Missed opportunities for vaccination (MOV) reduce seasonal influenza vaccine (SIV) coverage among high-risk older adults who frequently access healthcare services but remain unvaccinated. We conducted a retrospective cohort study using the Siracusa Local Health Authority immunization registry in Italy. Individuals aged ≥65years who received pneumococcal, herpes zoster, COVID-19, or respiratory syncytial virus vaccines during the 2023/24 and 2024/25 influenza seasons were assessed for SIV status. Outcomes included missed opportunities for SIV and co-administration patterns. Among 4485 COVID-19, 3428 pneumococcal, 1617 herpes zoster, and 198 respiratory syncytial virus vaccine recipients, the proportion of individuals who did not receive SIV during the same influenza season (i.e., missed SIV opportunities) was 10.2%, 8.0%, 18.4%, and 7.6%, respectively. Co-administration was highest in the pneumococcal (47.6%) and respiratory syncytial virus (42.4%) cohorts, and lower in the COVID-19 (8.9%) and herpes zoster (11.0%). Older age was positively associated with SIV uptake in the COVID-19 and pneumococcal groups, while sex was not a consistent determinant, except for higher uptake among males in the RSV cohort. MOV were frequent among older adults who received other recommended vaccines, underscoring persistent gaps in adult immunization delivery. These findings support the need for systematic assessment of influenza vaccination status at every healthcare encounter, broader co-administration practices, and strengthened training and organizational support for healthcare professionals to optimize influenza vaccination and strengthen prevention in this vulnerable population.

Knowledge, perception, and myths about the COVID-19 virus by indigenous communities

Background Patients admitted with viral respiratory tract infections are at risk of bacterial co-infections, often requiring antibiotics. Standard bacterial cultures may take days to yield results, making early indicators of bacterial co-infection a potential asset. Methods In a retrospective regionwide cohort study, we included all patients admitted to a hospital in the Central Denmark Region with COVID-19, influenza, or respiratory syncytial virus (RSV) in the period February 2019 to February 2024. Further inclusion criteria were having a blood sample taken for procalcitonin measurement and blood cultures within 72 h of admission. We evaluated the diagnostic value of procalcitonin compared to other inflammatory markers. Results There were 1,670 patients fulfilling the inclusion criteria. The majority 1,556 (92.2%) were infected with SARS-CoV-2, 51 (3.7%) with influenza A, 1 (0.1%) with influenza B, 45 (2.7%) with RSV, and 17 (1.0%) with multiple viruses. Blood cultures were positive in 43 (2.6%) of the patients after a median of 67.4 h from time of admission. Median procalcitonin levels were higher in patients with bacteraemia (1.7 µg/L) than in patients without bacteraemia (0.2 µg/L. Overall, procalcitonin cut-off at >0.25 µg/L and >0.50 µg/L tended to have higher sensitivity, specificity, positive and negative predictive values than C-reactive protein (CRP) > 100 mg/L and total leukocyte count >10 × 109 cells/L, although the numerical differences were small. Overall diagnostic performance for bacterial pneumonia was lower. Conclusions All biomarkers had relatively low sensitivity for bacteraemia and bacterial pneumonia in patients with viral respiratory tract infection.

During the COVID-19 pandemic, the field of infectious disease modeling advanced rapidly, with forecasting tools developed to track trends in transmission dynamics and anticipate potential shortages of critical resources such as hospital capacity. In this study, we compared short-term forecasting approaches for COVID-19 hospital admissions that generate forecasts one to five weeks ahead, using retrospective electronic health records. We extracted different features (e.g., daily emergency department visits) from an individual-level patient dataset covering six hospitals located in the region of Bern, Switzerland, from February 2020 to June 2023. We then applied five methods - last-observation carried forward (baseline), linear regression, XGBoost and two types of neural networks - to time series using a leave-future-out training scheme with multiple cutting points and optimized hyperparameters. Performance was evaluated using the root mean square error between forecasts and observations. Generally, we found that XGBoost outperformed the other methods in predicting future hospital admissions. Our results also show that adding features such as the number of hospital admissions with fever and augmenting hospital data with measurements of viral concentration in wastewater improves forecast accuracy. This study offers a thorough and systematic comparison of methods applicable to routine hospital data for real-time epidemic forecasting. With the increasing availability and volume of electronic health records, improved forecasting methods will contribute to more precise and timely information during epidemic waves of COVID-19 and other respiratory viruses, thereby strengthening evidence-based public health decision-making.

