Search Results (391)

Background: International migration is a growing global phenomenon involving diverse groups, such as labor migrants, international marriage migrants, refugees, and international students. International migrants face unique mental health challenges influenced by adversities such as social isolation and limited access to mental health services. This study employs bibliometric methods to systematically analyze the global body of literature on international migrants’ mental health. Methods: The literature on the mental health of international migrants published until October 2024 was searched using the Web of Science database. The search terms included (‘International migrants’ OR ‘migrant workers’ OR ‘international students’ OR ‘refugees’ OR ‘asylum seekers’ OR ‘smuggled migrants’) AND ‘mental health’. VOSviewer was used to conduct bibliometric analysis, focusing on co-authorship patterns, keyword co-occurrence, and citation networks. Results: Over the past four decades, research on the mental health of international migrants has grown substantially, with major migration destinations such as the United States, Europe, and Australia playing prominent roles in this field. ‘Post-traumatic stress disorder (PTSD)’ was the most frequent keyword in publications, with strong links to ‘trauma’ and ‘depression’. In recent years, with the impact of global socioenvironmental changes and emergencies such as the COVID-19 pandemic, the research focus has gradually shifted towards social support, service accessibility, and cultural adaptation. Conclusions: International migration is a far-reaching global phenomenon, and addressing the mental health of migrant populations is essential for advancing public health, social cohesion, and sustainable development. This study provides the first bibliometric overview of research in this domain, mapping its thematic evolution and collaborative structure. The findings offer valuable insights into the field’s development and may support future interdisciplinary collaboration and the formulation of culturally informed, evidence-based approaches in migrant mental health. Full article

The COVID-19 pandemic fundamentally disrupted assumptions about entrepreneurship, career planning, and professional development. This study explored how the pandemic influenced the entrepreneurial intentions of undergraduate business students in the United States. Using a qualitative methodology based on in-depth interviews with 31 students at a public Midwestern university, the research interpreted student narratives through the lenses of effectuation theory, resilience theory, and the theory of planned behavior. Findings revealed that many participants reframed entrepreneurship as a strategy for navigating economic uncertainty and enhancing personal agency. Students reported valuing adaptability, resourcefulness, and opportunity recognition, often experimenting with side hustles during the pandemic as a means of resilience. Their entrepreneurial thinking shifted from purely economic motivations toward aspirations for flexibility, self-fulfillment, and purposeful work. The study highlights the formative role of crisis contexts in shaping entrepreneurial identity among emerging professionals. It suggests that entrepreneurship education should move beyond traditional models, fostering skills for navigating complexity and building resilience. In doing so, the findings contribute to broader conversations about youth entrepreneurship, post-pandemic career development, and the evolving demands of the labor market in times of disruption. Full article

Background: Chronic cytomegalovirus (CMV) infection may favor the development of immunosenescence and inflammation that impair vaccine responses, including COVID-19. In addition, the polymorphism of the interferon-lambda gene (IFNλ) affects COVID-19 immune responses in older adults. Objective: We aimed to investigate the impact of IFNλ polymorphism (IL28B gene-rs12979860) on the immune/inflammatory response to vaccination with CoronaVac for COVID-19 in older adults who were CMV-seropositive. Methods: Blood samples from 42 CMV-seropositive older adults (73.7 ± 4.5 years) were collected before and 30 days after immunization with a second dose of the CoronaVac vaccine to evaluate the immune/inflammatory response. Results: At genotyping, 20 subjects were homozygous for the C/C alleles (Allele-1 group), 5 were homozygous for the T/T Alleles (Allele-2 group), and 17 were heterozygous (C/T, Alleles-1/2 group). The Allele-1 group showed higher IgG levels for COVID-19 (p = 0.0269) and intermediate monocyte percentage (p = 0.017), in contrast to a lower non-classical monocyte percentage (p = 0.0141) post-vaccination than pre-vaccination. Also, this group showed that IgG levels for CMV were positively associated with a systemic pro-inflammatory state and senescent T cells (CD4+ and CD8+). The Allele-2 group presented higher IFN-β levels at pre- (p = 0.0248) and post-vaccination (p = 0.0206) than the values in the Allele-1 and Alleles-1/2 groups, respectively. In addition, the Allele-2 and Alleles-1/2 groups showed that IgG levels for COVID-19 were positively associated with a balanced systemic inflammatory state. Conclusion: CMV-seropositivity in older adults who had Allele-1 could lead to an unbalanced systemic inflammatory state, which may impair their antibody response to COVID-19 vaccination compared to other volunteer groups. Full article

