Coronavirus disease 2019 (COVID-19) has created major global challenges, with vaccination remaining the most effective measure to reduce severe outcomes and mortality. In Korea, six vaccines were approved, and the rapid rollout initiated in February 2021 contributed to comparatively low global mortality. As the epidemiological landscape of COVID-19 evolved and evidence on vaccine immunogenicity and safety accumulated, Korea adapted its vaccination strategies. During the 2024-2025 season, two mRNA vaccines (Pfizer-BioNTech and Moderna) and one recombinant protein vaccine (Novavax) targeting JN.1 lineage were administered primarily to high-risk groups. Beginning in October 2025, two mRNA vaccines (Pfizer-BioNTech and Moderna) adapted to LP.8.1 variant have been introduced as the updated 2025-2026 season formulations. Although safety concerns arose initially, Korean studies confirmed that COVID-19 vaccines provided strong effectiveness and acceptable safety, consistent with international findings. To enhance preparedness for future pandemics and epidemics, sustaining surveillance systems and maintaining updated vaccination policies are critical to ensure effective public health responses.

This research aims to demonstrate and explain a meticulous care plan applicable to Mycoplasma pneumonia (MP) in children. This plan integrates multi-dimensional measures such as psychological care, respiratory tract management, dietary guidance, fever care and health education, forming a structured care path. A total of 122 children with MP admitted from May to September 2023 were selected for the study. They were divided into the experimental group and the control group by random number table method, with 61 cases in each group. The control group received routine care, while the experimental group received meticulous care on the basis of routine care. The plan mainly describes the story-telling communication skills in psychological care, the standard operation of nebulization inhalation parameters and back tapping in respiratory care, the hierarchical monitoring and treatment of fever, as well as the modular health education content for caregivers. The results show that meticulous care can promote symptom relief in children, reduce inflammatory indicators, enhance disease awareness and nursing satisfaction, verifying the feasibility and positive role of this nursing plan in clinical practice. This study provides a replicable and scalable operational framework for the systematic care of MP in children.

To estimate the effect of Medicaid continuous coverage provision (CCP) during the COVID-19 public health emergency on postpartum insurance for low-income noncitizen immigrants compared to citizens, and to assess whether state use of the from-conception-to-the-end-of-pregnancy (FCEP) policy, which excluded many immigrants from postpartum coverage, modified this effect.

This study used a quasi-experimental design (difference-in-differences, or DID) to compare the insurance coverage gains between low-income postpartum noncitizens and citizens, using 2019 as the reference year. We further applied a triple difference (DDD) approach to assess the effect of the FCEP-only coverage policy, hypothesizing that noncitizens in states using FCEP as the sole pathway would experience smaller gains than in other states using various pathways to cover pregnant noncitizens otherwise ineligible.

Using the 2016-2022 American Community Survey individual-level data, we identified 61,572 low-income citizens (weighted N = 7,553,823) and 10,444 low-income noncitizens (weighted N = 1,487,373), with 8 FCEP-only states and 23 other states with various pathways.

During the study period, the average postpartum uninsurance rate was 44.6% for noncitizens and 14.0% for citizens, while Medicaid coverage was 34.5% for noncitizens and 57.5% for citizens. Medicaid gains among noncitizens were statistically similar to gains among citizens in 2021 compared to 2019 in both FCEP-only states (DID = 2.3 percentage points [pp], 95% CI: -13.3, 8.7) and states with various pathways (DID = 4.6 pp, 95% CI: -1.2, 10.4), but these trends did not persist in 2022. We found no differences in insurance coverage gains among noncitizens between FCEP-only and states with various pathways.

Findings suggest that the CCP did not substantially reduce postpartum coverage inequities for noncitizen immigrants in either FCEP-only states or states with various pathways. Postpartum coverage inequities persisted under the CCPs, leaving many noncitizens uninsured.