Background: Multiple considerations exist for the anesthesiologists in covid-19 recovered patients with added problems arising due to rhino-orbital-cerebral mucormycosis and adverse effects of antifungal drugs. Overall morbidity and mortality are more in such patients. Managing such patients posted for surgical debridement presents a unique challenge to the anesthesiologist. Methods: A retrospective analysis of 118 patients operated for surgical debridement and histopathology confirmed mucormycosis cases were analysed from the medical record. A review of preoperative clinical and laboratory data, intraoperative anaesthesia details and postoperative outcome was done. Results: 118 confirmed mucormycosis patients were analysed. 98 patients tested covid positive, out of which 73 were hospitalized. 101 patients presented with diabetes mellitus. 53 patients were operated after 8 weeks of corona virus infection. 41 patients had increased creatinine levels. 7 patients presented with difficult intubation. Intraoperatively anesthesia concerns were tachycardia, hypertension, tachycardia combined with hypotension, arrythmias, hyperglycemia, raised end tidal carbon dioxide concentration (ETCO2), increased peak airway pressure and oozing in various patients. All patients were extubated. Postoperatively, 15 patients required oxygen, 92 were discharged and death resulted in 9 patients. Conclusion: Knowledge of disease, preoperative optimization and proper preparation of patients and postoperative icu care is must for successful management of mucormycosis patients undergoing surgical debridement.

Background: Corona virus disease 2019 (COVID-19) pandemic had placed an enormous burden on health systems worldwide, with severe disease and mortality disproportionately affecting unvaccinated individuals and those with underlying comorbidities. Vaccination remains the most effective strategy to prevent severe outcomes, yet evidence from South Asian settings remains limited. This study examined the clinical outcomes of hospitalized COVID-19 patients in Bangladesh in relation to their COVID-vaccination status. Methods: This hospital-based retrospective cross-sectional study was conducted at the dedicated COVID-19 ward under the Department of Internal Medicine in Bangladesh Medical University, Dhaka, Bangladesh during August 2021 to September 2021. A total of 492 adult patients were included consecutively irrespective of age and sex, diagnosed with COVID-19 based on clinical history, radiological findings and reverse-transcriptase polymerase chain reaction (RT-PCR) testing, who were treated under National Guidelines on Clinical Management of Coronavirus Disease 2019, were retrospectively enrolled in this study. The collected data were methodologically organized for computer entry and analysis. The data were analyzed using Statistical Package for Social Sciences (SPSS) version 29.0 (SPSS Inc., Chicago, IL, USA). Vaccination status was classified as unvaccinated (not a single dose received), partially vaccinated (received first dose only) and vaccinated (received at least two doses) of COVID-19 vaccine. Results: Total patients were 492, with mean age of 51.8 ± 17.4 years; 40.9% were aged e‑60 years and 66.9% had at least one comorbidity, most commonly diabetes mellitus (43.3%) and hypertension (37.6%). Among the study participants, only 16.9% were fully vaccinated followed by 5.5% partially vaccinated and 60.7% remained unvaccinated. Severe illness occurred in 75.6% of patients, disproportionately affecting the unvaccinated (83.1% vs 16.9% in vaccinated; p<0.001). Overall mortality was 17.1%, with vaccinated patients experiencing significantly lower mortality (6.0% vs. 94.0%; p<0.001). Vaccination reduced the odds of severe illness by 68% (OR 0.317, 95% CI: 0.201–0.500) and mortality by 82% (OR 0.183, 95% CI: 0.072–0.463). Intensive care unit (ICU) transfer was also less frequent among vaccinated patients (OR 0.342, 95% CI: 0.119–0.979). Length of hospital stay was slightly shorter among vaccinated patients (11.6 vs. 12.8 days), though it was not statistically significant. Conclusion: Vaccination was protective against severe COVID-19 outcomes, including ICU transfer and death. BIRDEM Med J 2026; 16(1): 3-8

