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Bibliography on: covid-19

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ESP: PubMed Auto Bibliography 14 Jun 2026 at 01:39 Created: 

covid-19

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS coronavirus 2, or SARS-CoV-2), a virus closely related to the SARS virus. The disease was discovered and named during the 2019-20 coronavirus outbreak. Those affected may develop a fever, dry cough, fatigue, and shortness of breath. A sore throat, runny nose or sneezing is less common. While the majority of cases result in mild symptoms, some can progress to pneumonia and multi-organ failure. The infection is spread from one person to others via respiratory droplets produced from the airways, often during coughing or sneezing. Time from exposure to onset of symptoms is generally between 2 and 14 days, with an average of 5 days. The standard method of diagnosis is by reverse transcription polymerase chain reaction (rRT-PCR) from a nasopharyngeal swab or sputum sample, with results within a few hours to 2 days. Antibody assays can also be used, using a blood serum sample, with results within a few days. The infection can also be diagnosed from a combination of symptoms, risk factors and a chest CT scan showing features of pneumonia. Correct handwashing technique, maintaining distance from people who are coughing and not touching one's face with unwashed hands are measures recommended to prevent the disease. It is also recommended to cover one's nose and mouth with a tissue or a bent elbow when coughing. Those who suspect they carry the virus are recommended to wear a surgical face mask and seek medical advice by calling a doctor rather than visiting a clinic in person. Masks are also recommended for those who are taking care of someone with a suspected infection but not for the general public. There is no vaccine or specific antiviral treatment, with management involving treatment of symptoms, supportive care and experimental measures. The case fatality rate is estimated at between 1% and 3%. The World Health Organization (WHO) has declared the 2019-20 coronavirus outbreak a Public Health Emergency of International Concern (PHEIC). As of 29 February 2020, China, Hong Kong, Iran, Italy, Japan, Singapore, South Korea and the United States are areas having evidence of community transmission of the disease.

NOTE: To obtain the entire bibliography (all 61702 citations) in bibtek format (a format that can be easily loaded into many different reference-manager software programs, click HERE.

Created with PubMed® Query: ( SARS-CoV-2 OR COVID-19 OR (wuhan AND coronavirus) AND review[SB] )NOT 40982904[pmid] NOT 40982965[pmid] NOT 35908569[pmid] NOT pmcbook NOT ispreviousversion

Citations The Papers (from PubMed®)

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RevDate: 2026-06-13
CmpDate: 2026-05-13

Dalrymple WA, JB Ratliff (2026)

A New Dawn: Resident Recruitment in the United States in the Post-COVID Era.

Seminars in neurology, 46(3):263-274.

The widespread adoption of virtual residency interviews in response to the COVID-19 pandemic led to an explosion in literature comparing the pros and cons of virtual and in-person interviews, but also led to an explosion in already-high residency application and interview volumes. While virtual interviews were substantially cheaper for all involved, there is fear that applicants and programs cannot judge one another as well as during in-person interviews. Likewise, increases in application volumes have made holistic application review more challenging for program directors, but the recent rise in "preference signaling" seems to be an optimal solution to that issue. 2020 also saw increased awareness of systemic inequities in the United States, and medical education and residency recruitment was not immune from scrutiny. Finally, the rise of artificial intelligence could again fundamentally change the resident selection process. It is imperative that the GME community continues to adapt to a changing world.

RevDate: 2026-06-13
CmpDate: 2026-06-01

Balakrishnar K, Long BS, Lo J, et al (2026)

Assessing the antecedents behind after-hours work in teleworkers: a scoping review.

Journal of public health (Oxford, England), 48(2):582-593.

BACKGROUND: Since the start of the COVID-19 pandemic, telework arrangements have become increasingly prevalent, driven by benefits such as greater autonomy, reduced work-related stress, decreased commuting time and cost, and enhanced flexibility. Despite these advantages, teleworkers are more likely to engage in after-hours work, creating additional strain that may impact health and organizational outcomes.

METHODS: A systematic search was conducted across seven online databases: Medline via OVID, Embase via OVID, APA PsycINFO via OVID, International Bibliography of Social Sciences via ProQuest, Sociological Abstracts via ProQuest, Business Source Premier via EBSCOhost, and CINAHL via EBSCOhost. Studies were included if they were empirical, peer-reviewed, published between 2010 and 2024, examined the antecedents of after-hours work, and focused on adults aged 18 to 65 engaged in telework. Descriptive thematic analysis was conducted to develop themes and sub-themes.

RESULTS: Findings: A total of 17 studies were included in the review: 13 cross-sectional studies, three qualitative studies, and one longitudinal study. Using the Person-Environment-Occupation framework, three overarching themes were identified: (i) misalignment between personal capacities and occupational demands; (ii) environmental constraints that undermine healthy role balance; and (iii) occupational role strain in the context of remote work.

CONCLUSIONS: These findings may help to inform the development of targeted interventions that reduce cases of after-hours work among teleworkers and promote their overall health and well-being. Future research should examine these antecedents in non-Western contexts and explore the interplay between the individual, environmental, and occupational factors shaping after-hours work behaviors.

RevDate: 2026-06-13
CmpDate: 2026-03-12

Sagués T, Ferrer A, Delgado JF, et al (2026)

Clozapine use and COVID-19 risk: A systematic review, meta-analysis, and retrospective cohort evidence.

Psychiatry research, 359:117040.

BACKGROUND: Clozapine's immune-modulating effects, including neutropenia and suppression of adaptive immunity, have raised concerns about its potential impact on SARS-CoV-2 infection risk and COVID-19 severity in individuals with treatment-resistant schizophrenia. Findings in the literature remain inconsistent.

METHODS: First, we conducted a longitudinal retrospective study in which we analysed 995 outpatients with severe mental disorders receiving antipsychotic treatment to assess the association between clozapine use and SARS-CoV-2 infection and disease severity. Secondly, we performed a systematic review of the literature and searched for studies published up to July 2025 examining the link between clozapine exposure and SARS-CoV-2 infection. Eight cohort studies plus our dataset were meta-analysed using a random-effects model.

RESULTS: In our cohort, clozapine users demonstrated a higher rate of SARS-CoV-2 infection (18% vs. 10%, p < 0.001) and increased COVID-19 severity compared to non-users. The meta-analysis comprised 155,945 participants, with individual study ORs ranging from 0.40 to 2.80. The pooled random-effects OR was 1.53 (95% CI: 1.02-2.30, p = 0.044), indicating a significant association between clozapine exposure and increased infection risk. However, high heterogeneity (I² = 91.2%) suggests variation in effects across studies.

CONCLUSIONS: Clozapine treatment is associated with an increased risk and severity of SARS-CoV-2 infection. Although meta-analytic results support this association, substantial heterogeneity in pooled estimates highlights the need for further research to clarify underlying clinical and methodological factors influencing risk.

RevDate: 2026-06-13
CmpDate: 2026-03-26

Andoh JE, Fu J, KH Nwanyanwu (2026)

Impact of United States federal funding on equity and vision research: lessons from history, justice, and politics, 1968-2025.

Current opinion in ophthalmology, 37(3):162-167.

PURPOSE OF REVIEW: Federal policy has long shaped the scope and inclusivity of vision research in the United States. This narrative review and opinion article evaluates the evolution of equity in vision research over time, from the landmark National Institutes of Health Revitalization Act of 1993 to the direct impact of federal policies in today's political landscape.

RECENT FINDINGS: Equity in vision research originated from early epidemiologic studies identifying social and behavioral determinants of health in the 1970s. The post-2020 period accelerated attention to structural disparities in healthcare, catalyzed by the COVID-19 pandemic and a national conversation on race. However, recent executive orders have reversed equity oriented federal policies, restricted terminology and data access, and changed research funding operations. These ongoing developments pose risks to progress in all areas of research.

SUMMARY: Equity in vision research in the United States remains vulnerable to federal priorities that serve to support or destabilize. The current political environment underscores the need for the ophthalmologic research community to safeguard data integrity, sustain diverse participation, and continue methodologically rigorous protocols to ensure continued progress toward equitable vision health.

RevDate: 2026-06-13
CmpDate: 2026-03-08

Giri B, Gurung M, Adnani QES, et al (2025)

Mental Health of Nepalese Migrant Workers: A Call for Action in South Korea.

JNMA; journal of the Nepal Medical Association, 63(288):636-640.

Mental health problems among migrants is a serious issue around the globe. Nepalese migrant workers in South Korea are facing serious mental health problem that affects not only the people involved but also the society at large. Moreover, the COVID-19 pandemic has worsened the already dire mental health situation of Nepali workers. Global health diplomacy can be a key factor in addressing mental health by engaging actors from various domains to evaluate mental health in global health priorities. This article reviews the current state of mental health and discusses the recent development in mental health among Nepalese migrant workers in South Korea.

RevDate: 2026-06-13
CmpDate: 2026-04-21

Poole-Wright K, Woodhall H, T Chalder (2026)

Healthcare worker fatigue during COVID-19, SARS, and MERS: a meta-analysis.

Occupational medicine (Oxford, England), 76(2):132-143.

BACKGROUND: The physical and psychological impact of caring for patients during a coronavirus public health emergency had adverse effects on healthcare workers (HCW), including fatigue.

AIMS: To examine the prevalence of fatigue among HCW during severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) or Coronavirus disease 19 (COVID-19) and identify associated risk and protective factors.

METHODS: Systematic searches of Embase, PsycINFO, Ovid-MEDLINE, CINAHL, HMIC and the Cochrane Library were conducted to July 2024. Inclusion criteria were English-language quantitative reports of fatigue in HCW during COVID-19, SARS and MERS. Random-effects meta-analyses were used to estimate pooled prevalence. Subgroup analyses examined fatigue by role, frontline status and personal protective equipment (PPE).

RESULTS: Eighty-eight articles (n = 74 914) met our inclusion criteria; 32 were eligible for meta-analysis. The pooled prevalence of fatigue was 55% (95% CI 46-65%, k = 32). Mental fatigue was reported by 58% (95% CI 17-90%, k = 4), while 53% (95% CI 38-67%, k = 11) experienced fatigue related to PPE use. No significant differences were observed between doctors and nurses (P = 0.327) or frontline and non-frontline staff (P = 0.103). Risk factors included stress, anxiety, depressive symptoms, workload and extended working hours, while resilience, self-efficacy and sufficient rest were protective. Substantial heterogeneity (I2 ∼99%) and reliance on cross-sectional designs limited causal inference.

CONCLUSIONS: Our study indicated that over half of HCW reported fatigue and highlighted its multifactorial nature. Organizational-level interventions, such as optimized shift patterns, mandated rest breaks and psychological support are essential to mitigate fatigue, safeguard wellbeing and ensure safe healthcare provision.

RevDate: 2026-06-12
CmpDate: 2026-06-12

Halder P, Debnath A, Achary T, et al (2026)

Systematic review and meta-analysis on depression burden among Type 2 diabetes patients in India.

Diabetology & metabolic syndrome, 18(1):.

BACKGROUND: Depression and Type 2 Diabetes Mellitus (T2DM) are closely linked health challenges in India, which currently has more than 101 million people living with diabetes. This systematic review and meta-analysis aimed to determine the pooled prevalence of depression among Indian T2DM patients, highlight regional differences, and identify associated risk factors.

METHODS: Following PRISMA guidelines, a thorough search was conducted across PubMed, Embase, Scopus, and Web of Science for studies published until February 3, 2025. Random-effects models were applied to calculate pooled prevalence, while subgroup analyses assessed variations by geographic region, diagnostic tool, and study setting. Heterogeneity was quantified using I² statistics. Publication bias was evaluated using funnel plots and Egger’s regression, with trim-and-fill analysis performed when bias was detected. Meta-regression examined the impact of covariates such as sample size, mean age, diabetes duration, hypertension, and urban residence.

RESULTS: A total of 59 studies with 24,073 participants were included. The pooled prevalence of depression among T2DM patients was 38% (95% CI: 33–42%), derived using a random-effects model to account for the substantial heterogeneity observed across studies (I² = 98.28%). This estimate reflects a statistical synthesis across studies with widely varying diagnostic tools, cutoff thresholds, and clinical settings, and should be interpreted as an approximation of the burden rather than a precise national prevalence figure. Mild, moderate, and severe depression accounted for 24%, 14%, and 14% of cases respectively. Regional variation was observed, with Western India showing the highest prevalence (48%) and multicenter studies the lowest (27%). Prevalence differed by diagnostic tool: CIDI-SF (20%), PHQ-9 (34%), and BDI (72% with lenient cutoffs). Hospital-based studies reported higher prevalence (42%) compared to community-based ones (28%). Females had a greater burden (39%) than males (31%). No significant differences were found between pre- and post-COVID-19 studies. Sensitivity analyses confirmed robustness of estimates. Meta-regression identified diabetes duration as a significant predictor (p = 0.026).

CONCLUSION: Nearly two in five Indian T2DM patients experience depression, emphasizing the urgent need for standardized screening and integration of mental health care into India’s National Program for Non-Communicable Diseases.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13098-026-02160-w.

RevDate: 2026-06-12

Michas G, Trikas G, A Trikas (2026)

Cardiovascular Risk Factors in Greece: Looking Beyond the Classics. A narrative review.

Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese pii:S1109-9666(26)00120-X [Epub ahead of print].

Cardiovascular disease is the leading cause of death in Greece, despite substantial reductions in age-standardized mortality over recent decades. These improvements have been largely confined to older populations, while the burden of cardiometabolic risk remains high. The Greek cardiovascular landscape has also evolved under the combined influence of population aging, the COVID-19 pandemic, persistent socioeconomic pressures, and increasingly stringent European Society of Cardiology targets for lipid and blood pressure control. Traditional determinants, particularly dyslipidemia, hypertension, diabetes, obesity, unhealthy dietary patterns, smoking, and physical inactivity, remain prevalent and frequently suboptimally controlled. Against this background, residual risk and emerging determinants of disease are increasingly recognized as clinically relevant contributors to cardiovascular burden. This narrative review summarizes recent evidence on the role of non-traditional risk factors in the Greek population, including lipoprotein(a), inflammation, metabolic dysfunction-associated steatotic liver disease, chronic kidney disease, chronic obstructive pulmonary disease, sleep disturbances, infections and vaccination, environmental exposures, mental health, and social determinants of health. Overall, the available evidence supports a broader cardiovascular prevention framework that extends beyond conventional risk-factor assessment. Integrating selected non-traditional determinants into clinical practice and prevention policy may improve risk stratification, support individualized care, and help address the evolving cardiovascular burden in Greece.

RevDate: 2026-06-12
CmpDate: 2020-07-13

Galván Casas C, Català A, Carretero Hernández G, et al (2020)

Classification of the cutaneous manifestations of COVID-19: a rapid prospective nationwide consensus study in Spain with 375 cases.

The British journal of dermatology, 183(1):71-77.

BACKGROUND: The cutaneous manifestations of COVID-19 disease are poorly characterized.

OBJECTIVES: To describe the cutaneous manifestations of COVID-19 disease and to relate them to other clinical findings.

METHODS: We carried out a nationwide case collection survey of images and clinical data. Using a consensus we described five clinical patterns. We later described the association of these patterns with patient demographics, the timing in relation to symptoms of the disease, the severity and the prognosis.

RESULTS: The lesions may be classified as acral areas of erythema with vesicles or pustules (pseudo-chilblain) (19%), other vesicular eruptions (9%), urticarial lesions (19%), maculopapular eruptions (47%) and livedo or necrosis (6%). Vesicular eruptions appear early in the course of the disease (15% before other symptoms). The pseudo-chilblain pattern frequently appears late in the evolution of the COVID-19 disease (59% after other symptoms), while the rest tend to appear with other symptoms of COVID-19. The severity of COVID-19 shows a gradient from less severe disease in acral lesions to more severe in the latter groups. The results are similar for confirmed and suspected cases, in terms of both clinical and epidemiological findings. Alternative diagnoses are discussed but seem unlikely for the most specific patterns (pseudo-chilblain and vesicular).

CONCLUSIONS: We provide a description of the cutaneous manifestations associated with COVID-19 infection. These may help clinicians approach patients with the disease and recognize cases presenting with few symptoms. What is already known about this topic? Previous descriptions of cutaneous manifestations of COVID-19 were case reports and mostly lacked illustrations. What does this study add? We describe a large, representative sample of patients with unexplained skin manifestations and a diagnosis of COVID-19, using a consensus method to define morphological patterns associated with COVID-19. We describe five clinical patterns associated with different patient demographics, timing and prognosis, and provide illustrations of these patterns to allow for easy recognition.

RevDate: 2026-06-12
CmpDate: 2020-08-11

Jiménez-Rodríguez D, Ruiz-Salvador D, Rodríguez Salvador MDM, et al (2020)

Consensus on Criteria for Good Practices in Video Consultation: A Delphi Study.

International journal of environmental research and public health, 17(15):.

The use of telemedicine has greatly increased, largely derived from the COVID-19 pandemic, which has created the need for a guide aimed towards the adequate management of a modality of health care: the video consultation. A Delphi study composed of three rounds was conducted with 16 experts in holding video consultations and managing non-technical skills from different specialties and nationalities to conceive a consensus on the criteria needed for properly managing video consultations by healthcare professionals. The consensus criteria were defined by three dimensions (preparation of video consultation, video consultation process, and post-video consultation) and their corresponding items. Excellent consensus data was obtained; therefore, use is recommended by any healthcare professional who is going to utilize a video consultation, in order to manage it effectively.

RevDate: 2026-06-12
CmpDate: 2021-03-08

Cakir OO, Castiglione F, Tandogdu Z, et al (2021)

Management of penile cancer patients during the COVID-19 pandemic: An eUROGEN accelerated Delphi consensus study.

Urologic oncology, 39(3):197.e9-197.e17.

OBJECTIVES: To develop an international consensus on managing penile cancer patients during the COVID-19 acute waves. A major concern for patients with penile cancer during the coronavirus disease 2019 (COVID-19) pandemic is how the enforced safety measures will affect their disease management. Delays in diagnosis and treatment initiation may have an impact on the extent of the primary lesion as well as the cancer-specific survival because of the development and progression of inguinal lymph node metastases.

MATERIALS AND METHODS: A review of the COVID-19 literature was conducted in conjunction with analysis of current international guidelines on the management of penile cancer. Results were presented to an international panel of experts on penile cancer and infection control by a virtual accelerated Delphi process using 4 survey rounds. Consensus opinion was defined as an agreement of ≥80%, which was used to reconfigure management pathways for penile cancer.

RESULTS: Limited evidence is available for delaying penile cancer management. The consensus rate of agreement was 100% that penile cancer pathways should be reconfigured, and measures should be developed to prevent perioperative nosocomial transmission of COVID-19. The panel also reached a consensus on several statements aimed at reconfiguring the management of penile cancer patients during the COVID-19 pandemic.

CONCLUSIONS: The international consensus panel proposed a framework for the diagnostic and invasive therapeutic procedures for penile cancer within a low-risk environment for COVID-19.

RevDate: 2026-06-12
CmpDate: 2022-02-11

Gallo G, Picciariello A, Di Tanna GL, et al (2022)

E-consensus on telemedicine in colorectal surgery: a RAND/UCLA-modified study.

Updates in surgery, 74(1):163-170.

Coronavirus disease 2019 (COVID-19) is revolutionizing healthcare delivery. The aim of the study was to reach consensus among experts on the possible applications of telemedicine in colorectal surgery. A group of 48 clinical practice recommendations (CPRs) was developed by a clinical guidance group based on coalescence of evidence and expert opinion. The Telemedicine in Colorectal Surgery Italian Working Group included 54 colorectal surgeons affiliated to the Italian Society of Colo-Rectal Surgery (SICCR) who were involved in the evaluation of the appropriateness of each CPR, based on published RAND/UCLA methodology, in two rounds. Stakeholders' median age was 44.5 (IQR 36-60) years, and 44 (81%) were males. Agreement was obtained on the applicability of telemonitoring and telemedicine for multidisciplinary pre-operative evaluation. The panel voted against the use of telemedicine for a first consultation. 15/48 statements deemed uncertain on round 1 and were re-elaborated and assessed by 51/54 (94%) panelists on round 2. Consensus was achieved in all but one statement concerning the cost of a teleconsultation. There was strong agreement on the usefulness of teleconsultation during follow-up of patients with diverticular disease after an in-person visit. This e-consensus provides the boundaries of telemedicine in colorectal surgery in Italy. Standardization of infrastructures and costs remains to be better elucidated.

RevDate: 2026-06-12
CmpDate: 2021-11-10

Makivić I, Švab V, РSelak (2021)

Mental Health Needs Assessment During the COVID-19 Pandemic: Consensus Based on Delphi Study.

Frontiers in public health, 9:732539.

