Search Results (555)

Background/Objectives: The COVID-19 pandemic and related lockdown measures markedly disrupted children’s lives, raising concerns particularly about their weight. We investigated changes in body mass index (BMI) in children by grade and sex, from pre- to post-COVID-19 lockdown, and BMI recovery post-lockdown. Methods: We retrospectively reviewed the height, weight, and BMI of students from a single elementary school from 2019 to 2023, excluding 2020 (the year of the COVID-19 lockdown). We conducted longitudinal and cross-sectional studies to examine changes in BMI according to grade and BMI status pre-lockdown (2019) and post-lockdown (2021–2023). Results: In the entire student body, the BMI Z-score in 2021, 1 year after the COVID-19 lockdown, had increased significantly compared with that in 2019, 1 year pre-lockdown (p = 0.009). However, longitudinal studies in each grade yielded different results. Students who were in the first grade in 2019 experienced a significant decrease in BMI Z-score post-lockdown (p = 0.003). In contrast, students who were in other grades showed a significant increase in BMI Z-score post-lockdown, with those who were in third grade in 2019 showing the most significant increase (p = 0.027). Conclusions: The degree of BMI increase in children and adolescents due to the COVID-19 lockdown was inconsistent. Changes in obesity status post-lockdown varied depending on age and obesity levels pre-COVID-19 lockdown. Therefore, to manage and prevent obesity-related metabolic diseases in the post-COVID-19 era, diverse approaches and strategies tailored to age and obesity grades during the COVID-19 lockdown will need to be adopted. Full article

The COVID-19 pandemic has caused over 7 million deaths, but its legacy extends beyond mortality. SARS-CoV-2 infection induces immune alterations that persist post-recovery, manifesting not only in long COVID (LC) but also in healthy individuals. Cytokines serve as critical orchestrators of these processes. The goal of this study is to investigate post-pandemic immune remodeling through cytokine assessment in both patients with LC and healthy donor, and to compare the post-pandemic population with pre-pandemic controls to find changes in the immune responses and cytokine profiles. A panel of 47 immune mediators (cytokines, chemokines, and growth factors) was measured with the MAGPIX multiplex analysis. LC was characterized by an increase in IL-7, IL-8, IL-17F, IL-18, EGF, FGF-2, PDGF-AA, sCD40L, and MCP-3 and a decrease in IL-4, IL-13, IL-22, IL-27, and FLT-3L. Comparing post-pandemic recovered individuals with pre-pandemic healthy cohort, we saw an upregulation of IL-13 and MCP-3 and a downregulation of MDC, M-CSF, IL-12, and IL-17F. While LC is characterized by persistent immune imbalance—particularly in cytokine networks—our data emphasize the critical need to study healthy donors in both pre- and post-pandemic eras when analyzing and interpreting these changes. Full article

This convergent mixed-methods investigation explores the changing place of Buddhism in Chinese youth lives in the post-pandemic era using data from a national survey (N = 2812) and semi-structured interviews (n = 24). Although traditional religious affiliation is still generally low among participants, Buddhism still serves as an important psychosocial and symbolic resource. In contrast to doctrinal commitments, youth connect with Buddhism through emotional identification, ritual adaptability, and virtual arenas. Results indicate a unique profile of symbolic-affective religiosity, whereby Buddhism is selectively taken up as an emotional regulation tool, moral guide, and existential reassurer. This form of engagement is frequently enabled by digital rituals, smartphone applications, and social media interactions, highlighting the mediatized character of modern spiritual engagement. Subgroup analysis reveals considerable heterogeneity among this population with differences by region, gender, level of education, and religion of family background, which implies that “Buddhist youth” in China must be conceived as a pluralistic and fluid category. The study contributes to scholarship on youth spirituality and post-institutional religion by emphasizing the functional rather than theological dimensions of religious engagement among East Asia’s younger generations. Full article

