-0428}, abstract = {Both the global prevalence of diabetes and the frequency of natural and man-made disasters are increasing. Of all chronic diseases, the consequences of sudden loss of medical supplies are most serious for those with diabetes, with people living with type 1 diabetes being at risk of death within a few days without insulin. This review considers how to prepare for and respond to sudden reductions in medical supplies to those with diabetes. Recent experiences with the COVID-19 pandemic in India, the war in Ukraine and the war/blockade in the Tigray region of Ethiopia are described, and the importance of prevention, preparedness, response and recovery are discussed. It is hoped that lessons from these and other disasters and ongoing advocacy and other actions may help to mitigate the risks of significant morbidity and mortality for people with diabetes in disaster-impacted regions across the world.}, } @article {pmid40233916, year = {2025}, author = {Pan, M and Cao, W and Zhai, J and Zheng, C and Xu, Y and Zhang, P}, title = {mRNA-based vaccines and therapies - a revolutionary approach for conquering fast-spreading infections and other clinical applications: a review.}, journal = {International journal of biological macromolecules}, volume = {309}, number = {Pt 4}, pages = {143134}, doi = {10.1016/j.ijbiomac.2025.143134}, pmid = {40233916}, issn = {1879-0003}, mesh = {Humans ; *COVID-19/prevention & control/immunology ; SARS-CoV-2/immunology ; *COVID-19 Vaccines/immunology/genetics/therapeutic use ; *RNA, Messenger/genetics/immunology/therapeutic use ; *Vaccines, Synthetic/immunology/genetics ; mRNA Vaccines ; }, abstract = {Since the beginning of the COVID-19 pandemic, the development of messenger RNA (mRNA) vaccines has made significant progress in the pharmaceutical industry. The two COVID-19 mRNA vaccines from Moderna and Pfizer/BioNTech have been approved for marketing and have made significant contributions to preventing the spread of SARS-CoV-2. In addition, mRNA therapy has brought hope to some diseases that do not have specific treatment methods or are difficult to treat, such as the Zika virus and influenza virus infections, as well as the prevention and treatment of tumors. With the rapid development of in vitro transcription (IVT) technology, delivery systems, and adjuvants, mRNA therapy has also been applied to hereditary diseases such as Fabry's disease. This article reviews the recent development of mRNA vaccines for structural modification, treatment and prevention of different diseases; delivery carriers and adjuvants; and routes of administration to promote the clinical application of mRNA therapies.}, } @article {pmid40233885, year = {2025}, author = {Wu, H and Weng, R and Li, J and Huang, Z and Tie, X and Li, J and Chen, K}, title = {Self-Assembling protein nanoparticle platform for multivalent antigen delivery in vaccine development.}, journal = {International journal of pharmaceutics}, volume = {676}, number = {}, pages = {125597}, doi = {10.1016/j.ijpharm.2025.125597}, pmid = {40233885}, issn = {1873-3476}, mesh = {Humans ; *Nanoparticles/chemistry/administration & dosage ; Animals ; *Vaccine Development/methods ; COVID-19/prevention & control/immunology ; *COVID-19 Vaccines/administration & dosage/immunology ; *Antigens/administration & dosage/immunology ; Drug Delivery Systems ; Adjuvants, Immunologic/administration & dosage ; SARS-CoV-2/immunology ; *Vaccines/administration & dosage ; *Proteins/chemistry/administration & dosage ; }, abstract = {Nanoparticle vaccines can efficiently and repeatedly display multivalent antigens, thereby improving the targeted delivery of antigens and inducing more durable immune responses, making them an important representative of novel vaccines. The global COVID-19 pandemic has accelerated the development of nanoparticle vaccines, offering a promising solution for the prevention and control of infectious diseases. Currently, the development of nanoparticle vaccines involves the use of various types of nanoparticles, including liposomes, polymers, inorganic materials, and emulsions. Protein nanoparticles candidate vaccines are attracting increasing attention because of their unique antigen presentation methods and self-assembly characteristics during their development, leading to a broad consensus on their promising future. Naturally self-assembling protein nanoparticles, such as ferritin, enhance antigen presentation, which aids in the activation of both humoral and cellular immune responses. This has led to significant advancements in the study of hepatitis B virus. Meanwhile, some synthetically engineered protein nanoparticles, such as mi3, and I53-50, can induce higher antibody titers through chemical conjugation with the SpyTag-SpyCatcher system, thereby providing better immunoprotection and showing promising prospects in the prevention of H1N1 and H3N2 influenza virus infections. This article reviews the unique advantages of protein nanoparticles as antigen delivery platforms, progress made in immunological design mechanisms, advances in the application of related adjuvants in preclinical and clinical trials, and the performance of commonly used computationally designed protein nanoparticles in preclinical trials, with a particular emphasis on the progress in the application of cationic nanoparticle vaccines. The aim is to provide future researchers with effective adjuvant strategies and high-quality selections for computationally designed protein nanoparticles, thereby promoting the clinical trial process of protein nanoparticles vaccines.}, } @article {pmid40233794, year = {2025}, author = {Zwicklbauer, K and Bergmann, M and Alberer, M and von Both, U and Hartmann, K}, title = {[Feline infectious peritonitis - a current overview].}, journal = {Tierarztliche Praxis. Ausgabe K, Kleintiere/Heimtiere}, volume = {53}, number = {2}, pages = {96-102}, doi = {10.1055/a-2524-3760}, pmid = {40233794}, issn = {2567-5842}, mesh = {Animals ; *Feline Infectious Peritonitis/virology/diagnosis/therapy/drug therapy/epidemiology ; Cats ; *Coronavirus, Feline/genetics/pathogenicity ; Antiviral Agents/therapeutic use ; }, abstract = {Coronaviruses (CoVs) are positive, single-stranded RNA viruses that can infect various animal species as well as humans. Particularly relevant for cats is the feline coronavirus (FCoV), which is widespread in cat populations worldwide. Infection with FCoV is usually asymptomatic. However, in multi-cat households, approximately 5-12% of FCoV-infected cats develop feline infectious peritonitis (FIP) due to mutations in the spike gene. FIP is an immune-mediated disease that previously was always fatal. These mutations result in a tropism shift from enterocytes to monocytes and macrophages. The associated change in the virulence of FCoV leads to the characteristic granulomatous vasculitis and perivasculitis observed in FIP. Recently, significant advancements have been made in understanding FIP. Studies show that antiviral drugs used in human medicine, such as the nucleoside analog GS-441524, are effective against FIP and can provide affected cats with a survival chance of up to 100%. Additionally, a novel FCoV variant, FCoV-23, has been identified in cats from Cyprus. According to newest research, this virus arose through a recombination between FCoV and the highly virulent pantropic canine coronavirus; it can be directly transmitted from cat to cat and lead to FIP. Furthermore, increasing evidence suggests that FIP is frequently associated with myocarditis. This article provides an overview of the current knowledge on FIP, including its pathology, clinical signs, effective treatment options, and preventive measures.}, } @article {pmid40233451, year = {2025}, author = {Yao, Z and Feng, Z and Zhang, H and Zhang, B}, title = {ScRNA-Seq reveals T cell immunity in COVID-19 patients and implications for immunotherapy.}, journal = {International immunopharmacology}, volume = {155}, number = {}, pages = {114663}, doi = {10.1016/j.intimp.2025.114663}, pmid = {40233451}, issn = {1878-1705}, mesh = {Humans ; *COVID-19/immunology/therapy ; *SARS-CoV-2/immunology ; Single-Cell Analysis ; *Immunotherapy/methods ; *T-Lymphocytes/immunology ; RNA-Seq ; Single-Cell Gene Expression Analysis ; }, abstract = {SARS-CoV-2, the virus causing COVID-19, poses significant health threats due to its high transmissibility and potential for severe respiratory complications. T cells, central to adaptive immunity, also interact with innate immunity, playing a pivotal role in coordinating defenses and eliminating infected cells. Single-cell RNA sequencing (scRNA-seq) has provided more subtle heterogeneity, rare subpopulations, or new subpopulations that are at the district differentiation stage or with specific function. Thus, elucidating how T cell heterogeneity impacts COVID-19 disease severity remains a critical question requiring comprehensive analysis. This review revealed the heterogeneity of the host T cells, including conventional T cells (CD8[+], CD4[+] T cells) and unconventional T cells, including natural killer T (NKT) cells, mucosal-associated invariant T (MAIT) and gamma-delta T (γδT) cells in COVID-19 patients with different clinical manifestations. Severe COVID-19 had marked lymphopenia, excessive activation, elevated exhaustion and reduced functional diversity of T cells. Pathogenic contributions arise from dysregulated cytotoxic T cells, Treg cells and unconventional T cells collectively driving systemic hyperinflammation and tissue injury. Current therapeutic strategies targeting T cells-such as enhancing virus-specific T cell responses, reverting T-cell exhaustion and alleviating inflammation-exhibit inconsistent efficacy, underscoring the need for combinatorial approaches. This review highlights how scRNA-seq deciphers T cell heterogeneity and dysfunction in COVID-19. By targeting T cell exhaustion, inflammation, and subset-specific deficits, these insights pave the way for therapies and vaccines.}, } @article {pmid40232102, year = {2025}, author = {Lin, D and Chen, W and Lin, Z and Liu, L and Zhang, M and Yang, H and Liu, Z and Chen, L}, title = {Viral Transmission in Sea Food Systems: Strategies for Control and Emerging Challenges.}, journal = {Foods (Basel, Switzerland)}, volume = {14}, number = {6}, pages = {}, pmid = {40232102}, issn = {2304-8158}, abstract = {The SARS-CoV-2 pandemic had widespread and severe impacts on both the global economy and human health. Facing the continuously mutating virus, this crisis has heightened concerns among consumers and businesses regarding viral transmission through seafood, particularly in the face of emerging, unknown viruses, underscoring our preparedness gaps. This review provides a succinct overview of the survival mechanisms of prevalent viruses in seafood, examines potential transmission pathways to humans during seafood processing, and discusses strategies for mitigating their spread throughout the seafood supply chain. Furthermore, the discussion highlights emerging trends in innovative antiviral technologies aimed at enhancing food safety. Person-to-person transmission remains the most likely source of infection within the supply chain. Therefore, it is still imperative to adhere to the implementation of standard processes, namely good manufacturing practices (GMP) and good hygiene practices (GHP), in the seafood business. In light of the significant losses caused by this crisis and the persistent presence of various viruses within the seafood supply chain, efforts are needed to implement predictive and preventive measures against potential emerging viruses. Future research should focus on monitoring and limiting viral transmission by integrating Industry 4.0 applications, smart technologies, and antiviral packaging, maximizing the potential of these emerging solutions.}, } @article {pmid40231930, year = {2025}, author = {Jackson, A and Lewis-Lloyd, CA and Merotohun, O and Crooks, CJ and Humes, DJ}, title = {Venous thromboembolism risk in the postoperative interval during the COVID-19 pandemic: meta-analysis.}, journal = {BJS open}, volume = {9}, number = {2}, pages = {}, pmid = {40231930}, issn = {2474-9842}, mesh = {Humans ; *COVID-19/epidemiology/complications ; *Venous Thromboembolism/epidemiology/etiology ; *Postoperative Complications/epidemiology ; Incidence ; SARS-CoV-2 ; Risk Factors ; }, abstract = {BACKGROUND: During the COVID-19 pandemic, global trends emerged, indicating increased venous thromboembolism (VTE) incidence among postoperative patients, potentially attributable to perioperative COVID-19 infection. However, there are insufficient data on VTE incidence among postoperative patients in the context of the pandemic. The aim of this study was to examine the global incidence of postoperative VTE during the COVID-19 pandemic.

METHODS: A systematic search of MEDLINE and Embase databases, as well as three other registered databases, was conducted from 1 January 2019 to 3 November 2023, with pre-registration in PROSPERO, the international prospective register of systematic reviews (CRD42023460464). Any study reporting patients aged ≥18 years undergoing surgery during the COVID-19 pandemic was included. Outcomes were aggregated absolute and unadjusted relative risks, plus incidence rates per 1000 person-years, of 30- or 90-day postoperative VTE in patients operated on before or during the COVID-19 pandemic and those with or without perioperative COVID-19 infection during the pandemic.

RESULTS: Of 5943 studies, 17 were available for meta-analysis, reporting on 3 035 037 patients. VTE incidence rates in perioperative COVID-19-positive compared with COVID-19-negative patients were significantly higher after total joint arthroplasty (244 (95% c.i. 110 to 541) versus 71 (95% c.i. 47 to 108) per 1000 person-years), other orthopaedic surgery (253 (95% c.i. 240 to 266) versus 138 (95% c.i. 84 to 229) per 1000 person-years), and emergency general and gastrointestinal surgery (474 (95% c.i. 226 to 995) versus 97 (95% c.i. 61 to 157) per 1000 person-years). No significant differences in VTE rates were reported in studies comparing pre-pandemic and pandemic VTE incidence rates.

CONCLUSION: There were consistent increased VTE rates in perioperative COVID-19-positive patients, particularly those undergoing orthopaedic surgery, and emergency general and gastrointestinal surgery. Further investigation is required to delineate postoperative VTE risk and how it varies by COVID-19 variant and vaccination to inform future practice.}, } @article {pmid40231656, year = {2025}, author = {Phillips, B and Abbott, C and Breit, S and St Onge, E}, title = {Olezarsen for the Treatment of Familial Chylomicronemia Syndrome.}, journal = {The Annals of pharmacotherapy}, volume = {59}, number = {11}, pages = {1031-1036}, doi = {10.1177/10600280251332500}, pmid = {40231656}, issn = {1542-6270}, mesh = {Humans ; *Hyperlipoproteinemia Type I/drug therapy/blood ; Apolipoprotein C-III/genetics ; *Oligonucleotides/therapeutic use/adverse effects/pharmacology ; *Oligonucleotides, Antisense/adverse effects/therapeutic use/administration & dosage ; Triglycerides/blood ; }, abstract = {OBJECTIVE: This review aims to evaluate the efficacy and safety of olezarsen (Tryngolza) in treating familial chylomicronemia syndrome (FCS), a rare genetic disorder characterized by severe hypertriglyceridemia.

DATA SOURCES: A comprehensive literature search was conducted via PubMed from January 2022 to mid-March 2025, using keywords such as olezarsen, antisense oligonucleotide, triglyceride, hypertriglyceridemia, apolipoprotein C3 (APOC3), and cardiovascular.

Relevant English-language studies assessing the pharmacokinetics, pharmacology, efficacy, or safety of olezarsen were included. Data from the US Food and Drug Administration (FDA)-approved package insert were also reviewed.

DATA SYNTHESIS: Olezarsen is an antisense oligonucleotide targeting APOC3 mRNA, a key regulator of plasma triglyceride levels. It has been shown to significantly reduce triglyceride levels via APOC3 protein degradation. Clinical trials have demonstrated substantial reductions in triglyceride levels and APOC3, with minimal adverse events. Phase 2 and 3 trials showed consistent efficacy and safety profiles, with common adverse events including COVID-19 infection, abdominal pain, and diarrhea.Relevance to Patient Care and Clinical Practice in Comparison to Existing Drugs:Olezarsen offers a targeted and effective treatment for FCS, addressing limitations of traditional therapies such as fibrates, omega-3 fatty acids, and statins. Its novel mechanism of action and once-monthly dosing regimen may improve patient adherence, providing significant advancement in FCS management.

CONCLUSION AND RELEVANCE: Olezarsen represents a new treatment for FCS, offering a targeted approach to significantly reduce triglyceride levels. Its integration into clinical practice has the potential to transform the management of FCS; however, more studies are needed to firmly establish its role.}, } @article {pmid40231214, year = {2025}, author = {Serafini, RA and Frere, JJ and Giosan, IM and Nwaneshiudu, CA}, title = {SARS-CoV-2-induced sensory perturbations: A narrative review of clinical phenotypes, molecular pathologies, and possible interventions.}, journal = {Brain, behavior, & immunity - health}, volume = {45}, number = {}, pages = {100983}, pmid = {40231214}, issn = {2666-3546}, abstract = {BACKGROUND: The acute and post-acute sequelae of SARS-CoV-2 infection have been of great clinical interest since the inception of the COVID-19 pandemic. Despite a high prevalence of individuals with persistent symptoms, a wholistic view of the effects of SARS-CoV-2 on special sensory systems is lacking. Considering the significant impact of normal sensory function on quality of life, the goal of this review is to highlight unresolved issues related to SARS-CoV-2-associated insults to the sensory nervous system.

MAJOR FINDINGS: In this narrative review, we discuss the epidemiology of SARS-CoV-2-induced sensory perturbations, underlying pathological mechanisms, and possible therapeutic strategies across the olfactory, gustatory, somatosensory, visual, and auditory systems. Examined literature included studies with human biospecimens, human-derived cell lines, and naturally susceptible animal models, which highlighted evidence of persistent functional disruption in all sensory systems. SARS-CoV-2 infection was associated with persistent inflammation in the olfactory epithelium/bulb, somatosensory ganglia, and gustatory systems, long-term transcriptional perturbations in the sensory central nervous system and peripheral nervous system, and detectable degeneration/apoptosis in the gustatory and visual systems. Few studies have proposed evidence-based therapeutic strategies for attenuating specific sensory abnormalities after SARS-CoV-2 infection.

CONCLUSION: While the olfactory system, and to some extent the visual and somatosensory systems, have been more thoroughly investigated from symptomatology, behavioral and molecular perspectives, there is still an unmet need for the development of therapeutics to treat COVID-induced impairment of these systems. Further, additional attention must be placed on COVID-associated impairment of the gustatory, visual, and auditory systems, which lack detailed mechanistic investigations into their pathogenesis.}, } @article {pmid40231071, year = {2025}, author = {Zhao, X and Du, X and Bai, S and Zheng, P and Zhou, X and Wang, Z}, title = {Differences in depression prevalence among older adults in China before and during the COVID-19 pandemic: a systematic review and meta-analysis.}, journal = {PeerJ}, volume = {13}, number = {}, pages = {e19251}, pmid = {40231071}, issn = {2167-8359}, mesh = {Humans ; *COVID-19/epidemiology/psychology ; China/epidemiology ; Prevalence ; Aged ; *Depression/epidemiology ; Middle Aged ; SARS-CoV-2 ; Pandemics ; Female ; Male ; Aged, 80 and over ; }, abstract = {OBJECTIVE: Changes in the prevalence of depression during the COVID-19 (Coronavirus disease 2019) pandemic among older adults in China have not been systematically evaluated. We aimed to systematically summarize existing evidence to conduct a meta-analysis to quantify changes in the prevalence of depression before and during the COVID-19 pandemic.

METHODS: The PubMed, Web of Science, Scopus, Embase, PsycINFO, China National Knowledge Infrastructure (CNKI), WangFang Data, CQVIP, and China Biology Medicine disc (CBMdisc) databases were searched from January 1, 2017, to November 20, 2024. Studies reporting the prevalence of depression among Chinese individuals aged 60 or older using validated diagnostic tools were included. A random-effects model was applied to estimate pooled prevalence, with subgroup analyses performed by demographic and socio-economic factors. Relative risks (RR) were calculated to compare prevalence across different pandemic stages.

RESULTS: A total of 101 studies involving 264,758 participants were included. The pooled prevalence of depression among older adults was 25.8% (95% CI [21.7-29.9]) from 2017-2019 and 23.8% (95% CI [19.8-27.8]) from 2020-2023. During the early pandemic stage (January-April 2020), prevalence significantly decreased (RR = 0.849, P < .001) but increased in later stages, reaching 24.4% by 2021-2023. The prevalence of depression among older adults during the COVID-19 pandemic showed a significant increasing trend (P trend  < .001). Subgroup analyses revealed higher prevalence among females, rural residents, individuals with lower education levels, and those living alone.