Although the elderly population is significantly vulnerable to Corona Virus Disease 2019 (COVID-19) infection, research pertaining to this demographic remains relatively limited. Therefore, this study aimed to summarize the clinical characteristics, assess risk factors for death in hospitalized patients with COVID-19 aged ≥90 years, and provide insight into the treatment of severe/critically ill patients. This cross-sectional study was conducted at a tertiary hospital in Beijing, including patients aged ≥90 years hospitalized with COVID-19 from December 1, 2022, to February 28, 2023. We collected clinical data and used a multivariable logistic regression model to identify mortality risk factors. The calibration curve further confirmed the predictive capabilities of the model. The study included 150 patients, with 54 severe/critical cases and an overall in-hospital mortality rate of 31 (20.7%) patients. Multivariable logistic regression revealed a decreased lymphocyte percentage (odd ratio (OR) 0.81 [95% confidence interval (CI) 0.72–0.92], P = .001) and venous thrombosis of lower limbs (OR 5.49 [95% CI 1.56–19.35], P = .008) significantly increased mortality risk. Paxlovid use within 5 days of symptom onset (OR 0.20 [95% CI 0.04–0.95], P = .042) reduced the risk. A decreased lymphocyte percentage and venous thrombosis of the lower limbs were associated with an increased risk of death. Conversely, the use of Paxlovid was correlated with a reduced risk of death among patients with COVID-19 aged ≥90 years.

Between 2010 and 2019, international travel increased by approximately 52.2%, highlighting the world's dependence on transportation for global connectivity. Although travel enhances global interactions, it also poses risks to public health through the potential transmission of diseases. The rapid global transmission of infectious diseases, exemplified by the outbreaks of COVID-19 and Zika virus, underscores the critical need for in-depth research into travel-associated disease dissemination. When individuals travel, they are exposed to a variety of diverse microbial environments, which can affect their healthy microbiome. In this review, we introduce the concept of "travel microbiota" to encapsulate the dynamic shifts in human microbial communities induced by travel across different transportation modes. This disruption can affect metabolic and immune functions and potentially facilitate the spread of diseases. Given these implications, it is crucial to investigate how different modes of transportation affect the human microbiota. Our study reviews the impact of travel on the human microbiota, highlighting differences across transportation modes. The objective is to establish a framework for understanding travel health and the role of microbiota in managing travel-related health risks. A comprehensive understanding of this relationship is essential for developing preventive strategies to safeguard and restore the human microbiota. To provide the specific content, relevant publications were identified on Google Scholar, PubMed, and Science Direct using specific keywords such as dysbiosis, gut, health, microbiome, microbiota, pathogens, travel, and transportation. We did not add any limits to the publication date during the inclusion of papers. However, it is noteworthy that the initial reports, including the aforementioned keywords, have been published starting from 2015. Travel has a profound impact on the human microbiota, and it is essential to consider the implications associated with various modes of transportation. Traveling through various modes of transportation, such as roadways, airways, and maritime, has significantly influenced human microbiota. Moreover, it acts as a dynamic interface for microbial exchange driving rapid shift in microbial diversity, community convergence, and the diversification of resistant genes. However, the underlying mechanism of these changes remains elusive. By integrating evidence across multiple modes of transportation, this review highlights travel as an underrecognized determinant of microbiome variability and introduces the term "Travel microbiota". Moreover, this review is pivotal for understanding the ways in which travel alters microbial diversity and developing effective interventions. It is imperative to conduct future research that focuses on conducting large-scale longitudinal studies to assess the effects of traveling on microbial composition and to develop potential preventive measures.

