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Bibliography on: covid-19

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ESP: PubMed Auto Bibliography 14 Nov 2025 at 01:44 Created: 

covid-19

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

NOTE: To obtain the entire bibliography (all 57959 citations) in bibtek format (a format that can be easily loaded into many different reference-manager software programs, click HERE.

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

Citations The Papers (from PubMed®)

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RevDate: 2025-11-13

Liu B, Liu C, Sunggip C, et al (2025)

Viruses in gastrointestinal cancers: Molecular pathogenesis, oncogenic mechanisms, and translational perspectives.

Molecular aspects of medicine, 106:101415 pii:S0098-2997(25)00079-2 [Epub ahead of print].

Viral pathogens are one of the most significant causes of human carcinogenesis, contributing to up to 15-20 % of worldwide cancers. The gastrointestinal (GI) tract is one of the most vulnerable human organ system to virus-mediated tumorigenesis as a result of frequent exposure to viral infections and various immunological processes. The present review aims to describe the dual roles of viral infections in the development of gastrointestinal cancers (GICs), with a focus on Human Immunodeficiency Virus (HIV) and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). HIV represents an oncological challenge in the era of effective antiretroviral therapy (ART), where significant immune dysfunction, persistent inflammation, and gut microbiome disruption render infected patients more susceptible to various GICs. On the other hand, SARS-CoV-2 is an emerging viral pathogen whose potential role in oncogenesis remains controversial yet biologically plausible. In this context, SARS-CoV-2 tropism to the gastrointestinal tissues and its capacity to drive cytokine storms, profound dysbiosis, and immune exhaustion raise significant questions regarding its potential to act as a pro-tumorigenic factor. Discussing mechanistic insights from well-known oncogenic viral pathogens, the present review describes the direct and indirect mechanisms by which these two major viruses may affect GI tumorigenesis. Moreover, this review translates these mechanisms into clinical perspectives, underscoring implications for diagnostics, prevention, and therapeutic strategies, while highlighting urgent research priorities for long-term surveillance and biomarker discovery. It highlights the importance of continuous scientific awareness to address the increasing cancer risks presented by emerging and re-emerging viruses through bridging virology and oncology.

RevDate: 2025-11-13

Bermúdez Endrino LM, Berral García A, Gómez Peña B, et al (2025)

Efficacy of technology interventions in preventing depression among older adults experiencing social isolation: a systematic review and meta-analysis.

Aging & mental health [Epub ahead of print].

OBJECTIVES: The global rise in the aging population, intensified by the COVID-19 pandemic, has increased loneliness, social isolation, and depression among older adults. This review aimed to examine the relationships between these psychological challenges and to assess the effectiveness of Information and Communication Technology (ICT)-based interventions in mitigating them.

METHOD: A systematic review and meta-analysis were conducted following PRISMA guidelines. Studies published within the last five years were retrieved from PubMed, Web of Science, Scopus, and CINAHL. Methodological quality was assessed using CONSORT and STROBE, and quantitative synthesis was performed with RevMan 5.4.1.

RESULTS: Thirteen studies, including experimental and observational designs, met the inclusion criteria; 61.5% analysed pandemic effects and 38.5% evaluated ICT interventions. Depression, loneliness, and social isolation were strongly associated, with the pandemic worsening outcomes, while pre-pandemic isolation predicted poorer mental health. ICT interventions significantly reduced depression (78% reduction; 95% CI 0.15-0.33; OR = 0.22) and anxiety (80% reduction; 95% CI 0.10-0.32; OR = 0.20), though their impact on social isolation was limited (95% CI 0.87-1.19; OR = 1.07).

CONCLUSION: ICT interventions effectively reduce depression and anxiety but have limited effects on social isolation, highlighting the need for long-term evaluation and community-based strategies to improve emotional well-being in older adults.

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

Rizzi M, Manzoni P, Germano C, et al (2025)

Lactoferrin, a Natural Protein with Multiple Functions in Health and Disease.

Nutrients, 17(21): pii:nu17213403.

Lactoferrin is a multifunctional glycoprotein showing multiple biological properties (antimicrobial, antiviral, antioxidant, antigenotoxic, prebiotic, probiotic) that play an essential role in maintaining host physiological homeostatic condition by exerting immunomodulatory and anti-inflammatory activities. Thanks to these biological properties, lactoferrin has widely been studied as a therapeutic agent in gastroenteric diseases, neonatal sepsis and necrotizing enterocolitis, lung diseases, and COVID-19, showing very heterogeneous results based on the disease considered and the population studied. Since lactoferrin is one of the main components of neutrophils' secondary granules, it has also been investigated as a potential disease-monitoring biomarker, especially for diseases in which inflammation is a key component. This narrative review offers updated and comprehensive insights into the available literature on lactoferrin biology, biological properties, and clinical utility.

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

Sorina E, Novacescu D, Barb AC, et al (2025)

From Burnout to Resilience: Addressing Moral Injury in Nursing Through Organizational Innovation in the Post-Pandemic Era.

Healthcare (Basel, Switzerland), 13(21):.

