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

He XY, Li XH, ZH Tong (2025)

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

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

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

RevDate: 2025-11-11

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

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

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

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

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

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

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

RevDate: 2025-11-11

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

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

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

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

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

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

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

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

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

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

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

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

RevDate: 2025-11-11

Lee DH, Lee W, H Bach (2025)

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

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

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

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

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

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

Infectious medicine, 4(4):100211.

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

RevDate: 2025-11-13

Sad SA, Iftikhar L, M Chamout (2025)

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

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

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

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

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

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

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

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

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

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

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

RevDate: 2025-11-10

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

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

Nature reviews. Microbiology [Epub ahead of print].

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

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

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

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

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

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

RevDate: 2025-11-12

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

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

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

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

RevDate: 2025-11-10

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Alali M (2025)

Pediatric Hepatitis-Associated Aplastic Anemia.

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

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

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

Alkhwaiter B, Aloud M, N Almezeini (2025)

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

JMIR mHealth and uHealth, 13:e75909.

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

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

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

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

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

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

Nadubinszky G, B Székács (2025)

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

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

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

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

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

Advances in Inhaled Nanoparticle Drug Delivery for Pulmonary Disease Management.

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

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

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

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

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

Frontiers in public health, 13:1659671.

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

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

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

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

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

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

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

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

iScience, 28(11):113750.

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

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

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

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

Frontiers in cellular and infection microbiology, 15:1697880.

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

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

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

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

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

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

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

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

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

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

Osifo SE, MA Shobode (2025)

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

Cureus, 17(10):e94102.

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

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

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

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

Frontiers in molecular biosciences, 12:1700263.

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

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

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

Tuberculosis: An Ongoing Global Threat.

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

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

RevDate: 2025-11-09

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

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

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

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

RevDate: 2025-11-14

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

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

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

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

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

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

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

Lin EA, KJ Renfree (2026)

AI-Enabled Remote Patient Monitoring Systems in Hand Surgery.

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

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

RevDate: 2025-11-16

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

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

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

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

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

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

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

RevDate: 2025-11-08

McCarthy K, RZ Silkiss (2025)

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

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

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

RevDate: 2025-11-07

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

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

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

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

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

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

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

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

RevDate: 2025-11-07

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

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

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

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

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

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

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

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

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

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

JMIR infodemiology, 5:e72165.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

RevDate: 2025-11-07

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

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

Pediatric cardiology [Epub ahead of print].

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

RevDate: 2025-11-07

Pervaiz A, AO Soubani (2025)

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

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

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

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

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

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

Cureus, 17(10):e93929.

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

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

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

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

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

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

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

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

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

Frontiers in psychiatry, 16:1627507.

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

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

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

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

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

RevDate: 2025-11-07

Gil YM (2025)

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

Journal of dental education [Epub ahead of print].

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

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

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

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

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

Pourshaban M, H Hasankhani (2025)

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

Nursing open, 12(11):e70216.

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

DESIGN: A concept analysis paper.

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

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

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

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

CONSENT: No patient or public contribution.

RevDate: 2025-11-06

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

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

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

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

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

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

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

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

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

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

Jung C, Gillmann HJ, T Stueber (2025)

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

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

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

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

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

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

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

Conduah AK, SH Ofoe (2025)

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

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

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

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

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

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

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

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

RevDate: 2025-11-06

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

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

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

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

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

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

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

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

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

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

Cureus, 17(10):e93877.

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

RevDate: 2025-11-16

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

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

Clinical pharmacology and therapeutics [Epub ahead of print].

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

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

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

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

BMC public health, 25(1):3787.

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

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

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

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

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

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

Organoids in respiratory virus research: advances and perspectives.

Molecular biomedicine, 6(1):100.

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

RevDate: 2025-11-05

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

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

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

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

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

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

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

Journal of medical Internet research, 27:e77331.

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

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

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

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

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

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

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

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

Upsala journal of medical sciences, 69:.

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

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

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

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

RevDate: 2025-11-04

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

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

Clinical microbiology reviews [Epub ahead of print].

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

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

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

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

PeerJ, 13:e20208.

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

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

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

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

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

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

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

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

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

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

Park YS, Schroeder D, OJ Kim (2025)

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

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

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

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

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

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

RevDate: 2025-11-07

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

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

BMC public health, 25(1):3758.

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

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

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

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

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

Kim S, Shrestha K, G Cho (2025)

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

Microsystems & nanoengineering, 11(1):204.

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

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

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

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

Frontiers in immunology, 16:1661117.

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

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

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

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

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

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

Frontiers in immunology, 16:1654604.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Frontiers in public health, 13:1677306.

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

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

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

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

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

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

SARS-CoV-2: A Liver Brief.

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

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

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

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

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

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

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

RevDate: 2025-11-02

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

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

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

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

RevDate: 2025-11-01

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

Maternal vaccination to prevent neonatal infections and combat antimicrobial resistance.

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

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

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

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

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

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

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

RevDate: 2025-11-01

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

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

Viral immunology [Epub ahead of print].

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

RevDate: 2025-11-07

Salvaggio MR, McCloskey C, E Siegrist (2025)

Syphilis in the post-Covid-19 pandemic world.

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

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

RevDate: 2025-11-08

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

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

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

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

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

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

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

The American journal of case reports, 26:e950045.

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

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

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

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

BMC public health, 25(1):3716.

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

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

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

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

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

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

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

BMC infectious diseases, 25(1):1463.

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

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

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

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

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

RevDate: 2025-11-06

Han S, Liu Y, Xing B, et al (2025)

Association of glucagon-like peptide-1 receptor agonist use with risk of infections: A systematic review and meta-analysis.

The Journal of infection, 91(5):106645 pii:S0163-4453(25)00245-2 [Epub ahead of print].

OBJECTIVE: To assess whether GLP-1 RA treatment influences infection risk in randomized clinical trials (RCTs).

