Search Results (49,925)

Respiratory syncytial virus (RSV) imposes a substantial burden of severe acute respiratory infection (SARI), especially in young children and the elderly. Methods: We describe RSV epidemiology among hospitalized SARI patients at the Ibn Sina University Hospital Center (Rabat, Morocco) from 1 January 2021, to 31 December 2025, using multiplex PCR (BioFire^® RP2.1plus or Xpert^® SARS-CoV-2/Flu/RSV). Results: Among 4604SARI samples, RSV prevalence was 16.1% (739/4604), predominantly pediatric (88.6%, p < 0.001), with peak burden in infants <6 months (70.4% of cases, p < 0.001). Pediatric prevalence was 28.3% (655/2316) vs. 3.8% (84/2204) in adults (p < 0.001), with predominance in the elderly ≥60 years (51/1041, 4.9%). Co-infections occurred in 46.7% (310/665) of FilmArray-tested positives (total = 665), led by rhinovirus/enterovirus (198/310, 63.9%), and were significantly higher in children (48.5%, p < 0.001). RSV peaked in winter (51.6%), except for summer dominance in 2021 (52.5%), reflecting COVID-19 non-pharmaceutical intervention effects. Conclusions: These data establish Morocco’s first comprehensive RSV surveillance baseline, highlighting post-pandemic epidemiological shifts. As maternal vaccines and monoclonal antibodies emerge, these data inform optimal implementation in low- and middle-income countries (LMICs). Full article

Although organisational climate is increasingly examined, explicit modelling of demographic interaction effects remains comparatively underrepresented. A search strategy was conducted (25 September 2025), and 358 records were identified and filtered in the Scopus and Covidence databases; subsequently, 60 peer-reviewed articles met the inclusion criteria following PRISMA-guided screening. R-project, reference to VOSviewer, and Biblioshiny were used to perform the bibliometric mapping to demonstrate three (3) large thematic clusters: (1) conceptual models with a focus on the Job Demands–Resources (JD–R) framework; (2) growing cross-sector and post-COVID literature; and (3) small but growing incorporation of interactive demographic variables (age, gender, tenure) other than control-variable treatment. The results show that organisational climate is always placed at the forefront as an important predictor of satisfaction, but intersectional demographic modelling is underdeveloped and geographically biased to Western and Asian factors. Yet improvements have been made in theoretical integration; however, a lack of constructs, methodological conservatism, and geographic skewness limit theoretical cumulation and practical translation. The proposed multi-factor model is conceptually derived from bibliometric patterns and requires empirical validation using CFA, SEM, and multilevel modelling. However, organisations should integrate satisfaction policies that reflect diverse demographic and contextual realities, rather than adopting a general approach. The study advances the model of employee satisfaction research by offering practical evidence and a theoretical framework to support the sustainability of industrial and organisational psychology. Full article

The aim of this study was to evaluate the association between baseline clinical and CT characteristics and to identify factors associated with intensive care unit (ICU) admission in hospitalized COVID-19 patients. This retrospective study included 176 adult patients with laboratory-confirmed SARS-CoV-2 infection hospitalized at the COVID Hospital of the Clinical Hospital Center Kosovska Mitrovica during 2021–2022 (Delta and Omicron variants). Patients were divided into two groups according to intensive care unit requirement: those treated in a general inpatient ward (No ICU) and those requiring ICU admission (ICU group). Demographic and clinical characteristics, lifestyle factors, CT findings, CT severity score (CTSS) values, and therapeutic interventions were compared between groups. Of the total cohort, 113 patients (64%) were hospitalized in a general inpatient ward, while 63 (36%) required intensive care unit admission. Independent predictors of ICU admission identified in the multivariate logistic regression analysis were obesity (B = 2.96, p < 0.001), dyspnea (B = 1.51, p = 0.041), higher CT severity score (B = 0.68, p < 0.001), and lower glucose levels (B = −0.27, p = 0.014). Furthermore, for each one-point increase in the CTSS, the odds of ICU admission nearly doubled (OR = 1.97). Total CT score values above the cut-off point (15.0) demonstrated significant reliability in discriminating the need for ICU transfer in patients with COVID-19. These findings suggest that combined clinical and radiological assessment at hospital admission may facilitate early identification of patients at high risk of requiring ICU care, with the CT severity score representing the strongest radiological predictor. Full article

