@article {pmid41765092, year = {2026}, author = {Tsiodras, S and Gupta, N and Hanscheid, T and Jokelainen, P and Drexler, JF and Barac, A and Gkrania-Klotsas, E and Mora-Rillo, M and Bulescu, C and Paño-Pardo, JR and Lescure, FX and Grobusch, MP}, title = {Language, trust, and the polio endgame: words matter in vaccine communication.}, journal = {Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases}, volume = {32}, number = {8}, pages = {1286-1292}, doi = {10.1016/j.cmi.2026.02.023}, pmid = {41765092}, issn = {1469-0691}, mesh = {Humans ; *Poliomyelitis/prevention & control/epidemiology ; *Vaccination Hesitancy/psychology ; *Trust ; *Poliovirus Vaccine, Oral/adverse effects/administration & dosage ; Communication ; Terminology as Topic ; *Health Communication ; *Language ; COVID-19 ; Vaccination/psychology ; Disease Eradication ; Poliovirus Vaccines ; }, abstract = {SCOPE: Vaccine hesitancy remains a major public health challenge, particularly in the post-COVID-19 era, and is exacerbated by misinformation and social distrust. Terminology used in scientific and public health communication may influence perceptions of vaccine safety and credibility. This Position Paper examines the use of the term 'vaccine-derived poliovirus' (VDPV) and its potential impact on vaccine confidence during the final phase of polio eradication.
METHODS: We reviewed published epidemiological, virological, and social science literature on circulating VDPV, vaccine hesitancy, and health communication. Institutional guidance from the WHO and the Global Polio Eradication Initiative was also examined. Evidence from qualitative studies exploring community perceptions of the term 'vaccine-derived poliovirus' was considered alongside broader literature on risk communication.
We examine the scientific basis and epidemiology of oral poliovirus vaccine use and circulating VDPV emergence, the evolving landscape of vaccine hesitancy, communication challenges surrounding the term VDPV, historical precedents in vaccine communication, the role of disinformation, and the potential risks and benefits of revising established terminology. We recommend that stakeholders formally evaluate the implications of current nomenclature, consider alternative terms and dual-layer communication strategies that distinguish technical from public-facing language, and ensure that any modification of terminology is accompanied by transparent justification.}, }
@article {pmid42114091, year = {2026}, author = {Johnson, D and Quinn, S and Algase, LF and Watkins, C and , }, title = {Telemedicine Policy and Practice: A Position Paper From the American College of Physicians.}, journal = {Annals of internal medicine}, volume = {179}, number = {7}, pages = {1030-1032}, doi = {10.7326/ANNALS-25-04194}, pmid = {42114091}, issn = {1539-3704}, mesh = {Humans ; COVID-19 ; *Telemedicine/legislation & jurisprudence/economics/organization & administration ; United States ; SARS-CoV-2 ; Pandemics ; *Health Policy ; Licensure, Medical ; Health Services Accessibility ; Patient Safety ; *Pneumonia, Viral/epidemiology/therapy ; *Coronavirus Infections/epidemiology/therapy ; Betacoronavirus ; Practice Patterns, Physicians' ; }, abstract = {In response to the COVID-19 pandemic, federal policymakers temporarily lifted long-standing restrictions on telemedicine, resulting in an unprecedented and rapid expansion of virtual care across video, audio, and asynchronous modalities. When integrated into longitudinal care relationships, telemedicine can increase access, reduce patient burden, and support continuity for people facing geographic, mobility, or socioeconomic barriers. However, telemedicine also introduces new clinical, regulatory, equity, and safety challenges that require deliberate policy design. Beyond its clinical considerations, telehealth offers environmental and logistical benefits, including reduced travel time and cost, decreased fuel consumption, lower transportation expenses, and lower greenhouse gas emissions. In this position paper, the American College of Physicians updates its previous policy paper on telemedicine to reflect changes in payment policy, licensure, prescribing authority, and utilization patterns that have occurred over the past decade and accelerated during the COVID-19 public health emergency. This paper focuses on access, payment policy, licensure, prescribing practices, equity, and patient safety across federal and state programs and private payers and emphasizes the conditions under which telemedicine should be integrated into clinical practice. Key developments addressed include the expansion and partial lapse of Medicare telemedicine waivers, evolving U.S. Drug Enforcement Administration rules governing prescribing, increased reliance on interstate practice, and normalization of telemedicine by private payers.}, }
@article {pmid42119693, year = {2026}, author = {Schomerus, G and Nicolas, ML and Fritz, F and Schneider, D and Büchner, R}, title = {What is the Role of "the Psyche"? Long COVID and ME/CFS as Test Cases for Evidence-Based and Patient-Centered Psychiatry and Psychotherapy.}, journal = {Psychiatrische Praxis}, volume = {53}, number = {5}, pages = {263-269}, doi = {10.1055/a-2866-9127}, pmid = {42119693}, issn = {1439-0876}, mesh = {Humans ; *Fatigue Syndrome, Chronic/psychology/therapy ; *Psychotherapy ; Post-Acute COVID-19 Syndrome ; *Evidence-Based Medicine ; *Patient-Centered Care ; *COVID-19/psychology ; Psychiatry ; }, abstract = {The role of psychological factors in the development and course of Long Covid (LC) and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) remains a subject of controversial debate. We argue that psychologizing LC and ME/CFS carries significant risks: it leads to potentially harmful therapies, invalidates the patients' experience of illness, hinders effective interventions such as pacing, diverts focus from necessary physical diagnostics and treatment, disadvantages patients in medical assessments, and places a considerable additional burden on the families of affected children or other relatives. We show that many of the arguments presented for a psychological contribution are nonspecific or insufficiently supported by empirical evidence. Our essay therefore advocates for extreme caution in attributing psychological factors to these conditions, in the interest of a specific, evidence-based, and patient-centered psychiatry and psychotherapy.}, }
@article {pmid42377340, year = {2026}, author = {Rodríguez-Rodríguez, E and Rodríguez-Rodríguez, P and Jiménez-Ortega, AI and Aparicio, A}, title = {[Nutrition, microbiota and respiratory infections: key aspects of their interaction].}, journal = {Nutricion hospitalaria}, volume = {43}, number = {Spec No4}, pages = {54-57}, doi = {10.20960/nh.06966}, pmid = {42377340}, issn = {1699-5198}, mesh = {Humans ; *Respiratory Tract Infections/immunology/microbiology/prevention & control ; *Nutritional Status ; Probiotics ; *Diet ; COVID-19/immunology ; Prebiotics ; *Gastrointestinal Microbiome ; *Microbiota ; }, abstract = {Introduction: respiratory infections (RI) have experienced a rebound following the lifting of COVID-19 restrictions, constituting a major public health problem. Diet and nutritional status are determining factors in the competence of the immune system, where the gut-lung axis has been identified as a key mechanism in regulating the immune response against these processes. Objectives: to analyze the scientific evidence on the role of diet and microbiota in the prevention and evolution of respiratory infections. Methods: narrative review of recent scientific literature on nutrients, dietary patterns, gut microbiota, and their relationship with respiratory immunity. Results: various nutrients such as fiber, n-3 polyunsaturated fatty acids, vitamins, minerals, and polyphenols, as well as the use of probiotics, modulate the gut microbiota and promote the production of metabolites, especially short-chain fatty acids (SCFAs), with immunomodulatory effects. These mechanisms contribute to improving the pulmonary immune response and reducing the incidence and severity of RI. Conclusions: a balanced and high-nutrient-density diet, rich in prebiotic and probiotic compounds, can contribute to strengthening the immune response and decreasing vulnerability to respiratory infections.}, }
@article {pmid42471030, year = {2026}, author = {Kumar, CS and Joe Thomas, M and Thomas, NP and Kotwani, VS}, title = {Domestic robots: recent trends and innovations.}, journal = {Disability and rehabilitation. Assistive technology}, volume = {}, number = {}, pages = {1-27}, doi = {10.1080/17483107.2026.2702778}, pmid = {42471030}, issn = {1748-3115}, abstract = {PURPOSE: Domestic Service Robots (DSRs) are employed to perform personalised tasks in domestic/household environments. Recent times, especially after the COVID-19 pandemic, have shown a rapid increase in demand for household companion bots. Despite the development of several such service robots, there are still potential challenges that need to be addressed. Domestic robots that perform basic household chores such as vacuum cleaning are the most popular and commercially a big hit. It is desirable to have an advanced multipurpose robot that can interact with humans and the surrounding environment in real time.
METHODS: A comparative analysis of existing DSRs and their corresponding gaps is highlighted in this article. Emphasis is given to the design/appearance, choice of sensors and actuators, cognition, effectiveness in manipulating domestic objects, control and task planning algorithms, safety measures and reliability of DSRs validated in real-world settings.
RESULTS: This article presents a systematic review of the latest developments in DSR and outlines the future direction of research to tackle the unsolved problems. Key highlights from 83 research articles published after 2020 in reputed journals/platforms are studied and analysed to understand the latest trends in DSR.
CONCLUSION: This review highlights current progress, identifies existing gaps, and outlines future research directions essential for deploying reliable domestic service robots in real world environments.}, }
@article {pmid42471883, year = {2025}, author = {Inuwa, U and Bakari, MA and Kaitafi, MT and Kadas, S}, title = {Analysis of Caesarean Deliveries (CD) at a Tertiary Hospital in Northeastern Nigeria: A 5 Year Review.}, journal = {Nigerian medical journal : journal of the Nigeria Medical Association}, volume = {66}, number = {5}, pages = {1768-1776}, pmid = {42471883}, issn = {0300-1652}, abstract = {BACKGROUND: One of the most commonly performed surgical procedures in Obstetrics is caesarean delivery (CD), and certainly the oldest surgical operation. Caesarean delivery is life-saving, especially when there is a failure or contraindication to vaginal delivery. However, the health risk and the cost of the surgery may be quite challenging, especially in low-resource countries like Nigeria. The observed increased prevalence rate in recent times is alarming and has become a major public health concern, calling for regular appraisal of its indications in order to reduce the prevalence. This study was undertaken to determine the prevalence, trend, indications, maternal and foetal outcomes at Modibbo Adama University Teaching Hospital, Yola, Adamawa State. Nigeria.
METHODOLOGY: It was a hospital-based retrospective study of all the cases of CD undertaken between 1st January 2018 and 31st December 2022. Names and hospital numbers of patients were identified; the case folders were traced and retrieved. Necessary information was obtained and analyzed using SPSS version 17 software. Results were presented in percentages, simple graphs, and ratios.
RESULTS: During the years under review, there were 8568 deliveries, out of which 2707 had cesarean delivery, giving a cesarean delivery rate of 31.6%. The major maternal indication was prolonged obstructed labor, 627 (23.09%), while that of foetal indication was foetal distress, 418 (15.44%). The trend of caesarean delivery in this study showed a steady increase between 2018 and 2019 and 2021 to 2022, with a drop in 2020. This was due to the lockdown following the COVID-19 pandemic in that year. The maternal mortality ratio was 776/100,000 live births, and case fatality was 0.8%, while perinatal mortality was 41/1000 births.
CONCLUSION: The caesarean delivery rate in this study was very high when compared to most teaching hospitals in Nigeria. Effort should therefore be made to reverse the ugly trend. Therefore, a thorough and meticulous assessment of patients should be done before a decision is taken for surgery, especially elective caesarean deliveries.}, }
@article {pmid42472491, year = {2026}, author = {Bijkerk, HJC and Antonis, AFG and Wagenaar, JA and Lam, TJGM and van Doorn, DCK}, title = {Anthelmintic stewardship: An essential step towards sustainable dairy farming.}, journal = {Veterinary parasitology}, volume = {347}, number = {}, pages = {110846}, doi = {10.1016/j.vetpar.2026.110846}, pmid = {42472491}, issn = {1873-2550}, abstract = {Helminth infections in grazing dairy cattle can lead to asymptomatic infections, subclinical- or clinical disease. Whether the course of infection leads to disease depends on various factors, leading to a broad variety of prevalence rates and severity of disease between farms, between groups of cattle in a farm and between individual animals. Production losses related to helminth infections, the difficulty in diagnosing helminth disease and the wide availability and high efficacy of anthelmintics have led to overreliance on these products. Combined with management and other factors, this results in the development of anthelmintic resistance and an environmental hazard of drug residues. To slow down the development of anthelmintic resistance and to reduce the consequences of anthelmintic use on the environment, anthelmintic stewardship (AHS) is urgently needed. We define AHS as a systematic approach to optimize the management of helminth infections with the goal to minimize their negative consequences through minimizing the usage of anthelmintics, reducing the development of anthelmintic resistance and reducing environmental contamination. Implementation of AHS requires an approach that considers the complexity of helminth infections weighing different interests, while transferring them to practical applications. An integrated approach implementing AHS on dairy farms is proposed, consisting of four steps: risk assessment, prevention, diagnostics, and treatment. For each of these steps, implementation possibilities and gaps are reviewed. Although there are knowledge and implementation gaps in each of the steps, enough tools are currently available to implement AHS based on the proposed four step approach on dairy farms.}, }
@article {pmid42472528, year = {2026}, author = {Dai, T and Wu, W and Wang, B and Feng, G and Wang, J and Hu, T and Lin, Y and Sun, F and Wei, G and Xia, Y and Chen, T and Liu, B}, title = {Advances in lateral flow immunoassays: from technological innovations to diverse applications.}, journal = {Talanta}, volume = {312}, number = {Pt A}, pages = {130269}, doi = {10.1016/j.talanta.2026.130269}, pmid = {42472528}, issn = {1873-3573}, abstract = {Lateral flow immunoassay (LFIA), as a rapid, simple, and cost-effective point-of-care testing (POCT) method, has made remarkable progress over the past few decades, especially demonstrating its unique public health value during the global 2019 coronavirus disease (COVID-19) pandemic. This review aims to systematically introduce the technical principles, core components, technological innovations of LFIA, applications in the field of analytical testing, and to explore the current challenges and future development directions. The review first introduces the basic principle and structural composition of LFIA. Then, it highlights the strategies related to performance improvement in LFIA, including structural engineering, nanomaterial innovations, buffer optimization, signal amplification, smartphone-based image analysis and the integration of artificial intelligence (AI) techniques. Subsequently, the main applications of LFIAs in analytical testing are discussed in detail, including the detection of pathogens, protein markers, and small molecule substances. Finally, this review points out the current status and emerging challenges of LFIAs, and elaborates on their future development trends, aiming to promote further technological advancements and wider application of this technology in the field of POCT.}, }
@article {pmid42060833, year = {2026}, author = {Johnson, VL and Hall, V and Berrington, R and Burdon, J and Schreder, S and McCarthy, M and Brough, C and Highton, PJ and Hadjiconstantinou, M and Game, FL and Keogh, LJ and Tesfaye, S and Valabhji, J and Petrie, JR and Dhatariya, KK and Yates, T and Davies, MJ and Khunti, K}, title = {Expert considerations to guide the development and delivery of an exercise intervention in people with type 2 diabetes-related foot ulcer disease.}, journal = {Diabetic medicine : a journal of the British Diabetic Association}, volume = {43}, number = {8}, pages = {e70338}, pmid = {42060833}, issn = {1464-5491}, support = {//National Institute for Health and Care Research/ ; }, mesh = {Humans ; *Diabetes Mellitus, Type 2/complications/therapy ; *Diabetic Foot/therapy/physiopathology ; *Exercise Therapy/methods ; Exercise ; Patient Education as Topic ; }, abstract = {OBJECTIVE: Engaging in exercise presents unique challenges for those with type 2 diabetes (T2D) and diabetes-related foot ulcer disease (DFUD). This brief report describes the development of practical considerations aiming to support exercise in people with T2D and DFUD.
RESEARCH DESIGN AND METHODS: An expert group of multidisciplinary healthcare professionals (HCPs), researchers and individuals with DFUD reviewed available evidence and developed practical considerations for the assessment, prescription and monitoring of exercise within an ongoing randomised controlled trial.
RESULTS: Key considerations include screening for contraindications, individualising exercise prescription, determining weight-bearing status and initial supervision by HCPs. Self monitoring of exercise and appropriate foot protection advice and care are also encouraged.
CONCLUSIONS: We have developed practical considerations to use when delivering an exercise intervention within a study aiming to improve cardiovascular health for people with T2D and DFUD. For this specific population, these recommendations include prescribing non-weight bearing physical activity (such as arm ergometry or chair-based upper limb exercises) for those with active foot ulcers, educating and encouraging footcare self-management (including how to check feet and when to seek advice), monitoring glucose levels in participants at high risk of hypoglycaemia or hyperglycaemia and reducing the barriers to exercise. Pragmatic measures aimed at maintaining safety include determining the level of pre-assessment and individualised monitoring based on clinical presentation and/or risk as well as equipment and staff resource. This approach may also be helpful when supporting exercise in a wider population.}, }
@article {pmid42129716, year = {2026}, author = {Farah, MM}, title = {The impact of telehealth services on healthcare access in rural areas.}, journal = {BMC public health}, volume = {26}, number = {1}, pages = {}, pmid = {42129716}, issn = {1471-2458}, mesh = {*Telemedicine/organization & administration ; Humans ; *Health Services Accessibility ; *Rural Health Services/organization & administration ; COVID-19/epidemiology ; *Rural Population ; Pandemics ; Digital Health ; SARS-CoV-2 ; }, abstract = {OBJECTIVE: This review aims to elucidate the role, advantages, and limitations of telehealth in enhancing healthcare access in rural regions globally.
METHODS: A comprehensive literature search was conducted across Google Scholar, PubMed, Web of Science, and specific national databases (including those from Turkey, Australia, and India) for studies published between 2000 and 2024. A PRISMA-style flow approach was used to document the study selection process. Relevant articles, reviews, and reports were analyzed using thematic synthesis.
FINDINGS: The review identified a range of telehealth services that effectively mitigate geographical and socioeconomic barriers by facilitating specialist consultations, enabling chronic disease management, and offering cost-effective solutions. Evidence from multiple studies indicates a reduction in emergency department visits and hospitalization rates. For instance, (Eze, P., Health Serv Insights 15, 2020) demonstrated that telehealth implementation can significantly reduce missed appointments, generating substantial cost savings for clinics. Nevertheless, the review found that significant challenges remain across the literature, including inadequate digital infrastructure, low technological literacy, data security concerns, and regulatory gaps (Butzner, M., & Cuffee, Y J Med Int Res 23:(8) e29575, 2020). The COVID-19 pandemic has markedly accelerated the adoption of telehealth practices worldwide (Bashshur, Telemedicine and e-Health 26(5):571-573, 2020).
CONCLUSION: Telehealth serves as a transformative tool for improving accessibility and equity in rural healthcare. Sustainable implementation requires prioritized investments in infrastructure, digital literacy programs, comprehensive legal frameworks, and robust cybersecurity measures. Hybrid models that integrate traditional services with telehealth, along with culturally adapted and patient-centered solutions, are crucial for developing inclusive and resilient future health systems.}, }
@article {pmid42469771, year = {2026}, author = {Kassie, AM and Endalamaw, A and Khatri, RB and Assefa, Y}, title = {Barriers and facilitators to diabetes service uptake and self-care management in Australia: a scoping review.}, journal = {BMC health services research}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12913-026-15150-5}, pmid = {42469771}, issn = {1472-6963}, abstract = {BACKGROUND: Diabetes represents a major and increasing public health burden in Australia. Despite this, there remains limited consolidated evidence on patterns of diabetes-related service uptake and self-management, particularly among priority population groups. This scoping review synthesizes existing evidence on diabetes-related health service utilization and self-management practices in Australia, focusing on key barriers and facilitators that affect access to care and engagement in self-management.
METHODS: We conducted a scoping review of journal articles published up to 20 October 2025. Major databases: PubMed, Embase, Scopus, and Web of Science, were utilized along with manual reference searches. Articles were screened in two stages, and data were extracted using a piloted template. A descriptive thematic analysis was performed focusing on the three major themes: service uptake, self-care management, and the associated barriers and facilitators. Diabetes service uptake was categorized into three subthemes: practitioner-based primary care, allied health and preventive services, and acute and emergency care. Moreover, the barriers and facilitators were organized using the socioecological framework.
RESULTS: Thirty-two articles were included in this review. The general population showed consistent engagement with practitioner-based routine diabetic services, with studies reporting up to 92% of adults visiting their general practitioners and having at least one HbA1c test over a six-month period. Aboriginal and Torres Strait Islander people also showed an improvement in primary care engagement despite a historical high dependency in acute care. In contrast, areas containing a higher proportion of overseas-born residents tended to rely more on acute services. The uptake of preventive services and allied health care was inconsistent and generally low. For example, up to 40% of adults had no contact with diabetes educators, dietitians, or podiatrists in some rural populations. One study has also reported that only 55.2% of high-risk adults were screened at least once for diabetes over a three-year period. Key barriers to service uptake and/or self-care management included limited health literacy, fragmented care pathways, financial constraints, cultural and language barriers, geographic remoteness, and variable digital capability. In contrast, coordinated multidisciplinary care, structured management plan, strong patient-provider relationship, social support, and access to digital health services were reported as important facilitators. Telehealth has also emerged as an effective facilitator for maintaining engagement, particularly during the COVID-19 pandemic.
CONCLUSION: Despite high engagement with routine primary care, significant gaps remain in preventive services and allied health use among people with diabetes in Australia, particularly among younger adults, rural residents, and socioeconomically disadvantaged or culturally diverse populations. Addressing these gaps requires equitable, person-centered, and integrated multidisciplinary care that aligns with patients' cultural values and everyday lives, alongside efforts in improving health literacy.}, }
@article {pmid42469840, year = {2026}, author = {Riley, A and Doughty, H and Hill, JE and Giebel, C and Harris, M and Williams, NH}, title = {Barriers to and facilitators of the implementation of Community Health Worker programmes in high-income countries: a systematic review.}, journal = {BMC health services research}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12913-026-15114-9}, pmid = {42469840}, issn = {1472-6963}, support = {NIHR200182/ARCNWC161//National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care North West Coast/ ; }, abstract = {BACKGROUND: Global interest in Community Health Workers (CHWs) is rising as health systems seek to address persistent health inequities and the social determinants of health. However, in high-income countries (HICs), CHW implementation remains fragmented. This systematic review synthesises evidence on the factors that act as barriers and facilitators to the implementation and integration of CHW programmes across HIC primary healthcare settings.
METHODS: We searched MEDLINE, Scopus, PsycINFO, and CINAHL for studies published between January 2001 and August 2025. Inclusion focused on qualitative, quantitative, and mixed-methods papers regarding CHW implementation in HICs. Methodological quality was appraised using the Mixed Methods Appraisal Tool (MMAT). Data were synthesised using a 'Best Fit' Framework Synthesis and confidence in the findings was assessed via GRADE-CERQual.
RESULTS: Seventy-two papers were included (US n = 64; UK n = 4; Australia n = 3; Belgium n = 1), primarily comprising qualitative and mixed methods designs. Key facilitators included leadership buy-in, the presence of implementation champions, and established community partnerships that enabled resource sharing. Prominent barriers included precarious, short-term funding models that prioritised quantitative outputs over relational labour; hierarchical medical power dynamics; and disconnected IT systems that necessitated redundant data entry. The COVID-19 pandemic acted as a catalyst, elevating the CHW role within public health infrastructure while simultaneously exposing digital divides and structural fragility. GRADE-CERQual ratings indicated high confidence in findings regarding funding sustainability, training, and integration.
CONCLUSIONS: The evidence synthesised in this review reveals a fundamental misalignment within current health services: while CHWs are valued for their unique relational capacity, they remain systemically undermined by transactional health system designs. Achieving sustainability requires a strategic shift toward long-term, flexible funding models and the workforce development of supportive infrastructure, including reflective supervision and standardised training. Integration must move beyond short-term, project-based initiatives toward a resilient and permanent public health workforce capable of addressing structural health inequities.
TRIAL REGISTRATION: PROSPERO: CRD42022310789.}, }
@article {pmid42470742, year = {2026}, author = {N, B and Radhakrishnan, SSR and V, RS and J, PK and Srinivasan, S and Lamech, T and S, RK and Mani, R and Sharma, M and Vasudeva, K and Mahadevan, A and Hb, V}, title = {Emerging importance of bio-bank for precision diagnostics and research in neuroinfections - a narrative review.}, journal = {Diagnostic microbiology and infectious disease}, volume = {116}, number = {3}, pages = {117546}, doi = {10.1016/j.diagmicrobio.2026.117546}, pmid = {42470742}, issn = {1879-0070}, abstract = {The diagnosis of neuroinfectious diseases, including Tuberculous Meningitis (TBM), viral encephalitis, Human Immunodeficiency Virus (HIV), and post COVID-19 neurological syndromes, remains challenging due to limited surveillance, non-specific symptoms, inadequate laboratory sensitivity, and restricted availability of high-quality CSF or tissue specimens. The critical need for early and precise diagnosis and the development of reliable, validated biomarkers highlight the importance of biospecimen-driven approaches that leverage CSF and other biobanked materials, as evidenced by the emerging literature. This review aims to summarize the need for biobanks, discuss sample preservation and tracking, examine quality control frameworks, and evaluate current advances, translational applications, and ongoing challenges of biobanking in neuroinfectious disease research. We extracted evidence from existing neuroinfection biobanks, reviewed global standards governing bio-specimen preservation and storage, and analyzed studies demonstrating how archived CSF, blood, and brain tissue have enabled pathogen characterization, biomarker discovery, and translational research. Our analysis shows that biobanked specimens have facilitated high-resolution pathogen genotyping, immune profiling, and identification of diagnostic and prognostic biomarkers, such as neuro-filament light chain (NfL) and CSF proteomic signatures. Strengthening biobanking infrastructure, harmonized governance, established FAIR-aligned data systems, and the integration of AI and digital analytics will help accelerate biomarker validation, drive diagnostic innovation, and ultimately improve clinical outcomes for patients worldwide.}, }
@article {pmid42467983, year = {2026}, author = {Tholo, N and Markey, G and Harrigan, R and Pandey, P and Prasad, B and Barai, RS and Gibson, DS and Shukla, P}, title = {The critical role of artificial intelligence and bioinformatics in accelerating peptide-based vaccine discovery for tackling global infectious diseases.}, journal = {Briefings in bioinformatics}, volume = {27}, number = {4}, pages = {}, doi = {10.1093/bib/bbag260}, pmid = {42467983}, issn = {1477-4054}, support = {//Department for the Economy/ ; }, mesh = {Humans ; *Artificial Intelligence ; *Computational Biology/methods ; Protein Subunit Vaccines ; Immunoinformatics ; *Vaccines, Subunit/immunology ; *Vaccine Development ; Epitopes, T-Lymphocyte/immunology ; Machine Learning ; COVID-19 Vaccines/immunology ; COVID-19/prevention & control/immunology ; *Communicable Diseases/immunology ; Epitopes, B-Lymphocyte/immunology ; }, abstract = {Peptide-based vaccines, enabled by bioinformatics and machine learning (ML), have emerged as one of the most promising approaches for rapid, safe, and cost-effective vaccine design against infectious diseases. Unlike conventional approaches that depend heavily on whole-pathogen cultures or recombinant protein expression, peptide vaccines can be designed in silico and synthesized quickly. Rational and targeted in silico approaches for the discovery of peptide-based vaccine candidates include B-cell and T-cell epitope prediction, immunogenicity, antigenicity, allergenicity, autoimmunity, population coverage, sequence conservation, molecular docking, molecular dynamics simulation, in silico cloning, and immunological simulation analyses. The combination of these comprehensive computational methods can effectively generate high-quality vaccine candidates for subsequent validation via in vitro and in vivo experiments. This review contextualizes the historical trajectory of peptide-based vaccinology, from early linear epitope discoveries in the 1960s to multi-epitope constructs and clinically tested candidates such as UB-612 and PepGNP-Covid19. It examines critical challenges in immunoinformatics, including performance gaps in epitope prediction tools, complexities in human leucocyte antigen (HLA) mapping, and the need for extensive manual intervention in pipelines. Artificial intelligence-driven approaches, spanning deep learning, and interpretable ML, are positioned to transform epitope prediction, reduce human error, and standardize reproducibility. These advances have the potential to support global outbreak response targets such as the Coalition for Epidemic Preparedness Innovations (CEPI) 100 Days Mission and the World Health Organization (WHO) Research and Development (R&D) Blueprint. However, their performance remains constrained by data quality, dataset imbalance, limited benchmark standardization, and persistent underrepresentation of many HLA alleles and population groups. Key Points Peptide-based vaccines, accelerated by bioinformatics and machine learning, offer a potentially rapid, relatively safe, and cost-effective alternative to traditional vaccine design, enabling in silico development and swift synthetic manufacturing. Computational methods such as B-cell and T-cell epitope prediction, immunogenicity analysis, and molecular simulations allow for rational and targeted vaccine candidate discovery, enhancing quality and efficiency. The field has evolved from early linear epitope discoveries in the 1960s to sophisticated multi-epitope constructs and clinically tested candidates like UB-612 and PepGNP-Covid19. Major challenges in immunoinformatics include performance limitations in epitope prediction tools, complexities in HLA mapping, and the necessity for manual intervention in data pipelines. Artificial intelligence-driven models, including deep learning and interpretable machine learning, promise to overcome these challenges by improving prediction accuracy, reducing errors, and supporting global epidemic response efforts such as CEPI's 100 Days Mission and the WHO R&D Blueprint.}, }
@article {pmid42468359, year = {2026}, author = {Kelly, JB and Brodie, G and Zeden, MS}, title = {Antisense oligonucleotides: design, implementation and future perspectives in microbiology.}, journal = {Current opinion in microbiology}, volume = {93}, number = {}, pages = {102794}, doi = {10.1016/j.mib.2026.102794}, pmid = {42468359}, issn = {1879-0364}, abstract = {Advances in molecular biology have expanded antimicrobial strategies that traditionally targeted proteins or metabolic pathways to now include RNA, enabling a previously unattainable precision through control of gene expression. The clinical potential of RNA-therapeutics was demonstrated during the COVID-19 pandemic, when mRNA vaccines marked a transformative milestone for RNA-based interventions for viral infections. Increasingly, similar principles are emerging for the treatment of bacterial infections. Antisense oligonucleotides (ASOs) bind complementary mRNA sequences to induce RNase H-mediated degradation or block their translation. Initially developed for genetic and neurodegenerative disorders, ASOs are now emerging as next-generation antibacterials, termed ASOBiotics, designed to silence essential bacterial genes. In this review, we explore the advances of ASO technologies with applications in bacterial pathogens, outlining design considerations while discussing the challenges and opportunities for making precision antibacterial therapeutics.}, }
@article {pmid40685732, year = {2026}, author = {Tabassum, H and Ankita, and Deo, V}, title = {Review of Nanomedicine Research Proposals Received at ICMR: Gaps in Research and Further Opportunities.}, journal = {Combinatorial chemistry & high throughput screening}, volume = {29}, number = {5}, pages = {808-817}, pmid = {40685732}, issn = {1875-5402}, mesh = {*Nanomedicine/economics ; Humans ; India ; *Biomedical Research ; COVID-19 ; Translational Research, Biomedical ; Neoplasms/diagnosis ; }, abstract = {INTRODUCTION: Nanomedicine integrates nanotechnology with healthcare, offering targeted diagnostics, therapeutic solutions, and preventive applications. India, through agencies such as the Indian Council of Medical Research (ICMR), the Department of Biotechnology (DBT), and the Department of Science & Technology (DST), has prioritized nanomedicine to address public health challenges. Despite significant progress, gaps persist in clinical translation and interdisciplinary applications.
OBJECTIVE: To analyze the scope, gaps, and opportunities in nanomedicine research in India, focusing on ICMR-funded projects.
METHODS: Data on nanomedicine proposals submitted to ICMR (2018-2022) were reviewed using keyword-based searches from databases and survey responses from principal investigators. Metrics included funding trends, research objectives, and outcomes. Quantitative and qualitative analyses assessed scientific progress and translational potential.
RESULTS: Over the past five years, the ICMR has funded over 250 projects, with a focus on cancer therapy, infectious diseases, and diagnostics. Achievements include nanoparticle-based drug delivery systems and diagnostics, with notable innovations like Albupax® and gold nanoparticlebased sensors. Research activity increased over the years, with a slight slowdown during the COVID-19 period. Funding was primarily allocated to states with established research infrastructures, underscoring the need for more equitable support nationwide.
DISCUSSION: Nanomedicine research in India has made significant progress, primarily in cancer; however, limited research has been observed in non-cancer applications and long-term safety studies. Differences in funding across various regions and difficulties in turning ideas into marketable products were major problems. Integrating nanomedicine with genetic tools offers promise for more targeted treatments.
CONCLUSION: The ICMR's support has advanced nanomedicine research in India, particularly in the field of oncology. To strengthen India's position in the field, future efforts must address unmet needs, including non-cancer applications, clinical translation, and regulatory harmonization. Collaborative initiatives and equitable funding distribution can accelerate advancements and strengthen the implementation of nanomedicine research.}, }
@article {pmid42138851, year = {2026}, author = {Silva, AS and Dornelas, R and Silva, JRLE}, title = {COVID-19-related voice disorders: a scoping review.}, journal = {CoDAS}, volume = {38}, number = {3}, pages = {e20250243}, pmid = {42138851}, issn = {2317-1782}, mesh = {Humans ; *Voice Disorders/virology/etiology ; *COVID-19/complications ; SARS-CoV-2 ; Adult ; Voice Quality ; }, abstract = {PURPOSE: To map the available evidence on voice changes in non-intubated adults diagnosed with mild to moderate COVID-19.
RESEARCH STRATEGIES: Scoping review conducted according to PRISMA-ScR guidelines, including studies published between 2019 and 2025. Systematic searches were performed in the MEDLINE (PubMed), EMBASE, LILACS, Scopus, Web of Science, and Cochrane Library databases and in grey literature sources (Google Scholar, MedRxiv, and ProQuest). Controlled descriptors and free terms related to COVID-19 and voice disorders were combined using Boolean operators.
SELECTION CRITERIA: The review included studies with adults (18-65 years) with a confirmed diagnosis of mild to moderate COVID-19 and excluded studies with individuals undergoing endotracheal intubation and with a previous history of voice disorders or respiratory comorbidities. The selection was performed by two independent reviewers.
DATA ANALYSIS: The data were extracted and analyzed descriptively and quantitatively, considering study characteristics, vocal assessment methods, and main outcomes.
RESULTS: Of the 35,497 records identified, 19 studies met the inclusion criteria. The most frequent voice disorders were dysphonia, hoarseness, reduction in maximum phonation time, and changes in acoustic measures such as jitter, shimmer, and harmonic-to-noise ratio. Associated symptoms included vocal fatigue, cough, dyspnea, and laryngeal discomfort, as well as a negative impact on voice-related quality of life.
CONCLUSION: Mild to moderate COVID-19 can lead to clinically relevant vocal impairments, reinforcing the need for speech-language-hearing follow-up and research to support vocal assessment and rehabilitation protocols in the post-infection period.}, }
@article {pmid42149126, year = {2026}, author = {Akinbolade, S and Potter, R and Inskip, A and Nesworthy, J and Brock, K and Norman, G}, title = {Repurposed Medicines for Viruses With Epidemic or Pandemic Potential: A Horizon Scan.}, journal = {Pharmacology research & perspectives}, volume = {14}, number = {3}, pages = {e70271}, pmid = {42149126}, issn = {2052-1707}, support = {HSRIC-2016-10 009//National Institute for Health and Care Research/ ; }, mesh = {Humans ; *Drug Repositioning/methods ; *Antiviral Agents/therapeutic use/pharmacology ; SARS-CoV-2 ; Pandemics ; Animals ; COVID-19 ; *Pneumonia, Viral/drug therapy/epidemiology ; *Coronavirus Infections/drug therapy ; COVID-19 Drug Treatment ; }, abstract = {Viruses such as Ebola, Marburg, influenza, mpox, MERS-CoV, SARS-CoV, and SARS-CoV-2 may be considered pathogens of epidemic or pandemic concern. Developing novel antiviral medicines can be time-consuming and resource intensive. Repurposing existing medicines with known or potential antiviral activity offers a faster, cost-effective strategy to expand treatment options during public health emergencies. This scan aimed to map current investigational activity involving repurposed medicines for these viruses. A horizon scanning approach was employed, starting with a targeted search in Embase followed by a systematic search of ClinicalTrials.gov to identify developmental stages of relevant technologies. Eligible technologies included UK- or EU-licensed medicines being investigated for antiviral use, while vaccines, unlicensed medicines, and treatments already approved for the target viruses were excluded. From the literature, 196 repurposed technologies were identified, and the expanded search on the clinical trials registry revealed 58 technologies in active clinical development. Interventional trial activity was limited to influenza and SARS-CoV-2, with 29 technologies for SARS-CoV-2 and two influenza technologies advancing to phase III evaluation. For other viruses, candidate repurposed technologies were identified only at preclinical or exploratory stages. Frequently investigated pharmacological classes included direct-acting antivirals, immunomodulators, and anti-inflammatory agents. While repurposing represents a potentially rapid strategy for therapeutic deployment, inclusion in this horizon scan does not imply clinical efficacy. Rigorous preclinical validation, pharmacokinetic feasibility assessment, and mechanistic confirmation remain essential before clinical translation.}, }
@article {pmid42149692, year = {2026}, author = {Amahong, K and Liu, Y and Zhang, Z and Tao, L and Sarshad, AA and Zhu, F}, title = {An integrative meta-analysis of SARS-CoV-2 RNA-protein interactomes identifies conserved host factors shared with other RNA viruses.}, journal = {Briefings in functional genomics}, volume = {25}, number = {}, pages = {}, pmid = {42149692}, issn = {2041-2657}, mesh = {Humans ; *SARS-CoV-2/metabolism/genetics ; *RNA, Viral/metabolism/genetics ; *Host-Pathogen Interactions ; *RNA-Binding Proteins/metabolism ; *RNA Viruses/metabolism/genetics ; Influenza A virus/metabolism/genetics ; Dengue Virus/metabolism/genetics ; COVID-19/virology/metabolism ; Zika Virus/metabolism/genetics ; }, abstract = {RNA viruses cause substantial global disease burden and depend on host RNA-binding proteins and translation machinery. However, it remains unclear which host factors are robustly engaged across independent Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) RNA interactome studies and to what extent these factors are shared with other RNA viruses. Here, we perform an integrative meta-analysis of eight published SARS-CoV-2 RNA-protein interactomes and compare them with corresponding Influenza A virus, Zika virus, and Dengue virus datasets to define conserved host networks and prioritize candidate host-directed antiviral targets. By integrating multiple datasets and applying ClusterProfiler together with curated pathway resources (KEGG, Reactome, WikiPathways, and Gene Ontology), we systematically characterize the functional landscape of SARS-CoV-2 RNA-protein interactions. The consensus SARS-CoV-2 interactome is enriched for mRNA processing, translation, RNA surveillance and innate immune functions. Cross-viral comparison identifies 275 host proteins shared across all four RNA viruses, forming interconnected modules that include key translation factors (EEF1A1, EIF4A1, EIF3H) and RNA-binding proteins (Nucleolin, ILF3). Drug-target annotation prioritizes 21 proteins with 35 approved or investigational modulators for host-directed antiviral repurposing. Together, these findings generate a consensus map of conserved host dependencies and highlight prioritized targets for future mechanistic and translational studies. Research Highlights Integrated SARS-CoV-2 datasets and compared with, Influenza A virus, Zika virus, Dengue virus. Identified 275 host proteins shared across these four pathogens. Conserved proteins were enriched in translation, RNA processing, and innate immune pathways. Prioritized 21 host targets and 35 drugs for antiviral repurposing.}, }
@article {pmid42171504, year = {2026}, author = {Brüssow, H}, title = {Extending the Targets for Coronavirus Antivirals Beyond That of Approved Drugs: Insights From Preclinical Research.}, journal = {Microbial biotechnology}, volume = {19}, number = {5}, pages = {e70376}, pmid = {42171504}, issn = {1751-7915}, mesh = {*Antiviral Agents/pharmacology/therapeutic use ; Humans ; SARS-CoV-2/drug effects ; *Betacoronavirus/drug effects ; COVID-19 Drug Treatment ; Animals ; Spike Glycoprotein, Coronavirus/metabolism/antagonists & inhibitors ; Drug Evaluation, Preclinical ; *Coronavirus Infections/drug therapy/virology ; COVID-19 ; Viral Nonstructural Proteins/antagonists & inhibitors/metabolism ; *Pneumonia, Viral/drug therapy/virology ; Pandemics ; }, abstract = {Antiviral drugs have been approved for the treatment of COVID-19. However, they present pharmacological limitations, a mixed efficacy profile and target just two coronavirus proteins. To extend the range of druggable coronavirus proteins, researchers explored small molecule N-glycan binders as inhibitors of SARS-CoV-2 spike protein interaction with the cell receptor. Other groups investigated lipopeptides as inhibitors of cell fusion by viral spikes. High throughput screening of chemical libraries yielded viral maturation inhibitors that targeted the viral M protein. Massive screening led to inhibitors of the non-structural coronavirus protein NSP14, a methyltransferase involved in viral mRNA cap synthesis. Machine learning-driven scans of chemical space revealed inhibitors of non-structural coronavirus protein NSP3, a papain-like protease subverting innate immune response to viral infection. A chimera of a nucleotide analogue coupled to an RNase L attractor bound the RNA-dependent RNA polymerase NSP12 and mediated degradation of the viral RNA. Several of these compounds showed comparable or even superior antiviral efficacy as approved COVID-19 drugs in preclinical animal tests. Parallel efforts were made to develop chemical compounds targeting host proteins needed for viral multiplication. Peptidomimetic tetrapeptides acted as inhibitors of the host protease TMPRSS2 involved in cell fusion by the viral spike protein. A repurposed TMPRSS2 inhibitor was tested in COVID-19 patients without demonstrating efficacy. A genetic screen demonstrated an enzyme involved in sphingomyelin synthesis and its inhibitor which impaired SARS-CoV-2 replication. A viral-cell protein interactome study showed 332 cellular proteins interacting with 26 coronaviral proteins. A chemoinformatic search found inhibitors for the interaction of NSP9 with host elongation factor eIF4A and for NSP13 with elongation factor eEF1A. Plitidepsin, a clinically used eEF1A inhibitor, was tested in human clinical trials with COVID-19 patients demonstrating in vivo antiviral activity and a trend for clinical amelioration in an underpowered phase 3 clinical trial.}, }
@article {pmid42191274, year = {2026}, author = {Parikesit, AA and Ansori, ANM and Kharisma, VD and Purnobasuki, H and Nugraha, Y}, title = {Advances in bioinformatics: Integration of biomolecular simulations and virtual reality for revolutionizing disease mechanism elucidation and therapeutic development.}, journal = {International review of cell and molecular biology}, volume = {402}, number = {}, pages = {211-236}, doi = {10.1016/bs.ircmb.2025.11.004}, pmid = {42191274}, issn = {1937-6448}, mesh = {Humans ; *Molecular Dynamics Simulation ; *Virtual Reality ; *Computational Biology/methods ; COVID-19/virology ; SARS-CoV-2 ; }, abstract = {Virtual reality and biomolecular simulations currently lie at the leading edge in dissecting the molecular pathways underlying the disease. This chapter will discuss how the integrations of various technologies will extend knowledge about complex biological processes and their contribution to disease pathophysiology. Advances in molecular dynamics (MD) simulations currently make it possible to record the behavior of proteins and other biomolecules with accurate temporal resolution and full atom detail. Such simulations include information on critical structural changes related to diseases, interactions with possible medication, and functionality of proteins. With recently improved speed, accuracy, and accessibility, MD. has become a basic research and drug development tool. From the researcher's point of view, virtual reality has revolutionized how one can conceptualize and interact with molecular structures. Virtual reality (VR) is a method that uses the three-dimensional presentation of biomolecules as manipulable virtual objects for intuitive insight into molecular interactions and structural connections. In this way, virtual technology can be very helpful in investigating complex chemical systems and creating new theories. It facilitates the Cloud-based co-creation of environments in cloud systems for molecular modeling. The same technologies allow real-time research collaboration by sharing and changing virtual molecules. These cooperative situations reward the generation of new ideas and information, which might provide novel discoveries that more direct approaches could not realize. This chapter will discuss the range of computational methods applied to elucidate molecular recognition mechanisms and will cover improved sampling methods and in silico screening. It will also describe how such techniques may be applied to investigate viral proteins and help develop vaccines and drugs during the COVID-19 pandemic. The combination of the predictive power of MD. Simulations with intuitive visualization capabilities from VR would allow researchers to achieve an unprecedented understanding of the molecular origin of many diseases. This should inspire innovation in therapeutic intervention and accelerate discovery in molecular biology.}, }
@article {pmid42453219, year = {2026}, author = {Neogi, SB and Saroha, E and Mishra, SS and Tolani, H and Samtani, R}, title = {Telemedicine: An exploration of global impact and Indian perspectives on healthcare delivery, effectiveness, and challenges.}, journal = {Journal of family medicine and primary care}, volume = {15}, number = {4}, pages = {1473-1478}, pmid = {42453219}, issn = {2249-4863}, abstract = {Telemedicine represents a transformative approach to healthcare delivery, leveraging information and communication technologies to bridge geographical barriers between patients and healthcare providers. This paper explores telemedicine's historical development, global applications, and specific relevance in India, particularly focusing on the eSanjeevani program. Despite its potential, telemedicine faces challenges, such as the digital divide, regulatory frameworks, patient acceptance, and technical limitations. Addressing these challenges requires collaborative efforts among stakeholders to ensure equitable access, data security, and interoperability of telemedicine platforms. Telemedicine has demonstrated its efficacy in enhancing access to healthcare services, particularly in underserved regions, and has emerged as a vital tool during the COVID-19 pandemic. The eSanjeevani program in India serves as a prominent example of successful telemedicine implementation, facilitating millions of consultations and bridging the urban-rural healthcare divide. Looking ahead, telemedicine holds promise in revolutionizing healthcare delivery, fostering ecological responsibility, and advancing toward universal health coverage. Embracing telemedicine represents a significant step toward a healthier, greener, and more sustainable future for healthcare systems worldwide.}, }
@article {pmid42453257, year = {2026}, author = {Rajeh, DA and Amer, KA and Alasmari, R and Brema, I and Aljumah, M and Aljuaid, S}, title = {Diabetic ketoacidosis after COVID-19 infection in newly diagnosed patients with diabetes in the Middle East and African countries: A systematic review and meta-analysis.}, journal = {Journal of family medicine and primary care}, volume = {15}, number = {4}, pages = {1527-1539}, pmid = {42453257}, issn = {2249-4863}, abstract = {INTRODUCTION: The risk of diabetic ketoacidosis (DKA) is increased following the severe acute respiratory syndrome coronavirus 2 infection, "COVID-19," however, little evidence is available regarding the prevalence and outcomes of DKA in newly diagnosed patients with diabetes in the Middle East and African countries. Our objective was to conduct a systematic review of case reports detailing the prevalence and outcomes of DKA in COVID-19 infected in the above referenced countries.
METHODS AND SUBJECTS: Our search encompassed Medline (via PubMed), Embase (via OVID), Web of Science, Scopus, grey literature sources such as Open Access Theses and Dissertations (OATD), and the reference lists of the included studies.
RESULTS: The results of the current meta-analysis study showed that 17 studies met the search criteria and a total of 22 patients (15 patients with newly type 1 diabetes and seven patients with newly diagnosed type 2 diabetes). About 69.5% of the patients were of Arabian ethnicity. Body mass index (BMI) was reported only for seven patients, with a mean of 25.04 k g/m[2]. Two patients died in patients with newly diagnosed type 2 diabetes, giving a mortality rate of 14.3%, while all patients were in type 1 diabetes, who had DKA survived.
CONCLUSIONS: Covid 19 infection in patients with new diabetes from the Middle East and African countries was associated with increased risk of DKA with high mortality in patients with newly diagnosed type 2 diabetes.}, }
@article {pmid42453521, year = {2026}, author = {Hsu, PC and Tsai, CC and Chu, TY and Kuo, CY}, title = {Jing-Si Herbal Tea as a multitargeted complementary therapy: Evidence from preclinical and clinical studies.}, journal = {Tzu chi medical journal}, volume = {38}, number = {3}, pages = {289-299}, pmid = {42453521}, issn = {2223-8956}, abstract = {Jing-Si Herbal Tea (JSHT) is a traditional multi-herbal preparation composed of flavonoids, polyphenols, triterpenoid saponins, glycyrrhizin, and other bioactive constituents that collectively contribute to a wide spectrum of biological activities. Emerging laboratory and clinical studies indicate that JSHT is associated with modulation of oxidative stress, inflammatory responses, and immune-related pathways, with reported antiviral and cytoprotective effects primarily observed in experimental models and exploratory clinical settings. This review synthesizes current evidence describing the diverse pharmacological actions of JSHT and its potential applications across oncologic, inflammatory, metabolic, and infectious disease contexts. Experimental findings suggest that JSHT may be associated with modulation of tumor progression-related processes, including epithelial-mesenchymal transition and aberrant nuclear factor kappa B activity, while being associated with intracellular oxidative stress-related activation of apoptosis- and ferroptosis-related pathways in cancer cell models. Its immunoregulatory capacity is reflected in the attenuation of pro-inflammatory cytokines and the promotion of anti-inflammatory macrophage phenotypes. In respiratory and infectious diseases such as coronavirus disease 2019 and chronic obstructive pulmonary disease, JSHT has been reported to attenuate hyperinflammatory responses and preserve cellular or organ function and has been associated with clinical improvement in selected observational studies, which should be interpreted cautiously. Early clinical data, including results from a randomized study in functional dyspepsia, suggest benefits for gastrointestinal symptoms and anxiety, accompanied by increases in serum butyrate that may indicate involvement of the gut-brain axis. Across available studies, JSHT has shown good tolerability with few reported adverse effects. Overall, the accumulating evidence suggests that JSHT may have potential relevance as a multitarget complementary approach, pending confirmation through well-controlled clinical studies. Nonetheless, more extensive, well-controlled clinical investigations are warranted to validate its efficacy and clarify its mechanistic pathways.}, }
@article {pmid42454043, year = {2026}, author = {Wendt, K and Schieck, M and Gille, C and Marschollek, M and Illig, T and Wolff, D and Nee, S}, title = {Biomarkers of post-acute infection syndrome: a systematic literature review.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1741761}, pmid = {42454043}, issn = {1664-3224}, mesh = {Humans ; *Biomarkers/metabolism ; Post-Acute COVID-19 Syndrome ; *COVID-19/complications ; *SARS-CoV-2 ; *Fatigue Syndrome, Chronic/diagnosis ; }, abstract = {BACKGROUND: Post-acute infection syndrome (PAIS) remained underrecognized before the COVID-19 pandemic, which further increased exposure by introducing a novel global cause. The global burden of post-acute COVID syndrome (PACS) and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) alone is estimated at several tens of millions affected worldwide. Biomarker discovery is central to improving PAIS diagnosis and may provide therapeutic targets. This review summarizes current knowledge on biomarkers for PAIS, including PACS and ME/CFS.
METHODS: A systematic literature search was conducted in PubMed and Web of Science. Inclusion criteria were: (1) studies including PAIS patients; (2) reporting laboratory or omics biomarkers; and (3) investigating biomarkers or pathomechanisms of PAIS. Although Guillain-Barré syndrome (GBS) is not PAIS, we have included it as a separate mechanistic comparator due to its prevalence in search results and its clinical and immunological similarities to PAIS.
RESULTS: A total of 142 studies analyzing PAIS biomarkers were included. GBS was analyzed separately and later compared with the other results. Overall, the reviewed studies employed heterogeneous approaches. While similar types of data were frequently investigated, analytical methods varied and often focused only on a subset of molecules. The results indicate that amino acid, energy, and lipid metabolism, microbiome, mitochondrial stress, and miRNA networks are affected. All pathways are connected via NF-κB.
DISCUSSION: PAIS is a multisystem disorder rooted in persistent immune activation, metabolic reprogramming, and systemic inflammation, driven not by active viral infection, but by dysregulated host responses. The NF-κB pathway serves as a unifying hub, connecting molecular, cellular, and clinical phenotypes. Our framework enables a shift from symptom-based to mechanism-based classification, paving the way for biologically grounded interventions.
CONCLUSION: This review synthesizes a broad spectrum of biomarkers in PAIS, integrating findings across pathogens and molecular levels rather than restricting to individual conditions or symptom clusters. This study highlights the differences and commonalities among pathogens and diseases that lead to post-acute sequelae, fills a critical knowledge gap, and provides a foundation for future research and clinical practice. Future studies incorporating multi-omics approaches, longitudinal designs, and larger patient cohorts are needed to validate specific biomarkers and advance the understanding of PAIS.}, }
@article {pmid42454050, year = {2026}, author = {Sanz-Muñoz, I and Farre-Avella, M and Barroso-Santos, PJ and Eiros, JM}, title = {State-of-the-art of the high dose influenza vaccine in Spain.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1843611}, pmid = {42454050}, issn = {1664-3224}, mesh = {Humans ; *Influenza Vaccines/administration & dosage/immunology ; Spain/epidemiology ; *Influenza, Human/prevention & control/immunology/epidemiology ; Vaccination ; Aged ; *COVID-19/prevention & control/epidemiology ; Middle Aged ; SARS-CoV-2 ; }, abstract = {High-dose (HD) influenza vaccines have demonstrated robust effectiveness in preventing severe influenza-related outcomes, including pneumonia, cardiorespiratory complications, and mortality, with evidence from randomized clinical trials, meta-analyses, and real-world studies consistently showing superiority over standard-dose (SD) vaccines and supporting international recommendations for adults aged ≥60 years. This is increasingly relevant in the context of global aging and immunosenescence, which weakens vaccine-induced immune responses and heightens biological frailty, functional decline, and the risk of severe complications in older adults, especially those with comorbidities. The objective of this work is to describe the introduction, uptake, and current use of HD influenza vaccines in Spain and to summarize the evidence supporting their broader adoption in adults ≥60 years of age. Methods include a narrative synthesis of clinical evidence and an analysis of vaccination strategies implemented across Spanish autonomous communities since the introduction of HD vaccines during the COVID-19 pandemic. Available evidence supports extending HD vaccine use as a population-based strategy to enhance protection and promote equitable access. The results show that the incorporation of HD influenza vaccines marked a significant shift in national vaccination strategies, with heterogeneous uptake across regions: while some prioritized institutionalized or dependent populations, others implemented mixed approaches that also included community-dwelling adults aged ≥60 years. In conclusion, a clear trend toward wider adoption is emerging, with an increasing number of autonomous communities incorporating HD vaccines into their programs and progressively lowering the recommended age threshold, in alignment with international guidance and the biological rationale for strengthened protection in older adults.}, }
@article {pmid42456241, year = {2026}, author = {Dietrich, N and Stubbert, B}, title = {Artificial intelligence for chest imaging in hantavirus pulmonary syndrome: A review of practical considerations for rare-disease imaging.}, journal = {Clinical imaging}, volume = {138}, number = {}, pages = {110895}, doi = {10.1016/j.clinimag.2026.110895}, pmid = {42456241}, issn = {1873-4499}, abstract = {Hantavirus pulmonary syndrome (HPS) is an uncommon zoonotic respiratory illness with a high case fatality rate. Recent travel-associated Andes orthohantavirus clusters have renewed interest in early radiographic recognition of the disease outside its usual geographic range. Artificial intelligence (AI) tools developed during the COVID-19 pandemic now inform several radiology workflows, but the application of AI to HPS chest imaging remains largely unexplored. This narrative review summarises the imaging features of HPS across modalities, considers lessons from AI applications in COVID-19 and viral pneumonia imaging, and discusses practical development considerations for HPS-aware imaging AI, including dataset development, label standardisation, realistic comparator inclusion, candidate modelling approaches, external validation, and clinical workflow integration. The review also considers challenges to HPS-aware imaging AI, including data scarcity, low pretest probability in non-endemic settings, overlapping imaging findings, and translational pitfalls from recent AI literature. As HPS is unlikely to support conventional disease-specific model development without coordinated data collection, future work will likely require multi-institutional datasets, prevalence-aware evaluation, and multimodal workflow integration that combines imaging with clinical, laboratory, and epidemiologic context.}, }
@article {pmid42459265, year = {2026}, author = {Vera, E and Galanis, P and Mangoulia, P and Pesiridis, T}, title = {Factors affecting nurses' professional quality of life in Europe - A systematic review.}, journal = {AIMS public health}, volume = {13}, number = {2}, pages = {485-512}, pmid = {42459265}, issn = {2327-8994}, abstract = {BACKGROUND: Nursing care involves both cognitive and emotional aspects, significantly impacting nurses' professional quality of life (ProQOL). This systematic review investigated the factors affecting nurses' professional quality of life in Europe.
METHODS: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting framework and was registered in the International Prospective Register of Systematic Reviews (registration number: CRD420251133948). Searches were conducted in PubMed, Scopus, CINAHL, ScienceDirect, and EBSCOhost from inception to August 2025. Eligible peer-reviewed quantitative studies from European Union countries utilized the ProQOL instrument, reporting on all three dimensions: compassion satisfaction, burnout, and secondary traumatic stress. Two reviewers independently screened records, extracted data, and appraised methodological quality using the Joanna Briggs Institute critical appraisal tool.
RESULTS: A total of 3407 records were initially identified, and 35 studies were ultimately included, comprising 8580 nursing staff across diverse clinical settings, predominantly hospitals, with 13 studies conducted during the coronavirus disease period in 2019. Most studies reported moderate levels of compassion satisfaction and moderate levels of burnout and secondary traumatic stress. Higher compassion satisfaction was generally associated with greater age and professional experience, relevant education and training, work engagement, supportive work environments, better perceived control over workload, and stronger psychosocial resources, including resilience, psychological flexibility, self-compassion, mindfulness, and social support. Higher burnout and secondary traumatic stress related to indirect exposure were consistently linked to a high workload, overtime, rotating schedules, job stress, workplace violence, employment in high-intensity clinical areas, and adverse psychological states, including persistent stress, fear related to the coronavirus disease, and moral distress.
CONCLUSIONS: Professional quality of life among European nursing staff is influenced by a combination of demographic, occupational, and psychosocial factors. Multilevel strategies addressing organizational stressors while strengthening individual and team-based resources are warranted to improve compassion satisfaction and reduce burnout and secondary traumatic stress.}, }
@article {pmid42459266, year = {2026}, author = {Du, D and Sun, G and Yuan, L and Yao, Y and Yang, T and Gao, J and Zhang, L}, title = {Internet healthcare in Chinese public hospitals: Towards high-quality development (1986-present).}, journal = {AIMS public health}, volume = {13}, number = {2}, pages = {598-621}, pmid = {42459266}, issn = {2327-8994}, abstract = {BACKGROUND: Internet healthcare has become a key part of China's hospital-centered health system. Driven by "Internet Plus Healthcare", Healthy China 2030, and public-hospital high-quality development policies, it has evolved from remote consultation experiments into regulated online-offline care pathways. This review traces its development from the first documented remote medical practice in 1986 to the present, focusing on policy, institutional models, clinical evidence, governance challenges, and reform.
METHODS: We conducted a structured narrative review of English- and Chinese-language sources on internet healthcare in Chinese public hospitals. PubMed/MEDLINE, Web of Science Core Collection, China National Knowledge Infrastructure (CNKI), and official policy sources were searched. Eligible sources addressed internet hospitals, telemedicine, online follow-ups, remote monitoring, e-prescriptions, insurance payments, digital governance, clinical outcomes, patient safety, equity, or implementation barriers in mainland China.
RESULTS: Internet healthcare progressed through early telemedicine, institutional network expansion, internet-hospital development, and pandemic-driven normalization. The 2018 regulatory framework positioned internet hospitals as extensions of licensed physical medical institutions, thereby permitting online follow-ups for common and chronic diseases while preserving offline accountability. During COVID-19, online consultation, e-prescriptions, drug delivery, and insurance payments rapidly expanded. Evidence suggests benefits for chronic disease management, medication adherence, cardiovascular secondary prevention, and reduced travel burden. However, evidence remains limited for diagnostic accuracy, adverse events, emergency escalation, and long-term outcomes. Persistent barriers include quality variation, workload, cybersecurity, data fragmentation, artificial intelligence (AI) accountability, reimbursement design, regional inequity, and digital exclusion among older adults.
CONCLUSION: China's model may be understood as a hospital-centered extension of public-hospital functions rather than a stand-alone virtual-care system. Future development should prioritize outcome-based evaluations, safety governance, equitable access, data interoperability, and accountability for internet-based and AI-assisted care.}, }
@article {pmid42459503, year = {2026}, author = {Larrain, D and Parker, CM}, title = {Beyond Prison Walls: A Scoping Review of Incarceration's Public Health Impacts in Latin America.}, journal = {Wellcome open research}, volume = {11}, number = {}, pages = {193}, pmid = {42459503}, issn = {2398-502X}, abstract = {BACKGROUND: Incarceration has vast and unequal impacts on public health beyond prison walls. Research from the United States documents these collateral consequences, including elevated mental illness and morbidity for the children and partners of incarcerated individuals, alongside community-level effects such as increased rates of teenage pregnancy and multidrug-resistant tuberculosis. In Latin America, however, these broader health impacts remain critically understudied. A significant barrier is the absence of data collection efforts or theoretical frameworks for mapping how Latin America's prisons affect the health of families and surrounding communities.
OBJECTIVE: This scoping review synthesises existing evidence on the collateral health consequences of incarceration in Latin America by conducting a comprehensive search in 2025 that included English, Spanish and Portuguese language peer-reviewed studies.
RESULTS: From 17 included documents, prisons emerge as epicentres for tuberculosis transmission to visiting families and surrounding communities. The evidence reveals significant mental and physical health burdens on families. Women with incarcerated partners experience depression and anxiety whilst managing economic strain and expanded caregiving responsibilities, often neglecting their own health. Children of incarcerated parents show marked emotional distress, and incarcerated mothers alongside their young children face severely inadequate healthcare access within detention spaces.
CONCLUSIONS: Despite collecting demographic data, most studies overlook how these burdens fall unequally across racialised populations. Future research must centre ethnoracial disparities and situated knowledge.}, }
@article {pmid42460684, year = {2026}, author = {Foláyan, MO and Arobo, A and Oyeyemi, E and Bhayat, A and Tantawi, ME}, title = {Integrating Oral Health Into Pandemic Preparedness and Response: Missed Opportunities and Strategic Imperatives for Global Health System Resilience and Security.}, journal = {Community dentistry and oral epidemiology}, volume = {}, number = {}, pages = {}, doi = {10.1111/cdoe.70092}, pmid = {42460684}, issn = {1600-0528}, abstract = {BACKGROUND: Despite evidence linking oral health to severe COVID-19 outcomes and its potential role in surveillance and service delivery, integration remained absent. This study enquired about: (1) representation of oral health in national COVID-19 taskforces and funding; (2) policy-level barriers to inclusion; (3) lessons from maintaining essential services; and (4) strategies for mobilizing oral health professionals in future emergencies.
METHODS: We conducted a scoping review guided by the PRISMA-ScR framework. Systematic searches were performed in PubMed/MEDLINE and Scopus (2000-2025) using tailored search strings combining key terms: oral health, pandemic preparedness, COVID-19, dentistry, health systems and related MeSH terms. Eligible evidence included peer-reviewed studies, reviews, policy documents and commentaries in English. Non-human studies were excluded. Data were charted using the WHO Health System Building Blocks framework.
RESULTS: After dual-reviewer screening, 2569-3860 records were screened, yielding 5-8 eligible studies per question (26 studies total). The evidence revealed a consistent narrative of systemic exclusion yet operational resilience. For representation, oral health professionals were almost universally absent from national COVID-19 task forces, with dedicated financial support entirely lacking. Regarding barriers, policy integration was hindered by the framing of oral care as non-essential, its omission from global health security architectures like the International Health Regulations, and limited professional advocacy. In contrast, lessons from service adaptation demonstrated that essential care was maintained through the rapid adoption of triage, teledentistry, robust infection control and effective communication. On workforce mobilization, while consensus existed on the potential for OHPs to expand into roles such as vaccination and surveillance, implementation was obstructed by a lack of pre-emergency training, formal deployment mechanisms and regulatory frameworks with minimal linkage to international instruments.
CONCLUSION: The review reflects systemic neglect of oral health, with the literature dominated by descriptions of clinical and operational adaptations rather than formal policy integration. We identify missed opportunities in leveraging OHPs for pandemic response and propose embedding oral health within One Health governance, financing, surveillance and emergency response structures to build more resilient health systems.}, }
@article {pmid42461048, year = {2026}, author = {Översti, S and Lytras, S and Kawakubo, S and Ito, J and Ghafari, M}, title = {From sites to structure to serology: a roadmap for structure-aware molecular evolution of antigenically evolving viruses.}, journal = {Journal of virology}, volume = {}, number = {}, pages = {e0168725}, doi = {10.1128/jvi.01687-25}, pmid = {42461048}, issn = {1098-5514}, abstract = {The genomic deluge has pushed viral molecular evolution into a site-resolved era. For antigenically evolving viruses such as influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), dense genomic sampling now supports mutation-annotated phylogenies and per-site estimates of mutation and substitution processes. These data highlight strong effects of sequence context, genomic region, RNA structure, and protein-level constraints that are blurred by classic uniform substitution models. In parallel, accurate structure prediction and emerging structure-aware phylogenetic and machine-learning approaches provide practical ways to map mutations onto three-dimensional constraints, identify structurally plausible escape routes, and interpret evolutionary rate variation through solvent exposure, packing, stability, glycosylation, receptor-binding interfaces, and epitope geometry. Finally, antigenic cartography translates some forms of genetic change into an epidemiologically meaningful phenotype-antigenic distance-while predictive modeling increasingly enables sequence-to-antigenicity inference for variants that have not yet been tested experimentally. Here, we outline a practical framework linking sites, structure, and serology for viruses in which antigenic evolution is a major component of immune escape and lineage turnover; highlight why genetic and antigenic "clocks" can diverge; and discuss how integrating genomic surveillance data, phylogenetics, structural analysis, and predictive modeling could support more prospective variant assessment and improved vaccine and therapeutic design.}, }
@article {pmid42461075, year = {2026}, author = {Hashemi, S and Pati, D}, title = {Healthcare Design for Pandemic Resilience: A Systems Thinking Approach.}, journal = {HERD}, volume = {}, number = {}, pages = {19375867261466289}, doi = {10.1177/19375867261466289}, pmid = {42461075}, issn = {2167-5112}, abstract = {BackgroundThe COVID-19 pandemic created unprecedented operational challenges (such as surge-capacity demands and infection-control requirements) that disturbed the equilibrium of healthcare work systems worldwide. Physical environments can play a pivotal role in mitigating or exacerbating these challenges.PurposeThis article aims to strengthen healthcare-system resilience in future pandemics by synthesizing the findings of existing literature to identify environmental factors that supported or hindered healthcare work systems during the COVID-19 pandemic.MethodsWe conducted a systematic search of the CINAHL, MEDLINE, PubMed, and ScienceDirect databases and complemented this search with handsearching. We included studies if they addressed the COVID-19 pandemic, focused on physical healthcare environments, and were published in English in peer-reviewed journals. With a focus on environmental influences, we deductively coded the findings using components of the Systems Engineering Initiative for Patient Safety (SEIPS) model.ResultsForty-two studies met the inclusion criteria. The analysis revealed six major operational challenges: (1) surge capacity, (2) infection control, (3) increased risk of errors, (4) rethinking of care models, (5) financial losses, and (6) the pandemic's adverse psychological impacts on staff and patients. The article documents environmental factors that influenced either the overall healthcare work system or its individual components during the COVID-19 pandemic. We identified three overarching roles for these environmental factors: they served as barriers, solutions, or facilitators.ConclusionsUsing the SEIPS framework can enable well-orchestrated pandemic-response planning by guiding the creation of design strategies that will strengthen resilience, flexibility, and safety in future health crises.}, }
@article {pmid42461270, year = {2026}, author = {Farrag, MA}, title = {The Role of Artificial Intelligence and Machine Learning in Predictive Virology: Forecasting, Tracking, and Combating Viral Threats.}, journal = {Vector borne and zoonotic diseases (Larchmont, N.Y.)}, volume = {}, number = {}, pages = {15303667261469037}, doi = {10.1177/15303667261469037}, pmid = {42461270}, issn = {1557-7759}, abstract = {The escalating threat of viral pandemics, dramatically illustrated by the COVID-19 crisis, has exposed the critical shortcomings of conventional reactive virology in addressing rapidly evolving pathogens. This review introduces predictive virology (PV) as an artificial intelligence (AI)-driven discipline within broader epidemic intelligence and public health surveillance that uses advanced computational tools to forecast viral threats and accelerate countermeasure design. The current review systematically examines how AI-driven approaches (e.g., machine learning and deep learning) are reshaping virology by integrating vast genomic datasets, multimodal surveillance signals, and advanced computational models to anticipate viral emergence and evolution before widespread transmission occurs. Core pillars of PV discussed include zero-shot mutational fitness and antigenic escape prediction using large protein language models; multimodal early-warning systems that fuse wastewater monitoring, digital epidemiology, mobility data, and social media; neural differential equation-based transmission modeling; generative AI for de novo design of broad-spectrum antivirals and vaccines; and ecological risk assessment of zoonotic spillovers. In retrospective benchmarks against deep mutational scanning experiments and real-world epidemiological outcomes (SARS-CoV-2 variants, influenza, and other outbreaks), several AI-powered tools have demonstrated performance comparable to or exceeding traditional methods, although prospective validation at scale remains limited. Despite remarkable progress, significant challenges persist, including data bias, overfitting to historical patterns, lack of prospective validation, and limited generalizability across settings. In addition, there are concerns about mechanistic interpretability, equitable global data integration, and responsible deployment. This review also critically addresses the ethical, governance, and equity implications of deploying predictive capabilities at a global scale. By consolidating cutting-edge AI methodologies with virological insights and acknowledging current limitations, this work provides a comprehensive framework for transitioning virology from a reactive to a truly predictive discipline, ultimately strengthening global health security and pandemic preparedness.}, }
@article {pmid42461676, year = {2026}, author = {Mace, SE and Doyle, CJ and Biddinger, PD and Bradin, S and Burdash, S and Lefort, R and Noll, S and Moriber, MR and Cornelius, A}, title = {Disaster preparedness for vulnerable populations during a pandemic: Part 1: Pandemics: Overview, history, and vulnerability for a pandemic.}, journal = {American journal of disaster medicine}, volume = {21}, number = {2}, pages = {109-118}, doi = {10.5055/ajdm.0531}, pmid = {42461676}, issn = {1932-149X}, mesh = {Humans ; *Vulnerable Populations ; *Pandemics/history ; COVID-19/epidemiology ; *Disaster Planning/organization & administration ; Pandemic Preparedness ; SARS-CoV-2 ; *Surge Capacity/organization & administration ; *Pneumonia, Viral/epidemiology ; *Coronavirus Infections/epidemiology ; United States ; }, abstract = {OBJECTIVE: To provide an overview of the literature on disaster preparedness regarding surge capacity, with a particular focus on vulnerable populations during a pandemic.
DESIGN: The Disaster Preparedness and Response Committee of the American College of Emergency Physicians addressed the topic of vulnerable populations during a pandemic. A workgroup of nine physicians with academic and/or disaster deployment experience was formed. A literature review focused on individuals with access and functional needs, also referred to as special healthcare needs (SHCNs) or vulnerable individuals, was performed. Search terms included pandemic, public health emergency of international concern, disaster, COVID-19, vulnerable population, individuals with access and functional needs, special healthcare needs (SHCN), surge capacity, and CMIST (communications, medical care, independence, supervision, and transportation). Search strategies included medical sources such as PubMed, Medline, Google Scholar, ScienceDirect, Scopus, and the Cochrane Database of Systematic Reviews. Reviews were performed by a librarian. In addition, relevant articles from the bibliographies of included studies and more recent articles identified by committee members were included. The workgroup evaluated the literature and identified issues regarding surge capacity occurring during a pandemic that particularly impacted the SHCN population. Potential solutions were identified.
RESULTS: Vulnerable individuals are at greater risk during a pandemic than the general population, although potential solutions to mitigate the impact of a pandemic on vulnerable individuals are possible.
CONCLUSIONS: Although pandemics can have significant adverse effects on the general population, vulnerable individuals have the greatest morbidity and mortality and are at greatest risk. Efforts are warranted to better address the negative impact of a pandemic, not just for the general population, but also for individuals with access and functional needs, and to find solutions that can help mitigate the consequences of a pandemic.}, }
@article {pmid42461677, year = {2026}, author = {Mace, SE and Doyle, CJ and Biddinger, PD and Bradin, S and Burdash, S and Lefort, R and Noll, S and Moriber, MR and Cornelius, A}, title = {Disaster preparedness for vulnerable populations during a pandemic: Part 2: The origins of a pandemic: Emerging infectious diseases, bioterrorism, and laboratory accidents.}, journal = {American journal of disaster medicine}, volume = {21}, number = {2}, pages = {119-131}, doi = {10.5055/ajdm.0527}, pmid = {42461677}, issn = {1932-149X}, mesh = {Humans ; *Vulnerable Populations ; *Pandemics ; *Bioterrorism ; *Disaster Planning/organization & administration ; COVID-19 ; *Communicable Diseases, Emerging/epidemiology ; Surge Capacity/organization & administration ; Pandemic Preparedness ; SARS-CoV-2 ; *Pneumonia, Viral/epidemiology ; *Coronavirus Infections/epidemiology ; }, abstract = {OBJECTIVE: To provide an overview of the literature on disaster preparedness regarding surge capacity with a particular focus on vulnerable populations during a pandemic.
DESIGN: The Disaster Preparedness and Response Committee of the American College of Emergency Physicians addressed the topic of vulnerable populations during a pandemic. A workgroup of nine physicians with academic and/or disaster deployment experience was formed. A literature review focused on individuals with access and functional needs, also referred to as special healthcare needs (SHCN) or vulnerable individuals, was performed. Search terms included pandemic, public health emergency of international concern (PHEIC), disaster, COVID-19, vulnerable population, individuals with access and functional needs, special health care needs (SHCN), surge capacity, and CMIST (communications, medical care, independence, supervision, and transportation). Search strategies included medical sources such as PubMed, Medline, Google Scholar, ScienceDirect, Scopus, and the Cochrane Database of Systematic Reviews. Reviews were performed by a librarian. In addition, relevant articles from the bibliographies of included studies and more recent articles identified by committee members were included. The workgroup evaluated the literature and identified issues regarding surge capacity occurring during a pandemic that particularly impacted the SHCN population. Potential solutions were identified.
RESULTS: Vulnerable individuals are at greater risk during a pandemic than the general population, although potential solutions to mitigate the impact of a pandemic on vulnerable individuals are -possible.
CONCLUSIONS: Although pandemics can have significant adverse effects on the general population, vulnerable individuals have the greatest morbidity and mortality and are at the greatest risk. Efforts are warranted to better address the negative impact of a pandemic, not just for the general population but also for individuals with access and functional needs, and to find solutions that can help mitigate the consequences of a pandemic.}, }
@article {pmid42461678, year = {2026}, author = {Mace, SE and Doyle, CJ and Biddinger, PD and Bradin, S and Burdash, S and Lefort, R and Noll, S and Moriber, MR and Cornelius, A}, title = {Disaster preparedness for vulnerable populations during a pandemic: Part 3: Surge capacity and communications in a pandemic.}, journal = {American journal of disaster medicine}, volume = {21}, number = {2}, pages = {133-148}, doi = {10.5055/ajdm.0525}, pmid = {42461678}, issn = {1932-149X}, mesh = {Humans ; *Vulnerable Populations ; *Pandemics ; *Surge Capacity/organization & administration ; COVID-19/epidemiology ; *Disaster Planning/organization & administration ; Pandemic Preparedness ; SARS-CoV-2 ; *Pneumonia, Viral/epidemiology ; *Coronavirus Infections/epidemiology ; United States ; }, abstract = {OBJECTIVE: To provide an overview of the literature on disaster preparedness regarding surge capacity with a particular focus on vulnerable populations during a pandemic.
DESIGN: The Disaster Preparedness and Response Committee of the American College of Emergency Physicians addressed the topic of vulnerable populations during a pandemic. A workgroup of nine physicians with academic and/or disaster deployment experience was formed. A literature review focused on individuals with access and functional needs, also referred to as special healthcare needs (SHCN) or vulnerable individuals, was performed. Search terms included pandemic, public health emergency of international concern (PHEIC), disaster, COVID-19, vulnerable population, individuals with access and functional needs, special health care needs (SHCN), surge capacity, and communications, medical care, independence, supervision, and transportation (CMIST). Search strategies included medical sources such as PubMed, Medline, Google Scholar, ScienceDirect, Scopus, and the Cochrane Database of Systematic Reviews. Reviews were performed by a librarian. In addition, relevant articles from the bibliographies of included studies and more recent articles identified by committee members were included. The workgroup evaluated the literature and identified issues regarding surge capacity occurring during a pandemic that particularly impacted the SHCN population. Potential solutions were identified.
RESULTS: Vulnerable individuals are at greater risk during a pandemic than the general population, although potential solutions to mitigate the impact of a pandemic on vulnerable individuals are possible.
CONCLUSIONS: Although pandemics can have significant adverse effects on the general population, vulnerable individuals have the greatest morbidity and mortality and are at the greatest risk. Efforts are warranted to better address the negative impact of a pandemic, not just for the general population but also for individuals with access and functional needs, and to find solutions that can help mitigate the consequences of a pandemic.}, }
@article {pmid42461679, year = {2026}, author = {Mace, SE and Doyle, CJ and Biddinger, PD and Bradin, S and Burdash, S and Lefort, R and Noll, S and Moriber, MR and Cornelius, A}, title = {Disaster preparedness for vulnerable populations during a pandemic: Part 4: Pandemics: Planning for those with access and functional needs in a pandemic.}, journal = {American journal of disaster medicine}, volume = {21}, number = {2}, pages = {149-159}, doi = {10.5055/ajdm.0526}, pmid = {42461679}, issn = {1932-149X}, mesh = {Humans ; *Vulnerable Populations ; *Disaster Planning/organization & administration ; *Pandemics ; *Surge Capacity/organization & administration ; *Health Services Accessibility ; Pandemic Preparedness ; COVID-19/epidemiology ; Health Services Needs and Demand ; }, abstract = {OBJECTIVE: To provide an overview of the literature on disaster preparedness regarding surge capacity with a particular focus on vulnerable populations during a pandemic.
DESIGN: The Disaster Preparedness and Response Committee of the American College of Emergency Physicians addressed the topic of vulnerable populations during a pandemic. A workgroup of nine physicians with academic and/or disaster deployment experience was formed. A literature review focused on individuals with access and functional needs, also referred to as special healthcare needs (SHCN) or vulnerable individuals, was performed. Search terms included pandemic, public health emergency of international concern (PHEIC), disaster, vulnerable population, individuals with access and functional needs, special health care needs (SHCN), surge capacity, and communications, medical care, independence, supervision, and transportation (CMIST). Search strategies included medical sources such as PubMed, Medline, Google Scholar, ScienceDirect, Scopus, and the Cochrane Database of Systematic Reviews. Reviews were performed by a librarian. In addition, relevant articles from the bibliographies of included studies and more recent articles identified by committee members were included. The workgroup evaluated the literature and identified issues regarding surge capacity occurring during a pandemic that particularly impacted the SHCN population. Potential solutions were identified.
RESULTS: Vulnerable individuals are at greater risk during a pandemic than the general population, although potential solutions to mitigate the impact of a pandemic on vulnerable individuals are possible.
CONCLUSIONS: Although pandemics can have significant adverse effects on the general population, vulnerable individuals have the greatest morbidity and mortality and are at the greatest risk. Efforts are warranted to better address the negative impact of a pandemic, not just for the general population but also for individuals with access and functional needs, and to find solutions that can help mitigate the consequences of a pandemic.}, }
@article {pmid42461883, year = {2026}, author = {Sheybani, F and Haddad, M}, title = {Community-Acquired CNS Infections in Western Asia (2010-2025): A Systematic Review.}, journal = {Neuroepidemiology}, volume = {}, number = {}, pages = {1-22}, doi = {10.1159/000553536}, pmid = {42461883}, issn = {1423-0208}, abstract = {UNLABELLED: Background / Objective: This systematic review aimed to summarize the epidemiology, etiology, diagnostic challenges, antimicrobial resistance, and clinical outcomes of community-acquired central nervous system (CNS) infections in Western Asian countries.
METHODS: A systematic search of PubMed was conducted for studies published from January 2010 to July 2025. Eligible studies included original research and case reports on CNS infections, while unrelated studies or studies outside Western Asia were excluded. Data were extracted and synthesized narratively by pathogen group. Risk of bias was assessed based on study design, sample size, and methodological quality.
RESULTS: Of 1,790 retrieved articles, 450 studies met the inclusion criteria, including case reports and observational studies across neonates, children, and adults. Streptococcus pneumoniae and Neisseria meningitidis were the most common bacterial pathogens; Listeria monocytogenes and multidrug-resistant Gram-negative organisms were notable. Among viral pathogens, Enteroviruses, herpes simplex virus type 1, and West Nile virus predominated, with increasing reports of post-COVID-19 autoimmune encephalitis. Tuberculous meningitis and neurobrucellosis remained significant causes of chronic CNS infections in endemic areas. Pneumococcal penicillin resistance exceeded 40% in some countries. Molecular diagnostic capacity and surveillance were limited.
LIMITATIONS: Evidence was limited by heterogeneity in study design, regional data gaps, and variable reporting of antimicrobial resistance, which may affect the comprehensiveness of the review. Conclusions / Interpretation: Community-acquired CNS infections continue to impose a substantial health burden in Western Asia. Expanded vaccination, improved molecular diagnostics, strengthened surveillance, and regional antimicrobial resistance monitoring are essential to reduce preventable mortality and long-term neurological sequelae.}, }
@article {pmid42462434, year = {2026}, author = {Wołowiec, Ł and Wesołowska, W and Skibicka, K and Jaśniak, A and Banach, J and Osiak, J and Wołowiec, A and Skibicki, T and Grześk, G}, title = {Pleiotropic effects of direct oral anticoagulants on the coagulation-inflammation-endothelium axis: A phenotype-stratified narrative review.}, journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie}, volume = {202}, number = {}, pages = {119768}, doi = {10.1016/j.biopha.2026.119768}, pmid = {42462434}, issn = {1950-6007}, abstract = {AIMS: Direct oral anticoagulants (DOACs) - dabigatran (a thrombin inhibitor) and rivaroxaban, apixaban, and edoxaban (factor Xa [FXa] inhibitors) - modify oxidative stress, endothelial inflammation, and barrier integrity beyond anticoagulation. We ask whether this reflects distinct pharmacology or silencing of proteases at protease-activated receptors (PARs), and propose a three-condition framework for when it becomes clinically measurable.
METHODS: Narrative review (PubMed, Scopus, Web of Science; primary search 2019-2026, with foundational earlier references retained) with claims graded on a six-tier hierarchy; A‡ marks trials formally negative or inconclusive owing to insufficient statistical power.
RESULTS: DOAC effects largely converge on one node - reduced PAR-1 signalling under thrombin inhibition and dual PAR-1/PAR-2 blockade under FXa inhibition - rather than independent targets; the FXa-PAR-2 axis is cross-validated across macrophages, liver sinusoidal endothelial cells, and neutrophils; and dabigatran plausibly differs qualitatively rather than only in degree - a working hypothesis whose mechanistic linchpin (residual exosite-I signalling) currently rests on a single unreplicated in-vitro study (level D). Clinically the signal sorts by phenotype and disease phase, not class: low-dose rivaroxaban benefits stable atherosclerosis (COMPASS) but not heart failure in sinus rhythm (COMMANDER-HF), and COVID-19 benefit appears only in convalescence (MICHELLE), not acutely or in outpatients (ACTIV-4B, A‡). A nationwide cohort linked DOACs to lower acute kidney injury and chronic kidney disease progression than vitamin K antagonists, pending separation from their nephrotoxicity.
CONCLUSIONS: Pleiotropy emerges where three conditions coincide - the protease is available at PARs, its generation is chronic, and PAR signalling is rate-limiting. This supports within-indication molecule selection (selection, not extension) and biomarker co-primary trials, not extension of indications.}, }
@article {pmid42463201, year = {2026}, author = {Byambasuren, O and Atkins, T and Baptista, S and Glasziou, P and Chakraborty, S}, title = {Effect of low-dose naltrexone for long COVID: a systematic review and meta-analysis.}, journal = {BMJ open}, volume = {16}, number = {7}, pages = {e111253}, doi = {10.1136/bmjopen-2025-111253}, pmid = {42463201}, issn = {2044-6055}, mesh = {Humans ; *Naltrexone/administration & dosage/therapeutic use ; Post-Acute COVID-19 Syndrome ; *COVID-19 Drug Treatment ; *Narcotic Antagonists/administration & dosage/therapeutic use ; Quality of Life ; Fatigue/drug therapy/etiology ; *COVID-19/complications ; SARS-CoV-2 ; }, abstract = {OBJECTIVE: Long covid is a debilitating chronic condition, and the effect of low-dose naltrexone (LDN) on its symptoms is unclear. We aimed to determine the effectiveness of LDN on symptoms of long covid.
DESIGN: Systematic review and meta-analysis.
DATA SOURCES: PubMed, Embase and Cochrane Library for published studies; ClinicalTrials.gov and WHO International Clinical Trials Registry Platform (ICTRP) for registered ongoing studies were searched through 5 May 2026.
ELIGIBILITY CRITERIA: We included randomised controlled trials and pre-post studies of patients with long covid reporting on fatigue, quality of life, cognitive symptoms or function and other long covid symptoms.
DATA EXTRACTION AND SYNTHESIS: Two independent reviewers used standardised methods to search, screen and select included studies. Risk of bias was assessed using the Newcastle-Ottawa Scale. Meta-analysis was conducted using random effects models.
RESULTS: Of 397 titles and abstracts screened, no randomised controlled trials were identified. Four observational pre-post studies from the USA and Ireland (n=155) met inclusion criteria. LDN doses varied from 1 mg/day to 6 mg/day. Pooled pre-post analyses showed moderate effects for reducing fatigue (Hedges' g=-0.74; 95% CI -1.11 to -0.37; p<0.001), brain fog (Hedges' g=-0.53; 95% CI -1.01 to -0.05; p=0.03) and improving sleep quality (Hedges' g=-0.60; 95% CI -0.91 to -0.30; p=0.0001), and large effects for pain (Hedges' g=-0.93; 95% CI -1.29 to -0.57; p<0.001) and daily functioning (Hedges' g=-0.93; 95% CI -1.29 to -0.57; p<0.0001) in favour of LDN. Heterogeneity ranged from 0% to 62%. No serious adverse events were reported in the two studies that assessed safety.
CONCLUSION: Limited evidence from small pre-post studies suggests LDN may improve fatigue, cognition, sleep, pain and functioning in long covid. However, certainty of evidence is low. Well-powered trials are needed to confirm efficacy, determine dosing and duration and identify subgroups most likely to benefit.
TRIAL REGISTRATION: https://doi.org/10.17605/OSF.IO/C2VKX.}, }
@article {pmid42464199, year = {2026}, author = {Pham, ANQ and Akram, I and Tiwana, MH and Smith, J}, title = {Waiting times for primary care appointments among older adults: a scoping review.}, journal = {BMC public health}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12889-026-28406-w}, pmid = {42464199}, issn = {1471-2458}, abstract = {BACKGROUND: Healthcare service waiting times have worsened due to the COVID-19 pandemic, particularly impacting older adults who need timely access to primary care to manage chronic conditions and prevent hospitalizations. This scoping review aims to fill a research gap by examining whether delays in primary care appointments for older adults occurred and, if so, how these delays have affected their access to primary care, with a focus on the role of social determinants of health.
METHODS: Following PRISMA guidelines, a systematic search was conducted across three health databases-MEDLINE (Ovid), CINAHL, and EMBASE-as well as one AI platform (typeset.io). To be included, articles needed to discuss waiting times for primary care appointments, include older adults in their target population, and be published in English since 2014. Non-English articles were excluded due to language proficiency constraints among the review team. The review also examined the impact of social determinants of health on equity in access to care.
RESULTS: This review identified a significant lack of research on primary care waiting times for older adults, with only twelve studies addressing the issue. Findings indicate that prolonged wait times act as a major barrier to accessing timely care, resulting in patient frustration, delayed treatment, and increased reliance on emergency services. The COVID-19 pandemic has exacerbated these challenges, particularly through care interruptions and the shift to virtual care, which is understudied regarding its impact on waiting times.
CONCLUSIONS: Prolonged waiting times for primary care disproportionately affect older adults, exacerbated by age-related health conditions and intersecting social determinants. Healthcare systems must address these barriers and prioritize research into tailored interventions to ensure equitable access to care for older adults.}, }
@article {pmid42465772, year = {2026}, author = {Feya, Q and Mkhize-Kwitshana, ZL and Milase, RN and Wadee, A and Naidoo, N and Maiga, M and Senzani, S and Nakiyingi, L and Mvubu, NE}, title = {Molecular signaling in coinfection: how M. tuberculosis and respiratory viruses rewire host immunity and alter TB outcomes.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1863302}, pmid = {42465772}, issn = {1664-3224}, mesh = {Humans ; *Coinfection/immunology ; *Mycobacterium tuberculosis/immunology ; Signal Transduction/immunology ; Animals ; *Tuberculosis/immunology ; Immunity, Innate ; Host-Pathogen Interactions/immunology ; *Respiratory Tract Infections/immunology ; }, abstract = {Tuberculosis (TB) caused by Mycobacterium tuberculosis (M. tuberculosis) and respiratory viral infections remain major, intersecting global health challenges, and their co-occurrence imposes a disproportionate burden in high-HIV/high-TB regions such as sub-Saharan Africa. Coinfection biology is heterogeneous and dynamic, driven by viral diversity including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza A/B, Respiratory Syncytial Virus (RSV), parainfluenza, metapneumovirus, rhinovirus, adenovirus, and bocavirus, and by the underlying TB stage, from latent and subclinical to active and reactivation disease. Innate sensing pathways, such as Toll-like receptors (TLR), retinoic acid-inducible gene I (RIG-I), and cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING), converge during coinfection, reshaping type I interferon (IFN-I), Nuclear Factor kappa-light-chain-enhancer of activated B cells (NF-κB), and AP-1-driven responses and triggering a network of autocrine and paracrine signaling that reprograms macrophages, dendritic cells, and T-cell subsets. This immune rewiring alters granuloma equilibrium through suppressed Th1/IFN-γ coordination, exaggerated Th17/IL-17-driven neutrophilia, and regulatory T-cell or IL-10-mediated dampening, which together destabilize macrophage activation and tissue architecture. Oxidative stress, mitochondrial dysfunction, and Matrix Metalloproteinases (MMP)-driven matrix remodeling further integrate with these pathways, converting inflammatory signals into epithelial damage, cavitation, and fibrosis. Consequently, disease outcomes depend critically on timing, viral burden, pathogen order, host immune endotype, and TB stage, such that the same virus can either preserve containment or drive progression depending on the local immunological context. Importantly, the effects of respiratory viral coinfection vary across the TB disease continuum, influencing early granuloma formation, latent infection, reactivation risk, and established disease through distinct immunological mechanisms. Host-directed therapies (HDT) targeting interferon, IL-1, TNF, inflammasome, or metabolic checkpoints hold mechanistic promise but exhibit variable clinical translation, underscoring the need for precision approaches that integrate stage- and endotype-specific biomarkers. This narrative review proposes an integrated systems framework that links viral sensing, immune rewiring, granuloma biology, and tissue-remodeling to TB-respiratory virus coinfection, and emphasizes how timing-aware, biomarker-guided strategies can refine diagnosis, clinical management, prognosis, and vaccine design in vulnerable populations.}, }
@article {pmid42466633, year = {2026}, author = {Li, Z and Han, X and Ren, Y}, title = {Global epidemiological and aetiological patterns of hand, foot, and mouth disease: a country-level scoping synthesis.}, journal = {Journal of global health}, volume = {16}, number = {}, pages = {04220}, doi = {10.7189/jogh.16.04220}, pmid = {42466633}, issn = {2047-2986}, mesh = {*Hand, Foot and Mouth Disease/epidemiology/etiology/virology ; Humans ; *Global Health/statistics & numerical data ; Incidence ; Disease Outbreaks ; Enterovirus ; COVID-19/epidemiology ; }, abstract = {BACKGROUND: Hand, foot, and mouth disease (HFMD) has historically been predominantly reported in the Asia-Pacific region, while its global epidemiology and aetiology remain fragmented and incompletely characterised. We aimed to synthesise currently available country-level evidence to describe global epidemiological and aetiological patterns of HFMD.
METHODS: We conducted a country-level scoping synthesis of published studies and publicly available surveillance reports through August 2025. Studies were eligible for inclusion if they reported epidemiological or aetiological data on HFMD at the national or subnational level, including case numbers, incidence, outbreaks, and enterovirus (EV) serotype distributions. We qualitatively synthesised the data, with a focus on surveillance availability, epidemiological trends, and major circulating EV serotypes.
RESULTS: Reported HFMD incidence declined during the COVID-19 pandemic and subsequently rebounded in many settings, in some settings exceeding pre-pandemic levels. Aetiological evidence suggests an increasing circulation of coxsackievirus A6 in multiple regions, with coxsackievirus A16 and EV A71 continuing to co-circulate in specific settings. However, routine epidemiological and aetiological surveillance remained largely concentrated in the Asia-Pacific region. In many other countries, available data were limited and primarily derived from outbreak-driven or sporadic studies. Heterogeneity was observed in surveillance systems and data availability across countries.
CONCLUSIONS: Global HFMD epidemiological and aetiological patterns are characterised by disparities in surveillance capacity and data availability. Developing standardised surveillance and aetiological monitoring is essential to further understand the global landscape of HFMD, improve data comparability, support early detection of epidemiological changes, and inform evidence-based prevention and control strategies.}, }
@article {pmid42466786, year = {2026}, author = {Szynal, D and Olszowski, T}, title = {Nurse burnout as a public health issue and Its impact on patient care quality. A narrative review.}, journal = {Roczniki Panstwowego Zakladu Higieny}, volume = {77}, number = {1}, pages = {21-32}, doi = {10.32394/rpzh/225226}, pmid = {42466786}, issn = {0035-7715}, mesh = {Humans ; *Burnout, Professional/psychology/prevention & control/epidemiology ; *Quality of Health Care ; Quality of Life ; *Nurses/psychology ; Workload/psychology ; Public Health ; Emotional Exhaustion ; }, abstract = {Occupational burnout among nurses is a significant public health issue. It affects both nurses' well-being and the quality of patient care. The aim of this narrative review is to provide a comprehensive synthesis of four key aspects of occupational burnout among nurses, namely its prevalence, determinants, consequences for patient care and mental health, and available prevention strategies. Literature was identified through searches of PubMed and Google Scholar. Articles published in English between 2015 and 2026 were reviewed and selected according to predefined inclusion and exclusion criteria. Burnout develops through the interaction of organizational, psychosocial, and individual factors. The most important contributors include work overload, staffing shortages, low autonomy, psychosocial stress, personality traits, and health status. Higher burnout levels are associated with increased medical errors, patient falls, and missed nursing care. Burnout also contributes to lower patient satisfaction and poorer perceived quality of care. Prolonged stress increases the risk of depression, anxiety, sleep disturbances, reduced psychological resilience, and intentions to leave the profession, negatively impacting nurses' quality of life and social functioning. Effective preventive and therapeutic strategies include mindfulness-based programs, cognitive-behavioral therapy, physical exercise, and resilience training. These interventions may be delivered both in person and digitally. Their effectiveness improves in supportive environments with allocated participation time and leadership engagement. Interventions at individual, team, and system levels reduce emotional exhaustion and depersonalization, enhance staff well-being, and improve patient safety. In the context of a global nursing shortage and increased workloads following the COVID-19 pandemic, multi-level strategies to prevent occupational burnout are essential for protecting nurses' mental health and maintaining high-quality healthcare. The review highlights the importance of multi-level preventive interventions to reduce burnout and improve healthcare outcomes.}, }
@article {pmid42467815, year = {2026}, author = {Mastrovito, B and Abou Chakra, CN and Mahé, C and Nunes, MC}, title = {How Pandemics Have Reshaped the Respiratory Virus Data Landscape in Europe: Scoping Review.}, journal = {Journal of medical Internet research}, volume = {28}, number = {}, pages = {e92917}, doi = {10.2196/92917}, pmid = {42467815}, issn = {1438-8871}, mesh = {Humans ; Europe/epidemiology ; *Respiratory Syncytial Virus Infections/epidemiology ; *Pandemics ; *Influenza, Human/epidemiology ; *COVID-19/epidemiology ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Acute respiratory infections caused by influenza, respiratory syncytial virus (RSV), and SARS-CoV-2 remain a major public health challenge in Europe. Although surveillance systems for these pathogens are well established, the past 2 decades have seen a rapid diversification of data streams supporting surveillance and research. This expanding data landscape, combined with fragmentation across institutions, sectors, and countries, may limit timely evidence synthesis and effective public health decision-making.
OBJECTIVE: This scoping review aimed to identify and characterize data sources used for surveillance and research on influenza, RSV, and SARS-CoV-2 in Europe over the past 20 years, and to examine their evolution over time, their alignment with research objectives, and geographic variation in data availability and use.
METHODS: We conducted a scoping review using an objective-driven analytical framework. Empirical reports published between January 2005 and September 2025 were identified in MEDLINE, Web of Science, and Embase. Eligible reports focused on influenza, RSV, or SARS-CoV-2 and included data from 12 European countries. Clinical and interventional studies were excluded. Reports were classified according to 4 research objectives: epidemiological monitoring, evaluation of interventions, assessment of disease burden and health outcomes, and analyses of population adherence and trust toward public health measures. Data sources were grouped into 9 categories, including surveillance systems, electronic health records (EHRs), registries, claims, surveys, digital, environmental, integrated datasets, and others.
RESULTS: A total of 2564 empirical reports were included. Over time, respiratory virus research relied on an increasingly diverse set of data streams. While surveillance systems remained central, particularly for epidemiological monitoring, their relative dominance declined. From 2020 onward, there was a marked expansion in the use of EHRs, registries, claims data, digital sources, and linked or integrated datasets, alongside increased use of open-access data. Data source use varied by research objective: surveillance data predominated in monitoring and intervention evaluation; EHRs in studies of risk factors and treatment effectiveness; surveys in seroprevalence and public trust analyses; and claims data in assessments of economic burden. Substantial geographic disparities were observed. Northern European countries more frequently used linked and multisource datasets, whereas Southern Europe relied more often on open-access or single-source data.
CONCLUSIONS: This scoping review provides a multipathogen, cross-country mapping of data sources for respiratory virus surveillance and research in Europe over 2 decades, applying an innovative objective-driven framework. Unlike prior reviews focused on single pathogens or data types, it offers a consolidated, comparative perspective based on 2564 reports to inform public health decision-making. The COVID-19 pandemic accelerated innovation in data generation and access, but progress remained largely centered on SARS-CoV-2, while structural fragmentation continues to limit timely, integrated data across Europe. Strengthening preparedness will require interoperable infrastructures, federated analysis platforms, sustainable funding for surveillance innovations, and cross-sectoral data sharing.}, }
@article {pmid42100538, year = {2026}, author = {Muturiki, M and Mapukata, NO and Chauke, L and Jewett, S}, title = {Mental health patterns and associated social determinants among university and college students in sub-Saharan Africa during the COVID-19 pandemic era: a scoping review.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1800724}, pmid = {42100538}, issn = {2296-2565}, mesh = {Humans ; *Social Determinants of Health ; *COVID-19/epidemiology/psychology ; *Students/psychology/statistics & numerical data ; Universities ; *Mental Health/statistics & numerical data ; Africa South of the Sahara/epidemiology ; Sub-Saharan African People ; Pandemics ; *Mental Disorders/epidemiology ; }, abstract = {BACKGROUND: Evidence on student mental health in sub-Saharan Africa (SSA) remains limited, particularly studies examining how mental health patterns intersect with social determinants within higher education institutions (HEIs). This scoping review identifies gaps in the literature documenting student mental health and associated social determinants during the COVID-19 period and highlights priorities for future research in SSA.
METHODS: Eight databases (MEDLINE, PsycInfo, Open Access Journals, CINAHL, Google Scholar, Cochrane Library, ProQuest, Scopus) and grey literature were searched for English-language studies from 2020 to 2023. Sixty-seven studies from 214 full-text articles screened met the inclusion criteria.
RESULTS: The included studies varied widely in their examination of student mental health and its links to social determinants of health (SDOH). Mental health was most frequently assessed in terms of depression, anxiety, suicidality, substance use disorders, and psychological distress. Mood disorders were the most commonly reported outcomes. Few studies explored help-seeking behavior. Reported social determinants aligned with structural factors (socioeconomic and political contexts, cultural norms, gender disparities) and intermediary factors such as academic stress, service access, and behavioral patterns including substance use, physical activity, sleep, and diet.
CONCLUSION: Although many studies addressed social determinants of student mental health in SSA, none provided comparable, multi-country data across HEIs. Most research focused on undergraduate particularly medical students, with limited attention to postgraduate populations. Future work should prioritize multi-country comparative studies and context-specific approaches that strengthen help-seeking and support for at-risk students across diverse SSA settings.}, }
@article {pmid42448413, year = {2026}, author = {Viknesh, K and Vijayalakshmi, P and Alex, AM and Muthumani, LN and Muthupandian, S and Desai, D and Ramanathan, S and Likson, A and Selvaraj, C}, title = {Energetic landscapes and fuzzy complexes: Computational targeting of viral intrinsically disordered proteins.}, journal = {Advances in protein chemistry and structural biology}, volume = {153}, number = {}, pages = {351-407}, doi = {10.1016/bs.apcsb.2026.04.009}, pmid = {42448413}, issn = {1876-1631}, mesh = {Humans ; *Intrinsically Disordered Proteins/chemistry/metabolism/antagonists & inhibitors ; *Viral Proteins/chemistry/metabolism/antagonists & inhibitors ; *Antiviral Agents/chemistry/pharmacology ; SARS-CoV-2 ; Machine Learning ; }, abstract = {The increased recognition of intrinsically disordered proteins (IDPs) as critical mediators in viral infections has shifted attention toward fuzzy drug targets, challenging the conventional structure-based paradigms of drug discovery due to their inherent conformational flexibility. The binding of viral IDPs and IDRs to host factors occurs in dynamic, multivalent, and context-dependent interactions and constitute flexible complexes, which form the basis of pathogenicity and immune evasion. In this review, the disordered proteins of viruses are considered with a combination of molecular, computational, and translational insights to assess the next-generation antiviral targets. In this, we have discuss about the energetic landscapes that control the disorder, functional disorder order transitions and the fuzzy interfaces as centers of the networks of virus-host interactions. Special focus is kept on the new lines of computational and AI-directed technologies such as ensemble-based docking, machine-learning computational models of IDP ligand recognition, and multi-omics-driven target prioritization. The experimental approaches that are modified to characterize disordered systems, including NMR spectroscopy and hybrid structural biology, are also reviewed. The translational applicability of the targeting of viral fuzziness is highlighted by case studies of HIV-1, influenza, SARS-CoV-2, and emerging viral pathogens. We also provide directions about the future involving adaptive pharmacophores, customized antiviral approaches, and AI-driven ensemble targeting making disordered viral proteins a paradigm shift in antiviral drug discovery.}, }
@article {pmid42449828, year = {2026}, author = {Hetta, HF and Haseeb, A and Bukhari, SQ and Alatawi, Z and Mahrous, AJ and Elrggal, ME and Masri, MA and Kotb, AA}, title = {Emerging Multimodal Point-of-Care Diagnostic Strategies for Rapid Detection and Management of Respiratory Viruses: A State-of-the-Art Review.}, journal = {Diagnostics (Basel, Switzerland)}, volume = {16}, number = {13}, pages = {}, doi = {10.3390/diagnostics16132048}, pmid = {42449828}, issn = {2075-4418}, support = {26UQU4310470GSSR02//Umm al-Qura University/ ; 26UQU4310470GSSR03//Umm al-Qura University/ ; }, abstract = {The co-circulation of respiratory viruses, including SARS-CoV-2, influenza A/B, and respiratory syncytial virus (RSV), represents a significant global health challenge that requires rapid, accurate, and differential diagnosis to support infection control and appropriate clinical decision-making. This narrative review summarizes emerging multimodal point-of-care testing (POCT) strategies for the detection and management of these respiratory viruses. Relevant studies were identified through literature searches of major scientific databases, including PubMed, Scopus, and Web of Science, focusing on recent advances in molecular diagnostics, biosensors, microfluidics, and digital health technologies. To improve clinical interpretation and comparative assessment, current POCT platforms were organized into four operational tiers based on infrastructure dependence, degree of portability, and level of decentralization of testing. Tier 1 (Professional Clinical Systems) includes fully integrated automated molecular diagnostic platforms designed for use in hospital and emergency care settings. Tier 2 (Field-Deployable Systems) comprises portable molecular and isothermal amplification technologies designed for use in decentralized or resource-limited environments. Tier 3 (Hardware-Lite Assays) includes simplified diagnostic approaches that minimize instrument requirements and are suitable for near-patient or low-infrastructure settings. Tier 4 (Consumer-Digital Diagnostics) encompasses emerging smartphone- and IoT-integrated diagnostic platforms that support user-driven testing and digital health connectivity. This tier-based framework reflects a proposed stratification of POCT technologies along a decentralization continuum and aims to facilitate comparison and selection of diagnostic strategies across diverse healthcare settings.}, }
@article {pmid42450061, year = {2026}, author = {Lim, S and Martina, B}, title = {Immune Mechanisms and Translational Study Design in Viral Vaccine Development.}, journal = {International journal of molecular sciences}, volume = {27}, number = {13}, pages = {}, doi = {10.3390/ijms27135790}, pmid = {42450061}, issn = {1422-0067}, mesh = {Humans ; Animals ; *Translational Research, Biomedical ; *Viral Vaccines/immunology ; *Vaccine Development/methods ; COVID-19/prevention & control/immunology ; SARS-CoV-2/immunology ; Adaptive Immunity ; Immunity, Innate ; COVID-19 Vaccines/immunology ; }, abstract = {Viral vaccine development requires both mechanistic understanding of protective immunity and translational study designs that connect preclinical data with human outcomes. Animal models remain important for early assessment of safety, immunogenicity and protective efficacy, but their predictive value depends on the question being asked, the pathophysiology of infection, the immune mechanisms expected to mediate protection, and the biomarkers chosen to bridge animal and human data. This review focuses on viral vaccines and examines innate and adaptive mechanisms of vaccine-induced protection, including B cell and antibody responses, Fc-mediated functions, Fc glycosylation, T cell memory and CD8+ cytotoxic responses. We discuss common reasons for clinical failure and show how preclinical endpoints can be classified as human-counterpart, surrogate or comparative/mechanistic readouts. Influenza and COVID-19 examples illustrate how different models can be combined across discovery, challenge, transmission and late-stage bridging studies. Emerging tools such as systems serology, omics, AI/ML and new approach methods can improve candidate prioritization, but their value depends on assay standardization, biological validation and cautious interpretation. A mechanism-driven model cascade, paired with human-relevant immunological readouts, can improve preclinical interpretation and reduce the risk of advancing candidates that are unlikely to succeed in clinical trials.}, }
@article {pmid42450077, year = {2026}, author = {Russjan, E and Zając, D and Kaczyńska, K}, title = {Therapeutic Potential of Glucagon-like Peptide-1 Receptor Agonists in Respiratory Disorders.}, journal = {International journal of molecular sciences}, volume = {27}, number = {13}, pages = {}, doi = {10.3390/ijms27135803}, pmid = {42450077}, issn = {1422-0067}, mesh = {Humans ; *Glucagon-Like Peptide-1 Receptor Agonists ; Pulmonary Disease, Chronic Obstructive/drug therapy ; Glucagon-Like Peptide-1 Receptor/metabolism ; Glucagon-Like Peptide 1/metabolism ; Animals ; COVID-19/metabolism ; Asthma/drug therapy ; Pulmonary Fibrosis/drug therapy ; Sleep Apnea, Obstructive/drug therapy ; SARS-CoV-2 ; }, abstract = {Glucagon-like peptide-1 (GLP-1) is an incretin hormone secreted in response to food intake that acts biologically by binding to GLP-1 receptors. The primary function of GLP-1 is to stimulate insulin secretion and inhibit glucagon secretion, which helps limit after-meal spikes in blood glucose. GLP-1 reduces intestinal contractility, slows down gastrointestinal motility and emptying, and also acts directly on the hypothalamus, thereby regulating appetite and food intake. Due to its metabolic effects, GLP-1 forms the basis of medications currently used to treat type 2 diabetes (T2DM) and obesity. However, it has also been observed that the use of GLP-1 agonists in the treatment of obesity or diabetes has a beneficial effect on comorbid respiratory conditions. This narrative review analyzes the scientific literature and describes the most recent information on the impact of GLP-1 receptor agonist (GLP-1 RA) therapies on the most common respiratory disorders-both the beneficial and undesirable effects. We discuss evidence that acute lung injury, COVID-19, pulmonary fibrosis, asthma, chronic obstructive pulmonary disease (COPD), and obstructive sleep apnea can benefit from therapies with various GLP-1 RAs. They can complement existing lung-targeted treatments, but as research progresses, they are likely to play an ever more important role in the treatment of respiratory diseases.}, }
@article {pmid42450260, year = {2026}, author = {Angamarca-Iguago, J and Parise-Vasco, JM and Reytor-González, C and Cagua-Ordoñez, J and Simancas-Racines, D}, title = {Temporal Dynamics of Innate Immune Activation and Viral Interference During Sequential Co-Infection with Influenza A Virus and SARS-CoV-2: Molecular Mechanisms, Clinical Evidence, and Therapeutic Implications.}, journal = {International journal of molecular sciences}, volume = {27}, number = {13}, pages = {}, doi = {10.3390/ijms27135994}, pmid = {42450260}, issn = {1422-0067}, mesh = {Humans ; *Immunity, Innate ; Animals ; *Influenza A virus/immunology ; *Influenza, Human/immunology/virology/drug therapy ; *SARS-CoV-2/immunology/physiology ; *COVID-19/immunology/virology ; *Coinfection/immunology/virology ; *Viral Interference ; Host-Pathogen Interactions/immunology ; Interferons ; Antiviral Agents/therapeutic use ; }, abstract = {The concurrent circulation of influenza A virus (IAV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has unveiled complex host-pathogen interactions governed by temporal dynamics of innate immune activation. This narrative review synthesizes evidence from human air-liquid interface (ALI) epithelial models, animal studies (hamster, ferret), clinical cohorts, and randomized controlled trials (2015-2026) to delineate the molecular mechanisms underlying viral interference between these two major respiratory pathogens. Prior IAV infection induces a robust type I/III interferon (IFN) response and broad interferon-stimulated gene (ISG) upregulation that restricts subsequent SARS-CoV-2 replication within a critical 24-72 h temporal window. Conversely, SARS-CoV-2 employs a multi-layered immune evasion strategy that blunts IFN induction, providing minimal heterologous protection. Simultaneous co-infection tends to exacerbate disease severity. Host genetic determinants, including OAS1 and TLR7 variants, modulate interference capacity. Therapeutically, early pegylated IFN-λ shows clinical benefit, while experimental evidence from in vitro and animal models suggests oseltamivir may paradoxically reduce IAV-induced interference. These findings underscore the need for multi-pathogen diagnostics, temporally informed clinical decision-making, and IFN-based therapeutic strategies during co-circulation periods.}, }
@article {pmid42450302, year = {2026}, author = {Basu, S and Adhikary, D and Ghosh, K and Chattopadhyay, S and Deb, S and Mondal, R and Roy, J and Chowdhury, A and Benito-León, J}, title = {Machine Learning and Deep Learning Frameworks for Human-Virus Protein-Protein Interaction Prediction: Emerging Architectures, Methods, Benchmarks, and Challenges.}, journal = {International journal of molecular sciences}, volume = {27}, number = {13}, pages = {}, doi = {10.3390/ijms27136034}, pmid = {42450302}, issn = {1422-0067}, mesh = {Humans ; *Deep Learning ; *Machine Learning ; SARS-CoV-2 ; COVID-19/virology ; *Viral Proteins/metabolism ; Host-Pathogen Interactions ; *Protein Interaction Mapping/methods ; Protein Interaction Maps ; Prediction Algorithms ; Betacoronavirus/metabolism ; Benchmarking ; }, abstract = {The outbreak of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has emerged as one of the most significant global health crises in recent history. Coronaviruses are a diverse group of RNA viruses classified into alpha, beta, gamma, and delta genera, with SARS-CoV-2 belonging to the beta-coronavirus family. The virus exhibits high transmissibility and causes a wide spectrum of clinical manifestations ranging from mild respiratory symptoms to severe complications such as acute respiratory distress syndrome, multi-organ failure, and death, particularly among elderly and immunocompromised individuals. Structurally, SARS-CoV-2 possesses a large single-stranded RNA genome encoding major structural proteins, including spike (S), envelope (E), membrane (M), and nucleocapsid (N) proteins, which play critical roles in host-cell recognition and viral infection. Understanding the molecular mechanisms of virus-host interactions, especially protein-protein interactions (PPIs), is essential for uncovering viral pathogenesis and identifying potential therapeutic targets. Traditional experimental techniques for PPI detection, such as yeast two-hybrid and affinity purification methods, are often expensive, labor-intensive, and prone to inaccuracies. Consequently, computational approaches based on machine learning (ML) and deep learning (DL) have gained significant attention for efficient and scalable PPI prediction. These methods use diverse biological information, including protein sequences, structural features, genomic data, Gene Ontology annotations, and interaction networks, to model complex biological relationships. This survey reviews computational approaches to PPI prediction, highlighting ML- and DL-based techniques, methodological advances, performance evaluation practices, and limitations that affect benchmark comparability. It also discusses biological databases and data sources commonly used in PPI studies and explicitly considers how models trained in coronavirus-centered settings may generalize to other viral families with different mechanisms of host interaction.}, }
@article {pmid42450918, year = {2026}, author = {Latzer, Y and Stein, D}, title = {The Impact of Recent Collective Trauma in Israel on Eating Disorders and Disordered Eating: An Overview and Clinical Perspective.}, journal = {Healthcare (Basel, Switzerland)}, volume = {14}, number = {13}, pages = {}, doi = {10.3390/healthcare14131908}, pmid = {42450918}, issn = {2227-9032}, abstract = {Background: Periods of collective crises are associated with substantial deterioration in mental health. Whereas trauma-related psychopathology has received considerable clinical and policy attention during such periods, eating disorders (EDs) and disordered eating (DE) remain comparatively under-recognized. EDs and DE are well recognized in the Israeli context; however, accumulating evidence indicates a significant increase in their prevalence during periods of collective crisis. Objective: We sought to synthesize empirical findings and clinical observations in Israel about the impact of the COVID-19 pandemic and the October 2023 War on the emergence and exacerbation of DE and EDs, and to examine the implications for clinical practice and mental health policy. Methods: We conducted a narrative review integrating epidemiological data, findings from Israeli healthcare organizations, scientific studies, and clinical insights from specialized ED services. Results: Across both crises, Israel experienced a marked increase in the full spectrum of eating-related disturbances, ranging from emotional eating and subclinical DE to severe full-blown EDs. Adolescents and young adults were particularly affected, but increased ED-related disturbance was also observed among adults and individuals with pre-existing EDs. These findings coincide with a prolonged duration period before receiving treatment and with limited service capacity. In response, the mental health system attempted to implement rapid adaptations, including expanded telemedicine, short-term targeted interventions, and new ambulatory and day treatment programs. Conclusions: Our findings indicate that DE and EDs constitute a significant and escalating mental health burden during periods of collective crises that is comparable to other trauma-related conditions. Just as comprehensive short- and long-term intervention frameworks have been developed for trauma-related conditions, similar models are urgently required for EDs.}, }
@article {pmid42452468, year = {2026}, author = {Rada, M and Petculescu, IM and Pah, AM and Avram, A and Velimirovici, DE and Velciov, AB and Tudoran, C and Iurciuc, S and Utu, D and Gheorghe, DR and Craciun, ML}, title = {Valvular Heart Disease and Heart Failure in the Post-COVID-19 Era: A Narrative Review of Mechanisms, Diagnosis, Differential Assessment, and Clinical Outcomes.}, journal = {Journal of clinical medicine}, volume = {15}, number = {13}, pages = {}, doi = {10.3390/jcm15135007}, pmid = {42452468}, issn = {2077-0383}, support = {Victor Babeș University of Medicine and Pharmacy Timișoara//Victor Babeș University of Medicine and Pharmacy Timișoara/ ; }, abstract = {Background/Objectives: Cardiovascular involvement is among the most consequential sequelae of SARS-CoV-2 infection. Myocardial injury, arrhythmia, and thromboembolic disease have been characterized in depth, yet the relationship between COVID-19 and valvular heart disease (VHD), and its interplay with heart failure (HF), has received comparatively limited synthesis. This narrative review consolidates current evidence on the mechanisms, diagnosis, differential assessment, and clinical outcomes linking acute and post-acute COVID-19 to valvular dysfunction and to incident or worsening heart failure, with emphasis on practical implications for cardiologists and internists. Methods: We searched PubMed, Scopus, and Web of Science (January 2020-January 2026) for studies on valvular dysfunction, heart failure, myocardial injury, and endothelial pathology in SARS-CoV-2 infection, and synthesized findings narratively. Results: Convergent pathways-endothelial injury, systemic hyperinflammation, micro- and macrovascular thrombosis, and pressure-volume overload-contribute to functional and, less frequently, structural valvular changes. Available evidence suggests that clinically relevant post-COVID valvular abnormalities are more often secondary/functional (mitral and tricuspid regurgitation) than primary structural lesions, although dedicated prospective valvular studies remain scarce. Pre-existing severe VHD markedly worsens acute COVID-19 prognosis. Elevated NT-proBNP, troponin, and interleukin-6 consistently predict decompensation and mortality, and a substantial minority of survivors show persistent fibrotic pulmonary changes and restrictive ventilatory defects on follow-up (pulmonary rather than cardiac findings). Conclusions: Post-COVID valvular dysfunction appears, on currently available but largely indirect evidence, predominantly functional and inflammation-related, and may overlap with HFpEF phenotypes in selected patients when objective diagnostic criteria are fulfilled. Biomarker-guided, multimodality follow-up is reasonable in high-risk survivors, and prospective longitudinal studies with standardized valvular endpoints remain a priority. Dedicated longitudinal evidence on valvular outcomes specifically remains very limited.}, }
@article {pmid42452593, year = {2026}, author = {Kasiak, P and Procyk, G}, title = {COACH Study: COVID-19 Influence on Cardiorespiratory Fitness in Athletes-A Systematic Review and Meta-Analysis.}, journal = {Journal of clinical medicine}, volume = {15}, number = {13}, pages = {}, doi = {10.3390/jcm15135133}, pmid = {42452593}, issn = {2077-0383}, abstract = {Objectives: We aimed to systematically review and meta-analyze the impact of COVID-19 infection on cardiorespiratory fitness (CRF): (1) within-athlete (the same participants before and after infection), and (2) between-athlete (infected vs. healthy reference participants). Methods: In this systematic review (PROSPERO Registry: CRD42024540430) we included observational studies enrolling recreational or competitive athletes ≥18 years old with laboratory confirmation of SARS-CoV-2 infection. The primary outcome was change in relative maximal oxygen uptake (VO2max). Secondary outcomes included changes in absolute VO2max, maximal ventilation (VEmax), and maximal heart rate (HRmax). We searched Embase, PubMed, Medline, Scopus, and Web of Science up to August 9th, 2025. Risk of bias was assessed with the JBI critical appraisal tool. Meta-analyses were performed with a random-effects model. Results: Twelve studies enrolling a total of 1595 participants met the eligibility criteria. COVID-19 infection was associated with lower relative VO2max (MD = -1.83 mL·kg[-1]·min[-1]; 95%CI [-3.16, -0.49]; p = 0.007; I[2] = 54%) and absolute VO2max (MD = -0.15 L·min[-1]; 95%CI [-0.29, -0.01]; p = 0.03; I[2] = 0%). COVID-19 infection was associated with lower VEmax (MD = -7.99 L·min[-1]; 95%CI [-12.94, -3.04]; p = 0.002; I[2] = 0%) but not with HRmax (MD = -0.34 bpm; 95%CI [-1.54, 0.86]; p = 0.58; I[2] = 0%). High heterogeneity of included studies was addressed with subgroup analyses. The risk of bias in most studies was high. The certainty of evidence was very low for each outcome. Conclusions: COVID-19 infection in athletes was associated with reduced VO2max and VEmax. The relationships were highly dependent on the quality of the studies. CRF and athlete profile should be considered when making shared decisions regarding safe return to sport after infection.}, }
@article {pmid42452704, year = {2026}, author = {Olarewaju, A and Adebowale, A and Odutola, P and Arnold, A}, title = {Use of Natriuretic Peptides in Critically Ill Patients: A Narrative Review.}, journal = {Journal of clinical medicine}, volume = {15}, number = {13}, pages = {}, doi = {10.3390/jcm15135244}, pmid = {42452704}, issn = {2077-0383}, abstract = {Background: Natriuretic peptides, including B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), are established biomarkers of myocardial stress and circulatory overload. Although originally validated for diagnosis and exclusion of heart failure, their diagnostic and prognostic applications have expanded significantly in the context of critical illness. However, interpretation in critically ill patients is complicated by confounding factors such as systemic inflammation and renal dysfunction. Objective: This review synthesizes current evidence on the diagnostic, monitoring, and prognostic applications of natriuretic peptides in critically ill adults. It further outlines practical considerations, confounding variables, and emerging complementary biomarkers pertinent to clinical decision-making. Methods: A structured search of PubMed, Embase, and the Cochrane Library (January 2000 to October 2025) identified studies evaluating BNP, NT-proBNP, and atrial natriuretic peptide (ANP) in intensive care unit (ICU) patients. Eligible studies and review articles assessed diagnostic utility, volume status, hemodynamic monitoring, and prognostic performance. Narrative synthesis was employed using information obtained from eligible studies. Results: Twenty-four studies met the inclusion criteria. BNP and NT-proBNP facilitate differentiation between cardiogenic and noncardiogenic respiratory failure, identification of mixed shock states, and assessment of volume status when used in association with other modalities such as echocardiography and ultrasonography. Elevated natriuretic peptide concentrations consistently predict mortality, acute kidney injury, prolonged mechanical ventilation, and adverse outcomes in several disease states, including sepsis, acute respiratory distress syndrome [ARDS], postoperative cardiac dysfunction, and COVID-19-related critical illness. However, interpretation remains limited by confounders, including renal impairment, age, systemic inflammation, brain injury, mechanical ventilation, and right-ventricular strain/dysfunction. Conclusions: Natriuretic peptides serve as valuable adjuncts for diagnostic assessment, hemodynamic monitoring, and risk stratification in the ICU. When interpreted with attention to biological kinetics and clinical context, these biomarkers enhance multimodal monitoring and support individualized management. Future research should refine ICU-specific cutoffs and assess natriuretic peptide-guided therapeutic strategies in prospective multicenter trials.}, }
@article {pmid36754956, year = {2023}, author = {Levy, ML and Bacharier, LB and Bateman, E and Boulet, LP and Brightling, C and Buhl, R and Brusselle, G and Cruz, AA and Drazen, JM and Duijts, L and Fleming, L and Inoue, H and Ko, FWS and Krishnan, JA and Mortimer, K and Pitrez, PM and Sheikh, A and Yorgancıoğlu, A and Reddel, HK}, title = {Key recommendations for primary care from the 2022 Global Initiative for Asthma (GINA) update.}, journal = {NPJ primary care respiratory medicine}, volume = {33}, number = {1}, pages = {7}, pmid = {36754956}, issn = {2055-1010}, mesh = {Adult ; Child ; Adolescent ; Humans ; *Anti-Asthmatic Agents/therapeutic use ; *Asthma/diagnosis/drug therapy ; Formoterol Fumarate/therapeutic use ; Adrenal Cortex Hormones/therapeutic use ; Administration, Inhalation ; Primary Health Care ; }, abstract = {The Global Initiative for Asthma (GINA) was established in 1993 by the World Health Organization and the US National Heart Lung and Blood Institute to improve asthma awareness, prevention and management worldwide. GINA develops and publishes evidence-based, annually updated resources for clinicians. GINA guidance is adopted by national asthma guidelines in many countries, adapted to fit local healthcare systems, practices, and resource availability. GINA is independent of industry, funded by the sale and licensing of its materials. This review summarizes key practical guidance for primary care from the 2022 GINA strategy report. It provides guidance on confirming the diagnosis of asthma using spirometry or peak expiratory flow. GINA recommends that all adults, adolescents and most children with asthma should receive inhaled corticosteroid (ICS)-containing therapy to reduce the risk of severe exacerbations, either taken regularly, or (for adults and adolescents with "mild" asthma) as combination ICS-formoterol taken as needed for symptom relief. For patients with moderate-severe asthma, the preferred regimen is maintenance-and-reliever therapy (MART) with ICS-formoterol. Asthma treatment is not "one size fits all"; GINA recommends individualized assessment, adjustment, and review of treatment. As many patients with difficult-to-treat or severe asthma are not referred early for specialist review, we provide updated guidance for primary care on diagnosis, further investigation, optimization and treatment of severe asthma across secondary and tertiary care. While the GINA strategy has global relevance, we recognize that there are special considerations for its adoption in low- and middle-income countries, particularly the current poor access to inhaled medications.}, }
@article {pmid36941668, year = {2023}, author = {Bos, LDJ and de Grooth, HJ and Tuinman, PR}, title = {A structured diagnostic algorithm for patients with ARDS.}, journal = {Critical care (London, England)}, volume = {27}, number = {1}, pages = {94}, pmid = {36941668}, issn = {1466-609X}, mesh = {Humans ; Critical Care ; *Emergency Medicine ; *Respiratory Distress Syndrome/diagnosis ; Algorithms ; Intensive Care Units ; }, abstract = {This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2023. Other selected articles can be found online at https://www.biomedcentral.com/collections/annualupdate2023 . Further information about the Annual Update in Intensive Care and Emergency Medicine is available from https://link.springer.com/bookseries/8901 .}, }
@article {pmid40708523, year = {2026}, author = {Lewis, GK and Ciupe, S and Sajadi, M}, title = {Unveiling an Immunological Mystery: Deciphering the Durability Divide in Vaccine-Elicited Antibody Responses.}, journal = {Current HIV research}, volume = {23}, number = {6}, pages = {494-509}, pmid = {40708523}, issn = {1873-4251}, support = {R01 GM152743/GM/NIGMS NIH HHS/United States ; }, mesh = {Humans ; Plasma Cells/immunology ; *Antibody Formation/immunology ; *Antibodies, Viral/immunology ; *COVID-19 Vaccines/immunology ; Animals ; *COVID-19/immunology/prevention & control ; SARS-CoV-2/immunology ; Receptors, Complement 3d/immunology ; AIDS Vaccines/immunology ; Epitopes/immunology ; }, abstract = {Achieving durable antibody-mediated protection remains critical in vaccine development, particularly for viral diseases like COVID-19 and HIV. We discuss factors influencing antibody durability, highlighting the role of long-lived plasma cells (LLPCs) in the bone marrow, which are essential for sustained antibody production over many years. The frequencies and properties of bone marrow LLPC are critical determinants of the broad spectrum of antibody durability for different vaccines. Vaccines for diseases like measles and mumps elicit long-lasting antibodies; those for COVID-19 and HIV do not. High epitope densities in the vaccine are known to favor antibody durability, but we discuss three underappreciated variables that also play a role in long-lived antibody responses. First, in addition to high epitope densities, we discuss the importance of CD21 as a critical determinant of antibody durability. CD21 is a B cell antigen receptor (BCR) complex component. It significantly affects BCR signaling strength in a way essential for generating LLPC in the bone marrow. Second, all antibody-secreting cells (ASC) are not created equal. There is a four-log range of antibody secretion rates, and we propose epigenetic imprinting of different rates on ASC, including LLPC, as a factor in antibody durability. Third, antibody durability afforded by bone marrow LLPC is independent of continuous antigenic stimulation. By contrast, tissue-resident T-bet+CD21low ASC also persists in secondary lymphoid tissues and continuously produces antibodies depending on persisting antigen and the tissue microenvironment. We discuss these variables in the context of making an HIV vaccine that elicits broadly neutralizing antibodies against HIV that persist at protective levels without continuous vaccination over many years.}, }
@article {pmid41582574, year = {2026}, author = {Chaudhary, V and Singh, AP and Sharma, H and Taumar, D}, title = {Advances in Fragment-based Drug Design: Lessons and Innovations from the Post-COVID Drug Discovery Landscape.}, journal = {Mini reviews in medicinal chemistry}, volume = {26}, number = {7}, pages = {497-509}, pmid = {41582574}, issn = {1875-5607}, mesh = {Humans ; *Drug Discovery/methods ; *Drug Design ; SARS-CoV-2/drug effects ; *Antiviral Agents/chemistry/pharmacology/therapeutic use ; Artificial Intelligence ; COVID-19 ; *COVID-19 Drug Treatment ; *Protease Inhibitors/chemistry/pharmacology ; Pandemics ; }, abstract = {Fragment-based drug discovery (FBDD) has emerged as a transformative strategy in modern medicinal chemistry, offering a rational and efficient alternative to traditional highthroughput screening (HTS). By utilizing small, low-molecular-weight fragments with moderate binding affinity, FBDD enables systematic optimization into potent lead compounds with improved physicochemical properties. Its modular and ligand-centric nature has proven particularly advantageous in accelerating early-stage drug discovery. The COVID-19 pandemic highlighted the adaptability of FBDD, as fragment screening and computational modeling rapidly identified inhibitors of the SARS-CoV-2 main protease (M[pro]). Integration with artificial intelligence (AI) and cloud-based platforms further enhanced the speed and global accessibility of fragment campaigns, setting a precedent for collaborative, open-science initiatives. Beyond infectious diseases, FBDD has demonstrated significant promise in oncology, antibacterial therapy, and neurodegenerative disorders, reflecting its versatility across diverse therapeutic landscapes. Recent technological advances have expanded the scope of FBDD. High-resolution cryo-electron microscopy and AI-driven structural prediction now enable the exploration of previously inaccessible or dynamic protein targets. Emerging modalities, such as PROTACs and RNA-targeted therapeutics, also intersect with fragment-based strategies, opening avenues for addressing so-called "undruggable" proteins. Despite persistent challenges, including the need for sensitive biophysical methods and sophisticated infrastructure, the approach continues to evolve. Looking ahead, the convergence of FBDD with machine learning, open-access fragment libraries, and global research collaboration positions it as a scalable, adaptive platform for drug discovery. As future health threats demand rapid innovation, FBDD is poised to remain a cornerstone of both academic and industrial research pipelines.}, }
@article {pmid41588957, year = {2026}, author = {Vineeth, ES and Saha, S and Nishtala, VB}, title = {A Mini Review on Metal Complexes as Potential Anti-SARS-CoV-2 Agents: Insights from Molecular Docking Studies.}, journal = {Mini reviews in medicinal chemistry}, volume = {26}, number = {6}, pages = {399-411}, pmid = {41588957}, issn = {1875-5607}, mesh = {*Antiviral Agents/chemistry/pharmacology/therapeutic use ; *Molecular Docking Simulation ; Humans ; *SARS-CoV-2/drug effects ; *Coordination Complexes/chemistry/pharmacology/therapeutic use ; *COVID-19 Drug Treatment ; Spike Glycoprotein, Coronavirus/metabolism/antagonists & inhibitors/chemistry ; }, abstract = {There is an urgent need to develop effective antiviral treatments against SARS-CoV-2. Despite the availability of vaccines, drug discovery remains critical for combating emerging variants. Molecular docking studies have become a vital computational tool for identifying antiviral drugs capable of inhibiting different SARS-CoV-2 proteins. This review explores the role of metal complexes as promising viral inhibitors through in silico molecular docking approaches. The binding abilities of several coordination complexes derived from iron, copper, palladium, and zinc ions have been evaluated against major viral proteins such as the spike glycoprotein, RNA-dependent RNA polymerase (RdRp), and the main protease (Mpro), which are responsible for viral infection. Comparative docking studies of specific metal-based compounds with conventional antiviral drugs highlight their superior binding affinities and inhibitory potential. Furthermore, ADME (Absorption, Distribution, Metabolism, and Excretion) analyses, molecular dynamics simulations, and drugdelivery strategies are discussed to assess pharmacokinetics and therapeutic viability. Overall, this review emphasizes the importance of molecular docking in the rational design of metal complexes as antiviral agents and its relevance for developing effective therapeutic strategies to combat COVID-19.}, }
@article {pmid41879458, year = {2026}, author = {de Oliveira, GT and Ikegaki, ABKB and de Souza, ILI and Agostini, SBN and Marques, MBF and de Araujo, MB}, title = {Minoxidil as a Prodrug: Review of Chemical, Pharmacological, and Technological Aspects in Alopecia Therapeutics.}, journal = {Mini reviews in medicinal chemistry}, volume = {26}, number = {9}, pages = {623-631}, doi = {10.2174/0113895575433118260115212307}, pmid = {41879458}, issn = {1875-5607}, mesh = {Humans ; *Minoxidil/chemistry/pharmacology/therapeutic use/pharmacokinetics ; *Alopecia/drug therapy ; *Prodrugs/chemistry/therapeutic use/pharmacology/pharmacokinetics ; Animals ; }, abstract = {Alopecia is a prevalent condition that affects both sexes, characterised by miniaturisation of hair follicles and changes in the dynamics of the hair cycle, such as androgenetic alopecia associated with various systemic factors, including the COVID-19 pandemic. Minoxidil (base), initially developed as an oral antihypertensive, is currently used in the treatment of alopecia, acting as a prodrug that requires hepatic sulphation to generate its active metabolite, minoxidil sulphate. Topical formulations use minoxidil sulphate, the active pharmaceutical ingredient, directly on the hair follicles. Pharmacogenomic studies highlight the critical role of SULT1A1 enzyme variability in modulating treatment response, supporting personalised therapeutic strategies. Despite challenges related to low water solubility, high permeability, and narrow therapeutic index, emerging pharmaceutical technologies, including minitablets, orodispersible forms, sublingual preparations, and modified release systems, offer the potential to optimise absorption, increase dosing accuracy, and reduce adverse effects. This review consolidates current knowledge on the chemistry, pharmacology, pharmacogenomics, and technological aspects of minoxidil (base) for systemic use, emphasising translational developments that may redefine its clinical applications and contribute to safer and more standardised therapies. The integration of medicinal chemistry, pharmaceutical technology, clinical pharmacology, and regulatory guidance is expected to promote oral minoxidil as a reliable, effective, and patient-centred therapeutic option for alopecia.}, }
@article {pmid41897014, year = {2026}, author = {Berg, A and Richter, C and Meyer, G}, title = {Internationally studied parameters related to the COVID-19 pandemic in nursing homes: a scoping review.}, journal = {Systematic reviews}, volume = {15}, number = {1}, pages = {}, pmid = {41897014}, issn = {2046-4053}, mesh = {*Nursing Homes/organization & administration ; *COVID-19/epidemiology ; Humans ; *Pandemics ; SARS-CoV-2 ; Nursing Home Residents ; }, abstract = {BACKGROUND: Nursing homes were severely affected by the COVID-19 pandemic. Standardised parameters are essential to understand and monitor the unintended consequences of pandemic control measures and changes in work processes. In this scoping review, we aimed to identify COVID-19-related parameters studied in nursing homes that could form a minimum data set suitable for database development. We focused on the perspectives of all interest-holders: facilities, residents, their relatives and nursing home staff.
METHODS: We searched MEDLINE and CINAHL and included quantitative studies published in English since the beginning of the pandemic (2020 to 2024). The extracted parameters were initially categorised according to five dimensions: pandemic-related data, facility level, staff level, residents and relatives. Within each dimension, the original terms were compared and inductively organised into (sub-)categories based on conceptual similarities, with synonymous terms subsequently standardised.
RESULTS: From 82 included articles, 96 different parameters related to COVID-19 in nursing homes were identified. Infection and mortality rates emerged as the pandemic-related data most often reported, particularly within this dimension but also across all dimensions. However, we found a broad range of resident-related parameters. Our most often identified facility-related parameters include the number of staff and the provision of personal protective equipment. Staff-related parameters most often studied were personal burden and stress. Only a few parameters (n = 9) were considered for relatives.
CONCLUSIONS: The diversity of the reported parameters indicates that a comprehensive database is required to adequately assess a pandemic situation in this vulnerable population. In terms of pandemic preparedness, our overview of the reported parameters offers a basis for the development of country- and context-specific data capture approaches.}, }
@article {pmid41914684, year = {2026}, author = {Brüssow, H}, title = {Antivirals Targeting Coronavirus RNA-Dependent RNA Polymerase and Main Protease: From Mechanisms of Action to Outcomes in COVID-19 Clinical Trials.}, journal = {Microbial biotechnology}, volume = {19}, number = {4}, pages = {e70342}, pmid = {41914684}, issn = {1751-7915}, mesh = {Humans ; *Antiviral Agents/therapeutic use/pharmacology ; *SARS-CoV-2/drug effects/enzymology ; Clinical Trials as Topic ; COVID-19 ; Animals ; *Coronavirus RNA-Dependent RNA Polymerase/antagonists & inhibitors ; COVID-19 Drug Treatment ; *Betacoronavirus/drug effects/enzymology ; Coronavirus 3C Proteases/antagonists & inhibitors ; *Coronavirus Infections/drug therapy/virology ; *Viral Nonstructural Proteins/antagonists & inhibitors ; Proline/analogs & derivatives/therapeutic use ; Treatment Outcome ; Cytidine/analogs & derivatives ; Hydroxylamines ; }, abstract = {The rapid global spread of SARS-CoV-2 triggered an unprecedented effort to develop effective antivirals. Among the first approved agents was remdesivir, an injectable nucleoside analogue developed by Gilead Sciences, that led to chain termination of viral RNA synthesis and showed broad antiviral activity against RNA viruses. Early clinical results were mixed: The US ACTT-1 trial reported an accelerated recovery and reduced mortality in treated patients, while the WHO Solidarity and a European trial revealed no impact of remdesivir on mortality. In contrast, a US trial in outpatients demonstrated a clear clinical benefit when treatment was administered early. Molnupiravir, an orally applicable nucleoside analogue developed by Merck, induces lethal mutations in the viral genome rather than chain termination. Molnupiravir showed in vivo antiviral activity against coronaviruses in different animals. In MOVe-OUT trials, molnupiravir reduced the rate of hospitalisation in treated outpatients. In the PANORAMIC trial, molnupiravir reduced the time to recovery in outpatients but not their rate of hospitalisation. No drug effect of molnupiravir was seen in the RECOVERY trial with hospitalised COVID-19 patients. Using structural biology and medicinal chemistry approaches, Pfizer developed nirmatrelvir, an oral inhibitor of the major coronavirus protease. In high-risk but not in standard-risk COVID-19 patients, the combination nirmatrelvir/ritonavir reduced the rate of hospitalisation (EPIC HR and SR trials). Retrospective cohort studies showed treatment effects in defined patient groups. This review compares the efficacy and clinical performance of different antivirals, including emerging drugs such as obeldesivir and alternative protease inhibitors (lopinavir, simnotrelvir). It further examines their roles in prophylaxis, treatment of long covid symptoms, pharmacological considerations and antiviral resistance. Particular attention is given to factors underlying variable outcome of the trials, including viral variant evolution, population immunity increases, disease severity changes and timing of therapy initiation.}, }
@article {pmid41920064, year = {2026}, author = {Splane, J and Hotta, TA and Lillington, S and Ulhman, M and Ippoliti, M and Castaneda, R}, title = {Canadian Clinical Practice Recommendations for Preventing Infections in Aesthetic Medicine.}, journal = {Plastic and aesthetic nursing}, volume = {46}, number = {2}, pages = {101-113}, pmid = {41920064}, issn = {2770-3517}, mesh = {Humans ; Canada ; *COVID-19/prevention & control/epidemiology ; *Infection Control/standards/methods ; *Practice Guidelines as Topic ; *Cross Infection/prevention & control ; SARS-CoV-2 ; }, abstract = {The COVID-19 pandemic exposed critical gaps in infection protection and control (IPC) protocols across health care settings, underscoring the urgent need for health care systems, organizations, and providers to prioritize robust safety standards to protect patient, provider, and public well-being. In aesthetic medicine-where demand for procedures continues to rise-maintaining stringent IPC practices is more important than ever. This article reviews fundamental IPC principles, current best-practices specific to aesthetic medicine, and facility-level recommendations in Canada. As IPC standards continue to evolve, their application within aesthetic settings remains essential to protecting patient, provider, and public health. Ongoing adaptation and improvement in response to emerging risks and rising procedural volumes are crucial to maintaining the integrity and safety of aesthetic practice.}, }
@article {pmid41922045, year = {2026}, author = {Gupta, J and Pinjari, D and Aggarwal, Y and Kumar, D and Syal, K and Bhattacharyya, R and Banerjee, D}, title = {Vitamin D in health and disease and potential shield against COVID-19.}, journal = {Advances in clinical chemistry}, volume = {132}, number = {}, pages = {223-254}, doi = {10.1016/bs.acc.2025.12.001}, pmid = {41922045}, issn = {2162-9471}, mesh = {Humans ; *Vitamin D/therapeutic use/analogs & derivatives/blood ; COVID-19 ; SARS-CoV-2 ; Pandemics ; Dietary Supplements ; *Coronavirus Infections/drug therapy/prevention & control ; *Pneumonia, Viral/drug therapy/prevention & control ; Betacoronavirus ; Vitamins/therapeutic use ; COVID-19 Drug Treatment ; }, abstract = {Vitamin D acts as a micronutrient, hormone, and immunomodulator. While well known for supporting bone health and preventing rickets, researchers are now exploring its potential to help fight infection, including COVID-19. Certain laboratory studies and observational research suggest that vitamin D supplementation may lower the risk of developing serious illnesses. Unfortunately, clinical studies have generated mixed results. This gap between laboratory findings and real-world outcomes highlights the need for high-quality research in the field. Another promising domain is the utilization of vitamin D analogs that can provide similar or even better benefits than native vitamin D, but with fewer side effects. Additionally, the standardization of vitamin D measurement from biologic samples in clinical and research laboratories must be improved to successfully manage individual patients and clinical research. All these aspects are dealt with in detail in this chapter.}, }
@article {pmid41924267, year = {2026}, author = {Ohta, E and Okada, E and Sawada, Y}, title = {Pustular psoriasis flare following COVID-19 infection: a case report and literature review.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1740000}, pmid = {41924267}, issn = {1664-3224}, mesh = {Humans ; Female ; *COVID-19/complications/immunology ; *Psoriasis/drug therapy/pathology/immunology/etiology ; Middle Aged ; *SARS-CoV-2/immunology ; }, abstract = {Generalized pustular psoriasis (GPP) is a rare, potentially life-threatening inflammatory disease characterized by neutrophilic pustules and systemic inflammation. We report a case of severe GPP triggered by SARS-CoV-2 infection in a 46-year-old woman with a long history of psoriasis. Eleven days after recovery from COVID-19 pneumonia, she developed widespread pustules and fever. Histopathology revealed subcorneal spongiform pustules and dermal neutrophilic infiltration consistent with GPP. Systemic corticosteroids followed by etretinate and deucravacitinib achieved complete remission. A literature review identified 11 infection- and 10 vaccine-related GPP cases. Compared with vaccine-associated cases, infection-related flares showed longer latency and higher corticosteroid use. Mechanistically, both SARS-CoV-2 infection and vaccination may be associated with IL-36 axis activation, potentially via spike protein-driven, Toll-like receptor-mediated innate immune signaling. This case highlights that distinct immune kinetics may underlie infection- and vaccine-related GPP, while supporting a putative role of IL-36-driven inflammation in COVID-19-associated disease exacerbation.}, }
@article {pmid41933448, year = {2026}, author = {Medina, YF and Rodríguez Grande, EI and Galindo, JL and Vargas Pinilla, OC and Soler, F and Espitia, GV}, title = {Non-pharmacological rehabilitation strategies for pulmonary and physical recovery in ICU survivors after COVID-19: A systematic review.}, journal = {Chronic respiratory disease}, volume = {23}, number = {}, pages = {14799731261439941}, pmid = {41933448}, issn = {1479-9731}, mesh = {Humans ; *COVID-19/rehabilitation/complications/physiopathology ; Survivors ; Intensive Care Units ; SARS-CoV-2 ; Recovery of Function ; Critical Care/methods ; Pandemics ; }, abstract = {BackgroundSurvivors of severe COVID-19 requiring intensive care frequently experience persistent pulmonary and functional impairment consistent with post-critical illness sequelae. The effectiveness of non-pharmacological rehabilitation in this severity-specific subgroup remains uncertain.MethodsA systematic review was conducted in accordance with PRISMA 2020 guidelines. PubMed, Epistemonikos, LILACS, and Google Scholar were searched for randomized and observational studies evaluating non-pharmacological rehabilitation in adult ICU survivors of COVID-19. Risk of bias was assessed using RoB 2 and ROBINS-I tools. Given substantial clinical and methodological heterogeneity, quantitative meta-analysis was not performed; a structured narrative synthesis was undertaken.ResultsFourteen studies met inclusion criteria. Five incorporated comparator groups, while nine employed uncontrolled pre-post designs. Interventions ranged from early ICU mobilization to inpatient and outpatient pulmonary rehabilitation. Controlled studies reported variable between-group benefits in dyspnea and functional outcomes, whereas observational studies consistently described within-group improvement over time. However, most studies were at moderate to serious risk of bias, and heterogeneity in intervention timing, dosage, and outcome assessment limited comparability.ConclusionsNon-pharmacological rehabilitation in ICU survivors of COVID-19 is associated with improvement over time; however, the certainty of causal effectiveness remains low. ICU survivors constitute a distinct recovery population within the broader post-COVID spectrum. Adequately powered, multicenter randomized trials with standardized protocols and harmonized outcomes are required to establish long-term effectiveness.}, }
@article {pmid41934674, year = {2026}, author = {Gillini, L and Sevilla-Hernández, C and Cavaleri, M}, title = {COVID-19 and its short- and long-term effects on the operations of the EMA: fostering innovation in the EU during and beyond time of crisis.}, journal = {European journal of public health}, volume = {36}, number = {2}, pages = {}, pmid = {41934674}, issn = {1464-360X}, mesh = {Humans ; COVID-19 ; European Union ; *Pandemics/prevention & control ; SARS-CoV-2 ; *Coronavirus Infections/epidemiology/drug therapy ; *Pneumonia, Viral/epidemiology/drug therapy ; *Government Agencies/organization & administration ; }, abstract = {The European Medicines Agency (EMA) played a crucial role in responding to the COVID-19 pandemic by implementing various innovations that facilitated the development and approval of vaccines and treatments. This article analyses some of those innovations on the agency's operations through literature on innovation in the public sector using a literature review, publications on EU policy along with internal knowledge by the authors. The agency's innovative approaches such as the establishment of the COVID-19 Emergency Task Force and the effective use of real-world evidence enabled the agency to provide rapid advice to developers and ensure the provision of scientific feedback to the authorities and the public during crisis. The changes implemented led to new legislation allowing long-term effects within the agency. The EMA has emerged from the COVID-19 pandemic strengthened by innovative approaches leading to new legislation enabling an expanded mandate of the agency. To sustain innovation at the EMA, the agency might have to consider a structured and comprehensive approach to innovation, including the importance of fostering an innovation culture within the organization.}, }
@article {pmid42445051, year = {2026}, author = {Balcha, WF and Kassahun, EA and Nega, AT and Abie, A and Demsie, DG and Negesse, CT and Feyisa, K and Mekonnen, BA and Biadigilign, TM and Addisu, ZD and Ayenew, W and Siraj, EA and Zewdie, S and Anagaw, YK and Alene, GM and Yismaw, MB and Yehualaw, A and Kebede, SY and Mihiretie, EA and Awoke, AM and Bante, SA and Tesfu, AA and Sendeku, FW and Demissie, BA and Shiferaw, WG and Megule, SM and Abebe, YM and Tessema, LW and Chekole, FA}, title = {Labor Pain Management Practices and Associated Factors Among Licensed Obstetric Care Providers in Ethiopia: A Systematic Review and Meta-Analysis.}, journal = {Health science reports}, volume = {9}, number = {7}, pages = {e72770}, pmid = {42445051}, issn = {2398-8835}, abstract = {BACKGROUND AND AIMS: Labor pain is a multidimensional experience influenced by emotional, cognitive, and cultural factors. It can be managed using pharmacological, non-pharmacological, or combined approaches. Licensed obstetric care providers (OCPs) are ethically obligated to ensure maternal comfort while safeguarding fetal safety. Evidence on labor pain management practices (LPMP) in Ethiopia remains inconsistent, as prior studies often included students or had unclear inclusion criteria. This systematic review and meta-analysis estimated the pooled prevalence of LPMP among licensed OCPs, identified associated factors, and examined trends before and during the COVID-19 pandemic.
METHODS: We searched major databases and repositories for studies published between January 1, 2018 and October 3, 2025. Risk of bias was assessed using the Joanna Briggs Institute checklist and modified Newcastle-Ottawa Scale, with inter-rater reliability analyses. Meta-analysis was conducted in STATA 17 using random or fixed-effects models. Heterogeneity was assessed using Cochran's Q test and quantified with I[2] statistic. Certainty of evidence rated using GRADE.
RESULTS: Twenty studies involving 7,202 participants were included. LPMP prevalence varied substantially across studies and settings. The pooled prevalence of overall LPMP was 46.9% (95% CI: 42.7-51.1; I[2] = 92.4%). Non-pharmacological practice was 42.8% (95% CI: 36.6-49.1), whereas pharmacological practice was 21.1% (95% CI: 12.5-29.7), decreasing to 15.2% after adjustment for publication bias. Pharmacological practice was modestly higher during COVID-19 (23.7% vs. 18.0%). Factors positively associated with LPMP included provider knowledge, attitudes, training, drug/protocol availability, supportive environments, higher education, longer experience, positive perceptions, being a midwife, and female sex. Certainty of evidence ranged from low to moderate.
CONCLUSION: LPMP prevalence varied considerably across studies and settings. While the pooled estimate suggests that fewer than half of Ethiopian OCPs practiced LPMP, substantial unexplained heterogeneity warrants cautious interpretation. Non-pharmacological methods were more commonly used than pharmacological approaches, highlighting opportunities to strengthen provider training, institutional support, and resource availability.}, }
@article {pmid42445255, year = {2026}, author = {Jha, S and Chaliha, LB and Pandey, K and Patel, R}, title = {Reimagining tuberculosis elimination in India: diagnostics, drug resistance, and digital health strategies.}, journal = {Frontiers in epidemiology}, volume = {6}, number = {}, pages = {1868261}, pmid = {42445255}, issn = {2674-1199}, abstract = {Tuberculosis (TB) remains a major global public health challenge and one of the leading infectious causes of mortality worldwide, with India contributing approximately 26% of the global TB burden. Despite substantial progress under the National Tuberculosis Elimination Programme (NTEP), India's efforts to achieve the ambitious 2025 TB elimination target continue to face major challenges due to the COVID-19 pandemic, multidrug-resistant tuberculosis (MDR-TB), healthcare disparities, and limitations in surveillance and reporting systems. This review provides a comprehensive overview of the epidemiology of TB in India and critically evaluates the impact of COVID-19, drug resistance, healthcare accessibility, and emerging diagnostic technologies on TB control efforts. A structured literature search was conducted using PubMed, Scopus, and Google Scholar, along with reports from the World Health Organization and the Government of India. The reviewed evidence indicates that the COVID-19 pandemic significantly disrupted TB diagnosis, treatment, surveillance, and healthcare accessibility, leading to declines in case notification and the possible accumulation of undiagnosed TB cases. In addition, the increasing burden of MDR/RR-TB, fragmented private healthcare systems, underreporting, and unequal access to diagnostics and treatment continue to hinder progress toward TB elimination. Although advancements including molecular diagnostics, digital surveillance platforms such as Nikshay, AI-assisted screening, and patient-support programmes have strengthened TB control strategies, important challenges related to implementation, infrastructure, scalability, and antimicrobial stewardship remain unresolved. This review highlights the need for integrated and patient-centred TB control strategies that combine rapid diagnostics, strengthened surveillance, public-private healthcare integration, health systems strengthening, and interventions addressing broader socioeconomic determinants such as poverty, malnutrition, and healthcare inequity. Coordinated multisectoral approaches will be essential for accelerating TB elimination efforts in India in the post-COVID era.}, }
@article {pmid42446912, year = {2026}, author = {Li, N and Yan, Y and Li, Y and Ni, J and Gao, J and Piao, X and Hou, X}, title = {The effect of high-dose of vitamin C on mortality among aged patients with severe COVID-19: A systematic review and meta-analysis.}, journal = {Clinical and investigative medicine. Medecine clinique et experimentale}, volume = {49}, number = {2}, pages = {31-42}, doi = {10.3138/CIM-2024-0302}, pmid = {42446912}, issn = {1488-2353}, mesh = {Humans ; *Ascorbic Acid/administration & dosage/therapeutic use ; *COVID-19/mortality ; Aged ; Critical Illness/mortality ; SARS-CoV-2 ; *COVID-19 Drug Treatment ; Randomized Controlled Trials as Topic ; }, abstract = {BACKGROUND: Critically ill patients are frequently deficient in vitamin C. Given the significant mortality rates in the elderly population associated with COVID-19, we aimed to systematically review the literature and evaluate whether high-dose vitamin C can reduce COVID-19 mortality in this population.
METHODS: Multiple data sources (PubMed, Web of Science, ScienceDirect, and medRxiv) were searched using the keywords "COVID-19" AND "vitamin C" up to November 2024. Randomized controlled trials (RCTs) involving COVID-19 patients with relevant data were collected. We used a random or fixed effects meta-analysis to calculate the pooling effect.
RESULTS: Eight RCTs comprising 2,104 patients were ultimately included in the meta-analysis. The pooling effect (odds ratio [OR] 0.97[95% CI 0.80-1.18, P = 0.76) suggested no significant difference in mortality rates between patients treated with high-dose vitamin C and those who were not.
CONCLUSIONS: Vitamin C supplementation might reduce the risk of COVID-19 mortality in critically ill patients; however, this effect varied by study. Additional research is necessary to arrive at a definitive conclusion on this subject.}, }
@article {pmid42447883, year = {2026}, author = {Naidoo, T and Morgenstern, C and Doohan, P and Earl, R and Rawson, T and Sheppard, RJ and Hicks, JT and Radhakrishnan, S and Johnson, R and Hartner, AM and Cattarino, L and McCain, K and Vicco, A and Imai-Eaton, N and Elsland, SV and Cori, A and McCabe, R and Bhatia, S and , }, title = {A systematic review of Nipah virus disease epidemiological parameters, outbreaks, and mathematical models.}, journal = {The Lancet. Infectious diseases}, volume = {}, number = {}, pages = {}, doi = {10.1016/S1473-3099(26)00239-2}, pmid = {42447883}, issn = {1474-4457}, abstract = {Our systematic review, based on PRISMA guidelines (PROSPERO CRD42023393345), characterised the epidemiology, outbreaks, and mathematical models of Nipah virus, an important public health threat in south and southeast Asia. We searched PubMed and Web of Science from database inception to March 14, 2025, and extracted 243 parameters, 89 risk factors, 39 models, and 23 distinct outbreaks from 119 papers. IgG seroprevalence estimates in the general population ranged from 0% to 12·5%. Nipah virus causes severe disease, with pooled case-fatality ratio estimates ranging widely from 9·1% (95% CI 0·2-41·3) in Singapore to 81·9% (95% CI 71·9-88·9) in Bangladesh. The infection timeline and clinical course of Nipah virus remain poorly characterised; we estimated a median incubation period of 8·77 days (165, 95% CI 7·53-10·02) from eight estimates in seven articles with sufficient information. Transmission parameter estimates were scarce, and all but one of five central estimates of the basic reproduction number were less than one. Nipah virus mathematical models (39) were rarely fitted to data (eight). All extracted information is accessible via our R package, epireview.}, }
@article {pmid42448011, year = {2026}, author = {Thapa, N and Jin, Y and Han, JH}, title = {Innate immune surveillance and nucleic acid sensing: Gatekeepers of inflammatory cell death in respiratory infectious diseases.}, journal = {Pharmacological research}, volume = {}, number = {}, pages = {108340}, doi = {10.1016/j.phrs.2026.108340}, pmid = {42448011}, issn = {1096-1186}, abstract = {Respiratory infections caused by viral pathogens, including influenza A virus, respiratory syncytial virus, and SARS-CoV-2, as well as bacterial pathogens, remain major contributors to global morbidity and mortality. The outcomes of these infections are largely determined by how the host innate immune system detects pathogen-derived nucleic acids and regulates subsequent inflammatory responses. Pattern recognition receptors (PRRs) located in endosomal and cytosolic compartments, including Toll-like receptors, RIG-I-like receptors, absent in melanoma 2, and Z-DNA-binding protein 1, as well as the cyclic GMP-AMP synthase-stimulator of interferon genes pathway, recognize viral and bacterial nucleic acids and initiate signaling cascades that promote cytokine production and antimicrobial defense. However, dysregulated PRR activation can trigger inflammatory programmed cell death, including apoptosis, pyroptosis, necroptosis, and PANoptosis. This review summarizes recent advances in understanding how nucleic acid sensing orchestrates inflammatory cell death during respiratory infections, with particular emphasis on pathogen- and cell type-specific mechanisms that shape disease outcomes. We further highlight the dual nature of these pathways, which are essential for pathogen clearance but can drive immunopathology when excessively activated. Defining how nucleic acid-sensing pathways shape inflammatory cell death in respiratory infections may guide host-directed therapies that enhance pathogen clearance while preserving lung function. Overall, the field remains constrained by the predominance of virus-focused and murine preclinical studies, whereas bacterial nucleic acid sensing during respiratory infections remains poorly defined. Future studies should integrate major bacterial infection models with human-relevant respiratory epithelial systems to better translate PRR-mediated immune mechanisms into host-directed therapeutic strategies.}, }
@article {pmid34814859, year = {2021}, author = {Doherty, A and Benedetto, V and Harris, C and Boland, P and Christian, DL and Hill, J and Bhutani, G and Clegg, AJ}, title = {The effectiveness of psychological support interventions for those exposed to mass infectious disease outbreaks: a systematic review.}, journal = {BMC psychiatry}, volume = {21}, number = {1}, pages = {592}, pmid = {34814859}, issn = {1471-244X}, mesh = {*Cognitive Behavioral Therapy ; Counseling ; Disease Outbreaks ; *Eye Movement Desensitization Reprocessing ; Humans ; Psychosocial Intervention ; }, abstract = {BACKGROUND: Mass outbreaks such as pandemics are associated with mental health problems requiring effective psychological interventions. Although several forms of psychological interventions may be advocated or used, some may lack strong evidence of efficacy and some may not have been evaluated in mass infectious disease outbreaks. This paper reports a systematic review of published studies (PROSPERO CRD:42020182094. Registered: 24.04.2020) examining the types and effectiveness of psychological support interventions for the general population and healthcare workers exposed to mass infectious disease outbreaks.
METHODS: A systematic review was conducted. Randomised Controlled Trials (RCT) were identified through searches of electronic databases: Medline (Ovid), Embase (Ovid), PsycINFO (EBSCO) and the Cochrane Library Database from inception to 06.05.2021 using an agreed search strategy. Studies were included if they assessed the effectiveness of interventions providing psychological support to the general population and / or healthcare workers exposed to mass infectious disease outbreaks. Studies were excluded if they focused on man-made or natural disasters or if they included armed forces, police, fire-fighters or coastguards.
RESULTS: Twenty-two RCTs were included after screening. Various psychological interventions have been used: therapist-guided therapy (n = 1); online counselling (n = 1); 'Emotional Freedom Techniques' (n = 1); mobile phone apps (n = 2); brief crisis intervention (n = 1); psychological-behavioural intervention (n = 1); Cognitive Behavioural Therapy (n = 3); progressive muscle relaxation (n = 2); emotional-based directed drawing (n = 1); psycho-educational debriefing (n = 1); guided imagery (n = 1); Eye Movement Desensitization and Reprocessing (EMDR) (n = 1); expressive writing (n = 2); tailored intervention for patients with a chronic medical conditions (n = 1); community health workers (n = 1); self-guided psychological intervention (n = 1), and a digital behaviour change intervention (n = 1). Meta-analyses showed that psychological interventions had a statistically significant benefit in managing depression (Standardised Mean Difference [SMD]: -0.40; 95% Confidence Interval [CI]: - 0.76 to - 0.03), and anxiety (SMD: -0.72; 95% CI: - 1.03 to - 0.40). The effect on stress was equivocal (SMD: 0.16; 95% CI: - 0.19 to 0.51). The heterogeneity of studies, studies' high risk of bias, and the lack of available evidence means uncertainty remains.
CONCLUSIONS: Further RCTs and intervention studies involving representative study populations are needed to inform the development of targeted and tailored psychological interventions for those exposed to mass infectious disease outbreaks.}, }
@article {pmid35604475, year = {2022}, author = {Ryan, P and Redenbaugh, V and McGucken, J and Kindle, G and Devlin, LA and Coulter, T and Buckland, MS and Seppänen, MRJ and Conlon, NP and Feighery, C and Edgar, JDM}, title = {Inborn Errors of Immunity on the Island of Ireland - a Cross-Jurisdictional UKPID/ESID Registry Report.}, journal = {Journal of clinical immunology}, volume = {42}, number = {6}, pages = {1293-1299}, pmid = {35604475}, issn = {1573-2592}, mesh = {Adult ; *Delayed Diagnosis ; Humans ; Immunoglobulins ; *Immunologic Deficiency Syndromes/diagnosis/epidemiology ; Registries ; United Kingdom/epidemiology ; }, abstract = {The epidemiology of inborn errors of immunity (IEI) in the Republic of Ireland was first published in 2005 but has not been updated since. IEI prevalence data from Northern Ireland was last published in 2018. Using data from the United Kingdom Primary Immune Deficiency (UKPID) and European Society for Immunodeficiencies (ESID) registries, we reviewed all registered cases of IEI affecting adult patients ≥ 18 years of age from the two largest immunology specialist centres in Northern Ireland and the Republic of Ireland, respectively and calculated the combined minimum adult prevalence of IEI on the island of Ireland for the first time. We also recorded data pertaining to presenting symptoms of IEI, diagnostic delay, immunoglobulin data, and genetic testing, as well as briefly reporting data pertaining to secondary immunodeficiency in both countries. As of 1 May 2020, we identified a minimum adult IEI prevalence in Ireland of 8.85/100,000 population.}, }
@article {pmid35674870, year = {2022}, author = {Arena, G and Sharma, K and Agyeah, G and Krüger, R and Grünewald, A and Fitzgerald, JC}, title = {Neurodegeneration and Neuroinflammation in Parkinson's Disease: a Self-Sustained Loop.}, journal = {Current neurology and neuroscience reports}, volume = {22}, number = {8}, pages = {427-440}, pmid = {35674870}, issn = {1534-6293}, mesh = {Animals ; *Gastrointestinal Microbiome ; Humans ; Inflammation/metabolism ; Neuroinflammatory Diseases ; Neurons/metabolism ; *Parkinson Disease/metabolism ; }, abstract = {PURPOSE OF REVIEW: Neuroinflammation plays a significant role in Parkinson's disease (PD) etiology along with mitochondrial dysfunction and impaired proteostasis. In this context, mechanisms related to immune response can act as modifiers at different steps of the neurodegenerative process and justify the growing interest in anti-inflammatory agents as potential disease-modifying treatments in PD. The discovery of inherited gene mutations in PD has allowed researchers to develop cellular and animal models to study the mechanisms of the underlying biology, but the original cause of neuroinflammation in PD is still debated to date.
RECENT FINDINGS: Cell autonomous alterations in neuronal cells, including mitochondrial damage and protein aggregation, could play a role, but recent findings also highlighted the importance of intercellular communication at both local and systemic level. This has given rise to debate about the role of non-neuronal cells in PD and reignited intense research into the gut-brain axis and other non-neuronal interactions in the development of the disease. Whatever the original trigger of neuroinflammation in PD, what appears quite clear is that the aberrant activation of glial cells and other components of the immune system creates a vicious circle in which neurodegeneration and neuroinflammation nourish each other. In this review, we will provide an up-to-date summary of the main cellular alterations underlying neuroinflammation in PD, including those induced by environmental factors (e.g. the gut microbiome) and those related to the genetic background of affected patients. Starting from the lesson provided by familial forms of PD, we will discuss pathophysiological mechanisms linked to inflammation that could also play a role in idiopathic forms. Finally, we will comment on the potential clinical translatability of immunobiomarkers identified in PD patient cohorts and provide an update on current therapeutic strategies aimed at overcoming or preventing inflammation in PD.}, }
@article {pmid35962190, year = {2022}, author = {Mohsen, MO and Bachmann, MF}, title = {Virus-like particle vaccinology, from bench to bedside.}, journal = {Cellular & molecular immunology}, volume = {19}, number = {9}, pages = {993-1011}, pmid = {35962190}, issn = {2042-0226}, mesh = {*Vaccines, Virus-Like Particle/chemistry ; Vaccinology ; *Viruses ; }, abstract = {Virus-like particles (VLPs) have become key tools in biology, medicine and even engineering. After their initial use to resolve viral structures at the atomic level, VLPs were rapidly harnessed to develop antiviral vaccines followed by their use as display platforms to generate any kind of vaccine. Most recently, VLPs have been employed as nanomachines to deliver pharmaceutically active products to specific sites and into specific cells in the body. Here, we focus on the use of VLPs for the development of vaccines with broad fields of indications ranging from classical vaccines against viruses to therapeutic vaccines against chronic inflammation, pain, allergy and cancer. In this review, we take a walk through time, starting with the latest developments in experimental preclinical VLP-based vaccines and ending with marketed vaccines, which earn billions of dollars every year, paving the way for the next wave of prophylactic and therapeutic vaccines already visible on the horizon.}, }
@article {pmid36056175, year = {2022}, author = {Aksan, A and Zepp, F and Anand, S and Stein, J}, title = {Intravenous ferric carboxymaltose for the management of iron deficiency and iron deficiency anaemia in children and adolescents: a review.}, journal = {European journal of pediatrics}, volume = {181}, number = {11}, pages = {3781-3793}, pmid = {36056175}, issn = {1432-1076}, mesh = {Administration, Intravenous ; Adolescent ; *Anemia, Iron-Deficiency/drug therapy/etiology ; Child ; Ferric Compounds/adverse effects ; Humans ; Iron/therapeutic use ; *Iron Deficiencies ; Maltose/adverse effects/analogs & derivatives ; Prospective Studies ; Retrospective Studies ; Treatment Outcome ; }, abstract = {UNLABELLED: Iron deficiency is the primary cause of anaemia worldwide and is particularly common among children and adolescents. Intravenous (IV) iron therapy is recommended for paediatric patients with certain comorbidities or if oral iron treatment has been unsuccessful. IV ferric carboxymaltose (FCM) has recently been approved by the US Food and Drug Administration for use in children aged > 1 year. This narrative review provides an overview of the available publications on the efficacy and safety of IV FCM in children and adolescents. A literature search using PubMed and Embase yielded 153 publications; 33 contained clinical data or reports on clinical experience relating to IV FCM in subjects < 18 years of age and were included in the review. No prospective, randomised controlled studies on the topic were found. Most publications were retrospective studies or case reports and included patients with various underlying conditions or patients with inflammatory bowel disease. Efficacy data were included in 27/33 publications and improvements in anaemia, and/or iron status parameters were reported in 26 of them. Safety data were included in 25/33 publications and were in line with the adverse events described in the prescribing information.
CONCLUSION: The available publications indicate that IV FCM, a nanomedicine with a unique and distinctive therapeutic profile, is an effective and generally well-tolerated treatment for iron deficiency or iron deficiency anaemia in children and adolescents. Despite the wealth of retrospective evidence, prospective, randomised controlled trials in the paediatric setting are still necessary.
WHAT IS KNOWN: • Iron deficiency and iron deficiency anaemia are usually managed using oral iron therapy, but intravenous iron therapy is recommended for certain paediatric patients. • Intravenous ferric carboxymaltose (FCM) has recently been approved in the US for use in children aged > 1 year.
WHAT IS NEW: • Despite evidence that FCM is effective and generally well tolerated in children and adolescents, so far, only retrospective studies, non-randomised uncontrolled prospective studies, or case reports have been published in full. • There is a strong need for prospective, randomised controlled trials on FCM in the paediatric setting.}, }
@article {pmid36662439, year = {2023}, author = {Otu, A and Kosmidis, C and Mathioudakis, AG and Ibe, C and Denning, DW}, title = {The clinical spectrum of aspergillosis in chronic obstructive pulmonary disease.}, journal = {Infection}, volume = {51}, number = {4}, pages = {813-829}, pmid = {36662439}, issn = {1439-0973}, mesh = {Humans ; *Aspergillosis/complications ; *Pulmonary Disease, Chronic Obstructive/complications ; *Pulmonary Aspergillosis/complications/diagnosis ; Aspergillus ; }, abstract = {Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. In this review, we present the clinical spectrum and pathogenesis of syndromes caused by Aspergillus in COPD namely invasive aspergillosis (IA), community-acquired Aspergillus pneumonia, chronic pulmonary Aspergillosis and Aspergillus sensitisation. Some of these entities are clearly linked to COPD, while others may coexist, but are less clearly liked directly to COPD. We discuss current uncertainties as these pertain to IA in COPD cohorts and explore areas for future research in this field.}, }
@article {pmid41860269, year = {2026}, author = {Slama Schwok, A}, title = {[Post-COVID neurological sequelae, proposed mechanisms and therapeutic approaches].}, journal = {Medecine sciences : M/S}, volume = {42}, number = {3}, pages = {280-289}, doi = {10.1051/medsci/2026036}, pmid = {41860269}, issn = {1958-5381}, mesh = {Humans ; *COVID-19/complications ; *Nervous System Diseases/therapy/etiology/epidemiology/virology ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; Female ; Pandemics ; *Coronavirus Infections/complications/therapy/epidemiology ; *Pneumonia, Viral/complications/therapy ; *Betacoronavirus ; Neuroinflammatory Diseases/etiology/therapy ; Adult ; }, abstract = {Approximately 5 % of patients suffer from the sequelae of the COVID-19 pandemics, representing a considerable number of individuals, often young or middle-aged working adults (18-50 years). Among them, women are disproportionately affected. The most common neurological symptoms include persistent cognitive impairment, known as "brain fog", chronic fatigue syndrome, inflammation of the nervous system (motor or autonomous), anxiety and depression, all of which significantly reduce patients' quality of life. There is therefore an urgent societal need to identify appropriate treatments based on a clear understanding of the underlying pathological mechanisms. This review describes the state of the art in Long neuro-COVID, with an emphasis on neuroinflammation, alteration of neurotransmission, and immune, endothelial and microvascular dysfunctions.}, }
@article {pmid41860271, year = {2026}, author = {Cracowski, JL and Molimard, M and Richard, V and Roustit, M and Khouri, C}, title = {[Assessing the risk-benefit balance of medicines: Some lessons from Covid-19].}, journal = {Medecine sciences : M/S}, volume = {42}, number = {3}, pages = {295-305}, doi = {10.1051/medsci/2026040}, pmid = {41860271}, issn = {1958-5381}, mesh = {Humans ; Pharmacovigilance ; COVID-19/epidemiology ; Risk Assessment/methods ; *COVID-19 Drug Treatment ; Drug-Related Side Effects and Adverse Reactions/epidemiology ; Pharmacoepidemiology/methods ; Clinical Trials as Topic ; SARS-CoV-2 ; Drug Interactions ; }, abstract = {The efficacy of medications is evaluated by clinical trials. However, such trials are not designed to assess adverse effects, particularly when those are rare. A robust pharmacovigilance system is therefore required to assess risks, supplemented as requested by pharmacoepidemiology studies. The benefits of medications are expressed in either relative or absolute terms and they vary depending on the baseline risk of the disease (its severity, potential complications, progression, and its incidence for the population-level benefits). This is not the case for adverse effects, which are influenced by the drug characteristics and the population receiving the treatment. In this context, can we truly balance the benefits and risks of medications? The experience of Covid-19 illustrates the complexity of this concept. It clearly highlights the need for a comprehensive approach, integrating analysis of clinical trials, pharmacovigilance monitoring, pharmacoepidemiology studies, and the detection of potential drug interactions. Finally, it is essential to inform and educate the general public about medications. This empowers individuals to accurately understand the complex concept of benefit-risk balance, prevents misleading over simplifications, and helps effectively counter misinformation.}, }
@article {pmid41860319, year = {2026}, author = {Kortz, TB and Hidalgo, JL and Akech, SO and Myatra, SN and Maves, RC and Perez-Fernandez, J and Acharya, SP and Coopersmith, CM and Jacob, ST and Johnston, C and Kissoon, N and Machado, FR and Molyneux, E and Morrow, BM and Pérez Cornejo, MS and Permpikul, C and Piyavechviratana, K and Rhodes, A and Ulisubisya, MM and Kumar, VK and Patel, H and Woznica, D and Nadkarni, VM}, title = {10 Steps to Improve Sepsis Care in Low-Resource Settings.}, journal = {Critical care medicine}, volume = {54}, number = {4}, pages = {939-949}, doi = {10.1097/CCM.0000000000007090}, pmid = {41860319}, issn = {1530-0293}, mesh = {Humans ; *Resource-Limited Settings ; *Sepsis/therapy/prevention & control/diagnosis ; *Quality Improvement/organization & administration ; Critical Care/standards ; Practice Guidelines as Topic ; Consensus ; }, abstract = {OBJECTIVES: To develop a practical consensus-based framework for 10 steps to improve sepsis care in low-resource settings (LRSs), aligned with the sepsis chain of survival and informed by global expertise.
DATA SOURCES: We reviewed peer-reviewed literature on sepsis epidemiology, prevention, recognition, and management in LRS; international guidelines, including the Surviving Sepsis Campaign; and prior "10-step" consensus frameworks for resuscitation and emergency care.
STUDY SELECTION: A Task Force representing adult and pediatric sepsis care, emergency care, critical care, infectious diseases, public health, and implementation science identified key domains from the above data sources.
DATA EXTRACTION: With guidance from methodologists and implementation science experts, we utilized an iterative, consensus-based process-literature review, Delphi survey, Utstein-style conference, stakeholder input, and public comment-to first define and then refine steps and implementation strategies.
DATA SYNTHESIS: The process resulted in 10 nonsequential, actionable steps covering governance and commodities, provider and caregiver education, community and facility prevention, early recognition and rapid response, timely guideline-based interventions, structured post-sepsis care, data systems, quality improvement, a culture of excellence and respect, and holistic well-being of patients, caregivers, and providers. Each step includes a rationale and potential implementation strategies adaptable to local resources and needs. Collectively, the ten steps emphasize integration across the continuum of care, equitable access to essential interventions, and the role of emerging technologies to prevent, recognize, monitor, and follow-up sepsis.
CONCLUSIONS: The 10 steps provide a consensus-driven roadmap for health leaders, clinicians, and policymakers to improve sepsis care, strengthen the sepsis chain of survival, reduce preventable morbidity and mortality, and address global inequities in sepsis outcomes.}, }
@article {pmid41860328, year = {2026}, author = {Myatra, SN and Boyer, KM and Hidalgo, JL and Maves, RC and Acharya, SP and Jacob, ST and Kortz, TB and Nadkarni, VM and Pérez Cornejo, MS and Perez-Fernandez, J and Johnston, C and Machado, FR and Morrow, BM and Coopersmith, CM and Kissoon, N and Molyneux, E and Permpikul, C and Piyavechviratana, K and Rhodes, A and Ulisubisya, MM and Kumar, VK and Patel, H and Woznica, D and Akech, SO}, title = {Gaps and Strategies for Management of Sepsis in Low-Resource Settings: Expert Consensus Statements Using a Delphi Method.}, journal = {Critical care medicine}, volume = {54}, number = {5}, pages = {1209-1224}, doi = {10.1097/CCM.0000000000007102}, pmid = {41860328}, issn = {1530-0293}, mesh = {Humans ; *Sepsis/therapy/diagnosis/prevention & control ; Resource-Limited Settings ; Delphi Technique ; Developing Countries ; Consensus ; }, abstract = {OBJECTIVES: Almost 80% of sepsis cases occur in low-resource settings (LRS), where limited resources impede the effective implementation of international guidelines for sepsis management. In addition, existing sepsis guidelines have not fully addressed specific issues relevant to LRS. Therefore, an international panel of 20 multiprofessional sepsis experts was convened to generate consensus on the gaps in and strategies for sepsis care in LRS. The recently developed "sepsis chain of survival" was used as a framework.
DATA SOURCES: MEDLINE, Embase.
STUDY SELECTION: Studies selected included human studies (clinical trials, cohort, case-control, and case series) reporting clinical outcomes in patients with sepsis from LRS between January 1, 2000, and July 4, 2024. Search terms included "developing countries," "LMIC," "resource-poor settings," and regional terms such as Africa, Southeast Asia, and Latin America. The Delphi process involved iterative, anonymous voting by the expert panel to achieve consensus to draft clinical practice statements.
DATA EXTRACTION: A detailed literature review was conducted using the "sepsis chain of survival" as a basis, with an emphasis on sepsis prevention, detection, therapy, post-sepsis care, education, and future research priorities. A total of 8865 studies were identified and screened, with 155 included in the review.
DATA SYNTHESIS: Based on literature review, the Delphi process achieved a stable consensus for 58 of 62 (94%) of the proposed clinical practice statements after eight survey rounds. These statements offer guidance on measures to improve the prevention, early recognition and time-sensitive, comprehensive management of sepsis in LRS through the continuum of care from first response to post-sepsis care and follow-up.
CONCLUSIONS: There remains a significant lack of high-quality evidence to support improvements in sepsis care for patients in LRS. Pending new data, the clinical practice statements identified here complement the existing international guidelines for sepsis management by serving as a basis for immediate care and future research in LRS.}, }
@article {pmid41860329, year = {2026}, author = {Hidalgo, JL and Akech, SO and Acharya, SP and Coopersmith, CM and Jacob, ST and Johnston, C and Kissoon, N and Machado, FR and Maves, RC and Molyneux, E and Morrow, BM and Myatra, SN and Pérez Cornejo, MS and Perez-Fernandez, J and Permpikul, C and Piyavechviratana, K and Rhodes, A and Kortz, TB and Kumar, VK and Ulisubisya, MM and Nadkarni, V}, title = {The Frame of Survival for Sepsis: A Practical Systems Framework for Time-Sensitive Critical Illness in Low-Resource Settings.}, journal = {Critical care medicine}, volume = {54}, number = {5}, pages = {1202-1208}, doi = {10.1097/CCM.0000000000007093}, pmid = {41860329}, issn = {1530-0293}, mesh = {Resource-Limited Settings ; *Sepsis/therapy/mortality/diagnosis ; Humans ; *Critical Illness/therapy/mortality ; Quality Improvement/organization & administration ; *Critical Care/organization & administration/standards ; }, abstract = {OBJECTIVES: Sepsis is a time-sensitive cause of preventable death worldwide, with disproportionate mortality in low-resource settings (LRS). Many recommendations in international sepsis guidance presume resources unavailable in many facilities and communities. We sought to develop a practical framework that helps health systems embed feasible sepsis actions within broader emergency and essential critical care systems, while highlighting where evidence is limited and where local learning systems are needed.
DATA SOURCES: A targeted scoping review of peer-reviewed and grey literature on sepsis epidemiology, emergency care systems, essential emergency and critical care, implementation strategies, and quality improvement (QI) in LRS; and key guideline and policy documents relevant to sepsis and emergency care.
STUDY SELECTION: We prioritized publications and guidance relevant to LRS, including observational studies, pragmatic implementation reports, consensus statements, and policies addressing emergency care organization, workforce, supply chains, diagnostics, and QI.
DATA EXTRACTION: Task force members abstracted actionable strategies, implementation barriers/enablers, and feasibility considerations across the care continuum (community, transport/prehospital, facility-based acute care, and referral). We also identified domains where guideline certainty is low or indirect for LRS.
DATA SYNTHESIS: A Society of Critical Care Medicine-convened multidisciplinary task force iteratively developed the "Sepsis Frame of Survival" using a structured process that included 1) scoping evidence review, 2) a Delphi-style prioritization of candidate framework elements by importance and feasibility, and 3) a structured consensus meeting ("Utstein-style" conference format) to finalize the model and its priority actions. We produced a concise implementation roadmap and a feasible measurement set aligned with resource constraints.
CONCLUSIONS: The Sepsis Frame of Survival is a pragmatic model to organize sepsis improvement as part of emergency and essential critical care strengthening. It emphasizes high-impact actions that can be implemented with limited resources (triage and early recognition, timely antimicrobials, oxygen and basic supportive care, cautious fluid resuscitation with reassessment, source control and referral, diagnostics/microbiology where feasible, and QI). The framework explicitly distinguishes near-term, feasible changes from longer-term system investments and highlights the need for locally generated evidence to guide quality indicators and resuscitation strategies in LRS.}, }
@article {pmid41861257, year = {2026}, author = {Madhugiri, R and Slanina, H and Saleem-Batcha, R and Ziebuhr, J}, title = {The Coronavirus Replication-Transcription Complex.}, journal = {Annual review of biochemistry}, volume = {95}, number = {1}, pages = {317-346}, doi = {10.1146/annurev-biochem-052621-091439}, pmid = {41861257}, issn = {1545-4509}, mesh = {*Virus Replication ; Humans ; *Coronavirus/genetics/physiology ; *RNA, Viral/genetics/biosynthesis/metabolism ; *RNA Replication ; Animals ; *Transcription, Genetic ; }, abstract = {Coronaviruses (family Coronaviridae, order Nidovirales) include major human and animal pathogens. They have exceptionally large RNA genomes and use complex strategies to replicate and express these genomes. Intensive research activities in recent years have significantly advanced our knowledge of the molecular mechanisms involved in coronavirus RNA synthesis. Here, we briefly review these mechanisms and focus in particular on the structures and functions of the core replication-transcription complex (RTC) and other enzyme functions that can be recruited to this complex to fulfil additional functions, for example, in the context of 5' capping of viral mRNAs or in the context of mechanisms that control the processivity, replication fidelity, and backtracking of RTCs. Some of these recent studies provided fundamentally new insight into specific roles of previously identified genetic markers of coronaviruses and other nidoviruses, including specific functions in an unconventional RNA capping mechanism and potential roles in proofreading and discontinuous negative-strand RNA synthesis.}, }
@article {pmid41862100, year = {2026}, author = {Cordeiro, J and Macela, C and Kleiner, R and Vaskovich-Koubi, D and Moura, LIF and Satchi-Fainaro, R and Florindo, HF}, title = {Harnessing the power of microbiome, nanotechnology, and immunity against cancer.}, journal = {Journal of controlled release : official journal of the Controlled Release Society}, volume = {394}, number = {}, pages = {114839}, doi = {10.1016/j.jconrel.2026.114839}, pmid = {41862100}, issn = {1873-4995}, mesh = {Humans ; *Microbiota/immunology ; *Neoplasms/immunology/therapy/microbiology ; *Nanotechnology/methods ; Animals ; Immunotherapy/methods ; Tumor Microenvironment/immunology ; }, abstract = {The human microbiome has emerged as a key player in health and disease, including cancer, which remains one of the leading causes of mortality worldwide. Although advances in understanding the tumor immune microenvironment and the development of immunotherapies have transformed cancer treatment, clinical efficacy remains limited by suboptimal response rates and severe side effects. Recent integrative research in cancer biology, immune-oncology, and cancer microbiome research, enabled by omics technologies and advanced bioinformatics, has begun to reveal intricate links between the microbiome, cancer progression, and immune modulation. These findings underscore the microbiome's pivotal role in shaping both therapeutic efficacy and resistance mechanisms. Currently, nanotechnology, propelled into mainstream success through the development of COVID-19 mRNA vaccines, is offering new tools for precision oncology. Nanomaterials are now being explored not only for targeted drug delivery but also for monitoring and modulating the microbiome, with significant potential for biomarker discovery and personalized medicine. In this article, we explore the role of the microbiota in tumorigenesis and cancer therapy, with a particular focus on its crosstalk with the immune system. We highlight emerging microbiota-targeted therapeutic strategies and discuss how nanotechnology-based systems are being designed to modulate the microbiome-immune-cancer axis. Finally, we discuss future directions in leveraging the convergence of microbiome science, nanotechnology, and immunotherapy to advance cancer treatment.}, }
@article {pmid41862909, year = {2026}, author = {Khalid, K and Abdullah, ADI and Lim, HX and Ali, RAR}, title = {Pharmacological and non-pharmacological management of long COVID.}, journal = {Virology journal}, volume = {23}, number = {1}, pages = {}, pmid = {41862909}, issn = {1743-422X}, mesh = {Humans ; *COVID-19/therapy/complications ; Post-Acute COVID-19 Syndrome ; Probiotics/therapeutic use ; SARS-CoV-2 ; Dysbiosis ; Pandemics ; *Coronavirus Infections/therapy ; }, abstract = {Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a major global health burden in terms of acute infection and long-term consequences. Approximately 10% of infected experience autonomic dysfunction, cardiovascular complications, and neurological impairments. While immune dysregulation, persistent viral reservoirs, chronic inflammation, gut dysbiosis, and vascular dysfunction are implicated, the exact pathophysiological mechanisms of Long COVID remain unclear. Additionally, treatment options are limited and challenging to prescribe due to symptom heterogeneity. Non-pharmacological interventions such as increased salt intake, elimination diets for gastrointestinal symptoms, and cognitive pacing for fatigue may not be sufficient for severe symptoms. Moreover, pharmacological interventions such as β-blockers, calcium channel blockers, pyridostigmine, antihistamines, and low-dose naltrexone can improve tachycardia, fatigue, and brain fog but there are no standardized guidelines. In light of evidence supporting a strong association of Long COVID with gut dysbiosis, probiotics have emerged as a promising intervention. Clinical studies have shown that Bacillus coagulans, Bacillus subtilis, Lactobacillus acidophilus, and Bifidobacterium species can improve fatigue, gastrointestinal health, and overall physical and mental well-being in Long COVID patients. Large-scale randomized controlled trials are warranted to validate probiotic efficacy in Long COVID and reduce burden on individual health and healthcare institutions.}, }
@article {pmid41862917, year = {2026}, author = {Luo, S and Zheng, Z and Karimi, L and Plebanski, M and Lankatillake, C and Sheahan, J and Anderson, K and Jovanovski, N and Seal, EL and Cockshaw, W and Wollersheim, D and Cleary, S and El-Ansary, D and Flanagan, KL and Jessup, R and Abrahamson, S and Whyler, N and Fineberg, D and Scoullar, MJL and Seeley, MC and Tippett, E and Xenos, S and Itsiopoulos, C}, title = {Between silence and solutions: a global guideline review of long COVID care and services in Australia.}, journal = {BMC health services research}, volume = {26}, number = {1}, pages = {}, pmid = {41862917}, issn = {1472-6963}, mesh = {Humans ; *COVID-19/therapy/epidemiology ; Australia ; *Practice Guidelines as Topic ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; Primary Health Care ; Delivery of Health Care ; }, abstract = {BACKGROUND: As the acute response to the COVID-19 pandemic shifts to long-term management, the lasting effects of infection are becoming increasingly evident. Long COVID continues to challenge healthcare systems, with many healthcare professionals reporting uncertainty about assessment and referral pathways. This updated review examines recent international guidelines alongside Australian services to identify gaps between guidelines and practice. METHODS: Between April and October 2025, we searched for guidelines on Long COVID published in English and assessed their quality by applying the AGREE II appraisal tool. We also conducted a grey literature search to profile active Australian services providing Long COVID care. RESULTS: Three new or updated guidelines were published in the United States, Canada, and New South Wales, Australia. Together with the World Health Organisation, United Kingdom and New Zealand guidelines identified in the previous review, all emphasise integrated, primary care-led approaches. Notably, Australian service delivery remains fragmented, with a growing number of primary health practitioner-led private services operating largely under a fee-for-service model, leading to variations in access and affordability. Many hospital-based outpatient clinics have been absorbed into existing chronic-disease services. The most fundamental challenge is statistical invisibility: without an activated diagnostic code, services cannot reliably identify or follow people living with Long COVID. This invisibility limits both surveillance and service planning. DISCUSSION AND CONCLUSIONS: Australia is currently developing national clinical best-practice guidelines for ME/CFS, which may also benefit Long COVID; however, Australia remains behind comparable nations such as Canada, the United Kingdom, and the United States in developing and implementing the integrated, multidisciplinary care models recommended internationally. This has significant implications, namely that the rapid transition from hospital-based Long COVID clinics to primary care-led services has resulted in fragmented and uncoordinated care. Strengthening Australia’s response will require national leadership and investment in workforce training, sustainable funding for care coordination, improved public and professional awareness, the establishment of primary care-led multidisciplinary pathways, and the activation of a dedicated diagnostic code. Also importantly, shifting to a patient-centred approach and patient-practitioner collaborative model of care is essential to prepare the health system for managing Long COVID and future complex, multi-system conditions.}, }
@article {pmid41863157, year = {2026}, author = {Mori, Y and Silwal, S and Wan Mohd Yunus, WMA and Sourander, A}, title = {Long-Term Trends in Screen Time Use Among Children and Adolescents: A Systematic Review Including Pre- and Post-COVID Periods.}, journal = {Clinical child psychology and psychiatry}, volume = {}, number = {}, pages = {13591045261432532}, doi = {10.1177/13591045261432532}, pmid = {41863157}, issn = {1461-7021}, abstract = {The rapid rise in internet access and smartphone use has significantly changed how children and adolescents engage in screen-based activities. To date, no systematic review has examined long-term trends in screen time use among children and adolescents that cover periods before and after the onset of the COVID-19 pandemic. This systematic review examined repeated cross-sectional studies to determine whether screen time use among children and adolescents changed over time. This systematic review was registered with PROSPERO (ID: CRD42021243869). The Web of Science, PubMed, Embase, and PsycINFO databases were searched to identify peer-reviewed studies that had been published in English, included data from at least two time points, and focused on children and adolescents between 0 and 19 years of age. The search was conducted without any restrictions on publication year. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality was assessed using the Quality Assessment Tool for Studies with Diverse Designs. A narrative synthesis was conducted following the Synthesis Without Meta-analysis guidelines. This review identified 60 studies covering the period 1991-2022. The findings indicate that traditional TV watching declined while the use of computers and video games grew. Screen time increased significantly over the years, especially after the COVID-19 pandemic started. The studies reviewed varied in how they defined and measured screen time. The review underscores the importance of continued research and evidence-based policies to guide responsible technology use in the lives of young people.}, }
@article {pmid41863427, year = {2026}, author = {Barzoki, MG and Farahmand, M and Mahmodi, MJ and Amirjannati, N and Malekshahi, SS}, title = {The Impact of SARS-CoV-2 on Male Infertility: A Systematic Review and Meta-Analysis of Cohort Studies.}, journal = {Reviews in medical virology}, volume = {36}, number = {2}, pages = {e70128}, doi = {10.1002/rmv.70128}, pmid = {41863427}, issn = {1099-1654}, support = {4021102//National Institute for Medical Research Development/ ; }, mesh = {Male ; Humans ; *Infertility, Male/virology/etiology/epidemiology ; *COVID-19/complications/virology ; *SARS-CoV-2/pathogenicity ; Spermatozoa/virology/pathology ; Sperm Motility ; Semen Analysis ; Sperm Count ; Cohort Studies ; Semen/virology ; DNA Fragmentation ; }, abstract = {Several conclusions have emerged regarding the impact of COVID-19 on the male reproductive system. This systematic review and meta-analysis aimed to provide a comprehensive update on the relationship between COVID-19 and male reproductive health. We investigated the effects of SARS-CoV-2 on various semen parameters, including semen volume, sperm concentration, sperm total count, total motility, progressive motility, morphology, and DNA fragmentation index (DFI). A literature review was conducted on all studies evaluating the impact of SARS-CoV-2 infection on male infertility from the beginning of 2019 through December 2023. Main electronic databases such as PubMed, Scopus, Cochrane Library, and Web of Science were used. The research question was based on the PECO framework, focusing on (Population) exposed to SARS-CoV-2 (Exposure), compared to uninfected men (Comparator), with conventional sperm parameters as the measured Outcome. The studies were divided into two groups for analysis: between-group comparisons, which compared sperm parameters of men recovered from COVID-19 to uninfected controls, and within-subject comparisons, which assessed sperm parameters in the same individuals before and after infection. Standardized mean differences (SMD) were calculated as effect sizes with 95% confidence intervals (CI) for each outcome. The DerSimonian-Laird method estimated between-study variance (τ[2]), while the Jackson method calculated confidence intervals for τ[2] and τ. Publication bias was assessed using funnel plots and Egger's test. This meta-analysis included two types of cohort studies: single-arm studies and those with a control group. In the single-arm studies, a statistically significant decrease in semen volume (p = 0.0023) was observed. Additionally, in the cohort studies with controls, there were statistically significant reductions in sperm concentration (p < 0.0001), total count (p = 0.0001), total motility (p = 0.0009), progressive sperm motility (0.0391), and DFI (0.04). This is the most up-to-date systematic review and meta-analysis incorporating cohort study data. The findings provide compelling evidence that SARS-CoV-2 infection adversely affects male reproductive health, particularly in terms of semen quality. The analysis reveals significant reductions in key semen parameters, including sperm count, concentration, total motility, and progressive motility. Adult maleand DFI.}, }
@article {pmid41864480, year = {2026}, author = {Rauf, M and Naveed, A and Asghar, MU}, title = {Post-acute sequelae of COVID-19: A disorder of impaired innate immune resolution - A narrative review.}, journal = {Clinical immunology (Orlando, Fla.)}, volume = {285}, number = {}, pages = {110701}, doi = {10.1016/j.clim.2026.110701}, pmid = {41864480}, issn = {1521-7035}, mesh = {Humans ; *Immunity, Innate/immunology ; *COVID-19/immunology/complications ; Post-Acute COVID-19 Syndrome ; *SARS-CoV-2/immunology ; Trained Immunity ; Alarmins/immunology ; Inflammation/immunology ; Inflammasomes/immunology ; Innate Immunity Recognition ; }, abstract = {Post-acute sequelae of COVID-19 (PASC) affect millions of people worldwide and are increasingly recognized as a disorder of failed innate immune resolution rather than a persistent viral infection. Emerging evidence shows that residual SARS-CoV-2 antigens, host-derived alarmins, reactivated latent viruses, and mucosal microbiome-derived products from oral-nasopharyngeal and gut reservoirs sustain the chronic activation of pattern-recognition receptors, inflammasomes, and complement pathways. In parallel, deficits in specialized pro-resolving mediators, impaired efferocytosis, and persistent tissue injury prevent physiological termination of inflammation. These unresolved cues drive long-lasting epigenetic and metabolic reprogramming of hematopoietic stem cells and myeloid lineages, creating maladaptive trained immunity states characterized by hyper-responsiveness or exhaustion of these cells. Thromboinflammatory processes, including aberrant NETosis and sustained interface signalingling, further reinforce self-perpetuating inflammatory circuits. Together, these pathways give rise to reproducible molecular endotypes, including thromboinflammatory, interferon-driven, and neuroinflammatory phenotypes, which explain clinical heterogeneity. Framing PASC as a disorder of impaired immune resolution within a mucosal microbial viral context provides a unifying mechanistic scaffold for biomarker identification and host-directed therapies. This review proposes that restoring active resolution programs, rebalancing metabolic-epigenetic networks, and dismantling pathogenic innate feedback loops are promising strategies for reversing the chronic immune imprint of PASC.}, }
@article {pmid41865876, year = {2026}, author = {Prichett, LM and Young, AS and Wu, EG and Yolken, RH and Severance, EG and Prandovszky, E and Carmichael, D and Badio, J and Kumra, T}, title = {Uneven Recovery: Intersectional Disparities in Youth Mental Health After COVID-19.}, journal = {Academic pediatrics}, volume = {26}, number = {4}, pages = {103299}, doi = {10.1016/j.acap.2026.103299}, pmid = {41865876}, issn = {1876-2867}, }
@article {pmid41866483, year = {2026}, author = {Liu, HQ and Liu, Y and Gu, KN and Song, YLQ}, title = {Meta-analysis of factors influencing depression in the elderly before and after the COVID-19 pandemic in 2023.}, journal = {BMC geriatrics}, volume = {26}, number = {1}, pages = {}, pmid = {41866483}, issn = {1471-2318}, mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Depression/epidemiology/psychology/diagnosis/etiology ; Aged ; *Pandemics ; Female ; Risk Factors ; SARS-CoV-2 ; }, abstract = {OBJECTIVE: This study aimed to explore and summarize the changes in depressive symptoms and their influencing factors among the elderly before and after the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, so as to provide evidence-based references for the prevention and management of depression in the elderly. METHOD: By searching published in PubMed, EBSCOhost, Springer Link, Web of Science, Taylor and Francis databases, the literature on depression in older adults was collected using the 15-item Geriatric Depression Scale (GDS-15), Depression Scale (CDS-11) questionnaire and diagnostic interview (CDI-SF) as a tool. Among them, in the included literature, before January 2023 was identified as the pre-outbreak of the COVID-19 pandemic, and due to the differences in the time of full liberalization of countries, the beginning of 2023 to now was identified as the late outbreak of the COVID-19 pandemic, and Stata17 was used for meta-analysis. RESULTS: Thirteen pre-COVID-19 pandemic and seven post-COVID-19 pandemic literatures were included. A total of seven influencing factors were included. Before the COVID-19 pandemic: Before the COVID-19 pandemic, trends in potential risks for depression among older adults included: being female (OR = 1.464, 95% CI: 1.164~1.840,p < 0.001), being divorced or widowed (OR = 2.126, 95% CI: 1.170~3.862, P = 0.013), and having a chronic disease (OR = 1.174, 95% CI: 1.023~1.347, P = 0.022), age ≥ 70 years (OR = 1.336,95%CI: 0.850~2.102, P = 0.210), loneliness (OR = 2.450,95%CI: 2.445~2.455, P = < 0.001) and the junior middle school and the following qualifications (OR＝1.145, 95% CI:0.873~1.501, p＝0.327) were trends in potential risks for depression in older adults. Living alone (OR = 0.939, 95%CI: 0.417~2.116, P = 0.88), high school education or above (OR = 0.904,95%CI: 0.640~1.276, P = 0.564) were the lower risks. After the outbreak: being female (OR = 1.156, 95% CI: 0.675 ~ 1.980, P = 0.596), the junior middle school and the following qualifications (OR = 1.05, 95% CI: 0.964 ~ 1.143, P = 0.264), having a chronic disease (OR = 1.269, 95% CI: 1.003 ~ 1.605, P = 0.047), age ≥ 70 years (OR = 1.472, 95% CI: 0.861 ~ 2.517, P = 0.158), there is loneliness (OR = 2.913, 95% CI: 2.372 ~ 3.578, p < 0.001), live alone (OR = 1.627, 95% CI: 0.798 ~ 3.318, P = 0.180), high school education or above (OR = 1.053,95%CI:0.757 ~ 1.465, P = 0.757) were trends in potential risks for depression in older adults, divorce or widowed (OR = 0.482,95%CI:0.041 ~ 5.704, P = 0.563) were lower risks. CONCLUSIONS: The study found that the association patterns between depression in the elderly and five factors (divorced or widowed status, aged ≥ 70 years, loneliness, living alone, and high school education or above) exhibited distinct characteristics before and after the pandemic. Among these, loneliness and chronic diseases were consistently significant risk factors for depression in the elderly, and the strength of the association between loneliness and depression was further enhanced in the post-pandemic period. Notably, the significant association between female gender and depression observed in the pre-pandemic period no longer existed in the post-pandemic period. This change is speculated to be related to adjustments in the coverage of social support after the pandemic, which requires further verification in subsequent studies. Based on the above association characteristics, targeted intervention measures can be adopted in the post-pandemic period, such as striving to alleviate loneliness in the elderly, strengthening health monitoring for key groups including the elderly living alone and those aged ≥ 70 years, and promoting the organic integration of chronic disease management and psychological assessment, so as to effectively reduce the risk of depression in the elderly.}, }
@article {pmid41866665, year = {2026}, author = {Tao, S and Zhou, Z and Li, X and Wang, XW and Liu, X and Kang, D}, title = {Recent Advances of Non-Nucleoside Polymerase Inhibitors With Broad-Spectrum Antiviral Activities.}, journal = {Medicinal research reviews}, volume = {46}, number = {4}, pages = {945-965}, doi = {10.1002/med.70041}, pmid = {41866665}, issn = {1098-1128}, support = {tsqn 202408055//Taishan Scholar Program of Shandong Province/ ; 2023YFC2308900//National Key Research and Development Program/ ; 2023YFE0206500//National Key Research and Development Program/ ; SYS202205//Shandong Laboratory Program/ ; //Qilu Young Scholars Program of Shandong University/ ; }, mesh = {*Antiviral Agents/pharmacology/chemistry/therapeutic use ; Humans ; *Enzyme Inhibitors/pharmacology/chemistry ; Animals ; SARS-CoV-2/drug effects/enzymology ; }, abstract = {A tremendous and painful price has been paid in the fight against pandemic viruses in the global health field. Emerging and re-emerging viruses serve as primary drivers of severe pandemics, such as influenza virus (IV), respiratory syncytial virus (RSV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Viral polymerases are highly conserved among viruses of the same genus. Inhibitors targeting polymerases often exhibit broad-spectrum antiviral activity against these same genus viruses, playing a crucial role in antiviral therapies. Non-nucleoside polymerase inhibitors demonstrate their superiority in terms of safety and anti-mutation ability out of nucleoside/nucleotide polymerase inhibitors. This review presents an overview of non-nucleoside polymerase inhibitors along with their relative antiviral activities and mechanisms of action, providing a reference for the development of novel antiviral drugs with broad-spectrum activities.}, }
@article {pmid41867155, year = {2026}, author = {Valero-Gaspar, T and Garriga, C and Unim, B and Feteira-Santos, R and Palmieri, L and Díaz, A and Rodríguez-Blázquez, C and Forjaz, MJ}, title = {Indirect impact of COVID-19 pandemic on health and wellbeing: a narrative review.}, journal = {Annali dell'Istituto superiore di sanita}, volume = {62}, number = {1}, pages = {53-66}, doi = {10.4415/ANN_26_01_08}, pmid = {41867155}, issn = {2384-8553}, mesh = {Humans ; *COVID-19/psychology/economics/epidemiology ; *Quality of Life ; Mental Health ; *Cost of Illness ; *Health Status ; Life Expectancy ; Pandemics ; Disability-Adjusted Life Years ; Psychological Well-Being ; Quality-Adjusted Life Years ; }, abstract = {INTRODUCTION: The COVID-19 pandemic had a profound impact on global health, notably affecting patients with non-COVID-19 conditions, who faced substantial disruptions in their treatment and care. The aim of this narrative review was to identify the main indicators used in literature to evaluate the indirect impact of COVID-19 on health and wellbeing.
METHOD: A literature search was conducted using PubMed from January 2021 to November 2022. The indicators were categorized into five main groups: burden of disease (BoD), life expectancy (LE), health-related quality of life (HRQoL), cost of illness and mental health status and were retrieved from 20 scientific articles.
RESULTS: Disability-adjusted life years (DALYs) revealed substantial health losses; a decrease in LE was observed, with inequalities across population subgroups; HRQoL showed impairments in physical functioning, daily activities and emotional well-being; productivity losses were economically relevant and varied by context and elevated symptoms of anxiety and depression were reported.
DISCUSSION: The compiled indicators may contribute to the development of sustainable pandemic mitigation policies.}, }
@article {pmid41868370, year = {2026}, author = {Li, H and Wang, T and Xiang, T and Xu, L and Zheng, Z and Zheng, X}, title = {Secondary fungal infections in severe acute viral diseases: clinical features and underlying immune mechanisms.}, journal = {Frontiers in microbiology}, volume = {17}, number = {}, pages = {1780547}, pmid = {41868370}, issn = {1664-302X}, abstract = {Secondary fungal infections are increasingly recognized as critical factors in the prognosis of severe acute viral infections, including influenza, SARS-CoV-2, Severe Fever with Thrombocytopenia Syndrome virus, and Dengue. This review outlines the clinical features of fungal complications, proposing a "virus-driven immune reprogramming" framework. It highlights how viral infections disrupt immune barriers, impair the Th17-IL-17 antifungal axis, attenuate platelet immune function, and involve unique pathogen interactions, creating a host immune microenvironment that is more susceptible to fungal invasion. Understanding these immune-injury mechanisms underscores the clinical importance of earlier surveillance of secondary fungal disease and informs the development of mechanism-guided therapeutic approaches to improve patient outcomes.}, }
@article {pmid41869111, year = {2026}, author = {Bartley, G and Waugh, S and Gopalan, V}, title = {Evaluating Study Techniques for Australian Medical Students During Clinical Placement: A Scoping Review.}, journal = {Cureus}, volume = {18}, number = {2}, pages = {e103802}, pmid = {41869111}, issn = {2168-8184}, abstract = {Transitioning from pre-clinical to clinical phases of medical education represents a unique challenge as students learn most content through self-directed learning (SDL), rather than the more prescriptive pre-clinical curriculum. There is a range of SDL study techniques employed by medical students on placement. The COVID-19 pandemic accelerated the adoption of digital resources, prompting a need to reassess the study techniques that best support clinical-year medical students. However, there is a lack of research on which study techniques Australian clinical-year medical students find most effective. The objective of this study is to evaluate the evidence on student-perceived utility of common study techniques for SDL whilst on clinical placement in Australia. A qualitative scoping review of literature on PubMed and Medline Ovid was performed in 2024. Study inclusion criteria for articles were published articles, English language, publication within 20 years, and focus on clinical-year medical students. Exclusion criteria were review articles, investigations focusing on a specific educational intervention, and studies including only pre-clinical students. Studies were qualitatively appraised and synthesised by tabulation in Microsoft Excel (Microsoft Corp., Redmond, WA, US). Risk of bias analysis was not performed. Nine studies from Australia, the USA, the UK, Thailand, Saudi Arabia, and Malaysia were analysed. This included seven cross-sectional, one mixed-methods, and one qualitative analysis. Sample size ranged from 12 to 350 students. Only two studies were conducted after the COVID-19 pandemic. Overall, the results of the included studies demonstrate a consistent trend towards third-party online tools, including question banks, mobile applications, and revision courses for SDL. The strength of evidence on students' perceived efficacy of study techniques in the post-pandemic era presented is limited due to the small number of included studies and the lack of formal study appraisal. There is also poor generalisability of pre-pandemic and international studies to the contemporary Australian context. As there is a lack of a standardised tool to evaluate study technique utility, comparison between studies is difficult. Ongoing research is required to develop evidence-based guidelines that can assist students in commencing SDL whilst on clinical placement.}, }
@article {pmid41869535, year = {2026}, author = {Singh, H and Tripathi, G and Khan, AA and Verma, A and Singh, A}, title = {Autophagy, telomerase, and endothelial dysfunction in COVID-19-induced cardiac injury: an evidence-graded genetic and epigenetic synthesis.}, journal = {Frontiers in cardiovascular medicine}, volume = {13}, number = {}, pages = {1769828}, pmid = {41869535}, issn = {2297-055X}, abstract = {BACKGROUND: Cardiac injury is a frequent and severe complication of COVID-19, yet the molecular mechanisms driving myocardial involvement remain incompletely understood. Dysregulated autophagy, telomerase/telomere biology, and endothelial dysfunction have emerged as biologically plausible and potentially interconnected contributors to COVID-19-associated cardiac injury.
METHODS: We conducted a narrative, evidence-graded review of literature retrieved from PubMed and EMBASE, with Google Scholar used selectively as a supplementary source to capture emerging or cross-disciplinary studies. Eligible studies included human investigations and relevant animal models reporting genetic, epigenetic, or molecular alterations in autophagy, telomerase, or endothelial pathways with cardiovascular relevance. Non-English publications, studies lacking primary data, and reports unrelated to cardiovascular or systemic disease mechanisms were excluded. Evidence was stratified as Level I (direct evidence in COVID-19-associated cardiac injury), Level II (COVID-19 systemic or vascular evidence with plausible cardiac relevance), and Level III (non-COVID cardiovascular or systemic disease; hypothesis-generating).
FINDINGS: Across viral, cardiovascular, and systemic contexts, key candidate genes, including ATG5, ATG7, Beclin-1, TERT, ICAM1, and eNOS -emerged as potential mediators of COVID-19-related cardiac injury. While endothelial activation is supported by relatively consistent clinical and molecular evidence, direct cardiac-tissue data linking autophagy and telomerase pathways to COVID-19-associated myocardial injury remain limited. These gaps highlight substantial uncertainty regarding causal mechanisms and inter-individual susceptibility.
CONCLUSION: Autophagy dysregulation, telomere attrition, and endothelial dysfunction represent convergent and biologically plausible mechanisms contributing to COVID-19-associated cardiac injury; however, current evidence remains largely indirect and derived from systemic or vascular compartments rather than cardiac tissue. Cardiac-specific, longitudinal genetic and epigenetic studies are required before these pathways can be considered for biomarker development or therapeutic targeting.}, }
@article {pmid41869602, year = {2026}, author = {Frodsham, C and Harvey, SB and Collins, D and Krakue, K and Dalgaard, VL and Lipscomb, R and Hotopf, M and Deady, M and Bryant, R and Gayed, A}, title = {Prevalence of post-traumatic stress disorder in healthcare workers before and during COVID-19: a systematic review and meta-analysis.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1735552}, pmid = {41869602}, issn = {2296-2565}, mesh = {Humans ; *Stress Disorders, Post-Traumatic/epidemiology ; *COVID-19/epidemiology/psychology ; Prevalence ; *Health Personnel/psychology/statistics & numerical data ; Frontline Workers ; Pandemics ; SARS-CoV-2 ; }, abstract = {UNLABELLED: The COVID-19 pandemic exacerbated many known risk factors for post-traumatic stress disorder (PTSD) among healthcare workers. This systematic review and meta-analysis examines pooled prevalence estimates of probable PTSD among this cohort prior to COVID-19 compared to during COVID-19 and investigates time trends in prevalence. Systematic multi-database literature searches were conducted to identify studies published between January 2017 and July 2023. Included studies reported the prevalence of probable PTSD, measured by validated screening tools, in clinical healthcare workers. Two reviewers independently conducted study screening, data extraction, and quality assessment. Random-effects meta-analyses were performed to estimate pooled prevalence of probable PTSD among healthcare workers in each time period. Subgroup analyses were carried out for year, profession, quality of study, COVID-19 mortality rates, and income level within the country of study. Screening identified 21 papers comprising 11,838 healthcare workers published in the 3 years preceding the pandemic, and 129 papers reporting on 130,363 healthcare workers during the pandemic. The pooled prevalence estimate of probable PTSD prior to the pandemic was 15.5% (95% CI: 12.3-19.3%) and this significantly increased during the pandemic to 24.8% (95% CI: 22.0-27.8%), peaking early in the pandemic in 2020 before returning to pre-pandemic levels in 2022. During the pandemic, prevalence estimates were significantly higher among nurses and those in countries with high COVID-19 mortality rates, whilst no significant difference was observed between studies conducted in high-income versus low- and middle-income countries. Substantial heterogeneity was observed. The findings of this review suggest that prevalence of PTSD among healthcare workers significantly increased following the COVID-19 outbreak. By the third year of the pandemic, probable PTSD prevalence rates appear to return to pre-pandemic levels, although these levels remain concerningly high. These findings support the call for targeted interventions to protect healthcare worker wellbeing, particularly during healthcare emergencies.
https://www.crd.york.ac.uk/PROSPERO/view/CRD42022364955, unique identifier is CRD42022364955.}, }
@article {pmid41869844, year = {2026}, author = {Weiss, SL and Peters, MJ and Oczkowski, SJW and Belley-Cote, E and Buysse, C and Choong, KLM and Deep, A and Inwald, DP and Flori, HR and Kneyber, MCJ and Menon, K and Murthy, S and Nunnally, ME and Parker, MM and Schlapbach, LJ and Oliveira, CF and Sorce, LR and Agus, M and Argent, AC and Balamuth, F and Bansal, A and Bem, RA and Brierley, J and Burns, KEA and Carlton, EF and Carrol, ED and Carroll, CL and Carter, MJ and Conlon, TW and Daniels, R and De Luca, D and Di Nardo, M and Dulfer, K and Faust, SN and Fernandez-Sarmiento, J and Fitzgerald, JC and Hall, M and Hsu, BS and Javouhey, E and Joosten, K and Karam, O and Kelly, SP and Lang, HJ and Lee, JH and Lemson, J and MacLaren, G and Manning, JC and Mehta, N and Morin, L and Morrow, BM and Nadel, S and Nishisaki, A and Pong, S and Raman, S and Randolph, AG and Ranjit, S and Ray, S and Remy, KE and Scott, HF and Sick-Samuels, AC and Souza, DC and Swan, T and Tibby, SM and Valla, FV and Watson, RS and Wiens, MO and Wolf, J and Zimmerman, JJ and Tissieres, P and Kissoon, N}, title = {Surviving Sepsis Campaign International Guidelines for the Management of Sepsis and Septic Shock in Children 2026.}, journal = {Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies}, volume = {27}, number = {4}, pages = {379-434}, doi = {10.1097/PCC.0000000000003927}, pmid = {41869844}, issn = {1529-7535}, mesh = {Humans ; *Shock, Septic/therapy ; *Sepsis/therapy ; Child ; Evidence-Based Medicine/standards ; Adolescent ; Infant ; Child, Preschool ; Practice Guidelines as Topic ; }, abstract = {OBJECTIVES: To update evidence-based management recommendations for clinicians caring for children (including infants, school-aged children, and adolescents) with sepsis or septic shock.
DESIGN: A panel of 68 international experts, representing 13 international organizations, as well as six methodologists, was convened. A formal conflict-of-interest policy was developed at the onset of the process and applied throughout. Teleconferences and electronic-based discussion among the chairs, co-chairs, methodologists, and subgroup leads as well as within subgroups, served as an integral part of the guideline development process.
METHODS: New priority topics and recommendations from the prior guideline iteration were used to identify Population, Intervention, Control, and Outcomes (PICO) questions likely to have new or updated evidence. We conducted a systematic review to identify the best available evidence, summarized the evidence, and then assessed the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation approach. We used the evidence-to-decision framework to formulate recommendations as strong or conditional, or as a good practice statement. "In our practice," statements were included when evidence was inconclusive to issue a recommendation but the panel felt that some guidance based on practice patterns may be appropriate.
RESULTS: The panel provided 61 statements on the management of children with sepsis or septic shock. Overall, five were strong recommendations, 24 were conditional recommendations, and ten were good practice statements. For 22 PICO questions, no recommendations could be made, but, for seven of these, "in our practice" statements were provided. Compared with the 2020 guidelines, 20 recommendations were new, 13 were updated for clarity and/or new evidence, six were reviewed but not changed, and 22 were carried forward based on consensus of the panel that new evidence was not available. Only three recommendations were based on high or moderate certainty of evidence.
CONCLUSIONS: Updated management guidelines were issued by a panel of international experts for the best care of children with sepsis or septic shock, acknowledging that most aspects of care continue to have relatively low quality of evidence.}, }
@article {pmid41870078, year = {2026}, author = {Bayurova, E and Kostyushev, D and Tikhonov, A and Chulanov, V and Gordeychuk, I}, title = {Broad-acting antivirals: the pursuit of pan-viral therapeutics in the era of pandemics.}, journal = {Journal of virology}, volume = {100}, number = {5}, pages = {e0007726}, pmid = {41870078}, issn = {1098-5514}, support = {25-65-00010//Russian Science Foundation/ ; }, mesh = {*Antiviral Agents/therapeutic use/pharmacology ; Humans ; *SARS-CoV-2/drug effects ; *COVID-19 Drug Treatment ; Host-Directed Therapy ; Pandemics ; Drug Repositioning ; Animals ; COVID-19/virology ; Drug Resistance, Viral ; }, abstract = {The ever-present threat of new viral epidemics makes the scientific community relentlessly work on the development of universal methods of antiviral therapy. The development of broad-spectrum antivirals (BSAs) focuses either on substances acting directly on viral proteins (direct-acting antivirals [DAA]) or on substances directed at the cell's own proteins (host-targeting antivirals [HTA]). Decades of development have led to the market entry of a number of DAAs with a wide range of antiviral activities; however, their clinical approval has been obtained for individual infections. HTAs have a number of advantages over DAAs, such as a wider range of antiviral activities and a high genetic barrier to viral resistance, which is undoubtedly important when preparing for a battle with an unknown pathogen. The COVID-19 pandemic has allowed for multiple clinical trials for repurposed HTAs, previously licensed for the treatment of other diseases, including cancer. Despite the enormous work done, the arsenal of BSAs capable of protecting against future pandemics caused by pathogen X is very limited. In this review, we described data on the most studied DAAs and HTAs, effective against at least two unrelated viral pathogens, focusing on those that have been studied in late preclinical and clinical trials. In the end, we highlighted alternative new approaches such as CRISPR-Cas therapy.}, }
@article {pmid41870559, year = {2026}, author = {Weiss, SL and Peters, MJ and Oczkowski, SJW and Belley-Cote, E and Buysse, C and Choong, KLM and Deep, A and Inwald, DP and Flori, HR and Kneyber, MCJ and Menon, K and Murthy, S and Nunnally, ME and Parker, MM and Schlapbach, LJ and Oliveira, CF and Sorce, LR and Agus, M and Argent, AC and Balamuth, F and Bansal, A and Bem, RA and Brierley, J and Burns, KEA and Carlton, EF and Carrol, ED and Carroll, CL and Carter, MJ and Conlon, TW and Daniels, R and De Luca, D and Di Nardo, M and Dulfer, K and Faust, SN and Fernandez-Sarmiento, J and Fitzgerald, JC and Hall, M and Hsu, BS and Javouhey, E and Joosten, K and Karam, O and Kelly, SP and Lang, HJ and Lee, JH and Lemson, J and MacLaren, G and Manning, JC and Mehta, N and Morin, L and Morrow, BM and Nadel, S and Nishisaki, A and Pong, S and Raman, S and Randolph, AG and Ranjit, S and Ray, S and Remy, KE and Scott, HF and Sick-Samuels, AC and Souza, DC and Swan, T and Tibby, SM and Valla, FV and Watson, RS and Wiens, MO and Wolf, J and Zimmerman, JJ and Tissieres, P and Kissoon, N}, title = {Surviving Sepsis Campaign International Guidelines for the Management of Sepsis and Septic Shock in Children 2026.}, journal = {Intensive care medicine}, volume = {52}, number = {5}, pages = {937-983}, pmid = {41870559}, issn = {1432-1238}, mesh = {Humans ; *Shock, Septic/therapy ; *Sepsis/therapy ; Child ; Evidence-Based Medicine ; *Practice Guidelines as Topic ; Adolescent ; Infant ; Child, Preschool ; }, abstract = {OBJECTIVE: To update evidence-based management recommendations for clinicians caring for children (including infants, school-aged children, and adolescents) with sepsis or septic shock.
DESIGN: A panel of 68 international experts, representing 13 international organizations, as well as six methodologists, was convened. A formal conflict-of-interest policy was developed at the onset of the process and applied throughout. Teleconferences and electronic-based discussion among the chairs, co-chairs, methodologists, and subgroup leads, as well as within subgroups, served as an integral part of the guideline development process.
METHODS: New priority topics and recommendations from the prior guideline iteration were used to identify Population, Intervention, Control, and Outcomes (PICO) questions likely to have new or updated evidence. We conducted a systematic review to identify the best available evidence, summarized the evidence, and then assessed the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation approach. We used the evidence-to-decision framework to formulate recommendations as strong or conditional, or as a good practice statement. "In our practice," statements were included when evidence was inconclusive to issue a recommendation, but the panel felt that some guidance based on practice patterns may be appropriate.
RESULTS: The panel provided 61 statements on the management of children with sepsis or septic shock. Overall, five were strong recommendations, 24 were conditional recommendations, and ten were good practice statements. For 22 PICO questions, no recommendations could be made, but for seven of these, "in our practice" statements were provided. Compared with the 2020 guidelines, 20 recommendations were new, 13 were updated for clarity and/or new evidence, six were reviewed but not changed, and 22 were carried forward based on consensus of the panel that new evidence was not available. Only three recommendations were based on high or moderate certainty of evidence.
CONCLUSIONS: Updated management guidelines were issued by a panel of international experts for the best care of children with sepsis or septic shock, acknowledging that most aspects of care continue to have relatively low quality of evidence.}, }
@article {pmid41871039, year = {2026}, author = {Kubica, J and Topoliński, T and Gajda, R and Musz, P and Kubica, A and Szarpak, Ł and Nowicki, K and Ziółkowski, M and Meszyński, S and Grzelak, S and Sokolov, O and Ratajczak, J and Umińska, JM and Niezgoda, P and Grzelakowska, K and Podhajski, P and Obońska, K and Laskowska, E and Piotrowicz, R and Tycińska, A and Specchia, G and Frantz, S and Störk, S and Navarese, EP}, title = {Artificial intelligence as the missing integrator in heart failure care - from remote monitoring to personalized therapy.}, journal = {Cardiology journal}, volume = {33}, number = {}, pages = {e00226032}, pmid = {41871039}, issn = {1898-018X}, mesh = {Humans ; *Heart Failure/therapy/diagnosis ; *Artificial Intelligence ; Remote Patient Monitoring ; COVID-19 ; *Precision Medicine/methods ; Digital Health ; Pandemics ; SARS-CoV-2 ; *Coronavirus Infections/epidemiology ; Telemedicine ; *Pneumonia, Viral/epidemiology ; Intelligent Systems ; }, abstract = {Heart failure (HF) remains a leading cause of morbidity, mortality, and healthcare utilization worldwide, despite the availability of effective evidence-based therapies. The principal challenge is no longer the absence of treatment options but the limited capacity of traditional care models to deliver guidelinedirected medical therapy (GDMT) consistently and at scale. The COVID-19 pandemic exposed the fragility of hospital-centered HF care, highlighting the need for more resilient, patient-centered management strategies. Remote monitoring (RM) has been proposed as a solution, yet its clinical impact has been inconsistent due to fragmented data streams, declining patient adherence, and heavy reliance on continuous human oversight. Artificial intelligence (AI) offers an opportunity to address these limitations by integrating multidimensional clinical data, enabling earlier detection of deterioration, supporting adherence, and prioritizing clinically meaningful interventions. Emerging evidence suggests that AI-assisted workflows can accelerate GDMT optimization and improve surrogate and clinical outcomes when implemented within supervised care pathways. This has led to the concept of next-generation remote monitoring (NGRM), in which AI analyzes longitudinal physiological and behavioral signals to generate context-aware alerts and actionable recommendations while reducing clinical workload. Successful implementation, however, requires rigorous validation, clear governance, integration with clinical workflows, and safeguards for safety, equity, and accountability. When embedded within structured HF care pathways, AI-enabled monitoring may help bridge the persistent gap between evidence and real-world implementation.}, }
@article {pmid41871621, year = {2026}, author = {Sartori, F and Crisafulli, E and Cariqueo, M and Di Chiara, C and Sartori, G and Fantin, A and Torres, A}, title = {Role of Vaccination in the Prevention of ECOPD.}, journal = {Seminars in respiratory and critical care medicine}, volume = {47}, number = {3}, pages = {323-333}, doi = {10.1055/a-2837-8778}, pmid = {41871621}, issn = {1098-9048}, mesh = {Humans ; *Pulmonary Disease, Chronic Obstructive/prevention & control/complications/immunology/physiopathology ; *Vaccination/methods ; Pneumococcal Vaccines/therapeutic use ; COVID-19 Vaccines/therapeutic use ; Influenza Vaccines/therapeutic use ; Respiratory Syncytial Virus Vaccines/therapeutic use ; COVID-19/prevention & control ; *Respiratory Tract Infections/prevention & control ; Influenza, Human/prevention & control ; Disease Progression ; }, abstract = {Exacerbations of chronic obstructive pulmonary disease (ECOPD) represent key events in the natural history of COPD and are associated with several adverse outcomes. Respiratory infections are major and potentially modifiable triggers of ECOPD, with viral pathogens such as the influenza virus, respiratory syncytial virus (RSV), and SARS-CoV-2, as well as bacterial infections caused by Streptococcus pneumoniae, playing a central role. This narrative review examines the current evidence supporting vaccination as a preventive strategy for ECOPD and discusses its translation into clinical practice. The biological rationale for vaccination in COPD is reviewed, including disease-related immune dysregulation, impaired mucociliary clearance, and increased susceptibility to respiratory pathogens. Evidence from randomized clinical trials, observational studies, meta-analyses, and real-world data is summarized for pneumococcal, influenza, SARS-CoV-2, and RSV vaccines. Pneumococcal vaccination has been shown to reduce the burden of community-acquired pneumonia and invasive pneumococcal disease, with conjugate and higher-valent vaccines providing enhanced immunogenicity in older and high-risk adults. Influenza vaccination consistently reduces severe exacerbations, hospitalizations, and mortality, with additional cardioprotective effects of relevance in COPD. SARS-CoV-2 vaccination markedly lowers the risk of severe COVID-19 and related respiratory deterioration in COPD, while recently licensed RSV vaccines offer a novel opportunity to prevent RSV-associated lower respiratory tract disease and potentially reduce exacerbation risk. Patient populations most likely to benefit from vaccination include frequent exacerbators, older adults, individuals with severe airflow limitation, multimorbidity, immune dysfunction, infection-prone phenotypes, and socially vulnerable groups. Future perspectives include precision vaccination strategies, novel vaccine platforms, coadministration approaches, and interventions to improve vaccine uptake. Vaccination emerges as a cornerstone of ECOPD prevention, with substantial potential to reduce exacerbation burden and improve long-term outcomes in COPD.}, }
@article {pmid41871844, year = {2026}, author = {Mullen, AK and Richardson, ET and Bassett, MT and Darity, WA}, title = {A plan for black American reparations.}, journal = {BMJ global health}, volume = {11}, number = {Suppl 1}, pages = {}, pmid = {41871844}, issn = {2059-7908}, mesh = {Humans ; United States ; *Black or African American ; Politics ; Health Policy ; Health Status Disparities ; COVID-19 ; Socioeconomic Disparities in Health ; }, abstract = {The frequent criticism of a programme of reparations for Black Americans is that, however justified, no feasible blueprint exists for its implementation. We provide a detailed outline of a viable plan for reparations for Black American descendants of persons enslaved in the USA. Central to the plan are monetary payments calculated to eliminate the racial wealth gap, the foremost economic indicator of the cumulative, intergenerational effects of White supremacy. Closing the racial wealth gap can, in turn, contribute significantly to reducing racial disparities in health, including overall life expectancy. By providing a comprehensive and actionable plan, it becomes clear that the primary obstacle to adoption of reparations by the US Congress is political resistance. The article concludes with a discussion of the current political climate regarding reparations in the USA and an assessment of whether there are grounds for optimism for progress in the reparations movement.}, }
@article {pmid41872830, year = {2026}, author = {Hu, C and Ying, L and Zhan, Y and Wang, J and Ye, J and Lu, J and Jin, H and Tan, X and Gu, L and Yao, Y and Jiang, N}, title = {Coexistence of pulmonary aspergillosis and cryptococcosis following treatment for SARS-CoV-2 infection in a kidney transplant recipient: a rare case report and literature review.}, journal = {BMC nephrology}, volume = {27}, number = {1}, pages = {}, pmid = {41872830}, issn = {1471-2369}, support = {Grant No.: 82370743//National Natural Science Foundation of China/ ; }, mesh = {Humans ; Female ; *Kidney Transplantation ; Middle Aged ; *Cryptococcosis/complications/diagnosis/drug therapy ; *COVID-19/complications/therapy ; *Pulmonary Aspergillosis/complications/diagnosis/drug therapy ; Antifungal Agents/therapeutic use ; Immunocompromised Host ; Coinfection ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)- associated pneumonia increases patients’ susceptibility to fungal superinfections, particularly among immunocompromised individuals. CASE PRESENTATION: A 60-year-old woman with history of kidney transplantation was admitted for recurrent fever and positive SARS-CoV-2 antigen on pharyngeal swab testing. The patient developed rapid-onset respiratory distress secondary to progressive pulmonary infection and received assisted mechanical ventilation. Microbiological sequencing and culture of bronchoalveolar lavage fluid and sputum, as well as serological tests, revealed the presence of Aspergillus fumigatus, Aspergillus lentulus and Cryptococcus neoformans, along with multiple bacterial and viral pathogens. Following a course of combined antifungal, antibacterial, and antiviral therapies, the patient was successfully weaned off mechanical ventilation. The lung exudates and the large cavitary abscess were absorbed completely. CONCLUSIONS: We reported successful treatment of a rare case of concurrent aspergillosis and cryptococcosis following SARS-CoV-2 pneumonia in a kidney transplantation recipient. The severe fungal infection was probably attributed to the immunosuppressive status associated with a history of solid organ transplantation, as well as prolonged administration of glucocorticoid and antibiotics.}, }
@article {pmid41873169, year = {2026}, author = {Abunijela, S and Greiner, T and Haas, W and Kerber, R and Pütz, P and Schattschneider, A and Schumacher, J and Buchholz, U}, title = {Frequency, dynamics, and duration of faecal shedding in SARS-CoV-2-infected individuals, a scoping review.}, journal = {Epidemiology and infection}, volume = {154}, number = {}, pages = {e44}, pmid = {41873169}, issn = {1469-4409}, support = {//Bundesministerium für Gesundheit/ ; }, mesh = {Humans ; *COVID-19/virology ; *Feces/virology ; *Virus Shedding ; *SARS-CoV-2 ; *Betacoronavirus ; Pandemics ; *Coronavirus Infections/epidemiology/virology ; *Pneumonia, Viral/virology/epidemiology ; RNA, Viral ; Viral Load ; }, abstract = {To estimate illness incidence or prevalence from wastewater data, modelling approaches may benefit from incorporating faecal shedding parameters. We systematically searched PubMed and a public repository on shedding data and included 33 studies that met at least one of our objectives. Among 32 studies, the proportion of SARS-CoV-2-infected individuals with detectable virus in stool ranged from 18 to 100%, with a pooled estimate of 54% (95% CI: 52-56%). Stratification by four clinical severity categories, ranging from asymptomatic to critically ill, showed no significant differences among categories (p-value = 0.49). The proportion of individuals with detectable SARS-CoV-2 RNA in stool was higher in children (61%) than in adults (53%; p-value = 0.02). In half of the individuals who initially shed the virus in stool, it remained detectable for an estimated 22 days post-symptom onset. Three studies documented viral load kinetics, indicating a peak between days 3 and 9. Twenty-five studies reported maximum shedding durations ranging from 2 to 12 weeks. Our review summarizes the frequency, dynamics, and duration of SARS-CoV-2 shedding in stool and may serve as a valuable foundation for modelling efforts involving faecal shedding indicators.}, }
@article {pmid41873421, year = {2026}, author = {Zhang, D and Wang, Y}, title = {The research progress on the role of glucose-6-phosphate dehydrogenase in immune regulation.}, journal = {PeerJ}, volume = {14}, number = {}, pages = {e20971}, pmid = {41873421}, issn = {2167-8359}, mesh = {Humans ; *Glucosephosphate Dehydrogenase/immunology/metabolism ; Glucosephosphate Dehydrogenase Deficiency/immunology ; Animals ; Autoimmune Diseases/immunology ; Immunity, Innate ; Neoplasms/immunology/enzymology ; T-Lymphocytes/immunology ; }, abstract = {Glucose-6-phosphate dehydrogenase (G6PD), the rate-limiting enzyme of the pentose phosphate pathway (PPP), plays a pivotal role in immune regulation by regulating metabolic reprogramming and redox homeostasis of immune cells. It mediates the production of nicotinamide adenine dinucleotide phosphate (NADPH) and ribose-5-phosphate (R5P), which are essential for the activation, proliferation, and effector function of T lymphocytes, B lymphocytes, macrophages, and neutrophils-specifically promoting T/B cell-mediated adaptive immunity and macrophage/neutrophil-mediated innate immune responses. Abnormal G6PD activity (deficiency or overexpression) is closely associated with the pathogenesis of immune-related diseases: G6PD deficiency increases susceptibility to autoimmune diseases (e.g., rheumatoid arthritis, systemic lupus erythematosus) and infectious diseases (e.g., hepatitis, malaria, COVID-19) by inducing oxidative stress and immune cell dysfunction; in tumor immunity, G6PD dualistically promotes tumor cell proliferation while regulating anti-tumor immunity via modulating cytoxic D8[+] T cell exhaustion and macrophage polarization. Additionally, G6PD-targeted immunotherapies, including small-molecule inhibitors and gene therapy, have shown promising preclinical potential for treating immune-related diseases. These findings highlight G6PD as a key metabolic-immune hub, providing critical theoretical basis for understanding immune regulation mechanisms and developing novel diagnostic and therapeutic strategies for autoimmune diseases, infectious diseases, and tumors.}, }
@article {pmid41873444, year = {2026}, author = {Kim, T}, title = {Lessons From the Coronavirus Disease 2019 Pandemic: Implications for Antimicrobial Stewardship for COVID-19 Management.}, journal = {Journal of Korean medical science}, volume = {41}, number = {11}, pages = {e72}, pmid = {41873444}, issn = {1598-6357}, mesh = {Humans ; *Antimicrobial Stewardship ; COVID-19 ; SARS-CoV-2 ; Pandemics ; *Anti-Bacterial Agents/therapeutic use ; *Coronavirus Infections/drug therapy ; Coinfection ; *Pneumonia, Viral/drug therapy ; }, abstract = {The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in millions of deaths worldwide and has now become a major respiratory infectious disease. Beyond the direct effects of the viral infection, one of the most significant and concerning issues to emerge is the exacerbated threat of antimicrobial resistance (AMR) by the indirect impacts of COVID-19. Early in the pandemic, widespread empirical antibiotic prescribing occurred despite low bacterial co-infection rates. In addition, azithromycin, whose antiviral effect remains unproven, was frequently used. This high, often unnecessary consumption, coupled with disrupted antimicrobial stewardship (AMS) and infection prevention and control (IPC) programs, created conditions favoring the emergence and spread of AMR. In patients with severe COVID-19, multidrug-resistant organisms were frequently implicated in secondary infections, particularly in intensive care units (ICUs). Nevertheless, previous studies analyzing AMR metrics before and during the COVID-19 pandemic have shown inconsistent results. Strategies to mitigate the COVID-19 pandemic, such as enhanced surveillance, social distancing resulting in lower respiratory infections, and strengthened IPC and targeted AMS interventions, could play protective roles to inhibit the development of AMR. Additionally, targeted interventions-such as prospective audit and feedback, biomarker-guided antibiotic discontinuation, diagnostic stewardship using a rapid molecular test to distinguish viral from bacterial infections, embedding AMS decision support into electronic medical records, and tailoring interventions to high-risk settings such as ICUs-demonstrated the feasibility of reducing unnecessary antimicrobial use (AMU) even during crisis conditions. Also, vaccination against SARS-CoV-2 may indirectly reduce AMU and AMR by lowering the incidence of severe disease and secondary bacterial infections. Future COVID-19-specific AMS frameworks must integrate these experiences during the pandemic. This review synthesizes current evidence on the interplay between COVID-19, AMR, and AMU, and outlines stewardship strategies to reduce AMR in COVID-19 management.}, }
@article {pmid41873445, year = {2026}, author = {Choe, YJ}, title = {Pediatric COVID-19 in Korea: Lessons and Strategies for Future Disease-X Preparedness.}, journal = {Journal of Korean medical science}, volume = {41}, number = {11}, pages = {e75}, pmid = {41873445}, issn = {1598-6357}, mesh = {Humans ; *COVID-19/epidemiology/prevention & control ; Republic of Korea/epidemiology ; Child ; SARS-CoV-2 ; COVID-19 Vaccines ; Pandemic Preparedness ; Adolescent ; Child, Preschool ; Pandemics ; }, abstract = {The coronavirus disease 2019 (COVID-19) pandemic has had distinct public health and societal impacts on children worldwidely, prompting calls to prepare for the next pandemic by incorporating children's needs. Republic of Korea's experience provides insights into pediatric-focused pandemic response. This review analyzes the impact of COVID-19 on children in Korea and evaluates the national response. This review encompasses the Korea Disease Control and Prevention Agency COVID-19 response white paper, National Medical Center response report, Ministry of Education and Seoul Metropolitan Office of Education white papers, focusing on pediatric data and policies. Key findings were supplemented with international studies on pediatric COVID-19 epidemiology, vaccination, and educational impacts. Children in Korea accounted for a substantial number of COVID-19 cases during omicron wave, yet severe outcomes remained rare. Surveillance adaptations included dedicated monitoring of pediatric multisystem inflammatory syndrome through antibody testing. The healthcare system rapidly adjusted to pediatric needs by allowing home isolation for mild cases and by permitting caregiver accompaniment during pediatric hospital isolation. Vaccine rollout for adolescents began in 2021 and for ages 5-11 in 2022, with an initial policy focusing on high-risk children and voluntary uptake for others. In the education sector, Korea implemented remote learning infrastructure, distributing devices and expanding internet access to bridge the digital divide. Korea's pandemic response illustrates the importance of pediatric-specific strategies: surveillance, child-friendly healthcare protocols, risk communication to improve vaccine acceptance, and treating schools and child services as essential infrastructure.}, }
@article {pmid41873446, year = {2026}, author = {Choi, JY}, title = {Severe COVID-19 in the Republic of Korea: Epidemiology, Risk Factors, Therapeutics, and Prognostic Models From Nationwide Data.}, journal = {Journal of Korean medical science}, volume = {41}, number = {11}, pages = {e96}, pmid = {41873446}, issn = {1598-6357}, support = {RS-2024-00439160/NRF/National Research Foundation/Korea ; }, mesh = {Humans ; *COVID-19/epidemiology/therapy/diagnosis ; Risk Factors ; Prognosis ; Republic of Korea/epidemiology ; SARS-CoV-2/isolation & purification ; Antiviral Agents/therapeutic use ; Comorbidity ; Severity of Illness Index ; Female ; }, abstract = {Severe coronavirus disease 2019 (COVID-19) has posed ongoing clinical and public health challenges worldwide, with Korea providing a unique perspective due to its comprehensive surveillance system and extensive real-world data. This review summarizes evidence from nationwide registries, cohort studies, and clinical trials in Korea, alongside global findings, to describe the epidemiology, risk factors, therapeutic interventions, and prognostic models for severe COVID-19. Between January 2020 and August 2023, Korea reported more than 34 million confirmed cases, with 38,112 classified as severe and 35,608 deaths, yielding one of the lowest case fatality rates among member countries comprising the Organisation for Economic Co-operation and Development. Severity was strongly associated with advanced age and comorbidities such as cardiovascular disease, diabetes mellitus, cancer, psychiatric disorders, and immunocompromised states, including solid organ transplantation and hematologic malignancies. Other risk modifiers included obesity, chronic kidney disease, asthma, and prolonged glucocorticoid therapy. Protective factors included vaccination, regular physical activity, and, in some studies, specific pharmacologic agents. The effectiveness of vaccines was consistently demonstrated, with booster doses markedly reducing hospitalization and mortality, including in high-risk groups such as pregnant women, patients with cancer, and transplant recipients. Antiviral therapies, notably nirmatrelvir/ritonavir and molnupiravir, significantly reduced severe outcomes, while immunomodulators such as dexamethasone and tocilizumab improved recovery in patients with severe disease. Advanced interventions, including extracorporeal membrane oxygenation and lung transplantation, were used for refractory respiratory failure, with favorable survival observed in selected patients. Prognostic models integrating clinical, radiological, and machine learning approaches have been developed to predict disease progression, supporting early risk stratification and resource allocation. The rapid generation of evidence on predicting, preventing, and treating severe disease is a critical element of pandemic preparedness. Although COVID-19 has transitioned to an endemic disease, sustaining and advancing the research expertise and infrastructure developed during the pandemic remains essential for responding to future emerging infectious disease outbreaks.}, }
@article {pmid41873447, year = {2026}, author = {Jang, Y and Jung, J and Peck, KR}, title = {Integrated Clinical and Social Impacts of the COVID-19 Pandemic in Korea: A Combined Systematic and Narrative Review.}, journal = {Journal of Korean medical science}, volume = {41}, number = {11}, pages = {e103}, pmid = {41873447}, issn = {1598-6357}, support = {HD22C2045//Korea Health Industry Development Institute/Republic of Korea ; }, mesh = {Humans ; *COVID-19/epidemiology/mortality ; Republic of Korea/epidemiology ; SARS-CoV-2/isolation & purification ; Pandemics ; Comorbidity ; Delivery of Health Care ; Seroepidemiologic Studies ; }, abstract = {Coronavirus disease 2019 (COVID-19) imposed substantial health and social burdens worldwide, disrupting healthcare delivery and challenging public health governance. Korea's early, coordinated response was associated with low mortality and maintained essential services, yet the prolonged pandemic exposed structural inequalities, workforce strain, and psychosocial impacts. To comprehensively understand these multidimensional effects, this review synthesizes systematic and narrative evidence on the clinical, epidemiologic, and societal consequences of COVID-19 in Korea. We conducted a combined systematic and narrative review of Korean evidence (2020-2025). The systematic review included studies from PubMed, Embase, KoreaMed, and KMbase, supplemented by manual journal searches. Eligible studies addressed key epidemiologic indicators, including seroprevalence, mortality among patients with comorbidities, severe outcomes in high-risk groups, and vaccination coverage by comorbidity. Quality was assessed using Joanna Briggs Institute tools. We additionally examined government white papers, national reports, policy briefs, and peer-reviewed articles to contextualize epidemiologic findings, synthesizing materials across health burden, healthcare system changes, social consequences, and policy responses. Twenty-four epidemiologic studies and 72 narrative sources were included. Seroprevalence remained below 1% during the early pandemic, increasing sharply after omicron's emergence. Patients with chronic illnesses consistently experienced higher risks of severe outcomes and mortality, while high-risk groups showed elevated odds of intensive care use and complications. Alongside clinical patterns, national data documented substantial reductions in outpatient visits, elective procedures, emergency care, and pediatric services. Burnout and psychological distress intensified among healthcare workers, while prolonged distancing and economic disruption contributed to widening social fatigue. Policy responses and vaccination improved population outcomes, although gaps persisted in communication strategies and addressing disparities across age, socioeconomic status, and comorbidity groups. Korea's experience underscores that preparedness must align clinical efficiency with social equity. Strengthening primary and emergency care, ensuring fair compensation and workforce protection, and maintaining transparent risk communication are essential for building a resilient, inclusive public health system to withstand future pandemics.}, }
@article {pmid41873448, year = {2026}, author = {Hwang, YH and Park, WB}, title = {COVID-19 Vaccination Strategy and Evidence in Korea.}, journal = {Journal of Korean medical science}, volume = {41}, number = {11}, pages = {e114}, pmid = {41873448}, issn = {1598-6357}, support = {/SNU/Seoul National University/Korea ; }, mesh = {Humans ; *COVID-19 Vaccines/immunology/administration & dosage ; Republic of Korea/epidemiology ; *COVID-19/prevention & control/epidemiology ; *SARS-CoV-2/immunology ; *Vaccination ; Vaccine Efficacy ; }, abstract = {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.}, }
@article {pmid41873479, year = {2026}, author = {Drake, JM and Rohani, P and Winter, A}, title = {Can vaccine-preventable disease resurgence be anticipated? Leading indicators and tipping points.}, journal = {Future microbiology}, volume = {21}, number = {3}, pages = {321-327}, pmid = {41873479}, issn = {1746-0921}, mesh = {Humans ; *Vaccine-Preventable Diseases/epidemiology/prevention & control ; Disease Outbreaks/prevention & control ; Computer Simulation ; *Vaccines/administration & dosage ; Vaccination ; *Communicable Diseases, Emerging/epidemiology/prevention & control ; }, abstract = {Vaccination programs have averted millions of childhood deaths, yet vaccine-preventable diseases (VPDs) continue to resurge as coverage declines and pathogen evolution undermines previously successful vaccines. Anticipating resurgence is a public health priority. We review theoretical and empirical advances in the study of early warning signals (EWS) of epidemic transitions, with a focus on critical slowing down (CSD) - a phenomenon in which recovery from perturbations becomes slower near the epidemic threshold. We summarize the mechanisms that generate CSD, indicators that can be extracted from surveillance data, and the conditions under which signals may be detectable. We then examine case studies to illustrate the opportunities and challenges of applying EWS to VPD resurgence. Theory and computer simulations show that CSD can precede both elimination and resurgence, with increases in variance and autocorrelation calculated from disease surveillance reports emerging as consistent indicators. Empirical evidence supports this potential, though performance depends on noise structure, seasonality, spatial clustering, and outbreak responses. Case studies highlight both successful applications and contexts where signals were weak or absent. EWS offer a promising framework for anticipating VPD resurgence, but further research is required to refine methods, integrate mechanistic and social-behavioral drivers, and evaluate applicability across pathogens and settings.}, }
@article {pmid41873550, year = {2025}, author = {Smatana, M and Löffler, Ľ and Pažitný, P and Kandilaki, D and Shuftan, N}, title = {Slovakia: Health System Review.}, journal = {Health systems in transition}, volume = {27}, number = {2}, pages = {1-300}, pmid = {41873550}, issn = {1817-6127}, mesh = {Slovakia/epidemiology ; Humans ; *Delivery of Health Care/organization & administration/economics ; *Health Care Reform/organization & administration ; COVID-19/epidemiology ; Life Expectancy ; Health Expenditures ; Universal Health Insurance/organization & administration ; Public Health Infrastructure ; }, abstract = {This analysis of the Slovak health system reviews developments in governance, organization, financing and delivery of care, health reforms and health system performance. Slovakia, a central European country with a population of 5.4 million, continues to face significant health and health care system challenges. Slovakia's health system is founded on universal coverage with compulsory health insurance, a broad benefits package and a competitive insurance model. Although life expectancy improved between 2000 and 2019, the COVID-19 pandemic reversed gains, and in 2023 Slovak life expectancy remained three years below the European Union (EU) average. Circulatory diseases and cancer are the leading causes of death, and noncommunicable diseases such as diabetes and mental illness are rising. Nearly one third of all mortality is linked to behavioural risk factors, including poor diet, high smoking rates, low physical activity and obesity. Slovakia's health care system features competition among three insurers - one state-owned (Všeobecná zdravotná poisťovňa, VšZP) and two private. Since major reforms in 2004, the system has decentralized responsibilities and adopted selective contracting to enhance efficiency. However, structural weaknesses remain, particularly in financial sustainability, accessibility and equity. Health spending from public sources was 8.3% of gross domestic product (GDP) in 2024, yet out-of-pocket (OOP) payments account for nearly 19% of expenditures, disproportionately burdening low-income households. Workforce shortages, especially in nursing and primary care, are worsened by emigration and an ageing staff. Urban-rural disparities persist, with modern infrastructure and specialized services concentrated in cities. Digital health advancements, such as the National Health Information System (NHIS), aim to modernize care and facilitate telemedicine, though implementation is uneven. Ongoing reforms target cost containment, infrastructure optimization and integration of long-term care (LTC). Key priorities include addressing regional disparities, improving workforce retention, reducing waiting times and enhancing eHealth adoption. Despite universal coverage, Slovakia must address persistent gaps in health outcomes, resource distribution and system resilience to meet the needs of its population.}, }
@article {pmid41873735, year = {2026}, author = {Ali, T and McConnell, A and Gill, CR and Powell, T and Stangl, KA}, title = {Healing the Divide: Bridging Physicians and Healthcare Administrators for Value-Based Care.}, journal = {American journal of medical quality : the official journal of the American College of Medical Quality}, volume = {41}, number = {3}, pages = {151-159}, doi = {10.1097/JMQ.0000000000000299}, pmid = {41873735}, issn = {1555-824X}, mesh = {Humans ; *Value-Based Health Care/organization & administration ; *Physicians/psychology/organization & administration ; Burnout, Professional/prevention & control ; *Hospital Administrators/organization & administration/psychology ; Organizational Culture ; *COVID-19/epidemiology ; United States ; SARS-CoV-2 ; }, abstract = {Misalignment between physicians and hospital administrators has long challenged US healthcare systems. The COVID-19 pandemic magnified these tensions, with physicians reporting increased burnout and administrators grappling with severe financial pressures. This narrative review synthesizes findings from peer-reviewed studies, national surveys, organizational case examples, and policy reports to evaluate physician-administrator relationships. The analysis identifies 6 thematic areas: shared vision and transparency, governance engagement, incentive alignment, administrative burden, physician well-being, technology and innovation, and organizational trust and culture. The literature consistently documents the persistence of misalignment: physicians cite loss of autonomy and administrative overload, while administrators must manage costs and ensure compliance. Evidence from health systems such as Mayo Clinic, Cleveland Clinic, and rural hospitals demonstrates that structured engagement strategies can mitigate these divides. Bridging the physician-administrator divide is critical for value-based care. In rural areas where hospital closures and workforce shortages are acute, collaborative models are urgently needed. The proposed framework highlights actionable strategies to reduce burnout, enhance retention, and strengthen patient-centered outcomes.}, }
@article {pmid41873998, year = {2026}, author = {Goh, GK and Foster, JA and Uversky, VN}, title = {Clues to Long COVID Linked to Virulence and Infectivity Found in Shell Proteins.}, journal = {Advances in respiratory medicine}, volume = {94}, number = {2}, pages = {}, pmid = {41873998}, issn = {2543-6031}, mesh = {Humans ; *SARS-CoV-2/pathogenicity ; Virulence ; Animals ; *COVID-19/virology ; *Betacoronavirus/pathogenicity ; Pandemics ; *Pneumonia, Viral/virology ; *Coronavirus Infections/virology ; Post-Acute COVID-19 Syndrome ; }, abstract = {Clinical, experimental, and computational evidence of COVID-19 virulence and infectivity has been linked to SARS-CoV-2 shell disorder. A strong link was first discovered using an AI disorder-predicting tool, which detected an unusually hard (low disorder) outer shell among all SARS-CoV-2-related viruses but not in the 2003 SARS-CoV-1. This could account for the high infectivity found in SARS-CoV-2-but not in SARS-CoV-1-as it is believed that hard shells protect viral particles from the onslaught of the antimicrobial enzymes present in the respiratory system and saliva. As a result, much larger quantities of particles are shed by COVID-19 patients. Abnormally hard outer shells (M) are associated with burrowing animals, e.g., pangolins, and SARS-CoV-2 likely acquired these shells due to its long-term evolutionary interactions with pangolins. As for virulence, the inner shell of SARS-CoV-2 (N) has been found to exhibit lower disorder than that of SARS-CoV-1. This lower disorder is consistent with the fact that SARS-CoV-2 is less virulent than SARS-CoV-1, as higher disorder in the inner shell is associated with more efficient protein-protein binding during replication. The link between N/M disorder and virulence or infectivity falls under the umbrella of shell disorder models (SDMs), which can connect virulence, infectivity, and long COVID under one coherent concept. Evidence of the reliability and reproducibility of SDMs as applied to COVID-19 is examined. The hard M that is resisting the antimicrobial enzymes in the respiratory system can be extended to immunological enzymes, especially those found in phagocytes such as macrophages, which can therefore become a reservoir for the virus.}, }
@article {pmid41874029, year = {2026}, author = {Benucci, M and Cioffi, E and Li Gobbi, F and Cassarà, EAM and Terenzi, R and Russo, E and Grossi, V and Lari, B and Infantino, M and Manfredi, M}, title = {Dermatomyositis with Anti-MDA5 Autoantibodies After SARS-CoV-2 mRNA Vaccination Treated with Tofacitinib: Integrating Literature Evidence and a Novel Observation.}, journal = {Antibodies (Basel, Switzerland)}, volume = {15}, number = {2}, pages = {}, pmid = {41874029}, issn = {2073-4468}, abstract = {COVID-19 mRNA vaccines activate type I interferon pathways and in genetically or immunologically predisposed individuals may trigger autoimmune responses, including autoantibodies against melanoma differentiation-associated protein 5 (MDA5). Although cases of dermatomyositis (DM), particularly anti-MDA5-positive DM, have been increasingly reported after SARS-CoV-2 vaccination, its clinical spectrum and management remain incompletely defined. We conducted a narrative review of the literature on post-vaccination dermatomyositis, focusing on clinical features, autoantibody profiles, therapeutic approaches, and outcomes. The review was enriched by the inclusion of a new case: a 60-year-old woman who developed anti-MDA5-positive dermatomyositis two weeks after receiving her fourth dose of the BNT162b2 (Pfizer/BioNTech) vaccine. She presented predominantly with cutaneous and articular manifestations in the absence of interstitial lung disease. Treatment with oral prednisone, intravenous alprostadil, and the Janus kinase inhibitor tofacitinib resulted in marked clinical improvement. This case, together with the literature review, illustrates both typical and atypical presentations of vaccine-associated anti-MDA5 DM, highlights diagnostic challenges without lung involvement, and suggests JAK inhibition as a potential therapeutic option, contributing to a more comprehensive understanding of post-vaccination dermatomyositis.}, }
@article {pmid41874324, year = {2026}, author = {Stoop, MHP and Driessen, GJA and Cohen, AF and Kruizinga, MD}, title = {Digital diagnostics, biomarkers and therapeutics in an evolving healthcare system: From promise to practice.}, journal = {British journal of clinical pharmacology}, volume = {92}, number = {7}, pages = {2016-2027}, pmid = {41874324}, issn = {1365-2125}, mesh = {Humans ; Digital Health ; *Biomarkers/analysis ; *COVID-19/diagnosis/therapy ; *Delivery of Health Care/trends ; SARS-CoV-2 ; }, abstract = {Health care is shifting towards a digital-guided system, integrating digital diagnostics, biomarkers and therapeutics in many care pathways. However, despite rapid technological advancement and preliminary adoption accelerated by the COVID-19 pandemic, a significant implementation gap persists. This narrative review explores the causes of this gap, highlighting several examples from early development to final implementation. These show that technical validation alone is insufficient. Success depends on alignment with clinical need, robust external validation, patient empowerment and sustainable funding models. Furthermore, other systemic barriers include data privacy concerns and lack of transparency by commercial companies. To improve adoption and translate promise to practice, more international alignment of regulations and international collaboration is needed. Lessons must be learned from promising initiatives that did not reach clinical care, as much as from their successful counterparts. Ultimately, a comprehensive redesign of healthcare will be undertaken, with digital diagnostics and therapeutics both embedded as critical components rather than add-ons. This demands a multi-stakeholder effort involving governments, regulatory bodies, insurance providers, industry, research funders, hospital leadership, clinicians and, most importantly, patients.}, }
@article {pmid41874331, year = {2026}, author = {Mathias, K and de Rezende, VL and Dal Bó Tiscoski, A and Dallefe, L and Dal-Pizzol, F and Barichello, T and Petronilho, F}, title = {From lungs to brain: the neuroimmune impact of respiratory microbiota.}, journal = {Expert review of respiratory medicine}, volume = {}, number = {}, pages = {1-10}, doi = {10.1080/17476348.2026.2648109}, pmid = {41874331}, issn = {1747-6356}, abstract = {INTRODUCTION: The bidirectional communication between the lungs and the central nervous system, known as the lung-brain axis, has emerged as an important framework for understanding systemic mechanisms influencing neurological health. Increasing evidence indicates that pulmonary inflammation, respiratory microbiota alterations, and environmental exposures can modulate neuroinflammation, blood-brain barrier integrity, and microglial activation.
AREAS COVERED: This review summarizes current experimental and clinical evidence describing the molecular, microbial, and neuroimmune mechanisms underlying the lung-brain axis. Particular emphasis is placed on the role of the respiratory microbiota across the upper and lower airways and its interaction with immune signaling pathways. In addition, the neurological consequences of pulmonary diseases and infections, including asthma and COVID-19, are discussed, highlighting neuroanatomical, humoral, and immunological routes linking pulmonary and brain physiology.
EXPERT OPINION: Emerging data suggest that the respiratory system functions as an immunometabolic interface capable of influencing neuroimmune regulation and brain function. Integrative approaches combining respiratory microbiota profiling, immune biomarkers, and neuroimaging may help clarify causal mechanisms and support the development of novel diagnostic and therapeutic strategies for neurological and post-infectious conditions.}, }
@article {pmid41874370, year = {2026}, author = {Liu, C and Dan, L and Wang, X and Chen, L and Yuan, X}, title = {Gut microbiota impact on lung diseases: a mini review of clinical evidence.}, journal = {Infection and immunity}, volume = {94}, number = {4}, pages = {e0043025}, pmid = {41874370}, issn = {1098-5522}, support = {202557-011//Youth Talent Cultivation Program of the China Association of Chinese Medicine/ ; 2023SJZC040//Science and Technology Project of Lishui/ ; }, mesh = {Humans ; *Gastrointestinal Microbiome/physiology ; *Lung Diseases/microbiology/therapy ; Dysbiosis/microbiology ; Fecal Microbiota Transplantation ; Probiotics/therapeutic use ; COVID-19/microbiology ; Prebiotics ; SARS-CoV-2 ; }, abstract = {The gut-lung axis represents a bidirectional communication network through which the gut microbiota (GM) influences respiratory health. This mini-review synthesizes clinical evidence on the role of the GM in lung diseases. We focused exclusively on human clinical trials, randomized controlled trials, meta-analyses, and systematic reviews, sourced from major databases after duplicate removal. The evidence indicates that GM dysbiosis is a significant risk factor for the susceptibility and severity of various respiratory conditions, including asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis (CF), and infections, such as COVID-19 and pneumonia. Specific microbial signatures and metabolic profiles, particularly involving short-chain fatty acids (SCFAs), are associated with disease states and outcomes. Interventions like probiotics, prebiotics, synbiotics, and fecal microbiota transplantation (FMT) show promise in modulating the GM and improving clinical parameters, though their efficacy can be inconsistent and influenced by confounding factors. In conclusion, the GM is a promising therapeutic target for lung diseases. However, future research must prioritize large-scale, longitudinal clinical trials and deeper mechanistic investigations to establish causality and develop effective, personalized microbiome-based therapies.}, }
@article {pmid41874968, year = {2026}, author = {Chen, L and Lan, H and Liu, W and Zuo, C and Kemp, GJ and Wang, S and Gong, Q and Suo, X}, title = {Widespread structural and functional brain alterations in COVID-19: a systematic review of MRI studies.}, journal = {Cerebral cortex (New York, N.Y. : 1991)}, volume = {36}, number = {3}, pages = {}, doi = {10.1093/cercor/bhag022}, pmid = {41874968}, issn = {1460-2199}, support = {82001800//National Natural Science Foundation of China/ ; 2021QNRC001//Young Elite Scientists Sponsorship Program/ ; 2022YFC2009904/2022YFC2009900//National Key Research and Development Program of China/ ; }, mesh = {Humans ; Magnetic Resonance Imaging/methods ; *Brain/diagnostic imaging/physiopathology/pathology ; *COVID-19/diagnostic imaging/physiopathology ; SARS-CoV-2 ; Pandemics ; Neuroimaging/methods ; *Coronavirus Infections/diagnostic imaging ; }, abstract = {The coronavirus disease 2019 (COVID-19) pandemic has not only challenged global public health but also generated interest in its neurological basis. A growing number of neuroimaging studies have used quantitative magnetic resonance imaging (MRI) to quantify brain alterations in COVID-19 patients. We conducted a comprehensive review to synthesize brain regions with abnormal MRI metrics of microstructure and function in COVID-19 patients compared to healthy controls. Drawing upon 49 studies sourced from PubMed, Embase, and Web of Science databases, our review showcases structural and functional brain abnormalities across many brain regions in COVID-19. Across multimodal MRI studies, alterations were predominantly in frontal regions, temporal regions, parietal regions, limbic system, and subcortical nuclei. Our findings may help understanding of the neurophysiological basis of acute neurological symptoms and long-term neurological sequelae associated with COVID-19.}, }
@article {pmid41875911, year = {2026}, author = {Duquenne, P and Liposits, G and Vonnes, CO and Navarrete, E and Serrano, AG and Canoui-Poitrine, F and Marinho, J and Akagündüz, B and Haase, KR and Verduzco-Aguirre, HC and Li, J and Eochagáin, CM and Soto-Perez-de-Celis, E and Ayala, AP and Baltussen, JC and Kantilal, K and Kantilal, K and Wing-Lok, C and de Acha, AP and Meckstroth, S and Perez, ACT and Güven, DC and Zhao, Y and Puts, M and Beauplet, B and Lund, JL and Pilleron, S and , }, title = {Prediction models for overall survival and all-cause mortality risk in older adults with cancer: a systematic review.}, journal = {The lancet. Healthy longevity}, volume = {7}, number = {3}, pages = {100829}, doi = {10.1016/j.lanhl.2026.100829}, pmid = {41875911}, issn = {2666-7568}, mesh = {Humans ; *Neoplasms/mortality ; Aged ; Risk Assessment ; Aged, 80 and over ; Cause of Death ; Prediction Algorithms ; Risk Factors ; }, abstract = {Mortality risk prediction models can support decision making in older adults with cancer; however, existing models are associated with a high risk of bias. This systematic review assessed published prediction models for overall and all-cause mortality in adults with cancer aged 65 years or older. We searched for publications in Ovid Embase, Ovid Medline, Cochrane CENTRAL, and EBSCO CINAHL on Nov 25, 2022, and updated the search on Feb 24, 2024. We included 250 studies, of which 182 (72·8%) reported both model development and internal validation. 176 (70·4%) of 250 models predicted overall survival; 40 (16·0%) models focused on lung cancer and 30 (12·0%) models on colorectal cancer. 43 (17·2%) models were specifically developed for older adults; 138 (55·2%) models did not incorporate geriatric variables such as comorbidities, nutrition, and cognition. Risk of bias was high in all models, largely owing to inappropriate handling of continuous predictors, univariable selection of predictors, and inadequate control for overfitting. These limitations preclude clinical use. Future models predicting overall and all-cause mortality in older adults with cancer should adhere to existing methodological guidelines and incorporate geriatric domains.}, }
@article {pmid41877640, year = {2026}, author = {Van Aswegen, R and Lanigan, S and Lyne, JP and McDonald, C and Hallahan, B}, title = {The impact of the COVID-19 pandemic on psychiatric morbidity and emergency mental health presentations in Ireland: a systematic review.}, journal = {Irish journal of psychological medicine}, volume = {}, number = {}, pages = {1-14}, doi = {10.1017/ipm.2026.10185}, pmid = {41877640}, issn = {2051-6967}, abstract = {OBJECTIVES: To examine the impact the COVID-19 pandemic in Ireland on symptoms and functioning in individuals across a range of mental health disorders.
METHODS: A systematic bibliographic search of case reports, cross-sectional and longitudinal studies was conducted between March 12[th], 2020, and December 20[th], 2024, among studies evaluating the impact of the COVID-19 pandemic on symptoms and functioning for individuals with pre-existing mental health disorders and for those who presented with self-harm or died by probable suicide in the Republic of Ireland. Studies were independently screened by two reviewers according to inclusion and exclusion criteria, with selected variables extracted and summarised. Risk of bias assessments and narrative synthesis of included studies were conducted.
RESULTS: Twenty-eight studies met inclusion criteria. Findings were heterogeneous and disorder specific. An increase in presentations of self-harm, anxiety disorders, and eating disorders to child and adolescent mental health services and emergency departments was noted, with relative stability of symptoms in other cohorts including bipolar disorder and treatment-resistant schizophrenia. Significant symptom deterioration, with poor quality of life and functioning was demonstrated in individuals with emotionally unstable personality disorder both cross-sectionally and longitudinally.
CONCLUSIONS: Most people with pre-existing mental disorders did not experience significant exacerbation associated with the pandemic, with exception of those with eating disorders and EUPD.}, }
@article {pmid41877761, year = {2026}, author = {Zekis, T and Grammatopoulou, E and Tsimouris, D and Sakellari, V and Patsaki, I}, title = {The effectiveness of respiratory training as a preventive strategy against cognitive decline: a mini review.}, journal = {Frontiers in rehabilitation sciences}, volume = {7}, number = {}, pages = {1778837}, pmid = {41877761}, issn = {2673-6861}, abstract = {Cognitive decline and dementia represent a growing global health burden, particularly among older adults and populations with cardiopulmonary and vascular risk factors. While physical exercise has been shown to exert protective effects on cognition, the role of respiratory muscle training (RMT) remains unclear. The aim of this review was to investigate the effects of RMT on cognitive function and cognitive decline. Respiratory muscle training has been implemented in older adults with elevated blood pressure, post-COVID-19 patients, patients with chronic obstructive pulmonary disease (COPD), and patients with obstructive sleep apnea (OSA). There is only preliminary evidence regarding the effectiveness of inspiratory muscle training (IMT) on cognitive function, with only one study reporting statistically significant between-group differences (i.e., respiratory muscle training vs. control) in specific cognitive domains. Although respiratory muscle training appears to be a potentially promising intervention for improving cognitive function, the current evidence is limited. Further well-designed randomized controlled trials are required to draw definitive conclusions regarding its preventive role in cognitive decline and dementia.}, }
@article {pmid41877964, year = {2026}, author = {Chalghaf, N and Chokri, I and Dhahbi, W and Ceylan, Hİ and Bragazzi, NL and Muntean, RI and Stefanica, V and Guelmami, N and Dergaa, I}, title = {Burnout Across Healthcare, Educational, and Professional Populations: A Comprehensive Scoping Review.}, journal = {Journal of multidisciplinary healthcare}, volume = {19}, number = {}, pages = {564113}, pmid = {41877964}, issn = {1178-2390}, abstract = {BACKGROUND: Burnout, defined by emotional exhaustion, depersonalization, and reduced personal accomplishment, is increasingly recognized as a significant threat to staff wellbeing, organizational performance, and patient safety in healthcare and related sectors. Although research on burnout has grown rapidly, the evidence base remains fragmented, limiting understanding of cross-population patterns, measurement approaches, and the effectiveness of interventions.
OBJECTIVE: This scoping review systematically maps and synthesizes the existing literature on burnout among healthcare workers, students, teachers, night shift workers, and other professional populations, with particular emphasis on its implications for staff well-being and quality of care.
METHODS: Following Arksey and O'Malley's framework and PRISMA-ScR guidelines, systematic searches were conducted in MEDLINE, Embase, PsycINFO, CINAHL, Scopus, Web of Science, and Cochrane from inception to December 2024. Eligible studies used validated instruments to assess burnout. Data synthesis employed narrative thematic analysis and systematic literature mapping.
RESULTS: Sixty-five studies were included (healthcare workers n=29; students n=18; teachers n=9; night shift workers n=6; other populations n=3). Six key themes emerged: prevalence variations (25-72%), with healthcare workers demonstrating the highest rates (35-68%) and strongest associations with compromised patient safety; diversity of measurement tools; intervention effectiveness patterns, wherein combined individual-organizational approaches demonstrated superiority over single-component strategies (effect size d=0.67, 95% CI: 0.42-0.91 at 12-month follow-up); organizational versus individual risk factors; temporal trends including COVID-19 impacts; and implementation challenges. Methodological heterogeneity limited cross-population comparability and the standardization of interventions.
CONCLUSION: Burnout represents a critical occupational health and patient safety concern. This scoping review highlights significant gaps in cross-population research, the need for standardized measurement approaches, and the importance of multilevel, evidence-based interventions. The findings provide essential insights for researchers, healthcare administrators, and policymakers aiming to design sustainable strategies to protect staff wellbeing and ensure safe, high-quality care.}, }
@article {pmid41878230, year = {2026}, author = {Choi, S and Huda, MN and John, JR and Eapen, V}, title = {The Effectiveness of Non-Pharmacological Interventions in Treating Adolescents and Young Adults with Neuropsychiatric Symptoms of Long COVID: A Systematic Review and Meta-Analysis.}, journal = {Neuropsychiatric disease and treatment}, volume = {22}, number = {}, pages = {570223}, pmid = {41878230}, issn = {1176-6328}, abstract = {BACKGROUND: The management of persistent symptoms for long COVID (eg, fatigue, concentration difficulties, sleep difficulties, loss of appetite and taste, depression, and anxiety) has not been widely studied among adolescents and young adults (AYA). This systematic review and meta-analysis aimed to synthesise and review evidence on the effectiveness of non-pharmacological interventions for AYA aged 13-25 years, presenting with long COVID symptoms.
METHODS: A systematic literature search was conducted in four electronic databases (PubMed, EMBASE, PsycInfo, and ProQuest) in addition to manual searches for studies from January 2020 to May 2025 (PROSPERO: CRD42024516016). The studies were screened for eligibility, and methodological quality was assessed using the Joanne Briggs Institute Critical Appraisal tool by two independent reviewers. Findings were summarised using a narrative synthesis approach, and where possible, a meta-analysis was conducted using a random effects model with standardised mean differences (SMD) and a 95% confidence interval (CI).
RESULTS: Of the 325 screened articles, seven studies were included, which discussed six interventions. Three studies reported on the effectiveness of three multidisciplinary rehabilitation programs (eg, neuropsychological rehabilitation program, multidisciplinary post-COVID rehabilitation program, micro-choice-based concentrated group rehabilitation), three on alternative medicine practices (eg, forest bathing, traditional Thai Medicine), and one on mechanical therapy (eg, enhanced external counterpulsation). Findings suggested that interventions, although varied in duration and follow-up, were effective in improving mental health (SMD: 0.64, 95%, p<0.0497). There were also non-statistical improvements in fatigue (SMD: 1.74, 95%, p = 0.1307), quality of life (SMD: -1.34, 95%, p = 0.2787), and cognitive function (SMD: 1.05, p = 0.2989).
CONCLUSION: This review's findings suggest that non-pharmacological interventions may effectively treat neuropsychiatric symptoms of long COVID in AYA, ensuring better outcomes. Nevertheless, further research must be conducted with longer-term follow-up and robust methodology to explore sustained benefits, which may better inform treatment decisions.
TRIAL REGISTRATION: This systematic review is registered in Prospero (CRD42024516016).}, }
@article {pmid41878337, year = {2026}, author = {Kayesh, MEH and Kohara, M and Tsukiyama-Kohara, K}, title = {Therapeutic potential of pycnogenol: antioxidant, anti-inflammatory, immunomodulatory, antiviral, and anticancer effects.}, journal = {Frontiers in pharmacology}, volume = {17}, number = {}, pages = {1755175}, pmid = {41878337}, issn = {1663-9812}, abstract = {Pycnogenol (PYC), a standardized extract derived from the bark of the French maritime pine (Pinus pinaster ssp. atlantica), exhibits a broad spectrum of biological activities, including antioxidant, anti-inflammatory, immunomodulatory, antiviral, and anticancer effects. These effects are attributed to the rich profile of polyphenolic compounds, which confer potent antioxidant and anti-inflammatory properties. Viral infections frequently induce oxidative stress, inflammation, and immune dysregulation, thereby posing substantial challenges to global public health. Accordingly, the development of effective antiviral agents applicable across diverse viral outbreak settings remains a critical goal. PYC has demonstrated antioxidant, anti-inflammatory, and antiviral potential against several viruses, including hepatitis C virus, dengue virus, and severe acute respiratory syndrome coronavirus 2. In addition, PYC exhibited anticancer activity by modulating cell signaling pathways, inhibiting tumor cell proliferation, inducing apoptosis, and suppressing angiogenesis. However, further research and clinical validation are required to confirm its therapeutic applications. Accordingly, this review summarizes the current understanding regarding the antioxidant, anti-inflammatory, and anticancer mechanisms of PYC. Moreover, the review highlights its immunomodulatory properties to inform future antiviral and anticancer drug development and therapeutic strategies.}, }
@article {pmid41878421, year = {2026}, author = {Araújo, M and Gurjar, D and Grandchamp, N and Saha, B and Silvestre, R}, title = {GenIV vaccines: bridging innovation to equity in neglected tropical diseases.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1756570}, pmid = {41878421}, issn = {1664-3224}, mesh = {Humans ; *Neglected Diseases/prevention & control/immunology ; Tropical Medicine ; *Leishmaniasis/prevention & control/immunology ; *COVID-19/prevention & control/immunology ; *Leishmaniasis Vaccines/immunology ; Vaccines, Synthetic/immunology ; Animals ; Vaccine Development ; }, abstract = {Recent breakthroughs in molecular vaccinology have defined a new generation of vaccines that integrate synthetic mRNA, self-amplifying RNA, and nanomaterial-based platforms. These fourth-generation vaccines offer exceptional adaptability, rapid design, and strong immunogenicity, as demonstrated during the COVID-19 pandemic. Their potential now extends to neglected tropical diseases (NTDs), where conventional vaccine strategies have failed to deliver durable protection. This review traces the evolution from whole-pathogen to precision molecular vaccines, highlighting the mechanisms, delivery systems, and translational advances that underpin the GenIV paradigm. Using leishmaniasis as a case study, we discuss how these technologies can bridge innovation and equity through technology transfer, regional manufacturing, and global collaboration. By integrating scientific, ethical, and implementation perspectives, this work outlines how next-generation vaccines can transform both epidemic preparedness and the equitable control of endemic diseases.}, }
@article {pmid41878671, year = {2025}, author = {Zhang, C and Jiang, F and Li, J and Shen, H and Wang, H and Huang, Y}, title = {Exploring the role of trained surgical care nurses in cricothyrotomy and other emergency procedures: a systematic review and meta-analysis.}, journal = {Frontiers in surgery}, volume = {12}, number = {}, pages = {1562039}, pmid = {41878671}, issn = {2296-875X}, abstract = {BACKGROUND: There is a severe shortage of healthcare professionals, emphasized in a stark manner by the recent COVID-19 pandemic, where the mortality rate was primarily a consequence of medical professionals lacking the technical know-how for conducting specialized procedures. Therefore, this systematic review and meta-analysis aimed to evaluate the success rates of nurse-performed emergency surgeries, focusing on trauma care (e.g., cricothyrotomy), rural obstetric emergencies (e.g., caesarean section, hysterectomy), and general procedures (e.g., laparotomy, appendectomy).
METHODS: A systematic search was conducted across eight major databases (PubMed, Embase, CINAHL, Scopus, Web of Science, PsycINFO, Cochrane Library, ProQuest) following PRISMA guidelines. Four eligible studies were identified, and data were pooled using a fixed-effects model.
RESULTS: The synthesis of data across the four selected studies revealed a pooled relative risk (RR) of 0.88 (95% CI: 0.78, 1.00) and odds ratio (OR) of 0.80 (95% CI: 0.65, 0.99) about the efficacy in emergency surgeries conducted by nurses. These four studies were the only ones meeting our strict inclusion criteria of reporting outcome data on nurse-performed emergency procedures. An analysis of heterogeneity demonstrated minimal variability among the studies, with a Chi[2] value of 1.54, df = 3, P = 0.67, and I[2] = 0%. The test for overall effect yielded a statistically significant Z statistic of 2.03 (P = 0.04), indicating a meaningful finding. The observed inferences also showed that the surgical procedures exhibited minimal complications.
CONCLUSION: This study suggests that trained nurses can safely and effectively perform selected emergency surgical procedures. While encouraging, the limited number of studies highlights the need for further research to confirm these findings and guide clinical practice.}, }
@article {pmid41879110, year = {2026}, author = {Isshak, R and Habib, R and Sorathia, AZ and Li, Z and Muppidi, V and Tamimi, M and Manoharan, R and Mercado, I and Modi, JP and Mohtadi, M and Ebeid, K and Ismail, M}, title = {"First Reported Case of Rapidly Progressive Pyogenic Liver Abscess with Isolation of Priestia megaterium: Case Report and Literature Review".}, journal = {Journal of investigative medicine high impact case reports}, volume = {14}, number = {}, pages = {23247096261436690}, pmid = {41879110}, issn = {2324-7096}, mesh = {Humans ; Female ; *Liver Abscess, Pyogenic/microbiology/diagnosis ; Aged ; *Bacillus megaterium/isolation & purification ; Fatal Outcome ; Tomography, X-Ray Computed ; Anti-Bacterial Agents/therapeutic use ; Immunocompromised Host ; *Gram-Positive Bacterial Infections/microbiology/diagnosis ; Diabetes Mellitus, Type 2/complications ; Drainage ; Coinfection ; }, abstract = {Priestia megaterium (formerly Bacillus megaterium) is a Gram-positive, spore-forming environmental bacillus rarely associated with human infection. In this report, we present a case of a rapidly progressive polymicrobial pyogenic liver abscess with subsequent isolation of P. megaterium in a 69-year-old woman with type II diabetes mellitus, chronic kidney disease, metabolic liver disease, and extensive antibiotic allergies. She initially presented with progressive abdominal pain and fever, with negative early imaging studies. Three weeks later, computed tomography (CT) demonstrated new hepatic abscesses. Interventional radiology drainage cultures initially grew Streptococcus intermedius, guiding targeted antimicrobial therapy; however, the patient clinically deteriorated with recurrent abscess formation despite drainage and broad-spectrum coverage. Subsequent aspirate cultures from the abscess fluid later grew P. megaterium, though this result was finalized after the patient's death on day 12 of admission despite intensive care and source control attempts. This case suggests that P. megaterium, traditionally regarded as nonpathogenic, may be recovered in severe infections in immunocompromised hosts; however, alternative explanations-including polymicrobial infection, antibiotic-mediated suppression of co-pathogens, iatrogenic introduction during drainage procedures, or culture contamination-must be carefully considered. Contributing factors likely included her underlying comorbidities, concurrent COVID-19 infection, delayed pathogen identification, and restrictions imposed by multiple drug allergies. Diagnostic challenges underscore the importance of repeated culture sampling, careful interpretation of microbiology results, and awareness of rare organisms when standard therapy is unsuccessful. This report expands the spectrum of diseases associated with P. megaterium. It emphasizes the need for multidisciplinary collaboration and heightened clinical vigilance in cases of rapidly progressive intra-abdominal infections that are unresponsive to conventional treatment.}, }
@article {pmid41879706, year = {2025}, author = {Boubakri, S and Barkous, B and Ben Lazreg, N and Talbi, I and Touré, M and Ben Saad, H}, title = {Reconsidering isolated FEV1 reduction: A case report of early-stage asthma with bronchial hyperreactivity and literature review.}, journal = {La Tunisie medicale}, volume = {103}, number = {10}, pages = {1525-1530}, doi = {10.62438/tunismed.v103i10.6028}, pmid = {41879706}, issn = {2724-7031}, mesh = {Humans ; Female ; Adult ; *Asthma/diagnosis/physiopathology/complications ; *Bronchial Hyperreactivity/diagnosis/physiopathology/complications ; Forced Expiratory Volume/physiology ; Bronchial Provocation Tests ; Spirometry ; Skin Tests ; }, abstract = {INTRODUCTION: Isolated low forced expiratory volume in one second (FEV1) spirometric impairment (ILFSI) is characterized by a decreased FEV1 while both forced vital capacity (FVC) and the FEV1/FVC ratio remain within normal ranges. This pattern may hide an underlying respiratory disorder that warrants further examination. Notably, the 2022 European respiratory society/American thoracic society (2022-ERS/ATS) guidelines do not classify ILFSI as pathological, a stance that has sparked some controversy. This teaching report discussed the case of a woman with ILFSI who developed mild bronchial hyperreactivity after undergoing a methacholine bronchial challenge test (MBCT) and exhibited positive skin prick tests (SPTs) for dust mites.
OBSERVATION: A 28-year-old professional interior designer, who has no history of smoking or exposure to wood smoke and allergens, and who previously experienced a mild case of coronavirus disease-2019, consulted a pulmonologist for chronic cough, sputum production, and recurrent sneezing episodes. Asthma was suspected, leading to the performance of SPTs, spirometry, and either a bronchodilator test (in case of an obstructive ventilatory impairment) or MBCT (in case of a normal spirometry) as requested in the pulmonologist referral letter. The spirometry results indicated ILFSI, with a low FEV1 (z-score = -1.74, 79%) while FVC (z-score = -0.97, 88%) and the FEV1/FVC ratio (z-score = -1.35) remained normal. According to the 2022-ERS/ATS guidelines, these findings are considered normal spirometry because of the maintained FVC and FEV1/FVC ratio. The MBCT confirmed mild bronchial hyperreactivity, showing a 20% drop in FEV1 at a dose of 96 µg. Furthermore, SPTs were positive for dust mites (Dermatophagoides pteronyssinus and farinae).