Pretraining on a large number of unlabeled 3D molecules has showcased superiority in various scientific applications. However, prior efforts typically focus on pretraining models in a specific domain, missing the opportunity to leverage cross-domain knowledge. To mitigate this gap, we introduce Equivariant Pretrained Transformer, an all-atom foundation model that can be pretrained from multiple domain 3D molecules. Built upon an E(3)-equivariant transformer, the model learns both atom-level interactions and graph-level structural features (e.g. residuals in proteins), allowing it to generalize across diverse tasks. The model achieves strong gains in ligand binding affinity prediction, while also performing competitively in predicting properties of proteins and small molecules. We further show that the model can help identify potential antiviral compounds against the main protease of the COVID-19 virus, and validate promising candidates through computational and experimental studies.

Deciphering the biological and ecological drivers of virus transmission in wildlife requires specific molecular diagnostic tools. Understanding viral shedding routes, loads, and particle infectivity is crucial for assessing transmission dynamics in reservoir hosts and spillover potential to other species, including humans. We investigated coronavirus (CoV) shedding patterns in the endemic Molossid bat species Mormopterus francoismoutoui on Reunion Island. We tested 1,326 fresh feces with two PCR assays: a pan-CoV multiprobe real-time PCR and a quantitative PCR (qPCR) targeting the RdRp gene of the alpha-CoV previously described in M. francoismoutoui. Both assays showed strong agreement, although the qPCR detected 1.55 times more positives. Temporal variation in CoV shedding prevalence was consistent across assays, and no significant differences in RdRp gene copy numbers were observed between adult females and juveniles. Urbanization may increase Molossid bats interactions with humans, livestock, and synanthropic species; a comprehensive assessment of spillover potential of Molossid-associated alpha-CoVs is therefore critical.

The impact of the COVID-19 virus disproportionately affected U.S. Indigenous peoples, who experienced the highest infection and death rates in comparison with non-Indigenous peoples. In this article, we use the framework of historical oppression, resilience, and transcendence (FHORT) to understand how Southeastern Indigenous peoples in the United States navigated hardships associated with the COVID-19 global pandemic. This culturally congruent framework contextualizes imbalances found at individual, family, and community ecological levels, illustrating a direct correlation to sociopolitical, historical, and cultural oppression. This research assessed interconnections of structural inequity and associated disruptions to Indigenous wholistic wellness amid the pandemic. Thirty-one community-based, critical ethnographic interviews were conducted following an Indigenous toolkit for ethical and culturally sensitive research to understand quantitative risk factors associated with participant responses to COVID-19. The following themes emerged: (a) racism, sexism, and discrimination; (b) increased trauma, financial stress, and violence; (c) physical symptoms; (d) impaired unity; and (e) disintegrated support and kinship networks. Risk factors associated with COVID-19 emerged in large part from systemic inequity, incongruence between Indigenous family values and physical distancing protocols, and impaired collectivism. Future crisis interventions should promote traditional protective factors to offset the impact of historical oppression, consistent with the FHORT.

Guillain-Barre syndrome (GBS) is an acute progressive polyradiculoneuropathy where body’s immune system mistakenly attacks the peripheral nerves and their spinal roots.Covid 19 is a highly contagious disease declared as a global pandemic in 2020. We report a case of GBS in asymptomatic non vaccinated ( against novel corona virus) covid 19 patient. A 18 years old male patient with no co morbidities admitted with 2 days history of sudden onset weakness of all four limbs. He was tested covid 19 RTPCR positive with no previous history of any symptoms of covid 19. His anti SARS COV2 antibody was positive. Nerve conduction velocity study showed severe acute motor neuropathy. He was electively intubated and ventilated, successfully treated with intravenous immunoglobulins. We conclude SARS COV2 can induce immune system without any prodomal symptoms, so we should aware about SARS COV 2 as an etiological agent of GBS.

