RevDate: 2025-06-28

Nichols JH, Smith AM, CB Jonsson (2025)

The Intersection of SARS-CoV-2 and Diabetes.

Microorganisms, 13(6):.

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.

RevDate: 2025-06-28

Duan Q, Ai T, Ma Y, et al (2025)

Research Progress on the Application of Neutralizing Nanobodies in the Prevention and Treatment of Viral Infections.

Microorganisms, 13(6):.

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.

RevDate: 2025-06-28

Welc N, Frącz W, Olejniczak R, et al (2025)

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.

Microorganisms, 13(6):.

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.

RevDate: 2025-06-26

Alford BS, Hughes CM, Gilpin DF, et al (2025)

Monitoring Antimicrobial Resistance in Care Homes Through Wastewater Surveillance - A Scoping Review.

The Journal of hospital infection pii:S0195-6701(25)00183-5 [Epub ahead of print].

BACKGROUND: Antimicrobial resistance poses a growing threat, especially in care homes where older residents are particularly vulnerable due to frequent antibiotic use and co-morbidities. Following the COVID-19 pandemic, there has been a growing focus on wastewater surveillance for detecting and monitoring pathogens in healthcare settings.

AIM: 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.

METHODS: Six electronic databases (MEDLINE, Embase, Scopus, Web of Science, ProQuest, and Google Scholar) were searched from date of inception until 26[th] August 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.

FINDINGS: 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.

CONCLUSION: 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.

RevDate: 2025-06-26

Lu Y, Qian C, Huang Y, et al (2025)

Advancing mRNA vaccines: A comprehensive review of design, delivery, and efficacy in infectious diseases.

International journal of biological macromolecules pii:S0141-8130(25)06056-8 [Epub ahead of print].

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.

RevDate: 2025-06-26

Lenz C, Song M, Bandara S, et al (2025)

Implementation of Jail and Prison-Based Medication Treatment for Opioid Use Disorder Programs: A Narrative Synthesis.

Medical care research and review : MCRR [Epub ahead of print].

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.

RevDate: 2025-06-29
CmpDate: 2025-06-26

Arrè V, De Luca R, Mrmić S, et al (2025)

Gastrointestinal inflammation and cancer: viral and bacterial interplay.

Gut microbes, 17(1):2519703.

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.

RevDate: 2025-06-27

Shitaye G, Ventserova N, D'Abrosca G, et al (2025)

The role of intrinsically disordered regions of SARS-CoV-2 nucleocapsid and non-structural protein 1 proteins.

Frontiers in chemistry, 13:1597656.

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.

RevDate: 2025-06-27

Yousufzai W, Heo A, Gu K, et al (2025)

First episode of psychiatric and neuropsychiatric disease among patients infected with COVID-19: A scoping review.

PCN reports : psychiatry and clinical neurosciences, 4(2):e70146.

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.

RevDate: 2025-06-28
CmpDate: 2025-06-26

Rocha DM, Pedroso AO, Menegueti MG, et al (2025)

Predictors of Anxiety, Depression, and Stress in Long COVID: Systematic Review of Prevalence.

International journal of environmental research and public health, 22(6):.

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.

RevDate: 2025-06-28
CmpDate: 2025-06-26

Bondanini G, Giovanelli C, Mucci N, et al (2025)

The Dual Impact of Digital Connectivity: Balancing Productivity and Well-Being in the Modern Workplace.

International journal of environmental research and public health, 22(6):.

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.

RevDate: 2025-06-28

Pálok D, Kiss B, Élő LG, et al (2025)

Enhancing Safety and Quality of Cardiopulmonary Resuscitation During Coronavirus Pandemic.

Journal of clinical medicine, 14(12):.

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.

RevDate: 2025-06-28

Tsimtsiou Z, Pagkozidis I, Pappa A, et al (2025)

What Do We Know About Contemporary Quality Improvement and Patient Safety Training Curricula in Health Workers? A Rapid Scoping Review.

Healthcare (Basel, Switzerland), 13(12):.

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.

RevDate: 2025-06-28
CmpDate: 2025-06-26

Akher SA, Wang KY, Hall K, et al (2025)

Harnessing Transient Expression Systems with Plant Viral Vectors for the Production of Biopharmaceuticals in Nicotiana benthamiana.

International journal of molecular sciences, 26(12):.

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.

RevDate: 2025-07-01

Ertural B, Çiçek BN, IA Kurnaz (2025)

RNA Therapeutics: Focus on Antisense Oligonucleotides in the Nervous System.

Biomolecules & therapeutics, 33(4):572-581.

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.

RevDate: 2025-07-01
CmpDate: 2025-07-01

Srinivasan S, Patel S, Hassan T, et al (2025)

Lessons from the pandemic: a retrospective study and literature comparative review of provider and patient experiences with telemedicine in spine care.