The COVID-19 pandemic has revealed significant gaps in mental health in terms of unrecognized and unmet needs. The goal was to accurately assess the needs and identify gaps in this area during the epidemiological crisis. A Delphi study to identify the needs was conducted with a group of decision-makers, experts, and users of mental health services. A starting point of the Delphi study was prepared in two working groups, based on recognizable international recommendations and experiences of the practitioners from the field situation. This initial set of emergency measures was supplemented through the first Delphi round, and consensus about the importance was reached in the second round. A total of 41 activities were derived, the vast majority of which were rated with a score of 4 or more. Mental health activities, which should be addressed in terms of needs, can be divided into systemic measures and service measures. This study recognizes a need to reorganize services in the direction of improving local accessibility and strengthening the network of services for immediate responses to the psychological, health, and social needs of individuals, including those arising from crisis situations, such as COVID-19 pandemic. The results of this study are in line with the international recommendations and also influenced the formulation of the Action Plan of the National Mental Health Program, while some of the measures were already implemented during the publication of the research results.

RevDate: 2026-06-12
CmpDate: 2021-12-30

Cascella M, Miceli L, Cutugno F, et al (2021)

A Delphi Consensus Approach for the Management of Chronic Pain during and after the COVID-19 Era.

International journal of environmental research and public health, 18(24):.

Due to a lack of published evidence on the topic, a modified Delphi approach was used to develop recommendations useful for chronic pain management during and after the COVID-19 pandemic. Focusing on the available literature and personal clinical expertise, an Italian board of nine professionals from different disciplines identified four main topics: prevention of chronic pain, treatment of chronic pain, consequences of inadequate treatment, and perspectives. They elaborated a semi-structured questionnaire. A multidisciplinary panel of experts in the field of pain management was requested to comment on the statements. Based on the answers provided, a structured questionnaire was prepared (Round 1). It included 21 statements divided into three categories (organizational issues; diagnosis and therapies; telemedicine and future perspectives). A five-point Likert scale was adopted. The threshold for consensus was set at a minimum of 70% of the number of respondents (level of agreement ≥ 4, Agree or Strongly Agree). A final questionnaire with rephrasing of the statements that did not reach the consensus threshold was elaborated (Round 2). A total of 29 clinicians were included in the panel. Twenty clinicians (69%) responded in both the first and second round. After two rounds, consensus (≥70%) was achieved in 20 out of 21 statements. The lack of consensus was recorded for the statement regarding the management of post-COVID pain (55%; Median 4; IQR 2.3). Another statement on telemedicine reached the threshold in the first round (70%), but the value was not confirmed in Round 2 (65%; Median 4; IQR 2). Most of the proposed items reached consensus, suggesting the need to make organizational changes, the structuring of careful diagnostic and therapeutic pathways, and the application of new technologies in pain medicine. Long-COVID-19 care is an issue that needs further research. Remote assistance for chronic pain must be regulated.

RevDate: 2026-06-12
CmpDate: 2022-03-21

Marino LV, Collaço NC, Ashton JJ, et al (2022)

Pedi-R-MAPP: The development of a nutritional awareness tool for use in remote paediatric consultations using a modified Delphi consensus.

Clinical nutrition (Edinburgh, Scotland), 41(3):661-672.

BACKGROUND & AIMS: The Remote Malnutrition Application (R-MAPP) was developed during the COVID-19 pandemic to provide support for health care professionals (HCPs) working in the community to complete remote nutritional assessments, and provide practical guidance for nutritional care. The aim of this study was to modify the R-MAPP into a version suitable for children, Pediatric Remote Malnutrition Application (Pedi-R-MAPP), and provide a structured approach to completing a nutrition focused assessment as part of a technology enabled care service (TECS) consultation.

METHODS: A ten-step process was completed: 1) permission to modify adult R-MAPP, 2) literature search to inform the Pedi-R-MAPP content, 3) Pedi-R-MAPP draft, 4) international survey of HCP practice using TECS, 5) nutrition experts invited to participate in a modified Delphi process, 6) first stakeholder meeting to agree purpose/draft of the tool, 7) round-one online survey, 8) statements with consensus removed from survey, 9) round-two online survey for statements with no consensus and 10) second stakeholder meeting with finalisation of the Pedi-R-MAPP nutrition awareness tool.

RESULTS: The international survey completed by 463 HCPs, 55% paediatricians, 38% dietitians, 7% nurses/others. When HCPs were asked to look back over the last 12 months, dietitians (n = 110) reported that 5.7 ± 10.6 out of every 10 appointments were completed in person; compared to paediatricians (n = 182) who reported 7.5 ± 7.0 out of every 10 appointments to be in person (p < 0.0001), with the remainder completed as TECS consultations. Overall, 74 articles were identified and used to develop the Pedi-R-MAPP which included colour-coded advice using a traffic light system; green, amber, red and purple. Eighteen participants agreed to participate in the Delphi consensus and completed both rounds of the modified Delphi survey. Agreement was reached at the first meeting on the purpose and draft sections of the proposed tool. In round-one of the online survey, 86% (n = 89/104) of statements reached consensus, whereas in round-two 12.5% (n = 13/104) of statements reached no consensus. At the second expert meeting, contested statements were discussed until agreement was reached and the Pedi-R-MAPP could be finalised.

CONCLUSION: The Pedi-R-MAPP nutrition awareness tool was developed using a modified Delphi consensus. This tool aims to support the technological transformation fast-tracked by the COVID-19 pandemic by providing a structured approach to completing a remote nutrition focused assessment, as well as identifying the frequency of follow up along with those children who may require in-person assessment.

RevDate: 2026-06-12
CmpDate: 2022-09-28

Pérez-Torres A, Caverni Muñoz A, Lou Arnal LM, et al (2021)

Multidisciplinary nutritional consensus on assessment and nutritional dietary treatment in patients with chronic kidney disease and SARS-CoV-2 infection.

Nefrologia, 41(4):453-460.

The presence of malnutrition in patients with Chronic Kidney Disease (CKD) is high, it can be made worse by SARS-CoV2 infection. The nutritional assessment should be adapted to minimize the infection, recommending monitoring: weight loss percentage, body mass index (BMI), loss of appetite, analytical parameters and functional capacity using the dynamometer. As well as the sarcopenia assessment using the SCARF scale, and the possibility of using the GLIM criteria in those patients who have been tested positive by MUST. It is important to adapt the nutritional recommendations in the caloric and protein intake, to the CKD stage and to the SARS-CoV2 infection stage. In patients with hypercatabolism, to prioritize preserving the nutritional status (35 kcal/kg weight/day, proteins up to 1.5 g/kg/day). The rest of the nutrients will be adapted to CKD stage and the analytical values. In the post-infection stage, a complete nutritional assessment is recommended, including sarcopenia. The energy and protein requirements in this phase will be adapted to the nutritional status, with special attention to the loss of muscle mass. Dietary recommendations need to be tailored to side effects of SARS-CoV-2 infection: anorexia, dysphagia, dysgeusia, and diarrhea. Anorexia and hypercatabolism makes it difficult to meet the requirements through diet, therefore the use of oral nutritional supplements is recommended as well as the enteral or parenteral nutrition in severe phases.

RevDate: 2026-06-12
CmpDate: 2023-02-03

Goya S, Sosa E, Nabaes Jodar M, et al (2023)

Assessing the hidden diversity underlying consensus sequences of SARS-CoV-2 using VICOS, a novel bioinformatic pipeline for identification of mixed viral populations.

Virus research, 325:199035.

INTRODUCTION: Coinfection with two SARS-CoV-2 viruses is still a very understudied phenomenon. Although next generation sequencing methods are very sensitive to detect heterogeneous viral populations in a sample, there is no standardized method for their characterization, so their clinical and epidemiological importance is unknown.

MATERIAL AND METHODS: We developed VICOS (Viral COinfection Surveillance), a new bioinformatic algorithm for variant calling, filtering and statistical analysis to identify samples suspected of being mixed SARS-CoV-2 populations from a large dataset in the framework of a community genomic surveillance. VICOS was used to detect SARS-CoV-2 coinfections in a dataset of 1,097 complete genomes collected between March 2020 and August 2021 in Argentina.

RESULTS: We detected 23 cases (2%) of SARS-CoV-2 coinfections. Detailed study of VICOS's results together with additional phylogenetic analysis revealed 3 cases of coinfections by two viruses of the same lineage, 2 cases by viruses of different genetic lineages, 13 were compatible with both coinfection and intra-host evolution, and 5 cases were likely a product of laboratory contamination.

DISCUSSION: Intra-sample viral diversity provides important information to understand the transmission dynamics of SARS-CoV-2. Advanced bioinformatics tools, such as VICOS, are a necessary resource to help unveil the hidden diversity of SARS-CoV-2.

RevDate: 2026-06-12
CmpDate: 2023-02-08

Killough N, Patterson L, The Covid-Genomics Uk Cog-Uk Consortium , et al (2023)

How public health authorities can use pathogen genomics in health protection practice: a consensus-building Delphi study conducted in the United Kingdom.

Microbial genomics, 9(2):.

Pathogen sequencing guided understanding of SARS-CoV-2 evolution during the COVID-19 pandemic. Many health systems developed pathogen genomics services to monitor SARS-CoV-2. There are no agreed guidelines about how pathogen genomic information should be used in public health practice. We undertook a modified Delphi study in three rounds to develop expert consensus statements about how genomic information should be used. Our aim was to inform health protection policy, planning and practice. Participants were from organisations that produced or used pathogen genomics information in the United Kingdom. The first round posed questions derived from a rapid literature review. Responses informed statements for the subsequent rounds. Consensus was accepted when 70 % or more of the responses were strongly agree/agree, or 70 % were disagree/strongly disagree on the five-point Likert scale. Consensus was achieved in 26 (96 %) of 27 statements. We grouped the statements into six categories: monitoring the emergence of new variants; understanding the epidemiological context of genomic data; using genomic data in outbreak risk assessment and risk management; prioritising the use of limited sequencing capacity; sequencing service performance; and sequencing service capability. The expert consensus statements will help guide public health authorities and policymakers to integrate pathogen genomics in health protection practice.

RevDate: 2026-06-12
CmpDate: 2023-08-14

Fox L, Santaolalla A, Handford J, et al (2023)

Redefining Cancer Research Priorities in Low- and Middle-Income Countries in the Post-COVID-19 Global Context: A Modified Delphi Consensus Process.

JCO global oncology, 9:e2300111.

PURPOSE: The post-COVID-19 funding landscape for cancer research globally has become increasingly challenging, particularly in resource-challenged regions (RCRs) lacking strong research ecosystems. We aimed to produce a list of priority areas for cancer research in countries with limited resources, informed by researchers and patients.

METHODS: Cancer experts in lower-resource health care systems (as defined by the World Bank as low- and middle-income countries; N = 151) were contacted to participate in a modified consensus-seeking Delphi survey, comprising two rounds. In round 1, participants (n = 69) rated predetermined areas of potential research priority (ARPs) for importance and suggested missing ARPs. In round 2, the same participants (n = 49) rated an integrated list of predetermined and suggested ARPs from round 1, then undertook a forced choice priority ranking exercise. Composite voting scores (T-scores) were used to rank the ARPs. Importance ratings were summarized descriptively. Findings were discussed with international patient advocacy organization representatives.

RESULTS: The top ARP was research into strategies adapting guidelines or treatment strategies in line with available resources (particularly systemic therapy) (T = 83). Others included cancer registries (T = 62); prevention (T = 52); end-of-life care (T = 53); and value-based and affordable care (T = 51). The top COVID-19/cancer ARP was strategies to incorporate what has been learned during the pandemic that can be maintained posteriorly (T = 36). Others included treatment schedule interruption (T = 24); cost-effective reduction of COVID-19 morbidity/mortality (T = 19); and pandemic preparedness (T = 18).

CONCLUSION: Areas of strategic priority favored by cancer researchers in RCRs are related to adaptive treatment guidelines; sustainable implementation of cancer registries; prevention strategies; value-based and affordable cancer care; investments in research capacity building; epidemiologic work on local risk factors for cancer; and combatting inequities of prevention and care access.

RevDate: 2026-06-12
CmpDate: 2024-10-19

Delaney KR, Gomes M, Browne NT, et al (2024)

The mental and behavioral health crisis in youth: Strategic solutions post COVID-19 pandemic: An American Academy of Nursing consensus paper.

Nursing outlook, 72(5):102177.

The COVID-19 pandemic wrought significant negative impacts on youth well-being, particularly among Black, Hispanic, American Indian, Alaska Native, and LGBTQ+ (Lesbian, gay, bisexual, transgender, queer or questioning) youth. The pandemic disrupted connections to family, school, and community, which are essential supports for youth mental health. Lessons learned from the pandemic suggest the role of stress and windows of opportunity to build resiliency. Drawing from a policy dialog on the youth mental health crisis conducted by 4 American Academy of Nursing Expert Panels, we present approaches to the current increase in youth mental health problems. Included is emerging literature on building youth resilience, particularly via re-establishing school and community connections. The role of families, schools, and community support is emphasized, particularly by creating a healing school environment and the pivotal role of school nurses. Recommendations include increased support for families, engaging the school nurse role, and developing school-based innovative programs to build connections and youth wellness.

RevDate: 2026-06-12
CmpDate: 2024-10-01

Holt G, D Hughes (2024)

Consensus study on UK weight management services' response to COVID-19: best practices in outpatient management, governance and digital solutions.

Journal of human nutrition and dietetics : the official journal of the British Dietetic Association, 37(5):1255-1264.

BACKGROUND: The COVID-19 pandemic put unprecedented pressure on weight management services. These services were required to adapt to continue to provide care for people living with obesity. This study sought to develop consensus recommendations on the best practice solutions adopted by weight management services in the United Kingdom during the COVID-19 pandemic.

METHODS: This study utilised a semi-structured interview and a modified Delphi methodology to develop a consensus of best practice recommendations identified by specialist weight management services during the pandemic.

RESULTS: Twenty-three healthcare professionals working in weight management service across the United Kingdom participated in the study. Analysis of interview transcripts identified four key thematic domains: outpatient, patient education and support, perioperative care and team working. Of the initial 43 unique recommendations, 30 reached consensus agreement. Outpatient recommendations focused on communication strategies, patient self-monitoring and remote patient tracking. Patient education and support recommendations addressed the development of online educational resources and support groups. Perioperative care recommendations emphasised case prioritisation, waiting list support and postoperative care. Team working recommendations targeted the use of digital collaboration tools and strategies for effective teamwork.

CONCLUSION: Developing consensus recommendations on best practice is a critical step for weight management and outpatient services to achieve higher standards of care. These recommendations provide a springboard for departmental discussions, paving the way for improved experiences for individuals living with obesity as they progress along their weight management journey.

RevDate: 2026-06-12
CmpDate: 2024-11-08

Hoelscher SH, McBride S, Bumpus S, et al (2024)

A Study to Determine Consensus for Nursing Documentation Reduction in Times of Crisis.

Computers, informatics, nursing : CIN, 42(10):712-721.

Nurses faced numerous challenges during the pandemic, particularly with the increased burden of electronic documentation. Surges in patient volume and visits led to rapid changes in nursing documentation, prompting diverse responses from regulatory and healthcare organizations. Nurses expressed safety concerns and struggled with changes, calling for national standards and regulatory support. Policy relaxations, such as the 1135 Waiver, sparked debate on the future of nursing care plan documentation. Using mixed-methods exploratory design, the study identified modifications of nursing documentation during crises, commonalities in documentation burden reduction for applicability beyond pandemics, and consensus on the definition of "surge." Documentation patterns were assessed from February to November 2022, involving 175 North American nurse leaders and informaticists. Data analysis included descriptive statistics, thematic analysis, and Pearson correlation coefficient. Significant differences were found between rural and urban settings (P = .02), with urban areas showing higher odds of changes to care plans (odds ratio, 4.889; 95% confidence interval, 1.27-18.78). Key findings highlighted the persistence of postcrisis documentation changes and varied definitions of surge criteria based on organizational leadership, policy, and mandates. The study yielded insights for modifying documentation, offering policy recommendations, and emphasizing ongoing collaboration and evidence-based approaches for future nursing practices.

RevDate: 2026-06-12
CmpDate: 2026-06-12

Mishra G, Rathee S, Garg M, et al (2026)

mRNA Vaccines: Unlocking Potential, Exploring Applications, and Envisioning Future Horizons.

Current drug delivery, 23(3):351-372.

In recent years, there have been notable strides in developing mRNA vaccines, resulting in the creation of potent immunizations against diverse diseases. This review examines the most recent advancements in this field, focusing on their implications for future vaccine development. The pursuit of heightened vaccine efficacy is investigated through cutting-edge methods in adjuvant selection, delivery system optimization, and antigen selection. The review also explores the potential for personalized vaccines based on genetic profiles, along with the latest techniques to ensure vaccine stability and extend shelf life. Highlighting the versatility of mRNA vaccines in addressing emerging infectious diseases and their variations, the review underscores the significance of swift response plans and advanced technologies to counter evolving viral mutations. In summary, this in-depth analysis emphasizes how mRNA vaccines hold transformative potential in reshaping both therapeutic and preventive strategies. Notable achievements include the creation of extremely potent mRNA vaccinations against the SARS-CoV-2 virus, resulting in the COVID-19 pandemic. Ongoing efforts to address challenges like long-term immune protection and increase the effectiveness and stability of mRNA vaccines are also discussed. This review's main goal is to provide a thorough summary of current advancements in mRNA vaccine technology while exploring how these advances may impact future approaches to treating and preventing different diseases.

RevDate: 2026-06-12
CmpDate: 2026-06-12

Prabha T, Thangavelu S, Parameswaran D, et al (2026)

Virtual Screening Approaches Towards the Discovery of Toll-like Receptor 7 (TLR7) Antagonists for the Management of Rheumatoid Arthritis During COVID Infection.

Current rheumatology reviews, 22(2):1-14.

BACKGROUND: Rheumatoid arthritis(RA) patients prompt to have high level of TLR7, when coronavirus (CoV-2) infect to these patients, further the level of TLR7 cloud be upregulated and leads to severe condition of RA. Since, some TLR7 antagonists targeting the TLR7 protein are in the clinical trials, but yet to reach the market, and many lead to serious toxicities.

OBJECTIVE: So, we have framed a hypothesis to discover the TLR7 antagonist that may inhibit to the upregulation of TLR 7 in RA patients during the CoV-2 infection via virtual screening methodology.

METHODS: Here we have focused to discover some novel TLR7 inhibitors from the ZINC database, which may effectively inhibit TLR7. Series of virtual screening analysis lead to the discovery of three active hits.

RESULTS AND DISCUSSION: Among these three molecules, ZINC95412580 had a highest binding energy of -15.4273 kcal/mol against the TLR7 protein (PDB Id: 6LW1) that also showed the maximum interactions within the binding pocket. c Conclusion: Thus, the compounds discovered through the use of various software can possibly be used for the management of rheumatoid arthritis during and after COVID infection. Hence, we can conclude that these molecules might be served as the inhibitors of TLR7 upregulation.

RevDate: 2026-06-12
CmpDate: 2025-06-25

Alves NS, Silva END, Melo GBT, et al (2025)

Agenda for COVID-19 and long COVID research priorities in Brazil: results of wide consultation and Delphi consensus, 2022-2023.

Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil, 34:e20240623.

OBJECTIVE: To propose an agenda of COVID-19 and long COVID research priorities, in order to guide government and research funding agencies to optimize health science, technology and innovation resources in Brazil.

METHODS: This is a qualitative study, carried out in two stages, between April 2022 and March 2023. In the first stage, a broad consultation was carried out to identify research priorities according to the axes of the COVID-19 Evidence Network to support Decision-making initiative, with 71 participants including researchers, health service managers, health science and technology managers, health professionals and health service users. In the second stage, a consensus was reached on the priorities proposed in the previous stage, using the Delphi method, with a panel of 20 experts on COVID-19 in the first round and 18 in the second round.

RESULTS: In the broad consultation, 186 priority lines of research on COVID-19 were received and consolidated into 161 research lines. Of these, 139 achieved consensus in the first round of the Delphi method, and a further 40 lines were received and included in the second round for consensus. The proposed agenda has 179 research lines on COVID-19. The predominant themes were evaluation, COVID-19 impact and sequelae, long COVID-19, mental illnesses and immunosuppression. The child population was of greatest interest.

CONCLUSIONS: This study demonstrated high levels of agreement among participants on COVID-19 and long COVID research priorities in Brazil.

RevDate: 2026-06-12
CmpDate: 2025-10-02

Lee J, Cowling J, Smith ME, et al (2025)

CAMERA: A Consensus Study to Ascertain Minimum Datasets for Ear Remote Assessments.

Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery, 50(6):1002-1010.

INTRODUCTION: Remote healthcare has demonstrated benefits in providing high quality care, improving patient access, and reducing morbidity. In ear, nose, and throat surgery, there has been a recent surge in remote care driven by advancements including endoscopic otoscopy and boothless audiometry, as well as the coronavirus pandemic, but uncertainty exists regarding the minimum data needed for accurate remote diagnosis.

METHODS: A panel of otology, audiology, general practice, and audiovestibular physicians was invited, and a literature review was undertaken to populate candidate dataset items for Round 1 of the Delphi process using the web-based software, Welphi. This was followed by two further Rounds, with controlled anonymised item-rating and qualitative feedback between rounds. Finally, a consensus meeting analysed and organised the results for dissemination of the final consensus outcomes.

RESULTS: Seventy studies were used to populate the questionnaire in Round 1. Thirty-four multi-disciplinary expert panellists determined the final data items across the 3 Delphi Rounds. Experts worked at over 16 different centres across the United Kingdom. There was an average response rate of 94% across all rounds.