The coronavirus disease 2019 (COVID-19) pandemic has put a renewed focus on the value of vaccines in combatting potentially life-threatening diseases. The primary aim was to conduct a longitudinal study on the dispensing patterns of vaccines (from 2017 to 2021) in a section of the private healthcare sector in South Africa. A descriptive cross-sectional pharmacoepidemiological study on health insurance data covering 5 years was conducted. The study included all vaccines available on the South African market (childhood, adult, travel, and other vaccines). The study population consisted of 3.8 million individuals. The descriptive statistics were calculated. The vaccine-dispensing patterns were distinctly different in 2021 compared to the preceding four years. The COVID-19 vaccine was introduced in 2021 in South Africa. Although the total number of medical insurance scheme members stayed relatively constant, the number of vaccine claims increased approximately seven-fold in 2021 compared to the average for the preceding four years (2017 to 2020). The tetanus and pneumococcal vaccines were the most dispensed bacterial vaccines, whilst the influenza and COVID-19 vaccines were the most dispensed viral vaccines. COVID-19 vaccines accounted for 55.74% of all vaccines dispensed over the 5 years, and for 85.70% of the vaccines dispensed in 2021. An increase in the number of bacterial vaccines dispensed was observed towards the middle of 2020, which was attributed to the pneumococcal vaccine. Pneumococcal vaccines were administered during the COVID-19 pandemic to prevent morbidity and mortality from co-/secondary infections and superinfections. Similar ongoing studies on vaccine-dispensing patterns in the post-COVID-19 era are necessary, especially since the outbreak of various vaccine-preventable diseases has recently been observed. Full article

Background/Objectives: The aim of this analysis of data from the multi-year nationwide SARSTer program in Poland was to compare the clinical presentation and course of COVID-19 in the last two infectious seasons. Methods: Clinical data from 719 consecutive patients hospitalized between April 2023 and March 2024 were compared with data from 360 patients hospitalized between 1 April 2024 and 31 March 2025. Results: In the 2023/2024 season, hospitalizations due to COVID-19 occurred primarily between September and January, and in the 2024/2025 season, the majority of hospitalizations occurred between July and November. In the 2024/2025 season, we documented a change in the age structure, with an increasing predominance of hospitalized patients over 70 years of age (68% vs. 60% in 2023/2024), a milder disease manifestation, reflected in a significantly lower percentage of patients with pulmonary lesions (19% vs. 24%), an improvement in the clinical course of the disease, reflected in a halving of the number of hospitalizations, a significantly higher percentage of patients with clinical improvement in subsequent weeks of hospitalization, including those discharged from the hospital within the first week (39% vs. 30%), and a significantly lower mortality rate (4.7% vs. 7.9%), especially among patients over 70 years of age (5.4% vs. 10.4%). This indicates that the trend of a milder disease course initiated by the emergence of the Omicron variant continues. Conclusions: In conclusion, our findings provide real-world clinical evidence of the evolution of the COVID-19 situation in the post-pandemic era. Full article

Identification of temporal relations among suicide mortality and economic/political implementations provides important information for not only planning suicide prevention but also socioeconomic/psychosocial measures. This cross-sectional observation study analyzed temporal fluctuations and causalities of suicide mortalities of working-age individuals, disaggregated by age/gender/social standing (employed/unemployed), in Japan from 2009 to 2024, using government databases, by joinpoint and vector-autoregressive analyses. Suicide mortality among total and employed females decreased until the COVID-19 pandemic outbreak but sharply increased, synchronized with the pandemic outbreak, before resuming a downward trend. Among males, the decreasing trends attenuated from 2016, followed by a transient increase in 2022. Unemployed males aged 40–69 exhibited four joinpoints: 2016 (decreasing–increasing), 2018 (increasing–decreasing), 2022 (decreasing–increasing), and 2023 (increasing–stable). In contrast, suicide mortality among unemployed females aged 40–69 sharply increased in 2022 and maintained the high level. Among individuals aged 30–39, suicide mortality reversed from decreasing to increasing in 2016 (males) and 2018 (unemployed females). Economic expansion was protective for employed individuals but had no significant effect on unemployed populations. The government management instability (AENROP) index was positively associated with suicide mortality among employed and unemployed males and employed females. Unemployed females aged 30–39 were sensitive to AENROP but not economic conditions, while those aged 40–69 were largely unaffected by either. Increasing employment of individuals with psychiatric disabilities was positively associated with suicide mortality among unemployed males (30–69) and females under 40. Positive impacts of the employment rates of individuals with psychiatric disabilities and unemployment enhanced from 2016 and 2022, respectively, whereas the impacts were inconstantly affected by political rather than economic factors. Suicide mortality among unemployed individuals has emerged as a critical public health concern in Japan, with rates more than doubling among males and tripling among females in the 2020s. These findings underscore the need for integrated suicide prevention policies that address both labor market vulnerabilities and psychosocial determinants. Full article

