Search Results (47,481)

Background/Objectives: The COVID-19 pandemic was characterized by the rapid transmission of the virus and a global race for vaccines, with vaccines such as AstraZeneca, CoronaVac, Pfizer, and Janssen arriving in Brazil in 2020. Concurrently, an infodemic of information, driven by the media and social media, highlighted the importance of health communication. This study examines how online newspapers in a Brazilian state disseminated information about vaccination and its relationship with vaccine adherence among the population. Methods: Quantitative research, in which a total of 5308 journalistic articles were verified, using two databases, one for the publication of journalistic articles and the other for vaccinations in the state, which applied 9,577,567 doses in the period. Results: The analyses demonstrated a positive correlation between the number of publications of articles and the number of applications of vaccines (rho = 0.407, p-value < 0.0005), revealing a relationship of both increase and decrease in the publication of newspaper articles and the application of vaccines in specific weeks during the analysis period. Vaccination data revealed low adherence to the booster dose by the population, with unequal values among the cities of the state. Conclusions: The study highlighted the potential importance of newspapers in disseminating information about vaccines during the pandemic, underscoring the need for regional health strategies to increase vaccination coverage. Full article

The COVID-19 pandemic has caused a surge in the use of disposable surgical masks, primarily composed of polypropylene (>86% carbon), whose improper disposal contributes to persistent microplastic pollution. In alignment with circular economy principles, this study explores the valorization of surgical masks into carbonaceous adsorbent materials (ACMs) for dye removal from water. The masks were chemically treated with concentrated H₂SO₄ at 85 °C for 2 h and subsequently activated with air (400 °C), CO₂, or steam (800 °C, 1 h). The resulting ACMs were characterized by SEM, FT-IR, nitrogen adsorption at −196 °C, and pH of the aqueous carbon suspension (pH_Sus, 1.96–9.25). CO₂ and steam activation yielded the highest surface areas (525 and 632 m²·g⁻¹, respectively). FT-IR confirmed the introduction of sulfonic groups, enhancing dye interactions. Adsorption tests using methylene blue (MB), methyl orange (MO), and orange G (OG) in ultrapure and river water showed removal efficiencies up to 100% for MB with ACM-WV and ~94% with ACM. All dyes followed pseudo-second-order kinetics. These findings demonstrate that surgical mask waste can be effectively transformed into high-value adsorbents for water treatment applications. Full article

Background: COVID-19 vaccination and subsequent booster doses became critical components of public health strategies to control the pandemic and reduce disease severity, especially in fragile individuals. Among these, subjects undergoing dialysis represent one of the highly vulnerable populations. Methods: We conducted a multicenter case–control study among dialysis patients between March 2021 and May 2022 (study population n = 3264). We evaluated anti-S/RBD-IgG and anti-SARS-CoV-2 neutralizing antibodies before (T3) and after (T4) the third dose in individuals with a COVID-19 diagnosis after the third dose (cases) and in those who did not report infection (controls). Results: The study included 187 cases and 150 controls. Serological analysis showed a significant increase (p < 0.001) in anti-SARS-CoV-2 antibody levels after the third vaccine dose (from T3 to T4) in both groups. At T3, with the same number of days between the second dose and T3, the antibody levels detected were significantly lower in cases as compared to controls. At T4, we observed similar antibody titers in the two groups. Notably, the mean difference in time from the third dose to T4 was significantly greater in controls (73.0 days vs. 36.7, p < 0.001), suggesting a reduced antibody waning in controls. Accordingly, multivariate analysis showed that the risk of infection was considerably reduced by the pre-third-dose antibody levels. Conclusions: This study reinforces the critical role of the humoral response in preventing infections in the vulnerable population of dialysis patients. Regular monitoring of antibody levels and timely administration of booster doses are essential to optimize protection in this group. Full article

A sense of belonging among university students is widely perceived as critical to engagement, retention and outcomes. The aim of our research is to improve understanding of how staff and students conceptualise belonging, how sense of belonging can be enhanced, and factors which work against it in the post-COVID era. Using interviews and focus groups, we asked professional services staff, academic staff, and students (n = 34) at one English university for their views. Thematic analysis generated three major themes: (1) understandings of belonging; (2) connections, caring and mattering; (3) challenges to belonging. The most significant finding was that sense of belonging is mostly located within non-tangible ‘moments’ which are mainly owned by students themselves. Sense of belonging is conceptually messy and complex in practice due to these non-tangible moments. Relational pedagogy, caring, mattering and consistency are key factors in improving belonging, and these can only be established in the context of authentic and trusting relationships. Student belonging was found to be mostly reliant on both relationships with staff and peers, but also the physical environment. Recommendations are for universities to review current roles and responsibilities of staff who provide pastoral care for students, ensuring they are adequately trained and supported; to recognise that belonging is largely about authentic, trusting relationships, and to allow the necessary time for it; and to consider the threats to sense of belonging, such as high staff sickness and turnover. This qualitative study helps unravel varying understandings of sense of belonging and provides original empirical insights to further contribute to the development of sense of belonging in higher education. Full article