Toxoplasmosis is a common zoonotic infection with various transmission mechanisms and wide distribution worldwide. Its probability of causing disease is related to alterations in the immune system as well as the parasite’s virulence. This study presents four cases of patients from rainforest areas in Colombia who did not have any known immunosuppression but do have a diagnosis of toxoplasmosis with pulmonary involvement, confirmed by serology. One of them also developed hypoxemic ventilatory failure and myocarditis. This outbreak of toxoplasmosis occurred in military personnel after coming into contact with common sources of exposure in the Colombian Amazon during a military training exercise. This article includes the diagnostic process, clinical manifestations, treatment, and importance of the parasite’s genotypic variants.

Emerging evidence implicates the oral-brain axis in neurodegeneration, yet large community-based studies remain limited. This study aimed to examine associations between periodontal health, oral microbiome, and cognitive performance, and to explore potential biological pathways underlying these relationships.

We conducted a cross-sectional analysis of 1157 participants from the community-based Taizhou Imaging Study, all of whom underwent comprehensive periodontal examinations, salivary microbiome profiling, and cognitive assessments. Periodontal health and microbiome features were treated as exposures, and cognitive performance as the outcome. Associations between periodontal indices and cognitive scores were assessed using beta regression models adjusted for relevant confounders. Cognition-related microbial features were identified using Multivariate Associations with Linear Models (MaAsLin3), followed by mediation analyses to explore potential pathways linking periodontal health to cognitive function.

Five clinical periodontal indices were found to be inversely associated with cognitive performance. Ten microbial genera (e.g., Haemophilus), 21 functional pathways (e.g., FoxO signalling), and two co-abundance modules, including a Treponema module, were significantly related to cognitive function. Mediation analysis suggested that 11 features, including nitrate-reducing taxa and a Treponema-driven inflammatory module, may partially mediate the relationship between periodontal health and cognition.

These community-based findings reveal microbiome-mediated links along the oral-brain axis and highlight periodontal health and oral microbial homoeostasis as potential targets for early prevention of cognitive decline.

This work was supported by the National Key R&D Program of China (2023YFC3606300), National Natural Science Foundation of China (82373658), Clinical Research General Project of the Shanghai Municipal Health Committee (202240355), Clinical Research General Project of Shanghai Municipal Health Commission (202440188), Noncommunicable Chronic Diseases-National Science and Technology Major Project (2023ZD0510000), Brain Science and Brain-like Intelligence Technology-National Science and Technology Major Project (2022ZD0211600).

Physical inactivity and sedentary behavior are important modifiable risk factors for noncommunicable diseases. High prevalences of physical inactivity among children and adolescents continue to represent a significant public health challenge globally, with approximately two-thirds of children worldwide not achieving the recommended daily amount of physical activity (PA). Countries in the Middle East exhibit some of the highest levels of physical inactivity and sedentary behavior, which contribute to the increasing rates of obesity among children and adolescents.

This study aims to provide a comparative synthesis of PA indicators among children and adolescents in Lebanon, Qatar, and the United Arab Emirates (UAE) based on the Active Healthy Kids Global Alliance (AHKGA) PA Report Cards and further compare the findings with regional and global trends.

Data were synthesized from previous AHKGA PA Report Cards published by researchers from Lebanon, Qatar, the UAE in the years 2016 (Global Matrix 2.0; 1998-2014 data), 2018 (Global Matrix 3.0; 2016-2017 data) and 2022 (Global Matrix 4.0; 2017-2022 data). We evaluated 10 key PA indicators across these countries to identify trends and gaps in PA levels among children and adolescents. These findings were further compared with regional and global data gathered and published in previous iterations of the AHKGA Global Matrix.