METHODS: Systematic searches were conducted across PubMed, EMBASE, Cochrane Library, and Web of Science (inception to September 24, 2024), and reference lists of eligible articles. RCTs comparing GLP-1 RA treatment with placebo or non-GLP-1 RA treatments were included. Dual reviewer resolved disagreements by consensus. Two reviewers independently extracted data following PRISMA recommendations and assessed risk of bias via Cochrane tool.

RESULTS: A total of 136 RCTs (n = 164,322) were included. GLP-1 RA treatment was associated with a significant reduction in serious infections (RR, 0.89; 95% CI, 0.86-0.93; absolute risk difference, -30 per 10,000 persons/year; I² = 0%), non-serious (RR, 0.90; 95% CI, 0.85-0.97; I² = 77%), and total infections (RR, 0.89; 95% CI, 0.84-0.94; I² = 77%). Reductions were observed for serious respiratory (RR, 0.84; 95% CI, 0.79-0.90), skin and subcutaneous (RR, 0.77; 95% CI, 0.68-0.87), musculoskeletal (RR, 0.79; 95% CI, 0.65-0.97), vascular (RR, 0.65; 95% CI, 0.47-0.90), and COVID-19 infections (RR, 0.82; 95% CI, 0.72-0.92), all with I² = 0%. Meta-regression showed greater weight loss (β = -0.011; P =.045), hemoglobin A1c reduction (β = -0.229; P =.026), and higher GLP-1 RA doses (RR, 0.87; 95% CI, 0.83-0.92) were associated with lower risk.

CONCLUSION: GLP-1 RA use was associated with reduced risk of serious infections, particularly in respiratory, skin, musculoskeletal, vascular systems and COVID-19, partially explained by weight loss and improved glycemic control.

RevDate: 2025-11-01

Mousavinejad SN, Lachouri R, Bahadorzadeh M, et al (2025)

Artificial intelligence for arterial blood gas interpretation.

Clinica chimica acta; international journal of clinical chemistry, 579:120691 pii:S0009-8981(25)00570-4 [Epub ahead of print].

Arterial blood gas (ABG) analysis is a fundamental diagnostic tool in clinical medicine, offering critical insights into a patient's respiratory and metabolic status. However, interpreting ABG results can be complex and time-sensitive, necessitating accurate and rapid analysis. With the advancement of artificial intelligence (AI), new avenues have emerged to enhance the interpretation and application of ABG data. This review explores the role of AI in ABG analysis, highlighting how machine learning algorithms and natural language models such as ChatGPT can aid in the systematic interpretation of complex physiological data. We examine the mechanisms through which AI systems analyze ABG parameters, including pH, PaCO2, and HCO3[-], and provide diagnostic recommendations. Specific applications, such as AI-driven models, in the detection of COVID-19 severity and pulmonary hypertension via ABG data are discussed, demonstrating the expanding clinical utility of AI technologies. Additionally, we explore the potential of 3D animated computer models as educational and diagnostic tools for interpreting blood gas data. The integration of AI into ABG interpretation holds promise for improving diagnostic accuracy, clinical decision-making, and patient outcomes, signaling a transformative shift in modern healthcare diagnostics.

RevDate: 2025-10-31

Rizzo M, Tubassum R, Kaplan CA, et al (2025)

Systematic Review and Meta-Analysis: The Associations of Prenatal Exposure to SARS-CoV-2 Infection and COVID-19 Vaccination With Child Neurodevelopment.

Journal of the American Academy of Child and Adolescent Psychiatry pii:S0890-8567(25)02151-3 [Epub ahead of print].

OBJECTIVE: We aimed to systematically review and meta-analyze evidence on the associations between prenatal exposure to SARS-CoV-2 infection or COVID-19 vaccination and child neurodevelopmental outcomes.

METHOD: We searched MEDLINE, EMBASE, PsycINFO, Web of Science, Scopus, and Cochrane CENTRAL for original research on neurodevelopmental outcomes in children prenatally exposed to SARS-CoV-2 infection and COVID-19 vaccination published in any language before November 8, 2024. We performed meta-analyses on any outcome reported in ≥3 controlled studies.

RESULTS: Seventy studies were identified on neurological (n = 7), neuroimaging (n = 12), motor (n = 3), audiological (n = 29) and neurodevelopmental (n = 35) assessments, and neurodevelopmental disorders (n = 2) with median sample sizes of N = 117 (IQR: 44-340) and follow-up ≤36 months. Meta-analyses of neonatal auditory screenings (n = 10), Ages and Stages Questionnaire (ASQ-3) (n = 9), and ASQ Social-Emotional (ASQ-SE) (n = 3) data suggested a higher risk of transient hearing impairment [RR = 2.01, 95% CI, 1.39-2.91] and delays in fine motor [RR = 1.55, 95% CI, 1.14-2.10] and problem-solving [RR = 1.32, 95% CI, 1.01-1.74] skills in children prenatally exposed to SARS-CoV-2 compared to unexposed children.

CONCLUSION: Prenatal SARS-CoV-2 exposure was associated with early impairments in hearing, fine motor, and problem-solving skills, which appear to resolve with time. No associations were identified with atypical neurological or neuroimaging outcomes. No adverse neurodevelopmental effects were reported in the two studies that examined prenatal COVID-19 vaccination. Study quality was generally moderate, with small sample sizes, inappropriate control groups, and unmeasured confounding. Taken together, the current body of research does not support a causal relationship between prenatal exposure to SARS-CoV-2 infection or COVID-19 vaccination and adverse neurodevelopmental outcomes.

RevDate: 2025-10-31

Mallouli SZ, Munblit D, Iakovleva E, et al (2025)

Persistent neurological sequelae in children and adolescents after SARS-CoV-2: a scoping review.

Infection [Epub ahead of print].