Background: The coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, remains a significant threat to global health. This continued threat is due to the emergence of new variants, the immune system’s limited ability to respond, and the limited effectiveness of available treatments for all individuals. Therefore, leveraging drug repurposing, a fast and inexpensive way to find other drugs that have already been shown to be safe and efficacious, becomes useful. This study leverages ADMET profiling, network pharmacology, and molecular docking to evaluate the repurposing of Product Nkabinde for COVID-19 treatment. Methods: ADMET analysis involving the bioactive phytochemicals of PN was evaluated for pharmacokinetic appropriateness and drug-likeness. Using topological analysis, a network of protein–protein interactions was built to identify hub genes, and predicted compound targets were intersected with COVID-19-associated genes to find shared targets. Their biological importance was characterized using functional enrichment analysis. The binding affinities of PN phytochemicals against hub proteins and SARS-CoV-2 viral proteases (Mpro and PLpro) were assessed by molecular docking using AutoDock Vina. To confirm docking accuracy, co-crystallized ligands were redocked using Schrodinger 2022-1. The multi-target therapeutic potential of PN in COVID-19 was assessed using this integrative network pharmacology and molecular docking technique. Results: Molecular docking demonstrated that PN phytochemicals displayed robust and persistent binding affinities for both viral and host targets. Oleanolic acid showed the best affinity toward Mpro (−12.9 kcal/mol vs. −8.3 kcal/mol), while quercetin-3-O-β-D-(6′-galloyl)-glucopyranoside showed better binding to PLpro (−8.4 kcal/mol vs. −6.4 kcal/mol). Procyanidin B2 toward HCK (−10.5 vs. −7.9 kcal/mol), diosgenin toward EGFR (−9.4 vs. −8.4 kcal/mol), rutin toward SRC (−10.5 vs. −7.8 kcal/mol), and pimelea factor P2 toward PIK3R1 (−11.0 vs. −8.2 kcal/mol) all showed significantly higher affinities than their corresponding co-crystallized ligands. Furthermore, procyanidin B2 demonstrated consistent binding to STAT1 and STAT3, confirming its role in modulating immune signals. Most of the PN phytochemicals show advantageous pharmacokinetic properties, including elevated anticipated gastrointestinal absorption and adherence to Lipinski’s rule of five, signifying favorable oral bioavailability and drug-like properties. Moreover, PN exhibits a remarkable multi-target binding capacity against both SARS-CoV-2 proteases and key host signaling proteins involved in immune regulation and inflammatory responses, as determined by this integrative network pharmacology and molecular docking investigation. Conclusions: PN’s prospects as a host-directed, antiviral treatment for COVID-19 are demonstrated by its coordinated modulation of the PI3K/AKT, JAK–STAT, SRC-family kinase, EGFR, and SYK pathways. These results necessitate further experimental and clinical validation, providing a solid computational basis for repurposing PN in the treatment of COVID-19. Full article