The COVID-19 pandemic has profoundly amplified burnout and moral injury among nurses, exposing structural vulnerabilities in healthcare systems and accelerating workforce attrition. Beyond the acute crisis, nurses continue to face chronic staff shortages, overwhelming workloads, and unresolved ethical tensions that compromise both well-being and quality of care. Synthesis of recent meta-analyses in this review indicates that nurse burnout during the pandemic ranged between 30% and 50%, illustrating the magnitude of the problem. Particular attention is given to innovative organizational strategies that foster resilience, including workload redistribution, enhanced professional autonomy, supportive leadership, and the integration of digital technologies such as telecare. Comparative perspectives across healthcare systems illustrate how policy reforms, staffing models, and ethical frameworks can mitigate psychological distress and strengthen organizational resilience. By reframing burnout and moral injury not only as individual challenges but as systemic phenomena requiring structural solutions, this review emphasizes the imperative of multilevel interventions. Building resilient nursing workforces through innovation, leadership, and evidence-based policies is essential for sustaining high-quality patient care in the post-pandemic era.

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

Shah ST, Ali Z, Waqar M, et al (2025)

Federated Learning in Public Health: A Systematic Review of Decentralized, Equitable, and Secure Disease Prevention Approaches.

Healthcare (Basel, Switzerland), 13(21):.

Background and Objectives: Public health needs collaborative, privacy-preserving analytics, but centralized AI is constrained by data sharing and governance. Federated learning (FL) enables training without moving sensitive data. This review assessed how FL is used for disease prevention in population and public health, and mapped benefits, challenges, and policy implications. Methods: Following PRISMA 2020, we searched PubMed, Scopus, Web of Science, IEEE Xplore, and Google Scholar for peer reviewed English-language studies from January 2020-30 June 2025, applying FL to surveillance, outbreak detection, risk prediction, or policy support. Two reviewers screened and extracted data with third-reviewer arbitration. Quality was appraised with a tool adapted from MMAT and AI reporting frameworks. No meta-analysis was performed. Results: Of 5230 records identified (4720 after deduplication), 200 full texts were assessed and 19 were included. Most used horizontal FL across multiple institutions for communicable diseases, COVID-19, tuberculosis and some chronic conditions. Reported gains included privacy preservation across sites, better generalizability from diverse data, near real-time intelligence, localized risk stratification, and support for resource planning. Common barriers were non-IID data, interoperability gaps, compute and network limits in low-resource settings, unclear legal pathways, and concerns about fairness and transparency. Few studies linked directly to formal public-health policy or low-resource deployments. Conclusions: FL is promising for equitable, secure, and scalable disease-prevention analytics that respect data sovereignty. Priorities include robust methods for heterogeneity, interoperable standards, secure aggregation, routine fairness auditing, clearer legal and regulatory guidance, and capacity building in underrepresented regions.

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

Lai YH, Chang MY, CC Wang (2025)

Applying Meta-Analytic Structural Equation Modeling to Examine the Relationships Among Work Stress, Job Burnout, and Turnover Intention in Taiwanese Nurses.

Healthcare (Basel, Switzerland), 13(21):.

Background/Objectives: Nursing staff are essential to healthcare delivery, yet Taiwan has experienced a significant rise in nurse turnover in recent years. Retention has thus become a critical concern for healthcare institutions. Identifying the factors influencing nurses' turnover intentions (TIs) and improving workplace conditions may help to reduce attrition. This study investigates the relationships among TI, work stress (WS), and job burnout (JB), examining variations across healthcare settings and comparing the periods before and after the COVID-19 pandemic. Methods: This study systematically reviews 28 studies published between 2011 and 2025, retrieved from Taiwan's Master's and Doctoral Thesis Knowledge Value Added System, Airiti Library, and Google Scholar. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA) guidelines. The data were analyzed using a combined approach of meta-analysis and structural equation modeling. Results: The findings of this study indicate that WS has a statistically significant impact on TI (path coefficient = 0.281, 95% CI: 0.102 to 0.459, p = 0.002). Similarly, JB significantly influences TI (path coefficient = 0.342, 95% CI: 0.163 to 0.520, p < 0.001). WS also has a strong and significant effect on JB (path coefficient = 0.612, 95% CI: 0.485 to 0.739, p < 0.001). These results suggest that WS has a particularly strong effect on JB among nurses working in non-medical center hospitals in Taiwan. Additionally, no significant differences were found in the relationships among TI, WS, and JB before and after the COVID-19 pandemic. Conclusions: Based on the findings of this study, it is recommended that healthcare administrators closely monitor the stress experienced by nursing staff and identify the key factors that lead to WS and JB. Developing targeted policies for different healthcare settings may help to reduce nurses' intentions to leave their jobs.

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

Pizarro-Mena R, Rotarou ES, Baracaldo-Campo HA, et al (2025)

Implementation of Telehealth Among Older People: A Challenge and Opportunity for Latin America and the Caribbean-A Literature Review.

Healthcare (Basel, Switzerland), 13(21):.