Journal of neurosurgery. Spine, 43(1):122-137.

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.

RevDate: 2025-06-30
CmpDate: 2025-06-30

Yang OO (2025)

The immunopathogenesis of SARS-CoV-2 infection: Overview of lessons learned in the first 5 years.

Journal of immunology (Baltimore, Md. : 1950), 214(6):1095-1104.

This review provides a broad overview of lessons learned in the five years since COVID-19 was identified. It is a bimodal disease, starting with an initially virus-driven phase, followed by resolution or ensuing inappropriate immune activation causing severe inflammation that is no longer strictly virus dependent. Humoral immunity is beneficial for preventing or attenuating the early stage, without benefit once the later stage begins. Neutralizing antibodies elicited by natural infection or vaccination are short-lived and highly vulnerable to viral sequence variation. By contrast, cellular immunity, particularly the CD8+ T cell arm, has a role in preventing or attenuating severe disease, is far less susceptible to viral variation, and is longer-lived than antibodies. Finally, an ill-defined phenomenon of prolonged symptoms after acute infection, termed "long COVID," is poorly understood but may involve various immunologic defects that are hyperactivating or immunosuppressive. Remaining issues include needing to better understand the immune dysregulation of severe disease to allow more tailored therapeutic interventions, developing antibody strategies that cope with the viral spike sequence variability, prolonging vaccine efficacy, and unraveling the mechanisms of long COVID to design therapeutic approaches.

RevDate: 2025-07-01
CmpDate: 2025-06-29

Velasco Arias JM, Peres AM, Nunes MGJ, et al (2025)

Essential competencies required of nurse managers in times of COVID-19: A scoping review.

International nursing review, 72(3):e13070.

AIM: To identify the essential competencies required of nurse managers in healthcare services during the COVID-19 pandemic.

BACKGROUND: Nurse managers play a vital role in healthcare services organization, requiring a diverse set of competencies. The increasing occurrence of epidemics in recent decades underscores the importance of understanding these competencies in pivotal junctures. The challenges faced during the COVID-19 pandemic present valuable opportunities to recognize the competencies of nurse managers and guide their responsiveness in addressing future health crises.

METHODS: A scoping review following the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guidelines was conducted. A comprehensive search was conducted across six databases (LILACS, BDENF, EMBASE, MEDLINE, SCOPUS, and Web of Science). Results were categorized according to the nurse manager competencies model by the American Organization for Nursing Leadership and were analyzed using the competing values framework model.

RESULTS: Out of 2033 potentially relevant sources identified, 17 studies met inclusion criteria. A total of 52 competencies were identified and categorized into four thematic categories: (1) the ability to collaborate in times of crisis; (2) maintaining control during a crisis; (3) adapting to changes caused by the crisis; and (4) preserving competitiveness through the crisis.

CONCLUSIONS: The findings highlight communication, decision-making, training, adaptability to change, and leadership as essential competencies required of nurse managers to address crises, such as pandemics.

This body of knowledge can serve as a reference point to enhance the response of nurse managers in the face of future health crisis scenarios. Additionally, it can serve as a framework for healthcare organizations to develop or improve their crisis management training programs.

RevDate: 2025-06-30
CmpDate: 2025-06-30

Stephens J, Ellis A, Roberts S, et al (2025)

Disordered eating instruments in the pregnancy cohort: a systematic review update.

Eating disorders, 33(4):512-536.

Pregnancy represents a crucial timepoint to screen for disordered eating due to the significant adverse impact on the woman and her infant. There has been an increased interest in disordered eating in pregnancy since the COVID-19 pandemic, which has disproportionately affected the mental health of pregnant women compared to the general population. This systematic review is an update to a previous review aiming to explore current psychometric evidence for any new pregnancy-specific instruments and other measures of disordered eating developed for non-pregnant populations. Systematic searches were conducted in PubMed, ProQuest, PsycInfo, CINAHL, Scopus, MEDLINE, and Embase from April 2019 to February 2024. A total of 20 citations met criteria for inclusion, with most studies of reasonable quality. Fourteen psychometric instruments were identified, including two new pregnancy-specific screening instruments. Overall, preliminary psychometric evidence for the PEBS, DEAPS, and EDE-PV was promising. There is an ongoing need for validation in different samples, study designs, settings, and administration methods are required. Similar to the original review on this topic, we did not find evidence to support a gold standard recommendation.

RevDate: 2025-06-26

Daovisan H, Sathiyamas J, Choowan P, et al (2025)

Rethinking Post-COVID-19 Behavioral Science: Old Questions, New Insights.

Behavioral sciences (Basel, Switzerland), 15(6):.

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.