DISCUSSION: This study highlights a multidisciplinary team's consensus essential dataset for effective remote ear assessment. With NHS waiting lists at an all-time high, remote assessment capacity could alleviate strain and enhance patient care. This initiative will facilitate novel service and pathway redesign with the aim of ensuring all patients have access to high-quality ear assessments, regardless of location. We are also hopeful that this standardised dataset will also facilitate research and audit of remote ear services.

RevDate: 2026-06-12
CmpDate: 2026-06-12

Nori W, Hussein ZA, Hamed RM, et al (2026)

Bridging Gaps in Long COVID Therapy: A Review.

Current medicinal chemistry, 33(10):1918-1940.

INTRODUCTION: Long COVID-19 (LC) is a condition that follows SARS-CoV- -2, an acute infection defined by persistent fatigue, dyspnea, and impaired cognitive function. LC presents a complex array that imposes ongoing challenges on global health, patients' quality of life, and functional capacity. Many inconsistencies surround its pathophysiology, diagnosis, prevention, and treatment. This review aims to cover missed gaps in LC with a special focus on therapeutic strategies concerning non-pharmacological, pharmacological, experimental, and innovative approaches for better patient management and outcomes, as well as to evaluate their effectiveness and guide future research.

METHODS: An online search was conducted using five digital repositories: PubMed, Scopus, Google Scholar, Web of Science, and the Cochrane Library. A combination of keywords associated with LC therapy was employed: "long COVID, "pharmacological options," "non-pharmacological options," "innovative strategies," "experimental", and" quality of life (QOL)." Relevant data were extracted and synthesized to categorize therapeutic approaches into subtypes. A critical analysis was conducted on their mechanism of action, indication, outcome, and limitations.

RESULTS: The pooled prevalence of LC was 42%, and the symptom duration ranged from 3 months to 2 years. The most important risk factors for LC were female sex, unvaccinated status, and cases with co-morbidities. Diagnosis of LC was challenging due to a lack of diagnostic standardization and reliable biomarkers.

DISCUSSION: Non-pharmacological strategies were employed first, showing diverse efficacies; however, the reported literature was hindered by small sampling. Pharmacological agents show promising results but need further validation. Experimental and innovative strategies need longer studies and validations.

CONCLUSION: LC has imposed a significant burden on community health, necessitating the appropriate allocation of health resources and community support. Preventive and therapeutic interventions show promise, but the variability in patient response underscores the need for personalized approaches and more well-designed trials. Collaborative research and multi-disciplinary teams are needed to mitigate the long-term effects of LC and improve patient outcomes.

RevDate: 2026-06-12
CmpDate: 2026-01-05

Parodi JF, Runzer-Colmenares FM, Cano-Gutiérrez C, et al (2025)

Developing a Latin American Delphi Consensus on Vaccination for Respiratory Diseases in Older Adults.

Annals of geriatric medicine and research, 29(4):440-449.

BACKGROUND: Respiratory infections significantly impact older adults in Latin America, highlighting the need for regionally adapted consensus-based vaccination recommendations to guide preventive strategies. This study aimed to develop a consensus among Latin American experts on vaccination against respiratory diseases in older adults in the region, including influenza, Streptococcus pneumoniae pneumonia, coronavirus disease 2019 (COVID-19), respiratory syncytial virus (RSV), and pertussis.

METHODS: A two-round Delphi methodology was employed, involving 35 specialists from various medical fields. A rapid evidence review was conducted using scientific databases and clinical practice guideline repositories. Participants evaluated each recommendation on a 1-to-5 scale; recommendations with 80% acceptance (score of 4 or higher) were approved.

RESULTS: The consensus resulted in recommendations for administering Tdap (tetanus, diphtheria, and pertussis) boosters every 10 years for pertussis and annual influenza vaccination in adults aged 65 years or older, using high-dose or adjuvanted formulations. Additionally, primary and annual booster COVID-19 vaccinations were recommended, along with a single dose of RSV vaccine for individuals aged 75 years and older, providing protection for at least two winter seasons. Routine administration of pneumococcal conjugate vaccine 15 (PCV15) or PCV20 was also recommended for adults aged 65 years or older who had not previously received a PCV.

CONCLUSIONS: The consensus provides a vaccination guide tailored to the Latin American context, aiming to bridge gaps in vaccination coverage among older adults in the region. This effort seeks to reduce the burden of respiratory diseases on frail healthcare systems and promote healthy aging in Latin America.

RevDate: 2026-06-12
CmpDate: 2025-10-13

Schlak A, Seidel I, Awan O, et al (2025)

Reaching Consensus on Long COVID Symptoms and Patient-Reported Outcomes Across the Veterans Health Administration Using a Modified Hybrid Nominal Group-Delphi Approach.

Medical care, 63(11):842-850.

BACKGROUND: A consistent approach to track Long COVID symptoms at the Veterans Health Administration (VHA) was lacking.

OBJECTIVES: To reach consensus among clinical stakeholders on how long COVID symptoms should be assessed at VHA outpatient visits and recommend an assessment battery.

RESEARCH DESIGN: Hybrid Delphi-Nominal Group approach.

SUBJECTS: Members of the VHA Long COVID Field Advisory Board (FAB) and the VHA Long COVID Community of Practice (CoP) participated. Veteran stakeholders provided input.

MEASURES: A literature review and clinician questionnaires identified 68 instruments across 14 symptom domains. In the first consensus round, FAB members excluded instruments with limited clinical usability. The remaining 25 instruments were ranked by CoP members. Multiple rounds of asynchronous voting were conducted until one instrument remained per domain. The top instruments were grouped into 3 batteries. Final consensus on a preferred battery was reached through additional voting. Veterans from the Los Angeles Veteran Engagement Panel assessed clarity, burden, and feasibility.

RESULTS: The final battery included the Modified Yorkshire COVID-19 Rehabilitation Survey, VHA Whole Health Well-Being Signs, the Exercise Vital Signs Questionnaire, and the 2-Minute Step Test. Whole Health questions were also included to support the VHA's Whole Health System mission. Symptom-specific instruments already used in VHA routine care were not included in the final battery, as clinics already had access to them.

CONCLUSIONS: A structured, rapid consensus process was used to identify a battery of symptom instruments to standardize Long COVID symptom assessment across VHA clinics.

RevDate: 2026-06-12
CmpDate: 2025-12-03

Mazurik K, Amah A, Dumitrescu DI, et al (2025)

Developing a minimum dataset for a national patient registry on Long COVID in Canada: a Delphi consensus-based study.

BMJ open, 15(12):e111474.

OBJECTIVES: To develop survey items for a national patient registry on Long COVID using a modified Delphi process.

DESIGN: This study was based on a modified Delphi process involving three rounds of anonymous, online surveys to develop consensus on and prioritise survey elements to be included in a minimum dataset for use in a national patient registry in Canada. Initial Long COVID items were identified through an environmental scan of the literature.

SETTING: This study focused on healthcare systems in Canada and was conducted online.

PARTICIPANTS: A panel of 52 experts (patients, caregivers, clinicians and researchers) participated in all three rounds of the online survey. These participants were recruited through the Long COVID Web network and word of mouth.

RESULTS: In total, 243 survey elements related to care, quality of life and symptoms were included in round 1 of the survey. 200 reached consensus and moved to round 2 with two additional elements being developed based on open-ended responses. In round 2, participants ranked these survey elements and 34 advanced. In round 3, 33 survey elements met the threshold of consensus with one added a priori. The 33 survey elements were then used to develop a Long COVID minimum dataset, which consists of 48 items.

CONCLUSIONS: The findings affirm broad consensus for collecting data related to fatigue, post-exertional malaise, cardiovascular issues, respiratory problems and cognitive issues. This highlighted the desire for quality-of-life indicators and information related to care utilisation, quality and access.

RevDate: 2026-06-12
CmpDate: 2026-02-13

Le Bui N, Nguyen KL, Phan Van B, et al (2026)

Cell-free systems for vaccine production.

Progress in molecular biology and translational science, 219:93-106.

Cell-free (CF) systems is harness cellular components including tRNAs, ribosomes, and polymerase to synthesize proteins in vitro. Owing to their significant CF systems offer substantial advantages over traditional cell-based systems, including higher speed, biosafety, and portability. As a result, CF systems have emerged as a powerful platform for biomedical research, with particularly promising applications in biosensing and diagnostics, protein production, synthetic biology and vaccine development. In this chapter, we provided a comprehensive overview of CF system applications in the field of biomedical sciences, with an emphasis on vaccine development and production. We also discussed their successful applications in the expression of antigens from challenging pathogens, such as Plasmodium falciparum, Chlamydia muridarum, and SARS-CoV-2. Moreover, this chapter proposed several promising innovations to address current limitations of CF platforms such as the shortage of post-translational modifications, endotoxin presence, and high production cost. Emerging solutions include glycoengineering to introduce functional glycosylation, freeze-drying for improving storage and distribution, exosome-based delivery for designing next generation vaccines, and even machine learning integration, to optimize the production pipelines.

RevDate: 2026-06-12
CmpDate: 2026-02-19

Anderson AS (2026)

Vaccines against antimicrobial resistance.

Philosophical transactions of the Royal Society of London. Series B, Biological sciences, 381(1944):.

Antimicrobial resistance (AMR) is a global clinical and economic threat due to the impact that it has on how potentially deadly infections can be treated. Without intervention, it is estimated that AMR will be responsible for 10 million deaths a year by 2050, with a cost of 100 trillion USD. Sustainable prevention strategies are urgently needed to control the spread of AMR in communities and healthcare settings. Vaccines play an important role, not only in protection against emerging drug-resistant pathogens, but also in reducing antibiotic consumption by preventing infections before antimicrobial intervention begins. This review provides an overview of several existing bacterial and viral vaccines that have demonstrated effectiveness in reducing this burden and discusses the importance of development of further vaccines to tackle AMR, with a particular focus on Clostridioides difficile and group B streptococcus, for which long-awaited vaccines may be on the horizon. This article is part of the Royal Society Science+ meeting issue 'Vaccines and antimicrobial resistance: from science to policy'.

RevDate: 2026-06-12
CmpDate: 2026-02-20

Trimarco V, Gallo P, Ghazihosseini S, et al (2026)

The Role of L-Arginine and Liposomal Vitamin C Supplementation as an Adjunct in Seasonal Respiratory Viral Infection Recovery.

Advances in respiratory medicine, 94(1):.

Respiratory seasonal viral infections remain one of the most important issues in community medicine. The heterogeneity of etiological agents and the characteristics of the hosts airway antiviral defenses account for the complex management of these infections. The clinical consequence of this picture is that, despite the widespread use of vaccination as the primary prevention strategy, the rates of acute respiratory complications remain still high. In addition, they determine post-infectious fatigue and organ dysfunction. Inflammation and oxidative stress are the principal pathogenic mechanisms responsible for clinical complications during respiratory seasonal viral infections. Nowadays, a growing body of evidence indicates that adjunctive nutritional support can contribute to relieve the symptoms during the acute and subacute phases of respiratory viral infections. We assess the data in the literature regarding the combination of L-Arginine and Liposomal Vitamin C as adjuvant treatment for respiratory seasonal viral infections. The database of the National Library of Medicine (PubMed) was searched using the keywords "L-Arginine, Vitamin C, dietary supplements, seasonal respiratory viral infections". The treatment of symptoms during acute and post-acute respiratory viral infections requires an integrated approach that includes vitamins and nutritional supplementation. The combination of L-Arginine and Liposomal Vitamin C seems to represent a nutritional support able to mitigate symptoms occurring during the acute or post-acute phase of infection.

RevDate: 2026-06-12
CmpDate: 2026-02-20

Wang Y, S Gandy (2026)

Golgi Fragmentation as a Potential Link Between SARS-CoV-2 Infection and Alzheimer's Disease: Mechanisms and Implications for Neurodegeneration in Long COVID.

Sub-cellular biochemistry, 111:463-482.

The COVID-19 pandemic has impacted millions of people worldwide, and recent studies have shown that SARS-CoV-2 infection can lead to an Alzheimer's-like neuropathological and biomarker phenotype, as well as clinical symptoms of "brain fog". This raises an intriguing question: "How and where might the molecular pathways underlying SARS-CoV-2 infection and Alzheimer's disease (AD) converge?" One common feature of both SARS-CoV-2 infection and AD is the alteration of the endomembrane system, particularly the fragmentation of the Golgi apparatus. In this review article, we summarize the existing literature on SARS-CoV-2 infection biology and speculate about the potential mechanisms linking Golgi defects, SARS-CoV-2 infection, and neurodegeneration.

RevDate: 2026-06-12
CmpDate: 2026-02-20

Nilormi A, Bensimon CM, Thomas M, et al (2026)

A scoping review of vaccine certificate implementation in Canada and OECD countries during the COVID-19 pandemic: Outcomes and lessons learned.

Human vaccines & immunotherapeutics, 22(1):2622178.

Vaccine certificates were introduced during the COVID-19 pandemic to document vaccination status, promote uptake and enable safer reopening of society. While these policies supported public health efforts, their implementation raised operational, ethical and legal concerns, sparking debate about their future use in health emergencies. We conducted a scoping review to synthesize the implementation processes, challenges and outcomes of vaccine certificate systems in Canada and other OECD countries. An academic search was conducted in August 2024, across Ovid MEDLINE, Embase and Scopus using controlled vocabulary and key words for sources published from 2020 onward. Grey literature was searched using Google and targeted government and organizational websites. Data were synthesized descriptively and analyzed deductively based on three pre-identified themes - public health, technological, and ethical-legal considerations - derived from the UK Royal Society's framework on COVID-19 vaccine certificate design. The search captured 128 sources (72 academic and 56 gray literature), covering all OECD countries except Chile, Colombia, Costa Rica, Mexico and Norway. Identified subthemes included: (1) purpose and trade-offs; (2) public health, socio-economic and health system impacts, (3) technological infrastructure and data security; (4) equity and accessibility; (5) privacy and surveillance; and (6) public acceptance and trust. Vaccine certificates aimed to support public health goals but posed challenges in digital implementation, particularly in creating secure and interoperable systems and raised concerns around equity, discrimination and privacy. Vaccine certificates show promise for future public health use. However, their success will depend on addressing ethical concerns, ensuring interoperability and strengthening digital infrastructure, regulations and public trust.

RevDate: 2026-06-12
CmpDate: 2026-05-18

Qaseem A, Obley AJ, Harrod CS, et al (2026)

COVID-19 Vaccines for 2025-2026 in Adults Who Are Not Pregnant or Immunocompromised: Rapid Practice Points From the American College of Physicians.

Annals of internal medicine, 179(5):728-733.

DESCRIPTION: The American College of Physicians (ACP) developed these rapid practice points addressing the effectiveness, comparative effectiveness, and harms of Omicron-adapted COVID-19 vaccines in adults (aged ≥18 years) who are not pregnant or immunocompromised.

METHODS: The ACP Population Health and Medical Science Committee developed the rapid practice points on the basis of a rapid review by the ACP Center for Evidence Reviews at Cochrane Austria and national disease surveillance data on the epidemiology and baseline risks for COVID-19.

UNLABELLED: The following practice points apply to those who are not pregnant or immunocompromised.

PRACTICE POINT 1: Adults aged 65 years or older should receive an updated 2025-2026 mRNA-based COVID-19 vaccine.

PRACTICE POINT 2: Adults aged 18 to 64 years at increased risk for severe COVID-19 should receive an updated 2025-2026 mRNA-based COVID-19 vaccine.

PRACTICE POINT 3: Adults aged 18 to 64 years who are not at increased risk for severe COVID-19 may consider receiving an updated 2025-2026 mRNA-based COVID-19 vaccine.

RevDate: 2026-06-12
CmpDate: 2026-02-24

Wang X, Schröder HC, Neufurth M, et al (2026)

Mucosal Wound Repair: Reinforcement of Respiratory Mucus Barrier Function by Inorganic Polyphosphate.

Progress in molecular and subcellular biology, 63:175-207.

Epithelial cell damage affects not only the skin, which covers the external surface of the human body, but also the non-keratinized epithelia, the mucosa, that lines the surfaces of internal organs, including the nasopharynx and lungs. This mucosa is characterized by a moist surface formed by the mucus overlying the epithelial cells. In the respiratory tract in particular, mucosa cells are constantly exposed to large amounts of environmental pathogens and stressors, including bacteria and viruses inhaled as aerosols. Therefore, mucins, a group of glycoproteins that constitute a major component of the mucus, play an important role in the innate immune defense provided by the protective mucus shield. This barrier function of the mucus can be disrupted by a number of agents, such as fine dust (particulate matter). Recent results have shown that inorganic polyphosphate (polyP), which can be administered, for example, in the form of a nasopharyngeal spray, offers a promising way to strengthen or repair impaired mucus function. This chapter describes the structure and formation of the mucus and its mucin building blocks, as well as the mode of action of polyP and drug-loaded polyP nanoparticles in restoring the mucus barrier, particularly with regard to their protective function against coronavirus infection.

RevDate: 2026-06-12
CmpDate: 2026-06-12

Löwy I (2026)

[Long Covid: a long story].

Medecine sciences : M/S, 42(2):187-193.

Patients with long Covid experience multiple, often very debilitating symptoms, yet their test results frequently appear normal. In the absence of objective indicators of a recognized disease, some professionals may conclude that the patient is suffering from a psychosomatic disorder. These patients face an epistemic injustice, that is, a failure to recognize their suffering as real. This injustice is rooted in a longstanding history of medically invisible disorders, which are diagnosed mainly on the basis of the patient's own narrative. The difficulties experienced by patients with long Covid cannot be dissociated from this history.

RevDate: 2026-06-12
CmpDate: 2026-02-24

Dræbel TA, Birhanu Z, Lien L, et al (2026)

Mental health impact of the COVID-19 pandemic on frontline healthcare workers in Ethiopia: a scoping review of associated mental health risk and protective factors.

BMJ open, 16(2):e107175.

OBJECTIVES: The mental health impacts of COVID-19 on frontline healthcare workers have been reported globally; however, there is limited evidence from low-income countries such as Ethiopia. We reviewed the literature to understand how COVID-19 impacted the mental health of frontline healthcare workers, including the associated risk and protective factors.

DESIGN: A scoping review of peer-reviewed research was conducted between 2020-2025 to explore the mental health and well-being of frontline healthcare workers in Ethiopia during COVID-19. The process adhered to the guidelines for data extraction outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Our search identified 35 studies, of which 29 studies were included in the final synthesis.

DATA SOURCES: Three online databases, PubMed, Web of Science and PsycInfo, were systematically searched for data.

ELIGIBILITY CRITERIA: Studies were considered for inclusion in the review if they focused on mental health conditions and psychosocial well-being among healthcare workers during COVID-19 in Ethiopia. Studies were only included if published in English and excluded if they were conference abstracts, case studies, reviews, commentaries, contained incomplete data or lacked variables of interest.

DATA EXTRACTION AND SYNTHESIS: Data extraction was conducted manually by two reviewers by using a data extraction sheet created in Excel.

RESULTS: Most frontline healthcare workers experienced symptoms of insomnia, psychological distress, stress, anxiety, post-traumatic stress disorder and depression during COVID-19. Female frontline healthcare workers, nurses, midwives and laboratory technicians reported higher rates of adverse mental health outcomes. Our results found that being married, living together with a spouse and having a high educational level were risk factors for adverse mental health outcomes.

CONCLUSION: The mental health and well-being of frontline healthcare workers is at risk during a global health crisis; however, there is a limited understanding of how to protect the mental health of frontline healthcare workers in low-income countries, such as Ethiopia, at such a critical time. Additional research is needed to better inform mental health preparedness interventions for frontline healthcare workers in these contexts, particularly given predictions of another pandemic occurring within the next decade.

RevDate: 2026-06-12
CmpDate: 2026-02-25

V Rey-Matias BM, S Ignacio ML, D Leochico CF, et al (2026)

Telerehabilitation for the Evaluation and Management of a Dizzy Patient: A Mini-Review.

JPMA. The Journal of the Pakistan Medical Association, 76(1):118-120.

Dizziness and vertigo are common, disabling symptoms, especially in older adults. They can negatively affect quality of life and independence of the person. Vestibular rehabilitation is a key treatment, but access is often limited by physical, geographic, and socioeconomic factors. Telerehabilitation has emerged as a viable alternative, particularly during the COVID-19 pandemic. This mini review synthesizes available evidence on vestibular telerehabilitation, focussing on feasibility, delivery methods, outcomes, and future directions. We have included commonly used outcomes measures like balance, gait, gaze stability, dizziness, psychological health, and quality of life. Findings suggest telerehabilitation is an effective alternative to in-person therapy. However, further research is needed to standardize protocols, evaluate cognitive outcomes, and ensure inclusivity across diverse populations. Digital innovations are a promising options for more accessible, patient-centered vestibular care.

RevDate: 2026-06-12
CmpDate: 2026-02-25

İşcan G, O Çöme (2026)

Security and privacy in e-health technologies: a scoping review of challenges and strategies in primary care.

Family practice, 43(2):.