This study analyzes how museums in Brașov County integrated digital technologies into their activities during the COVID-19 pandemic, with a focus on online communication and audience interaction. This research is based on a mixed-methods approach, including content analysis, semi-structured interviews with museum representatives, and a questionnaire applied to the visiting public. The aim is to identify the digital strategies used, the challenges encountered, and visitors’ perceptions regarding the usefulness of these tools. The results indicate an accelerated but uneven adoption of digital technologies, influenced by available resources, internal competencies, and institutional support. Frequent online interaction is positively correlated with the perceived quality of digital content, and openness to virtual activities is higher among younger and more educated audiences. Identified limitations include the lack of specialized personnel, reduced budgets, and administrative difficulties. This study emphasizes the need for institutional reforms and investments in digitalization to ensure the sustainability of the digital transition, without losing the value of the physical museum experience. Full article

Introduction: Human metapneumovirus (HMPV), though commonly perceived as a pediatric pathogen, significantly impacts adults, yet its role in acute respiratory tract infections (ARTIs) remains underappreciated. The COVID-19 pandemic has reshaped respiratory virus epidemiology and amplified the need for comprehensive differential diagnosis. This study aimed to comprehensively investigate the prevalence, clinical characteristics, and post-COVID-19 trends of HMPV infection in adults and to elucidate its critical role in the differential diagnosis of ARTIs by distinguishing it from other common viral pathogens. Methods: This was a retrospective, multicenter study conducted across six hospitals within the Acibadem Hospitals Group in Istanbul, Turkey. Data were collected from two periods: January 2016 to January 2020 (pre-COVID-19) and January 2021 to September 2023 (post-COVID-19), excluding the peak pandemic phase (March 2020 to May 2021). Respiratory samples (sputum, BAL, nasopharyngeal/nasal/throat swabs) were analyzed using multiplex PCR (Seegene RV12-ACE), with an expanded panel including SARS-CoV-2 in the post-COVID-19 era. Demographic data, comorbidities, symptoms, hospitalization, and ICU admission rates were collected. Results: In the post-COVID-19 period, 2197 positive viral panels were recorded, an increase from 1357 in the pre-COVID period, reflecting enhanced testing. HMPV prevalence reached 9.7% post-COVID-19, making it the fourth most common respiratory virus in adults (8.7% of 644 positive adult tests), following SARS-CoV-2 (26.4%), influenza A (21.3%), and rhinovirus (17.5%). The average age of HMPV-infected adults was 52.14 years (18–90 years); 64% were female. While 52% had no comorbidities, common underlying conditions included hypertension (24%), cancer (12%), and diabetes (10%). Weakness (34%), lower respiratory symptoms (16%), and fever (12%) were frequent. A significant proportion of HMPV patients required hospitalization (34%) and ICU admission (18%), with 40% receiving antibiotics. Despite potential severity, the mortality rate was low (2.8%). No significant difference in severity was observed between HMPV monoinfection and co-infected groups (e.g., with influenza A, rhinovirus, SARS-CoV-2, parainfluenza virus 2). Conclusion: Our findings establish HMPV as a significant and increasingly prevalent respiratory pathogen among adults in Istanbul in the post-COVID-19 era. Its non-specific clinical presentation underscores the critical importance of multiplex PCR for accurate differential diagnosis, enabling appropriate patient management and antimicrobial stewardship. While HMPV can lead to severe outcomes requiring hospitalization and ICU admission, particularly in patients with comorbidities, the overall mortality rate remains low. Given the lack of specific antiviral treatments and vaccines, sustained surveillance and continued research into targeted interventions are crucial. Full article

This study evaluates the performance of U.S. data center Exchange-Traded Funds (ETFs) relative to major equity and technology benchmarks, using monthly returns from January 2000 through December 2024, with particular emphasis on the COVID-19 period and the subsequent post-vaccine era. Data center ETFs have not provided better risk-adjusted returns even though they are often advertised as access points to the digital economy. Digital infrastructure demand increased through the pandemic but did not improve the performance of these funds which stayed weak across both traditional and conditional multi-factor asset pricing models. These ETFs struggle with asset selection and market timing proficiency, which leads to relatively poor performance results during volatile market conditions. The downside risks linked to these funds tend to match or exceed the downside risks of broader indices like the S&P 1500 Information Technology Index. Although these investments are based on strong thematic narratives, they do not achieve returns that align with investor expectations. Full article

