Search Results (29,287)

Background: Attendance to neonatal follow-up programs presents a significant factor associated with positive long-term outcomes of high-risk infants. Strategies to maximize participation benefit not only future interventions’ effectiveness but also healthcare systems and society. While a number of studies have focused on attrition or loss to follow-up, no studies have focused on the contributive risk factors to abstaining from neonatal follow-up programs specifically during the COVID-19 pandemic. This study aims to reveal the main factors linked to non-compliance in a neonatal follow-up program of a tertiary hospital. Methods: In this ambidirectional observational study, data from 1137 high-risk neonates who participated in a hospital follow-up program were collected (573 before and 564 after the COVID-19 pandemic). The study sample was grouped to three groups: G1 (N = 831), who maintained participation in the program; G2 (N = 196), who discontinued; and G3 (N = 110), who never visited the outpatient clinics. Data were obtained from the hospital’s Systems Applications and Products (SAP) Software and a structured questionnaire, answered by parents of newborns either discontinuing (G2) or not attending (G3) the follow-up program through a telephone contact. Results: The most frequently reported reason for discontinuance before the pandemic onset was the parents’ perception of no necessity to maintain participation (44.12%). During the COVID-19 pandemic, provider-related barriers to maintaining hospital access, inability to provide high-quality services (37.14%), and feelings of fear and insecurity (18.5%) emerged as factors for non-attendance. Citizenship and morbidity (respiratory distress syndrome, sepsis, necrotic enterocolitis, jaundice) acted as incentives to join the follow-up program during both study periods. Multiple regression analysis showed that multiple-gestation infants had higher odds of maintaining participation during the COVID-19 period (OR, 4.04; CI, 1.09–14.9). Conclusion: Understanding the potential impact of COVID-19 and the transformative changes in neonatal follow-up clinics is crucial for applying compliance strategies. Removing barriers to maintain family participation can lead to increased attendance rates. Full article

Infectious diseases manifesting in the form of epidemics or pandemics do not only cause devastating impacts on public health systems but also disrupt the functioning of the socio-economic structure. Further, risks associated with pandemics and epidemics become exacerbated with coincident compound hazards. This study aims to develop a framework that captures key elements and components of epidemic and pandemic preparedness and response systems, focusing on a multi-hazard context. A systematic literature review was used to collect data through peer-reviewed journal articles using three electronic databases, and 17 experts were involved in the validation. Epidemiological surveillance and early detection, risk and vulnerability assessments, preparedness, prediction and decision making, alerts and early warning, preventive strategies, control and mitigation, response, and elimination were identified as key elements associated with epidemic and pandemic preparedness and response systems in a multi-hazard context. All elements appear integrated within three interventional phases: upstream, interface, and downstream. A holistic approach focusing on all interventional phases is required for preparedness and response to pandemics and epidemics to counter their cascading and systemic effects. Further, a paradigm shift in the preparedness for multi-hazards during an epidemic or pandemic is essential due to the multiple challenges posed by concurrent hazards. Full article

The human leukocyte antigen (HLA) system plays a pivotal role in the immune response to viral infections, mediating the presentation of viral peptides to T cells and influencing both the strength and specificity of the host immune response. Variations in HLA genotypes across individuals lead to differences in susceptibility to viral infection and severity of illness. This study uses observations from the early phase of the COVID-19 pandemic to explore how specific HLA class I molecules affect clinical responses to SARS-CoV-2 infection. By analyzing paired high-resolution HLA types and viral genomic sequences from 60 patients, we assess the relationship between predicted HLA class I peptide binding repertoires and infection severity as measured by the sequential organ failure assessment score. This approach leverages functional convergence across HLA-C alleles to identify relationships that may otherwise be inaccessible due to allelic diversity and limitations in sample size. Surprisingly, our findings show that severely symptomatic infection in this cohort is associated with disproportionately abundant binding of SARS-CoV-2 structural and non-structural protein epitopes by patient HLA-C molecules. In addition, the extent of overlap between a given patient’s predicted HLA-C and HLA-A peptide binding repertoires correlates with worse prognoses in this cohort. The findings highlight immunologic mechanisms linking HLA-C molecules with the human response to viral pathogens that warrant further investigation. Full article