BACKGROUND: The rapid integration of e-health technologies-such as telehealth, mobile health (mHealth), and electronic health records-has transformed primary care delivery, especially during the COVID-19 pandemic. However, this transformation has revealed significant vulnerabilities in data privacy and security, particularly in decentralized and resource-limited primary care settings. This scoping review aims to map current evidence on privacy and security concerns related to e-health technologies in primary care and to identify mitigation strategies and research gaps.

METHODS: A systematic search was conducted in PubMed, ACM, Scopus, and Web of Science for studies published between 2019 and 2024. Eligible studies addressed both privacy/security issues and e-health technology use in primary care. A two-stage screening process and full-text review were applied. Data were extracted and thematically synthesized.

RESULTS: Fifty-two studies were included. E-health technologies examined included teleconsultations, patient portals, digital decision support tools, and artificial intelligence (AI)-based systems. Among included studies, telehealth accounted for 28%, mHealth and wearables 20%, electronic health records 16%, and AI applications 6%. Common concerns involved data breaches, insufficient encryption, lack of interoperability, consent ambiguity, and challenges in securing virtual consultations. Vulnerable groups-such as older adults and low-literacy populations-faced higher risks. Recommended strategies included privacy-by-design principles, secure infrastructure, user-centered design, clearer governance policies, provider training, and hybrid care models.

CONCLUSION: Addressing privacy and security in e-health requires more than technical solutions. Equitable, safe, and trustworthy systems must incorporate legal, ethical, and human-centered approaches. In primary care, privacy must be positioned as a core element of digital health equity, not an optional enhancement.

RevDate: 2026-06-12
CmpDate: 2026-04-27

Domnich A, E Pariani (2026)

Beyond the laboratory: how COVID-19 reshaped specimen collection, testing workflows, and diagnostic algorithms.

Expert review of molecular diagnostics, 26(2):127-139.

INTRODUCTION: The SARS-CoV-2 pandemic forced a radical expansion of essential public health laboratory services that went beyond basic testing. This perspective highlights key shifts in laboratory function, specifically toward decentralized testing, self-sampling, less invasive specimen types, point-of-care devices, and novel surveillance strategies.

AREAS COVERED: The surge in testing demand favored decentralized solutions, including rapid lateral flow tests, due to their flexibility, speed, and affordability. However, several challenges arose from the variable diagnostic accuracy of rapid self-tests and alternative specimen types when compared to reference laboratory-based molecular assays using nasopharyngeal swabs. For instance, the use of self-collected saliva, which is often preferred by patients, was hindered by a lack of internationally standardized processing protocols. A post-pandemic rebound in the circulation of respiratory pathogens other than SARS-CoV-2 was likely driven by both immunity debt and increased testing, including of less severe cases, commonly performed through more costly multiplex respiratory panels.

EXPERT OPINION: Moving forward, while over-the-counter self-tests for common respiratory viruses are now common, stricter regulatory oversight and improved data connectivity are essential. Local decision-makers must weigh the trade-offs between broad testing access and clinical performance, and implement robust diagnostic stewardship programs for acute respiratory infections.

RevDate: 2026-06-12
CmpDate: 2026-06-12

Van Assche J (2026)

The Social-Psychological Consequences of COVID-19: An Integrative Review and Research Agenda.

International journal of environmental research and public health, 23(2):.

The COVID-19 pandemic has revealed profound social-psychological vulnerabilities and strengths across societies worldwide. Beyond its immediate health implications, the pandemic has triggered a wave of mental health issues, disrupted social cohesion, and challenged community resilience. This paper synthesizes the current literature, critically discusses five recent studies as part of the Special Issue "Mental Health Consequences of COVID-19: The Role of Social Determinants", and articulates an agenda for future research within a social-psychological framework. Moving beyond mere negative effects such as anxiety, this review highlights the role of resilience, prosocial behavior, (digital) mental health interventions, and community social capital. Correspondingly, I advocate for interdisciplinary efforts to enhance awareness, preparedness, and adaptive capacity during health crises, emphasizing the need for a clearer focus on vulnerable social groups. In sum, recognizing the evolving global landscape, this work underscores the urgency of integrating psychological insights into public health policies to build resilient societies capable of confronting future pandemics and health emergencies.

RevDate: 2026-06-12
CmpDate: 2026-03-06

Federico M (2026)

Potential Impact of SARS-CoV-2 Spike Protein on HIV-1 Reservoir in People Living with HIV.

Viruses, 18(2):.

People living with HIV-1 (PLWH) are part of the so-called "fragile" populations to which COVID-19 vaccines were/are strongly recommended. The fact that most widely used COVID-19 vaccines rely on the production of a biologically active SARS-CoV-2 Spike protein expressed by synthetic mRNA poses the relevant question of whether and how this vaccination influences the fate of the HIV-1 reservoir. This report presents a detailed analysis of the literature data on the effects of SARS-CoV-2 Spike and COVID-19 vaccines on HIV-1 latently infected cells. Despite being limited in number, the experimental evidences consistently indicate that vaccine mRNA and/or SARS-CoV-2 Spike can effectively reactivate latent HIV-1. This conclusion has been drawn after "in vitro", "ex vivo", and "in vivo" assays, and with virus-associated Spike, soluble Spike, or its intracellular expression, as well as with COVID-19 mRNA vaccines. On the other hand, real-world observations on vaccinated PLWH under antiretroviral therapy (ART) provided evidence of HIV-1 reactivation almost exclusively in PLWH with unsuppressed viremia, as measured in terms of size of the HIV-1 reservoir. Although several issues still need to be clarified through urgent additional investigations, these data suggest the possibility that the Spike protein and/or the vaccine mRNA molecules affect the HIV-1 latency in PLWH.

RevDate: 2026-06-12
CmpDate: 2026-03-06

Marefat M, Tran D, Watson RM, et al (2026)

A practical model for integrated temporomandibular disorder assessment in the routine oral examination.

General dentistry, 74(2):57-61.

The COVID-19 era has seen an increase in orofacial pain related to temporomandibular disorders (TMDs). The increased relevance and awareness of these conditions, including the enactment of accreditation standards dictating the inclusion of TMD education in dental school curricula, highlights the need for a simplified TMD screening and evaluation model. A literature review was conducted to establish whether a widely accepted, comprehensive, and clinically practical approach to screening and evaluation for TMDs during routine oral examination was available. Previous studies and available medical and dental history forms were reviewed. While medical and dental history forms currently available to practitioners contain TMD-related questions, they are presented in a nonsequential, sporadic manner that may not lead to intuitive diagnosis from the dental practitioner. This article introduces a proposed model and questionnaire for incorporating TMD examinations into routine examinations. The inclusion of a more practical TMD screening and evaluation model in routine examination is intended to facilitate the dentist's identification and assessment of TMD signs and symptoms, leading to a more targeted approach in diagnosis and referral. This proposed model has not yet been validated clinically; the next steps include further development, implementation within a clinical setting, and evaluation of its effectiveness.

RevDate: 2026-06-12
CmpDate: 2026-04-28

Kozdrowicki M, Szczepaniak P, Kyslyi V, et al (2026)

The impact of inflammation, neuromodulation, and gut microbiota on developing cardiac fibrosis and hypertension.

Cardiovascular research, 122(6):681-706.

Cardiovascular diseases (CVD) are the leading cause of premature mortality worldwide. Due to pressure overload and cardiac fibrosis, CVD often begin with hypertension and gradually progress to heart failure. Cardiac fibrosis reduces the number of functional cardiomyocytes and the force of contraction while increasing oxygen demand. It has been noted that myofibroblasts, which produce excessive amounts of extracellular matrix in the failing heart, express specific proteins such as periostin, tenascin C, thrombospondin, and osteopontin. Their activation involves immune cells that have a well-documented effect on the pathogenesis of hypertension. Moreover, dysregulation of the autonomic nervous system and sympathetic hyperactivity heightens peripheral inflammation and fosters fibrosis. In this review, we outline and summarize the most significant and recent findings concerning the molecular pathways of immune activation, neuromodulation, epigenetic modifications, and the impact of gut microbiota on myofibroblast activation and fibrosis in the heart, as well as potential therapeutic options (e.g. experimental anti-inflammatory treatments, epigenetic modulators, and vagus nerve stimulation). We will also highlight how current heart failure treatments, including renin-angiotensin-aldosterone system (RAA) inhibitors, β-adrenergic receptor (β-AR) antagonists, sodium-glucose co-transporter 2 (SGLT2) inhibitors, the Dietary Approaches to Stop Hypertension (DASH), and the Mediterranean diet, affect these processes at a molecular level. A comprehensive understanding of the neuroimmune mechanisms involved in the pathogenesis of heart failure and hypertension is particularly crucial in light of the increased risk of CVD following the COVID-19 pandemic, which resulted from the 'cytokine storm' during SARS-CoV-2 infection.

RevDate: 2026-06-12
CmpDate: 2026-03-06

Hussein R, Shafiai N, Fakrurrozi A, et al (2026)

The impact of COVID-19 on dental practice and care: Adapting to unprecedented times.

Wiadomosci lekarskie (Warsaw, Poland : 1960), 79(1):223-231.

OBJECTIVE: Aim: This review aims to shed light on the ways dental practices and patient care strategies have evolved in response to the pandemic. It also investigates how patients' perspectives and dentist-patient dynamics have shifted, highlighting lessons for the future of dental healthcare systems.

PATIENTS AND METHODS: Materials and methods: The study is based on a comprehensive analysis of previously published research articles and clinical reports on how dental practitioners adapted their practices during the COVID-19 pandemic. It includes qualitative and quantitative data reflecting both professional and patient experiences. The pandemic led to the rapid adoption of new technologies, heightened hygiene protocols, and increased mental health burdens on both patients and practitioners. Tele-dentistry, limited in-person visits, and stricter sterilization practices became the norm. Patients expressed both fear and appreciation for enhanced safety, altering their expectations of dental care, resilience and adaptability in dental settings.

CONCLUSION: Conclusions The lessons learned from COVID-19 experience underline the importance of incorporating dentistry into broader public health strategies. Moving forward, there is a need to invest in innovative technologies, uphold rigorous hygiene standards, and provide mental workers and patients. These steps are essential to prepare for future health emergencies and ensure the sustainability of dental care delivery.

RevDate: 2026-06-12
CmpDate: 2026-06-12

Chen S, Li H, Jiang Z, et al (2026)

Effects of Traditional Chinese Medicine on Restoroing the immune balance of mild-to-moderate Patients with new coronavirus.

Indian journal of pharmacology, 58(2):114-125.

OBJECTIVE: Coronavirus disease 2019 (COVID-19) which brings the epidemic situation to the public has spread rapidly and produce multiple variations. At present, Western medicine still lacks the specific medicine or vaccines for coronavirus. However, amount of evidence shows that traditional Chinese medicine (TCM) has advantages in releasing the symptoms of mild-to-moderate COVID patients. Those treatments are not only improving the course of the primary disease but also curb progress to severe pneumonia or acute respiratory distress syndrome. Therefore, taking TCM intervention or combined treatments appropriately to prevent worsening illness is of vital significance. This study mainly focuses on the data analysis on the effects of TCM in restoring the immune balance of COVID patients. By collecting clinical data from mild to moderate patients, we expected to figure out if TCM only plays the role of curbing inflammation or having a two-way influence in balancing the immune microenvironment.

METHODS: Seven digital databases including PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, China Science and Technology Journal Database (VIP), Wanfang Database, and China Biology Medicine were searched from December 2019 to August 2022 nothingness of language restrictions. The studies retrieved from the database were selected and the data extracted to assess the methodological quality of the included randomized controlled trials (RCTs). Statistical analysis was completed. Pulmonary computed tomography, clinical cure rate, rate of conversion to severe cases, length of hospital stay, and scores of TCM syndrome were defined as the primary outcomes, the secondary outcomes were white blood cell count, lymphocyte (LYM) count, and C-reactive protein (CRP). This study was registered with PROSPERO (CRD42022341482).

RESULTS: Nine eligible RCTs including 1159 participants were included in this meta-analysis. Compared with Western medicine treatment alone, our meta-analyses found that traditional Chinese combined Western medicine treatment has a higher clinical cure rate, better absorption of lung inflammation, and significantly shorter hospital stay. In terms of inflammatory factors, TCM can significantly reduce the CRP content compared with Western medicine methods, but the leukocyte and LYM content was not significantly different between the two treatments. In some research, TCM even has a trend accelerating the inflammation process on some specific stages of the disease.

CONCLUSION: Chinese herbal medicine combined with conventional therapy is significantly effective and invulnerable in the treatment of mild-to-moderate COVID-19. In terms of control inflammation, TCM does not only block the disease onset by simply inhibiting inflammation but balancing the human environment through bidirectional regulation of inflammatory cells. However, considering of the lack of research into how TCM could activate the natural immune response, the discussion of the mechanism cannot be stretched, more high-quality RCTs are still needed in the future.

RevDate: 2026-06-12
CmpDate: 2026-03-06

Meena J, Agarwal A, Sandhu A, et al (2026)

Efficacy and safety of remdesivir for patients with severe acute respiratory syndrome coronavirus 2 infection: A systematic review of randomized controlled trials.

Indian journal of pharmacology, 58(2):137-141.

In view of the pandemic of coronavirus disease 2019 (COVID-19), there is a need to identify a specific antiviral therapy. We performed this systematic review to assess the efficacy of remdesivir in the treatment of COVID-19. We searched three electronic databases for clinical trials investigating remdesivir for COVID-19 and included this systematic review. Five trials evaluating 13,558 participants were eligible for this study. Remdesivir, as compared to standard care, increases the rate of clinical improvement at 2 weeks (risk ratio: 1.10; 95% confidence interval: 1.04-1.18). Time to clinical recovery was shorter in the remdesivir group than the standard care group. The mortality rate was lower at 2 weeks in the remdesivir group, but no difference was observed at 4 weeks postrandomization. Extending the duration of remdesivir from 5 days to 10 days did not improve efficacy but increased the risk of adverse events. Findings from this systematic review suggested that remdesivir may slightly improve recovery time and rate of clinical improvement.

RevDate: 2026-06-12
CmpDate: 2026-03-26

Taxiarchis A, I Pruner (2026)

Messengers of coagulopathy: complement-carrying extracellular vesicles in SARS-CoV-2 infection.

Current opinion in hematology, 33(3):105-112.

PURPOSE OF REVIEW: SARS-CoV-2 disease (COVID-19) is increasingly recognized as a thromboinflammatory vascular disorder characterized by dysregulated complement activation, endothelial injury, and sustained hypercoagulability. This review examines emerging evidence that extracellular vesicles act as key intermediaries linking complement activation to coagulation in acute and postacute COVID-19 infection.

RECENT FINDINGS: Recent studies demonstrate that extracellular vesicles released from platelets, endothelial cells, and neutrophils are markedly increased in COVID-19 and exhibit a combined procoagulant and complement-active phenotype. Sub-lytic complement attack, particularly membrane attack complex (MAC) deposition, triggers phosphatidylserine exposure and extracellular vesicle shedding, generating vesicles that support thrombin generation and propagate complement activity in the circulation. Extracellular vesicle-associated complement components, including C1q, C3 fragments, MASP2, and preassembled MACs, promote tissue factor decryption, platelet activation, and assembly of the prothrombinase complex, establishing a self-amplifying thromboinflammatory loop. Proteomic profiling further reveals compartment-specific extracellular vesicle signatures, with systemic extracellular vesicles enriched in complement and coagulation pathways. Importantly, complement-bearing and tissue factor-bearing extracellular vesicles persist beyond acute infection and are increasingly implicated in postacute sequelae of COVID-19.

SUMMARY: Extracellular vesicles serve as mobile platforms integrating complement activation with coagulation, providing a mechanistic framework for acute and chronic immunothrombosis in COVID-19. Targeting extracellular vesicle-mediated complement-coagulation crosstalk may offer novel diagnostic and therapeutic opportunities.

RevDate: 2026-06-12
CmpDate: 2026-04-09

Sakai K, Yoshida T, Chiba T, et al (2026)

Pitfalls in the management of undiagnosed secondary adrenal insufficiency: a case report and review of the literature.

Journal of medical case reports, 20(1):.

BACKGROUND: Prolonged cortisol deficiency in undiagnosed central adrenal insufficiency can lead to severe hypotonic hyponatremia due to inappropriate vasopressin secretion and malnutrition caused by inhibition of orexigenic signals. Notably, although hydrocortisone-induced recovery can trigger osmotic demyelination and refeeding syndromes, no previous report has simultaneously described these complications and documented significant decreases in vasopressin levels, along with changes in urine osmolality and volume before and after hydrocortisone administration.

CASE PRESENTATION: A 48-year-old Japanese man presented with fever, severe nausea, and oliguria and was brought to our hospital by ambulance due to impaired consciousness. Physical examination and laboratory analysis showed severe euvolemic hypotonic hyponatremia and low-normal glucose value. Low adrenocorticotrophic hormone and cortisol levels, undetectable 24-hour urinary free cortisol, and minimal response to corticotropin-releasing hormone indicated secondary adrenal insufficiency. Magnetic resonance imaging revealed slight pituitary swelling, suggesting hypophysitis. Treatment started with a 200 mg hydrocortisone infusion over 24 hours, and 6 hours later, the patient experienced a marked decrease in vasopressin levels, accompanied by significant dilute urine excretion and an excessively rapid increase in blood sodium levels, which posed a risk of osmotic demyelination. Rehydration with 5% dextrose and desmopressin was used to prevent this risk. Carefully adjusting plasma osmolality successfully prevented osmotic demyelination syndrome. Hydrocortisone replacement significantly increased the patient's appetite, leading to refeeding hypophosphatemia and disorientation; however, these resolved with intravenous sodium phosphate replacement. The patient developed a fever on day 12 and was confirmed to have coronavirus disease 2019. The fever subsided by day 16 with molnupiravir treatment and hydrocortisone dose adjustment, and he was discharged on day 23 with a maintenance dose of hydrocortisone.

CONCLUSION: Careful management is required while administering hydrocortisone in patients with undiagnosed adrenal insufficiency, as it may cause osmotic demyelination syndrome or refeeding syndrome due to sudden changes in blood electrolytes.

RevDate: 2026-06-12
CmpDate: 2026-03-07

Bragagnolo LM, Avarca CAC, Tofani LFN, et al (2026)

[Resilience and technological care arrangements in hospital settings during the COVID-19 pandemic: an integrative literature review].

Ciencia & saude coletiva, 31(2):e08452024.

This integrative review analyzed scientific literature to identify technological arrangements for care management (CM) in hospitals used during the COVID-19 pandemic, with the goal of understanding whether and how these arrangements contributed to the resilience of services and systems. A literature search was conducted in three databases for studies published between January 1, 2020, and May 10, 2023. Data analysis was guided by Cecílio's (2011) classification of CM into family, professional, and organizational dimensions. Within the family dimension, relational strategies were found to enhance hospital resilience. In the professional and organizational dimensions, shared decision-making and dialogical interactions among technologies supported resilient and comprehensive care. Information and communication technologies (ICT) played a key role in enabling hospital reorganization while preserving light technologies essential to humanized care. Health systems such as the SUS may benefit from integrating ICT with CM to strengthen coordination among families, professionals, and institutions.

RevDate: 2026-06-12
CmpDate: 2026-04-11

Heugno VJN, Kamdem OL, Same EGE, et al (2026)

Factors associated with long COVID in sub-Saharan Africa: a scoping review.

BMC infectious diseases, 26(1):.

BACKGROUND: Long COVID is a condition characterized by persistent symptoms of COVID-19 that continue to occur in patients after apparent recovery. Given that, these symptoms may vary from person to person due to clinical, demographic, and genetic factors as well as comorbidities, our review aims to identify and analyze risk factors associated with persistent symptoms of COVID-19 (long COVID) in the specific context of sub-Saharan Africa.

METHODS: Article searches were conducted in the PubMed, Scopus, African Journals Online (AJOL), Science Direct and Google Scholar databases using the keywords "long COVID" or "long-term COVID-19" or "post-COVID condition" or "post-acute sequelae of COVID-19" and "sub-Saharan Africa" or "sub-Saharan Africans". The obtained data were entered into software for duplication checking. Two reviewers selected and extracted the data. Due to substantial heterogeneity in definitions and study designs, a narrative synthesis approach was adopted. Fifteen studies were included in this review, totaling 8,233 participants previously infected with SARS-CoV-2, with approximately 2,011 patients with long COVID from six countries. Six studies were cross-sectional, three were retrospective, three were cohort studies, two were case-control, and one was a case report.

RESULTS: The review found that the prevalence of long COVID in sub-Saharan Africa ranged from 2% in Ghana to 66.7% in South Africa. The persistent COVID-19 symptoms most commonly experienced by people living in sub-Saharan Africa were fatigue (reported in 12 studies, 25-66% of patients), cough (7 studies, 9-86%), chest pain (9 studies, 9%-29%), dyspnea (10 studies, 15-45%), palpitations (4 studies, 10-30%), headache (9 studies, 12-38%), and cognitive impairment (6 studies, 8-20%). The main risk factors for the occurrence of persistent COVID-19 symptoms were older age (˃ 60 years), female sex, low education level, hypertension, type 2 diabetes, cardiovascular disease, length of hospitalization during the acute episode, number of initial COVID-19 symptoms, and initial disease severity.