Background: This study investigates the potential mechanisms behind changes in cardiac structure and function in long COVID patients. Methods: This study involved 176 consecutive outpatients in follow-up care (average age 55.9 years; 58.5% male) who experienced symptoms for over 12 weeks (average 6.2 ± 2.7 months), following coronavirus infection (COVID-19). Results: The patients with long COVID and cardiovascular manifestations were significantly more hospitalized (88.5% vs. 75.9%) and had longer hospital stays. Significant echocardiography changes were observed in the left ventricular ejection fraction (LVEF) (59.6 ± 5.4% vs. 62.5 ± 3.8%); longitudinal strain (LS) in the sub-endocardium and intra-myocardium layers (−20.9 vs. −22.0% and −18.6 vs. −19.5%); circumferential strain (CS) in the sub-epicardium layers (−9.6 vs. −10.5%); and CS post-systolic shortening (CS PSS) (0.138 vs. 0.088 s). Additionally, pathological cardiac magnetic resonance (CMR) findings were seen in 58.2% of the group of patients with long COVID and cardiovascular manifestation; 43.3% exhibited positive late gadolinium enhancement (LGE), 21.0% had elevated native T1 mapping, and 22.4% had elevated native T2 mapping. Conclusions: Most patients with long COVID showed structural and functional changes in their cardiovascular systems, primarily caused by prolonged inflammation. Using multimodality imaging is important for uncovering the mechanisms to predict chronic myocarditis, early-stage heart failure, and pre-ischemic states, which can lead to serious complications. Recognizing the specific cardiovascular phenotypes associated with long COVID is essential in order to provide timely and appropriate treatment. Full article

Background/Objectives: In the aftermath of the COVID-19 pandemic, individuals infected with SARS-CoV-2 have progressively displayed a range of symptoms linked to protracted COVID during the post-acute phase of illness. Concurrently, in several nations globally, the phenomenon of population aging has been intensifying. In this scenario, the aged population has become both vulnerable and high-risk during the acute phase of COVID-19, and faces significant dangers associated with long-COVID. This study seeks to analyze the incidence and spatial distribution of health complications in older people affected by COVID-19, in the first year of the pandemic (2020), in the State of Paraná, as well as to identify the factors associated with the development of cardiovascular, neurological, respiratory, and metabolic diseases. Method: An observational and retrospective study was carried out in the Brazilian state of Paraná. Participants were randomly selected from two databases. A total of 893 older people (≥60 years) participated in the study 12 months after acute COVID-19 infection. Telephone questionnaires were applied between March and December 2021. The Moran index test, logistic regression, and Poisson models were used to analyze the data. Results: In terms of age, most participants (66%) were between 60 and 69 years old, 25.8% were between 70 and 79 years old, and 8.2% were 80 years old or older. Most participants were female (51.2%), white (98.1%), had a partner (69.8%), and had been hospitalized due to COVID-19 (59.3%). Cardiovascular diseases were the most frequent in the population (39.5%), followed by metabolic diseases (27.3%). The long-term use of medication was associated with the development of metabolic diseases (aOR = 9.8), cardiovascular diseases (aOR = 6.6), and diseases in multiple organic systems (aOR = 3.2); living alone was associated with neurological diseases (aOR = 2.5), and the age group of 80 years or older (aOR = 2.4) was associated with cardiovascular events. The spatial distribution showed that complications in body groups are distributed randomly among the health regions of the state, with no influence from neighboring locations. Conclusions: Post-COVID-19 health complications are more frequent in older adults who have comorbidities and long-term medication use. Therefore, long-term monitoring of these individuals and investment in public policies for rehabilitation and prevention of complications are necessary. Full article