Background: The COVID-19 pandemic has had a profound impact on nurses’ mental health and overall wellness, both during and after the crisis. Objectives: This study aims to explore overall wellness during and after the pandemic, and the long-term psychological effects of the relationship between psychological distress and the eight dimensions of well-being among nurses in the post-pandemic era. Methods: A cross-sectional research design was used to conduct the study among 288 nurses from two regional hospitals in Albania. Participants were recruited using purposive sampling, selecting nurses based on availability and relevance to the study criteria. Data were collected through self-administered questionnaires using the DASS-21 scale and the Personal Assessment of the Eight Dimensions of Wellness. Descriptive statistics and Kendall’s Tau-b correlation were used to assess associations, followed by ordinal regression to explore the influence of demographic and professional variables. Results: Findings revealed persistent levels of psychological distress among nurses, especially related to anxiety and stress. Significant negative correlations were found between wellness dimensions particularly emotional and occupational wellness and psychological distress. Age and department assignment emerged as predictors of post-pandemic stress and depression. Conclusions: The study highlights the need for institutional strategies to support mental health and promote comprehensive well-being among nurses in the post-COVID-19 period. Investing in long-term psychological support and wellness training is essential for building a resilient nursing workforce. Full article

Tuberculosis remains a serious infectious disease that causes over 1.3 million deaths annually. Following the COVID-19 pandemic, the global incidence of tuberculosis has increased to 10.8 million cases. Pregnant women represent a particularly vulnerable population requiring tailored approaches to the prevention, diagnosis, and treatment of tuberculosis. SARS-CoV-2 infection may have impacted existing clinical protocols. Implementing updated methods of tuberculosis prevention, diagnosis, and treatment in pregnant women could help reduce adverse maternal and fetal outcomes. The aim of this review was to explore potential modifications in tuberculosis management among pregnant women in the post-COVID-19 era, including co-infection with SARS-CoV-2. Methods: A review was conducted, incorporating a systematic literature search across major international databases, including Medline, PubMed, Web of Science, Scopus, and Google Scholar. The search covered publications released between December 2019 and September 2024 and used targeted keywords such as “COVID-19” OR “SARS-CoV-2”, “tuberculosis” OR “TB” OR “latent tuberculosis infection” OR “pulmonary tuberculosis”, and “pregnancy” OR “pregnant women”. Results: Pregnant women living with HIV are at increased risk of developing tuberculosis, which can negatively affect both maternal and perinatal outcomes. Screening for tuberculosis is recommended for all HIV-positive pregnant women, even in the absence of clinical symptoms. Notably, immunological testing before and during pregnancy facilitates the timely and safe detection of tuberculosis infection, enabling preventive and therapeutic interventions during any stage of gestation and the early postpartum period, for the benefit of both mother and child. Drug–drug interactions play a significant role in tuberculosis management, both among anti-tuberculosis agents and with medications for comorbid conditions. Current knowledge of the pharmacokinetics and pharmacodynamics of antituberculosis agents, coupled with therapeutic drug monitoring, supports the development of individualized and effective treatment regimens, which are particularly critical for pregnant patients. Recommendations for managing tuberculosis in pregnant women after COVID-19 infection include measuring D-dimer levels, performing echocardiography, and consulting cardiologists to prevent treatment-related complications. Conclusions: Pregnant women represent a distinct subgroup of tuberculosis patients requiring individualized management. Changes observed in tuberculosis progression and treatment responses in pregnant women before and after SARS-CoV-2 infection should inform therapeutic choices, especially in cases of drug-resistant tuberculosis treated with bedaquiline. COVID-19 has been associated with increased cardiovascular risk, which may heighten the likelihood of adverse drug reactions in this population, especially given the limited therapeutic options. Further research is required to assess the long-term outcomes of latent tuberculosis infection in pregnant women and to evaluate the safety and efficacy of novel regimens for drug-resistant TB during pregnancy. Full article

Early-career teachers (ECTs) entered the profession during the COVID-19 pandemic, a period that introduced unique stressors to an already-demanding career phase. This systematic review examines empirical studies published between 2020 and February 2025 to explore how the pandemic influenced ECT wellbeing, with particular attention to stressors and protective factors impacting long-term retention and professional sustainability. Guided by PRISMA protocols, databases including Web of Science, ERIC, Google Scholar, and Scopus were searched, screening 470 records and identifying 30 studies that met inclusion criteria: peer-reviewed, empirical, focused on early-career teachers (within the first five years), and situated in or explicitly addressing the pandemic and its ongoing impacts. The results of Braun and Clarke’s thematic analysis (2006) revealed that pandemic-related challenges such as increased workload, professional isolation, disrupted induction processes, and emotional strain have persisted into the post-pandemic era, contributing to sustained risks of burnout and attrition. Regardless, protective factors identified during the pandemic—including high-quality mentoring, structured induction programmes, collegial support, professional autonomy, and effective individual coping strategies—continue to offer essential support, enhancing resilience and professional wellbeing. These findings underscore the necessity of institutionalising targeted supports to address the enduring effects of pandemic-related stressors on ECT wellbeing. By prioritising sustained mental health initiatives and structural supports, education systems can effectively mitigate long-term impacts and improve retention outcomes for early-career teachers in a post-pandemic educational landscape. Full article