CONCLUSION: The results of this report suggested a possible association between ILFSI and early allergic asthma, indicating that ILFSI should be re-examined in future revisions of the 2022-ERS/ATS guidelines for interpreting spirometric tests.}, }
@article {pmid41879902, year = {2026}, author = {Ashique, S and Das, J and Bhui, U and Islam, A and Taj, T and Ansari, MY and Kalra, JM and Hussain, MS}, title = {Drug repurposing against viral infections (2020-2025): clinical trials, computational strategies, and therapeutic interventions.}, journal = {Inflammopharmacology}, volume = {34}, number = {4}, pages = {2193-2218}, pmid = {41879902}, issn = {1568-5608}, mesh = {Humans ; *Drug Repositioning/methods/trends ; *Antiviral Agents/therapeutic use/pharmacology ; *Virus Diseases/drug therapy ; Clinical Trials as Topic/methods ; Animals ; Host-Directed Therapy ; }, abstract = {Over the past five years, amid the escalating threat of viral outbreaks, drug repurposing has emerged as a pivotal strategy for rapidly deploying existing pharmacological agents against newly emerging infectious diseases. This review provides a comprehensive analysis of drug repurposing efforts targeting major viral infections between 2020 and 2025, with a particular focus on clinical trials and intervention strategies. The background and growing significance of drug repurposing are discussed in the context of the urgent global demand for accelerated antiviral development. Key viral infections, including SARS-CoV-2, monkey pox virus, H1N1 influenza, dengue virus, Zika virus, and hepatitis B and C, are examined in detail, with an emphasis on therapeutic interventions and clinical trial outcomes. Tabulated data summarize the efficacy, target mechanisms, and trial phases of key repurposed drugs. Additionally, the integration of emerging technologies, particularly artificial intelligence and machine learning, has enhanced the identification of novel drug-virus interactions, thereby increasing the precision of repurposing strategies. The paradigm shift toward host-targeted therapies further offers an alternative approach by disrupting host factors essential for viral replication. Despite significant progress, clinical challenges such as drug resistance, dosing optimization, and safety concerns persist. Overall, this review underscores the evolving role of repurposed drugs as a strategic asset in combating current and future viral pandemics through an integrated, evidence-based framework. Unlike many prior reviews that focus on single pathogens or early in silico candidate lists, we (i) benchmarked computational predictions against Phase II–IV clinical outcomes and real-world evidence, (ii) compared host-directed versus virus-directed repurposing strategies across multiple viral families, and (iii) integrated organ-specific toxicity constraints to explain translational attrition and guide future trial design.}, }
@article {pmid41880671, year = {2026}, author = {Garriga-Salvó, C and Navarro, E and Lidón-Moyano, C and Arévalo, A and Roca, R and Morera, M and Llistosella, M}, title = {Psychological interventions for individuals with long COVID: a systematic review and meta-analysis.}, journal = {Health psychology review}, volume = {}, number = {}, pages = {1-22}, doi = {10.1080/17437199.2026.2646179}, pmid = {41880671}, issn = {1743-7202}, abstract = {Introduction: Long COVID involves a variety of persistent symptoms after initial SARS-CoV-2 infection, affects multiple functional areas and requires multidisciplinary treatment. Objective: This study aimed to explore the available evidence about psychological interventions for individuals with long COVID and their effectiveness in reducing some prevalent symptoms, such as fatigue, anxiety or depression, among others, and improving patient quality of life. Methodology: A systematic review and meta-analysis were conducted following the PRISMA 2020 guidelines. Two independent reviewers performed study selection and data extraction using Web of Science, Scopus, and PubMed databases prior to March 2024. Data synthesis was performed via random-effects meta-analysis, with heterogeneity assessed using the I2 statistic. Results: Of the 1041 articles obtained, 19 were included in the systematic review and 14 in the meta-analysis. Results showed significant reductions in symptoms of anxiety [SMD = -0.64 (95% CI: -1.18 to -0.10)], depression [SMD = -0.41 (95% CI: -0.73 to -0.10)] and fatigue [SMD = -1.37 (95% CI: -2.48 to -0.26)]. Significant improvements were only registered in self-perceived health-related quality of life [SMD = 7.59 (95% CI: 3.70-11.48)]. Conclusion: Results showed improvements in anxiety, depression or fatigue, highlighting the potential role of psychological interventions in patient recovery.}, }
@article {pmid41880835, year = {2026}, author = {Alturki, MS and Gomaa, MS}, title = {Medicinal chemistry strategies targeting viral proteases: From classical design to next-generation therapeutics.}, journal = {European journal of medicinal chemistry}, volume = {310}, number = {}, pages = {118779}, doi = {10.1016/j.ejmech.2026.118779}, pmid = {41880835}, issn = {1768-3254}, mesh = {Humans ; *Drug Design ; *SARS-CoV-2/enzymology/drug effects ; *Antiviral Agents/chemistry/pharmacology ; Chemistry, Pharmaceutical/methods ; Proteolysis Targeting Chimera ; COVID-19 Drug Treatment ; *Viral Protease Inhibitors/chemistry/pharmacology ; *Protease Inhibitors/chemistry/pharmacology ; Peptidomimetics/chemistry/pharmacology ; *Coronavirus 3C Proteases/antagonists & inhibitors/metabolism ; }, abstract = {Viral proteases are central targets in antiviral drug discovery and development because they play essential roles in viral replication and maturation. Although protease inhibitors have achieved major clinical success, traditional design strategies face challenges, including resistance development, poor oral exposure of early peptidomimetics, and off-target toxicity of highly reactive covalent warheads. Classical approaches, such as peptidomimetics, macrocyclization, and covalent warhead engineering, are discussed alongside contemporary strategies, including allosteric modulation and targeted protease degradation via proteolysis-targeting chimeras (PROTAC) technology. Particular emphasis is placed on how these strategies address key obstacles, such as resistance evolution, selectivity, metabolic stability, and oral bioavailability. Several quantitative case studies have also demonstrated the growing significance of computational tools in contemporary antiviral discovery. For SARS-CoV-2 main protease (Mpro), these workflows were enabled by the rapid availability of high-resolution experimental crystal structures of the target protein. The evolution of a weak fragment (Kd ≈ 1.7 mM; ΔG ≈ -3.6 kcal/mol) into a covalent inhibitor (QUB-00006-Int-07) with enzymatic inhibition (IC50 ≈ 830 nM) was successfully guided by molecular dynamics (MD) simulations and absolute binding free energy calculations. This was subsequently confirmed experimentally using NMR, ESI-MS, and FRET assays. Furthermore, out of 25 computationally prioritized candidates with Ki values less than 4 μM, 15 active Mpro inhibitors were identified using accelerated free-energy perturbation-based repurposing campaigns. Long-range allosteric pathways connecting the catalytic site to resistance-associated regions and experimentally verified allosteric pockets have also been discovered using dynamic nonequilibrium MD. Together, these integrated in silico approaches enable the early prioritization of high-affinity ligands, mechanistic understanding of resistance, and significant reduction of late-stage attrition in antiviral drug discovery. Through detailed case studies on SARS-CoV-2 main protease (Mpro), Zika virus NS2B-NS3 protease, and Dengue virus NS2B-NS3 protease, the review illustrates how medicinal chemistry principles translate molecular insights into clinically relevant antivirals. Finally, a forward-looking development roadmap is proposed that integrates potency, selectivity, pharmacokinetics, manufacturability, and resistance management toward the goal of broad-spectrum, durable, and adaptable protease-targeted therapeutics development.}, }
@article {pmid41881062, year = {2026}, author = {Safir, AH and Bird, MM and Orczykowski, ME}, title = {Development of effective 3D digital models for first-time learners of musculoskeletal anatomy.}, journal = {Anatomical sciences education}, volume = {19}, number = {7}, pages = {1060-1071}, pmid = {41881062}, issn = {1935-9780}, mesh = {Humans ; *Anatomy/education ; *Models, Anatomic ; *Imaging, Three-Dimensional ; Curriculum ; *Musculoskeletal System/anatomy & histology ; *Computer-Assisted Instruction/methods ; Educational Measurement ; Digital Media ; Learning ; Female ; Male ; COVID-19/epidemiology ; }, abstract = {Musculoskeletal anatomy is a critical component of allied health curricula. With the ubiquity of technology in the classroom and the recent COVID-19 pandemic creating accessibility barriers for students, there is a need for viable digital resources to enhance learning by supplementing traditional textbook studying. This article describes the creation of an annotated, interactive, three-dimensional digital model and presents preliminary data on its effectiveness for students learning musculoskeletal structures of the hip and knee for the first time. The 3D model was developed in Blender using open-source files and was uploaded to the Sketchfab platform. Eighty-one students in the musculoskeletal anatomy course at a large midwestern university took an assessment to measure their baseline anatomical knowledge, studied the testable structures from either the model or textbook images for 10 min, and took a follow-up assessment. Students in the 3D Model Group saw greater increases from their baseline scores and also reported higher confidence in what they had learned, increased ability to visualize anatomical structures, and greater enjoyment of their resource than students who used textbook images. The findings presented here suggest that creating effective, accessible 3D digital resources is feasible for educators without training in technology-related fields and that having access to these resources can be beneficial to first-time learners of anatomy.}, }
@article {pmid41882484, year = {2026}, author = {Yeo, HY and Hung, TM and Nghiem, N and Albrecht, S and Turner, N and McIntyre, P}, title = {The Economic Value of Non-pharmaceutical Interventions for Influenza and COVID-19: A Systematic Review.}, journal = {Applied health economics and health policy}, volume = {24}, number = {4}, pages = {655-670}, pmid = {41882484}, issn = {1179-1896}, support = {3725363//Flu Lab/ ; }, mesh = {Humans ; *Influenza, Human/prevention & control/economics/therapy ; *COVID-19/prevention & control/economics ; Cost-Benefit Analysis ; Cost-Effectiveness Analysis ; }, abstract = {BACKGROUND: Non-pharmaceutical interventions (NPIs) are central to mitigating COVID-19 and influenza, yet comparative economic evaluations remain scarce. This systematic review assessed the cost effectiveness and reporting quality of NPI evaluations across both diseases. The study was registered with PROSPERO (CRD42024552613).
METHODS: Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, we searched five medical (PubMed, Scopus, EMBASE, CINAHL, and EconLit) and four health technology assessment databases (NHS HTA, CRD DARE, NHS EED, and INAHTA) up to December 2025, including only full economic evaluations. The search strategy incorporated four domains-'influenza,' 'COVID-19,' 'NPIs,' and 'economic evaluation'-and was guided by the WHO NPI framework, encompassing five domains: personal protective, environmental, physical distancing, travel-related, and educational measures. Reporting quality was assessed using the Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) checklist.
RESULTS: Thirty-three studies (13 influenza, 20 COVID-19), predominantly from high-income countries, were included. School closures, the most frequently evaluated NPI, were generally not cost effective except during severe pandemics or bundled with other measures. Workforce and business closures were cost effective only in high-severity influenza, with inconsistent findings for COVID-19. Social distancing was cost effective for COVID-19 but not for H1N1 influenza. Isolation, lockdowns, and travel restrictions were cost effective only when implemented early. Face masks and hand hygiene, assessed solely for COVID-19, were generally cost effective when implemented alongside other measures. The median CHEERS score was 75.0%, with one study rated excellent.
CONCLUSION: Our review highlights heterogeneity in cost effectiveness by pandemic severity, intervention type, bundling of measures, and timing. Strategies that combined low-cost NPIs like masks or hand hygiene demonstrated better value, while socially disruptive measures like school and business closure incurred high costs with inconsistent cost-effectiveness outcomes. Integration with vaccines or antivirals further enhanced cost effectiveness. Evidence gaps include the scarcity of evaluations from low-resource settings and variability in country-specific value thresholds. Addressing these gaps is essential for guiding efficient and cost-effective pandemic preparedness.}, }
@article {pmid41882505, year = {2026}, author = {Lima, GG and Segati, AF and Oliveira, GS and de Melo, NS and da Cunha, TN and De Gaspari, E}, title = {COVID-19 and Pregnancy: Key Findings.}, journal = {Scandinavian journal of immunology}, volume = {103}, number = {4}, pages = {e70109}, pmid = {41882505}, issn = {1365-3083}, support = {305301/2022-5//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; 131308/2021-1//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; 132059/2025-8//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; Finance code 001//Coordenação de Aperfeiçoamento de Pessoal de Nível Superior/ ; 18/04202-0//Fundação de Amparo à Pesquisa do Estado de São Paulo/ ; 2021/11936-3//Fundação de Amparo à Pesquisa do Estado de São Paulo/ ; }, mesh = {Humans ; Female ; Pregnancy ; *COVID-19/immunology/prevention & control/transmission ; *SARS-CoV-2/immunology ; *Pregnancy Complications, Infectious/immunology/prevention & control/virology ; Placenta/immunology/pathology/virology ; *COVID-19 Vaccines/immunology ; Immunity, Maternally-Acquired ; Infectious Disease Transmission, Vertical/prevention & control ; Antibodies, Viral/immunology ; Vaccination ; }, abstract = {Pregnant individuals were prioritised for COVID-19 research due to concerns about increased susceptibility and limited clinical trial data. This narrative review synthesises evidence on maternal infection, immunological adaptations, placental susceptibility, and antibody transfer following maternal SARS-CoV-2 vaccination. Symptomatic COVID-19 during pregnancy increases risks of severe outcomes, whereas vertical transmission remains rare. Placental pathology is characterised mainly by maternal vascular malperfusion and inflammation, with limited evidence of direct viral infection. Maternal vaccination-particularly with mRNA vaccines-induces robust IgG responses with efficient transplacental and lactational transfer, conferring passive neonatal protection. Key uncertainties include optimal vaccine timing, durability of neonatal immunity, and variant-specific responses. Strengthening standardised research and ensuring inclusion of pregnant individuals is essential for global maternal health policy.}, }
@article {pmid41882567, year = {2026}, author = {Eliseev, P and Bayrakova, A and Vakhrusheva, D and Kazyulina, A and Samoilova, A and Vasilieva, I}, title = {Prevalence of non-tuberculous mycobacteria in various regions of the Russian Federation.}, journal = {BMC infectious diseases}, volume = {26}, number = {1}, pages = {}, pmid = {41882567}, issn = {1471-2334}, support = {123022100022-1//Ministry of Health of the Russian Federation/ ; }, mesh = {Russia/epidemiology ; *Nontuberculous Mycobacteria/genetics/classification/isolation & purification ; *Mycobacterium Infections, Nontuberculous/epidemiology/microbiology/diagnosis ; Prevalence ; Humans ; Whole Genome Sequencing ; Genotype ; }, abstract = {BACKGROUND: Non-tuberculous mycobacteria (NTM) are increasingly recognized as significant pathogens causing pulmonary and extrapulmonary diseases worldwide, including Russia. Despite a rising incidence, comprehensive data on the geographic distribution and species diversity of NTM across Russia remain limited. This study aims to analyze the prevalence and NTM species diversity in various Russian regions, highlighting regional variability and diagnostic challenges.
METHODS: A systematic review and analysis of published data and regional studies on NTM detection in different regions of Russia from 2010 to 2024 were conducted. Identification methods included GenoType Mycobacterium CM/AS assays, PCR, mass spectrometry (MALDI-TOF MS) and whole-genome sequencing. Data from multiple regions, including Moscow, Saint Petersburg, the Siberian Federal District and others, were analyzed to assess species diversity and epidemiological patterns.
RESULTS: The species spectrum of NTM in Russia is broad and heterogeneous. M. avium is the predominant species with an average frequency of 30-40%. A secondary group, including M. gordonae (13-25%) and M. intracellulare (12-20%), demonstrates significant prevalence. The remaining species, such as M. fortuitum, M. lentiflavum, M. kansasii, and M. abscessus, exhibit lower but notable frequencies ranging from 3% to 20%. Other species such as M. malmoense, M. xenopi, M. simiae etc. were less common, with frequencies below 5%. Regional differences in species prevalence were pronounced, with M. avium-intracellulare complex dominating in many areas reaching more than 50% of all NTM, while species like M. lentiflavum were more common in specific regions such as the Republic of Komi (44% of all NTM in the region). The COVID-19 pandemic (2020-2023) impacted epidemiological surveillance but did not substantially alter species diversity. Advanced molecular techniques, including whole-genome sequencing, revealed subspecies-level diversity, notably among M. avium and M. abscessus complexes.
CONCLUSIONS: This study underscores the significant geographic variability and species diversity of NTM in the Russian Federation. The detection rates and species spectrum depend on the diagnostic methods employed, highlighting the need for standardized, advanced molecular diagnostics. Continued surveillance and molecular characterization are crucial for improving diagnosis, guiding therapy, and understanding the epidemiology of NTM infections in Russia.}, }
@article {pmid41882857, year = {2025}, author = {Nishimura, H}, title = {[The multidisciplinary study, "Aerosol virology/Aerovirology"-A new frontier].}, journal = {Uirusu}, volume = {75}, number = {2}, pages = {121-134}, doi = {10.2222/jsv.75.121}, pmid = {41882857}, issn = {0042-6857}, mesh = {Humans ; *Virology/trends ; Aerosols ; COVID-19 ; *Pandemics ; SARS-CoV-2 ; *Coronavirus Infections/virology/transmission/epidemiology ; *Interdisciplinary Research/trends ; *Betacoronavirus ; *Air Microbiology ; }, abstract = {The COVID-19 pandemic has spurred vigorous research in a field that is old but new, a fusion of aerosol science and virology, each with its own history. I tentatively refer to this interdisciplinary field as "aerosol virology". This review article aims to convey the appeal of research in this field to virologists unfamiliar with aerosol science, covering fundamental knowledge of aerosols. In fact, preceding this article, I had published in the Japanese Journal of Aerosol Science a companion review with this, titled "An Introduction to Aerosol Virology"1）, which included basic virological knowledge for members less familiar with viruses, aiming to spark their interest in the field. To advance "aerosol virology", it is necessary to approach research goals with knowledge of both aerosol science and virology, not just one field. This represents a largely unexplored frontier even for virology. I hope members of the Virology Society will venture into this frontier. Both reviews were written with this aspiration in mind.}, }
@article {pmid41882974, year = {2026}, author = {Yang, B and Leader, J and Bowes, B and Aiyer, H and Dunn, H and Adams, SJ and O'Connell, ME and McIntyre, L and Dani, H and Johnson, R and Mendez, I and Lovo, S}, title = {Implementation and Evaluation of Virtual Care in Canadian Health Care Systems: A Scoping Review.}, journal = {Telemedicine journal and e-health : the official journal of the American Telemedicine Association}, volume = {32}, number = {7}, pages = {662-681}, doi = {10.1177/15305627261425160}, pmid = {41882974}, issn = {1556-3669}, mesh = {Humans ; Canada ; *COVID-19/epidemiology ; *Delivery of Health Care/organization & administration ; Digital Health ; Patient Satisfaction ; SARS-CoV-2 ; *Telemedicine/organization & administration ; Videoconferencing ; }, abstract = {OBJECTIVE: This scoping review examined available evidence in implementation and evaluation of virtual care in Canada. Virtual care saw recent uptake due to the COVID-19 pandemic; however, to ensure quality of care, rigorous implementation and evaluation frameworks are needed.
METHODS: Peer-reviewed and gray literature were searched to determine extent, range, and nature of evidence surrounding implementation and evaluation of virtual care based on the guidelines of the Joanna Briggs Institute. Although virtual care can encompass synchronous and asynchronous modalities, this review focused on synchronous virtual care, defined as real-time interactions between patients and providers via videoconferencing or telephone. Search included MEDLINE, EMBASE, Psych Info, and CINAHL databases and national and provincial health system, professional organization, and regulatory websites. Inclusion criteria included videoconferencing or telephone and English and French Canadian sources. Citations were screened by two researchers at title, abstract, and full-text levels.
RESULTS: Two hundred and eight (208) manuscripts were included for analysis. High numbers of studies on patient satisfaction, process outcomes, and barriers were identified, with underrepresentation of health and systems outcomes and impact evaluations. There were very few studies examining hybrid care, planetary health, and use of virtual care with equity-deserving groups.
DISCUSSION: This scoping review identified areas of importance for future research, including the use of virtual care in rural and remote regions, inpatient, long-term, and emergency settings, hybrid care, economic and planetary health impacts, and artificial intelligence. As well, enhancing standardization of implementation and evaluation guidelines will optimize quality of care and best practice.}, }
@article {pmid41883910, year = {2026}, author = {Montoya, S and Alvarez Ramirez, D and Chavarría, R and Zamora, EL and Soto Cordero, CA}, title = {Anesthesia in Patients With Long COVID or Post-infectious Respiratory Sequelae Undergoing Emergency Surgery: Clinical Challenges and Perioperative Strategies.}, journal = {Cureus}, volume = {18}, number = {2}, pages = {e104067}, pmid = {41883910}, issn = {2168-8184}, abstract = {The COVID-19 pandemic has left lasting health consequences that extend beyond the acute infection phase, with long COVID emerging as a complex multisystem condition that poses significant challenges in the perioperative setting. Patients with post-infectious respiratory or cardiovascular sequelae present an increased anesthetic risk due to persistent inflammation, pulmonary fibrosis, reduced lung compliance, and myocardial dysfunction. These alterations predispose to hypoxemia, arrhythmias, and hemodynamic instability during surgery, making preoperative assessment and individualized anesthetic planning essential. Comprehensive evaluation, including functional tests, cardiac and pulmonary imaging, and laboratory analysis, allows early identification of residual organ dysfunction that can compromise perioperative safety. Anesthetic management must be adapted to the patient's physiological condition, emphasizing lung-protective ventilation, cautious fluid therapy, and close hemodynamic monitoring. Regional anesthesia is preferred when feasible to minimize airway manipulation and reduce respiratory complications, while total intravenous anesthesia represents a safer option when general anesthesia is required. Postoperative care focuses on extended respiratory monitoring, multimodal analgesia to limit opioid use, and the implementation of pulmonary physiotherapy and antithrombotic prophylaxis to prevent complications. Psychological support is also recommended to address post-COVID anxiety and fatigue, contributing to holistic recovery. Although clinical guidelines provide useful recommendations, current evidence remains limited and heterogeneous. Further research is required to clarify the pathophysiological mechanisms of long COVID, evaluate anesthetic drug interactions, and develop validated risk stratification tools. Establishing standardized, evidence-based perioperative protocols is essential to improve outcomes and ensure patient safety in individuals with long COVID undergoing emergency surgery.}, }
@article {pmid41884447, year = {2026}, author = {Panda, PK and Garg, R}, title = {Rethinking COVID-19 seasonality: A summer respiratory virus in the tropics, contrast to influenza.}, journal = {World journal of virology}, volume = {15}, number = {1}, pages = {116492}, pmid = {41884447}, issn = {2220-3249}, abstract = {This opinion challenges the conventional view that coronavirus disease 2019 behaves as a uniformly winter-dominant respiratory infection. Analysis of multi-year surveillance data across hemispheres reveals that severe acute respiratory syndrome coronavirus-2 exhibits seasonal divergence, with consistent summer surges in tropical regions, such as India, and winter peaks in temperate climates. We propose that this pattern arises primarily from human (host) behavioural responses to multi-animal tropism to climatic (environment) extremes, which recreate high-risk indoor transmission settings under both heat and cold. Unlike influenza, severe acute respiratory syndrome coronavirus-2 (agent) combines thermal resilience, broad tissue tropism, and efficient pre-symptomatic transmission, allowing persistence beyond classical winter bounds. Recognizing coronavirus disease 2019 as a behaviourally modulated (through agent-host-environment triad) seasonal virus may help tailor regional surveillance, ventilation, and vaccination strategies in an era of accelerating climatic change.}, }
@article {pmid41884458, year = {2026}, author = {Younas, S and Farooq, S and Sahu, S and Mwita, RP and Özdemir, Ö}, title = {Next-generation mucosal vaccines for respiratory viruses: Immunological correlates, platform design and clinical translation.}, journal = {World journal of virology}, volume = {15}, number = {1}, pages = {116939}, pmid = {41884458}, issn = {2220-3249}, abstract = {Influenza, respiratory syncytial virus (RSV), and severe acute respiratory syndrome coronavirus 2 continue to cause substantial morbidity and mortality. Currently licensed intramuscular (IM) vaccines effectively reduce severe disease and death but only partially suppress infection and transmission because they induce limited immunity in the respiratory mucosa. This minireview summarizes next-generation mucosal vaccines for respiratory viruses, focusing on the immunological correlates of protection, platform design, and clinical translation. The literature was identified through focused searches of PubMed and Scopus, prioritizing human studies and late-stage preclinical data published between 2000 and 2025. We outline the key mucosal immune correlates required to block viral entry at the airway epithelium, including secretory IgA and tissue-resident memory T cells, and review advances across major vaccine platforms. Current clinical experience with coronavirus disease 2019, influenza, and RSV mucosal vaccines is discussed, along with challenges related to immune measurement, delivery optimization, evaluation of transmission outcomes, and scalable global implementation, including heterologous systemic-mucosal prime-boost strategies. Overall, accumulating evidence positions mucosal vaccination as a promising complement to IM vaccines, with the potential to shift respiratory virus control from disease mitigation to prevention of infection and transmission.}, }
@article {pmid41884461, year = {2026}, author = {Capobianco, M and Cappellani, F and Visalli, F and Avitabile, A and Gagliano, G and Nicolosi, SG and Khouyyi, M and D'Esposito, F and Gagliano, C and Zeppieri, M}, title = {Phlyctenular keratoconjunctivitis with viral triggers.}, journal = {World journal of virology}, volume = {15}, number = {1}, pages = {117124}, pmid = {41884461}, issn = {2220-3249}, abstract = {Phlyctenular keratoconjunctivitis (PKC) goes beyond limbal nodules. This pediatric ocular surface condition caused by delayed-type hypersensitivity to microbial antigens. The trigger is context-dependent: Mycobacterial antigens in tuberculosis-endemic areas; staphylococcal eyelid disease and rosacea in high-income areas. Although classically bacterial-driven, virus-associated presentations like herpes simplex virus (HSV)-linked phlyctenular disease, pediatric PKC during acute coronavirus disease 2019 (COVID-19) infection, and molluscum contagiosum-driven keratoconjunctivitis suggest the same antigen-mediated pathway. Photophobia and discomfort are prevalent, and corneal involvement can cause neovascularization, scarring, amblyopia, and perforation. This minireview combines epidemiologic, clinical, and immunopathologic data to identify causes and update care. Practical takeaways: (1) Treat the antigen source (blepharitis/rosacea, chlamydia, parasites) and screen for tuberculosis when risk factors exist. Consider viral triggers when history or exam suggest HSV, recent COVID-19, or eyelid molluscum; (2) Suppress inflammation promptly with a short, carefully tapered course of topical corticosteroids; (3) Use topical cyclosporine as a steroid-sparing agent in recurrent or steroid-dependent disease; and (4) Reduce antigen load with lid hygiene and targeted antimicrobials. Start antitubercular treatment for tuberculosis. If a viral cause is anticipated, add antiviral medication or molluscum lesion eradication to the steroid-sparing regimen. Trigger-focused, steroid-sparing treatment reduces recurrences, vision-threatening consequences, and steroid exposure.}, }
@article {pmid41884491, year = {2026}, author = {Ayoubkhani, D and Atchison, CJ and Banerjee, A and Brightling, C and Calvert, M and Diamond, I and Eggo, RM and Elliott, P and Evans, RA and Haroon, S and Herrett, E and Nafilyan, V and O'Mahoney, LL and Pinto Pereira, SM and Routen, A and Shafran, R and Stephenson, T and Sterne, J and Ward, H and Zaccardi, F and Khunti, K}, title = {Considerations for epidemiological studies investigating emerging post-acute infection syndromes: Long Covid as a case study.}, journal = {EClinicalMedicine}, volume = {94}, number = {}, pages = {103833}, pmid = {41884491}, issn = {2589-5370}, abstract = {Epidemiological research studies into Long Covid, currently defined by prolonged symptoms after SARS-CoV-2 infection, have reported widely varying prevalence estimates. As well as rapidly evolving scientific knowledge of Long Covid, these differences are partly driven by substantial methodological heterogeneity between studies, including the outcome definition of Long Covid; duration of follow-up; study design, period and population; sampling frame; data source; and the statistical techniques employed. Having a robust understanding of the prevalence of and risk factors for Long Covid is essential for informing treatment pathways, service provision and policy decisions. In preparation for the public health response to future epidemics and pandemics, this review outlines key epidemiological and statistical considerations and recommendations when designing studies of emerging post-acute infection syndromes, focussing on Long Covid as a case study.}, }
@article {pmid41886256, year = {2026}, author = {Bilezikian, JP and di Filippo, L and Bianchi, A and Bikle, DD and Binkley, N and Bouillon, R and Fassio, A and Frara, S and Jones, G and Latella, G and Laterza, L and Graniel, IP and Taccari, F and Trasciatti, S and White, JH and Giustina, A}, title = {Vitamin D in Gut and Systemic Immune Tolerance and in Infections' Risk: An International Evidence-Based Consensus Statement.}, journal = {Reviews in endocrine & metabolic disorders}, volume = {27}, number = {2}, pages = {183-200}, pmid = {41886256}, issn = {1573-2606}, mesh = {Humans ; *Vitamin D/immunology ; *Immune Tolerance/drug effects/physiology ; *Vitamin D Deficiency/immunology ; Intestinal Barrier Function ; *Gastrointestinal Tract/immunology ; *Infections/immunology ; *Gastrointestinal Microbiome/immunology ; }, abstract = {Vitamin D, classically linked to calcium-phosphate metabolism and skeletal health, is increasingly recognized as a pleiotropic hormone with effects on gastrointestinal and systemic immune functions. This International Consensus aims to critically evaluate the role of vitamin D in gastrointestinal homeostasis, infection prevention, and immune regulation. A multidisciplinary panel of experts conducted a comprehensive review of the literature, distinguishing between associative evidence from observational studies and causal inferences derived from interventional trials addressing gut barrier integrity, dysbiosis, intestinal cancer prevention, respiratory infections, and autoimmune diseases. While vitamin D deficiency has been consistently associated with alterations in gut microbiota composition, increased intestinal permeability, impaired immune tolerance, and increased susceptibility to infections and autoimmune conditions, evidence from interventional studies remains more variable. Clinical outcomes are influenced by baseline 25(OH)D status, supplementation dose and formulation, timing of intervention, and disease context. Vitamin D supplementation has shown potential benefits in selected settings (i.e., autoimmune diseases and acute respiratory infections), and particularly in cases of documented deficiency. Given its pleiotropic role and favourable safety profile, appropriate screening and optimization of vitamin D represent a low-cost and potentially impactful strategy to support gut barrier function and immune competence. While further research is needed to define these therapeutic applications, maintaining vitamin D concentrations above 20 or 30 ng/mL in individuals at skeletal or immunological risk emerges as a reasonable clinical target. This Consensus Panel supports the integration of vitamin D assessment and correction into routine care for at-risk populations and calls for greater awareness of its extra-skeletal relevance.}, }
@article {pmid41887023, year = {2026}, author = {Rosso, A and Riccio, M and Renzi, E and Patania, F and Baccolini, V and Kaisy, AM and Marzuillo, C and De Vito, C and Villari, P and Massimi, A}, title = {The role of school-based health education in promoting childhood and adolescent vaccination: A systematic review and Meta-analysis.}, journal = {Vaccine}, volume = {79}, number = {}, pages = {128479}, doi = {10.1016/j.vaccine.2026.128479}, pmid = {41887023}, issn = {1873-2518}, mesh = {Humans ; Adolescent ; Child ; *Vaccination/psychology/statistics & numerical data ; Health Knowledge, Attitudes, Practice ; *Health Education/methods ; *School Health Services ; Schools ; Vaccination Hesitancy ; Papillomavirus Vaccines/administration & dosage ; }, abstract = {BACKGROUND: Childhood and adolescent vaccination is a cornerstone of public health, yet coverage has stagnated or declined in several regions, partly due to vaccine hesitancy. Schools offer a unique setting to promote vaccination by reaching children and adolescents during formative years. This systematic review and meta-analysis aimed to synthesize evidence on the effectiveness of school-based health education interventions in improving vaccine-related knowledge, attitudes, intentions, and uptake.
METHODS: Following PRISMA guidelines, we searched six databases up to August 2024 for interventional studies evaluating school-based educational programmes targeting students aged 6-18 years. Randomized controlled trials and quasi-experimental studies assessing outcomes related to vaccine knowledge, attitudes, intention to vaccinate, or uptake were included. Studies focusing on COVID-19 vaccination were excluded. Risk of bias was assessed using validated tools. A random-effects meta-analysis was conducted for HPV vaccination uptake.
RESULTS: Thirty-eight studies (1985-2024) were included: 9 RCTs/cluster-RCTs, 14 controlled quasi-experimental studies, and 15 pre-post studies. HPV vaccination was the most frequently studied vaccine (26/38). Most interventions significantly improved vaccine knowledge, while effects on attitudes and intention were less consistent. Eleven studies assessed vaccine uptake, with most reporting post-intervention increases. Meta-analysis of randomized trials showed a significant effect on HPV uptake (RR 4.18, 95% CI 1.41-12.37), although heterogeneity was high and methodological quality varied.
CONCLUSIONS: School-based health education appears to improve vaccine knowledge and may contribute to increased uptake, particularly for HPV. However, evidence is limited by heterogeneity and risk of bias. More rigorous, theory-informed, and sustainable whole-school approaches are needed.}, }
@article {pmid41887024, year = {2026}, author = {Silva, LL and Lopes, VDS and da Silva, DCB and Nemer, CRB and Sartori, AL and Lima, JC and Freitas, BHBM}, title = {Global overview of vaccine trust: Evidence from a scoping review.}, journal = {Vaccine}, volume = {79}, number = {}, pages = {128482}, doi = {10.1016/j.vaccine.2026.128482}, pmid = {41887024}, issn = {1873-2518}, mesh = {Humans ; *Trust/psychology ; *COVID-19/prevention & control/psychology/epidemiology ; *Vaccination Hesitancy/psychology ; *Vaccination/psychology ; COVID-19 Vaccines ; *Vaccines ; SARS-CoV-2 ; Health Personnel/psychology ; Immunization Programs ; }, abstract = {BACKGROUND: Vaccine trust is essential for achieving high coverage rates and sustaining immunization programs worldwide. However, hesitancy intensified by the COVID-19 pandemic and the spread of misinformation has challenged trust in vaccines, healthcare professionals, and institutions. This scoping review maps global evidence on the determinants, challenges, and strategies to strengthen vaccine trust.
METHOD: The review followed the JBI Brazilian Centre for Evidence-Based Health Care methodology and the PRISMA-ScR guidelines, with a protocol registered on the Open Science Framework. Searches were conducted in seven databases and additional sources. Studies that directly addressed vaccine trust in any population were included. Data extraction and analysis combined descriptive statistics with narrative synthesis.
RESULTS: A total of 66 studies published between 2020 and 2024 were included, most of them conducted in the United States and focused on COVID-19. Vaccine trust was found to be influenced by perceptions of safety and effectiveness, trust in health systems, professionals, and institutions, as well as individual beliefs and cultural factors. The pandemic increased uncertainty but also encouraged new strategies for community engagement. Health literacy and the involvement of trusted professionals were identified as key elements in strengthening trust. Evidence gaps remain concerning groups such as adolescents, older adults, migrants, and populations in vulnerable situations. Several measurement instruments were mapped, but standardization remains limited.
CONCLUSION: Vaccine trust is a complex and context-dependent phenomenon. Strengthening it requires clear communication, context-specific strategies, active community engagement, and the involvement of healthcare professionals as trusted sources. Future research should include understudied populations, use validated instruments, and assess trust-building interventions to inform more equitable and effective immunization policies.}, }
@article {pmid41888606, year = {2026}, author = {Zheng, Y and Li, Y and Zeyneloglu, C and Tian, W and Babayev, H and D'Avino, P and He, Y and Ogulur, I and Bicer, C and Lu, G and Li, Y and Zhao, B and Li, S and Chang, L and Li, M and Liu, X and Huang, X and Cheng, H and Göksel, O and Göksel, T and Agache, I and Khaitov, M and Kudlay, D and Nadeau, K and Cheng, L and Shamji, M and Torres, MJ and Zhang, L and Akdis, M and Gao, YD and Akdis, CA}, title = {Risk and Protective Factors for Infection, Severe Disease, and Mortality in Epidemic Respiratory Viruses.}, journal = {Allergy}, volume = {81}, number = {5}, pages = {1397-1432}, doi = {10.1111/all.70314}, pmid = {41888606}, issn = {1398-9995}, support = {72204214,82400012//National Natural Science Foundation of China/ ; LTGY24H260001,LQN25H030006//Zhejiang Provincial Natural Science Foundation of China/ ; CXTD202501015//Zhejiang Clinovation Pride/ ; BQD2306//Start-up Research fund by The First Affiliated Hospital of Zhejiang University School of Medicine/ ; No.2023M743729//China Postdoctoral Science Foundation/ ; 2023SKY138//Shaoxing Health Commission/ ; JJKH20221077KJ//Scientific Research Project of Education Department of Jilin Province/ ; }, mesh = {Humans ; Risk Factors ; *Respiratory Tract Infections/mortality/epidemiology/virology ; *COVID-19/epidemiology/mortality ; SARS-CoV-2 ; Protective Factors ; *Virus Diseases/epidemiology/mortality ; }, abstract = {The post-COVID pandemic era has witnessed a concerning resurgence of respiratory viruses, driving a global increase in acute respiratory infections. This trend may stem from relaxed non-pharmaceutical interventions, waning herd immunity, immunological imprinting limiting heterosubtypic protection, or viral antigenic evolution. This review aims to identify and characterize risk and protective factors associated with infection, hospitalization, severe illness, and mortality, while elucidating the drivers of the rising incidence of respiratory virus infections post-pandemic. Evidence on SARS-CoV-2 sublineages, influenza, respiratory syncytial virus, rhinovirus, adenovirus, human metapneumovirus, human parainfluenza virus, human coronaviruses, and cytomegalovirus has been collected and identified. Identified risk factors include demographic characteristics such as pediatrics and older age, male sex, race (Black, Hispanic, American Indian or Alaska native), preterm birth, and HLA-DQA1, IFNAR2, ST6GAL, and B3GALT5 genetic susceptibility. Behavioral, socioeconomic (low socioeconomic status, crowded living conditions), environmental influences (cold seasons, pollution), smoking, obesity and malnutrition could also exacerbate the risk of infection and adverse outcomes. Comorbidities, such as chronic conditions and immunocompromised states, significantly increase the risk of severe disease and hospitalization. Laboratory indices linked to severe disease outcomes include neutrophilia or neutropenia, lymphopenia, eosinopenia, and elevated C-reactive protein. Viral subtypes, viral load kinetics, vaccination status, and antiviral therapies further delineate risk profiles. Epithelial barrier impairment and underlying chronic airway diseases characterized by type 2 immunity also play a detrimental role in the development and severity of respiratory viral infections. Our findings highlight the need for stratified prevention strategies, which combine universal measures targeting shared determinants with virus-specific interventions addressing unique virological and transmission dynamics. It will provide a critical framework for optimizing precision public health strategies to counter repeated respiratory threats in the evolving post-COVID-19 pandemic landscape.}, }
@article {pmid41888810, year = {2026}, author = {Lam, CHM and Cheung, KC and Mason, T and Hollingsworth, B}, title = {COVID-19's disruptions to cancer care pathways and widening of health inequalities in the UK: a systematic review.}, journal = {BMC health services research}, volume = {26}, number = {1}, pages = {}, pmid = {41888810}, issn = {1472-6963}, mesh = {Humans ; *COVID-19/epidemiology ; United Kingdom/epidemiology ; *Neoplasms/therapy/diagnosis ; *Healthcare Disparities/statistics & numerical data ; *Health Services Accessibility ; Socioeconomic Disparities in Health ; SARS-CoV-2 ; Pandemics ; Socioeconomic Factors ; }, abstract = {BACKGROUND: The COVID-19 pandemic has significantly impacted cancer care services in the United Kingdom (UK), potentially exacerbating pre-existing health inequalities. While emerging studies have documented service disruptions, a comprehensive synthesis of how these disruptions have widened disparities remains absent. This systematic review examines the extent to which the pandemic disrupted the cancer care pathway and intensified existing disparities across the UK, identifying key sociodemographic and geographical factors influencing access to services. METHODS: A systematic search of PubMed, Scopus, and CINAHL was conducted for studies published between January 2020 and October 2024. Eligible studies included observational and empirical research examining disparities in cancer screening, diagnosis, treatment, and outcomes during the COVID-19 pandemic, as well as the corresponding mitigation strategies. Data extraction followed a structured approach using a custom-developed extraction form designed for this review. Study quality was appraised using a bespoke scoring system, classifying studies as high, moderate, or low importance. Narrative synthesis, following the framework outlined by Popay et al., was then employed to identify key themes and explore relationships between findings. RESULTS: 30 out of 457 studies met the inclusion criteria. The review found that socioeconomic status (SES) emerged as the most significant determinant, with individuals from deprived areas experiencing greater barriers to screening, urgent referrals, and treatment access, leading to poorer patient outcomes. Ethnic minorities, particularly Black patients, faced disproportionate reductions in hospital admissions and cancer screening participation. Age-related disparities were also evident, as older adults maintained higher screening rates but faced greater COVID-19 risks, while younger adults from lower-income backgrounds encountered delays in diagnosis and treatment. CONCLUSIONS: The review highlights that the COVID-19 pandemic has exacerbated existing inequalities in UK cancer care, with SES, ethnicity, and age emerging as key determinants. Targeted interventions are essential, including the establishment of COVID-free “cold sites”, deployment of mobile screening units, and culturally tailored outreach programmes for ethnic minority communities. Strengthening regional healthcare capacity and conducting longitudinal assessments will be crucial in addressing disparities and ensuring equitable cancer care. Future research should focus on the long-term consequences of these disruptions on cancer outcomes and healthcare resilience. SYSTEMATIC REVIEW REGISTRATION: The protocol for this systematic review was registered on PROSPERO under the ID CRD42024602280.}, }
@article {pmid41890193, year = {2026}, author = {Zhu, B and Qu, S and Li, J and Deng, W and Shen, WJ and Chen, J}, title = {The mechanisms underlying COVID-19 induced insulin resistance: a narrative review.}, journal = {Frontiers in endocrinology}, volume = {17}, number = {}, pages = {1781679}, pmid = {41890193}, issn = {1664-2392}, mesh = {Humans ; *Insulin Resistance/physiology ; *COVID-19/complications/metabolism/immunology ; *SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; }, abstract = {The COVID-19 pandemic, caused by SARS-CoV-2, has resulted in a significant increase in insulin resistance and new-onset diabetes among recovered individuals. This review examines the multifactorial mechanisms underlying these metabolic complications, including activation of the immune system and inflammatory cascades, lifestyle changes, nutritional deficiencies, imbalances in amino acid metabolism, alterations in ketogenesis, disruptions in the gut microbiome, psychological impacts, and COVID-19 vaccines. We discuss how these factors collectively contribute to insulin resistance, particularly in the context of COVID-19, and highlight potential therapeutic strategies, such as dietary interventions and ACE2 activators, that may mitigate these effects. Our analysis underscores the need for targeted approaches to prevent and treat insulin resistance in post-COVID-19 patients, emphasizing the importance of understanding the pandemic's long-term metabolic consequences.}, }
@article {pmid41890586, year = {2025}, author = {Sadat Hoseini, AS and Divani, A and Nadali, J and Zare, L}, title = {Social Stigma Associated with COVID-19 in Healthcare Workers: A Concept Analysis.}, journal = {Journal of caring sciences}, volume = {14}, number = {4}, pages = {278-292}, pmid = {41890586}, issn = {2251-9920}, abstract = {INTRODUCTION: Despite the presence of "COVID-19-related social stigma" in health literature, there is no clear definition of this concept in healthcare setting. It is often confused with related terms such as shame, discrimination, and prejudice, leading to imprecise research questions and ineffective evaluations. The aim of this study was to elucidate the concept of social stigma associated with COVID-19 in healthcare workers using Rodgers' evolutionary concept analysis method.
METHODS: Rodgers' evolutionary method of concept analysis was employed to clarify COVID-19-related social stigma in healthcare workers. A literature review was conducted using key terms "COVID-19", "social stigma", and related terms in PubMed, Scopus, Cochrane, ProQuest databases, and Google Scholar from January 2019 to September 2024. Among 3993 studies found, 46 were selected for analysis. Data were analyzed using thematic analysis.
RESULTS: COVID-19-related social stigma among healthcare workers is a multidimensional concept characterized by three primary attributes: Alienation, Humiliation, and Ignorance. The antecedents identified include Fear, Fake news, and the Contagious Nature of the virus. Consequences of this stigma encompass Psychological Issues, Feelings of Worthlessness, Impaired Functionality, and Job Attrition.
CONCLUSION: Social stigmatization associated with COVID-19 exerts significant pressure on healthcare workers. It is crucial to understand the factors that exacerbate this issue. Identifying the dimensions of this stigma can provide valuable insights for policymakers and the media. The implementation of preventive measures, such as clear protocols tailored to the public's educational level and addressing fears of contamination, can improve the situation and reduce the financial strain caused by the loss of healthcare personnel, ultimately enhancing the quality of care.}, }
@article {pmid41890759, year = {2026}, author = {Zhang, K and Zhu, S and Zhang, M and Hu, H and Qin, S and Li, H and Zhao, P and Xu, Y}, title = {Convergent hub pathways targeted by IAV, SARS-CoV-2, and RSV in type II alveolar epithelial cells: molecular mechanisms and therapeutic implications.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1781447}, pmid = {41890759}, issn = {1664-3224}, mesh = {Humans ; *Alveolar Epithelial Cells/virology/immunology/metabolism ; *SARS-CoV-2/immunology/physiology ; *Respiratory Syncytial Virus Infections/immunology ; Signal Transduction/immunology ; *COVID-19/immunology/virology/metabolism ; *Influenza A virus/immunology/physiology ; Animals ; *Influenza, Human/immunology ; Innate Immunity Recognition ; Host-Pathogen Interactions ; Immunity, Innate ; }, abstract = {Type II alveolar epithelial cells (AEC2s) maintain surfactant homeostasis, support distal-lung repair, and contribute to antiviral innate defense. Influenza A virus (IAV), SARS-CoV-2, and respiratory syncytial virus (RSV) use distinct entry receptors, yet severe disease is repeatedly marked by AEC2 dysfunction, alveolar barrier failure, and dysregulated inflammation. We synthesize cross-virus evidence for convergence on a small set of host hubs: innate sensing and interferon signaling, mitochondria-centered immunometabolism and oxidative stress, post-translational signaling modules, barrier and surfactant programs, and regulated cell-death checkpoints. We summarize structural and post-translational mechanisms by which viral proteins disrupt pattern recognition receptor (PRR)-mitochondrial antiviral signaling protein (MAVS) signaling, couple mitochondrial injury to weakened antiviral responses, and bias epithelial fate toward inflammatory lytic injury. Where AEC2-specific evidence is incomplete, especially for integrated PANoptosis-like programs, we label these elements as working models and highlight validation needs. We compare model systems used to study AEC2 infection, including ALI cultures, organoids, lung-on-chip platforms, and single-cell or network analyses. Finally, we discuss host-directed therapeutic opportunities along the cascade, separating near-term approaches from longer-term platform strategies such as targeted protein degradation and targeted nanodelivery, and noting constraints in distal-lung delivery, onset kinetics, and safety. This AEC2-centered convergence framework supports mechanism-driven interpretation of severe viral pneumonia and guides broader-spectrum intervention concepts.}, }
@article {pmid41891493, year = {2026}, author = {Nakae, A and Matsubara, T and Hattori, T and Ohga, S and Shimo, K and Kumazaki, H and Oi, H and Takeda, K and Sumioka, H}, title = {Telework-related health outcomes in Japan and globally: Implications for avatar-based work standards.}, journal = {Work (Reading, Mass.)}, volume = {}, number = {}, pages = {10519815261434906}, doi = {10.1177/10519815261434906}, pmid = {41891493}, issn = {1875-9270}, abstract = {BackgroundThe COVID-19 pandemic has driven a global shift in teleworking, serving as a real-world experiment in remote labor. As workplaces advance toward technologically mediated environments, including avatar-based systems for remote interaction, understanding the health implications of teleworking is crucial for future occupational health standards.ObjectiveThis review examined the health-related outcomes of teleworking during the pandemic, comparing Japan and other countries to inform health-supportive remote work systems.MethodsA structured narrative review was conducted using MEDLINE (PubMed) and IEEE Xplore through January 9, 2026. Studies were included if they examined teleworking in adult workplace environments and reported physical, mental, behavioral, or performance-related outcomes. Data from 67 eligible studies (12 from Japan and 55 from other countries) were analyzed for the physical health, mental health, lifestyle factors, and work performance domains. Cultural and institutional factors were examined to understand the regional differences.ResultsTelework has been linked to musculoskeletal discomfort, sedentary behavior, psychological stress, and unhealthy lifestyle choices. Japanese and international studies have identified these challenges, although the manifestations vary by context. In Japan, inflexible teleworking, inadequate home infrastructure, and an office-centric culture exacerbate negative outcomes, particularly for women and caregivers. International studies have highlighted the benefits of flexible scheduling and organizational support. Cultural norms and institutional readiness mediated these effects.ConclusionsThis review demonstrates the need for evidence-based health standards for next-generation remote work environments including avatar-based systems. We propose recommendations incorporating ergonomic design, health monitoring, organizational flexibility, and cultural adaptation. As remote work technologies evolve, policy frameworks must prioritize worker well-being.}, }
@article {pmid41893739, year = {2026}, author = {Cui, Y and Liang, Z and Cong, H}, title = {From Design to Clinical Use: mRNA Vaccines for Infectious Diseases and Cancer.}, journal = {Vaccines}, volume = {14}, number = {3}, pages = {}, pmid = {41893739}, issn = {2076-393X}, abstract = {mRNA vaccines represent a revolutionary advance in vaccinology, boasting advantages like rapid development, robust immunogenicity and flexible antigen design over traditional vaccines. This review systematically summarizes the core research progress of mRNA vaccines, including their structural composition with five functional elements and novel subtypes (linear mRNA, self-amplifying RNA, circular RNA) with unique biological characteristics and application value. It elaborates on the immune activation mechanism of mRNA vaccines, which mimic natural viral infection to trigger both innate and adaptive immunity, and analyzes mainstream delivery systems (lipid nanoparticles, dendritic cells, protamine, exosomes, polymers) with their respective performance, advantages and bottlenecks. This review also details the clinical application status of mRNA vaccines in infectious diseases (influenza, rabies, monkeypox, SARS-CoV-2, HIV, parasites) and cancer therapy, highlighting promising preclinical and clinical results of candidate vaccines and combined therapeutic regimens. Additionally, it addresses the current limitations of mRNA vaccines, such as delivery inefficiency, production costs, and cold chain constraints. Finally, this review prospects the future development direction, emphasizing that the optimization of delivery systems, antigen design and production processes will further promote the clinical translation and diversified application of mRNA vaccines in disease prevention and treatment.}, }
@article {pmid41893762, year = {2026}, author = {Siniscalchi, C and Basaglia, M and Tufano, A and Imbalzano, E and Di Micco, P}, title = {Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT): An Immunopathogenic Model of Dysregulated Vaccine-Triggered Immunity.}, journal = {Vaccines}, volume = {14}, number = {3}, pages = {}, pmid = {41893762}, issn = {2076-393X}, abstract = {BACKGROUND/OBJECTIVES: Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare but severe immune-mediated adverse event associated with adenoviral vector-based SARS-CoV-2 vaccines. Beyond its clinical relevance, VITT provides a unique human model of vaccine-triggered autoimmunity and immune-thrombosis. This review critically reassesses the immunopathogenic framework of VITT in light of recent evidence.
METHODS: We conducted a structured narrative review of studies published between 2021 and 2025, focusing on clinical, epidemiological, and mechanistic data relevant to PF4 immunogenicity, platelet activation, and long-term outcomes.
RESULTS: Current evidence supports a multistep model in which adenoviral vector components form immunogenic PF4-polyanion complexes that induce high-affinity anti-PF4 IgG antibodies. These antibodies activate platelets via FcγRIIa, amplify complement signaling, promote neutrophil extracellular trap formation, and drive endothelial perturbation, establishing a self-sustaining thrombo-inflammatory loop. Recent longitudinal studies refine earlier interpretations by distinguishing persistent anti-PF4 seropositivity from sustained platelet-activating capacity. Epidemiological data support platform-enriched risk rather than absolute platform exclusivity, with a proposed mechanistic "border zone" for incomplete phenotypes.
CONCLUSIONS: VITT represents a tractable human model of vaccine-induced autoimmunity in which innate immune activation and multivalent antigen presentation converge to break tolerance. Updated evidence clarifies antibody persistence, platform enrichment, and translational implications, while highlighting unresolved questions regarding host susceptibility and long-term immune regulation.}, }
@article {pmid41893763, year = {2026}, author = {Huang, S and Yu, S and Zhang, M and Huang, Y and Tian, B and Lu, J}, title = {From Innate to Adaptive: Paradigm Shifts and Frontier Challenges in Next-Generation Vaccine Design.}, journal = {Vaccines}, volume = {14}, number = {3}, pages = {}, pmid = {41893763}, issn = {2076-393X}, support = {82400472//National Natural Science Foundation of China/ ; }, abstract = {The unprecedented success of mRNA vaccines during the COVID-19 pandemic marks a fundamental paradigm shift in vaccinology, moving the field from empirical pathogen modification toward the rational engineering of host immunity. This review synthesizes recent breakthroughs to construct a conceptual framework for understanding how modern vaccines function as programmable immune instructions. We first analyze the innate immune system as an instructional center, where recognition of vaccine components dictates the quality of ensuing adaptive responses. We then examine the germinal center (GC) as a micro-evolutionary engine for antibody maturation, the output of which can be tuned by vaccine design. The discussion centers on three integrated pillars of next-generation vaccines: computationally designed immunogens, spatiotemporally controlled adjuvant systems, and intelligent delivery platforms, emphasizing that their synergy is essential for achieving broad, durable protection against complex pathogens. Finally, we explore how the convergence of systems vaccinology, artificial intelligence, and personalized medicine is guiding the field toward a more predictable and rapid-response future, while also outlining key advances and persistent challenges.}, }
@article {pmid41893791, year = {2026}, author = {Pjanova, D and Rafeeque, A}, title = {SARS-CoV-2 Infection and Vaccination, Immune Dysregulation, and Cancer.}, journal = {Vaccines}, volume = {14}, number = {3}, pages = {}, pmid = {41893791}, issn = {2076-393X}, abstract = {Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection induces heterogeneous immune responses that influence both acute disease severity and long-term immune remodeling. A key question in the context of infection and vaccination is whether SARS-CoV-2 exerts direct oncogenic effects or instead acts as a transient immunological stressor capable of reinforcing tumor-permissive pathways. Current evidence does not support classical viral oncogenesis. Rather, severe infection is characterized by early interferon (IFN) imbalance followed by NF-κB-dominant inflammatory amplification, promoting sustained IL-6/JAK-STAT3 and MAPK signaling, chronic cytokine production, metabolic reprogramming, and impaired antitumor immune surveillance. At the molecular level, viral structural proteins modulate host signaling networks. The spike (S1) protein engages TLR2/TLR4-MyD88 pathways, activating NF-κB and MAPK cascades, while the membrane (M) protein reinforces NF-κB-STAT3 circuits linked to epithelial-mesenchymal transition and inflammatory gene expression. These mechanisms intensify pre-existing oncogenic signaling without initiating malignant transformation. Tissue-specific responses are further shaped by IFN competence, renin-angiotensin system balance, and metabolic context. In parallel, immune evasion programs shared by chronic viral infection and cancer, including checkpoint upregulation, impaired antigen presentation, and suppressive myeloid expansion, may be transiently reinforced following severe infection. In contrast, SARS-CoV-2 vaccination induces spatially restricted, self-limited innate activation without sustained inflammatory signaling or persistent antigen exposure. By preventing severe disease and chronic immune dysregulation, vaccination interrupts pathways hypothesized to intersect with cancer biology, with no evidence of increased cancer incidence. Ongoing longitudinal studies are required to clarify the long-term oncologic implications of post-infectious immune remodeling.}, }
@article {pmid41893795, year = {2026}, author = {Asaad, M and Mustafa, MO and Al-Haneedi, Y and Shalaby, L and Shams Eldin, R and Mohamedahmed, Y and Yassine, HM and Abdallah, AM and Emara, MM}, title = {The Feasibility of Developing a Universal SARS-CoV-2 Vaccine.}, journal = {Vaccines}, volume = {14}, number = {3}, pages = {}, pmid = {41893795}, issn = {2076-393X}, support = {ARG01-0521-230249//Qatar Research, Development and Innovation Council/ ; }, abstract = {As SARS-CoV-2 continues to evolve with increased transmissibility and immune evasion, the need for vaccines that provide broader and more durable protection has become increasingly urgent. The extensive research spurred by the pandemic has accelerated the development of diverse vaccine platforms, including mRNA, DNA, virus-like particles (VLPs), recombinant proteins, and mosaic mono- and polyvalent vaccines. While several of these platforms have reached regulatory approval and widespread clinical employment, others remain under evaluation or in various stages of clinical development. These vaccines have significantly reduced infection rates, severe disease, and hospitalizations, particularly among high-risk group. Nevertheless, the ongoing emergence of novel variants and subvariants has challenged the efficacy of both existing and newly developed vaccines. This evolving landscape underscores the urgent need for a universal SARS-CoV-2 vaccine platform capable of providing comprehensive and long-lasting immunity. In this review, we evaluate current and emerging strategies for SARS-CoV-2 universal vaccine development, with a focus on antigen design, breadth of immune protection, and clinical feasibility. Attention is given to various universal vaccine platforms such as the mosaic polyvalent spike construct, multi-epitope vaccines targeting the receptor-binding domain (RBD), and approaches centered on the conserved S2 subunit of the spike protein. We also discuss strategies leveraging additional conserved viral proteins and T helper (Th) and cytotoxic T lymphocyte (CTL) epitopes from across coronaviruses. By highlighting the advances in these areas, this review provides a framework to guide the rational design of next-generation universal vaccines capable of delivering broad and durable protection against SARS-CoV-2 variants.}, }
@article {pmid41893818, year = {2026}, author = {Kamransarkandi, M and Varyushina, EA and Gorshkov, AN and Stukova, MA}, title = {SARS-CoV-2 and Influenza Co-Circulation and Co-Vaccination: A Narrative Review.}, journal = {Vaccines}, volume = {14}, number = {3}, pages = {}, pmid = {41893818}, issn = {2076-393X}, support = {government contract, grant 125020401358-1//Ministry of Health of the Russian Federation/ ; }, abstract = {BACKGROUND/OBJECTIVES: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza virus are dangerous respiratory pathogens with high pandemic potential. Since 2021, these two viruses have been co-circulating, which implies additional risks of co-infection with both pathogens. Prophylactic vaccination is widely recognized as the most effective way to prevent COVID-19 and influenza and to reduce the severity of these diseases. This review analyzes recent data on the simultaneous circulation of influenza and SARS-CoV-2 viruses worldwide, including epidemiological data and the pathogenetic mechanisms of co-infection. Next, we focus on current approaches to simultaneous and combined vaccination against influenza and COVID-19. We outline the types of vaccines and summarize the available findings on the effectiveness and safety of co-vaccination.
METHODS: A comprehensive search was conducted using PubMed, Scopus, Web of Science, and ClinicalTrials to identify data relevant to SARS-CoV-2 and influenza co-circulation and dual vaccination.
RESULTS: Influenza and SARS-CoV-2 cause similar symptoms, and co-infection can significantly enhance the risks of pneumonia and acute respiratory distress syndrome progressing with a poor outcome, especially among children and the elderly. A range of influenza and COVID-19 vaccines built on different technological platforms is currently available on the market, with proven effectiveness, immunogenicity, and safety. A co-vaccination approach is more convenient for patients and is associated with better response to treatment, while also improving vaccine coverage and compliance and offering significant resource savings for healthcare systems.
CONCLUSIONS: The concurrent circulation of SARS-CoV-2 and influenza viruses presents a growing public health challenge. Simultaneous and combination vaccination strategies have emerged as effective tools to streamline immunization, enhance protection, and reduce healthcare burden. Future studies should elucidate the mechanisms of the exacerbation of respiratory disease caused by co-infection, as well as the optimal strategies for co-administering influenza and COVID-19 vaccines for long-term control of seasonal and potentially pandemic respiratory viruses.}, }
@article {pmid41894963, year = {2026}, author = {Li, Y and Fan, Z and Wang, Y and Liu, Y and Yang, B}, title = {A review of UVC air disinfection for built environments: Inactivation mechanisms, kinetic models, and influencing determinants.}, journal = {Journal of environmental management}, volume = {404}, number = {}, pages = {129461}, doi = {10.1016/j.jenvman.2026.129461}, pmid = {41894963}, issn = {1095-8630}, mesh = {*Ultraviolet Rays ; *Disinfection/methods ; *Air Microbiology ; Kinetics ; Humans ; COVID-19/prevention & control ; }, abstract = {The COVID-19 pandemic has significantly heightened public awareness of air quality and its implications for human health, propelling air sterilization technologies to the forefront research. This Review synthesizes recent progress in ultraviolet C (UVC)-based air disinfection, integrating inactivation mechanisms, irradiance distribution models and microbial inactivation kinetics. We compare major UVC light sources and examine how optical properties, spatial deployment and environmental conditions govern dose delivery and disinfection efficacy. Key physical and biological factors-including wavelength, airflow, humidity and microbial heterogeneity-are discussed in the context of predictive modelling and system optimization. We highlight critical limitations related to safety, penetration depth and energy efficiency, and outline future directions centred on far-UVC technologies, solid-state light sources and intelligent control strategies. Together, this Review provides a conceptual framework for the rational design and safe implementation of UVC air disinfection systems in public and built environments.}, }
@article {pmid41895046, year = {2026}, author = {Tscherne, A and Krammer, F}, title = {Seven decades after the Asian influenza pandemic: A historical review about immunity and vaccines against H2N2.}, journal = {Vaccine}, volume = {79}, number = {}, pages = {128467}, doi = {10.1016/j.vaccine.2026.128467}, pmid = {41895046}, issn = {1873-2518}, mesh = {Humans ; *Influenza Vaccines/immunology ; *Influenza A Virus, H2N2 Subtype/immunology ; *Influenza, Human/prevention & control/epidemiology/immunology/history ; History, 20th Century ; *Pandemics/prevention & control ; History, 21st Century ; Animals ; Asia/epidemiology ; Hemagglutinin Glycoproteins, Influenza Virus/immunology ; Neuraminidase/immunology ; Influenza A Virus, H3N2 Subtype/immunology ; Protein Subunit Vaccines ; }, abstract = {In 1957, a reassortant influenza A virus (IAV) H2N2 subtype emerged in humans and encountered a population that was antigenically naïve to this subtype. The lack of pre-existing immunity to the H2 hemagglutinin (HA) facilitated efficient human-to-human transmission, and by the end of the Summer of 1957, most countries around the world reported increasing influenza cases caused by the new influenza virus subtype. The pandemic lasted until 1958, resulting in millions of infections globally, with 1-4 million estimated deaths. The first vaccines targeting specifically the H2N2 subtype were available in autumn 1957, but their limited immunogenicity hampered a successful fight against the "Asian influenza pandemic". After the pandemic, H2N2 became seasonal in the following years. Most individuals developed immunity against both the H2 HA and N2 neuraminidase (NA) proteins of the virus, and vaccines administered in the early 1960s successfully boosted this immunity. In 1968, the circulating H2N2 was replaced by the H3N2 subtype, and individuals with pre-existing N2 immunity were partially cross-protected against severe H3N2 infection, as the two N2 NAs were antigenically similar. Since the disappearance of H2N2 from the human population in 1968, global H2 immunity has been decreasing. This raises concerns about a possible re-emergence of the H2 subtype from animal reservoirs, where the virus has circulated for decades, into the human population. As preparedness for future pandemics, research on H2-specific vaccines is currently ongoing, with several candidates being tested in preclinical studies and early-phase clinical trials. In contrast to 1957, vaccine technology platforms, but also the assays used to assess vaccine immunogenicity, and efficacy, have significantly improved. This review aims to summarize the key historical milestones of the Asian influenza pandemic, the impact of H2N2 immunity during and after the 1957 pandemic, the immunogenicity of H2N2-specific vaccines in both a pandemic and pre-pandemic situation, and H2N2-specific antiviral treatment.}, }
@article {pmid41895350, year = {2026}, author = {Karthik S, S and Jadhav, P and Paul, A and Kumar, R and Paul, D and Bose, S}, title = {Understanding gut microbiota dysbiosis as a plausible link between obstructive sleep apnea (OSA), viral infections, and lifestyle diseases.}, journal = {Microbial pathogenesis}, volume = {215}, number = {}, pages = {108466}, doi = {10.1016/j.micpath.2026.108466}, pmid = {41895350}, issn = {1096-1208}, mesh = {Humans ; *Sleep Apnea, Obstructive/microbiology/complications ; *Dysbiosis/complications/microbiology ; *Virus Diseases/complications/microbiology ; *Gastrointestinal Microbiome/physiology ; Life Style ; Inflammation ; Obesity ; }, abstract = {Obstructive sleep apnea (OSA) is a multifactorial disorder which is influenced by intermittent hypoxia, sleep fragmentation, and systemic inflammation. Recent evidence suggests that lifestyle diseases and viral infections further exacerbate OSA severity through common inflammatory and metabolic pathways. Parallelly, gut dysbiosis has gained recognition as a key mediator which links respiratory, metabolic, and infectious disease processes via the gut-lung axis. This review explores the convergent role of gut microbial dysbiosis across OSA, lifestyle-associated comorbidities such as obesity, diabetes, and cardiovascular disease and viral infections including respiratory syncytial virus (RSV), influenza, dengue, Human Immunodeficiency Virus (HIV), and SARS-CoV-2. Across these conditions, a recurring pattern of reduced beneficial commensals (e.g., Bifidobacterium, Faecalibacterium prausnitzii, Roseburia, Akkermansia muciniphila) and a noted increase of pro-inflammatory taxa (e.g., Escherichia, Streptococcus, Enterobacteriaceae) has been observed. It contributes to epithelial barrier breakdown, endotoxemia, metabolic dysfunction, and immune dysregulation. In OSA patients, intermittent hypoxia is observed that causes gut barrier impairment and microbial translocation, thus amplifying systemic inflammation. Similarly, viral infections reshape the gut ecology, bringing adverse effects to host immunity and respiratory outcomes. The review highlights upon the therapeutic potentials of prebiotics and probiotics supplementation for modulating gut dysbiosis. It discusses the role of these therapeutic interventions in improving metabolic homeostasis, reducing inflammation, and potentially mitigating OSA-related complications. Collectively, this analysis highlights gut dysbiosis as a plausible unifying mechanism connecting lifestyle diseases, viral infections, and OSA, presenting a compelling avenue for integrated, microbiome-targeted interventions.}, }
@article {pmid41895458, year = {2026}, author = {Fehrer, A and Windzio, L and Schoening, S and Steiner, S and Aschenbrenner, AC and Babel, N and Behrends, U and Bellmann-Strobl, J and Cammà, G and Cash, A and Doehner, W and den Dunnen, J and Fluge, Ø and Franke, C and Hoffmann, K and Kedor, C and Kim, L and Löhden, W and Mella, O and Mihatsch, LL and Peluso, MJ and Puta, C and Putrino, D and Ramoji, A and Sato, W and Sawitzki, B and Schlieper, G and Schoenfeld, Y and Seifert, M and Sigurdsson, F and Slaghekke, A and Sommerfelt, K and Sotzny, F and Stein, E and Steinacker, JM and Stingl, M and Systrom, DM and Tronstad, KJ and Wirth, K and Wörmann, B and Wüst, RCI and Yamamura, T and Scheibenbogen, C}, title = {Expert perspectives on Myalgic encephalomyelitis/chronic fatigue syndrome - Insights from the 3[rd] International Conference of the Charité Fatigue Center.}, journal = {Autoimmunity reviews}, volume = {25}, number = {5}, pages = {104043}, doi = {10.1016/j.autrev.2026.104043}, pmid = {41895458}, issn = {1873-0183}, mesh = {Humans ; *Fatigue Syndrome, Chronic/therapy/diagnosis/immunology/epidemiology ; *COVID-19/complications ; SARS-CoV-2 ; Pandemics ; Post-Acute COVID-19 Syndrome ; Quality of Life ; }, abstract = {Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex, multisystemic disorder mostly triggered by viral infections, with core symptoms including post-exertional malaise (PEM), fatigue, pain, and cognitive dysfunction. Its prevalence has increased significantly in the context of the coronavirus disease 2019 (COVID-19) pandemic. Despite its severity and impact on patients' quality of life, ME/CFS remains poorly understood. On May 12 and 13, 2025, the 3[rd] International Conference hosted by the Charité Fatigue Center brought together nearly 200 researchers from various disciplines on-site, and around 3,700 participants online to discuss recent advances in ME/CFS research, diagnostics, clinical care, and therapeutic trials. The program featured 33 lectures by international experts on key topics such as post-COVID syndrome (PCS), care structures, and pathophysiological mechanisms including cardiovascular dysregulation, immune dysregulation, autoimmune mechanisms, and metabolic dysfunction. In addition, results from clinical trials addressing disease mechanisms, including those specifically targeting autoantibodies, were presented. While public awareness and funding opportunities have increased in the wake of the pandemic and the emergence of PCS, ME/CFS remains severely underresearched. Sustained and adequately funded research efforts are urgently required to advance understanding, identify diagnostic markers, and develop targeted therapeutic interventions.}, }
@article {pmid41895795, year = {2026}, author = {Farag, NH and Ozen, A and Spaulding, AB and Khan, G and Barbouche, MR and Khan, MA and Zalloua, P and Al-Mahruqi, S and Zaher, W and Almayahi, ZK and Alsheikh-Ali, A and Burke, H and Sayegh, MH}, title = {Lessons learnt from the COVID-19 pandemic: Middle East and North Africa regional perspective for future preparedness.}, journal = {BMJ global health}, volume = {11}, number = {3}, pages = {}, pmid = {41895795}, issn = {2059-7908}, mesh = {Humans ; Africa, Northern/epidemiology ; Middle East/epidemiology ; *COVID-19/epidemiology ; Pandemic Preparedness ; *Pandemics/prevention & control ; SARS-CoV-2 ; Public Health ; Public Health Infrastructure ; }, abstract = {The COVID-19 pandemic revealed critical gaps in preparedness and response capacities globally. These gaps were evident in the Middle East and North Africa (MENA) region, as the region faces unique challenges due to ongoing humanitarian crises, political instability and large-scale religious gatherings, which further exacerbate the risk of spread of infectious diseases.In April 2024, a conference hosted by the US Centres for Disease Control and Prevention MENA Regional Office and National Institutes of Allergy and Infectious Diseases, in collaboration with the Mohammed Bin Rashid University of Medicine and Health Sciences, brought together 200 scientists and public health professionals from 16 countries to discuss lessons learnt from the COVID-19 pandemic and strategies to strengthen future preparedness and response. This report presents the key barriers to regional collaboration and data sharing identified during the conference, along with the proposed solutions, including establishing regional collaboration platforms, increasing public-private partnerships, operationalising the one health approach and leveraging technological advances.Reflections on the global pandemic response emphasise the need for improved communication, preparedness extending beyond the health sector and distribution of resources. The collective insights and recommendations in this report aim to provide a roadmap for strengthening emergency preparedness and response in the MENA region and globally, ensuring improved readiness for future public health emergencies.}, }
@article {pmid41896064, year = {2026}, author = {Lee, MM and Talbot, TR}, title = {The Role of Infection Prevention in Monitoring and Preventing Healthcare-Associated Viral Respiratory Infection.}, journal = {Infectious disease clinics of North America}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.idc.2026.01.012}, pmid = {41896064}, issn = {1557-9824}, abstract = {Health care-associated viral respiratory infections are common and cause increased patient morbidity and mortality. Although the threat of viral respiratory infection was underscored by the COVID-19 pandemic, respiratory viruses continue to have a significant impact in health care settings. Studies report decreased nosocomial transmission when aggressive infection control measures are implemented with more success using a multicomponent approach. This review focuses on the epidemiology, transmission, and role of infection prevention in the control of health care-associated respiratory viral infections.}, }
@article {pmid41897224, year = {2026}, author = {Guillari, A and Abagnale, M and Palazzo, C and Fulco, MA and Rea, T and Giordano, V}, title = {Nurse Retention in Hospitals: A Multilevel Integrative Review of Organizational Determinants.}, journal = {Healthcare (Basel, Switzerland)}, volume = {14}, number = {6}, pages = {}, pmid = {41897224}, issn = {2227-9032}, abstract = {Background/Objectives: Nurse retention remains a major global challenge for healthcare systems, intensified by workforce aging, rising care complexity, and the long-term impact of the COVID-19 pandemic. Despite extensive research, the evidence on nurse retention remains fragmented and frequently focuses on isolated determinants. This review aimed to synthesize the multifactorial determinants of nurse retention by integrating organizational, relational, and individual perspectives. Methods: An integrative review was conducted following Whittemore and Knafl's approach and reported according to PRISMA 2020 guidelines where applicable. A systematic search of six databases identified studies published between 2016 and 2026 addressing nurse retention in hospital settings. Included studies underwent methodological quality appraisal using validated tools, and findings were synthesized narratively. Results: Twenty-five articles were included. The analysis revealed differences in perspective between nurse managers and nurses regarding the factors that influence retention. Transformational and participative leadership among nurse managers enhanced staff retention through supportive organizational climates and higher professional commitment. For staff nurses, positive work environments, collegial support, and psychological resources such as self-efficacy and resilience were key predictors of intention to stay. These findings can be interpreted through Herzberg's Two-Factor Theory, Self-Determination Theory and Theory of Planned Behavior, which collectively highlight how recognition, autonomy, and competence satisfaction drive nurses' intention to remain in their roles. Conclusions: Nurse retention reflects dynamic, multilevel processes rather than the influence of single determinants. Integrated, theory-informed approaches targeting organizational structures, relational climates, and individual psychological resources are required to strengthen workforce sustainability and support high-quality care delivery.}, }
@article {pmid41897288, year = {2026}, author = {Hatfield, JS and Thielen, BK and Goyal, SM}, title = {Avian Metapneumovirus: Virology, Epidemiology, and Insights from a Comparative Analysis with Human Metapneumovirus-A Review.}, journal = {Biomolecules}, volume = {16}, number = {3}, pages = {}, pmid = {41897288}, issn = {2218-273X}, support = {T32 TR004385/TR/NCATS NIH HHS/United States ; UM1 TR004405/TR/NCATS NIH HHS/United States ; NU50CK000628/CC/CDC HHS/United States ; }, mesh = {*Metapneumovirus/genetics/pathogenicity/physiology/classification ; Humans ; Animals ; *Paramyxoviridae Infections/epidemiology/virology/veterinary ; Birds/virology ; Viral Proteins/genetics/metabolism ; Genome, Viral ; }, abstract = {Metapneumoviruses comprise a genus of negative-sense RNA viruses that cause significant respiratory disease across human and avian hosts. Human metapneumovirus (hMPV) is a globally prevalent pathogen associated with acute lower respiratory tract infections in infants, older adults, and immunocompromised individuals. Avian metapneumovirus (aMPV) imposes substantial economic losses on the poultry industry through respiratory disease, reproductive impairment, and high mortality in the presence of secondary infections. Despite their distinctive host ranges, hMPV and aMPV share a conserved genomic architecture and encode homologous structural and non-structural proteins that mediate viral entry, replication, assembly, and evasion of host innate immunity. Comparative analysis highlights that both have deeply conserved polymerase and nucleocapsid functions, and yet have a wide range of diversity in the attachment glycoprotein (G) and small hydrophobic protein (SH), reflecting divergent evolutionary pressures in human versus avian hosts that have led to such distinctive differences. The recent emergence and detection of aMPV/A and aMPV/B across the previously aMPV-free United States beginning in late 2023, combined with rising cases globally of hMPV post-SARS-CoV-2 pandemic, underscore the continued challenges of metapneumovirus surveillance and control in humans and animals. This review aims to highlight the current knowledge on the history, molecular virology, pathogenesis, epidemiology, diagnostics, and control strategies for aMPV while drawing mechanistic parallels to hMPV. By contextualizing shared biology and structure alongside host-specific adaptations, we aim to identify key gaps that shape vaccine design, antiviral development, and future research priorities aimed at mitigating the health and economic burden posed by metapneumoviruses found in both birds and humans.}, }
@article {pmid41897449, year = {2026}, author = {Ciullo, R and Femminò, S and Brizzi, MF and Pagliaro, P and Penna, C}, title = {Oxidative Stress in Takotsubo Syndrome: Insights into Extracellular Vesicles and Their Potential Clinical Relevance.}, journal = {Antioxidants (Basel, Switzerland)}, volume = {15}, number = {3}, pages = {}, pmid = {41897449}, issn = {2076-3921}, support = {117295 / 2025.1833//CRT Foundation/ ; PAGP_PRIN_2022_23_01-2022AA37N3//PRIN/ ; PENC_PRIN_2022_23_01-2022S74XWB//PRIN/ ; }, abstract = {Takotsubo syndrome (TTS) is an acute and reversible form of heart failure characterized by transient left ventricular dysfunction, typically triggered by acute stress stimuli. TTS, also referred to as "stress cardiomyopathy", may paradoxically be triggered not only by negative stressors but also by intense positive emotional experiences. Interestingly, TTS was sharply incremented during and following the COVID-19 pandemic. Despite increased clinical recognition, reliable biomarkers for early diagnosis and prognosis remains limited. Oxidative stress is increasingly recognized as a key mechanism in TTS, acting downstream of sympathetic overactivation, thus contributing to myocardial stunning, endothelial dysfunction, and inflammation. In this context, extracellular vesicles (EVs) have emerged as key mediators of intercellular communication and as potential circulating biomarkers, as they reflect the molecular state of their cells of origin. In this review, we summarize the current diagnostic approaches for TTS, including the InterTAK Diagnostic Score, imaging gold standards, and emerging biomarkers such as circulating miRNAs and EV cargo associated with TTS. Furthermore, we critically examine the mechanistic interplay between oxidative stress and EVs in TTS, highlighting translational perspectives and future directions for integrating EV-based biomarkers into personalized clinical management.}, }
@article {pmid41897663, year = {2026}, author = {Alzahrani, AJ}, title = {Molecular Point-of-Care Testing for Respiratory Infections: A Comprehensive Literature Review (2006-2026).}, journal = {Diagnostics (Basel, Switzerland)}, volume = {16}, number = {6}, pages = {}, pmid = {41897663}, issn = {2075-4418}, abstract = {Molecular point-of-care testing (POCT) for respiratory infections has undergone remarkable advancement over the past two decades, driven by technological innovation and urgent clinical needs highlighted by the COVID-19 pandemic. This comprehensive systematic review was conducted following PRISMA 2020 guidelines, synthesizing evidence from 254 peer-reviewed studies published between 2006 and 2026, with detailed analysis of the 30 most relevant papers selected through a rigorous four-stage screening process. The review examines the evolution of molecular POCT technologies, including reverse transcription polymerase chain reaction (RT-PCR), loop-mediated isothermal amplification (LAMP), recombinase polymerase amplification (RPA), and CRISPR-based detection systems. Key findings demonstrate that modern molecular POCT platforms achieve diagnostic performance comparable to laboratory-based testing, with sensitivities ranging from 88% to 100% and specificities from 98% to 100%, while delivering results in 15 to 80 min. These technologies enable rapid, accurate detection of major respiratory pathogens, including SARS-CoV-2, influenza A/B, respiratory syncytial virus (RSV), and atypical bacteria. The integration of microfluidic systems, portable devices, and smartphone-based analysis has expanded access to testing in resource-limited settings, emergency departments, and wearable platforms. This review provides critical insights for clinicians, researchers, and policymakers regarding the current state, clinical applications, and future directions of molecular POCT for respiratory infections.}, }
@article {pmid41898473, year = {2026}, author = {Higuchi, R and McBride, L}, title = {A Memoir of Inventing Real-Time PCR and Developing the ABI 7700.}, journal = {International journal of molecular sciences}, volume = {27}, number = {6}, pages = {}, pmid = {41898473}, issn = {1422-0067}, mesh = {*Real-Time Polymerase Chain Reaction/instrumentation/methods/history ; Humans ; History, 20th Century ; History, 21st Century ; *COVID-19/diagnosis/virology ; SARS-CoV-2/genetics/isolation & purification ; }, abstract = {Real-time PCR (qPCR) is today's definitive quantitative technology in molecular biology and diagnostics. Until 30 years ago, PCR product analyses were generally performed after amplification using gel-based methods. Quantification typically relied on visual inspection or densitometry of end-point products and was therefore relatively unreliable and poorly suited to high-throughput automation. To celebrate real-time PCR's 30-year anniversary of commercial availability, Professor Stephen Bustin, Guest Editor for the special edition, "Advancing Molecular Science Through Reproducible qPCR: MIQE Guidelines and Beyond," asked Russell Higuchi to give a historical account on how his idea of real-time PCR was conceived and brought to fruition. Dr. Higuchi then asked his collaborator, Lincoln McBride, who drove the development of the ABI 7700-the high-throughput real-time PCR instrument that gave researchers access to this technology-to co-author this dual memoir. This story is told from the perspectives of the two scientists most directly responsible for making real-time PCR practical and widely accessible. Taking turns, Russell Higuchi describes the conceptual and experimental steps at Cetus and then Roche that led from homogeneous PCR detection to continuous fluorescence monitoring, whilst Lincoln McBride details ABI's parallel efforts to commercialize Russ's invention. Together, they trace how experimental insight, engineering constraints, product development, and commercial decision-making shaped the Applied Biosystems 7700 Sequence Detection System and established real-time PCR as a practical and reliable quantitative technology. Their team's efforts persevered through technological uncertainty and within a complex corporate collaboration. They share key historical documents in their original form. Their accounts show how the 7700 system emerged as the convergence of chemistry, optics, software, and product development. The eventual global reliance on real-time PCR during the COVID-19 pandemic demonstrated, at unprecedented scale, the profound and enduring impact of these early technical and organizational choices.}, }
@article {pmid41898506, year = {2026}, author = {Oshitari, T}, title = {Pathogenesis of Non-Arteritic Anterior Ischemic Optic Neuropathy Associated with COVID-19.}, journal = {International journal of molecular sciences}, volume = {27}, number = {6}, pages = {}, pmid = {41898506}, issn = {1422-0067}, mesh = {Humans ; *Optic Neuropathy, Ischemic/etiology/pathology/virology ; *COVID-19/complications ; SARS-CoV-2 ; Angiotensin-Converting Enzyme 2/metabolism ; Peptidyl-Dipeptidase A/metabolism ; }, abstract = {Non-arteritic ischemic optic neuropathy (NAION) results from vascular insufficiency within the optic nerve head. The precise pathogenesis of NAION remains unclear; however, insufficient blood supply from the short posterior ciliary arteries and the choroidal circulation has been associated with its development. Although major risk factors include diabetes, hypertension, and hyperlipidemia, coronavirus disease 2019 (COVID-19) may also contribute to the development of NAION. This literature review presents our case of NAION associated with COVID-19 infection and summarizes previously reported cases of NAION following COVID-19 infection published in the English-language literature worldwide. Because direct infection of ocular tissues, including ocular vessels, via the angiotensin-converting enzyme 2 receptor is thought to contribute to the development of NAION, cases of NAION associated with COVID-19 vaccination were excluded from this review. Furthermore, we discuss the possible molecular mechanisms underlying the development of NAION after COVID-19 infection and highlight the potential risks of COVID-19 for clinical ophthalmologists.}, }
@article {pmid41899041, year = {2026}, author = {Alkhalifah, SA and Alshahrani, WA and Alshehri, AM and Al Yami, MS}, title = {Clinical Outcomes with the Use of Dipeptidyl Peptidase-4 (DPP-4) Inhibitor Among Patients with Diabetes Mellitus and COVID-19: A Systematic Review of Observational Studies.}, journal = {Journal of clinical medicine}, volume = {15}, number = {6}, pages = {}, pmid = {41899041}, issn = {2077-0383}, abstract = {Background: Diabetics with coronavirus disease 2019 (COVID-19) manifest more adverse clinical outcomes with elevated rates of death. It has been suggested that the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pathway of entrance into the host cell might be assisted by dipeptidyl peptidase-4 (DPP4), leading to inflammation and cytokine storm, with replication into the airways and unfavorable effects in the lungs. Consequently, the goal of this systematic review is to investigate the most recent data on the effect of DPP-4i (dipeptidyl peptidase-4 inhibitor) medications on clinical outcomes, mainly mortality among COVID-19 patients. Methods: By conducting a systematic search using PubMed and the Cochrane library, observational studies were identified to examine the association between DPP-4i medications and clinical outcomes including mortality, intensive care unit and hospital admissions. The methodologies of included studies were assessed utilizing the Newcastle-Ottawa Scale (NOS). Results: A total of nineteen studies were included with sample sizes varying from over 100 patients to 2.8 million and variant follow-up durations from 30 days up to discharge or death. Most of the population across the studies had COVID-19 for the first time, and the majority were hospitalized. Similarly, mortality definition varied among studies with different time points consisting of 30-day mortality, in-hospital mortality, or all-cause mortality. The majority of the studies identified no effect on mortality by DPP-4i, while a considerable proportion revealed beneficial effects; only four studies showed increased mortality. Conclusions: Real-world data from this review suggested a safe use of DPP-4i among COVID-19 patients; however, randomized clinical trials are required to confirm the beneficial outcomes and safe use.}, }
@article {pmid41899217, year = {2026}, author = {Boccatonda, A and Brighenti, A and Piamonti, D and Bandini, G and Fiorini, G and Vetrugno, L and Marchetti, G and Accogli, E and Serra, C and D'Ardes, D}, title = {The Role of CEUS in the Diagnosis and Follow-Up of Pleuropulmonary Diseases and Interventional Procedures.}, journal = {Journal of clinical medicine}, volume = {15}, number = {6}, pages = {}, pmid = {41899217}, issn = {2077-0383}, abstract = {Background: Contrast-enhanced ultrasound (CEUS) recently emerged as a valuable imaging modality for evaluating pleuropulmonary diseases. By combining morphological information from conventional B-mode ultrasound with real-time assessment of microvascular perfusion, CEUS can provide functional insights that improve diagnostic accuracy, guide interventions, and support patient surveillance. Methods: This review summarizes the current evidence on the use of CEUS in major pleuropulmonary disorders, including pneumonia, pleural effusion, pulmonary embolism, neoplasms, and COVID-19-related lung injury. The most relevant clinical studies and meta-analyses were analyzed, focusing on CEUS parameters, diagnostic performance, and integration with other imaging techniques. Results: CEUS enables the differentiation between inflammatory, ischemic, and malignant lesions through qualitative and quantitative analyses of enhancement patterns. Early and homogeneous enhancement is typical of inflammatory or infectious processes, whereas heterogeneous or delayed enhancement with early washout strongly suggests malignancy or ischemia. In pneumonia and pleural infections, CEUS identifies non-perfused or necrotic areas, guiding drainage and evaluating therapeutic responses. In pulmonary embolism, it reveals avascular consolidations corresponding to infarction, even when CT angiography is inconclusive. For peripheral lung tumors, CEUS assesses angiogenesis and vascular supply, correlating perfusion parameters with histopathology, and improving biopsy targeting. Furthermore, in COVID-19 pneumonia, CEUS can detect microvascular alterations related to thrombosis and fibrosis. Conclusions: CEUS is a safe, noninvasive, and radiation-free technique that provides unique real-time information on pulmonary perfusion. Its integration with conventional ultrasound enhances diagnostic precision, optimizes interventional guidance, and allows for dynamic monitoring of treatment response. Future developments in quantitative analysis, artificial intelligence, and targeted contrast agents are expected to further expand CEUS clinical applications in pleuropulmonary imaging.}, }
@article {pmid41899685, year = {2026}, author = {Motebang, ME and Ramphalla, P and Tsoka-Gwegweni, J}, title = {Scoping Review of the Models for Case-Based Health Programs in Africa: Towards Case-Based Surveillance for HIV in Lesotho.}, journal = {International journal of environmental research and public health}, volume = {23}, number = {3}, pages = {}, pmid = {41899685}, issn = {1660-4601}, mesh = {Lesotho/epidemiology ; Humans ; *HIV Infections/epidemiology ; *Population Surveillance/methods ; Public Health Infrastructure ; }, abstract = {The review aims at exploring models for case-base health programs across Africa that could best help Lesotho succeed in its efforts to establish a case-based surveillance (CBS) system for their HIV program. The review involves looking through several sources and databases including EBSCOHOST, Google Scholar, Science Direct and PubMed. The insights of suitable models were from the following Africa countries: South Africa, Kenya, Guinea, Tanzania, Ghana, Mozambique and Zambia. The study articles were published within the last 10 years, specifically from 2014 to 2024. This range was used as part of their inclusion criteria to ensure relevance of the articles. The studied models focused on infectious diseases such as measles, HIVand COVID-19. The key takeaway is that setting up electronic medical records systems (EMRs) is critical as a first step for any effective CBS. Using unique identifiers, establishing clear data governance policies and building strong infrastructure is a necessity in making CBS work. For a successful establishment of CBS, Lesotho should adopt these strategies that can be sustainable, improve disease tracking, response and ultimately health outcomes for Basotho.}, }
@article {pmid41900073, year = {2026}, author = {Topolewska, A and Zahorska, A and Łakocka, A and Kumirska, J}, title = {Z-Drugs in the Environment: A Review.}, journal = {Molecules (Basel, Switzerland)}, volume = {31}, number = {6}, pages = {}, pmid = {41900073}, issn = {1420-3049}, support = {DS-531-T130-D507-25//UNIVERSITY OF GDANSK/ ; }, mesh = {Humans ; Piperazines/analysis ; *Hypnotics and Sedatives/analysis ; Zolpidem/analysis ; Azabicyclo Compounds/analysis ; COVID-19 ; *Water Pollutants, Chemical/analysis ; Acetamides ; Pyrimidines ; }, abstract = {According to the World Health Organization (WHO), substance dependence and mental health disorders, such as anxiety, depression, post-traumatic stress disorder (PTSD), insomnia, bipolar disorder, and schizophrenia, affect >360 million people worldwide. As a result the increasing use of psychoactive pharmaceuticals, including non-benzodiazepines (also referred to as Z-drugs), has been observed. The COVID-19 pandemic has also had an additional significant negative effect on people's mental health. Among the aforementioned mental health disorders, chronic insomnia is reported to affect approximately 10% of the adult population. Z-drugs are frequently used in the treatment of insomnia due to their rapid onset of action. They are metabolized in the human organism, but noticeable amounts of the original compound are released to the environment via household wastewater. The extensive use of these pharmaceuticals has led to growing concern about the occurrence of their residues in the environment. Unfortunately, the information on the analytical methods for determining Z-drugs, their main metabolites and transformation products in the environment, efficiency of their removal in wastewater treatment plants, their fate, their presence in environmental matrices, and their ecotoxicological effects is limited. This review paper focuses on summarizing data on these topics. To the best of our knowledge, such a comprehensive review has not yet been published.}, }
@article {pmid41900169, year = {2026}, author = {Feng, Y and La, M}, title = {Overview in Machine-Learning-Assisted Sensing Techniques for Monitoring COVID-19.}, journal = {Micromachines}, volume = {17}, number = {3}, pages = {}, pmid = {41900169}, issn = {2072-666X}, support = {252102240012//Science and Technology Development Program of Henan Province/ ; }, abstract = {Viruses suddenly emerging from obscurity or anonymity affect our quality of life and increase incidence rate and mortality. A typical example is the global coronavirus disease 2019 (COVID-19) pandemic. Although severe acute respiratory syndrome coronavirus 2, known as the pathogen of COVID-19 has been significantly eliminated, its monitoring is still crucial, as the infectious disease may break out again. Therefore, it is necessary to develop simple and effective tools for monitoring COVID-19 and other diseases. Here, we summarize the progress of machine-learning-based biosensors in the monitoring and management of COVID-19. This article mainly includes three sections: machine learning algorithms, machine-learning-assisted biosensors, and challenges and future perspectives. We believe that this work is valuable for developing artificial-intelligence-based innovative analytical devices for healthcare monitoring and management of COVID-19 and other infectious diseases.}, }
@article {pmid41900303, year = {2026}, author = {Hommos, L and Gohil, H and Rob, M and Manyama, J and Ramy, H and Naseem, N and Nishan, H and Ibrahim, RS and Ibrahim, SS and Njoku, VCE and Al-Mutawa, I and Khan, AF and Holroyd, S and Zakaria, D}, title = {Long-Term Thyroid Complications Post-COVID-19: A Systematic Review.}, journal = {Microorganisms}, volume = {14}, number = {3}, pages = {}, pmid = {41900303}, issn = {2076-2607}, abstract = {Coronavirus disease 2019 (COVID-19) is increasingly shown to be a multisystem disorder with long-term complications, including endocrine system complications. The thyroid gland is also susceptible, as it contains ACE2 receptors, making it exposed to both direct viral damage and autoimmune-mediated dysfunction. Recent reports document the various thyroid complications that persist well after the acute infection phase. This systematic review investigates the long-term thyroid complications in individuals with a history of SARS-CoV-2 infection. A comprehensive literature search across several databases was conducted. Eligible studies reported new onset long-term thyroid complications occurring post-COVID-19 infection. Abstract and full-text screening as well as data extraction and quality assessment was performed by two independent reviewers. Only 28 studies met our inclusion criteria, reporting 419 patients from 18 countries. These studies included case reports, case series, cohort, and cross-sectional studies. Reported thyroid disorders included subacute thyroiditis, thyrotoxicosis, hyperthyroidism (including Graves' disease), isolated high T3/T4, hypothyroidism, central hypothyroidism, and non-thyroidal illness syndrome (NTIS). While many of these eventually resolved, a significant portion persisted or recurred, especially autoimmune thyroiditis. COVID-19 is associated with a range of long-term thyroid complications. Although some cases are temporary, others last, especially autoimmune thyroid disorders. Proposed mechanisms include direct viral cytotoxicity, cytokine-mediated Hypothalamic-Pituitary-Thyroid (HPT) axis suppression, post-viral autoimmunity, vascular injury, and neuroendocrine disruption. Routine thyroid function monitoring in COVID-19 survivors, particularly those with severe disease or persistent symptoms is recommended, and larger prospective studies are needed to better understand incidence and outcomes.}, }
@article {pmid41901738, year = {2026}, author = {Arthur, SE and Eyeson, J and Kubi, AA and Amartey, FA and Matey, R and Aboagye, JO and Kyei, GB}, title = {Acute Respiratory Infections in Ghanaian Children: Epidemiology, Antimicrobial Resistance, and Prevention Strategies.}, journal = {Pathogens (Basel, Switzerland)}, volume = {15}, number = {3}, pages = {}, pmid = {41901738}, issn = {2076-0817}, mesh = {Humans ; Ghana/epidemiology ; *Respiratory Tract Infections/epidemiology/prevention & control/microbiology/virology/drug therapy ; Child ; COVID-19/epidemiology/prevention & control ; SARS-CoV-2 ; Drug Resistance, Bacterial ; Acute Disease ; }, abstract = {Acute respiratory infections (ARIs) remain a common cause of morbidity and mortality in children, especially in sub-Saharan Africa, where countries such as Ghana are severely affected. This review presents recent data on ARI etiology, clinical burden, and antimicrobial resistance (AMR) from Ghana, spanning the pre-COVID-19 era (2010-2019) to the post-pandemic period (2020-2025). Before the COVID-19 pandemic, viral infections, such as respiratory syncytial virus (RSV), rhinoviruses, and influenza viruses, were the major contributors, along with established bacterial pathogens such as Streptococcus pneumoniae and Haemophilus influenzae. Social determinants, including undernutrition and indoor air pollution, also influenced these infections. In the COVID era, we have seen dramatic shifts in pathogen seasonality, the scaling of oxygen delivery systems, and the implementation of genomic surveillance for SARS-CoV-2, as well as new features such as maternal RSV vaccination and monoclonal antibody therapy. Despite its successes in vaccination coverage and health system strengthening, some challenges remain, including fluctuations in implementation and surveillance issues. The simultaneous challenges of pneumonia and hygiene will require integrated, coordinated, multisectoral responses that incorporate surveillance with antibiotic stewardship, sustainable oxygen systems, and interventions for nutrition and environmental health. The review also highlights research priorities and makes policy recommendations well aligned to support national ARI control efforts aimed at reducing child mortality due to ARI and achieving Sustainable Development Goals targets on child health.}, }
@article {pmid41902184, year = {2026}, author = {Hetényi, R and Hanna, D and Kopasz, Z and Szentpéteri, JL and Szabó, P and Somogyi, BA and Bányai, K and Szabó-Meleg, E}, title = {Wavelength-Specific UV-C Inactivation of Viruses in Liquids: Dose-Response, Mechanistic Insights, and Structural Integrity-A Systematic Review and Meta-Analysis.}, journal = {Viruses}, volume = {18}, number = {3}, pages = {}, pmid = {41902184}, issn = {1999-4915}, support = {TKP2021-NVA-07//National Research, Development, and Innovation Office of Hungary/ ; 2024-2.1.1-EKÖP//Ministry of Culture and Innovation, National Fund for Research, Development and Innovation/ ; }, mesh = {*Ultraviolet Rays ; *Virus Inactivation/radiation effects ; Dose-Response Relationship, Radiation ; SARS-CoV-2/radiation effects ; *Viruses/radiation effects ; Humans ; Disinfection/methods ; }, abstract = {This study evaluates fragmented data on ultraviolet-C (UV-C, 100-280 nm) irradiation for viral inactivation in liquid media, supporting advances such as whole-pathogen vaccine development and downstream research. Included studies reported viral strain identification, baseline titers (PFU or TCID50), UV-C wavelength, dosage, and log reductions, excluding studies employing alternative treatments. We searched (PubMed, Ovid Medline, Scopus, Embase, Web of Science; 10 April 2024) and identified 2813 records, of which 33 met the inclusion criteria. Risk of bias was assessed using ROBINS-I V2 to evaluate methodological rigor and inform improved reporting. Narrative synthesis summarized findings across viruses, while meta-analysis focused on 16 SARS-CoV-2 studies with standardized reporting. Meta-regression revealed a strong dose-response relationship (log_dose β = 3.38, 95% CI [2.95, 3.82], p < 0.001) with low heterogeneity (I[2] = 15.1%). Strain and wavelength-specific efficacy peaked at 267 nm (β = 6.42) and 275 nm (β = 3.78), while 253.7 nm offered structural preservation for downstream applications. Limitations included inconsistent dose reporting, matrix effects, and assay sensitivity. We propose a refined reporting framework and standard definitions for 'inactivation', ''disinfection,' and 'complete inactivation.' Our findings support reproducible UV-C evaluation, regulatory alignment, and safe implementation in pathogen control, biosafety, and clinical applications.}, }
@article {pmid41903098, year = {2026}, author = {Alwashmi, ASS and Khan, NU and Unar, A}, title = {Decoding Microbiota-Immune Interplay in Viral Pathogenesis: Toward Next-Generation Antiviral Therapies.}, journal = {Probiotics and antimicrobial proteins}, volume = {}, number = {}, pages = {}, pmid = {41903098}, issn = {1867-1314}, abstract = {Emerging viral threats, including COVID-19, influenza, and hepatitis B, underscore the urgent need for innovative antiviral strategies. Traditional antiviral drugs and vaccines are often limited by viral mutations, drug resistance, and inter-individual variability. The human microbiota has emerged as an active regulator of viral pathogenesis, influencing host susceptibility, immune responses, and therapeutic outcomes. This review comprehensively explores microbiota–virus interactions, including direct viral modulation by commensal bacteria and bacteriophages, metabolic reprogramming of host cells, and immunomodulation by microbial metabolites such as short-chain fatty acids (SCFAs) through the GPR43–NLRP3–MAVS axis. The gut–lung–immune axis and systemic consequences of virus-induced dysbiosis, including “leaky gut” and amplified cytokine responses (TNF-α, IL-6), are highlighted. Translational applications discussed include probiotics, prebiotics, postbiotics, fecal microbiota transplantation (FMT), and next-generation engineered microbial consortia. Evidence from clinical FMT trials in chronic hepatitis B, liver cirrhosis, and COVID-19 recovery, along with FDA-approved oral microbiota therapies, suggests therapeutic promise. The integration of AI-guided multi-omics approaches enables patient stratification and personalized interventions while addressing safety, strain specificity, and regulatory challenges. This review integrates mechanistic insights and clinical evidence to guide the development of next-generation microbiota-based precision antiviral therapies with improved efficacy and durability.}, }
@article {pmid41904986, year = {2026}, author = {Voget, R and Gütschow, M}, title = {Early Kinetic Characterization of SARS-CoV-2 Main Protease Inhibitors: A Review and Guidance for Biochemical Assessments.}, journal = {Biochemistry}, volume = {65}, number = {7}, pages = {860-881}, doi = {10.1021/acs.biochem.5c00794}, pmid = {41904986}, issn = {1520-4995}, mesh = {Kinetics ; Humans ; *SARS-CoV-2/enzymology/drug effects ; *Coronavirus 3C Proteases/antagonists & inhibitors/metabolism/chemistry ; *Protease Inhibitors/pharmacology/chemistry ; High-Throughput Screening Assays/methods ; COVID-19 Drug Treatment ; Substrate Specificity ; }, abstract = {Optical, microplate reader-based assays are a standard tool for the initial biochemical analysis of SARS-CoV-2 main protease (M[pro]) inhibitor candidates. Such assays monitor M[pro]-catalyzed substrate proteolysis in order to investigate the kinetic impact of inhibitors under examination on the catalytic reaction. This review outlines the numerous intricate considerations involved in establishing suitable assay protocols. Commonly employed M[pro] substrates that exploit different mechanisms for the optical detection of the cleavage reaction are introduced and compared with respect to their suitability for specific assay applications. The contribution of native or tagged forms of M[pro] and of the assay medium to representative kinetic data is debated. Protocols for high-throughput screening, IC50 investigation, elucidation of binding mode and modality, as well as for the determination of the kinetic parameters, Ki, αKi, kon, koff, and kinac/KI, are discussed with continuous reference to the underlying kinetic models. This review provides guidelines for the design and establishment of robust assays for precisely characterizing the kinetics of M[pro] inhibitor candidates. Typical confounders and false conclusions are demonstrated, along with strategies to circumvent these pitfalls.}, }
@article {pmid41905269, year = {2026}, author = {Liu, J and Jawahar, B and Wang, Y and O'Neill, B and Batson-Wright, Y}, title = {Understanding digital clinical communication in healthcare: A qualitative synthesis.}, journal = {Patient education and counseling}, volume = {149}, number = {}, pages = {109606}, doi = {10.1016/j.pec.2026.109606}, pmid = {41905269}, issn = {1873-5134}, mesh = {Humans ; Clinical Competence ; *Communication ; *Digital Health ; *Physician-Patient Relations ; Qualitative Research ; }, abstract = {BACKGROUND: The use of digital tools for two-way, real-time clinician-patient interactions has significantly increased, especially since the outbreak of the COVID-19 pandemic.
OBJECTIVES: This qualitative synthesis examines existing qualitative and mixed-method studies with qualitative components to capture the experiences of clinicians and patients using digital tools for real-time communication post-pandemic.
METHODS: A thematic synthesis approach was applied, reviewing 97 studies sourced from six databases. The synthesis identified three descriptive themes and two analytical themes.
RESULTS: Three primary descriptive themes included: improvising information gathering, managing emotional complexity, and enhancing understanding to facilitate care planning. Additionally, two analytical themes emphasised the need for training and teamwork in digital clinical communication.
CONCLUSION: The findings underscore the importance of 'webside manner' as a key clinical competence and highlight the value of collaborative decision-making between clinicians and patients.
PRACTICE IMPLICATIONS: This synthesis led to the development of the ICE-T Digital Clinical Communication Model, offering conceptual and educational guidance for clinicians and healthcare students engaging in real-time digital communication. The study addresses an educational gap, emphasising the need to train both clinicians and patients to navigate the digital divide and ensure high-quality care in digital interactions.}, }
@article {pmid41905519, year = {2026}, author = {Oudhini, A and Elghali, M and Zanina, Y and Changuel, M and Sakly, N}, title = {Autoimmunity following SARS-CoV-2 infection and vaccination: Systematic review and meta-analysis.}, journal = {Clinical immunology (Orlando, Fla.)}, volume = {285}, number = {}, pages = {110702}, doi = {10.1016/j.clim.2026.110702}, pmid = {41905519}, issn = {1521-7035}, mesh = {Humans ; *COVID-19/immunology/prevention & control ; *Autoimmunity/immunology ; *SARS-CoV-2/immunology ; *Autoimmune Diseases/immunology/etiology ; *Vaccination/adverse effects ; *COVID-19 Vaccines/immunology/adverse effects ; Diabetes Mellitus, Type 1/immunology ; }, abstract = {AIM: To systematically review and meta-analyze the available evidence on the association between SARS-CoV-2 infection, COVID-19 vaccination, and the development of new autoimmune conditions (AIC).
METHODS: This study followed the PRISMA guidelines. MEDLINE, Scopus, Cochrane Library, and Google Scholar were searched until December 31, 2024, for studies reporting new-onset autoimmunity after SARS-CoV-2 infection or vaccination. Meta-analyses using random-effects models calculated pooled odds ratios using RStudio 4.3.
RESULTS: Of the 2544 records identified, 39 studies were included in the systematic review, and 17 studies were included in the meta-analysis. A significant association was found between SARS-CoV-2 infection and new AIC (p = 0.0054) and particularly type 1 diabetes (p = 0.0229), blistering diseases (p = 0.0452), systemic sclerosis (p = 0.0153), and vitiligo (p = 0.0122). Regarding SARS-CoV-2 vaccine-induced autoimmunity, no association between COVID-19 vaccines and new AIC was observed.
CONCLUSION: This study provides evidence that SARS-CoV-2 infection may strongly induce autoimmunity.}, }
@article {pmid41906154, year = {2026}, author = {Granton, D and Hajjaj, OI and Ishaq, L and Ahimsadasan, R and Paleczny, SG and Ahimsadasan, N and Ying, E and Jabri, G and Mansuri, A and Warfield, N and Pettenuzzo, T and Honarmand, K and Gandhi, P and Englesakis, M and Fan, E}, title = {Complications in acute respiratory distress syndrome: a systematic review and meta-analysis.}, journal = {Critical care (London, England)}, volume = {30}, number = {1}, pages = {}, pmid = {41906154}, issn = {1466-609X}, mesh = {Humans ; *Respiratory Distress Syndrome/complications/therapy ; *Respiration, Artificial/adverse effects ; }, abstract = {BACKGROUND: Acute respiratory distress syndrome (ARDS) carries substantial morbidity and mortality. Supportive care with invasive mechanical ventilation (IMV) remains a cornerstone of management. The breadth and prevalence of complications experienced by patients with ARDS undergoing IMV is unclear. METHODS: We performed a systematic review and meta-analysis to quantify complications reported by studies featuring patients with ARDS undergoing IMV. We searched MEDLINE, MEDLINE In-Process/ePubs, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and ClinicalTrials.gov from database inception until November 28, 2025. We included randomized controlled trials (RCTs) and cohort studies featuring adults with ARDS undergoing IMV that reported at least one complication. We excluded studies of COVID-19, studies with 25% or more patients on extracorporeal life support, and studies with under 200 participants. We extracted data on any reported clinical complication, based on author definitions. For complications reported by three or more studies we performed a random effects meta-analysis of logit-transformed complication proportions using inverse-variance weighting. RESULTS: Of 25,421 citations, we reviewed 2620 full texts and included 53 studies (25 RCTs and 28 cohort studies). Complications were variably and infrequently reported. Only barotrauma, ventilator associated pneumonia (VAP), hypotension, arrhythmia, stroke, myopathy and cardiac arrest were reported by three or more RCTs. In cohort studies, barotrauma, VAP, acute renal failure, sepsis and bacteremia were reported by three or more studies. All estimates featured considerable heterogeneity. CONCLUSIONS: In this systematic review of studies including patients with ARDS receiving IMV, reporting of complications was variable and infrequent. Our synthesis was descriptive and did not investigate causality. Future studies should establish consensus on the spectrum of complications to improve reporting and help evaluate the risks and benefits of novel therapies. We propose a process to develop a core outcome set for complications experienced by patients with ARDS undergoing IMV. Preliminary results of this work were presented at the ESICM LIVES conference in October 2021}, }
@article {pmid41906362, year = {2026}, author = {Jin, F and Tao, X and Wu, H and Wu, L and Wang, Y}, title = {Invasive Necrotizing Tracheobronchial Aspergillosis in Children: A Case Series and Literature Review.}, journal = {The American journal of case reports}, volume = {27}, number = {}, pages = {e950588}, pmid = {41906362}, issn = {1941-5923}, mesh = {Humans ; Female ; Child ; Male ; Bronchoscopy ; Child, Preschool ; *Invasive Pulmonary Aspergillosis/diagnosis ; Necrosis ; Aspergillus flavus/isolation & purification ; Tomography, X-Ray Computed ; Bronchoalveolar Lavage Fluid/microbiology ; }, abstract = {BACKGROUND Invasive tracheobronchial aspergillosis is rare in children. Here, we describe 3 cases in which mucosal necrosis and erosion were observed on bronchoscopy, with pseudomembrane-like attachments on the mucosal surface. CASE REPORT Case 1: An 8-year-old girl with leukemia was admitted because of recurrent fever, persistent cough (>1 month), and 1 day of hemoptysis. Chest computed tomography (CT) revealed progression of patchy opacities and consolidation in the right upper and middle lobes compared with prior imaging. Next-generation sequencing (NGS) of bronchoalveolar lavage fluid (BALF) detected Aspergillus flavus. Case 2: An 8-year-old girl with fever for 4 days and cough for 2 days was admitted. After admission, recurrent fever occurred; hemophagocytic syndrome and coronavirus disease 2019 (COVID-19)-related multisystem inflammatory syndrome were diagnosed. Sputum culture results were positive for A. fumigatus. Chest CT demonstrated atelectasis of the right upper lobe and left lower lobe. NGS of BALF also detected A. fumigatus. Case 3: A 4-year-old boy was admitted for mesenchymal stem cell infusion. He had undergone bone marrow transplantation 6 months prior to admission. Occasional cough and fever were reported. Chest CT indicated infectious lesions in both lungs. NGS detected A. fumigatus. Bronchoscopy in all 3 children revealed necrotizing tracheobronchitis. All patients were successfully treated and discharged in stable condition. CONCLUSIONS This report describes 3 cases of invasive pulmonary aspergillosis with invasive necrotizing tracheobronchial aspergillosis, highlighting diagnostic and management challenges, as well as a potential role for bronchoscopy in treatment of this disease.}, }
@article {pmid41906527, year = {2026}, author = {Pan, WKM and Castillo, EC}, title = {Evaluation of the Healthy and Productive Aging Program in a Primary Care Facility Among Older Population in Pinamalayan, Oriental Mindoro.}, journal = {Public health nursing (Boston, Mass.)}, volume = {43}, number = {4}, pages = {990-997}, doi = {10.1111/phn.70119}, pmid = {41906527}, issn = {1525-1446}, mesh = {Humans ; *Health Literacy/statistics & numerical data ; *Primary Health Care ; Aged ; Philippines/epidemiology ; Female ; Male ; *COVID-19/epidemiology ; Program Evaluation ; *Healthy Aging ; Aged, 80 and over ; }, abstract = {INTRODUCTION: Health literacy is a critical factor for the well-being and self-management of the elderly. As the population ages, programs that enhance health literacy among the elderly are vital. This study evaluated the impact of the healthy and productive aging program on health literacy among Filipino elderly in a primary care setting.
METHOD: A quasi-experimental design involving 324 senior citizens were nonrandomly assigned to the intervention group or control group. Researchers measured health literacy across nine domains using descriptive statistics, independent t-tests and one-way ANOVA to analyze changes before, during, and after the COVID-19 pandemic.
RESULTS: The intervention group showed significant improvements in feeling understood and supported by healthcare providers (p = 0.022), having sufficient health information (p = 0.040), actively managing health (p = 0.001), social support (p = 0.001), navigating the healthcare system (p = 0.001), and finding reliable health information (p < 0.045). One-way ANOVA confirmed significant differences in perceived health literacy levels across the three periods among the intervention group (F = 31. 859, p = 0.001).
CONCLUSIONS: The program significantly impacted multiple health literacy domains. Results highlight the need for adaptable and responsive interventions with regular monitoring to improve the well-being of senior citizens and address specific literacy needs continuously.}, }
@article {pmid41906767, year = {2026}, author = {Luna-Tenorio, E and Torres-Mendoza, J and Franco-Colin, M and Alvarez-González, I and de la Cruz-Lopez, F and Garcés-Ramírez, L and Luna-Muñoz, J}, title = {COVID-19 and neurodegeneration: Perspectives on the impact of viruses on the brain.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {111}, number = {3}, pages = {935-943}, doi = {10.1177/13872877261434258}, pmid = {41906767}, issn = {1875-8908}, mesh = {Humans ; *Neurodegenerative Diseases/virology ; *COVID-19/complications ; *Brain/virology/pathology ; SARS-CoV-2 ; Pandemics ; *Coronavirus Infections/complications ; *Pneumonia, Viral/complications ; }, abstract = {The COVID-19 pandemic has highlighted the ability of SARS-CoV-2 to affect various systems in the human body, including the central nervous system (CNS). A number of neurological manifestations have been documented in patients with COVID-19, ranging from acute symptoms to long-term sequelae such as 'mental fog' and encephalitis. Persistent cognitive symptoms such as memory and attention deficits have been reported after COVID-19, based on clinical and epidemiological evidence. COVID-19-associated encephalitis has also been described in case reports. In addition, it has been proposed that SARS-CoV-2 infection may contribute to neurodegeneration through mechanisms such as chronic inflammation, disruption of the blood-brain barrier, and alterations in tau protein and amyloid-β. This article reviews the interrelation between viral infections and neurodegenerative diseases, emphasizing the impact of SARS-CoV-2 on the CNS and its possible involvement in the development of neurodegenerative pathologies. Although this evidence is preliminary, it highlights the need for long-term neurological follow-up in patients who have overcome COVID-19, especially those who presented neurological symptoms during the acute phase of the disease.}, }
@article {pmid41906773, year = {2026}, author = {Andersson, G and Carlbring, P}, title = {Preferences, tailoring, and self-tailoring in internet-delivered treatments: lessons learned.}, journal = {Expert review of neurotherapeutics}, volume = {26}, number = {5}, pages = {477-483}, doi = {10.1080/14737175.2026.2652294}, pmid = {41906773}, issn = {1744-8360}, mesh = {Humans ; *Cognitive Behavioral Therapy/methods ; *Internet ; *Patient Preference ; *Internet-Based Intervention ; }, abstract = {INTRODUCTION: Internet-delivered psychological treatments have been developed and tested in many trials and are also implemented.
AREAS COVERED: The authors focus on treatment preferences when clients are allowed to choose treatment orientation and how the treatment is set up. The literature was searched using Medline, Google Scholar and Scopus in November 2025, locating eight preference studies. They showed benefits in treatment satisfaction when preferences are included and possibly improved outcomes. The second focus was on tailored internet-delivered cognitive behavior therapy (ICBT). The authors review six recent controlled studies published from 2000 onwards on various subjects including COVID-19, domestic violence, chronic pain, climate distress, depression in older adults in Lithuania, and young adults with anxiety and depression in Brazil. These examples are in line with previous findings showing that tailored ICBT is effective, despite there being no clear benefits over diagnosis-specific or transdiagnostic ICBT. Finally, the authors reviewed published findings from two trials demonstrating that self-tailoring can work without clinician input.
EXPERT OPINION: There are robust findings showing that tailored internet interventions are effective, with further indication that preferences and self-tailoring may work too. Future research will likely incorporate artificial intelligence tools to a greater extent to improve treatment efficacy.}, }
@article {pmid41907803, year = {2026}, author = {Venkatesan, T and Demetriou, AM and Hempel, A and Bowling, DL}, title = {A scoping review of music-based digital therapeutics for stress, anxiety, and depression.}, journal = {Frontiers in human neuroscience}, volume = {20}, number = {}, pages = {1602004}, pmid = {41907803}, issn = {1662-5161}, abstract = {Rising rates of stress, anxiety, and depression-fueled by rapid sociocultural and economic shifts, digital overexposure, and the lasting impact of COVID-19-are accelerating investment in scalable tools aimed at enhancing resilience and wellbeing. Music-based digital therapeutics (MDTs) hold promise given music's unique ability to modulate core dimensions of health-affect, anxiety, and reward, as well as autonomic and social functioning-through a medium that is universal, intuitive, and increasingly accessible. To assess the current state of MDTs targeting stress, anxiety, and depression in adults, we conducted a scoping review using a modified Population, Intervention, Comparison, Outcome (PICO) keyword framework to structure Google search results. Twenty-two commercially available MDTs were identified for inclusion. We organize these MDTs into five principal categories based on underlying treatment strategies: (1) Preference-based music selection; (2) Affective Parameterization; (3) Affect Matching and Compensation; (4) Neural Entrainment; and (5) Biofeedback. We review general evidence supporting each strategy from music neuroscience and therapy research, as well as limited applied research testing specific MDTs. We conclude that, while general evidence supporting musical-based interventions for stress, anxiety, and depression is substantial, evidence for MDTs specifically is presently too limited to draw conclusions about real world effectiveness. Determining whether MDTs are likely to fulfill their potential will require increased focus on rigorous laboratory studies testing specific treatment strategies and randomized double-blind placebo-controlled trials conducted in ecologically valid settings. To support progress in this field, we make recommendations to support the sustainable development of MDTs as evidence-based tools to support mental health and wellbeing.}, }
@article {pmid41908878, year = {2026}, author = {Czylok, MA and Prokopiuk, M and Meller, K and Nazar, G and Kamieniecka, H and Jankowski, W and Zawadzka, M and Mazurkiewicz-Bełdzińska, M}, title = {Screen exposure and circadian disruption in paediatric epilepsy: risks and technology-based approaches - a literature review.}, journal = {Postepy psychiatrii neurologii}, volume = {35}, number = {1}, pages = {65-78}, pmid = {41908878}, issn = {2720-5371}, abstract = {PURPOSE: The increased use of digital devices, particularly following the coronavirus disease 2019 (COVID-19) pandemic, has raised concerns about their impact on sleep and seizure control in children with epilepsy. Blue light exposure from screens disrupts circadian rhythms by suppressing melatonin production, which can worsen sleep disturbances and potentially increase seizure frequency. This review aims to examine the relationships among technology use, sleep disturbances, and seizure control in paediatric patients with epilepsy.
VIEWS: We conducted a literature review of peer-reviewed studies from databases such as PubMed. The search terms included "blue-light exposure," "screen time," "sleep disturbances," and "epilepsy in children." Studies addressing the effects of blue light, screen time, and digital devices on sleep and seizure control in children with epilepsy were included. Data on sleep quality, seizure frequency, melatonin levels, and the use of mobile applications for sleep and seizure monitoring were analysed. Prolonged screen time was consistently linked to delayed sleep onset, reduced sleep duration, and poorer sleep quality, which may worsen seizure frequency. Children with epilepsy, especially those with photosensitivity, appear particularly susceptible to blue light's adverse effects. Some studies noted reduced melatonin and increased seizure activity following blue light exposure. The review also found growing interest in mobile apps and wearable devices for tracking sleep and seizures, though many tools lack validation.
CONCLUSIONS: Excessive screen time and exposure to blue light negatively affect sleep and seizure control in children with epilepsy. Digital tools offer promise for the nonpharmacological management of epilepsy but require further research to confirm their clinical value.}, }
@article {pmid41909201, year = {2026}, author = {Agouridis, AP and Hadjivasilis, A and Vougiouklakis, G and Ioannou, T and Charitonos, S and Christoforou, M and Ionas, E and Giannakakis, D and Spernovasilis, N}, title = {Inflammatory Bowel Disease Incidence following COVID-19: A Systematic Review and Meta-Analysis.}, journal = {GE Portuguese journal of gastroenterology}, volume = {33}, number = {1}, pages = {387-395}, pmid = {41909201}, issn = {2341-4545}, abstract = {BACKGROUND: A surge of cases of autoimmune and inflammatory diseases, such as inflammatory bowel disease (IBD), have been reported after coronavirus disease 2019 (COVID-19).
OBJECTIVE: The objective of this study was to assess whether COVID-19 has a role in IBD risk.
METHODS: We searched MEDLINE (PubMed), Cochrane Library and OpenGrey databases up to October 30, 2025, for studies evaluating the incidence of IBD following COVID-19 infection (PROSPERO ID: CRD42024534916).
RESULTS: After a full-text review of 84 manuscripts, a total of 8 studies were used in the qualitative analysis. The studies were conducted between 2023 and 2024 and included in total 28,659,801 people, 8,560,826 of which were previously infected with COVID-19 and 20,098,975 that served as healthy controls. The results from the pooled synthesis of 6 studies indicate a 39% higher incidence of IBD in people that were previously infected with COVID-19 (risk ratio [RR] 1.39, 95% CI: [1.12-1.74], p = 0.003, I [2] = 97%). Furthermore, from the pooled analysis of 4 eligible studies, a higher incidence of new ulcerative colitis cases following COVID-19 was observed (RR 1.25, 95% CI: [1.17-1.33], p < 0.00001, I [2] = 0%). On the contrary, no difference was observed in Crohn's disease incidence between COVID-19 and non-COVID-19 patients (RR 1.23 95% CI: [0.88, 1.72], p = 0.22, I [2] = 91%).
CONCLUSIONS: The findings of the present meta-analysis suggest an increased risk of IBD after COVID-19 infection. Although this is more evident regarding ulcerative colitis, we believe that the available outcomes arising from future studies will clarify the real incidence of Crohn's disease following COVID-19 infection.}, }
@article {pmid41909248, year = {2026}, author = {He, F and Xu, J and Yu, T and Zhu, X and Wang, X and Yang, J and Xia, Y and Wu, F and Su, S}, title = {Traditional Chinese medicine in influenza treatment: a bibliometric analysis integrating multiple databases.}, journal = {Frontiers in microbiology}, volume = {17}, number = {}, pages = {1761339}, pmid = {41909248}, issn = {1664-302X}, abstract = {BACKGROUND: Influenza, a highly contagious respiratory disease, is especially severe for the elderly, children, and immunocompromised individuals. Traditional Chinese medicine (TCM), with its antiviral, immune-modulating, and symptom-relieving properties, has gained attention as a potential treatment. This study uses bibliometric analysis to assess the research trends, hotspots, and progress of TCM in treating influenza.
METHODS: Literature from the Web of Science Core Collection (WOSCC), Scopus, and PubMed was analyzed using CiteSpace, VOSviewer, and Bibliometrix to explore author collaboration, research trends, clinical trials, and key advancements in TCM for influenza.
RESULT: Research on TCM for influenza has steadily increased since 2000, with a marked surge post-2019 following the COVID-19 pandemic. China leads the field, contributing nearly two-thirds of the publications. Research focuses on TCM interventions, antiviral mechanisms, and immune modulation, with emerging hotspots in network pharmacology and molecular mechanisms.
CONCLUSION: The study shows a steady annual growth rate of 16.94%, reflecting global interest in TCM for respiratory viral infections. Despite China's leadership, international collaboration remains limited (10.23%). Research has shifted from empirical formulations to modern scientific methods, but further large-scale trials are needed to confirm TCM's efficacy.}, }
@article {pmid41909619, year = {2026}, author = {Díez-Martínez, A and Strobl, K and Cámara-Ballesteros, A and Delgado-Buscalioni, R and de Pablo, PJ}, title = {Using atomic force microscopy for physical virology: touching and manipulating single virus particles.}, journal = {Biophysical reviews}, volume = {18}, number = {1}, pages = {95-108}, pmid = {41909619}, issn = {1867-2450}, abstract = {Atomic force microscopy (AFM) employs a nanometer-scale tip mounted on a microcantilever to scan surfaces where virus particles have been captured. Beyond generating high-resolution images of individual virions in liquid, AFM offers unique capabilities: manipulation of single particles, investigation of their biomechanical properties, and real-time observation of assembly and disassembly processes, including genome release. This chapter begins by outlining fundamental aspects of virus adsorption and imaging, highlighting, among other factors, the influence of tip-convolution artifacts. These principles are applied to reveal the adsorption behavior of the TGEV coronavirus on surfaces. Subsequent sections detail approaches for probing TMV's mechanical properties through single-indentation experiments and mechanical fatigue protocols. In this section, the mechanical fatigue approach is also discussed when used on 2D arrays of viral coat proteins. The review also discusses how these mechanical techniques can trigger genome release in minute virus of mice (MVM), a process that can alternatively be induced by temperature, as happens in bacteriophage T7. Finally, the chapter illustrates how AFM can serve as a nanomanipulation tool to move individual viruses across surfaces and estimate their adhesion strength.}, }
@article {pmid41912095, year = {2026}, author = {Wei, Q and Zhang, T and Schmit, N}, title = {Post-acute sequelae after Lassa fever: A systematic review and meta-analysis.}, journal = {The Journal of infection}, volume = {92}, number = {5}, pages = {106743}, doi = {10.1016/j.jinf.2026.106743}, pmid = {41912095}, issn = {1532-2742}, mesh = {Humans ; *Lassa Fever/complications/epidemiology ; *Hearing Loss/epidemiology/etiology/virology ; Incidence ; Lassa virus ; Prevalence ; Post-Acute COVID-19 Syndrome ; Africa, Western/epidemiology ; Post-Infectious Disorders ; }, abstract = {Post-acute sequelae are symptoms that persist or arise after the acute phase of an infection, but their frequency following outbreaks remains poorly understood. Recurrent Lassa fever outbreaks pose a significant public health threat in West Africa and may have long-term health effects. This study systematically reviewed the prevalence, incidence, duration, and characteristics of post-acute sequelae in survivors of Lassa virus infection. We searched PubMed and Web of Science up to November 17, 2025. Two reviewers screened and extracted data independently. We included six articles in the review. The most frequently reported post-acute sequela was hearing loss, with a pooled prevalence of 18% (95% CI 9-32) across 6 studies. Odds ratios for the association between Lassa fever and hearing loss were heterogeneous, with a statistically significant positive association in 2 of 5 studies and a positive effect direction in 2 further studies. Of an additional 37 potential post-acute sequelae, several with high prevalence also related to the audiovestibular system (e.g., tinnitus, balance disorder, and vertigo). Our findings highlight that Lassa fever survivors can experience diverse symptoms after recovery from acute infection, with hearing loss being the best-characterised. However, data gaps remain on its incidence after mild infections and its duration. A better understanding of post-acute sequelae after Lassa fever is necessary for accurate disease burden estimation and mathematical modelling studies.}, }
@article {pmid41912221, year = {2026}, author = {Ijaz, M and Mizori, R and Al Omran, Y}, title = {Effectiveness of Teledermatology on Clinical, Patient-Reported, and Operational Outcomes: A Systematic Review.}, journal = {Dermatology practical & conceptual}, volume = {16}, number = {1}, pages = {}, pmid = {41912221}, issn = {2160-9381}, abstract = {INTRODUCTION: Teledermatology (TD), the remote diagnosis and management of skin conditions using digital platforms, has rapidly evolved since its initial adoption in 1995. With the onset of the COVID-19 pandemic, the utilization of TD expanded significantly, offering a viable alternative to face-to-face (F2F) consultations, particularly in settings where access to dermatologists are limited.
OBJECTIVES: This systematic review aimed to evaluate the effectiveness of TD across three key domains: clinical outcomes, patient satisfaction, and cost-effectiveness.
METHODS: A systematic search was conducted across MEDLINE, Embase, and Web of Science for studies published between 2010 and July 2024. Studies comparing TD with in-person consultations in terms of diagnostic accuracy, patient satisfaction, and cost-effectiveness were included. The quality of the included studies were as assessed using the Newcastle-Ottawa Scale (NOS).
RESULTS: From 2,768 articles, 23 studies met the inclusion criteria. Clinical outcomes indicated moderate agreement between TD and F2F consultations, with a mean kappa coefficient of 0.57, reflecting diagnostic concordance. Patient satisfaction varied widely, with 26.57% of patients willing to replace F2F consultations with TD. TD was associated with significant cost savings, averaging US$81.31 per patient, with percentage savings ranging from 6.27% to 45.33%, depending on the healthcare system.
CONCLUSIONS: TD provides moderate diagnostic accuracy, substantial cost savings, and varying degrees of patient acceptance. However, successful implementation requires high-quality imaging, clinician training, and robust technical infrastructure. Further research is needed to optimize TD's role in dermatology, particularly in balancing virtual and F2F care.}, }
@article {pmid41912702, year = {2026}, author = {Candel-Pau, J and Maya-Enero, S and García-García, J and Valle-Del Barrio, B and Muñoz-Molinero, J and López-Vílchez, MÁ}, title = {Factors influencing SARS-CoV-2 placental antibody transfer and neonatal transmission. A prospective, cohort study and review of available literature.}, journal = {Journal of perinatology : official journal of the California Perinatal Association}, volume = {46}, number = {5}, pages = {717-725}, pmid = {41912702}, issn = {1476-5543}, mesh = {Humans ; Female ; Infant, Newborn ; Pregnancy ; Prospective Studies ; *COVID-19/transmission/immunology ; *Infectious Disease Transmission, Vertical/statistics & numerical data/prevention & control ; *SARS-CoV-2/immunology ; *Antibodies, Viral/blood/immunology ; *Pregnancy Complications, Infectious/immunology/virology ; *Immunity, Maternally-Acquired/immunology ; *Placenta/immunology ; Adult ; Male ; }, abstract = {OBJECTIVE: To describe SARS-CoV-2 serologic status, associated factors, and neonatal transmission following gestational COVID-19.
STUDY DESIGN: Prospective cohort study including neonates born to mothers with gestational COVID-19 at Hospital del Mar (Barcelona) between March 2020 and May 2022.
RESULTS: A total of 263 infants and 261 mothers were included. High seropositivity was observed in infected mothers (88.9%) and their newborns (82.8%), particularly following early gestational and mild-to-moderate infections and among vaccinated mothers. Higher placental antibody transfer ratios were observed in earlier maternal infections. However, a longer infection-to-delivery interval increased transfer ratios only for anti-nucleocapsid antibodies. Neonatal antibodies persisted for at least six months. Only 6.1% of neonates born to mothers with active infection tested positive, with no evidence of congenital transmission.
CONCLUSIONS: SARS-CoV-2 antibody placental transfer is frequent and efficient, conferring passive immunity during the first six months of life. Neonatal infection rate was low and attributable to horizontal transmission.}, }
@article {pmid41914563, year = {2026}, author = {Theo, CH and Sam, IC and Chan, YF}, title = {The Diverse Roles of Heparan Sulfate in RNA Virus Infections: Insights From Enterovirus A71, Severe Acute Respiratory Syndrome Coronavirus 2, and Chikungunya Virus.}, journal = {Journal of medical virology}, volume = {98}, number = {4}, pages = {e70888}, doi = {10.1002/jmv.70888}, pmid = {41914563}, issn = {1096-9071}, support = {//University Malaya Faculty of Medicine's Postgraduate Scholarship Fund/ ; MG001-2024//Universiti Malaya Matching Grant/ ; }, mesh = {Humans ; *Heparan Sulfate/metabolism ; *Chikungunya virus/physiology/metabolism ; *SARS-CoV-2/physiology ; *Enterovirus A, Human/physiology/metabolism ; Virus Attachment ; Animals ; Virus Internalization ; COVID-19/virology/metabolism ; Chikungunya Fever/virology/metabolism ; }, abstract = {Heparan sulfate (HS), a ubiquitously expressed glycosaminoglycan, functions as an attachment and/or internalization factor for diverse RNA and DNA viruses. Its broad viral attachment capacity arises from structural heterogeneity in sulfation patterns. This review examines HS interactions in enterovirus A71 (EV-A71), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and chikungunya virus (CHIKV), emphasizing shared features and virus-specific distinctions. HS mediates viral attachment in all three, and additionally promotes SARS-CoV-2 internalization when host receptor angiotensin-converting enzyme 2 is absent. Positively charged residues on the virion dictate HS affinity. High HS affinity enhances in vitro infectivity and plaque size in EV-A71 and SARS-CoV-2, though evidence for CHIKV remains inconclusive. In vivo, elevated HS affinity is associated with viral attenuation and diminished inflammatory responses for both EV-A71 and CHIKV; in EV-A71 specifically, increased HS affinity further correlates with reduced capsid stability and heightened sensitivity to neutralizing antibodies. HS mimetics targeting viral-HS interactions represent promising broad-spectrum antivirals, particularly those advancing in clinical trials.}, }
@article {pmid41914738, year = {2026}, author = {Xu, W and Okumura, CYM}, title = {Carbon metabolism and niche adaptation in Streptococcus pyogenes pathogenesis.}, journal = {mSphere}, volume = {11}, number = {4}, pages = {e0066825}, pmid = {41914738}, issn = {2379-5042}, support = {125033//Marshall University Joan C. Edwards School of Medicine/ ; U54GM104942//West Virginia Clinical and Translational Science Institute/ ; R15AI176429/NH/NIH HHS/United States ; }, mesh = {*Streptococcus pyogenes/pathogenicity/metabolism/genetics ; *Carbon/metabolism ; Humans ; Virulence Factors/metabolism ; Virulence ; *Streptococcal Infections/microbiology ; *Adaptation, Physiological ; Host-Pathogen Interactions ; Gene Expression Regulation, Bacterial ; }, abstract = {Responsible for over 500,000 deaths annually around the world, Streptococcus pyogenes (group A Streptococcus [GAS]) infections have resurged in the post-COVID-19 era due to immune debt and the rise of strains with enhanced adaptive capabilities. The formidable pathogenicity of GAS is fueled by metabolic plasticity that coordinates virulence with niche-specific adaptation. In this minireview, we dissect how GAS functions as a sophisticated metabolic decision-maker, revealing survival strategies of the bacteria that allow persistence and vulnerabilities that can be targeted for therapeutic development. From the oropharynx to the bloodstream, niche-specific carbon sources and availability dictate downstream biosynthetic processes, creating an integrated metabolic network that controls pathogen fitness. Dynamic shifts in central carbon metabolism are orchestrated by an expanded repertoire of global regulators that directly couple nutrient availability to virulence factor expression. The resulting bacterial metabolic byproducts serve as dual-purpose weapons, limiting competition with commensal microbes and reprogramming host cell immune responses. The ability of GAS to fine-tune and couple metabolism to niche-specific survival factors reveals pathogen-specific targets that can be exploited for therapy. We evaluate high-potential therapeutic strategies that aim to disrupt this critical metabolism-virulence nexus. The development of these precision anti-virulence strategies to counter GAS infections is critical in an era of rising antimicrobial resistance.}, }
@article {pmid41915408, year = {2026}, author = {Maynes, MA and Johnson, AJ}, title = {The impact of antigen presentation on BBB disruption and neuroinflammation.}, journal = {Physiology (Bethesda, Md.)}, volume = {}, number = {}, pages = {}, pmid = {41915408}, issn = {1548-9221}, support = {T32 AI170478/AI/NIAID NIH HHS/United States ; R01 NS103212/NS/NINDS NIH HHS/United States ; T32AI170478//HHS | NIH | National Institute of Allergy and Infectious Diseases (NIAID)/ ; RF1 NS122174/NS/NINDS NIH HHS/United States ; NS108212//HHS | NIH | National Institute of Neurological Disorders and Stroke (NINDS)/ ; NS12274//HHS | NIH | National Institute of Neurological Disorders and Stroke (NINDS)/ ; }, abstract = {Blood brain barrier (BBB) disruption is a potentially deadly complication of numerous neurological diseases as diverse as cerebral malaria, dengue hemorrhagic fever, tauopathies, multiple sclerosis, schizophrenia, Parkinson's disease, narcolepsy, and COVID-19. Neuroinflammation and immune cell infiltration are both drivers and a consequence of BBB disruption. In this review, we will provide an overview of how brain infiltrating T cell responses engage cellular components of the neurovascular unit (NVU) which regulates the BBB in preclinical models. This will provide context on how the immune system can contribute to vascular leakage and neuropathology in neurological diseases. We will discuss how discrete MHC class I and class II molecules on NVU cell types govern T cell entry, retention, and barrier disruption in neuroinflammatory diseases. Finally, we will summarize our current understanding of how discrete HLA genes associate with specific neurological diseases characterized by neuroinflammation and BBB disruption.}, }
@article {pmid41915598, year = {2026}, author = {Pacheco, FS and da Rocha Mota, RG and Pinho Jannini de Sá, YA and Hogaboam, CM and Castro-Faria-Neto, HC and Carvalho, VF}, title = {Glucocorticoids and Neutrophil Biology: Impact on the Development of Resistance to Glucocorticoid Therapy.}, journal = {Neuroimmunomodulation}, volume = {33}, number = {1}, pages = {213-224}, pmid = {41915598}, issn = {1423-0216}, mesh = {Humans ; *Glucocorticoids/pharmacology/therapeutic use ; *Neutrophils/drug effects/immunology ; Animals ; *Drug Resistance/immunology/physiology ; Th17 Cells/immunology/drug effects ; Inflammation/immunology/drug therapy ; }, abstract = {BACKGROUND: Neutrophils are the most abundant leukocytes in peripheral circulation and play a crucial role in combating infections and mediating inflammatory responses. Neutrophils are produced in bone marrow, have a short half-life in the blood, and are rapidly attracted to the tissues in response to infection or tissue damage.
SUMMARY: Glucocorticoids (GCs), stress hormones, and potent anti-inflammatory agents exert complex effects on neutrophils. While they generally suppress immune responses, GCs can paradoxically enhance neutrophil survival and function under certain conditions. This duality is evident in their ability to delay neutrophil apoptosis and to induce a shift of neutrophils from the marginated to the circulating pool, increasing the neutrophil presence in the bloodstream. Th17 cells, a subset of T-helper cells, recruit neutrophils to sites of infection and inflammation. In addition, neutrophils promote Th17 cell differentiation. GCs can enhance Th17 differentiation and IL-17 production, exacerbating neutrophil accumulation. Nevertheless, in glucocorticoid-resistant diseases, including multiple sclerosis (MS), traumatic brain injury (TBI), and encephalomyelitis, Th17 cells and neutrophils contribute to persistent inflammation. This resistance complicates the treatment of autoimmune diseases and chronic inflammatory disorders, also in the central nervous system, where standard glucocorticoid therapy fails to mitigate symptoms effectively.
KEY MESSAGES: In this context, we propose a mechanism for the development of resistance to GC driving by uncontrolled TH17 response and neutrophils induced by chronic stress. Understanding the interactions between neutrophils, Th17 cells, and GCs is essential for developing targeted therapies for diseases resistant to GC, such as MS, TBI, and encephalomyelitis.}, }
@article {pmid41915901, year = {2026}, author = {Nunns, M and Febrey, S and Becker, K and Weiland, M and Buckland, J and Abbott, R and Whear, R and Bethel, A and Shaw, L and Boddy, K and Carville, S and Harris, T and Thompson Coon, J and Melendez-Torres, GJ}, title = {The Effectiveness of Contact Tracing to Reduce Transmission of Infectious Diseases During Epidemic or Pandemic Response: Rapid Systematic Review.}, journal = {JMIR public health and surveillance}, volume = {12}, number = {}, pages = {e84805}, pmid = {41915901}, issn = {2369-2960}, mesh = {Humans ; *Contact Tracing/methods/statistics & numerical data ; *Pandemics/prevention & control ; *Epidemics/prevention & control ; *Communicable Diseases/transmission/epidemiology ; }, abstract = {BACKGROUND: Contact tracing (CT), the process of identifying and managing contacts of infected cases, is one public health and social measure that may reduce the spread of infectious diseases. While previous systematic reviews of CT exist, a comprehensive review of both the effectiveness and potential unintended consequences has not been undertaken to our knowledge. Understanding effective CT strategies could help governments and health authorities prepare effectively for emergency epidemic or pandemic situations.
OBJECTIVE: This study aims to systematically review the evidence on the effectiveness of CT across infectious diseases with epidemic or pandemic potential. Effectiveness is measured in terms of impacts on disease transmission, health care use, mortality, or unintended consequences.
METHODS: We searched 6 bibliographic databases (MEDLINE, Embase, Global Health, CINAHL Ultimate, Cochrane, and Scopus) between November 29 and December 3, 2024, with supplementary citation searching. We sought human studies comparing CT with interventions with no CT or other forms of CT, delivered in the community, in prespecified diseases of epidemic or pandemic potential. We included studies with any measure of disease transmission, related health care use, or unintended consequences of CT and prioritized studies with concurrent comparators. Screening, data extraction, and critical appraisal were performed in duplicate. Due to substantial heterogeneity, a narrative synthesis was performed. This review was informed by meetings with a patient and public involvement and engagement group.
RESULTS: After deduplication, a total of 12,816 titles and abstracts were screened, with 198 records assessed for eligibility at full text. Five additional studies were found through supplementary searching. Finally, 88 reports (of 86 studies) were included, of which 57 reports (of 55 studies) were prioritized. Two main routes of transmission were represented: respiratory (tuberculosis [TB], 15 studies; COVID-19, 5 studies) and blood-borne or sexually transmitted infections (STIs; 35 studies, of which 13 were in HIV, and 22 were bacterial or parasitic infections). No evidence was found on vector-borne, direct contact, or food- or water-borne routes of transmission. Evidence was highly heterogeneous, and more than half of the studies had notable methodological limitations. While there was no difference between CT and comparator interventions for most outcomes, there was some evidence of reductions in disease prevalence in TB and for provider-initiated CT to be superior to patient-led approaches in STIs. Only 2 studies reported measures of unintended consequences.
CONCLUSIONS: We found inconsistent evidence for the effectiveness of CT, focused primarily on TB and on contrasts between provider-initiated CT and patient-led referral in STIs and HIV. High heterogeneity in study design precluded clear assertions regarding optimal strategies for CT, including with respect to relevant subgroups. Future work should consider generalizability of CT mechanisms across contexts, including by route of transmission and from the Global South, and a more thorough account of unintended consequences.}, }
@article {pmid41915996, year = {2026}, author = {Yao, J and Shi, M and Chen, S and Zhang, H and Lin, Y and Hua, C and Gao, S}, title = {Mitochondrial kinase CMPK2 in immune homeostasis and disease: from metabolic regulation to inflammatory signaling.}, journal = {International immunopharmacology}, volume = {178}, number = {}, pages = {116582}, doi = {10.1016/j.intimp.2026.116582}, pmid = {41915996}, issn = {1878-1705}, mesh = {Humans ; Animals ; *Mitochondria/metabolism/enzymology/immunology ; Homeostasis ; *Inflammation/immunology/metabolism ; Signal Transduction ; cGAS-STING Signaling Pathway ; *Nucleoside-Phosphate Kinase/metabolism/immunology ; Immunity, Innate ; Energy Metabolism ; DNA, Mitochondrial/metabolism ; Virus Diseases/immunology ; Inflammasomes/metabolism ; }, abstract = {Cytidine monophosphate kinase 2 (CMPK2) is a pivotal mitochondrial enzyme that plays a multifaceted role in cellular nucleotide metabolism, immune regulation, and disease pathogenesis. This review comprehensively examines the structural characteristics, enzymatic functions, and regulatory mechanisms of CMPK2, emphasizing its significance in maintaining mitochondrial DNA (mtDNA) integrity and energy metabolism. We explore how CMPK2 links mitochondrial stress to inflammation through its involvement in key immune signaling pathways, including the NLRP3 inflammasome and cGAS-STING pathway, thereby modulating innate immune responses. Notably, CMPK2 is upregulated during viral infections, such as SARS-CoV-2 and Zika virus, where it restricts virus replication and enhance antiviral defenses. Furthermore, we discuss the implications of CMPK2 dysregulation in various non-communicable diseases, including systemic lupus erythematosus and neuroblastoma, highlighting its potential as a diagnostic biomarker and candidate therapeutic target. By integrating recent advances in our understanding of CMPK2's roles across infectious and non-infectious diseases, this review establishes CMPK2 as a pivotal node connecting mitochondrial metabolism, immune responses, and disease mechanisms. Our findings underscore the need for further research to elucidate CMPK2's complex functions and to explore its therapeutic potential in clinical applications, ultimately contributing to improved disease management strategies.}, }
@article {pmid41917406, year = {2026}, author = {Ota, M and Sano, K and Yoshihara, K and Watanabe, S and Hasegawa, H and Miyakawa, K}, title = {Applications of Pseudoviruses Bearing Glycoproteins of SARS-CoV-2 and Influenza Virus.}, journal = {Advances in experimental medicine and biology}, volume = {1491}, number = {}, pages = {361-372}, pmid = {41917406}, issn = {0065-2598}, mesh = {*Virology/methods ; *Viral Envelope ; *Glycoproteins ; *Orthomyxoviridae ; *SARS-CoV-2 ; Vaccine Development ; }, abstract = {This review discusses pseudoviruses, which are chimeric viral particles constructed by replacing the envelope glycoproteins of viruses such as human immunodeficiency virus (HIV) or vesicular stomatitis virus (VSV) with those of target viruses, and their advantages in the study of highly pathogenic respiratory viruses. These systems serve as valuable tools for elucidating viral entry mechanisms, screening antiviral drugs, quantitatively assessing virus-neutralizing antibodies, and evaluating vaccine efficacy, while reducing the safety risks associated with live viruses. Despite limitations such as applicability primarily to enveloped viruses, ongoing technological advances continue to improve pseudovirus systems, increasing their utility in vaccine development, antiviral research, and rapid response to emerging infectious diseases.}, }
@article {pmid41917409, year = {2026}, author = {Hatakeyama, D and Shoji, M and Kuzuhara, T}, title = {Pharmacophores of Influenza Virus PA Endonuclease Inhibitors.}, journal = {Advances in experimental medicine and biology}, volume = {1491}, number = {}, pages = {413-445}, pmid = {41917409}, issn = {0065-2598}, mesh = {Humans ; *Antiviral Agents/pharmacology/chemistry/therapeutic use ; *RNA-Dependent RNA Polymerase/antagonists & inhibitors/metabolism/chemistry ; *Viral Proteins/antagonists & inhibitors/metabolism/chemistry ; *Endonucleases/antagonists & inhibitors/metabolism ; *Enzyme Inhibitors/pharmacology/chemistry ; *Orthomyxoviridae/enzymology/drug effects ; Animals ; *Influenza, Human/drug therapy/virology ; Virus Replication/drug effects ; }, abstract = {With the emergence of the novel coronavirus in 2020, influenza viruses have remained out of the spotlight for some time. However, influenza viral infections have been reported in recent years, indicating that this pathogen remains a major threat. Therefore, in addition to elucidating the molecular mechanisms underlying viral proliferation, new drugs are being actively developed. One of the most effective targets for anti-influenza drugs is the endonuclease activity of the PA subunit, a component of the viral RNA-dependent polymerase, for which a wide variety of compounds have been reported to date. In this review, we introduce 100 compounds that inhibit the activity of this enzyme and the viral proliferation efficiency, showing their potential to be used as novel anti-influenza drugs.}, }
@article {pmid41918076, year = {2026}, author = {Wang, X and Meng, J and Li, Y and Xiang, Y and Wu, Y and Xiong, Y and Liu, P and Gao, S}, title = {The role of ivermectin in the prevention and treatment of SARS-CoV-2 infection: a meta-analysis of randomized controlled trials.}, journal = {BMC infectious diseases}, volume = {26}, number = {1}, pages = {}, pmid = {41918076}, issn = {1471-2334}, mesh = {*Ivermectin/therapeutic use/adverse effects ; Humans ; Randomized Controlled Trials as Topic ; *COVID-19 Drug Treatment ; *SARS-CoV-2/drug effects ; *COVID-19/prevention & control/mortality ; *Antiviral Agents/therapeutic use ; Treatment Outcome ; Hospitalization ; }, abstract = {BACKGROUND: Ivermectin, as a potential drug for the treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, remains controversial regarding its efficacy and safety. This study aims to systematically evaluate the therapeutic and preventive effect of ivermectin in patients with SARS-CoV-2 infection.
METHODS: A comprehensive literature search was conducted on October 11, 2025, to include randomized controlled trials (RCTs) assessing ivermectin for the treatment of SARS-CoV-2 infection. The primary outcome measures were mortality rate and adverse event rate for hospitalized patients and outpatient patients, while secondary outcomes included hospitalization time and recovery time. Given the anticipated clinical and methodological heterogeneity across the included RCTs (e.g., variations in ivermectin dosage, study population characteristics, trial implementation time and SARS-CoV-2 variants), a random-effects model was used for the meta-analysis to obtain a robust synthesis of heterogeneous study results and reliable estimation of pooled effect sizes.
RESULTS: A total of 40 RCTs involving 23,243 participants were included. Among them, 4 studies evaluated the preventive effect of ivermectin on SARS-CoV-2 infection, and the other 36 studies evaluated the therapeutic effect of ivermectin in patients with SARS-CoV-2 infection. For prevention, there was no statistically significant difference between the ivermectin group and control group in SARS-CoV-2 infection rate [risk ratio (RR) 0.37; 95% Confidence Interval (CI) 0.12 to 1.20]. For treatment, all-cause mortality for both hospitalized patients (RR 0.94; 95%CI 0.74 to 1.20) and outpatients (RR 0.88; 95%CI 0.55 to 1.42) showed no statistically significant difference. Adverse events for hospitalized patients (RR 1.02; 95%CI 0.76 to 1.37) and outpatients (RR 0.96; 95%CI 0.82 to 1.13) also showed no statistically significant difference.
CONCLUSIONS: This meta-analysis provides evidence that ivermectin does not statistically significantly reduce the risk of SARS-CoV-2 infection or improve clinical outcomes in patients with COVID-19. Further high-quality trials are needed to clarify the potential benefits of ivermectin.
CLINICAL TRIAL NUMBER: Not applicable.}, }
@article {pmid41918096, year = {2026}, author = {Çeleğen, İ and Sarıöz, A}, title = {Exposure to health misinformation on social media across key health domains: a systematic review and meta-analysis of survey-based studies.}, journal = {BMC public health}, volume = {26}, number = {1}, pages = {}, pmid = {41918096}, issn = {1471-2458}, mesh = {Humans ; *Social Media/statistics & numerical data ; Media Exposure ; COVID-19 ; *Communication ; Neoplasms ; Oral Health ; Vaccination ; Surveys and Questionnaires ; }, abstract = {BACKGROUND: Exposure to health misinformation on social media has emerged as a significant public health concern; however, survey-based evidence remains conceptually heterogeneous across health domains and outcome definitions. This systematic review and meta-analysis synthesized individual-level observational studies examining direct exposure to health misinformation across key domains, including COVID-19, vaccination, cancer, and oral health. METHODS: Following PRISMA 2020 and MOOSE guidelines, PubMed, Web of Science, and Scopus were searched (2010–2025). Eligible studies were observational and survey-based, reporting prevalence or determinants of individual-level exposure to health misinformation encountered on social media. Exposure was operationalized as (i) perceived exposure (self-reported encountering of misinformation) or (ii) item-level encounter/recognition of predefined misinformation claims framed as prior exposure. Constructs reflecting belief, attitudinal agreement, susceptibility, or behavioral responses were excluded from prevalence pooling to prevent conceptual conflation. Interventional or experimental correction studies were excluded to preserve comparability with naturalistic observational exposure measures. Random-effects meta-analyses were conducted in R (meta/metafor), with heterogeneity quantified using I[2]. Subgroup analyses were conducted by health domain, geographic region, and platform context. RESULTS: Eight studies (N = 22,780) met inclusion criteria. Reported prevalence estimates varied substantially (10%–87%) across domains and exposure operationalizations. The pooled prevalence was 59.0% (95% CI: 44.0–73.0); however, heterogeneity was extreme (I[2] = 99.8%). Accordingly, the pooled estimate is interpreted as a descriptive contextual summary rather than a generalizable population parameter. Subgroup analyses suggested domain-dependent patterns, with comparatively higher reported exposure in COVID-19 and oral health contexts and lower levels in cancer-related contexts. Across studies, younger age, lower health or digital literacy, and minority ethnicity were recurrently associated with higher reported exposure. Platform-related associations were context-dependent and varied by outcome construct and health domain, indicating that platform effects operate as environmental modifiers rather than intrinsic determinants. CONCLUSIONS: Exposure to health misinformation on social media appears common but highly variable across health domains, operational definitions, and platform environments. Given extreme between-study heterogeneity, reliance on cross-sectional self-reported measures, and variability in exposure operationalization, findings should be interpreted as contextual rather than universally generalizable. The most informative insights derive from domain- and context-specific patterns, which may inform targeted and evidence-sensitive public health strategies.}, }
@article {pmid41918638, year = {2026}, author = {Darkhabani, O and Ahmed, A}, title = {Pandemic-Induced Disruption and the Adaptive Resilience of the Medical Supply Chain: A Case Study of Saudi Arabia.}, journal = {Cureus}, volume = {18}, number = {2}, pages = {e104419}, pmid = {41918638}, issn = {2168-8184}, abstract = {The COVID-19 pandemic exposed profound vulnerabilities in global medical supply chains, largely driven by a reliance on Just-In-Time (JIT) efficiency and geographically concentrated manufacturing. While many Western economies faced sustained shortages and distribution chaos, the Kingdom of Saudi Arabia (KSA) achieved a rapid transition from initial scarcity to a surplus of essential supplies. This report analyzes the Saudi Arabian experience as a successful hybrid resilience model that synthesized centralized government authority with decentralized private sector agility. Centrally, the National Unified Procurement Company (NUPCO) utilized unified purchasing power to secure international deals, while the Saudi Food and Drug Authority (SFDA) provided regulatory agility by fast-tracking imports and registrations. Complementing this, major private distributors like Al Nahdi Medical Company reported digital logistics investments enabling distribution efficiency. The study concludes that Saudi Arabia's success stemmed from the ability to rapidly pivot from cost-efficiency to security and speed operations. For future preparedness, the report advocates for a paradigm shift that prioritizes localization of manufacturing, supply chain diversification, and the integration of advanced technologies like AI and blockchain to ensure long-term national health security.}, }
@article {pmid41918727, year = {2026}, author = {Stallmach, A and Layer, P and Katzer, K and Reuken, PA}, title = {Lessons from irritable bowel syndrome: potential for understanding and managing post-COVID.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1717324}, pmid = {41918727}, issn = {1664-3224}, mesh = {Humans ; *Irritable Bowel Syndrome/therapy/diagnosis/etiology ; *COVID-19/complications ; *SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Post-Infectious Disorders ; }, abstract = {Post-COVID presents a complex medical challenge characterized by persistent symptoms following SARS-CoV-2 infection. Similarities between post-COVID and post-infectious Irritable Bowel Syndrome (PI-IBS) suggest that the latter can serve as a useful model for understanding pathophysiological mechanisms and developing therapeutic approaches. Both conditions are functional disorders triggered by an acute infection, with multifactorial etiology and limited biomarker-based diagnostics. The variability of symptoms and the high frequency of comorbidities make these disorders particularly difficult to diagnose. Diagnostic efforts may be further hindered by the stigmatization of such disorders among healthcare providers, the health insurance industry, and the general public. This article explores the parallels between PI-IBS and post-COVID, highlighting, on the one hand, what can be learned from the management of IBS to better address the needs of patients with post-COVID long-term sequelae, and, on the other hand, raising doubts-based on decades of research into drug therapy development for IBS-about the likelihood of a rapidly available treatment for post-COVID.}, }
@article {pmid41918740, year = {2026}, author = {Yan, L and Fu, H and Zhang, H and Dong, H and Chen, J and Yu, L and Zhang, L}, title = {The impact of the COVID-19 pandemic on the epidemiology, clinical manifestations and molecular characteristics of Mycoplasma pneumoniae.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1741698}, pmid = {41918740}, issn = {1664-3224}, mesh = {Humans ; *Mycoplasma pneumoniae/genetics/drug effects/pathogenicity ; *Pneumonia, Mycoplasma/epidemiology/drug therapy/microbiology ; *COVID-19/epidemiology ; *SARS-CoV-2 ; Drug Resistance, Bacterial ; Macrolides/therapeutic use ; Anti-Bacterial Agents/therapeutic use ; Pandemics ; }, abstract = {Mycoplasma pneumoniae (MP) is a major causative agent of acute respiratory tract infections in children. Since 2023, its high prevalence coupled with rising rates of macrolide resistance has presented substantial challenges in the clinical management of pediatric MP infections. In light of the impact of the COVID-19 pandemic on the epidemiology of respiratory pathogens, this article reviews relevant global studies conducted before, during, and after the pandemic. A comprehensive narrative review approach was adopted, with literature searches conducted in databases including PubMed and Web of Science up to December 2025.The findings reveal notable shifts in the epidemiology of MP in the post-pandemic period: the epidemic season has lengthened with a displaced peak, the proportion of cases among school-aged children has risen, and the incidence of severe Mycoplasma pneumoniae pneumonia (SMPP) has increased. Globally, macrolide-resistant Mycoplasma pneumoniae (MRMP) rates continue to climb, remaining especially high in East Asia (>80%), and are closely linked to specific genotypes such as P1-1 and M4572. Disease severity is associated with both host-derived exaggerated inflammatory responses (e.g., elevated IL-6 and LDH) and the virulence activity of the CARDS toxin. The profile of co-infections has also undergone change. In summary, against a background of reduced pathogen exposure and the formation of immune intervals and high antimicrobial resistance, the COVID-19 pandemic has compounded the clinical complexity of managing MP infections. Future efforts should prioritize enhanced global surveillance, the development of rapid diagnostics and novel therapeutics, and the optimization of antibiotic stewardship strategies.}, }
@article {pmid41919061, year = {2026}, author = {Ziaka, M and Zagalioti, SC and Zgouridou, A and Fyntanidou, B and Exadaktylos, A}, title = {Pathophysiology of Cerebral Microbleeds in Patients with Severe Respiratory Failure and Acute Respiratory Distress Syndrome: A Scoping Review.}, journal = {International journal of general medicine}, volume = {19}, number = {}, pages = {575001}, pmid = {41919061}, issn = {1178-7074}, abstract = {Cerebral microbleeds (CMBs) are increasingly identified in critically ill patients with severe respiratory failure and acute respiratory distress syndrome (ARDS). This scoping review aims to systematically examine the existing literature to explore the mechanisms contributing to the development of CMBs in ARDS and to summarize current evidence on CMBs associated with severe respiratory failure. We conducted a comprehensive search across two databases, PubMed and CENTRAL, and relevant study registries (PROSPERO and Clinicaltrials.gov), between February 1 and March 3, 2025. Eligible studies included those reporting on the presence of CMBs in adult patients with severe respiratory failure or ARDS, regardless of whether mechanical ventilation (MV) was used. Eighteen observational studies involving critically ill patients with respiratory failure or ARDS were included, with sample sizes ranging from 9 to 214 patients. The proposed pathophysiological mechanisms for the development of CMBs include hypoxaemia and inflammation leading to endothelial injury and blood-brain barrier (BBB) dysfunction, cerebral hypoperfusion facilitating interaction between coronavirus disease 2019 (COVID-19) and angiotensin-converting enzyme 2 (ACE2) receptors, microangiopathy with the formation of diffuse microthrombi, and renal failure contributing to uraemia-associated BBB disruption. CMBs were predominantly localized in the corpus callosum and juxtacortical white matter. The majority of patients with CMBs were mechanically ventilated and experienced a prolonged duration of ventilation. Identified risk factors for CMBs development included greater disease severity, coagulation abnormalities, and renal dysfunction. In conclusion, CMBs are increasingly recognized in critically ill patients with ARDS, particularly in the corpus callosum and juxtacortical white matter, but current evidence is associative rather than causal. Their pathophysiology likely involves compromised small vessel integrity due to hypoxia-induced endothelial injury, inflammation, and possible direct viral effects on cerebral microvasculature. These mechanisms are further exacerbated by coagulation abnormalities and disruption of the BBB.}, }
@article {pmid41919347, year = {2026}, author = {Heald, CL and Kroll, JH and Murphy, JG and Farmer, DK and Fry, JL}, title = {Atmospheric Chemistry Insights from the Global COVID-19 Pandemic: A Review.}, journal = {Environmental science & technology}, volume = {60}, number = {14}, pages = {10393-10404}, pmid = {41919347}, issn = {1520-5851}, mesh = {*COVID-19 ; *Atmosphere/chemistry ; Air Pollutants/analysis ; Particulate Matter/analysis ; Ozone/analysis ; Pandemics ; Air Pollution ; SARS-CoV-2 ; Environmental Monitoring ; }, abstract = {The COVID-19 pandemic and resulting reductions in worldwide emissions, associated primarily with the transport sector, provided an unprecedented opportunity to explore the response of atmospheric chemistry and composition to large anthropogenic emissions perturbations. While air quality generally improved in early 2020, this was tempered by increased formation of secondary pollutants (e.g., O3 and secondary particulate matter, PM) in many regions studied. Declines in NOx emissions were largely responsible for the changes in O3, driving decreases in O3 concentrations in remote regions and increases in urban regions due to both decreases in O3 titration by NOx and also nonlinear changes in O3 production. Lower NOx levels also increased the levels of other oxidants (e.g., OH and O3), leading to a general increase in atmospheric oxidation in polluted urban regions. This enhanced oxidation promoted additional PM formation in some regions but was generally outweighed by decreases in primary PM and other secondary precursors (SO2 and VOCs). The COVID-19 pandemic gave rise to large local perturbations in air quality but only modest reductions in the global abundance of short-lived climate forcers (including O3 and PM).}, }
@article {pmid41920287, year = {2026}, author = {Qiao, N and Chen, JX and Liu, Y and Chen, Z and Chen, SJ}, title = {mRNA vaccines in cancer immunotherapy: current progress and perspectives in solid tumors and hematologic malignancies.}, journal = {MedScience}, volume = {20}, number = {1}, pages = {23-58}, pmid = {41920287}, issn = {3091-4981}, mesh = {Humans ; *Immunotherapy/methods ; *Cancer Vaccines/therapeutic use/immunology ; *Neoplasms/therapy/immunology ; Animals ; *Hematologic Neoplasms/therapy/immunology ; *mRNA Vaccines/immunology/therapeutic use ; Antigens, Neoplasm/immunology ; Nanoparticles ; COVID-19/prevention & control ; Vaccines, Synthetic/immunology/therapeutic use ; }, abstract = {The unprecedented success of mRNA vaccines during the COVID-19 pandemic has accelerated the development of nucleic acid-based therapeutics, particularly in oncology. Decades of foundational research on mRNA design, delivery, and immunogenicity have laid the groundwork for the application of mRNA vaccines in cancer treatment. Herein, we summarize the key principles of synthetic mRNA engineering, including the optimization of structural elements, nucleoside modification, and codon usage to improve stability, enhance translation efficiency, and modulate immune responses. We highlight diverse antigen strategies, including tumor-associated antigens; neoantigens; and novel sources, such as cryptic antigens, aberrant splicing variants, and transposable element-derived antigens. We discuss delivery platforms, particularly lipid nanoparticles (LNPs) and dendritic cell-based systems, in the context of improving mRNA biodistribution and immune activation. We further examine how mRNA vaccines stimulate antitumor responses by encoding antigens, modulating the tumor microenvironment, and supporting adoptive T cell therapies. We review preclinical and clinical advances in combining mRNA vaccine with immune checkpoint inhibitors for the treatment of solid tumors (e.g., melanoma, pancreatic cancer, and glioblastoma) and hematologic malignancies (e.g., acute myeloid leukemia, myelodysplastic syndrome, and multiple myeloma). Finally, we explore emerging innovations, such as targeted LNP platforms for in vivo chimeric antigen receptor T/T cell receptor T engineering and artificial intelligence-assisted vaccine design, underscoring the transformative potential of mRNA technology in cancer immunotherapy.}, }
@article {pmid41920581, year = {2026}, author = {Yoshizawa, M and Rafeedie, J and Tang, JJ and Lei, BT and Durazo-Arvizu, R and Azucar, D and Hudson, S and Rao, S and Imagawa, KK and Deavenport-Saman, A}, title = {Screen Time, Child Depression, and Anxiety During the COVID-19 Pandemic: Systematic Review and Meta-Analysis.}, journal = {JMIR pediatrics and parenting}, volume = {9}, number = {}, pages = {e83228}, pmid = {41920581}, issn = {2561-6722}, abstract = {BACKGROUND: In response to the COVID-19 pandemic, governments around the world enforced stay-at-home orders and social distancing guidelines that amplified the use of screen time among pediatric populations. Excessive screen time may negatively impact mental health by increasing depression and anxiety.
OBJECTIVE: The first aim was to conduct a systematic review of articles examining screen time and mental health outcomes among children and adolescents during the COVID-19 pandemic from 2020 to 2023. The second aim was to determine the combined effect sizes for the associations of screen time and depression and/or anxiety among children and adolescents during the COVID-19 pandemic from 2020 to 2023 and whether gender or age influenced outcomes.
METHODS: Bibliographic databases were searched including MEDLINE (Ovid), Embase (Elsevier), Cochrane Library (Wiley), CINAHL Complete (EBSCO), and PsycINFO (EBSCO). There were a total of 6462 nonduplicate studies that were screened. Study inclusion criteria included children ages 0 to <18 years, the effects of screen time on children during the COVID-19 pandemic, screen time and depression and/or anxiety, articles written in English, and articles, including quantitative and qualitative studies, published between 2020 and 2023. A total of 452 articles underwent full-text review with 23 articles meeting criteria for final article extraction.
RESULTS: A total of 23 studies totaling 29,581 children and adolescents were included in the study. Results showed that most studies reported a positive association between screen time and depression and/or anxiety (r=0.175, 95% CI 0.124-0.226, P<.001 and r=0.157, 95% CI 0.0994-0.214, P<.001, respectively) during COVID-19. Meta-regression revealed that screen time measured in problematic use of electronic devices had a 0.15 higher correlation with anxiety compared to screen time measured in duration of electronic device use.
CONCLUSIONS: During the COVID-19 pandemic, children and adolescents with higher levels of screen time had increased depression and/or anxiety. Findings suggest the need for ongoing parent, professional, and self-monitoring of youth screen behaviors and habits as well as activities that promote social connectedness during global or national health emergencies.}, }
@article {pmid41921044, year = {2026}, author = {Dubey, S and Khan, J and Alishlash, AS and Matalon, S}, title = {The cell with many faces: lung macrophage plasticity and function in response to environmental and pathogenic insults.}, journal = {Physiological reviews}, volume = {106}, number = {3}, pages = {1999-2055}, pmid = {41921044}, issn = {1522-1210}, support = {R01 HL031197/HL/NHLBI NIH HHS/United States ; R01HL031197-29S1//HHS | NIH | National Heart, Lung, and Blood Institute (NHLBI)/ ; REINVENT grant from the Department of Anesthesiology and Perioperative Medicine//University of Alabama at Birmingham (UAB)/ ; }, mesh = {Humans ; Animals ; *Macrophages, Alveolar/immunology/physiology ; *Cell Plasticity ; COVID-19/immunology ; *Lung Diseases/immunology ; *Lung/immunology ; *Environmental Exposure/adverse effects ; }, abstract = {Alveolar macrophages (AMs) are pivotal immune sentinels, essential for maintaining tissue homeostasis and mediating immune responses to inhaled particles and pathogens. They demonstrate remarkable plasticity by transitioning from proinflammatory (M1) and anti-inflammatory/reparative (M2) phenotypes in response to local signals. Upon exposure to environmental agents, such as particulate matter, atypical respiratory pathogens, opportunistic Gram-negative bacteria, or respiratory viruses, they undergo dynamic activation that profoundly influences their functional repertoire. Acute or chronic environmental/biological insults disrupt normal AM activities such as phagocytosis, efferocytosis, and cytokine production, inciting oxidative stress, inflammasome activation, and in some cases forms of programmed cell death such as pyroptosis. Although these responses are indispensable for eliminating noxious particles and pathogens, such as Mycoplasma pneumoniae or Klebsiella pneumoniae, influenza A, or SARS-CoV-2, they can also derail the resolution phase by perpetuating inflammation, driving tissue remodeling and fibrosis, and thereby fueling chronic lung disorders such as chronic obstructive pulmonary disease (COPD), pneumoconiosis, and post-COVID interstitial lung disease. Moreover, environmental and microbial exposures modify AMs by altering receptor repertoires, intracellular phenotype by signaling cascades, and cross talk with epithelial and mesenchymal cells that collectively determine the disease trajectory. Elucidating how diverse environmental agents, together with pathogens such as M. pneumoniae, K. pneumoniae, influenza A, and SARS-CoV-2, shape AM biology is therefore pivotal for understanding the pathogenesis of COPD, pneumoconiosis, progressive fibrotic lung disease, and COVID-19-related pulmonary sequelae. This review brings together the current insights into exposure-driven modulation of AM functions, highlighting recent advances and identifying knowledge gaps relevant for therapeutic targeting of exposure-induced and pathogen-mediated lung pathology.}, }
@article {pmid41922871, year = {2026}, author = {Tanriover, MD and Heininger, U and Çiftçi, E and Drăgănescu, AC and Fal, A and Tsolia, M and Zavadska, D and Orozco Fernández, R and Hozbor, DF and Middleton, DB and Muloiwa, R and Muñoz, FM and Ong-Lim, A and Tan, TQ and Forsyth, K}, title = {The Ongoing Challenge of Pertussis in Eastern and Northern Europe: Recommendations from the Global Pertussis Initiative.}, journal = {Infectious diseases and therapy}, volume = {15}, number = {5}, pages = {1175-1201}, pmid = {41922871}, issn = {2193-8229}, abstract = {Pertussis (whooping cough), a vaccine-preventable disease that affects people of any age, has resurged globally after the COVID-19 pandemic. Key reasons for recent pertussis outbreaks include suboptimal pertussis vaccination coverage (particularly for vaccination during pregnancy) and growing vaccination hesitancy. During the 2023-2024 pertussis outbreaks in Europe, adolescents aged 10-14 years and 15-19 years had the first and third highest incidence rates, respectively. To reduce pertussis burden, it is essential to strengthen vaccination programs in the indicated target groups. This requires increased awareness among healthcare professionals about the local epidemiology of pertussis and its clinical presentation, alongside reinforcement of the benefits of vaccination for disease prevention. In parallel, robust surveillance systems and strong public health capacity for early disease detection and response are crucial to effectively manage outbreaks and build resilience against future outbreaks. Infants remain at high risk for pertussis, with complications, hospitalisation, and death being more common than in other age groups. Immunisation programmes combining vaccination during pregnancy, to protect newborn infants until their primary immunisation series has induced immunity, and infant immunisation are key to reducing morbidity and mortality. Strategies to improve pertussis vaccination uptake among adolescents and adults, especially those with high-risk medical conditions, are also essential. Strengthening global collaborations to invest in and build surveillance systems capable of identifying and responding to future outbreaks, to align national policies, to scale up immunisation during pregnancy, and to adopt a life-long immunisation approach are needed to better control endemic pertussis and manage future outbreaks.}, }
@article {pmid41923421, year = {2026}, author = {Sharma, V and Arora, P and Dhiman, A and Harish, S and Gandhi, TK and Dash, S}, title = {Effectiveness of Telehealth-Based Speech Therapy in Improving Articulation, Resonance, Nasal Emission, and Intelligibility in Children With Repaired Cleft lip and Palate: A Systematic Review.}, journal = {International journal of language & communication disorders}, volume = {61}, number = {3}, pages = {e70236}, doi = {10.1111/1460-6984.70236}, pmid = {41923421}, issn = {1460-6984}, mesh = {Humans ; *Cleft Palate/surgery/complications ; *Cleft Lip/surgery/complications ; *Speech Therapy/methods ; Speech Intelligibility ; Telemedicine ; Child ; *Speech Disorders/etiology/rehabilitation/therapy ; *Articulation Disorders/etiology/rehabilitation/therapy ; Treatment Outcome ; }, abstract = {BACKGROUND: Cleft lip and palate (CLP) is a prevalent congenital anomaly associated with persistent speech disorders, including articulation errors, resonance imbalances, and nasal emission, despite surgical repair. Access to specialized speech-language pathologist care remains limited, particularly in remote and underserved regions. Telehealth has emerged as a scalable solution, yet systematic evidence on its efficacy, technological reliability, and implementation in CLP-specific speech therapy is lacking.
AIMS: This systematic review critically evaluates the effectiveness of telehealth-based speech interventions in improving articulation, resonance, nasal emission, and intelligibility in children with repaired CLP, while examining technological modalities, feasibility, data security, and barriers to adoption.
METHODS: Following PRISMA 2020 guidelines, we searched PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar from inception to 30 December 2025 using structured Boolean terms combining CLP, speech therapy, and telepractice. Interventional studies in English reporting paediatric speech outcomes were included. Data were extracted on study design, sample characteristics, intervention delivery, outcomes, and risk of bias using RoB 2.0, ROBINS-I, and SCED tools. Narrative synthesis was applied due to heterogeneity.
MAIN CONTRIBUTION: Eleven studies demonstrated consistent improvements in articulation accuracy (e.g., PCC increases of 15%-30%), resonance, and intelligibility via synchronous (Zoom, WhatsApp) and hybrid platforms. AI-assisted feedback and acoustic optimization enhanced fidelity. High caregiver satisfaction, reduced costs, and continuity during restrictions were key resilience factors. Connectivity issues, audio distortion, and small sample sizes were common limitations. Risk of bias was moderate overall.
CONCLUSIONS: Telehealth is a clinically effective, feasible, and secure modality for CLP speech rehabilitation, comparable to in-person therapy when technologically optimized. Hybrid models and caregiver integration are recommended. Large-scale RCTs are needed to confirm long-term efficacy and cost-effectiveness WHAT THIS PAPER ADDS: What is already known on this subject Telehealth has been used for speech therapy in various paediatric populations, with evidence of comparable outcomes to in-person care during the COVID-19 pandemic. However, prior to this review, no systematic synthesis existed specifically evaluating telepractice for speech disorders in children with repaired cleft lip and/or palate, despite their unique needs for targeted articulation and resonance intervention. What this paper adds to existing knowledge This review demonstrates that telehealth-based speech therapy consistently improves articulation accuracy, resonance, and intelligibility in children with repaired cleft lip and palate, with gains equivalent to in-person therapy across synchronous and hybrid models. It identifies platform-specific acoustic fidelity (e.g., Google Meet, optimized hardware) and caregiver engagement as critical enablers, while highlighting connectivity and audio distortion as manageable barriers. These findings establish telepractice as a viable, scalable standard for cleft-related speech rehabilitation. What are the potential or actual clinical implications of this study? Clinicians can confidently implement hybrid telepractice models with encrypted platforms and external microphones to maintain treatment continuity, especially in underserved areas. Routine integration of caregiver training and AI-assisted feedback is recommended to enhance adherence and outcomes. Health systems should prioritize low-bandwidth protocols and standardized acoustic calibration to ensure equitable access.}, }
@article {pmid41923926, year = {2026}, author = {De Lucia, A and Donisi, V and Rimondini, M and Del Piccolo, L and Perlini, C}, title = {Has the COVID-19 pandemic changed characteristics, administration modalities, and implementation of psychological interventions for chronic headache? An updated systematic review.}, journal = {Health psychology and behavioral medicine}, volume = {14}, number = {1}, pages = {2650006}, pmid = {41923926}, issn = {2164-2850}, abstract = {BACKGROUND: The COVID-19 pandemic has brought increased global attention to headache disorders. Building on a pre-pandemic published systematic review covering the period from 2008 to 2018, we updated the literature on evidence-based psychological interventions for adults with chronic headaches (CH), with a specific focus on the potential impact of the pandemic. Besides exploring characteristics of the interventions, evidence, and possible factors influencing their implementation in clinical practice, we aimed to investigate whether the pandemic affected interventions' features, delivery modalities, and uptake.
METHODS: We conducted a systematic search of PubMed and PsycINFO (2019-2024), checked ClinicalTrials.gov for upcoming trials, and consulted websites of clinical centers cited in the included studies. We assessed the quality of selected studies using the Quality Assessment Tool with Diverse Designs and carried out a narrative synthesis.
RESULTS: We included 20 studies (10 new and 10 updates of previously reviewed studies), with migraine being the most represented disease, and 12 upcoming trials. An emphasis on cognitive-behavioral therapy, biofeedback, and relaxation training still emerged, alongside a significant rise in eHealth solutions, particularly in upcoming trials, after the pandemic.
DISCUSSION: While the pandemic seems to have accelerated the adoption of eHealth for CH, the gap between research and clinical implementation of psychological intervention has not yet been effectively bridged.}, }
@article {pmid41924509, year = {2026}, author = {Pathak, H and Baliga, SP and Shibu, A and Thirthalli, J}, title = {Electroconvulsive therapy research in India: A scoping review.}, journal = {Indian journal of psychiatry}, volume = {68}, number = {3}, pages = {218-254}, pmid = {41924509}, issn = {0019-5545}, abstract = {BACKGROUND: Electroconvulsive therapy (ECT), since its introduction, remains one of psychiatry's most effective treatments. India has contributed substantially to research across its clinical, technical, ethical, and sociocultural dimensions. Despite this extensive body of work, the evidence has remained scattered and heterogeneous, without a single comprehensive synthesis.
AIM: The present review sought to systematically summarize the scope of ECT research conducted in India.
METHODS: Following PRISMA-ScR guidelines, a systematic search of major databases and Indian psychiatric journals was undertaken, and eligible studies were narratively synthesized.
RESULTS: A total of 270 articles were included. The findings demonstrate effectiveness of ECT in schizophrenia, depression, mania, and catatonia. Research on ECT parameters has refined understanding of stimulus dosing, seizure thresholds, pulse widths, and electrode placements, contributing to safer and more individualized treatment delivery. Literature on adverse effects indicates that most cognitive and noncognitive effects are transient and can be systematically monitored using structured tools. Anesthesia-related studies highlight agents that optimize seizure quality and cardiovascular stability, with propofol, etomidate, and ketamine offering distinct advantages. Adjuvants such as dexmedetomidine and esmolol effectively moderate sympathetic responses. Knowledge-attitude-practice studies reveal persistent knowledge gaps and media-driven stigma, although educational interventions improve perceptions. Legal and ethical discussions predominantly address challenges following the Mental Healthcare Act 2017. Additional literature addresses neurobiology, biomarkers, device development, service delivery trends, including COVID-19-related disruptions.
CONCLUSION: Overall, Indian ECT research is broad and methodologically diverse, yet important gaps remain, particularly regarding long-term outcomes, cost-effectiveness, qualitative perspectives, and ultrabrief pulse ECT. Addressing these gaps, enhancing awareness, and strengthening service capacity remain paramount.}, }
@article {pmid41924744, year = {2026}, author = {Khuna, L and Sriarmad, R and Pang, MYC and Longlalerng, K}, title = {Effects of exercise programs on cardiopulmonary function and signs and symptoms in patients with post-COVID-19 condition: a systematic review and meta-analysis.}, journal = {Frontiers in medicine}, volume = {13}, number = {}, pages = {1772741}, pmid = {41924744}, issn = {2296-858X}, abstract = {BACKGROUND: Exercise is increasingly recognized as an effective adjuvant therapy for individuals with post-COVID-19 condition. However, exercise interventions vary widely in intensity, frequency, setting, and duration. To date, no systematic review and meta-analysis has evaluated programs lasting at least 6 weeks in this population. This study aimed to assess the effects of exercise on cardiopulmonary function and clinical symptoms in patients with post-COVID-19 condition.
METHODS: We systematically searched for studies involving patients with post-COVID-19 condition in the Embase, MEDLINE/PubMed, and Scopus databases. The databases were searched using keywords including COVID-19 OR coronavirus OR SARS-CoV-2, AND exercise OR physical exercise OR rehabilitation program, AND pulmonary function OR lung function OR signs and symptoms, AND randomiz* contro* trial OR clinical trial OR RCT on July 2024. The risk of bias of individual trials and the certainty of the body of evidence were evaluated using the Physiotherapy Evidence Database scale and the Grading of Recommendations, Assessment, Development, and Evaluation approach, respectively. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement was used to describe the study selection process. The mean (± standard deviation) for continuous data and the frequency (n) and percentage (%) for dichotomous data were estimated, and the effects across trials were combined using a meta-analysis with random-effects models.
RESULTS: We included 10 randomized controlled trials comprising 602 participants. The age of participants ranged from 18 to 70 years. The average exercise duration across the 10 studies was 8.6 weeks (ranging from 6 to 16 weeks). Most exercise programs included aerobic exercise, resistance exercise, breathing exercise, thoracic mobility exercise, chest expansion exercise, and respiratory muscle training. The exercise programs included home-based or telehealth-based programs, center-based programs, and combined center- and home-based programs. Compared with control groups (e.g., usual care, exercise advice, or no structured exercise), exercise interventions significantly improved exercise capacity (6-min walk distance), pulmonary function (forced vital capacity and forced expiratory volume in 1 s), dyspnea (the modified Medical Research Council scale), physical pain, and health-related quality of life domains. The overall certainty of evidence for all outcome measures ranged from moderate to high.
CONCLUSION: Exercise programs of at least 6 weeks are associated with improved cardiopulmonary function, reduced dyspnea and pain, and enhanced physical and health-related outcomes in patients with post-COVID-19 condition.
https://www.crd.york.ac.uk/PROSPERO/view/CRD42024538786.}, }
@article {pmid41924886, year = {2026}, author = {Pullamsetti, SS and Vanderpool, RR and de Man, F and de Jesus Perez, VA and Hemnes, AR and Mukherjee, M and Mercer-Rosa, L and Spiekerkoetter, E and Tello, K and Bonnet, S and , }, title = {Advanced Molecular, Metabolic, and Imaging Approaches to Characterizing Right Ventricular Failure: A Scientific Statement From the American Heart Association.}, journal = {Circulation}, volume = {153}, number = {19}, pages = {e1304-e1322}, doi = {10.1161/CIR.0000000000001422}, pmid = {41924886}, issn = {1524-4539}, mesh = {Humans ; *Ventricular Dysfunction, Right/metabolism/physiopathology/diagnostic imaging/diagnosis ; *Heart Failure/metabolism/physiopathology/diagnostic imaging/diagnosis ; Hypertension, Pulmonary/physiopathology ; American Heart Association ; United States ; Ventricular Remodeling ; Animals ; Ventricular Function, Right ; }, abstract = {Right ventricular (RV) dysfunction is a key predictor of outcomes in pulmonary hypertension (PH), substantially contributing to illness and death. As PH progresses, increased pulmonary vascular resistance places chronic pressure overload on the right ventricle. Initially, the right ventricle adapts through hypertrophic remodeling, thickening the heart wall to maintain cardiac output. Over time, this adaptive phase shifts to maladaptive remodeling, marked by RV dilation, fibrosis, stiffness, and decoupling from the pulmonary artery, known as RV-pulmonary arterial uncoupling. This uncoupling reflects the inability of the right ventricle to sustain contractility against elevated afterload, ultimately leading to right heart failure, the primary cause of death in late-stage PH. Awareness of RV dysfunction has grown, extending beyond PH and pulmonary arterial hypertension to systemic conditions, such as heart failure with preserved ejection fraction, congenital heart disease, COVID-19, and complications of left ventricular assist device implantation. Research is increasingly focused on understanding the molecular and hemodynamic drivers of RV failure, including inflammation and altered cellular signaling. Innovations in imaging and biomarker discovery are improving the detection of maladaptive RV remodeling. Promising treatments, such as the activin signaling inhibitor sotatercept, may reduce pulmonary vascular resistance and support RV recovery. Further work is needed to enhance RV function and prevent failure. This review summarizes current knowledge on RV dysfunction in PH, emphasizing its mechanisms, clinical relevance, and therapeutic potential. Recognizing the right ventricle as a central therapeutic target may lead to more personalized, effective interventions and improved patient outcomes in PH and related conditions.}, }
@article {pmid41925132, year = {2026}, author = {Zhou, W and Fan, H}, title = {Towards sustainable age-inclusive workplaces: A systematic review on how technological tools support or hinder work participation for older workers (2014-2024).}, journal = {Work (Reading, Mass.)}, volume = {}, number = {}, pages = {10519815261435566}, doi = {10.1177/10519815261435566}, pmid = {41925132}, issn = {1875-9270}, abstract = {BackgroundThe rapid development of technological tools has significantly impacted the work participation of older workers. Technology opens new doors for older workers, though not everyone finds it easy to walk through them.ObjectiveThis review sought to investigate how technological tools influenced the participation of older workers in the workforce.MethodsWe searched four major databases (PubMed, Scopus, Web of Science, and Cochrane) using PRISMA guidelines to identify studies from the past decade (2014-2024).ResultsThirty-seven studies were included. Research on technology and older worker employment has grown substantially since 2020, with the COVID-19 pandemic likely driving this increased interest. Technological tools advance economic engagement and social inclusion for older workers, but they also generate participation barriers across personal and institutional dimensions.ConclusionsThe impact of technology on the employment of older workers depends largely on implementation strategies. Three strategies can help older workers prosper in digital workplaces: providing comprehensive training, designing user-friendly tools with older workers involved, and creating organizational support systems.}, }
@article {pmid41926781, year = {2026}, author = {Vidal, M and Gallego, C and Roncancio, G and Angarita, E and Cárdenas, R and Dueñas, K and García, JC and González, G and Granados, U and Londoño, JL and León, JDL and López, N and Marín, V and Martínez, É and Murgueitio, R and Mejía, A and Rodríguez, MJ and Silva, E and Uribe, LG}, title = {Expert consensus: first multidisciplinary consensus on nuclear cardiology.}, journal = {Archivos de cardiologia de Mexico}, volume = {96}, number = {Supl 2}, pages = {1-17}, pmid = {41926781}, issn = {1665-1731}, mesh = {Humans ; *Nuclear Medicine ; *Cardiology/methods ; *Cardiovascular Diseases/diagnostic imaging ; Consensus ; }, abstract = {BACKGROUND: Nuclear cardiology integrates nuclear medicine and cardiology to improve the diagnosis, risk stratification, and management of cardiovascular diseases. The continuous development of these techniques and their increasing clinical use require standardized, evidence-based protocols to optimize their application. Therefore, developing consensus documents is essential to ensure appropriate use of imaging for patient benefit.
OBJECTIVE: To develop consensus recommendations for the use of nuclear imaging in cardiovascular infections, coronary artery disease, left ventricular dysfunction, amyloidosis, and sarcoidosis by addressing unresolved questions in clinical practice among general practitioners and specialists, promoting updated and safe application in prevalent national pathologies.
METHOD: A multidisciplinary panel of 19 experts in cardiology, nuclear medicine, and infectious diseases answered 18 clinical questions based on an initial literature review and applying the Nominal Group Technique in a nine-phase process.
RESULTS: The consensus generated 18 recommendations on specific indications for nuclear cardiology studies and key elements for report standardization, improving clinical interpretation, assessing the impact of pharmacological therapies and surgical procedures, and evaluating prognostic value and integration with other imaging techniques.
CONCLUSIONS: The consensus provides practical, evidence-based guidance to standardize and optimize nuclear cardiology use in common cardiovascular diseases, promoting rational, effective, and economically viable application of these advanced diagnostic techniques. It strengthens clinical decision-making, therapeutic planning, and interdisciplinary coordination in comprehensive cardiovascular patient management in Colombia.}, }
@article {pmid41926837, year = {2026}, author = {Torres-Flores, A and Bautista-Sebastián, E and Rivera-Hernández, T and Ferat-Osorio, E and Arriaga-Pizano, L and Cérbulo-Vázquez, A and Ramírez-Ramírez, D and Bonifaz, L and Pelayo, R and López-Macías, C}, title = {COVID-19 in Latin America: Clinical and immunological insights, vaccine development, and lessons for pandemic preparedness.}, journal = {Seminars in immunology}, volume = {82}, number = {}, pages = {102025}, doi = {10.1016/j.smim.2026.102025}, pmid = {41926837}, issn = {1096-3618}, mesh = {Humans ; *COVID-19/immunology/epidemiology/prevention & control ; Latin America/epidemiology ; *COVID-19 Vaccines/immunology ; *SARS-CoV-2/immunology ; Pandemic Preparedness ; *Vaccine Development ; Pandemics/prevention & control ; }, abstract = {The COVID-19 pandemic had a profound impact on Latin America, exposing structural inequalities, fragmented healthcare systems, and longstanding technological dependence. The region experienced a high burden of infection and excess mortality, influenced by socioeconomic vulnerability and a high prevalence of metabolic comorbidities. In response, countries expanded diagnostic capacity, strengthened genomic surveillance, and increased participation in clinical research and therapeutic evaluation. Coordinated regional collaboration facilitated the detection and tracking of emerging SARS-CoV-2 variants. Local innovation also advanced diagnostic platforms and vaccine development, leading to regionally produced vaccines such as Soberana, Abdala, ARVAC, and Patria. These initiatives generated valuable clinical and immunological data, including characterization of inflammatory biomarkers associated with severe disease and evidence of hybrid immunity in highly exposed populations. However, persistent inequities in healthcare access, research investment, and manufacturing capacity continue to constrain regional self-sufficiency. Although collaboration among academia, industry, and government reduced certain external dependencies, structural limitations in funding stability, regulatory harmonization, and large-scale production remain. The Latin American experience highlights both adaptive scientific capacity during crisis conditions and the challenges of consolidating emergency-driven advances into durable preparedness. Sustained investment and coordinated governance will likely determine whether short-term responsiveness translates into long-term regional strengthening.}, }
@article {pmid41926893, year = {2026}, author = {Borromeo, AS and Manaloto, AM and Vicedo, RV}, title = {Megatrends and equity gaps in global digital health: A bibliometric review (2010-2025).}, journal = {Health policy (Amsterdam, Netherlands)}, volume = {169}, number = {}, pages = {105621}, doi = {10.1016/j.healthpol.2026.105621}, pmid = {41926893}, issn = {1872-6054}, mesh = {*Digital Health ; Humans ; *Bibliometrics ; *Global Health ; Evidence Gaps ; *Health Equity ; }, abstract = {BACKGROUND: Digital health has become increasingly prominent in health systems and policy discourse, yet published evidence remains fragmented across technologies, regions, and equity dimensions.
OBJECTIVE: To descriptively map the evolution of global digital health research from 2010 to October 2025 and identify its intellectual foundations, thematic fronts, and equity gaps using bibliometric methods.
METHODS: A bibliometric review of Scopus-indexed English-language journal articles was conducted and analyzed in VOSviewer (v1.6.20). Co-citation mapping used association-strength normalization with a minimum citation threshold of 15 cited references, resolution 0.50, and minimum cluster size 5. Co-word analysis of author keywords used a minimum occurrence threshold of 462, resolution 1.03, and minimum cluster size 6. Descriptive indicators summarized annual output and citation impact.
RESULTS: The dataset comprised 8210 articles with 140,459 citations (mean=17.1). Output surged after 2020, with 82.9% of publications appearing from 2020 to 2025 and peaking in 2025 (n = 1705). Co-citation analysis revealed four clusters: systems-strengthening in LMICs, digital epidemiology and algorithmic equity, digital-health literacy and evidence-based eHealth, and virtual-care transformation during COVID-19. Co-word analysis identified four thematic fronts: adult care and health disparities, digital health systems and workforce access, youth health literacy and digital inclusion, and pandemic-era virtual care. Cross-cutting gaps included interoperability, sustainability, digital literacy, responsible AI governance, equity-by-design, and LMIC-led evaluation.
CONCLUSIONS: Global digital health research has expanded rapidly into an interdisciplinary field. This review maps major themes and gaps but does not establish causal evidence of policy impact. Findings highlight priorities for interoperability, responsible AI, digital inclusion, sustainability, and LMIC-led evaluation.}, }
@article {pmid41927463, year = {2026}, author = {Griner, SB and Garza, SR and Alkhatib, SA and Footman, A and Brosnan, A and Farris, A and Van Der Pol, B}, title = {Point-of-care testing for chlamydia and gonorrhoea: a narrative review of patient perspectives and implementation into non-traditional settings.}, journal = {Sexually transmitted infections}, volume = {}, number = {}, pages = {}, doi = {10.1136/sextrans-2025-056736}, pmid = {41927463}, issn = {1472-3263}, abstract = {OBJECTIVES: The demand for point-of-care testing (POCT) increased exponentially during the COVID-19 pandemic, providing a convenient and accessible method of virus detection outside of traditional laboratory settings. As high rates of sexually transmitted infections (STIs) remain a prominent public health concern, POCT for STI detection may offer an option that reduces key barriers to care such as stigma and limited clinic hours. The aim of this narrative review is to identify key facilitators, barriers and gaps related to the acceptability and implementation of STI POCT from patient perspectives in non-traditional settings.
METHODS: To conduct this narrative review, a comprehensive literature search was conducted using PubMed, Embase and Scopus to identify relevant studies published between 1 January 2015 and May 2025, focusing on patient perspectives and contextual determinants of POCT implementation for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). Search terms included free-text keywords (such as "point of care") and indexed terms (such as Point-of-Care Testing (MeSH)). Findings were contextualised based on patient perspective data and implementation into non-traditional settings.
RESULTS: 40 studies were included in the narrative review, reflecting geographical regions where POCT implementation has been prioritised. Study designs and implementation environments varied. POCT for CT/NG screening generally reported high diagnostic accuracy and reliability as well as increased uptake and high acceptability across settings. Availability, perceived convenience and increased autonomy significantly influenced POCT uptake and implementation among patients. Implementation facilitators included ease of device usage, minimal training and improved quality of care. Implementation barriers primarily focused on logistics, workflow and cost.
CONCLUSIONS: Community-engaged approaches to designing and implementing STI POC tests in non-traditional settings are necessary to better understand specific needs. High patient satisfaction, device acceptability and improved health outcomes place STI POCT as a promising avenue for strengthening public health efforts against the STI epidemic.}, }
@article {pmid41927521, year = {2026}, author = {Yi, T and O'Hara, DV and Levin, A}, title = {Global kidney health: Are we failing the silent pandemic?.}, journal = {Journal of internal medicine}, volume = {300}, number = {1}, pages = {26-38}, doi = {10.1111/joim.70088}, pmid = {41927521}, issn = {1365-2796}, mesh = {Humans ; *Global Health ; COVID-19 ; *Pandemics/prevention & control ; *Renal Insufficiency, Chronic/diagnosis/epidemiology/therapy ; SARS-CoV-2 ; Mass Screening ; *Pneumonia, Viral/epidemiology ; *Coronavirus Infections/epidemiology ; Early Diagnosis ; }, abstract = {Chronic kidney disease (CKD), although not infectious, has a sharply rising global incidence, alarming rates of death and disability, and the potential to disrupt health systems and economies. Thus, it demands the urgency and global attention of past pandemics. Over 850 million people are affected, disproportionately impacting people in low- and middle-income countries. Although CKD can be detected with simple and cost-effective testing, it is a silent condition, often remaining asymptomatic until it has progressed to advanced stages where effective treatment options are limited. Early detection relies on systematic population-level screening, especially among individuals with comorbidities. The global response to CKD has remained largely silent: There is limited evidence of prioritization within health agendas and inadequate infrastructure for screening, surveillance, and treatment. Coordinated global action is required to halt this silent "pandemic," especially given advances in care and policy: New effective disease modifying therapies may lead to remission of CKD for many individuals, and the 2025 World Health Organization's adoption of the Kidney Health Resolution at the 78th World Health Assembly prioritizes kidney health to reduce the burden of noncommunicable diseases through promoting early screening, strengthening disease prevention, and improving access to care. In this review, we examine the failure to address the escalating CKD "pandemic" and explore how the use of low-cost and cost-effective screening tools, such as simple urine dipstick testing, and applying lessons learned from the COVID-19 pandemic are critical to further reframing CKD as a public health emergency and prioritizing kidney health on the global agenda.}, }
@article {pmid41927611, year = {2026}, author = {Longet, S and Paul, S}, title = {Current status of intranasal and inhaled COVID-19 vaccines.}, journal = {NPJ vaccines}, volume = {11}, number = {1}, pages = {}, pmid = {41927611}, issn = {2059-0105}, abstract = {The COVID-19 pandemic has accelerated the development of intranasal and inhaled COVID-19. vaccines. Four vector-based and one adjuvanted protein-based vaccines have been licenced. They have been shown to be safe. However, their ability to induce strong protective mucosal immunity in humans remains to be improved. Diversifying intranasal vaccine platforms, improving the delivery of vaccine components and determining mucosal correlates of protection could help in optimizing intranasal COVID-19 vaccine efficacy.}, }
@article {pmid41928484, year = {2026}, author = {Iuzabchuk, DA and Andrianova, AA and Yampolsky, IV and Kaskova, ZM and Smirnov, IV}, title = {Beyond Antiviral Therapy: Untapped Potential of HIV & HCV Protease Inhibitors.}, journal = {Medicinal research reviews}, volume = {46}, number = {4}, pages = {1042-1050}, doi = {10.1002/med.70040}, pmid = {41928484}, issn = {1098-1128}, support = {25-76-30006//Russian Science Foundation/ ; }, mesh = {Humans ; *Hepacivirus/enzymology/drug effects ; *Antiviral Agents/therapeutic use/pharmacology/chemistry ; Drug Repositioning ; *Protease Inhibitors/chemistry/pharmacology/therapeutic use ; *HIV Protease Inhibitors/chemistry/pharmacology/therapeutic use ; Animals ; *Viral Protease Inhibitors/chemistry/pharmacology/therapeutic use ; }, abstract = {Development of de novo therapeutic agents is a complex, costly, and a high-risk process, whereas repurposing approved and investigational drugs for novel targets offers a more efficient and cost-effective strategy, likely yielding higher success rates. This approach demonstrated its effectiveness during SARS-CoV-2 pandemic, when existing drugs were repurposed to combat the virus. Originally pivotal in developing antiviral treatments against HIV and HCV, viral protease inhibitors represent a structurally privileged class of compounds capable of targeting difficult and non-classical protein sites. They have demonstrated promising biological activity against diverse alternative targets, including fungal pathogens, multidrug-resistant bacteria, and cancer, making them prime candidates for repurposing. This mini-review highlights the unique structural and physicochemical properties of approved HCV and HIV viral protease inhibitors that enable their repurposing for the development of new therapeutic agents.}, }
@article {pmid41928489, year = {2026}, author = {Yagi, M and Tasaki, R and Komano, J}, title = {Meta-Analysis of COVID-19 Cluster Events Suggestive of Long-Distance Airborne Transmission/Inhalation.}, journal = {MicrobiologyOpen}, volume = {15}, number = {2}, pages = {e70232}, pmid = {41928489}, issn = {2045-8827}, mesh = {*COVID-19/transmission/epidemiology ; Humans ; SARS-CoV-2 ; Cluster Analysis ; Pandemics ; Infectious Disease Incubation Period ; Hospitalization/statistics & numerical data ; *Coronavirus Infections/transmission/epidemiology ; *Pneumonia, Viral/transmission/epidemiology ; *Betacoronavirus ; }, abstract = {SARS-CoV-2 spreads through both contact and airborne routes, the latter encompassing airborne transmission/inhalation as well as the direct deposition of infectious respiratory particles. During the early phase of the COVID-19 pandemic, numerous cluster events were suspected to involve long-distance airborne transmission/inhalation. We conducted a comparative analysis of these cluster events to characterize outbreak settings and associated clinical parameters. Thirteen cluster events from 2020 attributed to the original SARS-CoV-2 strain were examined, including choral activities, indoor sports, and bus tours. Incubation periods and infection-hospitalization rates (IHRs) were compared across settings and against estimates from large-scale cohort studies that predominantly reflect transmission via direct deposition. Statistical analyses were performed using the Mann-Whitney U test, Student's t-test, and Fisher's exact test (p < 0.05). The mean incubation period in suspected long-distance airborne transmission/inhalation cases was 6.1 ± 3.9 days (median: 5 days; N = 176), with indoor sports and choral events showing significantly shorter incubation periods (p = 0.034). The average IHR was 6.7 ± 12.5%, with significantly higher rates in choral clusters (p = 0.013). Age-adjusted IHRs were lower in long-distance airborne transmission/inhalation-related clusters than those reported from contact-tracing datasets. This analysis provides an integrated evaluation of long-distance airborne transmission/inhalation settings and their associated clinical characteristics. Activities involving vigorous respiration may contribute to shorter incubation periods and higher disease severity, potentially reflecting increased viral inoculum at exposure.}, }
@article {pmid41929258, year = {2026}, author = {Nayak, BB and Rajesh, R and Teppan, J and Gogg, T and Böhm, E}, title = {Interleukin-23 in lung and airway diseases: from pathogenesis to precision-guided therapeutic targeting.}, journal = {Frontiers in pharmacology}, volume = {17}, number = {}, pages = {1784434}, pmid = {41929258}, issn = {1663-9812}, abstract = {Interleukin-23 (IL-23) is a pleiotropic cytokine belonging to the IL-12 family and is predominantly produced by antigen-presenting cells. It plays a central role in shaping adaptive immunity by promoting the polarization, expansion, and maintenance of T helper 17 (Th17) cells, thereby driving the production of downstream effector cytokines such as IL-17A and IL-22. Under physiological conditions, IL-23 contributes to pulmonary immune homeostasis and host defense against bacterial and fungal pathogens. However, sustained or dysregulated IL-23 signaling promotes chronic inflammation and tissue damage. Beyond autoimmune diseases, where IL-23 is a well-established key mediator linked to disease severity and a validated therapeutic target, it has also emerged as a critical mediator in chronic lung diseases. Enhanced IL-23 signaling has been associated with increased disease severity, corticosteroid resistance, airway remodeling, and progressive tissue fibrosis, highlighting its contribution to both inflammatory and structural components of lung pathology. These findings suggest that IL-23 is not merely a bystander but an active driver of pathogenic processes in the respiratory system. In this review, we synthesize recent advances in understanding the role of IL-23 in chronic obstructive pulmonary disease, asthma, idiopathic pulmonary fibrosis, and coronavirus disease 2019. We further discuss the therapeutic potential of targeting IL-23 as a precision-guided strategy to modulate respiratory inflammation and remodeling, with particular emphasis on corticosteroid resistance, fibrotic endotypes, safety and pharmacologic tradeoffs, and the emerging role of IL-23-related biomarkers and molecular endotyping for precision-guided patient stratification and targeted intervention.}, }
@article {pmid41929267, year = {2025}, author = {Seguin, M and Cavagnoud, R and Gianella, C and Khomych, T and Vibla, N}, title = {Stressors, mental health and coping amongst forcibly displaced youth since the advent of COVID-19: A systematic review.}, journal = {Developmental child welfare}, volume = {7}, number = {4}, pages = {251-269}, pmid = {41929267}, issn = {2516-1040}, abstract = {Mental health is a key issue for forcibly displaced youth. The evidence base on the mental health of youth forcibly displaced since the start of the pandemic is undefined, as well as sources of stressors and coping approaches. This systematic review aims to identify literature on the mental health of forcibly displaced youth in low- and middle-income settings, with focus on displacement since the advent of the COVID-19 pandemic. Objectives are to examine (1) sources of stress, (2) prevalence and covariates of common mental disorders (CMDs) and (3) coping approaches. Six databases were searched in February 2023. Search terms focused on CMDs, stress and forcibly displaced populations. Articles based on data collected after the onset of the COVID-19 pandemic focused on forcibly displaced persons aged 10-29 were included. Quantitative observation and intervention studies reporting CMD prevalences and related concepts were included, as were qualitative studies about stressors and/or coping approaches. Prevalences of CMDs and covariates were tabulated. Inductive thematic coding was conducted on qualitative data on stressors and coping. Interpretation of coping data was guided by a taxonomy including problem solving, support seeking, distraction/avoidance and positive cognitive restructuring. Twenty-one articles were included. Economic issues were the most prominent source of stress and led to subsequent stressors. Depression and anxiety symptom prevalence ranged from 6.2% to 77.4% and 17.2%-32.8% respectively. Problem-solving and support seeking were the most common coping approaches. Supporting the mental health and coping approaches of this marginalised group is critical to recovery in the post-COVID era.}, }
@article {pmid41929539, year = {2026}, author = {Giannopoulou, I and Efstathiou, V and Stefanou, MI and Korkoliakou, P and Tsoporis, JN and Spandidos, DA and Rizos, E}, title = {Disrupted beginnings: Neurodevelopmental outcomes of COVID-19 lockdowns in early childhood (Review).}, journal = {Experimental and therapeutic medicine}, volume = {31}, number = {5}, pages = {137}, pmid = {41929539}, issn = {1792-1015}, abstract = {Early childhood development depends on stable routines, social interaction and responsive caregiving. The 2019 coronavirus disease pandemic disrupted these supports through lockdowns, reduced early-education access and elevated caregiver stress. The present review synthesized empirical studies (2020-2025) of children aged 0-5 years and found consistent evidence of modest increases in emotional and behavioral difficulties, particularly where caregiver stress or socioeconomic adversity was elevated. Cognitive, language and executive-function (EF) outcomes were found to be more heterogeneous and appeared most affected in the contexts of reduced stimulation or limited access to early learning, with EF processes showing particular sensitivity to stress-related and environmental disruptions. Biological findings (cortisol, DNA methylation and infant brain measures) showed a number of converging signals, particularly in higher-risk contexts, but remained preliminary given modest sample sizes, methodological heterogeneity and limited replication. Overall, this suggested that pandemic-related disruptions disproportionately affected children in vulnerable family contexts. Therefore, the present study suggested targeted caregiver mental-health support, preservation of early-education access during emergencies and longitudinal follow-up of high-risk cohorts.}, }
@article {pmid41930828, year = {2026}, author = {Lotti, V and Lagni, A and Diani, E and Palmisano, A and Cecchetto, R and Tonon, E and Sorio, C and Gibellini, D}, title = {When viruses meet cystic fibrosis: Insights into host-pathogen dynamics.}, journal = {Microbiological research}, volume = {308}, number = {}, pages = {128508}, doi = {10.1016/j.micres.2026.128508}, pmid = {41930828}, issn = {1618-0623}, mesh = {Humans ; *Cystic Fibrosis/virology/complications ; *Virus Diseases/virology/complications/epidemiology ; *Host-Pathogen Interactions ; *Respiratory Tract Infections/virology ; Viruses/pathogenicity ; Cystic Fibrosis Transmembrane Conductance Regulator/genetics ; }, abstract = {Cystic fibrosis (CF), an autosomal-recessive genetic disorder, is caused by mutations in the CFTR gene, which encodes for a membrane anion channel expressed on multiple organs, with major impact on the airways. The impaired ion transport leads to thickened mucus secretions, which in turn can cause pancreatic insufficiency, sinusitis, infertility and, particularly, chronic pulmonary infections. While bacterial colonization of the airways has been extensively studied, increasing evidence highlights the significant, yet underappreciated, role of respiratory viruses in exacerbating lung disease in people with CF (pwCF). This review provides a comprehensive overview of the pathogenesis, epidemiology, and clinical impact of key respiratory viruses, including respiratory syncytial virus (RSV), human rhinovirus (HRV), influenza viruses, parainfluenza viruses, coronaviruses, and emerging pathogens such as human bocavirus, as well as relevant non-respiratory viruses, such as Cytomegalovirus (CMV), Epstein-Barr virus (EBV) and hepatitis viruses. Viral infections in pwCF are associated, particularly in pediatric patients, with increased respiratory symptoms, higher hospitalization rate and long-term decline in lung function. Despite a similar incidence of viral infections to non-CF individuals, pwCF often exhibit more severe clinical outcomes, except for SARS-CoV-2 infection, which shows an incidence and severity unexpectedly attenuated in this cohort. Moreover, while CFTR modulators have dramatically improved clinical outcomes in pwCF, their effects on antiviral immunity remain poorly understood and are an area of active investigation. Elucidating virus-host interactions and the impact of CFTR restoration in this context is essential for optimizing preventive and therapeutic strategies against viral infections in CF.}, }
@article {pmid41932347, year = {2026}, author = {Camici, M and Piano Mortari, E and Del Duca, G and Cimini, E and Mazzotta, V and De Ponte, C and Mastrorosa, I and Mazzotta, S and Pinnetti, C and Notari, S and Bordoni, V and Gili, S and Prencipe, G and Maggi, F and Carsetti, R and Girardi, E and Antinori, A and Agrati, C}, title = {Intravenous immunoglobulin treatment for long COVID: a case report of clinical and immunological findings.}, journal = {The Lancet. Infectious diseases}, volume = {}, number = {}, pages = {}, doi = {10.1016/S1473-3099(26)00063-0}, pmid = {41932347}, issn = {1474-4457}, abstract = {A previously healthy 39-year-old man developed highly symptomatic post-COVID-19 condition (also known as long COVID) marked by cognitive dysfunction, disabling fatigue, and autonomic symptoms unresponsive to multiple multidisciplinary interventions. Given the presence of markedly elevated serum autoantibodies against G protein-coupled receptors, high-dose intravenous immunoglobulin therapy was initiated at 400 mg/kg per day for 5 consecutive days. After 4 weeks, a maintenance dose of 500 mg/kg was administered for 1 day, followed by two further maintenance cycles consisting of 500 mg/kg per day for 3 consecutive days, each given at 4-week intervals. In parallel, the patient underwent a cognitive stimulation intervention. Neurological symptoms were assessed with the Fatigue Assessment Scale and the WHO Disability Assessment Schedule 2.0, and the immunological profile was longitudinally analysed during intravenous immunoglobulin treatment. Fatigue scores normalised, neurocognitive performance returned to normal value, and quality of life improved after the first infusion and fully recovered within 1 year. Immunological profiling revealed the presence of an inverted CD4 to CD8 T-cell ratio that persisted during the whole follow-up. We also identified a CD8[+] T cell-monocyte complex and spontaneous IFNγ release. Intravenous immunoglobulin therapy was associated with a significant reduction of these complexes, spontaneous IFNγ and TNF production, markers of endothelial inflammation, and circulating autoantibody titres. This patient provides exploratory evidence that high-dose intravenous immunoglobulin was associated with sustained clinical recovery from long COVID over 1 year of follow-up, accompanied by immunological changes consistent with modulation of post-viral immune dysregulation, including a reduction in pathogenic T cell-monocyte synapses. Although causal inference cannot be established from a single patient, these findings suggest that this cellular interaction can contribute to long COVID and that immunomodulation could represent a rational therapeutic approach to be evaluated in selected patients.}, }
@article {pmid41932444, year = {2026}, author = {Sithole, MN and Khan, MR and Mohammed, HA and Khan, RA and Naik, K and Choonara, YE}, title = {A systematic review on vaccine developmental approaches: Evaluating efficacy, and addressing challenges of infectious diseases in the post-COVID-19 era.}, journal = {Virus research}, volume = {367}, number = {}, pages = {199720}, pmid = {41932444}, issn = {1872-7492}, mesh = {Humans ; *COVID-19/prevention & control/immunology ; *COVID-19 Vaccines/immunology ; *Vaccine Development/methods ; *SARS-CoV-2/immunology ; Vaccine Efficacy ; Vaccination ; }, abstract = {Vaccination prevents millions of fatalities annually and works as one of the most effective and cost-efficient public health interventions. This systematic review critically evaluates vaccine development strategies in the post-COVID-19 era, focusing on platform technologies, delivery systems, and the regulatory and societal challenges that shape vaccine efficacy and accessibility. The COVID-19 pandemic redefined expectations for vaccine science, compressing traditional development timelines, and accelerating the adoption of novel platforms, such as mRNA and viral vectors. While these innovations significantly reduced global morbidity and mortality, they also exposed persistent barriers, including unequal distribution and widespread vaccine hesitancy fuelled by misinformation. This review evaluates the biochemical foundations of vaccine design, including antigen selection, adjuvant use, and delivery optimisation, alongside the emerging formulation strategies and vaccine-platforms integration. The review emphasises the need for continuous alignment between scientific progress and equitable access. By integrating historical context, technical advancement, and social determinants, this review highlights the imperatives for future vaccine strategies to be not only scientifically robust, but also globally inclusive and implementation ready. By positioning recent advancements within the historical timeline of vaccine science, this review argues that the post-COVID-19 era represents an acceleration of progress where speed, adaptability and global equity are essential for safeguarding the populations against current and emerging threats from the pandemics and localized infectious challenges in medical emergencies.}, }
@article {pmid41933426, year = {2026}, author = {Zhao, Y and He, X and Hu, Y and Su, R and Liu, X and Jin, D and Ding, L and Chen, Y}, title = {Impact of the COVID-19 pandemic on the incidence of Clostridioides difficile infection based on hospital surveillance data: a systematic review and meta-analysis.}, journal = {Antimicrobial resistance and infection control}, volume = {15}, number = {1}, pages = {}, pmid = {41933426}, issn = {2047-2994}, mesh = {Humans ; *COVID-19/epidemiology ; Incidence ; *Clostridium Infections/epidemiology ; *Clostridioides difficile ; *Cross Infection/epidemiology ; Infection Control/methods ; SARS-CoV-2 ; Hospitals ; Pandemics ; }, abstract = {BACKGROUND: Clostridioides difficile infection (CDI) remains a substantial burden on healthcare systems worldwide. The COVID-19 pandemic has had profound and multifaceted effects on healthcare delivery and infection control practices, potentially influencing the epidemiology of CDI.
OBJECTIVE: To assess whether the coronavirus disease 2019 (COVID-19) pandemic has influenced the incidence of CDI and to explore potential contributing factors.
METHODS: This systematic review and meta-analysis was conducted in accordance with the PRISMA guidelines. Seven databases were searched for relevant literature published from December 2019 to October 2025. Study quality was assessed via the Newcastle‒Ottawa Scale (NOS) and the Joanna Briggs Institute (JBI) critical appraisal tools. Random- or fixed-effects models were selected according to heterogeneity. Publication bias was evaluated via funnel plots and Egger's test, and sensitivity analyses were conducted. The primary outcome was the incidence rate of CDI, expressed as cases per 10,000 patient-days. Incidence rate ratios (IRR) were calculated to compare the incidence of CDI between the prepandemic and pandemic periods.
RESULTS: Sixteen studies were included. The pooled CDI incidence rate was 4.42 (95% CI: 3.37-5.46) per 10,000 patient-days in the prepandemic period and 3.80 (95% CI: 2.63-4.96) per 10,000 patient-days during the pandemic. The pooled incidence rate ratio was 0.80 (95% CI: 0.67-0.97), indicating a significant reduction in the incidence of CDI. This decline was associated with changes in medical practices (e.g., the suspension of nonurgent and high-risk procedures), antimicrobial stewardship practices, and strengthened infection control measures (e.g., enhanced hand hygiene and environmental disinfection) during the pandemic.
CONCLUSION: Compared with the prepandemic period, the incidence of CDI decreased significantly during the COVID-19 pandemic. This finding suggests that strengthened infection prevention measures, improved antimicrobial stewardship, and adaptations in healthcare delivery may have contributed to reduced CDI transmission. Reinforcing these evidence-based foundational strategies may help mitigate the risk of CDI and other healthcare-associated infections during future public health emergencies.}, }
@article {pmid41934416, year = {2026}, author = {Sharma, S and Manikyam, HK}, title = {Emergence of SARS-CoV-2 omicron subvariant NB.1.8.1 in India: Genomic evolution, transmission patterns, and public health implications.}, journal = {The Indian journal of medical research}, volume = {163}, number = {1}, pages = {104-110}, pmid = {41934416}, issn = {0971-5916}, mesh = {India/epidemiology ; Humans ; *SARS-CoV-2/genetics/pathogenicity ; *COVID-19/epidemiology/transmission/virology/genetics ; *Public Health ; Evolution, Molecular ; *Spike Glycoprotein, Coronavirus/genetics ; Genome, Viral ; Retrospective Studies ; Mutation ; China/epidemiology ; }, abstract = {Background and objectives The NB.1.8.1 Omicron subvariant has demonstrated notable epidemiological relevance in India, though without evidence of a marked increase in severity compared to prior Omicron waves. Understanding its genomic trajectory and policy implications is critical. Methods This was a retrospective convergent mixed-methods study integrating genomic sequencing (GISAID, INSACOG), epidemiological counts (ICMR, WHO, CDC), and policy/advisory analysis (MoHFW, WHO-SEARO). Data were analysed across January-May 2025 using prevalence tracking, hospitalisation comparisons, and thematic policy review. Results Genomic analyses showed NB.1.8.1 carrying lineage-defining spike mutations (A435S, V445H, T478I) linked to transmissibility and immune escape. While prevalence rose in China, India reported <5% share. Hospitalisation burdens remained lower in India than in China. India's policy response showed increasing alignment between genomic surveillance outputs and subsequent public health advisories, with targeted booster promotion and enhanced surveillance in high-incidence States. Interpretation and conclusions NB.1.8.1 illustrates the dynamic evolutionary trajectory of SARS-CoV-2. India's adaptive genomic surveillance and flexible public health frameworks contributed to mitigating clinical severity, though surveillance gaps and rural under-reporting remain concerns. Sustained genomic tracking, booster equity, and real-time advisory mechanisms are needed to strengthen preparedness.}, }
@article {pmid41934421, year = {2026}, author = {Shakeel, A and Sircar, K and Popli, DB}, title = {Xerostomia after COVID-19 recovery: A preliminary investigation.}, journal = {The Indian journal of medical research}, volume = {163}, number = {1}, pages = {122-125}, pmid = {41934421}, issn = {0971-5916}, mesh = {Humans ; *Xerostomia/epidemiology/virology/etiology/physiopathology ; *COVID-19/complications/virology ; SARS-CoV-2/pathogenicity ; Female ; Male ; Middle Aged ; Adult ; Post-Acute COVID-19 Syndrome ; Aged ; Surveys and Questionnaires ; Betacoronavirus/pathogenicity ; Prevalence ; }, abstract = {Background and objectives Xerostomia, or dry mouth, was frequently reported during COVID-19 infection, but its persistence after recovery remains underexplored. This study aimed to assess the prevalence and duration of xerostomia following recovery from COVID-19 infection. Methods This observational study included 50 participants who had recovered from COVID-19. They were surveyed using a xerostomia assessment questionnaire and underwent the modified Schirmer test (MST) to measure their salivary flow rate. Results Overall, n=31(62%) of participants reported one or more xerostomia-related symptoms after recovery. "Feeling of dry mouth" (n=22, 44%) was the most common, followed by nocturnal water intake (n=18, 36%), difficulty swallowing dry food (n=7, 14%), and reliance on liquids during swallowing (n=6, 12%). Hyposalivation (MST <15 mm at 3 min) was observed in 10% (n=5) of participants, all of whom were infected during the second wave (Delta variant). A significant association was noted between self-reported dry mouth and MST findings (P=0.029). Symptoms persisted up to 15 months post-recovery. Interpretation and conclusions Xerostomia may persist after COVID-19 recovery, with potential implications for oral health. Early recognition and management are warranted.}, }
@article {pmid41934724, year = {2026}, author = {Hernández-Pizarro, HM and Prades-Colomé, A}, title = {The Spanish long-term care system reaches majority of age: A narrative review of evidence and lessons obtained.}, journal = {Health policy (Amsterdam, Netherlands)}, volume = {169}, number = {}, pages = {105620}, doi = {10.1016/j.healthpol.2026.105620}, pmid = {41934724}, issn = {1872-6054}, mesh = {Humans ; *Long-Term Care/economics/organization & administration ; Spain/epidemiology ; COVID-19/epidemiology ; Aged ; Pandemics ; SARS-CoV-2 ; Female ; *Pneumonia, Viral/epidemiology ; }, abstract = {BACKGROUND: Spain has one of the highest life expectancies at 65-years-old among OECD countries, yet only half of these years are expected to be in good health. Thus, many older people require support for carrying out activities of daily living. In response, the Spanish government established the Spanish long-term care (LTC) system in 2007.
OBJECTIVE: To review the published evidence from the analysis of the first 18 years of existence of the system.
METHODS: This study adopts a narrative literature review approach, drawing from academic and policy-oriented research on the Spanish LTC system.
RESULTS: The LTC system has improved the wellbeing of its beneficiaries -particularly in terms of health- and has reduced healthcare costs by lowering hospital admissions and primary care visits. However, it suffers from chronic underfunding and design flaws. Financial sustainability remains a challenge, especially due to low central Spanish government contributions and regional disparities. Nonetheless, the LTC system has yielded significant economic returns through job creation and increased female labour participation. LTC benefits have also influenced family decisions: reducing savings, increasing the supply of informal caregivers and delaying early retirement. The COVID-19 pandemic exposed structural vulnerabilities, particularly in residential care. Moreover, while the navigation across the LTC system ensures horizontal equity, inequity is documented in the form of providing the benefits.
CONCLUSIONS: After almost two decades of the Spanish LTC system, evidence calls for adequate and stable financing mechanisms to achieve sustainability. It should also expand towards service-based care, integrate with healthcare, and systematically measure quality-of-life outcomes.}, }
@article {pmid41935144, year = {2026}, author = {Rajesh Krishnan, A and Famiyeh, IM and Ahmad, A and Ji, PX and Sivachandran, N}, title = {Macular and retinal manifestations following COVID-19 vaccinations: a 2025 update systematic review and meta-analysis.}, journal = {Eye (London, England)}, volume = {40}, number = {7}, pages = {950-958}, pmid = {41935144}, issn = {1476-5454}, mesh = {Humans ; *COVID-19 Vaccines/adverse effects ; *Vaccination/adverse effects ; *COVID-19/prevention & control ; *Retinal Diseases/etiology/diagnosis/epidemiology ; SARS-CoV-2 ; }, abstract = {An increasing number of reports have linked COVID-19 vaccination to ocular complications, including retinal vascular occlusions, inflammatory disorders, and neuro-ophthalmic events. However, the spectrum and temporal associations of these ocular complications are not adequately understood. This study aims to characterise the types of retinal and macular complications, evaluate latency patterns, and assess the associations with COVID-19 vaccination from 2020 to 2025. We conducted a systematic review and meta-analysis according to the PRISMA 2020 guidelines. Studies reporting retinal or macular complications post-COVID-19 vaccination were searched via Ovid MEDLINE, Embase, and the Cochrane Library. Extracted data included study demographics, outcome, latency, and vaccine subtype. The risk of bias was assessed, and a random-effects meta-analysis was performed to estimate the pooled relative risk of ocular complications following vaccination. A total of 173 studies were included, with the most frequently reported outcome being retinal vascular occlusions (n = 107). The distribution of ocular complications was significantly different between COVID-19 vaccine and infection exposure (p = 0.014). Most complications occurred within the first month of exposure, particularly among mRNA vaccines, which had a significantly different adverse event rate across vaccine platforms (p = 0.0084). A meta-analysis resulted in a pooled relative risk of 2.40 (95% CI: 0.33-17.73) for retinal vein occlusion following vaccination; however, due to the uncertainty around the estimate, the association remains inconclusive. These findings support considering COVID-19 vaccination as a potential differential cause for patients with retinal vascular occlusions, highlighting the need for continued vaccine safety and surveillance.}, }
@article {pmid41935439, year = {2026}, author = {Alanazi, YA and Albilasi, B and Almaa, Z and Alqubaishi, AH and Alshammari, KH and Aljahdali, FK and Alsharif, A and Alanazi, OI and Abdulhadi, KO and Aljohani, R and Alsharif, A and Alghamdi, JF and Alsoud, AA and Alsharif, A and Alnafisah, MA}, title = {Paternal vaccine hesitancy and its impact on childhood immunization coverage in Saudi Arabia: A systematic review.}, journal = {Journal of infection and public health}, volume = {19}, number = {5}, pages = {103210}, doi = {10.1016/j.jiph.2026.103210}, pmid = {41935439}, issn = {1876-035X}, mesh = {Humans ; Saudi Arabia ; *Vaccination Hesitancy/psychology/statistics & numerical data ; *Fathers/psychology ; Male ; *Vaccination Coverage/statistics & numerical data ; *Vaccination/psychology/statistics & numerical data ; Health Knowledge, Attitudes, Practice ; }, abstract = {Vaccine hesitancy remains a challenge to achieving optimal childhood immunization coverage. This systematic review examined parental vaccine hesitancy in Saudi Arabia, with emphasis on paternal determinants and their association with vaccination uptake. Following PRISMA 2020 guidelines, databases were searched between January 2000 and January 2025. Hesitancy toward routine childhood vaccines was generally low (3%-20%), whereas hesitancy toward newer or non-mandatory vaccines, including COVID-19, influenza, and HPV, exceeded 50% in some settings. Studies reporting father-specific data indicated higher hesitancy among fathers, particularly regarding safety, novelty, and possible long-term effects. Common determinants included safety concerns, misinformation, social media influence, and low confidence in vaccine effectiveness. Hesitancy was associated with delayed schedules, incomplete immunization, and reduced uptake of optional vaccines. Vaccine hesitancy in Saudi Arabia appears vaccine-specific and influenced by sociocultural factors, with paternal attitudes playing a measurable role in immunization decision-making.}, }
@article {pmid41935699, year = {2026}, author = {Zheng, C and Zhu, J and Lu, Z and Jiang, L and Chen, F and Zhang, W and Jiang, Y}, title = {High-flow nasal oxygen versus conventional oxygen therapy in patients with hypoxemic COVID-19 pneumonia: A randomized controlled trials based meta-analysis.}, journal = {Respiratory medicine}, volume = {256}, number = {}, pages = {108806}, doi = {10.1016/j.rmed.2026.108806}, pmid = {41935699}, issn = {1532-3064}, mesh = {Humans ; *Oxygen Inhalation Therapy/methods ; *COVID-19/therapy/complications ; *Hypoxia/therapy/etiology ; Randomized Controlled Trials as Topic ; SARS-CoV-2 ; Pandemics ; *Pneumonia, Viral/therapy/complications ; Oxygen/administration & dosage ; Treatment Outcome ; Betacoronavirus ; *Coronavirus Infections/therapy/complications ; Blood Gas Analysis ; }, abstract = {BACKGROUND: Although the COVID-19 pandemic has ended, severe cases of COVID-19 pneumonia (pneumonia caused by SARS-CoV-2) are still common in clinical practice. These patients frequently suffer from hypoxemia, for which conventional oxygen therapy (COT) may be insufficient. High-flow nasal oxygen (HFNO) provides enhanced oxygen delivery, but its overall clinical benefits remain uncertain. Our meta-analysis assesses HFNO's effectiveness and safety compared to COT for treating COVID-19-related hypoxemia by combining data from RCTs.
METHODS: We thoroughly explored six databases to identify suitable RCTs that examined HFNO versus COT in COVID-19 hypoxemic patients. Mortality and intubation were the main outcomes, while secondary outcomes included hospitalization indicators and blood gas monitoring indicators following oxygen therapy.
RESULTS: Eight RCTs involving 2528 patients were included. HFNO therapy demonstrated significantly lower rates of total intubation (Risk ratio: 0.86 [0.78, 0.95], P = 0.003), as well as intubation at 7, 14, and 28 days compared with COT. Additionally, the HFNO group showed a shorter time to oxygen therapy de-escalation (MD: 3.53 [-4.50, -2.55] days, P < 0.00001). After oxygenation therapy, the HFNO group exhibited a lower respiratory rate (MD: 2.77 [-3.67, -1.88] breaths/min, P < 0.00001), PaCO2 (MD: 1.00 [-1.67, -0.33] mmHg, P = 0.003), and a higher SpO2/FiO2 ratio (MD: 47.00 [34.77, 59.23], P < 0.00001). Similar baseline characteristics and mortality rates were found between the two groups.
CONCLUSIONS: HFNO treatment demonstrated advantages over COT, with comparable mortality rates, reduced intubation requirements, and improved post-therapy monitoring metrics in patients with COVID-19-induced hypoxemia.}, }
@article {pmid41937007, year = {2026}, author = {García-Cesar, M and Cueto-Robledo, G and Roldan-Valadez, E and Torres-Rojas, MB and Navarro-Vergara, DI and Ruiz-Domínguez, D and Hernandez-Villa, L}, title = {Management of pulmonary arterial hypertension with intermediate-high-risk pulmonary embolism during pregnancy: Diagnostic challenges, catheter-directed thrombolysis, and intravenous treprostinil - A narrative review with an institutional case snapshot.}, journal = {Current problems in cardiology}, volume = {51}, number = {8}, pages = {103337}, doi = {10.1016/j.cpcardiol.2026.103337}, pmid = {41937007}, issn = {1535-6280}, mesh = {Humans ; Female ; Pregnancy ; *Epoprostenol/analogs & derivatives/administration & dosage/therapeutic use ; *Pulmonary Embolism/therapy/diagnosis/complications ; *Thrombolytic Therapy/methods ; *Pregnancy Complications, Cardiovascular/therapy/diagnosis ; Antihypertensive Agents/administration & dosage/therapeutic use ; Adolescent ; *Pulmonary Arterial Hypertension/diagnosis/therapy/complications ; }, abstract = {BACKGROUND: Maternal mortality from pregnancy-related pulmonary arterial hypertension (PAH) is estimated at 7-12%. The superimposition of pulmonary embolism (PE) and COVID-19 further compromises right-ventricular (RV) function. Pregnancy-compatible PAH pharmacotherapy and catheter-directed techniques show promise; however, their intersection remains undocumented.
METHODS: We performed a narrative review of imaging diagnosis, risk stratification, catheter-directed reperfusion, PAH-targeted pharmacotherapy, and multidisciplinary peripartum management of PAH complicated by acute PE during pregnancy. MEDLINE/PubMed, Embase, Scopus, and the Cochrane Library were searched up to March 2026. We also describe an institutional case from the Hospital General de México Dr. Eduardo Liceaga (Mexico City, Mexico).
RESULTS: Evidence supports echocardiography for initial assessment, CT pulmonary angiography for embolic/vascular evaluation, right-heart catheterization for hemodynamic determination, and catheter-directed thrombolysis for intermediate-high-risk PE when systemic thrombolysis is contraindicated. The institutional case describes a 17-year-old primigravida (24.6 weeks' gestation) with undiagnosed idiopathic PAH (mean pulmonary artery pressure 64 mmHg; pulmonary vascular resistance (PVR) 13.8 Wood units), intermediate-high-risk PE (thrombotic burden 37.5%), and COVID-19 pneumonia. Catheter-directed thrombolysis combined with sildenafil and intravenous treprostinil achieved substantial hemodynamic improvement (cardiac index 2.8 to 4.2 L/min/m²; PVR 13.8 to 6.7 Wood units). Elective cesarean at 37 weeks resulted in satisfactory maternal and neonatal outcomes.
CONCLUSIONS: Early, multidisciplinary approaches integrating invasive hemodynamics, catheter-directed thrombolysis, and pregnancy-compatible PAH therapy can decompress RV function and allow safe pregnancy continuation. Prospective international registries and pregnancy-specific PERT pathways are urgently needed.}, }
@article {pmid41937900, year = {2026}, author = {Kisielinski, K and Steigleder-Schweiger, C and Wagner, S and Korupp, S and Hockertz, S and Hirsch, O}, title = {Risks and benefits of face masks in children.}, journal = {Frontiers in pediatrics}, volume = {14}, number = {}, pages = {1679586}, pmid = {41937900}, issn = {2296-2360}, abstract = {INTRODUCTION: Children, a significant and vulnerable portion of the global population, are particularly susceptible to environmental factors.
METHODS: We conducted a systematic search and scoping review of 3,144 articles, including 107 publications from medical literature, to assess mask use in children during the 2020-2023 pandemic. We examined expected viral protection vs. scientific evidence and side effects, synthesizing findings with SWiM and GRADE frameworks for evidence certainty and the Cochrane adverse effects approach.
RESULTS: Masking children lacks ecological validity, with high-quality studies showing little real-world effectiveness against viruses. On the other hand, side effects can clearly be identified. Masks contain hazardous materials (carcinogens, heavy metals, organic compounds, and microplastic), impacting childreńs health by altering inhaled air (including elevated carbon dioxide) and causing many physical symptoms and bio-psychosocial issues (MIES, mask-induced exhaustion syndrome), akin to sick building syndrome. Toxicological assessments highlight risks to biology of the young. Evidence certainty is high for non-effectiveness, moderate for risks and side effects, and low to very low for viral protection or benefits in children.
CONCLUSIONS: With a negligible COVID-19 mortality rate in children (0.0003%) and no evidence of child-to-child or school-based transmission, masks offered little benefit during the pandemic. The documented adverse effects-respiratory impairment, toxicity, and health risks-outweigh any justification for their mandatory use. An individual risk-benefit analysis is essential (individual medical advice), but this review suggests avoiding this intervention in children because of its numerous downsides and the lack of proven efficacy. It is the responsibility of political leaders to address our findings.}, }
@article {pmid41939777, year = {2026}, author = {Sleman, S and Abid, OI and Abdullah, BJ and Abass, ZA and Ameen, MB}, title = {Safety and efficacy of major antiviral and immune therapies in pregnancy for maternal viral infections: evidence synthesis of maternal and neonatal outcomes.}, journal = {Frontiers in medicine}, volume = {13}, number = {}, pages = {1762439}, pmid = {41939777}, issn = {2296-858X}, abstract = {Antiviral safety and efficacy in pregnancy. Summarizing the key findings visually in a single high-impact figure. This will integrate pathogens, antivirals, maternal and neonatal outcomes, and evidence certainty.Flowchart titled "Graphical Abstract: Antiviral Safety & Efficacy in Pregnancy" summarizes evidence for antiviral treatments by infection. Green boxes (oseltamivir, acyclovir/valacyclovir, TDF/lamivudine, ART) indicate decreased maternal disease and no increase in congenital anomalies or preterm birth for influenza, HSV/VZV, HBV, and HIV. Yellow boxes for COVID-19 (paxlovid/remdesivir) show decreased maternal hospitalization with no proven risk to the fetus. Red boxes (tecovirimat for mpox, favipiravir for hemorrhagic fevers) highlight insufficient data or increased maternal risk with potential increase in congenital anomalies or preterm birth. Arrows indicate treatment progression and outcomes.}, }
@article {pmid41940074, year = {2026}, author = {Zhang, X and Liu, X and Zhou, Q and Yao, K}, title = {Extracellular vesicle-based delivery systems for nucleic acid therapeutics.}, journal = {Molecular therapy. Nucleic acids}, volume = {37}, number = {2}, pages = {102870}, pmid = {41940074}, issn = {2162-2531}, abstract = {Nucleic acid-based therapeutics, which involve the manipulation of genetic materials to treat or prevent diseases, have gained considerable attention, leading to the approval of medicines such as COVID-19 vaccines, patisiran (Onpattro), and nusinersen (Spinraza). However, their clinical application is hindered by challenges such as nuclease degradation, poor biodistribution, limited cellular uptake, and inefficient endosomal escape. Extracellular vesicles (EVs), which are natural nanoscale drug delivery systems derived from various eukaryotic and prokaryotic cells, offer a safe, efficient, specifically targeted, and non-pathogenic method for nucleic acid delivery. In this review, we summarize the classical methods and the latest research advances in EV preparation and nucleic acid loading. Additionally, we review the primary administration routes for nucleic acid-loaded EVs, such as intravenous, local, oral, intranasal, and inhalation delivery. By addressing these aspects, this review aims to guide the optimal design and clinical application of nucleic acid-loaded EVs.}, }
@article {pmid41940674, year = {2026}, author = {Jefferson, V and Endlich-Frazier, A and Letko, M}, title = {Exploring coronavirus cell entry with functional viromics.}, journal = {Journal of virology}, volume = {100}, number = {5}, pages = {e0172825}, pmid = {41940674}, issn = {1098-5514}, mesh = {Animals ; *Virus Internalization ; Humans ; *Coronavirus/physiology/genetics ; Zoonoses/virology ; *Coronavirus Infections/virology/transmission ; Chiroptera/virology ; Animals, Wild/virology ; }, abstract = {Over the past 2 decades, viral discovery has uncovered thousands of novel coronaviruses in wildlife, including viruses with high similarity to known human pathogens. As human coronaviruses emerge from cross-species transmission events involving wildlife and humans, their frequent discovery in wildlife suggests these viruses will continue to impact global health. Unfortunately, while viruses are discovered often, laboratory limitations have stymied research on experimentally assessing their zoonotic potential. Thus, new laboratory approaches and research mindsets are needed to functionally characterize the ever-growing virome. Here, we discuss several platforms we have developed and the resulting advancements made toward functionally annotating the virome, which we refer to collectively as "functional viromics." We also explore how these approaches may be adapted to assess other viral phenotypes and how laboratory-derived data sets on viral functions will improve next-generation models of zoonotic risk.}, }
@article {pmid41943131, year = {2026}, author = {Trigg, KL and Zhang, A and Wu, AW}, title = {Operational strategies among infectious disease clinical trial sites during pandemics: a scoping review.}, journal = {Trials}, volume = {27}, number = {1}, pages = {}, pmid = {41943131}, issn = {1745-6215}, mesh = {Humans ; *Pandemics ; COVID-19/epidemiology ; *Clinical Trials as Topic/organization & administration ; Pandemic Preparedness ; *Communicable Diseases/epidemiology/therapy ; SARS-CoV-2 ; }, abstract = {PURPOSE: The aim of this study is to examine documented strategies, challenges, and lessons related to clinical trial site operations during pandemics.
METHODS: This review focused on seven major pandemics: COVID-19, HIV/AIDS, Ebola, SARS, MERS, H1N1, and Zika. Searches were conducted using PubMed and Embase between September 2024 and February 2025, yielding 7572 unique records. After dual screening, 47 articles met inclusion criteria, with an additional 8 identified through citation searching, for a total of 55. Non-English articles were translated using Google Translate. Data were extracted and thematically analyzed through iterative familiarization, keyword identification, coding, and consensus discussion.
RESULTS: Of the 55 included articles, most originated from the European Region (61%) and the Americas (52%), with additional representation from Africa (19%), the Western Pacific (8%), Eastern Mediterranean (5%), and Southeast Asia (5%). Percentages exceed 100% because several studies reported across multiple regions. Study designs were predominantly descriptive (60%) with fewer randomized controlled trials (22%), observational (18%), and cohort studies (2%). COVID-19 accounted for the majority of articles (58%), followed by HIV/AIDS (20%), Ebola (13%), H1N1 (2%), and Zika (4%); no eligible studies addressed SARS or MERS. Operational themes included policy (73%), resources (55%), networks (53%), infrastructure (47%), technology (45%), study design (31%), and communication (22%). Publications peaked during pandemic years, reflecting intensified research activity. Reported challenges included protocol-practice misalignment, fragmented infrastructure, regulatory bottlenecks, and under-resourced sites. Reported practices included early site engagement in protocol development, streamlined ethics and contracting processes, investment in digital and decentralized infrastructure, and cross-trained staff. Gaps included limited use of adaptive trial designs and insufficient cross-national collaboration.
CONCLUSIONS: Clinical trial sites implemented systemic operational changes to sustain research during pandemics. Key lessons include the need to strengthen infrastructure, workforce capacity, and institutional adaptability, and the need to address persistent global inequities. Institutionalizing early site engagement, adaptive designs, and equitable collaboration will be essential to enable timely and resilient clinical research responses in future pandemics.}, }
@article {pmid41943161, year = {2026}, author = {Ankomah, M and Abekah-Nkrumah, G and Okai, GA and Yarney, L and Baku, AAA}, title = {An account of health systems resilience to emergencies in Africa: a scoping review.}, journal = {Globalization and health}, volume = {22}, number = {1}, pages = {}, pmid = {41943161}, issn = {1744-8603}, mesh = {Humans ; *COVID-19/epidemiology ; Africa/epidemiology ; *Delivery of Health Care/organization & administration ; Public Health Infrastructure ; Hemorrhagic Fever, Ebola/epidemiology/therapy ; *Emergencies ; Digital Health ; Disease Outbreaks ; }, abstract = {BACKGROUND: Healthcare systems across Africa continue to face a wide range of shocks. Using Ebola and COVID-19 as case studies, this study examines the various resilience strategies implemented in different countries and synthesises them in a way that can serve as a practical guide to make health systems in Africa more resilient for future emergencies. METHODOLOGY: The study is a scoping review that synthesises evidence from peer-reviewed journal articles and grey literature, structured around a conceptual framework developed by the authors. We focused on various aspects of health system resilience during the Ebola outbreaks and the COVID-19 pandemic in Africa. KEY FINDINGS: This review identifies six key elements vital to health system resilience in Africa: strong leadership and governance, equitable social protection, digital health innovation, trusted community engagement, a sustainable and flexible workforce, and adaptable infrastructure. However, several gaps must be addressed to strengthen resilience against future health emergencies. While political commitment and coordination mechanisms improved integration and awareness, poor decentralisation, weak accountability, and fragmented governance undermined effectiveness. Social protection initiatives and digital tools enabled rapid responses but persistent inequities in access and data gaps hindered their reach. Telemedicine and workforce expansion showed adaptability but lacked sustainability. Community trust and local innovations supported resilience, yet their potential was curtailed by top-down strategies and insufficient institutional support. CONCLUSION: This review emphasises the need for equitable, inclusive, and coherent strategies to strengthen resilient health systems in Africa. It calls for a shift from reactive, fragmented approaches to a long-term system-wide transformation grounded in inclusive governance, equitable social protection, robust digital health systems, a sustainable workforce, integrated and trusted community engagement, and adaptive physical infrastructure. Importantly, the review affirms that addressing deep-seated political, structural, and social inequities is crucial to ensuring resilience does not become an empty concept. The framework developed from this review provides a roadmap for policymakers to embed resilience as a core, institutional principle of long-term health system transformation, rather than a temporary emergency measure.}, }
@article {pmid41943240, year = {2026}, author = {Zhu, W and Qian, J and Peng, M and Li, Y and Hu, J}, title = {Post-COVID-19 Area Postrema Syndrome With SARS-CoV-2 in CSF: A Dual-Case Report and Review of the Literature.}, journal = {Immunity, inflammation and disease}, volume = {14}, number = {4}, pages = {e70421}, pmid = {41943240}, issn = {2050-4527}, support = {ZDXM2024003//Wenshan Prefecture People's Hospital 2024 Annual Internal Scientific Research Key Projects/ ; }, mesh = {Humans ; Female ; *COVID-19/complications/cerebrospinal fluid ; *SARS-CoV-2 ; *Area Postrema/pathology/virology ; Middle Aged ; Betacoronavirus ; Magnetic Resonance Imaging ; *Neuromyelitis Optica/cerebrospinal fluid ; Immunoglobulin G/cerebrospinal fluid ; Aquaporin 4/immunology ; Autoantibodies/cerebrospinal fluid ; Adult ; }, abstract = {BACKGROUND: Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune astrocytopathy characterized by inflammatory demyelinating lesions in the central nervous system. Area postrema syndrome (APS), marked by intractable nausea, vomiting, and hiccups, is a recognized but less common initial manifestation. Post-infectious autoimmunity triggered by SARS-CoV-2 has been increasingly associated with NMOSD pathogenesis; however, the clinical significance of direct viral neuroinvasion and its relationship to divergent patient outcomes remains poorly understood.
METHODS: We report two female patients who developed isolated APS shortly after COVID-19 infection. Both patients underwent comprehensive neurological evaluation, including brain and spinal magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) analysis with metagenomic next-generation sequencing (mNGS), and serological testing for aquaporin-4 immunoglobulin G (AQP4-IgG), myelin oligodendrocyte glycoprotein immunoglobulin G (MOG-IgG), and glial fibrillary acidic protein immunoglobulin G (GFAP-IgG) using cell-based assays. Clinical outcomes were compared in the context of antibody serostatus and treatment strategies. A review of the relevant literature on post-COVID NMOSD was also performed.
RESULTS: Both patients presented with intractable vomiting and hiccups following SARS-CoV-2 infection, and MRI demonstrated isolated T2/FLAIR hyperintense lesions in the dorsal medulla consistent with area postrema involvement. SARS-CoV-2 RNA sequences were detected in the CSF of both patients via mNGS, suggesting direct viral neuroinvasion or blood-brain barrier compromise. Despite similar initial presentations, their outcomes diverged dramatically. Patient 1 was AQP4-IgG negative, responded well to immunotherapy with intravenous immunoglobulin and corticosteroids followed by mycophenolate mofetil maintenance, and remained relapse-free at 12-month follow-up with significant lesion regression on MRI. Patient 2 was AQP4-IgG positive in both serum and CSF, and despite acute treatment, experienced a fatal relapse 6 months later with longitudinally extensive transverse myelitis while on low-dose prednisone monotherapy.
CONCLUSIONS: Isolated APS may represent an important yet under-recognized manifestation of post-COVID-19 autoimmune neuroinflammation. Detection of SARS-CoV-2 in CSF supports a role for direct viral neuroinvasion as a localized inflammatory stimulus. AQP4-IgG serostatus serves as a critical prognostic determinant: seronegativity is associated with a benign, monophasic course, whereas seropositivity mandates prompt initiation of potent immunosuppressive therapy to prevent devastating relapses. Clinicians should maintain a high index of suspicion for NMOSD in patients with unexplained persistent vomiting following COVID-19, and perform urgent neuroimaging and antibody testing for early risk stratification.}, }
@article {pmid41943416, year = {2026}, author = {Al-Momani, H and Alsheikh, A and Balawi, HA and Balawi, DA and Aolymat, I and Khasawneh, AI and Tabl, H and Zueter, AM}, title = {An Emerging Global Threat After The COVID-19 Pandemic: Monkeypox Similarities and Differences.}, journal = {Polish journal of microbiology}, volume = {75}, number = {1}, pages = {20-32}, pmid = {41943416}, issn = {2544-4646}, mesh = {Humans ; *COVID-19/epidemiology ; *Mpox, Monkeypox/epidemiology/transmission/prevention & control/virology ; Pandemics ; SARS-CoV-2 ; Monkeypox virus/classification ; Global Health ; Animals ; }, abstract = {During the post COVID-19 pandemic, monkeypox (mpox) has returned and become a significant concern for health. The epicenter of clade I mpox is within the Democratic Republic of Congo (DRC) where two subclade consists of Ia and Ib are now in circulation and maintain their transmission from human to human. As of late 2024, worldwide mpox cases had surpassed 100,000 across 127 nations, with the World Health Organization reporting over 260 fatalities. CDC recently reported that the spread of clade I is no longer limited to Africa, highlighting its growing potential to become a pandemic. The World Health Organization (WHO) declared the disease an international public health emergency on August 14, 2024. This undoubtedly raises the question of whether global outbreaks of mpox represent the onset of another full-blown pandemic. Although Monkeypox can lead to other public health issues (especially in areas where it is not usually endemic), it is unlikely to become a pandemic on the same scale as COVID-19. Moreover, it is more containable due to vaccine availability, its transmission dynamics, and lessons learned from COVID-19. Nonetheless, it is still important to remain vigilant to prevent outbreaks from spreading, particularly in vulnerable populations and regions with limited healthcare resources.}, }
@article {pmid41944494, year = {2026}, author = {Gao, T and Liu, J and Du, Y and Yang, J and Sheng, G and Zhou, L and Qiu, Y and Zhang, Q and Duan, M}, title = {Association Between Acute Gastrointestinal Injury and Mortality Risk in Critically Ill Patients: A Systematic Review and Meta-Analysis.}, journal = {Clinical and translational gastroenterology}, volume = {17}, number = {6}, pages = {e01028}, doi = {10.14309/ctg.0000000000001028}, pmid = {41944494}, issn = {2155-384X}, mesh = {Humans ; *Critical Illness/mortality ; Intensive Care Units/statistics & numerical data ; *Gastrointestinal Diseases/mortality/diagnosis ; Hospital Mortality ; Risk Factors ; Risk Assessment ; Severity of Illness Index ; }, abstract = {INTRODUCTION: To systematically evaluate the association between severe acute gastrointestinal injury (AGI)/gastrointestinal dysfunction score (GIDS) and mortality risk in adult intensive care unit (ICU) patients.
METHODS: We conducted a systematic review and meta-analysis. We searched the MEDLINE, Embase, Web of Science, and Cochrane Central Register of Controlled Trials databases for articles published between January 2016 and January 2025. Observational cohort studies reporting mortality outcomes in ICU patients with AGI (grades III-IV vs 0-II) or GIDS (scores 2-4 vs 0-1) were included. Studies focusing on specific subpopulations such as patients after cardiac surgery or with COVID-19 were excluded to maintain population homogeneity. The primary outcome was short-term all-cause mortality. Random-effects meta-analysis using inverse-variance weighting was performed using odds ratios (ORs) with 95% confidence intervals (CIs).
RESULTS: Eight studies involving 2,786 critically ill patients were included. The pooled analysis demonstrated that severe GI dysfunction (AGI III-IV or GIDS 2-4) was significantly associated with increased mortality risk (OR 2.78, 95% CI 2.19-3.52, I 2 = 42.5%). Subgroup analyses by outcome type (28-day/ICU mortality: OR 2.70, 95% CI 2.04-3.58; in-hospital mortality: OR 4.27, 95% CI 1.63-11.18) and scoring system (AGI: OR 2.75, 95% CI 2.07-3.67; GIDS: OR 3.18, 95% CI 1.43-7.07) showed consistent results. The addition of a large-scale prospective Chinese study (n = 1,102) and a multicenter European cohort (n = 540) strengthened the findings and broadened generalizability.
DISCUSSION: Severe AGI is strongly associated with increased mortality in critically ill patients. Early recognition and assessment of GI dysfunction using standardized grading systems may facilitate risk stratification and guide clinical management.}, }
@article {pmid41946616, year = {2026}, author = {Shammout, M and Abdullah, J and Shammout, A and Williams, R and McMillan, K}, title = {Altered sensation of the inferior alveolar nerve in sagittal spilt osteotomies: a review of cases at a major UK centre over 10 years.}, journal = {The British journal of oral & maxillofacial surgery}, volume = {64}, number = {5}, pages = {350-357}, doi = {10.1016/j.bjoms.2026.03.004}, pmid = {41946616}, issn = {1532-1940}, mesh = {Humans ; Female ; Retrospective Studies ; Adult ; *Mandibular Nerve Injuries/etiology/epidemiology ; Male ; United Kingdom/epidemiology ; *Osteotomy, Sagittal Split Ramus/adverse effects ; *Postoperative Complications/epidemiology/etiology ; Risk Factors ; Middle Aged ; Mandibular Nerve ; *Trigeminal Nerve Injuries/etiology ; }, abstract = {Inferior alveolar nerve (IAN) injuries are common complications of orthognathic surgery, with incidences reported from 0% to 85% due to inconsistent definitions, assessment methods and follow-up protocols. These limitations hinder comparisons, emphasising the need for standardised evaluation. This 10-year retrospective cohort study investigates IAN injury rates following mandibular osteotomies, focusing on medium-long term outcomes and risk factors. A retrospective cohort study was conducted at a tertiary orthognathic centre (2014-2024) on sagittal split osteotomies, performed either as stand-alone or as part of bimaxillary surgeries. Altered sensation was assessed via patient-reported outcomes during clinical follow ups (0-60+ months). While a final review was typically conducted at 6 months, extended follow ups addressed nerve symptoms, revision surgeries, or COVID-19 disruptions. Chi squared tests, Fisher's exact test and odds ratios evaluated associations with demographics, split quality, and nerve injuries. The primary outcome was altered sensation at ≥6 months. Of 221 procedures, 75.6% (n = 167) had follow ups ≥6 months, with 44.3% (n = 74/167) reporting altered sensation, primarily in the lower lip. Rates were 49% (n = 49/100) at 6-12 months, 50% (n = 13/26) at 13-18 months, and 29.2% (12/41) beyond 18 months. Females (OR = 1.07) and the 41-50 age group (50%, n = 2/4) showed slightly increased sensory changes, although they were not statistically significant. Unsatisfactory splits had higher altered sensation rates (60%, n = 6/10) compared with satisfactory splits (43.9%, n = 65/148) although these were not statistically significant (p = 0.15). Among documented nerve injuries, 100% (n = 7) resulted in sensory changes at ≥6 months. Altered sensation affected 44.3% (74/167); non-standardised follow up limits interpretation and supports standardised neurosensory reporting.}, }
@article {pmid41947042, year = {2026}, author = {Sahu, D and Van Nynatten, LR and Tweddell, D and Daley, M and Fraser, DD}, title = {Computational proteomics to enhance personalized treatment of COVID-19 and Long COVID.}, journal = {Clinical proteomics}, volume = {23}, number = {1}, pages = {}, pmid = {41947042}, issn = {1542-6416}, abstract = {The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to significant global health burden, including both acute infections and persistent post-acute sequelae, also known as Long COVID (LC) in survivors. While clinical management has reduced case-fatality rates, a substantial proportion of patients develop LC, a heterogeneous syndrome with long-term symptoms. This complex continuum requires therapeutic strategies for both the acute and chronic phases. Plasma proteomics has emerged as a powerful tool in precision medicine, offering insights into systemic molecular changes and disease trajectories. Using targeted and untargeted proteomic analyses, researchers can identify disease-relevant pathways, perform cellular deconvolution to assess tissue-specific contributions, and pinpoint therapeutic targets for both acute infection and persistent symptoms. Combined with bioinformatics and machine learning, these proteomic insights support biomarker discovery and drug repurposing strategies.}, }
@article {pmid41947427, year = {2026}, author = {Myer, A and Calfee, MW and Monge, M and Abdel-Hady, A and Aslett, D and Ratliff, KM}, title = {Exploring Surrogate Selection for Virucidal Aerosol Testing: A Qualitative Analysis.}, journal = {Environmental science & technology}, volume = {60}, number = {15}, pages = {11202-11217}, doi = {10.1021/acs.est.5c18416}, pmid = {41947427}, issn = {1520-5851}, mesh = {Aerosols ; Humans ; }, abstract = {The COVID-19 pandemic heightened interest in the development and testing of virucidal chemistries and technologies for use in indoor environments. Direct testing of pathogens often requires a high-level biosafety containment, which can restrict performance evaluations to smaller scales that may have limited translatability to the complexities of real-world indoor environments. Therefore, using viral surrogates that are safer to work with than target pathogens offers many potential benefits, including aerosol testing in more realistic conditions. This scoping review analyzes surrogate selection and use across aerosol, surface, and suspension-based tests and identifies bridges in surrogate selection considerations. A qualitative analysis of 133 studies was conducted to highlight trends, knowledge gaps, and future directions toward standardized surrogate selection frameworks. This review finds that Enterobacteria phage MS2 (MS2) and other bacteriophages are commonly used due to their practicality and safety. There are limited examples of concurrent pathogen and surrogate testing to assess suitability, which is highly context-dependent on the test conditions. Beyond virucide testing, the surrogate selection considerations discussed herein are informative for research on the persistence, transmission, transport, behavior, and nonchemical management of airborne viruses.}, }
@article {pmid41948023, year = {2026}, author = {Alrashidi, Y and Sriram, S and Beek, MA and Fadlalmola, HA and Albadrani, M}, title = {Work-related musculoskeletal disorders among gig-based food delivery workers: a systematic review and meta-analysis.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1788523}, pmid = {41948023}, issn = {2296-2565}, mesh = {Humans ; *Musculoskeletal Diseases/epidemiology ; Risk Factors ; *Occupational Diseases/epidemiology ; Working Conditions ; Prevalence ; }, abstract = {BACKGROUND: The digital economy has spurred gig work, especially in food delivery, which grew during COVID-19. However, gig workers face occupational hazards like traffic accidents, poor ergonomics, and unsafe conditions, leading to work-related musculoskeletal disorders (WMSDs). Studies show high rates of back and neck pain among delivery riders due to physical strain, repetitive motions, and long hours. WMSDs reduce productivity and increase healthcare costs. This review examines WMSD prevalence, risk factors, and related issues like accidents and violence among food delivery workers.
METHODS: We searched for relevant articles up to June 2025 from PubMed, Scopus, and Web of Science. Two independent reviewers extracted data from the selected studies, including baseline information, outcomes, and prevalence of WMSDs. All data analyses were performed using R version 4.3.3.
RESULTS: After removing 1,013 duplicate records, we retained 1,279 for screening. Following a thorough review, we identified 23 eligible entries for inclusion in our study. As per our analysis, delivery workers face high injury prevalence: lower back (43%), shoulder (39%), neck (30%), upper back (24%), and RTA (25%). Risk factors include gig economy systemic vulnerabilities, prolonged static postures, vibration exposure, open-door vehicles, and dangerous traffic practices. Different forms of violence (physical, verbal, and psychological) affected delivery workers, while exploitation and discrimination were particularly evident among minorities.
CONCLUSION: This review demonstrated a high burden of WMSDs among delivery workers, who face serious hazards like injuries, accidents, and violence due to precarious gig economy conditions, time pressures, and poor safety measures. This study provides the first quantitative pooled estimates of WMSD prevalence among food delivery workers, along with an additional narrative synthesis of traffic accidents and workplace violence.}, }
@article {pmid41948684, year = {2026}, author = {Mangahas, AM and Chang, M and Husain, IA}, title = {The Effect of COVID-19 on Voice Quality: A Systematic Review.}, journal = {World journal of otorhinolaryngology - head and neck surgery}, volume = {12}, number = {2}, pages = {218-227}, pmid = {41948684}, issn = {2589-1081}, abstract = {OBJECTIVES: To determine the effect of COVID-19 on voice by evaluating acoustic, aerodynamic, auditory-perceptual, and patient-reported measurements for COVID-19 patients compared to controls.
DATA SOURCES: A systematic review was conducted using PubMed and Embase.
REVIEW METHODS: Studies were reviewed for acoustic, aerodynamic, auditory-perceptual, and patient-reported outcomes.
RESULTS: Seven studies met criteria. There were 790 patients diagnosed with COVID-19 and 484 controls. Acoustic measurements revealed that COVID-19 patients had an increased harmonic-to-noise ratio (HNR) (27.14 vs. 41.37 dB), and increased fundamental frequency (177.66 vs. 172.81 Hz), jitter (0.73 vs. 0.31), and shimmer (4.43 vs. 3.42). Auditory-perceptual measurements indicated that COVID-19 patients had an increased Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) score (11.46 vs. 2.15). COVID-19 patients also had an increased Voice Handicap Index (VHI-10) score (4.89 vs. 1.59). Finally, COVID-19 patients had a statistically significant decrease in maximum phonation time compared to controls (9.94 s vs. 16.32 s, p = 0.01).
CONCLUSIONS: Although maximum phonation time was the only statistically significant measurement, other measurements were worse for COVID-19 patients. The current research suggests negative effects of COVID-19 on the voice; however, this is the first systematic review to summarize its effects with measurable outcomes. More studies with vocal measurements taken at different time points following infection are needed to understand the full long-term effect of COVID-19 on the voice. Additionally, studies evaluating voice quality for mild cases of COVID-19 with comparison to healthy controls are needed to understand its prevalence and effect as the severity of COVID-19 decreases.}, }
@article {pmid41949759, year = {2026}, author = {Kleinert, S}, title = {[Cardiovascular risk in inflammatory rheumatic diseases : Evidence-based strategies for risk reduction in rheumatologic practice].}, journal = {Zeitschrift fur Rheumatologie}, volume = {85}, number = {4}, pages = {307-316}, pmid = {41949759}, issn = {1435-1250}, mesh = {Humans ; *Cardiovascular Diseases/prevention & control/diagnosis/etiology ; Evidence-Based Medicine ; *Antirheumatic Agents/therapeutic use ; Risk Reduction Behavior ; *Rheumatic Diseases/drug therapy/complications ; Heart Disease Risk Factors ; *Rheumatology/standards ; Risk Factors ; Risk Assessment ; }, abstract = {Patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA) have a persistently increased cardiovascular (CV) risk and higher mortality, independently of traditional CV risk factors. Effective control of inflammation reduces CV events, whereas glucocorticoids increase the risk in a dose- and duration-dependent manner, even at ≤ 5 mg prednisolone/day. Disease-modifying antirheumatic drugs especially tumor necrosis factor (TNF) inhibitors, are largely protective through the reduction of systemic inflammation. For patients receiving Janus kinase (JAK) inhibitors or long-term glucocorticoid therapy, a structured CV risk assessment and guideline-based management of modifiable risk factors (including lipid optimization/statin therapy) are essential. Primary prevention should be based on the cardiovascular prevention guidelines of the European Society of Cardiology (ESC). Vaccinations (influenza, COVID-19, pneumococcus, respiratory syncytial virus, zoster) represent an effective pillar of CV prevention in populations at cardiovascular risk; however, evidence in patients with inflammatory rheumatic diseases is still lacking. The main challenge for CV prevention remains implementation: digital clinical reminders/decision support systems and multicomponent strategies can improve the implementation of recommendations.}, }
@article {pmid41951240, year = {2026}, author = {Ananth, S and Alimani, GS and Boccabella, C and Khaleva, E and Hansel, J and Wang, R and Roberts, G and Kosmidis, C and Bossios, A and Vestbo, J and Papageorgiou, E and Papadopoulos, NG and Beloukas, A and Mathioudakis, AG}, title = {Prevalence of respiratory viruses in stable and acute asthma: a systematic review and meta-analysis.}, journal = {European respiratory review : an official journal of the European Respiratory Society}, volume = {35}, number = {180}, pages = {}, pmid = {41951240}, issn = {1600-0617}, mesh = {Humans ; *Asthma/virology/epidemiology/diagnosis ; Prevalence ; *Respiratory Tract Infections/virology/epidemiology/diagnosis ; Acute Disease ; Child ; *Virus Diseases/epidemiology/virology ; Adult ; Risk Factors ; }, abstract = {BACKGROUND: Respiratory viruses, frequently detected in asthma, are associated with worse outcomes. This meta-analysis systematically quantifies the prevalence of respiratory viruses in stable and acute asthma, across children and adults, and explores factors associated with increased viral burden through meta-regression.
METHODS: This prospectively registered meta-analysis (PROSPERO-CRD42023375108) included studies employing molecular techniques to assess respiratory virus prevalence in asthma. Three databases were searched in August 2024. Risk of bias and certainty of evidence were assessed. We performed random-effects meta-analysis of proportions.
RESULTS: We included 111 eligible studies. Moderate-certainty evidence indicated a pooled prevalence of any respiratory virus of 33.9% (95% confidence interval 24.8-43.7%) in children and 23.0% (12.9-35.0%) in adults with stable asthma. In acute asthma, prevalence increased to 58.8% (52.5-65.0%) in children and 49.9% (41.2-58.5%) in adults (moderate certainty). Rhinovirus was the most frequently identified virus, especially in acute asthma (45.0% in children versus 21.2% in adults). Respiratory syncytial virus and bocavirus were more common in younger children, while coronavirus and influenza were more frequently detected in adults; respiratory syncytial virus peaked in older adults too. A higher prevalence of influenza virus B and adenovirus in children, and of influenza virus A and parainfluenza 2 in adults with severe versus non-severe acute asthma suggests a potential association with more severe acute attacks.
CONCLUSION: Respiratory viruses are common in both stable and acute asthma. This suggests that the diagnostic value of a positive viral test during acute episodes may be limited and could benefit from complementary biomarkers to improve interpretation.}, }
@article {pmid41951549, year = {2026}, author = {Scheid, PL and Padi, D and Schvach, H and Scheid, SE}, title = {Application of Telemedicine for Mission Support-Importance of a Cost-Benefit Analysis.}, journal = {Telemedicine journal and e-health : the official journal of the American Telemedicine Association}, volume = {32}, number = {7}, pages = {682-691}, doi = {10.1177/15305627261440753}, pmid = {41951549}, issn = {1556-3669}, mesh = {Cost-Benefit Analysis ; Humans ; *Telemedicine/economics/organization & administration ; Cost-Effectiveness Analysis ; *COVID-19/epidemiology ; *Medical Missions/organization & administration/economics ; Digital Health ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Digital health is more relevant now than ever before, and interventions have a clear potential to improve the quality of care while reducing health care costs. Telemedicine has emerged as a transformative approach to health care delivery, particularly accelerated by the COVID-19 pandemic. In mission environments, telemedicine increasingly supports the management of acute injuries, chronic conditions, predeployment screening, and follow-up assessments, often using low-bandwidth store-and-forward modalities.
METHOD: By reviewing existing literature and considering several different (heterogeneous) programs for "telemedicine for mission support," the key performance indicators are explored to evaluate telemedicine in missions, following its implementation. Both acute and chronic care use cases, as well as operational, clinical, and technical determinants of feasibility, were considered.
RESULTS: This article presents the clinical, operational, and economic benefits of "telemedicine in missions" and the metrics for a comprehensive cost-effectiveness analysis or cost-benefit analysis, considering its economic and clinical impacts.
CONCLUSIONS: Telemedicine in missions shows considerable differences from other telemedicine applications depending on the actors and the resulting circumstances. Considering the heterogeneity of the metrics provided, even within the field of "telemedicine in missions," the analyses have to be conducted in accordance with the encountered conditions. Nevertheless, a set of metrics can be applied to nearly all use cases across the different applications and actors. A mission-adaptable minimum data set is proposed to support standardized evaluation across diverse operational contexts.}, }
@article {pmid41951954, year = {2026}, author = {King, R and Ford, T and Coleman, Z and Hammond, E and Henley, D and Hirschtick, JL}, title = {Racial Disparities in Long COVID: Why Black Americans are Likely Underrepresented in Long COVID Estimates.}, journal = {Journal of racial and ethnic health disparities}, volume = {}, number = {}, pages = {}, pmid = {41951954}, issn = {2196-8837}, abstract = {In this conceptual paper, we posit that Black Americans are likely underrepresented in current Long COVID data estimates and explore potential reasons for this underrepresentation, with the purpose of beginning a critical dialogue within the Long COVID research community on this topic. Throughout the COVID-19 pandemic, Black individuals were 10% more likely to acquire SARS-CoV-2 and twice as likely to be hospitalized with COVID-19 than White individuals, increasing their risk for Long COVID. Nevertheless, studies based on national surveys and electronic health records often report lower Long COVID prevalence estimates for Black vs. White populations. Factors contributing to this discrepancy may include lack of Long COVID awareness, limited generalizability of existing studies, barriers to diagnosis, and medical racism and mistrust. Addressing these issues requires a comprehensive approach that includes creating targeted Long COVID awareness campaigns, updating the mode and breadth of data collection activities, reducing diagnostic barriers, and ultimately tackling the systemic racism that underlies these health inequities. Accurate representation in data is essential for understanding the full impact of Long COVID and developing interventions that are equitable and effective.}, }
@article {pmid41952158, year = {2026}, author = {Zhang, Y and Yu, X and Li, P and Ouyang, Y and Zhu, L and Luo, F}, title = {Targeting immunosenescence in lung diseases: mechanistic insights and clinical interventions.}, journal = {BMC medicine}, volume = {24}, number = {1}, pages = {}, pmid = {41952158}, issn = {1741-7015}, support = {No. W2411076//International Cooperation and Exchange of the National Natural Science Foundation of China/ ; }, mesh = {Humans ; *Immunosenescence/immunology ; *Lung Diseases/immunology/therapy ; Immunotherapy/methods ; }, abstract = {Immunosenescence, the age-related decline in immune function, plays a crucial role in the pathogenesis and progression of lung diseases, including chronic obstructive pulmonary disease, lung cancer, pulmonary fibrosis, asthma, and respiratory tract infections. This comprehensive review examines the hallmarks of immunosenescence, and illustrates the association between immunosenescence and the pathogenesis of lung diseases. In addition, we discuss current and emerging therapeutic strategies that have been evaluated in human clinical trials for targeting immunosenescence in lung diseases. Specifically, this review provides in-depth insights into the therapeutic strategies, including senolytics and senomorphics, immunotherapy, stem cell therapy, thymic rejuvenation, probiotics, and lifestyle. We also highlight the potential of personalized approaches integrating multi-omics data and artificial intelligence to guide biomarker-driven interventions, enabling truly personalized therapeutic strategies. Finally, this review underscores the imperative for rigorously designed clinical trials to develop and validate interventions that specifically target immunosenescence, with the ultimate goal of improving clinical outcomes for the aged population with lung diseases.}, }
@article {pmid41952170, year = {2026}, author = {Selby, A and Sutton, A and Bamford, E and Booth, A}, title = {Factors and mitigating strategies impacting receipt of healthcare by the Deaf community: an umbrella review.}, journal = {BMC health services research}, volume = {26}, number = {1}, pages = {}, pmid = {41952170}, issn = {1472-6963}, support = {NIHR207088//National Institute for Health and Care Research/ ; }, mesh = {Humans ; *Health Services Accessibility ; *Persons with Hearing Disabilities ; Sign Language ; Health Literacy ; Medical Interpreting ; Deaf Culture ; Communication Barriers ; Healthcare Disparities ; *Deafness ; }, abstract = {BACKGROUND: Despite over 70 million Deaf people using sign languages worldwide, their ability to access and receive health services remains disproportionately limited. The Deaf community commonly encounter reduced access to preventive care compared to the hearing population. This umbrella review aims to collate and appraise systematic reviews examining factors and mitigating strategies influencing Deaf people’s receipt of healthcare. METHODS: The protocol was registered in PROSPERO (CRD42024563083). Eligible systematic reviews investigated factors affecting healthcare receipt among the Deaf communities in any Organisation for Economic Co-operation and Development (OECD) country. Databases searched included MEDLINE, Embase, Cochrane Database of Systematic Reviews, CINAHL, PsycINFO, Science Citation Index, Social Sciences Citation Index, and PROSPERO. Screening, data extraction, and quality appraisal (AMSTAR 2) were undertaken independently by reviewers, with disagreements resolved by consensus. Data were synthesised narratively using a purpose-specific conceptual framework, categorising factors as individual or environmental. RESULTS: From 3,749 records, 32 systematic reviews were included. Most reviews (78%) were rated critically low in quality. Individual-level barriers were dominated by reduced health literacy (reported in 26 reviews), including inadequate access to sign language health information, limited family awareness, and poorer knowledge of medicines and preventive practices. Socioeconomic status, rural residence, minority ethnic background and limited family support were also linked to reduced healthcare access. Environmental factors included communication barriers, low Deaf awareness among healthcare professionals and shortages of qualified interpreters, all of which fostered Deaf people’s mistrust and disengagement with healthcare. Inadequate recording of communication needs, inaccessible complaints processes and COVID-19 policies further exacerbated inequalities. Strategies identified included sign language–adapted health education, interpreter provision, telehealth services, and specialist Deaf health clinics with interpreters, however few reviews offered evidence for effectiveness. CONCLUSIONS: Deaf people experience persistent, multifactorial barriers to equitable healthcare, driven by low health literacy, social disadvantage, poor communication support and systemic failings. Current evidence is largely of low methodological quality, underscoring the need for robust, co-produced research with Deaf communities. Priority areas include redesigning healthcare processes for accessible communication, expanding interpreter provision, and embedding Deaf awareness training into professional education to achieve systemic change.}, }
@article {pmid41952380, year = {2026}, author = {Pineschi, M and Rossi, S and Butini, S and Gemma, S and Carullo, G and Campiani, G}, title = {Beyond the Shadow of Indole: Medicinal Chemistry of Indolizines and Isoindolinones in the Fight Against Infectious Diseases.}, journal = {Archiv der Pharmazie}, volume = {359}, number = {4}, pages = {e70233}, doi = {10.1002/ardp.70233}, pmid = {41952380}, issn = {1521-4184}, support = {2022HYF8KS//Fondo per il Programma Nazionale di Ricerca e Progetti di Rilevante Interesse Nazionale (PRIN)/ ; PE00000007//NextGeneration EU-MUR PNRR Extended Partnership initiative on Emerging Infectious Diseases/ ; }, mesh = {Humans ; Structure-Activity Relationship ; *Indolizines/chemistry/pharmacology/chemical synthesis ; Chemistry, Pharmaceutical ; *Isoindoles/pharmacology/chemistry/chemical synthesis ; Animals ; *Anti-Infective Agents/pharmacology/chemistry/chemical synthesis ; *Communicable Diseases/drug therapy ; Drug Discovery ; Drug Design ; Indoles/chemistry/pharmacology ; Molecular Structure ; }, abstract = {Infectious diseases remain a major global health challenge, accounting for millions of deaths annually and placing an increasing burden on healthcare systems worldwide. The rapid emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) bacterial strains, together with recurrent outbreaks of viral infections such as SARS-CoV-2, Ebola, Zika, Monkeypox, and influenza, underscores the urgent need for novel therapeutic agents with diverse mechanisms of action. In this context, indolizines, isoindoles, and isoindolinones represent promising scaffolds in anti-infective drug discovery due to their unique structural features, versatile reactivity, and ability to engage multiple biological targets. This review provides an updated overview of the medicinal chemistry of indolizine and isoindoles, with particular emphasis on compounds demonstrating activities against infectious pathogens. Representative examples are highlighted to illustrate structure-activity relationships (SARs), scaffold-based optimization strategies, and emerging mechanistic insights. Relevant synthetic methodologies are discussed only in the context of biologically active compounds to provide a framework for rational design. Collectively, this review underscores the therapeutic potential of indolizine- and isoindole-derived scaffolds as versatile frameworks for anti-infective drug development and highlights opportunities for further chemical and biological exploration.}, }
@article {pmid41952921, year = {2026}, author = {Usman, AB and Comlan, MBL and Victory, KR and Geissler, A}, title = {Strengthening Global Health Security in West Africa: Insights from Joint External Evaluations and After-Action Reviews.}, journal = {Dialogues in health}, volume = {8}, number = {}, pages = {100294}, pmid = {41952921}, issn = {2772-6533}, abstract = {PURPOSE: West Africa faces recurring public health outbreaks, including Ebola, COVID-19, and Mpox, underscoring the need for strong Global Health Security (GHS) core capacities. This study uses Joint External Evaluation (JEE) scores and After-Action Review (AAR) findings to assess public health emergency preparedness across 15 West African countries and identify gaps between theoretical assessments and operational response capacity.
METHODS: A mixed-methods approach compared JEE scores (2016-2023) with thematic analysis of AAR findings from major outbreaks. Consistency between JEE-predicted capacities and AAR-reported challenges was assessed using a three-level rating system (High/Moderate/Low) and the Kappa statistic.
RESULTS: In 68 of 105 technical area comparisons (65%) of cases, JEE scores accurately predicted weaknesses in laboratory systems and workforce development. However, in 37 comparisons (35%) of cases, JEE scores overestimated preparedness, particularly in risk communication(all15 countries,100%), real-time surveillance(13 of 15 countries, 87%), and cross-border coordination, where countries with high scores faced operational failures during outbreaks. AARs revealed logistical bottlenecks, supply chain disruptions, and coordination failures not captured by JEEs. Alignment with SDG 3.d (health security), SDG 10 (inequalities), SDG 17 (partnerships), and SDG 9 (infrastructure) underscores broader development implications.
CONCLUSION: While JEE is valuable for baseline assessment, it incompletely predicts real-world outbreak response performance. Integrating AAR findings into national planning and refining JEE indicators to include operational metrics will enhance health security evaluations. Regionally coordinated action through WAHO is essential for addressing gaps and building resilient systems aligned with sustainable development goals.}, }
@article {pmid41953499, year = {2026}, author = {Kim, B and Choi, S}, title = {Comparing pre- and post-COVID-19 chronic allergy prevalence in children using National Health and Nutrition Examination Survey in 2019 and 2021.}, journal = {Allergologie select}, volume = {10}, number = {}, pages = {36-48}, pmid = {41953499}, issn = {2512-8957}, abstract = {OBJECTIVE: To investigate changes in demographic characteristics, parental smoking habits, and the prevalence of asthma, atopic dermatitis, and rhinitis among children in South Korea before and after the COVID-19 pandemic.
MATERIALS AND METHODS: A retrospective analysis of national health survey data from 2019 and 2021 was conducted, including children aged 3 - 18 years. Factors such as gender, age, location, housing type, family size, income, body mass index, subjective health status, influenza vaccination, family structure, and parental smoking habits were analyzed.
RESULTS: No significant differences were found in most demographic characteristics and parental features between 2019 and 2021, except for influenza vaccination rates and mothers' age at first childbirth. The influenza vaccination rate increased from 69.3% in 2019 to 77.8% in 2021, and the average maternal age at first birth increased from 28.46 years to 29.22 years. Asthma diagnoses showed no significant differences between the 2 years after adjusting for general and parent-related characteristics. For atopic dermatitis, significant differences in gender distribution were observed in 2021. Rhinitis diagnoses showed significant differences in age, area, and breastfeeding status between the two years.