OBJECTIVES: For the past five years, COVID-19 has not only been a priority for health planning but also a hotspot for clinical research. Yet, the weight of the worldwide COVID-19 pandemic arises from the critical phase consequences due to the onset of acute disease, associated containment measures, and documented ongoing disabling symptoms. Investigating the global longitudinal effects on children and adolescents will inform future health directives tailored to this population's needs. This review aimed to report the spectrum of persistent neurological sequelae in children and adolescents following SARS-CoV-2 infection.

METHODS: Hence, we conducted a scoping review following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We included the peer-reviewed articles from PubMed, Google Scholar, Web of Science, Cochrane Library, and WHO COVID database to identify relevant literature on long-COVID-19 neurological signs/symptoms among children and adolescents. The search covered the period between September 2020 and September 2024.

RESULTS: The results of our analysis of 33 studies found long-COVID-19-related neurological signs/symptoms were predominantly: pain and sensory problems (N = 74,612/91,543; 81.5%), followed by sleep disturbances (N = 14,630/91,543; 15.9%), and cognitive difficulties (N = 2274/91,543; 2.4%). The global prevalence of long COVID-19 neurological signs/symptoms was estimated between 0.4% (20/5032; 95% CI = 2.1-3%) and 34% (27/79) based on data obtained through online questionnaire; while it varied between 1.8% (4/215) and 83.14% (74/89; 95%CI =   -  0.12; 0.30) based on patient assessment. Long-COVID-19-related neurological signs/symptoms were more common in the 11-16 age group. Children with immunocompetent profiles were at higher risk of developing long-COVID-19-related neurological signs/symptoms.

CONCLUSION: Our results demonstrate a considerable burden of COVID-19-related persistent neurological signs/symptoms in children and adolescents, which should be taken into consideration in healthcare decision-making.

RevDate: 2025-11-02
CmpDate: 2025-10-31

Horstink N, Lassing K, Knoester M, et al (2025)

Host factors associated with respiratory particle emission and virus presence within respiratory particles: a systematic review.

Frontiers in microbiology, 16:1652124.

INTRODUCTION: Understanding host factor-related mechanisms that drive variability in respiratory particle emission and virus presence in exhaled particles is essential to assess transmission risk and potentially identify individuals with elevated infectiousness.

METHODS: We conducted a systematic review of human observational studies examining associations between host factors and either respiratory particle emission or virus presence in exhaled particles. Searches in PubMed, EMBASE, and Web of Science covered studies up to September 2024. Risk of bias was assessed using STROBE-based criteria. Findings were synthesized narratively, grouped by host factor and outcome type.

RESULTS: Forty-four studies met inclusion criteria: 34 assessed host factors in relation to particle emission, and 11 examined viral presence in exhaled particles. Fine particle emission (<5 μm) was most consistently associated with older age (n = 16), physical exercise (n = 6), and active infection (n = 6). No consistent associations were found for sex (n = 21), body mass index (BMI; n = 10), or smoking (n = 6). Viral presence-mainly influenza and SARS-CoV-2-was more strongly associated with time since symptom onset (n = 8) and lower respiratory symptoms (n = 3), based largely on genomic detection. Associations with other factors, including upper respiratory symptoms (n = 6), swab viral load (n = 11), age (n = 6), sex (n = 6), and BMI (n = 2), were inconsistent or absent. Physical exercise was not evaluated in relation to viral presence.

DISCUSSION: Fine respiratory particles (<5 μm) were the predominant size fraction detected and often contained higher concentrations of viral RNA. Age, physical exercise, and active infection were consistently associated with increased emission of these particles. The presence of respiratory viruses in exhaled air was more strongly linked to infection-related factors such as early symptom onset and lower respiratory involvement. These patterns suggest distinct mechanisms contributing to airborne transmission. Interpretation was limited by methodological heterogeneity and predominant reliance on PCR. Still, consistent associations with host factors suggest their potential as indicators for transmission risk. As evidence focused mainly on influenza and SARS-CoV-2, generalizability is limited. Standardized methods and further research are needed to strengthen outbreak preparedness.

RevDate: 2025-11-02
CmpDate: 2025-10-31

Qiao Y, Rong L, Chen H, et al (2025)

Gut microbiota, nutrients, and depression.

Frontiers in nutrition, 12:1581848.

In the post-COVID-19 era, depression incidence has risen sharply, and a healthy diet is confirmed to lower this risk. However, two critical gaps remain: it is unclear whether nutrients alleviate depressive symptoms by improving the gut microbiota, and existing evidence has notable limitations. This study aimed to address these by exploring how deficiencies in key nutrients (protein, lipids, sugars, vitamins, and minerals) affect gut microbiota diversity-potentially a driver of early depression-and systematically evaluating clinical/basic research on nutrients' role in gut microbiota-mediated depression intervention. Results showed nutrients enhance gut microbiota abundance and diversity, regulate the gut-brain axis to boost short-chain fatty acid (SCFA) and neurotransmitter synthesis, and reduce inflammation, thereby alleviating depression. Thus, a healthy anti-inflammatory diet (rich in vegetables, fruits, fish) may lower depressive symptom risk. Three key research gaps were identified: 1. Mechanistic evidence relies heavily on animal studies (e.g., mouse neurotransmitter experiments) with insufficient large-scale human randomized controlled trials (RCTs) to confirm causality; 2. Conflicting findings exist [e.g., alpha-linolenic acid (ALA) has no antidepressant effect in some human cohorts]; 3. The dose-response relationship (e.g., fiber needed to elevate SCFAs to antidepressant levels) is unquantified. Future studies should quantify dietary patterns and target gut microbiota metabolism to advance early depression prevention and deepen understanding of diet-microbiota-depression links.

RevDate: 2025-11-02
CmpDate: 2025-10-31

Sun N, Lu Y, Li C, et al (2025)

Genetic Risk of Different Populations in COVID-19 Susceptibility and Severity.

Infection and drug resistance, 18:5499-5505.