CONCLUSION: Long COVID is a reality in sub-Saharan Africa. Fatigue and hypertension have proven to be the most common symptom and risk factor, respectively. The heterogeneity of long COVID definitions across studies limits direct prevalence comparisons. Given the socio-economic challenges, pre-existing comorbidities and differences in health systems in the sub-Saharan region, it is therefore necessary to develop new strategies for care, rehabilitation and treatment (specific to the realities of the sub-Saharan region) targeted at each persistent symptom of COVID-19 in order to resolve this emerging problem and allow patients to have a good quality of life.

CLINICAL TRIAL NUMBER: Not applicable.

RevDate: 2026-06-12
CmpDate: 2026-03-07

Wang X, Li H, Li T, et al (2026)

Integrating ethics into infectious disease graduate training: a multidimensional framework for public health practice.

Frontiers in public health, 14:1744330.

Through a narrative review and synthesis of the global status of Infectious Disease Ethics (IDE) education, this paper proposes positioning IDE as a core competency in graduate training and constructs a three-dimensional integrated model of "Theory-Practice-Assessment." Drawing on the experience of the OPENING project by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), it emphasizes that the ethical framework must adapt to the paradigm shifts brought about by emerging technologies such as genomics. This model not only addresses the gaps in IDE education exposed by COVID-19 but also provides solutions to ethical challenges in fields like digital health and precision medicine, offering a practical pathway for the reform of global infectious disease graduate education.

RevDate: 2026-06-12
CmpDate: 2026-03-07

Bouchaala K, Bahloul M, Bradai S, et al (2025)

[Effect of awake prone positioning in non-intubated patients with community-acquired pneumonia complicated by hypoxemia].

Medecine tropicale et sante internationale, 5(4):.

INTRODUCTION: Several studies have suggested that the early use of awake prone positioning (PP) in patients with acute respiratory failure due to severe community-acquired pneumonia, hemodynamically stable and alert, may improve oxygenation and avoid the need for invasive mechanical ventilation. PP may also help reduce case fatality rate (CFR). The benefits of PP for oxygen-dependent patients hospitalized with non-intubated acute respiratory failure due to SARS-CoV-2 infection have been evaluated. We reviewed the literature to determine if PP could improve hypoxemia and signs of acute respiratory failure in patients with community-acquired or non-community-acquired pneumonia, reduce the need for invasive mechanical ventilation, and reduce CFRin patients with Covid-19.

MATERIALS AND METHODS: We searched with Medline for articles published in French or English containing the keywords "acute respiratory failure" or "acute respiratory distress" and "prone position."Results/Conclusion. Turning into prone position is a simple, inexpensive, and effective technique that improves the prognosis of patients with respiratory distress due to severe community-acquired pneumonia, regardless of the cause. This technique can be easily implemented in low-and middle-income countries, particularly in North Africa, sub-Saharan Africa, Asia, and South America.

RevDate: 2026-06-12
CmpDate: 2026-06-12

Saad S, DeCesare J, Meadows R, et al (2026)

Effect of COVID-19 infection on maternal and fetal outcomes of Pregnancy: A systematic review.

Pregnancy hypertension, 44:101432.

OBJECTIVES: This study aims to investigate the rates and statistical significance of maternal and neonatal complications in subjects with a positive COVID-19 diagnosis in pregnancy in comparison to subjects without a diagnosis of COVID-19 in pregnancy. We aim to improve the literature and patient information regarding the impact of COVID-19 on maternal and fetal outcomes to help draw conclusions or guide management.

STUDY DESIGN: Clinical outcomes were identified using International Classification of Diseases, Tenth Revision (ICD-10) billing codes. The control group included a sample of 15,000 patients delivered between 4/1/2019-12/31/2019. The COVID group included 10,608 patients from 4/1/2020-4/1/2022 who were confirmed COVID-19 positive within the 9 months prior to delivery. Binary logistic regression, Chi-square, and Fisher's exact test were used for statistical analysis.

RESULTS: Having COVID-19 during pregnancy is significantly associated with increased risk for preterm delivery (PTD), placental abnormalities, hypertensive disorders, and neonatal intensive care (NICU) admission. Rates of maternal mortality, fetal growth restriction (FGR) and intrauterine growth restriction (IUGR) were not significantly impacted by COVID-19. While the overall rate of FGR was not impacted, patients with 2nd trimester infection are at increased risk for FGR compared to patients with 3rd trimester infection.

CONCLUSIONS: This study demonstrates a statistically significant increased rate of preterm delivery, hypertensive disorders, placental abnormalities, and NICU admission for pregnancies affected by COVID-19. These findings can help guide recommendations for increased surveillance and counseling in pregnancies affected by COVID-19.

RevDate: 2026-06-12
CmpDate: 2026-06-12

Weiss SL, Peters MJ, Oczkowski SJW, et al (2026)

Surviving Sepsis Campaign International Guidelines for the Management of Sepsis and Septic Shock in Children 2026.

Intensive care medicine, 52(5):937-983.

OBJECTIVE: To update evidence-based management recommendations for clinicians caring for children (including infants, school-aged children, and adolescents) with sepsis or septic shock.

DESIGN: A panel of 68 international experts, representing 13 international organizations, as well as six methodologists, was convened. A formal conflict-of-interest policy was developed at the onset of the process and applied throughout. Teleconferences and electronic-based discussion among the chairs, co-chairs, methodologists, and subgroup leads, as well as within subgroups, served as an integral part of the guideline development process.

METHODS: New priority topics and recommendations from the prior guideline iteration were used to identify Population, Intervention, Control, and Outcomes (PICO) questions likely to have new or updated evidence. We conducted a systematic review to identify the best available evidence, summarized the evidence, and then assessed the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation approach. We used the evidence-to-decision framework to formulate recommendations as strong or conditional, or as a good practice statement. "In our practice," statements were included when evidence was inconclusive to issue a recommendation, but the panel felt that some guidance based on practice patterns may be appropriate.

RESULTS: The panel provided 61 statements on the management of children with sepsis or septic shock. Overall, five were strong recommendations, 24 were conditional recommendations, and ten were good practice statements. For 22 PICO questions, no recommendations could be made, but for seven of these, "in our practice" statements were provided. Compared with the 2020 guidelines, 20 recommendations were new, 13 were updated for clarity and/or new evidence, six were reviewed but not changed, and 22 were carried forward based on consensus of the panel that new evidence was not available. Only three recommendations were based on high or moderate certainty of evidence.

CONCLUSIONS: Updated management guidelines were issued by a panel of international experts for the best care of children with sepsis or septic shock, acknowledging that most aspects of care continue to have relatively low quality of evidence.

RevDate: 2026-06-12
CmpDate: 2026-06-12

Sartori F, Crisafulli E, Cariqueo M, et al (2026)

Role of Vaccination in the Prevention of ECOPD.

Seminars in respiratory and critical care medicine, 47(3):323-333.

Exacerbations of chronic obstructive pulmonary disease (ECOPD) represent key events in the natural history of COPD and are associated with several adverse outcomes. Respiratory infections are major and potentially modifiable triggers of ECOPD, with viral pathogens such as the influenza virus, respiratory syncytial virus (RSV), and SARS-CoV-2, as well as bacterial infections caused by Streptococcus pneumoniae, playing a central role. This narrative review examines the current evidence supporting vaccination as a preventive strategy for ECOPD and discusses its translation into clinical practice. The biological rationale for vaccination in COPD is reviewed, including disease-related immune dysregulation, impaired mucociliary clearance, and increased susceptibility to respiratory pathogens. Evidence from randomized clinical trials, observational studies, meta-analyses, and real-world data is summarized for pneumococcal, influenza, SARS-CoV-2, and RSV vaccines. Pneumococcal vaccination has been shown to reduce the burden of community-acquired pneumonia and invasive pneumococcal disease, with conjugate and higher-valent vaccines providing enhanced immunogenicity in older and high-risk adults. Influenza vaccination consistently reduces severe exacerbations, hospitalizations, and mortality, with additional cardioprotective effects of relevance in COPD. SARS-CoV-2 vaccination markedly lowers the risk of severe COVID-19 and related respiratory deterioration in COPD, while recently licensed RSV vaccines offer a novel opportunity to prevent RSV-associated lower respiratory tract disease and potentially reduce exacerbation risk. Patient populations most likely to benefit from vaccination include frequent exacerbators, older adults, individuals with severe airflow limitation, multimorbidity, immune dysfunction, infection-prone phenotypes, and socially vulnerable groups. Future perspectives include precision vaccination strategies, novel vaccine platforms, coadministration approaches, and interventions to improve vaccine uptake. Vaccination emerges as a cornerstone of ECOPD prevention, with substantial potential to reduce exacerbation burden and improve long-term outcomes in COPD.

RevDate: 2026-06-12
CmpDate: 2026-06-12

Pacheco FS, da Rocha Mota RG, Pinho Jannini de Sá YA, et al (2026)

Glucocorticoids and Neutrophil Biology: Impact on the Development of Resistance to Glucocorticoid Therapy.

Neuroimmunomodulation, 33(1):213-224.

BACKGROUND: Neutrophils are the most abundant leukocytes in peripheral circulation and play a crucial role in combating infections and mediating inflammatory responses. Neutrophils are produced in bone marrow, have a short half-life in the blood, and are rapidly attracted to the tissues in response to infection or tissue damage.

SUMMARY: Glucocorticoids (GCs), stress hormones, and potent anti-inflammatory agents exert complex effects on neutrophils. While they generally suppress immune responses, GCs can paradoxically enhance neutrophil survival and function under certain conditions. This duality is evident in their ability to delay neutrophil apoptosis and to induce a shift of neutrophils from the marginated to the circulating pool, increasing the neutrophil presence in the bloodstream. Th17 cells, a subset of T-helper cells, recruit neutrophils to sites of infection and inflammation. In addition, neutrophils promote Th17 cell differentiation. GCs can enhance Th17 differentiation and IL-17 production, exacerbating neutrophil accumulation. Nevertheless, in glucocorticoid-resistant diseases, including multiple sclerosis (MS), traumatic brain injury (TBI), and encephalomyelitis, Th17 cells and neutrophils contribute to persistent inflammation. This resistance complicates the treatment of autoimmune diseases and chronic inflammatory disorders, also in the central nervous system, where standard glucocorticoid therapy fails to mitigate symptoms effectively.

KEY MESSAGES: In this context, we propose a mechanism for the development of resistance to GC driving by uncontrolled TH17 response and neutrophils induced by chronic stress. Understanding the interactions between neutrophils, Th17 cells, and GCs is essential for developing targeted therapies for diseases resistant to GC, such as MS, TBI, and encephalomyelitis.

RevDate: 2026-06-12
CmpDate: 2026-06-12

Ferdous J (2026)

The weight of a hug: Abdominal obesity as a barrier to health and human connection.

Obesity research & clinical practice, 20(3):165-167.

A hug is a simple act of human connection, yet for many individuals with abdominal obesity, it can be physically challenging and emotionally uncomfortable. This paper examines how abdominal obesity affects both health and social interactions, using hugging as an illustrative example. In collectivist cultures such as Bangladesh, physical touch reinforces trust and family bonds. Obesity-related limitations can reduce closeness; promote avoidance and lower self-confidence, often compounded by social stigma. Abdominal obesity is also associated with increased risks of cardiovascular disease, diabetes, and premature mortality. Its prevalence is driven by sedentary lifestyles, processed food consumption, and environmental factors, further exacerbated during the COVID-19 pandemic. Addressing abdominal obesity requires holistic strategies, including improved nutrition, regular physical activity, stress management, and community support, to restore comfort, rebuild confidence, and strengthen personal relationships and community cohesion.

RevDate: 2026-06-12
CmpDate: 2026-06-12

Chen Y, Zheng J, Wang H, et al (2026)

Advance in the Kawasaki disease related coronary artery aneurysms: knowledge mapping, trends, and research frontiers.

Journal of cardiothoracic surgery, 21(1):.

BACKGROUND: Kawasaki disease (KD) is the leading cause of acquired heart disease in children. In untreated cases, coronary artery aneurysms (CAAs) may develop in up to 25% of patients. As the most significant long-term sequelae of KD, Kawasaki disease-related coronary artery aneurysms (KD-CAAs) contribute substantially to long-term cardiac morbidity and mortality. To date, few bibliometric study has specifically focused on this area.

METHODS: We conducted a search in the Web of Science Core Collection (WOSCC) for papers related to KD-CAAs published between 2005 and 2024, and performed visual analysis using CiteSpace, VOSviewer, and the "biblioshiny" web interface from the "bibliometrix" package in R. A total of 1018 publications were retrieved, which collectively received 25,068 citations, averaging 24.62 citations per paper.

RESULTS: A steady increase was shown in the cumulative number of publications. The highest productivity was observed in the United States of America (USA), followed by Japan, China, and Canada. The University of California system was identified as the most productive institution, and Pediatric Cardiology was recognized as the journal with the most publications. Burns Jane C, Tremoulet Adriana H, and McCrindle Brian W were found to be the most prolific authors, while Newburger Jane W was identified as the most co-cited author. It was revealed by keyword cluster analysis that KD-CAAs research was organized into ten distinct clusters, and three major research hotspots were highlighted: molecular pathogenesis and therapeutic resistance pathways, long-term vascular sequelae and management, and the impact of coronavirus disease 2019 (COVID-19). A shift in research focus from fundamental disease mechanisms toward long-term patient follow-up and multidisciplinary clinical collaboration was indicated by keyword burst detection, and this shift was reflected in terms such as "long-term management" and "health professionals".

CONCLUSIONS: Research on KD-CAAs requires further breakthroughs in molecular mechanisms and enhanced interdisciplinary integration. The resulting visualizations offer an efficient framework for identifying emerging trends and critical advances in KD-CAAs research.

RevDate: 2026-06-12
CmpDate: 2026-06-12

Chadha U, Kushnirenko A, Fernandes DC, et al (2026)

Augmenting healthcare systems for pandemic preparedness: a Lean Six Sigma perspective.

International journal for quality in health care : journal of the International Society for Quality in Health Care, 38(2):.

BACKGROUND: Past global healthcare crises have exposed vulnerabilities in healthcare systems, including inefficiencies in hospital operations, delayed response times, and overburdened infrastructure. Traditional hospital systems built for routine care were sometimes not resilient or adaptable in the face of such crises, resulting in global failures. This narrative review examines how Lean Six Sigma (LSS) principles can be incorporated into conventional hospital operations to enhance pandemic preparedness by building the resilience of hospital infrastructure, streamlining processes during time-sensitive situations, and improving waste reduction, all while being adaptable and sustainable.

METHODS: This narrative review synthesizes literature using Coronavirus Disease 2019 (COVID-19) as a benchmark to evaluate hospital response strategies, failures, and factors contributing to failure, including the critical assessment of ethical disruptions, operational weaknesses, and healthcare business models. LSS principle applications, i.e. DMAIC, Value Stream Mapping, SIPOC, FMEA, and Control Charts, were explored for facilitating efficient care, crisis response, and policy integration. Various case studies were used to support the comparative analysis and insights.

RESULTS: The literature indicates that adoption of LSS tools in the most vulnerable aspects of healthcare, including patient triage, supply chain optimization, and controlling and reducing mortality, has been associated with measurable improvements. Most importantly, integrating data-driven LSS resulted in enhanced surge responsiveness and ethical compliance within national healthcare frameworks and policies. However, despite its efficacy, there are institutional barriers like capital constraints, resistance to change, data inconsistencies, and a lack of legislative frameworks that impede widespread LSS adoption.

CONCLUSION: LSS offers an adaptable and scalable methodology to re-engineer conventional hospital operations and pandemic preparedness. The emphasis on 'kaizen' (continuous improvement), data-informed decision making, and focus on precision aligns with the needs of healthcare systems as revealed by recent crises. To unlock the potential for preparedness, healthcare systems and legislation must focus on institutionalizing LSS across public and private sectors through strategic investment, education, and cross-sector collaborations. This review provides a comprehensive framework for policymakers, governments, epidemiologists, doctors, and hospital business managers for building resilient, efficient, and pandemic-ready hospitals.

RevDate: 2026-06-12
CmpDate: 2026-06-12

Choi K, Choi S, Joe D, et al (2026)

Myocarditis After mRNA Vaccination: A Metabolic-Innate Immune Cascade Centered on Lipid Nanoparticles.

Mediators of inflammation, 2026(1):e8991922.

mRNA vaccine-associated myocarditis is a rare but clinically important adverse event whose pathogenesis remains incompletely understood. Initial hypotheses focused primarily on the spike protein antigen, with growing preclinical evidence implicating the lipid nanoparticle (LNP) delivery system as an additional and potentially important contributor to myocardial inflammation. Here, we propose a multi-hit model that integrates LNP-driven mechanisms as a central pathogenic axis, initiated by the systemic distribution and accumulation of LNPs in the heart. While the mRNA payload is cleared within days, the synthetic ionizable lipids -ALC-0315 (BNT162b2) and SM-102 (mRNA-1273) persist significantly longer than the mRNA payload itself. These two lipids differ in biodegradability and pharmacokinetic distinctions, together with differences in lipid dose and formulation, they may contribute to the divergent myocarditis rates observed between the two vaccine products. In this suggesting review, the first hit" involves the disruption of myocardial energy metabolism by these lipids, which can integrate into cellular membranes and impair mitochondrial fatty acid oxidation. This is compounded by a second hit of direct innate immune activation, preclinical studies demonstrate that LNPs engage pattern-recognition receptors (PRRs) like toll-like receptors (TLRs) and the NLRP3 inflammasome, leading to the release of pro-inflammatory cytokines such as IL-1β and IL-18. Inflammation is then amplified via Damage-associated molecular patterns (DAMPs) released from stressed cardiomyocytes. The clinical outcome-ranging from self-limited mild myocarditis to fulminant disease with diverse histopathological patterns-is likely shaped by host susceptibility factors, including sex hormones, genetic predisposition, and prior immune priming, that modulate the intensity of this pathogenic cascade.

RevDate: 2026-06-12
CmpDate: 2026-06-12

Tyagi A, Singh K, Singh PM, et al (2026)

Sympathetic and Parasympathetic Ganglion Blocks for Treatment of Long COVID-19 Symptoms: A Scoping Review.

Pain physician, 29(3):E151-E161.

BACKGROUND: Long COVID-19 affects approximately 10-30% of individuals who are infected with SARS-CoV-2 and is associated with persistent functional impairment and reduced quality of life. The heterogeneous, multisystemic nature and nonspecific symptomatology of long COVID-19 makes its treatment challenging. This scoping review evaluates existing evidence on sympathetic and parasympathetic ganglion blocks as potential interventions for patients suffering from long COVID-19.

OBJECTIVE: Our primary objective was to assess the effectiveness of sympathetic and parasympathetic ganglion blocks in treating patients with long COVID-19 by identifying the most commonly reported symptoms, symptom response to different block regimens, and any adverse effects associated with these interventions.

STUDY DESIGN: A scoping review.

SETTING: Outpatient clinics where patients received sympathetic blocks or parasympathetic blocks.

METHODS: A comprehensive search was conducted across PubMed, Embase, Cochrane CENTRAL, Web of Science, Google Scholar, and ClinicalTrials.gov using MeSH and free-text terms related to "long COVID-19," "post-COVID-19 syndrome," and "sympathetic ganglion blocks" and "parasympathetic blocks." Only English-language articles were included. Pre-print repositories and reference lists were also manually screened.

RESULTS: A total of 22 articles covering 505 patients were included in this review. The most frequently studied symptoms were olfactory dysfunction, fatigue, headache, and cognitive disturbances. The most commonly utilized intervention was the stellate ganglion block. The available evidence suggests that the stellate ganglion block could be an effective treatment for dysautonomia symptoms and cognitive dysfunction related to long COVID-19. Sphenopalatine ganglion block may be an effective option to treat headaches in long COVID-19 patients who are refractory to other treatments.

LIMITATIONS: The significant existing variations in treatment regimens precluded our ability to do a quantitative analysis. Reporting bias from case reports and small observational studies should also be considered.

CONCLUSIONS: Stellate ganglion blocks may offer therapeutic benefit for the dysautonomia and cognitive dysfunction associated with long COVID-19. Sphenopalatine ganglion blocks have shown promise in managing refractory headache symptoms in this population. Further well-designed, placebo-controlled randomized studies that employ validated outcome measures are required to establish the efficacy of sympathetic ganglion blocks in the treatment of long COVID-19.

RevDate: 2026-06-11

Farquhar H (2026)

AI-Enhanced Point-of-Care Diagnostics for Infectious Diseases in Resource-Limited Settings: A Scoping Review.

Tropical medicine & international health : TM & IH [Epub ahead of print].

OBJECTIVES: To systematically map the extent and nature of research on AI-enhanced point-of-care (POC) and rapid diagnostic technologies for infectious diseases in resource-limited settings, and to identify gaps in disease coverage, geographic representation and validation rigour.

METHODS: This scoping review followed JBI methodology and PRISMA-ScR guidelines. The protocol was registered on OSF (https://doi.org/10.17605/OSF.IO/KV8MP). Five databases (PubMed, Embase, Scopus, Web of Science and IEEE Xplore) were searched for studies published from January 2015 to March 2026. Title/abstract and full-text screening used rule-based keyword screening with manual validation (Cohen's kappa = 0.856). Data were extracted using a 19-variable charting form and enriched with PubMed Central full texts.