CONCLUSION: Depression prevalence among older adults in China decreased during the early pandemic response but showed an increasing trend over time, reflecting the complex mental health impact of prolonged public health measures. Effective interventions are needed to address the specific needs of vulnerable subgroups during and beyond public health crises.}, } @article {pmid40228664, year = {2025}, author = {Gabizon, AA}, title = {Cancer nanomedicine from a clinician-scientist perspective: Lessons and prospects.}, journal = {Journal of controlled release : official journal of the Controlled Release Society}, volume = {382}, number = {}, pages = {113731}, doi = {10.1016/j.jconrel.2025.113731}, pmid = {40228664}, issn = {1873-4995}, mesh = {Humans ; *Nanomedicine/methods ; *Neoplasms/drug therapy ; Doxorubicin/analogs & derivatives/administration & dosage ; Nanoparticles ; Liposomes ; COVID-19 ; Animals ; Polyethylene Glycols ; }, abstract = {The nanomedicine field has progressed enormously in the last couple of decades. From a loose group of liposomologists, polymer scientists, chemical engineers, and experts in metal nanoparticles, mesoporous silica, and other nanomaterials, the field has gradually consolidated and has generated vast amounts of research and clinical data, but, until the development of lipid nanoparticle (LNP)-based vaccinations for Covid-19, has remained with low visibility in the clinic. Applications in the cancer field are the most frequently sought projects in nanomedicine. For the last 45 years, my clinical career has mingled with my research career focusing on ways to formulate drugs in liposomes to improve their safety and efficacy in cancer therapy. In this review, I will discuss my contribution to the development of pegylated liposomal doxorubicin and other cancer nanomedicines from my privileged position as a clinician and scientist.}, } @article {pmid40227513, year = {2025}, author = {Casazza, M and Bolz, M and Huemer, J}, title = {Telemedicine in ophthalmology.}, journal = {Wiener medizinische Wochenschrift (1946)}, volume = {175}, number = {7-8}, pages = {153-161}, pmid = {40227513}, issn = {1563-258X}, mesh = {*Telemedicine/trends/organization & administration ; Humans ; *Ophthalmology/trends ; COVID-19/epidemiology ; Pandemics ; Forecasting ; SARS-CoV-2 ; Eye Diseases/therapy/diagnosis ; }, abstract = {Since its beginnings in the 1970s, telemedicine has advanced extensively. Telemedicine is now more accessible and powerful than ever thanks to developments in medical imaging, Internet accessibility, advancements in telecommunications infrastructure, exponential growth in computing power, and related computer-aided diagnoses. This is especially true in the field of ophthalmology. With the COVID 19 pandemic serving as a catalyst for the widespread adoption and acceptance of teleophthalmology, new models of healthcare provision integrating telemedicine are needed to meet the challenges of the modern world. The demand for ophthalmic services is growing globally due to population growth, aging, and a shortage of ophthalmologists. In this review, we discuss the development and use of telemedicine in the field of ophthalmology and shed light on the benefits and drawbacks of teleophthalmology.}, } @article {pmid40227439, year = {2025}, author = {Ciuciulkaite, I and Herrmann, K and Lahner, H}, title = {[Importance of peptide receptor radionuclide therapy for the management of neuroendocrine tumours].}, journal = {Radiologie (Heidelberg, Germany)}, volume = {65}, number = {5}, pages = {371-380}, pmid = {40227439}, issn = {2731-7056}, mesh = {Humans ; *Neuroendocrine Tumors/radiotherapy ; *Octreotide/therapeutic use/analogs & derivatives ; *Radiopharmaceuticals/therapeutic use ; *Receptors, Somatostatin/metabolism ; *Receptors, Peptide ; *Radioisotopes/therapeutic use ; Organometallic Compounds/therapeutic use ; Lutetium/therapeutic use ; }, abstract = {Neuroendocrine tumours (NETs) are rare, heterogeneous neoplasms that often express somatostatin receptors (SSTRs). This allows targeted peptide receptor radionuclide therapy (PRRT) for NETs. PRRT is currently indicated as second- or third-line therapy for metastatic or unresectable, progressive, SSTR-positive NETs of grade (G) 1 or 2. Adequate bone marrow reserves as well as renal and hepatic function are required for PRRT. The most commonly used radiopharmaceutical for PRRT is [177]Lu-DOTA-TATE. PRRT prolongs progression-free and overall survival, reduces or stabilises tumour burden, and improves tumour symptoms and quality of life. Adverse events associated with PRRT are mostly mild and transient. Haemato- and nephrotoxicity are the most common toxicities following PRRT. The NETTER‑2 and COMPOSE trials are investigating PRRT with [177]Lu-DOTA-TATE/-TOC in G2 and G3 gastroenteropancreatic NETs.}, } @article {pmid40227096, year = {2025}, author = {Li, J and Zhou, J and Li, P and Wang, Y and Ridderhof, N and Al-Tawfiq, JA and Brouwer, WP and Chen, K and de Knegt, RJ and Peppelenbosch, MP and Hansen, BE and Engel, MFM and Zheng, MH and Memish, ZA and Eslam, M and Janssen, HLA and Pan, Q and Ayada, I}, title = {The global prevalence and impact of steatotic liver disease and viral infections: A systematic review and meta-analysis.}, journal = {Hepatology communications}, volume = {9}, number = {5}, pages = {}, pmid = {40227096}, issn = {2471-254X}, mesh = {Humans ; Prevalence ; *Fatty Liver/epidemiology/virology ; Coinfection/epidemiology ; *HIV Infections/epidemiology/complications ; *COVID-19/epidemiology/complications ; Global Health ; Hepatitis C/epidemiology ; Hepatitis B/epidemiology/complications ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Steatotic liver disease (SLD) affects ~30% of adults worldwide. The global population is continuously threatened by epidemic and endemic viral diseases. This study aims to thoroughly examine the interaction between SLD and major viral diseases.

METHODS: We systematically searched databases from inception to April 2, 2024, for observational studies recording viral-infected adult patients with eligible data on the presence of hepatic steatosis.

RESULTS: Six hundred thirty-six eligible studies were included in the analysis of SLD prevalence. Among patients with monoinfections, the highest SLD prevalence was observed in those infected with HCV at 49% (95% CI: 47%-51%), followed by SARS-CoV-2 (39%, 95% CI [34%-44%]), HIV (39%, 95% CI [33%-44%]), and HBV (36%, 95% CI [32%-40%]). Additionally, co-infections, such as HCV-HIV and HBV-HCV, exhibit even higher SLD prevalence. The prevalence of steatohepatitis is particularly high in HIV-infected (24%, 95% CI: 17%-30%) and HCV-infected (18%, 95% CI: 13%-24%) populations. The co-existence of SLD with viral infections was associated not only with the progression of liver disease but also with more severe outcomes of the infections and poorer responses to antiviral treatment. The combination of cardiometabolic risk factors and viral-associated and host factors contributes to the higher risk of SLD in viral-infected populations.

CONCLUSIONS: SLD is highly prevalent in viral-infected populations, and the reciprocal interactions between SLD and viral diseases exacerbate both conditions, leading to poorer patient outcomes in general.}, } @article {pmid40227027, year = {2025}, author = {Wetherell, W}, title = {Review of the Emergency Preparedness, Resilience, and Response Exercise Frequency of NHS Acute Trusts in England.}, journal = {Disaster medicine and public health preparedness}, volume = {19}, number = {}, pages = {e91}, doi = {10.1017/dmp.2025.99}, pmid = {40227027}, issn = {1938-744X}, mesh = {Humans ; England ; State Medicine/organization & administration/statistics & numerical data ; *Civil Defense/methods/statistics & numerical data/standards ; COVID-19/epidemiology ; *Disaster Planning/methods/statistics & numerical data/standards ; }, abstract = {OBJECTIVE: In England, the Civil Contingencies Act (Contingency Planning) Regulations 2005 require National Health Service (NHS) Trusts which provide hospital accommodation and services in relation to accidents or emergencies to conduct Emergency Preparedness, Resilience and Response (EPRR) exercises. The NHS England EPRR Framework specifies the minimum frequencies of these exercises. This review assessed the number of Trusts conducting exercises in accordance with these frequencies one year after the national NHS COVID-19 response was stepped down.

METHODS: The outcome of interest was the number of Trusts having a record of conducting their most recent exercises in accordance with the minimum frequencies required by the NHS England EPRR Framework.

RESULTS: Of the applicable 122 Trusts, 95 had a record of conducting a communication systems exercise, 115 had a record of conducting a table-top exercise, 106 had a record of conducting a live play exercise and 90 had a record of conducting a command post exercise in accordance with the minimum frequencies.

CONCLUSION: Over one fifth of Trusts did not have a record of conducting an EPRR communications systems exercise as required. This review may also be of interest to other state-level bodies which specify high level EPRR requirements to healthcare providers.}, } @article {pmid40226776, year = {2025}, author = {Zhu, Y and Sun, L and Guan, S and Li, R and Yang, J and Cao, Y and Zhang, L and Li, T and Zhang, H and Bueber, M and Hall, BJ and Phillips, MR and Li, C}, title = {Evolving role of the internet in China as a medium for promoting psychological well-being and mental health: a scoping review.}, journal = {The Lancet regional health. Western Pacific}, volume = {56}, number = {}, pages = {101515}, pmid = {40226776}, issn = {2666-6065}, abstract = {The rapid development of China's 5G 'Internet Plus' industry has led to increasing use of the Internet to provide healthcare services. Internet-based services in China are already widely used to prevent, identify, monitor, and manage mental disorders, but few of these services have been formally evaluated. To provide a clear baseline of this rapidly evolving field, we searched articles published before December 31, 2022, about internet-based interventions and surveys for mental health-related conditions in China in five international databases (Web of Science, PubMed, PsycINFO, Embase, and Cochrane Library) and four Chinese databases (CNKI, SinoMed, VIP, and WanFang). The 143 identified studies-54 in Chinese and 89 in English-described internet-based interventions and surveys in individuals with mental disorders, community residents, college students, older adults, pregnant women, and health professionals. The number of identified studies, which were mainly conducted in economically developed regions of the country, quadrupled after the 2019 onset of the COVID-19 pandemic. Available studies suggest-but do not prove-that internet-based interventions can reduce the severity of psychiatric symptoms, decrease healthcare costs, and improve the quality of life for individuals with mental disorders. Innovative smartphone applications could potentially improve the quality and expand the scope of internet-based interventions, making them a key component in ongoing efforts to prevent and monitor mental illness, enhance the self-management of mental disorders, and alleviate psychological distress among adolescents and other at-risk populations. However, achieving this long-term goal will require establishing standardised methods of administering internet-based interventions, training mental health professionals to implement and monitor the interventions, identifying methods of maintaining the confidentiality of collected information, and rigorously assessing the effectiveness of the interventions based on periodic assessment of uniform outcome measures. Clinical and policy research about expanding internet-based mental health interventions should focus on confidentiality, efficacy, and cost-effectiveness.}, } @article {pmid40226433, year = {2025}, author = {Abou Mansour, M and El Rassi, C and Sleem, B and Borghol, R and Arabi, M}, title = {Thromboembolic Events in the Era of COVID-19: A Detailed Narrative Review.}, journal = {The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale}, volume = {2025}, number = {}, pages = {3804576}, pmid = {40226433}, issn = {1712-9532}, abstract = {COVID-19, caused by the SARS-CoV-2 virus, is not only characterized by respiratory symptoms but is also associated with a wide range of systemic complications, including significant hematologic abnormalities. This is a comprehensive review of the current literature, using PubMed and Google Scholar, on the pathophysiology and incidence of thromboembolic events in COVID-19 patients and thromboprophylaxis. COVID-19 infection induces a prothrombotic state in patients through the dysregulation of the renin-angiotensin-aldosterone system (RAAS), endothelial dysfunction, elevated von Willebrand factor (vWF), and a dysregulated immune response involving the complement system and neutrophil extracellular traps (NETs). As a result, thromboembolic complications have emerged in COVID-19 cases, occurring more frequently in severe cases and hospitalized patients. These thrombotic events affect both venous and arterial circulation, with increased incidences of deep venous thrombosis (DVT), pulmonary embolism (PE), systemic arterial thrombosis, and myocardial infarction (MI). While DVT and PE are more common, the literature highlights the potential lethal consequences of arterial thromboembolism (ATE). This review also briefly examines the ongoing discussions regarding the use of anticoagulants for the prevention of thrombotic events in COVID-19 patients. While theoretically promising, current studies have yielded varied outcomes: Some suggest potential benefits, whereas others report an increased risk of bleeding events among hospitalized patients. Therefore, further large-scale studies are needed to assess the efficacy and safety of anticoagulants for thromboprophylaxis in COVID-19 patients.}, } @article {pmid40226161, year = {2025}, author = {Etesami, I and Ansari, MS and Pourgholi, E and Heidari, S and Rafati, A and Bahramian, S and Danaei, B and Demokri, S and Fazeli, P and Memari, H and Mirzaee Godarzee, H and Sadeghi, B and Vahabi, SM}, title = {Drug- and Vaccine-Induced Cutaneous T-Cell Lymphoma: A Systematic Review of the Literature.}, journal = {Journal of skin cancer}, volume = {2025}, number = {}, pages = {3103865}, pmid = {40226161}, issn = {2090-2905}, abstract = {Cutaneous T-cell lymphomas (CTCLs) are a type of non-Hodgkin lymphoma that usually involves the skin. It has different subtypes including mycosis fungoides (MFs), Sézary syndrome (SS), primary cutaneous anaplastic large lymphoma (PC-ALCL), lymphomatoid papulosis (LyP), and subcutaneous panniculitis-like T-cell lymphoma (SPTCL). There are several reports of incidence, relapse, or progression of CTCLs by using specific drugs. We aim to identify drug- and vaccine-induced CTCL characteristics. A systematic search was conducted using MeSH terms/keywords: CTCL and drug-induced or drug-associated or vaccine-associated or vaccine induced through PubMed/Medline, Scopus, Web of Science, and Embase until May 10, 2024. Out of 14,031 papers, 60 articles were included, involving 71 patients with a mean age of 53.5 ± 17 years. Among them, 52.1% were male. Medications were categorized into four groups: conventional, biologics, small molecules, and vaccines. The most frequently reported medications in the first group were fingolimod (n = 8) and methotrexate (n = 7). Infliximab (n = 6) and etanercept (n = 5) were the most commonly reported biologics. Pfizer-BioNTech (n = 11) vaccine and JAK inhibitors (n = 3) were the most reported vaccine and small molecules. LyP (n = 17) was the most frequently reported type of CTCL, followed by PC-ALCL (n = 13), MF (n = 11), SS (n = 8), and SPTCL (n = 8). The most common underlying conditions were rheumatoid arthritis (n = 15) and multiple sclerosis (n = 10). Twenty patients (28%) experienced disease regression after discontinuing the drug, with a mean ± SD of 8.6 ± 8.8 weeks. In 14 patients (20%), chemotherapy and/or radiotherapy were initiated. Six patients passed away after being diagnosed with CTCL: two because of CTCL recurrence and four because of other complications. It is important recognizing CTCL as a possible, although rare, adverse effect of certain drugs and vaccines, and taking a history of vaccinations, especially COVID-19 vaccines, and immunosuppressive drugs such as fingolimod, TNF-a inhibitors, and methotrexate.}, } @article {pmid40225829, year = {2025}, author = {Maglione, MA and Klausner, JD and Wirnkar, PK and Fallarme, I and Lak, R and Sysawang, K and Fu, N and Yagyu, S and Motala, A and Tolentino, D and Hempel, S}, title = {A Rapid Systematic Review of U.S. Food and Drug Administration-Authorized COVID-19 Treatments.}, journal = {Open forum infectious diseases}, volume = {12}, number = {4}, pages = {ofaf097}, pmid = {40225829}, issn = {2328-8957}, abstract = {BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic era saw numerous treatments authorized for emergency use by the United States (US) Food and Drug Administration (FDA). The purpose of the review was to determine if convalescent plasma, antivirals, or monoclonal antibodies are associated with serious adverse events (SAEs) and, if so, which specific populations are at risk.

METHODS: PubMed, ClinicalTrials.gov, and the FDA submission database were searched through December 2023, and the Infectious Diseases Society of America guidelines, international COVID Network Meta-analysis database, and systematic reviews were reference mined to identify controlled studies with at least 1 US site. Reviewers abstracted study characteristics, number of patients experiencing each type of SAE, and methods of adverse event collection and reporting.

RESULTS: Fifty-four studies met inclusion criteria, including 31 randomized controlled trials. We found insufficient evidence of association of any SAE with antivirals and spike protein receptor-binding antibodies. In patients hospitalized with COVID-19, the monoclonal antibody tocilizumab, an interleukin 6 inhibitor, may be associated with elevated risk of neutropenia (moderate certainty) and infection (limited certainty). Convalescent plasma may be associated with thrombotic events (limited certainty) as well as bleeding events and infection in patients with hematologic cancers (moderate certainty). Inclusion of studies without a US site could potentially change the findings.

CONCLUSIONS: Severe COVID-19 infection may have serious consequences, especially in hospitalized patients with comorbidities. These consequences may be confused with toxicities of the interventions. Based on our analysis, approved treatments for COVID-19 should be prescribed as clinically indicated, although continued vigilance is warranted to identify rare and potentially significant toxicities that may arise in clinical practice.

CLINICAL TRIALS REGISTRATION: PROSPERO (CRD42023467821).}, } @article {pmid40225770, year = {2025}, author = {Joshi, KM and Salve, S and Dhanwade, D and Chavhan, M and Jagtap, S and Shinde, M and Holkar, R and Patil, R and Chabukswar, V}, title = {Advancing protein biosensors: redefining detection through innovations in materials, mechanisms, and applications for precision medicine and global diagnostics.}, journal = {RSC advances}, volume = {15}, number = {15}, pages = {11523-11536}, pmid = {40225770}, issn = {2046-2069}, abstract = {Protein biosensors are significant tools in modern diagnostics due to their exceptional sensitivity and specificity in detecting protein biomarkers critical for disease diagnosis, therapeutic monitoring, and biomedical research. Innovations in transduction methods, nanomaterials, and point-of-care system integration have spurred recent advancements in biosensor technology. This summary examines key developments in protein biosensors, focusing on their structure, applications, and future potential. Nanomaterial-enhanced electrochemical biosensors, such as graphene, polyaniline, and carbon nanotubes, offer improved signal transmission due to their large surface area and faster electron transfer rates. Label-free immunosensors activated with gold nanoparticles and MXene-based sensors capable of combined biomarker analysis for detecting ovarian cancer are notable examples. During the COVID-19 pandemic, colorimetric and fluorescence optical biosensors facilitated easier diagnostics. An example of this is the incorporation of SARS-CoV-2 detection technologies into mobile phones. Real-time, label-free tracking with molecular precision is now possible due to the development of new methods, such as CRISPR-based platforms and quartz crystal microbalance (QCM)-based biosensors. This advancement is crucial for effectively managing infectious diseases and cancer. Synthetic fluorescence biosensors increase diagnostics by improving the visualization of protein interactions and cellular communication. Despite these achievements, challenges related to scalability, sustainability, and regulatory compliance remain. Proposed solutions include sustainable biosensor manufacturing, artificial intelligence-enhanced analytics for efficacy evaluation, and multidisciplinary approaches to optimize interaction with decentralised diagnostic systems. This work demonstrates how protein biosensors can advance precision medicine and global health.}, } @article {pmid40225255, year = {2025}, author = {Ma, L and Ye, F}, title = {Effect of Isolation Measures on Nosocomial Infection Rates in Nursing Practice during COVID-19: A Meta-Analysis.}, journal = {Iranian journal of public health}, volume = {54}, number = {2}, pages = {297-308}, pmid = {40225255}, issn = {2251-6093}, abstract = {BACKGROUND: Nosocomial infections represent a critical challenge in nursing practice, particularly during the COVID-19 pandemic. Isolation measures have been implemented widely to curb the spread of infections within healthcare settings. We aimed to evaluate the effectiveness of isolation measures in reducing nosocomial infection rates in nursing practice during the COVID-19 pandemic.

METHODS: A systematic search was conducted using keywords such as "isolation measures," "nosocomial infection," and "COVID-19" and their combinations in international databases, focusing on articles published between 2020 and 2024. Data were analyzed using meta-analysis and a random effects model. Heterogeneity between studies was assessed with the I[2] test, and analyses were performed using STATA software.

RESULTS: The analysis of 8 selected articles with a total sample size of 10,532 individuals showed that the implementation of isolation measures significantly reduced nosocomial infection rates, with an average effect size of 0.58 (95% CI: 42.1-74.5).

CONCLUSION: Isolation measures are effective in reducing nosocomial infection rates in nursing practice during the COVID-19 pandemic. The findings support the continued use of these measures to enhance patient safety and control infection spread within healthcare facilities.}, } @article {pmid40225252, year = {2025}, author = {Akbari, H and Mohammadi, M and Hosseini, A}, title = {A Scientometric Perspective on Stigma Research in Medicine: A Bibliometric Review.}, journal = {Iranian journal of public health}, volume = {54}, number = {2}, pages = {346-360}, pmid = {40225252}, issn = {2251-6093}, abstract = {BACKGROUND: Stigma is a critical social determinant of health, influencing individuals' access to resources, quality of life, and overall well-being. Despite its significant implications, bibliometric studies on stigma in the medical field remain sparse. We provide a comprehensive scientometric analysis of stigma research in medicine over the past 30 years, highlighting trends, key focus areas, and evolving challenges.

METHODS: A bibliometric analysis was conducted using VOSviewer software, utilizing data from the Scopus database. The search included articles with the keyword "stigma*" in the title, published between 1992 and 2022, within the fields of Medicine, Nursing, and Professional Health. The initial search yielded 20,284 articles, narrowed down to 7,854 relevant publications for detailed analysis. Key metrics analyzed included co-authorship, co-occurrence of keywords, and co-citation patterns.

RESULTS: The analysis revealed a significant increase in stigma-related publications in the medical field, particularly since 2010, with a peak in 2022, largely driven by the COVID-19 pandemic. The research identified nine major keyword clusters, 40 associated diseases, and 36 target groups. Persistent diseases like HIV, mental illness, addiction, and cancer continue to be strongly associated with stigma.

CONCLUSION: The findings underscore the evolving nature of stigma research in medicine, with an increasing focus on intersecting stigmas and their persistent impact on public health. Future research should aim to develop comprehensive models and strategies to manage and reduce stigma, particularly for diseases with enduring stigmatic associations. Collaborative efforts among policymakers, healthcare providers, and society are crucial to address the social and economic consequences of stigma and improve health outcomes.}, } @article {pmid40225082, year = {2025}, author = {Liu, B and Xu, L and Wang, Y and Hao, C and Jiang, W}, title = {Understanding the unconventional reemergence of M. pneumoniae epidemics during the COVID-19 pandemic.}, journal = {Translational pediatrics}, volume = {14}, number = {3}, pages = {473-479}, pmid = {40225082}, issn = {2224-4344}, abstract = {Since the implementation of coronavirus disease 2019 (COVID-19) restrictions since 2020, the number of Mycoplasma pneumoniae (M. pneumoniae) infections in children has significantly decreased. However, after the end of the COVID pandemic, there has been a notable resurgence in M. pneumoniae infections, which is particularly unusual in terms of both the number of infections and their severity. The purpose of this article is to review the existing evidence and explore theories that underlying the epidemiological shifts of M. pneumoniae following the COVID-19 pandemic, and propose factors contributing to the unconventional resurgence of M. pneumoniae infections. Proposed factors include decline of M. pneumoniae immunity, circulation of different genetic types and emergence of new macrolide-resistant M. pneumoniae (MRMP) variants, immune dysregulation following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and others. Among these factors, the decline in M. pneumoniae immunity and the circulation of different genetic types are considered significant contributors. Further research in bacterial genomics and more robust immunology studies are needed to guide the prevention of M. pneumoniae infections and the allocation of healthcare resources. International cooperation and information sharing are crucial for understanding the epidemiological changes of M. pneumoniae. Further cross-regional collaboration is called to enhance our understanding of the scope of M. pneumoniae outbreaks and facilitate a collective response.}, } @article {pmid40224740, year = {2024}, author = {O' Regan-Hyde, M and Dalton-O Connor, C and Flynn, A and Murphy, A and McCarthy, VJC}, title = {Nurses' Experiences of the Caring Role during the COVID-19 Pandemic: A Scoping Review of Qualitative Research.}, journal = {Journal of nursing management}, volume = {2024}, number = {}, pages = {7147203}, pmid = {40224740}, issn = {1365-2834}, mesh = {Humans ; *COVID-19/nursing/epidemiology/psychology ; Qualitative Research ; *Nurse's Role/psychology ; Pandemics ; *Empathy ; *Nurses/psychology ; SARS-CoV-2 ; }, abstract = {AIMS: To synthesize the evidence on nurses' experiences of their caring role during the COVID-19 pandemic and identify emerging concepts that have affected nurses within the caring role in relation to (a) their professional lives and (b) their personal lives.