The coronavirus disease 2019 (COVID-19) pandemic has created challenges by threatening public health and triggering the largest global economic crisis in recent history. While environmental factors and social activities influence the clinical outcome of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure and COVID-19 severity, the host genetic background and variants are increasingly recognized as vital players in individual susceptibility to SARS-CoV-2 infection, ranging from asymptomatic infection to lethal COVID-19. A plethora of genome-wide association meta-analyses have been provided and will continue to provide genetic determinants of the heterogeneity of COVID-19 outcomes. Such discoveries undoubtedly deepen our understanding of the biological underpinnings of SARS-CoV-2 infection and COVID-19 disease, paving the way for the development of more efficient SARS-CoV-2 prevention strategies and drug repurposing. Here, we provide a brief overview of studies regarding host susceptibility to COVID-19 and its clinical outcomes, focusing on the identification of genome-wide significant loci from different ancestral populations.

RevDate: 2025-11-02
CmpDate: 2025-10-31

Cheng Y, X Zheng (2025)

Characteristics and mechanisms of liver injury caused by emerging infectious diseases.

Frontiers in immunology, 16:1647517.

Abnormal liver function has become a common phenomenon in emerging infectious diseases caused by viruses, with incidence rates ranging from 2.5% to 98.6% across different pathogens. This review summarized the characteristics of liver injury caused by SARS-CoV-2, MERS-CoV, H7N9, SFTSV, DENV, and EBOV viruses. Viral infection initiates liver injury through direct attack, ischemia, and microthrombosis, triggering an exaggerated immune response often exacerbated by drug toxicity. Core mechanisms involve interconnected mitochondrial dysfunction (causing energy failure, ROS/mt-DNA release), endoplasmic reticulum stress (with dual roles in adaptation and apoptosis), and aberrant inflammation. These pathways form a vicious cycle, culminating in hepatocyte death, metabolic disruption, and severe hepatic damage. An in-depth exploration of the causes and mechanisms of liver injury also provides diversified strategies for treating and preventing these infectious diseases.

RevDate: 2025-11-02

Gartmann J, Sturm C, A Bökel (2025)

Physiotherapy interventions in post- and long-COVID-19: a scoping review of the literature up to February 2023.

BMC health services research, 25(1):1425.

BACKGROUND: Physiotherapy is an accepted and recommended treatment for post- and long-COVID-19 condition. It is assumed that physiotherapists reported a lack of information on physiotherapy interventions and treatment parameters. This scoping review provides an overview of the evidence on physiotherapy interventions published in the scientific literature.

METHODS: The scoping review includes studies analysing physiotherapy treatment parameters and interventions in post- and long-COVID patients. Studies focusing on telemedicine or exclusively home-based workouts are excluded. A systematic literature search was conducted by two independent researchers in the databases PubMed, EBSCO, SCOPUS, Web of Science, EMBASE, PEDro, Cochrane, and WISO. Following the abstract screening process, data extraction and critical assessment were performed.

RESULTS: In this scoping review, 6 studies were included, providing information physiotherapy management of post- and long-COVID-19. The research identified respiratory therapy, aerobic training or strength training as key areas of focus.

CONCLUSION: This scoping review highlights the need for further studies on physiotherapy treatment in post- and long-COVID condition.

TRIAL REGISTRATION: Open Science Framework (Registry number osf.io/5k3tA).

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-025-13631-7.

RevDate: 2025-11-02
CmpDate: 2025-10-31

Palotino-Ferreira BM, Rocha SV, Nunes-Silva A, et al (2025)

The influence of structured physical activity on vaccination response from adults to older individuals: a systematic review on the Immunoinflammatory crosstalk of COVID-19.

Immunity & ageing : I & A, 22(1):44.

BACKGROUND: Amidst the ongoing COVID-19 pandemic, understanding factors that influence vaccine efficacy is crucial, particularly in older adults. Regular physical exercise and/or structured physical activity (SPA) has emerged as a potential modulator of immune responses, enhancing vaccine effectiveness. This systematic review aims to consolidate current evidence on the impact of SPA/exercise on both immune and inflammatory responses to COVID-19 vaccination in adults and older individuals.

METHODS: Most relevant studies were extracted from indexed databases using health subject terms in English, Portuguese, and Spanish. Studies that examined the impact of regular exercise or SPA on inflammatory and/or immunological responses in relation to COVID-19 immunization were selected. In particular, all chosen studies included individuals who received vaccinations either prior to or following the exercise regimen or SPA, and the main goal was to evaluate these effects on immunological and/or inflammatory reactions induced by vaccination.

RESULTS: Among the 7 studies included (n = 1149), the effects of regular exercise or PA on vaccine-induced immune responses while concurrently assessing inflammatory markers were examined. The findings suggest that moderate to high-intensity structured physical activity (50-70% of maximum heart rate for aerobic exercise and 60-80% of 1RM for resistance training), performed 3-5 times per week, was able to enhance immune responses to COVID-19 vaccination, particularly by mitigating chronic low-grade inflammation. Acute exercise can transiently boost immunity, whilst engagement in moderate SPA over a period of six months may contribute to sustained improvements in immune function, especially in older adults. However, these findings should be interpreted with caution due to variability in study design, sample characteristics, and potential confounding factors.

CONCLUSION: Regular exercise and SPA play a significant role in improving immune/inflammatory responses to COVID-19 vaccination. Older adults, in particular, may benefit from regular SPA and exercise as a strategy to counteract immunosenescence and optimize vaccine efficacy. However, further research is needed to better refine exercise protocols and determine long-term benefits in different populations.

RevDate: 2025-10-30

Ishola AA, Ahmed IA, MA Mikail (2025)

Molecular Roadmap of COVID-19: From Viral Entry to Therapeutic Targets.

Chemistry & biodiversity [Epub ahead of print].

