RevDate: 2025-11-15
CmpDate: 2025-11-13

Zakynthinos GE, Kokkinos NK, Tzima IG, et al (2025)

One Enzyme, Many Faces: The Expanding Role of DPP3 in Cardiovascular and Critical Care.

Journal of clinical medicine, 14(21):.

Dipeptidyl peptidase 3 (DPP3) is a zinc-dependent aminopeptidase that is found in several places and is thought to be a cytosolic enzyme that helps break down peptides. Recent studies, however, have revealed its extensive therapeutic relevance upon release into circulation, functioning not only as a biomarker for cellular injury but also as an active modulator of cardiovascular homeostasis and critical disease. High levels of circulating DPP3 (cDPP3) have been linked to the causes of cardiogenic shock, septic shock, acute coronary syndromes, heart failure, and serious viral diseases like COVID-19. Its enzymatic breakdown of angiotensin II disrupts vascular tone and myocardial contractility, leading to hemodynamic instability and multi-organ failure. In numerous cohorts, cDPP3 levels reliably correspond with disease severity, acute renal damage, and death, but dynamic trajectories yield superior predictive information relative to single assessments. In addition to risk stratification, translational studies utilizing rodent and porcine models illustrate that antibody-mediated inhibition of cDPP3 with the humanized monoclonal antibody Procizumab reinstates cardiac function, stabilizes renal perfusion, diminishes oxidative stress and inflammation, and enhances survival. First-in-human experiences in patients with refractory septic cardiomyopathy have further emphasized its therapeutic promise. DPP3 is a good example of a biomarker and a mediator in cardiovascular and critical care. Its growing clinical and translational profile makes cDPP3 a strong predictor of bad outcomes and a prospective target for treatment. Ongoing clinical trials using Procizumab will determine if neutralizing cDPP3 can lead to enhanced outcomes in individuals with cardiogenic and septic shock. This review outlines the physiological mechanisms, clinical implications, and emerging therapeutic potential of DPP3 in cardiovascular and critical care. Ongoing trials with Procizumab will clarify whether neutralizing cDPP3 can improve outcomes in patients with cardiogenic and septic shock.

RevDate: 2025-11-16
CmpDate: 2025-11-13

Varghese S, Al-Hassani I, Al-Aani U, et al (2025)

Long-Term Complications of Multisystem Inflammatory Syndrome in Children and Adults Post-COVID-19: A Systematic Review.

International journal of molecular sciences, 26(21):.

The SARS-CoV-2 pandemic has posed global medical challenges due to its ability to affect multiple organ systems. Among the post-COVID-19 complications, multisystem inflammatory syndrome has emerged as a severe condition affecting both children (MIS-C) and adults (MIS-A). This review aims to compile and analyze published data to investigate clinical characteristics, laboratory findings, and outcomes of MIS post-COVID-19. A comprehensive search of various databases was conducted to identify studies reporting MIS-related complications in pediatric and adult populations post-COVID-19 infection. Screening, data extraction, and cross-checking were performed by two independent reviewers. Only 64 studies met our inclusion criteria, and compiled results revealed that cardiac complications were the predominant manifestation followed by gastrointestinal, hematologic, neurological, and mucocutaneous involvement. Laboratory findings consistently demonstrated elevated inflammatory markers including CRP, ferritin, D-dimer, and IL-6. Most patients required hospitalization, and many needed intensive care; treatment typically involved IVIG, corticosteroids, and biologic therapies. While most patients recovered, a subset experienced persistent complications. These findings highlight the importance of early recognition, multidisciplinary management, and structured follow-up for MIS. Future research is warranted to clarify the underlying mechanisms, risk factors, and long-term outcomes associated with MIS in post-COVID-19 patients.

RevDate: 2025-11-16
CmpDate: 2025-11-13

Zolotarenko AD, Poghosyan HM, Sheptiy VV, et al (2025)

COVID-19 Hijacking of the Host Epigenome: Mechanisms, Biomarkers and Long-Term Consequences.

International journal of molecular sciences, 26(21):.

The epigenetics of COVID-19 is a rapidly expanding field that reveals how the SARS-CoV-2 virus initiates alterations in the host's genome, influencing the susceptibility to infection, the disease severity, and long-term consequences, known as "long COVID." In this review, we describe the mechanisms utilized by the virus to manipulate the host epigenome, suppressing antiviral responses and creating a favorable environment for viral replication. We also highlight virus-induced epigenetic changes across diverse cell populations that contribute to COVID-19 pathogenesis. Notably, the virus reprograms hematopoietic stem and progenitor cells, leading to long-lasting alterations in innate immunity, a phenomenon known as "trained immunity." These epigenetic modifications are maintained in differentiated daughter cells and may explain the persistent inflammation and other symptoms of long COVID. Furthermore, we discuss emerging epigenetic biomarkers of disease severity, including methylation signatures in genes such as AIM2, HLA-C, and PARP9, as well as dysregulated miRNA profiles. Understanding this complex interplay between the virus and the host's epigenetic landscape is crucial for developing new therapeutic approaches that target specific epigenetic modifications to suppress pathological processes and improve clinical outcomes for COVID-19 patients.

RevDate: 2025-11-15
CmpDate: 2025-11-13

Wolfe H, Shepherd CB, Lee R, et al (2025)

Real-world patient outcomes for telehealth-delivered, remote eating disorder treatment: a scoping review.

Journal of eating disorders, 13(1):259.

BACKGROUND: Only 30% of individuals with eating disorders receive specialized treatment. While preliminary evidence suggests that telehealth-delivered, remote eating disorder treatment may offer improved accessibility with similar effectiveness to in-person treatment, research on these services remains limited, particularly regarding the communities that are disproportionately affected by barriers to standard care. This scoping review sought to map the existing research on real-world patient outcomes in remote eating disorder treatment, identify knowledge gaps, and prioritize areas for future studies.

METHODS: This review followed the Joanna Briggs Institute methodology for scoping reviews. It comprises observational evaluations of telehealth-delivered, remote eating disorder treatment conducted in routine clinical settings. An electronic database search was performed in PsycINFO, PubMed, and ProQuest Dissertations & Theses Global in August 2024 and updated in September 2025.

RESULTS: Following the search and screening process, 27 articles, comprising six case reports and 21 cohort/case series designs, were deemed eligible for inclusion. Remote treatments evaluated differed across level of care, therapeutic modalities, provider types, dosage, and adjunctive technologies used. Just under half of the studies compared outcomes from remote and in-person treatment, while the remainder examined remote treatment alone. Articles were published between 2011 and 2025 and, when excluding case reports, nearly 60% evaluated programs that rapidly transitioned to remote delivery due to COVID-19. While demographic reporting was limited and inconsistent, available information indicated that participants ranged from three to 75 years old and were predominantly White, cisgender women/females diagnosed with anorexia nervosa. Though preliminary, findings tentatively suggest that remote eating disorder treatment can yield improvements across core outcome domains, largely comparable to in-person settings. Less is known about how outcomes may differ across demographic groups.

CONCLUSIONS: Overall, this body of literature remains small and characterized by limitations and inconsistencies, including differences in the treatment services evaluated as well as disparities in study design, methodology, and reporting. Utilization of remote treatment by historically excluded groups remains low, calling for further reflection around its accessibility for target communities. Additional studies with more rigorous, intentional designs are needed. The field would also benefit from standardization in relation to data collection and reporting to allow for better synthesis of findings.

RevDate: 2025-11-15
CmpDate: 2025-11-13

Kabadayı G, Atay Ö, Baysal Bakır D, et al (2025)

Expanding the clinical spectrum of Cernunnos/XLF deficiency: a literature review of a rare cause of severe combined immunodeficiency including a novel case.

BMC immunology, 26(1):89.

BACKGROUND: Severe combined immunodeficiency (SCID) is a congenital immunodeficiency characterized by significant numerical or functional defects in T lymphocytes and is often accompanied by B lymphocyte dysfunction. It presents early in life with severe, recurrent opportunistic infections. Early diagnosis and hematopoietic stem cell transplantation (HSCT) are vital for patient survival. Cernunnos/XLF deficiency is an autosomal recessive form of SCID caused by mutations in the NHEJ1 gene, which plays a critical role in repairing DNA double-strand breaks. First described in 2006, this condition remains exceedingly rare, with only about 55 cases reported to date. This study aimed to describe a novel infant with Cernunnos/XLF deficiency and to review previously reported patients carrying the same variant, thereby expanding the clinical spectrum of this rare disease.

METHODS: With written informed consent, we retrospectively evaluated a pediatric patient with Cernunnos/XLF deficiency followed at our clinic. Demographic, clinical, laboratory, and radiological findings were reviewed. The diagnosis was based on clinical and immunological features and confirmed via clinical exome sequencing. A literature review was conducted to compare the genotype-phenotype correlations of previously reported patients carrying the same NHEJ1 variant.

RESULTS: We report an infant who was hospitalized at 6.5 months of age with a preliminary diagnosis of meningitis and was subsequently diagnosed with Cernunnos/XLF deficiency. The patient exhibited microcephaly, growth retardation, recurrent infections, prolonged SARS-CoV-2 PCR positivity, and localized BCGitis following live Bacillus Calmette-Guérin (BCG) vaccination. Immunological evaluation revealed T- and B-cell lymphopenia and hypogammaglobulinemia. Genetic testing confirmed a homozygous nonsense mutation in NHEJ1. HSCT from a matched sibling donor was performed.

CONCLUSION: This study describes a rare case of Cernunnos/XLF deficiency diagnosed in early infancy, underscoring the value of early recognition and the critical role of genetic testing and HSCT. It also expands the clinical spectrum of the disease and provides a comparative perspective with previously reported patients carrying the same mutation. In infants presenting with unexplained infections or complications related to live vaccines, inborn errors of immunity should be considered. Our findings emphasize the importance of timely diagnosis and comprehensive, multidisciplinary follow-up, particularly in patients with additional complications.

RevDate: 2025-11-13
CmpDate: 2025-11-13

Bordoloi S, Singh SC, J Bayry (2025)

COVID-19-associated Autoimmune and Inflammatory Diseases: Molecular Mechanisms and the Role of IVIG Therapy.

Clinical reviews in allergy & immunology, 68(1):99.

The emergence of SARS-CoV-2 has not only reshaped our understanding of viral pathogenesis but also highlighted its capacity to trigger autoimmune and inflammatory diseases. Accumulating evidence indicates that SARS-CoV-2 infection can lead to a broad spectrum of immune-mediated complications, ranging from well-defined conditions such as Guillain-Barré syndrome, multisystem inflammatory syndrome in children (MIS-C), and systemic lupus erythematosus, to the development of diverse autoantibodies and atypical inflammatory phenotypes. This review synthesizes the current clinical and experimental evidence linking COVID-19 to autoimmune and inflammatory sequelae. We have provided a structured overview on the multifactorial mechanisms underpinning this immune dysregulation, including molecular mimicry, epitope spreading, bystander activation, cytokine storm, host genetic predisposition, and viral genomic variability. Additionally, we discussed the contribution of gut dysbiosis and metabolic reprogramming in shaping aberrant immune responses following infection. Special attention is given to the therapeutic potential of intravenous immunoglobulin (IVIG), which has shown promise in mitigating hyperinflammation and modulating autoimmunity in affected individuals. IVIG can provide therapeutic benefits by diverse mutually nonexclusive mechanisms. By integrating emerging insights across clinical immunology, virology, and host-pathogen interactions, this review aims to advance our understanding of COVID-19-induced immune complications and therapeutic strategies to manage post-COVID autoimmune and inflammatory syndromes.

RevDate: 2025-11-13
CmpDate: 2025-11-13

Limbach KE, Fan D, LG Melstrom (2026)

Remote Telemonitoring and Telehealth in Surgical Oncology.

Hematology/oncology clinics of North America, 40(1):79-88.

Remote monitoring and telehealth platforms have been of increasing interest since the beginning of the Corona Virus disease-2019 pandemic, with rising rates of implementation. Surgical oncology patients are a unique population that may derive a particular benefit from the use of such technology, which has been shown to be feasible and acceptable to patients and providers. Previous studies have shown benefits in quality of life and symptom severity as well as a decreased readmission rate in select surgical oncology clinical settings; however, further research is ongoing to more specifically determine how the use of remote telemonitoring will affect clinical outcomes including complications and cost.

RevDate: 2025-11-12
CmpDate: 2025-11-13

Rowland B, Sunkara P, Hicks MH, et al (2025)

Remote Patient Monitoring to Support Rapid Discharge-Wearables.

Advances in anesthesia, 43(1):127-138.

The ability to remotely monitor patients after hospital discharge with near real-time feedback with an integrated health network represents a technological advancement that has shown promising results across surgical and medical domains including improvements in hospital length of stay, unplanned readmission, and mortality. COVID-19 and improvements in monitoring technology has catalyzed the increased use and evaluation of remote monitoring. In this article, we provide a landscape of remote monitoring and its role in postdischarge care to date across medical and surgical domains in adult medicine. We also address implementation, research, and ethical considerations for remote monitoring in clinical care.

RevDate: 2025-11-15
CmpDate: 2025-11-13

Browne S, Kelly MP, Bowers B, et al (2025)

General practitioner care of residential aged care facility residents at end of life: a systematic literature review and narrative synthesis.

BMJ open, 15(11):e104243.

OBJECTIVES: In 2023, 21% of deaths occurred in residential aged care facilities (RACFs), a setting expected to play an increasing role in palliative and end-of-life care (PEoLC). General practitioners (GPs) oversee and deliver PEoLC in residential and nursing homes, yet little is known about their practice. We conducted a systematic review of the published evidence concerning how GPs provide this care: what they do and the quality, challenges and facilitators of that care.

DESIGN: Systematic review and narrative synthesis using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

DATA SOURCES: Medline, Embase, CINAHL, PsycINFO, Web of Science, Scopus and NHS Evidence and grey literature via Google Scholar were searched through 9 October 2024.

ELIGIBILITY CRITERIA: We included studies presenting new empirical data from qualitative, quantitative or mixed methods, were published in the English language and conducted in the UK, the European Union, Australia, New Zealand and Canada. We excluded studies with no new empirical data, discussion papers, conference abstracts, opinion pieces, study participants under 18 years old and in care settings other than RACF.

DATA EXTRACTION AND SYNTHESIS: One independent reviewer used standardised methods to search and screen study titles for inclusion. This reviewer assessed all abstracts of the included papers, and a second independent reviewer screened 60% of the abstracts to validate inclusion. Risk of bias was assessed using Gough's Weight of Evidence assessment. Thematic analysis was used to describe the contents of the included papers; a narrative synthesis approach was taken to report the findings at a more conceptual level.

RESULTS: The search identified 5936 titles: 35 papers were eligible and included in the synthesis. This is a nascent evidence base, lacking robust research designs and characterised by small sample sizes; the results describe the factors observed to be important in the delivery of care. Care provision is extremely variable; no models of optimal care have been put forward or tested. Challenges to care provision occur at every level of the care system. At macro level, service-level agreements and policies vary: at meso level, team-working, communication technology solutions and equipment availability vary: at micro level, GPs' interests in providing PEoLC vary as does their training. No study addresses residents' and relatives' experiences and expectations of GPs' involvement in PEoLC in RACFs.

CONCLUSIONS: The limited evidence base highlights that GP care at end of life for RACF residents varies greatly, with enablers and challenges at all levels in the existing care systems. Little research has examined GP PEoLC for RACF residents in its own right; insight is derived from studies that report on this issue as an adjunct to the main focus. With national policies focused on moving more PEoLC into community settings, these knowledge deficits require urgent attention.

RevDate: 2025-11-16
CmpDate: 2025-11-13

Kurz X, Cohet C, Perez-Gutthann S, et al (2025)

Strengthening Pharmacoepidemiology in a Changing Research Environment: The European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCePP).

Pharmacoepidemiology and drug safety, 34(11):e70263.

Key changes in the pharmacoepidemiological research environment had a significant influence on the activities of the European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCePP) over the last decade. These changes included the SARS-CoV-2 pandemic, the increased access to anonymized real-world data (RWD) sources, the integration of real-world evidence (RWE) into regulatory and public health decision-making, and the emergence of new technologies and methods. This paper describes how ENCePP has evolved in this changing environment to strengthen pharmacoepidemiological methods and practice in Europe and globally. It also provides future perspectives for the network. Through a collaborative approach in non-interventional research, ENCePP will collectively continue to promote excellence for RWE generation, supporting the safe and effective use of medicines.

RevDate: 2025-11-14
CmpDate: 2025-11-13

Ebrahimi F, Ebrahimi R, Beer M, et al (2025)

Colchicine for the secondary prevention of cardiovascular events.

The Cochrane database of systematic reviews, 11(11):CD014808.

RATIONALE: People with cardiovascular disease are at risk of recurrent major adverse cardiovascular events, and chronic low-grade inflammation may be a major underlying factor. Treatment with low-dose colchicine has been proposed for the secondary prevention of cardiovascular events in individuals at high cardiovascular risk. A previous Cochrane review showed considerable uncertainty regarding the benefits and harms of this approach.

OBJECTIVES: To evaluate the benefits and harms of low-dose colchicine in the prevention of cardiovascular events in adults with a history of stable CVD or following myocardial infarction or stroke.

SEARCH METHODS: We conducted a comprehensive search of the literature until February 2025 using Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, the drugs@FDA database, references of key papers, and references of included studies.

ELIGIBILITY CRITERIA: Randomised controlled trials (RCTs) comparing the use of low-dose colchicine for a minimum of six months versus any control intervention in patients of any age with cardiovascular disease (i.e. history of stable cardiovascular disease, previous myocardial infarction or stroke).

OUTCOMES: Our critical outcomes were all-cause mortality, myocardial infarction, and serious adverse events. Our important outcomes were cardiovascular mortality, stroke, all-cause hospitalisations, coronary revascularisation (percutaneous coronary intervention (PCI)/angioplasty or coronary artery bypass graft (CABG)), quality of life, and gastrointestinal adverse events (i.e. diarrhoea, nausea, abdominal pain, or vomiting).

RISK OF BIAS: Two authors independently assessed the risk of bias using the Cochrane RoB2 tool.

SYNTHESIS METHODS: We conducted meta-analyses using the random-effects model. We generated forest plots to facilitate visualisation of the data. We did not perform any subgroup analysis. We used GRADE to assess the certainty of evidence for all critical outcomes and for cardiovascular mortality, stroke, and coronary revascularisation. This was carried out by two review authors working independently.

INCLUDED STUDIES: We included 12 studies involving 22,983 randomised participants. The follow-up in the studies ranged from 6 to 80 months. Overall, 11,524 participants were assigned to low-dose colchicine treatment and 11,459 were assigned to a control intervention, which constituted either usual care plus placebo or usual care only. The doses of colchicine used were 0.5 mg once or twice daily. At baseline, the mean age of participants ranged from 57 to 74 years. Most participants (79.4%) were male.

SYNTHESIS OF RESULTS: There is high-certainty evidence that low-dose colchicine treatment reduces the risk of myocardial infarction, with a risk ratio (RR) of 0.74 (95% confidence interval (CI) 0.57 to 0.96; 22,153 participants, 8 studies; I[2] = 51%), yielding an absolute risk reduction of 9 fewer events (95% CI 16 fewer to 2 fewer) per 1000 patients, when the myocardial infarction rate is about 4% (36 events per 1000 patients) in the control group. There is also high-certainty evidence that low-dose colchicine reduces the risk of stroke with a RR of 0.67 (95% CI 0.47 to 0.95; 22,483 participants, 10 studies; I[2] = 40%), yielding an absolute risk reduction of 8 fewer events (95% CI 12 fewer to 1 fewer) per 1000 patients, when the stroke rate is about 2% (22 events per 1000 patients) in the control group. There is high-certainty evidence that the use of low-dose colchicine does not increase the rate of serious adverse events (RR 0.98, 95% CI 0.94 to 1.02; 15,677 participants, 4 studies; I[2] = 0%). However, gastrointestinal adverse events were more common under treatment with colchicine (RR 1.68, 95% CI 1.11 to 2.57; 22,185 participants, 10 studies; I[2] = 91%). For all other outcomes assessed, the evidence is of moderate certainty. Colchicine probably results in little to no difference in all-cause mortality (RR 1.01, 95% CI 0.84 to 1.21; 22,747 participants, 10 studies; I[2] = 1%; moderate-certainty evidence), in cardiovascular mortality (RR 0.94, 95% CI 0.73 to 1.22; 22,271 participants; 8 studies; I[2] = 13%; moderate-certainty evidence), and coronary revascularisation (RR 0.83, 95% CI 0.64 to 1.08; 13,705 participants, 5 studies; I[2] = 40%; moderate-certainty evidence). There is no evidence about the benefits or harms of colchicine on quality-of-life or on the risk of all-cause hospitalisation.

AUTHORS' CONCLUSIONS: People with cardiovascular disease using low-dose colchicine as secondary prevention for at least six months benefit from reduced rates of myocardial infarction and stroke, without an increase in serious adverse events. Moderate-certainty evidence did not show a benefit from low-dose colchicine for the risk of mortality (i.e. all-cause and cardiovascular mortality) or coronary revascularisation rates. Colchicine use was associated with an increased risk of gastrointestinal adverse events, which were typically described as mild and transient in nature. Additional studies are warranted to investigate the benefits and harms of low-dose colchicine in relevant subgroups and in specific indications, such as long-term use in individuals with stable coronary artery disease versus limited-time use following acute coronary syndrome.