Background: While mRNA vaccines effectively limit hospitalization and severe COVID-19 disease, the precise early innate immune mechanisms associated with their efficacy and reactogenicity remain underexplored. The identification of innate immune correlates prior to vaccination could provide mechanistic insights and potentially predict responses. Methods: We developed an in vitro model to study the innate immune activation of pre-vaccination peripheral blood mononuclear cells (PBMCs) collected from participants enrolled in a well-characterized COVID-19 BioNTech/Pfizer BNT162b2 vaccine (BNT162b2 vaccine) cohort. Pre-vaccination PBMCs were stimulated with empty lipid nanoparticle (LNP), mRNA-LNP, or Toll-like receptor (TLR) agonists. Using multiparameter spectral flow cytometry, we analyzed the baseline immune state, innate responsiveness to stimuli, and cytokine profiles of study participants. These pre-vaccination in vitro results were analyzed for correlations with post-vaccination symptoms and spike-specific IgG responses. Results: Baseline dendritic cell (DC) states inversely correlated with the magnitude of symptoms following BNT162b2 vaccination. Heightened conventional (cDC) and weaker plasmacytoid DC (pDC) responses to RNA stimuli correlated with the magnitude of an acute IgG response. IgG durability modestly correlated with a lower pDC state but higher cDC2 and monocyte baseline states and inversely correlated with TLR3 agonist responsiveness. Conclusions: The pre-vaccination assessment of innate immune function and resting states can be used to fit models potentially predictive of immunogenicity and reactogenicity to BNT162b2 vaccination. Pre-vaccination DC states may influence reactogenicity, while the response to RNA may impact antibody responses. Our data suggest that pre-vaccination assessment offers insights into the innate mechanisms driving mRNA vaccine responses and has predictive potential. Full article

While there are many postulates for the etiology of post-viral chronic fatigue and other symptomatology, little is known. We draw on our past experience of these syndromes to devise means which can expose the primary players of this malady in terms of a panoply participating biomolecules and the state of the stool microbiome. Using databases established from a large dataset of patients at risk of colorectal cancer who were followed longitudinally over 3 decades, and a smaller database dedicated to building a Long PASC cohort (Post-Acute Sequelae of COVID-19), we were able to ascertain factors that predisposed patients to (and resulted in) significant changes in various biomarkers, i.e., the stool microbiome and serum cytokine levels, which we verified by collecting stool and serum samples. There were significant changes in the stool microbiome with an inversion from the usual Bacillota and Bacteroidota species. Serum cytokines showed significant differences in MIP-1β versus TARC (CC chemokine ligand 17) in patients with either PASC or COVID-19 (p < 0.02); IL10 versus IL-12p70a (p < 0.02); IL-1b versus IL-6 (p < 0.01); MCP1 versus TARC (p < 0.03); IL-8 versus TARC (p < 0.002); and Eotaxin3 versus TARC (p < 0.004) in PASC. Some changes were seen solely in COVID-19, including MDC versus MIP-1α (p < 0.01); TNF-α versus IL-1-β (p < 0.06); MCP4 versus TARC (p < 0.0001). We also show correlates with chronic fatigue where an etiology was not identified. These findings in patients with positive criteria for PASC show profound changes in the microbiome and serum cytokine expression. Patients with chronic fatigue without clear viral etiologies also have common associations, including a history of tonsillectomy, which evokes a likely immune etiology. Full article