RevDate: 2025-06-26

Hemat Jouy S, Tonchev H, Mostafa SM, et al (2025)

Post-COVID Metabolic Fallout: A Growing Threat of New-Onset and Exacerbated Diabetes.

Biomedicines, 13(6):.

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.

RevDate: 2025-06-26

Zhu Y, Zhang Y, Shao J, et al (2025)

Glucocorticoid-Mediated Extracellular Matrix Regulation: Implications for Precision Therapy.

Biomedicines, 13(6):.

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.

RevDate: 2025-06-26

Doskas T, Vavougios GD, Kormas C, et al (2025)

Neurocognitive Impairment After COVID-19: Mechanisms, Phenotypes, and Links to Alzheimer's Disease.

Brain sciences, 15(6):.

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.

RevDate: 2025-06-26
CmpDate: 2025-06-26

Ponce A, Flores-Maldonado C, RG Contreras (2025)

Cardiac Glycosides: From Natural Defense Molecules to Emerging Therapeutic Agents.

Biomolecules, 15(6):.

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.

RevDate: 2025-06-26

Argyrou M, Pitsillou E, Hung A, et al (2025)

Insights into the pathogenic mechanisms associated with the SARS-CoV-2 spike protein.

Journal of structural biology, 217(3):108229 pii:S1047-8477(25)00064-4 [Epub ahead of print].

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.

RevDate: 2025-06-25

Ali SB, C Gurnari (2025)

Infections in VEXAS syndrome: a systematic review of the literature.

Current research in translational medicine, 73(4):103524 pii:S2452-3186(25)00033-9 [Epub ahead of print].

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.

RevDate: 2025-06-25

Hosseini H, Hosseini F, Bolourian S, et al (2025)

Formulation of bioactive-loaded chewing gums; techno-functional and health-promoting attributes along with in-vitro and in-vivo release studies.

Advances in colloid and interface science, 343:103583 pii:S0001-8686(25)00194-0 [Epub ahead of print].

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.

RevDate: 2025-06-25
CmpDate: 2025-06-25

Viniegra RFS, AG da Silva-Junior (2025)

Resilience and vulnerability in women's health care during the COVID-19 pandemic: an integrative review.

Ciencia & saude coletiva, 30(6):e03792025.

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.

RevDate: 2025-06-25

Torri F, Schirinzi E, Fontanelli L, et al (2025)

Telemedicine and remote monitoring in neuromuscular diseases: Challenges and opportunities.

Journal of neuromuscular diseases [Epub ahead of print].

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.

RevDate: 2025-06-27

Qian Q, Fan G, Yang W, et al (2025)

Advances in Diagnostic Techniques for Influenza Virus Infection: A Comprehensive Review.

Tropical medicine and infectious disease, 10(6):.

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.

RevDate: 2025-06-27

Nash C (2025)

Towards Optimal Health Through Boredom Aversion Based on Experiencing Psychological Flow in a Self-Directed Exercise Regime-A Scoping Review of Recent Research.

Sports (Basel, Switzerland), 13(6):.

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.

RevDate: 2025-06-27
CmpDate: 2025-06-25

Stasi C, M Bellini (2025)

Digestive Manifestations of Post-COVID-19: A Focus on Therapeutic Strategies.

Pathogens (Basel, Switzerland), 14(6):.

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.

RevDate: 2025-06-27
CmpDate: 2025-06-25

Hong M, Wu G, Ren Y, et al (2025)

Advancements in Pathogen Detection: Argonaute-Based Nucleic Acid Detection Technology.

Pathogens (Basel, Switzerland), 14(6):.

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.

RevDate: 2025-06-27

Bosco A, Fanos V, Bosone S, et al (2025)

SARS-CoV-2 in Asthmatic Children: Same Consequences in Different Endotypes?.

Metabolites, 15(6):.

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.

RevDate: 2025-06-27

Liu H, Coarfa C, Charania AN, et al (2025)

Secreted Phosphoprotein 1 in Lung Diseases.

Metabolites, 15(6):.

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.

RevDate: 2025-06-25

Nyongesa C, Majeed T, Remond M, et al (2025)

A Systematic Review of the Concepts of Efficacy, Effectiveness, and Efficiency as Applied and Measured for Virtual Health Care Delivery in Correctional Facilities.

Telemedicine journal and e-health : the official journal of the American Telemedicine Association [Epub ahead of print].

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.

RevDate: 2025-06-27

Snopkowska Lesniak SW, Maschio D, Neria F, et al (2025)

Novel Biomarkers for SARS-CoV-2 Infection: A Systematic Review and Meta-Analysis.

Journal of personalized medicine, 15(6):.

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.

RevDate: 2025-06-25

Loperena González PN, Karthigeyan KP, Corry J, et al (2025)

Mammalian fatty acid synthase: a commonly used viral host dependency factor and a putative target for host-targeted broad-spectrum antiviral therapeutic development.

mBio [Epub ahead of print].