FUNDING: Review author FE was supported by the Margot und Erich Goldschmidt & Peter René Jacobson Foundation. Review author CMS was supported by the Janggen Pöhn Foundation and the Swiss National Science Foundation (MD-PhD grant Number: 323530_221860).

REGISTRATION: This review is based on its protocol, which is available via DOI 10.1002/14651858.CD014808, and a previous review, which is available via DOI 10.1002/14651858.CD011047.pub2.

RevDate: 2025-11-15

Li X, Oberlander TF, C Lebel (2025)

Natural experiments: Disasters and disease outbreaks as models of perinatal hardship and its effects on child brain and behavior.

Neuroscience and biobehavioral reviews, 180:106475 pii:S0149-7634(25)00476-2 [Epub ahead of print].

Human brain development begins in utero and is influenced by the environment. Numerous studies show effects of perinatal maternal psychological distress (e.g., depression) on child brain and behavior. Less attention has been paid to exposure to external real-world stressors (e.g., objective hardship), which are independent of individual characteristics. We systematically reviewed 39 human studies on perinatal maternal stress from natural disasters and disease outbreaks and associations with children's brain structure and function, behavior, and mental health. Studies have mainly focused on the 1998 Quebec Ice Storm or the COVID-19 pandemic, with a handful from other natural disasters. Prenatal maternal objective hardship is related to brain volumes and functional connectivity, though studies have been small and in overlapping samples; no studies to date have examined postnatal maternal objective hardship and brain. Disaster- and disease-related perinatal hardship is related to multiple domains of neurodevelopmental outcomes, including temperament, cognition, and behaviour, with generally negative outcomes (more hardship predicts worse cognition/behaviour). Early gestational exposure is more associated with cognition, though more research is needed to understand windows of vulnerability. The apparent effects of prenatal objective stress on child behavior may occur in part through child brain alterations. Future studies with larger samples are needed, particularly to understand the effects of exposure timing and type, to further investigate sex differences, and to clarify the role of postnatal maternal objective hardship. The COVID-19 pandemic presents a unique opportunity to do this, and several ongoing studies are likely to provide valuable insight in the coming years.

RevDate: 2025-11-16

Spanoghe M, Antonacci T, Schneider N, et al (2025)

Viewpoint | linking long Covid and AD(H)D through neuroimmune dysfunction: A translational framework proposal for precision medicine.

Brain, behavior, and immunity, 131:106181 pii:S0889-1591(25)00423-4 [Epub ahead of print].

RevDate: 2025-11-12

Sharma D, Sinha R, Multisanti CR, et al (2025)

From personal hygiene products to health threats: Triclosan and its impact on endocrine health.

The Science of the total environment, 1006:180856 pii:S0048-9697(25)02496-9 [Epub ahead of print].

Daily exposure to diverse emerging environmental pollutants raises significant concern, particularly regarding endocrine-disrupting chemicals such as triclosan (TCS). Notably, in the post-COVID-19 pandemic, strategies to manage the disease have increased the use of products formulated with antibacterial compounds like TCS. TCS has been used worldwide as a broad-spectrum antibacterial agent over the past four decades. Owing to its antibacterial and antifungal properties, it is an ingredient in an array of commercial products, such as personal care, medical, acrylic, veterinary, and household items. Recent data reveal its frequent presence and widespread exposure in natural environments and human tissues. Studies across multiple species provide compelling evidence of its endocrine-disrupting effects, especially concerning reproductive hormones. Several proposed mechanisms of action include interference with hormone metabolism, disruption of hormone-receptor binding, and inhibition of steroidogenic enzyme activity. This review aims to elucidate the sources, bioaccumulation patterns, and endocrine-disrupting effects of TCS in humans. Further extrapolating and discussing the impact on non-target organisms, including aquatic species and rodents. Thus, it will help in guiding further research and related underlying mechanisms.

RevDate: 2025-11-12
CmpDate: 2025-11-13

Zamora FV, Santos ACFF, Zamora AV, et al (2025)

Hyperbaric Oxygen Treatment for Long-COVID syndrome: A Systematic Review of Current Evidence on Cognitive Decline.

Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc, 52(3):327-335.

INTRODUCTION: There is no established specific treatment for long-COVID syndrome (LCS), yet hyperbaric oxygen (HBO2) treatment has been studied as a potential option. Therefore, we conducted a systematic review to evaluate the benefits of HBO2 treatment in LCS patients.

METHODS: We systematically searched PubMed, Embase, and Cochrane databases until April 2024. Risk of bias and GRADE quality assessment were evaluated. This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with ID CRD42024530421.

RESULTS: Seven studies from seven countries, divided into RCTs and observational studies, included 199 participants. HBO₂ treatment protocols included breathing 100% oxygen at 2.0 ATA until 2.5 ATA; the number of sessions varied from ten to 60 depending on the patient's comorbidities and symptoms. Memory, executive function, attention, fatigue, and pain level improved with HBO2 treatment. The intervention had minimal side effects, and none were serious.

CONCLUSION: HBO₂ treatment might be a potential option and safe treatment in LCS patients. However, further research should be focused on evaluating its efficacy in a larger number of patients through randomized studies.

RevDate: 2025-11-15
CmpDate: 2025-11-13

Camacho-García M, Serrano-Macías M, Ortega-Martin E, et al (2025)

Drivers of health polarization during the COVID-19 pandemic: A systematic review.

Science advances, 11(46):eady5064.

Health polarization has emerged as a critical factor shaping public health attitudes and behaviors, particularly during crises such as the COVID-19 pandemic. This study provides a systematic review of the key determinants driving health polarization, highlighting the complex interplay of political, social, economic, and psychological factors. By synthesizing findings from 90 studies, we identify six primary drivers: political ideology and partisanship, misinformation and disinformation, social media structures and dynamics, trust in health institutions and professionals, risk and public health perceptions, and socioeconomic factors. Our analysis reveals how these determinants reinforce societal divisions, exacerbate health inequalities, and influence adherence to public health measures. Furthermore, we discuss the implications of these findings for designing effective interventions that address the root causes of health polarization. Understanding the mechanisms underlying these divisions is essential for mitigating their negative impact on public health and fostering more cohesive, evidence-based health communication strategies.

RevDate: 2025-11-12

Udi Y, Aitchison JD, Rout MP, et al (2025)

Breaking Barriers: Respiratory Viral Strategies Targeting the Host's Nuclear Pore Complex and Nuclear Transport Pathways.

Molecular biology of the cell [Epub ahead of print].

From stealthy infiltrators to blunt-force saboteurs, many human viruses-perhaps all-disrupt nuclear transport to control host gene expression, suppress immune responses, and redirect cellular resources toward their own replication. Among them, respiratory viruses stand out for their global impact and relentless evolution, from seasonal scourges to pandemic threats. Focusing on adenoviruses, influenza, rhinoviruses, RSV and SARS-CoV-2, we explore a series of molecular case studies that reveal both shared strategies and the diverse molecular innovations these respiratory pathogens use to subvert the nuclear transport machinery. We organize these tactics into six recurring strategies: NPC docking and nuclear entry, inhibition of immune-factor import, hijacking nuclear protein transport and karyopherins, sabotage of host mRNA export, degradation of FG-Nups, and exploitation of mitotic nuclear envelope breakdown. These insights not only illuminate fundamental virus-host conflicts but may also point the way toward new therapeutic vulnerabilities in the viruses' attack strategies.

RevDate: 2025-11-14
CmpDate: 2025-11-12

Serrano-Lázaro A, Portillo-Cortez K, de la Mora Mojica MB, et al (2025)

A Review on ZnO Nanostructures for Optical Biosensors: Morphology, Immobilization Strategies, and Biomedical Applications.

Nanomaterials (Basel, Switzerland), 15(21):.

ZnO nanostructures have attracted attention as transducer materials in optical biosensing platforms due to their wide bandgap, defect-mediated photoluminescence, high surface-to-volume ratio, and tunable morphology. This review examines how the dimensionality of ZnO nanostructures affects biosensor performance, particularly in terms of charge transport, signal transduction, and biomolecule immobilization. The synthesis approaches are discussed, highlighting how they influence crystallinity, defect density, and surface functionalization potential. The impact of immobilization strategies on sensor stability and sensitivity is also assessed. The role of ZnO in various optical detection schemes, including photoluminescence, surface plasmon resonance (SPR), localized (LSPR), fluorescence, and surface-enhanced Raman scattering (SERS), is reviewed, with emphasis on label-free and real-time detection. Representative case studies demonstrate the detection of clinically and environmentally relevant targets, such as glucose, dopamine, cancer biomarkers, and SARS-CoV-2 antigens, with limits of detection in the pico- to femtomolar range. Recent developments in ZnO-based hybrid systems and their integration into fiber-optic and microfluidic platforms are explored as scalable solutions for portable, multiplexed diagnostics. The review concludes by outlining current challenges related to reproducibility, long-term operational stability, and surface modification standardization. This work provides a framework for understanding structure-function relationships in ZnO-based biosensors and highlights future directions for their development in biomedical and environmental monitoring applications.

RevDate: 2025-11-14
CmpDate: 2025-11-12

Seo SH, MK Song (2025)

Advancements and challenges in next-generation mRNA vaccine manufacturing systems.

Clinical and experimental vaccine research, 14(4):299-307.

The coronavirus disease 2019 pandemic has accelerated the global adoption and development of messenger RNA (mRNA) vaccine technology. While traditional manufacturing approaches rely on centralized and batch-based processes that are limited in scalability and accessibility, recent innovations in modular, decentralized, and continuous-flow production systems offer promising alternatives. This review summarizes the evolution of mRNA manufacturing, examines technological advances such as BioNTech's BioNTainer and Quantoom's Ntensify, and critically evaluates persistent barriers including raw material supply, regulatory compliance, sustainability, and cold-chain requirements. The implementation of artificial intelligence, thermostable formulations, and self-amplifying mRNA technologies are discussed as future directions. Collectively, these innovations offer a pathway to equitable, scalable, and rapid vaccine deployment in the context of both pandemics and routine immunization.

RevDate: 2025-11-14
CmpDate: 2025-11-12

Cai J, Chen C, Wang J, et al (2025)

PROTAC: a revolutionary technology propelling small molecule drugs into the next golden age.

Frontiers in oncology, 15:1676414.

Proteolysis Targeting Chimera (PROTAC) is a heterobifunctional molecule comprising three core components: a target protein ligand (typically a small-molecule inhibitor), a linker, and an E3 ubiquitin ligase ligand. By harnessing the specificity of the endogenous ubiquitin-proteasome system (UPS), PROTACs induce ubiquitination and subsequent degradation of target proteins. This technology constitutes an advanced therapeutic strategy for selective protein degradation, thereby expanding the horizons of drug design. Its significant therapeutic potential extends to treating cancers, viral infections (e.g., HIV and SARS-CoV-2), and chronic diseases. Recent clinical studies on compounds such as ARV-471 have yielded encouraging results, validating the efficacy of this approach. Over the past decade, PROTAC technology has garnered widespread attention in biomedicine for its promise in developing novel targeted therapies. This review will elucidate the broad therapeutic prospects and future challenges of PROTACs by detailing their mechanism of action, recent advances, progress in targeted therapy research, and current clinical trial landscape.

RevDate: 2025-11-14
CmpDate: 2025-11-12

Zaiser C, Pahlenkemper M, Brandt G, et al (2025)

Feeding the feelings: gender differences in emotional eating during COVID-19: a systematic review and meta-analysis.

Frontiers in nutrition, 12:1680872.

CONTEXT: The COVID-19 pandemic intensified mental health issues and increased emotional eating (EE), a coping mechanism, where food is consumed in response to emotions rather than hunger. During the pandemic, gender-specific EE patterns were observed, with women reporting elevated EE levels in response to stress, anxiety, and depression due to various social and psychological factors.

OBJECTIVES: This study primarily focused on examining gender differences in EE during the COVID-19 pandemic. As a secondary outcome, it aimed to explore predictors of EE.

DATA SOURCES AND EXTRACTION: This systematic review was pre-registered (PROSPERO CRD42023421727) and adhered to PRESS and PRISMA guidelines. Studies published between March 2020 and August 2024 were identified across Scopus, Web of Science, PubMed, and PsycINFO. The quality assessment was performed using the "Critical Appraisal Checklist for Analytical Cross-Sectional Studies." The meta-analysis was conducted following MOOSE guidelines.

DATA ANALYSIS: Of 14,347 studies identified, 30 met inclusion criteria (only if population ≥18 years, without clinical diagnoses, gender-specific analysis regarding EE, observational studies with original data collection during COVID-19 pandemic), with 16 incorporated into the meta-analysis. Gender significantly moderated pandemic-related stress. Higher EE scores in women were linked to isolation and caregiving responsibilities, while men's EE often appeared as reward-seeking. Across diverse measures and regions, women consistently exhibited higher EE scores (Cohen's d = 0.39). Young adults and students showed a stronger association with EE, suggesting heightened vulnerability. Key predictors included increased food intake, COVID-19-related stress and lifestyle changes, sleep quality, and physical activity.

CONCLUSION: The predominance of cross-sectional designs limits the ability to draw causal conclusions, and selection bias in studies, often targeting specific groups, restricts generalizability. Future longitudinal studies are needed to assess causality and explore the inferences to additional factors, such as socioeconomic status and mental health. Gender-sensitive interventions are suggested to address EE risks, particularly in women.

PROSPERO (CRD42023421727). https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023421727.

RevDate: 2025-11-14
CmpDate: 2025-11-12

Alakeel AN, Alskait BK, Binshafi GB, et al (2025)

The Impact of Telehealth Adoption on Patient Outcomes: A Systematic Review.

Cureus, 17(10):e94328.

Telehealth adoption gained popularity during the coronavirus disease 2019 (COVID-19) pandemic and had substantial and various impacts on patient outcomes depending on the specific environment, healthcare system, and quality of telehealth services supplied. Hence, this systematic review explored those impacts and their sustainability post-pandemic. To conduct this systematic review, a thorough literature search was undertaken in electronic databases such as PubMed, Medline, Web of Science, Google Scholar, databases, Embase, and PsycINFO using relevant keywords. We included articles written in English and published in the last 10 years that reported on the impact of telehealth adoption on various patient outcomes and the impact of sustainability post-pandemic. The findings of this systematic review highlight the remarkable impact of telehealth adoption on patient outcomes and the sustainability of these initiatives post-pandemic. Telehealth has proven to enhance various aspects of healthcare, spanning from prevention to follow-up. Another effect of telehealth adoption is the significant reduction in hospitalizations. Furthermore, telehealth profoundly impacts hospital stays, leading to a decrease in all-cause hospital days per patient by 1.07 (95% confidence interval (CI): 1.76 to 0.39) days and a shorter mean hospital stay for condition-related hospitalizations by 89% (95% CI 1.42 to 0.36), providing evidence of efficient healthcare delivery. There was also a reduction in mortality rates for patients receiving telemedicine interventions. Telehealth is also cost-effective while remaining highly effective. Patient satisfaction is another key outcome of telehealth adoption observed. The convenience and reduced expenses of telehealth have garnered positive feedback from patients, reinforcing the desirability of telehealth as a viable alternative to in-person visits. Despite these numerous benefits, barriers and disparities in telehealth adoption and utilization persist, especially in rural hospitals that face challenges, including a lack of Health Information Exchange (HIE) capacity, limited patient engagement capabilities, and the absence of financial reimbursement. This systematic review underscores the remarkable impact of telehealth adoption on patient outcomes and its sustainability post-pandemic. However, barriers and disparities still exist, requiring attention to ensure equitable access to telehealth services. The evidence supports the continued development and implementation of telehealth initiatives to improve healthcare delivery and patient outcomes post-pandemic.

RevDate: 2025-11-16
CmpDate: 2025-11-12

Dagenais C, Proulx M, Hot A, et al (2025)

How to formulate high-quality lessons learned: a rapid review.

Global health action, 18(1):2546691.

Lessons learned convey information and experiences that were studied when carrying out projects or policies, in order to improve procedures and practices to better cope with future similar problems in other contexts. Although the term lessons learned appears in the titles of thousands of scientific articles, most do not describe how these lessons were produced or the level of rigor involved in their development. As part of a project aimed at deriving lessons from hospitals' resilience during the COVID-19 pandemic in five countries (the HoSPiCOVID project), we sought to systematised the process of producing these lessons. To do so, we conducted a rapid review to identify the best ways of developing quality lessons learned (QLLs). A QLL results from a systematic process of collecting, compiling, and analysing data derived from a research project. The rapid review follows the same key steps as a systematic review, adapted to a more accelerated and pragmatic format. From 1,881 documents initially identified, 18 were retained. Their analysis identified three principles to guide the process of developing QLLs: 1) Creating a supportive climate; 2) Choosing the right leaders or facilitators for the process; and 3) Engaging in a scientific approach. Based on these findings, we developed a guide comprising 11 steps, structured into two main phases: preparatory steps for QLL development, and steps for identifying and formulating QLLs. This guide offers a structured process for teams seeking to enhance the rigor, clarity, and potential transferability of the lessons they formulate.

RevDate: 2025-11-14
CmpDate: 2025-11-14

De Wals P, C Quach (2025)

Off-Label use of vaccines may save lives and money: lessons from the province of Quebec, Canada.

Expert review of vaccines, 24(1):1-13.

INTRODUCTION: In Canada, vaccines are authorized by Health Canada but publicly funded programs are of provincial/territorial jurisdiction. Off-label (OL) use of vaccines has been frequently implemented in Quebec over the last 30 years.

AREAS COVERED: The first part of this manuscript describes 11 recommendations from the Quebec Immunization Committee on meningococcal, pneumococcal, hepatitis A and B, HPV, rotavirus, and COVID-19 vaccines that were clearly OL. In the second part, challenges associated with OL use are discussed, including (i) the justifications of OL recommendations, (ii) the level of supporting scientific evidence, (iii) effectiveness and safety considerations, (iv) vaccine confidence and acceptability, (v) liability risks and informed consent.

EXPERT OPINION: With one exception, OL vaccine use in Quebec was successful. Reducing the number of doses or recommending the use of two different vaccines in a single immunization regimen (one vaccine having a much lower purchase cost than the other) allowed for more cost-effective immunization programs. Another OL's justification was to increase protection, by extending the age limit or interval between doses, or allowing an interchangeability of available vaccines. OL vaccine use should always be considered when properly justified by scientific evidence and vaccinology principles, and carefully evaluated when implemented.

RevDate: 2025-11-13
CmpDate: 2025-11-13

Liu R, Shao W, Q Ye (2025)

Resurgence of Mycoplasma pneumoniae Infections in the Post-COVID-19 Era: Epidemiology, Therapeutic Challenges, and Mitigation Strategies.

APMIS : acta pathologica, microbiologica, et immunologica Scandinavica, 133(11):e70092.

This study aims to review recent literature on the delayed re-emergence of Mycoplasma pneumoniae (MP) and to discuss its epidemiological characteristics, treatment strategies, and future research directions for global MP prevention and control. Through a systematic review of the recent relevant literature, the epidemiological changes in MP and the rate of increase in drug resistance during and after the COVID-19 pandemic were analyzed. Moreover, the main treatment strategies for MP, including traditional antibiotics, immunomodulators, and combination therapy, were comprehensively analyzed. The results demonstrated that nonpharmacological interventions (NPIs) implemented during the COVID-19 pandemic exerted a marked reduction in MP detection rates. However, subsequent to the progressive relaxation of NPI measures, a resurgence of MP infections has been observed across multiple global regions, accompanied by an escalating prevalence of antimicrobial resistance-particularly concerning macrolide antibiotics. The investigation further conducted systematic analyses of current therapeutic regimens for MP infection, providing critical evaluations of their respective clinical advantages and limitations in practical application. This study proposes strategies for MP's delayed recirculation control amidst its changing epidemiology and drug resistance, offering a scientific basis and practical suggestions for global MP prevention.

RevDate: 2025-11-11

Byrne D, Gale C, Canty N, et al (2025)

Neurological and neurodevelopmental effects of Covid and MIS-C on children.

Pediatric research [Epub ahead of print].

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been shown to cause a unique disease phenotype in the paediatric population compared to adults, following the emergence of Multisystem Inflammatory Syndrome of Children (MIS-C) and Paediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS). Over the course of the pandemic, neurological symptoms associated with SARS-CoV-2 have been reported in the paediatric population. The neurological and neurodevelopmental sequelae of both acute SARS-CoV-2 infection and MIS-C/PIMS-TS in the paediatric population are not well understood. Little is known about the underlying pathophysiology and the potential neurovirulence of SARS-CoV-2. Further awareness and research are needed on the neurological sequelae and long-term consequences of SARS-CoV-2 on the developing brain. IMPACT: Detailed review of the current knowledge on neurological and neurodevelopmental effects of SARS-CoV-2 and MIS-C on the paediatric population. Emphasise the importance of acknowledging the potential direct effects of SARS-CoV-2 and MIS-C on neurological and neurodevelopmental outcomes. Highlight the need for further research and inclusion of paediatric patients in follow up studies of long-term effects of SARS-CoV-2 and MIS-C focusing on neurodevelopmental and neurological sequelae.

