Lung function impairment, including preserved ratio impaired spirometry (PRISm) and airflow limitation (AL), is associated with increased risks of mortality and cardiovascular disease; however, the underlying biological mechanisms remain poorly understood. This study aimed to investigate the mediating role of biological aging, as well as the interactions and joint effects of lung function impairment and biological aging on adverse health outcomes.

A total of 349,456 UK Biobank participants (aged 40-69 years) were categorized into normal, PRISm, and AL groups based on baseline spirometric measurements. Biological aging was assessed using phenotypic age acceleration (PhenoAgeAccel) and frailty phenotype. PhenoAgeAccel was calculated using algorithms based on clinical biomarkers, and frailty was evaluated according to five established criteria. Cox proportional hazards models were used to assess the risks of all-cause mortality and CVD (including coronary artery disease, heart failure, and ischemic stroke). Mediation and interaction analyses further examined the associations between lung function impairment, biological aging, and adverse health outcomes.

Over an average follow-up of 13.8-14.4 years, 28,059 deaths and 34,863 incident CVD cases were recorded. PhenoAgeAccel mediated 12.8-16.2% of the association between lung function impairment and mortality, compared to 7.0-12.0% for frailty. For CVD, the mediation proportions were 8.5-15.9% (PhenoAgeAccel) and 7.4-8.6% (frailty). Significant multiplicative and additive interactions were found between lung function impairment and biological aging, especially for mortality risk. The joint analysis revealed that participants with both impaired lung function and accelerated biological aging had the highest mortality and CVD risks.

Biological aging partially mediates the associations between lung function impairment and adverse outcomes, exhibiting synergistic interactions with impaired lung function. Thus, therapies targeting biological aging may complement conventional lung function promotion in reducing health disparities among aging populations.

To assess treatment and identify predictive factors of worsening in COVID-19 patients.

This study was ambispective (both prospective and retrospective) and part of a multidisciplinary, multicenter project designed to generate epidemiological, sociological and anthropological data about the COVID-19 epidemic in Burkina Faso. Medical records of patients admitted for COVID-19 at the hospitals of Ouagadougou and Bobo-Dioulasso from March 2020 to April 2021 were reviewed. To identify predictive factors of severe complications, we used Poisson regression models.

In total, 1,511 patients were included, of whom 70% were aged ≤50 years, 59% were men and 97% were living in an urban area. Of the 86% of patients treated, 92.9% of them received the combo Azithromycin-hydroxychloroquine. A total of 78 (5.2%) patients experienced complications during hospitalization, and 49 (3.3%) patients died. Multivariate analysis identified patient's age, residence and comorbidity as factors associated with poor outcomes.

Although most people had symptoms, most of them recovered without sequelae, and few patients had severe forms of disease. Age was a strong predictor of worse outcomes in this population.

Pneumocystis jirovecii and Aspergillus fumigatus are important pathogens that cause fungal pulmonary infections. Because the manifestations of P. jirovecii pneumonia (PJP) or invasive pulmonary aspergillosis (IPA) are difficult to differentiate on computed tomography (CT) images and the treatment of the two diseases is different, correct imaging for diagnosis is highly significant. The present study developed and validated the diagnostic performance of a CT-based radiomics prediction model for differentiating IPA from PJP.

In total, 97 patients, 51 with IPA and 46 with PJP, were included in this study. Each patient underwent a non-enhanced chest CT examination. All the patients were randomly divided into two cohorts, training and validation, at a ratio of 7:3 using random seeds automatically generated using the RadCloud platform. Image segmentation, feature extraction, and radiomic feature selection were performed on the RadCloud platform. The regions of interest (ROIs) were manually segmented, including the consolidation area with the surrounding ground-glass opacity (GGO) area and the consolidation area alone. Six supervised-learning classifiers were used to develop a CT-based radiomics prediction model, which was estimated using the receiver operating characteristic (ROC) curve, area under the curve (AUC), sensitivity, specificity, precision, and F1-score. The radiomics score was also calculated to compare the prediction performance.

Classifiers trained with the consolidation area and surrounding GGO area as the ROI showed better prediction efficacy than classifiers trained using only the consolidation area as the ROI. The XGBoost model performed better than the other classifiers and radiomics scores in the validation cohort, with an AUC of 0.808 (95% CI, 0.655-0.961).