Background and Objectives: Coronavirus disease 2019 (COVID-19) triggers a dysregulated host response that may culminate in refractory hypoxaemic shock. Whether veno-venous ECMO modifies the inflammatory cascade more effectively in COVID-19 than in other septic states, and how it compares with conventional ventilatory support for COVID-19, remains uncertain. We compared three groups: COVID-19 patients supported with ECMO (COVID-ECMO, n = 25), non-COVID-19 septic shock patients on ECMO (SEPSIS-ECMO, n = 19) and critically ill COVID-19 patients managed without ECMO (COVID-CONV, n = 74). Methods: This retrospective study (January 2018–January 2025) extracted demographic, laboratory and clinical data at baseline, 48 h and 72 h. The primary end-point was the 72 h change in SOFA score (ΔSOFA). The secondary end-points included the evolution of interleukin-6 (IL-6), C-reactive protein (CRP), D-dimer and ferritin; haemodynamic variables; and 28 day mortality. A post hoc inverse-probability-of-treatment weighting (IPTW) sensitivity analysis adjusted for between-group severity imbalances. Results: Baseline APACHE II differed significantly (29.5 ± 5.8 COVID-ECMO, 27.4 ± 6.1 SEPSIS-ECMO, 18.2 ± 4.9 COVID-CONV; p < 0.001). At 48 h, IL-6 fell by 51.8% in COVID-ECMO (−1 116 ± 473 pg mL⁻¹) versus 32.4% in SEPSIS-ECMO and 18.7% in COVID-CONV (p < 0.001). The ΔSOFA values at 72 h were −4.6 ± 2.2, −3.1 ± 2.5 and −1.4 ± 1.9, respectively (p < 0.001). ECMO groups achieved larger mean arterial pressure rises (+16.8 and +14.2 mmHg) and greater norepinephrine reduction than COVID-CONV. The twenty-eight-day mortality was 36.0% (COVID-ECMO), 42.1% (SEPSIS-ECMO) and 39.2% (COVID-CONV) (p = 0.88). Across all patients, IL-6 clearance correlated with ΔSOFA (ρ = 0.48, p < 0.001) and with vasopressor-free days (ρ = 0.37, p = 0.002). Conclusions: ECMO, regardless of aetiology, accelerates inflammatory-marker decline and organ failure recovery compared with conventional COVID-19 management, but survival advantage remains elusive. COVID-19 appears to display a steeper cytokine-response curve to ECMO than bacterial sepsis, suggesting phenotype-specific benefits that merit confirmation in prospective trials. Full article

This paper investigates the dynamics of energy poverty across EU Member States from 2015 to 2023, a period characterized by economic recovery, the COVID-19 pandemic, and a significant energy crisis. Utilizing Eurostat EU-SILC data, the study analyzes trends in four key indicators: the inability to keep homes adequately warm, arrears on utility bills, housing cost overburden rate, and the at-risk-of-poverty rate. Data processing and trend analysis were performed using R and RStudio, while a k-means cluster analysis, executed in Python via Visual Studio Code, identified and compared distinct country groupings based on their energy poverty profiles in 2015 and 2023. The findings reveal a general improvement in energy poverty indicators across the EU until 2019, followed by a marked deterioration, particularly in energy affordability metrics post-2021 due to the energy crisis. This impact was observed to be distinct from general income poverty trends. While significant geographical disparities persist, with Southern and Eastern European countries often more vulnerable, the analysis also points to notable improvements in several Central and Eastern European nations. The cluster analysis, which identified eight clusters in 2015 and seven in 2023, suggests a degree of partial convergence. Key shifts include Poland’s transition to a lower-risk cluster and Spain’s move to a higher-risk group, while Southern Europe generally remains highly susceptible. This research underscores the dynamic and multifaceted nature of energy poverty, highlighting the necessity for targeted, context-specific policies. Addressing energy poverty is crucial for enhancing household resilience and achieving truly comprehensive energy security throughout the EU, especially amid the ongoing energy transition and potential future socio-economic shocks. Full article