Amid ongoing societal development, tourists’ travel behavior patterns have been undergoing substantial transformations, and understanding their evolution has emerged as a key area of scholarly interest. Taking Beijing as a case study, this research aims to uncover the spatiotemporal evolution patterns of tourist flows and their underlying driving mechanisms. Based on digital footprint relational data, a dual-perspective analytical framework—“tourist perception–tourist flow network”—is constructed. By integrating the center-of-gravity model, social network analysis, and regression models, the study systematically examines the dynamic spatial structure of tourist flows in Beijing from 2012 to 2024. The findings reveal that in the post-pandemic period, Beijing tourists place greater emphasis on the cultural connotation and experiential aspects of destinations. The gravitational center of tourist flows remains relatively stable, with core historical and cultural blocks retaining strong appeal, though a slight shift has occurred due to policy influences and emerging attractions. The evolution of the spatial network structure reveals that tourism flows have become more dispersed, while the influence of core scenic spots continues to intensify. Government policy orientation, tourism information retrieval, and the agglomeration of tourism resources significantly promote the structure of tourist flows, whereas the general level of tourism resources exerts no notable influence. These findings offer theoretical insights and practical guidance for the sustainable development and regional coordination of tourism in Beijing, and provide a valuable reference for the spatial restructuring of urban tourism in the post-COVID-19 era. Full article

The uptake of the COVID-19 and seasonal influenza (SI) vaccines have decreased in Europe and especially in Malta. The present study aimed to investigate the attitudes toward COVID-19 and SI vaccines and determine if individuals perceive that these vaccines are relevant to protect their health and identify reasons for their responses. A cross-sectional study using an anonymous questionnaire, informed by the Theory of Planned Behavior, addressing behavior beliefs and attitudes, and targeted at adult residents in Malta, was designed on Google Forms and disseminated using social media between January and March 2024. A total of 555 responses were received. The majority of respondents did not take/intend to take the COVID-19 (75%, n = 417) or SI (64.3%, n = 362) vaccines, with females being less likely to do so (p = 0.033). Perceived lack of safety (31.3%, n = 174) was the primary reason for rejecting the COVID-19 vaccine, and perceived lack of a threat from SI (26%, n = 144) was the reason for rejecting the SI vaccine. Those having chronic conditions were positively associated with uptake of both vaccines. In the post-pandemic era, these vaccines are not envisaged as having a major role in protecting one’s health. A high degree of skepticism especially toward the combined COVID-19 and SI vaccine in terms of safety, mostly in women, is still present. Full article

Ride-pooling, as a sustainable mode of ride-hailing services, enables different riders to share a vehicle while traveling along similar routes. The COVID-19 pandemic led to the suspension of this service, but Transportation Network Companies (TNCs) such as Uber and Lyft resumed it after a significant delay following the lockdown. This raises the question of what determinants shape ride-pooling in the post-pandemic era and how they spatially influence shared ride-hailing compared to the pre-pandemic period. To address this gap, this study employs geospatial analysis and machine learning to examine the factors affecting ride-pooling trips in pre- and post-pandemic periods. Using over 66 million trip records from 2019 and 43 million from 2023, we observe a significant decline in shared trip adoption, from 16% to 2.91%. The results of an extreme gradient boosting (XGBoost) model indicate a robust capture of non-linear relationships. The SHAP analysis reveals that the percentage of the non-white population is the dominant predictor in both years, although its influence weakened post-pandemic, with a breakpoint shift from 78% to 90%, suggesting reduced sharing in mid-range minority areas. Crime density and lower car ownership consistently correlate with higher sharing rates, while dense, transit-rich areas exhibit diminished reliance on shared trips. Our findings underscore the critical need to enhance transportation integration in underserved communities. Concurrently, they highlight the importance of encouraging shared ride adoption in well-served, high-demand areas where solo ride-hailing is prevalent. We believe these results can directly inform policies that foster more equitable, cost-effective, and sustainable shared mobility systems in the post-pandemic landscape. Full article