This article examines British Sufi responses to the COVID-19 pandemic within the broader context of Muslim experiences of and reactions to the pandemic. Set within a discussion pertaining to classical and contemporary expressions of Sufism, this article explores Sufi phenomena, including the murshid–murid (Sufi master–novice) dynamic, collective gathering and Sufi gaze (nazar) and whether these phenomena were possible within the inevitable digital environments Sufis were forced into as a result of the COVID pandemic and subsequent lockdowns, experienced in Britain. The author explores Sufi social and intellectual phenomena within classical and contemporary literature in relation to Sufi experiences in the West. She concludes that varied lived experiences and differing views on Sufism and both its classical and contemporary expressions were brought into question as a consequence of the COVID pandemic, the exploration of which are necessary in juxtaposition to one another to add nuance and depth and create holistic research of Sufi communities and Sufism more broadly, within contemporary Britain and further afield. Full article

Disease’s severity, mortality rates, and common failures to achieve clinical improvement during the unprecedented COVID-19 pandemic exposed the emergency need for new antiviral therapeutics with higher efficacy and fewer adverse effects. This study explores the potential to encapsulate multi-component plant extracts in liposomes as optimized delivery systems and to verify if they exert inhibitory effects against human seasonal betacoronavirus OC43 (HCoV-OC43) in vitro. The selection of Sambucus nigra, Potentilla reptans, Allium sativum, Aesculus hippocastanum, and Glycyrrhiza glabra L. plant extracts was based on their established pharmacological and antiviral properties. The physicochemical characterization of extract-loaded liposomes was conducted by DLS and electrokinetics. Encapsulated amounts of the extract were evaluated based on the total flavonoid content (TFC) and total polyphenol content (TPC) by colorimetric methods. The BALB 3T3 neutral red uptake (NRU) phototoxicity/cytotoxicity assay was used to estimate compounds’ safety. Photo irritation factors (PIFs) of the liposomes containing extracts were <2 which assigned them as non-phototoxic substances. The antiviral capacities of liposomes containing medicinal plant extracts against HCoV-OC43 were measured by the cytopathic effect inhibition test in susceptible HCT-8 cells. The antiviral activity increased by several times compared to “naked” extracts’ activity reported previously. A. hippocastanum extract showed 16 times higher inhibitory properties reaching a selectivity index (SI) of 58.96. Virucidal and virus-adsorption effects were investigated using the endpoint dilution method and ∆lgs comparison with infected and untreated controls. The results confirmed that nanoparticles do not directly affect the viral surface or cell membrane, but only serve as carriers of the active substances and the observed protection is due solely to the intracellular action of the extracts. Full article

The fight against coronavirus disease 2019 (COVID-19) continues. Since the pandemic’s onset, several biomarkers have been proposed to assess the diagnosis and prognosis of this disease. This research aimed to identify potential disease severity biomarkers in serum samples of patients with COVID-19 during the disease course. Data were collected using untargeted and targeted mass spectrometry methods. The results were interpreted by performing univariate and multivariate analyses. Important metabolite classes were identified by qualitative untargeted metabolomics in 15 serum samples from survivors of COVID-19. Quantitative targeted metabolomics on a larger patient cohort including 15 non-survivors confirmed serum 3-sulfate bile acids (i.e. GLCA-3S) were significantly increased in non-survivors compared to survivors during the early disease stage (p-value < 0.0001). Notably, it was associated with a higher risk of mortality (odds ratio of 26). A principal component analysis showed the ability to discriminate between survivors and non-survivors using the BA concentrations. Furthermore, increased BA-S is highly correlated with known parameters altered in severe clinical conditions. Full article