Although the COVID-19 pandemic negatively affected the health and quality of life of older people (OP), it provided an opportunity for the implementation of telehealth in the areas of Gerontology and Geriatrics, globally and in the countries of Latin America and the Caribbean, which enabled the continuity of healthcare interventions. Therefore, this literature review aimed to (a) conceptualize telehealth in OP through the lens of Gerontology and Geriatrics; (b) analyze the implementation, facilitators, and barriers of telehealth for OP during the COVID-19 pandemic at both global and Latin American and Caribbean regional levels; (c) identify lessons learned and considerations for improving implementation and reducing barriers to telehealth for OP; and (d) discuss challenges related to the integration of telehealth for OP in the region. The databases consulted were PubMed, Scopus, and Scielo; scientific articles in both English and Spanish were considered, including research conducted globally and in Latin American and Caribbean countries that contributed to the objectives of the literature review; the search was conducted from the year 2020 onwards. In addition, government documents and non-governmental technical guidelines from countries in the region were included, whether they focused specifically on older populations or the general population; the search was not limited to a specific time period. Initially, in our search strategy, 1631 scientific articles and 20 governmental and non-governmental documents were identified for the literature review. After eliminating duplicate and applying the inclusion and exclusion criteria, 84 documents were selected for the literature review (46 analyzed the implementation, barriers, and facilitators of telehealth during the COVID-19 pandemic). This literature review presents a conceptual analysis of the implementation and facilitators of, as well as barriers to, telehealth among OP during the COVID-19 pandemic from the perspective of healthcare providers and OP themselves. The paper synthesizes a number of international and Latin American experiences and proposes several recommendations for the implementation of telehealth for OP in the Latin American and Caribbean region. Despite the ongoing challenges regarding telehealth research and training, this review describes telehealth for OP as an intervention approach that improves the provision of holistic care, favoring OP autonomy, functionality, and overall quality of life. This review also proposes telehealth as a regular intervention approach to clinical practice in Gerontology and Geriatrics in the region. Collaborative endeavors are needed to further regulate and promote public policy on telehealth, telemedicine and telerehabilitation for OP.

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

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

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

Journal of clinical medicine, 14(21):.

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

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

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

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

International journal of molecular sciences, 26(21): pii:ijms262110695.

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

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

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

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

International journal of molecular sciences, 26(21): pii:ijms262110372.

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

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

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

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

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

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

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

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

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

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

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

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

BMC immunology, 26(1):89.

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

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

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

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

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

Bordoloi S, Singh SC, J Bayry (2025)

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

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

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

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

Limbach KE, Fan D, LG Melstrom (2026)

Remote Telemonitoring and Telehealth in Surgical Oncology.

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

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

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

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

Remote Patient Monitoring to Support Rapid Discharge-Wearables.

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

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

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

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

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

BMJ open, 15(11):e104243.

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

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

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

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

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

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

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

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

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

Colchicine for the secondary prevention of cardiovascular events.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Sengupta S, PR Williamson (2025)

mGem: When immunity turns against itself-GM-CSF autoantibodies drive opportunistic infection risk.

mBio, 16(11):e0138025.

Anti-cytokine autoantibodies represent an expanding field in immunology, and their study has revealed crucial insights into immune cell dysfunction. These autoantibodies are now classified by the International Union of Immunological Societies (IUIS) as phenocopies of primary immunological deficiencies within the broader category of inborn immunity defects. Indeed, the critical importance of these autoantibodies became starkly apparent during the COVID-19 pandemic when patients with type I interferon autoantibodies showed significantly higher rates of severe illness. This review examines how neutralizing autoantibodies, exemplified by those targeting granulocyte monocyte stimulating factor, can compromise immune function in otherwise immunocompetent individuals, making them more susceptible to specific fungal and bacterial infections. This understanding highlights the crucial role of anti-cytokine antibodies in infection susceptibility and immune system regulation.

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

Choong C, Dharma M, RD Barmanray (2025)

Not all hyperglycaemia in hospitalised pneumonia is created equal.

Internal medicine journal, 55(11):1955-1957.

Community-acquired pneumonia (CAP) remains a major cause of hospitalisation and mortality worldwide. Corticosteroid therapy reduces 30-day mortality in hospitalised patients with CAP but nearly doubles the risk of hyperglycaemia. It may appear that hyperglycaemia can arise from distinct mechanisms: "inflammation-mediated hyperglycaemia," which signals disease severity and predicts worse outcomes, and "corticosteroid-induced hyperglycaemia," a side effect of beneficial treatment that may appear not to increase mortality risk. Evidence from COVID-19 cohorts supports this distinction, showing that hyperglycaemia following corticosteroid use correlates with disease severity and longer hospital stays but not with increased mortality. Early glycaemic control reduces complications such as healthcare-associated infections in the context of hyperglycaemia due to inflammatory mediators and in the absence of corticosteroids, yet its role in corticosteroid-induced hyperglycaemia remains unclear. The lack of a standardised definition of hyperglycaemia further complicates research and clinical management. Understanding the differential impacts and optimal glucose targets for these potential hyperglycaemia subtypes is critical. Future research should focus on evaluating the effects of glucose control on outcomes in corticosteroid-associated hyperglycaemia, determining optimal glycaemic thresholds and evaluating suitable therapeutic management strategies in this clinical context.

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

Bhiman JN, Serwanga J, Ugwu CA, et al (2025)

Retaining African networks is urgent for global health.