Although the global emergency of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has subsided, the pandemic is not over, making the development of effective therapeutics crucial to reduce mortality and restore patient health. Identifying host molecular pathways targeted by the virus is essential for drug discovery, whether through repurposing existing drugs or developing new ones. This review examines the molecular mechanisms of SARS-CoV-2 infection, including signaling pathways, therapeutic targets, viral entry and replication strategies, and associated clinical features. It also discusses current global infection and mortality trends, clinical management, and prospects for drug development. Data were sourced from major scientific databases. Given the virus's high mutation rate and ongoing impact, multidisciplinary collaboration is needed. Plant-derived compounds and herbal medicines show promise as potential antiviral interventions against coronavirus disease 2019 (COVID-19). The information and data on COVID-19 were collated from various resources and literature databases such as PubMed, Science Direct, Wiley, Springer, Taylor and Francis, Scopus, Inflibnet, Google, and Google Scholar.

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

Roedl K, C Genbrugge (2025)

Managing cardiac arrest in the intensive care unit.

Current opinion in critical care, 31(6):729-734.

PURPOSE OF REVIEW: This review aims to explore the distinct clinical characteristics, epidemiology, treatment approaches, and research needs concerning cardiac arrest in the intensive care unit (ICU-CA), a specific subset of in-hospital cardiac arrest (IHCA). While IHCA remains a major cause of mortality, recent data indicate improved outcomes, with a notable variation in incidence and survival depending on the location, particularly within the ICU setting.

RECENT FINDINGS: Recent studies underscore that ICU-CA differs significantly from general IHCA in etiology, monitoring, and treatment environment. Although incidence rates vary widely (4-78 per 1000 ICU admissions), recent data suggest a stabilization. Causes of ICU-CA often involve noncardiac factors such as septic shock and respiratory failure. Treatment is typically guided by general advanced life support (ALS) protocols, but ICU-specific resources such as real-time monitoring, invasive pressure measurements, transesophageal echocardiography, and the potential for extracorporeal cardiopulmonary resuscitation offer unique advantages. The COVID-19 pandemic highlighted the vulnerability of ICU patients, with respiratory causes dominating and extremely poor outcomes reported.

SUMMARY: In summary, ICU-CA represents a distinct clinical entity requiring tailored research. Future directions should prioritize international registries, validation of predictive models using artificial intelligence, and clarification of do-not-resuscitate practices to improve outcomes and resource allocation in this critically ill population.

RevDate: 2025-11-02
CmpDate: 2025-10-30

Akhmetzhanov AR, Cheng HY, Cheng G, et al (2025)

Consolidating Estimates of the Incubation Period for Omicron Subvariants From the Literature and Their Comparison to the Estimate From Taiwan: A Systematic Review and Meta-Analysis, September 2024.

Influenza and other respiratory viruses, 19(11):e70171.

BACKGROUND: The COVID-19 pandemic was characterized by waves driven by distinct viral variants, including the Omicron variant, which emerged in October 2021. To formulate effective public health strategies and understand disease spread, accurate estimates of the incubation periods of these variants are important. Existing estimates often conflict due to biases caused by epidemic dynamics and selective inclusion of cases. Using data from Taiwan, where disease incidence remained low and contact tracing was comprehensive during the first months of the Omicron outbreak, this study aims to accurately estimate the incubation period of the Omicron (BA.1) variant incubation period.

METHODS: We reviewed the first 100 Omicron BA.1 symptomatic cases reported in Taiwan's contact-tracing records (between December 2021 and January 2022). Of these, 69 had usable information. Data on exposure and symptom onset dates were fitted with the generalized gamma. A systematic search and meta-analysis on incubation periods for Omicron BA.1/2/4/5 subvariants was then conducted to derive pooled mean estimates for the incubation periods of each subvariant.

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

CONCLUSIONS: Omicron subvariants have a relatively shorter incubation period compared to previous SARS-CoV-2 variants. A continuous update of incubation period estimates, based on available data, is necessary to develop guidelines that can reduce the socioeconomic costs associated with COVID-19.

RevDate: 2025-11-01
CmpDate: 2025-10-30

Raveendran VV, AlQattan S, E AlMutairy (2025)

A review on clinical implications of S100 proteins in lung diseases.

Frontiers in medicine, 12:1618772.

The S100 family of proteins plays a pivotal role in the pathogenesis of lung diseases, including asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis, pulmonary arterial hypertension (PAH), pulmonary fibrosis, lung cancers, acute lung injury, acute respiratory distress syndrome, COVID-19, and lung transplantation. This review comprehensively examines the contributions of S100 proteins to the progression of these disorders, focusing on their potential as diagnostic and prognostic biomarkers, as well as therapeutic targets. S100A protein-mediated key molecular mechanisms that influence inflammation, airway remodeling, fibrosis, and tumorigenesis in the lungs are discussed. The importance of their normal function is evident from the observation that simultaneous mutations in S100A3 and S100A13 predispose individuals to early-onset pulmonary fibrosis, underscoring their critical role in lung health. Furthermore, sustained S100 protein elevation is explored in the context of long COVID, shedding light on its role in chronic inflammation. These proteins act as damage-associated molecular patterns (DAMPs), activating immune pathways via receptors like TLR4 and RAGE, thereby driving inflammation and immune cell recruitment. Notably, in lung transplantation, elevated levels of S100A8, S100A9, and S100A12 serve as early biomarkers of graft rejection and complications such as graft-vs.-host disease, which indicates their role in mediating immune responses and transplant outcomes. While promising, the clinical application of S100 proteins faces challenges, including disease-specific variability and the need for robust validation across diverse populations. This narrative review underscores the dual potential of S100 proteins as biomarkers and therapeutic targets in respiratory medicine while emphasizing the importance of overcoming current limitations through targeted research and clinical trials.

RevDate: 2025-10-30
CmpDate: 2025-10-30

Basu T, AK Upadhyay (2025)

In silico approaches to identify therapeutic drug targets against COVID-19: a detailed review with a case study.

In silico pharmacology, 13(3):162.