BACKGROUND: The concept of caring is central to the science and art of nursing practice, and fulfilment of the caring role is fundamental to the profession. The COVID-19 pandemic imposed unprecedented change globally transforming the caring role of the nurse. The WHO highlights that a well-supported workforce is paramount to emergency preparedness; therefore, understanding the experiences of the nurse's caring role during the COVID-19 crisis is paramount to practice in future healthcare crises.

METHODS: A scoping review. Data Sources. Studies published between January 2020 and November 2023 were identified from the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Coronavirus Database, PUBMED, PsycINFO, PsycArticles, Scopus, Web of Science, and SocINDEX. Reporting Method. The scoping review adhered to the Joanna Briggs Institute (JBI) Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Review (PRISMA-ScR) checklist.

RESULTS: The search identified 1,347 studies, subsequent review of title and abstract, resulted in 117 full-text papers for further eligibility screening, with a total of 52 studies being included in the scoping review. Findings were grouped thematically using the Braun and Clarke (2006) approach. The five distinctive themes that emerged were (a) emotional turmoil, (b) erosion of care, (c) relationships and solidarity, (d) expansion of role, and (e) professional growth.

CONCLUSION: During the COVID-19 pandemic, there was an evolutionary shift in the caring role of the nurse, on a trajectory from emotional turmoil to professional growth. The process followed a theoretical framework of transformative learning that could support nurses' capability and preparedness in their caring role for future inevitable extreme events and crisis in healthcare. Implications for Nursing Management. Mapping current knowledge of the unprecedented COVID-19 crisis from a nurse's professional and personal perspective purposefully aims to highlight gaps for future research, education, and policy and is paramount to emergency preparedness and a well-supported workforce in future healthcare crisis.}, } @article {pmid40223920, year = {2025}, author = {Ralston, MR and McCreath, G and Lees, ZJ and Salt, IP and Sim, MAB and Watson, MJ and Freeman, DJ}, title = {Beyond body mass index: exploring the role of visceral adipose tissue in intensive care unit outcomes.}, journal = {BJA open}, volume = {14}, number = {}, pages = {100391}, pmid = {40223920}, issn = {2772-6096}, abstract = {Obesity is a worldwide health crisis and poses significant challenges in critical care. Many studies suggest an 'obesity paradox', in which obesity, defined by body mass index (BMI), is associated with better outcomes. However, the inability of BMI to discriminate between fat and muscle or between visceral adipose tissue and subcutaneous adipose tissue, limits its prediction of metabolic ill health. We suggest that the 'obesity paradox' may be more reflective of the limitations of BMI than the protective effect of obesity. We explore the biological processes leading to visceral fat accumulation, and the evidence linking it to outcomes in critical illness. In the 'spillover' hypothesis of adipose tissue expansion, caloric excess and impaired expansion of storage capacity in the subcutaneous adipose tissue lead to accumulation of visceral adipose tissue. This is associated with a chronic inflammatory state, which is integral to the link between visceral adiposity, type 2 diabetes mellitus, and ischaemic heart disease. We review the current evidence on visceral adiposity and critical illness outcomes. In COVID-19, increased visceral adipose tissue, irrespective of BMI, is associated with more severe disease. This is mirrored in acute pancreatitis, suggesting visceral adiposity is linked to poorer outcomes in some hyperinflammatory conditions. We suggest that visceral adiposity's chronic inflammatory state may potentiate acute inflammation in conditions such as COVID-19 and acute pancreatitis. Further work is required to investigate other critical illnesses, especially sepsis and acute respiratory distress syndrome, in which current evidence is scarce. This may give further insights into pathophysiology and inform tailored treatment and nutrition strategies based on body fat distribution.}, } @article {pmid40223789, year = {2025}, author = {Leep-Lazar, K and Ma, C and Stimpfel, AW}, title = {Factors Associated With Intent to Leave the Nursing Profession in the United States: An Integrative Review.}, journal = {Research in nursing & health}, volume = {48}, number = {4}, pages = {429-440}, doi = {10.1002/nur.22465}, pmid = {40223789}, issn = {1098-240X}, support = {//National Institute for Occupational Safety and Health./ ; }, mesh = {Humans ; United States ; *Personnel Turnover/statistics & numerical data ; *Job Satisfaction ; *COVID-19/epidemiology ; *Intention ; Workplace/psychology ; Workload/psychology ; }, abstract = {The ongoing regional nursing shortages in the United States, exacerbated by the COVID-19 pandemic, compromise patient safety and quality. Additionally, an aging workforce coupled with an aging population requiring more nursing care services limits organizations' ability to adequately staff their facilities. Nurses' turnover from the profession has been studied less than organizational turnover, thus, the purpose of this integrative review is to identify factors associated with intention to leave the nursing profession in the United States. Using Whittemore and Knafl's (2005) guidelines for integrative review methods, we conducted systematic searches in CINAHL, PubMed, and Web of Science in July 2024. There were 39 peer-reviewed studies that met inclusion criteria. Synthesis of findings resulted in four individual and four work-level themes associated with intent to leave the nursing profession. Individual themes included individual beliefs, health and wellbeing, individual work experiences, and career stability. Work-level themes included job characteristics, job demands/workload, resources and support, and work environment. Notably, job-level factors (i.e., workload, work environment, and support) were associated with professional turnover intention, which suggests that nurses do not believe their experiences will improve at another nursing job. Gaps in the literature include studies with nationally representative samples, studies using validated measures of health, and qualitative studies conducted with the aim of understanding why nurses want to leave the profession. To promote retention of nurses at the professional and organizational level, organizations should measure and modify relevant job-level factors, and the protection of nurses' wellness should be a top organizational priority.}, } @article {pmid40222787, year = {2025}, author = {Gautam, G and Moradikor, N}, title = {Stress in specific population: Cognitive decline in aging, occupational challenges, strategies for medical professionals.}, journal = {Progress in brain research}, volume = {291}, number = {}, pages = {363-379}, doi = {10.1016/bs.pbr.2025.01.017}, pmid = {40222787}, issn = {1875-7855}, mesh = {Humans ; *Cognitive Dysfunction/psychology/etiology ; *Aging/psychology ; *COVID-19/psychology ; *Health Personnel/psychology ; Burnout, Professional/psychology ; *Occupational Stress/psychology ; *Stress, Psychological/psychology ; Mindfulness ; }, abstract = {Understanding cognitive decline and its contributing causes, such as stress, which presents differently in different groups, is crucial given the aging population's rapid growth. This chapter looks at how stress affects older persons' cognitive decline, with a particular emphasis on the difficulties faced by medical professionals in their line of work and how to lessen the consequences. The severity and course of cognitive decline differ from person to person and are impacted by factors such as lifestyle, medical history, and stress at work. The COVID-19 pandemic has made medical practitioners' already high demands even more precarious. Stress in underprivileged areas and among veterans emphasizes the negative effects of work-related stress on mental health even more. Techniques that improve psychological well-being and lessen burnout include resilience training, digital tools, supportive leadership, and mindfulness-based stress reduction (MBSR). Enhancing work-life balance and promoting a healthier work environment can be achieved by combining these interventions with organizational changes. Aging-related cognitive impairment necessitates a multimodal strategy that includes targeted stress reduction methods and organizational adjustments. Setting mental health as a top priority in healthcare settings promotes the wellbeing of staff members, enhances patient care, and improves healthcare results.}, } @article {pmid40222381, year = {2025}, author = {Amouzou, A and Barros, AJD and Requejo, J and Faye, C and Akseer, N and Bendavid, E and Blumenberg, C and Borghi, J and El Baz, S and Federspiel, F and Ferreira, LZ and Hazel, E and Heft-Neal, S and Hellwig, F and Liu, L and Maïga, A and Munos, M and Pitt, C and Shawar, YR and Shiffman, J and Tam, Y and Walker, N and Akilimali, P and Alkema, L and Behanzin, P and Binyaruka, P and Bhutta, Z and Blanchard, A and Blencowe, H and Bradley, E and Brikci, N and Caicedo-Velásquez, B and Costello, A and Dotse-Gborgbortsi, W and El Arifeen, S and Ezzati, M and Freedman, LP and Guillot, M and Hanson, C and Heidkamp, R and Huicho, L and Izugbara, C and Jiwani, SS and Kabiru, C and Kiarie, H and Kinney, M and Kirakoya-Samadoulougou, F and Lawn, J and Madise, N and Mady, GRM and Masquelier, B and Melesse, D and Nilsen, K and Perin, J and Ram, U and Romanello, M and Saad, GE and Sharma, S and Sidze, EM and Spiegel, P and Tappis, H and Tatem, AJ and Temmerman, M and Victora, CG and Villavicencio, F and Wado, Y and Waiswa, P and Wakefield, J and Walton, S and You, D and Chopra, M and Black, RE and Boerma, T}, title = {The 2025 report of the Lancet Countdown to 2030 for women's, children's, and adolescents' health: tracking progress on health and nutrition.}, journal = {Lancet (London, England)}, volume = {405}, number = {10488}, pages = {1505-1554}, doi = {10.1016/S0140-6736(25)00151-5}, pmid = {40222381}, issn = {1474-547X}, } @article {pmid40222324, year = {2025}, author = {De Gagne, JC and Randall, PS and Koppel, PD and Cho, E and Blackwood, ER and Kang, HS}, title = {Online learning in nursing education: A 21st century bibliometric analysis.}, journal = {Nurse education today}, volume = {151}, number = {}, pages = {106740}, doi = {10.1016/j.nedt.2025.106740}, pmid = {40222324}, issn = {1532-2793}, mesh = {*Bibliometrics ; *Education, Distance/trends ; Humans ; *Education, Nursing/trends/methods ; COVID-19/epidemiology ; }, abstract = {BACKGROUND: Online learning has become an integral part of nursing education, especially in response to the growing reliance on technology and the global transition to remote learning.

AIM: This study explored research outputs and impact, collaborative networks, and thematic trends in online learning within nursing education to guide future educational advancements.

METHODS: A bibliometric analysis was conducted using the Web of Science database to examine publications spanning from 2000 to August 2024. VOSviewer and Biblioshiny were utilized to assess publication trends, co-authorship, co-citation, and keyword co-occurrence, providing a comprehensive view of the research landscape. Descriptive statistics and visualizations were employed to enhance clarity and facilitate interpretation of key findings.

RESULTS: The dataset encompassed 703 institutions across 56 countries, demonstrating the global scope of online learning research in nursing education. Publication output grew steadily, reaching a peak of 111 articles in 2022 (17 % of the total). The United States led with 555 publications and 2669 citations, followed by Australia (n = 92), Canada (n = 62), and Iran (n = 45). Co-authorship analysis revealed dense regional networks, with the University System of Ohio and the University of North Carolina as central hubs, though international collaborations were sparse. Keyword co-occurrence analysis identified three primary thematic clusters: (1) the impact of the COVID-19 pandemic, (2) student engagement, readiness, and motivation, and (3) technological integration and pedagogical approaches.

CONCLUSIONS: This bibliometric analysis provides a comprehensive overview of online learning research in nursing education, highlighting its growth, thematic focus areas, and collaborative networks. The findings serve as a foundation for advancing evidence-based, inclusive, and innovative educational practices. Online learning is no longer a peripheral aspect of nursing education but a cornerstone for driving excellence, equity, and innovation. By addressing existing gaps and embracing emerging opportunities, stakeholders can reimagine nursing education to better prepare students for the challenges of modern healthcare.}, } @article {pmid40220931, year = {2025}, author = {Ji, C and Li, S and Hu, C and Liu, T and Huang, Q and Yang, M and Yang, M and Wang, Q and Li, A and Guo, D and Huang, Y and Yin, S and Feng, S}, title = {Traditional Chinese medicine as a promising choice for future control of PEDV.}, journal = {Virus research}, volume = {356}, number = {}, pages = {199572}, pmid = {40220931}, issn = {1872-7492}, mesh = {Animals ; *Porcine epidemic diarrhea virus/drug effects ; Swine ; *Medicine, Chinese Traditional/methods ; *Antiviral Agents/pharmacology/therapeutic use ; *Swine Diseases/virology/drug therapy/prevention & control ; *Coronavirus Infections/veterinary/drug therapy/virology/prevention & control ; *Drugs, Chinese Herbal/pharmacology/therapeutic use ; }, abstract = {Porcine epidemic diarrhea virus (PEDV) is the major agent of the recent outbreaks of diarrhea in piglets, which has caused huge economic losses to the global swine industry. Since traditional vaccine strategies cannot provide complete protection for piglets, the development of safe, effective, and economical antiviral drugs is urgently needed. For many years, traditional Chinese medicines (TCMs) have been broadly applied for viral infectious diseases, exhibiting advantages such as abundant resources, lower toxicity, and minimal drug resistance. Many Chinese herbal monomers, single herbal extracts derived from these traditional drugs, and Chinese herbal recipes exhibit significant anti-PEDV effects in vitro and/or in vivo by targeting multiple sites and perspectives, including inhibition of the viral life cycle, anti-inflammation effects, enhancement of the host immune response, modulation of reactive oxygen species, and apoptosis. However, to date, no review has been published on the anti-PEDV effects of TCM. Therefore, this review summarizes the current control strategies for PEDV and systematically analyses the research progress of TCMs against PEDV. Furthermore, the future directions including the integration of nanotechnology and artificial intelligence with TCMs are also discussed. This review will provide a valuable reference for future studies on TCMs in antiviral research.}, } @article {pmid40219885, year = {2025}, author = {Krotkiewicz, M and Szynkaruk, A and Stachyra, A}, title = {Digital transformation in healthcare management: from Artificial Intelligence to blockchain.}, journal = {Wiadomosci lekarskie (Warsaw, Poland : 1960)}, volume = {78}, number = {3}, pages = {578-583}, doi = {10.36740/WLek/202445}, pmid = {40219885}, issn = {0043-5147}, mesh = {*Artificial Intelligence ; Humans ; *Blockchain ; COVID-19 ; Big Data ; *Internet of Things ; Telemedicine ; *Delivery of Health Care/organization & administration ; Computer Security ; Pandemics ; }, abstract = {The digital transformation of healthcare is revolutionizing the management of medical institutions, improving operational efficiency, patient outcomes, and data security. With the increasing complexity of healthcare systems, the integration of cutting-edge technologies such as Artificial Intelligence. The COVID-19 pandemic significantly accelerated digital transformation, compelling healthcare institutions to adopt telemedicine, AI-assisted diagnostics, and cloud-based medical records to meet growing patient demands and resource constraints. The rapid digital transformation of healthcare is driven by advancements in Artificial Intelligence (AI), blockchain, the Internet of Things (IoT), and Big Data. This review article aims to analyze the objectives and implications of digital transformation in medical institutions, focusing on the integration of AI, blockchain, and IoT in hospital management. The methodological approach for this review article focuses on synthesizing existing literature to examine the role of Artificial Intelligence (AI), blockchain, the Internet of Things (IoT), and Big Data in the digital transformation of healthcare management. The integration of Artificial Intelligence (AI), Blockchain, Internet of Things (IoT), and Big Data has demonstrated significant improvements in healthcare management, enhancing efficiency, patient outcomes, and data security.}, } @article {pmid40219884, year = {2025}, author = {Kamińsk, PI and Rizvi, F and Trubalski, M and Kaczmarski, M and Bełżek, A and Żerebiec, M and Rupeć, Z and Saj, N and Zulfiqar, Z and Niezbecka-Zając, J}, title = {Bone mineral density and pandemic.}, journal = {Wiadomosci lekarskie (Warsaw, Poland : 1960)}, volume = {78}, number = {3}, pages = {571-577}, doi = {10.36740/WLek/202327}, pmid = {40219884}, issn = {0043-5147}, mesh = {Humans ; *Bone Density/physiology ; *COVID-19/complications/epidemiology ; *Osteoporosis/etiology/epidemiology ; SARS-CoV-2 ; Exercise ; Pandemics ; Depression/complications ; Sedentary Behavior ; }, abstract = {The COVID-19 pandemic has significantly impacted physical health, including bone mineral density (BMD). This review aims to explore the effects of various pandemic-related factors such as reduced physical activity, stress, depression, dietary changes, and SARS-CoV-2 infection on BMD. Methods involved analyzing studies that investigate the impact of these factors on bone health, including observational studies, systematic reviews, and meta-analyses. Results show that decreased physical activity, depression, and changes in diet lead to a reduction in BMD, particularly in the lumbar spine and femoral neck. SARS-CoV-2 infection and the use of corticosteroids are also associated with an increased risk of osteoporosis. Additionally, cytokine storms induced by the virus further exacerbate bone resorption. The review also highlights the complex interaction between obesity, sedentary behavior, and BMD, which may contribute to either increased BMD in certain areas or lead to a higher risk of fractures. The study suggests that the pandemic may have long-term effects on bone health, emphasizing the need for preventive strategies, including promoting physical activity, managing stress, and cautious use of medications like corticosteroids. Further research is needed to understand the long-term consequences and to develop therapeutic interventions aimed at mitigating the adverse skeletal effects of COVID-19 and its treatments. Understanding the lasting impact on bone health requires a comprehensive approach considering the multifactorial aspects of the pandemic's effect on human physiology.}, } @article {pmid40219044, year = {2025}, author = {Marchesi, N and Allegri, M and Bruno, GM and Pascale, A and Govoni, S}, title = {Exploring the Potential of Dietary Supplements to Alleviate Pain Due to Long COVID.}, journal = {Nutrients}, volume = {17}, number = {7}, pages = {}, pmid = {40219044}, issn = {2072-6643}, mesh = {Humans ; *Dietary Supplements ; *COVID-19/complications ; SARS-CoV-2 ; *Chronic Pain/etiology ; Analgesics/therapeutic use ; *Pain Management/methods ; Post-Acute COVID-19 Syndrome ; *Pain/etiology/drug therapy ; }, abstract = {Long COVID, characterized by persistent symptoms following COVID-19 infection, significantly impacts individuals' health and daily functioning due to fatigue and pain. Focusing on pain, this review addresses nociplastic and chronic pain conditions. Interventions designed to reduce inflammation, oxidative stress, and enhance vagal activity may offer a promising approach to managing post-pandemic pain. This review presents individual components of food supplements with demonstrated efficacy in one or more pain conditions, focusing on their proposed mechanisms and clinical activity in pain, including their use in post-COVID-19 pain when available. Many of these substances have a long history of safe use and may offer an alternative to long-term analgesic drug treatment, which is often associated with potential side effects. This review also explores the potential for synergistic effects when combining these substances with each other or with conventional analgesics, considering the advantages for both patients and the healthcare system in using these substances as adjunctive or primary therapies for pain symptoms related to long COVID. While preclinical scientific literature provides a mechanistic basis for the action of several food supplements on pain control mechanisms and signaling pathways, clinical experience, particularly in the field of long COVID-associated pain, is still limited. However, the reviewed literature strongly suggests that the use of food supplements in long COVID-associated pain is an attainable goal, provided that rigorous clinical trials are conducted.}, } @article {pmid40217931, year = {2025}, author = {Olesińska, W and Biernatek, M and Lachowicz-Wiśniewska, S and Piątek, J}, title = {Systematic Review of the Impact of COVID-19 on Healthcare Systems and Society-The Role of Diagnostics and Nutrition in Pandemic Response.}, journal = {Journal of clinical medicine}, volume = {14}, number = {7}, pages = {}, pmid = {40217931}, issn = {2077-0383}, abstract = {The COVID-19 pandemic has revealed deep vulnerabilities in healthcare systems and public health preparedness. This systematic review examines the effectiveness of epidemiological procedures, the role of diagnostics, and the influence of nutritional status on immune function and disease severity. A total of 88 studies were analyzed, encompassing diagnostics, micronutrient deficiencies (notably vitamin D, C, E, zinc, and selenium), and the psychosocial impact of the pandemic. The results underscore the importance of integrated strategies-including accurate testing, preventive nutritional measures, and mental health support-in improving outcomes and societal resilience during global health crises. Unlike previous reviews that focused on isolated biomedical or public health elements, this study integrates diagnostics, immune-nutritional status, and psychosocial effects to present a comprehensive, multidimensional analysis of pandemic impact and preparedness.}, } @article {pmid40217755, year = {2025}, author = {Flisiak, R and Jaroszewicz, J and Kozielewicz, D and Kuchar, E and Parczewski, M and Pawłowska, M and Piekarska, A and Rzymski, P and Simon, K and Tomasiewicz, K and Zarębska-Michaluk, D}, title = {Management of SARS-CoV-2 Infection-Clinical Practice Guidelines of the Polish Association of Epidemiologists and Infectiologists, for 2025.}, journal = {Journal of clinical medicine}, volume = {14}, number = {7}, pages = {}, pmid = {40217755}, issn = {2077-0383}, abstract = {The first Polish recommendations for the management of COVID-19 were published by the Polish Society of Epidemiologists and Infectiologists (PTEiLChZ) on 31 March 2020, and the last three years ago. The emergence of new SARS-CoV-2 variants, a different course of the disease, as well as new knowledge about therapies and vaccines, requires updating diagnostic, therapeutic, and prophylactic guidelines. Despite the reduction in the threat associated with COVID-19, there is a risk of another epidemic caused by coronaviruses, which was an additional reason for developing a new version of the guidelines. In preparing these recommendations, the Delphi method was used, reaching a consensus after three survey cycles. Compared to the 2022 version, the names of the individual stages of the disease have been changed, adapting them to the realities of clinical practice, and attention was paid to the differences observed in immunosuppressed patients and in children. Some previously recommended drugs have been discontinued, including monoclonal antibodies. In addition, general principles of vaccination were presented, as well as issues related to the post-COVID syndrome.}, } @article {pmid40217604, year = {2025}, author = {Cioboata, R and Balteanu, MA and Osman, A and Vlasceanu, SG and Zlatian, OM and Mitroi, DM and Catana, OM and Socaci, A and Tieranu, EN}, title = {Coinfections in Tuberculosis in Low- and Middle-Income Countries: Epidemiology, Clinical Implications, Diagnostic Challenges, and Management Strategies-A Narrative Review.}, journal = {Journal of clinical medicine}, volume = {14}, number = {7}, pages = {}, pmid = {40217604}, issn = {2077-0383}, abstract = {Tuberculosis (TB) continues to be a major public health challenge in low- and middle-income countries (LMICs), where high burdens of coinfections exacerbate the disease's impact. In 2023, an estimated 8.2 million people were newly diagnosed with tuberculosis worldwide, reflecting an increase from 7.5 million in 2022 and 7.1 million in 2019. In LMICs, limited access to healthcare, inadequate nutrition, and poor living conditions contribute to higher coinfection rates among TB patients, leading to delayed diagnosis and treatment, which in turn exacerbates disease severity and facilitates transmission. This narrative review synthesizes the epidemiology, clinical implications, diagnostic challenges, and management strategies related to TB coinfections with viral pathogens including HIV, SARS-CoV-2, and influenza, bacteria such as Streptococcus pneumoniae, Staphylococcus aureus, Klebsiella pneumoniae, and Pseudomonas aeruginosa, fungi such as Aspergillus and Candida species, and parasites. This review highlights that overlapping symptoms, immune system compromise, and socioeconomic barriers in LMICs lead to delayed diagnoses and suboptimal treatment outcomes, while also addressing the challenges of managing drug interactions particularly in HIV-TB coinfections and underscoring the need for integrated diagnostic approaches, improved treatment regimens, and strengthened healthcare systems, thereby consolidating current evidence to inform future research priorities and policy interventions aimed at reducing the overall burden of TB and its coinfections in resource-limited settings.}, } @article {pmid40217329, year = {2025}, author = {Lin, ZZ and Cai, HW and Huang, YF and Zhou, LL and Yuan, ZY and He, LP and Li, J}, title = {Prevalence of depression among university students in China: a systematic review and meta-analysis.}, journal = {BMC psychology}, volume = {13}, number = {1}, pages = {373}, pmid = {40217329}, issn = {2050-7283}, support = {20241180013//National Undergraduate Training Program for Innovation and Entrepreneurship/ ; }, mesh = {Humans ; *Students/psychology/statistics & numerical data ; China/epidemiology ; *COVID-19/psychology/epidemiology ; Universities ; Prevalence ; *Depression/epidemiology ; Cross-Sectional Studies ; Male ; Female ; Young Adult ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Depression among university students in China represents a critical public health challenge, with emerging evidence suggesting exacerbated risks during the COVID-19 pandemic. Despite prior regional studies, a comprehensive national analysis comparing pre-pandemic and pandemic-era prevalence, while accounting for profession-specific stressors, remains lacking. This study aims to quantify depression prevalence across Chinese universities, identify high-risk subgroups, and assess the pandemic's impact.