This study investigates the effect of green innovation on environmental performance and the moderating role of ownership structure. A generalized method of moments regression approach was applied to a sample of 68 firms operating in the United Arab Emirates (UAE), observed from 2012 to 2024. The results indicate a significant and positive relationship between green innovation and environmental performance. In addition, institutional and state ownership strengthen this relationship. Splitting the sample according to key UAE characteristics (firms listed on the Abu Dhabi Securities Exchange versus the Dubai Financial Market, and the pre-UAE Vision versus post-UAE Vision period) as well as economic conditions (COVID-19) provides further interesting results. Our findings remain robust across alternative estimation methods. The results show significant differences in how ownership structures moderate green innovation effectiveness across the two markets. We also find that green innovation’s effectiveness on environmental performance significantly intensifies after the UAE Vision’s announcement. Our findings also indicate that the positive impact of green innovation on environmental performance becomes more pronounced in the post-COVID period. This paper provides an in-depth assessment of the role of sustainable tools (particularly green innovation) in enhancing environmental performance in the United Arab Emirates. It offers valuable insights for board members, CEOs, regulators, and policymakers who remain undecided or hesitant about implementing sustainability-oriented practices. Full article

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and post-COVID-19 syndrome share a symptom profile, including severe fatigue, cognitive dysfunction, exertional intolerance, sleep disturbances, hypervigilance, and the paradoxical state of being “wired but tired.” A well-established finding is sympathetic hyperactivity with reduced vagal tone, typically interpreted as autonomic nervous system dysfunction. Emerging evidence, however, suggests a broader disturbance across multiple neurotransmitter systems. This paper reviews current knowledge on neurotransmitter systems implicated in ME/CFS and Long COVID, focusing on potential mechanisms of dysregulation and their roles in disease pathology and symptom generation, as well as implications for treatment. In addition to abnormalities of the noradrenergic system, disturbances in serotonergic, GABAergic, and glutamatergic signaling have been reported. Contributing factors may include autoimmunity, neuroinflammation, gut dysbiosis, epigenetic influences, and stressors such as orthostatic intolerance, metabolic strain, and pain. A shift favoring excitatory over inhibitory neurotransmission can lead to excessive neural activation, autonomic dysfunction, sensory hypersensitivities, sleep disturbances, and cognitive impairment. Reduced GABAergic tone combined with increased glutamatergic and noradrenergic activity may elevate skeletal muscle tone, contributing to calcium overload, mitochondrial dysfunction, exertional intolerance, and post-exertional malaise. Various pharmacological treatments may partially rebalance these neurotransmitter systems, but limited efficacy highlights the need for systematic investigation and individualized strategies. Full article

Background: Regulatory restrictions and mandates typically offer short-term behaviour guidance, whereas interventions to improve knowledge and attitudes could result in more sustainable behavioural changes. Health authorities implemented awareness campaigns to enhance public knowledge and attitudes regarding COVID-19. This study explored the interplay between knowledge, attitudes and behaviours related to COVID-19 among university undergraduate students in Jordan, aiming to inform public health initiatives and educational programmes. Methods: A cross-sectional survey targeting undergraduate students enrolled at Yarmouk University in Jordan was conducted between January and May 2021. Participants consented to complete an anonymised validated self-administered questionnaire to evaluate their understanding of COVID-19 symptoms, treatment and transmission and attitudes and behaviours towards preventive measures. Data were analysed using descriptive and inferential statistics and structural equation modelling to investigate the associations between knowledge, attitudes and behaviours. Results: A total of 1375 undergraduate students participated in the survey. Knowledge of COVID-19 was low among most participants, with only 1.3% demonstrating high knowledge. Conversely, 58.5% exhibited good behaviour, and 31.4% reported full compliance with recommended behaviours. Significant differences were found in knowledge, attitudes and behaviours across different faculty clusters, with health faculties showing superior knowledge and more positive attitudes. Female participants (66.3%) were more likely to engage in positive behaviours than males (p-value = 0.02). Structural equation model (SEM) analysis showed that knowledge significantly influenced attitudes, which affected behaviours, confirming the model’s validity. Conclusions: The study highlights the critical role of knowledge and attitudes in shaping COVID-19-related behaviours among university students. Significant variations in knowledge and attitudes across different academic disciplines highlight the need for tailored educational interventions. The analysis supports the theoretical model linking knowledge, attitudes and behaviours, emphasising the importance of improving knowledge and attitudes to drive behaviour change. The findings suggest that comprehensive health education programmes targeting cognitive and affective aspects are essential for effective public health responses during pandemics. Full article