The COVID-19 pandemic and the resulting stay-at-home orders disrupted religious life across the United States, forcing congregations to rapidly adapt to unprecedented challenges. While existing research has explored the pandemic’s impact on individual religiosity, this article centers on how congregations were reshaped by the pandemic—sometimes temporarily, sometimes permanently. Drawing on nationally representative survey data from the Exploring the Pandemic Impact on Congregations project and the long-running Faith Communities Today initiative, this article analyzes trends in worship attendance, other forms of commitment to and engagement with congregations, congregational openness to change, and clergy well-being. The findings show that in-person worship attendance continues to decline, while online worship was adopted widely during the pandemic and remains common. Programming, volunteering, and financial giving have rebounded but still fall short of pre-pandemic levels or current needs. Many congregations embraced change early in the pandemic but have since reverted to old routines. Clergy are in relatively good health, yet growing numbers are reconsidering their futures in ministry. These shifts reveal the pandemic’s lasting impact on congregational life and raise critical questions for clergy, lay leaders, and researchers about institutional resilience, innovation, and leadership sustainability. The findings underscore the complex and evolving nature of post-pandemic ministry. Full article

Despite the increasing evidence of neurocognitive impairment (NCI) in patients suffering from post-COVID-19 conditions (PCC), the interplay between patient-reported symptoms and objective findings remains poorly characterized. Valid diagnostic tests and sufficient treatment strategies are lacking. We conducted a narrative perspective synthesis of current findings of NCI, standardized assessments (e.g., MoCA, PCCIS), and their association with inflammatory parameters. We highlighted findings on the discrepancy of subjective versus objectively measured neurocognitive impairment. The “subjectivity-objectivity-gap” may contribute to patient stigmatization, impair therapy adherence and be associated with a suboptimal clinical outcome. Although established multimodal interventions, such as cognitive rehabilitation, psychoeducation, group therapy, and pharmacotherapy—show preliminary efficacy, adherence may be compromised when subjective experiences of NCI are invalidated. We summarized the current state of the literature regarding demographic and clinical risk factors such as advanced age, lower education, neuropsychiatric comorbidities and evidence on the possible underlying role of persistent neuroinflammation in NCI in PCC. This perspective emphasizes the need for evidence-based diagnostic algorithms that integrate both subjective and objective NCI, explicitly addressing the risk of stigmatization. Future research should focus on addressing the neurobiological basis of NCI, discrepant NCI findings and associated stigmatization, and incorporate these findings in clinical guidelines. Full article

Since the outbreak of the COVID-19 pandemic in 2020, numerous studies have focused on the long-term effects of COVID infection. On 1 October 2021, the Centers for Disease Control (CDC) implemented a new code in the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for reporting ‘Post COVID-19 condition, unspecified (U09.9)’. This change indicated that the CDC recognized Long COVID as a real illness with associated chronic conditions. The National COVID Cohort Collaborative (N3C) provides researchers with abundant electronic health record (EHR) data by harmonizing EHR data across more than 80 different clinical organizations in the United States. This paper describes the creation of a COVID-positive N3C cohort balanced by the presence or absence of Long COVID (U09.9) and evaluates whether or not documented Long COVID (U09.9) is associated with decreased survival length. Full article