The X-linked TLR7 rs179008 T allele has been associated with altered antiviral immunity. Given their shared inflammatory pathways and higher pediatric mortality rates in Brazil during the pandemic, we investigated their association with multisystem inflammatory syndrome in children (MIS-C) together with Kawasaki disease (KS) following SARS-CoV-2 infection. A cross-sectional study (2021–2022) analyzed 73 hospitalized children (<13 years) with confirmed COVID-19. Genotyping for TLR7 rs179008, TLR8 (rs3764879, rs2407992), and TLR3 rs3775291 was performed via PCR and Sanger sequencing. MIS-C/KS cases were identified using CDC criteria, with severity classified by the need for ICU care. Statistical analysis included Fisher’s exact test and relative risk (RR) calculations. Hemizygous boys carrying the TLR7 T allele had a 1.87-fold higher risk of MIS-C/KS (p = 0.007) and a 1.75-fold increased risk of severe or critical outcomes. The T allele frequency was 2.6× higher in MIS-C/KS cases versus other COVID-19 presentations. All fatalities occurred in boys (3/8 MIS-C cases) with one T-allele carrier. No associations were found for TLR8 or TLR3 variants. The TLR7 rs179008 T allele is a potential genetic risk factor for severe post-COVID-19 inflammatory syndromes in boys, likely due to impaired immune signaling. These findings highlight its utility as a biomarker for risk stratification in pediatric populations. Full article

Trust in public institutions was challenged during the COVID-19 global pandemic, with widespread mistrust towards healthcare institutions as well as fellow public institutions. Concurrently, a new public institution or social tool, mass-market artificial intelligence (AI), more broadly emerged, which too may be a target of fluctuating public trust. Using national survey data from the United Kingdom’s Centre for Data Ethics and Innovation (survey year: 2022, N = 4320; survey year: 2023, N = 4232), we explore the level of trust in civic institutions (healthcare, non-healthcare, and AI) during and immediately after the COVID-19 pandemic in the United Kingdom using a naturalistic quasi-experimental design. At both waves (2022 and 2023), principal component analysis and structural equation modeling over thirteen public institutions and AI variables confirmed three factors (or domains) of public trust: trust in healthcare institutions, trust in fellow civic institutions other than healthcare, and trust in AI. Measurement invariance testing of mean levels of public trust along each distinct component revealed that as compared with 2022, in 2023, (1) trust in healthcare institutions and in fellow civic institutions other than healthcare significantly increased and (2) trust in AI remained approximately level. Next, latent profile modeling revealed four levels of a common public trust profile, with all three domains of public trust being normatively closely associated. Taken together, these results suggest that a psychological stance of public trust, PT, may increase after a societal crisis. Full article

Remote work, as a technologically possible and widely applicable working mode, gained renewed attention during lockdowns amidst the COVID-19 pandemic. On one hand, remote work ensured that working remained sustainable; on the other hand, the unexpected and widespread nature of the immediate shift to remote work led to issues in terms of practicing and adapting to the process. Moreover, remote work can have strong social, economic, and environmental effects that have to be comprehensively understood. The high interest of employees in continuing with full or hybrid remote work calls for effective coping strategies at the individual and organizational levels in the future. This article focuses on academic studies documenting the peculiarities of remote work during the COVID-19 lockdowns. The aim is to identify the issues relating to remote work during the COVID-19 lockdowns that are documented in academic studies and thematically classify them into a range of factors. In this study, bibliometric and content analyses were employed, leading to comprehensive insights into the following areas: (1) remote work as a cause for changes in physical and psychological health; (2) remote work as a cause for changes in daily behavior, routine, and lifestyle; (3) factors that affect the process and productivity of remote work; (4) societal, economic, and environmental consequences of remote work; and (5) the distribution of the effects of remote work on individuals, economic subjects, and sectors. In conclusion, this study on working practices during the COVID-19 lockdowns that were documented in academic studies offers several benefits and areas of novelty: first, a comprehensive overview of the widespread process of adjusting to this new working mode; second, a classification of factors that affected the process at different stages and in different areas; and third, common factors that had more widespread effects during the remote working period. The findings also offer the following theoretical and practical implications: For researchers, this article can be a reference offering a holistic view of remote working during these lockdowns. For practitioners, it can provide an understanding of the impacting factors and their contextualization in terms of health, sociodemographic, and sectoral aspects can allow for more accurate human resource management strategies. Full article