CONCLUSION: The COVID-19 pandemic may have influenced certain demographic characteristics, such as influenza vaccination rates and mothers' age at first childbirth, but the prevalence of asthma, atopic dermatitis, and rhinitis among children remained largely unchanged between 2019 and 2021. This study underscores the importance of monitoring the impact of social changes on children's health, particularly during significant events like the COVID-19 pandemic. Further research is required to understand the long-term effects of these changes on child health.}, }
@article {pmid41954649, year = {2026}, author = {Valencia, S and Jaimes, C and Victoria, T and Gee, MS}, title = {Strategies for radiology faculty recruitment and retention in a competitive market: implications for pediatric radiology.}, journal = {Pediatric radiology}, volume = {56}, number = {5}, pages = {1068-1077}, pmid = {41954649}, issn = {1432-1998}, mesh = {*Personnel Selection/methods ; Humans ; United States ; *Radiology ; *Faculty, Medical/supply & distribution ; Organizational Culture ; *Pediatrics ; *Radiologists/supply & distribution ; COVID-19/epidemiology ; Leadership ; Career Mobility ; Workload ; }, abstract = {This narrative review examines strategies and recommendations to address the current radiologist shortage in the USA, with a particular emphasis on workforce retention and preservation through operational efficiency, organizational leadership, cultural transformation, and technology integration. National workforce data, expert commentaries, and strategic frameworks from academic radiology and healthcare leadership literature were reviewed to contextualize current challenges and proposed solutions. The radiology workforce faces escalating pressure driven by rapidly increasing imaging volumes, limited growth in the number of practicing radiologists, and rising attrition rates. Between 2008 and 2018, radiologist workloads nearly doubled while workforce expansion was much smaller, exacerbating workload imbalance, burnout, and professional dissatisfaction. The COVID-19 pandemic exacerbated workforce challenges by causing an exodus of workers and making on-site work more challenging. Although short-term mitigation strategies exist, sustainable long-term solutions require coordinated cultural and structural changes that prioritize strategic hiring, transparent career advancement pathways, protected academic and professional development time, and optimized workflow efficiency supported by technology. In conclusion, effective management of the radiology workforce shortage necessitates integrated operational and cultural approaches, with departments implementing comprehensive and tailored interventions to expand workforce capacity, enhance professional fulfillment, and maintain high-quality patient care.}, }
@article {pmid41954969, year = {2026}, author = {Gentilini, P and Lindsay, JC and Konishi, N and Fukushima, M and Polykretis, P}, title = {Exploring the potential link between mRNA COVID-19 vaccinations and cancer: A case report with a review of haematopoietic malignancies with insights into pathogenic mechanisms.}, journal = {Oncotarget}, volume = {17}, number = {1}, pages = {34-49}, pmid = {41954969}, issn = {1949-2553}, mesh = {Humans ; Female ; *COVID-19 Vaccines/adverse effects/administration & dosage ; *Precursor Cell Lymphoblastic Leukemia-Lymphoma/etiology/chemically induced ; *COVID-19/prevention & control ; SARS-CoV-2/immunology ; Vaccination/adverse effects ; }, abstract = {Copyright: © 2026 Gentilini et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. This article investigates the potential association between modified mRNA (modRNA) COVID-19 vaccinations and the development of haematopoietic cancers. We present a case involving a healthy, young, athletic woman who developed acute lymphoblastic leukaemia (ALL) and lymphoblastic lymphoma (LBL) following her second dose of the Pfizer/BioNTech COVID-19 vaccine (Comirnaty®). This case is part of an expanding body of literature documenting similar occurrences after modRNA vaccinations, which we critically examine. Emerging evidence suggests that the biodistribution and persistence of modRNA, facilitated by lipid nanoparticles, can affect various tissues and organs, including the bone marrow and other blood-forming organs. Notably, modRNA vaccines exhibit a particular affinity for the bone marrow, potentially influencing the immune system at multiple levels and triggering both autoimmune disorders and neoplastic processes. In this article, we assess the risk of developing haematopoietic cancers post-modRNA vaccination based on current scientific literature and explore the reported potential genetic and molecular mechanisms involved in disease pathogenesis. By integrating clinical observations and current research, we aim to provide valuable insights into the potential carcinogenic outcomes associated with modRNA vaccination.}, }
@article {pmid41955274, year = {2026}, author = {Wu, D and Dasgupta, A and Hora, JS and Chen, KH and Banerjee, A and Archer, SL}, title = {SARS-CoV-2 targets mitochondria, exacerbating COVID-19 pneumonia.}, journal = {The Journal of physiology}, volume = {}, number = {}, pages = {}, doi = {10.1113/JP290297}, pmid = {41955274}, issn = {1469-7793}, support = {SEA-20-015//Southeastern Ontario Academic Medical Organization/ ; MM1181122/CAPMC/CIHR/Canada ; }, abstract = {Mitochondrial damage is a conserved feature of coronavirus infection, occurring with human (SARS-CoV-2, HCoV-OC43) and murine (MHV-1) coronaviruses. Coronaviruses damage mitochondria in airway epithelial cells (AEC), pulmonary artery smooth muscle cells (PASMC), pulmonary artery endothelial cells, immune cells and cardiomyocytes by causing rapid transcriptomic changes in nuclear-encoded genes regulating mitochondria and by viral proteins interacting with host mitochondrial proteins. Coronavirus infection causes mitochondrial depolarization, mitochondrial transition pore (MTP) opening, inhibition of the electron transport chain (ETC) and ATP synthetic apparatus, increased mitochondrial fission, apoptosis, and impaired mitochondrial oxygen sensing. Within hours of infection, SARS-CoV-2 induces transcriptional reprogramming of genes relevant to the mitochondrial matrix in AECs, downregulating mRNA encoding ETC complex I components and the ATP synthesis complex. These bioenergetic consequences of SARS-CoV-2 mitochondriopathy may contribute to long COVID. Infection also upregulates dynamin-related protein 1 (DRP1), activating mitochondrial fission while promoting apoptosis by activating apoptosis inducing factor (AIF) and caspase 7. Even without infection, transfection with specific coronaviral proteins opens the MTP and depolarizes the mitochondria, or activates DRP1 and AIF, promoting AEC damage or apoptosis, thereby contributing to diffuse alveolar damage. In human PASMCs, coronaviral M and Nsp9 proteins suppress hypoxic pulmonary vasoconstriction (HPV), a homeostatic mechanism in PASMCs that uses a mitochondrial oxygen sensor to redistribute blood flow to well-ventilated lung regions during pneumonia. Impairment of HPV, seen as intrapulmonary shunting, contributes to the profound hypoxaemia in COVID-19 pneumonia. Coronavirus-induced mitochondriopathy may have therapeutic relevance as blocking AIF-induced apoptosis or enhancing HPV appears beneficial in a MHV-1 model of COVID-19 pneumonia.}, }
@article {pmid41955863, year = {2026}, author = {Temiz, A and Tascilar, K}, title = {Why we need to maintain a critical view on big data and artificial intelligence predictions.}, journal = {Current opinion in immunology}, volume = {100}, number = {}, pages = {102776}, doi = {10.1016/j.coi.2026.102776}, pmid = {41955863}, issn = {1879-0372}, mesh = {Humans ; *Big Data ; *Artificial Intelligence ; Machine Learning ; *Rheumatology/methods ; Prediction Algorithms ; }, abstract = {Artificial intelligence (AI) and machine learning are widely promoted as transformative tools for medical practice, yet their impact in daily rheumatology remains limited. This review examines the gap between expectations and reality using historical parallels, conceptual considerations, and recent methodological evidence. Experiences with antioxidant supplementation, vitamin D, the microbiome, and the Human Genome Project illustrate a recurring pattern: early studies report large effects that diminish or disappear in larger, higher-quality studies. Meta-epidemiological work and the 'cursed auction' analogy explain why early and small studies systematically overestimate effects. Conceptually, individualized clinical risk remains a group-based construct, constrained by the reference class problem and irreducible uncertainty. Methodologically, many AI models in rheumatology suffer from small and heterogeneous datasets, overfitting, inadequate handling of missing data, poor calibration, and limited external or prospective validation. The failure of COVID-19 prediction models and the neutral trial of the Ada diagnostic assistant in rheumatology illustrate how strong retrospective performance often collapses in real-world use. In contrast, AI performs well in high signal-to-noise domains with abundant, structured data. Overall, AI can generate valuable insights and support narrowly defined tasks, but it cannot yet overcome the fundamental limits of noisy clinical data and group-based risk. Progress in rheumatology will require realistic expectations, large representative datasets, transparent methods, rigorous validation, and a focus on robust, interpretable tools that improve decisions for populations and well-defined patient subgroups rather than precise individual prediction.}, }
@article {pmid41955877, year = {2026}, author = {Ngwoke, I and Ahmed, MM and Gideon, JA and Okesanya, OJ and Danladi, NP and Agboola, AO and Abdullahi, YB and Oso, TA and Adebayo, UO and Eshun, G and Lucero-Prisno, DE}, title = {Molecular characteristics, epidemiological trends, and public health implications of human metapneumovirus (hMPV): a review.}, journal = {Virology}, volume = {619}, number = {}, pages = {110897}, doi = {10.1016/j.virol.2026.110897}, pmid = {41955877}, issn = {1096-0341}, mesh = {Humans ; *Metapneumovirus/genetics/immunology/pathogenicity/classification ; *Paramyxoviridae Infections/epidemiology/virology/transmission/diagnosis/immunology/prevention & control ; Public Health ; Disease Outbreaks ; }, abstract = {Human Metapneumovirus (hMPV) is an emerging respiratory pathogen associated with significant morbidity, particularly among young children, older adults, and immunocompromised individuals. Although clinically relevant, it remains underrecognized relative to influenza and respiratory syncytial virus (RSV). Recent regional outbreaks, including the January 2025 surge in northern China, highlight hMPV's capacity to cause significant above-seasonal transmission events, particularly in settings with immunity debt following prolonged non-pharmaceutical interventions. This review synthesizes current knowledge on hMPV epidemiology, genetic diversity, transmission dynamics, pathogenesis, host immune interactions, diagnostic approaches, and therapeutic and vaccine development efforts. A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and ScienceDirect with no publication date restriction, using MeSH and free-text terms including "hMPV," "epidemiology," "immune response," "diagnosis," "treatment," and "pandemic preparedness." Relevant reference lists were hand-searched to identify additional studies. Eligible articles included molecular, clinical, observational, and epidemiological studies; case reports and commentaries were excluded unless they provided unique outbreak insights. Findings emphasize that hMPV represents a growing public health concern due to limited awareness, diagnostic overlap with other viral pathogens, and the absence of targeted therapeutics or licensed vaccines. Strengthened surveillance, improved diagnostic capacity, and accelerated research into immunopathogenesis and vaccine platforms are urgently needed. Integrating hMPV into regional outbreak preparedness frameworks rather than pandemic-level frameworks applicable to influenza or SARS-CoV-2 while fostering collaborative research and proportionate public health communication, is essential to mitigate its future impact.}, }
@article {pmid41956814, year = {2026}, author = {Vincent, E}, title = {Resolving 'Collective Amnesia': uncovering disease outbreaks past to shape pandemic futures.}, journal = {Medical humanities}, volume = {}, number = {}, pages = {}, doi = {10.1136/medhum-2025-013473}, pmid = {41956814}, issn = {1473-4265}, abstract = {At the International Pandemic Sciences Conference in 2024, scholars of science and the medical humanities were united in asking one guiding question: how can we learn from disease outbreaks of the past to prepare for future pandemics? This article will explore how interdisciplinary public conference forums are productive spheres of knowledge exchange which enable proponents of science and literature to detect and trace past issues of public health which persist into present-day pandemics. The article considers the claim of bioethicists Maxwell J Smith and Ross Upshur that there is 'collective amnesia' when pandemics arise, to foreground the importance of uncovering and evaluating the visual, literary and media histories of pandemics past. Analysis of literary-historical research presented as part of the interdisciplinary 'Media and Epidemics' project, which analysed the visual and literary cultures of historic epidemics of influenza, demonstrates how historic literature and media collides with present-day public health discourse. Examining past epidemics reveals shared issues raised by COVID-19 media reportage concerning the historic role of storytelling, stigmatisation and fears of contagion. While COVID-19 haunts our recent past, there remains '[a]n urgency to understanding how narratives are constructed and understood between communities and their impact on structural factors, such as health policy' which can be enriched through 'a framework of public health humanities'. In conclusion, the proposed antidote to a global 'amnesia' centres on privileging memory, learning actionable lessons and telling stories of disease within collaborative medical humanities forums which unite literature and science.}, }
@article {pmid41957521, year = {2026}, author = {Hadidchi, R and Pahuja, S and Mehrotra-Varma, S and Zhao, W and Lee, RC and Henry, S and Duong, TQ}, title = {COVID-19 and cardiovascular outcomes in patients with pre-existing hypertension.}, journal = {Journal of human hypertension}, volume = {40}, number = {6}, pages = {446-455}, pmid = {41957521}, issn = {1476-5527}, mesh = {Humans ; *Hypertension/epidemiology/diagnosis/complications/physiopathology ; Female ; *COVID-19/complications/epidemiology/mortality/diagnosis ; Retrospective Studies ; Male ; Middle Aged ; Aged ; Risk Factors ; Stroke/epidemiology ; *Cardiovascular Diseases/epidemiology ; Myocardial Infarction/epidemiology ; Biomarkers/blood ; Heart Failure/epidemiology ; SARS-CoV-2 ; Comorbidity ; }, abstract = {Patients with hypertension have worse acute COVID-19 outcomes, but the long-term effects of SARS-CoV-2 infection is unclear. We conducted a retrospective cohort study of adults with hypertension and no prior cardiovascular events in the Montefiore Health System, comparing those with and without COVID-19 over up to 4.5 years post-infection. Outcomes included first-time myocardial infarction (MI), heart failure (HF), stroke, all-cause mortality, and major adverse cardiovascular events (MACE). Multivariate regression and inverse-probability weighting adjusted for demographics, comorbidities, socioeconomic status, and COVID-19 vaccination. Adjusted hazard ratios (HRs) with 95% confidence intervals were calculated. Sub-analyses examined hypertension stage and acute COVID-19 blood biomarkers in relation to outcomes. Among 75,180 hypertensive patients, hospitalized COVID-19 was associated with increased risk of first-time MI (adjusted HR = 1.40 [1.21-1.63]), HF (1.59 [1.45-1.75]), stroke (1.35 [1.17-1.57]), all-cause mortality (2.51 [2.17-2.90]), and MACE (1.65 [1.54-1.77]) compared to COVID-negative individuals. Non-hospitalized COVID-19 patients had elevated risks of HF (1.17 [1.06-1.30]) and MACE (1.14 [1.05-1.23]). Hospitalized COVID-19 was associated with an increase in MACE risk by 75% in those with normal blood pressure, and by 126% and 148% in those with elevated blood pressure and stage 1 hypertension, respectively. Abnormal C-reactive protein, creatinine, lactate dehydrogenase, D-dimer, hemoglobin, and neutrophil-to-lymphocyte ratio predicted higher MACE risk. COVID-19, irrespective of disease severity, puts hypertensive patients at greater risks of worse cardiovascular outcomes, especially those with more advanced hypertension. These findings underscore the importance of long-term cardiovascular monitoring in this vulnerable population.}, }
@article {pmid41958400, year = {2026}, author = {Morton, LC and Forshey, BM and Klinkhammer, KE and Romaner, A and Traore, Z and Hartman, LJ and Standley, CJ and Roess, AA}, title = {Local genomic epidemiology investigations of SARS-CoV-2 during the early pandemic response: A global systematic review.}, journal = {Epidemiology and infection}, volume = {154}, number = {}, pages = {e56}, pmid = {41958400}, issn = {1469-4409}, mesh = {Humans ; *COVID-19/epidemiology/transmission/virology ; *SARS-CoV-2/genetics ; Phylogeny ; Pandemics ; Genomics ; Whole Genome Sequencing ; Genome, Viral ; Molecular Epidemiology ; }, abstract = {Genomic epidemiology was essential for characterizing SARS-CoV-2 transmission during the early COVID-19 pandemic. This systematic review examined how whole-genome sequencing was used in local outbreak investigations published between March 2020 and March 2021. Searches of PubMed, Scopus, and Web of Science identified 32 studies from 18 countries that integrated genomic and epidemiological data for local outbreak investigations. Most studies were conducted in healthcare settings or in high-income countries. A limited number of studies were conducted in low- and middle-income countries, except for China and Vietnam. Illumina or Oxford Nanopore platforms and tiled-amplicon protocols were the most common sequencing methods. Phylogenetic trees were the most common genomic epidemiology analytical approach. Genomic data enabled confirmation of suspected transmission links, detection of multiple introductions, and identification of asymptomatic or presymptomatic transmission. Important enablers of early implementation included open-access genomics databases, standardized protocols (e.g. ARTIC), open-source tools (e.g. Nextstrain), and cross-sector partnerships and funding. Study quality and adherence to common observational study reporting guidelines varied widely. Familiarity with the STROME-ID guidelines for molecular epidemiology studies would have improved overall quality. These findings highlight the utility of genomic epidemiology in outbreak response and support its continued integration into public health surveillance systems.}, }
@article {pmid41958512, year = {2026}, author = {Crețu, OE and Poalelungi, CV and Neacșu, AV and Nenciu, A and Ceaușu, I}, title = {Epigenetic alterations in preeclampsia: a systematic review of current mechanisms and biomarker potential.}, journal = {Journal of medicine and life}, volume = {19}, number = {2}, pages = {69-88}, pmid = {41958512}, issn = {1844-3117}, mesh = {*Pre-Eclampsia/genetics/metabolism ; Female ; Humans ; Pregnancy ; *Epigenesis, Genetic ; *Biomarkers/metabolism ; Placenta Growth Factor/genetics/metabolism ; DNA Methylation/genetics ; }, abstract = {Preeclampsia (PE) remains a major cause of maternal and fetal morbidity and mortality worldwide, with placental dysfunction and angiogenic imbalance playing central roles in disease pathogenesis. Emerging evidence highlights epigenetic regulation and angiogenic biomarkers, including placental growth factor (PlGF), as key contributors to disease heterogeneity and risk stratification. A systematic review of studies published between 2022 and 2025 was conducted in accordance with PRISMA 2020 guidelines to synthesize current evidence on epigenetic mechanisms and biomarker potential in PE. In addition, a supplementary exploratory analysis was performed using laboratory-derived PlGF data to assess analytical variability and biological associations. Non-parametric methods were applied, including Mann-Whitney U testing to compare PlGF distributions by analytical sample classification and Kendall's tau correlation to evaluate associations with gestational age and the sFlt-1/PlGF ratio. The systematic review identified consistent epigenetic alterations involving DNA methylation, histone modifications, and non-coding RNAs across maternal and placental tissues. Supplementary analysis demonstrated significantly higher and more variable PlGF concentrations in analytically classified measured samples compared with accepted samples (P = 0.03), suggesting an influence of analytical factors on biomarker distribution. PlGF levels showed a positive association with gestational age (τ = 0.32, P = 0.04) and an inverse association with the sFlt-1/PlGF ratio (τ = -0.41, P = 0.02). These findings support PlGF as a biologically relevant marker of gestational progression and angiogenic balance while underscoring the importance of rigorous analytical quality control. Integrating epigenetic insights with robust biomarker analysis may enhance personalized risk stratification in preeclampsia.}, }
@article {pmid41961609, year = {2026}, author = {Garcia-Zamora, S and Pulido, L and Sosa Liprandi, MI and Nacinovich, F and Balsano, FJ and Herrera Paz, JJ and Procopio, G and Cursack, G and Picco, J and Cerezo, G and Cicco, L and Stecher, D and Morós, C and Garcia Brasca, D and Cocco, N and Dana, L and Pacheco Otero, M and Spennato, MC and Zapata, G and Sosa Liprandi, Á}, title = {Consensus document on the role of adult vaccination in the prevention of cardiovascular events. Joint Statement by the Argentine Federation of Cardiology (FAC), Argentine Society of Cardiology (SAC), and the Argentine Council of Cardiology Residents (CONAREC).}, journal = {Medicina}, volume = {86}, number = {2}, pages = {447-476}, pmid = {41961609}, issn = {1669-9106}, mesh = {Humans ; *Cardiovascular Diseases/prevention & control ; Argentina ; *Vaccination/standards ; Adult ; Influenza Vaccines/administration & dosage ; COVID-19 Vaccines/administration & dosage ; Cardiology ; Societies, Medical ; COVID-19/prevention & control ; Influenza, Human/prevention & control ; }, abstract = {Cardiovascular diseases remain the leading cause of death among adults, both in Argentina and worldwide. Numerous studies have established a consistent association between infections -particularly respiratory infections- and an increased risk of cardiovascular events, stroke, arrhythmias, and both cardiovascular and all-cause mortality. The underlying pathophysiological mechanisms include systemic inflammation, immune activation, endothelial dysfunction, prothrombotic states, sympathetic stimulation, and elevated myocardial oxygen demand. In respiratory infections, these effects are further exacerbated by hypoxemia and impaired gas exchange. Such alterations can trigger de novo cardiovascular events or exacerbate preexisting conditions, such as ischemic heart disease or heart failure. In this context, robust evidence supports the safety of vaccines against Influenza, Pneumococcus, Respiratory Syncytial Virus, COVID-19, and Herpes Zoster in adults, including those with established cardiovascular disease or risk factors. Moreover, these vaccines have demonstrated efficacy in reducing cardiovascular events by mitigating infection-related complications. Notably, influenza vaccination has proven safe even during the acute phase of myocardial infarction, when administered during hospitalization. Despite this strong evidence base, vaccination rates remain suboptimal among individuals with cardiovascular disease, both in Argentina and across Latin America. This consensus document reviews the current evidence linking infections and cardiovascular events, and highlights vaccines as a safe and cost-effective strategy for primary, secondary, and tertiary prevention. It also provides concrete recommendations to improve vaccine coverage and reduce residual cardiovascular risk in the region.}, }
@article {pmid41961611, year = {2026}, author = {Estenssoro, E and Steinberg, E and Plotnikow, GA}, title = {[Acute respiratory distress syndrome: a clinical and conceptual journey towards a global, valid, and fair definition].}, journal = {Medicina}, volume = {86}, number = {2}, pages = {495-507}, pmid = {41961611}, issn = {1669-9106}, mesh = {Humans ; *Respiratory Distress Syndrome/diagnosis/classification/physiopathology ; *COVID-19/complications ; SARS-CoV-2 ; }, abstract = {Acute Respiratory Distress Syndrome (ARDS) is an acute, severe form of respiratory failure characterized by profound hypoxemia, reduced thoracopulmonary compliance, alveolar collapse leading to intrapulmonary shunt, and increased deadspace ventilation. It can originate from pulmonary or extrapulmonary causes, leading to heterogeneous pathophysiology. Clinical variability has driven the pursuit of more precise diagnostic definitions to standardize management and facilitate research. Since its first description in 1967, multiple definitions and classifications of ARDS were proposed, including the Murray Score, the American-European Consensus Conference (AECC), and the Berlin Definition. More recently, the Kigali Definition from Rwanda and the challenges posed by COVID-19 pandemic prompted further re-evaluation of the syndrome. This led to the publication of the New Global ARDS Definition in 2023, which introduced new diagnostic categories and broader diagnostic tools. The ongoing need for refinement, combined with the pathophysiological heterogeneity, motivated an exploration by expert clinician and researchers about the value of defining and subphenotyping ARDS for research, education, and clinical care. To ensure representativeness and validity, a Delphi process was conducted by a panel that included members across all world regions, representing high-intermediate and low-resource settings. This review will explore the evolution of ARDS definitions over time, and the advantages and limitations each has presented in clinical and research contexts.}, }
@article {pmid41962202, year = {2026}, author = {Redenti, BJ and Zhong, Y and Yu, C and Dong, Y}, title = {Recent advances in LNP-mRNA vaccines.}, journal = {Colloids and surfaces. B, Biointerfaces}, volume = {265}, number = {}, pages = {115675}, doi = {10.1016/j.colsurfb.2026.115675}, pmid = {41962202}, issn = {1873-4367}, mesh = {Humans ; *RNA, Messenger/immunology/chemistry/genetics ; *Nanoparticles/chemistry ; Animals ; *Lipids/chemistry ; *COVID-19 Vaccines/immunology ; *mRNA Vaccines/immunology ; Immunotherapy/methods ; COVID-19/prevention & control/immunology ; SARS-CoV-2/immunology ; Liposomes ; }, abstract = {Messenger RNA (mRNA) vaccines have revolutionized immunotherapy by coupling modular mRNA engineering with advances in lipid nanoparticles (LNPs). LNPs, generally composed of ionizable lipid, phospholipid, cholesterol, and PEGylated lipid, have emerged as the leading vehicles for stabilizing mRNA and enhancing its cellular delivery. Concurrent innovations in mRNA chemistry and structure, such as nucleoside modification and untranslated region optimization, have improved translation efficiency, fidelity, and control of innate immune sensing. These synergistic advances underpinned the success of COVID-19 vaccines and have since propelled the rapid expansion of LNP-mRNA platforms across infectious and oncologic diseases. Preclinical and clinical studies now demonstrate potent and durable immune responses elicited by LNP-mRNA vaccines against diverse viral, bacterial, and cancer targets. Together, these findings illustrate how rational integration of biomaterial design with mRNA engineering defines the next generation of programmable immunotherapies. Continued refinement of both particle composition and mRNA architecture is poised to broaden the reach of mRNA nanomedicines across preventive and therapeutic domains.}, }
@article {pmid41962688, year = {2026}, author = {Chen, M and Driscoll, MS}, title = {Hypervitaminosis: The deleterious effects of vitamins on the skin.}, journal = {Clinics in dermatology}, volume = {44}, number = {3}, pages = {442-453}, doi = {10.1016/j.clindermatol.2026.04.011}, pmid = {41962688}, issn = {1879-1131}, mesh = {Humans ; *Vitamins/adverse effects/administration & dosage ; Niacin/adverse effects ; Vitamin E/adverse effects ; *Dietary Supplements/adverse effects ; Vitamin A/adverse effects ; Biotin/adverse effects ; Vitamin D/adverse effects ; *Skin Diseases/chemically induced ; *Skin/drug effects ; COVID-19 ; }, abstract = {Vitamin supplementation has recently shown a dramatic increase in usage, especially during the COVID-19 pandemic, as a potential aid in preventing, treating, and recovering from infection. In dermatology, vitamin supplements may be used to support the management of a myriad of conditions. A common misconception is that vitamins are safe to consume and that taking more will improve overall health; however, hypervitaminosis may lead to harmful effects. We provide an overview illustrating the use of vitamins A, D, E, niacin, and biotin in dermatology and the potential adverse effects of hypervitaminosis.}, }
@article {pmid41963630, year = {2026}, author = {Kurup, C and Ford, A and Heidke, P}, title = {Digital Strategies Utilised to Encourage Undergraduate Nursing Students' Engagement in Online Units of Study Throughout the COVID-19 Pandemic: A Systematic Review.}, journal = {Nursing open}, volume = {13}, number = {4}, pages = {e70528}, pmid = {41963630}, issn = {2054-1058}, mesh = {*COVID-19/epidemiology ; Humans ; *Students, Nursing/psychology ; *Education, Distance/methods ; *Education, Nursing, Baccalaureate/methods ; SARS-CoV-2 ; Pandemics ; Curriculum ; Digital Media ; }, abstract = {AIM: This systematic review provides an overview of digital strategies utilised to encourage undergraduate nursing students' engagement in online units of study throughout the COVID-19 pandemic.
BACKGROUND: In nursing education, engagement was crucial in acquiring knowledge, skills, critical thinking and problem-solving abilities. The COVID-19 pandemic forced schools and universities worldwide to quickly adapt from face-to-face learning to online platforms. While online teaching and digital technologies in education were not new, the urgency to create effective online learning opportunities that meet curriculum needs and maintain student engagement was particularly challenging for teaching staff and students.
DESIGN: REVIEW METHODS: The databases used were Embase, CINAHL, EMCARE, ERIC and BASE. The review was limited to English and literature published between January 2020 and September 2022 to capture the studies published around the COVID-19 lockdown. Three researchers independently completed the study selection, quality assessment and data extraction. Any discrepancies were resolved in a consensus-building conversation.
RESULTS: Multiple strategies, such as simulations, gamification and telehealth role-playing, effectively enhanced nursing students' online engagement during COVID-19. Instructor expertise, student-centred approaches and reliable infrastructure emerged as pivotal.
CONCLUSION: The COVID-19 pandemic accelerated the shift to online nursing education, highlighting the need for innovative strategies to sustain student engagement. Identifying the most effective pedagogical approaches, such as virtual simulations, gamification and experiential learning, will support future online learning. Integrating emerging technologies and student-centred teaching methods will be crucial in preparing nursing students for clinical practice in a post-pandemic world.}, }
@article {pmid41963927, year = {2026}, author = {Kariuki, CK and Doijen, J and Mann, MK and Xie, J and Van Loock, M and Van Damme, E}, title = {Beyond assembly: functions of the coronavirus M protein.}, journal = {Virology journal}, volume = {23}, number = {1}, pages = {}, pmid = {41963927}, issn = {1743-422X}, support = {OTA number HHSO100201700018C//The Office of the Administration for Strategic Preparedness and Response, Biomedical Advanced Research and Development Authority (BARDA)/ ; }, mesh = {Humans ; *Viral Matrix Proteins/metabolism/chemistry/genetics ; *Virus Assembly ; *SARS-CoV-2/physiology ; Coronavirus M Proteins ; COVID-19/virology ; *Betacoronavirus/physiology/genetics ; Animals ; Virus Release ; *Coronavirus Infections/virology/drug therapy ; }, abstract = {Coronaviruses are enveloped RNA viruses from the family Coronaviridae, notable for their crown-like spike glycoproteins. Though historically regarded as inconsequential, recent outbreaks, most notably COVID-19 caused by SARS-CoV-2, highlight their significant impact on global health. SARS-CoV-2 possesses a 27-31 kb, complex genome encoding multiple structural and non-structural proteins. The membrane/matrix (M) glycoprotein is the most abundant structural component of the viral envelope and confers the minimal requirement for virion formation. Its highly conserved structure, featuring three transmembrane domains, facilitates interactions with other viral proteins that are essential for assembly, budding, and maintaining the integrity of the viral envelope. Beyond its canonical functions in virion assembly and egress, emerging evidence suggests the M protein influences early infection processes, modulates host immune responses, and may serve as a promising antiviral target. This mini review consolidates current knowledge on the structure, multifunctional roles, and therapeutic potential of the coronavirus M protein, emphasizing the necessity for further research into its diverse functions throughout the viral lifecycle.}, }
@article {pmid41963958, year = {2026}, author = {Senyel, D and Boutros, E and Frith, M and Savira, F and Tong, L and Asiamah-Asare, BKY and Norman, R and Robinson, S and Boyd, JH}, title = {The (dis-)advantages of telehealth consultation for allied health services: a scoping review.}, journal = {BMC health services research}, volume = {26}, number = {1}, pages = {}, pmid = {41963958}, issn = {1472-6963}, mesh = {Humans ; COVID-19/epidemiology ; *Remote Consultation ; *Telemedicine ; Pandemics ; SARS-CoV-2 ; Health Services Accessibility ; }, abstract = {BACKGROUND: The COVID-19 pandemic resulted in an uptake of teleconsultations across the healthcare sector, including for allied health services. However, (dis-)advantages specific to allied health services are under-researched. The aim of this scoping review is the understand the (dis-)advantages patients and providers perceive when using teleconsultations for allied health services.
METHODS: This scoping review was conducted using the JBI methodology for scoping reviews and reported according to the PRISMA-ScR statement. The final search was conducted in January 2024, through the databases MEDLINE Complete, EMBASE, CINAHL, PsycINFO, AMED Allied and Complementary Medicine. Studies were eligible for inclusion if they reported qualitative findings on the (dis-)advantages of teleconsultations for allied health services from a patient's and/or provider's perspective. The screening process was conducted by two independent researchers, while the data extraction and inductive analysis were performed by the first author.
RESULTS: We identified 116 eligible articles. Eight categories were identified from a patient's perspective, including improved access to care, resource savings, convenience, comfort, reduced infection risk, effects on therapy, privacy, and patient-provider relationship. From the provider's perspective, additional categories included telehealth as a trigger for change and improvement, the patients in their own home, disruptions, interpreters, efficiency, changes to workday, and safety and risks.
CONCLUSION: While there are clear advantages, such as improved access to care, and disadvantages, such as the lack of hands-on treatment, the impact of telehealth often depends on the individual context of both the provider and the patient. Although some aspects are broadly relevant across all allied health professions, there are notable differences in the suitability of telehealth for specific services. Understanding the disadvantages and advantages of teleconsultations is key to informing policies and identifying suitable applications of telehealth.}, }
@article {pmid41965052, year = {2026}, author = {Li, M and Li, Z and Zhao, Z and Guo, Z}, title = {Oncovirus-Driven Endothelial Plasticity: Endothelial-to-Mesenchymal Transition as a Hijacked Pathway in Oncoviral Cardiovascular Pathogenesis.}, journal = {Reviews in medical virology}, volume = {36}, number = {3}, pages = {e70143}, doi = {10.1002/rmv.70143}, pmid = {41965052}, issn = {1099-1654}, mesh = {Humans ; *Endothelial-Mesenchymal Transition ; SARS-CoV-2/pathogenicity ; Signal Transduction ; Herpesvirus 8, Human/pathogenicity ; *Cardiovascular Diseases/virology/pathology ; Animals ; Host-Pathogen Interactions ; COVID-19/virology/pathology ; Neovascularization, Pathologic ; Epithelial-Mesenchymal Transition ; Endothelial Cells/virology/pathology ; *Oncogenic Viruses/pathogenicity ; }, abstract = {Oncoviruses utilise various molecular strategies to modulate host cells and induce microenvironments that favour viral persistence, immune evasion, and disease progression. Endothelial-to-mesenchymal transition (EndMT) has recently emerged as a critical, yet underrecognized, pathway hijacked by oncoviral pathogens to modulate endothelial plasticity within the cardiovascular system. Accumulating evidence indicates that Oncogenic and non-oncogenic viruses, including Kaposi's sarcoma-associated herpesvirus (KSHV/HHV-8), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), human immunodeficiency virus (HIV), and other endothelial-tropic viruses, directly manipulate host signalling networks, such as TGF-β, Wnt/β-catenin, Notch, and NF-κB, to induce partial or complete EndMT. This virus-driven EndMT contributes to vascular remodelling, chronic inflammation, aberrant angiogenesis, and the development of oncoviral-associated cardiovascular pathology and vascular tumours. The present review integrates current virological and mechanistic insights into EndMT as a hijacked host process, highlighting its role at the virus-host interface and discussing emerging antiviral and pathway-targeted strategies aimed at limiting oncovirus-mediated endothelial dysfunction.}, }
@article {pmid41965962, year = {2026}, author = {Sirago, G and Solarino, B and Dell'Erba, A and Ferorelli, D}, title = {Mapping 25 years of forensic and legal medicine research: a multi-database bibliometric and science-mapping analysis (2000-2025).}, journal = {Journal of forensic and legal medicine}, volume = {120}, number = {}, pages = {103127}, doi = {10.1016/j.jflm.2026.103127}, pmid = {41965962}, issn = {1878-7487}, mesh = {Humans ; *Forensic Medicine ; *Bibliometrics ; *Forensic Sciences ; *Biomedical Research ; }, abstract = {BACKGROUND: Forensic and legal medicine spans forensic pathology, clinical forensic practice, toxicology, genetics, imaging, and emerging digital methods. Long-horizon mapping can support research prioritisation and editorial strategy.
METHODS: We conducted performance analysis and science-mapping of records published between 2000 and 2025. Primary analyses were performed on Web of Science Core Collection records (articles and reviews) using bibliometrix/biblioshiny. Outputs included annual production, leading sources and countries, citation indicators, collaboration metrics, keyword co-occurrence, Callon centrality-density thematic mapping, and trend-topic analysis. A conservative, prespecified keyword harmonisation was applied to a small set of orthographic variants (medico-legal, postmortem, machine learning, deep learning). Scopus-derived outputs were used as a robustness comparison for source and country landscapes.
RESULTS: The WoS corpus comprised 16,190 documents from 3052 sources with 49,746 distinct authors and 372,874 cited references. Annual growth was 7.68%, with 5.07 co-authors per document and 13.38% international co-authorship. Output was concentrated in a compact Bradford nucleus of specialist forensic journals, while a long tail of occasional publications appeared in adjacent clinical and multidisciplinary venues. Thematic mapping identified four macro-domains-identification, risk/epidemiology, autopsy/postmortem pathology, and clinical forensic practice-with recent growth in COVID-19-related work, postmortem interval research, and AI/ML terminology.
CONCLUSIONS: Forensic and legal medicine shows sustained growth with a stable conceptual backbone and accelerating innovation in digital and computational themes. These maps can inform research prioritisation, training needs, and editorial planning across specialist forensic outlets.}, }
@article {pmid41965973, year = {2026}, author = {Yadav, P and Singh, A and Kumari, M and Verma, SK and Singh, D}, title = {Clinical evidence on BCG vaccination and COVID-19 infection: A systematic review.}, journal = {Respiratory investigation}, volume = {64}, number = {3}, pages = {101422}, doi = {10.1016/j.resinv.2026.101422}, pmid = {41965973}, issn = {2212-5353}, mesh = {*BCG Vaccine/immunology/administration & dosage ; Humans ; *COVID-19/prevention & control/immunology ; Immunity, Innate ; Trained Immunity ; *Pandemics/prevention & control ; SARS-CoV-2/immunology ; *Vaccination ; Cross Protection ; *Coronavirus Infections/prevention & control/immunology ; *Pneumonia, Viral/prevention & control/immunology ; }, abstract = {The COVID-19 pandemic, starting in late 2019, led to the rapid development of SARS-CoV-2 vaccines, though early availability was limited, and variants like Delta and Omicron impacted their effectiveness. The Bacillus Calmette-Guérin (BCG) vaccine, used to prevent tuberculosis, has attracted interest for its potential non-specific protective effects against COVID-19. This review systematically evaluates the role of BCG vaccination in enhancing innate immune responses and its utility against COVID-19, focusing on mechanisms like trained immunity and cross-protection. It also discusses recent studies on BCG's impact on COVID-19 outcomes. Preliminary clinical trial findings suggest potential benefits of BCG vaccination against COVID-19, but the evidence remains inconclusive. Therefore, this review highlights the necessity of additional studies to determine whether BCG can prevent COVID-19 infection, mitigate severe outcomes and hospitalizations, and serve as a preventive tool for future viral pandemics.}, }
@article {pmid41965977, year = {2026}, author = {Gashema, P and Iradukunda, PG and Rudacogora, JC and Siddig, EE and Shema, H and Bigirimana, R and de Dieu Harelimana, J and Louis, M and Muvunyi, CM}, title = {Unlocking Africa's vaccine Independence: The critical role of technology transfer and intellectual property.}, journal = {Vaccine}, volume = {81}, number = {}, pages = {128573}, doi = {10.1016/j.vaccine.2026.128573}, pmid = {41965977}, issn = {1873-2518}, mesh = {*Technology Transfer ; *Intellectual Property ; Humans ; Africa/epidemiology ; *COVID-19 Vaccines/supply & distribution ; *COVID-19/prevention & control/epidemiology ; SARS-CoV-2/immunology ; }, abstract = {The COVID-19 pandemic exposed Africa's profound dependency on external vaccine suppliers, with the continent producing less than 1% of global vaccines and hosting only 1.1% of clinical trials. Despite emerging initiatives, most African facilities remain limited to downstream fill-and-finish operations, while full vaccine antigen manufacturing capacity is largely absent. This perspective paper examines the critical role of Technology Transfer (TT) and Intellectual Property (IP) access in achieving Africa's vaccine independence. Effective TT must extend beyond documentation to include unspoken know-how, on-site mentorship, regulatory dossiers, and supply-chain integration. Simultaneously, pragmatic IP frameworks through voluntary licensing, patent pooling, and time-bound waivers are essential to enable lawful and sustainable local production. Drawing lessons from mature European and U.S. ecosystems, the paper highlights the need for regional manufacturing clusters, harmonized regulatory systems under the African Medicines Agency (AMA), and African pooled procurement mechanisms to ensure market viability. Persistent challenges such fragmented regulation, supply-chain fragility, limited skilled human capital, and uncertain financing continue to constrain progress and highlight the imperative for political commitment to be operationalized through sustained structural investments. Africa's vaccine sovereignty will depend on aligning TT with IP reform, regional cooperation, and predictable market assurance, transforming the continent from a dependent recipient into a resilient and globally competitive vaccine producer.}, }
@article {pmid41966154, year = {2025}, author = {Eshete, MT and Shrestha, P and Ang, C and Valderas, JM and Heymann, DL and Nordström, A and Lee, K and Cook, A and Wenham, C and Perel, P and Miranda, JJ and Garcia-Basteiro, AL and Clark, H and Legido-Quigley, H and Engebretsen, E}, title = {Exploring Grassroots Indicators for Pandemic Prevention, Preparedness, and Response: A Systematic Narrative Review.}, journal = {International journal of health policy and management}, volume = {14}, number = {}, pages = {8886}, pmid = {41966154}, issn = {2322-5939}, mesh = {Humans ; Pandemic Preparedness ; *COVID-19/prevention & control/epidemiology ; *Pandemics/prevention & control ; Public Health ; SARS-CoV-2 ; }, abstract = {BACKGROUND: The COVID-19 pandemic has revealed how conventional top-down, expert-driven indicators often fail to align with local community realities, marginalising their perspectives, concerns, knowledge, and narratives. However, the limitations of pandemic-related and global health security indicators are not unique but reflect recurring patterns across major social metrics. In response, an alternative paradigm advocates for grassroots-inclusive approaches to developing indicators. Our objective is to assess how and why grassroots-inclusive approaches complement top-down approaches to developing indicators, and to synthesise their theoretical and practical contributions to public health.
METHODS: We conducted a scoping review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. We systematically searched six databases (MEDLINE, Embase, CINAHL, Web of Science, Scopus, and PsycINFO), as well as Google Scholar, to identify relevant articles published from their inception to September 1, 2024. We included peer-reviewed articles, opinion pieces, and book chapters, narratively synthesising their findings.
RESULTS: This review included 43 studies from various disciplines. Across these studies, communities co-produced indicators through participatory workshops, interviews, and consensus exercises in areas such as environmental sustainability, disaster resilience, public health, well-being, and local development. The reported strengths included greater local relevance, community ownership, and accountability, alongside challenges in sustaining participation, integrating into top-down systems, and addressing data gaps. Notably, no study applied grassroots-inclusive indicators to health security or pandemic preparedness.
CONCLUSION: Despite retrieving and analysing articles from various disciplines, no study has specifically applied grassroots-inclusive indicators to health security or pandemic preparedness. However, the evidence clearly shows that it is both feasible and practical to integrate expert and non-expert perspectives when developing indicators.}, }
@article {pmid41966207, year = {2025}, author = {Hudon, PA and Haren, MT and Gartner, JB and Bergeron, F and Côté, A}, title = {Public Healthcare Procurement Strategies in Response to the COVID-19 Pandemic: A Scoping Review.}, journal = {International journal of health policy and management}, volume = {14}, number = {}, pages = {8556}, pmid = {41966207}, issn = {2322-5939}, mesh = {*COVID-19 ; Humans ; *Pandemics ; SARS-CoV-2 ; Personal Protective Equipment/supply & distribution ; *Equipment and Supplies/supply & distribution ; *Public Health ; Public Health Infrastructure ; }, abstract = {BACKGROUND: The COVID-19 pandemic posed unprecedented public healthcare procurement challenges. The objective of this review was to identify and characterise the scope of the literature on public procurement strategies for healthcare supplies during the COVID-19 pandemic (2019-2023) in relation to the public procurement contexts, systems, and processes and methods (the public procurement ecosystem) worldwide.
METHODS: We performed a scoping review of governmental strategies for the procurement of medical equipment, personal protective equipment (PPE), or medications related to the COVID-19 pandemic. Extracted data were mapped to the fields of the public procurement ecosystem. We used inductive thematic analysis to derive within-field themes, and subsequently, cross-cutting themes through which we structured a narrative synthesis.
RESULTS: 1909 unique studies were identified through a systematic search, of which 89 met the inclusion criteria. One hundred and ten themes were derived from the extracted data within the 21 fields of the public procurement ecosystem, and from these, 10 cross-cutting themes were identified which served to structure the narrative synthesis. It was clear in this literature that the scale and impact of the COVID-19 pandemic required governments to act well outside of the public procurement processes and methods themselves, to procure and distribute the required supplies. Notwithstanding the significant attention to contextual and system-level responses, there were significant responses at the procurement process and methods level, including rapid and temporary expedited procurement processes and longer-term strategic procurement responses.
CONCLUSION: This scoping review of public procurement strategies during the COVID-19 pandemic has demonstrated a focus of the literature not only on the public procurement processes and methods themselves, but also on governmental actions to adapt both structures of public procurement systems and conditions within broader environmental contexts to facilitate procurement goals.}, }
@article {pmid41967609, year = {2026}, author = {Žigová, K and Marčeková, Z and Gautieri, A and Rebroš, M}, title = {Recombinant Taq DNA polymerase.}, journal = {Journal of biotechnology}, volume = {415}, number = {}, pages = {152-169}, doi = {10.1016/j.jbiotec.2026.04.002}, pmid = {41967609}, issn = {1873-4863}, mesh = {*Taq Polymerase/chemistry/genetics/metabolism/isolation & purification ; Protein Engineering/methods ; *Recombinant Proteins/chemistry/genetics/metabolism ; Enzyme Stability ; Humans ; SARS-CoV-2 ; }, abstract = {The sudden COVID-19 pandemic highlights the importance of diagnostic assays in health security readiness. One persistent difficulty is the rapid molecular detection of pathogenic microorganisms and viruses. Taq DNA polymerase remains an essential component for COVID-19 molecular detection. Taq DNA polymerase exhibits a high level of thermostability, which results from tighter hydrophobic packing, increased salt bridges, shortened loops, and proline substitutions that reduce flexibility, enabling activity above 90 °C. In addition, engineered variants address limitations by improving fidelity, processivity, and stability. The enzyme´s thermostability has significantly increased the efficiency, automation, and specificity of PCR. Hot-start modifications using antibodies, aptamers, or chemical inhibitors further reduce non-specific amplification, strengthening its role in sensitive diagnostics. Although Taq polymerase is available from several commercial sources, it is crucial and urgent to produce enzymes recombinantly for use in research and diagnostic procedures. To satisfy the demands of industry, it is necessary to maximize and optimize its production. We provide an overview of the recombinant Taq DNA polymerase´s characteristics, structural features, engineering advances, production background and strategies, and purification history in this paper. Together, these insights underscore its central role in diagnostics, research, and biotechnology, as well as its continued relevance as a model enzyme for protein engineering.}, }
@article {pmid41968868, year = {2026}, author = {Tang, Y and Li, D and Zhu, Y and Duan, H and Zhao, A}, title = {Rational design of lipid and lipid-like structures for non-liver-targeted mRNA therapy.}, journal = {Biomaterials science}, volume = {14}, number = {9}, pages = {2237-2259}, doi = {10.1039/d5bm01344e}, pmid = {41968868}, issn = {2047-4849}, mesh = {Humans ; *Lipids/chemistry ; *RNA, Messenger/therapeutic use/genetics/chemistry/metabolism/administration & dosage ; Animals ; Liver/metabolism ; }, abstract = {The application of mRNA therapies has witnessed significant advancement since the outbreak of COVID-19. However, the widespread use of mRNA therapies has been restricted by the liver accumulation of traditional lipid structures used as delivery vectors. The efficacy of mRNA expression has been demonstrated to be highly related to vector structures and properties. To expand non-liver organs or cells as therapeutic targets for mRNA, lipid and other lipid-like molecules such as lipid analogs and lipid-like polymers with more favorable mRNA delivery efficiencies have been developed based on a deeper understanding of their structure-function correlations. This review primarily summarizes the structure commonalities leading to an excellent delivery performance and specific organ or cell targeting and illustrates the potential and future prospects of related materials in different biomedical applications of mRNA therapies.}, }
@article {pmid41969107, year = {2026}, author = {Jariah, ROA and Hakim, MS}, title = {Antiviral properties of phages: potential mechanisms of actions.}, journal = {The new microbiologica}, volume = {49}, number = {1}, pages = {1-10}, pmid = {41969107}, issn = {1121-7138}, mesh = {Humans ; *Bacteriophages/physiology ; SARS-CoV-2/physiology ; Animals ; COVID-19/virology/therapy ; Antiviral Agents ; }, abstract = {Bacteriophages (phages) have long been known to treat bacterial infections, although some early studies showed that phages also have potential antiviral mechanisms. This review provides a descriptive summary of ideas on how phages might have a significant role in inhibiting viral infections. Phages are known to directly modulate the host immunity that subsequently influences the immune responses against viral infections. It is also reasonable to explore the phage potential to directly inhibit viral infection in humans, including herpes simplex virus (HSV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Lastly, phages have been utilized as a molecular tool in phage display. Phages have already been engineered to produce monoclonal antibodies against the spike (S) protein of SARS-CoV-2. Despite all these possibilities, further extensive and deeper explorations are highly required.}, }
@article {pmid41971326, year = {2026}, author = {Cao, X and Tang, J and Liu, Y and Wang, X and Li, Q and Xu, Y and Li, X and Zhao, F}, title = {Evolutionary trajectory and co-infection dynamics of human influenza A(H1N1) virus (2000-2025): an integrated framework informed by expert-informed bibliometrics.}, journal = {Frontiers in microbiology}, volume = {17}, number = {}, pages = {1793244}, pmid = {41971326}, issn = {1664-302X}, abstract = {INTRODUCTION: Influenza A (H1N1) remains an important seasonal respiratory pathogen, but evidence on its evolutionary dynamics, reported co-detections, and surveillance priorities remains fragmented.
METHODS: We conducted an evidence-mapping synthesis (2000-2025) integrating bibliometric analysis, expert-guided curation, and sequence/structure-informed interpretation. A total of 15,028 records were retrieved from PubMed, Web of Science, and Scopus, and 11,848 unique publications were retained after deduplication. GenBank-derived hemagglutinin (HA) sequences and Swiss-Model homology models were used to characterize mutational patterns and structural features. Literature-derived co-detection records were extracted from eligible publications and interpreted using a method-aware framework.
RESULTS: A post-2010 shift in the HA mutational landscape was observed, with recurrent substitutions at sites including S13, S146, S160, and S202. Structure-informed comparison of representative HA models identified a conformationally flexible segment spanning residues aa190-aa226, suggesting potential relevance to the receptor-binding microenvironment. Mapping of literature-derived co-detection records showed that RSV and SARS-CoV-2 were among the most frequently reported co-pathogens; however, these proportions reflected reporting composition across heterogeneous studies rather than population-level co-infection prevalence. In a China-focused module, G219A in Eurasian avian-like (EA) H1N1 strains was prioritized through protocol-constrained expert annotation requiring isolate-level evidence and was interpreted as a hypothesis-generating site of interest within the receptor-binding region rather than an algorithm-derived global bibliometric signal.
DISCUSSION: This study provides an integrated overview of H1N1 research evolution, HA mutational change, and reported co-detection patterns over the past 25 years. The findings support a tiered, method-aware multi-pathogen surveillance framework for preparedness, while underscoring that heterogeneous literature-derived co-detection data require standardized definitions, assay-aware interpretation, and local calibration before translation into clinical or public health decision-making.}, }
@article {pmid41971592, year = {2026}, author = {Wang, K and Yang, Z}, title = {Future prospects of antiviral research in traditional Chinese medicine.}, journal = {Chinese herbal medicines}, volume = {18}, number = {2}, pages = {226-230}, pmid = {41971592}, issn = {2589-3610}, abstract = {Traditional Chinese medicine (TCM) has a long history of treating viral diseases through holistic approaches and multi-component formulations. In response to emerging global viral threats like coronavirus disease-2019 (COVID-19), TCM has demonstrated significant potential in both antiviral and immune-modulatory roles. This review summarizes the current state of TCM antiviral research, highlighting advances in identifying active components and elucidating their mechanisms, which include direct viral inhibition and immune regulation. Technological innovations, including artificial intelligence (AI)-driven drug discovery and advanced extraction methods, are accelerating the development of TCM antiviral products. However, challenges remain in standardization, mechanistic validation, and international regulatory acceptance. Looking ahead, research should prioritize systems pharmacology, the development of multi-dimensional evaluation models, standardized clinical trials, and global health integration. By addressing these challenges, TCM can play a vital role in worldwide antiviral strategies and public health.}, }
@article {pmid41972558, year = {2026}, author = {Sergazy, S and Gulyaev, A and Shulgau, Z}, title = {Oxidative Stress as a Mechanistic Link Between Severe Respiratory Viral Infection and Pulmonary Fibrosis.}, journal = {Biology}, volume = {15}, number = {7}, pages = {}, pmid = {41972558}, issn = {2079-7737}, support = {AP23489474//Ministry of Science and Higher Education of the Republic of Kazakhstan/ ; }, abstract = {Post-viral pulmonary fibrosis represents a clinically significant and mechanistically complex consequence of severe respiratory infection. The COVID-19 pandemic has highlighted that a subset of survivors, particularly those with severe pneumonia or acute respiratory distress syndrome, develop persistent fibrosis-like lung abnormalities, including reticulation and traction bronchiectasis, often accompanied by impaired gas transfer. Although the clinical course is heterogeneous and many lesions regress over time, longitudinal studies indicate that structural and functional impairment may persist for years in susceptible individuals. Oxidative stress has emerged as a plausible convergent mechanism linking acute epithelial injury, dysregulated inflammatory resolution, and chronic fibrotic remodeling. Reactive oxygen and nitrogen species amplify inflammatory signaling, promote epithelial cell death and senescence, influence macrophage polarization, and activate canonical profibrotic pathways, notably the TGF-β axis. Redox imbalance is embedded within reinforcing circuits involving NOX4-dependent ROS amplification, mitochondrial dysfunction, endoplasmic reticulum stress, inflammasome activation, and senescence-associated secretory programs. Persistent immune activation and organelle stress may sustain redox dysregulation beyond viral clearance, thereby bridging acute lung injury to maladaptive remodeling. This review integrates epidemiological, clinical, and mechanistic evidence to position oxidative stress as a central mediator of post-viral lung fibrosis and discusses therapeutic and translational implications.}, }
@article {pmid41972671, year = {2026}, author = {Asaba, CN and Gwanyama, BN and Ayuk, HS and Odo, TI and Bitazar, R and Noumi, T and Labonté, P and Bukong, TN}, title = {Neutrophil Extracellular Traps in Viral Infections: Regulation, Immune Consequences, and Pathogenic Outcomes.}, journal = {Cells}, volume = {15}, number = {7}, pages = {}, pmid = {41972671}, issn = {2073-4409}, support = {Relance 2024//The INRS-Armand-Frappier Santé Biotechnologie Research Centre/ ; 363424//A doctoral scholarship from the Fonds de Recherche du Québec./ ; }, mesh = {*Extracellular Traps/immunology ; Humans ; *Neutrophils/immunology ; *Virus Diseases/immunology ; Immunity, Innate ; COVID-19/immunology ; Animals ; SARS-CoV-2/immunology ; }, abstract = {Neutrophils are among the early responders of the innate immune system and play a key role in host defense against viral infections. Beyond their classical antimicrobial functions, neutrophils can engage in a specialized defense mechanism by releasing web-like extracellular DNA known as neutrophil extracellular traps (NETs). These extracellular traps are a mesh-like network of chromatin DNA decorated with cellular components, including histones, proteases, and antimicrobial enzymes, that function to contain and limit the spread of pathogens. While NET formation contributes to antiviral immunity, accumulating evidence indicates that excessive or dysregulated NET formation can significantly contribute to immunopathology during viral infections. Thus, depending on the context and outcome, NET formation may be viewed as a double-edged sword. Therefore, understanding the regulatory mechanisms governing NET formation and its harmful effects is critical for developing therapeutic strategies that enhance antiviral defense while minimizing tissue damage. In this review, we provide a comprehensive overview of the molecular mechanisms that drive NET formation and clearance, with a particular focus on how viruses modulate these processes to influence disease outcome. We also discuss the pathways underlying NET formation and subsequent neutrophil cell death (NETosis), including canonical and non-canonical pathways, and highlight key signaling axes involving SYK, MAPKs, and NF-κB. Using SARS-CoV-2 and hepatitis B virus as representative models, we examine how different viral components trigger, exploit, or evade NET targeting and how persistent accumulation of NETs can contribute to hyperinflammation, progressive tissue injury, and post-viral syndromes. We further explore emerging evidence linking impaired NET clearance and neutrophil heterogeneity, particularly low-density neutrophils (LDNs), to chronic inflammation and post-viral sequelae such as long COVID and autoimmune hepatitis. Finally, we summarize current and emerging therapeutic strategies aimed at modulating NET formation or enhancing NET clearance. Altogether, this review underscores the dual nature of NETs in viral infections, highlighting their potential roles in antiviral defense and tissue injury, and provides a framework for the development of targeted interventions to limit virus-induced immunopathology.}, }
@article {pmid41972882, year = {2026}, author = {Wang, Z and Chen, B and Gao, Y and Wu, C and Shuai, Q and Yan, Y}, title = {Redox-responsive nanoparticles for enhanced mRNA delivery: a comprehensive review.}, journal = {Journal of materials chemistry. B}, volume = {14}, number = {15}, pages = {4546-4570}, doi = {10.1039/d6tb00186f}, pmid = {41972882}, issn = {2050-7518}, mesh = {Oxidation-Reduction ; Humans ; *Nanoparticles/chemistry ; *RNA, Messenger/chemistry/metabolism/administration & dosage ; Animals ; COVID-19/prevention & control ; }, abstract = {The clinical success of mRNA vaccines during the COVID-19 pandemic highlighted the therapeutic potential of mRNA while exposing persistent delivery barriers, including intrinsic instability, poor cellular uptake, and inefficient intracellular trafficking. Redox-responsive nanoparticles (NPs) provide a promising strategy to improve mRNA delivery by undergoing stimulus-triggered disassembly in the reductive cytosol, facilitating efficient mRNA release, endosomal escape, and enhanced translation. This review elucidates emerging structure-function relationships by systematically linking redox-labile chemistries (e.g., disulfide, diselenide, and polysulfide), carrier type, and NP architecture to key biological outcomes, including endosomal escape, redox responsiveness, transfection efficiency, and biodistribution. We further identify critical translational challenges-such as tumor redox heterogeneity, insufficient systematic preclinical evaluation, and manufacturing constraints-and propose actionable strategies, including multi-stimulus-responsive systems, microfluidic and process-analytical manufacturing, and formulation approaches to improve efficacy, reproducibility, and stability. Collectively, these insights provide a practical framework to guide the rational design and clinical translation of next-generation redox-responsive mRNA delivery platforms.}, }
@article {pmid41973314, year = {2026}, author = {Peddireddy, S and VanWingerden, N and Patel, P and Howard, G and Berger, J}, title = {Stellate Ganglion Block in the Treatment of Long COVID: A Systematic Review.}, journal = {Current pain and headache reports}, volume = {30}, number = {1}, pages = {}, pmid = {41973314}, issn = {1534-3081}, mesh = {Humans ; *Stellate Ganglion/drug effects ; *Autonomic Nerve Block/methods ; *COVID-19/complications/therapy ; Post-Acute COVID-19 Syndrome ; Treatment Outcome ; }, abstract = {OBJECTIVES: This review evaluates stellate ganglion block as a treatment for long COVID, seeking to evaluate the treatment's efficacy by various symptoms and the limitations of the current literature.
STUDY DESIGN: Systematic Review.
SETTING: Ambulatory or Outpatient Setting.
METHODS, SUBJECTS: A systematic review of the current literature regarding use of stellate ganglion block in patients with long COVID was conducted. 2 databases were searched on August 28th, 2025. Search terms were "long COVID" and "stellate ganglion block", yielding 45 results. Studies examining patient outcomes after stellate ganglion block were included. Case reports, case series, basic science studies and previous reviews were excluded. Seven studies met inclusion criteria.
RESULTS: Patients received a single stellate ganglion block in some studies and multiple stellate ganglion blocks in others. All studies reported symptomatic improvement without control groups. Response rates ranged from 55.8% to 100%. The most robust improvements (> 80% patients reporting relief) were seen in cough, dyspnea, headache, joint pain, pain interference/intensity, pins/needles, subjective relief.
CONCLUSION: Stellate ganglion block is a promising treatment that appears to generate substantive benefit for many of the symptoms seen in long COVID. However, the current literature has small, uncontrolled studies with heterogenous study designs and follow-up periods. Standardized research with larger sample sizes, control groups, and longer-term follow up is necessary to elucidate the degree of benefit. IRB approval and clinical trial registration not required.}, }
@article {pmid41973527, year = {2026}, author = {Hudnall, SR and Jacobs, BC and Fields, KB}, title = {Functional Testing for Return to Activity with COVID-19.}, journal = {Current sports medicine reports}, volume = {25}, number = {4}, pages = {118-122}, doi = {10.1249/JSR.0000000000001330}, pmid = {41973527}, issn = {1537-8918}, mesh = {Humans ; *Return to Sport ; *COVID-19 ; *Exercise Test/methods ; SARS-CoV-2 ; *Coronavirus Infections/rehabilitation/physiopathology ; Pandemics ; *Pneumonia, Viral/rehabilitation/physiopathology ; Post-Acute COVID-19 Syndrome ; Betacoronavirus ; Recovery of Function ; }, abstract = {Return-to-play decisions following COVID-19 infection remain challenging due to persistent variability in cardiopulmonary and functional recovery. This review examines four validated functional tests: the Timed Up and Go, 6-Minute Walk Test, Kasch Pulse Step Recovery Test, and 1-Minute Sit-to-Stand Test and their potential roles in assessing readiness for physical activity and sport after COVID-19 infection. These office-based assessments are simple, reproducible, and sensitive to impairments in cardiovascular, pulmonary, and musculoskeletal function. Evidence suggests that post-COVID-19 individuals may demonstrate significant deficits in performance across functional tests, supporting their integration into return-to-play evaluations. The 6-Minute Walk Test is recommended as the primary measure of functional capacity, with the 1-Minute Sit-to-Stand Test as a validated alternative. Incorporating functional testing into return-to-play protocols can enhance clinical decision-making, guide rehabilitation, and promote safe resumption of physical activity.}, }
@article {pmid41973776, year = {2026}, author = {Fam, JY and Männikkö, N}, title = {Can the Bergen Facebook Addiction Scale be adapted across contexts? Evidence from a COnsensus-based Standards for the selection of health Measurement INstruments systematic review.}, journal = {Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors}, volume = {40}, number = {4}, pages = {484-497}, doi = {10.1037/adb0001149}, pmid = {41973776}, issn = {1939-1501}, mesh = {Humans ; *Psychometrics ; *Social Media ; COVID-19 ; Reproducibility of Results ; *Internet Addiction Disorder/diagnosis ; *Behavior, Addictive/diagnosis ; Pandemics ; *Psychiatric Status Rating Scales/standards ; Consensus ; SARS-CoV-2 ; }, abstract = {OBJECTIVE: The Bergen Facebook Addiction Scale (BFAS) has served as a foundation for a series of adapted measures designed to assess social media-related behavioral addictions. Despite widespread application of these instruments, a systematic evaluation of their psychometric properties is lacking. This review aimed to evaluate the measurement properties of the BFAS and its adaptations using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology.
METHOD: A systematic search was conducted to identify psychometric studies of the BFAS and its adapted versions, including the BFAS-18, Bergen Social Media Addiction Scale (BSMAS), Bergen Mukbang Addiction Scale, Social Media Addiction during COVID-19 Pandemic scale, and Social Networks Addiction Scale-6 Symptoms. Eligible studies were assessed using the COSMIN Risk of Bias checklist, and the quality of evidence was graded according to the COSMIN-Grading of Recommendations Assessment, Development and Evaluation approach.
RESULTS: A total of 55 studies were included. The BFAS and BSMAS demonstrated strong evidence for structural validity, internal consistency, measurement invariance, and hypothesis testing, with high-quality evidence across multiple domains. The BFAS-18 and Bergen Mukbang Addiction Scale received more limited and inconsistent support, while the Social Media Addiction during COVID-19 Pandemic scale and Social Networks Addiction Scale-6 Symptoms remain underexplored with very low-quality evidence. Across all scales, evidence for content validity, reliability, measurement error, and responsiveness was sparse, highlighting important gaps.
CONCLUSIONS: The BFAS and BSMAS currently represent the most robust instruments for assessing Facebook and social media addiction, respectively. However, additional research is required to strengthen evidence for other adaptations, particularly in relation to content validity, measurement error, and responsiveness, as well as to evaluate linguistic and cultural invariance. (PsycInfo Database Record (c) 2026 APA, all rights reserved).}, }
@article {pmid41974008, year = {2026}, author = {Albaloul, H and Nemer, A and Saini, N and Schuster, MG}, title = {Infectious Diseases: What You May Have Missed in 2025.}, journal = {Annals of internal medicine}, volume = {179}, number = {5_Supplement}, pages = {e2600983}, doi = {10.7326/ANNALS-26-00983}, pmid = {41974008}, issn = {1539-3704}, mesh = {Humans ; Female ; HIV Infections/drug therapy ; Influenza Vaccines/therapeutic use ; Anti-Bacterial Agents/therapeutic use ; COVID-19/prevention & control ; }, abstract = {This article highlights clinical trials on infectious diseases published in 2025 that we believe are highly relevant to internal medicine physicians who are not infectious diseases specialists. Selected studies address prevention and treatment strategies across infectious diseases. We highlight 2 studies of sexually transmitted infections (STIs): one examining the effectiveness of treating male partners to reduce recurrence of bacterial vaginosis and another study of doxycycline as postexposure prophylaxis against bacterial STI. A strategy for using methanamine hippurate to prevent recurrent urinary tract infections (UTIs) in older women is included in our review. We review the updated evidence supporting the effectiveness of COVID-19, respiratory syncytial virus, and influenza vaccines for the 2025-2026 season, and a modified messenger RNA influenza vaccine, which showed superior efficacy with an acceptable safety profile. In HIV care, a study of dual antiretroviral maintenance therapy showed that dolutegravir and lamivudine was noninferior to triple therapy at 48 weeks. A meta-analysis supporting shorter antibiotic courses for pyelonephritis and complicated UTIs provides important information for antibiotic stewardship strategies. In serious infections, dalbavancin was noninferior to standard therapy for Staphylococcus aureus bacteremia, whereas cefiderocol expanded treatment options for gram-negative bloodstream infections without clear superiority, particularly in carbapenem-resistant pathogens. Finally, a study found that elevated C-reactive protein identifies patients most likely to benefit from adjunctive corticosteroids in community-acquired pneumonia.}, }
@article {pmid41974432, year = {2026}, author = {Watanabe, H and Nagao, R and Kawabata, K and Mizutani, Y}, title = {[Olfactory Nerve: The Vulnerability Inherent in its Unique System and Neurological Diseases].}, journal = {Brain and nerve = Shinkei kenkyu no shinpo}, volume = {78}, number = {4}, pages = {303-311}, doi = {10.11477/mf.188160960780040303}, pmid = {41974432}, issn = {1881-6096}, mesh = {Humans ; *Olfactory Nerve/pathology/physiopathology ; *Parkinson Disease/complications ; *COVID-19/complications ; *Nervous System Diseases ; Animals ; }, abstract = {The olfactory nerve possesses unique anatomical features, including direct central nervous system (CNS) projection and continuous regeneration. Scientific advances have elucidated mechanisms such as combinatorial receptor coding and signal amplification. This review summarizes these foundations and examines olfactory dysfunction in COVID-19 and Parkinson's disease (PD). In COVID-19, evidence suggests that SARS-CoV-2 targets sustentacular cells rather than olfactory neurons, causing gene downregulation and parosmia attributed to incomplete peripheral filtering, while direct CNS invasion remains rare. In PD, olfactory loss is a prodromal feature. However, seed amplification assays reveal that alpha-synuclein aggregation in the nasal mucosa does not fully correlate with olfactory dysfunction, as reflected by differences between PD and Multiple System Atrophy. This, together with correlations with cardiac sympathetic denervation, challenges simple pathogen propagation hypotheses. We propose that PD-related hyposmia reflects a systemic vulnerability involving deficits in energy metabolism and neural network organization, rather than solely peripheral protein aggregation. Understanding these pathologies requires a multifaceted approach beyond anatomical lesions.}, }
@article {pmid41975034, year = {2026}, author = {Matthews, R and Alam, A and Bullmore, E and Michael, BD}, title = {Understanding the long-term neurological effects of SARS-CoV-2 infection.}, journal = {Nature reviews. Neurology}, volume = {22}, number = {6}, pages = {351-365}, pmid = {41975034}, issn = {1759-4766}, mesh = {Humans ; *COVID-19/complications ; *Nervous System Diseases/etiology ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Pandemics ; *Coronavirus Infections/complications ; Cognitive Dysfunction/etiology/physiopathology ; }, abstract = {Post-COVID-19 condition (PCC), also known as long COVID, is a heterogeneous condition marked by persistent symptoms following acute SARS-CoV-2 infection. As approximately 6% of people who have experienced acute COVID-19 are estimated to develop PCC, the potential population is vast. Many of the key symptoms of PCC reflect involvement of the nervous system, ranging from cognitive impairment ('brain fog'), headaches and fatigue to anxiety and depression. This Review summarizes the spectrum of neurological and psychological symptoms that occur following acute SARS-CoV-2 infection, with a particular focus on the international consensus-based core outcome set for PCC. We also explore the proposed underlying mechanisms, including evidence for immune system dysregulation, microvascular dysfunction and volumetric changes on neuroimaging. In addition, we review ongoing and completed large-scale treatment trials. Growing evidence suggests a bidirectional interaction between symptoms traditionally considered neurobiological in origin, such as cognitive deficits and headache, and those within the purview of psychiatry, such as anxiety and depression. PCC represents an opportunity to better understand the long-term consequences of acute infection and improve management strategies and outcomes, not only for people with the condition but also for those with other post-viral syndromes that affect brain health.}, }
@article {pmid41975314, year = {2026}, author = {Alhumaid, S and Alkhars, O and Algrafi, AS and Dossary, NA and Elhaj, N and Majzoub, RA and Turkistani, JA and Alhumaid, SM and Shaikh, HAA and Aldiaram, A and Alahmed, AH and Alomran, SA and AlQatifi, MB and Alkolib, MJ and Almubarak, MS and Al-Helal, H and Alhaddad, AJ and Alsouaib, HA and Albahrani, AA and Aldera, AH and Alnasser, FM and Alhmeed, N and Alsulaiman, MS and Al Alawi, Z and Alghazal, HA}, title = {Vaccine effectiveness across the Omicron evolutionary spectrum (BA.2, BA.5, XBB, JN.1, KP.3): a systematic review of studies published 2022-2025.}, journal = {BMC infectious diseases}, volume = {26}, number = {1}, pages = {}, pmid = {41975314}, issn = {1471-2334}, mesh = {*Vaccine Efficacy ; Humans ; *COVID-19 Vaccines/immunology ; *COVID-19/prevention & control/immunology/epidemiology/virology ; *SARS-CoV-2/immunology/genetics ; }, abstract = {BACKGROUND: Since late 2021, the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has undergone rapid evolutionary diversification, giving rise to successive subvariants with increasing immune escape. In response, coronavirus disease 2019 (COVID-19) vaccination strategies transitioned from ancestral-strain vaccines to variant-adapted formulations. Real-world evidence on the effectiveness and durability of these updated vaccines across the full Omicron evolutionary spectrum remains fragmented. OBJECTIVES: To synthesise real-world evidence on the effectiveness of COVID-19 vaccines against SARS-CoV-2 infection and severe clinical outcomes across successive Omicron subvariants from 2022 to 2025, with particular emphasis on variant-adapted vaccine formulations and waning immunity over time. METHODS: A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and registered in PROSPERO. MEDLINE (via PubMed), Embase, CINAHL, Scopus, and Web of Science Core Collection were systematically searched for peer-reviewed observational studies published between January 2022 and December 2025. Eligible studies assessed vaccine effectiveness during periods dominated by Omicron subvariants including BA.2, BA.5, XBB, BA.2.86/JN.1, and KP lineages. Findings were synthesised narratively due to substantial heterogeneity. RESULTS: Thirty observational studies from North America, Europe, and East Asia were included. Across Omicron subvariants, vaccine effectiveness against SARS-CoV-2 infection was generally modest and short-lived, with rapid waning within months after vaccination and estimates frequently approaching null during later subvariant periods. In contrast, updated and variant-adapted vaccines consistently provided meaningful protection against severe COVID-19 outcomes, including hospitalization and death. Protection was highest during BA.4/BA.5 and early XBB-dominant periods and declined with increasing time since vaccination, especially during JN.1- and KP-predominant periods and among the oldest age groups. Importantly, substantial protection against severe outcomes persisted within the first 1–3 months following vaccination, with effectiveness against hospitalization and death generally ≥ 50%, although effectiveness declined over time during later Omicron subvariant periods. CONCLUSION: Updated and variant-adapted COVID-19 vaccines continue to confer substantial protection against severe COVID-19 outcomes across successive Omicron subvariants, despite limited and rapidly waning effectiveness against SARS-CoV-2 infection. These findings support prioritisation of periodic booster vaccination for older adults and other high-risk populations, with vaccine performance primarily evaluated using protection against severe clinical outcomes. CLINICAL TRIAL NUMBER: Not applicable.}, }
@article {pmid41975359, year = {2026}, author = {Porter, AV and Joseph-Williams, N and Leighton, C and Gal, M and Edwards, A and Cooper, A}, title = {Barriers and facilitators to knowledge translation at the science-policy interface during the COVID-19 pandemic public health emergency: a rapid review and theoretical analysis to inform development of a logic model.}, journal = {BMC public health}, volume = {26}, number = {1}, pages = {}, pmid = {41975359}, issn = {1471-2458}, mesh = {Humans ; *COVID-19/epidemiology/prevention & control ; *Health Policy ; Models, Theoretical ; *Pandemics ; Policy Making ; *Public Health ; SARS-CoV-2 ; *Translational Research, Biomedical ; *Translational Science, Biomedical/organization & administration ; }, abstract = {BACKGROUND: The COVID-19 pandemic necessitated the rapid production, synthesis, and translation of best available evidence to inform public health policy and practice decisions. This presents a unique learning opportunity to understand the interventions and strategies used to promote evidence-informed decision-making at the science-policy interface during this public health emergency and to explore what hindered or facilitated these processes. OBJECTIVES: To describe the interventions at the science-policy interface used to support knowledge translation during the COVID-19 pandemic, explore the barriers and facilitators to such interventions, and apply findings to formal knowledge translation principles to inform the development of a logic model. METHODS: A systematic literature search of Medline via OVID, Scopus, and Web of Science was conducted. Studies were assessed for eligibility and critically appraised. A narrative synthesis was conducted. Knowledge translation models and frameworks were identified via Google Scholar and analysed for their applicability to a public health emergency context. RESULTS: We included 18 articles. The most common interventions at the science-policy interface were advisory committees, knowledge translation platforms and hubs, knowledge translation activities (knowledge brokering, priority-setting, workshops) and products (data visualisation and summaries). Barriers included: data availability and accessibility, time constraints, underrepresentation in advisory committees, political influence, and lack of transparency. Facilitators included: research coordination, interdisciplinary collaboration, transparency in research methods, and actionable and accessible evidence. We identified 11 knowledge translation models that contributed to the logic model. CONCLUSIONS: Our findings, developed from empirical findings and theoretical principles, offer valuable insights into how knowledge translation infrastructures and processes could be strengthened in preparation for future public health emergencies.}, }
@article {pmid41975387, year = {2026}, author = {Rák, T and Ormai, E and Pandur, E and Horváth, G and Adrienne, C}, title = {Exploring the interplay between olfaction and vision: neuroplasticity, rehabilitation, and the therapeutic potential of herbal ingredients.}, journal = {BMC complementary medicine and therapies}, volume = {26}, number = {1}, pages = {}, pmid = {41975387}, issn = {2662-7671}, support = {PTE GYTK-KK Kollab 2025, Dr. Györgyi Horváth//University of Pécs, Faculty of Pharmacy-Clinical Centre Collaboration Funding/ ; }, mesh = {Humans ; *Neuronal Plasticity ; Olfactory Training ; Oils, Volatile/therapeutic use ; *Vision Disorders/rehabilitation/drug therapy ; *Smell/physiology ; *Vision, Ocular/physiology ; }, abstract = {Post-COVID-19, olfactory and visual training have demonstrated health benefits, particularly for individuals with visual impairments and neurodegenerative conditions such as Parkinson’s and glaucoma. Integrating olfactory training with essential oils and developing multisensory technologies could improve the quality of life for those with sensory deficits, underscoring the brain’s adaptability and the therapeutic potential of herbal ingredients. This short review commentary proposes that the neuroplastic interplay between the olfactory and visual pathways, including their demonstrated anatomical and functional convergence, may provide a conceptual foundation for integrating olfactory stimulation into future visual rehabilitation strategies.}, }
@article {pmid41975908, year = {2026}, author = {Noh, W and Ko, Y}, title = {Resilience-Enhancing Programs for Nurses in the Era of COVID-19: A Systematic Review and Meta-Analysis.}, journal = {Healthcare (Basel, Switzerland)}, volume = {14}, number = {7}, pages = {}, pmid = {41975908}, issn = {2227-9032}, abstract = {Background/Objectives: In the post-pandemic era, growing concern about the mental health of healthcare professionals has led to the development of various resilience-enhancing programs. Although such programs are not new, having been implemented before the pandemic, it is important to investigate how post-pandemic programs differ from earlier ones. This review aimed to analyze resilience-enhancing programs for nurses and evaluate their effectiveness. Methods: This systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search was performed in the Cochrane Library, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and EMBASE. Six studies met the inclusion criteria. The meta-analysis was conducted using Stata version 16.0 (StataCorp LLC., College Station, TX, USA). Results: Six studies were included in the systematic review and meta-analysis. The characteristics of the included studies, such as country, study design, setting, population, outcome variables, and resilience-enhancing programs for nurses, were analyzed. The random-effects meta-analysis indicated a statistically significant positive effect on nurses' resilience (SMD = 0.58, 95% CI 0.10 to 1.07, Z = 2.35, p = 0.019). Conclusions: This study provides foundational evidence for understanding resilience-enhancing programs for nurses and highlights their potential value in post-pandemic healthcare settings.}, }
@article {pmid41976966, year = {2026}, author = {Mihai, AM and Marc, M and Lucaciu, F and Sima, A}, title = {Incident Heart Failure Risk Following COVID-19 Recovery: A Systematic Review and Meta-Analysis.}, journal = {Journal of clinical medicine}, volume = {15}, number = {7}, pages = {}, pmid = {41976966}, issn = {2077-0383}, support = {We would like to acknowledge the Victor Babes University of Medicine and Pharmacy, Timisoara, for paying the APC. The funder had no role in study design, data collection/analysis, decision to publish, or manuscript preparation//Victor Babeș University of Medicine and Pharmacy Timișoara/ ; }, abstract = {Background/Objectives: While acute cardiac injury during COVID-19 is well-documented, the long-term risk of new-onset heart failure (HF) in survivors remains a critical clinical concern. This study aims to quantify the risk of new-onset heart failure during a 25 months prognostic follow-up period following recovery from SARS-CoV-2. Methods: We conducted a systematic review and meta-analysis of nine high-quality studies (n > 400,000 survivors) in accordance with PRISMA 2020 guidelines. Databases including PubMed/MEDLINE and Scopus were searched through January 2026. A quantitative meta-analysis was performed on six studies using a random-effects model to pool adjusted hazard ratios (aHR). Results: The pooled analysis revealed a significant 35% increased risk of new-onset heart failure following COVID-19 recovery (aHR 1.35; 95% CI: 1.14-1.60; p = 0.001). Significant heterogeneity was observed (I[2] = 92.62%), reflecting diverse risk profiles among survivors. The risk was most pronounced in immunocompromised kidney transplant recipients (aHR 2.32) and younger adults under the age of 65 (aHR 1.53). Subclinical myocardial damage, characterized by reduced left ventricular longitudinal strain, was identified even in survivors who experienced mild initial infections. Conclusions: COVID-19 recovery serves as a significant independent risk factor for chronic heart failure, emphasizing that cardiovascular impact extends far beyond the acute phase. These findings necessitate the implementation of structured cardiovascular monitoring and biomarker screening for at least one year post-infection to address this emerging chronic disease burden.}, }
@article {pmid41977035, year = {2026}, author = {Mastrangelo, H and Sacco, MA and Gualtieri, S and Grimaldi, G and Monterossi, MD and Neri, G and Aquila, I}, title = {Placental Vascular Malperfusion, Perinatal Death and Neonatal Brain Injury: A Mechanism-Based Narrative Review with Medico-Legal Implications.}, journal = {Journal of clinical medicine}, volume = {15}, number = {7}, pages = {}, pmid = {41977035}, issn = {2077-0383}, abstract = {Background/Objectives: Placental vascular malperfusion, on both the maternal (MVM) and fetal (FVM) side, is a key mechanism linking hypertensive disorders of pregnancy, fetal growth restriction (FGR), stillbirth, preterm neonatal death and neonatal encephalopathy. Nevertheless, clinical use and medico-legal interpretation of placental findings remain inconsistent. To summarize recent evidence on the relationship between placental vascular malperfusion, perinatal mortality and neonatal brain injury, integrating standardized placental pathology with Doppler and angiogenic biomarkers, and to outline the main medico-legal implications. Methods: A PubMed search using the string "((placenta OR placental pathology) AND (stillbirth OR fetal death) AND (maternal vascular malperfusion OR fetal vascular malperfusion))" yielded 118 records. After excluding reviews, meta-analyses, case reports (except one illustrative SARS-CoV-2 placentitis case), non-human studies and papers without original histopathology, 33 studies were included: observational cohorts and case-control studies with standardized placental assessment, autopsy series, biomarker/Doppler cohorts, mechanistic work, one randomized trial protocol and a small number of focused clinical commentaries. Results: Across these studies, MVM emerges as the dominant placental lesion in pre-eclampsia, FGR and a large proportion of stillbirths, especially in early-onset disease and in association with maternal hypertension. FVM is strongly linked to stillbirth and term neonatal encephalopathy, and specific combinations of MVM, FVM and inflammatory lesions correspond to distinct patterns of brain injury. Large population-based cohorts confirm that maternal hypertensive disorders and placental malperfusion are major upstream causes of intrauterine hypoxia and preterm neonatal death. Doppler velocimetry and angiogenic biomarkers (PlGF, sFlt-1 and their ratio) are strongly associated with an increased likelihood of underlying MVM and adverse neonatal outcomes, although their predictive performance remains probabilistic and context-dependent rather than diagnostic. Mechanistic studies suggest roles for placental genomic instability and altered decidual immunity in defective placentation. Conclusions: Maternal and fetal vascular malperfusion represent converging pathways to FGR, stillbirth, preterm neonatal death and neonatal encephalopathy. Routine, standardized placental examination, interpreted together with Doppler and biomarker data, substantially improves causal attribution and timing of injury, with direct consequences for counselling, prevention and medico-legal assessment.}, }
@article {pmid41978842, year = {2026}, author = {Ganji, V and Kamble, B and Mustafa, F and Ravi, N and Madhusudhan, U and Archana, G and Kalpana, M and Taranikanti, M and John, NA}, title = {The Dual Burden: Long-Term Impact of COVID-19 on Tuberculosis Incidence - Presentation and Outcomes.}, journal = {Maedica}, volume = {21}, number = {1}, pages = {198-206}, pmid = {41978842}, issn = {1841-9038}, abstract = {INTRODUCTION: Tuberculosis (TB), caused by Mycobacterium tuberculosis, remains a major public health concern globally ranking as the second leading infectious disease and the 13th leading cause of death worldwide. The global healthcare systems have experienced unprecedented challenges in recent years due to COVID-19 pandemic causing widespread disruptions. Delaying TB diagnosis and treatment led to lower reported incidence but could increase mortality, hindering efforts to eradicate TB. Although a few studies have focused on COVID-19 and TB cases to date, most of them are case reports. Since it is unclear whether patients with COVID-TB co-infection have a worse prognosis or more likely to develop severe disease, we believed that doing this study was a necessity. The present systematic review investigates the long-term effects of COVID-19 on TB incidence, reporting follow-up and treatment outcomes.
OBJECTIVES: The present study aimed to explore the long-term impact of COVID-19 on TB incidence, presentation and outcome.
METHODS: We conducted our systematic review following PRISMA (Preferred reporting in systematic reviews and meta-analysis) guidelines. We performed a comprehensive literature search of EMBASE, PubMed, Scopus, The Lancet, Web of Science and Cochrane Central Register of Controlled Trials. The search items included "Corona virus disease 19", "impact of COVID-19", "SARS-CoV-2", "Tuberculosis", "TB and COVID-19 co-infection", "comorbidities", "prognosis", "incidence", "outcomes" and "risk factors" for articles published between the 1st of January 2020 and the 31st of June 2024. Searches were limited to English language only. We included articles with primary outcomes including studies which reported TB incidence or notification rates, clinical presentation, treatment interruption or outcomes of TB due to COVID-19 and TB-COVID-19 co-infection. Cohort studies, case-control studies, cross-sectional studies and surveillance or registry-based studies were included.
RESULTS: Information regarding COVID-19 and TB was collected from the databases, and out of 1973 articles, 41 articles were included. COVID-19 has had a negative impact on TB control programs leading to decrease in reporting of TB cases. As per the global tuberculosis report by WHO 2025, there has been approximately one-third reduction in incidence rates with TB case notifications declining by 21% of TB cases notification in 2020 compared to 2019. The reports indicated that the number of people diagnosed with TB was 7.5 million in 2022 above the baseline of 7.1 million in 2019 and 5.8 million in 2020.
CONCLUSION: COVID-19 has affected TB diagnosis and control, with a significant decline in TB case notifications leaving many undiagnosed cases, thereby reversing years of progress in TB control. The high-TB burden countries like India should tackle the havoc caused by the COVID-19 pandemic by addressing the needs of the poor and having a concrete agenda and perpetual TB strategy to reach the target by 2030.}, }
@article {pmid41979291, year = {2026}, author = {Abid, S and Jannath, H}, title = {Cardiac Effects in Post-COVID-19 Heart Failure: A Systematic Review of Longitudinal Imaging- and Biomarker-Based Structural and Functional Remodeling.}, journal = {Annals of cardiac anaesthesia}, volume = {29}, number = {2}, pages = {157-168}, pmid = {41979291}, issn = {0974-5181}, mesh = {Humans ; *COVID-19/complications ; Biomarkers/blood ; *Heart Failure/diagnostic imaging/physiopathology/etiology/blood ; *Ventricular Remodeling/physiology ; Echocardiography ; Post-Acute COVID-19 Syndrome ; Global Longitudinal Strain ; Magnetic Resonance Imaging ; }, abstract = {COVID-19 has been linked to persistent cardiovascular sequelae, yet the trajectory of structural and functional cardiac changes beyond the acute phase remains unclear. This systematic review synthesizes longitudinal evidence on post-COVID cardiac remodeling assessed by imaging and biomarkers. Following PRISMA guidelines, we searched PubMed and Cochrane Library (January 2020-April 2025) for peer-reviewed studies enrolling adults (≥18 years) with polymerase chain reaction (PCR)/antigen-confirmed SARS-CoV-2 infection and reporting cardiac outcomes ≥ 12 weeks post-infection. Eligible outcomes included imaging-based abnormalities (cardiac magnetic resonance [CMR]: T1/T2 mapping, late gadolinium enhancement [LGE]; echocardiography: left ventricular ejection fraction [LVEF], LV/RV strain). Longitudinal trends of biomarkers (troponin, NT-proBNP, C-reactive protein [CRP]) were also studied. Risk of bias was assessed using joanna briggs institute (JBI) tools; synthesis followed synthesis without metaanalysis (SWiM) principles. Fifteen studies (n ≈ 166,000; 14 cohorts, 1 case report) were included. Across CMR cohorts, global systolic function was largely preserved, but tissue abnormalities were frequent early and improved over time: edema indices normalized by ~ 12 months, while LGE prevalence declined (e.g. 50%→19% in paired scans). However, residual non-ischemic scars and elevated T1/T2 persisted in symptomatic subgroups. Echocardiography showed normal LVEF, but subtle left ventricular global longitudinal strain (LV-GLS) impairment versus controls (e.g. -18.5% vs - 19.3%). Biomarker trends were heterogeneous: natriuretic peptide positivity persisted in patients with prior cardiovascular disease (CVD), while troponin and CRP generally normalized. Large population-based cohorts demonstrated sustained 12-month risk for heart failure, myocarditis, and major cardiovascular events, graded by acute severity. Most patients recover gross systolic function, yet subclinical myocardial changes and elevated population-level cardiovascular risk persist up to 1 year. These findings support risk-stratified follow-up, judicious use of advanced imaging, and preventive cardiology strategies.}, }
@article {pmid41979592, year = {2026}, author = {Rosińska, M and Czarkowski, MP and Sadkowska-Todys, M}, title = {Infectious diseases in Poland in 2023.}, journal = {Przeglad epidemiologiczny}, volume = {79}, number = {4}, pages = {730-749}, doi = {10.32394/pe/218649}, pmid = {41979592}, issn = {0033-2100}, mesh = {Humans ; Poland/epidemiology ; *COVID-19/epidemiology/mortality ; *Communicable Diseases/epidemiology ; Incidence ; Adult ; Female ; Male ; Ukraine ; Middle Aged ; Infant ; Adolescent ; Child ; Registries ; Young Adult ; Aged ; Child, Preschool ; SARS-CoV-2 ; Pandemics ; Infant, Newborn ; *Refugees/statistics & numerical data ; }, abstract = {OBJECTIVE. The aim of this study was to summarize the epidemiological situation of infectious diseases in Poland in 2023. The ongoing impact of the COVID-19 pandemic and the effects of the influx of refugees to Ukraine were taken into account. MATERIAL AND METHODS. We performed a narrative review of studies published in Epidemiological Chronicle, along with data from the national infectious disease registry, Epibaza, which collects data from epidemiological investigations conducted by the State Sanitary Inspectorate. Mortality data were obtained from reports of the Statistics Poland Office. RESULTS. In 2023, 381,244 cases of COVID-19 and 4,329 deaths due to this disease were recorded. The COVID-19 mortality rate in 2023 was several times lower than in 2022, although COVID-19 still accounted for more deaths than other infectious diseases. An "immunity gap" effect was observed following the COVID-19 pandemic, resulting in a significant increase in the incidence of pertussis (2.5 times compared to 2022), influenza and influenza-like illnesses, and intestinal infections (enteric salmonellosis +57.9%, campylobacteriosis +64.1%, yersiniosis +74.5%, norovirus +27.8%). A reduction in the incidence was observed for rotavirus infections, for which routine infant vaccinations were introduced in 2021. The increase in pneumococcal disease incidence occurred mainly in the adult and senior population. While the number of new HIV diagnoses among Polish nationals is increasing, the number of cases among migrants has declined, although they still account for 25% of all new diagnoses. The incidence of other sexually transmitted infections also continues to increase (compared to 2022, gonorrhoea +110.6%, syphilis +89.6%). CONCLUSIONS. For many diseases, incidence increased compared to previous years, for a variety of reasons, including the persistent "immunity gap" following the pandemic and the specific nature of the vaccination program. The impact of the influx of refugees from Ukraine was minor.}, }
@article {pmid41981625, year = {2026}, author = {Graessner, H and Ripp, S and Pereira, AM and Schaefer, F and Mathijssen, I and Blay, JY and Mulders, PFA and Evangelista, T and Ligtenberg, MJL and Wilde, AAM and Ladenstein, R and Lohse, AW and Mosca, M and Swart, JF and Hernández, F and Fenaux, P and Dollfus, H and Verloes, A and Wagner, T and Bodemer, C and Wijnen, R and Scarpa, M and Jondeau, G and Tumienė, B and Gallina, S and Arzimanoglou, A and Sangiorgi, L}, title = {European Reference Networks - a flagship activity of the EU in the field of rare and complex diseases: from 2017 to 2025.}, journal = {Orphanet journal of rare diseases}, volume = {21}, number = {1}, pages = {}, pmid = {41981625}, issn = {1750-1172}, mesh = {Humans ; *Rare Diseases/epidemiology ; European Union ; Europe ; }, abstract = {BACKGROUND: Although individual rare and complex diseases (RDs) affect small patient populations, together they impact an estimated 27–36 million people across the European Union. Addressing this major public health challenge has been a long-term priority for the European Union, leading to the establishment of the European Reference Networks (ERNs) in 2017. MAIN BODY: ERNs are cross-border networks connecting clinical expert centres to share knowledge, improve and harmonise diagnosis and care for patients with rare and complex diseases. Since their inception, 24 ERNs have united 1,606 expert centres across 375 hospitals in all EU Member States and Norway. Their activities span multidisciplinary clinical collaboration, patient-centred governance, education and training, and the development of clinical guidelines. Over 4900 extremely rare or difficult cases have been discussed among experts without requiring the patients to travel abroad when expertise was not available in their own countries. A key factor for this success is the cross-border IT platform - known as the Clinical Patient Management System 2.0 - provided by the European Commission for medical discussions, which enables experts to share patient data, including medical images and lab results, in a secure and protected environment that is fully compliant with all relevant security and data privacy requirements. ERNs have demonstrated resilience in crises such as the COVID-19 pandemic and the war in Ukraine, providing rapid, coordinated responses to sustain care for vulnerable patient groups. The first formal evaluation in 2023 confirmed that more than 95% of member centres met quality standards, underscoring the networks’ maturity and effectiveness. Moving into the next phase, the Joint Action JARDIN (2024–2027) aims to integrate ERNs into national healthcare systems to ensure sustainability and equitable access to high-quality RD care. CONCLUSIONS: ERNs exemplify European solidarity and innovation in healthcare, transforming how rare disease expertise is shared and applied across borders. Their continued integration into national systems will be pivotal to achieving a truly cohesive European Health Union that delivers improved outcomes for all patients with rare and complex diseases.}, }
@article {pmid41981866, year = {2026}, author = {Sepúlveda, MD and Cardona Maya, WD and Zapata-Builes, W and Velilla, PA}, title = {Decoding NK Cell Subset Dysregulation in SARS-CoV-2 Infection: Phenotypic, Functional, and Transcriptomic Insights Into COVID-19 Pathogenesis.}, journal = {Scandinavian journal of immunology}, volume = {103}, number = {4}, pages = {e70115}, doi = {10.1111/sji.70115}, pmid = {41981866}, issn = {1365-3083}, support = {//Universidad de Antioquia/ ; //Universidad Cooperativa de Colombia/ ; }, mesh = {Humans ; *Killer Cells, Natural/immunology ; *COVID-19/immunology ; *SARS-CoV-2/immunology ; Transcriptome ; Phenotype ; *Coronavirus Infections/immunology ; *Betacoronavirus/immunology ; Immunity, Innate ; CD56 Antigen ; *Lymphocyte Subsets/immunology ; Immune System Exhaustion ; }, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection significantly affects innate immune responses, particularly those of natural killer (NK) cells, which play an important role in antiviral defence. This review combines phenotypic, functional, and transcriptomic findings to explain the disruption of NK cell subsets in COVID-19. Flow cytometry studies have shown generalised lymphopenia and a significant reduction in the CD56bright and CD56[dim]CD16[+] subsets. This change is linked to an increase in the CD56[dim]CD16[-] and CD56[-]CD16[+] populations, which correlate with disease severity. At the molecular level, there is an imbalance between activating and inhibitory receptors. This includes increases in NKG2A, PD-1, and LAG-3, along with decreases in NKp30, NKp46, and NKG2D. These findings are consistent with an exhausted phenotype and weakened cytotoxicity. Single-cell RNA sequencing (scRNA-seq) studies have identified an increase in proliferative, cytotoxic, and platelet-associated CD56[dim] NK subpopulations in severe cases and a reduction of CD56[bright] cells. Transcriptomic profiling showed that upregulation of interferon-stimulated genes (ISGs) and inflammatory pathways driven by STAT1/3, NF-κB activation, and transforming growth factor-beta (TGF-β) signalling suppresses NK effector functions. Collectively, these findings suggest a model in which progressive NK cell dysfunction may be associated with the immunopathogenesis of COVID-19. The integration of multi-omic and phenotypic approaches provides a comprehensive view of NK cell responses to SARS-CoV-2 and suggests potential biomarkers and therapeutic targets to restore NK cell antiviral activity.}, }
@article {pmid41981907, year = {2026}, author = {Bechini, A and Salvati, C and Del Riccio, M and Bonito, B and Stancanelli, E and Bruschi, M and Ionita, G and Iamarino, J and Bentivegna, D and Buscemi, P and Ciardi, G and Cosma, C and Stacchini, L and Bega, M and Schirripa, A and Bertizzolo, L and Muzii, B and Azzi, MV and Parisi, S and Trippi, F and Bonanni, P and Boccalini, S}, title = {Burden and Characteristics of Respiratory Syncytial Virus-Associated Bronchiolitis in Hospitalized Infants in Italy: A Systematic Review.}, journal = {Immunity, inflammation and disease}, volume = {14}, number = {4}, pages = {e70420}, pmid = {41981907}, issn = {2050-4527}, support = {//Sanofi and AstraZeneca/ ; }, mesh = {Humans ; Italy/epidemiology ; *Respiratory Syncytial Virus Infections/epidemiology/virology ; Infant ; *Hospitalization/statistics & numerical data ; *Respiratory Syncytial Virus, Human/genetics ; Infant, Newborn ; *Bronchiolitis/epidemiology/virology ; Coinfection/epidemiology/virology ; COVID-19/epidemiology ; Seasons ; Prevalence ; Child, Preschool ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Respiratory syncytial virus (RSV) is the main cause of bronchiolitis in infants. This systematic review aimed to evaluate the burden of RSV-associated bronchiolitis among hospitalized Italian infants between 2000 and 2023.
METHODS: A comprehensive literature search identified studies examining RSV-related hospitalizations for bronchiolitis in children aged 0-59 months. Eligible studies met the following criteria: conducted in Italy, focused on children, reported on RSV prevalence, co-infections, genotype distribution (RSV-A, RSV-B), and seasonal trends, and published in English or Italian. Data extraction focused on study design, infant characteristics (e.g., age, preterm birth), and RSV detection methods.
RESULTS: Twenty-four studies were included. Infants under 12 months were most affected. RSV was the primary pathogen identified, though co-infections with other respiratory viruses, such as human rhinovirus, were common. RSV infections typically peaked in late autumn and winter, but the COVID-19 pandemic altered these patterns. This review highlights the significant burden of RSV-associated bronchiolitis in Italian infants. While RSV remains the primary pathogen, co-infections and pandemic related factors have altered its epidemiological trends.
CONCLUSIONS: Nationwide RSV immunization programmes and improved diagnostics are crucial to ease the strain on pediatric intensive care units. Recent recommendations for widespread RSV long-acting monoclonal antibody use in infants offer promising solutions to address this challenge.}, }
@article {pmid41981982, year = {2026}, author = {Gou, H and Zhai, Y and Yu, Q and Liu, Y and Zhou, H and Zhao, Q}, title = {Epidemiological Changes in Mycoplasma pneumoniae Infections in Children and Adolescents Before and After COVID-19: A Systematic Review and Meta-Analysis.}, journal = {Reviews in medical virology}, volume = {36}, number = {3}, pages = {e70151}, doi = {10.1002/rmv.70151}, pmid = {41981982}, issn = {1099-1654}, support = {2024YFC3506000//National Key Research and Development Program of China/ ; }, mesh = {Humans ; *COVID-19/epidemiology ; *Pneumonia, Mycoplasma/epidemiology/microbiology ; Child ; *Mycoplasma pneumoniae/pathogenicity ; Adolescent ; Prevalence ; SARS-CoV-2 ; Child, Preschool ; }, abstract = {Mycoplasma pneumoniae (M. pneumoniae) is a major cause of respiratory tract infections in children and adolescents, yet its epidemiological burden before, during, and after the COVID-19 pandemic remains unclear. This meta-analysis, which searched Web of Science, Embase, PubMed, and Cochrane Library for reports published up to December 25, 2025, aimed to evaluate trends in the prevalence of M. pneumoniae infections across these three periods to guide clinical practice and public health responses. A total of 70 studies were included, and methodological quality was assessed using the Joanna Briggs Institute criteria. The pooled prevalence of M. pneumoniae infections before, during, and after COVID-19 was calculated in R 4.5.0, with Freeman-Tukey double arcsine transformation for extreme proportions. The prevalence of M. pneumoniae infections before COVID-19, during COVID-19, and after COVID-19 was 21.72% (95% CI: 17.09, 26.73), 10.73% (95% CI: 7.57, 14.35), and 28.64% (95% CI: 22.74, 34.93), respectively. Age-stratified analysis revealed the highest prevalence consistently in children > 6 years (pre-pandemic: 46.35%; during-pandemic: 27.32%; post-pandemic: 41.36%) and the lowest in infants < 1 year (8.21%, 4.87%, and 7.81%, respectively). Seasonally, pre-pandemic prevalence peaked in summer (33.34%) and autumn (31.00%). During the pandemic, overall rates declined but remained highest in autumn (15.51%). Post-pandemic, prevalence rebounded broadly, peaking in autumn (37.97%). In conclusion, this study summarises M. pneumoniae trends in children and adolescents before and after COVID-19, indicating a delayed resurgence following the pandemic, and highlights the need for further research to explain these patterns and improve future pandemic preparedness.}, }
@article {pmid41982246, year = {2026}, author = {Welberry Smith, M and Wrigley, A and Kojro, A and Emmanouilidou, A and O'Callaghan, J and Woywodt, A}, title = {No more waiting: 10 tips to turn kidney transplantation green.}, journal = {Clinical kidney journal}, volume = {19}, number = {4}, pages = {sfag073}, pmid = {41982246}, issn = {2048-8505}, abstract = {To date, the environmental impact of kidney transplantation has received much less attention than that of dialysis. Facilitating a pre-emptive transplant is probably one of the most environmentally friendly interventions available in kidney care, as it avoids dialysis, with its requirements for water and energy. However, transplant assessment also requires scrutiny, as it involves a multitude of tests, often with duplication of tests and sometimes with little, if any, evidence (e.g. cardiac testing of asymptomatic patients). Organ retrieval often involves air travel of either the organ or a surgical team, although more innovative approaches, such as drone transport, are being tested. Transplant anaesthesia also has an environmental footprint linked to volatile substances. Surgical tray optimization is well established in other surgical specialties to reduce the effects of repeatedly sterilizing instruments that are only rarely used. Post-transplant patients have a lot of regular blood tests, and it is time we scrutinise those and find a better balance between safe care and environmental footprint. Virtual appointments have become much more common since the COVID-19 pandemic and we should use them where appropriate, for example in long-term care of stable transplant patients. Transplantation is a very research-oriented specialty, and this also has an environmental footprint that is amenable to intervention. In addition, our congresses and conferences have an environmental footprint, and it is for us to promote meetings with just as much learning and interaction but less travel, waste and energy use. The opportunities are there for us to take and our tips provide ideas for clinical teams to turn kidney transplantation into a showcase for excellent, safe and environmentally friendly care in nephrology.}, }
@article {pmid41982635, year = {2026}, author = {Khezri, M and Holm, J and Dahlen, A and Johnson, C and Agyabeng, K and Lei, F and Pagán, JA and Healton, C and Farhat, T}, title = {Illicit drug supply, naloxone availability, and overdose mortality in the fentanyl era: a systematic review.}, journal = {Health affairs scholar}, volume = {4}, number = {4}, pages = {qxag074}, pmid = {41982635}, issn = {2976-5390}, abstract = {BACKGROUND: The overdose crisis is shaped by increasing synthetic opioids and expanding access to naloxone. We synthesized evidence on associations between illicit drug supply, naloxone availability/distribution, and overdose mortality.
METHODS: Following PRISMA, we searched 4 databases for studies between 2015 and 2025. Eligible studies examined associations of drug supply indicators or naloxone interventions, and overdose mortality. Data were extracted and synthesized narratively.
RESULTS: Forty-seven studies met inclusion criteria. Eighteen studies assessed drug supply changes and all but 2 found significant positive associations between increased fentanyl reports in drug seizures and overdose mortality. Drug seizure data were interpreted as indicators of supply trends or as enforcement disruptions. Thirty-one studies assessed naloxone availability. Thirteen studies reported naloxone access laws, take-home naloxone programs, and/or community interventions were associated with reductions in overdose deaths. Nine studies reported null effects, particularly during the COVID-19 pandemic.
CONCLUSIONS: Fentanyl reports in drug seizures and drug potency are key drivers of overdose mortality. This review highlights variability in interpreting drug seizure data and the need for clearer conceptualization in future research. Naloxone interventions show promise but depend on consistent implementation and effective targeting of high-risk populations. Coordinated public health strategies are needed to monitor the drug market and strengthen overdose prevention.}, }
@article {pmid41983114, year = {2025}, author = {Gushansky, KY and Sutinen, P and Jeon, S and Tuuminen, R}, title = {Exploring the Association Between Lipid-Lowering Medications and Dry Eye Disease in COVID-19 Patients.}, journal = {Romanian journal of ophthalmology}, volume = {69}, number = {4}, pages = {536-543}, pmid = {41983114}, issn = {2501-2533}, mesh = {Humans ; *Dry Eye Syndromes/epidemiology/diagnosis/etiology/prevention & control ; Retrospective Studies ; Female ; *COVID-19/epidemiology/complications ; Male ; Middle Aged ; *SARS-CoV-2 ; *Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Aged ; *Hypolipidemic Agents/therapeutic use ; Risk Factors ; }, abstract = {PURPOSE: To explore the associations between systemic lipid-lowering medications and dry eye disease (DED) in patients hospitalized for SARS-CoV-2.
METHODS: This retrospective cohort study analyzed electronic medical records of SARS-CoV-2 patients hospitalized at Shaare Zedek Medical Center from April 1, 2020, to December 31, 2024. Adults without a previous DED diagnosis who had an ophthalmologic examination confirming no DED within the year preceding hospitalization were included. Exclusions included ICU admissions, specific systemic conditions, ocular surgeries, and systemic medications known to induce DED. Patients were categorized into those who developed DED within six months post-hospitalization and those who did not.
RESULTS: Among the 1,165 patients, 167 (14.3%) developed DED post-hospitalization. After adjusting for age, gender, and SARS-CoV-2 vaccination status, an inverse association between statins and dry eye disease was evident. Treatment with any statin was associated with reduced odds of developing dry eye disease (OR 0.289, p<0.001), particularly with atorvastatin (OR 0.374, p<0.001) and simvastatin (OR 0.297, p<0.001).
DISCUSSION: The inverse association observed in this study supports a potential protective effect of statins, consistent with their known anti-inflammatory properties and their ability to reduce cholesterol-driven Meibomian gland dysfunction.
CONCLUSION: Statin use is inversely associated with the development of DED in SARS-CoV-2 hospitalized patients. The anti-inflammatory and cholesterol-lowering effects of statins provide a robust framework for understanding the underlying pathophysiological mechanisms.}, }
@article {pmid41983631, year = {2026}, author = {El-Kafrawy, SA and Abbas, AT and Abdel-Dayem, UA and El-Kafrawy, MS and Azhar, EI}, title = {IgY passive immunotherapy for pandemic preparedness: a One Health platform approach against pathogen X.}, journal = {Clinical microbiology reviews}, volume = {39}, number = {2}, pages = {e0024925}, pmid = {41983631}, issn = {1098-6618}, mesh = {*Immunoglobulins/therapeutic use/immunology ; Humans ; Animals ; *Immunization, Passive/methods ; Zoonoses/prevention & control ; Pandemic Preparedness ; One Health ; COVID-19/prevention & control ; SARS-CoV-2/immunology ; *Pandemics/prevention & control ; Chickens ; }, abstract = {SUMMARYThe rising threat of emerging infectious diseases, especially zoonotic pathogens crossing species barriers, highlights the urgent global need for scalable, rapid-response passive immunotherapy platforms. Chicken egg yolk-derived immunoglobulin Y (IgY) antibodies offer unique conceptual and practical advantages. This review critically evaluates IgY antibodies (IgY-Abs) as a One Health immunotherapeutic strategy with strong potential for mitigating zoonotic spillover risks. Drawing on insights from SARS-CoV-2, we highlight the advantages of IgY-Abs over traditional approaches in specific scenarios while emphasizing their role as a complementary rather than replacement platform within the broader passive immunotherapy landscape. We discuss key strategic considerations, regulatory challenges, and essential knowledge gaps. Finally, we propose a forward-looking research and development roadmap that emphasizes interdisciplinary collaboration, optimized production methods, targeted regulatory frameworks, and integrated One Health strategies to facilitate the rapid deployment of IgY-based countermeasures against WHO-priority zoonotic pathogens.}, }
@article {pmid41983640, year = {2026}, author = {Qu, Y and Xiao, Y and Liu, L and Qu, J}, title = {Diagnosis of Mucormycosis: Current Situation, Challenges and Future Prospects.}, journal = {Mycoses}, volume = {69}, number = {4}, pages = {e70175}, pmid = {41983640}, issn = {1439-0507}, mesh = {*Mucormycosis/diagnosis/microbiology ; Humans ; *Mucorales/isolation & purification ; Early Diagnosis ; Immunocompromised Host ; Biomarkers ; Artificial Intelligence ; COVID-19/complications ; }, abstract = {Mucormycosis, an aggressive fungal infection caused by members of the order Mucorales, progresses rapidly and is associated with high mortality, particularly in immunocompromised hosts such as patients with uncontrolled diabetes, transplant recipients or those with COVID-19-associated immunosuppression. Early diagnosis remains challenging with current clinical methods, yet it is essential to reduce mortality. This review examines the evolution of diagnostic strategies for mucormycosis, ranging from conventional techniques such as histopathology, culture and microscopy to advanced and emerging methods including molecular assays, serological testing, imaging and metabolomics. We also explore the ongoing transition towards integrated, rapid and non-invasive diagnostic platforms that leverage novel biomarkers, portable devices and artificial intelligence. These new technologies have the potential to facilitate early diagnosis, thereby enabling early treatment and reducing the mortality rate of mucormycosis.}, }
@article {pmid41984151, year = {2026}, author = {Myatra, SN and Nasa, P and Chanchalani, GP and Zimmerman, JL and Venkatesh, B and Machado, FR and Ostermann, M and Leeies, M and Coopersmith, CM and Sorce, LR and Weiss, B and Kuberkar, D and Abbenbroek, B and Acharya, SP and Akech, S and Akinci, SB and Al Duhailib, Z and Berger-Estilita, J and Branson, RD and De Waele, J and Derde, LPG and Divatia, MJ and Dzierba, AL and Elhoufy, AM and Fiest, KM and Fillipescu, D and Fox-Robichaud, AE and Freires, FJC and Fujii, T and Galarza, L and Gopalan, DP and Hamzaoui, O and Hidalgo, JL and Jayasinghe, AS and Kanoore Edul, VS and Lubis, AP and Matot, I and Mehta, S and Milic, V and Monnet, X and Morrow, BM and Nadkarni, VM and Needham, DM and Osinaike, BB and Patil, VP and Pérez Cornejo, MS and Perez-Fernandez, J and Ray, S and Robba, C and Rodriguez-Vega, GM and Rubulotta, F and Seifelnasr, O and Turnbull, AE and Ugarte, S and Vincent, JL and Wendon, J and Xie, J and Zabaleta Polo, YM and Burns, KEA}, title = {Gender equality and equity in intensive care: an international Delphi consensus study.}, journal = {Intensive care medicine}, volume = {52}, number = {5}, pages = {1035-1050}, pmid = {41984151}, issn = {1432-1238}, mesh = {Humans ; Delphi Technique ; Female ; *Gender Equity ; *Critical Care/standards ; Male ; *Consensus ; Middle Aged ; Adult ; Aged ; Surveys and Questionnaires ; }, abstract = {PURPOSE: We used Delphi methodology to provide guidance on gender equality and equity issues in professional life in intensive care, where information is evolving and no clear standard exists.
METHODS: A 12-member Steering Committee (7 women, 5 men) from 7 countries and 46 international panelists [(23 women, 21 men, 2 preferred not to disclose; median age 52 (33-75) years] from 32 countries (43% low- and middle-income) including intensive care practitioners, scientists, researchers, and trainees voted on 57 statements addressing issues related to gender equality and equity in 10 domains of professional life. Delphi rounds were conducted using online surveys. Consensus (at least 75% of panelists voting for a response option) and stability (consistent responses on iterative rounds) were assessed.
RESULTS: Six Delphi rounds were conducted between May and July 2025. A 100% response rate was achieved in each round. Consensus and stability were achieved on 43 (75%) of 57 statements from which 37 professional practice guidance statements were developed. Across domains, greater consensus was achieved on equality [23/27 (85.2%)] versus equity [12/18 (66.7%)] statements. Discordant equity statements primarily pertained to academia and engagement in multiprofessional meetings and the workplace.
CONCLUSION: Using a Delphi method, international experts reached consensus to generate 37 professional practice guidance statements. The consensus statements provide needed guidance for professional engagement and highlight areas for policy development to advance gender equity and equality for healthcare workers in intensive care. The discordant statements highlight areas for future research.}, }
@article {pmid41984738, year = {2026}, author = {Oliveira, TT and Medeiros, VPB and Freitas, JF and Melo Martins Silva, G and Xavier, TJDS and Fassarella Agnez-Lima, L}, title = {COVID-19 severity biomarkers identified by transcriptomics: a scoping review.}, journal = {Infectious diseases (London, England)}, volume = {58}, number = {7}, pages = {661-679}, doi = {10.1080/23744235.2026.2651977}, pmid = {41984738}, issn = {2374-4243}, mesh = {Humans ; Biomarkers/analysis ; *COVID-19/diagnosis/genetics/immunology ; Cytokines/genetics ; Gene Expression Profiling ; Severity of Illness Index ; *Transcriptome ; }, abstract = {BACKGROUND: Omics technologies, particularly transcriptomics, were widely used during the COVID-19 pandemic to investigate host and viral gene expression. Given the substantial number of studies published during this period, systematic reviews are essential for synthesising findings and identifying consistent patterns.
OBJECTIVES: This scoping review aimed to identify and evaluate transcriptomic studies of SARS-CoV-2 infection in humans published between 2020 and January 2023, with a focus on genes and pathways affected by the virus.
METHODS: A comprehensive literature search was conducted using PubMed and Scopus, employing predefined keywords. Studies were screened using established inclusion and exclusion criteria, and only articles published in journals affiliated with the Committee on Publication Ethics (COPE) or Directory of Open Access Journals (DOAJ) were included. Data extraction followed a two-step process, collecting detailed information on sample and patient characteristics, transcriptomic methods, and main findings.
RESULTS: Despite methodological differences and varying time points of sample collection, several immune-related genes and pathways were recurrently reported. These included cytokines and chemokines (e.g. CXCL8, TNF-α, CCL2, CXCL10, and IL-1B), interferon-stimulated genes (e.g. MX1, IFI27, IRF7, and ISG15), and neutrophil degranulation markers (e.g. S100A8 and S100A9).
CONCLUSIONS: The recurrent identification of these genes underscores their potential as prognostic biomarkers and therapeutic targets, thereby contributing to a deeper understanding of immunopathological mechanisms and supporting the development of improved diagnostic tools and early intervention strategies. However, limited reproducibility across studies poses challenges for robust meta-analyses, underscoring the urgent need for standardised guidelines and protocols to improve consistency and reliability in future research.}, }
@article {pmid41985440, year = {2026}, author = {Crotty, S}, title = {Immunological memory to vaccines.}, journal = {Immunity}, volume = {59}, number = {4}, pages = {813-832}, pmid = {41985440}, issn = {1097-4180}, support = {U19 AI142742/AI/NIAID NIH HHS/United States ; UM1 AI144462/AI/NIAID NIH HHS/United States ; }, mesh = {Humans ; *Immunologic Memory/immunology ; *Vaccines/immunology ; Animals ; CD8-Positive T-Lymphocytes/immunology ; B-Lymphocytes/immunology ; CD4-Positive T-Lymphocytes/immunology ; *SARS-CoV-2/immunology ; Adaptive Immunity ; *COVID-19/immunology/prevention & control ; }, abstract = {The extraordinary success of vaccines saving lives and improving human health is predicated on immune memory. Within the armamentarium of adaptive immunity, a holistic view of the different components contributing to immune protection is important for understanding the myriad benefits of vaccines. This review presents the current understanding of vaccine-generated memory, integrating layers of immunity including B cells, CD8+ T cells, CD4+ T cells, and antibody responses, with emphasis on human vaccine data. Functions and durability of distinct memory types are considered, including those of tissue-resident and circulating cells as well as hybrid immunity, and within this context, common misconceptions and important next questions are discussed. Understanding the multifaceted layers that underlie protective immunity can guide future vaccines and broader immune-focused interventions. A video lecture accompanies this review (https://youtu.be/8DeZJ6V7nuI). VIDEO ABSTRACT.}, }
@article {pmid41985441, year = {2026}, author = {Fields, CA and Bhattacharya, D}, title = {Plasma cell ontogenies, functions, and lifespans.}, journal = {Immunity}, volume = {59}, number = {4}, pages = {833-846}, doi = {10.1016/j.immuni.2026.01.030}, pmid = {41985441}, issn = {1097-4180}, mesh = {*Plasma Cells/immunology/cytology ; Animals ; Humans ; *B-Lymphocytes/immunology ; Cell Differentiation/immunology ; Germinal Center/immunology ; Immunologic Memory ; }, abstract = {B cell development is one of the best-understood processes within the immune system. Coordination between transcriptional programs and antigen receptor assembly determines B cell fate, diversifies the antibody repertoire, and allocates specificities to the best-suited subsets. This enables B cells to respond to a wide variety of challenges, which, when encountered, can lead B cells to seemingly converge upon a common fate: the antibody-secreting plasma cell. Yet, as we discuss in this review, this convergence is not complete. Developmental origins, anatomical sites, the nature of the challenge, and other factors all leave their marks on plasma cells in ways that diversify their functions and longevity. Looking forward, these marks may provide targets to engineer vaccines that provide durable antibody-mediated immunity.}, }
@article {pmid41985976, year = {2026}, author = {Davies, SR and Davies, AL and Higgins, JPT and Caldwell, DM and Thornton, ZA and Aiton, E and Ali, I and Dawson, S and McGrath, C and Parkhouse, T and Yardley, L and Yates, J and Letley, L and Ismail, SA and Christensen, H and French, CE}, title = {Effectiveness of interventions to increase vaccine uptake: component network meta-analysis.}, journal = {BMJ (Clinical research ed.)}, volume = {393}, number = {}, pages = {e087578}, pmid = {41985976}, issn = {1756-1833}, mesh = {Humans ; *COVID-19/prevention & control/epidemiology ; *COVID-19 Vaccines/administration & dosage ; SARS-CoV-2 ; *Vaccination/statistics & numerical data ; Randomized Controlled Trials as Topic ; Adherence Interventions ; Pandemics/prevention & control ; *Immunization Programs ; Bayes Theorem ; }, abstract = {OBJECTIVES: To identify the effective components of interventions to increase vaccine uptake and to explore variations in effectiveness by population group and in relation to the covid-19 pandemic.
DESIGN: Component network meta-analysis.
SETTING: Systematic review of randomised controlled trials in high and upper middle income countries.
PARTICIPANTS: 237 studies with 570 intervention arms and 4 361 717 participants.
INTERVENTIONS: Any intervention targeting vaccine recipients or their caregivers aiming to increase demand for, or access to, vaccinations on the UK immunisation schedule. Key content and delivery features of interventions were identified using a bespoke coding framework co-developed with stakeholders.
MAIN OUTCOME MEASURES: The outcome of interest was vaccine uptake. Bayesian component level meta-regression estimated relative effects of intervention components as ratios of odds ratios with 95% credible intervals (CrIs).
RESULTS: Of the included studies, 110 were at low risk of bias, 96 had some concerns, and 31 were at high risk. 40% (n=1 744 686) of the participants were male. For children, there was evidence of beneficial effects for payments to cover costs (ratio of odds ratios 3.01, 95% CrI 1.49 to 6.06) and decision aids (2.73, 1.14 to 7.06), and some evidence for extended opportunities (1.37, 0.98 to 1.95) and social factors (1.27, 0.99 to 1.65). For adolescents and young adults, there were beneficial effects for personal delivery formats (2.13, 1.09 to 4.40), delivery by community members alongside healthcare professionals (6.42, 1.94 to 25.62), and social factors (2.62, 1.45 to 5.04), and negative effects for decision aids (0.43, 0.18 to 0.98) and human versus non-human interaction (0.47, 0.21 to 1.02). For adults, beneficial effects were shown for human interaction (1.86, 1.42 to 2.45), extended opportunities (1.63, 1.35 to 2.00), help with appointment scheduling (1.38, 1.06 to 1.78), payments to cover costs (1.47, 1.03 to 2.16), and motivational interviewing (1.79, 1.21 to 2.64), and there was some evidence for financial incentives (1.15, 0.99 to 1.35) and information on vaccine safety and/or efficacy (1.15, 0.99 to 1.32). For adults, evidence also showed a negative effect of non-human interaction versus no interaction (0.72, 0.57 to 0.92). Subgroup analyses showed variation for underserved populations and in relation to the covid-19 pandemic (before 2020 and 2020 onwards).
CONCLUSION: Overall, extended opportunities, appointment scheduling help, financial incentives, payments to cover costs, and motivational interviewing were effective content components of interventions to increase vaccine uptake. Effective delivery components overall were human interaction and delivery by community members alongside healthcare professionals. However, effective components varied by age group, for underserved populations, and in analyses investigating the impact of the covid-19 pandemic. These findings have important implications for designing, optimising, and implementing targeted interventions, highlighting which components are effective across different populations and contexts. Consideration of the economic data on interventions should further support resource informed decision making.}, }
@article {pmid41986256, year = {2026}, author = {Andrés, C and Prats-Méndez, I and Midgley, S and Berginc, N and González-Sánchez, A and Johannesen, CK and Antón, A and Nadal-Barón, P and Fischer, TK and Harvala, H and Benschop, KSM}, title = {Circulation Patterns, Genetic Diversity, and Public Health Implications of Enterovirus D68, Europe, 2014-2024.}, journal = {Emerging infectious diseases}, volume = {32}, number = {4}, pages = {491-499}, pmid = {41986256}, issn = {1080-6059}, mesh = {Humans ; Europe/epidemiology ; *Enterovirus Infections/epidemiology/virology ; *Genetic Variation ; *Enterovirus D, Human/genetics/classification ; Public Health ; Phylogeny ; COVID-19/epidemiology ; }, abstract = {Enterovirus D68 (EV-D68) represents a continuing public health concern, given its association with severe respiratory illness and neurologic complications. In this study, we analyzed EV-D68 circulation and genetic evolution during 2014-2024 using data from 18 countries in Europe. Of 61,297 enterovirus-positive specimens, molecular detection and viral protein 1 sequencing identified 3,541 (6%) EV-D68 cases. A biennial circulation pattern was observed; detection rates ranged from 9% in 2014 to 0.9% in 2019. The pattern was disrupted in 2020 because of measures implemented in response to the COVID-19 pandemic, but then notable increases occurred in 2021 (14%), 2022 (10.7%), and 2024 (20.6%). Subgenogroups B3 (59.8%) and A2/D (28.0%) were predominant; A2/D reemerged as dominant in 2024. Mutation analyses revealed changes in antigenic regions. Our findings underscore the persistent adaptation and resurgence of EV-D68 after COVID-19. Continued genomic surveillance is essential to monitor transmission patterns caused by antigenic changes.}, }
@article {pmid41987025, year = {2026}, author = {Mora Castaño, I and Hasbun, R}, title = {Neurological manifestations of respiratory viral infections.}, journal = {Current opinion in infectious diseases}, volume = {39}, number = {3}, pages = {218-226}, doi = {10.1097/QCO.0000000000001189}, pmid = {41987025}, issn = {1473-6527}, mesh = {Humans ; *Respiratory Tract Infections/complications/virology/epidemiology ; *Nervous System Diseases/virology/etiology/diagnosis/epidemiology ; *Virus Diseases/complications ; *COVID-19/complications/epidemiology ; SARS-CoV-2 ; }, abstract = {PURPOSE OF REVIEW: This review summarizes current evidence on the general epidemiology, routes of central nervous system (CNS) invasion, clinical manifestations, diagnostic approaches, and treatment considerations associated with neurological complications of respiratory viral infections. Greater awareness of the neurological impact of respiratory viral infections is crucial to improving patient outcomes and mitigating long-term burden of these diseases.
RECENT FINDINGS: Recent studies have reinforced the association between respiratory viral infections and a broad spectrum of neurological complications. Evidence accumulated during and after the coronavirus disease 2019 (COVID-19) pandemic has expanded this awareness, and emerging data suggest that immune-mediated mechanisms such as glial cell activation, rather than direct viral neurotropism alone, play a central role in CNS injury. Although diagnostic limitations still exist, some advances have been made to increase specificity of resources available for clinicians, particularly PCR and immunologic profiling. Furthermore, vaccination against certain respiratory viruses may reduce the risk of subsequent neurodegenerative disease, highlighting the potential impact of preventive strategies on long-term neurological burden.
SUMMARY: Establishing causality between respiratory viral infections and subsequent neurological dysfunction remains challenging given the ubiquitous nature of many respiratory viruses and their capacity to cause lifelong latent or persistent infection. Even though some efforts have been made to optimize diagnosis and treatment, addressing these challenges will require further coordinated efforts across clinicians, researchers and healthcare policymakers.}, }
@article {pmid41987085, year = {2026}, author = {Burton, K and Best, J and DeCoster, J and Ritchwood, TD}, title = {Pandemic ready or playing catch-up? A scoping review of public health training programs for pandemic preparedness and response efforts.}, journal = {BMC public health}, volume = {26}, number = {1}, pages = {}, pmid = {41987085}, issn = {1471-2458}, mesh = {Humans ; *Pandemic Preparedness ; *COVID-19/epidemiology/prevention & control ; *Public Health/education ; Public Health Infrastructure ; *Pandemics ; *Education, Public Health Professional/organization & administration ; }, abstract = {BACKGROUND: The COVID-19 pandemic underscored the urgent need for scalable, adaptable training programs to support public health preparedness and response. While many training initiatives emerged globally, their effectiveness, sustainability, and relevance to community needs remain uneven. This scoping review characterizes the landscape of pandemic-related training programs and identifies barriers, facilitators, and gaps in preparedness education for public health professionals, community-based organizations (CBOs), and frontline responders. METHODS: We conducted a scoping review of English-language peer-reviewed articles published between 2005 and 2023. Using the Consolidated Framework for Implementation Research (CFIR) to guide data extraction and thematic synthesis, we examined training programs focused on pandemic preparedness, including design, delivery, implementation processes, and evaluation strategies. RESULTS: Thirty-eight studies met inclusion criteria. Training programs varied in scope, format, and target populations, with most focused on COVID-19 and conducted in low- and middle-income countries. Programs commonly emphasized contact tracing, epidemiology, surveillance, and community engagement. While virtual formats increased accessibility, participants often preferred in-person, interactive learning. Facilitators were associated with perceived success included strong partnerships, culturally tailored materials, and improvement through feedback, while barriers were associated with program challenges included limited infrastructure, unclear learning objectives, lack of sustained funding, and inadequate evaluation. Most programs were reactive and short-term, with minimal input from community stakeholders. Trust, equity, and cultural responsiveness emerged as central themes. CONCLUSIONS: Preparedness training programs remain fragmented and overly reliant on crisis-driven implementation. Future programs would benefit from prioritizing sustained investment, co-design with community partners, and use of validated frameworks like CFIR to guide development and evaluation. Strengthening the capacity of CBOs and embedding preparedness within trusted community networks are essential to building equitable and resilient public health systems.}, }
@article {pmid41987119, year = {2026}, author = {Oshinubi, K and Chen, Y and Doerry, E and Gel, ES and Hepp, C and Lant, T and Mehrotra, S and Sabo, S and Mihaljevic, J}, title = {A systematic review of spatial epidemiological modeling approaches applied during the COVID-19 pandemic.}, journal = {BMC public health}, volume = {26}, number = {1}, pages = {}, pmid = {41987119}, issn = {1471-2458}, support = {R01 AI168144/AI/NIAID NIH HHS/United States ; R01AI168144//National Institute of Allergy and Infectious Diseases of the National Institutes of Health/ ; }, mesh = {Humans ; *COVID-19/epidemiology ; *Epidemiological Models ; *Spatial Analysis ; Pandemics ; SARS-CoV-2 ; }, abstract = {BACKGROUND: A wide range of epidemiological modeling approaches have been applied to the SARS-CoV-2 pandemic, which presents an opportunity to assess common approaches applied to specific research questions. Spatial models interrogate how heterogeneities and host movement dynamics influence local and regional patterns of disease, issues that were of great interest for understanding and controlling SARS-CoV-2. OBJECTIVE: Here, we present a systematic review of spatial epidemiological modeling approaches of SARS-CoV-2. We describe common themes and highlight unique strategies, providing a foundation for researchers to devise spatial models most appropriate for future pathogens and epidemics. Our review also categorizes the research questions that were addressed with spatial models, highlights parameter estimation techniques, and describes the cyber infrastructure used for model development. METHODS: We conducted a systematic review using Web of Science and a standardized set of keywords, followed by thorough examination of abstracts and full texts to determine which studies met our inclusion criteria. To guide our description and comparisons of models, we developed a Geography, Population, Movement (GPM) framework that conceptualizes the interactions between three distinct subcomponents of any spatial model. The geographic model represents the physical arena in which the model is implemented, the intra-population model describes the transmission and disease processes that occur within distinct spatial units of the geography, and the movement model describes the algorithms that dictate how hosts move among spatial units within the geography. RESULTS: The search identified a total of 193 articles, of which 109 were included in our review. The most abundant intra-population modeling methods were agent-based (47.7%) and compartmental modeling (29.4%) approaches. Movement models ranged in complexity, with the most complex models implementing commuter movement among many points of interest in the geographic arena, which were sometimes parameterized by fine-scale mobility data. Geographic models ranged from describing microcosms, such as single classrooms, all the way up to multi-country models. Of the 63.3% of models studies that specified the programming language used, we detected ten different languages, with Matlab and Python being the most frequent, although only 30.6% of studies provided open-access code for their models. We also described eight specialized software systems that were used to construct agent-based or compartment models of COVID-19. CONCLUSIONS: Our review identified and characterized a variety of spatial modeling strategies and software that were usefully employed to address many relevant epidemiological questions for COVID-19. Future research is needed to quantitatively assess which modeling approaches are most appropriate in specific situations, to answer specific questions, or to apply to certain disease systems. Moreover, future cyber-infrastructure could help to modularize and standardize modeling approaches, which would increase transparency and reproducibility, and which would facilitate a detailed examination of which model attributes relate to model performance in a variety of contexts.}, }
@article {pmid41987698, year = {2026}, author = {Bucharová, M and Hořejší, B and Kantor, J and Perimal-Lewis, L and Klugar, M}, title = {Virtual music therapy during the COVID-19 pandemic: an updated scoping review.}, journal = {JBI evidence synthesis}, volume = {24}, number = {7}, pages = {1368-1430}, pmid = {41987698}, issn = {2689-8381}, mesh = {Humans ; *COVID-19 ; *Music Therapy/methods ; SARS-CoV-2 ; Pandemics ; Telemedicine ; }, abstract = {OBJECTIVE: The objective of this update to a previously published scoping review was to map how music therapists used virtual music therapy during the COVID-19 pandemic.
INTRODUCTION: Virtual music therapy underwent significant development during the COVID-19 pandemic. Consequently, the number of publications increased dramatically compared to early 2021, when only 10 records were available. An update to the previous scoping review was necessary to explore the current state of this emerging music therapy discipline and provide important information for health care practitioners, scholars, and researchers.
ELIGIBILITY CRITERIA: This scoping review included studies examining how music therapists (population) delivered virtual, remote, or online music therapy (concept) across all client groups during the COVID-19 pandemic (context). All types of evidence were included except for literature reviews, newspaper articles, essays, editorials, letters to the editor, and bachelor's theses. The search strategy was conducted in English across relevant databases and journals.
METHODS: Following the JBI methodology for scoping reviews, we updated a scoping review published in 2021. Available evidence was searched for in databases, including searches for unpublished studies, gray literature, and relevant journal archives, along with manual searches of reference lists. The search was limited from October 2020 (the date of the previous search) until December 2024. Two independent reviewers screened all reports against the eligibility criteria and performed the data extraction.
RESULTS: The global music therapy community adapted to the restrictions resulting from the COVID-19 pandemic through a significant expansion of virtual music therapy. A total of 145 new records, along with 5 records from the original review, were included in this scoping review. The papers were from North America (n=63), Europe (n=34), Asia (n=19), and Oceania (n=16), with the rest developed through international cooperation (n=18). Most texts described virtual music therapy in the form of synchronous video calls. We reported the characteristics of the records, the types of texts, the client groups to which virtual music therapy was delivered, and the platforms and equipment used. We identified research papers (n=103), other texts (n=44), study protocols, and an evidence implementation report. We also described the challenges, facilitators, and barriers, along with the music therapy methods. Most frequently, a combination of active and receptive methods was used, with an emphasis on listening, singing, and music-based relaxation or imagery methods. Virtual music therapy was delivered to a wide range of clients, including those with various medical diagnoses and mental health issues; caregivers; and health care workers. Virtual music therapy took place in clients' homes, hospitals, or educational settings.
CONCLUSIONS: The virtual music therapy field experienced significant growth during the COVID-19 pandemic and developed into a distinct area of music therapy. This scoping review reports on a substantial body of relevant evidence, providing detailed insights into the nuances of virtual music therapy practice, which may remain useful even beyond pandemic restrictions. Future research is needed to examine the impact of virtual music therapy in the post-COVID-19 era and its potential as a complementary approach to face-to-face therapy.
REVIEW REGISTRATION: OSF https://osf.io/tnw3c/.
SUPPLEMENTAL DIGITAL CONTENT: A Czech-language version of the abstract of this review is available: http://links.lww.com/SRX/A189.}, }
@article {pmid41988578, year = {2026}, author = {Vargas-Veliz, SR and Izquierdo-Cevallos, DR and Fajardo-Vargas, JE and Solórzano-Rezabala, DK and Peralta-Gamboa, DA}, title = {Psychosocial risks in Latin America: trends and research gaps.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1788232}, pmid = {41988578}, issn = {2296-2565}, mesh = {Latin America/epidemiology ; Humans ; *COVID-19/epidemiology/psychology ; *Mental Health ; Bibliometrics ; Evidence Gaps ; *Stress, Psychological/epidemiology ; Working Conditions ; Burnout, Professional/epidemiology ; }, abstract = {This study analyzes the scientific evolution of psychosocial risks in Latin America through a bibliometric analysis of 1,866 articles indexed in Scopus and Web of Science between 1963 and 2026. The results show sustained growth in academic production, particularly during the last decade, accompanied by an increase in impact measured by citations. The international collaboration network reveals a structure articulated in South-South and South-North patterns, with Brazil as a regional node and the United States as a transnational bridge. The keyword co-occurrence analysis identifies three main thematic clusters: (1) mental health and psychological distress-including anxiety, depression, and stress-; (2) labor and organizational factors, including burnout, working conditions, workplace violence, and job satisfaction; and (3) the disruptive effects of the COVID-19 pandemic, which reorganized the recent scientific agenda. The findings demonstrate that psychosocial risks in Latin America constitute a field in consolidation, characterized by the convergence of clinical, labor, and structural dimensions, and by growing regional visibility in the international literature. However, limitations persist, associated with the predominance of cross-sectional studies, the underrepresentation of informal and precarious sectors, and geographical asymmetries in scientific infrastructure. It is suggested to advance toward comparative, longitudinal, and interdisciplinary approaches that integrate mental health, work organization, and regional socioeconomic contexts. This study provides an empirical basis for understanding the investigative configuration of the field and guiding future research agendas, public policies, and interventions aimed at psychosocial well-being in the region.}, }
@article {pmid41989511, year = {2026}, author = {Sun, S and Guo, X and Liu, S and Wu, S and Ma, L and Yang, H}, title = {Probiotics and Bacteriocins Against SARS-CoV-2: Therapeutic Frontiers and Mechanistic Insights.}, journal = {Probiotics and antimicrobial proteins}, volume = {}, number = {}, pages = {}, pmid = {41989511}, issn = {1867-1314}, support = {No. C2023201049//Natural Science Foundation of Hebei Province/ ; No. C20230309//Funding Program for Introducing Overseas Scholars of Hebei Province/ ; }, abstract = {The COVID-19 pandemic has posed significant challenges to global public health. The continuous mutations of its pathogen, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have further complicated containment efforts. As functional foods, probiotics and their metabolites, particularly bacteriocins, are recognized for their safety and potential antiviral roles in infection prevention and health management. This review summarizes the current research status, mechanisms, and potential applications of probiotics and bacteriocins against SARS-CoV-2. Clinical and preclinical evidence indicates that specific probiotic strains, such as Lactiplantibacillus plantarum GUANKE, Lactococcus lactis strain Plasma, and Lactiplantibacillus plantarum MPL16/CRL1506, can effectively alleviate clinical symptoms, shorten disease duration, and reduce the risk of severe illness by modulating the gut microbiota, strengthening the mucosal barrier, and enhancing innate immune responses. Representative bacteriocins, including nisin, pediocin PA-1, plantaricin W, glycocin F, and lactococcine G, can mitigate cytokine storms and gut dysbiosis by modulating host immunity, for example, by inhibiting inflammatory factor release as observed in cellular and animal models. Furthermore, molecular docking and dynamics simulations suggest that these bacteriocins may inhibit viral entry and replication by competitively binding to the SARS-CoV-2 Spike (S) protein or the angiotensin-converting enzyme 2 (ACE2) receptor and by interfering with key viral enzyme activities. However, translating these promising findings—supported by clinical observations, animal studies, and computational predictions—into practical applications requires overcoming major bottlenecks, from mechanistic elucidation and in vivo validation to formulation development. Therefore, future research should focus on more in-depth studies to bridge the gap between experimental evidence and clinical translation.}, }
@article {pmid41990021, year = {2026}, author = {Wandrekar, J and Ranade, K and Chakrapani, V and Lakshmi, P}, title = {Mental Health of Transgender and Gender-Diverse Persons in India: A Scoping Review of Literature Since Legal Recognition of Self-Affirmed Gender Identity, 2014-2024.}, journal = {LGBT health}, volume = {13}, number = {4}, pages = {195-214}, pmid = {41990021}, issn = {2325-8306}, mesh = {Humans ; India/epidemiology ; *Transgender Persons/psychology ; Male ; Female ; *Mental Health ; Gender Identity ; Gender-Nonconforming Persons ; *Sexual and Gender Minorities/psychology ; }, abstract = {PURPOSE: India's 2014 Supreme Court ruling in National Legal Services Authority v. Union of India affirmed transgender and gender-diverse (TGD) persons as equal citizens with a right to self-identified gender. This scoping review (2014-2024) sought to map TGD mental health research in India, characterize study details and themes, and identify gaps to guide future research and interventions.
METHODS: Following Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a systematic search of peer-reviewed literature (PubMed, PsycINFO, Web of Science, Google Scholar, specific journal search, hand search) and grey literature (Google Scholar, websites of LGBTQ organizations, and digital thesis repositories Shodh Ganga and Shodh Gangotri). All publications between April 2014 and December 2024 that focused on the mental health of the Indian transgender population were included.
RESULTS: From 246 initial sources, 124 were included in the review. The reviewed studies described prevalence rates of common mental disorders, transgender-specific psychosocial stressors, positive psychology variables, role of mental health professionals, mental health interventions and guidelines, forced gender "correction" practices, mental health impact of gender-affirming surgeries, links between sexual health and mental health, and experiences during the COVID-19 pandemic.
CONCLUSIONS: This review demonstrates substantial mental health needs among TGD communities in India but a narrow, uneven evidence base. Several articles revealed researcher misconceptions indicating ethical and epistemic harm. Priority next steps are adequately powered, intersectional longitudinal studies and rigorously evaluated, community-partnered interventions (including family support and mental health professional training) to advance gender-affirming, evidence-based care.}, }
@article {pmid41991389, year = {2026}, author = {de Oliveira, LMC and de Araújo, ANB and Soares, TSL and Ferreira, LP and Queiroga, BAM and de Lima, MLLT and de Arruda, RG and Lucena, JA}, title = {The Relationship Between Teachers' Vocal Production Conditions, Interpersonal Communication Competence, and Mental Health After the Pandemic in Brazil.}, journal = {Journal of voice : official journal of the Voice Foundation}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.jvoice.2026.03.003}, pmid = {41991389}, issn = {1873-4588}, abstract = {OBJECTIVE: To determine whether teachers' vocal production conditions and interpersonal communication competence are associated with mental health after the COVID-19 pandemic in Brazil.
STUDY DESIGN: Cross-sectional study with an analytical approach.
METHOD: The sample comprised 361 middle and high school teachers from Pernambuco state schools. Data were collected using the following instruments: Teacher Vocal Production Condition (VPC-T) and Screening Index for Voice Disorder (SIVD), which characterized teachers' vocal profiles and working conditions; the Interpersonal Communication Competence Scale (ICCS), which assessed interpersonal communication competence; the State-Trait Anxiety Inventory (STAI), which assessed trait and state anxiety; and the Self-Reported Questionnaire (SRQ-20), which suggests the level of suspicion (presence/absence) of a common mental disorder. Pearson's correlation test, multiple linear regression analysis, chi-square test, and the ANOVA test were performed for comparison analysis between variables.
RESULTS: Higher levels of anxiety and common mental distress were associated with the presence of self-reported voice disorders and less-developed interpersonal communication skills. Voice disorders were self-reported by 44.41% of teachers, while 40.44% presented high anxiety on the STAI-S and 38.78% on the STAI-T. There was an indication that 25% of teachers had common mental distress. The data also indicated that participants had good interpersonal communication skills, particularly in the domains of environmental control, self-disclosure, and immediacy.
CONCLUSION: Self-reported voice disorders and trait and state anxiety are notably present in teachers. Their vocal production conditions and interpersonal communication skills were associated with anxiety and common mental distress after the COVID-19 pandemic.}, }
@article {pmid41991875, year = {2026}, author = {Hensel, O and Pfrommer, L and Furch, P and Strutz, N and Wohlgemuth, WA and Posa, A}, title = {[Post-COVID: An inventory focusing on the key complaints PEM and POTS].}, journal = {MMW Fortschritte der Medizin}, volume = {168}, number = {Suppl 3}, pages = {3-10}, doi = {10.1007/s15006-026-5691-7}, pmid = {41991875}, issn = {1613-3560}, mesh = {Humans ; *COVID-19/complications/therapy ; *Postural Orthostatic Tachycardia Syndrome/therapy/etiology/diagnosis ; Post-Acute COVID-19 Syndrome ; }, abstract = {BACKGROUND: More than five years after the start of the COVID-19 pandemic, its long-term effects are increasingly coming into focus. Post-COVID disease poses a significant challenge, - not only for the individuals affected, but also for healthcare providers and society as a whole. In order to improve care for post-COVID patients, the current state of research should be reviewed and the frequent and characteristic complaints post-exertional malaise and postural tachycardia syndrome should be presented.
METHOD: The literature search for this narrative review was conducted in the PubMed and Semantic Scholar databases.
RESULTS: Post-COVID symptoms are often nonspecific, diverse, and fluctuating. However, post-exertional malaise and postural tachycardia syndrome are characteristic of post-COVID when they occur newly after COVID-19 disease. Post-exertional malaise is an intensification of symptoms after exertion that occurs in about 86% of post-COVID patients. Pacing is a promising treatment approach here. Postural tachycardia syndrome manifests as autonomic, tachycardic, orthostatic dysregulation and affects up to 82% of post-COVID patients. Symptomatic therapy includes pharmacological and non-pharmacological measures.
CONCLUSIONS: Post-exertional malaise and postural tachycardia syndrome are typical and characteristic post-COVID symptoms. Current scientific findings underscore the SARS-CoV-2-related organic origin of post-COVID symptoms.}, }
@article {pmid41992382, year = {2026}, author = {Cuteri, V and Preziuso, S and Li, Y and Laus, F}, title = {Fecal virome at the human-animal interface: a one health perspective on an uncharted frontier.}, journal = {Animal microbiome}, volume = {8}, number = {1}, pages = {}, pmid = {41992382}, issn = {2524-4671}, abstract = {The exponential growth of the human population and associated intensifications in animal farming, pet ownership, and habitat anthropisation have dramatically increased human-animal interactions. Global livestock production now exceeds 24 billion animals annually, and pet ownership has risen to over 70% of households in many developed nations, creating unprecedented interfaces for viral exchange. This heightened contact has multiplied opportunities for zoonotic and reverse-zoonotic transmission, as tragically exemplified by the SARS-CoV-2 pandemic. The fecal virome—defined as the totality of viral nucleic acids in the gastrointestinal tract—represents a crucial, yet largely unexplored, pathway for such exchanges. While the bacterial microbiome’s role is increasingly recognized, the virome’s composition, dynamics, and transmissibility between co-habiting humans and animals remain poorly characterized. This review compiles current evidence on the fecal virome of key domestic animals (equines, livestock, pets) and their human contacts under the “One Health” framework. We critically evaluate methodological approaches—from targeted PCR to viral metagenomics—and highlight the discovery of novel viruses and identification of zoonotic agents through metagenomic approaches. Critically, we identify significant knowledge gaps, including the absence of definitive evidence for contemporary cross-species transmission versus shared ancestry or convergent evolution. We propose a strategic research agenda focused on longitudinal studies of human-animal cohorts, standardized metagenomic methodologies, and functional analyses of the virome. Elucidating the fecal virome at this interface is paramount for developing proactive surveillance strategies to predict and prevent the next emerging viral disease.}, }
@article {pmid41992508, year = {2026}, author = {Alsaqer, K and Alhmoud, SH and Khamis, S}, title = {Healthcare Providers' Attitudes and Willingness Toward Monkeypox Vaccination in Jordan: A National Cross-Sectional Survey.}, journal = {Public health nursing (Boston, Mass.)}, volume = {43}, number = {4}, pages = {957-964}, doi = {10.1111/phn.70126}, pmid = {41992508}, issn = {1525-1446}, mesh = {Humans ; Cross-Sectional Studies ; Jordan ; Female ; Male ; Adult ; Surveys and Questionnaires ; *Attitude of Health Personnel ; *Vaccination/psychology/statistics & numerical data ; *Health Personnel/psychology/statistics & numerical data ; *Mpox, Monkeypox/prevention & control ; Middle Aged ; COVID-19/prevention & control ; }, abstract = {BACKGROUND: Despite their crucial role, research shows that healthcare professionals are not well-informed about or adequately equipped to handle newly emerging infectious diseases like monkeypox.
AIM: This study aims to assess attitudes and willingness toward monkeypox among Jordanian healthcare providers.
METHOD: This was an analytical cross-sectional survey conducted among healthcare providers in Jordan. Data were collected using a self-administered questionnaire (online and paper-based, as needed) over a defined 4-8-week period.
RESULTS: A total of 638 healthcare providers participated in the study. The mean age was 35.8 ± 8.4 years. Composite measures showed moderate willingness (mean = 3.56 ± 0.78) but high concern levels (mean = 3.98 ± 0.61). Willingness did not differ significantly across most demographic variables; however, concerns were higher among single participants and those with 5-10 years of experience. A moderate positive correlation was found between willingness and concerns (r = 0.42, p < 0.001). Logistic regression identified COVID-19 vaccination history (OR = 2.22, p = 0.019), trust in health agencies (OR = 1.21, p = 0.028), and greater willingness scores (OR = 1.41, p = 0.006) as significant predictors of acceptance. Concerns did not significantly reduce the likelihood of willingness.
CONCLUSION: Jordanian Healthcare providers demonstrated relatively low immediate willingness to vaccinate, driven by substantial concerns about safety, effectiveness, and vaccine defects. Confidence in public health agencies and prior vaccination history significantly improved acceptance.}, }
@article {pmid41993129, year = {2026}, author = {Ugwu, OP and Ogenyi, FC and Basajja, M and Ugwu, CN and Mustafa, MM and Okon, MB}, title = {Nanoparticle-mediated mRNA delivery for cancer, autoimmunity, and genetic diseases: a rapid review.}, journal = {Frontiers in drug delivery}, volume = {6}, number = {}, pages = {1793322}, pmid = {41993129}, issn = {2674-0850}, abstract = {INTRODUCTION: Messenger RNA (mRNA) therapeutics have advanced from experimental platforms to clinical application, driven largely by the success of lipid nanoparticle (LNP)-based COVID-19 vaccines. Building on this progress, nanoparticle-mediated mRNA delivery is being extended to non-infectious indications, including oncology, autoimmune disorders, and inherited diseases. However, challenges such as extrahepatic targeting, endosomal escape, repeat-dose immunogenicity, thermostability, and scalable manufacturing remain significant barriers to translation.
METHODS: A rapid review of peer-reviewed studies and registered clinical trials published between January 2020 and October 2025 was conducted. Searches were performed in PubMed, Scopus, Web of Science Core Collection, and ClinicalTrials.gov using combined terms related to RNA modality and nanoparticle delivery. Eligible studies focused on non-viral nanoparticle platforms for therapeutic, non-infectious mRNA delivery, including applications in protein replacement, genome editing, and immune modulation. Screening yielded 15 studies for inclusion.
RESULTS: LNPs remain the most clinically advanced platform for therapeutic mRNA delivery. At the same time, polymeric, peptide-based, exosome-inspired, and hybrid nanoparticle systems are expanding the delivery landscape. Emerging RNA formats, including self-amplifying RNA and circular RNA, show potential to prolong expression at lower doses. Clinically, individualized mRNA neoantigen therapy (mRNA-4157/V940) combined with pembrolizumab reduced recurrence risk by approximately 49% in high-risk melanoma in the KEYNOTE-942 phase 2b trial, supporting phase 3 development. In cystic fibrosis, inhaled CFTR mRNA (ARCT-032) advanced to phase 2 after early phase 1 data demonstrated safety and tolerability.
DISCUSSION: Evidence for non-viral nanoparticle-mediated mRNA therapeutics is strong in preclinical research and increasingly promising in clinical applications beyond vaccinology. While LNPs dominate current translation, alternative carriers and improved RNA formats may broaden tissue targeting and therapeutic durability. Advances in biodegradable ionisable lipids, organ-selective LNPs, and lyophilised or solid formulations are being developed to address persistent delivery and manufacturing constraints. As the field matures, regulatory and policy frameworks will need to align with therapeutic endpoints and support long-term safety monitoring.}, }
@article {pmid41993174, year = {2026}, author = {Mohiuddin, N and Shah, Y and Subramaniam, S}, title = {Regulation of histones in thromboinflammation.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1791619}, pmid = {41993174}, issn = {1664-3224}, mesh = {Humans ; *Histones/metabolism/immunology ; *Thromboinflammation/immunology/metabolism ; Animals ; Extracellular Traps/immunology/metabolism ; Protein Processing, Post-Translational ; COVID-19/immunology ; Alarmins/metabolism ; *SARS-CoV-2 ; Nucleosomes/metabolism ; Inflammation/immunology ; }, abstract = {Extracellular histones, once regarded solely as nuclear structural proteins, are now recognized as potent mediators of thrombo-inflammation which is the pathological interface of coagulation and immunity. Released during necrosis, apoptosis, and neutrophil extracellular trap (NET) formation, histones act as damage-associated molecular patterns (DAMPs), engaging receptors such as Toll-like receptors (TLR2, TLR4, TLR9) to trigger endothelial dysfunction, platelet activation, and cytokine release. Post-translational modifications (PTMs), including citrullination, acetylation, and methylation, further modulate histone immunogenicity, cytotoxicity, and procoagulant potential. These mechanisms amplify thrombin generation, impair anticoagulant pathways, and promote vascular permeability, positioning histones as central drivers of immunothrombosis in sepsis, stroke, ARDS, COVID-19, and autoimmune disorders. Circulating histones and nucleosomes are emerging as biomarkers for disease severity and prognosis. Therapeutic strategies targeting histones, such as neutralizing antibodies, heparin derivatives, PAD inhibitors, and activated protein C, show promise in mitigating histone-driven pathology. This review highlights mechanistic insights into histone biology and explores translational opportunities for targeted interventions at the intersection of inflammation and thrombosis.}, }
@article {pmid41993206, year = {2026}, author = {Manu, GP and Bonney, JHK and Bawa, FK and Quashie, PK and Kusi, KA and Amoah, LE}, title = {Reduced COVID-19 severity in Africa: a systematic review of host genetic and immunological responses to SARS-CoV-2 infection.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1782808}, pmid = {41993206}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/immunology/genetics/epidemiology ; *SARS-CoV-2/immunology ; Africa/epidemiology ; Severity of Illness Index ; Cytokines ; African People ; T-Lymphocytes/immunology ; }, abstract = {BACKGROUND: The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had immense global consequences, leading to widespread illness, deaths, and devastated economies. Despite this, Africa has experienced a high prevalence of asymptomatic coronavirus disease 2019 (COVID-19) and mild cases. While reported cases and deaths have been lower, limited testing and undiagnosed infections make it difficult to determine the true burden of the disease. Understanding the unique immune response and the variations in genetics affect COVID-19 outcomes in African populations is important for shaping future public health responses. This review examines key immune factors and genetic variations in key host proteins that may help explain why COVID-19 was less severe in Africa.
METHODOLOGY: A systematic review was conducted following PRISMA guidelines to identify studies published between 2019 and January 2026 that investigated immunological responses and genetic variations associated with COVID-19 in African populations. Literature searches were performed in PubMed, Scopus, and African Journals Online (AJOL). Inclusion criteria focused on studies reporting responses from cytokines, T-cells, antibodies or host genetic factors. After screening 4,170 records and removing duplicates, 420 studies were assessed for abstracts, and 240 full texts were reviewed. A total of 40 studies were included, and data synthesized narratively due to heterogeneity in study designs and outcomes.
RESULTS: Of the 40 studies analyzed from 19 African populations, 26 focused on immunological responses and 9 on host genetic factors. Immune studies revealed widespread pre-existing immunity, including cross-reactive antibodies (especially to the N proteins) and polyfunctional T-cell responses, likely shaped by exposure to malaria, helminths, and other coronaviruses. Severe COVID-19 cases showed elevated IL-6, TNF-α, and IFN-γ, while asymptomatic individuals had broader, milder cytokine profiles. Antibody responses were robust across disease severities, with long-lasting IgG activity. Genetic studies identified HLA-B41, B42, C16, and C17 as risk alleles, while HLA-DQB106, DQB103, and B*15 conferred protection. ACE2 polymorphisms including rs2285666, rs73635825 were reportedly prevalent in Africans and were linked to varied ACE2 expression, viral load, and disease severity.
CONCLUSION: The findings suggest that immune and genetic adaptations in African populations may have modulated susceptibility and severity of SARS-CoV-2 infection outcomes in Africans.
https://www.crd.york.ac.uk/PROSPERO/view, identifier CRD420251121731.}, }
@article {pmid41993579, year = {2026}, author = {Song, JH and Shim, SR and Shin, J and Choe, WH and Park, J and Lee, TH and Kang, S and Rhee, TG and Huh, KC}, title = {Clinical effects of ursodeoxycholic acid in COVID-19 infection: a systematic review and dose-response meta-analysis.}, journal = {Frontiers in pharmacology}, volume = {17}, number = {}, pages = {1719144}, pmid = {41993579}, issn = {1663-9812}, abstract = {OBJECTIVES: Previous studies have shown that ursodeoxycholic acid (UDCA) reduces COVID-19 infection by inhibiting farnesoid X receptor activity, a direct regulator of ACE2. Even though UDCA, an easily accessible medication with few side effects, could be considered for administration to prevent infection and relieve symptoms for COVID-19 infection, there are limited supporting studies with a high-level of evidence and recommendations for the exact dosage of UDCA. We conducted a systematic review and dose-response meta-analysis to evaluate the clinical effect of UDCA in COVID-19 infection.
METHODS: Studies were identified through a literature search: PubMed, Embase, and Cochrane from inception to March 2025. We included research related to COVID-19 infection and UDCA. Primary outcomes were COVID-19 infection rate, mortality rate, COVID-19 severe infection risk, ventilator use, hospitalization, ICU hospitalization, and recovery time between UDCA group and controls. The secondary outcome was UDCA dose-response association regarding infection risk. We analyzed for odds ratios (ORs), including infection rate, mortality rate, severe infection risk, ventilator use, hospitalization, and intensive care unit hospitalization, and for standardized mean difference (SMD), including recovery time between UDCA groups and controls. Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) was used to evaluate bias risk.
RESULTS: Of 188 articles, 15 cohort studies with 716,310 participants (control = 495,276; UDCA treatment = 221,034) were included. The level of risk of bias was seven studies at low, four at moderate, and four at serious. UDCA showed association with a lower risk of infection (OR, 0.69; 95% CI, 0.55-0.86), lower severe infection risk (OR, 0.75; 95% CI, 0.64-0.89), and ventilator use (OR, 0.75; 95% CI, 0.62-0.90) compared to controls.
CONCLUSION: The findings support evidence for the clinical effects of UDCA for COVID-19 infection. There is a need for randomized trials to evaluate UDCA as a potential prophylactic agent against COVID-19.
https://www.crd.york.ac.uk/PROSPERO/view/CRD420251019195, identifier #CRD420251019195.}, }
@article {pmid41995128, year = {2026}, author = {Gonah, L and Ginindza, TG and Hlongwana, KW}, title = {Mapping global evidence on compassion fatigue among healthcare workers during COVID-19: insights and implications for future preparedness - a scoping review.}, journal = {Journal of global health}, volume = {16}, number = {}, pages = {04130}, pmid = {41995128}, issn = {2047-2986}, mesh = {Humans ; *Compassion Fatigue/epidemiology ; *COVID-19/epidemiology/psychology ; *Health Personnel/psychology ; Risk Factors ; Frontline Workers ; Prevalence ; }, abstract = {BACKGROUND: Compassion fatigue (CF) is a critical occupational hazard for healthcare workers (HCWs), intensified by the COVID-19 pandemic, with implications for well-being, retention, and quality of care. We aimed to map the global evidence on CF prevalence, risk factors, effects, interventions, and research gaps among HCWs during the COVID-19 pandemic.
METHODS: A scoping review of 56 studies from 21 countries (2020-2025) was conducted following PRISMA-ScR guidelines. Seven databases were searched, and findings were synthesised narratively with attention to occupational, demographic, and systemic determinants of CF.
RESULTS: Compassion fatigue prevalence ranged from 20 to 87%. It was most pronounced among nurses, women, frontline staff, early-career professionals, and those in under-resourced or rural settings. Key risk factors included high workload, long shifts, repeated exposure to death, moral distress, and limited organisational support. Symptoms encompassed emotional exhaustion, depersonalisation, diminished empathy, and co-occurring anxiety, depression, or secondary traumatic stress. Interventions (resilience and peer-support programmes, self-compassion training, motivational messaging, and mobile psychoeducation) showed small-to-moderate benefits but were limited by methodological heterogeneity and scarce robust evaluation. Temporally, CF peaked during early pandemic surges and persisted among frontline staff and in resource-constrained or long-COVID contexts.
CONCLUSIONS: Compassion fatigue is a multifactorial, context-dependent hazard disproportionately affecting vulnerable HCWs. Effective mitigation requires longitudinal research, inclusive global representation, and multi-level strategies linking individual resilience with organisational reform and policy action to safeguard HCW well-being in current and future crises.}, }
@article {pmid41995349, year = {2026}, author = {Schiffer, JT and Reeves, DB and Mayer, B and Rodriguez, LR and Duke, ER and Haddock, B and Avila-Ponce de Leon, U and Iwami, S and Owens, K and Esmaeili-Wellman, S}, title = {Clinical trial simulation of antiviral drugs.}, journal = {Journal of virology}, volume = {100}, number = {5}, pages = {e0181424}, pmid = {41995349}, issn = {1098-5514}, support = {R01AI77512//National Institute of Allergy and Infectious Diseases/ ; R01 AI186721/AI/NIAID NIH HHS/United States ; R01 AI150500/AI/NIAID NIH HHS/United States ; }, mesh = {*Antiviral Agents/pharmacokinetics/pharmacology/therapeutic use ; Humans ; *Clinical Trials as Topic ; Computer Simulation ; Viral Load/drug effects ; Models, Theoretical ; *Virus Diseases/drug therapy/virology ; Models, Biological ; }, abstract = {Antiviral clinical trial simulation (CTS) is a type of mathematical modeling that couples viral- immune dynamics (VID) unique to each human viral pathogen, with mechanistic, pharmacokinetic (PK), and pharmacodynamic (PD) drug characteristics. Validation is achieved by matching model output to detailed viral load trajectories from trials. Antiviral CTS can be applied at all stages of drug development to viruses with distinct shedding patterns. Models can capture the activity of small molecules, neutralizing antibodies, and cellular therapies, as well as combination strategies to enhance potency and avoid drug resistance. Several principles are observed across antiviral CTS models. First, PK and PD models that recapitulate drug levels and concentration-dependent antiviral activity are often necessary, but never sufficient to predict trial results. VID equations are also required to guide optimal treatment timing because expanding immune responses synergistically eliminate infection but are deleterious if too sustained or intense. Therefore, equivalent antiviral doses may have different efficacy if given during different infection stages. Second, antiviral CTS models identify effective plasma drug concentrations in humans, which are often poorly predicted by in vitro assays. Finally, models that do not consider drug mechanisms lead to incorrect efficacy estimates. Data-validated CTS is increasingly used to inform drug dose and dosing interval, treatment timing and duration, virologic endpoint selection, and sample size, particularly when applied to detailed phase 1 and 2 trial data. Given the high expense of antiviral licensure trials, CTS models are vital to optimize trial efficacy and de-risk the drug development process.}, }
@article {pmid41995633, year = {2026}, author = {Kruger, EC and Fataar, A and Kengne, AP and Erasmus, RT and Zemlin, AE}, title = {Mapping the evidence: a scoping review of the impact of COVID-19 on non-communicable disease care in Sub-Saharan Africa.}, journal = {Critical reviews in clinical laboratory sciences}, volume = {}, number = {}, pages = {1-13}, doi = {10.1080/10408363.2026.2651301}, pmid = {41995633}, issn = {1549-781X}, abstract = {Non-communicable diseases (NCDs) are the leading cause of mortality globally and account for a growing proportion of the disease burden in sub-Saharan Africa (SSA), where health systems face significant resource constraints. The COVID-19 pandemic disrupted healthcare delivery globally, raising concerns that interruptions to routine NCD care could lead to higher morbidity and mortality among populations requiring ongoing care. Although evidence of the pandemic's impact on NCD care has been documented in high-income settings, the experience of SSA health systems, which entered the pandemic with preexisting infrastructure and workforce limitations, remains incompletely understood. This scoping review aimed to systematically map the evidence on COVID-19's impact on NCD care in SSA and to identify service adaptations implemented to maintain care continuity during the pandemic. Studies examining the COVID-19 pandemic and disruptions in NCD screening, diagnosis, or monitoring among adults in SSA were identified from four electronic databases: PubMed/Medline, Scopus, EBSCOhost, and Web of Science. The search strategy combined Medical Subject Headings (MeSH) terms and keywords related to geographic location (SSA), exposure (COVID-19 pandemic and related public health measures), and outcomes (screening, diagnosis, and monitoring of NCDs). Inclusion was limited to original research published between March 2020 and December 2023, written in English, French, or German, and reporting observational data on pandemic-related disruptions to NCD care. Two reviewers independently screened titles, abstracts, and full texts, with data extraction conducted using a standardized form capturing study characteristics, NCD types examined, nature of documented disruptions, and reported innovations. Twenty-eight studies were eligible for inclusion across seven countries in SSA, with the majority of evidence originating from South Africa and Ethiopia. Included studies were mainly retrospective and cross-sectional, with some using mixed-methods and time-series designs, and examined various NCDs, including diabetes mellitus, hypertension, and cancers. Sample sizes ranged from fewer than 100 participants to datasets exceeding 9 million records. Due to the heterogeneity of study designs, populations, and outcomes, findings were synthesized narratively. Six major themes emerged: disrupted access to routine care, interruptions to diagnostics and monitoring, medicine supply chain challenges, adoption of remote care models, health equity impacts, and clinical outcome implications. The pandemic was associated with widespread barriers to healthcare access, diagnostic delays, and medication shortages, with the implementation of innovations such as telemedicine and community-based delivery often hindered by technological and resource limitations. COVID-19 significantly disrupted NCD care across SSA, though health systems demonstrated notable capacity for adaptation, emphasizing the need for resilient service delivery models and equity-focused monitoring to safeguard care during future health emergencies.}, }
@article {pmid41996417, year = {2026}, author = {Byrd, W and Salehi, N and Henderson, C}, title = {Covid-19 testing, sick-pay and public health outbreak management of respiratory infections in care homes: three rapid reviews of the literature.}, journal = {Journal of public health (Oxford, England)}, volume = {48}, number = {2}, pages = {539-542}, pmid = {41996417}, issn = {1741-3850}, support = {NIHR154310//UK National Institute for Health Research Health and Social Care Delivery Research/ ; }, mesh = {Humans ; COVID-19 ; *Disease Outbreaks/prevention & control ; COVID-19 Testing ; Pandemics ; *Coronavirus Infections/diagnosis/epidemiology ; *Pneumonia, Viral/diagnosis/epidemiology ; *Respiratory Tract Infections/epidemiology/diagnosis/therapy ; SARS-CoV-2 ; *Public Health ; *Nursing Homes ; Betacoronavirus ; *Clinical Laboratory Techniques ; }, abstract = {BACKGROUND: Credible and costed plans for managing future outbreaks of Covid-19 and other respiratory infections depend on the availability of good quality evidence. Methods: Three rapid reviews (RRs) examined evidence on: Bibliographic database searches for each RR and supplementary grey literature searches of Google for RR1 and RR3.
RESULTS: RR1 included 1 study, RR2 none, and RR3, 1 report. RR1: a study of testing undertaken during an outbreak of Covid-19 in one care home. RR3: a report briefly described recommended inputs of one local authority's public health service into managing outbreaks of respiratory infections in settings including care homes.
CONCLUSION: The reviews found little-to-no recent evidence on care home providers' policy and practice on asymptomatic Covid-19 testing, care home sick pay and/or shift backfill, and the incidence of Covid-19 and other respiratory infections, nor on costs of public health teams' outbreak management.}, }
@article {pmid41996892, year = {2026}, author = {Liu, C and Yuan, X}, title = {Respiratory viruses as key drivers of pulmonary fibrosis: integrated pathways from barrier injury to immune-fibrotic crosstalk.}, journal = {Virology}, volume = {620}, number = {}, pages = {110913}, doi = {10.1016/j.virol.2026.110913}, pmid = {41996892}, issn = {1096-0341}, mesh = {Humans ; *Pulmonary Fibrosis/virology/immunology/pathology ; Signal Transduction ; Animals ; Transforming Growth Factor beta/metabolism ; Macrophages, Alveolar/immunology ; SARS-CoV-2/pathogenicity ; COVID-19/complications/virology/immunology ; Lung/virology/pathology/immunology ; }, abstract = {Pulmonary fibrosis (PF), a highly heterogeneous form of interstitial lung disease, presents substantial challenges for both basic research and clinical management due to its complex pathogenesis and poor clinical outcomes. In recent years, PF induced by respiratory viral infections has emerged as a forefront topic in respiratory medicine. However, the dynamic regulatory network linking virus-mediated alveolar epithelial injury, aberrant tissue repair, and fibroblast activation remains incompletely understood. This review focuses on representative respiratory viruses-including Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), seasonal influenza viruses, and highly pathogenic avian influenza viruses-and analyzes, from multiple mechanistic dimensions, how viral infection drives the development of PF. The article analyzes how viral infections contribute to tissue damage and functional loss in the lungs via direct host-cell injury, dysregulated immune responses, and disturbances in epigenetic regulation. In particular, the review highlights the aberrant activation of the transforming growth factor-β (TGF-β)/Smad signaling pathway and virus-induced polarization of alveolar macrophages as key processes in the progression of fibrosis. Furthermore, this review systematically summarizes the shared molecular pathways triggered by viral infections in the development of PF and their potential biomarkers, providing a theoretical basis for targeted therapies. In conclusion, respiratory viruses are not only significant etiological factors in PF, but also accelerate the fibrotic process through immune-fibrotic interactions. This review provides a theoretical framework for a deeper understanding of virus-induced PF and outlines directions for the development of targeted therapies and clinical intervention strategies.}, }
@article {pmid41998470, year = {2026}, author = {Ho, JKY and Brewster, A and Kienzler, H and Brown, JSL}, title = {Perceived Discrimination and Mental Health Among First-Generation East Asian Immigrants: A Systematic Review.}, journal = {Journal of racial and ethnic health disparities}, volume = {}, number = {}, pages = {}, pmid = {41998470}, issn = {2196-8837}, abstract = {BACKGROUND: Research has found that first-generation immigrants often experience poorer mental health outcomes than later-generation immigrants and native-born individuals. Perceived discrimination is a key factor, exacerbated by recent global events such as COVID-19. However, much of the literature aggregates immigrants of different Asian ethnicities and generational statuses, despite documented disparities in mental health outcomes. This review aims to address this gap in literature by systematically reviewing empirical studies that explore the relationship between perceived discrimination and mental health outcomes of first-generation immigrants from East Asia only. METHODS: This review was registered on the PROSPERO international registry for systematic review protocols (Registration Number: CRD42024505188). Five databases (Embase, PsycINFO, Medline, Web of Science and Scopus) were searched for quantitative, English-language studies that explored the relationship between perceived discrimination and validated measures of mental health outcomes among first-generation East Asian immigrants. Studies were appraised for methodological quality using The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Analytical Cross-Sectional Studies tool [1]. Findings were synthesised narratively due to heterogeneity in methodology across studies. RESULTS: Out of 1,061 screened articles, 10 studies met the inclusion criteria. All included studies explored perceived discrimination, through racial discrimination. Only studies of Korean or Chinese first-generation immigrants were found. Ten studies reported a significant association between perceived racial discrimination and poorer mental health outcomes, particularly depressive symptoms. A range of variables that influenced this relationship were also identified, with degree of social support emerging as a consistent factor. Methodological limitations included inconsistent control for relevant sociodemographic or immigrant-related variables and differences in in exclusion or inclusion criteria used in the different studies. CONCLUSION: Overall, the findings highlight that experiences of perceived racial discrimination have a detrimental impact on the mental health of first-generation Korean and Chinese immigrants. However, inconsistencies in the measurement and study design presented challenges for synthesising the results and drawing firm conclusions, particularly regarding the role of influencing variables. Future research should use more consistent measures of perceived discrimination and mental health to better quantify the outcomes and understand the mental health implications. Research should also continue to disaggregate data by both generational status and specific East Asian ethnic groups, particularly those underrepresented in the current review, such as Japanese, Taiwanese, and Mongolian immigrants.}, }
@article {pmid41998754, year = {2026}, author = {Amanat, N and Hosseini, SH and Habibisaravi, R and Omrani, MG}, title = {COVID-19 vaccination hesitancy in pediatrics: a systematic review.}, journal = {Systematic reviews}, volume = {15}, number = {1}, pages = {}, pmid = {41998754}, issn = {2046-4053}, mesh = {Humans ; *Vaccination Hesitancy/psychology ; *COVID-19/prevention & control ; *COVID-19 Vaccines/administration & dosage ; *Parents/psychology ; Child ; Pediatrics ; SARS-CoV-2 ; *Vaccination/psychology ; Health Knowledge, Attitudes, Practice ; Infant ; }, abstract = {BACKGROUND: Vaccine-preventable diseases remain among the top ten global health threats. These findings indicate an important link between health and vaccine literacy. Children are less affected by COVID-19 than adults are but can be particularly vulnerable in communities with inadequate and weak infrastructure. One in five parents was skeptical about the COVID-19 vaccine. The present study combined the findings of previous studies to identify the reasons for parental hesitancy related to children's COVID-19 vaccination.
METHODS: We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to investigate vaccine hesitancy among parents of children aged 0-18 years in the context of COVID-19. We searched PubMed, Scopus, Web of Science, and Google Scholar using the keywords "vaccine hesitancy," "pediatrics," and "COVID-19" for studies published between January 2019 and August 2024. Eligible studies were published in English and focused on parental perspectives. Two independent reviewers screened 2950 records, extracted data, and assessed study quality using the Joanna Briggs Institute (JBI) critical appraisal checklists. Thematic analysis identified key drivers of vaccine hesitancy.
RESULTS: Of the 48 full-text articles screened, 22 studies met the eligibility criteria. The included studies took place in 11 different countries. The thematic analysis resulted in two main headings: (1) vaccine-related concerns, which included safety/trust concerns (100% of studies) and accessibility barriers (13.6%), and (2) user-related concerns: risk perception (31.8%), lack of knowledge (50%), cultural manifestation (13.6%), and previous medical conditions (31.8%). Universal concerns about safety and trust were evident in all studies, while cultural and accessibility barriers were context-specific and fluctuated by region and population.
CONCLUSION: The study points to interventions for reversing parental hesitation towards pediatric COVID-19 vaccination, like tailored education programs, streamlining distribution procedures, creating public acceptance through local community opinion leaders, and appropriate risk communication by public health institutions. All of these can contribute to making sound policies and making future immunization planning easier.}, }
@article {pmid41999993, year = {2026}, author = {Farsiu, N and Khodadadpour Mahani, F and Arefinia, N and Charostad, J and Pardeshenas, M and Mirzaei, H and Nakhaie, M and Hassandarvish, P and AbuBakar, S}, title = {From legacy to innovation: A comprehensive review of vaccine platforms against viral infections.}, journal = {Virus research}, volume = {368}, number = {}, pages = {199730}, pmid = {41999993}, issn = {1872-7492}, mesh = {Humans ; *Virus Diseases/prevention & control/immunology ; Vaccines, Virus-Like Particle/immunology ; *Vaccine Development/methods ; *Viral Vaccines/immunology ; Animals ; Vaccines, DNA/immunology ; Vaccination/methods ; COVID-19/prevention & control/immunology ; COVID-19 Vaccines/immunology ; Vaccines, Subunit/immunology ; Vaccines, Attenuated/immunology ; Vaccine Efficacy ; }, abstract = {Viral infections continue to pose a substantial global health concern, resulting in extensive morbidity and mortality among various populations. Although conventional vaccinations have been pivotal in managing and eliminating certain viral infections, the introduction of new viruses and the resurgence of existing ones underscore the ongoing necessity for creative immunization techniques. This review offers an extensive examination of both conventional and novel vaccine platforms for preventing viral diseases. It analyzes traditional approaches such as inactivated and attenuated vaccines in conjunction with innovative technologies, including subunit, viral vector-based, DNA, mRNA, and virus-like particle (VLP) vaccines. Furthermore, novel strategies to enhance vaccination efficacy, including nanoparticle-based and plant-derived vaccines, are examined. Each platform is evaluated according to its mode of action, immunogenicity, safety, scalability, and adaptation to novel threats. Empirical instances, especially observations from the COVID-19 pandemic, are employed to underscore the achievements, obstacles, and pragmatic utilization of these tools. By reviewing the scientific foundations and developmental pathways of diverse vaccine strategies, this paper offers a more profound understanding of the evolving landscape of viral vaccine development. Finally, this review emphasizes the critical role of innovation in strengthening global readiness for current and future outbreaks.}, }
@article {pmid42000530, year = {2026}, author = {Yoshii, K and Kunisawa, J}, title = {Alcaligenes lipid A: a unique TLR4 agonist mucosal adjuvant inducing secretory IgA and Th17 responses.}, journal = {Current opinion in virology}, volume = {76}, number = {}, pages = {101533}, doi = {10.1016/j.coviro.2026.101533}, pmid = {42000530}, issn = {1879-6265}, abstract = {The COVID-19 pandemic has underscored the importance of infectious disease control. In this context, intensive efforts are underway to develop novel vaccine modalities that will enable the production of effective and safe vaccines in preparation for future pandemics caused by emerging and re-emerging infectious diseases. To maximize the performance of these new modalities, adjuvants tailored to the characteristics of each platform are indispensable. In particular, the ability to elicit appropriate immune responses with minimal amounts of antigen is a critical determinant of both vaccine efficacy and safety in the development of mucosal vaccines that confer protection against infection by inducing immune responses in mucosal tissues - the primary sites of pathogen entry. Consequently, the development of superior adjuvants is a key factor for the practical implementation of mucosal vaccines. In this article, we focus on adjuvant development aimed at the creation of mucosal vaccines and introduce our efforts to apply Alcaligenes-derived lipid A to mucosal vaccine platforms.}, }
@article {pmid42000586, year = {2026}, author = {Gulati, RR and Yaqub, F and Goodman, AL}, title = {Enhancing uptake of respiratory vaccinations in asthma and chronic obstructive pulmonary disease (COPD) patients: a systematic review.}, journal = {Vaccine}, volume = {81}, number = {}, pages = {128560}, doi = {10.1016/j.vaccine.2026.128560}, pmid = {42000586}, issn = {1873-2518}, mesh = {Humans ; *Pulmonary Disease, Chronic Obstructive/immunology ; *Asthma/immunology ; Pneumococcal Vaccines/administration & dosage ; *Vaccination/statistics & numerical data ; Influenza Vaccines/administration & dosage ; COVID-19 Vaccines/administration & dosage ; COVID-19/prevention & control ; Influenza, Human/prevention & control ; Patient Education as Topic ; Randomized Controlled Trials as Topic ; }, abstract = {INTRODUCTION: Despite influenza, pneumococcal and COVID vaccines being widely recommended for patients with chronic respiratory disease, vaccination rates in this cohort remain low. The aim of this systematic review is to identify interventions which are effective in increasing respiratory vaccination rates in adults with chronic obstructive pulmonary disease (COPD) or asthma.
METHODS: The inclusion and exclusion criteria for the study can be found in the PROSPERO protocol (PROSPERO registration no: CRD42025588565). A search was run across four databases (MEDLINE, Embase, CENTRAL and ClinicalTrials.gov) in February 2025, which returned 2537 studies. Eleven studies were deemed to meet the study inclusion/exclusion criteria and these were narratively synthesised: four randomised clinical trials (RCTs), six longitudinal studies and one observational cohort study. Risk of bias was assessed using the Cochrane's Risk of Bias (RoB-V2) and ROBIN-I-V2 tools. Studies were categorised according to the COM-B model of behaviour change.
RESULTS: All 11 studies consisted of COPD populations, with four studies also including asthma patients. Interventions focused on patient education, with/without involvement of a healthcare professional (HCP). Nine of the eleven studies showed a statistically significant improvement in influenza and/or pneumococcal vaccination rate with an intervention. No studies assessing COVID vaccine uptake in this population were suitable for inclusion. Most studies targeted patients' capability to get vaccinated through improving patients' and HCPs' knowledge. Fewer studies focused on social opportunity (e.g. support from other patients/HCPs) or automatic motivation (e.g. reminders).
DISCUSSION: The published literature in this area is currently limited. Most studies are non-randomised and are at high-risk of bias, making meta-analysis not possible. Further research should assess the practicalities (physical opportunity) of vaccination, especially in low-income economies (where most respiratory patients reside) and standardising research methods to allow for future meta-analysis.
OTHER: There is no funding for this review.}, }
@article {pmid42000938, year = {2026}, author = {Ramirez Campos, MS and Barati, K and Samavi, R and Pires, P and Duncan, L and Sassi, RB and Noseworthy, MD and Gadsden, SA and Doyle, TE}, title = {Multimodal artificial intelligence and online learning in youth mental health: a scoping review.}, journal = {Npj mental health research}, volume = {5}, number = {1}, pages = {}, pmid = {42000938}, issn = {2731-4251}, abstract = {Youth mental health-related problems and disorders have garnered increased attention due to global prevalence estimates that have, in some cases, increased following the COVID-19 pandemic. Various methodologies have been proposed to leverage artificial intelligence (AI) for detecting mental health problems in the general population; however, research specifically focused on AI methods for youth remains limited. Shortcomings in modern AI include limited training data modalities (i.e., types of input data used for model training), reliance on offline training, and the use of static models. This scoping review provides an overview of evidence that uses AI methods applied to youth mental health (YMH) and provides an assessment of the current state of research that integrates multimodal AI (i.e., models that incorporate multiple data modalities) and/or online learning (i.e., incremental or continual model training from streaming data) for the diagnosis, monitoring, and treatment of YMH-related problems. The findings indicate that research in AI applied to YMH is limited in the areas of multimodal AI and online learning. The number of studies in this field is steadily growing. Studies incorporating online learning demonstrate that this approach enhances model performance and adaptability, which is crucial for developing translational models capable of addressing real-world challenges effectively. Despite these advances, key challenges remain, including the availability and long-term validity of multimodal data, the lack of participant-related information in certain databases and studies, the ethical and logistical difficulties of collecting data from minors, and the computational costs of training robust AI models.}, }
@article {pmid42001013, year = {2026}, author = {Marks, Y and Cunningham, J and Jiang, A and Li, L and Lin, YS and McGrory, A and Ouyang, Y and Tran, NA and Wang, Y and Heath, A}, title = {A systematic review of sample size determination in Bayesian randomized clinical trials: full Bayesian methods are rarely used.}, journal = {BMC medical research methodology}, volume = {26}, number = {1}, pages = {}, pmid = {42001013}, issn = {1471-2288}, support = {463252//Canadian Institutes for Health Research Grant/ ; CIHR Grant #184898//CANSSI-CRT award; CIHR CANTRAIN program/ ; RGPIN-2021-03366//Canada Research Chair in Statistical Trial Design; Natural Sciences and Engineering Research Council of Canada/ ; }, mesh = {Bayes Theorem ; Humans ; Sample Size ; *Randomized Controlled Trials as Topic/methods/statistics & numerical data ; *Research Design ; COVID-19/epidemiology ; }, abstract = {BACKGROUND: Utilizing Bayesian methods in clinical trials has become increasingly popular, as they can incorporate prior information into the design, and allow for smaller sample sizes while providing reliable and robust statistical results. Various Bayesian methods for sample size determination are available, and while these methods are well justified and understood, it is unclear how they are being used in practice. This study aims to understand how sample sizes for Bayesian efficacy randomized clinical trials (RCTs) are determined and inform future designs of Bayesian trials. METHODS: A systematic literature review was conducted in May 2023 and updated in July 2025. We included completed RCTs which (a) assessed the efficacy of interventions in humans; (b) utilized a Bayesian framework for the primary data analysis; (c) published in English; and (d) enrolled participants between December 2009 – July 2025. RESULTS: The literature search produced 74,833 records, of which 27,890 were duplicates, and 46,943 were screened using manual and automated screening. 283 full texts were screened and 164 studies moved to extraction. Our findings demonstrate a slow increase in RCTs using Bayesian methods to analyse primary efficacy data from 2012 onwards, with a sharp increase during the COVID-19 pandemic (42%). The most common method for sample size determination in Bayesian RCTs was a hybrid approach (58%) in which elements of Bayesian and frequentist theory are combined. Bayesian RCTs predominantly took place in North America (34%) and mainly focused on adult study populations (85%). Bayesian trials were used in a variety of disease areas; the most common being COVID-19 (31%). CONCLUSION: Fully Bayesian methods for sample size determination are rarely used in practice, despite significant theoretical development. Our review revealed a lack of standardized reporting across Bayesian RCTs, making it challenging to review the sample size determination. The CONSORT statement indicates that RCTs must report sample size calculations; adhered to by only 84% of included RCTs. Among RCTs that reported sample size determination, relevant information was frequently omitted from reports and discussed in poorly structured supplementary materials. Thus, there is a critical need for greater transparency, standardization and translation of relevant methodology in Bayesian RCTs.}, }
@article {pmid42001977, year = {2026}, author = {Nilius, H and Kuster, L and Boss, R and Boschetti, L and Mihalek, N and Soares Ferreira Junior, A and Naas, S and Jegerlehner, S and Largiader, CR and Nakas, C and Nagler, M}, title = {Dissemination in diagnostic accuracy studies is not associated with methodological quality: a systematic review and meta-epidemiological analysis.}, journal = {Journal of clinical epidemiology}, volume = {195}, number = {}, pages = {112270}, doi = {10.1016/j.jclinepi.2026.112270}, pmid = {42001977}, issn = {1878-5921}, mesh = {Humans ; *COVID-19/diagnosis/epidemiology ; Journal Impact Factor ; SARS-CoV-2 ; *Information Dissemination ; Pandemics ; }, abstract = {OBJECTIVES: To evaluate associations between methodological characteristics and dissemination measures in diagnostic accuracy studies. The COVID-19 pandemic generated a large body of studies addressing a single diagnostic question, allowing assessment of how study characteristics relate to dissemination.
STUDY DESIGN AND SETTING: Using a preregistered systematic review (PROSPERO CRD42023343656), we identified studies evaluating the diagnostic performance of SARS-CoV-2 serological tests through Medline, Embase, and the iSearch Portfolio. Risk of bias and applicability were assessed using QUADAS-2. Study characteristics were linked to dissemination measures, including journal impact factor, citation counts, network-based scientific influence (PageRank), and policy and guideline citations, using multivariable regression models.
RESULTS: Among 18,092 screened records, 782 studies met the inclusion criteria. QUADAS-2 assessments varied substantially, with 772 of 782 studies (98.7%) exhibiting high or unclear risk of bias in at least one domain. Dissemination measures were positively associated with journal impact factor, earlier publication year, reporting of extreme diagnostic accuracy estimates, and higher last author H-index. In contrast, the number of domains rated as low risk of bias or high applicability was not positively associated with citation counts, network-based scientific influence, or policy citations.
CONCLUSION: Dissemination was primarily associated with structural and authorship characteristics rather than QUADAS-2 ratings. These findings suggest that dissemination in diagnostic research is more closely linked to structural factors than assessed methodological quality and support strengthening diagnostic-specific approaches to evidence appraisal.
PLAIN LANGUAGE SUMMARY: We examined whether high-quality diagnostic studies receive more attention in science and clinical practice. Using a large set of studies on COVID-19 antibody tests, we found that attention was mainly linked to factors such as the journal, publication timing, and authorship, rather than to methodological quality. Studies reporting very high accuracy also received more attention. This suggests that widely cited or highly visible studies are not necessarily the most reliable. Our findings highlight the need for careful evaluation of diagnostic studies and stronger emphasis on study quality when interpreting and using research results.}, }
@article {pmid42005246, year = {2026}, author = {Lala, A and Vysochyn, M and Shyshkova, K}, title = {COVID-19-Associated Cardiovascular Complications: A Narrative Literature Review.}, journal = {Cureus}, volume = {18}, number = {3}, pages = {e105394}, pmid = {42005246}, issn = {2168-8184}, abstract = {Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 2019, coronavirus disease 2019 (COVID-19) has caused significant global morbidity and mortality. Although initially recognized as a respiratory illness, COVID-19 is now understood to be a systemic disease with substantial cardiovascular involvement. Both patients with pre-existing cardiovascular disease and those without prior cardiac conditions may develop a wide range of cardiovascular complications during and after acute infection. Reported complications include myocardial injury, myocarditis, heart failure, arrhythmias, and thromboembolic events, all of which contribute to increased disease severity and mortality. This narrative review summarizes current evidence on cardiovascular complications associated with COVID-19 among adult patients in the United States, with particular attention to differences between individuals with pre-existing cardiovascular disease and those who develop new cardiovascular pathology following SARS-CoV-2 infection. This review discusses proposed mechanisms of cardiovascular injury, clinical manifestations, diagnostic approaches, and current management strategies. By summarizing current knowledge, this review aimed to increase awareness of COVID-19-related cardiovascular complications, support timely recognition in emergency and inpatient settings, and assist clinicians in improving patient outcomes.}, }
@article {pmid42005429, year = {2026}, author = {Rukundo, G and Moore, M and Semukunzi, H and Chatterjee, S and Musabyimana, JP and Mambo Muvunyi, C and Green, CA}, title = {Vaccine cold chain and understanding what underpins vaccine security for vaccine preventable diseases.}, journal = {BMJ medicine}, volume = {5}, number = {1}, pages = {e001835}, pmid = {42005429}, issn = {2754-0413}, abstract = {Vaccines have saved an estimated 154 million lives in the past 50 years and support 15 of the 17 United Nations sustainable development goals. Vaccines are also an important tool in the control of new outbreaks of infectious diseases. The vaccine cold chain, however, is key in enabling and empowering implementation of vaccine policy and societal protection from all vaccine preventable diseases, and is especially relevant in low and middle income countries in sub-Saharan Africa. The vaccine cold chain is a complex, highly specialised, temperature controlled supply chain network that extends from the point of vaccine manufacture to dose administration, and has multiple points of vulnerability. Large quantities of vaccines are lost because of excess heat or accidental freezing, resulting in missed opportunities for vaccination. Disruption to the provision of routine vaccines during the covid-19 pandemic resulted in millions of children not being vaccinated. The vaccine cold chain needs strategic prioritisation for investment and innovation so that the next generation of vaccine cold chains for low and middle income countries can be designed towards providing reliable and sustainable vaccine security in an uncertain world of climate change, managing the advent of new vaccine technologies, and narrowing inequalities in global health for resource poor communities. This review focuses on the vaccine cold chain in African low and middle income countries, and how new and emerging advances in vaccine science and challenges will affect the readiness to control the burden of vaccine preventable disease on the continent.}, }
@article {pmid42005985, year = {2026}, author = {Msobo, A and Maphari, PW and Koorsen, G and Singab, ANB and Mhlongo, MI}, title = {Modernising antiviral drug discovery: harnessing medicinal plants through machine learning and metabolomics to target the SARS-CoV-2 main protease.}, journal = {In silico pharmacology}, volume = {14}, number = {2}, pages = {120}, pmid = {42005985}, issn = {2193-9616}, abstract = {The COVID-19 pandemic highlighted critical limitations in the speed, scalability and translational efficiency of conventional antiviral drug discovery. Although vaccines and repurposed antivirals have reduced disease severity, the continued emergence of SARS-CoV-2 variants and breakthrough infections underscores the need for sustained discovery of novel therapeutics. The main protease (Mpro), an essential and highly conserved enzyme required for viral replication remains a validated and attractive antiviral target. Medicinal plants represent a vast and underexplored source of structurally diverse bioactive compounds with antiviral potential; however, traditional plant-based drug discovery approaches are often constrained by reliance on ethnobotanical knowledge and fragmented screening workflows. This review critically examines emerging strategies that integrate machine learning, LC-MS-based metabolomics and network pharmacology to modernise medicinal plant-based antiviral discovery. We highlight how machine learning enables data-driven prioritisation of candidate compounds and plant species beyond well-studied taxa, while metabolomics provides experimental validation through comprehensive chemical profiling and dereplication. Molecular docking and molecular dynamics further refine candidate selection by evaluating binding modes and stability, whereas network pharmacology offers systems-level insight into multitarget and multipathway effects. Importantly, we discuss key limitations of these approaches, including data bias, model interpretability, and gaps between in silico prediction and experimental validation. By synthesising these methodologies into a unified computational-experimental pipeline, this review provides a critical framework for accelerating the discovery of plant-derived Mpro inhibitors and supports the development of resilient antiviral strategies for current and future pandemics.}, }
@article {pmid42007013, year = {2022}, author = {Smith, S and Day, T and Webster, S and Davies, S and Hardcastle, T and Williams, A}, title = {Clinical audit of POM-V / POM prescriptions by remote consultation via a veterinary video telemedicine smartphone application.}, journal = {Veterinary evidence}, volume = {7}, number = {2}, pages = {}, pmid = {42007013}, issn = {2396-9776}, abstract = {UNLABELLED: There is an erratum to this paper published in Veterinary Evidence Vol 7, Issue 2 (2022): 10.18849/VE.V7I2.627.
OBJECTIVE: To assess outcomes of a limited period (7 months) of remote video consultation with prescribing of prescription-only (POM) or prescription-only-veterinary (POM-V) medications by Royal College of Veterinary Surgeons (RCVS) registered veterinary surgeons to UK clients via a veterinary telemedicine smartphone application.
BACKGROUND: Objective evidence is needed to inform the veterinary profession on the impact that remote prescribing, without physical examination in person, has on animal health and welfare. During the COVID-19 pandemic, the RCVS allowed remote prescribing temporarily.
METHODS: Clinical records from all veterinary video consultations from 1 April-31 October 2020 were reviewed. Details were assessed pertaining to: signalment, body system / disease categories managed, referrals into practice, medication classes prescribed and outcomes following POM-V / POM medications. Records of adverse events and antimicrobial prescribing were reviewed.
RESULTS: 16.6% (3,541/21,383) of video consults had a POM-V / POM prescribed; with a (mild) adverse event rate of 0.8% (30/3541). Antibacterials were prescribed in 5.88% of all consultations (1,258/21,383), 99.3% (1249/1258) being first line. Follow-up on prescribing was available in 67.7% (2,399/3541) of cases. 89% (2135/2399) of all known treatment outcomes were complete or had an expected response to treatment. Dermatological disease was the most common body system / disease category seen and prescribed for.
CONCLUSION: Low prescribing rates (including antibacterials) were recorded, treatments were efficacious and no harm was done by prescribing remotely via a veterinary video consult app.
CUSTOM SECTION: Veterinary surgeons and governing bodies are invited to use the information provided in this clinical audit to inform decisions on the suitability of remote consultations and prescribing in veterinary medicine.}, }
@article {pmid42007740, year = {2026}, author = {Almaraz-De-Santiago, J and Solís-Torres, N and Escudero-Lourdes, C and Méndez-Frausto, G and Gonzalez-Curiel, I and Rivas-Santiago, B and Rivas-Santiago, C}, title = {Particulate Matter and Innate Airway Immunity: Mechanisms of Disruption and Impact on Respiratory Infections.}, journal = {Immunological investigations}, volume = {55}, number = {5}, pages = {1029-1053}, doi = {10.1080/08820139.2026.2655720}, pmid = {42007740}, issn = {1532-4311}, mesh = {Humans ; *Immunity, Innate ; *Particulate Matter/adverse effects/immunology ; Animals ; *Respiratory Tract Infections/immunology ; SARS-CoV-2/immunology ; *Respiratory System/immunology ; Disease Susceptibility ; Respiratory Mucosa/immunology ; }, abstract = {BACKGROUND: Air pollution is a major global public health challenge, with particulate matter (PM) as a leading environmental risk factor for increased morbidity and premature mortality worldwide. The respiratory tract is the primary interface for PM exposure, where airway epithelial cells and innate immune systems coordinate frontline host defense. Chronic PM-exposure disrupts this system, impairing airway immune homeostasis and increasing susceptibility to respiratory infections.
OBJECTIVE: This review aims to integrate current molecular and cellular evidence describing how PM affects airway innate immunity, focusing on its impact on host defense mechanisms and its role in increasing susceptibility to respiratory infections.
METHODS: A comprehensive literature review was conducted focusing on PM interactions with the respiratory tract and their effects on airway epithelial and innate immune functions, emphasizing mechanisms of immune dysregulation.
RESULTS: PM-exposure induces innate immune dysregulation characterized by oxidative imbalance, altered cytokine and chemokine signaling, reduced phagocytic capacity, and decreased production of host defense peptides, resulting in impaired epithelial barrier integrity, persistent inflammation, defective pathogen clearance, and increased susceptibility and severity of respiratory infections, including tuberculosis, bacterial pneumonia, and viral respiratory diseases such as COVID-19.
CONCLUSION: PM is a key driver of airway innate immune dysfunction and increased susceptibility to respiratory infections by disrupting epithelial and immune defense pathways, weakening host resistance, and exacerbating disease burden. Further studies are needed to elucidate PM-immune interactions and support the development of preventive and therapeutic strategies.}, }
@article {pmid42009524, year = {2026}, author = {Mao, M and He, Z and Wang, J and Li, M and Hao, X}, title = {[Research progress in mRNA vaccines for animal disease prevention and control].}, journal = {Sheng wu gong cheng xue bao = Chinese journal of biotechnology}, volume = {42}, number = {4}, pages = {1458-1469}, doi = {10.13345/j.cjb.250738}, pmid = {42009524}, issn = {1872-2075}, support = {2025BBF02009//the Key Research and Development Program of Ningxia Hui Autonomous Region/ ; 32360877 and 32370198//the National Natural Science Foundation of China/ ; 2023AAC02016//the Ningxia Hui Autonomous Region Natural Science Foundation/ ; }, mesh = {Animals ; *mRNA Vaccines/immunology ; *Vaccines, Synthetic/immunology ; SARS-CoV-2/immunology ; COVID-19/prevention & control ; Vaccine Development ; RNA, Messenger/immunology/genetics ; }, abstract = {mRNA vaccines, as an emerging preventive measure, have gained widespread recognition due to their high efficacy, favorable safety profile, substantial research potential, and short development cycle. In recent years, the global pandemic of COVID-19 has greatly promoted the development of mRNA vaccines, and the research process in mRNA vaccines for animal disease prevention. This paper briefly reviews the structural and functional characteristics of mRNA vaccines, as well as the latest research progress in mRNA vaccines for animal diseases caused by viruses, bacteria, and parasites, with the aim of providing a reference for future research on mRNA vaccines for animal diseases.}, }
@article {pmid42009582, year = {2026}, author = {Dutta, S}, title = {International collaborations in neonatal and fetal medicine - Low-and-middle income countries have the patients and high-income countries have the technology: Consensus, conundrums and controversies.}, journal = {Seminars in fetal & neonatal medicine}, volume = {31}, number = {3}, pages = {101737}, doi = {10.1016/j.siny.2026.101737}, pmid = {42009582}, issn = {1878-0946}, mesh = {Humans ; *Developing Countries ; *International Cooperation ; Developed Countries ; *Neonatology ; COVID-19/epidemiology ; }, abstract = {International collaborations between investigators in low-and-middle-income countries (LMICs) and high-income countries (HICs) in neonatal and fetal medicine have expanded over the past decade. This narrative review documents a rise in HIC-LMIC publications since 2014, with a plateau and transient dip during the COVID-19 pandemic. It analyses leadership, patient recruitment, and how HIC-based technologies and laboratory platforms shape research agendas. Many influential trials are conceived and sponsored by HIC institutions, with recruitment concentrated in LMICs because of higher disease burden, larger eligible populations and lower costs. Meanwhile, LMIC centers report growing readiness to support randomized controlled trials, and LMIC-conceived, led and completed multicentre studies are increasingly reported. Ongoing concerns include misalignment between donor priorities and national agendas, inequities in authorship and leadership, and ethical challenges related to standards of care, post-trial access, consent and compensation. The review compares regulatory, consent and insurance processes in India and the United States, and highlights enabling factors such as harmonised guidelines, global registries, political goodwill and professional networks. It anticipates a doubling of HIC-LMIC collaborative studies over the next decade, rapid growth of South-South partnerships, and gradual, though incomplete, correction of authorship and leadership imbalances in global neonatal and fetal medicine.}, }
@article {pmid42009999, year = {2026}, author = {Ashique, S and Mondal, M and Hussain, MS and Islam, A and Tariq, M and Chellappan, DK and Yasmin, S and Malik, T and Attar, JR and Ansari, MY}, title = {Safety and efficacy of COVID-19 vaccines in pregnant and lactating women: a comprehensive review.}, journal = {Inflammopharmacology}, volume = {34}, number = {5}, pages = {2873-2888}, pmid = {42009999}, issn = {1568-5608}, mesh = {Humans ; Female ; Pregnancy ; *COVID-19 Vaccines/adverse effects/administration & dosage/immunology ; *Lactation/immunology ; *COVID-19/prevention & control/immunology ; Breast Feeding ; *Pregnancy Complications, Infectious/prevention & control ; SARS-CoV-2/immunology ; Vaccine Efficacy ; Vaccination ; }, abstract = {Breastfeeding plays a critical role in providing essential nutrients and antibodies that enhance the health of new-borns and infants, supporting their immune systems and overall growth and development. Healthcare professionals, universally recommend breastfeeding for the first six months of an infant's life, in conjunction with an appropriate complementary diet. However, the COVID-19 pandemic has understandably raised concerns among lactating mothers and pregnant women regarding the risks of infection and vaccine safety. Therefore, it is essential to carefully evaluate the potential dangers of COVID-19 transmission within this vulnerable population especially when considering vaccination for pregnant and breastfeeding women. Encouragingly, the United States Food and Drug Administration has granted approval for the use of two COVID-19 vaccines namely, Pfizer-BioNTech COVID-19 and Moderna COVID-19 to contain the spread of the COVID-19 virus. Both vaccines have been approved for administration in pregnant and breastfeeding women, providing much-needed reassurance to those with concerns about vaccine safety. It is important to recognize that the benefits of vaccination for both the mother and the infant far outweigh the risks associated with COVID-19 infection. Therefore, lactating mothers should view vaccination as a vital measure to protect themselves and their infants from the virus. In addition to elaborating on the successes of safety and effectiveness, this review is unique that it also includes current and newly updated evidence published between 2020 and 2025, comprehensively discussing on several newer vaccine platforms together with recent viral variants. Furthermore, it synthesizes information on the transfer of transplacental and a breast-milk antibody that outlines a clear evidence-gap that may direct further research within pregnant and lactating populations.}, }
@article {pmid42010035, year = {2026}, author = {Elalouf, A and Maoz, H}, title = {Immunomodulatory Strategies for Managing Viral Infections in Solid Organ Transplantation: Progress and Challenges.}, journal = {Current microbiology}, volume = {83}, number = {6}, pages = {}, pmid = {42010035}, issn = {1432-0991}, mesh = {Humans ; *Organ Transplantation/adverse effects ; *Virus Diseases/immunology/therapy/prevention & control ; *Immunomodulation ; Antiviral Agents/therapeutic use ; Immunosuppression Therapy/adverse effects ; Immunosuppressive Agents/therapeutic use ; }, abstract = {Solid organ transplantation (SOT) is a critical treatment for end-stage organ failure. Still, lifelong immunosuppression leaves recipients vulnerable to opportunistic viral infections, which can lead to severe complications such as graft dysfunction and post-transplant lymphoproliferative disorder. With emerging viral threats such as SARS-CoV-2 and arboviruses, alongside persistent challenges posed by CMV, EBV, and BKV, this review is timely in addressing the evolving landscape of post-transplant viral infections and their management. Recent studies highlight how immunosuppression impairs both innate and adaptive antiviral defenses, including diminished toll-like receptor signaling, dysfunction of NK cells, and disrupted T- and B-cell responses. Viruses exploit these deficits through immune evasion strategies, such as MHC-I downregulation and the production of immunosuppressive microRNA. Advances in management include antiviral prophylaxis, adoptive T-cell therapy, and immune monitoring, with emerging therapies like virus-specific T-cell infusions and complement inhibition showing promise. The findings underscore the need for personalized, organ-specific approaches to post-transplant care. Enhanced surveillance, vaccination strategies, and novel immunotherapies are critical in mitigating viral risks. Future research should focus on immune-risk stratification and the development of an adaptable therapeutic approach to enhance transplant outcomes in the face of evolving viral threats.}, }
@article {pmid42010704, year = {2026}, author = {Wang, RY and Zheng, Y and Ge, Y and Xu, YF and Ding, Y}, title = {Electrophysiological features and outcomes of post-infectious myoclonus-ataxia syndrome: a case report and literature review.}, journal = {Journal of medical case reports}, volume = {20}, number = {1}, pages = {}, pmid = {42010704}, issn = {1752-1947}, support = {LY24H090004//Natural Science Foundation of Zhejiang Province/ ; 82201607//National Natural Science Foundation of China/ ; }, mesh = {Female ; Humans ; Middle Aged ; *Ataxia/physiopathology/drug therapy/virology/diagnosis/etiology ; Betacoronavirus ; *Coronavirus Infections/complications/physiopathology ; *COVID-19/complications ; Electroencephalography ; Electromyography ; Methylprednisolone/therapeutic use/administration & dosage ; *Myoclonus/physiopathology/drug therapy/etiology/diagnosis/virology ; Pandemics ; *Post-Infectious Disorders/diagnosis/therapy ; SARS-CoV-2 ; Syndrome ; Treatment Outcome ; }, abstract = {BACKGROUND: Myoclonus has become one of the neurological manifestations associated with coronavirus disease 2019 (COVID-19); however, the origin and pathophysiological mechanism remained uncertain.
CASE PRESENTATION: A rare case of myoclonus-ataxia syndrome associated with COVID-19 was presented. A 52-year-old Asian woman exhibited generalized myoclonus, ataxia, nystagmus, and dysarthria two weeks after a fever episode, which deteriorated rapidly within a few days. Electromyography (EMG) revealed synchronized bursts in both hands concurrent with myoclonic jerks. The absence of somatosensory evoked potential and lack of correlation between electromyography (EEG) and EMG suggested a subcortical origin of the myoclonus. A post-infectious immune-mediated process was considered the most likely mechanism, given the latency from fever to myoclonus onset, and the absence of other possible etiologies. Treatment with intravenous methylprednisolone led to notable improvement and a good outcome at the two-month follow-up.
CONCLUSION: Myoclonus arising from subcortical structures can be associated with COVID-19. Early aggressive immunotherapy is important for a favorable outcome. Review of similar cases along with our report suggests COVID-19-associated myoclonus-ataxia as a distinct syndrome warranting prompt diagnosis and treatment.}, }
@article {pmid42011141, year = {2026}, author = {Lloyd-Jones, G and Santamarina, MG and Alcock, R and Oudkerk, M}, title = {Acute COVID-19 lung disease and long COVID vascular pathophysiology modelling: the relevance of medical imaging in building multidisciplinary understanding.}, journal = {The British journal of radiology}, volume = {99}, number = {1182}, pages = {1009-1023}, doi = {10.1093/bjr/tqag056}, pmid = {42011141}, issn = {1748-880X}, mesh = {*COVID-19/diagnostic imaging/epidemiology/physiopathology ; *Post-Acute COVID-19 Syndrome/diagnostic imaging/epidemiology/physiopathology ; *Diagnostic Imaging/methods ; *Lung/blood supply/diagnostic imaging ; SARS-CoV-2 ; Acute Disease ; Models, Theoretical ; Interdisciplinary Research/methods ; Guidelines as Topic ; Humans ; }, abstract = {Radiologists have a central role in building understanding of many diseases. In multidisciplinary settings, medical imaging has a role in diagnosing, assessing severity, monitoring progress and delineating anatomical structures involved in diseases. Imaging also helps to elucidate models of disease pathogenesis. In this review, imaging features of COVID-19 lung disease are analysed in the context of pathophysiological processes in different phases of the disease. Radiological evidence is presented for the central role of vasculopathic phenomena in both the acute and post-acute phases of COVID-19. From the outset of the COVID-19 pandemic, a lack of formal collaborative interdisciplinary systems to build models of pathophysiology led to widespread misunderstanding of the lung disease. Specifically, the lack of a systematic multidisciplinary approach to share concepts relating to radiological evidence with collaborators from other medical and scientific fields led to the use of terminology which was, and remains, potentially inappropriate or misleading. In conclusion, imaging is essential to multidisciplinary understanding of COVID-19 vascular pathophysiology. Current evidence should lead to adapted diagnostic guidelines for long COVID. Formation of collaborative systems to build interdisciplinary understanding of disease pathogenesis across all medical and scientific specialties should be a priority at the outset of any future pandemic.}, }
@article {pmid42011734, year = {2026}, author = {Santos, MLK and Schmidt, CR and Dalcól, CX and Malkiewiez, MM and Alvarez, AG and Fabrizzio, GC and de Melo Lanzoni, GM and Lorenzini, E}, title = {Care Transition Strategies, Opportunities, and Challenges for Patients Following COVID-19 Hospitalization: An Integrative Review.}, journal = {Clinical nursing research}, volume = {35}, number = {5}, pages = {235-247}, doi = {10.1177/10547738261429358}, pmid = {42011734}, issn = {1552-3799}, mesh = {Humans ; *Continuity of Patient Care/organization & administration ; *COVID-19/therapy ; *Hospitalization ; Pandemics ; Patient Discharge ; SARS-CoV-2 ; Telemedicine ; *Transitional Care/organization & administration ; }, abstract = {Care transition is a strategy that aims to overcome the fragmentation of healthcare services, ensuring continuity of care. The review question was: What scientific evidence is available on care transition strategies for patients after hospitalization for COVID-19 and what are the opportunities and challenges of their implementation? Integrative literature review was guided by Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines and carried out between March and June 2024 in the Medical Literature Analysis and Retrieval System Online, Web of Science, Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Cochrane Library, Scientific Electronic Library Online and Scopus databases, using Medical Subject Headings, Health Sciences Descriptors, and Entry Terms. Fourteen articles published between 2020 and 2023 were included, with 57% originating from the Americas, 28.6% using a qualitative approach, 78.6% addressing the transition from hospital to home, and 78.6% involving patients. The results were organized into four thematic categories: virtual care transition; patients' and healthcare professionals' experiences in care environments; patients' needs after hospital discharge; and care transition assessment through Care Transition Measure (CTM-15). Care transition strategies, including teleconsultations, videoconferencing, telerehabilitation, and discharge guidance, can reduce complications and readmissions and improve patient satisfaction, but challenges such as early discharge, poor communication, lack of protocols, variability in care transition strategies, and discontinuity of care still persist. The results of this review highlight the importance of structured, patient-centered transition planning, integration of telehealth and remote monitoring, and the use of systematic assessment tools, such as the CTM-15, to optimize post-hospital care for COVID-19 survivors.}, }
@article {pmid42012187, year = {2026}, author = {Salisch, F and Müller-Ruttloff, C}, title = {Behind the membranous curtain-lipid dynamics and functions in coronaviral replication.}, journal = {Journal of virology}, volume = {100}, number = {5}, pages = {e0175325}, pmid = {42012187}, issn = {1098-5514}, support = {06/2023//University Medical Center Giessen-Marburg/ ; project 71_0016//Von-Behring-Röntgen-Stiftung/ ; project 530813989//Deutsche Forschungsgemeinschaft/ ; //Hessisches Ministerium für Wissenschaft und Kunst/ ; //Research Campus of Central Hesse/ ; }, mesh = {*Virus Replication/physiology ; Humans ; *SARS-CoV-2/physiology ; *Lipid Metabolism ; COVID-19/virology/metabolism ; Animals ; Host-Pathogen Interactions ; *Lipids/chemistry ; Cell Membrane/metabolism ; }, abstract = {Lipids are naturally occurring hydrophobic biomolecules characterized by remarkable structural diversity. This includes various types of head groups, varying fatty acid chain lengths, degrees of unsaturation, and stereochemical configurations. Such variability enables lipids to serve multiple biological functions, such as forming membranes, storing energy, and facilitating signaling. Given their diverse roles, it is not surprising that approximately 5% of genes in eukaryotic cells are involved in lipid biosynthesis pathways. The multifunctional nature of lipids also makes them attractive targets for pathogens, including viruses, as cellular lipids are involved in and manipulated throughout every stage of viral replication. In the initial phase of replication, viruses exploit existing cellular lipids for entry and trafficking. After the replication is established and viral proteins are processed, extensive reprogramming of lipid synthesis and redistribution supports viral replication, assembly, and other processes. This review focuses on how coronaviruses, especially severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), utilize different lipid species and related cellular enzymes to interfere with lipid dynamics and functions and how this affects the different stages of coronaviral replication in vitro. Besides illuminating virus-host lipid interactions, this review identifies remaining open questions and promising new avenues for future mechanistic research.}, }
@article {pmid42012503, year = {2026}, author = {Gödecke, V}, title = {[Immune complex- and complement-mediated glomerulonephritides].}, journal = {Innere Medizin (Heidelberg, Germany)}, volume = {67}, number = {5}, pages = {506-514}, pmid = {42012503}, issn = {2731-7099}, mesh = {Humans ; *Glomerulonephritis/immunology/pathology/diagnosis/therapy ; *Antigen-Antibody Complex/immunology ; Lupus Nephritis/immunology/pathology/diagnosis/therapy ; Kidney Glomerulus/pathology/immunology ; Complement C3/immunology ; *Immune Complex Diseases/immunology/pathology/diagnosis/therapy ; Glomerulonephritis, Membranoproliferative/immunology/pathology ; Complement Pathway, Alternative/immunology ; *Complement System Proteins/immunology ; Biopsy ; Cryoglobulinemia/immunology/pathology ; }, abstract = {Glomerulonephritis represents a heterogeneous group of kidney diseases characterized by inflammation of the glomeruli and capable of leading to acute or chronic kidney failure. In addition to the primary glomerulonephritides described elsewhere in this issue, there is a group of diseases in which immune complex deposition or disturbances in complement regulation play a central pathogenic role. Among the most important and clinically relevant forms of these immune complex- and complement-mediated glomerulonephritides are postinfectious glomerulonephritis (PIGN), lupus nephritis (LN), cryoglobulinemic glomerulonephritis, and C3 glomerulopathy (C3G). While PIGN, LN, and cryoglobulinemic glomerulonephritis are characterized by glomerular immune complex deposits, C3 glomerulopathy is primarily based on a dysregulation of the alternative complement pathway. These diseases require specialized treatment in university outpatient clinics in collaboration with nephrology practices. Renal biopsy is a key diagnostic tool, and histologically, a membranoproliferative pattern is frequently observed. This article provides a systematic overview of immune complex- and complement-mediated glomerulonephritis and compares their pathogenesis, clinical presentation, immunoserological profiles, histology, and available therapies.}, }
@article {pmid42013593, year = {2026}, author = {Sarnaik, AY and Khan, ZU and Rajeswaran, T and Majoe, A and Zeng, J and Ponrajah, L and Kastura, Z and Iftikhar, L and Islam, MA and Basharat, N and Hassan, M and Kaur, J and Torres, DL and Bhattacharyya, DS and AlShurman, BA and Namiha, N and Butt, ZA}, title = {The role of misinformation in COVID-19 vaccine hesitancy in low- & middle-income countries.}, journal = {Vaccine}, volume = {82}, number = {}, pages = {128595}, doi = {10.1016/j.vaccine.2026.128595}, pmid = {42013593}, issn = {1873-2518}, mesh = {*Vaccination Hesitancy/psychology ; Humans ; *COVID-19/prevention & control ; Developing Countries ; *COVID-19 Vaccines/administration & dosage ; *Communication ; Social Media ; Pandemics/prevention & control ; SARS-CoV-2 ; Vaccination/psychology ; }, abstract = {BACKGROUND: During the COVID-19 pandemic, timely vaccination was crucial in acquiring herd immunity. While high-income countries typically had better access to vaccines, interventions were implemented to improve accessibility for low and middle-income countries (LMICs). Vaccine uptake presented major barriers to achieving herd immunity globally and was more significant in LMICs. Vaccine hesitancy was amplified by misinformation, including but not limited to social media misinformation. This scoping review aims to: (1) explore the role of misinformation in COVID-19 vaccine hesitancy in LMICs and (2) identify primary sources, key themes, and dissemination channels of this misinformation, encompassing all relevant sources but with an emphasis on social media, given the infodemic context which proved to be particularly significant during the COVID-19 pandemic.
METHODS: This scoping review was conducted using the Arksey and O'Malley framework and PRISMA-ScR guidelines. Five databases (Scopus, Embase, PubMed, CINAHL, and PsycINFO) were searched using predefined search terms. All identified articles underwent a rigorous screening process, and if eligible, proceeded to data extraction.
RESULTS: In total, 119 studies were included in this review. Primary dissemination platforms included Facebook, WhatsApp, X, YouTube, Instagram, TikTok, Telegram, Pinterest, LinkedIn, and Zalo. Key themes of misinformation identified included (1) malicious intent, (2) fear of side effects, (3) concerns about vaccine development and safety, (4) religious and cultural beliefs, and (5) natural immunity.
CONCLUSION: Overall, this scoping review addresses the literature gap in the role of misinformation pertaining to COVID-19 vaccine hesitancy and suggests investing in misinformation-mitigation interventions to reduce public harms and disruptions.}, }
@article {pmid42013745, year = {2026}, author = {Previti, S and Calcaterra, E and González, FV and Di Chio, C and Calabrò, ML and Ettari, R and Zappalà, M}, title = {Macrocycles and stapled-peptides in the fight against SARS-CoV-2: a review.}, journal = {European journal of medicinal chemistry}, volume = {312}, number = {}, pages = {118828}, doi = {10.1016/j.ejmech.2026.118828}, pmid = {42013745}, issn = {1768-3254}, mesh = {*Antiviral Agents/chemistry/pharmacology/therapeutic use ; Humans ; *SARS-CoV-2/drug effects ; *Macrocyclic Compounds/chemistry/pharmacology/therapeutic use ; *Peptides/chemistry/pharmacology/therapeutic use ; Structure-Activity Relationship ; *COVID-19 Drug Treatment ; COVID-19/virology ; Animals ; }, abstract = {The development of innovative therapeutic strategies for challenging biological targets has led to a resurgence of interest in macrocyclic and peptide-stapled compounds. The conformationally constrained architectures of these compounds enable high affinity, selectivity, and improved pharmacokinetic profiles compared with linear analogues. These properties position macrocycles and stapled-peptides as promising platforms for the development of next-generation therapeutics, including antiviral agents addressing emerging diseases such as COVID-19. In six years, the scientific community has provided several structure-activity relationship studies in which the anti-SARS-CoV-2 effects of macrocycles and stapled-peptides have been reported. The present review aims to discuss macrocycles and stapled-peptides with inhibitory properties against SARS-CoV-2 infection. A particular focus has been addressed to the design of cyclic entities, effect of ring size, presence of unnatural amino acids, stapling position, stereochemistry, role of linkers, pan-antiviral effects, metabolic stability assessment, and selectivity profile, among others. Comparisons with linear counterparts were discussed, wherever applicable, to elucidate the differences in terms of biological properties towards the target, antiviral effects in cell-based assays, molecular architecture, and proteolytic resistance. Overall, the development of macrocycles and stapled-peptides against SARS-CoV-2 was found to be a productive strategy for the identification of novel and effective antiviral agents. Furthermore, future challenges and perspectives have been discussed.}, }
@article {pmid42015364, year = {2026}, author = {Page, R and Carter, G}, title = {Unsteady Foundations: The Effects of Environmental Instability on Nurses and Implications for Nursing Management-An Integrative Review.}, journal = {Journal of nursing management}, volume = {2026}, number = {1}, pages = {e9920089}, pmid = {42015364}, issn = {1365-2834}, mesh = {Humans ; Working Conditions ; *Workplace/psychology/standards ; COVID-19/epidemiology ; *Nurses/psychology ; Personnel Turnover ; Leadership ; Organizational Culture ; }, abstract = {AIM: To determine the state of the science of how instability in the nursing practice environment affects nurses.
BACKGROUND: The COVID-19 pandemic, workforce shortages, and an aging population have highlighted the critical need to build and maintain stable nursing practice environments. Factors such as staffing inconsistencies, fluctuating workloads, and workplace violence create instability. While research has explored nursing practice environments broadly, limited research has been conducted on how instability affects nurses.
METHODS: An integrative review was conducted using CINAHL, PsycINFO, and PubMed, with search terms related to instability and fluctuations in the nursing practice environment. Articles from 2014 to 2026 were included if they addressed instability in the nursing practice environment and its impact on nurses in hospital settings. Fifteen studies were included in this integrative review.
FINDINGS: Instability in the nursing practice environment has many sources. Organizational support plays a significant role in determining the magnitude and management of environmental instability. Adverse nurse outcomes from instability in the nursing practice environment include decreased well-being, increased turnover, and workplace violence.
Effective leadership and management are necessary to create and maintain positive nursing practice environments, manage environmental instability, and improve nurse well-being and retention. Targeted strategies such as collaborating with policymakers, strengthening the nursing workforce pipeline, and supporting nurses in their practice environments can mitigate environmental instability and its adverse effects on nurses.
CONCLUSIONS: Instability is a common feature of nursing practice environments. Excessive instability can cause adverse nurse outcomes. Nurse leaders are optimally situated to mitigate environmental instability and provide leadership support to improve nurse outcomes.}, }
@article {pmid42015917, year = {2026}, author = {Okechukwu Paul-Chima, U and Michael Ben, O and Fabian C, O and Jovita Nnenna, U and Chinyere N, U}, title = {Self-amplifying RNA (saRNA) and circular RNA (circRNA) vaccines: Progress, evidence gaps, and translational pathways for durable and scalable immunization.}, journal = {Human vaccines & immunotherapeutics}, volume = {22}, number = {1}, pages = {2661120}, pmid = {42015917}, issn = {2164-554X}, mesh = {Humans ; *RNA, Circular/immunology/genetics ; Animals ; *COVID-19 Vaccines/immunology/administration & dosage/genetics ; *COVID-19/prevention & control/immunology ; SARS-CoV-2/immunology/genetics ; *RNA/immunology ; }, abstract = {Self-amplifying RNA (saRNA) and circular RNA (circRNA) are emerging vaccine modalities that extend conventional, non-replicating mRNA platforms. Self-amplifying RNA encodes a replicase that amplifies intracellular RNA templates, enabling high antigen expression at substantially lower doses than non-replicating mRNA. Circular RNA has a covalently closed topology that confers resistance to exonucleases and supports sustained translation through cap-independent initiation. The evidence base remains asymmetric: saRNA has progressed through multiple human studies, including phase 3 evaluations of COVID-19 vaccines, and has received regulatory authorization in several jurisdictions, whereas circRNA vaccines remain largely preclinical, with limited publicly available human data. This review integrates clinical, animal, and mechanistic evidence, proposes a '3D' framework (durability, dose-sparing, and deployability) and identifies key barriers to robust cross-platform comparison, encompassing delivery systems, innate immune sensing, and chemistry, manufacturing and controls (CMC).}, }
@article {pmid42017651, year = {2026}, author = {Bing, J and Li, S and Ji, L and Du, H and Shamoon, NM and Nobile, CJ and Huang, G}, title = {Global emergence and rapid spread of Candidozyma auris (syn. Candida auris): epidemiology, biology, and antifungal resistance.}, journal = {Clinical microbiology reviews}, volume = {39}, number = {2}, pages = {e0039425}, pmid = {42017651}, issn = {1098-6618}, support = {2025YFE0205500//National Key Research and Development Program of China/ ; 32530005 and 82272359//National Natural Science Foundation of China/ ; 32570226//National Natural Science Foundation of China/ ; 82172290//National Natural Science Foundation of China/ ; 23JC1404200//Science and Technology Innovation Plan Of Shanghai Science and Technology Commission/ ; R35GM156045/GM/NIGMS NIH HHS/United States ; //The Kamangar family/ ; }, mesh = {Humans ; *Antifungal Agents/pharmacology ; *Drug Resistance, Fungal ; *Candida auris/drug effects/pathogenicity/genetics ; Global Health ; *Communicable Diseases, Emerging/epidemiology/microbiology ; COVID-19/epidemiology ; *Candidiasis/epidemiology/microbiology/transmission ; Drug Resistance, Multiple, Fungal ; }, abstract = {SUMMARYThe emerging fungal pathogen Candidozyma auris (syn. Candida auris; C. auris) has attracted considerable attention from the scientific, clinical, and public health communities due to its multidrug resistance, environmental persistence, and high transmissibility. Since its first description in Japan in 2009, C. auris has spread rapidly worldwide, with a marked acceleration following the coronavirus disease 2019 (COVID-19) pandemic. As of December 2025, 84,941 colonization or infection cases have been reported across 82 countries spanning 6 continents. In this review, we summarize the current knowledge of the biology and global epidemiology of C. auris. We first examine its taxonomy, proposed origins, and key biological, genetic, and phenotypic characteristics, with particular emphasis on factors underlying environmental persistence, transmission dynamics, antifungal resistance, and virulence. Drawing on published literature and publicly available surveillance data from national public health authorities worldwide, we provide an updated overview of the global epidemiological landscape and evolving transmission patterns of C. auris. Finally, we discuss potential strategies to mitigate the continued and escalating global spread of this emerging multidrug-resistant fungal pathogen.}, }
@article {pmid42018659, year = {2026}, author = {Wu, CJ and Caligaris-Cappio, F and Chiorazzi, N and Gribben, JG and Hallek, M and Wierda, WG and Kipps, TJ}, title = {Unfinished business in chronic lymphocytic leukemia: translational and clinical priorities for a cure.}, journal = {Blood}, volume = {148}, number = {2}, pages = {175-186}, doi = {10.1182/blood.2025032393}, pmid = {42018659}, issn = {1528-0020}, mesh = {Humans ; *Leukemia, Lymphocytic, Chronic, B-Cell/therapy/immunology/genetics ; Translational Research, Biomedical ; COVID-19/epidemiology ; SARS-CoV-2 ; }, abstract = {Remarkable progress in the understanding of disease pathogenesis and treatment across hematologic malignancies has been achieved in the past 2 decades. Nevertheless, the reliable elimination of disease remains elusive for many cancers. Chronic lymphocytic leukemia (CLL) exemplifies the needs that must be addressed to close the gap between discovery science and the remaining clinical challenges. In CLL, targeted therapies have substantially prolonged survival and enabled long-term disease control for many patients. However, curative outcomes remain exceptional, particularly in high-risk groups such as those with TP53 disruption, dual resistance to Bruton tyrosine kinase and B-cell lymphoma 2 inhibitors, or transformation to aggressive lymphoma. Recent insights into the interconnection between cancer and immunity have positioned CLL as a model example of cancer-associated immunodeficiency, a realization brought into sharp focus by the severe acute respiratory syndrome coronavirus 2 pandemic during which patients with CLL were at extremely high-risk for infection and poor outcomes. Therefore, complications related to infections, autoimmunity, and secondary cancers continue to contribute substantially to morbidity and mortality, underscoring the need for research on immune dysfunction in CLL. Furthermore, pronounced heterogeneity in disease progression and therapeutic resistance highlight the need for mechanistic studies to clarify these distinct biological patterns. Advances in these areas not only hold the promise of curative therapy for broader patient subgroups in CLL but will also inform innovation in research on other cancers, particularly in establishing a molecular definition of disease and defining those interactions with the underlying and resultant immune deficiencies.}, }
@article {pmid42018766, year = {2026}, author = {Straus, W}, title = {From discovery through emergency use to the present: Safety evaluation of the COVID-19 mRNA-1273 (Moderna) vaccine.}, journal = {Human vaccines & immunotherapeutics}, volume = {22}, number = {1}, pages = {2653369}, pmid = {42018766}, issn = {2164-554X}, mesh = {Humans ; 2019-nCoV Vaccine mRNA-1273/adverse effects ; *COVID-19/prevention & control ; Emergency Use Authorization ; *COVID-19 Vaccines/adverse effects ; SARS-CoV-2/immunology ; Adverse Drug Reaction Reporting Systems ; Vaccine Development ; }, abstract = {The COVID-19 pandemic created an urgent need to develop preventive vaccines to blunt the impact of the greatest global health crisis in a century. Two vaccines, both employing mRNA technology, were developed from bench to bedside in under one year - a milestone considered nearly impossible. This paper examines the evolving safety profile of mRNA-1273, from development under Operation Warp Speed through Emergency Use Authorization, and subsequent deployment at nearly unprecedented scale. Vaccine safety was characterized during clinical development and refined through well-established safety monitoring systems (e.g. Vaccine Adverse Event Reporting System [VAERS]), as well as newly introduced systems such as V-Safe. Key safety findings, such as myocarditis, are reviewed as well as safety findings in special populations. The complementary contributions of public, private, and academic sectors highlight how collaboration and rigorous monitoring supported timely and comprehensive safety assessment of a new vaccine in the extraordinary setting of a global pandemic.}, }
@article {pmid42018905, year = {2026}, author = {Silva, JAD and Barbosa, MEJDP and Sena, MM and Sousa, VMF and Vieira, NFC}, title = {[Implications of the COVID-19 pandemic on the health behaviors of adolescent and young parents: integrative review].}, journal = {Ciencia & saude coletiva}, volume = {31}, number = {3}, pages = {e12012024}, doi = {10.1590/1413-81232026313.12012024}, pmid = {42018905}, issn = {1678-4561}, mesh = {Humans ; *COVID-19/epidemiology/psychology ; Adolescent ; *Health Behavior ; *Parents/psychology ; Mental Health ; Socioeconomic Factors ; Health Services Accessibility ; Risk-Taking ; }, abstract = {The study aims to identify the implications of the COVID-19 pandemic on the health behaviors of adolescent and young parents, highlighting parenthood and their impacts on the health and well-being. This is an integrative literature review, carried out by searching for scientific publications indexed in the following databases: Virtual Health Library (BVS), Medical Literature Analysis and Retrieval System Online (MedLine/PubMed), Scopus and Web of Science (WOS). As a result, after reading 137 titles and abstracts and 69 full articles, 7 articles were selected for the final sample. The results of the included articles were grouped into two analytical categories: cross-cutting themes, which contemplate the implications resulting from COVID-19, such as impacts on mental and emotional health, socioeconomic aspects and access to health and education services. The second category was composed of specific themes addressed individually in each study, such as immunization, maternal and child health and food insecurity. From the analysis, a significant increase in risk behaviors and vulnerabilities suffered by young parents and adolescents was identified, with future implications for health and well-being, in addition to economic, emotional and social challenges.}, }
@article {pmid42018907, year = {2026}, author = {Mangas, GM and Rodriguez, JGV and Santos, JARBD and Souza, FNB and Silva, LFLD and Azevedo Junior, GL and Chivaca, A and Jessen, NPJ and Oliveira, Â and Mesquita, ET}, title = {Fundamentals of Acute Pericarditis: State of the Art.}, journal = {Arquivos brasileiros de cardiologia}, volume = {123}, number = {2}, pages = {e20240572}, pmid = {42018907}, issn = {1678-4170}, mesh = {Humans ; *Pericarditis/etiology/diagnosis/therapy/physiopathology ; Acute Disease ; COVID-19/complications ; }, abstract = {Acute pericarditis is an inflammation of the pericardium, the lining that surrounds the heart. It is the most common inflammatory heart condition. The disease frequently affects young adults and can manifest with varying severity. Pericarditis can have diverse causes, including viral infections, autoimmune diseases, post-infarction conditions, and, more recently, SARS-CoV-2 infections or COVID-19 vaccines. In developing countries, especially in Africa, tuberculosis is the leading cause of pericarditis, often associated with HIV. Diagnosis is based on clinical criteria, such as chest pain and electrocardiographic changes, and it can be supported by imaging studies such as echocardiography, cardiac magnetic resonance imaging, and computed tomography. Identification of etiology is crucial to personalized treatment, although the specific cause is often unidentified. New research has highlighted the role of the NLRP3 inflammasome in the pathophysiology of pericarditis, which may pave the way for new therapies. Furthermore, technological advancements and artificial intelligence are discussed as promising tools to improve the management of pericarditis.}, }
@article {pmid42019647, year = {2026}, author = {Nieuwland, JM and Scaramuzza, A and Bugiani, M and van de Berg, WDJ and Middeldorp, J}, title = {Human brain matters: Navigating the neuropathology of COVID-19.}, journal = {Brain pathology (Zurich, Switzerland)}, volume = {}, number = {}, pages = {e70101}, doi = {10.1111/bpa.70101}, pmid = {42019647}, issn = {1750-3639}, support = {//European research project NEUROCOV, funded by Horizon Europe (EU)/ ; }, abstract = {Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused millions of deaths worldwide. Although the incidence of severe acute cases has declined, the prevalence of long COVID, also known as post-acute sequelae of COVID-19 (PASC), is rising. The pathological mechanisms underlying severe COVID-19, along with the relationship to neurological disorders and potential risk for neurodegeneration, remain poorly understood. The aim of this narrative review is to summarize neuropathological features described in postmortem human COVID-19 brains (n = 352). Furthermore, analysis of biofluids and neuroimaging from PASC patients underline long-term changes in the proteome and CNS response following the infection. Postmortem brain studies from severe COVID-19 patients highlight disruption of the fluid-brain barriers and vascular dysregulation defined by endothelial inflammation and disruption, hemorrhages, and hypoxic-ischemic damage. Neuroinflammation, including astrogliosis, microglia nodules and infiltration of adaptive immune cells, has been reported in the olfactory bulb, medulla oblongata, midbrain and cerebellum. Neuronal damage was demonstrated in the hippocampus, midbrain and cerebellum in severe COVID-19 and protein aggregation was observed in the midbrain and entorhinal cortex. Neuropathological burden and elevated blood and/or cerebrospinal fluid (CSF) levels of proinflammatory cytokines (e.g. IL-6) and neuro-axonal proteins (e.g. NfL) correlated with severity of anosmia, memory deficits, and cerebellar ataxia. Elderly patients and/or patients with underlying neurological diseases were more susceptible and had worsened symptoms. Potential disease mechanisms underlying neurological symptoms observed in severe COVID-19 are vascular and fluid-brain barrier abnormalities, chronic neuroinflammation, persistent axonal damage and protein aggregation. In PASC patients, an altered biofluid proteome with increased neuronal proteins and pro-inflammatory cytokines was observed. The pathological burden in affected brain regions may contribute to manifestations such as anosmia, memory deficits, and cerebellar ataxia.}, }
@article {pmid42021240, year = {2026}, author = {Moufawad, M and DeLapp, S and Rhodes, ST and Rose, KL and Domoff, SE and Kells, M and Hunger, JM and Wallace, L and Brewer, S and Coleman, A and Rakowski, A and Aguilar, N and Hahn, SL}, title = {A systematic review of social media use among rural US adolescents and associated health outcomes.}, journal = {BMC public health}, volume = {26}, number = {1}, pages = {}, pmid = {42021240}, issn = {1471-2458}, mesh = {Humans ; *Social Media/statistics & numerical data ; Adolescent ; *Rural Population/statistics & numerical data ; United States/epidemiology ; COVID-19/epidemiology ; *Adolescent Behavior/psychology ; Media Exposure ; Digital Media ; }, abstract = {BACKGROUND: Understanding social media use among rural adolescents is important because they are a geographically and socially isolated population which may impact how they use social media and affect the impacts of use. The goal of this study was to systematically review and evaluate the literature on rural US adolescent social media use. Specifically, what is known about their social media use, amount and type of use, and the associations between social media use and health outcomes. METHODS: A systematic search was conducted on seven databases: PubMed, CINAHL, SCOPUS, PsycINFO (ProQuest), Web of Science, Embase, and Google Scholar. Studies were eligible for inclusion if they sampled rural US populations, sampled adolescents (ages 10–19), and had at least one of the following as an outcome: how much adolescents use social media, how adolescents are using social media including content, and/or whether social media use was associated with a health outcome. RESULTS: A total of 34 articles matched the inclusion criteria and were included in analysis (N = 22,315). Results suggest that rural US adolescents use social media to the same extent as non-rural adolescents. Rural adolescents with marginalized identities rely on social media to form connections with those with shared identities outside of their geographic area. Social media also fostered an environment for harmful connections, as numerous studies reported cyberbullying. In respect to mental health, using social media was found to be an avenue for coping with anxiety during the COVID-19 pandemic; however, increased time spent on social media did not reduce existing feelings of nervousness, anxiety, depression, or stress in the pandemic. Interventional studies indicated that social media was successfully used as a tool to disseminate health information and provide support to marginalized groups amongst the already hard-to-reach population of rural adolescents. CONCLUSIONS: This systematic review highlights the lack of research dedicated to social media use amongst rural US adolescents, despite high prevalence of use. More research on the specific popularity of platforms and content consumed is needed to understand the nuanced effects of social media and to further investigate social media usage as a potential intervention target for this geographically and socially isolated population.}, }
@article {pmid42021332, year = {2026}, author = {Halder, P and Debnath, A and Achary, T and Mondal, A and Dhandapani, G and Mandal, I and Saha, S and Nongkynrih, B and Thakur, JS}, title = {Systematic review and meta-analysis on depression burden among Type 2 diabetes patients in India.}, journal = {Diabetology & metabolic syndrome}, volume = {18}, number = {1}, pages = {}, pmid = {42021332}, issn = {1758-5996}, abstract = {BACKGROUND: Depression and Type 2 Diabetes Mellitus (T2DM) are closely linked health challenges in India, which currently has more than 101 million people living with diabetes. This systematic review and meta-analysis aimed to determine the pooled prevalence of depression among Indian T2DM patients, highlight regional differences, and identify associated risk factors. METHODS: Following PRISMA guidelines, a thorough search was conducted across PubMed, Embase, Scopus, and Web of Science for studies published until February 3, 2025. Random-effects models were applied to calculate pooled prevalence, while subgroup analyses assessed variations by geographic region, diagnostic tool, and study setting. Heterogeneity was quantified using I[2] statistics. Publication bias was evaluated using funnel plots and Egger’s regression, with trim-and-fill analysis performed when bias was detected. Meta-regression examined the impact of covariates such as sample size, mean age, diabetes duration, hypertension, and urban residence. RESULTS: A total of 59 studies with 24,073 participants were included. The pooled prevalence of depression among T2DM patients was 38% (95% CI: 33–42%), derived using a random-effects model to account for the substantial heterogeneity observed across studies (I[2] = 98.28%). This estimate reflects a statistical synthesis across studies with widely varying diagnostic tools, cutoff thresholds, and clinical settings, and should be interpreted as an approximation of the burden rather than a precise national prevalence figure. Mild, moderate, and severe depression accounted for 24%, 14%, and 14% of cases respectively. Regional variation was observed, with Western India showing the highest prevalence (48%) and multicenter studies the lowest (27%). Prevalence differed by diagnostic tool: CIDI-SF (20%), PHQ-9 (34%), and BDI (72% with lenient cutoffs). Hospital-based studies reported higher prevalence (42%) compared to community-based ones (28%). Females had a greater burden (39%) than males (31%). No significant differences were found between pre- and post-COVID-19 studies. Sensitivity analyses confirmed robustness of estimates. Meta-regression identified diabetes duration as a significant predictor (p = 0.026). CONCLUSION: Nearly two in five Indian T2DM patients experience depression, emphasizing the urgent need for standardized screening and integration of mental health care into India’s National Program for Non-Communicable Diseases.}, }
@article {pmid42021395, year = {2026}, author = {Chen, Y and Zheng, J and Wang, H and Wu, Z}, title = {Advance in the Kawasaki disease related coronary artery aneurysms: knowledge mapping, trends, and research frontiers.}, journal = {Journal of cardiothoracic surgery}, volume = {21}, number = {1}, pages = {}, pmid = {42021395}, issn = {1749-8090}, mesh = {*Mucocutaneous Lymph Node Syndrome/complications ; Humans ; *Coronary Aneurysm/etiology ; Bibliometrics ; *Biomedical Research/trends ; }, abstract = {BACKGROUND: Kawasaki disease (KD) is the leading cause of acquired heart disease in children. In untreated cases, coronary artery aneurysms (CAAs) may develop in up to 25% of patients. As the most significant long-term sequelae of KD, Kawasaki disease-related coronary artery aneurysms (KD-CAAs) contribute substantially to long-term cardiac morbidity and mortality. To date, few bibliometric study has specifically focused on this area.
METHODS: We conducted a search in the Web of Science Core Collection (WOSCC) for papers related to KD-CAAs published between 2005 and 2024, and performed visual analysis using CiteSpace, VOSviewer, and the "biblioshiny" web interface from the "bibliometrix" package in R. A total of 1018 publications were retrieved, which collectively received 25,068 citations, averaging 24.62 citations per paper.
RESULTS: A steady increase was shown in the cumulative number of publications. The highest productivity was observed in the United States of America (USA), followed by Japan, China, and Canada. The University of California system was identified as the most productive institution, and Pediatric Cardiology was recognized as the journal with the most publications. Burns Jane C, Tremoulet Adriana H, and McCrindle Brian W were found to be the most prolific authors, while Newburger Jane W was identified as the most co-cited author. It was revealed by keyword cluster analysis that KD-CAAs research was organized into ten distinct clusters, and three major research hotspots were highlighted: molecular pathogenesis and therapeutic resistance pathways, long-term vascular sequelae and management, and the impact of coronavirus disease 2019 (COVID-19). A shift in research focus from fundamental disease mechanisms toward long-term patient follow-up and multidisciplinary clinical collaboration was indicated by keyword burst detection, and this shift was reflected in terms such as "long-term management" and "health professionals".
CONCLUSIONS: Research on KD-CAAs requires further breakthroughs in molecular mechanisms and enhanced interdisciplinary integration. The resulting visualizations offer an efficient framework for identifying emerging trends and critical advances in KD-CAAs research.}, }
@article {pmid42022217, year = {2026}, author = {Carissa Aurelia, L and Selva, KJ and Chung, AW}, title = {Building better antibody responses: The interplay of infection, vaccination, and immune imprinting.}, journal = {PNAS nexus}, volume = {5}, number = {4}, pages = {pgag110}, pmid = {42022217}, issn = {2752-6542}, abstract = {Antibodies are critical for protection against a range of viral respiratory diseases, including SARS-CoV-2, but the induction of durable and potent antibody responses continues to be a challenge. Beyond neutralization, there is growing appreciation for the potential protective role of Fc-mediated functions, especially against immune-evasive variants. Induction of polyfunctional antibody responses is a complex multifactorial process that is shaped by interactions between various antibody features, viral properties, and host factors. Here, we review lessons learned from the COVID-19 pandemic regarding how prior infection and different vaccination strategies can modulate plasma and mucosal antibody profiles, including isotypes, immunoglobulin G subclasses, Fc glycosylation, and consequently, antibody functions. Additionally, we discuss the challenges of immune imprinting and its effects upon antibody responses to viral variants. This review provides insights into optimizing antibody-based strategies for COVID-19 prevention and treatment, emphasizing the need for further research to understand the mechanisms behind effective antibody responses and their impact upon clinical outcomes.}, }
@article {pmid42022434, year = {2026}, author = {Julius, N and John, M and Emmanuel, N}, title = {Public Health Achievements in Rwanda: A 21st Century Transformation.}, journal = {Public health challenges}, volume = {5}, number = {}, pages = {e70225}, pmid = {42022434}, issn = {2769-2450}, abstract = {This narrative review documents how Rwanda has transformed in public health extraordinarily post the 1994 Genocide against the Tutsi, placing it as an exemplary model for health care systems resilience in low-income countries. The review is based on the World Health Organization building blocks to look at the strategic changes that have led to measurable gains in the health of Rwandan people. Good centralized leadership and control have been key to this accomplishment. This made it possible to decentralize service delivery, build excellent health information systems, and invest money in the health workforce. A key part of the transformation is universal health coverage (UHC), especially mutuelle de santé, which increased coverage from 27% in 2004 to more than 85%, hence cutting down out of pocket costs, which improved equity. Integration and use of community health workers (CHWs) have been instrumental in expansion of primary care to the population mostly in rural settings, improving maternal and child life, tuberculosis (TB) treatment through direct observed therapy (DOT), and disease surveillance. These coordinated actions have resulted in substantial reductions in mortality from infectious diseases (HIV/AIDS, TB, and malaria), maternal and child health indicators, and the gradual integration of services for noncommunicable diseases and mental health. Rwanda's health system was stress tested and proved its effectiveness in the COVID-19 and Marburg outbreaks, proving exceptional planning and rapid response capacities. Despite Rwanda's achievement, obstacles still persist, such as reliance on foreign funds, limited human resources lowering the quality-of-service delivery, and mental health challenges still in existence. Rwanda's experience illustrates that a proactive government, citizen participation, and research-based innovation may produce rapid and significant overall health gains, providing a valuable model for similar situations to other countries.}, }
@article {pmid42024317, year = {2026}, author = {Brunner, M and Preckel, F and Götz, T and Lüdtke, O and Keller, L}, title = {High math anxiety is associated with lower math achievement across 90 countries: An individual participant data meta-analysis of representative student and adult samples.}, journal = {Psychological bulletin}, volume = {152}, number = {2}, pages = {207-253}, doi = {10.1037/bul0000514}, pmid = {42024317}, issn = {1939-1455}, support = {//German Research Foundation/ ; }, mesh = {Humans ; *Mathematics ; *Anxiety/psychology/epidemiology ; Adult ; Female ; *Academic Success ; *Students/psychology/statistics & numerical data ; Male ; *COVID-19 ; }, abstract = {Math anxiety and math achievement are reciprocally related, which likely impacts individuals' agency; their educational and career trajectories in science, technology, engineering, and mathematics fields; and countries' economic growth in these areas. Previous meta-analyses on this relationship have faced limitations from studies by using small convenience samples and have encountered methodological issues, such as variance restriction, low statistical power, and ecological bias. To address these challenges, the present research synthesis is the first to use a comprehensive collection of representative individual participant data from international large-scale assessments. This analysis incorporated cumulative evidence from 1980 to 2022, including 452 probability samples from 90 countries, and covered student and adult populations. The meta-analytic average correlation between math anxiety and math achievement was r = -.26. Moderator analyses revealed novel evidence that this relationship is sensitive to both construct characteristics and individual and contextual factors. Specifically, the negative relationship was weaker for the worry facet of math anxiety compared to its affective and cognitive interference facets, and it was weaker following the onset of the COVID-19 pandemic in 2020. Additionally, the negative relationship was stronger for individuals with average and high levels of math achievement and in countries with higher gross domestic product per capita. Gender differences in the relationship were largely negligible after 2010, although female individuals exhibited a stronger negative relationship in the 1980s and 1990s than male individuals. In summary, synthesizing individual participant data from international large-scale assessments provided novel, nuanced, and robust evidence for research, practice, and policy. (PsycInfo Database Record (c) 2026 APA, all rights reserved).}, }
@article {pmid42024896, year = {2026}, author = {Raina, SK}, title = {Methodological considerations regarding comparison group verification in maternal COVID-19 research.}, journal = {The Indian journal of medical research}, volume = {163}, number = {3}, pages = {420}, pmid = {42024896}, issn = {0971-5916}, }
@article {pmid42025371, year = {2026}, author = {Imai, Y}, title = {Viral infection and establishing new therapeutic platforms- On the occasion of receiving the 16th Setsuro Ebashi award.}, journal = {Journal of pharmacological sciences}, volume = {161}, number = {2}, pages = {25-27}, doi = {10.1016/j.jphs.2026.03.002}, pmid = {42025371}, issn = {1347-8648}, mesh = {Humans ; *Awards and Prizes ; COVID-19 ; SARS-CoV-2 ; Pandemics ; *Coronavirus Infections/immunology/drug therapy ; Angiotensin-Converting Enzyme 2 ; Animals ; *Pneumonia, Viral/immunology/drug therapy ; Immunity, Innate ; Betacoronavirus ; Influenza, Human/immunology ; }, abstract = {During the past quarter century, a series of global pandemics-caused by coronaviruses (SARS-CoV, MERS-CoV, SARS-CoV-2) and influenza A (H1N1, H5N1)-has underscored that viral infection is not merely a transient invasion but a systemic and temporal perturbation of the host life system. My research has sought to elucidate the principles by which the host organism senses, integrates, and regulates responses to viral stress, spanning molecular to organismal levels. Key discoveries include the identification of ACE2 as the functional receptor for SARS-CoV and a critical regulator of disease severity; elucidation of innate-immune overactivation ("cytokine storm") as a driver of fatal pathology; identification of lipid-mediated RNA regulation that restrains excessive inflammation; and discovery of neuro-immune and epigenetic mechanisms linking acute infection to long-term dysfunction. These findings reveal infection as a multi-layered biological reprogramming process involving immunity, metabolism, the nervous system, and chromatin architecture. Building on this mechanistic foundation, we established data-driven infrastructures-AI-assisted predictive models and Medical MLOps systems-that integrate clinical and molecular data for personalized infection medicine. This perspective summarizes the evolution of this integrative research and discusses future directions toward precision therapeutics for acute and post-infectious syndromes.}, }
@article {pmid42025580, year = {2026}, author = {Shukla, SK and Singh, A and Yadav, R and Kumar, A}, title = {Advances in molecular diagnostic strategies during the SARS-CoV-2 pandemic.}, journal = {Expert review of molecular diagnostics}, volume = {26}, number = {4}, pages = {293-308}, doi = {10.1080/14737159.2026.2665263}, pmid = {42025580}, issn = {1744-8352}, mesh = {Humans ; *COVID-19/diagnosis/epidemiology/virology ; *SARS-CoV-2/genetics/isolation & purification ; *Molecular Diagnostic Techniques/methods ; Pandemics ; COVID-19 Testing/methods ; COVID-19 Nucleic Acid Testing/methods ; Rapid Diagnostic Tests ; Pandemic Preparedness ; CRISPR-Cas Systems ; }, abstract = {INTRODUCTION: The SARS-CoV-2 pandemic provided critical insights into pandemic preparedness. The community spread can be slowed down or contained through effective, rapid, and robust diagnosis of infected individuals.
AREA COVERED: During the pandemic, substantial advances were made in developing rapid and cost-effective diagnostic approaches. Self-collected gargle samples offer clear advantages over conventional NSP/OPS methods by reducing reliance on trained personnel and personal protective equipment. Colorimetric assays further improve accessibility, enabling rapid, instrument-free, and visually interpretable detection at low cost. CRISPR-based diagnostics present a promising alternative to RT-PCR, facilitating scalable mass screening with reduced technical dependence. Concurrently, optimization of RT-PCR workflows-particularly through minimization of pre-PCR steps-can enhance speed and affordability. The integration of digital technologies and artificial intelligence further leverages diagnostic capabilities. Despite this, improved regulatory frameworks and resilient supply chains are critical for ensuring scalable, equitable access, and effective pandemic preparedness.
EXPERT OPINION: Global efforts were made to develop sensitive, rapid, cost-effective, and noninvasive technologies to identify the pandemic virus; however, variations in sensitivity/specificity and limited sample size validation hampered their utility in routine diagnostics. The COVID-19 pandemic has ended, but global efforts are still needed to combat the early infection of subsequent waves or similar disease waves.}, }
@article {pmid42027925, year = {2026}, author = {Mullen, L and Kobokovich Mui, A and Watson, C and Heymann, D and McCloskey, B and Hughes, G and Bonell, C}, title = {Effectiveness of public health measures and strategies to reduce risk of spread of respiratory pathogens at sporting mass gatherings: systematic literature review.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1789413}, pmid = {42027925}, issn = {2296-2565}, mesh = {Humans ; *Sports ; *Respiratory Tract Infections/prevention & control ; *Public Health ; *Mass Gatherings ; *COVID-19/prevention & control ; }, abstract = {OBJECTIVES: To determine the type and effectiveness of public health interventions implemented at sporting mass gatherings to mitigate respiratory infectious disease spread and understand how feasible and acceptable the interventions were to implement.
DESIGN: Systematic review.
DATA SOURCES: Medline, EMBASE, Cochrane Library, Scopus, Web of Science, Global Health, Epistemonikos, Global Index Medicus, WHO Library, WHO IRIS, IOC and FIFA were search in June 2023 and July 2025.
Studies that assessed public health strategies for sporting mass gatherings aiming to reduced respiratory infections were included. Publications prior to 2000, predictive modeling studies, commentaries, editorials, literature reviews, pre-prints and studies that did not retrospectively discuss official sporting events were excluded.
RESULTS: Thirty-four articles assessing 37 sporting MGs were included. The most common MGs assessed were the Olympic Games (n = 10). Almost all articles described multi-layered intervention packages including bubble approaches, routine testing, country entry screening, masking, physical distancing and/or isolation and quarantine. Based on an effectiveness framework developed for this study, 23 articles described effective intervention packages, three described non-effective packages and six were indeterminate. Feasibility concerns appeared a challenge for MGs with many spectators and linked to scalability issues. Acceptability factors were likely influenced by perceptions of increased work burden, compliance levels and stakeholder engagement.
CONCLUSION: This systematic review provides the first opportunity to comprehensively map pre-pandemic and pandemic-era planning for sporting MGs and underscores the importance of multilayered, context-specific intervention packages which may meaningfully reduce the risk of respiratory disease spread.
CRD42023433619.}, }
@article {pmid42027972, year = {2025}, author = {Amiri-Dashatan, N and Koushki, M and Parsamanesh, N and Ahmadi, N and Chiti, H and Rezaei, M and Razzaghi, Z and Robati, RM}, title = {COVID-19: A Systematic Review of Metabolomics Data and Predicting Potential Biomarkers Based on Pathway Analysis.}, journal = {Tanaffos}, volume = {24}, number = {1}, pages = {9-29}, pmid = {42027972}, issn = {1735-0344}, abstract = {The COVID-19 pandemic is a worldwide disaster in medicine, public health, and the economy. Many details of COVID-19 are currently unknown. This study aims to offer dysregulated metabolic profiles as potential biomarkers for SARS-CoV-2 infection by analyzing identified COVID-19 metabolites. We searched PubMed, Web of Science, EMBASE, and Scopus for metabolomics studies on COVID-19 patients. Studies investigating COVID-19 metabolite changes and utilizing mass spectrometry-based techniques are included. Two reviewers separately retrieved pertinent data for each selected publication. Differences of opinion among the reviewers were settled via conversation, and a final judgment was obtained. The online MetaboAnalyst 3.0 was used to conduct the pathway analysis of COVID-19. This study comprised 31 investigations with QUADOMICS quality evaluation. We isolated modified metabolites that have been found in at least three other investigations. The metabolomics data in response to SARS-CoV-2 alter at the metabolite expression level, leading to dysregulation of major metabolic pathways, including carbohydrates, amino acids, and lipids associated with COVID-19. The pathway analysis of metabolic reprogramming across different biological samples demonstrated a significant role in amino acid metabolism, including phenylalanine, tyrosine, and tryptophan production, in the severity of COVID-19. This review showed dysregulated metabolic profiling for identifying individuals with high severity of COVID-19. These results provide an understanding of metabolic pathways and how dysregulated metabolic profiling reflects the severity of COVID-19 in the general population. The high frequency of changed metabolites might be used as COVID-19 biomarkers for early detection, and significant metabolic routes could reveal new information about pathogenesis and lead to potential treatment targets.}, }
@article {pmid42028925, year = {2026}, author = {Silva, LI and Gonzalez-Zambrano, CM and Ferreira, VCMP and Corrêa, FC and Dias-Melicio, LA}, title = {MicroRNAs in Acute COVID-19 and Long COVID: Dysregulation, Pathogenic Roles, and Clinical Implications.}, journal = {Journal of immunology research}, volume = {2026}, number = {1}, pages = {e5862241}, pmid = {42028925}, issn = {2314-7156}, support = {001//Coordenação de Aperfeiçoamento de Pessoal de Nível Superior/ ; }, mesh = {Humans ; *COVID-19/genetics/immunology ; *MicroRNAs/genetics/immunology ; *SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Biomarkers ; Extracellular Vesicles ; Gene Expression Regulation ; Inflammation/genetics ; Pandemics ; *Betacoronavirus ; }, abstract = {MicroRNAs (miRNAs) are key post-transcriptional regulators of gene expression with central roles in immune responses, inflammation, and viral pathogenesis. Increasing evidence indicates that severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection induces marked dysregulation of host and viral miRNAs (v-miRNAs), contributing to disease severity during acute COVID-19 and to the persistent manifestations observed in long COVID (LC). This narrative review critically synthesizes current evidence on miRNA dysregulation across the acute and post-acute phases of COVID-19, highlighting their pathogenic roles, clinical relevance, and existing knowledge gaps. During acute infection, altered miRNA profiles-including those associated with immune activation, endothelial dysfunction, and immunothrombosis-reflect both host responses and viral strategies of immune modulation, including miRNAs carried by extracellular vesicles (EVs) and SARS-CoV-2-derived v-miRNAs. In LC, emerging data suggest that persistent miRNA alterations are associated with unresolved inflammation, pulmonary dysfunction, neurological symptoms, and vascular injury, although available studies remain limited and heterogeneous. Overall, miRNAs represent promising biomarkers and potential therapeutic targets in COVID-19; however, robust longitudinal and mechanistic studies are urgently needed to clarify their causal roles and translational utility in post-acute disease.}, }
@article {pmid42033452, year = {2026}, author = {Mok, TC and Mok, CC}, title = {Vaccination in systemic lupus erythematosus.}, journal = {Human vaccines & immunotherapeutics}, volume = {22}, number = {1}, pages = {2663637}, pmid = {42033452}, issn = {2164-554X}, mesh = {Humans ; *Lupus Erythematosus, Systemic/immunology/complications/drug therapy ; *Vaccination/methods ; COVID-19 Vaccines/immunology/administration & dosage ; Pneumococcal Vaccines/immunology/administration & dosage ; Influenza Vaccines/immunology/administration & dosage ; Immunosuppressive Agents/therapeutic use ; }, abstract = {Despite advancement in anti-microbial therapies, infection remains the leading cause of mortality in systemic lupus erythematosus (SLE). Vaccination is a major strategy in reducing infection risk. Recent studies suggest most SLE patients are able to mount an adequate immune response to the SARS-CoV2 vaccines but lower immunogenicity is observed with influenza and pneumococcal vaccination. Current evidence does not indicate an increased risk of SLE flares after administration of common vaccines. Live vaccines are less preferred to inactivated or recombinant vaccines in SLE patients receiving immunosuppression. However, the decision to vaccinate should be individualized according to risk and benefit evaluation. Vaccination in patients with SLE should best be performed during periods of low disease activity or remission. In patients receiving intense immunosuppression or biologic/targeted therapies, particularly B-cell depletion, vaccine responses are expected to be attenuated. Adjunctive measures such as booster dose of vaccines, passive immunization and microbial prophylaxis may be considered.}, }
@article {pmid42033494, year = {2026}, author = {Chakraborty, B and Singh, T}, title = {mRNA vaccines for viral diseases: mechanism, advances, and future perspective.}, journal = {Molecular biology reports}, volume = {53}, number = {1}, pages = {}, pmid = {42033494}, issn = {1573-4978}, mesh = {Humans ; COVID-19 Vaccines/immunology ; mRNA Vaccines/immunology ; *Virus Diseases/prevention & control/immunology ; SARS-CoV-2/immunology ; *COVID-19/prevention & control/immunology ; *Viral Vaccines/immunology ; Animals ; Vaccine Development ; *RNA, Messenger/immunology/genetics ; Vaccines, Synthetic/immunology ; }, abstract = {The rapid development and global distribution of messenger ribonucleic acid (mRNA) vaccines against Coronavirus Disease 2019 (COVID-19) indicated an important shift in vaccine science and public health response. Unlike traditional vaccines that rely on live-attenuated or inactivated pathogens, mRNA vaccines use synthetic mRNA encoding the antigen, allowing host cells to produce the antigen and elicit strong immune responses. The success of mRNA vaccines against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has gradually increased global curiosity in applying this technology to treat other diseases. This review discusses the scientific basis of mRNA vaccines, including their mechanism of action, advantages in antigen design, expandable manufacturing, and modern delivery systems such as organic, inorganic, and hybrid. Beyond COVID-19, mRNA vaccines are being studied for other viral diseases, including influenza, Human Immunodeficiency Virus (HIV), Zika, and dengue. The intrinsic flexibility and speed of mRNA technology make it a valuable platform for next-generation pandemic preparedness and new therapeutic development. Despite these advantages, many challenges exist, including mRNA instability, cold-chain storage requirements, regulatory issues, and concerns regarding global vaccine availability and acceptance. Overcoming these will be critical for the full long-term potential of mRNA vaccines as a sustainable and transformative platform for global health. This review highlights recent advances, current challenges, and future perspectives of mRNA vaccine technology for viral diseases.}, }
@article {pmid42034588, year = {2026}, author = {Shang, J and Cui, H and Shu, C and Zheng, L and Liu, F and Peng, Y and Wei, Z and Ni, X and Liu, J}, title = {Comprehensive overview of triclosan neurotoxicity and construction of adverse outcome pathways using a systems toxicology approach: Triclosan-induced attention-deficit hyperactivity disorder as an example.}, journal = {Ecotoxicology and environmental safety}, volume = {316}, number = {}, pages = {120169}, doi = {10.1016/j.ecoenv.2026.120169}, pmid = {42034588}, issn = {1090-2414}, mesh = {*Triclosan/toxicity ; *Attention Deficit Disorder with Hyperactivity/chemically induced ; Humans ; Animals ; *Adverse Outcome Pathways ; *Neurotoxicity Syndromes/etiology ; *Anti-Infective Agents, Local/toxicity ; Risk Assessment ; *Environmental Pollutants/toxicity ; }, abstract = {Triclosan (TCS) is widely applied to daily necessities as a chemical bacteriostatic agent. Environmental TCS levels have increased significantly following the coronavirus disease 2019 pandemic, posing a potential threat to humans and ecosystems. Epidemiological investigations and toxicological studies have shown that long-term TCS exposure can damage human tissues and organs and induce neurodevelopmental disorders in offspring. However, studies on the mechanisms underlying its neurotoxicity and toxicity risk assessments are limited. This review summarizes the status of environmental and human TCS exposure and systematically outlines its neurotoxic effects. To further elucidate the mechanisms underlying TCS neurotoxicity, using TCS-induced attention-deficit hyperactivity disorder (ADHD) as an example, we constructed an adverse outcome pathway (AOP) framework based on a systematic toxicology approach. We found that TCS increased the expression of cannabinoid receptor 1, which activates the "neuroactive ligand-receptor interaction" pathway, leading to ADHD-like behaviors, including cognitive, learning, and memory deficits, by modulating chemical synaptic transmission and neurotransmitter levels. The AOP framework was further used to assess the associated neurodevelopmental toxicity risks of TCS, contributing to a better understanding of its characteristics and safety. Thus, future research on the mechanisms underlying TCS toxicity and issues related to its detection and regulation should be emphasized.}, }
@article {pmid42034797, year = {2026}, author = {Balak, N and Broekman, M and Samprón, N and Tsianaka, E and Sandvik, U and Bolger, C and Soleman, J and Visocchi, M and Agboola, KM and Syrmos, N and Vulekovic, P and Mathiesen, T and Ganau, M and , }, title = {Ethical aspects of waiting lists in neurosurgery.}, journal = {Acta neurochirurgica}, volume = {168}, number = {1}, pages = {}, pmid = {42034797}, issn = {0942-0940}, mesh = {Humans ; *Waiting Lists ; *Elective Surgical Procedures/ethics ; *Neurosurgical Procedures/ethics ; COVID-19 ; *Health Services Accessibility/ethics ; Ethical Dilemmas ; Pandemics ; SARS-CoV-2 ; }, abstract = {PURPOSE: Long waiting times for elective surgery have been a persistent problem in many countries since well before the COVID-19 pandemic. This study aims to describe the extent of waiting lists× for elective neurosurgery and discuss the potential ethical dilemmas they pose.
METHODS: A narrative review was conducted on waiting lists & times in neurosurgery using PubMed and the Web of Science Core Collection.
RESULTS: The majority of the available data on elective surgery waiting times and lists are based on analyses of non-neurosurgical interventions. These are generally high-volume surgical procedures, such as cataract surgery, hip replacement, and knee replacement. Elective surgery waiting times challenge the clinical application of the bioethical principles of beneficence, nonmaleficence, autonomy, and justice. Extensive waiting may prolong time to benefit or even lead to harm. Moreover, failure to receive timely care runs counter to patients' autonomous wishes to be treated without delay. Finally, different principles of distributive justice are likely to contradict each other under the conditions of restrained access to care that exist when patients must wait for care. It is essential to ensure that patients on waiting lists receive fair access to health care services.
CONCLUSION: This analysis indicates that long waiting lists potentially violate three of the four basic biomedical principles proposed by Beauchamp and Childress. The fourth principle, justice, is also challenged and remains to be analyzed in reference to underlying ethical principles. From an ethical perspective, waiting lists create accountability at the governmental, institutional, and physician levels, although not to an equal degree.}, }
@article {pmid42035205, year = {2026}, author = {Yuan, MQ and Pan, YF and Zhang, ZY and Wu, YX and Zhu, KD and Wang, ZR and Zhang, ZY and Xiong, JQ and Xu, Z and Huang, L and Wang, FS and Shi, L}, title = {Therapeutic potential of mesenchymal stromal cells in COVID-19: a meta-analysis of clinical trials conducted since the pandemic onset.}, journal = {Stem cell research & therapy}, volume = {17}, number = {1}, pages = {}, pmid = {42035205}, issn = {1757-6512}, support = {No. 2022YFA1105604//National Key Research and Development Program of China/ ; }, mesh = {Humans ; *COVID-19/therapy/mortality/epidemiology ; *Mesenchymal Stem Cell Transplantation/methods ; *Mesenchymal Stem Cells/cytology ; *SARS-CoV-2 ; Clinical Trials as Topic ; Pandemics ; Treatment Outcome ; }, abstract = {BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can induce immune dysregulation and multi-organ injury; mesenchymal stromal cell (MSC) therapy has shown promise in clinical trials for COVID-19 and may have broader applicability to pneumonia induced by respiratory viruses (e.g., the influenza virus). This meta-analysis synthesized the available comparative clinical evidence on the safety and efficacy of MSCs in patients with moderate to critical COVID-19 and examined the reported outcomes relevant to Long-COVID.
METHODS: We searched the PubMed, Embase, and CNKI databases for original, comparative studies in moderate, severe, or critical COVID-19 published up to September 2, 2024. Twenty-four eligible studies (13 RCTs and 11 non-randomized controlled trials; n = 1080) were included in the mortality meta-analysis. Patients were assigned to either the intervention group (MSC therapy plus standard care) or the control group (standard care with or without placebo). The primary efficacy outcome was all-cause mortality, while the primary safety outcomes were adverse events (AEs) and serious adverse events (SAEs). Secondary outcomes included clinical recovery, hospitalization metrics, chest imaging, and inflammatory biomarkers. We performed a pooled meta-analysis on mortality with subgroup analyses (by disease severity, administration route, dosing frequency, and study design), assessment of publication bias (using funnel plots and Egger's test), and evaluation of the quality of evidence via the GRADE approach. AEs/SAEs were analyzed using meta-analysis and descriptive statistics, while other secondary outcomes were summarized descriptively.
RESULTS: MSC therapy significantly reduced all-cause mortality (MSC: 26.4% vs control: 31.9%; fixed-effect OR = 0.74, 95% CI 0.55-0.99), with low heterogeneity (I[2] = 2.8%, P =0.422[Q-test]) and no publication bias. The quality of evidence was moderate (according to the GRADE assessment). The subgroup analysis revealed a significant survival benefit in severe/critical patients (OR = 0.73, 95% CI 0.54-0.98) but not in studies that included moderate cases (OR = 0.91, 95% CI 0.23-3.65). No significant heterogeneity was found across study designs, administration routes, or dosing frequencies, which confirmed the robustness of the primary findings while indicating insufficient evidence to determine the optimal regimen. The secondary outcomes suggested improvements in clinical recovery, pulmonary function, and pro-/anti-inflammatory cytokine balance in patients that received MSC therapy. Limited studies with long-term follow-up indicated potential benefits for Long-COVID outcomes (e.g., fatigue, quality of life, residual CT abnormalities, and exercise tolerance). No significant differences were observed in AEs or SAEs post-MSC infusion, which suggested that MSC therapy was well tolerated.
CONCLUSION: This meta-analysis indicated that MSC therapy may reduce mortality in patients with severe or critical COVID-19, demonstrating a favorable safety profile and potential benefits for Long-COVID and other viral pneumonias. Further large-scale, rigorous RCTs and mechanistic studies are warranted to strengthen the evidence base and standardize MSC administration regimens (source, dosing, frequency, and intervals) for managing COVID-19, Long-COVID, and other viral pneumonias.}, }
@article {pmid42035616, year = {2026}, author = {Kimura, R and Hayashi, Y and Fujimoto-Sato, Y and Ishii, H and Suzuki, Y and Katayama, K and Mizukoshi, F and Ryo, A and Kimura, H}, title = {Decoding viral evolution through integrative bioinformatics: From genomes to global health.}, journal = {Virology}, volume = {620}, number = {}, pages = {110920}, doi = {10.1016/j.virol.2026.110920}, pmid = {42035616}, issn = {1096-0341}, mesh = {*Computational Biology/methods ; Humans ; *Evolution, Molecular ; *Genome, Viral ; Phylogeny ; Global Health ; *Viruses/genetics/classification ; SARS-CoV-2/genetics ; Animals ; }, abstract = {Bioinformatics has transformed modern virology by linking genomic variation to epidemiology, protein structure, and public health action. This review integrates core analytical frameworks-sequence alignment and genome annotation; maximum-likelihood and Bayesian phylogenetic/phylodynamic inference; codon-based selection and recombination analyses; and AI-assisted structural prediction combined with deep mutational scanning (DMS)-to convert viral sequences into mechanistic and predictive insight. We emphasize how global surveillance ecosystems (GISRS, GISAID, and Nextstrain) and sustained regional programs reveal genotype turnover, antigenic drift, and seasonality in RSV, HPIV, norovirus, and SARS-CoV-2, enabling near real-time lineage tracking and vaccine-strain deliberation. Mapping positively selected residues and recombination breakpoints onto three-dimensional protein structures clarifies immune escape in key surface glycoproteins (e.g., RSV F/G, HPIV HN/F, norovirus VP1) and strengthens genotype-phenotype interpretation. Comparative reinfection patterns-lifelong immunity in measles versus recurrent RSV/HPIV infections-illustrate how evolutionary rate and antigenic constraint shape population immunity and control strategies. Despite major advances, progress remains constrained by geographic sampling bias, incomplete metadata, uneven computational capacity, and uncertainties in molecular clocks, recombination inference, and machine-learning predictions. The field is now moving toward predictive virology, integrating AI-enabled structural modeling, mutational fitness landscapes, and clinical-immunological metadata within real-time analytical platforms to anticipate immune-escape trajectories. Prioritizing pediatric respiratory pathogens alongside influenza and coronaviruses, and reinforcing equitable data-sharing and governance, will be essential for globally inclusive, forward-looking viral surveillance and intervention.}, }
@article {pmid42038565, year = {2026}, author = {Baldo, KAT and King, RAN and San Juan, FGF and Dungog, CC and Solidum, JGN and Ceriales, JA and Dela Cruz, MCP and Ho, FDV and Picart, N and Plantado, ANR and Perez, J and Garcia, JP and Lapeña, JFF and Paz-Pacheco, E and Tantengco, OAG}, title = {Epidemiology, Diagnosis, and Management of Thyroid Cancer in the Philippines.}, journal = {Indian journal of surgical oncology}, volume = {17}, number = {3}, pages = {484-498}, pmid = {42038565}, issn = {0975-7651}, abstract = {Thyroid cancer incidence is rising in the Philippines, warranting attention due to unique risk factors and growing economic implications. This review examines the epidemiological trends, diagnosis, treatment, impact of COVID-19, and economic burden associated with thyroid cancer in the Philippines. We conducted a literature search in Scopus and HERDIN to synthesize the existing data on the epidemiology, diagnosis, and management of thyroid cancer in the Philippines. Filipinos exhibit a higher prevalence of BRAFV600E mutations, and thyroid cancer is more common among females and older individuals. Diagnostic procedures include risk assessment, family history evaluation, neck examination, hormone tests, neck ultrasonograms, thyroid scans, and biopsies guided by the Bethesda System. Treatment primarily involves surgery, which is determined by risk classification and disease extent. Total or near-total thyroidectomy is recommended for most cases, followed by postoperative management tailored to individual patient factors. Anaplastic thyroid cancer may require multimodal approaches. The COVID-19 pandemic disrupted healthcare access, leading to delays in thyroid cancer treatment and challenges in monitoring, prompting the adoption of telemedicine. However, the pandemic's psychological impact on thyroid cancer survivors is concerning. The economic burden remains substantial despite health insurance programs. In conclusion, thyroid cancer in the Philippines necessitates enhanced prevention, early detection, determination of risk factors, risk stratification, and treatment strategies. The COVID-19 pandemic emphasized the need for adaptable healthcare systems. This study summarized the epidemiology, diagnosis, and management of thyroid cancer in the Philippines. Implementation of existing policies and further research on the Filipino population is vital to address this growing health concern and ensure improved outcomes for thyroid cancer patients.}, }
@article {pmid42038922, year = {2025}, author = {Kiran, MA and Saeed, S and Bin Nafisah, A and Alqarni, A and Alotaibi, AH and Alqahtan, AS and Aljadaan, H and Osayl, HB and Alsane, M and Alsuhail, N and Alrawaf, N and Albalawi, RS and Alanazi, SA and Aloufi, R}, title = {Impact of The COVID-19 Pandemic on Salivary Gland-related Healthcare Interventions; A Systematic Review And Meta-analysis :.}, journal = {Galen medical journal}, volume = {14}, number = {}, pages = {e3970}, pmid = {42038922}, issn = {2322-2379}, abstract = {BACKGROUND: The emergence of SARS-CoV-2 variants has raised concerns regarding their potential impact on perioperative outcomes. Its effect on patients undergoing surgery for salivary gland diseases remains unclear. This systematic review and meta-analysis aimed to evaluate the impact of the COVID-19 pandemic on salivary gland-related healthcare interventions, including cancer treatments, sialendoscopy procedures, and parotid surgery outcomes.
MATERIALS AND METHODS: Following PRISMA guidelines, a systematic search was conducted in PubMed, Embase, and Web of Science (2019-2025) for studies reporting pre- and during-COVID data. Two reviewers independently screened records, extracted data, and assessed risk of bias using the Newcastle-Ottawa Scale. A random-effects meta-analysis was performed to pool odds ratios (ORs) for intervention outcomes.
RESULTS: Four studies (n=7,740 participants) were included. The pooled OR for salivary gland interventions during versus pre-COVID was 1.08 (95% CI: 0.88-1.33, P=0.45), indicating no significant change, with moderate heterogeneity (I²=46%). Subgroup analyses revealed increased odds of wound dehiscence post-parotid surgery (OR=4.40, 95% CI: 1.18-16.40) but no significant differences in delayed cancer diagnosis or urgent sialendoscopy.
CONCLUSION: The COVID-19 pandemic did not significantly alter overall salivary gland intervention rates or adverse events, though some procedural complications increased non-significantly. Limited evidence underscores the need for larger, standardized studies. While this shows that surgeons maintained quality of practice in this era during the COVID-19.}, }
@article {pmid42039182, year = {2026}, author = {Lap, CR and van Houten, M and Bogaert, D and Biesbroek, G}, title = {A perfect storm: the immunological and pathophysiological landscape of pediatric post-COVID-19 condition.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1794596}, pmid = {42039182}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/immunology/complications ; *SARS-CoV-2/immunology ; Child ; Post-Acute COVID-19 Syndrome ; Immunity, Innate ; Dysbiosis/immunology ; Adolescent ; }, abstract = {Pediatric Post-COVID Condition (PPCC) represents a significant and complex long-term sequela of SARS-CoV-2 infection, affecting a subset of children and adolescents even after mild acute disease. While acute COVID-19 is generally milder in children due to a more robust innate immune response, the mechanisms driving the persistence of symptoms in PPCC remain incompletely understood and likely multifactorial. This narrative review synthesizes current epidemiological data and explores the "perfect storm" of immunological and pathophysiological alterations underpinning the condition. We examine critical hypotheses including a dysregulated immune response characterized by altered T-cell subsets, monocyte activation, and autoantibody production. We discuss the potential role of persistent SARS-CoV-2 viral reservoirs in "sanctuary sites" like the gastrointestinal tract and the reactivation of latent viruses such as Epstein-Barr virus (EBV). Furthermore, the review details downstream pathogenic pathways, including vascular endothelial inflammation (thrombo-inflammation), neuroinflammation, and metabolic dysfunctions affecting the mitochondria and tryptophan-kynurenine pathway. Finally, we address the role of microbiome dysbiosis in perpetuating systemic inflammation and the gut-lung axis dysfunction. Given the heterogeneity of clinical presentations, we conclude that PPCC is likely a syndrome of overlapping biological phenotypes. Future research must prioritize identifying these specific biological endotypes to develop targeted diagnostic and therapeutic strategies for the pediatric population.}, }
@article {pmid42040795, year = {2022}, author = {Najafi Kashkooli, A and Jooya, P and Navari, F and Gorjizadeh, N and Poudineh, M and Pouralimohamadi, N and Asadian, A and Sabet, H}, title = {Digestive System Involvement During Coronavirus Disease 2019; the Newest Clinical Features and Potential Mechanisms : Digestive System Involvements and COVID-19.}, journal = {Galen medical journal}, volume = {11}, number = {}, pages = {e2569}, pmid = {42040795}, issn = {2322-2379}, abstract = {The coronavirus disease 2019 (COVID-19), which is caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has been recognized as a worldwide pandemic and mostly affects the respiratory system. A considerable proportion of patients; however, might also experience gastrointestinal (GI) manifestations. Several investigations have assessed GI and hepatic involvement in this disease, although the mechanisms of these involvements in relation to the progression of COVID-19 remain unclear. This review summarized the clinical observations and the main mechanisms behind GI, liver, and pancreatic involvement among COVID-19 patients.}, }
@article {pmid42040796, year = {2022}, author = {Bagheri Lankarani, K and Akbari, M and Homayounfar, R and Tabrizi, R and Vali, M and Zakeri, MR and Farjam, M and Khodadost, M and Ahmadizar, F}, title = {Therapeutic Efficacy of Melatonin in Patients with Coronavirus 2019: A Systematic Review and Meta-Analysis of Randomized Controlled Trials : Melatonin in COVID-19 Patients.}, journal = {Galen medical journal}, volume = {11}, number = {}, pages = {e2562}, pmid = {42040796}, issn = {2322-2379}, abstract = {The efficacy of melatonin in the treatment of patients with coronavirus 2019 (COVID-19) is controversial. This review has summarized the evidence on the efficacy of oral melatonin compared to placebo in patients with mild to moderate COVID-19 infection. We searched four international online databases and all randomized clinical trials (RCTs) that investigated the effects of melatonin compared with the placebo on clinical outcomes, including mortality, discharge time, O2 saturation (SaO2), and c-reactive protein (CRP) levels in patients with COVID-19 infection, were included. The standard random-effects model with hybrid continuity correction was used to pool the risk ratio (RR), weighted mean difference (WMD), and the I2 index to assess the heterogeneity. A total of 272 patients from five RCTs were included. Our meta-analysis showed melatonin compared to placebo, decreased discharge time (WMD=-0.93 days; 95% confidence interval [CI]:-2.94 to 1.07, P=0.36; I2=56.78%) and the risk of mortality (RR=0.72; 95% CI:0.25 to 2.13, P=0.56; I2=0.0%) in COVID-19 patients. Melatonin intake compared to placebo significantly increased SaO2 (WMD=1.38%; 95% CI:0.09 to 2.68, P=0.04; I2=49.82%) and decreased the CRP levels (WMD=-7.24 mg/l; 95% CI:-11.28 to -3.21, P0.001) in a sensitivity analysis. Our findings showed the efficacy of melatonin compared to placebo in patients with mild to moderate COVID-19 infection.}, }
@article {pmid42041273, year = {2026}, author = {Silveira, JM and Nakaishi, APM and da Silva, MG and Dos Santos, DO and Gastaldi, AC}, title = {Effects of Exercise-Based Pulmonary Rehabilitation in Patients with Long COVID: A Systematic Review and Meta-Analysis.}, journal = {Advances in respiratory medicine}, volume = {94}, number = {2}, pages = {}, pmid = {42041273}, issn = {2543-6031}, mesh = {Humans ; *COVID-19/rehabilitation/complications/physiopathology ; *Exercise Therapy/methods ; Quality of Life ; Post-Acute COVID-19 Syndrome ; Exercise Tolerance ; SARS-CoV-2 ; Randomized Controlled Trials as Topic ; }, abstract = {Background/Objective: A substantial proportion of infected individuals develop persistent symptoms after the acute phase of COVID-19, regardless of initial disease severity. Long COVID (LC) remains a public health challenge characterized by impaired functional exercise capacity (FEC) and quality of life (QoL). We systematically synthesized evidence on the effects of in-person outpatient pulmonary rehabilitation (OPR) with individualized and supervised exercise in adults with LC. Methods: Following PROSPERO (CRD42023389365), this study reviewed randomized controlled trials (RCTs) and observational cohort studies (OCSs) published between November 2019 and January 2026 in MEDLINE/PubMed, Web of Science, PEDro, and EMBASE. Results: Fifteen studies (n = 803) were included. OPR improved FEC (6MWT; MD: 53.72 m, 95% CI 43.69-63.75) and 30″SST (MD: 4.68, 95% CI 3.59-5.77) and reduced exertional dyspnea. RCTs showed benefits in physical (MD: 8.04, 95% CI 3.02-13.05) and mental QoL (MD: 6.60, 95% CI 2.01-11.18) and dyspnea impact, with inconsistent PF findings. Fatigue showed a trend toward improvement but was measured using heterogeneous patient-reported tools in RCTs and OCSs. Conclusions: Supervised PR improves FEC, QoL, and dyspnea in individuals with LC. In patients with fatigue/PEM, systematic assessment and continuous symptom monitoring are essential. High-quality controlled studies are needed to strengthen evidence and clinical guide.}, }
@article {pmid42041392, year = {2026}, author = {Markwitz, M and Welc, N and Kępińska, K and Bowszyc-Dmochowska, M and Dmochowski, M}, title = {Non-COVID-19 Vaccinations and the Induction of Autoantibodies in Pemphigus Diseases: A Review of the Speculative Issue and Our Clinical-Laboratory Experience.}, journal = {Antibodies (Basel, Switzerland)}, volume = {15}, number = {2}, pages = {}, pmid = {42041392}, issn = {2073-4468}, abstract = {Background: Pemphigus diseases are rare autoimmune blistering disorders mediated by pathogenic autoantibodies directed mainly against desmoglein 1 and desmoglein 3. Although most cases are considered idiopathic, external triggers that can disrupt immune tolerance have been described. Vaccination has been discussed as a potential precipitating factor in autoimmune skin diseases. However, the relationship between vaccination and the induction of pemphigus-related autoantibodies has not been comprehensively summarized. Methods: We conducted a narrative review of all available studies published in the last 25 years identified through medical databases, excluding studies on COVID-19 vaccinations. Reports describing either new-onset pemphigus or exacerbation of preexisting pemphigus with a temporal association to vaccination were included. Clinical characteristics, vaccine type, latency period, direct immunofluorescence findings, and ELISA results for desmoglein autoantibodies were analyzed. In addition, we present our own clinical-laboratory experience illustrating this issue. Results: The current evidence consists predominantly of case reports and small case series. Published cases describe pemphigus vulgaris and pemphigus foliaceus occurring after vaccinations against influenza, hepatitis B, tetanus, diphtheria, pertussis, rabies, and other routinely administered immunizations. The latency period most often ranged from several days to a few weeks. Immunopathological findings were consistent with classical pemphigus diseases, including intercellular IgG deposits in the epidermis and circulating autoantibodies against desmoglein 1 and/or desmoglein 3. Our patient was a 78-year-old woman who developed cutaneous form of pemphigus vulgaris, diagnosed with direct immunofluorescence (DIF) and multiplex ELISA, 10 days after diphtheria-tetanus-pertussis vaccination. The patient had a positive family history of autoimmune blistering disease, namely mucous membrane pemphigoid. Conclusions: Based on the currently available evidence, a direct causal relationship between vaccination and pemphigus diseases cannot be established. Nevertheless, accumulated clinical and serological observations suggest that vaccination may act as a triggering factor in genetically or immunologically predisposed individuals, possibly by amplifying pre-existing subclinical autoreactive immune responses. Further population-based and mechanistic studies are required to clarify this association, while the overall benefits of vaccination remain substantial.}, }
@article {pmid42041609, year = {2026}, author = {Breaux, AM and Miller, GR and Cooper, HD and Bembenick, KN and Reddy, A and Ahmadzadeh, S and Shekoohi, S and Kaye, AD}, title = {Critical Care Sedation: Emerging Clinical Considerations and Risks of Volatile Anesthetics for Sedation: A Narrative Review.}, journal = {Diseases (Basel, Switzerland)}, volume = {14}, number = {4}, pages = {}, pmid = {42041609}, issn = {2079-9721}, abstract = {Volatile anesthetics have steadily become more popular in intensive care units for sedation for reasons related to their beneficial pharmacokinetic and pharmacodynamic properties. Common anesthetics such as isoflurane and sevoflurane rapidly reach sedative levels in the body, but they are also rapidly eliminated, allowing for quick recovery. These agents have minimal impact on the liver and kidneys, which makes them attractive options when compared to other agents including opioids, benzodiazepines, ketamine, and propofol. Use of delivery systems like AnaConDa[®] (Anaesthetic Conserving Device; Sedana Medical AB, Danderyd, Sweden) has enabled providers to easily use these agents in the Intensive Care Unit (ICU). In this regard, they have recently provided additional beneficial consideration during intravenous drug shortages seen during the COVID-19 pandemic and at other times. These agents have shown organ-protective effects in the kidneys and lungs, which may even reduce the total time spent in the ICU. Pharmacodynamically, these anesthetics mediate their effects through central nervous system ion channels to exert analgesic and anxiolytic actions, thereby minimizing effects in the kidneys and lungs. These agents are primarily eliminated via exhalation, which makes them potential options for those with liver or kidney failure. This narrative review examines current efficacy and risks of using volatile anesthetics for sedation in the ICU setting and clinical roles for the future.}, }
@article {pmid42041712, year = {2026}, author = {Vo, AH and Libmann, M and Carson, D and Wang, K and Puri, S and Butowski, N and Winters-Stone, K}, title = {A Scoping Review of Exercise Oncology in the Primary Brain Tumor Patient-Caregiver Dyad.}, journal = {Current oncology (Toronto, Ont.)}, volume = {33}, number = {4}, pages = {}, pmid = {42041712}, issn = {1718-7729}, mesh = {Humans ; *Brain Neoplasms/therapy/psychology ; *Caregivers/psychology ; *Exercise Therapy/methods ; Quality of Life ; Exercise ; }, abstract = {BACKGROUND: Primary malignant brain tumors (PBT) impose substantial burdens on patients and caregivers. Caregivers are essential in the delivery of outpatient care for patients with PBT but experience high levels of fatigue, distress, and health decline. Although exercise is known to improve outcomes in cancer patients, interventions tailored specifically to the PBT patient-caregiver dyad remain limited. Dyadic intervention, as well as exercise oncology, are emerging areas of active research in neuro-oncology. This scoping review incorporates both principles to evaluate the existing literature on exercise interventions on primary brain tumor patient-caregiver dyads.
METHODS: We conducted a comprehensive search of MEDLINE (PubMed), Embase, CINAHL (EBSCO), Rehabilitation & Sports Medicine (EBSCO), and Cochrane Central (Ovid) in December 2025 for studies involving exercise interventions that included adult PBT patients and caregivers.
RESULTS: Of the 1126 records screened, eight studies were included: four yoga-based interventions (three feasibility trials and one ongoing multicenter RCT), one pilot ski-based intervention, and three aerobic and resistance training-based interventions (two qualitative and one ongoing trial). The interventions were safe and feasible, with high adherence and retention. The preliminary reported benefits included improvements in fatigue, sleep, quality of life, and caregiver distress for the dyads. Videoconference delivery was effective, particularly during the COVID-19 pandemic. The eight included studies comprised 5-67 dyads, with four being single-arm feasibility studies.