This paper is the fourth installment in The Haunting of Long-Term Care: Understanding Healthcare Aides’ Experiences with Death and Dying During the COVID-19 Pandemic, a serialization of my doctoral research published in the Journal of Applied Hermeneutics. What follows is not only an academic inquiry, but the telling of a story – one shaped by suspicion, hiddenness and the ghosts that refuse to remain in the shadows of the house. Guided by a philosophical hermeneutic approach, I interviewed eight healthcare aides working in long-term care to understand how they made sense of death and dying during the COVID-19 pandemic. As an institution meant to care for older adults nearing the end of life, the long-term care home is, unavoidably, a place of death and dying. Yet death and dying are often kept in the shadows of long-term care, tucked into dark corners where the experiences of those who receive and deliver care remain largely unacknowledged, unexamined, and unquestioned. When the COVID-19 virus entered these homes, it did so like a kind of ghost – claiming the lives of older adults in ways that were unfamiliar, sudden, and deeply frightening. Healthcare aides were the first to encounter these ghosts, and the strange yet eerily familiar forms of death and dying they brought with them. As such, I came to understand my research as a kind of story, a frightening one, and healthcare aides’ experiences as a haunting of long-term care. In this fourth and final paper, the story descends without resolution. In the years since the pandemic, long-term care appears to have returned to the status quo, with few meaningful changes made to improve death and dying. I return to the structural integrity of the institution—the haunted house itself—and to how healthcare aides locate their experiences within enduring institutional failures that prevent quality care for dying residents. Remaining in the house, healthcare aides are understood as playing a game of hide-and-seek, where the structural problems laid bare during the pandemic have once again been hidden in dark corners. To explore this, I describe the ongoing limitations healthcare aides had “seen” during the pandemic, namely inadequate staffing and limited support. I then move to the “hide” section of the paper, which serves as the discussion, where I explore how these issues are being concealed again, the ghosts of the pandemic banished to the shadows, threatening to reappear. Finally, I offer a philosophical discussion of healthcare aides’ positionality through Heidegger’s understanding of the uncanny, particularly authentic versus inauthentic experience.

Purpose Open and distance learning (ODL), facilitated by technology, is a widely recognized platform for delivering education worldwide. Students have greater freedom with traditional distance learning in terms of both physical distances and session schedules. The purpose of the study is to comprehend the role that private tutoring played throughout the Corona Virus Disease (COVID)-19 pandemic. It covers the aspects of private tutoring using a blended approach, the involvement of distance learners in private tutoring and variations in tutoring participation based on gender and location. Design/methodology/approach The study employed a mixed-methods design with quantitative data from questionnaires of 380 participants, comprising distance learners and their parents, and qualitative data from individual interviews of 24 participants, including distance learners, parents, and teachers. Findings The study has identified how many distance learners engaged in tutoring and how gender and geography affected participation rates during the COVID-19 epidemic. It has also concentrated on the traits and practices of fee-paying hybrid private tutoring. The COVID-19 outbreak significantly influences the ODL method, which offers educational services through a blended tactic. Originality/value Although fee-paying tutoring in a blended mode has been popular during the COVID-19 pandemic, its features and methods in the context of distance learning are not well understood. The study contributes to technology-based learning, distance education, private tutoring, blended learning, and social perspectives, providing an argument over the participation and consequences of distance learners' private tutoring during the COVID-19 epidemic.

Retraction notice to “Autonomous Service for Managing Real Time Notification in Detection of Covid-19 Virus” [Computers and Electrical Engineering 101 (2022) 108117

Remote Telemonitoring and Telehealth in Surgical Oncology.