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.

RevDate: 2025-06-27
CmpDate: 2025-06-25

Byrne AL, Pace NL, Thomas PS, et al (2025)

Peripheral venous blood gas analysis for the diagnosis of respiratory failure, hypercarbia and metabolic disturbance in adults.

The Cochrane database of systematic reviews, 6(6):CD010841.

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.

RevDate: 2025-06-25

Bouchat C, Blum S, Fobé E, et al (2024)

Policy advisory bodies during crises: a scoping review of the COVID-19 literature in Europe.

Evidence & policy : a journal of research, debate and practice [Epub ahead of print].

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.

RevDate: 2025-06-26
CmpDate: 2025-06-25

Magura J, Nhari SR, TI Nzimakwe (2025)

Barriers to ART adherence in sub-Saharan Africa: a scoping review toward achieving UNAIDS 95-95-95 targets.

Frontiers in public health, 13:1609743.

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.

RevDate: 2025-06-24

Lall S, Vijayasarathy M, Joshi NV, et al (2025)

Resurrection of the Helical Hairpin Hypothesis for Understanding Coronavirus Fusion.

The Journal of membrane biology [Epub ahead of print].

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.

RevDate: 2025-06-24

Liao J, Liang Y, Liu Z, et al (2025)

Pyroptosis in acute respiratory distress syndrome and pulmonary fibrosis.

Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie, 189:118286 pii:S0753-3322(25)00480-9 [Epub ahead of print].

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.

RevDate: 2025-06-24
CmpDate: 2025-06-24

Emery K, Dhaliwal J, Light R, et al (2025)

Enabling Vaccine Uptake: Strategies for the Public Health Sector.

British journal of hospital medicine (London, England : 2005), 86(6):1-14.

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.

RevDate: 2025-06-24
CmpDate: 2025-06-24

Ramakrishnan R, Washington A, Suveena S, et al (2025)

From DNA to Big Data: NGS Technologies and Their Applications.

Methods in molecular biology (Clifton, N.J.), 2952:459-482.

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.

RevDate: 2025-06-24

Shukla S, Vishwakarma K, Singh AK, et al (2025)

Curdlan: a microbial biopolymer of multifarious applications for a sustainable environment.

Protoplasma [Epub ahead of print].

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.

RevDate: 2025-06-26
CmpDate: 2025-06-24

Tan YJ, SZ Lin (2025)

Isolated Abducens Nerve Palsies from COVID-19 Infections: Clinical Features and Outcomes.

Neurology India, 73(3):524-528.

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.

RevDate: 2025-06-26
CmpDate: 2025-06-24

Rahman MH, Usmani NG, Chandra P, et al (2025)

Mobile Apps to Prevent Violence Against Women and Girls (VAWG): Systematic App Research and Content Analysis.

JMIR formative research, 9:e66247 pii:v9i1e66247.

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.

RevDate: 2025-06-24
CmpDate: 2025-06-24

Xu Y, Xu JW, Wu Y, et al (2025)

Prevalence and prognosis of sarcopenia in acute COVID-19 and long COVID: a systematic review and meta-analysis.

Annals of medicine, 57(1):2519678.

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.

RevDate: 2025-06-24
CmpDate: 2025-06-24

Abdekhoda M, A Dehnad (2025)

Strategies to combat infodemics in public health.

Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit, 31(5):340-349.

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.

RevDate: 2025-06-24
CmpDate: 2025-06-24

Gschwend A, Mach-Perrot V, Sobral G, et al (2025)

[Factors influencing COVID-19 vaccine hesitancy among healthcare workers in Switzerland].

Revue medicale suisse, 21(923):1290-1294.

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.

RevDate: 2025-06-24

Vora V, Kanyal S, Chauhan A, et al (2025)

Cultural perceptions and social determinants of health in perinatal mental health: An obstetric-psychiatric perspective.

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Epub ahead of print].

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.

RevDate: 2025-06-27
CmpDate: 2025-06-27

Iannuccelli C, Favretti M, Dolcini G, et al (2025)

Fibromyalgia: one year in review 2025.

Clinical and experimental rheumatology, 43(6):957-969.

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.

RevDate: 2025-06-27
CmpDate: 2025-06-27

de Andrade ML, do Monte AL, Gerage AM, et al (2025)

Effects of Physical Exercise on Functional Physical Performance in Individuals With Long COVID: A Systematic Review.

Journal of cardiopulmonary rehabilitation and prevention, 45(4):239-246.

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.

RevDate: 2025-06-27
CmpDate: 2025-06-27

Loef B, Bosma E, van Kerkhof LWM, et al (2025)

Night-shift work and susceptibility to infectious diseases: a systematic review and meta-analysis.