Health tourism, a sector that has gained increasing global attention, particularly in the context of sustainable development, is poised for significant growth even in the face of the COVID-19 pandemic. This study investigates the challenges faced by the health tourism sector in a small Mediterranean country, focusing on sustainable recovery strategies. The current study aims to determine managerial implications post-COVID-19, emphasizing sustainability in operational practices and long-term demand growth. We conducted in-depth interviews with 32 health tourism managers and experts, and the qualitative content analysis with Leximancer identified key themes such as sustainable demand management, organizational adaptation, and crisis recovery. This study revealed eight critical themes related to managerial survival and the demand for sustainable practices in health tourism, namely “demand”, “hotel”, “tour operators”, “employees”, “crises”, “social media”, “word of mouth”, and “time”. These findings underscore the importance of integrating sustainability into tourism recovery strategies, ensuring long-term resilience for the industry. This study, which provides theoretical and practical insights into the sustainable growth of health tourism amidst global crises, serves as a valuable reference for stakeholders seeking sustainable development solutions, inspiring them to contribute to the sector’s growth. Full article

The COVID-19 pandemic has had a significant impact on every individual in the United States. The launch of the COVID-19 vaccines is estimated to have averted millions of deaths and reduced over 18 million COVID-19-related hospitalizations. In September 2023, the updated 2023–2024 COVID-19 vaccine, which includes a monovalent component that corresponds to the omicron variant XBB.1.5, reflecting the predominant circulating variant at the time of strain selection, was approved and was recommended for use in all people ≥ 6 months of age. Despite this recommendation, the US uptake of the updated COVID-19 vaccines over the 2023–2024 season has been far from optimal, placing many people at unnecessary risk of severe COVID-19 outcomes. This paper provides an overview of the current state of COVID-19 in 2023–2024 and barriers to vaccine uptake. With the continued evolution of the virus, the potential for more virulent variants, reduced public acceptance of vaccination, and the potential barriers that contributed to low vaccine uptake are explored to provide solutions for improving COVID-19 protection for future seasons. Full article

Background: Studies evaluating the effects of natural disasters on cancer outcomes are scarce, especially among USA ethnic minority groups, and none have focused on the effects of concurrent natural disasters and the COVID-19 pandemic. The goal of this secondary data analysis is to explore the impact of concurrent exposure to COVID-19 and earthquakes on psychological distress and symptom burden among Puerto Rican cancer survivors. Methods: This secondary data analysis (n = 101) was part of a longitudinal case–control cohort study (n = 402) aimed at describing unmet psychological needs among Puerto Rican cancer patients and non-cancer subjects previously exposed to Hurricane María in 2017. The research team pooled data from participants (cancer survivors and non-cancer group) from their baseline assessments and from follow-up assessments conducted during January–July 2020 (earthquake and the lockdown period). A descriptive, paired t-test, non-parametric mean rank test, and two-sided Pearson correlation analyses were performed. Results: Psychological distress and cancer symptom burden diminished over time. Resilience was significantly correlated with all the psychological and symptom burden variables during both pre- and post-earthquake and COVID-19 assessment periods. Conclusions: The results support the role of resilience, social support, and post-traumatic growth as potential protective factors preventing psychological distress and diminishing cancer symptom burden among cancer survivors exposed to natural disasters and the COVID-19 pandemic. Full article