Trends in microbiology, 33(11):1150-1154.

The Global Immunology and Immune Sequencing for Epidemic Response (GIISER) network, established in 2021, exemplifies the power of South-South collaboration in pandemic preparedness and response. Emerging from the COVID-19 crisis, GIISER integrated genomic surveillance, immunology, and capacity building across African, Asian, and South American sites, enabling rapid detection and characterization of SARS-CoV-2 variants. Through technology transfer, standardized protocols, and coordinated training, GIISER informed public health policy, advanced monoclonal antibody discovery, and strengthened local expertise. As COVID-19 research subsides and in the context of profound funding constraints, GIISER's scientific successes highlight the urgent need to sustain and expand regional networks to address current and future infectious disease threats, while championing diversity and scientific leadership in low- and middle-income countries (LMICs).

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

van Hal ARL, Roman Galdran S, Wijnen RMH, et al (2025)

Collaborative Efforts in Pediatric Surgery: Lessons from European Randomized Controlled Trials.

European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie, 35(6):505-515.

Conducting multicenter randomized controlled trials (RCTs) in pediatric surgery for rare congenital anomalies presents unique challenges, including low patient recruitment, complex regulatory landscapes, and variability in care standards. This paper reflects on the experiences and lessons learned from the MUC-FIRE and STEPS-EA trials, supported by the European Reference Network for Rare Inherited and Congenital Anomalies (ERNICA), to provide guidance for future studies.A retrospective review was conducted on the design and execution of these trials, focusing on team composition, endpoint selection, patient recruitment strategies, regulatory compliance, and adaptive methodologies. Insights were derived from study protocols, monitoring reports, and the authors' experiences.Key factors contributing to trial success included multidisciplinary collaboration, leveraging existing research networks, and defining clear, measurable endpoints. Challenges such as recruitment delays, regulatory hurdles, and variations in care were mitigated through flexible protocols, proactive amendments, and stakeholder engagement. The COVID-19 pandemic amplified these difficulties, necessitating innovative strategies and extended timelines.The MUC-FIRE and STEPS-EA trials underscore the critical importance of international collaboration, adaptive strategies, and patient-centered approaches in overcoming the complexities of multicenter RCTs. Lessons from these experiences can inform the design and implementation of future trials, ultimately enhancing evidence generation and improving outcomes for children with rare congenital anomalies.

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

Sessford JD, Dodwell A, Elms K, et al (2025)

Factors associated with mental health outcomes among family caregivers to adults with COVID: a scoping review.

Disability and rehabilitation, 47(23):5983-6000.

PURPOSE: Family caregivers (FCGs) are essential to the health and wellbeing of people affected by COVID. Protecting mental health of FCGs is essential to sustaining their caregiving role. The objective of this scoping review was to synthesise identified risks factors and protective factors for mental health of FCGs to adults with COVID.

MATERIALS AND METHODS: Using the Joanna Briggs Institute (JBI) methodology, the search was conducted across Medline, CINAHL, and PsycINFO. Original studies conducted since the pandemic began were included. The population was adult FCGs to adults with COVID, and studies reported mental health outcomes and related factors.

RESULTS: Of 3474 identified articles, 22 met inclusion criteria (14 quantitative, seven qualitative, one mixed-methods, 18/22 conducted in Iran). Across all study designs, risk factors included limited support, financial burden, family challenges, unpredictable nature of COVID, inexperience, isolation, and unpleasant experiences. Protective factors included accessing support services, self-reinforcement, coping strategies, professional help, and online intervention.

CONCLUSIONS: Quantitative and qualitative research identified common mental health risk factors and protective factors for FCGs to adults with COVID. These factors may inform development of supports and services for FCGs to people with COVID, such as online interventions. Studies did not distinguish acute versus long COVID.

RevDate: 2023-03-21
CmpDate: 2023-03-02

Vigneron C, Py BF, Monneret G, et al (2023)

The double sides of NLRP3 inflammasome activation in sepsis.

Clinical science (London, England : 1979), 137(5):333-351.

Sepsis is defined as a life-threatening organ dysfunction induced by a dysregulated host immune response to infection. Immune response induced by sepsis is complex and dynamic. It is schematically described as an early dysregulated systemic inflammatory response leading to organ failures and early deaths, followed by the development of persistent immune alterations affecting both the innate and adaptive immune responses associated with increased risk of secondary infections, viral reactivations, and late mortality. In this review, we will focus on the role of NACHT, leucin-rich repeat and pyrin-containing protein 3 (NLRP3) inflammasome in the pathophysiology of sepsis. NLRP3 inflammasome is a multiproteic intracellular complex activated by infectious pathogens through a two-step process resulting in the release of the pro-inflammatory cytokines IL-1β and IL-18 and the formation of membrane pores by gasdermin D, inducing a pro-inflammatory form of cell death called pyroptosis. The role of NLRP3 inflammasome in the pathophysiology of sepsis can be ambivalent. Indeed, although it might protect against sepsis when moderately activated after initial infection, excessive NLRP3 inflammasome activation can induce dysregulated inflammation leading to multiple organ failure and death during the acute phase of the disease. Moreover, this activation might become exhausted and contribute to post-septic immunosuppression, driving impaired functions of innate and adaptive immune cells. Targeting the NLRP3 inflammasome could thus be an attractive option in sepsis either through IL-1β and IL-18 antagonists or through inhibition of NLRP3 inflammasome pathway downstream components. Available treatments and results of first clinical trials will be discussed.