Scandinavian journal of work, environment & health, 51(4):298-311.

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 systematically searched for studies published up to September 2024. Studies were included if they comprised a working population, night-shift workers were compared to non-shift workers, and the outcome was an infectious disease. Results were descriptively synthesized for common respiratory infections (flu and common cold), SARS-CoV-2 infection, and other infections. Pooled effect estimates were calculated using random-effects meta-analysis.

RESULTS: In total, 16 articles describing 14 studies among 191 320 workers were included. Based on 4 studies, night-shift work was not associated with a significantly increased risk of common respiratory infections [odds ratio (OR) 1.11, 95% confidence interval (CI) 0.97-1.27, I[2]=65.8%[. However, night-shift workers had a higher risk of SARS-CoV-2 infection than non-shift workers (OR 1.31, 95% CI 1.09-1.58, I[2]=92.2%, N=10 studies). This association was stronger in higher-quality studies and studies conducted in the first year of the COVID-19 pandemic. For other infections, insufficient studies were available to conduct a meta-analysis. The certainty of evidence was graded very low due to a limited number of (prospective cohort) studies and high inconsistency in the available studies.

CONCLUSIONS: This systematic review and meta-analysis showed that night-shift work was associated with an increased risk of SARS-CoV-2 infection, but not of common respiratory infections. To address the lack of high-certainty evidence, more studies are needed that apply a prospective design with appropriate adjustment for confounding factors and more extensive information on night-shift work exposure.

RevDate: 2025-06-27
CmpDate: 2024-04-08

James ER, Church LWP, Hoffman SL, et al (2024)

Piloting delivery of PfSPZ vaccines for malaria through a cryogenic vaccine cold chain to travel and military medicine clinics.

Journal of travel medicine, 31(3):.

BACKGROUND: PfSPZ vaccines comprising Plasmodium falciparum (Pf) sporozoites (SPZ) have demonstrated > 90% protection against variant Pf malaria infections for at least 12 weeks; they are the only vaccines with the level of efficacy necessary to protect travellers. PfSPZ are eukaryotic cells stabilized by cryopreservation and distributed using a cryogenic (below -150 °C) cold chain. The Ebola vaccine and mRNA vaccines against SARS-CoV-2 pioneered uptake of vaccines requiring non-standard ultra-low temperature cold chains. The cryogenic cold chain using liquid nitrogen (LN2) vapour phase (LNVP) cryoshippers, is simpler, more efficient than -80, -20 or 2-8 °C cold chains, and does not use electricity. This study was conducted to evaluate implementation and integration of a cryogenically distributed vaccine at travel and military immunization clinics.

METHODS: We conducted sequential 28-day studies evaluating vaccine shipping, storage, maintenance and accession at two US military and two civilian travel health/immunization clinics. In each clinic, personnel were trained in equipment use, procurement and handling of LN2, temperature monitoring and inventory record keeping by in-person or video instruction.

RESULTS: Sites required 2-4 h/person for two persons to assimilate and develop the expertise to manage vaccine storage and LNVP operations. LN2 for recharging cryoshippers was delivered every 1-2 weeks. Vaccine ordering, receipt, storage and inventory control was conducted effectively. Simulated single dose vaccine cryovial retrieval and thawing were performed successfully in different travel clinic settings. Continuous temperature monitoring at each site was maintained with only one short excursion above -150 °C (-145 °C) through shipping, use and reverse logistics. Staff, during and at study conclusion, provided feedback that has been incorporated into our models for cold chain logistics.

CONCLUSIONS: These studies demonstrated that the training in delivery, storage, administration and integration of PfSPZ vaccines can be successfully managed in different immunization clinic settings for travellers and military personnel.

RevDate: 2025-06-24

Richter A (2025)

Current experience with manual push subcutaneous immunoglobulin (SCIg) in patients with immune deficiencies.

Immunological medicine [Epub ahead of print].

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.

RevDate: 2025-06-25
CmpDate: 2025-06-24

Bausch-Jurken M, G Alter (2025)

The immunological impact of revaccination in a hybrid-immune world.

Frontiers in immunology, 16:1588259.

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.

RevDate: 2025-06-25

Coyne BM, Ito D, Tariq A, et al (2025)

Ascertaining the mechanistic etiology of COVID-associated glomerulonephritis: a systematic review.

Frontiers in medicine, 12:1568943.

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.

RevDate: 2025-06-25
CmpDate: 2025-06-24

Nazir M, Mir IR, Lone SA, et al (2025)

Innate immunity, therapeutic targets and monoclonal antibodies in SARS-CoV-2 infection.

PeerJ, 13:e19462.

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.

RevDate: 2025-06-24

Wu J, Deng X, Luo J, et al (2025)

Update in the Treatment of Cirrhotic Patients with Portal Vein Thrombosis.