CONCLUSIONS: Current literature on dyadic exercise intervention in neuro-oncology consists primarily of small-scale feasibility and pilot studies. Initial findings have demonstrated that such interventions are safe. However, preliminary efficacy remains limited due to the risk of bias and lack of statistical power. Larger randomized clinical trials with objective endpoints are needed to define efficacy and guide evidence-based protocols.}, }
@article {pmid42041941, year = {2026}, author = {Ramos-Nino, ME}, title = {Triple Latency as a Driver of Chronic Inflammation: An Integrative View of HSV, EBV, and CMV Persistence in Immunocompetent Hosts.}, journal = {Clinics and practice}, volume = {16}, number = {4}, pages = {}, pmid = {42041941}, issn = {2039-7275}, abstract = {Background: Herpes simplex virus (HSV), Epstein-Barr virus (EBV), and cytomegalovirus (CMV) establish lifelong latency in sensory neurons, lymphoid tissue, and myeloid-endothelial cells, respectively. A substantial proportion of adults worldwide are infected with all three viruses and may experience concurrent herpesvirus latency, yet they have largely been studied independently. This review examined whether latent and intermittently reactivating herpesviruses share overlapping inflammatory signatures and whether their combined presence contributes to chronic inflammatory burden. Methods: A narrative integrative review was conducted using MEDLINE, Embase, and Google Scholar (inception-October 2025). Evidence from thirty-one cohort studies and mechanistic investigations spanning virology, immunology, neurology, and clinical medicine was synthesized. Results: Herpesvirus reactivation rates ranged from 23% in general Intensive Care Unit (ICU) populations to 85% in severe COVID-19. Concurrent reactivation of multiple viruses occurred in 34-63% of critically ill patients and was associated with worse clinical outcomes. Notably, simultaneous CMV and EBV reactivation independently predicted mortality (adjusted hazard ratio, 3.17; 95% CI, 1.41-7.13). Across infections, overlapping inflammatory biomarkers, including IL-6, TNF-α, CRP, and PGE2, were consistently elevated, reflecting convergent activation of IFN and NF-κB signaling pathways. Mechanistic studies suggest cross-compartment immune priming, where CMV-driven T-cell exhaustion facilitates EBV reactivation, and viral cytokine signaling enhances HSV-associated neuroinflammation. Conclusions: HSV, EBV, and CMV triple latency may represent an underrecognized contributor to chronic inflammation in immunocompetent hosts. Understanding this multi-virus inflammatory network may inform mechanistic research, biomarker-guided risk stratification, and therapeutic strategies targeting convergent inflammatory pathways. Prospective interventional studies incorporating concurrent multi-virus monitoring are needed to clarify causal relationships.}, }
@article {pmid42041954, year = {2026}, author = {Liu, Y and Khatchadourian, C and Sanders, L and Eweroke, Q and Warner-McCutcheon, C and Lewis, J and Santos, J and Venketaraman, V}, title = {Systematic Review: The Impact of COVID-19 Vaccination on Myocarditis Risk and Recovery.}, journal = {Clinics and practice}, volume = {16}, number = {4}, pages = {}, pmid = {42041954}, issn = {2039-7275}, support = {R15 HL143545/HL/NHLBI NIH HHS/United States ; }, abstract = {Background: Myocarditis is an uncommon but recognized adverse event following mRNA COVID-19 vaccination, with risk varying by age, sex, dose number, and vaccine product. Clarifying the magnitude of risk, clinical course, and recovery-relative to myocarditis following SARS-CoV-2 infection-is essential for risk-benefit assessment and public health guidance. Methods: We performed a systematic PubMed and Embase search (January 2020-December 2024) and synthesized cohort, registry, and surveillance data on myocarditis incidence and outcomes following mRNA COVID-19 vaccination. Outcomes included incidence, observed-to-expected (OE) or incidence rate (IRRs) ratios, hospitalization, and short-term recovery. Study selection followed PRISMA 2020 systematic review guidelines. Results: Myocarditis following mRNA COVID-19 vaccination was identified as a rare adverse event, most commonly occurring after the second dose and in younger male individuals. Across multiple cohort and registry-based studies, cases were generally mild and self-limited, with most patients recovering without complication. In contrast, myocarditis following SARS-CoV-2 infection was consistently associated with more severe outcomes, including higher rates of hospitalization and mortality. Conclusions: Vaccine-associated myocarditis is rare, typically mild, and self-limited, with excellent short-term recovery; vaccinated individuals also exhibit lower odds of in-hospital death and intubation. In contrast, infection-associated myocarditis is more frequent and severe. Overall, the benefit-risk profile of mRNA vaccination remains strongly favorable.}, }
@article {pmid42042039, year = {2026}, author = {Chang, H and Wu, CS and Yeh, TY and Ko, WC}, title = {Tea Polyphenols in the COVID-19 Era: Mechanistic Insights and Translational Challenges.}, journal = {Current issues in molecular biology}, volume = {48}, number = {4}, pages = {}, pmid = {42042039}, issn = {1467-3045}, support = {Not applicable//Renal Care Research and Health Promotion Association, New Taipei City/ ; }, abstract = {The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has driven the global COVID-19 pandemic, imposing a tremendous burden on public health. As the virus continually evolves through rapid mutations, the pandemic has transitioned into a prolonged endemic phase. Despite the development of novel drugs and vaccines, clinical outcomes remain suboptimal for vulnerable populations, including the elderly and those with comorbidities or compromised immunity. Tea polyphenols, a class of structurally diverse and bioactive nutraceuticals, may modulate viral entry, replication, and host inflammatory pathways implicated in disease progression through pleiotropic effects on viral attachment, membrane fusion, intracellular replication, and proteolytic processing. Here, we provide an updated chemo-biological perspective on the antiviral and immunomodulatory mechanisms of tea polyphenols against SARS-CoV-2. Current evidence highlights their potential to serve as promising candidates for further mechanistic and translational investigation as adjunctive strategies and nutraceuticals for COVID-19 management. Importantly, no large-scale randomized controlled trials have yet demonstrated clinical benefit of tea polyphenols in COVID-19.}, }
@article {pmid42042775, year = {2026}, author = {Damnjanović, K and Djurov, K and Galic, M and Lisul, B and Mocanu, IV and Shukla, S and Enstone, A and Dai, L and Vrdelja, M and Batselova, H and Drăgănescu, A and Tešović, G}, title = {Vaccine Confidence and Vaccine Hesitancy in Several Countries in Southeastern Europe in Past 10 Years: A Structured Review of Published Literature.}, journal = {Vaccines}, volume = {14}, number = {4}, pages = {}, pmid = {42042775}, issn = {2076-393X}, support = {N/A//Merck Sharp & Dohme LLC/ ; }, abstract = {OBJECTIVES: Despite vaccination being the most effective way of preventing infections and vaccination rates recovering worldwide after the COVID-19 pandemic, vaccine hesitancy persists. Some factors, such as psychological and social barriers, can negatively impact views on vaccines and can contribute to vaccine hesitancy. The primary objective of this structured literature review is to investigate the available evidence relating to factors affecting vaccine hesitancy within several countries in Southeastern Europe.
METHODS: An electronic database search was conducted to identify studies assessing the public and healthcare professionals' (HCPs) attitudes towards vaccination in Southeastern Europe. These searches were supplemented with grey literature searches. Included studies were conducted in Bulgaria, Croatia, Romania, Serbia, and Slovenia between 1 January 2012 and 31 December 2022.
RESULTS: Of the 35 studies identified from the database searches, the most prominent theme observed across Romania, Croatia, and Bulgaria was low confidence in COVID-19 vaccines. Across all age groups, COVID-19 vaccine confidence in these regions was highly dependent on whether individuals thought vaccines were safe and effective, as well as their general trust in vaccines. Confidence in COVID-19 vaccines was seen as relatively high, with attitudes towards routine and elective vaccines being generally positive amongst the general public and HCPs, in Romania, Croatia, Serbia and Slovenia. However, uncertainty around the effectiveness of the vaccine still exists. In Bulgaria, trust in routine and elective vaccines remained low in the general public. Complacency and financial constraints were also identified as underlying causes of vaccine hesitancy.
CONCLUSIONS: The main cause behind vaccine hesitancy in several countries in Southeastern Europe is distrust in vaccine effectiveness and safety. These key findings can be utilised to support evidence-based decisions regarding where to focus resources to improve public and HCP perception of vaccines in Southeastern Europe.}, }
@article {pmid42042784, year = {2026}, author = {Runzer-Colmenares, FM and Cahuapaza-Gutierrez, NL and Calderon-Hernandez, CC and Umeres-Bravo, MM}, title = {Effects of Respiratory Vaccines in Older Adults with Cardiovascular Diseases: A Scoping Review.}, journal = {Vaccines}, volume = {14}, number = {4}, pages = {}, pmid = {42042784}, issn = {2076-393X}, abstract = {Background/Objectives: Vaccination against respiratory viruses-such as respiratory syncytial virus (RSV), pneumococcal disease, influenza, and COVID-19-may reduce the risk of adverse outcomes in older adults with cardiovascular disease. This study conducted a scoping review of the effects of respiratory vaccines in older adults with cardiovascular disease. Methods: We included studies evaluating adults aged ≥ 60 years with cardiovascular disease who received different types of respiratory vaccines. Eligible designs comprised clinical trials, observational cohort studies, and other relevant studies. Editorials, commentaries, and non-original publications were excluded. A comprehensive and targeted literature search was conducted in PubMed, Scopus, EMBASE, and Web of Science from database inception through January 2026. Results: A total of 25 studies were included, encompassing 1,782,787 adults aged ≥ 60 years with cardiovascular disease who received various respiratory vaccines. RSV vaccines were associated with a lower incidence of cardiorespiratory hospitalization and stroke among vaccinated individuals. Pneumococcal vaccines showed that sequential dual vaccination strategies were associated with a lower risk of cardiovascular events. Influenza vaccination was associated with improved cardiovascular outcomes, lower mortality, and reduced adverse events. COVID-19 vaccines were associated with reductions in mortality and hospitalizations. These benefits are particularly relevant in an older population with a high burden of comorbidities; therefore, complete vaccination schedules, including booster doses, should be considered a central strategy for prevention and comprehensive management in this high-risk group. Conclusions: Vaccination against respiratory viruses in older adults with cardiovascular disease demonstrates an overall favorable/acceptable profile of efficacy and safety, with reductions in mortality, hospitalizations, and cardiovascular events, without a significant increase in serious adverse events.}, }
@article {pmid42042800, year = {2026}, author = {Lopes de Abreu, AJ and Mpande, CAM and Song, Y and Nicholson, MW and Nannei, C and Friede, M}, title = {Unpacking the mRNA Supply Chain: Challenges and Opportunities for Global Health.}, journal = {Vaccines}, volume = {14}, number = {4}, pages = {}, pmid = {42042800}, issn = {2076-393X}, abstract = {The COVID-19 pandemic highlighted both the transformative potential of mRNA vaccines and the structural challenges associated with their supply chains. Unlike traditional vaccine platforms, mRNA vaccines depend on highly specialized raw materials, including plasmid DNA (pDNA), nucleotides, enzymes, and lipid nanoparticles (LNP), that are produced by a limited number of global suppliers. These dependencies, combined with platform-specific manufacturing processes and stringent cold chain requirements, introduce vulnerabilities across production, distribution, and regulatory oversight. This narrative review examines the distinctive features of mRNA vaccine supply chains and identifies key challenges and opportunities across three interconnected domains: manufacturing systems, logistics and distribution, and regulatory governance. Drawing on literature published between January 2021 and March 2026, the review synthesizes evidence on supply chain bottlenecks revealed during the COVID-19 pandemic, including upstream raw-material dependencies, limitations in manufacturing scale-up, cold chain constraints, and regulatory fragmentation. Particular attention is given to the implications of these challenges for low- and middle-income countries, where infrastructure, technical capacity, and regulatory resources may limit participation in mRNA vaccine production and deployment. The review also highlights emerging strategies to strengthen supply chain resilience, including diversification of input suppliers, development of regional manufacturing hubs, improvements in vaccine thermostability, regulatory harmonization initiatives, and the use of digital technologies for supply chain management. By integrating insights from manufacturing, logistics, and regulatory perspectives, this study contributes to a better understanding of the structural characteristics shaping mRNA vaccine supply chains and identifies priority areas for strengthening global preparedness for future health emergencies.}, }
@article {pmid42042827, year = {2026}, author = {Aljohani, M}, title = {Seasonal Influenza Vaccine Uptake, Acceptance and Willingness to Vaccinate in Post-COVID-19 Vaccine Era Among Adult High-Risk Groups in Gulf Cooperation Council Countries (GCC): A Narrative Review of the Literature.}, journal = {Vaccines}, volume = {14}, number = {4}, pages = {}, pmid = {42042827}, issn = {2076-393X}, abstract = {BACKGROUND/OBJECTIVES: Reports on seasonal influenza vaccine (SIV) coverage in Gulf Cooperation Council (GCC) countries showed lower than targeted coverage among high-risk populations both before and after the COVID-19 pandemic and subsequent COVID-19 vaccine release. This narrative review aims to synthesise SIV coverage following the introduction of COVID-19 vaccines among at-risk groups in the GCC region.
METHODS: Database searches included PubMed and Google Scholar for articles assessing SIV uptake, acceptance, hesitancy, and intention to vaccinate among adults in high-risk groups in GCC countries, with data collected after the introduction of COVID-19 vaccines.
RESULTS: SIV uptake ranged from 1.8% among pregnant women to 64.1% among dialysis patients in Saudi Arabia. Healthcare workers (HCWs) demonstrated the highest overall coverage, reaching 64.5% for annual uptake in Bahrain, with 79% of HCWs in Saudi Arabia intending to vaccinate. Prevalent barriers included low risk perception and consideration of influenza as a mild disease not necessitating SIV uptake, as well as vaccine effectiveness and safety concerns. Previous vaccination, physician advice, and policy or mandates for HCWs were identified as frequent facilitators of uptake.
CONCLUSION: Suboptimal uptake was reported among most high-risk groups in GCC countries. Health Belief Model components and physician involvement appear to have a significant impact on vaccine uptake among the intended population. More emphasis should be directed toward effective risk communication and action cues methods to enhance uptake among high-risk groups. Future research is needed to cover understudied areas like the elderly aged ≥ 65 years, cancer and other high-risk groups, in addition to further studies for GCC countries other than Saudi Arabia in the post-COVID-19 vaccine period.}, }
@article {pmid42042830, year = {2026}, author = {Bellavite, P and Di Fede, G and Mantovani, M and Zanolin, E}, title = {Autoimmune Features of Post-COVID-19 Vaccination Syndrome and Their Impacts on the Renin-Angiotensin System.}, journal = {Vaccines}, volume = {14}, number = {4}, pages = {}, pmid = {42042830}, issn = {2076-393X}, abstract = {One of the most critical aspects of post-acute COVID-19 syndrome (PACS) and post-acute COVID-19 vaccination syndrome (PACVS) is the presence of autoantibodies. These autoantibodies are directed against various receptors in the autonomic and cardiovascular systems, including those targeting proteins of the renin-angiotensin system (RAS). The RAS plays a central role in regulating vascular homeostasis, inflammation, and endothelial function. During SARS-CoV-2 infection, the interaction of the spike (S) protein with angiotensin-converting enzyme 2 (ACE2) can alter the balance of the RAS, favoring an imbalance towards the ACE/Angiotensin II/AT1R axis, known for its pro-inflammatory, pro-thrombotic, and vasoconstrictive properties. Similar pathological mechanisms also come into play in response to vaccinations that use the S protein as an antigen. Studies conducted by other groups and us on patients with PACS and PACVS have revealed the presence of autoantibodies directed against these RAS components and the mechanisms by which these antibodies can worsen the clinical situation. In particular, anti-ACE2, presumably formed by the anti-idiotype network or molecular mimicry, is correlated with PACVS symptoms in many patients. Furthermore, the presence of anti-MAS1 antibodies can reduce the efficiency of the ACE2/Angiotensin-(1-7)/MAS1 axis, which normally acts as a counter-regulator. Considering this evidence, an analysis of RAS molecules and the autoantibodies implicated in reactions to them may be useful for evaluating a state of persistent dysregulation associated with post-vaccination symptoms such as asthenia, headache, skin edema and bruising, cardiovascular alterations, and neurovegetative manifestations. Finally, we offer insights into diagnosing these multifaceted syndromes and working hypotheses to guide research into possible therapeutic approaches.}, }
@article {pmid42043214, year = {2026}, author = {Natarajan, M and Jayashankar, B and Nataraj, R}, title = {Placental Vulnerability to SARS-CoV-2: Viral Entry Pathways and Immune Activation.}, journal = {Viruses}, volume = {18}, number = {4}, pages = {}, pmid = {42043214}, issn = {1999-4915}, mesh = {Humans ; Female ; Pregnancy ; *Virus Internalization ; *Placenta/virology/immunology ; *SARS-CoV-2/physiology ; *COVID-19/immunology/virology ; *Pregnancy Complications, Infectious/immunology/virology ; Angiotensin-Converting Enzyme 2 ; Infectious Disease Transmission, Vertical ; Spike Glycoprotein, Coronavirus/metabolism ; }, abstract = {Pregnancy represents a distinct immunological and physiological state that modifies maternal susceptibility to SARS-CoV-2 and influences the clinical and biological course of COVID-19. Accumulating evidence indicates that the interaction between viral entry determinants, gestation-specific immune modulation, placental endocrine-angiogenic pathways, and systemic inflammatory responses underlies the characteristic manifestations of SARS-CoV-2 infection during pregnancy. This review consolidates current understanding of SARS-CoV-2 viral structure, receptor biology, and the gestational regulation of key entry cofactors, including ACE2, TMPRSS2, NRP1, CTSL and FURIN, within reproductive and placental tissues. The review further integrates documented mechanisms of cytokine-mediated immune dysregulation, endothelial injury, thrombo-inflammation, and steroidogenic alteration observed in affected pregnancies, and examines their contribution to placental malperfusion, preeclampsia-like presentations, fetal growth abnormalities and preterm birth. Published molecular and computational studies characterising trophoblast antiviral defenses, receptor expression patterns, and structural determinants of Spike-ACE2 affinity are synthesised to contextualise the biological basis of placental susceptibility and the rarity of confirmed transplacental transmission. Current evidence on maternal clinical outcomes, fetal and neonatal consequences, vaccination efficacy, therapeutic considerations and contemporary management guidelines is also critically reviewed. By integrating molecular, immunological, pathological and clinical insights, this article provides a comprehensive framework for understanding the interaction between SARS-CoV-2 infection and pregnancy-specific physiology, with implications for risk assessment, preventive strategies and maternal-fetal care.}, }
@article {pmid42043241, year = {2026}, author = {Tasker, S and Spiri, AM and Hartmann, K and Addie, DD and Belák, S and Bergmann, M and Egberink, H and Frymus, T and Hofmann-Lehmann, R and Marsilio, F and Pennisi, MG and Thiry, E and Truyen, U and Boucraut-Baralon, C and Möstl, K and Hosie, MJ}, title = {Update on Treatment of Feline Infectious Peritonitis: European Advisory Board on Cat Diseases (ABCD) Guidelines.}, journal = {Viruses}, volume = {18}, number = {4}, pages = {}, pmid = {42043241}, issn = {1999-4915}, mesh = {Animals ; Cats ; *Feline Infectious Peritonitis/drug therapy/diagnosis/virology ; *Antiviral Agents/therapeutic use/administration & dosage ; Adenosine Monophosphate/analogs & derivatives/therapeutic use ; Alanine/analogs & derivatives/therapeutic use ; Europe ; Coronavirus, Feline/drug effects ; Adenosine/analogs & derivatives ; Cytidine/analogs & derivatives ; Hydroxylamines ; }, abstract = {Feline infectious peritonitis (FIP) is a disease arising as a result of feline coronavirus infection. It used to be regarded a fatal disease, with euthanasia commonly recommended following diagnosis due to its very poor prognosis. The availability of effective antiviral therapies, particularly nucleoside analogues such as oral GS-441524, has fundamentally changed the outlook for cats with FIP. FIP is now a treatable and frequently curable disease. In these revised guidelines, the European Advisory Board on Cat Diseases (ABCD) presents an update on the treatment of FIP, incorporating the findings of new studies including the range of available treatments (such as GS-441524, remdesivir and molnupiravir (EIDD-2801) and its active metabolite EIDD-1931), which varies globally, as well as suggestions for monitoring and prognostic indicators. Tables are used to present easy-to-find information on antiviral and supportive treatments for cats with FIP. GS-441524 is the most extensively studied antiviral for FIP with treatment success rates often exceeding 90%. Remdesivir is primarily reserved as an injectable antiviral for severely affected cats unable to tolerate oral medication; it is usually replaced by oral medication as soon as, and when, possible. Although 84-day treatment courses have historically been used, emerging evidence suggests that shorter regimens of 42 days can be equally effective.}, }
@article {pmid42043247, year = {2026}, author = {Mahajan, S and Mahajan, S and Kaushik, N}, title = {Integrative Insights into the Immunopathogenesis and Organ-Specific Immunological Mechanisms of Long COVID: A Narrative Review.}, journal = {Viruses}, volume = {18}, number = {4}, pages = {}, pmid = {42043247}, issn = {1999-4915}, mesh = {Humans ; *COVID-19/immunology/pathology ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2/immunology ; Immunity, Innate ; Adaptive Immunity ; }, abstract = {Long COVID (LC), also referred to as post-acute sequelae of SARS-CoV-2 infection, is characterized by persistent symptoms originating 3 months following acute COVID-19, lasting for at least two months and frequently affecting individuals who initially experienced mild to moderate disease. The clinical spectrum is heterogeneous, involving respiratory, cardiovascular, neurological, renal, gastrointestinal, and endocrine systems, thereby posing substantial diagnostic and therapeutic challenges. Despite extensive investigation, the precise immunopathogenic mechanisms underlying LC remain incompletely defined. Accumulating evidence suggests that LC is driven by a multifactorial interplay of persistent viral antigen reservoirs, chronic immune activation, dysregulated innate and adaptive immune responses, autoimmunity, endothelial dysfunction, microvascular injury, and aberrant tissue repair. These systemic immune perturbations manifest variably across different organs, contributing to the diverse clinical phenotypes observed. However, mechanistic clarity is hindered by heterogeneity in study designs, limited longitudinal data, and the absence of standardized immunological profiling. This narrative review provides integrative insights into the immunopathogenesis of LC, synthesizing current evidence on systemic immune dysregulation and organ-specific immunological mechanisms. A conceptual framework is proposed to facilitate a structured understanding of this complex syndrome and to guide future research toward targeted immunomodulatory strategies.}, }
@article {pmid42043661, year = {2026}, author = {Pashapour, H and Nikfarjam, A and Ghaffari, M and Kavousi, A and Aslani, N and Karami, M}, title = {Good Practices for Managing Acute Respiratory Viral Infections at Aerial Entry Points: A Scoping Review.}, journal = {Journal of epidemiology and global health}, volume = {16}, number = {1}, pages = {}, pmid = {42043661}, issn = {2210-6014}, support = {43013183//Shahid Beheshti University of Medical Sciences/ ; }, mesh = {Humans ; *Quarantine/methods ; *Contact Tracing/methods ; *COVID-19/prevention & control/epidemiology ; *Respiratory Tract Infections/prevention & control ; Disease Outbreaks/prevention & control ; *Virus Diseases/prevention & control ; }, abstract = {BACKGROUND: Aerial entry points are critical in the international spread of infectious diseases, underscoring the need for effective management of acute respiratory viral infections (ARVIs). Recent global outbreaks, including COVID‑19, have highlighted the importance of strengthened public health measures at air borders. However, evidence on ARVI management strategies at these points remains fragmented. This scoping review mapped and synthesized existing approaches to quarantine protocols, contact‑tracing methods, and advanced or innovative technologies used at aerial entry points. METHODS: We conducted a scoping review following the Arksey and O’Malley framework, refined by Levac et al., and reported in accordance with PRISMA ScR guidelines. Scientific databases were systematically searched for English language studies published between 2003 and 2024 that described the management of ARVIs at air borders. Data from eligible studies were charted and analyzed using thematic analysis to identify and categorize quarantine approaches, contact tracing strategies, and advanced or innovative technologies applied in these settings. RESULTS: A total of 80 studies were included in the review, addressing diseases such as COVID 19, influenza, SARS, and Ebola. Most studies were conducted in high income countries and in regions of Southeast Asia and the Western Pacific. Various quarantine approaches were identified, including mandatory quarantine, risk based quarantine, and home based isolation strategies. Contact tracing methods ranged from traditional manual approaches using passenger information to technology supported systems that improved the speed of identifying exposed individuals. Several studies reported the use of advanced digital technologies such as digital health passports, geofencing monitoring systems, and electronic reporting platforms to support monitoring, compliance, and data management during public health responses at air borders. CONCLUSION: The findings highlight the diverse range of quarantine protocols, contact tracing approaches, and emerging technological tools used to manage ARVIs at air borders. Despite these developments, evidence regarding the effectiveness and long term implementation of these strategies remains limited. Further research is needed to strengthen the evidence base and support evidence informed policies for managing respiratory infectious diseases at international points of entry.}, }
@article {pmid42044369, year = {2026}, author = {Banerjee, P and Holly, L}, title = {Everyday Digital Technology Use and Youth Health: Scoping Review of Longitudinal Studies.}, journal = {JMIR public health and surveillance}, volume = {12}, number = {}, pages = {e85094}, pmid = {42044369}, issn = {2369-2960}, mesh = {Humans ; Adolescent ; Longitudinal Studies ; *Digital Technology/statistics & numerical data ; Digital Media ; *Adolescent Health/statistics & numerical data ; Social Media/statistics & numerical data ; Child ; Young Adult ; COVID-19/epidemiology ; Digital Health ; }, abstract = {BACKGROUND: Everyday digital technologies such as social media, gaming, and internet use are deeply integrated into the lives of children, adolescents, and young adults. While these platforms can foster connection, learning, and entertainment, concerns have grown about their potential to influence mental, physical, and social well-being. Research on this topic has expanded rapidly over the past decade, yet much of it remains cross-sectional, limiting insights into long-term outcomes. Longitudinal studies are essential to capture evolving patterns of digital engagement, identify causal relationships, and guide effective policies and interventions that support youth in navigating digital environments. In particular, evidence is needed to distinguish between beneficial and harmful forms of digital engagement, such as social connection versus problematic use, and to understand how these impacts differ across diverse populations and contexts. The COVID-19 pandemic further accelerated young people's technology use, underscoring the urgency of examining both risks and opportunities. This review, therefore, synthesizes longitudinal research to map trends, identify knowledge gaps, and inform future directions.
OBJECTIVE: The study aimed to systematically identify and map longitudinal studies examining associations between everyday digital technology use (eg, social media, gaming, and internet use) and the health and well-being of youth (25 years or younger) and to chart the types of evidence available by technology category, outcomes, and geographical setting in order to highlight key gaps for future research.
METHODS: A systematic search of PubMed, Embase, and PsycArticles (2014-2024) was conducted and reported in accordance with PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). Data extraction covered demographics, digital technology categories, and health outcomes. Studies were grouped into 6 key themes: social media use and mental health, digital addiction and behavioral outcomes, physical activity and digital technology, digital health technologies and cognitive development, parental influence and digital technology, and digital well-being and risk behaviors.
RESULTS: Of the 456 studies identified, 267 were longitudinal studies relevant to our research aims. Internet use (n=201 studies), social media (n=140 studies), and gaming (n=83 studies) dominated the themes. Mental health was the most frequently assessed outcome, with a focus on anxiety and depression. Geographically, 15% (40/267) of studies originated from low- and middle-income countries, with the majority from high-income settings such as the United States (n=76 studies) and Australia (n=15 studies). Nearly half (131/267, 49%) were published post 2020, reflecting heightened interest during the COVID-19 pandemic.
CONCLUSIONS: Longitudinal evidence on everyday digital technology use and youth health is growing but remains concentrated in mental health outcomes and high-income settings, with notable gaps in physical health, educational outcomes, and equity-focused research. These findings highlight the need for more diverse, methodologically robust longitudinal studies to inform context-sensitive policies and interventions that balance the risks and benefits of digital engagement for young people.}, }
@article {pmid42044651, year = {2026}, author = {Agyemang, C and Tetteh, J and Mbaye, MN and Lamptey, R and Seidu, S and Khunti, K and Kengne, AP}, title = {Burden and determinants of diabetes in sub-Saharan Africa.}, journal = {The lancet. Diabetes & endocrinology}, volume = {14}, number = {6}, pages = {498-511}, doi = {10.1016/S2213-8587(26)00065-3}, pmid = {42044651}, issn = {2213-8595}, mesh = {Humans ; Africa South of the Sahara/epidemiology ; *Diabetes Mellitus, Type 2/epidemiology/etiology ; Prevalence ; *Cost of Illness ; COVID-19/epidemiology ; Sub-Saharan African People ; }, abstract = {The prevalence of type 2 diabetes is rising rapidly across sub-Saharan Africa; however, its epidemiology, clinical phenotypes, and underlying mechanisms remain insufficiently characterised. This first paper in a Series on diabetes in sub-Saharan Africa synthesises current evidence on the burden, distribution, and determinants of diabetes, including emerging phenotypes and the roles of early life adversity, psychosocial stress, and interactions with infectious disease. We also identify major gaps in surveillance systems, research capacity, prevention, and clinical management across the region. Sub-Saharan Africa is experiencing one of the fastest global increases in diabetes, with the highest proportion of undiagnosed cases and a projected steep rise in intermediate hyperglycaemia and diabetes by 2050. Urbanisation, ageing, obesity, and lifestyle transitions are major contributors; however, a substantial proportion of type 2 diabetes occurs in lean individuals (BMI <25 kg/m[2]), particularly in rural settings, suggesting distinct metabolic and developmental pathways not captured by models derived from high-income countries. Bidirectional interactions between diabetes and malaria, tuberculosis, HIV, or COVID-19 make disease trajectories complex. Persistent gaps in surveillance, a reliance on modelled estimates, low genomic representation, and constrained access to modern diabetes medications hinder progress. Strengthening health system capacity, improving data infrastructure, and investing in regionally driven research are essential to develop effective, context-specific interventions and advance precision medicine tailored to sub-Saharan African populations.}, }
@article {pmid42045685, year = {2026}, author = {Mehdizadeh, M and Zhang, FW and Yu, LC and Li, JH and Posso, AN and Mustoe, AK and Escobar-Domingo, MJ and Foppiani, J and Karinja, S and Lee, BT}, title = {Telemedicine in Plastic Surgery: A Systematic Review and Meta-analysis of Utilization and Outcomes Pre- and Post-pandemic.}, journal = {Aesthetic plastic surgery}, volume = {}, number = {}, pages = {}, pmid = {42045685}, issn = {1432-5241}, abstract = {BACKGROUND: Telemedicine revolutionized healthcare post-COVID-19 by expanding virtual care across consultations, post-operative care, and inter-physician collaboration. However, its impact on adoption and effectiveness in plastic surgery remains underexplored. This study systematically compares pre- and post-pandemic telemedicine in plastic surgery, focusing on outcomes, accessibility, and patient satisfaction to inform best practices.
METHODS: A systematic review was conducted using PubMed, Medline, and Web of Science, following PRISMA guidelines, for articles published through November 2024. Extracted data included author, year, country, subspecialty, pandemic classification, sample size, demographics, utilization, barriers, travel time/distance, satisfaction, complications, and appointment duration. Meta-analyses calculated pooled estimates with 95% confidence intervals. Meta-regression and Welch's t-test assessed pre- versus post-pandemic differences. Analyses were performed in R 4.4.1.
RESULTS: Of 450 identified publications, 72 met inclusion criteria, encompassing 9435 subjects (mean age: 47.99). 89.3% (95% CI 59.3-96.2%) of patients reported willingness to reuse telemedicine, and the pooled satisfaction rate was 83.9% (95% CI 79.4-88.5; p < 0.05). Meta-analysis showed significant reductions in travel time (120 min; p < 0.05) and distance (187.1 km; p < 0.05). Five studies reported a mean appointment duration of 16.07 min. Complications were rare (7.7%; 95% CI 2.9-18.6%; p < 0.05). Post-pandemic satisfaction score was lower (81.1 vs. 91.2; p = 0.0315), likely reflecting increased utilization and technological barriers. Other outcomes, including complication rates and willingness to reuse telemedicine, showed no significant difference (p > 0.05).
CONCLUSION: Telemedicine plays an evolving role in plastic surgery, reducing travel burden and maintaining safety. However, lower post-pandemic satisfaction highlights the need to improve accessibility and technology to optimize outcomes.
LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .}, }
@article {pmid42046671, year = {2026}, author = {Hudu, SA and Jimoh, AO}, title = {Operational zoonotic containment of Middle East respiratory syndrome coronavirus in Saudi Arabia: An implementation-oriented One Health genomic framework.}, journal = {Veterinary world}, volume = {19}, number = {3}, pages = {1322-1341}, pmid = {42046671}, issn = {0972-8988}, abstract = {Middle East respiratory syndrome coronavirus (MERS-CoV) remains a persistent zoonotic threat more than a decade after its first detection, with Saudi Arabia continuing to be the global epicenter of human infections and the main reservoir interface through dromedary camels. Despite ongoing surveillance, advances in molecular diagnostics, and research on vaccines and therapeutics, sporadic zoonotic spillovers and healthcare-associated outbreaks still occur, showing that current prevention strategies are still not enough. This review compiles current evidence from epidemiological studies, camel reservoir research, genomic monitoring, and public health reports published between 2012 and April 2025 to identify the key gaps preventing effective containment. Special focus is given to recent genomic discoveries, including post-2022 clade B sublineages, recombination events, and spike protein changes that might affect transmission and the effectiveness of countermeasures. Available data suggest that MERS-CoV epidemiology is driven by repeated camel-to-human transmission, followed by occasional amplification in healthcare settings rather than sustained community spread. High seroprevalence and frequent detection of viral RNA in juvenile camels, seasonal gathering in markets, and extensive animal movement networks contribute to ongoing viral circulation at the animal-human interface. Genomic studies consistently show close phylogenetic relationships between camel and human isolates, confirming recurrent zoonotic transmissions. However, fragmented surveillance systems, delayed genomic data integration, inconsistent biosecurity practices, and limited field evidence for camel vaccination pose major barriers to control. Additionally, hospital outbreaks continue to occur due to delayed diagnosis, overcrowding, and incomplete adherence to infection-prevention protocols, underscoring the need for improved clinical preparedness. Based on the integrated synthesis of epidemiological, veterinary, and genomic evidence, this review proposes an implementation-focused One Health genomic framework tailored to the Saudi context. The proposed roadmap highlights real-time connection of human and camel surveillance, expands genomic sequencing capacity, targets vaccination strategies in camels and high-risk human populations, standardizes biosecurity measures in markets and abattoirs, and strengthens infection control systems in healthcare facilities. Alignment with national governance structures and Saudi Vision 2030 offers a practical pathway for coordinated multi-sectoral action. This review concludes that MERS-CoV is unlikely to be eradicated soon, but it can be effectively managed through a genomics-enabled, operational One Health approach that combines surveillance, vaccination, clinical preparedness, and policy coordination. The model outlined here provides a scalable way to reduce zoonotic spillover risk and strengthen readiness against future coronavirus and emerging zoonotic threats.}, }
@article {pmid42046765, year = {2026}, author = {Matenga-Ikihele, A and Asafo, F and Tuesday, R and Netzler, N and Puliuvea, C and Percival, T}, title = {Pacific-Led Responses to COVID-19: Lessons for Future Pandemic Preparedness.}, journal = {Journal of the Royal Society of New Zealand}, volume = {56}, number = {2}, pages = {e70049}, pmid = {42046765}, issn = {1175-8899}, abstract = {The COVID-19 pandemic exposed deep inequities in health systems globally and in Aotearoa New Zealand, with Pacific communities experiencing a disproportionate burden of illness, economic hardship, and social disruption. Despite these challenges, Pacific communities demonstrated resilience, culturally grounded leadership, and the ability to meet community needs through collective action. This qualitative review of peer-reviewed literature, government reports, and community-led research identified five interconnected themes: (1) community partnerships; (2) Pacific-centred approaches; (3) clear and trusted communication; (4) digital inclusion and literacy skills; and (5) economic support and sustainability. From these themes, key enablers were identified, which included community leadership, trusted communication strategies, and agile local systems, alongside barriers such as underinvestment, digital exclusion, reliance on unpaid labour, and limited inclusion of Pacific leadership in early planning. The findings highlight that Pacific-led systems are not supplementary but an essential public health infrastructure. Embedding these approaches within national emergency planning, through sustainable funding, formal governance roles, and strengthened digital inclusion, offers a pathway to a more equitable, trusted, and resilient pandemic response.}, }
@article {pmid42047168, year = {2026}, author = {Uzer, F and Erendor, F and Sanlioglu, S}, title = {SARS-CoV-2 Variants and Immune Evasion: Mapping the Future of Vaccine Design.}, journal = {Reviews in medical virology}, volume = {36}, number = {3}, pages = {e70157}, pmid = {42047168}, issn = {1099-1654}, mesh = {Humans ; *Immune Evasion ; *SARS-CoV-2/immunology/genetics ; *Spike Glycoprotein, Coronavirus/immunology/genetics/chemistry ; *COVID-19/immunology/prevention & control/virology ; *COVID-19 Vaccines/immunology ; Vaccine Development ; Evolution, Molecular ; Mutation ; Animals ; }, abstract = {The evolutionary trajectory of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has progressed through several distinct phases since its zoonotic emergence, transitioning from initial human adaptation to an era of rapid antigenic drift and complex immune evasion. As of early 2026, the global landscape is dominated by highly evolved sublineages of the Omicron (B.1.1.529) variant, including the JN.1-descendent subvariants NB.1.8.1 and XFG. This review provides a comprehensive overview of the molecular mechanisms driving viral fitness, with a primary focus on the structural transformations within the spike (S) protein's receptor-binding domain (RBD), N-terminal domain (NTD), and S2 subunit. We examine the biophysical impacts of pivotal mutations, such as E484 K, K417 N, and F486P, alongside the phenomenon of convergent evolution and epistatic compensation. Furthermore, we provide an integrated analysis of current knowledge regarding the evolving dynamics of humoral and cellular immunity, exploring the challenges posed by immune imprinting and the decline of neutralizing antibody titers against antigenically distant strains. A comparative discussion of SARS-CoV-2 and seasonal influenza highlights divergent evolutionary paces but converging regulatory frameworks for annual vaccine updates. Finally, the current status of next-generation vaccine platforms is evaluated, specifically mosaic nanoparticles and mucosal delivery systems, which aim to provide pan-sarbecovirus protection and interrupt transmission. These insights are integrated into a policy framework focused on annual strain selection and enhanced genomic surveillance for sustainable long-term pandemic management.}, }
@article {pmid42047233, year = {2026}, author = {Bashir, HM and Ciftci, D}, title = {Impact of COVID-19 on female reproductive health and communication post-pandemic: A scoping review.}, journal = {African journal of reproductive health}, volume = {30}, number = {8}, pages = {102-118}, doi = {10.29063/ajrh2026/v30i8.10}, pmid = {42047233}, issn = {1118-4841}, mesh = {Humans ; *COVID-19/epidemiology/psychology ; Female ; *Reproductive Health ; SARS-CoV-2 ; *Health Communication ; Pandemics ; }, abstract = {The COVID-19 pandemic significantly affected Female Reproductive Health (FRH), intensifying physiological and psychological conditions such as amenorrhea and postpartum related issues. While clinical studies have well-documented these impacts on FRH, no studies empirically tested health communication interventions, revealing a significant research gap. This scoping review bridges this gap, mapping evidence on the impact of COVID-19 on FRH and probing the untapped potential of communication strategies to mitigate these impacts. Following PRISMA-ScR guidelines, we systematically searched PubMed, PsycINFO, BMJ Global Health, and Frontiers (2021-2024) for peer-reviewed studies. The 13 included studies documented menstrual irregularities in 50-67% of women post-infection/vaccination, fertility rate declines of 18 per 100,000 women, and postpartum depression prevalence of 25.27%. Eligibility criteria included Women of reproductive age (15-49 years) affected by COVID-19's impact and implemented strategies addressing these impacts post-pandemic. We proposed integrating robust trauma-informed communication road map such as digital health literacy programs and community-led strategic initiatives.}, }
@article {pmid42047332, year = {2026}, author = {Paik, S and Um, S and Kim, IS and Park, EJ and Kim, KT and Basu, J and Oh, DC and Jo, EK}, title = {Exploiting autophagy-targeting natural compounds for potential antimicrobial actions.}, journal = {Autophagy}, volume = {}, number = {}, pages = {1-26}, doi = {10.1080/15548627.2026.2662426}, pmid = {42047332}, issn = {1554-8635}, abstract = {Natural products are biologically active compounds used for therapeutic interventions for various diseases, particularly infections. Autophagy is an intracellular catabolic pathway involving lysosomal degradation and is closely associated with immunological pathways, effectively combating bacterial, viral, fungal, and parasitic infections. Accumulating evidence suggests that autophagy activation or inhibition by natural products promotes antimicrobial responses against various pathogens. Numerous natural products can modulate autophagy through diverse signaling pathways, suggesting their potential as a host-directed therapeutic strategy that may complement conventional drug regimens or help mitigate drug resistance in various infectious diseases. However, it remains largely unclear whether these effects are mediated by direct modulation of autophagy or indirectly through associated mechanisms, including enhanced immune defense, attenuation of pathological inflammation, or crosstalk with other organelle functions. Additionally, multiple pathogens can evade host responses; thus, autophagy activation may inadvertently create favorable conditions for certain pathogens. This review discusses the current knowledge of natural products in terms of their antimicrobial actions through autophagy regulation, particularly the roles of distinct natural product classes, such as polyphenols, alkaloids, terpenoids, quinones, peptides, and macrolides in modulating autophagy for potentially contributing to control various infectious diseases. Exploring the intricate molecular interplay between natural products and autophagy in limiting infections may provide valuable insights that could inform the development of innovative host-directed antimicrobial treatments based on autophagy regulation.Abbreviations: 3-MA: 3-methyladenine; AM: alveolar macrophages; AMP: antimicrobial peptides; AMPK: 5' adenosine monophosphate-activated protein kinase; ARDS: acute respiratory distress syndrome; ART: artemisinin; ASFV: African swine fever virus; ATG: autophagy related; AZM: azithromycin; BafA1: bafilomycin A1; BECN1: beclin 1; BMDM: bone marrow-derived macrophage; BNIP3: BCL2 interacting protein 3; BNIP3L: BCL2 interacting protein 3 like; CALCOCO2/NDP52: calcium binding and coiled-coil domain 2; CAMKK2: calcium/calmodulin-dependent protein kinase kinase 2; CBD: cannabidiol; CF: cystic fibrosis; CGA: chlorogenic acid; CGAS: cyclic GMP-AMP synthase; CHUK/IKKα: component of inhibitor of nuclear factor kappa B kinase complex; CLP: cecal ligation and puncture; CLR: clarithromycin; CMA: chaperone-mediated autophagy; CoV: coronavirus; DHT: dihydrotanshinone I; EGCG: epigallocatechin-3-gallate; EIF2A: eukaryotic translation initiation factor 2A; EIF2AK2: eukaryotic translation initiation factor 2 alpha kinase 2; ESKAPE: Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.; ESRRA: estrogen related receptor alpha; FOXO1: forkhead box O1; FUNDC1: FUN14 domain containing 1; HBV: hepatitis B virus; HCV: hepatitis C virus; HDT: host-directed therapy; HIV: human immunodeficiency virus; HMGB1: high mobility group box 1; HSV: herpes simplex virus; IAV: influenza A virus; ICT: isocryptotanshinone; IFN: interferon; IKBKB/IKKβ: inhibitor of nuclear factor kappa B kinase subunit beta; IL: interleukin; INH: isoniazid; IRF3: IFN regulatory factor 3; KEAP1: kelch like ECH associated protein 1; LAMP: lysosomal associated membrane protein; LAP: LC3-associated phagocytosis; LPS: lipopolysaccharide; MAP1LC3/LC3: microtubule associated protein 1 light chain 3; MAPK: mitogen-activated protein kinase; MDM: monocyte-derived macrophage; MDR: multidrug-resistant; MON: monotropein; Mtb: Mycobacterium tuberculosis; MTOR: mechanistic target of rapamycin kinase; mtROS: mitochondrial ROS; NET: neutrophil extracellular trap; NFE2L2/Nrf2: NFE2 like bZIP transcription factor 2; NFKB/NF-κB: nuclear factor kappa B; NLRP3: NLR family pyrin domain containing 3; NLRX1: NLR family member X1; NOTCH1: notch receptor 1; NTM: nontuberculous mycobacteria; OMS: ohmyungsamycin; PAK1: p21 (RAC1) activated kinase 1; PINK1: PTEN induced kinase 1; PKM/PKM2: pyruvate kinase M1/2; PLD: phospholipase D; PM: peritoneal macrophage; PPM1A: protein phosphatase, Mg2+/Mn2+ dependent 1A; PRKN/parkin: parkin RBR E3 ubiquitin protein ligase; PtdIns3K: phosphatidylinositol 3-kinase; PtdIns3P: phosphatidylinositol-3-phosphate; PTEN: phosphatase and tensin homolog; RB1CC1/FIP200: RB1 inducible coiled-coil 1; RELA/p65: RELA proto-oncogene, NF-kB subunit; RIF: rifampicin; ROS: reactive oxygen species; RSV: resveratrol; RUBCN/rubicon: rubicon autophagy regulator; SAR: selective autophagy receptor; SIRT: sirtuin; STING1: stimulator of interferon response cGAMP interactor 1; STX17: syntaxin 17; Tat: trans-activator of transcription; TB: tuberculosis; TBK1: TANK binding kinase 1; TFEB: transcription factor EB; TLR: toll like receptor; TNA: tanshinone IIA; TNF: tumor necrosis factor; UA: ursolic acid; ULK1/Atg1: unc-51 like autophagy activating kinase 1; UPR: unfolded protein response; UVRAG: UV radiation resistance associated; VAMP8: vesicle associated membrane protein 8; VDR: vitamin D receptor; WIPI2: WD repeat domain, phosphoinositide interacting 2; ZFYVE1/DFCP1: zinc finger FYVE-type containing 1; ZIKV: Zika virus.}, }
@article {pmid42048372, year = {2026}, author = {Braga, A and Fialho, SCAV and Martins, CAO and Duvivier, KM and Callado, GY and Araujo Júnior, E and de Rezende-Filho, J}, title = {Maternal vaccination in the immunization era: implementation, uptake, and emerging vaccines.}, journal = {Journal of perinatal medicine}, volume = {54}, number = {6}, pages = {962-973}, pmid = {42048372}, issn = {1619-3997}, mesh = {Humans ; Female ; Pregnancy ; *Vaccination/methods ; *Pregnancy Complications, Infectious/prevention & control ; *Immunization Programs ; *Vaccines ; }, abstract = {Maternal immunization has ascended as a cornerstone of contemporary strategies aimed at safeguarding pregnant women, fetuses, and children in early childhood against vaccine-preventable diseases. The profound physiological and immunological adaptations inherent to gestation heighten maternal susceptibility to infectious morbidity, while several pathogens, including influenza, pertussis, COVID-19, rubella, and respiratory syncytial virus (RSV), pose significant risks of adverse maternal, fetal, and neonatal outcomes. Although an extensive body of evidence attests to the safety and effectiveness of maternal vaccines, global uptake among pregnant people remains markedly uneven and, in many settings, critically suboptimal. A nuanced understanding of national and international immunization programs, along with their structural and sociocultural challenges, is imperative to strengthen perinatal health protection. This narrative review synthesizes evidence drawn from peer-reviewed scientific literature, global health agency publications, and official national immunization guidelines. Extracted data were complemented by analyses of the immunological landscape of pregnancy, current vaccine recommendations, established safety profiles, and maternal immunization schedules across high-, middle-, and low-income countries. Particular emphasis was placed on the vaccines most consistently recommended during pregnancy, namely influenza, Tdap, COVID-19, and RSV, as well as on contextual determinants influencing vaccine hesitancy, access barriers, and global disparities in coverage.}, }
@article {pmid42048529, year = {2026}, author = {Ventriglio, A and Torales, J and Castaldelli-Maia, JM and Caycho-Rodríguez, T and Hualparuca-Olivera, L and Bhugra, D}, title = {The past, present and future of Social Psychiatry.}, journal = {International review of psychiatry (Abingdon, England)}, volume = {38}, number = {1-3}, pages = {6-16}, doi = {10.1080/09540261.2025.2523454}, pmid = {42048529}, issn = {1369-1627}, mesh = {Humans ; *Community Psychiatry/trends/history ; *Models, Biopsychosocial ; History, 20th Century ; History, 21st Century ; *Social Determinants of Health ; COVID-19 ; *Mental Disorders/therapy ; }, abstract = {In psychiatry, tensions have often arisen between biological and social approaches, despite their interconnection. Social psychiatry has evolved alongside changing understandings of mental health and its ties to broader social and geopolitical determinants. Global factors such as economic inequality, migration, and social exclusion are increasingly recognized as key influences on mental health outcomes. Nonetheless, challenges like stigma, lack of access, and resource limitations persist. The Biopsychosocial Model remains central to social psychiatry, offering an integrated framework that considers biological, psychological, and social dimensions. This comprehensive perspective ensures that interventions target not only symptoms but also contextual factors contributing to mental illness. The future of social psychiatry will be shaped by heightened awareness of social determinants, particularly amid global crises like war or COVID-19. Consistent application of the biopsychosocial model in clinical settings is essential. Policy advocacy focused on housing, employment, and inclusive care-alongside cultural sensitivity and the use of digital tools-will be vital. Moreover, enhancing psychiatric education and fostering interdisciplinary collaboration will be key to addressing social determinants across all levels of mental health care.}, }
@article {pmid42048993, year = {2026}, author = {Amiral, J and Seghatchian, J}, title = {An in-depth synthetic wrap on the immune-hemostatic axis in human disease.}, journal = {Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis}, volume = {65}, number = {3}, pages = {104441}, doi = {10.1016/j.transci.2026.104441}, pmid = {42048993}, issn = {1473-0502}, mesh = {Humans ; *COVID-19/immunology/blood ; *Hemostasis/immunology ; *SARS-CoV-2 ; Inflammation/immunology ; Renin-Angiotensin System/immunology ; }, abstract = {Human defense systems (immunity, inflammation, hemostasis, fibrinolysis, and the renin-angiotensin-aldosterone system) have co-evolved to provide multilayered protection against infections, trauma, malignancies, and metabolic disturbances. In humans, these systems reach exceptional regulatory sophistication and are coordinated through integrated immunological and hemostatic mechanisms forming the frontline of defense. While highly efficient under physiological conditions, these networks can become dysregulated when challenged by overwhelming pathological stimuli. The COVID-19 pandemic exemplified these vulnerabilities, revealing profound inter-individual variability in immune activation that shaped susceptibility, disease progression, and outcomes. Similar variability extends to autoimmune disorders, cancer, and neurodegenerative diseases, where immunity and hemostasis govern detection, response, and chronicity. Artificial-intelligence models now propose an "immunological age," reflecting cumulative immune behavior and predictive disease risk. Nevertheless, pathologies may escape immune-hemostatic control and become refractory to therapy, leading to severe complications or fatal outcomes, as emphasized previously. This review synthesizes current understanding of the molecular, cellular, and systemic interplays linking immunity, inflammation, hemostasis, fibrinolysis, and RAAS. We highlight how these interdependent pathways shape disease expression across infections, autoimmunity, sepsis, malignancy, and cardiometabolic syndromes. In addition, we examine emerging laboratory biomarkers, such as NETs, Annexin A1, micro-RNAs, sACE2, and procoagulant platelets, that now provide unprecedented insights into immunothrombosis and thrombo-inflammation. By integrating mechanistic biology with diagnostic innovation, this narrative presents a unified perspective on immune-hemostatic interactions and outlines how these insights may reshape therapeutic strategies and precision medicine.}, }
@article {pmid42049130, year = {2026}, author = {de la Mota, S and Suchet, L and van Wijk, M and Stibbs, DJ and Silva Couto, P and Rafiq, QA}, title = {On the road to in vivo CAR-T success: Comparing promising viral and non-viral vectors.}, journal = {Biotechnology advances}, volume = {90}, number = {}, pages = {108907}, doi = {10.1016/j.biotechadv.2026.108907}, pmid = {42049130}, issn = {1873-1899}, mesh = {Humans ; *Immunotherapy, Adoptive/methods ; *Genetic Vectors/genetics ; *Receptors, Chimeric Antigen/genetics/immunology/therapeutic use ; Animals ; Genetic Therapy/methods ; Nanoparticles ; Gene Transfer Techniques ; Viruses/genetics ; Lentivirus/genetics ; }, abstract = {Chimeric antigen receptor (CAR)-T-cell therapies have demonstrated substantial efficacy in haematological malignancies, with multiple products approved for clinical use. However, broader application remains limited by severe toxicities, reduced efficacy toward solid tumours, and the high cost and complexity of ex vivo manufacturing. The autologous nature of most current therapies contributes to variable product quality, lengthy vein-to-vein times, and restricted patient access. In vivo CAR-T therapy has emerged as a potential solution, aiming to generate functional CAR-T-cells within the patient, with several platforms progressing into early Phase I clinical trials. This approach eliminates reliance on patient-derived starting material, reduces manufacturing failure rates, and offers the prospect of off-the-shelf availability at lower cost. Central to in vivo CAR-T development is selecting an appropriate gene delivery platform. Viral vectors, including lentiviral, adenoviral, and adeno-associated viral systems, have an established role in ex vivo CAR-T manufacturing and in vivo gene therapies. Non-viral vectors, such as lipid nanoparticles (LNP) and polyplexes, have garnered increasing attention due to their high packaging capacity, potential for redosing, and validation in large-scale production, as exemplified by mRNA-LNP vaccines against COVID-19. Recently, the in vivo CAR-T engineering toolbox has expanded with DNA-based LNP platforms capable of stably integrating CAR transgenes via transposon systems, fourth-generation T-cell-targeted lentiviral systems that minimise CAR display on vector particles and aberrant splicing, and emerging genome-editing technologies. This review compares viral and non-viral vectors for in vivo CAR-T therapy, evaluating their relative advantages and limitations in terms of safety, efficacy, scalability, analytical methods, regulatory implementation and commercial feasibility.}, }
@article {pmid42049507, year = {2026}, author = {Morello, CM and Mnatzaganian, CL and Painter, NA}, title = {Emerging and Off-Label Uses Of Glucagon-Like Peptide-1 Receptor Agonists (GLP1-RA) and Dual GIP/GLP1-RAs.}, journal = {Journal of the American Board of Family Medicine : JABFM}, volume = {39}, number = {1}, pages = {}, pmid = {42049507}, issn = {1558-7118}, mesh = {Humans ; *Glucagon-Like Peptide-1 Receptor Agonists ; *Diabetes Mellitus, Type 2/drug therapy ; *Off-Label Use ; *Obesity/drug therapy ; *Gastric Inhibitory Polypeptide/therapeutic use ; *Hypoglycemic Agents/therapeutic use ; }, abstract = {BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP1-RAs) and the glucagon-dependent insulinotropic polypeptide (GIP)/GLP1-RA are approved for type 2 diabetes (T2D) and obesity given their profound impact on glycemic weight management. Additional indications include reducing cardiovascular disease risk and progression of chronic kidney disease (CKD) in T2D as well as obstructive sleep apnea in patients with obesity. These enhanced effects are likely due to their pleiotropic effects, leading to decreased inflammation and other benefits. This review explored emerging evidence for uses of GLP1-RAs and GIP/GLP1-RA that have been researched but not yet approved. Clinicians may use this information to guide treatment decisions.
REVIEW PROCESS: PubMed and Embase literature searches were conducted using Medical Subject Heading terms. Studies referencing GLP1-RAs and GIP/GLP1-RA were included if they were published in approximately the last decade, included adults, and were either a randomized controlled trial, meta-analysis, or observational study. Of 319 articles reviewed, 27 met inclusion criteria.
EMERGING AND COMPELLING USES: Initial positive impacts have been noted for the following conditions: liver disease/liver transplant, CKD/kidney transplant, Alzheimer's disease, Parkinson's disease, substance use disorders, osteoarthritis, rheumatoid arthritis, psoriasis, COVID-19 virus, asthma, chronic obstructive pulmonary disorder, polycystic ovarian syndrome, and short bowel syndrome.
CONSIDERATIONS: Large randomized controlled trials may lead to approvals of these conditions and are encouraged. Safety and adverse effects of these medications must be assessed when initiating or modifying doses.
CONCLUSION: GLP1-RAs and GIP/GLP1-RA have demonstrated early benefits to several conditions beyond their current approved indications. Clinicians can use this information to determine treatment options for patients, particularly in those with T2D, cardiovascular disease, and/or obesity.}, }
@article {pmid42050447, year = {2026}, author = {El-Saed, A and Al-Fayez, S and AlAmeer, K and Zunitan, MA and Othman, F and Farahat, F and Fletcher, T and Okwor, T and Mahamed, H and Hurwitz, HH and Willet, V and Alshamrani, MM and Baller, A}, title = {Secondary attack rates after mpox exposure in multiple settings during the 2022-2024 pandemic: a systematic review.}, journal = {BMC infectious diseases}, volume = {26}, number = {1}, pages = {}, pmid = {42050447}, issn = {1471-2334}, mesh = {Humans ; *SARS-CoV-2/genetics ; *COVID-19/epidemiology/transmission/virology ; *Pandemics ; }, abstract = {BACKGROUND: Estimating secondary attack rates is essential for assessing the spread potential of mpox during an outbreak. The objective of the study was to assess secondary attack rates after mpox exposure in multiple settings worldwide.
METHODS: A systematic review was conducted for studies published between May 2022 and September 2024 and reporting mpox exposure data. The levels and types of exposure were defined as per the study description.
RESULTS: A total of 62 studies including 8712 mpox exposures were included. Out of 8712 exposures, 239 were associated with mpox infection (secondary attack rate of 2.74%). The rates were highest in household setting (4.02%), intermediate in congregate/community setting (2.50%), and lowest in healthcare setting (0.81%). The rates were highest in the African region (8.00%), intermediate in the European region (4.23%), and lowest in the American region (1.10%). Clade data were available in 17 (27.42%) studies; mainly clade IIb (15 studies) and to less extent clades Ia and Ib (one study each). Secondary attack rates were higher among individuals reporting sexual contact (11.35%) compared with non-sexual contact (1.34%, p < 0.001). Non-sexual contact exposures (83.17%) were more frequent (p < 0.001) than sexual contact exposures (13.66%, p < 0.001).
CONCLUSIONS: The overall mpox secondary attack rate in the published data from the 2022-2024 multi-country outbreak is relatively low (< 3%). While exposures involving non-sexual contact were more prevalent in all settings, sexual contact was responsible for the majority of secondary infections in household and congregate/community settings. The findings may guide mpox preventive and control activities in different settings.
CLINICAL TRIAL: Not applicable.}, }
@article {pmid42050591, year = {2026}, author = {Tan, E and Loveys, K and Ali, W and McKinlay, CJD and Dalziel, SR}, title = {Digital tools for recruitment and retention of participants in paediatric clinical research: a scoping review.}, journal = {Trials}, volume = {27}, number = {1}, pages = {}, pmid = {42050591}, issn = {1745-6215}, support = {19/003//Health Research Council of New Zealand/ ; 17/614//Health Research Council of New Zealand/ ; }, mesh = {Adolescent ; Child ; Child, Preschool ; Humans ; Biomedical Research/methods ; COVID-19/epidemiology ; *Digital Health ; *Digital Media ; Pandemics ; *Patient Selection ; *Pediatrics/methods ; SARS-CoV-2 ; Social Media ; *Clinical Trials as Topic ; }, abstract = {BACKGROUND: Digital tools are increasingly used to support recruitment and retention of participants in paediatric research, particularly since the COVID-19 pandemic. However, the extent of the evidence supporting this method in paediatric populations has yet to be evaluated. This scoping review aimed to review the literature on digital tools for recruitment and/or retention of participants in paediatric research, including emerging evidence following the pandemic.
METHODS: A scoping review was conducted following Joanna Briggs Institute methodology. We included peer-reviewed quantitative, qualitative, and mixed-method studies evaluating a digital tool for recruitment or retention in paediatric research in any patient population aged <13 years. Records were identified from systematic database searches with a librarian (EMBASE, MEDLINE, CINAHL), limited to English, from 2013 onwards (last search 03/07/2024), and manual searches. Records were screened and extracted independently in duplicate. The data were charted and narratively summarised.
RESULTS: Sixty-one out of 4988 records were included. Most evaluations used an observational design; only 5 (8%) involved a randomised experiment. The host studies were mostly aiming to recruit children aged 5-12 years (n = 42; 69%), with a predominantly health promotion (n = 18; 30%), developmental (n = 12; 20%), or oncology (n = 9; 15%) focus. Most studies used multi-component digital interventions for recruitment (n = 39/53; 74%) or retention (n = 17/31; 55%). Social media (n = 33/52; 62%) and websites (n = 19/53; 36%) were most commonly used for recruitment, whereas text/instant messaging (n = 17/31; 55%) and email (n = 11/31; 36%) were the most common retention strategies. The estimates of recruitment and retention rates, and reach per digital tool varied widely between studies. Strategies in underserved populations reflected those used most commonly overall. Multi-component digital strategies were found to support a high rate of retention (84.1-90.7%) during pandemic restrictions.
CONCLUSIONS: This scoping review highlights the broad array of digital tools that have been used to support recruitment and retention in studies of infants and children, including in subgroups of underserved populations and in response to the COVID-19 pandemic. Most evaluations were observational and examined multi-component digital interventions. The lack of studies with a robust analytical design in the literature signals a need for further high-quality, randomised, within-study evaluations following standardised reporting criteria.
REGISTRATION: The protocol was registered on the Open Science Framework (OSF) at https://osf.io/ybfhr/ . Registered on July 5 2024.}, }
@article {pmid42051502, year = {2026}, author = {Huang, S and Zhang, X and Luo, W and Yao, Y and Hu, J and Wang, X and Xin, H}, title = {Drugs against broad-spectrum of coronaviruses.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1728474}, pmid = {42051502}, issn = {1664-3224}, mesh = {Humans ; *Antiviral Agents/therapeutic use/pharmacology ; *SARS-CoV-2/drug effects ; *COVID-19 Drug Treatment ; Medicine, Chinese Traditional ; Animals ; Coronavirus/drug effects ; COVID-19/virology ; }, abstract = {The continuous emergence of severe acute respiratory type 2 coronavirus (SARS-CoV-2) variants (e.g., Omicron) and the threat of future emerging coronavirus pandemics highlight the urgent need for broad-spectrum antiviral strategies. While various therapeutics exist, a systematic integration of diverse treatment modalities remains lacking. This review introduces a comprehensive conceptual framework that compares and integrates four major therapeutic categories: small-molecule drugs (targeting viral enzymes), macromolecular drugs (including peptides and polymers), Traditional Chinese Medicine (TCM, focusing on holistic regulation and active ingredients), and carrier vector vaccines. Beyond traditional pharmacology, we further incorporate the emerging role of Artificial Intelligence (AI) and computational screening in accelerating the discovery of broad-spectrum inhibitors. The primary goal of this article is to: (1) critically analyze the distinct antiviral mechanisms, advantages, and limitations of each category; (2) explore synergistic combination therapies (e.g., combining antiviral drugs with immunomodulators or TCM) to overcome drug resistance; and (3) provide a strategic reference for developing "pan-coronavirus" therapeutics that are resilient against viral mutations.}, }
@article {pmid42051540, year = {2026}, author = {Jin, H and An, Y and Huang, J and Luo, T and Wu, X}, title = {Pathophysiological mechanisms of post-exertional malaise: an integrative analysis based on the metabolism-immune-neuro interaction model.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1774310}, pmid = {42051540}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/immunology/complications/metabolism ; Post-Acute COVID-19 Syndrome ; Mitochondria/metabolism ; *Fatigue Syndrome, Chronic/immunology/physiopathology/metabolism ; *SARS-CoV-2/immunology ; Neuroimmunomodulation ; Animals ; Exercise ; Reactive Oxygen Species/metabolism ; Energy Metabolism ; }, abstract = {Post-exertional malaise (PEM) is a common core symptom in various chronic debilitating conditions, such as Post COVID-19 Condition (PCC, also known as Long COVID) and Chronic Fatigue Syndrome (CFS). It is characterized by the delayed and persistent exacerbation of symptoms following even mild physical or cognitive activities. This review presents a systematic review of the pathophysiological mechanisms involved in PEM, proposing a dynamic framework of multi-system interactions that may lead to homeostatic imbalance. The etiology of PEM is multifactorial, potentially involving factors such as the persistent presence of pathogens, exposure to environmental toxins, and genetic predisposition. Collectively, these factors may establish a vulnerable baseline that heightens the body's physiological response to stressors, such as exercise, potentially triggering a pathological reaction. First, mitochondrial dysfunction and metabolic abnormalities may act as potential initiating factors in PEM, manifesting as impaired ATP synthesis, overproduction of reactive oxygen species (ROS), and the accumulation of metabolic byproducts. It is crucial to emphasize that exercise itself induces a 'toxic excitatory effect,' whereby healthy individuals enhance mitochondrial function and antioxidant defenses through physical activity. However, in individuals predisposed to PEM, due to underlying pathological conditions (e.g., sequelae of viral infections), this adaptive process is disrupted, preventing effective restoration of mitochondrial homeostasis and may initiate a potential vicious cycle of dysfunction. Second, ROS and mitochondrial DNA (mtDNA), as damage-associated molecular patterns (DAMPs), along with pathogen-associated molecular patterns (PAMPs), may activate the NLRP3 inflammasome and induce the release of pro-inflammatory cytokines such as IL-1β, IL-6, and TNF-α, potentially transforming localized metabolic stress into a systemic inflammatory response. Subsequently, peripheral inflammation may be transmitted to the central nervous system through disruption of the blood-brain barrier and vagal nerve pathways, activating glial cells and initiating neuroinflammation. This process may ultimately affect the brain's interoceptive network, particularly the insular cortex, resulting in altered perception and processing of signals related to fatigue and pain. Furthermore, mitochondrial dysfunction in neurons may contribute to central energy depletion, which may impair synaptic plasticity and induce cognitive deficits and brain fatigue. Ultimately, this review proposes that PEM may arise from a complex interplay among mitochondrial dysfunction, immune activation, and neuroinflammation, which together form a self-perpetuating loop of "energy exhaustion - inflammation amplification," potentially contributing to the chronic and multi-system nature of PEM symptoms. The integrated "metabolism-immune-neuro" interaction model presented in this article may provide a potential comprehensive framework for understanding PEM and highlights the need for a multi-target, collaborative intervention approach that may help disrupt the pathological cycle.}, }
@article {pmid42051939, year = {2026}, author = {do Nascimento, BB and Silva, BGB and de Souza, LA and Andrade, JCBN and de Sá Del Fiol, F}, title = {From Widespread Use to Loss of Effectiveness: The Consequences of Inappropriate Azithromycin Prescriptions During the COVID-19 Pandemic-A Systematic Review and Meta-Analysis.}, journal = {International journal of microbiology}, volume = {2026}, number = {}, pages = {8643896}, pmid = {42051939}, issn = {1687-918X}, abstract = {OBJECTIVES: We are aimed at evaluating whether the widespread use of azithromycin during the COVID-19 pandemic led to a significant increase in bacterial resistance compared with the prepandemic period and estimating the magnitude of this effect through a systematic review and meta-analysis.
METHODS: This systematic review followed the PRISMA 2020 guidelines and Cochrane Handbook (Page,2021). Observational studies published between 2015 and 2025 reporting azithromycin resistance before and after the COVID-19 pandemic were identified. Odds ratios (ORs) were pooled using a random-effects model. Methodological quality was assessed using the Newcastle-Ottawa scale.
RESULTS: Eight studies met the eligibility criteria and were included in the quantitative synthesis. The meta-analysis demonstrated a significant increase in azithromycin resistance in the postpandemic period, with a pooled OR of 2.71 (95% CI: 2.04-3.59). Substantial heterogeneity was observed (I [2] = 73.5%), justifying the use of a random-effects model.
CONCLUSIONS: The findings provide robust evidence that the excessive and largely empirical use of azithromycin during the COVID-19 pandemic contributed to a global rise in bacterial resistance. Strengthening antimicrobial stewardship policies is essential to preserve the clinical effectiveness of macrolides during future public health emergencies.}, }
@article {pmid42051949, year = {2026}, author = {Mugundan, UM and Saravanan, V and Rajanandh, MG}, title = {Could excessive zinc supplementation during pregnancy cause menkes disease? A hypothesis worth investigating.}, journal = {Frontiers in pediatrics}, volume = {14}, number = {}, pages = {1734361}, pmid = {42051949}, issn = {2296-2360}, abstract = {BACKGROUND: Copper is an essential micronutrient critical for fetal neurodevelopment, haematopoiesis, angiogenesis, and immune function, with maternal transfer-particularly in the third trimester-playing a key role in establishing fetal copper stores. Disruption of this process, due to genetic defects or micronutrient imbalance, can lead to significant neonatal complications.
OBJECTIVE: This review examines the potential role of excessive maternal zinc supplementation as an underrecognized environmental modifier in Menkes disease (MD), an X-linked disorder caused by mutations in the ATP7A copper transporter. We hypothesize that in fetuses with ATP7A dysfunction, elevated maternal zinc intake may further impair copper absorption and placental transfer through competitive antagonism, thereby exacerbating fetal copper deficiency and influencing disease severity or onset.
EVIDENCE: Limited clinical data in pregnant women demonstrate that zinc supplementation can reduce maternal and fetal copper levels, supported by consistent findings from animal models and case reports indicating disrupted copper homeostasis. However, no large-scale or disease-specific studies have evaluated this interaction in relation to Menkes disease or neonatal outcomes.
CONCLUSION: Given the widespread use of zinc supplementation, particularly during the COVID-19 era, its impact on fetal copper status in genetically susceptible populations warrants urgent investigation. Targeted retrospective analyses and well-designed prospective studies are needed to validate this hypothesis. A re-evaluation of prenatal micronutrient strategies with emphasis on trace element balance may improve risk stratification and optimize maternal-fetal health outcomes.}, }
@article {pmid42052276, year = {2026}, author = {Han, S and Qin, T and Feng, Z}, title = {Artificial intelligence and synthetic biology in traditional Chinese medicine: revolutionizing public health applications.}, journal = {Frontiers in plant science}, volume = {17}, number = {}, pages = {1789960}, pmid = {42052276}, issn = {1664-462X}, abstract = {Traditional Chinese Medicine (TCM) has played a vital role in public health throughout history, particularly evidenced during the COVID-19 pandemic, where it demonstrated both accessibility and clinical efficacy. However, TCM faces critical challenges, including unsustainable medicinal resources, ambiguous multi-target mechanisms, and a lack of standardized clinical evaluation systems. Addressing these issues requires interdisciplinary integration, particularly between synthetic biology and artificial intelligence (AI). Synthetic biology offers solutions to resource scarcity and production standardization by enabling the sustainable biosynthesis of active compounds. Meanwhile, AI enhances TCM research through bioinformatics-driven compound prediction, machine learning-assisted quality control, and network pharmacology-based mechanism elucidation. AI also improves diagnostic reproducibility, aligning with synthetic biology's precision-driven framework. Together, these technologies facilitate the transformation of TCM from an experience-based practice into a standardized, evidence-based public health intervention. This review highlights the synergistic potential of AI and synthetic biology in overcoming TCM's modernization barriers. By leveraging AI for data-driven drug discovery and synthetic biology for scalable production, TCM can achieve sustainable development while retaining its therapeutic value. Future efforts should focus on enhancing AI interpretability, expanding biological databases, and optimizing cross-disciplinary collaboration to fully realize this integration.}, }
@article {pmid42052932, year = {2024}, author = {Williams, TR and Bass, JE and Swain, M and Jennings, D and Wyatt, WN and Foster, S}, title = {Unpacking the stress of 2020: Black Americans cope with systemic trauma.}, journal = {Clinical psychology & psychotherapy}, volume = {31}, number = {1}, pages = {e2944}, doi = {10.1002/cpp.2944}, pmid = {42052932}, issn = {1099-0879}, support = {//American Association of University Women/ ; }, mesh = {Humans ; *Black or African American/psychology ; *COVID-19/psychology/ethnology ; United States ; *Adaptation, Psychological ; *Psychological Trauma/psychology/ethnology/therapy ; *Stress, Psychological/psychology/ethnology ; Racism/psychology ; Grief ; Posttraumatic Growth, Psychological ; }, abstract = {The year 2020 was a challenging and traumatic year for Americans, especially Black Americans. Many Black people quickly succumbed to Coronavirus Disease 2019 (COVID-19). This paper describes systemic trauma as a lens to conceptualize the effects of COVID-19, racial stress and trauma, and grief. A recount of the events during the year 2020 is reviewed. Racism towards Black people was at an all-time high. Complicated and collective grief was ever-present. As a by-product of COVID-19, economic and health disparities resurfaced to further complicate Black people's well-being. Systemic trauma is described as a comprehensive and inclusive framework that captures the intensity and depth of the trauma Black Americans experienced. We argue that culturally appropriate interventions are needed to help Black people continue to heal from the distress of 2020. Race-informed trauma treatment is a culturally appropriate intervention that facilitates healing, improves the quality of life, and fosters posttraumatic growth for Black Americans. We offer race-informed treatment as a theoretical orientation that can facilitate healing and posttraumatic growth for Black people.}, }
@article {pmid42053299, year = {2026}, author = {Darko, E and Akortia, D and Nkrumah, G and Opoku Agyapong, F and Twumasi-Ankrah, S and Owusu-Ansah, M and Glazik, R and Shaw, A and Grassly, N and Owusu-Dabo, E and Adu-Sarkodie, Y and Owusu, M}, title = {Environmental surveillance of pathogens in Africa.}, journal = {Applied and environmental microbiology}, volume = {92}, number = {5}, pages = {e0193225}, pmid = {42053299}, issn = {1098-5336}, support = {INV-INV-076273//Bill and Melinda Gates Foundation/ ; }, mesh = {Africa/epidemiology ; *Environmental Monitoring/methods ; Viruses/isolation & purification ; Bacteria/isolation & purification ; Humans ; Fungi/isolation & purification ; }, abstract = {The control of infectious diseases depends on effective diagnostics and interventions. In Africa, resource limitations hinder clinical surveillance. Environmental surveillance (ES), particularly wastewater surveillance, offers a cost-effective alternative. While globally expanding, its application in Africa remains limited. This review aimed to describe published studies in Africa that have utilized ES for the detection of infectious pathogens of public health importance in Africa. The study employed a rapid review approach to synthesize evidence on ES of infectious pathogens in Africa, following guidance from the Cochrane Rapid Reviews Methods. Articles from major databases, including Scopus, PubMed, Science Direct, and Cochrane, were screened using Catchii.org. Duplicates were removed, and data were extracted into Excel, and study quality was appraised using the AXIS tool and a modified Newcastle-Ottawa Scale. The search strategy identified 2,189 articles, of which 90 were found to be eligible. We identified 47 microbial species that have been reported across studies. These consisted of 46.8% bacteria (n = 22), 36.2% viruses (n = 17), 4.3% fungi (n = 2), and 12.7% parasites (n = 6). Among viruses identified, SARS-CoV-2 was the most common, followed by rotaviruses and polioviruses. Vibrio cholerae was mostly reported among bacterial pathogens. The most common sampling method was grab sampling (n = 85, 94.4%), while two-phase separation (n = 22, 37.3%) and filtration (n = 11, 39.3%) were the most frequently used concentration methods for viral and bacterial detection, respectively. ES of infectious pathogens in Africa remains limited. There is a need to expand this to enhance pathogen monitoring, transmission insights, and preparedness for emerging variants.}, }
@article {pmid42053373, year = {2026}, author = {Pfannschmidt, V and Röhren, F and Stollenwerk, A and Leonhardt, S}, title = {A systematic review of pandemic ventilator designs.}, journal = {Biomedizinische Technik. Biomedical engineering}, volume = {}, number = {}, pages = {}, pmid = {42053373}, issn = {1862-278X}, abstract = {This paper presents a systematic literature research and review of ventilator systems developed during the COVID-19 pandemic. Peer-reviewed journal and conference articles published through January 16th, 2025 were screened, and eligible systems were classified by actuation principle. Performance criteria were derived from Emergency Use Authorization requirements and used to generate a score-based ranking for each class. Performance was analyzed within and across classes to identify the situations in which each actuation principle is most advantageous. As an indicator of study quality, we evaluated the testing modalities reported for each device. Valve-based ventilators emerged as the most mature class in terms of ventilation functionality and testing. An emerging class of bag-based systems performed remarkably well compared with established valve- and blower-based designs. Across all three classes, the most frequent shortcomings concerned oxygen dosage of the inspired gas and the implementation of monitoring and alarm functions. Finally, we provide recommendations on development processes, testing procedures, and mitigation of supply-chain vulnerabilities that may support ventilator development in future pandemics.}, }
@article {pmid42053725, year = {2026}, author = {Ardizzone, A and Agoy, CA and Carota, G and Altruda, I and Erba, I and Del Re, M and Esposito, E and Caruso, G}, title = {Assessing the Risk of Myocarditis Post-COVID-19 Vaccination: A Systematic Review of Case Reports from 2023 to 2025.}, journal = {Cardiovascular toxicology}, volume = {26}, number = {5}, pages = {}, pmid = {42053725}, issn = {1559-0259}, mesh = {Humans ; *Myocarditis/chemically induced/therapy/diagnosis/epidemiology ; *COVID-19 Vaccines/adverse effects ; Male ; Adolescent ; Risk Factors ; Risk Assessment ; Young Adult ; Female ; *Vaccination/adverse effects ; *COVID-19/prevention & control ; Child ; Adult ; Case Reports as Topic ; Middle Aged ; }, abstract = {COVID-19 vaccines covered a crucial role in mitigating the pandemic; however, rare adverse events such as myocarditis continue to raise safety concerns. This systematic review evaluated whether the clinical profile and outcomes of COVID-19 vaccine–associated myocarditis (CVAM) have changed in the post-2022 era. Following PRISMA guidelines, case reports published between 2023 and 2025 were identified through Web of Science, Embase, and PubMed (MEDLINE). Twenty-eight articles describing 35 patients were included. CVAM predominantly affected males, with the highest frequency among adolescents aged 10–19 years, and most cases occurred after the second vaccine dose, typically within two weeks. Chest pain was the most common presenting symptom, followed by tachycardia, fever, and dyspnea. Elevated cardiac biomarkers, electrocardiographic abnormalities, and myocardial edema on cardiac magnetic resonance imaging were frequently observed, with reduced left ventricular ejection fraction in a subset of patients. Management ranged from nonsteroidal anti-inflammatory drugs and colchicine to immunosuppressive therapy and mechanical circulatory support in severe cases. Although many patients experienced clinical improvement, fatal cases were documented, and follow-up revealed persistent late gadolinium enhancement and recurrent arrhythmias in several individuals, indicating incomplete myocardial recovery. Unlike earlier reviews reporting largely mild and self-limiting disease, this 2023–2025 case series documents fatal outcomes, persistent myocardial fibrosis, and recurrent arrhythmias, suggesting that CVAM may lead to long-term cardiac sequelae in a subset of patient. These findings indicate that contemporary clinical spectrum of CVAM may be broader and more severe than previously recognized, underscoring the need for prolonged surveillance and updated management strategies.}, }
@article {pmid42054706, year = {2026}, author = {Vilaseca, A and Toledano, M and Flanagan, EP}, title = {Complexities in evaluation and management of infectious myelopathies.}, journal = {Current opinion in infectious diseases}, volume = {39}, number = {3}, pages = {227-239}, doi = {10.1097/QCO.0000000000001204}, pmid = {42054706}, issn = {1473-6527}, mesh = {Humans ; Myelitis/diagnosis/virology ; *COVID-19/complications/epidemiology ; *Spinal Cord Diseases/diagnosis/virology ; SARS-CoV-2 ; Magnetic Resonance Imaging ; Neuromuscular Diseases ; Central Nervous System Viral Diseases ; }, abstract = {PURPOSE OF REVIEW: To review recent advances in infectious myelopathies and integrate them into a practical, syndrome-based approach that supports early recognition, guides testing, and avoids pitfalls.
RECENT FINDINGS: Advances in MRI pattern recognition and pathogen-specific diagnostics have refined the evaluation of infectious myelopathies, with strategies tailored to geographic epidemiology, host susceptibility, and distinction from immune-mediated causes. During the COVID-19 pandemic, SARS-CoV-2-associated myelopathy emerged as a rare para- or postinfectious cause of myelitis. The pandemic coincided with a decline in enterovirus outbreaks and acute flaccid myelitis, which are now re-emerging, underscoring the importance of epidemiologic surveillance. Metagenomic next-generation sequencing is useful in suspected infectious myelopathy because it can identify unexpected pathogens from cerebrospinal fluid, but its imperfect sensitivity and contamination risk mean it should complement rather than replace conventional testing. Growing recognition of compartmentalized central nervous system inflammation and cerebrospinal fluid viral escape in HIV myelopathy has shifted management toward antiretroviral resistance patterns and treatment optimization. Therapeutic advances remain limited and largely pathogen-specific, although targeted approaches such as mogamulizumab for HTLV-1-associated myelopathy are promising.
SUMMARY: Recent progress in infectious myelopathies has been driven by improved pathogen detection and more tailored diagnostic strategies, although treatment advances are beginning to emerge.}, }
@article {pmid42055480, year = {2026}, author = {Lu, X and Shi, Y and Chen, L and Jiang, X and Wang, Z and Tu, Y}, title = {Recombinant human interleukin-7 for patients with infection-associated lymphopenia: a systematic review and meta-analysis.}, journal = {Respiratory medicine}, volume = {257}, number = {}, pages = {108858}, doi = {10.1016/j.rmed.2026.108858}, pmid = {42055480}, issn = {1532-3064}, mesh = {Humans ; *Interleukin-7/therapeutic use ; *Lymphopenia/drug therapy/etiology/mortality ; *COVID-19/complications/mortality ; *Sepsis/complications ; Recombinant Proteins/therapeutic use ; Lymphocyte Count ; Randomized Controlled Trials as Topic ; Length of Stay ; SARS-CoV-2 ; Intensive Care Units ; *COVID-19 Drug Treatment ; }, abstract = {PURPOSE: This study aims to evaluate the efficacy of recombinant human interleukin-7 (rhIL-7) in treating lymphopenia and related clinical outcomes in patients with infection-associated lymphopenia through a meta-analysis.
METHODS: A Literature retrieval was conducted across databases, including the Cochrane Library, Web of Science, PubMed, Embase, SinoMed, CNKI, Wanfang, and VIP from the inception until October 2025. Randomized controlled trials of rhIL-7 for the treatment of lymphopenia were screened and identified for eligibility. Primary outcomes included absolute lymphocyte counts (ALC), mortality, intensive care unit (ICU) length of stay, and incidence of secondary infections.
RESULTS: Four studies were included, covering sepsis and COVID-19. In septic patients, rhIL-7 significantly increased ALC (MD = 1.33 at 3 weeks; 95% CI [0.29, 2.38]; MD = 1.14 at 4 weeks; 95% CI [0.02, 2.25]), CD4[+] T-cell counts (MD = 0.56 at 3 weeks; 95% CI [0.08, 1.05]) and CD8[+] T-cell counts (MD = 0.40 at 2 weeks; 95% CI [0.05, 0.76]). However, rhIL-7 failed to reduce mortality (RR = 1.01; 95% CI [0.36, 2.81]) or the incidence of secondary infections (RR = 1.05; 95% CI [0.48, 2.30]) in patients with sepsis. In patients with COVID-19, rhIL-7 did not significantly increase ALC at 30 days (MD = 0.46; 95% CI [-0.15, 1.08]) or reduce mortality (RR = 0.85; 95% CI [0.55, 1.33]), but it did significantly reduce the incidence of secondary infections (RR = 0.58; 95% CI [0.46, 0.74]; p < 0.0001). A combined analysis revealed that rhIL-7 significantly increased ALC (MD = 1.15 at 3 weeks; 95% CI [0.47, 1.84]; MD = 0.80 at 4 weeks; 95% CI [0.24, 1.36]) and reduced the risk of secondary infections (RR = 0.64; 95% CI [0.50, 0.81]), but had no effect on mortality or ICU length of stay.
CONCLUSION: RhIL-7 effectively ameliorates sepsis-associated lymphopenia but does not improve prognosis. Although rhIL-7 reduces the incidence of secondary infections in COVID-19 patients, confounding factors related to the pandemic context must be taken into account.}, }
@article {pmid42055829, year = {2026}, author = {Shammout, M and Abdullah, J and Shammout, A and Williams, R and Mcmillan, K}, title = {A call for fixed standards: a decade of orthognathic surgery, biting into revision rates and metalwork removal.}, journal = {The British journal of oral & maxillofacial surgery}, volume = {64}, number = {6}, pages = {457-463}, doi = {10.1016/j.bjoms.2026.03.011}, pmid = {42055829}, issn = {1532-1940}, mesh = {Humans ; *Hardware Removal/statistics & numerical data ; *Bone Plates ; *Orthognathic Surgical Procedures/instrumentation/standards ; Retrospective Studies ; *Reoperation/statistics & numerical data ; Female ; Male ; Titanium ; Adult ; *Device Removal/statistics & numerical data ; Benchmarking ; }, abstract = {The removal rate of titanium miniplates following orthognathic surgery varies widely (3.2-27.5%) due to inconsistent study designs and mixed samples. Plate removal is not routinely conducted in the UK. A 2019-2020 meta-analysis reported a 13.4% removal rate, though regular audits are uncommon. This study evaluates whether audit of local plate removal rates against established benchmarks merits encouragement. A retrospective review was conducted of orthognathic surgery at a tertiary centre (2014-2024). Procedures included Le Fort osteotomy, bilateral sagittal split osteotomy (BSSO), bimaxillary osteotomy (BIMAX), genioplasty, and other mandibular osteotomies. All patients received two postoperative doses of dexamethasone and intravenous antibiotics. Data collected included demographics, smoking status, surgical site, re-plating, and antibiotic use. The primary outcome was return to theatre (RTT) for plate removal or replacement. Chi squared, Fisher's exact, and binomial tests were used to assess statistical significance. Over 10 years, 417 patients underwent 429 orthognathic procedures, including 12 revisions to achieve the desired skeletal and orthodontic outcome. Overall, metalwork removal/adjustment occurred in 46 cases, predominantly within the first year, with infection identified as the leading cause. The removal rate was 10.7% (46/429), consistent with the 13.4% benchmark (p = 0.12). Yearly rates generally aligned with the benchmark, except in 2021, when deviations were likely to have been influenced by COVID-19-related disruptions. Smoking (p = 1.0) and oral antibiotics on discharge (p = 0.09) were not significantly associated with plate removal rates. These findings validate the 13.4% benchmark for metalwork removal. Routine audit and inter-unit collaboration are vital for refining benchmarks and improving patient care.}, }
@article {pmid42056917, year = {2026}, author = {Bergqvist, E and Valerio-Shewmaker, M and Swartz, M and Patel, J and Padilla, L and Amavisca, XF and Gandhi, H and Messiah, SE}, title = {Association of race, ethnicity, and pediatric long COVID and MIS-C: a systematic review and meta-analysis.}, journal = {BMC infectious diseases}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12879-026-12848-z}, pmid = {42056917}, issn = {1471-2334}, abstract = {BACKGROUND: Pediatric long COVID and other post-COVID conditions, particularly in relation to racial, ethnic, and household social determinants, are not yet well understood. This study aims to synthesize evidence on racial and ethnic disparities in pediatric long COVID and related conditions like MIS-C. METHODS: A systematic review and meta-analysis were performed on studies reporting post-COVID conditions and outcomes by race and ethnicity. Studies were identified through comprehensive database searches, screened for relevance, and assessed for quality. Data on race, ethnicity, and social determinants were extracted and analyzed using random-effects models to estimate pooled odds ratios. Sensitivity analyses were performed to address potential publication bias. RESULTS: Non-Hispanic Black children had significantly higher odds of ICU admission (OR 1.89, 95% CI 1.01–3.28), MIS-C development (OR 2.37, 95% CI 1.43–3.90), and PIMS-TS (OR 16.28, 95% CI 9.24–28.70) compared to Non-Hispanic White children. Although Hispanic children showed a protective effect against severe MIS-C (OR 0.77, 95% CI 0.64–0.93), their MIS-C incidence remained higher (OR 2.70, 95% CI 1.10–6.65). Elevated risks of MIS-C death were observed for Asian/Pacific Islander (OR 6.79, 95% CI 1.2-38.52) and Alaskan Indian/Native American children (OR 4.07, 95% CI 3.4-44.53). Additionally, Asian children had increased odds of PIMS-TS (OR 6.42, 95% CI 2.70-15.27), while groups labeled as ‘Other’ were at higher odds for both PIMS-TS (OR 9.75, 95% CI 3.04–31.30) and MIS-C (OR 2.36, 95% CI 1.18–4.71). CONCLUSIONS: Significant racial and ethnic disparities in pediatric long COVID, and MIS-C outcomes emphasize the need for targeted interventions addressing social and healthcare inequities. CLINICAL TRIAL NUMBER: Not applicable.}, }
@article {pmid42057724, year = {2026}, author = {Hay, JA and Larremore, DB and Aatresh, AV and Kissler, S}, title = {Integrating viral kinetics into routine outbreak surveillance: challenges, opportunities and lessons from COVID-19.}, journal = {Philosophical transactions of the Royal Society of London. Series B, Biological sciences}, volume = {381}, number = {1949}, pages = {}, doi = {10.1098/rstb.2024.0347}, pmid = {42057724}, issn = {1471-2970}, support = {//National Science Foundation/ ; /WT_/Wellcome Trust/United Kingdom ; }, mesh = {*COVID-19/virology/epidemiology ; Humans ; *SARS-CoV-2/physiology ; Pandemics ; Kinetics ; *Betacoronavirus/physiology ; *Coronavirus Infections/epidemiology/virology ; *Pneumonia, Viral/epidemiology/virology ; }, abstract = {Viral kinetics provide crucial insights into the biology and epidemiology of infections, with direct implications for basic science, therapeutics development and policy. The COVID-19 pandemic showcased the power of viral kinetics surveillance and modelling; however, our understanding of viral kinetics has been limited to retrospective analyses, convenience samples and bespoke models. To strengthen responses to ongoing and emerging outbreaks, we argue that viral kinetics should be a core component of pathogen surveillance. Building upon insights gained during the COVID-19 pandemic, we review ways that continuous viral kinetic surveillance supports infectious disease response by informing epidemiological parameters, development and deployment of therapeutics, and adaptive policy design. To achieve this, various challenges must be addressed regarding data standards, study design and communication. We advocate for the creation of a global, living library of viral kinetics data, with associated data sharing standards, modelling toolkits and on-demand epidemiological reports. Successfully integrating viral kinetics into active disease surveillance efforts will support both active outbreak response and improve the knowledge base vital for pandemic preparedness. This article is part of the Theo Murphy meeting issue 'Evaluating anti-infective drugs'.}, }
@article {pmid42057741, year = {2026}, author = {Mtei, M and Hien Trang, TP and Navarro-Torné, A and Douglas, IJ and Schultze, A}, title = {Approaches to observational study designs and analytical options to evaluate the safety of multi-dose vaccines: a systematic review.}, journal = {Expert review of vaccines}, volume = {25}, number = {1}, pages = {2667740}, doi = {10.1080/14760584.2026.2667740}, pmid = {42057741}, issn = {1744-8395}, mesh = {Humans ; *Observational Studies as Topic/methods ; *Research Design ; *Vaccines/administration & dosage/adverse effects ; *COVID-19 Vaccines/administration & dosage/adverse effects ; *Vaccination/adverse effects/methods ; }, abstract = {INTRODUCTION: Observational studies require careful considerations when evaluating the safety of multidose vaccines. We reviewed design and analytical approaches in observational studies evaluating the safety of multidose vaccines in the post-licensure phase.
METHODS: EMBASE, MEDLINE, Web of Science, and Scopus (2018-2022) were searched for hypothesis-testing studies evaluating the safety of multidose vaccines. Key features from frequently used designs were extracted.
RESULTS: Among 123 eligible studies, cohort (46%) and self-controlled case series (SCCS)/self-controlled risk interval (SCRI) (40%) followed by case-control (12%) were the most common designs, and 15% of studies used multiple designs. Among cohort studies evaluating multiple doses, vaccination date (36%) and cohort entry with time-updated exposure status (32%) were frequent approaches used to define time zero. Twenty-eight percent of cohort studies did not report time zero; all but one evaluated COVID-19 vaccine effect on post-delivery and fertility-related outcomes. For SCCS/SCRI, 64% of studies accounted for event-dependent exposures, mainly by including pre-exposure periods (53%) and modified SCCS model (48%), while 20% employed multiple correction strategies. Among studies using multiple designs, 68% reached consistent conclusions.
CONCLUSIONS: SCCS/SCRI and cohort designs dominate multidose vaccine safety studies. Clear reporting on time zero in pregnancy and fertility-related cohort studies, and on addressing event-dependent exposures in SCCS/SCRI studies is needed, along with guidance on interpreting results from multiple designs.}, }
@article {pmid42058503, year = {2026}, author = {Dimnjaković, J and Buble, T and Brborović, O}, title = {Observational studies on the association of outpatient antidiabetic medication use and COVID-19 outcomes: are the findings more relevant to diabetes management than to COVID-19 pathology? A mini-review.}, journal = {Frontiers in clinical diabetes and healthcare}, volume = {7}, number = {}, pages = {1760695}, pmid = {42058503}, issn = {2673-6616}, abstract = {At the start of the COVID-19 pandemic, there were concerns that some antidiabetic medications might worsen outcomes, though anti-inflammatory properties suggested possible benefits. Many observational studies examined antidiabetic medications use and COVID-19 outcomes. Meta-analyses showed that insulin was linked to worse outcomes, while metformin, sodium-glucose cotransporter 2 (SGLT-2) inhibitors, and glucagon-like peptide-1 (GLP-1) agonists were associated with better outcomes. Findings on dipeptidyl peptidase-4 (DPP-4) inhibitors, pioglitazone, and sulfonylureas were mixed-showing neutral, beneficial, or negative effects. However, randomized controlled trials (RCTs) testing these medications after SARS-CoV-2 infection found no effect on COVID-19 outcomes, implying that their anti-inflammatory effects do not translate into meaningful clinical benefits during acute infection. This discrepancy prompts questioning what observational studies actually measured. Given that many studies applied robust statistical methods, their results are unlikely solely due to confounding or indication bias. We hypothesize that these studies reveal broader cardiovascular effects and illuminate diabetes management more than they inform COVID-19 pathology. Their findings align with current 2022 American Diabetes Association/European Association for the Study of Diabetes (ADA/EASD) consensus guidelines for the management of type 2 diabetes mellitus endorsing metformin, SGLT-2 inhibitors, and GLP-1 agonists as first-line therapies, recommending cautious early insulin use, and reserving DPP-4 inhibitors, sulfonylureas, and pioglitazone for selective cases. This is applicable regardless of COVID-19 status. Further research should determine whether infection-related clinical endpoints, such as mortality or hospitalization from COVID-19 or other infections, might serve as valid surrogate markers for cardiovascular outcomes.}, }
@article {pmid42058812, year = {2026}, author = {Ibrahim, Y and Qureshi, A and Jackson, M and Zovich, B and Freeland, C and Flomo, M and Alik, K and Yakubov, R and Chen, LH and Yeboah, PK and Cohen, C}, title = {Why does hepatitis B remain underprioritized? A view through lived experience.}, journal = {World journal of methodology}, volume = {16}, number = {2}, pages = {114604}, pmid = {42058812}, issn = {2222-0682}, abstract = {Nearly 259 million people are living with chronic hepatitis B globally, with just 7 million of them receiving life-saving treatment. In 2022, 83% of all viral hepatitis deaths were attributed to hepatitis B. Despite the availability of effective vaccines, diagnostics, and treatments, hepatitis B continues to be underprioritized on the global health agenda. Stigma and discrimination have been pervasive and entrenched in numerous countries, resulting in economic and social setbacks for people living with hepatitis B. Through the personal stories of several individuals living with hepatitis B worldwide, this article explores the question: Why does hepatitis B remain underprioritized? It walks through the roadblocks hindering the progress towards hepatitis B elimination efforts and draws lessons from other diseases - such as human immunodeficiency virus, coronavirus disease 2019, and Ebola, where advocacy, political commitment, and sustained funding led to meaningful progress in prevention, diagnosis, and treatment. This evidence-backed perspective is based on decades-long efforts of the Hepatitis B Foundation, collaborating with international partners to prevent new infections, documenting the lived experiences of those living with hepatitis B and supporting them, and advocating for better care and policies affecting those impacted by the disease. Beyond identifying persistent challenges to eliminating hepatitis B, the article succinctly issues a call to action for greater investment, cross-sector collaboration, integration of disease programs to improve efficiency, and inclusion of patient-reported outcomes in hepatitis B management and evaluation, to better support those living with hepatitis B.}, }
@article {pmid42059835, year = {2026}, author = {Ávila-Aguero, ML and Brenes-Chacon, H and Falleiros-Arlant, LH and Brea-Del Castillo, J and Soriano-Fallas, A and Naranjo-Zúñiga, G and Sáez-Llorens, X and Gentile, A and Lopez-Medina, E and Muñoz, FM}, title = {COVID-19 in pediatrics in Latin America: six years later.}, journal = {Expert review of vaccines}, volume = {25}, number = {1}, pages = {2667741}, doi = {10.1080/14760584.2026.2667741}, pmid = {42059835}, issn = {1744-8395}, mesh = {Humans ; *COVID-19/prevention & control/epidemiology ; Latin America/epidemiology ; *Immunization Programs ; Child ; Pandemics/prevention & control ; Vaccination Coverage ; Vaccination/statistics & numerical data ; SARS-CoV-2 ; COVID-19 Vaccines/administration & dosage ; Child Health ; Infant ; }, abstract = {INTRODUCTION: Six years later, the impact of the COVID-19 pandemic on children in Latin America remains profound. Even though they were considered less susceptible to the disease, infants have emerged as one of the most affected populations, with the pandemic exposing deep inequities and magnifying vulnerabilities. This paper is presented as a perspective from SLIPE on COVID-19, providing expert insight into the current epidemiological situation in the region.
AREAS COVERED: This review analyzes the effects of the COVID-19 pandemic on children's health and wellbeing, education, and immunization efforts. Vaccination coverage against COVID-19 in children is suboptimal, particularly among those with high-risk underlying conditions, and the disruption of routine immunization programs has led to outbreaks of vaccine preventable diseases in the region.
EXPERT OPINION: Addressing these challenges requires strengthening both COVID-19 vaccination strategies for high-risk pediatric populations and routine childhood immunization programs, along with effective communication to combat misinformation, prioritization of educational recovery, social protection, and resilient health systems. Recovery must focus on closing inequity gaps and placing children at the center of public policy to safeguard their future.}, }
@article {pmid42059914, year = {2026}, author = {Lobaina, D and Llorens, C and Eldawy, N and Kosseifi, G and Puvvala, A and Srivastav, M and Miron, E and Frishman, M and Nasr, M and Jhumkhawala, V and Jimenez, S and Etzel, M and Knecht, M and Mejia, M and Sacca, L}, title = {The Role of Telehealth in Decreasing Barriers in Accessing Primary and Specialized Care Services in U.S. Rural and Underserved Communities: A Scoping Review.}, journal = {Telemedicine journal and e-health : the official journal of the American Telemedicine Association}, volume = {}, number = {}, pages = {15305627261443159}, doi = {10.1177/15305627261443159}, pmid = {42059914}, issn = {1556-3669}, abstract = {BACKGROUND: Telehealth has emerged as a promising strategy to mitigate access barriers, particularly following rapid expansion during the COVID-19 pandemic; however, evidence on its role across care settings and populations remains fragmented. This scoping review synthesizes United States (U.S.)-based evidence on the role of telehealth in improving access to primary and specialized medical care for underserved, rural, and hard-to-reach adult populations.
METHODS: Guided by the Arksey and O'Malley framework and PRISMA-ScR guidelines, peer-reviewed studies were identified through PubMed, Embase, and the Cochrane Library. Eligible studies examined telehealth use in adult U.S. populations and reported outcomes related to health care access, social determinants of health (SDoH), or implementation strategies. Data were charted and synthesized narratively, with implementation approaches categorized using the ERIC framework.
RESULTS: Of 9,212 records identified, 242 studies met inclusion criteria. Telehealth was associated with comparable or improved access and clinical outcomes across primary care, specialty care, behavioral health, palliative care, and perioperative settings. Commonly addressed SDoH and demographic characteristics included age, race/ethnicity, socioeconomic status, insurance coverage, geography, and digital access. While telehealth reduced barriers related to transportation, travel burden, and scheduling flexibility, disparities persisted for older adults, individuals with limited English proficiency, and those with low digital literacy or broadband access. Implementation strategies most frequently involved adapting interventions to local context, iterative evaluation, and clinician support, whereas financial and infrastructure-level strategies were less commonly reported.
CONCLUSIONS: Extant literature suggests that telehealth has broad and firm support for its role in reducing access barriers and improving health outcomes across a wide range of conditions and populations. Therefore, future community-based approaches should focus on integrating telehealth into existing care delivery systems, tailoring interventions to the needs and preferences of different populations, and addressing structural barriers such as digital access, health literacy, and reimbursement to ensure sustained implementation.}, }
@article {pmid42060541, year = {2026}, author = {Sanchez Villalobos, N and van Loenen, T and Ngongalah, L and Connolly, MA and Stein, ML and Rovers, CP and Timen, A}, title = {Hybrid Care Modifications in the Delivery of Nonpandemic Care During the COVID-19 Pandemic: Scoping Review.}, journal = {Journal of medical Internet research}, volume = {28}, number = {}, pages = {e84756}, pmid = {42060541}, issn = {1438-8871}, mesh = {Humans ; COVID-19/epidemiology ; Europe/epidemiology ; Pandemics ; *Delivery of Health Care/organization & administration ; *Telemedicine/organization & administration ; Digital Health/organization & administration ; }, abstract = {BACKGROUND: The COVID-19 pandemic had an unprecedented impact on the delivery of health care, with digital interventions accelerating more than ever before. However, evidence of how hybrid care models, combining digital health interventions with in-person care, were implemented during the pandemic remains scattered. Understanding hybrid care models is imperative to build resilient health systems that can ensure access to care during crisis situations.
OBJECTIVE: The study aimed to examine the implementation of hybrid care modifications to support the delivery of nonpandemic health care services in Europe during the COVID-19 pandemic.
METHODS: A scoping review was conducted following PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Systematic searches were conducted in PubMed or MEDLINE, Embase, CINAHL, Web of Science, and PsycINFO on May 22, 2024, and updated on January 14, 2026. Studies were eligible if they included primary data on the use of digital care modifications implemented or scaled up during the COVID-19 pandemic for the delivery of nonpandemic health care services in Europe. Non-peer-reviewed publications and studies with a primary focus on mental health or pediatric care were excluded. Quality appraisal was conducted using the Mixed Methods Appraisal Tool. Descriptions of digital care modifications were inductively analyzed and used to create digital flows, combining telehealth systems, digital interventions, and care functions. Digital care modifications were categorized according to their hybrid care implementation (digital-only or hybrid). Study evaluations were extracted using the Kirkpatrick model.
RESULTS: A total of 189 studies were included for analysis. Studies covered evidence from 2020 to 2024, a total of 23 countries, and 37 health care disciplines. Hybrid care implementation was reported in over 60% (115/189) of the studies, describing various forms of digital and in-person care. Care modifications incorporating in-person and digital care components were more commonly described in specialty care contexts. A total of 68 distinct digital flows were identified, with a limited number of telehealth systems allowing substantial variety in both interventions and care functions. Prominent digital flows included the use of online platforms to support video and messaging for follow-up care. Over half of the studies did not describe any kind of evaluation.
CONCLUSIONS: This review has shown how few telehealth systems were able to support a variety of care functions in the delivery of nonpandemic care throughout the COVID-19 pandemic, underscoring their practical versatility. Integrating digital health as part of hybrid care models is essential in designing care pathways that can adapt to different contexts, including future health crises. Although a comprehensive search was conducted, the heterogeneous reporting of care modifications may have influenced the interpretation of the findings. In the future, research may expand the application of hybrid care models to innovative strategies for effective crisis management.}, }
@article {pmid42060826, year = {2026}, author = {Bawne, G and Coenen, L and Nutma, E and Middeldorp, J and Lorenowicz, MJ}, title = {When Viruses Talk through Extracellular Vesicles: a New Perspective on Sars-Cov-2-Induced Neurodegeneration.}, journal = {Journal of extracellular vesicles}, volume = {15}, number = {5}, pages = {e70272}, pmid = {42060826}, issn = {2001-3078}, mesh = {Humans ; *Extracellular Vesicles/metabolism/virology ; *COVID-19/complications/metabolism/virology ; *Neurodegenerative Diseases/virology/metabolism/etiology ; *SARS-CoV-2 ; MicroRNAs/metabolism/genetics ; Animals ; Alzheimer Disease/metabolism/virology ; }, abstract = {SARS-CoV-2 infection is linked to persistent neurological symptoms Post-Acute Sequelae SARS-CoV-2 (neuro-PASC) and elevated risk of neurodegenerative disease, but molecular events connecting acute viral injury to long-term CNS dysfunction remain unclear. Here, we advance a perspective that Extracellular Vesicles (EVs) act as active mediators bridging SARS-CoV-2 infection and neurodegenerative processes. As nanoscale messengers capable of crossing the blood-brain barrier, EVs can transmit post-viral signals and orchestrate multi-target gene regulation in recipient cells through their microRNA (EV-miRNA) cargo. Our integrative analysis suggests that EV-miRNAs dysregulated in acute COVID-19, Alzheimer's Disease (AD), and Parkinson's Disease (PD) converge on pathways governing neurovascular integrity, redox and metabolic homeostasis, and neuronal proteostasis. We propose that sustained dysregulation of these interconnected modules-driven by EV-mediated signalling-may underlie the perpetuation of neuro-PASC and accelerate neurodegeneration in susceptible individuals. Viewing EVs as mechanistic agents that both transmit and amplify pathogenic cues reframes them as actionable targets for intervention and risk stratification. This perspective calls for translational frameworks that leverage EVs to illuminate, predict, and modify the trajectory of post-viral neurodegeneration.}, }
@article {pmid42061613, year = {2026}, author = {Kaur, H and Gupta, P and Dhaliwal, M and Chakrabarti, A}, title = {Fungal infections in diabetes mellitus.}, journal = {Indian journal of medical microbiology}, volume = {61}, number = {}, pages = {101130}, doi = {10.1016/j.ijmmb.2026.101130}, pmid = {42061613}, issn = {1998-3646}, mesh = {Humans ; Antifungal Agents/therapeutic use ; *Mycoses/diagnosis/drug therapy ; *Diabetes Complications/microbiology ; *Diabetes Mellitus/microbiology/immunology ; Mucormycosis ; Risk Factors ; COVID-19 ; }, abstract = {PURPOSE: Diabetes mellitus is recognised as a global health problem and has increasingly been associated with fungal infections, as an independent risk factor. Diabetic patients are predisposed to both superficial as well as invasive fungal disease, and account for substantial morbidity and mortality. Recent pandemic of COVID-19 underlined the global problem of mucormycosis, however, the burden of fungal infections among diabetics has a much broader horizon. This review aims to summarise the spectrum of fungal infections encountered among diabetic patients, along with elucidating immunopathogenesis and clinical challenges encountered in diagnosis and management of such infections.
METHODS: We conducted a narrative review of all published literature focusing on spectrum of fungal infections, immunopathogenesis and clinical challenges encountered in diagnosis and management, among diabetic patients.
RESULTS: Diabetes mellitus facilitates the acquisition and progression of fungal infections via multiple coordinated mechanisms viz. hyperglycemia, impaired immune (innate and adaptive) response, altered microenvironment and endothelial dysfunction. These changes in the milieu contribute to pervasive clinical presentations, ranging from cutaneous and oral candidiasis to invasive fungal diseases like mucormycosis, aspergillosis and cryptococcosis. Besides predisposing to fungal infections, diabetes also serves as a prognostic factor and has been noted to worsen the outcome. Furthermore, the altered microenvironment affects the pharmacokinetics of antifungal drugs and can also reduce the efficacy of antifungal regime, further convoluting and worsening the progression of disease.
CONCLUSION: Early diagnosis and management of fungal infections is necessary to mitigate the associated morbidity and mortality among diabetic patients. A multidisciplinary approach is imperative as diabetes hampers the effectiveness of conventional antifungal regimens and facilitates antifungal resistance. Regular monitoring of glycaemic index and compliance for drugs, along with lifestyle modifications desired for optimal levels, is pre-requisite for antifungal therapy to exhibit desired action.}, }
@article {pmid42061662, year = {2026}, author = {Mahooti, M and Safaei, F and Abdolalipour, E and Ahmadbeigi, G and Shokouhi, H and Fallah, T and Zare, D}, title = {Short-chain fatty acid-producing probiotics: an effective approach for modulating gut dysbiosis and mitigating inflammatory responses.}, journal = {Microbial pathogenesis}, volume = {216}, number = {}, pages = {108520}, doi = {10.1016/j.micpath.2026.108520}, pmid = {42061662}, issn = {1096-1208}, mesh = {*Probiotics/therapeutic use ; Humans ; *Fatty Acids, Volatile/metabolism/biosynthesis ; *Inflammation/prevention & control ; *Dysbiosis/therapy/microbiology ; *Gastrointestinal Microbiome/drug effects ; Animals ; COVID-19 ; Diabetes Mellitus, Type 2 ; Neoplasms ; Obesity ; Cardiovascular Diseases ; }, abstract = {Alterations in the intestinal microbiome participate with inflammatory responses and associate with pathological outcomes, along with changing the production of myriad metabolites such as short-chain fatty acids. A growing body of evidences have indicated that different dietary components, like polyphenols, may also increase short-chain fatty acids production by gut microbiota, playing a preventative role against various diseases, such as type 2 diabetes (T2D), obesity, cardiovascular diseases (CVD), and even mitigate inflammation attributed to disorders like those observed in COVID-19 and even cancer. Some infectious illnesses alter the microbiome, resulting in a decrease in the production of fermentative products, such as short-chain fatty acids. Managing the microbiome with probiotics to compensate the changes caused by these diseases leads to improvements in the microbiome and a reduction in inflammation. This reduction may even have positive effects in managing cancer. In this review, we compile cutting-edge discoveries on probiotic-derived SCFAs, highlighting their mechanisms associated with their prophylactic and therapeutic potential and their impact across infectious and non-infectious diseases, particularly in mitigating inflammation. Therefore, this review seeks to facilitate the development, evaluation, and clinical implementation of SCFAs-based interventions in future studies, particularly in preventive and therapeutic clinical settings.}, }
@article {pmid42061834, year = {2026}, author = {Leonforte, F and Nicosia, V and Comite, P and Morlino, G and Mistretta, A}, title = {Media Exposure and Its Association With Vaccine Attitudes, Intentions, and Hesitancy: Systematic Review.}, journal = {Journal of medical Internet research}, volume = {28}, number = {}, pages = {e74280}, pmid = {42061834}, issn = {1438-8871}, mesh = {Humans ; Media Exposure ; *Vaccination Hesitancy/psychology ; *COVID-19/prevention & control ; *Intention ; Vaccination ; SARS-CoV-2 ; Female ; *Health Knowledge, Attitudes, Practice ; Adult ; COVID-19 Vaccines ; }, abstract = {BACKGROUND: Vaccine hesitancy, amplified by the COVID-19 "infodemic," has emerged as a pressing public health challenge. Communication strategies are pivotal for enhancing vaccine literacy, countering misinformation, and sustaining immunization programs.
OBJECTIVE: This systematic review evaluates the association between communication channels and vaccine hesitancy and adherence, while examining the moderating role of sociodemographic factors.
METHODS: A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-compliant search was conducted across PubMed, Scopus, and Web of Science, yielding 17,407 records screened according to predefined eligibility criteria (peer-reviewed studies with N>1000 adults assessing communication media targeting vaccine hesitancy and adherence, excluding pediatric, health care-specific, and non-English research). After full-text assessment, studies were appraised using the Modified Medical Education Research Study Quality Instrument for methodological quality and the Joanna Briggs Institute Critical Appraisal Checklist, ROBIN-I (Risk of Bias in Nonrandomized Studies of Interventions), or RoB 2.0 (Risk-of-Bias 2.0 tool for randomized trials) tools for risk of bias.
RESULTS: Thirty-six studies were included (26 cross-sectional, 4 quasi-experimental, 4 randomized controlled trials, 1 cohort, and 1 global analysis). Randomized and nonrandomized experimental studies demonstrated that tailored communication strategies delivered via radio, web platforms, and social media significantly improved vaccine acceptance. Adaptive public health campaigns achieved up to an 8% weekly increase in uptake in Madagascar (relative risk 1.08; 95% CI 1.01-1.15) and a 7.8% higher vaccination rate among Nigerian adults at first follow-up compared with controls. Digital and social media campaigns effectively reduced hesitancy and enhanced trust among hesitant pregnant women in the United States. Sociodemographic factors significantly moderated communication outcomes: a COVID-19 chatbot proved most effective among individuals with lower education and minority backgrounds, while religiosity (b=0.17; 95% CI 0.05-0.30; t810=2.80; P=.005) and cultural congruence (odds ratio 1.89; P<.01) influenced message credibility and engagement, respectively. The persuasive effect of online memes on COVID-19 vaccine intentions was not significantly influenced by gender (P=.83), age (P=.60), or political orientation (P=.44). Age-specific effects were observed, with greater responsiveness to a social media campaign among adults aged 25-34 years and reduced hesitancy among older groups. Multiple cross-sectional studies indicated higher adherence among audiences exposed to traditional media (television, radio, newspapers) and lower trust among social media users. Other studies suggested significant influences of gender, age, socioeconomic status, education level, and political orientation.
CONCLUSIONS: By synthesizing fragmented evidence, this review provides a systematic examination of the interplay between multichannel media and vaccine acceptance. It diverges from existing literature by integrating both traditional and digital media perspectives through the lens of sociodemographic moderation. This work offers a critical framework for public health interventions, advocating for rigorous longitudinal research to establish definitive causal links between communication and behavior. Consequently, these findings support a "precision" communication model, enabling the development of culturally congruent strategies tailored to specific recipient profiles to bolster vaccine adherence.
TRIAL REGISTRATION: PROSPERO CRD42025637441; https://tinyurl.com/4r9w83kw.}, }
@article {pmid42066776, year = {2026}, author = {Akil, H and Maras, PM and Turner, CA}, title = {Stress fitness: A neuroscientific approach to building emotional resilience.}, journal = {Neuron}, volume = {114}, number = {13}, pages = {2298-2314}, doi = {10.1016/j.neuron.2026.03.032}, pmid = {42066776}, issn = {1097-4199}, mesh = {Humans ; *Resilience, Psychological ; *Stress, Psychological/psychology/physiopathology ; *COVID-19/psychology ; *Emotions/physiology ; Animals ; *Anxiety Disorders/psychology ; }, abstract = {Across the globe, rates of mood and anxiety disorders have been increasing steadily, a trend accelerated by the COVID-19 pandemic. Stress triggers these disorders, precipitating initial episodes and provoking relapses. In this perspective, we argue that the stress system is not merely a threat mechanism but also an ongoing and active monitor of the environment and that resilience is not simply the lack of sensitivity to stress but an active function with an intrinsic neurobiology. Through the interplay of genetic, developmental, and experiential mechanisms, individuals evolve their own "stress-resilience algorithm" that determines their stress reactivity and the resulting adaptive or maladaptive consequences. This algorithm represents a dynamic, lifelong process that is often self-reinforcing. We underscore the importance of focusing on prevention by assessing and enhancing an individual's "stress fitness." This perspective offers a new conceptualization of the neurobiology of stress and resilience as a framework for basic and translational neuroscience research aimed at confronting the challenges of stress disorders.}, }
@article {pmid42067236, year = {2026}, author = {Tolchard, J and Le Marchand, T and Aspers, RLEG and Batta, G and Bechinger, B and Brath, U and Chasapi, SA and Čikoš, A and Ecsedi, K and Favier, A and Ferreira, ASD and Fiala, R and Georgiopoulou, PD and Gómez, JS and Jaudzems, K and Karlsson, G and Kentgens, APM and Lambregts, SFH and Morelli, F and Mulder, FAA and Natarajan, SV and Persson, C and Pierattelli, R and Pons, M and Raya, J and Redfield, C and Smrečki, V and Spyroulias, GA and Trébosc, J and Vallet, A and van Heijenoort, C and van Ingen, H and Vosegaard, T and Wirmer-Bartoschek, J and Schwalbe, H and Lesage, A and Pintacuda, G}, title = {Moving NMR infrastructures to remote access capabilities.}, journal = {Progress in nuclear magnetic resonance spectroscopy}, volume = {152-153}, number = {}, pages = {101595}, doi = {10.1016/j.pnmrs.2026.101595}, pmid = {42067236}, issn = {1873-3301}, abstract = {Traditionally, Nuclear Magnetic Resonance (NMR) infrastructures have relied on in-person access, requiring researchers to travel to centralized facilities to conduct experiments. However, recent advancements in remote access technologies, accelerated by the constraints imposed by the COVID-19 pandemic, have demonstrated the feasibility and strategic benefits of transitioning NMR operations toward remote accessibility. This review examines the key challenges and opportunities associated with remote access to NMR instrumentation, including standardized protocols for sample handling, secure authentication mechanisms, real-time instrument control, and data management. By establishing a unified framework for remote access, we aim to enhance the sustainability and accessibility of NMR facilities. Our findings highlight the necessity for collaborative efforts to develop best practices that ensure reproducibility, high-quality data acquisition, and equitable access to NMR infrastructure on a global scale.}, }
@article {pmid42067749, year = {2026}, author = {Sharma, B and Smith, R and E Pennell, C}, title = {Global Trends in Maternal Mortality and Efforts to Improve Maternal Outcomes Through Sociomedical Interventions.}, journal = {Reproductive sciences (Thousand Oaks, Calif.)}, volume = {33}, number = {5}, pages = {950-960}, pmid = {42067749}, issn = {1933-7205}, mesh = {*Maternal Mortality/trends ; Humans ; Female ; Pregnancy ; COVID-19 ; Developing Countries ; *Global Health ; }, abstract = {Maternal mortality continues to be a major global health concern that disproportionately affects low- and middle-income countries (LMICs), with the World Health Organisation (WHO) estimating a maternal death occurring every two minutes. The data-sparse LMICs employ a multitude of estimation approaches to gauge maternal mortality ratios (MMR); however, their classification of deaths and reproducibility of estimates remain open to discussion. Despite a considerable reduction of MMR levels since 2000, more recently, the MMR levels in countries including the US have resurged due to the sociomedical crises brought about by the COVID-19 pandemic. The United Nations' Sustainable Development Goal (SDG) 3.1 aims to achieve global maternal mortality ratios of less than 70 per 100,000 live births and below 140 per 100,000 live births at the national level by 2030. However, recent projections indicate it will remain unmet by a margin of a million maternal deaths. Many LMICs apply the three-delays framework of maternal deaths that requires verbal autopsy to be used in tandem with the identification of maternal deaths. The three-delays model devised in the mid-1990s allows LMICs to gear their resources towards specific intervention points. A significant portion of the existing literature has focused on the description of the magnitude of the issue and the factors precipitating maternal deaths. Innovative solutions have recently been implemented, such as repurposing military helicopters to reduce the delays in managing obstetric complications. Similarly, prospective studies are required to devise ways to address the sociomedical mechanisms underlying maternal deaths.}, }
@article {pmid42067830, year = {2026}, author = {Youssef, DM and Al-Shehabi, H and Johann, S and Kitts, J and Bauer, M and Montt-Maray, E and Bcheraoui, CE}, title = {Public health emergency response through field epidemiology training and rapid response teams - a scoping review.}, journal = {BMC public health}, volume = {26}, number = {1}, pages = {}, pmid = {42067830}, issn = {1471-2458}, mesh = {Humans ; *Epidemiology/education ; *Public Health/education ; Public Health Infrastructure ; }, abstract = {BACKGROUND: Public Health Emergency Workforce (PHEW) plays a significant role in the detection and rapid response to emerging diseases, thus helping countries manage global threats. In line with the International Health Regulations' call for strengthening national capacities, field epidemiology training programs (FETPs) and rapid response teams (RRTs) have been developed to enhance countries' preparedness and response capacities. This scoping review synthesizes the evidence on available FETPs and RRTs and on their effectiveness as well as the challenges they face.
METHODS: A scoping review was conducted using EMBASE, Ovid Medline and Scopus databases in addition to the grey literature for studies published after year 2000, in the English language. Studies were selected by two independent reviewers and data were extracted into an excel sheet. Included manuscripts were analyzed through a narrative synthesis.
RESULTS: Four thousand one hundred ten studies were identified from the three peer-reviewed databases and six articles from the grey literature. Finally, 67 studies were included in the review comprising 47 identified through our search and 20 sourced from the references. The studies on PHEW training included FETPs encompassing those with laboratory and veterinary focus, and training on rapid response. Enhancement in learning acquired, course satisfaction, application of skills in workplace and engagements in key emergency response activities were found. However, lack of funding and a standardized curriculum were still among the most common challenges facing FETPs and RRTs.
CONCLUSION: While PHEW training including FETPs and RRTs are essential for building resilience against health threats, financial challenges, lack of standardized curricula and operating procedures hinders their effectiveness. Integrating One Health and laboratory skills into FETPs are vital, as seen during the COVID-19 pandemic response. Governments should work towards increasing funding and incentivizing graduate retention. They should also collaborate with organizations such as the International Association of National Public Health Institutes (IANPHI) and the Global Field Epidemiology Partnership (GFEP) to establish standardized curricula for FETP and RRT.}, }
@article {pmid42068116, year = {2026}, author = {Peart, SR and Haj-Yahya, R and Nugent, M and Ganbold, O and Harbinson, L and Jly, C and Manley, BJ and Whitehead, CL}, title = {Preterm Birth and Perinatal Mortality During the COVID-19 Pandemic Period: A Systematic Review and Meta-Analysis.}, journal = {Journal of paediatrics and child health}, volume = {62}, number = {6}, pages = {924-935}, pmid = {42068116}, issn = {1440-1754}, mesh = {Humans ; *Premature Birth/epidemiology ; *COVID-19/epidemiology ; Pregnancy ; *Perinatal Mortality/trends ; Female ; Infant, Newborn ; Stillbirth/epidemiology ; Pandemics ; }, abstract = {BACKGROUND: Preterm birth rates may have been affected during the COVID-19 pandemic but the impact of this on perinatal morbidity is unknown.
AIM: To review the impact of the COVID-19 pandemic on rates of preterm birth and perinatal mortality.
METHODS: Medline, Embase, and online pre-prints were searched from Jan 2020 to Oct 2022. Case-control, cohort studies and reports comparing rates of preterm birth, stillbirth and neonatal death before and during the COVID-19 pandemic period were included. The pooled odds ratio (OR) for preterm birth, stillbirth and neonatal death was calculated using a random effects model. The primary outcome was the rate of preterm birth, stillbirth and neonatal death in the pre-pandemic and pandemic periods.
RESULTS: 100 studies were included. Compared with pre-pandemic periods, there was a decrease in preterm births during the pandemic period: OR 0.95 (95% CI 0.94-0.97) I [2] = 0.93, with the greatest reduction for births < 28 weeks' gestation in high-income countries: OR 0.92 (95% CI 0.88-0.96), I [2] = 0.46. There was a reduction in neonatal deaths in high-income countries: OR 0.78 (95% CI 0.64-0.95), I [2] = 0.4. In low- and middle-income countries the stillbirth rate increased during the pandemic compared with the pre-pandemic period: OR 1.18 (95% CI 1.02-1.36), I [2] = 0.86.
CONCLUSION: The COVID-19 pandemic was associated with a reduction in preterm births and neonatal deaths. Further research is needed to investigate the mechanisms underlying these findings. Stillbirth rates increased in low- and middle-income countries where access to healthcare may have been restricted and strategies to address this in future pandemics are warranted.}, }
@article {pmid42068729, year = {2026}, author = {Menin, IBF and Dias, ADC and da Rosa, MI and Colonetti, T and Grande, AJ}, title = {COVID-19 vaccine hesitancy among people with epilepsy: an updated systematic review and meta-analysis.}, journal = {Seizure}, volume = {138}, number = {}, pages = {198-211}, doi = {10.1016/j.seizure.2026.04.007}, pmid = {42068729}, issn = {1532-2688}, mesh = {Humans ; *Epilepsy/psychology ; *Vaccination Hesitancy/psychology ; *COVID-19 Vaccines ; *COVID-19/prevention & control ; Vaccination/psychology ; }, abstract = {OBJECTIVE: To systematically review and meta-analyze COVID-19 vaccine hesitancy among individuals with epilepsy.
METHODS: Following PRISMA 2020 guidelines, we searched Cochrane CENTRAL, MEDLINE, EMBASE, CINAHL, LILACS, PsycINFO databases, and grey literature through February 6, 2026. We included studies addressing COVID-19 vaccination hesitancy in adults with epilepsy, with no date or language restrictions. Two reviewers independently screened articles, extracted data, and assessed quality using the Newcastle-Ottawa Scale (NOS). Meta-analyses were conducted using random-effects models, with heterogeneity assessed using I² statistics. The certainty of evidence was evaluated using the GRADE criteria.
RESULTS: Fourteen studies comprising 4230 participants were included. Overall vaccination willingness was 51.7% (95% CI: 36.6-68.8%, I²=98%). Among unvaccinated individuals, 44.2% (95% CI: 26.6-61.8%, I²=95%) expressed willingness to be vaccinated. Well-controlled epilepsy was associated with higher vaccination rates (OR 1.91, 95% CI: 1.49-2.46, I²=0%). Conversely, frequent seizures (daily/weekly) were associated with lower vaccination likelihood (OR 0.52, 95% CI: 0.35-0.76, I²=0%). The primary reasons for vaccine hesitancy were fear of seizure worsening (23.8-88.5% across studies) and concerns about side effects (13.0-53.0%). Methodological quality was generally poor, with only one study rated as "satisfactory" using NOS criteria. GRADE assessment indicated very low certainty of evidence due to serious risk of bias, inconsistency, and imprecision.
CONCLUSIONS: COVID-19 vaccine hesitancy remains present in people with epilepsy, primarily driven by concerns about seizure exacerbation. Individuals with well-controlled epilepsy show higher vaccination acceptance. Healthcare providers should address specific concerns about seizure control while emphasizing vaccine safety data. High-quality prospective studies using validated instruments are recommended.}, }
@article {pmid42068781, year = {2026}, author = {Chang, SY and Hsieh, CY and Lee, WY and Hung, HM and Lee, HF and Hsu, HC}, title = {The career choices of nursing students after the COVID-19 pandemic: A scoping review.}, journal = {International journal of nursing studies}, volume = {180}, number = {}, pages = {105547}, doi = {10.1016/j.ijnurstu.2026.105547}, pmid = {42068781}, issn = {1873-491X}, mesh = {Humans ; *Career Choice ; *Coronavirus Infections/epidemiology ; *COVID-19/epidemiology ; Pandemics ; *Pneumonia, Viral/epidemiology ; *Students, Nursing/psychology ; }, abstract = {BACKGROUND: The COVID-19 pandemic disrupted nursing education worldwide, limiting clinical learning opportunities and increasing psychological stress. These challenges forced nursing students to make career decisions in uncertain, risky, and changing social environments.
OBJECTIVE: To explore the scope, influencing factors, and strategies related to nursing students' career choices after the pandemic.
DESIGN: A scoping review following Arksey and O'Malley's framework.
METHODS: Six databases were searched without restrictions on language or publication date. Seventeen studies involving 5167 nursing students from Asia, Europe, and the Middle East were included. Data were analyzed thematically to identify career intentions, influencing factors, and development strategies.
RESULTS: Most nursing students intended to remain in the profession, although their intentions varied by country and over time. Key positive influences included strengthened professional identity, societal recognition, and supportive learning environments. Negative influences included perceived occupational risk, inadequate compensation, and reduced clinical experience. Recommended strategies included flexible teaching approaches, enhanced clinical preparation, psychological support, and policy measures to improve working conditions and enhance professional image.
CONCLUSIONS: Despite these significant challenges, many nursing students showed resilience and a willingness to remain in nursing. Investment in education, mentorship, and workforce policy is vital to sustain the nursing workforce and strengthen healthcare resilience in the face of future crises.}, }
@article {pmid42069208, year = {2026}, author = {Singh, Y and Gupta, A and Gupta, S and Goud, P and Pandey, SN and Goyal, K and Kumbhar, PS and Singh, SK and Dua, K and Gupta, G}, title = {Pentraxin-3 as a diagnostic and prognostic biomarker in inflammatory lung diseases.}, journal = {Clinica chimica acta; international journal of clinical chemistry}, volume = {589}, number = {}, pages = {121044}, doi = {10.1016/j.cca.2026.121044}, pmid = {42069208}, issn = {1873-3492}, mesh = {Humans ; Pentraxins ; *Serum Amyloid P-Component/analysis/metabolism ; *C-Reactive Protein/analysis/metabolism ; Biomarkers/blood/analysis ; Prognosis ; COVID-19 ; SARS-CoV-2 ; *Pneumonia, Viral/diagnosis/blood ; Pandemics ; }, abstract = {Inflammatory lung diseases, including community-acquired pneumonia, acute respiratory distress syndrome (ARDS), severe viral pneumonia (including COVID-19), ventilator-associated pneumonia, and exacerbations of chronic obstructive pulmonary disease (COPD), necessitate prompt diagnostic and prognostic assessments accompanied by microbiological confirmation of the causative pathogen. Conventional biomarkers, including C-reactive protein and procalcitonin, are insufficient to distinguish between localized pulmonary and systemic inflammation. This narrative review summarizes the studies on Pentraxin-3 (PTX3), a locally synthesized, extrahepatic acute-phase protein secreted by endothelial cells, epithelial cells, and myeloid leukocytes at sites of inflammation, as a diagnostic and prognostic biomarker in the continuum of inflammatory lung diseases. Plasma PTX3 indicates systemic endothelial activation and disease severity, whereas bronchoalveolar lavage PTX3 concentrations provide compartment-specific diagnostic data, identify follow-up infections, and allow therapeutic escalation in relation to the disease phenotype. Nevertheless, clinical laboratory implementation involves matrix-specific reference levels, analytical validation containing limits of detection/quantification, precision, linearity, and interfering studies according to CLSI, commutable calibrators, and traceability hierarchies. The pre-analytical procedure is standardized, and platform-independent decision limits through harmonized assays, preparation of external quality assessment, and compatibility of acute-care turnaround times are required to implement multicenter PTX3 in routine clinical laboratory diagnostics.}, }
@article {pmid42069590, year = {2026}, author = {Yeh, CF and Ianalieva, L and Wong, HK and Wu, CC and Yang, KC}, title = {Nanomedicine-based theranostics in atherosclerotic cardiovascular diseases.}, journal = {Journal of biomedical science}, volume = {33}, number = {1}, pages = {}, pmid = {42069590}, issn = {1423-0127}, support = {111-2314-B-002-069 MY3, 112-2314-B-002-277 MY3, 112-2918-I-002-002, 112-2926-I-002-511-G (KCY)//National Science and Technology Council/ ; NHRI-EX113-11213BI (KCY)//National Health Research Institutes/ ; IBMS-CRC111-P01 (KCY), AS-TM-113-01-02 (KCY), AS-GC-110-L06 (KCY, SYC)//Academia Sinica/ ; VN112-06, VN-113-03, 112-S0307, 112-S0311, 113-S0196, 113-IF0002, 113-E0008 (KCY)//National Taiwan University Hospital/ ; 110F005-112-M2 (KCY)//National Taiwan University College of Medicine, National Taiwan University Hospital and Min-Sheng General Hospital/ ; NSCCMOH-131-41, 111C101-051, 112C101-031 (KCY)//of National Taiwan University College of Medicine and National Taiwan University Hospital/ ; 112L7849, 113L7832 (KCY)//National Taiwan University/ ; NTU ABRC TCE//NTU Advanced Biomedical Research Center, Taiwan Centers of Excellence/ ; }, mesh = {Humans ; *Theranostic Nanomedicine/methods ; *Atherosclerosis/therapy/diagnosis ; COVID-19/prevention & control ; *Nanomedicine ; Animals ; SARS-CoV-2 ; *Cardiovascular Diseases/therapy ; }, abstract = {Current treatment for atherosclerotic cardiovascular diseases (ASCVD) mainly focuses on the modification of systemic risk factors, such as hyperglycemia and hyperlipidemia. Despite significant efforts and expanse, achieving early and proper diagnosis of ASCVD to improve clinical outcomes remains challenging, and vascular-targeted therapies or genetic editing, while ideal, are still limited. The development of nanomedicine-based mRNA vaccines for SARS-CoV-2 has demonstrated the potential of nanotechnology to target previously inaccessible molecules. Precision therapies by nanomedicine targeting specific tissues/molecules hold potential for new treatment paradigms by precisely modulating disease-causing molecular pathways within diseased tissues, including dysfunctional vasculature. By leveraging insights into the pathogenic contributors of atherogenesis, researchers have optimized nanoplatforms' composition, synthesis strategies, and surface design to enhance therapeutic efficacy and enable early diagnosis. Herein, we present an updated overview of therapeutic and diagnostic strategies using nanomedicine for ASCVD, and explore future research directions and innovative approaches for nanomedicine-driven theranostics in cardiovascular care.}, }
@article {pmid42070118, year = {2026}, author = {Kusuma, NHS and Irnandi, DF and Pakpahan, C and An Nguyen, TT}, title = {Masturbation as a sexual and psychological coping strategy in long-distance relationships: a systematic review.}, journal = {The journal of sexual medicine}, volume = {23}, number = {5}, pages = {}, doi = {10.1093/jsxmed/qdag121}, pmid = {42070118}, issn = {1743-6109}, mesh = {Humans ; *Masturbation/psychology ; *Adaptation, Psychological ; Female ; Personal Satisfaction ; Male ; *Sexual Behavior/psychology ; COVID-19/psychology ; *Sexual Partners/psychology ; *Interpersonal Relations ; Coping Skills ; }, abstract = {INTRODUCTION: Long-distance relationships (LDRs) reduce opportunities for physical intimacy, often prompting individuals to seek alternative sexual activities such as masturbation. Although common, its influence on sexual satisfaction, sexual health, psychological well-being, and relational stability in LDRs remains understudied. Moreover, cultural and population differences shape diverse meanings and perspectives on masturbation.
OBJECTIVES: We employed a systematic review approach to explore the role of masturbation within long-distance relationships. Specifically, this review aims to examine how masturbation is associated with sexual, relational, and psychological outcomes and how these perspectives vary across cultural contexts.
METHODS: A systematic review was conducted following the PRISMA guidelines, compiling both quantitative and qualitative studies on masturbation as an alternative sexual activity in LDRs as well as its implications for sexual satisfaction, relationship satisfaction, and psychological well-being.
RESULTS: Fourteen studies were eligible for further analysis in which men reported higher frequencies of masturbation compared to women, with significant increases observed in the context of long-distance relationships and during COVID-19 quarantine periods. Men were mainly motivated by biological release, orgasm, and stress reduction, often with pornography, whereas women reported broader motives such as relaxation, better sleep, stress relief, and emotional closeness. The effects on sexual satisfaction were mixed: masturbation was reported to be associated with greater body awareness, self-esteem, and relational harmony, yet excessive frequency was linked to lower satisfaction and arousal. Mutual, technology-mediated practices helped maintain intimacy, while excessive solitary use undermined relationship quality. From a sexual health perspective, moderate masturbation may be associated with indirect benefits through improved body awareness, whereas frequent use was linked to poorer experiences. Psychologically, it served as a coping strategy for sleep and stress, but excessive engagement increased anxiety and reduced emotional well-being.
CONCLUSION: Masturbation appears to be a common and potentially adaptive alternative sexual activity in the context of LDRs and during the COVID-19 pandemic. However, in Eastern contexts, its meaning and impact are strongly shaped by sociocultural and religious norms.}, }
@article {pmid42070964, year = {2026}, author = {Kamel, EM and Khadrawy, SM and Allam, AA and Ahmed, NA and Aba Alkhayl, FF and Lamsabhi, AM}, title = {Targeting the Elongin BC-BC-Box Interface: Structural Insights, Peptidic Disruptors and Emerging Small-Molecule Strategies.}, journal = {Chemical biology & drug design}, volume = {107}, number = {5}, pages = {e70307}, doi = {10.1111/cbdd.70307}, pmid = {42070964}, issn = {1747-0285}, support = {IMSIU-DDRSP2601//Imam Mohammad Ibn Saud Islamic University (IMSIU)/ ; }, mesh = {Humans ; *Elongin/metabolism/chemistry/antagonists & inhibitors ; *Peptides/chemistry/pharmacology/metabolism ; *Small Molecule Libraries/chemistry/pharmacology/metabolism ; Protein Binding/drug effects ; }, abstract = {Protein-protein interactions (PPIs) that orchestrate ubiquitin-dependent signaling have long challenged drug discovery because their interfaces are typically large and hydrophobic. The heterodimeric adaptor Elongin BC (ELOB/ELOC) defies this stereotype: its BC-box-binding groove is a deep, rigid pocket that anchors dozens of cellular and viral partners to cullin-RING ligases and to transcriptional machinery. Recent structural and chemical-biology breakthroughs have converted this once "undruggable" site into a tractable target. A sub-nanomolar peptide derived from the chromatin factor EPOP has been shown to displace native BC-box proteins, trigger apoptosis in multiple cancer lines, and unveil a transcriptomic signature that converges on MYC and cell-cycle control. Parallel fragment screens and crystallography have mapped adjacent hot spots suitable for small-molecule growth, while functional genomics highlights Elongin BC as a pan-cancer dependency and an unexpected regulator of the SARS-CoV-2 co-receptor TMPRSS2. This review synthesizes the structural principles of BC-box recognition, the current state of peptide and fragment-based inhibitors, and the biological consequences of disrupting the Elongin BC hub. We discuss therapeutic prospects in oncology and virology, outline key challenges-delivery, selectivity, and resistance-and propose future directions ranging from stapled-peptide optimization to covalent fragment tethering and PROTAC strategies. Together, these advances position Elongin BC inhibition at the forefront of next-generation PPI drug discovery, offering a unified approach to modulate ubiquitin signaling, epigenetic regulation, and viral entry through a single conserved pocket.}, }
@article {pmid42071153, year = {2026}, author = {Gomes, JP}, title = {Genome Sequencing in Infectious Disease Outbreaks.}, journal = {Advances in experimental medicine and biology}, volume = {1504}, number = {}, pages = {357-371}, pmid = {42071153}, issn = {0065-2598}, mesh = {Humans ; *Disease Outbreaks ; *Whole Genome Sequencing/methods ; *Genome, Viral ; *COVID-19/epidemiology/virology/transmission ; *SARS-CoV-2/genetics/pathogenicity ; *Genome, Bacterial ; *Communicable Diseases/epidemiology/genetics/transmission ; Animals ; High-Throughput Nucleotide Sequencing/methods ; }, abstract = {Genome sequencing has become a crucial tool in the management and understanding of infectious disease outbreaks. By decoding the entire genetic material of pathogens, this technology allows scientists to track the spread and evolution of infectious agents with unprecedented precision. During an outbreak, one of the key applications of genome sequencing is in tracing the transmission pathways of the disease. By comparing the genetic sequences of pathogens from different patients and sources, epidemiologists can determine the source of the outbreak and how the disease is spreading through populations. In addition, genome sequencing has the potential to identify mutations that may affect transmissibility, virulence, or resistance to treatment, providing critical insights for public health responses, for instance enabling targeted interventions, such as specific treatments or vaccines. During the last years, this was particularly evident for multiple internationally occurring severe outbreaks caused by either bacteria or virus, with special emphasis during the COVID-19 pandemic, where genome sequencing played a vital role in monitoring the emergence of new variants and informing vaccine strategies. As sequencing technologies continue to advance and associated costs decline, their integration into public health strategies will be essential for more effective control and prevention of infectious disease outbreaks in the future.}, }
@article {pmid42072232, year = {2026}, author = {Franco, A and Angelone, F and Calderone, D and Ponsiglione, AM and Romano, M and Ricciardi, C and Amato, F}, title = {Telemedicine and 5G Technologies: A Systematic Global Review of Applications over the Past Decade.}, journal = {Bioengineering (Basel, Switzerland)}, volume = {13}, number = {4}, pages = {}, pmid = {42072232}, issn = {2306-5354}, support = {E63C22002040007//RESTART - RESearch and innovation on future Telecommunications systems and networks, to make Italy more smART/ ; }, abstract = {This systematic review analyzes how the introduction and progressive deployment of 5G networks have influenced the evolution of telemedicine between 2014 and 2024, focusing on their impact on performance, accessibility, and the feasibility of advanced clinical applications across the pre-COVID-19, COVID-19, and post-COVID-19 periods. The review was conducted in accordance with PRISMA guidelines and included publications retrieved from SCOPUS, PubMed, and Web of Science using a PICO-based search strategy. Studies were selected based on predefined inclusion and exclusion criteria, and extracted data included clinical parameters, network characteristics such as bandwidth and latency, geographic setting, and type of telemedicine service. A total of 45 studies met the inclusion criteria, with most published between 2020 and 2024. The most frequently reported applications were telediagnosis, particularly robotic ultrasound, followed by telesurgery and teleconsultation. The low latency enabled by 5G networks supported complex telesurgical procedures over distances exceeding 5000 km, while in ultra-remote areas, hybrid solutions combining 5G and fiber-optic networks were often adopted to ensure stable connections. The integration of robotic platforms and AI-based tools further enhanced the precision and reliability of remote procedures. Overall, 5G technology has significantly advanced telemedicine by enabling real-time, high-quality care over long distances, improving access to specialist services and supporting more equitable and efficient digital healthcare delivery, particularly in underserved regions.}, }
@article {pmid42074180, year = {2026}, author = {Mosteanu, IM and Parliteanu, OA and Mahler, B and Mitrea, A and Clenciu, D and Stefan, AG and Timofticiuc, DCP and Stoichita, A and Popoviciu, MS and Reurean Pintilei, DV and Rosu, MM and Radu Gheonea, TC and Vladu, BE and Boldeanu, L and Mota, E and Efrem, IC and Vladu, IM and Mota, M}, title = {Diabetes Mellitus and COVID-19 in Adults: A Systematic Review of Pathophysiological Connections, Clinical Outcomes, and Therapeutic Considerations.}, journal = {International journal of molecular sciences}, volume = {27}, number = {8}, pages = {}, pmid = {42074180}, issn = {1422-0067}, support = {NA//University of Medicine and Pharmacy of Craiova/ ; }, mesh = {Humans ; *COVID-19/complications/epidemiology/therapy/physiopathology ; SARS-CoV-2/isolation & purification ; Adult ; *Diabetes Mellitus/physiopathology ; Hyperglycemia ; *Diabetes Mellitus, Type 2/complications ; }, abstract = {The disproportionately severe disease course of diabetic patients with SARS-CoV-2 infection was repeatedly observed by clinicians during the COVID-19 pandemic. The overlap between metabolic impairment, viral pathophysiology, and chronic inflammation created a pattern that urged deeper examination. The aim of this paper was to review and synthesize evidence regarding the interaction between diabetes mellitus and COVID-19. We synthesized evidence across mechanistic pathways (immune dysregulation, chronic inflammation, ACE2/DPP-4-related signaling, endothelial dysfunction, and pancreatic involvement) and key clinical outcomes (severity, intensive care unit (ICU) admission, mortality, dysglycaemia/new-onset diabetes, and DKA). This systematic search was conducted in PubMed, Clinical Key, and Google Scholar. The eligibility criteria included papers on adults (≥18 years) with pre-existing diabetes mellitus (type 1 or type 2) or newly diagnosed diabetes/hyperglycemia and confirmed SARS-CoV-2 infection, published between January 2020 and October 2025, in English language. The PRISMA guidelines were used for data extraction. We identified 412 articles, out of which only 30 met all the inclusion criteria. Diabetes was consistently evoked as a major risk factor for severe COVID-19, being associated with higher susceptibility to pneumonia, respiratory failure, ICU admission, and mortality. The explanation lies in the impaired immune system, endothelial dysfunction, and metabolic repercussions imposed by hyperglycemia. Several antidiabetic drugs appeared protective in multiple cohorts. In conclusion, the accumulated evidence underscores the tight interplay between metabolic disease and COVID-19. Essentially, the clinical management of these patients would be a thoughtful selection of antidiabetic therapy and close metabolic monitoring.}, }
@article {pmid42074269, year = {2026}, author = {Rangel, K and Villas-Bôas, MHS and De-Simone, SG}, title = {Advances in Ozone-Based Inactivation of SARS-CoV-2: An Updated Review.}, journal = {International journal of molecular sciences}, volume = {27}, number = {8}, pages = {}, pmid = {42074269}, issn = {1422-0067}, support = {#200.960-2022//Carlos Chagas Filho Foundation for Research Support of the State of Rio de Janeiro (FAPERJ)/ ; #30515- 2020-5//Brazilian Council for Scientific Research (CNPq)/ ; }, mesh = {*Ozone/pharmacology ; Humans ; *SARS-CoV-2/drug effects ; COVID-19/prevention & control/virology ; Disinfection/methods ; *Disinfectants/pharmacology ; Pandemics/prevention & control ; *Virus Inactivation/drug effects ; *Betacoronavirus/drug effects ; }, abstract = {The onset of the COVID-19 pandemic prompted the rapid development and deployment of novel strategies and methodologies to manage the dissemination of microorganisms. Understanding the crucial role that contaminated surfaces play in the spread of viruses highlights the importance of having effective cleaning and disinfection protocols in place for inanimate objects. A variety of antimicrobial agents have shown strong effectiveness against the SARS-CoV-2 virus. Various factors can impact on the performance of these agents. As a result, technologies utilizing ozone's microbicidal effects have been developed or improved for cleaning indoor areas, surfaces, and materials, despite ozone's diverse uses being known for years. Ozone offers the advantage of adaptability for both gaseous and aqueous use, depending on the nature of the decontaminated surfaces. Moreover, ozone-infused water is ecologically benign, possesses microbial-fighting capabilities, and synergistically reinforces the biocidal action of other chemical disinfectants. This review aims to summarize the efforts dedicated to harnessing gaseous and aqueous ozone as a valuable means to eliminate the SARS-CoV-2 virus from environments, surfaces, clinical equipment, and office supplies. This review sourced evidence-based articles from electronic databases, including MEDLINE (via PubMed), EMBASE, the Cochrane Library (CENTRAL), and preprint repositories. The findings illustrated that ozone could serve as an additional tool for curbing the proliferation of COVID-19 and other viral infections. Additionally, we elucidated the operational attributes of ozone, the variables that influence its disinfection potency, and the mechanisms of its virucidal action. Notably, this review does not encompass the disinfection of the COVID-19 virus in wastewater.}, }
@article {pmid42074690, year = {2026}, author = {Lucaciu, FC and Wellmann, N and Mihai, AM and Sima, A and Rosca, O and Suba, MI and Tarau, A and Bosoanca, A and Marc, M}, title = {Post-COVID Respiratory Sequelae in COPD: Mucus Plugging, Infectious Complications, and Risk-Stratified Follow-Up.}, journal = {Journal of clinical medicine}, volume = {15}, number = {8}, pages = {}, pmid = {42074690}, issn = {2077-0383}, abstract = {Context/Objectives: In patients with COPD (chronic obstructive pulmonary disease), SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection represents an overlap of viral injury on a lung already affected by pathological mucus, altered mucociliary clearance, chronic inflammation, and impaired antiviral immunity. Methods: A focused narrative review (2020-2025) was conducted using clinical, experimental, and consensus evidence. The evidence was synthesized qualitatively, with priority given to cohort studies, meta-analyses, and mechanism-focused studies with clinical relevance. Results: Mucus obstruction ("mucus plugs") is frequent in COPD (41-67%) and is associated with unfavorable outcomes. COPD also increases the risk of post-COVID respiratory sequelae. Bacterial coinfection at presentation is uncommon (3-5%), whereas secondary bacterial infections are more frequent (14-18%), especially in severe disease requiring intensive care, where VA-LRTI/VAP (ventilator-associated lower respiratory tract infection/ventilator-associated pneumonia) become predominant. Sepsis, whether viral or mixed, reflects disease severity and may contribute to functional decline and susceptibility to reinfections; however, the concept of a post-acute "sepsis legacy" in COPD after COVID-19 should currently be regarded as a clinically plausible but still emerging hypothesis rather than an established COPD-specific outcome. During recovery, acute exacerbation risk rises to 5.6% versus 3.9%, peaking in the first 30 days after severe disease (aHR ≈ 8.14). Persistent dyspnea and reduced DLCO (diffusing capacity for carbon monoxide) suggest ARDS-related injury, tissue remodeling, and microvascular dysfunction. Conclusions: In COPD, post-COVID respiratory sequelae result from the interaction of mucus, immunity, and infectious/sepsis-related complications. The first post-discharge month is a critical period requiring careful risk stratification and targeted follow-up.}, }
@article {pmid42075512, year = {2026}, author = {Alexandru, GC and Gligor, LN and Chioran, D and Roi, CI and Riviș, M and Pricop, MO and Urîtu, A and Pacnejer, AM and Manea, HC and Olariu, TR}, title = {Post-COVID-19 Jaw Osteonecrosis: A Narrative Review.}, journal = {Medicina (Kaunas, Lithuania)}, volume = {62}, number = {4}, pages = {}, pmid = {42075512}, issn = {1648-9144}, mesh = {Humans ; *COVID-19/complications ; *Osteonecrosis/etiology/therapy ; Risk Factors ; *Jaw Diseases/etiology/therapy ; SARS-CoV-2 ; Mucormycosis/complications ; Bisphosphonate-Associated Osteonecrosis of the Jaw ; }, abstract = {Background and Objectives: Osteonecrosis of the jaw (ONJ) occurring after infection with SARS-CoV-2 has emerged as an increasingly reported complication in the post-COVID-19 era. Post-COVID-19 osteonecrosis of the jaw (PC-ONJ) has been described in association with both COVID-19-associated mucormycosis (CAM) and non-fungal phenotypes. This narrative review aims to synthesize and critically analyze the available evidence regarding terminology and classification, epidemiology and risk factors, pathophysiological mechanisms, clinical and imaging characteristics, diagnostic challenges, and management strategies relevant to oral and maxillofacial surgery practice. Materials and Methods: An extensive literature search was conducted in the PubMed/MEDLINE, Scopus, Web of Science, ScienceDirect, and Google Scholar databases. The search targeted peer-reviewed publications published between 2020 and 2025, reflecting the post-pandemic emergence of this clinical spectrum. Original studies, systematic and narrative reviews, multicenter case series, consensus guidelines, and well-documented case reports were considered. Results: Available data, largely derived from case reports and small series, demonstrate a predominance of maxillary involvement and frequent association with diabetes mellitus and systemic corticosteroid therapy. Proposed mechanisms include COVID-19-associated endothelial dysfunction, microvascular thrombosis, immune dysregulation, metabolic imbalance, and treatment-related effects. Clinically, patients may present with persistent orofacial pain, tooth mobility, exposed or probeable bone, and frequent sinonasal extension, with symptoms sometimes preceding bone exposure. Diagnostic challenges arise from the overlap with medication-related osteonecrosis of the jaw (MRONJ), osteoradionecrosis (ORN), and chronic osteomyelitis. Imaging is essential for assessing disease extent but remains insufficient for etiologic differentiation, making histopathological examination and targeted microbiological investigations necessary, particularly to exclude invasive fungal infection. Conclusions: Management must be etiology-driven. CAM requires urgent antifungal therapy combined with surgical debridement, whereas non-fungal forms are generally managed with conservative surgery and appropriate antimicrobial stewardship. Standardized diagnostic criteria and prospective multicenter studies are needed to reduce nosological ambiguity and optimize clinical decision-making in this emerging post-viral condition.}, }
@article {pmid42075521, year = {2026}, author = {Balan, A and Graham, G and Sorin, H and Marcu, M and Gheorghe, N and Gabriela, M and Florescu, AR and Popa, AM and Lascu, A and Mot, CI and Mihaicuta, S and Frent, SM}, title = {Efficacy and Safety of Vagus Nerve Stimulation for Hospitalized COVID-19 Patients: A Systematic Review and Methodological Evaluation of Randomized Controlled Trials.}, journal = {Medicina (Kaunas, Lithuania)}, volume = {62}, number = {4}, pages = {}, pmid = {42075521}, issn = {1648-9144}, mesh = {Humans ; Randomized Controlled Trials as Topic ; *Vagus Nerve Stimulation/methods/adverse effects ; *COVID-19/therapy ; Hospitalization ; Treatment Outcome ; SARS-CoV-2 ; }, abstract = {Background and Objectives: Coronavirus disease 2019 (COVID-19) is characterized by excessive inflammatory responses, including the so-called cytokine storm, which contributes substantially to morbidity and mortality in hospitalized patients. The vagus nerve, through the cholinergic anti-inflammatory pathway, represents a theoretically attractive therapeutic target for modulating systemic inflammation. Vagus nerve stimulation (VNS) has emerged as a potential adjunctive treatment for COVID-19, with several randomized controlled trials (RCTs) investigating its efficacy on inflammatory biomarkers and clinical outcomes. The quality of this evidence base has not been rigorously evaluated. This systematic review critically appraises all available RCT evidence for VNS in hospitalized COVID-19 patients. Materials and Methods: We systematically searched PubMed, Scopus, Cochrane (CENTRAL), and Web of Science from database inception to January 2026, for RCTs evaluating any form of VNS (invasive, non-invasive, cervical, or auricular) in hospitalized patients with confirmed acute COVID-19. Two reviewers independently screened titles, abstracts, and full texts according to pre-specified eligibility criteria. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool, with assessments initially performed using multiple artificial intelligence tools and subsequently validated by the authors in accordance with PRISMA 2020 guidelines. Given substantial heterogeneity and high risk of bias, narrative synthesis was performed rather than meta-analysis. Also, GRADE assessment was performed. Results: From 437 records identified, six RCTs comprising 221 patients met the inclusion criteria. Five trials (83%) were rated as high risk of bias, primarily due to inadequate blinding, substantial baseline imbalances, significant missing data and extensive multiple testing without statistical correction. The single double-blind trial with a credible sham control (Rangon et al.) found null results across all outcomes, including clinical progression, ICU transfer, and mortality, while the five "high" risk-of-bias trials generally reported positive findings on various inflammatory markers and clinical outcomes. One trial (Corrêa et al.) measured heart rate variability as a direct indicator of vagal activation and found no change despite claiming anti-inflammatory effects, contradicting the proposed mechanism of action. Significant cognitive findings from an interim analysis (Uehara et al., n = 21) disappeared in the larger completed trial (Corrêa et al., n = 52), providing empirical demonstration of false positive findings in small, underpowered studies. Conclusions: Currently available evidence supporting the use of VNS for acute COVID-19 remains scarce; however, the physiological rationale remains sound, although the absence of reliable target engagement markers in the included studies limits confidence in this treatment method. Large-scale, double-blind, sham-controlled trials are required before VNS can be firmly recommended for COVID-19 management.}, }
@article {pmid42075693, year = {2026}, author = {Amusan, OT and Guo, H}, title = {CMGC Kinases in Viral Infection and Human Disease.}, journal = {Pathogens (Basel, Switzerland)}, volume = {15}, number = {4}, pages = {}, pmid = {42075693}, issn = {2076-0817}, support = {R21CA303392//National Institute of Health/ ; P20GM134974//National Institute of Health/ ; }, mesh = {Animals ; Humans ; Host-Pathogen Interactions ; Receptor Cross-Talk ; *Signal Transduction ; *Virus Diseases/enzymology ; Phosphorylation ; *Protein Serine-Threonine Kinases/metabolism ; }, abstract = {Cellular processes rely heavily on protein phosphorylation, a mechanism essential for organismal physiology and pathology. The CMGC family comprises a large group of serine/threonine kinases defined by a conserved catalytic core and closely related kinase domains. While several CMGC members have been extensively studied, others, including the RCK and CDKL subfamilies, remain less studied. Here, we synthesize current knowledge of CMGC kinases, emphasizing their structural organization, mechanisms of activation, and roles in infection and disease. CMGC kinases such as CDKs and DYRKs are activated downstream of growth factor signaling to drive proliferative programs. In contrast, other CMGC members respond to cellular stress signals, including stress cytokines, and function during quiescence or adverse conditions to regulate antiproliferative and pro-survival pathways. Through these context-dependent activities, CMGCs govern fundamental cellular processes, including growth, metabolism, transcription, and genome integrity. Although individual CMGC kinases operate within distinct signaling cascades, substantial crosstalk exists among their pathways. Both DNA and RNA viruses exploit host CMGC networks to reprogram the intracellular environment and enhance replication. While CMGC-virus interactions are often proviral, specific CMGC-mediated antiviral responses have been described, notably in SARS-CoV-2 infection. Collectively, CMGC kinases occupy a central position in cellular homeostasis and disease.}, }
@article {pmid42075711, year = {2026}, author = {Khan, MA and Khan, MH and Allemailem, KS}, title = {Mitogen-Activated Protein Kinases: Therapeutic Signaling Catalysts in Viral Immune Evasion.}, journal = {Pathogens (Basel, Switzerland)}, volume = {15}, number = {4}, pages = {}, pmid = {42075711}, issn = {2076-0817}, mesh = {Humans ; *Immune Evasion ; *Mitogen-Activated Protein Kinases/metabolism/immunology ; *Virus Diseases/immunology/drug therapy/virology ; SARS-CoV-2/immunology ; Signal Transduction ; Antiviral Agents/therapeutic use/pharmacology ; Animals ; *MAP Kinase Signaling System/immunology ; COVID-19/immunology ; Host-Pathogen Interactions/immunology ; }, abstract = {The mitogen-activated protein kinase (MAPK) pathways, ERK, JNK, and p38, are key regulators of immune responses during viral infections. These signaling cascades control cytokine production, T cell activity, and antigen presentation. However, many viruses can hijack MAPK pathways to avoid immune detection, promote their replication, and establish chronic infection. In this review, we discuss how different viruses, including HSV-1, HBV, HCMV, and SARS-CoV-2, manipulate MAPK signaling to alter host cell functions. A particular focus is given to the CD1d-iNKT cell axis, which plays a critical role in early antiviral responses but is often disrupted through MAPK-dependent mechanisms. We explore how changes in MAPK signaling affect antigen-presenting cells, drive T cell exhaustion, and reprogram immune cell metabolism, factors that contribute to viral immune evasion. The review also examines therapeutic strategies aimed at targeting MAPKs to improve antiviral immunity. These include small-molecule inhibitors and immune modulators that may enhance antiviral responses while limiting side effects. We emphasize the importance of context, as MAPK-targeted therapies must be carefully timed and tailored to avoid suppressing protective immunity or triggering unwanted inflammation. Overall, this review highlights the therapeutic potential and challenges of targeting MAPK pathways in viral infections and encourages further research into selective, host-directed antiviral strategies.}, }
@article {pmid42075977, year = {2026}, author = {Büyüker, SM and Khan, KA and Khalil, AQK and Khan, I and Jahan, S and Adil, M and Al-Rohily, KM and Al-Khamees, AH and Khalil, AAK}, title = {Elaeocarpus sylvestris (Lour.) Poir.: Phytochemistry and Pharmacological Potential-A Review.}, journal = {Molecules (Basel, Switzerland)}, volume = {31}, number = {8}, pages = {}, pmid = {42075977}, issn = {1420-3049}, mesh = {Humans ; *Plant Extracts/chemistry/pharmacology ; *Phytochemicals/chemistry/pharmacology ; Antiviral Agents/chemistry/pharmacology ; *Elaeocarpaceae/chemistry ; Antioxidants/chemistry/pharmacology ; Animals ; Anti-Inflammatory Agents/chemistry/pharmacology ; Flavonoids/chemistry/pharmacology ; COVID-19 Drug Treatment ; Antineoplastic Agents, Phytogenic/chemistry/pharmacology ; }, abstract = {Elaeocarpus sylvestris (Lour.) Poir., an evergreen tree native to East and Southeast Asia, has gained increasing scientific attention owing to its broad pharmacological properties. Traditionally used in East Asian medicine to treat inflammation, fever, and infectious diseases, modern research has revealed diverse bioactivities, including potent antioxidant, anti-inflammatory, antiviral, anticancer, antidiabetic, and immunomodulatory effects. This therapeutic potential is primarily attributed to its rich phytochemical composition, particularly polyphenols such as geraniin, 1,2,3,4,6-penta-O-galloyl-β-D-glucose and quercetin. This review particularly focuses on the chemistry of E. sylvestris, summarizing structurally elucidated compounds, including hydrolysable tannins, flavonoids, and triterpenoids, along with recent insights into the structure-activity relationships that underpin these antiviral, antioxidant, and anticancer activities. Recent studies have demonstrated substantial antiviral efficacy of E. sylvestris extracts and isolated compounds against major human pathogens, including herpesviruses, influenza A virus, and SARS-CoV-2, supported by in silico, in vitro, in vivo, and early-phase clinical evaluations. Its cosmeceutical applications, including antioxidant, skin-whitening, and blue-light protective effects, further highlight its multifunctional potential. To our knowledge, this is the first comprehensive review summarizing the phytochemistry, pharmacological activities, therapeutic potential, and cosmeceutical applications of E. sylvestris. Despite these promising findings, challenges remain in elucidating precise molecular mechanisms, pharmacokinetics, and clinical validation. This review identifies current research gaps and future directions necessary to advance E. sylvestris as a scientifically validated natural therapeutic resource.}, }
@article {pmid42076082, year = {2026}, author = {Generalov, E and Shevelev, A and Romanov, D and Tarasova, O and Pozdniakova, N}, title = {RNA Therapeutics in Viral Infections and Cancer: Mechanisms, Challenges, and Prospects: A Review.}, journal = {Pharmaceutics}, volume = {18}, number = {4}, pages = {}, pmid = {42076082}, issn = {1999-4923}, support = {25-24-01206//Russian Science Foundation/ ; }, abstract = {Background: RNA therapeutics represent a rapidly advancing field with significant potential for treating viral infections and cancer. This review examines the current landscape of RNA-based strategies, including siRNA, miRNA mimics, and antisense oligonucleotides. For viral infections, the focus is on hepatitis B (HBV) and C (HCV), HIV, and SARS-CoV-2. Approaches include targeting viral transcripts directly (e.g., siRNAs against HBV surface antigen) or host factors critical for viral replication (e.g., anti-miR-122 miravirsen for HCV). The successful development of mRNA vaccines for COVID-19 is highlighted as a major breakthrough, demonstrating the feasibility of rapid RNA vaccine deployment. The manuscript reviews several RNA therapeutics in oncology that have reached clinical trials. These include TargomiR (a miR-16 mimic for mesothelioma), cobomarsen (an anti-miR-155 for lymphomas), and MRX34 (a miR-34a mimic for various solid tumours). The review also covers emerging candidates like an miR-221 inhibitor and various strategies for breast cancer, such as targeting Bcl-2, KRAS, and specific miRNAs. A critical challenge across both fields is developing efficient and safe delivery systems, including lipid nanoparticles, GalNAc conjugates, and bacterial minicells. Despite promising preclinical results, clinical translation has been hampered by issues like insufficient delivery efficiency to human tumours, toxicity, and the complex, interconnected regulatory networks of miRNAs, which can lead to unpredictable off-target effects. Conclusions: While RNA therapeutics hold immense promise, overcoming delivery barriers and enhancing understanding of RNA regulatory networks are essential for future success.}, }
@article {pmid42076446, year = {2026}, author = {Al-Halawani, R and Qassem, M and Kyriacou, PA}, title = {Modelling Skin Pigmentation Using the Monte Carlo Technique: A Review.}, journal = {Sensors (Basel, Switzerland)}, volume = {26}, number = {8}, pages = {}, pmid = {42076446}, issn = {1424-8220}, mesh = {Monte Carlo Method ; *Skin Pigmentation/physiology ; Melanins/metabolism ; Humans ; COVID-19/epidemiology/virology ; *Models, Biological ; Computer Simulation ; SARS-CoV-2 ; }, abstract = {The impact of skin pigmentation on the accuracy of optical biomedical devices has gained increased attention since the COVID-19 pandemic, particularly following evidence of oximetry measurement bias in dark-skinned individuals. Meanwhile, many computational models utilising the Monte Carlo (MC) technique have been developed as a cost-effective and scalable method for investigating these effects. Hence, this review explores the application of the MC technique in modelling skin pigmentation, focusing specifically on how melanin in the epidermis is represented across different studies. First, the biological mechanisms of pigmentation and current stratification methods are outlined to contextualise the variability in skin tone, followed by the principles of MC modelling, including photon scattering, absorption, reflection, and detection. Following a screening and exclusion process, 50 studies were evaluated in terms of how melanin concentration and distribution are incorporated into MC models and their applications, revealing a range of approaches that include analytical equations, experimental optical property measurements, or hybrid methods. The benefits and limitations of each approach is discussed, in addition to emerging advancements such as heterogeneous melanin distribution and the relation between optical properties and skin colour classification scales. Overall, the review outlines the current methodological approaches utilised for skin pigmentation modelling and offers a reference framework for researchers seeking to improve the representation of skin pigmentation in MC-based optical simulations.}, }
@article {pmid42077021, year = {2026}, author = {Maunder, RG and Strudwick, G and Heeney, ND and Lawson, A and Chaukos, D and Margolese, N}, title = {What Nurse Leaders Can Learn From the Pre-Pandemic Literature Regarding Occupational Stress in Hospital-Based Healthcare Workers.}, journal = {Nursing leadership (Toronto, Ont.)}, volume = {38}, number = {4}, pages = {79-91}, doi = {10.12927/cjnl.2026.27822}, pmid = {42077021}, issn = {1929-6355}, mesh = {Humans ; *Occupational Stress/psychology ; COVID-19 ; *Leadership ; *Nurse Administrators/psychology ; Pandemics ; Frontline Workers ; }, abstract = {The purpose of this paper is to identify studies of hospital-based occupational stress prior to the COVID-19 pandemic that can offer lessons to nurse leaders in our current post-pandemic environment. A scoping review was conducted based on the Joanna Briggs Institute framework, including key phases and principles identified by Arksey and O'Malley. Evidence from different disciplines and settings has been relatively siloed. Nurses and doctors have tended to be studied separately using different constructs. Progress in developing more effective interventions to mitigate occupational stress in healthcare may require greater cross-disciplinary collaboration in which nurse leaders are well poised to lead.}, }
@article {pmid42077335, year = {2025}, author = {Tian, V and Ramlee, F and Hamzah, H and Ng, TS}, title = {Exploring Sleep and Physical Activity among Young Adults Across Asia: A Systematic Literature Review.}, journal = {The Malaysian journal of medical sciences : MJMS}, volume = {32}, number = {4}, pages = {106-128}, pmid = {42077335}, issn = {1394-195X}, abstract = {Previous studies have examined the association between sleep and physical activity; however, few have systematically reviewed the studies on young adults in Asia. Therefore, the present study aimed to systematically summarise the research on sleep and physical activity among young adults in Asia and critically assess the methodological quality of existing studies. The review process adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, beginning with research question formulation and systematic searches through identification, screening, and eligibility in the Scopus, PubMed, and ScienceDirect databases. Subsequently, the studies underwent quality appraisal, data extraction, and analysis. Thematic analysis organised the findings into three main themes: i) the prevalence of sleep quality and physical activity in Asia; ii) the association between sleep quality and physical activity; and iii) sleep quality and physical activity during the COVID-19 outbreak. These findings reveal a high prevalence of sleep deprivation and poor sleep quality among young adults in Asia, whereas the prevalence of physical activity varies. Moreover, the COVID-19 outbreak negatively affected sleep quality and physical activity. Therefore, proactive measures should be implemented to improve sleep quality and promote physical activity, thereby improving physical and mental health.}, }
@article {pmid42077952, year = {2026}, author = {He, J and Rameli, MRM}, title = {A systematic review of predictors of college students' subjective well-being: evidence from pre- and post-pandemic literature.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1793063}, pmid = {42077952}, issn = {2296-2565}, mesh = {Humans ; *Students/psychology ; Psychological Well-Being ; Universities ; *COVID-19/psychology/epidemiology ; *Mental Health ; Social Support ; Adaptation, Psychological ; China/epidemiology ; Coping Skills ; Exercise ; }, abstract = {BACKGROUND: The COVID-19 pandemic significantly affected the mental health of university populations, necessitating a systematic synthesis of the predictors of subjective well-being among Chinese college students.
METHODS: Following PRISMA 2020 guidelines, the researchers searched PubMed, Web of Science, and Scopus for peer-reviewed studies published between 2018 and 2024, completing the final search on December 30, 2024. Methodological quality was evaluated using design-specific JBI appraisal tools to accommodate the diverse longitudinal, quasi-experimental, qualitative, and cross-sectional methodologies within the sample. The analytic process utilized a two-stage thematic synthesis involving deductive data extraction followed by inductive theme generation to maintain methodological precision.
RESULTS: The final sample included 34 studies comprising 15,301 participants and revealed six primary predictive clusters for well-being, including social support, interpersonal dynamics, physical activity, and individual resilience. Longitudinal and quasi-experimental findings indicate that familial cohesion, leisure crafting, and adaptive coping strategies are sustained predictors of happiness during the post-pandemic recovery phase. Qualitative data further elucidate subjective challenges regarding digital temperance and the construction of self-identity in virtual environments.
CONCLUSION: This study provides an empirical framework to guide higher education administrators and policymakers in developing targeted mental health interventions tailored to evolving academic environments.}, }
@article {pmid42079577, year = {2026}, author = {Xi, H and Li, M and Shen, J and Lin, Y and Wang, B and Yu, Q and Wang, H and Zhao, Y}, title = {COVID-19 vaccination and clinical outcomes of immune checkpoint inhibitors therapy in cancer patients: a meta-analysis of real-world studies.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1807267}, pmid = {42079577}, issn = {1664-3224}, mesh = {Humans ; *Immune Checkpoint Inhibitors/therapeutic use ; *Neoplasms/drug therapy/mortality/immunology ; *COVID-19/prevention & control/immunology ; *COVID-19 Vaccines/immunology/therapeutic use/administration & dosage ; *SARS-CoV-2/immunology ; Treatment Outcome ; Observational Studies as Topic ; Vaccination ; }, abstract = {BACKGROUND: Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy, yet treatment responses remain heterogeneous. With the widespread implementation of coronavirus disease 2019 (COVID-19) vaccination, uncertainty persists regarding its impact on antitumor efficacy in patients receiving ICIs. While vaccine safety has been extensively studied, the association between COVID-19 vaccination and ICI therapeutic outcomes has not been systematically evaluated.
METHODS: We conducted a systematic review and meta-analysis of observational studies examining the association between COVID-19 vaccination and oncologic outcomes in patients treated with ICIs. PubMed, Embase, and Scopus were searched from 2020 to December 31, 2025. Primary outcomes were overall survival (OS) and progression-free survival (PFS); secondary outcomes included objective response rate (ORR) and disease control rate (DCR). Hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using random-effects models.
RESULTS: Ten observational studies comprising 4,929 patients receiving ICIs were included. COVID-19 vaccination was associated with significantly improved PFS (pooled HR = 0.66, 95% CI 0.48-0.90) and OS (pooled HR = 0.51, 95% CI 0.39-0.66) compared with no vaccination. Vaccinated patients showed numerically higher ORR (pooled OR = 1.74, 95% CI 0.89-3.41) and DCR (pooled OR = 1.74, 95% CI 0.83-3.46), although these differences were not statistically significant. Subgroup analyses by vaccine platform and cancer type yielded consistent associations.
CONCLUSIONS: COVID-19 vaccination is associated with improved survival outcomes in patients receiving ICIs. Although the observational nature of available data warrants cautious interpretation, the consistency of findings and their biological plausibility support the clinical compatibility of vaccination with ICI therapy, but causal or synergistic effects cannot be established from these data. These results reinforce current vaccination recommendations and highlight the need for prospective studies to further elucidate underlying mechanisms and optimize integration with cancer immunotherapy.
https://www.crd.york.ac.uk/prospero/, identifier CRD420261277938.}, }
@article {pmid42079584, year = {2026}, author = {Liu, X and Mai, Z and Sun, L and Deng, L and Tang, M and Li, G and Yang, X}, title = {Respiratory epithelial cells as central mediators of immune crosstalk in SARS-CoV-2 infection.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1799580}, pmid = {42079584}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/immunology/pathology ; *SARS-CoV-2/immunology ; *Epithelial Cells/immunology/virology ; *Respiratory Mucosa/immunology/virology ; Angiotensin-Converting Enzyme 2 ; Renin-Angiotensin System/immunology ; Animals ; Signal Transduction ; Cytokines/immunology ; }, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induces life-threatening acute lung injury (ALI) and disrupts immune homeostasis, however, the role of epithelial-immune cell crosstalk in driving this pathology remains incompletely elucidated. Respiratory epithelial cells (RECs) as the primary targets of SARS-CoV-2 via the ACE2 receptor, act as central mediators of immune crosstalk that balances antiviral defense and immunopathology in COVID-19. Beyond forming a physical barrier against pathogen invasion, RECs regulate bidirectional crosstalk with immune cells (including alveolar macrophages, dendritic cells, neutrophils, and lymphocytes) through multiple mechanisms, such as cytokine signaling, antigen presentation, PD-L1 checkpoint modulation, and renin-angiotensin-aldosterone system (RAAS) dysregulation. Under physiological conditions, these interactions promote viral clearance and epithelial repair; In contrast, dysregulation of such crosstalk leads to excessive inflammatory responses like cytokine storm and impaires tissue regeneration. Elucidating the molecular dynamics underlying REC-immune crosstalk is crucial for gaining insights into the development of targeted therapies (e.g., modulating cytokine signaling, restoring RAAS balance) to mitigate the severity of COVID-19. This review summarized recent findings to clarify how REC-mediated immune crosstalk dictates antiviral responses and pathological outcomes, thereby providing a theoretical basis for optimizing therapeutic strategies that strengthen antiviral immunity while minimizing immunopathology.}, }
@article {pmid42080553, year = {2026}, author = {Zhang, L and Hoffmann, M and Pöhlmann, S}, title = {Lock out: targeting TMPRSS2 to block influenza and coronaviruses.}, journal = {Journal of virology}, volume = {100}, number = {6}, pages = {e0080725}, pmid = {42080553}, issn = {1098-5514}, support = {101057100//HORIZON EUROPE Health/ ; COFONI 14-76403-184//Niedersächsisches Ministerium für Wissenschaft und Kultur/ ; VIGILANT (101041799)//HORIZON EUROPE Health/ ; TTU 01.829//German Center for Infection Research/ ; }, mesh = {Humans ; *Serine Endopeptidases/metabolism/genetics ; SARS-CoV-2 ; *Influenza, Human/drug therapy/virology ; *Influenza A virus/drug effects ; *Antiviral Agents/pharmacology/therapeutic use ; COVID-19 ; *Coronavirus Infections/drug therapy/virology ; Animals ; Pandemics ; *Betacoronavirus/drug effects ; *Pneumonia, Viral/drug therapy/virology ; Spike Glycoprotein, Coronavirus/metabolism ; }, abstract = {Coronaviruses and influenza A viruses (IAV) can cause severe respiratory disease and have pandemic potential. Both viruses depend on priming of their glycoproteins by host cell proteases for the acquisition of infectivity, and the responsible enzymes represent potential targets for intervention. Initial studies suggested that these viruses may exploit redundant proteolytic systems. However, research conducted over the last two decades has pointed to a key role for a single enzyme in coronavirus and IAV priming, the transmembrane protease serine 2 (TMPRSS2). Interest in TMPRSS2 as a host dependency factor and therapeutic target intensified during the COVID-19 pandemic, prompting extensive investigation into its biology, substrate specificity, and pharmacological inhibition. Here, we review recent efforts to define the role of TMPRSS2 in coronavirus infection and to target this protease for antiviral intervention.}, }
@article {pmid42081038, year = {2026}, author = {McGrath, H and Brennan, E and Harmon, D}, title = {The assessment of clinical competence in medical students during the COVID-19 pandemic: a scoping review.}, journal = {Irish journal of medical science}, volume = {}, number = {}, pages = {}, pmid = {42081038}, issn = {1863-4362}, abstract = {BACKGROUND: The COVID-19 pandemic necessitated unprecedented changes to clinical education and assessment. Restrictions on in-person clinical encounters led to rapid adoption of digital assessment modalities, raising concerns about graduate preparedness and the validity of pandemic-adapted assessment approaches. Wojniusz, [40].
OBJECTIVES: This scoping review aimed to: (1) map approaches to assessing clinical competence in medical students during COVID-19; and (2) evaluate the validity, reliability, feasibility, and acceptability of pandemic-adapted assessments.
METHODS: Following Arksey and O'Malley's framework, we systematically searched six databases (PubMed/MEDLINE, Scopus, Web of Science, EMBASE, ERIC, Google Scholar) for peer-reviewed empirical studies published March 2020-March 2023 examining clinical competence assessment in final-year medical students. Studies were analyzed using Van der Vleuten's utility framework (validity, reliability, feasibility, acceptability) and Miller's Pyramid to categorize competency levels assessed.
RESULTS: From 1,247 references, 13 studies met inclusion criteria, representing 8 countries. Virtual OSCEs were the predominant assessment method (n = 8, 62%). Study designs were predominantly weak: surveys (n = 6), evaluative case studies (n = 4), and observational studies (n = 2), with only three cohort studies providing stronger evidence. Most studies (92%) focused on feasibility and acceptability rather than validity or psychometric properties. Physical examination and procedural skills assessment remained a critical unresolved limitation across all digital modalities. No studies employed generalizability theory or Kane's validity framework.
CONCLUSIONS: A paucity of rigorous research on pandemic-adapted assessment validity exists. Published studies employed weak designs producing non-generalizable findings focused on feasibility over validity. Urgent research priorities include: longitudinal cohort studies comparing pandemic-trained graduates to pre-pandemic cohorts; psychometric validation of hybrid assessment models now institutionalized; application of contemporary validity frameworks to digital assessments; and equity analysis of differential impacts across student populations. The field requires systematic validity evidence before permanently adopting pandemic-adapted approaches.}, }
@article {pmid42081931, year = {2026}, author = {Basil, B and Eze, OE}, title = {Strengthening laboratory quality through risk-based thinking: Implementation challenges and opportunities in Nigeria.}, journal = {Clinica chimica acta; international journal of clinical chemistry}, volume = {589}, number = {}, pages = {121041}, doi = {10.1016/j.cca.2026.121041}, pmid = {42081931}, issn = {1873-3492}, mesh = {Nigeria ; Humans ; Quality Control ; *Laboratories, Clinical/standards ; *Laboratories/standards ; }, abstract = {BACKGROUND: Medical laboratories in Nigeria are pivotal for national health security but operate under severe infrastructural deficits and a high disease burden. Traditional Quality Control (QC) methods are prevalent but reactive and fail to address the high proportion of errors occurring in pre- and post-analytical phases. This necessitates a strategic shift toward Risk-Based Thinking (RBT) as mandated by the new ISO 15189:2022 standard to bridge the gap between international requirements and local environmental volatility.
OBJECTIVES: This review assesses the current state of laboratory quality in Nigeria and evaluates the applicability of RBT frameworks (ISO 15189:2022 and CLSI EP23) in resource-limited settings. It aims to identify structural and cultural implementation barriers and propose actionable mitigation strategies.
METHODS: This comprehensive narrative review utilized a systematic search strategy across PubMed, Scopus, and AJOL covering 2010-2025. Data from 85 identified sources, including 66 studies selected using a defined criticality matrix, were synthesized using the Plan-Do-Check-Act (PDCA) framework operationalized with specific quality indicators to contrast regulatory expectations with operational realities.
MAIN TEXT: The sector is polarized, with elite private and donor-funded public laboratories driving accreditation (representing only 26 facilities or < 0.5% of the sector), while the majority struggle with a punitive blame culture, the "Japa" syndrome workforce crisis, and erratic power supply. RBT frameworks like Parvin's Risk Management Index offer tools to quantify these unique environmental risks and enable targeted resource allocation. Case studies from EL-LAB and HVL, alongside adaptive lessons from the COVID-19 pandemic, demonstrate that RBT facilitates resilience by scientifically validating investments in solar energy and staff competence to mitigate local hazards.
CONCLUSION: Transitioning to RBT is critical for Nigerian laboratories to move from reactive compliance to proactive resilience. By managing risks like power instability and supply chain volatility, laboratories can effectively optimize scarce resources through data-driven mitigation to ensure patient safety.}, }
@article {pmid42083745, year = {2026}, author = {Hussain, SR and El Sahly, HM}, title = {Novel vaccine platforms for respiratory viruses: a review of licensed vaccines and candidates in late-stage development.}, journal = {Expert review of vaccines}, volume = {25}, number = {1}, pages = {2667742}, doi = {10.1080/14760584.2026.2667742}, pmid = {42083745}, issn = {1744-8395}, mesh = {Humans ; *Vaccine Development ; *Respiratory Syncytial Virus Infections/prevention & control/immunology ; Respiratory Syncytial Virus Vaccines/immunology/administration & dosage ; COVID-19 Vaccines/immunology/administration & dosage ; Animals ; *COVID-19/prevention & control/immunology ; *Viral Vaccines/immunology/administration & dosage ; *Respiratory Tract Infections/prevention & control/immunology ; Vaccines, Synthetic/immunology ; Influenza Vaccines/immunology/administration & dosage ; Adenoviridae/genetics ; }, abstract = {INTRODUCTION: Respiratory infections with influenza, respiratory syncytial virus (RSV), and SARS-CoV-2 are a major cause of global mortality. Vaccination is a cornerstone of disease prevention, though traditional platforms face challenges. Recently, several vaccines utilizing mRNA and adenovirus platforms were brought to the market, with additional vaccines undergoing Phase 3 clinical testing.
AREAS COVERED: This review assesses vaccine literature primarily from 2020 to the present, using National Library of Medicine databases. The rapidity of mRNA technology was tested and implemented successfully during the COVID-19 pandemic. Since then, the mRNA RSV vaccine has been licensed as well. mRNA platforms also offer the ability of combining antigens for multivalent vaccines against multiple pathogens. Several combination products have been used in phase III clinical trials. Adenovirus-vectored vaccines for respiratory viruses have the added advantage of mucosal-based delivery and inducing a potentially stronger local immune response. However, both of these platforms have immunogenicity and safety shortcomings.
EXPERT OPINION: Novel respiratory virus vaccine platforms have demonstrated their importance with both endemic and pandemic pathogens, because of decades of concerted efforts and investment in research. Expediting future vaccine development requires a continuation of these efforts with a focus on pre-clinical models and a better understanding of correlates of protection.}, }
@article {pmid42083839, year = {2026}, author = {Godart, N and Cruanès, T and Hirot, F and Huas, C}, title = {[Eating disorders].}, journal = {La Revue du praticien}, volume = {76}, number = {4}, pages = {433-440}, pmid = {42083839}, issn = {2101-017X}, mesh = {Humans ; *Feeding and Eating Disorders/therapy/diagnosis/epidemiology ; COVID-19/epidemiology ; Anorexia Nervosa/diagnosis/therapy/epidemiology ; }, abstract = {Eating disorders (EDs) are very frequent and are increasing since the Covid-19 pandemic. They include anorexia nervosa, bulimia nervosa, binge eating disorder, avoidance and restriction disorders and their subsyndromic forms. EDs affect people of all ages, they generate somatic, psychiatric and social complications. Early diagnosis and appropriate care can considerably improve the prognosis. Unfortunately, these disorders steel underdiagnosed and the specialized care pathway available are not well known. After describing eating disorders, the article outlines elements for identification and initial assessment, and discusses the main lines of treatment, which must be multidisciplinary, coordinated, gradual and tailored to each individual.}, }
@article {pmid42084832, year = {2026}, author = {Venkataraman, A and Joseph, NH and Sadanandan, G and Balasubramanian, S}, title = {Navigating the Challenges of Implementing Tuberculosis Research During COVID-19 Pandemic: Insights from the Pediatric Tuberculosis-Moderate Acute Malnutrition Study.}, journal = {Indian pediatrics}, volume = {}, number = {}, pages = {}, pmid = {42084832}, issn = {0974-7559}, support = {BT/RLF/Re-entry/69/2017//Department of Biotechnology, Ministry of Science and Technology, India/ ; }, abstract = {Clinical research involving children presents significant challenges due to physiological, ethical, regulatory, and practical considerations unique to this vulnerable population. These intrinsic challenges were amplified during the COVID-19 pandemic, which substantially disrupted pediatric research and child health services. The pandemic exposed critical ethical, operational, and communicative tensions, especially with respect to informed consent, caregiver trust, and safe research implementation. Examining these intersecting challenges can improve and strengthen pediatric research to remain ethically robust and child-centred in the event of future public health crises.}, }
@article {pmid42085748, year = {2026}, author = {Tuite, AR and Forbes, N and Salvadori, MI and Tunis, M}, title = {Cost-effectiveness of ongoing COVID-19 vaccination in the context of high population immunity: A structured review of international economic evidence.}, journal = {Vaccine}, volume = {83}, number = {}, pages = {128660}, doi = {10.1016/j.vaccine.2026.128660}, pmid = {42085748}, issn = {1873-2518}, mesh = {Humans ; *Cost-Benefit Analysis ; *COVID-19/prevention & control/economics/immunology/epidemiology ; *COVID-19 Vaccines/economics/administration & dosage/immunology ; Cost-Effectiveness Analysis ; *Vaccination/economics ; SARS-CoV-2/immunology ; Quality-Adjusted Life Years ; Disability-Adjusted Life Years ; Middle Aged ; Aged ; Female ; Child ; Adult ; }, abstract = {BACKGROUND: In the context of ongoing SARS-CoV-2 circulation and high population immunity, jurisdictions face decisions about which population groups should receive ongoing annual vaccination. Economic evaluations are increasingly central to these deliberations but the growing body of global cost-effectiveness evidence has not been synthesized.
OBJECTIVE: To summarize cost-effectiveness evidence for COVID-19 vaccination from 2023 onwards, organized by population groups of policy relevance.
METHODS: We conducted a structured literature search in December 2025 across MEDLINE, Embase, and EconLit, supplemented by grey literature searches of National Immunization Technical Advisory Group (NITAG) websites. From 644 screened references, 21 studies met inclusion criteria: economic evaluations of COVID-19 vaccination from 2023 onwards reporting cost-effectiveness of annual vaccination compared to no additional vaccination in quality-adjusted life years (QALYs) or disability-adjusted life years (DALYs). Results were synthesized by population group.
RESULTS: Annual COVID-19 vaccination was economically favourable for older adults (≥60-65 years) across all 18 contributing studies spanning 12 countries and using diverse analytic approaches. For individuals with underlying conditions or comorbidities, results were more variable, with cost-effectiveness depending on age, specific conditions, and vaccine price. Vaccination of healthy working-age adults (3 of 4 studies) and children (2 of 3 studies) was generally unfavourable at standard cost-effectiveness thresholds. Limited evidence was identified for healthcare workers and no economic evaluations from 2023 onwards were identified for pregnancy. The evidence base was geographically concentrated in high-income countries, with approximately half of included studies reporting industry funding. Sequential US economic evaluations demonstrated progressive declines in cost-effectiveness as disease burden decreased over time.
CONCLUSIONS: The economic evidence supports a risk-stratified approach to COVID-19 vaccination, with the strongest economic value observed for older adults and individuals with comorbidities. Cost-effectiveness is dynamic, sensitive to disease burden, vaccine price, and population characteristics, and should be reassessed regularly as epidemiological conditions evolve.}, }
@article {pmid42085825, year = {2026}, author = {Ambade, PN and Zimmerman, C and Haddad, C and Koperski, C and Rashid, G and Kafri, A and Yazdani, F and Renirie, RH and Pruitt, D and MacKinnon, NJ}, title = {Updating knowledge on existing approaches on advanced care planning interventions: An umbrella review.}, journal = {Archives of gerontology and geriatrics}, volume = {148}, number = {}, pages = {106255}, doi = {10.1016/j.archger.2026.106255}, pmid = {42085825}, issn = {1872-6976}, mesh = {Humans ; *Advance Care Planning/organization & administration ; *Terminal Care ; *COVID-19/epidemiology ; Aged ; Palliative Care ; SARS-CoV-2 ; Quality of Life ; }, abstract = {CONTEXT: Advanced care planning (ACP) can reduce hospitalizations, increase quality of life, and align treatment with patient wishes, while lowering healthcare costs. However, healthcare providers' discomfort, lack of training, and patient anxiety may hinder ACP. Furthermore, disparities exist among minority and low-income groups. Growing research highlights the need for standardized definitions and broader implementation, especially post-COVID-19, incorporating digital tools, economic impacts, ethics, and family roles to improve ACP worldwide.
OBJECTIVES: This study aims to update and synthesize knowledge from all published systematic reviews from the past ten years, focusing on ACP-related interventions.
METHODS: We conducted a comprehensive search across PubMed, Cochrane, and Scopus, including only English-language, peer-reviewed systematic reviews published between 2015 and 2025. We employed rigorous screening, dual-reviewer validation, and quality-assessment tools, and synthesized evidence on intervention effectiveness across diverse populations and settings to identify effective ACP strategies.
RESULTS: Of the deduplicated 7513 records, 61 reviews met the inclusion criteria. For older adult patients, structured conversations reduce unnecessary aggressive treatments and align end-of-life care with preferences. Among racial groups, peer support and palliative consultations boost ACP completion. Patient-centric interventions include video decision aids and web tools, whereas provider-centric interventions include conversation guides, reminder systems, electronic coordination platforms, and facilitator training.
CONCLUSION: ACP is an ongoing process tailored to patient preferences, requiring efforts to address stigmatized conversations, especially in minority communities and severe illnesses. Emphasis on research into digital tools, policy incentives, infrastructure, and family support is essential. Bridging research and practice will improve outcomes and patient-centered end-of-life care.
KEY MESSAGE: This article describes an umbrella review of 61 systematic reviews on advanced care planning-related interventions. The analysis indicates that the reviews covered interventions focusing on both facility and community-based individuals and had a specific population or disease focus. The articles covered both patient and provider-centric interventions.}, }
@article {pmid42086298, year = {2026}, author = {Stark, L and Noble, DJ and Meinhart, M and Erhardt-Ohren, B and Karmin, S and Poulton, C and Sarraf, D and Bustreo, F and Seff, I}, title = {A systematic review of infectious disease outbreaks and violence against women and girls: changes in magnitude, mechanisms and lessons for the future.}, journal = {BMJ global health}, volume = {11}, number = {5}, pages = {}, pmid = {42086298}, issn = {2059-7908}, mesh = {Humans ; Female ; COVID-19/epidemiology ; *Disease Outbreaks ; Pandemics ; SARS-CoV-2 ; *Gender-Based Violence/statistics & numerical data ; *Violence/statistics & numerical data ; *Coronavirus Infections/epidemiology ; *Pneumonia, Viral/epidemiology ; }, abstract = {Infectious disease outbreaks (outbreaks) are increasing across the globe due to climate change, urbanisation and changes in land use, and many of their response measures impact risk factors for violence against women and girls (VAWG). We conducted a systematic review to consolidate existing evidence on the impact of any outbreaks, and their public health responses, on the change in magnitude of VAWG and mechanisms facilitating violence among women and girls in low-income and middle-income countries. Though our search strategy aimed to capture studies from any outbreak since 2014, all quantitative evidence on VAWG impacts, and all but one qualitative study, focused on the COVID-19 pandemic, and only three studies disaggregated outcomes for women versus girls. Overall, our synthesis of the evidence points to increased VAWG during the first year of the COVID-19 pandemic compared with pre-pandemic levels. We identified five broad mechanisms through which violence occurred against women and girls: (1) income loss due to economic shutdown, financial insecurity, and/or job loss, (2) movement restrictions, (3) changes in access to public services, (4) fear of exposure to infectious disease, and (5) a legacy of mistrust in health systems from previous outbreaks. Our study demonstrates the novelty of VAWG monitoring during outbreaks, the need for increased surveillance and the known mechanisms to date through which VAWG may be perpetrated during outbreaks. By implementing both short-term protective measures and long-term structural reforms, outbreak responses may not only break the cycle of VAWG exacerbated by public health emergencies but build resilient systems that protect women, girls and marginalised populations before, during and after crises.}, }
@article {pmid42086409, year = {2026}, author = {Elahi, S}, title = {Erythroid-hormonal axis in long COVID.}, journal = {Trends in molecular medicine}, volume = {32}, number = {7}, pages = {620-623}, doi = {10.1016/j.molmed.2026.04.006}, pmid = {42086409}, issn = {1471-499X}, mesh = {Humans ; *COVID-19/metabolism/immunology/pathology/virology ; Post-Acute COVID-19 Syndrome ; *Erythropoiesis ; *SARS-CoV-2 ; *Erythroid Cells/metabolism ; Animals ; }, abstract = {Long COVID may reflect a failure of coordinated physiological recovery rather than persistent infection. Emerging evidence identifies inflammation-driven disruption of erythropoiesis and hormonal balance as central mechanisms linking immune dysregulation, metabolic stress, and persistent symptoms. This framework positions erythroid-endocrine pathways as key determinants of recovery and promising therapeutic targets.}, }
@article {pmid42086867, year = {2026}, author = {Elahi, S}, title = {Immune regulation by erythroid cells: how erythroid progenitor cells and mature red blood cells shape immunity.}, journal = {Nature reviews. Immunology}, volume = {}, number = {}, pages = {}, pmid = {42086867}, issn = {1474-1741}, abstract = {Once considered to be passive oxygen carriers, erythroid cells are now recognized as dynamic modulators of immune responses. Erythroid progenitors and precursors, collectively known as CD71[+] erythroid cells, can suppress innate and adaptive immune responses in neonates, in mothers during pregnancy, in chronic conditions such as cancer and autoimmunity, and during infection with viruses, including SARS-CoV-2 and HIV. Mature red blood cells engage pathogens directly, scavenge chemokines, cytokines and nucleic acids, and modulate immune functions through redox buffering and receptor-mediated interactions. The immune effects of red blood cells are highly context dependent, ranging from suppression to activation. This Review highlights the emerging field of erythroid-immune crosstalk and its translational potential in the settings of infection, cancer, pregnancy and chronic inflammatory conditions.}, }
@article {pmid42087099, year = {2026}, author = {Varmazyar, S}, title = {Smartphone use and related factors with hand pain among university students: a systematic review.}, journal = {BMC musculoskeletal disorders}, volume = {27}, number = {1}, pages = {}, pmid = {42087099}, issn = {1471-2474}, mesh = {Humans ; *Smartphone ; *Students ; Universities ; *Hand/physiopathology ; Risk Factors ; *Musculoskeletal Pain/epidemiology/etiology ; }, abstract = {BACKGROUND: University students often use smartphones for daily tasks, which can lead to awkward posture and musculoskeletal pain in the hand, wrist, and fingers due to prolonged use. This review aims to investigate the relationship between smartphone use and hand pain among university students.
METHODS: For this review, we collected and analyzed original English-language articles published between 2014 and 2024. Keywords were selected from the MeSH database. We excluded review articles, books, letters, reports, and other non-original sources, as well as studies that focused on mobile phones or populations other than university students and smartphone users. Additionally, articles addressing pain in other body parts, injuries, and complications from smartphone use, as well as those published during the COVID-19 pandemic, were also omitted. We utilized various keyword combinations related to "university", "students", "smartphone use", "addiction", "overuse", "hand", "pain", "musculoskeletal pain", "wrist", "fingers", "thumb", "risk factors", "characteristics", and "posture" in the search, along with the use of "AND", "OR", or no conjunctions, and the use of quotation marks for one, two, or a few keywords. Literature was obtained from databases such as Web of Science, ScienceDirect, Scopus, PubMed, and ProQuest. A total of 18 studies were selected from 390 primary literature sources, following the PRISMA framework.
RESULTS: A total of 393 articles were found in the initial search. Duplicate articles were removed, leaving 259 that were examined according to inclusion and exclusion criteria. After assessing the relevance of titles and abstracts, screening, and qualitatively evaluating journals, 18 articles were included in the study. Brazil, Saudi Arabia, and Turkey had the highest number of articles (n = 3 or 16.6% of articles). The age group investigated was 18 to 26 years old. Based on the identified risk factors, the articles were discussed in three groups: (1) role of smartphone duration, addiction, and hand pain (83.3% of studies investigated the duration of smartphone use, while 38.8% surveyed smartphone addiction), (2) the effect of smartphone holding posture on the hand and hand pain (38.8% of studies), and (3) the relation of smartphone physical characteristics to hand pain (27.7% of studies). Daily usage duration ranged from less than or equal to 4 h/day (53.2%) to 7 h or more (73.9%). The reported range of smartphone addiction among students was between 15.9% and 66.6%. The reported prevalence of wrist, hand, and thumb pain was 19.2% to 68.7%. Between 14.75% and 41% of students use their right hand to hold smartphones and type with their right thumb, while 24% to 77.79% use both hands and both thumbs. The size and weight of smartphones can predict hand pain.
CONCLUSIONS: The amount of time spent using a smartphone, how it is held, how long it has been owned, smartphone addiction, holding posture, frequent thumb movements, preferred hand position, screen size, weight of the smartphone, and smartphone -related the purpose of usage are all risk factors that can lead to pain in the hand, wrist, palm, thumb, and other fingers.}, }
@article {pmid42087263, year = {2026}, author = {Wogick, L and Goyal, SM}, title = {Porcine epidemic diarrhea virus: a model for coronavirus persistence and immune escape in intensive livestock systems.}, journal = {Porcine health management}, volume = {12}, number = {1}, pages = {}, pmid = {42087263}, issn = {2055-5660}, abstract = {Porcine epidemic diarrhea virus (PEDV) is an enteric alphacoronavirus that has shifted from a sporadic regional pathogen to a worldwide, persistent virus, despite years of vaccination, biosecurity measures, and monitoring. Since the early 1970s, PEDV has shown strong genetic flexibility, the ability to evade immunity, survive in the environment, and spread quickly through connected livestock networks. Major outbreaks in Asia, Europe, and North America, especially the 2013-2014 outbreak in the United States, have revealed key weaknesses in traditional control methods for enteric coronaviruses, especially those that depend on systemic immunization. In this review, we bring together over fifty years of PEDV research to look at how viral evolution, mucosal immune responses, and livestock production systems work together to keep the virus circulating. We point out that changes in the spike gene, including recombination and deletions, along with changes in other viral genes, affect disease severity, immune system recognition of the virus, and the inability of vaccines to provide protection. We also stress the key role of lactogenic immunity and the gut-mammary-secretory IgA system in protecting newborn animals, which helps explain why vaccine inoculations have not been effective in stopping the spread of enteric coronaviruses. By combining evidence from molecular, immune, epidemiological, and systems research, we suggest that PEDV is a strong example for studying how coronaviruses persist under immune pressure in managed animal groups. Using a One Health approach, this review encourages moving away from only reacting to outbreaks and instead focusing on ongoing, genome-based management of coronaviruses in livestock operations.}, }
@article {pmid42087622, year = {2026}, author = {Lorusso, R and De Piero, ME and Mariani, S and Ravaux, JM and Nardelli, P and Jacobs, JP and Guarracino, F and Patroniti, N and van Bussel, BCT and van der Horst, ICC and Taccone, FS and Heinsar, S and Shekar, K and Yamashita, MH and Obonyo, NG and Ciullo, AL and Riera, J and Dalton, H and Wang, A and Zaaqoq, AM and MacLaren, G and Ramanathan, K and Suen, JY and Li Bassi, G and Sato, K and Fraser, JF and Peek, GJ and Arora, RC and , }, title = {Hemodynamic monitoring during veno-venous extracorporeal membrane oxygenation: A scoping review.}, journal = {Perfusion}, volume = {41}, number = {1_suppl}, pages = {95S-109S}, doi = {10.1177/02676591261429826}, pmid = {42087622}, issn = {1477-111X}, support = {//The Bill and Melinda Gate Foundation/ ; }, mesh = {Humans ; *Extracorporeal Membrane Oxygenation/methods ; *Hemodynamic Monitoring/methods ; *Hemodynamics ; }, abstract = {BackgroundIn adult patients receiving veno-venous Extracorporeal Membrane Oxygenation (VV ECMO), cardiovascular performance plays a critical role in determining oxygen delivery, organ perfusion and safe titration of extracorporeal support. Despite the increasing VV ECMO use, contemporary guidance on hemodynamic monitoring remains limited and largely experience-based. This scoping review aimed to map available basic and advanced monitoring approaches and to identify current evidence gaps.MethodsPubMed, EMBASE, and Cochrane CENTRAL were searched from inception until September 2025, along with reference lists of relevant articles. We included studies of any design reporting techniques, targets, or protocols for hemodynamic monitoring during VV ECMO.ResultsOf 465 records screened, 106 met inclusion criteria. No protocolized, evidence-based hemodynamic monitoring protocol specific to VV ECMO was identified. The available evidence was heterogeneous and mostly derived from physiologic studies or single-center observational cohorts. Findings were narratively synthesized across three domains: basic bedside monitoring, diagnostic/prognostic tools and advanced assessment of cardiopulmonary interaction. Across studies, no monitoring strategy consistently reduced time-to-wean or mortality. Observational data suggested that care bundles and multidisciplinary approaches may reduce complications. However, the risk of bias limits causal inference.ConclusionsDespite the complex interaction between native cardiovascular function and extracorporeal circulation, VV ECMO lacks consensus on evidence-based hemodynamic monitoring pathways. A pragmatic core monitoring bundle with tiered triggers for escalation is necessary. Future priorities include implementation models based on multidisciplinary teams, specific training, standardized bundles, and multicenter studies aimed to define right ventricular-centered targets to improve safety and clinical decision-making.}, }
@article {pmid42087798, year = {2026}, author = {Rosca, EC and Oke, J and Jefferson, T and Brassey, J and Onakpoya, I and Plüddemann, A and Gandini, S and Maltoni, S and Evans, D and Conly, J and Heneghan, C}, title = {Serial cycle threshold to assess the infectious potential of SARS-CoV-2: A systematic review.}, journal = {Epidemiology and infection}, volume = {154}, number = {}, pages = {e89}, doi = {10.1017/S0950268826101484}, pmid = {42087798}, issn = {1469-4409}, support = {//University of Calgary/ ; }, mesh = {Humans ; *SARS-CoV-2/genetics/isolation & purification/pathogenicity ; *COVID-19/diagnosis/transmission/virology/epidemiology ; }, abstract = {We sought to assess predictive factors for SARS-CoV-2 infectiousness using a meta-analytic approach. We searched LitCovid, medRxiv, Google Scholar, and the WHO COVID-19 database until June 30 2025, including studies which cultured SARS-CoV-2, relating them to clinico-epidemiologic and laboratory variables and RT-PCR cycle threshold (Ct) values. Using linear mixed-effects regression models, we tested for independent associations with Ct values with 95%CIs and adjusted P-values in a multivariable model. We used a modified QUADAS criteria to assess risk-of-bias. We included 50 studies, with 39 in quantitative synthesis. The percentage of culture-positive specimens decreased with increasing Ct values (subgroup test difference Q = 96.71;P < 0.001) and time since the first PCR test (Q = 26.95;P = 0.0026). Presence of symptoms (Q = 20.1;P < 0.01), gene platform used (Q = 14.89;P = 0.002), being a cancer patient (Q = 24.9;P < 0.0001), and vaccination status (Q = 8.80;P = 0.012) were associated with increased culture-positivity, whereas a rising Ct (adjusted Ct change -6.58[95%CI] -5.30, -7.86;P < 0.001) was strongly associated with culture-negativity. Analysing 186 immunocompetent patients with 1,393 Ct values, 2 consecutive Cts ≥ 30 or a rising Ct value on serial testing demonstrated a sensitivity of 87.5% and specificity of 96.3% using culture positivity as the outcome. Serial Ct monitoring, integrated with clinico-epidemiologic data is a valuable tool for assessing infectiousness, providing objective criteria for discontinuing isolation and guiding clinical decisions.}, }
@article {pmid42088248, year = {2026}, author = {Biscaldi, V and Guerini, J and Ghelfi, M and Velasco, V}, title = {Instruments used to measure well-being, ill-being, and health-related lifestyle behaviors in students attending Italian universities: a systematic review.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1787567}, pmid = {42088248}, issn = {2296-2565}, mesh = {Humans ; *Students/psychology/statistics & numerical data ; Italy ; Universities ; Psychological Well-Being ; *Life Style ; *Health Behavior ; Female ; *Health Status ; Surveys and Questionnaires ; Male ; }, abstract = {BACKGROUND: The well-being of university students is increasingly recognized as a critical public health issue, influenced by complex interactions among psychological, behavioral, and contextual factors. Despite growing research, measurement tools often lack standardization and contextual specificity, limiting the understanding of students' health. This review aimed to map and critically analyze instruments assessing well-being, ill-being, and health-related lifestyle behaviors among Italian university students, as well as the associated variables, including risk and protective factors.
METHODS: The systematic review followed PRISMA guidelines and included peer-reviewed studies published from 2010 onward, identified across five databases: Scopus, APA PsycInfo, PubMed, ERIC, and Web of Science. A structured data extraction process was applied to collect information on sample characteristics, health-related outcomes, and associated variables (protective and risk factors). Descriptive statistics were used to synthesize frequencies, proportions, and distributions of measurement instruments and constructs across the included studies.
RESULTS: A total of 223 studies were included. Samples were largely non-probabilistic and female-biased. Ill-being measures appeared exclusively in 66.3% of the studies, while 7.9% focused on well-being, and 25.8% included both. A total of 159 instruments assessing well-being and ill-being were identified. Of these, the majority measured ill-being (118 instruments), followed by instruments assessing well-being (28), and a smaller number addressing both constructs (13). In addition, 154 instruments measuring lifestyle were identified. Lifestyle behaviors were measured in a fragmented, health-risk-oriented manner, often lacking contextual influences. Individual predictors (130) were prioritized over relational and environmental factors (53). Few instruments were tailored specifically to university students, and many studies used non-validated or ad hoc tools, especially those developed during the COVID-19 pandemic.
DISCUSSION: Findings highlight the need for standardized, validated, and context-sensitive instruments to assess student health holistically.}, }
@article {pmid42088258, year = {2026}, author = {Huang, H and Chen, S and Fang, Z and Ma, Y and Xu, Y and Dong, G}, title = {The "two-hit" storm: a hyper-inflammatory endotype in pediatric long COVID and its role in the severity of secondary bacterial pneumonia-a mechanistic review and clinical implications.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1782871}, pmid = {42088258}, issn = {2296-2565}, mesh = {Humans ; *COVID-19/immunology/complications ; Post-Acute COVID-19 Syndrome ; *Pneumonia, Bacterial/immunology ; Child ; SARS-CoV-2 ; *Inflammation/immunology ; Community-Acquired Pneumonia ; Severity of Illness Index ; }, abstract = {Following the COVID-19 pandemic, the clinical patterns of pediatric respiratory infections have undergone significant changes, with increasing attention on the immunological imprint left by Post-Acute Sequelae of SARS-CoV-2 infection (PASC), commonly known as Long COVID. A perplexing clinical phenomenon has been observed: some children with a history of Long COVID exhibit a disproportionately severe inflammatory response and extensive lung injury when encountering common community-acquired pneumonia, such as that caused by Mycoplasma pneumoniae or Streptococcus pneumoniae, inconsistent with their pathogen load. This review aims to dissect this phenomenon and proposes the "Immune Priming and Two-Hit" model as its core pathophysiological framework. This model posits that the Long COVID state constitutes the "first hit," establishing a "primed" or "hyper-reactive" immune baseline through viral persistence, trained immunity-induced monocyte reprogramming, and sustained endothelial dysfunction. Upon the "second hit" of a bacterial infection, this primed immune system triggers a dysregulated, synergistically amplified inflammatory cascade. The mechanisms involve the exponential release of cytokines such as Interleukin-6 (IL-6), IL-1β, and Tumor Necrosis Factor-α (TNF-α), inflammation-mediated immunothrombosis, and excessive activation of Neutrophil Extracellular Trap formation (NETosis), ultimately leading to severe outcomes like Acute Respiratory Distress Syndrome (ARDS) and necrotizing pneumonia. Consequently, identifying and defining this "Hyper-inflammatory endotype" is of critical clinical importance. We define it as an "endotype" to emphasize the distinct, host-determined pathophysiological mechanisms underlying it, rather than merely a collection of clinical manifestations. By monitoring biomarkers such as ferritin, D-dimer, lactate dehydrogenase (LDH), and lymphocyte counts, clinicians may be able to perform early risk stratification of these children. This approach not only facilitates a shift in therapeutic strategy from purely antimicrobial therapy to "host-directed therapy"-emphasizing the necessity of early, adequate corticosteroid use and consideration of anticoagulation-but also provides a new theoretical basis and intervention window for preventing long-term sequelae such as pulmonary fibrosis.}, }
@article {pmid42088527, year = {2026}, author = {Focosi, D and Franchini, M and Casadevall, A}, title = {On the Use of Immunoglobulins for Pre-exposure Prophylaxis Against COVID-19 in Immunocompromised Patients.}, journal = {Infection and drug resistance}, volume = {19}, number = {}, pages = {540925}, pmid = {42088527}, issn = {1178-6973}, abstract = {COVID-19 remains a cause of significant mortality and morbidity for immunocompromised patients. In the current absence of effective monoclonal antibodies to SARS-CoV-2, standard commercial intravenous/subcutaneous immunoglobulin (IVIG/SCIG) lots provide an option for passive immunotherapy since these now consistently contain SARS-CoV-2-reactive antibodies. Strong mechanistic considerations and emerging observational data support the use of IVIG/SCIG as a biologically plausible option for COVID-19 pre-exposure prophylaxis (PreEP) in immunocompromised patients. In this review, we summarize the supporting evidence available and consider optimal use cases. Neutralization capacity against Omicron lineages is consistently reduced and highly variable between lots, and there is an intrinsic several-month lag between donor immunity and product infusion. The available information in literature sources consistently reflects the use of standard replacement dosing of IVIG/SCIG and does not systematically analyze COVID-19-specific safety or outcomes with dose intensification. While the available evidence suggests that IVIG/SCIG may be effective in PreEP, without dedicated randomized or well-controlled human trials, the magnitude of clinical benefit from this intervention remains uncertain, especially against contemporary Omicron sublineages.}, }
@article {pmid42091413, year = {2026}, author = {Abbehausen, C}, title = {"Metal-based compounds in antiviral and Antiparasitic research: Mechanistic insights from HIV NCp7 and leishmaniasis case studies".}, journal = {Journal of inorganic biochemistry}, volume = {281}, number = {}, pages = {113341}, doi = {10.1016/j.jinorgbio.2026.113341}, pmid = {42091413}, issn = {1873-3344}, mesh = {Humans ; *Leishmaniasis/drug therapy ; *gag Gene Products, Human Immunodeficiency Virus/metabolism/antagonists & inhibitors/chemistry ; *Antiparasitic Agents/chemistry/pharmacology/therapeutic use ; *HIV-1/drug effects ; *Antiviral Agents/chemistry/pharmacology/therapeutic use ; *HIV Infections/drug therapy ; Animals ; Zinc Fingers ; *Coordination Complexes/chemistry/pharmacology/therapeutic use ; }, abstract = {Metallodrugs have long occupied a significant position in medicinal chemistry, yet their application to infectious diseases has historically lagged the extensive development observed in cancer therapy. The COVID-19 pandemic, together with the increased spread of parasitic diseases driven by climate change and human migration, has renewed interest in metal-based compounds as antiviral and antiparasitic agents. These efforts have been further enabled by advances in computational modeling and mechanistic analysis, allowing rational design strategies that extend beyond in vitro drug screening. This focused review traces a coherent body of work, including studies developed by our research group, illustrating how fundamental coordination chemistry principles can be progressively integrated to address infectious disease challenges. Viral molecular targets, exemplified by the HIV-1 nucleocapsid protein NCp7, a zinc finger protein essential for multiple stages of retroviral replication, demonstrate how combined spectroscopic, mass-spectrometric, and computational approaches enable molecular-level understanding of metal-mediated zinc finger inhibition. Similar principles have been extended to neglected and emerging viral pathogens, including arboviruses such as Zika and chikungunya, where metal-based compounds can be modulated to interfere with different steps of replication cycle. In contrast, kinetoplastids such as Leishmania spp. present a complex intracellular environment in which the biological activity of metal complexes is governed predominantly by redox perturbation, disruption of thiol-dependent metabolism, and mitochondrial dysfunction. By following a continuous methodological and conceptual progression from drug-screening to mechanistic approach and in vivo models, this review highlights this transition and underscores the potential of metallodrugs in infectious disease agents.}, }
@article {pmid42091717, year = {2026}, author = {Amal, HM and Mohamed, AMG and Abdel-Halim, MO and Hassan, MS and Khorshid, OA and Osman, WA}, title = {Exploring the long-term hydroxychloroquine's effects on COVID-19 outcomes in patients with autoimmune diseases: a systematic review and meta-analysis.}, journal = {European journal of clinical pharmacology}, volume = {82}, number = {6}, pages = {}, pmid = {42091717}, issn = {1432-1041}, mesh = {Humans ; *Hydroxychloroquine/therapeutic use/administration & dosage ; *Autoimmune Diseases/drug therapy/mortality/complications ; COVID-19/mortality ; *COVID-19 Drug Treatment ; SARS-CoV-2 ; Treatment Outcome ; Pandemics ; Observational Studies as Topic ; }, abstract = {BACKGROUND: Hydroxychloroquine (HCQ) usage in COVID patients was a popular topic of study, especially during the first wave of the pandemic. However, the long-term impact of HCQ therapy on infected COVID-19 patients remains unclear.
OBJECTIVES: Holding a PROSPERO registration (CRD42025113906), this study aimed to investigate the impact of long-term treatment with HCQ in patients with autoimmune diseases on mortality, as well as on the development of disease-related complications.
METHODS: A comprehensive search was conducted across multiple databases. Full-text reports were included for clinical trials and observational studies on adult patients with autoimmune disease and confirmed COVID-19 infection subjected to HCQ therapy.
RESULTS: The search process has identified 1,126 studies, of which 17 observational studies were included.No randomized controlled trials meeting the inclusion criteria were found. Eligible studies involved 229,142 autoimmune patients treated with HCQ, of which 197,118 patients were diagnosed with COVID-19. In 14 observational studies (196,965 patients), HCQ use was associated with a lower overall mortality rate by 21% in patients with autoimmune diseases and COVID-19 (RR 0.79; 95% CI: 0.64-0.97, p = 0.02). This association may reflect a potential survival benefit; however, given the observational nature of the studies included, causal inference cannot be established, and the findings should be interpreted cautiously. There was no significant difference between HCQ-treated patients and untreated patients regarding hospitalization (12 studies with 2,238 patients included), ICU admission (8 studies with 527 patients included), mechanical ventilation (8 studies with 546 patients included), sepsis (2 studies with 132 patients included), or thrombo-embolic events rates (2 studies with 195 patients included) (RR 0.92, 95% CI 0.75- 1.14; p = 0.46), (RR 1.45; 95% CI; 0.82- 2.56, p = 0.2) and (RR 1.28; 95% CI; 0.68- 2.4, p = 0.44), (RR 1.44; 95% CI; 0.57 - 3.65, p = 0.44), (RR 0.89; 95% CI; 0.16-4.97, p = 0.89), respectively. Nonetheless, the incidence of Acute Kidney Injury (AKI) in 2 studies (136 patients) was higher in HCQ-treated groups compared to the untreated groups (RR 2.31; 95% CI; 1.29-4.12, p = 0.0047).
CONCLUSION: HCQ was associated with a significantly lower overall mortality rate in patients with autoimmune diseases and COVID-19; this association is consistent with its known immunomodulatory properties. On the other hand, it does not prevent COVID-19-related complications and could be associated with an increased risk for developing AKI. However, given the observational nature of all included studies, causal inference cannot be established. Future research is needed to confirm these observed survival benefits and to establish clear safety parameters regarding renal toxicity.}, }
@article {pmid42091820, year = {2026}, author = {Syed, P and Schembri, MA and McCann, AJ and Meunier, FA}, title = {Case Study: Illuminating the Nanoscale World of Microbiology.}, journal = {Methods in molecular biology (Clifton, N.J.)}, volume = {3034}, number = {}, pages = {303-327}, pmid = {42091820}, issn = {1940-6029}, mesh = {*Microscopy/methods ; *Bacteria/ultrastructure/metabolism ; Single Molecule Imaging/methods ; Microscopy, Fluorescence/methods ; Host-Pathogen Interactions ; Nanotechnology/methods ; Software ; }, abstract = {Super-resolution microscopy has emerged as a groundbreaking tool in microbiology, enabling the visualization of structures and molecules far below the diffraction limit of light. We provide an overview of the various techniques employed in super-resolution microscopy, including deterministic (scanning and structured illumination) and stochastic (single-molecule localization microscopy and fluctuation-based computation) methods, summarizing their respective advantages and limitations. Applications in microbiology are presented, including investigations of cellular processes, physiology, cell wall biology, and elucidation of bacterial toxin pathogenesis mechanisms at nanoscale resolution. New and emerging uses of super-resolution microscopy are also explored, focusing on addressing critical challenges in the field: pathogen-host interactions, antibiotic resistance, mode of action of bacterial toxins, and nanoscale detail of bacterial secretion systems and their translocated effectors. With the expanding accessibility of resources and increasing availability of open-source software to democratize data analysis, super-resolution microscopy is poised to revolutionize our understanding of the nanoscale world in microbiology, paving the way for new discoveries.}, }
@article {pmid42091825, year = {2026}, author = {Gerdes, R and Roberts, R and Jackson, TD and Premji, R and Deibert, D and Choi, C and Steer, KJD and Bani-Fatemi, A and Dennett, L and Lytvyak, E and Ferguson-Pell, M and Tsuyuki, R and Durand-Moreau, Q and Gross, DP and Hagtvedt, R and Vandermeer, B and Nowrouzi-Kia, B and Straube, S}, title = {Telehealth Treatments of Common Psychological Disorders: An Overview and Meta-analysis.}, journal = {Journal of occupational rehabilitation}, volume = {}, number = {}, pages = {}, pmid = {42091825}, issn = {1573-3688}, abstract = {PURPOSE: The evidence base for telehealth treatments for mental health has grown substantially in the years following the COVID-19 pandemic. We conducted a narrative synthesis and meta-analysis of reviews investigating the efficacy of live, one-to-one telehealth interventions for common mental disorders.
METHODS: We conducted a search for systematic reviews of randomized controlled trials or controlled before-and-after studies. Two independent reviewers screened potentially eligible references and extracted data from all eligible reviews. A meta-regression was conducted with reviews containing data suitable for quantitative analysis. A narrative synthesis of results was undertaken for included reviews that did not contain suitable quantitative data.
RESULTS: The search yielded 4180 references, from which 11 eligible reviews were identified. Seven systematic reviews with meta-analyses were included in the meta-regression. Only telehealth interventions for depression and anxiety disorders were identified in the eligible literature. A small significant effect was observed for interventions targeting depression and comparing to active control, where SMD = - 0.316, and p = 0.003.
CONCLUSIONS: The results of the meta-regression and narrative synthesis indicate that live one-to-one telehealth produces similar reductions in symptom severity across diagnoses and comparator groups. We identified that most of the research on telehealth for common mental disorders includes low-intensity, self-help tools with reduced clinician involvement, highlighting that much of the research conducted in this area aims at providing care at reduced cost, despite the importance of therapeutic alliance in the provision of mental health care. Investigations of telehealth interventions targeting posttraumatic stress disorder in non-military populations are also needed.}, }
@article {pmid42093970, year = {2026}, author = {Qiu, W and Wang, S and Huang, Y and Xu, N and Yang, J and Wu, H}, title = {Global research trends and future frontiers in the immunology of spontaneous abortion: a 25-year scientometric analysis.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1753732}, pmid = {42093970}, issn = {1664-3224}, mesh = {Humans ; Female ; *Abortion, Spontaneous/immunology ; Pregnancy ; *Bibliometrics ; *Allergy and Immunology/trends ; *Biomedical Research/trends ; }, abstract = {BACKGROUND: The intricate role of the immune system in spontaneous abortion is a critical and rapidly evolving field of reproductive medicine.
METHODS: We conducted a scientometric analysis of 4,495 publications on the immunology of spontaneous abortion retrieved from the Web of Science Core Collection for the period 2000-2025. Bibliometric tools, including CiteSpace and HistCite, were used to analyze publication trends, collaboration networks, co-citation patterns, and keyword evolution to identify the intellectual structure and research frontiers.
RESULTS: The annual publication output experienced rapid growth from 2008, peaking in 2022. The American Journal of Reproductive Immunology was the most prolific journal, while China and the USA were the leading countries in scientific collaboration. Co-citation analysis identified foundational works by authors such as Atik RB (2018) and Quenby S (2021). Burst detection analysis revealed a dynamic shift in research hotspots over time, with recent high-strength keywords including "recurrent implantation failure" (strength: 15.87), "chronic endometritis" (13.4), and "maternal-fetal interface" (10.35). Timeline and cluster analyses further pinpointed the field's evolution from foundational topics like "tolerance" and "antiphospholipid syndrome" to current emerging frontiers. These new frontiers are concentrated in distinct clusters, prominently including #0 recurrent pregnancy loss, #2 maternal-fetal interface, #11 chronic endometritis, and #12 COVID-19. Alluvial flow visualization confirmed that themes related to "regulatory_t_cells" and therapeutic interventions at the "maternal-fetal_interface" represent major developing research streams.
CONCLUSION: This study comprehensively maps the historical landscape and dynamic evolution of research on immunology in spontaneous abortion, identifying key emerging frontiers that may represent important directions for future investigation in the field.}, }
@article {pmid42094618, year = {2026}, author = {Amegashie, EA and Sikeola, RO and Kwayisi-Darkwah, CK and Atampugbire, G and Tagoe, EA and Paintsil, E and Torpey, K and Quaye, O}, title = {Viral Mechanisms and Drug Influences on Janus Kinase/Signal Transducers and Activators of Transcription (JAK/STAT) Pathway in Human Coronaviruses Infection: A Systematic Review.}, journal = {Health science reports}, volume = {9}, number = {}, pages = {e72474}, pmid = {42094618}, issn = {2398-8835}, abstract = {BACKGROUND AND AIM: Janus kinases/signal transducers and activators of transcription (JAK/STAT) pathway is crucial for various stages of immunity, from innate to adaptive responses. Type 1 IFNs activate JAK/STAT pathway by binding to receptors on JAK, phosphorylating STAT and upregulating interferon-stimulated genes (ISGs) leading to cytokines production. Viruses, however, have developed mechanisms to prevent antiviral type I IFNs induction, resulting in active viral replication. This study seeks to review viral mechanisms, drug influences, and vitamin D supplements affecting the JAK/STAT pathway in human coronavirus infection.
METHODS: Literature searches were conducted across Google Scholar, Scopus, PubMed, and ScienceDirect in accordance with the PRISMA guidelines. The study included all publications that satisfied the PRISMA criteria, were written in English, and fell within a 10-year window from July 2014 to June 2024. Forty-seven (47) studies satisfied the requirement for selection, out of which 31 studies were on viral mechanism, 12 were on drug interaction, and 2 were on vitamin D supplements.
RESULTS: There is consistent evidence of viral proteins, including ORF6, ORF8, spike, NSP14, NSP 1, and N of human coronaviruses disrupting the JAK/STAT pathway. Ruxolitinib, baricitinib, and Liantua Qingwen capsules have, however, been shown to stabilize the pathway by attacking viral proteins, inhibiting some pro-inflammatory cytokines, and downregulating STAT components to lessen cytokine storm, during hyperinflammation.
CONCLUSION: This finding emphasizes the need for controlled regulation of JAK/STAT pathway to address coronavirus infections and immune disruptions, with continued research essential in developing targeted treatment against present and future viral threats.}, }
@article {pmid42094979, year = {2026}, author = {Huang, Y and Zhang, X and Miao, R and Wang, J and Xi, X and Pan, H and Lu, Y and Li, D}, title = {Hybrid immunity strategies: heterologous vaccination combined with natural SARS-CoV-2 infection.}, journal = {Frontiers in medicine}, volume = {13}, number = {}, pages = {1828887}, pmid = {42094979}, issn = {2296-858X}, abstract = {The continuous evolution of SARS-CoV-2 poses a significant challenge to existing immune barriers, highlighting the limitations of single-modality immunization. Hybrid immunity, shaped by the combination of natural infection and vaccination, induces more potent, broad-spectrum, and durable protective immunity. This review proposes that heterologous vaccination - the sequential use of vaccines based on different technological platforms - can serve as an active public health strategy to simulate and optimize hybrid immunity. We systematically elaborate on the synergistic advantages of hybrid immunity at both the humoral and cellular levels, citing evidence from multiple clinical trials that for both convalescent individuals and infection-naïve populations, heterologous vaccination regimens outperform homologous regimens in enhancing the breadth of neutralizing antibodies, strengthening cross-protection, and establishing robust immune memory. By mimicking the antigenic distance effect, heterologous vaccination safely replicates the immunological benefits of natural infection without the associated risks, positioning it as a key strategic tool to counter persistent viral evolution and build a resilient population-wide immune barrier.}, }
@article {pmid42095491, year = {2026}, author = {Hu, R and Dou, Y and Li, C and Mu, Y and Ouyang, H and Shen, W and Zhang, J}, title = {Decoding Undesirable Inflammatory Responses of Nucleic Acid-Delivering Lipid Nanoparticles.}, journal = {Advanced science (Weinheim, Baden-Wurttemberg, Germany)}, volume = {13}, number = {33}, pages = {e75548}, pmid = {42095491}, issn = {2198-3844}, support = {CQYC20220303706//Chongqing Innovation Leading Talent Project/ ; CSTB2022TIAD-KPX0156//Key Program for Technological Innovation & Application Development of Chongqing/ ; 2023GGXM005//Key Medical Program Integrated by Chongqing Science and Technology Bureau and Chongqing Health Commission/ ; CSTB2024NSCQ-QCXMX0005//New Chongqing Youth Innovative Talent Program/ ; }, mesh = {Humans ; *Nanoparticles/chemistry/adverse effects/administration & dosage ; *Lipids/chemistry/immunology ; *Inflammation/immunology ; Animals ; *Nucleic Acids/administration & dosage ; *COVID-19 Vaccines/immunology/administration & dosage ; *COVID-19/prevention & control/immunology ; SARS-CoV-2/immunology ; Liposomes ; }, abstract = {Lipid nanoparticles (LNPs) are transformative vectors for nucleic acid delivery, proven safe and effective in COVID-19 mRNA vaccines, and enabling advances in cancer immunotherapy and gene editing. However, their inherent immunogenicity presents a double-edged sword: beneficial adjuvant effects in vaccination can become detrimental inflammatory responses in applications like treating inflammatory/fibrotic diseases or gene editing-based therapies. This review comprehensively evaluates LNP-associated inflammation and mitigation strategies. We begin with an in-depth analysis of molecular mechanisms, detailing how specific lipid components, endocytic pathway activation, and nucleic acid sensing drive immune stimulation. Key modulatory factors, including LNP structural characteristics, administration routes, and biodistribution, are examined. We then explore cutting-edge engineering approaches to circumvent immunogenicity, encompassing structure-guided design of ionizable lipids, sophisticated biomimetic strategies using natural membrane coatings, innovative co-delivery systems incorporating anti-inflammatory agents, and emerging technologies for immune-evasive LNPs. By elucidating the intricate relationship between nanocarrier physicochemical properties and host immune recognition, while addressing translational hurdles, this review provides critical insights for developing safer, next-generation LNPs tailored for diverse therapeutic applications.}, }
@article {pmid42095944, year = {2026}, author = {Azi, AO and Lim, HS and Yohanna, E}, title = {Air pollution in Malaysia: current understanding and future directions.}, journal = {Environmental geochemistry and health}, volume = {48}, number = {7}, pages = {}, pmid = {42095944}, issn = {1573-2983}, support = {FRGS/1/2021/STG08/USM/02/2//Ministry of Higher Education (MOHE)/ ; }, mesh = {Malaysia/epidemiology ; *Air Pollution/analysis/adverse effects ; Particulate Matter/analysis ; *Air Pollutants/analysis ; Humans ; Environmental Monitoring/methods ; COVID-19/epidemiology ; }, abstract = {Air pollution remains a significant environmental and public health issue in Malaysia, with notable effects on the economy and climate. Despite long-standing monitoring systems and regulations, comprehensive assessments that combine multiple data sources with health impact analysis are still lacking. This study reviews peer-reviewed studies, haze events from 1983 to 2024, regulatory documents from the Department of Environment, Malaysia, and data from air quality monitoring stations across regions. and presents an integrated assessment of air quality across strategic and important urban, industrial, coastal, and residential areas. It analyses trends in the Air Pollutant Index and PM2.5 levels from 2013 to 2024, and uses exposure-response models to estimate related deaths and economic impacts. Satellite data (MODIS and AERONET) help understand spatial variation and cross-border pollution. Average PM2.5 levels ranged from 8.66-16.77 µg/m[3], consistently above WHO guidelines from 2021. In 2020, PM2.5 exposure was linked to 1.419 early deaths in four urban areas, costing about MYR 2.46 billion (USD 524 million). Population-attributable fractions ranged from 2.6-7.1%, with risk rising by 2.7-7.6% per 10 µg/m[3] increase. The study identified 12 major haze events, notably in 1997 and 2015. COVID-19 restrictions temporarily reduced emissions, but levels quickly rebounded afterward. Conclusively, Malaysia's air quality issues are mainly due to transport, industry, dust, and recurring transboundary haze. Solutions include better source tracking, enhanced secondary pollutant monitoring, integrating health data more effectively, adopting advanced technologies, and aligning policies with WHO standards. Pollution effects are more pronounced in metropolitan regions due to proximity to dense sources.}, }
@article {pmid42096655, year = {2026}, author = {Ren, J and Qiu, J and Cai, J and Li, Y and Huang, L and Li, X}, title = {Effectiveness of digital health interventions in reducing loneliness among older adults: a systematic review and meta-analysis.}, journal = {Age and ageing}, volume = {55}, number = {5}, pages = {}, doi = {10.1093/ageing/afag122}, pmid = {42096655}, issn = {1468-2834}, support = {2023AH040086//Anhui Province University Scientific Research Projects/ ; YJS20240069//Anhui Province University Scientific Research Projects/ ; }, mesh = {*Loneliness ; *Digital Health ; Humans ; Aged ; Randomized Controlled Trials as Topic ; Middle Aged ; Internet-Based Intervention ; *Cognitive Training ; }, abstract = {BACKGROUND: Loneliness affects 12% of older adults globally, with concerns exacerbated by the COVID-19 pandemic. While digital health interventions (DHIs) show promise, evidence of their effectiveness remains mixed.
METHODOLOGY: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted in the PubMed, Cochrane, Web of Science and Embase databases (2010-25). Inclusion criteria were adults aged 60 years, with loneliness as the primary or secondary outcome. Study quality was assessed using GRADE and Cochrane risk of bias tools. Subgroup analyses explored intervention type, measurement scales, national development level, pandemic timing and some secondary outcomes.
RESULTS: Seventeen studies (n = 2423) showed DHIs significantly reduced loneliness scores (standardized mean difference [SMD] = -0.39, 95% CI -0.77 to -0.01). Subgroup analyses revealed significant reductions for social cognitive training (SMD = -0.82, 95% CI -1.47 to -0.16). Greater effectiveness was observed in developed countries (SMD = -0.30, 95% CI: -0.51 to -0.09) and during the pandemic period (SMD = -0.54, 95% CI: -1.03 to -0.06). DHIs also improved mental health (SMD = 0.98, 95% CI: 0.12 to 1.84) and marginally reduced depressive symptoms (SMD = -0.73, 95% CI: -1.45 to 0.00).
CONCLUSION: DHIs show promise in reducing loneliness scores among older adults, particularly through cognitive-focused interventions in supportive digital environments. However, the overall effect is modest and highly heterogeneous, with benefits that appear context-dependent and short-lived. Future research should prioritise standardised measurement, diverse populations and long-term follow-up to optimise DHI design.}, }
@article {pmid42096888, year = {2026}, author = {Unger, M and Munro, JB}, title = {Control of viral envelope glycoprotein function revealed by single-molecule imaging.}, journal = {Current opinion in structural biology}, volume = {98}, number = {}, pages = {103275}, pmid = {42096888}, issn = {1879-033X}, support = {R01 AI150322/AI/NIAID NIH HHS/United States ; R01 AI174645/AI/NIAID NIH HHS/United States ; R01 GM143773/GM/NIGMS NIH HHS/United States ; }, mesh = {*Viral Envelope Proteins/chemistry/metabolism ; *Single Molecule Imaging/methods ; Fluorescence Resonance Energy Transfer ; Virus Internalization ; Humans ; Protein Conformation ; }, abstract = {Viral envelope glycoproteins catalyze membrane fusion during entry into cells. Envelope glycoprotein function has traditionally been viewed through the lens of kinetic control, where environmental cues like pH trigger irreversible refolding from the pre-fusion conformation to the post-fusion conformation. Single-molecule Förster resonance energy transfer (smFRET) imaging has revealed an additional layer of thermodynamic control that governs the conformational dynamics of envelope glycoproteins in their pre-fusion form. smFRET studies of the envelope glycoproteins from HIV-1, SARS-CoV-2, MERS-CoV, Ebola virus, and influenza A virus demonstrate that these glycoproteins dynamically sample an ensemble of pre-fusion conformations whose relative stabilities respond to pH, receptor binding, ions, and host proteases. This thermodynamic tuning precedes the kinetically controlled transition that promotes membrane fusion. Collectively, smFRET imaging has transformed our understanding of viral entry, illustrating how the pre-fusion energy landscape of envelope glycoproteins is tuned by the host environment to maintain viral fitness.}, }
@article {pmid42096990, year = {2026}, author = {Auckburally, A and Grubb, TL and Perchiazzi, G and Högman, M and Nyman, G}, title = {Nitric oxide and its role in the management of hypoxaemia in the anaesthetised horse-a narrative review.}, journal = {Veterinary anaesthesia and analgesia}, volume = {53}, number = {4}, pages = {101227}, doi = {10.1016/j.vaa.2026.101227}, pmid = {42096990}, issn = {1467-2995}, mesh = {Animals ; Horses ; *Hypoxia/veterinary/drug therapy ; *Nitric Oxide/administration & dosage/therapeutic use ; *Horse Diseases/drug therapy ; *Anesthesia, General/veterinary/adverse effects ; }, abstract = {OBJECTIVE: To outline historical aspects of nitric oxide, including its discovery and biological effects, to describe the current use of inhaled nitric oxide (iNO) in human healthcare, and to review the available evidence on the use of pulsed iNO (PiNO) for the management of hypoxaemia in anaesthetised horses.
DATABASES USED: Google Scholar and PubMed databases were searched using the search terms nitric oxide, PiNO, environment, discovery, acute respiratory distress syndrome, COVID-19, SARS-CoV-2, horse, pony, hypoxaemia, and anaesthesia.
CONCLUSIONS: Inhaled NO is licensed in the management of hypoxic respiratory failure in human neonates and has also been used to treat refractory hypoxaemia in humans fulfilling certain criteria. There is now a substantial body of evidence demonstrating that PiNO is an effective treatment option for managing hypoxaemia during general anaesthesia in horses. The administration of PiNO to well-ventilated alveoli leads to a redistribution of pulmonary blood flow from dependent, nonventilated regions to nondependent, better ventilated regions of the lung. This reduces intrapulmonary shunting and improves indices of oxygenation and oxygen delivery. Whilst much of the evidence is experimental, there are some descriptions of its successful use in client-owned horses undergoing surgery for colic and arthroscopic procedures. As the prototypical delivery device (the NOrse, Datex-Ohmeda Research Department, Helsinki, Finland) has been redeveloped, the use of PiNO in clinical equine anaesthesia may offer a realistic treatment option for the management of hypoxaemia in anaesthetised horses in the near future.}, }
@article {pmid42097077, year = {2026}, author = {Baldry, K and Koekemoer, E and Olckers, C}, title = {Structural constraints and psychological need satisfaction among platform-based delivery riders in South Africa.}, journal = {Acta psychologica}, volume = {266}, number = {}, pages = {106989}, doi = {10.1016/j.actpsy.2026.106989}, pmid = {42097077}, issn = {1873-6297}, mesh = {Humans ; South Africa ; Female ; Adult ; Male ; *Employment/psychology ; *Personal Satisfaction ; Personal Autonomy ; Qualitative Research ; *COVID-19/psychology ; }, abstract = {Platform-based motorbike delivery riders have become an essential part of the urban labour force, especially since the COVID-19 pandemic increased online shopping. This qualitative study used Self-Determination Theory and the Psychology of Working Theory to explore how motorbike delivery work promotes or undermines riders' psychological needs of competence, relatedness and autonomy. Ten motorbike delivery riders in Johannesburg, Gauteng, participated in twenty semi-structured interviews (two per participant). Hybrid thematic analyses were employed to analyse the data. Findings indicated that, amidst high unemployment and limited job opportunities in South Africa, platform-based motorbike delivery work partially satisfies riders' psychological needs. Relatedness was supported in interactions with customers and co-workers but limited by experiences of social stigmatisation. As independent contractors, riders enjoyed greater labour market flexibility and often earned more than in previous jobs, both of which promoted their autonomy. However, constant concerns regarding personal safety severely undermined this need. Challenges such as limited training and procedural injustice also restricted their need for competence. This study extends the Psychology of Working Theory by demonstrating how structural constraints not only influence the attainment of decent work but also shape the outcomes of decent work, specifically the fulfilment of psychological needs in precarious labour contexts.}, }
@article {pmid42097153, year = {2026}, author = {Zumla, A and Hui, DS and Peiris, M and Perlman, S}, title = {Respiratory infections due to human common cold coronaviruses, SARS-CoV, MERS-CoV, and SARS-CoV-2: epidemiology, pathogenesis, clinical features, diagnostics, therapeutics, and vaccine landscapes.}, journal = {The Lancet. Respiratory medicine}, volume = {14}, number = {6}, pages = {545-566}, doi = {10.1016/S2213-2600(26)00049-4}, pmid = {42097153}, issn = {2213-2619}, mesh = {Humans ; *Coronavirus Infections/epidemiology/diagnosis/therapy/prevention & control/transmission ; Middle East Respiratory Syndrome Coronavirus/pathogenicity ; SARS-CoV-2 ; COVID-19 ; *Severe Acute Respiratory Syndrome/epidemiology/diagnosis/therapy/prevention & control ; Viral Vaccines ; Severe acute respiratory syndrome-related coronavirus/pathogenicity ; Pandemics/prevention & control ; *Betacoronavirus ; *Pneumonia, Viral/epidemiology/diagnosis/therapy/prevention & control/transmission ; Animals ; *Common Cold/epidemiology/diagnosis/therapy ; COVID-19 Vaccines ; *Respiratory Tract Infections/epidemiology/diagnosis/therapy/virology ; }, abstract = {Over the past half-century, perceptions of human coronaviruses have evolved from their initial characterisation as causes of the common cold to recognition of their capacity to trigger severe disease and global epidemics. The emergence of three zoonotic coronaviruses-severe acute respiratory syndrome coronavirus (SARS-CoV) in 2002, Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012, and SARS-CoV-2 in 2019, has had profound health, economic, and societal consequences and continues to influence global epidemic-preparedness strategies. All three viruses remain on the WHO Blueprint of priority pathogens for research and development. This Review summarises current knowledge on human coronaviruses, drawing lessons from the past 25 years of epidemic outbreaks. The shared and divergent features of SARS-CoV, MERS-CoV, and SARS-CoV-2, including their origins, evolution, transmission determinants, zoonotic transmission, viral entry pathways, pathogenesis, spectrum of clinical manifestations, long-term sequelae, and case-fatality profiles are highlighted. The full range of clinical manifestations, from asymptomatic or atypical presentations to severe acute respiratory and multisystem disease, are outlined together with risk factors for progression and populations with the greatest susceptibility. Diagnostic approaches, including molecular assays, antigen-based tests, and imaging modalities are described alongside current therapeutics, antiviral strategies, immunomodulators, supportive care principles, and evidence from clinical trials. Advances in diagnostics, vaccines, therapeutics, and infection-control practices are examined together with persistent challenges in early recognition, particularly in resource-limited settings. Strengthening multinational clinical trial capacity, leveraging digital innovations, and embedding One Health approaches are essential to mitigating spillover risks and improving global readiness. We review the latest data, identify gaps and opportunities, and outline forward-looking strategies to anticipate and prepare for the threat of future coronaviruses, and other existing or new respiratory pathogens with epidemic potential. Clinicians and other health-care workers play a central role in detecting and reporting possible lethal coronavirus infection including atypical presentations, enabling rapid, coordinated infection control and management responses.}, }
@article {pmid42097990, year = {2026}, author = {Bruffaerts, R}, title = {Mental Health in College Students: From Epidemiological Findings to Sustainable Policies.}, journal = {Annual review of clinical psychology}, volume = {22}, number = {1}, pages = {533-557}, doi = {10.1146/annurev-clinpsy-061724-084303}, pmid = {42097990}, issn = {1548-5951}, mesh = {Humans ; *Students/psychology/statistics & numerical data ; Universities/statistics & numerical data ; *Mental Disorders/epidemiology ; *COVID-19 ; *Mental Health ; *Mental Health Services/statistics & numerical data ; Young Adult ; Academia ; }, abstract = {Higher education has seen rising enrollment, mobility, and diversity; there are approximately 254 million students globally, a figure that has doubled since the early 2000s. The college years (roughly the age range between 18 and 30) coincide with key developmental phases marked by personal, social, and academic stressors like leaving home and adjusting to new environments. This period is high-risk for mental health issues such as anxiety and depression, which negatively affect academic success and future quality of life. The COVID-19 pandemic challenged students' mental health due to isolation, online learning, and fears of infection. Despite growing emotional problems, many students do not seek help, and this avoidance results in inadequate treatment and fragmented mental health services. These issues present significant challenges in addressing mental health within higher education and beyond. The goal of this article is to offer a thorough, critical review of the existing research on college mental health, including key data-driven epidemiological findings on mental disorders, theory-driven approaches to challenges faced during college, and prospects for future research.}, }
@article {pmid42098872, year = {2026}, author = {Donglin, W and Xuewei, W and Syed Jaapar, SZ and Ab Razak, A}, title = {Cultural background and pandemic context as moderators of the association between expressive suppression and sleep quality in healthy adults: a systematic review and meta‑analysis.}, journal = {BMC psychology}, volume = {14}, number = {1}, pages = {}, pmid = {42098872}, issn = {2050-7283}, mesh = {Humans ; *Sleep Quality ; *COVID-19/psychology ; *Emotional Regulation ; Pandemics ; Adult ; }, abstract = {BACKGROUND: Expressive suppression is a widely used emotion regulation strategy, but studies have reported mixed findings regarding its association with sleep quality in healthy adults. This meta-analysis aimed to synthesize the evidence on the association between expressive suppression and sleep quality in non-clinical adult samples and examine the moderating effect of cultural background and pandemic context.
METHODS: Electronic databases including PubMed, EBSCO, and Web of Science were systematically searched from database inception to May 2025 using predefined search terms related to emotion regulation and sleep quality. Studies were included if they: (1) involved non-clinical adult samples; (2) assessed expressive suppression with the Emotion Regulation Questionnaire (ERQ); (3) used standardized self-report measures of sleep quality (e.g., PSQI, ISI); and (4) reported zero-order Pearson correlations. A total of twenty-three independent samples (N = 13,636) met the inclusion criteria. A random-effects model was used to estimate the pooled effect size, and pre-specified subgroup and moderation analyses were conducted.
RESULTS: Expressive suppression showed a small but significant positive association with poorer sleep quality (r = .14, 95% CI [0.12, 0.16], p < .0001). Between-study heterogeneity was low (I² = 28.21%). The association was stronger in studies explicitly focused on COVID-19-related stress than in studies conducted in general contexts, whereas cultural background, type of sleep measure, study design, and publication period did not significantly moderate the effect.
CONCLUSION: Habitual use of expressive suppression appears to be associated with poorer sleep quality in healthy adults, and this association may be stronger under conditions of major psychosocial stress such as the COVID-19 pandemic. Interventions that reduce reliance on suppression or promote more flexible emotion regulation may help support sleep health, particularly during periods of widespread stress.
TRIAL REGISTRATION: This study has been registered with the PROSPERO (registration number: CRD420251059053).}, }
@article {pmid42099599, year = {2026}, author = {Liu, Y and Zhong, R and Wu, X and Wang, Y and Zhang, J and Kou, Z}, title = {Global trends and research hotspots in autoimmune encephalitis: insights from a bibliometric and visualized analysis: 1971-2025.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1798782}, pmid = {42099599}, issn = {1664-3224}, mesh = {*Bibliometrics ; Humans ; *Encephalitis/immunology/therapy ; *Hashimoto Disease/immunology/epidemiology/therapy ; History, 21st Century ; History, 20th Century ; *Biomedical Research/trends ; }, abstract = {BACKGROUND: Autoimmune encephalitis (AE) encompasses a highly heterogeneous spectrum of severe immune-mediated neurological disorders. Over the past 50 years, research has expanded rapidly, yet a quantitative synthesis of its evolution, key contributors, and thematic trends is lacking. Here, we provide a comprehensive 50-year, multi-database bibliometric study that systematically maps the full trajectory of AE research-from early descriptions to the current era of mechanism-driven therapeutics-using advanced analytical tools.
METHODS: We systematically retrieved AE-related publications from 1971 to May 24, 2025 from PubMed, Web of Science, and Scopus. After deduplication, records were analyzed using bibliometric tools (CiteSpace, VOSviewer, Bibliometrix). Analyses included publication trends, national/institutional contributions, author networks, journal distributions, co-citation patterns, keyword co-occurrence, and thematic evolution.
RESULTS: Annual publications surged after 2007, coinciding with the discovery of anti-NMDA receptor encephalitis (anti-NMDAR AE), reaching a peak in 2022. The USA and China were the leading contributors by volume, while Spain had the highest average citation impact. The University of Pennsylvania and the University of Oxford emerged as the most productive institutions. Dr. Josep Dalmau is the most prolific author in the field, leading a major collaborative cluster. Frontiers in Neurology published the most papers, while Neurology had the highest H-index. Keyword and thematic analyses confirmed anti-NMDAR AE as the dominant research focus, with intense scholarly interest in its pathogenesis, diagnosis, and immunotherapy. Recent trends highlight emerging topics like COVID-19-associated AE, anti-IGLON5 disease.
CONCLUSIONS: This study outlines the development, collaboration patterns, and research hotspots in AE. Research continues to center on anti-NMDAR encephalitis, with a growing focus on clinical and therapeutic applications. Future directions include mechanistic studies, biomarker discovery, and advanced immunotherapies.}, }
@article {pmid42099707, year = {2026}, author = {Lokonon, BE and Houetohossou, SCA and Tchede, BA and Yapi, RB and Cailleau, A and Haydon, DT and Bonfoh, B}, title = {The use of artificial intelligence based modelling techniques in One Health-related infectious disease studies in Sub-Saharan Africa: a review.}, journal = {Frontiers in artificial intelligence}, volume = {9}, number = {}, pages = {1778800}, pmid = {42099707}, issn = {2624-8212}, abstract = {BACKGROUND: Sub-Saharan Africa continues to face a substantial burden of infectious diseases, many of which are zoonotic and shaped by complex interactions across human, animal, and environmental systems. Artificial Intelligence (AI), encompassing machine learning (ML) and deep-learning (DL) techniques, has emerged as a powerful tool for enhancing disease prediction, surveillance, diagnosis, and decision-making within a One Health (OH) framework.
METHOD: This systematic review synthesizes evidence from 62 peer-reviewed studies to assess how AI-based modelling techniques have been applied to infectious disease research across Sub-Saharan Africa.
RESULTS: Results show that AI adoption has grown rapidly since 2019, with a pronounced surge in publications between 2021 and 2024. However, research leadership and implementation capacity remain geographically uneven, with South Africa, Ethiopia, Kenya, and Tanzania dominating the landscape. Across studies, AI tools were used primarily for classification and prediction tasks, with ensemble models and deep-learning architectures showing the strongest performance (with median accuracy close to 100% for Convolutional Neural Network model). Malaria (24%), HIV (12%), COVID-19 (12%), and Tuberculosis (6.7%) were the most frequently targeted diseases, while zoonotic and environmentally linked infections were comparatively underrepresented. Most studies relied exclusively on human data, revealing a persistent gap in the integration of animal and environmental components critical to the OH paradigm.
CONCLUSION: Despite promising applications, including image-based parasite detection, IoT-enabled surveillance, ecological risk modelling, and smartphone-assisted diagnostics, AI deployment remains constrained by limited computational infrastructure, inadequate digital connectivity, data-governance weaknesses, and shortages of AI-trained specialists. Conversely, expanding mobile connectivity, cloud-based analytics, and advancements in multilingual AI tools could create new opportunities to strengthen surveillance systems, empower health workers, and improve community engagement.}, }
@article {pmid42100527, year = {2026}, author = {Alghamdi, B and Albedah, N and Almalki, T and Almudarra, S and Penttinen, P and Wang, C and Hong, PY}, title = {Wastewater-based surveillance of microbial pathogens in GCC countries (2015-2025): a scoping review and questionnaire survey with stakeholders.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1786753}, pmid = {42100527}, issn = {2296-2565}, mesh = {*Wastewater/microbiology ; Surveys and Questionnaires ; Humans ; }, abstract = {BACKGROUND: Wastewater-based surveillance (WBS) of microbial pathogens has become an increasingly useful approach to monitor public health at the population level. However, these efforts varied widely in scope, methodology and focus within the GCC region. It remains unclear how WBS is being used across the region, and to what extent it can inform decision-making or contribute to long-term surveillance infrastructure within the GCC. This review aimed to critically assess WBS studies conducted across GCC and to provide perspective on how to further strengthen the ability of WBS to inform and provide early detection on the emergence of health concerns arising from microbial contaminants that are circulating in the community.
METHODS: This review was conducted following the PRISMA extension for scoping reviews guidance, aiming to identify and critically evaluate peer-reviewed studies that applied WBS across GCC between January 2015 and October 2025. A structured English-language literature search was carried out on the Web of Science, Scopus, and Google Scholar. Search results were screened against predefined inclusion and exclusion criteria. A survey was conducted with GCC stakeholders involved in the execution of wastewater surveillance, and their responses were studied to align actual WBS activities against that reported in the literature.
RESULTS: A total of 26 studies met the inclusion criteria for this review, with uneven distribution of studies published across the GCC countries (n = 6). The main targets reported in the WBS studies are antimicrobial resistance (AMR) and SARS-CoV-2. Majority of the studies report qualitative presence of microbial targets and lack quantitative measurements that are required to facilitate decision-making and intervention measures. Emerging methods and technology that can enable WBS were discussed to facilitate future WBS effort in GCC.
CONCLUSION: Although WBS holds significant promises to enhance public health surveillance in the GCC, its potential remains underutilized. Moving forward, addressing capacity training and providing sustainable long-term funding mechanisms, standardizing methodological differences and/or providing a guideline that detail the best practices, promoting a consortium-based surveillance system and initiating research that can facilitate the utilization of WBS data to inform decision-making processes would be crucial for the successful integration of WBS into the region's public health framework.}, }
@article {pmid42100531, year = {2026}, author = {Carbajal, C and Dasgupta, T and Russell, E and Latt, SM and Horgan, G and Peterson, L and Mistry, HD and Kitchen, K and Wilson, M and Smith, V and Boulding, H and Sheen, KS and Van Citters, AD and Nelson, EC and Duncan, EL and von Dadelszen, P and , and Silverio, SA and Magee, LA}, title = {Women's experiences of maternity care in high-income countries during the pandemic health system shock: a follow-up systematic review and qualitative evidence synthesis.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1715725}, pmid = {42100531}, issn = {2296-2565}, mesh = {Humans ; Female ; *COVID-19/epidemiology ; *Maternal Health Services/organization & administration ; Pregnancy ; *Developed Countries ; Qualitative Research ; SARS-CoV-2 ; Pandemics ; }, abstract = {INTRODUCTION: COVID-19 disrupted healthcare systems globally, particularly challenging maternity services which continued to be operated as an essential service. Reconfigurations were implemented to continue providing care in a safe manner and in line with infection control restrictions. This systematic review of women's experiences of maternity care during the COVID-19 pandemic in high-income countries (HICs), aimed to synthesize published literature and inform future responses to global disasters.
MATERIAL AND METHODS: Electronic database of Scopus, MEDLINE, EMBASE, CINAHL PsychINFO, and the Cochrane COVID Study Register, were searched from June 2021- June 2024 to identify eligible records. Thematic synthesis was used to synthesise the data.
RESULTS: 79 studies were included with data from over 20,000 perinatal women, most were of moderate to high methodological quality. Data synthesis showed 11 themes across five main concepts related to maternity service reconfigurations, namely: (1) Care-seeking and care experience, (2) Virtual care, (3) Self-monitoring, (4) Vaccination, and (5) Ethical future of maternity care.
CONCLUSIONS: Women predominantly viewed changes to maternity care negatively. Future strategies to ensure safeguarding of mothers and infants during crises should include enhancing service accessibility, emphasizing women-centered care, and prioritizing support systems for mothers and infants.
https://www.crd.york.ac.uk/PROSPERO/view/CRD42022355948, identifier: CRD42022355948.}, }
@article {pmid42101066, year = {2026}, author = {Boufleuer, E and Vieira, TW and Sakamoto, VTM and Anschau, F and Tavares, JP and Filho, FFD and Pai, DD}, title = {Psychological and Cognitive Sequelae of COVID-19: Systematic Review and Meta-Analysis.}, journal = {Journal of psychiatric and mental health nursing}, volume = {33}, number = {4}, pages = {653-666}, pmid = {42101066}, issn = {1365-2850}, support = {312850/2025-5//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; }, mesh = {Humans ; *COVID-19/psychology/complications ; *Cognitive Dysfunction/epidemiology/etiology ; *Sleep Wake Disorders/epidemiology/etiology ; *Anxiety/epidemiology/etiology ; Post-Acute COVID-19 Syndrome ; *Depression/epidemiology/etiology ; }, abstract = {INTRODUCTION: COVID-19 pandemic has exacerbated global mental health problems with the development of persistent symptoms.
AIM: To conduct a prevalence meta-analysis of persistent psychological and cognitive sequelae of COVID-19 based on cohort studies.
METHOD: This study followed PRISMA. Cohort studies that followed individuals for at least 12 weeks post-COVID-19 were included and pediatric studies were excluded. The databases Embase, Lilacs/BVS, PubMed, SciELO and Scopus were searched in November 2023. Meta-analyses were performed with subgroup analyses conducted. Results were presented with forest plot graphs and tables. Risk of bias and methodological quality were assessed using Eggers's Test and the Newcastle-Ottawa Scale.
RESULTS: 2,456 studies were identified and screened. Forty-seven articles were included in the systematic review, and 46 in the meta-analysis (192,158 participants). The most prevalent psychological outcome was anxiety (0.17; 95% CI 0.11-0.27, 19 studies), followed by cognitive impairments (0.15; 95% CI 0.11-0.20, 35 studies), sleep disturbances (0.14; 95% CI 0.09-0.19, 33 studies) and depression (0.11; 95% CI 0.06-0.19, 16 studies).
DISCUSSION: The mental health consequences of COVID-19 highlight the need for long-term monitoring and represent a significant public health challenge. The limitation is the heterogeneity among the studies.
These findings represent a public health issue emphasizing the need for public policies and support strategies to mitigate consequences.
CONCLUSION: Although high prevalence rates were identified, the prediction intervals were wide and heterogeneity remained high-common characteristics of studies conducted during the pandemic.
REGISTRATION: Registered in the international Prospective Register of Ongoing Systematic Reviews (PROSPERO) under number CRD42023460632, on September 5, 2023.}, }
@article {pmid42101598, year = {2026}, author = {Coles, S}, title = {Vaccine Adverse Effects: An Overview.}, journal = {American family physician}, volume = {113}, number = {4}, pages = {339-348}, pmid = {42101598}, issn = {1532-0650}, mesh = {Humans ; *Vaccines/adverse effects ; Measles-Mumps-Rubella Vaccine/adverse effects ; COVID-19 Vaccines/adverse effects ; *Vaccination/adverse effects ; Thimerosal/adverse effects ; Female ; Pregnancy ; }, abstract = {Vaccines are one of the most successful medical advances in modern times. Patients are increasingly questioning the necessity of immunizing themselves and their families, and family physicians should be aware of the risks and benefits of recommended immunizations to accurately counsel about adverse effects and address vaccine hesitancy. Vaccines are associated with local adverse reactions, such as pain and redness. Thimerosal is currently used only in multidose vials of influenza vaccine; exposure to thimerosal through vaccines is not associated with adverse neurologic outcomes. The measles-mumps-rubella vaccine is not associated with autism spectrum disorder. The respiratory syncytial virus vaccine does not increase the risk of stillbirth, infant death, birth defects, or growth restriction when administered during pregnancy. COVID-19 vaccine minimally increases the risk of myocarditis and pericarditis. Physicians should counsel patients and guide them to credible resources if patients are considering vaccine refusal. The Vaccine Adverse Event Reporting System and National Vaccine Injury Compensation Program track adverse events from vaccines; the National Vaccine Injury Compensation Program provides compensation for documented harms from vaccinations.}, }
@article {pmid42103644, year = {2026}, author = {Liu, LY and Xu, YS}, title = {[Research progress on laryngitis in children infected with the Omicron variant of the Novel Coronavirus].}, journal = {Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery}, volume = {61}, number = {4}, pages = {487-492}, doi = {10.3760/cma.j.cn115330-20251102-00580}, pmid = {42103644}, issn = {1673-0860}, support = {TJYXZDXK-3-016B//Tianjin Key Medical Discipline(Specialist)Construction Project/ ; CMANKUA202401//Research and Application of Influenza Early Warning Technology for Children Based on Multi-Source Big Data/ ; }, mesh = {Humans ; *Laryngitis/epidemiology/virology/diagnosis/therapy ; *COVID-19 ; SARS-CoV-2 ; *Coronavirus Infections/epidemiology ; *Betacoronavirus ; Child ; Pandemics ; *Pneumonia, Viral/epidemiology ; Child, Preschool ; }, }
@article {pmid42104283, year = {2026}, author = {Bates, J and Moon, JR and Gaisser, S and Nikiforov, A and Ryan, JG and Chekar, CK and Meurant, R and Vignola-Gagné, E and Iwuji, C and Grapsa, E and Barbéra-Tomás, D and Meseguer, E and Davey, G and Hopkins, MM}, title = {Policy challenges in the provision of COVID-19 border screening: evidence from eight countries.}, journal = {BMC public health}, volume = {26}, number = {1}, pages = {}, pmid = {42104283}, issn = {1471-2458}, support = {ES/W00156X/1//Economic and Social Research Council/ ; }, mesh = {Humans ; *COVID-19/diagnosis/epidemiology/prevention & control ; Private Sector ; Australia/epidemiology ; *Health Policy ; Canada/epidemiology ; *Mass Screening/organization & administration ; United Kingdom ; South Africa/epidemiology ; Spain/epidemiology ; *COVID-19 Testing ; Germany/epidemiology ; Republic of Korea/epidemiology ; }, abstract = {BACKGROUND: While border screening measures were widely adopted by countries during the COVID-19 pandemic, a lack of consensus on the utility of border screening created a gap in best practice for its implementation. As such, countries adopted a diversity of approaches, providing an opportunity to evaluate the configuration and evolution of border screening systems. The article addresses three questions: (i) how did countries configure their border screening systems for COVID-19? (ii) In what contexts did countries rely on public or private providers of these services? (iii) what do policies and narratives reveal about the perceived role of border screening in global public health? The article contributes to long-standing debates over the private sector's role in public health and the perceived value of border screening measures.
METHODS: This article presents results from an international comparative study based on tracking the organisation of border screening in eight countries. Secondary data was collected between July 2021 - June 2022 from official government websites and policy publications, private sector sources where relevant, and trusted media sources in each study country. The countries included are Australia, Canada, Germany, Ireland, South Africa, South Korea, Spain, and the United Kingdom.
RESULTS: All study countries used private provision for pre-departure diagnostic testing for international travellers. In contrast, screening of arriving travellers was more diverse. Countries that opted for private sector post-arrival screening saw governance challenges around accreditation and monitoring of providers, while public service provision saw challenges in capacity and high resource costs. Travel was often framed as a 'luxury,' allowing states to shift responsibility for obtaining tests onto individuals; especially in the context of individuals travelling from low income to high income countries.
CONCLUSIONS: The different approaches countries followed for screening of departing and incoming travellers suggests wealthy countries were more oriented towards defending their populations against disease importation, rather protecting the international community from disease exportation. These findings provide an opportunity to reflect on the purpose and implementation of border screening. We emphasise a need for further discussion on the efficacy of border screening from both perspectives, given the tendency for countries to rely on these measures.}, }
@article {pmid42104831, year = {2026}, author = {Widyaningrum, R and Ambarwati, K and Kuntari, T and Putri, TA and Kusumaninrum, PD}, title = {Mothers' and Health Care Professionals' Experiences of Remote Provision of One-to-One Synchronous Breastfeeding Support: A Qualitative Systematic Review.}, journal = {Asia-Pacific journal of public health}, volume = {}, number = {}, pages = {10105395261437273}, doi = {10.1177/10105395261437273}, pmid = {42104831}, issn = {1941-2479}, abstract = {Breastfeeding has been shown to provide numerous benefits for mothers and babies in the short and long term. During the COVID-19 pandemic, breastfeeding support, which was traditionally provided offline, shifted to online platforms. Although these remote services were available before the pandemic began, online interventions emerged as an alternative and proved effective in helping mothers breastfeed during that period. We aimed to explore the existing literature on the experiences of mothers and health care professionals with remote one-to-one synchronous breastfeeding support and to identify the unmet support needs of mothers regarding this type of support. We systematically searched seven literature databases: MEDLINE, CINAHL Plus, MIDIRS, Web of Science, ASSIA, WHO Global Index, and Google Search. Articles published before 2010 and in languages other than English and Bahasa were excluded. A thematic approach was used to synthesise the data. Twenty-one studies were included in this review. Three themes generated from the synthesis: (1) mothers' acceptance of one-to-one synchronous telelactation, (2) benefit of one-to-one synchronous telelactation, and (3) challenges faced in one-to-one synchronous telelactation. In conclusion, mothers generally accepted one-to-one synchronous breastfeeding support as an alternative to in-person sessions, although some challenges remain. Further improvements are needed to address accessibility and scheduling issues.}, }
@article {pmid42105055, year = {2026}, author = {Nolan, B and O'Connor, C}, title = {Therapies for Infantile Haemangiomas: Current Practice and Evolving Perspectives.}, journal = {Dermatology and therapy}, volume = {16}, number = {5}, pages = {2363-2376}, pmid = {42105055}, issn = {2193-8210}, support = {223047/Z/21/Z/WT_/Wellcome Trust/United Kingdom ; }, abstract = {Infantile haemangiomas (IH) are the most common vascular tumours of infancy, characterised by a predictable trajectory of rapid proliferation, plateau, and slow spontaneous involution. Although most regress uneventfully, a significant minority risk ulceration, functional compromise, or disfigurement, and therefore require timely intervention. The therapeutic landscape was once dominated by corticosteroids, interferon, and cytotoxic chemotherapeutics of modest efficacy and considerable toxicity. Management was revolutionized in 2008 by the discovery that the beta-blocker propranolol induced prompt and sustained regression. Propranolol has since become the established first-line therapy for IH, with efficacy and safety confirmed by randomized controlled trials and corroborated by observational cohorts. Mechanistically there are multiple temporally stratified actions: immediate vasoconstriction, suppression of angiogenic signalling pathways, induction of endothelial apoptosis, and ultimately the promotion of adipogenic differentiation in keeping with natural involution. Safety is favourable under expert supervision, though hypoglycemia remains the principal preventable hazard, necessitating caregiver education on feeding regimens and "sick day" rules. Rebound growth, encountered in roughly one-fifth of cases, usually responds to re-treatment. Alternative beta-blockers such as atenolol and nadolol provide comparable efficacy with potential advantages in tolerability or dosing convenience. Topical timolol has limited effectiveness for small superficial lesions, while sirolimus, becaplermin gel, laser devices, and surgery may have circumscribed adjunctive roles. Corticosteroids and cytotoxic agents are now confined to salvage use. Contemporary perspectives extend beyond pharmacology to encompass caregiver experience and health-system burden. Recent work highlights the low burden of treatment with propranolol, while digital innovations such as photo-triage during the COVID-19 pandemic illustrate opportunities to reduce healthcare exposure and improve equity of access. This review describes the evolution of drug therapy for IH and integrates mechanistic insights, clinical pragmatism, and patient-centred innovations to chart the current trajectory of care.}, }
@article {pmid42105073, year = {2026}, author = {Schultz, T and Rosenthal, S}, title = {Telemedicine in Pediatric Headache in a Post-COVID-19 World: A Narrative Review and Practical Implementation.}, journal = {Current pain and headache reports}, volume = {30}, number = {1}, pages = {}, pmid = {42105073}, issn = {1534-3081}, mesh = {Humans ; *Telemedicine ; Child ; *Headache/therapy ; *COVID-19/epidemiology ; *Migraine Disorders/therapy ; Pediatrics/methods ; }, abstract = {PURPOSE OF REVIEW: Pediatric migraine is a leading cause of disability worldwide, yet access to pediatric headache specialists remains limited due to workforce scarcities and geographic disparities. This review examines the evolution of telemedicine in headache care, evaluates current evidence for safety and efficacy, and explores its role in improving access and multidisciplinary management.
RECENT FINDINGS: Randomized trials and observational studies demonstrate that telemedicine provides clinical outcomes comparable to in-person visits with high patient satisfaction and reduced logistical burden. Emerging data support its safety in non-acute headache evaluation as well as benefit of supporting multidisciplinary care. Professional societies, including the American Headache Society and the American Academy of Pediatrics, endorse telemedicine as an appropriate modality for headache management. Telemedicine has matured into a sustainable, evidence-based approach for pediatric headache care. When implemented thoughtfully, it expands access, supports multidisciplinary treatment, and maintains safety, positioning it as an essential component of future headache care delivery models.}, }
@article {pmid42105110, year = {2026}, author = {Savorgnan, F and Prabhu, J and Pilla, P and Flores, S and Loomba, RS and Acosta, S}, title = {Pulse Oximetry, Skin Pigmentation, and Occult Hypoxemia in Pediatric Cardiac Critical Care.}, journal = {Pediatric cardiology}, volume = {}, number = {}, pages = {}, pmid = {42105110}, issn = {1432-1971}, abstract = {Pulse oximetry (SpO2) is central to oxygenation assessment in pediatric and cardiac intensive care. Increasing evidence demonstrates that SpO2 may systematically overestimate arterial oxygen saturation (SaO2), particularly in individuals with darker skin pigmentation, thereby increasing the risk of occult hypoxemia-arterial hypoxemia not detected by pulse oximetry. We sought to synthesize current evidence and define implications for pediatric and congenital heart disease populations. We performed a narrative review of experimental physiology studies; observational adult and pediatric cohorts; pediatric COVID-19, ICU, and cardiac ICU investigations; device-comparison analyses; systematic reviews; and regulatory evaluations reporting paired SpO2-SaO2 measurements or validated reference standards stratified by race, ethnicity, or objectively measured skin pigmentation. Data sources included PubMed, MEDLINE, and bibliographies of relevant studies. Experimental data demonstrate directional SpO2 overestimation that increases during hypoxemia. Large adult cohorts confirm higher rates of occult hypoxemia in patients with darker skin pigmentation, findings subsequently replicated in hospitalized children. Emerging pediatric cardiac ICU data suggest that physiologic complexity may further amplify SpO2-SaO2 discordance. Device-comparison studies reveal variability across manufacturers, influenced by calibration datasets and signal-processing algorithms. Across populations, misclassification is most clinically relevant near commonly used escalation thresholds. SpO2 frequently overestimates SaO2 in darker skin pigmentation and during hypoxemia, increasing vulnerability to occult hypoxemia in hospitalized and critically ill children. In pediatric cardiac populations-where narrow saturation thresholds guide management-contextual, bias-aware interpretation of pulse oximetry is essential to support accurate decision-making and equitable care.}, }
@article {pmid42105330, year = {2026}, author = {Callens, S and Dambre, C and De Schryver, A and Desmet, S and Flamaing, J and Peeters, M and Vigneron, L and Van Laethem, Y}, title = {Pneumococcal vaccination in Belgian adults: a practical translation of the 2025 Superior Health Council guidelines.}, journal = {Acta clinica Belgica}, volume = {}, number = {}, pages = {1-11}, doi = {10.1080/17843286.2026.2671079}, pmid = {42105330}, issn = {2295-3337}, abstract = {BACKGROUND: Pneumococcal disease remains a significant burden in Belgian adults, with 2,120 cases of invasive pneumococcal disease (IPD) reported in 2024, the highest in a decade. Despite clear indications, vaccination uptake remains unacceptably low (13-24% in risk groups). Complex sequential vaccination schedules involving pneumococcal conjugate vaccines followed by the 23-valent polysaccharide vaccine (PPV23), combined with limited awareness among healthcare providers and the public, and incomplete reimbursement policies, have contributed to implementation barriers and poor adherence.
METHODS: This review provides a practice-oriented translation of the 2025 Superior Health Council of Belgium guidelines on adult pneumococcal vaccination. We analysed Belgian National Reference Centre 2024 serotype surveillance data to support age-stratified vaccine selection recommendations.
KEY RECOMMENDATIONS: A single-dose conjugate vaccine approach now replaces all prior sequential regimens. Vaccine selection is age-stratified based on Belgian serotype epidemiology: PCV20 for adults 18-49 years with risk conditions (serotype 4 coverage critical); PCV20 or PCV21 for ages 50-84 years; and PCV21 preferred for adults ≥ 85 years (15% coverage advantage). PPV23 is eliminated from routine recommendations. Co-administration with influenza, RSV, and COVID-19 vaccines is supported, enabling maximal respiratory protection in a single visit.
CONCLUSION: One conjugate vaccine dose, selected by age, provides maximal pneumococcal protection. The challenge is implementation to increase vaccination coverage: every clinical encounter with an at-risk adult is a vaccination opportunity.}, }
@article {pmid42106620, year = {2026}, author = {Zakaria, AM and El Shahidy, SM and Diab, AM}, title = {Epidemiology and genetic variation of acute viral gastroenteritis in children under five years in the Middle East (2020-2025): a systematic review and meta-analysis.}, journal = {BMC infectious diseases}, volume = {26}, number = {1}, pages = {}, pmid = {42106620}, issn = {1471-2334}, mesh = {Humans ; *Gastroenteritis/epidemiology/virology ; Middle East/epidemiology ; *Genetic Variation ; Infant ; Child, Preschool ; Prevalence ; Infant, Newborn ; Coinfection/epidemiology/virology ; Rotavirus/genetics ; Rotavirus Infections/epidemiology/virology ; *Virus Diseases/epidemiology/virology ; Acute Disease ; }, abstract = {BACKGROUND: Acute viral gastroenteritis remains a major cause of morbidity and hospitalization among children under five years worldwide. In the Middle East, epidemiological and molecular evidence remains fragmented, particularly in the post-COVID-19 period. This systematic review and meta-analysis aimed to synthesize recent data (2020-2025) on the prevalence, genetic diversity, and co-infection patterns of enteric viruses among children aged 0-59 months in the region.
METHODS: A comprehensive search of PubMed/MEDLINE, Scopus, Web of Science, ScienceDirect, and the WHO Global Index Medicus identified eligible observational and molecular studies published between 1 January 2020 and 31 May 2025. Study selection, data extraction, and risk-of-bias assessment were independently conducted by two reviewers according to PRISMA 2020 guidelines. The protocol was prospectively registered in PROSPERO (CRD420251064184). Pooled prevalence estimates were calculated using a random-effects model with Freeman-Tukey double arcsine transformation.
RESULTS: Forty-three studies, including 22,021 children tested for acute gastroenteritis (AGE) from nine Middle Eastern countries, met the inclusion criteria. Rotavirus (28 studies) was the most prevalent pathogen, with a pooled prevalence of 30.4% (95% CI: 24.3-35.8; I² = 96%, p < 0.001), followed by norovirus (12 studies) at 23.5% (95% CI: 11.4-29), adenovirus (13 studies) at 11.3% (95% CI: 8.6-17.6), and astrovirus (10 studies) at 6.0% (95% CI: 1.3-12.7). Predominant rotavirus genotypes included G1, G2, G3, and G9, commonly combined with P[8], P[4], and P[6], with G3P[8] and G1P[8] as dominant constellations. Norovirus GII.4 and recombinant GII.4[P16] strains were frequently detected. Viral co-infections were also reported, particularly involving rotavirus and other enteric viruses.
CONCLUSION: Rotavirus and norovirus remain the principal viral causes of pediatric acute gastroenteritis in the Middle East and exhibit substantial genetic diversity with frequent co-infection patterns. However, marked inter-study heterogeneity and uneven geographic representation limit regional generalizability. Strengthened molecular surveillance, standardized diagnostic approaches, and continuous genotype monitoring are essential to optimize prevention strategies and vaccination policies across the region.}, }
@article {pmid42106756, year = {2026}, author = {Saito, H and Tartari, E and Garlasco, J and Pittet, D and Allegranzi, B}, title = {Global landscape of locally produced alcohol-based handrub in health care settings: a scoping review.}, journal = {Antimicrobial resistance and infection control}, volume = {15}, number = {1}, pages = {}, pmid = {42106756}, issn = {2047-2994}, mesh = {Humans ; *COVID-19/prevention & control ; Developing Countries ; *Ethanol ; *Hand Disinfection/methods ; Health Personnel ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Reliable access to alcohol-based handrub (ABHR) is essential for hand hygiene and infection prevention, yet many low- and middle-income countries (LMICs) continue to face supply constraints. A 2011 WHO global assessment demonstrated that WHO-recommended ABHR formulations produced locally at low cost, were well accepted by healthcare workers, but also highlighted persistent barriers, including challenges in procuring ingredients and dispensers and in ensuring adequate quality control. This review aimed to provide an updated global synthesis of evidence on local ABHR production in healthcare settings.
METHODS: Following the Joanna Briggs Institute framework and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, we systematically searched Embase, Medline, and CINAHL from inception to 19 March 2025. Two reviewers independently conducted title-abstract screening, full-text screening and data extraction. Primary research articles reporting local ABHR production in healthcare settings in LMICs were eligible for data extraction and descriptive synthesis.
RESULTS: Of 2343 articles screened, 31 studies from 19 countries were included (2006-2023). Over half (n = 18, 58%) were conducted during the COVID-19 pandemic; 22 described health-facility production and 9 described factory-level manufacturing. Of the 22 health-facility production studies, 12 (55%) used WHO Formulation 1 (ethanol-based) or modifications thereof. Pharmacists most commonly led production at the health-facility level. Only 6% (two articles) reported the source of alcohol, and less than half evaluated efficacy or organoleptic properties (13 and 12, respectively). Most funded studies relied on high-income-country (HIC) grants (17 of 24, 71%).
CONCLUSIONS: Local ABHR production remains infrequently reported in the literature, although publications increased during the COVID-19 pandemic. Heavy reliance on short-term, HIC-funded initiatives raises concerns about the long-term scalability and sustainability of local ABHR production in LMICs. Strengthening national regulatory capacity, quality-control laboratories, and sustainable financing is critical to maintain safe ABHR access beyond pandemic contexts, for resilient national supply chains and in-country quality control capacity.}, }
@article {pmid42106840, year = {2026}, author = {Hu, H and Jin, G and Zhang, X}, title = {Older adults and online health misinformation: a systematic literature review.}, journal = {BMC psychology}, volume = {14}, number = {1}, pages = {}, pmid = {42106840}, issn = {2050-7283}, support = {No. 24CXW053//National Social Science Fund Youth Project/ ; No. 12625311//Fundamental Research Funds for the Central Universities/ ; }, mesh = {Humans ; Digital Media ; *Communication ; Aged ; *Internet ; *Health Literacy ; COVID-19 ; *Social Media ; *Health Communication ; }, abstract = {As older adults increasingly rely on the internet for health-related information, concerns about their vulnerability to online health misinformation have intensified. This systematic literature review synthesizes findings from 26 empirical studies published between 2000 and 2024 to examine how older adults interact with health misinformation in digital contexts. The review identifies a complex interplay of factors contributing to their susceptibility, including cognitive decline, gaps in digital and health literacy, emotional and psychological influences, and the role of social relationships. However, most studies lack theoretical grounding, platform-specific analysis, and geographical diversity. Conceptual inconsistencies and a COVID-19 research bias further limit generalizability. The review calls for clearer definitions, interdisciplinary approaches, and targeted interventions to address this urgent public health issue and provide a foundation for designing more targeted and effective interventions.}, }
@article {pmid42106851, year = {2026}, author = {Zhu, S and Li, X and Chen, R and Wu, S and Jiang, L and Li, M and Huang, L and Cui, N}, title = {Rare pediatric multi-system thrombosis post-COVID-19: a three-year follow-up case report and narrative review on rivaroxaban for long-term management.}, journal = {Orphanet journal of rare diseases}, volume = {21}, number = {1}, pages = {}, pmid = {42106851}, issn = {1750-1172}, support = {SZXK202106//Key Laboratory in Science and Technology Development Project of Suzhou/ ; SS202067//Key Laboratory in Science and Technology Development Project of Suzhou/ ; }, mesh = {Child ; Humans ; Male ; Anticoagulants/therapeutic use ; *COVID-19/complications ; *Factor Xa Inhibitors/therapeutic use ; Follow-Up Studies ; Pulmonary Embolism/drug therapy/etiology ; Retrospective Studies ; *Rivaroxaban/therapeutic use ; SARS-CoV-2/physiology ; *Thrombosis/drug therapy/etiology ; *Venous Thromboembolism/drug therapy/etiology ; }, abstract = {This retrospective study presents a 10-year-old male with multi-systemic venous thromboembolism (VTE) secondary to COVID-19, including right ventricular thrombus(40 mm × 18 mm), bilateral iliac vein thrombosis, pulmonary embolism, and renal vein thrombosis. The child presented with fever, abdominal pain, and elevated inflammatory markers (CRP 222.72 mg/L, WBC 22.41 × 10[[9]]/L). Imaging confirmed extensive thrombi in the right ventricle, pulmonary arteries, and lower extremities. Anticoagulation with rivaroxaban (10 mg QD) was initiated alongside anti-infective and anti-inflammatory therapies. Over a 3-year follow-up, thrombus burden significantly regressed, with D-dimer decreasing from 73 430 µg/L to 290 µg/L, and no recurrence or bleeding complications were observed. Coagulation parameters (PT, APTT) stabilized within therapeutic ranges. This case suggests the efficacy and safety of rivaroxaban in long-term management of multi-system VTE in pediatric patient, especially in cases of COVID-19-associated hypercoagulability. The primary clinical outcomes were the resolution of thrombus burden as evidenced by imaging and the absence of bleeding complications or recurrence during the follow-up period. The findings align with emerging evidence supporting direct oral anticoagulants (DOACs) in children, emphasizing individualized dosing and long-term management. Further studies are warranted to validate DOACs' role in pediatric thrombosis, especially in the context of viral infections.}, }
@article {pmid42107172, year = {2026}, author = {Alenzi, TK and Alhussaini, NT and Alhazmi, OA and Althuwaiqeb, MS and Alotaibi, RF and Alqahtani, SM and Badroun, DK and Alotaibi, SA and Almehayawi, SS and Basamih, K and Al-Otaibi, WA and Allemailem, KS}, title = {Association of ABO blood groups with SARS-CoV-2 infection in Saudi Arabia based on a systematic review and meta-analysis.}, journal = {Journal of infection and public health}, volume = {19}, number = {6}, pages = {103240}, doi = {10.1016/j.jiph.2026.103240}, pmid = {42107172}, issn = {1876-035X}, mesh = {Humans ; Saudi Arabia/epidemiology ; *ABO Blood-Group System ; *COVID-19/epidemiology/blood ; SARS-CoV-2 ; Female ; Disease Susceptibility ; }, abstract = {Although previous studies and meta-analyses have suggested modest and population-dependent associations between ABO blood groups and susceptibility to SARS-CoV-2 infection, findings have remained inconsistent across different geographic regions. We synthesized data from nine studies conducted in Saudi Arabia between 2020 and 2024 to define national patterns. Eight datasets with extractable data contributed 7650 laboratory-confirmed cases to quantitative analyses. Group O accounted for the largest proportion of infections (random effects estimate 41.7%, 95% CI 38.0-45.6), followed by group A (27.8%, 95% CI 25.6-29.9) and group B (21.2%, 95% CI 18.0-24.6). Group AB represented the smallest fraction (6.4%, 95% CI 3.7-9.9). Substantial heterogeneity was observed across all blood groups (I[2] 72.1-96.5%) yet leave-one-out analyses confirmed stable pooled estimates. Statistical assessments provided no evidence of publication bias. The pooled distributions closely mirrored background ABO frequencies in the Saudi population, indicating that ABO-related differences in infection susceptibility are modest relative to epidemiologic and demographic factors.}, }
@article {pmid42107305, year = {2026}, author = {Ching, LY and Kunnath, AP}, title = {The resurgent threat: human metapneumovirus in a post-pandemic landscape.}, journal = {Diagnostic microbiology and infectious disease}, volume = {116}, number = {1}, pages = {117445}, doi = {10.1016/j.diagmicrobio.2026.117445}, pmid = {42107305}, issn = {1879-0070}, mesh = {Humans ; *Metapneumovirus ; *Paramyxoviridae Infections/epidemiology/prevention & control/diagnosis/virology ; COVID-19/epidemiology ; Pandemics ; Seasons ; SARS-CoV-2 ; }, abstract = {The COVID-19 pandemic profoundly disrupted global respiratory virus transmission. Widespread nonpharmaceutical interventions (NPIs) sharply suppressed common pathogens, including human metapneumovirus (HMPV). However, as these measures were lifted, HMPV re-emerged with unexpected intensity-a resurgence driven primarily by population-wide "immunity debt" accrued during years of reduced viral exposure. Unlike influenza or RSV, HMPV's post-pandemic behavior has challenged long-held assumptions about seasonal respiratory virus dynamics. Traditional late-winter peaks have given way to out-of-season surges, year-round co-circulation with other viruses has become commonplace, and existing surveillance systems designed for a pre-pandemic world have proven inadequate. This review examines HMPV's renewed clinical and public health significance, focusing on epidemiological shifts, health system pressures, diagnostic gaps, and the critical need for coordinated, multi-pathogen preparedness. We argue that HMPV is no longer a minor seasonal pathogen but a persistent stressor requiring targeted countermeasures, including accelerated vaccine development, integrated surveillance, and healthcare system redesign.}, }
@article {pmid42107387, year = {2026}, author = {Goode, JR and Rothholz, MC and Foster, SL and Brody, ER and Gräbenstein, JD}, title = {Pharmacy-Based Immunization Delivery: A Comprehensive History and Current Challenges.}, journal = {Journal of the American College of Clinical Pharmacy : JACCP}, volume = {9}, number = {6}, pages = {e70219}, doi = {10.1002/jac5.70219}, pmid = {42107387}, issn = {2574-9870}, mesh = {Humans ; United States ; *Pharmacists/organization & administration ; COVID-19/prevention & control/epidemiology ; History, 20th Century ; COVID-19 Vaccines/administration & dosage ; History, 21st Century ; History, 19th Century ; *Immunization/history ; *Immunization Programs/history ; Professional Role ; Vaccines/administration & dosage ; }, abstract = {Pharmacists and their teams have a long history of involvement with vaccines. This paper describes the contributions of pharmacy-based immunization delivery in the United States from the 1800's to date. Early activities centered around storage and distribution of antitoxins and vaccines. From the 1950s through the early 1990s, pharmacists were facilitating administration of vaccines by other health care providers. In the early 1990s, efforts began to allow pharmacists to administer vaccines, with the first pharmacist immunization training in 1994. By 2009, all 50 states allowed pharmacists to administer vaccines. From the 1990s onward, pharmacists increasingly contributed to national vaccine policies and guidelines, and states expanded their authority to a broader range of patient ages and vaccines. The coronavirus disease 2019 (COVID-19) pandemic opened more opportunities for pharmacy-based involvement, including federal expansion of immunizing authority to children aged 3 years and older, and the authority for pharmacy technicians and student pharmacists to administer vaccines. Pharmacists and their teams administered more than 50% of the COVID-19 vaccines. Today, the majority of adult vaccines are administered in pharmacy-based settings. Even with pharmacy's substantial contributions to immunization delivery in the United States, challenges persist for providers and patients, including inconsistent state-to-state immunizing authority by age and disease and payor payment. Pharmacy-based immunization delivery has become a significant contributor to improving public health by protecting against vaccine-preventable diseases.}, }
@article {pmid42107644, year = {2026}, author = {Maio, N and Rouault, TA}, title = {Iron-sulfur cofactors in nucleic acid metabolism and protein synthesis: Assembly, delivery, and putative roles in cellular and viral systems.}, journal = {The Journal of biological chemistry}, volume = {302}, number = {6}, pages = {113129}, pmid = {42107644}, issn = {1083-351X}, mesh = {*Iron-Sulfur Proteins/metabolism ; Humans ; *Iron/metabolism ; *Sulfur/metabolism ; *Protein Biosynthesis ; *Nucleic Acids/metabolism ; Animals ; Viral Proteins/metabolism ; SARS-CoV-2/metabolism ; DNA Replication ; Virus Replication ; *Coenzymes/metabolism ; }, abstract = {Composed of iron (Fe) and inorganic sulfur (S), iron-sulfur clusters (ISCs) are ancient cofactors present across all domains of life and in some viruses. Over the past 3 decades, cytosolic and nuclear Fe-S proteins have emerged as integral components of DNA replication and repair machineries, telomere maintenance pathways, transcriptional processes, cell cycle regulation, and protein synthesis. More recently, ISCs were identified in viral proteins, including multiple components of the SARS-CoV-2 replication and transcription complex (RTC), which collectively host seven experimentally verified Fe-S cofactors. The coexistence of multiple ISC-dependent enzymes within both cellular and viral replication machineries raises fundamental questions about how these metal cofactors coordinate genome maintenance, replication, and host-virus interactions. Here, we provide an inventory of known mammalian nucleocytoplasmic Fe-S proteins, discuss mechanisms of ISC acquisition, explore the potential roles of ISCs within cellular and viral replication complexes, and highlight critical gaps in our understanding of ISC delivery, coordination, and function among Fe-S proteins in large multi-subunit assemblies.}, }
@article {pmid42108283, year = {2026}, author = {Azadinia, F and Shamsi, F and Ebrahimi-Takamjani, I and Rasouli, O}, title = {Changes in Quadriceps Force Control and Torque Quality Following Anterior Cruciate Ligament Injury and Reconstruction: Associations with Functional Performance-A Systematic Review and Meta-Analysis.}, journal = {Sports medicine - open}, volume = {12}, number = {1}, pages = {}, pmid = {42108283}, issn = {2199-1170}, abstract = {BACKGROUND: Consistent force output is a critical indicator of the neuromuscular system's effectiveness. Although force signals inherently fluctuate, the ability of skeletal muscles to generate accurate and steady force offers insights into the system's adaptability and its ability to adjust motor control strategies to meet task demands. This systematic review and meta-analysis aimed to synthesize evidence on quadriceps force control in individuals with anterior cruciate ligament (ACL) injury and/or surgical reconstruction (ACLR). Additionally, it sought to explore the relationship between force control measures and physical function outcomes.