RESULTS: From 1072 records, 551 remained after deduplication and 237 studies were included. Publication volume grew exponentially, with 44% published in 2025-2026. COVID-19 (32%), malaria (27%) and tuberculosis (14%) dominated; neglected tropical diseases accounted for fewer than 8%. Microscopy (21%), molecular diagnostics (17%), biosensors (14%) and rapid diagnostic tests (14%) were the most common modalities. Convolutional neural networks predominated (26%), followed by random forests (10%) and support vector machines (8%). Only 7% of studies reported prospective field validation, while 62% did not report validation level. Geographic analysis revealed concentration in East Africa and South Asia, with underrepresentation of West Africa and Latin America.

CONCLUSIONS: AI-enhanced POC diagnostics for infectious diseases in resource-limited settings is a rapidly growing field facing critical gaps in validation rigour, disease equity and geographic representation. Only 16 of 237 studies (6.8%) report prospective field validation. Future research should prioritise field validation, expand beyond the COVID-19/malaria/TB triad and involve end-user communities from the design stage.

RevDate: 2026-06-11

Frühwein M (2026)

[Focus on respiratory vaccinations].

MMW Fortschritte der Medizin, 168(11):38-41.

RevDate: 2026-06-12

Chang L, Xu W, Wang X, et al (2026)

CRISPR diagnostics: from trans-nuclease activity to cancer diagnosis.

Cell & bioscience pii:10.1186/s13578-026-01603-1 [Epub ahead of print].

The field of nucleic acid-based testing experienced a decade-long stagnation since the development of quantitative polymerase chain reaction (qPCR) in 1992 and isothermal amplification methods in the early 2000s. However, in 2016, the discovery of trans-nuclease activity in CRISPR-Cas systems revolutionized the molecular diagnostics for nucleic acids. A typical CRISPR diagnostic workflow comprises three phases: (1) target recognition through CRISPR RNA (crRNA)-guided hybridization; (2) signal transduction via trans-cleavage of engineered reporters (e.g., fluorophore-quencher oligonucleotides), and (3) signal readout using fluorescence, electrochemical, or colorimetric platforms. Emerging shortly prior to the COVID-19 pandemic, CRISPR diagnostics quickly gained prominence as a field-deployable alternative to qPCR due to its rapidity (< 1 h), minimal equipment requirements, and field adaptability. This technological paradigm underwent rigorous validation and refinement alongside the rapid evolution of SARS-CoV-2 detection, which facilitated its adaptation for cancer diagnosis. Recent advancements in sensitivity (attomolar-level detection) and specificity (single-nucleotide discrimination) have enabled transformative applications in cancer diagnostics, including: (1) identification of nucleic acid biomarkers, such as high-frequency somatic mutations, circulating nucleic acids and miRNAs; and (2) detection of non-nucleic acid biomarkers, including epigenetic aberrations, proteins, small molecules and metabolite biomarkers. This review chronicles the decadal evolution of CRISPR diagnostics, with particular emphasis on recent advancements of its application in cancer diagnosis. We critically evaluate persistent technical limitations, including PAM sequence restriction, suboptimal sensitivity and specificity, quantitative constraints, and unmet point-of-care testing (POCT) in complex biological matrices. Additionally, we discuss prospective solutions to address these challenges.

RevDate: 2026-06-12
CmpDate: 2026-06-12

Zhao YY, CE Evans (2026)

Contemporary Endothelial Genome Editing Technologies: Towards Precision Genetic Medicine for Vascular Diseases.

International journal of molecular sciences, 27(11): pii:ijms27115100.

Endothelial dysfunction is a key characteristic of many diseases, including atherosclerosis, hypertension, heart failure, stroke, cancer, acute respiratory distress syndrome (ARDS), peripheral vascular disease, coronavirus 2019 (COVID-19), and pulmonary arterial hypertension (PAH). To improve understanding of the roles of endothelial cells (ECs) in health and disease, EC-specific genome editing technologies have been developed in recent years. Therapeutic strategies that aim to restore a healthy endothelial monolayer include the inhibition of endothelial genes that cause EC injury and dysfunction and the induction or activation of endothelial genes that drive EC repair and regeneration. In this review, we describe established recombinase-mediated genetic modification technologies and emerging EC-specific genome editing technologies including viral and non-viral delivery of the CRISPR/Cas9 genome editing system, and we summarize the strengths and limitations of each technology. We then discuss possible avenues for future research, including the development of organ-specific EC genome editing technologies. In short, EC-specific genome editing technologies can be used to modulate gene expression selectively in ECs and even within a specific vascular bed and/or distinctive EC subtype, and, in doing so, greatly improve the understanding of vascular biology and help develop precision genetic medicine targeting the disease-causing vascular bed(s) to effectively treat diseases caused by vascular endothelial dysfunction.

RevDate: 2026-06-12
CmpDate: 2026-06-12

Karanikola M, N Middleton (2026)

Suicide Prevention as a Pillar of Sustainable Mental Health: A Focused Comparative Narrative Review of the Republic of Cyprus and Selected European Countries in the Post-COVID-19 Era.

Healthcare (Basel, Switzerland), 14(11): pii:healthcare14111528.

Background/Objectives: Mental health and suicide prevention are increasingly recognized as critical components of sustainable development in the European Union (EU), particularly in light of the broader mental health challenges highlighted during the COVID-19 pandemic. This review aimed to explore suicide prevention policies and mental health strategies across selected European countries through a focused comparative analysis centered on the Republic of Cyprus. Methods: A narrative review design was applied. A purposive literature search focused on national strategies, epidemiological trends, policy papers, and peer-reviewed articles published from 2000 to January 2026 was followed. Databases searched included PubMed, Scopus, PsychInfo, Embase and Google Scholar, supplemented by grey literature from the World Health Organization (WHO), European Commission, and national health authorities. The review focused on selected European countries, i.e., the United Kingdom, Sweden, Finland, Greece, and the Republic of Cyprus, chosen to illustrate variation in suicide prevention policies, health system structures, and implementation frameworks. Evidence was critically appraised and synthesized thematically to identify commonalities and contrasts in policy, implementation and emerging challenges. Results: The review identified substantial variation in national suicide prevention strategies, monitoring systems, and policy implementation across the selected countries. Persistent gender- and age-related disparities in suicide patterns were observed, alongside the influence of socio-economic determinants, and the broader mental health effects associated with the COVID-19 pandemic. The findings also underscored the need for robust, gender-sensitive, and data-driven national strategies that are contextually grounded and equitably resourced. Conclusions: This review concludes with recommendations for enhancing mental health sustainability across Europe, emphasizing cross-sectoral coordination, improved surveillance systems, and future research priorities.

RevDate: 2026-06-12
CmpDate: 2026-06-12

Scocca V, Lauda L, Nocini R, et al (2026)

Nasal Epithelial Organoids as Translational Platforms in Inflammatory, Infectious, and Precision Medicine Applications: A Systematic Review.

Journal of clinical medicine, 15(11): pii:jcm15114016.

Background/Objectives: The airway epithelium plays a central role in host defense, inflammatory signaling, and disease progression across infectious, inflammatory, and genetic respiratory disorders. Human nasal epithelial organoids have emerged as accessible and patient-specific in vitro platforms with increasing translational relevance. This systematic review aimed to critically evaluate the current evidence on nasal epithelial organoid models, focusing on donor characteristics, culture methodologies, differentiation strategies, and translational applications. Methods: A systematic search of PubMed/MEDLINE, Embase, Scopus, Ovid MEDLINE, and Cochrane Library was conducted for studies published between 1990 and April 2026. The review followed PRISMA guidelines and was structured according to the PICOTS framework. Eligible studies included in vitro experimental investigations using human-derived nasal epithelial organoids in infectious, inflammatory, or precision medicine contexts. Risk of bias was assessed using the QUIN tool. Results: Seventeen studies met the inclusion criteria. Applications clustered into three principal domains: infectious disease modeling, inflammatory and epithelial remodeling research, and cystic fibrosis precision medicine. Most studies employed expandable three-dimensional Matrigel-embedded organoids or organoid-derived air-liquid interface systems. Infection-focused studies demonstrated variant-specific viral replication dynamics and epithelial immune responses, while inflammatory models reproduced disease-associated differentiation and remodeling phenotypes. Cystic fibrosis oriented studies showed that organoid swelling and electrophysiological assays correlate with CFTR functional rescue and, in selected cases, clinical response. Methodological heterogeneity across protocols and outcome reporting precluded quantitative synthesis. Conclusions: Human nasal epithelial organoids represent versatile translational platforms bridging accessible patient-derived tissue and advanced airway disease modeling. Although variability in culture protocols and functional benchmarks limits standardization, these models hold significant promise for mechanistic investigation, therapeutic stratification, and precision medicine applications.

RevDate: 2026-06-12
CmpDate: 2026-06-12

Balan A, Graham G, Herban S, et al (2026)

Transcutaneous Auricular Vagus Nerve Stimulation for Post-COVID-19 Condition: A Systematic Review and Critical Appraisal of Clinical Evidence.

Journal of clinical medicine, 15(11): pii:jcm15114247.

Background: Long COVID, or post-COVID-19 condition (PCC), affects around 36% of individuals following SARS-CoV-2 infection, manifesting as persistent fatigue, cognitive dysfunction, and dysautonomia among its hallmark features. Affecting an estimated 400 million individuals globally, it imposes an annual economic burden exceeding $1 trillion, yet no pharmacological therapy has demonstrated consistent efficacy in adequately powered randomized controlled trials. Transcutaneous auricular vagus nerve stimulation (taVNS) has emerged as a candidate intervention targeting the autonomic dysfunction and neuroinflammation responsible for PCC pathophysiology. Methods: We conducted a PRISMA 2020-compliant systematic review (PROSPERO: CRD420261287286) searching PubMed, Scopus, Cochrane, and Web of Science databases from inception to January 2026 for studies evaluating any form of VNS in adults with Long COVID. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool, the JADAD scale, and the PEDro scale. Certainty of evidence was evaluated using the GRADE framework. Narrative synthesis followed SWiM guidelines. Results: Five studies (n = 154 participants) (three randomized controlled trials (RCTs) and two single-arm studies) met inclusion criteria. Three of five studies (60%) were rated high overall risk of bias; only two RCTs achieved "some concerns." The only adequately double-blinded RCT found no significant between-group differences across all outcomes. Paradoxically, in the best-powered RCT (Percin et al.), sham stimulation produced significantly greater fatigue improvement than active taVNS, despite active taVNS producing significant HRV increases consistent with cardiac autonomic modulation. All efficacy outcomes were rated "very low" certainty (GRADE); safety was rated "low" certainty. Conclusions: Currently available evidence supporting the use of taVNS for Long COVID remains limited, and the absence of reliable target engagement markers in the included studies constrains confidence in this approach. Nonetheless, the physiological rationale remains sound, and the favorable safety profile across all included studies supports the feasibility of future investigation. However, given that positive findings were confined to inadequately controlled studies, enthusiasm for further research should be directed first toward mechanistic clarification and rigorous dose-finding work. Large-scale, double-blind, sham-controlled trials incorporating validated markers of vagal engagement are required before taVNS can be firmly recommended for COVID-19 sequelae management.

RevDate: 2026-06-12

Morales-Juárez A, Reed JB, Romanovich-Brown O, et al (2026)

How Is U.S. Food-Insecurity Related to Dietary Quality? A Scoping Review to Inform Nutrition Security Across the Lifespan.

Nutrients, 18(11): pii:nu18111680.

Background/Objectives: This review examined how different levels of U.S. food-security (FS) relate to dietary markers, informing the concept of nutrition security over the lifespan. Methods: The authors followed PRISMA-ScR guidelines. PubMed, CINAHL, Scopus, Embase, and CAB Abstracts were searched for eligible U.S.-based, English-language studies examining FS and dietary markers in free-living, disease-free populations, excluding COVID-19-era research. Two reviewers independently screened records in Covidence, with discrepancies resolved by a third reviewer. The percentage of studies evaluating >2 FS levels was determined. Dietary markers were classified into three domains: food and beverage (9 components), nutrient (16 components) and bioactive (2 components) markers. The percentages of studies with significant differences were estimated for each dietary domain. Results: Of 1069 records, 78 met full-text eligibility. Among these, 15% evaluated dietary markers across >2 FS levels. Among adults, differences by FS status were observed in 67% of assessed food and beverage components (6 out of 9), 50% of nutrient components (8 out of 16), and all evaluated bioactives (100%; 2 out of 2). Children exhibited differences in all assessed food and beverage components (100%; 9 out of 9) and 29% (2 out of 7) of nutrients by FS level. Adolescents had fewer dietary marker differences than children and adults. Findings among infants, pregnant women and older adults were limited, with no studies for lactating women. Conclusions: Low FS level is associated with poorer dietary markers across the lifespan compared with FS. Age-specific differences highlight the need for targeted interventions and nutrition security measures.

RevDate: 2026-06-12

Lesgards JF (2026)

Whey Proteins and Immunity: Mechanisms Underlying Immune System Reinforcement and Protection Against Viral and Bacterial Infections.

Nutrients, 18(11): pii:nu18111770.

This review aims to examine the immunological, anti-inflammatory, antiviral, and antibacterial activities of key whey and milk proteins, specifically lactoferrin, glycomacropeptide, β-lactoglobulin, α-lactalbumin and their derived peptides, particularly lactoferricin and lactoferrampin, highlighting their potential as preventive or therapeutic agents. Whey and dairy products represent complex biological matrices that, beyond their high nutritional value, serve as reservoirs of bioactive proteins and peptides with documented health-promoting properties. It has been reported that certain whey proteins (WPs) and whey-derived peptides may contribute to improvements in both innate and adaptive immunity, exert direct antiviral and antibacterial effects while also modulating host defenses through immunoregulatory, antioxidant, and anti-inflammatory activities. These mechanisms contribute not only to enhanced resistance against viral pathogens but also to maintaining intestinal homeostasis and microbiota balance, both of which are critical during infection. In recent years, particularly in the context of the COVID-19 pandemic, natural bioactive compounds derived from whey, and, more broadly, milk, have attracted increasing attention as potential adjuncts or alternatives to conventional antivirals, with reported activity not only against SARS-CoV-2, influenza but also other viral and microbial infections. Despite encouraging in vitro and in vivo evidence, clinical validation remains limited, and the antiviral and immunomodulatory effects of WPs still require deeper mechanistic clarification. Future research should focus on identifying molecular targets, as well as characterizing the pharmacokinetics and safety profiles of WPs and WP peptides across diverse clinical settings. At the same time, attention should be given to optimizing their application as nutraceuticals or functional dairy ingredients.

RevDate: 2026-06-12
CmpDate: 2026-06-12

Papic N, Kosuta I, Ljubas D, et al (2026)

Not just another shot: Tailoring vaccination in the era of modern liver transplantation.

World journal of transplantation, 16(2):118012.

Infections remain a leading cause of morbidity and mortality in patients with cirrhosis and liver transplantation (LT). Vaccination is underutilized despite proven benefits, and responses are often blunted by cirrhosis-associated immune dysfunction and post-transplant immunosuppression. This review synthesizes current evidence and recent advances in vaccination strategies for adult LT recipients, emphasizing optimal timing, novel vaccine platforms, and precision vaccinology. We discuss emerging data on coronavirus disease 2019, respiratory syncytial virus, and new pneumococcal and hepatitis B vaccines, highlight strategies to overcome immunogenicity gaps, and address implementation barriers. A practical roadmap and clinician-focused algorithms are proposed to integrate vaccination into the continuum of LT care.

RevDate: 2026-06-11
CmpDate: 2026-06-11

Segal NL (2025)

What's in Twins' Names? Mixed Credit Reports/Twin Research Review: Treating Twins with Central Nervous System Infection; Twin Insights into COVID-19; Septal Aneurism in Monozygotic Twins; Twin Births via Assisted Reproduction vs. Natural Conception; Tribute to Dr. Helen E. Fisher/ Human Interest: Twins Rally for Twin Hostages; Tribute to the National Mothers of Twins Clubs Founder; Quadruplet Birth; Identical Twin Politician; Identical Twin Actresses.

Twin research and human genetics : the official journal of the International Society for Twin Studies, 28(1):112-115.

Giving twins similar names places them at increased risk for mixed credit reports as they enter young adulthood and beyond. Attorneys specializing in this area of the law are often required to manage lawsuits againt the agencies responsible for such errors. This overview is followed by summaries of twin research and reports of treating twins with central nervous system infection, twins with COVID-19, and twins with septal aneurism, as well as a review of the comparative outcomes of twins born via assisted reproduction versus natural conception and a tribute to the late Dr Helen E. Fisher. Human interest items include a twins' rally for Israeli twins held hostage in Gaza, a tribute to the founding member of the National Mothers of Twins Clubs (now Multiples of America), a quadruplet birth, an identical twin politician, and identical twin actresses.

RevDate: 2026-06-10
CmpDate: 2026-01-07

Murata A, Tanaka M, Takayoshi M, et al (2026)

Osmotic nephropathy as a potentially underrecognized cause of acute kidney injury during SGLT2 inhibitor therapy: a case report and literature review.

CEN case reports, 15(1):16.

In recent years, sodium-glucose cotransporter 2 (SGLT2) inhibitors have become essential therapeutic agents in the management of chronic kidney disease (CKD), owing to their established renoprotective effects. Although acute kidney injury (AKI) may occasionally occur during SGLT2 inhibitor therapy, its pathological features remain incompletely understood. Here, we report a case of AKI caused by osmotic nephropathy in a patient with underlying CKD following the initiation of an SGLT2 inhibitor. We also review previously reported cases of SGLT2 inhibitor-associated osmotic nephropathy. A 71-year-old man with type 2 diabetes and CKD developed oliguric AKI, with his serum creatinine level increasing from 2.0 to 8.3 mg/dL, one month after initiating dapagliflozin. During this period, he experienced transient appetite loss associated with a COVID-19 infection. Despite initial management for presumed prerenal AKI, his renal function did not improve with intravenous fluid therapy, and he required hemodialysis. Kidney biopsy revealed characteristic features of osmotic nephropathy, including numerous isometric vacuoles within the epithelial cells of proximal tubules with preserved brush borders. His renal function began to improve approximately two weeks after discontinuation of the SGLT2 inhibitor, and eventually returned to baseline. This case and literature review highlight the potential for osmotic nephropathy as a rare but reversible complication of SGLT2 inhibitor therapy, which may be triggered by volume depletion, particularly in diabetic patients with pre-existing renal dysfunction. Recognition of this underdiagnosed entity is crucial for timely diagnosis and appropriate management.

RevDate: 2026-06-11
CmpDate: 2026-01-31

Llanes AC, Bandhlish A, Pipavath S, et al (2026)

Refining the Radiologic Recognition of Pulmonary Alveolar Proteinosis: A Crazy-Paving Pattern Approach.

Seminars in roentgenology, 61:150961.

Pulmonary alveolar proteinosis (PAP) is a rare airspace disease classically associated with the crazy-paving pattern on high-resolution computed tomography (HRCT). While highly suggestive, this imaging pattern is not pathognomonic and appears across a wide spectrum of pulmonary pathologies. In this review, we adopt a phenotype-first approach, using representative imaging cases to walk the reader through the differential diagnosis of crazy-paving, with attention to radiologic distribution, clinical context, and disease acuity. We emphasize distinguishing features between PAP and its mimics-including pulmonary edema, diffuse alveolar hemorrhage, organizing pneumonia, mucinous adenocarcinoma, exogenous lipoid pneumonia, acute fulminant PAP, and COVID-19 pneumonia-using side-by-side imaging and contextual pearls. Special attention is given to the radiologic clues favoring autoimmune versus secondary PAP, including geographic distribution of ground-glass opacities, subpleural sparing, and lower lobe predominance. The review concludes with a summary of diagnostic strategies, pathologic correlation, and treatment options, including insights from post-pandemic diagnostic pitfalls. This pattern-based framework is designed for the radiologist and serves as a practical guide for recognizing PAP within the broader spectrum of airspace diseases.

RevDate: 2026-06-10
CmpDate: 2026-01-12

Maleev VV, Fomin VV, Manakhov KM, et al (2025)

[Cardio-renal syndrome: perspectives of research in infectious diseases].

Terapevticheskii arkhiv, 97(11):902-907.

Clinical and prognostic significance of cardio-renal syndrome in various infectious diseases are discussed. Incidence and prognosis, as well as pathogenesis of cardio-renal syndrome in patients with infectious diseases, admitted to ICU of infectious hospitals, as well as hemorrhagic fever with renal syndrome and in COVID-19 are reviewed.

RevDate: 2026-06-10
CmpDate: 2026-01-14

Pechanova O, L Paulis (2025)

Nitric Oxide at the Nexus of ACE2 Biology and COVID-19: Implications for Cardiovascular and Neurodegenerative Comorbidities.

Physiological research, 74(Suppl 2):S171-S184.