This radiomics model can effectively assist in the differential diagnosis of PJP and IPA. The consolidation area with the surrounding GGO area was more suitable for ROI segmentation.

The deployment of mRNA vaccines against SARS-CoV-2 is a major landmark in controlling the COVID-19 pandemic. However, the activation of adaptive immunity and its longevity after a booster dose warrant further investigation. Moreover, the interplay between inflammation and immune thrombosis after transfection needs further insights that could help examine the vaccine's potential for adverse events following immunization (AEFIs). This study investigates the biochemical and hematological responses to the third dose of a COVID-19 mRNA vaccine in 68 healthy participants who had previously received two doses of the vaccine. Blood samples were collected at baseline (before vaccine dose; D0), 48 hours post-vaccination (D2), and then at days 30, 60, 120, and 180 (D30, D60, D120, D180). The study focused on analyzing changes in anti-SARS-COV-2 immunoglobulins (IgG and IgA), inflammatory biomarkers (IL-6, IFN-γ, CRP, hs-CRP), coagulation factors (PT, APTT, D-dimers), and blood cell counts (neutrophils, leukocytes, platelets) at D2 post-vaccination, and IgG and IgA at days 2, 30, 60, 120, and 180 post-vaccination. In this study, no clinical AEFIs were observed in any of the recipients. Slight changes were observed in the levels of inflammatory and coagulation biomarkers, and blood cells. Levels of CRP and hs-CRP increased slightly but significantly, d-dimers were raised, and PT and aPTT were prolonged significantly. A small but significant decrease was observed in IFN-γ and mean lymphocyte counts, whereas no change was observed in the levels of IL-6, neutrophils, and platelet count at D2. Levels of IgG and IgA showed sustained increase over the six-month period. These results collectively demonstrate that the third dose of the mRNA vaccine elicits a rapid and sustained immune response characterized by increased IgG and IgA levels. The changes observed in inflammatory markers and coagulation factors after vaccination observed shortly after vaccination require further investigations.

Quit Sense is a Just-in-Time Adaptive Intervention (JITAI) smartphone app that provides real-time automated and in-situ support to help people attempting to quit smoking manage cue-induced cravings. This process evaluation study explored views and experiences of feasibility trial participants and assessed: (1) intervention experiences, (2) how these might help explain causal pathways towards behaviour change and (3) experiences of study participation.

Qualitative interviews nested within a two-arm feasibility randomized control trial.

We purposefully sampled 20 participants (15 intervention, 5 usual care) for semi-structured telephone interviews. Data were thematically analysed and was supplemented with a descriptive analysis of relevant experiences to hypothesize causal pathways to behaviour change.

Motivations for engaging in the trial and intervention included wanting greater accountability and to be part of something. Reasons for disengaging included successfully quitting (app no longer needed), lapsing/relapsing and preferring other support types. Mechanisms which reportedly enabled successful quit attempts included the app's prequit preparation phase through insights into smoking cues, the delivery of lapse avoidance strategies and the supportive messages which helped to reinforce the goal of quitting. The trial was conducted during the COVID-19 pandemic and provided examples of situations and contexts in which Quit Sense was used and felt to be (un)helpful for cessation.

The Quit Sense app and trial were well received by participants. Participants reported that the preparation phase used for app training prior to their quit date was of particular value and not currently offered by other apps tried.

This review provides insight into the contemporary challenges and initiatives in mental health care across Egypt, the Middle East, and North Africa (MENA) region. It examines the structural barriers, including fragmented public health systems and inadequate resource allocation, which hinder access to mental health services. The COVID-19 pandemic exacerbated these challenges, prompting innovative approaches like telepsychiatry and the establishment of specialized psychiatric hospitals. Despite advancements in psychiatric education and research, disparities persist, particularly in rural mental health care. Limited funding, workforce shortages, and barriers to accessing medications and post-hospitalization support further compound the issue. International and local efforts aim to address these challenges, with a focus on enhancing child and adolescent mental health services and supporting populations affected by the refugee crisis. Policy reforms, increased financial allocation, and workforce development are essential for overcoming these obstacles and ensuring equitable access to quality mental health care throughout the MENA region. This review underscores the urgent need for collaborative action to improve mental health outcomes and reduce disparities in the region.