Background: The COVID-19 pandemic has fundamentally changed the quality and quantity of people’s food consumption. Objective: This study aimed to explore the dietary shifts among different racial groups resulting from the COVID-19 pandemic, focusing on changes in consumption across various food categories. Methods: This cross-sectional study included a sample of 10,050 urban residents aged 40–100 years across the United States. Dietary patterns among African American, Asian, Hispanic, and White populations were assessed before and since the pandemic (retrospective condition) using the Dietary Screening Tool (DST). The DST investigates consumption trends in food groups aligned with the MyPlate guidelines, plus fat, sugar, and sweet (FSS) intake and processed meats. Results: This study found significant shifts in food consumption patterns among racial groups since COVID-19. The data indicate that African American individuals largely reduced their consumption of several food groups compared to White individuals, with a 43% decrease in processed meats, 42% in dairy, 36% in lean protein, 21% in fruit, 17% in grains, and 15% in FSS, although their vegetable consumption did not significantly decrease. African American individuals also consumed 66% less processed meat, 57% less dairy, and 30% less lean protein in comparison to Asian individuals. Hispanic individuals also showed a tendency to reduce their consumption more than White individuals, with a 34% decrease in dairy, 28% in vegetables, and 24% in fruit. In contrast, Asian individuals consumed 37% less FSS and 34% less grains than White individuals. Additionally, when compared to Asian individuals, Hispanic individuals consumed 49% less dairy and 47% less processed meat. The findings also revealed that African American individuals were the most nutritionally vulnerable group since the pandemic. Specifically, they were 38% and 35% more likely to be considered at nutritional risk than Asians and White participants, respectively. Conclusions: These findings illuminate the considerable dietary shifts induced by the COVID-19 pandemic and emphasize the critical need to address the racial disparities in nutritional vulnerability and public health policy. Full article

Background: The COVID-19 pandemic has led to reduced physical activity and increased sedentary behaviors, negatively impacting mental and physical health. Engaging in physical activity at home during quarantine became essential to counteracting these adverse effects. To develop appropriate physical activity programs, assessing individuals’ fitness levels and the impact of inactivity is crucial. This study aims to compare motor abilities—including flexibility, balance, reaction time, cardiovascular endurance, and lower and upper limb strength—assessed both in-person and remotely, to determine the accuracy and repeatability of self-administered tests. Methods: A total of 35 young subjects (age 24.2 ± 1.97 years, BMI 22.4 ± 2.61 kg/m²) participated in this study. Each participant underwent a battery of motor ability tests designed to assess various fitness components. The tests were administered twice for each subject: once in a laboratory setting and once remotely at home. The sequence of tests was randomly assigned to ensure unbiased results. Both the in-person and remote assessments were used to evaluate the accuracy and reliability of self-administered tests. Results: The comparison of test results between the laboratory and remote settings revealed percentage differences ranging from 5% to 10%. This variation is considered an acceptable margin of error, suggesting that the tests conducted remotely were relatively accurate when compared to those performed in a controlled laboratory environment. Conclusions: The findings indicate that remote fitness testing is a promising method for evaluating motor abilities. With an acceptable margin of error, remote assessments can be effectively used to personalize training programs based on individuals’ physiological characteristics. This approach may be particularly beneficial during times of limited access to fitness facilities, such as during quarantine, or for individuals seeking more flexible fitness evaluation methods. Full article

Background: We investigated the expression of inflammation, placental development, and function markers, including cluster of differentiation 44 (CD44), osteopontin (OPN), and cyclooxygenase-2 (COX-2), to shed light on the controversy regarding the impact of the COVID-19 epidemic on fetal development and pregnancy outcomes. Methods: We immunohistochemically analyzed placental tissue from 170 patients (65 COVID-positive and unvaccinated women; 35 Pfeizer-vaccinated and COVID-negative women; and 70 COVID-negative and unvaccinated women, without any other associated pathology) for particularities in the expression of these three molecules. Results: CD44 expression was highest in COVID-negative and unvaccinated women, moderate in COVID-positive cases, and lowest in vaccinated and COVID-negative women. OPN expression was highest in COVID-negative and Pfeizer-vaccinated cases, moderate in COVID-negative and unvaccinated cases, and lowest in COVID-positive cases. COX-2 expression was increased in COVID-negative and unvaccinated women, modestly elevated in COVID-positive and unvaccinated cases, and lowest in vaccinated cases. Conclusions: These findings reflected an alteration in the placental structure and consequent function due to altered expression of the three studied molecules. Full article