METHODS: A literature search was conducted across several databases, including PubMed, EMBASE, Scopus, Web of Science, and SPORTDiscus. Risk of bias was assessed using the adapted Newcastle-Ottawa tool. The study included individuals with unilateral ACL injury and/or ACLR, with comparisons to uninjured controls or unaffected contralateral limbs. Primary outcomes included torque quality, force accuracy, and force/torque steadiness, while secondary outcomes included function-related clinical questionnaires and performance tests. Eligible studies consisted of observational studies and baseline data from interventional studies published in English. Standardized mean differences (SMDs) were calculated using a random effects meta-analysis.
RESULTS: A total of 33 studies were included, comprising 20 individuals with ACLR, 12 with ACL injuries, and one with both. The meta-analysis showed significant effects of ACL injury (SMD = 0.84) and ACLR (SMD = 1.57) on quadriceps torque frequency content. Individuals with ACLR had a greater root mean squared error (RMSE) or absolute error (AE) in force output compared to healthy controls (SMD = 0.35) and exhibited a significant difference in the coefficient of variation (CoV) of the force signal (SMD = 0.22), indicating impaired force control in those with ACLR.
CONCLUSIONS: ACL injury impairs quadriceps force control in the injured limb, as shown by torque frequency content analysis. While ACL reconstruction is the gold standard for joint stability, it may not fully restore neuromuscular function, potentially compromising physical functioning. However, the limited number of high-quality studies may weaken these conclusions.
REGISTRATION: The review protocol was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42024571495).}, }
@article {pmid42109487, year = {2026}, author = {Hu, Y and Li, J and Zheng, Y and Cheng, Y and Li, W and Wang, X and Sun, Y}, title = {Epidemiology and clinical impact of pediatric RSV co-infections after the COVID-19 pandemic: a narrative review.}, journal = {Frontiers in pediatrics}, volume = {14}, number = {}, pages = {1787312}, pmid = {42109487}, issn = {2296-2360}, abstract = {The coronavirus disease 2019 (COVID-19) pandemic profoundly disrupted the global epidemiology of respiratory syncytial virus (RSV), leading to atypical off-season surges and altering infection dynamics across different climatic zones. This review synthesizes evidence on the landscape of pediatric RSV co-infections in this transformed post-pandemic context. RSV co-infection is frequent, with human rhinovirus (HRV) being the most common viral co-pathogen and Streptococcus pneumoniae (Spn) and Haemophilus influenzae (Hi) predominating as bacterial co-infections. Critically, these co-infections are significantly associated with heightened disease severity, including more intense clinical presentations, prolonged hospitalizations, increased intensive care unit (ICU) admission rates, and greater therapeutic complexity. The relaxation of non-pharmaceutical interventions has been linked to a rebound in co-infection rates. While advances in molecular diagnostics have improved detection, and new prophylactics like nirsevimab offer promise, significant challenges remain. These include gaps in understanding pathogenic synergies, inequities in access to novel interventions, and the need for strategies to manage the ongoing evolution of RSV epidemiology. This underscores the necessity for enhanced surveillance, equitable prevention, and targeted research to mitigate the substantial burden of pediatric RSV co-infections.}, }
@article {pmid42111388, year = {2026}, author = {Bongiovanni, G and Polelli, V and Stainer, A and Russo, M and Gatti, R and Aliberti, S and Amati, F}, title = {Home-based rehabilitation in interstitial lung disease: picturing the present and drawing the future through a systematic review of the literature.}, journal = {ERJ open research}, volume = {12}, number = {2}, pages = {}, pmid = {42111388}, issn = {2312-0541}, abstract = {BACKGROUND: Rehabilitation represents a key nonpharmacological treatment for patients with interstitial lung diseases (ILDs). As a consequence of improvement in technologies and social distancing in the SARS-CoV-2 era, a growing body of evidence demonstrated the effectiveness of tele-rehabilitation programmes for chronic respiratory diseases.
METHODS: We conducted a systematic review to identify randomised controlled trials (RCTs) on tele-rehabilitation in ILD and extended the search to ongoing trials.
RESULTS: Throughout our research, we identified four RCTs describing home rehabilitation in ILD. All RCTs were heterogenous small trials. Thus, a meta-analysis could not be performed, and data were reported in a descriptive way. The primary outcomes of the RCTs analysed included both physical and functional measures. We also identified through ClinicalTrials.gov four ongoing clinical trials investigating pulmonary rehabilitation in ILD with a considerable degree of heterogeneity regarding the populations included. In our systematic review, we also highlighted the key pillars for future trials in the field.
CONCLUSION: Potential treatment trajectories on outcomes of ILD patients related to the implementation of tele-rehabilitation are also discussed.}, }
@article {pmid42111593, year = {2026}, author = {Zhao, J and Wang, J and Jiang, L and Li, F and Ji, L and Jin, H}, title = {Pandemic fatigue and associated factors: a meta-analysis using the COM-B model.}, journal = {Frontiers in psychology}, volume = {17}, number = {}, pages = {1765375}, pmid = {42111593}, issn = {1664-1078}, abstract = {BACKGROUND: Pandemic fatigue during the prolonged COVID-19 crisis undermines sustained engagement with protective measures and public health messaging. Existing studies provide heterogeneous prevalence estimates and disparate lists of correlates but lack a unified, theory-driven synthesis.
METHODS: Searches were conducted in six databases up until March 2026. This study synthesized the prevalence of pandemic fatigue and factors associated with it during COVID-19 using the COM-B model and TDF theory.
RESULTS: Twenty-three cross-sectional studies (n = 49,285) were included. The pooled prevalence of pandemic fatigue was 51% (95%CI: 0.38, 0.65), with substantial heterogeneity. Health literacy (Capability) was inversely associated with fatigue (β = -0.257, 95%CI: -0.404, -0.110). Opportunity-related stressors-including bereavement due to COVID-19 (β = 0.281, 95%CI: 0.124, 0.437), daily troubles (β = 0.296, 95%CI:0.211, 0.380), and working student status (β = 0.232, 95%CI: 0.122, 0.341)-were positively associated with pandemic fatigue. Motivation-related factors showed mixed associations, whereas negative emotional states were associated with higher odds of pandemic fatigue.
CONCLUSION: Pandemic fatigue is common and was associated with diverse capability-, opportunity-, and motivation-related factors. A COM-B-informed interpretation suggests multi-level strategies that combine skills building, supportive environments, and psychosocial support.}, }
@article {pmid42112438, year = {2026}, author = {Liu, Y and Zhang, Y and Liang, L and Zhang, H and Zhang, T and Rong, X and Tan, J and Mi, Y}, title = {Engineering strategies and decision frameworks for virus-like particle-based vaccines against infectious diseases.}, journal = {Frontiers in microbiology}, volume = {17}, number = {}, pages = {1795711}, pmid = {42112438}, issn = {1664-302X}, abstract = {Virus-like particles (VLPs) have emerged as a versatile and clinically validated platform for developing safe, effective vaccines against infectious diseases. However, the expanding toolkit of VLP engineering strategies-spanning genetic fusion, modular conjugation, and nucleic acid encapsulation-creates a critical need for a rational selection framework to match technological strengths with specific vaccine objectives. This review addresses this gap by constructing a comparative decision-making framework centered on four core engineering dimensions: cargo flexibility, loading specificity, functional efficiency, and manufacturability. We systematically juxtapose two principal technology streams: (1) the display of protein antigens (through genetic, chemical, and bio-conjugation) and (2) the encapsulation of nucleic acid cargo (via physical, electrostatic, and programmable packaging mechanisms), evaluating each within this unified framework. This technological dissection is directly linked to the development landscape of VLP-based vaccines against major pathogens-including HBV, HPV, malaria, influenza, and SARS-CoV-2-illustrating how strategic choices at the engineering level fundamentally underpin immunogenic potency and translational success. By sequentially considering immunological objectives, antigen compatibility, surface display modality, interior cargo integration, and manufacturing constraints, this framework facilitates rational, stepwise VLP vaccine design. Looking forward, we discuss emerging trends toward modular and computationally guided platforms for antigen placement and scaffold design. By integrating a structured technology assessment with translational insights, this review aims to provide a practical roadmap for the rational design and accelerated development of next-generation, broadly protective VLP-based vaccines.}, }
@article {pmid42113367, year = {2026}, author = {Shukla, S and Sharma, MP and Rashmi, R and Misra, G}, title = {Long non-coding RNAs as modulators of endocrine therapy response in hormone receptor-positive breast cancer.}, journal = {Molecular biology reports}, volume = {53}, number = {1}, pages = {}, pmid = {42113367}, issn = {1573-4978}, mesh = {Humans ; *Breast Neoplasms/genetics/drug therapy/metabolism ; Female ; *RNA, Long Noncoding/genetics/metabolism ; Drug Resistance, Neoplasm/genetics ; Receptors, Estrogen/metabolism/genetics ; *Antineoplastic Agents, Hormonal/therapeutic use/pharmacology ; Gene Expression Regulation, Neoplastic/drug effects ; Tumor Microenvironment/genetics/drug effects ; Signal Transduction/drug effects ; }, abstract = {Breast cancer is a major cause of cancer-related mortality among women, with hormone receptor-positive (HR+) breast cancer accounting for 70-80% of diagnosed cases. The current treatment approaches include both endocrine monotherapy and combinational strategies incorporating targeted signaling pathway inhibitors. Despite recent therapeutic advances that have significantly improved patient outcomes, the development of resistance to endocrine therapies leads to relapses and treatment failure. Emerging evidence has shown that long non-coding RNAs (lncRNAs) are therapeutic modulators; however, their involvement in clinical studies has not been much explored. In HR+ breast cancer, lncRNAs influence both sensitivity and resistance to endocrine therapy by modulating estrogen receptor (ER) function, switching between alternative survival pathways, and altering tumor epigenetics and tumor microenvironment. The major focus of this comprehensive review is to understand the role of lncRNAs in overcoming the endocrine resistance issues in the treatment of HR+ breast cancer. It presents a comprehensive approach focused on endocrine therapy mechanisms, resistance, and adaptive escape pathways of HR+ tumor cells. By mapping these mechanisms of endocrine therapy, the review reveals novel therapeutic targets for the treatment of HR+ breast cancer. Lastly, it highlights the specialized lncRNA-based therapeutics for bone metastatic niches in HR+ breast cancer and current approaches of therapeutic targeting of lncRNAs for disease treatment.}, }
@article {pmid42115141, year = {2026}, author = {Yang, MJ and Bohnet-Joschko, S}, title = {Thematic Mapping and Evolution of Social Media Mining in Health Research: Hybrid Bibliometric Synthesis.}, journal = {Journal of medical Internet research}, volume = {28}, number = {}, pages = {e86200}, pmid = {42115141}, issn = {1438-8871}, mesh = {*Bibliometrics ; *Data Mining/methods ; *Social Media ; Humans ; Machine Learning ; PubMed ; }, abstract = {BACKGROUND: Social media platforms offer extensive data, as they are widely used globally. Social media mining (SMM) enables real-time monitoring of user-reported health information and serves as a supplement to traditional health data analytics. However, the rapid proliferation of literature has produced fragmentation, and a comprehensive knowledge map regarding SMM is lacking. Further, existing bibliometric reviews in health fields are easily undermined by synonym fragmentation and parameter settings, reducing their robustness. Thus, a more robust, reproducible, and decision-oriented bibliometric framework is required.
OBJECTIVE: This study aimed to (1) outline key thematic clusters in health-related SMM and map their dynamic evolution, and (2) methodologically demonstrate how machine learning-based bibliometric analysis can strengthen the robustness, transparency, and foresight capacity of evidence synthesis.
METHODS: This study designed a fully automated and reproducible bibliometric analysis of PubMed journal articles published from 2015 to 2025 (n=250) and analyzed records with both abstracts and keywords (n=189). We performed cleaning and standardization for titles, abstracts, author keywords, and MeSH terms, and carried out an exploratory descriptive analysis to obtain preliminary insights into publication patterns. Subsequently, we used SPECTER2 and PubMedBERT embeddings with keywords and abstracts to construct a hybrid similarity matrix. Then, we applied Uniform Manifold Approximation and Projection for dimensionality reduction, followed by Hierarchical Density-Based Spatial Clustering of Applications with Noise for thematic clustering, and visualized the results in a 3D strategic coordinate system (maturity, influence, and recency). We performed intercluster relationship analysis and time-slice analysis to examine thematic intersections and evolution. To ensure robustness and enhance interpretability, we implemented dual-level validation.
RESULTS: We identified 6 thematic clusters: cluster 1 (candidate incubator pool of peripheral cross-cutting topics in health-related SMM), cluster 2 (computational methods in health informatics), cluster 3 (public attitudes and sociopsychological determinants), cluster 4 (infodemiology and the COVID-19 information ecosystem), cluster 5 (health communication and public health engagement), and cluster 6 (social media analysis and network methods). Strategic 3D mapping revealed that methodological clusters (clusters 2 and 6) occupied high-maturity and high-influence positions, while application-driven clusters (clusters 3 and 4) occupied high-influence and high-recency positions, representing rapidly expanding frontiers. Clusters 1 and 5 demonstrated strong potential for further growth. Temporal slicing confirmed a trajectory moving from methodological consolidation and thematic diversification to a renewed focus on convergence and problem-solving. Validation showed strong semantic coherence and robustness of the methods and findings.
CONCLUSIONS: We developed a semantic-structural hybrid bibliometric framework with dual-level validation, reducing synonym fragmentation and parameter sensitivity inherent in traditional approaches. The resulting decision-oriented knowledge map offers strategic guidance for infodemiology-informed and audience-segmented public health communication, research priority settings, and the deployment and evaluation of real-world surveillance and pharmacovigilance workflows while supporting evidence-driven and patient-centered decision-making in public health and health care.}, }
@article {pmid42115792, year = {2026}, author = {Manti, S and Licari, A and Del Giudice, MM and Tosca, MA and Ciprandi, G and Marseglia, G}, title = {Pragmatic management of acute cough in children and adolescents: an updated position paper by the Italian Society of Pediatric Allergy and Immunology (SIAIP).}, journal = {Allergologia et immunopathologia}, volume = {54}, number = {3}, pages = {31-41}, pmid = {42115792}, issn = {1578-1267}, support = {//The publication was supported by the Italian Society of Pediatric Allergy and Immunology (SIAIP)./ ; }, mesh = {Humans ; Adolescent ; Child ; *Cough/therapy/diagnosis/etiology ; Acute Disease ; Italy ; Antitussive Agents/therapeutic use ; SARS-CoV-2 ; Allergy and Immunology ; Societies, Medical ; Quality of Life ; }, abstract = {BACKGROUND: Cough is one of the most common and distressing symptoms in pediatric practice and represents a major cause of medical consultation, parental anxiety, and inappropriate medication use. Although most acute cough episodes are benign and self-limiting, they can significantly affect child's sleep, school performance, and quality of life. The COVID-19 pandemic and subsequent changes in infection patterns and immune responses have further highlighted the need to update the existing clinical guidance.
OBJECTIVE: This joint position paper by the Italian Society of Pediatric Allergy and Immunology (SIAIP) aims to provide a pragmatic, evidence-based update on the management of acute and post-viral cough in children and adolescents, integrating recent scientific advances and real-world clinical experiences.
METHODS: A multidisciplinary board of experts from SIAIP critically reviewed the literature published from 2019 to 2025 and updated the previous 2019 SIAIP document. The group achieved consensus on diagnostic and therapeutic recommendations through structured discussion and iterative revision.
RESULTS: The document emphasizes a stepwise approach to pediatric acute cough, starting with careful history-taking, clinical evaluation, and reassurance. Non-pharmacological measures-hydration, nasal saline irrigation, and avoidance of irritants-remain the first-line management. Pharmacological therapy may be considered in selected cases where cough is particularly distressing or significantly interferes with sleep; peripherally acting, nonsedative antitussives represent a reasonable option in terms of efficacy and safety. Centrally acting antitussives and unnecessary antibiotics should be avoided. Standardized, high-quality natural medical devices-with appropriate supporting evidence-represent a valid option. Honey-based preparations can be considered as complementary options. The paper also discusses new insights into cough pathophysiology, particularly the role of airway sensory hypersensitivity and neurogenic inflammation, which are paving the way for mechanism-based treatments.
CONCLUSIONS: This position paper provides an updated, pragmatic framework for the management of acute and post-viral cough in children and adolescents. It promotes rational drug use, integration of non-pharmacological and complementary measures, and awareness of emerging therapeutic targets. A mechanism-driven, individualized, and family-centered approach is advocated to improve clinical outcomes and quality of life for pediatric patients.}, }
@article {pmid42116176, year = {2026}, author = {Soliman, AR and Abouzeid, A and Ahmed, HH}, title = {Obesity and respiratory diseases: mechanisms, phenotypes, and clinical implications.}, journal = {Diabetology & metabolic syndrome}, volume = {18}, number = {1}, pages = {}, pmid = {42116176}, issn = {1758-5996}, abstract = {BACKGROUND: Obesity has emerged as a global pandemic with profound implications for respiratory health. The complex interplay between excessive adiposity and pulmonary function encompasses mechanical, metabolic, and inflammatory pathways that significantly impact morbidity and mortality.
OBJECTIVES: This comprehensive review synthesizes current evidence on obesity-related respiratory disorders, examining pathophysiological mechanisms, clinical phenotypes, epidemiological trends, and therapeutic considerations across the spectrum of respiratory diseases. This review provides a novel integrative framework unifying mechanical, inflammatory, and metabolic mechanisms across all major obesity-related respiratory conditions, with emphasis on clinically actionable phenotyping and emerging pharmacological therapies.
METHODS: We conducted a narrative review of peer-reviewed literature (PubMed/MEDLINE, Embase, and Cochrane Database, January 2000 - December 2024, using pre-specified MeSH terms; study selection and quality assessment followed SANRA guidelines focusing on the relationship between obesity and respiratory disorders including asthma, obstructive sleep apnea (OSA), obesity hypoventilation syndrome (OHS), chronic obstructive pulmonary disease (COPD), respiratory infections, and lung cancer.
RESULTS: Obesity profoundly affects respiratory mechanics through a right-shift of the static volume-pressure relationship of the chest wall, reducing FRC and ERV without a true restrictive pattern, altered respiratory muscle function, and systemic inflammation. Asthma prevalence increases with body mass index, demonstrating distinct phenotypes including atopic, insulin-resistant, dyslipidemic, and non-Th2 neutrophilic subtypes. OSA affects 22% of men and 17% of women, with obesity being the principal modifiable risk factor. OHS occurs in 8-20% of obese patients with sleep-disordered breathing, characterized by daytime hypercapnia (arising from impaired neuromuscular ventilatory drive and progressive nocturnal hypoventilation) and increased cardiovascular mortality. Paradoxically, obesity appears protective in advanced COPD by reducing FRC, thereby increasing inspiratory capacity and limiting dynamic pulmonary hyperinflation, and ARDS-the so-called obesity paradox-while conferring increased risk in COVID-19 pneumonitis. In lung cancer, obesity demonstrates complex relationships with risk and prognosis that vary by sex, smoking status, and disease stage.
CONCLUSIONS: Obesity-related respiratory disorders represent a multifaceted clinical challenge requiring integrated multidisciplinary approaches. Understanding distinct phenotypes and pathophysiological mechanisms is essential for personalized therapeutic strategies addressing both weight management and respiratory-specific interventions. Emerging pharmacological therapies including GLP-1 receptor agonists and dual GIP/GLP-1 agonists show particular promise in improving OSA severity and airway inflammation.}, }
@article {pmid42116640, year = {2026}, author = {Verryt, C and Gray, P and McNaughton, P and Peake, J and Wong, M and Aho, G and Best, E and Brewerton, M and Lutui, F and Tulifau, LE and Qin, R and Viali, S and White, P and Wood, A and Woon, ST and Cole, T and Charry, AP and Hsiao, KC}, title = {Guideline for the Diagnosis and Management of Heritable IFNAR1 Deficiency in Oceania.}, journal = {Journal of paediatrics and child health}, volume = {}, number = {}, pages = {}, doi = {10.1111/jpc.70421}, pmid = {42116640}, issn = {1440-1754}, abstract = {Autosomal recessive interferon alpha and beta receptor subunit 1 (IFNAR1) deficiency is a rare and heritable inborn error of immunity (IEI) predisposing individuals to severe and life-threatening viral infections. It is more common in people of Western Polynesian ancestry, with estimates of around one in six thousand live births affected, due to being homozygous for or having two copies of the regionally relevant pathogenic IFNAR1 variant c.1156G>T, p.Glu386*. IFNAR1 deficiency confers an increased risk of severe and life-threatening infections caused by naturally circulating viruses including influenza, SARS-CoV-2, herpes simplex virus, respiratory syncytial virus (RSV), arboviruses and viruses in live attenuated vaccines (LAVs) including measles-mumps-rubella (MMR) and yellow fever. Complications including virus induced systemic hyperinflammation (VISH) are associated with significant mortality. This document outlines expert consensus regarding early identification, diagnostic workup and management of IFNAR1 deficiency in Australia, Aotearoa New Zealand and Western Pacific nations.}, }
@article {pmid42117022, year = {2026}, author = {Yousefi, M and Sheydaee, F and Khoshnoodifar, M}, title = {E-learning Challenges among Healthcare Students: A Scoping Review.}, journal = {Journal of advances in medical education & professionalism}, volume = {14}, number = {2}, pages = {129-147}, pmid = {42117022}, issn = {2322-2220}, abstract = {INTRODUCTION: Despite the growing reliance on e-learning and the paradigm-shifting impact of the COVID-19 pandemic on educational systems, there is a lack of up-to-date evidence on the specific challenges that healthcare students confront in practical courses. Thus, this scoping review aims to address the challenges of E-learning among healthcare students post-pandemic and to provide possible solutions.
METHODS: This study was undertaken using the PRISMA Extension for Scoping Reviews (PRISMA-ScR) checklist. A search of English-language materials and peer-reviewed articles was performed from January 2020 to November 18, 2023, across five databases: PubMed, Web of Science, Scopus, ERIC, and EMBASE. Quality appraisal was done using JBI checklists.
RESULTS: Of the 4,559 potential records, 95 articles were included in this study. Using thematic analysis, 12 themes were identified, including Rapid progression and obligatory shift, Physical and mental problems of learners, Low digital literacy, Technical problems, Financial burden, Challenges of designing a practical course, Omission of learners' feedback in Designing, Learning contents and adopted strategy challenges, Unpreparedness of users, Lack of engagement and distracting learning environment, Lack of users' security and support, and Summative evaluation challenges.
CONCLUSION: Although a vast majority of literature highlights the effectiveness of E-learning courses, weaknesses such as engagement, interaction, development of practical skills, and evaluation of challenges are mentioned in literature. Thus, the use of blended learning in the LMICs in conjunction with instructional models, like the ADDIE model, is strongly recommended throughout the entire learning process to forecast upcoming challenges and prevent them, thereby boosting the quality of an E-learning course.}, }
@article {pmid42117444, year = {2026}, author = {Iannizzi, C and Chai, KL and Piechotta, V and Monsef, I and Wood, EM and Lamikanra, AA and Roberts, DJ and McQuilten, Z and So-Osman, C and Jindal, A and Estcourt, LJ and Skoetz, N and Kreuzberger, N}, title = {Convalescent plasma for people with COVID-19.}, journal = {The Cochrane database of systematic reviews}, volume = {5}, number = {5}, pages = {CD013600}, pmid = {42117444}, issn = {1469-493X}, support = {101015756/ERC_/European Research Council/International ; }, mesh = {Humans ; Randomized Controlled Trials as Topic ; COVID-19 Serotherapy ; *COVID-19/therapy/mortality ; Immunization, Passive/methods/adverse effects ; SARS-CoV-2 ; Quality of Life ; Betacoronavirus ; }, abstract = {RATIONALE: Convalescent plasma (CP) may reduce mortality in people with viral respiratory diseases, and is being investigated as a potential therapy for coronavirus disease 2019 (COVID-19). A thorough understanding of the current body of evidence regarding the benefits and risks of this intervention is required.
OBJECTIVES: To assess the effectiveness and safety of convalescent plasma transfusion in the treatment of people with COVID-19.
SEARCH METHODS: To identify completed and ongoing studies, we searched CENTRAL, MEDLINE, Embase, the Epistemonikos COVID-19 L*OVE Platform, and clinical trial registries to October 2024.
ELIGIBILITY CRITERIA: We included randomised controlled trials (RCTs) evaluating convalescent plasma for people with COVID-19, irrespective of disease severity, age, gender, or ethnicity. We excluded studies investigating other coronavirus diseases or standard immunoglobulin.
OUTCOMES: We used the GRADE approach to rate the certainty of evidence for the following outcomes: all-cause mortality (up to day 28), worsening and improvement of clinical status (for individuals with moderate to severe disease), hospital admission or death, COVID-19 symptoms resolution (for individuals with mild disease), quality of life (QoL), grade 3/4 adverse events, and serious adverse events.
RISK OF BIAS: We used RoB 2 to assess bias in included studies.
SYNTHESIS METHODS: We followed standard Cochrane methodology.
INCLUDED STUDIES: We included 48 RCTs (24,518 participants), 15 of which were added in this update. We also identified 36 new ongoing studies and 33 completed studies awaiting classification.
SYNTHESIS OF RESULTS: Individuals with a confirmed diagnosis of COVID-19 and moderate to severe disease Forty-two RCTs investigated the use of CP for 21,393 participants with moderate to severe disease. Of these, 36 RCTs (20,798 participants) compared CP to placebo or standard care, five (604 participants) to standard plasma, and one (190 participants) to human immunoglobulin. In the full review, we performed subgroup analyses by antibody detection, time since symptom onset, country income level, and key comorbidities. Convalescent plasma versus placebo or standard care alone CP does not reduce all-cause mortality at up to day 28 (risk ratio (RR) 0.96, 95% confidence interval (CI) 0.90 to 1.03; 31 RCTs, 20,798 participants; high-certainty evidence). It has little to no impact on the need for invasive mechanical ventilation, or death (RR 1.03, 95% CI 0.98 to 1.08; 8 RCTs, 15,189 participants; high-certainty evidence) and has no impact on whether participants are discharged from hospital (RR 1.00, 95% CI 0.97 to 1.02; 9 RCTs, 13,930 participants; high-certainty evidence). CP may have little to no impact on QoL (MD 1.00, 95% CI -2.14 to 4.14; 1 RCT, 483 participants; low-certainty evidence). CP may have little to no impact on the risk of grade 3/4 adverse events (RR 1.17, 95% CI 0.96 to 1.42; 6 RCTs, 2392 participants; low-certainty evidence). It probably has little to no effect on the risk of serious adverse events (RR 1.19, 95% CI 1.02 to 1.38; 11 studies, 5298 participants; moderate-certainty evidence). Convalescent plasma versus standard plasma The evidence is uncertain about whether CP reduces all-cause mortality at up to day 28 (RR 0.77, 95% CI 0.53 to 1.10; 5 RCTs, 604 participants; very low-certainty evidence) and whether it increases the need for invasive mechanical ventilation, or death (RR 5.59, 95% CI 0.29 to 108.38; 1 study, 34 participants; very low-certainty evidence). The evidence is uncertain about whether convalescent plasma reduces or increases the risk of grade 3/4 adverse events (1 RCT, 248 participants). The evidence is also uncertain about whether CP reduces the risk of serious adverse events (RR 0.82, 95% CI 0.57 to 1.17; 4 RCTs, 447 participants; very low-certainty evidence). No studies in this comparison reported clinical improvement or QoL. Individuals with a confirmed diagnosis of SARS-CoV-2 infection and mild disease Six RCTs investigated the use of CP for 2761 participants with mild disease. Four RCTs (1164 participants) compared CP to placebo or standard care alone, and two (1597 participants) to standard plasma. Convalescent plasma versus placebo or standard care alone The evidence is uncertain about whether CP reduces all-cause mortality at up to day 28 (odds ratio (OR) 1.24, 95% CI 0.33 to 4.60; 3 RCTs, 1004 participants; very low-certainty evidence) and admission to hospital or death within 28 days (RR 0.45, 95% CI 0.04 to 4.81; 2 RCTs, 493 participants; very low-certainty evidence). It may have little to no impact on time to COVID-19 symptom resolution (hazard ratio (HR) 1.05, 95% CI 0.85 to 1.30; 1 RCT, 376 participants) and on the risk of grade 3/4 adverse events (RR 1.29, 95% CI 0.75 to 2.19; 1 RCT, 376 participants), both with low-certainty evidence. The evidence is uncertain about whether CP has an impact on the risk of serious adverse events (RR 0.84, 95% CI 0.56 to 1.26; 2 RCTs, 494 participants; very low-certainty evidence). No studies in this comparison reported other critical outcomes. Convalescent plasma versus standard plasma The evidence is uncertain about whether CP reduces all-cause mortality at up to day 28 (RR 0.41, 95% CI 0.05 to 3.06; 2 RCTs, 1597 participants; very low-certainty evidence). It probably reduces admission to hospital or death within 28 days (RR 0.50, 95% CI 0.32 to 0.78; 2 RCTs, 1597 participants; moderate-certainty evidence). CP may have little to no effect on initial symptom resolution at up to day 28 (RR 1.12, 95% CI 0.82 to 1.54; 1 RCT, 416 participants; low-certainty evidence). Neither study in this comparison reported other critical outcomes.
AUTHORS' CONCLUSIONS: Compared with placebo or standard care, high-certainty evidence shows that CP does not reduce mortality in individuals with moderate to severe disease and has little to no effect on clinical improvement or worsening. CP probably has little to no effect on serious adverse events. Publication of ongoing studies might resolve some of the uncertainties around CP therapy for people with asymptomatic or mild disease. This review was previously a living systematic review, from the first version published in 2020 until our last search in October 2024. The research question is no longer a priority for decision-making, new studies are less frequently published, and research that might impact the conclusions of the review is no longer emerging.
FUNDING: The European Commission, Belgium SUPorting high quality evaluation of COVID-19 convalescent plasma thrOughouT Europe (SUPPORT-E, grant number 101015756) supported this review.
REGISTRATION: Protocol registered with the Center for Open Science on 17 April 2020 (DOI: 10.17605/OSF.IO/DWF53). Access the 2023 version of this review here: DOI: 10.1002/14651858.CD013600.pub6.}, }
@article {pmid42117901, year = {2026}, author = {Scaglione, F and Ciprandi, G}, title = {Corticosteroids or NSAIDs in Managing Acute Respiratory Infections: Valuable Differences.}, journal = {Journal of immunology research}, volume = {2026}, number = {1}, pages = {e9991040}, pmid = {42117901}, issn = {2314-7156}, mesh = {Humans ; *Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; *Adrenal Cortex Hormones/therapeutic use ; *Respiratory Tract Infections/drug therapy ; Oxidative Stress/drug effects ; COVID-19 ; SARS-CoV-2 ; Pandemics ; *Coronavirus Infections/drug therapy/immunology ; *Pneumonia, Viral/drug therapy/immunology ; Betacoronavirus ; COVID-19 Drug Treatment ; Acute Disease ; }, abstract = {Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used for respiratory infections. These drugs work by blocking two enzymes, COX-1 and COX-2, which regulate the production of prostaglandins, mediators involved in pain, fever, and inflammation. Corticosteroids (CSs) are commonly used in outpatient settings for anti-inflammatory purposes in the treatment of infectious diseases. However, their potential side effects, such as immunosuppression and increased metabolism, can be overlooked, even at low doses. Their use is clearly defined for severe conditions. Other infections, such as community-acquired pneumonia, pharyngotonsillitis, or otitis, do not have supportive data for the use of systemic CSs. For COVID-19, CSs are beneficial for severe cases that require ventilation, while they may not be helpful in mild cases. Infection-induced inflammation is associated with oxidative stress, a condition that arises from an imbalance between reactive oxygen species (ROS) and inadequate antioxidant responses. This stress worsens inflammatory reactions and can lead to severe respiratory infections and tissue damage. Managing oxidative stress is crucial in treating respiratory infections, and both CSs and NSAIDs can help reduce it. NSAIDs are preferred for treating symptoms such as fever and pain during the early phases of infections, especially viral ones, without hindering the immune response. CSs are powerful anti-inflammatory medications that are useful for treating infections in patients with asthma or allergies. However, CSs are not recommended for relieving pain and fever and can weaken the immune response. Both NSAIDs and steroids can mask serious infections, so doctors must be cautious in their use.}, }
@article {pmid42118190, year = {2026}, author = {Ebell, M and Kurotschka, P}, title = {Effectiveness of Nirmatrelvir/Ritonavir for Outpatients in the Era of Omicron, Vaccination, and Previous Infection: A Meta-analysis.}, journal = {Journal of general internal medicine}, volume = {}, number = {}, pages = {}, pmid = {42118190}, issn = {1525-1497}, abstract = {BACKGROUND: Since the benefit of nirmatrelvir-ritonavir (N-R) may have changed in contemporary patients, we assessed the effectiveness of N-R for preventing hospitalization and death among outpatients with COVID-19 in the Omicron era.
METHODS: This was a meta-analysis of cohort studies comparing rates of hospitalization and/or mortality in outpatients treated with N-R compared with untreated patients. Analysis was limited to studies conducted since December 2021 that performed an adjusted multivariate analysis. Quality was assessed using the Newcastle-Ottawa Scale. Summary estimates of adjusted relative risks (aRR) with 95% confidence intervals (CI) and prediction intervals (PI) were calculated overall and for prespecified subgroups. Heterogeneity was summarized visually and with τ and 95% PIs. Absolute effects were estimated by applying pooled aRRs to baseline risks to obtain absolute risk reductions (ARRs) and numbers needed to treat (NNTs).
RESULTS: Forty-seven studies (10,791,211 patients) were included. Pooled aRRs were 0.54 (95% CI, 0.43-0.68) for all-cause hospitalization and 0.45 (0.36-0.56) for COVID-19 hospitalization. Pooled RRs were 0.30 (0.23-0.39) for all-cause mortality and 0.43 (0.32-0.59) for COVID-19 mortality. PIs were < 1.0 for COVID-19 hospitalization (0.21-0.96), all-cause mortality (0.11-0.83), and any mortality (0.13-0.88), indicating likely benefit in future studies in similar settings. Subgroup analyses showed larger effects earlier in the Omicron period for hospitalization (RR 0.46 vs 0.68; p = 0.0049) and the composite outcome (0.45 vs 0.68; p = 0.0078), and a smaller mortality reduction among immunocompromised patients (RR 0.26 vs 0.11; p = 0.034). The estimated NNT to prevent a COVID-19 hospitalization for patients at low risk (0.16%), moderate risk (2.2%), and high risk (8.9%) of hospitalization based on a validated risk score were 1148, 84, and 20 respectively.
DISCUSSION: N-R is associated with reduced hospitalization and death. Absolute risk reductions of hospitalization are small in low-risk patients but clinically meaningful in moderate- and high-risk patients.}, }
@article {pmid42120165, year = {2026}, author = {Lot, L and DePietro, R and Tosh, AK}, title = {Diagnosis and Management of Eating Disorders in Adolescents and Young Adults.}, journal = {Primary care}, volume = {53}, number = {2}, pages = {295-310}, doi = {10.1016/j.pop.2026.01.011}, pmid = {42120165}, issn = {1558-299X}, mesh = {Humans ; *Feeding and Eating Disorders/diagnosis/therapy/epidemiology ; Adolescent ; Young Adult ; COVID-19/epidemiology ; Anorexia Nervosa/diagnosis/therapy ; Mass Screening ; United States/epidemiology ; }, abstract = {Eating disorders (EDs) are characterized by persistent disturbance of eating behavior that impairs health or psychosocial functioning. ED can persist for decades resulting in substantial burdens and psychosocial impairments. An increased prevalence of anorexia nervosa was noted during the COVID-19 pandemic. Despite a worsening trend in risky eating behavior among US college students, only 22% of colleges report offering year-round ED screening opportunities with 45% offering ED screenings once per year or semester. Furthermore, 20% or less of those who screened positive, received treatment.}, }
@article {pmid42121619, year = {2026}, author = {Kész, A and Balatoni, I}, title = {Globalization in the Healthcare Industry: Drivers, Risks, and Adaptation.}, journal = {Healthcare (Basel, Switzerland)}, volume = {14}, number = {9}, pages = {}, pmid = {42121619}, issn = {2227-9032}, abstract = {Globalization refers to the increasing density of economic, social, and technological interconnections on a global scale. In the healthcare industry, it simultaneously accelerates innovation and increases systemic vulnerabilities. This study aims to review and conceptually synthesise the main channels of impact: (1) pharmaceuticals, clinical development, and regulation; (2) supply chains and resilience; (3) service mobility (health tourism); (4) human resources and competencies; (5) digitalization, artificial intelligence (AI), and data governance; (6) ethics, law, and public policy; and (7) sustainability and climate change. The COVID-19 pandemic highlighted the risks associated with global interdependencies, particularly in supply chains, while also demonstrating the innovation-accelerating effects of knowledge sharing and international cooperation. Particular attention is given to artificial intelligence and digital health, which open up new potential for efficiency and quality improvement from research and development through diagnostics to healthcare organization, while simultaneously intensifying concerns related to data protection, cyber security, and liability. Telemedicine, platform-based systems, and real-world data may contribute to addressing the care needs of ageing societies, but only when supported by appropriate competencies and sound data governance. As global data flows intensify, the importance of data protection, bias mitigation, transparency, and accountability correspondingly increases. Through the cultural channels of globalization, health-conscious lifestyles and complementary approaches are also spreading, which we address in a brief, separate subsection. The guidelines of international organizations foster standardization; however, due to differences in local capacities and institutional environments, the effects are not homogeneous. In conclusion, the study emphasises the dual nature of globalization; it expands access and accelerates innovation, while at the same time creating new vulnerabilities-in supply chains, labour mobility, and data security-and, together with climate-related risks, generating complex adaptive pressures for the healthcare industry.}, }
@article {pmid42121847, year = {2026}, author = {Vezzoli, M and Dieci, G and Ferrari, R}, title = {The Viral Immunoshadow: Early Adenovirus Strategies for Cloaking Innate Immunity with E1A, E4orf1, and Beyond.}, journal = {Cells}, volume = {15}, number = {9}, pages = {}, pmid = {42121847}, issn = {2073-4409}, support = {IG2022-27712//Italian Association for Cancer Research (AIRC)/ ; }, mesh = {Humans ; *Immunity, Innate/immunology ; *Adenoviruses, Human/immunology/pathogenicity ; *Adenovirus E1A Proteins/immunology/metabolism ; *Adenovirus E4 Proteins/immunology/metabolism ; Animals ; Virus Replication ; }, abstract = {Human adenovirus (HAdV), a double-stranded DNA virus, targets terminally differentiated cells in the upper respiratory tract. As a key platform for gene therapy vectors, elucidating HAdV's virulence factors is vital for optimizing therapeutic applications and mitigating risks. To achieve productive replication, HAdV strategically neutralizes host immune defenses and induces S-phase pathways essential for viral propagation. This review synthesizes the latest insights into the key pathways through which HAdVs harness these early proteins to enhance virulence, skilfully evading and counteracting host defense mechanisms while propelling viral replication. As foundational platforms for gene therapy vectors (e.g., in oncology and rare disease treatments) and vaccine backbones (e.g., COVID-19 vaccines like ChAdOx1), understanding HAdV's immunoshadowing-the multifaceted strategies used to cloak innate and adaptive immunity-is crucial for enhancing vector safety and efficacy. Recent insights unveil how early viral proteins-including E1A, E1B-55K, E4orf1, E4orf3, E4orf6, and the E3 complex-participate in these processes. This review critically synthesizes these pathways, evaluating study limitations such as reliance on immortalized cell lines that underestimate the role of these proteins in immunological competent cells, and addresses unresolved controversies, including differential immunoshadowing efficacy across HAdV species that impacts vaccine design.}, }
@article {pmid42121889, year = {2026}, author = {Kopańska, M and Trojniak, J and Góral-Półrola, J and Pąchalska, M}, title = {Alterations in Cortical Oscillatory Dynamics Following SARS-CoV-2 Infection: QEEG Biomarkers of Vulnerability to Attention and Seizure-Related Symptoms.}, journal = {Cells}, volume = {15}, number = {9}, pages = {}, pmid = {42121889}, issn = {2073-4409}, mesh = {Humans ; *COVID-19/complications/physiopathology ; *Electroencephalography/methods ; *Seizures/physiopathology/etiology ; Biomarkers/metabolism ; SARS-CoV-2 ; *Attention/physiology ; *Cerebral Cortex/physiopathology ; }, abstract = {SARS-CoV-2 infection is associated with not only acute respiratory symptoms but is also characterized by strong neurotropism which may contribute to the development of the multisystem post-COVID syndrome (PASC). Patients frequently report chronic neurocognitive disorders such as brain fog, significant attention deficits and increased susceptibility to epileptiform discharges. The aim of this review is to systematize the knowledge regarding deviations in quantitative electroencephalography (QEEG) recordings in convalescents and to evaluate the utility of this method as an objective biomarker. This work constitutes a comprehensive literature review integrating the latest data on neuroinflammation, blood-brain barrier damage and changes in cortical oscillatory dynamics induced by the infection. The literature analysis indicates that the virus may induce a pathological excitation and inhibition imbalance (E/I imbalance) in neuronal networks. In QEEG studies this manifests as excessive activity of slow bands (Theta, Delta), a deficit of rhythms responsible for attention and sensorimotor integration (SMR) and a pathologically elevated Theta to Beta ratio (TBR). In conclusion, QEEG can serve as an objective and highly sensitive tool supporting the diagnosis and stratification of patients with neurocognitive complications of Long COVID. The integration of precise electrophysiological phenotyping with targeted behavioral neuromodulation (e.g., EEG-Biofeedback) fits into the paradigm of personalized medicine and offers a prospective strategy for mitigating long-term neurological burdens.}, }
@article {pmid42122974, year = {2026}, author = {Baiasu, AF and Rotaru-Zavaleanu, AD and Boldea, AM and Ruscu, MA and Serbanescu, MS and Radu, L}, title = {Bridging Traditional Modeling and Artificial Intelligence in Measles Epidemiology: Methods, Applications, and Future Directions-A Narrative Review.}, journal = {Journal of clinical medicine}, volume = {15}, number = {9}, pages = {}, pmid = {42122974}, issn = {2077-0383}, abstract = {Measles remains one of the most contagious infectious diseases globally and continues to pose substantial public health risks despite decades of effective vaccination. This narrative review examines both classical and contemporary computational approaches used for measles monitoring, prediction, and control, with particular attention given to the emerging role of artificial intelligence (AI). We synthesized findings from 46 studies; 31 focused directly on measles and 15 on methodologically relevant studies from related infectious diseases (COVID-19, influenza, malaria), selected through searches of PubMed, Scopus, Web of Science, IEEE Xplore, and preprint servers, conducted between June and December 2025. Traditional compartmental models (SIR, SEIR, MSEIR), statistical tools (ARIMA, SARIMA), and seroepidemiological analysis provide transparent, well-characterized frameworks for estimating transmission dynamics and simulating intervention scenarios. Spatial modeling, network analysis, and Monte Carlo simulations have added geographic granularity to outbreak characterization. More recently, AI and machine learning (ML) methods, including supervised algorithms (Random Forest, XGBoost, SVM), deep learning architectures (CNN, LSTM), and hybrid mechanistic ML models, have shown improved predictive performance by integrating multiple data sources: epidemiological records, demographic profiles, mobility patterns, and behavioral indicators. AI-based approaches appear most valuable for high-dimensional risk prediction and image-based diagnostic tasks, while classical models retain clear advantages for policy-oriented scenario analysis. However, no AI-based or hybrid model identified in this review has been adopted into routine national measles surveillance or used for vaccination policy decisions at scale. Important challenges remain: data quality varies across settings, model generalizability cannot be assumed, and computational infrastructure disparities limit deployment in high-burden regions. Explainable AI, federated learning, workforce training for model interpretation, and integration of vaccination registries with mobility and genomic surveillance data represent concrete future directions for strengthening computational support for measles elimination.}, }
@article {pmid42123618, year = {2026}, author = {Wirth, KJ and Scheibenbogen, C}, title = {Imbalance of Excitatory and Inhibitory Neurotransmitter Systems in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.}, journal = {International journal of molecular sciences}, volume = {27}, number = {9}, pages = {}, pmid = {42123618}, issn = {1422-0067}, mesh = {Humans ; *Fatigue Syndrome, Chronic/metabolism/physiopathology/pathology ; *Neurotransmitter Agents/metabolism ; Post-Acute COVID-19 Syndrome ; Animals ; SARS-CoV-2 ; }, abstract = {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.}, }
@article {pmid42126095, year = {2025}, author = {Pourshaban, M and Allahbakhshian, A and Purabdollah, M}, title = {Mapping the Contributing Factors to Missed Nursing Care in Hospital Settings During a Global Health Crisis: A Systematic Scoping Review.}, journal = {Journal of nursing management}, volume = {2025}, number = {1}, pages = {e7343469}, doi = {10.1155/jonm/7343469}, pmid = {42126095}, issn = {1365-2834}, support = {75775//Student Research Committee, Tabriz University of Medical Sciences/ ; }, mesh = {Humans ; *COVID-19/nursing/epidemiology ; *Nursing Care/standards ; Global Health ; }, abstract = {BACKGROUND: Little foreknowledge and preparation exist for health-related crises, and they do not match the magnitude of the problem. During the COVID-19 pandemic, nursing care in some countries faced more challenges. One of these challenges was missed nursing care. This scoping review aims to identify and map the factors influencing missed nursing care in hospital settings during the COVID-19 pandemic in studies conducted in developed and developing countries.
METHODS: A scoping review was conducted according to methodology recommended by the Joanna Briggs Institute (JBI). We searched five databases-PubMed, Scopus, CINAHL, ProQuest, and Web of Science-as well as the Google Scholar search engine, from December 2019 to July 2025. Keywords of the study were selected according to the Medical Subject Headings (MeSH) and previous research. We included studies in hospital wards that examined missed nursing care and related concepts, specifically those whose data collection periods occurred during the COVID-19 pandemic. Language restrictions were not applied. The factors were derived inductively, considering conceptual similarities, relevance to the core themes, and similarities in meaning, including aspects related to the missed nursing care model, the developed model derived from it related to the factors considered for missed nursing care, and emerging challenges introduced by COVID-19. Findings were reported following the PRISMA-ScR.
FINDINGS: From the 1966 studies, we included 57 articles in the final review. Among them, 50 were cross-sectional, four were qualitative, two were mixed, and one was quasiexperimental. They were conducted mainly in Iran and the hospital units. Four main themes and nine subthemes emerged (1) work environment (structure, work climate), (2) nurse characteristics (individual and professional, personal), (3) workflow characteristics (intensity, predictability, risk), (4) country (developed, developing). Although the lack of human resources was reported in most studies, it was not the most significant contributing factor.
CONCLUSION: These findings can inform the development of strategies to address underlying factors affecting workflow, such as nurses' attitudes and the work environment, thereby enhancing adaptability to future global health crises and serving as a crucial policy foundation for mitigating the missed nursing care during health emergencies.
PRACTICAL IMPLICATIONS: These findings not only complement other global research exploring the reasons behind missed cares in nursing but also offer a framework for understanding and anticipating reported instances of missed care, enabling targeted interventions to address them effectively.}, }
@article {pmid42126431, year = {2026}, author = {Brosnan, C and Rossi, A and van der Hoorn, A and Due-Tønnessen, P and Looby, S and , }, title = {Choosing wisely in neuroradiology: evaluating CT and MR utilization trends in Europe.}, journal = {European radiology}, volume = {36}, number = {8}, pages = {6589-6598}, pmid = {42126431}, issn = {1432-1084}, mesh = {Europe ; *Tomography, X-Ray Computed/statistics & numerical data/trends ; *Magnetic Resonance Imaging/statistics & numerical data/trends ; Humans ; *Neuroimaging/trends/statistics & numerical data ; }, abstract = {OBJECTIVES: To assess trends in volume and utilization of neuroimaging (CT and MR) across Europe over the last decade, within the context of evolving clinical practice on behalf of the European Society of Neuroradiology's Choosing Wisely committee.
MATERIALS AND METHODS: A systematic search of PubMed was performed (following PRISMA 2020 guidelines) to identify studies reporting European neuroimaging volumes. As no eligible studies were identified, descriptive analysis of Eurostat and OECD data was performed for 29 European countries from 2015 to 2022, covering CT and MR examination volumes and scanner availability per 100,000 population across four geographic regions (Northern, Southern, Eastern, and Western Europe). Total CT/MR volumes served as neuroimaging surrogates.
RESULTS: 316 publications were identified (with none meeting predefined inclusion criteria). Eurostat data from 29 countries revealed substantial growth in imaging from 2015 to 2022. Per capita CT exam rates increased 40.8% (10,872 to 15,312 per 100,000 population), and MR scan rates increased 43.5% (5746 to 8244 per 100,000 population). Scanner availability also increased (CT scanners from 2.3 to 2.68, MR scanners from 1.43 to 2.11 per 100,000 population). Regional variations were evident: Western Europe showed the highest utilization rates, Eastern Europe demonstrated the largest relative growth despite lower absolute numbers. All regions experienced consistent growth except during the 2020 COVID-19 disruptions.
CONCLUSION: Neuroimaging utilization has substantially increased across Europe from 2015 to 2022, with disproportionate growth in scan volumes relative to scanner availability. These findings highlight regional disparities in utilization and underscore the need for coordinated evidence-based appropriateness initiatives to support sustainable neuroimaging practice.
KEY POINTS: Question Have CT and MR neuroimaging utilization rates changed across Europe over the last decade compared to scanner availability? Findings CT and MR scan rates increased 40.8% and 43.5%, respectively, from 2015 to 2022, reflecting increased per-scanner utilization across the continent. Clinical relevance Neuroimaging examination volumes increased substantially across Europe from 2015 to 2022. This highlights the value of evidence-based imaging appropriateness initiatives to ensure sustainable healthcare resource utilization.}, }
@article {pmid42127260, year = {2026}, author = {Antar, AAR}, title = {CROI 2026: Acute and Postacute COVID-19.}, journal = {Topics in antiviral medicine}, volume = {34}, number = {2}, pages = {494-500}, pmid = {42127260}, issn = {2161-5853}, mesh = {Humans ; *COVID-19/immunology/complications/therapy ; Post-Acute COVID-19 Syndrome ; *SARS-CoV-2/immunology ; *COVID-19 Drug Treatment ; Acute Disease ; }, abstract = {The 2026 Conference on Retroviruses and Opportunistic Infections (CROI) furthered our understanding of acute COVID-19, long COVID, postacute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), viral immunity, and SARS-CoV-2 therapeutics. Results of a first-in-human validation study of DNA-encoded monoclonal antibody (DMAb) technology demonstrated safety and robust and durable monoclonal antibody (mAb) production, giving the green light to further develop the DMAb platform. Pemivibart administration to people with advanced HIV was well tolerated and associated with good levels of neutralizing antibodies. A new pan-coronavirus 3C-like protease inhibitor was shown to have similar pharmacokinetics and a similar safety profile in people with renal impairment and people with hepatic impairment. A study of SARS-CoV-2 infections in 2023 demonstrated continued risk for new incident diagnoses and worsening of prior comorbidities in the year after infection. SARS-CoV-2 infection in people with HIV is associated with discernible decline in estimated glomerular filtration rate in the 2 years after infection. A blinded study of circulating SARS-CoV-2 antigen found no association between the presence of antigen and the likelihood of having long COVID. Most people with long COVID in a cohort study have experienced stigma or feeling dismissed in interactions with their clinicians.}, }
@article {pmid42127571, year = {2026}, author = {Obilor, HN and Oluwole, O and Ross-White, A and Premji, SS and , and , }, title = {Mental health and mental health care of South and East Asian immigrant pregnant women residing in five OECD Countries: A systematic review.}, journal = {Midwifery}, volume = {159}, number = {}, pages = {104818}, doi = {10.1016/j.midw.2026.104818}, pmid = {42127571}, issn = {1532-3099}, mesh = {Female ; Humans ; Pregnancy ; Asia, Southern/ethnology ; Australia/epidemiology ; Canada/epidemiology ; East Asian People ; *Emigrants and Immigrants/psychology/statistics & numerical data ; *Mental Health/ethnology ; *Mental Health Services/statistics & numerical data/standards ; New Zealand/epidemiology ; Organisation for Economic Co-Operation and Development/organization & administration ; *Pregnant People/psychology/ethnology ; South Asian People ; United Kingdom/epidemiology ; United States/epidemiology ; Asia, Eastern/ethnology ; }, abstract = {BACKGROUND: South and East Asian immigrant pregnant women across Organisation for Economic Co-Operation and Development (OECD) countries face barriers to accessing perinatal mental health care. This review examined the prevalence of common mental health conditions and experiences with perinatal mental health services among South and East Asian immigrant pregnant women in five OECD countries (Canada, the United Kingdom, the United States, Australia, and New Zealand).
METHODS: A systematic review was conducted using a comprehensive search strategy developed by an expert librarian for five databases (CINAHL, MEDLINE, EMBASE, PsycINFO, and MIDIRS) from inception to February 2026. Quantitative, qualitative, and mixed-methods studies and published abstracts were considered.
RESULTS: The review comprised six studies (five quantitative and one qualitative) conducted in Canada, the United Kingdom and the United States. The point prevalence of depression and state anxiety among participants was 16.3% and 19.7%, respectively, based on studies published mostly between 2012 and 2016. The qualitative study suggested that the utilization of mental health services was poor due to a lack of understanding of mental health issues, stigma, language barriers, cultural taboos, and distrust of mental health professionals.
CONCLUSIONS: The review highlights the magnitude of antenatal depression and anxiety among South and East Asian immigrants, mainly before the COVID-19 pandemic. More research is required to understand the current demand for perinatal mental health services among immigrant South and East Asian pregnant women. Evaluating how effectively each OECD country is prioritizing the mental health needs of this population post-COVID-19 will inform practice and policy reform.
https://www.crd.york.ac.uk/PROSPERO/view/CRD42023440054 PROSPERO Identifier: CRD42023440054.}, }
@article {pmid42128596, year = {2026}, author = {De Sousa-De Sousa, L and Espinosa, HG and Maté-Muñoz, JL and Ramón Heredia-Elvar, J and Martín, L and Solís-Mencía, C and García-Fernández, P}, title = {A decade of concussion in rugby: a 2014-2024 systematic review and meta-analysis update.}, journal = {British journal of sports medicine}, volume = {60}, number = {11}, pages = {811-826}, doi = {10.1136/bjsports-2025-110774}, pmid = {42128596}, issn = {1473-0480}, mesh = {Humans ; *Brain Concussion/epidemiology/diagnosis ; *Football/injuries ; Incidence ; *Athletic Injuries/epidemiology/diagnosis ; Male ; Female ; }, abstract = {OBJECTIVE: To quantify the incidence of concussions identified through clinical assessments or diagnostic protocols in rugby union (RU) (sevens and XVs) and rugby league (RL) over the past decade and analyse differences by sex, playing level, match versus training exposure and concussion assessment protocols (Head Injury Assessment (HIA) vs non-HIA).
DESIGN: Systematic review and meta-analysis.
DATA SOURCES: PubMed, Web of Science, Scopus, Embase, SPORTDiscus, PsycINFO and CINAHL were searched in February 2025 for studies published between 2014 and 2025.
Studies were eligible if they reported concussions identified through clinical assessment or diagnostic protocols in rugby with extractable exposure data (match-player-hours and/or training-player-hours) and incidence rates per 1000 player-hours.
RESULTS: 98 studies, comprising 10 591 concussions across 3 275 130 player-hours, met the inclusion criteria. Studies included data from 2003 to 2023. The pooled overall concussion incidence was 9.74 per 1000 player-hours (95% CI 8.54 to 10.95) in RU and 9.20 (95% CI 7.38 to 11.02) in RL, with no significant difference between codes (p=0.891). When analysed by subgroups, no statistically significant overall sex-based differences in concussion incidence were observed in either RU or RL; however, post hoc analyses identified higher concussion incidence among female youth players (<18 years) compared with males. Match play showed a markedly higher incidence than training (RU: 10.98 per 1000 match-player-hours vs 0.34 per 1000 training-player-hours; RL: 10.45 per 1000 match-player-hours vs 0.32 per 1000 training-player-hours; p<0.001). Studies using HIA protocols reported nearly double the incidence compared with non-HIA protocols (RU: 15.35 vs 7.72; rate ratio=1.83; p<0.001). Concussion trends reflected external factors, including COVID-19 disruptions and policy changes.
CONCLUSION: Concussion incidence in rugby appears to be strongly influenced by match intensity and assessment protocol. Structured diagnostic approaches, such as the HIA protocol, are associated with higher reported concussion incidence, likely reflecting improved detection.
PROSPERO REGISTRATION: CRD42023480774.}, }
@article {pmid42128720, year = {2026}, author = {Cantor-Cutiva, LC and Ramirez Ardila, MDP and Hunter, EJ}, title = {Gaps and Future Directions in the Research About Masking and Voice Production: Bibliometric Analysis, Systematic Literature Review, and Meta-analysis.}, journal = {Journal of voice : official journal of the Voice Foundation}, volume = {}, number = {}, pages = {}, pmid = {42128720}, issn = {1873-4588}, support = {R01 DC012315/DC/NIDCD NIH HHS/United States ; }, abstract = {BACKGROUND: While facemasks have played a vital role in mitigating the spread of infectious diseases, their prolonged use has raised questions about their potential effects on voice production and communication.
METHODS: The present study integrated three complementary methodological approaches with three specific aims. First, to identify trends in research on facemasks and voice production, including thematic clusters and patterns, using bibliometric methods. Second, critically appraise and synthesize findings from primary research studies on the effects of facemask use on voice-related outcomes through a systematic literature review. Third, to determine the pooled effects of facemask use on selected vocal outcomes, where data allow, using meta-analysis.
RESULTS: In total, 48 publications were included in this review. The term co-occurrence network map generated with VOSviewer showed three clusters: voice-related consequences of mask use during the COVID-19 pandemic, the impact of protective equipment on speech acoustics and intelligibility, and acoustic markers of voice quality in healthy speakers. The overlay visualization map showed that earlier studies emphasized the subjective assessment of the relationship between facemasks and voice production. In contrast, more recent publications reflect a growing interest in the instrumental assessment of the relationship. Most studies based their results on voice acoustic analysis, followed by questionnaires and aerodynamic assessment. The results suggested no significant differences in fundamental frequency, jitter, shimmer, harmonics-to-noise ratio, and maximum phonation time. The results on vocal effort and sound pressure levels are inconsistent. The meta-analysis suggested that facemasks cause a small increase in SPL, but the effect was not statistically significant.
CONCLUSION: Facemasks create complex communication challenges that extend beyond acoustic changes to encompass multimodal perception disruption and disproportionate impacts on vulnerable populations. While acoustic measurements show minimal direct effects, the elimination of visual speech cues and facial expression recognition may create substantial barriers for individuals with hearing impairments, developmental disabilities, and age-related communication difficulties.}, }
@article {pmid42129070, year = {2026}, author = {Veenstra, TD}, title = {Basic Virology.}, journal = {Advances in experimental medicine and biology}, volume = {1511}, number = {}, pages = {29-49}, pmid = {42129070}, issn = {0065-2598}, mesh = {Humans ; *SARS-CoV-2/genetics/physiology ; *Virology/methods ; *Proteomics/methods ; *COVID-19/virology/epidemiology ; Genome, Viral ; Viral Proteins/metabolism/genetics ; Animals ; }, abstract = {Current generations are living through a historical event in virology: the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. If you asked people when the last major pandemic was, many would probably say the Spanish flu of 1918-1920. Pandemics happen more frequently than most people think (Sampath et al., Cureus 13:e18136-18144, 2021). There have been at least five recorded pandemics between the Spanish flu and the recent SARS-CoV-2 pandemic. While the SARS-CoV-2 pandemic has brought with it indescribable sorrow and pain, it has also increased people's awareness of the impact viruses can have on life on Earth. Terms such as hygiene, modes of infection, community spread, quarantine, vaccines, etc. have become part of our daily conversations. As this book's first chapter provided a basic review of proteomic technologies for virologists, this chapter provides a basic review of virology for proteomic scientists. While virologist may find this chapter unsatisfying, hopefully proteomic scientists will learn enough to be able to understand how proteomic technology can be used to further detail the structure, function, and life cycle of viruses. This chapter will provide both generic and specific examples of viral structures, how they infect cells, and their effects on both the infected cell and the entire organism.}, }
@article {pmid42129072, year = {2026}, author = {Veenstra, TD}, title = {Viral Prognosis Using Proteomics.}, journal = {Advances in experimental medicine and biology}, volume = {1511}, number = {}, pages = {75-102}, pmid = {42129072}, issn = {0065-2598}, mesh = {Humans ; *Proteomics/methods ; *COVID-19/diagnosis/virology/metabolism ; *SARS-CoV-2/genetics/metabolism/pathogenicity ; Prognosis ; }, abstract = {So much was learned during the COVID-19 pandemic of 2020-2023. Some of the things that were learned were obvious. Many people in the public learned about social distancing, personal hygiene, and how to conduct a COVID-19 diagnostic test. Pharmaceutical companies and government organizations learned to efficiently work together to produce and distribute vaccines in record time. Although it may have generated controversy, the value in getting vaccinated was revalidated. There were other things that the world learned, although it was not as obvious. The effect of vaccination rate on preventing virus mutation became evident during the pandemic. The original SARS-CoV-2 virus that started the pandemic mutated several times over the course of the pandemic. One thing that became clear during the pandemic was the lack of knowledge on how SARS-CoV-2 infection would affect individuals during the course of the disease. This inability to accurately prognose the disease made it difficult to personalize treatments for specific individuals and the distribution of resources to protect the most vulnerable populations challenging. What is required to increase the accuracy of prognosis is more knowledge about how dynamic changes occur within the host cell during viral infection. Since many proteins become dysregulated during infection, proteomics is a prime technology for gaining this knowledge to increase prognostic capabilities and enable personalized treatments that alleviate the suffering viruses cause on humanity.}, }
@article {pmid42129074, year = {2026}, author = {Veenstra, TD}, title = {The Pathology of Viral Infections.}, journal = {Advances in experimental medicine and biology}, volume = {1511}, number = {}, pages = {127-158}, pmid = {42129074}, issn = {0065-2598}, mesh = {Humans ; *Virus Diseases/pathology/virology ; Viruses/pathogenicity ; Microbiota ; Animals ; Host-Pathogen Interactions/physiology ; }, abstract = {If you were to ask, "Biologically speaking, what are humans made of?", almost everyone would reply "Human cells and molecules, of course." This seemingly logical answer, however, does not truly capture the diversity of the human organism. Over the past couple of decades scientists have discovered that humans are a collective of cohabitating human, bacteria, and fungi cells along with countless numbers of viruses. Collectively, these microorganisms are referred to as the microbiome (Lederberg and McCray, The Scientist 15:8, 2001). The most recent estimates suggest the biological material from these microorganisms makes up as much as half of every human. Considering the size of the microbiome, it is not surprising that humans share an intimate relationship with viruses since they will be found wherever life exists.}, }
@article {pmid42129077, year = {2026}, author = {Veenstra, TD}, title = {Proteomic Analysis of Influenza.}, journal = {Advances in experimental medicine and biology}, volume = {1511}, number = {}, pages = {223-258}, pmid = {42129077}, issn = {0065-2598}, mesh = {Humans ; *Influenza, Human/metabolism/virology/epidemiology ; *Proteomics/methods ; Animals ; Pandemics ; *Proteome ; *Viral Proteins/metabolism/genetics ; }, abstract = {The past several years have increased the public's knowledge of various terms related to virology. Besides learning about messenger RNA (mRNA) vaccines, N95 masks, and coronaviruses (CoVs), we became familiar with the term pandemic. Pandemics are not novel. There have been approximately 250 pandemics recorded throughout history since 1200 B.C. with approximately 20 of these resulting in the deaths of more than one million people (https://study.com/learn/lesson/pandemics-in-history.html ; Sampath S et al., Cureus 13:e18136, 2021). The earliest recorded pandemic for which there is detailed information is the Justinian plague (Drancourt M and Raoult D, Clin Microbiol Infect 22:911-915, 2016). This pandemic began in 540 A.D., lasted for two centuries, and was a major factor that hastened the fall of the Roman Empire. So what exactly is a pandemic? At its most basic a pandemic is a disease that is simultaneously occurring worldwide, affecting many individuals. This definition does not include anything about the severity of the disease or the population's immunity. While most people would say that pandemics and epidemics are extremely rare, there have been six just in the last two decades (Bhadoria P et al., J Family Med Prim Care 10:2745-2750, 2021). These include the severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1), swine flu, Middle Eastern respiratory syndrome CoV infection, Ebola virus, Zika virus, and the most recent SARS-CoV-2 pandemic (see Table 9.1).}, }
@article {pmid42129712, year = {2026}, author = {Mahmoudi, S and Mohammadpour, M and Olfat, M}, title = {Remdesivir for the treatment of children hospitalized with COVID-19: a systematic review and meta-analysis.}, journal = {BMC pulmonary medicine}, volume = {26}, number = {1}, pages = {}, pmid = {42129712}, issn = {1471-2466}, mesh = {Child ; Child, Preschool ; Humans ; Infant ; *Adenosine Monophosphate/analogs & derivatives/therapeutic use/adverse effects/analogs & derivatives ; *Alanine/analogs & derivatives/therapeutic use/adverse effects/analogs & derivatives ; *Antiviral Agents/therapeutic use/adverse effects ; COVID-19/therapy ; *COVID-19 Drug Treatment ; Hospital Mortality ; Hospitalization ; Pandemics ; *Pneumonia, Viral/drug therapy/mortality ; Respiration, Artificial/statistics & numerical data ; SARS-CoV-2 ; Treatment Outcome ; }, abstract = {INTRODUCTION: Remdesivir (RDV) is an FDA-approved drug for the treatment of COVID-19 in children weighing at least 3.5 kg. While its safety and efficacy are well established in adults, data in pediatric populations remain limited and are largely extrapolated from adult studies. Therefore, we aimed to assess the clinical outcomes and safety of RDV in pediatric patients.
METHODS: We performed a systematic review and meta-analysis of studies evaluating RDV in hospitalized children under 18 years with COVID-19. The primary outcomes were in-hospital mortality and the level of respiratory support (baseline and highest). The secondary outcome was the safety profile of RDV identified by adverse events and treatment discontinuation. Meta-analysis was performed only on patients who received RDV.
RESULTS: From 1298 records, 16 studies were included. A total of 722 patients who received remdesivir were included in this study. Pooled analysis at admission showed that 28% of patients required no oxygen, 23% needed low-flow oxygen, 21% needed high-flow oxygen, 11% required non-invasive ventilation (NIV), and 9% were treated with mechanical ventilation (MV). During hospitalization, the highest respiratory support required was no oxygen in 27%, low-flow oxygen in 33%, high-flow oxygen in 32%, NIV in 5%, and MV in 19%. Overall mortality was 2% (95% CI: 0.00, 0.04, I[2] = 59.81%, p < 0.001). The most frequent RDV-related adverse events were elevated ALT in 11% (95% CI: 0.00, 0.42, I[2] = 94.02%, p < 0.001), increased AST in 10% (95% CI: 0.00, 0.41, I[2] = 94.56%, p = < 0.001), unspecified liver enzymes elevation in 8% (95% CI: 0.01, 0.20, I[2] = 81.84%, p < 0.001), and hypertension in 10% (95% CI: 0.00, 0.58, I[2] = 97.16%, p < 0.001). Bradycardia (3%) and increased creatinine (2%) were also reported. Almost all studies reported no drug-related serious adverse events.
CONCLUSION: This meta-analysis suggests that RDV has an acceptable safety profile in pediatric patients with COVID-19. The most commonly reported adverse events were elevated hepatic enzymes and hypertension, with occasional reports of bradycardia and increased creatinine. The pooled results should be interpreted with caution due to study heterogeneity and possible publication bias.}, }
@article {pmid42131658, year = {2026}, author = {Joy, P and Kunthavai, R and Sahu, S and Routray, S}, title = {COVID-19 and Congenital Cleft Lip and Palate: A Systematic Review Focusing on Nonsyndromic Neonatal Outcomes.}, journal = {Cureus}, volume = {18}, number = {4}, pages = {e106878}, pmid = {42131658}, issn = {2168-8184}, abstract = {Craniofacial anomalies (CFAs), such as cleft lip and palate, are among the most frequent birth defects, often necessitating multidisciplinary care. The COVID-19 pandemic raised concerns that maternal SARS-CoV-2 infection and associated factors, such as fever, inflammation, and psychosocial stress, might elevate teratogenic risk. This systematic review aims to synthesize the evidence on the association between maternal COVID-19 exposure and nonsyndromic CFAs in neonates. We conducted a systematic review in accordance with the PRISMA 2020 guidelines. Major electronic databases (PubMed/MEDLINE, Embase, Web of Science, Cochrane Library, and the WHO COVID-19 Database) were searched from their inception until February 2025. We included studies examining the association between documented maternal COVID-19 infection (before or during pregnancy) and the incidence, type, or severity of CFAs, with a focus on nonsyndromic orofacial clefts (NSOFC). Risk of bias of the studies was assessed using the ROBINS-I tool. Findings were synthesized narratively, and bibliometric analyses, including geo-mapping and conceptual structure mapping, were performed. Eleven studies met the inclusion criteria. The evidence was mixed: smaller regional studies suggested a possible link, particularly with first-trimester infection, which aligns with the critical timing of craniofacial development. However, large-scale, robust epidemiological and registry-based studies from the USA and Nordic countries consistently found no significant association between maternal COVID-19 infection and congenital anomalies. A meta-analysis could not be performed due to study heterogeneity. Maternal stress and fear of COVID-19 were repeatedly highlighted as potential factors, in some cases showing stronger or even paradoxical associations than the infection itself. Research activity was concentrated primarily in Saudi Arabia and the United States. Robust population-level evidence does not currently support a direct, major causal link between maternal SARS-CoV-2 infection and NSOFC. While a modest or context-specific association cannot be entirely excluded, the effects of maternal psychosocial stressors and restricted healthcare access during the pandemic appear to be important explanatory factors that warrant further investigation, independent of the viral infection itself.}, }
@article {pmid42132825, year = {2026}, author = {Wong, LP and Megat Hashim, MMAA and Huang, Z and Zhao, Q and Lee, HY}, title = {Navigating acceptance: challenges and barriers to Nipah virus vaccine uptake in Malaysia's muslim-majority context.}, journal = {Expert review of vaccines}, volume = {25}, number = {1}, pages = {2674683}, doi = {10.1080/14760584.2026.2674683}, pmid = {42132825}, issn = {1744-8395}, mesh = {Humans ; Malaysia/epidemiology ; *Nipah Virus/immunology ; *Henipavirus Infections/prevention & control ; *Patient Acceptance of Health Care/psychology ; *Islam/psychology ; *Vaccination Hesitancy/psychology ; *Vaccination/psychology ; Health Knowledge, Attitudes, Practice ; COVID-19/prevention & control ; *Viral Vaccines/administration & dosage/immunology ; }, abstract = {INTRODUCTION: The development of Nipah virus (NiV) vaccine offers a vital opportunity for pandemic preparedness in Southeast Asia, especially in Malaysia, where the first outbreak occurred. However, vaccine acceptance must be understood within diverse cultural, religious, and social contexts.
AREAS COVERED: This review explores key challenges and barriers to NiV vaccine uptake among Malaysia's Muslim-majority population, drawing insights from past rollouts such as COVID-19 and HPV vaccines. Key issues include religious concerns, misinformation, historical hesitancy, lack of trust in health authorities, and gaps in knowledge, attitudes, and perceptions, which collectively hinder vaccine acceptance and uptake. The paper also highlights enablers namely religious endorsements, transparent communication, and culturally sensitive engagement with trusted healthcare and community leaders. Evidence-based strategies, like motivational interviewing, narrative communication, and tailored outreach, are discussed. Finally, the 7C model is introduced as a structured framework to address behavioral and psychological barriers to vaccination.
EXPERT OPINION: Research gaps remain in understanding local psychological drivers, religious governance dynamics, and misinformation patterns. Future efforts should prioritize nationwide KAP studies, validation of behavioral frameworks such as the 7C model, and interventional research on culturally tailored communication. Integrating early halal certification and coordinated religious engagement will be essential for effective and equitable uptake.}, }
@article {pmid42133579, year = {2026}, author = {Lai, X and Gao, Q and Wu, L}, title = {A 56-Year-Old Male Farmer From China With Severe Fever With Thrombocytopenia Syndrome and Pulmonary Aspergillosis: A Case Report and Review of Literature.}, journal = {The American journal of case reports}, volume = {27}, number = {}, pages = {e951798}, pmid = {42133579}, issn = {1941-5923}, mesh = {Male ; Humans ; Middle Aged ; *Severe Fever with Thrombocytopenia Syndrome/diagnosis/complications ; *Pulmonary Aspergillosis/diagnosis/complications ; China ; Phlebovirus ; Aspergillus fumigatus/isolation & purification ; Antifungal Agents/therapeutic use ; }, abstract = {BACKGROUND Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne infectious disease caused by the Dabie bandavirus (commonly known as SFTS virus, or SFTSV). SFTSV-induced immunosuppression during infection renders patients highly susceptible to invasive pulmonary aspergillosis. SFTS-associated pulmonary aspergillosis (SAPA) presents major therapeutic challenges and is linked to drastically worsened outcomes, including high mortality. This report aims to highlight the diagnostic and therapeutic challenges of SAPA and emphasize the value of early diagnosis using metagenomic next-generation sequencing (mNGS). CASE REPORT We report a case of a previously healthy 56-year-old male farmer admitted with SFTS. On hospital day 3, when only mild cough had begun, mNGS of both blood and sputum concurrently detected Aspergillus fumigatus alongside SFTSV. This very early, pre-radiographic diagnosis prompted immediate targeted therapy with voriconazole and favipiravir. Despite this, imaging showed progressive pulmonary infiltrates with cavitation. The clinical course was further complicated by severe acute respiratory syndrome coronavirus 2 co-infection, but the patient recovered with intensive care and was discharged on day 24. A review of 13 literature-reported SAPA cases revealed a mortality rate of 30.77% (4/13). CONCLUSIONS SAPA is a severe, rapidly progressive complication of SFTS with high mortality, typically emerging 1-2 weeks after onset. This case highlights the importance of early diagnosis using rapid methods such as mNGS and the need for timely antifungal intervention to improve patient outcomes. Early antifungal therapy in high-risk patients is crucial.}, }
@article {pmid42134908, year = {2026}, author = {Herlinda, O and Jundullah, SM and Saminarsih, DS}, title = {Reaching the margins: examining equity in Indonesia's COVID-19 vaccination strategy.}, journal = {BMJ global health}, volume = {11}, number = {5}, pages = {}, pmid = {42134908}, issn = {2059-7908}, mesh = {Humans ; Indonesia/epidemiology ; *COVID-19/prevention & control ; *COVID-19 Vaccines/supply & distribution ; *Pandemics/prevention & control ; SARS-CoV-2 ; *Vaccination ; *Pneumonia, Viral/prevention & control/epidemiology ; *Coronavirus Infections/prevention & control/epidemiology ; }, abstract = {The COVID-19 pandemic profoundly affected health, social and economic systems worldwide. In less than a year, COVID-19 vaccines were developed and distributed. However, global and national distribution efforts faced significant challenges in ensuring equitable access, particularly for vulnerable populations. Despite WHO guidelines for national vaccine allocation, governments encountered difficulties in vaccine allocation and prioritisation. While Indonesia's COVID-19 primary dose coverage surpassed 70%, disparities persisted both across and within provinces as well as among different population groups. Discussion about the definition of vulnerable population and who should be prioritised remains critical to preparing for future pandemics. This paper argues for the establishment of clear guidelines for national governments on the allocation of vaccines, enabling timely action in future pandemics to prevent avoidable deaths and disabilities. Robust governance and data also remain a key area to improve. Drawing on Indonesia's experience with COVID-19, this paper offers recommendations for vaccine allocation during a respiratory pathogen pandemic.}, }
@article {pmid42134950, year = {2026}, author = {Tebay, Z and McNamara, P}, title = {GP burnout post-COVID-19 pandemic: a narrative review on burnout with consideration towards Deep End practices.}, journal = {The British journal of general practice : the journal of the Royal College of General Practitioners}, volume = {76}, number = {suppl 1}, pages = {}, doi = {10.3399/bjgp26X745485}, pmid = {42134950}, issn = {1478-5242}, mesh = {Humans ; *Burnout, Professional/epidemiology/psychology ; *COVID-19/epidemiology/psychology ; Workload/psychology ; United Kingdom/epidemiology ; SARS-CoV-2 ; *General Practitioners/psychology ; Pandemics ; }, abstract = {BACKGROUND: Recent data suggest that GP burnout is of significant concern, particularly post-pandemic. Burnout is defined as a syndrome of fatigue and apathy resulting from chronic workplace stress; as many as 75% of GP trainees recently reported these symptoms. Increased workload and demand coupled with workforce shortages and systemic strain are contributing factors. GP burnout impacts continuity of care and threatens patient safety. These pressures significantly impact deprived Deep End practices.
AIM: To review recent evidence on GP burnout in the UK over the pandemic period, with consideration of its impact on deprived practices.
METHOD: Narrative review of 2019-2023 UK-based studies exploring GP burnout, synthesising findings from peer-reviewed literature, policy reports, and national surveys. The review focused on trends, potential drivers, and interventions.
RESULTS: Evidence indicates a sustained rise in GP burnout, accelerated over the pandemic. Contributing factors include workload intensity, administrative burden, consulting pressures, and moral failure. Studies revealed that Deep End GPs experience disproportionate burnout rates due to complex patient needs, unprecedented demand, and limited resources. Interventions involving institutional and systemic changes to improve workflow and expand the multidisciplinary team must be assessed. A meta-analysis of UK-based GP data would be invaluable to evaluate preventative interventions across different practices.
CONCLUSION: GP burnout is a growing problem, complicated by COVID-19. Future research should examine long-term trajectories and appraise protective factors, given the limitation of this review capturing small studies. UK policy should prioritise retention, resource allocation, and offer targeted support for practices, particularly Deep End, to not only protect practitioner wellbeing but service sustainability for patients.}, }
@article {pmid42135534, year = {2026}, author = {Della Rosa, G and Raffo, M and Tammaro, S and Morelli, M and Arcaniolo, D and Pandolfo, SD and Sciorio, C and Romano, L and Manfredi, C and Cindolo, L and De Sio, M and Spirito, L}, title = {The impact of COVID-19 on sexual behavior, male sexual function, and reproductive health: an interdisciplinary narrative review from a urological perspective.}, journal = {International urology and nephrology}, volume = {}, number = {}, pages = {}, pmid = {42135534}, issn = {1573-2584}, abstract = {The COVID-19 pandemic profoundly modified daily life and interpersonal relationships, with relevant consequences on sexual health, which integrates biological, psychological, and social components. This narrative review summarizes current evidence regarding the impact of the pandemic on sexual behavior, sexual function, and male reproductive health. A comprehensive literature search of recent studies and clinical reports was performed focusing on psychosexual wellbeing, erectile function, fertility, and healthcare access during and after infection or lockdown periods. Current evidence indicates that lockdown-related stress, anxiety, and depression were consistently associated with reduced sexual desire and frequency of sexual activity, as reported in predominantly cross-sectional, questionnaire-based studies conducted during lockdown periods, particularly among couples with children and non-cohabiting partners, whereas alternative sexual practices increased. Sexual activity generally recovered after restrictions were lifted. Emerging data suggest a possible association between COVID-19 and erectile dysfunction mediated by endothelial damage, hypogonadism, and psychological distress, while long-COVID symptoms may further worsen sexual function. Male fertility alterations related to inflammatory and oxidative stress pathways have also been reported. Overall, the pandemic primarily affected sexuality through psychosocial mechanisms, although potential organic effects of SARS-CoV-2 infection on erectile function and fertility cannot be excluded. This review provides an interdisciplinary synthesis of current evidence with a specific focus on clinically relevant urological implications, including erectile dysfunction and male reproductive health, which remain incompletely addressed in the existing literature.}, }
@article {pmid42135711, year = {2026}, author = {Wang, M and Liu, H and Zhu, W and Li, Z and Li, C and Jin, L}, title = {Factors affecting loneliness in pregnant women: A scoping review.}, journal = {BMC pregnancy and childbirth}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12884-026-09061-w}, pmid = {42135711}, issn = {1471-2393}, abstract = {BACKGROUND: Loneliness during pregnancy is a critical yet overlooked determinant of maternal health, distinct from postpartum depression. While the COVID-19 pandemic highlighted this vulnerability, the mechanisms and typologies of prenatal loneliness remain under-researched.
METHODS: A scoping review was conducted following PRISMA-ScR guidelines. Seven databases were searched up to March 15, 2025. Influencing factors were first screened according to the Social-Ecological Model (SEM) framework, followed by thematic analysis.
RESULTS: Twenty-three studies were included. Alongside emotional and social loneliness, a context-specific form tied to role transition during matrescence was identified ('transitional loneliness'). The reported prevalence of loneliness varied substantially, ranging from 26.26% to 55.40%. This wide variation likely reflects methodological heterogeneity (e.g., sampling and assessment tools) and population characteristics. Determinants were categorized into individual, interpersonal, community, and societal levels.
CONCLUSIONS: Current generic instruments fail to capture the unique transitional nature of prenatal loneliness. Addressing this issue requires developing pregnancy-specific assessment tools and implementing multi-level interventions targeting multi-level socio-ecological factors.}, }
@article {pmid42135872, year = {2025}, author = {Mäki, K and Llewellyn-Zaidi, A and St Louis, D and Ralsky, M and O'Neill, DG and Hedhammar, Å and Packer, RMA and Ekenstedt, KJ and Bell, JS and Murphy, B and Seath, IJ and Courtin, A and Montonen, M and Nygård, A and Reunanen, V}, title = {Moving from information and collaboration to action: report from the 5th International Dog Health Workshop in Helsinki, June 2024.}, journal = {Companion animal health and genetics}, volume = {12}, number = {1}, pages = {}, pmid = {42135872}, issn = {3059-3255}, abstract = {BACKGROUND: The International Partnership for Dogs, together with a rotating national host organisation, holds approximately biennial meetings called the International Dog Health Workshop (IDHW). These workshops bring together a broad range of stakeholders in dog health and welfare, including scientists and veterinary practitioners, to improve the international sharing of information and resources, to provide a forum for ongoing collaboration, and to identify and agree on specific needs and actions to improve canine health and welfare.
WORKSHOP PRESENTATION: 5th International Dog Health Workshop was hosted by the Finnish Kennel Club in Helsinki, Finland, in June 2024. The workshop was structured around four key issues facing those working to improve dog health: 'Supply and Demand', 'Breeding for Health and Well-Being', 'Big Data', and 'Does the Colour Matter? Defining Breed vs. Variety'. The workshop provided an opportunity for participants to meet face-to-face after a five-year hiatus due to COVID-19, on the 10[th] anniversary of the International Partnership for Dogs. Among the 106 decision-makers from 16 countries who attended the workshop, there was broad agreement on several issues during the discussions, such as following the scientific evidence on canine genetics and health, moving away from extreme conformation, and using all available tools, including crossbreeding, to maintain and increase genetic variation within dog breeds. It was agreed that these principles should become priorities for welfare-minded organisations at the national and international levels. Better education of puppy buyers, breeders, show judges, and other relevant parties was recurringly identified as a priority across all four themes of the workshop.
CONCLUSIONS: In summary, key agreements from the 5th IDHW were that organisations must comply fully with relevant national animal welfare legislation, that organisations must work to eliminate extreme conformations from all dogs and to improve and maintain genetic diversity within subpopulations of dogs, and that organisations should recognise and support crossbreeding as an accepted and valuable tool for modern dog breeding.}, }
@article {pmid42138330, year = {2026}, author = {Gardner, J}, title = {The immunogenicity and safety of adenoviral-based vaccines.}, journal = {Current opinion in allergy and clinical immunology}, volume = {26}, number = {4}, pages = {264-273}, pmid = {42138330}, issn = {1473-6322}, mesh = {Humans ; *SARS-CoV-2/immunology ; *Genetic Vectors/immunology/genetics ; *COVID-19/immunology/prevention & control ; *T-Lymphocytes/immunology ; *COVID-19 Vaccines/immunology ; Animals ; *Adenoviridae/immunology/genetics ; *Adenoviruses, Human/immunology/genetics ; *Immunogenicity, Vaccine ; Cross Reactions ; }, abstract = {PURPOSE OF REVIEW: Human adenoviruses (HAdVs) have shown promise as versatile and effective delivery vectors for vaccine development. This was highlighted during the COVID-19 pandemic, which demonstrated the importance of effective vaccines but also provided scope to explore potential limitations of current viral-vector based strategies. This review summarizes the current applications of adenoviral vectors, in addition to discussing the immunological mechanisms underpinning immunogenicity and safety of viral vector-based vaccines.
RECENT FINDINGS: Clinical trials involving HAdVs have been undertaken to combat a range of infectious diseases, such as SARS-CoV-2, Ebola and HIV-1. However, empirical evidence indicates that preexisting T-cell immunity to adenoviruses may occur independent of serological exposure, predominantly arising from the conserved nature of immunogenic hexon proteins. As a result, T-cell responses are frequently detectable and often demonstrate broad cross-reactivity between human and nonhuman adenovirus (AdV) serotypes. Adverse events to vaccination are rare, although thrombotic events and severe cutaneous adverse reactions have been reported.
SUMMARY: Antivector T-cell immunogenicity arising from preexisting viral exposure or T-cell cross-reactivity may influence vaccine-specific immune responses. Continuous iterative refinement within the development of new vaccine vector technologies is therefore essential to circumvent limitations associated with vector-specific T-cell responses. However, mechanistic insight on the role of T-cells within pathomechanisms of adverse events remains unclear.}, }
@article {pmid42138647, year = {2026}, author = {Bu, GL and Chen, LN and Wu, PH and Zeng, MS and Zhong, Q}, title = {Preventing Both EBV Infection and EBV-Associated Diseases: Advances in Vaccine Research.}, journal = {Journal of medical virology}, volume = {98}, number = {5}, pages = {e70961}, doi = {10.1002/jmv.70961}, pmid = {42138647}, issn = {1096-9071}, support = {U24A20743//National Natural Science Foundation of China/ ; 32441094//National Natural Science Foundation of China/ ; 82030046//National Natural Science Foundation of China/ ; 82572641//National Natural Science Foundation of China/ ; 2022YFC3400900//National Key Research and Development Program of China/ ; 2023ZD0501000//Noncommunicable Chronic Diseases-National Science and Technology Major Project/ ; 2025M781430//China Postdoctoral Science Foundation/ ; }, mesh = {Humans ; *Epstein-Barr Virus Infections/prevention & control/immunology ; *Herpesvirus 4, Human/immunology ; Vaccine Development ; *Herpesvirus Vaccines/immunology ; *Viral Vaccines/immunology ; }, abstract = {Epstein-Barr Virus (EBV), the first identified human oncovirus, is associated with a variety of human malignancies. It is estimated that more than 90% of the adults worldwide are infected with EBV. In 2020, EBV-attributable cancers accounted for approximately 1.3%-1.9% of the global cancer burden. Currently, no licensed vaccine against EBV is available for clinical use. The success of COVID-19 vaccines has provided a framework and momentum for novel efforts against EBV, accelerating vaccine research and yielding several promising candidates, some of which have entered clinical trials. These advances are expected to contribute substantially to preventing EBV infection and managing EBV-associated diseases. In this review, we assess the current landscape and recent advances in EBV vaccine research, summarizing progress across different vaccine platforms. This overview intends to provide a theoretical foundation for the future development and translational application of EBV vaccines.}, }
@article {pmid42139088, year = {2026}, author = {Esa, N and Matsuda, S and Kuwabara, H and Oe, K and Okazaki, A and Suzuka, T and Wada, Y and Shoda, T and Kotani, T and Takeuchi, T}, title = {Microscopic polyangiitis-associated interstitial lung disease with acute exacerbation after SARS-CoV-2 infection: a case report and literature review.}, journal = {Modern rheumatology case reports}, volume = {10}, number = {1}, pages = {}, doi = {10.1093/mrcr/rxag035}, pmid = {42139088}, issn = {2472-5625}, mesh = {Humans ; Male ; *Lung Diseases, Interstitial/etiology/diagnostic imaging ; *Microscopic Polyangiitis/complications ; Aged, 80 and over ; *COVID-19/complications ; Fatal Outcome ; SARS-CoV-2 ; Tomography, X-Ray Computed ; Disease Progression ; *Coronavirus Infections/complications ; *Pneumonia, Viral/complications ; Pandemics ; Betacoronavirus ; }, abstract = {Microscopic polyangiitis (MPA) is a type of systemic inflammatory small vessel vasculitis that is frequently accompanied by interstitial lung disease (ILD). Acute exacerbations (AE) of ILD are fatal complications in patients with MPA and can be triggered by various factors, including infections. We report a case of AE of MPA-ILD following severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection. An 81-year-old male with MPA during remission maintenance therapy was hospitalised for Coronavirus disease 2019 pneumonia. Treatment for SARS-CoV-2 infection improved his respiratory symptoms and radiological findings, but his respiratory condition suddenly deteriorated with a high fever on hospital Day 52. Chest high-resolution computed tomography showed diffuse bilateral ground glass opacity, and we diagnosed AE of MPA-ILD. He was refractory to steroid pulse therapy and died on the second day after the onset of AE. Pathologic autopsy revealed hyaline membrane formation over the entire bilateral lobes, consistent with the exudative phase of the diffuse alveolar damage pattern. Our case suggests that persistent immune activation during the post-acute phase of SARS-CoV-2 infection may contribute to delayed AE of MPA-ILD with a diffuse alveolar damage pattern through macrophage-driven lung injury, given that ILD exacerbation occurred approximately 2 months after the onset of Coronavirus disease 2019 pneumonia.}, }
@article {pmid42139648, year = {2026}, author = {Meza, N and Lizana, FJ and Velásquez, M and Hormazábal, J and Morgado, B and Osses-González, PI and Silva, CE and Villalobos, SV and Bachelet, VC}, title = {Quality of reporting of systematic reviews with meta-analysis of diagnostic test accuracy of rapid antigen tests for SARS-CoV-2 according to PRISMA-DTA: A meta-epidemiological survey.}, journal = {Medwave}, volume = {26}, number = {4}, pages = {e3219}, doi = {10.5867/medwave.2026.04.3219}, pmid = {42139648}, issn = {0717-6384}, mesh = {Humans ; *COVID-19/diagnosis/epidemiology ; *Systematic Reviews as Topic ; Rapid Diagnostic Tests ; Sensitivity and Specificity ; *COVID-19 Serological Testing ; *SARS-CoV-2/isolation & purification/immunology ; Meta-Analysis as Topic ; *Research Design/standards ; Antigens, Viral ; }, abstract = {INTRODUCTION: Systematic reviews are crucial for informing health decisions and supporting evidence-based policymaking. Reporting guidelines aim to reduce ambiguity and confusion while promoting clarity, completeness, and transparency in reporting. Our study aimed to assess the completeness of reporting of diagnostic test accuracy systematic reviews with meta-analysis on rapid antigen tests for SARS-CoV-2 deployed during the COVID-19 pandemic using the PRISMA-DTA guideline.
METHODS: We conducted a meta-epidemiological survey of systematic reviews with meta-analysis of rapid antigen tests for SARS-CoV-2. We searched MEDLINE/PubMed, EMBASE, L·OVE Covid-19, and Web of Science Clarivate, covering the period from inception to April 3, 2025, with no language restrictions. We included reviews that used explicit systematic review methodologies with summary estimates of test sensitivity and specificity. We assessed compliance with the 27 PRISMA-DTA items.
RESULTS: After screening 5252 publications, we included 38 reviews. We found no PRISMA-DTA item with a low reporting frequency. Regarding the number of items reported, 23 (60%) of the included studies reported over 66%, and 15 (40%) reported between 33% and 66%, with none reporting fewer than 33%. None of the included reviews complied with the full PRISMA-DTA checklist.
CONCLUSIONS: Our meta-epidemiological survey reveals persistent shortcomings in the reporting quality of systematic reviews evaluating rapid antigen test accuracy for SARS-CoV-2. While some items were consistently addressed, numerous critical domains requiring a deeper understanding of the specific diagnostic test accuracy assessment methods showed low reporting adherence.}, }
@article {pmid42140392, year = {2026}, author = {Streiber, M and Schubert, US and Traeger, A}, title = {Innovative lipid nanoparticle formulations: Bridging the gap toward decentralized personalized gene therapies.}, journal = {Journal of controlled release : official journal of the Controlled Release Society}, volume = {395}, number = {}, pages = {115023}, doi = {10.1016/j.jconrel.2026.115023}, pmid = {42140392}, issn = {1873-4995}, mesh = {Humans ; *Nanoparticles/chemistry/administration & dosage ; *Lipids/chemistry ; *Precision Medicine/methods ; *Genetic Therapy/methods ; Animals ; Liposomes ; }, abstract = {Lipid nanoparticles (LNPs) have become a key technology for delivering nucleic acids, playing a critical role in the success of mRNA vaccines and RNA-based therapeutics. Established manufacturing methods, including microfluidic mixing and impingement jet mixing, have exhibited excellent scalability, reproducibility, and clinical relevance, most notably during the development of vaccines for SARS-CoV-2. Nevertheless, these techniques are accompanied by challenges related to the handling of organic solvents (ethanol), scalability for personalized medicine, and environmental considerations. This review draws attention to recent innovations in LNP formulation that seek to address these challenges through alternative and complementary approaches. One central focus of this review highlights post-formation encapsulation strategies, utilizing preformed vesicles or other nanostructures. These strategies facilitate modular, on-demand loading of nucleic acids. In addition, organic solvent-free techniques, including thermocycling, calcium-mediated DNA encapsulation, and aqueous sonication, offer new opportunities for biocompatible, streamlined manufacturing. In line with these formulation strategies, the review discusses recent progress in continuous manufacturing platforms, which enable end-to-end process control, real-time analytics, and increased production efficiency. By comparing conventional and emerging techniques, this review provides an overview of the evolving LNP formulation landscape and identifies key opportunities for integrating innovation into conventional production pipelines.}, }
@article {pmid42140539, year = {2026}, author = {Tamariz, L and Shehadeh, LA and Bast, E and Klimas, N and Palacio, A}, title = {The role of the endothelium in long COVID.}, journal = {Vascular pharmacology}, volume = {163}, number = {}, pages = {107654}, doi = {10.1016/j.vph.2026.107654}, pmid = {42140539}, issn = {1879-3649}, mesh = {Animals ; Humans ; *Cardiovascular Diseases/physiopathology/virology/drug therapy ; *Endothelium, Vascular/physiopathology/drug effects/metabolism/virology ; Pandemics ; *Pneumonia, Viral/physiopathology/drug therapy/virology ; *Post-Acute COVID-19 Syndrome/physiopathology ; SARS-CoV-2 ; Vasodilation/drug effects ; }, abstract = {SARS-CoV2 infection significantly increases the risk of cardiovascular events through multiple interconnected mechanisms including systemic inflammation, dysautonomia, endothelial dysfunction, and prothrombotic states. The endothelium plays a critical role in this increase in risk together with dysautonomia and mast cell activation. SARS-CoV2 activates endothelial cells creating a pro-inflammatory, and pro-thrombotic phenotype. This phenotype could lead to microcirculatory changes that decrease oxygen delivery to tissues because of loss of laminar flow, lack of nitric oxide dependent vasodilation, increased viscosity and abnormal constriction of vascular smooth muscle cells due to neuropathy. There are several ways of identifying patients with endothelial dysfunction and the most used is flow mediated dilation. Many randomized trials have already found significant treatments for endothelial dysfunction and include antihypertensives, statins, beta-blockers, supplements and lifestyle interventions. Only two studies using vitamin C and L-arginine demonstrated improvements in flow mediated dilation in patients with long COVID.}, }
@article {pmid42140729, year = {2026}, author = {El Kardoudi, A and Ouzir, M and Chetoui, A and Kaoutar, K and Ghandour, EK and Chigr, F}, title = {[Mental health symptoms during the Covid-19 pandemic and hypertension in Morocco].}, journal = {Soins; la revue de reference infirmiere}, volume = {71}, number = {905}, pages = {10-17}, doi = {10.1016/j.soin.2026.03.002}, pmid = {42140729}, issn = {0038-0814}, mesh = {Humans ; Morocco/epidemiology ; COVID-19/psychology ; *Hypertension/psychology/epidemiology ; *Depression/epidemiology/etiology ; *Anxiety/epidemiology/etiology ; Pandemics ; *Stress, Psychological/epidemiology/etiology ; Male ; Female ; Middle Aged ; *Coronavirus Infections/psychology/epidemiology ; *Pneumonia, Viral/psychology/epidemiology ; SARS-CoV-2 ; *Mental Health ; Adult ; *Betacoronavirus ; }, abstract = {The Covid-19 pandemic has had well-established effects on mental health. However, few studies have examined its specific impact on people with hypertension. To address this gap, a study was conducted in the Beni Mellal province, Morocco, to assess the psychological repercussions of Covid-19 in hypertensive patients compared to normotensive controls. Symptoms of depression, anxiety, and stress were measured using the DASS-21 scale.}, }
@article {pmid42141948, year = {2026}, author = {Lamikanra, OK and Venigalla, M and Olowofeso, AM and Aneni, EC and Osondu, CU and Otite, FO}, title = {COVID-19 and the ICU: Redesigning Critical Care Services for a New Era.}, journal = {Journal of intensive care medicine}, volume = {}, number = {}, pages = {8850666261451793}, doi = {10.1177/08850666261451793}, pmid = {42141948}, issn = {1525-1489}, abstract = {BackgroundCoronavirus disease 2019 (COVID-19), caused by the SARS-CoV-2 virus, was first identified in late 2019 and went on to profoundly disrupt health care systems worldwide. The pandemic led to unprecedented increases in healthcare delivery costs, widespread disruption in medical supply chains, workforce instability, and a loss of typical inpatient caregiver support. These challenges affected all levels of care, from primary health services to highly specialized intensive care units (ICUs). Before vaccines were available, ICUs were overwhelmed by critically ill patients requiring mechanical ventilation, saturating capacity and straining staff.ObjectivesThis article seeks to examine the effect that COVID-19 had on ICUs globally, acknowledging its impact with an aim to identify solutions that can be used to help mitigate the overburdening of this limited resource in future pandemics.MethodsA narrative review approach was used, drawing on published literature, observational data, and institutional responses from 2020 to 2025, to analyze structural, operational, and clinical adjustments in ICU design and function.ResultsKey adaptations included physical redesigns, rapid infection-control upgrades, the use of negative pressure rooms, expansion of tele-ICU systems, and virtual family engagement strategies. These interventions were implemented to address ICU crowding, equipment shortages, and staff burnout, and helped to maintain continuity of care during surge conditions.ConclusionsThe COVID-19 pandemic demonstrated the need for ICUs to be more agile, scalable, and future-facing. Lessons learned highlight the importance of preparedness strategies that strengthen ICU resilience and support critical care delivery in future public health emergencies.}, }
@article {pmid42142180, year = {2026}, author = {Mapindra, MP and Mahindra, MP and McNamara, P and Kartasasmita, C and Semple, MG and Clark, H and Madsen, J}, title = {Prevalence of common respiratory viruses of infants with respiratory tract infections in European countries in the past decade: a systematic review and meta-analysis comparing between the pre-COVID-19, pandemic, and post-COVID-19 periods.}, journal = {European journal of pediatrics}, volume = {185}, number = {6}, pages = {}, pmid = {42142180}, issn = {1432-1076}, mesh = {Humans ; *Respiratory Tract Infections/virology/epidemiology ; Europe/epidemiology ; *COVID-19/epidemiology ; Prevalence ; Infant ; Infant, Newborn ; Pandemics ; SARS-CoV-2 ; Respiratory Syncytial Virus Infections/epidemiology ; }, abstract = {UNLABELLED: The purpose of this study is. to determine the leading cause of respiratory tract infections over the decade; this review examined the proportions of airway viruses in infants with respiratory tract infections in Europe before, during, and after the COVID-19 pandemic. The protocol for this systematic review was registered in the PROSPERO database (CRD42024497097). Literature searches in PubMed, Embase, Scopus, and Web of Science (WoS) identified 20,453 studies reporting respiratory viral testing in Europe over the past decade (2012/13-2022/23). Eligible studies were English-language full-text or grey articles with low risk of bias and complete data, and reports that explicitly provided the number of positive airway virus cases (n, virus) and the total infant population (N). Risk of bias was assessed using the Hoy et al. scoring system. Pooled prevalence estimates (pooled proportion [95% CI]) were calculated for pre-, during-, and post-COVID-19 periods using proportional meta-analysis with the MetaProp package in R. Fifty studies before, ten studies during, and 18 studies after the COVID-19 pandemic were eligible for proportional meta-analyses of viral testing in infants. Before the pandemic, the predominant viruses in infants with respiratory infections were Respiratory Syncytial Virus (RSV) (0.48 [0.41-0.56]), Human rhinovirus (HRV) (0.24 [0.18-0.29]), and Influenza virus (IV) (0.08 [0.04-0.12]). Post-pandemic, the leading viruses were RSV (0.63 [0.51-0.75]), HRV (0.25 [0.11-0.40]), and IV (0.10 [0.00-0.20]) again.
CONCLUSIONS: RSV and HRV remained the two most identified viruses in infants with respiratory infections, pre- and post-COVID-19 pandemic. Interestingly, both RSV and IV were suppressed during the pandemic. The trajectory dynamics of respiratory viruses were divergent, with resilient viruses (RSV, HRV, and IV) regaining dominance more rapidly than persistently suppressed viruses.
WHAT IS KNOWN: • The COVID-19 pandemic induced an infection precautions policy, which reduced the spread of respiratory infectious diseases. • Respiratory Syncytial Virus (RSV) was estimated as one of the most common causes of respiratory infections in infants. Still, there are no reports summarising the geographical distributions of the various viral agents of infant respiratory diseases.
WHAT IS NEW: • This meta-analysis shows that the prevalence of RSV and HRV infections in infants remains high in Europe following the COVID-19 pandemic and the associated precautionary policy. Furthermore, RSV proportionally experienced a marked reduction during COVID-19 pandemic (lockdown periods). However, the immunological debt may have led to a re-emergence in RSV positivity after the lockdown periods. • Our proportional meta-analysis indicates the heterogeneous post-pandemic recovery patterns of each respiratory virus commonly identified in infants, where HRV was shown to be resilient whilst RSV was rapidly rebound.}, }
@article {pmid42142525, year = {2026}, author = {Trang, TPH and Bazelier, MT and Klungel, OH and Bots, SH}, title = {Quality and methodological heterogeneity of COVID-19 vaccine safety studies focusing on the myocarditis safety signal: A systematic review, meta-analysis and meta-regression.}, journal = {Vaccine}, volume = {85}, number = {}, pages = {128722}, doi = {10.1016/j.vaccine.2026.128722}, pmid = {42142525}, issn = {1873-2518}, mesh = {Humans ; *COVID-19 Vaccines/adverse effects/administration & dosage ; *Myocarditis/etiology/epidemiology/chemically induced ; *COVID-19/prevention & control ; SARS-CoV-2/immunology ; Observational Studies as Topic ; Vaccination/adverse effects ; }, abstract = {BACKGROUND: The risk of myocarditis following COVID-19 vaccines has been widely investigated, yielding highly variable effect estimates. It remains unclear how much of this variation can be explained by methodological differences and study quality. This study aimed to evaluate the methodology of observational studies on myocarditis risk post-COVID-19 vaccination and identify sources of heterogeneity.
METHODS: We systematically searched PubMed and EMBASE for observational studies reporting relative risks of myocarditis after COVID-19 vaccination published between December 2020 and October 2023. Risk of Bias (RoB) was assessed using the ROBINS-I tool. Meta-analysis and multivariable meta-regression were conducted for studies addressing comparable population-intervention-comparator-outcome (PICO) questions.
RESULTS: We included 30 studies, comprising 35 design-specific analyses. We identified considerable variability in design elements including risk window length (7-288 days), reference period timing (three different ways), and control for COVID-19 disease (five different approaches). Thirteen (37%) design-specific analyses had serious or critical overall RoB. We observed strongest heterogeneity between studies in general population for dose 2 of BNT162b2 and mRNA-1273 compared to unvaccinated individuals/reference period (I[2] = 96%, prediction interval (PI) of relative risk 0.40-20.20; I[2] = 92%, PI 1.23-88.63, respectively). Meta-regression for the former PICO indicated that after adjusting for age and sex, effect estimates of samples with 28-day risk window were 0.56 times (95% CI 0.43-0.72) lower than those with 7-day risk window, but its overall effect was not significant. The effect of study design, outcome definition, approaches to handle COVID-19 infection and overall RoB were not significant in the meta-regression.
CONCLUSIONS: There is substantial variation in study design specifications and corresponding heterogeneity in reported effect estimates. Design choices like risk window length may explain some of this heterogeneity, although evidence remains inconclusive. Future vaccine safety studies should include sensitivity analyses to explore the effect of design choices on their findings.}, }
@article {pmid42143870, year = {2026}, author = {Wang, B and Cheah, KSL and Beh, WF}, title = {Fostering collaborative creativity and ensemble skills through virtual ensembles in hybrid music education: A systematic literature review.}, journal = {Acta psychologica}, volume = {267}, number = {}, pages = {107060}, doi = {10.1016/j.actpsy.2026.107060}, pmid = {42143870}, issn = {1873-6297}, mesh = {Humans ; *Music ; *Creativity ; *Cooperative Behavior ; *COVID-19 ; Virtual Reality ; }, abstract = {The sudden change of music education to a hybrid form during the COVID-19 pandemic has made virtual ensembles the primary way of learning together. The authors aim through this review to understand how much digital platforms such as JackTrip, Jamulus, Zoom, and Soundtrap have affected the student engagement in musical ensemble practice. The paper emphasizes virtually choreographed concerts not only as a method for being able to continue training when difficulties arise but also to develop creative cooperation, self-management, and more advanced group playing skills. Seventeen peer-reviewed articles from 2020 to 2025 show that low latency platforms such as JackTrip and Jamulus are instrumental in facilitating musical engagement in real-time. Along with this, by using constructivist pedagogical methods like project-based learning, flipped classrooms, and DIY/DIWO, students become relentlessly more creative with music. Tools like Soundtrap help students create ideas asynchronously, while real-time platforms support timing and listening skills. However, there are still problems besides these advantages. Latency, audio compression, the difference in the equipment, and complicated user interfaces make it difficult for everyone to participate equally and for the group to stay together. The review points out that the success of virtual ensemble learning depends on instruction supported by well-aligned technology, which means planning, scaffolding, and technical support as well as flexible roles. This study provides a framework for educators, curriculum developers, and institutions seeking to improve hybrid music education. The right technology with inclusive, reflective teaching, virtual ensembles can become great ways to work together creatively and perform well.}, }
@article {pmid42144508, year = {2026}, author = {Malhotra, D and Nepal, RM and Zografaki, I and Kyaw, MH and Nikolopoulou, P and de Almeida, RS and Lopez, SMC and Wiblin, S and Williams, F and Pope, S and Whittle, I and Pearson, F and Curcio, D}, title = {Severity of COVID-19 Omicron Variants: A Global Systematic Review.}, journal = {Infectious diseases and therapy}, volume = {15}, number = {7}, pages = {1827-1849}, pmid = {42144508}, issn = {2193-8229}, abstract = {INTRODUCTION: The continual emergence of new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants drives the need to update evidence on coronavirus disease 2019 (COVID-19) severity and disease burden, and better understand the impact on prevention, treatment, and healthcare systems.
METHODS: This systematic review aimed to determine relative disease severity, through comparative measures of hospitalization, intensive care unit admission and mortality, between SARS-CoV-2 variants of concern emerging since Omicron was first identified. A protocol was registered a priori (PROSPERO ID: CRD42024619193). Systematic searches of MEDLINE and EMBASE databases were conducted in November 2024 and supplemented by conference searches from 2022-2024. Population, Exposure, Comparisons, Outcomes (PECO) criteria were used to screen publications for inclusion. Critical appraisal tools published in the Joanna Briggs Institute (JBI) Handbook for Evidence Synthesis were used to assess the risk of bias of the primary studies included. The outcomes associated with Omicron variants, identified by sequencing or predominance periods, included hospitalization, admission to intensive care, death, and various composite endpoints.
RESULTS: Thirty-two studies fulfilled the eligibility criteria, most reported on relative disease severity for early Omicron BA.5 (n = 23) and XBB (n = 24) variants. Overall, COVID-19 severity appeared largely comparable across the various Omicron subvariants. Among the subset of studies that directly compared various severity outcomes to earlier SARS-CoV-2 variants (n = 7), some reported modest increases or decreases in severity. However, these differences were generally not statistically significant. Five studies stratifying outcomes by the presence of comorbid conditions noted that comorbidities were predictors of significantly worse COVID-19 disease outcomes (p = 0.000-0.027).
CONCLUSIONS: Overall, this systematic review found the severity of COVID-19 disease to be comparable among Omicron subvariants. As SARS-CoV-2 subvariants continue to emerge, these results highlight the continuing need for vaccination against SARS-CoV-2 infection alongside early antiviral intervention to support short-term management and long-term reduction of COVID-19-associated morbidity and mortality.}, }
@article {pmid42144551, year = {2026}, author = {Chehade, M and Meyers, S and McCright-Gill, T and Gifford, R and Sahin, M and Shy, ME and Manion, M and Campbell, D and Rothenberg, ME and Macaluso, M}, title = {Collaboration as a Catalyst for Advancing Rare Disease Research: The Experience of the Rare Diseases Clinical Research Network.}, journal = {Clinical and translational science}, volume = {19}, number = {6}, pages = {e70585}, pmid = {42144551}, issn = {1752-8062}, mesh = {*Rare Diseases/therapy/diagnosis ; Humans ; *Biomedical Research/organization & administration ; United States ; Information Dissemination ; COVID-19/epidemiology ; *Translational Research, Biomedical/organization & administration ; Cooperative Behavior ; National Institutes of Health (U.S.) ; *Intersectoral Collaboration ; Patient Advocacy ; }, abstract = {The Rare Diseases Clinical Research Network (RDCRN) was established to improve diagnosis, treatment, and research collaboration across rare diseases through collaborative, multi-site, translational, and clinical research. Its governance framework promotes efficient data sharing and collaboration among research consortia, NIH representatives, and patient advocacy groups (PAGs). This infrastructure facilitates coordinated efforts to advance rare disease research through shared resources and communication. Prompted by the COVID-19 pandemic's impact on rare disease patients, the RDCRN recognized cross-consortia collaboration as a priority. Its policies promote data sharing while protecting participant confidentiality. PAGs participate in governance, study design, and regulatory discussions, helping to identify patient-relevant priorities, improve recruitment and retention, and strengthen trust between researchers and patients. Cross-consortia efforts have addressed challenges like biomarker identification and harmonization of clinical measures, leading to new methods and standardized data collection that benefit multiple rare diseases. Studies by teams focusing on different diseases have led to improved diagnostic tools by addressing overlapping disease presentations. The RDCRN offers scholars cross-consortia opportunities for presentations, competitions, and NIH training collaborations, fostering growth and networking. Network meetings promote exchange and process standardization; pilot projects facilitate independent grant submissions, forming a pipeline of skilled investigators. The RDCRN fosters trust, shared vision, and open communication by cultivating a culture of mutual respect, shared learning, and collective problem solving. By engaging a wide range of stakeholders, it has aligned its research with patient needs, advancing innovation. Its high-impact publications, effective mentoring programs, and pioneering cross-consortia initiatives underscore the value of collaboration in rare disease research.}, }
@article {pmid42144754, year = {2026}, author = {Cho, JY and Kim, KH}, title = {Current Challenges and Emerging Therapeutic Strategies in Acute Myocarditis.}, journal = {Korean circulation journal}, volume = {}, number = {}, pages = {}, doi = {10.4070/kcj.2026.0006}, pmid = {42144754}, issn = {1738-5520}, abstract = {Acute myocarditis encompasses a heterogeneous group of inflammatory myocardial disorders with clinical presentations ranging from self-limited chest pain to fulminant cardiogenic shock. Despite advances in cardiac magnetic resonance imaging and molecular diagnostics, substantial uncertainty persists regarding early diagnosis, etiologic classification, and optimal therapeutic strategies. Current management relies largely on supportive care, as robust randomized evidence guiding immunomodulatory therapy remains limited and confined to selected virus-negative or autoimmune phenotypes. This review synthesizes contemporary evidence on the pathophysiology, diagnostic challenges, and treatment paradigms of acute myocarditis, with a particular focus on the critical distinction between virus-positive and virus-negative disease. We discuss established supportive and guideline-directed therapies, emerging immunomodulatory approaches-including corticosteroids, biologics targeting interleukin-1, complement, and mammalian target of rapamycin pathways-and the evolving role of mechanical circulatory support in fulminant myocarditis. COVID-19 vaccination-related myocarditis is highlighted as a modern example of immune-triggered, predominantly virus-negative myocarditis, illustrating both the generally favorable prognosis and the potential for severe clinical courses. Finally, this review outlines future directions toward precision immunocardiology, emphasizing the integration of endomyocardial biopsy, molecular virology, multi-omics profiling, and artificial intelligence-guided phenotyping to enable mechanism-driven, individualized therapy. Advancing from empirical management to precision-based intervention will be essential to improving outcomes in acute myocarditis.}, }
@article {pmid42146723, year = {2026}, author = {Shipton, A and Mcbain, K and Wake, M and Goldfeld, S and Mensah, F}, title = {Policy Responses to the COVID-19 Pandemic in High-Income Countries and the Associated Maternal-Infant Health Outcomes: A Systematic Literature and Policy Review.}, journal = {Health science reports}, volume = {9}, number = {5}, pages = {e71523}, pmid = {42146723}, issn = {2398-8835}, abstract = {BACKGROUND: Foreseeing how policy impacts pregnant women and infants is limited by ethical challenges of experimental research within these groups. The COVID-19 pandemic generated natural experiments, offering rare opportunities to explore associations between specific policy responses and maternal-infant health outcomes. These insights are useful for informing policy design aligned with the 2030 Sustainable Development Goals.
AIMS: To systematically review evidence of associations between COVID-19 policies, OxCGRT Stringency Index (a University of Oxford tool for comparing the stringency of policies) and maternal-infant health outcomes during pregnancy, birth, and the first 12 months postpartum from 2020-2022 in high-income countries.
METHODS: Following PRISMA guidelines, Embase, MEDLINE, PubMed, and Web of Science were searched (January 1 2020-July 9 2022) using subject headings, keywords, and variants for "COVID-19", "policies", "perinatal", and "randomized", and "non-randomized" study designs. Eligible studies were from high-income countries, published in English, and used comparison groups. Two reviewers independently extracted and analyzed data. Heterogeneity and risk of bias made meta-analysis inappropriate. Outcomes were instead reported using tables and visuals of effect sizes, ratio estimates, and 95% confidence intervals.
RESULTS: Of 3143 citations, 35 studies met inclusion criteria. All reported high OxCGRT Stringency Index during exposure, validating the fidelity of adhering to defined policy exposure periods. Lockdown was associated with reductions in preterm and low birthweight births, infant emergency admissions, and breast feeding women, and increases in hypertensive disorders of pregnancy and gestational diabetes mellitus. Telehealth was associated with earlier gestational age at antenatal visits and less breast feeding women. Maternal mental health and stillbirth results were mixed.
CONCLUSION: High stringency policies, including lockdowns and telehealth, were associated with both favorable and adverse maternal-infant outcomes. Findings inform avenues for future causal inference research and areas for mitigation planning should high stringency policies be reintroduced, supporting progress towards the 2030 Sustainable Development Goals.}, }
@article {pmid42146922, year = {2026}, author = {Ravi, N and Bamgbose, MO and Abdelkhalek, YY and Parkar, S and Alnasser, Y}, title = {Telemedicine for new immigrant children in the US: a tool for equity or another layer of disparity?.}, journal = {Frontiers in pediatrics}, volume = {14}, number = {}, pages = {1814069}, pmid = {42146922}, issn = {2296-2360}, abstract = {Telemedicine refers to the use of digital communication tools to deliver healthcare services. In pediatrics care in the United States (US), it has become an important approach to expand access to primary and subspecialty care while reducing travel demands and improving continuity of care, particularly for children in remote and underserved communities. Evidence consistently shows that telemedicine can supplement in-person visits while maintaining high levels of family satisfaction and clinical effectiveness among American families. This narrative review was developed to assess the applicability of telemedicine for new immigrant families in the US using a structured literature search across PubMed, Scopus, Google Scholar, and Cochrane of published English literature. Peer-reviewed studies were included if they were conducted in the last 50 years and focused on pediatric patients from birth to 21 years of age. Findings were synthesized to evaluate the acceptance, accessibility, feasibility, and applicability of telemedicine for new immigrant children in the US. Across the reviewed literature, telemedicine has meaningful potential in narrowing health disparities faced by new immigrant families such as transportation, specialist shortages, scheduling delays, limited English proficiency, and difficulty navigating the complex healthcare system. Furthermore, telemedicine can connect families with providers who share similar cultural and linguistic backgrounds, thereby strengthening cultural sensitivity and trust. Still, it comes with several obstacles limiting its use among new immigrant families. From digital divide, poor network coverage, low health literacy, privacy concerns, immigration-related concerns, to mistrust, the challenges are numerous. Studies during the COVID-19 pandemic found low acceptance and infeasibility of telemedicine for new immigrant families. However, telemedicine offers multiple opportunities and future directions to better serve immigrant children and their families. Expanding multilingual telehealth platforms and integrating telemedicine access points into schools, community centers, and immigrant resource hubs can enhance accessibility, usability, and acceptance. Pairing telemedicine with artificial intelligence can have huge future potential and might be a tool for inclusive care at lower cost. Furthermore, policy amendments, particularly broader Medicaid telemedicine coverage and mandates for interpreter integration into telemedicine workflows, are essential for promoting more equitable access with higher acceptance and more applicability for new immigrant children in the US.}, }
@article {pmid42147457, year = {2026}, author = {Zhang, Y and Sun, Y and Wang, J and Wang, L and Fang, R and Wu, X and Yang, X and Guo, Y and Li, S}, title = {A Scoping Review of Machine Learning Applications Across Epidemiological Stages of Zoonotic Disease.}, journal = {Transboundary and emerging diseases}, volume = {2026}, number = {}, pages = {2215823}, pmid = {42147457}, issn = {1865-1682}, mesh = {*Zoonoses/epidemiology/prevention & control ; Animals ; *Machine Learning ; Humans ; Communicable Diseases, Emerging/epidemiology ; COVID-19/epidemiology ; }, abstract = {Emerging zoonotic diseases represent a significant threat to global health. While machine learning (ML) holds promise for their management, a comprehensive understanding of how these technologies are applied across the entire animal-to-human transmission pathway is lacking. This scoping review systematically maps ML applications in zoonotic disease management to identify research trends, methodological approaches, and critical gaps across different epidemiological stages and functional domains. We organize the literature along two dimensions: epidemiological stages, from animal hosts to human populations, and functional domain, including diagnosis, epidemiology, and intervention. We searched PubMed and Web of Science for studies on 14 preselected high-priority zoonotic diseases. The search string combined keywords for the selected diseases, ML techniques, and functional applications (diagnosis, epidemiology, and intervention). A total of 966 studies were included in the final analysis, of which 72.8% focused on COVID-19. Our analysis shows robust ML performance in clinical diagnostics, epidemic forecasting, and intervention optimization within human populations. However, critical gaps persist, only 1.96% of studies examined the animal-human interface, no ML models explicitly targeted spillover prevention, and studies on animal-reservoir surveillance remain limited. All spillover studies originated from high-income or upper-middle-income countries (UMICs), in contrast with low- and lower-middle-income countries (LMICs) contributing 21.4% of human-stage studies. These findings reveal a pronounced mismatch between research investment and spillover risk and highlight the need for greater emphasis on spillover mechanisms, enhanced integration of cross-species transmission dynamics, and methods suitable for surveillance in resource-limited settings. Addressing these imbalances is essential for advancing a shift from reactive outbreak response to proactive spillover prevention within a One Health framework.}, }
@article {pmid42148087, year = {2026}, author = {Huang, ZY and Chen, J and Zhu, B and Liu, XL}, title = {Infection risk associated with teclistamab in relapsed/refractory multiple myeloma: a systematic review and meta-analysis of clinical trial and real-world evidence.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1804838}, pmid = {42148087}, issn = {1664-3224}, mesh = {Humans ; *Multiple Myeloma/drug therapy/immunology ; *Antibodies, Bispecific/adverse effects/therapeutic use ; *Infections/epidemiology/etiology ; B-Cell Maturation Antigen/immunology ; Clinical Trials as Topic ; }, abstract = {BACKGROUND: Teclistamab, a B-cell maturation antigen (BCMA) × CD3 bispecific antibody (BsAb), has shown remarkable efficacy in relapsed/refractory multiple myeloma (RRMM). However, its mechanism leads to profound hypogammaglobulinemia, making infection a critical concern. This systematic review and meta-analysis aimed to quantify the infectious burden and contrast outcomes between clinical trial and real-world evidence (RWE).
METHODS: We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library for studies reporting infection outcomes in RRMM patients treated with teclistamab. Pooled incidences of any-grade and grade ≥3 infections were calculated using a random-effects model. Subgroup analysis compared the pivotal MajesTEC-1 trial with multi-institutional RWE cohorts.
RESULTS: Five studies encompassing 714 patients were included. The overall pooled incidence was 56.5% (95% CI: 43.1%-69.9%) for any-grade infections and 27.6% (95% CI: 21.0%-34.3%) for grade ≥3 infections. Subgroup analysis revealed a significantly higher risk in the clinical trial compared to RWE (Any-grade: 76.4% vs. 45.4%, p< 0.01; Grade ≥3: 44.8% vs. 22.8%, p<0.01). Infection-related mortality was reported in all cohorts, ranging from 0.9% to 7.3%, with COVID-19 and opportunistic pathogens (for example, Pneumocystis jirovecii) being prevalent. Significant heterogeneity was driven by variations in follow-up duration and intravenous immunoglobulin (IVIG) prophylaxis rates (range: 41.8%-81.3%).
CONCLUSIONS: Teclistamab is associated with a substantial and cumulative infectious burden. The lower infection rates in RWE may reflect shorter follow-up and evolving prophylactic strategies. Standardized infection surveillance, including regular IgG monitoring and consideration of IVIG replacement in patients with low IgG levels, may help optimize the safety of BCMA-directed bispecific therapies.
https://www.crd.york.ac.uk/prospero/, identifier CRD420261297645.}, }
@article {pmid42148106, year = {2026}, author = {Guo, H and Wang, H and Wu, S and Lin, H and Wang, G and Pu, Q}, title = {Determinants of success and failure of antibody-based strategies against respiratory viruses: insights from RSV and SARS-CoV-2.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1818721}, pmid = {42148106}, issn = {1664-3224}, mesh = {Humans ; *SARS-CoV-2/immunology ; *Respiratory Syncytial Virus Infections/immunology/therapy ; *COVID-19/immunology/therapy ; *Antibodies, Viral/immunology/therapeutic use ; *Antibodies, Neutralizing/immunology/therapeutic use ; *Respiratory Syncytial Virus, Human/immunology ; Spike Glycoprotein, Coronavirus/immunology ; Epitopes/immunology ; Antibodies, Monoclonal/therapeutic use/immunology ; Animals ; }, abstract = {Respiratory syncytial virus (RSV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) represent two extremes in the outcome of antibody-based interventions. The long-acting monoclonal antibody nirsevimab has achieved durable, population-level protection against RSV in infants, reducing hospitalizations by 70-90% with no evidence of antigenic escape. In contrast, all neutralizing monoclonal antibodies against SARS-CoV-2 became obsolete within three years due to rapid viral evolution, particularly in the spike receptor-binding domain. This review dissects the mechanistic determinants underlying this divergence. We propose four key principles that govern antibody efficacy against respiratory viruses: (i) targeting a structurally conserved epitope with high fitness cost for escape; (ii) achieving sufficient antibody concentrations in the airway epithelial lining fluid; (iii) the vulnerability of single-epitope strategies against mutable viral targets; and (iv) the auxiliary but non-substitutable role of Fc effector functions. By comparing RSV and SARS-CoV-2, we illustrate how these principles align in successful interventions and fail in others. Finally, we discuss emerging strategies-particularly inhaled delivery and mRNA-encoded antibodies-that may overcome current limitations and enable durable protection against antigenically variable respiratory pathogens.}, }
@article {pmid42148664, year = {2026}, author = {Arnaboldi, PM and Becker, J and Nath, A and Coyle, PK and Handel, A and Sellati, TJ and Gomes-Solecki, M and Garcet, S and Henderson, MK and Mullins, P and Cowan, E and McCombie, WR and Wellins, AM and Allegretta, M and Bergquist, J and Schutzer, SE}, title = {Designing studies for post-treatment Lyme disease and other infection-associated chronic illnesses.}, journal = {Brain : a journal of neurology}, volume = {149}, number = {6}, pages = {1842-1859}, pmid = {42148664}, issn = {1460-2156}, support = {//Banbury Center of Cold Spring Harbor Laboratory/ ; }, mesh = {Humans ; *Fatigue Syndrome, Chronic/diagnosis/therapy ; *Lyme Disease/diagnosis/therapy ; Post-Lyme Disease Syndrome/diagnosis ; Chronic Disease ; *Multiple Sclerosis/diagnosis/therapy ; *Research Design ; COVID-19/therapy/diagnosis ; }, abstract = {Infection-associated chronic illnesses (IACIs) encompass a spectrum of poorly understood syndromes often marked by significant neurologic and multisystem symptoms following an infectious event. This review focuses on several diseases representative of the IACI spectrum. These are post-treatment Lyme disease syndrome (PTLDS), long COVID, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and multiple sclerosis (MS). Their clinical and biological complexity, combined with a lack of clear diagnostic criteria and objective available laboratory biomarkers, makes them difficult to distinguish from conditions with overlapping features. This presents challenges for research studies, as well as diagnosis and clinical management. This diagnostic ambiguity, coupled with heterogeneous patient presentations, has led to challenges in research, including misclassification of study participants and inconsistent or irreproducible findings. Some PTLDS research exemplifies these issues, which also extend to other IACIs. To advance the field, we highlight key methodological refinements and approaches for studying IACIs, including rigorous participant selection, standardized sample collection protocols, and the use of appropriate control groups, including those with microbiologic proof of the initial infection when known and technologically feasible. We also address broader influences on research quality, such as stigma, historical neglect, and the urgency to find treatments, which have contributed to the proliferation of poorly controlled studies and questionable practices. Drawing lessons from past challenges, we propose a path forward grounded in fit-for-purpose methodological rigour to improve scientific understanding and support evidence-based therapeutic development for IACIs.}, }
@article {pmid42148826, year = {2026}, author = {Fresilli, S and Belletti, A and Labanca, R and Monti, G and Schultz, MJ and Corbo, F and Luciano, AP and Ferrara, B and Turi, S and Landoni, G and , }, title = {Nebulized Heparin in Adults With Acute Respiratory Failure: A Meta-Analysis of Randomized Trials.}, journal = {Critical care medicine}, volume = {54}, number = {7}, pages = {1755-1766}, doi = {10.1097/CCM.0000000000007161}, pmid = {42148826}, issn = {1530-0293}, mesh = {Humans ; *Heparin/administration & dosage/therapeutic use ; Randomized Controlled Trials as Topic ; *Respiratory Insufficiency/drug therapy/mortality ; *Anticoagulants/administration & dosage ; Nebulizers and Vaporizers ; Administration, Inhalation ; Adult ; COVID-19/complications ; }, abstract = {OBJECTIVES: Dysregulated pulmonary coagulation and inflammation is a hallmark of respiratory failure in various etiologies. Excessive fibrin deposition contributes to alveolar collapse, impaired gas exchange, and progression to pulmonary fibrosis. Nebulized heparin can mitigate these coagulation and inflammation disturbances. Although several randomized controlled trials have explored its effects, results remain inconsistent and limited by small patient populations. We conducted a random-effects meta-analysis to calculate the risk ratio (RR) and 95% CIs.
DATA SOURCES: We systematically searched PubMed, Embase, and Cochrane Central Register of Controlled Trials for randomized controlled trials comparing nebulized unfractionated heparin to standard care or placebo in adult patients with respiratory failure either invasively mechanical ventilated or not. The primary outcome was all-cause mortality at the longest follow-up.
STUDY SELECTION: We included randomized clinical trials enrolling adult patients with respiratory failure, comparing nebulized heparin vs. standard care or placebo, and reporting at least one clinical outcome, including all-cause mortality.
DATA EXTRACTION: Two independent investigators extracted data on trial design, setting, etiology of respiratory failure, heparin dosing regimens, follow-up duration, and outcomes. Discrepancies were resolved by consensus.
DATA SYNTHESIS: We identified 16 studies (787 receiving nebulized heparin, 833 control). Six (38%) were multicenter, five focused on COVID-19, 12 enrolled ICU patients, and dosing clustered around 25,000 international units (IUs) three times a day (~75,000 IU/d for ~10 d). At the longest follow-up, nebulized heparin reduced all-cause mortality vs. control (110/645 [17.1%] vs. 157/711 [22.1%]; RR, 0.79; 95% CI, 0.66-0.95; with ten studies included). Nebulized heparin was also associated with more ventilation-free days by day 28 (mean difference, +4.85; 95% CI, 1.47-8.24). Major bleeding was rare (1.1 vs. 0.7%; RR, 1.48; 95% CI, 0.42-5.18), while no minor bleeding or heparin-induced thrombocytopenia was reported.
CONCLUSIONS: Nebulized unfractionated heparin may improve survival in patients with respiratory failure without increasing adverse events.}, }
@article {pmid42149279, year = {2026}, author = {Abu-Qatouseh, L and Al-Kubaisi, K and Laham, NA and Al-Adham, I and Collier, PJ}, title = {Pandemic Preparedness and Health System Resilience: Lessons from Jordan's COVID-19 Response.}, journal = {Journal of community health}, volume = {}, number = {}, pages = {}, pmid = {42149279}, issn = {1573-3610}, abstract = {This review article provides a comprehensive analysis of Jordan's health sector preparedness and response to the COVID-19 pandemic from 2020 to 2025. It critically examines the national response framework, the capacity and challenges of frontline healthcare workers, and the systemic strengths and weaknesses of the healthcare system. The article further explores the multifaceted economic and social impacts of the pandemic on Jordanian society, including the effects on the economy, education, and mental health. Finally, it discusses the post-pandemic improvements and long-term strategies being implemented to strengthen the resilience of Jordan's healthcare system. The findings indicate that while Jordan's initial response was robust and well-coordinated, the prolonged nature of the pandemic exposed significant vulnerabilities in resource availability, practical training, and the psychological well-being of healthcare workers. By 2025, Jordan has made substantial progress in institutional reforms and health system strengthening, although challenges remain in sustaining these improvements. This review synthesizes the key lessons learned [1] and offers evidence-based recommendations for enhancing institutional preparedness and resilience for future public health emergencies. The experience of Jordan provides valuable insights for other resource-constrained settings facing similar health security challenges.}, }
@article {pmid42151636, year = {2026}, author = {Khateb, AM}, title = {Review of the Microbial Spectrum of Mixed Respiratory Fungal Infections.}, journal = {Journal of epidemiology and global health}, volume = {16}, number = {1}, pages = {}, pmid = {42151636}, issn = {2210-6014}, mesh = {Humans ; *Coinfection/microbiology/diagnosis ; *Respiratory Tract Infections/microbiology/diagnosis ; *Mycoses/diagnosis/microbiology ; Risk Factors ; }, abstract = {BACKGROUND: This review examines the increasing clinical challenge of mixed respiratory fungal infections (MRFIs), emphasizing interkingdom interactions and their impact on disease progression and patient outcomes.
MAIN BODY: We critically analyze current literature on the clinical implications, risk factors, and diagnostic complexities of MRFIs, with a primary focus on fungal-bacterial, fungal-viral, and fungal-parasitic co-infections. Fungal-bacterial co-infections, often involving Candida spp. and Pseudomonas aeruginosa, significantly worsen disease severity. Fungal-viral co-infections, particularly in COVID-19 patients with Candida albicans and Aspergillus fumigatus, represent a major threat. While rare, fungal-parasitic co-infections pose risks for immunocompromised individuals. The review highlights diagnostic difficulties due to non-specific symptoms and the vital need to distinguish colonization from true infection. It also explores the complex symbiotic, synergistic, and antagonistic relationships between fungi and other microorganisms, alongside the immune-modulating role of commensal fungi.
CONCLUSION: Ultimately, this review seeks to enhance understanding of MRFIs to improve diagnostic and therapeutic strategies and patient care.}, }
@article {pmid42151642, year = {2026}, author = {Cirovic, A and Brankovic, N and Antelj, G and Cirovic, A}, title = {Iron Deficiency as an Important Predictor of Arterial and Venous Thrombosis, Myocarditis, and Atrial Fibrillation in COVID-19 and Influenza.}, journal = {Cardiovascular toxicology}, volume = {26}, number = {6}, pages = {}, pmid = {42151642}, issn = {1559-0259}, mesh = {Humans ; *COVID-19 ; *Myocarditis/virology/epidemiology/diagnosis ; *Influenza, Human/epidemiology/complications/diagnosis/virology ; *Atrial Fibrillation/epidemiology/diagnosis/virology/etiology ; *Thrombosis/epidemiology/diagnosis/etiology/virology ; SARS-CoV-2 ; Animals ; Risk Factors ; *Iron Deficiencies ; Pandemics ; *Anemia, Iron-Deficiency/epidemiology/diagnosis/blood ; *Coronavirus Infections/epidemiology ; *Pneumonia, Viral/epidemiology ; }, abstract = {Arterial and venous thrombosis, atrial fibrillation, and viral myocarditis are potentially life-threatening conditions and well-documented complications of both COVID-19 and influenza. Therefore, clinicians should be aware of all factors that may promote their occurrence, particularly those related to common viral infections such as influenza and SARS-CoV-2. Both influenza and SARS-CoV-2 utilize transferrin receptor 1 (TfR1) to enter host cells; notably, SARS-CoV-2 has been detected in tissues that do not express ACE2. TfR1 is highly expressed on cardiomyocytes, as well as on endothelial cells. Iron deficiency -a common disorder in the general population- promotes overexpression of TfR1, thereby facilitating the entry of SARS-CoV-2 and influenza viruses into cardiomyocytes and endothelial cells. Therefore, an increased expression of the TfR1 on cardiomyocytes may consequently contribute to the development of viral myocarditis, and atrial fibrillation. Finally, TfR1 is involved in viral uptake by endothelial cells and in molecular pathways implicated in thrombus formation. Clinicians should recognize that individuals with iron deficiency and concomitant SARS-CoV-2 or influenza infection may be at increased risk of arterial and venous thrombosis, atrial fibrillation, and viral myocarditis. Given that approximately two billion people worldwide have some degree of iron deficiency-especially older adults and young children-appropriate preventive strategies should be considered.}, }
@article {pmid42151979, year = {2026}, author = {Bergsträsser, J and Schmahl, T and Steinhäuser, J and Goetz, K}, title = {Interventions against loneliness and social isolation in older adults- a systematic review.}, journal = {BMC public health}, volume = {26}, number = {1}, pages = {}, pmid = {42151979}, issn = {1471-2458}, mesh = {Humans ; *Loneliness/psychology ; *Social Isolation/psychology ; *COVID-19/psychology ; Aged ; Pandemics ; Middle Aged ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Loneliness is a growing health and social challenge. The COVID-19 pandemic boosted feelings of loneliness for many people. To combat loneliness, a wide range of interventions have been developed and evaluated for their efficacy and effectiveness. As a result, many new interventions to alleviate loneliness have been developed, especially technological interventions. Therefore, the objective of this study was to conduct a comprehensive and up-to-date systematic review to identify interventions aimed at loneliness and social isolation among adults, 60 years and older published during or post-pandemic.
METHODS: A comprehensive literature search was conducted for studies between 2020 and 2024 across five online databases: MEDLINE via PubMed, Web of Science, Scopus, Cochrane Library, and CINAHL. Title and abstract screening, critical appraisal of the studies, and data extraction were performed by two independent reviewers. A narrative approach was adopted to assess and integrate the diverse findings from the research.
RESULTS: Ultimately, 79 studies were included in this systematic review. The results are structured based on the categorization of the interventions, which includes differentiation between analogue interventions, technological interventions and multicomponent (analogue and technological) interventions. The effectiveness of analogue interventions, particularly community-based interventions such as group meetings, social participation programs, and educational or psychological interventions, tended to be superior to that of technological interventions.
CONCLUSIONS: The combination of analogue and technological interventions in particular produced promising results regarding a decrease of loneliness. Specific interventions must be tailored to the target group and setting and regularly reevaluated. The aim now should be to implement these interventions comprehensively and monitor their effectiveness over several years. Future research should focus on differentiating the circumstances under which various forms of intervention are effective.
TRIAL REGISTRATION: PROSPERO systematic review registration: CRD42024538755.}, }
@article {pmid42152524, year = {2026}, author = {Kim, J and Lee, H and Jang, YS}, title = {Macrophage Immune Responses in Viral Infections: Functional Plasticity and Therapeutic Targeting.}, journal = {Journal of microbiology and biotechnology}, volume = {36}, number = {}, pages = {e2602035}, pmid = {42152524}, issn = {1738-8872}, mesh = {Humans ; *Macrophages/immunology ; *Virus Diseases/immunology/therapy ; Immunity, Innate ; Animals ; Host-Directed Therapy ; COVID-19/immunology/virology/therapy ; SARS-CoV-2/immunology ; Macrophage Activation ; Antiviral Agents/therapeutic use ; Cytokines/immunology ; Cell Plasticity ; }, abstract = {Macrophages play dual roles, contributing to both protection and disease progression during viral infections. As crucial immune cells against pathogens, they activate innate immunity by releasing antiviral agents and inflammatory cytokines. At the same time, they serve as targets for infection and as carriers of viruses, thereby contributing to viral dissemination. This review emphasizes macrophage plasticity and the functional shifts it undergoes during M1/M2 polarization. It also explores mechanisms that maintain persistent viral reservoirs in chronic infections such as SARS-CoV-2 and discusses the impact of macrophage dysregulation on the immune microenvironment. Furthermore, it highlights recent advances in macrophage-targeted therapies, including reprogramming macrophages for homeostasis, eliminating pathogenic macrophages, and boosting antiviral responses.}, }
@article {pmid42153918, year = {2026}, author = {Thain, BK}, title = {Syndemic Effects of Covid-19 Lockdown on Chemsex and HIV Among MSM in Malaysia: A Narrative Review.}, journal = {Journal of the International Association of Providers of AIDS Care}, volume = {25}, number = {}, pages = {23259582261447929}, pmid = {42153918}, issn = {2325-9582}, mesh = {Humans ; *Chemsex/psychology ; Malaysia/epidemiology ; Male ; *HIV Infections/epidemiology/psychology/transmission/diagnosis ; *Homosexuality, Male/psychology/statistics & numerical data ; *COVID-19/epidemiology/psychology/prevention & control ; *Substance-Related Disorders/epidemiology ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Chemsex, sexual activity under the influence of psychoactive substances, remains a major public health concern for men who have sex with men (MSM) globally. In Malaysia's conservative context, the convergence of chemsex and HIV transmission presents complex challenges. This narrative review examines how the Covid-19 pandemic and extended lockdown disrupted HIV services and intensified psychosocial stressors, amplifying chemsex, HIV, and mental health issues among Malaysian MSM.
METHODS: A systematic search of international databases (2018-2025) identified relevant studies through keyword screening of articles, abstracts, and full texts.
KEY FINDINGS: The Covid-19 lockdown exacerbated psychosocial stressors such as isolation and minority stress, altered chemsex patterns, and increased drug use. Disruption of HIV testing and treatment delayed diagnoses and potentially heightened transmission, while PrEP uptake remained low (18.3%) despite awareness.
CONCLUSION: The pandemic intensified syndemic interactions concerning chemsex, HIV, and mental health. Urgent, integrated, person-centered intervention is needed to address this multifaceted crisis.}, }
@article {pmid42154963, year = {2026}, author = {Clarke, C and Esposito, D and Urdaneta, V and Mukherjee, P and Buttery, AK}, title = {Safety of COVID-19 mRNA-1273 booster doses in Asian populations: A literature review of post-marketing observational studies.}, journal = {Human vaccines & immunotherapeutics}, volume = {22}, number = {1}, pages = {2662118}, pmid = {42154963}, issn = {2164-554X}, mesh = {Humans ; *COVID-19/prevention & control ; *Immunization, Secondary/adverse effects/methods ; Product Surveillance, Postmarketing ; *COVID-19 Vaccines/adverse effects/administration & dosage ; Observational Studies as Topic ; *2019-nCoV Vaccine mRNA-1273/adverse effects/administration & dosage ; Asia/epidemiology ; SARS-CoV-2/immunology ; Asian People ; }, abstract = {Real-world data on the safety of COVID-19 booster doses in Asian populations are needed to inform national immunization programs. The safety profile of mRNA-1273 (Moderna, Inc.) was evaluated using post-marketing observational data. PubMed and EMBASE were searched on June 30, 2025, for studies meeting the following predefined criteria: observational design, adverse events (AEs), mRNA-1273 boosters (dose 3+), and population data from the South-East Asia and Western-Pacific regions. Data on study characteristics, and AE incidence and severity, were extracted. Of 886 records screened, 27 studies from eight countries (Japan, the Republic of Korea, Australia, Taiwan, Indonesia, Thailand, the Philippines, and Singapore) met the inclusion criteria. Across studies, mRNA-1273 boosters were well tolerated, with severe AEs occurring at low frequency. Based on the included observational studies, these findings support the favorable safety profile of mRNA-1273 boosters in Asian populations. Long-term safety monitoring is needed to guide public-health responses to evolving SARS-CoV-2 variants.}, }
@article {pmid42155083, year = {2026}, author = {Alnaeem, MM and Alshamlan, MJ}, title = {Medical Device-Related Pressure Injuries: A Systematic Review for Prevalence, Causes, and Risk Factors Since the COVID-19 Pandemic.}, journal = {Advances in skin & wound care}, volume = {39}, number = {6}, pages = {E286-E294}, doi = {10.1097/ASW.0000000000000468}, pmid = {42155083}, issn = {1538-8654}, mesh = {Humans ; *Pressure Ulcer/epidemiology/etiology ; *COVID-19/epidemiology ; Risk Factors ; Prevalence ; *Equipment and Supplies/adverse effects ; Intensive Care Units ; Pandemics ; Female ; }, abstract = {OBJECTIVE: The intensive care unit (ICU) is a critical environment where patients are at risk for developing medical device-related pressure injuries (MDRPIs). This review aims to synthesize the literature and assess the prevalence, causes, and risk factors of MDRPIs, particularly in the context of the COVID-19 pandemic.
DATA SOURCES: A systematic review was conducted to guide this study. A comprehensive search strategy was used across multiple databases, including PubMed, EMBASE, Web of Science, Scopus, and CINAHL.
STUDY SELECTION: The search focused on studies published between 2019 and 2024, specifically targeting adult patients in the ICU. Studies focusing on pediatric populations, patients with mental illnesses, or those investigating ulcers unrelated to MDRPIs were excluded.
DATA EXTRACTION: After screening and selecting relevant studies, data were extracted and analyzed in numerical data.
DATA SYNTHESIS: The review included 35 studies, revealing a high prevalence of MDRPIs in ICU settings, ranging from 5.01% to 62.4% across various countries. The prevalence was related to several factors, such as patient demographics (age and comorbidities), ICU practices, and the type and duration of medical device usage. Mechanical ventilation, nasogastric tubes, and endotracheal tubes were among the most common devices associated with MDRPIs.
CONCLUSIONS: Tailored interventions, such as regular skin assessments and pressure-redistributing devices, are crucial for preventing MDRPIs and improving patient outcomes. The COVID-19 pandemic experience emphasizes the need for vigilant monitoring and evidence-based preventive measures in critical care environments.}, }
@article {pmid42156022, year = {2026}, author = {Murai, H}, title = {[Imported Infectious Diseases of the Nervous System].}, journal = {Brain and nerve = Shinkei kenkyu no shinpo}, volume = {78}, number = {5}, pages = {432-436}, doi = {10.11477/mf.188160960780050432}, pmid = {42156022}, issn = {1881-6096}, mesh = {Humans ; Animals ; Rabies/epidemiology/transmission ; Japan/epidemiology ; Dengue/epidemiology/transmission ; Dogs ; }, abstract = {Although sanitary conditions in Japan are generally favorable, pathogens may be introduced by patients who acquire the infections overseas. Dengue fever has a high global incidence, with nearly 200 cases occurring annually in Japan. Most of these infections are acquired in Southeast Asia. As dengue fever is transmitted by mosquitoes, preventive measures against insect bites are important. The incidence of Japanese encephalitis has markedly decreased in Japan owing to widespread vaccination. This disease is mosquito-borne, and only approximately 1% of infected individuals develop symptoms. However, once symptoms appear, the mortality rate is 20-30%. A characteristic clinical feature of this condition is the presence of extrapyramidal symptoms. Rabies is a representative disease transmitted through dog bites. In Japan, its incidence has dramatically declined owing to canine vaccination and the control of stray dogs. Once rabies develops, the fulminant form accounts for 70-80% of cases. Measles is a representative disease that is transmitted between humans. It is highly contagious and requires careful monitoring. During the coronavirus disease-19 pandemic, the number of measles cases decreased. Recently, the trend has reversed, with many patients believed to have been infected in Vietnam.}, }
@article {pmid42156048, year = {2026}, author = {Shimohata, T}, title = {[COVID-19-Associated Encephalitis and Encephalopathy: Current Status].}, journal = {Brain and nerve = Shinkei kenkyu no shinpo}, volume = {78}, number = {5}, pages = {567-572}, doi = {10.11477/mf.188160960780050567}, pmid = {42156048}, issn = {1881-6096}, mesh = {Humans ; COVID-19/complications ; *Brain Diseases/therapy/etiology ; *Coronavirus Infections/complications/therapy/epidemiology ; Pandemics ; *Pneumonia, Viral/complications/therapy/epidemiology ; *Encephalitis, Viral/therapy ; SARS-CoV-2 ; *Betacoronavirus ; }, abstract = {In recent years, the incidence of COVID-19-associated encephalitis and encephalopathy has decreased due to viral mutations and the acquisition of population immunity. The underlying mechanisms are now thought to involve immune-mediated pathology and cerebral microvascular injury, rather than direct viral invasion. In adults, encephalitis and encephalopathy are independent predictors of disease severity and mortality. In children, acute necrotizing encephalopathy is associated with high mortality rates and long-term neurological sequelae. Regarding treatment, correction of reversible factors and timely immunotherapy are essential, and favorable responses to high-dose corticosteroids and interleukin-6 receptor blockade have been reported.}, }
@article {pmid42156133, year = {2026}, author = {Richter, ML and Ditmore, MH and de Vries, J}, title = {Demanding solidarity, not salvation: sex work and global health.}, journal = {BMJ global health}, volume = {11}, number = {5}, pages = {}, pmid = {42156133}, issn = {2059-7908}, mesh = {Humans ; *Global Health ; *Human Rights ; *Sex Work ; COVID-19/epidemiology ; *International Cooperation ; }, abstract = {There is increasing attention paid to solidarity in global health, but its substance and definitions remain contested. We explore the tensions between global health institutions' historic approaches to sex work, their commitment to health and human rights and how these are connected to or disconnected from solidarity. We foreground the protracted and incomplete evolution from international health approaches to sex workers as spreaders of pathogens that should be punished, to sex work health programmes that are situated within human rights principles. Thus, substantial resources and material changes to laws, policies and programmes are required to action claims of 'standing in solidarity' with sex workers. We argue that the drastic cuts to global health funding initiated by the Trump Administration in January 2025 require careful consideration of what 'solidarity' with the most marginalised entails and bold action.}, }
@article {pmid42157493, year = {2026}, author = {Portillo-Ledesma, S and Lee, S and Laederach, A and Schlick, T}, title = {Open questions on viral frameshifting: Exploiting the structural plasticity of the frameshifting element for therapeutic intervention.}, journal = {Biophysical journal}, volume = {}, number = {}, pages = {}, pmid = {42157493}, issn = {1542-0086}, support = {R35 GM122562/GM/NIGMS NIH HHS/United States ; }, abstract = {Programmed ribosomal frameshifting (PRF) is a specialized controlled-slippage genetic mechanism that viruses such as SARS-CoV-2 and HIV-1 use to shift the reading frame during translation. This process is used in compact viral genomes to enhance their protein repertoire, maintain a precise balance of viral proteins necessary for successful replication, and enhance survival within a host. Because this mechanism is vital to the viral life cycle and remains consistent across strains, frameshifting has emerged as a promising therapeutic target for new antiviral therapeutic strategies. However, the complexity of the frameshifting process has posed many challenges that need to be addressed so that the relationship between cellular mechanisms and viral replication can be exploited for novel therapeutics. In this review, we introduce frameshifting mechanisms, define open questions being explored by many modeling and experimental studies, and illustrate how coarse-grained graphs have been used in our lab to study frameshifting mechanisms. Specifically, we describe how conformational landscapes, mutation designs of frameshifting elements, all-atom molecular dynamics, and enhanced sampling simulations have been combined with chemical mapping and functional experiments to advance studies of three viral systems employing -1 PRF: SARS-CoV-2, HIV-1, and chikungunya.}, }
@article {pmid42158631, year = {2026}, author = {Dai, CL and Guo, Y and Sharma, M and Chen, CC and Rodriguez, J}, title = {Evidence-based Review of Yoga Interventions for Adolescent Health and Well-being in US Schools.}, journal = {International journal of yoga}, volume = {19}, number = {1}, pages = {10-20}, pmid = {42158631}, issn = {0973-6131}, abstract = {The adolescent behavioral health crisis has intensified pressures to foster both physical health and mental well-being, particularly in the post-COVID-19. Yoga, as a holistic approach, has been integrated into existing curricula and positive behavioral interventions. This review examines the implementation and impact of yoga interventions in the U.S., with a focus on adolescent students in secondary schools, to identify effective strategies and provide recommendations to ensure the sustainable integration of yoga into school-based behavioral health initiatives. The articles were systematically searched from EBSCOhost, PubMed, and Web of Science databases. Inclusion criteria were: yoga component with physical elements, implemented in U.S. secondary schools as part of PE curricular or school interventions, and published in English in peer-reviewed journals. This review synthesizes findings from 17 studies on yoga interventions, highlighting notable benefits across physical and psychosocial outcomes. While most interventions are integrated into the school day, some alterations, including the afterschool and virtual formats, have emerged, providing insight into accessibility to school health promotion. The review suggests that ongoing research to refine intervention designs, address implementation barriers, and expand the reach of yoga interventions to racially and ethnically diverse populations is warranted. Overall, this review advocates for integrating yoga into health promotion initiatives, which provide adolescents with practical tools to enhance their well-being in the educational setting.}, }
@article {pmid42158816, year = {2026}, author = {Zhang, W and Li, X and Ma, H and Li, Y and Xi, Y and Wang, W and Liu, Y and Han, P}, title = {The Adjunctive Role of Hyperbaric Oxygen Therapy in Microbial Infection-Related Conditions.}, journal = {International journal of medical sciences}, volume = {23}, number = {6}, pages = {2154-2165}, pmid = {42158816}, issn = {1449-1907}, mesh = {Humans ; *Hyperbaric Oxygenation/methods ; *COVID-19/therapy/immunology ; Diabetic Foot/therapy ; Mucormycosis/therapy ; SARS-CoV-2 ; Soft Tissue Infections/therapy ; Combined Modality Therapy ; *Bacterial Infections/therapy ; Diving and Hyperbaric Medicine ; }, abstract = {Hyperbaric oxygen therapy (HBOT) demonstrates expanding applications in infectious diseases through its multimodal mechanisms. As an adjunctive treatment, HBOT directly exerts antimicrobial effects through oxygen toxicity and reactive oxygen species generation, while indirectly enhances host immunity by improving neutrophil function and promoting tissue repair. Clinical evidence supports its adjunctive use in complex infections including diabetic foot wounds, necrotizing soft tissue infections, COVID-19, and mucormycosis, particularly in hypoxic wounds where conventional therapies show limited efficacy. While current studies are promising, further randomized trials are needed to standardize protocols and confirm efficacy.}, }
@article {pmid42159324, year = {2026}, author = {Imani, D and Dashti, N and Peymani, A and Soltani, A and Hassanzadeh Makoui, M}, title = {Effect of Pentoxifylline on Inflammatory Markers in COVID-19: A Meta-Analysis of Randomized Controlled Trials.}, journal = {Viral immunology}, volume = {39}, number = {6}, pages = {223-231}, doi = {10.1177/08828245261445782}, pmid = {42159324}, issn = {1557-8976}, mesh = {Humans ; *Pentoxifylline/therapeutic use ; Interleukin-6/blood ; Randomized Controlled Trials as Topic ; C-Reactive Protein/analysis ; *COVID-19 Drug Treatment ; Biomarkers/blood ; *COVID-19/immunology/blood ; SARS-CoV-2 ; *Inflammation/drug therapy ; }, abstract = {The hyperinflammatory response in COVID-19 is a major factor contributing to morbidity. Pentoxifylline, a methylxanthine derivative, has immunomodulatory properties, but its effects on inflammatory markers in COVID-19 remain unclear. This meta-analysis aims to evaluate the efficacy of pentoxifylline supplementation on CRP and interleukin-6 (IL-6) levels in these patients. A systematic search was conducted across multiple databases for randomized controlled trials (RCTs) published up to September 2025. Four RCTs, including 178 cases and 321 controls for CRP, and two RCTs, including 70 cases and 70 controls for IL-6, were included. Two reviewers independently performed data extraction and assessed the risk of bias using the Cochrane tool. Pooled standardized mean differences (SMDs) were calculated using a random-effects model. Heterogeneity was analyzed through meta-regression, and the conclusiveness of the evidence was evaluated using Trial Sequential Analysis (TSA). Pentoxifylline did not significantly reduce C-reactive protein (CRP) levels compared to the control group (SMD = -0.89; 95% CI: -1.85 to 0.07; p = 0.07). However, substantial heterogeneity was noted across the studies (I[2] = 95.3%). Similarly, a nonsignificant trend toward reduction was observed for IL-6 (SMD = -0.22; 95% CI: -0.96 to 0.52; p = 0.55), accompanied by significant heterogeneity (I[2] = 79.1%). Given the limited number of studies included, the results are inherently fragile, and one additional trial could substantially shift the pooled estimate. Meta-regression analysis indicated that patient age and publication year did not account for the heterogeneity, although there was a nonsignificant trend suggesting that a longer treatment duration might be associated with greater CRP reduction. TSA for CRP showed that cumulative evidence suggested futility and a lack of meaningful effect, confirming a significant lack of effect. The included studies generally had a low risk of attrition and reporting bias. Current evidence does not support the use of pentoxifylline for significantly reducing CRP or IL-6 levels in COVID-19 patients. The findings regarding CRP are considered conclusive, but the limited number of studies suggests that further trials on this outcome may alter this conclusion.}, }
@article {pmid42159817, year = {2026}, author = {Ali, S and Shafiq, M and Aziz, A and Rahman, NU and Bakky, MAH}, title = {The Prevalence of Methicillin-resistant Staphylococcus aureus in Clinical Settings of Pakistan: A Systematic Review and Meta-Analysis.}, journal = {Journal of epidemiology and global health}, volume = {16}, number = {1}, pages = {}, pmid = {42159817}, issn = {2210-6014}, mesh = {Humans ; *Methicillin-Resistant Staphylococcus aureus/isolation & purification ; Pakistan/epidemiology ; Prevalence ; *Staphylococcal Infections/epidemiology/microbiology ; }, abstract = {BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) represents a significant and growing public health challenge in Pakistan, due to antibiotic misuse, weak infection control measures and rapid bacterial evolution. Determining the overall prevalence of MRSA in the country is crucial for informing targeted treatment protocols and effective management strategies. This study conducted a systematic review and meta-analysis to establish the pooled prevalence of MRSA in Pakistan.
METHODS: We searched electronic databases (Google Scholar, PubMed, Embase) for studies published between 2015 and 2025. The PRISMA guidelines were followed to conduct this systematic review. Meta-analyses were performed using R Studio software, applying both fixed- and random-effects models to calculate pooled prevalence. The heterogeneity was assessed using the I² statistics. Publication bias was assessed using Begg's and Egger's tests. Most studies used cefoxitin disk diffusion to characterize MRSA, while some studies used PCR to detect the mecA gene.
RESULTS: Sixty-eight studies meeting the inclusion criteria were analyzed. The overall pooled MRSA prevalence was estimated at 50% (95% CI: 45-54%), with I² = 98.9). Year-wise subgroup analysis revealed significant variation from 2015 to 2025, with estimates ranging from 64% (95% CI: 26-90%), with I² = 96.68 in 2022 to a low of 34% (95% CI: 17-56%), with I² = 99.16 in 2020, which may be due to reduced healthcare access and infection control measures implemented during the COVID-19 lockdowns. The pooled estimate among general patients and healthcare personnel was 50% (95% CI: 44-57%), with I² = 98.5 and 44% (95% CI: 30-60%), with I² = 95.4, respectively. The subgroup differences test (p = 0.54) for population type revealed no statistically significant difference. The Begg's test (p = 0.2378) and Egger's test (p = 0.8893) showed no significant evidence of bias. The significant variation between the two diagnostic methods (p = 0.03) showed that the observed heterogeneity may be due to diagnostic methods used across the studies.
CONCLUSION: The high pooled prevalence of MRSA in Pakistan highlights an urgent need for strengthened antimicrobial stewardship, standardized surveillance systems, and integrated infection prevention strategies.}, }
@article {pmid42160264, year = {2026}, author = {Romoff, M and Chandekar, A and Beyer, R and Kim, MS and Baz, S and Mills, ES and Park, DY and Lee, YP and Bhatia, N and Hashmi, S and Wu, HH}, title = {Evaluating Virtual and Hybrid Mentorship in Orthopaedic Surgery: Perceived Benefits, Challenges, and Impacts in the Post-COVID Era.}, journal = {JBJS reviews}, volume = {14}, number = {5}, pages = {}, pmid = {42160264}, issn = {2329-9185}, mesh = {Humans ; COVID-19 ; *Mentors ; *Orthopedics/education ; Pandemics ; SARS-CoV-2 ; }, abstract = {» Virtual and hybrid mentorship models have transitioned from temporary coronavirus disease 2019 pandemic responses to durable, scalable components of the orthopaedic training curriculum. » Despite high trainee satisfaction, most orthopaedic virtual mentorship programs rely on short-term, self-reported metrics and lack the objective, longitudinal tracking of research productivity or career advancement seen in other specialties. » While virtual pipelines demonstrate the potential to broaden access for underrepresented groups, inconsistent collection of detailed demographic and socioeconomic data limits the assessment of their true impact on diversity. » Neurosurgery and plastic surgery provide instructive models for virtual collaboratives that successfully use standardized expectations and longitudinal outcome tracking to measure success. » To ensure these programs drive equitable change rather than just broader participation, future orthopaedic virtual mentorship programs should incorporate standardized outcome frameworks, mentor perspectives, and longitudinal, multi-institutional follow-up.}, }
@article {pmid42161577, year = {2026}, author = {O'Donovan, CJ and Ramanan, AV}, title = {Infection, inflammation and immune dysregulation: evolving perspectives on the host response.}, journal = {Archives of disease in childhood}, volume = {}, number = {}, pages = {}, doi = {10.1136/archdischild-2025-330158}, pmid = {42161577}, issn = {1468-2044}, abstract = {Host inflammatory responses contribute substantially to infection-related morbidity, and in severe cases such as sepsis, acute respiratory distress syndrome (ARDS) and haemophagocytic lymphohistiocytosis, immune-mediated tissue injury may exceed the direct effects of pathogens themselves. Although traditional wisdom has considered immunosuppression risky when antimicrobial therapy is required, modern insights into immune biology reveal a more nuanced landscape in which targeted immunomodulators can attenuate harmful inflammation without broadly compromising host defence. This evolution is particularly relevant in paediatrics, influenced by developmental stage, distinct exposure history and patterns of host response. The COVID-19 pandemic catalysed wider acceptance of immunomodulation in infection management, including corticosteroids in children and highlighted safe use of agents such as baricitinib. Platform trials of the hyperinflammatory syndrome (paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2) also identified benefits of methylprednisolone and tocilizumab in select groups. For other paediatric infections, including dengue, influenza and Epstein-Barr virus, the evidence remains sparse, with emerging mechanistic and early-phase clinical studies exploring interleukin (IL)-1 blockade, corticosteroids, immunoglobulin and anticytokine biologics. In paediatric sepsis, immunophenotype-guided trials represent a major conceptual advance. Adaptive studies, such as TRIPS and GRACE-2, aim to tailor immunomodulation to hyperinflammation or immunoparalysis, though definitive efficacy data are awaited. Parallel efforts in ARDS explore statins, IL-6 blockade and cell-based therapies, but robust paediatric evidence is still lacking. Collectively, evolving insights and trial designs offer renewed opportunities to use targeted immunomodulation in the management of paediatric infection. Large-scale, collaborative paediatric research networks will be essential to translate these advances and better integrate infection research into everyday paediatric practice.}, }
@article {pmid42162612, year = {2026}, author = {Stiefel, P and Muñoz-García, J and Pino-Mejías, R}, title = {Blood pressure variability: a growing but still overlooked topic.}, journal = {Revista clinica espanola}, volume = {}, number = {}, pages = {502580}, doi = {10.1016/j.rceng.2026.502580}, pmid = {42162612}, issn = {2254-8874}, abstract = {The importance of blood pressure variability has grown exponentially over the past two to three years. In this review, we aim to discuss the reasons underlying this increasing interest. First, we describe the different methods used to assess blood pressure variability, including very short-term (beat-to-beat), short-term (24-h ambulatory blood pressure monitoring), mid-term (home self-measurements), and long-term (visit-to-visit measurements), as well as the mathematical indices used to quantify it. We then address the clinical relevance of blood pressure variability. First, increased variability is more prevalent in several health conditions not necessarily related to vascular disease, such as mental illness, severity of COVID-19 infection, bone fractures, and various forms of cognitive impairment. Second, blood pressure variability appears to be involved in the progression from prehypertensive states to established hypertension and, once hypertension is present, in the development of target organ damage. It has also been associated with an increased risk of gestational hypertension, preeclampsia, and adverse neonatal outcomes. Furthermore, blood pressure variability, even independently of mean arterial blood pressure, influences the development, prognosis, and complications of coronary and cerebrovascular disease. Finally, we discuss evidence suggesting that blood pressure variability is associated with both vascular and all-cause mortality.}, }
@article {pmid42163819, year = {2026}, author = {McDonnell, R and Chauhan, A and Adams, C and Cardenas, A and Moscova, M and Walsan, R and Sina, M and Munro, A and Manias, E and Mitchell, R and Gust, A and Sabesan, S and Harrison, R}, title = {Applying Change Models and Methods During a Period of Vast Digital Transformation: A Systematic Review of Practice in Healthcare.}, journal = {The International journal of health planning and management}, volume = {}, number = {}, pages = {}, doi = {10.1002/hpm.70092}, pmid = {42163819}, issn = {1099-1751}, support = {//National Health and Medical Research Council/ ; //Western Sydney Local Health District/ ; //University of New South Wales/ ; //Western Health Foundation/ ; //Townsville Hospital and Health Service/ ; //Monash University/ ; }, abstract = {INTRODUCTION: Reflection and learning about the use of virtual care in healthcare delivery has become a central goal for health systems internationally. Insights drawn in the aftermath of the COVID-19 pandemic have led to vast changes to embed virtual care in health care delivery. This study explored the methodologies used to manage change that encompasses virtual care and factors contributing to success.
METHODS: A systematic review and narrative synthesis was undertaken. Eligible articles were those reporting structured change management processes in the context of virtual care published between 1st January 2019-31st December 2023, identified by searching four electronic databases (Scopus, MedLine, PsycInfo and Business Source Premier). Data were extracted and synthesised from the eligible studies.
RESULTS: Seventeen studies met inclusion criteria describing changes occurring within hospital settings or in community health centres. Kotter's 8-Step Model was the most frequently applied change framework, often combined with other approaches. Commonly enablers included high quality communication among all parties involved and strong leadership. Common barriers included overemphasis on technology at the expense of people and processes, linear application of models, and lack of mechanisms to monitor change progress.
DISCUSSION: Structured change methodologies were often integrated in a strategic change framework with process improvement methods utilised to support the change process. Managing change relating to the technology with attention to the clinical and people aspects of change was considered a key gap and challenge in the context of virtual care change. Change leadership and the integration of technical and clinical teams were identified as key enablers.}, }
@article {pmid42163826, year = {2026}, author = {Guan, Z and Li, X and Zhu, X}, title = {Emerging Insights of Management of Venous Thromboembolism in Patients With Cancer.}, journal = {Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis}, volume = {32}, number = {}, pages = {10760296261454788}, pmid = {42163826}, issn = {1938-2723}, mesh = {Humans ; *Venous Thromboembolism/etiology/drug therapy ; *Neoplasms/complications ; *Anticoagulants/therapeutic use/adverse effects ; Female ; Risk Factors ; }, abstract = {Cancer -associated thrombosis (CAT), particularly venous thromboembolism (VTE), is a major contributor to mortality in cancer patients and is widely recognized as a leading cause of death after the direct effects of cancer progression. Cancer patients have significantly higher VTE risk than the general population, due to hypercoagulable states and anticancer therapies, with those with advanced malignancies carrying the highest risk. Primary thromboprophylaxis and anticoagulation are pivotal for CAT management. Despite advances, key challenges include different thrombotic and bleeding risks across cancers and how recurrent VTE affects anticoagulation duration. Low-molecular-weight heparin (LMWH) has largely replaced warfarin, and direct oral anticoagulants (DOACs) are challenging LMWH's first-line role with proven efficacy. However, the key dilemma is balancing thromboprophylaxis and treatment against anticoagulant-induced bleeding, particularly in the context of recurrent VTE. Current CAT guidelines show discrepancies and gaps in clinical coverage; some conclusions derived from meta-analyses need validation via more randomized controlled trials. This review synthesizes recent CAT research (focused on VTE) across epidemiology, pathophysiology, laboratory assessments, and management. It analyzes how cancer type, patient conditions, and drug-drug interactions influence anticoagulant selection, supported by a review of the corresponding experimental evidence. Additionally, the article addresses key clinical scenarios (e.g., intracerebral hemorrhage, pregnancy, pediatric and adolescent patients, and COVID-19) to aid clinical decision-making, delineates unresolved clinical controversies, and integrates high-quality cohort/subgroup data to guide meta-analysis validation. By summarizing risk-benefit consideration, this article provides a framework for complex cases and informs future RCT design.}, }
@article {pmid42163969, year = {2026}, author = {Hendriks, S and Grady, C and Fitzgerald, ML and Gross, RS and Maughan, C and Peluso, MJ and Varma, S and Nath, A and Rid, A}, title = {The next phase in Long COVID research: addressing the ethical challenges in trials of disease-modifying treatments.}, journal = {EClinicalMedicine}, volume = {95}, number = {}, pages = {103918}, pmid = {42163969}, issn = {2589-5370}, abstract = {Almost five years after COVID-19 emerged, multiple scientific uncertainties remain about why some people experience ongoing symptoms long after being infected with SARS-CoV-2 (Long COVID). The pathophysiology underlying Long COVID and its potential to represent several endotypes are still under investigation. These scientific uncertainties around Long COVID have been cited as a reason to delay treatment trials until the disease is better understood. In this paper, a group of bioethicists, clinician-scientists and people with lived experience with Long COVID argue that it is ethically imperative to conduct trials of disease-modifying treatments for Long COVID now. Furthermore, we argue that although conducting such trials can pose ethical challenges, these challenges can be overcome through careful research priority-setting, rigorous trial design, fair participant selection, and ensuring that the risk-benefit profile is favorable.}, }
@article {pmid42164546, year = {2026}, author = {Petrovan, A and Puiu, L and Pop, CM}, title = {COVID-19, the disease that changed the world.}, journal = {Medicine and pharmacy reports}, volume = {99}, number = {2}, pages = {91-105}, pmid = {42164546}, issn = {2668-0572}, abstract = {Five years ago, the COVID-19 coronavirus emerged as an invisible threat that profoundly disrupted the world, becoming a public health challenge. The COVID-19 pandemic has shown us how important it is to have health systems that can quickly find and track new viruses as they spread and has ushered in a new era of genomic surveillance, allowing scientists to track the evolution of the coronavirus, providing public health strategies. Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), responsible for the COVID-19 pandemic, has been associated with very important global morbidity and mortality. The discovery of SARS-CoV-2 in bats and pangolins in South Asian countries indicates that SARS-CoV-2 likely originated from wildlife being the third highly pathogenic human coronavirus. The increased contagiousness of SARS-CoV-2 virus was due to the spike glycoprotein (S) that favors the attachment of the virus to the cell surface. SARS-CoV-2 infection triggers a damaging triad of oxidative stress, intense inflammation with cytokine storm, and endothelial dysfunction, leading to widespread cellular damage, blood clotting with thrombosis, and organ failure by overwhelming the body's antioxidant defenses, damaging blood vessel linings, and promoting hyperinflammation, all crucial factors in severe COVID disease. The purpose of the review is to make a synthesis of the data known so far about SARS-CoV-2 virus etiology, the complex interactions between the virus and the host, imbalanced immune response and cytokine storm, molecular mechanisms by which the spike protein drives endothelial dysfunction and, multisystemic pulmonary, cardiovascular, neurological, renal involvement.}, }
@article {pmid42164657, year = {2026}, author = {Li, K and Cao, R and Li, M and Tian, Z and Fan, H and Hong, B and Liu, X}, title = {Organoids: From Bench to Bedside Applications.}, journal = {MedComm}, volume = {7}, number = {}, pages = {e70768}, pmid = {42164657}, issn = {2688-2663}, abstract = {Organoids are three-dimensiona(3D) models derived from stem cells that closely replicate the structure and cellular complexity of human tissues, providing physiologically relevant platforms for biomedical research. This technology addresses the limitations of two-dimensional (2D) cultures, reduces species-specific discrepancies, and is particularly valuable for investigating virus-host interactions and pathogenic mechanisms under near-physiological conditions. This review systematically outlines key advancements in organoid-based virology, including the propagation of hard-to-culture pathogens such as human rhinovirus C (HRV-C) and norovirus (NoV), as well as novel insights into viral pathogenesis, including the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Zika virus (ZIKV) infection, and the translational utility of organoids for antiviral drug screening and preclinical assessment. It further examines the use of organoids in modeling cancer and neurological diseases, compares the strengths and limitations of different cellular sources, and discusses their potential integration with emerging technologies such as CRISPR gene editing and 3D bioprinting. In addition, it maps a translational pathway from molecular mechanisms to clinical practice to facilitate the study of disease mechanisms and accelerate drug and vaccine development. Finally, holistic strategies are proposed to address existing challenges, such as the lack of immune components and inadequate vascularization. Together, these efforts aim to promote the broader adoption of organoid technology across the life sciences and translational medicine.}, }
@article {pmid42165098, year = {2026}, author = {Li, S and Qiu, L and Li, Y and Liu, X and Luo, Z and Liu, J and Ma, X}, title = {Global prevalence of prolonged grief disorder during the COVID-19 pandemic under standardized diagnostic frameworks: A systematic review and meta-analysis.}, journal = {Psychological medicine}, volume = {56}, number = {}, pages = {e160}, pmid = {42165098}, issn = {1469-8978}, mesh = {Humans ; *COVID-19/psychology/epidemiology ; Prevalence ; *Prolonged Grief Disorder/epidemiology/diagnosis ; Pandemics ; Global Health ; }, abstract = {Prolonged grief disorder (PGD), recently classified in ICD-11 and DSM-5-TR, is characterized by persistent and functionally impairing grief lasting beyond 6-12 months. The COVID-19 pandemic was accompanied by widespread mortality, social isolation, disrupted mourning rituals, and social disconnection, raising concerns about a potentially high burden of PGD during the pandemic period. We conducted a systematic review and meta-analysis, following PRISMA guidelines and PROSPERO registration (CRD42023463720), to estimate PGD prevalence under standardized ICD-11 and DSM-5-TR diagnostic frameworks and to examine potential moderators during the COVID-19 pandemic. PubMed, EMBASE, and the Cochrane Library were searched from inception to October 2024. Eligible studies included adults who experienced bereavement during the pandemic and were assessed using validated PGD instruments (PG-13-R, ICG, BGQ). Random-effects models were applied to pool prevalence estimates, with subgroup and meta-regression analyses. Thirteen studies comprising 5,766 participants were included. The pooled prevalence of PGD during the pandemic period was 24% (95% CI: 13%-36%), with the highest estimates observed in China (43%, 95% CI: 33%-54%). In the overall pooled analysis, studies applying DSM-5-TR criteria yielded lower prevalence estimates than those using ICD-11 criteria (18% vs.26%, p = 0.41). Digital interventions showed no statistically significant pooled effects (Hedges' g = -0.38, 95% CI: -0.90 to 0.14). The high and geographically heterogeneous prevalence of PGD observed during the COVID-19 pandemic underscores the need to strengthen mental health surveillance, standardized assessment, and service accessibility in large-scale public health emergencies, and provides important evidence to inform population-level interventions and resource allocation strategies.}, }
@article {pmid42165724, year = {2026}, author = {Dhar, RR and Reshmi, B and Holla, R}, title = {Barriers to help-seeking for cancer in India: A scoping review.}, journal = {The Indian journal of medical research}, volume = {163}, number = {4}, pages = {534-540}, pmid = {42165724}, issn = {0971-5916}, mesh = {Humans ; India/epidemiology ; *Neoplasms/epidemiology/therapy/diagnosis/psychology ; *Health Services Accessibility ; *Patient Acceptance of Health Care ; *Help-Seeking Behavior ; }, abstract = {Background and objectives Cancer is a leading cause of death in India, with delays in diagnosis and treatment contributing to poor outcomes. Although several studies document these delays, most focus on single cancer types or specific regions. This review aimed to synthesise evidence across cancers to identify barriers to help-seeking and their implications for cancer control in India. Methods A scoping review was conducted using Arksey and O'Malley and Levac frameworks, guided by the PRISMA-ScR checklist. The protocol was registered on the Open Science Framework. Systematic searches were carried out in PubMed, EMBASE, and Scopus for studies published in English between January 2010 and December 2024. Eligible studies included empirical research on barriers to help-seeking among individuals with cancer in India. Titles and abstracts were screened using Rayyan, followed by full-text review. Data were charted and synthesised thematically. Results Of 349 records screened, 30 studies met the inclusion criteria. Barriers were categorised as: financial and economic, lack of awareness/knowledge, cultural stigma and embarrassment, reliance on alternative medicine, systemic and health system inefficiencies, psychological fear and distrust, family and gender bias, and COVID-19-related disruptions. These factors collectively led to delays in presentation, diagnosis, and treatment of cancer in India. Interpretation and conclusions Delays in cancer care in India arise from intersecting socio-economic, cultural, systemic, and gendered barriers. Strengthening insurance coverage, patient navigation, awareness initiatives, gender-sensitive services, and long-term investments in rural infrastructure and psychosocial support are critical to improving timely cancer care.}, }
@article {pmid42166076, year = {2026}, author = {Haimi, M}, title = {Addressing the silent epidemic: a narrative review and evidence synthesis of digital health and telehealth interventions for loneliness in older adults.}, journal = {Aging clinical and experimental research}, volume = {38}, number = {1}, pages = {}, pmid = {42166076}, issn = {1720-8319}, mesh = {Humans ; *Loneliness/psychology ; Digital Health ; *Telemedicine ; *COVID-19/epidemiology/psychology ; Social Isolation/psychology ; Aged ; SARS-CoV-2 ; Depression ; }, abstract = {BACKGROUND: Loneliness and social isolation represent major threats to the health and well-being of older adults, conferring elevated risks for depression, cognitive decline, cardiovascular disease, and premature mortality. The rapid proliferation of digital health technologies and telehealth services-accelerated by the COVID-19 pandemic-has opened new pathways for addressing these challenges at scale.
OBJECTIVE: This narrative review synthesizes the current evidence on the effectiveness of digital health and telehealth interventions in reducing loneliness and social isolation among older adults, examines the diverse modalities employed, identifies barriers to equitable adoption, and proposes directions for future research.
METHODS: A narrative synthesis was conducted drawing on systematic reviews, meta-analyses, randomized controlled trials, and observational studies identified through PubMed, PsycINFO, CINAHL, Cochrane Library, and Web of Science, primarily spanning 2020-2025. Interventions examined include telehealth video visits, empathy-focused telephone programs, group videoconferencing, digital mental health platforms, mobile health applications, social robots, and AI-enabled companions.
RESULTS: Telehealth video visits, empathy-focused telephone programs, and group-based videoconferencing demonstrate meaningful reductions in loneliness, depression, and anxiety in several RCTs and pilot studies. Digital mental health platforms incorporating cognitive behavioral therapy and mindfulness show promise, as do AI-enabled social robots in institutional and community settings. However, meta-analytic evidence reveals considerable heterogeneity: some pooled analyses report modest to null overall effects, while others find medium effect sizes (d = - 0.47). Intervention effectiveness appears contingent on design features, population characteristics, training support, and integration with existing social networks. The digital divide-limited digital literacy, technology access, usability challenges, and preference for in-person care-remains a challenging barrier to equitable implementation.
CONCLUSIONS: Digital health and telehealth interventions hold considerable promise for mitigating loneliness among older adults. However, their benefits cannot be realized without systematically addressing the digital divide. Large-scale, well-powered RCTs with standardized outcome measures and longer follow-up periods are urgently needed, alongside implementation science research to translate evidence into scalable practice.}, }
@article {pmid42166945, year = {2026}, author = {Duy, NBP}, title = {What are the intellectual foundations and thematic structures shaping flow experience research in tourism?.}, journal = {Acta psychologica}, volume = {267}, number = {}, pages = {107104}, doi = {10.1016/j.actpsy.2026.107104}, pmid = {42166945}, issn = {1873-6297}, mesh = {Humans ; *Tourism ; *Virtual Reality ; *COVID-19 ; }, abstract = {This study addresses the fragmented state of research on flow experience in the tourism sector, an increasingly important concept in the modern experience economy. The main objective was to systematize and map the intellectual structure, development, and future trajectory of this field. Applying a hybrid bibliometric-systematic literature review method, the paper analyzed 118 articles from the Scopus database (2011-2025) using VOSviewer and Bibliometrix. The study's conclusions were further reinforced and validated through a comparative analysis with data extracted from the Web of Science database. Key findings revealed two distinct research phases, with a significant boom after 2020 driven by the impact of the COVID-19 pandemic and the rise of virtual reality (VR) tourism. Thematic analysis revealed a clear knowledge structure, with basic themes serving as the theoretical basis, while motor themes (authenticity and tourism live streaming) drove the current research. This landscape was divided into a psychological core, focused on exploring the nature of the experience, and a managerial core, centered on applying the flow experience for strategic goals. This study contributes a new conceptual framework that organizes the research field into antecedents, flow state, and outcomes, while also providing practical guidance for managers to design engaging experiences.}, }
@article {pmid42167127, year = {2026}, author = {Boamah, SA and Sedzro, MT and Alexander, A and Ramirez, K and Shams, S and Rugole, D and Zhou, F and Belita, E}, title = {Harnessing leadership experiences for improved healthcare delivery: A scoping review of the experiences of healthcare leaders in navigating crisis.}, journal = {International journal of nursing studies}, volume = {181}, number = {}, pages = {105577}, doi = {10.1016/j.ijnurstu.2026.105577}, pmid = {42167127}, issn = {1873-491X}, mesh = {*Leadership ; Humans ; *COVID-19/epidemiology ; *Delivery of Health Care/organization & administration ; Pandemics ; SARS-CoV-2 ; }, abstract = {BACKGROUND: The COVID-19 pandemic placed unprecedented strain on health care systems worldwide, exposing and amplifying longstanding vulnerabilities in leadership and management structures. Although the roles of frontline healthcare workers have been widely documented, the experiences of healthcare leaders remain understudied.
OBJECTIVE: To systematically synthesize global evidence on healthcare leaders' experiences in navigating crises, with a particular focus on the pandemic; and to derive actionable strategies to strengthen crisis preparedness, response capacity, and health system resilience.
DESIGN: A scoping review was conducted following Arksey and O'Malley's framework. The reporting of the review adhered to the recommendations outlined in the PRISMA-ScR checklist.
METHODS: Peer-reviewed articles published in English from 2020 to 2026 that reported on the experiences of healthcare leaders were included. Gray literature, review articles, and studies that did not explicitly focus on managerial experiences were excluded. Databases including EMBASE, Emcare, CINAHL, MEDLINE (Ovid), PsycINFO, Scopus and Web of Science were searched. A total of 20,107 records were identified, of which 10,203 were screened after deduplication. After full-text review, 277 articles were extracted for analysis. Data extraction followed a structured approach, capturing study characteristics, healthcare settings, and key findings. Thematic analysis was conducted using Delve software, with systematic coding applied to ensure analytical rigor.
RESULTS: Three interrelated themes with 16 sub-themes emerged: (1) navigating leadership challenges during crisis, (2) leadership strategies and adaptive responses, and (3) implications for future crisis leadership and resilient health systems. The findings illuminate how adaptive leadership, judicious resource allocation, transparent communication, digital transformation, and attention to workforce mental health function as critical mechanisms for navigating complex health crises.
CONCLUSIONS: This study demonstrates that effective healthcare crisis leadership extends beyond operational competence to require adaptability, clear communication, and sustained commitment to workforce well-being. Strengthening leadership capacity, investing in interoperable digital infrastructure, and embedding mental health supports within crisis preparedness frameworks will be critical to enhancing health system responsiveness and sustaining resilient care delivery during future global disruptions.
SOCIAL MEDIA ABSTRACT: Healthcare leaders showed great adaptability during COVID-19, but lasting system resilience requires more than individual effort. It demands investment in equitable, well-resourced systems, ethical leadership, integrated digital infrastructure, and cultures that support leader and staff well-being. [A scoping review | @SABoamah].}, }
@article {pmid42167688, year = {2026}, author = {Valenzuela-Fuenzalida, JJ and Valarezo, LM and Silva, V and Delgado, F and Nazar-Izquierdo, D and Bruna-Mejias, A and Nova-Baeza, P and Donoso, MO and Amaro, GO and Cifuentes-Suazo, G and Moya, MP and Gimeno, JS and Konschake, M and Loaiza-Giraldo, JP}, title = {Occurrence of Myocarditis in Patients Immunized with Different Types of COVID-19 Vaccines: A Systematic Review and Meta-Analysis.}, journal = {Virus research}, volume = {369}, number = {}, pages = {199748}, pmid = {42167688}, issn = {1872-7492}, mesh = {Humans ; *COVID-19/prevention & control ; *COVID-19 Vaccines/adverse effects/administration & dosage ; *Myocarditis/epidemiology/etiology ; SARS-CoV-2/immunology ; Vaccination/adverse effects ; }, abstract = {BACKGROUND: Myocarditis has emerged as a rare but clinically relevant adverse event reported after COVID-19 vaccination, particularly following widespread use of vaccines based on novel molecular platforms. Given variability in vaccine technologies, population characteristics, and surveillance methodologies, a comprehensive quantitative synthesis is required to better characterize the occurrence of post-vaccination myocarditis. This study aimed to characterize the distribution of reported myocarditis cases among individuals receiving COVID-19 vaccines, including mRNA, viral vector, and protein-subunit platforms, and to synthesize available evidence on reported post-vaccination myocarditis across different demographic and geographic subgroups.
METHODS: This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD420251118332). MEDLINE, Web of Science, Scopus, CINAHL, Google Scholar, and LILACS were searched from inception to January 2024 for observational studies reporting myocarditis following COVID-19 vaccination. Cohort, case-control, cross-sectional studies, and case series were eligible. Study quality was assessed using the ROBINS-I tool. Random-effects models were applied to estimate pooled proportions with 95% confidence intervals (CIs). Statistical heterogeneity was quantified using the I² statistic, and prespecified subgroup analyses were performed by sex, age, geographic region, and vaccine platform. Publication bias was explored using funnel plot analysis.
RESULTS: Fifty-nine studies comprising 196,478,861 vaccinated individuals and 13,348 reported myocarditis cases were included. Due to substantial heterogeneity in study designs and denominators, pooled estimates represent the proportion of myocarditis cases within reported samples rather than population-level incidence or risk. Across all included studies, the pooled proportion of myocarditis cases within reported study samples was 34% (95% CI: 19-50%), with considerable heterogeneity (I² = 100%). These estimates should not be interpreted as population-level incidence or risk. Reported myocarditis cases were more frequently observed among males (72%, 95% CI: 58-86%) than females (56%, 95% CI: 35-77%) and were predominantly identified in individuals younger than 40 years. Subgroup analyses by region and vaccine platform should be interpreted cautiously due to methodological variability and potential selection bias. Funnel plot asymmetry suggested possible small-study effects.
CONCLUSIONS: This systematic review and meta-analysis aimed to characterize the distribution of reported myocarditis cases following COVID-19 vaccination rather than to estimate population-level incidence or risk. Although pooled proportions within reported samples were substantial, these estimates do not reflect population-level incidence. Available evidence suggests that myocarditis following COVID-19 vaccination remains uncommon at the population level, predominantly affecting younger males and more commonly reported after mRNA-based vaccines. Most reported cases appear to follow a benign and self-limited clinical course. These findings support the overall favorable benefit-risk profile of COVID-19 vaccines while underscoring the need for continued pharmacovigilance and more robust epidemiological studies to better characterize the epidemiology of vaccine-associated myocarditis.}, }
@article {pmid42168400, year = {2026}, author = {Si, Y and Zhu, X and Zhang, Y and Zhou, Z and Liu, Y and Ma, H}, title = {PANoptosis as a Therapeutic Target for COVID-19.}, journal = {Current microbiology}, volume = {83}, number = {7}, pages = {}, pmid = {42168400}, issn = {1432-0991}, support = {No.2023-CX-TD-66//the Innovation Capability Support Program of Shaanxi/ ; 82202367//the National Natural Science Foundation of China/ ; }, mesh = {Humans ; *COVID-19/immunology/virology/pathology ; *SARS-CoV-2/drug effects/physiology ; *Apoptosis/drug effects ; Pyroptosis/drug effects ; *Necroptosis/drug effects ; Cytokine Release Syndrome/immunology ; *COVID-19 Drug Treatment ; Antiviral Agents/therapeutic use/pharmacology ; Post-Acute COVID-19 Syndrome ; Animals ; }, abstract = {Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has sparked a global pandemic with extensive spread, posing a severe threat to public health due to its high mortality rate in severe cases. The continuous emergence of variants with enhanced immune evasion capabilities, coupled with the prolonged and debilitating symptoms of Long Coronavirus Disease (Long COVID) such as intermittent dyspnea, persistent fatigue, and cognitive impairment (brain fog), has become a major global concern. The pathogenesis of COVID-19 is a complex interplay of direct viral cytotoxicity and an overwhelming secondary inflammatory response in the host, with the latter being a key driver of immune homeostasis disruption. Accumulating evidence indicates that PANoptosis, an integrated programmed cell death process involving the crosstalk and coordinated activation of apoptosis, pyroptosis, and necroptosis, is closely linked to the cytokine storm syndrome triggered by SARS-CoV-2 infection. As a critical mediator of various infectious diseases, PANoptosis plays a pivotal role in regulating the balance between viral clearance and pathological inflammation. This review specifically targets SARS-CoV-2, adopting a "basic mechanism-molecular regulation-therapeutic target-clinical translation" framework. We elaborate on SARS-CoV-2-induced PANoptosis mechanisms, including its constituent cell death pathways and contributions to cytokine storms. By dissecting the intricate regulatory networks between PANoptosis and interferon (IFN) signaling during viral infection, this work aims to identify potential therapeutic targets and provide novel insights for the development of effective strategies to mitigate severe COVID-19 and its long-term sequelae.}, }
@article {pmid42168956, year = {2026}, author = {Ottiger, M and Poppele, I and Seefen Soliman, AS and Schlesinger, T and Müller, K}, title = {Factors influencing work ability and return-to-work in individuals affected by post-COVID: a systematic review.}, journal = {BMC public health}, volume = {26}, number = {1}, pages = {}, pmid = {42168956}, issn = {1471-2458}, mesh = {Humans ; *Return to Work/statistics & numerical data ; *COVID-19/psychology ; Post-Acute COVID-19 Syndrome ; Working Conditions ; Work Capacity Evaluation ; }, abstract = {BACKGROUND: Post-COVID is associated with prolonged impairments in work ability and return-to-work (RTW). The heterogeneity and complexity of post-COVID symptoms present major obstacles to a sustainable RTW. This systematic review aims to identify facilitators and obstacles affecting work ability and RTW.
METHODS: Eligible studies examined factors affecting work ability or RTW in post-COVID patients. Systematic search of literature was performed up to March 2025 using MEDLINE, CENTRAL, PsycINFO, Scopus, and Web of Science. Study selection followed the Preferred Reporting Items for Systematic Review and Meta-analysis Statement. Risk of bias was evaluated with the "Joanna Briggs Institute Critical Appraisal Tools".
RESULTS: 31 studies published between 2021 and 2025 were included in the analysis. Most originated from Europe and North America with sample sizes reaching from small qualitative studies to large registry-based cohort studies. The identified factors (N = 59; facilitators: n = 25, obstacles: n = 34) could be grouped into four domains: Disease-related factors associated with SARS-CoV-2 infection (n = 8), Individual biopsychosocial factors (n = 35), Contextual workplace factors (n = 10), Healthcare system and service-related factors (n = 6). The most frequently reported obstacles were fatigue and neurocognitive impairments, stigmatization, lack of managerial support, and rigid RTW policies. Adequate workplace adjustments, interprofessional therapeutic interventions, and self-management strategies facilitate work ability and RTW.
CONCLUSIONS: Work ability and RTW with post-COVID is determined by complex multilevel interactions of biopsychosocial, workplace-related, and systemic factors. Findings suggest that coordinated care and workplace adaptations may help to bridge the gap between medical recovery and occupational participation. Future research should aim to better understand how multiple factors interact in individual cases to develop targeted, evidence-based interventions and policy frameworks.
PROSPERO REGISTRATION NUMBER: CRD420251010826.}, }
@article {pmid42168998, year = {2026}, author = {Meshref, M and Hussein, AS and Allam, SA and Moghib, K and Younis, H and Shalaby, N}, title = {Viral associations in multiple sclerosis: pathogenetic mechanisms and therapeutic implications.}, journal = {Virology journal}, volume = {23}, number = {1}, pages = {}, pmid = {42168998}, issn = {1743-422X}, mesh = {Humans ; *Multiple Sclerosis/virology/immunology/therapy/etiology ; *Virus Diseases/complications/virology/immunology ; Animals ; Herpesviridae/pathogenicity ; }, abstract = {Multiple sclerosis (MS) is a neurological inflammatory disease with a complex etiology involving the dysregulated immune system, chronic inflammation, and genetic susceptibility. Although the precise cause of MS is unknown, previous studies have found a strong link between MS and certain viral infections, leading researchers to speculate that viruses may play a role in MS pathogenesis by acting as environmental triggers. We present a comprehensive review of viral associations with MS, focusing on viruses with strong evidence for involvement in disease development, including members of the Herpesviridae family-such as Epstein-Barr virus, human herpesvirus 6, varicella-zoster virus, herpes simplex virus 1, cytomegalovirus, and SARS-CoV-2. Those viruses appear to modulate the neuro-immunological system in genetically susceptible individuals, leading to immune-mediated demyelination. Viral exposure is thought to represent an early initiating or permissive event that triggers downstream immune dysregulation, ultimately leading to MS onset in predisposed hosts. Additionally, they can cause latent infections with episodes of reactivation, which might be associated with relapsing presentation of MS. Several theories have been proposed to explain the viral etiology of MS, including molecular mimicry, virus-induced inflammatory response, autoreactive T- and B-cell activation, and increased susceptibility to antigenic exposure. Besides addressing the current knowledge gap, we also highlight future research directions for effective MS management, including developing experimental models and conducting clinical trials, identifying specific biomarkers, and investigating novel antiviral agents. An improved understanding of MS etiology and the role of viruses in its physiopathology may enable more targeted interventions and better treatment outcomes.}, }
@article {pmid42169206, year = {2026}, author = {Ropeter, J and Overhageböck, N and Dreier, M and Meyerdierks, D and Imran, A and Heinsohn, T and Steinmann, M and Kuhlmann, A and Jahn, B and Lange, B and Klett-Tammen, CJ and Harries, M}, title = {Impact of the COVID-19 pandemic on diagnosis, and healthcare utilization, among patients with cancer (lung, breast, and pancreas) and cardiovascular diseases (HF, AF, hypertensive, and chronic ischemic heart disease) in Germany: two systematic reviews.}, journal = {Systematic reviews}, volume = {15}, number = {1}, pages = {}, pmid = {42169206}, issn = {2046-4053}, support = {031L0299H//Bundesministerium für Forschung, Technologie und Raumfahrt/ ; }, mesh = {Humans ; *COVID-19/epidemiology ; Germany/epidemiology ; *Cardiovascular Diseases/diagnosis/therapy/epidemiology ; *Patient Acceptance of Health Care/statistics & numerical data ; *Neoplasms/diagnosis/therapy/epidemiology ; Pandemics ; SARS-CoV-2 ; Female ; Hospitalization/statistics & numerical data ; }, abstract = {BACKGROUND: The COVID-19 pandemic and related non-pharmaceutical interventions (NPIs) (e.g., lockdowns and contact restrictions) disrupted routine healthcare delivery. In Germany, these measures affected diagnostic and treatment services for people with cancer and cardiovascular diseases, potentially delaying diagnosis and adversely influencing outcomes. We assessed whether and to what extent diagnosis, health utilization and health outcome among patients with selected cancer and cardiovascular conditions changed in Germany during the pandemic.
METHODS: We conducted two systematic reviews of studies from Germany on selected cancers (breast, lung and pancreatic) and cardiovascular conditions (atrial fibrillation/flutter, heart failure, hypertensive and chronic ischemic heart disease). Protocols were registered in PROSPERO and the reviews were reported in accordance with PRISMA. We searched PubMed, Web of Science, Cochrane Library, Scopus, and Embase and screened grey literature. Outcomes included changes in new diagnoses, healthcare utilization, treatment, and disease-specific mortality during the pandemic (2020-2023) compared with the pre-pandemic period (2018-2019). Two reviewers independently screened records, extracted data, and assessed risk of bias using an adapted ROBINS-E tool. Owing to heterogeneity, we synthesized findings narratively.
RESULTS: We screened 1991 records for cancer and 4,981 records for cardiovascular diseases, and included 9 cancer studies and 10 cardiovascular studies. For cancer, several studies reported a relative reduction in new breast and lung cancer diagnoses of up to 25% during lockdown periods; hospital admissions decreased by up to 9%. For cardiovascular conditions, hospital admissions for atrial fibrillation/flutter and heart failure decreased by up to 20%, particularly during pandemic peaks. Evidence on treatment delays, changes in treatment, and mortality was limited, and outcomes for other included diagnoses were often not reported.
DISCUSSION: The available evidence indicates substantial reductions in hospital admissions and new diagnoses among patients with cancer and cardiovascular disease in Germany during the pandemic, suggesting major disruptions to care delivery. However, heterogeneity and gaps in the evidence base limit a comprehensive assessment of downstream outcomes. More comprehensive, linked data and further research are needed to quantify the full pandemic's impact and to strengthen health-system resilience for future crises.}, }
@article {pmid42169472, year = {2026}, author = {Das, HK and Amudhan, S and Bhaskarapillai, B and Sasi, S and Sridhar, R and Prasad, NN and Kanmani, TR}, title = {Prevalence of Common Mental Health Problems Among Transgender and Non-Binary Individuals During the COVID-19 Pandemic: A Systematic Review & Meta-Analysis.}, journal = {The International journal of social psychiatry}, volume = {}, number = {}, pages = {207640261453025}, doi = {10.1177/00207640261453025}, pmid = {42169472}, issn = {1741-2854}, abstract = {INTRODUCTION: The COVID-19 pandemic has exacerbated the mental health challenges globally and adversely affected the marginalised populations, including transgender and non-binary (TNB) individuals. Despite evidence, there is a lacuna of a systematic synthesis explicitly focussing on the prevalence of screen-positive common mental health problems, as prior reviews either examined sexual and gender minority populations as a whole or overlooked the full scope of pandemic-related mental health challenges, which the current review seeks to address through systematic review and meta-analysis.
METHODOLOGY: A comprehensive literature search was conducted across PubMed, Scopus, PsycINFO, and Web of Science, applying the PRISMA 2020 guidelines between March and August 2025. Eligible studies reporting the mental health outcomes of TNB individuals during the pandemic were screened, extracted, and critically appraised with the help of the COVIDENCE and JBI checklists for analytical cross-sectional studies. Meta-analyses were performed using a DerSimonian-Laird random effects model with the Hartung-Knapp-Sidik-Jonkman (HKSJ) adjustment to estimate pooled prevalence with 95% confidence intervals. Heterogeneity was quantified with I[2] statistics.
RESULTS: For depression (n = 4,832), the screen-positive pooled prevalence was estimated as 0.59 (95% CI [0.47, 0.70]; I[2] = 98.23%). The pooled prevalence for screen-positive anxiety (n = 2,833) and substance (n = 1,632) use was 0.50(95% CI [0.37, 0.63]; I[2] = 94.04%) and 0.47 (95% CI [0.16, 0.79]; I[2] = 98.58%), respectively. It is identified that the pandemic reinforced existing healthcare disparities, with disrupted gender-affirming care (e.g. hormone therapy, surgeries) significantly associated with increased psychological distress and gender dysphoria among transgender and gender diverse individuals.
CONCLUSION: Mental health problems among TNB individuals were markedly elevated during the COVID-19 pandemic, highlighting the urgent need for tailored mental health interventions, uninterrupted gender-affirming care, and policies that address systemic social stigma and discrimination. Strengthening telehealth, community-based supports, and inclusive public health strategies are essential to mitigate disparities and promote resilience in this population.}, }
@article {pmid42170790, year = {2026}, author = {Carretero Rey, M}, title = {[Epidemiological surveillance of Andes virus: have we really learned anything after COVID-19?].}, journal = {Revista espanola de salud publica}, volume = {100}, number = {}, pages = {}, pmid = {42170790}, issn = {2173-9110}, mesh = {Humans ; Animals ; COVID-19 ; Zoonoses/epidemiology ; *Hantavirus Infections/epidemiology/transmission/prevention & control ; *Pandemics ; SARS-CoV-2 ; *Epidemiological Monitoring ; *Orthohantavirus ; *Coronavirus Infections/epidemiology ; *Pneumonia, Viral/epidemiology ; *Betacoronavirus ; Disease Outbreaks ; *Communicable Diseases, Emerging/epidemiology ; Spain/epidemiology ; Viral Zoonoses/epidemiology ; }, abstract = {Recent Andes virus outbreaks have reignited international debate regarding Public Health preparedness for hantaviruses with documented interpersonal transmission capacity. Unlike other orthohantaviruses, Andes virus has demonstrated person-to-person transmission in specific epidemiological settings, including household and nosocomial environments. The recent emergence of cases linked to multinational outbreaks has prompted renewed assessments and recommendations from international public health organizations. This manuscript presents an epidemiological reflection on current surveillance challenges associated with emerging hantaviruses following the experience gained during the COVID-19 pandemic. It also reviews aspects related to zoonotic surveillance, molecular monitoring, early detection, and integrated One Health approaches applied to preparedness against future emerging threats. Available evidence highlights the need to strengthen multidisciplinary surveillance systems capable of integrating human, environmental, and zoonotic information in order to improve responses to complex epidemiological scenarios associated with emerging hantaviruses.}, }
@article {pmid42171849, year = {2026}, author = {Simon, MR and Nussbaum, JM and Goodson, K and Allen, BL and Smith, M and Yalif, IU and Cohen, AK}, title = {Industrial Pollution and Health in Louisiana: A Systematic Review of Quantitative and Qualitative Studies.}, journal = {Current environmental health reports}, volume = {13}, number = {1}, pages = {}, pmid = {42171849}, issn = {2196-5412}, support = {P30-ES030284/ES/NIEHS NIH HHS/United States ; 2318237, 2318238, 2318239//National Science Foundation/ ; }, mesh = {Humans ; Louisiana/epidemiology ; *Environmental Exposure/adverse effects ; *Air Pollution/adverse effects ; COVID-19/epidemiology ; *Environmental Pollution/adverse effects ; Oil and Gas Industry ; }, abstract = {PURPOSE OF REVIEW: Louisiana has one of the largest concentrations of petrochemical industry in the USA. Many studies have assessed patterns of industrial pollution and health in Louisiana; we aim to systematically review this evidence. We systematically searched PubMed, Web of Science, Embase, APA PsycInfo, and GreenFILE for peer-reviewed papers published 1999-2024 that reported geographical variation in health or industrial pollution, and/or tested for an association between the two in Louisiana. We used Covidence to support standardized review and extraction.
RECENT FINDINGS: We identified 2485 non-duplicate papers in our search; 53 met the inclusion criteria. Most reported quantitative findings. All studies of industrial pollution described air pollution (some also described other pollution). Studies described various health outcomes, including cancer, respiratory health, mortality, and COVID-19. Overall, people who lived closer to industrial activity had higher pollution exposure and worse health. Black and lower-income residents were exposed to more industrial activity than white and higher-income residents. Twenty-one studies assessed statistical associations between industrial pollution and health; many found an association. Twenty-one studies were quantitative and adjusted for confounding, 29 studies did not adjust for confounding (including qualitative studies), and three studies did not adjust for confounding and had authors with industry ties. Evidence suggests that there is a higher burden of air pollution and worse health outcomes in industrialized areas of Louisiana. While there was some evidence of significant associations between industrial pollution and health outcomes, research with larger sample sizes and improved pollution exposure measurements could be informative.}, }
@article {pmid42172294, year = {2026}, author = {Swartwood, NA and Singh, N and Mortazavi, SA and Can, MH and Cui, H and Ryuk, DK and MacPherson, P and Horton, KC and Menzies, NA}, title = {Differences in tuberculosis prevalence by sex in low- and middle-income countries over 1993-2025: A systematic review and meta-analysis.}, journal = {PLoS medicine}, volume = {23}, number = {5}, pages = {e1005114}, pmid = {42172294}, issn = {1549-1676}, mesh = {Humans ; Prevalence ; Male ; Female ; *Developing Countries/economics ; Sex Factors ; *Tuberculosis/epidemiology ; Risk Factors ; }, abstract = {BACKGROUND: Global and national initiatives to combat tuberculosis (TB) have expanded over recent years. Despite this, the TB burden remains high in some population groups, with men recognized as having elevated TB risks. Summary measures of sex differences in TB prevalence were last estimated in 2016. Since then, many additional prevalence surveys have been conducted, including in the highest TB burden countries. We conducted a systematic review of sex-stratified TB prevalence survey data published over 1993-2025, to provide updated estimates of male-to-female (M:F) TB prevalence ratios and determine whether sex-related disparities in TB burden have closed over time.
METHODS AND FINDINGS: We identified surveys reporting community-representative, sex-stratified estimates of pulmonary TB prevalence in low- and middle-income countries (LMICs), including surveys from an earlier review (covering January 1993-March 2016) and a new systematic review (covering 1st December 2015-13th October 2025). This review was prospectively registered with PROSPERO (CRD42024503853) and included searches of PubMed, Embase, Global Health, the Cochrane Library, Africa Index Medicus, LILACS, and SciELO. We extracted data on bacteriologically confirmed and smear-positive TB prevalence among adults (aged ≥ 15 years), stratified by sex. Risk of bias was evaluated using eight criteria specific to prevalence surveys. We fit multi-level Bayesian regression models with study- and country-level random effects to estimate the M:F ratio of TB prevalence (male prevalence divided by female prevalence), overall and for key subgroups. In meta-regression analyses, we estimated how prevalence ratios varied over time and according to known TB risk factors and TB case definitions. We identified 10,124 publications and extracted data from 100 eligible studies representing 102 unique prevalence surveys and 4,658,310 participants (45.6% male) in 33 LMICs. TB prevalence was higher in men than women in 90/102 of the included surveys, with a pooled M:F prevalence ratio of 2.02 (95% credible interval (CrI): 1.71, 2.34) for bacteriologically confirmed TB and 2.38 (95% CrI: 1.91, 2.90) for smear-positive TB. Time trend analyses showed a 2.0% (95% CrI: -0.2, 4.5%) average annual change in the M:F ratio of bacteriologically confirmed TB over the study period. The M:F prevalence ratio was estimated to be higher for countries with greater excess HIV prevalence among men, and countries with greater gender equity (as measured by the United Nation's Gender Development Index). The estimated M:F prevalence ratio was also higher for surveys that did not restrict testing to individuals reporting TB symptoms. Study limitations include heterogeneity in survey methods and definitions, as well as limited data from the Americas, Eastern Mediterranean, and Europe WHO world regions and post-COVID-19 period.
CONCLUSIONS: Men in LMICs consistently experience TB at a higher prevalence than women. Time trend estimates are uncertain, but consistent with widening sex differences in TB prevalence over the last three decades, despite efforts to address the risk factors underlying this excess TB burden.}, }
@article {pmid42172568, year = {2026}, author = {Santos, C and Da Ponte, G}, title = {Moral Distress, Work Engagement, and Meaningful Work in Healthcare: A Narrative Review.}, journal = {Acta medica portuguesa}, volume = {}, number = {}, pages = {}, doi = {10.20344/amp.24197}, pmid = {42172568}, issn = {1646-0758}, abstract = {The psychological well-being of healthcare professionals is increasingly recognized as a critical determinant of patient safety, quality of care, and healthcare system sustainability. Among the constructs most relevant to this domain are moral distress, work engagement, and meaningful work. This narrative review aimed to synthesize conceptual and empirical evidence on these three constructs and to examine their interrelations and implications for healthcare practice. A selective narrative review of the literature was conducted, integrating theoretical frameworks, systematic and integrative reviews, and empirical studies, resulting in a final synthesis of 41 articles. Moral distress arises when clinicians are prevented from acting in accordance with their ethical convictions, often due to institutional or systemic constraints, and has been consistently associated with burnout, turnover, and compromised quality of care. In contrast, work engagement - characterized by vigor, dedication, and absorption - and meaningful work - reflecting the perception that professional activities have meaning and purpose - function as protective factors that enhance resilience and sustain intrinsic motivation. Evidence highlights the central role of organizational climate, leadership, resource availability, and ethical culture in shaping experiences of distress, engagement, and meaningfulness, a dynamic further intensified during the COVID-19 pandemic. The synthesis emphasizes that organizational and systemic interventions, including ethics consultation, supportive leadership, workflow redesign, and resilience-building programs, are essential to mitigate moral distress and promote engagement and meaningful work. The integration of these constructs aligns with the Quadruple Aim, reinforcing the premise that caring for healthcare professionals is indispensable to caring for patients.}, }
@article {pmid42172606, year = {2026}, author = {Vagg, T and Doherty, R and Ranganathan, SC and Plant, BJ}, title = {Reporting of Telehealth Implementation in Cystic Fibrosis: Scoping Review Using a Novel Theory-Based Evaluation Lens.}, journal = {Journal of medical Internet research}, volume = {28}, number = {}, pages = {e86194}, pmid = {42172606}, issn = {1438-8871}, mesh = {*Cystic Fibrosis/therapy ; *Telemedicine ; Humans ; Digital Health ; }, abstract = {BACKGROUND: Many inductive reviews exploring telehealth and its application in health care have identified missing or inconsistently reported implementation data, calling for a standardized approach to telehealth research.
OBJECTIVE: Using cystic fibrosis (CF) as a case exemplar, this study evaluated the adherence of telehealth research to standardized reporting frameworks through a theory-based evaluation lens to assess implementation reporting quality and identify knowledge gaps and strengths across the literature.
METHODS: We conducted an updated systematic review of the PubMed, Scopus, and Web of Science databases using a novel deductive approach to identify relevant scientific papers available in English and focusing on the delivery of telehealth interventions to CF populations as part of or alongside routine CF care. Two relevant reporting checklists were identified in the Equator Network database (Guidelines and Checklist for the Reporting on Digital Health Implementations [iCHECK-DH] and Template for Intervention Description and Replication for Telehealth [TIDiER-telehealth]) to extract data from the papers. Each checklist category was described as being "fully reported" (score=2), "partially reported" (score=1), and "did not report" (score=0) for each paper. An overall score was calculated for adherence to the checklists.
RESULTS: In total, 98 studies published between 2006 and May 2025 were included in this review, with the majority appearing during the COVID-19 pandemic (2021-2022). Most studies were conducted in a single country, predominantly the United States, Australia, and the United Kingdom, and were published in medical journals. Telehealth was variably described, with video call-based models in combination with remote monitoring being most common. The median score was 22/40 (range 11-29, 55.0% adherent) for iCHECK and 15/24 (range 6-23, 62.5% adherent) for TIDiER, demonstrating moderate overall reporting quality. For iCHECK, ≥50% of studies fully reported 6/20 categories, partially reported 9/20 categories, and did not report 3/20 categories. For TIDiER, ≥50% of studies fully reported 4/12 categories, partially reported 6/12 categories, and did not report 1/12 categories, indicating persistent gaps in intervention description despite improved partial reporting.
CONCLUSIONS: Key areas, such as justification for telehealth, target populations, and outcomes, are well documented, offering valuable insights into the rationale for and outcomes associated with telehealth. However, implementation processes remain underreported, partly due to the more recent adoption of frameworks like iCHECK and TIDiER. The clinical implications of the current evidence limit the implementation of telehealth in terms of the ability to assess feasibility and readiness for adoption; understand financial implications and plan sustainably; ensure patient safety, data protection, and equity; interpret outcome data in context; and share, replicate, or scale evidence-based models of care. Strengthening the commitment to standardized telehealth reporting will ultimately support clinical decision-making and improve the effective and equitable integration of telehealth into care.}, }
@article {pmid42172709, year = {2026}, author = {Jing, W and Zheng, M and Yang, X and He, B and Zhang, X and Cui, W}, title = {Micro- and nanoplastics in the central nervous system: Transport pathways, neurotoxicity, and implications for brain disorders.}, journal = {Ecotoxicology and environmental safety}, volume = {319}, number = {}, pages = {120278}, doi = {10.1016/j.ecoenv.2026.120278}, pmid = {42172709}, issn = {1090-2414}, mesh = {Humans ; Animals ; *Central Nervous System/drug effects/metabolism ; *Microplastics/toxicity/pharmacokinetics ; *Brain Diseases/chemically induced ; Blood-Brain Barrier/metabolism ; *Nanoparticles/toxicity ; *Neurotoxicity Syndromes/etiology ; Environmental Pollutants/toxicity ; }, abstract = {Micro- and nano-plastics (MNPs) are widely distributed across global ecosystems and have been extensively detected in human tissues, including the brain. The levels of MNPs are highly correlated with the occurrence of various brain disorders, suggesting the potential central nervous system (CNS) toxicity of MNPs. In this review, we summarize the major circuits by which MNPs may transport into and out of the CNS, including blood-brain barrier crossing, nasal-to-brain routes, and glymphatic system transport. Small-sized MNPs are difficult to eliminate from the brain, which may explain why MNPs may accumulate in the brain. We further discuss the potential neurotoxic effects of MNPs, such as inducing synaptic and neuronal injury, promoting neuroinflammation, dysregulating the neuroendocrine system, and modulating the gut-brain axis. MNP-induced CNS toxicity follows a pattern in which increased susceptibility occurs before direct toxicity. We also review evidence that MNPs, together with environmental and genetic factors, may synergistically contribute to cognitive impairment in Alzheimer's disease, motor dysfunction in Parkinson's disease, and depression- and anxiety-like behaviors. Prenatal exposure to MNPs might induce autism spectrum disorder-related phenotypes in offspring. MNPs could also obstruct cerebral vessels and trigger acute cerebrovascular diseases, as well as promote the entry of viruses such as SARS-CoV-2 into the CNS, thereby increasing the occurrence of neurological symptoms. Finally, this review discusses physical, pharmacological, and plastics substitution interventions designed to regulate MNPs transport in the brain and enhance neuroprotection, thereby reducing CNS toxicity of MNPs.}, }
@article {pmid42173631, year = {2026}, author = {Vaidya, H and Kumar, M}, title = {AI in multi-omics analysis in viral diseases.}, journal = {Progress in molecular biology and translational science}, volume = {222}, number = {}, pages = {229-240}, doi = {10.1016/bs.pmbts.2026.02.005}, pmid = {42173631}, issn = {1878-0814}, mesh = {*Multiomics ; Humans ; *Artificial Intelligence ; *Virus Diseases/genetics/metabolism/virology ; Machine Learning ; Genomics ; Metabolomics ; Proteomics ; }, abstract = {Viral diseases are a serious threat to human health worldwide, and are known to cause long-term health complications as well as epidemics and pandemics. Yet it is difficult to understand how they spread, persist, and damage the body, which requires advanced methods. Multi-omics datasets, including genomics, transcriptomics, epigenomics, proteomics and metabolomics provide a complete view of virus-host interactions. However, the integration and interpretation of these high dimensional datasets remain a major challenge. To overcome this, artificial Intelligence (AI), including machine learning (ML) and network-based approaches, has proven to be a powerful tool to analyze, integrate, and interpret multi-omics data. This chapter discusses examples from studies on SARS-CoV-2, HIV, influenza, EBV and others, where AI has been applied to multi-omics research. These studies show how AI-assisted multi-omics approaches are helping in the advancement of viral disease research by providing better understanding of virus induced cellular changes, identifying biomarkers, designing targeted therapies etc. Therefore, integrating multi-omics with AI enables improved diagnosis, treatment, and prevention of viral diseases. We have also discussed challenges faced in combining multi-omics with AI and highlighted future directions that would help in enhancing AI assisted multi-omics research.}, }
@article {pmid42173633, year = {2026}, author = {Agrawal, P}, title = {AI in multi-omics analysis of COVID-19 patient data.}, journal = {Progress in molecular biology and translational science}, volume = {222}, number = {}, pages = {261-293}, doi = {10.1016/bs.pmbts.2026.01.017}, pmid = {42173633}, issn = {1878-0814}, support = {//Non-US Government Research Support type/ ; }, mesh = {Humans ; *Multiomics ; *COVID-19/genetics/virology/metabolism ; *Artificial Intelligence ; *SARS-CoV-2 ; Genomics ; Proteomics ; Pandemics ; Metabolomics ; Machine Learning ; Data Analytics ; }, abstract = {The COVID-19 pandemic has led to an unprecedented increase in the volume of biological data generation, demonstrating the importance of developing an integrative and intelligent analytical framework. In the last few years, advancements in the artificial intelligence (AI) approaches have completely transformed the biological research landscape. Researchers have integrated the AI approaches with the multi-omics data generated from the COVID-19 patients to have a systems-level understanding of underlying disease mechanisms, predicting new variants and their spread rate, disease severity, immune response, and therapeutic opportunities. In this chapter, we have explored the utility of AI on multi-omics data. We started with an introduction to different kinds of omics data, such as genomics, epigenomics, transcriptomics, proteomics, and metabolomics. Next, we elaborated on what AI is and discussed its types, which include conventional machine learning methods (supervised and unsupervised), deep learning methods (autoencoders and convolutional neural networks), and network-based methods (graph neural networks, network propagation, and knowledge graphs). Next, we discussed different types of integration methods (early, intermediate, and late) used for integrating AI and multi-omics data. Moving ahead, we mentioned several applications of AI, such as biomarker discovery, host-pathogen interaction, drug repurposing, and predicting long COVID. Lastly, we mentioned several important projects and consortia and discussed several important case studies highlighting the usefulness of integrating AI with multi-omics data for personalized medicine.}, }
@article {pmid42173646, year = {2026}, author = {Decker, BK and O'Donnell, M}, title = {Infection Prevention and Control in the Intensive Care Unit.}, journal = {Critical care clinics}, volume = {42}, number = {3}, pages = {611-634}, doi = {10.1016/j.ccc.2025.12.010}, pmid = {42173646}, issn = {1557-8232}, mesh = {Humans ; *Intensive Care Units ; *Cross Infection/prevention & control ; *Infection Control/methods/standards ; *COVID-19/prevention & control/epidemiology ; Risk Factors ; SARS-CoV-2 ; }, abstract = {Health care-associated infections are common and burdensome in intensive care units, contributing to increased costs, morbidity, and mortality. The coronavirus disease 2019 (COVID-19) pandemic led to an increase in the incidence of intensive care unit (ICU)-acquired infections and multidrug-resistant organisms (MDROs), highlighting the urgent need for effective prevention strategies. This article summarizes core infection prevention practices in the ICU, examines risk factors, reviews approaches to limit the spread of MDROs and explores innovations in infection prevention.}, }
@article {pmid42173648, year = {2026}, author = {Sweeney, DA and Wittebole, X and Kalil, AC}, title = {The Respiratory Triple Pandemic in the Intensive Care Unit: Epidemiology, Clinical Features and Management of COVID-19, Influenza and Respiratory Syncytial Virus.}, journal = {Critical care clinics}, volume = {42}, number = {3}, pages = {651-667}, doi = {10.1016/j.ccc.2026.01.007}, pmid = {42173648}, issn = {1557-8232}, mesh = {Humans ; *Respiratory Syncytial Virus Infections/epidemiology/therapy/diagnosis ; *Influenza, Human/epidemiology/therapy/diagnosis ; *COVID-19/epidemiology/therapy/diagnosis ; *Intensive Care Units ; Antiviral Agents/therapeutic use ; SARS-CoV-2 ; Pandemics ; }, abstract = {The anticipated "tripledemic" during the 2023-2024 season-in which simultaneous epidemics of SARS‑CoV‑2, influenza, and respiratory syncytial virus were projected-ultimately fell short of early forecasts. Nevertheless, each virus remains a significant public health concern in its own right. This article reviews the microbiology, diagnosis, and treatment of these three pathogens (including the role of immunomodulatory therapies), as well as key considerations for hospital infection prevention in the care of critically ill patients. The piece highlights the clinical indistinguishability of these viral infections and acknowledges the evolving public health discourse surrounding the role of vaccination in preventing disease.}, }
@article {pmid42174645, year = {2026}, author = {Plaut, S}, title = {A systematic scoping review and conceptual analysis of new-onset fibromyalgia manifestations after non-hospitalized COVID-19: empirics, definitions, methodologies, pathophysiology, mapping of literature, and knowledge gaps.}, journal = {Journal of translational medicine}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12967-026-08145-7}, pmid = {42174645}, issn = {1479-5876}, abstract = {BACKGROUND: The global coronavirus pandemic has led to a quiet wave of a chronic illness referred to as 'Long/Post Covid-19 syndrome' (LC) which bears a notable resemblance to functional-somatic or 'fibromyalgia-type' syndromes, and whose pathophysiology is undetermined. The lack of effective therapies for LC is straining healthcare systems worldwide and causing widespread public health and socioeconomic concerns. "Fibromyalgia" is a controversial chronic pain condition of unknown etiology largely attributed to generalized sensory hypersensitivity due to dysregulated central pain processing pathways (i.e. neuroplasting central sensitization). Despite intense research and growing attention in the scientific community, the clinical overlap of fibromyalgia, somatic symptom disorder, and post-viral chronic fatigue, is a medical puzzle yet to be solved, especially when occurring in non-severe infections and previously healthy individuals.
METHODS: This systematic scoping review covers the empirical findings on new-onset fibromyalgia manifestations after non-hospitalized covid-19. MEDLINE, Web of Science, and APA PsycINFO were searched in a systematic scoping approach for empirical studies on new-onset fibromyalgia after non-severe non-hospitalized covid-19, charting study characteristics and outcome data. A total of 228 records were included.
FINDINGS: Various types of methods, tools, and study designs are being used for LC research, with inconsistency in key concepts and definitions. This leads to a fragmented understanding of the relationship between SARS-CoV-2 infection and LC. Prevalence studies of post-Covid fibromyalgia are ongoing and susceptible to bias. The empirical evidence supports an overlap between LC, chronic fatigue syndrome, and fibromyalgia but the molecular mechanisms still remain unclear. There are conflicting findings regarding presence of viral particles, central sensitization, autoantibodies, and more.
DISCUSSION: This review highlights the need for standardized definitions and rigorous methodologies in research on LC. Future research should focus on epidemiological population-based studies with representative sampling and improving methodology, refining evolving definitions, harmonization of research, elucidating neurological mechanisms in hypothesis driven studies, and developing effective therapeutic strategies. The discussion synthesizes findings and offers an integrative mechanism for the pathophysiology of fibromyalgia and multisystem medically unexplained manifestations of LC as a non-autoimmune connective tissue disease. It helps explain neuropsychiatric and psychosomatic manifestations and is used to make testable theory-based predictions for future hypothesis-driven investigations.}, }
@article {pmid42175870, year = {2026}, author = {Allgoewer, K and Lavenia, A and Secco, L and Schaller, T and Fitzek, A and Kriebel, C and Azeke, AT and Kondo, T and Tse, R and Chui, P and Schmiedel, S and Ondruschka, B}, title = {Autopsy practices for high-consequence infectious diseases: global guidelines, alternatives, and the BSL-4 gap.}, journal = {Emerging microbes & infections}, volume = {15}, number = {1}, pages = {2678656}, pmid = {42175870}, issn = {2222-1751}, mesh = {*Autopsy/instrumentation/methods/standards ; Humans ; *Containment of Biohazards/methods ; Communicable Disease Control ; *Hemorrhagic Fevers, Viral/pathology/prevention & control/transmission/virology ; Resource-Limited Settings ; Tomography, X-Ray Computed ; Robotics ; COVID-19/pathology/prevention & control/virology ; Pandemics ; Practice Guidelines as Topic ; }, abstract = {Autopsies play a critical role in elucidating the pathogenesis of emerging infectious diseases, particularly in cases involving high-consequence pathogens such as viral haemorrhagic fevers (VHFs). While biosafety concerns have restricted post-mortem examinations in such contexts, the COVID-19 pandemic has renewed interest in autopsy-based research and highlighted both the potential and the gaps in current biosafety protocols. This narrative review outlines autopsy practices in the context of high-consequence infectious diseases (HCIDs) with a focus on VHFs, summarizes reported autopsy cases, explores alternative post-mortem methods, and examines the evolution of legal and institutional frameworks in response to the pandemic. A comparison of official international guidelines shows that while detailed autopsy protocols have been published for pathogens requiring BSL-3 containment - particularly in the United States (US) and United Kingdom (UK) - no official procedural guidance seems to be available for performing autopsies under BSL-4 conditions. Instead, current recommendations at this level are limited to post-mortem handling and disposal of the deceased. This regulatory and procedural gap underscores the urgent need for harmonized, high-containment autopsy protocols that balance biosafety with scientific value. Developing such frameworks will be essential to improve outbreak preparedness and enable evidence-based responses to future pandemics globally. Accordingly, we propose a structured, system-based approach to BSL-4 autopsy practice as a foundation for discussion and future guideline development.}, }
@article {pmid42176005, year = {2026}, author = {Walia, HK and Choudhary, K and Kumar, N}, title = {Aptamer-conjugated nanoparticles: emerging nano-enabled platforms for rapid and sensitive detection of viral infections.}, journal = {Archives of microbiology}, volume = {208}, number = {8}, pages = {}, pmid = {42176005}, issn = {1432-072X}, mesh = {Humans ; *Nanoparticles/chemistry ; *Aptamers, Nucleotide/chemistry ; *COVID-19/diagnosis ; Biosensing Techniques/methods ; SARS-CoV-2/isolation & purification ; *Virus Diseases/diagnosis ; Rapid Diagnostic Tests ; Nanotechnology/methods ; }, abstract = {During the recent outbreak of SARS-CoV-2, the global healthcare system experienced firsthand the importance of accurate and rapid detection techniques in the containment of pandemic situations. Conventional viral detection techniques, although highly specific, often suffer from slow, labour-intensive workflows that limit their applicability for rapid diagnosis. Moreover, their reliability can be compromised by factors such as inadequate technical expertise and improper sample handling, potentially leading to erroneous results. When the global public health system is continuously struggling to control viral diseases like dengue, influenza, hepatitis B, and acquired immunodeficiency syndrome, cutting-edge nanotechnology and biosensor-enabled next-generation diagnostic platforms have shown improved analytical performances. Among these, aptamer-conjugated nanoparticles (ACNPs) have emerged as a promising nanosystem that integrates the high molecular recognition capability of aptamers with the unique physicochemical and optical properties of nanoparticles. Aptamers are short, single-stranded DNA, RNA, or peptide sequences that offer remarkable affinity and selectivity toward diverse viral biomarkers, including proteins, nucleic acids, and intact virions. Their conjugation with nanoparticles imparts superior stability, signal amplification, and biofunctional versatility under physiological conditions. These hybrid systems demonstrate substantial potential in biosensing, bioimaging, and providing enhanced diagnostic precision. This review aims to present the fundamental design principles of ACNP-based detection strategies and to highlight recent advances in viral diagnostics. Additionally, it underscores the underlying sensing mechanisms and analytical advantages, and discusses the current challenges associated with ACNP-enabled diagnostic platforms.}, }
@article {pmid42176257, year = {2026}, author = {Abdelhady, E and Abdo Khalafallah, M and Alkajah, HA and Reda Elmahadi, R and Willer, BL and Tobias, JD}, title = {Telemedicine-Enabled Surgical Outreach across the Surgical Continuum to Bridge the Gap in Low- and Middle-Income Countries: Lessons from the COVID-19 Era and Applications Beyond.}, journal = {Telemedicine journal and e-health : the official journal of the American Telemedicine Association}, volume = {}, number = {}, pages = {15305627261453274}, doi = {10.1177/15305627261453274}, pmid = {42176257}, issn = {1556-3669}, abstract = {INTRODUCTION: Telemedicine has revolutionized health care delivery globally, reducing health care costs, increasing patient satisfaction, and improving surgical outcomes. Innovation is often born out of necessity, and during the Coronavirus disease 2019 (COVID-19) pandemic, there was a surge of telemedicine initiatives both in surgical education and surgical care delivery. This has been well documented in high-income countries, but there has been less evaluation of the use and potential application of telemedicine in low- and middle-income countries (LMICs) to support surgical outreach efforts. This review seeks to describe telemedicine-enabled surgical outreach across the surgical continuum that emerged from the COVID-19 era in LMICs and provide recommendations for future practices.
METHODS: A scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Identified studies on telemedicine indexed in PubMed, Web of Science, Scopus, and Embase from January 2020 to February 2025 were aggregated. The search terms included "telemedicine," "surgery," "COVID-19," "SARS-CoV-2," "e-learning," "remote," "tele-simulation," and "LMICs." Of 713 papers, 15 eligible studies were found. Data were summarized by study type, intervention type, and outcomes. Themes of accessibility, efficacy, and user satisfaction were analyzed. Key implementation challenges were reviewed. Summary recommendations for future directions are provided.
RESULTS: The 15 studies identified provide evidence for the feasibility and effectiveness of a variety of surgical teleinterventions within LMICs. The majority of the qualifying research consisted of prospective cohort studies that involved physicians, surgical residents, and patients. The primary findings include improvements in surgical skills, positive perception by participants, and high satisfaction with tele-simulation and e-learning. Key implementation challenges identified were technical issues, insufficient infrastructure, and unreliable internet.
CONCLUSION: Preliminary experience suggests that telemedicine applications during the COVID-19 pandemic proved to be effective tools for both surgical education and patient care. These initiatives may hold promise for augmenting surgical outreach efforts in a more sustainable fashion to facilitate both surgeon training and improved care delivery for underserved communities in LMICs. However, numerous challenges must be addressed to ensure long-term effectiveness and sustainability.}, }
@article {pmid42176585, year = {2026}, author = {Wang, Q and Wang, XN and Liu, XQ and Zhao, LG and Jing, ZT and Tian, T and Zhang, JT and Zhao, YX and Li, JM and Diao, NC and Shi, K and Du, R}, title = {Prevalence and risk factors of bovine tuberculosis in dairy cattle, 2020-2025: A systematic review and meta-analysis of available literature.}, journal = {Preventive veterinary medicine}, volume = {254}, number = {}, pages = {106920}, doi = {10.1016/j.prevetmed.2026.106920}, pmid = {42176585}, issn = {1873-1716}, abstract = {BACKGROUND: Bovine tuberculosis (bTB) is a zoonotic disease caused by members of the Mycobacterium tuberculosis complex (MTBC), with Mycobacterium bovis being the primary agent responsible for infections in cattle, posing a significant threat to the global dairy industry. Although the COVID-19 pandemic during the 2020-2025 period may have disrupted its epidemiology, a comprehensive global meta-analysis of bTB prevalence and risk factors in dairy cattle for this period is currently lacking.
METHODS: We conducted an extensive literature search across multiple databases, including CNKI, PubMed, ScienceDirect, VIP, and Wan Fang. A total of 4783 records were initially identified, of which 45 studies met the inclusion criteria, encompassing 468,769 dairy cattle across 10 countries.
RESULTS: The global pooled bTB prevalence was 6.9% (95% CI: 4.4-9.9). Africa had the highest regional prevalence (12.4%, 95% CI: 6.6-19.7), and Ethiopia the highest among countries (16.6%, 95% CI: 7.8-27.9). Low-income countries showed higher prevalence (16.7%, 95% CI: 8.9-26.3) than others. Rapid antibody tests yielded significantly higher infection rates (24.8%, 95% CI: 9.7-44.1) than other diagnostic methods. Prevalence differed significantly between lactating and non-lactating cows (p < 0.05). Other risk factors assessed included breed, sex, age, farming mode, sampling time, sample type, and tuberculin type.
CONCLUSIONS: bTB remains a significant challenge in dairy production, demanding tailored control strategies adapted to regional contexts. However, the geographic distribution of available studies was heavily skewed, with the majority originating from China and Africa, while regions with advanced control programs were underrepresented. This geographic limitation should be carefully considered when interpreting the global estimates. Surveillance efforts should prioritize high-risk populations, particularly hybrid cattle, aging animals, and lactating cows, through the combined use of interferon‑γ release assays and tuberculin tests. Effective control hinges on integrated approaches including veterinary capacity building, genetic selection for disease resistance, and management at the wildlife-livestock interface. Sustainable prevalence reduction requires evidence-based measures designed for local production systems.}, }
@article {pmid42176717, year = {2026}, author = {Farsiu, N and Charostad, J and Khodadadpour Mahani, F and Mir, Y and Rezaei Zadeh Rukerd, M and Zeinali Nezhad, N and Shahpar, A and Pardeshenas, M and Nakhaie, M}, title = {An extensive overview on MicroRNAs and pandemic-prone viral diseases: The next frontier in predicting and mitigating pandemics.}, journal = {Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases}, volume = {142}, number = {}, pages = {105963}, doi = {10.1016/j.meegid.2026.105963}, pmid = {42176717}, issn = {1567-7257}, mesh = {*MicroRNAs/genetics/metabolism ; Humans ; *Pandemics/prevention & control ; SARS-CoV-2 ; *Virus Diseases/genetics/epidemiology ; Host-Pathogen Interactions/genetics ; COVID-19 ; Biomarkers ; Middle East Respiratory Syndrome Coronavirus/genetics ; Influenza, Human/genetics/epidemiology/virology ; *Coronavirus Infections/genetics/epidemiology/virology ; }, abstract = {MicroRNAs (miRNAs) are small non-coding RNAs that regulate gene expression and play important roles in host-virus interactions. Increasing evidence indicates that viral infections can alter host miRNA expression profiles, influencing viral replication, immune responses, and disease severity. In this review, we summarize current knowledge on miRNA dysregulation in major pandemic-prone viral infections, including severe acute respiratory syndrome coronavirus (SARS-CoV), SARS-CoV-2, (middle east respiratory syndrome coronavirus) MERS-CoV, and influenza viruses. We also discuss how specific miRNAs may function as antiviral or proviral regulators by targeting viral genomes or key host signaling pathways involved in immune responses and inflammation. Particular attention is given to the potential role of circulating miRNAs as diagnostic or prognostic biomarkers, as well as the emerging concept of miRNA-based therapeutics. While numerous studies report associations between altered miRNA expression and infection outcomes, most findings are derived from relatively small and heterogeneous cohorts and require further validation. Consequently, many proposed miRNA applications remain at an exploratory stage. Nevertheless, advances in high-throughput sequencing, integrative omics approaches, and functional validation studies are expected to improve our understanding of miRNA-mediated regulatory networks during viral infections. These developments may ultimately support the development of host-response biomarkers and therapeutic strategies that contribute to improved surveillance and preparedness for future viral outbreaks.}, }
@article {pmid42176857, year = {2026}, author = {Shaban, RZ and Curtis, K and Fry, M and McCormack, B and Parker, D and Macbeth, D and Mitchell, BG and Russo, PL and Friedman, ND and Bennett, N and Thompson, L and Dalton, JA and Dempsey, K and Henderson, B and Considine, J and Bowes, R and Powell, M and Battaglini, E and Dodson, N and El-Assad, K and McKay, K and Viengkham, C}, title = {Professional practice requirements and competency standards for infection prevention and control professionals in residential aged care: A scoping review.}, journal = {American journal of infection control}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.ajic.2026.05.013}, pmid = {42176857}, issn = {1527-3296}, abstract = {BACKGROUND: Healthcare-associated infections are a major health issue for older adults in residential aged care homes (RACHs). Events like the COVID-19 pandemic have increased focus on the practice of infection prevention and control professionals (ICPs) in RACHs.
AIM: To synthesise evidence on practice requirements and competency standards for ICPs in RACHs globally.
METHODS: This scoping review examined literature from electronic bibliographic databases and gray literature via citation chaining and manual searching limited to English from 1980 to 2025. Studies were screened against eligibility criteria. Data were analyzed using descriptive statistics and framework analysis.
RESULTS: Forty-nine articles were included. Key practice requirements in the white literature included surveillance, staff education, resident care, and employee health; and directing IPC activities, standard precautions, and resident care in the gray literature. Training and credentialing featured less frequently, identifying a need for specialized training. Only 2 formal competency certifications were noted as a requirement or expectation for ICPs.
CONCLUSION: Several key elements of practice have been identified, but there is limited detail and consistency regarding qualifications, competency standards, and credentialing.
IMPACT: This work reviewed the literature regarding ICP practice requirements, qualifications, and credentialing. Gaps in this literature indicate a need for formal, evidence-based guidelines for ICPs in RACHs.}, }
@article {pmid42177562, year = {2026}, author = {Bagaforo, RJ and Dupas, MC and Abrams, S and Dellicour, S and Hens, N}, title = {A scoping review of COVID-19 modelling studies in Belgium 2020-2024: incorporation of behaviour and lessons learned.}, journal = {Archives of public health = Archives belges de sante publique}, volume = {}, number = {}, pages = {}, doi = {10.1186/s13690-026-01959-3}, pmid = {42177562}, issn = {0778-7367}, support = {G0A4624N//Fonds Wetenschappelijk Onderzoek/ ; G0A4624N//Fonds Wetenschappelijk Onderzoek/ ; G0A4624N//Fonds Wetenschappelijk Onderzoek/ ; TD/231/BE-PIN//Belgian Federal Science Policy Office/ ; TD/231/BE-PIN//Belgian Federal Science Policy Office/ ; TD/231/BE-PIN//Belgian Federal Science Policy Office/ ; }, abstract = {BACKGROUND: The COVID-19 pandemic underscored the importance of integrating human behaviour in infectious disease modelling approaches, yet an in-depth assessment of how behavioural components are incorporated remains limited. We conducted a scoping review of COVID-19 models applied to Belgian data to examine how behavioural dynamics, both voluntary and policy-driven, were represented within model structures. Our aim was to identify current practices, highlight methodological gaps, and provide recommendations for the development of behaviourally integrated epidemiological models.
METHODS: Using Scopus and PubMed, we identified 98 studies published between March 2020 and October 2024, describing 105 models in total. Models were classified by model class (mathematical, statistical, or ensemble), objectives, approaches used to incorporate behavioural factors, and types of behaviour data employed.
RESULTS: Behavioural integration was confined to specific modelling contexts, with only half of the 105 models incorporating behavioural components. Mechanistic models, particularly compartmental models, were the most likely to include behavioural features, especially in studies assessing non-pharmaceutical interventions or conducting long-term forecasts and scenario analyses. Behavioural change was most commonly represented through modifications to transmission parameters or contact matrices. These adjustments were frequently informed by social contact surveys or mobility data derived from various sources.
CONCLUSIONS: In contrast to previous reviews that focused exclusively on behavioural models, this study evaluates the full landscape of Belgian COVID-19 models, offering a comprehensive perspective on how behavioural representation varies across modelling approaches. Our findings recommend that effective behavioural integration relies on timely, routine, and disaggregated surveillance and behaviour data, alongside the use of flexible mechanistic models.}, }
@article {pmid42178124, year = {2026}, author = {Saad, MH and Taha, TH and Alhudhaibi, AM and Albatli, SA and El-Sayed, MH and Sidkey, NM and El-Fakharany, EM}, title = {Insights into prospective antiviral activities of algal polysaccharides along with their properties, extraction, and characterization: A review.}, journal = {International journal of biological macromolecules}, volume = {368}, number = {}, pages = {152675}, doi = {10.1016/j.ijbiomac.2026.152675}, pmid = {42178124}, issn = {1879-0003}, mesh = {*Antiviral Agents/pharmacology/chemistry/isolation & purification/therapeutic use ; *Polysaccharides/pharmacology/chemistry/isolation & purification ; Humans ; SARS-CoV-2/drug effects ; *COVID-19 Drug Treatment ; Animals ; }, abstract = {The global escalation of viral outbreaks, particularly the COVID-19 pandemic caused by SARS-CoV-2, highlights the urgent need for effective antiviral agents against emerging infections. Despite their importance, quarantine and vaccination alone are insufficient, necessitating advanced approaches for effective viral infection control. One such strategy involves investigating efficacious antiviral agents that don't induce toxicity. Algal polysaccharides represent a significant frontier in pharmacological research for the development of novel antiviral therapeutics. Unlike other sources, marine algae offer an underexploited reservoir of unique metabolites with potent, broad-spectrum antiviral properties. A multitude of studies have recognized numerous algal polysaccharides exhibiting antiviral characteristics, including laminaran, alginate, carrageenan, fucan, and naviculan. Moreover, these polysaccharides exert antiviral effects through diverse mechanisms, including blocking viral attachment and entry into host cells, as well as inhibiting viral genome replication and protein synthesis. The shift towards treatment with polysaccharides derived from marine algae represents a step towards more flexible and resistance-resistant antiviral strategies. By leveraging the gradual evolution of algal metabolites, researchers can develop agents that are not only effective against current threats but also adaptable to changes in the antigenic composition of future viral outbreaks. This review summarizes recent advances in the current understanding of algal polysaccharides, including their production, extraction methods, structural characterization, and applications in gene delivery. It also provides a critical discussion of structure-activity relationships, antiviral mechanisms, and comparative evaluation of different classes of algal polysaccharides to support their advancement as promising natural antiviral agents for future research and therapeutic development.}, }
@article {pmid42178216, year = {2026}, author = {Chadha, U and Kushnirenko, A and Fernandes, DC and Patel, KB and Crothers, NJ and Singh, H and Isiksalan, M and Nasir, I and Armstrong, S and Behdinan, K}, title = {Augmenting healthcare systems for pandemic preparedness: a Lean Six Sigma perspective.}, journal = {International journal for quality in health care : journal of the International Society for Quality in Health Care}, volume = {38}, number = {2}, pages = {}, pmid = {42178216}, issn = {1464-3677}, mesh = {Humans ; Pandemic Preparedness/organization & administration ; *COVID-19 ; *Pandemics/prevention & control ; *Total Quality Management/organization & administration ; Efficiency, Organizational ; Public Health Infrastructure ; SARS-CoV-2 ; *Delivery of Health Care/organization & administration ; Hospital Administration ; *Coronavirus Infections/epidemiology ; Betacoronavirus ; }, abstract = {BACKGROUND: Past global healthcare crises have exposed vulnerabilities in healthcare systems, including inefficiencies in hospital operations, delayed response times, and overburdened infrastructure. Traditional hospital systems built for routine care were sometimes not resilient or adaptable in the face of such crises, resulting in global failures. This narrative review examines how Lean Six Sigma (LSS) principles can be incorporated into conventional hospital operations to enhance pandemic preparedness by building the resilience of hospital infrastructure, streamlining processes during time-sensitive situations, and improving waste reduction, all while being adaptable and sustainable.
METHODS: This narrative review synthesizes literature using Coronavirus Disease 2019 (COVID-19) as a benchmark to evaluate hospital response strategies, failures, and factors contributing to failure, including the critical assessment of ethical disruptions, operational weaknesses, and healthcare business models. LSS principle applications, i.e. DMAIC, Value Stream Mapping, SIPOC, FMEA, and Control Charts, were explored for facilitating efficient care, crisis response, and policy integration. Various case studies were used to support the comparative analysis and insights.
RESULTS: The literature indicates that adoption of LSS tools in the most vulnerable aspects of healthcare, including patient triage, supply chain optimization, and controlling and reducing mortality, has been associated with measurable improvements. Most importantly, integrating data-driven LSS resulted in enhanced surge responsiveness and ethical compliance within national healthcare frameworks and policies. However, despite its efficacy, there are institutional barriers like capital constraints, resistance to change, data inconsistencies, and a lack of legislative frameworks that impede widespread LSS adoption.
CONCLUSION: LSS offers an adaptable and scalable methodology to re-engineer conventional hospital operations and pandemic preparedness. The emphasis on 'kaizen' (continuous improvement), data-informed decision making, and focus on precision aligns with the needs of healthcare systems as revealed by recent crises. To unlock the potential for preparedness, healthcare systems and legislation must focus on institutionalizing LSS across public and private sectors through strategic investment, education, and cross-sector collaborations. This review provides a comprehensive framework for policymakers, governments, epidemiologists, doctors, and hospital business managers for building resilient, efficient, and pandemic-ready hospitals.}, }
@article {pmid42178593, year = {2026}, author = {Esperatti, M and Olmos, M and Fuentes, N}, title = {ARDS and corticosteroids: beyond COVID-19.}, journal = {Pneumonia (Nathan Qld.)}, volume = {18}, number = {1}, pages = {}, pmid = {42178593}, issn = {2200-6133}, abstract = {Acute respiratory distress syndrome (ARDS) remains a high‑mortality condition despite major advances in ventilatory and supportive care. Because lung injury is driven by uncontrolled inflammation and disruption of the alveolar–capillary barrier, corticosteroids have long been considered a biologically plausible therapy. Over several decades, randomized trials have evaluated different corticosteroid types, doses, durations, and initiation timings in heterogeneous populations, including patients with primary ARDS and those with sepsis or pneumonia complicated by ARDS. The COVID‑19 pandemic provided a unique opportunity to study a more homogeneous cause of ARDS, generating additional evidence supporting corticosteroid efficacy in virus‑related respiratory failure. Despite these advances, clinical practice remains variable worldwide. Evolving definitions, diverse trial designs, and etiologic variability have led to uncertainty regarding indication, optimal dosing, drug selection, and treatment duration. The new global definition of ARDS now includes patients supported with noninvasive ventilation or high‑flow nasal oxygen, raising questions about how evidence derived from invasively ventilated populations applies to these groups. Parallel research identifying inflammatory subphenotypes with potentially divergent treatment responses further underscores the need for individualized, evidence‑based strategies. In this review, we examine conceptual, biological, and clinical considerations and synthesize the available evidence to inform decision‑making. We propose a pragmatic, context‑based framework to guide corticosteroid use in ARDS according to etiology and patient characteristics, emphasizing early initiation—ideally within 24–48 hours—and regimens equivalent to ≥80 mg/day of methylprednisolone or ≥400 mg/day of hydrocortisone for at least seven days, which have demonstrated efficacy with an acceptable safety profile. Research priorities include optimizing dose and duration, evaluating non‑ventilated and underrepresented subgroups, and clarifying phenotype‑specific effects and long‑term safety.}, }
@article {pmid42179466, year = {2026}, author = {Von Rekowski, CP and Fonseca, TAH and Araújo, R and Calado, CRC and Bento, L and Pinto, I}, title = {Blood biomarker trajectories in ICU-directed prediction models - A scoping review.}, journal = {The EPMA journal}, volume = {17}, number = {2}, pages = {427-455}, pmid = {42179466}, issn = {1878-5077}, abstract = {BACKGROUND: Despite advanced analytical methods and increasing data availability, most intensive care unit (ICU) prediction models rely on static measurements. However, longitudinal monitoring of biomarkers may better capture disease progression and support timely, individualized interventions within the framework of predictive, preventive, and personalized medicine (PPPM). Since the COVID-19 pandemic, interest in both static and dynamic modelling has expanded. Therefore, this review aimed to summarize current evidence on the use of longitudinal blood biomarker data in ICU prediction models, assess how the pandemic shaped this research, and report validation strategies.
METHODS: This scoping review followed the PRISMA-ScR guidelines. PubMed and Google Scholar were searched for studies on blood biomarker trajectory analysis in the ICU published between 2014 and 2025, covering five years before and after the onset of the COVID-19 pandemic.
RESULTS: Forty-seven studies were included, mainly from North America (47%), Europe (45%), and Asia (34%). ICU and hospital mortality were the predominant outcomes. Although 53% of studies used pre-pandemic data, 94% were published afterwards. The most frequent biomarker categories were immune response (74.5%) and metabolic/organ function (66.0%). Common biomarkers included platelets and lactate (n = 9), lymphocytes and mHLA-DR (n = 6), and creatinine and interleukin-6 (n = 5). Modelling approaches integrated longitudinal regression-based models (31.9%), latent class-based models (44.7%), and machine-learning/data-driven clustering (27.7%). Trajectory patterns varied depending on both biomarker type and modelling technique. Cox regression, Kaplan-Meier, and logistic regression were commonly applied to assess associations with outcomes. Notably, only 21% of studies reported any form of validation, highlighting a major limitation for clinical applicability.
CONCLUSION: Blood biomarker trajectories have potential to improve dynamic risk prediction and stratification, supporting targeted prevention through early identification of high-risk patterns, and enable more personalized treatment via adaptive, patient-specific approaches. Nevertheless, substantial methodological heterogeneity and the low proportion of validated models limit clinical applicability. Greater standardization and robust validation are essential to facilitate translation into PPPM-oriented intensive care.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13167-026-00456-5.}, }
@article {pmid42181019, year = {2026}, author = {Koehler, SM and Ayhan, E}, title = {What's New in Wide-Awake Local Anesthesia No Tourniquet (WALANT) Hand Surgery?.}, journal = {Journal of hand surgery global online}, volume = {8}, number = {4}, pages = {101033}, pmid = {42181019}, issn = {2589-5141}, abstract = {Wide-awake local anesthesia no tourniquet (WALANT) has evolved from a novel technique to an increasingly adopted anesthetic strategy in hand surgery. In the post-coronavirus disease (COVID)-19 era, there has been a marked expansion in WALANT-related literature, necessitating synthesis of contemporary evidence to guide clinical practice. This narrative review examines recent WALANT studies organized into six thematic domains: comparative trials versus traditional anesthesia, use in the pediatric population, patient satisfaction and experience, environmental impact, cost comparison and value-based care, and applications beyond the hand and wrist. Comparative studies consistently demonstrate that WALANT provides noninferior functional outcomes and complication rates relative to regional and general anesthesia, with improved intraoperative pain and similar early postoperative pain. Pediatric data support feasibility and high satisfaction in appropriately selected patients, particularly adolescents. Patient satisfaction is uniformly high, with strong willingness to repeat WALANT procedures. WALANT pathways also reduce solid waste and carbon emissions, particularly when procedures are performed outside the main operating room. Cost analyses demonstrate substantial savings driven by decreased anesthesia use and site-of-service optimization. Expanding indications now include proximal upper extremity procedures and select nonupper extremity surgeries, reflecting increasing surgeon experience and confidence. WALANT represents a mature, evidence-supported care pathway that aligns clinical outcomes with patient-centered experience, environmental sustainability, and cost efficiency. Its greatest impact is realized when integrated into procedure room-based workflows with careful patient selection and standardized technique. Future efforts should focus on refining indications, optimizing patient experience, and expanding scalable implementation across diverse practice settings.}, }
@article {pmid42181087, year = {2026}, author = {Kaushik, R and Re, S}, title = {Artificial intelligence directed computational protein design: lessons from COVID-19 for pandemic-ready vaccines and antibody therapeutics.}, journal = {Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques}, volume = {29}, number = {}, pages = {16146}, pmid = {42181087}, issn = {1482-1826}, mesh = {*Artificial Intelligence ; Humans ; *COVID-19 Vaccines/chemistry ; *COVID-19/prevention & control ; *Drug Design ; SARS-CoV-2/drug effects ; Antibodies, Neutralizing/immunology ; Antibodies, Viral/immunology ; Pandemic Preparedness ; }, abstract = {Artificial intelligence (AI) directed computational protein design has emerged as a transformative force in modern therapeutic discovery, reshaping how vaccines and antibody-based interventions are conceived, optimized, and deployed against emerging infectious diseases. The COVID-19 pandemic served as an unprecedented real-world stress test for these technologies, highlighting their potential to accelerate antigen design, guide antibody optimization, and anticipate viral evolution in near real time. AI driven approaches contributed to faster characterization of viral variants, supported vaccine and broadly neutralizing antibodies developments. Despite the significant contributions, the pandemic also revealed important limitations that must be addressed before such approaches can be relied upon as cornerstones of global preparedness. Challenges related to data bias, model interpretability, experimental validation bottlenecks, and integration with existing regulatory frameworks became increasingly apparent. In several cases, the gap between computational promise and translational readiness underscored the need for closer coupling between in silico design, laboratory experimentation, and clinical evaluation. Moreover, the rapid pace of AI innovation often outstripped established regulatory pathways, raising questions about standardization, validation, and long-term safety. This mini review provides a focused overview of recent advances in AI enabled computational protein design, with an emphasis on applications relevant to pandemic response. Drawing on lessons from COVID-19 case studies, it examines translational and regulatory considerations, highlights unresolved controversies, and identifies critical research gaps. Collectively, these insights outline a path toward transitioning AI designed vaccines and antibody therapeutics from reactive emergency tools into proactive, scalable infrastructures for future pandemic preparedness.}, }
@article {pmid42181627, year = {2026}, author = {Maurya, N and Le, A and Melbourne, G and Chow, JSF}, title = {Long-term cardiovascular impact of COVID-19 among hospitalised and non-hospitalised populations: a narrative synthesis review.}, journal = {Frontiers in cardiovascular medicine}, volume = {13}, number = {}, pages = {1741293}, pmid = {42181627}, issn = {2297-055X}, abstract = {INTRODUCTION: COVID-19, initially recognised as a respiratory illness, affects multiple organ systems, including the cardiovascular system. Both hospitalised and non-hospitalised patients may experience persistent cardiac complications; however, the long-term impact across different levels of disease severity remains unclear. This review aims to summarise the existing evidence on the long-term cardiovascular impact of COVID-19, with a particular focus on differences between hospitalised and non-hospitalised patients.
METHOD: PubMed, MEDLINE, CINAHL, and Embase databases were searched for studies published between December 2019 and January 2024 that investigated cardiovascular outcomes in long COVID. Studies were screened for eligibility, and data were extracted using a standardised form. Due to heterogeneity across the included studies, a narrative synthesis was performed.
RESULTS: Seventy-one studies were included, most of which were observational and conducted in Europe and Asia, with follow-up periods ranging from <1 to >24 months. Hospitalised patients reported more frequent cardiovascular symptoms; however, echocardiographic abnormalities were observed across all groups. Reporting of symptom severity was inconsistent. Common cardiovascular manifestations included palpitations, chest pain, fatigue, and arrhythmias. Persistent cardiac dysfunction and dysautonomia were observed regardless of hospitalisation status.
CONCLUSION: Hospitalised patients are at higher risk of long-term cardiovascular complications, including myocardial injury, arrhythmias, and heart failure, while non-hospitalised individuals may experience subclinical cardiac changes. Vaccination appears to have a protective effect. Standardised, prospective studies are needed to clarify long-term cardiovascular risks and to guide follow-up care.}, }
@article {pmid42183922, year = {2026}, author = {Kavak, S}, title = {Biomechanics and Oxidative Stress: An Integrative Review of the Redox-Mechanobiological Axis and the Role of Trace Elements in Disease.}, journal = {Biological trace element research}, volume = {}, number = {}, pages = {}, pmid = {42183922}, issn = {1559-0720}, abstract = {Oxidative stress and mechanobiological signaling are increasingly recognized as interconnected determinants of cellular and systemic homeostasis. Reactive oxygen species (ROS), traditionally associated with molecular damage, are now understood to directly regulate cytoskeletal remodeling, membrane viscoelasticity, mitochondrial dynamics, and mechanotransduction pathways including focal adhesion kinase (FAK), integrins, and Yes-associated protein/transcriptional coactivator with PDZ-binding motif (YAP/TAZ). Conversely, biomechanical forces such as extracellular matrix stiffness, cyclic stretch, and disturbed shear stress modulate intracellular redox signaling through mitochondrial dysfunction, NADPH oxidase activation, and inflammatory pathways. This bidirectional interaction forms a self-amplifying "redox-mechanobiological axis" that contributes to endothelial dysfunction, fibrosis, thrombosis, tumor progression, and viral pathophysiology.Trace elements, particularly selenium, zinc, and iron, emerge as critical modulators of this axis by influencing antioxidant defense systems, cytoskeletal integrity, membrane stability, ferroptosis, and cellular stiffness. Selenium-dependent selenoproteins regulate mitochondrial redox balance and actin organization; zinc stabilizes membrane architecture and mechanosensitive proteins; and iron-mediated Fenton chemistry promotes oxidative injury, ferroptosis, and biomechanical alterations.This review integrates molecular mechanisms, mechanobiological principles, and recent clinical findings-particularly from cardiovascular disease, cancer biology, and COVID-19-to propose a unified framework linking oxidative stress to biomechanical dysfunction. In addition, current controversies, methodological limitations, and future therapeutic directions targeting the redox-mechanobiological axis are critically discussed.}, }
@article {pmid42184107, year = {2026}, author = {Khoo, LY and Dhillon, SK}, title = {Comparative review of artificial intelligence for transcriptomic biomarker discovery in coronavirus disease 2019 (COVID-19).}, journal = {Briefings in bioinformatics}, volume = {27}, number = {3}, pages = {}, pmid = {42184107}, issn = {1477-4054}, support = {//Ministry of Higher Education, Malaysia/ ; FP019-2022//Fundamental Research Grant Scheme/ ; }, mesh = {*Artificial Intelligence ; *COVID-19/genetics/virology/metabolism ; Humans ; *SARS-CoV-2/genetics ; Biomarkers/metabolism ; *Transcriptome ; Gene Expression Profiling ; }, abstract = {The Coronavirus Disease 2019 (COVID-19) pandemic has highlighted the significance of reliable molecular biomarkers in clinical use. Despite the popularity of traditional statistical approaches, the high dimensionality of transcriptomic data presents challenges for these conventional methods. While artificial intelligence (AI) algorithms have emerged as highly advantageous for handling these complex datasets, there is a lack of evaluation of these approaches in COVID-19 transcriptomic studies. This review aims to provide an evaluation of these studies employed for transcriptomic biomarker discovery in COVID-19 using AI, assessing their study designs, methodologies, and outcomes. Based on a comprehensive search for literature across five databases including Web of Science Core Collection, Scopus, PubMed/MEDLINE, IEEE Xplore Digital Library, and LitCovid from December 2019 to March 2025, this review selected 63 studies for a narrative synthesis of four key sections: (i) The Landscape of AI-Driven COVID-19 Transcriptomics, (ii) Limitations of Studies, (iii) A Proposed AI-Driven Transcriptomics Framework, and (iv) Clinical Translation Challenges, Opportunities, and Future Directions. Our analysis revealed limitations in data quality, sample size, and heterogeneity, as well as methodologies regarding validation and interpretability. Thus, we proposed an evidence-informed workflow that addresses these current limitations in study design, while acknowledging real-world constraints. We further discuss the emerging potential of agentic AI systems as a promising solution to current limitations. By bridging methodological gaps with translation considerations, this review can enhance pandemic response strategies for future emerging infectious diseases. Key Points Applications observed in reviewed studies mainly included applications in diagnosis and severity stratification of COVID-19 patients. The limitations of current studies included small sample sizes, the reliance on public datasets lacking detailed metadata, batch effects and data heterogeneity reducing model robustness, the lack of external validation, risks of data leakage and circular validation leading to inflated performance metrics, and challenges in model interpretability. An evidence-informed AI-driven framework is proposed, acknowledging real-world constraints including small pandemic cohort sizes, domain shift from viral evolution, and resource-limited settings, with emerging agentic AI systems offering potential solutions.}, }
@article {pmid42185895, year = {2026}, author = {Petakh, P and Ravlo, E and Pan, Q and Bruzzone, R and Oksenych, V and Vähä-Koskela, M and Kamyshnyi, O and Kainov, DE}, title = {Standardizing antiviral response metrics for mono- and combination therapies in acute, chronic and latent viral infections.}, journal = {Virology journal}, volume = {23}, number = {1}, pages = {}, pmid = {42185895}, issn = {1743-422X}, mesh = {*Antiviral Agents/therapeutic use/pharmacology ; Humans ; Drug Therapy, Combination ; *Virus Diseases/drug therapy ; Drug Resistance, Viral ; SARS-CoV-2/drug effects ; COVID-19 ; Pandemics ; Microbial Sensitivity Tests/standards ; *Coronavirus Infections/drug therapy/virology ; Animals ; *COVID-19 Drug Treatment ; Betacoronavirus/drug effects ; }, abstract = {The COVID-19 pandemic showed that heterogeneous antiviral assay designs, endpoints and reporting practices can obscure which candidate drugs and combinations are genuinely promising. As antiviral discovery expands from acute infections to chronic and latent viral diseases, the field needs a compact, reproducible and biologically interpretable set of response metrics. In this Personal View, we argue that EC50 and the selectivity index should be retained for pharmacological interpretation but systematically complemented by drug sensitivity scores (DSS), which integrate potency and efficacy across the tested concentration range, and by ΔDSS, calculated as DSS_antiviral minus DSS_toxicity from matched efficacy and viability curves. We propose standardized modules for resistance passaging, sequencing and host-side-effect profiling so that monotherapies are assessed not only for antiviral potency but also for durability and host-cell perturbation. For combinations, we discuss Bliss, ZIP, HSA and Loewe models as complementary tools for identifying additive or synergistic regimens while accounting for toxicity, resistance suppression and drug-drug interactions. Finally, we outline how harmonized metrics can support organoid, animal and clinical prioritization, improve machine-learning datasets and guide pandemic response, including rapid monotherapy testing for some DNA viruses and early combination testing for RNA and reverse-transcribing viruses.}, }
@article {pmid42188759, year = {2026}, author = {Wiysonge, CS and Adamu, AA and Bwaka, AM and Wiysonge, CN and Ticha, JM and Katsande, R and Bita Fouda, AA and Safdar, N and Teka Bekele, A and Iwu-Jaja, C and Bathondoli, B and Ndiaye, S and Amani, A and Demanou, M and Ainan, S and Gunaratna, MP and Diop, A and Han, Y and Kfutwah, A and Mukaro, R and Doshi, RH and Lukoya, CO and Nyarko, K and Mwenda, JM and Masresha, BG}, title = {Vaccine-Preventable Disease Control in the WHO African Region After the COVID-19 Public Health Emergency of International Concern: Implications for Recovery, Resilience, and System Transformation.}, journal = {Vaccines}, volume = {14}, number = {5}, pages = {}, pmid = {42188759}, issn = {2076-393X}, abstract = {BACKGROUND: The end of the COVID-19 public health emergency of international concern (PHEIC) in May 2023 marked a transition from disruption to recovery and rebuilding of health systems. The WHO African Region entered this period with declining routine immunization coverage, widening inequities, and fragile surveillance systems. We conducted a critical narrative synthesis of post-PHEIC recovery and the transformation of immunization systems in the region from 2023 to 2025.
METHODS: We thematically analyzed publicly available data from the WHO and other sources using a systems-oriented framework covering immunization coverage, equity, vaccine introductions, disease control, governance, financing, and data systems.
RESULTS: Regional coverage for most antigens was restored to 2019 pre-pandemic levels by 2024, e.g., three doses of diphtheria-tetanus-pertussis-containing vaccines at 76%. However, progress remains insufficient to meet the Immunization Agenda 2030 (IA2030) target of 90% coverage. In addition, there were 6.7 million zero-dose children in the 2024 birth cohort (6.3% higher than the 6.3 million in 2019), concentrated in a few countries. The IA2030 target is a 50% reduction in the number of zero-dose children by 2030, compared to 2019. Recovery initiatives have restored services, while accelerated introductions (e.g., malaria vaccines introduced in 20 new countries in 2024-2025) signal renewed system momentum. Yet, progress has plateaued at pre-pandemic levels, reflecting structural constraints rather than sustained transformation. Concurrently, recurrent outbreaks of measles, yellow fever, and other vaccine-preventable diseases highlight persistent immunity gaps and surveillance limitations. Structural constraints (including financing fragility, subnational inequities, and system fragmentation) continue to limit sustained progress.
CONCLUSION: This study offers important insights that can inform immunization policymaking in the WHO African Region and beyond. Current post-PHEIC trends reflect recovery without transformation. Achieving IA2030 targets will require a shift from broad coverage expansion to precision delivery approaches that prioritize zero-dose and underserved populations. Immunization must be positioned as a central pillar of primary health care and health security systems.}, }
@article {pmid42188768, year = {2026}, author = {Xue, H and Haynesworth, K and Hempel, HA and Kemp, TJ and Pinto, LA}, title = {Measuring Humoral Immune Responses to SARS-CoV-2: A Comprehensive Review of Serological Assays.}, journal = {Vaccines}, volume = {14}, number = {5}, pages = {}, pmid = {42188768}, issn = {2076-393X}, support = {Contract No. 75N91019D00024/CA/NCI NIH HHS/United States ; }, abstract = {The COVID-19 pandemic highlighted the critical role of serological assays in understanding antiviral immune responses, monitoring vaccine efficacy, and informing public health strategies. This review provides a comprehensive overview of commonly used SARS-CoV-2 antibody detection methods, focusing on binding and neutralization assays. Antibody binding assays, including enzyme-linked immunosorbent assays (ELISAs), chemiluminescence immunoassays (CLIAs), lateral flow immunoassays (LFAs), and multiplex platforms, enable the rapid and high-throughput detection of immunoglobulin isotypes against various viral antigens. Neutralization assays, including live-virus, pseudovirus (PsV), and surrogate assays, offer functional insights into the ability of antibodies to prevent viral entry, though they often require higher biosafety levels and optimization. Serological assays, primarily antibody binding assays and several surrogate neutralization assays, received Emergency Use Authorization (EUA) during the pandemic, supporting seroprevalence efforts. Antibody binding assays and neutralization assays were also widely used in vaccine immunogenicity studies. Despite many standardization initiatives, assay standardization and data harmonization remain challenging and require further efforts. The choice of assay should be guided by study goals: antibody binding assays are preferred for high-throughput monitoring and epidemiological studies, while neutralization assays are essential for assessing functional immunity and variant-specific neutralization and protection.}, }
@article {pmid42188804, year = {2026}, author = {Omondi, J and Ambogo, R and Ochieng, C and Farag, M and Mutwiri, G}, title = {Impact of the COVID-19 Pandemic on HPV Vaccination in Low- and Middle-Income Countries: A Scoping Review.}, journal = {Vaccines}, volume = {14}, number = {5}, pages = {}, pmid = {42188804}, issn = {2076-393X}, support = {345526//University of Saskatchewan, OPVPA/ ; }, abstract = {Background: The COVID-19 pandemic caused disruptions in HPV vaccination and may have severely undermined global cervical cancer prevention, posing long-term risks to controlling cervical cancer and other HPV-related diseases. Objective: We conducted a scoping review to map and synthesize available evidence on how the COVID-19 pandemic has affected human papillomavirus (HPV) vaccination programs in low- and middle-income countries (LMICs) focusing on changes in vaccine delivery and coverage, determinants of uptake, economic and programmatic consequences and vaccine hesitancy. Methods: Inclusion criteria were limited to studies published in the English language between January 2020 to May 2025, and followed JBI and Arksey & O'Malley's scoping review guidelines. The review proceeded through three stages: database searches, gray literature and citation tracking and used a PRISMA-ScR checklist to guide narrative and tabular synthesis. Results: A total of 1063 records, 57 studies were included in the final analysis, and these were spread out across 37 low- and middle-income countries (LMICs) mainly in Africa, Asia, and Latin America. Our analysis revealed that HPV vaccination coverage declined substantially during the COVID-19 pandemic, with reductions of up to 90% reported across the included studies, in the context of school closures, workforce redeployment, and supply-chain disruptions. Recovery efforts also faced major barriers including vaccine hesitancy, misinformation about COVID-19 vaccines, and travel restrictions. Strategies like digital tools, mobile clinics, and community health workers showed promise alongside integrated school- and facility-based approaches, although there is limited evidence on cost-effectiveness and long-term sustainability of these strategies. Conclusions: HPV vaccination in LMICs was significantly disrupted by the COVID-19 pandemic due to unreliable vaccine supply chains, health-worker shortages, and challenges tied to school-based vaccine delivery. Although recovery methods show potential, longer observation periods are needed to determine their full effectiveness.}, }
@article {pmid42188806, year = {2026}, author = {Lee, HM}, title = {Immune Cell Signaling in Feline Infectious Peritonitis Virus Infection and Implications for Vaccine Design.}, journal = {Vaccines}, volume = {14}, number = {5}, pages = {}, pmid = {42188806}, issn = {2076-393X}, support = {Research Grant, 2024//Chungnam National University/ ; }, abstract = {Feline infectious peritonitis virus (FIPV) remains one of the most challenging viral diseases in veterinary medicine, largely owing to the absence of a consistently effective and safe vaccine. Despite widespread feline coronavirus infection, only a subset of infected cats progresses to feline infectious peritonitis, indicating that host immune responses are key determinants of disease outcomes. Accumulating evidence indicates that disease severity is driven not only by viral replication but also by macrophage- and monocyte-centered immune signaling, leading to excessive inflammation and systemic immunopathology in the host. Previous vaccine approaches against FIPV have failed to provide consistent protection and, in some cases, have been associated with enhanced disease. These outcomes suggest that vaccine-induced immune responses that recapitulate pathogenic signaling patterns may exacerbate disease rather than confer protection. In this review, we discuss the current knowledge of immune cell signaling pathways implicated in FIPV infection, including innate sensing through Toll-like receptors, downstream mitogen-activated protein kinases and NF-κB signaling, cytokine production profiles, Fc receptor-associated processes, and intracellular pathways such as autophagy, and how these mechanisms shape vaccine-induced immunity. By integrating insights from immune signaling kinetics, antibody functionality, adjuvant-driven pathway engagement, and platform-specific immune signatures, this review emphasizes the need to reframe FIPV vaccine development strategies that actively shape host immune responses. Rather than maximizing immunogenicity, successful vaccine design is likely to depend on limiting sustained macrophage activation and pro-inflammatory cytokine amplification while supporting antiviral immune functions, thereby reducing the risk of antibody-dependent enhancement and immunopathology. Beyond feline diseases, these considerations provide broader lessons for vaccine design in settings where immune-mediated pathology contributes to disease severity.}, }
@article {pmid42188810, year = {2026}, author = {Park, SH and Son, YM}, title = {Bacterial Membrane Vesicles as Versatile Platforms for Systemic and Mucosal Vaccines.}, journal = {Vaccines}, volume = {14}, number = {5}, pages = {}, pmid = {42188810}, issn = {2076-393X}, support = {RS-2024-00438990//Korea Health Industry Development Institute/Republic of Korea ; RS-2025-16066763//National Research Foundation of Korea/ ; }, abstract = {Bacterial membrane vesicles (BMVs), encompassing outer membrane vesicles (OMVs) released from Gram-negative bacteria and extracellular vesicles (EVs) released from Gram-positive bacteria, have emerged as promising vaccine platforms owing to their intrinsic immunostimulatory properties and capacity to deliver a wide range of antigens. Although conventional vaccines effectively prevent infectious diseases, their long-term efficacy is often limited by antigenic variation and reliance on a restricted number of licensed adjuvants. BMVs, as self-adjuvanting systems, enable both antigen delivery and innate immune activation. BMVs are nanoscale lipid bilayer structures enriched with pathogen-associated molecular patterns (PAMPs), facilitating their recognition and uptake by antigen-presenting cells. This leads to the activation of pattern recognition receptors and the induction of pro-inflammatory cytokines, type I interferons, and adaptive immune responses, including antibody production and Th1- and Th17-biased cellular immunity. Recent studies highlight the versatility of BMVs as vaccine platforms across bacterial, fungal, and viral infection models. BMVs induce protective immunity by promoting both systemic and mucosal immune responses, thereby reducing bacterial burden and limiting pathogen colonization across diverse infection models. These properties have supported their application in viral vaccine development, including influenza and SARS-CoV-2, with the potential to enhance mucosal immunity. Despite these advantages, challenges remain in standardization, safety, and antigen-loading efficiency. Engineered BMVs incorporating protein or mRNA antigens may further enhance antigen presentation and CD8[+] T cell responses. This review summarizes the biological features, immunological mechanisms, and future potential of BMVs in vaccine development.}, }
@article {pmid42189412, year = {2026}, author = {Minari, TP}, title = {Modernization of Nutritional Assessment in Population Surveys: Integrating Anthropometry, Body Composition, and Biomarkers in the Digital Era.}, journal = {Current nutrition reports}, volume = {15}, number = {1}, pages = {}, pmid = {42189412}, issn = {2161-3311}, mesh = {Humans ; *Body Composition ; *Nutrition Assessment ; *Anthropometry/methods ; Biomarkers/analysis ; Nutritional Status ; COVID-19/epidemiology ; Digital Health ; *Nutrition Surveys/methods ; Malnutrition/diagnosis ; SARS-CoV-2 ; Public Health ; }, abstract = {PURPOSE OF REVIEW: This narrative review examines current approaches to nutritional status assessment in population-based surveys, emphasizing the complementary roles of anthropometric measurements, body composition analysis, and biochemical indicators. It aims to critically analyze methodological advances, operational constraints, and emerging strategies to improve the quality and applicability of nutritional surveillance in public health.
RECENT FINDINGS: Anthropometry remains the most widely used method due to its feasibility and scalability, although its diagnostic capacity is limited. Body composition techniques provide more detailed insights into tissue distribution but are constrained by cost and infrastructure requirements. Biochemical indicators offer high sensitivity for detecting metabolic and micronutrient alterations, yet their use in large-scale surveys is restricted by logistical and ethical challenges. The COVID-19 pandemic exposed vulnerabilities in data collection systems and highlighted the need for more resilient surveillance approaches. In parallel, digital technologies have expanded possibilities for data integration and analysis, although their implementation remains uneven across settings. A comprehensive approach to nutritional assessment requires the integration of complementary methods to address the multidimensional nature of malnutrition and chronic disease monitoring. Strengthening population-based surveys depends on balancing methodological rigor with operational feasibility, alongside investments in infrastructure, workforce capacity, and data governance. Advances in digital health may enhance surveillance systems, but their impact will depend on equitable implementation and alignment with public health priorities and equity-oriented strategies.}, }
@article {pmid42189856, year = {2026}, author = {Malieuze Nanfah, MD and Binam Nkot, VM and Yop Kite, MM and Beack Bayengue, SS and Tchamba, GB and Tandja, AG and Koloko, BL and Ngo Malabo, ET and Ekwe Priso, JGLF and Embolo Enyegue, EL and Koanga Mogtomo, ML and Kojom Foko, LP}, title = {Burden and clinical impact of 'neglected' transfusion-transmitted infections in Cameroon: A systematic review and meta-analysis.}, journal = {PLoS neglected tropical diseases}, volume = {20}, number = {5}, pages = {e0014378}, pmid = {42189856}, issn = {1935-2735}, mesh = {Humans ; Cameroon/epidemiology ; *Transfusion Reaction/epidemiology ; Blood Donors ; *Blood-Borne Infections/epidemiology ; Prevalence ; Blood Donation ; Blood Banks ; Blood Safety ; }, abstract = {BACKGROUND: Blood supply is a public health challenge in African countries. In Cameroon, blood selection guidelines focus on four viral and bacterial pathogens (HIV, hepatitis B and C viruses, Treponema pallidum) associated with transfusion-transmitted infections (TTIs). Other pathogens, often endemic (e.g., Plasmodium spp.), are not routinely screened in blood banks and are not included in blood safety guidelines or surveillance, despite their potential for transfusion transmission.
MATERIALS AND METHODS: Here, we conducted a systematic review and meta-analysis of prevalence, determinants, and clinical impact of 'neglected' pathogens, defined as pathogens not included in national blood safety guidelines (e.g., filaria, dengue virus, Toxoplasma gondii), in blood banks. Additionally, we identified the most urgent challenges and proposed actionable solutions to guide blood safety guidelines in the country.
RESULTS: A total of 18 studies, covering ~12,500 donations, were included, with the bulk coming from donors living in three regions (Littoral, Northwest, Centre). Plasmodium parasite (68.4%) was the major studied pathogen, even though an evident publication bias was found (p = 0.004). The other pathogens included dengue virus (5.3%), T. gondii (5.3%), and HTLV-1 (5.3%). The filarial parasite Loa loa was consistently accidentally found. Even though there is no evidence of SARS-CoV-2-associated TTIs till now, the pooled proportion of this virus was 17.7%. The pooled proportions of infection in blood donors were 16.6% for Plasmodium spp. and 0.5% for Loa loa. There is a paucity of clinical impact studies on these 'neglected' TTIs, and the available literature suggests impaired levels of immunoglobulin E and albumin. We identified urgent challenges, including awareness among healthcare providers and policymakers, diagnostic and logistical constraints, and low microbial density infections, associated with neglected pathogen-related blood safety.
CONCLUSION: We opine that providing more epidemiological evidence is crucial to address the above-mentioned challenges for guiding and guaranteeing blood safety in Cameroon.}, }
@article {pmid42191709, year = {2026}, author = {Fleming, D and Smith, E and Ostrowsky, J and Ulrich, A and Leighton, T and Vestin, N and Mehr, AJ and Furst, R and Norton, A and Lackritz, E}, title = {Trends in funding for coronavirus vaccine research and development: implications for preparedness against future coronavirus threats.}, journal = {NPJ vaccines}, volume = {}, number = {}, pages = {}, doi = {10.1038/s41541-026-01493-x}, pmid = {42191709}, issn = {2059-0105}, support = {226543/WT_/Wellcome Trust/United Kingdom ; 226543/WT_/Wellcome Trust/United Kingdom ; }, abstract = {The COVID-19 pandemic triggered unprecedented investment in coronavirus vaccine R&D, but the long-term trajectory of this funding remains unclear. We mapped coronavirus vaccine grant support from 2020 through 2025, and found an early surge focused on ancestral SARS-CoV-2, a pivot toward broadly protective coronavirus vaccines (BPCV), and then a steep decline in publicly available funding overall, especially in the United States. Reduced sustained investment may weaken future preparedness and response globally to emergent coronavirus threats.}, }
@article {pmid42192748, year = {2026}, author = {Ramos Marichal, AI and Brady, SP and Ho, HH and Tarullo, AR and Gill, SV}, title = {Physical Activity, Sleep, and Cognition in Preschool-Aged Children: A Scoping Review.}, journal = {Brain sciences}, volume = {16}, number = {5}, pages = {}, pmid = {42192748}, issn = {2076-3425}, abstract = {BACKGROUND/OBJECTIVES: Early childhood is a critical period for executive function and broader cognitive development. Physical activity and sleep are modifiable health behaviors that support neurobiological processes underlying learning. While each has been widely examined, research investigating their combined or interactive relationships with learning remains fragmented. This scoping review synthesizes the literature on associations among physical activity, sleep, and cognition in preschool-aged children (3-5 years) and identifies gaps in the integration of these domains.
METHODS: Electronic databases were searched for peer-reviewed studies published within the past 10 years. Eligible studies included typically developing children aged 3-5 years and examined overlaps between at least two domains: physical activity, sleep, and cognition. Cross-sectional and longitudinal observational studies were included; intervention and review studies, and those conducted during the COVID-19 pandemic, were excluded.
RESULTS: Thirty-eight studies met the inclusion criteria. Evidence examining physical activity and sleep was limited and inconsistent. Sleep quality indicators (e.g., sleep efficiency and bedtime regularity) were more often reported to be associated with executive function and broader cognitive outcomes than total sleep duration, which showed variable relationships. Findings linking physical activity and cognition were heterogeneous; however, moderate-intensity and cognitively engaging activities were more often reported in association with executive function than total activity or intensity alone.