METHODS: A systematic search was conducted on PubMed, CNKI, Wang-fang Database, and Web of Science. The articles were cross-sectional studies focusing on the prevalence of depression among university students in China, with clearly defined criteria for diagnosing depression included. MetaXL 5.3 was used to pool the outcomes and perform a meta-analysis, assessing the prevalence of depression among university students and influential factors such as the impact of COVID-19.

RESULTS: Data from 32 cross-sectional studies (n = 93,679) on depression prevalence among students were analyzed. The prevalence estimates ranged from 12.1% to 77.1%, with a summary prevalence of 34.70% after meta-analytic pooling. Subgroup investigations based on major, sample size, geographical region, gender, and the influence of COVID-19 were conducted. Prior to the pandemic, student depression prevalence was 35.0% (95%CI, 26.9%-43.4%), which increased to 38.7% (95%CI, 33.6%-44.0%) during and after the pandemic.

DISCUSSION: This study underscores a substantial mental health burden among Chinese university students, intensified by pandemic-related disruptions. Medical students and those in high-stress regions warrant prioritized interventions. Systemic reforms in healthcare education and regionally tailored mental health policies are urgently needed. Longitudinal studies are critical to track post-pandemic recovery trajectories.

CRD42024502949.}, } @article {pmid40216549, year = {2025}, author = {Mueller, HJ and Pennington, EL and Carr, AS and Barner, JC}, title = {Effectiveness of Telehealth for Disease Management During the Perinatal Period: A Scoping Review.}, journal = {Telemedicine journal and e-health : the official journal of the American Telemedicine Association}, volume = {31}, number = {8}, pages = {938-957}, doi = {10.1089/tmj.2024.0501}, pmid = {40216549}, issn = {1556-3669}, mesh = {Humans ; *Telemedicine/organization & administration ; Female ; Pregnancy ; *COVID-19/epidemiology ; *Perinatal Care/methods/organization & administration ; SARS-CoV-2 ; *Disease Management ; *Pregnancy Complications/therapy ; }, abstract = {Introduction: Many perinatal services to manage chronic diseases transitioned to telehealth following the onset of the coronavirus disease 2019 (COVID-19) pandemic. This study was conducted to review the literature and summarize the effectiveness of telehealth for diabetes, hypertensive disorders of pregnancy (HDP), mental health (anxiety and depression), and opioid use disorder (OUD) management during the perinatal period postonset of COVID-19. Methods: PubMed, CINAHL, Web of Science, and IEEE Xplore databases were searched for articles published between 2020 and 2023 using keywords (COVID-19) and (maternal, maternity, obstetrics, perinatal, pregnancy) and (telemedicine, telehealth). Inclusion criteria were: intervention or change in practice with clinical results, postonset of COVID-19, English language, and addressed disease management (i.e., diabetes, hypertension, mental health, OUD) during pregnancy or postpartum. Exclusion criteria were: commentary, guideline, protocol, or review articles and perspectives. Results: The review included 24 articles, including 7 randomized controlled trials. Articles evaluated diabetes (N = 9), HDP (N = 4), mental health (N = 10), and OUD (N = 1). One-half (N = 12) were conducted in the United States and telehealth interventions (e.g., app, videoconferencing, audio visits) and clinical effectiveness varied by disease state. Most studies reported at least one positive outcome of telehealth (N = 19, 79.2%); however, some also reported negative outcomes (N = 8, 33.3%). Glycemic control was adequately achieved in most studies (N = 8, 88.9%), and the majority of studies (N = 3, 75%) reported positive or neutral results for the management of HDP. Various telehealth interventions resulted in lower anxiety and depression symptoms. Only one study examined OUD and reported negative outcomes. Conclusions: Telehealth offered effective management of diabetes, hypertension, anxiety, and depression in perinatal women and often improved patient outcomes during COVID-19. Therefore, telehealth should continue to be offered to perinatal women with these chronic conditions as appropriate for individual and clinical situations. More research is needed to evaluate the effectiveness of telehealth interventions for OUD management.}, } @article {pmid40215617, year = {2025}, author = {Srinivasan, S and Patel, S and Hassan, T and Venkatesh, P and Farid, M and Guirguis, M and Hall, K and Barrie, U and Tamimi, MA and Bagley, CA and Aoun, SG}, title = {Lessons from the pandemic: a retrospective study and literature comparative review of provider and patient experiences with telemedicine in spine care.}, journal = {Journal of neurosurgery. Spine}, volume = {43}, number = {1}, pages = {122-137}, doi = {10.3171/2025.1.SPINE24959}, pmid = {40215617}, issn = {1547-5646}, mesh = {Humans ; *Telemedicine ; *COVID-19/epidemiology ; Retrospective Studies ; Female ; *Patient Satisfaction ; Male ; Middle Aged ; Adult ; *Spinal Diseases/surgery ; Surveys and Questionnaires ; Aged ; Pandemics ; }, abstract = {OBJECTIVE: Telemedicine use for patient care in spine surgery drastically increased after the advent of the COVID-19 pandemic. The authors aimed to examine factors influencing telemedicine utilization during this period by comparing perspectives from patients and spine surgeons to better guide the use of telehealth beyond the pandemic.

METHODS: Between June 2021 and December 2021, a survey was administered to spine care patients receiving virtual visits at a single multidisciplinary spine center to assess their telemedicine experience, including visit quality, overall communication, and technical challenges. Furthermore, a systematic review using the PubMed, Google Scholar, Embase and Web of Science databases in accordance with the PRISMA guidelines was conducted to identify survey studies of spine surgeons and patients assessing telemedicine experiences.

RESULTS: A total of 407 patients were included in our survey; 65.6% were female, and 82.8% were at least 55 years of age. Most patients were White (86.2%) and had at least a bachelor's degree (81.6%). The majority of respondents (96.8%) reported being satisfied or very satisfied with their telemedicine visits. Explanations at the end of visit (p < 0.001), time spent during the visit (p < 0.001), and absence of technical issues (p < 0.001) were significantly associated with increased patient satisfaction. Barriers to access such as education level, age, or race were not significantly associated with patient satisfaction (p > 0.05). The authors also performed a systematic review that identified 10 studies on patient attitudes toward telemedicine with 3569 respondents in North America and 10 surveys of spine surgeons with 3043 respondents internationally. Most telemedicine visits were pre- or postoperative (56.3%, 1914/3399; range 42%-95%), and the majority of patients reported traveling less than 25 miles for in-person visits (63.3%, 815/1287; range 57%-68%). Nine patient studies revealed a high patient satisfaction level with telemedicine (79.7%, 2248/2821; range 36%-93%). The virtual physical examination was of greater concern for surgeons (48.6%, 433/891; range 10%-91%) than for patients (15.5%, 156/1007; range 2%-74%).

CONCLUSIONS: This study highlights the high level of patient satisfaction with telemedicine in spine care, emphasizing factors including clear explanations, sufficient time during visits, and minimal technical issues. Despite concerns about the virtual physical examination, especially among surgeons, telemedicine was effectively utilized for pre- and postoperative care. Telemedicine can continue to play a valuable role in spine care beyond the pandemic, provided that technical challenges are addressed, and communication remains clear and thorough.}, } @article {pmid40215094, year = {2025}, author = {Xu, R and Jiang, J and Ding, L and Song, D and Chen, Y}, title = {Innovation of Ratiometric Sensing Strategies Based on Graphitic Carbon Nitride.}, journal = {Critical reviews in analytical chemistry}, volume = {}, number = {}, pages = {1-25}, doi = {10.1080/10408347.2025.2486213}, pmid = {40215094}, issn = {1547-6510}, abstract = {Graphitic carbon nitride (g-C3N4), a π-conjugated semiconductor with visible-light absorption, has emerged as a versatile material for ratiometric sensing due to its thermal/chemical stability, biocompatibility, and tunable optoelectronic properties. This review highlights recent advances in g-C3N4-based ratiometric electrochemiluminescence (ECL), fluorescence (FL), and photoelectrochemical (PEC) sensors for ultrasensitive detection of diverse analytes. Ratiometric ECL platforms achieved remarkable detection limits, such as 0.2 nM for Hg[2+] and 59 aM for SARS-CoV-2 RdRp gene, leveraging dual-potential or dual-wavelength strategies. FL sensors enabled selective quantification of analysts, such as Ce[3+] (6.4 × 10[-8 ]mol/L) and tetracycline (5.0 nM) via aggregation-induced emission or inner filter effect mechanisms. In PEC sensing, spatial-resolved dual-electrode systems attained ultrahigh sensitivity for Escherichia coli (0.66 cfu/mL) and alpha-fetoprotein (0.2 pg/mL). These g-C3N4-based sensors demonstrated enhanced sensitivity and reliability across environmental, biomedical, and food safety applications. The synergy of g-C3N4's structural advantages and ratiometric design principles demonstrates broad application prospects in fields such as food and environmental safety analysis, as well as early disease diagnosis.}, } @article {pmid40214651, year = {2025}, author = {Akingbola, A and Adewole, O and Adegbesan, A and Peters, F and Odukoya, T and Aremu, O and Adeleke, O and Idris, A and Owolabi, A and Aiyenuro, A}, title = {From Wuhan to Omicron K.P2 strain: A comprehensive review of SARS-CoV-2 phylogeny and public health implications of the latest booster vaccine.}, journal = {Human vaccines & immunotherapeutics}, volume = {21}, number = {1}, pages = {2485840}, doi = {10.1080/21645515.2025.2485840}, pmid = {40214651}, issn = {2164-554X}, mesh = {Humans ; *SARS-CoV-2/genetics/immunology/classification ; *COVID-19/prevention & control/epidemiology/virology/immunology ; *COVID-19 Vaccines/immunology/administration & dosage ; Immunization, Secondary ; Phylogeny ; Public Health ; Mutation ; }, abstract = {The SARS-CoV-2 virus continues to evolve, with the Omicron KP.2 variant, a descendant of BA.2.86, emerging as a public health concern due to its rapid spread and resistance to existing immunity. This review examines the phylogenetic evolution of SARS-CoV-2, focusing on KP.2 and its key mutations (R346T, F456L, V1104L), alongside its epidemiological implications. It also discusses the development and approval of the KP.2-adapted booster vaccine, shown in clinical trials to significantly enhance immune responses and protect against symptomatic and severe disease, particularly in vulnerable groups. Despite vaccine advancements, challenges in global distribution and inequity persist, especially in low- and middle-income countries, increasing the risk of vaccine-resistant variants. The manuscript underscores the importance of equitable access to the KP.2-adapted booster to control the pandemic and prevent future outbreaks, while highlighting the need for continuous surveillance and broader-spectrum vaccine research as the virus evolves.}, } @article {pmid40214136, year = {2025}, author = {Baruah, A}, title = {A Paradigmatic Shift: Telehealth Counselling's Expansion and Challenges in India.}, journal = {Journal of evaluation in clinical practice}, volume = {31}, number = {3}, pages = {e70089}, doi = {10.1111/jep.70089}, pmid = {40214136}, issn = {1365-2753}, support = {//This study was supported by Christ University Delhi NCR./ ; }, mesh = {India/epidemiology ; Humans ; *Telemedicine/organization & administration ; *COVID-19/epidemiology ; *Counseling/organization & administration/methods ; *Mental Health Services/organization & administration ; Health Services Accessibility/organization & administration ; SARS-CoV-2 ; }, abstract = {BACKGROUND: This study provides a comprehensive analysis of the rapid expansion and transformative impact of telehealth counselling in India, a trend significantly propelled by the challenges posed by the COVID-19 pandemic.

METHODOLOGY: This paper presents a perspective on the current telehealth landscape, synthesizing insights from an extensive literature review. The investigation integrates qualitative insights from health care practitioners and clients, allowing for a multifaceted understanding of the emerging obstacles linked to telehealth implementation. The synthesis is structured around several key concepts identified in the literature, including the efficacy of telehealth counselling services compared to traditional face-to-face interactions, the resilience of mental health services during crises, and the growing acceptance of digital modalities among patients. Additionally, it explores significant challenges such as disparities in technological access, the need for comprehensive regulatory frameworks, varying levels of patient receptivity, infrastructural limitations, and the readiness of health care professionals to adopt telehealth technologies.

RESULTS: By focusing on these areas, the paper elucidates the complex interplay of technical, regulatory, and cultural factors shaping the telehealth ecosystem in India. It advocates for urgent policy enhancements and the continuous integration of technology to effectively address these barriers.

DISCUSSION: This perspective underscores the potential for telehealth counselling to evolve into a permanent and essential component of India's mental health service delivery model, ultimately contributing to a more resilient and accessible health care system.

CONCLUSION: The conclusions drawn emphasize the necessity for targeted policy interventions and the establishment of robust technological infrastructures to foster a more inclusive and effective telehealth environment, ensuring mental health services reach all segments of the population.}, } @article {pmid40213632, year = {2025}, author = {Dezawa, M}, title = {Macrophage- and pluripotent-like reparative Muse cells are unique endogenous stem cells distinct from other somatic stem cells.}, journal = {Frontiers in bioengineering and biotechnology}, volume = {13}, number = {}, pages = {1553382}, pmid = {40213632}, issn = {2296-4185}, abstract = {Muse cells are endogenous reparative stem cells with dual characteristics: pluripotent-like and macrophage-like. They can be identified by the pluripotent surface marker stage-specific embryonic antigen-3-positive (SSEA-3 (+)) cells in the bone marrow, peripheral blood, and various organs, including the umbilical cord and amnion. Muse cells can differentiate into ectodermal, endodermal, and mesodermal lineage cells, self-renew, and selectively migrate to damaged sites by sensing one of the universal tissue damage signals, sphingosine-1-phosphate (S1P). At these sites, they phagocytose damaged/apoptotic cells and differentiate into the same cell type as the phagocytosed cells. In this manner, Muse cells replace damaged/apoptotic cells with healthy, functioning cells, thereby repairing tissues. Due to their specific immunosuppressive and immunotolerant mechanism, clinical trials have been conducted for acute myocardial infarction (AMI), subacute ischemic stroke, epidermolysis bullosa, amyotrophic lateral sclerosis (ALS), cervical spinal cord injury, neonatal hypoxic-ischemic encephalopathy (HIE), and COVID-19 acute respiratory distress syndrome. These trials involved the intravenous injection of ∼1.5 × 10[7] donor Muse cells without human leukocyte antigen (HLA) matching or immunosuppressant treatment, and they demonstrated safety and therapeutic efficacy. Thus, donor Muse cell treatment does not require gene manipulation, differentiation induction, or surgical intervention. These unique characteristics distinguish Muse cells from other somatic stem cells, such as mesenchymal stem cells, VSEL stem cells, and marrow-isolated adult multi-lineage inducible (MIAMI) cells.}, } @article {pmid40212904, year = {2025}, author = {Schipper, AE and Sloane, CSM and Shimelis, LB and Kim, RT}, title = {Technological innovations in layperson CPR education - A scoping review.}, journal = {Resuscitation plus}, volume = {23}, number = {}, pages = {100924}, pmid = {40212904}, issn = {2666-5204}, abstract = {BACKGROUND: Rapid initiation of CPR is key for survival in out-of-hospital cardiac arrests, making bystander CPR education a key part of the cardiac chain-of-survival. CPR classes continue to include new technologies that enable more widespread and high-fidelity training. We aimed to examine the landscape of technological innovations in layperson CPR training since the onset of the COVID-19 pandemic.

METHODS: We searched Cochrane, Medline, PubMed, and Web of Science from database inception to July 2024 for studies. We included articles with layperson CPR classes that included a technological advance, either in the equipment or mode of delivery of education. We focused on studies published after the start of 2020.

RESULTS: Out of 1070 studies screened, 50 met the selection criteria. The primary groups of technology found were extended reality (20), feedback devices (11), asynchronous video instruction (10), tele-education (5), and low-cost CPR manikins (4). These technologies show promise to offer comparable or improved effectiveness compared to traditional options. Several topics may warrant further investigation, such as cognitive load associated with extended reality, the practicality of student-created CPR training devices, and possible interactive effects between technologies.

CONCLUSION: Future systematic reviews should evaluate the specific learning contexts for which these individual technologies, or combinations of these technologies, may be best suited to guide regulating bodies and CPR instructors in their pedagogical decisions.}, } @article {pmid40212158, year = {2025}, author = {Abbas, AH and Haji, MR and Shimal, AA and Kurmasha, YH and Al-Janabi, AAH and Azeez, ZT and Al-Ali, ARS and Al-Najati, HMH and Al-Waeli, ARA and Abdulhadi, NASA and Al-Tuaama, AZH and Al-Ashtary, MM and Hussin, OA}, title = {A multidisciplinary review of long COVID to address the challenges in diagnosis and updated management guidelines.}, journal = {Annals of medicine and surgery (2012)}, volume = {87}, number = {4}, pages = {2105-2117}, pmid = {40212158}, issn = {2049-0801}, abstract = {Long COVID has emerged as a significant challenge since the COVID-19 pandemic, which was declared as an outbreak in March 2020, marked by diverse symptoms and prolonged duration of disease. Defined by the WHO as symptoms persisting or emerging for at least two months post-SARS-CoV-2 infection without an alternative cause, its prevalence varies globally, with estimates of 10-20% in Europe, 7.3% in the USA, and 3.0% in the UK. The condition's etiology remains unclear, involving factors, such as renin-angiotensin system overactivation, persistent viral reservoirs, immune dysregulation, and autoantibodies. Reactivated viruses, like EBV and HSV-6, alongside epigenetic alterations, exacerbate mitochondrial dysfunction and energy imbalance. Emerging evidence links SARS-CoV-2 to chromatin and gut microbiome changes, further influencing long-term health impacts. Diagnosis of long COVID requires detailed systemic evaluation through medical history and physical examination. Management is highly individualized, focusing mainly on the patient's symptoms and affected systems. A multidisciplinary approach is essential, integrating diverse perspectives to address systemic manifestations, underlying mechanisms, and therapeutic strategies. Enhanced understanding of long COVID's pathophysiology and clinical features is critical to improving patient outcomes and quality of life. With a growing number of cases expected globally, advancing research and disseminating knowledge on long COVID remain vital for developing effective diagnostic and management frameworks, ultimately supporting better care for affected individuals.}, } @article {pmid40212143, year = {2025}, author = {Nayak, SS and Amini-Salehi, E and Ulrich, MT and Sahli, Y and Fleischman, M and Patel, M and Naeiji, M and Maghsoodifar, H and Sadeghi Douki, SAH and Alotaibi, A and Faraji, N and Hassanipour, S and Hashemi, M and Keivanlou, MH}, title = {Exploring the evolution of evidence synthesis: a bibliometric analysis of umbrella reviews in medicine.}, journal = {Annals of medicine and surgery (2012)}, volume = {87}, number = {4}, pages = {2035-2048}, pmid = {40212143}, issn = {2049-0801}, abstract = {BACKGROUND: Umbrella review studies have become increasingly vital in evidence synthesis, offering a comprehensive overview by analyzing multiple systematic reviews and meta-analyses. This bibliometric study aimed to delineate the growth and thematic evolution of umbrella reviews within evidence-based medicine, illuminating their integral role in synthesizing high-level evidence.