RevDate: 2025-11-13
CmpDate: 2025-11-13

He XY, Li XH, ZH Tong (2025)

[Cognitive impairment in long COVID: advances in pathological mechanisms and exercise rehabilitation interventions].

Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases, 48(11):1087-1095.

Since the outbreak of the novel coronavirus (COVID-19) pandemic, long-term effects of the virus, known as long-COVID, has emerged. It is a chronic syndrome following infection. It is estimated that around 20% of COVID-19 survivors worldwide experience cognitive dysfunction. This is characterized by impairments in executive function, attention, memory, and other cognitive domains, and can have a significant impact on quality of life and social functioning. This article systematically reviewed recent studies and summarized the potential pathological mechanisms underlying cognitive dysfunction in long COVID, including neuroinflammation, glial cell dysregulation, involvement of the olfactory pathway and limbic system, autoimmunity and viral reactivation, cerebrovascular and blood-brain barrier damage, as well as abnormalities in neurotrophic factors and synaptic plasticity. Additionally, it explored the effects of exercise rehabilitation and multidimensional comprehensive rehabilitation strategies. The aim was to provide theoretical and scientific foundations for optimizing intervention programs for cognitive dysfunction in long COVID and for formulating clinical guidelines and public health policies.

RevDate: 2025-11-11

Ledderer L, Nielsen KH, Skodborg L, et al (2025)

Public trust and mistrust of COVID-19 vaccines: A systematic meta-narrative review.

Vaccine, 69:127947 pii:S0264-410X(25)01245-9 [Epub ahead of print].

INTRODUCTION: Trust played a fundamental role in vaccine decision-making and uptake during the COVID-19 pandemic. The purpose of this study is to explore how public trust was conceptualized, operationalized, and implicated in vaccine uptake research on COVID-19 vaccines.

METHODS: Using a systematic meta-narrative review, we searched literature around trust/distrust, science and COVID-19 vaccines. This involved identifying research areas, aims, methods, and sample sizes for each study while inductively/deductively exploring six narratives of trust - attitudinal, cognitive, affective, contingent, contextual, and communicated - developed in a previous study to synthesize findings across diverse disciplines and methodologies.

RESULTS: The final sample consisted of 79 peer-reviewed studies on trust in relation to COVID-19 vaccination. Our analysis revealed a degree of methodological uniformity as most were quantitative survey-based investigations conducted in Europe and the United States with trust typically operationalized through Likert-scale measures assessing attitudes toward science, scientists, public health authorities, and the vaccines themselves. Conceptual diversity was also evident as although trust was treated as a key explanatory factor in nearly all studies, its referents varied widely, from institutions and information sources to personal dispositions and social dynamics. Similarly, the implications of trust ranged from vaccination intention and motivation to hesitancy and actual uptake. The meta-narrative framework highlighted that attitudinal and contingent trust dominated the literature, while cognitive and affective dimensions were mainly underexplored. Despite the methodological dominance of quantitative approaches, this standardization offers strengths of comparability and policy relevance, but the limited exploration of emotional, relational, and communicative aspects of trust points to missed opportunities for more nuanced understanding.

CONCLUSION: The meta-narrative approach provided a valuable tool for synthesizing conceptual pluralism. Our findings suggest that trust in vaccination is not a singular construct, but a constellation of interrelated attitudes and judgments shaped by context, communication, and experience, each with implications for public health.

RevDate: 2025-11-11

Jimeno J, Varona JF, Lopez-Martin JA, et al (2025)

Pharmacological reprogramming of plitidepsin as a SARS-CoV-2 inhibitor.

Molecular aspects of medicine, 106:101412 pii:S0098-2997(25)00076-7 [Epub ahead of print].

Selective pressures in the ocean promote the evolution of potent molecules that may be useful in therapeutic settings. Tunicates provide a rich source of bioactive molecules that have been shown to have anti-neoplastic and anti-microbial activities. Plitidepsin, a natural marine cyclic depsipeptide originally isolated from the tunicate Aplidium albicans, was originally developed as an anti-tumor drug, and has been approved for use in Australia in patients with advanced pretreated myeloma. Early in the SARS-CoV-2 pandemic, plitidepsin was shown to have potent preclinical efficacy against the virus, suggesting that it could be repurposed for the treatment of COVID-19. This review summarizes the clinical development of plitidepsin first as an anti-tumor drug, before providing a recapitulation of current efforts to repurpose the molecule as an antiviral therapy. The pharmacokinetic and pharmacodynamic data on plitidepsin will be analyzed, and the various experimental lines of evidence in support of the molecule's multifactorial mechanism of action will be explored. Finally, the available data on the use of plitidepsin in patients with COVID-19 will be presented, including results from a Phase I proof-of-concept study, real-world data from immunocompromised patients, and a look of results from a Phase III clinical trial that confirms the working hypothesis.

RevDate: 2025-11-12
CmpDate: 2025-11-12

Desai S, Rath C, Bhandarkar N, et al (2025)

Virtual Reality Experience to Relieve Stress, Burnout, Fatigue, and Anxiety in Healthcare Professionals: A Systematic Review.

Journal of healthcare management / American College of Healthcare Executives, 70(6):416-434.

GOAL: Healthcare professionals (HCPs) working long shifts are prone to physical, emotional, and psychological stress leading to harmful effects on their mental health, an issue compounded by the COVID-19 pandemic. Novel efforts such as virtual reality (VR)-based immersion have been explored to mitigate this problem in HCPs. However, the studies vary in their clinical settings, scales used for measuring outcomes related to mental health, sample size, and other relevant parameters. We conducted a systematic review (SR) to collate all available evidence on the feasibility and efficacy of VR-based interventions for reducing stress, burnout, fatigue, and anxiety in HCPs.

METHODS: We searched major databases for comprehensive literature on HCP mental well-being measures in September 2023 and February 2024. Risk of bias was assessed using the Effective Public Health Practice Project (EPHPP) quality assessment tool, and PRISMA guidelines were used for reporting this SR.

PRINCIPAL FINDINGS: A total of 17 studies out of 1,422 citations were included in the final analysis. The number of study participants ranged from 14 to 219 (1,053 total). Seven studies were randomized controlled trials, and the rest were pre-post intervention studies. Meta-analysis was not feasible because the included studies were heterogeneous in their study settings, methodology, and assessed mental health domain. Based on the EPHPP tool, one study had a strong global rating, two had a moderate rating, and 14 had a weak rating.

PRACTICAL APPLICATIONS: VR-based interventions during break times appear to be feasible and useful in addressing HCP stress, burnout, fatigue, and anxiety. However, limited high-quality studies warrant caution in interpretation.

RevDate: 2025-11-11

Lee DH, Lee W, H Bach (2025)

Nanomedicine in the development of vaccines against Herpesviridae: a narrative review.

Nanomedicine (London, England) [Epub ahead of print].

The Herpesviridae family, more commonly known as herpesviruses, includes the Alphaherpesvirinae, Betaherpesvirinae, and Gammaherpesvirinae subfamilies, each with unique clinical presentations. Herpesvirus infections are a major public health concern. Current management approaches for herpesviruses primarily focus on antiviral or symptomatic treatment, with few licensed vaccines. Recent advancements in nanotechnology applied to the COVID-19 pandemic have created new opportunities to develop vaccines using nanomedicine to prevent herpesvirus infections. The authors reviewed 62 papers studying nanomedicine applications for vaccine development for herpesviruses. Nanoparticle-based vaccine delivery strategies may be feasible and practical options for herpesvirus prevention.

RevDate: 2025-11-13
CmpDate: 2025-11-12

Abbas U, Kumar H, Hussain N, et al (2025)

Immune dysregulation in type 2 diabetes mellitus: Implications for tuberculosis, COVID-19, and HIV/AIDS.

Infectious medicine, 4(4):100211.

Diabetes mellitus (DM) is a complex and multifactorial disorder associated with elevated blood sugar levels, poor insulin sensitivity, and inadequate insulin production. It has a major impact on the immune system, making a person more susceptible to and influenced by a variety of infectious illnesses. This narrative review summarizes the relationship between chronic inflammation and high glucose levels in DM, on susceptibility and outcomes in endemic infectious diseases. We focused on impact of DM on disease progression, and treatment response in these infections. Literature was identified through searches of PubMed, Scopus, and Google Scholar, focusing on epidemiologic, clinical, and mechanistic studies. The evidences suggest that immune modulation in DM has profound inverse relations with the outcome of infectious diseases including tuberculosis, COVID-19, and HIV/AIDS. DM increases the risk of developing severe forms of infectious diseases due to downregulation of the immune system which is associated with glycemic control. There is a need to understand the relationship between DM and immunological control for developing methods to reduce these risks and improve outcomes for the affected population.

RevDate: 2025-11-13

Sad SA, Iftikhar L, M Chamout (2025)

Revisiting HPV vaccination post-COVID: geopolitical, sociocultural, and ethical disparities in global health.

International journal for equity in health, 24(1):308.

BACKGROUND: HPV vaccines have been revolutionary in preventing HPV-related cervical cancer and reshaping the cervical cancer screening guidelines in the past decades. Yet, challenges persist in achieving universal accessibility and utilization. Since the COVID-19 pandemic, shifts have emerged in HPV vaccine research, implementation strategies, and the determinants shaping uptake and delivery, particularly from a global equity perspective.

METHODS: This is a scoping review examining English-language, peer-reviewed articles published following the onset of the COVID-19 pandemic until the end of 2024. It focuses on the human papillomavirus (HPV) vaccine and factors influencing its uptake. Articles were retrieved from PubMed and Embase databases and screened for relevance using predefined search terms.

RESULTS: Out of 2755 articles, 349 were included. We identified that most peer-reviewed articles focus on interventions and implementation strategies more than acknowledging geopolitical affairs, gender specificity, religious and ethical dimensions, medical mistrust, or healthcare discrimination. Most of the articles were cross-sectional in nature and most were funded by the National Cancer Institute. Interestingly, we found no peer-reviewed articles on the intersectionality of Judaism and HPV vaccine uptake, with a limited number on Islamic, Christian, or other religious intersectionality. Articles addressing how low- and middle-income countries could be equipped to develop and manage their own vaccine programs and manufacturing were largely absent; instead, cost-effectiveness research focused primarily on the vaccine’s ability to reduce disease burden.

CONCLUSION: Post-pandemic research on HPV vaccination indicates that levels of hesitancy and uptake have remained relatively stable. However, the literature highlights persistent inconsistencies in how the vaccine is prioritized across communities, healthcare professionals, and health systems. Messaging regarding its importance for cancer prevention remains fragmented, while cost barriers and the absence of the vaccine from many national immunization schedules continue to limit access. Notably, ethical, religious, and cultural considerations receive limited attention in current research, despite the pandemic underscoring the global significance of these factors in shaping health behaviors. These findings suggest a need to re-examine how HPV vaccination is framed and advanced as a public health priority within diverse sociocultural and systemic contexts.

RevDate: 2025-11-13
CmpDate: 2025-11-13

Badra R, Zhang W, Tam JSL, et al (2025)

A Systematic Review of New, Enhanced Surveillance Systems and Methodologies for Zoonotic Influenza Viruses in Animals and Human-Animal Interface.

Influenza and other respiratory viruses, 19(11):e70178.

In 2009, the World Health Organization (WHO) developed a public health research agenda for influenza to guide researchers and outline directions and priority areas for research on influenza aiming at reducing the burden of seasonal epidemic influenza and the risk and impact of pandemic influenza. The agenda was updated in 2017, but since then, important research has been conducted, and major changes have occurred to the global health landscape impacted mainly by the COVID-19 pandemic. Therefore, there is a need to assess advances in zoonotic influenza surveillance methods reported between 2017 and 2024 in order to highlight key achievements and identify remaining gaps that limit their broader implementation, hence informing an update of the research agenda. We conducted a comprehensive literature review of zoonotic influenza surveillance and monitoring, focusing on novel and enhanced methodologies reported globally between 2017 and 2024. A systematic analysis was performed following PRISMA guidelines on 7490 peer-reviewed manuscripts from 2017 to 2024 retrieved from PubMed, of which 164 records were included in this review. Analysis of the information collected indicated several advances and gaps at different levels of surveillance and unmet public health needs. Most countries do not have active and comprehensive surveillance programs for zoonotic influenza at the human-animal interface, which underestimates the true burden of zoonotic influenza diseases. The review concludes with a set of high-priority research recommendations focused on filling gaps in One Health data integration, validation, and field deployment of novel diagnostic technologies, wider adoption of noninvasive and environmental surveillance approaches, and stronger linkage of methodological innovations to risk assessment and policy action. In light of the recent upsurge in H5N1 activity and cross-species transmission, the WHO has convened multiple R&D Blueprint consultations over the past year to prioritize research and development for H5N1 candidate vaccines, diagnostics, and pandemic preparedness. These ongoing initiatives underscore the critical importance of strengthening surveillance at the human-animal interface.

RevDate: 2025-11-10

Uraki R, Korber B, Diamond MS, et al (2025)

SARS-CoV-2 variants: biology, pathogenicity, immunity and control.

Nature reviews. Microbiology [Epub ahead of print].

More than 5 years have passed since the emergence of the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), yet this virus continues to circulate globally, undergoing evolutionary changes. The effective control of SARS-CoV-2 necessitates an understanding of its antigenicity, replicative capacity, pathogenicity and transmissibility, as well as the development of preventive and treatment options. In this Review, we describe the origins and evolution of SARS-CoV-2, and outline variant and subvariant-specific characteristics. We also discuss the challenges faced in implementing prevention and treatment methods, such as the emergence of antigenically distinct variants and the phenomenon of immune imprinting. This Review provides insights into combating the ongoing COVID-19 pandemic and guidance for future research and vaccine development efforts.

RevDate: 2025-11-13
CmpDate: 2025-11-13

Adusei-Mensah F, Olubamwo O, Olaleye S, et al (2025)

Updating the impact of mRNA COVID-19 vaccine exposure during pregnancy on obstetric and neonatal outcomes.

Taiwanese journal of obstetrics & gynecology, 64(6):957-970.

Being a new vaccine platform, continuous monitoring of the mRNA COVID-19 vaccines in pregnant women is of critical importance. This systematic review and meta-analysis evaluate the maternal and neonatal outcomes associated with mRNA COVID-19 vaccination during pregnancy. We conducted a systematic search of PubMed, Embase, Cochrane Library, and clinical trial registries for studies published between December 2020 and July 2024. Studies were included if they assessed obstetric and neonatal outcomes following mRNA COVID-19 vaccination in pregnant women. Data were extracted and analyzed using a random-effects model to calculate pooled odds ratios (ORs) and 95 % confidence intervals (CIs). Fifteen studies met the inclusion criteria, encompassing 42,944 vaccinated and 183,733 unvaccinated pregnant women. mRNA vaccination was associated with a significant reduction in preterm delivery (OR 0.743, 95 % CI 0.607-0.911), fetal distress (OR 0.699, 95 % CI 0.546-0.893), neonatal congenital abnormalities (OR 0.712, 95 % CI 0.570-0.889), and NICU admissions (OR 0.718, 95 % CI 0.617-0.836). However, a slight increase in gestational diabetes risk was observed (OR 1.107, 95 % CI 1.054-1.162). mRNA COVID-19 vaccines are safe during pregnancy and associated with reduced risks of adverse obstetric and neonatal outcomes. An observed marginal increase in gestational diabetes risk underscores the need for continuous monitoring. These findings support the inclusion of pregnant women in vaccination campaigns and inform public health policies and clinical practices to improve maternal and neonatal health outcomes.

RevDate: 2025-11-12

Rong H, Ren J, Wu Q, et al (2025)

Repurposing niclosamide for COVID-19: Synergistic strategies of nanotechnology and novel materials to enhance antiviral efficacy.

Microbial pathogenesis, 210:108169 pii:S0882-4010(25)00894-0 [Epub ahead of print].

The persistent prevalence of COVID-19 and its emerging variants continues to threaten global health security. While most of these viruses have been controlled through medications or vaccines, the increasing number of SARS-CoV-2 variants and the inequitable access to vaccines across nations remain significant challenges for epidemiological management. Niclosamide, an FDA-approved anthelmintic drug, exhibits broad-spectrum antitumor, antibacterial, and antiviral properties, yet suffers from poor bioavailability. Repurposing niclosamide in combination with advanced material technologies may offer a promising therapeutic strategy. To optimize its future clinical applications, we summarize the antiviral mechanisms of niclosamide and emphasize strategies such as nanotechnology and novel material design to enhance its bioavailability and stability. Additionally, we discuss the latest clinical trial outcomes of niclosamide. Looking ahead, with the ongoing advancements in material synthesis, the synergistic integration of nano-hybridization and innovative material systems for niclosamide is poised to become a pivotal tool in epidemiological management and combating viral threats, providing an innovative, accessible, and cost-effective solution for pandemic control.

RevDate: 2025-11-10

Xavier D, Silva W, Correa F, et al (2025)

Experience of Parenting Children and Adolescents with Cystic Fibrosis: A Systematic Review of Qualitative Studies and Meta-Synthesis.

Respiratory medicine pii:S0954-6111(25)00548-7 [Epub ahead of print].

BACKGROUND: Caring for children with cystic fibrosis (CF) poses significant emotional and practical challenges for parents and caregivers. Understanding their experiences is crucial to improving care.

METHODS: A systematic review was conducted of qualitative studies on the experiences of parents and caregivers of children and adolescents with CF. Multiple databases were searched. Studies were independently screened and appraised. A meta-synthesis approach was used to integrate the findings.

RESULTS: Key themes were identified in 27 studies, mainly from English-speaking countries: impact of diagnosis, routine care demands, healthcare relationships, faith, adolescent transition, support systems, uncertain future, palliative care, and COVID-19 challenges. Caregivers face emotional distress, guilt, and burden, along with the limitations of the healthcare system and social stigma. Optimism about treatments coexisted with fear and uncertainty. Adolescent transition brought challenges in terms of autonomy and adherence to treatment. Spirituality was both a coping tool and a source of conflict.

CONCLUSIONS: Caregiving for children and adolescents with CF is complex and multifaceted. Clear communication, continuous psychosocial support, and respect for both emotional and spiritual needs are vital, especially upon receiving the diagnosis and during adolescence. Open discussions on sensitive topics, such as palliative care, can improve caregiver experiences and outcomes.

RevDate: 2025-11-13
CmpDate: 2025-11-13

Goodfellow H, Blandford A, Bradbury K, et al (2025)

Development and implementation of a digital health intervention in routine care for long COVID patients: a comprehensive synopsis.

Health and social care delivery research, 13(39):1-27.

BACKGROUND: By July 2020, large numbers of post-COVID patients were experiencing symptoms for weeks or months, but traditional National Health Service models of rehabilitation service delivery could not meet demand.

OBJECTIVES: Design and deploy a digital health intervention to provide digitally delivered, remotely supported rehabilitation to long COVID patients on complicated and evolving pathways.

METHODS: The multidisciplinary team combined established research methods based on engineering and computer science (considering safety, stability and user requirements) with those based on biomedical and health service research (considering effectiveness and population impact). Qualitative data comprised recordings of meetings between study team members and clinicians and semistructured interviews with clinician and patient users. Quantitative data comprised referral, registration and usage rates; demographic and clinical characteristics of patients; and patient-reported outcome measures.

RESULTS: We created a modifiable digital health intervention, 'Living With COVID Recovery[TM] developed by Living With Ltd', London, UK, that continues to be used by National Health Service trusts. The digital health intervention included integration into a clinical pathway, a clinician-facing dashboard, two-way messaging and a patient-facing app with information and evidence-based treatments. We aimed to register 1000 users. By study completion on 20 December 2022, there were 9781 patients invited, of whom 7679 (78.5%) had registered, at 33 National Health Service clinics.

LIMITATIONS: Data came from patients at long COVID clinics, however data were unlikely to be representative of people with long COVID. We could not observe clinics under lockdown and had limited access to patient digital health intervention users or to people not engaging with the digital health intervention. Patient user data were incomplete, with inconsistent patient-reported outcome measure and other questionnaire data completion and no data on initial severity of disease, vaccination status, comorbidities or other individual circumstances.

CONCLUSIONS: Long COVID can be extremely debilitating, comparable to stage IV lung cancer in relation to fatigue and health-related quality of life. Care and rehabilitation should address the management of fatigue and reflect the impact of social disadvantage on symptom severity. With sufficient resources, a digital health intervention can be developed quickly and effectively using agile methodology and bringing together a genuinely multidisciplinary team, including, importantly, an industry partner. Digital health intervention product design and deployment are both important in getting National Health Service trusts, healthcare professionals and patients to engage with a digital health intervention. Projects should work closely with all user groups. Lockdown and the unmet need of a new patient group encouraged those who might otherwise have been reluctant to try a digital health intervention. Many patients and clinics accepted this digital remote support, which helped patients feel cared for while reducing strain on health services. This may encourage acceptance of other digital health intervention, although medical record integration remains a deterrent to clinics.