SARS-CoV-2, the causative agent of COVID-19, emerged in late 2019 and rapidly developed into a global health crisis. In this study, we analysed 173,194 SARS-CoV-2 genomes from the GISAID database to explore the intra-continental dynamics and distribution of variants across Africa between 2020 and 2024. We have identified 1377 distinct lineages, which were classified by clade to assess associations with infection and mortality rate. So, we conducted a Shannon entropy analysis to confirm the diversity and we applied a Correspondence Analysis (CA). Our findings revealed that one of the deadliest in Africa during the Delta wave, lineage AY.45 predominated in the South Africa cluster, whereas AY.34.1 drove transmission in the Atlantic West Africa cluster, underscoring regional heterogeneity. Furthermore, early in the pandemic, men exhibited a 39% higher risk of infection compared to women (aOR: 1.39, 95% CI [1.34–1.45]), particularly in association with clade G. By contrast, later stages were dominated by clade GRA, which disproportionately affected the elderly (≥70 years; aOR: 1.39, 95% CI [1.33–1.45]) and children (0–9 years; aOR: 1.26, 95% CI [1.20–1.33]). Our analysis highlighted that the pandemic on the African continent unfolded as a mosaic of epidemics shaped by diverse variants and regional epidemiological contexts. These findings emphasize the importance of genomic surveillance to capture local epidemic signatures and inform region-specific public health strategies. Full article

Glamping tourism has expanded rapidly as travelers increasingly seek nature-based experiences combined with comfort and privacy, particularly in the post-COVID-19 period. Online reviews provide a valuable source of insight into how guests perceive such experiential accommodation, yet large-scale, data-driven analyses of glamping sentiment remain limited. This study applies machine-learning techniques to classify customer sentiment expressed in online reviews of glamping sites in South Korea. A total of 3233 reviews were collected from ten leading glamping locations on Naver Map, cleaned, and translated from Korean to English. Sentiment labels (negative, neutral, and positive) were generated using VADER (Valence Aware Dictionary and sEntiment Reasoner), a lexicon-based sentiment scoring tool validated for short informal texts and the labeled corpus was subsequently used to train and evaluate six supervised classifiers. Six supervised classifiers—Naïve Bayes, k-Nearest Neighbors, Random Forest, Logistic Regression, Gradient Boosting, and Support Vector Machine (SVM)—were trained and evaluated through stratified ten-fold cross-validation using accuracy, AUC, F1-score, and Matthews Correlation Coefficient (MCC). Results indicate that SVM achieved the strongest overall discriminatory performance, particularly in identifying minority sentiment classes under substantial class imbalance. These findings suggest that automated sentiment classification holds practical potential for supporting evidence-based service monitoring and reputation management in glamping tourism, although further validation in operational settings is needed before deployment can be recommended. Full article

Amid escalating global crises, tourism sustainability is threatened by heightened industry vulnerability, yet the intrinsic coupling of tourism industry vulnerability (TIV) and resilience (TIR) remains underexplored via systemic theoretical frameworks. This study aimed to define TIV/TIR as industry-specific constructs and develop an integrated analytical model grounded in dissipative structure theory to characterize tourism systems’ crisis responses. We selected Southwest China’s ethnic minority regions (Guizhou, Guangxi, Yunnan) as cases, using 2015–2024 prefecture-level panel data to explores the spatio-temporal differentiation characteristics of TIV/TIR. Results revealed severe COVID-19-induced TIV surges in 2020–2021, followed by rapid TIR rebounds; TIV and TIR exhibited a significant negative correlation with regional heterogeneity. Most cities showed high TIV–low TIR, with Guizhou displaying negative TIV-TIR spatial autocorrelation and Guangxi–Yunnan showing TIR clustering; inter-city TIV disparities widened while TIR levels converged, leading to a low-vulnerability, balanced-resilience tourism system by 2024. This research introduces the novel sensitivity-adaptive capacity-recovery (SACR) framework, advancing understanding of TIV-TIR dynamics and providing targeted empirical insights for tourism resilience building and sustainable development in resource-dependent destinations. Full article