METHODS: Utilizing the Web of Science Core Collection, we performed a search for publications on umbrella reviews, identifying relevant articles through a refined strategy. Analytical tools including VOS Viewer and CiteSpace were employed to visualize connections and trends among the gathered data, converting intricate bibliometric information into comprehensible visual maps.

RESULTS: Our search yielded 2965 pertinent publications, highlighting a marked growth in research output, particularly from 2010 to 2023. The United States, United Kingdom, and China were predominant in this field, with leading institutions like King's College London and the University of Toronto at the forefront. The analysis identified major journals such as BMJ Open and PLOS One as key publishers. Co-citation and keyword analysis revealed current research focuses, with recent trends emphasizing COVID-19 and mental health. The study also uncovered a robust international collaboration network, underscoring the global impact of umbrella reviews.

CONCLUSION: This bibliometric analysis confirms the expanding influence and utility of umbrella reviews in medical research and decision-making. By charting the evolution and current trends in this field, our study not only showcases the geographical and institutional distribution of research but also guides future scholarly efforts to advance evidence synthesis methodologies.}, } @article {pmid40211768, year = {2025}, author = {Gao, J and Zhao, D and Nouri, HR and Chu, HW and Huang, H}, title = {Transcriptional Regulation of Mouse Mast Cell Differentiation and the Role of Human Lung Mast Cells in Airway Inflammation.}, journal = {Immunological reviews}, volume = {331}, number = {1}, pages = {e70026}, pmid = {40211768}, issn = {1600-065X}, support = {R01 AI083986/AI/NIAID NIH HHS/United States ; R01AI152504/NH/NIH HHS/United States ; U19 AI125357/AI/NIAID NIH HHS/United States ; R01AI107022/NH/NIH HHS/United States ; R01 AI107022/AI/NIAID NIH HHS/United States ; R01 AI150082/AI/NIAID NIH HHS/United States ; R01AI150082/NH/NIH HHS/United States ; R01 AI152504/AI/NIAID NIH HHS/United States ; R56 AI180204/AI/NIAID NIH HHS/United States ; R01 AI161296/AI/NIAID NIH HHS/United States ; R01AI161296/NH/NIH HHS/United States ; R01AI083986/NH/NIH HHS/United States ; R01 AI182277/AI/NIAID NIH HHS/United States ; U19AI125357/NH/NIH HHS/United States ; }, mesh = {Animals ; Humans ; *Mast Cells/immunology/metabolism ; Cell Differentiation/genetics ; Mice ; *Lung/immunology ; Gene Expression Regulation ; Inflammation/immunology ; *COVID-19/immunology ; Transcription Factors/metabolism ; *SARS-CoV-2/immunology ; }, abstract = {Mast cells (MCs) play a critical role in allergic inflammation, anaphylaxis, and chronic inflammatory diseases such as asthma, COPD, and osteoarthritis. Dysregulated MC activation can lead to MC activation syndrome (MACS), which is observed in patients with long COVID. MCs express the high-affinity receptor for IgE and, upon activation, release mediators and cytokines that trigger anaphylactic shock and promote allergic inflammation. They also interact with epithelial and nerve cells, which are crucial in forming a complex network of cell-cell and gene-gene interactions driving chronic inflammation that can confer resistance to treatment. In this review, in the context of the literature, we focus on experiments conducted in our laboratory investigating how transcription factors and enhancers regulate genes critical in mouse MC differentiation and function related to human lung inflammation.}, } @article {pmid40211538, year = {2025}, author = {Bhojnagarwala, PS and Jose, J and Zhao, S and Weiner, DB}, title = {DNA-based immunotherapy for cancer: In vivo approaches for recalcitrant targets.}, journal = {Molecular therapy : the journal of the American Society of Gene Therapy}, volume = {33}, number = {6}, pages = {2719-2739}, pmid = {40211538}, issn = {1525-0024}, mesh = {Humans ; *Neoplasms/therapy/immunology ; *Vaccines, DNA/immunology/therapeutic use/genetics ; *Immunotherapy/methods ; *Cancer Vaccines/immunology/therapeutic use/genetics ; COVID-19/immunology ; Animals ; SARS-CoV-2/immunology ; Antigens, Neoplasm/immunology/genetics ; }, abstract = {Immunotherapy has revolutionized cancer treatment and complements traditional therapies, including surgery, chemotherapy, radiation therapy, and targeted therapies. Immunotherapy redirects the patient's immune system against tumors via several immune-mediated approaches. Over the past few years, therapeutic immunization, which enable the patient's T cells to better recognize and kill tumors, have been increasingly tested in the clinic, with several approaches demonstrating treatment improvements. There has been a renewed interest in cancer vaccines due to advances in tumor antigen identification, immune response optimization, novel adjuvants, next-generation vaccine delivery platforms, and antigen designs. The COVID-19 pandemic accelerated progress in nucleic acid-based vaccine manufacturing, which spurred broader interest in mRNA or plasmid platforms. Enhanced DNA vaccine designs, including optimized leader sequences and RNA and codon optimizations, improved formulations, and delivery via adaptive electroporation using stereotactic intramuscular/intradermal methods have improved T cell responses to plasmid-delivered tumor antigens. Additionally, advancements for direct in vivo delivery of DNA-encoded monospecific/bispecific antibodies offer novel tumor-targeting strategies. This review summarizes the recent clinical data for therapeutic cancer vaccines utilizing the DNA platform, including vaccines targeting common tumor-associated and viral antigens and neoantigen vaccines using nucleic acid technologies. We also summarize preclinical data using DNA-launched monoclonal/bispecific antibodies, underscoring their potential as a novel cancer therapy tool.}, } @article {pmid40210368, year = {2025}, author = {Verduzco-Gutierrez, M and Fleming, TK and Azola, AM}, title = {Considerations for Long COVID Rehabilitation in Women.}, journal = {Physical medicine and rehabilitation clinics of North America}, volume = {36}, number = {2}, pages = {371-387}, doi = {10.1016/j.pmr.2024.11.009}, pmid = {40210368}, issn = {1558-1381}, mesh = {Humans ; *COVID-19/rehabilitation/epidemiology ; Female ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Sex Factors ; }, abstract = {The coronavirus disease 2019 (COVID-19) pandemic has given rise to long COVID, a prolonged manifestation of severe acute respiratory syndrome coronavirus 2 infection, which presents with varied symptoms and conditions lasting beyond expected acute illness. Despite efforts, diagnostic and treatment approaches remain insufficient, particularly for women who experience higher prevalence rates. Rehabilitation professionals have played a crucial role during the pandemic. Individualized rehabilitation plans, encompassing various therapies and interdisciplinary collaborations, are essential. Addressing disparities and biological sex differences is paramount, requiring increased research, understanding, and advocacy for effective rehabilitative care tailored to all individuals affected by long COVID.}, } @article {pmid40209971, year = {2025}, author = {Adiguzel, Y and Bogdanos, DP and Shoenfeld, Y}, title = {Molecular/antigenic mimicry and immunological cross-reactivity explains SARS-CoV-2-induced autoimmunity.}, journal = {Autoimmunity reviews}, volume = {24}, number = {7}, pages = {103811}, doi = {10.1016/j.autrev.2025.103811}, pmid = {40209971}, issn = {1873-0183}, mesh = {Humans ; *Molecular Mimicry/immunology ; Cross Reactions/immunology ; *COVID-19/immunology ; *SARS-CoV-2/immunology ; *Autoimmunity ; Autoantibodies/immunology ; Autoantigens/immunology ; *Autoimmune Diseases/immunology ; Epitopes/immunology ; }, abstract = {COVID-19 pandemic is over, but its effects on chronic illnesses remain a challenging issue. Understanding the influence of SARS-COV-2-mediated autoimmunity and overt autoimmune disease is of paramount importance, as it can provide a critical mass of information regarding both infection-mediated (and vaccination-induced) autoimmune phenomena in susceptible individuals during the disease course, and short or long-term post-disease sequelae. The high prevalence of organ and non-organ specific autoantibody positivity in patients with COVID-19 led to studies attempting to delineate the origin and the underlying mechanism responsible for their induction nature, identifying novel autoantigens, and the self-epitope sequences which could be the impetus for the initiating autoreactive responses. Herein, we provide a meticulous review of the studies reporting those mimicking sequences that have been experimentally validated, based on the assumption that molecular mimicry and immunological crossreactivity may account for autoantibody development. Most reports are based on bioinformatics approaches, and only a disproportionally small number of studies currently demonstrate immunological crossreactivity. We took the opportunity to further review and searched for the linear human epitope sequences of human, through the epitopes deposited at the Immune Epitope Database. This included an analysis of autoimmune disease as the disease data to comprehensively understand the subject matter. The critical overview of the findings underscore the urgent and immense need for further research to gain a comprehensive understanding of the mechanisms involved and the anticipated appraisal that molecular mimicry and immunological crossreactivity is indeed central to the loss of immunological tolerance during SARS-COV-2 infection.}, } @article {pmid40208120, year = {2025}, author = {Fournier, L and Pérez-Rodriguez, F and Rohr, M and Buvelot, H and Vetter, P}, title = {[Measles: a persistent threat despite an effective vaccine].}, journal = {Revue medicale suisse}, volume = {21}, number = {913}, pages = {736-741}, doi = {10.53738/REVMED.2025.21.913.736}, pmid = {40208120}, issn = {1660-9379}, mesh = {Humans ; *Measles/prevention & control/epidemiology/diagnosis ; *Measles Vaccine/administration & dosage ; COVID-19/epidemiology/prevention & control ; Vaccination ; Immunocompromised Host ; Child ; }, abstract = {Measles is a highly transmissible viral disease. Following a decrease in vaccination rate between 2020 and 2023 due to the SARS-CoV-2 pandemic, a new surge of cases is observed worldwide. No direct antiviral is currently licensed against measles. Young children and immunocompromised individuals are the most at risk to develop complications. The best way to prevent transmission and complications is through vaccination. Public health measures are required to break transmission chains and protect the most fragile ones. The aim of this article is to review the epidemiology and the virological aspects of measles, to clarify the protection conferred by vaccination and to specify the key elements of diagnosis and management.}, } @article {pmid40206484, year = {2025}, author = {Satyanarayanan, SK and Yip, TF and Han, Z and Zhu, H and Qin, D and Lee, SMY}, title = {Role of toll-like receptors in post-COVID-19 associated neurodegenerative disorders?.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1458281}, pmid = {40206484}, issn = {2296-858X}, abstract = {In the intricate realm of interactions between hosts and pathogens, Toll-like receptors (TLRs), which play a crucial role in the innate immune response, possess the ability to identify specific molecular signatures. This includes components originating from pathogens such as SARS-CoV-2, as well as the resulting damage-associated molecular patterns (DAMPs), the endogenous molecules released after cellular damage. A developing perspective suggests that TLRs play a central role in neuroinflammation, a fundamental factor in neurodegenerative conditions like Alzheimer's and Parkinson's disease (PD). This comprehensive review consolidates current research investigating the potential interplay between TLRs, their signaling mechanisms, and the processes of neurodegeneration following SARS-CoV-2 infection with an aim to elucidate the involvement of TLRs in the long-term neurological complications of COVID-19 and explore the potential of targeting TLRs as a means of implementing intervention strategies for the prevention or treatment of COVID-19-associated long-term brain outcomes.}, } @article {pmid40206469, year = {2025}, author = {Snopkowska Lesniak, SW and Maschio, D and Henriquez-Camacho, C and Moreno Cuerda, V}, title = {Biomarkers for SARS-CoV-2 infection. A narrative review.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1563998}, pmid = {40206469}, issn = {2296-858X}, abstract = {COVID-19 is an infectious disease caused by SARS-CoV-2 with devastating effects on health-care systems. The magnitude of the problem has moved physicians and investigators to identify strategies to detect patients at a high risk of severe disease. The aim of this study was to identify the most relevant biomarkers in the published literature and their correlation with clinical outcomes. To this end, we performed a revision of studies that investigated laboratory abnormalities in patients with COVID-19, comparing non-severe and severe patients. Blood biomarkers were classified into five main categories: hematological, coagulation related to the liver or kidney, and inflammatory. From our analysis, the most relevant biomarkers associated with severe infection for each category were increased levels of leukocytes, neutrophils, and neutrophil-to-lymphocyte ratio; decreased platelet count; and high levels of aspartate transaminase, alanine transaminase, creatine kinase, troponin, creatinine, and blood urea nitrogen, C-reactive protein, ferritin, and IL-6. Moreover, lactate dehydrogenase and D-dimer levels were independent risk factors for death.}, } @article {pmid40205144, year = {2025}, author = {Bonanni, P and Heo, JY and Honda, H and Lee, PI and Mouliom, A and Leong, HN and Del Pilar Martin Matos, M and Dawson, R}, title = {Optimal Timing of Vaccination: A Narrative Review of Integrating Strategies for COVID-19, Influenza, and Respiratory Syncytial Virus.}, journal = {Infectious diseases and therapy}, volume = {14}, number = {5}, pages = {911-932}, pmid = {40205144}, issn = {2193-8229}, abstract = {Lower respiratory tract infections caused by SARS-CoV-2, influenza, and respiratory syncytial virus (RSV) cause a significant disease burden globally, despite the availability of effective vaccines. Certain populations, such as older adults (≥ 60 years) and individuals of all ages with particular comorbidities, are at increased risk for severe outcomes, including hospitalization and death. National administration schedules for available vaccines against respiratory viruses are not unified, and not all current guidelines are clear and directive, concerning the optimal timing of vaccination. Herein, we formulate an evidence-based position regarding the optimal timing of COVID-19, influenza, and RSV vaccination for older adults and individuals with chronic comorbidities, based on a synthesis of the literature and current guidelines. Vaccination impact and timing were found to be influenced by vaccinee risk factors, including age and comorbidities, and waning vaccine effectiveness and seasonal pathogen burden. Because COVID-19, influenza, and RSV display unique seasonal patterns within and between regions, local epidemiological surveillance of each virus is crucial for determining optimal vaccination timing and guidelines. To maximize the benefits of these respiratory virus vaccines, the timing of peak vaccine effectiveness and period of greatest risk for severe outcomes should be aligned. Thus, COVID-19, influenza, and other recommended vaccines given ahead of the start of the respiratory virus season (or other regionally appropriate time) and co-administered at a single, routine visit represent the optimal approach to protecting at-risk populations. More data will be required to establish the clinical benefit of additional RSV vaccine doses and whether these may be integrated within a seasonal schedule. Coordinated policy decisions that align with strain selection for new and annually reformulated vaccines would enable the timely raising of public health awareness, ultimately leading to enhanced vaccine uptake. Implementation strategies will require engagement of healthcare providers and strong, evidence-based public health recommendations for integrated vaccine schedules.}, } @article {pmid40205087, year = {2025}, author = {Cao, Q and Zhang, N and Leng, C and Wang, S and Ma, J}, title = {Emerging Viral Infections (ZIKV, SARS-CoV-2, and MPXV) and Depression: Ketamine and (S, R)-Ketamine as Promising Antidepressants.}, journal = {Reviews in medical virology}, volume = {35}, number = {3}, pages = {e70036}, doi = {10.1002/rmv.70036}, pmid = {40205087}, issn = {1099-1654}, mesh = {Humans ; *Ketamine/therapeutic use/chemistry ; *Antidepressive Agents/therapeutic use ; *COVID-19/psychology/complications/virology ; *Depression/drug therapy/virology/etiology ; SARS-CoV-2/drug effects ; }, abstract = {Emerging viral pathogens, newly reported or rapidly evolving viruses, are a significant public health concern worldwide. Beyond their characteristic clinical presentations, emerging viruses, such as monkeypox virus (MPXV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have been increasingly implicated in the development of various neuropsychiatric complications including depression, mainly due to their ability to induce neuroinflammation, immune dysfunction, and neurotransmitter imbalances. Depression is a common mental health condition characterised by continuous low mood or sadness, pessimism, anxiety, and even a tendency to suicide as the main symptoms. Post viral depression commonly shows significant challenges, as traditional antidepressant agents exhibit suboptimal efficacy and prolonged onset of action. Regarding this, ketamine and its enantiomers, S-ketamine and R-ketamine, have recently received increasing attention as potential options in light of their potent and effective antidepressant properties. The present review describes the underlying pathophysiological mechanisms of depression associated with emerging viruses, highlighting the role of neuroinflammation and disturbances inneurotransmitter systems. It also discusses the antidepressant mechanisms of ketamine and its enantiomers, the current clinical evidence demonstrating their effectiveness and safety, especially in the case of treatment-resistant depression, and their growing relevance for mood complications linked to emerging viral infections, including depression. Although preliminary reports propose effectiveness, additional studies are needed to present optimal treatment strategies, long-term safety, and incorporation into clinical practice. Addressing these challenges will be critical for optimising the effectiveness of ketamine- and (S, R)-ketamine-containing therapeutic protocols in treating depression linked to emerging viral infections.}, } @article {pmid40204625, year = {2025}, author = {Fagundo-Rivera, J and García-Lozano, MS and Portero-Prados, FJ and Romero-Castillo, R and Badillo-Sánchez, N and Fernández-León, P}, title = {Barriers to healthcare access for irregular immigrants after their arrival in Spain: a systematic review.}, journal = {European journal of public health}, volume = {35}, number = {3}, pages = {407-422}, pmid = {40204625}, issn = {1464-360X}, mesh = {Humans ; Spain ; *Health Services Accessibility/statistics & numerical data ; *Emigrants and Immigrants/statistics & numerical data ; Communication Barriers ; }, abstract = {Examining the barriers encountered by irregular immigrants in accessing the public health system is crucial for the continuity of healthcare processes. This approach not only heightens patient-centered care but also fosters long-term public health preparedness and social cohesion. The aim of this review was to examine the existing barriers to accessing the Spanish healthcare system for the immigrant population. A systematic review of original articles was conducted based on the PRISMA methodology. Studies registered in PubMed, Scopus, CINAHL, LILACS, Web of Science, and Enfispo were analyzed. A total of 4773 articles were identified, of which 15 were selected for review. Among the selected articles, 10 employed qualitative methodologies, 1 utilized a mixed methodology, and 4 used quantitative methodologies. A variety of access barriers related to communication, administrative issues, and misinformation about legal aspects were identified. It was noted that one in five immigrants has experienced at least one barrier to accessing the Spanish healthcare system. Barriers to access to the health system are clearly shared by both immigrants and healthcare professionals. Barriers to access to the health system are a result of the coalition of organizational factors, cultural experiences, and socioeconomic and educational determinants. Access to healthcare for irregular migrants in Spain is hindered by language barriers, misinformation, and administrative obstacles, exacerbated by the COVID-19 pandemic. Policies are needed to ensure equitable care, enhance communication, streamline procedures, and strengthen collaboration with non-governmental organizations and cultural mediators to optimize healthcare responses.}, } @article {pmid40204602, year = {2025}, author = {Lin, SH and Liu, JW and Yen, YT and Chen, MT and Wang, JT and Tu, YK and Fang, CT and Chang, SC}, title = {Effectiveness of molnupiravir as early treatment for COVID-19 to prevent mortality and hospitalisation in high-risk adults: A systematic review and meta-analysis of randomised trials and real-world studies involving 1,612,082 patients.}, journal = {Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi}, volume = {58}, number = {5}, pages = {545-553}, doi = {10.1016/j.jmii.2025.03.015}, pmid = {40204602}, issn = {1995-9133}, mesh = {Humans ; *Hospitalization/statistics & numerical data ; Randomized Controlled Trials as Topic ; *COVID-19/mortality ; SARS-CoV-2/drug effects ; *Antiviral Agents/therapeutic use ; *Hydroxylamines/therapeutic use ; *COVID-19 Drug Treatment ; *Cytidine/analogs & derivatives/therapeutic use ; Adult ; Middle Aged ; Treatment Outcome ; Aged ; }, abstract = {BACKGROUND: The efficacy of molnupiravir for COVID-19 treatment remains controversial due to substantial heterogeneity in dosage and study settings across randomised controlled trials (RCTs).

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

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

CONCLUSIONS: Molnupiravir significantly reduces the risk of mortality. It also lowers the risk of hospitalisation in the oldest group (mean age ≥75 years) but not in younger groups (mean age 45-74 years).}, } @article {pmid40204184, year = {2025}, author = {Higgins, DM and Bryan, MA and O'Leary, ST and Opel, DJ}, title = {The Impact of the Coronavirus Disease 2019 Pandemic on Parental Childhood Vaccine Attitudes in the United States.}, journal = {Academic pediatrics}, volume = {25}, number = {6}, pages = {102829}, doi = {10.1016/j.acap.2025.102829}, pmid = {40204184}, issn = {1876-2867}, } @article {pmid40203968, year = {2025}, author = {Fuster-Casanovas, A and Melero, SM and Cabutto, D and Carrion, C and Vidal-Alaball, J and Herrera-Ramos, E and Barcons, C and Duarte-Díaz, A}, title = {Exploring digital health tools for depression management in primary health care: Systematic review and meta-analysis.}, journal = {Journal of affective disorders}, volume = {381}, number = {}, pages = {494-506}, doi = {10.1016/j.jad.2025.03.187}, pmid = {40203968}, issn = {1573-2517}, mesh = {Humans ; Primary Health Care ; *Telemedicine ; *Depression/therapy ; COVID-19/psychology ; Mobile Applications ; Digital Health ; }, abstract = {BACKGROUND: Digital health tools are transforming mental health care, particularly in treating depression, which affects 5 % of the global population and is projected to be the top disease burden by 2030. In primary care, these tools improve accessibility and efficacy, addressing rising mental health demands, especially post-COVID-19.

OBJECTIVE: The aim of this study is to assess the efficacy of digital health tools for the management of depression within primary care.

METHODS: A systematic review followed PRISMA guidelines, focusing on digital health tools for reducing depressive symptoms. Controlled trials were included, with RCTs assessed via the Cochrane risk-of-bias tool and non-RCTs evaluated using the JBI checklist for quasi-experimental studies. Depressive symptom reduction was the primary outcome.