FUTURE WORK: This research focused on the development, deployment and evaluation of a digitally enabled rehabilitation programme for long COVID. Clinical effectiveness will be assessed within the Symptoms, Trajectory, Inequalities and Management: Understanding Long-COVID to Address and Transform Existing Integrated Care Pathways (UCL, London, UK) study.

FUNDING: This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR132243.

RevDate: 2025-11-12
CmpDate: 2025-11-12

Alali M (2025)

Pediatric Hepatitis-Associated Aplastic Anemia.

Pediatric annals, 54(11):e400-e403.

Hepatitis-associated aplastic anemia (HAAA) is a rare but life-threatening disorder that requires early recognition and intervention. Pediatricians play a critical role in identifying cases where acute hepatitis transitions to severe bone marrow failure. This review presents the diagnostic and therapeutic complexities associated with HAAA, emphasizing the importance of a multidisciplinary approach. Key topics include the pathophysiology of immune-mediated marrow suppression, diagnostic strategies (eg, immunophenotyping, bone marrow biopsy), and management approaches (eg, immunosuppressive therapy, hematopoietic stem cell transplantation). The review also highlights emerging evidence on viral triggers, such as severe acute respiratory syndrome coronavirus 2, and underscores the need for heightened clinical awareness and standardized treatment strategies.

RevDate: 2025-11-13
CmpDate: 2025-11-12

Alkhwaiter B, Aloud M, N Almezeini (2025)

User Experience in mHealth Research: Bibliometric Analysis of Trends and Developments (2007-2023).

JMIR mHealth and uHealth, 13:e75909.

BACKGROUND: The significance of mobile health (mHealth) apps transforms traditional health care delivery and enables individuals to actively manage their health. The success and effectiveness of mHealth apps heavily depend on the user experience and satisfaction. Previous studies have examined mHealth adoption through systematic literature reviews, focusing on mental health, chronic disease management, fitness, and public health responses to crises like the COVID-19 pandemic. However, the state of research, the key trends, themes, and gaps in the user experience and satisfaction with mHealth apps remain unexplored.

OBJECTIVE: This study aimed to investigate the state of research on user experience in mHealth apps through a bibliometric analysis. Furthermore, the study aims to systematically identify research trends and themes by extending the analysis of the science mapping technique, co-word analysis, and bibliographic coupling.

METHODS: The bibliographic data corpus was collected from Scopus and Web of Science and systematically analyzed using bibliometric performance analysis and science mapping techniques. The methodology incorporates various data processing and visualization tools, including VOS Viewer, OriginLab, and SiteSpace. Then, a comprehensive review metric, combining the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework and a 4-step approach from data collection to interpretation is used.

RESULTS: The bibliographic analysis spans 16 years and includes 814 unique publications authored by 4870 researchers from 81 countries and 1948 organizations, published across 351 high-impact journals and prominent conferences. The analysis of research trends identifies 2 key trends: the differentiation in keyword usage for user experience and user satisfaction, and the research methodologies used within the domain. Furthermore, 5 research themes were identified exploring critical aspects of technology use, user engagement, and clinical integration. Although all 5 themes overlap, each theme focuses on distinct elements that help delineate their contributions to the overall understanding of mHealth apps: technological evaluation (Theme 1), design features for engagement (Theme 2), patient usability (Theme 3), long-term engagement factors (Theme 4), and clinical integration (Theme 5).

CONCLUSIONS: This study offers a fundamental understanding of the bibliographic landscape of research on user experience and satisfaction with mHealth apps. By identifying major research clusters, influential works, and emerging topics, this analysis provides evidence-based guidance for researchers, developers, and health informatics practitioners. Furthermore, based on the research trends findings, future research should prioritize expanding the scope of user experience (UX) evaluation by incorporating diverse user populations, longitudinal studies, and emerging technologies such as artificial intelligence and personalized interventions. Integrating insights from interdisciplinary perspectives such as human-computer interaction, behavioral sciences, and health care informatics, the understanding of user needs and app effectiveness can be enhanced. A more standardized framework for assessing UX in mHealth apps is also recommended to facilitate comparability across studies and improve app design to maximize user engagement and health outcomes.

RevDate: 2025-11-17
CmpDate: 2025-11-12

Nadubinszky G, B Székács (2025)

[Connection between viral infections, vaccines, and dementia].

Orvosi hetilap, 166(45):1763-1768.

Dementia represents a growing public health challenge in the elderly population worldwide, with its development being influenced by multifactorial mechanisms. In recent years, increasing evidence has supported the notion that certain viral infections – particularly herpesviruses, the human immunodeficiency virus (HIV), and SARS-CoV-2 – may contribute to neurodegenerative processes either directly or indirectly. It has been demonstrated that chronic inflammation, immune system dysregulation, and blood–brain barrier damage induced by viral agents potentially promote the pathogenesis of dementia, especially Alzheimer’s disease. Simultaneously, remarkable new research has emerged highlighting the potential protective effects of vaccination. According to a study conducted by Stanford University and published in 2025, elderly adults vaccinated against herpes zoster (shingles) exhibited a significantly lower incidence of dementia over a 7-year follow-up period. Researchers identified a 20% relative risk reduction, particularly among women. Other studies have supported similar effects for vaccines against influenza, tetanus, and diphtheria. The aim of our publication was to summarize the causative role of viral infections in dementia and to present the inhibitory effects of vaccines, which likely extend beyond specific antiviral infection prevention. Furthermore, we sought to emphasize the clinical and public health significance of these findings, particularly for the elderly population with compromised immune systems. Orv Hetil. 2025; 166(45): 1763–1768.

RevDate: 2025-11-14
CmpDate: 2025-11-13

Fan Y, Zhou Y, Zhao J, et al (2025)

Advances in Inhaled Nanoparticle Drug Delivery for Pulmonary Disease Management.

FASEB journal : official publication of the Federation of American Societies for Experimental Biology, 39(21):e71191.

Pulmonary disorders, notably highlighted by the global impact of COVID-19, continue to pose serious public health concerns with limited treatment options. To address the urgent need for effective lung-targeted therapies, strategies that maximize local therapeutic efficacy while minimizing systemic toxicity are essential to the unique anatomical location of the lungs, inhaled therapy provides a promising strategy for locally targeted drug delivery through intranasal or intratracheal administration. Integrating biomedical nanotechnology and inhaled therapy, inhaled nanoparticle drug delivery systems (INDDs) have emerged as a powerful platform capable of penetrating mucus and pulmonary surfactant barriers, enhancing lung distribution and retention, and precisely delivering small molecules, proteins, and nucleic acids in lung lesions and cells using natural or synthetic carriers. The INDDs provide a universal translational platform for structurally analogous drugs and a wide array of respiratory disorders. This review summarizes recent advances in INDDs, focusing on the critical carrier materials in formulation, performance in in vitro and in vivo, and inhalation dosage forms, highlighting design strategies to overcome lung barriers and improve clinical and preclinical therapeutic efficacy in lung diseases.

RevDate: 2025-11-12
CmpDate: 2025-11-12

Hou J, Duan W, Wang Y, et al (2025)

A systematic review of impacts of COVID-19 on depression and anxiety among general populations around the world.

Frontiers in public health, 13:1659671.

BACKGROUND: The COVID-19 pandemic has profoundly impacted global mental health, with significant disparities in depression and anxiety observed across populations and countries. Existing literature highlights the role of social determinants of health (SDH) in shaping mental health outcomes, yet systematic reviews synthesizing these impacts across diverse socioeconomic and policy contexts remain limited. This study provides an overview of how COVID-19 is affecting depression and anxiety among general populations, alongside inequalities driven by the SDH.

METHODS: Six databases (CNKI, Embase, PubMed, Scopus, Cochrane Library, Web of Science) were searched from March 2020 to February 2024. Inclusion criteria encompassed cross-sectional/longitudinal studies assessing depression/anxiety in adults (≥18 years) using validated scales (e.g., PHQ-9, GAD-7). After screening 4,916 records, 59 studies met eligibility criteria. Quality assessment utilized the Joanna Briggs Institute tool, and data extraction covered study characteristics, outcomes, and SDH factors. This review is registered with PROSPERO: CRD420251023201.

RESULTS: Among 59 studies (39 from low- and middle-income countries [LMICs]; 16 from high-income countries [HICs]), younger individuals, women, and socioeconomically disadvantaged groups exhibited heightened vulnerability to depression and anxiety. High-income countries with stringent lockdowns (e.g., the U.S., France) reported sustained psychological distress, while nations adopting effective early containment strategies saw mental health improvements over time. Population-level determinants, including healthcare infrastructure and policy stringency, significantly influenced outcomes. Low-resource settings faced worsened mental health burdens due to prolonged restrictions and limited medical access. Individual and community-level factors such as unemployment, housing instability, and low social support amplified risks. Temporal trends revealed worsening mental health during extended lockdowns and disparities in recovery trajectories across regions.

CONCLUSION: The COVID-19 pandemic exacerbated mental health inequalities, disproportionately affecting specific groups and underscoring the interplay of SDH. Tailored interventions addressing socioeconomic vulnerabilities, enhancing social support, and balancing infection control with psychological well-being are critical.

https://www.crd.york.ac.uk/PROSPERO/view/CRD420251023201, identifier CRD420251023201.

RevDate: 2025-11-12
CmpDate: 2025-11-12

Requena B, Barbas C, C Gonzalez-Riano (2025)

Unraveling virus-host interactions: Current advances in viral lipidomics.

iScience, 28(11):113750.

Viruses significantly alter host lipid metabolism to facilitate their replication, assembly, and immune evasion. Lipidomics, a mass spectrometry-driven field, enables the comprehensive profiling of virus-induced lipid remodeling and provides crucial insights into host-pathogen interactions. This review provides a comprehensive overview of cutting-edge lipidomic research in viral infections, focusing on studies published from January 2023 onwards. Emphasis is placed on recent advancements in understanding key respiratory viruses (e.g., SARS-CoV-2), bloodborne pathogens (HIV, HCV), and emerging viral threats such as West Nile or the Dengue viruses. We examine the latest analytical platforms, annotation techniques, and biological findings, highlighting how specific alterations in glycerophospholipid, sphingolipid, and sterol pathways reveal novel diagnostic and therapeutic opportunities. While challenges in standardization, isomer annotation, and clinical translation persist, emerging MS technologies and computational strategies promise to overcome these limitations. Integrating lipidomics with systems biology approaches will be crucial for advancing precision virology and developing next-generation antiviral therapies.

RevDate: 2025-11-12
CmpDate: 2025-11-12

He Y, Yuan Y, Zhou M, et al (2025)

Development of siRNA therapeutics to combat microbial infections: a bibliometric analysis.

Frontiers in cellular and infection microbiology, 15:1697880.

BACKGROUND: The rise of antimicrobial resistance and the COVID-19 pandemic highlight the limitations of traditional therapies. Small interfering RNA (siRNA) therapeutics, which utilize RNA interference for targeted gene silencing, present a promising approach to combating microbial infections. However, research in this area remains fragmented. This study employs a comprehensive bibliometric analysis to chart research trends and inform future directions.

METHODS: A total of 8,426 publications from the Web of Science Core Collection (2001-2025) were analyzed using CiteSpace and VOSviewer software to examine annual publication trends, geographic and institutional contributions, author networks, journal impacts, and keyword evolution. Data extraction focused on English-language articles.

RESULTS: The publication trends for siRNA therapeutics in microbial infections have evolved in three phases: rapid growth, stabilization at a peak, and subsequent cyclical fluctuations. Research contributions spanned 99 countries and regions, with 5,564 institutions and 1,234 journals involved. China (2,849 publications) and the United States (2,820 publications) led in publication volume. While the United States maintained dominance in academic influence and collaboration, China has steadily increased its research output in this area. The Journal of Virology emerged as the leading journal in terms of both productivity and citation impact. Key research areas include delivery systems, target selection, manufacturing technologies, antiviral therapeutics, and combination therapies. The field has shifted from basic mechanistic studies to clinical applications, with future research poised to focus on organ-specific delivery beyond the liver, exploration of diverse administration routes, integration of artificial intelligence-driven strategies, and enhanced global collaboration.

CONCLUSION: This bibliometric analysis offers a comprehensive overview of siRNA therapeutics for microbial infections, highlighting collaboration networks and academic influence across authors, countries, institutions, and journals. The study provides valuable insights into current research trends and serves as a foundational reference for guiding future collaborative efforts and innovations in this field.

RevDate: 2025-11-12
CmpDate: 2025-11-12

Ige MA, Ren X, Yang Y, et al (2025)

mRNA therapeutics: Transforming medicine through innovation in design, delivery, and disease treatment.

Molecular therapy. Nucleic acids, 36(4):102721.

mRNA therapeutics have revolutionized medicine, offering a versatile platform to address previously untreatable diseases. Recent advancements in biotechnology have enabled the efficient production of functional proteins, antibodies, and peptides via mRNA, providing rapid and adaptable solutions for vaccine development and therapeutic interventions. The success of mRNA vaccines, exemplified during the COVID-19 pandemic, underscores their potential for combating infectious diseases with unparalleled speed and scalability. This review explores the latest developments in mRNA technology, including innovations in design, delivery, and disease treatment; modulation of immune response; and the role of AI. Particular emphasis is placed on optimizing mRNA constructs to maximize therapeutic efficacy, new delivery vehicles for mRNA, and the modulations of immune response evoked by mRNA vaccines. The potential applications of mRNA therapeutics in genetic disorders, infectious diseases, and cancer are highlighted, alongside a discussion of existing challenges such as delivery efficiency and production scalability. By integrating molecular biology, RNA technology, and nanotechnology, mRNA therapeutics hold the promise of transforming precision medicine. These advancements offer hope for patients with complex or intractable conditions, paving the way for a new era in targeted therapies and personalized healthcare.

RevDate: 2025-11-12
CmpDate: 2025-11-12

Osifo SE, MA Shobode (2025)

Telerehabilitation After Total Knee Arthroplasty: A Narrative Review of Its Effectiveness, Safety, and Access in the Post-COVID Era.

Cureus, 17(10):e94102.

Osteoarthritis (OA) is a leading cause of disability worldwide, affecting primarily older adults. With rising rates of obesity and population aging, the global burden of OA is expected to grow substantially. Total knee arthroplasty (TKA) remains the definitive treatment for end-stage knee OA. However, the growing demand for postoperative rehabilitation has intensified the strain on the physical therapy (PT) workforce. The COVID-19 pandemic accelerated the adoption of telerehabilitation, but evidence regarding its effectiveness, safety, cost-efficiency, and equity after TKA remains scattered. A narrative review of English-language, full-text articles published between January 2018 and May 2025 was performed. PubMed, MEDLINE, and Google Scholar were searched using terms including "telerehabilitation", "virtual physical therapy", and "total knee arthroplasty". Eligible studies were randomized controlled trials (RCTs), cohort studies, case series (n ≥ 10), or systematic reviews/meta-analyses that compared telerehabilitation with conventional in-person rehabilitation after TKA. Outcomes included functional metrics, e.g., Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oxford Knee Score (OKS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Knee Society Score (KSS), pain (visual analog scale, VAS), patient satisfaction, adherence, cost/utilization data, and equity indicators. Eight studies (six RCTs, two meta-analyses; n ≈ 2,070) met the inclusion criteria. Interventions included AI-driven apps, video-based therapy, and wearable sensors. Most studies found telerehabilitation to be non-inferior to conventional PT in improving pain, range of motion (ROM), and function. Meta-analyses showed comparable gains in KOOS, ROM, and VAS scores. Cost-effectiveness was favorable in bundled care models, though technology costs were inconsistently reported. No increased adverse events were observed. Digital literacy and broadband access emerged as equity challenges. Telerehabilitation is a safe, effective adjunct to in-person PT following TKA, with potential to expand access and reduce system strain. Hybrid models may offer the most sustainable path forward.

RevDate: 2025-11-12
CmpDate: 2025-11-12

Smail SW, Ismail BA, Maghdid IS, et al (2025)

Antioxidant and oxidative enzymes, genetic variants, and cofactors as prognostic biomarkers of COVID-19 severity and mortality: a systematic review.

Frontiers in molecular biosciences, 12:1700263.

Oxidative stress plays a pivotal role in the pathogenesis and progression of coronavirus disease 2019 (COVID-19). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection disrupts redox homeostasis through excessive generation of reactive oxygen and nitrogen species, driving inflammation, endothelial dysfunction, and multi-organ injury. Serum oxidative and antioxidative enzymes, their genetic polymorphisms, and essential micronutrient cofactors have emerged as potential prognostic biomarkers for COVID-19 severity and mortality. Evidence indicates that imbalances in antioxidant enzymes such as superoxide dismutase, catalase, glutathione peroxidase, and glutathione reductase correlate with disease progression, while polymorphisms in GST, superoxide dismutase, CAT, and HO-1 genes may modify susceptibility and outcomes. Biomarkers of oxidative damage, including malondialdehyde, 8-isoprostanes, nitrotyrosine, and protein carbonyls, consistently associate with respiratory failure, intensive care admission, and mortality. Furthermore, micronutrients such as selenium, zinc, copper, manganese, and iron, which act as enzymatic cofactors, influence antioxidant defense capacity and clinical prognosis. Despite promising data, limitations in biomarker standardization and assay specificity remain key challenges for clinical translation. The aim of this systematic review is to integrate enzymatic, genetic, and cofactor-based biomarkers to enhance risk stratification, challenging and to improve prognostic modelling in COVID-19. A better understanding of these biomarkers may facilitate early identification of high-risk patients, guide therapeutic interventions, and ultimately improve clinical outcomes in COVID-19.

RevDate: 2025-11-12
CmpDate: 2025-11-12

Farnia P, Velayati AA, Ghanavi J, et al (2026)

Tuberculosis: An Ongoing Global Threat.

Advances in experimental medicine and biology, 1484:1-31.

Tuberculosis (TB) remains one of the world's most urgent public health challenges, with a substantial global burden that continues to affect millions annually. According to the World Health Organization (WHO) Global Tuberculosis Report 2024, approximately 10.6 million people developed TB in 2023, resulting in 1.6 million deaths. The highest incidence rates persist in low- and middle-income countries, where socioeconomic determinants such as poverty, malnutrition, overcrowded living conditions, and limited access to quality healthcare exacerbate disease transmission and worsen outcomes. The emergence and spread of drug-resistant TB, including multidrug-resistant (MDR-TB), extensively drug-resistant (XDR-TB), and totally drug-resistant (TDR-TB) strains, pose significant challenges to effective treatment and control, contributing to increased mortality and healthcare costs. The coronavirus disease-2019 (COVID-19) pandemic has further disrupted TB services worldwide, causing declines in case detection, delayed diagnoses, and interruptions in treatment, thereby reversing years of progress. Despite the availability of effective vaccines and treatment regimens, gaps in awareness, funding, healthcare infrastructure, and social determinants of health hinder global elimination efforts. Coordinated, multisectoral strategies are essential to address this complex epidemic, improving diagnostic capacity, expanding access to comprehensive treatment, combating stigma, addressing socioeconomic barriers, and investing in research for novel prevention and therapeutic tools. These efforts are critical to achieving the WHO's End TB Strategy targets and ultimately eliminating TB as a public health threat.

RevDate: 2025-11-09

Wu Y, Huang S, Sha Q, et al (2025)

Emerging and Re-emerging viruses as triggers of human endogenous retrovirus activation: Implications for aging and age-related pathologies.

Molecular aspects of medicine, 106:101422 pii:S0098-2997(25)00086-X [Epub ahead of print].

The human genome contains a substantial legacy of ancient retroviral infections known as Human Endogenous Retroviruses (HERVs), composing 8 % of our DNA. In healthy young individuals, these elements are kept dormant by robust epigenetic mechanisms, primarily DNA methylation and repressive H3K9me3 histone marks. However, this epigenetic silencing deteriorates with age, leading to the reactivation of HERVs, particularly the youngest HERV-K subfamily. This report posits that this HERV awakening is not a passive byproduct of aging but an active, transmissible driver of pathology. The reactivation of HERVs leads to the production of retrovirus-like particles (RVLPs) that can induce senescence in healthy neighboring cells, propagating a contagious aging phenomenon. Furthermore, the accumulation of HERV-derived dsRNA and reverse-transcribed DNA triggers chronic innate immune responses through pathways including cGAS-STING and IFIH1-MAVS, fueling the systemic, low-grade inflammation characteristic of inflammaging, catalytically accelerated by exogenous viral infections. Pathogens such as SARS-CoV-2, Epstein-Barr Virus (EBV), and Herpes Simplex Virus (HSV-1) can directly transactivate HERVs via their own viral proteins, overwhelming the already compromised epigenetic controls in an aging host. This mechanistic link between viral triggers and endogenous retroviral activity is strongly implicated in a range of age-related diseases, including neurodegenerative disorders such as Alzheimer's disease and Amyotrophic Lateral Sclerosis (ALS), where the HERV-K envelope protein is directly neurotoxic. It is also linked to autoimmune diseases like Multiple Sclerosis and various cancers. This report synthesizes these findings and identifies a novel mechanistic link between viral activity, chronic inflammation, and the onset of age-related diseases.