CONCLUSIONS: Findings suggest that sleep quality and characteristics of physical activity may be relevant for preschool cognitive outcomes. Greater integration of these domains is needed, and future research should examine physical activity, sleep, and cognition within a single integrated framework to clarify potential interactive pathways linking these behaviors within this evidence base and to inform physical activity recommendations for early childhood development.}, }
@article {pmid42193193, year = {2026}, author = {Lee, J and Hwang, H and Hyun, DH}, title = {Plasma Membrane Redox Failure Links COVID-19 Metabolic Stress to Ferroptotic Neurodegeneration.}, journal = {Antioxidants (Basel, Switzerland)}, volume = {15}, number = {5}, pages = {}, pmid = {42193193}, issn = {2076-3921}, support = {RS-2026-25470627//National Research Foundation (NRF) of the Korean government (Ministry of Science and ICT)/ ; }, abstract = {Oxidative stress and redox imbalance are central features of both age-related neurodegenerative disorders and the persistent neurological sequelae of coronavirus disease 2019. Increasing evidence suggests that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection disrupts neuronal redox homeostasis via mitochondrial dysfunction, iron dysregulation, inflammatory signaling, and the depletion of pyridine nucleotide pools. In that context, ferroptosis provides a unifying mechanistic framework linking lipid peroxidation to progressive neuronal injury. This review proposes that neuronal vulnerability might depend not only on the oxidative burden itself but also on the failure of membrane-localized antioxidant defenses. Particular emphasis is placed on the plasma membrane redox system (PMRS), a membrane-associated quinone-reducing network that can support coenzyme Q redox cycling and constrain lipid radical propagation at the plasma membrane. Unlike canonical ferroptosis defense systems that rely predominantly on NADPH, components of the PMRS, particularly cytochrome b5 reductase, can also use NADH, conferring partial metabolic flexibility in conditions of redox stress. We further discuss how SARS-CoV-2-induced NAD[+] depletion might progressively destabilize this membrane-proximal defense architecture, potentially lowering the ferroptotic threshold of vulnerable neurons. Finally, we outline therapeutic strategies that might reinforce PMRS-dependent membrane redox control through NRF2 activation, NAD[+] restoration, coenzyme Q-centered interventions, and modulation of iron-catalyzed lipid oxidation.}, }
@article {pmid42193385, year = {2026}, author = {Lee, WH and Kim, E}, title = {Mucosal Vaccine Development: From Adjuvant Design to Next-Generation Delivery Strategies.}, journal = {Biomedicines}, volume = {14}, number = {5}, pages = {}, pmid = {42193385}, issn = {2227-9059}, support = {RS-2026-25479119//National Research Foundation of Korea/ ; 2022R1F1A1074797//National Research Foundation of Korea/ ; }, abstract = {Most infectious pathogens enter the host through mucosal surfaces, yet conventional injectable vaccines primarily induce systemic immunity without eliciting robust secretory immunoglobulin A (SIgA) responses at mucosal sites. The COVID-19 pandemic highlighted this limitation, as intramuscular mRNA vaccines failed to establish durable mucosal immunity in the upper respiratory tract. This review covers recent progress in mucosal vaccine development. We first discuss the organization of the mucosal immune system, focusing on SIgA induction, tissue-resident memory T (TRM) cells, and resident memory B (BRM) cells. We then examine mucosal adjuvants, from cholera toxin and heat-labile enterotoxin derivatives to stimulator of interferon gene (STING) agonists and a strategy to enhance alum adjuvanticity through neutrophil elastase inhibition. Delivery routes including intranasal, oral, and sublingual administration are reviewed alongside viral vectors, nanoparticles, mRNA-lipid nanoparticles, virus-like particles, and engineered bacterial platforms. The roles of innate immune cells, T helper cell subsets, and the microbiota in shaping vaccine responses are discussed. Finally, we survey licensed mucosal vaccines and the COVID-19 mucosal vaccine pipeline, analyze persistent barriers to clinical translation including the absence of validated mucosal correlates of protection, and outline future directions for thermostable formulations and systems biology-driven vaccine design.}, }
@article {pmid42193881, year = {2026}, author = {Chidanand, D and Cheruku, R and Perla, NS and Darapaneni, A and Panguluri, SK}, title = {Impact of Supplemental Oxygen on Cardiovascular Physiology.}, journal = {Cells}, volume = {15}, number = {10}, pages = {}, pmid = {42193881}, issn = {2073-4409}, mesh = {Humans ; *Oxygen ; Oxidative Stress/drug effects ; Reactive Oxygen Species/metabolism ; Animals ; *Cardiovascular Physiological Phenomena/drug effects ; Hyperoxia/physiopathology ; Lung/physiopathology ; *Oxygen Inhalation Therapy/adverse effects ; COVID-19/therapy ; Respiration, Artificial ; }, abstract = {Supplemental oxygen is a cornerstone intervention in modern clinical practice, widely used to correct hypoxemia in emergency, perioperative, and critical care settings. While oxygen therapy is lifesaving, accumulating evidence indicates that excessive oxygen exposure can induce significant pathophysiological disturbances, particularly within the cardiovascular and pulmonary systems. Hyperoxia (PaO2 > 100 mm Hg) promotes the generation of reactive oxygen species (ROS), leading to oxidative stress, mitochondrial dysfunction, and the activation of pro-fibrotic pathways. When combined with mechanical ventilation, these effects are further amplified through alterations in intrathoracic pressure, reduced venous return, and increased pulmonary vascular resistance, collectively imposing hemodynamic stress on the myocardium. These mechanical and biochemical perturbations converge to drive structural, functional, and electrical remodeling of the heart, including conduction abnormalities and arrhythmogenesis. Emerging clinical insights, particularly from critically ill and COVID-19 populations, underscore the importance of titrated oxygen strategies that balance adequate tissue oxygenation with minimization of hyperoxic injury. This review synthesizes current evidence on hyperoxia-induced oxidative stress, heart-lung interactions, and mechanisms underlying myocardial remodeling to provide a comprehensive framework for optimizing oxygen therapy.}, }
@article {pmid42193931, year = {2026}, author = {Farooqui, SA and Santerre, M and Shcherbik, N and Sawaya, BE}, title = {Memory Impairments: Type, Causes, and Molecular Players-Memory Dysfunction Across Neurologic Insults.}, journal = {Cells}, volume = {15}, number = {10}, pages = {}, pmid = {42193931}, issn = {2073-4409}, mesh = {Humans ; *Memory Disorders/virology/etiology/pathology/metabolism ; Animals ; Hippocampus/virology/pathology/metabolism ; }, abstract = {Viral infections of the central nervous system produce memory impairment through mechanisms that extend beyond acute neuronal injury. Herpes simplex virus type 1, human immunodeficiency virus, varicella zoster virus, cytomegalovirus, Epstein-Barr virus, influenza, SARS-CoV-2, West Nile virus, and Zika virus each enter or engage the brain through distinct routes, yet converge on four shared molecular pathways that selectively damage hippocampal circuits: mitochondria-associated membrane (MAM) dysfunction, chronic neuroinflammation, blood-brain barrier (BBB) disruption, and impaired CREB-BDNF signaling. These pathways specifically compromise the dentate gyrus, CA3, and CA1 subfields, producing predictable deficits in pattern separation, associative retrieval, and temporal memory binding. Antiretroviral and antiviral therapies suppress viral replication but fail to reverse organelle-level dysfunction, leaving most hippocampal injury unaddressed. Emerging plasma biomarkers, p-tau217, neurofilament light chain, and GFAP, combined with hippocampal subfield MRI, now enable mechanistic stratification before irreversible circuit loss occurs. This review proposes, as a unifying hypothesis, that virus-associated memory impairment represents a convergent hippocampal syndrome driven by shared downstream pathways, and that combination therapies targeting these pathways simultaneously offer greater therapeutic promise than pathogen-specific approaches alone. The evidentiary basis for this framework varies across pathogens and conditions; direct mechanistic evidence, mechanistic analogy, and preclinical data are distinguished throughout.}, }
@article {pmid42193949, year = {2026}, author = {Abdelhakim, M and Miyata, T}, title = {Plasminogen Activator Inhibitor-1 as a Therapeutic Target for Healthy Longevity, Immunosenescence, and Age-Related Disease: Translational Development of the Small-Molecule Inhibitor TM5614.}, journal = {Cells}, volume = {15}, number = {10}, pages = {}, pmid = {42193949}, issn = {2073-4409}, mesh = {Humans ; *Plasminogen Activator Inhibitor 1/metabolism ; Animals ; *Longevity/drug effects ; *Immunosenescence/drug effects ; Translational Research, Biomedical ; *Aging/drug effects ; *para-Aminobenzoates/pharmacology/therapeutic use ; Piperazines ; }, abstract = {Plasminogen activator inhibitor-1 (PAI-1), encoded by SERPINE1, is the principal physiological inhibitor of tissue-type and urokinase-type plasminogen activators and a central regulator of fibrinolysis. Beyond its canonical hemostatic role, PAI-1 has emerged as a pleiotropic mediator of tissue remodeling, fibrosis, metabolic dysfunction, cancer progression, cellular senescence, and age-associated immune dysregulation. A central argument of this review is that PAI-1 should be understood not only as a downstream biomarker of aging-associated pathology, but also as an active effector linking senescence-associated secretory phenotype (SASP) signaling, chronic low-grade inflammation, impaired immune surveillance, fibrotic extracellular matrix remodeling, and a prothrombotic state. In this framework, PAI-1 may function as an immune-aging checkpoint: a molecular node through which senescent, stromal, malignant, and inflammatory cells reinforce immune evasion and tissue dysfunction. Structure-guided drug discovery has enabled the development of small-molecule PAI-1 inhibitors, including TM5275, TM5441, TM5509, and TM5614. Among these, TM5614 is an orally available investigational compound that has progressed to clinical evaluation. Preclinical studies support anti-thrombotic, anti-fibrotic, anti-inflammatory, anti-senescent, and tumor-microenvironment-modulating effects of PAI-1 inhibition, while early clinical studies have evaluated TM5614 in chronic myeloid leukemia, immune-checkpoint-refractory malignant melanoma, non-small-cell lung cancer, and COVID-19-associated pneumonia. This review summarizes the biology of PAI-1, expands the discussion of immunoaging, reviews representative preclinical and clinical data, compares available PAI-1 inhibitors, and discusses the translational opportunities and safety considerations for TM5614 and related compounds.}, }
@article {pmid42194913, year = {2026}, author = {Almulhem, MM and Siraj, RA}, title = {Mental Health in Cystic Fibrosis in the Modulator Era: Epidemiology, Prognostic Significance, and Therapeutic Implications.}, journal = {Journal of clinical medicine}, volume = {15}, number = {10}, pages = {}, pmid = {42194913}, issn = {2077-0383}, abstract = {Individuals with cystic fibrosis (CF) face significant treatment burdens, and as life expectancy has increased, there is growing emphasis on their psychosocial well-being. Prevalence data indicate that approximately one-quarter to one-third of individuals with CF and their caregivers experience clinically significant anxiety or depression. Specifically, pooled global estimates report an anxiety prevalence of 24.9% (95% CI: 20.8-28.9%) and depression prevalence of 13-33% in adults with CF, with caregivers experiencing even higher rates (anxiety: 35-38%; depression: 20-35%). Depression is independently associated with a nearly twofold increase in mortality risk and substantially higher healthcare costs, underscoring its prognostic significance. These mental health comorbidities are consistently associated with reduced treatment adherence, diminished quality of life, increased healthcare utilisation, and decreased survival. Accordingly, psychological well-being has emerged as a key patient outcome that directly shapes engagement with care and the effectiveness of long-term CF management. International CF guidelines now recommend routine mental health screening within multidisciplinary care frameworks. Evidence-based interventions include cognitive-behavioural therapy (CBT), which is endorsed as a primary treatment, although access remains limited, and stepped-care pharmacotherapy, primarily selective serotonin reuptake inhibitors (SSRIs), for moderate to severe symptoms. Telemedicine and other digital health approaches have expanded access to psychological support, with remote CBT and online programmes demonstrating feasibility and symptom improvement during the COVID-19 pandemic and beyond. The advent of CFTR modulator therapies has significantly altered clinical outcomes, enabling many patients to achieve improved lung function and daily functioning. Nevertheless, mental health challenges persist, as individuals navigate new identity shifts and anxieties despite enhanced physical health. The implementation of mental healthcare remains inconsistent; while screening rates have increased, timely follow-up and integrated psychosocial support are frequently insufficient across care centres. This narrative review highlights the ongoing need to integrate mental health management into CF care to optimise adherence, patient outcomes, and long-term survival in the current therapeutic landscape.}, }
@article {pmid42195058, year = {2026}, author = {Groff, P and De Vuono, S}, title = {Non-Invasive Respiratory Support in "De Novo" Acute Hypoxemic Respiratory Failure: Which Technique Is Best?.}, journal = {Medicina (Kaunas, Lithuania)}, volume = {62}, number = {5}, pages = {}, pmid = {42195058}, issn = {1648-9144}, mesh = {Humans ; *Respiratory Insufficiency/therapy ; *Hypoxia/therapy ; COVID-19/complications ; *Noninvasive Ventilation/methods ; Practice Guidelines as Topic ; Acute Disease ; }, abstract = {Background: One of the most debated scientific topics in recent years is the role of non-invasive respiratory support techniques in the treatment of de novo acute hypoxemic respiratory failure. Until pre-COVID-19, the most accredited guidelines did not make recommendations for or against the use of these techniques in this clinical condition, and the increased risk of adverse events for patients who failed the non-invasive approach was widely reported in the literature. The most recent guidelines recommend the use of HFNC as a first-line technique in the treatment of de novo acute hypoxemic respiratory failure to avoid the need for tracheal intubation. However, the strength of these recommendations remains weak, the quality of the underlying evidence is poor, and their usefulness in deciding which technique to apply to an individual patient is questionable. Aim: The aim of this review was to provide the reader with some critical tools to interpret the different indications regarding the choice of the best non-invasive support technique to be used in this setting. Methods: To this end, we analyzed the available literature on this topic, privileging the works that are most useful in correlating the practical indications to the pathophysiological assumptions. Results and Conclusions: The notable heterogeneity of the studies on which the current recommendations are based, as well as the affirmation of the concept of patient self-induced lung injury (P-SILI), highlights the importance of assessing each patient's risk of developing this complication, individualizing treatment to the patient's specific needs, and monitoring the patient during treatment.}, }
@article {pmid42196353, year = {2026}, author = {Jarończyk, M and Walory, J}, title = {Mortality Assessment in Patients with Cardiovascular Disease and COVID-19: A Systematic Review and Meta-Analysis.}, journal = {International journal of molecular sciences}, volume = {27}, number = {10}, pages = {}, pmid = {42196353}, issn = {1422-0067}, mesh = {Humans ; *Cardiovascular Diseases/mortality/complications/epidemiology ; *COVID-19/mortality/epidemiology/complications ; Comorbidity ; Hypertension/mortality/epidemiology ; Diabetes Mellitus/mortality/epidemiology ; SARS-CoV-2/isolation & purification ; Renal Insufficiency, Chronic/mortality/epidemiology ; }, abstract = {The COVID-19 pandemic has had a profound impact on global health, especially among patients with cardiovascular disease (CVD) and the existence of additional conditions such as diabetes (DM), hypertension (HT), and chronic kidney disease (CKD) can have a significant impact on survival rates. The aim of this study was to determine the mortality rate in patients with CVD and the impact of other comorbidities on the death of patients with COVID-19. This systematic review was conducted using PubMed, EMBASE, and Google Scholar databases from August 2020 to June 2025. Inclusion criteria were patients with cardiovascular disease and associated comorbidities during the COVID-19 pandemic. Article selection was limited to articles published in English and Polish. Statistical analysis using a random-effects model was performed using STATA software. Heterogeneity between studies was examined, and a funnel plot for publication bias was generated. The higher mortality rates (OR = 3.00, 95% CI: 2.06-4.38) for patients with cardiovascular disease were observed. In the group of patients with comorbidities such as hypertension and diabetes mellitus the risk of death was also determined and for HT was OR = 1.94, 95% CI, 1.50-2.52 and for DM OR = 2.17, 95% CI: 1.64-2.86. The mortality in the chronic kidney disease group was higher than for HT and DM (OR = 3.91, 95% CI: 2.50-6.10). The risk of death is three times higher for patients with COVID-19 and CVD. High mortality risk is also linked to diabetes and hypertension but for chronic kidney disease patients increased up to four times.}, }
@article {pmid42196720, year = {2026}, author = {Norlund, P and Arsanjani, JJ and Paasch, JM}, title = {Spatio-Temporal COVID-19 Modeling: A Global Systematic Review of Data Integration, Equity, and Lessons for Pandemic Preparedness.}, journal = {International journal of environmental research and public health}, volume = {23}, number = {5}, pages = {}, pmid = {42196720}, issn = {1660-4601}, mesh = {*COVID-19/epidemiology ; Pandemic Preparedness ; Humans ; Spatio-Temporal Analysis ; Bayes Theorem ; Pandemics ; SARS-CoV-2 ; }, abstract = {The COVID-19 pandemic generated an unprecedented volume of spatially and temporally resolved data, enabling rapid development of spatio-temporal models for surveillance, forecasting, and policy support. However, the evolution, geographic distribution, and equity implications of these models remain insufficiently synthesized. This study presents a global systematic review of 363 peer-reviewed studies published between January 2020 and August 2025 using publicly available data. Following PRISMA 2020 guidelines, studies were classified by geographic scale, modeling approach, data streams, and analytical purpose. The results indicate that Bayesian and compartmental models remained dominant throughout the pandemic, although methodological diversity increased over time with the growing use of machine learning and hybrid frameworks integrating mobility, environmental, and socio-demographic data. Data integration was more common than previously reported. Approximately 30% of studies relied on a single data stream, while 70% incorporated multiple sources, although most multi-source approaches combined only two data types and relatively few studies integrated three or more. Geographic coverage was uneven, with a strong concentration of studies in high-income regions and persistent underrepresentation of low- and middle-income contexts. Models incorporating finer spatial scales and socio-demographic variables more frequently supported geographically targeted interpretation of risk, vulnerability, testing access, and intervention needs. Overall, the findings highlight the importance of multi-source data integration, improved geographic representativeness, and transparent uncertainty communication, alongside the need for FAIR-aligned and equity-aware data infrastructures to strengthen future pandemic preparedness.}, }
@article {pmid42196842, year = {2026}, author = {Oksentowicz, MA and Sztachelska, M and Dymicka-Piekarska, V}, title = {Platelet-to-Lymphocyte Ratio-A Real or Fake Bridge Between Inflammation and Coagulation in COVID-19 Patients: A Scoping Review.}, journal = {Diagnostics (Basel, Switzerland)}, volume = {16}, number = {10}, pages = {}, pmid = {42196842}, issn = {2075-4418}, support = {SUB/1/DN/22/005/2209//Medical University of Białystok/ ; }, abstract = {Background: Patients with COVID-19 often develop COVID-19-Associated Coagulopathy (CAC)-an imbalance between procoagulant and anticoagulant pathways resulting from the uncontrolled inflammatory response triggered by SARS-CoV-2 infection. This study aims to investigate the impact of a hematological and inflammatory parameter-the platelet-to-lymphocyte ratio (PLR)-on the severity and mortality of COVID-19. Methods: We conducted a comprehensive search of the PubMed database and yielded 75 articles published in the period of 2020-2025, of which 20 studies that evaluated the prognostic value of PLR on hospital admission in COVID-19 patients were included. The review particularly focuses on ROC analyses and reported AUC values. Results: A total of 20 studies were analyzed, including 13 studies assessing disease severity and 14 studies evaluating mortality. Higher PLR values have been observed in patients with a more severe course of COVID-19 compared to those with milder disease, and in non-survivors compared to survivors. However, the literature shows inconsistency regarding the diagnostic utility of PLR based on ROC curve analysis. The reported AUC values ranged from 0.559 to 0.811 for disease severity differentiation and from 0.474 to 0.758 for mortality, which may be related to the heterogeneity of the study populations included in the analysis. Conclusions: PLR may not serve as a direct bridge between inflammation and coagulation in COVID-19-Associated Coagulopathy, but it is indirectly linked to disease severity and mortality, as it reflects changes in both platelet and lymphocyte counts. It is a complementary marker that may assist clinicians in assessing COVID-19 patients but still requires further investigation.}, }
@article {pmid42198337, year = {2026}, author = {Akkineni, S and Gulani, M and Kouzi, SA and D'Souza, MJ and Uddin, MN}, title = {Delivery of mRNA Therapeutics Beyond Infectious Diseases: Design Innovations and Applications in Oncology, Cardiovascular, and Rare Genetic Diseases.}, journal = {Pharmaceuticals (Basel, Switzerland)}, volume = {19}, number = {5}, pages = {}, pmid = {42198337}, issn = {1424-8247}, abstract = {Empowered by nanotechnology, messenger RNA (mRNA) therapeutics have shown a rapid evolution post COVID-19 from a conceptual platform to a clinically validated modality, and they diversified into oncology, cardiovascular diseases, and rare disorders. As a template for in situ protein production, it offers several advantages over traditional proteins and DNA drugs. The intrinsic stability of mRNA and its sensitivity to innate immune sensing hinder its capacity for immediate cellular entry, necessitating its need for a delivery system to obtain optimal therapeutic potential. This review explores the innovations in nanocarrier engineering, design principles for lipid nanoparticles-mRNA (LNPs) platforms, and their clinical translation across the prominent indications. It also addresses their safety, immunogenicity, and scalability while addressing the key limitations and manufacturing scalability through comparative platform analysis. Although LNPs usually dominate their delivery through encapsulation and manufacturability, their limitations, like repeat dose reactogenicity and liver tropism, require next-generation designs like SORT lipids, stimuli-responsive hybrids for extrahepatic targeting. In oncology, LNP-mRNA drives the neoantigen vaccines, and rare diseases leverage the transient enzyme replacement. While the safety profiles highlight the innate immune tuning through nucleoside mods and lipid biodegradability, chronic administration risks are still persistent. While there are novel scalability options like microfluidic mixing to support the production gaps in organ selectivity and durability, their adoption is hindered. We outline the future directions to perceive mRNA's full potential as a broader therapeutic class.}, }
@article {pmid42198624, year = {2026}, author = {Vashishat, I and Han, SE and Assogba, BD}, title = {COVID-19 in Space: Possible Health Risks and Preparedness Guidelines.}, journal = {Pathogens (Basel, Switzerland)}, volume = {15}, number = {5}, pages = {}, pmid = {42198624}, issn = {2076-0817}, support = {SRIG104486.//Kwantlen Polytechnic University/ ; }, mesh = {Humans ; Astronauts ; *COVID-19/transmission/epidemiology/prevention & control/virology ; Pandemic Preparedness ; Pandemics/prevention & control ; SARS-CoV-2 ; *Space Flight ; Weightlessness ; }, abstract = {BACKGROUND: The COVID-19 pandemic resulted in over 705 million infections and 7 million deaths, underscoring the importance of understanding disease behavior across diverse environments. As NASA, SpaceX, and ISRO prepare for more frequent missions, managing health risks for astronauts and space tourists is essential.
OBJECTIVE: This study reviews the literature on airborne infections in space, identifies research gaps, and establishes preparedness strategies for potential COVID-19 outbreaks during space missions.
METHODS: A systematic literature review was conducted to identify studies examining airborne infectious diseases in space. To compare these findings with Earth-based data, pathogen safety data sheets were used. A separate systematic review was conducted to explore similarities between COVID-19 and the identified airborne infectious diseases. A comparative approach was used to predict COVID-19's potential behavior in microgravity. Existing guidelines for managing airborne diseases in space and on Earth were reviewed and compared to develop a set of preparedness recommendations for COVID-19 in space.
RESULTS: Nine airborne infectious diseases occurring in space were identified. Six tentative effects of COVID-19 in a microgravity environment were theorized in this study. We propose recommendations to improve current space travel health guidelines and address the identified risks.
CONCLUSIONS: The results of this study will change the course of human space exploration by assisting in the protection of space travelers and guiding the development of new protocols that include comprehensive safety features.}, }
@article {pmid42198648, year = {2026}, author = {Alanazi, A and Ibrahim, MN and Alenezi, MA and Albalawi, WO}, title = {Molecular Mechanisms of Mucormycosis Pathogenesis: Host-Pathogen Interactions and Immune Evasion.}, journal = {Pathogens (Basel, Switzerland)}, volume = {15}, number = {5}, pages = {}, pmid = {42198648}, issn = {2076-0817}, mesh = {Humans ; *Mucormycosis/immunology/microbiology/pathology ; *Immune Evasion ; *Host-Pathogen Interactions/immunology ; *Mucorales/pathogenicity/immunology ; Endoplasmic Reticulum Chaperone BiP ; COVID-19/immunology/complications ; Animals ; Virulence Factors/metabolism ; Immunity, Innate ; SARS-CoV-2 ; }, abstract = {Mucormycosis, triggered by fungi of the order Mucorales, represents a potentially fatal invasive mycosis, with death rates over 50% despite intensive therapy. The COVID-19 pandemic brought a sharp increase in cases, especially in individuals with diabetes mellitus and those undergoing immunosuppressive treatment, emphasizing significant gaps in our comprehension of disease pathogenesis. Emerging molecular studies have highlighted key virulence factors, such as the CotH family of invasins that facilitate endothelial invasion via interaction with glucose-regulated protein 78 (GRP78), complex iron acquisition systems necessary for fungal growth, and the release of mucoricin, a ricin-like toxin that impairs vascular integrity. Host defense depends mainly on innate immunity, with neutrophils and macrophages working as critical effector cells, while adaptive Th1 and Th17 responses aid in the fungal removal. Mucorales use a variety of immune evasion techniques, such as pathogen-associated molecular pattern (PAMP) masking via cell wall transformations, resistance to phagocytic death, and metabolic utilization of host factors including hyperglycemia and increased free iron in diabetic ketoacidosis (DKA). This review summarizes current evidence of the molecular processes underlying mucormycosis pathogenesis, underscoring host-pathogen interactions at the cellular and molecular levels, immune evasion tactics, and translational potential for new diagnostic and therapeutic approaches. Comprehending these molecular processes is crucial for creating efficient therapies against mucormycosis in an era of growing immunocompromised patients and expanding infectious disease synergies.}, }
@article {pmid42198669, year = {2026}, author = {Bahmad, HF and Ghssein, G and Bahmad, M and Elajami, TK and Forghani, I and Tuda, C and Ruiz-Cordero, R}, title = {Paleopathology Meets Public Health: Deep-Time Syndemics and the Ecology of Emerging Infections.}, journal = {Pathogens (Basel, Switzerland)}, volume = {15}, number = {5}, pages = {}, pmid = {42198669}, issn = {2076-0817}, mesh = {Humans ; *Public Health ; *Paleopathology/methods ; SARS-CoV-2 ; COVID-19/epidemiology ; Pandemics ; *Communicable Diseases, Emerging/epidemiology ; DNA, Ancient/analysis ; *Coronavirus Infections/epidemiology ; }, abstract = {Why do pandemics keep emerging despite decades of surveillance and response? Paleopathology, the study of disease traces in ancient remains, has been revolutionized by ancient DNA (aDNA) analysis and next-generation sequencing (NGS). Reconstructing pathogen genomes from archaeological material enables the identification of extinct lineages, the refinement of disease chronologies, and the characterization of long-term host-pathogen co-evolution. This provides context for public health challenges, including the emergence of pandemics and antimicrobial resistance (AMR). Infectious diseases are increasingly understood as complex phenomena arising from biological, ecological, and sociopolitical forces. Integrating paleopathology, aDNA, and paleomicrobiology supports a deep-time syndemic framework, revealing how recurring biosocial drivers have structured infectious disease risk throughout history. Ancient resistome studies demonstrate that AMR predates modern antibiotic use, reframing resistance as an intrinsic ecological feature rather than solely a modern phenomenon. Coronavirus disease 2019 (COVID-19) reaffirmed how infection intersects with chronic disease, health system fragility, and social inequities. This review highlights how integrating evolutionary perspectives into One Health shifts surveillance from a reactive approach to upstream risk mitigation and spillover prevention.}, }
@article {pmid42198712, year = {2026}, author = {Shalaby, L and Al-Haneedi, Y and Abdelhamid, A and Yassine, H and Emara, MM}, title = {Furin as a Novel Pan-Viral Therapeutic Target: Implications for Dengue and SARS-CoV-2.}, journal = {Viruses}, volume = {18}, number = {5}, pages = {}, pmid = {42198712}, issn = {1999-4915}, support = {ARG01-0521-230249//Qatar Research, Development and Innovation Council, Academic Research/ ; }, mesh = {Humans ; *Furin/antagonists & inhibitors/metabolism ; *Antiviral Agents/pharmacology/therapeutic use ; *Dengue Virus/drug effects/physiology ; *SARS-CoV-2/drug effects/physiology ; Virus Internalization/drug effects ; *Dengue/drug therapy/virology ; COVID-19/virology ; *COVID-19 Drug Treatment ; Animals ; Host-Directed Therapy ; Spike Glycoprotein, Coronavirus/metabolism ; }, abstract = {Dengue virus (DENV) and SARS-CoV-2 are emerging viral pathogens that share overlapping clinical features, including fever, fatigue, and respiratory symptoms, complicating differential diagnosis in endemic regions. Their co-circulation has increased the risk of co-infections, which may result in unpredictable disease progression, increased morbidity, and mortality. This overlap presents a significant challenge in managing outbreaks, as both viruses pose a major public health threat. Vaccines and direct-acting antivirals may be rendered ineffective by viral mutations, making it difficult to address evolving strains. Host-directed antivirals offer a promising alternative, potentially maintaining efficacy against a multitude of variants. Both DENV and SARS-CoV-2 rely on host proteases for viral maturation and entry, with furin playing a crucial role in viral glycoprotein cleavage. In DENV, furin cleaves the prM protein, facilitating virion maturation, while in SARS-CoV-2, the polybasic furin cleavage site in the spike protein enhances viral entry. This makes furin a compelling pan-viral target, where inhibiting furin could reduce viral fitness without relying on viral mutations. This review highlights the therapeutic rationale for targeting furin and discusses luteolin, a furin inhibitor showing antiviral activity against both viruses. Furin-targeted therapies may offer a durable antiviral strategy effective across DENV serotypes, SARS-CoV-2 variants, and co-infection settings.}, }
@article {pmid42198723, year = {2026}, author = {Griffith, LD and Dervisevic, S and Powell, PP}, title = {Development and Evaluation of Molecular Diagnostic Tests for SARS-CoV-2 at English NHS Sites Throughout the COVID-19 Pandemic.}, journal = {Viruses}, volume = {18}, number = {5}, pages = {}, pmid = {42198723}, issn = {1999-4915}, support = {MR/R015937/1/MRC_/Medical Research Council/United Kingdom ; }, mesh = {Humans ; *SARS-CoV-2/genetics/isolation & purification ; *COVID-19/diagnosis/epidemiology ; *Molecular Diagnostic Techniques/methods ; Pandemics ; Sensitivity and Specificity ; United Kingdom/epidemiology ; Nucleic Acid Amplification Techniques/methods ; State Medicine ; COVID-19 Nucleic Acid Testing/methods ; COVID-19 Testing/methods ; Retrospective Studies ; England/epidemiology ; }, abstract = {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.}, }
@article {pmid42198738, year = {2026}, author = {Skowron, K and Bauza-Kaszewska, J and Budzyńska, A and Wiktorczyk-Kapischke, N and Czuba, J and Wałecka-Zacharska, E and Wnuk, K and Zapadka, M and Kasprzyk, K and Grudlewska-Buda, K}, title = {Bat-Borne Viruses and Pandemic Risk: Could Europe Be an Emergence Hotspot?.}, journal = {Viruses}, volume = {18}, number = {5}, pages = {}, pmid = {42198738}, issn = {1999-4915}, mesh = {*RNA Viruses/isolation & purification ; *Zoonoses/epidemiology/transmission/virology ; *Viral Zoonoses/epidemiology/transmission/virology ; *Disease Reservoirs/virology ; Virus Diseases/epidemiology/transmission/virology ; Pandemics ; Chiroptera/virology ; Europe/epidemiology ; *SARS-CoV-2 ; *Middle East Respiratory Syndrome Coronavirus ; Animals ; }, abstract = {The recent SARS-CoV-2 pandemic-which had significant worldwide health, economic, and other effects-indicated the need to monitor zoonotic viruses with pandemic potential. The aim of this review is to assess bat-borne viruses as a potential pandemic risk, with a particular focus on Europe. The presence and activity of bats, as well as diseases emerging in humans in various regions of the world, point to their importance in the context of a possible outbreak of future epidemics. The rate of genetic change observed among viruses requires constant scrutiny on all continents, including Europe. Bats are a considerable source of many zoonotic viruses, including coronaviruses, filoviruses and paramyxoviruses. Among viruses associated with bats, RNA viruses are the dominant ones, characterized by high pathogenicity and often leading to interspecies transmission. The majority (about 80%) of RNA viruses were identified in bats from three families: Vespertilionidae, Rhinolophidae and Pteropodidae. Understanding how viruses are transmitted in the environment and the role of reservoir organisms and intermediate hosts is crucial to determining the level of epidemic risk. This review discuses viruses identified in bats globally, with a special focus on Europe, and evaluates their potential to cause epidemics.}, }
@article {pmid42198749, year = {2026}, author = {Hou, S and Shen, X and Sun, D and An, Y and Zhou, Y and Sun, X and Wang, S and Liu, X and Zhu, M and Zhao, S and Liu, Z and Wu, X and Liu, R}, title = {NLR Inflammasomes in Viral Infections: From Molecular Mechanisms to Therapeutic Interventions.}, journal = {Viruses}, volume = {18}, number = {5}, pages = {}, pmid = {42198749}, issn = {1999-4915}, support = {No.82272330//National Natural Science Foundation of China/ ; 2024JC-ZDXM-42//Shaanxi Provincial Natural Science Basic Research Program Key Project/ ; }, mesh = {*Inflammasomes/immunology/metabolism ; Humans ; *Virus Diseases/immunology/virology/drug therapy ; Immune Evasion ; Innate Immunity Recognition ; Animals ; *NLR Proteins/immunology/metabolism ; Immunity, Innate ; Pyroptosis ; Host-Pathogen Interactions ; }, abstract = {The innate immune system serves as the primary barrier against viral invasion, utilizing pattern recognition receptors (PRRs) to orchestrate a rapid defense. Among these, the nucleotide-binding domain and leucine-rich repeat (NLR) containing proteins function as central signaling scaffolds, assembling into multiprotein complexes known as inflammasomes. These complexes drive the maturation of pro-inflammatory cytokines IL-1β and IL-18, and initiate gasdermin D (GSDMD)-mediated pyroptosis, a lytic cell death pathway that eliminates intracellular replication niches. This comprehensive review synthesizes the diversified landscape of inflammasome activation during viral infections, extending beyond the canonical NLRP3 inflammasome to include specialized sensors such as NLRP6, NLRP9, NLRP1, NLRP12, and NLRC4. We critically evaluate the evolutionary "arms race" between host defenses and viral pathogens, detailing the sophisticated immune evasion strategies employed by viruses-ranging from the expression of decoy proteins and direct proteolytic cleavage of immune sensors to the manipulation of post-translational modifications (PTMs). Furthermore, we discuss the dual nature of inflammasome activation, which balances protective viral clearance against pathological hyperinflammation, and provide an exhaustive analysis of novel therapeutic strategies, including direct NLR inhibitors and downstream cytokine blockers, currently navigating clinical transition.}, }
@article {pmid42198768, year = {2026}, author = {Ambasta, RK and Das, SR}, title = {Viral Comorbidities Remodel Host Transcriptome and Redox Signaling in an NADPH Oxidase Isoform-Specific Manner.}, journal = {Viruses}, volume = {18}, number = {5}, pages = {}, pmid = {42198768}, issn = {1999-4915}, support = {U24OD035523//National Institutes of Health Clinical Center/ ; }, mesh = {Humans ; Oxidation-Reduction ; *Signal Transduction ; *NADPH Oxidases/metabolism/genetics ; Reactive Oxygen Species/metabolism ; *Transcriptome ; *Virus Diseases/metabolism/genetics/virology ; MicroRNAs/genetics/metabolism ; Animals ; Host-Pathogen Interactions ; }, abstract = {Viral comorbidities elicit complex host responses by activating redox-sensitive signaling pathways, prominently those regulated by NADPH oxidase (Nox) enzymes. Nox are critical components of host defense, generating reactive oxygen species (ROS) that modulate key cellular signaling cascades. Under normal physiological conditions, Nox activity is tightly controlled; however, viral infections frequently disrupt this regulation, leading to aberrant upregulation of specific Nox isoforms. Elevated expression of individual Nox enzymes has been observed in infections such as influenza A and hepatitis C virus, while simultaneous activation of multiple Nox isoforms occurs in HIV and SARS-CoV infections. Similar patterns of dual or multi-isoform Nox activation are also reported in complex disease states, including diabetes, thrombosis, and fibrosis. MicroRNAs play a crucial role in this process by selectively regulating Nox isoform expression during viral infection, thereby remodeling the host redox environment. Nox-derived ROS influence multiple downstream signaling pathways, including SMAD, MAPK, CXCR-mediated signaling, and the JNK/ERK axis, promoting inflammation and fibrosis that worsen viral disease outcomes. Additionally, several FDA-approved drugs, investigational agents, and microRNA-based therapeutics show promise in modulating Nox activity. Therefore, this article substantiates how viral infections reprogram host transcriptomic and redox signaling networks, contributing to viral pathogenesis and offering potential therapeutic intervention strategies.}, }
@article {pmid42199010, year = {2026}, author = {Kim, YJ and Lee, SJ and Lee, W and Kim, SJ and Ahn, DG}, title = {Modulation of Host Innate Immune Response by Highly Pathogenic Human Coronaviruses during Viral Infection.}, journal = {Journal of microbiology and biotechnology}, volume = {36}, number = {}, pages = {e2602038}, pmid = {42199010}, issn = {1738-8872}, mesh = {Humans ; *Immunity, Innate ; SARS-CoV-2/immunology ; *Coronavirus Infections/immunology/virology ; Immune Evasion ; COVID-19/immunology ; *Coronavirus/immunology/pathogenicity ; *Betacoronavirus/immunology/pathogenicity ; Severe acute respiratory syndrome-related coronavirus/immunology/pathogenicity ; Middle East Respiratory Syndrome Coronavirus/immunology/pathogenicity ; Pandemics ; Innate Immunity Recognition ; *Pneumonia, Viral/immunology/virology ; Host-Pathogen Interactions/immunology ; Animals ; }, abstract = {Highly pathogenic human coronaviruses, including SARS-CoV, SARS-CoV-2, and MERS-CoV have emerged as significant public health threats due to their ability to cause widespread outbreaks and pandemics. These viruses induce dysregulated inflammatory responses, typified by cytokine storms that drive extensive tissue damage in pulmonary and extrapulmonary systems, leading to acute respiratory distress syndrome (ARDS) and multi-organ failure. These pathological outcomes are driven by sophisticated mechanisms that manipulate host immune pathways and evade innate and adaptive immune surveillance. The innate immune system plays a pivotal role in the early detection and control of viral infections through mechanisms such as cytoplasmic RNA sensors, Toll-like receptors, interferon signaling, and inflammasome activation. However, these coronaviruses effectively exploit and subvert these processes, suppressing antiviral defenses while amplifying inflammatory cascades. This review delineates the molecular and cellular strategies employed by these pathogens to evade immune recognition and exacerbate immune-mediated tissue injury. Understanding these processes is fundamental for guiding the development of targeted antiviral interventions, immunomodulatory therapeutics, and robust strategies to mitigate the impact of future coronavirus pandemics.}, }
@article {pmid42199422, year = {2026}, author = {Zhang, J and Li, C and Wu, Y and Wang, L and Yu, J and Wang, A and Kong, W and Ning, M and Chen, J and Chen, Y}, title = {Fc effector functions in RNA viral infections: mechanisms of antiviral immunity and implications for vaccine design.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1772257}, pmid = {42199422}, issn = {1664-3224}, mesh = {Humans ; Animals ; *Immunoglobulin Fc Fragments/immunology ; *Viral Vaccines/immunology ; *Receptors, Fc/immunology ; Antibody-Dependent Cell Cytotoxicity ; *Antibodies, Viral/immunology ; Antibodies, Neutralizing/immunology ; *RNA Virus Infections/immunology/prevention & control ; Vaccine Development ; Antibody-Dependent Enhancement ; }, abstract = {Neutralizing antibodies (NAbs) have long been the principal correlate of antiviral protection. Evidence now indicates that antibody Fc-mediated effector functions play indispensable and context-dependent roles in antiviral immunity. Through interactions between the fragment crystallizable (Fc) domain and Fc receptors (FcRs) or complement components, antibodies mediate a broad spectrum of effector mechanisms, including antibody-dependent cellular cytotoxicity (ADCC), antibody-dependent cellular and neutrophil phagocytosis (ADCP and ADNP), and complement activation, contributing to viral control beyond direct neutralization. In this review, we integrate recent evidence on Fc effector biology across major viral infections, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza virus, human immunodeficiency virus (HIV), Ebola virus (EBOV), and dengue virus (DENV). We discuss how Fc-FcR interactions shape antiviral immune outcomes, modulate vaccine efficacy, and influence the balance between protective immunity and immunopathology, including antibody-dependent enhancement (ADE). We focus on the experimental strategies used to assess Fc-mediated functions and on the inherent limitations of in vitro assays and animal models in defining their physiological relevance in humans. We explore how different vaccine platforms and immunization strategies shape Fc effector profiles, specifically through antibody subclass selection, Fc glycosylation patterns, and engagement with Fcγ receptors. We also summarize emerging approaches to Fc engineering and glycan modification that aim to enhance antibody efficacy while limiting adverse immune activation. This review summarizes current understanding of Fc effector functions in antiviral immunity and discusses their relevance for the design of next-generation vaccines and antibody-based therapies.}, }
@article {pmid42199444, year = {2026}, author = {Okezie, CW and Badru, OA and Ibitoye, FA and Edeh, JC and Adeagbo, OA}, title = {Perspective of People Living With HIV and Healthcare Workers on the Uptake, Barriers, and Benefits of Multimonth Dispensing: A Qualitative Systematic Review.}, journal = {AIDS research and treatment}, volume = {2026}, number = {}, pages = {1392259}, pmid = {42199444}, issn = {2090-1240}, abstract = {INTRODUCTION: Multimonth dispensing (MMD) is a strategy in the HIV care continuum for people living with HIV (PLWH), especially for those who are virally suppressed. With the increase in MMD following the COVID-19 pandemic, there is a dearth of data on its impact on HIV care outcomes, such as viral suppression. Therefore, we conducted a qualitative systematic review to explore how PLWH and healthcare workers (HCWs) perceive the uptake, barriers, challenges, and benefits of MMD, as well as its effects on viral suppression.
METHODS: In January 2025, following the PRISMA approach, we searched CINAHL, Embase, PubMed, and Scopus databases for articles. Two reviewers independently performed the screen, extraction, and appraisal processes. We descriptively reported the findings in line with our objectives.
RESULTS: Of the 3521 studies found, only 15 were included in this review, and most were from sub-Saharan Africa. HCWs initiated PLWH on MMD because of the COVID-19 pandemic, particularly to reduce clinic traffic, even when they did not meet the criteria for MMD. The barriers to PLWH initiating MMD, confirmed by HCWs, include privacy concerns and the stigma associated with having multiple antiretroviral therapy (ART) medication bottles and the stockout of ART medications in clinics. Furthermore, some PLWH refused MMD because plenty of ART bottles can increase the risk of unintended HIV disclosure. Confirmed by HCWs, PLWH share their medication with others and, at times, misuse it. Regarding MMD benefits, PLWH reported job stability as a benefit because of reduced permission from work to refill ART medication and waiting time in the clinics, a decrease in stigma and discrimination, and a generally improved HIV care experience; all confirmed by HCWs. Furthermore, HCWs reported benefits, including reduced workload and burnout. Interestingly, unlike PLWH's claim that MMD improved adherence and viral suppression, HCWs reported the opposite.
CONCLUSION: The COVID-19 pandemic increased MMD rollout to those who met and those who did not meet its criteria, leading to shorter waiting times, job stability, and reduced HCWs' burnout. However, HIV clinics should initiate MMD for PLWH who meet the criteria, which allows for closer monitoring of the unsuppressed PLWH.}, }
@article {pmid42199803, year = {2026}, author = {Liu, Y and Yang, M and Liao, Y and Hu, Z}, title = {Global research trends, reporting and handling of missing data in observational studies of type 2 diabetes mellitus with mild cognitive impairment from 2020 to 2025: a systematic review.}, journal = {Frontiers in endocrinology}, volume = {17}, number = {}, pages = {1649881}, pmid = {42199803}, issn = {1664-2392}, mesh = {*Diabetes Mellitus, Type 2/complications/epidemiology ; *Cognitive Dysfunction/epidemiology/complications ; Humans ; *Observational Studies as Topic ; Bibliometrics ; }, abstract = {BACKGROUND: Missing data is common in observational studies, and even more so in type 2 diabetes mellitus with mild cognitive impairment(T2DM-MCI), which limits the completion of assessments. We evaluated the extent, current reporting, and handling of missing data, as well as the prevailing research trends in observational studies related to T2DM-MCI.
METHODS: A systematic search of PubMed, Embase, and Cochrane Library was conducted from January 2020 to April 2025 to identify observational studies related to T2DM-MCI. Bibliometrics was performed using VOSviewer and CiteSpace to evaluate publishing trends, authors, journals, and keywords. The reporting and handling of missing data were assessed according to the guidelines recommended by STROBE and Sterne et al., with a focus on the recording, causes, mechanisms, processing methods, and sensitivity analysis of missing data. Data analysis was conducted using SPSS 26, and visualization was performed using Origin Pro 2024.
RESULTS: Among the 4,471 screened records, 88 studies (78 in English and 10 in Chinese) were included in this analysis. Among the 78 English articles, the annual publication volume exhibited fluctuations, peaking in 2024. Chinese institutions and authors led in research output. Diabetes, Metabolic Syndrome, and Obesity had the highest publication volume (7, 8.97%). Keyword identified five clusters: 1) resting-state functional magnetic resonance imaging, 2) metabolic disorders, 3) clinical assessment tools, 4) molecular mechanisms, and 5) emerging fields such as the gut microbiome.
MISSING DATA: Only 22.7% (n = 20) of the studies quantified the missing data, with an average of 9.1%. Among studies with missing data (n = 23), 52.2% (n = 12) provided reasons for missing data, primarily citing poor quality of data collection (41.7%) and loss to follow-up (41.7%). Complete case analysis was the predominant method for addressing missing data (93.3%). No study articulated the hypothesized mechanisms underlying the missing data, and only 4.4% (n = 1) performed a sensitivity analysis.
CONCLUSION: In the domain of T2DM-MCI, research outcomes post-COVID-19 pandemic indicate a rebound, with China maintaining a leading position in scientific research output. However, the reporting of missing data remains ambiguous, and the methods employed to handle such data are insufficient, which may potentially introduce bias.
https://doi.org/10.17605/OSF.IO/EZDXM.}, }
@article {pmid42201010, year = {2026}, author = {Ceasovschih, A and Kounis, NG and Markos, S and Ejubovic, M and Cherska, M and Barkas, F and Ristovski, V and Corlateanu, A and Sivapalan, P and Kotlyarov, S and Sorodoc, V and Sorodoc, L}, title = {Kounis Syndrome Features in Special Populations.}, journal = {Medical sciences (Basel, Switzerland)}, volume = {14}, number = {2}, pages = {}, pmid = {42201010}, issn = {2076-3271}, mesh = {Humans ; *Kounis Syndrome/epidemiology/diagnosis/immunology/etiology ; Female ; Pregnancy ; }, abstract = {Kounis syndrome (KS) describes the occurrence of acute coronary syndromes precipitated by allergic, hypersensitivity, or anaphylactic reactions and represents a unique intersection between immunologic activation and cardiovascular disease. The epidemiology of KS is likely underestimated due to diagnostic overlap with other cardiac and allergic conditions and limited awareness across medical specialties. This narrative review focuses on the distinctive features of KS in special populations, emphasizing how patients' age, comorbidities, immune status, and vascular substrate modify presentation, diagnosis, and outcomes. In elderly patients, polypharmacy, increased plaque vulnerability, and endothelial dysfunction favor Type II and III KS. Pediatric cases, although rare, are predominantly Type I and strongly associated with food allergies, insect stings, vaccines, and antibiotics, with under-recognition driven by diagnostic bias and ethical concerns surrounding invasive testing. Patients with coronary stents, cardiac devices, chronic kidney disease, and those receiving dialysis exhibit heightened susceptibility due to chronic inflammation, foreign-body hypersensitivity, and prothrombotic states. Pregnancy and the peripartum period represent a unique immuno-hemodynamic milieu in which Th2 immune shift, increased coronary vasoreactivity, and obstetric triggers can compromise both maternal and fetal perfusion. Additional risk modulation is observed in atopic individuals, asthmatics, patients with autoimmune, inflammatory, oncologic, psychiatric, and neurodevelopmental conditions, as well as in COVID-19 and post-infectious states. We propose a host-modified framework for KS that complements traditional classification by integrating immune phenotype and vascular substrate, enabling improved risk stratification and personalized preventive strategies.}, }
@article {pmid42201879, year = {2026}, author = {Oliveira, GM and Ferreira, MCFLA and Filho, SS and Netto, OM and Cade, JR}, title = {Effectiveness of Telemedicine-Based Interventions in Primary Health Care: A Systematic Review in a Universal Health System.}, journal = {Telemedicine journal and e-health : the official journal of the American Telemedicine Association}, volume = {}, number = {}, pages = {15305627261453270}, doi = {10.1177/15305627261453270}, pmid = {42201879}, issn = {1556-3669}, abstract = {INTRODUCTION: Telemedicine has increasingly been adopted as a digital care strategy to support access, continuity, and care coordination in primary health care (PHC). While its use accelerated during the COVID-19 pandemic, evidence regarding the effectiveness of telemedicine-based interventions in routine primary care remains heterogeneous and highly context-dependent. The objective of this review was to critically assess the effectiveness of telemedicine-based interventions in PHC, focusing on their effects on access, continuity, and care coordination, and to identify implementation-related barriers and facilitators based on empirical evidence from a universal health system context.
METHODS: A systematic review was conducted in accordance with PRISMA 2020 and registered in PROSPERO (CRD420251005446). Searches were performed in PubMed/MEDLINE, SciELO, and BVS/LILACS for studies published between 2015 and 2025. Two reviewers independently screened studies and extracted data. Risk of bias was assessed using RoB 2.0 and ROBINS-I. Due to methodological heterogeneity, findings were synthesized through a structured narrative approach (SWiM), and certainty of evidence was interpreted qualitatively based on study design, risk of bias, and consistency of findings.
RESULTS: Twenty-two studies were included, evaluating teleconsultations, telemonitoring, telediagnosis, tele-regulation, and tele-education in PHC settings. Telemedicine-based interventions were associated with improved access, reduced waiting times, and enhanced care coordination, particularly when embedded within primary care teams and integrated with information systems. Telemonitoring showed more consistent benefits for chronic disease management and continuity of care. User and provider acceptability was generally high, although technical limitations, workload concerns, and digital inequities were frequently reported. Certainty of evidence ranged from low to moderate.
CONCLUSIONS: Telemedicine-based interventions can strengthen core PHC functions when implemented as integrated organizational components of routine care delivery rather than as standalone technologies. Their effectiveness is strongly shaped by implementation context, digital infrastructure, and workforce readiness, highlighting the need for pragmatic and implementation-focused evaluations to inform sustainable telemedicine integration in primary care systems.}, }
@article {pmid42202423, year = {2026}, author = {Liu, R and Fan, Y and Xiong, S and Lin, J and Patel, A and Du, X and Di Tanna, GL and Liu, H}, title = {Drivers of and implementation strategies for influenza vaccination for cardiovascular populations in China: a scoping review.}, journal = {Vaccine}, volume = {86}, number = {}, pages = {128761}, doi = {10.1016/j.vaccine.2026.128761}, pmid = {42202423}, issn = {1873-2518}, mesh = {Humans ; *Influenza Vaccines/administration & dosage ; *Influenza, Human/prevention & control/epidemiology ; China/epidemiology ; *Cardiovascular Diseases/epidemiology ; *Vaccination/statistics & numerical data ; Vaccination Hesitancy ; Vaccination Coverage ; COVID-19/epidemiology/prevention & control ; Immunization Programs ; }, abstract = {INTRODUCTION: Understanding the drivers of influenza vaccine hesitancy, acceptance, demand, and uptake especially in low- and middle-income countries is a priority in preventing seasonal influenza as outlined in the World Health Organization (WHO) global influenza strategy. Individuals with cardiovascular disease (CVD) are a key target group recommended by WHO, yet influenza vaccine coverage in China is reported to be extremely low. We aim to explore drivers of this and implementation strategies used to increase the influenza vaccine coverage among CVD populations in China.
METHODS: We conducted a scoping review using academic databases, the Chinese Clinical Trial Registry, and Chinese grey literature repositories from database inception till August 2025, based on predetermined inclusion criteria. Data on potential determinants of vaccine uptake and intervention details were extracted and analyzed using a narrative synthesis. Implementation strategies were mapped to the Availability, Accessibility, Acceptability, and Quality (AAAQ) health service delivery framework.
FINDINGS: Thirteen publications published between 2009 and 2024 were included, with an increase in outputs since the COVID-19 pandemic. Lower vaccine uptake appeared to be associated with lower socioeconomic status and poorer health literacy. Physician recommendations, accessible vaccine clinics, and adequate vaccine supply appeared to be health system related facilitators to vaccination. Four studies reported implementation strategies comprising provider education and recommendations, public funding, and follow-up on vaccination status. Incorporating strategies that addressed a greater number of AAAQ domains appeared to result in higher influenza vaccine uptake.
CONCLUSION: Drivers and implementation strategies of influenza vaccination have not been widely studied among CVD populations in China. Available information suggests that higher patient sociodemographic status, greater health literacy, presence of physician recommendations, accessible vaccine clinics, and affordable vaccines may positively drive influenza vaccination. Addressing gaps in the AAAQ domains through targeted implementation strategies could improve influenza vaccination. Future strategies should undergo rigorous evaluation.
REGISTRATION DETAILS: Our protocol is registered at Open Science Foundation (OSF) with registration DOI https://doi.org/10.17605/OSF.IO/XDMBT.}, }
@article {pmid42203050, year = {2026}, author = {Zhao, X and Wang, Y and Yi, Y and Zhan, H and Chen, H and Song, Q}, title = {Association between adherence to 24-hour movement guidelines and anxiety and depression: A systematic review and meta-analysis of observational studies.}, journal = {Journal of affective disorders}, volume = {411}, number = {}, pages = {121998}, doi = {10.1016/j.jad.2026.121998}, pmid = {42203050}, issn = {1573-2517}, mesh = {Humans ; *Anxiety/prevention & control/psychology/epidemiology ; *Depression/prevention & control/psychology/epidemiology ; Observational Studies as Topic ; *Exercise/psychology ; Sedentary Behavior ; *COVID-19/psychology ; *Guideline Adherence ; }, abstract = {BACKGROUND: Depression and anxiety constitute a global health crisis, with prevalence increasing by 27.6% during the COVID-19 pandemic. The 24-Hour Movement Guidelines, integrating physical activity, sedentary behavior, and sleep, have been linked to improved mental health, yet no meta-analysis has quantified these associations.
METHODS: Following PRISMA guidelines, PubMed, Embase, Cochrane Library, and Web of Science were searched through January 1, 2026. Observational studies examining adherence to the 24-Hour Movement Guidelines and anxiety or depression were included. Cross-sectional and cohort studies were assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Tools, with the 8-item checklist for cross-sectional studies and the 11-item checklist for cohort studies. Random-effects models generated pooled odds ratios (ORs) with 95% confidence intervals (CIs).
RESULTS: Twenty studies (17 cross-sectional, 3 cohort) involving 323,440 participants from seven countries were included, with the majority being adolescents (n = 210,394, 65%). Adherence to the 24-Hour Movement Guidelines was significantly associated with lower odds of anxiety and depression symptoms. Meeting one, two, or three guideline components was consistently linked to lower odds of anxiety (ORs = 0.74, 0.59, and 0.43, respectively) and depression (ORs = 0.73, 0.55, and 0.41, respectively). Among individual components, adherence to sleep recommendations demonstrated the strongest associations for both anxiety (OR = 0.72) and depression (OR = 0.69), followed by sedentary behavior and physical activity. Sensitivity and publication bias analyses confirmed robustness.
CONCLUSIONS: Adherence to the 24-Hour Movement Guidelines is significantly associated with lower risks of anxiety and depression, supporting their integration into mental health prevention strategies.}, }
@article {pmid42203413, year = {2026}, author = {Baker, JM and Dickson, RP}, title = {The Role of the Respiratory Microbiome in Pneumonia.}, journal = {Clinics in chest medicine}, volume = {47}, number = {2}, pages = {199-213}, doi = {10.1016/j.ccm.2025.12.004}, pmid = {42203413}, issn = {1557-8216}, mesh = {Humans ; *Microbiota ; COVID-19 ; *Lung/microbiology ; SARS-CoV-2 ; *Pneumonia, Viral/microbiology ; Pandemics ; *Pneumonia/microbiology ; Betacoronavirus ; }, abstract = {The lung microbiome field has matured into a promising area of translational research. Emerging evidence from the past decade, including studies of COVID pneumonia, indicates a role for respiratory microbiota in pneumonia pathogenesis. Here, the authors discuss areas of investigation that will be essential to refine an ecology-based conceptual framework of pneumonia pathogenesis, which will ultimately guide the development of microbiome-targeted diagnostics and therapeutics for pneumonia management.}, }
@article {pmid42203415, year = {2026}, author = {Naghshtabrizi, N and Robinson, KM}, title = {Respiratory Viral and Bacterial Superinfection.}, journal = {Clinics in chest medicine}, volume = {47}, number = {2}, pages = {225-235}, doi = {10.1016/j.ccm.2025.12.006}, pmid = {42203415}, issn = {1557-8216}, mesh = {Humans ; *Superinfection/immunology ; Coinfection ; *Pneumonia, Bacterial/immunology ; COVID-19/complications ; Influenza, Human/complications/immunology ; *Respiratory Tract Infections/immunology/virology/complications ; Immunity, Innate ; }, abstract = {Respiratory viral infections are major predisposing factors for secondary bacterial pneumonia, a complication associated with increased disease severity, prolonged hospitalizations, and higher mortality. This review discusses the key mechanisms by which viral infections disrupt lung physiology, impair innate and adaptive immune defenses, and dysregulate cytokine signaling, creating a permissive environment for bacterial superinfection. Common pathogenic processes across different respiratory viruses are highlighted to provide a comprehensive understanding of how viral infections alter host susceptibility to bacterial pneumonia.}, }
@article {pmid42203428, year = {2026}, author = {Renzetti, M and Losier, A}, title = {Vaccines Against Pneumonia: Current Updates.}, journal = {Clinics in chest medicine}, volume = {47}, number = {2}, pages = {399-417}, doi = {10.1016/j.ccm.2025.12.019}, pmid = {42203428}, issn = {1557-8216}, mesh = {Humans ; Pneumococcal Vaccines/therapeutic use ; Pertussis Vaccine/therapeutic use ; COVID-19 Vaccines ; COVID-19/prevention & control ; Influenza Vaccines/therapeutic use ; Vaccination ; Pneumonia, Pneumococcal/prevention & control ; Respiratory Syncytial Virus Vaccines/therapeutic use ; *Pneumonia/prevention & control ; SARS-CoV-2 ; Haemophilus Vaccines/therapeutic use ; }, abstract = {Pneumonia is one of the global leading causes of mortality and impacts all age groups. Both viruses and bacteria can contribute to the development of lower respiratory tract infections and incidences of each vary in different age groups and immune statuses. Vaccines exist to target many of the pathogens associated with pneumonia including influenza, COVID-19, respiratory syncytial virus, pneumococcal pneumonia, pertussis, and Haemophilus influenzae type b. Vaccinations have demonstrated positive effects at reducing rates of infection and hospitalizations related to pneumonia. However, vaccination rates remain low and barriers including vaccine hesitancy exist among the general population.}, }
@article {pmid42205352, year = {2026}, author = {Soriano, JB and Miravitlles, M and López-Campos, JL and García-Río, F and Ancochea, J}, title = {[2027: A new year for a new epidemiological study of chronic obstructive pulmonary disease in Spain].}, journal = {Open respiratory archives}, volume = {8}, number = {3}, pages = {100628}, pmid = {42205352}, issn = {2659-6636}, abstract = {A real opportunity exists to conduct a fourth epidemiological study of COPD in Spain by 2027, continuing the trilogy begun with IBERPOC (1997), EPISCAN (2007), and EPISCAN II (2017). These previous studies have been fundamental to understanding the evolution of COPD, showing a relative reduction in prevalence but a persistently high underdiagnosis rate (around 75%). The need for a new study is justified by six key reasons: 1) Monitoring the secular evolution of the disease. 2) Evaluating the impact of new exposures (pollution, vaping, etc.) and phenotypes (COPD in non-smokers, pre-COPD, etc.). 3) Integrating novel tests such as low-dose CT scans or biomarkers for earlier and more accurate diagnosis. 4) Validating new screening tools. 5) Evaluating the quality of care and the burden of disease in the post-COVID-19 era. 6) Creation of a prospective cohort for translational research. Novel funding models, such as final contributions, should be explored. This review argues that a study in 2027 would not be a mere repetition, but an opportunity to make a qualitative leap toward a multidimensional and precise characterization of COPD in Spain today.}, }
@article {pmid42205482, year = {2026}, author = {Albelasi, A}, title = {Symptoms, mechanisms, and management of long COVID: understanding its prevalence, characteristics, and healthcare challenges in Saudi Arabia.}, journal = {Frontiers in cellular and infection microbiology}, volume = {16}, number = {}, pages = {1747443}, pmid = {42205482}, issn = {2235-2988}, mesh = {Humans ; *COVID-19/epidemiology/therapy ; Saudi Arabia/epidemiology ; Post-Acute COVID-19 Syndrome ; Prevalence ; SARS-CoV-2 ; Pandemics ; }, abstract = {Long COVID is a prolonged health condition wherein patients continue to experience symptoms long after recovering from infection, so it presents a significant global health challenge with multi-organ involvement. This review provides evidence from several studies to elucidate the prevalence, symptom clusters, and underlying mechanisms of Long COVID. Key findings highlight fatigue (25-73%), cognitive dysfunction, respiratory symptoms (dyspnea: 6.9-47%), cardiovascular symptoms (49.37/1,000), and reproductive symptoms (menstrual irregularities, erectile dysfunction) as predominant manifestations. Mechanistic insights include viral persistence, immune dysregulation, and endothelial dysfunction. The review gives detailed information about prevalence and immunological studies carried out in Saudi Arabia on Long COVID and underscores the importance of longitudinal immune studies, multidisciplinary approaches, biobanks, and global collaborations to improve patient outcomes. Recommendations emphasize tailored therapies, psychological support, and large-scale cohort studies to address heterogeneity and optimize care for Long COVID patients in Saudi Arabia.}, }
@article {pmid42205661, year = {2026}, author = {Shrivastava, M and Suri, I}, title = {Day-of-Surgery Cancellations in NHS and Independent-Sector Elective Surgery in England: A Narrative Review of Publicly Available Data.}, journal = {Cureus}, volume = {18}, number = {4}, pages = {e107720}, pmid = {42205661}, issn = {2168-8184}, abstract = {Day-of-surgery cancellation of elective surgery causes patient harm, wastes theatre capacity, and reflects wider perioperative system pressure. In England, the principal public source for routine surveillance is the NHS England Quarterly Monitoring of Cancelled Operations (QMCO) collection, but direct comparison between NHS trusts and independent-sector providers remains methodologically difficult. This revised narrative review synthesised 10 publicly available NHS England datasets/documents and 13 supporting peer-reviewed or policy sources relevant to elective surgery cancellation and independent-sector provision. Publicly available national time-series data show that last-minute non-clinical cancellation rates have generally remained around 1% of elective admissions since the early 2000s, whereas the proportion of cancelled patients not treated within 28 days increased substantially after the COVID-19 pause in data collection. In the latest official commentary, 21,456 operations were cancelled at the last minute in the third quarter (Q3) 2025/26, and 4,821 patients (22.5%) breached the 28-day standard. Recent provider files identify only a small number of independent-sector organisations. Across the public extracts reviewed from 2021/22 to 2025/26 (Q1-Q3), identifiable independent-sector providers accounted for 296 cancellations versus 337,004 in NHS organisations, contributing under 0.2% of recorded cancellations in each year examined. However, the public files do not provide matched provider-level denominators or case-mix adjustment, and the reporting scope has changed over time. The main conclusion is therefore methodological: current public English data are suitable for surveillance of NHS-funded last-minute cancellations, but they do not permit a fair denominator-matched comparison of day-of-surgery cancellation rates between NHS trusts and private providers. Future comparative work will require linked activity denominators, transparent provider classification, and standardised sector-wide reporting.}, }
@article {pmid42207935, year = {2026}, author = {Boulton, AJ and Elfeky, A and Court, R and Grove, A and Wilson, A and Auguste, P and Clayton, D and Gallacher, D and Goligher, EC and MacLeod Hall, C and McAuley, DF and Perkins, GD and Scholefield, BR and Thompson, M and Yeung, J and Chen, YF and Couper, K}, title = {Technology-Enhanced Strategies to Optimize Positive End-Expiratory Pressure in Patients Receiving Invasive Mechanical Ventilation: A Systematic Review and Meta-Analysis.}, journal = {Critical care medicine}, volume = {54}, number = {7}, pages = {1767-1778}, pmid = {42207935}, issn = {1530-0293}, mesh = {Humans ; *Positive-Pressure Respiration/methods ; *Respiration, Artificial/methods ; Cost-Benefit Analysis ; Intensive Care Units ; }, abstract = {OBJECTIVES: To undertake a systematic review evaluating the clinical and cost-effectiveness of technology-enhanced positive end-expiratory pressure (PEEP) optimization strategies in adults and children receiving invasive mechanical ventilation on an ICU.
DATA SOURCES: We searched key electronic databases (including MEDLINE and Embase) from inception to July 2024.
STUDY SELECTION: We included randomized studies examining clinical or cost-effectiveness of technology-enhanced PEEP optimization strategies compared with standard care or an alternative PEEP optimization strategy in adults and children. The primary outcome was duration of mechanical ventilation and secondary outcomes were clinical effectiveness (e.g., mortality) and efficacy (e.g., PEEP).
DATA EXTRACTION: Two reviewers independently assessed eligibility, extracted data, assessed risk of bias (Revised Cochrane tool) and performed Grading of Recommendations Assessment, Development and Evaluation evidence certainty assessments.
DATA SYNTHESIS: Our database and trial register search retrieved 8845 results, of which 34 studies (2951 patients) were included. Eight studies were at low risk of bias. Across studies, 7 technologies were evaluated, most commonly esophageal balloon measurement of transpulmonary pressure (10 studies), electrical impedance tomography (7 studies), pressure-volume curve analysis (6 studies), and fully automated closed-loop ventilation (5 studies). Meta-analysis used random-effects models. Duration of mechanical ventilation was reported in only three studies (172 patients, two technologies) and there was no effect compared with standard care (mean difference -0.06 d; 95% CI, -0.20 to 0.09; very low-certainty evidence).For 28-day mortality (10 studies; 1,719 patients; six technologies), technology-enhanced PEEP optimization reduced 28-day mortality (risk ratio 0.69; 95% CI, 0.52-0.93; very low-certainty evidence). No significant differences were found for other clinical-effectiveness outcomes. We identified no evidence in children or on cost-effectiveness.
CONCLUSIONS: Technology-enhanced PEEP optimization strategies did not reduce duration of mechanical ventilation, but these technologies may reduce mortality. Evidence certainty was low or very low, highlighting the urgent need for adequately powered randomized trials.
REGISTRATION: PROSPERO (CRD42024555390).}, }
@article {pmid42208954, year = {2026}, author = {Baker, B and Baz Lomba, JA and Bitilinyu-Bangoh, J and Berglöf, A and Bombaywala, S and Calvert-Joshua, T and Kaboré, B and Kingpriest, P and Lang, T and Levy, JI and Lompo, P and Lyimo, E and Martens, L and Mavoko, HM and Mesuere, B and Moremi, N and Mulder, N and Ndure, SL and Rameto, MA and Rinke de Wit, TF and Sebukoto, H and Smith, E and Tahita, MC and Tevuzula, VM and Tippett Barr, BA and Tiwari, A and Tran, T and Ubomba-Jaswa, E and Van Den Bossche, T and Wolday, D and Krolicka, A and Baraka, V and Pitkänen, T and Lood, R}, title = {Project ODIN: advancing environmental genomic surveillance for public health across sub-Saharan Africa.}, journal = {The Lancet. Microbe}, volume = {}, number = {}, pages = {101426}, doi = {10.1016/j.lanmic.2026.101426}, pmid = {42208954}, issn = {2666-5247}, abstract = {Persistent SARS-CoV-2 transmission, ongoing mpox outbreaks, and the continued spread of endemic diseases such as typhoid fever and cholera underscore the urgent need for global, multiomics surveillance. In this Personal View, we present Project ODIN, a consortium of European and African partners launched in 2023 that aims to meet this challenge by deploying innovative systems for near real-time pathogen detection and actionable public health insights. The project is a collaboration between high-income and low-income countries in northern Europe and sub-Saharan Africa. Focusing on low-income and middle-income countries, ODIN integrates metagenomics with mobile laboratory systems for comprehensive pathogen monitoring across diverse environments. ODIN emphasises standardised sampling, bioinformatics pipelines, and data-sharing protocols to ensure reliable, interoperable results while addressing infrastructure and resource limitations. By bridging gaps in genomic surveillance, these initiatives seek to strengthen outbreak preparedness, improve pathogen detection, monitor antimicrobial resistance, and provide a holistic approach to One Health challenges. Together, these innovations could advance global surveillance capacity-particularly in under-resourced regions-paving the way for effective disease control and evidence-based policy making.}, }
@article {pmid42210267, year = {2026}, author = {Caffe, S and Bautista, EG and Roman-Orozco, OS and Sanhueza, A}, title = {COVID-19 morbidity and mortality in young people in selected countries of the Americas.}, journal = {International journal for equity in health}, volume = {25}, number = {1}, pages = {}, pmid = {42210267}, issn = {1475-9276}, mesh = {Humans ; Adolescent ; *COVID-19/mortality/epidemiology ; Female ; Child ; Young Adult ; Male ; Americas/epidemiology ; Incidence ; SARS-CoV-2 ; Comorbidity ; Morbidity ; }, abstract = {BACKGROUND: While COVID-19 primarily affected adults, the epidemiology among adolescents and young adults has been less explored. This study describes the burden, outcomes, and correlates of COVID-19 among people aged 10-24 years in selected countries in the Americas during the acute pandemic phase (2020-mid-2022).
METHODS: We analyzed case-based surveillance data reported by 32 countries and territories to the Pan American Health Organization between January 2020 and July 2022. Confirmed and probable SARS-CoV-2 infections were included following WHO definitions. We described age, sex, and temporal distributions, estimated cumulative incidence, and assessed associations between recovery status, comorbidities, and treatment modalities using logistic regression models adjusted for age and sex.
RESULTS: A total of 17,031,217 COVID-19 cases were reported among young people (72% aged 10-19; 28% aged 20-24). Females accounted for 53% of cases. The pooled cumulative incidence was 7.7 per 100 population aged 10-24, ranging from 0.1 in Cuba to 52.0 in Bonaire, Sint Eustatius, and Saba. Recovery was documented in 88.9% of adolescents and 87.0% of young adults. The odds of recovery were lower among those aged 20-24 years (aOR 0.84, 95% CI 0.83-0.84), those with ≥ 1 comorbidity (aOR 0.17, 95% CI 0.16-0.18), and those requiring ventilatory support (aOR 0.28, 95% CI 0.25-0.31). Females and hospitalized patients had slightly higher recovery odds. Cardiovascular, kidney, and diabetic comorbidities were significantly associated with increased mortality.
CONCLUSIONS: Young people in the Americas represented a substantial proportion of COVID-19 cases, though with low overall mortality. However, chronic conditions markedly increased the risk of poor outcomes. Strengthening surveillance, ensuring continuity of care for young people with chronic diseases, and tailoring risk communication are essential components of future pandemic preparedness and life-course health strategies.}, }
@article {pmid42210365, year = {2026}, author = {Murunga, AA and Ngoye, B and Wafula, FP}, title = {Short-term health system responses to epidemics across hard-to-reach areas in sub-Saharan Africa: a scoping review.}, journal = {Infectious diseases of poverty}, volume = {15}, number = {1}, pages = {}, pmid = {42210365}, issn = {2049-9957}, support = {MR/T022078/1.//the Wellcome Trust (UKAid), the Economic and Social Research Council, and the Medical Research Council/ ; }, mesh = {Humans ; Africa South of the Sahara/epidemiology ; *Epidemics/prevention & control ; Public Health Infrastructure ; *Delivery of Health Care/organization & administration ; *COVID-19/epidemiology/prevention & control ; Resource-Limited Settings ; Hemorrhagic Fever, Ebola/epidemiology/prevention & control ; SARS-CoV-2 ; Evidence Gaps ; }, abstract = {BACKGROUND: Epidemics and disease outbreaks continue to threaten public health security in sub-Saharan Africa (SSA), disproportionately impacting impoverished and hard-to-reach populations. Although many country-specific studies exist, few syntheses have examined short-term health system responses to epidemics in hard-to-reach areas of SSA and their effects on health equity and resilience. This scoping review consolidates regional evidence on structural and policy-relevant lessons for enhancing health system preparedness and epidemic management in resource-limited settings.
METHODS: A scoping review was conducted in accordance with the PRISMA-ScR guidelines. Four electronic databases (PubMed, Cochrane Library, CAB Direct, and Google scholar) and grey literature sources for studies published between 2012 and 2022. Eligible studies reported short-term (immediate or early-phase) health system responses to epidemic-prone infectious diseases in SSA. Data were extracted thematically using Excel and analysed using a modified Donabedian framework encompassing structures, processes, and outcomes.
RESULTS: Fifteen studies met the inclusion criteria and examined responses to Coronavirus 2019 (COVID-19), Ebola Virus Disease (EVD), and other epidemic-prone infections. Common weaknesses identified included shortages of trained healthcare workers, limited financial resources, poor leadership and coordination, and weak information systems. However, countries such as Rwanda, Ethiopia, Nigeria, and Uganda demonstrated adaptive governance, decentralised coordination, and the use of digital tools to improve surveillance, communication, and service delivery. Strong community engagement helped reduce stigma and increased adherence to control measures, especially in rural and underserved areas. Countries that incorporated epidemic response into existing primary healthcare and routine services achieved better equity and system resilience.
CONCLUSION: The scoping review underscores strong evidence for incorporating epidemic preparedness into the broader health system. Policy focus areas include enhancing leadership and governance, establishing swift response mechanisms at subnational levels, and utilising technology for real-time data and coordination. Regional collaborations like those facilitated by the Africa CDC can improve collective resilience. Going forward, policies should prioritise not just emergency response but also ongoing investment in flexible, learning health systems that can withstand shocks while consistently providing essential services.}, }
@article {pmid42210924, year = {2026}, author = {Zhu, Y and Chen, Y and Izumoji, G and Qu, S and Wu, D and Chu, H and Wang, Y and Sun, H and Li, X}, title = {Neurobiological mechanisms of olfactory dysfunction: a ten-year bibliometric and visualization analysis.}, journal = {Frontiers in medicine}, volume = {13}, number = {}, pages = {1812327}, pmid = {42210924}, issn = {2296-858X}, abstract = {BACKGROUND: Olfactory dysfunction (OD) has gained prominence in neurodegenerative diseases and COVID-19 sequelae in recent years. Its mechanisms have also attracted increasing research interest. However, there is currently a scarcity of bibliometric analyses in this field.
METHODS: Articles related to OD mechanisms were searched in the Web of Science Core Collection (WoSCC) and Scopus. Data merging and bibliometric analysis were conducted using CiteSpace, VOSviewer, Excel, Scimago Graphica, and the bibliometrix in R package. Simultaneously, PubMed was used to search and summarize interventional clinical trials in this field, and their protocols were tracked through trial registration information and ethical approval records.
RESULTS: A total of 7,915 articles met the inclusion criteria in WoSCC and Scopus. Overall, the number of articles published annually on the mechanisms of OD is on the rise. The USA (2635 publications), University of California System (143 publications), and Thomas Hummel (174 publications) are the most productive country, institution, and author, respectively. Keyword analysis shows that "COVID-19," "Parkinson's disease," "inflammation," "odorant receptor," and other related topics are hot topics and trends in research. PubMed retrieved and included 14 interventional clinical trials. These trials mainly focus on pharmacological interventions, non-pharmacological interventions, surgical interventions, and mechanistic studies.
CONCLUSION: Mechanistic research on OD is advancing from macroscopic observations to precise molecular mechanisms. This review synthesizes evidence on how distinct etiologies, ranging from post-viral and inflammatory damage to neurodegeneration and metabolic imbalances, contribute to OD. Notably, the dysregulation of the inflammatory NF-κB, signal-transducing cAMP, and neuroregenerative Wnt/β-catenin pathways may collectively contribute to the development of OD. By integrating bibliometric trends with clinical trial evaluations, this study delineates a clear translational pipeline from mechanism exploration to clinical interventions.}, }
@article {pmid42211274, year = {2026}, author = {Okungu, V and Mulupi, S and Muriithi, GN and Achala, DM and Adote, E and Mbachu, CO and Beshaha, SA and Nwosu, CO and Ataguba, JE}, title = {Scoping review of COVID-19 vaccines access, equity, hesitancy, and uptake in Kenya: lessons for the next pandemic.}, journal = {Frontiers in health services}, volume = {6}, number = {}, pages = {1648814}, pmid = {42211274}, issn = {2813-0146}, abstract = {INTRODUCTION: The global rollout of COVID-19 vaccines was hampered by hesitancy, even as the pandemic intensified, underscoring the urgent need to strengthen vaccination efforts to reach most of the population. The primary objective of this review was to identify the critical barriers to equitable and timely access to and uptake of vaccines in Kenya with a view to mitigating the impacts of future pandemics, such as COVID-19.
METHODS: A digital search was conducted between February and March 17, 2024, and between December 2025 and February 2026, using four databases: PUBMED, Google Scholar, Cochrane Library, and Africa Journals Online. The search was limited to peer-reviewed articles only. The keywords used in the search were: COVID-19 vaccine + Access +Kenya; COVID-19 vaccine +Uptake+ Kenya; COVID-19 vaccine +Equity+ Kenya; COVID-19 vaccine +Hesitancy+ Kenya. The search was restricted to studies published from 2020, when the first vaccines were rolled out. Three researchers independently reviewed articles for inclusion and exclusion.
RESULTS: A total of 60 articles were included in the review. The main themes identified include geographic access, socio-demographic factors, economic and political determinants, and distrust in government systems. Among the critical determinants of COVID-19 vaccine uptake, confidence in the vaccine's efficacy and safety was a significant consideration. Geographic access to vaccination sites hindered uptake; for example, only 9.7% were vaccinated in a hard-to-reach county, compared to 53% in an urban county. Sociodemographic factors, including age, gender, level of education, occupation, and co-morbidity, significantly influenced vaccine uptake in Kenya. Above all, the Ministry of Health's failure to mount a convincing response to myths and misconceptions about the COVID-19 vaccine ultimately affected vaccination coverage nationwide.
CONCLUSION: Future preparedness must ensure inclusive vaccine strategies led by governments with clear policies and tailored outreach. Communication should address vulnerable groups and reduce hesitancy. Improving access and engaging communities are key to equity. Social workers help build trust and local relevance.}, }
@article {pmid42211665, year = {2026}, author = {Jia, Y and Wang, Y}, title = {Comparative progress on the mechanisms of airway mucosal injury induced by different pathogens: SARS-CoV-2, influenza A virus, and Mycoplasma pneumoniae.}, journal = {Frontiers in cellular and infection microbiology}, volume = {16}, number = {}, pages = {1777403}, pmid = {42211665}, issn = {2235-2988}, mesh = {Humans ; *SARS-CoV-2/pathogenicity ; *COVID-19/pathology/virology/immunology ; *Influenza, Human/pathology/virology ; *Mycoplasma pneumoniae/pathogenicity ; *Respiratory Mucosa/microbiology/pathology/virology/immunology ; *Influenza A virus/pathogenicity ; *Pneumonia, Mycoplasma/pathology/microbiology/immunology ; Animals ; Angiotensin-Converting Enzyme 2/metabolism ; }, abstract = {Respiratory infectious diseases remain a major global public health challenge. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), Influenza A Virus (IAV), and Mycoplasma pneumoniae (MP), as three representative respiratory pathogens, all clinically cause airway epithelial shedding, ciliary dysfunction, and Acute Respiratory Distress Syndrome (ARDS). Notably, they are the common triggers of acute respiratory infections characterized by persistent and severe cough, a clinical hallmark rooted in the structural disintegration of the airway mucosal barrier. However, the molecular mechanisms by which they compromise the airway mucosal barrier exhibit significant heterogeneity. Currently, there is a paucity of systematic reviews offering a comparative analysis between these viral and atypical bacterial pathogens. This review comprehensively examines the pathogenic mechanisms of these three agents across four dimensions: receptor recognition, direct cytotoxicity, immunopathology, and abnormal tissue repair. Studies indicate that during the invasion phase, SARS-CoV-2 relies on the Angiotensin-converting enzyme 2 (ACE2) receptor and Transmembrane protease, serine 2 (TMPRSS2) -mediated membrane fusion; IAV identifies sialic acid receptors via hemagglutinin, whereas MP utilizes specialized attachment organelles for "gliding" colonization. Regarding cellular injury mechanisms, SARS-CoV-2 primarily hijacks the endoplasmic reticulum (ER) to induce stress responses and promote syncytium formation; IAV predominantly targets mitochondria to trigger apoptosis and cellular necrosis; while MP utilizes hydrogen peroxide and Community-Acquired Respiratory Distress Syndrome (CARDS) toxin to implement oxidative damage and vacuolating toxicity. At the immunopathological level, SARS-CoV-2-induced delayed interferon response and cytokine storm, IAV-triggered excessive formation of neutrophil extracellular traps (NETs), and MP-mediated activation of the NOD-like receptor thermal protein domain associated protein 3 (NLRP3) inflammasome are key drivers exacerbating airway injury. Furthermore, distinct acute injury mechanisms determine differentiated long-term prognoses, such as pulmonary fibrosis, airway hyperresponsiveness, and airway remodeling. In summary, elucidating the commonalities and specificities of these mechanisms has significant clinical guidance value for precisely distinguishing clinical phenotypes, predicting disease progression, and developing host-directed therapies targeting specific injury pathways.}, }
@article {pmid42211706, year = {2026}, author = {Shin, HY and Ki, M}, title = {COVID-19 legislative response and challenges in Republic of Korea.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1800597}, pmid = {42211706}, issn = {2296-2565}, mesh = {Republic of Korea/epidemiology ; Humans ; *COVID-19/epidemiology/prevention & control ; Pandemic Preparedness ; SARS-CoV-2 ; *Pandemics ; *Health Policy/legislation & jurisprudence ; *Communicable Disease Control/legislation & jurisprudence ; }, abstract = {This narrative review systematically analyzes the longitudinal evolution of South Korea's legal and institutional frameworks from the 2015 MERS outbreak through the COVID-19 pandemic. The study introduces the "Pandemic Response Pentad," an original conceptual model positioning Legislation as the foundational core, mediated by Governance, to drive three interconnected field operations. Based on this framework, Korea's infectious disease control system is evaluated across four operational domains: (1) governance reform and personnel structure enhancement, (2) epidemiological response capabilities and data utilization, (3) medical response system, including vaccination programs and supply stockpiling, and (4) social response mechanisms, encompassing social distancing and the protection of vulnerable populations. While rapid legislative enactments enabled effective disease control, they also generated profound ethical tensions regarding fundamental human rights. To mitigate these unintended socioeconomic consequences, Korea institutionalized extensive statutory compensation mechanisms for healthcare facilities, small business owners, and vaccine injuries. The findings highlight that advancing national research infrastructure and establishing policy-oriented think tanks for future pandemic preparedness strictly require proactive legislative backing. Ultimately, this study provides valuable insights into the critical interplay between legal mandates and institutional resilience in global health crisis management.}, }
@article {pmid42213226, year = {2026}, author = {Zorina, O and Beiki, O and Holt, M and Buisker, J and Ferber, P and Fermont, JM and Kelly, RJ}, title = {Global Epidemiology of Paroxysmal Nocturnal Hemoglobinuria: A Systematic Literature Review.}, journal = {Journal of epidemiology and global health}, volume = {}, number = {}, pages = {}, doi = {10.1007/s44197-026-00537-8}, pmid = {42213226}, issn = {2210-6014}, abstract = {BACKGROUND: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired hematological disorder characterized by chronic intravascular hemolysis and an increased risk of thrombosis. A systematic synthesis of disease epidemiology is essential to understand disease patterns, improve timely diagnosis, and guide healthcare policies. This review aims to consolidate contemporary estimates of PNH incidence and prevalence globally and describe any observed trends in these epidemiological parameters.
METHODS: A systematic search of electronic databases was performed in November 2024 and identified 27 studies published between 2006 and 2024 following PRISMA guidelines. All population-based observational studies reporting incidence or prevalence measures of PNH were included, with no restrictions on age or geography; the synthesis of results focused on studies evaluated as medium or high-quality based on a structured assessment.
RESULTS: The annual incidence of patients diagnosed with PNH ranged from 0.17 to 0.35 per 100,000 population between 2002 and 2022 in the majority of high-quality studies. Regional variability emerged: studies from countries with high healthcare system quality scores consistently reported higher incidence estimates than those from countries with low scores. Yearly prevalence estimates in 2010-2021 ranged from 1.1 to 2.1 per 100,000 population, while longer-period prevalence (10-17 years) ranged from 1.5 to 6.4 per 100,000 population.
DISCUSSION: The prevalence of diagnosed PNH has been steadily growing since 2006 across all regions, possibly reflecting improved survival rates following the introduction of effective therapies or improved diagnostic practices. Despite disruptions observed during the COVID-19 pandemic (2020-2021), this upward trend is expected to continue as treatment access improves globally. The lower incidence reported in the regions with lower healthcare quality scores reflects potential underdiagnosis of PNH or unequal access to healthcare, highlighting the need for strengthening healthcare systems to ensure timely diagnosis and access to treatment of PNH.
CONCLUSIONS: This review provides updated global estimates of the incidence and prevalence of PNH, offers new insights into epidemiological trends, and highlights potential regional inequities in diagnosis and treatment. The results aim to support future research initiatives and inform healthcare strategies to improve outcomes for patients with PNH.}, }
@article {pmid42213322, year = {2026}, author = {Ahmad, T and Alhammadi, BA and Almaazmi, SY and Arafa, S and Blatch, GL and Dutta, T and Gestwicki, JE and Keyzers, RA and Meskiri, A and Sharafeldin, A and Shonhai, A and Singh, H}, title = {Malaria Public Health Status: Global Context and Update on Gulf Cooperation Council Countries.}, journal = {Advances in experimental medicine and biology}, volume = {1507}, number = {}, pages = {35-53}, pmid = {42213322}, issn = {0065-2598}, mesh = {Humans ; Antimalarials/therapeutic use ; *Malaria/epidemiology/prevention & control/drug therapy/transmission ; Animals ; *Public Health ; Middle East/epidemiology ; Drug Resistance ; Plasmodium falciparum/drug effects/pathogenicity ; Malaria Vaccines/therapeutic use ; Global Health ; }, abstract = {From 2000 to 2019, the global malaria death toll fell from 864,000 to 576,000 deaths; however, progress on reducing this toll has since slowed, with the COVID-19 pandemic contributing to an increase in the mortality rate since 2020. The emergence of widespread resistance in the major malaria parasite (Plasmodium falciparum) to first-line treatment drugs has highlighted the need for new antimalarials and smarter drug delivery strategies. Nevertheless, recent successes of the first malaria vaccines (RTS,S/AS01 and R21/MM) have renewed the promise of widely applicable vaccines in the future. Since 2015, the Eastern Mediterranean Region has experienced an overall increase in malaria cases and deaths. In the Arabian Peninsula, while most of the Gulf Cooperation Council (GCC) countries have been declared free of indigenous malaria (Bahrain, Kuwait, Qatar, and the United Arab Emirates), malaria is still endemic in two GCC countries (Saudi Arabia and Oman) and their neighbors (Yemen). Furthermore, a number of factors threaten malaria control in this region, especially antimalarial drug resistance, the emergence of highly invasive mosquito species, increasing average temperatures, and imported malaria. In this review, we assess the current worldwide status of malaria before providing a critical evaluation of the malaria situation in the GCC countries.}, }
@article {pmid42215147, year = {2026}, author = {Petropoulou, D and Karampela, I and Christodoulatos, GS and Kounatidis, D and Vallianou, NG and Dalamaga, M}, title = {Hormonal, metabolic and metabolomic biomarkers in long COVID.}, journal = {Advances in clinical chemistry}, volume = {133}, number = {}, pages = {217-283}, doi = {10.1016/bs.acc.2026.01.002}, pmid = {42215147}, issn = {2162-9471}, mesh = {Humans ; Biomarkers/metabolism/blood ; Post-Acute COVID-19 Syndrome ; *COVID-19/metabolism/complications ; *Hormones/metabolism ; Metabolomics ; SARS-CoV-2 ; }, abstract = {Long COVID (LC), a complex syndrome affecting approximately 6-12 % of individuals post infection, is characterized by persistent, fluctuating, or progressive symptoms lasting at least three months. Its pathogenic mechanisms involve viral persistence, chronic inflammation, immune dysregulation, endothelial dysfunction, and endocrine/metabolic abnormalities. Currently, no specific diagnostic tests exist for LC, highlighting the need for reliable biomarkers. This review synthesizes current evidence on hormonal, metabolic, and metabolite biomarkers in LC. While vitamin D deficiency is prevalent in LC, being associated with neurocognitive symptoms, delayed recovery and poor physical performance, particularly in older adults, its lack of specificity reduces diagnostic utility. Insulin resistance markers consistently correlate with fatigue, mood disturbances, and myalgia, suggesting a distinct metabolic LC phenotype. Lower cortisol frequently correlates with fatigue, sensory disturbances, and neurocognitive symptoms. Alterations in cortisol/adrenocorticotropic hormone, growth hormone, prolactin, and gonadotropins suggest a potential hypothalamic-pituitary axis involvement; however, these abnormalities are often transient, dynamic or nonsignificant. While some patients may exhibit low free triiodothyronine associated with fatigue, no significant incidence of thyroid dysfunction and autoimmunity was associated with LC. Despite the absence of a distinct and consistent metabolomic signature, LC is characterized by the activation of the kynurenine pathway, including increased kynurenine and quinolinic acid, being associated with fatigue, neurocognitive and depressive symptoms. Emerging metabolites of mitochondrial dysfunction and lipid metabolism alterations require further validation. Despite promising findings, evidence remains scattered, hindered by small sample sizes and methodological limitations. Future research should prioritize standardization of biomarker assessment, validation in diverse populations, and exploration of targeted therapeutic interventions.}, }
@article {pmid42215223, year = {2026}, author = {Li, T and Li, X and Liu, M and Shahbaz, Z and You, J and Quan, Z and Li, J and Liu, Y and Xu, Y and Wang, L}, title = {Analysis of foodborne disease outbreak surveillance in the China Mainland 2014-2023.}, journal = {Food microbiology}, volume = {139}, number = {}, pages = {105143}, doi = {10.1016/j.fm.2026.105143}, pmid = {42215223}, issn = {1095-9998}, mesh = {China/epidemiology ; Humans ; *Disease Outbreaks/statistics & numerical data ; *Foodborne Diseases/epidemiology/microbiology/mortality ; Seasons ; Mushroom Poisoning/epidemiology ; Agaricales/pathogenicity ; COVID-19/epidemiology ; Salmonella/isolation & purification ; Vibrio parahaemolyticus/isolation & purification ; }, abstract = {Foodborne diseases pose a significant public health and economic burden worldwide. This study systematically analyzed a decade (2014-2023) of national surveillance data from mainland China, encompassing 50,434 outbreaks, 311,672 illnesses, and 1330 fatalities. The results revealed pronounced geographical disparities, with five provinces (Shandong, Yunnan, Hunan, Guizhou, and Sichuan) collectively accounting for 59.27% of outbreaks. A distinct seasonal peak was observed from June to August, correlated with high temperature and humidity. Poisonous mushrooms were the predominant causative agent, responsible for 50.65% of outbreaks with identified etiology and the highest case fatality. Microbial pathogens, notably Vibrio parahaemolyticus and Salmonella spp., were also major contributors. Most outbreaks and fatalities occurred in household settings, with a notable surge during the COVID-19 pandemic. Our findings underscore the critical need for targeted interventions, enhanced public education on toxic mushrooms, and strengthened surveillance systems to reduce the burden of foodborne diseases in China.}, }
@article {pmid42215915, year = {2026}, author = {Khorram-Manesh, A and Carlström, E}, title = {Patient-centered care for patients requiring dialysis during disasters and public health emergencies: a scoping review.}, journal = {International journal of emergency medicine}, volume = {19}, number = {1}, pages = {}, pmid = {42215915}, issn = {1865-1372}, abstract = {BACKGROUND: Disasters and public health emergencies disrupt health systems, threaten continuity of care, and disproportionately affect medically vulnerable populations. Patients requiring dialysis are especially at risk because their survival depends on regular access to complex, resource-intensive treatment. While disaster nephrology literature increasingly addresses preparedness and resilience, it remains unclear how explicitly this literature addresses patient-centered care.
OBJECTIVE: To map the literature on patient-centered care for patients requiring dialysis during disasters and public health emergencies, with attention to preparedness, continuity of care, communication, access, and vulnerable populations.
METHODS: A scoping review was conducted using searches in Web of Science, Scopus, and PubMed. Search terms combined concepts related to disaster, emergency, patient-centered care, vulnerability, dialysis, and alternative care facilities. Records were screened for relevance to dialysis care in disasters or public health emergencies, or for conceptual relevance to patient-centered dialysis care in disrupted settings. Both authors conducted screening, eligibility assessment, and data charting, using a predefined set of inclusion criteria and a consistent conceptual framework. The search was intentionally focused to prioritize literature most directly relevant to dialysis-dependent patients in disaster and public health emergency contexts. Forty-three studies were included.
RESULTS: The included studies comprised reviews, scoping reviews, observational studies, qualitative studies, case studies, program reports, pilot studies, trials, and conceptual papers. The literature clustered around six themes: preparedness for dialysis patients and providers; continuity of care and treatment access; infrastructure, logistics, and resilience; patient awareness, communication, and lived experience; public health emergency adaptations, particularly during COVID-19; and broader frameworks for disaster risk reduction in kidney care. Although relatively few studies explicitly used the term patient-centered care, many addressed closely related domains, including communication, care planning, family involvement, psychosocial support, access, and continuity. Taken together, the findings suggest that patient-centered dialysis care in emergencies is shaped by broader health system factors, including preparedness, coordination, service design, and equity.
CONCLUSIONS: Patients requiring dialysis are among the most vulnerable groups during disasters and public health emergencies. Existing literature provides a strong foundation in preparedness and continuity of treatment but addresses patient-centered care more often implicitly than explicitly. Future research should develop and test patient-centered indicators for dialysis care in emergencies, including communication, shared planning, caregiver involvement, psychosocial support, and the role of alternative care facilities.}, }
@article {pmid42215997, year = {2026}, author = {Harmouch, J and Green, R and Mayilsamy, K and Tosi, K and Mohapatra, S and Mohapatra, SS}, title = {Convergence of neuroinflammation across major neurotropic viral exposomes in AD and ADRD.}, journal = {Journal of neuroinflammation}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12974-026-03876-2}, pmid = {42215997}, issn = {1742-2094}, support = {AG086245, IK6BX004212, BX006456//National Institute of Health USA and Dept of Vet Affairs, USA/ ; AG086245, IK6BX006032, BX005757//National Institute of Health,USA and Dept of Veteran Affairs USA/ ; }, abstract = {BACKGROUND: Alzheimer's disease (AD) and Alzheimer's disease-related dementias (ADRD) are multifactorial neurodegenerative disorders driven by complex interactions among genetic susceptibility, aging, and environmental exposures. Growing epidemiological and mechanistic evidence implicates neurotropic viral exposomes, defined as cumulative lifetime viral infections, as significant contributors to AD risk. Viral encephalitis and common viral infections, including herpes simplex virus type 1 (HSV-1), human immunodeficiency virus (HIV), cytomegalovirus (CMV), SARS-CoV-2, and influenza, have been associated with an increased incidence of AD/ADRD; however, the molecular mechanisms underlying these associations remain incompletely understood.
METHODS: A systematic literature review was conducted using PubMed, Web of Science, Scopus, and Google Scholar (1990-2025) to identify epidemiological, experimental, and mechanistic studies linking viral infections to AD-related pathology. Systems biology approaches were applied using Cytoscape, STRING, KEGG, WikiPathways, and Ingenuity Pathway Analysis to construct protein-protein interaction networks and identify convergent biological processes shared between AD and viral host-response pathways. Functional enrichment analyses focused on neuroinflammation, amyloid-β (Aβ) metabolism, tau pathology, autophagy, and blood-brain barrier (BBB) integrity.
RESULTS: Across diverse viral infections, strong convergence was observed in innate immune activation pathways, including microglial priming and NLRP3 inflammasome signaling, accompanied by chronic production of proinflammatory cytokines (IL-1β, TNF-α, IFN-γ). Multiple viruses modulated amyloidogenic APP processing, impaired Aβ clearance, promoted tau hyperphosphorylation, disrupted autophagy-lysosomal systems, and compromised BBB integrity. Systems-level analyses revealed overlapping signaling hubs, including NF-κB, MAPK, PI3K-Akt, and cGAS-STING that amplify neurodegenerative cascades, with effects most pronounced in genetically susceptible populations such as APOE4 carriers.
CONCLUSIONS: Collectively, current evidence supports a mechanistic link between viral exposomes and AD/ADRD mediated through convergent neuroinflammatory, and proteostatic pathways. Although viral infections alone are unlikely to be sufficient to cause AD, recurrent or persistent viral exposures may act as potent disease modifiers that accelerate neurodegenerative processes. Integrating viral biomarkers, genetic risk stratification, and systems biology approaches offers promising opportunities for early diagnosis, prevention, and development of mechanism-guided therapeutic strategies.}, }
@article {pmid42216226, year = {2026}, author = {, }, title = {Bridging the gap: the Pasteur Network's approach to equitable vaccine development and manufacturing.}, journal = {BMC global and public health}, volume = {4}, number = {1}, pages = {}, pmid = {42216226}, issn = {2731-913X}, abstract = {Equitable access to vaccines remains a cornerstone of global health security, yet persistent gaps in regional manufacturing capacity continue to undermine timely and fair distribution. The COVID-19 pandemic exposed the risks of highly concentrated production systems and underscored the need for locally anchored manufacturing models capable of responding rapidly to public health emergencies. The Pasteur Network (PN)-a global consortium of 32 public health and research institutes across Africa, Asia, Europe, and the Americas-offers an operational example of decentralized vaccine manufacturing embedded in national public health systems linking regional manufacturing capacity with public health priorities. Here, we examine the contributions and challenges of members within the PN engaged in vaccine manufacturing. Twelve members currently produce more than 525 million doses annually, covering a broad range of human and veterinary vaccines. Embedded within national health systems, the PN members combine research, development, and partial or end-to-end manufacturing capacities, ensuring close alignment with national public health priorities. Several members within the PN also contribute to global initiatives, including the Coalition for Epidemic Preparedness Innovations (CEPI) manufacturing network, reinforcing their role in global preparedness efforts. Despite these strengths, common barriers persist across the PN, including workforce retention challenges, limited sustainable core funding, supply chain vulnerabilities, fragmented regulatory pathways, and insufficient coordination. We argue that the PN illustrates a scalable, public-health-embedded manufacturing model that complements existing industrial and technology-transfer approaches and should inform future global financing and governance.}, }
@article {pmid42216347, year = {2026}, author = {Faseeh, A and Rida, M and Karim, NE and Zafar, A and Shah, A and Perveen, A}, title = {Prevalence and long-term outcomes of brain fog and cognitive impairment in individuals with long COVID: A systematic review.}, journal = {Medicine}, volume = {105}, number = {22}, pages = {e49022}, pmid = {42216347}, issn = {1536-5964}, mesh = {Humans ; *Cognitive Dysfunction/epidemiology/etiology ; Prevalence ; *COVID-19/complications/epidemiology ; Post-Acute COVID-19 Syndrome ; Female ; Male ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Long COVID is increasingly recognized as a complex multisystem condition, with brain fog and cognitive impairment emerging as some of its manifestations. Despite growing literature, the pooled prevalence, subgroup differences, and underlying mechanisms remain incompletely understood.
METHODS: We systematically reviewed 47 studies (2000-2025) encompassing over 25,000 patients to evaluate the prevalence of brain fog and cognitive impairment among long COVID populations. Data were extracted on study design, patient demographics, follow-up duration, and subgroup variables including gender, hospitalization, vaccination, and geographic region. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS v9.0) and JBI checklists. Quantitative synthesis was performed with subgroup and temporal analyses, presented in forest plots and summary figures.
RESULTS: The pooled prevalence of brain fog was 30% (95% CI: 28-32), while cognitive impairment was 25% (95% CI: 23-27). Female patients consistently showed higher rates compared to males (34% vs 23% for brain fog; 29% vs 21% for cognitive impairment). Community-managed patients demonstrated higher prevalence compared to hospitalized cohorts, and unvaccinated individuals had a greater burden than vaccinated ones. Temporal analyses indicated that prevalence increased with longer follow-up, suggesting symptom persistence or late manifestation. Pathophysiological explanations include neuroinflammation, microvascular injury, immune dysregulation, and psychosocial stressors.
CONCLUSION: Brain fog and cognitive impairment are common, persistent, and clinically significant features of long COVID. Gender differences, vaccination status, and follow-up duration influence prevalence. Future studies should focus on mechanisms, preventive strategies, and targeted interventions to mitigate long-term cognitive sequelae.}, }
@article {pmid42219104, year = {2026}, author = {Maiti, S and Joseph, J}, title = {From systemic disease to the eye: Why senescence deserves attention in ocular infections.}, journal = {Experimental eye research}, volume = {270}, number = {}, pages = {111095}, doi = {10.1016/j.exer.2026.111095}, pmid = {42219104}, issn = {1096-0007}, abstract = {The global increase in life expectancy has led to a growing elderly population, bringing new challenges in managing infectious diseases. Advancing age is accompanied by progressive dysfunction of both innate and adaptive immunity, resulting in impaired responses to pathogens and elevated morbidity and mortality. Cellular senescence, a state of permanent cell-cycle arrest with extensive molecular and phenotypic changes, including chromatin remodelling and the senescence-associated secretory phenotype (SASP), has emerged as a key factor in this process. Though initially protective as a tumor-suppressive mechanism, senescence becomes maladaptive with age, contributing to inflammaging, immune dysregulation, and heightened susceptibility to infection. In ocular diseases, such as age-related macular degeneration and chronic keratitis, senescent cells in retinal pigment epithelium and corneal tissues drive persistent inflammation and fibrosis, exacerbating vulnerability to opportunistic pathogens. Pathogens can exploit senescent cells through virulence factors and persistent inflammatory responses, thereby promoting chronic infection and even age-related diseases. Conversely, senescent cells and their SASP can intensify infection severity, as shown in viral infections such as SARS-CoV-2 and bacterial pathogens including Streptococcus pneumoniae and Mycobacterium tuberculosis. This reciprocal relationship illustrates how infection accelerates cellular aging while aging predisposes individuals to more severe infections. Emerging therapeutic strategies targeting senescence, including senolytics and senomorphics, hold promise for mitigating infection-related pathology. In parallel, vaccines and immunotherapies tailored to the aging immune system will be crucial for reducing infection burden in older populations. This review integrates current evidence on the bidirectional interplay between senescence and infection, emphasizing its clinical relevance and potential for translational intervention.}, }
@article {pmid42221305, year = {2026}, author = {Flisiak, R and Frankova, S and Jindal, S and Aster, V and Hunyady, B and Makara, M and Kristian, P and Stanekova, DV and Zarębska-Michaluk, D and Valckx, S and Hendrickx, G and Van Damme, P and Maticic, M}, title = {Towards elimination of viral hepatitis in the Czech Republic, Hungary, Poland and Slovakia: insights from the Viral Hepatitis Prevention Board (VHPB).}, journal = {Clinical and experimental hepatology}, volume = {12}, number = {1}, pages = {1-10}, pmid = {42221305}, issn = {2392-1099}, abstract = {The Visegrad Group - the Czech Republic, Hungary, Poland and Slovakia - face shared challenges in preventing and controlling viral hepatitis. A regional meeting convened by the Viral Hepatitis Prevention Board evaluated health systems, epidemiology, and national policies, revealing accomplishments and needs for prevention, screening, diagnosis, and linkage to care of viral hepatitis. Universal hepatitis B (HBV) vaccination exists, yet vaccine hesitancy and incomplete coverage threaten progress, while surveillance and registries remain fragmented. Access to hepatitis C (HCV) treatment has improved recently, but remains centralized, with limited engagement of marginalized populations. Elimination of HCV by 2030 is unlikely due to insufficient screening, COVID-19-related healthcare disruptions, and weak political commitment, whereas HBV control depends on maintaining high vaccination coverage and robust monitoring. Participants called for harmonized national guidelines, strengthened regional collaboration, and sustainable action plans backed up by political commitment. Urgent, coordinated efforts are needed to achieve the WHO 2030 elimination goals.}, }
@article {pmid42221476, year = {2026}, author = {Passerini, I and Pereira, EG and Galvão Fernandes Alves, I and Padoveze, MC}, title = {Simulation of healthcare professional teams in infection prevention and control: A scoping review.}, journal = {Journal of infection prevention}, volume = {}, number = {}, pages = {17571774261456671}, pmid = {42221476}, issn = {1757-1774}, abstract = {BACKGROUND: Healthcare-associated infections (HAIs) are a major public health concern. Although interprofessional education (IPE) is recognized as a promising strategy, there is limited robust evidence demonstrating its effectiveness in reducing infection rates in healthcare settings.
AIM/OBJECTIVE: To identify studies on interprofessional simulation for healthcare teams focused on infection prevention and control (IPC).
METHODS: This scoping review followed the PRISMA-ScR checklist and was registered on the OSF platform (https://osf.io/bj6uc/). Six databases (MEDLINE, Embase, Web of Science, CINAHL, ERIC, Scopus) were searched, yielding 632 citations. After screening and applying exclusion criteria, 11 studies were included.
FINDING/RESULTS: Among the selected studies, four (36.4%) originated from the United States. Five studies (45.5%) employed simulation practices based on evidence or expert consensus. Seven studies (63.6%) involved teams comprising three or more professional categories. All studies addressed infectious diseases requiring rapid response, mainly COVID-19 (55%) and Ebola (45%). Most (81.8%) used patient simulators. The most frequently addressed IPE competencies were teamwork (90.9%), roles and responsibilities (81.8%), and interprofessional communication (72.7%).
DISCUSSION: Findings indicate a reliance on expert-driven simulation practices and a concentration on emergency contexts. There is a lack of studies evaluating interprofessional simulation in routine care environments, such as primary health care and long-term care. Additionally, the absence of medium- and long-term outcome assessments limits our understanding of the sustained impact of interprofessional simulation on IPC. Further research is needed to support evidence-based implementation in diverse healthcare settings.}, }
@article {pmid42221597, year = {2026}, author = {Kebe, AT and Diarra, B and Kalossi, I and Traore, BM and Savadogo, L and Sangho, H}, title = {[Associated factors with vaccine hesitancy in sub-Saharan Africa: a literature review].}, journal = {The Pan African medical journal}, volume = {53}, number = {}, pages = {143}, pmid = {42221597}, issn = {1937-8688}, mesh = {Humans ; *Vaccination Hesitancy/statistics & numerical data/psychology ; Africa South of the Sahara ; *Vaccination/psychology/statistics & numerical data ; *Vaccines/administration & dosage ; COVID-19 Vaccines/administration & dosage ; Immunization Programs ; *Patient Acceptance of Health Care/statistics & numerical data ; Sub-Saharan African People ; }, abstract = {Vaccination is a key intervention for reducing infant and child morbidity and mortality. Its success depends largely on public acceptance. This study aims to understand the determinants of vaccine hesitancy in sub-Saharan Africa. The methodological approach consisted of a systematic review of the literature, conducted through consultation of PubMed and grey literature, according to Population/Patient, Intervention, Comparison, and Outcome (PICO) criteria and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Of the 32 studies included, 28 were peer-reviewed, while the others were taken from dissertations and theses by master's and doctoral students in health sciences. The main factors contributing to hesitancy include young age, rural location, low educational attainment, doubts about the safety and efficacy of vaccines, and fear of possible side effects. Mistrust of governments and the influence of social media also play a role. This review identifies these barriers and proposes solutions to improve vaccine uptake, particularly for the Expanded Programme on Immunisation and COVID-19 vaccines.}, }
@article {pmid42221881, year = {2026}, author = {Asadigandomani, H and Tahmasebi, A and Jalilzadeh, M and Arab Bafrani, M and Mahmoudi, F and Daneshvar, K and Zonouzi, SK and Riazi-Esfahani, H and Khalili Pour, E}, title = {Impact of COVID-19 pandemic on surgical volume, clinical presentations, and management of rhegmatogenous retinal detachment: A systematic review and meta-analysis.}, journal = {SAGE open medicine}, volume = {14}, number = {}, pages = {20503121261456478}, pmid = {42221881}, issn = {2050-3121}, abstract = {PURPOSE: To systematically evaluate the impact of the COVID-19 pandemic, particularly lockdown (LD) periods, on the incidence, clinical presentations, surgical management, and outcomes of rhegmatogenous retinal detachment (RRD).
METHODS: A systematic literature search was conducted in PubMed, Embase, and Web of Science up to June 2025. Observational studies comparing RRD patients during COVID-19 LDs or pandemic periods with pre-pandemic controls were included. Outcomes assessed included RRD incidence, baseline clinical characteristics, intervals from symptom onset to first visit and surgery, surgical interventions, and anatomical and visual outcomes. Meta-analyses were performed for comparable outcomes using random- or fixed-effects models based on heterogeneity.
RESULTS: Twenty-nine observational studies involving more than 116,000 eyes were included. COVID-19-related restrictions were associated with a significant reduction in RRD surgical volume (rate ratio 0.71; 95% CI: 0.60-0.84), although marked regional heterogeneity was observed. Marked heterogeneity across studies appeared to be partly related to differences in LD severity, duration, and regional healthcare system burden. Patients presenting during LD periods were significantly less likely to have macula-on RRD (OR = 0.61; 95% CI: 0.46-0.83) and more likely to exhibit moderate-to-severe proliferative vitreoretinopathy (PVR) (OR = 2.58; 95% CI: 1.37-4.87) compared with pre-LD periods. Time from symptom onset to surgery increased during LD periods, while presentation-to-surgery intervals decreased. Surgical practice shifted toward greater use of pars plana vitrectomy (PPV), often combined with longer-acting gas tamponades or silicone oil. Despite increased disease severity, single-surgery retinal attachment rates and postoperative visual outcomes remained largely unchanged across periods.
CONCLUSIONS: The COVID-19 pandemic had substantial and region-specific effects on RRD management, influencing patient presentation patterns, disease severity, and surgical strategies. Nevertheless, adaptive healthcare responses helped preserve overall anatomical and visual outcomes.}, }
@article {pmid42222230, year = {2026}, author = {Al-Bar, MH}, title = {Sudden sensorineural olfactory loss: a structured narrative review and proposal for a standardised terminological framework.}, journal = {Frontiers in surgery}, volume = {13}, number = {}, pages = {1838659}, pmid = {42222230}, issn = {2296-875X}, abstract = {BACKGROUND: Sudden loss of smell - particularly when sensorineural in origin - is a clinically disabling condition that the medical community has never adequately named. Patients presenting with acute olfactory loss encounter a field without shared definitions, dedicated ICD codes, or guidelines built around their specific presentation. The consequence is diagnostic delay, terminological inconsistency in the literature, and a research base that cannot be meaningfully synthesised.
OBJECTIVE: This paper reviews the evidence on sudden sensorineural olfactory loss, demonstrates that existing terminology is inadequate, and proposes a single new clinical term: Sudden Sensorineural Olfactory Loss (SSNOL). Two descriptive aetiological categories are introduced solely to guide future research, not as additional terminology.
METHODS: A structured narrative review was conducted using PubMed, Embase, and Scopus databases. Studies were selected based on relevance to sudden olfactory dysfunction, neural pathway mechanisms, diagnostic imaging, and clinical management. Both primary research articles and systematic reviews published between 2000 and 2024 were considered.
RESULTS: The evidence describes a condition with serious, sometimes permanent neural consequences. Post-viral olfactory loss - which received relatively limited specialist attention before the COVID-19 pandemic - was suddenly experienced by hundreds of millions of people, exposing how poorly the field was equipped to respond. Diagnostic tools are blunt. Treatment options are thin. Olfactory training is the only intervention with consistent evidence behind it. None of this will improve without better terminology to organise research around.
CONCLUSION: We propose the term "Sudden Sensorineural Olfactory Loss" (SSNOL) as the sole terminological contribution of this paper, modelled on the established precedent of sudden sensorineural hearing loss (SSNHL). To guide future research, two descriptive aetiological categories are described - SSNOL-Viral and SSNOL-Idiopathic - presented as hypothesis-generating models to support future research design. Traumatic olfactory loss is explicitly excluded from the SSNOL definition and should be managed under existing post-traumatic frameworks.}, }
@article {pmid42223244, year = {2026}, author = {Akhavan, M and Khodavaisy, S and Akbarzadeh, S and Mojtahedi, SS and Xu, J and Aala, F and Shafaati, M and Salehi, M}, title = {Post-Viral Aspergillosis: A Systematic Review of Incidence, Clinical Manifestations, and Outcomes.}, journal = {Reviews in medical virology}, volume = {36}, number = {3}, pages = {e70163}, doi = {10.1002/rmv.70163}, pmid = {42223244}, issn = {1099-1654}, support = {//Association Canadienne d'Anthropologie Physique/ ; }, mesh = {Humans ; Incidence ; *COVID-19/complications/virology/epidemiology ; Antifungal Agents/therapeutic use ; Immunocompromised Host ; *Aspergillosis/epidemiology/drug therapy/diagnosis ; SARS-CoV-2/pathogenicity ; *Virus Diseases/complications ; }, abstract = {Invasive aspergillosis (IA) has traditionally been associated with immunocompromised individuals. Post-viral aspergillosis (PVA) has emerged as a significant secondary complication among patients with viral infections, particularly during the COVID-19 pandemic. This systematic review aimed to summarise the patients' clinical characteristics, diagnostic approaches, treatment options, and outcomes of PVA across various respiratory viral infections. This study was registered in PROSPERO (No. CRD420250652078) and followed the PRISMA 2020 guidelines. We systematically searched PubMed, Embase, Scopus, and Web of Science for publications without a time limitation up to the end of May 2025 reporting clinical data on PVA in patients following infections by respiratory viruses, including SARS-CoV-2, influenza, respiratory syncytial virus (RSV), metapneumovirus, parainfluenza, rhinovirus, adenovirus, and cytomegalovirus (CMV). Overall, the reports highlighted PVA occurrence after infections by SARS-CoV-2, influenza, and CMV. Our analyses revealed that PVA is a clinically heterogeneous but frequently deadly infection in patients who are critically ill, immunocompromised patients, or those receiving corticosteroids, following respiratory viral infections. Among critically ill patients, PVA is a clinically important complication of respiratory viral infections, and timely diagnosis and early initiation of appropriate antifungal therapy- considering that Aspergillus is an aerobic fungus requiring specific culture conditions-play a key role in improving patient outcomes.}, }
@article {pmid42225335, year = {2026}, author = {Chen, M and Wei, S and Sun, J and Zhang, C}, title = {Compassion fatigue and associated factors among palliative care nurses: A systematic review and meta-analysis.}, journal = {Applied nursing research : ANR}, volume = {89}, number = {}, pages = {152070}, doi = {10.1016/j.apnr.2026.152070}, pmid = {42225335}, issn = {1532-8201}, mesh = {Humans ; *Burnout, Professional/psychology ; *Compassion Fatigue/psychology ; Cross-Sectional Studies ; *Hospice and Palliative Care Nursing ; *Palliative Care/psychology ; }, abstract = {BACKGROUND: Palliative care nurses face a high risk of compassion fatigue due to chronic exposure to suffering and death. However, synthesized evidence regarding its prevalence and key determinants remains scarce. This meta-analysis aims to inform targeted support strategies for safeguarding the well-being of nurses and maintaining the quality of care.
PURPOSE: To systematically quantify the levels of compassion fatigue among palliative care nurses and synthesize the key influencing factors.
METHODS: We systematically searched 11 electronic databases from their inception to April 2025. Studies were included if they met the following criteria: (1) cross-sectional design; (2) palliative care nurses as participants; (3) assessment of compassion fatigue levels or associated factors; (4) publication in Chinese or English. Random-effects meta-analyses and pre-specified subgroup analyses were conducted in Stata.
RESULTS: Twelve cross-sectional studies involving 3515 palliative care nurses from high- and middle-income countries were included (no eligible low-income country studies). Pooled analysis showed moderate mean scores of compassion satisfaction (34.64), burnout (25.24), and secondary traumatic stress (26.76). Subgroup analyses indicated that nurses in high-income countries reported significantly better outcomes than their counterparts in middle-income countries. Secondary traumatic stress increased in post-2020 (COVID-19 pandemic) studies. Key influencing factors spanned demographic, work-related, psychological, and social domains, with psychological resilience and strong social support being the most prominent protective factors for nurse well-being.
CONCLUSIONS: This meta-analysis indicates that palliative care nurses encounter moderate compassion fatigue, and secondary traumatic stress has deteriorated in recent years. Multilevel interventions (which prioritize resilience training, strengthening support systems, and optimizing the work environment) are recommended to alleviate compassion fatigue and protect the well-being of palliative care nurses.}, }
@article {pmid42226636, year = {2026}, author = {Xiao, Y and Bai, L and Zhan, Z and Fang, L and Liu, R and Fan, W}, title = {The role and mechanism of ZBP1 in the occurrence and development of systemic inflammation.}, journal = {Histology and histopathology}, volume = {}, number = {}, pages = {25102}, doi = {10.14670/HH-25-102}, pmid = {42226636}, issn = {1699-5848}, support = {82270968//National Natural Science Foundation of China/ ; }, abstract = {This review aims to comprehensively summarize the roles and underlying mechanisms of Z-DNA-binding protein 1 (ZBP1) in the onset and progression of systemic inflammation. As a critical initiator of PANoptosis and a sensor of Z-nucleic acids (e.g., viral RNA replication intermediates), ZBP1 has garnered growing attention in recent years for its critical involvement in various inflammatory diseases. By integrating current research progress, this review further explores the functional roles of ZBP1 in distinct inflammatory diseases and its potential value as a novel therapeutic target. Through systematic collation and analysis of recent studies on the regulatory mechanisms of ZBP1 in systemic inflammation, this review covers a broad range of disease areas, including neuroinflammation, diseases of the digestive, musculoskeletal, circulatory, and endocrine systems, as well as autoimmune diseases, sepsis, and bone marrow failure. Comprehensive analysis of these studies further elucidates the common regulatory mechanisms and disease-specific roles of ZBP1 in diverse inflammatory diseases. ZBP1 exerts diverse functions in inflammatory diseases across multiple organ systems. In the nervous system, it exacerbates brain injury and neuroinflammation by activating the RIPK3 (receptor-interacting protein kinase 3)-MLKL (mixed lineage kinase domain-like protein)-dependent necroptosis pathway. In digestive system diseases, it contributes to the pathological processes of periodontal disease and non-alcoholic steatohepatitis by regulating pyroptosis and inflammatory responses. In the musculoskeletal system, it accelerates the progression of osteoarthritis by facilitating chondrocyte damage and inflammation. In the circulatory system, it mitigates inflammatory responses in myocarditis and heart failure by inhibiting the activation of RIPK3 and NF-κB signaling pathways. In the endocrine system, it is implicated in the development of type 2 diabetes by regulating inflammatory responses and insulin resistance. In the respiratory system, it mediates programmed cell death and inflammatory responses by activating pathways such as ZBP1-RIPK3-MLKL, thereby participating in lung injury processes in diseases such as asthma, ARDS, and COVID-19. In the immune system, it aggravates the pathological progression of systemic lupus erythematosus and rheumatoid arthritis by triggering inflammatory cell death and related signaling pathways. ZBP1 exerts a pivotal role in the onset and progression of systemic inflammation by regulating inflammatory responses and tissue damage through multiple cell death and inflammatory signaling pathways. These findings not only offer novel insights into the mechanistic underpinnings of ZBP1 in systemic inflammation but also lay a theoretical basis for developing ZBP1-targeted therapeutic strategies. Future research should further elucidate the disease-specific mechanisms of ZBP1 in distinct inflammatory disorders and assess its therapeutic potential, thereby providing novel directions and strategies for the management of systemic inflammation- associated diseases.}, }
@article {pmid42226661, year = {2026}, author = {Guo, A and Bell, AG and Myhrvold, C}, title = {Towards deployable CRISPR-based nucleic acid detection.}, journal = {Progress in biomedical engineering (Bristol, England)}, volume = {8}, number = {2}, pages = {}, pmid = {42226661}, issn = {2516-1091}, support = {R01 AI182281/AI/NIAID NIH HHS/United States ; T32 GM148739/GM/NIGMS NIH HHS/United States ; T32 GM007388/GM/NIGMS NIH HHS/United States ; }, mesh = {Humans ; Nucleic Acid Amplification Techniques/methods ; SARS-CoV-2/genetics/isolation & purification ; *COVID-19/diagnosis/virology ; *CRISPR-Cas Systems ; Molecular Diagnostic Techniques/methods ; Point-of-Care Systems ; *COVID-19 Nucleic Acid Testing/methods ; *Clustered Regularly Interspaced Short Palindromic Repeats ; Rapid Diagnostic Tests ; }, abstract = {Deployable diagnostics are necessary for the control and treatment of infectious diseases, with significant unmet needs revealed during the COVID-19 pandemic. Nucleic acid diagnostics remain among the most sensitive and specific forms of detection, yet their reliance on laboratory equipment and trained personnel limits their deployment in resource limited settings. CRISPR-based diagnostics are uniquely positioned to enable rapid, affordable, and highly accurate nucleic acid testing at both the point-of-care and the point-of-need. In this review, we discuss advances toward deployable CRISPR-based diagnostics. We begin by examining innovations in sample processing methods, emphasizing strategies that reduce equipment requirements and enhance compatibility across diverse sample types and pathogens. We then explore developments in one-pot isothermal and amplification-free approaches, comparing the benefits and tradeoffs associated with each, as well as multiplexing strategies for simultaneous detection of multiple pathogens. Finally, we consider additional factors that impact assay deployability, including reagent lyophilization to minimize cold chain dependence and readout technologies that enable detection in resource-limited settings. We conclude by outlining remaining challenges and opportunities for future progress.}, }
@article {pmid42227017, year = {2026}, author = {Sheerah, HA and Alzaaqi, SM and Arafa, A and Banjar, WM and Liu, K and Withers, M and El-Jardali, F and Penttinen, P and Al-Jedai, AH and Selbie, D}, title = {Evolution of the Healthcare System in Saudi Arabia Over the Last Century: A Historical and Policy Analysis.}, journal = {Journal of healthcare leadership}, volume = {18}, number = {}, pages = {598238}, pmid = {42227017}, issn = {1179-3201}, abstract = {This article presents a narrative historical review of the development of the Saudi healthcare system from the establishment of the Public Health Directorate in 1925 to the ongoing reforms under Vision 2030. Saudi Arabia's healthcare journey has included major milestones, including the founding of the Ministry of Health in 1951, national immunization programs, the expansion of hospital infrastructure, and the introduction of primary healthcare services. Each era of national development contributed to shaping a system that today serves a rapidly growing and diverse population. Major reforms under the reigns of King Khalid, King Fahd, and King Abdullah significantly improved healthcare access, quality, and health outcomes. These reforms were supported by evolving governance mechanisms, including centralized administration through the Ministry of Health, national development planning, expanded public financing, and regulatory frameworks guiding healthcare delivery. In the contemporary period, under Vision 2030, healthcare transformation has accelerated through initiatives emphasizing public-private partnerships and sustainable financing. Digital health has expanded through national electronic health records, telemedicine platforms, integrated health information systems, and emerging artificial intelligence applications. The healthcare system has also demonstrated resilience in responding to challenges such as the MERS-CoV and COVID-19 pandemics, as well as the health demands of the Hajj pilgrimage. Despite substantial progress, challenges remain, including regional disparities, rising non-communicable diseases, and workforce sustainability. The Saudi experience offers important policy and leadership lessons for countries pursuing large-scale health system reform.}, }
@article {pmid42228279, year = {2026}, author = {Terra, C and Terrier, O and Le Gouellec, A}, title = {Host metabolic responses to SARS-CoV-2 and influenza viruses: parallels and contrasts.}, journal = {Metabolomics : Official journal of the Metabolomic Society}, volume = {22}, number = {3}, pages = {}, pmid = {42228279}, issn = {1573-3890}, support = {IDIVIA-MET//Fondation Air Liquide/ ; IDIVIA-MET//Fondation Air Liquide/ ; AO#15-11//Fondation Innovations en Infectiologie/ ; }, mesh = {Humans ; *SARS-CoV-2 ; *Influenza, Human/metabolism/virology ; *COVID-19/metabolism/virology ; *Host-Pathogen Interactions ; *Orthomyxoviridae/physiology/metabolism ; Virus Replication ; Citric Acid Cycle ; Metabolic Reprogramming ; }, abstract = {BACKGROUND: SARS-CoV-2 and Influenza virus are two major respiratory viruses, responsible for the COVID-19 and the flu respectively. To achieve their replication, these viruses do not merely hijack host cells; they reprogram them, and the host's metabolism is no exception.
AIM OF THE REVIEW: This review explores how two major respiratory pathogens, SARS-CoV-2 and influenza virus, manipulate host metabolism to fuel their replication and drive disease.
Despite differences in their genome organization and replication strategies, both viruses disrupt central metabolic pathways, including glucose processing, the Krebs cycle, amino acid and nucleotide synthesis. Common effects include enhanced anaerobic glycolysis, depletion of key amino acids, activation of the kynurenine pathway, and disruption of purine signaling. However, each virus leaves a distinct metabolic fingerprint. SARS-CoV-2 infection leads to glucose accumulation, alters late-stage Krebs cycle metabolites, and significantly disrupts nucleotide production. In contrast, influenza viral infection depletes glucose and dampens Krebs cycle activity, with a less consistent impact on nucleotide pathways. Viral proteins, such as SARS-CoV-2 ORF3a and influenza virus NS1, play a crucial role in these metabolic shifts. These changes not only reflect viral strategies but also correlate with disease severity. As metabolomics technologies advance, understanding these virus-specific and shared metabolic changes could unlock new diagnostic tools, prognostic markers, and treatment strategies.}, }
@article {pmid42229123, year = {2026}, author = {Al-Rifai, RH and Taher, S and Amoodi, H and Alshamma, D and Rasheed, L and Alhammadi, W and Alhosani, S and Meslamani, AA}, title = {Human Middle East Respiratory Syndrome Coronavirus (MERS-CoV) research in the Gulf Cooperation Council Countries: A mapping scoping review of epidemiology, clade, and research priority gaps.}, journal = {Journal of infection and public health}, volume = {19}, number = {7}, pages = {103272}, doi = {10.1016/j.jiph.2026.103272}, pmid = {42229123}, issn = {1876-035X}, mesh = {Humans ; *Middle East Respiratory Syndrome Coronavirus/genetics/classification ; *Coronavirus Infections/epidemiology/virology ; Animals ; Evidence Gaps ; Middle East/epidemiology ; Saudi Arabia/epidemiology ; }, abstract = {Middle East Respiratory Syndrome Coronavirus (MERS-CoV) continues to pose a substantial public health challenge within Gulf Cooperation Council (GCC) countries. This scoping review systematically examines geographic distribution, methodological characteristics, and thematic priorities of published research, while identifying critical evidence gaps. A total of 171 peer-reviewed studies on human MERS-CoV were included, with a marked predominance from Saudi Arabia (88.3%). Research output peaked in 2016 and 2019, followed by a decline coinciding with the COVID-19 pandemic. Cross-sectional designs were most common (43.3%), with widespread reliance on non-probability sampling (95.3%). Epidemiology and surveillance constituted the primary research focus (∼24%), with case fatality rate being the most frequently reported metric (43.9%). Limited genomic investigations were identified, with Clade B representing 71.4% of characterized strains. Overall, the evidence base reflects geographic concentration, methodological heterogeneity, and thematic limitations, underscoring the need for expanded research scope and enhanced regional collaboration.}, }
@article {pmid42229246, year = {2026}, author = {Kontogiannis, G and Tzamalis, P and Giannikopoulos, A and Nikoletseas, S}, title = {On-device cough detection and respiratory disease classification enhanced by generative data augmentation.}, journal = {Computers in biology and medicine}, volume = {213}, number = {}, pages = {111784}, doi = {10.1016/j.compbiomed.2026.111784}, pmid = {42229246}, issn = {1879-0534}, abstract = {BACKGROUND: Cough sounds are accessible, non-invasive biomarkers for respiratory disease assessment and can be captured using consumer-grade smartphones. Existing approaches typically focus solely on cough detection or rely on server-based deep learning for disease classification, which limits deployability and raises privacy concerns. Small, imbalanced cough datasets further hinder model generalization.
OBJECTIVE: To develop a multilayer, smartphone-compatible AI framework for automated cough detection and respiratory disease classification, and to propose a pioneering generative augmentation strategy utilizing a suite of five Variational Autoencoder (VAE) variants and a probabilistic cough-level fusion mechanism to improve disease classification under severe data scarcity and the limitations of conventional audio augmentation techniques.
METHODS: The proposed framework consists of three AI modules: (1) A Cough Detection Module (CDM) that performs real-time cough event detection and segmentation from continuous audio using lightweight models optimized for on-device execution. (2) A Disease Analysis Module (DAM) that classifies cough events into asthma, COVID-19, or healthy classes using parallel Support Vector Machine classifiers and a probabilistic cough-level fusion strategy. (3) A Generative Augmentation Module (GAM) employing five distinct VAE architectures. This module uniquely operates across the time-frequency domain for latent feature optimization while reconstructing samples in the time-domain to ensure acoustic verifiability.
RESULTS: The CDM provides reliable segmentation across heterogeneous recording conditions. The DAM achieves strong discriminability between asthma, COVID-19, and healthy coughs using compact cepstral and spectral features. The multi-variant GAM framework demonstrates superior efficacy in alleviating class imbalance specifically, the cross-domain (time-frequency to time-domain) reconstruction allows for the clinical verification of synthetic biomarkers. All system components operate in real time on commodity Android hardware.
CONCLUSION: This integrated framework addresses key limitations in dataset availability, model generalizability, and deployability, introducing an interpretable generative approach that demonstrates the feasibility of smartphone-based acoustic sensing as a scalable and privacy-preserving tool for respiratory health monitoring.}, }
@article {pmid42231138, year = {2026}, author = {Raps, SJ and Phillips, AK and McGinnis, LJ and Heyne, RE and Tilbury, ME and Patrician, PA}, title = {Patient Outcomes Associated With Continuous Remote Patient Monitoring: A Scoping Review.}, journal = {Worldviews on evidence-based nursing}, volume = {23}, number = {3}, pages = {e70134}, doi = {10.1111/wvn.70134}, pmid = {42231138}, issn = {1741-6787}, mesh = {Humans ; *Remote Patient Monitoring ; COVID-19/nursing ; Pandemics ; Digital Health ; Telemedicine ; }, abstract = {BACKGROUND: The COVID-19 pandemic highlighted the need for alternative healthcare delivery models, leading to the development of Continuous Remote Patient Monitoring (CRPM). CRPM allows for real-time monitoring of high-risk patients, reducing the burden on hospital resources. The integration of virtual nursing into CRPM has enhanced remote care capabilities, though it has also introduced new challenges related to patient safety and staffing, that is, nurse-to-patient ratios.
OBJECTIVE: This scoping review aims to explore the current evidence on virtual nursing using CRPM and identify challenges or barriers that help further future research and healthcare practices.
METHODS: This scoping review followed the PRISMA-ScR guidelines. Eligible studies focused on virtual nursing with physiological monitoring in either remote hospital or home-based care settings, with explicit examination of nursing care and its impact on patient and nursing outcomes. Peer-reviewed articles published in the past 10 years in English were included. Four databases (Ovid, PubMed, CINAHL, and Medline) were searched with support from a medical librarian. After screening 207 records using Covidence, 17 studies met the inclusion criteria. Two reviewers independently screened all records, with a third resolving discrepancies. Data was charted using a standardized extraction template.
RESULTS: Seventeen studies were included in this review. CRPM was associated with reported benefits in managing chronic conditions, extending acute care into home settings, and enhancing healthcare system adaptability, particularly during the COVID-19 pandemic. Clinical benefits included early detection of health deterioration, reduced hospital readmissions, and improved patient satisfaction. Nurses played a pivotal role in physiologic data interpretation and intervention, highlighting the importance of continuous oversight in achieving favorable outcomes. However, implementation challenges, such as alert fatigue, data overload, user interface complexity, and financial sustainability were consistently reported. These findings underscore the need for improved data management systems, targeted nurse training, and sustainable funding models to support broader CRPM adoption.
LINKING EVIDENCE TO ACTION: Virtual nursing within CRPM demonstrates strong potential to improve patient outcomes and reduce hospitalizations by extending inpatient-level physiologic surveillance into home-based and hospital-at-home settings through continuous, nurse-led monitoring. Successful integration of this model into routine practice will require addressing challenges related to data management, clinician workload associated with 24/7 surveillance, and sustainable funding mechanisms to support continuous virtual nursing coverage.}, }
@article {pmid42231687, year = {2026}, author = {Verma, A}, title = {Common and Rare Emerging and Re-Emerging Infectious Diseases in Pediatric Transplant Recipients: A Comprehensive Review.}, journal = {Pediatric transplantation}, volume = {30}, number = {6}, pages = {e70365}, doi = {10.1111/petr.70365}, pmid = {42231687}, issn = {1399-3046}, mesh = {Humans ; *Communicable Diseases, Emerging/epidemiology/diagnosis ; Child ; *Organ Transplantation ; Immunocompromised Host ; *Postoperative Complications/epidemiology ; *Transplant Recipients ; }, abstract = {The established pathogens, including cytomegalovirus, Epstein-Barr virus, and bacterial bloodstream infections, remain leading causes of morbidity and mortality in pediatric transplant recipients (PTR). However, over the past two decades, the landscape of infectious diseases in this population has evolved substantially, marked by an increasing burden of emerging and re-emerging pathogens. The global rise in multidrug-resistant bacteria and fungi has complicated antimicrobial management and limited therapeutic options. Concurrently, novel and re-emerging viral threats, most notably severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and other opportunistic viruses have been associated with severe disease, graft dysfunction, and prolonged hospitalization in immunocompromised children. Declining vaccination coverage has further contributed to the resurgence of vaccine-preventable infections such as measles and pertussis, which often present a more aggressive clinical course in PTR. Rare but consequential emerging pathogens, including arboviruses, hepatitis E virus, polyomaviruses, lymphocytic choriomeningitis virus, Enterovirus D68, Mpox (monkeypox virus), avian influenza A(H5N1), and emerging fungi, pose additional risks through both donor-derived transmission and community exposure, particularly in endemic and resource-limited settings. Broader global factors, including climate change, increased travel, and population displacement, have expanded pathogen distribution and exposure risk. Simultaneously, advances in molecular and syndromic diagnostics have improved pathogen detection, identifying infections previously under-recognized in transplant populations. These evolving epidemiological trends highlight the importance of ongoing surveillance, improved vaccination strategies, antimicrobial stewardship, and individualized prevention and treatment approaches. This comprehensive review synthesizes current evidence on most encountered and rare emerging and re-emerging bacterial, viral, and fungal infectious diseases affecting PTR.}, }
@article {pmid42231938, year = {2026}, author = {Okwei, ANN}, title = {Artificial intelligence and digital health equity: a post-pandemic evidence synthesis and implementation safeguards framework.}, journal = {Frontiers in digital health}, volume = {8}, number = {}, pages = {1785700}, pmid = {42231938}, issn = {2673-253X}, abstract = {INTRODUCTION: The rapid expansion of AI-enabled digital health after COVID-19 created new possibilities for extending care while raising concerns about unequal access, subgroup underperformance, and weak accountability. These effects remain difficult to interpret because telehealth infrastructure, predictive analytics, clinical decision support, and generative AI operate through different equity mechanisms.
METHODS: A transparent narrative evidence synthesis was conducted using peer-reviewed literature and selected governance documents. Structured searches of PubMed, Scopus, Web of Science, and IEEE Xplore were refreshed on March 5, 2026, for English-language sources published between January 1, 2020, and December 31, 2025. A second reviewer independently assessed a sample of 12 full-text inclusion and exclusion decisions using the same pre-specified criteria, with 100% agreement. The final corpus included 29 sources.
RESULTS: Evidence was strongest for digital access barriers, subgroup underperformance, and implementation-related governance concerns. AI-assisted screening and digitally mediated remote support showed conditional benefits in targeted settings when high-touch support was built into implementation. Evidence on generative AI and language-support tools was comparatively smaller, newer, and concentrated in representational-bias applications, with limited evidence of sustained downstream equity gains.
CONCLUSION: AI-enabled digital health may reduce selected barriers to care when supported by equitable access conditions, subgroup validation, accountable governance, and implementation oversight. Equity gains were conditional rather than automatic, and evidentiary depth varied substantially across modalities. The review distills recurring patterns into a synthesis-derived operational roadmap for procurement, validation, implementation, and post-deployment monitoring.}, }
@article {pmid42232574, year = {2026}, author = {Pan, C and Wang, S and Yang, Y and Hu, J and Pan, Y}, title = {Curcumin-piperine supplementation modulates inflammation, oxidative stress, and cardiometabolic risk: a systematic review of randomized controlled trials.}, journal = {Frontiers in nutrition}, volume = {13}, number = {}, pages = {1814168}, pmid = {42232574}, issn = {2296-861X}, abstract = {BACKGROUND: Although curcumin has well-established anti-inflammatory and antioxidant qualities, its low bioavailability limits its therapeutic applicability. Piperine improves systemic exposure and absorption of curcumin. This systematic study aimed to examine the effectiveness and safety of curcumin-piperine supplementation in relation to inflammatory, metabolic, cardiovascular, autoimmune, infectious, and pulmonary disorders.
METHODS: From 2026, a comprehensive search of randomised controlled trials (RCTs) was conducted across the main electronic databases. Studies that assessed oral curcumin in combination with piperine and reported results related to oxidative stress, inflammation, metabolism, cardiovascular disease, or clinical symptoms were considered eligible. Using accepted methodological standards, the risk of bias was evaluated.
RESULTS: There were 20 RCTs with sample sizes ranging from 8 to 117 individuals and durations ranging from 1 to 12 weeks. Doses of piperine (5-15 mg/day) and curcumin (500-1,500 mg/day) varied. Fifteen out of twenty trials indicated significant decreases in inflammatory biomarkers [C-reactive protein (CRP), high-sensitivity CRP (hs-CRP), and interleukin-6 (IL-6)]. Of 15 studies evaluating these outcomes, 12 showed improvements in oxidative stress markers, including superoxide dismutase (SOD), total antioxidant capacity (TAC), and malondialdehyde (MDA). Supplementation dramatically decreased fasting blood glucose (FBS), glycated haemoglobin (HbA1C), and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) in individuals with metabolic syndrome (MetS) and type 2 diabetes. At the same time, 14 out of 18 trials showed reductions in lipid markers (triglycerides (TG), LDL-C, total cholesterol, and HDL-C). After coronary artery bypass grafting and acute myocardial infarction (AMI), cardiovascular populations showed decreases in cardiac damage biomarkers (CK-MB, AST, and ALT). COVID-19, premenstrual syndrome (PMS), dysmenorrhea, and chronic pulmonary illness all showed symptom-based improvements. No significant adverse effects were noted. None of the trials was high risk; 13 had low risk of bias, and 6 had moderate issues.
CONCLUSION: In a variety of clinical populations, curcumin-piperine supplementation consistently demonstrates anti-inflammatory, antioxidant, metabolic, and cardioprotective effects, with a good safety profile. Its utility as an adjuvant in metabolic and cardiometabolic illnesses is most strongly supported by evidence. To verify clinical efficacy and improve dosing techniques, larger, longer-term RCTs with standardized objectives are necessary.}, }
@article {pmid42233731, year = {2026}, author = {Shaver, N and Dahroug, L and Vyas, N and McGuire, M and Tahsin, A and Adedunye, D and Gauthier, S and Sterling, E and Collins, E and Hughes, SE and Rafferty, AM and Rafferty, E and Groot, G and Laframboise, W and Mann, C and Bhereur, A and Edwards, J and McQuillan, R and Theodoratou, E and Edjoc, R and Little, J}, title = {Barriers and facilitators for return-to-work following post-COVID-19 condition: A scoping review.}, journal = {Work (Reading, Mass.)}, volume = {}, number = {}, pages = {10519815261454982}, doi = {10.1177/10519815261454982}, pmid = {42233731}, issn = {1875-9270}, abstract = {BackgroundSupporting workers with post-COVID condition in returning to work is critical. Qualitative evidence may provide insight into the complex factors shaping this process and inform intervention and policy development.ObjectiveTo identify and synthesize qualitative evidence on barriers and facilitators influencing return to work following post-COVID condition.MethodsWe conducted a scoping review using the Arksey and O'Malley framework, refined by Levac et al. MEDLINE, EMBASE, CINAHL, and Scopus were searched from inception to July 2025. Eligible qualitative and mixed-methods studies examined barriers and facilitators to returning to work among working-age adults with post-COVID condition or healthcare professionals involved in their care. Data were synthesized using critical interpretive synthesis, informed by the International Classification of Functioning, Disability and Health framework.ResultsTwenty-nine qualitative or mixed-methods studies (n=1902 participants) were included. Barriers and facilitators operated across domains within broader organizational and systemic contexts. Fluctuating, unpredictable symptoms were major barriers, while gradual rehabilitation and energy management facilitated return to work. Mismatches between work capacity and job demands limited work participation. Environmental barriers included stigma, inflexible policies, limited accommodations, and financial or compensation pressures, while facilitators included flexible work arrangements, supportive leadership, and collaborative planning. Guilt and fear of underperformance were personal barriers, while acceptance and motivation facilitated return to work. Specialists identified fragmented services and limitations of current care models as systemic concerns.ConclusionsPost-COVID condition necessitates flexible, multidisciplinary return-to-work models that accommodate symptom variability and address psychosocial needs. Improved coordination across healthcare, workplace, and social systems is essential for sustainable workforce participation.RegistrationThe review protocol was publicly registered on the Open Science Framework prior to screening and was approved by all team members (https://osf.io/nrbu5/).}, }
@article {pmid42233803, year = {2026}, author = {Ferreira, APR and Silva, ENXD and Molina, MDCB and Assis, SG}, title = {Childhood obesity and food insecurity: scoping review - 2020 to 2023.}, journal = {Ciencia & saude coletiva}, volume = {31}, number = {4}, pages = {e22732024}, doi = {10.1590/1413-81232026314.22732024}, pmid = {42233803}, issn = {1678-4561}, mesh = {Humans ; *Food Insecurity ; *Pediatric Obesity/epidemiology ; *COVID-19/epidemiology ; Child ; Socioeconomic Factors ; Socioeconomic Disparities in Health ; Pandemics ; Food Supply ; Cross-Sectional Studies ; }, abstract = {This study conducted a scoping review to examine the relationship between food insecurity and childhood obesity, analyzing 47 articles with empirical data published between 2020 and 2023. The studies were categorized by income level of the countries of origin and included cross-sectional surveys, cohorts, and ecological approaches. Most of the research focused on low- and middle-income countries, where food insecurity is more prevalent, but articles from high-income countries were also analyzed. The principal factors evaluated were the household's socioeconomic status, the children's age group and gender, and the COVID-19 pandemic's impact. The results point to a significant association between food insecurity and childhood obesity, especially in low-income households and in regions with insufficient policies on both issues. The COVID-19 pandemic has deteriorated inequalities, reducing access to healthy foods and increasing childhood obesity rates. Thus, the two problems are interconnected and multifactorial and require interventions tailored to local contexts. An integrated and contextualized approach is essential to promote child health.}, }
@article {pmid42235797, year = {2026}, author = {Manzoor, S}, title = {Pan-pathogen vaccine approaches: Toward broad-spectrum immunity in a One Health era.}, journal = {Journal of microbiological methods}, volume = {247}, number = {}, pages = {107563}, doi = {10.1016/j.mimet.2026.107563}, pmid = {42235797}, issn = {1872-8359}, mesh = {Humans ; Animals ; *Vaccine Development/methods ; Vaccinology/methods ; *Communicable Diseases, Emerging/prevention & control/immunology ; *Viral Vaccines/immunology ; *Vaccines/immunology ; Global Health ; SARS-CoV-2/immunology ; Immunoinformatics ; Pandemic Preparedness ; Epitopes/immunology ; COVID-19/prevention & control ; }, abstract = {Emerging and re-emerging infectious diseases (EIDs) represent an escalating threat to global public health, as exemplified by outbreaks of COVID-19, Ebola, Zika, and other zoonotic viruses. Traditional pathogen-specific vaccines, although effective for individual diseases, face significant limitations in addressing EIDs due to long development timelines, resource intensity, and restricted adaptability to novel pathogens or variants. Pan-pathogen vaccines-designed to provide broad-spectrum immunity across multiple related or unrelated pathogens-offer a transformative approach to pandemic preparedness. This review presents a comprehensive overview of pan-pathogen vaccinology within the One Health framework, emphasizing the integration of human, animal, and environmental health for proactive disease prevention. We provide explicit definitions for "universal", "broad-spectrum", and "pan-pathogen" vaccines and embed the One Health principle into the full vaccine development lifecycle through real-world case studies, including Nipah virus and rVSV-Ebola. The review highlights strategies for epitope discovery using comparative genomics, evolutionary biology, and immunoinformatics to identify conserved antigenic regions, and details mechanisms of cross-protective immunity mediated by T cells, broadly neutralizing antibodies, mucosal responses, and trained innate immunity with emphasis on their interplay. Advanced vaccine platforms-mRNA, viral vectors, protein subunits, and nanoparticle-based systems-are evaluated for their capacity to deliver multivalent, chimeric, and mosaic antigens. Preclinical and clinical advances against influenza, coronaviruses, flaviviruses, filoviruses, and critically, bacterial, fungal, parasitic, and DNA virus targets are summarized. Ethical, regulatory, and global health considerations for equitable vaccine distribution are discussed, with expanded safety analysis addressing pan-pathogen-specific hazards such as antigenic competition, autoimmunity, and regulatory adaptation. Persistent gaps, including antigenic variability, immune imprinting, safety concerns, and challenges in clinical validation, are identified, alongside controversies surrounding the balance between broad coverage and potential immune escape. Integrating genomic surveillance, predictive modeling, and emerging technologies such as artificial intelligence, systems biology, and synthetic vaccinology is essential to optimize vaccine design and accelerate translational implementation. Collectively, pan-pathogen vaccines represent a proactive, adaptive, and globally coordinated strategy to mitigate future pandemics and strengthen long-term health security.}, }
@article {pmid42238204, year = {2026}, author = {Mahallawi, WH}, title = {Artificial Intelligence in Dialysis Therapies: Applications in Hemodialysis and Peritoneal Dialysis for Managing Infectious Diseases and Complications.}, journal = {Saudi medical journal}, volume = {47}, number = {6}, pages = {998-1007}, pmid = {42238204}, issn = {1658-3175}, mesh = {Humans ; *Artificial Intelligence ; Peritoneal Dialysis/methods ; *Renal Dialysis/methods ; Sepsis/mortality ; }, abstract = {This narrative review synthesizes evidence from a systematic literature search (2019-2025) on artificial intelligence (AI) applications in hemodialysis and peritoneal dialysis for managing infections and complications. Dialysis patients face infection rates 100-fold higher than the general population and sepsis mortality exceeding 35%. The AI, utilizing machine learning algorithms such as XGBoost, deep neural networks, and explainable AI tools, revolutionizes care through precise diagnostics, prognostics, and therapeutics. Key models demonstrate high accuracy in predicting bloodstream infections (area under the curve [AUC] 0.914), classifying peritonitis (F1 0.93), detecting SARS-CoV-2 (AUROC 0.82), and forecasting mortality (AUC 0.979). Therapeutically, AI guides antibiotic stewardship, reducing inappropriate use by 18-67%, and mitigates intradialytic hypotension via ultrafiltration adjustments, reducing incidence by 25-40%. Despite promising results, challenges include data scarcity, algorithmic bias, and the integration of these tools into clinical workflows. Future directions involve diverse datasets, explainable AI, and real-time decision support systems. The AI holds transformative potential for personalizing dialysis management and improving patient outcomes.}, }
@article {pmid42238848, year = {2026}, author = {Yaghobi, M and Jalilian, M}, title = {The potential role of indomethacin in COVID-19 management: A systematic review of therapeutic and mechanistic evidence.}, journal = {New microbes and new infections}, volume = {72}, number = {}, pages = {101771}, pmid = {42238848}, issn = {2052-2975}, abstract = {BACKGROUND: Indomethacin has been proposed as a repurposed agent for COVID-19 due to its anti-inflammatory and potential antiviral effects against coronaviruses. However, the available evidence is limited, heterogeneous, and largely indirect, with a large observational NSAID study dominating the sample size without evaluating indomethacin-specific efficacy.
METHODS: We conducted a PRISMA 2020-compliant systematic review registered in PROSPERO (CRD420251272994). Major databases and trial registries were searched from January 2019 to July 2025 using reproducible strategies. Eligible studies included randomized trials, observational studies, case series, and experimental investigations. Clinical and mechanistic evidence were synthesized separately, and risk of bias was assessed using RoB 2 and ROBINS-I tools.
RESULTS: Eight studies were included: two randomized trials, three observational studies, one case series, one in vitro study, and one pharmacokinetic/pharmacodynamic modeling study. The largest dataset (n = 536,423) provided indirect safety data only. Small clinical studies suggested faster symptom resolution and shorter hospitalization in mild-to-moderate cases, but findings were inconsistent and at risk of bias. Experimental studies supported antiviral mechanisms, including inhibition of viral RNA synthesis and host translation pathways. No study evaluated prophylactic use.
CONCLUSION: Evidence for indomethacin in COVID-19 remains limited and low certainty. Safety conclusions should be cautious given incomplete reporting and known NSAID risks. Larger, well-designed randomized trials are required.}, }
@article {pmid42239536, year = {2026}, author = {Singh, P and Saravanan, A and Seitz, J and Alkarzon, N and Medugu, N}, title = {A one health perspective on the intestinal microbiome's role in COVID-19 outcomes and recovery.}, journal = {Frontiers in cellular and infection microbiology}, volume = {16}, number = {}, pages = {1763844}, pmid = {42239536}, issn = {2235-2988}, mesh = {Humans ; *COVID-19/microbiology/therapy ; Dysbiosis/microbiology ; *Gastrointestinal Microbiome/physiology ; SARS-CoV-2 ; Animals ; Fecal Microbiota Transplantation ; Probiotics/therapeutic use ; Prebiotics ; Pandemics ; }, abstract = {Emerging infectious diseases, particularly zoonotic ones, remain major global health concerns. The Coronavirus Disease 2019 (COVID-19) pandemic, caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), highlights the interconnectedness of human, animal, and environmental health within the One Health framework. The intestinal microbiome plays a central role in host immunity and systemic homeostasis, and its disruption has been linked to altered disease severity and recovery patterns in COVID-19. Evidence suggests that SARS-CoV-2 infection induces intestinal dysbiosis, modifies immune signaling, and affects the microbiota-gut-brain axis (MGBA), contributing to neuropsychiatric and metabolic complications. This review synthesizes current findings on the intestinal microbiome's role in COVID-19 pathophysiology and recovery, explores emerging therapeutic strategies including probiotics, prebiotics, and fecal microbiota transplantation, and emphasizes the importance of integrating microbiome research into pandemic preparedness through a One Health approach.}, }
@article {pmid42239667, year = {2026}, author = {Trejo-Castro, AI and Marín-Obispo, LM and Carrion-Alvarez, D and Mora-Godínez, S and Martinez-Torteya, A and Hernández-Brenes, C and Martinez-Ledesma, E}, title = {A bibliometric and text-mining analysis of lipidomics and metabolomics in human disease.}, journal = {Frontiers in physiology}, volume = {17}, number = {}, pages = {1727465}, pmid = {42239667}, issn = {1664-042X}, abstract = {INTRODUCTION: Lipidomics and metabolomics have become key approaches for understanding and diagnosing human diseases, including type 2 diabetes, Alzheimer's disease, cancer, and kidney dysfunction. This study provides a comprehensive overview of the evolution of these disciplines through a bibliometric and text-mining analysis of scientific production from 2004 to 2024, based on data from Scopus and validated through a multi-database comparative approach.
METHODS: A total of 9,628 articles were harmonized and analyzed using Bibliometrix, Scimago Graphica, OpenRefine, and custom R scripts to identify the most productive journals, authors, countries, and institutions, and to map thematic structures and keyword dynamics. Beyond traditional bibliometric indicators, our integrative approach combined quantitative trends with semantic and conceptual mapping to trace the methodological and translational evolution of the field. To ensure robustness and generalizability, equivalent searches were conducted in the Web of Science Core Collection and PubMed, and cross-database validation assessed concordance in journal and country rankings, as well as temporal and thematic trends.
RESULTS: The field shows rapid expansion, with an annual growth rate of 32.6%. The United States and China lead global output, followed by major European contributors. Core topics include Alzheimer's disease, obesity, and breast cancer, while emerging areas focus on artificial intelligence, multi-omics integration, and Mendelian randomization. Analytical methodologies such as liquid chromatography-mass spectrometry, gas chromatography-mass spectrometry, and nuclear magnetic resonance, together with metabolic diseases, remain central to the field. In contrast, niche themes such as microbiota-COVID-19 interactions and oxidative stress-cancer associations represent emerging interdisciplinary bridges.
DISCUSSION: Overall, lipidomics and metabolomics are evolving toward integrative and computational frameworks with strong diagnostic potential, underscoring the need for validated biomarkers, standardized data pipelines, and open repositories to enable clinical translation.}, }
@article {pmid42240857, year = {2026}, author = {Desai, M and Malik, S and Singh, A and Kukreti, R and Kukreti, S and Grewal, GK}, title = {Targeting oxidative stress pathways in epilepsy: mechanistic insights into the role of ascorbic acid.}, journal = {Molecular biology reports}, volume = {53}, number = {1}, pages = {}, pmid = {42240857}, issn = {1573-4978}, support = {TAR/2022/000636//Department of Science and Technology, Ministry of Science and Technology, India/ ; }, mesh = {*Ascorbic Acid/pharmacology/therapeutic use/metabolism ; Humans ; *Epilepsy/drug therapy/metabolism ; *Oxidative Stress/drug effects ; Animals ; Antioxidants/pharmacology/therapeutic use ; Signal Transduction/drug effects ; Anticonvulsants/pharmacology/therapeutic use ; Reactive Oxygen Species/metabolism ; NF-E2-Related Factor 2/metabolism ; NF-kappa B/metabolism ; }, abstract = {Epilepsy, a neurological disease, is linked to oxidative stress generated due to the synchronous firing of neurons during seizures and use of antiseizure medications (ASMs). Among commonly prescribed ASMs, carbamazepine, valproate, and levetiracetam have been implicated in modulating oxidative stress-related signaling pathways, including Nrf2, NF-κB, and MAPK. Ascorbic acid, a potent antioxidant capable of crossing the blood-brain barrier, has emerged as a promising therapeutic candidate. This review examines the molecular mechanisms underlying ASM-associated oxidative stress in clinical, non-kindled/kindled preclinical, as well as non-epilepsy models, and highlights evidence demonstrating the ability of ascorbic acid to attenuate ROS accumulation, enhance endogenous antioxidant defenses, and modulate redox-sensitive signaling pathways implicated in epileptogenesis and ASM-induced toxicity. Collectively, the available evidence suggests that ascorbic acid has the potential to confer neuroprotection and reduce oxidative injury in epilepsy. Insights presented in this review aim to initiate research focusing on ascorbic acid as an adjuvant in epilepsy. Further studies are warranted to clarify its interactions with ASM metabolism, to optimize dosing strategies, and to establish its translational potential as an adjuvant therapy in clinical epilepsy management.}, }
@article {pmid42241918, year = {2026}, author = {Sierra, NM and Hernández Rincón, EH and Bejarano, VN and Ghotme, KA}, title = {Unlocking global neurosurgery: how telemedicine addresses unmet needs and future prospects - a scoping review.}, journal = {Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia}, volume = {152}, number = {}, pages = {112121}, doi = {10.1016/j.jocn.2026.112121}, pmid = {42241918}, issn = {1532-2653}, abstract = {INTRODUCTION: Telemedicine, as defined by the WHO, utilizes information and communication technologies for disease diagnosis, treatment, and prevention, enabling remote healthcare delivery. While its adoption accelerated during the COVID-19 pandemic, its role in global neurosurgery remains underexplored and presents unique challenges.
OBJECTIVE: This scoping review examines the implementation of telemedicine in neurosurgery and its subspecialties across different global contexts-before, during, and after the COVID-19 pandemic.
METHODS: We scoped the scientific literature published in English, Spanish, and Portuguese from 2014 to 2024. We analyzed primary and secondary studies, excluding gray literature. Initial searches yielded 3,622 articles, with 67 studies meeting the eligibility criteria for final review.
RESULTS: Telemedicine has been implemented in various neurosurgical subspecialties, including general neurosurgery, perioperative assessment, traumatic brain injury, stroke, neurosurgical oncology, spine surgery, neurocritical care, functional neurosurgery, and pediatric neurosurgery. Reported outcomes encompass patient and neurosurgeon satisfaction and perceptions regarding telemedicine's role during and beyond the COVID-19 pandemic.
CONCLUSIONS: Telemedicine holds promise in addressing unmet needs in global neurosurgical care, offering benefits such as enhanced clinical effectiveness, patient satisfaction, cost-effectiveness, and reduced hospital readmissions. It extends access to specialized care, improving the overall quality of life and proving indispensable in contemporary neurosurgery, especially within a global context. Continued research and optimization of telemedicine implementation are essential for ensuring safe and effective healthcare delivery, particularly within the global neurosurgical landscape.}, }
@article {pmid42243031, year = {2026}, author = {Savvidou, P and Iosifidis, E and Roilides, E and Gika, H and Antachopoulos, C}, title = {Viral respiratory infections in children and metabolomics: a review of literature.}, journal = {Paediatric respiratory reviews}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.prrv.2026.05.007}, pmid = {42243031}, issn = {1526-0550}, abstract = {Acute respiratory infections (ARIs) are the most common infectious diseases during childhood, responsible for significant morbidity and mortality in the pediatric population worldwide. Metabolomics, the global analysis of small metabolites, is a novel tool that offers insights into diagnostics and prognostics of viral respiratory infections. This review summarizes the existing literature on metabolomic studies in viral acute respiratory infections (ARIs) within the pediatric population. Metabolomic research on patients with bronchiolitis has addressed several clinical questions, such as discrimination by causative agent, i.e. respiratory syncytial virus or rhinovirus, and most importantly prognosis, predicting disease severity and long-term outcomes. In pneumonia, studies have focused on discriminating viral from bacterial etiology and from healthy controls but also predicting disease severity. There is a growing number of studies on metabolomics in ARIs providing a strong foundation for addressing remaining challenges and allowing for more comparable results and greater impact on clinical practice.}, }
@article {pmid42243943, year = {2026}, author = {Kayda, I and Lechiile, K and Kinshella, MW and Bone, JN and Lavoie, PM and Goldfarb, DM}, title = {Sensitivity of gargle samples compared to swabs for SARS-CoV-2 detection with nucleic acid amplification testing: a systematic review and meta-analysis.}, journal = {Virology journal}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12985-026-03206-1}, pmid = {42243943}, issn = {1743-422X}, abstract = {BACKGROUND: Gargle sampling emerged as a novel method for diagnostic testing during the coronavirus disease 2019 (COVID-19) pandemic, yet uncertainty remained about its performance when compared with conventional sampling methods.
OBJECTIVE: To evaluate the performance of self-collected gargle samples compared to traditional healthcare worker (HCW)-collected upper respiratory tract swabs for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection with nucleic acid amplification testing (NAAT).
METHODS: We conducted a systematic review (PROSPERO registration: CRD42022312628) to (1) estimate sensitivity of gargle sampling, (2) estimate the difference in sensitivity between gargle and swab methods, and (3) understand how various testing contexts may impact gargle sensitivity. MEDLINE, EMBASE, Web of Science, Global Index Medicus, and preprint servers were searched. Studies reporting primary data and investigating COVID-19 diagnostic performance of self-collected gargle samples compared to HCW-collected swabs tested using NAAT were included. Quality assessment was performed, and random effects meta-analysis was conducted to estimate the pooled gargle sensitivity and mean difference in sensitivity between gargle and swab methods.
RESULTS: Searches identified 1453 results with 32 studies included. Meta-analysis pooled 34 gargle-swab comparisons. Gargle sensitivity was estimated to be 92.2% (95% confidence interval: 89.6% to 94.2%), and 3.3% (0.4% to 6.3%) less sensitive than swab collection. Gargle sensitivity was greater than 87.0% across diverse patient characteristics, settings, type or volume of gargle liquid, length of gargling time, wait time prior to gargling, and reference swab type used. Greatest sensitivities were observed when gargle sampling for 30 s or greater using 5-9 mL of saline. Gargle sensitivity of 93.0% (87.8% to 96.1%) was observed when there was no required wait time, and 90.1% (87.0% to 92.5%) when compared to combined nasopharyngeal and oropharyngeal swabs.
CONCLUSION: Gargle sampling may be a sensitive, alternative method for SARS-CoV-2 detection across various testing contexts, and its implementation has potential to reduce barriers associated with HCW-collected swabs, that may be challenging to collect.}, }
@article {pmid42245362, year = {2026}, author = {Alrossies, AS}, title = {Post-COVID syndrome in Pakistan, India, and Bangladesh: a systematic narrative review of epidemiology, clinical manifestations, and healthcare system responses.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1714880}, pmid = {42245362}, issn = {2296-2565}, mesh = {Humans ; Post-Acute COVID-19 Syndrome ; *COVID-19/epidemiology/complications ; India/epidemiology ; Bangladesh/epidemiology ; Pakistan/epidemiology ; Female ; Prevalence ; *Delivery of Health Care ; }, abstract = {BACKGROUND: Post-COVID syndrome, defined by the WHO as persistent multisystem symptoms extending beyond 4 weeks post-infection, has emerged as a critical public health concern in South Asia, a region home to approximately 1. 9 billion individuals across Pakistan, India and Bangladesh. Despite the disproportionate burden affecting an estimated 54.3 million individuals in this region, no prior systematic synthesis has integrated evidence across all three major South Asian countries, creating a significant gap in the evidence-based policy development.
METHODS: This systematic narrative review, conducted following the PRISMA-ScR guidelines, synthesized evidence from 388 peer-reviewed publications identified through PubMed, Scopus, and Google Scholar databases (January 2020-December 2023). Study quality was assessed using the JBI Critical Appraisal Checklist and the GRADE framework. Two independent reviewers performed the screening (inter-rater reliability: 87.3%) and data extraction (concordance: 94.1%).
RESULTS: The prevalence of post-COVID syndrome varied geographically: 15.8%-18.3% in Pakistan, 9.4%-22.5% to 11.2%-16.8% in India, Females consistently demonstrated higher prevalence across all countries, with ratios ranging from 1.41:1 to 1.81:1. The peak burden occurred in the 35-54 age group. Urban areas reported a higher prevalence than rural areas, with disparities correlating with healthcare infrastructure metrics. Fatigue (58.3%), brain fog (52.1%), and memory problems (48.7%) were the most prevalent symptoms. The prevalence declined across successive pandemic waves, with vaccination associated with substantial reductions in later waves.
CONCLUSION: Post-COVID syndrome poses a substantial and ongoing public health challenge in South Asia, disproportionately affecting women and adults of working age. Urban-rural disparities in prevalence reflect underlying healthcare access inequities rather than true epidemiological differences. Urgent priorities include establishing dedicated post-COVID clinics, strengthening rehabilitation infrastructure, and conducting region-specific genetic and long-term outcome research to inform evidence-based interventions for this vulnerable population.}, }
@article {pmid42245628, year = {2026}, author = {Yuan, H and Zhang, T and Du, M and Liang, Z}, title = {Progressive cerebral infarction as the presenting feature of ANCA-associated vasculitis with concurrent Evans syndrome: a case report and literature review.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1764226}, pmid = {42245628}, issn = {1664-3224}, mesh = {Humans ; Female ; *Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/complications/diagnosis/therapy/immunology ; Aged ; *Cerebral Infarction/etiology/diagnosis/therapy ; *Anemia, Hemolytic, Autoimmune/complications/therapy/diagnosis/immunology ; *Thrombocytopenia/complications/diagnosis/therapy/immunology ; Plasma Exchange ; Antibodies, Antineutrophil Cytoplasmic/blood/immunology ; *COVID-19/complications/therapy ; SARS-CoV-2 ; Cyclophosphamide/therapeutic use ; }, abstract = {Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a systemic autoimmune disease, and central nervous system involvement, though uncommon, can be a severe manifestation. The co-occurrence of AAV and Evans syndrome (ES) is exceptionally rare and may reflect broader immune dysregulation. A 72-year-old female presented with progressive right-sided hemiplegia and mixed aphasia. Imaging revealed multiple acute cerebral infarcts. Laboratory findings showed anemia, thrombocytopenia, acute kidney injury, and elevated inflammatory markers. Serology confirmed myeloperoxidase (MPO)-ANCA positivity, supporting a diagnosis of AAV, most consistent with microscopic polyangiitis. Subsequent hematological workup supported concurrent autoimmune cytopenias consistent with probable ES. Despite corticosteroids and intravenous immunoglobulin, her condition deteriorated with left middle cerebral artery occlusion; during hospitalization, this deterioration coincided with a SARS-CoV-2 infection. Management was escalated to therapeutic plasma exchange and cyclophosphamide. This regimen stabilized renal and hematological parameters, although severe neurological deficits and thrombocytopenia persisted. This case highlights that stroke may be a catastrophic presenting feature of AAV and that concurrent autoimmune cytopenias may add substantial diagnostic and therapeutic complexity. Early ANCA testing in cryptogenic or progressive stroke with systemic involvement is vital, and management requires careful balance between immunosuppression and infection risk.}, }
@article {pmid42246405, year = {2026}, author = {Zheng, Z and Yousefi, M and Marks, M and Dixit, A and Wahid, R and Viscidi, E and Anderson, EJ}, title = {A narrative review of COVID-19 epidemiology and mRNA vaccine impact in children <12 years during the omicron era (November 2021 - December 2025).}, journal = {Expert review of vaccines}, volume = {25}, number = {1}, pages = {2684961}, doi = {10.1080/14760584.2026.2684961}, pmid = {42246405}, issn = {1744-8395}, mesh = {Child ; Child, Preschool ; Humans ; Infant ; *COVID-19/epidemiology/prevention & control/immunology ; *COVID-19 Vaccines/administration & dosage/immunology ; Hospitalization/statistics & numerical data ; mRNA Vaccines/administration & dosage/immunology ; Post-Acute COVID-19 Syndrome/epidemiology ; *SARS-CoV-2/immunology ; Vaccination/statistics & numerical data ; Vaccine Efficacy/statistics & numerical data ; }, abstract = {INTRODUCTION: COVID-19 continues to pose a burden in children under 12 years of age during the Omicron era (November 2021 - December 2025). Following Omicron's emergence, SARS-CoV-2 seroprevalence increased rapidly, with most children infected by ages 2-4 years. Pediatric hospitalization rates declined after the initial Omicron wave but remained elevated in children under 2 years and in those with underlying conditions. While healthy children typically experience mild illnesses, severe outcomes-including hospitalization, admission to an intensive care unit, death, and multisystem inflammatory syndrome-can occur, particularly in unvaccinated children.
AREAS COVERED: This narrative review summarizes current evidence on pediatric COVID-19 epidemiology and vaccine impact, including infection rates, severe outcomes, post-acute COVID-19 syndrome (Long COVID), and mRNA vaccine effectiveness and uptake in high-income regions. A literature search included peer-reviewed publications, surveillance data, and reports from health agencies during the Omicron era.
EXPERT OPINION: mRNA vaccines are effective in reducing pediatric COVID-19-related morbidity, but uptake remains low globally. Addressing parental concerns, improving vaccine accessibility, and promoting evidence-based communication are critical to increasing uptake. Given the continued disease burden and the potential for severe outcomes, ensuring access to mRNA COVID-19 vaccines for children at higher risk and for families who wish to vaccinate their children is beneficial.}, }
@article {pmid42247671, year = {2026}, author = {Datta, B and Jaremski, JE and Wilkins, AS and Hoffman, Z}, title = {Assessing income heterogeneity of female sex as risk factor for long COVID: a meta-analytic investigation.}, journal = {Biodemography and social biology}, volume = {71}, number = {2}, pages = {125-136}, doi = {10.1080/19485565.2026.2684735}, pmid = {42247671}, issn = {1948-5573}, mesh = {Humans ; Female ; *Income/statistics & numerical data ; *COVID-19/epidemiology/economics ; Middle Aged ; Risk Factors ; United States/epidemiology ; Adult ; Post-Acute COVID-19 Syndrome ; Adolescent ; Sex Factors ; Aged ; Young Adult ; SARS-CoV-2 ; Age Factors ; Behavioral Risk Factor Surveillance System ; }, abstract = {Women have a higher risk of Long COVID, defined as symptoms persisting for three or more months after SARS-CoV-2 infection. This study examines whether the elevated risk of Long COVID among women varies across income subgroups in a nationally representative sample of the U.S. population. Using data from the 2023 Behavioral Risk Factor Surveillance System (BRFSS), we estimated adjusted odds ratios for Long COVID associated with female sex, stratified by four age categories and 11 income groups. We conducted random-effects meta-analyses of income subgroup estimates within each age category and assessed heterogeneity using Cochran's Q, I[2] statistics, prediction intervals, and Galbraith plots. Among younger age groups (18-34, 35-49, and 50-64 years), Cochran's Q ranged from 7.70 to 10.98 (p > 0.10), and I[2] was 0.00%, indicating no significant heterogeneity across income groups. In the ≥65 age group, Cochran's Q was 18.35 (p = 0.0494), and I[2] was 21.96%, suggesting modest heterogeneity. The 95% prediction interval for the ≥65 group (1.121-1.978) was wider than those for younger groups: 1.437-1.975 (18-34 years), 1.551-2.019 (35-49 years), and 1.355-1.766 (50-64 years).}, }
@article {pmid42247713, year = {2026}, author = {Käufer, C and Kotzur, R and Lau, K and Richter, F}, title = {Beyond brain fog: viral proteins as convergent drivers of neuroinflammation and proteinopathy.}, journal = {Current opinion in virology}, volume = {76}, number = {}, pages = {101559}, doi = {10.1016/j.coviro.2026.101559}, pmid = {42247713}, issn = {1879-6265}, abstract = {Post-viral neurological syndromes, such as post-acute sequelae of COVID-19, present a paradox of severe symptoms despite minimal CNS viral replication. The 'protein-as-pathogen' model, where shed viral proteins act as soluble neurotoxins, is now central to understanding this phenomenon. This review presents the opinion that the most critical recent developments are not that these proteins are toxic, but how their mechanisms converge. We synthesize evidence from the last two years showing that proteins from diverse, highly infectious virus families with zoonotic potential (e.g. Coronaviridae, Flaviviridae, Orthomyxoviridae) engage shared host pathways. We focus on two convergent mechanisms: (1) the activation of glial Toll-like receptor (TLR)4/TLR2 signaling, which initiates a chronic neuroinflammatory cascade, and (2) the disruption of host proteostasis, which seeds neurodegenerative proteinopathies like alpha-synuclein and tau aggregation. This framework positions post-viral syndromes as mechanistically related disorders and identifies pan-viral therapeutic targets, such as TLR inhibitors and autophagy activators.}, }
@article {pmid42247732, year = {2026}, author = {Bykerk, VP and Bartlett, SJ and Schieir, O and Boire, G and Hitchon, CA and Thorne, C and Tin, D and Haraoui, B and Bessette, L and Hazlewood, G and Allard-Chamard, H and Kuriya, B and Valois, MF and Pope, JE and , }, title = {Lessons from an early rheumatoid arthritis incident cohort.}, journal = {Seminars in arthritis and rheumatism}, volume = {79}, number = {}, pages = {152992}, doi = {10.1016/j.semarthrit.2026.152992}, pmid = {42247732}, issn = {1532-866X}, mesh = {Humans ; *Arthritis, Rheumatoid/drug therapy/diagnosis/epidemiology ; *Registries ; *Antirheumatic Agents/therapeutic use ; Canada/epidemiology ; Cohort Studies ; Female ; Methotrexate/therapeutic use ; Early Diagnosis ; Patient Reported Outcome Measures ; }, abstract = {BACKGROUND: The Canadian Early Arthritis Cohort (CATCH) study, a pioneering national registry established in 2007, has generated robust real-world evidence that has significantly advanced early rheumatoid arthritis (ERA) care in Canada and internationally.
METHODS: Data have been collected from over 3800 patients across 25 sites and >35,000 study visits.
RESULTS: This paper synthesizes 15 key learnings from CATCH that span early diagnosis, treatment strategies, patient-reported outcomes, and health equity. Findings underscore the importance of standardized data collection, early methotrexate use, and treat-to-target approaches, while also highlighting challenges such as persistent disease activity, treatment adherence, and disparities linked to sex, comorbidities, and social determinants of health. CATCH has contributed to the development and validation of novel outcome measures, supported the training of future rheumatology leaders, and informed national and international guidelines. Its infrastructure enabled continuity of research during the COVID-19 pandemic and supports pragmatic trials and innovations in care delivery.
CONCLUSIONS: As real-world incident cohort, CATCH has helped to answer questions that impact clinical and policy decisions, and CATCH exemplifies the enduring value of well-curated patient registries in generating actionable insights to improve outcomes for people living with ERA.}, }
@article {pmid42248032, year = {2026}, author = {Rajalingam, A and Ganjiwale, A}, title = {Viral-Induced autoimmune Disorders: Mechanistic insights and emerging concepts.}, journal = {Human immunology}, volume = {87}, number = {8}, pages = {111765}, doi = {10.1016/j.humimm.2026.111765}, pmid = {42248032}, issn = {1879-1166}, abstract = {Autoimmune disorders (ADs) result from a complex interaction of genetic predisposition and environmental triggers, with viral infections identified as primary causes. This review summarizes current evidence on how viruses-including Epstein-Barr Virus (EBV), Enteroviruses, and SARS-CoV-2-initiate and worsen autoimmunity. We explore established mechanisms such as molecular mimicry, bystander activation, and epitope spreading, while highlighting the emerging roles of maladaptive trained immunity and cytokine storms in chronic inflammation. Additionally, we discuss the bidirectional relationship between gut microbiota dysbiosis and virus-induced immune failure. Understanding these layered interactions is crucial for developing biomarker-driven diagnostic and treatment strategies.}, }
@article {pmid42249389, year = {2026}, author = {Thompson, C and Fonseca-Cuevas, A and Frimpong, KJE and Martin, W}, title = {Facilitators and barriers to childhood immunization in Canada: a scoping review.}, journal = {BMC public health}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12889-026-27858-4}, pmid = {42249389}, issn = {1471-2458}, support = {Establishment Grant 2024-2025//Saskatchewan Health Research Foundation/ ; }, abstract = {BACKGROUND: Immunization is a primary prevention public health strategy that has saved more lives than any other health service. Achieving the recommended 95% childhood immunization coverage rate remains a challenge in Canada, especially post-COVID-19. This challenge highlights the need to better understand current immunization facilitators and barriers to improve coverage rates. This study aimed to determine: (1) Factors that support and create barriers to childhood immunization for families with children 0-6 years of age in Canada (2) If childhood immunization facilitators and barriers changed from pre-to-post-COVID-19.
METHODS: Using Arksey and O'Malley scoping review framework informed by Levac et al. and JBI Scoping Review Guidelines, seven databases were searched: MedLine (OVID), EMBASE (OVID), Web of Science (Clarivate), CINAHL (EBSCOhost), Cochrane Library (Wiley), APA PsycArticles (OVID), ProQuest Dissertations and Theses (Clarivate) for peer-reviewed literature. Articles were screened against inclusion/exclusion criteria, data extracted and thematically analyzed using the Braun and Clarke framework.
RESULTS: Thirty-one studies were included. Five identified themes had a dual role supporting and creating barriers to childhood immunization and included: access to healthcare services, cognitive reasoning, affective influences on decision-making, external influences, and information. Two standalone barriers included: use of alternative medicine and colonial institutional practices. Differences pre-to-post-COVID-19 in factors supporting immunization included: cognitive reasoning and access to healthcare services; barriers included cognitive reasoning, information, access to healthcare services, and colonial institutional practices.
CONCLUSIONS: This scoping review highlighted factors from caregiver perspectives that support and create barriers to childhood immunization including cognitive reasoning, affective influences on decision-making, and information. Post-COVID-19 considerations noted in our findings were affective influences on decision-making - trust and relationships and access to healthcare services. There appears an immunization information time gap in the prenatal period. Colonial institutional practices create access challenges for Indigenous families. To better understand these gaps, additional research is needed to understand current immunization information practices in the prenatal period, the contextual nuances of immunization service delivery, and Indigenous Peoples' experiences with immunization services. Further exploration of these areas may help to inform strategies to address identified barriers, strengthen immunization services, and improve immunization coverage rates.}, }
@article {pmid42250263, year = {2026}, author = {Tahir, T and Siddique, MA and Ijaz, K and Nadeem, H and Rehman, A and Khan, S and Tarar, AH and Lajwanti, and Zafar, MAS and Raja, F and Jafar, U and Alsubari, AMA and Ehsan, M and Ikram, J}, title = {Metformin for COVID-19: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials.}, journal = {Reviews in medical virology}, volume = {36}, number = {4}, pages = {e70172}, doi = {10.1002/rmv.70172}, pmid = {42250263}, issn = {1099-1654}, mesh = {*Metformin/therapeutic use/adverse effects ; Humans ; Randomized Controlled Trials as Topic ; *COVID-19 Drug Treatment ; Hospitalization/statistics & numerical data ; *Hypoglycemic Agents/therapeutic use ; SARS-CoV-2/drug effects ; COVID-19/mortality ; Treatment Outcome ; }, abstract = {Metformin has been shown to reduce hospitalisation and symptom duration among adults with COVID-19, but the effect has not been studied. We conducted this meta-analysis to assess the efficacy and safety of metformin in patients with COVID-19. Randomized controlled trials (RCTs) comparing metformin with placebo in COVID-19 were identified through major databases through November 2025. We performed statistical analyses using RevMan 5.4, employing the random-effects model, along with Risk Ratio (RR) and Mean Difference (MD) as the effect measures. Our meta-analysis of four RCTs showed that metformin did not significantly reduce the composite outcome of hospitalisation, emergency department (ED) visits, or death, compared with placebo (RR 0.60, 95% CI 0.40-0.90.21). The incidence of all-cause mortality (RR 1.00; 95% CI 0.06-15.91) and serious adverse events (RR 2.86; 95% CI 0.76-10.76) was also comparable between the two groups. Our meta-analysis, with low to moderate certainty, found that metformin may provide modest benefit in reducing hospitalisation, ED visits, or mortality in patients with COVID-19 without an association with increased serious adverse events. However, these findings should be interpreted cautiously, given the limited number of trials, low event rates, and clinical heterogeneity across studies. Further large RCTs are needed before metformin can be considered for use in COVID-19.}, }
@article {pmid42250934, year = {2026}, author = {Ferguson, M and Englund, HM and Habeck, J}, title = {Virtual learning modalities and clinical competence in baccalaureate nursing education: An integrative review.}, journal = {Journal of professional nursing : official journal of the American Association of Colleges of Nursing}, volume = {64}, number = {}, pages = {34-41}, doi = {10.1016/j.profnurs.2026.02.012}, pmid = {42250934}, issn = {1532-8481}, mesh = {Humans ; *Education, Nursing, Baccalaureate/methods ; *Clinical Competence ; *Virtual Reality ; *Students, Nursing/psychology ; *Education, Distance/methods ; COVID-19/epidemiology ; }, abstract = {BACKGROUND: The COVID-19 pandemic accelerated the use of digital education in nursing, including simulation, virtual reality (VR), telehealth, and AI-supported tools. Despite increased access and engagement, concerns remain about preparation for clinical practice.
AIM: To examine associations between virtual learning modalities and clinical competence and workforce readiness among undergraduate nursing students.
METHODS: The authors conducted an integrative review guided by PRISMA and SWiM and used Whittemore and Knafl's five-step methodology to synthesize evidence from diverse study designs.
RESULTS: Five themes were identified: foundational skill development, perceived clinical readiness, communication and psychosocial competency, instructional design and faculty capacity, and equity and access. Virtual learning was generally associated with cognitive and affective outcomes, while evidence related to psychomotor skill development and readiness for hands-on care was mixed. Perceived preparedness differed across studies and was commonly described in relation to instructional quality, faculty support, and access to technology.
CONCLUSIONS: Virtual learning supports clinical education but does not replace hands-on experiences. Blended models integrating virtual and in-person learning, supported by faculty development and equitable access, are recommended to promote clinical competence and workforce readiness.}, }
@article {pmid42250978, year = {2026}, author = {Luján, M and Heili-Frades, S and Abad, A and López-Padilla, D and Sayas, J and Cebrià, MA and Sánchez-Zaballos, M and Alonso, P and Pardo, A and Ussetti, P and Landete, P and Ramírez, MT}, title = {SEPAR Position Paper on Infrastructure, Technology, Staffing, Quality Standards, and Management of Intermediate Respiratory Care Units in Spain.}, journal = {Archivos de bronconeumologia}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.arbres.2026.05.007}, pmid = {42250978}, issn = {1579-2129}, abstract = {Intermediate Respiratory Care Units (IRCUs) play an increasingly important role in the management of patients with acute or acute-on-chronic respiratory failure who require more advanced monitoring and respiratory support than can be provided on conventional hospital wards but do not require admission to an Intensive Care Unit (ICU). Their development has been driven by the widespread adoption of noninvasive ventilation, high-flow nasal cannula (HFNC) therapy, and continuous respiratory monitoring, and their strategic value was clearly demonstrated during the COVID-19 pandemic. This position paper from the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) provides evidence-informed recommendations regarding the infrastructure, technology, staffing, organization, and quality standards necessary for the optimal functioning of IRCUs in Spain. A multidisciplinary panel of experts developed consensus-based guidance drawing on available scientific evidence and clinical experience, addressing architectural design, technological resources, professional roles, training pathways, clinical care models, and quality indicators. IRCUs have emerged as a key component in the management of acute and chronic respiratory failure, contributing to improved clinical outcomes and more efficient use of critical care resources. This document highlights the importance of standardized admission criteria, structured care processes, multidisciplinary coordination, and continuous performance evaluation using validated indicators to support the consolidation of IRCUs as high-value, sustainable components of modern respiratory care systems.}, }
@article {pmid42251625, year = {2026}, author = {Thoburn, E and Giannakoulis, VG and Hu, T and Goebe, H and Raina, S and Moran, MM and Perreault, B and Val-Maranes, L and Millar, EB and Whittle, I and Pearson, F and Lopez, SMC}, title = {Safety of BNT162b2 COVID-19 Vaccine in Pregnancy: A Systematic Review.}, journal = {Infectious diseases and therapy}, volume = {15}, number = {8}, pages = {2087-2101}, pmid = {42251625}, issn = {2193-8229}, abstract = {INTRODUCTION: Since COVID-19 vaccine introduction in December 2020, > 13 billion doses have been distributed globally, including > 5 billion Pfizer-BioNTech (BNT162b2) doses. Real-world evidence in pregnancy remains heterogenous in design and outcome definitions, with limited analysis by dose timing or variant period. Most reviews evaluated COVID-19 vaccines as a class without focus on individual products, limiting product-specific interpretation. Given expanding evidence and public concern around safety of vaccines during pregnancy, an updated, pregnancy-focused systematic review of BNT162b2 safety is warranted. This study aimed to review and synthesize evidence on the safety of Pfizer-BioNTech COVID-19 vaccine in pregnant women, including pregnancy-related outcomes.
METHODS: A systematic literature review (PROSPERO registered) was conducted in accordance with Cochrane methodology and reported following PRISMA guidelines. Medline and Embase were searched from December 2020 to June 2025, supplemented by regulatory reports and conference searches. Eligible randomized and observational studies reporting obstetric or neonatal outcomes after ≥ 1 dose of BNT162b2 were included. Quality appraisal was conducted using NICE checklists. Results were narratively synthesized and reported following SWiM guidance.
RESULTS: Across 25 studies, comprising > 450,000 BNT162b2-vaccinated pregnant women, no increased risk was observed for miscarriage, congenital anomalies, preterm birth, hypertensive disorders, small for gestational age, low birth weight, or neonatal death, with effect estimates broadly consistent and centered around the null across available trimester-stratified analyses, dose numbers, and study design. However, trimester-specific data, particularly for first-trimester exposure, were limited.
CONCLUSION: The cumulative evidence demonstrates a reassuring safety profile for Pfizer-BioNTech (BNT162b2) COVID-19 vaccination with no indication of increased pregnancy-related or neonatal risk. The evidence is mainly observational and heterogeneous, with limited precision for rare outcomes, but the results align with findings from international registry, surveillance, and population-based evidence and support BNT162b2 vaccination in pregnancy as an effective and safe means to reduce preventable maternal morbidity, although evidence remains limited for first-trimester-specific exposure.
TRIAL REGISTRATION: The review protocol was prospectively registered with PROSPERO [CRD420251080193] [1].}, }
@article {pmid42253106, year = {2026}, author = {Khalil, A}, title = {Antiviral nucleoside mimics: the development and future perspective of Molnupiravir.}, journal = {Future medicinal chemistry}, volume = {18}, number = {14}, pages = {1895-1906}, doi = {10.1080/17568919.2026.2684621}, pmid = {42253106}, issn = {1756-8927}, mesh = {*Antiviral Agents/chemistry/pharmacology/chemical synthesis ; Humans ; *Nucleosides/chemistry/pharmacology ; *Hydroxylamines/chemistry/pharmacology/chemical synthesis ; *Cytidine/analogs & derivatives/pharmacology/chemistry/chemical synthesis ; SARS-CoV-2/drug effects ; RNA-Dependent RNA Polymerase/antagonists & inhibitors/metabolism ; COVID-19 Drug Treatment ; *Uridine/analogs & derivatives/chemistry/pharmacology ; Bioisosterism ; }, abstract = {In 2021, the U.S. Food and Drug Administration (FDA) authorized the oral prodrug molnupiravir, the β-D-N4-hydroxycytidine precursor, for emergency use as an antiviral agent against SARS-CoV-2. Molnupiravir (MK-4482, EIDD-2801) was originally developed at Emory University, where its design leveraged the bioisosteric replacement of the carbonyl group in the pyrimidine base of endogenous uridine with an oxime (NHOH) functionality. This modification enabled effective mimicking of natural nucleosides and enhanced antiviral activity by targeting the viral RNA-dependent RNA polymerase (RdRp). In this review, the collective advancements in the synthesis of molnupiravir aimed at achieving scalable, cost-effective, and efficient manufacturing are discussed, along with an exploration of oxime bioisosterism within medicinal chemistry.}, }
@article {pmid42253600, year = {2026}, author = {Kraselnik, A and McGowan, H and Amiali, IA and Gibson, I and Joshi, S and Magero, N and Miller, CH and Oulousian, S and Sharma, A and Sonyuy, MF and Kulnik, ST and Shah, NS}, title = {Factors Influencing the Uptake of Digital Health Interventions for Cardiovascular Disease Prevention Among Healthcare Providers: A Systematic Review.}, journal = {Global heart}, volume = {21}, number = {1}, pages = {45}, pmid = {42253600}, issn = {2211-8179}, mesh = {Humans ; Digital Health ; *Cardiovascular Diseases/prevention & control ; *Health Personnel ; *Secondary Prevention/methods ; Telemedicine ; Attitude of Health Personnel ; *Primary Prevention/methods ; }, abstract = {BACKGROUND: Digital health interventions (DHIs) offer major potential for improving cardiovascular disease (CVD) primary and secondary prevention, but their adoption by healthcare providers (HCPs) remains inconsistent.
OBJECTIVE: To identify barriers and facilitators to DHI uptake in CVD primary and secondary prevention from HCPs' perspectives.
METHODS: We conducted a systematic review of studies published between 2020 and 2024 that investigated HCPs' perceptions of DHI implementation for CVD primary and secondary prevention. We appraised individual study quality using a validated tool. We performed a qualitative synthesis of reported barriers and facilitators, categorized according to country income level and according to the World Heart Federation Roadmap domains: HCPs, patients, technology, and health systems.
RESULTS: We included 125 primary studies (101 qualitative, 15 quantitative, 9 mixed methods). The most frequently cited barrier was excessive workload, both from existing responsibilities and additional tasks introduced by DHIs. The leading facilitator was the perceived positive clinical impact of DHIs-such as improved adherence, reduced hospital readmissions, and better outcomes. HCP motivation, adequate training, and system integration also facilitated adoption. Many factors-like effects on HCP-patient relationships and workflow-functioned as either barriers or facilitators, depending on the setting. Patient-related barriers included limited digital access and literacy; facilitators included perceived gains in patient-centered care. Health system factors such as organizational structure, financing, and policy support were commonly mentioned, with mixed views. Technology-related facilitators included usability, adaptability, and integration with electronic records; instability was a key barrier.
CONCLUSIONS: This is the first systematic review to synthesize post-COVID-19 literature on HCPs' perceptions of DHIs in CVD primary and secondary prevention. While offering a rich, global overview, limitations include a predominance of qualitative studies and lack of data from low-income countries. Effective implementation must address workload, align with workflows, and build trust through training and leadership.
LAY SUMMARY: This research analyzed 125 studies from 33 countries to understand the factors that influence healthcare professionals' uptake of digital health tools, such as apps and wearable devices, for preventing cardiovascular disease.The leading facilitator for adoption is the perceived positive clinical impact; doctors and nurses are highly motivated to use digital tools when they help patients follow treatments better, reduce hospital readmission rates, and improve overall heart health.The most significant barrier is the perceived excessive workload. While some digital health tools can be time-saving, many providers feel that they add burdensome technical tasks to their already busy schedules, which undermines their acceptance.Uptake is also influenced by patient-related factors, such as digital literacy and internet access, as well as technological factors like how easily a tool integrates into existing hospital computer systems.To improve the future of cardiovascular care, digital tools should be co-designed with clinicians to ensure they fit seamlessly into daily work routines and are supported by proper training and strong institutional leadership.}, }
@article {pmid42253757, year = {2026}, author = {Maharjan, R and Shin, CY and Lee, SK and Ha, ES and Park, H and Kim, JS and Kim, KH and Kim, NA and Kim, MS and Jeong, SH}, title = {Stabilization strategies and advancements in lyophilization to preserve integrity and efficacy of next-generation biologicals.}, journal = {International journal of pharmaceutics: X}, volume = {11}, number = {}, pages = {100575}, pmid = {42253757}, issn = {2590-1567}, abstract = {The success of mRNA-lipid nanoparticles (LNPs) vaccines during the COVID-19 pandemic has significantly increased global demand for stable, thermo-resistant biologicals. Lyophilization remains a cornerstone technology for enhancing the stability of these formulations; however, the freezing and drying processes impose major stresses that can compromise the integrity of fragile LNPs. This review systematically explores the molecular mechanisms by which lyoprotectants, including sugars, polyols, amino acids, and polymers, mitigate challenges such as ice-induced denaturation, dehydration-driven aggregation, and interfacial destabilization. This review emphasizes the importance of optimized sucrose-trehalose combinations and effective ice-nucleation control in preserving encapsulation efficiency and maintaining particle integrity. Furthermore, the review discusses advanced process optimization tools, including digital twin modeling and in-line Raman spectroscopy, which enhance lyophilization efficiency by reducing primary drying times by up to 40% while ensuring critical quality attributes are preserved. Additionally, emerging applications utilizing novel excipient combinations are highlighted, showcasing their potential to enable refrigerated storage of viral vectors. With 85% of commercial conjugates relying on lyophilization, recent advancements in continuous freeze-drying technology, such as spin-freeze approaches, have achieved cycle times that are three-fold faster. These developments provide a comprehensive roadmap for overcoming cold chain limitations while addressing the stabilization needs of next-generation biologicals, CRISPR-based systems, and personalized medicines.}, }
@article {pmid42253906, year = {2026}, author = {Bukhari, OM}, title = {Perception, Acceptance, and Utilization of Teledentistry by the Public: A Literature Review.}, journal = {Journal of International Society of Preventive & Community Dentistry}, volume = {16}, number = {2}, pages = {107-115}, pmid = {42253906}, issn = {2231-0762}, abstract = {OBJECTIVES: Teledentistry demonstrates significant potential in enhancing access to, reducing costs of, and improving oral healthcare delivery, particularly in under-resourced areas and during crises, like the coronavirus disease 2019 (COVID-19) pandemic. Despite its high acceptance rate among dental professionals, the perspectives of patients and the public remain less explored. This narrative review synthesizes evidence on public perception, acceptance, utilization, and satisfaction of teledentistry globally.
METHODS: A comprehensive search was conducted across PubMed, Scopus, EMBASE, Web of Science, Cochrane Database, and Google Scholar for peer-reviewed English articles (2010-2025) using keywords like "teledentistry," "patients," and "public." Included studies assessed patient and public perspectives on teledentistry benefits, barriers, satisfaction, and utilization. Exclusions comprised non-patient or non-English articles. Data from 21 selected studies were narratively synthesized.
RESULTS: Awareness of teledentistry varied widely (e.g., 64% aware in one Saudi Arabian study vs. 87.3% unaware of teledentistry in a study in Jeddah). Attitudes were generally positive, as seen with 82.4% of the cohort in a Malaysian study, where the convenience of tele-orthodontics and increased safety during COVID-19 were observed, although older adults across the studies and those with lower levels of education reported technological barriers. Acceptance rates of teledentistry were high among patients (70%-87% in Saudi Arabia, the United Kingdom, and Malaysia), particularly when used for triage and follow-ups, but lower for complex treatments (e.g., 35.3% of patients in a Qatar study noted unresolved issues following teledentistry consultations, like pulpitis). Satisfaction was favorable across the cohorts (reaching between 72% and 94% across multiple studies) due to the benefits of reduced treatment time and lower financial cost; however, patient satisfaction declined when they faced dental conditions requiring physical intervention. Key barriers faced by patients and the public to teledentistry included limited awareness, patient concerns with diagnostic accuracy, and technical access issues.
CONCLUSION: Public perception of teledentistry is moderate, attitudes are broadly positive, and teledentistry is being increasingly accepted with high satisfaction rates for convenient, non-urgent care. However, demographic factors, such as age, education, and location, and clinical limitations for hands-on treatments limit its utilization. Teledentistry is best positioned as a complement to traditional care through hybrid models. Future efforts should prioritize targeted education, improved accessibility, and standardized teledentistry protocols to optimize equitable implementation.}, }
@article {pmid42254411, year = {2026}, author = {Chen, S and Wen, Z and Wang, C and Li, J and Zou, K}, title = {High-flow nasal cannula for acute respiratory failure: a bibliometric analysis of current trends and future directions.}, journal = {Frontiers in medicine}, volume = {13}, number = {}, pages = {1811474}, pmid = {42254411}, issn = {2296-858X}, abstract = {BACKGROUND: High-flow nasal cannula (HFNC) oxygen therapy has emerged as a pivotal non-invasive respiratory support modality for acute respiratory failure (ARF), fundamentally transforming critical care practice. Despite substantial growth in HFNC research and clinical significance, no comprehensive bibliometric analysis has systematically examined the knowledge structure, research trends, and emerging frontiers in this rapidly evolving field.
METHODS: A comprehensive bibliometric analysis was conducted using the Web of Science Core Collection (WOSCC), supplemented by PubMed and Scopus for literature retrieval, covering publications from January 2015 to December 2025. Search terms included combinations of "acute respiratory failure," "respiratory failure," "ARF," "high-flow nasal oxygen," "high-flow oxygen," and "HFNC" in titles and abstracts. Data were analyzed using three visualization tools: CiteSpace (version 6.4.R1), VOSviewer (version 1.6.20), and Bibliometrix in R (version 4.5.1) to examine publication trends, country collaborations, author networks, journal distributions, co-citation patterns, and keyword evolution.
RESULTS: A total of 1,477 publications were identified, with annual output peaking at 256 in 2022, reflecting intensified research during the COVID-19 pandemic. The United States led in productivity (n = 139), while France achieved the highest citation impact (TC = 7,726). Keyword and co-citation clustering revealed evolving research foci from foundational respiratory support (2015-2017) to pandemic-driven applications (2019-2021) and emerging artificial intelligence (AI) integration (2022-2025). Nine distinct research clusters were identified, with recent emphasis on chronic obstructive pulmonary disease, reintubation, and advanced respiratory technologies.
CONCLUSION: The findings highlight HFNC's successful transition from experimental therapy to evidence-based standard care, with future trends indicating movement toward personalized medicine approaches and technology-enhanced respiratory care delivery systems.}, }
@article {pmid42254753, year = {2026}, author = {Yen, PS and Huang, JJ and Lu, JC and Chang, TN}, title = {International Microsurgery Club for 10 Years-A New Online Education Platform and Beyond.}, journal = {Seminars in plastic surgery}, volume = {40}, number = {2}, pages = {183-192}, pmid = {42254753}, issn = {1535-2188}, abstract = {The rapid evolution of digital communication has transformed medical education, a shift accelerated by the COVID-19 pandemic. The International Microsurgery Club (IMC), founded in 2016 as a private Facebook group for verified professionals, exemplifies how social media can democratize microsurgical education on a global scale. By the end of 2025, IMC Facebook group had grown to over 22,600 members from more than 70 countries, facilitating case sharing, peer consultation, and professional recognition beyond geographic and institutional boundaries. Analysis of IMC activity between 2019 and 2025 identified 2,124 unique case-related posts contributed by 526 authors, with wide geographic diversity and high engagement independent of posting frequency. During the pandemic, IMC expanded into a sustained weekly webinar series, delivering nearly 600 sessions featuring international experts. Complemented by an open-access journal, a digital educational Web site, and multi-platform social media integration, IMC has evolved into a comprehensive, sustainable ecosystem for global microsurgical education, offering an effective model that complements traditional academic pathways.}, }
@article {pmid42255427, year = {2026}, author = {Lawal, B and Saidu Musa, S and Soe Thu, M and Ondee, T and Chatsirisakul, O and Pongpirul, K}, title = {Post-acute metabolic changes and risk of new-onset diabetes following COVID-19: a systematic review and meta-analysis.}, journal = {Frontiers in endocrinology}, volume = {17}, number = {}, pages = {1835180}, pmid = {42255427}, issn = {1664-2392}, mesh = {Humans ; Blood Glucose/metabolism ; *COVID-19/complications/metabolism ; *Diabetes Mellitus/etiology/metabolism ; Glycated Hemoglobin/metabolism ; Insulin Resistance ; Post-Acute COVID-19 Syndrome/complications/metabolism ; Risk Factors ; }, abstract = {BACKGROUND: COVID-19 has been associated with persistent metabolic disturbances; however, the magnitude, consistency, and underlying mechanisms of post-infection alterations in glucose regulation remain incompletely characterized.
METHODS: We conducted a systematic review and meta-analysis in accordance with PRISMA guidelines. PubMed and Embase were searched on December 18, 2024, for studies published from 2020 onward. Eligible studies included observational cohort and cross-sectional designs assessing metabolic outcomes at least three months after recovery from COVID-19.
RESULTS: Sixteen studies met inclusion criteria. Pooled analysis suggested a 41% increased risk of new-onset diabetes among COVID-19 survivors compared with non-infected individuals (RR 1.41, 95% CI: 1.38-1.44); however, this estimate was predominantly driven by a single large-scale study. Quantitative synthesis demonstrated higher HbA1c (SMD 1.44, 95% CI: 0.36-2.52) and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) (SMD 0.96, 95% CI: 0.33-1.58), consistent with impaired glycemic control and increased insulin resistance. In contrast, fasting blood glucose (FBG) findings were inconsistent and highly heterogeneous (SMD 0.77, 95% CI: -0.40-1.94). Substantial heterogeneity was observed across outcomes.
CONCLUSION: COVID-19 may be associated with an increased risk of incident diabetes and persistent metabolic dysregulation. However, the limited number of studies contributing to pooled risk estimates and the influence of large registry-based data warrant cautious interpretation. These findings support consideration of metabolic monitoring and longitudinal follow-up in post-COVID care, particularly among individuals at elevated cardiometabolic risk.
https://www.crd.york.ac.uk/prospero/, identifier CRD42025630971.}, }
@article {pmid42255944, year = {2026}, author = {Abdul Khalek, J and Al Hajjar, M and Al-Khalil, Z and Salem, J and Zareef, R and Bitar, F and Arabi, M}, title = {Unveiling the Link Between COVID-19 and Pulmonary Hypertension.}, journal = {The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale}, volume = {2026}, number = {}, pages = {9352258}, pmid = {42255944}, issn = {1712-9532}, abstract = {INTRODUCTION: The COVID-19 pandemic, caused by the SARS-CoV-2 virus, was first identified in Wuhan, China, in December 2019 and has had a significant impact on global health. The virus uncovered multifaceted complications across various organ systems, including the cardiovascular system. Pulmonary hypertension, often exacerbated in settings of severe or prolonged viral infections, presents unique challenges in the context of COVID-19 due to its complex pathophysiology involving vascular inflammation and thrombotic events.
METHODS: This narrative review aims to delineate the emerging relationship between COVID-19 and pulmonary hypertension, focusing on pathophysiological insights, clinical implications, and evolving therapeutic strategies, enriching clinical practice and guiding future research of this complex interaction. We conducted a comprehensive literature review using databases such as MEDLINE, PubMed, and Google Scholar with keywords related to pulmonary hypertension and COVID-19, covering studies published between December 2019 and February 2025.
RESULTS: COVID-19 has been linked to an increased incidence of pulmonary hypertension due to direct viral effects on pulmonary vasculature and secondary inflammatory responses. Clinical manifestations of pulmonary hypertension in COVID-19 include typical symptoms such as dyspnea and chest pain. Effective management strategies include the use of vasodilators, anticoagulants, and tailored experimental treatments. The review also emphasizes the importance of long-term follow-up and monitoring to evaluate disease progression and treatment response.
CONCLUSION: The intersection of COVID-19 and pulmonary hypertension presents a significant challenge in cardiovascular medicine, necessitating advanced diagnostic and therapeutic approaches. The insights gained from the current pandemic will likely influence broader public health strategies and clinical protocols, improving outcomes for patients with pulmonary hypertension and those at risk of severe viral infections. Future research should focus on personalized medicine approaches and the development of innovative treatments to manage the unique aspects of pulmonary hypertension in the context of COVID-19.}, }
@article {pmid42256552, year = {2026}, author = {Huang, F and Zhan, P and Shi, X and Sun, Y and Song, X and Sun, P and Liu, B}, title = {Therapeutic potential of the sphingosine kinase 2 inhibitor opaganib.}, journal = {Pharmaceutical science advances}, volume = {4}, number = {}, pages = {100125}, pmid = {42256552}, issn = {2773-2169}, abstract = {Opaganib is a proprietary, host-directed, potentially broadly potent, first-in-class oral sphingosine kinase 2 (SphK2) selective inhibitor developed by RedHill Biopharma Tel Aviv, Israel. It is currently the most widely used selective SphK2 inhibitor. It simultaneously inhibits three sphingolipid-metabolizing enzymes in human cells-SphK2, dihydroceramide desaturase (DES1), and glucosylceramide synthase (GCS)-leading to depletion of sphingosine 1-phosphate (S1P), accumulation of ceramides and dihydroceramides, and suppression of key pro-survival pathways including pERK, pAKT, and NF-κB. These events promote autophagy, apoptosis, and disruption of viral replication. A large body of evidence indicates that SphK plays an important role in health and disease. This study reviews the role and mechanisms of opaganib effects as anticancer, anti-inflammatory, and antiviral agent. The latest research directions for opaganib are described as gastrointestinal acute radiation syndrome (GI-ARS), chemical exposure indications, and COVID-19, Ebola, and other viruses, providing new therapeutic ideas and considerations for future research and clinical trials.}, }
@article {pmid42256623, year = {2026}, author = {Hattingh, A and Joubert, J and Viljoen, M}, title = {Transitioning regulatory authorities in South Africa: a comparative review of the organisational structure and management practices.}, journal = {Journal of pharmaceutical policy and practice}, volume = {19}, number = {1}, pages = {2673693}, pmid = {42256623}, issn = {2052-3211}, abstract = {BACKGROUND: South Africa's transition from the Medicines Control Council (MCC) to the South African Health Products Regulatory Authority (SAHPRA) in 2018 marked a critical shift in the regulatory landscape. The MCC faced prolonged timelines, inadequate resources and a growing application backlog. This review comparatively examines how organisational, governance, managerial and procedural reforms introduced under SAHPRA (2018-2022) addressed these structural and performance limitations, and assesses their implications for regulatory policy and future system strengthening.
METHOD: A mixed-method literature review combining qualitative thematic synthesis and quantitative descriptive analysis was conducted, drawing on publicly available sources, including government reports, academic journal articles, and organisational websites. Quantitative data (e.g. median approval timelines, backlog volumes and approval numbers) were systematically extracted from included studies and official reports without primary statistical modelling. Keywords included 'SAHPRA', 'MCC', 'management structures', 'organisational structures', 'regulatory review process', 'approval timelines', 'medicine approval', and 'regulatory authorities'. Screening followed predefined inclusion and exclusion criteria, and data extraction captured governance structures, funding models, quality systems, reliance pathways, review timelines and backlog metrics.
RESULTS: SAHPRA's implementation of reliance-based review pathways and risk-based assessments, alongside streamlined operations, reduced median approval times from 2,124 in 2018 to 783 days in 2020, and increased new chemical entity registrations from 15 to 155 over the same period. The inherited backlog (8,220 new applications in 2018) was cleared by 2022. The transition improved financial independence, enhanced institutional autonomy and reduced administrative bottlenecks. SAHPRA also demonstrated responsiveness during the COVID-19 pandemic through expedited review pathways.
CONCLUSION: The transition from MCC to SAHPRA represents a structural and procedural modernisation of South Africa's regulatory framework. While improving efficiency and access to essential medicines, findings should be interpreted cautiously due to reliance on secondary data and variation across sources. Continued digital reform, capacity development and strengthening post-marketing surveillance remain key priorities.}, }
@article {pmid42256699, year = {2026}, author = {Mussi, M and Zengarini, C and Corrà, A and Brunetti, T and Natale, A and La Placa, M and Piraccini, BM and Guglielmo, A and Pileri, A}, title = {Cutaneous Lymphomas and Lymphoproliferative Disorders Associated With SARS-CoV-2 Vaccination: A Systematic Review.}, journal = {Journal of skin cancer}, volume = {2026}, number = {}, pages = {4893577}, pmid = {42256699}, issn = {2090-2905}, abstract = {BACKGROUND: Cutaneous lymphomas (CLs) are rare neoplastic skin disorders, primarily of T-cell origin. Since the widespread rollout of SARS-CoV-2 vaccines, several cases of CLs and non-neoplastic lymphoproliferative disorders (nn-LPDs) temporally associated with vaccination have been reported, raising concerns about a potential immunologic link.
OBJECTIVE: To systematically review the literature on cases of CLs and related nn-LPDs occurring after COVID-19 vaccination, focusing on clinical features, subtype distribution, latency to onset, and proposed pathophysiological mechanisms.
METHODS: A systematic review was conducted according to PRISMA guidelines. Case reports and series describing new-onset or relapsed CLs or nn-LPDs temporally following SARS-CoV-2 vaccination were included. Demographic, clinical, histological, therapeutic and temporal data were extracted and analysed.
RESULTS: Fifteen manuscripts encompassing 35 cases met the inclusion criteria. Eighteen (51.4%) were histologically confirmed CLs, most commonly lymphomatoid papulosis (n = 9), followed by Sézary syndrome (n = 3) and mycosis fungoides (n = 2). The remaining 17 cases (48.6%) were classified as nn-LPDs, including cutaneous lymphoid hyperplasia, lymphomatoid reactions and CD4+ small/medium T-cell lymphoproliferative disorders. CD30 positivity was noted in 76.2% of the cases with available immunophenotyping. Most patients (80%) received the BNT162b2 (Pfizer-BioNTech) vaccine. In the 17 new-onset CLs, time to onset ranged from 3 to 42 days, with most cases clustering within 14 days.
CONCLUSIONS: Most of the cases were low-grade T-cell CLs and nn-LPDs. Although a causal relationship cannot be established, the short latency observed in many new-onset cases raises the possibility that some patients may have harboured an undiagnosed disease, with vaccination acting as a trigger for clinical manifestation or for raised awareness. These findings support indeed the need for continued pharmacovigilance among clinicians, especially in patients with prior or latent lymphoproliferative conditions. Nevertheless, these extremely rare and indolent events should not alter the overall favourable risk-benefit profile of COVID-19 vaccination.}, }
@article {pmid42256801, year = {2026}, author = {Whalley, R and Primdal, A and Hardie, I and Xiao, Z and Auyeung, B}, title = {Maternal SARS-CoV-2 infection during pregnancy and child neurodevelopmental outcomes: A systematic review and meta-analysis of observational studies.}, journal = {Preventive medicine reports}, volume = {67}, number = {}, pages = {103508}, pmid = {42256801}, issn = {2211-3355}, abstract = {OBJECTIVE: To assess: (a) associations between prenatal SARS-CoV-2 exposure and early childhood neurodevelopmental outcomes, and (b) whether these varied by infection trimester.
METHODS: We conducted a systematic review and meta-analysis of observational studies modelling the neurodevelopmental outcomes of children prenatally exposed to SARS-CoV-2 compared to unexposed children. PubMed and PsychInfo were systematically searched from inception to March 2025. Primary analysis was random-effects modelling of overall associations. Secondary analysis assessed variation by trimester via standardised mean differences (SMD).
RESULTS: 11 observational studies were included. Overall, there was no statistically significant association between prenatal SARS-CoV-2 exposure and early childhood neurodevelopmental outcomes, both before (odds ratio: 1.08; 95% confidence intervals: 0.82, 1.42) and after (odds ratio: 0.98; 95% CI: 0.81, 1.17) excluding high variance studies. First trimester prenatal SARS-CoV-2 exposure was associated with poorer neurodevelopmental scores (3.87; 95% CI: 3.19, 4.55) than prenatal exposure in the second trimester (6.07; 95% CI: 5.11, 7.03) or third trimester (6.31; 95% CI: 5.54, 7.09). However, this analysis was limited to three studies only, with high heterogeneity between studies.
CONCLUSIONS: Prenatal SARS-CoV-2 exposure is not associated with early childhood neurodevelopmental outcomes. Future research should keep monitoring associations as more data becomes available. More robust research is required on trimester-specific associations.}, }
@article {pmid42256874, year = {2026}, author = {Jalilian, S and Bastani, MN and Afsharzadeh, F}, title = {Insight to Neglected Biomarkers in COVID-19: A Comprehensive Narrative Review".}, journal = {Biomarker insights}, volume = {21}, number = {}, pages = {11772719261452224}, pmid = {42256874}, issn = {1177-2719}, abstract = {In the context of COVID-19, a range of neglected biomarkers provide critical insights into the mechanisms of the disease and potential therapeutic targets. This review aims to address this gap by systematically analyzing the diagnostic and prognostic potential of these neglected biomarkers, with particular emphasis on their mechanistic connections to COVID-19 pathophysiology. Reduced levels of adiponectin and prostacyclin (PGI2) and elevated level of endothelin are associated with endothelial dysfunction, whereas elevated levels of endocan and endoglin are indicative of elevated vascular inflammation. Increased concentrations of markers such as angiopoietin, E-selectin, P-selectin, ICAM-1, and VCAM-1 suggest endothelial activation, while higher levels of fractalkine, galectin, HMGB1, and osteopontin reflect an ongoing inflammatory state. Immunological markers, including HMGB1, neopterin, and serum amyloid A, are significantly elevated, underscoring prolonged immune activation associated with severe COVID-19. Elevated levels of matrix metalloproteinases (MMPs) and soluble urokinase plasminogen activator receptor (SuPAR) highlight tissue remodeling and fibrinolytic imbalance related to vascular injury. Additionally, increases in soluble fms-like tyrosine kinase-1 (sFlt-1) and pentraxin reflect inflammatory pathways that exacerbate endothelial dysfunction. Elevated levels of syndecan-1 reflect endothelial glycocalyx degradation and impaired endothelial barrier integrity. Increased von Willebrand factor (vWF) indicates endothelial activation and injury with a prothrombotic shift. Elevated surfactant protein D (SP-D) is a marker of pulmonary epithelial injury and disruption of the alveolar-capillary interface. Other biomarkers, such as the receptor for advanced glycation end products (RAGE) and MR-proADM, signal oxidative stress and endothelial damage. Collectively, these biomarkers emphasize the extensive vascular and endothelial impairment in COVID-19, suggesting their utility as diagnostic tools and potential targets for therapeutic intervention against the systemic effects of the disease. This review advocates for the integration of these biomarkers into standard monitoring and treatment protocols for COVID-19, thereby enhancing personalized care. Furthermore, our analysis underscores the necessity for additional research into the roles of these biomarkers in other endothelial disorders, ultimately contributing to a more nuanced approach to managing viral infections characterized by vascular complications.}, }
@article {pmid42257651, year = {2026}, author = {Vicente, C and Froes, F and Lopalco, PL and Heffernan, C and Nilforooshan, R and Martin, F and Leroux-Roels, I and Nesher, L and Déplanque, T and Dani, N and Coelho, A and Pinto de Castro, N and Tayarani-Binazir, K}, title = {From burden to benefit: overcoming barriers to immunization in adults, with a focus on respiratory syncytial virus.}, journal = {Expert review of vaccines}, volume = {25}, number = {1}, pages = {2684962}, doi = {10.1080/14760584.2026.2684962}, pmid = {42257651}, issn = {1744-8395}, mesh = {Humans ; *Respiratory Syncytial Virus Infections/prevention & control/epidemiology ; *Respiratory Syncytial Virus Vaccines/administration & dosage/immunology/adverse effects ; *Vaccination/statistics & numerical data/methods ; Adult ; Vaccine Efficacy ; Respiratory Syncytial Virus, Human/immunology ; }, abstract = {INTRODUCTION: Respiratory syncytial virus (RSV) is a leading cause of acute respiratory infection, with substantial morbidity and mortality in older adults, yet its impact in this population remains underrecognized compared with childhood RSV. Despite the availability of effective vaccines, RSV immunization in adults is underutilized, as observed for other vaccines.
AREAS COVERED: We summarize the RSV burden in adult populations and present clinical and real-world evidence supporting efficacy/effectiveness and safety of three approved RSV vaccines. We explore barriers to adult vaccine uptake - including limited awareness, lack of reimbursement, mistrust, misinformation, and inconsistent guidance - and highlight broader benefits of adult immunization, including reducing antimicrobial resistance and promoting healthy aging. We conclude that to improve uptake, communication strategies should include messages that emphasize how vaccination prevents severe illness, preserves independence, and supports everyday well-being. We highlight that a life-course immunization strategy, built on trust, is essential to achieve equitable protection across populations.
EXPERT OPINION: Adult vaccines remain undervalued despite their proven safety and benefits, which extend beyond infection prevention to support healthy aging and reduce antimicrobial resistance. To maximize their impact, strategies such as harmonizing recommendations, improving reimbursement, leveraging digital tools, and addressing vaccine hesitancy through better communication and research are essential.}, }
@article {pmid42257882, year = {2026}, author = {Meybohm, P and Baron, DM and Fries, D and Lasocki, S and Vlaar, APJ and Zacharowski, K and Choorapoikayil, S}, title = {Patient blood management in general intensive care patients.}, journal = {Intensive care medicine}, volume = {52}, number = {6}, pages = {1290-1305}, pmid = {42257882}, issn = {1432-1238}, mesh = {Humans ; *Critical Care/methods ; *Anemia/therapy ; Critical Illness/therapy ; Intensive Care Units/organization & administration ; *Blood Transfusion/methods ; Erythropoietin/therapeutic use ; Platelet Transfusion/methods ; }, abstract = {PURPOSE: Critically ill and high-risk perioperative patients requiring intensive care are often multimorbid and depend on rapid, highly specialized management. While most comorbidities are difficult to modify in the acute setting, anemia, particularly iron-defi ciency anemia, represents a potentially modifiable risk factor. Clinicians are also often confronted with complex alterations in hemostasis that require rapid assessment and targeted therapeutic interventions, including the optimal use of blood products. This narrative review summarizes the current evidence on Patient Blood Management strategies, including anemia management, the use of small-volume tubes, and the appropriate use of blood products in intensive care unit patients.
RESULTS: Intravenous iron supplementation can safely raise hemoglobin to a clinically meaningful degree. Erythropoietin therapy may also raise hemoglobin, but its use should remain selective given uncertain thromboembolic risk. Small-volume blood collection tubes and closed blood-conservation systems should be routinely used to reduce iatrogenic anemia. Current evidence supports restrictive red blood cell transfusion strategies in most clinical settings, particularly in patients with gastrointestinal bleeding. Similarly, a restrictive platelet transfusion strategy is supported by current evidence. Prophylactic platelet transfusion should be reserved for high-risk hematologic malignancies. In other critically ill patients with severe thrombocytopenia, a therapeutic (bleeding-driven) approach is preferred. Finally, current evidence does not support prophylactic fresh frozen plasma transfusion in non-bleeding patients.
CONCLUSIONS: Overall, these findings support the implementation of Patient Blood Management strategies that optimize blood health and promote safer, more individualized care in critically ill patients.}, }
@article {pmid42258511, year = {2026}, author = {Bolshov, O and Chumachenko, D}, title = {Reinforcement learning for policymaking in epidemic control: A scoping review.}, journal = {PloS one}, volume = {21}, number = {6}, pages = {e0351176}, pmid = {42258511}, issn = {1932-6203}, mesh = {*Reinforcement Machine Learning ; Humans ; *Policy Making ; *Epidemics/prevention & control ; *COVID-19/epidemiology/prevention & control ; Algorithms ; }, abstract = {BACKGROUND: Managing an epidemic demands policies that respond at the pace of the outbreak. Conventional rule‑based interventions struggle to keep up, prompting interest in reinforcement learning (RL) for designing non‑pharmaceutical interventions (NPIs). However, current evidence is fragmented across diverse models and reporting styles.
OBJECTIVES: To systematically map how RL is applied for epidemic NPI design, describe modeling choices, algorithm architectures, evaluation practices, and identify trends and research gaps.
METHODS: Peer-reviewed studies (2014-2025, English) that applied deep RL to select NPIs were retrieved from IEEE Xplore, ACM Digital Library, ScienceDirect, and Scopus, searched on December 23, 2025. Reference list scanning supplemented database results. Predefined data items (bibliographic details, epidemic and RL model characteristics, experiments, validation methods, outcomes) were charted and summarized descriptively.
RESULTS: Of 512 retrieved records, 10 met the inclusion criteria, and three additional studies were identified via reference-list scanning, yielding 13. Five employed value‑based methods, four policy‑gradient, and four hybrid; one study additionally incorporated model-based planning. Six simulations relied on compartmental models, six on agent‑based models, and one on a hybrid model. Action spaces were predominantly discrete restriction levels. Five studies incorporated sequence-modeling techniques to include temporal context into a state space. Eleven studies designed reward functions as a trade-off between pandemic severity and socio-economic cost. According to the reviewed studies, RL policies across various settings outperform heuristic, rule-based, and historical baselines in reducing infections, deaths, or lockdown duration while limiting economic loss.
CONCLUSIONS: RL shows promise for adaptive epidemic control. Comparison is hampered by simplified economic costs, inconsistent calibration rigor, varied evaluation metrics, and limited uncertainty or policy robustness analysis. Future work should establish common benchmark environments and reporting standards, incorporate empirically grounded economic and behavioral models, adopt uncertainty-aware and probabilistic RL, develop more sophisticated control spaces, investigate more advanced algorithms, and validate learned policies prospectively to enable real-world deployment.}, }
@article {pmid42258788, year = {2026}, author = {León-Herrera, S and Sánchez-Castro, M and Luisa Neves, A and Rodríguez-Pérez, MP and Jobim Fischer, V and Hutmacher, D and Aldakhil, R and Vaillancourt de Dios, M and Anjos de Almeida, V and Oliván-Blázquez, B and Magallón-Botaya, R and Benoy, C and Gómez-Bravo, R}, title = {Digital Interventions Addressing Cognitive and Psychological Symptoms in Long COVID: Scoping Review of Multicomponent Approaches.}, journal = {Interactive journal of medical research}, volume = {15}, number = {}, pages = {e80616}, pmid = {42258788}, issn = {1929-073X}, abstract = {BACKGROUND: Long COVID, or postacute COVID-19 syndrome, presents with persistent cognitive and psychological symptoms such as brain fog, anxiety, depression, and fatigue, significantly impacting quality of life and daily functioning. Digital health interventions offer a scalable, accessible solution to bridge care gaps, especially where conventional neuropsychological support is limited. However, evidence regarding their effectiveness for neuropsychiatric symptoms in long COVID remains fragmented.
OBJECTIVE: This scoping review aimed to systematically identify and map the existing evidence on digital interventions targeting cognitive and psychological symptoms in individuals with long COVID. The review also sought to categorize intervention types, assess reported outcomes, and identify methodological gaps to inform future clinical and research priorities.
METHODS: The review followed the Arksey and O'Malley framework and adhered to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Comprehensive searches were conducted in 4 databases (PubMed, Scopus, Web of Science, and ScienceDirect) from December 2024 to February 2025. Eligible studies included peer-reviewed and gray literature published in English or Spanish since 2020. Studies were screened and selected based on predefined inclusion and exclusion criteria. Data were extracted using a standardized charting form and synthesized narratively, with thematic grouping by intervention type.
RESULTS: Of 888 records identified, 25 (2.82%) were included. Intervention types encompassed telehealth platforms, mobile health apps, virtual reality, online cognitive and psychological therapies, game-based cognitive training, neuromodulation (transcranial direct current stimulation), and multicomponent programs. Most studies reported improvements in psychological well-being, emotional regulation, and cognitive domains such as attention and memory. However, findings varied, with some interventions showing no significant cognitive gains or sustained effects. Common limitations included small sample sizes, lack of control groups, heterogeneity in outcomes and intervention protocols, and short follow-up durations. The underrepresentation of older adults and underserved populations was also noted.
CONCLUSIONS: Digital interventions show promise for addressing cognitive and psychological symptoms in long COVID, particularly when delivered as multicomponent programs. Nonetheless, the evidence base remains preliminary. Future research should prioritize high-quality randomized trials with standardized outcome measures, long-term follow-up, and diverse participant samples. Addressing barriers related to digital literacy and access will be essential to ensure equity and real-world effectiveness.}, }
@article {pmid42260222, year = {2026}, author = {Bravo-Hernández, Z and Márquez-Domínguez, L and Domínguez-Ramírez, L and Martínez-de la Peña, CF and Santos-López, G}, title = {Programmed -1 ribosomal frameshifting in SARS-CoV-2: molecular mechanisms and implications for antiviral targeting.}, journal = {Virus genes}, volume = {}, number = {}, pages = {}, pmid = {42260222}, issn = {1572-994X}, support = {R-2020-785-085//Instituto Mexicano del Seguro Social/ ; }, abstract = {The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genome is organized into two functional regions. The 5' region comprises an open reading frame (ORF1a) that encodes the polyprotein pp1a and, through a programmed frameshifting event, enables the production of the extended polyprotein pp1ab. These polyproteins are processed by the viral proteases 3CLpro and PLpro into 16 nonstructural proteins (nsps). Nsps 1-11 participate in polyprotein processing, formation, and regulation of the replication-transcription complex, and modulation of host immune responses. Nsps 12-16 form the core of the viral RNA synthesis machinery and are primarily associated with RNA-dependent RNA polymerase activity, proofreading, capping, and RNA modification, while also functioning in coordination with additional nsps. The 3' functional region of the genome encodes structural (S, E, M, and N) and accessory proteins (e.g., 3a, 6, 7a, 8, and 9b) that contribute to viral assembly, replication efficiency, and pathogenicity. Synthesis of pp1ab depends on a programmed -1 ribosomal frameshifting (-1 PRF) event mediated by cis-acting RNA elements that induce a one-nucleotide shift in the 5' direction of the ribosome. This mechanism is critical for maintaining the stoichiometric balance of replication proteins. Here, we review recent current insights into the molecular mechanisms and structural dynamics of -1 PRF in SARS-CoV-2 and discuss its potential as a therapeutic target for antiviral intervention across clinically relevant coronaviruses.}, }
@article {pmid42261850, year = {2026}, author = {Choi, K and Choi, S and Joe, D and Seo, YS and Ham, J and Chung, H and Ramadan, Y and Park, YS}, title = {Myocarditis After mRNA Vaccination: A Metabolic-Innate Immune Cascade Centered on Lipid Nanoparticles.}, journal = {Mediators of inflammation}, volume = {2026}, number = {1}, pages = {e8991922}, pmid = {42261850}, issn = {1466-1861}, support = {RS-2024-00346434//Ministry of Science, ICT and Future Planning/ ; 2020R1I1A1A01067800//Ministry of Education/ ; }, mesh = {*Myocarditis/immunology/metabolism/etiology ; Humans ; Animals ; *Nanoparticles/chemistry ; *Immunity, Innate/physiology ; *Lipids/chemistry ; Inflammasomes/metabolism ; *Vaccination/adverse effects ; *mRNA Vaccines/adverse effects ; 2019-nCoV Vaccine mRNA-1273 ; *RNA, Messenger ; NLR Family, Pyrin Domain-Containing 3 Protein/metabolism ; Liposomes ; }, abstract = {mRNA vaccine-associated myocarditis is a rare but clinically important adverse event whose pathogenesis remains incompletely understood. Initial hypotheses focused primarily on the spike protein antigen, with growing preclinical evidence implicating the lipid nanoparticle (LNP) delivery system as an additional and potentially important contributor to myocardial inflammation. Here, we propose a multi-hit model that integrates LNP-driven mechanisms as a central pathogenic axis, initiated by the systemic distribution and accumulation of LNPs in the heart. While the mRNA payload is cleared within days, the synthetic ionizable lipids -ALC-0315 (BNT162b2) and SM-102 (mRNA-1273) persist significantly longer than the mRNA payload itself. These two lipids differ in biodegradability and pharmacokinetic distinctions, together with differences in lipid dose and formulation, they may contribute to the divergent myocarditis rates observed between the two vaccine products. In this suggesting review, the first hit" involves the disruption of myocardial energy metabolism by these lipids, which can integrate into cellular membranes and impair mitochondrial fatty acid oxidation. This is compounded by a second hit of direct innate immune activation, preclinical studies demonstrate that LNPs engage pattern-recognition receptors (PRRs) like toll-like receptors (TLRs) and the NLRP3 inflammasome, leading to the release of pro-inflammatory cytokines such as IL-1β and IL-18. Inflammation is then amplified via Damage-associated molecular patterns (DAMPs) released from stressed cardiomyocytes. The clinical outcome-ranging from self-limited mild myocarditis to fulminant disease with diverse histopathological patterns-is likely shaped by host susceptibility factors, including sex hormones, genetic predisposition, and prior immune priming, that modulate the intensity of this pathogenic cascade.}, }
@article {pmid42262130, year = {2026}, author = {Yu, H-M and Zhu, M-L and Zhao, Y-L and Tan, J-X and Luo, S-C and Pang, P-P and Zheng, C-B}, title = {Research progress on the association between viruses and cardiac diseases.}, journal = {Journal of virology}, volume = {}, number = {}, pages = {e0038326}, doi = {10.1128/jvi.00383-26}, pmid = {42262130}, issn = {1098-5514}, abstract = {Virus-related cardiac diseases encompass a diverse spectrum of cardiovascular pathologies caused by direct viral infection and indirect immune-mediated injury. Major cardiotropic and cardioactive viruses-including severe acute respiratory syndrome coronavirus 2, influenza virus, human immunodeficiency virus, arboviruses (dengue virus, chikungunya virus, Zika virus), enteroviruses (coxsackievirus B3), and human cytomegalovirus-contribute to myocardial injury manifesting as myocarditis, pericarditis, arrhythmias, acute and chronic heart failure, and thromboembolic complications. Mechanisms of cardiac involvement are multifactorial, involving direct infection of cardiac cells leading to cytopathic effects and innate immune activation, dysregulated adaptive immune responses promoting myocardial inflammation and fibrosis, electrophysiological disturbances, and systemic effects such as endothelial dysfunction and prothrombotic states that precipitate ischemic events. Clinical manifestations range from subclinical injury to fulminant myocardial inflammation and may also include long-term sequelae, such as post-acute cardiovascular symptoms, as observed in long COVID cases. Therapeutic strategies emphasize early antiviral treatment when effective agents exist, judicious immunomodulation based on viral replication status, and supportive management of cardiac dysfunction and arrhythmias. Prevention through vaccination, personal protective measures, vector control, and optimization of cardiovascular risk factors remains pivotal to reduce the burden of virus-associated cardiovascular diseases. Future research requires improved diagnostic precision, mechanistic elucidation, and randomized trials to optimize antiviral and immunomodulatory interventions and to develop vaccines for currently unmet viral targets. An integrated, mechanism-informed approach across prevention, acute management, and long-term care is essential to mitigate the cardiovascular morbidity and mortality attributable to viral infections.}, }
@article {pmid42262134, year = {2026}, author = {Artusa, V and Limanaqi, F and Santacroce, E and Clerici, M and Cossarizza, A and Biasin, M and Gibellini, L and Trabattoni, D}, title = {Alpha-synuclein at the crossroads of host-virus interactions: immunological roles beyond the nervous system.}, journal = {Journal of virology}, volume = {}, number = {}, pages = {e0019126}, doi = {10.1128/jvi.00191-26}, pmid = {42262134}, issn = {1098-5514}, abstract = {Alpha-synuclein (α-syn) is best known as a presynaptic protein that supports synaptic vesicle dynamics and neurotransmission. Conversely, misfolded or aggregated α-syn represents a hallmark of synucleinopathies, including Parkinson's disease. Beyond the nervous system, α-syn has been detected in peripheral compartments, including blood cells and selected epithelial tissues, although the robustness and context dependence of expression outside neuronal and erythroid lineages remain under active investigation. Also, it can be released extracellularly through unconventional secretion or cell damage. These observations have reframed α-syn as an immune-relevant molecule positioned at host-pathogen interfaces, endowed with antimicrobial peptide-like and damage-associated molecular pattern-like properties that enable shaping of both innate and adaptive immunity. Increasing evidence indicates that viral challenge alters α-syn expression, localization, and conformational states in central and peripheral settings, in part through interferon-dependent programs that couple antiviral immunity with cellular homeostasis. A plethora of RNA viruses, such as influenza virus, flavivirus, enterovirus, and coronavirus, perturb α-syn abundance, post-translational modifications, trafficking, secretion, and aggregation propensity. These effects converge on shared mechanisms that include altered proteostasis, autophagy-lysosomal dysfunction, oxidative and mitochondrial injury, and inflammatory signaling. Importantly, outcomes are highly context dependent, ranging from cell-intrinsic antiviral restriction to aggregation-prone states that may fuel chronic inflammation and neurodegeneration. Collectively, the evidence discussed herein supports a dual framework in which α-syn contributes to antiviral defense; yet, under conditions of sustained inflammation or impaired clearance, it may undergo pathological transformation that promotes neuronal damage. Defining when virus-induced α-syn responses are protective versus pathogenic, and clarifying their relevance to human disease, will be critical for developing strategies that target host-virus interactions, neuroinflammation, and α-syn proteostasis in infection-associated synucleinopathies.}, }
@article {pmid42262426, year = {2026}, author = {Sivasubramaniam, P and Alagarsamy, K and Michael, MM and Arumugam, TU and Antonysamy, M}, title = {IgY technology (egg yolk antibodies) in respiratory medicine: applications and future prospects.}, journal = {Archives of microbiology}, volume = {208}, number = {9}, pages = {}, pmid = {42262426}, issn = {1432-072X}, mesh = {*Immunoglobulins/immunology/therapeutic use ; Humans ; Animals ; Immunization, Passive/methods ; *Egg Yolk/immunology ; COVID-19 ; SARS-CoV-2/immunology ; *Respiratory Tract Infections/immunology/therapy ; Pandemics ; Chickens ; }, abstract = {The respiratory system is under strain due to rising infections and diseases affecting millions globally, with antimicrobial resistance, allergens, and the recent pandemic further burdening public health. These challenges emphasize the critical need for support-based adjunct or combination biologics as essential measures for combating disease pathogenesis and optimizing the rational use of antimicrobials and steroids. Passive immunization represents an encouraging approach, with immunoglobulin Y (IgY) derived from hyperimmunized hen egg yolk emerging as a promising, cost-effective, and ethical alternative to conventional mammalian-derived antibodies. IgY technology addresses challenges including stability, process complexity, and antimicrobial resistance, offering practical advantages for human and animal applications. This review examines the application of IgY technology against majorly evolving respiratory pathogens and conditions - influenza virus, SARS-CoV-2, respiratory syncytial virus, Mycobacterium tuberculosis, Streptococcus pneumoniae, and respiratory allergens - highlighting IgY technology's significance as biologics across viral, bacterial, and allergen-driven respiratory diseases. Evidence from the IgY literature is broadly encouraging, demonstrating efficacy in pathogen neutralization, virulence attenuation, and hypersensitivity suppression, particularly through intranasal and oral delivery routes. IgY technology represents an affordable and scalable tool for low- and middle-income countries (LMICs) and beyond. Future priorities should include standardized antibody production protocols, optimized formulations and dosing strategies, rational point-of-care diagnostic integration, and well-designed prospective trials in high-burden settings to bring forth IgY technology's translational potential against prevailing and forthcoming respiratory afflictions.}, }
@article {pmid42263302, year = {2026}, author = {Tyagi, A and Singh, K and Singh, PM and Gerges, FJ}, title = {Sympathetic and Parasympathetic Ganglion Blocks for Treatment of Long COVID-19 Symptoms: A Scoping Review.}, journal = {Pain physician}, volume = {29}, number = {3}, pages = {E151-E161}, pmid = {42263302}, issn = {2150-1149}, mesh = {Humans ; *Autonomic Nerve Block/methods ; *Ganglia, Parasympathetic/drug effects ; *Ganglia, Sympathetic/drug effects ; Pandemics ; *Post-Acute COVID-19 Syndrome/therapy ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Long COVID-19 affects approximately 10-30% of individuals who are infected with SARS-CoV-2 and is associated with persistent functional impairment and reduced quality of life. The heterogeneous, multisystemic nature and nonspecific symptomatology of long COVID-19 makes its treatment challenging. This scoping review evaluates existing evidence on sympathetic and parasympathetic ganglion blocks as potential interventions for patients suffering from long COVID-19.
OBJECTIVE: Our primary objective was to assess the effectiveness of sympathetic and parasympathetic ganglion blocks in treating patients with long COVID-19 by identifying the most commonly reported symptoms, symptom response to different block regimens, and any adverse effects associated with these interventions.
STUDY DESIGN: A scoping review.
SETTING: Outpatient clinics where patients received sympathetic blocks or parasympathetic blocks.
METHODS: A comprehensive search was conducted across PubMed, Embase, Cochrane CENTRAL, Web of Science, Google Scholar, and ClinicalTrials.gov using MeSH and free-text terms related to "long COVID-19," "post-COVID-19 syndrome," and "sympathetic ganglion blocks" and "parasympathetic blocks." Only English-language articles were included. Pre-print repositories and reference lists were also manually screened.
RESULTS: A total of 22 articles covering 505 patients were included in this review. The most frequently studied symptoms were olfactory dysfunction, fatigue, headache, and cognitive disturbances. The most commonly utilized intervention was the stellate ganglion block. The available evidence suggests that the stellate ganglion block could be an effective treatment for dysautonomia symptoms and cognitive dysfunction related to long COVID-19. Sphenopalatine ganglion block may be an effective option to treat headaches in long COVID-19 patients who are refractory to other treatments.
LIMITATIONS: The significant existing variations in treatment regimens precluded our ability to do a quantitative analysis. Reporting bias from case reports and small observational studies should also be considered.
CONCLUSIONS: Stellate ganglion blocks may offer therapeutic benefit for the dysautonomia and cognitive dysfunction associated with long COVID-19. Sphenopalatine ganglion blocks have shown promise in managing refractory headache symptoms in this population. Further well-designed, placebo-controlled randomized studies that employ validated outcome measures are required to establish the efficacy of sympathetic ganglion blocks in the treatment of long COVID-19.}, }
@article {pmid42263636, year = {2026}, author = {Mohd Pakri, MA and Khalid, NA and Shah, JA and Mohamed Shaffril, HA}, title = {Factors influencing farmer's adaptation potential towards post COVID-19 impacts: A systematic literature review.}, journal = {Journal of environmental management}, volume = {411}, number = {}, pages = {130134}, doi = {10.1016/j.jenvman.2026.130134}, pmid = {42263636}, issn = {1095-8630}, mesh = {*Farmers/psychology ; *COVID-19 ; Humans ; *Agriculture ; *Adaptation, Psychological ; Pandemics ; SARS-CoV-2 ; Coping Skills ; }, abstract = {The COVID-19 pandemic has had a profound impact on the global agricultural sector, affecting all stages of the food system, from production to consumption. This study aims to comprehensively explore the factors influencing farmers' coping potential to adapt to the challenges posed by the COVID-19 crisis. A systematic literature review (SLR) was conducted, adhering to the ROSES (Reporting Standards for Systematic Evidence Syntheses) methodology. Publications were selected from two major academic databases, Scopus and Web of Science. Through thematic analysis, seven key themes emerged: (1) resource management and input accessibility, (2) diversification of activities and strategic planning, (3) community networks and cooperation, (4) digital transformation in agriculture, (5) individual farmer behaviors and capabilities, (6) market chain resilience and adaptation, and (7) policy support and government initiatives. These themes were further refined into 19 sub-themes, shedding light on the multifaceted nature of farmers' coping potential during crises. This review not only synthesizes existing research but also offers novel insights into the adaptation strategies of farmers, highlighting critical areas for policy intervention, capacity building, and future research to enhance agricultural resilience in the face of global disruptions.}, }
@article {pmid42263803, year = {2026}, author = {Rambabu, I and Baskar, G and Suliman, M and Saeed, M and Radhakrishnan, M and Balu, R and Palaniyandi, T}, title = {Engineered CRISPR-Cas systems for transcriptional regulation and precision molecular diagnostics: advances, challenges, and emerging microfluidic integration.}, journal = {Clinica chimica acta; international journal of clinical chemistry}, volume = {591}, number = {}, pages = {121145}, doi = {10.1016/j.cca.2026.121145}, pmid = {42263803}, issn = {1873-3492}, abstract = {CRISPR-Cas technology has evolved rapidly from a bacterial adaptive immune system to transformative use in molecular diagnostic and genomic engineering. Beyond traditional genome-editing capabilities, newly engineered versions of CRISPR/Cas can be used for programmable transcriptional regulation, epigenetic modification, molecular imaging, and ultrasensitive nucleic acid detection. Specifically, catalytic-inactive Cas proteins like dCas9 and dCas12 retain their ability to bind specific sequences on DNA but do not cleave it. Therefore, these proteins can be reversibly regulated by either CRISPRi or CRISPRa to alter gene expression. Thus, they represent powerful tools for both functional genomic studies and synthetic biological applications. Advances in CRISPR engineering have recently greatly increased the diagnostic potential of Cas12 and Cas13 enzymes. For example, collateral cleavage activity allowed the creation of CRISPR-based diagnostic platforms (SHERLOCK, DETECTR and FELUDA), which can detect target DNA/RNA sequences at high sensitivity and specificity. Moreover, they were demonstrated to work in detecting several infectious pathogens (SARS-CoV-2, Zika virus, and M. tuberculosis) and thus have significant value in point-of-care testing, especially when there is limited availability of resources. CRISPR systems are also being combined with increasing frequency with epigenetic regulators, fluorescence microscopy methods, biosensors, and lab-on-a-chip platforms that incorporate microfluidics to provide improved molecular analysis and automated diagnosis. The purpose of this review is to describe how engineered CRISPR-Cas systems have been developed from primarily genome editing tools into multi-functional platforms for transcriptional regulation, epigenetic engineering, diagnostics, imaging, and emerging microfluidic integrations. Additionally, this review will address some of the current challenges that exist with using CRISPR-based technologies, including off-target effects, delivery efficiency, diagnostic standardization, scaling up production, and translating these technologies clinically.}, }
@article {pmid42266820, year = {2026}, author = {Xing, K and Wen, J and Xing, D and Liang, B}, title = {Digital first primary care in NHS England: evaluating alignment with patient-centered care and implications for future practice.}, journal = {Frontiers in digital health}, volume = {8}, number = {}, pages = {1723805}, pmid = {42266820}, issn = {2673-253X}, abstract = {The Digital First Primary Care (DFPC) model, introduced by NHS England, aims to enhance healthcare accessibility and efficiency by leveraging digital tools such as telemedicine, digital triage, and virtual consultations. In this structured narrative review, we synthesized UK-focused empirical, policy, and implementation literature to examine DFPC through the patient-centered care (PCC) domains of access, autonomy, shared decision-making, continuity, relational quality, and equity. The available evidence suggests that DFPC can improve convenience, flexibility, and timeliness of first contact for some patients, but these gains are unevenly distributed and depend heavily on system design, workflow integration, and patient capability. Evidence generated during the COVID-19 emergency should not be conflated with the evaluation of routine, policy-driven post-pandemic DFPC, because the goals, constraints, and patient expectations differ across these contexts. We therefore argue that DFPC aligns with PCC only when implemented within a flexible hybrid model that preserves modality choice, supports continuity, provides safe escalation to in-person care, and actively mitigates digital exclusion. Future research should prioritize patient-reported experience, continuity, safety, and equity outcomes under routine post-pandemic conditions.}, }
@article {pmid42267299, year = {2026}, author = {Zu, Y and Wang, H and Wu, J and Tang, C and Han, R and Fang, F}, title = {Permanent hypoparathyroidism following SARS-CoV-2 infection: a case report with two-year follow-up and literature review.}, journal = {Frontiers in endocrinology}, volume = {17}, number = {}, pages = {1712510}, pmid = {42267299}, issn = {1664-2392}, mesh = {Adult ; Female ; Humans ; Betacoronavirus ; Calcium/therapeutic use ; *COVID-19/complications ; Follow-Up Studies ; Hashimoto Disease/complications ; Hypocalcemia/etiology ; *Hypoparathyroidism/blood/diagnosis/virology ; Pandemics ; Parathyroid Hormone/blood ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; }, abstract = {Beyond its predominant respiratory involvement, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection has also been implicated in endocrine dysfunction. Hypocalcemia is common in Coronavirus Disease 2019 (COVID-19), yet the insufficient compensatory rise in parathyroid hormone (PTH) and its long-term outcomes remain poorly characterized. We describe a young adult Chinese woman with no history of neck surgery who developed severe symptomatic hypocalcemia shortly after acute SARS-CoV-2 infection. Laboratory evaluation revealed inappropriately low PTH levels with concomitant hyperphosphatemia, consistent with hypoparathyroidism (HypoPT). Although baseline calcium/PTH data prior to infection were unavailable, the regular calcium and vitamin D supplementation, along with serial monitoring over more than two years, demonstrated persistently suppressed PTH secretion, supporting a diagnosis of permanent HypoPT. Thyroid imaging and antibody testing confirmed coexistent Hashimoto's thyroiditis, raising the possibility of an autoimmune contribution. To contextualize this case, we reviewed 14 previously published reports of COVID-19-associated HypoPT, among which no cases originating from China were identified. Based on available data, it cannot be ruled out that SARS-CoV-2 infection may contribute to the development of new-onset HypoPT in addition to worsening pre-existing conditions. Young-onset patients without a history of surgery-particularly those whose hypocalcemia severity does not clearly parallel the severity of infection-appear to have a higher likelihood of subsequent persistent dysfunction, though this observation remains preliminary. This case, together with the literature, underscores the need for extended follow-up in patients presenting with hypocalcemia and blunted PTH responses after COVID-19. Comprehensive autoimmune evaluation and, where appropriate, genetic testing should be considered to clarify etiology and guide long-term management.}, }
@article {pmid42267411, year = {2026}, author = {Jung, J and Cho, I and Moon, J}, title = {Factors Associated With Work Productivity Loss Among Workers During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis of Correlations.}, journal = {Workplace health & safety}, volume = {}, number = {}, pages = {21650799261454290}, doi = {10.1177/21650799261454290}, pmid = {42267411}, issn = {2165-0969}, abstract = {Background:The COVID-19 pandemic disrupted work environments worldwide, increasing productivity loss through absenteeism and presenteeism. Identifying key associated factors is essential for informing workplace health strategies during public health crises. Methods/Project: A systematic review and meta-analysis were conducted following PRISMA guidelines, using comprehensive searches of seven electronic databases from inception through January 2024. Studies were systematically selected based on predefined eligibility criteria, and 24 studies examining individual and work-related factors associated with work productivity loss were included. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal tools. Correlation coefficients were synthesized using a random-effects meta-analysis of correlations in STATA 17.0, and heterogeneity was evaluated using the I[2] statistic and Cochran's Q test. Findings: Twenty-one factors were analyzed. Job stress, fear of COVID-19, mental health problems, job insecurity, turnover intention, exhaustion, and job demands exhibited moderate positive correlations with productivity loss during the COVID-19 pandemic. Fear of COVID-19 and mental health problems showed relatively large positive correlations with presenteeism. General health status was the factor most strongly associated with absenteeism, exhibiting a moderate negative correlation. Conclusions/Application to Practice: These findings identify key individual and work-related determinants of productivity loss during pandemics. The results support the development of targeted workplace health promotion, mental health support, and preparedness strategies to mitigate productivity loss during future public health emergencies.}, }
@article {pmid42267834, year = {2026}, author = {Yu, J and Li, W and Xu, Y and Tang, J}, title = {Gut microbiota-derived short-chain fatty acids (SCFAs): immunomodulatory effects and therapeutic potential in infections.}, journal = {Clinical microbiology reviews}, volume = {}, number = {}, pages = {e0036825}, doi = {10.1128/cmr.00368-25}, pmid = {42267834}, issn = {1098-6618}, abstract = {SUMMARYThe human gut microbiotas constitute a complex microecosystem essential for host homeostasis. Among its metabolites, short-chain fatty acids (SCFAs) act as key signaling molecules linking microbial activity to host immunity and barrier function. Based on existing literature, we conducted a comprehensive analysis of the interaction between SCFAs and 11 key gut pathogens. These pathogens include bacteria (i.e., Staphylococcus aureus, Clostridioides difficile, Salmonella spp., Campylobacter jejuni, Klebsiella pneumoniae, Vibrio cholerae), fungi (i.e., Candida albicans), and viruses (i.e., SARS-CoV-2, influenza virus, respiratory syncytial virus, rotavirus). In terms of antibacterial effects, SCFAs exhibit antibacterial activity against most gut microorganisms, but they support the colonization of a few species (i.e., Campylobacter jejuni). Given the complex interactions between SCFAs and the gut microbiota, as well as their regulatory roles in infection, further investigation of the microbiota-SCFA axis is essential for developing effective strategies to prevent and treat infectious diseases. This review systematically summarizes the mechanism and clinical evidence of SCFAs in microbial infections to provide novel ideas for infectious disease management.}, }
@article {pmid42268693, year = {2026}, author = {Zhao, V and Gutman, G}, title = {Navigating Identification and Management of Substance Use in Adolescents.}, journal = {Pediatric annals}, volume = {55}, number = {6}, pages = {e229-e233}, doi = {10.3928/19382359-20260223-05}, pmid = {42268693}, issn = {1938-2359}, mesh = {Humans ; *Substance-Related Disorders/diagnosis/therapy/epidemiology ; Adolescent ; Motivational Interviewing ; Adolescent Behavior ; COVID-19/epidemiology ; Physician's Role ; }, abstract = {Substance use in adolescents is an important public health topic. It can affect cognitive development and is associated with negative outcomes, such as school truancy, low graduation rates, and increased high-risk behaviors (eg, unprotected sex, dangerous driving), as well as high rates of suicide, substance abuse, dependence in adulthood, and death by overdose. Substance use among adolescents declined during the coronavirus 2019 pandemic and has continued to do so, resulting in the lowest rates of substance use in decades. Despite this decrease, physicians and nonphysician practitioners still need to be prepared to navigate this issue in teenagers and young adults. The role of primary care physicians and other practitioners includes promotion of abstinence from substances, using validated screening questionnaires, and treatment through motivational interviewing and harm reduction, as well as referring to specialists, higher levels of care, and rehabilitation centers as needed.}, }
@article {pmid42269323, year = {2026}, author = {Lequipe Mamani, C and Salazar, MDT and Poma Plata, GL and Camacho Garnica, RA and Sandi Lora, F}, title = {Clinical characteristics and factors associated with mortality in critically ill COVID-19 patients at high altitude.}, journal = {Journal of critical care}, volume = {95}, number = {}, pages = {155650}, doi = {10.1016/j.jcrc.2026.155650}, pmid = {42269323}, issn = {1557-8615}, abstract = {OBJECTIVE: To investigate factors associated with mortality in critically ill COVID-19 patients at 3640 m above sea level (m.a.s.l.), focusing on the interaction between altitude-induced secondary erythrocytosis and virus-induced hyperviscosity.
METHODS: We conducted a retrospective cohort study of 59 adult patients with severe ARDS admitted to the ICU in La Paz, Bolivia. Severe ARDS was defined using altitude-adapted criteria.
RESULTS: Non-survivors exhibited significantly higher median hematocrit (53.4% vs 49.7%; p = 0.0001) and D-dimer (29,729 vs 16,521 ng/mL; p = 0.0001) compared to survivors. An "APACHE II paradox" was observed, as survivors had significantly higher admission scores than non-survivors (24 vs 17; p = 0.01). While initial ventilatory mechanics were comparable (14.3 vs 14.1 cm H₂O; p = 0.81), non-survivors experienced exclusive complications, including pneumothorax (24.2%) and pulmonary embolism (18.2%).
CONCLUSIONS: Hyperviscosity, exacerbated by altitude-induced erythrocytosis, is a primary factor associated with mortality in this environment. Traditional severity scores may not adequately stratify risk in high-altitude contexts, highlighting the need for altitude-specific protocols focusing on rheological control.}, }
@article {pmid42269957, year = {2026}, author = {Salehinejad, MA and Fathi Jouzdani, A and Bandeira, ID and Bender, S and Bikson, M and Castelo-Branco, M and Cohen Kadosh, R and Costanzo, F and Croarkin, PE and Desarkar, P and Dyke, K and Eickhoff, S and Fitzgerald, PB and Hartwigsen, G and Koenig, J and Martino, D and Menghini, D and Mirfazeli, FS and Moliadze, V and Nitsche, MA and Oberman, LM and Siniatchkin, M and Vaziri, Z and Vicario, CM and Vöckel, J and Wischnewski, M and Wolters, CH and Zangen, A and Zaehle, T and Zomorrodi, R and Brunoni, AR}, title = {Global prevalence and disability burden of brain disorders: Impact of neurological, mental, and substance use disorders.}, journal = {Neuroscience and biobehavioral reviews}, volume = {188}, number = {}, pages = {106808}, doi = {10.1016/j.neubiorev.2026.106808}, pmid = {42269957}, issn = {1873-7528}, mesh = {Humans ; *Mental Disorders/epidemiology ; *Substance-Related Disorders/epidemiology ; Prevalence ; *Nervous System Diseases/epidemiology ; *COVID-19/epidemiology ; *Brain Diseases/epidemiology ; *Global Burden of Disease ; Disability-Adjusted Life Years ; *Persons with Disabilities/statistics & numerical data ; Cost of Illness ; }, abstract = {Brain disorders-encompassing neurological, mental, and substance use disorders-account for 10 of the top 25 causes of disability worldwide according to the Global Burden of Disease (GBD) 2021 study. Despite such an impact, they have not been centrally analyzed in prior GBD studies. This paper synthesizes the latest disability-focused GBD study to quantify the prevalence and disability burden of 35 conditions from 2010 to 2021, a period marking the first decline in global health outcomes in three decades. It further incorporates disability metrics from 2021 to 2023 to contextualize post-pandemic trends. The paper covers the prevalence and disability burden of neurological, mental, and substance use disorders along with COVID-19 using disability-adjusted life-years (DALYs) and years lived with disability (YLDs) metrics. From 2010-2021, Parkinson's, Alzheimer's, and migraine (in neurological disorders), major depressive, anxiety, and eating disorders (in mental disorders), and opioid and drug use disorders (in substance use disorders) showed the greatest increases in age-adjusted prevalence rates across both sexes. In 2021, neurological disorders were the largest contributor to DALYs among brain-disorder categories, while depressive and anxiety disorders ranked as the 2nd and 6th leading causes of global YLDs. Alzheimer's disease/dementias, Parkinson's disease, autism spectrum disorder (ASD), depressive and anxiety disorders, and opioid and drug use disorders showed the largest increases in burden within their respective categories between 2010 and 2021. In both 2021 and 2023, females had higher prevalence rates of overall neurological disorders, headache/migraine, multiple sclerosis, depressive/anxiety disorders, and anorexia nervosa, while males had higher rates of stroke, Parkinson's disease, ASD/ADHD, and substance use disorders. In DALY/YLD metrics, females showed higher rates for anorexia nervosa and multiple sclerosis, and males for ASD, certain neurological disorders, COVID-19, and substance use disorders. In the 2021-2023 extension analysis, disability data showed increases in prevalence and disability of several brain disorders, mostly anxiety disorders, while the COVID-19 disability burden declined markedly by 2023. Further sex-specific disability burden metrics, key insights from each disorder, and limitations/confounds are discussed.}, }
@article {pmid42270545, year = {2026}, author = {Louvet, A and Ntandja Wandji, LC and Mathurin, P}, title = {Updates in clinical science: Alcohol-related hepatitis.}, journal = {Journal of hepatology}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.jhep.2026.04.016}, pmid = {42270545}, issn = {1600-0641}, abstract = {Alcohol-related hepatitis (AH) is a complex disease associated with numerous unmet needs, particularly in diagnosis and treatment. The epidemiology of AH has evolved in recent years, reflecting changes in alcohol consumption during the COVID-19 pandemic and the increasing incidence of AH following bariatric surgery. Advances have also been made in the non-invasive diagnosis of AH, helping to reduce the need for liver biopsy, as well as in the management of infection. Several novel therapeutic strategies have been evaluated, including faecal microbiota transplantation, IL-1 receptor antagonists, oxysterols, and reduced exposure to corticosteroids or antibiotics. Although the results of these trials have been relatively disappointing, they have helped identify promising directions for future research. In patients with the most severe form of AH, particularly those who do not respond to corticosteroids, several studies have suggested that the indications for early liver transplantation could be expanded. Overall, developments over recent years have generated increased optimism regarding the management of patients with severe AH.}, }
@article {pmid42270928, year = {2026}, author = {Sanyal, D and Chaubey, B}, title = {SARS-CoV-2 3CL protease interaction with host factors - identifying novel drug targets.}, journal = {Archives of virology}, volume = {171}, number = {7}, pages = {}, pmid = {42270928}, issn = {1432-8798}, mesh = {Humans ; *SARS-CoV-2/enzymology ; *Coronavirus 3C Proteases/metabolism ; *Host-Pathogen Interactions ; COVID-19/virology ; Immunity, Innate ; }, abstract = {SARS-CoV-2 3CL protease (3CL[Pro]) plays crucial role in the viral life cycle by releasing different non-structural proteins from viral polyproteins. It also interacts with several host factors and orchestrates different host cell pathways by cleaving key cellular factors involved in immune modulation, cellular metabolism and cell death. Several host factors have been identified as high confidence substrates of 3CL[Pro] which regulates host cellular environment both in an enzyme-dependent and enzyme-independent manner. Degradation of RIG-I, TRIM25 and NLRP12 by 3CL[Pro] downregulates the innate immune response while enzyme-independent interaction with host factors like MAVS promote both its degradation and upregulation. Cellular transcription and translation are altered by interaction of 3CL[Pro] with host proteins. It affects cell-death by interacting with factors like Gal-8, NDP52 and GSDMD. Post-COVID neurodegenerative disorders have been observed due to the downregulation of neuronal factors like NEMO and UBE3A. The spectrum of 3CL[Pro] interaction with the key host factors indicates the alternate role of viral protease that modulates host response during infection. Several 3CL[Pro] targets and their cleavage sites on the target proteins have been identified. This review highlights the crosstalk between 3CL[Pro] and different host factors as possible alternate therapeutic targets to inhibit the viral propagation as well as address the post COVID clinical issues.}, }
@article {pmid42271099, year = {2026}, author = {Kuai, M and Li, B and Shi, Z and Huang, Q and Pan, Y and Tang, M and Gao, X and Fang, J and Lü, P}, title = {Molecular Insights Into Endometriosis for Early Detection and Therapeutic Targets.}, journal = {Reproductive sciences (Thousand Oaks, Calif.)}, volume = {}, number = {}, pages = {}, pmid = {42271099}, issn = {1933-7205}, support = {Grant No. K2024018//Medical Scientific Research Foundation of Jiangsu Commission of Health/ ; KYCX24_3922//Postgraduate Research & Practice Innovation Program of Jiangsu Province/ ; Grant No. Jdfyxgzx004//COVID-19 Special Fund of the Affiliated Hospital of Jiangsu University/ ; }, abstract = {Endometriosis is a hormone-dependent chronic inflammatory disease associated with pain and infertility, remains diagnostically and therapeutically challenging due to its multifactorial nature. Molecular mechanisms of the dynamic changes during disease pathogenesis may help identify potential diagnostic biomarkers and therapeutic targets. This paper reviews the molecular pathological alterations in endometriosis, focusing on the regulation of sex hormones, the endometrial microenvironment, immune dysregulation, and relevant signaling pathways. The lack of reliable early detection biomarkers significantly contributes to diagnostic delays. We summarize the research progress on biomarkers for endometriosis, providing the latest information on early diagnosis. We also review the therapeutic strategies targeting anti-proliferative/pro-apoptotic pathways and inflammatory responses. Although challenges persist in translating mechanistic discoveries into clinical applications, preclinical evidence suggests that addressing diagnostic delays and advancing innovative therapies may hold potential for yielding targeted management strategies for this complex disease.}, }
@article {pmid42271357, year = {2026}, author = {Javed, MN and Khan, SM and Hussain, JM and Alam, H and Sheikh, M and Saleem, Z and Parkash, S and Rani, M and Khan, M and Saleem, H and Asif, MA and Zayed, A}, title = {Effectiveness of telerehabilitation in patients with post-COVID-19: an updated systematic review and meta-analysis of randomized controlled trials.}, journal = {BMC pulmonary medicine}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12890-026-04377-x}, pmid = {42271357}, issn = {1471-2466}, abstract = {INTRODUCTION: Post-COVID-19 syndrome affects 10-15% of survivors, causing multisystem complications and significant economic burden. Telerehabilitation (TR) has emerged as a scalable solution to deliver care remotely. This study aims to re-evaluate the effectiveness of TR in improving physical and psychological outcomes in post-COVID-19 patients.
METHODS: Registered on PROSPERO (CRD420251082578) under PRISMA guidelines, we searched PubMed, Cochrane, and Scopus from April 2024 till July 2025 for randomized trials. Primary outcomes included clinical symptoms (Borg score, dyspnea) and physical function (30-s sit-to-stand test, 6-min walking distance). A random-effects model assessed pooled outcomes with heterogeneity (I[2]) and sensitivity analyses along with subgroup analysis. Additionally, publication bias and certainty of evidence using Gradepro was performed. Risk of bias was evaluated using the Cochrane ROB2 tool.
RESULTS: Twenty-eight randomized controlled trials (RCT's) comprising approximately 1,400 participants were included. TR significantly improved physical function, including the 30 s-STS (MD = 2.07; 95% CI: 1.24 to 2.90; p < 0.00001) and 6MWD (MD = 85.83 m; 95% CI: 67.14 to 104.52; p < 0.00001). Significant reductions were observed in dyspnea (Borg overall MD = -3.74, p = 0.003) and fatigue (VASF MD = -1.83, p < 0.0001). However, no significant differences were found for HADS-Anxiety (p = 0.27) or HADS-Depression (p = 0.11). Pulmonary function showed significant gains only in FEV1 change scores (p = 0.008). Preliminary data suggests a favorable safety profile; while no serious adverse events were reported across the trials, safety was infrequently listed as a primary outcome.
CONCLUSION: TR appears to be a promising and well-tolerated modality for enhancing physical capacity and alleviating fatigue in post-COVID-19 patients, though further large-scale studies with safety as a primary endpoint are warranted to definitively establish its safety profile. While physical gains are robust, additional targeted interventions may be necessary to address psychological and pulmonary sequelae.}, }
@article {pmid42272086, year = {2026}, author = {Jan, A and Waheed, B and Hussein, GA and Pandey, P and Sultana, H and Kumar, S and Dagnaw, M}, title = {Prevalence, Comparative Risk, and Predictors of Shock in Children With Multisystem Inflammatory Syndrome Associated With COVID-19: A Systematic Review and Meta-Analysis.}, journal = {Journal of paediatrics and child health}, volume = {}, number = {}, pages = {}, doi = {10.1111/jpc.70470}, pmid = {42272086}, issn = {1440-1754}, abstract = {BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C) is a severe hyperinflammatory condition associated with SARS-CoV-2 infection and is frequently complicated by cardiovascular dysfunction, particularly shock. Early recognition of shock in MIS-C is critical to reduce morbidity and mortality.
OBJECTIVE: This systematic review and meta-analysis aimed to evaluate the prevalence, comparative risk, and predictors of shock among children with MIS-C, enhancing clinical management and informing future research.
METHODS: A systematic search of PubMed, Embase and Web of Science was conducted from database inception to 15 July 2025. Observational studies reporting prevalence, comparative risk or predictors of shock in children with MIS-C were included. Random-effects meta-analysis with Freeman-Tukey double arcsine transformation was used to estimate pooled prevalence with 95% confidence intervals (CI). Relative risks (RR) were pooled for comparative analyses. Subgroup analyses, sensitivity analyses and meta-regression were performed to explore heterogeneity. Publication bias was assessed using funnel plots and Egger's regression test.
RESULTS: Seventy studies involving 13 263 children with MIS-C were included. The pooled prevalence of shock was 56% (95% CI: 49%-63%), although substantial heterogeneity was observed (I[2] = 98.4%). Sensitivity analyses excluding studies with sample sizes < 50 and < 100 participants yielded pooled prevalence estimates of 50% (95% CI: 40%-59%) and 46% (95% CI: 33%-59%), respectively. Subgroup analyses demonstrated variation according to publication year and diagnostic criteria. Children with MIS-C had a significantly increased risk of shock compared with Kawasaki disease cohorts (RR = 8.52, 95% CI: 1.24-58.41; p < 0.05) and acute/severe COVID-19 cohorts without MIS-C (RR = 4.42, 95% CI: 2.44-8.02; p < 0.001). Echocardiographic abnormalities, myocardial dysfunction, elevated inflammatory markers and acute kidney injury were consistently associated with shock.
CONCLUSION: The certainty of evidence ranged from very low to low because of substantial heterogeneity, imprecision and methodological variability across studies. Despite these limitations, shock remains a frequent and serious complication of MIS-C, highlighting the importance of early cardiovascular assessment and timely recognition of high-risk children.}, }
@article {pmid42273166, year = {2026}, author = {Alhumaid, S and Alshehri, SM and Sabr, Z and Aborshaid, FA and Noorsaeed, S and Alsaidalani, AA and Banjar, SS and Aljasem, K and AlQahtani, FA and Baltyour, SA and Bu Subaih, AJ and Alwesaibi, AA and Alghanim, AH and Al Alawi, Z and Alsaadoun, DS}, title = {Persistence, chronicity, and recurrence of infection-associated urticaria following viral infections in children and adults: a systematic review.}, journal = {Frontiers in allergy}, volume = {7}, number = {}, pages = {1847423}, pmid = {42273166}, issn = {2673-6101}, abstract = {BACKGROUND: Viral infections are recognized triggers of acute urticaria; however, the long-term outcomes of infection-associated urticaria, including persistence, recurrence, and progression to chronic disease, remain incompletely characterized.
OBJECTIVE: To systematically review the available evidence on the persistence, chronicity, and recurrence of infection-associated urticaria following viral infections in children and adults.
METHODS: A systematic review was conducted in accordance with PRISMA 2020 guidelines and prospectively registered in PROSPERO (CRD420261319656). Electronic databases (PubMed, Embase, CINAHL, Scopus, and Web of Science) were searched from inception to 17 March 2026. Observational studies reporting long-term outcomes of infection-associated urticaria following viral infection were included. Data extraction and risk of bias assessment using the Newcastle-Ottawa Scale were performed independently by two reviewers. Due to substantial heterogeneity, findings were synthesized narratively.
RESULTS: Five studies involving 596 participants were included. Most cases of infection-associated urticaria occurred during the acute phase of infection and resolved within weeks to months. However, persistence beyond 6 months was reported in up to 9.5% of cases, and a small proportion demonstrated persistent symptoms extending beyond 1 year. Reported recurrence and chronicity rates ranged from approximately 7% to 30%, although several estimates were derived from mixed-etiology cohorts in which infection-related cases were not analyzed separately. Delayed-onset urticaria, particularly following SARS-CoV-2 infection, was associated with an increased likelihood of progression to chronic spontaneous urticaria. However, interpretation is limited by the inclusion of mixed-etiology cohorts in which viral infection was not always laboratory-confirmed or analyzed separately.
CONCLUSION: Infection-associated urticaria is typically self-limiting; however, a small but potentially clinically relevant subset of patients may develop persistent or chronic symptoms. Recognition of potential risk patterns, particularly delayed-onset urticaria in the context of SARS-CoV-2 infection, may support improved patient counselling and follow-up. Current evidence remains limited by heterogeneous study designs, mixed aetiologies, and inconsistent pathogen-specific reporting. Further prospective studies with standardized definitions and pathogen-specific analyses are needed.
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=1319656, identifier CRD420261319656.}, }
@article {pmid42273265, year = {2026}, author = {Shi, P and Zhang, Z and He, W and Duan, Y and He, Y and Feng, H and Shu, J}, title = {Leveraging single B cell antibody platforms to develop countermeasures against animal viral diseases: recent advances and future perspectives.}, journal = {Frontiers in veterinary science}, volume = {13}, number = {}, pages = {1854176}, pmid = {42273265}, issn = {2297-1769}, abstract = {The discovery and application of monoclonal antibodies (mAbs) have fundamentally revolutionized clinical medicine, driving significant paradigm shifts in disease prevention, precise diagnosis and targeted treatment. The demand for high-affinity antibodies continues to surge, yet traditional discovery platforms such as hybridoma and phage display suffer from low efficiency, disrupted native pairing, and time-consuming workflows. Single B cell antibody technology overcomes these limitations by directly retrieving naturally paired heavy and light chain sequences from antigen-specific B cells, thereby preserving authentic affinity and specificity. Following its remarkable success in combating human emergencies like COVID-19, this platform is now being rapidly adapted to veterinary viral diseases, a critical effort under the "One Health" framework to safeguard both animal and public health. This review systematically outlines the core principles and workflows of single B cell-based mAb discovery. It then summarizes recent advances in applying this technology to viruses that infect animals and zoonotic viruses, emphasizing how native antibody repertoires have been harnessed to generate high-affinity mAbs. Ultimately, the article concludes with a discussion of current technical challenges, proposing future research directions to improve both the accessibility and efficacy of veterinary immunotherapeutics.}, }
@article {pmid42275913, year = {2026}, author = {Mhade, S and Bhosekar, U and Hill, MD and Sinclair, S and Agrawal, S and Guerrini, J and Pletz, K and Zou, L and Koebcke, A and Kummer, AG and Ventura, PC and Del Valle, SY and Chinazzi, M and Litvinova, M and Vespignani, A and Ajelli, M}, title = {Mapping the landscape of individual-based models for respiratory pathogen transmission in the pandemic and post-pandemic era (2020-2024): A systematic review.}, journal = {Epidemics}, volume = {56}, number = {}, pages = {100924}, doi = {10.1016/j.epidem.2026.100924}, pmid = {42275913}, issn = {1878-0067}, abstract = {Individual-based models (IBMs) provide a mechanistic framework in which population-level outcomes emerge from interactions between individuals. We conducted a systematic review on IBMs for respiratory pathogens published in 2020-2024. We identified 855 eligible studies. Publications peaked in 2021, with a geographical distribution positively correlated with national GDP, leaving regions understudied. Most studies focused on SARS-CoV-2 and assessed public health interventions. Research priorities evolved over time, shifting from social distancing to vaccination. Age was included in 72.4% of studies; other sociodemographic factors (e.g., race/ethnicity) were rarely considered. This review maps the IBM landscape, offering a framework to guide future modeling efforts.}, }
@article {pmid42276971, year = {2026}, author = {Farquhar, H}, title = {AI-Enhanced Point-of-Care Diagnostics for Infectious Diseases in Resource-Limited Settings: A Scoping Review.}, journal = {Tropical medicine & international health : TM & IH}, volume = {}, number = {}, pages = {}, doi = {10.1111/tmi.70170}, pmid = {42276971}, issn = {1365-3156}, abstract = {OBJECTIVES: To systematically map the extent and nature of research on AI-enhanced point-of-care (POC) and rapid diagnostic technologies for infectious diseases in resource-limited settings, and to identify gaps in disease coverage, geographic representation and validation rigour.
METHODS: This scoping review followed JBI methodology and PRISMA-ScR guidelines. The protocol was registered on OSF (https://doi.org/10.17605/OSF.IO/KV8MP). Five databases (PubMed, Embase, Scopus, Web of Science and IEEE Xplore) were searched for studies published from January 2015 to March 2026. Title/abstract and full-text screening used rule-based keyword screening with manual validation (Cohen's kappa = 0.856). Data were extracted using a 19-variable charting form and enriched with PubMed Central full texts.
RESULTS: From 1072 records, 551 remained after deduplication and 237 studies were included. Publication volume grew exponentially, with 44% published in 2025-2026. COVID-19 (32%), malaria (27%) and tuberculosis (14%) dominated; neglected tropical diseases accounted for fewer than 8%. Microscopy (21%), molecular diagnostics (17%), biosensors (14%) and rapid diagnostic tests (14%) were the most common modalities. Convolutional neural networks predominated (26%), followed by random forests (10%) and support vector machines (8%). Only 7% of studies reported prospective field validation, while 62% did not report validation level. Geographic analysis revealed concentration in East Africa and South Asia, with underrepresentation of West Africa and Latin America.