Based on data collected between 1998 and 2022, less than one-third (15%-33%) of children and adolescents in Lebanon, Qatar, and the UAE achieved the recommended daily average of 60 minutes of moderate- to vigorous-intensity PA. Additionally, more than one-half (45%-74%) of children and adolescents exceeded the recommended limit of 2 hours of recreational screen time per day. Overall, boys were more physically active than girls; however, PA levels declined with increasing age. Other behavioral indicators such as participation in organized sports and active transportation revealed insufficient PA levels. The results were slightly better for sources of influence indicators especially with the opportunities provided by schools and governments. Compared with global estimates, PA levels in the Middle Eastern countries were similar to the averages observed across Asian countries participating in the AHKGA; however, they were generally lower than PA levels in other regions of the world.

Data from a 25-year period show consistently low levels of PA and high levels of sedentary behavior among children and adolescents from these 3 Arab Middle Eastern countries. Despite governmental investments in implementation of PA initiatives, there seems to be a lag in eliciting increases in PA at the population level. Evidence points to a critical need for behavioral and lifestyle modifications among children and adolescents. These concerns are exacerbated by a lack of national surveillance systems and evidence-based policy interventions to improve PA levels.

Objective: To investigate the association of prepregnancy overweight/obesity and gestational diabetes mellitus (GDM) with autistic-like behaviors in children. Methods: The data from the Ma'anshan Birth Cohort between May 2013 and September 2014 were used,the information about prepregnancy weight, height, gestational weight gain, and pregnancy complications were collected in the first, second, and third trimesters. Children were screened for autistic-like behaviors at 18 months of age. Logistic regression models were used to analyze the association of prepregnancy overweight/obesity and GDM with autistic-like behaviors in children. Multiplicative and additive interaction analyses were conducted to explore potential interactive effects of maternal prepregnancy overweight/obesity and GDM on autistic-like behaviors risk. Results: In the cohort, 401 cases (12.9%) of GDM and 309 cases (9.7%) of prepregnancy overweight were detected, respectively. A total of 432 cases (13.8%) children were screened to be positive for autism-like behaviors at 18 months of age. Logistic regression analysis revealed that both GDM and prepregnancy overweight/obesity showed significant positive associations with autistic-like behaviors in children (OR=1.41, 95%CI: 1.06-1.88; OR=1.43, 95%CI: 1.04-1.97). GDM complicated with prepregnancy overweight/obesity had a higher association with autistic-like behaviors in children (OR=2.42, 95%CI: 1.50-3.90), multiplicative interaction model analysis showed significant interactive effect between GDM and prepregnancy overweight/obesity on autistic-like behaviors risk in children (OR=2.29,95%CI:1.42-3.69). Conclusions: Prepregnancy overweight/obesity and GDM might increase the risk for social developmental disorders in children. Close attention should be paied to prepregnancy weight management and health monitoring for children exposed to these high-risk prenatal factors.

Adverse pregnancy and perinatal outcomes (APPOs), including pre-term birth, pre-eclampsia and gestational diabetes, can result in maternal and neonatal morbidity and mortality, parental anxiety and increased healthcare costs. A better understanding of the causes of APPOs is essential to inform lifestyle and pharmaceutical interventions for their prevention and management. Given the difficulty of undertaking randomised controlled trials in pregnant women, triangulating evidence from across methods with different sources of bias may improve causal inference for APPOs. The purpose of the Mendelian randomisation in pregnancy (MR-PREG) collaboration is to support such triangulation using genetic (eg, Mendelian randomisation (MR)) and non-genetic (eg, partner negative controls) approaches to investigate the causal effects of maternal exposures on a comprehensive set of APPOs.

The MR-PREG collaboration includes individual participant data from three birth cohorts (two from the UK and one from Norway) and UK Biobank, as well as summary data from FinnGen and publicly available genome-wide association studies (GWAS). Data have been harmonised across studies and currently include information on up to 35 APPOs in up to 707 797 women.