SARS-CoV-2 engages ACE2 for cell entry, perturbing the counter-regulatory ACE2/Ang-(1-7)/Mas axis and shifting the renin angiotensin system toward ACE/Ang II/AT1 signaling, with a concomitant reduction in nitric oxide (NO) bioavailability. NO sits at the crossroads of these pathways, acting both as an antiviral modulator of spike-ACE2 interactions and as a downstream mediator of Mas-dependent endothelial protection. This review summarizes evidence on NO across three layers: (i) viral entry (S nitrosylation of spike/ACE2, protease modulation), (ii) cardiovascular comorbidities (hypertension, obesity, diabetes) where ACE2 downregulation impairs endothelial NO synthase (eNOS)-dependent NO production and promotes thrombosis and microvascular dysfunction, and (iii) neurovascular/ neurodegenerative sequelae, in which renin-angiotensin-aldosterone system (RAAS) dysregulation along with imbalance between protective eNOS/nNOS and inflammatory iNOS fosters blood-brain barrier disruption, microthrombosis, and cognitive impairment. Shared mechanisms - endotheliitis, microvascular dysfunction, and neuroinflammation may explain convergent risks for cardiac injury and cognitive decline in long COVID-19. Putative therapeutic strategies may include restoring physiological NO (via Mas agonism, Ang-(1-7), inhibition of Ang 1-7 degradation and recombinant ACE2), pulmonary-selective inhaled NO, hybrid S nitrosylated agents, and selective attenuation of iNOS/peroxynitrite alongside endothelial support. Targeted modulation - enhancing eNOS/nNOS while constraining iNOS offers a unified framework to mitigate both cardiovascular and neurodegenerative consequences of COVID-19.

RevDate: 2026-06-11
CmpDate: 2026-02-20

Bhattacharya S, Easmin N, Panja A, et al (2025)

mRNA-Based Cancer Vaccines: A Review of the Current Scenario and Future Prospects.

Protein and peptide letters, 32(11):776-790.

Messenger RNA (mRNA) has gained increasing attention as a valuable tool to cure various human diseases, particularly malignant tumors. Such growing interest has been triggered largely by the phenomenal clinical success of mRNA vaccines developed using lipid nanoparticle (LNP) technology against COVID-19. mRNA may be used to produce cancer immunotherapies in numerous different ways, including cancer vaccines to induce or enhance immunity to tumor-specific antigens (TSAs) or tumor-associated antigens (TAAs). mRNA can also be used to adoptively transfer T-cells for the expression of antigen receptors, such as chimeric antigen receptors (CARs), therapeutic antibodies, and immunomodulatory proteins to re-engineer the tumor microenvironment. However, the therapeutic potential of mRNA-based cancer immunotherapy is not fully utilized due to a few limitations, such as mRNA instability, production of immunogenicity, and a lack of efficient in-vivo delivery methods. This review provides an overview of the current advancements and future directions of mRNA-based cancer therapies, including various delivery routes and therapeutic platforms. It addresses the mechanistic basis of mRNA cancer vaccines, non-replicating and self-amplifying mRNA, as well as their clinical development, personalized vaccines, and applications of mRNA for encoding antigen receptors, antibodies, and immunomodulatory proteins. Moreover, the review addresses nanoparticle-based platforms, such as lipid nanoparticles (LNPs), polymeric nanoparticles, and peptide-based nanoparticles, all used to improve the therapeutic effectiveness of mRNA-based drugs by improving their targeted delivery to tissues. This review aims to provide insights into the use of state-of-the-art mRNA-based cancer immunotherapy.

RevDate: 2026-06-10
CmpDate: 2026-03-06

Petakh P, Halabitska I, Petrecka H, et al (2026)

Complex interactions between stress, nutrition, gut microbiota, and infectious diseases and their impact on health in global conflicts: A narrative review.

The Journal of nutritional biochemistry, 151:110267.

Following the global recovery from the COVID-19 pandemic, wars and conflicts have escalated to levels unseen since the Cold War. It is well known that conflict is accompanied not only by significant losses among both military personnel and civilians but also by rising levels of stress and stress-related disorders within the general population. Stress is bidirectionally connected with the state of the gut microbiota through the gut-brain axis. Dietary factors and eating behaviours also play crucial roles in shaping gut microbiota composition. On the one hand, conflict negatively affects food availability and dietary patterns, leading to reduced meal frequency and potentially diminishing microbiota diversity. On the other hand, stress-induced alterations in eating behaviour, such as bulimia or anorexia, can further impair gut microbiota composition. Additionally, individuals in conflict zones face heightened risks of infectious diseases due to disrupted vaccination schedules, poor sanitation, and limited access to clean drinking water. Stress-related immune changes may increase susceptibility to infections and raise the likelihood of adverse outcomes. Moreover, the frequent use of antibiotics to treat infections during conflicts contributes to reduced gut microbiota diversity. This review narratively examines the complex interactions among stress, immune responses, dietary patterns, infectious diseases, and gut microbiota in conflict-affected areas, and provides new perspectives on the role of artificial intelligence in modelling such comorbid pathologies.

RevDate: 2026-06-11
CmpDate: 2026-01-19

Okinaka K, JT Schiffer (2026)

Strategies for mitigating severe COVID-19 in patients with haematological malignancy during the omicron era.

The Journal of antimicrobial chemotherapy, 81(2):.

Despite a decrease in disease severity since the emergence of the severe acute respiratory syndrome coronavirus 2 Omicron variant, coronavirus disease-2019 (COVID-19) continues to pose a significant threat to patients with haematological malignancies (HM). Although repeated booster vaccinations enhance protection against severe illnesses in immunocompromised individuals, they remain at heightened risk of adverse outcomes. This underscores the crucial need for effective pharmacologic strategies to prevent and treat infection. This review examines current strategies for preventing severe COVID-19 in patients with HM, focusing on pre-exposure prophylaxis and early treatment of COVID-19. New monoclonal antibodies have been developed, offering effective pre-exposure prophylaxis. Antiviral agents and monoclonal antibodies demonstrated efficacy in limiting severe COVID-19 outcomes in patients with HM, though some patients, particularly the elderly, remain at risk of critical illness and death. Prolonged infection over months is also common, particularly in patients with lymphoid malignancies. Sustained viral shedding and ongoing mutation may be associated with chronic symptoms and is the likely source of several novel variants of concern that prolonged the pandemic. While HM subtype and advanced age are risk factors for severe or persistent COVID-19, there are no accurate tools for predicting individual risk. Given this uncertainty, prompt medical consultation, timely prescription of antiviral agents, and close monitoring are essential to minimize the risk of adverse outcomes in this vulnerable population.

RevDate: 2026-06-11
CmpDate: 2026-01-20

D'angelo MA, Nicolai R, Di Nicolantonio S, et al (2025)

Comparison of Teledentistry and Traditional Clinical Examination for Detection of DMFT Index in Children: A Systematic Review.

Pediatric dentistry, 47(6):380-387.

Purpose: This study systematically analyzed the published literature to evaluate the reliability of the caries experience index detection conducted in children (younger than 18 years of age) through teledental systems, comparing it with data obtained through traditional dental consultations. The question to be explored was whether dentists could use teledentistry to assess the caries risk index by calculating the DMFT (decayed, missing, and filled permanent teeth) score, thereby potentially reducing consultation time. Methods: A systematic English-language literature review was conducted, including the period from 2014 to 2024, that included the MeSH terms (("telemedicine"[Mesh]) AND "dental caries"[Mesh]) AND "DMF index"[Mesh]). Inclusion and exclusion criteria were defined according to the PICO methodology. A total of 11 manuscripts met the inclusion criteria. The methodological quality of these studies was assessed using the Newcastle-Ottawa Scale (NOS) with specific tools for cross-over studies. Results: From the 11 studies reviewed, it was suggested that teledentistry, through the use of intraoral photographs or video recordings, may represent a reliable, noninvasive, and efficient alternative for the detection of the caries experience index, compared to clinical examinations performed according to the traditional method. In most cases, the results were comparable between the two approaches. Conclusion: Incorporating teledentistry in combination with regular dental appointments could streamline clinical processes, enable effective treatment planning, and facilitate remote monitoring of the oral health status of patients, making it a timely and contemporary solution for a connected and health-conscious society-which is particularly valuable during public health crises such as the COVID-19 pandemic.

RevDate: 2026-06-12
CmpDate: 2026-06-12

Shi Y, Li B, Zheng Y, et al (2026)

Therapeutic effect of anti-neuroinflammatory supplement combined with olfactory training on post-covid olfactory dysfunction: a systematic review and meta-analysis.

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 283(6):3503-3512.

BACKGROUND: There is no established specific treatment for post-COVID olfactory dysfunction (PCOD) currently. Olfactory training (OT) is the only effective intervention supported by clinical evidence. The anti-neuroinflammatory supplement palmitoylethanolamide and luteolin (PEA-LUT) has shown potential in alleviating the symptoms of post-COVID, but its therapeutic effect on olfactory dysfunction and the gain effect when combined with OT remain to be evaluated.

METHODS: We comprehensively searched the online databases EMBASE, PubMed, ScienceDirect, Web of Science, Cochrane Library, Google Scholar, and ClinicalTrials.govfor the literature related to the treatment of PCOD, identified studies reporting the efficacy of PEA-LUT combined with OT, extracted the treatment outcome data, and performed data synthesis.

RESULTS: A total of 7 eligible RCTs published between 2021 and 2024 were included, comprising 525 patients with PCOD. Of the seven studies, five (71.4%) used the full Threshold-Discrimination-Identification (TDI) scoresystem to assess olfactory function, while two (28.6%) used only the Identification ("I") subscale; 332 patients (63.2%) received PEA-LUT + OT therapy and 203 (38.8%) received OT alone. Meta-analysis of these studies showed that patients receiving PEA-LUT combined with OT had significantly higher TDI scores compared to those receiving OT alone (Standard mean difference (SMD) = 0.90; 95% CI: 0.24-1.58; P < 0.01). The overall response rate was also significantly higher in the combination group (Risk difference (RD) = 0.33; 95% CI: 0.01-0.64; P = 0.04).

CONCLUSION: The neuroprotective properties of PEA-LUT appear to enhance recovery from post-COVID olfactory dysfunction. When combined with olfactory training, this treatment shows promising potential as a novel therapeutic approach.

RevDate: 2026-06-11
CmpDate: 2026-02-14

Galletta MAK, Hashimoto AS, de Almeida Estrambk G, et al (2026)

Prevalence of postpartum depression in the COVID-19 pandemic and associated factors: systematic review and meta-analysis.

BMC pregnancy and childbirth, 26(1):157.

BACKGROUND: The COVID-19 pandemic created a disruptive scenario with an increase in the prevalence of postpartum depression (PPD) and new associated risk factors, which deserve to be better studied, in different global contexts, which led to the present systematic review study.

METHODS: Observational studies published in English, Portuguese, and Spanish between 2020 and 2025 were included, and a meta-analysis was conducted using a random-effects model.

RESULTS: An initial survey of 1741 articles, of which 90 studies were selected with a total of 64,6994 women evaluated for PPD, with a range between 50 (1) and 5,134 (2) women. The overall prevalence of postpartum depression during the COVID-19 pandemic was 28.48% (25.14-31.94), with rates of 23.52% (18.961-28.40) in studies that used the Edinburgh Postnatal Depression Scale (EPDS) as a diagnostic instrument with a cutoff point ≥ 13. Studies from 31 countries were included, with higher prevalence observed in Latin America (34.08%), with lower rates in Europe (31.50%), the Middle East (29.31%), USA/Canada (24.26%), and Asia (22.32%). There was a higher prevalence of PPD in countries with a lower Human Development Index (HDI) (30.95%), with higher COVID-19 CFR (32.56%), higher maternal mortality (30.43%); and with the highest Gender Inequality Index (GII) (35.41%). PPD rates increased with postpartum time, varying between 18.31% (up to 1 month), 20.78% (up to 3 months), 34.67% (up to 6 months) and 36.55% (up to 12 months). Additionally, 11 protective factors and 53 risk factors were identified, most related to the pandemic, but also with the presence of factors already consolidated in the literature before the pandemic.

DISCUSSION: There was a global increase in the prevalence of PPD during the pandemic, with an intensification of pre-existing regional differences, causing the impact of the pandemic to be different according to the region.

CONCLUSIONS: The social and health crisis of the pandemic negatively impacted postpartum mental health, with significant regional differences.

TRIAL REGISTRATION: The study was registered in PROSPERO with the code CRD42023392973.

RevDate: 2026-06-11
CmpDate: 2026-03-25

Ahmad A, Gundeti MS, R M, et al (2026)

Status of evidence on efficacy and safety of Indian traditional medicine (Ayush) for COVID-19: a qualitative review and evidence map synthesis.

Systematic reviews, 15(1):.

BACKGROUND: The novel coronavirus (COVID-19), caused by SARS-CoV-2, was first reported in Wuhan, China, in December 2019. Its rapid spread, high mutation rate, and challenges in containment led the WHO to declare it a global pandemic on March 11, 2020. Traditional medicine played a supportive role during the COVID-19 pandemic by offering immune-boosting and symptom-relieving remedies, especially in regions with limited access to conventional healthcare. Several countries, including India, have integrated traditional therapies with modern treatment protocols to enhance patient outcomes and reduce disease burden.

OBJECTIVES: This review aims to critically synthesize the existing evidence on the efficacy and safety of Ayush interventions in the management of COVID-19 in India. It seeks to qualitatively analyze published literature and clinical trial data, and to develop an evidence map categorizing interventions by type and associated clinical outcomes.

METHODS: A comprehensive literature search was conducted across seven electronic databases, including the National Repository on R&D Initiatives of the Ministry of Ayush, WHO COVID-19 dashboard for clinical trials, AYUSH Research Portal, PubMed, Cochrane Library, WHO ICTRP, and CTRI. Studies published between 2019 and June 2024 were considered. A total of 3626 records were identified (2572 from indexed databases and 1054 from trial registries). After removing 640 duplicates, 2986 studies were screened for title and abstract. Following exclusion of 802 records, full-text assessment was performed on the remaining studies. After screening, 304 studies were included in the final review (178 Ayurveda, 22 Siddha, 31 Homeopathy, 22 Unani, and 51 Yoga). Risk of bias was assessed using the ROB 2 and ROBINS-I tools. Data extraction and collation were performed in accordance with the PRISMA guidelines. The study protocol was registered in PROSPERO.

RESULTS: A total of 304 studies were included, comprising 58 (19.1%) prophylaxis studies, 151 (49.7%) treatment studies, and 17 (5.6%) post-COVID rehabilitation studies across different Ayush systems. Ayurveda accounted for the largest proportion of publications (n = 178), followed by Yoga (n = 51). Among the randomized controlled trials, approximately half were assessed as having low-to-moderate risk of bias, whereas the remaining studies exhibited high or unclear risk of bias, primarily due to inadequate reporting of randomization procedures, allocation concealment, and blinding. Considerable methodological variability was observed across studies, including differences in intervention type, duration, outcome measures, and quality assessment scores.

CONCLUSION: While there is significant data on Ayush and COVID-19, current studies vary too widely to be definitive. Future research must prioritize rigorous scientific standards if these systems are to be effectively integrated into public health responses.

RevDate: 2026-06-12
CmpDate: 2026-02-23

Chao CM, Liu JW, Tang HJ, et al (2026)

The escalating threat of multidrug-resistant organisms: COVID-19 impact, global burden, and the Taiwanese experience.

Expert review of anti-infective therapy, 24(1):63-73.

INTRODUCTION: The COVID-19 pandemic has intensified global health challenges, including a silent but escalating crisis: multidrug-resistant organisms (MDROs). As healthcare systems strained under viral outbreaks, infection control and antimicrobial stewardship efforts suffered, accelerating the spread of antimicrobial resistance (AMR).

AREAS COVERED: This review examines the indirect effects of the COVID-19 pandemic on AMR, emphasizing changes in antibiotic utilization, healthcare-associated infections, and resistance trends. Global and regional epidemiological data are presented, with a special focus on Taiwan's evolving MDROs landscape, clinical burden, and strategic responses.

EXPERT OPINION: COVID-19 has both exposed and intensified vulnerabilities in AMR control. While the pandemic fostered certain infection control practices, it also disrupted antimicrobial oversight, leading to surges in MDROs prevalence. Taiwan's experience underscores the value of coordinated guidelines, real-time diagnostics, and artificial intelligence-driven stewardship. Rebuilding and future-proofing AMR responses requires integrated global policies, sustained surveillance, and innovation in diagnostics and therapeutics. Unless comprehensive action is taken, MDROs may emerge as the defining post-pandemic threat to modern medicine.

RevDate: 2026-06-10
CmpDate: 2026-03-26

Morimoto Y, Higashi H, Izumi H, et al (2026)

[Factors that contribute to the death/severity and onset of COVID-19 infection in working generation: Investigation of general health examination items by narrative review].

Sangyo eiseigaku zasshi = Journal of occupational health, 68(2):39-54.

The coronavirus disease 2019 (COVID-19) pandemic that affected Japan remains vivid in our collective memory. Currently classified as a Category 5 virus (for which medical institutions and individuals primarily implement preventive measures independently, without significant administrative intervention such as isolation), COVID-19 infections continue to peak biannually, currently driven by the Nimbus variant, a derivative of the Omicron strain. This situation necessitates ongoing vigilance in infection prevention efforts. While it is well-established that environmental factors, such as proper ventilation, are crucial in mitigating the risk of COVID-19 transmission, it has become evident that variations in individual susceptibility exist; some individuals contract the virus while others do not, even in identical environments. Personal factors, including pre-existing medical conditions, influence this disparity. This narrative review examines personal factors related to general health assessments within the workplace, incorporating data from systematic reviews and meta-analyses, as well as insights from both international and domestic academic societies. Although the strength of evidence varies, factors such as male gender, smoking, alcohol consumption, obesity, inadequate sleep, insufficient physical activity, hypertension, hyperlipidemia, diabetes, and chronic obstructive pulmonary disease have been identified as contributors to the severity and onset of COVID-19, as well as its associated mortality.

RevDate: 2026-06-11
CmpDate: 2026-01-25

Malemnganba T, Baghel K, Mehrotra S, et al (2026)

Unlocking the power of antimicrobial peptides to combat infectious agents.

Advances in protein chemistry and structural biology, 149:203-244.

The rapid rise of antibiotic-resistant bacteria has become a major clinical challenge, creating an urgent need for alternative therapeutic strategies. Antimicrobial peptides (AMPs) have emerged as promising candidates in the fight against these resistant pathogens. Naturally produced by a wide variety of organisms, AMPs are a crucial part of the innate immune system, offering a broad-spectrum antimicrobial effect against bacteria, fungi, viruses, and parasites. Unlike traditional antibiotics, AMPs primarily target microbial membranes, which reduces the likelihood of resistance development. Beyond their pathogen-destroying properties, AMPs enhance immune responses, aid in wound healing, and exhibit anticancer properties. Their ability to act swiftly and in synergy with the host immune system offers a distinct advantage over conventional antibiotics. Furthermore, AMPs hold the potential to be developed into novel treatments for infections that have become resistant to all available therapies. However, bacterial resistance mechanisms to AMPs-such as membrane modifications, protease production, and biofilm formation-underscore the complex interactions between hosts and pathogens. Despite these challenges, AMPs present an exciting avenue across multiple sectors, including medicine, agriculture, and food safety. Recent research also highlights their potential in treating viral infections, including COVID-19, showcasing their versatile applications. This chapter discusses the role of AMPs in addressing antibiotic resistance, their mechanisms of action, and their diverse therapeutic applications beyond bacterial infections.

RevDate: 2026-06-10
CmpDate: 2026-06-05

Song X, Lian Z, Wang R, et al (2026)

The Phases of Living Evidence Synthesis Using AI AI: Living Evidence Synthesis (Version 1).

Journal of medical Internet research, 28:e76130.

BACKGROUND: Living evidence (LE) synthesis refers to the method of continuously updating systematic evidence reviews to incorporate new evidence. It has emerged to address the limitations of the traditional systematic review process, particularly the absence of or delays in publication updates. The emergence of COVID-19 accelerated the progress in the field of LE synthesis, and currently, the applications of artificial intelligence (AI) in LE synthesis are expanding rapidly. However, in which phases of LE synthesis should AI be used remains an unanswered question.

OBJECTIVE: This study aims to (1) document the phases of LE synthesis where AI is used and (2) investigate whether AI improves the efficiency, accuracy, or utility of LE synthesis.

METHODS: We searched Web of Science, PubMed, the Cochrane Library, Epistemonikos, the Campbell Library, IEEE Xplore, medRxiv, COVID-19 Evidence Network to support Decision-making, and McMaster Health Forum. We used Covidence to facilitate the monthly screening and extraction processes to maintain the LE synthesis process. Studies that used or developed AI or semiautomated tools in the phases of LE synthesis were included.

RESULTS: A total of 24 studies were included, including 17 on LE syntheses, with 4 involving tool development, and 7 on living meta-analyses, with 3 involving tool development. First, a total of 34 AI or semiautomated tools were involved, comprising 12 AI tools and 22 semiautomated tools. The most frequently used AI or semiautomated tools were machine learning classifiers (n=5) and the Living Interactive Evidence synthesis platform (n=3). Second, 20 AI or semiautomated tools were used for the data extraction or collection and risk of bias assessment phase, and only 1 AI tool was used for the publication update phase. Third, 3 studies demonstrated the improvement in efficiency achieved based on time, workload, and conflict rate metrics. Nine studies applied AI or semiautomated tools in LE synthesis, obtaining a mean recall rate of 96.24%, and 6 studies achieved a mean F1-score of 92.17%. Additionally, 8 studies reported precision values ranging from 0.2% to 100%.