RESULTS: A total of 29 controlled trials met the inclusion criteria, identifying were web-based platforms, mobile apps, phone calls, text messages, and decision algorithms. The meta-analysis revealed that digital health tools had a significant effect on depressive symptoms (g = -0.22, 95 % CI: -0.37; -0.06, I[2] = 79.64 %). At 6 to 12-month follow-up, the random effects meta-analysis showed that digital health tools had a significant effect on depressive symptoms (g = -0.19, 95%CI: -0.29; -0.09, I[2] = 53.42 %).

CONCLUSIONS: Digital health tools are effective in reducing the symptoms of repression. Symptom severity does not predict suitability for digital treatment, emphasizing the need for gender-sensitive approaches and strategies for older adults. Integrating digital interventions into clinical guidelines requires studies like this to support their adoption in real-world practice.}, } @article {pmid40203050, year = {2025}, author = {Li, Y and Hu, Y and Zhang, Y and Cheng, K and Zhang, C and Wang, J}, title = {Advances in Subacute Thyroiditis: Pathogenesis, Diagnosis, and Therapies.}, journal = {FASEB journal : official publication of the Federation of American Societies for Experimental Biology}, volume = {39}, number = {7}, pages = {e70525}, doi = {10.1096/fj.202403264R}, pmid = {40203050}, issn = {1530-6860}, support = {YDZJ202501ZYTS133//the Science and Technology Development Project of Jilin Province/ ; 2024SCZ90//the Health Talent Project of Jilin Province department of Finance/ ; 2024B12//Bethune Project of Jilin Unversity/ ; }, mesh = {Humans ; *Thyroiditis, Subacute/diagnosis/therapy/etiology/drug therapy ; *COVID-19/complications ; SARS-CoV-2 ; COVID-19 Drug Treatment ; }, abstract = {Subacute thyroiditis (SAT) is an inflammatory thyroid disease that is often associated with viral infections. In particular, SARS-COV-2 and its vaccine were found to cause SAT during the recent COVID-19 pandemic. However, the pathogenesis, clinical features, and processes still need further profiling. Recently, there are new findings and understanding about the pathogenic mechanisms of SAT. Some HLA genes have been shown to increase the risk of SAT development, and inflammatory cytokine storms could promote the progression of SAT. Some new diagnostic criteria for SAT have been proposed to facilitate clinicians' diagnosis of SAT when facing atypical symptoms in a manner of rapidity and accuracy. Plus, new treatments for SAT with herbal medicines have been proposed recently as an addition to the conventional steroidal drugs and NSAIDs. This review will provide a summary of these recent progresses of SAT on pathogenesis, diagnosis, and therapies with emphasis on the role of a variety of virus pathogens, including the COVID-19 virus.}, } @article {pmid40202690, year = {2025}, author = {Wu, Q and Han, J and Yan, Y and Kuo, YH and Shen, ZM}, title = {Reinforcement learning for healthcare operations management: methodological framework, recent developments, and future research directions.}, journal = {Health care management science}, volume = {28}, number = {2}, pages = {298-333}, pmid = {40202690}, issn = {1572-9389}, support = {21222881//Health Bureau/ ; 27200419//University Grants Committee/ ; }, mesh = {Humans ; COVID-19/epidemiology ; *Delivery of Health Care/organization & administration ; SARS-CoV-2 ; *Machine Learning ; Pandemics ; }, abstract = {With the advancement in computing power and data science techniques, reinforcement learning (RL) has emerged as a powerful tool for decision-making problems in complex systems. In recent years, the research on RL for healthcare operations has grown rapidly. Especially during the COVID-19 pandemic, RL has played a critical role in optimizing decisions with greater degrees of uncertainty. RL for healthcare applications has been an exciting topic across multiple disciplines, including operations research, operations management, healthcare systems engineering, and data science. This review paper first provides a tutorial on the overall framework of RL, including its key components, training models, and approximators. Then, we present the recent advances of RL in the domain of healthcare operations management (HOM) and analyze the current trends. Our paper concludes by presenting existing challenges and future directions for RL in HOM.}, } @article {pmid40202004, year = {2025}, author = {Zhang, Z and Du, B and Wu, X and Hu, X and Diao, S and Dong, R}, title = {[Research progress on the relationship between mitochondrial dynamics imbalance and novel coronavirus infection-related acute respiratory distress syndrome].}, journal = {Zhonghua wei zhong bing ji jiu yi xue}, volume = {37}, number = {3}, pages = {300-304}, doi = {10.3760/cma.j.cn121430-20241126-00957}, pmid = {40202004}, issn = {2095-4352}, mesh = {Humans ; *Respiratory Distress Syndrome/metabolism/virology/etiology ; COVID-19 ; *Mitochondrial Dynamics ; *Mitochondria/metabolism ; DNA, Mitochondrial ; Hypoxia-Inducible Factor 1, alpha Subunit/metabolism ; Dynamins ; SARS-CoV-2 ; }, abstract = {Patients with severe pneumonia caused by novel coronavirus infection are often complicated with acute respiratory distress syndrome (ARDS), which has a high mortality. ARDS is characterized by diffuse alveolar damage, pulmonary edema, and hypoxemia. Mitochondria are prone to morphological and functional abnormalities under hypoxia and viral infection, which can lead to cell apoptosis and damage, severely impacting the disease progression. Mitochondria maintain homeostasis through fission and fusion. In ARDS, hypoxia leads to the phosphorylation of dynamin-related protein 1 (Drp1), triggering excessive mitochondrial fission and damaging the alveolar epithelial barrier. Animal experiments have shown that inhibiting this process can alleviate lung injury, providing a potential direction for treatment. The pathology of novel coronavirus infection-related ARDS is similar to that of typical ARDS but more severe. Viral infection and hypoxia disrupt the mitochondrial balance, causing fission and autophagy abnormalities, promoting oxidative stress and mitochondrial DNA (mtDNA) release, activating inflammasomes, inducing the expression of hypoxia-inducible factor-1α (HIF-1α), exacerbating viral infection, inflammation, and coagulation reactions, and resulting in multiple organ damage. Mechanical ventilation and glucocorticoids are commonly used in the treatment of novel coronavirus infection-related ARDS. Mechanical ventilation is likely to cause lung and diaphragm injuries and changes in mitochondrial dynamics, while the lung protective ventilation strategy can reduce the adverse effects. Glucocorticoids can regulate mitochondrial function and immune response and improve the patient's condition through multiple pathways. The mitochondrial dynamics imbalance in novel coronavirus infection-related ARDS is caused by hypoxia and viral proteins, leading to lung and multiple organ injuries. To clarify the pathophysiological mechanism of mitochondrial dynamics imbalance in novel coronavirus infection-related ARDS and explore effective strategies for regulating mitochondrial dynamics balance to treat this disease, so as to provide new treatment targets and methods for patients with novel coronavirus infection-related ARDS. The existing treatments have limitations. Future research needs to deeply study the mechanism of mitochondrial dysfunction, develop new therapies and regulatory strategies, and improve the treatment effect.}, } @article {pmid40201990, year = {2025}, author = {Zhang, J and Li, Y and Li, H and Zhou, J}, title = {[Acute respiratory distress syndrome caused by severe respiratory infectious diseases: clinical significance and solution of maintaining artificial airway closure].}, journal = {Zhonghua wei zhong bing ji jiu yi xue}, volume = {37}, number = {3}, pages = {221-224}, doi = {10.3760/cma.j.cn121430-20240506-00404}, pmid = {40201990}, issn = {2095-4352}, mesh = {Humans ; *Respiratory Distress Syndrome/therapy/etiology ; *Respiration, Artificial ; Ventilator-Induced Lung Injury/prevention & control ; *Severe Acute Respiratory Syndrome ; COVID-19 ; Clinical Relevance ; }, abstract = {Since the beginning of the 21st century, the severe respiratory infectious diseases worldwide [such as severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), influenza A H1N1 and novel coronavirus infection have attracted wide attention from all walks of life due to their superior pathogenicity and transmissibility. Aerosols-carrying pathogens are the main transmission route of many severe respiratory infectious diseases, which can lead to severe respiratory failure and even acute respiratory distress syndrome (ARDS) in infected individuals. Mechanical ventilation is the primary treatment for ARDS, and the small tidal volume, appropriate level of positive end-expiratory pressure based lung protective ventilation strategy can effectively reduce the incidence of ventilator-induced lung injury (VILI). However, in the process of clinical treatment, it is sometimes necessary to briefly disconnect the connection between the artificial airway and the ventilator circuit, which will not only cause the residual aerosol in the respiratory system to spill out and pollute the surrounding environment, increase the risk of nosocomial infection including medical staff, but also interfere with the implementation of lung protective ventilation strategy and aggravate ventilator-induced lung injury. In addition, studies have shown that a lot of medical staff have nosocomial infections, especially staff involved in tracheal intubation, extubation and other airway related operations. In addition to enhancing personal protective measures, it is crucial to safeguard healthcare workers from aerosol contamination and minimize associated risks during airway management. At present, there are few researches on the temporary sealing of airway lines and ventilator system, and there is a lack of clear guidance. This review summarizes the research status in related fields to provide a reference for corresponding solutions and programs.}, } @article {pmid40199308, year = {2024}, author = {Bona, JP}, title = {Knowledge Representation and Management in the Age of Long Covid and Large Language Models: a 2022-2023 Survey.}, journal = {Yearbook of medical informatics}, volume = {33}, number = {1}, pages = {216-222}, pmid = {40199308}, issn = {2364-0502}, mesh = {Humans ; *Artificial Intelligence ; COVID-19 ; *Large Language Models ; Surveys and Questionnaires ; *Post-Acute COVID-19 Syndrome/epidemiology ; }, abstract = {OBJECTIVES: To select, present, and summarize cutting edge work in the field of Knowledge Representation and Management (KRM) published in 2022 and 2023.

METHODS: A comprehensive set of KRM-relevant articles published in 2022 and 2023 was retrieved by querying PubMed. Topic modeling with Latent Dirichlet Allocation was used to further refine this query and suggest areas of focus. Selected articles were chosen based on a review of their title and abstract.

RESULTS: An initial set of 8,706 publications were retrieved from PubMed. From these, fifteen papers were ultimately selected matching one of two main themes: KRM for long COVID, and KRM approaches used in combination with generative large language models.

CONCLUSIONS: This survey shows the ongoing development and versatility of KRM approaches, both to improve our understanding of a global health crisis and to augment and evaluate cutting edge technologies from other areas of artificial intelligence.}, } @article {pmid40199042, year = {2025}, author = {Baaden, M and Glowacki, DR}, title = {Virtual reality in drug design: Benefits, applications and industrial perspectives.}, journal = {Current opinion in structural biology}, volume = {92}, number = {}, pages = {103044}, doi = {10.1016/j.sbi.2025.103044}, pmid = {40199042}, issn = {1879-033X}, mesh = {*Drug Design ; *Virtual Reality ; Humans ; SARS-CoV-2 ; Molecular Docking Simulation ; Ligands ; Drug Discovery/methods ; COVID-19/virology ; Drug Industry ; COVID-19 Drug Treatment ; }, abstract = {Virtual reality (VR) is a tool which has transformative potential in domains which involve the visualization of complex 3D data such as structure-based drug design (SBDD), where it offers new ways to visualize and manipulate complex molecular structures in three dimensions, and enable intuitive exploration of protein-ligand complexes. In this article, we outline three levels of interaction which are available in immersive VR environments for drug discovery, and provide illustrative case studies with applications in COVID-19 research and protein-ligand docking. We discuss VR's role in drug discovery based on conversations with experts from the pharmaceutical industry. While industry experts are mostly optimistic about the potential of VR, they point to the challenges related to integration with existing workflows and the need for improved hardware ergonomics, as well as ensuring a synergistic relationship between VR and an expanding suite of artificial intelligence (AI) tools.}, } @article {pmid40198822, year = {2025}, author = {O'Connor, H and DiSalvo, M and Gersten, M and Boyden, S and Uchida, M}, title = {Effects of the COVID-19 Pandemic on Early Child Development: A Systematic Review & Meta-Analysis.}, journal = {Journal of developmental and behavioral pediatrics : JDBP}, volume = {46}, number = {2}, pages = {e227-e239}, doi = {10.1097/DBP.0000000000001352}, pmid = {40198822}, issn = {1536-7312}, support = {1K23MH122667-01//Foundation for the National Institutes of Health/ ; }, mesh = {Humans ; *COVID-19/epidemiology ; *Child Development/physiology ; *Developmental Disabilities/epidemiology/etiology ; Child, Preschool ; Child ; Infant ; }, abstract = {OBJECTIVE: To explore the effects of the COVID-19 pandemic on early childhood development and identify areas of interest surrounding development.

METHODS: A systematic literature review was performed to identify articles examining how the COVID-19 pandemic has affected early childhood development, and a meta-analysis was conducted from the results of those articles to examine the degree of the impact of the pandemic on the areas of childhood development.

RESULTS: Ten articles from 6 countries were identified that met all inclusion and exclusion criteria. The multivariate meta-analysis showed no significant difference in overall development (pooled Cohen's d = 0.28, 95% CI, -0.33 to 0.88; p = 0.18) or odds for developmental delay (pooled odds ratio (OR) = 1.44, 95% CI, 0.77 to 2.67; p = 0.20) between pre-COVID-19 development and COVID-19 development. However, there was significantly more impairment (d = 0.46, p = 0.003) and greater odds (72%; OR = 1.72, p = 0.01) for developmental delay in the language and communication domain for COVID-19 children versus pre-COVID-19 children.

CONCLUSION: While exposure to the COVID-19 pandemic was not associated with global developmental delays, it had a significant impact on child development regarding language and communication. Further research monitoring effects of the COVID-19 pandemic is necessary, and parents and communities should focus on increasing early intervention and enriched curriculum to offset these delays.}, } @article {pmid40198479, year = {2025}, author = {Khalil, Z and Fouly, M and Helito, P}, title = {Unprecedented case of rapid-onset autoimmune hepatitis triggered by COVID-19 mRNA vaccination, complicated by concurrent severe hemophagocytic lymphohistiocytosis and acute liver failure in a previously healthy adult: a multidisciplinary approach and review of therapeutic interventions.}, journal = {Clinical journal of gastroenterology}, volume = {18}, number = {3}, pages = {408-416}, pmid = {40198479}, issn = {1865-7265}, mesh = {Humans ; Male ; *Lymphohistiocytosis, Hemophagocytic/etiology/therapy/diagnosis ; Adult ; *Liver Failure, Acute/etiology/therapy ; *Hepatitis, Autoimmune/etiology/therapy/diagnosis ; *COVID-19 Vaccines/adverse effects ; COVID-19/prevention & control ; }, abstract = {A previously healthy 35-year-old male developed acute autoimmune hepatitis 5 weeks after receiving his second dose of an mRNA vaccine, presenting with jaundice, elevated liver enzymes, and abdominal pain. The condition rapidly progressed to severe hemophagocytic lymphohistiocytosis (HLH) and acute liver failure, confirmed by liver biopsy and bone marrow aspirate. Despite aggressive multidisciplinary treatment, including corticosteroids, immunoglobulin, and IL-1 antagonists, the patient deteriorated, developing multi-organ failure. Emergency liver transplantation was considered but was not viable due to his unstable condition. The case highlights a potential rare vaccine-associated immune response which we believe has not been reported in the literature, requiring prompt recognition and multidisciplinary management. Further research is needed to understand the underlying immunogenic triggers and optimize treatment.}, } @article {pmid40198477, year = {2025}, author = {Allela, OQB and Ali, NAM and Sanghvi, G and Roopashree, R and Kashyap, A and Krithiga, T and Panigrahi, R and Kubaev, A and Kareem, RA and Sameer, HN and Yaseen, A and Athab, ZH and Adil, M}, title = {The Role of Viral Infections in Acute Kidney Injury and Mesenchymal Stem Cell-Based Therapy.}, journal = {Stem cell reviews and reports}, volume = {21}, number = {5}, pages = {1199-1236}, doi = {10.1007/s12015-025-10873-0}, pmid = {40198477}, issn = {2629-3277}, mesh = {*Acute Kidney Injury/therapy/virology/pathology ; Humans ; *Mesenchymal Stem Cell Transplantation ; *Mesenchymal Stem Cells/cytology ; Animals ; *COVID-19/complications/virology/therapy ; SARS-CoV-2/pathogenicity ; *Virus Diseases/complications/therapy ; Exosomes/transplantation/metabolism ; }, abstract = {Viruses may cause a wide range of renal problems. Furthermore, many kidney diseases may be brought on by viral infections. Both the primary cause and a contributing factor of acute kidney injury (AKI) may be viral infections. As an example, it is recommended that patients with dengue virus (DENV) infections undergo careful monitoring of their AKI levels. Also, researchers' data so far lend credence to the several hypothesized pathophysiological mechanisms via which AKI can develop in SARS-CoV- 2 infection. Thus, it is critical to comprehend how viral infections cause AKI. Finding an effective method of treating AKI caused by viruses is also vital. Thus, a potential cell-free method for treating AKI that uses regenerative and anti-inflammatory processes is mesenchymal stem cells (MSCs) and their exosomes (MSC-EXOs). MSCs alleviate tissue damage and enhance protective effects on damaged kidneys in AKI. Furthermore, MSC-EXOs have exhibited substantial regulatory impact on a range of immune cells and exhibit robust immune regulation in the therapy of AKI. Thus, in models of AKI caused by ischemia-reperfusion damage, nephrotoxins, or sepsis, MSCs and MSC-EXOs improved renal function, decreased inflammation, and improved healing. Therefore, MSCs and MSC-EXOs may help treat AKI caused by different viruses. Consequently, we have explored several innovative and significant processes in this work that pertain to the role of viruses in AKI and the significance of viral illness in the onset of AKI. After that, we assessed the key aspects of MSCs and MSC-EXOs for AKI therapy. We have concluded by outlining the current state of and plans for future research into MSC- and EXO-based therapeutic approaches for the treatment of AKI brought on by viruses.}, } @article {pmid40197228, year = {2025}, author = {Noma, K and Asano, T and Taniguchi, M and Ashihara, K and Okada, S}, title = {Anti-cytokine autoantibodies in human susceptibility to infectious diseases: insights from Inborn errors of immunity.}, journal = {Immunological medicine}, volume = {48}, number = {2}, pages = {124-140}, doi = {10.1080/25785826.2025.2488553}, pmid = {40197228}, issn = {2578-5826}, mesh = {Humans ; *Autoantibodies/immunology ; *Cytokines/immunology ; *COVID-19/immunology ; Disease Susceptibility ; *SARS-CoV-2/immunology ; *Communicable Diseases/immunology ; }, abstract = {The study of Inborn Errors of Immunity (IEIs) is critical for understanding the complex mechanisms of the human immune response to infectious diseases. Specific IEIs, characterized by selective susceptibility to certain pathogens, have enhanced our understanding of the key molecular pathways and cellular subsets involved in host defense against pathogens. These insights revealed that patients with anti-cytokine autoantibodies exhibit phenotypes similar to those with pathogenic mutations in genes encoding signaling molecules. This new disease concept is currently categorized as 'Phenocopies of IEI'. This category includes anti-cytokine autoantibodies targeting IL-17/IL-22, IFN-γ, IL-6, GM-CSF, and type I IFNs. Abundant anti-cytokine autoantibodies deplete corresponding cytokines, impair signaling pathways, and increase susceptibility to specific pathogens. We herein demonstrate the clinical and etiological significance of anti-cytokine autoantibodies in human immunity to pathogens. Insights from studies of rare IEIs underscore the pathological importance of cytokine-targeting autoantibodies. Simultaneously, the diverse clinical phenotype of patients with these autoantibodies suggests that the influences of cytokine dysfunction are broader than previously recognized. Furthermore, comprehensive studies prompted by the COVID-19 pandemic highlighted the substantial clinical impact of autoantibodies and their potential role in shaping the outcomes of infectious disease.}, } @article {pmid40197159, year = {2025}, author = {Alizon, S and Sofonea, MT}, title = {SARS-CoV-2 epidemiology, kinetics, and evolution: A narrative review.}, journal = {Virulence}, volume = {16}, number = {1}, pages = {2480633}, pmid = {40197159}, issn = {2150-5608}, mesh = {Humans ; *COVID-19/epidemiology/transmission/virology ; *SARS-CoV-2/genetics/pathogenicity ; Pandemics ; Evolution, Molecular ; }, abstract = {Since winter 2019, SARS-CoV-2 has emerged, spread, and evolved all around the globe. We explore 4 y of evolutionary epidemiology of this virus, ranging from the applied public health challenges to the more conceptual evolutionary biology perspectives. Through this review, we first present the spread and lethality of the infections it causes, starting from its emergence in Wuhan (China) from the initial epidemics all around the world, compare the virus to other betacoronaviruses, focus on its airborne transmission, compare containment strategies ("zero-COVID" vs. "herd immunity"), explain its phylogeographical tracking, underline the importance of natural selection on the epidemics, mention its within-host population dynamics. Finally, we discuss how the pandemic has transformed (or should transform) the surveillance and prevention of viral respiratory infections and identify perspectives for the research on epidemiology of COVID-19.}, } @article {pmid40197126, year = {2025}, author = {Klingl, YE and Petrauskas, A and Jaślan, D and Grimm, C}, title = {TPCs: FROM PLANT TO HUMAN.}, journal = {Physiological reviews}, volume = {105}, number = {3}, pages = {1695-1732}, doi = {10.1152/physrev.00044.2024}, pmid = {40197126}, issn = {1522-1210}, support = {DFG GR4315/6-1//Deutsche Forschungsgemeinschaft (DFG)/ ; DFG GR4315/7-1//Deutsche Forschungsgemeinschaft (DFG)/ ; SFB1328 A21//Deutsche Forschungsgemeinschaft (DFG)/ ; TRR152 P04//Deutsche Forschungsgemeinschaft (DFG)/ ; GRK2338 P08//Deutsche Forschungsgemeinschaft (DFG)/ ; }, mesh = {Humans ; Animals ; *Calcium Channels/metabolism/genetics ; COVID-19/metabolism ; NADP/analogs & derivatives/metabolism ; Calcium Signaling ; Calcium/metabolism ; }, abstract = {In 2005, the Arabidopsis thaliana two-pore channel TPC1 channel was identified as a vacuolar Ca[2+]-release channel. In 2009, three independent groups published studies on mammalian TPCs as nicotinic acid adenine dinucleotide phosphate (NAADP)-activated endolysosomal Ca[2+] release channels, results that were eventually challenged by two other groups, claiming mammalian TPCs to be phosphatidylinositol-3,5-bisphosphate [PI(3,5)P2]-activated Na[+] channels. By now this dispute seems to have been largely reconciled. Lipophilic small molecule agonists of TPC2, mimicking either the NAADP or the PI(3,5)P2 mode of channel activation, revealed, together with structural evidence, that TPC2 can change its selectivity for Ca[2+] versus Na[+] in a ligand-dependent fashion (N- vs. P-type activation). Furthermore, the NAADP-binding proteins Jupiter microtubule-associated homolog 2 protein (JPT2) and Lsm12 were discovered, corroborating the hypothesis that NAADP activation of TPCs only works in the presence of these auxiliary NAADP-binding proteins. Pathophysiologically, loss or gain of function of TPCs has effects on autophagy, exocytosis, endocytosis, and intracellular trafficking, e.g., LDL cholesterol trafficking leading to fatty liver disease or viral and bacterial toxin trafficking, corroborating the roles of TPCs in infectious diseases such as Ebola or COVID-19. Defects in the trafficking of epidermal growth factor receptor and β1-integrin suggested roles in cancer. In neurodegenerative lysosomal storage disease models, P-type activation of TPC2 was found to have beneficial effects on both in vitro and in vivo hallmarks of Niemann-Pick disease type C1, Batten disease, and mucolipidosis type IV. Here, we cover the latest on the structure, function, physiology, and pathophysiology of these channels with a focus initially on plants followed by mammalian TPCs, and we discuss their potential as drug targets, including currently available pharmacology.}, } @article {pmid40196380, year = {2025}, author = {Safi, D and Khouri, F and Zareef, R and Arabi, M}, title = {Antivirals in COVID-19: A Focus on Pediatric Cardiac Patients.}, journal = {The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale}, volume = {2025}, number = {}, pages = {4573096}, pmid = {40196380}, issn = {1712-9532}, abstract = {The COVID-19 pandemic created an unprecedented public health crisis, driven by its rapid global spread and the urgent need for worldwide collaborative interventions to contain it. This urgency spurred the search for therapeutic agents to prevent or manage the infection. Among these, various types of antivirals emerged as a prominent treatment option, supported by a wealth of observational studies and randomized controlled trials. The results from such studies conflict, with some concluding efficacy and others the lack thereof, with variability also occurring depending on the severity of COVID-19 in the studied population. In addition, many agents have been explored using randomized controlled trials-the gold standard in evaluating the efficacy of an intervention-to only a limited degree, with most of the evidence behind their use concluded using observational studies. Thus, the sheer volume of data has made it challenging to resolve inconsistencies and determine true efficacy. Furthermore, there is a paucity in the literature regarding the use of antivirals in the pediatric population infected with COVID-19, with their use being extrapolated from the results of studies done on adult patients. As such, additional trials are needed to solidify the effectiveness of antivirals in managing COVID-19, particularly in the underexplored and especially vulnerable pediatric cardiac patients. Therefore, utilizing the results from randomized controlled trials, this narrative review evaluates the rationale behind the use of antivirals, summarizes the findings from the literature, and concludes with a focused discussion on their application in pediatric cardiac patients.}, } @article {pmid40195851, year = {2025}, author = {Chung, J and Pierce, J and Franklin, C and Olson, RM and Morrison, AR and Amos-Landgraf, J}, title = {Translating animal models of SARS-CoV-2 infection to vascular, neurological and gastrointestinal manifestations of COVID-19.}, journal = {Disease models & mechanisms}, volume = {18}, number = {9}, pages = {}, pmid = {40195851}, issn = {1754-8411}, support = {IK2BX002527//U.S. Department of Veterans Affairs/ ; I01 CX002231/CX/CSRD VA/United States ; R01 HL163005/HL/NHLBI NIH HHS/United States ; T32 OD011126/OD/NIH HHS/United States ; P20 GM103652/GM/NIGMS NIH HHS/United States ; T32OD011126//NIH Office of the Director/ ; R01 HL139795/HL/NHLBI NIH HHS/United States ; U42 OD010918/OD/NIH HHS/United States ; IK2 BX002527/BX/BLRD VA/United States ; U42OD010918//Institutes of Health (NIH)/ ; }, mesh = {*COVID-19/complications/pathology/virology ; Animals ; *Disease Models, Animal ; *SARS-CoV-2/physiology ; *Gastrointestinal Diseases/virology/etiology/pathology ; Humans ; *Nervous System Diseases/virology/etiology/pathology ; *Vascular Diseases/virology/etiology ; Gastrointestinal Tract/pathology/virology ; *Translational Research, Biomedical ; }, abstract = {Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) initiated a global pandemic resulting in an estimated 775 million infections with over 7 million deaths, it has become evident that COVID-19 is not solely a pulmonary disease. Emerging evidence has shown that, in a subset of patients, certain symptoms - including chest pain, stroke, anosmia, dysgeusia, diarrhea and abdominal pain - all indicate a role of vascular, neurological and gastrointestinal (GI) pathology in the disease process. Many of these disease processes persist long after the acute disease has been resolved, resulting in 'long COVID' or post-acute sequelae of COVID-19 (PASC). The molecular mechanisms underlying the acute and systemic conditions associated with COVID-19 remain incompletely defined. Appropriate animal models provide a method of understanding underlying disease mechanisms at the system level through the study of disease progression, tissue pathology, immune system response to the pathogen and behavioral responses. However, very few studies have addressed PASC and whether existing models hold promise for studying this challenging problem. Here, we review the current literature on cardiovascular, neurological and GI pathobiology caused by COVID-19 in patients, along with established animal models of the acute disease manifestations and their prospects for use in PASC studies. Our aim is to provide guidance for the selection of appropriate models in order to recapitulate certain aspects of the disease to enhance the translatability of mechanistic studies.}, } @article {pmid40195015, year = {2025}, author = {Zubair, A and Ahmad, H and Arif, MM and Ali, M}, title = {mRNA vaccines against HIV: Hopes and challenges.}, journal = {HIV medicine}, volume = {26}, number = {6}, pages = {824-838}, doi = {10.1111/hiv.70024}, pmid = {40195015}, issn = {1468-1293}, mesh = {Humans ; *AIDS Vaccines/immunology ; *HIV Infections/prevention & control/immunology ; *Vaccines, Synthetic/immunology ; *HIV-1/immunology ; mRNA Vaccines/immunology ; Vaccine Development ; *RNA, Messenger/immunology ; Clinical Trials as Topic ; }, abstract = {BACKGROUND: Since the introduction of the first licensed mRNA-based vaccines against COVID-19, there has been significant interest in leveraging this technology for other vaccines. An unprecedented surge of mRNA vaccines has emerged in preclinical, clinical, and various research phases since 2020. The rapid development of mRNA formulations, delivery methods, and manufacturing processes has made this trend foreseeable. There is an urgent demand for effective and easily transportable vaccines in regions where the virus is prevalent, and mRNA technology shows promise in addressing this need.