RevDate: 2025-11-14

Mulet I Piera X, Del Campo-Montoya R, Cuadrado-Tejedor M, et al (2025)

Intranasal delivery of lipid-based nanoparticles for the treatment of neurodegenerative diseases: advances, challenges and future perspectives.

Expert opinion on drug delivery [Epub ahead of print].

INTRODUCTION: Neurodegenerative diseases such as Parkinson's or Alzheimer's disease urgently require new therapeutic approaches. Despite significant efforts, no disease-modifying therapies targeting specific molecular pathways have demonstrated consistent clinical efficacy. This challenge has shifted attention toward drug delivery strategies that improve bioavailability, targeting, and patient accessibility. Intranasal delivery has emerged as a promising, non-invasive approach that bypasses the blood-brain barrier, and improves patient compliance. Lipid-based systems, especially following the success of COVID-19 vaccines, have gained attention as versatile platforms for delivering RNAs. Their ability to encapsulate diverse payloads and tunable composition makes them ideal candidates for targeting neurodegenerative disorders via the intranasal route.

AREAS COVERED: This review discusses recent advances in intranasal delivery for the treatment of neurodegenerative disorders, emphasizing on lipid-based nanoparticles. It addresses formulation challenges such as stability, targeting efficiency, and compatibility with nasal physiology, and outlines key design parameters affecting brain delivery. Future directions are explored to advance formulation development and clinical translation.

EXPERT OPINION: Intranasal lipid-based drug delivery represents a promising strategy to bypass the blood-brain barrier in neurogenerative disorder treatment. Although regulatory gaps and the absence of long-term safety evaluation, intranasal administration offers clear advantages for CNS targeting underscoring strong potential for future clinical translation.

RevDate: 2025-11-12
CmpDate: 2025-11-12

Lin EA, KJ Renfree (2026)

AI-Enabled Remote Patient Monitoring Systems in Hand Surgery.

Hand clinics, 42(1):75-83.

Artificial intelligence-enabled remote patient monitoring is transforming hand surgery by using advanced technologies like machine learning and computer vision to track patient recovery in real-time. Wearable devices and sensors collect objective data, enabling early detection of complications and personalized rehabilitation protocols. Accelerated by the COVID-19 pandemic, these technologies can potentially replace in-person visits, offering tailored-treatment options through data-driven insights.

RevDate: 2025-11-16

Ludwig-Walz H, Heinisch S, Siemens W, et al (2025)

Trends in physical fitness among children and adolescents in Europe: A systematic review and meta-analyses during and after the COVID-19 pandemic.

Journal of sport and health science pii:S2095-2546(25)00083-3 [Epub ahead of print].

BACKGROUND: Physical fitness is a key indicator of current and future health in children and adolescents. Evidence suggests that fitness levels have declined then stagnated in recent decades, but it remains unclear how the coronavirus disease 2019 (COVID-19) pandemic has impacted this trend.

METHODS: We conducted a systematic review and meta-analyses to assess pandemic-related changes in physical fitness among children and adolescents (0-19 years) in the World Health Organization European Region. Seven databases were searched up to February 28, 2025 for studies reporting validated pre- and during/post-pandemic fitness measurements. Two reviewers independently performed screening, data extraction, risk-of-bias assessment (Risk Of Bias In Non-randomized Studies - of Exposure; ROBINS-E), and certainty grading (Grading of Recommendations, Assessment, Development and Evaluation; GRADE). Random-effects meta-analyses yielded standardized mean differences (SMDs) with 95% confidence intervals (95%CIs). Subgroup analyses examined sex, age, year, and national restriction severity (Oxford Stringency Index).

RESULTS: Thirty-two studies comprising 270,179 participants and 1,519,386 fitness measurements from 17 European countries were included. Cardiorespiratory fitness declined significantly during the pandemic, especially in 2021, with reductions in endurance (SMD = -0.43; 95%CI: -0.61 to -0.25) and speed (SMD = -0.29; 95%CI: -0.61 to 0.03). While speed returned to baseline by 2023, endurance remained below pre-pandemic levels (SMD = -0.10; 95%CI: -0.12 to -0.08). Girls and adolescents were disproportionately affected. In contrast to cardiorespiratory fitness, muscular fitness remained largely unchanged. Stricter national regulations were associated with greater declines in cardiorespiratory fitness.

CONCLUSION: COVID-19 pandemic restrictions were associated with a marked decline in cardiorespiratory fitness in European children and adolescents, with levels not recovered by 2023. These findings call for urgent, targeted public health interventions to improve physical fitness and prevent long-term health consequences.

RevDate: 2025-11-08

McCarthy K, RZ Silkiss (2025)

Ocular manifestations of vaccine-preventable diseases: A comprehensive review.

Vaccine, 68:127900 pii:S0264-410X(25)01197-1 [Epub ahead of print].

Vaccine-preventable diseases (VPDs) remain a significant contributor to global ocular morbidity, yet their ophthalmic manifestations are often underrecognized. This review synthesizes current evidence on viral and bacterial VPDs with ocular involvement, highlighting a spectrum of presentations-from conjunctivitis to keratitis, uveitis, and optic neuritis. Such infections may affect a range of ocular tissues through mechanisms including direct viral invasion, immune-mediated inflammation, and secondary complications. While the frequency and severity of ocular involvement vary among pathogens, the potential for permanent vision loss, particularly in unvaccinated or immunocompromised individuals, underscores the clinical and public health importance of early recognition and prevention. Conditions such as congenital rubella syndrome, herpes zoster ophthalmicus, and acute retinal necrosis illustrate the breadth of pathology, while emerging infections like COVID-19 and monkeypox further expand the spectrum. Vaccination remains the most effective strategy for mitigating both systemic and ophthalmic sequelae. Greater awareness of ocular manifestations can facilitate earlier diagnosis, enhance outbreak detection, and reinforce the critical role of immunization in preserving vision.

RevDate: 2025-11-07

Thomas C, Gosling J, Ashton RE, et al (2025)

A scoping literature review of rehabilitation policy recommendations during the COVID-19 pandemic in the WHO European Region.

Health policy (Amsterdam, Netherlands), 163:105477 pii:S0168-8510(25)00232-5 [Epub ahead of print].

BACKGROUND: As with other frontline healthcare services, the delivery of rehabilitation services has been greatly affected by the COVID-19 pandemic with many services suspended, despite WHO's mandate that rehabilitation is an essential service.

OBJECTIVE: This review aimed to provide an overview of policy responses that were taken across the WHO European Region to identify systems and processes that helped to inform and shape decisions pertaining to rehabilitation during the COVID-19 pandemic.

METHODS: A scoping literature search was conducted according to PRISMA-ScR guidelines and prospectively registered on Prospero (ID: CRD42024550641). Cinahl, Cochrane, PubMed and Scopus databases were searched from inception to February 2024. Eligibility criteria for selecting publications: Published work that includes any policy documents that informed rehabilitation during the COVID-19 pandemic in any of the 53 World Health Organisation European member states. Search results were extracted using the PESTLE heading framework in Microsoft Excel.

RESULTS: Seven publications comprising seven policy documents from Italy (N=2), England (N=2) and the United Kingdom (N=3) were included in this review. Five key areas were identified in response to COVID-19 and rehabilitation: 1) government direction, 2) funding, 3) education, 4) telerehabilitation, and 5) social distancing and isolation.

CONCLUSIONS: Our study's findings demonstrate a dearth of published government policy documentation referring to rehabilitation in response to the COVID-19 pandemic. This lack of published documents indicates that rehabilitation is not considered an essential health service during emergency response. Research should investigate the systems and processes of key decision-makers to inform future rehabilitation pandemic preparations.

RevDate: 2025-11-07

Zhang Q, Lewis KB, Phillips JC, et al (2025)

Decisional needs of older adults considering COVID-19 booster vaccinations: A systematic review comparing China with other countries.

Vaccine, 68:127949 pii:S0264-410X(25)01247-2 [Epub ahead of print].

INTRODUCTION: Older adults are at high risk of severe COVID-19 outcomes. Although COVID-19 booster vaccinations reduce disease severity and hospitalizations, many older adults are hesitant about receiving one. Our study aimed to identify the decisional needs of older adults considering COVID-19 booster vaccination.

METHODS: We conducted a systematic review and used PRISMA reporting guidelines. Eligible studies reported decisional needs of people 60 years or older considering COVID-19 booster vaccinations. We searched five databases from December 2019 to October 2024. Two reviewers independently screened studies, extracted data, and assessed study quality. We used the Ottawa Decision Support Framework coding manual for descriptive analysis.

RESULTS: Of 5156 citations screened, nine studies were eligible. Studies were conducted in six countries (4 in China, 1 each in England, Israel, Malaysia, Saudi Arabia, and the United States) and involved 7684 adults aged 60 to 94 years old, with 56.9 % having chronic health conditions. In all studies, adults reported inadequate knowledge. Other decisional needs were: delay in acceptance of booster vaccination (3 China, 4 other countries); manifestation of decisional conflict (3 China; 3 other countries); inadequate support and resources from governments, healthcare authorities, healthcare professionals and family members (1 China; 4 others); and personal and health-related characteristics (chronic health condition) influencing their COVID-19 booster vaccination decision (3 China, 1 other).

DISCUSSION: Many older adults were hesitant about COVID-19 booster vaccinations. Common decisional needs were inadequate knowledge, inadequate support, and being concerns about the effect of vaccines on their chronic health conditions. Decisional needs of older adults considering COVID-19 vaccination could be addressed using decision support tools.

RevDate: 2025-11-10
CmpDate: 2025-11-07

White BK, Talamayan F, Aynsley TR, et al (2025)

Current Approaches To and Implementation of Information Environment Assessments in the Context of Public Health: Rapid Review.

JMIR infodemiology, 5:e72165.

BACKGROUND: With the advances in digital information sharing channels, democratization of content, and access, as well as social shifts in information exchange, we live in increasingly complex information environments. How people process and manage this is layered with multiple determinants that can impact information seeking, health behaviors, and public health. Understanding the dynamics of the information environment in priority populations and its impact on communities and individuals is critical for those working in public health and health emergencies.

OBJECTIVE: This study aimed to provide an overview of the approaches to and implementation of information environment assessments as they relate to public health and health emergencies.

METHODS: We conducted a rapid scoping review of the approaches to, and implementation of information environment assessments. The search followed guidance from the Joanna Briggs Institute on conducting systematic scoping reviews, and our reporting is in line with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for scoping reviews. We included both academic and gray literature in the English language. As this is an emerging field, an additional step involved input from an informal expert group to identify any further tools or approaches. Studies that assessed, described, or discussed approaches to assessing the information environment were included. We excluded papers where the information environment was not the primary focus, or the focus was on individual components only. Two authors (BKW and SVM) independently screened results for inclusion.

RESULTS: A total of 17 publications were identified through the structured literature and internet searches, with an additional 5 sourced from the informal expert group. The review highlighted a significant variety in the breadth and number of domains covered in an assessment, including information needs, seeking, access, production, engagement, information quality, and reach. Some assessments adopted a comprehensive, systems-oriented approach, examining factors influencing information beyond the individual level to encompass broader systemic dynamics, while others were significantly narrower in scope.

CONCLUSIONS: The COVID-19 pandemic has intensified interest in understanding how the information environment shapes people's access to, engagement with, and ability to act on health information. Assessing the information environment is a critical step in identifying and understanding barriers and facilitators that impact different populations and identifying opportunities for strengthening systems. However, a universally accepted approach for such assessments in public health and health emergencies is currently lacking. This paper contributes to the literature by synthesizing current knowledge on assessment tools and frameworks, providing a foundation for future research and development in this area.

RevDate: 2025-11-07
CmpDate: 2025-11-07

De Rubeis V, Tonmyr L, Rahman S, et al (2025)

Changes in child maltreatment occurrence during the COVID-19 pandemic: A systematic review.

Child abuse & neglect, 169(Pt 1):107744.

BACKGROUND: Child maltreatment (CM) is an important public health issue. During the COVID-19 pandemic, there was widespread concern that CM risk factors were exacerbated while opportunities to seek support were reduced, potentially impacting occurrences of CM.

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

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

METHODS: We conducted a systematic review of primary studies identified in multiple databases. Independent reviewers screened titles/abstracts and full texts. Moderate to low risk of bias studies were synthesized using frequency counts to categorize CM outcomes as having increased, decreased, or not changed from pre- to during the pandemic. These were used to develop narrative statements, which underwent assessment for certainty in the evidence.

RESULTS: We included 71 studies. Most CM outcomes relied on administrative data and showed mixed findings across the categories. Overall, there was likely no change in emotional neglect (moderate certainty), and may have been an increase in neglect (low certainty) and exposure to intimate partner violence (very low certainty). Changes in physical, sexual, and psychological abuse and any CM were very uncertain.

DISCUSSION: The evidence informing changes in CM from before to during the COVID-19 pandemic is mixed and very uncertain for most outcomes, underpinned by gaps in the CM data collection systems during the pandemic period. Efforts to strengthen CM data and surveillance systems could improve preparedness for future pandemic situations.

RevDate: 2025-11-07

Kalani M, Zare M, Choopanizadeh M, et al (2025)

Kawasaki Disease: Unraveling Immunopathogenesis, Genetic Factors, and AI Applications in Diagnosis with a Focus on Iran.

Pediatric cardiology [Epub ahead of print].

Kawasaki disease (KD) is an acute multisystem vasculitis that represents the leading cause of acquired pediatric heart disease in children aged 1-5 years in developed nations. The diagnosis of KD remains clinically challenging due to its diverse clinical manifestations and the absence of definitive laboratory tests. Growing evidence suggests that inflammatory processes play a pivotal role in the pathogenesis of KD, implicating a significant involvement of the immune system in disease development. Given the established associations between KD and various biomarkers, ranging from genetic factors to immune system components, this review systematically examines the current knowledge on the immunological and genetic aspects of KD, with a particular focus on the Iranian population. Meanwhile, artificial intelligence (AI) may be revolutionized disease diagnosis, prognosis, and predictive modeling. Its applications have extended to KD, including early detection and classification, as briefly discussed in this review. By synthesizing existing evidence, we aim to identify critical research gaps and enhance understanding of KD's unique characteristics in this demographic context.

RevDate: 2025-11-07

Pervaiz A, AO Soubani (2025)

Virus-associated pulmonary aspergillosis: A rising challenge in respiratory infections.

The American journal of the medical sciences pii:S0002-9629(25)01258-3 [Epub ahead of print].

Invasive Aspergillosis (IA) is a severe fungal infection primarily caused by Aspergillus species, notably Aspergillus fumigatus. However, newly emerging species, some exhibiting antifungal resistance, are becoming increasingly common. IA mainly affects immunocompromised individuals, including those with hematological malignancies and solid organ transplant recipients. In recent years, however, new at-risk populations have been identified, regardless of immune status, particularly those with severe viral infections requiring intensive care unit admission. This condition has gained prominence in intensive care unit settings following the recent H1N1 influenza and COVID-19 pandemics. Virus-associated pulmonary Aspergillosis (VAPA) encompasses two distinct entities: influenza-associated pulmonary Aspergillosis (IAPA) and COVID-19-associated pulmonary Aspergillosis (CAPA). These conditions are typically diagnosed in 10-20% of patients with severe influenza or COVID-19 when appropriate diagnostic methods are employed. Key diagnostic tools include bronchoalveolar lavage for fungal culture, galactomannan testing, and Aspergillus PCR, complemented by bronchoscopy to detect invasive Aspergillus tracheobronchitis visually. Azole antifungals are the first-line treatment, with liposomal amphotericin B serving as an alternative in regions with azole resistance. Despite antifungal interventions, IAPA and CAPA are linked to poor outcomes, with fatality rates often surpassing 50%. This review article discusses the pathophysiological mechanisms, clinical characteristics, diagnosis, and treatment of IAPA and CAPA. Additionally, it highlights key knowledge gaps and suggests potential areas for future research.

RevDate: 2025-11-09
CmpDate: 2025-11-07

Idahor CO, Esomu EO, Ogbonna N, et al (2025)

Infectious Disease Surveillance in the Era of Big Data and AI: Opportunities and Pitfalls.

Cureus, 17(10):e93929.

The landscape of infectious disease surveillance (IDS) is undergoing a profound shift, driven by the rapid emergence of big data and artificial intelligence (AI). Traditional surveillance systems, while foundational to public health, are increasingly limited by delayed reporting, data silos, and fragmented information flows. In response to these limitations, the integration of AI and big data offers new possibilities for enhancing disease detection, monitoring, and response strategies on both local and global scales. This review explores the potential of AI-enabled tools and big data systems to support early outbreak detection, real-time surveillance, and predictive modeling. These technologies facilitate the synthesis of diverse datasets, including clinical, genomic, geospatial, and environmental information, enabling a more holistic understanding of disease patterns. Additionally, AI contributes to improved diagnostic accuracy and optimized resource allocation, which are critical during public health emergencies. However, the adoption of these technologies has not been without challenges. Concerns about data privacy, equity in access, algorithmic bias, and over-reliance on automated systems present significant ethical and operational hurdles. In low-resource settings, limited digital infrastructure further complicates implementation. The review also highlights real-world applications from recent outbreaks, such as COVID-19, influenza, and Zika, to demonstrate both the promise and the limitations of AI-driven surveillance. To move forward responsibly, public health systems must adopt a balanced approach that integrates AI capabilities with human oversight. Strategic investment, cross-sector collaboration, and the development of clear ethical frameworks are essential to unlocking the full potential of big data and AI in infectious disease surveillance.

RevDate: 2025-11-09
CmpDate: 2025-11-07

Tembo A, Gray A, Nyamuzihwa T, et al (2025)

Leveraging community pharmacies for HIV services in South Africa: Opportunities and constraints.

Southern African journal of HIV medicine, 26(1):1739.

Access to HIV services in South Africa remains challenging, despite their availability in the public healthcare sector. While the legislative framework allows for the provision of these services in community pharmacies, the process is often complex. This article describes various models for the provision of HIV services in community pharmacies in South Africa through a review of existing policies and legislation. It further discusses barriers and opportunities for the expansion of services. The existing legal framework enables prescribing by healthcare professionals other than medical practitioners through authorisations issued under either the Medicines and Related Substances Act of 1965 or the Nursing Act of 2005. Community pharmacies have extended their role beyond dispensing medication, with the emergence of telehealth and potential initiatives such as Pharmacist-Initiated Management of Antiretroviral Therapy (PIMART). Telehealth, accelerated by the COVID-19 pandemic, provides remote consultations and electronic prescriptions. PIMART, on the other hand, can empower pharmacists to initiate and manage antiretroviral therapy (ART) for HIV patients, a role traditionally reserved for clinicians. Extending Nurse-Initiated Management of Antiretroviral Therapy (NIMART) into the private sector could further increase ART rollout. Despite these advancements made in the last two decades, legislative reforms are necessary to fully realise the potential of community pharmacies for providing HIV services.

RevDate: 2025-11-09
CmpDate: 2025-11-07

Dhaliwal S, Fremont D, Li W, et al (2025)

Depression and depressive symptoms in physicians prior to the COVID-19 pandemic: a systematic review and meta-analysis.

Frontiers in psychiatry, 16:1627507.

BACKGROUND: Mental health disorders, such as depression, can significantly impact a physician's well-being and the quality of care they provide. We conducted a systematic review and meta-analysis to identify risk factors and to estimate the prevalence of depression and depressive symptoms in physicians prior to the COVID-19 pandemic.

METHODS: This PRISMA 2020-compliant systematic review and meta-analysis searched EMBASE, APA PsycINFO, and MEDLINE databases for studies published between January 2002 and March 2020 (pre-COVID-19 period). Risk of bias was assessed using a modified Newcastle-Ottawa Scale for cohort and cross-sectional studies. We included studies of physicians where depression/depressive symptoms were measured by either a validated questionnaire or clinical diagnosis. The primary and secondary outcomes measures included assessing the prevalence of depression/depressive symptoms, and whether depression differed by pertinent risk factors (study design, sex, specialty, training stage) in the literature prior to the COVID-19 pandemic.

RESULTS: Forty-two studies from 14 countries involving 27,284 physicians (7,293 with depression or depressive symptoms) were included. The pooled prevalence estimate was 34.2% (95% CI: 26.4-43.0%), with substantial heterogeneity identified across studies (I[2] = 98%). Most studies were cross-sectional surveys (n=28) and cohort studies (n=14). A total of 13 different assessment methods were used. We found no statistically significant difference in depression between male and female physicians (OR: 0.78, 95% CI: 0.46, 131), and a slightly increased rates in residents compared to staff physicians [pooled estimates of 36% (95% CI: 26-47%) and 29% (95% CI: 13-53%)]. Finally, 25 studies were deemed "High" risk of bias, while the remaining 17 were "Low" risk.

CONCLUSIONS: In this review examining depression and depressive symptoms among physicians, we report a pooled estimate of 34% prior to the COVID-19 pandemic. Due to the high degree of heterogeneity in study design and limited examination of key risk factors, limited conclusions can be made regarding the true prevalence across the physicians, and how best to target interventions.

https://www.crd.york.ac.uk/prospero/, identifier CRD42021232814.