The COVID-19 pandemic placed unprecedented pressure on diagnostic services worldwide. The first cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the UK were confirmed on 31 January 2020, prompting National Health Service (NHS) laboratories to scale diagnostic procedures. The demand for testing rapidly exceeded historical norms for respiratory virus diagnostics, necessitating substantial government investment in consumables, assay development, and workforce expansion. This review presents a retrospective evaluation of SARS-CoV-2 diagnostic platforms deployed within the Norfolk and Norwich University Hospital (NNUH) trust and compares them with those implemented by other regional laboratories during the pandemic. It examines the molecular mechanisms, performance, scalability, and specificity of the multiple molecular testing approaches to optimise workflow based on the evolving technology. The integration of complementary platforms through a stratified testing strategy enabled high-throughput population screening while preserving diagnostic resolution for complex respiratory cases, substantially improving laboratory efficiency and resilience. The emerging diagnostic methodologies, RT-LAMP and CRISPR-based assays, are described, and we discuss their potential roles in future outbreaks. We critically evaluate the overall preparedness of UK health services for the COVID-19 pandemic and highlight key priorities for future pandemic preparedness at both local and national levels. Full article

Background and Objectives: The objective of this study was to investigate the relationship between clinical periodontal status and COVID-19 severity, including intensive care unit (ICU) admission and in-hospital mortality, in a cohort of hospitalized patients. Materials and Methods: This single-center, cross-sectional study included 44 patients with polymerase chain reaction-confirmed COVID-19 hospitalized at Buca Seyfi Demirsoy Training and Research Hospital, Izmir, Turkey, between August and December 2021. Of these, 32 (72.7%) were admitted to the ICU and 12 (27.3%) to the inpatient service. All participants underwent a full-mouth clinical periodontal examination to assess probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BoP), and plaque index (PI). Clinical data, demographics, comorbidities, and validated disease severity scores (GCS, APACHE II and SOFA) were extracted from electronic medical records, and a univariate logistic regression analysis was performed to identify factors associated with in-hospital mortality. Results: Patients admitted to the ICU (n = 32) were significantly older, had a higher prevalence of comorbidities, and showed higher CAL (p = 0.049) and PI (p < 0.001) values than those treated in the inpatient service. Deceased patients (n = 15) had a significantly higher PI than survivors (p = 0.024). In the univariate logistic regression analysis, APACHE II was the only variable significantly associated with in-hospital mortality (OR = 0.867, p = 0.003), however none of the periodontal parameters, including CAL and PI, showed a statistically significant association with mortality. Conclusions: Poorer periodontal findings, particularly higher CAL and PI values, were more frequently observed in patients requiring ICU care. However, periodontal parameters were not significantly associated with in-hospital mortality in univariate analysis. Given the cross-sectional design, small sample size, and lack of multivariable adjustment, these findings should be interpreted as unadjusted associations rather than evidence of an independent or causal relationship. Full article