METHODOLOGY: The data was retrieved from various databases, including Google Scholar, PubMed, Science Direct, ClinicalTrials.gov, and government websites. The following terms were used in the search strategies: HIV, vaccines, mRNA vaccines, clinical trials, and preclinical trials. A total of 35 articles were identified and subsequently screened for data regarding mRNA vaccines for HIV.

RESULTS: mRNA vaccines are an effective solution for HIV treatment, as demonstrated by various research studies referenced in the article.

CONCLUSION: This review evaluates the current state of HIV-1 mRNA vaccine development, clarifies various targeting strategies, highlights recent research findings, and provides insights into the challenges and potential solutions associated with these issues. In this review, we have explored mRNA vaccines, focusing on their functional structure, design, manufacturing, and distribution methodologies.}, } @article {pmid40194536, year = {2025}, author = {Bejon, P and Agweyu, A and Ochola-Oyier, LI and Hamaluba, M and Kamuya, D and Kinyanjui, S and Barasa, E}, title = {Rethinking the evidence on COVID-19 in Africa.}, journal = {The Lancet. Infectious diseases}, volume = {25}, number = {8}, pages = {e463-e471}, doi = {10.1016/S1473-3099(25)00071-4}, pmid = {40194536}, issn = {1474-4457}, mesh = {Humans ; *COVID-19/epidemiology/mortality/transmission ; Africa/epidemiology ; SARS-CoV-2 ; Kenya/epidemiology ; Pandemics ; Prevalence ; }, abstract = {The COVID-19 pandemic was predicted to cause substantial mortality in Africa. However, some countries in Africa had a striking absence of overwhelmed hospitals and low reported mortality. The marked contrast with the overwhelmed hospitals and high mortality seen in Europe and other high-income settings was regarded as puzzling and a paradox. In this Review, we reflect on possible explanations for the paradox with particular reference to observations made on the ground in Kenya. The evidence is inconsistent with reduced viral transmission or poor surveillance as primary explanations for the discrepancy. Population age structure is an important but incomplete explanation of the epidemiology. Due to the high prevalence of asymptomatic infection, low mortality, and evidence of reduced inflammatory responses, we hypothesise that some populations in Africa might have reduced susceptibility to symptomatic COVID-19. The reduced inflammatory responses might result from immunoregulation or cross-reactive, pre-pandemic cellular immunity, although the evidence is not definitive. Local data are essential to develop public health policies that align with the reality on the ground rather than external perceptions.}, } @article {pmid40194268, year = {2025}, author = {Jeremic, D and Navarro-Lopez, JD and Jimenez-Diaz, L}, title = {Clinical Benefits and Risks of Antiamyloid Antibodies in Sporadic Alzheimer Disease: Systematic Review and Network Meta-Analysis With a Web Application.}, journal = {Journal of medical Internet research}, volume = {27}, number = {}, pages = {e68454}, pmid = {40194268}, issn = {1438-8871}, mesh = {Humans ; *Alzheimer Disease/drug therapy ; Bayes Theorem ; *Internet ; Risk Assessment ; }, abstract = {BACKGROUND: Despite the increasing approval of antiamyloid antibodies for Alzheimer disease (AD), their clinical relevance and risk-benefit profile remain uncertain. The heterogeneity of AD and the limited availability of long-term clinical data make it difficult to establish a clear rationale for selecting one treatment over another.

OBJECTIVE: The aim of this work was to assess and compare the efficacy and safety of antiamyloid antibodies through an interactive online meta-analytic approach by performing conventional pair-wise meta-analyses and frequentist and Bayesian network meta-analyses of phase II and III clinical trial results. To achieve this, we developed AlzMeta.app 2.0, a freely accessible web application that enables researchers and clinicians to evaluate the relative and absolute risks and benefits of these therapies in real time, incorporating different prior choices and assumptions of baseline risks of disease progression and adverse events.

METHODS: We adhered to PRISMA-NMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for reporting of systematic reviews with network meta-analysis) and GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) guidelines for reporting and rating the certainty of evidence. Clinical trial reports (until September 30, 2024) were retrieved from PubMed, Google Scholar, and clinical trial databases (including ClinicalTrials.gov). Studies with <20 sporadic AD patients and a modified Jadad score <3 were excluded. Risk of bias was assessed with the RoB-2 tool. Relative risks and benefits have been expressed as risk ratios and standardized mean differences, with confidence, credible, and prediction intervals calculated for all outcomes. For significant results, the intervention effects were ranked in frequentist and Bayesian frameworks, and their clinical relevance was determined by the absolute risk per 1000 people and number needed to treat (NNT) for a wide range of control responses.

RESULTS: Among 7 treatments tested in 21,236 patients (26 studies with low risk of bias or with some concerns), donanemab was the best-ranked treatment on cognitive and functional measures, and it was almost 2 times more effective than aducanumab and lecanemab and significantly more beneficial than other treatments on the global (cognitive and functional) Clinical Dementia Rating Scale-Sum of Boxes (NNT=10, 95% CI 8-16). Special caution is required regarding cerebral edema and microbleeding due to the clinically relevant risks of edema for donanemab (NNT=8, 95% CI 5-16), aducanumab (NNT=10, 95% CI 6-17), and lecanemab (NNT=14, 95% CI 7-31), which may outweigh the benefits.

CONCLUSIONS: Our results showed that donanemab is more effective and has a safety profile similar to aducanumab and lecanemab, highlighting the need for treatment options with improved safety. Potential bias may have been introduced in the included trials due to unblinding caused by frequent cerebral edema and microbleeds, as well as the impact of the COVID-19 pandemic.}, } @article {pmid40194267, year = {2025}, author = {Bakhti, R and Daler, H and Ogunro, H and Hope, S and Hargreaves, D and Nicholls, D}, title = {Exploring Engagement With and Effectiveness of Digital Mental Health Interventions in Young People of Different Ethnicities: Systematic Review.}, journal = {Journal of medical Internet research}, volume = {27}, number = {}, pages = {e68544}, pmid = {40194267}, issn = {1438-8871}, mesh = {Humans ; *Mental Disorders/therapy/ethnology ; COVID-19/psychology/epidemiology ; *Ethnicity/psychology ; Adolescent ; Young Adult ; *Mental Health ; Telemedicine ; *Mental Health Services ; }, abstract = {BACKGROUND: The prevalence of mental health difficulties among young people has risen in recent years, with 75% of mental disorders emerging before the age of 24 years. The identification and treatment of mental health issues earlier in life improves later-life outcomes. The COVID-19 pandemic spurred the growth of digital mental health interventions (DMHIs), which offer accessible support. However, young people of different ethnicities face barriers to DMHIs, such as socioeconomic disadvantage and cultural stigma.

OBJECTIVE: This review aimed to summarize and evaluate the engagement with and effectiveness of DMHIs among young people of different ethnicities.

METHODS: A systematic search was conducted in MEDLINE, Embase, and PsycINFO for studies published between January 2019 and May 2024, with an update in September 2024. The inclusion criteria were participants aged <25 years using DMHIs from various ethnic backgrounds. Three reviewers independently screened and selected the studies. Data on engagement (eg, use and uptake) and effectiveness (eg, clinical outcomes and symptom improvement) were extracted and synthesized to compare findings. Studies were assessed for quality using the Mixed Methods Appraisal Tool.

RESULTS: The final search yielded 67 studies, of which 7 (10%) met inclusion criteria. There were 1853 participants across the 7 studies, all from high-income countries. Participants were predominantly aged 12 to 25 years, with representation of diverse ethnic identities, including Black, Asian, Hispanic, mixed race, and Aboriginal individuals. Engagement outcomes varied, with culturally relatable, low-cost interventions showing higher retention and user satisfaction. Linguistic barriers and country of origin impeded the effectiveness of some interventions, while near-peer mentorship, coproduction, and tailored content improved the effectiveness of DMHIs. While initial results are promising, small sample sizes, heterogeneity in outcome assessments, and a paucity of longitudinal data impeded robust comparisons and generalizability.

CONCLUSIONS: DMHIs show potential as engaging and effective mental health promotional tools for young people of different ethnicities, especially when coproduced and culturally relatable. Initial data suggest that interventions facilitating near-peer mentoring, linguistic adaptation, low cost, and cultural relatability have improved engagement and effectiveness. Future research should focus on developing a consensus definition of DMHIs, exploring DMHIs in children aged <12 years, and conducting detailed qualitative and quantitative research on use factors and treatment efficacy of DMHIs for young people of different ethnicities.

TRIAL REGISTRATION: PROSPERO CRD42024544364; https://tinyurl.com/yk5jt8yk.}, } @article {pmid40193038, year = {2025}, author = {Sadowski, J and Ostrowska, SA and Klaudel, T and Zaborska, M and Chruszcz, M and Sztangreciak-Lehun, A and Bułdak, RJ}, title = {Neuropsychiatric disorders in the course to SARS-CoV-2 virus infection, including biological pathomechanisms, psychosocial factors and long COVID-19 associated with "brain fog".}, journal = {Journal of neurovirology}, volume = {31}, number = {2}, pages = {116-130}, pmid = {40193038}, issn = {1538-2443}, mesh = {Humans ; *COVID-19/psychology/complications/virology/immunology/pathology ; SARS-CoV-2/pathogenicity ; *Mental Disorders/virology/psychology ; *Brain/virology/pathology/physiopathology ; Post-Acute COVID-19 Syndrome ; Cytokine Release Syndrome/virology/psychology ; }, abstract = {During the COVID-19 pandemic, neuropsychiatric disorders began to be observed in a significant proportion of patients, occurring at different times after infection and characterised by varying degrees of severity. This article discusses neurological and psychiatric disorders associated with SARS-CoV-2 virus infection, taking into account biological pathomechanisms and psychosocial factors. The long COVID-19 along with the "brain fog" phenomenon were considered in the study. The purpose of the study is to analyse and discuss the available information from the scientific literature on the possible association between SARS-CoV-2 virus infection and the occurrence of neuropsychiatric disorders with different degrees of severity and temporal correlation. To discuss the correlation of COVID-19 with the occurrence of neuropsychiatric disorders, a systematic literature review was conducted using the following databases: PubMed, Elsevier and Google Scholar. The following keywords were used when searching the materials used: "neuropsychiatric disorders", "COVID-19", "SARS-CoV-2", "NeuroCOVID", "cytokine storm" and "long COVID-19". Focusing on the characteristics of the materials and methods used, as well as the results obtained and conclusions reached in each article, 164 publications of research, meta-analysis, review and case reports were included in the study. Neuropsychiatric disorders resulting from SARS-CoV-2 virus infection are multifactorial in nature. The main elements responsible for the varied pattern of symptoms include direct and indirect central nervous system effects of the disease, individual patient conditions, psychosocial factors, severity of immune responses and severity of infection. The neuropsychiatric effects of SARS-CoV-2 infection can be divided into symptoms directly related to the neurological and psychiatric zones and mixed disorders.}, } @article {pmid40191963, year = {2025}, author = {Anandari, D and Kurniawan, A and Gamelia, E}, title = {Enablers and Barriers of Telemedicine in Indonesia: A Systematic Review.}, journal = {Public health nursing (Boston, Mass.)}, volume = {42}, number = {4}, pages = {1575-1584}, doi = {10.1111/phn.13552}, pmid = {40191963}, issn = {1525-1446}, mesh = {Humans ; *Telemedicine/statistics & numerical data ; Indonesia ; *COVID-19/epidemiology ; *Patient Acceptance of Health Care/psychology/statistics & numerical data ; *Health Services Accessibility ; Pandemics ; }, abstract = {OBJECTIVE: Health-seeking behavior related to the utilization of health services has experienced exceptionally noteworthy changes after the COVID-19 pandemic. That is telemedicine, which has become more commonplace amid lockdowns. The pandemic status has ended today, but since telemedicine utilization has numerous benefits, the innovation must stay accessible. This systematic review aimed to describe telemedicine utilization and which factors could become enablers and barriers.

DESIGN: The literature search for the review was conducted in November 2024. The articles reviewed were published in 2019-2024 and selected from Science Direct, Springer, ProQuest, and EBSCOhost databases.

RESULTS: The articles were research articles and used qualitative methods. Based on search results, screening process, and review articles, we describe enabling factors and barriers of telemedicine utilization through users' (patients) and providers' (health practitioners) points of view. We also define infrastructures, such as smart city development, that contribute to the development of telemedicine.

CONCLUSIONS: Future research into people's perception of telemedicine, developing telemedicine technology, and finding alternatives to getting electricity and internet connection with a low budget will promote telemedicine utilization.}, } @article {pmid40191455, year = {2025}, author = {Prashar, N and Mohammed, SB and Raja, NS and Mohideen, HS}, title = {Rerouting therapeutic peptides and unlocking their potential against SARS-CoV2.}, journal = {3 Biotech}, volume = {15}, number = {5}, pages = {116}, pmid = {40191455}, issn = {2190-572X}, abstract = {The COVID-19 pandemic highlighted the potential of peptide-based therapies as an alternative to traditional pharmaceutical treatments for SARS-CoV-2 and its variants. Our review explores the role of therapeutic peptides in modulating immune responses, inhibiting viral entry, and disrupting replication. Despite challenges such as stability, bioavailability, and the rapid mutation of the virus, ongoing research and clinical trials show that peptide-based treatments are increasingly becoming integral to future viral outbreak responses. Advancements in computational modelling methods in combination with artificial intelligence will enable mass screening of therapeutic peptides and thereby, comprehending a peptide repurposing strategy similar to the small molecule repurposing. These findings suggest that peptide-based therapies play a critical and promising role in future pandemic preparedness and outbreak management.}, } @article {pmid40191438, year = {2025}, author = {Karimi, R and Norozirad, M and Esmaeili, F and Mansourian, M and Marateb, HR}, title = {COVID-19 Vaccination and Cardiovascular Events: A Systematic Review and Bayesian Multivariate Meta-Analysis of Preventive Benefits and Risks.}, journal = {International journal of preventive medicine}, volume = {16}, number = {}, pages = {14}, pmid = {40191438}, issn = {2008-7802}, abstract = {BACKGROUND: To provide a detailed understanding and apply a comprehensive strategy, this study examines the association between COVID-19 vaccination and cardiovascular events. We conducted a Bayesian multivariate meta-analysis using summary data across multiple outcomes including myocardial infarction, stroke, arrhythmia, and CAD, considering potential dependencies in the data. Markov chain Monte Carlo (MCMC) methods were detected for easy implementation of the Bayesian approach. Also, the sensitivity analysis of the model was done by using different priors.

METHODS: Fifteen studies were included in the systematic review, with eleven studies comparing the results between the vaccine group and the unvaccinated group. Additionally, six studies were used for further analysis to compare mRNA COVID-19 Vaccines (Pfizer-BioNTech and Moderna).