RevDate: 2025-11-07

Gil YM (2025)

Research Trends in Medical and Dental Education (2015-2024) Based on Author Keywords: Commonalities, Differences, and Opportunities for Collaboration.

Journal of dental education [Epub ahead of print].

OBJECTIVES: Medical and dental education share the common goal of preparing clinically competent and socially responsible health professionals. Despite this shared goal, the two disciplines have evolved as distinct academic fields, with limited empirical comparisons between them. Understanding their commonalities and differences can foster mutual development and cross-disciplinary collaboration. This study aims to compare research priorities in medical and dental education by analyzing author keywords from representative journals in each field.

METHODS: A bibliometric analysis was conducted using author keywords from two medical education journals (Advances in Health Sciences Education and BMC Medical Education) and two dental education journals (European Journal of Dental Education and Journal of Dental Education) over a 10-year period (2015-2024). Data were retrieved from the Web of Science database, including only original research articles and review articles. Frequency analysis of the top 10 author keywords was performed in 2-year intervals, and bump charts were created to visualize temporal ranking changes. In addition, co-occurrence network maps were constructed using all keywords appearing 10 or more times over the study period. Data processing and visualization were conducted using VOSviewer and Tableau software.

RESULTS: A total of 9391 articles were analyzed, comprising 6806 articles from medical education journals and 2585 articles from dental education journals. Both fields consistently emphasized "students," "assessment," and "curriculum" as core research topics. However, medical education placed greater emphasis on "postgraduate medical education" and student mental health (e.g., empathy, resilience, and depression), whereas dental education focused more on "educational technology" and clinical skills development (e.g., simulation, virtual reality, and psychomotor skills). The keyword "covid-19" emerged prominently in both fields from 2019 to 2020 onward, reflecting the pandemic's transformative impact on education. "Interprofessional education" appeared as a shared emerging theme, suggesting growing recognition of collaborative practice needs.

CONCLUSION: This study identifies both foundational commonalities and discipline-specific innovations in medical and dental education research over the past decade. These findings suggest that shared interests and distinctive priorities can lead to meaningful opportunities for collaborative educational development and joint research efforts across health professions education.

RevDate: 2025-11-09
CmpDate: 2025-11-07

Pourshaban M, H Hasankhani (2025)

What Is 'Missed Nursing Care' During an Emerging Infectious Disease? A Concept Analysis.

Nursing open, 12(11):e70216.

AIM: Missed nursing care (MNC) is a global and important phenomenon in nursing and is universally used as an indicator of the quality of nursing care. However, no precise definition is available for this concept's dimensions and clinical features during an emerging infectious disease. This study aims to furnish a comprehensive evidence-based definition of MNC in the context of the COVID-19 pandemic.

DESIGN: A concept analysis paper.

METHODS: This study was conducted using an integrative approach to the concept analysis of Walker and Avant. In the literature review stage, the databases CINAHL, Web of Science, Scopus and PubMed as well as the Google Scholar search engine were searched from December 2019 to April 2024. Keywords of the study were selected according to the Medical Subject Headings (MeSH) and previous research. Textual analysis of the selected articles was conducted using an inductive and deductive approach. Throughout the study, the authors followed the SRQR checklist.

RESULTS: The results indicated the concept of 'missed nursing care' during an emerging and infectious disease such as COVID-19 refers to a set of nursing activities and procedures that require interaction and close contact with patients and must be included in the care and treatment plan for patients (supportive, psychological-social care and basic/bedside care). However, these activities have been presented as suboptimal, prioritised and interrupted. These attributes are caused by the complexity of caring for emerging diseases, aggravating lack of human and material resources, communication/teamwork and individual factors.

CONCLUSION: The concept of MNC during an emerging infectious disease is an altered cognitive process that can be defined as disrupted nursing care (DNC) in the nurse role adjustment, time management and care environment for various reasons. COVID-19 has been the most significant disruptor in healthcare, but it will not be the last.

This conceptual analysis can help sensitise care managers to the holistic view and adaptation of policies and strategies in crises, develop care models and theories, and help researchers generate specific tools or clinical scales for accreditation in emerging infectious diseases.

CONSENT: No patient or public contribution.

RevDate: 2025-11-06

Obeid C, Oenema A, Jaalouk D, et al (2025)

Determinants of adherence to the Mediterranean diet among adults in Mediterranean countries: a systematic literature review.

Public health nutrition pii:S1368980025101432 [Epub ahead of print].

OBJECTIVE: This study aims to provide an overview of evidence on factors affecting Mediterranean Diet (MD) adherence across socio-ecological levels (individual, interpersonal, and environmental) in Mediterranean countries, which can be target points for future interventions to promote MD adherence.

DESIGN: A systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines and registered in the Prospero database (CRD42020189337). Literature was searched in PubMed, Web of Science and PsycINFO.

SETTING: The MD is one of the healthiest dietary patterns, reducing risk of chronic disease while promoting better health outcomes. However, adherence to the MD remains challenging, even in Mediterranean countries.

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

RESULTS: A total of 37 cross-sectional studies were included, with 190 to 13,262 participants. Most studies (30/37) were conducted in European Mediterranean countries, primarily Italy (n=14), Spain (n=9) and Greece (n=6). All studies involved community-based samples; two studies included only women. Individual-level determinants were the most frequently examined. Higher socioeconomic status (SES), regular breakfast consumption, being unemployed, a job seeker, or retired were linked to better MD adherence. Socio-cognitive and interpersonal factors were underexplored. At the environmental level, COVID-19 confinement boosted adherence, whereas the effects of economic crises were inconsistent. Effect sizes were mostly very small to small, and findings are based on low-quality studies.

CONCLUSIONS: This systematic review highlighted several socio-economic and environmental factors potentially influencing MD adherence. However, more robust research is needed to better understand socio-cognitive and ecological factors.

RevDate: 2025-11-10
CmpDate: 2025-11-07

Jung C, Gillmann HJ, T Stueber (2025)

Effectiveness and safety of prolonged prone positioning in adult patients with acute respiratory distress syndrome (ARDS): a systematic review and meta-analysis.

Critical care (London, England), 29(1):475.

BACKGROUND: Prolonged prone positioning (PPP) for ≥ 24 h may enhance outcomes in moderate to severe acute respiratory distress syndrome (ARDS), but may also increase risks such as pressure injuries and complications. Despite clinical rationale, high-quality evidence for PPP's safety and efficacy remains scarce.

METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCT) and observational studies. Trials that compared two distinct treatment groups in adult patients with ARDS were included: prone position < 24 h (standard) and ≥ 24 h (prolonged). Databases searched included MEDLINE, CENTRAL, ClinicalTrials.gov, ISRCTN, ICTRP and the Cochrane Covid-19 Study Register (last search: 3 July 2025). Risk of bias was assessed using ROB-2 for RCTs, and the ROBINS-I V2 tool for non-randomised intervention studies (NRSI). The primary outcome was mortality. Secondary outcomes included improvement of oxygenation and adverse events. Outcomes (Risk ratios and hazard ratios) were calculated using a random-effect model with 95% confidence intervals (CI). The quality of evidence was evaluated using the GRADE assessment.

RESULTS: Of 19,986 records, 9 (n = 1,045) were included in the qualitative and quantitative analysis. Four studies, including two small RCTs (n = 112) and two NRSIs (n = 581), had a low to moderate risk of bias. Most studies included patients with COVID-19 ARDS. Meta-analysis showed no significant effect on 90-day mortality (n = 641, HR 0.72; 95% CI 0.41-1.25). No heterogeneity was detected among studies (I² = 0%), but the confidence interval for I² was wide (95% CI: 0-89%), suggesting the possibility that substantial heterogeneity may exist. Similarly, no significant differences were found for secondary outcomes.

DISCUSSION: Current evidence does not support the use of PPP outside of clinical studies. Pooled data from small trials and NRSIs reveal no significant effect of PPP on mortality, oxygenation, or safety outcomes. The evidence is of low to very low certainty, limited by inconsistency and imprecision. The wide confidence intervals indicate low statistical power, therefore both harm and benefit remain plausible on the basis of the available evidence. Well-powered RCTs are needed to clarify the potential benefits and risks of PPP in ARDS.

RevDate: 2025-11-09
CmpDate: 2025-11-07

Conduah AK, SH Ofoe (2025)

Intersecting impacts of ageing, migration, and socioeconomic disparities on health equity: a post-pandemic policy review.

International journal for equity in health, 24(1):304.

BACKGROUND: The COVID-19 pandemic exposed and intensified structural inequities at the nexus of ageing, migration, and socioeconomic vulnerability. These overlapping disadvantages resulted in uneven health outcomes and highlighted systemic fragilities in health systems; yet, few policy reviews have integrated these demographic dimensions into a single analytical framework.

OBJECTIVES: This review critically examines how ageing, migration, and socioeconomic disparities intersect to shape health equity during and after the pandemic. It identifies structural bottlenecks, adaptive responses, and lessons for policy design in low- and middle-income as well as high-income contexts.

METHODS: A systematic policy review was conducted following PRISMA 2020 guidelines and preregistered on the Open Science Framework. Peer-reviewed studies, institutional reports, and grey literature published between 2020 and 2024 were appraised using differentiated quality criteria. Thematic convergence, guided by the Social Determinants of Health, Human Capital Theory, and Feminist Gerontology, informed narrative synthesis across 49 included sources.

RESULTS: A total of four intersecting themes emerged: (1) demographic inequality and uneven risk exposure; (2) exclusionary health systems and digital divides; (3) socioeconomic precarity and erosion of human capital; and (4) fragmented policy responses with limited ageing- and migrant-sensitivity. Comparative evidence underscores persistent inequities across regions, with gaps most pronounced in the Global South.

CONCLUSION: Post-pandemic health equity demands integrated and anticipatory governance. Strengthened geriatric and migrant-inclusive health systems, expanded universal social protection, investment in digital and community infrastructure, and institutionalised intersectional policy design are essential to break cycles of cumulative disadvantage and advance health justice. This review uniquely integrates ageing, migration, and socioeconomic inequities into a unified framework across regions, offering theory-informed policy clusters to guide future governance.

PROTOCOL REGISTRATION: The review protocol was prospectively registered on the Open Science Framework (OSF) under the DOI: https://doi.org/10.17605/OSF.IO/6YHC4 .

RevDate: 2025-11-06

Habtie TE, Adisu MA, Feleke SF, et al (2025)

Burden Beyond the Bedside: A Global Synthesis of Depression in Informal Cancer Caregivers: An Umbrella Review.

Journal of pain and symptom management pii:S0885-3924(25)00917-0 [Epub ahead of print].

OBJECTIVE: The aim of this umbrella review is to synthesize pooled prevalence of existing evidence on depressive morbidity among informal cancer caregivers.

METHOD: This umbrella review was conducted in accordance with PRISMA guidelines, and the protocol was registered in PROSPERO (CRD420251032522). A comprehensive search of major databases was performed to identify relevant studies. Predefined inclusion and exclusion criteria were applied. The corrected covered area (CCA) was calculated to assess overlap, and the methodological quality of included reviews was evaluated using the AMSTAR 2 tool.

RESULTS: This umbrella review included four systematic reviews and meta-analyses, comprising a total of 160 primary studies with 40,605 participants worldwide. The pooled global prevalence of depression among informal caregivers of cancer patients was 38% (95% CI: 28%-48%). However, prevalence estimates varied widely, ranging from 4% to 55%, likely due to differences in the depression assessment tools used across studies.

CONCLUSION AND RECOMMENDATION: In conclusion, this review reveals a high prevalence of depression among informal caregivers of cancer patients a burden comparable to or exceeding that observed in other chronic illnesses and global crises such as the COVID-19 pandemic. Integrating routine mental health screening using validated tools such as the CES-D or PHQ-9 into oncology care is essential. Structured interventions including counseling, psych-education, and respite care should be embedded within care pathways. Future research should prioritize standardized assessment tools and caregiver-focused strategies to enhance comparability and guide best practices. Policymakers must invest in caregiver mental health to ensure sustainable and compassionate cancer care systems.

RevDate: 2025-11-08
CmpDate: 2025-11-06

Dimitrakopoulou A, Sarantaki A, Nanou CI, et al (2025)

Long COVID-Related Fatigue During Pregnancy: A Systematic Review.

Cureus, 17(10):e93877.

Long sequelae of COVID-19 (Long COVID), or post-acute sequelae of SARS-CoV-2 infection, encompasses a wide range of persistent symptoms, with fatigue emerging as one of the most prevalent and disabling. Pregnant individuals may be uniquely susceptible to post-viral fatigue due to immunological and physiological adaptations during gestation. This review consolidates existing data regarding the prevalence, risk factors, and clinical implications of Long COVID-associated fatigue in pregnant individuals. A narrative review was conducted of studies examining fatigue among pregnant individuals with confirmed SARS-CoV-2 infection. Key outcomes included fatigue prevalence, symptom persistence, associated risk or protective factors, and comparisons with non-pregnant populations. Across both the acute and post-acute stages of COVID-19, fatigue emerged as a consistently common symptom. Its prevalence and persistence varied significantly across studies, partly due to heterogeneity in assessment tools and follow-up durations. Severe acute illness, hospitalization, obesity, and smoking during pregnancy were linked to a higher risk of prolonged fatigue, whereas anosmia appeared to act as a potential protective factor. In contrast, comorbidities such as hypertension, diabetes, and lung disease were not significantly linked to fatigue risk. No consistent associations were found with maternal age or alcohol use. Long COVID-related fatigue presents a substantial burden in pregnancy, with implications for maternal health, quality of life, and postpartum recovery. Early recognition, individualized care strategies, and public health interventions targeting modifiable risk factors are essential to support this vulnerable population. Ongoing research is essential to uncover underlying mechanisms and guide evidence-based clinical management.

RevDate: 2025-11-16

Grandinetti C, Budwal-Jagait M, Abid H, et al (2025)

Evolving Standards: Good Clinical Practice Insights from US FDA, MHRA UK, and Health Canada.

Clinical pharmacology and therapeutics [Epub ahead of print].

As clinical trial design and conduct continue to evolve with innovative approaches, new technologies, and emerging data sources, regulatory frameworks are undergoing significant updates to align with these advancements. This article explores recent revisions to the International Council for Harmonization (ICH) Guideline for Good Clinical Practice (GCP) E6(R3) and the regulatory perspectives on adopting a risk-proportionate approach to trial design and conduct. Drawing from insights shared at the FDA-MHRA-HC 2024 Joint GCP Symposium, this article highlights the key themes shaping the future of clinical trials, including quality-by-design (QbD), risk proportionality, and cross-regulatory collaboration. Additionally, this article addresses the impact of the COVID-19 pandemic in accelerating trial innovations, such as the use of decentralized trial elements and digital health technologies (DHTs), while also emphasizing the need for regulatory flexibility to accelerate their adoption. Regulatory agencies, such as the US-FDA, MHRA-UK, and Health Canada, have issued guidance to promote clinical trial flexibilities and proportionate, risk-based approaches, ensuring the protection of participant rights, safety, and well-being and overall reliability of trial results. These updates advocate for proportionate approaches to trial oversight, which allow for innovation while safeguarding the trial's critical to quality factors. As regulators continue to refine their practices and enhance collaboration, the integration of QbD and risk proportionality into clinical trials and cross-regulatory collaboration will ultimately drive more efficient, participant-centered trials and improve the global clinical research landscape.

RevDate: 2025-11-09
CmpDate: 2025-11-06

Sun YT, Wu W, Guo ZH, et al (2025)

Burnout among doctors in China: a systematic review and meta-analysis.

BMC public health, 25(1):3787.

OBJECTIVES: The current study was performed to systemically examine the prevalence of burnout, risk factors among Chinese doctors, and possible treatment strategies.

METHODS: Two authors independently conducted literature searches in PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Chinese Scientific and Technical Papers and Citation (CSTPC) databases from the year of 1974 (when "burnout" was first defined), to May 27th, 2023, without language restriction. All published studies investigating burnout, and/or its 3 dimensions among practicing doctors in China, were included. Quality assessment followed the Joanna Briggs Institute (JBI) Critical Appraisal Checklists.

RESULTS: A total of 133 studies comprising 193,866 Chinese doctors were included in the current study. The pooled prevalence of burnout and severe burnout among Chinese doctors were 61% and 12%, respectively. The corona virus disease 19 (COVID-19) pandemic had a significant impact on severe burnout (14%). Emergency physicians had the highest prevalence of burnout (91%), while neurologists experienced the highest prevalence of emotional exhaustion (69%) and depersonalization (59%), whereas the lowest personal accomplishment levels were detected among anesthesiologists (65%). Additionally, 27 risk factors were demonstrated to be associated with burnout among Chinese doctors. Of which, personal psychological status was the greatest predictor of burnout among Chinese doctors (OR 3.88, 95% CI 3.75-4.01).

CONCLUSIONS: The overall prevalence of burnout is high among Chinese doctors, and it varies across different medical specialties. Personal psychological status was the greatest predictor of burnout among Chinese doctors. Regular psychological counseling, workload alleviation and income increase are recommended coping strategies.

RevDate: 2025-11-08
CmpDate: 2025-11-05

Li X, Xiao H, Zhou M, et al (2025)

Organoids in respiratory virus research: advances and perspectives.

Molecular biomedicine, 6(1):100.

The pandemics of respiratory viruses pose a worldwide public health problem and bio-safety threat. Therefore, the development of high-throughput and accurate infection models is crucial for elucidating viral pathogenesis and accelerating countermeasures to address the evolving respiratory viruses and the unexpected outbreaks of emerging variants. Compared to traditional 2D cultures, organoids exhibit pronounced intercellular interactions, extracellular matrix signaling, and tissue-specific multicellular cooperation, thereby more accurately recapitulating the in vivo microphysiological environment. However, research involving animal models typically requires prolonged experimental timelines, making it challenging to perform high-throughput screening or rapidly develop therapeutic strategies within the valuable timeframe. Since the outbreak of SARS-CoV-2, organoids have significantly advanced basic virology research and demonstrated potential in replicating the pathological and immunological characteristics in human patients. This review provides a comprehensive summary of the theoretical foundations, methodological framework, and complete procedures for identification and validation in organoid construction, along with their applications in the investigation of various respiratory viruses, such as coronaviruses, the influenza virus, respiratory syncytial virus, and others. Overall, the development of organoids, in conjunction with the integration of interdisciplinary technologies, has significantly advanced our fundamental understanding of the immunopathology process of respiratory viral infections, improved research efficiency, and provided precise tools for translational medical research.

RevDate: 2025-11-05

Faghir-Ganji M, Abdolmohammadi N, Ansari-Moghaddam A, et al (2025)

COVID-19 vaccination and stroke risk: A systematic review and meta-analysis of ischemic and hemorrhagic events.

Journal of infection and public health, 19(1):103021 pii:S1876-0341(25)00370-3 [Epub ahead of print].

Reports of potential side effects have led to public concerns regarding COVID-19 vaccines. This systematic review and meta-analysis globally investigated the adverse effects, focusing specifically on the risks of stroke, myocarditis, and pneumonia following COVID-19 vaccination. A systematic search was performed across databases (including PubMed, Scopus, and Google Scholar) using MeSH terms such as "adverse events," "COVID-19," and "SARS-CoV-2," spanning from February 2019 to December 2023. From 708 reports identified, 8 studies were ultimately included. For hemorrhagic and ischemic stroke, the pooled risk ratio was 1.13 (95 % CI: 0.87 -1.47), but this result showed high heterogeneity (I[2]=97.7 %). Subgroup analysis confirmed that the study country was a significant contributor to this variability. Overall, the meta-analysis revealed no statistically significant increase in the pooled risk of the investigated adverse outcomes (stroke, myocarditis, or pneumonia). Given the substantial disease prevention benefits, these findings support the recommendation for widespread vaccination across all age groups.

RevDate: 2025-11-08
CmpDate: 2025-11-05

Jung HW, Kim DY, Lee I, et al (2025)

Key Features of Digital Phenotyping for Monitoring Mental Disorders: Systematic Review.

Journal of medical Internet research, 27:e77331.

BACKGROUND: The COVID-19 pandemic has intensified mental health issues globally, highlighting the urgent need for remote mental health monitoring. Digital phenotyping using smart devices has emerged as a promising approach, but it remains unclear which features are essential for predicting depression and anxiety.

OBJECTIVE: This study aimed to identify the types of features collected through smart packages-integrated systems combining smartphones with wearable devices such as Actiwatches, smart bands, and smartwatches-and to determine which features should be considered essential for mental health monitoring based on the type of device used.

METHODS: A systematic review was conducted. Searches were performed across Web of Science, PubMed, and Scopus on February 5, 2025. Inclusion criteria comprised quantitative studies involving adults (≥19 years) using smart devices to predict depression or anxiety based on passive data collection. Studies focusing solely on smartphones or qualitative designs were excluded. Risk of bias was assessed using the Mixed Methods Appraisal Tool and the Quality Criteria Checklist. Data were synthesized descriptively, and the relative contribution of each feature was further assessed by calculating coverage (proportion of studies using a feature) and importance among used (proportion identifying it as important when used). These metrics were visualized in quadrant-based scatter plots to identify consistently important features across devices.