The evolution and spatial dissemination of SARS-CoV-2 Omicron subvariants have been characterized by rapid lineage replacement and complex transmission dynamics influenced by regional connectivity. This study presents a comprehensive discrete phylogeographic analysis of 90,136 SARS-CoV-2 sequences collected in Poland from 2022 to 2024 to reconstruct the dispersal dynamics of major Omicron lineages, including BA.1, BA.2, BA.5, CH.1, XBB.1, and JN.1. Utilizing Bayesian statistical frameworks, we identified significant viral transitions between the 16 Polish voivodeships and established variant-specific dominance windows ranging from 2 to 4 months. Our findings reveal a highly dynamic epidemic landscape with shifting regional epicenters. The initial BA.1 wave was primarily driven by the Mazovian voivodeship, accounting for 36.1% of outward migration events. This pattern shifted dramatically with the rise in BA.2, which was centered in the industrial Silesian region in the south-west, a densely populated area with strong economic ties to neighboring countries, potentially reflecting a different introduction or transmission dynamic. Furthermore, the epidemic landscape continued to reconfigure during the BA.5 wave, marked by the emergence of new transmission hubs in eastern border regions such as Lublin. Subsequent lineages exhibited distinct geographic signatures: BA.5 spread broadly along the Baltic-central corridor, CH.1 was centered in the north-east, XBB.1 re-emerged in the west-central region of Greater Poland, and JN.1 was driven overwhelmingly by Lesser Poland. These transitions highlight that regional transmission hubs are transient and influenced by local factors such as population density, cross-border mobility, and socio-economic connectivity. This study underscores the critical value of dense genomic surveillance in identifying evolving dispersal routes to inform adaptive, region-specific public health interventions. Full article

Background and Clinical Significance: Osmotic demyelination syndrome (ODS) and pituitary apoplexy are rare but potentially severe neurological and endocrine complications that can arise in the context of profound metabolic stress. Case Presentation: We describe the case of a previously healthy 34-year-old man who developed severe symptomatic hyponatremia shortly after receiving his second dose of an mRNA COVID-19 vaccine. Initial laboratory findings and clinical assessment were consistent with syndrome of inappropriate antidiuretic hormone secretion. Following correction of serum sodium, the patient experienced neurological deterioration with gait disturbance, dysarthria, and cognitive impairment. Follow-up brain MRI demonstrated extrapontine osmotic demyelination involving the basal ganglia and thalamus, despite initially normal imaging. During subsequent endocrinological follow-up, pituitary MRI revealed pituitary apoplexy in a previously unrecognized adenoma, accompanied by evolving partial hypopituitarism. The patient was managed with careful electrolyte control and long-term hormone replacement therapy, including hydrocortisone, levothyroxine, and recombinant growth hormone, resulting in gradual functional and cognitive improvement. Conclusions: This case highlights the interaction between severe hyponatremia, osmotic stress, and pituitary vulnerability, and emphasizes the need for cautious sodium correction, careful interpretation of temporal associations, and continued clinical vigilance in the context of COVID-19 vaccination programs. Full article

Background/Objectives: The clinical determinants and functional relevance of persistent lung ultrasound (LUS) abnormalities after COVID-19 pneumonia remain poorly characterized. We aimed to identify determinants of qualitative LUS abnormalities and global lung involvement assessed by the LUS score, and to evaluate their association with persistent dyspnoea. Methods: We conducted a prospective observational study that included 261 patients who were hospitalized for COVID-19 pneumonia and were assessed 1–6 months after discharge. A standardized 14-zone LUS protocol was used to assess qualitative abnormalities (pleural line irregularity, ≥3 B-lines, and subpleural consolidations) and to calculate the LUS score. Associations with clinical variables, including dyspnoea assessed by the modified Medical Research Council (mMRC) scale, were analyzed using multivariable logistic regression. Results: The severity of the acute pneumonia episode emerged as the strongest determinant of qualitative LUS abnormalities and elevated LUS score (>6). Increasing age was independently associated with ultrasound findings. Persistent dyspnoea (mMRC ≥ 1) was associated with all qualitative abnormalities and with a higher prevalence of elevated LUS score (56.6% vs. 22.1%; p < 0.001). A graded association was observed between dyspnoea severity and both qualitative findings and LUS score. An increase in dyspnoea from baseline (ΔmMRC ≥ 1) remained independently associated with an elevated LUS score. Conclusions: Persistent LUS abnormalities are strongly associated with the severity of the acute episode. The LUS score provides a robust, clinically meaningful measure of residual lung involvement and shows a stronger association with persistent dyspnoea than qualitative findings, supporting its role in follow-up and risk stratification. Full article