CONCLUSIONS: AI and semiautomated tools primarily facilitate data extraction or collection and risk of bias assessment. The use of AI or semiautomated tools in LE synthesis improves efficiency, leading to high accuracy, recall, and F1-scores, while precision varies across tools.

RevDate: 2026-06-11
CmpDate: 2026-06-05

Dunn M, 't Hoen E, Boulet P, et al (2026)

TRIPS flexibilities help change policy and practice to increase access to medicines: evidence from 2001 to 2024.

BMJ global health, 11(1):.

INTRODUCTION: Millions of people lack access to safe and effective pharmaceuticals because they are unaffordable or unavailable, particularly in 'developing' and 'least-developed' countries (DCs, LDCs), and increasingly in high-income countries (HICs). Management of intellectual property (IP) related to new medicines has a significant impact on access to safe, affordable and effective medicines. The Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) provides the international legal framework for IP protection and mandates 20-year patents in all technological fields, including pharmaceuticals. TRIPS contains flexibilities, such as compulsory licensing (CL) and transition provisions for LDCs, which governments can use to facilitate access to health technologies. The use of these flexibilities is underreported in the literature, and a thorough analysis has not been undertaken since the COVID-19 pandemic.

METHODS: A scoping review of three medical and legal databases and temporal analysis of all known instances of use or potential use of CLs and the LDC pharmaceutical transition measure between 2001-2024.

RESULTS: 61% of the 149 CL instances were executed. The relative rates of CL use between countries have shifted: HICs represent over half of CL instances in the last decade. CLs are increasingly considered for chronic, non-communicable and rare diseases. The threat of CL use continues to provide impetus for price negotiations, voluntary licences or other measures to improve access. Almost all eligible countries have invoked the right to use the LDC transition measure.

CONCLUSIONS: TRIPS flexibilities have been used to facilitate access to medicines (including vaccines) over the quarter-century since the adoption of the World Trade Organization's Doha Declaration on TRIPS and Public Health. The flexibilities play a vital role in ensuring that new medicines are affordable and are likely to continue to be in a future where geopolitical forces have drastically altered the financing structures of medicines provision in DCs and LDCs.

RevDate: 2026-06-11
CmpDate: 2026-03-17

Keels JN, LaPlante RD, Lee CS, et al (2026)

Prevalence of new-onset diabetes following COVID-19 infection: A systematic review and meta-analysis.

Diabetes, obesity & metabolism, 28(4):3182-3192.

AIM: To estimate the prevalence of new-onset diabetes in adults (≥ 18 years) following SARS-CoV-2 infection.

MATERIALS AND METHODS: This meta-analysis includes studies written in English that measured the number of adults (≥ 18 years) diagnosed with diabetes following SARS-CoV-2 infection. Studies underwent dual independent review; quality was assessed by using the New Castle Ottawa Scale. A random-effects meta-analysis was conducted to obtain the pooled estimate of new-onset diabetes. To understand the relationship between patient characteristics (age, sex) and study variable (duration of follow-up), a random effects meta-regression was used.

RESULTS: A total of 33 articles were retained for analysis. The overall estimated prevalence of new-onset diabetes (combined T1DM and T2DM or undefined) was 8.33% (95% CI 7.47, 9.18%, z = 19.04, p < 0.001; Q = 6791.24, I[2], 99.68%). The overall estimated prevalence of new-onset T2DM in COVID-19 was 8.92% (95% CI 7.88%, 9.96%, z = 16.77, p < 0.001; Q = 27659.74; p < 0.001, I[2] = 99.96%). The overall estimated prevalence of new-onset T1DM was 0.86% (95% CI 0.0072%, 0.0099%, z = 12.59, p < 0.001; Q = 9456.28; p < 0.001, I[2] = 99.94%). At the study level, there was no significant relationship identified with age, sex, or follow-up duration.

CONCLUSIONS: This systematic review and meta-analysis revealed a notable increase in T2DM or combined (T1DM, T2DM, or undefined) conditions. As such, it may be important to understand the underlying factors contributing to increased prevalence.

RevDate: 2026-06-11
CmpDate: 2026-02-21

Kyriakopoulos AM, McCullough PA, S Seneff (2026)

Taurine intake ameliorates lactic acidosis and hyperferritinemia occurring after mRNA SARS-CoV-2 vaccination in a patient with β-thalassemia trait: a case report and review of literature.

Journal of medical case reports, 20(1):.

BACKGROUND: Taurine is a powerful antioxidant necessary for mitochondrial function. Lactic acidosis is a complication encountered in the condition mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS), which can be successfully treated with supplemental taurine. Furthermore, taurine regulates the production of iron-dependent proteins such as ferritin that can act as chelating agents to sequester labile iron.

CASE PRESENTATION: A 38-year-old Greek male with a β-zero thalassemia trait developed multiple severe symptoms soon after his first and only mRNA (Pfizer) SARS-CoV-2 vaccination that included hematological stress to be a candidate for blood transfusion. Amongst the hematological readings, the patient had lactate levels > 4 mmol/ml, indicating lactic acidosis, and ferritin levels > 820 ng/ml, representing hyperferritinemia. Moreover, the patient has organic acid and plasma metabolite levels in the urine that are indicative of mitochondrial dysfunction. Regular taurine intake (500 mg/day) for years helped the patient control lactate and ferritin levels and avoid more serious clinical decompensation.

CONCLUSION: Regular taurine intake helps to avoid lactic acidosis and reverse hyperferritinemia after mRNA SARS-CoV-2 vaccination in a patient with β-zero thalassemia trait with no obvious genetic trait linked to mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes. Taurine seemed to be protective for mitochondria.

RevDate: 2026-06-11
CmpDate: 2026-02-11

Kharkivska Y, Shkel O, YK Kim (2026)

Syntenins at the crossroads of host-virus interactions.

Methods (San Diego, Calif.), 247:175-183.

Syntenin is a multifunctional PDZ-domain adaptor protein that orchestrates membrane trafficking, cytoskeletal remodeling, and exosome biogenesis. Initially identified as a syndecan-binding molecule, syntenin has since emerged as a central hub connecting membrane receptors to intracellular signaling pathways that regulate adhesion, motility, immune signaling, and cellular plasticity. While extensively studied in cancer and neural development, recent discoveries reveal that a wide range of viruses exploit syntenin to facilitate their replication, assembly, or dissemination. This review consolidates current evidence across diverse viral infections to elucidate the molecular mechanisms underlying the interaction between syntenin and viruses. Coronaviruses utilize syntenin to link PDZ-binding motifs to p38 MAPK-driven inflammation and endosomal entry. Papillomaviruses and Epstein-Barr virus hijack the CD63-syntenin-ALIX complex to control vesicle-mediated trafficking. Hepatitis C virus employs it to secrete E2-coated, antibody-resistant exosomes. Dengue virus harnesses its mosquito homolog AeSyntenin to package sfRNA for transmission. Human T-cell leukemia virus type 1 employs its Tax-1 oncoprotein to bind the PDZ domains of syntenin, remodel extracellular vesicle cargo, and promote viral spread. In contrast, during human immunodeficiency virus infection, syntenin restricts viral fusion at the plasma membrane, though the nucleocapsid mimics its PDZ tandem to promote virion release. Collectively, these findings establish syntenin as a dynamic regulator at the host-virus interface, capable of exerting both proviral and antiviral effects. Emerging pharmacological strategies targeting syntenin PDZ domains further underscore its potential as a broad-spectrum, host-directed antiviral target.

RevDate: 2026-06-10
CmpDate: 2026-06-10

Chigozie VU, Nnamani MN, Igwe KN, et al (2026)

Integrating infodemiology and infodemics management to address antimicrobial resistance and vaccine hesitancy challenges in Nigeria/Africa.

Journal of communication in healthcare, 19(2):131-153.

BACKGROUND: Antimicrobial resistance (AMR) and vaccine hesitancy (VH) are significant public health threats in Nigeria/Africa, due to limited healthcare infrastructure and health literacy, thus encouraging misinformation, which further exacerbates these issues.

METHODS: This review examines recent literature to explore how Infodemiology and Infodemics management can be integrated into strategies addressing AMR and VH in Nigeria and Africa. A narrative review methodology was employed, sourcing studies mostly from 2020 onwards to ensure contemporary relevance.

RESULTS: Infodemiology offers tools for addressing the dual public health threats of AMR and VH in Nigeria/Africa. Evidence reveals AMR behaviors are strongly influenced by misconceptions about antibiotics, such as their efficacy against viral infections, perpetuated by social media and word-of-mouth misinformation. Similarly, VH is fueled by cultural beliefs and mistrust in health systems, amplified during the COVID-19 pandemic, where myths about infertility and harmful ingredients led to skepticism. Infodemiology enables real-time tracking of misinformation trends through digital tools, allowing health authorities to identify hotspots and intervene with targeted campaigns.

CONCLUSION: Integrating infodemiology into AMR and VH management strategies enhances public health outcomes by addressing misinformation at its roots and promoting evidence-based practices. By leveraging digital tools and engaging trusted local figures, health systems can foster trust and literacy among communities. African governments must invest in digital health infrastructure, establish supportive policies, and foster partnerships with social media platforms to sustainably manage infodemics. These strategies are ivotal for reducing AMR and increasing vaccine acceptance, ultimately safeguarding health across human, animal, and environmental domains.

RevDate: 2026-06-11
CmpDate: 2026-05-18

Martins C, Mitchell MJ, Peer D, et al (2026)

The RNA delivery dilemma-lipid versus polymer nanoparticle platforms.

Drug delivery and translational research, 16(6):1667-1684.

Since the first market authorization of RNA therapies, just eight years ago, the field has witnessed an extraordinary expansion, ranging from hepatic delivery for rare genetic diseases to global-scale vaccination during the COVID-19 pandemic, and now to cutting-edge cancer vaccines and gene editing strategies entering late-stage clinical trials. In parallel, the RNA therapeutics landscape has evolved rapidly, progressing from small interfering RNAs to next-generation and combinatorial RNA modalities. None of these breakthroughs would have been possible without the development of sophisticated RNA delivery technologies capable of navigating complex biological environments, enabling precise cellular targeting, and facilitating efficient intracellular trafficking. In this Editorial Note, we take a step back to reflect on key lessons learned throughout the RNA delivery journey. Featuring insights from leading and experienced voices in the field, this manuscript highlights critical milestones, persistent challenges, and the roles of lipid nanoparticles (LNPs) and polymer nanoparticles (PNPs) as RNA delivery platforms. These experts reflect on the features that have positioned LNPs as the current RNA delivery gold standard, while also exploring the untapped potential and distinctive advantages of polymer-based nanosystems. Collectively, these perspectives underscore a striking truth: we are only beginning to unlock the full therapeutic potential of RNA, and nanomedicine will certainly continue to shape the future clinical translation of RNA-based therapies.

RevDate: 2026-06-11
CmpDate: 2026-01-30

Beran J, J Slíva (2025)

The last ten years with inosine pranobex - from an "old" therapeutic agent to vaccine research, including anti-cancer vaccines.

Casopis lekaru ceskych, 164(7-8):321-323.

Inosine pranobex (IP), also known as inosine pranobex dimepranol, is an immunomodulatory drug with a history spanning more than fifty years. It was first introduced in the 1970s and has since been licensed in more than 50 countries around the world. It was originally considered a potential drug for AIDS, which raised high hopes at the time of the discovery of the HIV virus. However, after initial interest, its use in this area declined, and for a long time, IP was no longer discussed significantly in professional literature or clinical practice. Renewed interest came only in the last decade, when IP began to reappear in connection with the treatment of acute respiratory infections, diseases caused by human papillomavirus (HPV), and other viral diseases, including COVID-19. It also began to be used as an adjuvant in the foot-and-mouth disease vaccine, and research began on an IP-based anti-tumor vaccine.

RevDate: 2026-06-11
CmpDate: 2026-01-31

Nesari AM, MotieGhader H, S Ghorbian (2026)

Advances and challenges in single-cell RNA sequencing data analysis: a comprehensive review.

Briefings in bioinformatics, 27(1):.

Single-cell RNA sequencing (scRNA-seq) has transformed the resolution of cellular heterogeneity, offering insights into dynamic biological processes from tumor evolution to immune regulation. However, its clinical translation is limited by challenges such as data sparsity, batch effects (differences caused by technical variation rather than biology), and the absence of standardized benchmarks for core pipelines like Seurat and Scanpy. This review outlines emerging computational strategies that address these limitations: (A) robust preprocessing, including SCTransform for zero-inflation(an excess of zero counts in gene-expression data) correction and Harmony for batch integration-achieving 30% faster alignment than BBKNN in cohorts exceeding 100,000 cells; (B) transformer-based annotation tools such as scGPT and CellTypist, which reach >95% accuracy in immune profiling using models pretrained on 33 million cells; and (C) multimodal integration with spatial transcriptomics (e.g., 10x Visium, cell2location v2), which delineate microenvironmental niches and rare CX3CR1+ T-cell subsets in disease contexts like glioblastoma and severe COVID-19. We further assess how scANVI bridges scRNA-seq and ATAC-seq to uncover epigenetic mechanisms underlying therapy resistance, and how spatial methods elucidate tumor-immune crosstalk at subcellular resolution. Despite these advances, ethical risks remain, particularly around re-identification of rare patient-derived clones such as pre-metastatic cells. To promote clinical adoption, we propose a roadmap that prioritizes benchmarked workflows (e.g., scverse ecosystem), privacy-aware data sharing via federated learning, and causal AI approaches to disentangle biological signal from technical artifact. By synthesizing computational innovations with translational case studies, this review equips researchers to navigate both the analytical and ethical complexities of scRNA-seq in pursuit of actionable diagnostics.

RevDate: 2026-06-11
CmpDate: 2026-02-02

Kshatriya M, Syal R, Als D, et al (2026)

Implementation of health and health-related sustainable development goals: progress, challenges and opportunities-a systematic literature review update.

BMJ global health, 11(2):.

INTRODUCTION: A prior systematic review assessed progress in health and health-related sustainable development goals (HHSDGs) from 2015 to 2019, identifying an important need for countries to strengthen implementation of multisectoral work, capacity building, financial stability and data availability. We undertook an updated systematic review to assess additional progress, challenges and opportunities for HHSDG implementation from 2019 to 2025, including the pandemic periods. This update aims to assess where countries are presently in HHSDG implementation and if further recommendations can be made in the final stretch to the 2030 targets.

METHODS: We followed a comparable comprehensive search strategy as the first review, focusing on implementation and acceleration strategies for HHSDGs. We undertook a qualitative synthesis from peer-reviewed and grey literature for specific databases, including studies and reports published from June 2019 to January 2025.

RESULTS: A total of 192 publications were included in the review of which 150 provided national-level information and 42 provided multicountry or regional information. Findings suggest a high level of political commitment in most countries and many HHSDG efforts being aligned with existing national development strategies. There was a noteworthy shift towards decentralised, subnational approaches to provide contextually relevant interventions. Multisectoral, multistakeholder, integrated approaches for implementation are increasing and proving to be effective. Diverse monitoring and evaluation strategies were employed, and (cross-country) knowledge sharing was instrumental to SDG policy and programme planning. Service disruptions incurred by the COVID-19 pandemic, lack of quality data and obtaining sustainable funding were frequently cited challenges to implementation.

CONCLUSIONS: Ensuring continuous financial investments and strengthening data availability are essential to accelerate HHSDG implementation. Recommendations for progress include strengthening primary healthcare, fostering multisectoral collaboration and addressing deep-rooted societal perceptions around gender inequity. Future research should examine the interplay of multiple SDGs, and the impact of factors such as cost-effective cross-regional approaches for project implementation.

RevDate: 2026-06-11
CmpDate: 2026-02-03

Fan C, Dai Y, Du H, et al (2026)

Successful treatment of severe cerebral malaria with artificial liver blood purification technology: A case report.

Medicine, 105(5):e47528.

RATIONALE: Plasmodium falciparum infection can lead to acute thrombocytopenia, severe hemolytic anemia, and acute liver and kidney failure, among which the fatality rate of cerebral malaria is as high as 20% to 30%. Continuous bedside blood purification technology is an important intervention measure for severe malaria. The artificial liver blood purification technology, with its multimode clearance advantage, is widely used in the treatment of critical conditions such as liver failure, sepsis, and novel coronavirus infection. We described a case of severe cerebral malaria complicated with severe liver and kidney injury, cerebral edema and heart failure. The patient was cured after treatment with artificial liver blood purification technology. A literature review was also conducted.

PATIENT CONCERNS: A 43-year-old male patient was admitted to our hospital due to fever and confusion. The patient had frequently traveled to Nigeria on business in the past 10 years. Three days ago, he developed high fever and confusion. Blood smear examination revealed infection with Plasmodium falciparum. He also suffered from acute liver and kidney function impairment, severe thrombocytopenia, coagulation dysfunction, cerebral edema, and anuria.

DIAGNOSES: Peripheral blood smear, for the diagnosis of malignant malaria parasite infection.

INTERVENTIONS: The patient received treatments such as artemether for antimalarial parasites, artificial liver blood purification, and ICU support.

OUTCOMES: Through continuous renal replacement therapy combined with artificial liver blood purification technology for fluid management, immune complex clearance, and correction of water, electrolyte and acid-base disorders, the patient was successfully treated.

LESSONS: The integration of artificial liver blood purification with continuous renal replacement therapy may serve as an effective rescue therapy for severe malaria with multi-organ failure, potentially by mitigating the systemic inflammatory response and supporting organ recovery. This case highlights the potential of combined extracorporeal support in managing critical tropical infections.

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ESP Quick Facts

ESP Origins

In the early 1990's, Robert Robbins was a faculty member at Johns Hopkins, where he directed the informatics core of GDB — the human gene-mapping database of the international human genome project. To share papers with colleagues around the world, he set up a small paper-sharing section on his personal web page. This small project evolved into The Electronic Scholarly Publishing Project.

ESP Support

In 1995, Robbins became the VP/IT of the Fred Hutchinson Cancer Research Center in Seattle, WA. Soon after arriving in Seattle, Robbins secured funding, through the ELSI component of the US Human Genome Project, to create the original ESP.ORG web site, with the formal goal of providing free, world-wide access to the literature of classical genetics.

ESP Rationale

Although the methods of molecular biology can seem almost magical to the uninitiated, the original techniques of classical genetics are readily appreciated by one and all: cross individuals that differ in some inherited trait, collect all of the progeny, score their attributes, and propose mechanisms to explain the patterns of inheritance observed.

ESP Goal

In reading the early works of classical genetics, one is drawn, almost inexorably, into ever more complex models, until molecular explanations begin to seem both necessary and natural. At that point, the tools for understanding genome research are at hand. Assisting readers reach this point was the original goal of The Electronic Scholarly Publishing Project.

ESP Usage

Usage of the site grew rapidly and has remained high. Faculty began to use the site for their assigned readings. Other on-line publishers, ranging from The New York Times to Nature referenced ESP materials in their own publications. Nobel laureates (e.g., Joshua Lederberg) regularly used the site and even wrote to suggest changes and improvements.

ESP Content

When the site began, no journals were making their early content available in digital format. As a result, ESP was obliged to digitize classic literature before it could be made available. For many important papers — such as Mendel's original paper or the first genetic map — ESP had to produce entirely new typeset versions of the works, if they were to be available in a high-quality format.

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Early support from the DOE component of the Human Genome Project was critically important for getting the ESP project on a firm foundation. Since that funding ended (nearly 20 years ago), the project has been operated as a purely volunteer effort. Anyone wishing to assist in these efforts should send an email to Robbins.

ESP Plans

With the development of methods for adding typeset side notes to PDF files, the ESP project now plans to add annotated versions of some classical papers to its holdings. We also plan to add new reference and pedagogical material. We have already started providing regularly updated, comprehensive bibliographies to the ESP.ORG site.

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With the world now in the middle of a new and rapidly spreading pandemic, now is the time to read this book, originally published in 2012, that describes animal infections and the next human pandemic (that's actually the book's subtitle). You would be hard pressed to find a more relevant explanation of how this got started and why there will be more after this one. R. Robbins

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Papers in Classical Genetics

The ESP began as an effort to share a handful of key papers from the early days of classical genetics. Now the collection has grown to include hundreds of papers, in full-text format.

Digital Books

Along with papers on classical genetics, ESP offers a collection of full-text digital books, including many works by Darwin and even a collection of poetry — Chicago Poems by Carl Sandburg.

Timelines

ESP now offers a large collection of user-selected side-by-side timelines (e.g., all science vs. all other categories, or arts and culture vs. world history), designed to provide a comparative context for appreciating world events.

Biographies

Biographical information about many key scientists (e.g., Walter Sutton).

Selected Bibliographies

Bibliographies on several topics of potential interest to the ESP community are automatically maintained and generated on the ESP site.

ESP Picks from Around the Web (updated 28 JUL 2024 )