CONCLUSIONS: AI-enhanced POC diagnostics for infectious diseases in resource-limited settings is a rapidly growing field facing critical gaps in validation rigour, disease equity and geographic representation. Only 16 of 237 studies (6.8%) report prospective field validation. Future research should prioritise field validation, expand beyond the COVID-19/malaria/TB triad and involve end-user communities from the design stage.}, }
@article {pmid42277518, year = {2026}, author = {Frühwein, M}, title = {[Focus on respiratory vaccinations].}, journal = {MMW Fortschritte der Medizin}, volume = {168}, number = {11}, pages = {38-41}, doi = {10.1007/s15006-026-5953-4}, pmid = {42277518}, issn = {1613-3560}, }
@article {pmid42277912, year = {2026}, author = {Chang, L and Xu, W and Wang, X and Xue, Y and Zhang, Y and Zhu, X and Zhang, Y and Liang, T and Liu, W}, title = {CRISPR diagnostics: from trans-nuclease activity to cancer diagnosis.}, journal = {Cell & bioscience}, volume = {}, number = {}, pages = {}, doi = {10.1186/s13578-026-01603-1}, pmid = {42277912}, issn = {2045-3701}, support = {2019YFC1316000//National Key Research and Development Program of China/ ; 81830089//National Natural Science Foundation of China/ ; 82188102//National Natural Science Foundation of China/ ; LQ23H200004//Natural Science Foundation of Zhejiang Province/ ; }, abstract = {The field of nucleic acid-based testing experienced a decade-long stagnation since the development of quantitative polymerase chain reaction (qPCR) in 1992 and isothermal amplification methods in the early 2000s. However, in 2016, the discovery of trans-nuclease activity in CRISPR-Cas systems revolutionized the molecular diagnostics for nucleic acids. A typical CRISPR diagnostic workflow comprises three phases: (1) target recognition through CRISPR RNA (crRNA)-guided hybridization; (2) signal transduction via trans-cleavage of engineered reporters (e.g., fluorophore-quencher oligonucleotides), and (3) signal readout using fluorescence, electrochemical, or colorimetric platforms. Emerging shortly prior to the COVID-19 pandemic, CRISPR diagnostics quickly gained prominence as a field-deployable alternative to qPCR due to its rapidity (< 1 h), minimal equipment requirements, and field adaptability. This technological paradigm underwent rigorous validation and refinement alongside the rapid evolution of SARS-CoV-2 detection, which facilitated its adaptation for cancer diagnosis. Recent advancements in sensitivity (attomolar-level detection) and specificity (single-nucleotide discrimination) have enabled transformative applications in cancer diagnostics, including: (1) identification of nucleic acid biomarkers, such as high-frequency somatic mutations, circulating nucleic acids and miRNAs; and (2) detection of non-nucleic acid biomarkers, including epigenetic aberrations, proteins, small molecules and metabolite biomarkers. This review chronicles the decadal evolution of CRISPR diagnostics, with particular emphasis on recent advancements of its application in cancer diagnosis. We critically evaluate persistent technical limitations, including PAM sequence restriction, suboptimal sensitivity and specificity, quantitative constraints, and unmet point-of-care testing (POCT) in complex biological matrices. Additionally, we discuss prospective solutions to address these challenges.}, }
@article {pmid42278622, year = {2026}, author = {Zhao, YY and Evans, CE}, title = {Contemporary Endothelial Genome Editing Technologies: Towards Precision Genetic Medicine for Vascular Diseases.}, journal = {International journal of molecular sciences}, volume = {27}, number = {11}, pages = {}, pmid = {42278622}, issn = {1422-0067}, support = {1R01HL133951-21/NH/NIH HHS/United States ; 2R01HL164014-22/NH/NIH HHS/United States ; 3R01HL162299-22/NH/NIH HHS/United States ; 4R01HL172447-23/NH/NIH HHS/United States ; 24TPA1285575//American Heart Association/ ; 23SCEFIA1155876//American Heart Association/ ; 5P20GM103499-23/NH/NIH HHS/United States ; }, mesh = {Humans ; *Gene Editing/methods ; CRISPR-Cas Systems ; *Vascular Diseases/genetics/therapy ; *Endothelial Cells/metabolism ; Animals ; *Precision Medicine/methods ; *Genetic Therapy/methods ; Endothelium, Vascular/metabolism ; }, abstract = {Endothelial dysfunction is a key characteristic of many diseases, including atherosclerosis, hypertension, heart failure, stroke, cancer, acute respiratory distress syndrome (ARDS), peripheral vascular disease, coronavirus 2019 (COVID-19), and pulmonary arterial hypertension (PAH). To improve understanding of the roles of endothelial cells (ECs) in health and disease, EC-specific genome editing technologies have been developed in recent years. Therapeutic strategies that aim to restore a healthy endothelial monolayer include the inhibition of endothelial genes that cause EC injury and dysfunction and the induction or activation of endothelial genes that drive EC repair and regeneration. In this review, we describe established recombinase-mediated genetic modification technologies and emerging EC-specific genome editing technologies including viral and non-viral delivery of the CRISPR/Cas9 genome editing system, and we summarize the strengths and limitations of each technology. We then discuss possible avenues for future research, including the development of organ-specific EC genome editing technologies. In short, EC-specific genome editing technologies can be used to modulate gene expression selectively in ECs and even within a specific vascular bed and/or distinctive EC subtype, and, in doing so, greatly improve the understanding of vascular biology and help develop precision genetic medicine targeting the disease-causing vascular bed(s) to effectively treat diseases caused by vascular endothelial dysfunction.}, }
@article {pmid42278781, year = {2026}, author = {Karanikola, M and Middleton, N}, title = {Suicide Prevention as a Pillar of Sustainable Mental Health: A Focused Comparative Narrative Review of the Republic of Cyprus and Selected European Countries in the Post-COVID-19 Era.}, journal = {Healthcare (Basel, Switzerland)}, volume = {14}, number = {11}, pages = {}, pmid = {42278781}, issn = {2227-9032}, abstract = {Background/Objectives: Mental health and suicide prevention are increasingly recognized as critical components of sustainable development in the European Union (EU), particularly in light of the broader mental health challenges highlighted during the COVID-19 pandemic. This review aimed to explore suicide prevention policies and mental health strategies across selected European countries through a focused comparative analysis centered on the Republic of Cyprus. Methods: A narrative review design was applied. A purposive literature search focused on national strategies, epidemiological trends, policy papers, and peer-reviewed articles published from 2000 to January 2026 was followed. Databases searched included PubMed, Scopus, PsychInfo, Embase and Google Scholar, supplemented by grey literature from the World Health Organization (WHO), European Commission, and national health authorities. The review focused on selected European countries, i.e., the United Kingdom, Sweden, Finland, Greece, and the Republic of Cyprus, chosen to illustrate variation in suicide prevention policies, health system structures, and implementation frameworks. Evidence was critically appraised and synthesized thematically to identify commonalities and contrasts in policy, implementation and emerging challenges. Results: The review identified substantial variation in national suicide prevention strategies, monitoring systems, and policy implementation across the selected countries. Persistent gender- and age-related disparities in suicide patterns were observed, alongside the influence of socio-economic determinants, and the broader mental health effects associated with the COVID-19 pandemic. The findings also underscored the need for robust, gender-sensitive, and data-driven national strategies that are contextually grounded and equitably resourced. Conclusions: This review concludes with recommendations for enhancing mental health sustainability across Europe, emphasizing cross-sectoral coordination, improved surveillance systems, and future research priorities.}, }
@article {pmid42278883, year = {2026}, author = {Scocca, V and Lauda, L and Nocini, R and Dell'Aversana Orabona, G}, title = {Nasal Epithelial Organoids as Translational Platforms in Inflammatory, Infectious, and Precision Medicine Applications: A Systematic Review.}, journal = {Journal of clinical medicine}, volume = {15}, number = {11}, pages = {}, pmid = {42278883}, issn = {2077-0383}, abstract = {Background/Objectives: The airway epithelium plays a central role in host defense, inflammatory signaling, and disease progression across infectious, inflammatory, and genetic respiratory disorders. Human nasal epithelial organoids have emerged as accessible and patient-specific in vitro platforms with increasing translational relevance. This systematic review aimed to critically evaluate the current evidence on nasal epithelial organoid models, focusing on donor characteristics, culture methodologies, differentiation strategies, and translational applications. Methods: A systematic search of PubMed/MEDLINE, Embase, Scopus, Ovid MEDLINE, and Cochrane Library was conducted for studies published between 1990 and April 2026. The review followed PRISMA guidelines and was structured according to the PICOTS framework. Eligible studies included in vitro experimental investigations using human-derived nasal epithelial organoids in infectious, inflammatory, or precision medicine contexts. Risk of bias was assessed using the QUIN tool. Results: Seventeen studies met the inclusion criteria. Applications clustered into three principal domains: infectious disease modeling, inflammatory and epithelial remodeling research, and cystic fibrosis precision medicine. Most studies employed expandable three-dimensional Matrigel-embedded organoids or organoid-derived air-liquid interface systems. Infection-focused studies demonstrated variant-specific viral replication dynamics and epithelial immune responses, while inflammatory models reproduced disease-associated differentiation and remodeling phenotypes. Cystic fibrosis oriented studies showed that organoid swelling and electrophysiological assays correlate with CFTR functional rescue and, in selected cases, clinical response. Methodological heterogeneity across protocols and outcome reporting precluded quantitative synthesis. Conclusions: Human nasal epithelial organoids represent versatile translational platforms bridging accessible patient-derived tissue and advanced airway disease modeling. Although variability in culture protocols and functional benchmarks limits standardization, these models hold significant promise for mechanistic investigation, therapeutic stratification, and precision medicine applications.}, }
@article {pmid42279108, year = {2026}, author = {Balan, A and Graham, G and Herban, S and Marcu, M and Gheorghe, N and Mara, G and Rasinar, FC and Lascu, A and Mot, CI and Dan, TF and Mihaicuta, S and Frent, SM}, title = {Transcutaneous Auricular Vagus Nerve Stimulation for Post-COVID-19 Condition: A Systematic Review and Critical Appraisal of Clinical Evidence.}, journal = {Journal of clinical medicine}, volume = {15}, number = {11}, pages = {}, pmid = {42279108}, issn = {2077-0383}, abstract = {Background: Long COVID, or post-COVID-19 condition (PCC), affects around 36% of individuals following SARS-CoV-2 infection, manifesting as persistent fatigue, cognitive dysfunction, and dysautonomia among its hallmark features. Affecting an estimated 400 million individuals globally, it imposes an annual economic burden exceeding $1 trillion, yet no pharmacological therapy has demonstrated consistent efficacy in adequately powered randomized controlled trials. Transcutaneous auricular vagus nerve stimulation (taVNS) has emerged as a candidate intervention targeting the autonomic dysfunction and neuroinflammation responsible for PCC pathophysiology. Methods: We conducted a PRISMA 2020-compliant systematic review (PROSPERO: CRD420261287286) searching PubMed, Scopus, Cochrane, and Web of Science databases from inception to January 2026 for studies evaluating any form of VNS in adults with Long COVID. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool, the JADAD scale, and the PEDro scale. Certainty of evidence was evaluated using the GRADE framework. Narrative synthesis followed SWiM guidelines. Results: Five studies (n = 154 participants) (three randomized controlled trials (RCTs) and two single-arm studies) met inclusion criteria. Three of five studies (60%) were rated high overall risk of bias; only two RCTs achieved "some concerns." The only adequately double-blinded RCT found no significant between-group differences across all outcomes. Paradoxically, in the best-powered RCT (Percin et al.), sham stimulation produced significantly greater fatigue improvement than active taVNS, despite active taVNS producing significant HRV increases consistent with cardiac autonomic modulation. All efficacy outcomes were rated "very low" certainty (GRADE); safety was rated "low" certainty. Conclusions: Currently available evidence supporting the use of taVNS for Long COVID remains limited, and the absence of reliable target engagement markers in the included studies constrains confidence in this approach. Nonetheless, the physiological rationale remains sound, and the favorable safety profile across all included studies supports the feasibility of future investigation. However, given that positive findings were confined to inadequately controlled studies, enthusiasm for further research should be directed first toward mechanistic clarification and rigorous dose-finding work. Large-scale, double-blind, sham-controlled trials incorporating validated markers of vagal engagement are required before taVNS can be firmly recommended for COVID-19 sequelae management.}, }
@article {pmid42280324, year = {2026}, author = {Morales-Juárez, A and Reed, JB and Romanovich-Brown, O and Tooze, JA and Eicher-Miller, HA}, title = {How Is U.S. Food-Insecurity Related to Dietary Quality? A Scoping Review to Inform Nutrition Security Across the Lifespan.}, journal = {Nutrients}, volume = {18}, number = {11}, pages = {}, pmid = {42280324}, issn = {2072-6643}, support = {Elevating the Visibility of Research: Seed Funding for Academic Books and Monographs//Purdue University System/ ; Hatch Project IND90005789//United States Department of Agriculture/ ; Danone International Prize for Alimentation//Fondation pour la Recherche Médicale/ ; }, mesh = {Humans ; United States ; *Food Security ; *Food Insecurity ; *Diet ; Child ; Adult ; Nutritive Value ; Female ; Adolescent ; Infant ; Child, Preschool ; }, abstract = {Background/Objectives: This review examined how different levels of U.S. food-security (FS) relate to dietary markers, informing the concept of nutrition security over the lifespan. Methods: The authors followed PRISMA-ScR guidelines. PubMed, CINAHL, Scopus, Embase, and CAB Abstracts were searched for eligible U.S.-based, English-language studies examining FS and dietary markers in free-living, disease-free populations, excluding COVID-19-era research. Two reviewers independently screened records in Covidence, with discrepancies resolved by a third reviewer. The percentage of studies evaluating >2 FS levels was determined. Dietary markers were classified into three domains: food and beverage (9 components), nutrient (16 components) and bioactive (2 components) markers. The percentages of studies with significant differences were estimated for each dietary domain. Results: Of 1069 records, 78 met full-text eligibility. Among these, 15% evaluated dietary markers across >2 FS levels. Among adults, differences by FS status were observed in 67% of assessed food and beverage components (6 out of 9), 50% of nutrient components (8 out of 16), and all evaluated bioactives (100%; 2 out of 2). Children exhibited differences in all assessed food and beverage components (100%; 9 out of 9) and 29% (2 out of 7) of nutrients by FS level. Adolescents had fewer dietary marker differences than children and adults. Findings among infants, pregnant women and older adults were limited, with no studies for lactating women. Conclusions: Low FS level is associated with poorer dietary markers across the lifespan compared with FS. Age-specific differences highlight the need for targeted interventions and nutrition security measures.}, }
@article {pmid42280413, year = {2026}, author = {Lesgards, JF}, title = {Whey Proteins and Immunity: Mechanisms Underlying Immune System Reinforcement and Protection Against Viral and Bacterial Infections.}, journal = {Nutrients}, volume = {18}, number = {11}, pages = {}, pmid = {42280413}, issn = {2072-6643}, mesh = {Animals ; Humans ; *Bacterial Infections/prevention & control/immunology ; Bioactive Peptides, Dietary ; COVID-19/immunology/prevention & control ; Immunity, Innate ; Lactalbumin/administration & dosage ; Lactoferrin/administration & dosage ; Milk Proteins ; *Virus Diseases/prevention & control/immunology ; *Whey Proteins/administration & dosage/immunology ; Dietary Supplements ; }, abstract = {This review aims to examine the immunological, anti-inflammatory, antiviral, and antibacterial activities of key whey and milk proteins, specifically lactoferrin, glycomacropeptide, β-lactoglobulin, α-lactalbumin and their derived peptides, particularly lactoferricin and lactoferrampin, highlighting their potential as preventive or therapeutic agents. Whey and dairy products represent complex biological matrices that, beyond their high nutritional value, serve as reservoirs of bioactive proteins and peptides with documented health-promoting properties. It has been reported that certain whey proteins (WPs) and whey-derived peptides may contribute to improvements in both innate and adaptive immunity, exert direct antiviral and antibacterial effects while also modulating host defenses through immunoregulatory, antioxidant, and anti-inflammatory activities. These mechanisms contribute not only to enhanced resistance against viral pathogens but also to maintaining intestinal homeostasis and microbiota balance, both of which are critical during infection. In recent years, particularly in the context of the COVID-19 pandemic, natural bioactive compounds derived from whey, and, more broadly, milk, have attracted increasing attention as potential adjuncts or alternatives to conventional antivirals, with reported activity not only against SARS-CoV-2, influenza but also other viral and microbial infections. Despite encouraging in vitro and in vivo evidence, clinical validation remains limited, and the antiviral and immunomodulatory effects of WPs still require deeper mechanistic clarification. Future research should focus on identifying molecular targets, as well as characterizing the pharmacokinetics and safety profiles of WPs and WP peptides across diverse clinical settings. At the same time, attention should be given to optimizing their application as nutraceuticals or functional dairy ingredients.}, }
@article {pmid42281865, year = {2026}, author = {Papic, N and Kosuta, I and Ljubas, D and Vrsaljko, N and Sesa, V and Domislovic, V and Ahsan, S and Mrzljak, A}, title = {Not just another shot: Tailoring vaccination in the era of modern liver transplantation.}, journal = {World journal of transplantation}, volume = {16}, number = {2}, pages = {118012}, pmid = {42281865}, issn = {2220-3230}, abstract = {Infections remain a leading cause of morbidity and mortality in patients with cirrhosis and liver transplantation (LT). Vaccination is underutilized despite proven benefits, and responses are often blunted by cirrhosis-associated immune dysfunction and post-transplant immunosuppression. This review synthesizes current evidence and recent advances in vaccination strategies for adult LT recipients, emphasizing optimal timing, novel vaccine platforms, and precision vaccinology. We discuss emerging data on coronavirus disease 2019, respiratory syncytial virus, and new pneumococcal and hepatitis B vaccines, highlight strategies to overcome immunogenicity gaps, and address implementation barriers. A practical roadmap and clinician-focused algorithms are proposed to integrate vaccination into the continuum of LT care.}, }
@article {pmid42285439, year = {2026}, author = {Michas, G and Trikas, G and Trikas, A}, title = {Cardiovascular Risk Factors in Greece: Looking Beyond the Classics. A narrative review.}, journal = {Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.hjc.2026.06.002}, pmid = {42285439}, issn = {2241-5955}, abstract = {Cardiovascular disease is the leading cause of death in Greece, despite substantial reductions in age-standardized mortality over recent decades. These improvements have been largely confined to older populations, while the burden of cardiometabolic risk remains high. The Greek cardiovascular landscape has also evolved under the combined influence of population aging, the COVID-19 pandemic, persistent socioeconomic pressures, and increasingly stringent European Society of Cardiology targets for lipid and blood pressure control. Traditional determinants, particularly dyslipidemia, hypertension, diabetes, obesity, unhealthy dietary patterns, smoking, and physical inactivity, remain prevalent and frequently suboptimally controlled. Against this background, residual risk and emerging determinants of disease are increasingly recognized as clinically relevant contributors to cardiovascular burden. This narrative review summarizes recent evidence on the role of non-traditional risk factors in the Greek population, including lipoprotein(a), inflammation, metabolic dysfunction-associated steatotic liver disease, chronic kidney disease, chronic obstructive pulmonary disease, sleep disturbances, infections and vaccination, environmental exposures, mental health, and social determinants of health. Overall, the available evidence supports a broader cardiovascular prevention framework that extends beyond conventional risk-factor assessment. Integrating selected non-traditional determinants into clinical practice and prevention policy may improve risk stratification, support individualized care, and help address the evolving cardiovascular burden in Greece.}, }
@article {pmid42285845, year = {2026}, author = {Chen, PC and Hsu, YL and Wu, LS and Liu, XL and Tsai, HJ and Wang, JY and , }, title = {Pediatric post-acute sequelae of SARS-CoV-2 infection in Taiwan: Insights from the DISCOVER cohort.}, journal = {Pediatrics and neonatology}, volume = {67}, number = {4}, pages = {343-349}, doi = {10.1016/j.pedneo.2026.03.007}, pmid = {42285845}, issn = {2212-1692}, mesh = {Humans ; Taiwan/epidemiology ; *COVID-19/complications/diagnosis/epidemiology ; Post-Acute COVID-19 Syndrome ; Child ; Cohort Studies ; SARS-CoV-2 ; }, abstract = {The post-acute sequelae of SARS-CoV-2 infection (PASC), or long COVID, represent a multifaceted challenge in pediatric populations, characterized by symptoms persisting beyond the acute phase. In Taiwan, where early public health measures initially contained the pandemic, the 2022 Omicron surge prompted focused investigation into pediatric PASC, highlighting the critical need for longitudinal data in this specific demographic. To address this challenge, the Diagnosis and Support for COVID Children to Enhance Recovery (DISCOVER) study was established as a prospective, multidisciplinary cohort. By employing a multimodal approach, this study characterizes the clinical landscape of pediatric PASC in Taiwan through validated screening instruments, AI-driven diagnostics, and pulmonary assessments, while concurrently evaluating immune biomarkers, vaccination protection, and vitamin D intervention. This review synthesizes comprehensive findings from the cohort. While the acute phase of infection was predominantly mild, a substantial proportion of children experienced persistent multisystem symptoms, with fatigue, respiratory issues, and somatic complaints being most prevalent. Vaccination was found to significantly modify the disease trajectory, offering protection against subsequent gastrointestinal sequelae and preserving pulmonary function by mitigating small airway resistance. Furthermore, advanced diagnostic modalities, including impulse oscillometry and deep learning-assisted echocardiography, successfully unmasked subclinical organ dysfunction that conventional methods often failed to detect. Mechanistic investigations revealed that symptom severity was closely linked to elevated anti-nucleocapsid antibody titers, while markers of T-cell exhaustion evidenced persistent immune dysregulation, rather than ongoing viral replication. Notably, a preliminary single-center randomized controlled trial within this cohort provided early evidence that vitamin D supplementation may reduce the overall symptom burden and modulate pro-inflammatory cytokine profiles in children with PASC. Collectively, these findings underscore the multisystem nature and immune-driven mechanism of pediatric PASC, while highlighting the role of vaccination, advanced diagnostics, and targeted nutritional interventions in improving recovery. CLINICAL TRIAL REGISTRATION: NCT05426291 (ClinicalTrials.gov).}, }
@article {pmid42286395, year = {2026}, author = {Jia, Y and Han, X and Ma, Y and Wang, X and Yang, Y and Zhang, A and Ding, K and Chen, S}, title = {Reverse genetics strategies for coronaviruses: platform construction and applications in vaccine development.}, journal = {Virus genes}, volume = {}, number = {}, pages = {}, pmid = {42286395}, issn = {1572-994X}, support = {ZDYF202605//Xinxiang Major Science and Technology Special Project/ ; 252102111004//the Science and Technology Research Project of Henan Province/ ; }, abstract = {The continuous emergence of novel coronaviruses, characterized by high mutation rates and frequent recombination events, poses severe threats to global "One Health." Notably, the recent outbreak of the recombinant feline coronavirus (FCoV-23) and the persistence of SARS-CoV-2 variants underscore the urgent need to understand viral pathogenesis and cross-species transmission mechanisms. Reverse genetics technology serves as a critical platform for bridging genomic sequencing to functional virology, enabling targeted mutagenesis and the generation of recombinant viruses. However, the construction of reverse genetics systems for coronaviruses is often hampered by their exceptionally large genomes and the instability of viral cDNA sequences in bacterial hosts due to cytotoxicity. This review moves beyond a simple enumeration of methods to systematically compare current reverse genetics strategies-including in vitro ligation, bacterial artificial chromosome (BAC) systems, and transformation-associated recombination (TAR)-across different viral genera. Furthermore, we critically evaluate the application of these platforms in deciphering pathogenic mechanisms and developing next-generation vaccines, with a specific focus on overcoming technical bottlenecks and designing broad-spectrum countermeasures against emerging cross-species threats.}, }
@article {pmid42286517, year = {2026}, author = {Adnyanaschah, R and Abdulah, R and Oktora, MP}, title = {Clinical manifestations and laboratory findings in patients coinfected with dengue virus and SARS-CoV-2: a systematic review.}, journal = {BMC infectious diseases}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12879-026-13752-2}, pmid = {42286517}, issn = {1471-2334}, abstract = {BACKGROUND: Dengue Hemorrhagic Fever and Coronavirus disease 2019 (COVID-19) are infectious diseases caused by dengue virus (DENV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). While DENV remains endemic in many tropical regions, SARS-CoV-2 spread globally beginning in 2020. Reports of coinfection have emerged from several countries. This systematic review describes the clinical manifestations and laboratory findings reported in patients coinfected with DENV and SARS-CoV-2.
METHODS: This review followed the PRISMA guidelines and collecting data from PubMed for articles published between 2020 and 2025 that discussed DENV and SARS-CoV-2 coinfection. Eligible study designs included theoretical articles, case reports, case series, and cohort studies. Data were synthesized descriptively due to heterogeneity and the absence of comparator groups.
RESULTS: Fifteen studies met the inclusion criteria, identifying 65 patients with SARS-CoV-2 and DENV coinfection. Reported symptoms included fever (69%), vomiting (57%), abdominal pain (55%), rash (54%), and shock (51%). Laboratory findings also showed hematological and physiological alterations including hypotension (57.14%), tachypnea (50%), fever (62.5%), neutropenia (33.33%), neutrophilia (50%), lymphopenia (42.86%), and lymphocytosis (28.57%). These percentages represent descriptive counts across heterogeneous case reports and do not reflect prevalence estimates.
CONCLUSIONS: Patients with DENV and SARS-CoV-2 coinfection exhibit a range of clinical and laboratory abnormalities, but the available evidence-primarily case reports and case series without comparator groups-does not allow conclusions about disease severity or prognosis relative to monoinfection. The findings should therefore be interpreted as descriptive and hypothesis-generating. Careful diagnostic evaluation and clinical monitoring remain essential in suspected coinfection cases.
CLINICAL TRIAL NUMBER: Not applicable.}, }
@article {pmid42288770, year = {2026}, author = {Lamadrid, A and Leiva-Escobar, I and Soza, A and Quentin, W}, title = {Impact of the COVID-19 pandemic on hepatitis C care across the cascade of care: a scoping review.}, journal = {BMC infectious diseases}, volume = {26}, number = {1}, pages = {}, pmid = {42288770}, issn = {1471-2334}, mesh = {Humans ; *COVID-19/epidemiology ; *Hepatitis C/therapy/diagnosis/epidemiology ; SARS-CoV-2 ; Pandemics ; Europe/epidemiology ; Hepacivirus ; }, abstract = {BACKGROUND: The COVID-19 pandemic was associated with widespread health services disruption, including challenges in the management of chronic infectious diseases. However, evidence regarding reported changes in hepatitis C virus (HCV) care during this period remains limited and fragmented. We aimed to map the available evidence on reported changes in HCV care during the COVID-19 pandemic across the HCV cascade of care.
METHOD: We conducted a scoping review following the Arksey and O'Malley methodological framework. Searches of Medline (PubMed), Cochrane Library, Embase, Scopus, Web of Science, and grey literature identified studies reporting pandemic-related changes in HCV diagnosis, linkage to care, treatment, or cure from; March 2020 to March 2025. Data were extracted on the study setting, stage of the cascade of care, and observed changes in HCV care, and synthesized narratively.
RESULTS: Twenty-eight studies met the inclusion criteria. Eighteen were conducted in Europe and North America. Most studies found declines in HCV care across all stages of the cascade of care: diagnosis (15 of 21 studies), linkage to care (9 of 10), treatment initiation or completion (18 of 27), and cure (6 of 13). Among the included studies, linkage to care was the stage most consistently reported as disrupted.
CONCLUSION: Evidence on reported changes in the HCV cascade of care during the COVID-19 pandemic is limited and geographically skewed toward high-income countries. Available data suggest service reductions across all stages, with linkage to care being the stage most frequently reported as disrupted among the studies that assessed it. Strengthening surveillance, ensuring routine monitoring at all stages of the cascade of care, and building resilient HCV services are critical to safeguarding progress toward the 2030 hepatitis elimination goal.}, }
@article {pmid42290783, year = {2026}, author = {Shah, SFA and Tharwat, M and Rehman, A and Alshanbari, FA}, title = {The impact of bacterial and viral diseases on dromedary camel (Camelus dromedarius) welfare: a comprehensive review.}, journal = {Frontiers in veterinary science}, volume = {13}, number = {}, pages = {1795334}, pmid = {42290783}, issn = {2297-1769}, abstract = {Dromedary camels (Camelus dromedarius) are vital to food security, livelihoods and cultural identity in arid and semi-arid regions of Africa, the Middle East and South Asia, with global populations exceeding 35-40 million and continuing to rise as climate change favors livestock adapted to harsh environments. Despite their expanding roles in meat and milk production, transport, tourism and racing, camel health and welfare remain comparatively underexplored, particularly regarding infectious diseases. This review synthesizes current knowledge on major bacterial infections, including brucellosis, tuberculosis, mastitis, suppurative infections, salmonellosis, and clostridial diseases, as well as important viral diseases such as Middle East respiratory syndrome coronavirus, camel pox, Rift Valley fever, rabies, contagious ecthyma, and peste des petits ruminants, with a focus on their implications for animal welfare. These diseases commonly lead to acute and chronic pain, fever, respiratory compromise, reproductive failure, debilitation, and mortality, and are associated with physiological stress responses such as activation of the hypothalamic-pituitary-adrenal axis and increased acute-phase proteins, alongside behavioral changes including lethargy, reduced grooming, altered social interactions, and impaired maternal and working behaviors. Using the Five Freedoms and the Five Domains Model frameworks, this review demonstrates how infectious diseases undermine multiple dimensions of camel welfare, including nutrition, physical comfort, health, behavior, and mental state. Beyond individual animals, camel diseases have significant socioeconomic and ethical implications. Several pathogens are zoonotic, posing risks to pastoralists, veterinarians, and other stakeholders, and influencing trade regulations, disease control strategies, and culling practices, which may further exacerbate welfare compromise. Key knowledge gaps remain, including the lack of validated camel-specific welfare assessment tools, limited longitudinal data on welfare trajectories during disease outbreaks, and insufficient integration of welfare indicators into surveillance and control programs. The review highlights priority research and policy needs, including the development of field-adapted welfare scoring systems, evaluation of welfare impacts of interventions such as vaccination and movement restrictions, and stronger integration of animal welfare into One Health and One Welfare frameworks to support sustainable camel production and resilient dryland livelihoods.}, }
@article {pmid42291020, year = {2026}, author = {Khani, E and Afsharirad, H and Yadegari, AT and Zarezadeh, M and Asham, H and Bannazadeh-Baghi, H and Entezari-Maleki, T}, title = {Nirmatrelvir/Ritonavir Efficacy in Immunocompetent Patients with Confirmed Omicron Variant of Severe Acute Respiratory Syndrome Coronavirus 2: An Updated Systematic Review and Meta-analysis.}, journal = {Journal of research in pharmacy practice}, volume = {15}, number = {1}, pages = {20}, pmid = {42291020}, issn = {2319-9644}, abstract = {The high mutations of the Omicron variant of severe acute respiratory syndrome coronavirus 2 raised concerns regarding the efficacy of antivirals. This meta-analysis aimed to determine the impact of nirmatrelvir/ritonavir on the outcomes of immunocompetent patients with confirmed Omicron variant. Three reviewers systemically searched PubMed (Medline), Cochrane Library, and Embase databases up to June 9, 2025. Randomized clinical trials (RCTs) and observational studies with a control group were screened for eligibility to extract data. Studies that included only patients with immunosuppression, malignancy, or renal failure, severe disease, or assessed nirmatrelvir/ritonavir efficacy on variants other than Omicron were excluded. Forty-six observational studies, including 6,099,805 participants, were involved in the meta-analysis. Our findings revealed that nirmatrelvir/ritonavir significantly decreases death (risk ratio [RR] =0.31; 95% confidence interval [CI]: 0.23-0.40), disease progression (RR = 0.57; 95% CI: 0.42-0.71), hospitalization (RR = 0.45; 95% CI: 0.35-0.56), composite outcome of hospitalization and death (RR = 0.58; 95% CI: 0.44-0.71), ventilation (RR = 0.46; 95% CI: 0.19-0.72), and intensive care unit admission (RR = 0.56; 95% CI: 0.38-0.73) compared to the control group. However, no significant difference was shown across the two groups regarding hospitalization duration (mean difference = -2.34; 95% CI: -5.60-0.93). The current updated meta-analysis supported the efficacy of nirmatrelvir/ritonavir on the Omicron variant. However, further RCTs are recommended for accurate results.}, }
@article {pmid42291037, year = {2026}, author = {Seboka, BT and Ma, L and Magliano, DJ and Talic, S and Junior, ADSM and Borlotti, A and Brears, HT and Dennis, A and Banerjee, A and Marwick, TH and Huynh, Q}, title = {The impact of post-acute sequelae of COVID-19 on cardiac function and structure: A systematic review and a hybrid individual participant data meta-analysis.}, journal = {American journal of preventive cardiology}, volume = {27}, number = {}, pages = {101457}, pmid = {42291037}, issn = {2666-6677}, abstract = {BACKGROUND: Post-acute sequelae of SARS-CoV-2 infection (PASC), also referred to as Long COVID, affect a significant proportion of COVID-19 survivors, with evidence suggesting cardiovascular involvement. However, the nature, extent, and clinical significance of these alterations remain uncertain.
AIM: To synthesize evidence on structural and functional cardiac alterations in individuals with PASC compared with those without PASC.
METHOD: We systematically searched seven databases. Random-effects meta-analyses were performed and supplemented by individual participant data (IPD) analyses from three studies. Univariable and multivariable meta-regressions examined associations with study-level characteristics. Publication bias and evidence certainty were assessed using standard methods (funnel plots, Egger's test, trim-and-fill, and GRADE).
RESULTS: From 3580 records, 17 studies with 4852 participants (3173 PASC, 1679 controls) met the inclusion criteria. IPD analysis revealed an impairment in global longitudinal strain (GLS) (mean difference (MD) = 3.63 %) in individuals with PASC. When using categorical thresholds, 58 % of individuals with PASC had GLS < 16 %, indicating a significant prevalence of subclinical left ventricular dysfunction. Meta-analysis supported these findings, showing impaired GLS (MD = 1.07 %), along with reductions in left ventricular ejection fraction (MD = -1.30 %) and left ventricular end-diastolic volume (MD=-3.98 mL). Meta-regression showed that cardiac dysfunction was more frequently observed in individuals with older age, diabetes, and hypertension.
CONCLUSION: This review indicates that PASC is associated with modest, subclinical alterations in cardiac function. These alterations appear more pronounced in older adults and those with cardiometabolic comorbidities, highlighting the potential value of risk-stratified cardiovascular surveillance in individuals with PASC. The long-term clinical relevance of these changes remains unclear and warrants further study.}, }
@article {pmid42291464, year = {2026}, author = {Nwokocha, C and Palacios, J and Kolawole, T and Nwokocha, M and Anyaorah, C and Chiroma, JH and McGrowder, D and Orie, N and Husaini, DC}, title = {Toward Precision in Myocardial Injury Management: A Critical Synthesis and the C.A.L.I.B.R.A.T.E. Framework for Biomarker Integration.}, journal = {Clinical Medicine Insights. Cardiology}, volume = {20}, number = {}, pages = {11795468261454738}, pmid = {42291464}, issn = {1179-5468}, abstract = {Cardiovascular diseases remain the leading cause of global mortality, necessitating precise strategies for diagnosing and managing myocardial injury. This review critically synthesizes the current biomarker landscape and proposes an integrative framework to address the significant translational gaps between biomarker science and clinical practice. We conducted a comprehensive critical review, analyzing established and emerging biomarkers, including cardiac troponins, natriuretic peptides, and inflammatory and fibrotic markers, within the context of biological confounders, etiology-specific challenges, and clinical implementation barriers. Through thematic synthesis, we developed the novel C.A.L.I.B.R.A.T.E. framework to structure biomarker integration. While high-sensitivity assays have improved detection, they reveal chronic elevations in conditions like renal dysfunction, aging, and heart failure, reducing specificity and complicating acute diagnosis. Emerging biomarkers (eg, sST2, galectin-3) offer prognostic insight but lack therapeutic guidance and specificity. Etiology-specific puzzles (eg, myocarditis, COVID-19, MINOCA) highlight the limitations of isolated biomarker interpretation. The C.A.L.I.B.R.A.T.E. framework addresses these gaps by integrating Clinical context, Assay characteristics, Likelihood, Injury mechanism, Biomarker profiles, Rule-out/in thresholds, Adjunctive tests, Time kinetics, and Etiologies & comorbidities. The future of myocardial injury management depends on shifting from isolated biomarker measurement to integrated, algorithm-driven interpretation. The C.A.L.I.B.R.A.T.E. framework provides a structured pathway for personalized diagnostic reasoning, bridging the translational chasm and advancing precision cardiology through context-dependent, multi-modal data synthesis.}, }
@article {pmid42291864, year = {2026}, author = {Vipler, BS and Arnet, C and Keniston, A and Mardo, M and King, CJ}, title = {Balancing the Positives and Negatives: A Bibliometric Analysis of Positive and Negative Study Publication Patterns in High-Impact General Medical Journals.}, journal = {Cureus}, volume = {18}, number = {5}, pages = {e108720}, pmid = {42291864}, issn = {2168-8184}, abstract = {Despite calls to publish negative studies in prominent medical journals, greater submission and acceptance of positive results remains an issue. We aimed to quantify the degree to which high-impact general medical journals publish negative study results. We searched MEDLINE/PubMed for all randomized controlled trials published in five high-impact general medicine journals: Annals of Internal Medicine, the British Medical Journal (BMJ), the Journal of the American Medical Association (JAMA), the Lancet, and the New England Journal of Medicine (NEJM). Our search spanned a 10-year period from 2014 to 2023, which included data from before and after the emergence of the COVID-19 global pandemic. We performed single-author data extraction via abstract review to determine study positivity, defined as statistical significance for the primary outcome, flagging abstracts for secondary review if positivity was not clear. Two authors reviewed all flagged abstracts. We calculated the proportion of negative studies (i.e., not meeting statistical significance for the primary outcome) overall, by journal, and by publication year. We used logistic regression to model the odds of a study reporting a negative result by journal and year. Our search yielded 3722 individual citations, with screening resulting in 3600 randomized controlled trials for review, with 31% of studies reporting negative results. The proportion of negative studies varied, ranging from 22% in the Lancet to 51% in BMJ and JAMA. The proportion of negative studies remained consistent over time. High-impact general medical journals vary widely in the percentage of negative studies that they publish but did not change over time, even during and after a global pandemic. Further study is needed to determine factors influencing this phenomenon and what can be done to minimize publication bias.}, }
@article {pmid42292375, year = {2026}, author = {Salvador Ibarra, IJ and Mora Guzmán, Z and Borrás Enríquez, AJ and Alpuche, J and Castañeda-Hernández, G and Pérez-Campos, E and Hernández-Huerta, MT and Cabrera-Fuentes, HA}, title = {Proteomic signals are not equal clinical phenotypes: redefining evidence standards in arbovirus-SARS-CoV-2 cross-reactivity.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1849848}, pmid = {42292375}, issn = {1664-3224}, mesh = {Humans ; *Proteomics/methods ; Cross Reactions/immunology ; *SARS-CoV-2/immunology ; *Dengue Virus/immunology ; *COVID-19/immunology ; Phenotype ; *Dengue/immunology/virology ; }, abstract = {The interaction between SARS-CoV-2 and dengue virus represents a biologically plausible yet clinically unresolved challenge in regions where both pathogens co-circulate. Emerging omics-based studies propose that prior SARS-CoV-2 exposure may shape a distinct dengue phenotype through immune imprinting and antibody-dependent mechanisms. However, whether these molecular signals translate into clinically meaningful outcomes remains unclear. This Perspective argues that current evidence remains preliminary and insufficient for clinically actionable interpretation, particularly regarding the conflation of group-level proteomic signals with patient-level clinical phenotypes. Using a recent pilot proteomic study as an illustrative example, we highlight key methodological constraints, including pooled sampling, limited sample size, inadequate control of confounding, and absence of longitudinal and clinical validation. We propose a framework for advancing from exploratory omics observations to clinically interpretable evidence, emphasizing patient-level resolution, temporal dynamics, statistical rigor, functional validation, and integration with standardized clinical endpoints. We also examine the clinical and public health consequences of premature inference, including the potential for premature clinical interpretation, overestimation of disease associations, and challenges in translational interpretation. We conclude that proteomic signals should be regarded as hypothesis-generating rather than predictive until supported by robust, reproducible, and clinically anchored evidence.}, }
@article {pmid42292490, year = {2026}, author = {Lu, J and Ahmad, A and Chomont, N and Costiniuk, CT}, title = {Dynamics of HIV reservoirs following repeated anti-SARS-CoV-2 vaccination.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1829485}, pmid = {42292490}, issn = {1664-3224}, mesh = {Humans ; *HIV Infections/immunology/virology ; *SARS-CoV-2/immunology/physiology ; *COVID-19/prevention & control/immunology ; *COVID-19 Vaccines/immunology ; Virus Latency ; Vaccination ; CD4-Positive T-Lymphocytes/immunology/virology ; *HIV-1/physiology ; Disease Reservoirs/virology ; Virus Activation ; }, abstract = {Due to persistent immune dysfunction, People with HIV (PWH) are at increased risk of more severe infections with SARS-CoV-2 and hospitalizations. In several countries, they were listed as a priority group for receiving anti-SARS-CoV-2 vaccines when these vaccines were in scarce supply. These prophylactic vaccines do not completely prevent infections in vaccinated individuals, especially with a heterologous vaccine strain. However, they persistently reduce the severity of breakthrough infections, hospitalization rates and deaths. Although antiretroviral therapy (ART) suppresses HIV replication below the levels detectable by the assays used routinely in clinical care, it does not eliminate viral reservoirs; a small pool of infected cells carrying HIV proviruses integrated into the genomes of CD4[+] T cells and a subset of myeloid cells. Since vaccines work by stimulating these cells, they may theoretically reactivate latent HIV, increase plasma viremia and modulate the size of the HIV reservoir. The apprehension of HIV reactivation in PWH on ART prompted several studies in the past five years to investigate the impact of anti-SARS-CoV-2 vaccination on the markers of HIV persistence. Collectively, these studies have shown that the vaccination is generally safe in PWH on ART and induces only transient increases in viremia with no measurable impact on the size of the reservoir. However, in PWH with unsuppressed viremia, the vaccination was accompanied by more prolonged increases in viremia and in the frequencies of HIV-infected cells. In this review, we discuss these studies, their outcomes, their implications for HIV cure and propose topics for further research.}, }
@article {pmid42292740, year = {2026}, author = {Lora, D and Lalueza Blanco, A and Maestro de la Calle, G and García Reyne, A and Ruíz-Ruigómez, M and Calderón, EJ and Menéndez-Orenga, M}, title = {A visual framework for classifying adaptive design clinical trials using the GATE frame and PICO terminology.}, journal = {Dialogues in health}, volume = {8}, number = {}, pages = {100315}, pmid = {42292740}, issn = {2772-6533}, abstract = {An adaptive design of a clinical trial is a trial design that offers pre-planned opportunities to use accumulating trial data to modify aspects of an ongoing trial while preserving the validity and integrity of that trial. The Consolidated Standards Of Reporting Trials (CONSORT) 2025 statements show the minimum information that should be included in the reporting of trials to ensure that trial protocols and trials reports are clear and transparent. Pre-planned interim analysis of adaptive clinical trials can modify the study population, the randomization, the intervention arms, the primary outcome or the clinical trial phase. Such key aspects can be reported using the Adaptive designs CONSORT Extension (ACE) statement, and additionally, conceptualised and represented using the Graphic Appraisal Tool for Epidemiological (GATE) and the PICO terminology (Population, Intervention, Comparison and Outcome). The main purpose of this article is to show how the GATE frame can complement the ACE guidelines by serving as a teaching tool to explain adaptive design clinical trials to a clinical or nonspecialist audience using examples of clinical trials for the prevention and treatment of COVID-19.}, }
@article {pmid42292916, year = {2026}, author = {Otani, K and Kinoshita, T and Shindo, R and Kurushima, S}, title = {Digital harassment and its mental health impact among healthcare professionals: A scoping review.}, journal = {PCN reports : psychiatry and clinical neurosciences}, volume = {5}, number = {2}, pages = {e70362}, pmid = {42292916}, issn = {2769-2558}, abstract = {Digital harassment, including workplace cyberbullying, online defamation, and social media attacks, has been reported among healthcare professionals. This scoping review systematically maps existing evidence on digital harassment and its mental health consequences among healthcare professionals. Following Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, we searched MEDLINE, Google Scholar, and Ichushi-Web through December 2025. Twenty-four studies from 12 countries were included. Workplace cyberbullying prevalence ranged from 1.5% to 46.6%. Across studies, digital harassment was reported in association with depression, anxiety, burnout, post-traumatic stress disorder (PTSD) symptoms, and moral injury-related experiences, although causal relationships could not be established. Seven included studies (28%) addressed pandemic-related digital harassment, including online abuse and stigmatization of healthcare workers during the COVID-19 period. Within the English- and Japanese-language literature identified in this review, Japanese studies were limited (three studies). From a consultation-liaison psychiatry perspective, harassment following ethically mandated actions may relate to moral injury-related experiences and may warrant further attention to institutional support. Evidence for effective interventions remains scarce. This review suggests that digital harassment may represent an emerging occupational concern with potential mental health implications. The evidence base was predominantly cross-sectional and methodologically heterogeneous, and findings should therefore be interpreted cautiously. Important needs include institutional policies, legal protections, psychological support systems, and further research on intervention effectiveness and cross-cultural patterns.}, }
@article {pmid42294056, year = {2026}, author = {Baumann, H and Thomas, G and Alley, S and Duncan, MJ and Browne, M and Wollesen, B and Vandelanotte, C and Gilson, N}, title = {The past, present and future use of technology-enabled physical activity interventions in clinical and non-clinical populations: a bibliometric trend analysis across four decades.}, journal = {Frontiers in digital health}, volume = {8}, number = {}, pages = {1801405}, pmid = {42294056}, issn = {2673-253X}, abstract = {BACKGROUND: Physical inactivity remains a persistent global health challenge despite long-standing evidence that regular physical activity (PA) reduces chronic disease risk, cognitive decline and premature mortality. In parallel, digital health technologies have expanded rapidly, yet it remains unclear how distinct platform types have emerged, diffused and been differentially adopted in clinical vs. non-clinical populations.
METHODS: We conducted a large-scale bibliometric trend analysis of technology-supported PA interventions indexed in Scopus and SportDiscus, covering records published from 1953 to 2025. Using an active-learning screening workflow with title/abstract screening, sensitivity checks and consensus adjudication, we identified 2,981 eligible studies published between 1988 and 2025 across 757 journals and 63 countries. Studies were coded by population (clinical vs. non-clinical), platform cluster, and author-reported PA outcome direction abstracted from the publication record.
RESULTS: Publications increased markedly after 2008, with smartphone/mHealth and wearable sensors becoming the dominant platform clusters in the 2010s and early 2020s. In the smoothed overall trajectories, publication activity reached its highest level around 2022, followed by a contraction concentrated mainly in mature clinical platform clusters. Non-clinical studies generally adopted newer platforms earlier, whereas clinical studies showed a recurrent lag before converging for more established, accessible technologies. A distinct population-level reversal was visible in mature platforms: non-clinical studies led early smartphone, wearable and web-based uptake, clinical studies became more prominent around the COVID-19 period, and non-clinical studies again predominated by 2025 for smartphone/mHealth, wearable sensors and web applications. Multi-component designs were common, with the strongest network backbone centred on smartphone, wearable and web-based combinations. Reported PA improvement signals were common across both population strata, but these findings reflect patterns in published study reporting rather than comparative effectiveness.
CONCLUSIONS: By providing a platform-centred, cross-population and temporally resolved map of technology-enabled PA interventions, this study identifies mature technology backbones, emerging areas of experimentation, and recurrent translational gaps between clinical and non-clinical contexts. The findings support more theory-informed and implementation-aware intervention design while underscoring that bibliometric prominence should not be equated with real-world efficacy.}, }
@article {pmid42294358, year = {2026}, author = {Chetty, L and Reddy, P and Ramdin, S and Govender, N}, title = {Long term cardiometabolic outcomes in COVID positive patients.}, journal = {Journal of public health research}, volume = {15}, number = {2}, pages = {22799036261445801}, pmid = {42294358}, issn = {2279-9028}, abstract = {In South Africa, approximately 4.5 million confirmed COVID-19 cases and 103,000 deaths have been noted. Symptoms range from being asymptomatic, mild respiratory issues to severe multi-organ failure and consequent death. Cardiometabolic risk factors, viz., type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM), atherosclerosis, chronic kidney disease, hypertension, heart failure, and obesity, are flagged as the most prevalent comorbidities associated with the risk of severe COVID-19 and death. Many who have recovered from hospitalization continue to experience lingering symptoms known as long COVID, which have been linked to new-onset cardiometabolic disorders (CMD). This narrative review thus focusses on the clinical factors and the patient burden of diabetes mellitus and hypertension as two of the most commonly observed CMD, and aims to raise awareness regarding possible cardiometabolic complications. The findings expand the existing literature on the cardiometabolic effects of COVID-19, concentrating on outcomes observed more than three months after the acute phase of the illness.}, }
@article {pmid42298083, year = {2026}, author = {Al-Shami, AS and Anwar, MM}, title = {The lung-brain axis in neurodegeneration: inflammatory, immune, and vascular mechanisms with therapeutic implications.}, journal = {Inflammopharmacology}, volume = {}, number = {}, pages = {}, pmid = {42298083}, issn = {1568-5608}, abstract = {Neurodegenerative and chronic pulmonary diseases represent major global health challenges and have widely been investigated separately. Emerging evidence indicates the existence of a lung-brain axis, through which pulmonary pathology and environmental exposures can influence neurological health. The current review highlights the mechanistic and clinical evidence linking chronic lung inflammation, air pollution, and immune dysregulation to the onset and progression of Alzheimer's disease (AD), Parkinson's disease (PD), Multiple sclerosis (MS), and amyotrophic lateral sclerosis (ALS). A pathway-based framework is presented in which lung inflammation, systemic cytokine release, oxidative stress, blood-brain barrier disruption, immune priming, and protein misfolding mediate lung-to-brain communication. Associations between chronic obstructive pulmonary disease, asthma, particulate matter exposure, and adverse neurological outcomes including cognitive decline, brain atrophy, disease progression, and elevated neurodegenerative risk are emphasized. Specific mechanisms are addressed, including immune-mediated effects in multiple sclerosis, inhalation-driven protein aggregation in Parkinson's disease, and vascular and oxidative injury contributing to dementia and amyotrophic lateral sclerosis. COVID-19 is considered a clinical model of acute lung-brain axis disruption, demonstrating inflammation-driven neurocognitive consequences, and its role in this context was also highlighted. Additionally, potential preventive and therapeutic strategies are discussed, highlighting pulmonary health and environmental exposure reduction as modifiable factors that may help mitigate neurological disease. This integrative review underscores the clinical relevance of the lung-brain axis and calls for interdisciplinary strategies to improve neurological outcomes through pulmonary and environmental interventions.}, }
@article {pmid42298693, year = {2026}, author = {Meng, X and Wang, L and Tian, X}, title = {MSCs/EVs-based therapy targeting DAD: research progress and future perspectives from ARDS and COVID-19 to RP-ILD.}, journal = {Stem cell research & therapy}, volume = {}, number = {}, pages = {}, doi = {10.1186/s13287-026-05115-0}, pmid = {42298693}, issn = {1757-6512}, abstract = {Diffuse alveolar damage (DAD) is the core pathological process of acute lung injury, characterized by dual injury to alveolar epithelial and capillary endothelial cells, initiation of an inflammatory storm, and subsequent fibrotic remodeling, with persistently high clinical mortality. This pathological change is not restricted to a single disease but widely exists in critical pulmonary disorders such as acute respiratory distress syndrome (ARDS), severe COVID-19, and rapidly progressive interstitial lung disease (RP-ILD), acting as a key driver of disease progression. In recent years, mesenchymal stromal cells (MSCs) and their derived extracellular vesicles (EVs) have become research hotspots for their superior immunomodulatory, anti-apoptotic, tissue-repair, and anti-fibrotic properties. Based on the DAD pathological framework, this article systematically correlates epithelial barrier injury, inflammatory cascade amplification and pulmonary fibrotic remodeling with the therapeutic mechanisms of MSCs and their derived EVs in ARDS, COVID-19 and RP-ILD. It aims to provide a solid basis for the clinical translation of MSCs- and EVs-based therapies and promote their development into a mechanism-driven therapeutic paradigm targeting DAD, with great clinical value and academic innovation.}, }
@article {pmid42299918, year = {2026}, author = {Martyn, O and Devos, J and Bourron, P and AbouElwafa, D and Vitoux, O and Fougerolles, TR}, title = {A Cross-Country Evaluation of Respiratory Syncytial Virus and Human Metapneumovirus Surveillance Systems: Identifying Gaps and Best Practices for Improved Disease Monitoring.}, journal = {Reviews in medical virology}, volume = {36}, number = {4}, pages = {e70175}, pmid = {42299918}, issn = {1099-1654}, support = {//Sanofi/ ; }, mesh = {Humans ; *Metapneumovirus/pathogenicity/isolation & purification ; *Respiratory Syncytial Virus Infections/epidemiology/virology ; *Paramyxoviridae Infections/epidemiology/virology ; *Respiratory Syncytial Virus, Human/pathogenicity/isolation & purification ; United States/epidemiology ; *Epidemiological Monitoring ; Japan/epidemiology ; United Kingdom/epidemiology ; Germany/epidemiology ; France/epidemiology ; Spain/epidemiology ; Italy/epidemiology ; Population Surveillance ; }, abstract = {Respiratory syncytial virus (RSV) and human metapneumovirus (hMPV) are seasonal respiratory viruses that can cause severe outcomes, particularly in older adults; however, their burden remains under-captured. The World Health Organisation (WHO) recommends expanding surveillance over pathogens, such as RSV and hMPV, through the Mosaic Respiratory Surveillance Framework. Although COVID-19 accelerated RSV surveillance, similar advancements for hMPV are lacking. This study evaluated and compared RSV and hMPV surveillance across multiple countries. A comparative qualitative analysis of RSV and hMPV surveillance was conducted in France, Germany, Italy, Japan, Spain, the United Kingdom, and the United States using a framework based on the WHO guidance. Surveillance systems were mapped across seven modules: non-medically attended community, virological, community, outbreak, primary care, hospital, and mortality surveillance. Each was assessed using five criteria: granularity, timing, representativeness, sampling strategy, and communication. Sources included public health institution webpages, surveillance subsystems, and peer-reviewed publications. Most countries have dedicated RSV surveillance frameworks, with the United States and Spain having the most comprehensive systems. Key areas for potential improvement included limited adult-centric data and severe outcome reporting. No country had robust surveillance for hMPV (Germany reported hMPV-specific hospital data, whereas France, Germany, and the United Kingdom published sentinel positivity rates), and detection was mainly through influenza or COVID-19 virological surveillance. The absence of hMPV reporting from active sentinel surveillance, year-round monitoring, demographic and severity data, and restricted public information dissemination are common limitations. Significant limitations persist in RSV and particularly hMPV surveillance, highlighting the need for more robust, comprehensive systems.}, }
@article {pmid42300346, year = {2026}, author = {N, SR and Jin, GW and Choy, JH}, title = {Nanochemical modulation of ECM-driven pseudo-resistance: convergent microenvironmental pathways in COVID-19 and cancer.}, journal = {Chemical communications (Cambridge, England)}, volume = {62}, number = {49}, pages = {12205-12215}, doi = {10.1039/d5cc07234d}, pmid = {42300346}, issn = {1364-548X}, mesh = {Humans ; *Extracellular Matrix/metabolism/drug effects ; *COVID-19/pathology ; SARS-CoV-2 ; *Neoplasms/pathology/drug therapy/metabolism ; Tumor Microenvironment/drug effects ; Pulmonary Fibrosis/pathology ; Animals ; }, abstract = {Extracellular matrix (ECM) remodeling is increasingly recognized as a central determinant of inflammation, fibrosis, and therapeutic response across chronic diseases. This Perspective examines how post-COVID-19 pulmonary fibrosis and stromal-driven resistance in solid tumors converge on a shared phenomenon, ECM-driven pseudo-resistance, an extrinsic and reversible microenvironmental state in which pathological matrix architecture, fibro-inflammatory signaling, and immune exclusion transiently limit therapeutic efficacy without conferring stable, mutation-driven cellular resistance. We highlight how nanochemical strategies, including ECM-penetrating and ECM-modulating nanohybrids, can dismantle these physical and signaling barriers by reprogramming matrix stiffness, mechanotransduction, and immune accessibility. By integrating evidence from virology, oncology, and materials science, this review proposes that targeting conserved ECM pathways through advanced nanochemistry offers a cross-disease therapeutic paradigm for overcoming pseudo-resistance in fibrotic and malignant pathologies.}, }
@article {pmid42300867, year = {2026}, author = {Debbag, R and Avila-Agüero, ML and Gentile, A and Torres, J and Torres, C and Vazquez, L and Beltran, C and Brea-Del Castillo, J and Dagan, R}, title = {Post-pandemic impact on the epidemiology of invasive pneumococcal disease: consensus statement from the Latin American Society of Pediatric Infectious Diseases (SLIPE).}, journal = {Expert review of vaccines}, volume = {25}, number = {1}, pages = {2689604}, doi = {10.1080/14760584.2026.2689604}, pmid = {42300867}, issn = {1744-8395}, mesh = {Humans ; *Pneumococcal Infections/epidemiology/prevention & control ; *Pneumococcal Vaccines/administration & dosage/immunology ; Latin America/epidemiology ; Immunization Programs ; *COVID-19/epidemiology ; Streptococcus pneumoniae/immunology ; Caribbean Region/epidemiology ; Vaccines, Conjugate/administration & dosage ; Child ; Vaccination Coverage ; Vaccination ; Incidence ; }, abstract = {INTRODUCTION: The Latin American Society of Pediatric Infectious Diseases (SLIPE) convened a multidisciplinary expert panel to assess the post-pandemic epidemiology of invasive pneumococcal disease (IPD) in Latin America and the Caribbean. The COVID-19 pandemic initially reduced IPD incidence due to non-pharmaceutical interventions, but subsequent relaxation of restrictions, coupled with immunization gaps, led to a resurgence of pneumococcal infections. The consensus statement reviews literature and regional surveillance data to analyze how disrupted vaccination programs, socioeconomic inequities, and weakened healthcare systems amplified the regional vulnerability to vaccine-preventable diseases.
AREAS COVERED: This document addresses epidemiologic changes in IPD following the pandemic, the interplay between respiratory viral infections and pneumococcal disease, trends in pneumococcal conjugate vaccine (PCV) coverage and related barriers, and the emergence of non-vaccine serotypes causing IPD.
EXPERT OPINION: Sustaining herd protection in the region requires strengthening vaccination infrastructure, restoring confidence through effective communication, and ensuring the completion of booster doses in the second year of life. Despite limited serotype data, countries should prioritize the timely adoption of higher-valency PCVs in feasible schedules to mitigate the growing burden of pneumococcal disease and prevent further setbacks in child health.}, }
@article {pmid42302976, year = {2026}, author = {Xie, L and Wu, LH and Ni, XC and Zhang, JN}, title = {Beyond proteostasis: LONP1 as an immunometabolic checkpoint in health and disease.}, journal = {Biochemical pharmacology}, volume = {251}, number = {Pt 2}, pages = {118170}, doi = {10.1016/j.bcp.2026.118170}, pmid = {42302976}, issn = {1873-2968}, abstract = {Mitochondrial Lon protease 1 (LONP1) is an ATP-dependent protease involved in mitochondrial protein quality control, mitochondrial DNA (mtDNA) maintenance, and stress adaptation. Beyond this canonical role, accumulating evidence links LONP1 to metabolic rewiring, inflammatory signaling, immune-cell polarization, and disease-associated mitochondrial dysfunction. Recent human LONP1 cryo-electron microscopy (cryo-EM) structures have revealed nucleotide- and substrate-dependent conformational states, including fold-sensing intermediates, pore-loop rearrangements, and catalytic-site organization, providing a structural framework for substrate processing and state-dependent ligandability. Functionally, LONP1 regulates the turnover or stability of metabolic enzymes such as pyruvate dehydrogenase kinase 4 (PDK4), 3-hydroxy-3-methylglutaryl-CoA synthase 2 (HMGCS2), and aconitase 2 (ACO2), thereby influencing carbon flux, epigenetic regulation, and immune-related metabolic programs. LONP1 deficiency or dysfunction can promote mitochondrial stress responses, including mtDNA release and cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING)-dependent inflammation, with implications for aging, pulmonary fibrosis, developmental disorders such as cerebral, ocular, dental, auricular, and skeletal anomalies (CODAS) syndrome, and organ injury. Conversely, increased LONP1 activity or expression has been associated with tumor progression, desmoplastic remodeling, ferroptosis resistance, and viral pathogenesis in selected models, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coxsackievirus B3 (CVB3). Pharmacological studies, including activators, dual-target inhibitors, and bortezomib-bound structural complexes, support the potential ligandability of LONP1 but also highlight unresolved issues in selectivity, target engagement, mitochondrial toxicity, and context-dependent therapeutic windows. This review summarizes current structural, mechanistic, and pharmacological evidence for LONP1 as a context-dependent immunometabolic regulatory node and discusses limitations and open questions that must be addressed before clinical translation.}, }
@article {pmid42302999, year = {2026}, author = {de Victoria Carazo, JM and Guirao Arrabal, E and Montero-Alonso, MÁ and Yuste Ossorio, ME and García García, F and Hernández Quero, J}, title = {Incidence, mortality and risk factors in COVID-19-associated pulmonary aspergillosis (CAPA): an umbrella review and meta-meta-analyses (2020-2025).}, journal = {Respiratory medicine}, volume = {260}, number = {}, pages = {108960}, doi = {10.1016/j.rmed.2026.108960}, pmid = {42302999}, issn = {1532-3064}, mesh = {Humans ; *COVID-19/complications/epidemiology/mortality ; Critical Illness ; Incidence ; *Pulmonary Aspergillosis/mortality/epidemiology ; Risk Factors ; SARS-CoV-2/physiology ; }, abstract = {INTRODUCTION: COVID-19-associated pulmonary aspergillosis (CAPA) has emerged as a severe and potentially underrecognised complication in patients with SARS-CoV-2 infection, particularly in intensive care units (ICUs). Existing reviews show substantial heterogeneity in diagnostic criteria, incidence estimates, and reported risk factors, limiting reliable interpretation of the overall evidence base.
MATERIALS AND METHODS: this umbrella review synthesised systematic reviews and meta-analyses published between 2020 and 2025 to clarify the incidence, mortality, and risk factors associated with CAPA. Searches were conducted in PubMed and Scopus. Eligibility was restricted to articles published in English and Spanish. Pooled estimates were re-calculated through a dedicated meta-metaanalysis.
RESULTS: sixteen reviews met the inclusion criteria, nine of them with meta-analysis. The pooled incidence among critically ill patients was 11.3% (95% CI 9.2-13.9), strongly influenced by diagnostic variability and the limited use of bronchoalveolar lavage during the pandemic. Overall mortality reached 51.6% (IQR 48.3-54.5), and CAPA tripled the risk of death compared with non-CAPA patients (OR 3.08; 95% CI 2.73-3.49). Consistent risk factors identified across meta-analyses included advanced age (OR 1.05 per year), chronic obstructive pulmonary disease (OR 1.98), type 2 diabetes mellitus (OR 1.25), systemic corticosteroid exposure (OR 1.72), and IL-6 inhibitors (OR 2.32).
DISCUSSION AND CONCLUSIONS: the marked heterogeneity observed across studies highlights the urgent need for harmonised and clinically applicable diagnostic criteria. CAPA remains an underdiagnosed condition associated with substantial mortality, underscoring the importance of early recognition strategies and improved diagnostic availability to guide timely management in high-risk patients.}, }
@article {pmid42303108, year = {2026}, author = {Zhang, T and Zhang, H and Huang, S and Nong, T and Mo, X and Huang, J and Zheng, H and Liu, Y}, title = {Worldwide prevalence of diabetic ketoacidosis at diagnosis of type 1 diabetes: A systematic review and meta-analysis.}, journal = {Preventive medicine}, volume = {210}, number = {}, pages = {108625}, doi = {10.1016/j.ypmed.2026.108625}, pmid = {42303108}, issn = {1096-0260}, mesh = {Humans ; *Diabetic Ketoacidosis/epidemiology ; *Diabetes Mellitus, Type 1/complications/epidemiology/diagnosis ; Prevalence ; *Global Health/statistics & numerical data ; Female ; Delayed Diagnosis ; COVID-19/epidemiology ; }, abstract = {OBJECTIVE: Diabetic ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes (T1D) and a marker of delayed diagnosis, associated with significant morbidity, mortality, and healthcare costs. Global estimates of DKA at T1D onset remain inconsistent.
METHODS: We conducted a systematic review and meta-analysis, searching PubMed (1996), Web of Science (1966), Embase (1947), and Scopus (1980), each from its inception to October 2025, without restrictions. Studies reporting DKA prevalence at diagnosis in individuals <19 years with newly diagnosed T1D were included. Pooled prevalence was calculated using random-effects meta-analysis. Subgroup analyses explored variations by country, region, World Bank income level, and pre- versus post-COVID-19 period; meta-regression examined continuous moderators.
RESULTS: A total of 233 studies from 58 countries (380,191 participants) were included. The pooled global prevalence was 41.9% (CI = 39.7, 44.0; I[2] = 99.3%; prediction interval: 12.9, 74.3), ranging from 15.6% (Sweden) to 78.5% (Thailand). Rates were lower in high-income (38.6%) countries (p < 0.001). Younger age and higher female proportion were independently associated with higher prevalence.
CONCLUSIONS: Approximately two in five children with new-onset T1D present in DKA. The rising trend is indicative of ongoing challenges in achieving timely diagnosis, demanding urgent public health strategies encompassing clinical vigilance and innovative early detection approaches.}, }
@article {pmid42304269, year = {2026}, author = {Conway-Moore, K and Birch, JM and McKinlay, AR and Graham, F and Oliver, EJ and Bambra, C and Kelly, MP and Bonell, C}, title = {The association between populist-aligned views and engagement with public health interventions: a systematic review of longitudinal studies.}, journal = {BMC public health}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12889-026-28020-w}, pmid = {42304269}, issn = {1471-2458}, support = {NIHR206124//National Institute for Health and Care Research/ ; }, abstract = {BACKGROUND: Population-level engagement with public health interventions is needed to achieve impact. Recently, however, there has been evidence of increasing resistance to government-led public health interventions in areas such as vaccination, climate change mitigation, sexual and reproductive healthcare, and non-pharmaceutical-based infection control measures. The rise in populist attitudes that has taken place in many countries over the last two decades may be one potential explanation for this phenomenon, given the importance placed on individual freedom and national sovereignty, and a distrust of scientific, government and other elites within much populist discourse.
METHODS: To understand how populist-aligned views might subsequently influence the receipt of public health interventions, we systematically reviewed quantitative, longitudinal evidence across thirteen bibliographic databases and relevant websites, published between 2008 and 2024. All studies were set in Organisation for Economic Co-operation and Development (OECD) countries and results were synthesised narratively.
RESULTS: Across 16 included studies, much of the evidence focused on COVID-19. We found evidence that prior populist-aligned attitudes have a negative impact on subsequent receipt of public health interventions, such as the COVID-19 vaccine and non-pharmaceutical-based prevention measures against COVID-19 (i.e., engaging in masking and social distancing) through both existing and increasing distrust in elite institutions and actors over time. We also found preliminary evidence about the potentially negative role of populist-aligned attitudes on the receipt of other vaccinations before and during the COVID-19 pandemic.
CONCLUSIONS: From a policy perspective, the findings from this review suggest the need for proactive efforts by political, scientific and medical establishments to build and maintain trust, thereby strengthening the reputation of both the public health leaders and institutions that engage with those more likely to be resistant to public health interventions to increase overall acceptance and uptake.
TRIAL REGISTRATION: PROSPERO registration number CRD4202451312.}, }
@article {pmid42305755, year = {2026}, author = {Sharif, N and Chen, W and Niu, M}, title = {Mental health problems among ethnic minorities during public crises: a systematic review of coping strategies during the COVID-19 pandemic.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1822085}, pmid = {42305755}, issn = {2296-2565}, mesh = {*COVID-19/psychology ; Humans ; *Minority Groups/psychology ; Coping Skills ; *Adaptation, Psychological ; *Ethnicity/psychology ; *Mental Health/ethnology ; Pandemics ; *Mental Disorders/psychology ; SARS-CoV-2 ; }, abstract = {Public health crises exert a disproportionate psychological burden on ethnic minority populations, exacerbating pre-existing health disparities. Drawing upon the COVID-19 pandemic as a focal case, this systematic review synthesizes the coping strategies employed by ethnic minority communities, organized through the lens of ecological systems theory. Adhering to PRISMA guidelines, 65 peer-reviewed studies published between 2020 and 2023 were analyzed. The synthesis identified a multi-tiered coping response: (1) individual-level cognitive-emotional regulation and faith-based practices; (2) microsystem-level familial and communal support and digital mediation; (3) exosystem-level community governance and health policy; and (4) macrosystem-level cultural values and systemic belief structures. The analysis revealed a pronounced research emphasis on individual and microsystemic adaptations, exposing a critical empirical gap concerning structural and policy-driven interventions. While culturally tailored individual support is essential, these findings underscore the need for future research and policy to prioritize integrated, multilevel frameworks capable of effectively mitigating mental health inequities during future public health emergencies.}, }
@article {pmid42307131, year = {2026}, author = {Specchia, ML and Zaçe, D and Cacciuttolo, MG and La Gatta, E and Petrella, L and Messina, R and Beccia, F and Capriolo, A and Turati, G and Di Pietro, ML}, title = {Addressing food and nutrition insecurity in European countries: a scoping review of strategies and policies.}, journal = {Annali dell'Istituto superiore di sanita}, volume = {62}, number = {2}, pages = {163-178}, doi = {10.4415/ANN_26_02_09}, pmid = {42307131}, issn = {2384-8553}, mesh = {Europe ; Humans ; *Food Insecurity ; *Food Supply ; *Nutrition Policy ; Agriculture ; COVID-19/epidemiology ; Food Security ; }, abstract = {BACKGROUND: Food and nutrition insecurity (FNI) is a major public health concern, due to its association with a variety of adverse health outcomes.
OBJECTIVE: The aim of this article is to provide a description of the strategies and policies to mitigate FNI in European countries, with a particular focus on economic, agriculture and social macro-areas.
METHODS: A scoping review, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA) guidelines, was performed to map any study design, reporting policies and strategies that tackle FNI through food and nutrition security (FNS), access, utilization, or stability.
RESULTS: The review identified 13 documents from institutional websites and 6 scientific articles, published from 2005 to 2022. The included papers highlight a multifaceted approach to addressing food insecurity, with policies covering several dimensions. The policies identified can be categorized into several key themes: agriculture and fisheries, nutrition, environment, sustainability, economy, stakeholder's views, COVID-19 pandemic and other crisis, vulnerable populations (women, children, migrants) and information campaigns. The review describes in detail several policies, examining their effectiveness and the challenges faced in ensuring that these initiatives result in tangible improvements in food access, affordability, and nutritional quality, particularly for vulnerable populations.
CONCLUSIONS: The results show a current lack of a specific and coherent policy framework on FNI at a European level. Policy fragmentation is mainly due to the multidimensional nature of FNI, which has interconnections with many different areas of the food system. The findings suggest a comprehensive approach, incorporating several policy measures and involving multiple stakeholders to ensure sustainable and equitable access to nutritious food.}, }
@article {pmid42307996, year = {2026}, author = {Chang, TMS}, title = {Artificial Cells: Perspective on Reconstructing Biological Cells and "Out of the Box" Innovations.}, journal = {Chembiochem : a European journal of chemical biology}, volume = {27}, number = {12}, pages = {e202500933}, pmid = {42307996}, issn = {1439-7633}, support = {271810//Virage Centre of Excellence in High Technology award, McGill University Advancement Program/ ; }, mesh = {Humans ; *Artificial Cells/metabolism/chemistry ; *Erythrocytes/cytology/metabolism ; Oxygen/metabolism ; COVID-19/prevention & control ; }, abstract = {The first artificial cell (Chang 1957, 1964) was in the form of artificial red blood cells (RBCs), one of the most important cells because all cells, tissues, organs, and indeed the human being need it for survival. I first reconstructed artificial RBCs in vitro. This is made of cellular dimensions with ultrathin membranes of polymer, crosslinked protein, protein-lipid, or lipid. The next step in this work is to develop this for actual use to replace RBCs in the body. This is a more complex task requiring modifying the configuration and dimensions. Instead of starting with all three functions, a bottom-up approach is used. First, one with only oxygen transport function shows promising results in clinical trials with patients. A future direction is the development of artificial cells that have all three red blood cell functions including antioxidant, oxygen, and CO2 transport. My research group has also been doing innovative research going outside the box of RBCs. This way, extensive variations in contents, membranes, dimensions, and configurations are possible. This allows for worldwide and innovative applications that encompass hemoperfusion, delivery systems, COVID-19 vaccines, cancer therapy, therapy for hereditary enzyme defects like phenylketonuria, cell/stem cell therapy, microbes, nanomedicine, biotherapeutics, gene therapy, regenerative medicine, agricultural applications, aquatic culture, fermentation, nanorobotics, and other areas.}, }
@article {pmid42309184, year = {2026}, author = {Zhou, W and Xu, P}, title = {Deciphering viral infections at single-cell resolution: From immune dynamics to host-pathogen interactions.}, journal = {Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases}, volume = {143}, number = {}, pages = {105969}, doi = {10.1016/j.meegid.2026.105969}, pmid = {42309184}, issn = {1567-7257}, abstract = {Single-cell RNA sequencing (scRNA-seq) has emerged as a transformative technology in infectious disease research, enabling high-resolution characterization of cellular heterogeneity, immune dynamics, and host-pathogen interactions at the single-cell level. In the context of viral infections-including SARS-CoV-2, hepatitis B virus (HBV), human immunodeficiency virus (HIV), influenza virus, and respiratory syncytial virus (RSV)-scRNA-seq has provided critical insights into immune-cell heterogeneity, immune landscape remodeling, and the emergence of previously unrecognized cellular states. Beyond immune profiling, scRNA-seq enables direct detection of viral transcripts within infected cells. This allows discrimination between productively infected and bystander cells and reveals virus-induced transcriptional reprogramming within target tissues. Additionally, single-cell approaches facilitate the analysis of adaptive immune repertoires through integrated integrated T-cell receptor (TCR) and B-cell receptor (BCR) sequencing sequencing and uncover intra-host viral diversity and evolutionary dynamics at unprecedented resolution. This review summarizes recent advances in the application of scRNA-seq in viral infection research, with a focus on immune regulation, host-pathogen co-transcriptomics, inflammatory signaling pathways, biomarker discovery, and translational implications. Comparative single-cell studies across acute and chronic viral infections have further revealed both shared antiviral programs and virus-specific immune adaptations.We further discuss current technical limitations and emerging computational strategies, as well as future integration with spatial transcriptomics and multi-omics platforms. Collectively, these developments highlight the potential of single-cell technologies to advance mechanistic understanding and guide precision diagnostics and therapeutic strategies in viral diseases.}, }
@article {pmid42309909, year = {2026}, author = {Guedj, E and Horowitz, T and Verger, A}, title = {Brain [18F]FDG PET in Encephalitis and Postinfectious Neurocognitive Syndromes.}, journal = {PET clinics}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.cpet.2026.05.003}, pmid = {42309909}, issn = {1879-9809}, abstract = {Brain [18F]FDG PET can reveal metabolic abnormalities that precede, exceed, or clarify structural MR imaging findings. Among inflammatory brain diseases, the strongest clinical rationale is currently in autoimmune encephalitis, where fluorodeoxyglucose (FDG) PET increases diagnostic sensitivity, supports syndrome-oriented metabolic pattern recognition, and may contribute to selected follow-up. In viral encephalitis, use is selective rather than routine. In post-coronavirus infectious disease (COVID) condition and related postinfectious syndromes, FDG PET may support biological stratification and differential diagnosis in a subset of patients. Interpretation remains highly dependent on clinical context and methods. Translocator protein (TSPO) PET adds mechanistic information on neuroimmune activation but belongs mainly to the research domain.}, }
@article {pmid42310647, year = {2026}, author = {Al-Marwani, S and Murang, Z and Tuah, NA}, title = {Integration technology into health care: a scoping review of digital interventions for adult obesity management.}, journal = {BMC public health}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12889-026-27904-1}, pmid = {42310647}, issn = {1471-2458}, abstract = {BACKGROUND: Digital health interventions are emerging as an approach to support obesity management through self-management and remote care. However, utilization, impact, and practicality remain unclear. This study aims to map research on digital health interventions for obesity management among adults, describing their characteristics, uses, and outcomes, and identifying gaps.
METHODS: A comprehensive scoping review following Arksey and O'Malley's methodological framework, in accordance with the Joanna Briggs Institute's guidelines and reported in line with the PRISMA-ScR guidelines, examined studies published between 2015 and 2025 across four databases: PubMed, Google Scholar, Scopus, and APA PsycNet.
RESULTS: A total of 43 studies met the eligibility criteria. Digital health interventions for obesity encompassed consultations and education on healthy lifestyle, behavioral change strategies, physical activity, dietary management, weight goal setting, intermittent fasting, gamification, and psychological support. Digital health interventions were delivered through telehealth, mobile apps, web-based programs, multicomponent digital approaches integrating several digital tools, and hybrid models combining digital delivery with face-to-face communication. These interventions often supported by devices such as digital scales, wearable trackers, and telemonitoring units to enhance self-monitoring, adherence, and engagement. The interventions were implemented across clinical, workplace, and community settings, including adaptations developed during the COVID-19 pandemic. The included studies showed varying and inconsistently reported outcomes, with some showing significant weight loss, improvements in metabolic markers and behavioral outcomes, including dietary adherence, physical activity, and self-monitoring, as well as favorable feasibility outcomes and the potential to maintain continuity of service delivery during the COVID-19 outbreak.
CONCLUSIONS: Digital health interventions used telehealth, mobile applications, web-based, multicomponent, and hybrid models across different settings, including healthcare settings (e.g., clinical and primary care) and community settings. Digital devices, such as scales, wearables, and activity trackers, were often incorporated to support self-tracking, adherence, and engagement. Reported outcomes included weight loss, improved self-monitoring, and behavioral changes such as enhanced dietary adherence and increased physical activity, and a favorable feasibility outcome; however, these outcomes were not consistently reported across all studies. Key gaps included short follow-up periods and limited evidence from LMICs. Future research should prioritize sustainable, equitable, scalable, culturally adapted, and cost-effective digital interventions.}, }
@article {pmid42310689, year = {2026}, author = {Cornil, A and Roussel, S and Vander Haegen, M and Grenier, C and Vanpee, D and Van den Broucke, S}, title = {Key factors for promoting protective behaviours in future pandemics: an umbrella review.}, journal = {Archives of public health = Archives belges de sante publique}, volume = {}, number = {}, pages = {}, doi = {10.1186/s13690-026-01948-6}, pmid = {42310689}, issn = {0778-7367}, abstract = {BACKGROUND: The COVID-19 pandemic highlighted the critical importance of protective behaviours-such as mask-wearing, hand hygiene, and physical distancing-in managing public health crises. Understanding the factors that influence these behaviours is essential for improving preparedness and response in future health crises. This umbrella review aimed to synthesize evidence on determinants of protective behaviours during pandemics and to provide recommendations for policy and practice.
METHODS: Following PRISMA 2020 guidelines, we conducted an umbrella review of peer-reviewed literature reviews and meta-analyses published up to June 2025. Searches in Epistemonikos, MEDLINE, and Scopus targeted reviews on "protective behaviours" and "COVID-19", including other infectious diseases. Eligibility criteria followed the Population-Concept-Context framework: general population, multifactorial determinants of protective behaviours, and pandemic contexts. Data extraction was performed in a table that included review characteristics, behavioural domains (general compliance, medical interventions, open dialogue promotion, information handling, hygiene, physical distancing, and other behaviours), and factor valence. We conducted a narrative synthesis organizing factors by sociodemographic, personal, and social-environmental categories, with valence classification based on consistency of findings across reviews. Quality appraisal used the Joanna Briggs Institute checklist.
RESULTS: From 86 records identified, 11 met inclusion criteria, covering COVID-19 and other diseases (e.g., H1N1, SARS, MERS, Ebola). Quality scores averaged 8.8/10. Protective behaviours were influenced by three categories of factors: (1) sociodemographic (age, gender, education, socio-economic status) (2), personal (perceptions, beliefs, trust in authorities and science, political orientation) and (3) social/environmental (access to protective materials, social norms, community support, health education and communication, policies). Enabling factors included trust in credible sources, perceived effectiveness of measures, and multimodal communication. Barriers comprised misinformation, conspiracy beliefs, and resource inaccessibility. Some factors (e.g., age, gender, education) showed inconsistent effects across behaviours. Findings underscore the need for culturally sensitive messaging, transparent communication, and targeted interventions for vulnerable populations.
CONCLUSIONS: This umbrella review identifies multi-level determinants of protective behaviours to inform pandemic preparedness. It highlights the need for transparent communication through trusted channels, culturally adapted messaging, equitable access to protective resources, and targeted interventions for low-engagement groups. Integrating these determinants early may enhance population-level adherence.
REGISTRATION: PROSPERO registration number: CRD42023467236.}, }
@article {pmid42311945, year = {2026}, author = {Vasileiou, E and Nena, E and Ntolios, P and Zissimopoulos, A and Constantinides, T}, title = {Vitamin D levels, general health status, and work productivity among healthcare workers-a scoping review of published literature (2010-2025).}, journal = {Frontiers in nutrition}, volume = {13}, number = {}, pages = {1816046}, pmid = {42311945}, issn = {2296-861X}, abstract = {INTRODUCTION: The risk for Vitamin D deficiency has been reported to be elevated among healthcare workers (HCWs), a fact that raises concerns about their health, resilience, and work performance. The objective of the study is to review published literature on Vitamin D deficiency among HCWs, reported health implications as well as the association with productivity.
METHODS: A comprehensive search of two databases (2010-2025), PubMed and Scopus was conducted with Google Scholar used as a supplementary source following PRISMA-ScR guidelines. The inclusion criteria were full-text studies in English enrolling HCWs per WHO definition, measuring serum 25(OH)D, and reporting health or work-related outcomes.
RESULTS: Thirty-six studies met the criteria 30 cross-sectional, 2 prospective, 4 interventional studies, 2 of which were Randomized Controlled Trials (RCTs). Vitamin D deficiency was highly prevalent across studies with reported prevalence ranging from 30% to over 90% varying by geographic region, season, professional role, deficiency threshold and assay method, particularly among nurses and shift workers. Key determinants included indoor work, long shifts, night duties, limited sun exposure, female sex, younger age, higher Body Mass Index (BMI), veiling, and lack of supplementation. Seasonal variation was confirmed. Deficiency was linked to immune vulnerability (higher SARS-CoV-2 infection), musculoskeletal issues, and mixed evidence for mental health outcomes. Limited data suggest higher Vitamin D levels may reduce presenteeism. RCTs demonstrated that high-dose supplementation improved serum levels and reduced respiratory infections.
CONCLUSION: Existing literature points that Vitamin D inadequacy among HCWs represents significant occupational health concern highlighting important evidence gaps and future research priorities.}, }
@article {pmid42311972, year = {2026}, author = {Al Sabbah, H and Bani Hani, A and Bessadet, N and Aremu, O}, title = {A semantic FAIRness framework for epidemiological analysis of COVID-19 data in the UAE.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1759032}, pmid = {42311972}, issn = {2296-2565}, mesh = {*COVID-19/epidemiology ; Humans ; United Arab Emirates/epidemiology ; *Semantics ; SARS-CoV-2 ; *Information Dissemination/methods ; Data Analytics ; }, abstract = {The increasing availability of Coronavirus disease 2019 (COVID-19)-related data has highlighted the need for robust epidemiological analysis to support public health decision-making, particularly in contexts where data are heterogeneous and fragmented. In the United Arab Emirates (UAE), COVID-19 research has generated diverse genomic, clinical, and epidemiological datasets, yet their integration and reuse remain challenging due to inconsistencies in data representation, semantics, and interoperability. This study aimed to review key genomic and epidemiological studies related to COVID-19 in the UAE and, informed by identified gaps, proposes a semantic FAIRness framework for epidemiological data integration and analysis. The framework leverages the FAIR data principles and semantic technologies to provide a conceptual architecture for aggregating heterogeneous data sources, transforming data using ontological models, and enabling semantic linkage and reasoning across datasets. At a conceptual level, the framework is intended to support comparative analysis across studies, facilitate transparent representation of uncertainty, and promote semantically interoperable data sharing among diverse stakeholders. While selected components of the framework build on prior proof-of-concept implementations, the framework as a whole has not yet been fully implemented or empirically evaluated. The proposed approach is therefore positioned as a foundation for future development and evaluation, with the potential to enhance evidence-informed epidemiological analysis and public health decision-making in the UAE and similar contexts.}, }
@article {pmid42313357, year = {2026}, author = {Chhokar, JK and Antonipillai, V}, title = {Prescription Medication Access Among Immigrant and Refugee Populations in Canada: A Scoping Review.}, journal = {Journal of immigrant and minority health}, volume = {}, number = {}, pages = {}, pmid = {42313357}, issn = {1557-1920}, abstract = {Access to prescription medication is a critical component of healthcare; however, immigrant and refugee populations in Canada face barriers that contribute to inequities in access to these essential treatments, which may subsequently influence health outcomes. This scoping review examines the existing literature on prescription medication access among immigrant and refugee populations in Canada, identifying key barriers and addressing knowledge gaps affecting medication access and related health outcomes. The Joanna Briggs Institute scoping review methodology was employed, including 21 peer-reviewed studies and 6 grey literature reports. Using the Socio-Ecological Model of Health (SEM), the findings were synthesized across individual, interpersonal, organizational, community, and societal levels to examine factors influencing prescription medication access among immigrant and refugee populations. Barriers to prescription medication access were identified across multiple SEM levels. At the individual level, language barriers, cultural beliefs regarding medications, and limited health system literacy affected medication access. Interpersonal barriers included challenges in patient-provider communication and concerns regarding privacy. Organizational barriers included structural characteristics of the healthcare system, including the gatekeeper model and limited availability of interpreter services. Community-level barriers included socioeconomic constraints affecting the ability to obtain medications. Societal level barriers included variation in provincial prescription drug coverage, reliance on private insurance, and disruptions associated with the COVID-19 pandemic. Addressing inequities in prescription medication access among immigrant and refugee populations will require coordinated multi-level strategies that improve health system navigation, communication supports, and medication coverage.}, }
@article {pmid42314718, year = {2026}, author = {Abubakar, I and Tellez, D and Aldridge, RW and Altare, C and Barreto, ML and Boukari, Y and Burns, R and Cabieses, B and Devakumar, D and Fouad, F and Hargreaves, S and Knipper, M and Kumar, BN and Langella, R and Lau, K and Madise, N and Miranda, JJ and Mosca, D and Parikh, K and Pocock, N and Rast, E and Romanello, M and Rubenstein, L and Sheikh, K and Stevenson, K and Trummer, U and Zimmerman, C and Spiegel, PB}, title = {The UCL-Lancet Commission on Migration and Health: review of the state of progress.}, journal = {Lancet (London, England)}, volume = {407}, number = {10547}, pages = {2554-2576}, doi = {10.1016/S0140-6736(26)00494-0}, pmid = {42314718}, issn = {1474-547X}, mesh = {Humans ; *Emigration and Immigration/trends ; Health Policy ; *Health Services Accessibility ; *Refugees ; *Transients and Migrants ; }, abstract = {Although progress towards implementation of international agreements since publication of the UCL-Lancet Commission on Migration and Health in December, 2018, has been slow, global trends in migration and forced displacement have continued to rise. However, the COVID-19 pandemic showed that reaching refugees and migrants with health interventions is feasible with political will. The benefits of refugee-inclusive and migrant-inclusive health-care systems during emergencies (eg, COVID-19 and the war in Ukraine) are apparent, with numerous examples of inclusive policy making being rapidly introduced and innovative models developed to support health-care access, including preventive measures such as vaccination. Lessons from these successes should be learned and incorporated into future policy and practice. However, global political and financial uncertainty and disruption-combined with multiple conflicts and natural disasters-have increased individuals' need to move, which will continue to be exacerbated by the climate crisis. Although new conflicts and exacerbations of existing ones have led to a rise in forced displacement within and across national borders, labour migration has also risen dramatically, with the pandemic highlighting the health and social needs of these groups globally. The need for strong leadership and accountability, engagement of policy makers in the highest-level fora, and improved access to quality health services for refugees and migrants has never been greater. In this Review, nearly 8 years after the UCL-Lancet Commission on Migration and Health was published, we renew our call for action to: (1) improve health-care access and optimise outcomes for refugees and migrants by emphasising health in all migration and forced displacement policies; (2) establish data systems to monitor progress, together with appropriate use of new technologies to improve access, prevent harm, and safeguard privacy; (3) support research on adaptation to and mitigation of the health consequences of climate change on refugees and migrants; and (4) renew focus on the political determinants of health outcomes for people on the move. At this pivotal moment, with geopolitical, sociodemographic, and environmental turmoil, political leaders and societies can shape a better future by leveraging the human capital of migrants and upholding the human rights and dignity of all.}, }
@article {pmid42316311, year = {2026}, author = {Wang, A and Hussain, N and Mudhar, A and Robbins, J and Friessen, J and Hicks, A and Satyapriya, S and Whitson, B and Bhandary, S and Khorsandi, M and Awad, H}, title = {Recent perioperative challenges in anesthesia during expansion of heart transplantation.}, journal = {Journal of cardiothoracic surgery}, volume = {}, number = {}, pages = {}, doi = {10.1186/s13019-026-04365-6}, pmid = {42316311}, issn = {1749-8090}, abstract = {The evolving landscape of heart transplantation requires cardiac anesthesiologists to adapt to new paradigms aimed at expanding donor and recipient pools such as utilizing more donor hearts from older donors, those with higher BMI, left ventricular hypertrophy (LVH), or coronary artery disease, as well as grafts obtained through long-distance procurement and from donors with infectious conditions such as hepatitis C, COVID-19, and HIV. The promising use of devices such as Organ Care System (OCS), Paragonix SherpaPak (SCTS), and Hypothermic Oxygenated Machine Perfusion (HOPE) for preservation of donor hearts, as well as recent increases in donation after circulatory death (DCD) transplants, exemplifies these advancements. In particular, the introduction of beating heart DCD transplants offers the opportunity to minimize ischemic times. However, perioperative complications such as catecholamine-sensitive and resistant vasoplegia, acute right-sided heart dysfunction, primary graft dysfunction (PGD), surgical bleeding, and coagulopathy complicate the picture. The expansion of donor and recipient pools increases the risk of ischemia and reperfusion injury. Despite these challenges, cardiac anesthesiologists must be vigilant in recognizing and managing these complications to ensure the best short and long-term outcomes. For example, novel prediction tools for PGD such as RADIAL and PREDICTA may assist in facilitating earlier intervention in high-risk patients. Finally, the interplay between surgical bleeding, vasoplegia, acute RV dysfunction/failure, and PGD immediately post-transplant provides a significant challenge to cardiac anesthesiologists. By addressing these challenges, they can improve outcomes and play a pivotal role in advancing heart transplantation. Their efforts will make the expansion worthwhile, increasing the availability of donor hearts and enhancing patient care.}, }
@article {pmid42316411, year = {2026}, author = {Nikpour, J and Bouvier, M and Razmpour, O and Leslie, SL and Cimiotti, JP}, title = {Virtual Nursing Programs in Acute Care Settings: A Scoping Review of Patient, Nurse, and System-Level Outcomes.}, journal = {The Journal of nursing administration}, volume = {56}, number = {7}, pages = {390-396}, doi = {10.1097/NNA.0000000000001753}, pmid = {42316411}, issn = {1539-0721}, mesh = {Humans ; Patient Satisfaction ; *COVID-19/nursing/epidemiology ; *Nursing Staff, Hospital/organization & administration ; *Telenursing/organization & administration ; }, abstract = {OBJECTIVE: To synthesize the literature on the influence of virtual nursing (VN) on patient, nurse, and system-level outcomes in acute care.
BACKGROUND: Persistent nursing workforce challenges, including staff shortages and turnover, have been intensified by the COVID-19 pandemic, rising patient acuity, and increasing documentation demands. Many health systems have adopted VN programs, where remote nurses support bedside staff using audiovisual technology. Although these programs are rapidly expanding, evidence of their effectiveness remains limited.
METHODS: These authors conducted a scoping review following PRISMA guidelines. Eleven studies reporting patient, nurse, or system-level outcomes were included.
RESULTS: Most studies were cross-sectional pilots. Evidence was strongest for nurse and patient satisfaction, with reports of improved discharge efficiency, reduced administrative burden, and higher patient satisfaction. Findings for other outcomes, including safety indicators and financial metrics, were inconsistently reported.
CONCLUSIONS: Virtual nursing shows promise for enhancing patient satisfaction and workflow efficiency, but cannot replace investments in sufficient bedside staff and resources.}, }
@article {pmid42316413, year = {2026}, author = {Crossen, EM and Murphy, J}, title = {Elements of Effective Professional Governance: An Integrative Review.}, journal = {The Journal of nursing administration}, volume = {56}, number = {7}, pages = {403-408}, doi = {10.1097/NNA.0000000000001755}, pmid = {42316413}, issn = {1539-0721}, mesh = {Humans ; *Leadership ; *COVID-19/nursing/epidemiology ; *Decision Making ; *Clinical Governance/organization & administration ; *Nurse's Role ; }, abstract = {OBJECTIVE: This review synthesizes literature on elements of professional governance structures that support effective nurse-led decision-making and sustained engagement.
BACKGROUND: Professional governance has been demonstrated to enhance nursing engagement and improve patient outcomes. However, it remains unclear which elements of governance structures are most effective in a complex post-COVID-19 healthcare environment.
METHODS: A systematic search and critical appraisal were conducted to identify relevant literature. Data were extracted and analyzed to identify key themes.
RESULTS: Eight articles met the inclusion criteria. Thematic analysis revealed 4 key elements influencing nurse-led decision-making and engagement: council structure, leadership engagement, clinical nurse accessibility, and education and training. Several barriers to engagement were also noted.
CONCLUSIONS: Effective professional governance structures are crucial for fostering nurse-led decision-making and engagement. Future research should focus on empirical evaluations of professional governance structures and protocols to guide best practices in a rapidly changing healthcare landscape.}, }
@article {pmid42317109, year = {2026}, author = {Davoodi, Z and Laurie, C and Tingley, K and Skidmore, B and Shaver, N and Sundaram, ME and Fell, DB and Brouwers, M and Sulis, G}, title = {Risk-of-bias assessment of vaccine effectiveness studies: a scoping review of systematic reviews.}, journal = {Epidemiology and infection}, volume = {154}, number = {}, pages = {e95}, doi = {10.1017/S0950268826101794}, pmid = {42317109}, issn = {1469-4409}, mesh = {Humans ; *Vaccine Efficacy ; Bias ; Systematic Reviews as Topic ; COVID-19/prevention & control ; *COVID-19 Vaccines ; }, abstract = {Observational vaccine effectiveness (VE) studies provide essential real-world evidence but are prone to bias. Valid synthesis relies on rigorous risk-of-bias (RoB) assessment in systematic reviews of VE studies. Following JBI guidance, we mapped and described RoB assessment methodologies in systematic reviews of VE studies. We searched MEDLINE, Embase, and Web of Science from 1 January 2013 to 17 May 2023 and the grey literature from 1 January 2018 to 15 August 2023. Of 367 identified reviews, 38 lacked any RoB assessment, yielding 203 systematic reviews. Of these, 190 used existing tools (NOS (85/190, 44.7%), ROBINS-I (46/190, 24.2%), and JBI (11/190, 5.8%)) and 13 used an author-developed tool (13/203, 6.4%). Tools were adapted in 16.7% (34/203) of reviews and 7.2% (14/203) used multiple tools. Reviews included 20 (±25.7) observational studies, commonly cohorts (175/203, 86.2%), with COVID-19 (66/203, 32.5%) and seasonal influenza (62/203, 30.5%) frequently studied. VE was reported descriptively in 25.1% (51/203) of reviews, while 74.9% (152/203) provided meta-analyzed estimates primarily based on laboratory-confirmed infection (137/203, 67.5%) and symptomatic disease (130/203, 64.0%). Our findings indicate heterogeneous RoB assessment, reflected by use of different/multiple tools, frequent adaptations, author-developed methods, and absence of RoB assessment, highlighting the need for clearer guidance or tailored tools.}, }
@article {pmid42317372, year = {2026}, author = {Pan, Y and Liu, G and Wang, H and Zhu, J and Tong, J and Li, Z and Yang, Q}, title = {From immunological mechanisms to targeted therapies: a bibliometric analysis in the domain of research concerning neutrophil extracellular traps and pulmonary diseases (2006-2025).}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1837492}, pmid = {42317372}, issn = {1664-3224}, mesh = {*Extracellular Traps/immunology ; *Bibliometrics ; Humans ; *Neutrophils/immunology ; *COVID-19/immunology ; *Lung Diseases/immunology/therapy ; *SARS-CoV-2/immunology ; Animals ; }, abstract = {OBJECTIVES: Neutrophil extracellular traps (NETs) are a crucial mechanism of the neutrophil immune response and exhibit complex dual pathological and physiological effects in pulmonary diseases. In recent years, this research domain has increased significantly, yet systematic bibliometric research remains absent. Therefore, this study utilizes bibliometric methods to thoroughly examine the research landscape and development sequence of this domain, aiming to provide theoretical references for future research.
METHODS: In this study, VOSviewer and CiteSpace were used to conduct a visualization analysis of the article concerning NETs and pulmonary diseases indexed in the Web of Science Core Collection (WoSCC) and Scopus databases from January 1st, 2006, to December 31st, 2025. Additionally, we utilized the R package bibliometric and Origin 2025b to optimize the data and visualization charts, ensuring that the analytical results were presented with greater clarity and intuitiveness.
RESULTS: This study covered 1, 539 articles from 561 journals. The results indicate that since 2006, this domain has seen a phased growth trend. The phase from 2010 to 2018 was a stable growth phase; After 2019, propelled by the COVID-19 virus infection (COVID-19), it entered a significant development phase, and reached its peak in 2022. In terms of influence, China and the United States are leading contributors. Mark R. Looney of the University of California is the core author, and "Frontiers in Immunology" is the most frequently cited journal. Through the visualization analysis of topic categories, keywords, and references indicates that research focal points in this domain have progressively transitioned from initial fundamental mechanisms and pathological descriptions to concerns regarding pulmonary inflammation, immune thrombosis, COVID-19, and biomarkers, subsequently extending to frontiers such as the NLRP3 inflammasome, interstitial lung disease (ILD), and tumor microenvironment (TME).
CONCLUSIONS: This study is the first application of bibliometric methods to visually present research domains related to NETs and pulmonary diseases, revealing the correlation between NETs and ILD, lung cancer (LC), and respiratory infections, along with the underlying mechanisms, continues to be a hot topic in research. However, the predominant function of NETs in specific diseases and their potential utility as therapeutic targets still necessitate further systematic elaboration.}, }
@article {pmid42317536, year = {2026}, author = {Arzanani, KG and Rashidian Vaziri, MR and Sharif, S and Mollaee, M}, title = {A review on applications and safety of 222 nm far UVC light for surface and air disinfection.}, journal = {Biophysical reviews}, volume = {18}, number = {2}, pages = {545-561}, pmid = {42317536}, issn = {1867-2450}, abstract = {The emergence of the COVID-19 pandemic has highlighted the critical need for disinfecting methods that are effective to control and reduce the fast spread of infectious diseases. Among these methods, 222 nm UVC light has garnered noteworthy attention due to its unique properties and promising applications. In this paper, the importance, applications, safety considerations, and generation of 222-nm UVC light for disinfection are explored. The various UVC wavelengths commonly employed for disinfection purposes, emphasizing the distinct advantages of 222 nm are reviewed. It is discussed how 222 nm UVC light effectively inactivates pathogens on surfaces, making it a valuable tool for healthcare facilities, public spaces, and residential areas. The use of 222 nm UVC light in food processing, storage, and agricultural settings is explored. Its role in purifying indoor air, particularly in crowded environments, is examined. Specifically, its efficacy against viral pathogens, including SARS-CoV-2, is focused on. The studies on the impact of 222 nm UVC light on human skin and eyes considering both acute and long-term effects are discussed. The technological aspects of generating 222-nm UVC light are also explored.}, }
@article {pmid42317701, year = {2026}, author = {Chen, S and Vermol, VV and Yu, J and Jiang, H}, title = {Immersive metaverse art as a psychological intervention for depression and anxiety: a narrative review and multilevel model integrating engagement, cultural identity, and neurocognitive mechanisms.}, journal = {Frontiers in psychology}, volume = {17}, number = {}, pages = {1829947}, pmid = {42317701}, issn = {1664-1078}, abstract = {Depression and anxiety rank among the leading causes of global disability, yet traditional treatments reach only a minority of affected individuals. The COVID-19 pandemic further exacerbated this crisis, triggering a ~ 25% worldwide surge in anxiety and depression prevalence. In parallel, immersive digital environments (the "metaverse") are maturing as platforms for creative expression and social connection. This review proposes that immersive metaverse art - interactive art experiences in VR/AR - can act as a multilevel psychobehavioral modulator. We integrate recent evidence showing that such experiences enhance engagement (flow, presence), enable identity exploration (customizable avatars, cultural narratives), and engage neurocognitive systems (reward, attention, regulation). Empirical studies of VR art interventions report acute mood improvements, stress reduction, and greater social connectedness. We synthesize these findings into a conceptual model linking core components (immersion, creative agency, social avatar, cultural symbolism) to mediating processes (flow, meaning-making, belonging) and outcomes (symptom relief, emotional regulation, behavioral activation). Rather than examining these domains as separate interdisciplinary themes, the review integrates them within a unified clinical framework focused on transdiagnostic mechanisms relevant to depression and anxiety. We compare immersive art therapy with traditional art therapy, noting unique advantages (scalability, personalization) and novel risks (overdependence, identity diffusion). Finally, we outline translational pathways - e.g. integrating VR art with cognitive therapies and highlight the need for rigorous trials and cross-cultural validation. Overall, immersive metaverse art emerges as a promising, if nascent, approach to mental health intervention, warranting further empirical and ethical scrutiny.}, }
@article {pmid42318393, year = {2026}, author = {Xu, J and Liu, F and Yuan, HY and Pan, H and Xi, X and Chen, C and Li, DH and Lu, Y}, title = {COVID-19 vaccination in pregnancy: efficacy of second-generation vaccines, maternal-neonatal safety, and strategies to address vaccine hesitancy.}, journal = {Frontiers in medicine}, volume = {13}, number = {}, pages = {1835847}, pmid = {42318393}, issn = {2296-858X}, abstract = {The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has had a profound impact on global public health. The Omicron variant, marked by high transmissibility and pronounced immune evasion capabilities, poses a particularly severe threat. Pregnant women undergo physiological immune modulation during pregnancy, which increases their susceptibility to severe disease following SARS-CoV-2 infection. This heightened risk is evidenced by elevated rates of intensive care unit (ICU) admission and increased maternal mortality. Additional pregnancy-related physiological changes-including heightened oxygen consumption and reduced respiratory reserve-further compromise respiratory function and worsen clinical outcomes in infected individuals. Although robust evidence confirms the efficacy and safety of COVID-19 vaccines, vaccine hesitancy remains prevalent among pregnant women due to concerns about potential adverse effects and fetal safety. This review evaluates current vaccination strategies for pregnant women using second-generation COVID-19 vaccines, with particular emphasis on maternal and neonatal health outcomes. It also analyzes barriers to vaccine uptake and underscores the need for further research to refine vaccination protocols, support equitable access, and ensure the safe and effective deployment of vaccines-ultimately mitigating the risks of SARS-CoV-2 infection during pregnancy.}, }
@article {pmid42318873, year = {2026}, author = {Liao, R and Luo, M and Yang, F and Xu, L and Zhang, J and Zhang, W and Guan, S and Zhang, Y and Luo, P and Cheng, P and Yang, J and Li, Y and Wang, Q}, title = {Bacterial mRNA Vaccines: Programming Immunity Against Antimicrobial Resistance.}, journal = {Drug development research}, volume = {87}, number = {5}, pages = {e70335}, pmid = {42318873}, issn = {1098-2299}, support = {32370993//National Natural Science Foundation of China/ ; 82173764//National Natural Science Foundation of China/ ; 2025ZD01903302//National Science and Technology Major Project/ ; 2021YFC2302500//National Science and Technology Major Project/ ; 2024YFC2310804//National Science and Technology Major Project/ ; CSTB2025NSCQ-GPX0624//Natural Science Foundation of Chongqing/ ; }, mesh = {Humans ; Animals ; *Drug Resistance, Bacterial/immunology ; *Bacterial Vaccines/immunology/administration & dosage ; *RNA, Messenger/immunology/administration & dosage ; *mRNA Vaccines/immunology ; Antigens, Bacterial/immunology ; Nanoparticles ; Vaccines, Synthetic/immunology ; Vaccine Development ; }, abstract = {The relentless rise of antimicrobial resistance poses a critical threat to global health, urgently demanding the development of antibacterial vaccines. Messenger RNA (mRNA) technology, validated during the COVID-19 pandemic, offers a powerful platform of fast development and flexibility. However, its application against bacterial pathogens remains an emerging frontier due to the structural complexity of bacterial antigens, challenges in achieving effective mucosal and cellular delivery, and the need to elicit balanced Th1/Th17-dominated immune responses for durable protection. Progress in antigen design, mRNA engineering, and lipid nanoparticle (LNP) delivery has enabled early preclinical success against Mycobacterium tuberculosis, Pseudomonas aeruginosa, and Streptococcus pneumoniae. Yet, challenges such as complex antigen expression, mucosal targeting, and immune durability persist. This review provides a brief overview of recent advances in bacterial mRNA vaccine design, including antigen selection, mRNA engineering, and delivery platform optimization. Additionally, we summarize current preclinical progress across key bacterial pathogens and highlight emerging strategies that integrate AI-guided antigen discovery, synthetic biology, and next-generation delivery systems to accelerate clinical translation. Finally, we highlight the prospects of bacterial mRNA vaccines by integrating synthetic biology, AI-driven antigen prediction, and advanced delivery systems. These cutting-edge technologies hold the promise of overcoming existing barriers, ultimately establishing mRNA vaccines as a viable and powerful strategy to curb the tide of antibiotic-resistant infections.}, }
@article {pmid42319502, year = {2026}, author = {Ahmad, R and Ullah, Z and Li, M and Tong, Y}, title = {Emergence, evolution, and global dissemination of antimicrobial resistance: A One Health review.}, journal = {Archives of microbiology}, volume = {208}, number = {9}, pages = {}, pmid = {42319502}, issn = {1432-072X}, mesh = {Humans ; Animals ; *Anti-Bacterial Agents/pharmacology/therapeutic use ; *Drug Resistance, Bacterial/genetics ; *One Health ; *Bacteria/drug effects/genetics ; Global Health ; Gene Transfer, Horizontal ; Bacterial Infections/microbiology/drug therapy ; Drug Resistance, Multiple, Bacterial ; }, abstract = {Antimicrobial resistance (AMR) is a critical global health threat that undermines the treatment of infections and compromises medical interventions. AMR develops when microorganisms evolve mechanisms to survive antimicrobial exposure, a process accelerated by misuse and overuse of antibiotics in human medicine, agriculture, and veterinary settings. Bacterial resistance poses the greatest immediate concern, contributing to an estimated 1.27 million deaths in 2019 and nearly 5 million deaths associated with resistant infections worldwide. Without urgent intervention, Projections suggest that AMR could cause up to 10 million deaths annually by 2050, potentially surpassing cancer as a leading cause of mortality although these estimates remain subject to uncertainty. This review examines key biological mechanisms of resistance, including enzymatic degradation, target modification, efflux pumps, porin loss, and horizontal gene transfer. It highlights global hotspots and emerging resistance determinants such as NDM-1 and mcr-1, as well as antibiotic usage trends across human and animal sectors. Unlike acute pandemics such as COVID-19, AMR progresses silently but persistently, earning recognition as a "slow pandemic." Its spread involves interconnected human, animal, and environmental reservoirs, necessitating a One Health approach. The review also summarizes current global responses, including the WHO Global Action Plan, surveillance platforms such as GLASS, and ECDC, and research initiatives like CARB-X and GARDP. Despite progress, significant gaps remain in policy, surveillance, and antimicrobial stewardship, particularly in low- and middle-income countries, underscoring the urgent need for coordinated multisectoral action. However, the conclusions drawn are limited by variability in global surveillance data, differences in reporting standards, and reliance on previously published studies, which may not fully capture regional disparities.}, }
@article {pmid42320154, year = {2026}, author = {Reeves, J and Daynes, E and Janaudis-Ferreira, T and Agarwal, K and Spencer, L and Tsai, LL and Alison, JA}, title = {Physiotherapy management of Long-COVID: an evidence-based approach.}, journal = {Brazilian journal of physical therapy}, volume = {30}, number = {4}, pages = {101609}, pmid = {42320154}, issn = {1809-9246}, abstract = {BACKGROUND: Long-COVID is a heterogenous, episodic, and multisystemic condition which can result following infection with a novel pathogen, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Whilst a precise pathophysiological cause is unknown, several mechanisms are hypothesised, each with plausible scientific rationale. Most people experiencing persistent symptoms following COVID-19 infection recover, yet some experience severe and debilitating illness for years after infection. Strategies to manage the sequelae of Long-COVID can improve the lives of sufferers.
OBJECTIVE: To describe the physiotherapy management of Long-COVID based on current evidence.
CONTENT: Those with 'invisible illness' (illness without outwardly visible signs), such as Long-COVID, often report stigmatisation and scepticism from healthcare systems. Validation of the experience of those with Long-COVID is therefore crucial to ensure patient-centred care. Thorough patient assessment is required to provide tailored management approaches given the diversity of Long-COVID presentations. Red flags that may contraindicate certain rehabilitation approaches (particularly exercise-based interventions) or that warrant further investigation should be considered. Assessments of fatigue, post-exertional malaise, respiratory symptoms, neurocognitive symptoms (i.e., brain fog), physical function, and orthostatic intolerance are strongly recommended. Management strategies may involve pacing and energy conservation techniques, pulmonary rehabilitation, inspiratory muscle training, dysfunctional breathing retraining, lifestyle and dietary strategies to manage orthostatic intolerance, and return-to-work planning.
CONCLUSION: Physiotherapists are well positioned to deliver individualised, patient-centred, and validating care based on best available evidence.}, }
@article {pmid42320893, year = {2026}, author = {Koo, BS and Nederlof, RA and Jeon, E and Bae, GS and Kim, DS and Hong, JJ and Bakker, J}, title = {Machine Learning in Nonhuman Primate Models of Infectious Diseases: Current Applications and Future Perspectives.}, journal = {Journal of the American Association for Laboratory Animal Science : JAALAS}, volume = {}, number = {}, pages = {1-10}, doi = {10.30802/AALAS-JAALAS-26-043}, pmid = {42320893}, issn = {2769-6677}, abstract = {The amount of biologic data produced by biomedical research has increased significantly in both volume and complexity in recent years. Advances in computational power have increasingly enabled the use of machine learning (ML) to analyze and predict patterns from large-scale, complex biologic datasets. In nonhuman primate (NHP) infectious disease models, such high-dimensional datasets containing a large number of features are often obtained by next-generation sequencing-based multiomics and immunologic analyses. As a result, ML is particularly valuable for effective analysis and predictive modeling in this context. This review demonstrates that the application of ML in NHP infectious disease models has increased over time. Ensemble methods, particularly random forest, have emerged as the most frequently used algorithms, followed by regression and clustering approaches. Logistic regression and hierarchical clustering were the most commonly applied regression and clustering methods, respectively. These techniques are primarily used for vaccine response prediction, biomarker discovery, disease progression analysis, gene and pathway identification, and immune response characterization. Despite this increasing trend, the overall adoption of ML in NHP infectious disease models remains limited, which may reflect gaps in familiarity and computational expertise among researchers. Recent advances in generative artificial intelligence and user-friendly analytical platforms are expected to improve accessibility and promote broader adoption. This review aims to support understanding and facilitate wider application of ML in NHP infectious disease models.}, }
@article {pmid42322485, year = {2026}, author = {Domingo-Del-Val, D and Lozano-Berges, G and Moradell, A and Gómez-Bruton, A and Matute-Llorente, Á and Casajús, JA}, title = {Temporal Trends in Health-Related Components of Physical Fitness of European Children and Adolescents from 1965 to 2025: A Systematic Review of Data on 417,362 Participants from 20 Countries.}, journal = {Sports medicine - open}, volume = {12}, number = {1}, pages = {}, pmid = {42322485}, issn = {2199-1170}, support = {CUS/621/2023//Gobierno de Aragón/ ; }, abstract = {BACKGROUND: Physical fitness is an important indicator of health during childhood and adolescence. Several components of physical fitness showed declining trends, with periods of acceleration or stabilisation depending on the component. Although Europe is the most studied continent, existing reviews have largely relied on single-test approaches or descriptive summaries, without simultaneously examining all health-related components, accounting for between-study variability analyses, or extending monitoring beyond 2014 to include the COVID-19 pandemic. This systematic review aims to analyse temporal trends of health-related components of physical fitness in European children and adolescents aged 6-16 years, examining differences by sex and age groups.
METHODS: A systematic search was conducted in PubMed, Web of Science, SPORTDiscus and Scopus up to December 2025. Eligible studies were conducted in European countries and included children and adolescents aged 6-16 years, using repeated cross-sectional designs and reporting physical fitness components at two or more time points including sample sizes, means and standard deviations. Study quality was assessed with a modified Downs and Black checklist. Data were standardised into z scores based on sample-weighted means and standard deviations, considering the study, physical fitness component, sex and age. Linear mixed models were developed for each physical fitness component to estimate trends (linear, quadratic or cubic) and interactions by sex or age group.
RESULTS: Thirty-eight studies were included, representing 417,362 children and adolescents, from 20 European countries between 1965 and 2023. Cardiorespiratory endurance increased until the 1980s, then declined with a deceleration between 2015 and 2023. Body composition decreased linearly up to 2022, more markedly among males. Upper-body strength declined from the 1970s to 2020s, stabilising between the 1980s and 2000s. Lower-body strength increased until the 1980s and declined until 2023. Flexibility declined continuously, with an accelerated decrease after the 2000s.
CONCLUSIONS: Health-related components of physical fitness showed persistent declines among European children and adolescents, with differences in the shape and magnitude of trends. These findings highlight the heterogeneity of the available evidence and the need for a standardised, valid and feasible European fitness test battery. Public initiatives should continue to promote adherence to physical activity guidelines, particularly muscle-strengthening recommendations.
REGISTRATION: PROSPERO ID: CRD42024609888.}, }
@article {pmid42323274, year = {2026}, author = {Wu, G and Jiang, S and Zhang, J}, title = {Lessons from warfarin management during the COVID-19 pandemic: from crisis to an opportunity to revolutionize telemedicine for chronic disease care.}, journal = {Expert review of hematology}, volume = {}, number = {}, pages = {1-7}, doi = {10.1080/17474086.2026.2692435}, pmid = {42323274}, issn = {1747-4094}, abstract = {INTRODUCTION: Corona virus disease 2019 (COVID-19) had a dramatic impact on the daily management of warfarin. To improve the quality of warfarin anticoagulation management in the outbreak setting while reducing the risk of patient exposure to COVID-19, researchers around the world have conducted many explorations and practices on warfarin management models.
AREAS COVERED: This review analyzes the factors affecting the management of warfarin by COVID-19, summarizes the current situation of warfarin management in the epidemic environment, introduces the characteristics and limitations of feasible warfarin management strategies, and provides a reference for the selection of warfarin management plans in clinical practice. From before 31 May 2025, we conducted a literature search using the PubMed database to identify relevant studies.
EXPERT OPINION: Warfarin management faced major challenges during the epidemic, exposing the vulnerability of its management system. At the same time, this state of affairs has driven improvements and innovations in related programs, facilitating the use of telemedicine technology in anticoagulation therapy. More importantly, this change is expected to inspire legislators and policy makers to introduce policies to extend telemedicine to a wider range of chronic disease management areas, thereby improving the overall quality and efficiency of healthcare services.}, }
@article {pmid42323682, year = {2026}, author = {Hussain, BM and Hannigan, M and Conklin, D and Gordon, M and Huckins, A and Beauvais, A}, title = {Disordered eating behaviors, food insecurity and the COVID-19 pandemic among undergraduate students in the United States: a systematic review.}, journal = {Journal of eating disorders}, volume = {}, number = {}, pages = {}, doi = {10.1186/s40337-026-01604-y}, pmid = {42323682}, issn = {2050-2974}, abstract = {BACKGROUND: Eating disorders are highly prevalent among undergraduate students at colleges and universities in the United States (US). These behaviors may be associated with food insecurity and the COVID-19 pandemic, as both represent stressors that may be difficult for young adults to independently manage and cope with, turning to maladaptive coping strategies that are characteristic of disordered eating. The aim of this systematic review was to understand the relationship between eating disorders, defined by DSM-5 criteria, and food insecurity among undergraduate college students in the US, with additional consideration for the effects of the COVID-19 pandemic.
METHODS: PubMed, Cochrane Library, Scopus, Global Health (Ovid), PsycInfo, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Psychology Database were searched from 2014 to 2024 to capture eating disorders as defined by the DSM-5 criteria, searching terms representing eating disorders, food insecurity, and COVID-19. Articles were screened independently by 2 researchers using inclusion criteria agreed upon by all authors.
RESULTS: Disordered eating was associated with food insecurity and changes in behavior due to the COVID-19 pandemic. All studies were cross sectional with the number of participants ranging from 98 to 1996. Due to heterogeneity in assessment tools used in studies pooling of data and direct comparison of findings was limited. While no study measured eating disorders, food insecurity, and COVID-19 together, studies did reveal that food insecurity and COVID-19 were both associated with emotional eating that may indicate a greater risk for binge eating disorder.
CONCLUSIONS: While the overall data is limited, studies examining the effect of food insecurity or COVID-19 on undergraduate eating behaviors found that students experienced a significant increase in depressive and anxious symptoms contributing to disordered eating patterns. This may have a long-term impact on academic and health outcomes for young adults.
PROSPERO registration number CRD42024577588.}, }
@article {pmid42324038, year = {2026}, author = {Ikrar, T and Muchsin, W and Sophian, A}, title = {Beyond strain-specific immunity: Conserved antigenic targets, emerging platforms, and translational challenges in universal influenza and pan-coronavirus vaccine development.}, journal = {Journal of virological methods}, volume = {345}, number = {}, pages = {115432}, doi = {10.1016/j.jviromet.2026.115432}, pmid = {42324038}, issn = {1879-0984}, abstract = {BACKGROUND: The global burden of respiratory viral disease is shaped by two enduring threats: influenza, responsible for 290,000-650,000 annual deaths, and coronaviruses, exemplified by the catastrophic SARS-CoV-2 pandemic that caused over 7 million confirmed fatalities and profound socioeconomic disruption. Current strain-specific vaccines remain inherently reactive, incapable of anticipating antigenic drift, reassortment, or zoonotic emergence. A paradigm shift toward universal vaccines-designed to target evolutionarily conserved viral epitopes and confer durable, broad-spectrum protection across strains, subtypes, and viral genera-represents the most strategically consequential frontier in contemporary vaccinology and pandemic preparedness.
OBJECTIVE: This comparative narrative review provides an integrated synthesis of universal influenza vaccine (UIV) and pan-coronavirus vaccine (UCV) development, critically evaluating conserved immunological targets, advanced platform technologies, Phase I-III clinical pipeline status, and key translational barriers. By juxtaposing both developmental trajectories in a single analytical framework, we identify convergent scientific principles and divergent challenges to inform a unified pandemic preparedness strategy-an approach not previously addressed in the literature.
METHODS: A structured narrative review was conducted via systematic literature search of PubMed, EMBASE, and ClinicalTrials.gov covering 2015-June 2026, supplemented by hand-searching reference lists of landmark studies. MeSH and free-text terms encompassed universal influenza vaccines, pan-coronavirus vaccines, mRNA vaccine platforms, hemagglutinin stalk, neuraminidase, M2e, receptor-binding domain (RBD), fusion peptide, S2 subunit, and broadly neutralizing antibodies. Peer-reviewed original research articles, Phase I-III clinical trial reports, and authoritative reviews were included; non-English publications and preclinical-only studies lacking translational immunogenicity data were excluded.
RESULTS: Conserved viral epitopes-principally the hemagglutinin (HA) stalk domain, neuraminidase (NA) ectodomain, and M2e protein for influenza, and the receptor-binding domain (RBD) Class 4 epitope, fusion peptide, and S2 subunit for coronaviruses-have been validated as targets for broadly neutralizing antibodies (bnAbs). Multiple advanced platforms, including lipid nanoparticle-encapsulated mRNA, adenoviral vectors, computationally designed self-assembling nanoparticles (Mosaic-8 RBD-I53-50, SpFN), and structure-guided protein antigens, are progressing through early-phase clinical trials with promising cross-reactive immunogenicity profiles. Comparative analysis reveals that UIV development benefits from well-characterised bnAb epitopes and established animal challenge models, while UCV development is accelerated by unprecedented mRNA manufacturing infrastructure and genomic surveillance networks built during the COVID-19 response. Shared translational obstacles include antigenic imprinting, the absence of validated correlates of protection for cross-strain immunity, and inequitable manufacturing scalability.
CONCLUSIONS: Cross-strain protective vaccines against influenza and coronaviruses are scientifically achievable, supported by converging immunological principles and advancing clinical evidence across both fields. Accelerating translation to population-level protection requires coordinated investment in epitope-focused antigen engineering, correlate-of-protection validation, adaptive regulatory frameworks, and equitable global manufacturing capacity. Crucially, the scientific and policy lessons of COVID-19-both the remarkable speed enabled by prior platform investments and the inequities exposed in global vaccine distribution-must be integrated into universal respiratory virus vaccine programmes now, before the next pandemic forces another reactive response.}, }
@article {pmid42325158, year = {2026}, author = {Ivers, N and Yogasingam, S and Lacroix, M and Brown, KA and Antony, J and Soobiah, C and Simeoni, M and Willis, TA and Crawshaw, J and Antonopoulou, V and Meyer, C and Solbak, NM and Murray, BJ and Butler, EA and Lepage, S and Giltenane, M and Carter, MD and Fontaine, G and Sykes, M and Halasy, M and Bazazo, A and Seaton, S and Canavan, T and Alderson, S and Reis, C and Linklater, S and Lalor, A and Fletcher, A and Gearon, E and Jenkins, H and Wallis, JA and Grobler, L and Beccaria, L and Cyril, S and Rozbroj, T and Han, JX and Xu, AX and Wu, K and Rouleau, G and Shah, M and Konnyu, K and Colquhoun, H and Presseau, J and O'Connor, D and Lorencatto, F and Grimshaw, JM}, title = {Audit and feedback: effects on professional practice.}, journal = {The Cochrane database of systematic reviews}, volume = {6}, number = {6}, pages = {CD000259}, pmid = {42325158}, issn = {1469-493X}, mesh = {Humans ; *Professional Practice/standards/statistics & numerical data ; *Feedback ; Randomized Controlled Trials as Topic ; }, abstract = {BACKGROUND: Audit and feedback (A&F) is a widely used strategy to improve professional practice. This is supported by prior Cochrane reviews and behavioural theories describing how healthcare professionals are prompted to modify their practice when given data showing that their clinical practice is inconsistent with a desirable target. Yet there remains uncertainty regarding the effects of A&F on improving healthcare practice and the characteristics of A&F that lead to a greater impact.
OBJECTIVES: To assess the effects of A&F on the practice of healthcare professionals and to examine factors that may explain variation in the effectiveness of A&F.
SEARCH METHODS: With the Cochrane Effective Practice and Organisation of Care (EPOC) group information scientist, we updated our search strategy to include studies published from 2010 to June 2020. Search updates were performed on 28 February 2019 and 11 June 2020. We searched MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCO), the Cochrane Library, clinicaltrials.gov (all dates to June 2020), WHO ICTRP (all dates to February Week 3 2019, no information available in 2020 due to COVID-19 pandemic). An updated search and duplicate screen was completed on February 14, 2022; studies that met inclusion criteria are included in the 'Studies awaiting classification' section.
SELECTION CRITERIA: Randomised trials, including cluster-trials and cross-over and factorial designs, featuring A&F (defined as measurement of clinical performance over a specified period of time (audit) and provision of the resulting data to clinicians or clinical teams (feedback)) in any trial arm that reported objectively measured health professional practice outcomes.
DATA COLLECTION AND ANALYSIS: For this updated review, we re-extracted data for each study arm, including theory-informed variables regarding how the A&F was conducted and behaviour change techniques for each intervention, as well as study-level characteristics including risk of bias. For each study, we extracted outcome data for every healthcare professional practice targeted by A&F. All data were extracted by a minimum of two independent review authors. For studies with dichotomous outcomes that included arms with and without A&F, we calculated risk differences (RDs) (absolute difference between arms in proportion of desired practice completed) and also odds ratios (ORs). We synthesised the median RDs and interquartile ranges (IQRs) across all trials. We then conducted meta-analyses, accounting for multiple outcomes from a given study and weighted by effective sample size, using reported (or imputed, when necessary) intra-cluster correlation coefficients. Next, we explored the role of baseline performance, co-interventions, targeted behaviour, and study design factors on the estimated effects of A&F. Finally, we conducted exploratory meta-regressions to test preselected variables that might be associated with A&F effect size: characteristics of the audit (number of indicators, aggregation of data); delivery of the feedback (multi-modal format, local champion, nature of comparator, repeated delivery); and components supporting action (facilitation, provision of specific plans for improvement, co-development of action plans).
MAIN RESULTS: We included 292 studies with 678 arms; 133 (46%) had a low risk of bias, 41 (14%) unclear, and 113 (39%) had a high risk of bias. There were 26 (9%) studies conducted in low- or middle-income countries. In most studies (237, 81%), the recipients of A&F were physicians. Professional practices most commonly targeted in the studies were prescribing (138 studies, 47%) and test-ordering (103 studies, 35%). Most studies featured multifaceted interventions: the most common co-interventions were clinician education (377 study arms, 56%) and reminders (100 study arms, 15%). Forty-eight unique behaviour change techniques were identified within the study arms (mean 5.2, standard deviation 2.8, range 1 to 29). Synthesis of 558 dichotomous outcomes measuring professional practices from 177 studies testing A&F versus control revealed a median absolute improvement in desired practice of 2.7%, with an IQR of 0.0 to 8.6. Meta-analyses of these studies, accounting for multiple outcomes from the same study and weighting by effective sample size accounting for clustering, found a mean absolute increase in desired practice of 6.2% (95% confidence interval (CI) 4.1 to 8.2; moderate-certainty evidence) and an OR of 1.47 (95% CI 1.31 to 1.64; moderate-certainty evidence). Effects were similar for pre-planned subgroup analyses focused on prescribing and test-ordering outcomes. Lower baseline performance and increased number of co-interventions were both associated with larger intervention effects. Meta-regressions comparing the presence versus absence of specific A&F components to explore heterogeneity, accounting for baseline performance and number of co-interventions, suggested that A&F effects were greater with individual-recipient-level data rather than team-level data, comparing performance to top-peers or a benchmark, involving a local champion with whom the recipient had a relationship, using interactive modalities rather than just didactic or just written format, and with facilitation to support engagement, and action plans to improve performance. The meta-regressions did not find significant effects with the number of indicators in the audit, comparison to average performance of all peers, or co-development of action plans. Contrary to expectations, repeated delivery was associated with lower effect size. Direct comparisons from head-to-head trials support the use of peer-comparisons versus no comparison at all and the use of design elements in feedback that facilitate the identification and action of high-priority clinical items.
AUTHORS' CONCLUSIONS: A&F can be effective in improving professional practice, but effects vary in size. A&F is most often delivered along with co-interventions which can contribute additive effects. A&F may be most effective when designed to help recipients prioritise and take action on high-priority clinical issues and with the following characteristics: 1. targets important performance metrics where health professionals have substantial room for improvement (audit); 2. measures the individual recipient's practice, rather than their team or organisation (audit); 3. involves a local champion with an existing relationship with the recipient (feedback); 4. includes multiple, interactive modalities such as verbal and written (feedback); 5. compares performance to top peers or a benchmark (feedback); 6. facilitates engagement with the feedback (action); 7. features an actionable plan with specific advice for improvement (action). These conclusions require further confirmatory research; future research should focus on discerning ways to optimise the effectiveness of A&F interventions.}, }
@article {pmid42325292, year = {2024}, author = {Muruganantham, JK and Veerabathiran, R}, title = {Genetic Basis for Mucormycosis Progression in COVID-19 Patients: From Susceptibility to Severity.}, journal = {Infectious diseases & immunity}, volume = {4}, number = {2}, pages = {86-92}, pmid = {42325292}, issn = {2693-8839}, abstract = {The dynamics of COVID-19 and mucormycosis reveal a complex interplay of genetic factors that influence the susceptibility, severity, and immune responses. COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), exhibits an increased incidence of mucormycosis, particularly in individuals with comorbidities or corticosteroid therapy. Mucormycosis is a fungal infection that affects the sinuses, orbits, and lungs and demands timely intervention with antifungal medications and surgery because of its life-threatening nature. Research on the genetic underpinnings of this intersection has unveiled key insights into the pathogenicity of Mucorales. Breakthroughs in genetic tools have exposed virulence factors, such as the CotH protein family and high-affinity iron-uptake mechanisms. Genetic susceptibility is a pivotal element in identifying individuals at risk of developing COVID-19, facilitating early detection, and allowing for personalized treatment strategies. DPP9, MIF, and TYK2 are among the genes implicated in COVID-19 severity, emphasizing the intricate relationship between genetic makeup and viral response. The genetic landscape extends to viral entry mechanisms, thereby affecting infection efficiency. Specific polymorphisms in genes such as IFNAR2, OAS3, and TYK2 are associated with COVID-19 severity, indicating shared genetic bases between severe and hospitalized cases. Mucormycosis is genetically predisposed, particularly in immunocompromised individuals. The challenge lies in understanding the genetic factors influencing susceptibility and offering insights into pathogenesis and potential therapeutic avenues. Organ transplantation adds another layer, increasing susceptibility to infections such as COVID-19 and mucormycosis. The impact of immunosuppression on COVID-19 severity remains elusive, necessitating ongoing research on the immunological mechanisms. Despite the challenges posed by emerging SARS-CoV-2 variants, the intricate connection between genetic factors and the interplay of COVID-19 and mucormycosis presents an opportunity for personalized treatment, targeted interventions, and refined public health strategies.}, }
@article {pmid42325367, year = {2025}, author = {Zhang, R and Gu, X and Zhang, H and Guo, Y and Cao, B}, title = {Long COVID: current research and future directions.}, journal = {Infectious diseases & immunity}, volume = {5}, number = {4}, pages = {260-271}, pmid = {42325367}, issn = {2693-8839}, abstract = {Long coronavirus disease (COVID) is defined as the continuation or development of new symptoms three months after the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and that last for at least two months, with no other explanation for their cause. This disease includes various clinical manifestations that affect multiple organ systems, such as complications in respiratory, cardiovascular, neurological, and musculoskeletal systems. The most commonly reported symptoms include fatigue, cognitive dysfunction, dyspnea, and chest pain; however, the prevalence and severity of these symptoms vary greatly among individuals. The underlying mechanisms of long COVID are complex and multifaceted, encompassing viral persistence, immune system dysfunction, mitochondrial abnormalities, endothelial impairment, and alterations in the microbiome. Further, long COVID has imposed a significant burden on individuals, healthcare systems, and the economy by impairing an individual's quality of life and functional capacity, thereby increasing costs and demand for care and rehabilitation services. This review summarizes the definition, phenotypes, mechanisms, and current treatment advancements of long COVID and highlights specific research directions for future investigation.}, }
@article {pmid42325370, year = {2025}, author = {Liu, S and Guo, Y and Wang, FS}, title = {Viral persistence in long COVID: Research advances and treatment strategies.}, journal = {Infectious diseases & immunity}, volume = {5}, number = {4}, pages = {272-288}, pmid = {42325370}, issn = {2693-8839}, abstract = {Although the coronavirus disease 2019 (COVID-19) pandemic has ended, the enduring health impacts of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection continue to garner global attention, as approximately 10% of patients develop long COVID (post COVID-19 condition). The epidemiological characteristics and symptoms of long COVID have been reported, and various pathogenic hypotheses have been proposed. Recent evidence suggests that SARS-CoV-2 nucleic acids or fragments persist in some patients post-infection and that these are correlated with long COVID symptoms. This review focuses on clinical studies linking SARS-CoV-2 persistence to long COVID symptoms, and explores the relationship between viral persistence and other etiological hypotheses, such as immune dysregulation, vascular issues, coagulation dysfunction, microbiome dysbiosis, brainstem/vagus nerve signaling dysfunction, and latent virus reactivation. Futhermore, treatment strategies for long COVID are proposed based on current clinical trials of antiviral and immune modulation therapies. Understanding the role of viral persistence in long COVID pathogenesis is critical for developing targeted therapies and improving clinical management of this debilitating condition.}, }
@article {pmid42325371, year = {2025}, author = {Jin, X and Ren, L and Ren, X and Wang, J}, title = {A survey of SARS-CoV-2 tropism.}, journal = {Infectious diseases & immunity}, volume = {5}, number = {4}, pages = {289-302}, pmid = {42325371}, issn = {2693-8839}, abstract = {The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has significantly burdened global public health. However, the tropism of SARS-CoV-2 within the human body remains not fully understood. In this review, we overview the literature on SARS-CoV-2 infection across various human organs and tissues. We summarize the relevant specimen types, techniques for examining SARS-CoV-2 tropism, and findings at both organ/tissue and cellular levels. To systematically evaluate the evidence supporting SARS-CoV-2 tissue tropism, we establish a hierarchical classification system based on two key criteria: (1) specimen origin and (2) detection methodology. Clinical specimens obtained directly from COVID-19 patients provide the most definitive evidence, whereas organoid-derived specimens and animal models indicate potential infectivity under artificial conditions. In terms of detection methods, we prioritize viral particle identification over viral protein or RNA detection, as the latter requires further confirmation to establish productive infection. Our findings indicate that SARS-CoV-2 potentially targets multiple human organ systems, including the respiratory tract, lungs, kidneys, heart, blood vessels, pancreas, small intestine, liver, and salivary glands. By contrast, viral tropism for the central nervous system and the reproductive system remains uncertain and requires further validation. At the cellular level, we identify specific target cell types vulnerable to infection, including ciliated epithelial cells, alveolar type II pneumocytes, enterocytes, cardiomyocytes, vascular endothelial cells, renal tubular epithelial cells, and pancreatic acinar cells. Furthermore, we analyze the correlation between angiotensin-converting enzyme 2 receptor distribution patterns and viral tropism, as well as potential variations in tissue specificity among different viral variants. We expect this review to provide a comprehensive landscape of SARS-CoV-2 tropism and enhance our understanding of the life cycle and consequences of SARS-CoV-2 infection within the human body.}, }
@article {pmid42325459, year = {2026}, author = {Ravindhiran, R and Chidambaram, K and Subramanian, A and Velayutham, S and Ramar, M and Dhandapani, K}, title = {Uncovering the Predisposing Factors of Mucormycosis: Insights from Systematic Review.}, journal = {Indian journal of microbiology}, volume = {66}, number = {3}, pages = {522-535}, pmid = {42325459}, issn = {0046-8991}, abstract = {Mucormycosis is a life-threatening fungal infection with high morbidity and mortality, particularly affecting immunocompromised individuals. Despite its growing clinical significance, its true global prevalence remains unclear. This systematic review identifies the key risk factors, epidemiological trends, and clinical challenges associated with mucormycosis. A comprehensive literature search was conducted to analyze global case reports, underlying predisposing conditions, and regional variations in disease manifestation. The leading risk factor in developed nations is hematological malignancies, while uncontrolled diabetes mellitus dominates in regions like India. Environmental and climatic factors influence fungal exposure and disease progression. Diagnosis remains challenging due to nonspecific symptoms, contributing to delayed treatment and poor outcomes. Early recognition of risk factors and improved diagnostic strategies are critical to reducing mucormycosis-related mortality. Public health initiatives must prioritise awareness, especially in high-risk populations. Further research is needed to address gaps in treatment and prevention.}, }
@article {pmid42325681, year = {2026}, author = {Sheng, J and Song, Y and Zhang, A and Wang, M and Li, T and Ji, J}, title = {Unraveling the cardiovascular burden of long COVID: symptom profiles, underlying mechanisms, and clinical management insights.}, journal = {Frontiers in cardiovascular medicine}, volume = {13}, number = {}, pages = {1786633}, pmid = {42325681}, issn = {2297-055X}, abstract = {BACKGROUND: Long COVID refers to multisystem symptoms that begin within 3 months of COVID-19 infection and persist for at least 2 months. To this day, Long COVID remains a challenging clinical entity and a substantial global health burden, with cardiovascular sequelae representing a prominent component. Patients frequently report a range of symptoms including chest pain, palpitations, fatigue, and exercise intolerance.
OBJECTIVE: This mini review aims to synthesize current evidence on the symptom profiles, underlying mechanisms, and clinical management of Long COVID-related cardiovascular complications.
METHODS: We conducted a targeted narrative literature search of PubMed/MEDLINE, Web of Science, Scopus, Embase, and Google Scholar for articles published up to January 2026 using combinations of "Long COVID," "post-acute sequelae of SARS-CoV-2 infection," "cardiovascular," "myocarditis," "endothelial dysfunction," "microvascular injury," "dysautonomia," "vaccination," and "SARS-CoV-2 variants." Original studies, systematic reviews, meta-analyses, clinical guidance documents, and selected mechanistic studies were prioritized, whereas non-peer-reviewed preprints and single case reports were included only when they provided unique mechanistic or hypothesis-generating information. Eligibility was based on cardiovascular relevance to Long COVID; studies without post-acute or cardiovascular relevance were excluded.
RESULTS: The evidence indicates that cardiovascular Long COVID is heterogeneous and multifactorial, involving viral persistence, immune dysregulation, endothelial dysfunction, microvascular injury with hypercoagulability, autonomic nervous system dysregulation, and risk modification by acute disease severity, vaccination status, and SARS-CoV-2 variant period. Current management strategies remain primarily symptom-based, with emphasis on cardiovascular risk assessment, mechanism-informed phenotyping, graded rehabilitation, dysautonomia-directed treatment, and multidisciplinary follow-up.
CONCLUSIONS: Cardiovascular Long COVID is a heterogeneous burden driven by interacting mechanisms. Current evidence supports subgroup-based risk stratification and mechanism-informed management, while future studies should standardize endpoints and evaluate mechanism-targeted interventions.}, }
@article {pmid42326053, year = {2026}, author = {Fernàndez-López, L}, title = {Community-Based Rapid Testing for HIV in Europe and Central Asia: A Narrative Review of Models, Effectiveness, and Implementation Challenges.}, journal = {Infection and drug resistance}, volume = {19}, number = {}, pages = {541591}, pmid = {42326053}, issn = {1178-6973}, abstract = {This narrative review examines the evolution, implementation, and impact of Community-Based HIV Testing (CBT) across Europe and Central Asia (ECA), a region where late diagnosis remains a persistent challenge and key populations continue to face substantial structural, legal, and social barriers to accessing conventional healthcare. This review synthesises evidence from academic studies, surveillance reports, and European initiatives to describe the diverse modalities of CBT, as well as their contribution to earlier diagnosis, improved case-finding among first-time testers, and more timely linkage to care. Across the region, CBT showed higher acceptability and positivity yields than facility-based testing, reaching populations disproportionately affected by HIV, such as men who have sex with men, people who inject drugs, migrants, and sex workers, and supports differentiated, person-centred service delivery aligned with World Health Organization and European Centre for Disease Prevention and Control guidance. Despite clear progress, major implementation gaps persist, driven by restrictive regulatory frameworks, uneven adoption of innovations such as lay provider testing and HIV self-testing, limited integration of community-generated data into national surveillance systems, and structural inequities including stigma, criminalisation, and lack of universal healthcare entitlements. This review also notes the resilience and adaptability of community-based models during recent crises, including COVID-19 and the war in Ukraine. Overall, the evidence demonstrates that CBT is a fundamental component of HIV prevention and diagnosis in ECA. Fully realising its potential requires updated policies that enable task-sharing, integration of multi-disease testing, strong referral pathways, sustainable financing, and formal incorporation of community-generated data into national monitoring frameworks. Strengthening these components is essential to accelerate progress toward the 2030 goal of ending AIDS as a public health threat.}, }
@article {pmid42326550, year = {2024}, author = {Halma, M}, title = {Alterations of SARS-CoV-2 Evolutionary Dynamics by Pharmaceutical Factors.}, journal = {Infectious diseases & immunity}, volume = {4}, number = {1}, pages = {35-40}, pmid = {42326550}, issn = {2693-8839}, abstract = {The outbreak of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) has been influenced by the human response to the virus. These responses have undoubtedly impacted the evolutionary dynamics of the virus in ways distinct from a scenario lacking a widespread response. Two important pharmaceutical interventions, vaccination and the utilization of medications, particularly molnupiravir, known to have mutagenic properties, were the focus of this article. The impact of molnupiravir on human health was evaluated through 3 mechanisms: viral resistance, mutagenesis of SARS-CoV-2, and mutagenesis occurring in patients undergoing treatment with molnupiravir. These mechanisms, as well as the impact of vaccination, have inadvertently given rise to unforeseen challenges in the management of the COVID-19 crisis. Taking a systems view in future pandemic responses, and taking into account the evolution of the pandemic virus, may be critical to ending the pandemic at an earlier date.}, }
@article {pmid42326936, year = {2026}, author = {Xiang, Y and Sun, G and Xiang, P and Hu, J and Tian, L and Zhang, Q and Wang, J and Xie, C}, title = {Confronting the known unknown: historical lessons and future strategies for Disease X.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1833807}, pmid = {42326936}, issn = {2296-2565}, mesh = {Animals ; Humans ; *COVID-19/epidemiology/prevention & control ; *Henipavirus Infections/epidemiology/prevention & control ; India/epidemiology ; Nipah Virus ; One Health ; *Pandemic Preparedness/methods ; Pandemics/prevention & control ; SARS-CoV-2 ; }, abstract = {The 2026 outbreak of Nipah virus in West Bengal, India, a known WHO priority pathogen, serves as a timely reminder of the constant threat from high-consequence emerging diseases and underscores the critical relevance of Disease X-a future pandemic caused by an unknown pathogen. The profound global health and economic impact of COVID-19 has made the potential devastation of Disease X tangible. However, despite the insights gained from COVID-19, significant gaps remain in translating this awareness into an effective, coordinated, and pre-emptive preparedness strategy. This review advances an integrated response framework built around a One Health surveillance diagnostic therapeutic continuum. This foundational system enables real-time pathogen tracking and host immune profiling across human, animal, and environmental interfaces. Insights generated through this continuum directly inform the timely activation of non-pharmaceutical interventions, guide dynamic modeling, and enable the precise deployment of rapid medical countermeasures. Furthermore, these measures should be supported by resilient health infrastructure and equitable data sharing mechanisms, and be embedded within a governance model that prioritizes global collaboration and equity. Ultimately, mitigating Disease X requires a unified strategy that seamlessly integrates continuous monitoring, diagnostics, and treatment within a resilient and equitable operational architecture, thereby transforming pandemic preparedness from concept into reality.}, }
@article {pmid42327608, year = {2026}, author = {Mostafa, MEA and Ahmed, AE and Abdulqader, MN and Abdel-Karim, SAM and Elgebaly, AS and Hagras, SAA}, title = {Antiviral Properties of Green-Synthesized Silver and Zinc Oxide Nanoparticles Against Coronaviruses: A Review.}, journal = {International journal of microbiology}, volume = {2026}, number = {}, pages = {7207868}, pmid = {42327608}, issn = {1687-918X}, abstract = {It is acknowledged that COVID-19 pandemic triggered by SARS-CoV-2 outbreak demands the development of efficient antiviral modalities independent of traditional vaccines and antiviral reagents. Metallic nanoparticles, such as silver nanoparticles (Ag-NPs) and zinc oxide nanoparticles (ZnO-NPs), have attracted considerable attention as promising antiviral agents due to their distinctive physicochemical properties and universal antimicrobial activity. This article examines the progress made between (2021 and 2025) in the green synthesis and the antiviral applications of Ag-NPs and ZnO-NPs against Coronavirus. The environmental friendly synthesis protocols using natural plant juices have been highlighted in this article due to their lower toxicity and greater biocompatibility. Various characterization methods, such as scanning electron microscopy (SEM), transmission electron microscopy (TEM), X-ray diffraction (XRD), and UV-Vis spectrophotometry, have been used to examine nanoparticle morphology, stability, and surface characteristics. The findings reveald that Ag-NPs can suppress the viral replication by interacting strongly with S proteins, thereby hindering the cellular entry of the targeted Coronavirus. In contrast, ZnO-NPs showed that they have dual purposes: direct antiviral effects and immunomodulatory effects that involve cytokine regulation. The antiviral properties and the limitations of the individual nanoparticles are significantly modified by hybrid nanocomposites. In closing, the significance of using green-synthesized Ag-NPs and ZnO-NPs as antiviral materials is tremendous and warrants further exploration for antiviral applications. Nonetheless, there are still some unaddressed areas concerning the standardization of synthesis techniques and the validation of prolonged safety. Finally, it has been proven that there is a need for collaboration between nanotechnology and green technology in the development of environmentally benign, and universal antiviral medications against any future coronavirus pandemics.}, }
@article {pmid42327741, year = {2026}, author = {Ma, J and Chen, H and He, Y and Huang, Y and Duan, X and Liu, Q and Liu, Z and Liu, H}, title = {COVID-19 mRNA vaccines: a prospective outlook from technological innovation to clinical practice.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1757291}, pmid = {42327741}, issn = {1664-3224}, mesh = {Humans ; *COVID-19 Vaccines/immunology ; *COVID-19/prevention & control/immunology ; *SARS-CoV-2/immunology ; Vaccine Development ; Vaccines, Synthetic/immunology ; mRNA Vaccines/immunology ; Nanoparticles ; Animals ; Vaccination ; Antibodies, Viral/immunology ; Nanovaccines ; Antibodies, Neutralizing/immunology ; Liposomes ; }, abstract = {The COVID-19 pandemic established mRNA vaccines as a clinically validated platform for rapid vaccine development and deployment. This review summarizes recent progress in COVID-19 mRNA vaccine technology, clinical performance, immunological mechanisms, and translational applications. First-generation nucleoside-modified mRNA vaccines formulated in lipid nanoparticles demonstrated strong protection against symptomatic disease and, more durably, against severe outcomes, while variant-driven immune escape, waning protection against infection, limited mucosal immunity, and heterogeneous responses in special populations revealed important constraints. The review compares mRNA vaccines with other COVID-19 vaccine platforms and clarifies endpoint-specific correlates of protection, emphasizing the distinct roles of neutralizing antibodies, memory B cells, T-cell responses, and non-neutralizing antibody functions. It further examines unresolved issues associated with repeated vaccination, including immune imprinting and IgG4 class switching, and evaluates technological strategies designed to improve durability, breadth, delivery, and immune programming. Key innovations include optimized RNA chemistry, structure-guided antigen design, advanced lipid nanoparticle formulations, alternative delivery systems, immune-shaping adjuvant approaches, and next-generation RNA formats such as self-amplifying RNA and circular RNA. Finally, the review discusses vaccination strategies for immunocompromised individuals, pregnant and lactating women, older adults, and children, as well as the expansion of mRNA technology into respiratory virus vaccines, cancer immunotherapy, and therapeutic protein expression. These developments define mRNA technology as a modular platform whose clinical impact depends on aligning RNA architecture, delivery system, antigen design, and target population.}, }
@article {pmid42327772, year = {2026}, author = {Wang, S and Chen, T and Liu, S and Du, Z and Kong, Y and Yuan, Y and Ding, T and Wang, Q}, title = {Idiopathic multiple castleman disease case combined with severe neuropathy, Sjogren's syndrome and membrane nephropathy treated by rituximab: a case report and literature review.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1804654}, pmid = {42327772}, issn = {1664-3224}, mesh = {Humans ; Female ; *Castleman Disease/drug therapy/diagnosis/complications ; *Rituximab/therapeutic use ; *Sjogren's Syndrome/drug therapy/complications/diagnosis ; Aged ; *Glomerulonephritis, Membranous/drug therapy/complications/diagnosis ; *Immunologic Factors/therapeutic use ; Treatment Outcome ; }, abstract = {BACKGROUND: Idiopathic multicentric Castleman disease (iMCD) is a lymphoproliferative disorder characterized by dysregulated systemic immunity. Multiple cytokines had been found involved in the disease pathogenesis. Hence, involvement of multiple systems in iMCD complicates diagnosis and efficacy assessments. Although guidelines recommend anti-interleukin-6 (IL-6) agents as the primary treatment, options for second-line therapy remain indeterminate.
CASE PRESENTATION: A 65-year-old woman presented with progressive polyneuropathy and nephrotic-range proteinuria ten days after COVID-19 vaccination. Evaluation revealed multicentric lymphadenopathy, elevated IL-6, and plasmacytic-variant CD histopathology (HHV-8 negative). Concurrent Sjögren's syndrome and anti-PLA2R-negative membranous nephropathy were confirmed. After exclusion of POEMS syndrome, iMCD-NOS with intermediate severity was diagnosed. Initial rituximab-cyclophosphamide-dexamethasone therapy resulted in paradoxical neurological worsening despite declining VEGF levels. Anti-IL-6 therapy was inaccessible due to economic constraints. Single-agent rituximab was initiated and continued for nine cycles over 24 months, achieving clinical remission by January 2024 with near-normalization of inflammatory markers, resolution of proteinuria, and neurological recovery.
CONCLUSIONS: This case demonstrates that rituximab monotherapy can achieve clinical remission in iMCD-NOS with concurrent autoimmune manifestations when anti-IL-6 therapy is unavailable. The delayed response pattern-with biomarker improvement preceding clinical recovery-highlights the importance of serial VEGF monitoring and persistence with B-cell-directed therapy before concluding treatment failure.}, }
@article {pmid42327821, year = {2026}, author = {Diago-Navarro, E and García-Vaz, C and Fanjul, G and Naniche, D and Almuedo-Riera, A and Bassat, Q}, title = {From Ebola to Hantavirus: Spain's Preparedness for High-Consequence Infectious Diseases.}, journal = {The Lancet regional health. Europe}, volume = {66}, number = {}, pages = {101749}, pmid = {42327821}, issn = {2666-7762}, abstract = {The hantavirus outbreak linked to the MV Hondius cruise ship, managed by Spanish authorities in May 2026, provides a timely opportunity to examine how Spain prepares and responds to imported high-consequence infectious diseases (HCID). This crisis bears greater resemblance to Spain's 2014 Ebola response than to the early stages of the COVID-19 pandemic. A decade after Ebola, Spain has built substantially stronger HCID capacities: a network of High Level Isolation and Treatment Units, improved clinical protocols, diagnostic capacity, and more consistent technical communication. Coordination with international partners functioned effectively. However, structural challenges persist: political tensions between central and regional authorities complicated real-time operational coordination and spilled into public communication, undermining the perception of a unified, technically-led response. Finalisation of a National Preparedness and Response Plan and full operationalisation of the National Public Health Agency (AESAP) remain urgent priorities. These domestic challenges sit within a deteriorating global health financing environment, directly eroding the surveillance and response capacities that HCID containment depends upon globally. Spain's Estrategia Española de Salud Global 2025-2030, its seat on the WHO Executive Board and its commitment to increasing ODA, position it well to advocate for stronger HCID-specific frameworks internationally, building on the genuine progress this response demonstrated.}, }
@article {pmid42328006, year = {2025}, author = {Sekar, PKC and Veerabathiran, R}, title = {COVID-19 associated acute kidney injury.}, journal = {Infectious diseases & immunity}, volume = {5}, number = {3}, pages = {190-197}, pmid = {42328006}, issn = {2693-8839}, abstract = {Acute kidney injury (AKI) associated with Coronavirus Disease 2019 (COVID-19) is a notable complication of COVID-19 that is difficult to diagnose and treat. This review summarizes the prevalence, pathophysiology, clinical presentation, and management of COVID-19-associated AKI (hereafter COVID-19 AKI). COVID-19 AKI is linked to a multisystem inflammatory syndrome and presents symptoms similar to those of AKI, which is associated with increased morbidity and death rates. The pathophysiological mechanisms of AKI include direct viral injury, cytokine storms, and systemic effects on the renin-angiotensin-aldosterone system. The diagnostic assessment of patients at risk for AKI involves screening for symptoms such as decreased urine output, fluid retention, and fatigue. In contrast, biomarkers like serum creatinine and blood urea nitrogen are used for early detection. The management strategies for COVID-19 AKI, such as avoiding nephrotoxic medications, are similar to those for AKI of other causes. Renal replacement therapy may be considered as a treatment option for severe COVID-19 AKI, particularly in cases of fluid overload, or electrolyte imbalances that cannot be managed with conservative treatments. Future research is essential to elucidate the pathophysiology, optimize diagnostic criteria, and develop targeted therapies for COVID-19 AKI. A multidisciplinary approach focusing on physical and mental health is crucial for comprehensive patient care. Addressing these gaps will necessitate substantial funding support to propel research efforts and improve patient outcomes.}, }
@article {pmid42328007, year = {2025}, author = {Bassetti, M and Giacobbe, DR and Sepulcri, C and Labate, L}, title = {Epidemiology, clinical overview, and potential risk of a new pandemic of measles virus.}, journal = {Infectious diseases & immunity}, volume = {5}, number = {3}, pages = {198-205}, pmid = {42328007}, issn = {2693-8839}, abstract = {Measles outbreaks are increasingly being reported worldwide, posing a global health problem of pandemic potential. Europe was particularly affected in 2024, with a surge in cases linked to a decrease in herd immunity caused by reduced vaccination rates. COVID-19 has worsened the already alarming situation due to the disruption of surveillance systems and access to vaccinations. Here, we discuss the issue of the global surge of measles, its clinical picture, and the role of vaccination, focusing in particular on the European region and describing the underlying causes and potential of a measles pandemic. The purpose of this review is to address current measles epidemiology, highlighting the risks of a potential measles pandemic and exploring possible strategies to address it.}, }
@article {pmid42328241, year = {2024}, author = {Wang, M and Guo, H and Ju, B and Zhang, Z}, title = {Original Antigenic Sin on Antibody Response in SARS-CoV-2 Infection.}, journal = {Infectious diseases & immunity}, volume = {4}, number = {3}, pages = {132-137}, pmid = {42328241}, issn = {2693-8839}, abstract = {Infection and vaccination can provide protective immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, the emergence of SARS-CoV-2 variants has persisted, leading to breakthrough infections. Owing to the original antigenic sin (OAS), variant breakthrough infection or vaccination potentially induces a stronger antibody response against the ancestral strain than to subsequent variants, as in the case of influenza. Thus, overcoming OAS is important for the development of future vaccine designs. This review summarizes the recent findings on OAS in the antibody response to SARS-CoV-2 and its variants, with an emphasis on future vaccine designs.}, }
@article {pmid42328981, year = {2026}, author = {Ortiz-Mateu, J and Martinez-Gil, L}, title = {Role of TMDs in Class I viral fusion proteins.}, journal = {Microbiology and molecular biology reviews : MMBR}, volume = {}, number = {}, pages = {e0000626}, doi = {10.1128/mmbr.00006-26}, pmid = {42328981}, issn = {1098-5557}, abstract = {SUMMARYClass I fusion proteins are trimeric viral membrane proteins that mediate fusion between the virion and cellular membranes. In their prefusion state, they comprise three domains: a globular "head" domain that binds the target cell receptor, a helical "stalk" domain, and a transmembrane domain (TMD) at the carboxy-terminal end that anchors the protein in the viral membrane. However, it is now evident that the role of the TMD extends beyond simple membrane anchoring. This review explores the dynamic and regulatory functions of the TMD throughout the viral life cycle. TMDs contribute to intracellular trafficking and modulate membrane fusion activity and receptor binding. During virion assembly, they facilitate the incorporation of fusion proteins into budding particles, and influence virion formation and release. Furthermore, TMDs mediate interactions between viral and host proteins, shaping the structural organization of viral complexes, and impacting cellular responses to infection. Collectively, these findings highlight the TMD as a critical determinant of viral fitness and infectivity, underscoring its potential as a novel therapeutic target.}, }
@article {pmid42329435, year = {2026}, author = {Kareem, RA and Sameer, HN and Athab, ZH and Adil, M and Yaseen, A and Allela, OQB}, title = {Review: natural compounds as PCSK9 inhibitors for antiviral therapy.}, journal = {Archives of microbiology}, volume = {208}, number = {9}, pages = {}, pmid = {42329435}, issn = {1432-072X}, mesh = {Humans ; *PCSK9 Inhibitors ; *Antiviral Agents/pharmacology/therapeutic use ; Proprotein Convertase 9/metabolism ; *Biological Products/pharmacology/therapeutic use ; Animals ; SARS-CoV-2/drug effects ; Antibodies, Monoclonal, Humanized/pharmacology ; *Virus Diseases/drug therapy ; }, abstract = {From the perspective of both the host cell and the virus, cholesterol (CHO) plays a critical role during viral infection. Proprotein convertase subtilisin/kexin type 9 (PCSK9) increases the risk of cardiovascular disease by regulating plasma levels of lipoprotein(a), triglyceride-rich lipoproteins, and low-density lipoprotein cholesterol (LDL-C), and by promoting the degradation of the LDL receptor (LDLR). Emerging evidence implicates PCSK9 in the pathophysiology of several viral diseases, including human immunodeficiency virus (HIV), SARS-CoV-2, dengue virus (DENV), and hepatitis viruses. Two monoclonal antibody PCSK9 inhibitors (PCSK9i), evolocumab (Repatha[®]) and alirocumab (Praluent[®]), are approved by the Food and Drug Administration (FDA) for managing atherosclerotic risk. However, despite preclinical studies suggesting that these inhibitors and other CHO-lowering medications may interfere with viral replication, their therapeutic application as antivirals remains limited due to various restrictions. Naturally occurring compounds such as curcumin, berberine, quercetin, and polyphenols have demonstrated PCSK9-modulating and antiviral properties in preclinical models against viruses including HIV, hepatitis viruses, SARS-CoV-2, DENV, herpes simplex virus, human cytomegalovirus, and Epstein-Barr virus. Crucially, the majority of evidence for these natural substances remains preclinical, derived from in vitro and animal studies. The contribution of PCSK9 inhibition to the reported antiviral effects remains unclear, as pleiotropic mechanisms may be involved. Therefore, rather than being clinically proven substitutes for licensed PCSK9-targeted treatments, these molecules should be considered experimental or maybe supplementary medicines. This review examines the current preclinical evidence for natural inhibitors of PCSK9 and their antiviral properties, discusses clinical assessments to date, and considers the potential future role of naturally occurring PCSK9i in antiviral development, acknowledging the substantial research gaps that remain.}, }
@article {pmid42329791, year = {2026}, author = {Jhandai, P and Vaddadi, K and Liu, L}, title = {NAD[+] metabolism at the host-virus interface.}, journal = {The Journal of general virology}, volume = {107}, number = {6}, pages = {}, pmid = {42329791}, issn = {1465-2099}, mesh = {*NAD/metabolism ; Humans ; Sirtuins/metabolism ; Poly(ADP-ribose) Polymerases/metabolism ; *Host-Pathogen Interactions ; Animals ; ADP-ribosyl Cyclase 1/metabolism ; Virus Replication ; *Virus Diseases/metabolism/virology ; *Viruses/metabolism ; SARS-CoV-2/metabolism ; }, abstract = {Nicotinamide adenine dinucleotide (NAD[+]) is one of the most important metabolic coenzymes that not only drives redox reactions and energy production but also acts as a critical substrate for several enzymes involved in immune signalling, DNA repair and epigenetic regulation. Viral infections are known as potent modulators of NAD[+] metabolism, with pathogens such as SARS-CoV-2, influenza A virus, Zika virus, herpes simplex virus and human immunodeficiency virus altering NAD[+] biosynthesis and consumption to benefit their persistence and replication. In this review, we summarize the current understanding of NAD[+] metabolism and its regulatory enzymes: sirtuins, poly (ADP-ribose) polymerases and CD38/CD157. We then discuss the interplay between NAD[+] homeostasis and virus infection. Understanding how diverse viruses manipulate NAD[+] metabolism could lead to broad-spectrum antiviral strategies grounded in metabolic resilience.}, }
@article {pmid42331642, year = {2026}, author = {Guedj, E and Verger, A and Horowitz, T}, title = {Brain [18F]FDG PET in Subjective Cognitive Complaints: From Diagnostic Gap to Neurobiological Insight.}, journal = {PET clinics}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.cpet.2026.05.004}, pmid = {42331642}, issn = {1879-9809}, abstract = {Subjective cognitive complaints are heterogeneous and may occur with normal, subtle, or objectively abnormal cognitive testing. Fluorodeoxyglucose (FDG) PET can help explore their metabolic substrate, particularly in subjective cognitive decline within the Alzheimer's disease continuum. In mild traumatic brain injury and long coronavirus disease (COVID), available studies suggest possible metabolic-network abnormalities but involve more heterogeneous populations and should be interpreted cautiously within multimodal, clinically characterized frameworks.}, }
@article {pmid42332867, year = {2026}, author = {Barash, JA and Madden, J and Kofke, WA}, title = {Opioid-Associated Hippocampal Injury: Past, Present, and Future Directions.}, journal = {Hippocampus}, volume = {36}, number = {4}, pages = {e70111}, doi = {10.1002/hipo.70111}, pmid = {42332867}, issn = {1098-1063}, support = {1R21DA051737-01A1/DA/NIDA NIH HHS/United States ; }, mesh = {Humans ; *Hippocampus/drug effects/pathology/injuries ; Animals ; *Analgesics, Opioid/adverse effects ; *Opioid-Related Disorders/complications/pathology/epidemiology ; Amnesia/chemically induced ; }, abstract = {Three of the great public health challenges of our time converge at the hippocampus. The first, dementia, most commonly in the form of Alzheimer's disease, is well known to cause progressive hippocampal damage, resulting in the memory loss associated with the illness. The second, COVID-19 infection, has thus far been linked to hippocampal alterations across multiple studies. Lastly, the third, opioids-especially in the setting of misuse-have been associated with acute and persistent hippocampal injury; this review focuses on the collection of pre-clinical, clinical, and epidemiologic observations supporting this final relationship. Basic science work dating back decades has demonstrated a hypermetabolic response to opioids and associated damage to the hippocampus. The earliest cases recognized as opioid-associated amnestic syndrome (OAS) were subsequently identified in 2012 and reported as part of larger case series several years later. In 2019, a related but more fulminant syndrome involving cerebellar, hippocampal, and basal nuclei transient edema with restricted diffusion (CHANTER) was first described. From these investigations, a growing body of data has since emerged to suggest that regular opioid use, particularly at higher doses or potency, may be connected to a reduction in hippocampal volume and greater risk of dementia. This review begins with a synthesis of data supporting the underlying pathological mechanisms of opioid-associated hippocampal injury (OAHI), then covers the clinical spectrum of this phenomenon. Lastly, we will close with implications of OAHI that warrant further study, including the future epidemiologic impact on related cognitive disorders in the wake of the opioid epidemic and potential therapeutic applications of opioid antagonism for mild cognitive impairment.}, }
@article {pmid42333972, year = {2026}, author = {Pizarro Andrade, RLN and Enriquez Canto, Y and Angulo Salas, RJ and Cahui Ramirez, CR and Díaz Gervasi, GM}, title = {Mental health outcomes and physical activity during the COVID-19 pandemic: A systematic review and meta-analysis of observational studies.}, journal = {Journal of health psychology}, volume = {}, number = {}, pages = {13591053261460700}, doi = {10.1177/13591053261460700}, pmid = {42333972}, issn = {1461-7277}, abstract = {The COVID-19 pandemic disrupted physical activity behaviors and worsened mental health worldwide. This study synthesized observational evidence on relationships between physical activity and depression, anxiety, and stress in adults during COVID-19. A systematic review and multilevel random-effects meta-analysis (PROSPERO CRD42023491651) of observational studies published January 2020-May 2023 included 38 studies with 140,915 adults using validated measures. Physical activity showed significant inverse associations with depression (r = -0.18; p < 0.001) and stress (r = -0.14; p = 0.043), but not anxiety (p = 0.340). Heterogeneity was substantial. Findings suggest physical activity can serve as a low-risk adjunct to mitigate depressive symptoms and perceived stress during public health crises, though interpretation should be cautious given observational design and high heterogeneity. Clinically, brief assessment and promotion of regular physical activity-tailored to context and delivered in-person or remotely-may support psychological well-being, while anxiety may require combined approaches during emergencies.}, }
@article {pmid42334213, year = {2026}, author = {Bermejo-Jambrina, M and Paužuolis, M and Kimpel, J and Gerold, G}, title = {Double trouble: how co- and superinfections shape viral dynamics and host responses.}, journal = {Journal of virology}, volume = {}, number = {}, pages = {e0205525}, doi = {10.1128/jvi.02055-25}, pmid = {42334213}, issn = {1098-5514}, abstract = {Concurrent infection of humans by multiple distinct viruses is a common biological phenomenon with important consequences for virus-host interactions. While coinfection refers to the simultaneous infection of an individual or cell with two or more viruses, superinfection denotes the establishment of a secondary infection following a primary one, in which the initial infection influences the susceptibility, replication, or outcome of the secondary infection. Virus-virus interactions can be antagonistic, facilitative, dependent/assisted, or neutral. Antagonistic interactions include superinfection exclusion, whereby a primary virus prevents or restricts secondary infection of the same cell, securing access to host resources and stabilizing replication while limiting genetic and viral diversity. In contrast, facilitative viral interactions arise when one virus disrupts tissue barriers, suppresses immune responses, or remodels cellular pathways, thereby increasing susceptibility to additional viral infections. These interactions intersect with fundamental viral strategies, including the generation of genetically diverse RNA virus quasispecies that promote rapid adaptation and the deployment of DNA virus immunoevasins that interfere with antigen presentation and host immune recognition. While each of these processes has been extensively studied individually, their combined impact during coinfection remains poorly defined. In this review, we synthesize current knowledge on virus-virus interactions, viral diversity, and immune evasion in the context of multi-viral infections. We focus on how interactions at cellular and tissue levels shape infection outcomes, influence viral evolution, and contribute to virus-host coevolution. Finally, we also highlight key gaps in our understanding of viral interference and cooperation and discuss emerging approaches needed to define the spatiotemporal dynamics of coinfection in vivo.}, }
@article {pmid42334562, year = {2026}, author = {Khudair, M and Swift, SL and Dienes, K and Kannan, YA and Vedhara, K}, title = {Factors associated with vaccination intentions and uptake among pregnant women in the UK: A scoping review.}, journal = {Human vaccines & immunotherapeutics}, volume = {22}, number = {1}, pages = {2687220}, pmid = {42334562}, issn = {2164-554X}, mesh = {Humans ; Female ; Pregnancy ; United Kingdom ; *Vaccination/psychology/statistics & numerical data ; *Pregnant People/psychology ; *Vaccination Hesitancy/psychology/statistics & numerical data ; *Health Knowledge, Attitudes, Practice ; *Patient Acceptance of Health Care/psychology ; *Intention ; }, abstract = {This scoping review aimed to identify factors associated with vaccination decisions among pregnant women in the UK, guided by the SAGE matrix on vaccine hesitancy, and explored differences between qualitative and quantitative findings and between vaccine intentions (attitudes) and actual uptake (behaviors). Embase®, MEDLINE®, PsycInfo, Web of Science, and Cochrane were searched; rapid review methodologies were applied. From 2,326 records, 49 primary studies were included (published 2010-2025). We identified 222 qualitative factors from 32 studies, and 114 quantitative factors from 30 studies. Qualitative studies frequently reported individual and group influences, particularly beliefs and attitudes about vaccine effectiveness and safety, and the role of healthcare professionals in decision-making. Quantitative studies highlighted sociodemographic influences, including older age, ethnicity, and lower social/economic deprivation. Factors found to be associated with vaccination intention vs. uptake were inconsistent, though these findings should be interpreted cautiously given the modest number of studies addressing this issue.}, }
@article {pmid42336668, year = {2026}, author = {Hasmee, N and Joshi, H and Gurung, M and Singh, B and Naseema, S}, title = {Optimising ICU supply chains: Evidence-based strategies for efficiency, resilience and patient safety-a structured narrative review.}, journal = {BMJ open quality}, volume = {15}, number = {2}, pages = {}, pmid = {42336668}, issn = {2399-6641}, mesh = {Humans ; *Intensive Care Units/organization & administration ; *Patient Safety/standards ; COVID-19/epidemiology ; *Efficiency, Organizational ; SARS-CoV-2 ; Evidence-Based Practice ; }, abstract = {Inventory management in intensive care units (ICUs) plays a critical role in ensuring uninterrupted patient care, yet it remains an underprioritised component of healthcare operations. This narrative review explores current challenges and evidence-based strategies for optimising ICU supply chains. Issues such as unpredictable demand, manual stock tracking, procurement inefficiencies and limited staff training often contribute to stockouts, expired supplies and delayed interventions. The COVID-19 pandemic further exposed systemic vulnerabilities, emphasising the need for resilient, technology-driven supply systems. A comprehensive literature search (2004-2025) was conducted across PubMed, Scopus, Web of Science and Google Scholar using keywords related to ICU inventory, artificial intelligence (AI) forecasting, radio frequency identification (RFID), procurement and digital health logistics. Findings were synthesised into thematic categories addressing core problems and interventions. Key strategies include implementing automated tracking systems, adopting AI-driven demand forecasting, standardising procurement policies, training ICU staff in inventory best practices and establishing emergency buffer stock. Emerging technologies such as digital twins and blockchain are highlighted for their potential to enhance transparency, responsiveness and planning accuracy. Additionally, fostering multisourcing supplier partnerships and optimising ICU storage space can further enhance system agility and reduce waste. In conclusion, ICU supply chains must evolve from reactive, manual systems to proactive, data-driven frameworks. Hospitals should invest in digital infrastructure, staff training and ethical procurement models to build resilient, cost-effective and patient-centred supply chains.}, }
@article {pmid42337147, year = {2026}, author = {Lansayan, J and Chin, KL and AbuBakar, S and Zainal, N}, title = {Clinical Manifestations and Immunological Impacts in Co-Infections and Sequential Infections of SARS-CoV-2 and Arboviruses.}, journal = {Current microbiology}, volume = {83}, number = {8}, pages = {}, pmid = {42337147}, issn = {1432-0991}, support = {MO002D-2021//Ministry of Higher Education, Malaysia/ ; MO002D-2021//Ministry of Higher Education, Malaysia/ ; MO002D-2021//Ministry of Higher Education, Malaysia/ ; MO002D-2021//Ministry of Higher Education, Malaysia/ ; }, mesh = {Humans ; *Coinfection/immunology/virology ; *COVID-19/immunology ; *Arbovirus Infections/immunology/pathology/virology/diagnosis ; SARS-CoV-2/immunology ; Arboviruses/immunology ; Cross Reactions ; Antibody-Dependent Enhancement ; *Coronavirus Infections/immunology ; *Pneumonia, Viral/immunology/virology ; Pandemics ; Betacoronavirus/immunology ; }, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and arboviruses represent major global public health threats, each with distinct epidemiological and pathogenic profiles that often overlap in endemic regions. Reports of co-infection and cross-reactivity between these viruses highlight the need for deeper understanding of their interactions. Co-infections pose diagnostic challenges due to overlapping clinical symptoms and immune modulation, which may exacerbate disease severity. Moreover, antibodies generated from prior virus infections may influence the outcome of subsequent infections through mechanisms such as cross-reactivity and antibody-dependent enhancement (ADE). This review summarises current knowledge on the clinical manifestations and immunological consequences of co- and subsequent infections involving SARS-CoV-2 and arboviruses. Emphasis is placed on underlying pathophysiological mechanisms, including cross-reactivity and ADE, that shape host immune responses. Understanding these interactions is essential for improving diagnostic accuracy and guiding public health strategies to mitigate the risks associated with co-infections and sequential viral infections.}, }
@article {pmid42338490, year = {2026}, author = {Nirala, S and Huang, C and Mu, Q}, title = {TORCH infections at the maternal-fetal placental transmission: an overview of multi-omics, pathogenesis and innate immune defense.}, journal = {Frontiers in cellular and infection microbiology}, volume = {16}, number = {}, pages = {1817189}, pmid = {42338490}, issn = {2235-2988}, mesh = {Humans ; Female ; Pregnancy ; *Infectious Disease Transmission, Vertical ; *Immunity, Innate ; *Placenta/virology/immunology/parasitology ; *Pregnancy Complications, Infectious/immunology/virology ; Multiomics ; Host-Pathogen Interactions/immunology ; Toxoplasmosis/transmission/immunology ; Rubella/transmission/immunology ; Toxoplasma/immunology/pathogenicity ; Animals ; Proteomics ; Zika Virus Infection/transmission/immunology ; SARS-CoV-2/immunology ; Maternal-Fetal Exchange/immunology ; }, abstract = {The maternal-fetal interface represents a dynamic immunological frontier where pregnancy outcomes are determined by the delicate balance between host defense and microbial pathogenesis. Vertical transmission of pathogens across the placental barrier can lead to devastating consequences including fetal loss, stillbirth, prematurity, and congenital anomalies. The classic TORCH acronym encompasses Toxoplasma gondii, Other agents, Rubella virus, Cytomegalovirus, and Herpes simplex virus, though emerging viruses including Zika virus and SARS-CoV-2 have expanded this spectrum. This review synthesizes current understanding of molecular mechanisms underlying vertical transmission, emphasizing the placenta's multi-layered defense system encompassing the syncytiotrophoblast physical barrier, specialized decidual immune cell populations including decidual natural killer cells and macrophages, and constitutive antimicrobial signaling pathways focusing on the placenta's multi-layered defense system encompassing the syncytiotrophoblast physical barrier, specialized decidual immune cell populations including decidual natural killer cells and macrophages, and constitutive antimicrobial signaling pathways. Concurrently, we examine pathogen strategies to subvert these defenses through receptor manipulation, immune evasion, and intracellular replication niches. A major focus is dedicated to the impact of proteomics and single-cell multi-omics in deconvoluting the host-pathogen interactome and identifying biomarkers of fetal injury. Recent seroprevalence studies demonstrate that younger women represent the most susceptible population to acute TORCH infections, highlighting the need for targeted screening programs. This synthesis provides a framework for developing precision diagnostics and targeted interventions to prevent vertical transmission and reduce the global burden of congenital infections.}, }
@article {pmid42339932, year = {2026}, author = {Theodoro, EL and Prediger, KM and Damacena, MA and Silva, CVD and Cano, RDN and Uehara, SCDSA}, title = {Oral manifestations associated with long COVID: a scoping review.}, journal = {Revista brasileira de enfermagem}, volume = {79}, number = {}, pages = {e20250198}, pmid = {42339932}, issn = {1984-0446}, mesh = {Humans ; Post-Acute COVID-19 Syndrome ; *COVID-19/complications ; *Mouth Diseases/etiology/epidemiology ; Quality of Life ; SARS-CoV-2 ; Female ; }, abstract = {OBJECTIVES: to map scientific evidence on oral manifestations originating during long COVID.
METHODS: this is a scoping review based on the method described by JBI. Primary articles published in Portuguese, English, and Spanish between March 2020 and December 2024 were included from the PubMed, Web of Science, Virtual Health Library, Scopus, Excerpta Medica dataBASE, and Scientific Electronic Library Online databases, and a descriptive analysis was performed.
RESULTS: of the 15 studies analyzed, the most frequent oral manifestations of long COVID were taste alterations, xerostomia, difficulty chewing, gingival bleeding, periodontitis, and changes in the teeth.
CONCLUSIONS: an association between long COVID and various oral manifestations was evidenced, impacting the quality of life of patients. Factors such as age, comorbidities, and social inequalities influence the persistence of these manifestations, with a higher prevalence in women. Multiprofessional collaboration and clearer guidelines are essential to improve dental care.}, }
@article {pmid42340118, year = {2026}, author = {Poder, TG and Camara, MA and Bouchard, PA and Lellouche, F}, title = {Pricing Policy for Medical Oxygen and Potential Savings.}, journal = {Journal of evaluation in clinical practice}, volume = {32}, number = {4}, pages = {e70510}, pmid = {42340118}, issn = {1365-2753}, mesh = {Humans ; Quebec ; *Oxygen Inhalation Therapy/economics ; *Cost Savings ; *Oxygen/economics/therapeutic use ; *COVID-19/epidemiology ; *Costs and Cost Analysis ; }, abstract = {BACKGROUND: Medical oxygen is essential in modern medicine.
AIMS: This study analyzes the pricing policies and costs of medical oxygen in Quebec, provides elements of international comparison, and explores the potential savings through the optimization of oxygen therapy practices.
MATERIALS AND METHODS: It combines a narrative literature review, an analysis of administrative and financial documents, as well as administrative data obtained from representatives of the healthcare sector in Quebec.
RESULTS: The literature review highlights the challenges of producing, storing, and distributing medical oxygen, which have been accentuated by the COVID-19 pandemic. A very large disparity in pricing policies is also noted among healthcare systems, especially when cylinders are predominantly used. In Quebec, costs vary according to production methods, logistics, and contractual clauses. Optimizing oxygen therapy practices would allow significant savings, particularly by reducing oxygen consumption through various strategies.
DISCUSSION: The study shows the complexity of managing medical oxygen costs, amplified by limited competition and rigid contractual clauses. International comparison highlights the importance of infrastructure, while optimizing oxygen therapy practices offers significant savings potential. To reduce costs, it is recommended to improve distribution management, adopt more flexible contractual clauses, and strengthen competition.
CONCLUSION: To optimize medical oxygen use, actions to undertake from managers and clinicians are highlighted.}, }
@article {pmid42340456, year = {2026}, author = {Tahmtan, A and Nissapatorn, V and Saravanabhavan, SS and Taherkhani, S and Aghcheli, B}, title = {Viral Infections and Neurodegenerative Diseases: Reinterpreting the Crosstalk Through a Dual-Role Lens.}, journal = {Current microbiology}, volume = {83}, number = {8}, pages = {}, pmid = {42340456}, issn = {1432-0991}, mesh = {Humans ; *Neurodegenerative Diseases/virology/therapy ; Genetic Vectors/genetics ; *Virus Diseases/complications/virology/therapy ; Genetic Therapy/methods ; Animals ; Gene Therapy Agents ; }, abstract = {Neurodegenerative diseases (NDDs) are multifactorial disorders with increasing evidence implicating viral infections in their pathogenesis. However, current reviews often catalog virus-disease associations without integrating this evidence into a unified conceptual model that also accounts for the therapeutic potential of viral platforms. This review investigates recent literature to propose a "dual-role" model for viruses in NDDs. We analyze how diverse viruses (e.g., HSV-1, HIV, EBV, and SARS-CoV-2) converge on shared pathogenic pathways, including protein misfolding, chronic neuroinflammation, and mitochondrial dysfunction, across different NDDs. Paradoxically, engineered viral vectors derived from neurotropic viruses are being investigated as tools for targeted gene therapy. To address these therapeutic applications of viruses, this review also provides an in-depth report of the various viral vector technologies developed. The approaches involved in designing rationally engineered viral vectors based on various adeno-associated virus serotypes through rational design, directed evolution and machine learning strategies, as well as the lentiviral and herpes simplex virus-based platform are described. Different strategies that have been used to incorporate large and/or small payloads such as gene replacement, RNA interference, microRNA cassettes, CRISPR-based gene editing (base editing, prime editing, CRISPRa and CRISPRi) and the double AAV systems to deliver larger transgene cassette have also been reviewed. This review further includes various routes of administration including intrathecal, intracerebroventricular and convection-enhanced delivery with the use of Focused Ultrasound. The constraints imposed by the Blood-Brain Barrier are discussed, especially the approach using receptor-mediated transcytosis for crossing. The review also critically evaluates obstacles toward clinical translation of viral vectors due to various factors including immunogenicity, the presence of pre-existing neutralising antibodies and dose-dependent toxicity, illustrated by the fatal outcome of ASPIRO and DMD trials. Finally, this review concludes with other promising non-viral approaches such as lipid nanoparticle and extracellular vesicles. Future research needs include long-term studies to investigate causality and extensive safety optimization of viral vectors.}, }
@article {pmid42340792, year = {2026}, author = {Elgazzar, YA and Abdelrazek, M and Ghozzy, OAM and Mashhour, K and Elhady, MA and Amro, OAEA and Mokhtar, HM and Abdellatif, KAK and Mohamed, MM and Alsharif, MB and Mawkili, H and Hendi, AM and Dhayihi, TM and Adawy, Z and Ali, RF}, title = {CT-Assessed Sarcopenia Combined with Laboratory Inflammatory Markers for Outcome Prediction in Critically Ill, Pulmonary, and Geriatric Patients: A Systematic Review and Meta-Analysis.}, journal = {La Clinica terapeutica}, volume = {177}, number = {4}, pages = {903-915}, doi = {10.7417/CT.2026.2085}, pmid = {42340792}, issn = {1972-6007}, mesh = {Humans ; *Sarcopenia/diagnostic imaging/blood/mortality ; *Tomography, X-Ray Computed ; *Critical Illness ; Biomarkers/blood ; Prognosis ; Aged ; C-Reactive Protein/analysis ; *Lung Diseases/blood/complications/mortality ; Length of Stay ; Respiration, Artificial/statistics & numerical data ; Predictive Value of Tests ; *Inflammation/blood ; }, abstract = {BACKGROUND: Sarcopenia, assessed via computed tomography (CT), is an emerging prognostic tool in critically ill, pulmonary, and geriatric patients. Laboratory inflammatory markers such as C-reactive protein (CRP), interleukin-6 (IL-6), and neutrophil-to-lymphocyte ratio (NLR) are routinely obtained in these populations. Whether CT-assessed sarcopenia combined with laboratory markers offers superior prognostic accuracy over either measure alone remains unclear.
OBJECTIVES: To systematically evaluate the prognostic value of CT-assessed sarcopenia, alone or combined with laboratory inflammatory/nutritional markers, for predicting mortality, mechanical ventilation duration, and ICU length of stay in critically ill, pulmonary, and geriatric patients.
METHODS: MEDLINE/PubMed, Scopus, Embase, and Cochrane Library were searched from inception to December 2024. Observational studies (prospective or retrospective cohorts, case-control) that reported CT-based sarcopenia assessment alongside at least one laboratory inflammatory marker and at least one clinical outcome were included. Two reviewers independently screened studies, extracted data, and assessed methodological quality using the Newcastle-Ottawa Scale (NOS). Random-effects meta-analysis was performed; heterogeneity was assessed using the I² statistic.
RESULTS: Twenty-five studies encompassing 12,347 patients were identified. The pooled odds ratio for mortality in sarcopenic versus non-sarcopenic patients was 2.28 (95% CI: 1.83-2.83; I² = 22.1%) across critically ill ICU cohorts. In COVID-19 pulmonary populations, pooled OR for in-hospital mortality with low skeletal muscle mass was 5.84 (95% CI: 1.07-31.83). CT-derived muscle measurements correlated inversely with CRP (r = -0.315), fibrinogen (r = -0.392), D-dimers (r = -0.363), and WBC count (r = -0.287). Combined CT-sarcopenia and inflammatory marker models outperformed conventional scoring systems (APACHE II, SOFA, CURB-65, PSI).
CONCLUSIONS: CT-assessed sarcopenia, when integrated with laboratory inflammatory markers, provides a robust, mechanistically grounded, and clinically accessible multimodal prognostic framework across critically ill, pulmonary, and geriatric populations.}, }
@article {pmid42342266, year = {2026}, author = {Xu, J and Kathiresan, T and Siddiqui, A and Mazzone, SB and Vogel, A}, title = {Cough biomarkers for diagnosis and monitoring of respiratory disease: a systematic review.}, journal = {European respiratory review : an official journal of the European Respiratory Society}, volume = {35}, number = {180}, pages = {}, pmid = {42342266}, issn = {1600-0617}, mesh = {Humans ; *Cough/diagnosis/physiopathology/etiology ; Biomarkers ; Predictive Value of Tests ; *Respiratory Tract Diseases/diagnosis/physiopathology ; *Acoustics ; Prognosis ; }, abstract = {Cough is a common and physiologically informative component of respiratory morbidity, but its potential for diagnosing and monitoring disease is not thoroughly investigated. This systematic review synthesised the literature on algorithmic and statistical models analysing cough acoustics for diagnosing or monitoring respiratory conditions. Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, five databases (PubMed, Embase, Scopus, Web of Science and CENTRAL) were systematically searched for studies published from January 2010 to June 2025. Eligible studies performed quantitative acoustic feature analysis of human coughs using statistical, machine learning or deep learning models and reported diagnostic or prognostic performance. 89 studies from 34 countries were assessed, covering cough detection (n=31), disease classification (n=55) and disease severity prediction (n=3), reflecting potential applications in disease monitoring. Deep learning approaches, especially convolutional and recurrent networks, were predominant (n=56) and tended to achieve the higher accuracies, although machine learning ensemble methods and logistic regression also demonstrated strong performance, particularly with well-engineered features. Across different diseases, sensitivities and specificities were often reported to be ≥90%, notably for tuberculosis, asthma and COVID-19. However, methodological weaknesses were common, with only 11.2% of studies introducing external validation, 71.1-87.6% demonstrating high risk of bias (according to PROBAST-AI) and most based on small, homogeneous or crowdsourced cohorts with limited generalisability. These limitations contribute to inflated internal performance and uncertainty about real-world applicability. Cough acoustic biomarkers hold promise as an adjunctive tool for screening and longitudinal monitoring in low-resource environments. Nevertheless, widespread implementation will require large, multicentre validation, standardised calibration, bias control and incorporation into privacy-preserving workflows.}, }
@article {pmid42342297, year = {2026}, author = {Yasam, SK and Vignesh, N and Rajagopal, S}, title = {Advances in ferroptosis research and applications.}, journal = {International review of cell and molecular biology}, volume = {405}, number = {}, pages = {149-186}, doi = {10.1016/bs.ircmb.2025.12.004}, pmid = {42342297}, issn = {1937-6448}, mesh = {*Ferroptosis/drug effects/physiology ; Humans ; Animals ; COVID-19/metabolism/pathology/virology ; Iron/metabolism ; Lipid Peroxidation ; SARS-CoV-2 ; Neoplasms/pathology/metabolism ; Neurodegenerative Diseases/pathology/metabolism ; Pulmonary Fibrosis/pathology/metabolism ; Renal Insufficiency, Chronic/metabolism/pathology ; }, abstract = {Ferroptosis is an iron-dependent form of regulated cell death driven by lipid peroxidation and redox imbalance. It has emerged as a pivotal mechanism implicated in various diseases, including cancer, chronic kidney diseases (CKD), neurodegenerative disorders, pulmonary fibrosis, chronic wounds, and viral infections such as COVID-19. This chapter presents a comprehensive overview of the molecular underpinnings of ferroptosis, emphasizing its key regulators-iron metabolism, lipid peroxidation pathways, and antioxidant defenses such as GPX4 and system Xc[-]. We explore recent advances highlighting the therapeutic potential of ferroptosis modulation across multiple pathological contexts. In cancer, ferroptosis inducers have shown efficacy in overcoming drug resistance and enhancing immunotherapy. In contrast, inhibition of ferroptosis offers protective effects in neurodegenerative diseases, ischemia-reperfusion injury, and chronic inflammatory conditions. Applications in nanomedicine have further enabled targeted delivery of ferroptosis modulators, expanding their clinical relevance. The chapter also discusses emerging roles of ferroptosis in wound healing, CKD and pulmonary fibrosis, with particular attention to COVID-19-related lung injury. Finally, we evaluate current therapeutic strategies, safety considerations, and potential clinical applications, along with future directions including biomarker development and personalized medicine. Our aim is to provide a unified perspective on ferroptosis as a disease-modifying mechanism and to highlight its growing importance as a therapeutic target across diverse clinical disciplines.}, }
@article {pmid42342836, year = {2026}, author = {Schuele, L and Nzoyikorera, N and Udahemuka, JC and Cassidy, H and Murhula Masirika, L and Nieuwenhuijse, DF and Nduwimana, C and Molenkamp, R and Nyandwi, J and Boter, M and Minega Ndoli, J and Zaeck, LM and Musabyimana, JP and de Vries, RD and Mbiribindi, JB and Siangoli, FB and Otani, S and Aarestrup, FM and Koopmans, M and Ndishimye, P and Oude Munnink, BB}, title = {Capacity building for genomic surveillance of mpox and other emerging diseases in resource-limited settings within the African Great Lakes region.}, journal = {Communications medicine}, volume = {6}, number = {1}, pages = {}, pmid = {42342836}, issn = {2730-664X}, abstract = {Genomic surveillance has become an indispensable tool for the identification of pathogens and tracking of transmission chains. Building upon the global sequencing and surveillance infrastructure developed and expanded during the COVID-19 pandemic, these capacities are now being adapted to track other pathogens in low- and middle-income countries which remain disproportionately affected by infectious diseases. This is evident in the recent and unprecedented spread of mpox virus in regions experiencing multiple concurrent infectious disease outbreaks, highlighting the need for broad, adaptable diagnostic detection and sequencing capacity. In this Perspective, we describe the applications, insights, and challenges encountered during ongoing capacity building efforts for the characterization of the mpox outbreak and other emerging pathogens in the African Great Lakes Region.}, }
@article {pmid42342874, year = {2026}, author = {Locci, M and Pardi, N}, title = {Immunological mechanisms of mRNA vaccines for infectious diseases.}, journal = {Nature}, volume = {654}, number = {8120}, pages = {892-901}, pmid = {42342874}, issn = {1476-4687}, mesh = {Animals ; Humans ; Adaptive Immunity ; Adjuvants, Immunologic ; *Communicable Diseases/immunology ; COVID-19/prevention & control/immunology ; COVID-19 Vaccines/immunology ; Immunity, Innate ; Immunogenicity, Vaccine ; *mRNA Vaccines/immunology ; Nanoparticles/chemistry ; *RNA, Messenger/immunology/chemistry/genetics ; Vaccines, Synthetic/immunology/chemistry ; Liposomes ; }, abstract = {Nucleoside-modified mRNA-lipid-nanoparticle (mRNA-LNP) vaccines confer a high level of protection against severe COVID-19 and, since their first authorization for human use in 2020, have saved millions of lives. The efficacy of this vaccine platform relies on the induction of powerful and coordinated innate and adaptive immune responses. A deep understanding of the mechanisms of action by which mRNA-LNP vaccines drive protective immunity is crucial for advancing the development of next-generation mRNA vaccines with improved immunogenicity and tolerability. A flurry of recent studies has shed light on aspects of this vaccine modality's modus operandi. Nonetheless, key gaps in knowledge remain, including understanding how LNPs are sensed by the immune system and exert their adjuvant activity, identifying the specific signals and cellular pathways critical for eliciting protective immune responses and determining whether it is feasible to uncouple vaccine immunogenicity and reactogenicity. Here we review the known and unknown features of the immunological mechanisms of mRNA-LNP vaccines for infectious diseases. Furthermore, we discuss how the components of this vaccine platform can be modified to fine-tune immune responses against challenging pathogens for which effective vaccines do not exist or need improvement.}, }
@article {pmid42342927, year = {2026}, author = {Li, X and Kang, M and Jiao, XY and Merits, A and Veit, M and Rey, FA and Dai, H and Wang, XY and He, WT and Holmes, EC and Varjak, M and Mahalingam, S and Wang, D and Jiang, Z and Wang, S and Li, X and Peng, Z and He, N and Su, S}, title = {Addressing the zoonotic threat of merbecoviruses.}, journal = {Nature microbiology}, volume = {11}, number = {7}, pages = {1774-1785}, pmid = {42342927}, issn = {2058-5276}, mesh = {Animals ; Humans ; Receptors, Virus/metabolism ; *Zoonoses/virology/transmission ; Virus Internalization ; *Coronavirus Infections/virology/prevention & control/transmission/epidemiology/diagnosis ; *Viral Zoonoses/virology/prevention & control/transmission ; *Coronavirus/genetics/classification/physiology/pathogenicity ; Angiotensin-Converting Enzyme 2/metabolism ; }, abstract = {Merbecovirus is a subgenus of betacoronaviruses and exhibits high genetic diversity with a capacity for cross-species transmission. However, beyond Middle East respiratory syndrome coronavirus (MERS-CoV), our knowledge of the ecology and pathogenic potential of these viruses remains limited. Merbecoviruses were once thought to rely exclusively on dipeptidyl peptidase 4 for cell entry, but recent discoveries have revealed that several members can also engage with angiotensin-converting enzyme 2 or aminopeptidase N, expanding their receptor repertoire and potential host range. Here we summarize recent advances in understanding of the receptor usage of merbecoviruses and examine how these insights inform pandemic preparedness and risk assessment. We discuss the development of targeted diagnostics, broad-spectrum antivirals and vaccines, including pan-coronavirus strategies. Together, these advances provide a foundation for predictive surveillance and rational countermeasure design, enabling earlier detection and more effective containment of future merbecovirus spillover events before they escalate into epidemics.}, }
@article {pmid42344053, year = {2026}, author = {Nichols, E and Arhin-Wiredu, K and Bratton, S and Cercone, E and Longa Chanda, S and Cobos Muñoz, D and Ebonwu, J and Espinosa-Bode, A and Handzel, E and Kapombe, P and Martin, D and Moolenaar, R and Muhwava, W and Atuheire, EB}, title = {Integrating mortality surveillance as a routine component of national essential public health functions: a blueprint for action.}, journal = {BMJ public health}, volume = {4}, number = {2}, pages = {e003392}, pmid = {42344053}, issn = {2753-4294}, abstract = {The COVID-19 pandemic and other recent public health responses have highlighted significant challenges in global mortality data collection, with approximately 40% of deaths unregistered and fragmented reporting systems hampering public health responses. This paper supports the establishment of routine mortality surveillance as a core function of essential public health services, emphasising the need for integration with civil registration and vital statistics (CRVS) systems. By leveraging existing frameworks and proposing a Theory of Change (ToC), we outline critical linkages between CRVS and mortality surveillance that enhance data accuracy, timeliness and utility for public health decision-making. The paper provides examples across key enablers-policies, agreements and legislation; infrastructure; governance, funding and resources; and people and organisational culture-that facilitate these linkages. We also present examples from initiatives like the Africa CDC's Mortality Surveillance Programme to illustrate effective strategies in low- and middle-income countries (LMICs). The ToC serves as a blueprint for stakeholders to implement strategic interventions aimed at overcoming barriers to linking systems and data integration and utilisation. Ultimately, this paper underscores the importance of coordinated efforts among national public health agencies, civil registration authorities and other stakeholders to improve mortality data systems globally. By addressing these systemic challenges through enhanced collaboration and technological innovation, we can significantly advance public health outcomes and policy formulation in response to future health crises.}, }
@article {pmid42344113, year = {2026}, author = {Mohamed, RA and Huitao, S and Si, M and Jinguan, Z and Mabrouk, MS}, title = {An End-to-End Modular Blueprint for Rapid mRNA Vaccine Development, Computational Design, Functional Validation, and Scalable Delivery Against Evolving Pathogens.}, journal = {In silico pharmacology}, volume = {14}, number = {2}, pages = {173}, pmid = {42344113}, issn = {2193-9616}, abstract = {The rapid emergence of new pathogens evolving viral variants. Underscores the need for agile vaccine platforms capable of outpacing infectious threats. Building on the success of mRNA vaccine technology during the COVID-19 pandemic. We integrated computational precision tool to help the young Scientifics map the vaccine design. It is not a validated lab protocol nor does it report experimental results. Instead, it offers a stepwise conceptual roadmap to guide future wet-lab research. We also outline in silico workflow encompassing antigen selection, consensus sequence generation. The first step in the workflow is to check the conserved antigenic domains and epitopes. Bioinformatic analysis supported antigen identifying and its targets using appropriate tools, followed by consensus sequence creation through multiple sequence alignment using specific platforms. mRNA constructs were optimized via codon adaptation, GC content balancing, and secondary structure analysis. Delivery strategies also were briefly assessed between the FDA approved systems. Lipid nanoparticle formulation, were incorporated into the design to theoretically enhance stability and cellular uptake. Robust protein expression both in vitro and in vivo assessments further suggested the immunogenic potential along with providing a computational basis for future preclinical evaluation. This study review provides a step-by-step protocol that clarifies and simplifies the design process for linear mRNA constructs. The framework translates complex design considerations into actionable, sequential guidelines, enabling researchers to rationally design vaccine candidates in silico. Certainly, we support accelerated design efforts against current threats, while also serving as a preparedness blueprint for future pandemics.}, }
@article {pmid42344246, year = {2026}, author = {Birhman, N and Kharkwal, G and Roy, S and Shaikh, N and Velamuri, PS and Lata, H and Saxena, A and Satija, A and Singh, KJ and Madan, T and Kishore, J and Kanti, P and Anand, T}, title = {Occupational health and safety in the wake of COVID-19: insights from India's workforce.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1807940}, pmid = {42344246}, issn = {2296-2565}, mesh = {Humans ; *COVID-19/epidemiology/prevention & control ; *Occupational Health ; India/epidemiology ; Working Conditions ; *Health Personnel/psychology ; SARS-CoV-2 ; Occupational Exposure/prevention & control ; Frontline Workers ; Pandemics ; Workplace ; }, abstract = {INTRODUCTION: Occupational health and safety (OHS) practices witnessed profound changes worldwide during the COVID-19 pandemic. The pandemic exposed critical vulnerabilities in workplace preparedness, particularly among workers in high-exposure and essential service sectors.
METHODS: A systematic review was conducted following PRISMA guidelines using PubMed, Google Scholar, DOAJ, ResearchGate, and gray literature sources. Studies published between January 2020 and December 2024 focusing on occupational exposure, workplace transmission, OHS guidelines, and workforce health during COVID-19 were included.
RESULTS: Healthcare workers experienced the highest occupational risk due to sustained patient contact and aerosol-generating procedures, accompanied by significant psychological distress and burnout. Essential workers, manufacturing sectors, retail workers, educators, and informal sector workers also faced substantial occupational and socioeconomic challenges. Workplace interventions including engineering controls, administrative controls, PPE use, vaccination strategies, and digital surveillance tools reduced workplace transmission. Remote-enabled sectors demonstrated lower infection risk but increased mental health concerns.
DISCUSSION: The COVID-19 pandemic transformed traditional OHS frameworks by integrating infectious disease preparedness, vaccination strategies, mental health support, and workplace surveillance into occupational safety systems. The findings emphasize the need for integrated, adaptive, and equitable OHS frameworks aligned with public health preparedness to strengthen workforce resilience against future pandemics.}, }
@article {pmid42344751, year = {2026}, author = {Toboltoc, PC and Gagiu, I and Lukusa, AL and Vekony, A}, title = {Hemato-Oncology Care During and After the COVID-19 Pandemic: Changes in Treatment Pathways, Patient Flow, and Durable Organizational Adaptations.}, journal = {Cureus}, volume = {18}, number = {6}, pages = {e111331}, pmid = {42344751}, issn = {2168-8184}, abstract = {The COVID-19 pandemic disrupted cancer care at every level of the clinical pathway, but its effect on hemato-oncology was distinctive because patients with hematologic malignancies often require urgent diagnosis, frequent hospital visits, transfusion support, intensive therapy, transplantation, cellular therapy, and infection-sensitive follow-up. This narrative review examines the pandemic as a disruption of hemato-oncology care delivery rather than only as a source of excess infection-related morbidity. It synthesizes evidence on diagnostic access, patient flow, treatment prioritization, infection-control circuits, day-hospital organization, inpatient access, telemedicine and hybrid follow-up, supportive care, vaccination, antiviral pathways, and high-complexity care delivery. The review distinguishes between temporary crisis restrictions, harmful diagnostic and therapeutic delays, and durable organizational adaptations that may remain relevant after the acute pandemic period. Evidence from cancer-service disruption studies, hemato-oncology outcome registries, telemedicine cohorts, and European hematopoietic cell transplantation activity surveys indicates that hemato-oncology care pathways were reorganized and selectively redirected during the pandemic, while selected components recovered through structured triage, protected circuits, remote review of stable patients, and individualized timing of transplantation and cellular therapy. The post-pandemic priority is not to preserve restrictive crisis practice, but to retain the organizational discipline generated by the crisis: protected diagnostic capacity, risk-stratified access, selective hybrid care, rapid infectious-risk assessment pathways, disciplined day-hospital scheduling, and reserved in-person capacity for unstable, procedure-dependent, or curative-intent patients. These adaptations should be maintained only insofar as they improve access, safety, and continuity of care without normalizing delayed diagnosis or undertreatment of aggressive disease.}, }
@article {pmid42344914, year = {2026}, author = {Batool, R}, title = {From Jenner to genomics: the unfolding future of vaccinology.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1860464}, pmid = {42344914}, issn = {1664-3224}, mesh = {Humans ; *Vaccinology/trends/methods ; Genomics ; *COVID-19/immunology/prevention & control ; Animals ; COVID-19 Vaccines/immunology ; *SARS-CoV-2/immunology ; Vaccine Development ; History, 20th Century ; Vaccines/immunology ; Vaccines, DNA/immunology ; History, 21st Century ; }, abstract = {The development of the smallpox vaccine two centuries ago laid the foundation for modern vaccinology. Smallpox, once a major killer in human history, was eradicated globally in 1980. This breakthrough encouraged the development of contemporary vaccine technologies, including inactivated, recombinant, viral vector, and mRNA platforms. Owing to developments in genetics, bioinformatics, and molecular biology, personalised vaccines have been made possible. Advances in the field of immunology facilitated an accelerated response to the COVID-19 pandemic. This perspective synthesises key developments and technological advances in the field of global immunisation. The author sheds light on emerging tools, transformative platforms, and long-term directions in vaccine science research.}, }
@article {pmid42345054, year = {2026}, author = {Calcaterra, G and Oreto, L and Perrone, M and Chessa, M and Bianco, F and Borrelli, N and Leonardi, B and Moscatelli, S and Ciliberti, P and Sabatino, J and Guccione, P and Martino, F and Thiene, G and Di Salvo, G and Bassareo, PP}, title = {[Kawasaki disease: the update of American Heart Association guidelines. What adult cardiologists need to know].}, journal = {Giornale italiano di cardiologia (2006)}, volume = {27}, number = {7}, pages = {479-488}, doi = {10.1714/4722.47387}, pmid = {42345054}, issn = {1972-6481}, mesh = {Adult ; Child ; Child, Preschool ; Humans ; American Heart Association ; Cardiologists ; Diagnosis, Differential ; Immunoglobulins, Intravenous/therapeutic use ; *Mucocutaneous Lymph Node Syndrome/diagnosis/therapy/complications/physiopathology ; Practice Guidelines as Topic ; United States ; }, abstract = {The recent document from the American Heart Association updates the guidelines on the diagnosis and management of Kawasaki disease (KD), a severe acute systemic inflammatory and febrile illness with mucocutaneous manifestations and lymph node involvement primarily affecting children under 5 years of age. Coronary artery involvement, with dilation and aneurysms in approximately 25% of patients, and cardiovascular system involvement make KD the most common systemic vasculitides and the leading cause of acquired heart disease in pre-school children living in developed countries. Classic KD is diagnosed based on established clinical and laboratory criteria, which exclude other similar conditions. The etiology and pathogenesis of KD remain unknown, with the disease affecting genetically susceptible children through an immune-mediated mechanism. The leading theory is that an unidentified trigger initiates a multi-organ inflammatory pathological cascade, sometimes resulting in incomplete or atypical forms in younger patients. For this reason, the American guidelines review KD diagnostic criteria, cardiac imaging techniques (echocardiography, coronary computed tomography, magnetic resonance imaging), specific therapies (intravenous immunoglobulin, aspirin, and additional treatments for resistant cases), management of myocardial infarctions, and the transition of care from pediatric to adult age. This review article also highlights future research areas, the role of inflammation, the development of differential diagnostic algorithms for multisystem inflammatory syndrome in children associated with SARS-CoV-2 infection, and the use of new oral anticoagulants. Lastly, the most recent data on the long-term course of the disease and the regression of coronary aneurysms are revisited.}, }
@article {pmid42345733, year = {2026}, author = {Ionescu, A and Mihăilescu, A and Dumache, R and Capcelea, A and Turceanu, AD and Albulescu, N and Săndesc, MA}, title = {Perioperative Anemia, Transfusion Practices, and Patient Blood Management: Lessons from the COVID-19 Pandemic.}, journal = {Hematology reports}, volume = {18}, number = {3}, pages = {}, pmid = {42345733}, issn = {2038-8322}, abstract = {The COVID-19 pandemic exposed vulnerabilities in global blood supply systems and accelerated the adoption of patient blood management (PBM) strategies aimed at optimizing transfusion practices in surgical care. Perioperative anemia is a key contributor to adverse outcomes and is frequently treated with allogeneic blood transfusion (ABT), which carries infectious and immunologic risks. Iron deficiency remains the most common and potentially correctable cause of perioperative anemia. This narrative review examines various approaches to perioperative anemia, strategies to minimize reliance on ABT, and alternatives within the PBM paradigm. Evidence supports the use of iron therapy, erythropoiesis-stimulating agents, antifibrinolytic strategies, and blood conservation techniques to reduce transfusion requirements and improve clinical outcomes. Lessons from the COVID-19 pandemic highlight PBM as a framework to enhance transfusion safety and sustainability. Broader implementation of PBM may improve patient outcomes, reduce unnecessary transfusions, and preserve scarce blood resources.}, }
@article {pmid42345852, year = {2026}, author = {Ferrara, F and De Berardinis, F and Scognamiglio, M and Zovi, A}, title = {The Shifting Paradigm of Monoclonal Antibodies in COVID-19 Management: From Early Triumphs to Viral Resistance and Future Perspectives.}, journal = {Antibodies (Basel, Switzerland)}, volume = {15}, number = {3}, pages = {}, pmid = {42345852}, issn = {2073-4468}, abstract = {BACKGROUND: Monoclonal antibodies (mAbs) initially played a major role in outpatient COVID-19 management by providing rapid passive immunity and reducing progression to severe disease. However, continuous SARS-CoV-2 evolution progressively compromised the effectiveness of several anti-spike products. This narrative review summarizes the trajectory of COVID-19 mAbs across three phases: early clinical efficacy, loss of efficacy due to immune escape, and future directions.
METHODS: We conducted a narrative review focusing on mechanisms of action, pivotal clinical trials, and real-world effectiveness of neutralizing anti-spike mAbs and host-directed immunomodulatory mAbs. Emphasis was placed on the impact of variants-especially Omicron-on susceptibility and clinical use, as well as on emerging next-generation platforms.
RESULTS: First-generation neutralizing mAbs substantially reduced the hospitalization rates during the Alpha and Delta waves, while immunomodulatory mAbs became standard options for the hyperinflammatory phase in hospitalized patients. With the emergence of Omicron and its sub-lineages, extensive immune escape led to marked reductions in neutralization for many earlier anti-spike agents and consequent restrictions in use. Later-generation approaches targeting more conserved epitopes provided temporary solutions but were also challenged by ongoing antigenic drift. Host-directed immunomodulators retained clinical relevance because their mechanism is independent of viral spike mutations.
CONCLUSIONS: The clinical role of monoclonal antibodies in COVID-19 has been dynamic and increasingly constrained by viral evolution. Future strategies should prioritize broadly neutralizing antibodies targeting conserved epitopes, innovative delivery platforms, and integration with real-time surveillance to preserve clinical utility in the endemic phase and improve preparedness for future outbreaks.}, }
@article {pmid42345854, year = {2026}, author = {Lim, XR and Teo, RXW and Par, RYX and Leung, BPL}, title = {Anti-Type I Interferon Autoantibodies in COVID-19 and Systemic Lupus Erythematosus: A Comparative Review.}, journal = {Antibodies (Basel, Switzerland)}, volume = {15}, number = {3}, pages = {}, pmid = {42345854}, issn = {2073-4468}, abstract = {Type I interferons (IFN-I), including IFN-α, IFN-β, and IFN-ω, are central to antiviral defence and immune regulation. Autoantibodies targeting IFN-I (anti-IFN-I AAbs) have emerged as key pathogenic factors in severe coronavirus disease 2019 (COVID-19) and are detectable in systemic lupus erythematosus (SLE), a prototypic IFN-driven autoimmune disease. Here we compare the prevalence and clinical impact of anti-IFN-I autoantibodies (Aabs) in COVID-19 and SLE based on a structured review of 53 studies from 2014 to 2025 and highlight the clinical associations and therapeutic opportunities presented by these autoantibodies. In COVID-19, neutralising anti-IFN-α and/or anti-IFN-ω AAbs were consistently associated with severe disease and impaired antiviral responses, particularly in older male populations. In SLE, anti-IFN-α AAbs were variably detected; neutralising antibodies were associated with reduced interferon gene signatures in some cohorts but inconsistent correlations with disease activity. Therapeutically, anti-IFN-I AAbs in COVID-19 may inform risk stratification and early antiviral strategies, whereas in SLE, IFN-α blockade, including IFN-α kinoid vaccination, demonstrates modulation of IFN signatures but variable clinical benefit. Notably, these findings reveal an immunological paradox: the same neutralising mechanism that impairs antiviral defence in COVID-19 may attenuate chronic IFN-driven inflammation in SLE. Taken together, anti-IFN-I AAbs exert context-dependent effects: pathogenic in acute viral infection yet potentially modulatory in chronic IFN-driven autoimmunity. Prospective longitudinal studies are required to further clarify their translational utility and long-term clinical impact.}, }
@article {pmid42346165, year = {2026}, author = {Ntais, C and Chatziprodromidou, IP}, title = {COVID-19 and Interacting Public Health Threats in Europe During 2020-2025: A Narrative Review.}, journal = {Epidemiologia (Basel, Switzerland)}, volume = {7}, number = {3}, pages = {}, pmid = {42346165}, issn = {2673-3986}, abstract = {Between 2020 and 2025, Europe has faced multiple interacting public health threats shaped by and following the COVID-19 pandemic. Alongside COVID-19, the region experienced other infectious disease events, including monkeypox, measles resurgence, legionellosis and acute hepatitis of unknown origin in children. At the same time, non-communicable disease burdens, including obesity, type II diabetes mellitus, disruption of chronic disease care, mental health disorders and increased problematic digital use, intensified during and after the pandemic period. Antimicrobial resistance (AMR) remained a major cross-cutting threat because it undermines the effective treatment of infections and weakens emergency preparedness. This narrative review synthesizes peer-reviewed articles and selected reports from international organizations for the 2020-2025 period, using COVID-19 as the organizing context for examining interconnected infectious, chronic and system-level threats. Across these topics, recurring themes included vaccination gaps, fragmented surveillance, disruption of routine care, health system inequities, misinformation and insufficient preparedness for cross-border threats. The review supports integrated surveillance, continuity plans for essential services, stronger vaccination and risk-communication strategies and sustained AMR stewardship within a One Health framework. Coordinated action across public health, primary care, mental health and chronic disease policy is essential for future resilience.}, }
@article {pmid42346828, year = {2026}, author = {Cacciatore, S and Abbatecola, G and Calvani, R and Veronese, N}, title = {Effectiveness and Safety of Ozone Therapy in Humans: An Umbrella Review of Systematic Reviews with Meta-Analyses of Randomized Clinical Trials.}, journal = {Medical sciences (Basel, Switzerland)}, volume = {14}, number = {2}, pages = {}, pmid = {42346828}, issn = {2076-3271}, mesh = {Humans ; *Ozone/therapeutic use/adverse effects ; Randomized Controlled Trials as Topic ; COVID-19/therapy ; Systematic Reviews as Topic ; *Chronic Periodontitis/therapy/drug therapy ; Treatment Outcome ; Meta-Analysis as Topic ; Diabetic Foot/therapy ; SARS-CoV-2 ; }, abstract = {BACKGROUND/OBJECTIVES: Ozone therapy has been proposed across multiple clinical conditions based on hormetic, antioxidant, and immunomodulatory effects, but its efficacy and safety remain controversial. We conducted an umbrella review to appraise the effectiveness and safety of ozone therapy using evidence from meta-analyses of randomized controlled trials (RCTs).
METHODS: We searched MEDLINE, Web of Science, Embase, and the Cochrane Library from inception to 14 February 2025, with an updated search performed on 9 May 2026. Eligible studies were systematic reviews with meta-analyses comparing ozone therapy with non-active controls, including placebo, sham, saline, or standard care. Methodological quality was evaluated with AMSTAR-2 and certainty of evidence with GRADE.
RESULTS: Of 1243 records identified, seven meta-analyses representing four clinical indications (chronic periodontitis, COVID-19, diabetic foot ulcers, and impacted mandibular third-molar surgery) were included. In chronic periodontitis, evidence was mixed: one meta-analysis found no significant adjunctive benefit, whereas a more recent meta-analysis reported improvements in probing depth and gingival index, but not in bleeding on probing, plaque index, or clinical attachment level. For COVID-19, ozone therapy reduced PCR positivity at follow-up (RR 0.07; 95% CI 0.01-0.34), although this was considered a clinically non-important surrogate endpoint, and showed no significant benefit for hospital stay, intensive care unit admission, or mortality. For diabetic foot ulcers, ozone therapy was not superior to control treatment for ulcer healing (RR 1.69; 95% CI 0.90-3.17) or reduction in ulcer area. In third-molar surgery, ozone therapy did not reduce swelling or improve mouth opening, but was associated with improved short-term quality of life and reduced analgesic use. Safety outcomes were inconsistently reported, and available data did not allow firm conclusions regarding adverse events. The certainty of evidence was low or very low for all outcomes.
CONCLUSIONS: Despite mechanistic plausibility, current meta-analytic evidence from RCTs remains inconsistent, methodologically fragile, and largely based on low- or very low-certainty findings. Routine clinical use is not justified pending adequately powered, blinded RCTs with standardized dosing and delivery, patient-centered endpoints, and rigorous safety monitoring.}, }
@article {pmid42347188, year = {2026}, author = {Bambara, S and Isingizwe, MC and Adegboyega, TT and Mutesa, L}, title = {A Systematic Review of Gastrointestinal and Respiratory Pathogen Detection in Wastewater in Africa, with Focus on Rwanda: Implications for Early Warning and Public Health Surveillance.}, journal = {Pathogens (Basel, Switzerland)}, volume = {15}, number = {6}, pages = {}, pmid = {42347188}, issn = {2076-0817}, mesh = {Humans ; Rwanda/epidemiology ; *Wastewater/virology/microbiology ; *Respiratory Tract Infections/epidemiology/virology/microbiology ; *Public Health Surveillance ; Public Health ; Wastewater-Based Epidemiological Monitoring ; }, abstract = {In Africa, the disease burden of diarrheal and respiratory diseases is amplified by limited surveillance capacity, diagnostic limitations, and socioeconomic inequalities. In rapidly urbanizing settings such as Kigali (Rwanda), integrating wastewater-based epidemiology (WBE) into existing surveillance systems offers a promising strategy for generating real-time epidemiological intelligence, identifying community-level hotspots, and addressing gaps in traditional reporting systems. Gastrointestinal and respiratory infections remain major causes of morbidity and mortality globally, particularly in low- and middle-income countries (LMICs), where traditional clinical surveillance systems frequently underreport the true disease burden. This systematic review synthesizes current evidence on the detection of gastrointestinal and respiratory pathogens in wastewater and evaluates the utility of WBE for early warning and public health action. A narrative review approach was used to identify peer-reviewed literature, global health reports, and surveillance studies focusing on the wastewater detection of gastrointestinal and respiratory pathogens. Databases including PubMed, Scopus, and Google Scholar were searched for studies published between 2000 and 2026. The search yielded 1247 records, of which 312 duplicates were removed. After title/abstract screening, 228 full-text articles were retrieved and assessed for eligibility. After a detailed evaluation, 108 studies were excluded for the following reasons: absence of pathogen-specific wastewater data (n = 46), a focus on environmental monitoring without public health relevance (n = 25), insufficient methodological description (n = 21), or other eligibility limitations such as a lack of primary data (n = 16). WBE provides a non-invasive, cost-effective approach for monitoring symptomatic and asymptomatic infections. Challenges involve variability in sampling, environmental factors affecting viral decay, and differences in laboratory workflows. WBE is a powerful complement to traditional infectious disease surveillance, offering early warning capabilities, population-level coverage, and real-time insights into pathogen circulation. Integrating WBE into surveillance programs, especially in LMICs such as Rwanda, can significantly strengthen epidemic preparedness, guide resource allocation, and improve outbreak response. Sustained investment in laboratory capacity, standardized protocols, and multisector collaboration is essential to fully leverage WBE for public health protection.}, }
@article {pmid42347608, year = {2026}, author = {Jang, HY and Ko, Y and Han, SY}, title = {Understanding Healthcare Workers' COVID-19 Vaccination Decision-Making as a Dynamic Process: A Qualitative Meta-Synthesis.}, journal = {Vaccines}, volume = {14}, number = {6}, pages = {}, pmid = {42347608}, issn = {2076-393X}, support = {HY- 202200000003466//Hanyang University/ ; }, abstract = {Background/Objectives: Healthcare workers play a critical role in vaccination programs, yet vaccine hesitancy has been widely reported even among this group during the Coronavirus disease 2019 (COVID-19) pandemic. Previous studies have primarily focused on identifying factors associated with vaccine acceptance, offering limited insight into the processes underlying decision-making. This study aimed to synthesize qualitative studies on healthcare workers' COVID-19 vaccination experiences to develop a comprehensive understanding of their decision-making processes. Methods: A qualitative meta-synthesis was conducted using the thematic synthesis approach proposed by Thomas and Harden. Electronic databases including PubMed, Embase, and CINAHL were searched for qualitative studies published up to February 2026. Thirteen studies were included following PRISMA guidelines. Data were analyzed through line-by-line coding, followed by the development of descriptive and analytical themes. Results: Four analytical themes were identified: (1) vaccination as a dynamic risk-benefit negotiation process, (2) trust as a central mechanism shaping information interpretation, (3) socially embedded and relationally negotiated decision-making, and (4) moral identity as a driver of vaccination behavior. Healthcare workers' vaccination decision-making was not a static choice but an evolving process shaped by continuous appraisal of risks and benefits, filtered through trust in information and institutions, influenced by social interactions, and guided by professional identity and ethical responsibility. Conclusions: Healthcare workers' vaccination decision-making is a multidimensional process embedded in cognitive, social, and ethical contexts. Interventions should move beyond individual-level approaches and instead focus on building trust, leveraging social networks, and reinforcing professional identity with implications for future public health crises.}, }
@article {pmid42347619, year = {2026}, author = {Kong, F and Wu, N and Liang, S and Yan, Y}, title = {Next-Generation Vaccine Design for Porcine Enteric Coronaviruses: Aligning Antigenic Breadth, Mucosal Immunity, and Translational Evaluation.}, journal = {Vaccines}, volume = {14}, number = {6}, pages = {}, pmid = {42347619}, issn = {2076-393X}, support = {LH2022C070//Heilongjiang Provincial Natural Science Foundation of China/ ; }, abstract = {Porcine enteric coronaviruses (PECs), including porcine epidemic diarrhea virus (PEDV), transmissible gastroenteritis virus (TGEV), porcine deltacoronavirus (PDCoV), and swine acute diarrhea syndrome coronavirus (SADS-CoV), remain major causes of neonatal diarrhea, dehydration, mortality, and economic loss in swine production. Despite substantial progress in vaccine development, durable field protection is still inconsistent. In this narrative review, this narrative review synthesizes current knowledge on PEC vaccine design from three connected perspectives: antigenic breadth, mucosal immunity, and translational evaluation. The economic and virological context of PEC vaccine development is first summarized, including the recurrent production burden of PECs, coronavirus genome organization, structural proteins, and the central role of the spike protein in receptor engagement, membrane fusion, and neutralizing antibody induction. Key issues are then discussed, including how spike diversity, conformational stability, epitope accessibility, glycan shielding, and antigen matching influence protective breadth; why intestinal secretory IgA, mucosal immune-cell trafficking, local memory responses, and lactogenic immunity should be prioritized as biologically relevant endpoints; and how delivery route, adjuvant selection, and platform design shape response quality. Current evidence on recombinant protein, viral-vectored, nanoparticle, virus-like particle, probiotic, plant-derived, and mRNA-based approaches is compared with attention to both promise and current evidentiary and translational limitations. The available literature suggests that future progress in PEC vaccinology is likely to depend less on platform novelty alone than on integrated vaccine designs that align antigen selection, mucosal delivery, maternal-neonatal protection, heterologous challenge, manufacturability, and field applicability.}, }
@article {pmid42347657, year = {2026}, author = {Frączek, B and Pieniawska-Śmiech, K and Babicki, M and Balcer, B and Dolata, N and Pokorna-Kałwak, D and Kłoda, K}, title = {Maternal Vaccine Acceptance and Attitudes Before and After the COVID-19 Pandemic: A Narrative Literature Review.}, journal = {Vaccines}, volume = {14}, number = {6}, pages = {}, pmid = {42347657}, issn = {2076-393X}, abstract = {OBJECTIVES: This study aims to assess the acceptance of vaccinations among pregnant women, particularly against influenza, pertussis, COVID-19, and RSV, and to identify factors influencing their willingness to get vaccinated. It also seeks to evaluate the impact of the COVID-19 pandemic on maternal attitudes and behaviors regarding vaccination.
METHODS: The analysis involved a review of existing literature and studies to evaluate the level of vaccine acceptance among pregnant women before and after the COVID-19 pandemic. Factors contributing to vaccine hesitancy, including misinformation, lack of knowledge, and the influence of healthcare professionals, were examined.
RESULTS: The findings indicated that, despite scientific evidence supporting the safety and efficacy of vaccines during pregnancy, public concerns remain about their impact on the developing fetus. The outbreak of the COVID-19 pandemic has increased awareness of the risk of infectious diseases, but at the same time, its impact on vaccination rates among pregnant women is ambiguous and geographically diverse. Misinformation and decreased access to healthcare during the pandemic negatively affected vaccine uptake. Trustworthy information provided by healthcare professionals emerged as a key factor in promoting vaccine acceptance.
CONCLUSIONS: To improve vaccination rates among pregnant women, it is essential to provide clear, evidence-based information through healthcare professionals, particularly those directly caring for pregnant women. Educational campaigns should address concerns calmly and without judgment, emphasizing the safety and benefits of vaccinations. Enhanced access to healthcare and vaccinations, along with strategic information dissemination, can significantly improve vaccine acceptance during pregnancy. Lessons learned from past pandemics should be incorporated into the development of healthcare strategies aimed at implementing recommended vaccinations for pregnant women in the future.}, }
@article {pmid42347672, year = {2026}, author = {Aljadeeah, S and Payedimarri, AB and Dochez, C and Kielmann, K and Wirtz, VJ and Hargreaves, S and Ravinetto, R}, title = {Access to Vaccines Among Asylum Seekers, Refugees, and Undocumented Migrants Across the Migratory Cycle in the European Union, European Economic Area, Switzerland and the United Kingdom: A Scoping Review.}, journal = {Vaccines}, volume = {14}, number = {6}, pages = {}, pmid = {42347672}, issn = {2076-393X}, abstract = {Introduction: Inequities in access to medicines persist for asylum seekers, refugees, and undocumented migrants in Europe. For vaccines, access gaps not only exist for these groups in childhood routine immunization, but also for life-course and catch-up vaccinations. As part of a broader project examining access to medicines and vaccines for migrants across all stages of the migration cycle, this scoping review synthesizes evidence on the determinants of access to vaccines. Methods: We conducted a scoping review across PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Database of Systematic Reviews, Scopus, and grey literature sources, covering the period 2000-2024. Sources were eligible if they addressed access to vaccines among migrants. We examined access to vaccines along the life course, and across phases of the migratory cycle, including departure, transit, reception and settlement, and return or deportation. Results: A total of 47 research studies and grey literature reports were included. Most studies focused on migrants in reception and settlement (destination) settings, with only twelve sources addressing other phases of the migratory cycle. Across European countries, migrants were frequently reported to have lower uptake of routine vaccines (e.g., measles-mumps-rubella (MMR), polio, diphtheria-tetanus-pertussis (DTP), and human papillomavirus (HPV)) and COVID-19 vaccines than host populations. The most frequently reported barriers were related to migrants' legal status, administrative requirements, and lack of documentation, alongside poor affordability of vaccination, limited awareness of their rights, and mistrust in the health system. Conclusions: Health systems need to adopt innovative approaches to expand vaccine access for migrant populations. Further, protecting confidentiality is essential for building trust and reducing ethical and legal risks. Flexible and coordinated vaccination strategies are required to address migrants' mobility across the different migration stages and settings. Our findings appeal for sustained improvements in access to vaccines among migrants in Europe, contingent on strong policy commitments to equity, data protection, and the adoption of life-course and catch-up vaccination strategies.}, }
@article {pmid42348970, year = {2026}, author = {Zhang, W and Yuan, W and Yuan, C and Cheng, Y and Zhang, D and Cao, X and Ding, C}, title = {Shared and context-specific mechanisms of T cell exhaustion in chronic viral infections and cancer: Transcriptional, metabolic, epigenetic, and therapeutic perspectives.}, journal = {Cytokine & growth factor reviews}, volume = {90}, number = {}, pages = {88-106}, doi = {10.1016/j.cytogfr.2026.06.004}, pmid = {42348970}, issn = {1879-0305}, mesh = {Humans ; *T-Cell Exhaustion ; *Neoplasms/immunology/therapy/genetics/metabolism ; Epigenesis, Genetic ; *Virus Diseases/immunology/genetics/therapy ; Animals ; Transcription, Genetic ; *T-Lymphocytes/immunology ; *COVID-19/immunology/genetics/therapy ; SARS-CoV-2/immunology ; }, abstract = {T cells are crucial for defending against viral infection and cancer by eliminating infected or transformed cells and establishing immune memory. However, persistent antigenic stimulation in chronic infections or tumors drives T cells into a dysfunctional state known as exhaustion. This state is characterized by reduced proliferation and effector functions, upregulation of inhibitory receptors like PD-1, LAG-3, and CTLA-4, and alterations in transcriptional, epigenetic, and metabolic programs. T cell exhaustion is driven by both intrinsic factors, including changes in transcription factor networks and metabolic dysfunction, and extrinsic factors, such as continuous antigen exposure and an immunosuppressive microenvironment. Key molecules like PD-1, TOX, and TCF-1 are central to this process, though the complex interactions between intrinsic and extrinsic signals in chronic viral infections and cancers remain poorly understood. This review summarized T cell exhaustion in chronic viral infections, such as HIV, HBV, and SARS-CoV-2, as well as in tumors, emphasizing shared mechanisms and context-specific differences. We focused on the roles of transcriptional networks, metabolic changes, immune checkpoints, and exhaustion-related signaling. Additionally, we discussed emerging therapeutic strategies, such as immune checkpoint inhibitors, CAR-T cell therapies, cytokine supplementation, and metabolic interventions, based on recent high-impact studies. By integrating insights from both chronic infection and cancer, this review aims to identify common principles of T cell exhaustion and propose strategies to improve clinical outcomes in chronic viral diseases and cancer immunotherapy.}, }
@article {pmid42349034, year = {2026}, author = {Abdel-Moneim, AS and Al-Balushi, MS and Al-Jabri, AA}, title = {Post-COVID-19 immune dysregulation and autoimmune sequelae.}, journal = {Virology}, volume = {623}, number = {}, pages = {111017}, doi = {10.1016/j.virol.2026.111017}, pmid = {42349034}, issn = {1096-0341}, abstract = {SARS-CoV-2 infection induces profound immune dysregulation, including hyperinflammation, lymphopenia, and innate/adaptive immune imbalance. In some individuals, these responses persist beyond viral clearance, creating conditions that may disrupt immunological self-tolerance and precipitate autoimmune phenomena. We critically review mechanistic and clinical evidence linking SARS-CoV-2 infection to autoimmunity. Viral entry via ACE2/TMPRSS2, endothelial injury, and renin-angiotensin system dysregulation generates a pro-inflammatory milieu. Immune pathways, including molecular mimicry, bystander activation, epitope spreading, and persistent antigenic stimulation, can trigger the activation of autoreactive lymphocytes. Emerging evidence further implicates SARS-CoV-2-associated oral-gut microbiome dysbiosis and alterations in tryptophan and arginine metabolic checkpoints as contributors to chronic inflammatory signaling and impaired tolerance maintenance. We propose a mechanistic cascade from viral infection to dysbiosis to metabolic perturbation to loss of tolerance to autoantibody generation. Clinical manifestations encompass neurological, hematological, endocrine, and systemic autoimmune syndromes, with evidence of autoantibody emergence and post-COVID-19 immune sequelae. SARS-CoV-2 acts as an amplifier of autoimmune reaction in genetically susceptible hosts. Understanding these mechanisms is critical for identifying at-risk individuals and informing preventive and therapeutic strategies for post-COVID-19 autoimmune sequelae.}, }
@article {pmid42349528, year = {2026}, author = {Elgendi, MM and Stewart, SH and Sherry, S and Deacon, SH}, title = {Did COVID-19 change the trajectory of children's internalising symptoms? A meta-analysis of longitudinal studies and moderating factors.}, journal = {Journal of affective disorders}, volume = {413}, number = {}, pages = {122168}, doi = {10.1016/j.jad.2026.122168}, pmid = {42349528}, issn = {1573-2517}, abstract = {The COVID-19 pandemic disrupted children's and adolescents' daily lives worldwide, raising concerns about changes in internalising symptoms. Prior reviews have documented elevated depression and anxiety symptoms during the pandemic, but cross-sectional designs have limited conclusions about within-person change and its moderators. To address this gap, we conducted a meta-analysis of longitudinal studies assessing internalising symptoms before and during the COVID-19 pandemic. Eighty peer-reviewed studies (187 effect sizes) contributed data from youth aged 5-17 years across 20 countries. Standardized mean change (SMC) effect sizes were synthesised using random-effects models with robust variance estimation. Guided by Bronfenbrenner's ecological systems theory, we examined moderators spanning individual, family/school, contextual, and temporal domains. Overall, internalising symptoms increased modestly from pre- to peri-pandemic assessments (SMC = 0.32, 95% CI [0.11, 0.53]; multilevel SMC = 0.34, 95% CI [0.15, 0.53]). Effects varied widely across studies (I[2] = 97.9%), indicating highly heterogeneous symptom trajectories, and suggesting that pooled estimates should be interpreted cautiously. Larger increases were observed in studies including parent-report measures and in contexts of full school closures and highly stringent government responses. Age, gender/sex, region, COVID prevalence, and assessment timing were not significant moderators. Although there were larger increases for composite scores across broad internalising and depressive symptoms than for anxiety or stress, there were no statistically robust between-domain differences. Together, these results indicate that internalising symptoms increased modestly during the COVID-19 pandemic, but that youth experiences were highly context-dependent, underscoring the importance of considering ecological conditions-such as school closures and policy responses-when evaluating pandemic-related mental health change.}, }
@article {pmid42350210, year = {2026}, author = {Marchesi, F and Girmenia, C and Trecarichi, EM and Piciocchi, A and Busca, A and Candoni, A and Cattaneo, C and Delia, M and Del Principe, MI and Fianchi, L and Gentile, G and Fracchiolla, NS and Tumbarello, M and Vignetti, M and Venditti, A and Pagano, L}, title = {Antibacterial, antifungal and antiviral prophylaxis and vaccination strategies in adult patients with acute myeloid and promyelocytic leukemia: An expert panel consensus from the GIMEMA group.}, journal = {Blood reviews}, volume = {}, number = {}, pages = {101412}, doi = {10.1016/j.blre.2026.101412}, pmid = {42350210}, issn = {1532-1681}, abstract = {Infections are a leading cause of morbidity, mortality, and treatment delays in AML and APL. While international guidelines emphasize intensive chemotherapy, they often overlook less intensive regimens, rely on outdated data, and ignore rising MDR infections. A GIMEMA survey across Italian centers revealed significant heterogeneity in antimicrobial prophylaxis, and vaccination practices. An expert panel reviewed 2012-2025 English literature with focus on infections via Delphi/nominal group methods, achieving ≥70% consensus. Prophylaxis with fluoroquinolones showed low agreement (28%) for intensive chemotherapy and venetoclax-based regimens due to no survival benefit, MDR pressure and microbiota disruption; not recommended for low-intensity/palliative care. Posaconazole is advised for intensive chemotherapy with or without FLT3 inhibitors, venetoclax-based regimens, HMA with or without ivosidenib (first 4 cycles), but not APL/palliative care. Antiviral prophylaxis is recommended for APL receiving arsenic trioxide; limited evidence elsewhere. The panel supports universal pneumococcal, influenza, SARS-CoV-2 and herpes zoster vaccination. Overall, these consensus statements aim to harmonize practice and highlight key areas requiring specifically designed prospective studies.}, }
@article {pmid42350880, year = {2026}, author = {Filippatos, F and Kakleas, K and Michos, A}, title = {Immunopathogenesis and Cytokine Pathways in Reactive Infectious Mucocutaneous Eruption (RIME) in Pediatric Population: Infectious Triggers and Molecular Insights.}, journal = {Clinical reviews in allergy & immunology}, volume = {69}, number = {1}, pages = {}, pmid = {42350880}, issn = {1559-0267}, mesh = {Humans ; *Cytokines/metabolism/immunology ; Child ; *Mucositis/immunology/diagnosis ; Immunity, Innate ; Signal Transduction ; Innate Immunity Recognition ; }, abstract = {Reactive infectious mucocutaneous eruption (RIME) is increasingly recognized as a pediatric syndrome in which severe mucositis follows a recent infection and cutaneous involvement is usually limited. Although Mycoplasma pneumoniae remains the prototype trigger, influenza, SARS-CoV-2, adenovirus, respiratory syncytial virus, and other respiratory pathogens can produce a similar clinical phenotype. This narrative review summarizes pediatric RIME/MIRM literature and selected adult or comparator-disease evidence when direct pediatric data are unavailable, explicitly distinguishing direct RIME evidence from extrapolated mechanisms. This review synthesizes current evidence on the immunopathogenesis of RIME in children, with emphasis on how pathogen-specific factors intersect with innate and adaptive immune pathways to drive mucosal injury. We discuss the central roles of epithelial sensing, inflammasome activation, cytokine amplification, neutrophil recruitment, and T-cell polarization, and we relate these mechanisms to the severe oral, ocular, and anogenital disease that often defines pediatric presentations. We also integrate emerging proteomic data showing recurring molecular programs, including acute-phase and complement activation, neutrophil-associated epithelial injury, and interferon-inducible antiviral responses. In addition, we review the possible contribution of genetic susceptibility, especially variation in innate immune sensors and cytokine signaling pathways, to disease severity and recurrence. Finally, we address the main diagnostic challenges, histopathologic and imaging findings, differential diagnosis from Stevens-Johnson syndrome, erythema multiforme, and Kawasaki disease, and the implications of these insights for risk stratification and treatment. Taken together, current evidence supports RIME as a pathogen-triggered, mucosa-predominant inflammatory syndrome in which exaggerated host responses, rather than pathogen presence alone, shape the clinical phenotype.}, }
@article {pmid42351066, year = {2026}, author = {Tolera, ST and Zerihun, E and Hunduma, G and Letta, S}, title = {Application of health belief model (HBM) in health sciences and medical researches: systematic review on African and Asian countries.}, journal = {BMC public health}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12889-026-28281-5}, pmid = {42351066}, issn = {1471-2458}, abstract = {BACKGROUND: The Health Belief Model (HBM) is a widely used psychological framework for explaining and predicting individual's health related attitudes, belief, and behaviors. Although the model has been applied across various fields of health and medical sciences, the extent of its global use, particularly across African and Asian countries has not been well documented.
OBJECTIVE: This systematic review aimed to assess the application of HBM in health sciences and medical research conducted between 2010 and 2025 in Africa and Asian countries.
METHODS: The review followed the updated Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Searches were conducted using keywords "Health Belief Model" combined with Boolean operators (AND, OR) across major databases, including PubMed, CINAHL, Web of Science, Scopus, Cochrane Library and PsycINFO. Eligible studies included peer-reviewed research articles applying the HBM within African and Asian contexts.
RESULT: From a total of 1,421 identified records, 77 studies met the inclusion criteria. Of these, 61% (n = 47) were conducted in Africa countries and 39% (n = 30) in Asian countries. Most studies (64.94%) employed cross-sectional quantitative design, while 12% used mixed-methods approaches. Random controlled trial account for 9.11% of studies, quasi-experimental design for 7%, and qualitative approaches (including focus groups and in-depth interviews) for 6%. Overall, 85.71% of the studies applied all core components of HBM. Fifteen studies examined COVID-19 vaccine acceptance, nine focused on HIV/AIDS testing, counseling and prevention, and eleven studies explored non-communicable diseases prevention. Additionally, six studies assessed women's adherence to breast cancer screening, and four studies examined cervical cancer screening behaviours using HBM.
CONCLUSION: A current systematic review demonstrates that the HBM remain a valuable framework for understanding and influencing health behaviors across diverse settings. Its application in Africa and Asian research highlights its usefulness in guiding targeted interventions that address perceived susceptibility, severity, benefits, barriers, and cues to action, ultimately contributing to improved health outcomes.}, }
@article {pmid42351227, year = {2026}, author = {Kumar, N and Khandavalli, N and Avedissian, SN and Chand, HS and Acharya, A and Byrareddy, SN}, title = {Translational insights into Long-COVID: evaluation of preclinical animal models along the lung-brain-immune axis with focus on Golden Syrian Hamsters.}, journal = {Journal of neuroinflammation}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12974-026-03928-7}, pmid = {42351227}, issn = {1742-2094}, support = {DA052845, DA059874, DA061678/NH/NIH HHS/United States ; }, abstract = {Long-COVID, also referred to as post-acute sequelae of COVID-19 (PASC), is a heterogeneous disorder encompassing more than 200 reported symptoms that commonly affect the respiratory and nervous systems. Emerging clinical evidence indicates that unresolved lung inflammation, vascular injury, and immune dysregulation drive sustained neuroinflammation and impaired neurocognitive function in Long-COVID patients. Given the ethical and logistical constraints of human studies, biologically relevant animal models are essential for understanding the mechanisms and for evaluating therapeutic strategies against Long-COVID. In this review, we synthesize current evidence from preclinical animal models of Long-COVID, with a particular emphasis on the Golden Syrian Hamsters. Golden Syrian Hamsters are naturally susceptible to SARS-CoV-2 infection without the need for genetic modification and recapitulate key features of human disease, including robust viral replication, pulmonary pathology, and inflammatory response during acute infection. Importantly, accumulating evidence demonstrates that Golden Syrian Hamsters develop persistent post-acute abnormalities along the lung-brain-immune axis, including impaired alveolar repair, fibrotic lung remodeling, neuroinflammation, viral or antigen persistence, and behavioral alterations that parallel core features of Long-COVID. We compare the strengths and limitations of Golden Syrian Hamsters with other commonly used pre-clinical animal models including mice, and non-human primates, highlighting differences in translational relevance, feasibility, and ability to model chronic lung-brain-immune axis dysfunction. While there are limitations, particularly regarding limited availability of immunological reagents and validated cognitive and behavioral assays, the Golden Syrian Hamsters offers a balanced and accessible platform for mechanistic studies of PASC. Overall, this review positions Golden Syrian Hamster as a robust translational model for investigating lung-brain-immune axis pathology in Long-COVID and for advancing the development of targeted therapeutic interventions.}, }
@article {pmid42351549, year = {2026}, author = {Shati, A and Abdulmutaali, A and Alsaeed, N}, title = {Respiratory Disease Detection: A Systematic Review of AI-Based Approaches, from Audio and Visual Unimodal Methods to Multimodal Integration.}, journal = {Diagnostics (Basel, Switzerland)}, volume = {16}, number = {12}, pages = {}, pmid = {42351549}, issn = {2075-4418}, support = {RA.KKU/2/46/1446H//The Deanship of Research and Graduate Studies at King Khalid University/ ; }, abstract = {Background: Respiratory diseases (RDs), including asthma, COVID-19, chronic obstructive pulmonary disease (COPD), and pneumonia, remain a major global health challenge, contributing substantially to global morbidity and mortality. Conventional diagnosis relies heavily on clinicians' expertise to interpret respiratory sounds and radiographic images, a process that can be subjective, time-consuming, and prone to inter-observer variability. Recent advances in artificial intelligence (AI) and machine learning (ML) have enabled automated diagnostic approaches that can improve the efficiency, consistency, and scalability of respiratory disease detection. However, existing research remains fragmented across different data modalities. Methods: This review systematically analyzes recent studies on AI-based respiratory disease detection using both visual modalities (e.g., chest X-rays, computed tomography (CT) scans, and ultrasound) and audio modalities (e.g., cough and breath sounds). To provide a comprehensive perspective, the reviewed literature is organized using a unified taxonomy that categorizes existing approaches into three main groups: audio-based, visual-based, and audio-visual-based methods. In addition, two conceptual frameworks are proposed to illustrate representative pipelines for audio-based and visual-based respiratory disease classification. Results: The analysis reveals that most existing studies focus on single-modality approaches, while multimodal integration remains relatively underexplored. Only a limited number of studies combine audio and visual data within unified frameworks, primarily due to the scarcity of synchronized multimodal datasets collected from the same patients. The proposed taxonomy and conceptual frameworks provide a structured basis for comparing existing methods, identifying methodological trends, and highlighting key research gaps in multimodal respiratory disease detection. Conclusions: Future research should prioritize the development of multimodal datasets, robust evaluation protocols, and interpretable and lightweight AI models suitable for real-world clinical deployment. Advancing multimodal integration has the potential to significantly enhance the accuracy, reliability, and clinical applicability of AI-driven respiratory disease diagnosis systems.}, }
@article {pmid42351791, year = {2026}, author = {Zdrobe, Z and Tornyi, I and Sárközi, AT and Horváth, I}, title = {The Complement System and Its Role in Eosinophilic Inflammation in Respiratory Diseases.}, journal = {Biomedicines}, volume = {14}, number = {6}, pages = {}, pmid = {42351791}, issn = {2227-9059}, abstract = {The complement system is a key link between innate and adaptive immunity, contributing to pathogen elimination, immune regulation, and tissue homeostasis. Its activation is not only crucial in infections, such as COVID-19, but also plays a major role in the pathomechanism of several non-infectious respiratory diseases, such as asthma, COPD, sarcoidosis and lung cancer. Complement components can modulate the quality of the adaptive immune responses, including through the regulation of T2 immunity and eosinophilic inflammation, thereby linking natural defense to complex immune processes. In recent years, it has become increasingly clear that dysregulated complement activity contributes to inflammation, thrombosis and tissue damage in a wide range of respiratory diseases. The study of the various components of this cascade system may therefore be promising from both a diagnostic and therapeutic point of view. Some of its components may serve as biomarkers for distinguishing between different phenotypes of certain lung diseases, while their targeted inhibition or modulation may open the way towards new treatment options. A better understanding of the complement system's integrative and regulatory role not only allows for a deeper insight into immunological interactions but may also bring us closer to phenotype-oriented, immunology-based pulmonology, which may have real clinical benefits in the future.}, }
@article {pmid42352300, year = {2026}, author = {Beyoğlu, D and Idle, JR}, title = {The Gut-Lung Microbiome Crosstalk and Pulmonary Disease.}, journal = {Biomolecules}, volume = {16}, number = {6}, pages = {}, pmid = {42352300}, issn = {2218-273X}, mesh = {Humans ; *Lung/microbiology/metabolism ; *Gastrointestinal Microbiome ; *Lung Diseases/microbiology/metabolism ; Animals ; COVID-19/microbiology ; *Microbiota ; Dysbiosis ; }, abstract = {Both the gut and the lungs possess a microbiome, a community of commensal bacteria, archaea, fungi, and viruses that perform important housekeeping functions in those organs. The colonic microbiome primarily ferments indigestible dietary fibers into essential short-chain fatty acids, synthesizes essential vitamins, regulates the mucosal immune system, and forms a protective barrier against pathogenic colonization. The lung microbiome maintains respiratory health primarily by regulating mucosal immunity, providing a physical barrier against invading pathogens, and producing beneficial metabolites. Several colonic microbiota metabolites, including the short-chain fatty acids acetate, propionate, and butyrate, together with the tryptophan metabolites indole-3-acetate and indole-3-propionate, secondary bile acids, and the polyamines spermidine and putrescine, are transported to the lungs via the gut-lung axis. These colonic microbiota biomolecules suppress lung inflammation, strengthen immune homeostasis, and reduce the severity of respiratory diseases. In contrast, lung microorganisms and their metabolites can travel to the gut via the gut-lung axis, influencing intestinal immune responses and potentially leading to an imbalance of gut microorganisms or dysbiosis. This means that respiratory diseases may lead to digestive issues, intestinal inflammation and chronic diseases. Here, we have reviewed this crosstalk and its impact on the principal pulmonary diseases: asthma, chronic obstructive pulmonary disease, cystic fibrosis, bronchogenic carcinoma, COVID-19, interstitial lung diseases, pneumonia, and tuberculosis. It is concluded that the gut microbiome plays a significant part in lung health and disease. Diet, tobacco smoking and electronic cigarette vaping all impact both the gut and lung microbiomes.}, }
@article {pmid42353563, year = {2026}, author = {Liu, J and Mao, N and Cui, Y and Bao, Y and Tang, C}, title = {Research Progress on Coronary Artery Injury and Myocardial Ischemia in Multisystem Inflammatory Syndrome in Children.}, journal = {Current issues in molecular biology}, volume = {48}, number = {6}, pages = {}, pmid = {42353563}, issn = {1467-3045}, abstract = {Multisystem inflammatory syndrome in children (MIS-C) is a severe systemic inflammatory complication triggered by prior SARS-CoV-2 infection. It predominantly affects the cardiovascular system, and coronary artery injury, myocardial dysfunction, and myocardial ischemia are closely associated with disease severity and clinical outcomes. This article reviews the immunopathological characteristics and clinical manifestations of MIS-C-related coronary artery lesions, including coronary artery dilation and aneurysm formation, as well as the key pathophysiological mechanisms leading to myocardial ischemia. Based on recent clinical and translational research, we summarize current approaches to diagnosis, risk stratification, acute medical management, and long-term follow-up strategies. By synthesizing updated evidence, this review aims to provide theoretical support and practical clinical guidance for the early identification, timely intervention, and optimized management of affected children, ultimately improving their long-term cardiovascular prognosis.}, }
@article {pmid42353688, year = {2026}, author = {Wahnou, H and El Kebbaj, R and Demoré, B and Limami, Y and Duval, RE}, title = {Current State of the Fight Against Antimicrobial Resistance: What Are the Different Strategies for Tomorrow?.}, journal = {Antibiotics (Basel, Switzerland)}, volume = {15}, number = {6}, pages = {}, pmid = {42353688}, issn = {2079-6382}, abstract = {Antimicrobial resistance (AMR) is a leading global cause of death, with recent World Health Organization (WHO) data revealing that one in six laboratory-confirmed bacterial infections shows resistance to at least one antibiotic treatment. This review comprehensively analyzes the AMR landscape in 2026, detailing its evolution, mechanisms, and the innovative strategies being deployed to combat it. Driven by Darwinian selection and accelerated by factors like antibiotic overuse during the Coronavirus Disease 2019 (COVID-19) pandemic (predominantly in hospitalized patients with suspected bacterial co-infection), AMR is propelled by a diverse molecular arsenal in bacteria. Key mechanisms include enzymatic drug inactivation (e.g., the diversifying β-lactamase superfamily), target site modification (e.g., mcr genes conferring colistin resistance), efflux pumps, and biofilm formation. The rapid global spread of these traits is facilitated by a dynamic "mobilome", a network of plasmids and transposons that shuttle resistance genes between species. This crisis has sparked a major scientific mobilization. Advances include the discovery of novel antibiotic scaffolds like lariocidin and the regulatory approval of critical new antibiotic/inhibitor combinations such as sulbactam/durlobactam and aztreonam/avibactam, which target highly resistant Gram-negative bacteria. Moreover, the first-in-class antibiotic gepotidacin offers a new option for urinary tract infections. Beyond traditional drugs, the pipeline is diversifying to include phage therapy, antivirulence strategies, and artificial intelligence-guided drug discovery. This diversification is critical as it helps preserve the effectiveness of existing Medically Important Antimicrobials (MIAs), those deemed essential for human medicine, by providing alternative or adjunctive treatment options. However, scientific innovation alone is insufficient. This review argues that lasting success requires parallel progress in global policy and infrastructure. Strategic priorities beyond 2026 must include finalizing and funding updated global action plans, strengthening real-time surveillance and diagnostic capacity, especially in low-resource settings, and implementing new economic models to de-risk antibiotic development. Embedding effective antimicrobial stewardship within universal health coverage and pandemic preparedness plans is crucial. Ultimately, defeating AMR demands an unprecedented, coordinated global effort that outpaces the relentless adaptability of bacterial pathogens.}, }
@article {pmid42354127, year = {2026}, author = {Piva, M and Martelossi-Cebinelli, G and Mendes-Pierotti, S and Chinen, WH and Cardines, PHF and Martinez, RM and Georgetti, SR and Baracat, MM and Vicentini, FTMC and Verri, WA and Casagrande, R}, title = {Flavonoids as Nutraceuticals to Treat Inflammatory Diseases: Focusing on Quercetin, Kaempferol, Luteolin, Apigenin, Epicatechin and Their Effects on Hepatic, Nervous, and Pulmonary Systems.}, journal = {Foods (Basel, Switzerland)}, volume = {15}, number = {12}, pages = {}, pmid = {42354127}, issn = {2304-8158}, support = {Grant call #067/2024//Fundação Araucária/ ; #309633/2021-4, #405027/2021-4, #307852/2019-9; #481049/2012-6; #427946/2018-2 and # 405848/2025-0//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; finance code 001//Coordenação de Aperfeicoamento de Pessoal de Nível Superior/ ; n/a//Fundação de Amparo à Pesquisa do Estado de São Paulo/ ; dotação orçamentária #4560.19.571.06.6153; eprotocolo 21.234.745-0//Secretaria de Estado da Ciência, Tecnologia, e Ensino Superior (SETI)/ ; }, abstract = {The immune response is essential in the protection of our body against pathogens; however, the inflammatory response caused by the immune system can become a disease itself. In fact, anti-inflammatory and immune-suppressive drugs are applied to limit the immune response to treat inflammatory diseases. Flavonoids are plant-derived polyphenols extensively investigated for their anti-inflammatory and antioxidant properties in inflammatory diseases. Studies applying isolated compounds as well as using supplements as nutraceuticals based on flavonoids have been conducted. Our review systematically analyzed the top five studied flavonoids between 2020 and 2025: quercetin (1742 articles), kaempferol (642), luteolin (589), apigenin (419), and epicatechin (354), highlighting their major therapeutic applications in diseases affecting the liver (12%), nervous system (11%), and lungs (10%). Mechanistically, these compounds act as multi-target agents mainly by inhibiting NF-κB and inducing Nrf2-dependent antioxidant programs. Application of advanced delivery systems, which increase oral bioavailability by up to 20-fold, overcomes pharmacokinetic bottlenecks. Clinical highlights demonstrated promising therapeutic effects, including reduced intrahepatic lipid accumulation in non-alcoholic fatty liver disease patients following quercetin supplementation (11.5% to 9.6%) and accelerated SARS-CoV-2 clearance after quercetin phytosome administration. The translation of flavonoids into standardized clinical therapies remains limited by the lack of large-scale, well-controlled clinical trials.}, }
@article {pmid42354220, year = {2026}, author = {Messova, AM and Ganiyeva, I and Abdrakhmanova, ST and Tuleubayeva, A and Sanbayev, M and Makibayeva, MG and Tamadon, A}, title = {Autoimmune Thyroid Diseases After COVID-19 Infection: A Systematic Review of Clinical Manifestation and Outcomes.}, journal = {International journal of environmental research and public health}, volume = {23}, number = {6}, pages = {}, pmid = {42354220}, issn = {1660-4601}, mesh = {Humans ; *COVID-19/complications ; *Graves Disease/etiology ; *Hashimoto Disease/etiology ; SARS-CoV-2 ; *Thyroiditis, Autoimmune/etiology ; }, abstract = {Background: Increasing evidence suggests that COVID-19 can induce or exacerbate autoimmune disorders, including immune-mediated thyroid dysfunction. The most common autoimmune thyroid diseases are Graves' disease and Hashimoto's thyroiditis; the mechanisms by which viral infections like SARS-CoV-2 trigger these diseases are not fully understood. Objectives: This study aims to systematically review published clinical evidence on the presentation, laboratory characteristics, and outcomes of autoimmune thyroid diseases after COVID-19 infection. Methods: The review followed the PRISMA 2020 framework. Scopus, Web of Science, and PubMed were searched for English-language studies between January 2020 and December 2025 using the terms COVID-19, SARS-CoV-2, autoimmune thyroiditis, Graves' disease, Hashimoto's thyroiditis, and autoimmune thyroid disease. Results: In total, 46 studies (five cohort studies and 41 case reports/series) involving 3856 patients were analyzed. The findings indicate that a significant increase in TPOAb prevalence occurs post-COVID-19 infection (15.7% vs. 7.7% in controls). New-onset Graves' disease (GD) post-COVID-19 presented with higher fT3/fT4 ratios and more aggressive thyrotoxicosis compared to non-viral cases. Rare but severe manifestations included thyrotoxic periodic paralysis, Hashimoto's encephalopathy, and dilated cardiomyopathy. Conclusions: SARS-CoV-2 may act as a trigger for autoimmune thyroid diseases, particularly in moderate-to-severe infections; however, the strength of this association warrants further investigation with controlled prospective data. Standard therapy remains effective, but thyroid function monitoring is advisable during post-COVID-19 recovery. An interdisciplinary approach is essential for early diagnosis and management of systemic complications.}, }
@article {pmid42354473, year = {2026}, author = {De Micco, F and Di Palma, G and Ferorelli, D and Giacomobono, F and Lima Arrais Ribeiro, I and Nóbrega, JBMD and Scendoni, R}, title = {Patient Safety Implications of Opportunistic Pathogens and Healthcare-Associated Infections in COVID-19 Patients: A Narrative Review.}, journal = {Healthcare (Basel, Switzerland)}, volume = {14}, number = {12}, pages = {}, pmid = {42354473}, issn = {2227-9032}, abstract = {The COVID-19 pandemic has highlighted the increased vulnerability of hospitalized patients to healthcare-associated infections (HAIs), which significantly impact patient safety and clinical outcomes. This narrative review summarizes the main opportunistic pathogens associated with HAIs in COVID-19 patients, with particular focus on multidrug-resistant organisms such as Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, Staphylococcus aureus, and Candida spp. The review also examines key aspects of antimicrobial resistance, prevention and control strategies, and medico-legal implications. The evidence supports the need for a multifaceted approach based on antibiotic stewardship, infection prevention guidelines, and multidisciplinary clinical risk management.}, }
@article {pmid42354881, year = {2026}, author = {Precup, CV and Mateescu, DM and Enache, A and Buhas, CL and Muresan, CO}, title = {SARS-CoV-2 Persistence and Cardiovascular Sequelae in the Post-COVID Era: A Public Health Microbiology Perspective on Sudden Cardiac Death and Pulmonary Thromboembolism.}, journal = {Microorganisms}, volume = {14}, number = {6}, pages = {}, pmid = {42354881}, issn = {2076-2607}, support = {Victor Babeș University of Medicine and Pharmacy Timișoara//Victor Babeș University of Medicine and Pharmacy Timișoara/ ; }, abstract = {Post-acute sequelae of SARS-CoV-2 infection (PASC) extend well beyond the acute respiratory phase, with accumulating virological evidence that SARS-CoV-2 RNA, viral antigens, and proteolytic fragments may persist in cardiovascular and other extrapulmonary tissues, although the extent to which such detection represents replication-competent reservoirs versus residual viral material with uncertain pathological relevance remains under active investigation. Sudden cardiac death (SCD) and fatal pulmonary thromboembolism (PTE) have emerged as forensically and epidemiologically significant outcomes in individuals with prior infection, situated at the intersection of microbiology, public health, and forensic medicine. To synthesize current evidence on the virological mechanisms by which SARS-CoV-2 may contribute to post-acute sudden cardiac death (SCD) and pulmonary thromboembolism (PTE), the population-level epidemiology of these outcomes, and their implications for public health surveillance and forensic practice, we conducted a narrative review of PubMed (MEDLINE), Scopus, and Web of Science Core Collection. The search covered publications from January 2020 to December 2025 and focused on SARS-CoV-2 cellular tropism and tissue persistence, immune-mediated and thromboinflammatory mechanisms, excess cardiovascular and thromboembolic mortality, and autopsy-based pathological findings. After de-duplication of 1837 initially identified records (412 duplicates removed) and screening of 1425 unique records, 78 studies were retained for final synthesis based on virological, epidemiological, and forensic relevance. SARS-CoV-2 enters cardiomyocytes, pericytes, and vascular endothelial cells through ACE2-dependent mechanisms, with cathepsin L compensating for the limited cardiac expression of TMPRSS2. Viral RNA and antigen have been detected in cardiovascular and other extrapulmonary tissues months after symptom onset in selected autopsy series, although persistent detection of viral components does not necessarily indicate ongoing productive infection or direct tissue injury. Endothelial dysfunction, neutrophil extracellular trap (NET) formation, complement activation, and persistent thromboinflammation have been proposed as plausible mechanistic substrates for arrhythmogenic remodelling and thromboembolic events, although definitive causal pathways remain incompletely understood. Population-based studies document persistent excess cardiovascular mortality across multiple jurisdictions, with hazard ratios for pulmonary embolism remaining elevated months after acute infection, particularly in unvaccinated individuals. Autopsy series identify mixed pathological patterns including focal lymphocytic infiltrates, microvascular thrombosis, contraction-band necrosis, and cardiomyocyte vacuolation, although fulminant lymphocytic myocarditis fulfilling Dallas criteria remains uncommon. A microbiology-informed framework uniting tissue-based viral detection, standardized cardiac and pulmonary sampling protocols, and prospective post-mortem registries is needed to better characterize the potential contribution of SARS-CoV-2 to post-acute cardiovascular mortality and to support cause-of-death certification, public health surveillance, and medicolegal practice in the post-pandemic era. Many of the proposed mechanisms remain under active investigation, and definitive causal relationships between viral persistence and adverse cardiovascular outcomes have not yet been conclusively established.}, }
@article {pmid42354940, year = {2026}, author = {Mpakosi, A and Cholevas, V and Lianou, A and Tziraki, F and Vogiatzis, I and Cholevas, S and Tzouvelekis, I and Mironidou-Tzouveleki, M and Tsante, KA and Tsakri, D and Petrakis, V and Ioannou, P and Bonovas, S and Sokou, R and Tsantes, AG}, title = {Targeting Zoonotic Spillover Drivers for Global Pandemic Prevention: A Narrative Review.}, journal = {Microorganisms}, volume = {14}, number = {6}, pages = {}, pmid = {42354940}, issn = {2076-2607}, abstract = {Zoonoses account for the majority of recognized mammalian viral spillover events, primarily originating from bats, rodents, and primates. Human activities have significantly accelerated these transmissions. This narrative review synthesizes the evolutionary, ecological, pathogen-related, and anthropogenic drivers of viral zoonotic spillover to identify critical leverage points for pandemic prevention. A narrative literature review was conducted. The analysis focused on factors enabling animal pathogens to transform into human pathogens, examining host species, pathogen traits, human-animal interactions, and environmental impacts. Pathogen transformation depends on host traits, contact frequency, and viral characteristics. Anthropogenic drivers-including livestock expansion, the bushmeat trade, wet markets, and the exotic pet industry-significantly elevate spillover risks. Effective pandemic prevention requires targeted interventions at the wildlife-livestock-human interfaces. A holistic, multidisciplinary collaboration between national governments and international organizations is essential to mitigate future risks.}, }
@article {pmid42355811, year = {2026}, author = {Khawandi, J and Choaib, A and Azzam, M and Oudit, GY and Patel, K and Nazzal, J and Khader, AA and Kawtharany, H and Al Zabibi, MA and Ahmad, J and Kivan, H and Al Hussein, S and Rehman, AU and Piché, A and Vasquez Camargo, A and McNaughton, C and Lam, GY and Kamrul, R and Afzal, S and Schunemann, HJ and Wiercioch, W and Nieuwlaat, R and Brignardello-Petersen, R and Falcone, EL and Mustafa, RA}, title = {Echocardiogram Testing in Patients with Post-COVID-19 Condition: A Systematic Review and Meta-Analysis.}, journal = {Journal of clinical medicine}, volume = {15}, number = {12}, pages = {}, pmid = {42355811}, issn = {2077-0383}, support = {2223-HQ-000415//Public Health Agency of Canada/ ; }, abstract = {Background: Post-COVID-19 condition (PCC) is a complication following acute COVID-19 infection, which may lead to long-term cardiac abnormalities. This review aimed to assess the prevalence of structural/functional deviations in echocardiography in individuals with PCC compared to patients without PCC. Methods: We searched three databases. Two reviewers independently screened articles using LASER Al and extracted relevant data using a piloted Excel sheet. We performed meta-analysis using OpenMeta and RevManWeb and a subgroup analysis based on patients' settings during acute COVID-19. We assessed the risk of bias using the Hoy et al. tool and the certainty using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Results: We included 16 studies that reported on differences in echocardiographic findings in patients with or without PCC. Individuals with PCC were more likely to have structural/functional deviations in echocardiographic readings of unclear clinical significance, particularly those who were hospitalized during acute COVID-19. The overall certainty of the evidence was very low due to the high risk of bias, indirectness, and imprecision. Conclusions: This review provides insight into the use of echocardiograms and the frequency of test deviations in individuals with PCC. Despite existing evidence, there is a need for future studies to assess the diagnostic test accuracy of echocardiograms in PCC.}, }
@article {pmid42356418, year = {2026}, author = {Posta, E and Gyarmati, E and Majoros, L and Fekete, I and Varkonyi, I and Zold, E and Barta, Z}, title = {Across Kingdoms: The Bacteriome, Mycobiome, and Virome in Autoimmune Diseases: Mechanistic Insights, Therapeutic Perspectives, and the Emerging Role of COVID-19.}, journal = {Nutrients}, volume = {18}, number = {12}, pages = {}, pmid = {42356418}, issn = {2072-6643}, mesh = {Humans ; *COVID-19/immunology ; *Autoimmune Diseases/microbiology/immunology/virology/therapy ; SARS-CoV-2 ; *Virome ; Dysbiosis/immunology ; *Gastrointestinal Microbiome/immunology ; }, abstract = {Autoimmune and immune-mediated inflammatory diseases (IMIDs) develop when genetically and environmentally susceptible hosts lose stable immune tolerance. The gut ecosystem is increasingly recognized as a biologically active interface in this process. Its bacterial, fungal, and viral components may shape mucosal and systemic immunity through antigenic stimulation, barrier regulation, and metabolite-dependent signaling, although the strength of evidence is uneven: bacteriome data are currently the most mature, whereas mycobiome, virome, and phageome findings remain more disease-specific and emerging. Dysbiosis may influence autoimmunity through overlapping routes, including epithelial barrier failure, altered short-chain fatty acid, bile acid, and tryptophan metabolism, molecular mimicry, and cross-kingdom microbial interactions. Nutrition is central to this network because dietary substrates determine microbial growth, metabolic output, epithelial integrity, and immune-cell differentiation. In this narrative review, we integrate evidence on disease-associated bacteriome, mycobiome, and virome patterns in systemic autoimmune diseases, with emphasis on rheumatoid arthritis, systemic lupus erythematosus, Sjögren's syndrome, systemic sclerosis, spondyloarthritis, vasculitides, and idiopathic inflammatory myopathies. COVID-19 is considered not as a proven causal driver of autoimmunity, but as an example of an environmental and infectious insult capable of perturbing microbiome-barrier-immune communication. Finally, we discuss diet-based and microbiome-targeted approaches, including probiotics, prebiotics, synbiotics, and postbiotics, as adjunctive strategies that may help restore microbial resilience and immune balance. A better understanding of the diet-microbiome-host immunity axis may support more personalized preventive and therapeutic concepts in autoimmune disease.}, }
@article {pmid42356487, year = {2026}, author = {Chiririwa, H}, title = {Selected Cannabinoids, Cannabimimetic Agents and Artemisia Combinations as Theoretical Adjunct Strategies Against COVID-19.}, journal = {Pharmaceuticals (Basel, Switzerland)}, volume = {19}, number = {6}, pages = {}, pmid = {42356487}, issn = {1424-8247}, abstract = {COVID-19 has spurred much interest in complementary and alternative agents for therapeutic purposes having antiviral and immunomodulatory effects. In these, natural products and bioactive compounds from plants have been at the center of attention due to their easy access, relatively low risk and long history of use in traditional medicine. This paper reviews in detail and critically assesses the scientific data that presently proposes the use of certain cannabinoids, cannabimimetic compounds and Artemisia species in the treatment and prevention of COVID-19. It gives an account of medicinal approaches to cannabinoids like cannabidiol (CBD), Δ9-tetrahydrocannabinol (THC) alongside other minor cannabinoids and synthetic and naturally-occurring cannabimimetics. The paper reports the potential of Artemisia annua and other species as treatments, especially focusing on their antiviral, anti-regulatory, anti-inflammatory and immunomodulating properties. It highlights the molecular interactions with SARS-CoV-2 targets as well as cytokine regulation and modulation of oxidative stress pathways, with special emphasis on these areas. The paper raises multiple issues like preclinical and clinical studies, safety aspects, regulatory hurdles and drawbacks related to the use of these natural compounds. After analyzing all the available data, the article entertains the idea of a cannabinoid-Artemisia combination as a supportive or adjunct therapy in COVID-19 treatment. It also points out that the clinical trials are insufficient concerning the establishment of effectiveness, determination of the appropriate dosage and assurance of the long-term safety of the treatment.}, }
@article {pmid42357296, year = {2026}, author = {Dos Santos, RPN and Betancourt Roldan, DC and Guven, M and Leite, LC and Furlan, FJM and da Silva, GRM and de Oliveira, VAP and Capriglione, CDS and da Silva, JP and Pinto, JC and Eş, I and Balbino, TA}, title = {Microfluidic-Driven Assembly of RNA Nanocomplexes: Design, Process Control and Translational Perspectives in Oncology.}, journal = {Pharmaceutics}, volume = {18}, number = {6}, pages = {}, pmid = {42357296}, issn = {1999-4923}, support = {124C536//Scientific and Technological Research Council of Turkey/ ; YTB//Presidency for Turks Abroad and Related Communities/ ; }, abstract = {RNA-based therapeutics are becoming increasingly important in oncology, particularly following the rapid development of mRNA technologies during the COVID-19 pandemic, but their success strongly depends on how efficiently they can be delivered to target cells. Microfluidic technologies have redefined the design and manufacturing of RNA-based nanocomplexes, as they enable precise control over physicochemical features that are critical for clinical translation in oncology. This review examines recent developments in microfluidic-assisted synthesis of RNA nanocarriers, with a focus on cancer applications. Through a detailed analysis of material systems, device architectures, and formulation strategies, we explore how laminar flow environments enable reproducible encapsulation, tunable particle size, and improved payload stability. We examine the microfluidic assembly of lipid nanoparticles and polymeric carriers for RNA delivery, highlighting strategies to enhance durability, bioavailability, and cellular uptake. Advancements in process optimization, including flow parameter refinement and inline monitoring, are discussed alongside the influence of device geometries on mixing dynamics and nucleation. Beyond formulation, we explore the integration of microfluidics with tumor-on-chip platforms to evaluate transport, penetration, and therapeutic response in physiologically relevant cancer models. By connecting technological innovation with preclinical application, this work outlines the trajectory toward next-generation, personalized RNA nanomedicines enabled by microfluidic precision.}, }
@article {pmid42357309, year = {2026}, author = {Porta, EOJ and AlKharboush, DF and Jackson, L and Pang, F and Darin, A and Louka, J and Quamruzzaman, M and Shi, X and Wells, G and Kozielski, F}, title = {Targeting SARS-CoV-2 Non-Structural Proteins: A Blueprint for Next-Generation Small-Molecule Coronavirus Antivirals.}, journal = {Pharmaceutics}, volume = {18}, number = {6}, pages = {}, pmid = {42357309}, issn = {1999-4923}, support = {MR/X013995/1/MRC_/Medical Research Council/United Kingdom ; }, abstract = {The SARS-CoV-2 non-structural proteome remains the most clinically validated and strategically important landscape for direct-acting small-molecule antiviral drug discovery. The success of inhibitors targeting the main protease (M[pro], Nsp5) and RNA-dependent RNA polymerase (RdRp, Nsp12) has firmly established viral replication enzymes as tractable, druggable, and therapeutically relevant targets, while setting clear benchmarks for translational antiviral development. Building on this foundation, a second wave of non-structural protein (Nsp) targets has emerged with increasing translational promise, including the papain-like protease (PL[pro]), the bifunctional Nsp14 proofreading and capping machinery, Nsp16 2'-O-methyltransferase, Nsp13 helicase, and Nsp15 endoribonuclease. In parallel, additional components such as Nsp1 and the Mac1 domain of Nsp3 continue to expand the antiviral design space, although they remain at earlier stages of chemical validation. In this review, we comprehensively assess SARS-CoV-2 non-structural proteins through a medicinal chemistry and translational lens, with an emphasis on structural tractability, mechanism of action, quality of chemical matter, cellular and in vivo antiviral evidence, evolutionary conservation, resistance liabilities, and developability. Particular attention is given to the features that distinguish tool compounds from genuinely actionable leads and to the opportunities for rational combination regimens that extend beyond first-generation protease- and polymerase-centred therapy. Collectively, the non-structural proteome offers the strongest foundation for next-generation and potentially broader-spectrum coronavirus antivirals with improved resilience to viral evolution.}, }
@article {pmid42357322, year = {2026}, author = {Porta, EOJ and AlKharboush, DF and Jackson, L and Pang, F and Darin, A and Louka, J and Shi, X and Wells, G and Kozielski, F}, title = {Targeting SARS-CoV-2 Structural and Accessory Proteins: Emerging Opportunities for Small-Molecule Coronavirus Antivirals.}, journal = {Pharmaceutics}, volume = {18}, number = {6}, pages = {}, pmid = {42357322}, issn = {1999-4923}, support = {MR/X013995/1/MRC_/Medical Research Council/United Kingdom ; }, abstract = {Although antiviral development against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been dominated by replication-directed strategies, structural and accessory proteins offer a complementary and increasingly important opportunity for small-molecule intervention. These proteins control key processes outside the core replication machinery, including viral entry, membrane remodelling, virion assembly, egress, and host immune modulation, thereby expanding the mechanistic scope of antiviral design. However, many of these targets are membrane-associated, oligomeric, conformationally dynamic, or function through protein-protein interactions, creating distinct challenges in target validation, assay design, and chemical optimisation. In this review, we comprehensively and critically evaluate the structural and accessory proteomes of SARS-CoV-2, with a strict focus on small-molecule tractability and translational relevance. We highlight the most credible direct-acting opportunities, focusing on the membrane (M), envelope (E), and nucleocapsid (N) structural proteins, together with the accessory protein open reading frame 3a (ORF3a), for which emerging chemical matter strengthens confidence in druggability. In contrast, Spike (S) and several host-interface accessory proteins, including ORF6, ORF8, ORF9b, and ORF10, are best viewed as more selective or earlier-stage opportunities that require stronger on-target chemical validation. Emphasis is placed on structural accessibility, mechanism-based assay systems, evidence quality, cellular and in vivo activity, and developability constraints relevant to exposure at the infection site. Rather than replacing replication-directed antivirals, these non-canonical targets are best considered adjunctive or complementary components of future combination strategies designed to broaden antiviral coverage, enhance robustness, and improve pandemic preparedness.}, }
@article {pmid42357443, year = {2026}, author = {Zhao, S and Lin, Z and Wang, M}, title = {Positive-Strand RNA Viral RdRps: From Structure Conservation and Activity Assay to Drug Development.}, journal = {Molecules (Basel, Switzerland)}, volume = {31}, number = {12}, pages = {}, pmid = {42357443}, issn = {1420-3049}, mesh = {*RNA-Dependent RNA Polymerase/chemistry/antagonists & inhibitors/metabolism/genetics ; *Antiviral Agents/pharmacology/chemistry/therapeutic use ; Humans ; *Drug Development ; *Positive-Strand RNA Viruses/enzymology/drug effects/genetics ; RNA Replication/drug effects ; Virus Replication/drug effects ; SARS-CoV-2/enzymology/drug effects ; }, abstract = {Positive-strand RNA viruses represented by SARS-CoV-2 and DENV spread globally with high infectivity and frequent mutations, posing a severe threat to human health. However, specific and effective antiviral drugs remain limited. RNA-dependent RNA polymerase (RdRp) plays a critical role in the genome replication of RNA viruses and shows high structural conservation. No homologous protein exists in human cells, making RdRp an effective, safe, and broad-spectrum antiviral target. Therefore, establishing an RdRp activity assay for drug development based on its mechanism is of great significance. This paper summarizes the structural characteristics of RdRp and the methods for constructing RdRp activity assay, especially for cell-free activity assay. In addition, several reported RdRp inhibitors and their pharmaceutical progress are also reviewed, aiming to provide a reference for the development of novel antiviral drugs targeting RdRp.}, }
@article {pmid42357608, year = {2026}, author = {Domingo, JL}, title = {Toxicants, Exposome, and Hantavirus Disease: A One Health Perspective.}, journal = {Viruses}, volume = {18}, number = {6}, pages = {}, pmid = {42357608}, issn = {1999-4915}, mesh = {Humans ; *Hantavirus Infections/transmission/epidemiology/virology ; Orthohantavirus ; Animals ; Climate Change ; *One Health ; *Environmental Exposure/adverse effects ; *Exposome ; SARS-CoV-2 ; COVID-19 ; Zoonoses/virology ; }, abstract = {Although hantaviruses have traditionally been considered geographically restricted rodent-borne pathogens, globalization, climate change, ecosystem disruption, and environmental contamination may collectively favor novel transmission scenarios and altered epidemiological patterns. The experience gained during the SARS-CoV-2 pandemic showed the importance of environmental determinants, airborne exposure, and host susceptibility factors in emerging viral diseases. In this context, increasing but still indirect evidence suggests that environmental toxicants and the exposome may modulate susceptibility to hantavirus infection and influence disease severity. The proposed mechanisms include oxidative stress, endothelial dysfunction, pulmonary inflammation, and immune dysregulation, rather than direct causal effects of toxicants on infection itself. This article discusses current knowledge regarding interactions among toxic environmental exposures, climate change, and hantavirus disease, with special emphasis on Andes orthohantavirus (ANDV), the principal hantavirus known to exhibit person-to-person transmission. The article integrates recent evidence within the One Health framework and highlights future research priorities linking environmental toxicology, zoonotic disease ecology, and global environmental change.}, }
@article {pmid42357652, year = {2026}, author = {Jia, T and Huang, Z and Xia, N and Yuan, Q}, title = {Broad Neutralizing Antibodies Against SARS-CoV-2: Current Progress and Engineering Strategies.}, journal = {Viruses}, volume = {18}, number = {6}, pages = {}, pmid = {42357652}, issn = {1999-4915}, support = {824B2066//National Natural Science Foundation of China/ ; 92369110//National Natural Science Foundation of China/ ; 82272305//National Natural Science Foundation of China/ ; }, mesh = {*Antibodies, Neutralizing/immunology/therapeutic use ; Humans ; *SARS-CoV-2/immunology/genetics ; *Antibodies, Viral/immunology/therapeutic use ; *COVID-19/immunology/prevention & control ; Spike Glycoprotein, Coronavirus/immunology/genetics ; Animals ; Epitopes/immunology ; Single-Domain Antibodies/immunology ; Protein Engineering ; Mutation ; }, abstract = {The high-frequency mutation characteristics of SARS-CoV-2 have posed formidable challenges to the development of vaccines and therapeutic agents. Neutralizing antibodies, which serve as effective tools for prevention and control, have undergone continuous updates and iterations in response to viral mutations. This article provides a comprehensive review of researchers' efforts to achieve both high neutralizing potency and high mutation tolerance in SARS-CoV-2-targeting neutralizing antibodies. Building on the characteristics of conventional antibodies directed against distinct epitopes on the S protein, it further discusses the research on nanobodies, antibody cocktails, multi-specific antibodies, and other antibody formats and engineering approaches, including artificial intelligence-enabled optimization. Each antibody-based strategy targeting SARS-CoV-2 has its own distinctive advantages and potential applications, providing an integrated perspective to support the continued development of antiviral neutralizing antibodies.}, }
@article {pmid42359054, year = {2026}, author = {Dinç, HÖ and Saribaş, S and Kocazeybek, B}, title = {The immunopathological spectrum of COVID-19: from cytokine storm to autoimmunity-a systematic review.}, journal = {Frontiers in medicine}, volume = {13}, number = {}, pages = {1864452}, pmid = {42359054}, issn = {2296-858X}, abstract = {INTRODUCTION: This systematic review aimed to provide a comprehensive evaluation of the immunopathological mechanisms associated with SARS-CoV-2 infection and COVID-19 vaccination based on current evidence. Particular emphasis was placed on cytokine storm, endothelial dysfunction, complement activation, and autoimmune processes in COVID-19 pathogenesis.
METHODS: The study was conducted as a systematic literature review in accordance with PRISMA guidelines. English-language research articles published between 2020 and 2026 were identified through a structured search of the Scopus database. A total of 1,331 records were screened, and 53 studies were included based on predefined inclusion and exclusion criteria. The findings were systematically categorized according to major immunopathological mechanisms.
RESULTS: The included studies indicate that endothelial dysfunction (24.5%) and cytokine dysregulation (18.9%) are the most frequently reported mechanisms in COVID-19 immunopathogenesis. Autoimmune responses (15.1%), complement activation (17%), and immune complex-mediated inflammation also play significant roles. Elevated levels of proinflammatory cytokines, lymphopenia, and markers of vascular injury were consistently associated with increased disease severity and mortality. In addition, persistent immunological alterations and autoantibody production were observed in a subset of patients during the post-COVID period.
CONCLUSION: COVID-19 pathogenesis is driven by complex and interconnected immunopathological mechanisms rather than viral effects alone. Hyperinflammation, endothelial dysfunction, complement activation, and autoimmune processes are key determinants of disease severity and clinical outcomes. These findings underscore the importance of targeted immunomodulatory strategies and provide a comprehensive framework for future research.}, }
@article {pmid42359168, year = {2026}, author = {Mundt, B and Kant, R and Grzybek, M}, title = {Viral pathogens in urban rats: A one health systematic review of global surveillance evidence.}, journal = {One health (Amsterdam, Netherlands)}, volume = {23}, number = {}, pages = {101468}, pmid = {42359168}, issn = {2352-7714}, abstract = {BACKGROUND: Commensal rats (Rattus norvegicus and Rattus rattus) thrive in urban environments worldwide, where they live near humans and may act as reservoirs for viral pathogens of public health relevance. Although rats are increasingly recognised as sentinels of urban environmental health, the diversity and distribution of viral infections circulating in urban rat populations remain incompletely characterised within a One Health framework.
OBJECTIVES: This systematic review synthesises global evidence on viral pathogens detected in urban rats, focusing on rat hepatitis E virus/Rocahepevirus ratti and human-associated hepatitis E virus/Paslahepevirus balayani where distinguishable, Seoul virus (SEOV), SARS-CoV-2, and additional viral taxa identified through targeted surveillance or, in rare cases, metagenomic approaches.
METHODS: Following PRISMA 2020 guidelines, five electronic databases were searched for primary studies reporting viral detection in urban Rattus spp. Eligible studies underwent screening, structured data extraction and quality appraisal. Viral prevalence was summarised descriptively by pathogen and geographic region.
RESULTS: A total of 70 studies met the inclusion criteria, spanning Europe, Asia, North America, South America and the Caribbean. HEV and SEOV were the most frequently reported viruses, with prevalence varying widely between regions. HEV prevalence ranged from low levels in parts of Europe and Asia to high levels in North America. SEOV was detected across all regions, with particularly high prevalence in parts of Asia and the Americas. SARS-CoV-2 was not detected in European rats but was reported at low to moderate prevalence in the Americas. Numerous additional viral pathogens were identified.
CONCLUSIONS: Urban rats globally harbour diverse viral communities, including pathogens with zoonotic potential. Surveillance remains uneven and methodologically heterogeneous. Integrating rat biomonitoring into coordinated One Health surveillance systems is critical to strengthen early warning capacity and mitigate zoonotic risk.}, }
@article {pmid42361431, year = {2026}, author = {Bourgon, C and Moseman, EA}, title = {On or within: spatial determinants of antigen handling in the nasal turbinates.}, journal = {Current opinion in immunology}, volume = {101}, number = {}, pages = {102808}, doi = {10.1016/j.coi.2026.102808}, pmid = {42361431}, issn = {1879-0372}, mesh = {Humans ; Animals ; *Turbinates/immunology ; *Nasal Mucosa/immunology ; *SARS-CoV-2/immunology ; *COVID-19/immunology/prevention & control ; *Antigens/immunology ; Lymph Nodes/immunology ; *COVID-19 Vaccines/immunology ; Immunity, Mucosal ; }, abstract = {The SARS-CoV-2 pandemic has renewed interest in mucosal vaccines, yet these approaches have long struggled to generate durable protection against airway pathogens. A key limitation is the incomplete understanding of how upper airway antigens are handled to shape immune response quality and durability. Antigens located within the airspace or on the mucosal surface can be directly sampled by mucosal-associated lymphoid tissues (MALTs), such as Nasal-associated lymphoid tissue (NALT) in mice, or tonsils in humans. Because MALTs lack afferent lymphatics, antigen entry occurs primarily across a specialized epithelium. In contrast, antigens that arise within the mucosa following barrier breach are captured by immune cells and lymphatics for delivery to draining lymph nodes. This framework suggests that 'on the mucosa' antigens preferentially engage MALTs, whereas 'within the mucosa' antigens are handled by lymph nodes. However, the rules governing antigen handling within the nasal cavity remain poorly defined, limiting rational mucosal vaccine design.}, }
@article {pmid42361718, year = {2026}, author = {Sanga, NA and Oranzie, M and January, JL and Cox, M and Januarie, KC and Cupido, C and Tovide, OO and Pokpas, K and Douman, SF and Iwuoha, EI}, title = {Bioelectrochemical Sensing Dynamics of SARS-CoV-2 Biomarkers.}, journal = {Bioelectrochemistry (Amsterdam, Netherlands)}, volume = {172}, number = {}, pages = {109368}, doi = {10.1016/j.bioelechem.2026.109368}, pmid = {42361718}, issn = {1878-562X}, abstract = {The SARS-CoV-2 outbreak has underscored the urgent need for rapid, sensitive and accessible diagnostic technologies. This review provides a comprehensive overview of recent advances in nucleic acid- and antibody-based bioelectrochemical detection strategies for SARS-CoV-2, targeting the nucleocapsid (N) protein, spike (S) protein, the receptor binding domain (RBD) antigens and the viral RNA genome. Particular emphasis is placed on aptasensor, immunosensor and genosensor, highlighting biosensor design strategies and associated advantages and limitations. Key analytical parameters, such as sensitivity, detection limit, response time, transduction mechanisms and integrated nanomaterials are compared and discussed. Future perspectives on the innovative nucleic acid- and antibody-based point-of-care biosensors for SARS-CoV-2 are presented.}, }
@article {pmid42362025, year = {2026}, author = {Liaw, PC and Zarychanski, R and Lawler, PR and Lother, SA and Mendelson, AA}, title = {The evolving role of heparin in sepsis: Therapeutic potential in the age of immunothrombosis.}, journal = {Journal of thrombosis and haemostasis : JTH}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.jtha.2026.06.017}, pmid = {42362025}, issn = {1538-7836}, abstract = {Sepsis is a life-threatening syndrome caused by a dysregulated host response to infection and remains a leading cause of global morbidity and mortality. Despite decades of research, most biologically targeted therapies have failed to improve survival, highlighting the need for new treatment strategies that address the complex pathophysiology of sepsis. A defining feature of sepsis is immunothrombosis, characterized by widespread activation of inflammation and coagulation, endothelial injury, platelet activation, and neutrophil extracellular trap (NET) formation, resulting in both macrovascular thrombosis and microvascular occlusion. Heparin is commonly used as an anticoagulant and has re-emerged as a potential therapeutic agent for sepsis due to its pleiotropic properties that extend beyond anticoagulant effects. Heparin exhibits anti-inflammatory and antimicrobial activities, inhibits immune activation, neutralizes damage-associated molecular patterns (DAMPs), and modulates NET-mediated pathology. Clinical evidence for efficacy in sepsis remains limited, and no adequately powered randomized trials have confirmed a net survival benefit of therapeutic-dose heparin. This may reflect historical challenges with trial methodology and the heterogeneous nature of human sepsis. Data from COVID-19-associated sepsis suggest that severity may influence outcomes, with potential benefits in earlier disease stages and possible harm in advanced stages. Emerging interest in non-anticoagulant heparin derivatives and biomarker-guided patient selection may offer scientific opportunities to optimize therapeutic benefit while minimizing bleeding, but these approaches remain investigational. This review synthesizes current mechanistic, preclinical, and clinical evidence supporting heparin-based strategies in sepsis and emphasizes that therapeutic use beyond standard thromboprophylaxis should be evaluated in clinical trials before being applied in practice.}, }
@article {pmid42362430, year = {2026}, author = {Wei, HY and Lin, CY and Lin, YJ and Huang, SC and Shih, YL and Lin, FT and Yang, CH}, title = {Evolution of COVID-19 antiviral interventions in Taiwan, 2022-2025: Insights from public health policy.}, journal = {Journal of the Formosan Medical Association = Taiwan yi zhi}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.jfma.2026.06.042}, pmid = {42362430}, issn = {0929-6646}, abstract = {This study reviewed the use of COVID-19 antiviral agents in Taiwan (2022-2025), focusing on how policy changes influenced drug deployment, and explored trends in outpatient visits, hospitalizations, emergency department visits, and mortality. Policy changes and usage patterns of Remdesivir, Molnupiravir, and Nirmatrelvir/Ritonavir, were tracked using the Stockpile Management Information System (SMIS). As policies shifted to focus on the treatment of mild-to-severe cases in high-risk groups, the percentages of both oral antivirals and Remdesivir use increased. Remdesivir use (among hospitalized patients and emergency departments visits) rose from 10% in 2022 to 20% during COVID resurgence in 2025. Among adults aged ≥65 years, the oral antiviral utilization percentage remained stable at 53-54% after March 2023 based on total healthcare visits, and reached 65-69% when using outpatient visits as the denominator. As vaccine coverage expanded and herd immunity increased through 2022-2024, Taiwan's population developed robust hybrid immunity, hospitalizations and deaths declined substantially in subsequent epidemic waves. This analysis of the utilization percentages of COVID-19 antiviral drugs may serve as a valuable reference for future drug procurement and resource allocation. Timely, and adaptive deployment of antiviral agents remains critical for mitigating public health and healthcare system burdens during large-scale epidemics.}, }
@article {pmid42362970, year = {2026}, author = {Said, N and Jones, I and Anderson-Baucum, EK and Evans-Molina, C}, title = {SARS-CoV-2 and diabetes: a post-pandemic reappraisal.}, journal = {Diabetologia}, volume = {}, number = {}, pages = {}, pmid = {42362970}, issn = {1432-0428}, support = {I01BX001733//U.S. Department of Veterans Affairs/ ; P30DK097512/DK/NIDDK NIH HHS/United States ; R01DK093954/DK/NIDDK NIH HHS/United States ; R01DK127308/DK/NIDDK NIH HHS/United States ; }, abstract = {The COVID-19 pandemic was a dynamic and often confusing period for clinical and biomedical research. As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread globally, knowledge accumulated rapidly through publications that were frequently based on preliminary or sometimes conflicting evidence, yet these papers played a critical role in shaping evolving medical, research and societal responses. Early in the pandemic, diabetes emerged as one of the strongest predictors of severe COVID-19 outcomes and mortality, placing it at the centre of early risk-stratification and therapeutic frameworks and prompting urgent efforts to understand the biological basis of these associations. As the pandemic progressed, reports of new-onset diabetes following COVID-19 infection raised the possibility of a bidirectional relationship between SARS-CoV-2 infection and diabetes. In this review, we provide a post-pandemic reappraisal of the clinical and experimental literature examining the intersection of COVID-19 and diabetes. We summarise proposed pathophysiological mechanisms, including the effects of SARS-CoV-2 infection in the pancreas and on peripheral insulin-sensitive tissues. We review key meta-analyses assessing the association between COVID-19 and incident type 1 and type 2 diabetes and highlight strengths and weaknesses of the epidemiologic studies underpinning these findings. We highlight the highest-quality evidence from prospective cohorts, as well as relevant clinical trials and registry-based studies that emerged from this collective experience. We discuss emerging relationships between long COVID and diabetes and the effect of vaccination on diabetes risk following SARS-CoV-2 infection. Finally, we identify critical knowledge gaps and outline priorities for ongoing and future studies needed to resolve remaining uncertainties.}, }
@article {pmid42363391, year = {2026}, author = {Kazmi, SM and Khan, MO and Safdar, SN and Ahmad, S and Ghazi, KR and Bakhshi, SK}, title = {The Evolution of Patient Safety Practices Over the Last Two Decades.}, journal = {JPMA. The Journal of the Pakistan Medical Association}, volume = {76(Suppl 1)}, number = {3}, pages = {S131-S135}, doi = {10.47391/JPMA.AKU-10Surg-24}, pmid = {42363391}, issn = {0030-9982}, mesh = {Humans ; *Patient Safety/standards ; COVID-19 ; Pandemics ; SARS-CoV-2 ; Artificial Intelligence ; *Pneumonia, Viral/epidemiology ; *Coronavirus Infections/epidemiology ; Electronic Health Records ; Digital Health ; Telemedicine ; Betacoronavirus ; }, abstract = {Patient safety has undergone significant evolution over the past two decades, driven by a shift towards systemsbased approaches, the adoption of technological solutions, and a growing global commitment to improving healthcare outcomes. Early milestones (2000- 2010) saw the establishment of key safety protocols, including the "To Err is Human" report and the World Health Organisation's global initiatives. The following decade (2011-2020) marked the widespread integration of electronic health records and simulation-based training. The coronavirus disease-2019 pandemic presented unique challenges, including healthcare resource shortages and increased errors, but also accelerated innovations, such as telehealth and clinical decision-support tools. More recently, artificial intelligence has emerged as a powerful tool for enhancing patient safety, offering predictive capabilities and personalised care. However, barriers such as organisational resistance, resource constraints and inconsistent data-collection remain. Looking ahead, fostering a culture of safety, collaboration and continuous innovation is essential to address systemic gaps, and to ensure safer healthcare practices globally.}, }
@article {pmid42364134, year = {2026}, author = {Vacaru, RP and Didilescu, AC and Scannapieco, FA}, title = {Oral Health, Periodontitis, and Respiratory Diseases: Biological Pathways.}, journal = {Journal of periodontal research}, volume = {}, number = {}, pages = {}, doi = {10.1111/jre.70126}, pmid = {42364134}, issn = {1600-0765}, abstract = {Poor oral hygiene and periodontitis influence lung diseases such as pneumonia, chronic obstructive pulmonary disease (COPD), COVID-19, and asthma. The normal lung is not sterile, with a distinct microbial ecosystem that is spatially varied along the respiratory tract. The biogeography of the lung microbiome is balanced between microbial microaspiration from the oral-pharynx and clearance. The mouth is an important reservoir for respiratory pathogens including Streptococcus pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa, and Staphylococcus aureus, as well as oral microbes (Porphyromonas, Prevotella, Fusobacterium, etc.). Poor oral hygiene and periodontitis increase the bacterial load that can be aspirated, and the host produces pro-inflammatory components that enhance microbial virulence and compromize epithelial integrity. Both poor oral hygiene and periodontitis have been associated with pneumonia, particularly in hospitals and nursing home settings. Periodontitis may also facilitate viral pneumonia (including COVID-19) by altering receptor expression and immune function. Periodontitis correlates with COPD severity and exacerbation frequency through pathways involving matrix metalloproteinases and cytokines. Periodontitis also is associated with asthma and acute exacerbations. Inflammation shapes the lung microbiome by impacting microbial nutrient availability through vascular leakage, inducing changes to epithelial cells which facilitate bacterial adherence, and inducing the production of cytokines, leading to mucus overproduction, inhibition of phagocytosis, and enhancement of microbial pathogen virulence. Multiple biological pathways have been examined in vitro that suggest how "the oral-lung axis" influences pneumonia, COPD, and asthma. Periodontal treatment and effective oral hygiene should be well integrated into medical care to prevent and manage respiratory diseases.}, }
@article {pmid42364372, year = {2026}, author = {Tomassini, L and Onofri, M and Gambelunghe, C and Fedeli, P and Scendoni, R and Pini, N and Lancia, M}, title = {Toward methodological standardization in forensic immunohistochemistry: a critical appraisal of 144 post-mortem studies and a proposed evaluative framework.}, journal = {Legal medicine (Tokyo, Japan)}, volume = {84}, number = {}, pages = {102894}, doi = {10.1016/j.legalmed.2026.102894}, pmid = {42364372}, issn = {1873-4162}, mesh = {Humans ; *Immunohistochemistry/standards/methods ; *Forensic Pathology/methods/standards ; Autopsy/methods ; Quality Control ; }, abstract = {Immunohistochemistry (IHC) is widely applied in post-mortem forensic investigations. Its evidentiary value depends critically on methodological standardization. Following PRISMA guidelines and PROSPERO registration (CRD420251063965), we systematically searched PubMed, Scopus, and Web of Science for original IHC studies on human autopsy material. A total of 144 studies were included and evaluated against six predefined methodological criteria (M1-M6) addressing slide interpretation metrics, multi-reader assessment, observer blinding, concordance reporting, quality control, and predefined positivity thresholds. IHC was applied across diverse forensic domains, most frequently in traumatic brain injury (16%), sudden cardiac death (14%), COVID-19-related death (13%), and wound vitality/wound dating (11%). Quantitative or semi-quantitative slide reading (M1) was adopted in 75.7% of studies, and quality control measures (M5) in 52.8%. By contrast, blinded reading (M3) was implemented in only 40% of applicable studies, inter-observer concordance (M4) in 10%, and predefined positivity thresholds (M6) in only 4.2% of studies. Only 38.9% of studies met three or more methodological criteria, and a single study satisfied all six criteria. Forensic IHC demonstrates broad application and considerable inferential ambition, but its methodological foundations remain inconsistently consolidated. We propose that future forensic IHC studies place greater emphasis on analytical validation, standardized interpretation criteria, assessment of observer agreement, and systematic reporting of relevant pre-analytical variables in order to improve reproducibility and comparability.}, }
@article {pmid42364454, year = {2026}, author = {Madia, VN and Patacchini, E and Saccoliti, F and Zarbo, L and Arpacioglu, M and Costi, R and Di Santo, R}, title = {Twin engines of viral replication: Medicinal chemistry insights on SARS-CoV-2 nsp12 and nsp13.}, journal = {European journal of medicinal chemistry}, volume = {317}, number = {}, pages = {119083}, doi = {10.1016/j.ejmech.2026.119083}, pmid = {42364454}, issn = {1768-3254}, abstract = {The SARS-CoV-2 pandemic highlighted the urgent need for antivirals targeting essential viral enzymes. Herein, we critically examine the current landscape of small molecule inhibitors targeting the highly conserved non-structural protein 12 (nsp12), the RNA-dependent RNA polymerase, and non-structural protein 13 (nsp13), the helicase, both critical for viral genome replication. Structural and mechanistic features that inform rational inhibitor design, including active sites and cofactor interactions, are discussed. For nsp12, nucleoside analogues derived from a drug repurposing strategy, as well as emerging non-nucleoside inhibitors targeting allosteric sites, are evaluated. Development of ATPase and helicase inhibitors for nsp13 is at an earlier stage, but promising scaffolds have been revealed through high-throughput and structure-based screening. An in-depth analysis of small molecule inhibitors from synthetic and natural sources is presented for both enzymes, highlighting key limitations and strategic directions to advance the development of next-generation antivirals against SARS-CoV-2 through targeted modulation of nsp12 and nsp13.}, }
@article {pmid42366006, year = {2026}, author = {Bush, SH and Kabir, M and French Merkley, V and Sikora, L and Agar, M and Hosie, A and Featherstone, I and Isenberg, S and Lawlor, P}, title = {Clinical checklists of multicomponent non-pharmacological interventions for delirium management in adult patients in non-ICU inpatient healthcare settings: a rapid review.}, journal = {BMJ open}, volume = {16}, number = {6}, pages = {e105740}, pmid = {42366006}, issn = {2044-6055}, mesh = {Humans ; *Delirium/therapy/prevention & control ; *Checklist ; Inpatients ; Adult ; }, abstract = {OBJECTIVES: To identify clinical checklists of multicomponent non-pharmacological interventions for the prevention and treatment of delirium used in non-intensive care unit inpatient healthcare settings, their content and reported implementation.