RESULTS: From 1382 records, 22 studies across 11 countries were included. The overall synthesis identified a core feature package-accelerometer, steps, heart rate (HR), and sleep. Device-specific analyses revealed further nuances: in Actiwatch studies, accelerometer and activity were consistently important, but sleep features were rarely examined. In smart band studies, HR, steps, sleep, and phone usage were essential, while GPS, electrodermal activity (EDA), and skin temperature showed high importance when used, suggesting opportunities for broader adoption. In smartwatch studies, sleep and HR emerged as core features, whereas steps and accelerometer were widely used but often not identified as important.

CONCLUSIONS: This systematic review identified a core feature package comprising accelerometer, steps, HR, and sleep that consistently contributes to mood disorder prediction across devices. At the same time, device-specific differences were observed: Actiwatch studies mainly emphasized accelerometer and activity but underused sleep features; smart bands highlighted HR, steps, sleep, and phone usage, with EDA, skin temperature, and GPS showing additional promise; and smartwatches most reliably leveraged sleep and HR, while steps and accelerometer were widely used yet less effective. These findings suggest that while a shared core set of features exists, optimizing digital phenotyping requires tailoring feature selection to the characteristics of each device type. To advance this field, improving data accessibility, particularly in smartwatch ecosystems, and adopting standardized reporting frameworks will be essential to enhance comparability, reproducibility, and future meta-analytic integration.

RevDate: 2025-11-07
CmpDate: 2025-11-05

Zethelius B, Rubin J, Pihlström N, et al (2025)

Overview of approved COVID-19 vaccines in the EU, recommendations for use in Sweden and vaccine uptake over time: Report from the Swedish Medical Products Agency and the Public Health Agency of Sweden.

Upsala journal of medical sciences, 69:.

OBJECTIVE: The aim of this review is to describe the regulatory background of the COVID-19 vaccines, the national recommendations for use issued and vaccine uptake in Sweden. It includes an overview of licensing and relevant safety aspects identified by the European Medicines Agency (EMA) and the national vaccination plan issued by the Public Health Agency (PHA) of Sweden.

MATERIALS AND METHODS: Information on dates of licensing and safety aspects of importance identified by EMA published on its website, was compiled and presented in a chronological order. National recommendations on COVID-19-vaccination and vaccinations-data on uptake and coverage using the national-vaccine-register are presented.

RESULTS: COVID-19 vaccines development, assessments using rolling review and licensing of the covid-19 vaccines was done in 2020 during less than a year. Large-scale production was implemented. Monthly safety reviews performed by the EMA identified risk for thrombosis with thrombocytopenia syndrome with adenoviral vaccines and myocarditis for mRNA vaccines which led to restrictions in national recommendations for specified groups.National vaccinations were launched in a phased manner during 2021. Persons of high age, risk groups and nursing home personnel were prioritised during primary vaccinations and for initial boosters. In the Swedish population, 85% recieved at least on vaccine dose from the age of 12. At least two doses were recieved by 81% from age 18 and 95% from age 80.

CONCLUSION: Recommendations for national use adhered to relevant adverse drug reactions identified. The vaccine coverage was high. Timelines presented should be considered in follow-up studies of COVID-19-vaccines to manage possible selection bias and confounding.

RevDate: 2025-11-04

Yapa HM, MacLean EL-H, Menzies NA, et al (2025)

Drug-resistant tuberculosis: a priority pathogen for enhanced public health research and practice.

Clinical microbiology reviews [Epub ahead of print].

SUMMARYDrug-resistant tuberculosis (DR-TB) causes substantial morbidity and mortality and has hindered progress toward TB elimination. This slowed progress toward the WHO End TB Strategy's targets was exacerbated by lower TB detection during the COVID-19 pandemic. To inform research and development priorities, we conducted a narrative review of global DR-TB epidemiology and strategies for DR-TB prevention, diagnostics, and treatment. Gaps remain in DR-TB diagnosis, TB drug susceptibility testing (DST), and treatment. The review also shows that DR-TB causes significant post-disease disability, particularly chronic lung disease, impacting quality of life. Newer oral regimens for multidrug-resistant TB are shorter and more effective than traditional regimens. New antibiotics under development may help overcome remaining safety and tolerability issues, while novel advanced therapeutics and precision medicine offer hope to those failing treatment. Emerging diagnostics include rapid DST for second-line drugs, but a paradigm shift is needed to ensure novel DSTs become available as new drugs are introduced. Person-centered research is urgently needed to accelerate the response to DR-TB amidst the global threat of antimicrobial resistance, yet global investment in TB prevention and care currently falls short of need. A holistic approach to interventions to improve DR-TB prevention and care is needed, encompassing all health system components and their interactions, including a One Health approach and consideration of the wider determinants of health.

RevDate: 2025-11-06
CmpDate: 2025-11-04

Şimşek S, Altay S, Salman FS, et al (2025)

Fairness-based techniques to optimize vaccine allocation among migrants during pandemics: a scoping review.

PeerJ, 13:e20208.

INTRODUCTION: Migrants face significant barriers to vaccination due to disparities in access and coverage, necessitating fairness-based strategies and inclusive healthcare infrastructure to ensure equitable immunization, especially during pandemics. This study investigates fairness-based vaccination strategies, focusing on migrant vaccination status during pandemics, and migrant specific vaccine distribution models.

METHODS: The authors employed established scoping review methods to explore the research question: How have fairness-based strategies for vaccine allocation affected vaccination coverage among migrants during pandemics in urban and rural areas? A scoping review was conducted following the PRISMA and expectation, client group, location, impact, professionals, and service (ECLIPSE) guidelines, utilizing the Joanna Briggs Institute's Checklist for Qualitative Research. The review involved a comprehensive database search across PubMed, Scopus, Web of Science, Cochrane Library, and Ovid MedLine. The eligibility criteria for publications included at least one of the following aspects related to migrants: access to vaccines or frequency of vaccine uptake, vaccine hesitancy, vaccine modeling and optimization approaches, or discussions grounded in principles of fairness. Searches were limited to the articles published in English between 2000-2022. Initially, 5,653 articles were identified, which were reduced to 305 after title screening. Following abstract screening, 19 articles meeting the inclusion criteria-focused on vaccination modeling, allocation, fairness optimization, and behaviors or attitudes in migrant populations-were selected for full-text evaluation.

RESULTS: Vaccination rates among migrants range from 42.7% to 87%, which are lower compared to the host population. Although the willingness to vaccinate is around 70%, significant barriers such as language obstacles, lack of access to healthcare services, and insufficient information remain critical challenges. While 19 of the studies defined fairness through the use of health services, four of them discussed it on community participation, and two employed modeling approaches. Various techniques, including community involvement, digital health messages and national refugee centers, have been employed to allocate vaccines fairly and consistently. The concept of equity has been addressed inconsistently across studies, and there is insufficient data to develop a fair vaccine distribution strategy for migrant populations.

CONCLUSION: This study highlights the following: (1) the challenges migrants face, including limited access to healthcare, language barriers and poor living conditions, which complicate equitable vaccine allocation; (2) the lack of specific, systematic national vaccine allocation programs targeting migrants; and (3) the need for a targeted, fairness-based approach, along with further research on national policies and vaccine delivery models that prioritize migrants and address their unique vulnerabilities.

RevDate: 2025-11-06
CmpDate: 2025-11-04

Rostami Zarinabadi C, Daliri S, Rohani-Rasaf M, et al (2025)

Post-Traumatic Stress Disorder after Disaster and Mass-Casualty Incidents in Developed and Developing Countries: A Meta-Analysis Study.

Iranian journal of psychiatry, 20(3):383-404.

Objective: Disasters impact global health, with Post Traumatic Stress Disorder (PTSD) being a significant early consequence. Countries differ in their response to disasters and health management, affecting PTSD prevalence. This study aims to compare PTSD prevalence in developed and developing countries and investigate its trends post-COVID-19 compared to other mass-casualty incidents. Method : This study was conducted using systematic review and meta-analysis methods regarding the prevalence of PTSD in the world. Accordingly, all the English language articles published from the beginning of 2010 to the end of 2024 were extracted from the Scopus, Web of Science, PubMed, Cochrane Library, and Google Scholar databases and were investigated. Data analysis was done by random effects model, meta-regression, I[2] index, and Egger test using the STATA (ver. 17) software. Results: One hundred and eight studies, with a total sample size of 498,796, were included in the meta-analysis. The prevalence of PTSD in developed countries at various intervals after exposure to disaster was as follows: 26.3% (1-3 months), 44.5% (4-6 months), 11.1% (7-12 months), 24.0% (13-24 months), and 22.0% (25-36 months). In developing countries, the corresponding prevalence rates were 26.0%, 25.2%, 30.4%, 21.4%, and 20.9%, respectively. PTSD prevalence in men was slightly higher in developing countries compared to developed countries, but the difference was minimal. Conclusion: More than one-fifth of disaster-exposed populations develop PTSD, with no significant prevalence difference between developed and developing countries. PTSD prevalence was higher in men from developing countries, but no significant gender differences were found otherwise. Prompt diagnostic and therapeutic interventions are essential globally to mitigate PTSD's impacts.

RevDate: 2025-11-08
CmpDate: 2025-11-04

Park YS, Schroeder D, OJ Kim (2025)

Research Ethics Challenges in Pandemic Korea and Their Implications for the Revised 2024 Declaration of Helsinki.

Journal of Korean medical science, 40(42):e281.

BACKGROUND: The pandemic significantly impacted research ethics, vastly magnifying existing challenges. This study examines challenges for research ethics in Korea during coronavirus disease 2019 (COVID-19) and their implications for the 2024 revised Declaration of Helsinki.

METHODS: As a literature search method, we applied the scoping review protocol using six databases, search keywords related to research ethics and COVID-19, then analyzed key themes against the revised Helsinki Declaration.

RESULTS: We reviewed the literature on research ethics during the COVID-19 pandemic in the Republic of Korea, identifying ten key themes: 1) participant safety; 2) national governance; 3) community engagement; 4) global cooperation; 5) reliable research; 6) rapid Institutional Review Board reviews; 7) consent adaptation; 8) fair inclusion of vulnerable groups; 9) ethics of human challenge trials; and 10) use of human materials without consent. The revised Helsinki Declaration of 2024 newly introduces: 1) ethical principles in public health emergencies; 2) meaningful community engagement; 3) scientific rigor; and the Declaration reframes 4) addressing vulnerability; and 5) informed consent for biological materials.

CONCLUSION: By analyzing the relevance and implications of the challenges identified in this literature review in relation to the revisions made to the Declaration of Helsinki in 2024, we demonstrate that the updated Declaration addresses most of the ethical challenges posed by research in pandemic Korea. This paper highlights that the 2024 revision underscores the significance of research ethics during pandemic situations and proposes approaches to enhance the research environment and ecosystem in the 21st century post-pandemic.

RevDate: 2025-11-07

Heinz SS, O'Brien AJ, Walker C, et al (2025)

Mediating pathways between resilience, mental health and wellbeing: a scoping review of individual, social, and systemic factors.

BMC public health, 25(1):3758.

BACKGROUND: Resilience strongly predicts health and wellbeing across populations, but mediating pathways may vary between cultural and socioeconomic contexts. This scoping review examines the mediating variables that explain the relationships between resilience, mental health and wellbeing across different socioeconomic contexts.

METHODS: Following a literature search of four databases (PubMed, PsycInfo, Scopus, and CINAHL), we identified 824 potentially relevant papers. After rigorous screening using predefined inclusion criteria, 24 high-quality studies were included in the final review. Two independent reviewers assessed methodological quality using the Joanna Briggs Institute Critical Appraisal Tools.

FINDINGS: Three levels of mediating pathways emerged: individual factors (self-esteem, self-efficacy, mindfulness, self-compassion, coping strategies, emotional regulation); social factors (family support, social networks, community resources); and systemic factors (economic security, digital inclusion, burnout, religious coping). Resilience was consistently associated with better wellbeing, but mediating factors varied by context. In impoverished contexts, structural determinants of economic stability, service availability, and social protection schemes were pivotal in how resilience is enacted to shape wellbeing. In advantaged contexts, internal psychological capacities and social support emerged as primary mediators through which resilience shapes wellbeing. Studies in Western contexts focused on individual factors, while studies in Eastern environments highlighted social factors. Studies in Middle Eastern settings emphasised religious coping mechanisms, while Global South research prioritised resource availability. During acute crises (COVID-19) positive reappraisal and stress recovery were critical mediators, whereas chronic adversity contexts emphasised social support networks and coping mechanisms.

CONCLUSION: Resilience and wellbeing operate through distinct mediation pathways influenced by social, cultural, and environmental factors. Interventions should target context-specific mediators rather than employing generalised strategies. Future research should address knowledge gaps concerning Indigenous populations and employ longitudinal methodologies to establish causality across diverse environments.

RevDate: 2025-11-06
CmpDate: 2025-11-03

Kim S, Shrestha K, G Cho (2025)

Towards practical point-of-care quick, ubiquitous, integrated, cost-efficient molecular diagnostic Kit (QUICK) PCR for future pandemic response.

Microsystems & nanoengineering, 11(1):204.

In response to the ongoing threat of infectious disease outbreaks, such as coronavirus disease (COVID-19) pandemic, numerous technological advancements in nucleic acid amplification testing (NAAT) based point-of-care test (PoCT) have been introduced to enable simple, rapid, and accurate diagnostic tests. However, only a few innovations in NAAT methods have been successfully commercialized. In this review, the significant advancements in diagnostic technologies, focusing on sample preparation methods, rapid thermal cycling technologies, and integrated result readout methods, are summarized with their key limitations that have hindered the practical implementation of polymerase chain reaction (PCR)-based PoCT, called a QUICK-PCR: quick, ubiquitous, integrated, cost-efficient molecular diagnostic kit based on PCR. In addition, the details of the core components to realize QUICK-PCR were prospectively suggested with a comparative overview for the PCR-based molecular diagnosis process, innovations in sample preparation using microfluidic chips, and direct PCR approaches. Especially, advancement in recent thermal cycling techniques that use Joule heating, thermoelectric heating, and plasmonic heating were highlighted while integrated readout methods that utilize fluorescence, colorimetry, and electrochemical techniques were examined. Based on analyzing key barriers in developing PCR-based PoCT, we highlight recent advancements in developing the PCR-based PoCT which can be implemented in the QUICK-PCR. The prospective QUICK-PCR will remove inequality in health care in resource-limited remote areas under the threatens of infectious diseases.

RevDate: 2025-11-05
CmpDate: 2025-11-03

Li J, Zhang J, Li SG, et al (2025)

Rapidly progressive anti-GBM disease secondary to long-standing rheumatoid arthritis: a case report and literature review.

Frontiers in immunology, 16:1661117.

BACKGROUND: Long-standing rheumatoid arthritis (RA) complicated by anti-glomerular basement membrane (anti-GBM) disease is exceptionally rare.

CASE: A 71-year-old man with long-standing seropositive RA developed a rapidly progressive glomerulonephritis due to anti-GBM disease, without any known drug triggers. Despite plasmapheresis (therapeutic plasma exchange), corticosteroids, and low-dose cyclophosphamide, he remained dialysis-dependent; RA activity was subsequently controlled with tocilizumab. Complications included Stenotrophomonas maltophilia pneumonia, COVID-19 and cytomegalovirus infection, and he died of pneumonia eight months after diagnosis.

CONCLUSION: This case highlights the need for early serological testing for anti-GBM disease in RA patients with unexplained hematuria/proteinuria and for immunosuppressive therapy mindful of infection risk. Additionally, our literature review identified only ten reported cases of RA with anti-GBM disease, highlighting the rarity of this condition.

RevDate: 2025-11-05
CmpDate: 2025-11-03

Hartnell L, Agudelo-Romero P, Montgomery ST, et al (2025)

What goes up must come down: dynamics of type 1 interferon signaling across the lifespan.

Frontiers in immunology, 16:1654604.

Type 1 interferons (T1IFNs) are typically expressed in low concentrations under homeostatic conditions, but upon pathogenic insult or perturbation of the pathway, these critical immune signaling molecules can become either protectors from or drivers of pathology. While essential for initiating antiviral defense and modulating inflammation, dysregulation of T1IFN signaling can contribute to immunopathology, making it and its associated pathways prime targets for immune evasion and disruption by pathogens. This review focuses on the changes in T1IFN signaling across the lifespan, with particular emphasis on the role of the Stimulator of Interferon Genes (STING) pathway in autoimmune and infectious disease susceptibility, especially in the context of viral infections. Aging is associated with diminished T1IFN responsiveness, partially resulting from chronic stimulation of the STING pathway, which contributes to increased susceptibility and impaired viral clearance. Conversely, neonates and young children also show increased vulnerability to certain viral infections, but whether this is driven by T1IFN differences or another mechanism remains incompletely understood. Despite growing interest in T1IFN-based immunotherapies, pediatric and elderly populations remain underrepresented in clinical trials. Here, we advocate for a deeper molecular and systems understanding of how the interferon response evolves across the human lifespan, to inform age-tailored therapeutic approaches and more inclusive study designs, thereby improving outcomes in both the youngest and oldest patients.

RevDate: 2025-11-05
CmpDate: 2025-11-03

Khan A, Asghar T, Yumn L, et al (2025)

Trends in hypertensive heart disease-related mortality among population with Alzheimer's in the United States: a 22-year nationwide analysis.

Annals of medicine and surgery (2012), 87(11):7325-7333.

BACKGROUND: Alzheimer's disease (AD) is a progressive neurodegenerative disorder, while hypertensive heart disease (HHD) is a major cardiovascular condition linked to chronic hypertension (HTN). HTN is common among patients with AD, significantly impacting mortality. This study explores trends in HHD-related mortality among patients with AD in the US from 1999 to 2020, utilizing the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database.

METHODS: Data from the CDC WONDER database were used to extract mortality information for individuals aged ≥65 years, with AD and HHD as the underlying or contributing causes of death. Mortality rates were analyzed by age, sex, race/ethnicity, urban-rural classification, and region. Both crude- and age-adjusted mortality rates (AAMRs) were calculated. Joinpoint regression was employed to identify significant trends and changes in mortality over time.

RESULTS: HHD-associated mortality among patients with AD showed a significant upward trend, with deaths rising from 710 in 1999 to 3263 in 2020. The AAMR increased from 2.08 per 100 000 in 1999 to 6.26 per 100 000 in 2020, a threefold increase. Female patients had higher mortality rates than males throughout the study period. The highest mortality rates were observed in the age group of 85+ years, with notable regional disparities, particularly in the South and Midwest. The COVID-19 pandemic in 2020 contributed to a marked spike in mortality.

CONCLUSION: A concerning rise in HHD-related mortality among patients with AD, particularly in the last decade is observed. Significant disparities exist across demographic groups and regions. These findings highlight the need for public health interventions and policies to address the dual burden of AD and HHD.

RevDate: 2025-11-05
CmpDate: 2025-11-03

Abbasher Hussien Mohamed Ahmed K, Kalool Fadlalla Ahmad T, Ismail Abdu Ismail M, et al (2025)

Neurological manifestations of COVID-19 and its vaccines: an updated comprehensive review with an insight into pathophysiology.

Annals of medicine and surgery (2012), 87(11):7346-7355.

The COVID-19 pandemic caused by SARS-CoV-2 has had a significant global impact on the respiratory system and multiple organ systems, including the nervous system. Neurological manifestations associated with COVID-19 infection and its vaccines have been increasingly recognized, ranging from problems with smell and taste to more severe conditions such as encephalitis, stroke, and Guillain-Barré syndrome. This narrative review critically evaluates the neurological manifestations of COVID-19 infection and its vaccines, providing insights into potential pathophysiological mechanisms. A comprehensive literature search was conducted, and data were retrieved from various databases. The prevalence, types, and severity of neurological symptoms in COVID-19 patients were discussed. The possible mechanisms of neurological injury in COVID-19 were explored, including direct viral invasion, hypoxic brain injury, immune-mediated damage, and cerebrovascular injury. Furthermore, the review addressed the neurological complications associated with COVID-19 vaccination. While severe vaccine-related adverse effects remain rare, understanding their occurrence is essential for risk assessment and public health interventions. In conclusion, COVID-19 can affect the nervous system in various ways, leading to various neurological symptoms. Further research is necessary to enhance our understanding of these manifestations and develop effective preventive and treatment strategies to manage this global health crisis.

RevDate: 2025-11-05
CmpDate: 2025-11-03

Sedrak P, Dounaevskaia V, Mancini GBJ, et al (2025)

Vaccination in Patients with Cardiovascular Disease: A Case-Based Approach and Contemporary Review.

CJC open, 7(10):1375-1388.