Clinical and molecular hepatology pii:cmh.2025.0411 [Epub ahead of print].

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.

RevDate: 2025-06-24
CmpDate: 2025-06-24

Burtscher M, Strasser B, Klimont J, et al (2025)

The Impact of Living at Moderate Altitude on Healthy Aging in Austria: Epidemiological Findings and Potential Underlying Mechanisms.

Gerontology, 71(5):351-364.

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.

RevDate: 2025-06-23

Mousavi A, Shojaei S, Parhizkar P, et al (2025)

Ischemic modified albumin and thiol levels in Coronavirus disease 19: a systematic review and meta-analysis.

Diagnostic and prognostic research, 9(1):13.

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.

RevDate: 2025-06-26
CmpDate: 2025-06-24

Anderson W, Lancaster K, van Wichelen S, et al (2025)

Epistemic preparedness.

BMJ global health, 10(6):.

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.

RevDate: 2025-06-23

Liu JW, Lai CC, PR Hsueh (2025)

Resurgence of human metapneumovirus in the post-COVID-19 era: pathogenesis, epidemiological shifts, clinical impact, and future challenges.

The Lancet. Infectious diseases pii:S1473-3099(25)00240-3 [Epub ahead of print].

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.

RevDate: 2025-06-26
CmpDate: 2025-06-24

Gao P, Chen X, Li Y, et al (2025)

Anti-CASPR2 meningoencephalitis with thickened dura mater induced by various infections: A case report and literature review.

Medicine, 104(25):e42873.

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.

RevDate: 2025-06-24
CmpDate: 2025-06-24

Luyt D, Stiti K, Valter R, et al (2025)

[Not Available].

Sante publique (Vandoeuvre-les-Nancy, France), 37(2):57-71.

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.

RevDate: 2025-06-24
CmpDate: 2025-06-24

Luo X, Li Y, Xu J, et al (2025)

AI in Medical Questionnaires: Innovations, Diagnosis, and Implications.

Journal of medical Internet research, 27:e72398 pii:v27i1e72398.

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.

RevDate: 2025-06-24
CmpDate: 2025-06-24

Samson J, Gilbey M, Taylor N, et al (2025)

Virtual Simulated Placements in Health Care Education: Scoping Review.

JMIR medical education, 11:e58794 pii:v11i1e58794.

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.

RevDate: 2025-06-25

Vatsha P, Vardhan G, Kumari T, et al (2025)

Efficacy and safety of remdesivir and favipiravir in COVID-19 patients - A systematic review and meta-analysis.

Journal of family medicine and primary care, 14(5):1604-1616.

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.

RevDate: 2025-06-25

Ravikoti S, Bhatia V, SK Mohanasundari (2025)

Approaches for cessation and elimination of tobacco to atttain sustainable development goal.

Journal of family medicine and primary care, 14(5):1589-1596.

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.

RevDate: 2025-06-25

Seijas-Otero N, Blanco-Pintos T, Regueira-Iglesias A, et al (2025)

Antiseptics as effective virucidal agents against SARS-CoV-2: Systematic review and Bayesian network meta-analysis.

The Japanese dental science review, 61:138-154.

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.

RevDate: 2025-06-26
CmpDate: 2025-06-26

Piñana JL, Martino R, Cesaro S, et al (2025)

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.

Current opinion in infectious diseases, 38(4):290-299.

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.

RevDate: 2025-06-26
CmpDate: 2025-06-26

Zanella MC, Rhee C, M Klompas (2025)

Preventing respiratory viral transmission in healthcare settings.

Current opinion in infectious diseases, 38(4):339-346.

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.

RevDate: 2025-06-26
CmpDate: 2025-06-26

Kamitani E, DeLuca JB, Y Mizuno (2025)

Systematic review of infodemiology studies using artificial intelligence: social media posts on HIV preexposure prophylaxis.

AIDS (London, England), 39(9):1254-1261.

OBJECTIVES: To explore how artificial intelligence (AI) can enhance infodemiology, which distributes and scans information in the electronic medium, to process social media posts for HIV preexposure prophylaxis (PrEP).

DESIGN: Systematic review.

METHODS: We searched in the U.S. Centers for Disease Control and Prevention's Prevention Research Synthesis database through June 2024 (PROSPERO: CRD42023458870). We included infodemiology studies published in English and reported using AI to process social media posts on PrEP. Two reviewers independently screened citations, extracted data, and conducted a risk of bias assessment using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies. Findings are narratively summarized.