RevDate: 2025-11-12

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

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

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

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

RevDate: 2025-11-12

Li X, Oberlander TF, C Lebel (2025)

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

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

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

RevDate: 2025-11-12

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

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

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

RevDate: 2025-11-12

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

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

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

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

RevDate: 2025-11-12

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

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

Science advances, 11(46):eady5064.

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

RevDate: 2025-11-12

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

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

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

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

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

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

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

Nanomaterials (Basel, Switzerland), 15(21): pii:nano15211627.

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

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

Seo SH, MK Song (2025)

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

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

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

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

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

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

Frontiers in oncology, 15:1676414.

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

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

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

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

Frontiers in nutrition, 12:1680872.

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

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

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

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

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

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

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

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

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

Cureus, 17(10):e94328.

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

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

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

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

Global health action, 18(1):2546691.

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

RevDate: 2025-11-12

Liu R, Shao W, Q Ye (2025)

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

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

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

RevDate: 2025-11-11

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

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

Pediatric research [Epub ahead of print].

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

RevDate: 2025-11-11

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: 2025-11-12
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

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

Nadubinszky G, B Székács (2025)

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

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

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

Ouchi K, T Oishi (2025)

Recent Global Trends of Macrolide-resistant Mycoplasma pneumoniae : Why Has the Macrolide-resistant Rate Decreased in Japan?.

The Pediatric infectious disease journal, 44(12):e446-e449.

Mycoplasma pneumoniae pneumonia incidence was much decreased worldwide from 2020 to 2023 due to global infection control measures against the novel coronavirus epidemic. However, it resurfaced in the second half of 2023 following the relaxation of infection control measures, and the threat of macrolide-resistant M. pneumoniae has reemerged, especially in East Asian countries. A reduction of the rate of macrolide-resistant M. pneumoniae was seen in Japan and a part of Taiwan during the pandemic, so it is important to minimize selection pressure favoring macrolide-resistant M. pneumoniae by avoiding overuse of macrolides.

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

Xia W, Hau C, Burns J, et al (2025)

Smartphone intervention apps for schizophrenia: A review of the academic literature and app stores.

Schizophrenia research, 285:204-214.

BACKGROUND: While the interest and use of apps for anxiety and depression accelerated with COVID-19, less is known about the status of apps for people with schizophrenia and psychosis-spectrum disorders. This study aims to offer a comprehensive overview of the research and commercial app marketplaces (Apple, Android) to assess how recent technological advances translate into tools patients can use today.

METHODS: In December 2024, we conducted a narrative review for apps related to schizophrenia and coded a brief overview of the studies, eligibility, outcomes and experiences, engagement and features, attrition and adherence, and app availability. We simultaneously conducted a search on the U.S. Google Play and the U.S. Apple App Store for apps denoted in the research literature and other commercially available apps.

RESULTS: The academic literature search yielded 3753 articles, of which 34 were included. Across these 34 studies, 32 unique apps related to schizophrenia and psychosis were featured. A search of the U.S. app marketplaces yielded only one relevant app peer-reviewed in the last decade and that was broadly accessible to patients.

CONCLUSION: To realize the full clinical utility of these apps, it is essential to shift the focus toward their specific features and functionalities, supported by more rigorous research and follow-up studies. There is a pressing need for greater standardization in outcome measures and record-keeping practices to ensure consistency and reliability across the field. While the number of commercially available apps has increased, the lack of robust, large-scale controlled studies and standardized controls has resulted in inconsistent findings. Findings highlight the importance of conducting more controlled studies and randomized clinical trials with appropriate controls to strengthen the evidence base and guide the effective implementation of digital health interventions in mental health care.

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

Yıldız E (2025)

Ethical Big Data for Personalised Mental Health Nursing: A P4 and Systems View.

Journal of psychiatric and mental health nursing, 32(6):1404-1411.

BACKGROUND: Mental health nursing faces transformation through big data and metadata integration. These technologies create new opportunities but introduce ethical and practical complexities. Digital adoption accelerated during COVID-19, making it essential to understand implications for nursing practice.

AIM: This perspective paper aims to critically examine the transformative potential and ethical dilemmas of leveraging big data in mental health nursing, guided by systems biology and P4 (Predictive, Preventive, Personalised, and Participatory) medicine principles. It seeks to define the evolving roles of mental health nurses in this new digital landscape.

METHOD: This perspective essay utilises a focused literature review of key studies in nursing, psychiatry, informatics, and ethics, alongside theoretical approaches including systems biology, P4 medicine, and a personalist ethical framework. The analysis explores the integration of big data, focusing on potential benefits, risks, and ethical considerations.

RESULTS: Big data contributes meaningfully to early diagnosis, personalised treatments, and prevention strategies. However, these contributions must supplement, not substitute, traditional nursing approaches. AI diagnostic tools and digital phenotyping for relapse prediction demonstrate practical applications. Excessive algorithmic dependence risks damaging patient-nurse relationships. Data privacy, algorithmic bias, and access inequities present significant ethical challenges requiring careful attention.