Background: Transmissible gastroenteritis virus (TGEV), a coronavirus (CoV) infecting pigs, uses its spike (S) glycoprotein to bind porcine aminopeptidase N (pAPN) for cell entry. Although structural studies have identified receptor-binding motifs (RBMs) within the receptor-binding domain (RBD) of the S protein, the functional relevance of individual residues for TGEV receptor recognition, cell entry, and infection remain unclear. Methods: In this study, we performed structure-guided mutagenesis of the TGEV RBD to evaluate the contribution of specific residues to receptor binding and viral infectivity. Results: Using soluble RBD proteins, we found that most of the RBD residues within the pAPN-binding interface contribute to the binding interaction. Nonetheless, TGEV reverse genetics experiments revealed that just three RBD residues (Gly527, Tyr528, and Trp571) were indispensable for viral cell entry. Mutations at these positions, which are conserved among group 1 alpha-CoVs abolished infectivity, highlighting their central role in the virus–receptor interface. Conclusions: Our findings provide a detailed functional map of the TGEV RBD and offer insights into the evolution of receptor recognition across CoV.

In the current economic conditions the sphere of culture is becoming an important structural component of national economy that ensures upbringing of citizens and therefore the growth of labour potential in the country. The goal of the research is to work out a forecast of developing structural components of the sphere of culture in today’s conditions on the basis of regressive analysis method. By results of the research the author came to the conclusion that the number of professional theatres in Russia in 2000-2019 increased considerably and their visitation stepped up too. Due to adverse consequences of the corona virus infection in 2020–2022 the number of theater visitors dropped. On the basis of forecast models we can assume that the number of professional theaters and their visiting will rise in the short-term period, however, the increase rate will be lower in comparison with the previous time. At the same time it should be pointed out that in 2000–2022 a real museum boom took place in Russia: the number of museum institutions grew by 50% and museum visiting – by 66%. According to the presented models, in the medium-term run this trend will continue. The rise in people interest in visiting museum institutions shall be taken into account by regional and municipal bodies of power in elaboration of strategies for tourist potential development in territorial entities. As for libraries, in the medium-term run their number will drop, which can be explained by the wide use of digital information carriers and transformation of library role in today’s culture.

Background: Penile fracture is an uncommon urological emergency. Before the era of the novel corona virus, we hardly dealt with one case per year. But with the imposition of lockdown due to COVID-19, there was a surge in penile fracture cases. The objective of this study was to investigate the relationship between COVID-19 and penile fracture. Methods: From April 2020 to December 2020, when nationwide lockdown was imposed, all the patients presenting with penile fractures were enrolled in the study. The study was a retrospective study. Patients were also assessed for symptoms of COVID-19, and a nasal swab was taken for COVID-19 polymerase chain reaction (PCR). Results: The study included 9 patients. The age range was 22-50 years with a mean of 31.2 years. Manual bending was the most common cause (66.7%). The mean time interval between trauma to hospital admission was 44 hours. While one patient had mild upper respiratory tract symptoms, none tested positive for COVID-19. Conclusions: Though there was a surge in penile fracture cases, no association was found between the two. Neither patient tested positive for COVID-19, nor had developed upper respiratory tract symptoms. The reason for the sudden surge may be due to the lockdown itself, when people had to stay indoors and were involved in activities leading to penile fracture. The other reason may be the shutdown of other local hospitals when all the patients landed up in a tertiary care center like ours.

Objective: The aim of this study is to evaluate whether the level of awareness of individuals’ dental and gingival health has changed in parallel with the increased awareness in personal hygiene due to Corona Virus Disease-2019 (COVID-19) pandemic using a questionnaire. Methods: This cross-sectional study included 200 individuals who applied to Periodontology Clinics. The 24-item questionnaire was developed with the specific aim of assessing participants' awareness of dental and gingival disease during the ongoing pandemic. Number and percentage values were calculated for descriptive statistics. Chi-square test was used to compare categorical data between the groups. Results: Majority of respondents (74%) indicated no change in the frequency of their tooth brushing habits during the period of the COVID-19 pandemic while 10% reported decrease in their brushing frequency. Males made less changes in tooth brushing frequency during the pandemic than females (P<.05). Periodontal treatment was considered to be safe and very safe by 47% of participants in terms of the risk of Corona virus transmission. Although there was a statistical difference between gender groups for this question (P<.05), there was no difference among education groups (P>.05). Conclusion: Our findings show that knowledge and awareness about dental and gingival health, which is an essential component of general health, is insufficient during the COVID-19 pandemic