Background: Current guidelines endorse the integration of exercise into cancer care. The diagnosis of cancer and its treatment, however, may introduce factors that make exercise engagement difficult, especially for individuals with advanced stages of disease. In this paper, we describe the baseline screening and triage process implemented for the Alberta Cancer Exercise (ACE) hybrid effectiveness-implementation study and share findings that highlight the multifaceted complexity of the process and the direct role of the clinical exercise physiologist (CEP). Methods: ACE was a hybrid effectiveness-implementation study examining the benefit of 12-week cancer-specific community-based exercise program. The ACE screening process was developed by integrating evidence-based guidelines with oncology rehabilitation expertise to ensure safe and standardized participation across cancer populations. The screening process involved four steps: (1) a pre-screen for high-risk cancers, (2) completion of a cancer-specific intake form and the Physical Activity Readiness Questionnaire for Everyone (PAR-Q+), (3) a CEP-led interview to further evaluate cancer status, cancer-related symptoms and other health issues (performed in-person or by phone), and (4) a baseline fitness assessment that included measurement of vital signs. Results: A total of 2596 individuals registered and underwent prescreening for ACE with 2570 (86.6%) consenting to participate. After full screening including the baseline fitness testing, 209 participants (8.1%) were identified as requiring further medical clearance. Of these, 191 (91.4%) had either a high-risk cancer, metastatic disease or were in the palliative end-stage of cancer, and 161 (84.3%) reported cancer-related symptoms potentially affecting their ability to exercise. In total, 806 (31.4%) participants were triaged to CEP-supervised in-person programming, 1754 (68.2%) participants to ACE community programming, and 8 (0.3%) specifically to virtual programming (post-COVID-19 option). Conclusions: The findings highlight the complexity and challenges of the screening and triage process, and the value of a highly trained CEP-led iterative approach that included the application of clinical reasoning. Full article

This study addresses the critical need for accurate tourism demand (TD) forecasting in Bulgaria using economic indicators, developing robust predictive models to navigate post-pandemic market volatility. The COVID-19 pandemic exposed tourism’s vulnerability to systemic shocks, highlighting deficiencies in traditional forecasting approaches. Bulgaria’s tourism industry, characterized by strong seasonal variations and economic sensitivity, requires enhanced methodologies for strategic planning in uncertain environments. The research employs comprehensive comparative analysis of machine learning (ML) and deep machine learning (DML) methodologies. Monthly overnight stay data from Bulgaria’s National Statistical Institute (2005–2024) were integrated with COVID-19 case data, Consumer Price Index (CPI) and Bulgarian Gross Domestic Product (GDP) variables for the same period. Multiple approaches were implemented including Prophet with external regressors, Ridge regression, LightGBM, and gradient boosting models using inverse MAE weighting optimization, alongside deep learning architectures such as Bidirectional LSTM with attention mechanisms and XGBoost configurations, as each model statistical significance was estimated. Contrary to prevailing assumptions about deep learning superiority, traditional machine learning ensemble approaches demonstrated superior performance. The ensemble model combining Prophet, LightGBM, and Ridge regression achieved optimal results with MAE of 156,847 and MAPE of 14.23%, outperforming individual models by 10.2%. Deep learning alternatives, particularly Bi-LSTM architectures, exhibited significant deficiencies with negative R² scores, indicating fundamental limitations in capturing seasonal tourism patterns, probable data dependence and overfitting. The findings, provide tourism stakeholders and policymakers with empirically validated forecasting tools for enhanced decision-making. The ensemble approach combined with statistical significance testing offers improved accuracy for investment planning, marketing budget allocation, and operational capacity management during economic volatility. Economic indicator integration enables proactive responses to market disruptions, supporting resilient tourism planning strategies and crisis management protocols. Full article