CONCLUSION: Big data implementation should enhance, not replace, human interaction in mental health nursing. A new synthesis is proposed where data-driven insights support efficiency, allowing nurses more time for complex emotional needs. Key recommendations include strengthening data literacy in nursing education, developing robust data governance policies, and establishing comprehensive ethical principles to preserve the essential human dimension of care and ensure equitable access.

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

Leung JG, Schmitt CJ, AK Kuhn (2025)

Clozapine and nirmatrelvir/ritonavir coadministration without apparent interaction in a patient with mild COVID-19 infection: A case with review of other clozapine-related CYP3A4 interactions.

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 82(22):1228-1237.

PURPOSE: Clozapine is primarily metabolized by cytochrome P450 (CYP) 1A2 and to a lesser extent by CYP2C19, CYP2D6, and CYP3A4. The global pandemic of coronavirus disease 2019 (COVID-19) and use of nirmatrelvir/ritonavir brought forth new challenges for those caring for patients prescribed clozapine. Prescribing information describes a consideration for a clozapine dose reduction while monitoring for adverse reactions when clozapine is used with nirmatrelvir/ritonavir. Other drug information resources consider the combination a contraindication. A case is reported in which therapeutic drug monitoring demonstrated a lack of interaction between clozapine and nirmatrelvir/ritonavir. The complexities of infection-associated clozapine toxicity are discussed and a review is provided of CYP3A4 drug and gene interactions with clozapine.

SUMMARY: A 75-year-old woman with schizophrenia, prescribed clozapine 200 mg by mouth at bedtime, was initiated on nirmatrelvir/ritonavir after developing a mild COVID-19 infection. Two days later, the patient was brought to the emergency department after an unwitnessed fall. Clozapine toxicity was included in the differential diagnosis, although no other signs or symptoms of elevated clozapine levels were present. Nirmatrelvir/ritonavir was discontinued. Clozapine was withheld for 1 day while a clozapine level was pending, but this measurement revealed no interaction when compared to a baseline level of clozapine.

CONCLUSION: Although there are hypothetical concerns when initiating a CYP3A4 inhibitor with concomitant clozapine, the information derived from this case does not clearly support an interaction with the addition of nirmatrelvir/ritonavir during mild COVID-19 infection. It is important to understand the risks of withholding clozapine, although fortunately no psychiatric concerns developed. In reviewing the literature, CYP3A4 inhibitors or genetic polymorphisms seem to have a minimal impact on clozapine levels, although clinical monitoring is warranted.

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

Zeng S, Xie Y, Shi Y, et al (2025)

CRNDE, a Potential Therapeutic Target in Human Diseases.

Current pharmaceutical design, 31(39):3107-3116.

Long non-coding RNAs (lncRNAs) are RNA molecules exceeding 200 nucleotides in length with minimal or no protein-coding potential. However, a large number of lncRNAs have been discovered as research has progressed, and the traditional view of these noncoding RNAs does not appear to be entirely correct. Recent research has also unveiled their significant roles in various biological processes, spotlighting lncRNAs' importance. The oncogenic lncRNA, Colorectal tumor Differentially Expressed (CRNDE), is prominently studied in cancer contexts. One study found that the modulation of CRNDE expression led to an improvement in the median survival of cancer patients, extending it from 19.2 months to 32.5 months. Nonetheless, CRNDE also exhibits deregulated expression in non-malignant diseases, influencing their pathologies and serving as a potential biomarker and therapeutic target. For example, in the context of COVID-19, with CRNDE serving as a diagnostic indicator, its diagnostic accuracy attains a value as high as 0.889. This review examines CRNDE's expression in specific human diseases, including non-cancerous and cancerous conditions, its impact on disease progression, the underlying mechanisms, and recent therapeutic approaches.

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

Heidari F, Farahighasreaboonasr F, Hassan ZM, et al (2025)

Annual SZ: An Alternative Immunotherapy for COVID-19 and Long COVID.

Infectious disorders drug targets, 25(5):e18715265323116.

Since the outbreak of coronavirus disease 2019 (COVID-19) in late 2019 and early 2020, the identification of drugs to control severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and its symptoms has been a pressing focus of research. Cytokine storm and acute respiratory distress syndrome (ARDS) are the leading causes of mortality following infection. In this review, we discuss immune pathogenesis and four medications, including Remdesivir, Tocilizumab, Dexamethasone, and Annual SZ for COVID-19. A comparison of the effectiveness and therapeutic usage of drugs as reported in clinical trials and reports was made at different disease levels as well. Clinical studies indicate that Annual SZ with mild side effects was more affordable and might be more effective than other medications. Additionally, Annual SZ was capable of reducing the levels of pro-inflammatory cytokines as well as viral attachment and RNA replication.

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

Pal R, Kumar P, Khare E, et al (2025)

Repercussion of SARS-CoV-2 on the Sexual Function in Males: An Updated Review.

Infectious disorders drug targets, 25(5):e18715265323126.