The main aims of MR-PREG are to strengthen the evidence base for (1) prevention, by advancing understanding of maternal lifestyle factors on APPOs, (2) the role of pre-conceptional health, by improving understanding of the effect of maternal pre-existing conditions on APPOs, and (3) treatments, by evaluating the efficacy and safety of existing medications used for pre-existing conditions, and by identifying and testing novel or repurposed therapies for APPOs. To date, our published work has mainly addressed aims 1 and 3. Examples include triangulation of evidence from MR, conventional multivariable regression and paternal negative control, showing that higher maternal body mass index increases the risk of multiple APPOs, as well as the identification of maternal circulating metabolites and proteins that may influence birth weight.

Future priorities include increasing diversity within the MR-PREG collaboration by expanding representation of participants from non-European ancestries. We are also integrating molecular data, including circulating protein levels and placental transcriptomics, to better characterise the molecular mechanisms underlying APPOs. Additionally, we are using whole-exome and whole-genome sequencing to identify novel causal genes and to inform the prioritisation of candidate therapeutic targets for APPOs.

Reports of Hafnia infections in humans are infrequent, and the triad of Hafnia infection complicated by lung abscess and pneumothorax remains rarely documented. On January 25, 2025, a patient with a critical case of invasive Hafnia alvei pneumonia complicated by lung abscess and pneumothorax was admitted to Guangde Traditional Chinese Medicine Hospital. The patient had underlying comorbidities including diabetes mellitus and hepatitis B liver cirrhosis. The medical team identified severe pneumonia and its causative pathogen, Hafnia alvei through detailed examinations. An individualized treatment plan was formulated based on the results of drug susceptibility tests. However, the patient's condition progressed rapidly, and he experienced endotracheal intubation, mechanical ventilation, complicated by shock. Re-examination of imaging after treatment revealed progression of pulmonary cavities, along with the complication of lung abscess and tension pneumothorax. The neurological prognosis was poor after cardiopulmonary resuscitation (CPR), and the patient was discharged voluntarily. The triad of pneumonia, lung abscess, and pneumothorax caused by Hafnia alvei in this case has unique clinical manifestations, suggesting that clinicians should be alert to infections caused by rare pathogens such as Hafnia alvei when facing infected patients with multiple underlying diseases. Early identification of the invasive characteristics of the pathogen (rapidly progressive cavity plus secondary abscess/pneumothorax) is crucial. This case provides diagnostic and therapeutic insights for clinicians encountering similar infections, improving their understanding and management of Hafnia alvei infections.

Hepatic glycolipid metabolic dysregulation is a hallmark of type 2 diabetes mellitus (T2DM), with emerging evidence implicating ferroptosis as a critical pathogenic mechanism. Propyl gallate (PG), a naturally occurring antioxidant, may counteract redox imbalance; however, its impact on ferroptosis and gut-liver axis remains poorly understood. In this study, we investigated the protective effects of PG against high-fat diet (HFD)-induced diabetic liver injury in both in vivo and in vitro models. A combination of hepatic metabolomics, ferroptosis-related assays, and 16S rRNA sequencing was employed. PG significantly reduced hepatic lipid accumulation and oxidative stress by inhibiting ferroptosis, primarily through activation of the SLC7A11/GPX4 axis. Metabolomic analysis further demonstrated PG-mediated normalization of lipid peroxidation and glutathione metabolism in the liver. Notably, PG also enhanced intestinal barrier integrity by upregulating tight junction proteins (e.g., occludin, and ZO-1) and reshaping gut microbial composition, marked by increased abundance of beneficial genera such as Lactobacillus and Ruminococcus, known for their anti-inflammatory and antioxidant roles. Collectively, these findings suggest that PG ameliorates diabetic liver injury via dual mechanisms: (1) direct inhibition of SLC7A11/GPX4-dependent ferroptosis and (2) indirect modulation of gut microbiota to preserve intestinal barrier function. This study positions PG as a promising candidate for T2DM therapy by targeting both hepatic redox imbalance and gut dysbiosis.