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, primarily affects the respiratory system, has impacted millions worldwide and resulted in significant morbidity and mortality. The development of effective therapies for treatment is crucial to reduce the burden of the disease, as the current treatments are mainly supportive. Therefore, identifying therapeutic drug targets for COVID-19 is of utmost importance. Overall, identifying and validating drug targets for COVID-19 is an active area of research. Advances in understanding the molecular mechanisms underlying SARS-CoV-2 infection and the host response to the virus will continue to inform the development of effective therapies for COVID-19. Computational biology has played a crucial role in developing therapeutics for COVID-19, such as drug discovery, vaccine development, understanding viral evolution, predicting drug resistance, and repurposing existing drugs. In this review, we will discuss the details of the different drug targets and their mode of action. Computational biology has been an essential tool in the fight against COVID-19, helping researchers develop new treatments and vaccines and understand the behaviour and evolution of the virus. We demonstrate a case study on the in-silico identification of natural compounds as potential IL-6 inhibitors, highlighting their relevance in managing COVID-19-associated cytokine storms.

RevDate: 2025-10-30

Liao C, Zhao X, Q Wang (2025)

Design and Development of Small-Molecule Drugs Targeting Enzymes Utilizing Two-Metal-Ion Catalytic Mechanisms.

Medicinal research reviews [Epub ahead of print].

The active sites of numerous metalloproteins feature two metal ion cofactors-either identical or distinct-that are positioned in close proximity, typically around 3.8 Å apart. This two-metal-ion catalytic mechanism (TCM) endows these enzymes with a remarkable catalytic efficiency. Enzymes employing TCM play vital biological roles in both humans and pathogenic organisms, with some identified as validated therapeutic targets. Various rational drug design approaches, including nucleoside analogs, prodrugs, metal-binding group design, bioisosteres, pharmacophore modeling, scaffold hopping, tautomerism, and structure-based drug design, have been successfully applied to several enzymes with TCMs, thus yielding the development and approval of many small-molecule drugs for the treatment of several diseases, including certain catastrophic illnesses, such as hepatitis C infection, coronavirus disease 2019, and acquired immune deficiency syndrome. Additionally, drug repurposing has proven to be a critical strategy in the development of therapeutics targeting TCM enzymes. This article reviews the significant achievements in design and development of small-molecule drugs targeting several enzymes with TCMs, including RNA-dependent RNA polymerase, HIV-1 integrase, influenza virus cap-dependent endonuclease, and phosphodiesterase, hoping to offer valuable insights and guidance to facilitate future drug discovery efforts focused on these enzymes and related molecular targets.

RevDate: 2025-10-30

Cardoso MR, Sánchez ODR, Greenwald M, et al (2025)

Intersectionality and Intimate Partner Violence: Risk Factors and Vulnerabilities During the COVID-19 Pandemic and Other Humanitarian Emergencies.

Trauma, violence & abuse [Epub ahead of print].

Intimate partner violence (IPV) presents significant global health, human rights, and protection challenges, particularly during emergencies. The Coronavirus Disease 2019 (COVID-19) pandemic exacerbated preexisting social inequalities, including those related to gender, race/ethnicity, and class, and led to an increase in IPV due to lockdown measures and economic stressors. This study aims to examine risk factors contributing to increased IPV among women and girls during COVID-19 mitigation strategies, explore the intersectional vulnerabilities of Black women in this setting, and compare IPV prevalence during the pandemic with other crises such as natural disasters and conflict settings. The review synthesized existing research to answer two primary questions. A comprehensive search was conducted across 11 databases. Eligible studies were peer-reviewed, published in English, Portuguese, or Spanish, and included women aged 15 years or older. Data extraction and quality assessments were performed by independent reviewers using the Joanna Briggs Institute critical appraisal tools. The findings revealed that IPV rates increased during the COVID-19 pandemic due to risk factors such as economic stress, social isolation, and lack of access to healthcare. Vulnerabilities were particularly pronounced for women and girls from marginalized groups, including Black women, who experienced compounded effects of race, class, and gender. The analysis also found similar patterns of increased IPV during other emergencies, including natural disasters and humanitarian crises. Key barriers to protection from IPV included limited access to resources, social and community support, and discrimination at a societal level. The findings underscore the need for targeted interventions that address the specific needs of women experiencing IPV during crises, with a particular focus on marginalized groups. Recommendations include strengthening support systems, improving access to healthcare and protection networks, promoting anti-racist and equity-focused policies, and enhancing data collection methodologies. Addressing the intersectional nature of vulnerabilities is crucial to developing effective, culturally appropriate solutions to protect women and girls during crises.

RevDate: 2025-10-30

Mundt C, Yusufoğlu B, Kudenko D, et al (2025)

AI-Driven Personalized Nutrition: Integrating Omics, Ethics, and Digital Health.

Molecular nutrition & food research [Epub ahead of print].

Personalized nutrition (PN) aims to prevent and manage chronic diseases by providing individualized dietary guidance based on genetic, metabolic, and lifestyle data. Artificial intelligence (AI) has become a key enabler in PN by analyzing large-scale, multiomics datasets in obesity, diabetes, cardiovascular, and gastrointestinal disorders, where digital twins and health knowledge graphs support personalized interventions. Current findings demonstrate that AI models can guide microbiome-based dietary interventions, and support obesity management, thereby extending the scope of conventional nutritional strategies as supported by deepened bibliometric analyses. This study highlights the global increase in AI-based PN studies, accelerated by digital health demands and the COVID-19 pandemic, and the expansion of traditional nutrition strategies through machine learning approaches with the integration of microbiome-based models and omics. However, challenges such as algorithmic bias, limited generalizability, and data privacy remain. To overcome these issues, diverse datasets, explainable AI approaches, and standardized multicenter validation protocols are proposed. These steps are critical for transforming AI-supported PN from a conceptual potential into a fair, reliable, and clinically applicable structure. The growing consensus in the literature highlights that AI can support individual and societal health goals by transforming nutrition science through predictive, adaptive, and ethically based approaches.

RevDate: 2025-11-01
CmpDate: 2025-10-30

Kelsen SG, Maurer M, Waters M, et al (2025)

Safety and tolerability of astegolimab, an anti-ST2 monoclonal antibody: a narrative review.