SARS-CoV-2, also called coronavirus causes SARS-CoV-2 or severe acute respiratory syndrome, a highly transmissible disease that has rapidly spread worldwide, straining healthcare systems and leading to a substantial number of fatalities. Interestingly, SARSCoV- 2 has revealed a gender difference, with males dying at a greater rate and with more severe cases than women. It's worth noting that the male reproductive system might be particularly susceptible to damage during periods of moderate to severe sickness, which has been linked to cases of orchitis and erectile dysfunction. Furthermore, SARS-CoV-2 virus particles have been found in the tissues of the testes and penile of both living patients who have recovered from the virus and in post-mortem analyses of males who have died from it. For males who have recovered from SARS-CoV-2, sexual transmission is not a big concern, even though moderate to severe infections may have detrimental effects on male reproductive health. This includes the depletion of germ cells and Leydig cells that leads to a decrease in the formation of sperm, potentially decreasing the release of male sex hormones. These adverse effects may result in issues such as infertility and sexual dysfunction, which are of growing concern for couples looking to conceive or those in need of assisted reproduction. Numerous investigations have examined SARS-CoV-2's effects on male reproductive health from a variety of perspectives. The purpose of this review is to give a general summary of how SARS-CoV-2 has affected male reproductive 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: 2025-11-11

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: 2025-11-11

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: 2025-11-10

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: 2025-11-10

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: 2025-11-10

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 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: 2025-11-10

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: 2025-11-10

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 pii:v13i1e75909.

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: 2025-11-10

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: 2025-11-10

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: 2025-11-10

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: 2025-11-10

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: 2025-11-10

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: 2025-11-10

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: 2025-11-10

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: 2025-11-09

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: 2025-11-09

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, noninvasive 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 and other therapeutic molecules. 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, with emphasis on lipid-based nanoparticle formulations. 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: 2025-11-08

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: 2025-11-08

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: 2025-11-07
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 pii:v5i1e72165.

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: 2025-11-07
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: 2025-11-07
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: 2025-11-07
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: 2025-11-06
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: 2025-11-06
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: 2025-11-07
CmpDate: 2025-11-07

Wei C, Jiang W, Luo M, et al (2025)

BBB breakdown caused by plasma membrane pore formation.

Trends in cell biology, 35(11):933-943.

The blood-brain barrier, recently reintroduced as the blood-brain border (BBB), is a dynamic interface between the central nervous system (CNS) and the bloodstream. Disruption of the BBB exposes the CNS to peripheral pathogens and harmful substances, causing or worsening various CNS diseases. While traditional views attribute BBB failure to tight junction disruption or increased transcytosis, recent studies highlight the critical role of gasdermin D (GSDMD) pore formation in brain endothelial cells (bECs) during BBB disruption by lipopolysaccharide (LPS) or bacterial infections. This mechanism may also be involved in neurological complications like the 'brain fog' seen in long COVID. Pore formation in bECs may represent a prevalent mechanism causing BBB leakage. Investigating membrane-permeabilizing pores or channels and their effects on BBB integrity is a growing area of research. Further exploration of molecular processes that maintain, disrupt, and restore bEC membrane integrity will advance our understanding of brain vasculature and aid in developing new therapies for BBB-related diseases.

RevDate: 2025-11-06

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: 2025-11-06
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: 2025-11-06

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: 2025-11-05
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: 2025-11-05
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: 2025-11-06
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: 2025-11-06
CmpDate: 2025-11-06

Kawai K, Muhere CF, Lemos EV, et al (2025)

Viral Infections and Risk of Cardiovascular Disease: Systematic Review and Meta-Analysis.

Journal of the American Heart Association, 14(21):e042670.

BACKGROUND: We conducted a systematic review and meta-analysis of studies examining the association of viral infections with the risk of cardiovascular disease, including coronary heart disease (CHD) and stroke.

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

RESULTS: We included 155 studies. HIV infection was consistently associated with an elevated risk of CHD (pooled adjusted risk ratio [RR], 1.60 [95% CI, 1.38-1.85]) and stroke (RR, 1.45 [95% CI, 1.26-1.67]). SARS-CoV-2 infection was associated with an increased risk of CHD (RR, 1.74 [95% CI, 1.44-2.11]) and stroke (RR, 1.69 [95% CI, 1.23-2.31]). In self-controlled case series studies, laboratory-confirmed influenza infection was associated with an elevated risk of acute myocardial infarction (pooled incidence rate ratio, 4.01 [95% CI, 2.66-6.05]) and stroke during the first 1 month (incidence rate ratio, 5.01 [95% CI, 3.41-7.37]). In cohort studies, hepatitis C virus infection was associated with a higher risk of CHD (RR, 1.27 [95% CI, 1.13-1.42]) and stroke (RR, 1.23 [95% CI, 1.04-1.46]). Herpes zoster was also associated with an elevated risk of CHD (RR, 1.12 [95% CI, 1.08-1.15]) and stroke (RR, 1.18 [95% CI, 1.09-1.27]). There is insufficient evidence to determine the effect of cytomegalovirus on cardiovascular disease. Although on a limited basis, hepatitis A virus, herpes simplex virus type 1, respiratory syncytial virus, human papillomavirus, dengue, and chikungunya have been linked to an increased risk of cardiovascular disease.