Introduction: The change in environmental and social context during the COVID-19 pandemic affected daily activities of people with spinal cord injury (SCI), their interactions within the community, and, consequently, their social participation during the first wave of the pandemic. However, there is little information about the changes in social participation as the pandemic evolved in Canada. Objective: Our aim was to explore the change in the social participation of adults with SCI after the first two years of the COVID-19 pandemic in Canada. Methods: A follow-up from a previous study exploring the social participation of adults with SCI living during the first wave was conducted eight months later (second wave). Social participation was measured using the Assessment of Life Habits (LIFE-H 4.0) and Measure of Quality of the Environment (MQE) among 18 adults with SCI. Results: Participants reported increases between both waves of COVID-19 in some life habit categories, including mobility, personal care and health, nutrition, and recreation. New environmental factors were identified as facilitators, including the increased availability of businesses in the community. Conclusion: These findings indicate that people with SCI experienced greater realization and satisfaction with certain life habits. Although most barriers and facilitators showed little or no change between the two waves, the reduction in environmental barriers and the increase in facilitators may have contributed to improved social participation as the pandemic progressed. Full article

Although acute kidney injury (AKI) is common among patients with coronavirus disease 2019 (COVID-19), there are only limited data on its occurrence at intensive care unit (ICU) admission. Assessing the factors associated with AKI is essential for early diagnosis and intervention. This study aims to compare the clinical and laboratory characteristics and survival outcomes of COVİD-19 patients with and without AKI at ICU admission and determine the factors associated with AKI. In this study, patients with SARS-CoV-2 infection were categorized based on the presence (AKI group) or absence (non-AKI group) of AKI. Clinical and laboratory data and outcomes were analyzed retrospectively. Of the 712 patients included in this study, 198 were assigned to the AKI group and 514 were assigned to the non-AKI group. Patients with AKI had more comorbidities and higher disease severity; higher rates of invasive mechanical ventilation, vasopressor therapy, and mortality; and longer hospital stays (p < 0.05). Our multivariate analysis identified advanced age, a high Acute Physiology and Chronic Health Evaluation II score, a high neutrophil-to-lymphocyte ratio, a low albumin level, and the presence of comorbidities as independent factors associated with AKI. In patients with COVID-19, AKI observed at ICU admission is associated with advanced age and increased disease severity. The early diagnosis and monitoring of patients may improve clinical outcomes. Full article

Background: Weekend presentation to the emergency department (ED) has been associated with increased morbidity and mortality in various clinical settings. However, the literature is scant whether such an effect exists for patients presenting with COVID-19 infection. Additionally, comparative analyses of mortality predictors in COVID-19 patients evaluated at the emergency department need further exploration. Methods: This retrospective cohort study examined factors associated with mortality among adult patients (aged ≥ 18 years) who presented with COVID-19 to the emergency departments of five hospitals within the Johns Hopkins Health System (combined capacity: 2513 beds) between March 1 and 4 May 2020. Data were extracted from electronic health records. Multivariable logistic regression was utilized to assess the relationship between mortality and a range of variables, including sociodemographic characteristics, clinical presentation, laboratory parameters, pre-existing comorbidities, and weekend versus weekday presentation. Results: Of the 2767 patients, 685 (25%) presented to the emergency department on weekends. Compared to weekday presenters, weekend patients were more likely to be hospitalized (64%), and these patients had a mean symptom duration of 5 days (SD ± 6). Weekend presenters also exhibited higher rates of clinical frailty, dehydration, hypoxia, and respiratory distress upon arrival. In multivariable logistic regression analysis adjusting for sociodemographic characteristics, clinical risk factors, and laboratory findings, independent predictors of increased mortality included absence of a primary care provider (OR 3.47; 95% CI: 2.37–5.07), peripheral oxygen saturation (SpO₂) < 95% at presentation (OR 1.46; 95% CI: 1.001–2.12), and hyperglycemia (OR 2.13; 95% CI: 1.25–3.65). Notably, the presence of crackles on physical examination demonstrated a trend toward reduced mortality (OR 0.47; 95% CI: 0.24–0.92). Conclusions: While weekend presentation was associated with higher hospitalization rates among patients with COVID-19, it did not independently predict increased mortality. Absence of a primary care provider, hypoxia, and hyperglycemia at presentation emerged as strong, independent predictors of mortality in the ED setting. Race, gender, and obesity were not significantly associated with mortality in this cohort, warranting further investigation. These findings may support more effective triage and risk stratification strategies in current and future public health emergencies. Full article