The COVID-19 pandemic has highlighted the intricate nature of disease dynamics, extending beyond transmission patterns to the complex interplay of intervention strategies. In the post-COVID-19 era, reinfection has emerged as a critical factor, shaping how we model disease progression, evaluate immunity, and assess the effectiveness of public health interventions. This research uniquely explores the varied efficacy of existing vaccines and the pivotal role of vaccination timing in the context of COVID-19. Departing from conventional modeling, we introduce two models that account for the impact of vaccines on infections, reinfections, and deaths. We estimate model parameters under the Bayesian framework, specifically utilizing the Metropolis–Hastings Sampler. We conduct data-driven scenario analyses for the State of Qatar, quantifying the potential duration during which the healthcare system could have been overwhelmed by an influx of new COVID-19 cases surpassing available hospital beds. Additionally, the research explores similarities in predictive probability distributions of cumulative infections, reinfections, and deaths, employing the Hellinger distance metric. Comparative analysis, utilizing the Bayes factor, underscores the plausibility of a model assuming a different susceptibility rate to reinfection, as opposed to assuming the same susceptibility rate for both infections and reinfections. Results highlight the adverse outcomes associated with delayed vaccination, emphasizing the efficacy of early vaccination in reducing infections, reinfections, and deaths. Our research advocates for prioritization of early vaccination as a key strategy in effectively combating future pandemics, thereby providing vital insights for evidence-based public health interventions. Full article

Background: Globally, pneumonia claims the lives of about 700,000 children under the age of 5 every year. Pneumococcal conjugate vaccine (PCV) was introduced in India phase-wise, beginning in high-burden states, and the rollout was completed nationwide by 2021—representing a major initiative by the Ministry of Health and Family Welfare (MoHFW). Despite the challenges posed by the COVID-19 pandemic, the campaign succeeded in maintaining progress and achieving nationwide coverage. This narrative review highlights the significant decisions, processes, and coordinated efforts of the various stakeholders involved that led to this successful PCV rollout. Methodology: A comprehensive desk review of both published and unpublished literature relevant to pneumonia burden and the efficacy and effectiveness of PCVs, along with documentation of PCV introduction and the scale-up was carried out. Results: The documentation of the PCV journey has been broken down into four sections: pre-introduction, PCV Phase-I introduction, pan-India rapid expansion, and the period post-introduction. Since the nationwide rollout in 2021, PCV coverage in India has steadily increased, reflecting successful immunization efforts. WUENIC, which is an annual WHO, and UNICEF estimates of national immunization coverage also show a positive trend in vaccination coverage (PCV booster coverage = 25% (2021), rising to 83% (2023), aligning with the goals of the WHO and UNICEF’s Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD). Conclusions: The phased rollout was an ambitious effort by the MoHFW, which was particularly challenging given the overlap with the COVID-19 pandemic. Despite these hurdles, the MoHFW, along with strong collaboration from development partners and stakeholders, successfully navigated the complex rollout. Future studies on the role of PCVs in reducing antibiotic resistance and the economic benefits of PCV introduction could help policymakers sustain funding and prioritize vaccine procurement decisions. Full article

In the post-COVID-19 era, the dynamic spread of COVID-19 poses new challenges to epidemiological modelling, particularly due to the absence of large-scale screening and the growing complexity introduced by immune failure and reinfections. This paper proposes an AEIHD (antibody-acquired, exposed, infected, hospitalised, and deceased) model to analyse and predict COVID-19 transmission dynamics in the post-COVID-19 era. This model removes the susceptible compartment and combines the recovered and vaccinated compartments into an “antibody-acquired” compartment. It also introduces a new hospitalised compartment to monitor severe cases. The model incorporates an antibody-acquired infection rate to account for immune failure. The Extended Kalman Filter based on the AEIHD model is proposed for real-time state and parameter estimation, overcoming the limitations of fixed-parameter approaches and enhancing adaptability to nonlinear dynamics. Simulation studies based on reported data from Australia validate the AEIHD model, demonstrating its capability to accurately capture COVID-19 transmission dynamics with limited statistical information. The proposed approach addresses the key limitations of traditional SIR and SEIR models by integrating hospitalisation data and time-varying parameters, offering a robust framework for monitoring and predicting epidemic behaviours in the post-COVID-19 era. It also provides a valuable tool for public health decision-making and resource allocation to handle rapidly evolving epidemiology. Full article