Respiratory research, 26(1):302.

Chronic inflammation is an underlying feature of respiratory diseases such as chronic obstructive pulmonary disease (COPD). Novel therapies that target the inflammatory mechanisms driving acute exacerbations of COPD are required. The ST2 receptor, which binds the alarmin interleukin (IL)-33 to initiate an inflammatory response, is a potential target. Astegolimab, a fully human immunoglobulin G2 monoclonal antibody, which binds with high affinity to ST2 to prevent binding of IL-33, is a potential therapy for COPD. However, targeting inflammatory pathways that form part of the immune system may have unintended consequences, such as implications for the response to infection and cardiovascular function. Therefore, an understanding of astegolimab's safety profile in clinical use is essential. This narrative review summarizes clinical safety data from published clinical trials of astegolimab with a focus on adverse events of interest, including infections and cardiac events. Astegolimab was shown to be well tolerated in > 580 patients with asthma, atopic dermatitis, COPD, and severe COVID-19 pneumonia who took part in Phase II trials. The frequency of adverse events (AEs) and serious AEs was similar between the astegolimab and placebo arms in each trial (AEs: 41-81% vs. 58-77%; serious AEs: 3-29% vs. 0-41%, respectively). The number of deaths was similar between treatment arms and there were no astegolimab-related deaths. Astegolimab did not increase the risk of infection or major adverse cardiac events. Ongoing Phase IIb and Phase III trials of astegolimab in patients with COPD who have a history of frequent acute exacerbation(s) of COPD will provide a future opportunity to confirm the safety profile of astegolimab.

RevDate: 2025-11-01
CmpDate: 2025-10-30

Zheng S, DM Lowe (2025)

Current infectious disease management challenges in inborn errors of immunity.

Annals of clinical microbiology and antimicrobials, 24(1):60.

Inborn errors of immunity (IEIs) are a frequently underdiagnosed group of disorders, with infectious complications posing significant clinical challenges. Recognizing atypical presentations of common infections and the presence of rare opportunistic pathogens can be critical in suspecting an underlying IEI. Among the infectious complications, chronic viral infections are particularly difficult to manage due to limited evidence-based guidelines. Intra-host viral evolution in these patients can lead to treatment resistance and the emergence of novel viral strains, raising concerns about their potential role as reservoirs for mutant viruses. Novel pathogens such as Aichivirus have been identified as significant causes of infection in individuals with IEIs. Furthermore, infections such as talaromycosis, tuberculosis, BCG-related disease, leishmaniasis, and melioidosis may be underrecognized in certain groups of patients with IEIs, largely due to differences in geographic exposure and environmental risk factors. The effects of emerging infections, such as mpox and Middle East respiratory syndrome coronavirus, on individuals with IEIs remain largely unknown. Management strategies for infections in this population include vaccinations, immunoglobulin replacement, and antimicrobial prophylaxis. However, newer higher valency conjugate pneumococcal vaccines may limit the utility of traditional pneumococcal polysaccharide vaccines in assessing immune function. While immunoglobulin replacement is cost-effective, it can interfere with serological diagnostics. Additionally, antimicrobial resistance is a growing issue, emphasizing the need for improved empiric antibiotic strategies and research into optimal treatment durations. This review highlights the key challenges faced by infectious disease clinicians in the care of patients with IEIs.

RevDate: 2025-10-29
CmpDate: 2025-10-29

Vishnu P, DM Aboulafia (2025)

Hemostatic Disorders Following Severe Acute Respiratory Syndrome Coronavirus 2 Infection, COVID-19 Vaccination, and Long-COVID Syndrome: Current Evidence and Controversies in Clinical Practice.

Clinics in laboratory medicine, 45(4):643-655.

The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has presented profound global health challenges. Beyond acute illness, a substantial proportion of individuals experience persistent symptoms including fatigue, brain fog, and post-exertional malaise, collectively known as Long-COVID. Among the complications associated with SARS-CoV-2 infection and vaccination, hemostatic disorders ranging from mild platelet dysfunction to severe thromboembolic events, and rare but serious coagulation-related adverse effects, such as vaccine-induced immune thrombotic thrombocytopenia, have emerged as a significant concern. Herein we provide an overview of current information and controversies surrounding hemostatic complications in SARS-CoV-2 infection and COVID-19 vaccination.

RevDate: 2025-10-29
CmpDate: 2025-10-29

Barnes K, Faasse K, AL Geers (2025)

The COVID-19 pandemic: a special case of placebo and nocebo effects.

Handbook of clinical neurology, 213:247-262.

In late 2019, reports of pneumonia from an unknown cause marked the beginning of an unprecedented health crisis with far-reaching societal consequences. The ensuing global pandemic placed immense strain on healthcare systems, disrupted economies, and altered the way that we work, communicate, and interact. Importantly, as the SARS-Cov-2 (COVID-19) virus spread, so did a range of psychological stressors, including fear, anxiety, and uncertainty. This chapter examines the trajectory of placebo- and nocebo-relevant factors during the early, mid, and late stages of the pandemic, highlighting their impact on health outcomes and human behavior. Understanding the interplay between psychological and physical health during the pandemic is crucial for minimizing maladaptive health outcomes in the future. We therefore review current strategies for mitigating the nocebo effect and leveraging the placebo effect that may be employed to enhance health and well-being and attenuate pandemic-related harms.

RevDate: 2025-10-29
CmpDate: 2025-10-29

Dutta S, Ganguly A, S Ghosh Roy (2025)

The interplay between gamma delta (γδ) T cells and cellular stress pathways in the pathogenesis of emerging human viral zoonoses.

International review of cell and molecular biology, 398:99-149.