CONCLUSIONS: Influenza, SARS-CoV-2, HIV, hepatitis C virus, and herpes zoster were associated with an increased risk of major cardiovascular events. Vaccines may play an important role in preventing the risk of cardiovascular disease.

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

Mugwagwa T, Marcano Belisario J, Hartley L, et al (2025)

Nirmatrelvir/ritonavir treatment for COVID-19: an economic value systematic literature review.

Journal of medical economics, 28(1):1933-1954.

AIMS: Nirmatrelvir/ritonavir (NMV/r) is an antiviral drug used to treat mild-to-moderate coronavirus disease 2019 (COVID-19) in patients at high risk of progression to severe COVID-19. We conducted an economic systematic literature review to assess key parameters, structures, and outcomes of existing models and analyses of the economic value of NMV/r treatment.

METHODS: A systematic search of Embase, MEDLINE, and MEDLINE In-Process, as well as bibliographies of systematic reviews and conference and health technology assessment websites, identified relevant articles published between 2022 and 2024. A quality assessment was conducted for each economic evaluation using the Drummond checklist.

RESULTS: Of the 22 included economic evaluations, most were cost-utility analyses (n = 10) and cost-effectiveness analyses (n = 9). Most used a short-term decision tree with a long-term Markov model (n = 5), with time horizons between 28 days to a lifetime, and were from a healthcare system perspective (n = 7). Most conducted scenario analyses (n = 15) and/or sensitivity analyses (n = 18), and many based treatment effectiveness estimates on the Evaluation of Protease Inhibition for COVID-19 in High-Risk Patients (EPIC-HR) randomized controlled trial (n = 7). Overall, NMV/r showed economic value across different willingness-to-pay thresholds when compared with standard of care or best supportive care, and all economic evaluations were high or moderate quality.

LIMITATIONS: Most included economic evaluations were from high-income countries and all were written in English and may not be generalizable to low-income countries or healthcare systems.

CONCLUSION: While economic evaluations were heterogeneous in terms of modeling approach, population, treatments, and context, these findings indicate that NMV/r has economic value for patients with mild-to-moderate COVID-19 with a high risk of progression to severe disease. Significant changes to the burden of COVID-19 due to the evolution of COVID-19 variants and new vaccination strategies, may warrant updates models.

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

Adin ME, Nguyen D, Shin C, et al (2025)

COVID-19 vaccine-associated reactive axillary lymph nodes on FDG PET/CT: a systematic review and meta-analysis.

Nuclear medicine communications, 46(12):1232-1239.

PURPOSE: COVID-19 vaccine-induced reactive axillary lymph nodes (RAL) on fluorodeoxyglucose (FDG) PET/computed tomography (CT) imaging can mimic malignant lymphadenopathy, leading to diagnostic errors. Reported RAL prevalence varies widely in the literature, and factors contributing to its development remain poorly understood. This meta-analysis aims to evaluate vaccine-induced RAL observed on FDG PET/CT imaging and consolidate evidence from multiple studies to assess its prevalence, duration, and associations with vaccine-related factors and demographic characteristics.

METHOD: Using multiple databases, a systematic review and meta-analysis was conducted on studies reporting RAL on FDG PET/CT following COVID-19 vaccination. The primary outcome was RAL prevalence, while the secondary outcomes were maximum standardized uptake value (SUV max), vaccine-to-scan interval, and associations with vaccine type and demographics.

RESULTS: A total of 25 studies comprising of 5010 subjects were included. Mean SUV max of reactive nodes was 2.8 ± 1.2. Overall, RAL prevalence was 38.6% ± 17.6, higher in females (58.1% versus 41.9%, P  = 0.02) and younger individuals (mean age 63.3 versus 70.7 years, P  = 0.03). The RAL rate was not statistically different between mRNA (39.9% ± 16.9) and non-mRNA vaccines (26.3% ± 30.9). However, subanalysis showed about 40% RAL with Pfizer and Moderna mRNA vaccines and AstraZeneca non-mRNA vaccine, versus much lower, below 20%, RAL with Sinovac and Johnson & Johnson non-mRNA vaccines. Stricter PET/CT interpretation criteria using blood pool threshold reduced RAL prevalence to <20%. RAL rate declined with time but was still present after 1 month.

CONCLUSION: Low activity RAL is common on FDG PET/CT after COVID-19 vaccination, while higher activity RAL (above blood pool) that can lead to clinical errors is less frequent. The frequency of RAL is affected by expected factors, such as age, gender, vaccine type, and time after vaccination, which indirectly suggest the link between RAL and COVID-19 postvaccinal immunity.

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: 2025-11-05
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 pii:v27i1e77331.

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.

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ESP Quick Facts

ESP Origins

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

ESP Support

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

ESP Rationale

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

ESP Goal

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

ESP Usage

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

ESP Content

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

ESP Help

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

ESP Plans

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

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

Electronic Scholarly Publishing
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E-mail: RJR8222 @ gmail.com

Papers in Classical Genetics

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

Digital Books

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

Timelines

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

Biographies

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

Selected Bibliographies

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

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