We propose a composite index to measure and benchmark community participation in cross-border tourism development processes. The index synthesizes information regarding three dimensions of this construct, deemed as very important by the extant literature: residents’ engagement in the planning process and willingness to proactively welcome tourists and provide tourist services directly through sharing-economy platforms. The latter aspect is crucial to develop a local tourist supply able to combine environmental sustainability and financial feasibility in marginal areas, where public funding is scarce and private investments are unprofitable. This study offers a methodological innovation using response rates to open-ended questions to measure residents’ engagement in tourism planning. By applying the ELECTRE III algorithm, which is non-compensatory and ensures reliability in the presence of a high degree of uncertainty, survey information is aggregated in a single figure, which can be easily interpreted by destination managers and policymakers. After COVID-19, in readying for the next pandemic, decision makers should find our index as a very relevant and useful tool for tourism recovery and innovation planning, including compliance with measures to prevent the spread of future infections. We apply the proposed index to ten Croatian and Italian lands involved in a European development project. Data were collected through face-to-face interviews with residents, according to an availability sampling design. We obtained 879 valid questionnaires. The robustness of the resulting index is tested through an uncertainty and a sensitivity analysis. Full article

Background: Hepatitis A virus (HAV) infection is a significant global cause of viral hepatitis. At present, the anti-HAV vaccine in Italy is proposed exclusively for specific high-risk groups, and a universal vaccination program is not implemented. Objectives: This study aimed to assess the level of immunity against HAV in patients of both sexes across age groups ranging from 0 to 95 years admitted to the San Giovanni di Dio e Ruggi d’Aragona Hospital in Salerno, Italy, over a 9-year period (2015–2023). Methods: The total HAV seroprevalence by chemiluminescence Vitros system immunodiagnostics (ortho-diagnostics) was obtained by database analysis, stratifying patients for gender and age group in both the pre-pandemic (2015–2019) and pandemic (2020–2023) periods. Results: Out of 28,104 samples collected in 2015–2023, 20,613 resulted positive by total HAV immune screening, with a significant reduction in the annualized proportion of events during the pandemic period compared to the pre-pandemic period. HAV was more abundant in males than females in both periods (exceeding the 70%), with a statistically significant decrease in HAV in females in 2015–2019. The 61–70-year-old age group is more susceptible for both genders, with a strong deviation from the 41–50-year-old age group compared to the 51–60-year-old group. The pandemic period affected the number of analyzed samples in 2020. Conclusions: The study revealed high HAV seroprevalence, especially in males and individuals aged 61–70 years. There was a notable decrease in seroprevalence during the pandemic compared to pre-pandemic years. These results emphasize the need for ongoing monitoring and suggest that a universal vaccination program could address regional immunity gaps and lower disease incidence. Full article

Invariant natural killer T (iNKT) cells are glycolipid-reactive T cells with potent immunoregulatory properties. iNKT cells activated with the marine-sponge-derived glycolipid, α-galactosylceramide (αGC), provide a universal source of T-cell help that has shown considerable promise for a wide array of therapeutic applications. This includes harnessing iNKT-cell-mediated immune responses to adjuvant whole inactivated influenza virus (WIV) vaccines. An important concern with WIV vaccines is that under certain circumstances, they are capable of triggering vaccine-associated enhanced respiratory disease (VAERD). This immunopathological phenomenon can arise after immunization with an oil-in-water (OIW) adjuvanted WIV vaccine, followed by infection with a hemagglutinin and neuraminidase mismatched challenge virus. This elicits antibodies (Abs) that bind immunodominant epitopes in the HA2 region of the heterologous virus, which purportedly causes enhanced virus fusion activity to the host cell and increased infection. Here, we show that αGC can induce severe VAERD in pigs. However, instead of stimulating high concentrations of HA2 Abs, αGC elicits high concentrations of interferon (IFN)-γ-secreting cells both in the lungs and systemically. Additionally, we found that VAERD mediated by iNKT cells results in distinct cytokine profiles and altered adaptation of the challenge virus following infection compared to an OIW adjuvant. Overall, these results provide a cautionary note about considering the formulation of WIV vaccines with iNKT-cell agonists as a potential strategy to modulate antigen-specific immunity. Full article