This chapter examines the intricate relationship between gamma-delta (γδ) T cells and cellular stress pathways in the context of emerging infectious diseases. γδ T cells, a distinct subset of lymphocytes, are integral to the innate immune response, as they can recognize a diverse array of antigens independently of Major Histocompatibility Complex (MHC) restriction. They function as initial sentinels, secreting cytokines, and cytotoxic molecules to directly eradicate infected cells and regulate the immune system. This chapter examines the activation mechanisms of γδ T cells in response to viral infectious agents such as Influenza A virus, SARS-CoV-2, West Nile Virus (WNV), Dengue virus, and Human immunodeficiency virus (HIV) emphasizing their role in pathogen control and disease progression. The document examines cellular stress pathways, specifically the unfolded protein response (UPR) and integrated stress response (ISR), which are frequently activated by pathogens. These pathways initiate protective mechanisms; however, their dysregulation may lead to pathological conditions. The chapter examines the mechanisms by which certain pathogens utilize host stress responses to enhance replication and evade immune detection. The impact of stress on γδ T cell functionality and immune responses is examined. The document examines the potential of γδ T cell-based therapies for diverse infections, highlighting the necessity for additional research to enhance delivery methods and reduce the risk of autoimmune disorders. Comprehending these interactions is essential for formulating innovative approaches to prevent and treat emerging infectious diseases.

RevDate: 2025-10-29

Gromer DJ, Kalash S, Tanios R, et al (2025)

The relationship between the immunogenicity and reactogenicity of vaccines: A narrative review.

Vaccine, 68:127892 pii:S0264-410X(25)01189-2 [Epub ahead of print].

The relationship between vaccine reactogenicity and immunogenicity remains an underexplored but increasingly critical area of vaccinology. This narrative review synthesizes evidence examining this relationship across a diverse array of vaccine platforms and pathogens. The available data suggest a modest but consistent positive association between systemic reactogenicity and humoral immunogenicity, particularly for mRNA-based SARS-CoV-2 vaccines. Associations with innate and adaptive cellular immunity are less well studied. Local reactions are less consistently predictive of immune response than systemic ones. Reactogenicity appears more pronounced in younger adults, females, and those with certain HLA alleles-factors also associated with stronger immune responses. Whether the priming or booster dose of a vaccine series drives greater reactogenicity and immunogenicity appears to depend upon whether the vaccine is live-attenuated or not. However, substantial heterogeneity exists in study design, population, outcome measurement, and statistical analysis. This review emphasizes the need for harmonized tools to quantify vaccine reactogenicity and for study designs that account for pre-vaccination immune status to distinguish true associations from confounding factors and better clarify the relationship between post-vaccine symptoms and immunologic outcomes. Understanding the mechanistic links between innate immune activation, tolerability, and adaptive immune responses could inform vaccine development, clinical trial endpoints, and public communication strategies. As vaccine technologies evolve and tolerability becomes a differentiating factor, further research is needed to unravel the biological basis of vaccine-associated symptoms and their role in predicting protection.

RevDate: 2025-10-29

Garry RF (2025)

SARS-CoV-2 Spike displays multiple adaptive changes in addition to the furin cleavage site.

Virology, 614:110720 pii:S0042-6822(25)00334-4 [Epub ahead of print].

Evolution of SARS-CoV-2 from bat sarbecoviruses involved multiple changes in Spike in addition to insertion of the furin cleavage site (FCS). Analysis of the closely related Spike of BANAL-20-52 reveals key adaptations in the SARS-CoV-2 Spike beyond the FCS that occurred prior to the spillover of SARS-CoV-2's immediate progenitor to humans. Bat sarbecoviruses have enteric tropism and spread mostly by the gastrointestinal route. Their Spike proteins predominantly assume the locked form, which is able to resist the low pH of the bat gastrointestinal tract. Initial changes during the SARS-CoV-2 evolutionary pathway included substitutions that expanded the host range of the sarbecovirus progenitor and allowed circulation in nonbat mammals. Adaptation of the SARS-CoV-2 progenitors also involved remodeling of the amino-terminal domain. Respiratory adaptation occurred during circulation in nonbat animals and resulted in greater propensity for Spike to assume open forms that are less compact and more metastable than the locked or closed forms. Substitutions at monomer interfaces in the Spike trimer facilitate the open shift. Like FCS insertion, these substitutions make Spike more susceptible to low pH degradation and could not have occurred in bats. After SARS-CoV-2 spilled over to humans Spikes of the dominant lineage acquired an aspartic acid to glycine substitution at position 614 that further decreases interaction between monomers and promotes opening of the Spike trimer. A multi-stage evolutionary trajectory is also evident during cross-species transmissions of bat sarbecoviruses to pangolins and the first known spillovers of SARS-CoV via the wildlife trade.

RevDate: 2025-11-01
CmpDate: 2025-10-29

Nor Isamuddin NH, AbuBakar S, Chin KL, et al (2025)

Heterologous immunity and antibody-dependent enhancement in respiratory virus infections.

Molecular biology reports, 53(1):27.

Respiratory viruses such as influenza viruses and coronaviruses pose persistent and evolving threats to global public health, driven by diverse mechanisms of immune evasion, cross-species transmission, and pandemic potential. Understanding the interplay between heterologous immunity and antibody-dependent enhancement (ADE) is crucial in delineating both protective and pathogenic immune responses following infection or vaccination. This review synthesizes current advances in the molecular and cellular mechanisms underlying virus-agnostic innate defenses, adaptive receptor diversification via V(D)J recombination, and the structural and functional bases of T and B cell cross-reactivity. The dualistic nature of antibody responses is examined in the context of Fc receptor- and complement-mediated ADE, emphasizing the implications for immune protection versus immunopathology. The impact of pre-existing cross-reactive immunity, primed by prior exposures to antigenically distinct viruses or vaccines, is discussed with evidence from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and other seasonal respiratory outbreaks. Finally, the review evaluates recent progress and ongoing challenges in universal vaccine development, proposing that the rational harnessing of broad-spectrum and cross-reactive immune mechanisms will be essential for enhancing pandemic preparedness and mitigating the risks associated with immune enhancement phenomena.

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