RESULTS: Of the 135 citations screened, eight infodemiology studies were identified, analyzing over 58.9 million posts. Infodemiology studies found the PrEP topics commonly discussed in communities (e.g., barriers of uptake), rumors that may raise public health concerns (e.g., PrEP is a prevention method against COVID-19 infection), geographic locations where concerns regarding risk of acquiring HIV were raised (e.g., most HIV-related posts were from the 10 states with the highest numbers of new HIV diagnoses), and predicted HIV trends (e.g., HIV-related tweets were negatively correlated with the county-level HIV incidence rate in the following year).

CONCLUSIONS: Despite the limitations of this review including a small number of studies reviewed, our review suggests social media posts may provide information on real-time PrEP-related concerns, and AI can accelerate and enhance the processing of mass data to identify the information that communities need and the areas/locations that may need HIV prevention intervention.

RevDate: 2025-06-26
CmpDate: 2025-06-26

Alzuabi A, A AlBloushi (2025)

Unilateral Frosted Branch Angiitis Following COVID-19 Disease: Case Report and Literature Review.

The Keio journal of medicine, 74(2):101-105.

Frosted branch angiitis (FBA) is a rare and aggressive form of retinal vasculitis that can cause vision loss. This condition is typically idiopathic and can be associated with various infections or malignancies. Recently, FBA has been linked to COVID-19 in some reports. This report describes a rare association between COVID-19 and FBA and presents characteristic findings from multimodal imaging. We describe the case of a 30-year-old man, otherwise healthy, who experienced acute vision loss in his left eye 1 week after testing positive for COVID-19. His initial visual acuity was 20/20 in the right eye and counting fingers at 2 feet in the left eye. A fundus examination disclosed extensive vascular sheathing affecting the arteries and veins, accompanied by widespread intraretinal, preretinal, and subretinal hemorrhages indicative of FBA. Fundus fluorescein angiography revealed notably delayed filling in both arterial and venous systems. Optical coherence tomography of the left eye displayed inner retinal layer hyperreflectivity, suggesting ischemia coupled with substantial subretinal fluid. The systemic evaluation of the patient was unremarkable. The treatment included systemic corticosteroids, azathioprine, intravitreal bevacizumab, and panretinal photocoagulation. After 6 months of treatment, the left eye examination showed resolution of vascular sheathing, retinal hemorrhages, and subretinal fluid, although the final visual acuity in the left eye remained unchanged. In conclusion, FBA may manifest in otherwise healthy and immunocompetent individuals following SARS-CoV-2 infection.

RevDate: 2025-06-25

Xu R, Zhang G, Che Y, et al (2025)

Ablation combined with video-assisted thoracic surgery hybrid technique for multiple primary lung cancer.

iScience, 28(6):112703.

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.

RevDate: 2025-06-24

Ibrahim M, Ahmad J, Abbas M, et al (2025)

The Role of N-terminal Pro-B-Type Natriuretic Peptide, Troponins, and D-dimer in Acute Cardio-Respiratory Syndromes: A Multi-specialty Systematic Review.

Cureus, 17(5):e84460.

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.

RevDate: 2025-06-24

Saxena S, Mandrah V, Tariq W, et al (2025)

The Future of mRNA Vaccines: Potential Beyond COVID-19.

Cureus, 17(5):e84529.

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.

RevDate: 2025-06-23

Jwa S, Imanishi Y, Ascher MT, et al (2025)

Communication interventions to reduce parental vaccine hesitancy: A systematic review.

Vaccine, 61:127401 pii:S0264-410X(25)00698-X [Epub ahead of print].

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.

RevDate: 2025-06-23

Okano M, Okubo K, Gotoh M, et al (2025)

Practical guideline for the management of allergic rhinitis in Japan 2024.

Auris, nasus, larynx, 52(4):426-441 pii:S0385-8146(25)00082-3 [Epub ahead of print].

The Practical Guideline for the Management of Allergic Rhinitis in Japan was first published in 1993. After the COVID-19 pandemic, the current 10th edition was published in 2024. The most recent collection of evidence from the literature, such as the sustained post-treatment effect of sublingual immunotherapy on Japanese cedar pollinosis, was added to the revised guideline, which incorporates evidence-based medicine. In this revised guideline, a diagram illustrating the pathogenesis of allergic rhinitis and the mechanisms of action of various pharmacological treatments has been added. Also included is a diagram that shows the mechanism of action of allergen immunotherapy and a more detailed description of the oral allergy syndrome. The clinical question and answer section was also revised along with the introduction of new questions, such as: Does anti-IgE antibody treatment effectively reduce the symptoms of severe seasonal allergic rhinitis? Also updated was the evidence-based step-by-step strategy for treatment.

RevDate: 2025-06-23

Mothae SA, Chiliza TE, NE Mvubu (2025)

SARS-CoV-2 host-pathogen interactome: insights into more players during pathogenesis.

Virology, 610:110607 pii:S0042-6822(25)00220-X [Epub ahead of print].