We examine the current state and challenges of mental health services in the Republic of Croatia, a Central European country with a population of 3.87 million. Croatia's healthcare system delivers mental health services across primary, secondary, and tertiary levels, largely supported by the Croatian Health Insurance Fund, which administers the country's universal healthcare system, ensuring wide accessibility. Key policy frameworks include the Strategic Framework for the Development of Mental Health until 2030 and the Action Plan in Addictions. However, challenges persist, including a lack of community-based approaches, underfunding, and workforce shortages, particularly in child and adolescent psychiatry. The paper also highlights the impact of the COVID-19 pandemic and Croatia's 2020 earthquake on mental health services, emphasizing a transition toward telepsychiatry and mobile psychiatric teams. Additionally, post-traumatic stress disorder (PTSD) is underscored as a significant public health issue in Croatia.

The COVID-19 pandemic led to reports of increased levels of psychological distress and mental health problems world-wide. In Sweden, contrary to most other countries, the COVID-19 strategy was mainly based on voluntary restrictions. It remains unclear whether this reduced mental health problems. We therefore aimed to investigate the long-term impact of the COVID-19 pandemic on mental health in Sweden in terms of mental health service utilisation, antidepressant and anxiolytic/sedative use, and suicide rates for the two years before, during and after the pandemic in a nationwide retrospective register study, covering the entire Swedish population from ten years of age between 1 January 2018 and 31 December 2023. Publicly available data from three national registers were used. We found that, despite the stress induced by the COVID-19 pandemic, there was neither an overall impact on mental health service utilisation nor a post-pandemic rebound. Nonetheless, there were vulnerable subgroups, which could be overlooked when only examining the population as a whole. Young women and girls fared worse in terms of psychoactive substance use and anxiety. Older men fared worse in terms of suicide rates. Identifying vulnerable populations already now, may be a means to effectively mitigate mental health problems during future pandemics.

Cultural awareness on mental health is enhancing over time in the Middle East, thus increasing number of individuals who feel more confident to seek the help they require. This epidemiological cross-sectional retrospective analytical study aims to identify and observe the impact of COVID-19 on sociodemographic trends and diagnostic profiles of outpatient attendees at Rashid Hospital, Dubai in a 5-years period. From a cohort of 5135 newly registered patients at Rashid Hospital outpatient department, demographic data, diagnoses and devised treatment plan of 3679 patients - between the ages of 18-59 years were analyzed. SPSS software was employed to analyze trends across the presenting population. Chi-square analysis was utilized to identify possible associations between trends. Overall increasing trend in the frequency of patients presenting to Rashid Hospital Psychiatry outpatient clinic. Key findings included equal gender distribution, highest frequency of 21-40 years old attendees, depressive and anxiety related disorders occupied the majority of diagnoses. The findings highlight key demographic and clinical trends across patients. Symptoms of depression, anxiety and sleep related disorders emerged during the COVID-19 pandemic. Consistently increasing number of attendees favor the increase in mental health awareness and the positive attitudes towards seeking help.

To effectively curb coronavirus disease 2019 (COVID-19), it is essential to understand the risk factors for breakthrough acute infections of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) despite vaccination. We conducted a case-control study to assess risk factors for acute SARS-CoV-2 infections requiring hospitalization in vaccinated individuals. The study included 50 vaccinated patients who experienced breakthrough infections requiring hospitalization (inpatient cohort) and 250 control participants from the outpatient cohort of the "Genomic Surveillance and Immune Response Monitoring for COVID-19 in the Metropolitan Area of the Aburrá Valley, Medellín-Colombia". Demographic characteristics, vaccination status, and immune responses were compared between cases and controls using multivariate logistic regression. Advanced age (≥ 65 years), male sex, high-risk comorbidities, and immunosuppression were associated with an increased risk of breakthrough SARS-CoV-2 infections despite prior vaccination. In contrast, receipt of a booster dose and the presence of neutralizing antibodies were linked to a reduced risk of such infections. This study identifies key risk and protective factors associated with breakthrough SARS-CoV-2 infections. Derived from a high-middle-income setting, these real-world findings provide valuable insights to guide targeted vaccination strategies for vulnerable populations.