Vaccination is a crucial preventative strategy, particularly in individuals with cardiovascular (CV) disease (CVD). People living with CVD are at increased risk of morbidity and mortality from vaccine-preventable infections such as influenza, severe acute respiratory syndrome-corona virus 2 (SARS-CoV-2), respiratory syncytial virus (RSV), varicella zoster virus (VZV), and pneumococcal disease. These infections also have been associated with downstream CV complications, including ischemic events and myocarditis. Randomized controlled trials have demonstrated that influenza vaccination reduces major adverse CV events and all-cause mortality, especially in people with CVD. The same has been observed in registry analyses during the SARS-CoV-2 pandemic. Pooling of data from observational and cohort studies also has shown significant benefit of vaccination against RSV, VZV, and pneumococcal disease in older populations and those with CV comorbidities. Despite recommendations from national public health guidelines and immunization programs, vaccination uptake in patients with CVD remains suboptimal. This low uptake is influenced by lack of vaccine information, access issues, and mistrust in the healthcare system, all summarized in the term "vaccine hesitancy." Vaccination promotion should focus on addressing these gaps in communication and access barriers at the provider, community, and public health levels. Healthcare providers including cardiologists are reminded, through this review, of the importance of emphasizing vaccination recommendations during clinical encounters. Addressing patient misconceptions and providing patient decision aids strongly improves acceptance rates. Continued efforts at the community and public health levels should address barriers to access and advance surveillance methods to target improved clinical outcomes for groups at risk.

RevDate: 2025-11-05
CmpDate: 2025-11-03

Yang F, Huang X, Huang W, et al (2025)

Development and testing of a public health emergency intelligence analysis system based on text analysis and NLP analysis.

Frontiers in public health, 13:1677306.

OBJECTIVE: To tackle challenges including delayed information support and inefficient decision-making in public health emergency response, this study develops an intelligence analysis system for public health emergencies based on emergency information management theory from library and information science.

METHODS: Using 1,026 text data items such as government reports and flow survey records from the COVID-19 epidemic in Shijiazhuang City (1,033 confirmed cases), multimodal analysis methods were integrated, including logistic regression, C5.0 decision tree, TransH-based knowledge graph, and chi-square test. The BIO tagging scheme was adopted with annotations performed by three epidemiology professionals, achieving an inter-annotator agreement (Kappa) of 0.78.

RESULTS: Key transmission sites were identified by chi-square test (χ [2] = 87.32, p < 0.001). Risk factors such as advanced age (OR = 3.15) and village clinic visits (OR = 4.72) were identified through logistic regression. A case-place-time network was constructed using the TransH algorithm (accuracy 0.89). The C5.0 decision tree classified high-risk areas (AUC = 0.91), and Apriori association rules revealed patterns such as "wedding banquet → family gathering" (confidence 0.86). A Python-based system improved intelligence extraction efficiency by 47.8%.

CONCLUSION: The study successfully establishes an interdisciplinary framework integrating library informatics, epidemiology, and AI. It identifies churches and wedding banquets as key transmission nodes, and village clinics as amplifiers due to delays in identification and reporting. The developed software tool enhances response efficiency, supporting rapid contact tracing and control strategy formulation.

RevDate: 2025-11-03
CmpDate: 2025-11-03

Limami Y, Wahnou H, Ndayambaje M, et al (2025)

SARS-CoV-2: A Liver Brief.

WIREs mechanisms of disease, 17(6):e70005.

The Coronavirus Disease 2019 (COVID-19) pandemic, caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has revealed the virus's ability to induce multi-organ damage, including significant liver injury. The molecular mechanisms of liver dysfunction in COVID-19 patients are explored, focusing on direct viral infection, immune-mediated damage, and the gut-liver axis. SARS-CoV-2 enters liver cells through the Angiotensin-Converting Enzyme 2 (ACE2) and Transmembrane Serine Protease 2 (TMPRSS2) receptors, but alternative pathways, such as CD209/Dendritic Cell-Specific Intercellular adhesion molecule-3-Grabbing Non-integrin (DC-SIGN) and AXL receptors, can also contribute to viral entry. Additionally, immune responses, particularly the cytokine storm, exacerbate liver inflammation, leading to hepatocyte damage. Pre-existing liver conditions, such as metabolic-associated fatty liver disease (MAFLD), alcohol-related liver disease (ALD), and liver fibrosis, heighten the risk of severe outcomes in COVID-19 patients. Post-COVID-19 liver complications, including fibrosis progression and persistent liver damage, have been reported, with emerging evidence suggesting chronic inflammation, viral persistence, and autoimmune reactions as potential contributors. Furthermore, Drug-Induced Liver Injury (DILI) from COVID-19 treatments remains a concern, highlighting the need for careful management. Consequently, understanding the interplay between SARS-CoV-2 and the liver is critical for improving patient outcomes and developing targeted therapies to mitigate liver-related complications in both acute and Long COVID-19 phases. This article is categorized under: Infectious Diseases > Molecular and Cellular Physiology.

RevDate: 2025-11-03
CmpDate: 2025-11-03

Xu Q, Zhao T, Cai X, et al (2025)

Global Hesitancy of COVID-19 Vaccine Among Vulnerable Population From 2020 to 2023: A Systematic Review and Meta-Analysis.

Reviews in medical virology, 35(6):e70079.

Vaccination is an effective response to the COVID-19 pandemic, but vaccine hesitancy is a major challenge. This study aims to explore the pooled prevalence and factors of COVID-19 vaccine hesitancy. We searched the studies published from January 2020 to December 2023 in PubMed, Web of Science, and Embase. The studies with complete start time of the study and national information were included in the generalised additive model to explore the factors affecting the COVID-19 vaccine hesitancy rate by calculating OR and 95%CI. A total of 629 studies were included. The pooled global hesitancy rates of COVID-19 vaccine were 34.6% (95% CI: 31.2%-38.1%) in vulnerable population and 33.2% (95% CI: 31.7%-34.8%) in general populations. The regression model showed that the hesitancy rate of COVID-19 vaccine was correlated with the duration of the epidemic, the monthly governmental stringency index, the monthly incidence and mortality of COVID-19, SDI, geographical location, and health status. Local governments should pay special attention to vaccination of vulnerable population and encourage vaccination to cope with the next possible wave of pandemic as incidence declines and restrictions are eased. The international community should timely provide vaccines for low economy countries.

RevDate: 2025-11-02

Anang V, Kumar P, Pracha J, et al (2025)

SARS-CoV-2 innate immune recognition and implications for respiratory health.

Cytokine & growth factor reviews, 86:167-180 pii:S1359-6101(25)00142-X [Epub ahead of print].

The ongoing global health impact of SARS-CoV-2, particularly on lung and respiratory health, underscores the critical need to decipher the intricate interplay between the virus and the host innate immune system. This review provides an analysis of the key pattern recognition receptors (PRRs) involved in SARS-CoV-2 recognition within the lung, including toll-like receptors (TLRs), RIG-I-like receptors (RLRs), NOD-like receptors (NLRs), and C-type lectin receptors (CLRs). We discuss how the engagement of these innate sentinels triggers crucial downstream consequences, ranging from protective antiviral interferon (IFN) responses to detrimental hyperinflammation characteristic of severe COVID-19. Numerous studies have identified sophisticated mechanisms employed by SARS-CoV-2 to evade or suppress early IFN induction, contributing to unchecked viral replication and subsequent immunopathology. We explore how this aberrant innate immune response drives the "cytokine storm", leading to acute respiratory distress syndrome (ARDS) and long-term sequelae. Furthermore, this review critically assesses current and emerging therapeutic strategies aimed at modulating innate immunity, including TLR agonists/antagonists, RIG-I/MDA5 modulators, NLRP3 inflammasome inhibitors, and IFN-based therapies, highlighting their potential and associated challenges. Finally, we identify key research gaps, emphasizing the need for cell-type-specific PRR studies, comprehensive mapping of viral evasion mechanisms, and the development of precision immunotherapies to enhance protective responses and mitigate pathogenic inflammation for future respiratory viral threats.

RevDate: 2025-11-01

Galiza EP, Nakebembe E, Mboizi R, et al (2025)

Maternal vaccination to prevent neonatal infections and combat antimicrobial resistance.

Seminars in fetal & neonatal medicine pii:S1744-165X(25)00074-5 [Epub ahead of print].

Maternal vaccination during pregnancy is emerging as a powerful strategy in protecting newborns from infectious diseases, improving neonatal outcomes, and potentially reducing antimicrobial use and resistance. Maternal immunisation works by eliciting protective antibodies in the mother that are transferred to the fetus transplacentally and through breastmilk postnatally to provide the infant with passive immunity during the first vulnerable months of life. There is sufficient evidence to support the role of maternal vaccination in averting many neonatal infections that would otherwise require medical intervention. By preventing infections in mothers and their newborn, maternal vaccination also holds significant potential for reducing antimicrobial use and antimicrobial resistance. Fewer neonatal infections translate to a reduced need for antimicrobial use in the neonatal period and in postpartum women, therefore lowering the selective pressure for drug-resistant bacteria. Routine maternal vaccines (tetanus, diphtheria, acellular pertussis (Tdap), influenza, COVID-19, respiratory syncytial virus) already confer measurable antibiotic-sparing benefits by preventing infections that typically trigger antimicrobial therapy in mothers and neonates. Pipeline candidates (Group B Streptococcus, Klebsiella pneumoniae, Escherichia coli) could further lower neonatal sepsis burden, reducing broad-spectrum antimicrobial use in neonatal intensive care units to help slow antimicrobial resistance. Integrated with antibiotic stewardship and infection-prevention measures, maternal immunisation offers a practical, scalable practice to limit perinatal antibiotic exposure.

RevDate: 2025-11-14
CmpDate: 2025-11-01

Mayer KH, Beyrer C, Cohen MS, et al (2025)

Challenges and opportunities in developing integrated sexual and reproductive health programmes.

Lancet (London, England), 406(10515):2168-2190.

Sexual and reproductive health and rights are fundamental to both human and societal wellbeing and sustainable development, and encompass a broad array of sociocultural and clinical issues that affect all people across the life course. In 2018, the Guttmacher-Lancet Commission described sexual and reproductive health as a state of physical, emotional, mental, and social wellbeing in relation to all aspects of sexuality and reproduction, not merely the absence of disease, dysfunction, or infirmity. The Commission advocated for a positive approach to sexuality and reproduction that recognises the role of pleasurable sexual relationships, trust, and communication in promoting self-esteem and overall wellbeing. The Commission also stipulated that people have a right to make decisions governing their bodies and to access services that support that right. In light of recent sociocultural changes, biomedical advances that have impacted sexual and reproductive health and rights, and the key findings of the Guttmacher-Lancet Commission, we bring together themes from this Lancet Series to discuss the new scientific developments and sociopolitical changes that affect the programmatic integration of sexual and reproductive health services. As people who present for one sexual and reproductive health service frequently have other unmet sexual and reproductive health-related needs, there are often benefits to interventions and services that address multiple connected sexual and reproductive health issues during one clinical encounter (eg, family planning visits, including testing for HIV and other sexually transmitted infections), which supports the rationale for an integrated approach. Historically, key components of sexual and reproductive health have been managed separately, partly because of siloed and inadequate funding streams and structural limitations (eg, separate location of service delivery or insufficient staff cross-training). Vertical methods have also evolved from the need for different approaches to reach key populations, who might be reluctant to seek care from primary health care clinics. We build on the findings of the papers in this Series to discuss the rationale for sexual and reproductive health programmatic integration, which has the potential to better engage patients in care by meeting their preferences, simplify the user experience, and save resources when implemented in a thoughtful, culturally tailored manner. However, wide-scale sexual and reproductive health programmatic integration faces multiple challenges, requiring broadly trained health-care providers, a range of clinical and outreach channels, and well-resourced health systems. Programmatic integration might be further constrained by societal norms and regulations (eg, punitive laws, institutional homophobia, legal restrictions on access to safe abortion, and opposition to sexual and reproductive rights). Notably, the Trump Administration's withdrawal of support from various sexual and reproductive health programmes in January, 2025, is a major threat to continued progress. This Series paper provides a call to action based on the key findings from this Series that delineates the steps needed to better integrate programmes to optimise sexual and reproductive health outcomes.

RevDate: 2025-11-01

Farjami Z, Moradi M, Ebrahimi N, et al (2025)

COVID-19: Understanding the Granulocyte Response and Exploring Their Therapeutic Interventions.

Viral immunology [Epub ahead of print].

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), has led to a global health crisis by triggering extensive systemic and immune dysregulation. Granulocytes, including neutrophils, eosinophils, and basophils, are critical components of the innate immune system that play dual roles in protection and pathogenesis during infection. In this review, we examine the multifaceted roles of granulocytes in COVID-19 and their impact on disease severity through excessive inflammation, cytokine storm, and tissue damage. Neutrophil extracellular traps (NETs) and the overactivation of neutrophil subtypes contribute to the development of thrombosis and acute respiratory distress syndrome. In contrast, eosinophils and basophils modulate T helper 2-type and allergic responses that may influence recovery or disease progression. We further summarize the therapeutic strategies targeting granulocyte activation and signaling pathways, including IL-1, IL-6, IL-17, IL-5 receptor, granulocyte-macrophage colony-stimulating factor inhibitors, and antihistamines, emphasizing their clinical outcomes, approval status, and the global regions in which they are studied. Understanding the regulatory mechanisms of granulocyte activation and inhibition provides new insights into COVID-19 immunopathology and opens pathways for targeted immunomodulatory therapy. These findings underscore the importance of balancing protective immune functions with controlled anti-inflammatory interventions to mitigate the severe complications of SARS-CoV-2 infection.

RevDate: 2025-11-07

Salvaggio MR, McCloskey C, E Siegrist (2025)

Syphilis in the post-Covid-19 pandemic world.

The American journal of the medical sciences pii:S0002-9629(25)01263-7 [Epub ahead of print].

Syphilis, an ancient malady, remains clinically relevant. Recent increases in syphilis cases, especially congenital syphilis, should increase the clinician's index of suspicion when presented with one of the protean clinical syndromes associated with syphilis. Diagnosis and monitoring of response to treatment remain reliant on testing modalities with varying degrees of sensitivity and specificity, requiring clinical discernment. Penicillin remains the recommended treatment in most syphilis cases. New treatment options may be available soon.

RevDate: 2025-11-08

Sawangjit R, Sadoyu S, Manosanthipaibul S, et al (2025)

Effectiveness and safety of turmeric for the treatment of COVID-19: An updated systematic review and meta-analysis of randomized controlled trials.

Complementary therapies in medicine, 95:103295 pii:S0965-2299(25)00171-2 [Epub ahead of print].

We conducted a comprehensive and updated systematic review and meta-analysis (SR-MA) to determine the effectiveness and safety of turmeric in patients with coronavirus disease 2019 (COVID-19). Multiple databases were searched from inception to July 31, 2024, for randomized controlled trials (RCTs) assessing turmeric in mild to severe COVID-19. This SR-MA uniquely includes recent trials conducted alongside modern antiviral-based regimens and explores effect modifiers by disease severity, comorbidity, formulation, and treatment duration. Twenty-three RCTs with 1407 participants were included, making this the largest synthesis to date. Most studies (17/23, 73.9 %) enrolled hospitalized patients; over half involved mild to moderate cases. The most common intervention was nano-curcumin 160-240 mg/day (39 %), used as an adjunct to standard care. Nine studies were rated high risk of bias (ROB). Meta-analysis showed turmeric significantly reduced all-cause mortality (Relative risk (RR) = 0.39; 95 % confidence interval (95 %CI): 0.23-0.67; I[2] = 0 %; n = 8 RCTs; moderate certainty), suggesting a 61 % reduction in risk of death. It also reduced the need for intubation/mechanical ventilation (RR = 0.35; 95 %CI: 0.17-0.72) and clinical deterioration (RR=0.36; 95 %CI: 0.22-0.59), while improving overall symptom resolution (RR = 1.36; 95 %CI: 1.16-1.59). These results remained robust after excluding high ROB studies. Adverse events, mostly mild gastrointestinal symptoms, were comparable to placebo. In conclusion, turmeric, particularly bioavailability-enhanced nano-curcumin, provides meaningful clinical benefits and favorable safety profile as adjunctive therapy for COVID-19. Further large-scale, high-quality, multicenter RCTs are warranted to confirm its therapeutic potential, particularly in resource-limited settings.

RevDate: 2025-11-07
CmpDate: 2025-11-01

Thiriveedi M, Patel H, Curran C, et al (2025)

Post-COVID-19-Associated Asymptomatic Sarcoidosis with Hypercalcemia and Renal Dysfunction: A Case Report and Literature Review.

The American journal of case reports, 26:e950045.

BACKGROUND Sarcoidosis is a multisystem granulomatous disease of unknown etiology that often presents with nonspecific symptoms and lacks a definitive diagnostic test. Diagnosis can be particularly challenging in atypical cases without hallmark features such as bilateral hilar lymphadenopathy or cutaneous lesions. The recent literature suggests that post-COVID-19 immune dysregulation may act as a novel trigger for sarcoidosis. CASE REPORT We present the case of a 60-year-old Black woman with hypertension, osteoarthritis, and a recent coronavirus disease 2019 (COVID-19) infection complicated by persistent anosmia. Routine laboratory testing revealed hypercalcemia, renal insufficiency, and anemia. Despite discontinuing over-the-counter supplements, her hypercalcemia persisted, although she remained otherwise asymptomatic. Diagnostic workup showed normal 25-hydroxy vitamin D, suppressed parathyroid hormone (PTH) levels, and elevated 1,25-dihydroxy vitamin D. Imaging revealed nonspecific pulmonary nodules without hilar lymphadenopathy. Biopsy of a supraclavicular lymph node demonstrated non-caseating granulomas, establishing the diagnosis of sarcoidosis. Treatment with oral prednisone led to improvement of biochemical abnormalities and radiographic findings. CONCLUSIONS This case underscores the diagnostic challenges of sarcoidosis in the absence of classic pulmonary features and highlights the importance of recognizing hypercalcemia and elevated 1,25-dihydroxy vitamin D as key diagnostic clues. Notably, to the best of our knowledge, no prior reports have described asymptomatic sarcoidosis in the post-COVID-19 setting, making this case a unique contribution to the emerging literature. However, as this is a single-patient observation, causality cannot be inferred, and larger studies are needed to explore this potential association.

RevDate: 2025-11-04
CmpDate: 2025-11-01

Salami B, Tulli-Shah M, Ali I, et al (2025)

A scoping review of intersectional health research related to the COVID-19 pandemic in North America: key findings.

BMC public health, 25(1):3716.

BACKGROUND: This scoping review maps the key findings of intersectional research related to the COVID-19 pandemic in North America. Intersectional approaches highlight how overlapping systems of oppression shape health and social outcomes.

METHODS: A total of 21 studies were included, comprising 10 quantitative, 8 qualitative, and 3 mixed-methods designs. Studies were reviewed to assess the use of intersectional research methods and to identify common findings across the literature.

RESULTS: Intersectional research methods are increasingly utilized in pandemic-related studies in North America. Thematic analysis revealed five key themes: deepening disparities in health care systems, barriers to accessing social services, changes to working conditions across economic sectors, impacts of lockdown restrictions, and impacts on mental health. This review also found that interruptions to community connections influenced access to resources, shaping life chances for some populations. Importantly, intersectional research related to the pandemic has often decentralized race, which contrasts with broader non-intersectional studies.

CONCLUSIONS: Findings underscore the need for public health policies informed by intersectional frameworks. Inequities related to class, race, and gender highlight the importance of disaggregated data collection as standard practice. Targeted interventions, such as workplace protections for racialized women in precarious jobs, are critical to addressing compounded vulnerabilities and ensuring equity in pandemic responses.

RevDate: 2025-11-14
CmpDate: 2025-11-01

Zhou S, Gao S, Fang Y, et al (2025)

Efficacy of vitamin C in COVID-19 management: a systematic review and meta-analysis.

BMC infectious diseases, 25(1):1463.

BACKGROUND: COVID-19 has posed a global burden, with vitamin C considered a potential treatment due to its antioxidant, anti-inflammatory, and antimicrobial properties. However, its efficacy remains uncertain. This study aims to evaluate the impact of vitamin C supplementation on COVID-19 patients.

METHODS: A comprehensive literature search was conducted across PubMed, MEDLINE, Embase, CBMdisc, WanFang Data, and CNKI from October 26, 2012, to October 1, 2023. The primary outcomes were 28-day mortality and in-hospital mortality, and the secondary outcomes were intensive care units (ICU) length of stay, duration of mechanical ventilation, length of vasopressor use, changes in SOFA score, and PaO2/FiO2 ratio. Random-effects models were employed to analyze the study outcomes. The Cochrane Systematic Review Guidelines and the GRADE system were utilized evaluated the risk of bias and the quality of evidence.

RESULTS: A total of thirteen studies were included with sample of 12,062. Most of these included studies exhibited low to indeterminate bias risk. The quality of evidence ranged from very low to moderate across in included studies. The overall results indicated that non-substantial favorable impacts were observed in short-term mortality (risk ratio [RR]: 0.92, 95% Confidence Interval [CI]: 0.72 to 1.17, P = 0.415) and in hospital mortality (RR: 1.05, 95% CI: 0.95 to 1.16, P = 0.286), nor other secondary clinical outcomes.

CONCLUSION: Although the current application of vitamin C in COVID treatment and management, our findings revealed that vitamin C did not significantly improve COVID outcomes. More high-quality and multicenter trials are required to further elucidate the association between vitamin C and COVID-19.

TRIAL REGISTRATION: Registration of systematic reviews: This study was registered with the International Prospective Register of Systematic Reviews (PROSPERO), under the registration number CRD42024527599.

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