Background/Objectives: While the prevalence of depression increases during the peri- and post-menopausal periods, the potential of diet as both a modifiable risk factor and complementary treatment option has received limited research attention in this population. To address this gap, we conducted a scoping review aiming to map and synthesize the existing literature on diet and depression in peri- and post-menopause. Methods: Studies were identified through Medline, EMBASE, PsycINFO, CENTRAL, Web of Science, and Scopus. After deduplication in Covidence, two reviewers independently screened titles, abstracts, and full texts using predefined eligibility criteria. Data were extracted using standardized forms and presented in tables and figures. Methodological quality was assessed using the Cochrane RoB-2 for intervention studies and NHLBI tools for observational studies. Results: Thirty-eight studies met the inclusion criteria, including 29 observational and 9 interventional studies. Dietary patterns showed the most consistent associations with depressive symptoms, whereas findings for foods, nutrients, and other food components were inconsistent. Most observational studies had a moderate to high risk of bias, while over half of experimental studies were rated as low risk. Conclusions: Although limited by volume and poor methodological quality, existing evidence suggests that healthy diets may be protective against depressive symptoms in peri- and post-menopausal women, while unhealthy diets may increase risk. High-quality cohort studies and clinical trials are needed to guide future research and inform professionals working at the intersection of nutrition, psychiatry, and women’s health. Protocol registration: osf.io/b89r6. Full article

Introduction: Neuroinflammation is a common pathological hallmark of Coronavirus Disease 2019 (COVID-19) and epilepsy; however, their shared immunogenomic mechanisms remain poorly defined. This study explores shared immune-inflammatory transcriptomic signatures and identifies potential repositioning therapeutics. Methods: We integrated single-cell RNA-seq data from peripheral blood mononuclear cells (PBMCs) of COVID-19 patients and healthy donors (GSE149689), and bulk RNA-seq data from hippocampal tissue of patients with Temporal Lobe Epilepsy with Hippocampal Sclerosis (TLE-HS) and healthy controls (GSE256068). Common Differentially Expressed Genes (DEGs) were identified and subjected to GO/KEGG enrichment, a PPI network, hub gene detection (cytoHubba), and transcriptional regulation analysis (ENCODE-based TF/miRNA networks). Drug repositioning was performed using the LINCS L1000 database. Results: We identified 25 DEGs shared across datasets, including 22 upregulated genes enriched in cytokine–cytokine receptor interaction, NF-κB, and Toll-like receptor pathways. PPI analysis revealed a CX3CR1–TLR4-centered immune module. Gabapentin emerged as a promising repositioning candidate with potential to downregulate CX3CR1, TLR4, and selectin P ligand (SELPLG). Receiver Operating Characteristic (ROC) analysis confirmed the diagnostic value of these targets (AUC > 0.90 in epilepsy). A mechanistic model was proposed to illustrate Gabapentin’s dual action on microglial polarization and cytokine suppression. Conclusions: Our results reveal a shared CX3CR1–TLR4–NF-κB inflammatory axis in COVID-19 and epilepsy, supporting Gabapentin as a potential dual-action immunomodulator. These findings reveal a previously underappreciated immunomodulatory role for Gabapentin, providing mechanistic rationale for its repositioning in neuroinflammatory conditions beyond seizure control. Full article

Since the onset of the COVID-19 pandemic, the Republic of Korea has experienced continuous waves of SARS-CoV-2 variants. The current study aimed to analyze the long-term trends of variant prevalence and associated changes in immune responses within the country. Whole-genome sequencing was performed on confirmed patient samples collected from December 2020 to May 2025, and variant distribution, genetic diversity, and neutralization were compared. As a result of analyzing a total of 157,962 gene sequences, various Omicron sub-lineages, including BA.1, BA.2, BA.5, followed by JN.1, KP.3, and NB.1.8.1, were seen to circulate sequentially over time. The nucleotide diversity of the SARS-CoV-2 genome gradually increased after the JN.1 outbreak. Of the tested variants, hamster antiserum neutralization analysis indicated that Omicron NB.1.8.1, which began to circulate in 2025, exhibited the lowest neutralization activity, with an approximately 6.6-fold decrease compared to JN.1. This suggests a potential expansion in the dominance of new variants with enhanced immune evasion. As the transmission of SARS-CoV-2 continues, new variants with novel characteristics may emerge; therefore, continuous national genomic surveillance and immunological characterization are considered crucial for early detection of emerging variants and for guiding effective public health responses. Full article