RESULTS: Bayesian meta-analysis revealed a link between vaccines and CAD risk (OR, 1.70; 95% CrI: 1.11-2.57), particularly after BNT162b2 (OR, 1.64; 95% CrI: 1.06-2.55) and second dose (OR, 3.44; 95% CrI: 1.99-5.98). No increased risk of heart attack, arrhythmia, or stroke was observed post-COVID-19 vaccination. As the only noteworthy point, a protective effect on stroke (OR, 0.19; 95% CrI: 0.10-0.39) and myocardial infarction (OR, 0.003; 95% CrI: 0.001-0.006) was observed after the third dose of the vaccine.

CONCLUSIONS: Secondary analysis showed no notable disparity in cardiovascular outcomes between BNT162b2 and mRNA vaccines. The association of COVID-19 vaccination with the risk of coronary artery disease should be considered in future vaccine technologies for the next pandemic.}, } @article {pmid40190856, year = {2025}, author = {Khan, S and Hussain Timraz, J and Al Ghamdi, NA and Metwali, NY and Yaseen, FA and Alshaqha, AM and Alamri, SH and Turkistani, H and Dwaima, A and Ali Algarni, I}, title = {COVID-19 and Its Effects on the Hepatobiliary System: A Literature Review.}, journal = {Cureus}, volume = {17}, number = {3}, pages = {e80231}, pmid = {40190856}, issn = {2168-8184}, abstract = {COVID-19 encompasses a wide clinical spectrum, from mild influenza-like illness to severe pneumonia and systemic complications. There is emerging literature on hepatobiliary involvement in COVID-19, especially elevation in liver enzymes as surrogate markers of liver injury. Angiotensin-converting enzyme 2 receptors within the hepatobiliary system are a portal of entry for SARS-CoV-2, after which injury may be perpetuated through hypoxia and cytokine storms. This literature review covers studies published before 2024 from databases such as PubMed, Google Scholar, Springer, and BMC Library. The keywords used were "COVID-19", "liver", "SARS-CoV-2", "chronic liver disease", and other relevant terms to ensure a wide scope of investigation. The most common liver enzymes elevated among COVID-19 patients include aspartate transaminase, alanine transaminase, and alkaline phosphatase, all of which are associated with the severity of the disease. Chronic liver disease (CLD) and hepatocellular carcinoma (HCC) patients have worse outcomes with increased ICU admission rates and increased mortality. COVID-19 vaccination in CLD and liver transplant recipients is very often associated with suboptimal antibody responses, adding to the risks. SARS-CoV-2 causes liver involvement through direct viral cytopathic effects, immune-mediated injury, and systemic hypoxia. Individuals with CLD are particularly vulnerable to severe illness.}, } @article {pmid40190702, year = {2025}, author = {Cho, JY and Prakash, T and Lam, W and Seegert, N and Samore, MH and Pavia, AT and Nelson, RE and Chaiyakunapruk, N}, title = {Understanding macroeconomic indicators affected by COVID-19 containment policies in the United States: a scoping review.}, journal = {Health affairs scholar}, volume = {3}, number = {4}, pages = {qxaf045}, pmid = {40190702}, issn = {2976-5390}, abstract = {Containment policies were essential in controlling the spread of the COVID-19 pandemic in the United States, but they also introduced significant economic challenges. This scoping review aimed to examine the macroeconomic indicators used to assess COVID-19 closure and containment policies in the United States. We reviewed 42 eligible studies from 4516 records identified across PubMed, Web of Science, and EconLit. These studies explored various economic impacts, focusing on employment, labor market indicators, consumer spendings, etc., primarily using publicly available sources. During the pandemic, high-frequency data (eg, mobility and card transactions) became newly accessible and played a key role in evaluating the real-time effects of mitigation policies. Our review summarizes macroeconomic indicators investigated and provides researchers and policymakers with a list of data sources for assessment of economic impacts in the future. This review emphasizes the need for comprehensive evaluations to balance public health measures with economic considerations in future pandemic responses.}, } @article {pmid40190619, year = {2025}, author = {Williams, KA}, title = {Advancing Health Equity and Addressing Health Disparities.}, journal = {American journal of lifestyle medicine}, volume = {}, number = {}, pages = {15598276251329888}, pmid = {40190619}, issn = {1559-8284}, abstract = {This article describes the factors contributing to ethnic health disparities and their impact on health equity in the United States. Historical examples of infectious diseases, such as smallpox, yellow fever, polio, HIV, and COVID-19, illustrate racial mortality differences that were eliminated by removing the diseases. In addition, disparities in cardiovascular death risk factors, including hypertension, type 2 diabetes, inflammation, hyperlipidemia, chronic kidney disease (CKD), and obesity, are examined. The adoption of whole food plant-based (WFPB) diets is proposed as a practical and culturally sensitive solution to mitigate these disparities and promote health equity. Evidence-based strategies are discussed to support implementation.}, } @article {pmid40190037, year = {2025}, author = {Heiser, BJ and Veyssi, A and Ghosh, D}, title = {Recent strategies for enhanced delivery of mRNA to the lungs.}, journal = {Nanomedicine (London, England)}, volume = {20}, number = {9}, pages = {1043-1069}, pmid = {40190037}, issn = {1748-6963}, mesh = {Humans ; *RNA, Messenger/administration & dosage/therapeutic use/genetics ; *Lung/metabolism ; *Drug Delivery Systems/methods ; COVID-19/therapy/virology ; Animals ; SARS-CoV-2 ; COVID-19 Vaccines/administration & dosage ; }, abstract = {mRNA-based therapies have emerged as a transformative tool in modern medicine, gaining significant attention following their successful use in COVID-19 vaccines. Delivery to the lungs offers several compelling advantages for mRNA delivery. The lungs are one of the most vascularized organs in the body, which provides an extensive surface area that can facilitate efficient drug transport. Local delivery to the lungs bypasses gastrointestinal degradation, potentially enhancing therapeutic efficacy. In addition, the extensive capillary network of the lungs provides an ideal target for systemic delivery. However, developing effective mRNA therapies for the lungs presents significant challenges. The complex anatomy of the lungs and the body's immune response to foreign particles create barriers to delivery. This review discusses key approaches for overcoming these challenges and improving mRNA delivery to the lungs. It examines both local and systemic delivery strategies aimed at improving lung delivery while mitigating off-target effects. Although substantial progress has been made in lung-targeted mRNA therapies, challenges remain in optimizing cellular uptake and achieving therapeutic efficacy within pulmonary tissues. The continued refinement of delivery strategies that enhance lung-specific targeting while minimizing degradation is critical for the clinical success of mRNA-based pulmonary therapies.}, } @article {pmid40189996, year = {2025}, author = {Guglielmi, V and Colangeli, L and Parrotta, ME and Ciammariconi, A and Milani, I and D'Adamo, M and Sbraccia, P and Capoccia, D}, title = {Social isolation and loneliness in non-communicable chronic diseases: Impact of COVID-19 pandemic, population aging and technological progress.}, journal = {Nutrition, metabolism, and cardiovascular diseases : NMCD}, volume = {35}, number = {6}, pages = {104015}, doi = {10.1016/j.numecd.2025.104015}, pmid = {40189996}, issn = {1590-3729}, mesh = {Humans ; *COVID-19/epidemiology/psychology ; *Social Isolation/psychology ; *Loneliness/psychology ; *Noncommunicable Diseases/epidemiology/psychology/therapy ; *Aging/psychology ; SARS-CoV-2 ; Risk Factors ; Chronic Disease ; Pandemics ; Aged ; }, abstract = {AIMS: Social isolation and loneliness have increasingly emerged as closely linked to onset and progression of non-communicable chronic diseases (NCDs). The aim of this review is to highlight the importance of addressing social isolation in the prevention and management of NCDs such as obesity, type 2 diabetes, and cardiovascular diseases in order to hinder their development and improve their outcomes.

DATA SYNTHESIS: Social isolation and loneliness affect a significant portion of the older adult population, due to decrease in social interactions, chronic illnesses and sensory impairments. However, many other vulnerable populations may experience social isolation because of psychiatric or disabling health conditions, substances abuse, low socioeconomic status, unemployment and belonging to ethnic or marginalized minorities. The unprecedented COVID-19-related social distancing can be taken as a proof-of-concept of the detrimental role of poor interactions in NCDs prevention and management not only at individual level but also in a public health perspective. Indeed, social isolation has been linked to unhealthy lifestyle choices, disrupted sleep quality, low utilization of healthcare, preventive services and adherence to treatments. Underlying mechanisms like inflammation and stress responses may also play a role in the association between social isolation and worse NCDs outcomes.

CONCLUSIONS: Social isolation negatively impacts on the development, progression and management of NCDs. Effective interventions for social isolation should address both societal factors and healthcare-related needs. To counteract the detrimental effects of social distancing during COVID-19 pandemic, the use of telemedicine was implemented. However, telemedicine is not always available, and legislative and age-related barriers persist.}, } @article {pmid40189700, year = {2025}, author = {Li, S and Sun, J and Li, H and Han, Z and Wang, T and Gao, S and Zhu, P and Chen, Y and Yan, P and Wang, M and Liu, G}, title = {Expression of SARS-CoV-2 entry receptor ACE2 in human brain and its association with Alzheimer's disease and COVID-19.}, journal = {Molecular psychiatry}, volume = {30}, number = {7}, pages = {3257-3268}, pmid = {40189700}, issn = {1476-5578}, support = {82071212, and 81901181//National Natural Science Foundation of China (National Science Foundation of China)/ ; }, mesh = {Humans ; *Alzheimer Disease/metabolism/genetics/virology ; COVID-19/metabolism ; *Angiotensin-Converting Enzyme 2/metabolism/genetics ; *Brain/metabolism/virology ; SARS-CoV-2 ; Pandemics ; Betacoronavirus ; RNA, Messenger/metabolism ; *Pneumonia, Viral/metabolism ; Virus Internalization ; Peptidyl-Dipeptidase A/metabolism/genetics ; }, abstract = {It is known that infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cause coronavirus disease 2019 (COVID-19). It is widely reported that Alzheimer's disease (AD) is associated with the highest risk of COVID-19 infection, hospitalization and mortality. However, it remains largely unclear about the link between AD and COVID-19. ACE2 is an entry receptor for SARS-CoV-2. We consider that there may be a link between AD and COVID-19 through the expression of ACE2. Here, we summarize recent findings about the ACE2 expression especially in AD and COVID-19, and shows that (1) ACE2 shows mRNA and protein expression in human brain tissues, especially in neurons and non-neuron cells; (2) low ACE2 mRNA and protein expression are sufficient for SARS-CoV-2 entry into the human brain through the neural route (olfactory and/or vagal) and the hematogenous route; (3) SARS-CoV-2 RNA and protein were detected in brains of COVID-19 patients; (4) SARS-CoV-2 infects and replicates in human brain dependent on ACE2; (5) SARS-CoV-2 viral RNA load shows a positive association with ACE2 mRNA levels and COVID-19 severity; (6) ACE2 shows increased expression in AD compared with controls in human brain; (7) ACE2 shows increased expression in COVID-19 compared with controls in human brain; (8) ACE2 expression levels affect COVID-19 outcomes. Together, ACE2 shows significantly increased mRNA and protein expression in AD compared with controls in human brain. Consequently, the increased expression of ACE2 would facilitate infection with SARS-CoV-2, and play a role in the context of COVID-19. These findings suggest that the expression of ACE2 may partly explain the link of AD with COVID-19 infection, hospitalization and mortality.}, } @article {pmid40189453, year = {2025}, author = {Lorea, CF and Pressman, K and Schuler-Faccini, L}, title = {Infections during pregnancy: An ongoing threat.}, journal = {Seminars in perinatology}, volume = {49}, number = {4}, pages = {152075}, doi = {10.1016/j.semperi.2025.152075}, pmid = {40189453}, issn = {1558-075X}, mesh = {Humans ; Pregnancy ; Female ; *Pregnancy Complications, Infectious/epidemiology/virology/prevention & control ; *Infectious Disease Transmission, Vertical/prevention & control ; COVID-19/epidemiology ; Zika Virus Infection ; Infant, Newborn ; SARS-CoV-2 ; }, abstract = {Congenital infections are an ongoing relevant cause of congenital and perinatal abnormalities since effective vaccination is not available for many diseases. Moreover, climate change, mutational evolution of pathogens, or their vectors associated with intense human traveling predispose to outbreaks and modification of the geographic distribution of traditionally limited infectious diseases. Here, we review the so-called TORCH infections (toxoplasmosis, others, rubella, cytomegalovirus, herpes) with a special emphasis on the arboviral infections (zika, dengue, chikungunya, oropouche). Although respiratory viruses are rarely transmitted through the placenta, the maternal condition itself can cause adverse effects on the developing embryo/fetus (COVID-19, influenza). Some perinatal-acquired infections will also be briefly discussed due to their relevance in the child's development. The majority of teratogenic congenital and some perinatal-acquired infections have effects on the central nervous system or sensory organs with long-lasting disabilities. Vaccines are unavailable for several teratogenic or perinatal infections, and treatment options are still limited, particularly for arboviral and other emergent diseases. Social inequalities are associated with the prevalence, fetal outcomes and long-term disabilities of these diseases. The One Health approach could be an essential way to reduce the burden of these diseases in the population.}, } @article {pmid40189198, year = {2025}, author = {Azeem, M and Cancemi, P and Mukhtar, F and Marino, S and Peri, E and Di Prima, G and De Caro, V}, title = {Efficacy and limitations of SARS-CoV-2 vaccines - A systematic review.}, journal = {Life sciences}, volume = {371}, number = {}, pages = {123610}, doi = {10.1016/j.lfs.2025.123610}, pmid = {40189198}, issn = {1879-0631}, mesh = {Humans ; *COVID-19 Vaccines/immunology/adverse effects/therapeutic use ; *COVID-19/prevention & control/immunology ; *SARS-CoV-2/immunology ; *Vaccine Efficacy ; Vaccines, Inactivated/immunology ; BNT162 Vaccine ; }, abstract = {The emergence of the SARS-CoV-2 virus worldwide led to the call for the development of effective and safe vaccines to contain the spread and effects of COVID-19. Using information from 40 publications, including clinical trials and observational studies from 2019 to 2024, this review assesses the effectiveness, safety, and limitations of four major vaccines: Sinopharm (BBIBP-CorV), Moderna (mRNA-1273), Pfizer-BioNTech (BNT162b2), and CoronaVac. Pfizer-BioNTech and Moderna's mRNA vaccines proved to be more effective than others; Moderna's vaccines showed an efficacy of 94.1 % against symptomatic infection, while Pfizer-BioNTech's vaccines showed an efficacy of up to 95 %, against severe diseases and hospitalization. These vaccinations, which included protection against Omicron and Delta variants, offered notable protection against serious illness, hospitalization, and mortality. Severe adverse events were rare while most adverse events were mild to moderate, such as headaches, fatigue, and localized reactions. In contrast, inactivated virus vaccines such as Sinopharm and CoronaVac with efficacies ranging from 50 to 79 % against symptomatic infection showed lower levels of effectiveness. In Phase 3 trial, Sinopharm showed 72.8 % efficacy, whereas CoronaVac demonstrated roughly 67 % efficacy in population against hospitalization and severe disease. Booster doses were required for adequate immunological response, especially against novel strains, as these vaccinations proved to be less effective in older populations. They showed considerable safety profiles, with mild side effects, but their low immunogenicity is concerning. This review emphasizes the importance of continuously evaluating vaccines in response to the evolving virus, essential for improving international immunization programs.}, } @article {pmid40188989, year = {2025}, author = {Khalaf, WS and Morgan, RN and Elkhatib, WF}, title = {Clinical microbiology and artificial intelligence: Different applications, challenges, and future prospects.}, journal = {Journal of microbiological methods}, volume = {232-234}, number = {}, pages = {107125}, doi = {10.1016/j.mimet.2025.107125}, pmid = {40188989}, issn = {1872-8359}, mesh = {Humans ; *Artificial Intelligence/trends ; COVID-19/virology ; Algorithms ; Machine Learning ; *Microbiological Techniques/methods ; SARS-CoV-2 ; Quantitative Structure-Activity Relationship ; Deep Learning ; }, abstract = {Conventional clinical microbiological techniques are enhanced by the introduction of artificial intelligence (AI). Comprehensive data processing and analysis enabled the development of curated datasets that has been effectively used in training different AI algorithms. Recently, a number of machine learning (ML) and deep learning (DL) algorithms are developed and evaluated using diverse microbiological datasets. These datasets included spectral analysis (Raman and MALDI-TOF spectroscopy), microscopic images (Gram and acid fast stains), and genomic and protein sequences (whole genome sequencing (WGS) and protein data banks (PDBs)). The primary objective of these algorithms is to minimize the time, effort, and expenses linked to conventional analytical methods. Furthermore, AI algorithms are incorporated with quantitative structure-activity relationship (QSAR) models to predict novel antimicrobial agents that address the continuing surge of antimicrobial resistance. During the COVID-19 pandemic, AI algorithms played a crucial role in vaccine developments and the discovery of new antiviral agents, and introduced potential drug candidates via drug repurposing. However, despite their significant benefits, the implementation of AI encounters various challenges, including ethical considerations, the potential for bias, and errors related to data training. This review seeks to provide an overview of the most recent applications of artificial intelligence in clinical microbiology, with the intention of educating a wider audience of clinical practitioners regarding the current uses of machine learning algorithms and encouraging their implementation. Furthermore, it will discuss the challenges related to the incorporation of AI into clinical microbiology laboratories and examine future opportunities for AI within the realm of infectious disease epidemiology.}, } @article {pmid40188841, year = {2025}, author = {Yunas, I and Islam, MA and Sindhu, KN and Devall, AJ and Podesek, M and Alam, SS and Kundu, S and Mammoliti, KM and Aswat, A and Price, MJ and Zamora, J and Oladapo, OT and Gallos, I and Coomarasamy, A}, title = {Causes of and risk factors for postpartum haemorrhage: a systematic review and meta-analysis.}, journal = {Lancet (London, England)}, volume = {405}, number = {10488}, pages = {1468-1480}, doi = {10.1016/S0140-6736(25)00448-9}, pmid = {40188841}, issn = {1474-547X}, support = {001/WHO_/World Health Organization/International ; }, mesh = {Humans ; *Postpartum Hemorrhage/etiology/epidemiology ; Female ; Risk Factors ; Pregnancy ; }, abstract = {BACKGROUND: An understanding of the causes of postpartum haemorrhage is needed to provide appropriate treatment and services. Knowledge of the risk factors for postpartum haemorrhage can help address modifiable risk factors. We did a systematic review and meta-analysis to identify and quantify the various causes and risk factors for postpartum haemorrhage.

METHODS: In this systematic review and meta-analysis, we did a systematic literature search in MEDLINE, Embase, Web of Science, Cochrane Library, and Google Scholar for cohort studies of postpartum haemorrhage from Jan 1, 1960, to Nov 30, 2024 without language restrictions. At least two authors independently undertook study selection, data extraction, and quality assessment. Population-based cohort studies available in English were eligible. Rates of postpartum haemorrhage causes as well as crude and adjusted odds ratios (ORs) for risk factors were pooled using a random-effects model. Risk factors were classified as having weak, moderate, or strong association based on the pooled ORs: weak (OR >1 to 1·5), moderate (OR >1·5 to 2), and strong (OR >2). This study is registered with PROSPERO, CRD42023479686.

FINDINGS: We synthesised data from 327 studies, including 847 413 451 women with no restriction on age, race, or ethnicity. Most studies were of high methodological quality. The pooled rates of the five commonly reported causes of postpartum haemorrhage were uterine atony (70·6% [95% CI 63·9-77·3]; n=834 707 women, 14 studies), genital tract trauma (16·9% [9·3-24·6]; n=18 449 women, six studies), retained placenta (16·4% [12·3-20·5]; n=235 021 women, nine studies), abnormal placentation (3·9% [0·1-7·6]; n=29 638 women, two studies), and coagulopathy (2·7% [0·8-4·5]; n=236 261, nine studies). The pooled rate of women with multiple postpartum haemorrhage causes was 7·8% (95% CI 4·7-10·8; n=666, two studies). Risk factors with a strong association with postpartum haemorrhage included anaemia, previous postpartum haemorrhage, caesarean birth, female genital mutilation, sepsis, no antenatal care, multiple pregnancy, placenta praevia, assisted reproductive technology use, macrosomia with a birthweight of more than 4500 g, and shoulder dystocia. Risk factors with moderate association with postpartum haemorrhage included BMI ≥30 kg/m[2], COVID-19 infection, gestational diabetes, polyhydramnios, pre-eclampsia, and antepartum haemorrhage. Risk factors with weak association with postpartum haemorrhage included Black and Asian ethnicity, BMI 25-29·9 kg/m[2], asthma, thrombocytopenia, uterine fibroids, antidepressant use, induction of labour, instrumental birth, and premature rupture of membranes.

INTERPRETATION: The finding that uterine atony is the commonest cause of postpartum haemorrhage supports the WHO recommendation for all women giving birth to be given prophylactic uterotonics. Knowledge of risk factors with a strong association with postpartum haemorrhage can help to identify women at high risk of postpartum haemorrhage who could benefit from enhanced prophylaxis and treatment. The importance of multiple concurrent causes of postpartum haemorrhage supports the use of treatment bundles.

FUNDING: Gates Foundation.}, } @article {pmid40188463, year = {2025}, author = {Loef, B and Bosma, E and van Kerkhof, LWM and Proper, KI and van Baarle, D and Dollé, MET}, title = {Night-shift work and susceptibility to infectious diseases: a systematic review and meta-analysis.}, journal = {Scandinavian journal of work, environment & health}, volume = {51}, number = {4}, pages = {298-311}, pmid = {40188463}, issn = {1795-990X}, mesh = {Humans ; *Shift Work Schedule/adverse effects ; *COVID-19/epidemiology ; Disease Susceptibility/epidemiology ; SARS-CoV-2 ; *Communicable Diseases/epidemiology ; }, abstract = {OBJECTIVES: A growing body of research on infection susceptibility among night-shift workers has emerged, particularly since the COVID-19 pandemic. However, a comprehensive overview is still lacking. Therefore, this review aimed to synthesize the evidence on the association between night-shift work and susceptibility to infectious diseases.

METHODS: Embase and PsycINFO were sy