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.

RevDate: 2025-06-25

Cabral-Marques O, Schimke LF, Moll G, et al (2025)

Advancing research on regulatory autoantibodies targeting GPCRs: Insights from the 5th international symposium.

Autoimmunity reviews, 24(9):103855 pii:S1568-9972(25)00115-6 [Epub ahead of print].

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.

RevDate: 2025-06-23

Beuren T, Ferrari F, Franzoni LT, et al (2025)

Exploring the interplay between host genetics and acute and long COVID: A narrative review.

Clinics (Sao Paulo, Brazil), 80:100708 pii:S1807-5932(25)00127-9 [Epub ahead of print].

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.

RevDate: 2025-06-23

Smet M, Berkell M, Górska A, et al (2025)

Drivers of quasispecies development in SARS-CoV-2 and implications for emergent variants and COVID-19.

Virology, 610:110584 pii:S0042-6822(25)00197-7 [Epub ahead of print].

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.

RevDate: 2025-06-24
CmpDate: 2025-06-24

Fando AA, Ilyichev AA, Litvinova VR, et al (2025)

[DNA Vaccine Technologies: Design and Delivery].

Molekuliarnaia biologiia, 59(1):3-21.

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.

RevDate: 2025-06-24
CmpDate: 2025-06-24

Nakajima K, Hirose A, Yoshino M, et al (2025)

Midwives' Support for Couples in Japanese Hospitals and Clinics During the COVID-19 Pandemic: A Cross-Sectional Survey.

Nursing open, 12(6):e70250.

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.

RevDate: 2025-06-23

Pail O, Lin MJ, Anagnostou T, et al (2025)

Cancer vaccines and the future of immunotherapy.

Lancet (London, England) pii:S0140-6736(25)00553-7 [Epub ahead of print].

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.

RevDate: 2025-06-23

Kantor R, Pau AK, Kozal MJ, et al (2025)

Do we need routine integrase resistance testing before starting antiretroviral therapy?.

The lancet. HIV pii:S2352-3018(25)00108-0 [Epub ahead of print].

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.

RevDate: 2025-06-24
CmpDate: 2025-06-23

Pangrazzi L, B Weinberger (2025)

Recent developments of vaccines for older adults: Adjuvants and beyond.

Human vaccines & immunotherapeutics, 21(1):2517931.

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.

RevDate: 2025-06-23

Lang SM, H Schiffl (2025)

Long-term renal consequences of COVID-19. Emerging evidence and unanswered questions.

International urology and nephrology [Epub ahead of print].

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.

RevDate: 2025-06-23

Bhattacharya S, Singh A, A Kashyap (2025)

Digital horizons in non-communicable disease care: a bibliometric exploration of intervention impact and innovation.

Frontiers in digital health, 7:1528711.

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.

RevDate: 2025-06-24

Xu Q, Lian H, Zhou R, et al (2025)

Curcumin and multiple health outcomes: critical umbrella review of intervention meta-analyses.

Frontiers in pharmacology, 16:1601204.

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.

RevDate: 2025-06-23

Abeykoon AMH, Wilson M, Subbarao K, et al (2025)

Severe acute respiratory syndrome coronavirus-2 shedding in exhaled material: A systematic review.

Epidemiology and infection pii:S0950268825100174 [Epub ahead of print].

RevDate: 2025-06-23

Wang N, Sun L, Qian G, et al (2025)

Neutrophil heterogeneity in Kawasaki disease and multisystem inflammatory syndrome in children.

Pediatric research [Epub ahead of print].

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.

RevDate: 2025-06-19

Bhattacharyya D, J Das Sarma (2025)

The pleiotropic anti-cancer, antiviral, and anti-neuro-immunomodulatory role of methanolic neem bark extract.

Journal of natural medicines [Epub ahead of print].

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.

RevDate: 2025-06-21
CmpDate: 2025-06-19

Yin L, He H, Zhang H, et al (2025)

Revolution of AAV in Drug Discovery: From Delivery System to Clinical Application.

Journal of medical virology, 97(6):e70447.

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.

RevDate: 2025-06-20

Macdonald D, Bigelow-Talbert K, Ross-White A, et al (2025)

Understanding the experiences of birthing care during COVID-19: A qualitative systematic review.

International journal of nursing studies advances, 8:100295.

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.

RevDate: 2025-06-20

Asghari KM, Kakavand N, Khosroshahi MT, et al (2025)

Viral Etiologies and Histopathological Features of Olfactory Dysfunction: A Systematic Review.

Health science reports, 8(6):e70917.

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.

RevDate: 2025-06-20

Cai Y, Kamarudin S, S Nujaimi (2025)

Willingness to share information on social media: a systematic literature review (2020-2024).

Frontiers in psychology, 16:1567506.

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.

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