DESIGN: Rapid review.
DATA SOURCES: Medline, Embase, PsycINFO, CINAHL and Cochrane CENTRAL were searched from 1 January 1999 to 31 March 2022 and updated on 16 January 2025. A comprehensive grey literature search, including websites of guideline development groups and international delirium organisations, was conducted on 26 and 27 February 2024.
ELIGIBILITY CRITERIA: We included records reporting the use of a 'clinical checklist' used by the healthcare team, family carers or adult patient (≥18 years) to prompt and document multicomponent non-pharmacological interventions for the prevention or treatment of delirium. Publication language was restricted to English and French.
DATA EXTRACTION AND SYNTHESIS: Using rapid review methodology, two independent reviewers screened the included records. A single reviewer undertook the data extraction, with a third independent reviewer verifying the data extraction for completeness. All included studies were assessed using the JBI critical appraisal tools according to the study design. A narrative synthesis was used to summarise the findings.
RESULTS: From the database searches, 4796 records were identified. After the removal of duplicates, 3513 records underwent title and abstract screening, with 344 records undergoing full-text screening. A final 32 records were included. From the grey literature search, 6593 records were reviewed for relevance, from which 62 records were included in full-text screening. No grey literature records were of high enough quality to be included. All studies were published in English, with most studies conducted in the USA, n=12/32 (37.5%). The 32 studies were quasi-experimental (n=18), randomised controlled trials (n=8), qualitative (n=4), expert opinion (n=1) and policy/consensus guidelines (n=1). Clinical checklists included structured protocols, algorithms and order sets, which were paper-based or part of electronic delirium order sets. People with dementia participated as key stakeholders for a guidance document during the COVID-19 pandemic, but the target population was not included in the development phase of other checklists. Target users of clinical checklists were usually healthcare staff and trained volunteers and rarely family carers and study intervention nurses. Four of the 32 studies included all 10 National Institute for Health and Care Excellence clinical factors/preventive strategies for non-pharmacological interventions. For the remaining 28 studies, missing domains varied and included: therapeutic/cognitive activity, hydration, nutrition, constipation, urinary catheterisation, hypoxia, infection, pain and medication review. Only two studies involved family carers as active partners in patient care. Reported formal economic analysis was limited.
CONCLUSIONS: Codesign of future clinical checklists should involve patients and family carers. Further research is needed on the feasibility of using clinical checklists by all members of the interprofessional team and family carers, the factors needed to ensure high levels of adherence and sustainability of multicomponent non-pharmacological interventions for delirium management, in addition to economic evaluations.
PROSPERO REGISTRATION: CRD42022342328.}, }
@article {pmid42366185, year = {2026}, author = {Benson, B and Taheri, M and Suleman, S and Paslawski, T and O'Brien, JM and Cruz, M and Sullivan, P and Khan, S and Boden, C and Abramyk, C and Reimche, E and Valiani, S and McIlduff, C and , }, title = {Patient- and Family-Centered Care, Communication, and Relationship Development Along a Technological Continuum in the ICU: A Scoping Review.}, journal = {Critical care explorations}, volume = {8}, number = {7}, pages = {e1429}, pmid = {42366185}, issn = {2639-8028}, mesh = {Humans ; *Intensive Care Units/organization & administration ; *Patient-Centered Care/organization & administration ; *Communication ; *COVID-19 ; *Professional-Family Relations ; SARS-CoV-2 ; Pandemics ; }, abstract = {OBJECTIVES: Effective multidirectional and longitudinal communication is essential to patient- and family-centered care (PFCC) in the ICU. While communication technologies have the potential to facilitate effective communication, their utilization, especially during the COVID-19 pandemic, has been variable. This scoping review answers the following research questions: What communication tools, strategies, and programs have been used in ICUs? What are their reported effects on PFCC and multidirectional communication? To what extent do these studies consider equity, diversity, and inclusion principles?
DATA SOURCES: The scoping review followed Arksey and O'Malley's (2005) framework and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. We conducted a search covering the period from 2007 to 2024, focusing on the concepts of communication, ICU, and PFCC in OVID Medline, EBSCO CINAHL, and OVID Embase. Relevant studies were screened and reported in this review.
STUDY SELECTION: Searches identified 3280 unique sources, which were screened at a three-stage asynchronous review. A total of 131 articles were included in this review.
DATA EXTRACTION: Communication tools, strategies, and programs were categorized into technology-based and non-technology-based interventions. Technology-based interventions included eight subcategories such as data-enabled devices, electrolarynx, and eye trackers. Non-technology-based strategies included 13 subcategories such as family meetings, diaries, and dedicated personnel.
DATA SYNTHESIS: Positive outcomes were reported in 82% of studies for both technology-based and non-technology-based communication tools, strategies, and programs on PFCC.
CONCLUSION: Most technology and non-technology communication tools, strategies, and programs positively impact communication and PFCC in the ICU. However, only 4% of studies focused on equity, diversity, and inclusion in the evaluation, design, or development of their intervention, indicating a need for further research in this area.}, }
@article {pmid42366188, year = {2026}, author = {Ralethoko, N and Letumanyane, K}, title = {A comparative assessment of road traffic injury patterns in KwaZulu-Natal and the Western Cape before, during and after COVID-19 (2019-2023).}, journal = {International journal of injury control and safety promotion}, volume = {}, number = {}, pages = {1-16}, doi = {10.1080/17457300.2026.2691909}, pmid = {42366188}, issn = {1745-7319}, abstract = {Road traffic injuries (RTIs) are a significant cause of death in South Africa; however, the effects of the COVID-19 pandemic on provincial RTI patterns remain insufficiently explored. This systematic review compared RTI patterns in KwaZulu-Natal and the Western Cape across pre-COVID-19 (2019), during-COVID-19 (2020-2021), and post-COVID-19 (2022-2023) periods. A systematic search of five electronic databases and grey literature sources was conducted, with 90 sources included following an adapted PRISMA 2020 framework. Findings were analysed using a descriptive comparative approach and synthesised through narrative synthesis guided by the framework proposed by Popay et al. (2006). In KwaZulu-Natal, fatalities declined from 2,331 in 2019 to 2,031 in 2020 before returning to slightly below baseline levels (2,229) in 2023. In contrast, fatalities in the Western Cape increased from 1,013 in 2019 to 1,158 in 2020, declined slightly in 2021, and increased further to 1,371 in 2023. Males aged 25-39 years and pedestrians remained the most affected groups across all study periods. The findings suggest that both pandemic-related behavioural changes and persistent structural and system-level factors may have contributed to the observed provincial differences in RTI patterns.}, }
@article {pmid42366377, year = {2026}, author = {Antón-Ruiz, JA and Bernabé, M and Heredia-Oliva, E}, title = {Prevalence of depression, anxiety, and stress among university students in the post-COVID-19 period: a systematic review and meta-analysis.}, journal = {BMC psychology}, volume = {}, number = {}, pages = {}, doi = {10.1186/s40359-026-05066-4}, pmid = {42366377}, issn = {2050-7283}, abstract = {BACKGROUND: The COVID-19 pandemic has had lasting effects on university students' mental health. While numerous studies have examined depression, anxiety, and stress during the pandemic, the post-pandemic burden of these conditions remains unclear. This systematic review and meta-analysis aimed to estimate the pooled prevalence of depression, anxiety, and stress among university students during the post-COVID-19 period.
METHODS: A systematic search of PubMed, Web of Science, MEDLINE, and Scopus was conducted from inception to August 2025 following PRISMA guidelines (OSF: 10.17605/OSF.IO/S3R2E). Cross-sectional studies published between 2022 and 2025 reporting the prevalence of depression, anxiety, and/or stress among university students using validated assessment tools were included. Study quality was assessed using the Joanna Briggs Institute checklist. Single-arm meta-analyses of proportions were performed using logit transformation. Subgroup analyses by geographic region, meta-regression, sensitivity analyses, and publication bias assessments were conducted.
RESULTS: Sixty-three studies involving more than 255,000 university students across multiple global regions were included. The pooled prevalence of overall depression was 45.1% (95% CI: 38.5% to 51.8%), with prevalence estimates of 21.9% for mild, 12.8% for moderate, and 4.1% for severe depression. The pooled prevalence of overall anxiety was 43.6% (95% CI: 35.3% to 52.3%), with 23.1% mild, 13.7% moderate, and 6.1% severe anxiety. Overall stress prevalence was 45.6% (95% CI: 32.9% to 58.8%), while high perceived stress affected 14.5% of students. Significant regional variations were observed for depression and anxiety. Meta-regression indicated no consistent temporal trends, although prevalence varied by sample size and, for moderate and severe anxiety, by publication year. Sensitivity analyses confirmed robust findings. Publication bias was detected in mild depression, mild anxiety, and severe anxiety subgroups.
CONCLUSIONS: Depression, anxiety, and stress remain highly prevalent among university students in the post-pandemic period, highlighting a sustained mental health burden. Most studies were cross-sectional and relied on self-reported measures, with variability in sample sizes and sociocultural contexts, hindering comparability and generalizability. Despite these constraints, these findings highlight the urgent need for targeted mental health screening, preventive strategies, and accessible psychological support services within higher education settings.}, }
@article {pmid42367802, year = {2026}, author = {Fu, J and Mi, Z and Li, Z}, title = {SARS-CoV-2-host and interactions: the dual roles of E3 ubiquitin ligases and ubiquitin-like modification mechanisms in viral infection.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1796416}, pmid = {42367802}, issn = {1664-3224}, mesh = {Humans ; *Ubiquitin-Protein Ligases/metabolism ; *SARS-CoV-2/physiology ; *COVID-19/immunology ; *Host-Pathogen Interactions/immunology ; Virus Replication ; Ubiquitin/metabolism ; Ubiquitination ; Animals ; Pandemics ; Immune Evasion ; *Coronavirus Infections/immunology ; }, abstract = {Following the global outbreak of the COVID-19 pandemic, the interactions between SARS-CoV-2 and host cells have attracted widespread attention. As crucial intracellular enzymes, E3 ubiquitin ligases are involved in numerous physiological processes, including protein degradation, cell cycle regulation, and immune responses. Recent studies have demonstrated that E3 ubiquitin ligases play a pivotal role in the interplay between SARS-CoV-2 and the host. Through interactions with host E3 enzymes, SARS-CoV-2 regulates key processes such as viral replication, immune evasion, and apoptosis. For instance, viral proteins can bind to E3 enzymes to modulate host immune responses and inhibit interferon production, thereby promoting persistent infection. Conversely, E3 enzymes can also regulate the viral life cycle and host cell survival by mediating targeted protein degradation. This mini-review summarizes the roles of E3 ubiquitin ligases in SARS-CoV-2 infection, introduces E3 ligase-mediated ubiquitin-like modifications, and discusses their underlying mechanisms at the virus-host interface. Furthermore, we highlight future research directions and potential therapeutic strategies. Understanding the functions of E3 ubiquitin ligases not only provides novel insights into the pathogenesis of SARS-CoV-2 but also offers promising targets for the development of antiviral therapeutics.}, }
@article {pmid42368852, year = {2026}, author = {Endara-Mina, J and Escudero, CJ and Intriago, C and Coloma-Ramirez, L and Cabrera, W and Gonzaga, R and Fuentes, S and Chicaiza, D and Carvajal, C and Lopez-Carrera, R and Baño-Jimenez, B and Ruilova, J and Atahualpa, E and Aldaz, J and Quishpe, M and Simbaña-Rivera, K}, title = {Associated thromboembolic events to the post COVID syndrome: a systematic review and meta-analysis.}, journal = {Frontiers in cardiovascular medicine}, volume = {13}, number = {}, pages = {1742868}, pmid = {42368852}, issn = {2297-055X}, abstract = {BACKGROUND: The COVID-19 pandemic has imposed a substantial worldwide health burden; a fraction of people develops post-COVID syndrome, in which symptoms persist long after the initial phase of infection. Although these individuals may be more susceptible to developing thromboembolic events, the extent and significance of this link remain uncertain. This systematic review and meta-analysis sought to explore the prevalence of thromboembolic events in people with post-COVID syndrome, therefore addressing knowledge gaps and providing critical information for therapeutic management.
METHODS: Following PRISMA principles, a thorough search across numerous databases-including Medline, Web of Science, Scopus, Dimensions, the Virtual Health Library, the British Library, and Google Scholars-was performed. Analytical cross-sectional, case-control, and cohort studies on individuals with post-COVID syndrome were considered eligible research. Meta-analysis was performed using Review Manager 5.4.1, with a random-effects model providing hazard ratios (HR) and 95% confidence intervals (CI) for specific thromboembolic events.
RESULTS: The initial database search yielded 1,617 publications, 1,021 of which passed title and abstract screening after duplicates were removed. Following a full-text analysis of 83 publications, 20 met the inclusion criteria, with 5 included in the quantitative synthesis and 15 in the qualitative synthesis.
CONCLUSION: Emphasizing ramifications for clinical therapy, particularly among vascular surgeons, this thorough review and meta-analysis exposes a significant thromboembolic risk among patients with post-COVID syndrome. The outcomes highlight the need for early detection, proactive monitoring, and tailored preventive treatments, including anticoagulant drugs.
https://www.crd.york.ac.uk/PROSPERO/view/CRD42023441556, PROSPERO CRD42023441556.}, }
@article {pmid42368930, year = {2026}, author = {Miao, R and Wang, J and Huang, Y and Zhang, X and Lei, P and Li, D and Chen, C and Lu, Y}, title = {Optimizing COVID-19 vaccination strategies for high-risk populations: potential and challenges of combining heterologous boosting with respiratory mucosal delivery.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1849650}, pmid = {42368930}, issn = {2296-2565}, mesh = {Humans ; *COVID-19/prevention & control/immunology ; *COVID-19 Vaccines/administration & dosage/immunology ; SARS-CoV-2/immunology ; Immunity, Mucosal ; *Immunization, Secondary/methods ; *Respiratory Mucosa/immunology ; *Vaccination/methods ; }, abstract = {Despite the decline of the global peak of COVID-19, SARS-CoV-2 continues to circulate, evolve, and undergo immune escape, posing persistent threats, particularly to older adults, individuals with comorbidities, and immunocompromised populations. Although existing vaccination strategies have substantially reduced the risks of severe disease, hospitalization, and death, their ability to block infection and transmission remains limited, and protection wanes over time. Current heterologous booster strategies still rely largely on combinations of different parenteral vaccine platforms. Although these regimens can enhance systemic humoral and cellular immunity, they are insufficient to robustly induce upper respiratory mucosal immunity, thereby limiting their role in early infection control and interruption of transmission. Because respiratory mucosal vaccines target the natural entry site of SARS-CoV-2, they have the potential to induce secretory IgA, tissue-resident memory immune cells, and local immune memory, offering distinct advantages in compensating for the shortcomings of conventional heterologous boosting. Combining heterologous boosting with respiratory mucosal delivery may further enhance the control of viral infection, early replication, and subsequent transmission while preserving systemic immunity, thereby providing more comprehensive immune protection for high-risk populations. However, this strategy still faces challenges related to mucosal barriers, delivery efficiency, adjuvant safety, manufacturing scale-up, and incomplete clinical evaluation frameworks. Future high-quality studies focusing on high-risk populations are needed to clarify its value in preventing infection, protecting against severe disease, and providing long-term protection.}, }
@article {pmid42369559, year = {2026}, author = {Xu, W and Wang, J and Liu, X and Lu, M and Zhang, Z and Li, L}, title = {mRNA vaccines against viral pathogens: molecular design, delivery systems, and clinical applications.}, journal = {Frontiers in microbiology}, volume = {17}, number = {}, pages = {1821852}, pmid = {42369559}, issn = {1664-302X}, abstract = {As a next-generation vaccine technology, mRNA vaccines mark a transformative advancement in vaccinology research. Their key strengths lie in rapid development cycles, high-efficiency manufacturing processes, robust immunogenic properties, and adaptable design frameworks. For infectious disease prevention, mRNA-based immunizations targeting SARS-CoV-2, such as the mRNA-1273 vaccine, have shown promising results in clinical evaluations. Validated efficacy metrics and safety profiles have supported their regulatory approval for public use. Additionally, mRNA platforms have shown substantial therapeutic potential against respiratory syncytial virus. However, this technology still faces multiple challenges, including poor stability, limited delivery efficiency, high production costs, unclear mechanisms of adverse reactions. Distinct from existing literature that primarily focuses on COVID-19 or specific delivery technologies, this review provides a comprehensive, integrated framework covering molecular design, delivery systems, and clinical translation across multiple viral pathogens, while also critically analyzing current controversies and future directions. This review aims to provide a comprehensive reference for researchers and clinicians in related fields.}, }
@article {pmid42369668, year = {2026}, author = {Peter, S and Mohana, T and Anandhi, D and Priya, VS and Sleeba, RK and Haridas, HP and Mohanan, MT and Thoduvayil, S and Mathew, S and Santhamma, DM and Divakaran, DR}, title = {ACE/ACE2 axis in cardiovascular disease and COVID-19: Molecular insights and therapeutic perspectives.}, journal = {Journal of cardiovascular and thoracic research}, volume = {18}, number = {1}, pages = {15-25}, pmid = {42369668}, issn = {2008-5117}, abstract = {The renin-angiotensin system (RAS) plays a central role in regulating blood pressure and cardiovascular health. Angiotensin-converting enzyme (ACE) facilitates the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor that contributes to hypertension and heart failure. Conversely, ACE2 converts angiotensin II into angiotensin-(1-7), a vasodilator with protective cardiovascular effects. An imbalance between ACE and ACE2 activities has been increasingly associated with the progression of cardiovascular diseases and complications related to COVID-19. This review analyzed 100 relevant studies published up to May 2024, identified through a comprehensive literature search on PubMed and Scopus. The findings highlighted that dysregulation of the ACE/ACE2 axis exacerbates cardiovascular dysfunction. The interaction of SARS-CoV-2 with ACE2 reduces its protective function, intensifying inflammatory responses and leading to complications such as lung injury and heart failure. Additionally, genetic polymorphisms in ACE and ACE2 influence individual susceptibility and severity of COVID-19. Promising therapeutic strategies, including ACE2-based peptides and angiotensin II receptor modulators, are under investigation but require further clinical validation. Targeting the ACE/ACE2 axis could provide effective treatment options for cardiovascular disease and COVID-19-related complications, warranting further in-depth research.}, }
@article {pmid42370216, year = {2026}, author = {Karasneh, D and Patel, M and Hasan, SS and Conway, BR and Sadeq, AA and Aldeyab, MA}, title = {Impact of the COVID-19 pandemic on systemic anti-cancer therapy in patients with breast cancer: a systematic review and meta-analysis.}, journal = {Journal of pharmaceutical policy and practice}, volume = {19}, number = {1}, pages = {2684148}, pmid = {42370216}, issn = {2052-3211}, abstract = {BACKGROUND: The COVID-19 pandemic caused significant disruptions in oncology services worldwide. Breast cancer care depends on timely and coordinated treatment pathways. This review assessed changes in systemic anti-cancer therapy, including chemotherapy, endocrine therapy, targeted therapy, and immunotherapy. Secondary outcomes included treatment delays, short-term mortality, and hospital admissions.
METHODS: We conducted a systematic review and meta-analysis following PRISMA guidelines. The protocol was registered with PROSPERO (CRD42024542702). We searched PubMed, Scopus, Web of Science, and CINAHL for studies published between March 2020 and August 2024. We included original studies comparing adult breast cancer patients treated before and during the pandemic. Patients of any stage and sex were eligible. We assessed risk of bias and used a random-effects model to present pooled proportions and odds ratios (ORs) with 95% confidence intervals (CIs).
RESULTS: Forty-eight studies were included in the review, and 35 in the meta-analysis. Chemotherapy use increased from 35% before the pandemic to 42% during the pandemic. This rise was driven by an increase in neoadjuvant chemotherapy, from 18% to 22%, while adjuvant chemotherapy remained stable. Endocrine therapy increased from 35% to 42%. Neoadjuvant endocrine therapy rose from 2% to 10%, whereas adjuvant endocrine therapy declined from 46% to 43%. Targeted therapy and immunotherapy showed minimal change. The pooled OR for short-term mortality was 0.81 (95% CI: 0.56-1.15). Hospital admission estimates showed wide confidence intervals, reflecting heterogeneity.
CONCLUSION: The pandemic led to notable shifts in systemic treatment patterns, particularly an increase in the use of neoadjuvant strategies. Short-term mortality did not significantly differ between periods. The study findings should be interpreted with caution due to variability in studies. Health systems require robust pharmaceutical policies and resilient triage frameworks to ensure continuity of cancer treatment during future crises.}, }
@article {pmid42370424, year = {2026}, author = {Ratautas, D and Serapinas, S and Stakelytė, D and Guobužaitė, S and Danytė, A and Dagys, M}, title = {Quo Vadis, Electrochemical DNA Biosensor? Lessons from Three Decades of SNP Sensing.}, journal = {ACS sensors}, volume = {}, number = {}, pages = {}, doi = {10.1021/acssensors.6c01221}, pmid = {42370424}, issn = {2379-3694}, abstract = {Electrochemical DNA biosensors have been studied for over three decades, producing thousands of publications and a sophisticated engineering toolkit. However, a broad clinical adoption remains limited. The COVID-19 pandemic served as a stress test-global demand, unprecedented funding, accelerated regulatory pathways, and a clearly defined genomic target-yet electrochemical nucleic acid biosensors played no meaningful role in the diagnostic response, indicating that the barriers to translation are structural. Here, rather than cataloguing sensing formats, we analyze the field framing progress through three interacting constraints focusing on single-nucleotide polymorphism (SNP) sensing: the biological realities of nucleic acid targets, the physical limits of surface-based hybridization, and the clinical/market environment that governs adoption. We find that many advances optimize analytical performance under laboratory conditions while leaving application complexity largely unresolved. Yet, viable niches emerge at the intersection of low information complexity and operational urgency-rapid pharmacogenomic genotyping, now driven by directive clinical guidelines, and infection diagnostics, where simplicity matters more than sophistication. A broader redirection emerges when DNA acts not as the analyte but as a functional tool: Electrochemical aptamer-based sensors are entering commercial markets; nuclease and enzymatic activity profiling exploits the regime where these sensors perform best; and therapeutic oligonucleotides-invisible to standard sequencing workflows-map naturally onto the platform's strengths. The field's most transferable contribution may not be DNA detection itself, but the programmable molecular interfaces it has developed.}, }
@article {pmid42370758, year = {2026}, author = {Ogungbite, AB and Sibiya, M}, title = {A Narrative Review of Artificial Intelligence for Drug Repurposing: Lessons From COVID-19 and Oncology (2020-2025).}, journal = {CPT: pharmacometrics & systems pharmacology}, volume = {15}, number = {7}, pages = {e70272}, pmid = {42370758}, issn = {2163-8306}, mesh = {*Drug Repositioning/methods/trends ; Humans ; *Artificial Intelligence/trends ; COVID-19 ; SARS-CoV-2 ; Machine Learning ; *COVID-19 Drug Treatment ; Antineoplastic Agents/therapeutic use ; Deep Learning ; *Neoplasms/drug therapy ; Medical Oncology/methods/trends ; Natural Language Processing ; }, abstract = {Drug repurposing presents a cost-effective and time-efficient strategy to identify new therapeutic applications for existing drugs. Recent advances in artificial intelligence, including machine learning, deep learning, knowledge graphs, and natural language processing, have revolutionized this field by enabling automated discovery of drug-disease associations. This review examines the role of artificial intelligence in drug repurposing, drawing insights from two critical case areas: Coronavirus disease 2019 and oncology. We explore current trends, methodological frameworks, and technological innovations in artificial intelligence-driven drug repurposing, as well as challenges and emerging future directions. The findings of this paper underscore the transformative potential of artificial intelligence in biomedical research and justify its continued integration in pharmaceutical pipelines.}, }
@article {pmid42371105, year = {2026}, author = {Nofal, S and Al-Said, O and Alnimer, K and Sarah, JM and Alam, TA and Ali, O and Abuquteish, D}, title = {Efficacy and safety of Ensitrelvir in COVID-19 patients: a systematic review and meta-analysis with focus on viral clearance and RNA change.}, journal = {European journal of clinical pharmacology}, volume = {82}, number = {7}, pages = {}, pmid = {42371105}, issn = {1432-1041}, mesh = {Humans ; *COVID-19 Drug Treatment ; *Antiviral Agents/therapeutic use/adverse effects/administration & dosage ; RNA, Viral/blood ; SARS-CoV-2/drug effects ; Randomized Controlled Trials as Topic ; COVID-19/virology ; Treatment Outcome ; Indazoles ; Triazines ; Triazoles ; }, abstract = {BACKGROUND: Coronavirus Disease (COVID-19), which is caused by SARS-CoV-2 virus, led to a worldwide pandemic in late 2019, thus challenged the healthcare infrastructure across the world, creating an urgent need for the development of effective antiviral medications to handle its spread and evolving strains.
OBJECTIVE: This Meta-Analysis aims to investigate the overall efficacy and safety of Ensitrelvir.
METHODS: We conducted a systematic review and meta-analysis, according to PRISMA guidelines, searching web databases for relevant literature. We limited our eligibility to randomized clinical trials involving mild-to-moderate COVID-19 patients.
RESULTS: Our study included four randomized controlled trials involving a total of 2,890 patients. For patients with mild-to-moderate Covid-19, treatment with Ensitrelvir (125 mg or 250 mg) was associated with significantly improved outcomes compared to placebo across several metrics: higher viral clearance was observed for 125 mg [MD = - 37.74, P < 0.00001] and 250 mg [MD = - 35.02, P < 0.00001]; greater reductions in viral RNA were achieved by 125 mg [MD = -1.41, P < 0.00001] and 250 mg [MD = -1.37, P < 0.00001]; and a significantly lower proportion of patients maintained a positive viral titer at 125 mg [RR 0.08, P < 0.00001, I[2] = 82%] and 250 mg [RR 0.10, P < 0.00001, I[2] = 16%]. Ultimately, there were no significant differences in reported outcomes between the 125 mg and 250 mg Ensitrelvir dosage groups.
CONCLUSION: This systematic review and meta-analysis support Ensitrelvir efficacy and safety in promoting rapid viral clearance and greater reduction in viral RNA in mild-to-moderate or asymptomatic COVID-19 patients, justifying its integration into outpatient treatment protocols while emphasizing the need for further large-scale, variant-inclusive studies to validate and extend these findings.
REGISTRATION: PROSPERO (CRD420251030953).}, }
@article {pmid42371512, year = {2026}, author = {Cezar da Cruz, D and Haertl, K and Tomlin, GS and Yu, CH and Hernández-Lanas, O and Haigh, J}, title = {Mapping the occupational therapy process in response to COVID-19 and long COVID: A scoping review.}, journal = {The British journal of occupational therapy}, volume = {89}, number = {7}, pages = {435-448}, pmid = {42371512}, issn = {1477-6006}, abstract = {BACKGROUND: COVID-19 and long COVID have had an impact worldwide on people's participation in occupations. Occupational therapists play a role in supporting individuals' recovery and participation in daily life.
OBJECTIVE: This present study undertook a scoping review of research on COVID-19 and long COVID to map the occupational therapy process with this population, including evaluation, intervention and outcomes.
METHODOLOGY: Three online databases were searched to identify research papers published between 2020 and 2023 from all countries, published in English, Portuguese, or Spanish. From 455 texts, 25 studies were selected for this review.
RESULTS: Studies were conducted across varied healthcare settings, mainly inpatient hospitals. Participants ranged from children to older adults, with adults being the most represented group. Standardised assessments included occupational history, activities, body functions, cognition and emotional regulation. Interventions were educational, compensatory, restorative or acquisitional, with outcomes focused on daily living activities, performance skills and client factors.
CONCLUSION: Our review underscores the need for more comprehensive documentation of occupational therapy effectiveness, particularly in unpredictable circumstances such as COVID.}, }
@article {pmid42374300, year = {2026}, author = {Kennard, A and Kılıç, A and Alsugeir, D and Hamada, Y and Rangaka, MX}, title = {A systematic review of the determinants of vaccine hesitancy in the UK: Implications for future TB vaccine adoption.}, journal = {BMC public health}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12889-026-28299-9}, pmid = {42374300}, issn = {1471-2458}, abstract = {BACKGROUND: Tuberculosis (TB) is a deadly yet vaccine-preventable disease mostly affecting adolescents and adults. Novel TB vaccines are now emerging, particularly for these populations; however, vaccine hesitancy, characterised by delays, doubts or refusal to seek or accept vaccines, poses a challenge for sufficient adoption once these vaccines become available. Thus, this review systematically explored system- and individual-level determinants of vaccine hesitancy among adults in the UK, interpreting implications for the adoption of novel TB vaccines.
METHODS: Five databases systematically searched for studies from 2020 - 2024 reporting qualitative outcomes on determinants of vaccine hesitancy among people living in the UK. Thematic analysis mapped extracted data onto a framework combining the Strategic Advisory Group of Experts (SAGE) model to explore system-level factors (e.g., vaccine-specific influences) and the Perceptions and Practicalities Approach (PaPA) to explore individual-level factors (e.g., perceptual influences) of vaccine hesitancy. The Mixed Methods Appraisal Tool was used to assess study quality.
RESULTS: 29 qualitative and 21 mixed methods studies; 87.5% investigated hesitancy to COVID-19 vaccines. All SAGE themes were identified at the system level, most notably vaccine novelty, the media environment and health system experiences. At individual-level, all PaPA themes emerged, with vaccine-specific beliefs and knowledge most frequently identified. Overall, themes varied across the lifespan, with adolescents influenced mainly by media and social norms, and older adults by safety concerns and trust in health professionals.
CONCLUSIONS: Vaccine hesitancy determinants interacted and were compounded in vulnerable subgroups, while post-pandemic disruptions to TB services may undermine adoption of novel TB vaccines. Addressing these challenges requires multi-level strategies centred on trusted, culturally sensitive communication. Delivery through routine, school and community-based programs aligns with evidence from high-incidence settings and highlights the need for coordinated action by policymakers and healthcare providers.}, }
@article {pmid42374517, year = {2026}, author = {Harvey, E and Van Brussel, K and Holmes, EC}, title = {Empowering One Health with metagenomics.}, journal = {One health outlook}, volume = {}, number = {}, pages = {}, doi = {10.1186/s42522-026-00225-4}, pmid = {42374517}, issn = {2524-4655}, support = {GNT2017197//National Health and Medical Research Council/ ; }, abstract = {In an increasingly connected world a global One Health approach to the management of human, animal and ecosystem health will be critical to effective infectious disease responses. The emergence and rapid global spread of several emerging and re-emerging pathogens in the past decade has highlighted the need for rapid, sensitive and accurate diagnostics. Metagenomics, while commonly used for research purposes for almost two decades, entered the global spotlight during the COVID-19 pandemic. In this review we discuss the impacts that metagenomic studies have had on our understanding of origins, aetiology and ecology of infectious diseases within a One Health context. We also discuss the role of metagenomics in the future of diagnostics and disease surveillance, and outline the challenges and limitations of current metagenomic methods.}, }
@article {pmid42374546, year = {2026}, author = {Stroobants, T and Willemart, C and Walravens, M and Veeckmans, G and Ligthart, S and Hoste, E and Benoit, DD and Berghe, TV and Jorens, PG}, title = {Clinical implications of ferroptosis in critical illness: a narrative review.}, journal = {Journal of intensive care}, volume = {}, number = {}, pages = {}, doi = {10.1186/s40560-026-00899-y}, pmid = {42374546}, issn = {2052-0492}, support = {BOF-IMPULS//University of Antwerp/ ; 1SH9524N//Fund for Scientific Research (FWO) Flanders/ ; }, abstract = {Despite major advances in care for patients admitted to the intensive care unit (ICU), mortality remains high and functional outcomes for ICU survivors are often poor. The persistent burden underscores the need for innovative, mechanism-based approaches. Precision medicine has emerged as a promising paradigm in critical illness, and regulated cell death (RCD) may offer a novel entry point for targeted interventions. Among the various RCD pathways, ferroptosis, an iron-dependent form of RCD driven by excessive lipid peroxidation within cellular membranes, has gained increasing attention. Its mechanistic distinctiveness from other RCDs and potential reversibility make it particularly relevant in acute, dynamic disease states. In this narrative review, we explore the role of ferroptosis in critical care, focusing on high-impact conditions such as sepsis, COVID-19, ischaemia-reperfusion injury, and neurological emergencies. We outline the molecular mechanisms of ferroptosis and discuss how it may contribute to organ dysfunction across systems. While most insights to date stem from preclinical models, emerging clinical data suggest translational potential. We highlight key studies, discuss current limitations in detection and therapeutic targeting, and consider how the evaluation of ferroptosis could help shape the future of precision medicine in the ICU.}, }
@article {pmid42374888, year = {2026}, author = {Talabani, B and Hanif, S and Ramzan, K and Mohammed, F and Naseem, A and Alauddin, E}, title = {Improving COVID-19 Vaccine Uptake Among Ethnic Minority Communities in Wales: A Community-Based Approach.}, journal = {Immunology and cell biology}, volume = {}, number = {}, pages = {}, doi = {10.1111/imcb.70140}, pmid = {42374888}, issn = {1440-1711}, abstract = {During the COVID-19 pandemic, misinformation and vaccine hesitancy disproportionately affected ethnic minority communities across the United Kingdom, including in Wales. Muslim Doctors Cymru (MDC), a grassroots coalition of Muslim healthcare professionals, played a pivotal role in countering this challenge. This paper describes the strategies and impact of MDC's work in addressing health misinformation, building trust, and promoting vaccine uptake among ethnic minority communities in Wales. Through culturally sensitive engagement, multilingual public health messaging, and close collaboration with mosques, community leaders, and local media, MDC delivered targeted outreach that bridged gaps between public health authorities and underserved populations. This case study draws on a grassroots-efforts approach to tackling vaccine inequity using community-based approaches. Findings highlight the importance of culturally competent healthcare communication and the value of community-led initiatives in improving public health outcomes during crises. MDC's model offers a replicable framework for addressing health inequalities and misinformation in diverse populations.}, }
@article {pmid42376297, year = {2026}, author = {Mao, X and Cai, M and Fan, B}, title = {Lung organoids for respiratory diseases: overcoming translational hurdles in drug discovery and safety assessment.}, journal = {Frontiers in bioengineering and biotechnology}, volume = {14}, number = {}, pages = {1859058}, pmid = {42376297}, issn = {2296-4185}, abstract = {Respiratory diseases, encompassing chronic inflammatory conditions, interstitial fibrotic disorders, acute infectious diseases, and pulmonary malignancies, represent a profound global health burden with unacceptably high morbidity and mortality rates. Historically, the pharmaceutical pipeline for respiratory therapeutics has suffered staggering attrition rates during clinical development. This is primarily due to the fundamental inability of conventional two-dimensional cell cultures and in vivo animal models to faithfully recapitulate the complex three-dimensional architecture, multicellular heterogeneity, and human-specific physiological dynamics of the pulmonary system. To bridge this critical translational gap, lung organoids-self-organizing, three-dimensional microphysiological constructs derived from pluripotent or adult stem cells-have emerged as a useful human-cell-based platform. This comprehensive review critically evaluates current lung organoid technologies, elucidating their derivation pathways and capacity for high-fidelity disease modeling. We analyze their application in dissecting the pathogenesis of chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, viral infections including SARS-CoV-2, and non-small cell lung cancer. Furthermore, we highlight their important role in predictive toxicology for assessing environmental inhalation hazards, cosmetic safety, and drug-induced lung injury, aligning with evolving regulations prioritizing alternatives to animal testing. Despite their immense potential, widespread clinical and industrial translation is currently impeded by biological bottlenecks: the absence of functional vascularization, incomplete immune integration, and reliance on undefined xenogeneic matrices. We systematically examine bioengineering strategies addressing these limitations-including synthetic hydrogels, microfluidic organ-on-a-chip platforms, and 3D bioprinting-to overcome translational hurdles, accelerate precision medicine, and improve respiratory pharmacology.}, }
@article {pmid42376726, year = {2026}, author = {Abdul Rahman, H and Zahari, NH}, title = {The Silent Crisis: Loneliness in Older Adults-A Critical Review of Impacts, Strategies and Path Forward.}, journal = {Scandinavian journal of caring sciences}, volume = {40}, number = {3}, pages = {e70292}, doi = {10.1111/scs.70292}, pmid = {42376726}, issn = {1471-6712}, mesh = {Humans ; *Loneliness/psychology ; Aged ; *COVID-19/psychology ; Aged, 80 and over ; Middle Aged ; Male ; Female ; *Social Isolation/psychology ; }, abstract = {BACKGROUND: Loneliness, distinct from social isolation, is a subjective sense of social disconnection exacerbating a public health crisis among older adults. Affecting ~33% of community-dwelling individuals aged 50-80 years post-COVID-19, it rivals smoking in mortality risk and drives cognitive, cardiovascular, and mental health declines. This review synthesises evidence to inform clinical strategies.
METHODS: A critical review of per-reviewed meta-analyses, RCTs, and prospective cohorts literature (2019-2025) was conducted for adults aged 50 years and above. Studies were selected using validated loneliness or social isolation measures, with quality appraised via AMSTAR-2, Cochrane RoB 2, and Newcastle-Ottawa Scale; 34 studies met eligibility criteria from an initial yield of 1,847 records.
RESULTS: Prevalence of loneliness stands at 29% isolation by 2024, highest among those with poor health (53%-75%), unemployment (52%), solitary living, and ages 50-64. Loneliness elevates all-cause mortality (32%), dementia (50%-59%), cardiovascular events (29%-32%), depression (40%), and anxiety (35%). Mechanisms include increased inflammation (↑CRP, IL-6), HPA dysregulation, immune compromise, hippocampal atrophy, and behavioural lapses. Interventions like CBT/reminiscence therapy, multicomponent programs, animal therapy, exercise, and digital platforms have been shown to reduce loneliness, though primary care implementation lags due to screening/referral barriers. Tools such as the UCLA Loneliness Scale enable feasible assessment.
CONCLUSIONS: Loneliness as a geriatric syndrome demands mandated screening, provider education, and reimbursement reforms. Coordinated healthcare-community efforts could avert substantial morbidity/mortality, addressing gaps in long-term outcomes and cost-effectiveness research.}, }
@article {pmid42376837, year = {2026}, author = {Tafazoli, A and Dowran, R}, title = {Syncytia Formation in the Pathogenesis of SARS-CoV-2 Infection: Lessons from Viral Infections.}, journal = {Viral immunology}, volume = {39}, number = {6}, pages = {232-240}, doi = {10.1177/08828245261433819}, pmid = {42376837}, issn = {1557-8976}, mesh = {Humans ; *Giant Cells/virology/immunology ; *COVID-19/virology/immunology/pathology ; Spike Glycoprotein, Coronavirus/genetics/immunology/metabolism ; *SARS-CoV-2/pathogenicity/genetics/immunology/physiology ; Virus Internalization ; Immunity, Innate ; Mutation ; Animals ; }, abstract = {It is widely known that numerous enveloped viruses can produce multinucleated cells (syncytia) as a result of viral entry-related membrane fusion events. By protecting the virus from the host's immune reaction, these syncytia are thought to promote viral reproduction. Syncytia are collections of merged cells. A viral spike protein (S) on the surface of an infected cell interacts with receptors on nearby cells to cause the syncytia response. The innate immune system's response to viruses affects how syncytia form. Some interferon-stimulated genes change the membrane in a way that reduces the likelihood of fusion. The severe acute respiratory syndrome coronavirus (SARS-CoV-2) virus is quickly changing; also, several mutations occurred in its S protein. Individually and together, the Alpha, Beta, Gamma, and Delta variants carry mutations that significantly affect S function and syncytia formation. The function of syncytia in newly emerging variant diseases is still unknown, though. Syncytia could cause disease through promoting viral transmission, cytopathicity, immunological evasion, and inflammatory responses. The SARS-CoV-2 S protein variations include several changes that improve receptor interactions, fusogenicity, and antibody reactivity. A wide range of clinical symptoms, including moderate febrile sickness, severe respiratory distress, and occasionally deadly lung damage, can be brought on by an infection with SARS-CoV-2. Several of these lung illnesses (MERS-CoV) are linked to both the Middle East Respiratory Syndrome (MERS) and the severe acute respiratory syndrome coronavirus (SARS-CoV). Compared to acute respiratory syndromes, the lung thrombosis brought on by Coronavirus disease 2019 (COVID-19) is incredibly severe. In this review we focused on innate immunological elements that prevent syncytia from forming and the molecular triggers of S-mediated fusion.}, }
@article {pmid42377214, year = {2026}, author = {Tanriover, MD and Forsyth, K and He, Q and Diavatopoulos, DA and Orozco Fernández, R and Hozbor, DF and Middleton, DB and Muloiwa, R and Muñoz, FM and Ong-Lim, A and Tan, TQ and Heininger, U}, title = {Immunological insights into why pertussis continues to be endemic.}, journal = {Human vaccines & immunotherapeutics}, volume = {22}, number = {1}, pages = {2692306}, pmid = {42377214}, issn = {2164-554X}, mesh = {*Whooping Cough/epidemiology/immunology/prevention & control ; Humans ; *Bordetella pertussis/immunology/genetics ; *Pertussis Vaccine/immunology/administration & dosage ; *Endemic Diseases/prevention & control ; Th1 Cells/immunology ; Th17 Cells/immunology ; Vaccines, Acellular/immunology ; Th2 Cells/immunology ; }, abstract = {Pertussis (whooping cough) is a vaccine-preventable bacterial disease caused by Bordetella pertussis. Despite widespread vaccination, cases have increased globally since the 1990s, with notable outbreaks in 2012, 2016, and following the COVID-19 pandemic. Persistent endemicity and periodic epidemics are driven by limited prevention of nasal colonization, waning immunity after vaccination or natural infection, and pathogen adaptation. Differences between acellular (aP) and whole-cell (wP) vaccines reflect distinct immune profiles, with aP vaccines favoring Th2 responses and wP vaccines inducing Th1/Th17 responses and tissue-resident memory T cells. Circulating strains have evolved under vaccine pressure, including shifts in ptxP, ptxA and prn alleles, increasing pertussis toxin production, emergence of pertactin-deficient variants, and rising macrolide resistance linked to 23S rRNA mutations. Optimizing current vaccine strategies and developing next-generation vaccines that improve durable, Th1/Th17-polarized immunity and reduce transmission are essential for enhanced pertussis control.}, }
@article {pmid42378128, year = {2026}, author = {Escobar, M and Arenas, Á and Perdomo-Luna, C and Londoño, D and Molano, JC and Nieto, M and Borrero, E and Vanegas, E}, title = {Is mental health in Colombia a right or a privilege?.}, journal = {Biomedica : revista del Instituto Nacional de Salud}, volume = {46}, number = {2}, pages = {219-227}, doi = {10.7705/biomedica.7429}, pmid = {42378128}, issn = {2590-7379}, mesh = {Colombia/epidemiology ; Humans ; *COVID-19/epidemiology/psychology ; *Mental Disorders/epidemiology/therapy ; *Mental Health ; *Mental Health Services/organization & administration ; Health Services Accessibility ; Armed Conflicts ; Social Stigma ; Healthcare Disparities ; SARS-CoV-2 ; Right to Health ; Pandemics ; }, abstract = {This article offers a vision of the mental health situation in Colombia, highlighting its growing relevance in the public sphere and the specific challenges facing the country. It analyzes the impact of the armed conflict and the COVID-19 pandemic on the mental health of the Colombian population, focusing on how these situations have exacerbated pre-existing problems. Additionally, the existence of significant barriers to accessing specialized services is highlighted, such as stigma, lack of trained personnel, and high costs associated with the treatment of mental disorders. Therefore, the need to address inequalities in mental health care is raised, both nationally and internationally. Finally, recommendations are proposed to improve prevention, community care and access to mental health services in Colombia.}, }
@article {pmid42378358, year = {2026}, author = {Atencio, MA and Luini, JA and Cappella, RB and Mattei, L and Giuffre, CV and Pereyra Huertas, J and Scherñuk Schroh, MP and Davit Baridón, NS and Boscardin, C and Esandi, ME and Duran, LG}, title = {Effectiveness of strategies to prevent burnout syndrome in hospital-based healthcare personnel: an overview of systematic reviews.}, journal = {Revista de la Facultad de Ciencias Medicas (Cordoba, Argentina)}, volume = {83}, number = {2}, pages = {e49503}, doi = {10.31053/1853.0605.v83.n2.49503}, pmid = {42378358}, issn = {1853-0605}, mesh = {Humans ; *Burnout, Professional/prevention & control ; *Personnel, Hospital/psychology ; *COVID-19/psychology ; *Health Personnel/psychology ; SARS-CoV-2 ; }, abstract = {INTRODUCTION: Burnout syndrome (BO) significantly affects healthcare personnel, especially in hospital settings. The COVID-19 pandemic has intensified this issue, highlighting the need for effective preventive strategies.
OBJECTIVES: To synthesize available evidence on the effectiveness of individual, organizational, and combined strategies to prevent or reduce BO in hospital-based healthcare personnel.
MATERIALS AND METHODS: A systematic search was conducted in PubMed, Cochrane Library, Epistemonikos, and the Virtual Health Library for systematic reviews published between January 1, 2014, and January 15, 2024. Reviews with or without meta-analyses were included if they evaluated preventive interventions for BO and contained at least one primary study. Reviews focused solely on stress, well-being, or anxiety without specific BO outcomes were excluded. Two reviewers independently extracted data on study characteristics, types of interventions, measurement tools, and outcomes. A de novo extraction of 107 primary studies was also performed.
RESULTS: Twenty-seven systematic reviews were included. The most frequently evaluated interventions were mindfulness, cognitive-behavioral therapy, workload reduction, and professional coaching. Structured, in-person interventions generally showed greater effectiveness. Organizational strategies yielded mixed results.
CONCLUSION: Both individual and organizational interventions can reduce BO in healthcare professionals. Structured, face-to-face, and multifaceted approaches appear to be more effective. High-quality research is needed, with emphasis on implementation strategies tailored to clinical contexts.}, }
@article {pmid42379196, year = {2026}, author = {Blakney, AK and Top, KA and Cowling, BJ and Larson, HJ and Shattock, RJ and Sadarangani, M}, title = {Safety and efficacy of mRNA vaccines: a mechanistic and public health perspective.}, journal = {Lancet (London, England)}, volume = {}, number = {}, pages = {}, doi = {10.1016/S0140-6736(26)00512-X}, pmid = {42379196}, issn = {1474-547X}, abstract = {mRNA vaccines represent a transformative advance in vaccinology, combining rapid development timelines, scalable manufacturing, and strong immunogenicity with a favourable safety profile. Global deployment of mRNA vaccines during the COVID-19 pandemic provided an unprecedented real-world evaluation of this platform, with billions of doses administered across diverse populations. In this Review, we critically examine the safety and efficacy of mRNA vaccines from mechanistic, preclinical, clinical, and public health perspectives. We outline the biological basis of mRNA vaccines, including their transient cytoplasmic expression, lack of genomic integration, and rapid clearance, distinguishing them clearly from other gene therapies. We synthesise evidence on vaccine components, manufacturing quality controls, and regulatory standards that underpin safety, alongside data from randomised trials, post-authorisation surveillance, and active pharmacovigilance systems. We also review real-world effectiveness across age groups, pregnancy, and populations that are immunocompromised, along with the effects on transmission. Last, we address public perception and vaccine confidence, and discuss implications for next-generation mRNA vaccines, including strategies to reduce reactogenicity, improve breadth and durability of immunity, enhance global access, and support sustainable public trust. Together, the accumulated evidence affirms mRNA vaccines as a safe, effective, and adaptable platform with enduring relevance for future infectious disease prevention and public health preparedness, and for the treatment of cancer and autoimmunity.}, }
@article {pmid42379531, year = {2026}, author = {Alsulami, AS and Al-Kuraishy, HM and Al-Gareeb, AI and Abdelnaby, MA and Haggag, MM and El-Saber Batiha, G}, title = {Pathophysiology of silent hypoxia in COVID-19: Truth and mystery.}, journal = {Respiratory medicine}, volume = {261}, number = {}, pages = {109013}, doi = {10.1016/j.rmed.2026.109013}, pmid = {42379531}, issn = {1532-3064}, abstract = {Coronavirus disease 2019 (COVID-19) is a highly infectious viral disease caused by the SARS-CoV-2. COVID-19 commonly leads to mild flu-like illness in most of cases. However, severe COVID-19-induced pneumonia and associated acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) may lead to ventilation-perfusion mismatch and the development of silent hypoxia. Silent hypoxemia is observed in critically COVID-19 patients without signs of subjective dyspnea that is often linked with poor clinical outcomes. Proposed mechanisms include impairment of peripheral carotid chemoreceptors, attenuation of the sensitivity of the respiratory center, and the development of acute vascular distress syndrome (AVDS). However, it should be noted that while AVDS is supported by imaging and pathological evidence, the roles of carotid body dysfunction and other proposed mechanisms remain incompletely validated and require further investigation. The pathophysiology of silent hypoxia in COVID-19 and other viral infections is a complex condition. Accordingly, this review aims to explain and discuss the pathophysiology of silent hypoxia, and its critical role in COVID-19.}, }
@article {pmid42380588, year = {2026}, author = {Singh, A and Tekade, M and Nagaraja, S and Bharti, A and Tekade, RK}, title = {Advancements in RNA-based therapies from bench to bedside.}, journal = {npj drug discovery}, volume = {3}, number = {1}, pages = {}, pmid = {42380588}, issn = {3005-1452}, abstract = {RNA research has advanced rapidly, becoming a key component of modern therapeutics. This review outlines key milestones and innovations from antisense oligonucleotides and RNA interference to mRNA therapies and aptamers that have enabled targeted treatments for diverse diseases. The success of COVID-19 mRNA vaccines highlighted the remarkable clinical potential of RNA-based technologies. Emphasis is placed on delivery technologies, landmark approvals, and ongoing trials shaping the future of RNA-based medicine.}, }
@article {pmid42380995, year = {2026}, author = {Delano, P and Serra-Suton, V and Benavides, FG and Utzet, M}, title = {Prolonged return to work and hampered work ability: insights from a scoping review on the impact of long COVID on healthcare workers job performance.}, journal = {BMC health services research}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12913-026-15032-w}, pmid = {42380995}, issn = {1472-6963}, abstract = {BACKGROUND: Healthcare workers (HCWs) may have a higher risk of developing long COVID due to greater exposure to COVID-19, with symptoms extending beyond the acute phase impacting their daily living activities and job performance.
AIMS: To systematically map the existing literature on the impact of long COVID on HCWs' job performance, focusing on their time to return to work and work ability.
METHODS: A scoping review following PRISMA-ScR guidance included peer-reviewed studies in English or Spanish (January 2020-December 2024). Four databases were searched. Experimental, epidemiological and qualitative studies were eligible. Two reviewers independently screened records. Methodological quality was appraised using the Mixed-Methods Appraisal tool (MMAT).
RESULTS: Nineteen studies were included, mainly European and predominantly cross-sectional. Long COVID was most often defined as symptoms lasting ≥ 3 months. Among HCWs with prior infection or whole-staff samples, prevalence ranged from 10% to 74%, with multiple reports above 50%. Thirteen studies evaluated RTW, with 19-63% resumed work within six months, commonly with restrictions, while around one in five remained unable to work in some cohorts. Full-time employment decreased markedly (e.g., 57% pre-infection vs 31% at follow-up). Between 16% and 40% required workplace adjustments such as reduced hours, reassignment, or avoidance of night shifts. Sixteen studies reported diminished work ability compared with pre-infection or unaffected peers. Greater symptom burden, particularly cognitive impairment and fatigue, consistently predicted poorer outcomes. One study estimated a mean of 223 days to reach current work-ability levels. Older age, depression, comorbidity, and acute disease severity were recurrent associated factors while evidence for gender and job category was inconsistent.
CONCLUSIONS: Long COVID delays RTW and reduces work ability in HCWs. Health services should plan long-term occupational follow-up, flexible reintegration pathways, and targeted accommodations while higher-quality longitudinal research refines risk and prognosis.}, }
@article {pmid42381166, year = {2026}, author = {Yang, Y and Weng, J and Tao, Y and Luo, B and Lian, D and Li, F and Yan, J and Chen, Y}, title = {Cost-Effectiveness of Vaccination Strategies for COVID-19: A Systematic Review.}, journal = {Journal of evidence-based medicine}, volume = {19}, number = {2}, pages = {e70136}, doi = {10.1111/jebm.70136}, pmid = {42381166}, issn = {1756-5391}, mesh = {Humans ; *Cost-Benefit Analysis ; Cost-Effectiveness Analysis ; *COVID-19/prevention & control/economics ; *COVID-19 Vaccines/economics/administration & dosage ; *Vaccination/economics/methods ; SARS-CoV-2 ; }, abstract = {OBJECTIVES: This study aims to provide a comprehensive overview of the cost-effectiveness of COVID-19 vaccination strategies and examine the reporting quality of the included studies.
METHODS: A systematic search was performed across PubMed, Web of Science, Embase, Cochrane Library, the International Network of Agencies for Health Technology Assessment, and Chinese databases (CNKI, WanFang, VIP, and SinoMed). Health economic evaluations published from inception to December 19, 2024, considering both costs and effects of vaccination strategies for COVID-19 were included. The reporting quality of the included studies was comprehensively assessed according to the Consolidated Health Economic Evaluation Reporting Standards Checklist (CHEERS) 2022. A narrative synthesis was employed to summarize and present the findings across diverse vaccination strategies. To ensure transparency, the study protocol was registered prospectively in the Prospective Register of Systematic Reviews (CRD42025629706).
RESULTS: A total of 68 studies were included. These studies were heterogeneous concerning reporting quality, vaccination strategies, adopted perspective, applied models, and outcome indicator used. The CHEERS quality scoring rate of 68 studies ranged from 23% to 88%, with a median of 71%. Vaccination was consistently found more cost-effective or cost-saving than no vaccination. Prioritizing high-risk populations, particularly older adults, delivered even higher economic benefits across diverse settings.
CONCLUSION: COVID-19 vaccination remains cost-effective globally. While rapid deployment and high risk prioritization maximize economic benefits, optimal strategies are sensitive to epidemiological and methodological factors, placing substantial demands on policymakers. Future research should integrate long-term impacts, health equity, and reporting standards to strengthen evidence based vaccination policies.}, }
@article {pmid42381225, year = {2026}, author = {Shakerdi, AL and Drda, J and Dutta, JA and Vockley, J}, title = {Immune Dysregulation in Branched Chain Organic Acidemias.}, journal = {Journal of inherited metabolic disease}, volume = {49}, number = {4}, pages = {e70203}, pmid = {42381225}, issn = {1573-2665}, support = {1U54HD121579-01//Foundation for the National Institutes of Health/ ; }, mesh = {Humans ; *Amino Acid Metabolism, Inborn Errors/immunology ; Cytopenia ; Animals ; Adaptive Immunity ; }, abstract = {Organic acidemias (OAs) are a group of inherited disorders, most commonly caused by defects in mitochondrial enzymes involved in amino acid and fatty acid metabolism. While they characteristically present with metabolic and neurological crises, growing evidence reveals a significant burden of chronic immune dysregulation in some disorders and patients. This review provides a synthesis of clinical and mechanistic evidence discussing immune dysregulation in OAs. Cytopenia can occur in OAs and predispose patients to recurrent and severe infections. Adaptive immune deficits, such as hypogammaglobulinemia, reduced B and T cell populations, and impaired vaccine-specific antibody responses, including to diphtheria and tetanus in MSUD and to the inactivated COVID-19 vaccine in propionic acidemia, have also been reported. Additionally, some case series note hyperinflammatory conditions, such as hemophagocytic lymphohistiocytosis. Mechanistic studies indicate that accumulated metabolites disrupt innate and adaptive hematopoietic progenitor function, mitochondrial homeostasis, and inflammatory signaling. Emerging therapeutic avenues, such as gene and mRNA-based therapies, hold the potential to improve or normalize the biochemical phenotype in OAs. While their impact on immune abnormalities remains largely unexplored, future clinical trials offer an opportunity to systematically assess potential effects on immune parameters. OAs are increasingly recognized as disorders with intrinsic immune dysregulation, extending beyond their well-characterized metabolic and neurological manifestations. Future clinical trials will benefit from including immunological endpoints to evaluate immunological recovery for novel therapies.}, }
@article {pmid42381868, year = {2026}, author = {Wang, Z and Wang, J and Wu, Q and Wang, B}, title = {Glycemic variability and the short-term mortality of hospitalized patients with COVID-19: a meta-analysis.}, journal = {Frontiers in endocrinology}, volume = {17}, number = {}, pages = {1846640}, pmid = {42381868}, issn = {1664-2392}, mesh = {Humans ; *COVID-19/mortality/blood ; Hospitalization ; *Blood Glucose/metabolism/analysis ; SARS-CoV-2 ; *Coronavirus Infections/mortality/blood ; Hospital Mortality ; *Pneumonia, Viral/mortality/blood ; Pandemics ; *Betacoronavirus ; }, abstract = {BACKGROUND: Glucose variability (GV) reflects fluctuations in blood glucose and may better capture metabolic instability than static glycemic measures in patients with Coronavirus disease 2019 (COVID-19). However, its association with mortality remains uncertain due to heterogeneous study designs and inconsistent findings. This meta-analysis was performed to evaluate the association between GV and short-term all-cause mortality in adult patients hospitalized with COVID-19.
METHODS: PubMed, Embase, and Web of Science were systematically searched for longitudinal observational studies reporting the association between GV and mortality in patients hospitalized with COVID-19. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using a random-effects model accounting for the possible influence of heterogeneity.
RESULTS: Ten cohort studies comprising 11 datasets and 77,395 patients were included, with 8,189 deaths. High GV was associated with a significantly increased risk of all-cause mortality (RR = 2.10, 95% CI: 1.69-2.59; I² = 45%). The association was stronger in studies with a mean age ≥ 62 years (RR = 2.79) compared with < 62 years (RR = 1.78; p for subgroup difference = 0.03). Results were consistent across GV metrics, analytic models, adjustment for diabetes status, and study quality (all p > 0.05). Meta-regression analysis showed that mean age demonstrated a borderline association with the effect estimate (coefficient = 0.020, p = 0.07), explaining a moderate proportion of heterogeneity (adjusted R² = 49.2%).
CONCLUSIONS: Higher GV is associated with increased short-term mortality in hospitalized patients with COVID-19, supporting its role as a potential prognostic marker.
https://www.crd.york.ac.uk/prospero/, identifier CRD420261358246.}, }
@article {pmid42382219, year = {2026}, author = {Renukappa, S and Subbarao, C and Suresh, S and Pillai, P and Fernando, K and Rangaswamy, C and Shetty, J and Krishnadas, R and Veenith, T}, title = {An assessment of cyber security and resilience of the National Digital Health Mission of India.}, journal = {Oxford open digital health}, volume = {4}, number = {}, pages = {oqag012}, pmid = {42382219}, issn = {2754-4591}, abstract = {The healthcare sector has undergone a transformation driven by the adoption of digital technology. Digital strategies have become the principal mechanism for delivering high-quality, cost-effective healthcare at scale. The Indian Government is also rapidly deploying the Ayushman Bharat Digital Mission (ABDM), launched in September 2021. ABDM is the flagship programme of the Indian Government, which has become the standard platform for healthcare delivery and allied services, including insurance management. The COVID-19 pandemic further accelerated digital adoption, making dependence on digital infrastructure both pervasive and unavoidable. Ensuring cybersecurity and resilience is therefore fundamental to uninterrupted healthcare delivery. This paper examines cyber resilience and cybersecurity within ABDM, with specific reference to its architecture and governing policies. A rigorous assessment of cyber resilience and cybersecurity, encompassing potential threats and attack vectors, is essential to the programme&#×2019;s long-term success. We conclude that ABDM&#×2019;s success is intrinsically linked to robust cybersecurity and resilience. Further work is required to develop a comprehensive framework for ABDM cyber resilience and security that is applicable across all ecosystem partners.}, }
@article {pmid42384225, year = {2026}, author = {Miranda, M and Brown, M and van Haren, FMP and Brown, B and Page, CP}, title = {Nebulised heparin as a treatment for lung diseases: formulation challenges and pulmonary drug delivery strategies.}, journal = {Lung}, volume = {204}, number = {1}, pages = {}, pmid = {42384225}, issn = {1432-1750}, mesh = {Humans ; *Heparin/administration & dosage/chemistry ; Administration, Inhalation ; Nebulizers and Vaporizers ; *COVID-19 Drug Treatment ; *Drug Delivery Systems ; *Lung Diseases/drug therapy ; *Anticoagulants/administration & dosage ; COVID-19 ; SARS-CoV-2 ; Drug Compounding ; Aerosols ; }, abstract = {The COVID-19 pandemic further emphasized the global demand for heparin and its expanding clinical relevance, indicating that even one of the oldest drugs in medicine continues to reveal new therapeutic horizons. Traditionally recognized for its anticoagulant and antithrombotic activities, heparin is increasingly being explored for its versatile therapeutic potential in the treatment of a range of pulmonary diseases, including respiratory infections (e.g. COVID-19), Acute Respiratory Distress Syndrome (ARDS), asthma, chronic obstructive pulmonary disease (COPD) and cystic fibrosis. In all of these diseases, inhaled unfractionated heparin (UFH) therapy has been investigated in a number of clinical trials that have demonstrated promise for this drug when administered directly to the lungs. However, using heparin by this "off label" route of administration, poses a number of technical challenges: the physicochemical properties of heparin at therapeutic doses often results in highly viscous formulations, causing device blockage and drug sorption during nebulization. These limitations underscore the need for innovative formulation strategies to improve aerosol flow, reduce dosing inefficiencies, and enable reliable pulmonary administration. Advancing heparin formulations for delivery to the lung could therefore unlock significant benefits for a wide spectrum of respiratory disorders, marking a new chapter in the long medical history of this drug as discussed below.}, }
@article {pmid42384642, year = {2026}, author = {Kagbadouno, M and Camara, O and Diallo, BM and Camara, AD and Soumah, A and Leno, M and Béavogui, F and Gassama, MD and Camara, I and Coulibaly, B and Kaba, D and Camara, A and Boiro, S and Ilboudo, H and Rayaisse, JB and MacLeod, A and Ndungu, J and Bieler, S and Bessell, P and Ott, D and Lejon, V and Ravel, S and Courtin, F and Solano, P and Jamonneau, V and Bart, JM and Rotureau, B and Bucheton, B and Camara, M}, title = {Elimination of gambiense human African trypanosomiasis as a public health problem in Republic of Guinea: Paving the way for zero transmission.}, journal = {PLoS neglected tropical diseases}, volume = {20}, number = {7}, pages = {e0014469}, pmid = {42384642}, issn = {1935-2735}, mesh = {Humans ; *Trypanosomiasis, African/prevention & control/epidemiology/transmission ; Animals ; Guinea/epidemiology ; *Trypanosoma brucei gambiense/physiology ; *Disease Eradication ; Public Health ; Insect Vectors/parasitology ; Tsetse Flies/parasitology ; }, abstract = {The Republic of Guinea has faced an important challenge with human African trypanosomiasis (HAT), which was endemic over the last century. After initial control in the 1960s-1970s, HAT resurged in the 1990s along the Guinean coast, driven by economic and demographic pressures on the mangrove ecosystem. In response, the Guinean government established a national control program in 2002, focusing on medical mass screenings. In 2012, vector control using tiny targets was introduced in the East Boffa focus to reduce fly density and human-vector contact. However, the Ebola epidemic from 2013 to 2016 disrupted these efforts, leading to a reliance on passive screening. Resuming screenings in 2016-2017 revealed increased cases in all foci except the East Boffa area, where vector control had been effective. Vector control continued during the SARS-CoV2 pandemic and at the same time targeted door-to-door screenings were introduced to target high-risk individuals. Since 2018, around 30,000 at-risk individuals have been screened annually. These strategies reduced the total number of new cases below 1 per 10,000 inhabitants in endemic areas over the period 2019-2023, allowing to validate the elimination of HAT as a public health problem. The Guinean team and partners then focused on systematic spatial monitoring of patients and community engagement in vector control. The program also integrates control of other neglected tropical diseases and addresses new research questions, especially about anatomical and animal reservoirs for parasites. These efforts, combined with implementation of improved diagnostic tests and new oral treatments, through active involvement in multiple clinical trials and studies, now aim to interrupt HAT transmission by 2030.}, }
@article {pmid42386620, year = {2026}, author = {Kishikawa, JI}, title = {[Structural Analysis Using Cryo-electron Microscopy for Protein-based Drug Design].}, journal = {Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan}, volume = {146}, number = {7}, pages = {631-639}, doi = {10.1248/yakushi.25-00183-3}, pmid = {42386620}, issn = {1347-5231}, mesh = {*Cryoelectron Microscopy/methods ; *Drug Design ; Angiotensin-Converting Enzyme 2 ; SARS-CoV-2 ; Protein Conformation ; Spike Glycoprotein, Coronavirus/chemistry/metabolism ; Humans ; Vibrio cholerae/enzymology ; Peptidyl-Dipeptidase A/chemistry ; Protein Binding ; Betacoronavirus ; }, abstract = {Structure-based drug design (SBDD) plays a crucial role in modern drug discovery. SBDD is a methodology that utilizes the three-dimensional (3D) structural information of a target protein to computationally search for compounds that bind to it and/or to optimize the binding of known compounds. This article provides an overview of recent advances in SBDD. Furthermore, we introduce 2 case studies conducted by the authors using single-particle analysis via Cryo-electron microscopy (Cryo-EM), a powerful technique for obtaining protein structures. The first example is the sodium ion (Na[+])-translocating NADH-quinone oxidoreductase derived from Vibrio cholerae. This enzyme is suggested to undergo large conformational changes during the reaction cycle. By performing classification in single-particle analysis, we successfully captured a partial view of these conformational dynamics. The second example involves the angiotensin-converting enzyme 2 (ACE2) decoy, which binds to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein and inhibits infection. Focusing on ACE2, which is critical for SARS-CoV-2 infection, an ACE2 decoy was developed to achieve higher binding affinity than the wild-type ACE2. We successfully elucidated how this ACE2 decoy binds to the spike protein.}, }
@article {pmid42387249, year = {2026}, author = {Frischhut, M and Gamba, S and Magazzini, L and Pertile, P}, title = {The Price of National Pharmaceutical Pricing in the EU: A Proposal for "Common Procurement".}, journal = {Applied health economics and health policy}, volume = {}, number = {}, pages = {}, pmid = {42387249}, issn = {1179-1896}, abstract = {Within the European Union (EU), pricing and reimbursement decisions for new medicines are the responsibility of individual Member States. The presence of many regulated prices for medicines within the EU single market drives strategic decisions by payers and manufacturers, resulting, among other things, in launch delays and unequal patient access across European countries. To increase equity in patient access, we propose strengthening collaboration on medicines procurement among Member States beyond emergency situations. Joint initiatives undertaken by groups of countries have demonstrated their potential to deliver benefits, and the need for common procurement initiatives has become apparent during the coronavirus disease 2019 (COVID-19) pandemic. We present our proposal within the context of the current European regulatory framework and the recently proposed "Critical Medicines Act", emphasising the key legislative provisions that can be invoked to support a common procurement initiative. We also provide relevant, actionable options for designing such initiatives. Strong political commitment and agreement on equity and solidarity principles would be needed for the successful implementation of the proposal.}, }
@article {pmid42388294, year = {2026}, author = {Arévalo-Guadalupe, GC and Gamboa-Tama, JE and Mederos-Mollineda, K and Peralta-Gamboa, DA}, title = {Digital epidemiology and public health surveillance: scientometric mapping of emerging technologies and challenges (2000-2025).}, journal = {Frontiers in digital health}, volume = {8}, number = {}, pages = {1789164}, pmid = {42388294}, issn = {2673-253X}, abstract = {The rapid advancement of digital technologies has transformed traditional mechanisms of epidemiological surveillance and response, giving rise to an interdisciplinary field known as digital epidemiology. This study presents a scientometric mapping of the main trends, collaboration networks, and thematic foci linked to the use of emerging technologies-such as artificial intelligence, machine learning, big data, the Internet of Things (IoT), and social media mining-in global public health surveillance from 2000 to 2025. The methodology combines bibliometric and social network analysis on documents indexed in Scopus and Web of Science, complemented by a qualitative examination of the fifty most cited studies. The results reveal an exponential growth in scientific output starting from 2010, with an inflection point during the COVID-19 pandemic. The United States, the United Kingdom, and China stand out as the primary centers of production and international collaboration. However, significant gaps persist in digital equity, interoperability, and ethical governance, particularly in regions with lower technological infrastructure. This work contributes to understanding the evolution and challenges of digital epidemiology, proposing a future research agenda centered on algorithmic ethics, transparency, international cooperation, and technological inclusion in vulnerable contexts.}, }
@article {pmid42388544, year = {2026}, author = {Simon, AK and Bhatt, S and Thakkar, VP and Sajjanshetty, M and Bano, S and Maheswaran, T and Sivaguru, K}, title = {A Narrative Review of Teledentistry in the AI Era: Scope, Opportunities, and Future Prospects in India.}, journal = {Cureus}, volume = {18}, number = {5}, pages = {e110008}, pmid = {42388544}, issn = {2168-8184}, abstract = {Teledentistry has evolved from pilot programs and COVID-19 adaptations into a clinically validated component of modern oral healthcare. In India, where access to dental care remains severely limited in rural populations, the convergence of teledentistry with artificial intelligence (AI) offers an urgent opportunity to reduce the burden of oral diseases. This narrative review examines the modalities and clinical evidence for teledentistry; awareness profiles and adoption barriers among Indian dental professionals and students; the diagnostic capabilities and readiness landscape for AI in dentistry; and the prospects, challenges, and implementation frameworks for AI-teledentistry integration in India. Evidence supports the diagnostic validity of synchronous and asynchronous teledental platforms for caries screening, oral lesion triage, and community surveillance. AI tools, including convolutional neural networks, large language models, and AI-generated educational content, enhance diagnostic accuracy, patient education, and resource optimization. However, formal training deficits, rural infrastructure gaps, limited oral health digital initiatives, and the absence of national regulatory frameworks remain critical barriers. A coordinated policy response that integrates AI into the dental curriculum and is supported by equity-centered implementation research is required.}, }
@article {pmid42388548, year = {2026}, author = {Koul, PA and Vora, A and Tiwaskar, M and Bhargava, R and Dhar, R and Ramasubramanian, VR and Kher, V and Nangia, V and Jha, V and Dutta, T and Mahajan, M}, title = {Life Course Vaccination Continuum (LCVAC): An Expert Consensus on Life Course Vaccination in India.}, journal = {Cureus}, volume = {18}, number = {5}, pages = {e110007}, pmid = {42388548}, issn = {2168-8184}, abstract = {India's immunization program focuses predominantly on children, leaving adults vulnerable to vaccine-preventable diseases (VPDs). The COVID-19 pandemic further disrupted routine vaccination. A life course approach (LCA) is needed to address these gaps. However, implementation of adult vaccination programs in low- and middle-income countries (LMICs) remains challenged by inequities in healthcare access, infrastructural limitations, and variable awareness regarding adult immunization. A 16-member expert panel from pulmonology, geriatrics, oncology, obstetrics, nephrology, diabetology, and life sciences reviewed literature (2014-2023) from MEDLINE, Scopus, and Cochrane databases. Using a structured, evidence-based grading approach, the panel formulated consensus recommendations for adult vaccination in India. The Life Course Vaccination Continuum (LCVAC) proposes three target groups: adults aged 18-59 years with comorbidities; elderly ≥60 years with or without comorbidities; and healthy adults aged 18-60 years. Key recommended vaccines include Tdap (every 10 years), influenza (annual), pneumococcal (PCV13/PPSV23 series), zoster (for ≥50 years), hepatitis B, meningococcal, and hepatitis A (risk-based). Major barriers identified include vaccine hesitancy, cost, access limitations, and inadequate provider prioritization. Life Course Vaccination Continuum provides the first comprehensive expert consensus on life course vaccination in India. The framework is intended to complement broader public health strengthening efforts, and its successful implementation will require vaccine awareness campaigns, healthcare professional education, equitable access strategies, and the establishment of dedicated adult vaccination centers nationwide.}, }
@article {pmid42388750, year = {2026}, author = {Luo, X and Deng, JS and Chen, JN and Ye, T and Chen, SJ and Su, HL and Tung, TH and Zhu, JS}, title = {Bidirectional associations between influenza and COVID-19 vaccination: a systematic review and meta-analysis.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1756985}, pmid = {42388750}, issn = {2296-2565}, mesh = {Humans ; *COVID-19 Vaccines/administration & dosage ; *Influenza, Human/prevention & control ; *Influenza Vaccines/administration & dosage ; *Vaccination/statistics & numerical data/psychology ; *COVID-19/prevention & control ; *Patient Acceptance of Health Care/statistics & numerical data ; }, abstract = {PURPOSE: This study aimed to investigate the effect of vaccination history on future willingness or behavior to receive vaccinations for influenza and COVID-19.
METHODS: In this systematic review and meta-analysis, the PubMed, Embase, Web of Science, Cochrane Library, APA PsycInfo, CINAHL and Scopus databases were searched up to February 28, 2026, to identify relevant studies in accordance with the inclusion and exclusion criteria. The analysis ultimately included 145 population-based studies conducted in the United States, China, Thailand, the United Arab Emirates, Egypt, and other countries.
RESULTS: Prior vaccination histories for influenza and COVID-19 interacted with each other and were associated with an increased willingness and likelihood to receive future vaccines. Specifically, having received the influenza vaccine was associated with an increased willingness to receive the COVID-19 vaccine(odds ratio [OR] = 2.73, 95% confidence interval [CI]: 2.34-3.19, 95% prediction interval:[PI] 0.66-11.07), as well as with an increased likelihood of actually receiving the COVID-19 vaccine (OR = 2.76, 95% CI: 2.32-3.29, 95%PI: 0.90-8.52). Receiving a COVID-19 vaccine was associated with an increased willingness to receive a influenza vaccine (OR = 3.04, 95% CI: 1.25-7.39), and was also associated with an increased likelihood of actually receiving the influenza vaccine (OR = 3.91, 95% CI: 2.45-6.24, 95%PI: 0.81-18.81).
CONCLUSION: In conclusion, prior vaccination history was associated with higher odds of future vaccination, and influenza and COVID-19 vaccination experiences influenced each other. Influenza and COVID-19 vaccine promotion strategies can likely be combined to increase overall vaccination rates.
PROSPERO identifier CRD42024594174.}, }
@article {pmid42389412, year = {2026}, author = {El-Annan, RJ and Safi, D and Arabi, M}, title = {Point-of-care Cardiac Ultrasound in Coronavirus Disease 2019: Indications and Potentials.}, journal = {Journal of cardiovascular echography}, volume = {36}, number = {2}, pages = {101-110}, pmid = {42389412}, issn = {2211-4122}, abstract = {Coronavirus disease 2019 (COVID-19) strained health systems worldwide and underscored the need for rapid, safe, and efficient bedside imaging. This narrative review synthesizes forty studies, largely from the United States and Europe, on the role of point-of-care ultrasound (POCUS) in the care of patients with COVID-19, with emphasis on cardiology. Compared with full transthoracic echocardiography and computed tomography, POCUS is faster, less costly, and free of ionizing radiation. Several reports document a reduction in staff exposure time by up to seventy-one percent, lowering infection risk and conserving personal protective equipment. In critically ill patients, POCUS frequently identifies right ventricular dysfunction and pulmonary abnormalities, including vertical reverberation artifacts and subpleural consolidations, which support timely clinical decisions; some series observed management changes in as many as seventy percent of cases. Limitations include operator dependence, variable image quality, and a restricted field of view that can necessitate complementary imaging. Overall, POCUS shows strong promise as an integral element of COVID-19 pathways and routine cardiovascular care. Broader training, competency assessment, and standardized protocols are needed to ensure consistent, high-quality implementation at the bedside.}, }
@article {pmid42389926, year = {2026}, author = {Öztürk, K and Haslak, F and Yıldız, M and Adrovic, A and Kasapçopur, Ö}, title = {Nailfold Videocapillaroscopy in Pediatric Rheumatology: Established Roles, Emerging Applications, and Future Perspectives.}, journal = {Balkan medical journal}, volume = {43}, number = {7}, pages = {360-371}, pmid = {42389926}, issn = {2146-3131}, mesh = {Humans ; *Microscopic Angioscopy/methods/trends ; Child ; Raynaud Disease/diagnosis/physiopathology ; *Rheumatology/methods/trends/instrumentation ; *Nails/blood supply/physiopathology ; Scleroderma, Systemic/diagnosis/physiopathology ; *Pediatrics/methods/trends ; Capillaries/physiopathology ; }, abstract = {Nailfold videocapillaroscopy (NVC) provides direct, non-invasive access to the peripheral microcirculation and has become a central tool in adult rheumatology. Its primary clinical value lies in the evaluation of patients presenting with signs of Raynaud phenomenon (RP) and scleroderma-spectrum disorders. In particular, NVC facilitates the differentiation between primary and secondary (scleroderma-related) RP. The characteristic scleroderma pattern observed on NVC, including giant capillaries, capillary loss, microhemorrhages, and architectural disorganization, supports the diagnosis of scleroderma-spectrum disorders. International standardization efforts have further improved the reliability and interpretability of these findings, particularly in adult populations with RP and systemic sclerosis (SSc). In children, the clinical utility of NVC is now well established for similar indications; however, interpretation requires age-specific reference data. Pediatric capillary density, diameter, and length vary throughout childhood, and minor findings such as tortuosity, crossing, and isolated microhemorrhages may also be observed in healthy individuals. Without normative pediatric data, these features may be overinterpreted as pathological findings. Beyond RP and juvenile SSc, evidence supporting the use of NVC is accumulating across a range of pediatric rheumatic diseases. NVC abnormalities have been reported in juvenile dermatomyositis (JDM), mixed connective tissue disease, childhood-onset systemic lupus erythematosus, juvenile Sjögren disease, and juvenile localized scleroderma. Among these conditions, JDM demonstrates the strongest association between NVC abnormalities-including reduced capillary density, dilatation, abnormal morphology, and microhemorrhages-and disease activity. In contrast, findings in juvenile idiopathic arthritis remain non-specific. More recent studies involving pediatric patients with Behçet disease, psoriatic arthritis, and certain autoinflammatory and vasculitic disorders suggest that NVC may detect subtle microvascular alterations; however, disease-specific patterns have not been established outside the scleroderma spectrum. Selected non-rheumatologic conditions, particularly diabetes mellitus, severe acute respiratory syndrome coronavirus 2 infection, multisystem inflammatory syndrome in children, and long coronavirus disease, further highlight the potential of NVC to reflect systemic endothelial dysfunction and non-specific microvascular injury, although these applications remain exploratory. Despite its promise, several limitations continue to restrict the broader clinical application of NVC. Pediatric reference data remain heterogeneous, scoring systems are largely adapted from adult protocols, and longitudinal evidence linking capillaroscopic changes to disease progression, treatment response, or long-term outcomes remains limited. Standardized image acquisition and reporting, multicenter cohort studies, and validation of automated image-analysis techniques are essential next steps for translating descriptive observations into clinically actionable information. This review summarizes the contribution of NVC to pediatric rheumatology and explores potential areas for future expansion. The strongest indications remain RP and scleroderma-spectrum disorders, whereas the most promising emerging application is in JDM, where microvascular changes correlate with disease activity. Across other pediatric rheumatic diseases, NVC currently serves as a complementary descriptive tool for vascular phenotyping rather than a standalone diagnostic modality. With the development of age-specific reference standards, harmonized protocols, and longitudinal validation studies, NVC has the potential to evolve from a descriptive imaging technique into an integral component of risk stratification and disease monitoring in pediatric rheumatology.}, }
@article {pmid42390108, year = {2026}, author = {Marie, SE}, title = {Examining the state of telehealth for mental health and substance use care after the coronavirus disease 2019 pandemic: An integrative review.}, journal = {The Journal of international medical research}, volume = {54}, number = {7}, pages = {3000605261459841}, pmid = {42390108}, issn = {1473-2300}, mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Substance-Related Disorders/therapy/psychology ; *Telemedicine ; *Mental Disorders/therapy/psychology ; Pandemics ; SARS-CoV-2 ; Mental Health ; Mental Health Teletherapy ; Health Services Accessibility ; Mental Health Services ; Patient Satisfaction ; Digital Health ; }, abstract = {ObjectiveThe objective of this integrative review was to synthesize literature and provide implications for clinical practice on telehealth use among patients with serious mental illness and substance use disorders following the coronavirus disease 2019 pandemic.MethodsAn integrative review guided by Socio-Technical Systems Theory was applied. The PubMed, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Medline, Academic Search Complete, and Gale Health and Wellness databases were searched for publications from 1 January 2019 to 1 December 2024. Articles selected according to the established inclusion and exclusion criteria were evaluated using a rapid critical appraisal checklist developed by Fineout-Overholt and Melnyk.ResultsAmong the 172 articles reviewed, 16 peer-reviewed and 2 government publications were included. Four themes were identified: (a) treatment adherence; (b) satisfaction reported by patients and providers; (c) telehealth policy developments; and (d) access to services. Telehealth supported continuity of care, improved satisfaction, and improved access. Technological and financial barriers restricted equitable access. Policy changes enabled broader adoption; however, regulatory approaches varied across jurisdictions.ConclusionTelehealth remains an integral method for delivering mental health and substance use care following the coronavirus disease 2019 pandemic. Greater focus is needed on long-term effectiveness and limitations of telehealth.}, }
@article {pmid42390310, year = {2026}, author = {Bidhendi-Yarandi, R and Nosrati Nejad, F and Biglarian, A and Roshnfekr, P and Behboudi-Gandevani, S}, title = {Global prevalence of domestic violence against adults during COVID-19 and its determinants: A systematic review, meta-analysis, and meta-regression analysis.}, journal = {Women's health (London, England)}, volume = {22}, number = {}, pages = {17455057261465474}, pmid = {42390310}, issn = {1745-5065}, mesh = {Humans ; *COVID-19/epidemiology/psychology ; Prevalence ; *Domestic Violence/statistics & numerical data ; Female ; Adult ; Global Health/statistics & numerical data ; SARS-CoV-2 ; Regression Analysis ; Male ; }, abstract = {BackgroundDomestic violence (DV) is a pressing public health issue with worldwide implications. Crises like the COVID-19 pandemic can exacerbate this problem, as social and personal challenges intersect with the disruptive effects of health measures.ObjectiveThis study aimed to determine the prevalence of DV during the COVID-19 pandemic and identify its associated determinants.DesignSystematic review and meta-analysis.Data sources and methodsA comprehensive review of the literature in PubMed/Medline, EMBASE, PsycINFO and Cochrane Covid-19 register up to July 2024 were conducted. Pooled prevalence of DV during COVID-19, including overall and subtype prevalence were assessed, while also extracting associated factors and determinants. Meta-regression analyzed the impact of determinants on heterogeneity. A random effects model estimated the pooled prevalence using the meta-prop method, applying Freeman-Tukey double arcsine transformation for variance stabilization.ResultsA total of 37 qualifying studies were included in our final analysis with a total sample size of 160,701 individuals. The overall pooled prevalence of DV, regardless of subtypes, was 13% (95% CI: 12-14%). Among the different subtypes, psychological violence had the highest pooled prevalence of 24% (95% CI: 19-28%), while financial violence had the lowest pooled prevalence of 7% (95% CI: 6-9%). Sexual violence (11%, 95% CI: 9-12%), physical violence (10%, 95% CI: 9-12%), and violence involving threats and controlling behaviors 11% (95% CI: 8-13%) had approximately similar prevalence rates. Meta-regression analyses showed the risk of overall DV was significantly higher among younger women Risk Difference (RD) =15% (P<0.001), 40 years and younger individuals RD=12% (P<0.001), and those living in developing countries RD=14% (P<0.001) compared to their counterparts. On average, women had a higher risk of overall DV than the elderly and men RD=9% (P<0.001).ConclusionThe study revealed a concerning global prevalence of DV at 13% during the COVID-19 pandemic, with psychological violence being the most common subtype. Women and young adults were identified as particularly vulnerable, with risk differentials of 15% and 12%, respectively, notably higher in developing countries (14%). This comprehensive assessment of DV prevalence and determinants offers valuable insights for future research and public health strategies.RegistrationPROSPERO CRD42022351634.}, }
@article {pmid42391723, year = {2026}, author = {Husein, A and Jamal, A and Ali, R and Kamal, MA and Alqurashi, YE and Nasim, A and Hussain, SA and Hattiwale, HM}, title = {Ras signalling in infectious disease pathology: Mechanisms, tissue damage, and clinical implications.}, journal = {Pathology, research and practice}, volume = {286}, number = {}, pages = {156609}, doi = {10.1016/j.prp.2026.156609}, pmid = {42391723}, issn = {1618-0631}, abstract = {Ras signalling is an important regulator of cell proliferation, survival, differentiation, and immune responses. Although Ras pathways have been extensively studied in cancer biology, increasing evidence suggests that many pathogens also manipulate Ras-associated signalling networks to support infection, persistence, and immune evasion. Viruses, bacteria, and parasites can alter Ras activity either directly or indirectly through downstream pathways such as MAPK/ERK and PI3K/AKT. However, activation of ERK or AKT does not always indicate direct Ras involvement, and this distinction remains important in infectious disease research. Recent studies show that pathogens including SARS-CoV-2, Epstein-Barr virus, hepatitis B virus, Helicobacter pylori, Pseudomonas aeruginosa, Mycobacterium tuberculosis, and Leishmania species regulate Ras-associated signalling in ways that contribute not only to pathogen survival but also to inflammation, tissue injury, and disease progression. In several infections, isoform-specific regulation of H-Ras, K-Ras, and N-Ras has also been observed, suggesting distinct roles in immune modulation and pathological outcomes. Dysregulated Ras-associated signalling has been linked to lung injury, liver fibrosis, gastric epithelial damage, granuloma formation, and systemic dissemination of infection. This review summarizes current evidence on the role of Ras signalling in infectious disease pathology, focusing on host-pathogen interactions, isoform-specific regulation, tissue damage, and therapeutic implications. Although Ras signalling represents a promising host-directed target, much of the current evidence remains indirect and requires further pathogen-specific validation.}, }
@article {pmid42392062, year = {2026}, author = {Leichtle, A and Bruchhage, KL and Hoffmann, TK and Leffers, D}, title = {[Otitis media - update on clinical presentation, diagnosis and therapy].}, journal = {Laryngo- rhino- otologie}, volume = {105}, number = {7}, pages = {450-460}, doi = {10.1055/a-2606-8101}, pmid = {42392062}, issn = {1438-8685}, mesh = {Humans ; *Otitis Media/diagnosis/therapy/epidemiology/etiology ; Risk Factors ; COVID-19/epidemiology ; Chronic Disease ; Acute Disease ; }, abstract = {Otitis media is a complex disease. The pathogenesis of both acute and chronic otitis media results from a complex interplay of anatomical, microbiological, and immunological factors. Identified risk factors include patient-related aspects such as nutrition, allergies, ethnicity, and genetic predisposition, as well as environmental factors such as socioeconomic status, tobacco use, attendance at daycare centers and recurrent respiratory infections. During the COVID-19 pandemic, strict measures led to a significant decline in the incidence of acute otitis media. However, infections with variants such as Omicron showed an increased rate of secretory otitis media. In the post-COVID phase, complication rates due to middle ear infections rose again, with prevalence returning to pre-lockdown levels. Preventive measures focus on ensuring adequate Eustachian tube function, treating allergies, and consistently administering pneumococcal vaccinations. In contrast, surgical treatment remains the gold standard for chronic middle ear infections and cholesteatoma. However, radical removal can be associated with high morbidity rates, underscoring the need for innovative approaches. These include optical coherence tomography (OCT) and minimally invasive laser surgery. Furthermore, new insights into the role of the immune system in the pathogenesis of both acute and chronic otitis media could open up new therapeutic possibilities for the future. This article discusses the current state of knowledge on the pathophysiological mechanisms, classification, diagnosis, and treatment of otitis media, as well as new treatment models and their implications.}, }
@article {pmid42392626, year = {2026}, author = {Beulen, V and Noben, C and Smits, M and Mertens, H and Paulus, A and Van Mook, W}, title = {Workforce shortages and supported access to medical care for hospital employees: a scoping review.}, journal = {BMJ open}, volume = {16}, number = {7}, pages = {e117423}, pmid = {42392626}, issn = {2044-6055}, mesh = {Humans ; *Health Services Accessibility ; COVID-19 ; SARS-CoV-2 ; *Personnel, Hospital ; Pandemics ; }, abstract = {OBJECTIVES: This scoping review synthesises peer-reviewed and grey literature on supported access to medical care for hospital employees with existing physical health complaints to understand how it may reduce sickness absenteeism by promoting sustainable employability and to identify gaps and opportunities to inform the design and implementation of organisational supported care frameworks.
DESIGN: We conducted this scoping review following the Arksey and O'Malley framework and Levac et al's methodological recommendations, reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extensions for Scoping Reviews (PRISMA-ScR).
DATA SOURCES: MEDLINE (Ovid), Embase (Elsevier), CINAHL (EBSCO) and Web of Science were searched from database inception to 8 November 2024. The search was updated on 18 May 2026. This was supplemented by forward and backward citation tracking of included peer-reviewed articles and targeted hand searching of Dutch grey literature in Medisch Contact , a leading Dutch professional journal for the medical profession, focusing on clinical practice, medical policy and professional issues.
ELIGIBILITY: English-language or Dutch-language peer-reviewed publications and well-argued opinion pieces on healthcare workers' access to care (COVID-19 and beyond) in hospital or transferable settings were included. Sources focused on mental health or health promotion, financial aspects, personal protective equipment, patient access or healthcare worker utilisation, as well as non-English/Dutch sources, webpages and papers without full text, were excluded.
DATA EXTRACTION: ASReview was used for title and abstract screening following the SAFE procedure and full-text screening was conducted with team consensus.
RESULTS: 27 publications were included from 36 685 identified records. The literature was predominantly qualitative in nature and COVID-19-focused, yielding four themes (ethical considerations, multilevel challenges, target groups and strategies and outcomes). It also highlighted limited evidence on evaluated supported-access interventions and workforce outcomes beyond crises.
CONCLUSIONS: Although supported access to medical care for hospital employees appears a promising multilevel, system-embedded strategy to reduce sickness absenteeism and promote sustainable employability in general, the evidence to substantiate and justify such strategies beyond acute crises is limited. Moreover, current literature lacks clear conceptualisation, operationalisation as well as robust implementation and evaluation frameworks. Addressing these gaps is a priority for future research to scientifically scaffold policies and frameworks to sustain a healthy and stable future hospital workforce.}, }
@article {pmid42392788, year = {2026}, author = {Yan, X and Tang, X and Zhang, YZ and Liu, YY and Liu, Y and Pang, WT and Yang, FW and Jin, XY}, title = {[Status analysis of clinical outcome for treatment of long COVID with traditional Chinese and western medicines].}, journal = {Zhongguo Zhong yao za zhi = Zhongguo zhongyao zazhi = China journal of Chinese materia medica}, volume = {51}, number = {7}, pages = {2081-2091}, doi = {10.19540/j.cnki.cjcmm.20251125.501}, pmid = {42392788}, issn = {1001-5302}, mesh = {Humans ; COVID-19 ; *Drugs, Chinese Herbal/therapeutic use ; *Medicine, Chinese Traditional ; Pandemics ; *Post-Acute COVID-19 Syndrome/drug therapy ; SARS-CoV-2/physiology/drug effects ; Treatment Outcome ; }, abstract = {This study sorted out the clinical outcome of traditional Chinese and western medicines in the treatment of long COVID to lay the foundation for the construction of a core indicator set. Search was made on some databases and platforms from their inception to December 2024, which included eight databases of CNKI, Wanfang, SinoMed, VIP, PubMed, Cochrane Library, EMbase, and Web of Science and three clinical research protocol registration platforms, namely the Chinese Clinical Trial Registry(ChiCTR), the International Traditional Medicine Clinical Trial Registry(ITMCTR), and the American Clinical Trial Registry(ClinicalTrials.gov). Two researchers independently extracted the basic information, outcomes, measurement time points, and measurement tools of literature in parallel according to the inclusion and exclusion standards. If there are any differences, a third researcher would make discussions and decisions. A total of 152 studies, including 50 literature studies and 102 protocol studies, were ultimately included. A total of 338 outcomes indicators were reported, with a reporting frequency of 1 633 times. Outcome indicators can be classified into 10 indicator domains based on attributes, including symptoms and signs(694 times, 42.50%), TCM diseases(61 times, 3.74%), security incidents(93 times, 5.70%), etiological detection(23 times, 1.41%), long-term prognosis(72 times, 4.41%), economic indicators(14 times, 0.86%), physical and chemical testing(472 times, 28.90%), quality of life(173 times, 10.59%), major events(16 times, 0.97%), and other indicators(15 times, 0.92%). There were problems in the outcomes indicators of treating long COVID with both traditional Chinese and western medicines, such as significant differences in symptom descriptions, lack of standardization in indicator selection, diverse choices of measurement tools, diverse selection of measurement time, lack of practicality in clinical practice, and non-prominent TCM indicators. These issues led to scattered evidence and the absence of a unified core indicator set to guide clinical research. Further efforts are needed to develop COS of integrated traditional Chinese and western medicine treatments for long COVID, and to enhance the quality of clinical research on long COVID.}, }
@article {pmid42393625, year = {2026}, author = {Shrivastav, VN and Akurathi, HK and Kalariya, H and Savaj, D}, title = {Anemia burden in tuberculosis patients across Southeast Asia: a systematic review and meta-analysis.}, journal = {BMC pulmonary medicine}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12890-026-04404-x}, pmid = {42393625}, issn = {1471-2466}, abstract = {BACKGROUND: Anemia represents a significant comorbidity in tuberculosis (TB) patients, affecting treatment outcomes and mortality. Despite Southeast Asia accounting for 46% of global TB cases, no comprehensive regional synthesis of anemia burden exists, limiting evidence-based policy development.
OBJECTIVES: This systematic review and meta-analysis aimed to estimate the pooled prevalence of anemia among tuberculosis patients across Southeast Asia and to examine variations in prevalence by geographic, demographic, and clinical characteristics.
METHODS: We searched PubMed, Embase, Scopus, and Web of Science for observational studies published from 2000 onwards that reported anemia prevalence in drug-susceptible TB patients from Southeast Asian countries. Random-effects meta-analysis was performed to calculate pooled prevalence estimates with 95% confidence intervals. Subgroup analyses were conducted by country, HIV co-infection status, treatment status, study setting, COVID-19 period, and World Bank income classification. Publication bias was assessed using Egger's and Begg's tests.
RESULTS: Twenty-one studies comprising 6,090 TB patients from five Southeast Asian countries were included. The pooled prevalence of anemia was 72% (95% CI: 68%-76%), with substantial heterogeneity (I²=89.9%). These regional prevalence estimates are higher than the global pooled estimate of 53.9% reported by Barzegari et al. (2019), reflecting the distinct epidemiological context of Southeast Asia. Subgroup analysis revealed significantly higher prevalence in HIV-positive patients (88%, 95% CI: 78%-94%) compared to HIV-negative patients (70%, 95% CI: 65%-74%). Studies conducted during COVID-19 showed elevated prevalence (84%, 95% CI: 75%-90%) compared to pre-COVID (72%, 95% CI: 70%-73%) and post-COVID periods (72%, 95% CI: 68%-83%, p = 0.03). Lower-middle income countries showed higher prevalence (73%, 95% CI: 69%-77%) than upper-middle income countries (67%, 95% CI: 63%-70%). No significant publication bias was detected (Egger's p = 0.721, Begg's p = 0.537).
CONCLUSIONS: This first regional synthesis demonstrates that anemia affects three-quarters of TB patients in Southeast Asia, with significant variation by HIV status, income level, and pandemic period. Unlike previous global estimates (53.9%), our region-specific findings (72%) and documentation of COVID-19 impact (84% during pandemic) provide actionable evidence for Southeast Asian TB programs to integrate anemia screening and management, particularly for vulnerable populations during health system disruptions.}, }
@article {pmid42393859, year = {2026}, author = {Wickramarathna, EAAM}, title = {Student-authored expressions of gratitude as an alternative approach to ceremonial body donor commemoration: An experience from a New Sri Lankan Medical Faculty.}, journal = {Anatomical sciences education}, volume = {}, number = {}, pages = {}, doi = {10.1002/ase.70298}, pmid = {42393859}, issn = {1935-9780}, abstract = {The sustainability of body donation programs is contingent not only on cultural and religious frameworks that motivate altruistic giving, but also on the institutional practices that honor donors and maintain public trust. In Sri Lanka, Theravada Buddhist principles of dana (generosity) and karuna (compassion) underpin a well-established culture of body donation. The formal memorial ceremonies have served as the conventional expression of institutional gratitude to body donors. The Faculty of Medicine (FOM) at Wayamba University of Sri Lanka (WUSL), however, faced successive and compounding adversities following its inaugural student intake in 2018-including the Easter Sunday terrorist attack (2019), the COVID-19 pandemic (2020-2022), and a national economic crisis (2022-2023)-that rendered formal ceremonial commemoration logistically and practically unfeasible. In response, the corresponding author implemented an alternative commemorative practice in which medical students authored gratitude notes, poems, and artistic tributes addressed to body donors. This discursive article describes that initiative, situates it within the pluralistic society of Sri Lanka, and examines its implications for humanistic medical education. Drawing on the established literature on reflective writing, professional identity formation, and inclusive commemorative practice, student-authored expressions of gratitude are proposed as a pedagogically meaningful, complementary, and mutually reinforcing practice alongside formal ceremony. This experience offers a transferable model for newly established or resource-limited medical institutions navigating institutional constraints while remaining committed to the body donor commemoration.}, }
@article {pmid42393869, year = {2026}, author = {Marne, O and Jacob Machado, D}, title = {Advancing FAIR phylogenetics for health threats: a systematic review of SARS-CoV-2 research and guidelines for future outbreaks.}, journal = {Cladistics : the international journal of the Willi Hennig Society}, volume = {}, number = {}, pages = {}, doi = {10.1111/cla.70050}, pmid = {42393869}, issn = {1096-0031}, abstract = {During the COVID-19 pandemic, the need for quick public health action often conflicted with the careful methods required in phylogenetics. To explore this, we reviewed 217 SARS-CoV-2 studies published from January 2020 to March 2025 in 121 journals. We found many methodological problems that weaken the reliability and reproducibility of these studies. Key issues include missing outgroup sampling, which affects ingroup topology, tree rooting and how we interpret evolutionary changes and relationships. Another issue is the lack of gene annotations, which can cause characters from one gene to align with those of a different gene. Many studies also misinterpret support or other branch statistics, treating them as proof of clade accuracy instead of as measures of relative evidence. In addition, 91% of the studies do not follow FAIR (Findable, Accessible, Interoperable, and Reusable) data principles, with data and code often unavailable. Finally, we also found a "prestige paradox": journals with higher impact factors do not necessarily have better methods or transparency. Therefore, we offer simple guidelines for authors, reviewers and editors to improve transparency and FAIR data standards in viral phylogenetics, making writing and reviewing papers easier, ensuring published phylogenetic analyses remain a trustworthy resource for future pandemics.}, }
@article {pmid42393993, year = {2026}, author = {Ito, E and Harris, L and Gold, S and Archer, A}, title = {AI-Enabled Public Health Surveillance: Interim Findings from a Scoping Review of Governance and Implementation Frameworks.}, journal = {Studies in health technology and informatics}, volume = {338}, number = {}, pages = {211-212}, doi = {10.3233/SHTI260831}, pmid = {42393993}, issn = {1879-8365}, mesh = {Humans ; *Artificial Intelligence ; *COVID-19/epidemiology ; *Public Health Surveillance/methods ; SARS-CoV-2 ; }, abstract = {Artificial intelligence (AI)-enabled public health surveillance systems have expanded rapidly following the COVID-19 pandemic, yet governance and implementation structures guiding their deployment remain inconsistently defined. We conducted a scoping review following PRISMA-ScR guidelines to examine governance and regulatory frameworks associated with AI-enabled surveillance systems. A search of three databases yielded 707 unique records after deduplication. Preliminary findings indicate a predominance of centralized governance models and limited explicit articulation of equity safeguards or public oversight mechanisms. Results will provide a typology of centralized, federated, and hybrid governance models characterized by authorization structure, data governance architecture, oversight mechanisms, and equity safeguards, to inform the design of accountable AI surveillance systems.}, }
@article {pmid42395315, year = {2026}, author = {Turebekova, D and Kosherova, B and Dauletkaliyeva, Z and Shayakhmetova, Y and Marchenko, A and Solyanov, D and Hendrixson, V and Kadyrova, I}, title = {Long COVID and health-related quality of life: a systematic review of immune, inflammatory, and metabolic markers.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1846407}, pmid = {42395315}, issn = {2296-2565}, mesh = {Humans ; *Quality of Life ; Biomarkers/blood ; *COVID-19/immunology ; *Inflammation/immunology ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; }, abstract = {INTRODUCTION: Long COVID is known to be associated with prolonged multiple organ symptoms and decreased health-related quality of life (HRQoL), but the pathogenesis and relationship between immune, inflammatory, and metabolic biomarkers and HRQoL remains poorly understood. This systematic review aims to synthesize the evidence on the health-related quality of life of patients with Long COVID and to summarize the reported associations between health-related outcomes and biomarkers.
METHODS: We conducted a systematic search in PubMed, Web of Science, and Scopus in search of studies that evaluated immune, inflammatory, or metabolic biomarkers and HRQoL in patients with Long COVID. This review included case-control and cohort studies with a control group. The Rayyan tool was used to select studies, and full-text articles were evaluated for compliance with the criteria. Information was obtained on biomarkers, analytical methods, tools for assessing the HRQoL, and the relationship between HRQoL and biomarkers. Due to the high heterogeneity of the methods, the results were summarized in a descriptive form.
RESULTS: Ten studies were included, involving 1,078 patients with Long COVID and 768 healthy controls. Most studies that used various methods to assess HRQoL consistently reported long-term deterioration after COVID, with the greatest deterioration observed in the areas of physical functioning, vitality, fatigue, daily activities, pain, discomfort, and respiratory distress. The most frequently measured markers were related to inflammation and endothelial/coagulation pathways, including CRP, hsCRP, IL-6, TNF-α, D-dimer, and VCAM-1. Autoimmune, metabolic, intestinal barrier, and omics-based markers were measured less frequently, but indicated phenotype-specific biological heterogeneity. Only a few studies have identified a direct link between biomarkers and HRQoL. Lower HRQoL indicators were associated with increased neurotoxicity, decreased calcium levels, systemic inflammation, endothelial dysfunction, and signals from individual autoantibodies.
CONCLUSION: Our results indicate that Long COVID is consistently associated with a long-term decline in HRQoL, especially in the physical and functional areas. The available data indicate the presence of a strong signal regarding inflammatory processes and endothelial coagulation, while autoimmune, metabolic, and genetic data indicate phenotype-specific heterogeneity.
Unique identifier: CRD420251239371, URL: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420251239371.}, }
@article {pmid42396427, year = {2026}, author = {Grover, S and Vaishya, R and Gupta, BM and Mahapatra, N and Chaman, SM and Madhu, S}, title = {A bibliometric assessment of the Indian Journal of Psychiatry: Trends, impact, and collaboration (2009-2024).}, journal = {Indian journal of psychiatry}, volume = {68}, number = {6}, pages = {510-516}, pmid = {42396427}, issn = {0019-5545}, abstract = {BACKGROUND: The Indian Journal of Psychiatry (IJP) serves as a premier repository for psychiatric research in India.
AIM: This study conducts a comprehensive bibliometric analysis to evaluate the journal's publication trends and citation impact from 2009 to 2024.
METHODS: Bibliographic data were retrieved from the Scopus database, covering the period from January 2009 to December 2024. A final dataset of 2,357 publications was analyzed for this paper.
RESULTS: The journal experienced robust growth, registering an average annual publication growth rate of 9.16% over the 16 years. The journal's Impact Factor rose significantly from 0.384 in 2010 to a peak of 3.1 in 2022. Authors from India contributed 88.63% of the total output, anchored by institutions such as the National Institute of Mental Health and Neuro Sciences, Bangalore, and the Post Graduate Institute of Medical Education and Research, Chandigarh, although international contributions from countries like Switzerland (Citation per paper [CPP]: 22.36), Germany (CPP: 17.68), Canada (CPP: 17.68), and Italy (CPP: 17.63) demonstrated a higher citation efficiency compared to those from India (11.6). The authorship pattern revealed a definitive shift from single-author (reduced from 28.65% to 9.9%) to collaborative, multiauthor research. Thematically, research concentrated on core areas such as depression and schizophrenia, while displaying responsiveness to emerging crises like the COVID-19 pandemic.
CONCLUSION: The IJP has consistently demonstrated a trajectory of upward influence and academic reputation over the past 16 years. While the journal serves as a vibrant ecosystem for domestic research, future strategies should focus on leveraging international collaborations to enhance global visibility and citation impact further.}, }
@article {pmid42396674, year = {2026}, author = {Charlton, K and Pickles, S and Kent, K}, title = {Redistributing power in food systems: How community-led responses move from crisis buffering to systems transformation.}, journal = {The Proceedings of the Nutrition Society}, volume = {}, number = {}, pages = {1-39}, doi = {10.1017/S0029665126105059}, pmid = {42396674}, issn = {1475-2719}, abstract = {Food and nutrition insecurity in high‑income countries is increasingly persistent, driven by intersecting economic, social and environmental disruptions. In Australia, acute shocks such as the COVID‑19 pandemic, floods and bushfires, alongside chronic pressures including rising food prices, housing stress and concentrated corporate power, have exposed structural weaknesses in food access, governance and system resilience. This review examines how community‑led responses to food and nutrition insecurity function during disruption, whether they buffer short-term hardship or contribute to adaptive capacity and redistribution of agency. Guided by the six‑pillar food security framework and a socio-ecological model, responses are examined across household, community, organisational and governance levels. A continuum of responses is identified, ranging from downstream emergency food relief that buffers immediate hardship, through to community and organisational food infrastructure that strengthens local resilience, and governance‑level responses with greater transformative potential. Drawing on this synthesis, we propose the SEEDS (Socio-Ecological Enablers of Dietary Security) Model, which conceptualises how food system responses across socio-ecological levels and over time can progress from buffering (acute) to adaptation (medium‑term), and ultimately transformation (long‑term). Central to this framework is a shift in decision‑making power, accountability and participation. While many initiatives improve food access and short‑term stability during crises, the greatest potential for transformation lies where responses are embedded within governance structures, enable meaningful community participation, and influence policy, procurement and resource allocation. Implications for public health nutrition practice include expanded roles in systems leadership, cross‑sector governance and advocacy for upstream policy reform.}, }
@article {pmid42398834, year = {2026}, author = {Zhou, J and Li, N and Liu, R and Kabanov, AV and Polacheck, WJ and Nguyen, J and Cao, Y}, title = {New approach methodologies (NAMs) for preclinical and translational evaluation of mRNA-lipid nanoparticle (LNP) therapeutics.}, journal = {Journal of controlled release : official journal of the Controlled Release Society}, volume = {397}, number = {}, pages = {115157}, doi = {10.1016/j.jconrel.2026.115157}, pmid = {42398834}, issn = {1873-4995}, abstract = {Messenger RNA-lipid nanoparticle (mRNA-LNP) therapeutics have emerged as a versatile drug modality, enabling in vivo protein expression for vaccines, cancer immunotherapy, and the treatment of genetic and metabolic diseases. Although mRNA-LNP platforms achieved rapid clinical success during the COVID-19 pandemic, most candidates fail to progress beyond preclinical development, largely due to the limited capacity of conventional animal models to predict human-relevant efficacy, safety, inflammation, biodistribution, and population heterogeneity. New approach methodologies (NAMs), encompassing advanced in vitro and ex vivo human systems and in silico computational models, offer a promising strategy to address these translational gaps while reducing reliance on animal testing. In this review, we evaluate commonly used animal models for mRNA-LNP development and highlight key areas where animal findings have shown poor concordance with human clinical outcomes. We then provide a comprehensive overview of emerging NAM technologies, including in vitro and ex vivo-based platforms such as two-dimensional and three-dimensional cell culture systems and microphysiological platforms; as well as in silico tools, including physiologically based pharmacokinetic (PBPK), quantitative systems pharmacology (QSP), and artificial intelligence (AI) models for formulation design and delivery optimization. Collectively, this review highlights how systematic adoption of NAMs can improve human predictivity, accelerate development timelines, and support more efficient, ethical, and translational robust mRNA-LNP drug development.}, }
@article {pmid42398993, year = {2026}, author = {Ahmad Nazari, MA and Yaacob, SS and Muzaini, K and Rosely, MF and Md Yazin, NKR and Mohamad, M}, title = {Factors associated with occupational fatigue among healthcare workers in Malaysia: a systematic review.}, journal = {BMJ open}, volume = {16}, number = {7}, pages = {e118439}, pmid = {42398993}, issn = {2044-6055}, mesh = {Humans ; Malaysia/epidemiology ; *Fatigue/epidemiology/etiology ; *Health Personnel/psychology ; *Occupational Diseases/epidemiology ; Risk Factors ; Working Conditions ; }, abstract = {BACKGROUND: Due to the nature of their work, occupational fatigue is an important issue among healthcare workers (HCWs), with implications for workers' health, patient safety and healthcare organisation performance. However, the evidence on factors of work fatigue among HCWs in Malaysia remains fragmented.
OBJECTIVE: To synthesise the existing evidence on work fatigue among HCWs in Malaysia, with a focus on its associated factors across HCW populations and to examine the types of fatigue instruments used.
DESIGN: Systematic literature review.
SETTING: Literature on fatigue among HCWs in Malaysia.
PARTICIPANT: Studies on occupational fatigue involving HCWs conducted within the Malaysian context.
METHOD: A systematic literature search was conducted using electronic databases of PubMed, Scopus, Web of Science and Science Direct. Studies must involve HCWs. Studies not in English, focusing on burn-out and different fatigue constructs, such as compassion fatigue, were excluded. Data extracted included study characteristics, setting, fatigue instruments, HCW groups and key findings. Factors associated with fatigue were synthesised thematically. This review followed Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, and the quality of the study was assessed using the Newcastle-Ottawa Scale.
MAIN OUTCOME MEASURE: Factors associated with work fatigue among HCWs in Malaysia.
RESULTS: Out of 1699 articles screened, 138 studies were within the Malaysian setting. Nine (n=9) articles were finally included. One study, each was conducted nationwide, in Peninsular zones, in Melaka and Kuala Lumpur, also, three studies in Selangor and two in Sarawak. A total of 4662 HCWs participated, of which 1419 were doctors (30.4%), 1014 nurses (21.8%) and 2229 HCWs of various positions (47.8%). Fatigue instruments used were the Occupational Fatigue/Exhaustion Recovery Scale, the Chalder Fatigue Scale, the Fatigue Assessment Scale, the Zoom Exhaustion and Fatigue Scale, and the postacute COVID syndrome checklist. Two studies used electroencephalogram. Thematic synthesis identified factors such as high job demands (66.67%), high effort (11.11%), sustained strain (11.11%), and an environmental/contextual factor related to the COVID-19 pandemic (11.11%). An integrated conceptual framework is proposed.
CONCLUSION: Occupational fatigue among HCWs in Malaysia is multifactorial. Limitations include heterogeneity in study design and fatigue assessment tools. Despite the limited number of included studies, the findings provide theory-informed insights into understanding occupational fatigue; however, they should be interpreted cautiously, despite the need for standardised work fatigue surveillance as part of an efficient fatigue management system.
REGISTRATION: This review was registered under PROSPERO with the ID of CRD420251001576.}, }
@article {pmid42399828, year = {2026}, author = {Appel, S and Coughtrey, AE and Kyrdalen, A and Takeda, A and Newlands, F and Stephenson, T and Shafran, R and Pereira, SMP}, title = {Understanding heterogeneity in paediatric long COVID research: an overview of reviews and recommendations for future pandemics.}, journal = {BMC pediatrics}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12887-026-07276-6}, pmid = {42399828}, issn = {1471-2431}, abstract = {BACKGROUND: Studies of Long COVID or Post-COVID-19 condition in children and young people have varied considerably in their reported prevalences. We aimed to examine the methodological heterogeneity underlying this variability and explore whether methodological characteristics were correlated with reported Long COVID outcome prevalence, in order to inform recommendations to improve reporting in future pandemic-related epidemiological research.
METHODS: We conducted an overview of reviews with a narrative synthesis, identifying systematic reviews and meta-analyses and extracting their included primary studies. We identified reviews of Long COVID in children & young people in PubMed and Embase using a systematic search strategy. We extracted key methodological details including study design, sample size, sample and control group characteristics, data collection and reporting methods, as well as time-point(s) of surveying and frequency of follow-up. We explored correlations between these factors and prevalence of Long COVID via Spearman's rank correlation coefficients or the Kruskal-Wallis test.
RESULTS: 69 studies, from identified reviews, met the inclusion criteria with outcome symptom prevalence varying between 0 and 90% at > 3-months post-COVID-19 infection. Only 19% of studies used an established Long COVID definition to guide analyses. There was substantial heterogeneity in the design and outcome reporting of Long COVID studies. We did not find Long COVID prevalence varied by examined methodological factors (p ≥ 0.08 for all correlations).
CONCLUSION: While substantial methodological heterogeneity was observed across studies of paediatric Long COVID, no statistically significant correlations were identified between examined methodological factors and reported prevalence. Such variability limits comparability across studies and highlights the need for more standardised definitions, outcome measures, and reporting approaches in future pandemic-related epidemiological research: we discuss reporting guidelines and recommendations for future paediatric epidemiological research during a pandemic.}, }
@article {pmid42402140, year = {2026}, author = {Fésü, D and Horváth, G and Müller, V}, title = {[Long-COVID syndrome and lung-specific abnormalities following COVID-19].}, journal = {Orvosi hetilap}, volume = {167}, number = {27}, pages = {1051-1058}, doi = {10.1556/650.2026.33584}, pmid = {42402140}, issn = {1788-6120}, mesh = {Humans ; *COVID-19/complications/physiopathology ; *Pulmonary Fibrosis/etiology ; Quality of Life ; Post-Acute COVID-19 Syndrome ; *Lung/diagnostic imaging ; SARS-CoV-2 ; Antiviral Agents/therapeutic use ; Respiratory Function Tests ; }, abstract = {Following the acute phase of a SARS-CoV-2 infection, post-COVID - or long-COVID - syndrome may develop. This condition is characterized by unpleasant, persistent or new-onset symptoms following the acute phase of the infection. It might lead to an impaired health-related quality of life of affected patients and may involve multiple organ systems. It often poses diagnostic and therapeutic challenges for the healthcare system, and its exact course and outcomes are not yet fully understood. A multidisciplinary approach is required for diagnosis, including imaging studies (e.g., chest CT), tests to assess functional status (e.g., 6-minute walk test, pulmonary function tests, cardiopulmonary exercise testing) and the evaluation of parameters reported by patients subjectively (e.g., symptom burden, health-related quality of life). As part of long-COVID, lung parenchymal changes or abnormalities resulting from the viral infection can be detected on imaging studies in some cases, referred as post-COVID pulmonary fibrosis. Currently, therapeutic options are limited and largely based on symptomatic or organ-specific approaches. However, antiviral treatments used in the acute phase, such as remdesivir or nirmatrelvir/ritonavir, may be potentially beneficial regarding the development of late complications. Prevention, particularly COVID-19 vaccination, plays a key role, as it has been shown to reduce the risk of severe acute disease and the later probability of long-COVID syndrome. Further long-term patient follow-up is necessary to better understand the pathomechanisms underlying long-term effects of the virus, such as long-COVID and post-COVID pulmonary fibrosis. This article aims to present an up-to-date, comprehensive review of long-COVID syndrome and post-COVID pulmonary fibrosis. Orv Hetil. 2026; 167(27): 1051-1058.}, }
@article {pmid42402418, year = {2026}, author = {Ma, S and Chen, H and Wang, J}, title = {Occurrence of antibacterials, antivirals, and anti-inflammatory pharmaceuticals for COVID-19 treatment as emerging contaminants in the Chinese freshwater environment before, during and after the pandemic: the need for dynamic eco-pharmacovigilance.}, journal = {Environmental health and preventive medicine}, volume = {31}, number = {}, pages = {44}, doi = {10.1265/ehpm.25-00395}, pmid = {42402418}, issn = {1347-4715}, mesh = {China/epidemiology ; *Antiviral Agents/analysis ; Humans ; *Fresh Water/chemistry ; *Pharmacovigilance ; *Anti-Bacterial Agents/analysis ; *COVID-19 Drug Treatment ; *Water Pollutants, Chemical/analysis ; *Anti-Inflammatory Agents/analysis ; COVID-19/epidemiology ; Pandemics ; Environmental Monitoring ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Global epidemic diseases such as COVID-19 have driven both the excessive use of pharmaceuticals and shifts in their usage spectrum. Consequently, the profile of pharmaceuticals in the environment (PiE) may undergo dynamic temporal changes, posing a significant challenge to eco-pharmacovigilance (EPV), a specialized branch of pharmacovigilance focused on detecting, evaluating, understanding, and preventing the adverse environmental effects of pharmaceuticals.
METHODS: Based on data extracted from 89 studies published between 2014 and 2025, this review conducts a focused comparison of the occurrence patterns of 43 selected typical anti-COVID-19 drugs (20 antibacterials, 11 antivirals, and 12 anti-inflammatory pharmaceuticals) as contaminants in distinct regions across China's seven major river basins before, during, and after the pandemic. The need of dynamic EPV was then analyzed.
RESULTS: Before the COVID-19 outbreak, erythromycin, ampicillin, roxithromycin, and acetaminophen dominated the PiE profile in terms of reported maximum residual concentrations; during the pandemic lockdown, ciprofloxacin, ofloxacin, azithromycin, and ketoprofen were identified as the top-priority anti-COVID-19 PiE; after the pandemic, azithromycin, norfloxacin, ofloxacin, ciprofloxacin, and roxithromycin remained the dominant PiE. Residual levels of individual PiE at the same location varied noticeably across the three periods.
CONCLUSIONS: Results revealed highly distinct regional and temporal variations in surface freshwater pollution by these COVID-19-associated PiE across the three periods, with no consistent regularity observed, thereby further highlighting the necessity of implementing EPV in a "dynamic" manner. Drawing on the framework of dynamic pharmacovigilance, the implementation of dynamic EPV can be promoted by establishing a dynamic watch-list mechanism, clarifying stakeholder roles, and advancing supportive policies and technological platforms, so as to enable adaptive interventions for the timely management of event-driven pharmaceutical pollution.}, }
@article {pmid42402538, year = {2026}, author = {Kumar, K}, title = {Applications of Recombinant DNA Technology in Medicine: A Comprehensive Review.}, journal = {Molecular biotechnology}, volume = {}, number = {}, pages = {}, pmid = {42402538}, issn = {1559-0305}, abstract = {Recombinant DNA (rDNA) technology has revolutionised modern medicine by providing precise genetic manipulation for therapeutic, diagnostic, and preventive uses. By integrating genetic material from multiple sources, rDNA permits the creation of physiologically active compounds and the development of new medical therapies. This study summarises the basics of rDNA technology, including DNA separation, gene cloning, vector design, transformation, and expression systems, emphasising their foundational importance in biotechnology. Recombinant procedures make it possible to produce insulin, growth hormones, interferons, monoclonal antibodies, and enzymes on a large scale with better purity, safety, and scalability in the biopharmaceutical industry. Subunit, DNA, and viral-vector vaccines are examples of recombinant vaccines that have been effectively used to prevent infectious diseases such COVID-19, HPV, and hepatitis B. Gene therapy techniques using viral and non-viral vectors, together with CRISPR-based genome editing, provide targeted repair of genetic diseases. Additionally, recombinant systems promote pharmacogenomics and personalised medicine by improving molecular diagnostics such as PCR, qPCR, DNA probes, and enzyme-based tests. Furthermore, platforms for translational research and disease modelling are provided by genetically modified animal and cell models. The paper further examines ethical, safety, and regulatory considerations, as well as upcoming technologies such as CRISPR 2.0, synthetic biology, mRNA therapies, and designer vaccinations. Together, rDNA technology is still revolutionising healthcare by providing novel approaches to illness diagnosis, treatment, and prevention.}, }
@article {pmid42404849, year = {2025}, author = {Cairney, P and Intropido, S}, title = {The pursuit of equity in COVID-19 policy and policymaking: A qualitative systematic review.}, journal = {Open research Europe}, volume = {5}, number = {}, pages = {167}, pmid = {42404849}, issn = {2732-5121}, abstract = {BACKGROUND: The COVID-19 pandemic produced a devastating and unequal effect on global population health and wellbeing. Although research demonstrated multiple COVID-19 inequalities, the pursuit of equity (to address unfair inequalities) remained politically contested and overshadowed by higher priority crisis responses. It is essential to learn from these experiences to inform future crisis responses and anticipate the lack of proportionate and sustained attention to inequalities. We seek to understand how COVID-19 equity research defines this policy problem, offers solutions, and considers their feasibility in complex and political policy processes.
METHODS: We conducted a qualitative systematic review (2024) to identify peer reviewed journal articles on COVID-19, policymaking, and equity in three databases (Web of Science, Scopus, Proquest). We sought articles providing a non-trivial reference to policymaking concepts, including 55 texts that meet the inclusion criteria, and adding 30 texts by snowballing. We used an immersive and inductive approach to identify key themes and show how the use of policy concepts and theories informs an overall narrative of COVID-19 equity research.
RESULTS: This research documents the unequal impact of the COVID-19 pandemic and policy, then identifies potential policy solutions and some hopes that governments will support them. However, it highlights a major gap between this aspiration for change versus political reality, and identifies barriers to the production and use of lessons for future crises.
CONCLUSION: Most governments appear to have learned few lessons about inequalities from their COVID-19 experiences. The literature suggests that most governments will contribute to very similar unfair inequalities in their responses to the next crisis.}, }
@article {pmid42404887, year = {2026}, author = {Ponnachan, P and Dhawlarker, A and Yasmin, H and Shah, A and Malhotra, A and Shastri, A and Al-Ramadi, BK and Kishore, U}, title = {Mechanisms and impact of long COVID: pathophysiology, neuropsychiatric effects and vaccination.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1710777}, pmid = {42404887}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/immunology/physiopathology/psychology/complications/prevention & control ; Post-Acute COVID-19 Syndrome ; *SARS-CoV-2/immunology ; *COVID-19 Vaccines/immunology ; Vaccination ; Mental Disorders/etiology ; }, abstract = {Long COVID or post-acute sequelae of COVID-19 is defined as an after-effect of acute COVID-19 infection. Its broad clinical symptoms include brain fog, shortness of breath, fatigue, joint, chest, or muscle pain, dysautonomia and neuropsychiatric symptoms such as anxiety, depression and post-traumatic stress disorder. It is estimated that 1 in every 5 COVID-19 survivors exhibit symptoms within the Long COVID bracket. An array of risk factors such as smoking habit, age, obesity, female sex, and prior hospitalization may increase the probability of a person developing Long COVID. While the underlying mechanisms of Long COVID remain elusive, we examine the various possible pathophysiologies involved in Long COVID. We take up impactful neuropsychiatric issues as another spectrum of Long COVID symptoms and the likely effect of various forms of COVID-19 vaccines. In this review, the focus will be on the main mechanisms associated with the development of long COVID, which include latent Epstein-Barr virus reactivation, molecular mimicry, virus persistence, autoantibodies, and mitochondrial dysfunction. Understanding these mechanisms shed light on the continued persistence of COVID-19 related symptoms long after the resolution of acute infection. For instance, the reactivation of Epstein-Barr virus in the immunocompromised context seen post-acute SARS-CoV-2 infection could lead to the symptoms commonly observed in Long COVID such as fatigue and brain fog. The Epstein-Barr virus could possibly disrupt mitochondrial function, explaining the fatigue commonly observed in Long COVID patients. Other factors such as continued presence of viral particles in specific areas such as the gut may result in continued inflammation, leading to manifestations such as fatigue, cognitive impairment and gastrointestinal dysfunction. Additionally, heightened and persistent presence of autoantibodies post-acute infection results in persistent symptoms and could potentially trigger the onset of autoimmune disorders. We also aim to revisit the diverse and prolonged effects of the COVID-19 pandemic that continue to affect the well-being and quality of human life.}, }
@article {pmid42404899, year = {2026}, author = {Oh, SJ and Shin, OS and Hur, JY}, title = {From infection to dysfunction: viral triggers and antiviral immune factors in Alzheimer's disease pathology.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1839357}, pmid = {42404899}, issn = {1664-3224}, mesh = {Humans ; *Alzheimer Disease/immunology/pathology/virology ; Animals ; *Virus Diseases/immunology ; Brain/immunology/virology/pathology ; Host-Pathogen Interactions/immunology ; SARS-CoV-2/immunology ; }, abstract = {Neurodegenerative diseases and neurocognitive disorders increasingly appear to share a common and underappreciated contributor: the viral-immune axis in the brain. This review presents current evidence linking neurotropic viruses and host antiviral immunity to the onset and progression of neurodegeneration and neurocognitive dysfunction. We explore how viral infections, particularly by Herpesviruses, Severe Acute Respiratory Syndrome Coronavirus 2, and Human Immunodeficiency Virus, disrupt neural homeostasis through neuroinflammation, amyloidosis, tauopathy, and autophagy dysregulation in neurodegeneration including Alzheimer's disease (AD). Simultaneously, host antiviral mechanisms, including type I interferons and interferon regulatory factors, often amplify neuronal damage when dysregulated. By examining viral and immune interactions within the neurodegenerative diseases, this review aims to broaden our understanding of the viral-immune axis in the brain and inspire novel approaches to prevention and treatment.}, }
@article {pmid42405478, year = {2026}, author = {Wyszynski, DF and Renz, C and Espinueva, A and Shulman, LP and Lee, E and Fitzgibbon, A and Brown, G}, title = {Remdesivir Use During Pregnancy: Findings From the Prospective COVID-19 International Drug Pregnancy Registry and Narrative Literature Review.}, journal = {Journal of pregnancy}, volume = {2026}, number = {1}, pages = {e8700344}, pmid = {42405478}, issn = {2090-2735}, support = {//Genentech/ ; //Roche/ ; //Merck Sharp and Dohme United Kingdom/ ; //Regeneron Pharmaceuticals/ ; //GlaxoSmithKline/ ; //Gilead Sciences/ ; }, mesh = {Female ; Humans ; Pregnancy ; *Adenosine Monophosphate/analogs & derivatives/adverse effects/therapeutic use ; *COVID-19 Drug Treatment ; *Antiviral Agents/adverse effects/therapeutic use ; *Alanine/analogs & derivatives/adverse effects/therapeutic use ; *Pregnancy Complications, Infectious/drug therapy ; Registries ; Adult ; Prospective Studies ; SARS-CoV-2 ; COVID-19 ; }, abstract = {BACKGROUND AND AIMS: Remdesivir (RDV), an inhibitor of coronavirus replication including SARS-CoV-2, has been approved for the treatment of COVID-19. Nevertheless, its use during pregnancy lacks specific efficacy and safety data due to the exclusion of pregnant patients from clinical trials. Authorization for compassionate use in pregnant women was granted during the conduct of the Phase 3 clinical trials in adult patients hospitalized with moderate or severe COVID-19. Available evidence from prior studies suggests that no consistent safety concern has been identified, although available data remain limited. The most commonly reported adverse event (AE) is transaminitis, which rarely necessitates treatment discontinuation.
METHODS: Safety data for RDV exposure during pregnancy were collected by the COVID-19 International Drug Pregnancy Registry (COVID-PR) between December 2021 and November 2023. Information was obtained through self-administered online questionnaires completed during pregnancy and up to 1 year after live birth, with medical record corroboration when available.
RESULTS: Nine women reported a total of 15 AEs, with an additional seven AEs reported in three infants. Ten of these AEs were considered serious and included a life-threatening hypersensitivity episode. No consistent pattern of AEs suggestive of a specific safety concern was identified.
CONCLUSIONS: This study contributes additional observational safety data regarding RDV use during pregnancy. However, due to the small size of the study population and various study limitations, definitive conclusions about the safety of this treatment in pregnant populations cannot be drawn.
PLAIN LANGUAGE SUMMARY: RDV is a drug used to treat COVID-19 by blocking the virus from multiplying in the body. However, since pregnant women were not included in early clinical trials, we did not have much information about how safe and effective this drug is for them. During the pandemic, some pregnant women with severe COVID-19 were allowed to receive RDV through compassionate use programs, and our study is aimed at collecting data on their experiences. We looked at 23 pregnant women who took RDV between December 2021 and November 2023. Out of these, eight were followed through the end of their pregnancy, resulting in seven live births and one miscarriage. Some women and their babies experienced side effects, with the most common being temporary increases in liver enzyme levels, and one woman had a serious allergic reaction. Overall, no consistent pattern of adverse pregnancy or infant outcomes was identified. However, because only a small number of pregnancies were available for analysis and many participants were lost to follow-up, larger studies are needed to better understand the safety of RDV use during pregnancy.}, }
@article {pmid42405958, year = {2026}, author = {Zarrinpanah, T and Mashhadi Abolghasem Shirazi, M and Modarressi, SMH and Haghighat, S}, title = {Next-generation vaccine adjuvants: Integrating nanotechnology, systems immunology, and computational approaches for precision vaccinology.}, journal = {Human vaccines & immunotherapeutics}, volume = {22}, number = {1}, pages = {2684345}, pmid = {42405958}, issn = {2164-554X}, mesh = {Humans ; *Vaccinology/methods ; *Adjuvants, Immunologic/administration & dosage ; *Nanotechnology/methods ; *Adjuvants, Vaccine/administration & dosage ; Immunoinformatics ; *Vaccines/immunology ; COVID-19 Vaccines/immunology ; Vaccine Development/methods ; Systems Biology ; Nanoparticles ; Animals ; Immunity, Innate ; }, abstract = {Vaccines based on purified antigens, recombinant proteins, and nucleic acid platforms increasingly depend on adjuvants to induce robust, durable, and appropriately polarized immune responses in humans. While classical adjuvants such as aluminum salts and oil-in-water emulsions have enabled the success of many licensed vaccines, their largely empirical design limits adaptability to emerging pathogens and population-specific needs. This review presents a translational framework for next-generation vaccine adjuvant development by integrating nanotechnology-based delivery systems, innate immune signaling mechanisms, and systems-level computational strategies relevant to human vaccination. We summarize the mechanisms and clinical relevance of licensed and advanced adjuvants, including alum, MF59, AS01/AS04, saponins, toll-like receptor agonists, and lipid nanoparticles, with emphasis on influenza, HPV, herpes zoster, and COVID-19 vaccines. By linking immunological mechanisms with delivery engineering and predictive modeling, this review highlights rational strategies to support safer and more effective human vaccines.}, }
@article {pmid42406005, year = {2026}, author = {Ahuja, S and Kanwar, D and Silakari, P and Sahu, SK and Kaur, P}, title = {Medicinal Chemistry Perspectives on Drug Repurposing: Innovative Approaches and Therapeutic Breakthrough.}, journal = {Therapeutic innovation & regulatory science}, volume = {}, number = {}, pages = {}, pmid = {42406005}, issn = {2168-4804}, abstract = {Drug repurposing involves the discovery of new therapeutic uses of existing drugs that have already been approved by the regulatory authorities. It provides an alternative with more efficient approaches to traditional drug discovery, leveraging already known safety profiles, shortened development and financial costs. Current advances in computational biology, artificial intelligence and big-data analytics have expanded the range of opportunities for systematic repurposing, but the successful translation of these opportunities is increasingly dependent on the holistic input of medicinal chemistry. The therapeutic relevance of medicinal chemistry-guided repurposing is being investigated over a range of unmet medical conditions, such as complicated diseases, rare diseases and new health crises, such as the COVID-19 pandemic. In this review, we underscore the critical importance of medicinal chemistry, including structure-activity relationship analysis, molecular optimization, target engagement assay, and ADMET refinement, in supporting the efficacy and safety of repurposed candidates. We further discuss the co-existence of these strategies with in silico predictions of the target, virtual screening, and phenotypic assays to narrow down lead compounds and improve translational success. Additionally, the role of medicinal chemistry in personalized medicine is also taken into account, where special attention is paid to the possibility of modifying pharmacological characteristics to patient-specific molecular and biological phenotypes. The study aims to encourage researchers and clinicians to adopt the revolutionary potential of drug repurposing to enhance treatment decisions and overall health outcomes among a large number of patients. Moreover, in a medical landscape that is becoming more complex, drug repurposing can transform the pharmaceutical industry, accelerate the process of making viable therapy available, and facilitate the delivery of quality healthcare.}, }
@article {pmid42406015, year = {2026}, author = {Mirchevska, G}, title = {The Emerging Global Threat of Candida auris: A Call for Enhanced Public Health Policy and Regional Coordination.}, journal = {Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)}, volume = {47}, number = {2}, pages = {73-83}, doi = {10.2478/prilozi-2026-0020}, pmid = {42406015}, issn = {1857-8985}, mesh = {Humans ; *Candida auris/drug effects ; *Health Policy ; Antifungal Agents/therapeutic use ; *Cross Infection/prevention & control/epidemiology/microbiology ; Global Health ; *Candidiasis/epidemiology/prevention & control/diagnosis/drug therapy ; Infection Control ; COVID-19/epidemiology ; *Public Health ; Drug Resistance, Fungal ; Candidiasis, Invasive ; }, abstract = {Antimicrobial resistance represents a paramount challenge to global public health in the 21st century. The multidrug-resistant fungal pathogen Candida auris poses a critical and escalating threat to global public health. Characterized by rapid nosocomial transmission, persistent environmental contamination, and resistance to multiple antifungal classes, C. auris challenges healthcare systems worldwide. Its independent emergence across distinct geographic clades and exponential rise in cases, exacerbated by the COVID-19 pandemic, underscore the urgent need for robust, coordinated response. This review synthesizes the current knowledge on C. auris with a focus on its implications for public health policy, particularly in the European and Balkan healthcare settings, where surveillance gaps and cross-border transmission risks remain pronounced. We analyze the key drivers of spread, including diagnostic misidentification, extensive antifungal resistance, and lapses in infection control, and evaluate the strain on surveillance and hospital preparedness. Effective mitigation is fundamentally dependent on implementing comprehensive, multi-faceted infection prevention and control strategies, guided by antifungal stewardship and rapid diagnostics. We conclude that addressing the C. auris threat requires an urgent, coordinated international and regional response focused on strengthening surveillance networks, standardizing diagnostic and infection prevention and control protocols, and fostering data sharing across borders to contain this resilient pathogen.}, }
@article {pmid42406565, year = {2026}, author = {Mugwagwa, T and Marcano Belisario, J and Hartley, L and Phan, NTN and Mokgokong, R}, title = {Evaluation of nirmatrelvir/ritonavir treatment for COVID-19 on health-related outcomes: a global economic value systematic literature review.}, journal = {Journal of medical economics}, volume = {29}, number = {1}, pages = {1875-1897}, doi = {10.1080/13696998.2026.2695551}, pmid = {42406565}, issn = {1941-837X}, mesh = {*Ritonavir/therapeutic use/economics ; Humans ; *COVID-19 Drug Treatment ; Cost-Benefit Analysis ; Quality-Adjusted Life Years ; *Antiviral Agents/economics/therapeutic use ; Cost-Effectiveness Analysis ; Drug Combinations ; COVID-19 ; SARS-CoV-2 ; Lopinavir ; }, abstract = {AIMS: Nirmatrelvir/ritonavir (NMV/r)[i] is an antiviral drug indicated for the treatment of patients with mild to moderate coronavirus disease 2019 (COVID-19) who are at high risk of progressing to severe disease. We performed an updated economic systematic literature review (eSLR) of NMV/r to build upon evidence reported in our previous eSLR and additionally examine the health-related outcomes associated with NMV/r and any potential effect of long COVID.
METHODS: A systematic search of Embase, PubMed, Cochrane, and EconLit and of conference and health technology assessment agency websites was performed to identify economic analyses published between January 2022 and October 2025.
RESULTS: Of the 33 included economic evaluations, most were cost-utility analyses (n = 16) and used an analysis of a short-term decision tree with a long-term Markov model (n = 11). Several types of health-related endpoints were reported by studies, with most including hospital-related endpoints (n = 20), quality-adjusted life-years (QALYs) (n = 18), and death-related endpoints (n = 18). Positive health-related outcomes were associated with NMV/r treatment, including reductions in hospitalizations and deaths and an increase in QALYs. NMV/r treatment was also associated with a reduced number of patients with long COVID complications.
LIMITATIONS: Most studies were conducted in high-income countries, were based on different COVID-19 variants, and were limited in data on the long COVID population.
CONCLUSION: In addition to monetary benefits, NMV/r provides short-term and long-term health-related benefits to patients with mild to moderate COVID-19. This study provides further support for NMV/r as a cost-effective treatment option.}, }
@article {pmid42407372, year = {2026}, author = {Kachanov, A and Brezgin, S and Kostyusheva, A and Ponomareva, N and Chulanov, V and Parodi, A and Kostyushev, D}, title = {Safeguarding nanovesicles and their payload: A framework for stable storage.}, journal = {Colloids and surfaces. B, Biointerfaces}, volume = {267}, number = {}, pages = {115956}, doi = {10.1016/j.colsurfb.2026.115956}, pmid = {42407372}, issn = {1873-4367}, abstract = {Recent advances in biomedical science have shifted therapeutic strategies toward biologics, nucleic acid-based medicines, and precision gene regulation, demanding equally sophisticated delivery and preservation vehicles. This shift is epitomized by the breakthrough of RNA therapeutics during the COVID-19 pandemic, which are now advancing into oncology, autoimmune disorders, and inflammatory diseases, alongside powerful gene-editing, and gene-regulation tools. Biological nanoparticles and, in particular, (EVs) are uniquely positioned to enable targeted delivery of these advanced strategies. Their favorable biodistribution, biocompatibility, biodegradability, and high loading capacity make them an ideal delivery platform. However, a critical translational gap remains: while experimental innovation accelerates, the practical knowledge of selecting appropriate dosage forms, storage conditions, and necessary stabilizers is lacking. This challenge extends beyond maintaining vehicle integrity to the crucial preservation of the therapeutic payload's activity. This review examines current advancements in EVs storage methods and conditions, highlighting the challenges for preserving functional activity of the payload. By evaluating preservation strategies and their effects on EV integrity and cargo stability, we discuss critical insights to enhance storage, ensuring both structural preservation of EVs and functionality of bioactive cargo.}, }
@article {pmid42410869, year = {2026}, author = {O'Donnell, J and Fenn, R}, title = {Respiratory Support in the Emergency Department: An Updated Systematic Review and Meta-Analysis.}, journal = {Worldviews on evidence-based nursing}, volume = {23}, number = {4}, pages = {e70165}, pmid = {42410869}, issn = {1741-6787}, mesh = {Humans ; *Emergency Service, Hospital/organization & administration/statistics & numerical data ; Noninvasive Ventilation ; *Oxygen Inhalation Therapy/methods ; *Respiratory Therapy/methods ; }, abstract = {BACKGROUND: An estimated 20% of emergency department (ED) patients require respiratory support (RS). Evidence suggests that nasal high flow (NHF) reduces RS need.
AIMS: This is an update of a published review comparing NHF to non-invasive ventilation (NIV) or to conventional oxygen therapy (COT) in adult ED patients.
METHOD: This updated systematic review (SR) and meta-analysis (MA) methods reflect the Cochrane Collaboration's methodology. The search of six databases was first completed in July 2023 and then repeated in November 2025. Databases were searched for randomized controlled trials (RCTs) comparing NHF to COT or NIV in the ED. Three summary estimates were reported: (1) need to escalate care, (2) mortality, and (3) adverse events (AEs).
RESULTS: The updated search identified three new studies, bringing the total to 21 eligible RCTs (n = 2158). One of the six MA conclusions was statistically significant. Compared with COT, NHF showed no SS difference in the risk of escalation (RR 0.65; 95% CI [0.41, 1.04]; p = 0.07), mortality (RR 1.05; 95% CI [0.74, 1.51]; p = 0.77), and AE (RR was 0.98; 95% CI [0.6, 1.6]; p = 0.94) outcomes were found. Compared with NIV, NHF increased the risk of escalation by 86% (RR 1.86; 95% CI [1.26, 2.75]; p = 0.001), but mortality risk was not SS (RR 1.33; 95% CI [0.86, 2.06]; p = 0.20).
LINKING EVIDENCE TO ACTION: Evidence suggests NHF therapy may be an alternative to COT in managing RS in EDs. While NHF may not be as effective as NIV at preventing escalation, it does not increase mortality risk, offering a nuanced approach to RS tailored to patient-specific needs. This evidence-informed decision-making can enhance patient outcomes. However, further research is needed, especially given the COVID-19 pandemic's impact on ED research.}, }
@article {pmid42410924, year = {2026}, author = {Liu, W and Wang, B and Cosco, TD and Cai, Z and Tang, X and Zhou, Z and Ren, Z}, title = {Prevalence of anxiety and depressive symptoms among older adults during COVID-19 lockdowns: a systematic review and meta-analysis.}, journal = {Aging & mental health}, volume = {}, number = {}, pages = {1-14}, doi = {10.1080/13607863.2026.2690401}, pmid = {42410924}, issn = {1364-6915}, abstract = {BACKGROUND: The COVID-19 lockdowns presented an unprecedented challenge to public mental health. The impact of these lockdowns on older adults remains unclear. To quantify the prevalence of anxiety and depressive symptoms among older adults during COVID-19 lockdowns, we conducted this systematic review and meta-analysis.
METHODS: We systematically searched nine electronic databases for relevant literature published in English or Chinese, covering the period from January 1, 2020, to November 29, 2024. The Joanna Briggs Institute Critical Appraisal tool was used to assess the risk of bias. A random-effects model was used to calculate the overall pooled prevalence.
RESULTS: A total of 51 articles, encompassing 57 studies, satisfied the inclusion criteria and included data from 26,616 participants across 23 countries. The estimated prevalence of anxiety and depressive symptoms was 12.82% (95% CI: 9.13-17.72) and 15.01% (95% CI:11.61-19.19), respectively. Factors significantly associated with anxiety symptom prevalence included the proportion of females, study quality, lockdown duration, international travel control policies, workplace closure policies, and changes in human mobility across six categories of location. Factors significantly associated with depressive symptom prevalence included study quality, international travel control policies, and public transport closure policies.
CONCLUSIONS: This study enhances our understanding of anxiety and depression symptoms among older adults during COVID-19 lockdowns, notably revealing the moderating effects of human mobility on anxiety symptoms. The findings offer tentative insights for comprehending and addressing the psychological impact of major public health emergencies on older adults.}, }
@article {pmid42411042, year = {2026}, author = {Zhang, Y and Chen, J and Li, J and Xu, Z and Wang, J and Shang, L}, title = {Advances in Antiviral Drug Development Targeting Viral Proteases.}, journal = {Medicinal research reviews}, volume = {}, number = {}, pages = {}, doi = {10.1002/med.70075}, pmid = {42411042}, issn = {1098-1128}, support = {22177055//National Natural Science Foundation of China/ ; U23A20147//National Natural Science Foundation of China/ ; GZNL2023A01002//R&D Program of Guangzhou Laboratory/ ; 63243133//Fundamental Research Funds for the Central Universities, Nankai University/ ; }, abstract = {Viral proteases are critical targets in antiviral drug development due to their essential role in the viral lifecycle and high conservation across viral strains. This review summarizes the recent progress of antiviral drugs based on protease structures, with a focus on the structural characteristics and inhibitor design strategies targeting Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), Enterovirus 71 (EV71), Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV). Based on the three-dimensional structure of proteases, various types of protease inhibitors such as peptidomimetic, non-peptidic, and natural product-derived inhibitors are discussed. Given the critical challenge of drug resistance in antiviral therapies, we address the mechanisms of protease inhibitor resistance and explore advanced strategies, including allosteric inhibition, dual-target inhibition, and Proteolysis-Targeting Chimeras (PROTAC) to overcome drug resistance. This review also explores the cutting-edge applications of artificial intelligence (AI) for viral protease-based antiviral drug discovery, providing valuable insights for the rational design and development of antiviral drugs.}, }
@article {pmid42412197, year = {2026}, author = {Goldberg-Bockhorn, E and Reich, A and Vahl, JM and Hoffmann, TK and Hahn, J}, title = {[Otorhinolaryngologic infections in the post-pandemic context: What can we learn from the literature?].}, journal = {HNO}, volume = {}, number = {}, pages = {}, pmid = {42412197}, issn = {1433-0458}, abstract = {BACKGROUND: The epidemiology of various respiratory infections changed due to the impact of the COVID-19 pandemic. Lockdowns and other containment measures (nonpharmacologic interventions, NPI) led to a decline in virus circulation, resulting in fewer cases at hospitals and practices. Once restrictions were eased, a rebound effect was observed worldwide, resulting in an increase in viral and severe invasive bacterial infections.
OBJECTIVE: Various case series on different ear, nose, and throat (ENT) infections have been conducted in the context of the pandemic in Germany. These studies should be summarized and interpreted in the context of currently available data.
MATERIALS AND METHODS: The literature review focuses particularly on studies from Germany before, during, and after the pandemic, supplemented by European and international data.
RESULTS: Following the lifting of NPIs, a general increase in severe bacterial ENT infections was observed worldwide, particularly among children. Evidence from the underlying retrospective data from Germany is limited. For mastoiditis and complicated sinus infections, cohort studies showed no change in the bacterial spectrum or in the complication rate. Microbiological data for peritonsillar abscesses are currently lacking. Necrotizing fasciitis in the head and neck region increased globally. Reliable data from Germany are currently unavailable.
CONCLUSION: The increased susceptibility due to low exposure to pathogens during the pandemic and the simultaneous surge in post-pandemic virus circulation is believed to be the main cause of the rise in infections. The current data do not prove a direct influence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Vaccinations, strict hygiene measures, patient education, and monitoring could help to mitigate the severity of such phenomena in the future.}, }
@article {pmid42412629, year = {2026}, author = {Dai, Y and Li, S and He, X and Lu, K and Tian, J and Huang, Y and Wei, D and He, X and Duan, X and Liu, Y and Zhang, B}, title = {Recent advances in functional studies of coronavirus NSP13 helicase and challenges in inhibitor development.}, journal = {Virulence}, volume = {17}, number = {1}, pages = {2696653}, pmid = {42412629}, issn = {2150-5608}, mesh = {Humans ; *Viral Nonstructural Proteins/metabolism/antagonists & inhibitors/chemistry/genetics ; *Antiviral Agents/pharmacology ; *RNA Helicases/metabolism/antagonists & inhibitors/genetics/chemistry ; Virus Replication/drug effects ; *Coronavirus/enzymology/drug effects/genetics ; G-Quadruplexes ; SARS-CoV-2/enzymology/drug effects/genetics ; COVID-19 Drug Treatment ; Methyltransferases ; }, abstract = {Coronavirus helicase NSP13 is essential for viral replication and transcription and is a promising target for broad-spectrum anti-coronavirus drugs due to its high sequence conservation and structural homology. This review summarizes NSP13 sequence features, structural organization, and functional activities across the seven human-infecting coronaviruses. We outline key enzymatic properties, including duplex RNA/DNA unwinding and NTP hydrolysis, and describe how NSP13 cooperates with other nonstructural proteins to drive replication and transcription. Beyond canonical helicase roles, we discuss the genomic distribution of G-quadruplex (G4) elements in coronaviruses and potential functional connections between G4 structures and NSP13 in regulating the viral life cycle. Finally, we highlight recent progress in developing NSP13-targeting inhibitors and consider their potential utility against COVID-19 and other emerging coronaviruses, providing a rationale for broad-spectrum antiviral design.}, }
@article {pmid42414952, year = {2026}, author = {Parent-Lamarche, A and Beauregard, N and Blanc, MÈ and Cadieux, N and Dextras-Gauthier, J and Afota, MC and Merkouche, W and Hamouche, S and R'biaa, O and Garneau, J}, title = {Teleworking and its impact on health and well-being: a systematic review of longitudinal studies considering the psychosocial work environment (2005-2024).}, journal = {BMC public health}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12889-026-28220-4}, pmid = {42414952}, issn = {1471-2458}, support = {IRSST 2024-0004//Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail/ ; }, abstract = {BACKGROUND: Teleworking expanded dramatically during the COVID-19 pandemic and is expected to remain widespread. While it offers benefits such as greater autonomy and improved work-life balance, teleworking also poses challenges related to workload, social isolation, and blurred boundaries between work and personal life, shaped by the psychosocial work environment. These contrasting effects raise questions about whether teleworking promotes or undermines workers' health. This systematic review synthesizes longitudinal evidence on the relationship between teleworking and workers' health, with particular attention to the role of the psychosocial work environment as an explanatory framework. Specifically, it addresses two questions: (1) What is the impact of teleworking on health (physical and mental) when psychosocial work environment factors are considered? (2) How have longitudinal studies examined the relationship between teleworking and health, including direct, mediation, and moderation effects, and how the role of teleworking in these relationships has been studied?
METHODS: This systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42024599518). We searched five electronic databases (Embase, Medline, PsycInfo, Web of Science, CINAHL Plus) and bibliographies for longitudinal studies published between 2005 and 2024 in OECD countries. Eligible studies examined teleworking and workers' health (physical and/or psychological) in combination with psychosocial work environment factors. Study quality was assessed using the National Heart, Lung, and Blood Institute (NHLBI) Quality Assessment Tool. Data from 20 studies published between 2017 and 2024 were extracted and synthesized based on study and psychosocial work environment characteristics, as well as the nature of the association between telework and health outcomes.
RESULTS: All 20 studies were rated fair or good in methodological quality. Teleworking effects on health were heterogeneous and context-dependent, increasing psychological distress, exhaustion, and anxiety under high psychosocial risk (i.e., adverse work conditions such as high workload or work intensification, low autonomy, limited social support, job insecurity, reduced psychological detachment, and blurred work-nonwork boundaries) or mandatory arrangements, but protective with autonomy, supportive psychosocial conditions, or individual resources. Psychosocial work environment factors such as autonomy, job security, workload, and social support emerged as central determinants of health outcomes. Effects operated through moderation and mediation involving psychosocial work environment factors. Important gaps remain, particularly the limited investigation of physical health outcomes.
CONCLUSIONS: Teleworking is neither uniformly beneficial nor harmful. Its health impact depends on psychosocial work environment factors, individual characteristics, and contextual conditions. Longitudinal research should expand the range of psychosocial work environment factors examined, consider physical health outcomes, and investigate effects across pre-, during-, and post-pandemic periods. These insights are critical to inform evidence-based workplace interventions and organizational policies that promote employee health.}, }
@article {pmid42415007, year = {2026}, author = {Tsehay, A and Menkir, S and Hailegebriel, T}, title = {Prevalence and associated risk factors of malaria in Amhara National Regional State: a systematic review and meta-analyses.}, journal = {Malaria journal}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12936-026-06034-4}, pmid = {42415007}, issn = {1475-2875}, abstract = {BACKGROUND: Malaria is a major parasitic infectious disease caused by Plasmodium species and remains a significant public health challenge in sub-Saharan African, including Ethiopia. The Amhara National Regional State is among the most malaria-affected region in Ethiopia. However, comprehensive evidence on the pooled prevalence of malaria and its associated risks in the region has been limited. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of malaria and identify its associated risk factors in Amhara National Regional State.
METHODS: A systematic search of studies published between 2013 to March 3, 2023, was conducted using PubMed, Springer nature, Science Direct, and Google Scholar. Eligible studies were selected based on predefined inclusion criteria. Data were extracted using Microsoft Excel and analysed with Stata version 17. Heterogeneity among studies was assessed using the inverse variance (I[2]) statistic, while publication bias was evaluated using Egger's regression test and funnel plot.
RESULTS: Out of 2,743 records initially identified, 43 studies met the inclusion criteria. The pooled prevalence of malaria in the Amhara National Regional State was 14% (95% CI 12.0-17.0%). Subgroup analysis showed that the highest (17%, 95% CI 4.0-30.0%) pooled prevalence was from South and North Gonder Zones, whereas the lowest (8%, 95% CI 5.0-11.0%) prevalence was observed in East Gojjam Zone. Malaria prevalence estimate varied according to the diagnostic methods; with microscopy reporting a prevalence of 16%; 95% CI 13.0-18% and combination of microscopy with RDT reporting 9%; 95% CI 4.0-14.0%. The prevalence increased from 13% (95% CI 10.0-17%) before the onset of COVID-19 pandemic to 15% (95% CI 14.0-10.0%) after the onset. Plasmodium falciparum was the predominant species, accounting 9% (95% CI 6-11%) of the infection followed by P. vivax at 5% (95% CI 4-5%). Significant predictors of malarial infection included, the presence of stagnant water near residences (OR = 2.64; 95% CI 2.09-3.34), engagement in outdoor night activities (OR = 1.69; 95% CI 1.33-2.16), and lack of insecticide treated net (ITN) utilization (OR = 2.05; 95% CI 1.71-2.46).
CONCLUSION: This systematic review and meta-analysis revealed that malaria remained a considerable public health burden in the Amhara National Regional State with Plasmodium falciparum as the dominant species. Malaria prevalence varied across administrative zones, diagnostic methods, study seasons, and study periods. Environmental and behavioural factors significantly contributed to malaria transmission, highlighting the need for a strengthened and targeted malaria prevention and controlled interventions in the region.}, }
@article {pmid42415124, year = {2026}, author = {Sewell, PE and Jensen, C}, title = {Clinical rationale for thymic restoration in adult immunosenescence.}, journal = {Immunity & ageing : I & A}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12979-026-00584-6}, pmid = {42415124}, issn = {1742-4933}, abstract = {Age-related thymic involution is a central feature of immunosenescence and intersects with multiple "hallmarks of aging", including genomic instability, telomere attrition, mitochondrial dysfunction, and chronic inflammation. The decline in thymic epithelial integrity and FOXN1-driven thymopoiesis reduces naïve T-cell output, contracts TCR repertoire diversity, and perturbs central tolerance, contributing to increased susceptibility to infection, cancer, and autoimmunity. These changes occur alongside broader immune-aging phenomena such as inflammaging and frailty and are reflected in poorer vaccine responses and altered outcomes to novel pathogens such as SARS-CoV‑2. This review integrates mechanistic, preclinical, and human data to reassess the adult thymus as a therapeutic target. Higher-confidence domains for thymic restoration include cancer immunosurveillance, infectious disease vulnerability, vaccine responsiveness, and post-treatment immune reconstitution, supported by modeling of age-related disease incidence, transplant and HIV cohorts, and new observational links between radiographic thymic health, mortality, and immunotherapy outcomes. High-plausibility but less directly validated domains include autoimmunity, chronic herpesvirus control, HIV immunological non-responders, and post-acute infection syndromes such as long COVID, which share convergent patterns of T-cell dysfunction and persistent immune activation. The translational landscape spans hormonal and somatotropic modulation (sex steroid ablation, growth hormone/ghrelin), cytokine and growth-factor strategies (IL‑7, IL‑22, KGF/BMP4, FGF21), cell- and tissue-engineering approaches leveraging thymic epithelial stem cells and FOXN1-reprogrammed stromal cells, and gene-therapy concepts such as intrathymic AAV delivery of FOXN1, AIRE, chemokines, and stromal-support pathways. Collectively, these data support the biological plausibility of adult thymus restoration but highlight that robust, domain-specific clinical benefits have not yet been demonstrated in controlled trials. Future work should prioritize harmonized structural and functional biomarkers, domain-focused interventional studies in high-risk populations, and combined strategies that situate thymus-directed interventions within broader efforts to modify immune and organismal aging.}, }
@article {pmid42415281, year = {2026}, author = {Aldana, BI and Freude, K}, title = {Chemokines in Alzheimer's Disease: Early Defence, Late Damage and the Impact of Sex and Infection.}, journal = {Basic & clinical pharmacology & toxicology}, volume = {139}, number = {2}, pages = {e70273}, pmid = {42415281}, issn = {1742-7843}, support = {R434-2023-242//Lundbeck Foundation/ ; N/A//Alzheimersfonden/ ; }, mesh = {Humans ; *Alzheimer Disease/immunology/metabolism ; *Chemokines/metabolism/immunology ; Animals ; Female ; Male ; Sex Factors ; Signal Transduction ; Virus Diseases/immunology ; Neuroinflammatory Diseases/immunology ; COVID-19/immunology ; Receptors, Chemokine/metabolism ; Brain/immunology/metabolism ; Sex Characteristics ; }, abstract = {Chemokines constitute a versatile signalling network maintaining homeostasis and glia-neuron communication in the healthy brain but become progressively dysregulated during aging and Alzheimer's disease (AD). This review examines how chemokine systems transition from tightly regulated homeostatic signals to drivers of chronic neuroinflammation in AD. We describe the major chemokine families (CC, CXC, CX3C) and their dominant central nervous system (CNS) receptors (CCR2, CXCR3, CX3CR1), which activate canonical inflammatory pathways including NF-κB, JAK/STAT and PI3K-AKT. In AD, chemokine dysregulation occurs in a coordinated manner across multiple functional modules, including recruitment-associated (CCL2, CXCL1), interferon-inducible (CXCL10), loss-of-restraint (CX3CL1) and vascular-associated chemokines. These alterations shift the network from regulated immune communication to self-sustaining inflammatory circuits perpetuating chronic neuroinflammation. These networks reprogram microglia and astrocytes into disease-associated phenotypes, amplify peripheral immune cell infiltration and destabilise synaptic function. Biological sex profoundly influences neuroinflammatory trajectories, with females exhibiting enhanced microglial senescence and interferon signalling, while males show accelerated complement activation. Viral pathogens, particularly neurotropic viruses (HSV-1, HHV-6, VZV) and SARS-CoV-2, actively reprogram chemokine networks, linking infection to amyloid-β accumulation, tau pathology and neurodegeneration. Therapeutically, chemokine axes represent precision targets requiring stage-matched, sex-stratified interventions rather than broad anti-inflammatory approaches. Understanding chemokine network dynamics offers mechanistic insights into AD pathogenesis and could provide pointers for therapeutic strategies.}, }
@article {pmid42415571, year = {2026}, author = {Kılıç, S}, title = {Effectiveness of manual detorsion in the treatment of testicular torsion: systematic review and meta-analysis.}, journal = {The Canadian journal of urology}, volume = {33}, number = {3}, pages = {505-514}, pmid = {42415571}, issn = {1488-5581}, mesh = {Humans ; Male ; *Spermatic Cord Torsion/therapy/surgery ; Treatment Outcome ; Orchiectomy ; *Musculoskeletal Manipulations/methods ; }, abstract = {OBJECTIVES: Testicular torsion is the most common surgical cause of an acute scrotum. Manuel detorsion renewed attention as a practical initial treatment, particularly in the COVID-19 pandemic. This study aims to systematically review and meta-analyze the current literature to determine whether manual detorsion offers a viable alternative to immediate surgery in improving testicular salvage rates.
METHODS: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines and registered with PROSPERO (CRD420251039489). Studies including ≥30 male patients comparing manual detorsion and surgical exploration were included. Searches were performed in PubMed/MEDLINE, Scopus, TR Index, and Web of Science. Risk of bias was assessed using a predefined scoring system based on methodology, sample size, and follow-up objectivity. Data were synthesized using RevMan 5.4 to calculate pooled risk ratios.
RESULTS: Eight retrospective studies involving a total of 670 patients were included. Patients were divided into a manual detorsion group (G1, n = 394) and a surgical exploration group (G2, n = 316). Success rates of manual detorsion ranged from 15% to 76%, while orchiectomy rates were lower in G1 (0% to 10.3%) compared to G2 (0% to 43.8%). The pooled success rate of manual detorsion was 75.7%. Although orchiectomy rates appeared numerically lower in the manual detorsion group (3.8% vs. 29.2%), the pooled analysis did not demonstrate a statistically significant overall difference between the two groups (risk ratio [RR] = 1.23; 95% CI: 0.82-1.84; p = 0.31).
CONCLUSION: Manual detorsion appears time-saving and effective maneuver. To our knowledge, this is the first meta-analysis focused exclusively on manual detorsion, and it supports its consideration as an initial management strategy in selected clinical scenarios.}, }
@article {pmid42415773, year = {2026}, author = {Kusunoki, H and Sakai, R and Watanabe, Y and Kakeya, H}, title = {Persistent excess mortality in post-pandemic Japan: current evidence, methodological limitations, and future directions.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1878166}, pmid = {42415773}, issn = {2296-2565}, mesh = {Japan/epidemiology ; Humans ; *COVID-19/mortality/prevention & control ; *Mortality/trends ; COVID-19 Vaccines/administration & dosage ; Pandemics ; SARS-CoV-2 ; Immunization, Secondary ; }, abstract = {More than six years after the emergence of COVID-19, Japan continues to experience persistently elevated excess mortality despite entering a post-pandemic phase. Excess mortality, defined as the difference between observed and expected deaths, reflects both direct and indirect effects of the pandemic, including healthcare disruption, delayed care, and broader social changes. In Japan, mortality decreased slightly in 2020 but increased markedly from 2022 onward, with annual excess deaths approaching 100,000, despite widespread vaccination and the predominance of the less virulent Omicron variant. Multiple factors may underlie this sustained increase, including population aging, changes in healthcare access, delayed diagnosis and treatment, regional disparities, and psychosocial stress. Some ecological and observational studies have reported a statistical association between repeated COVID-19 booster vaccination and excess mortality in Japan; however, these findings do not establish causality, and a causal relationship cannot currently be concluded. Against this background, this narrative review examines persistent excess mortality in Japan, uses the literature on repeated booster vaccination as an illustrative example to highlight methodological limitations, and discusses the need for nationwide, linked individual-level data infrastructure and appropriate analytical frameworks for more robust future evaluations.}, }
@article {pmid42415774, year = {2026}, author = {You, Q and Li, J and Yang, L and Zhang, Y and Chen, L}, title = {Prevalence of secondary traumatic stress in nurses: a meta-analysis of observational studies.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1877091}, pmid = {42415774}, issn = {2296-2565}, mesh = {Humans ; Prevalence ; *Nurses/psychology/statistics & numerical data ; Observational Studies as Topic ; *Compassion Fatigue/epidemiology ; COVID-19/epidemiology ; }, abstract = {BACKGROUND: The reported prevalence of secondary traumatic stress (STS) among nurses varies considerably across studies, ranging from 22. 1 to 84.4%. This meta-analysis aimed to estimate the pooled prevalence of STS and identify potential moderating factors among nurses.
METHODS: From the inception of each target database to April 2026, a comprehensive search was performed across PubMed, Web of Science, Scopus, Embase, Cochrane Library, CINAHL, and PsycINFO. We calculated the pooled prevalence of STS using a random-effects model and assessed heterogeneity using the I[2] statistic. Subgroup analyses and meta-regression were conducted to explore potential sources of heterogeneity.
RESULTS: A total of 28 studies comprising 7,090 nurses were included. The pooled prevalence of STS in nurses was 57.3% (95% CI: 49.7-64.9%). STS prevalence was significantly associated with mean age (β = -0.064, p = 0.023), work experience (β = -0.080, p = 0.040), publication year (during COVID-19: β = 0.979, p = 0.024; after COVID-19: β = 0.848, p = 0.030), and geographic region (North America: β = -0.881, p = 0.019; Europe: β = -1.031, p = 0.005).
CONCLUSIONS: Our findings indicated that STS was very prevalent in nurses, and the prevalence is moderated by mean age, work experience, publication year, and geographic region. Regular STS assessments and multi-level support systems, such as early warning, peer support, and mental health training, are recommended to reduce STS risk and enhance the wellbeing of nurses.}, }
@article {pmid42415809, year = {2026}, author = {Sun, C and Chen, Q and Wang, Y and Yuan, S and Su, Y and Zhang, L}, title = {A visualization analysis of Traditional Chinese Medicine for influenza prevention and treatment: advances, hotspots, and future trends.}, journal = {Frontiers in medicine}, volume = {13}, number = {}, pages = {1852941}, pmid = {42415809}, issn = {2296-858X}, abstract = {OBJECTIVES: As an acute respiratory infectious disease, influenza continues to impose a substantial public health burden worldwide. This study aims to systematically review the progress of research on the treatment of influenza with Traditional Chinese Medicine (TCM) from 2005 to 2025, identify current research hotspots, and forecast future development trends, in order to provide a clear and systematic reference framework for subsequent research.
METHODS: A bibliometric and scientometric analysis was conducted using the Web of Science Core Collection (WOSCC), PubMed, and Scopus databases. Following the PRISMA 2020 guidelines, the retrieved records underwent a comprehensive deduplication process and stringent quality control checks. By comprehensively applying CiteSpace, VOSviewer, and the R-based Bibliometrix package, metrics and visualization were performed across multiple dimensions, including publication volume, geographical contribution, annual trends, national/regional influence, core authors and institutions, and keywords.
RESULTS: A total of 1,527 publications were included in this study. Since 2014, publication output in this field has shown significant growth, with a rapid upward trend emerging after 2020. At the national and institutional level, China ranked first globally in both the number of publications and total citation frequency. Research institutions in China not only serve as the dominant force in this field but also act as hubs for international collaboration. Notable contributions were made by institutions such as the Chinese Academy of Sciences, Beijing University of Chinese Medicine, and the China Academy of Chinese Medical Sciences. Journal analysis revealed that the Journal of Ethnopharmacology is the most influential journal in this domain. In terms of scholarly impact, Yang Zifeng ranked first in both h-index and publication output, establishing them as the most prolific and influential core scholar in the field. Keyword analysis indicated that research focuses on core themes such as "herbal medicine" and "antiviral activity." The evolutionary trajectory demonstrates a shift from traditional clinical practice toward modern mechanistic investigation. Driven by emerging public health events such as COVID-19, the field has rapidly integrated cutting-edge methodologies like network pharmacology, reflecting distinct characteristics of contemporary responsiveness and interdisciplinary convergence.
CONCLUSION: This analysis confirms that TCM for influenza has matured into a structured and interdisciplinary research field. Substantial evidence supports its multi-component and multi-target therapeutic model as a clinically effective strategy against influenza. Future efforts should prioritize the integration of mechanistic insights with standardized clinical translation to enhance global antiviral preparedness.}, }
@article {pmid42416292, year = {2026}, author = {Kim, SJ and Choi, KS}, title = {Vaccination-driven evolution of infectious bronchitis virus in Korea: implication for the control of other coronavirus infections.}, journal = {Frontiers in veterinary science}, volume = {13}, number = {}, pages = {1859772}, pmid = {42416292}, issn = {2297-1769}, abstract = {Infectious bronchitis virus (IBV) remains a major pathogen in global poultry production due to its extensive genetic diversity and rapid evolutionary capacity. Antigenic diversification driven by mutation, homologous recombination, and sustained immune selection pressure complicates long-term control and reduces vaccine effectiveness. Increasing evidence suggests that IBV evolution is largely driven by the selective expansion of pre-existing variants under changing ecological and immunological conditions, rather than by the de novo emergence of novel lineages. South Korea provides a valuable model for understanding these processes within intensive poultry systems characterized by high host density, extensive farm connectivity, widespread vaccination, and long-term molecular surveillance. Since its first isolation in 1986, IBV in Korea has undergone repeated cycles of lineage emergence, diversification, and replacement, culminating in the predominance of nephropathogenic GI-19 viruses, including KM91 and QX-like variants. Persistent co-circulation of multiple lineages, together with frequent recombination and regional viral introduction, has shaped a highly dynamic viral population. Within this environment, vaccination plays a central yet paradoxical role. While essential for disease control, widespread vaccination imposes continuous immune selection pressure and may contribute to co-circulation of vaccine-derived and field strains, facilitating recombination and the emergence of immune escape variants. These processes drive lineage turnover and antigenic mismatch between circulating viruses and vaccine strains, forming a vaccination-driven evolutionary cycle. This review integrates global IBV diversity with insights from the Korean system to propose an evolution-centered framework in which viral genetic plasticity, host population dynamics, and vaccination practices interact. These findings have important implications for optimizing vaccination strategies and provide broader insights into the evolutionary dynamics of rapidly evolving RNA viruses under sustained immune pressure.}, }
@article {pmid42417247, year = {2026}, author = {Gong, H and Cai, C}, title = {Plastic antibodies that see viruses: optical sensing with molecularly imprinted polymers.}, journal = {Chemical communications (Cambridge, England)}, volume = {}, number = {}, pages = {}, doi = {10.1039/d6cc03116a}, pmid = {42417247}, issn = {1364-548X}, abstract = {The need for rapid, sensitive, and selective detection of viral pathogens has never been more apparent. Molecularly imprinted polymers have emerged as robust synthetic receptors that rival biological antibodies in affinity and specificity, while offering superior chemical stability, low cost, and design flexibility. This Feature Article focuses on recent advances in the integration of virus-imprinted polymers with optical transducers, creating powerful platforms for viral diagnostics. We discuss key imprinting strategies including solid-phase synthesis, epitope imprinting, and nanogel approaches that enable precise recognition of whole viruses or their surface proteins. The optical readout mechanisms-fluorescence, resonance light scattering, colorimetric/visual detection, and surface plasmon resonance-are critically reviewed, with emphasis on signal amplification, multiplexing, and point-of-care deployment. Special attention is paid to the work of our group and others in engineering paper-based sensors, ratiometric probes, and smartphone-readable devices that detect viruses from Hepatitis A and B to SARS-CoV-2 and influenza at femtomolar or even attomolar levels. Current challenges and future directions for virus-imprinted optical sensors are discussed, highlighting the road toward commercial and clinical translation.}, }
@article {pmid42417638, year = {2026}, author = {Bendoumou, M and Langlet, P and Gustot, T}, title = {Auto-immune hepatitis following COVID-19 Vaccination and SARS-COV2 infection : A narrative Review.}, journal = {Acta gastro-enterologica Belgica}, volume = {89}, number = {2}, pages = {341-354}, doi = {10.51821/89.2.15138}, pmid = {42417638}, issn = {1784-3227}, mesh = {Humans ; *Hepatitis, Autoimmune/etiology/immunology/drug therapy/diagnosis ; *COVID-19/prevention & control/epidemiology/immunology ; *COVID-19 Vaccines/adverse effects ; Female ; SARS-CoV-2 ; *Vaccination/adverse effects ; }, abstract = {BACKGROUND AND OBJECTIVES: Since the onset of the COVID-19 pandemic, both SARS-CoV-2 infection and vaccination have been implicated as potential triggers for de novo autoimmune hepatitis (AIH). This review summarizes published cases, outlining clinical and biological features, treatment approaches, and outcomes.
METHODS: A PubMed search identified reports of new-onset AIH following SARS-CoV-2 infection or COVID-19 vaccination up to February 1, 2025. Inclusion criteria encompassed case reports, series, and reviews. Data were extracted on demographics, vaccine type, onset timing, laboratory findings, histology, treatments, and outcomes.
RESULTS: A total of 74 post-vaccination AIH cases and 22 post-infection cases were included. Post-vaccination AIH predominantly affected older women (median age 62) and occurred mainly after mRNA vaccines, with a median onset of 14 days. Most patients showed marked transaminase elevation, high IgG, and positive ANA (74.3%). Liver biopsies (performed in 92% of cases) showed features compatible with AIH. A total of 80% of the 50 cases of our study with available serology and liver histology were classified as probable / definite AIH, according to the simplified AIH score. Corticosteroid therapy was effective in most cases (survival 95.9%). Post-infection AIH cases showed similar features but affected younger individuals (median age 47), with uniformly favorable responses to immunosuppression.
CONCLUSIONS: New-onset AIH can occur following both SARS-CoV-2 infection or vaccination. Although these events remain rare, recognition of this association is essential for timely diagnosis and management.}, }
@article {pmid42417685, year = {2026}, author = {Hovnanian, A and Mondon, G and Titeux, M}, title = {History and future of RNA medicines.}, journal = {The Journal of investigative dermatology}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.jid.2026.05.023}, pmid = {42417685}, issn = {1523-1747}, abstract = {RNA therapeutics are a versatile class of medicines that exploit different types of RNA molecules to prevent or treat a wide spectrum of diseases. Compared with traditional small-molecule drugs, protein drugs, or gene therapies, these therapies offer notable advantages, including faster, less expensive development, and simplified manufacturing. The field encompasses multiple modalities, such as antisense oligonucleotides, small interfering RNAs, microRNAs, mRNAs, and aptamers. The success of mRNA vaccines against SARS-CoV-2 has accelerated research and clinical translation of RNA approaches for conditions with limited treatment options, including chronic wounds, aggressive metastatic melanoma, and autoimmune and genetic skin diseases.}, }
@article {pmid42417944, year = {2026}, author = {Li, Y and Yu, W and Yun, J and Wang, J and Liu, Y and Su, H and Guo, H and Yang, J and Yan, Y and Yan, X and Zhang, S and Yang, H and Wang, Z}, title = {Virus infections and cancers: from mechanisms to therapeutics.}, journal = {Molecular biomedicine}, volume = {7}, number = {1}, pages = {}, pmid = {42417944}, issn = {2662-8651}, support = {202503021211266//The Natural Science Foundation of Shanxi Province/ ; 2021M691995//china postdoctoral foundation committee/ ; }, mesh = {Humans ; *Neoplasms/virology/therapy ; Tumor Microenvironment ; *Oncogenic Viruses/genetics ; *Virus Diseases/therapy/complications/virology ; *Tumor Virus Infections/therapy ; Animals ; }, abstract = {Viral infections are a major contributor to global cancer incidence and mortality. However, integrative reviews that connect viral classification, carcinogenic mechanisms, tumor microenvironment remodeling, and translational strategies remain limited. This review summarizes the classification and epidemiological characteristics of major oncogenic viruses, including human papillomavirus (HPV), Epstein-Barr virus (EBV), hepatitis B virus (HBV), hepatitis C virus (HCV), Merkel cell polyomavirus (MCPyV), human T-lymphotropic virus type 1 (HTLV-1), Kaposi's sarcoma-associated herpesvirus (KSHV), and human immunodeficiency virus (HIV), as well as emerging viruses such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We then discuss the molecular basis of virus-associated carcinogenesis, including viral oncogenes, viral DNA integration, epigenetic remodeling, aberrant host signaling, and metabolic dysregulation. We further examine how chronic inflammation and fibrosis create oncogenic niches within the tumor microenvironment (TME), how viruses promote tumor progression through immune evasion and immune exhaustion, and how infected cells interact with stromal and immune components of the TME. At the preventive and therapeutic levels, we discuss antiviral therapies, vaccines, biomarker-based precision diagnostics, and prognostic strategies, with particular attention to the synergistic potential of emerging therapeutic approaches such as immune checkpoint inhibitors (ICIs), CAR-T therapy, and oncolytic viruses (OVs). Finally, we highlight how multi-omics approaches, single-cell transcriptomics, spatial transcriptomics, organoid models, and artificial intelligence can advance mechanistic studies and translational innovation in virus-associated cancers. Overall, this review provides an integrated framework for understanding, preventing, and treating virus-associated tumorigenesis.}, }
@article {pmid42420694, year = {2026}, author = {Mosa, KA and Khare, T and Syed, F and Sirajudeen, F and Afzal, S and Dairi, Z and Younus, K and Chauhan, V and Kumar, A and Shaaban, AM and Katoch, M}, title = {Plant Biofactories for Vaccination: Progress in Edible Vaccine Technologies as a Sustainable Approach to Global Immunization.}, journal = {Plant foods for human nutrition (Dordrecht, Netherlands)}, volume = {81}, number = {3}, pages = {}, pmid = {42420694}, issn = {1573-9104}, support = {24021450161//Office of the Vice Chancellor for Research and Graduate Studies at the University of Sharjah/ ; }, mesh = {*Vaccines, Edible/immunology ; Humans ; Animals ; Plants, Genetically Modified ; *Vaccination/veterinary/methods ; Vaccine Development ; }, abstract = {Globally, the pathogen-driven enteric diseases remain a leading cause of morbidity and mortality, disproportionately affecting populations in low-income regions. While significant strides have been made in vaccine research, challenges such as high production costs, complex manufacturing processes, and inefficient distribution continue to hinder global vaccine accessibility. To overcome these challenges, plant-based edible vaccines have emerged as a promising and innovative alternative, offering advantages such as affordability, ease of administration, and reduced reliance on cold-chain infrastructure. This study presents a comprehensive overview of recent advances in the development of edible plant-derived vaccines, highlighting the strategic evolution from conventional genetic engineering to more refined and scalable biotechnological methods. In the work, various applications targeting diseases such as measles, hepatitis B, rabies, dengue, and norovirus, are discussed as well as veterinary vaccines for livestock and aquaculture. The significant progress in creating vaccines targeting prevalent human pathogens is examined and the discussion is extended to include edible vaccines developed for livestock, underscoring their role in both public and veterinary health. Furthermore, the review emphasizes the transformative potential of 'omics' technologies, such as genomics, proteomics, and metabolomics, as well as artificial intelligence in streamlining vaccine design, improving antigen expression, and accelerating development timelines. This assessment review was conducted by performing a comprehensive literature survey of peer-reviewed articles. By integrating multidisciplinary insights, the work underscores the feasibility and future prospects of edible plant vaccines as a sustainable solution to global immunization challenges, with practical applications in improving vaccine accessibility, enhancing outbreak preparedness, and supporting immunization efforts in resource-limited settings. It aims to inform and inspire continued research and collaborative innovation in this emerging field with significant implications for global public health.}, }
@article {pmid42420701, year = {2026}, author = {Zeng, Y and Fu, BM and Tarbell, JM}, title = {Endothelial Surface Glycocalyx in Vascular Functions and Diseases.}, journal = {Advances in experimental medicine and biology}, volume = {1512}, number = {}, pages = {1-42}, pmid = {42420701}, issn = {0065-2598}, mesh = {*Glycocalyx/metabolism/ultrastructure/pathology/physiology ; Humans ; *Mechanotransduction, Cellular/physiology ; Animals ; *Endothelium, Vascular/metabolism/pathology ; *Vascular Diseases/metabolism/pathology ; *Endothelial Cells/metabolism/pathology ; }, abstract = {Endothelial cells (ECs), which form the inner lining of the vasculature, are perpetually exposed to mechanical stimuli from blood flow. Their capacity to sense and respond to these forces is essential for vascular homeostasis. A diverse array of mechanosensors operates on the EC surface, within the plasma membrane, and throughout the cytoskeleton. Among these, the endothelial surface glycocalyx (ESG)-uniquely positioned at the blood-endothelium interface and intimately linked to classical mechanosensory complexes-has emerged as a pivotal yet underappreciated regulator. Once viewed merely as a passive barrier, the ESG is now acknowledged as a primary mechanosensor that converts hemodynamic forces into biochemical signals critical for vascular health. This updated chapter from the first edition offers a comprehensive review of the ESG. We begin with its molecular composition, ultrastructural organization, and variable thickness, as elucidated by advanced imaging techniques such as immunolabeling, electron microscopy, and super-resolution microscopy. Next, we examine the ESG's biomechanical properties and its central role in endothelial mechanotransduction and barrier regulation. We then explore its dynamic remodeling in response to physiological and pathological stimuli, with a focus on degradation in major vascular diseases. ESG shedding is not only a hallmark but also a causal driver of pathophysiology in conditions including atherosclerosis, sepsis, diabetes, cancer metastasis, and COVID-19-associated endotheliopathy. Finally, we spotlight emerging diagnostic tools for evaluating ESG integrity and review promising therapeutic strategies to preserve or restore its structure and function.}, }
@article {pmid42421001, year = {2026}, author = {Nila, FH and Villeneuve, M and Chang, KJ and Subramaniam, P}, title = {Service continuity of community-based health and social care organisations in times of disaster and health emergencies: a mapping review.}, journal = {BMC health services research}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12913-026-15001-3}, pmid = {42421001}, issn = {1472-6963}, abstract = {BACKGROUND: The physical and economic impacts of disaster and health emergencies have become a global concern that continues to generate discussion regarding disaster preparedness, response, and mitigation strategies. Maintaining continuity of services during these challenging and dynamic circumstances requires adequate organisational preparedness. This study aimed to map the existing research on the emergency management capabilities of community-based health and social care organisations and identify the factors that impact service continuity as a critical component of business continuity planning.
METHOD: This mapping review was carried out in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Eight databases were searched: Medline, PsycINFO, Embase, CINAHL, Scopus, ProQuest, Web of Science, EBSCOhost. Studies written in English and published between January 2000 and August 2022 were included. Eligible studies were primarily focused on business or service continuity of community-based health and social care organisations. Thematic analysis of data was conducted.
RESULTS: Out of 3,195 articles, 176 met the inclusion criteria, mostly conducted in developed countries. These studies investigated various natural hazard emergencies, disease outbreaks, and pandemics, using different study designs, offering valuable insights into emergency management capabilities of community-based health and social care organisations across the disaster cycle. The findings suggest that several factors can serve as both barriers and enablers to the continuity of care, depending on the context and the specific stage of the disaster cycle at which they are addressed. Limited research was found on organisational preparedness for at-risk clients, including the elderly and individuals with disabilities. Additionally, there is a scarcity of research on the prevention and recovery stages of the emergency management cycle.
CONCLUSION: This mapping review offers a comprehensive overview of the factors influencing service continuity, highlights existing research gaps and targeted recommendation for service providers and governments to inform effective planning that ensures continuity of service and supports for people whose health, safety and well-being can be compromised in emergency situations. Future research could focus on strengthening organisational resilience during the prevention phase, examine tools and approaches for optimising emergency management efforts, and investigate strategies to improve cross-sector collaboration across all stages of disaster management cycle.}, }
@article {pmid42421498, year = {2026}, author = {Carnevali, F and Muollo, MC and Biagini, L and Rossi, G}, title = {Xenosialylation as immunological chimerism: a host-centered unifying model for viral and post-vaccination immune complications.}, journal = {European cytokine network}, volume = {37}, number = {2}, pages = {55-77}, pmid = {42421498}, issn = {1952-4005}, mesh = {Humans ; Glycosylation ; *COVID-19/immunology/prevention & control ; *SARS-CoV-2/immunology ; *Vaccination/adverse effects ; *COVID-19 Vaccines/immunology/adverse effects ; Neuraminic Acids/immunology ; *Models, Immunological ; Animals ; }, abstract = {Severe immune-mediated complications following viral infections and vaccinations, including COVID-19 and anti-SARS-CoV-2 immunization, display remarkable clinical overlap despite occurring in distinct biological contexts. In a previous hypothesis-driven work, we proposed that metabolic incorporation of the non-human sialic acid N-glycolylneuraminic acid (Neu5Gc) into human glycoconjugates-defined as xenosialylation-may contribute to post-infectious and post-vaccination immune dysregulation. We further suggest that this phenomenon may represent a form of "immunological chimerism", in which host glycoconjugates incorporate non-self molecular structures that predispose the immune system to varying degrees of immune imbalance. In its most severe manifestation, this process may culminate in a profound state of immune dysregulation characterized by loss of immune tolerance, aberrant antibody responses, cytokine storm, and thrombo-inflammatory pathology, which we define as "immunological marasmus". In the present paper, we extend this conceptual framework by integrating glycobiology, Fc immunoglobulin glycosylation, endothelial biology, and sex-dependent immune regulation into a unified, testable immunopathogenic model. We hypothesize that interindividual differences in the extent, tissue distribution, and persistence of xenosialylation may influence susceptibility to exaggerated innate and adaptive immune responses following antigenic challenge. In this context, immune activation may unmask pre-existing xeno-sialylated self-structures embedded within host glycans, promoting varying degrees of glycan dysregulation, autoantibody production, immunothrombosis and chronic inflammatory sequelae. We further propose circulating anti-Neu5Gc antibodies as functional biomarkers for risk stratification and outline preventive strategies based on dietary modulation of xenosialic acid exposure. Taken together, this expanded model provides a potential mechanistic framework for understanding the shared immunological features of post-viral syndromes and vaccine-related adverse immune reactions, while offering a basis for experimental validation and future approaches to personalized risk mitigation.}, }
@article {pmid42421939, year = {2026}, author = {Li, E and Shi, M and Huang, S}, title = {New-onset allergic diseases after SARS-CoV-2 infection: mechanistic hypotheses and emerging strategies for risk stratification.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1879430}, pmid = {42421939}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/immunology/complications ; *SARS-CoV-2/immunology ; *Hypersensitivity/immunology/epidemiology ; Animals ; Risk Assessment ; }, abstract = {Multinational cohort studies consistently associate SARS-CoV-2 infection with elevated incidence of allergic diseases, with hazard ratios of 2.25 for asthma and 1.23 for allergic rhinitis persisting beyond six months post-infection; whether this excess risk reflects de novo allergic sensitization or preferential unmasking of pre-existing subclinical atopy remains to be established. Yet mechanisms bridging acute viral illness to delayed allergic phenotypes remain incompletely understood. This review synthesizes recent advances across epithelial biology, immunology, and neuroimmune interactions to propose a unified mechanistic framework organized around three interconnected axes. First, epithelial injury during COVID-19 triggers passive IL-33 release while inducing active TSLP and IL-25 production. These alarmins act through mechanistically distinct pathways to converge on type 2 immune priming, which is established and reinforced by epigenetic memory in group 2 innate lymphoid cells and dendritic cells. Second, regulatory T cell depletion and, hypothetically, hematopoietic stem and progenitor cell epigenetic reprogramming driven by acute interleukin-6 elevation may generate immune cell progeny with persistently altered inflammatory responsiveness, while dendritic cells adopt Th2-polarizing phenotypes that lower the threshold for allergic sensitization; the direct contribution of hematopoietic reprogramming to Th2-skewed allergic outcomes remains to be demonstrated. Third, mast cells undergo direct spike protein-mediated activation via angiotensin-converting enzyme 2 receptors, and alarmin-primed mast cells establish bidirectional crosstalk with sensory neurons that amplifies neuroinflammation and links long COVID symptoms to heightened allergic susceptibility. Together, these axes define a post-infectious vulnerability window during which allergen encounters trigger exaggerated type 2 responses. Risk stratification incorporating disease severity, circulating biomarkers including immunoglobulin E and eosinophil counts, and genetic susceptibility variants may identify individuals requiring targeted surveillance, while mechanistically informed interventions such as low-dose interleukin-2, mast cell stabilizers, and alarmin-targeted biologics warrant prospective evaluation in convalescent cohorts.}, }
@article {pmid42421948, year = {2026}, author = {Liu, A and Chen, H and Liu, Q and Al-Azab, M and Shaher, F and Li, J and Liu, T and Yang, M}, title = {Cardiovascular sequelae of Long COVID: immune dysregulation inflammation as central drivers.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1815269}, pmid = {42421948}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/immunology/complications ; Post-Acute COVID-19 Syndrome ; *Cardiovascular Diseases/immunology/etiology ; *Inflammation/immunology ; Immunity, Innate ; *SARS-CoV-2/immunology ; Animals ; Adaptive Immunity ; }, abstract = {Long coronavirus disease 2019 (Long COVID-19), also referred to as post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, has emerged as a major global health challenge. Common manifestations include fatigue, dyspnea, cognitive dysfunction, and exercise intolerance. Beyond these systemic manifestations, the enduring cardiovascular manifestations are increasingly identified as core characteristics of Long COVID-19 syndromes secondary to SARS-CoV-2 infection, encompassing myocarditis, ischemic and non-ischemic heart disease, arrhythmias, heart failure, and thrombotic events. Accumulating evidence suggests that immune dysregulation and persistent inflammation are central drivers of cardiovascular injury in Long COVID. Persistent activation of innate and adaptive immune pathways fosters endothelial injury, thrombo-inflammation, and adverse myocardial remodeling. In this review, we focus on current clinical and experimental evidence to delineate the immune-mediated mechanisms underlying cardiovascular sequelae in Long COVID and explore potential therapeutic strategies targeting persistent inflammation and immune dysregulation.}, }
@article {pmid42421959, year = {2026}, author = {Bansal, A}, title = {Proteomic landscapes of post-COVID condition: biomarkers and translational pathways.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1783192}, pmid = {42421959}, issn = {1664-3224}, mesh = {Humans ; *Biomarkers/blood/metabolism ; *Proteomics/methods ; *COVID-19/complications/immunology/metabolism ; Post-Acute COVID-19 Syndrome ; *SARS-CoV-2 ; }, abstract = {Post-COVID condition is a heterogeneous, multi-system sequela of SARS-CoV-2 infection that imposes substantial socioeconomic burden and currently needs validated diagnostic biomarkers or established therapeutic pathways. This brief communication synthesises blood-based proteomic and targeted biomarker evidence and organises it into three overlapping pathophysiological domains: persistent immune dysregulation (IL-6, IL-20, MCP-1 and TNF- α), endothelial dysfunction and disordered haemostasis (VEGF-A, P-selectin, vWF, ICAM-1 and D-dimer); and neurological injury (NFL, GFAP, NAAA, LXN, NBL1, HAGH). Across studies, no single protein provides adequate diagnostic performance; phenotype-linked multi-analyte panels show the greatest promise. Researching post-COVID conditions requires harmonised case definitions, cross-platform validation, and the integration of coagulation assays and extracellular vesicle profiling to improve tissue signal detection.}, }
@article {pmid42421968, year = {2026}, author = {Ramesh, RP and Premraj, A and Yasmin, H and Alkaabi, H and Dodan, S and Almahri, M and Alameri, N and Alyaarbi, YY and Mohteshamuddin, K and Al Aiyan, A and George, AJT and Conca, W and Kishore, U}, title = {Delving into the innate and adaptive immunity of camelids: a paradigm of interspecies adaptation and evolutionary innovation.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1833289}, pmid = {42421968}, issn = {1664-3224}, mesh = {Animals ; *Immunity, Innate ; *Adaptive Immunity ; *Camelidae/immunology/genetics ; *Biological Evolution ; Humans ; *Adaptation, Physiological/immunology ; Camelus/immunology ; }, abstract = {Camelids have evolved to survive some of the most challenging climatic conditions on our planet and are resilient to physiological stress such as temperature extremes, drought, storms, intense ultraviolet radiation, dehydration, and starvation. They exhibit remarkable resistance to several diseases that severely affect other livestock including tetanus, foot-and-mouth disease, and bovine spongiform encephalopathy. The robust nature of the camelid immune system, which maintains functionality under extreme conditions, is remarkable. The special features of the camelid immune system include differences (when compared to ruminants) in the distribution and anatomy of their lymphoid organs. The innate immune system merits further investigation, though potent antimicrobial peptides have been identified in camelid milk. It is in the adaptive immune response that the most distinctive aspects of the camelid immune system are seen, especially, the presence of heavy chain-only antibodies, somatic hypermutation of T cell receptors; in the dromedary, a significant number of γδ T cells. In this review, the interplay between innate and adaptive immunity in camelids is examined, highlighting their functions in systemic and mucosal immune defense. An understanding of these adaptations is important for the development of innovative biomedical applications, such as nanobody-based diagnostics and therapeutics. In addition, dromedary camels are the main likely animal reservoir for the Middle East Respiratory Syndrome Coronavirus (MERS-CoV), an emerging zoonotic pathogen with potential for large-scale human spillover. Finally, as climate change is likely to result in increased environmental stress worldwide, a comparison of how the immune system in different species has adapted to their environment will be important.}, }
@article {pmid42422050, year = {2026}, author = {Ha, KM}, title = {A post-PHEIC review of cultural awareness in the COVID-19 response.}, journal = {Public health reviews}, volume = {47}, number = {}, pages = {1608243}, pmid = {42422050}, issn = {0301-0422}, abstract = {OBJECTIVES: The PHEIC status of COVID-19 was officially lifted by the WHO on May 5, 2023. However, many nations continue to grapple with its impacts, particularly those that have not fully embraced the emergency culture. This study aims to explore ways to enhance emergency culture that rose during the COVID-19 response, ultimately contributing to effective pandemic management.
METHODS: A systematic literature review, including the PRISMA 2020 flow diagram and checklist, was used to compare cultural unawareness with cultural awareness across six nations: Japan, Sweden, South Africa, the United States, Brazil, and Australia.
RESULTS: To varying degrees, all six nations exhibited cultural unawareness during their COVID-19 responses, which manifested in issues such as personal responsibilities, herd immunity, inequalities, individualism, economic priorities, language barriers, and other factors.
CONCLUSION: These six nations must adaptively transform their cultural unawareness into cultural awareness while enhancing leadership, communication, cultural competence, emergency preparedness, and international cooperation. This study offers a comprehensive perspective on the emergency culture surrounding the coronavirus pandemic, emphasizing the critical importance of cultural awareness.}, }
@article {pmid42422161, year = {2026}, author = {Santis, B and Baldo, F and Vento, G and Nobile, S}, title = {Impact of COVID-19 on Subsequent Lung Function in Childhood: A Systematized Review.}, journal = {Health science reports}, volume = {9}, number = {7}, pages = {e72793}, pmid = {42422161}, issn = {2398-8835}, abstract = {BACKGROUND AND AIMS: The SARS-CoV-2 infection can lead to transiently altered lung function in adults, but data is less clear in children. We aimed to summarize the available evidence about respiratory outcomes after COVID-19 in childhood.
METHODS: We conducted a literature search on post-COVID-19 lung function tests (LFT) on the Medline and Cochrane databases, including studies published between 2019 and 2025.
RESULTS: Three hundred forty-seven publications were identified, and 20 were selected. Results are presented in two sections, based on the duration of follow-up. Most studies included spirometry, whereas many of them presented data from diffusing lung capacity for carbon monoxide, multiple breath nitrogen washout, fractional exhaled nitric oxide, impulse oscillometry, 6-minute walking test, and interrupter resistance. Five papers described no association between COVID-19 and respiratory outcomes, nor a link between the persistence of symptoms and the outcomes. Other authors reported a mild obstructive pattern which showed reversibility post bronchodilators, or a restrictive pattern, particularly when long-COVID was evident. Some papers showed that pulmonary function may be influenced by the initial severity of the SARS-CoV-2 infection.
CONCLUSION: Some studies reported no clear association between lung function impairment and previous history of COVID-19. Other authors reported mild, transient consequences. A small number of papers concluded that severe infection, which is relatively rare in children, might affect pulmonary function. The main limitation of this review was the high heterogeneity of the included studies, especially regarding the COVID-19 severity, the age groups, the LFT details, and the duration of follow-up.}, }
@article {pmid42422237, year = {2026}, author = {Garzón-Duque, MO and Rodriguez-Ospina, FL and Tobón, ST and Vasquez-Trespalacios, EM and Naranjo, VM}, title = {Food insecurity, habits, and working conditions in subsistence workers during COVID-19 isolation, Medellin, Colombia, 2021.}, journal = {Revista brasileira de medicina do trabalho : publicacao oficial da Associacao Nacional de Medicina do Trabalho-ANAMT}, volume = {24}, number = {}, pages = {e20261279}, pmid = {42422237}, issn = {1679-4435}, abstract = {INTRODUCTION: Mandatory isolation and quarantine measures implemented between 2020 and 2021 had important repercussions on labor dynamics.
OBJECTIVES: To identify the characteristics of COVID-19 isolation, as well as the habits and working conditions that characterize food insecurity in subsistence workers in Medellin, Colombia, in 2021.
METHODS: Cross-sectional study using primary data sources. An interviewer-administered survey was conducted among 656 workers selected through snowball sampling.
RESULTS: Overall, 56.4% were men and 74.7% were aged ≥45 years. Furthermore, 89.9% of women were the primary household income provider, and 74.8% did not have a partner. Alcohol and tobacco use were more frequent among men, and 43.0% of women consumed two meals a day. Furthermore, 95.6% of participants underwent mandatory quarantine; 73.2% remained isolated > 12 weeks; and 77.0% received support during isolation. The prevalence of moderate/severe food insecurity was 44.1%, increasing to 51.4% among women. Conditions characterizing food insecurity included being female, consuming one meal a day, not having a partner, being the primary household income provider, lacking work permit, not receiving government food assistance, making payment arrangements with landlords, and receiving food assistance from a university.
CONCLUSIONS: Although food insecurity decreased by 10 percentage points, the conditions characterizing it reveal the subsistence circumstances experienced by workers, particularly women, whose social and occupational disadvantage deepened.}, }
@article {pmid42424026, year = {2026}, author = {Kianfar, E}, title = {Vitamins impacting mental/physical well-being during viral pandemics: a mechanistic review based on COVID-19: a comprehensive review.}, journal = {Inflammopharmacology}, volume = {}, number = {}, pages = {}, pmid = {42424026}, issn = {1568-5608}, abstract = {The emergence of novel strains of SARS-CoV-2 highlights the pressing need to investigate various strategies for enhancing pandemic resilience. Even though tried-and-true methods like social separation, masks, and vaccinations have proven effective, issues with immunizations make finding a global answer more complex. This paper underscores the pivotal connection between immunological resilience and vitamins, shedding light on the compromised immune response resulting from undernourishment. Vitamins become essential for protecting the body from viral invasion, particularly from SARS-CoV-2. Crucial roles in cellular activities are played by vitamin A, which is necessary for vision, and the B-vitamin complex, which supports energy synthesis and nerve function. In the context of viral infections, the significance of vitamin D, crucial for both immune system function and bone health, along with vitamin C and its ability to combat free radicals, becomes paramount.This research aims to to elucidate the specific effects and mechanisms by which essential vitamins (A, B, C, D, and E) contribute to the mitigation of COVID-19. By investigating the distinct roles of vitamins within the framework of the pandemic, this research seeks to clarify the potential benefits that these micronutrients may offer in mitigating the severity of COVID-19 and bolstering immune responses to combat viral infectons.}, }
@article {pmid42424341, year = {2026}, author = {Ruan, B and Tian, J and Wang, X and Su, D}, title = {The Association Between eHealth Literacy and Health Behaviors During and Since the COVID-19 Pandemic: Systematic Review and Meta-Analysis.}, journal = {Journal of medical Internet research}, volume = {28}, number = {}, pages = {e94233}, pmid = {42424341}, issn = {1438-8871}, mesh = {*COVID-19/epidemiology ; Humans ; *Health Behavior ; *Health Literacy ; Digital Health ; *Pandemics ; SARS-CoV-2 ; *Telemedicine ; }, abstract = {BACKGROUND: Since COVID-19, health information seeking, service navigation, and routine care have become increasingly digitally mediated. It remains unclear whether the association between eHealth literacy and health behaviors is consistent across behavioral domains, populations, and analytic frameworks.
OBJECTIVE: This systematic review and meta-analysis synthesized COVID-19 and post-COVID-19 evidence on the association between eHealth literacy and health behaviors and examined variation across study contexts.
METHODS: We conducted a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020-compliant, PROSPERO-registered review (CRD420251009048). PubMed, Embase, Web of Science Core Collection, CINAHL Ultimate, and Scopus were searched from January 1, 2020, through March 27, 2026. Eligible observational studies assessed eHealth literacy and reported analyzable associations with health behavior outcomes collected in 2020 or later. Health behaviors were classified as health decision-making, health-promoting, or health management behaviors. Correlation coefficients, grouped odds ratios (ORs), and continuous ORs were synthesized separately using random-effects models with Knapp-Hartung adjustment. Certainty was assessed using the Grading of Recommendations Assessment, Development, and Evaluation framework.
RESULTS: In total, 19 studies were included: 10 contributed correlation coefficients, 6 grouped ORs, and 3 continuous ORs. In the correlation-based synthesis, higher eHealth literacy was associated with more favorable health behaviors (pooled r=0.43, 95% CI 0.36-0.51; 95% prediction interval 0.22-0.61), with substantial heterogeneity (I2=80.50%). In the grouped OR synthesis, higher eHealth literacy was also associated with more favorable health behaviors (pooled OR 2.12, 95% CI 1.47-3.05; 95% prediction interval 1.11-4.06), with moderate heterogeneity (I2=46.33%). In the continuous OR synthesis, all 3 studies showed positive associations, but the pooled effect was not statistically significant (pooled OR 1.07, 95% CI 0.89-1.30; 95% prediction interval 0.84-1.37), with very high heterogeneity (I2=97.98%). Subgroup analyses showed a significant difference only by geriatric status in the grouped OR synthesis. Certainty was low for the grouped OR synthesis and very low for the other 2 syntheses.
CONCLUSIONS: Higher eHealth literacy was generally associated with more favorable health behaviors in the correlation-based and grouped OR syntheses, whereas evidence from the continuous OR synthesis was inconclusive. Given the predominantly cross-sectional evidence base, heterogeneity, risk-of-bias concerns, and low to very low certainty, the association should be interpreted as contextual and associative rather than causal or uniform. This review is innovative in synthesizing COVID-19 and post-COVID-19 evidence, applying a functional classification of health behaviors, and analyzing distinct effect measures separately. Unlike previous reviews that summarized the association more broadly, it avoids a single mixed pooled effect and provides a cautious, context-specific interpretation. In practice, interventions should pair eHealth literacy improvement with trustworthy digital services, clinician support, and behavior-specific conditions that help translate digital information into sustained health-related action.}, }
@article {pmid42424858, year = {2026}, author = {Etemadifar, M and Salari, M and Rezaei, K and Hojjatipour, F}, title = {Multiple sclerosis during an emergency or crisis: A narrative review focused on the effect of war and COVID-19 pandemic.}, journal = {Multiple sclerosis and related disorders}, volume = {113}, number = {}, pages = {107361}, doi = {10.1016/j.msard.2026.107361}, pmid = {42424858}, issn = {2211-0356}, abstract = {BACKGROUND: Armed conflict fractures the systems that multiple sclerosis (MS) care depends on, yet MS-specific guidance for war is scarce. The aim of this study is to synthesize evidence on MS care during armed conflict and other crises, and to develop practical, crisis-ready recommendations to maintain treatment continuity, reduce inequities, and guide clinicians and policymakers.
METHODS: We reviewed peer-reviewed literature (2000-2025) on MS during conflicts; when MS-war data were scarce, we utilized transferable evidence from COVID-19 MS studies.
RESULTS AND CONCLUSION: War disrupts disease-modifying therapies (DMT) supply, safety monitoring, rehabilitation, and continuity of care, widening inequities. A key controversy was whether to continue higher-risk DMTs with limited labs/MRI, and which monitoring to prioritize. Our recommendations established a five-action basis: create a single MS crisis hub (information, tele-access, patient passports), safeguard DMTs with lean pharmacovigilance and predefined substitutions, adopt tele-first care with a relapse pathway favoring high-dose oral steroids when appropriate, deliver equity-first outreach via mobile clinics and transport/fee support, and run a minimal data loop (stock, relapses, severe adverse events, hospitalizations, brief fatigue screening) for weekly course correction. Additionally, the basis of recommendations was transformed into a three-stage guideline figure.}, }
@article {pmid42424887, year = {2026}, author = {Hayes, JE and Hayes, SA and Wilkins, D and Lindley, MR and Stuetz, RM}, title = {Olfaction as a diagnostic instrument - a review of current, and future medical applications.}, journal = {Talanta}, volume = {311}, number = {}, pages = {130256}, doi = {10.1016/j.talanta.2026.130256}, pmid = {42424887}, issn = {1873-3573}, abstract = {The olfactory sense has evolved to provide environmental and physiological cues through the detection of volatile organic compounds. While historically a clinician's sense of smell was used to assist in diagnosing illness, with some notable exceptions, this has fallen out of favour with the advent of analytical tools. Recently, world events have shown that olfactory methodologies can be highly useful for diagnostic purposes. The emergence of the SARS-CoV-2 virus (causing COVID-19) presented a number of logistical issues with regards to establishing fast and accurate diagnosis-while the idea of detection dogs was proposed at the time, little in the way of routine clinical application was accomplished for this disease. The reasons for this are multifactored, but the use of olfaction as a diagnostic tool can be efficacious, provided appropriate methodological considerations are met. Here, the use of olfaction within a medical diagnostic framework is discussed; with olfactory diagnosis having the potential of very high sensitivity and specificity, but with a low diagnostic cost in terms of expense, time, and patient discomfort. This review will also discuss the ways in which olfactory medical diagnosis can be accomplished using humans, dogs, as well as other animals. Finally, this paper will outline recommendations of how future olfactory diagnostic options can be researched and implemented to ensure best practice.}, }
@article {pmid42425738, year = {2026}, author = {Lac, J and Han, S and Ahmad, M and Starey, H and Ganguly, S and Tett, M and Adeyemi, O and Bray, JJH and Ahmad, MT and Providência, R}, title = {Low-dose corticosteroids in severe pulmonary infection: a meta-analysis of randomised controlled trials.}, journal = {BMJ open respiratory research}, volume = {13}, number = {1}, pages = {}, pmid = {42425738}, issn = {2052-4439}, mesh = {Humans ; Randomized Controlled Trials as Topic ; *Adrenal Cortex Hormones/administration & dosage ; Length of Stay/statistics & numerical data ; Community-Acquired Pneumonia/drug therapy/mortality ; Intensive Care Units ; Respiratory Distress Syndrome/drug therapy/mortality ; COVID-19/mortality ; COVID-19 Drug Treatment ; Pneumonia, Pneumocystis/drug therapy/mortality ; Community-Acquired Infections/drug therapy/mortality ; SARS-CoV-2 ; Sepsis/drug therapy/mortality ; }, abstract = {PURPOSE: Pulmonary infections are one of the leading causes of intensive care unit (ICU) admission and contribute to high mortality rates. This paper aimed to determine the effect of low-dose corticosteroids on outcomes in patients with severe pulmonary infections, including coronavirus disease of 2019, community-acquired pneumonia (CAP), pneumocystis pneumonia, sepsis, septic shock, and acute respiratory distress syndrome.
METHODS: We systematically reviewed randomised controlled trials (RCTs) comparing low-dose corticosteroids (≤400 mg hydrocortisone-equivalent daily) to placebo or standard care in adults with severe pulmonary infections. The primary outcome was short-term mortality (≤90 days). Secondary outcomes included 28-day mortality, 30-day mortality, number of patients with at least one serious adverse event, length of hospital stay and ICU stay.
RESULTS: We analysed twelve RCTs including 4622 patients and 1203 events. The pooled OR showed a short-term mortality benefit: 0.83 (95% CI 0.70 to 0.98; p=0.029; I²=2.0%; number needed to treat: 37.84; Grading of Recommendations Assessment, Development and Evaluation (GRADE): low certainty). There was a reduction in length of ICU stay in patients with CAP, with a pooled mean difference of -0.78 days (95% CI -1.46 to -0.10, p=0.025). The use of corticosteroids did not significantly affect the length of hospital stay or severe adverse events. A significant difference remained in longer courses of steroids, whereas shorter courses had no significant difference (≤7 days vs >7 days; OR: 0.69; 95% CI 0.53 to 0.89; p=0.039 vs OR: 0.96; 95% CI 0.813 to 1.14; p=0.67; subgroup differences: p=0.03). Subgroup analyses in patients with CAP showed a significant benefit in short-term mortality (OR: 0.72, 95% CI 0.54 to 0.98; p=0.034; number needed to treat: 28.10).
CONCLUSION: We found that low-dose corticosteroids significantly reduce 90-day mortality in severe CAP, although evidence for their benefit in other severe pulmonary infections and at shorter follow-up intervals remains inconclusive.
PROSPERO REGISTRATION NUMBER: CRD42024627881.}, }
@article {pmid42427146, year = {2026}, author = {Ghosh, AK and Overgaard, JD and Abubeker, I and Rice, EM and Larson, AM and Pagel, EM and Hurt, RT and Gilman, EA}, title = {Consultative General Internal Medicine for Complex Care: The Model, Outcomes, and Lessons Learned.}, journal = {The Permanente journal}, volume = {}, number = {}, pages = {1-7}, doi = {10.7812/TPP/25.212}, pmid = {42427146}, issn = {1552-5775}, abstract = {As the landscape of modern medicine evolves, new health care delivery models are needed to meet the growing complexity of medical care. Primary care clinicians are increasingly managing patients with multiple chronic conditions, a challenge that will intensify as the population ages. Complex medical care involves multiple factors that contribute to difficulties in providing optimal quality of care for patients facing these types of medical problems. To address this need, models of consultative general internal medicine have emerged at various tertiary care institutions across the United States to synthesize prior evaluations, recommend appropriate testing and specialty consultations, and integrate findings into a cohesive care plan for implementation by patients' local care teams. Variability in expertise, patient volume, and structure exists across institutions, but the expansion of multidisciplinary care capabilities during the COVID-19 pandemic has created new opportunities for destination-type practices. This narrative review explores how consultative medicine will be crucial to providing integrative, patient-centric care by enhancing diagnostic accuracy, coordinating multidisciplinary input, and communicating actionable care plans to patients.}, }
@article {pmid42428921, year = {2026}, author = {Kassymbek, S and Abduldayeva, A and Safonov, N}, title = {Global prevalence of post-COVID-19 condition (Long COVID): a systematic review and meta-analysis of observational studies.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1839646}, pmid = {42428921}, issn = {2296-2565}, mesh = {Humans ; *COVID-19/epidemiology/complications ; Prevalence ; Post-Acute COVID-19 Syndrome ; Observational Studies as Topic ; *Global Health/statistics & numerical data ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Long COVID is an umbrella term for persistent, relapsing, or newly developed health problems after SARS-CoV-2 infection, whereas post-COVID-19 condition (PCC) refers more specifically to the World Health Organization clinical case definition. Reported prevalence varies substantially because of differences in terminology, operational definitions, study populations, follow-up duration, hospitalization status, and symptom ascertainment. This systematic review and meta-analysis synthesized global observational evidence on Long COVID/PCC prevalence and examined major sources of variability.
METHODS: A systematic review and meta-analysis was conducted according to PRISMA 2020 principles. PubMed/MEDLINE, Scopus, Web of Science, and the WHO COVID-19 Global Literature Database were searched for studies published from 1 January 2020 to 23 February 2026. Observational studies were eligible if they included individuals with confirmed or probable SARS-CoV-2 infection, reported Long COVID/PCC or persistent post-COVID symptoms at least 4 weeks after acute infection, and provided numerator and denominator data. Terminology and operational case definitions were extracted separately. Prevalence estimates were pooled using a random-effects model with logit transformation and back-transformation. Heterogeneity was assessed using Cochran's Q, I[2], tau[2], and prediction intervals. Subgroup and sensitivity analyses were performed.
RESULTS: Twenty-two studies contributing 27 prevalence estimates and more than 200,000 participants were included. The primary estimate-level pooled prevalence was 30.8% (95% CI 26.8-35.0). Heterogeneity was extreme: Q = 8031.9, df = 26, p < 0.001; I[2] = 99.7%; tau[2] = 0.252 on the logit scale. The prediction interval was 14.0-54.8%. Pooled prevalence was higher among hospitalized cohorts (37.9%, 95% CI 29.5-47.1) than among non-hospitalized, community-based, or mixed cohorts (26.2%, 95% CI 22.0-30.9). WHO-defined PCC yielded lower prevalence (22.8%, 95% CI 14.3-34.4) than broader symptom-based definitions (39.7%, 95% CI 30.5-49.5). Cohort-level sensitivity analysis yielded a similar prevalence of 31.0% (95% CI 26.8-35.4).
CONCLUSION: Long COVID/PCC represents a substantial post-acute public health burden. However, because heterogeneity was extreme, the pooled prevalence should be interpreted as a descriptive summary of heterogeneous observational evidence rather than as a single precise global rate. Standardized definitions, harmonized surveillance, transparent reporting, rehabilitation pathways, and multidisciplinary care models are needed.}, }
@article {pmid42430764, year = {2026}, author = {Hasenpusch, C and Kuper, P and Skiba, EM and Sprenger, AA and Matterne, U and Kannengießer, L and Grätsch, EI and Shin, J and Li, M and Apfelbacher, CJ}, title = {Interventions to Enhance COVID-19 Pandemic Health Literacy in Health Professionals: Systematic Review.}, journal = {JMIR medical education}, volume = {12}, number = {}, pages = {e70400}, pmid = {42430764}, issn = {2369-3762}, mesh = {Humans ; *COVID-19/epidemiology/prevention & control ; *Health Literacy/methods ; *Health Personnel/education ; Pandemics ; SARS-CoV-2 ; }, abstract = {BACKGROUND: The COVID-19 pandemic has placed a significant burden on health professionals (HPs). They face higher infection risks due to the nature of their work environment and patient care responsibilities. Their ability to access and apply reliable COVID-19 information affects their own preventive behavior and that of those around them. In this context, health literacy (HL) has become increasingly important. Despite extensive research, information to foster COVID-19-related HL in HPs remains limited.
OBJECTIVE: This systematic review aimed to identify, appraise, and synthesize intervention studies on the effectiveness of COVID-19-related HL interventions in HPs.
METHODS: Five electronic databases (eg, PubMed (MEDLINE), Embase), six clinical trials registries (eg, ISRCTN registry), one preprint server (MEDRXIV), published conference proceedings, and five gray literature databases (eg, opengrey.eu, ProQuest) were searched in May 2022 and updated in August 2025. Reference lists of included studies were screened manually. Two reviewers independently screened titles, abstracts, and full-texts according to eligibility criteria and extracted data; disagreements were resolved by discussion or consultation with a third reviewer. We included randomized controlled trials (RCTs), nonrandomized studies of interventions, and uncontrolled before-and-after studies evaluating the effectiveness of any COVID-19-related HL intervention. Primary outcomes include COVID-19-related HL, its four facets (access, understand, appraise, and apply COVID-19 information), and indicators (eg, COVID-19-related knowledge), assessed at postintervention and follow-up. When studies were sufficiently similar, random-effects meta-analyses were performed; otherwise, a narrative synthesis was provided. Risk of bias was assessed using validated tools based on study design, and the overall certainty of the evidence was evaluated by the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach.
RESULTS: We included 15 RCTs (2034 participants), 4 nonrandomized studies of interventions (291 participants), 74 uncontrolled before-and-after studies (327,298 participants), 5 ongoing studies, and 1 study with awaiting classification. Interventions targeted a broad range of health occupational groups. Intervention type, delivery mode, methods, settings, and comparator varied widely. No outcome measure explicitly referred to an HL model. Most studies aimed to enhance COVID-19-related knowledge and skills, and had a high risk of bias. COVID-19-related interventions may increase knowledge of vaccines (standardized mean difference 1.00; 95% CI 0.33 to 1.67, I2=24%), and the infection prevention control skills, such as donning and doffing of personal protective equipment (standardized mean difference 1.95; 95% CI 1.82 to 3.09, I2=46%), but the evidence remains very uncertain.
CONCLUSIONS: COVID-19-related HL interventions may promote HP's short-term competencies in infection control. However, the evidence remains uncertain, primarily due to the low quality of studies, characterized by a high risk of bias. Interventions specifically designed to enhance the full COVID-19 HL operationalized by its four facets are lacking. High-quality RCTs with sufficient statistical power, grounded in HL theoretical principles, are needed to achieve precise understanding.}, }
@article {pmid42430872, year = {2026}, author = {Hensley, AA and Jiles, KA and Edwards, S and Clinchard, C and Hosig, K}, title = {Characteristics of successful and unsuccessful strategies to increase vaccine intention and improve vaccine uptake for U.S. adult populations in the Affordable Care Act era (2010-2025): a systematic review and meta-regression.}, journal = {Vaccine}, volume = {88}, number = {}, pages = {128910}, doi = {10.1016/j.vaccine.2026.128910}, pmid = {42430872}, issn = {1873-2518}, abstract = {BACKGROUND: Vaccine-preventable diseases continue to burden U.S. population health. Despite the Affordable Care Act (ACA) eliminating cost-sharing for recommended vaccines in 2010, adult vaccination rates persistently fall below Healthy People 2030 targets, signaling that access alone is insufficient.
OBJECTIVES: To synthesize peer-reviewed literature (2010-2025) on interventions designed to increase vaccine intention or uptake among U.S. adults; characterize strategies, populations, settings, and study quality; and identify predictors of vaccine uptake rate.
METHODS: Following PRISMA 2020 guidelines, a multi-database search was conducted across PubMed, Web of Science, Ovid/MEDLINE, and EBSCOhost, with a final updated search in December 2025. Dual independent reviewers screened studies in two stages. Quality was assessed using the EPHPP tool and certainty evaluated using GRADE. Strategies were categorized per the WHO Behavioral and Social Drivers of Vaccination (BeSD) Model. A meta-regression was conducted on 79 studies, with narrative synthesis across all 92 included studies.
RESULTS: Of 11,219 records, 92 studies were included. Study designs were predominantly RCTs; Influenza and COVID-19 vaccines were most commonly studied. In the meta-regression (adjusted R[2] = 0.229), prioritizing a specific population (b=0.121, p=.027), using service quality improvement strategies (b=0.226, p=.040), and recruiting through community-based partner organizations (b=0.585, p=.005) or healthcare organizations (b=0.230, p=.040) were associated with significantly higher vaccine uptake rates. Onsite vaccination was associated with lower uptake rates (b=-0.185, p=.033), an effect confirmed as specific to the COVID-19 pandemic emergency-response context rather than a generalizable effect of the strategy in sensitivity analysis. Narrative synthesis identified message framing and educational campaigns as the most frequently deployed strategies, with multi-component designs and community partnerships showing the most favorable outcomes.
CONCLUSIONS: Effective adult vaccination strategies were multifactorial. Service quality improvement, priority population focus, and community-based recruitment were the strongest predictors of higher uptake. Findings support the WHO BeSD model's Practical Issues domain: reducing friction outperformed persuasion alone. GRADE certainty remained LOW to MODERATE, emphasizing the need for higher-quality, equity-focused research.
REGISTRATION: This systematic review was registered at Open Science Framework: 10.17605/OSF.IO/SM7YD.}, }
@article {pmid42432642, year = {2026}, author = {Jöud, AS and Thorén, H and Spreco, A and Lundh, T and Timpka, T and Gerlee, P}, title = {Computational forecasting using Swedish data in the vaccination phase of the COVID-19 pandemic: a systematic literature review deliberating modelling relevance for public health and healthcare.}, journal = {BMC health services research}, volume = {26}, number = {1}, pages = {}, pmid = {42432642}, issn = {1472-6963}, mesh = {Sweden/epidemiology ; Humans ; *COVID-19/prevention & control/epidemiology ; Forecasting/methods ; *Public Health ; *Vaccination ; *COVID-19 Vaccines ; Pandemics ; SARS-CoV-2 ; }, abstract = {BACKGROUND: The benefits of computational forecasting in the later phase of the COVID-19 pandemic when vaccines and clinical pharmaceutical interventions were available have seldom been assessed. We aimed to evaluate computational forecasting research applied to Swedish populations in the vaccination phase of the pandemic.
METHODS: A systematic search was performed on March 8, 2024 in the electronic databases PubMed, Scopus, Cochrane library, Embase, Love platform and Epistemikos. An updated version of the Risk of bias Opinion Tool (ROBOT) was used to assess the quality of evidence reported in the papers identified in the search. The articles fulfilling the quality criteria were assessed for suitability for meta-analysis. Data were extracted from the selected articles for synthesis of characteristics, and a thematic analysis was used for a qualitative synthesis of the contents.
RESULTS: Of 2034 unique publications identified in the database search, 6 articles satisfied the selection and quality criteria. Variability in the reporting of forecasting performance results was found to make a quantitative meta-analysis of forecast performance infeasible. The data synthesis showed that statistical modeling using Bayesian calibration was the most common methodological approach. No external model validation was reported, but 5/6 articles included internal model corroboration data. The primary theme resulting from the qualitative synthesis of article content was design or refinement of computational models with demonstration of model use in health service practice as a secondary theme. None of the articles referred to health service policymaking as the primary research context.
CONCLUSION: Computational forecasting research using Swedish population data from the vaccination phase of the COVID-19 pandemic was deployed in a model design context. While methodological knowledge was developed, most of the research was not initiated to solve the public health and healthcare problems at hand. Our results indicate that the alignment between computational forecasting research and policymaking needs in the vaccination phase of pandemics can be enhanced.}, }
@article {pmid42432680, year = {2026}, author = {Sasso, EM and Eaton-Fitch, N and Thapaliya, K and Marshall-Gradisnik, S}, title = {Neurological impairment in long COVID: implications for neurodegenerative disease.}, journal = {Journal of translational medicine}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12967-026-08607-y}, pmid = {42432680}, issn = {1479-5876}, support = {489798//Stafford Fox Medical Research Foundation/ ; 1199502//National Health and Medical Research Council/ ; 47107//Mason Foundation/ ; 49979//McCusker Charitable Foundation/ ; 4676//Ian and Talei Stewart, the Buxton Foundation/ ; 4579//Blake Beckett Trust Foundation/ ; 4570//Alison Hunter Memorial Foundation/ ; 4575//Change for ME Charity/ ; Dr John Hamwood//Dr John Hamwood/ ; 4879//Henty Community/ ; }, abstract = {BACKGROUND: It has been six years since the COVID-19 pandemic and, despite substantial advances in management, the disease sequelae known as long COVID continues to represent a significant medical and societal burden. Long COVID is characterised by persistent neurological and neurocognitive symptoms, including brain fog, memory deficits, attention impairments, and fatigue, lasting for months after acute SARS-CoV-2 infection.
MAIN BODY: In this review, we collated emerging neurological findings related to long COVID, discussing neurodegenerative processes associated with long COVID, potential clinical implications and research limitations. Neurological and neurocognitive manifestations arise through multiple mechanisms, including direct SARS-CoV-2 invasion of the central nervous system and peripheral lymphocyte infiltration. Additionally, neurovascular damage potentially contributes to neurodegeneration through neuronal injury, impaired neurogenesis, microvascular abnormality and sustained neuroinflammation.
CONCLUSION: Understanding the mechanisms underlying neurological and neurocognitive symptoms is essential for developing long-term monitoring strategies and targeted interventions to mitigate neurocognitive decline in individuals with long COVID.}, }
@article {pmid42433760, year = {2026}, author = {Magsi, IA and Advani, A and Alokozay, E and Qutub, Z and Hamid, M and Kharka, M and Kunwar, R and Ahsan, S and Msheik, A and Waqas, SA and Hassan, A and Waseem, N and Patel, T and Ahmed, R and Hemida, MF}, title = {Trends and disparities in HIV before and after COVID-19 from 1999 to 2023.}, journal = {Annals of medicine and surgery (2012)}, volume = {88}, number = {7}, pages = {4306-4313}, pmid = {42433760}, issn = {2049-0801}, abstract = {Despite advances in human immunodeficiency virus (HIV) treatment, disparities in HIV-related mortality persist across demographic groups in the United States. The COVID-19 pandemic disrupted healthcare systems and may have influenced established mortality trends. This study evaluates HIV-related mortality in the U.S. from 1999 to 2023, with emphasis on changes following the onset of COVID-19. Data were obtained from the CDC WONDER database, identifying HIV-related deaths (ICD-10: B20-B24) among adults aged 25 to 85+. Age-adjusted mortality rates (AAMR) per 100 000 were calculated. Trends were analyzed using Joinpoint regression to estimate annual percent changes (APCs) and average annual percent changes (AAPCs). From 1999 to 2023, there were 271 932 HIV-related deaths in the U.S. The overall AAMR declined by an AAPC of -4.34%, with a slower post-COVID decline of -4.19% (P < 0.05) from 2020 to 2023. Gender-stratified analysis showed greater post-COVID declines in women (APC: - .58%) than in men (APC: -3.90%). Older adults (85+) experienced a post-COVID increase in mortality (APC: +12.37%). Urban centers showed an APC increase (+2.33%), while rural areas continued to decline. Racial disparities narrowed modestly. Black and Hispanic populations saw sharper post-COVID declines (APCs: -6.21% and -6.26%, respectively) compared to White populations (-1.33%). The Southern U.S. remained the highest-burdened region across both timeframes. Observed mortality trends were temporally associated with demographic characteristics and urbanization patterns during the COVID-19 period. While HIV mortality continues to decline, the COVID-19 pandemic has disrupted progress, especially among elderly and urban populations. Persistent disparities demand targeted, equitable public health interventions.}, }
@article {pmid42433775, year = {2026}, author = {Abera, EG and Himbaro, SA and Megersa, SW and Ashine, AH and Tukeni, KN and Gebremichael, EH}, title = {Emerging trends in post-COVID immune dysregulation: a narrative review.}, journal = {Annals of medicine and surgery (2012)}, volume = {88}, number = {7}, pages = {4362-4370}, pmid = {42433775}, issn = {2049-0801}, abstract = {BACKGROUND: Long coronavirus disease (COVID), or post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is a multi-system condition associated with persistent immune dysregulation, autoimmunity, and vascular perturbations. Understanding these immunological mechanisms is essential for guiding clinical management and therapeutic strategies.
METHODS: We conducted a narrative review of peer-reviewed human studies published between January 2020 and August 2025, using PubMed/Medline, Scopus, and Web of Science, supplemented by manual searches. Studies reporting immunological assessments in long COVID patients, recovered individuals, or healthy controls were included. Findings were extracted and synthesized thematically across six domains: humoral and cellular immunity, autoimmune signatures, proteomic/metabolic and vascular dysregulation, viral persistence, complement/coagulation/thromboinflammation, and pediatric long COVID.
RESULTS: Long COVID is characterized by persistent low-grade inflammation, T- and B-cell dysregulation, and prolonged adaptive immune activation. Humoral responses remain elevated, while T-cell exhaustion and loss of coordination between immune compartments are common. Autoimmune phenomena, including latent and polyautoimmunity targeting cytokines, thyroid antigens, and interferons, are frequently observed. Proteomic, metabolic, and vascular perturbations, complement activation, and thromboinflammatory processes contribute to ongoing symptoms. Viral persistence and early immune biomarkers predict long COVID development. These immune alterations correlate with fatigue, cognitive impairment, respiratory dysfunction, and reduced quality of life in both adults and children.
CONCLUSION: SARS-CoV-2 infection leaves a lasting immunological footprint marked by chronic inflammation, adaptive immune dysregulation, autoimmunity, and vascular perturbations. Integrating longitudinal immune assessments, biomarker profiling, and early predictive markers is critical for identifying high-risk individuals and informing interventions to reduce long COVID morbidity.}, }
@article {pmid42434515, year = {2026}, author = {Chen, B and Tao, X and Wang, Y}, title = {Emerging Strategies for Antitumor Immunotherapy and Antiviral Defense Through the cGAS-STING Pathway.}, journal = {International journal of nanomedicine}, volume = {21}, number = {}, pages = {593033}, pmid = {42434515}, issn = {1178-2013}, mesh = {Humans ; cGAS-STING Signaling Pathway ; *Immunotherapy/methods ; *Neoplasms/therapy/immunology ; *Membrane Proteins/metabolism ; *Nucleotidyltransferases/metabolism ; Animals ; STING Protein ; Cyclic Guanosine Monophosphate-Adenosine Monophosphate Synthase ; Immunity, Innate ; Antiviral Agents/pharmacology ; Signal Transduction ; Virus Diseases/immunology/therapy ; Host-Directed Therapy ; }, abstract = {The cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING) pathway is a central regulator of innate immunity and plays a critical role in inducing pro-inflammatory cytokines and type I interferons (IFN-I). This pathway has emerged as a promising target for cancer immunotherapy and antiviral treatments. Despite its promise, the clinical translation of STING agonists is hindered by several challenges, including structural instability, high production costs, and inefficient delivery systems. These barriers underscore the urgent need for further research and innovation to optimize STING-based therapies. This review provides a comprehensive overview of the cGAS-STING pathway, focusing on its activation mechanisms and recent advances aimed at enhancing its therapeutic efficacy. Alternative activators of STING, including metal ions, exogenous DNA, and endogenous DNA, are discussed for their potential to stimulate this pathway. Furthermore, synergistic therapeutic strategies combining cGAS-STING activation with reactive oxygen species (ROS)-based treatments, such as photodynamic therapy, radiotherapy, sonodynamic therapy, and chemodynamic therapy, are highlighted. Finally, recent progress in harnessing STING activation for antiviral defense against emerging pathogens, such as SARS-CoV-2 and influenza viruses, is summarized to provide insights into the future development of cGAS-STING-targeted immunotherapies.}, }
@article {pmid42434765, year = {2026}, author = {Joshi, A and Ogbemudia, H and Cruess, C and Livinski, AA and Hall, R and Roback, E and Jain, J and Sharma, A and Smith-Davidson, P and Xu, M and Asher, V and Joseph, PV and Levy, JM}, title = {Point-of-care smell testing for evaluation of olfactory function: a narrative review of clinical utility.}, journal = {Frontiers in allergy}, volume = {7}, number = {}, pages = {1882615}, pmid = {42434765}, issn = {2673-6101}, abstract = {IMPORTANCE: Olfactory dysfunction (OD) is increasingly recognized as a clinically relevant biomarker for a wide range of health conditions, including neurodegenerative diseases, respiratory infections such as COVID-19, psychiatric disorders, and age-related sensory decline. Despite its diagnostic value, olfactory testing remains underutilized in routine clinical care due to challenges related to test accessibility, cultural adaptability, cost and practical implementation.
OBSERVATIONS: This narrative review provides a clinically focused synthesis of olfactory tests suitable for point-of-care (POC), focusing on their diagnostic accuracy, administration methods, user-friendliness, and applicability across diverse clinical populations. Commonly used tests such as the University of Pennsylvania Smell Identification Test (UPSIT®) and Sniffin' Sticks® are discussed alongside emerging rapid screening tools, pediatric assessments, and culturally adapted tests. Attention is given to distinguishing screening tools from comprehensive diagnostic batteries and to the role of point-of-care (POC) testing in primary care, neurology, and otorhinolaryngology settings. Practical considerations including assessment time, workflow feasibility, and clinical decision pathways are also examined. This review emphasizes the translation of available psychophysical tests into a practical POC framework for real-world clinical use.
CONCLUSIONS AND RELEVANCE: Available olfactory tests vary substantially in diagnostic accuracy, feasibility, and clinical applicability, highlighting the importance of selecting tests based on clinical indication and practice setting. Brief POC tests are best positioned as screening tools, while comprehensive batteries remain necessary when diagnostic precision is required. The main contribution of this review is a clinically oriented framework that distinguishes screening from diagnostic testing and aligns test selection with adult and pediatric clinical scenarios, workflow constraints, and referral needs. A tiered clinical approach using rapid screening followed by targeted comprehensive testing may represent the most practical, cost and time effective strategy for integrating olfactory assessment into routine care. Broader implementation of clinically feasible olfactory testing may improve early disease detection, support clinical decision making, and enhance patient care across conditions associated with OD.}, }
@article {pmid42435889, year = {2026}, author = {Gazda, J and Koky, T and Robinska, A and Bo, N and Bjornsson, ES and Drazilova, S and Janicko, M and Díaz, LA and Rhoads, F and Jarcuska, P and Arab, JP}, title = {Epidemiology of Alcohol-Associated Hepatitis: A Systematic Review of Population-Based Studies.}, journal = {Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.cgh.2026.06.032}, pmid = {42435889}, issn = {1542-7714}, abstract = {BACKGROUND AND AIMS: Alcohol-associated hepatitis (AH) is an acute and severe manifestation of alcohol-related liver injury that can occur at any stage of fibrosis. Despite its high mortality, reliable epidemiological data on AH remain limited. We conducted a systematic review to synthesize available population-based estimates of AH annual incidence and point prevalence from 2000 to 2025.
METHODS: A comprehensive literature search of MEDLINE (PubMed), Scopus, and the Cochrane Library was performed. Eligible studies reporting population-based rates of AH were included. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data.
RESULTS: Eleven population-based studies from seven countries were included. Reported annual incidence rates of AH ranged from 1.02 per 100,000 inhabitants in Iceland to 98.5 per 100,000 inhabitants in the United States, with a median incidence rate of 6.8 cases per 100,000 inhabitants (IQR 4.2-19). Among the nine studies reporting at least two estimates over time, seven demonstrated an increasing incidence rate, whereas two reported a decrease. A pre-pandemic sensitivity analysis excluding studies affected by the COVID-19 pandemic showed a similar pattern, with incidence rates increasing in five of the seven studies. Two studies reported a surge in incidence during the COVID-19 pandemic, while one of them extended follow-up beyond the pandemic period and observed a gradual return toward pre-pandemic levels. No studies reported prevalence data.
CONCLUSION: The global burden of AH remains poorly characterized. Existing population-based estimates are highly heterogeneous, reflecting differences in case definitions as well as probable true epidemiological variation across countries, and collectively suggest an increasing trend over the past 25 years. These findings underscore the urgent need for prospective studies employing standardized and harmonized methodologies to more accurately define the burden of this condition.}, }
@article {pmid42436688, year = {2026}, author = {Hernandez, J and Delgado, S and McCarthy, M and Nelson, F and Rammohan, K}, title = {The Impact of COVID-19 Infection and Vaccination on Neuromyelitis Optica Spectrum Disorder and Myelin Oligodendrocyte Glycoprotein Antibody Disease: A Narrative Review.}, journal = {Journal of central nervous system disease}, volume = {18}, number = {}, pages = {11795735261467600}, pmid = {42436688}, issn = {1179-5735}, abstract = {Despite the estimated 776 million coronavirus disease 2019 (COVID-19) cases globally, little is known about its impact on immune-mediated neurological disorders such as neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody disorder (MOGAD). Scattered case reports, and reviews address this association, but none have collectively examined the impact of COVID-19 infection or vaccination on established and new-onset NMOSD and MOGAD. Reviewing all published reports of COVID-19 infection and vaccination in NMOSD and MOGAD from December 2019 to October 2024, this report examined the effects of infection and vaccination on patients with established disease and the occurrence of new-onset NMOSD and MOGAD. Outcomes associated with COVID-19 infection in NMOSD and MOGAD patients revealed similar hospitalization rates but a notable difference in deaths in NMOSD patients treated with rituximab. Following COVID-19 infection, twice as many patients developed new-onset MOGAD compared to NMOSD, with a similar larger number of patients who developed MOGAD than NMOSD post-COVID-19 vaccination. While the heavy female predominance in NMOSD is well-established, a greater ratio of male to female patients developed MOGAD post-infection and post-vaccination. Clinicians should closely monitor NMOSD patients with COVID-19 infection, particularly those receiving B-cell depleting therapies, among whom mortality was more frequently reported. The rise in NMOSD and MOGAD following COVID-19 infection and vaccination cases warrants further investigation of the underlying immunological mechanisms. Molecular mimicry and a bystander immune-mediated injury likely play a greater role in central nervous system damage than does direct viral injury.}, }
@article {pmid42438709, year = {2026}, author = {Torres-Pasillas, HA and Luna-García, H and Celaya-Padilla, JM and Espino-Salinas, CH and Acra-Despradel, C and Villalba-Condori, K and Cárdenas Núñez, YM}, title = {Metabolomic datasets in COVID-19 research: a systematic literature review of availability, characteristics, and methodologies.}, journal = {PeerJ}, volume = {14}, number = {}, pages = {e21313}, pmid = {42438709}, issn = {2167-8359}, mesh = {Humans ; *Metabolomics/methods ; *COVID-19/metabolism ; *Biomedical Research ; SARS-CoV-2 ; *Datasets as Topic ; Information Dissemination ; }, abstract = {The COVID-19 pandemic has accelerated the integration of metabolomics and Machine Learning in biomedical research, resulting in the creation of numerous datasets with high potential for reuse. However, information regarding their accessibility, quality, and usability remains scattered and inconsistent. This systematic review aims to identify and evaluate publicly available human metabolomic datasets related to COVID-19, providing detailed information on their main characteristics and how to access them, with the goal to inform their potential for reuse in future research. Following PRISMA guidelines and the Kitchenham methodology, we conducted a comprehensive search of the scientific literature and specialized metabolomics repositories, identifying 110 unique datasets. Each dataset was assessed based on 15 variables related to data availability, accessibility, collection methodologies, sample sizes, and the extent of participant metadata provided. These datasets offer significant value for secondary analyses and ML applications, contributing to insights into disease mechanisms, early diagnosis, and patient stratification. By offering a structured overview of dataset characteristics, this review aims to support researchers in identifying suitable resources, encourages data reuse, and promotes best practices for data sharing and standardization in the context of COVID-19 and metabolomics. Nonetheless, our findings reveal critical limitations, including the underuse of dedicated repositories, frequent unavailability of raw data, lack of standardization in processed data, and insufficient metadata-particularly regarding participant demographics and clinical information. Inconsistencies in data formats and reporting standards further hinder dataset findability, interoperability, and reuse. To enhance the value and impact of future metabolomic research, we recommend adopting standardized reporting guidelines, improving metadata completeness, ensuring the availability of raw data, and promoting the use of interoperable repositories to facilitate reproducibility, integration, and broader application of shared datasets.}, }
@article {pmid42438902, year = {2026}, author = {Kim, JH}, title = {Use of corticosteroids in sepsis and infectious diseases: a narrative review.}, journal = {The Korean journal of internal medicine}, volume = {41}, number = {4}, pages = {585-596}, pmid = {42438902}, issn = {2005-6648}, mesh = {Humans ; *Adrenal Cortex Hormones/therapeutic use/adverse effects ; *Sepsis/drug therapy ; COVID-19 ; Critical Illness ; SARS-CoV-2 ; COVID-19 Drug Treatment ; Community-Acquired Pneumonia/drug therapy ; *Anti-Inflammatory Agents/therapeutic use/adverse effects ; Shock, Septic/drug therapy ; *Pneumonia, Viral/drug therapy/diagnosis ; Pandemics ; Treatment Outcome ; }, abstract = {Critically ill patients with septic shock exhibit dysregulated host inflammatory responses. Critical illness-related corticosteroid insufficiency (CIRCI) has been recognized as a potential contributor to poor outcomes in critically ill patients. CIRCI is characterized by dysregulation of the hypothalamic-pituitary-adrenal axis, which results in a state of systemic inflammation through altered cortisol metabolism and tissue resistance to corticosteroids, all of which may lead to systemic inflammation. Based on these pathophysiological mechanisms, the beneficial anti-inflammatory effects of corticosteroids have been proposed and evaluated in several clinical trials. However, evidence of the beneficial effects of corticosteroids has been evolving for years. While some studies have demonstrated beneficial outcomes, such as accelerated shock reversal, reduced duration of mechanical ventilation, and reduced mortality, other studies have failed to demonstrate significant mortality benefits. Such disparity in studies suggests the heterogeneity of critical illnesses and the difficulty in identifying optimal indications for corticosteroids. Recent studies demonstrated the beneficial role of corticosteroids in patients with severe COVID-19 and community-acquired pneumonia. Given the evolving body of evidence, this review discusses the utility of corticosteroids in critically ill patients, including those with sepsis, septic shock, COVID-19, and severe community-acquired pneumonia.}, }
@article {pmid42438903, year = {2026}, author = {Kong, J and Hong, S and Oh, J and Lee, S and Smith, L and Branda, F and Cho, H and Hwang, J and Yon, DK}, title = {Autoimmune diseases in the era of COVID-19: emerging mechanisms, clinical implications, vaccine considerations, and future directions.}, journal = {The Korean journal of internal medicine}, volume = {41}, number = {4}, pages = {597-619}, pmid = {42438903}, issn = {2005-6648}, support = {//Institute of Information & Communications Technology Planning & Evaluation/ ; RS-2024-00509257//Ministry of Science and ICT/ ; }, mesh = {Humans ; *COVID-19/immunology ; *Autoimmune Diseases/immunology/drug therapy/epidemiology ; *COVID-19 Vaccines/adverse effects ; SARS-CoV-2/immunology ; Immunosuppressive Agents/therapeutic use/adverse effects ; Immunocompromised Host ; Pandemics ; Risk Factors ; *Pneumonia, Viral/immunology/prevention & control/epidemiology ; *Coronavirus Infections/immunology/epidemiology/prevention & control ; }, abstract = {The coronavirus disease 2019 (COVID-19) pandemic has highlighted a complex, bidirectional relationship between SARSCoV-2 infection and autoimmune diseases. This review examines how SARS-CoV-2 infection influences the incidence, progression, and outcomes of five major autoimmune conditions: systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, inflammatory bowel disease, and Guillain-Barré syndrome. Patients with autoimmune diseases are at increased risk of severe COVID-19 due to intrinsic immune dysregulation and the use of immunosuppressive therapies, both of which impair antiviral host defenses. Conversely, COVID-19 has been implicated in the initiation and exacerbation of autoimmune responses through mechanisms such as molecular mimicry and bystander activation. Concerns have also arisen regarding the safety and efficacy of COVID-19 vaccines in immunocompromised populations. Although vaccines are generally tolerated in these individuals, certain immunosuppressive therapies may attenuate humoral and cellular immune responses. Strategies such as adjusting immunosuppressive regimens and optimizing the timing of vaccination have been proposed to improve vaccine efficacy. Disease-specific considerations are essential to balance infection risk with adequate control of autoimmune activity. Overall, this review underscores the importance of individualized treatment strategies, close clinical monitoring, and interdisciplinary care in managing patients with autoimmune diseases during the COVID-19 pandemic. A deeper understanding of these interactions will be critical for improving patient outcomes and preparing for future pandemics involving immune-mediated diseases.}, }
@article {pmid42441431, year = {2026}, author = {Warkentin, TE and Greinacher, A}, title = {Platelet-Activating Anti-Platelet Factor 4 Disorders.}, journal = {The New England journal of medicine}, volume = {}, number = {}, pages = {}, doi = {10.1056/NEJMra2502459}, pmid = {42441431}, issn = {1533-4406}, abstract = {Platelet-activating antibodies against platelet factor 4 (PF4) cause highly prothrombotic disorders with reduced platelet counts. In heparin-induced thrombocytopenia (HIT), these antibodies bind PF4-heparin complexes, causing heparin-dependent platelet activation. Less common autoimmune and spontaneous HIT variants that are triggered by heparin and nonpharmacologic polyanions, respectively, have atypical clinical features and antibodies with additional heparin-independent platelet-activating properties. Vaccine-induced immune thrombocytopenia and thrombosis (VITT) antibodies directly target PF4. Initially, VITT was linked to adenoviral vector-based coronavirus disease 2019 vaccines, but in rare cases, an immune thrombocytopenia and thrombosis disorder that is clinically nearly identical to VITT can be caused by infection resulting from natural exposure to viruses, especially adenovirus. In persons with the IGLV3-21*02/*03 gene, anti-adenovirus protein VII antibody specificity shifts to PF4 by way of a specific somatic hypermutation (K31E) that creates VITT antibodies. In VITT-like monoclonal gammopathy of thrombotic significance, monoclonal anti-PF4 antibodies cause chronic prothrombotic conditions. Accurate diagnosis relies on distinct assays for HIT and VITT antibodies. Beyond anticoagulation, inhibition of FcγIIa receptor-mediated platelet activation may be needed for anti-PF4 disorders with heparin-independent reactivity (e.g., high-dose immune globulin in acute disease manifestations and Bruton's tyrosine kinase inhibitors in chronic manifestations).}, }
@article {pmid42441648, year = {2026}, author = {Capodici, A and Filippeschi, A and Noci, F and Michelucci, A and El Motarajji, S and Benedetto, V and Vandelli, A and Passino, C and Emdin, M and Nuti, S and Avizzano, CA and Bellè, N and Giannoni, A}, title = {Mapping global inequities in telemedicine implementation: An umbrella review of barriers and facilitators.}, journal = {PloS one}, volume = {21}, number = {7}, pages = {e0351885}, doi = {10.1371/journal.pone.0351885}, pmid = {42441648}, issn = {1932-6203}, mesh = {Humans ; *Telemedicine ; *COVID-19/epidemiology ; SARS-CoV-2/isolation & purification ; Digital Health ; Global Health ; *Healthcare Disparities ; Evidence Gaps ; }, abstract = {Telemedicine expanded rapidly during the COVID-19 pandemic, yet its diffusion has remained uneven across health systems. Whether implementation challenges differ systematically across economic contexts, and what implications these differences hold for global digital health equity, has not been comprehensively characterized. This study presents an umbrella review (PROSPERO CRD42024615998) of systematic reviews and meta-analyses indexed in PubMed and Scopus through December 2025 that reported barriers and/or facilitators to telemedicine implementation. Methodological quality was appraised using R-AMSTAR. Reported items were extracted verbatim, embedded with the Universal Sentence Encoder, and grouped into thematic clusters using HDBSCAN density-based clustering, with parameters optimized by SLSQP for cluster cohesion (median intra-cluster similarity ≥ 0.5). Analyses were stratified by World Bank country income group to characterize context-specific implementation profiles, identify evidence gaps, and detect orphaned barriers, defined as challenges lacking any corresponding documented facilitator. A total of 161 systematic reviews were included, yielding 1,333 barriers and 504 facilitators (corresponding to a barrier-to-facilitator ratio of 2.6:1). Across all settings, the most frequently reported barriers were high costs (n = 106), technical issues (n = 94), and training and knowledge (n = 91). Thematic profiles differed markedly by income group: high-income countries reported predominantly second-generation challenges centered on workflow integration, interoperability, and user experience, whereas lower-middle-income countries reported foundational barriers centered on infrastructures and costs. Evidence produced from low-income countries was entirely absent. Several high-frequency barriers lacked corresponding facilitator clusters, indicating challenges for which the published literature provides no documented solutions. The global telemedicine evidence base is itself inequitably distributed and risks reinforcing the disparities it is intended to reduce. High-income settings require implementation research focused on human and organizational factors, whereas lower-income settings require foundational research and investment in basic infrastructures before workflow-level optimization becomes meaningful. Without context-specific, equity-oriented strategies, telemedicine risks widening rather than narrowing the global digital health divide.}, }
@article {pmid42442307, year = {2026}, author = {Alaka, M and Tuaillon, E and Desnues, B}, title = {Intravenous immunoglobulin therapy in viral infections: Lessons learned from COVID-19.}, journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie}, volume = {201}, number = {}, pages = {119762}, doi = {10.1016/j.biopha.2026.119762}, pmid = {42442307}, issn = {1950-6007}, abstract = {OBJECTIVES: Intravenous immunoglobulin (IVIg) exerts both antiviral and immunomodulatory effects, but its role in viral infections remains incompletely defined. This review aims to provide an integrated overview of IVIg mechanisms of action and to evaluate its clinical relevance in viral diseases, with particular emphasis on coronavirus disease 2019 (COVID-19).
METHODS: A structured narrative literature review was conducted using PubMed (MEDLINE) and complemented by manual screening of the reference lists of relevant publications. The search included studies available through early 2026 addressing the mechanisms of action of IVIg and its clinical application in viral infections. Records were screened by title, abstract, and full-text evaluation according to predefined eligibility criteria, and the evidence was synthesized qualitatively.
RESULTS: IVIg acts through multiple mechanisms, including fragment antigen binding (Fab)-mediated neutralization, fragment crystallizable (Fc) receptor modulation, complement inhibition, cytokine regulation, and neonatal Fc receptor (FcRn)-mediated immunoglobulin G clearance. In immunodeficient patients, IVIg provides passive antiviral immunity and improves viral control. In contrast, in severe viral infections such as COVID-19, disease severity is largely driven by immune dysregulation. In this context, IVIg may exert benefit primarily through immunomodulatory effects rather than direct antiviral activity. Clinical studies in COVID-19 have shown heterogeneous results, influenced by treatment timing, patient selection, dosing strategies, and concomitant therapies.
CONCLUSIONS: IVIg should be considered a context-dependent immunomodulatory therapy rather than a universal antiviral strategy. Its clinical efficacy likely depends on alignment between its mechanisms and disease-specific immunopathology, highlighting the need for biomarker-guided and stage-specific therapeutic approaches.}, }
@article {pmid42442360, year = {2026}, author = {Kazer, SW and Walsh, JML and Juttukonda, LJ and Ordovas-Montanes, J}, title = {Nasal immunity in respiratory viral infection, transmission, and protection.}, journal = {Immunity}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.immuni.2026.06.011}, pmid = {42442360}, issn = {1097-4180}, abstract = {The nasal mucosa plays key roles in protecting against airborne pathogens as the major barrier to the airway. Catalyzed by the COVID-19 pandemic, recent studies focusing on nasal immunity have begun to elucidate how epithelial and immune cells work in concert to fight viral infection, reduce spread to the lower airways, and limit onward transmission. Technologies such as single-cell RNA sequencing and air-liquid interface models are enabling high-resolution views of the cell states and responses that dictate infection resolution and memory formation. Here, we review our current understanding of the cells of the nasal mucosa at homeostasis and their responses during and following viral infection in mice and humans. We discuss emerging correlates of protection before and after exposure, noting the differences between infection and intramuscular vaccination. Finally, we examine novel intranasal vaccination strategies and propose approaches to program tissue-scale memory into the nose to prevent disease and viral spread.}, }
@article {pmid42442743, year = {2026}, author = {Lee, DH and Hideki, K}, title = {Reassessing Early COVID-19 Strategies in East Asia: Insights from Japan and South Korea.}, journal = {Journal of preventive medicine and public health = Yebang Uihakhoe chi}, volume = {}, number = {}, pages = {}, doi = {10.3961/jpmph.26.274}, pmid = {42442743}, issn = {2233-4521}, abstract = {East Asian countries had remarkably low COVID-19 mortality in 2020, a pattern widely cited as evidence of effective public health interventions. However, Japan and South Korea-often classified as having followed similar early intervention strategies-adopted substantially different approaches. These differences are largely obscured by commonly used stringency indices and policy score analyses. While neither country implemented a lockdown, South Korea pursued an aggressive, government-mandated strategy based on extensive testing, isolation, quarantine, and compulsory data collection. In contrast, Japan relied on a voluntary model with limited mass testing, a policy that drew strong criticism during the early phase of the pandemic. Because asymptomatic COVID-19 infection was highly prevalent, these divergent testing policies were particularly important in shaping patterns of community transmission. Using excess mortality as a comprehensive outcome metric, Japan's outcomes were as favorable as South Korea's through the pre-Omicron period, despite Japan's limited testing. In 2020, excess mortality was negligible in both countries (-1.7% in Japan vs. +0.3% to +2.1% in South Korea). In 2021, excess mortality increased modestly (+2.2% vs. +4.0% to +5.6%). However, in 2022, after both countries had achieved approximately 80% vaccination coverage, excess mortality rose substantially (+7.6% vs. +19.6% to +21.0%), threefold higher in South Korea. These similar patterns of excess mortality in 2 countries with contrasting testing strategies challenge the view that East Asia's early success stemmed primarily from stringent virus suppression measures. They also highlight the need to consider alternative explanations, including the possibility that pre-existing immunity differed substantially across geographical regions.}, }
@article {pmid41373324, year = {2025}, author = {Haimi, M and Inchi, L}, title = {Bridging Distance, Delivering Care: Pediatric Tele-Nutrition in the Digital Health Era-A Narrative Review.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {23}, pages = {}, pmid = {41373324}, issn = {2227-9032}, abstract = {BACKGROUND: The emergence of telehealth has transformed healthcare delivery across multiple disciplines, with tele-nutrition representing a rapidly evolving field that addresses nutritional assessment, counseling, and management through digital platforms.
OBJECTIVE: This narrative review examines the current landscape of pediatric tele-nutrition services, exploring technological platforms, clinical applications, evidence for effectiveness, implementation considerations, and future directions.
METHODS: A comprehensive literature search was conducted across PubMed, CINAHL, Embase, and Web of Science databases from January 2010 to October 2025. A total of 114 relevant sources were selected, encompassing randomized controlled trials, observational studies, systematic reviews, implementation studies, clinical guidelines, and policy documents.
RESULTS: This review synthesized 114 sources, predominantly from the United States (54%) and European nations (21%), with evidence expansion accelerating post-COVID-19 pandemic. Evidence suggests pediatric tele-nutrition demonstrates clinical outcomes comparable to traditional in-person care across diverse populations including obesity management, diabetes, gastrointestinal disorders, feeding difficulties, metabolic conditions, and preventive nutrition services. Multiple technology platforms are utilized, with synchronous video consultations most common (60-85% of encounters). Benefits include enhanced access to specialized care, increased frequency of contact, reduced family burden, and high satisfaction rates (>80% across most studies). Challenges include limitations in physical assessment, digital equity concerns affecting vulnerable populations, variable reimbursement policies, and the need for provider training. Hybrid models combining virtual and in-person care appear optimal for many conditions.
CONCLUSIONS: Pediatric tele-nutrition represents a viable and effective care delivery model with particular advantages for families facing geographic, logistic, or access barriers. Continued attention to digital equity, provider training, regulatory frameworks, sustainable reimbursement policies, and rigorous evidence generation will optimize implementation and outcomes. Future directions include artificial intelligence applications, precision nutrition approaches, and expanded global health applications.}, }
@article {pmid41373396, year = {2025}, author = {Shiel, EV and Connor, Z and Downes, M and Bailey-Shaw, A and Hemingway, S and Walters, C and Kola-Palmer, S}, title = {What Evidence Exists on the Effectiveness of Psychotherapy for Trauma-Related Distress? A Scoping Review.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {23}, pages = {}, pmid = {41373396}, issn = {2227-9032}, abstract = {Background/Objectives: Trauma-related distress poses significant mental health challenges, with psychotherapy serving as a primary intervention. The Walters Method is a promising new alternative that may help where traditional methods fall short (i.e., in complex or violent cases), but before it can be implemented widely, the existing evidence on the effectiveness of other psychotherapies for trauma-related distress must be mapped to see how and where it relates to other techniques. The aim of this scoping review was to provide an overview of existing evidence on the effectiveness of psychotherapy for trauma-related distress. Methods: A scoping review was conducted to better understand the effectiveness of psychotherapies for trauma-related distress (including PTSD, acute stress disorder, or other serious mental health issues). Results: Thirty-three articles were analysed. Included articles included adults with PTSD, incarcerated women, childbirth trauma survivors, female survivors of sexual abuse, hospitalised COVID-19 patients, adults with serious mental illness, veterans and active soldiers, firefighters, and refugees. Eye Movement Desensitisation and Reprocessing and Cognitive Behavioural Therapy were the most studied and effective treatments. Prolonged Exposure and Narrative Exposure Therapy were less common but noteworthy. Other therapies, including psychodynamic approaches, are seldom studied but have proven effective when explored, highlighting knowledge gaps and potential missed opportunities. Success with these alternative approaches-especially in complex trauma cases like intimate partner violence or child loss where EMDR and CBT may be less effective-suggests they have potential, but further research is needed for validation. Conclusions: This review offers novel contributions to the field by emphasising innovative therapeutic perspectives that extend beyond traditional, more studied, evidence-based approaches such as CBT and EMDR, thereby expanding treatment options for diverse clinical presentations. Alternative therapies show promise, particularly for complex trauma cases like intimate partner violence or child loss where established approaches may be less effective; however, further research is needed to validate their efficacy across diverse populations. Selection of psychotherapy should be based on clients' goals and comfort, and the cultural and contextual compatibility between the person and intervention. Future research should prioritise underexplored therapies to address current knowledge gaps and improve treatment accessibility for varied clinical needs.}, }
@article {pmid41373500, year = {2025}, author = {Leonardi, R and Lo Bianco, M and Spinello, S and Betta, P and Gagliano, C and Calabrese, V and Polizzi, A and Malaguarnera, G}, title = {Resveratrol as an Adjunct Antiviral Agent in Pediatric Viral Infections: A Review on Mechanistic Insights and Gut Microbiota Modulation.}, journal = {International journal of molecular sciences}, volume = {26}, number = {23}, pages = {}, pmid = {41373500}, issn = {1422-0067}, mesh = {Humans ; *Resveratrol/therapeutic use/pharmacology ; *Gastrointestinal Microbiome/drug effects ; *Antiviral Agents/therapeutic use/pharmacology ; Child ; *Virus Diseases/drug therapy/microbiology ; SARS-CoV-2/drug effects ; Dysbiosis/drug therapy ; COVID-19 ; Rotavirus/drug effects ; }, abstract = {Pediatric viral infections impose a heavy burden on child health, often worsened by infection-induced gut dysbiosis. Resveratrol, a natural polyphenol with antiviral, anti-inflammatory, and microbiota-modulating properties, has been proposed to interrupt this pathogenic feedback. To our knowledge, this is the first narrative review focused on resveratrol's antiviral activity in pediatric viral infections, concurrently evaluating its impact on the gut microbiota and their interrelationship. We synthetized preclinical and the limited available pediatric clinical data regarding resveratrol's effect on SARS-CoV-2, respiratory syncytial virus, influenza, rotavirus, and norovirus, extracting information on the models, routes of administration, dosages, mechanisms, and outcomes. Resveratrol interferes with viral lifecycles via diverse mechanisms (modulation of host signaling cascades, capsid or structural protein interactions, and suppression of pro-viral chaperones) while concurrently reshaping the gut microbiota (reducing opportunistic taxa and enriching beneficial genera such as Bifidobacterium and Lactobacillus) leading to improved short-chain fatty acid profiles, barrier integrity, and dampened inflammation. Intranasal resveratrol in children shows clinical benefit, while oral use is underexplored and limited by poor bioavailability; adult data hint at supportive microbiome and anti-inflammatory effects if the delivery is optimized. These dual antiviral and microbiome-directed effects position resveratrol as a promising adjunct in pediatric viral disease management, though well-powered pediatric clinical trials are needed to define dosages, delivery strategies, and the contribution of microbiota-mediated synergy.}, }
@article {pmid41373540, year = {2025}, author = {Popa, AE and Popa, E and Dramba, T and Coman, EA and Poroch, M and Ungureanu, M and Bacusca, A and Slanina, AM and Bacoanu, G and Poroch, V}, title = {Dysregulated Resolution of Inflammation After Respiratory Viral Infections: Molecular Pathways Linking Neuroinflammation to Post-Viral Neuropathic Pain-A Narrative Review.}, journal = {International journal of molecular sciences}, volume = {26}, number = {23}, pages = {}, pmid = {41373540}, issn = {1422-0067}, mesh = {Humans ; *Neuroinflammatory Diseases/immunology/etiology/metabolism/pathology ; *Neuralgia/immunology/etiology/virology ; *COVID-19/complications/immunology ; Animals ; *Inflammation ; SARS-CoV-2 ; Microglia/immunology/metabolism ; Mitochondria/metabolism ; Signal Transduction ; Macrophages/immunology/metabolism ; Immunity, Innate ; *Respiratory Tract Infections/complications/immunology ; }, abstract = {Post-viral neuroinflammatory syndromes, particularly those occurring after SARS-CoV-2 infection, have received increasing attention due to their complex and persistent neurological manifestations. The aim of this narrative review is to integrate current evidence on the molecular and cellular mechanisms underlying chronic neuroinflammation following viral infections, with a focus on dysregulated innate immune responses, macrophage-microglia interactions, oxidative-mitochondrial stress, and impaired inflammation resolution pathways. Our synthesis shows that prolonged activation of macrophages and glial cells promotes the continuous release of pro-inflammatory mediators, while defective phagocytosis and inadequate clearance of cellular debris maintain an inflammatory microenvironment. Mitochondrial dysfunction further amplifies immune activation by stimulating metabolic stress and reactive oxygen species production. In parallel, deficiencies in mediators specialized in inflammation resolution impede the transition from inflammation to resolution, allowing neuroimmune imbalance and nociceptive sensitization to persist long after virus clearance. Key conclusions indicate that these interconnected mechanisms collectively contribute to the long-term neurological symptoms observed in post-viral states, including cognitive impairment, neuropathic pain, and fatigue. Emerging therapeutic strategies targeting cytokine signaling, microglial reactivity, mitochondrial function, and resolution pathways are promising, but remain insufficiently validated in clinical practice. Overall, evidence suggests that post-viral neuroinflammation results from the convergence of sustained immune activation and failure of endogenous resolution mechanisms, highlighting the need for further mechanistic studies and targeted interventions.}, }
@article {pmid41373962, year = {2025}, author = {Rosanoff, A and von Ehrlich, B and Nelson, D}, title = {A Proposed Scale to Assess Magnesium Status Using Serum Calcium and Magnesium Ratios.}, journal = {Nutrients}, volume = {17}, number = {23}, pages = {}, pmid = {41373962}, issn = {2072-6643}, mesh = {Humans ; *Magnesium/blood ; *Calcium/blood ; COVID-19/blood/mortality ; Biomarkers/blood ; *Magnesium Deficiency/blood/diagnosis ; SARS-CoV-2 ; Adult ; Female ; Male ; Middle Aged ; }, abstract = {Background/Objectives: Reliable markers of human magnesium (Mg) status are needed. Methods: Current Mg studies report ratios between serum Mg and calcium (Ca) using four interchangeable expressions (i.e., molar or weight calculations of Mg/Ca or Ca/Mg). We propose a scale using ratios of serum Mg and Ca to assess Mg status, unified for all four expressions. We explore its application for case studies and published research. Results:Case Studies (4)-the proposed serum Mg/Ca scale showed better Mg diagnostic value than serum Mg alone. Published Studies-A. The proposed Mg/Ca scale's "depleted Mg" status predicted mortality among hospitalized COVID-19 patients in ROC/AUC analyses. B. The serum Ca/Mg proposed scale, when applied to "healthy" adults with "normal" serum Mg, exposed a "seriously depleted" to "adequate" range of Mg status. C. In a study of periodontal disease, patients designated "adequate" or "mild" Mg depletion by the proposed scale showed greater 5-year improvement than those with scale's "moderate to serious" Mg depletion status. D. Finally, the proposed scale demonstrated appropriate diagnostic value of serum Ca/Mg in acute coronary syndrome patients only when "corrected Ca" was NOT used in ratio calculation. Conclusions: The proposed scale needs both total serum Ca and Mg measures in identical units, i.e., mg/dL or mg% (for weight ratios); mmol/L or mEq/L (for molar ratios). Authors/reviewers/editors need to take care when reporting units/methodology of serum Mg and Ca ratios for clear reporting as to weight or molar ratio and use of total or corrected values. Future trials and statistical testing are needed to determine whether ratios between serum Mg and Ca yield more precise measures of physiological Mg status than serum Mg alone. Our findings indicate the proposed scale is worthy of further study as a marker of Mg deficit.}, }
@article {pmid41374027, year = {2025}, author = {Koliou, MP and Skalkos, D}, title = {Post-Pandemic Shifts in Sustainable Food Behavior: A Systematic Review of Emerging Consumer Trends.}, journal = {Nutrients}, volume = {17}, number = {23}, pages = {}, pmid = {41374027}, issn = {2072-6643}, mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Feeding Behavior/psychology ; *Consumer Behavior ; *Food Preferences/psychology ; SARS-CoV-2 ; Pandemics ; Hunger ; Female ; Emotions ; Male ; }, abstract = {The COVID-19 pandemic and its associated economic stressors have profoundly reshaped consumer eating behaviors, presenting an urgent and underexplored challenge for the academic community. This interdisciplinary review critically examines how these disruptions have influenced both food approach and food avoidance patterns, offering a structured analysis of eight key behavioral parameters: Hunger (H), Food Responsiveness (FR), Emotional Overeating (EOE), Enjoyment of Food (EF), Satiety Responsiveness (SR), Emotional Under Eating (EUE), Food Fussiness (FF), and Slowness in Eating (SE). Drawing on recent literature, we highlight significant shifts in these traits-such as heightened hedonic hunger, age-related changes in food preferences, and gender-specific emotional-satiety dynamics-underscoring the complex interplay between emotional states, physiological cues, and behavioral tendencies. Grounded in the systematic examination of peer-reviewed studies in the post-COVID period, this review offers a robust and comprehensive synthesis of current evidence. The novelty of this work lies in its integration of findings into targeted proposition statements for each parameter, visually supported by original flow charts. These culminate in the development of a "Consumers' Eating Behavior Index"-a conceptual tool designed to guide researchers, healthcare professionals, and policymakers in understanding and responding to post-pandemic dietary transformations. By emphasizing the emotional and psychological dimensions of eating, this index offers a timely framework for designing tailored public health interventions that promote sustainable nutritional habits. This study calls for renewed academic attention to the behavioral consequences of global crises, positioning eating behavior research as a critical frontier in post-COVID recovery and resilience.}, }
@article {pmid41375068, year = {2025}, author = {Isidoro, C}, title = {SARS-CoV2 and Anti-COVID-19 mRNA Vaccines: Is There a Plausible Mechanistic Link with Cancer?.}, journal = {Cancers}, volume = {17}, number = {23}, pages = {}, pmid = {41375068}, issn = {2072-6694}, abstract = {To contrast the COVID-19 pandemic brought by the corona virus SARS-CoV-2, two mRNA-based anti-COVID-19 vaccines (by Pfizer-BioNTech and Moderna) were made available relatively quickly and deployed worldwide based on an emergency approval. Being considered vulnerable and at risk of infection, cancer patients have been prioritized for COVID-19 vaccination and vaccinated repeatedly because of the short time protection provided by these vaccines. Recently, a surge in the incidence and rapid progression of cancers has been observed in many countries, which could (at least partially) represent cancers undiagnosed or untreated during the pandemic. It has also been suggested that the SARS-CoV-2 itself or even the anti-COVID-19 mRNA vaccines could have contributed to the recurrence and worse clinical outcome in cancer patients, given the high incidence of COVID-19 in hospitalized patients and that these patients have been vaccinated with priority several times and in a short period. Although it appears extremely unlikely that SARS-CoV-2 and anti-COVID-19 mRNA vaccines elicit genotoxic events and cause neo-cancerogenesis in a short time, they could still cause non-genotoxic pro-carcinogenic effects by triggering an exaggerated inflammatory reaction, compromising immune homeostasis, stimulating cell proliferation, and negatively affecting cellular stress response and damage repair machinery. This could result in the promotion of regrowth of dormant micrometastases or relapses of stable minimal residual disease. Such a harmful outcome may likely result from a synergy between the virus and the vaccine, especially in multi-vaccinated and multi-infected individuals. Here, I bring the cell pathologist's point of view and discuss the multiple possible mechanisms by which the virus and the anti-COVID-19 mRNA vaccine might favor tumorigenesis. While a causal link cannot be established at this stage, knowledge of potential carcinogenic risks could help doctors and health policymakers take the best actions to protect vulnerable patients and convince the vaccine developer to design a vaccine free from such harm.}, }
@article {pmid41375650, year = {2025}, author = {Watts, P and Deac, A and Netuveli, G}, title = {An Umbrella Review of Quality of Life Among the General Population During the COVID-19 Pandemic.}, journal = {Journal of clinical medicine}, volume = {14}, number = {23}, pages = {}, pmid = {41375650}, issn = {2077-0383}, abstract = {Background/Objectives: The COVID-19 pandemic has had widespread effects on quality of life (QoL). This umbrella review aimed to synthesise review-level evidence on the impact of the COVID-19 pandemic on QoL across the general population, including children, adolescents, adults, and older people. Methods: A systematic search of databases (MEDLINE (PubMed); EBSCOHost; Scopus; Google Scholar) and review repositories was conducted to identify systematic reviews, meta-analyses, and scoping reviews published between 2019 and 2025. Eligible reviews (2019-2025, English, peer-reviewed) included narrative, systematic and meta-analytic syntheses of quantitative, qualitative or mixed-methods evidence examining the impact of the COVID-19 pandemic on quality of life in the general population, using validated QoL measures. The review followed Joanna Briggs Institute methodology for umbrella reviews, with data synthesised narratively by QoL domain and population group. Results: Nine reviews met the inclusion criteria, encompassing 272 primary studies. Most reported declines in QoL across psychological, physical, and social domains. Children and adolescents experienced reductions in emotional and social functioning. Working-age adults reported psychological strain linked to economic and health-related stressors, while older adults were vulnerable to isolation and reduced social QoL. Environmental and structural factors also influenced QoL. Sociodemographic disparities were observed, with lower QoL reported among women, younger individuals, and those with lower socioeconomic status. Conclusions: The COVID-19 pandemic was associated with substantial declines in QoL across population groups, shaped by psychological, social, and structural factors. Findings highlight the importance of addressing social inequalities and enhancing resilience in future public health crises.}, }
@article {pmid41375836, year = {2025}, author = {Stratulat-Chiriac, I and Țarcă, E and Chistol, RO and Halip, IA and Țarcă, V and Furnică, C}, title = {Association Between Congenital Gastrointestinal Malformation Outcome and Largely Asymptomatic SARS-CoV-2 Infection in Pediatric Patients-A Systematic Review.}, journal = {Journal of clinical medicine}, volume = {14}, number = {23}, pages = {}, pmid = {41375836}, issn = {2077-0383}, abstract = {Objective. Limited evidence is available concerning the surgical outcomes of patients with congenital gastrointestinal malformations and perioperative SARS-CoV-2 infection. This study examines the scientific evidence on SARS-CoV-2 infection and congenital gastrointestinal malformations requiring surgery in children. Material and Methods. We performed a systematic review of studies reporting data on children with congenital gastrointestinal malformations and SARS-CoV-2 infection, published in international databases (PubMed and Embase) from pandemic inception up to August 2024. Studies not reporting data on the SARS-CoV-2 infection status on patients with congenital digestive malformation were excluded. We assessed the quality of the included studies according to the Joanna Institute (JBI) appraisal checklist, adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, and registered the protocol with the PROSPERO database (CRD42024550744). Results. From the 902 titles retrieved, eight observational studies met the inclusion criteria comprising 29 patients from countries with different socioeconomic statuses. Most patients were neonates (75%) with a median age of 3 days at diagnosis and male to female ratio of 2:1. In total, 18 (62%) presented upper gastrointestinal tract anomalies, including esophageal atresia ± tracheoesophageal fistula (n = 10, 34.48%), duodenal atresia (n = 3, 10.3%), and congenital hypertrophic pyloric stenosis (n = 5, 17.2%). Lower digestive tract malformations (11, 38%) included anorectal malformations (n = 6, 20.6%), intestinal atresia (n = 3, 10.3%), Hirschsprung disease (n = 1, 3.44%), and Meckel's diverticulum (n = 1, 3.44%). Surgeries were primarily emergency or urgent procedures and only pyloromyotomy (5/5) was consistently operated minimally invasively. SARS-CoV-2 infection was identified mainly on routine screening (>95%). Of 29 patients, 85% were discharged home, and no postoperative surgical mortality and significant complications directly associated with COVID-19 were identified, although routine postoperative morbidity not linked to SARS-CoV-2 was observed. Conclusions. Pediatric patients with congenital gastrointestinal malformationsand perioperative SARS-CoV-2 infection typically have mild illness and favorable surgical outcomes. SARS-CoV-2 positivity alone should not delay essential surgery when infection control measures are ensured. Standardized, multicenter studies are needed to clarify perioperative risks to and inform management of this high-risk group.}, }
@article {pmid41376141, year = {2025}, author = {Sucu, R and Erku, D and Filiniuk, O and Kohler, R}, title = {Establishing an independent HTA agency in Ukraine: a conceptual framework for governance, operations, and long-term sustainability.}, journal = {International journal of technology assessment in health care}, volume = {41}, number = {1}, pages = {e85}, doi = {10.1017/S0266462325103255}, pmid = {41376141}, issn = {1471-6348}, support = {AID-121-C-17-00004//United States Agency for International Development/ ; }, mesh = {Ukraine ; *Technology Assessment, Biomedical/organization & administration/legislation & jurisprudence ; Humans ; COVID-19/epidemiology ; SARS-CoV-2 ; Health Policy ; }, abstract = {OBJECTIVES: Health technology assessment (HTA) has become an integral part of Ukraine's health system since its formal introduction into national legislation in 2017. By 2020, HTA was mandated for evaluating publicly funded medicines, laying the groundwork for more evidence-based healthcare decisions. Although the creation of an independent HTA agency was initially planned for 2022, implementation was delayed due to the COVID-19 pandemic and Russia's ongoing invasion. The relevant Cabinet Resolution calls for the establishment of an autonomous agency by January 2026. This commentary outlines a strategic, evidence-informed framework to guide the agency's formation.
METHODS: Drawing on the 2018 State Strategy for Access to Medicines, the 2022 Law on Medicinal Products, and international best practices, we proposed to the Government of Ukraine a two-tier structure encompassing core business functions (HTA and appraisal, guideline development, pricing, and listing) and support business functions (data and analytics, finance and strategy, IT, human resources, legal, and communications). Each department is tasked with clear mandates and supported by performance indicators to promote transparency, accountability, and operational efficiency.
RESULTS: A phased roadmap for 2025-2027 details the legal, institutional, and financial steps required for successful implementation. Key opportunities - including international partnerships and system-wide reform - are weighed alongside risks such as funding uncertainty, workforce limitations, and geopolitical instability.
CONCLUSION: By embedding HTA into national policy processes and ensuring institutional independence, Ukraine can enhance the value of healthcare investments and build long-term resilience into its health system.}, }
@article {pmid41376972, year = {2025}, author = {Soto-Feijóo, R and Landín, E and Martínez-Martínez, H and Carreiras, M and Fanego, A and Ferreiro, L and Rodríguez-Núñez, N and Toubes, ME and Valdés, L}, title = {Analyzing pleural fluid attributes in SARS-CoV-2 infection: a systematic review.}, journal = {Journal of thoracic disease}, volume = {17}, number = {11}, pages = {10510-10518}, pmid = {41376972}, issn = {2072-1439}, abstract = {BACKGROUND: The characteristics of pleural fluid (PF) in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are poorly understood. During the pandemic, several cases of pleural effusion (PE) have been reported, but no clear conclusions have been reached regarding the features of this fluid. This systematic review aimed to analyze and summarize the available evidence on PF attributes in patients with SARS-CoV-2 infection.
METHODS: Systematic literature search using the PRISMA methodology of studies describing PF characteristics of SARS-CoV-2 patients and treatment of PE.
RESULTS: Eighteen articles (32 patients and 37 PF samples) were included. Median age was 61 years (range, 25-81 years), male/female ratio 5.4:1. PE was predominantly unilateral (71.4%), with no distinction between one side and the other; it usually extended over 2/3 of the hemithorax (50%) and its appearance was variable [serous (50%), hematic or serohematic (28.1%) and purulent (21.9%)]. PF was exudative in 88.9% of cases, but with PF protein and PF/serum protein ratio values less than 3 g/dL and 0.5 in 36.7% and 54.5%, respectively. The pH and glucose values were less than 7.20 and 60 mg/dL in 28.6% and 24% of cases, respectively. The percentage of neutrophils (≥50%) was higher than that of lymphocytes/monocytes [12/26 (46.2%) vs. 7/26 (26.9%), respectively]. Polymerase chain reaction (PCR) on PF was positive for SARS-CoV-2 in 6/23 cases (26.1%) and for other pathogens in 8 (5 bacteria and 3 fungi). Almost all patients underwent thoracentesis and the medical treatment received by the cases with positive PCR for SARS-CoV-2 on PF varied. Patient follow-up was provided in 25 cases and 10 cases died (40%).
CONCLUSIONS: PE from coronavirus disease 2019 (COVID-19) infection is more frequent among males aged 50-80 years, generally unilateral and large. Its appearance is variable, with features of lactate dehydrogenase (LDH)-discordant exudate, usually predominantly neutrophilic, with treatment like that of any other PE. PE from COVID-19 infection is a poor prognostic sign and associated with worse mortality.}, }
@article {pmid41377081, year = {2025}, author = {Lin, L and Talib, MBA}, title = {Exploring the relationship between domain-specific self-efficacy and motivation among university students: a systematic review (2019-2024).}, journal = {Frontiers in psychology}, volume = {16}, number = {}, pages = {1702507}, pmid = {41377081}, issn = {1664-1078}, abstract = {The interplay between domain-specific self-efficacy and motivation in higher education has garnered significant attention, particularly in the context of challenges such as the COVID-19 pandemic that have profoundly altered the educational landscape. This study provides a systematic review of the literature on the relationship between domain-specific self-efficacy and motivation among university students, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. From an initial pool of 5,890 articles sourced from the Education Resources Information Centre (ERIC), Scopus, and Web of Science (WoS) databases, 31 studies published between 2019 and 2024 were analyzed. Our findings underscore a predominantly positive correlation between domain-specific self-efficacy and motivation. Higher levels of self-efficacy are consistently linked to increased motivation, suggesting that enhancing self-efficacy could be a crucial strategy for boosting student motivation and, thus, academic success. Notably, many studies focus on Asian regions, highlighting both the universality and cultural specificity of these findings. However, the presence of an outlier study that found no significant relationship between self-efficacy and motivation indicates the complexity of these constructs and the potential impact of situational factors, warranting further investigation. Additionally, this review reveals a growing academic interest in self-efficacy and motivation, particularly within social sciences and education. This trend underscores the importance of a multidisciplinary approach to understanding the intricate dynamics between self-efficacy and motivation. The documented rise in research attention reflects a growing recognition of the critical role that self-efficacy and motivation play in student learning outcomes. In conclusion, this systematic review not only highlights the significant positive impact of domain-specific self-efficacy on student motivation but also calls for more nuanced studies. Future research should explore under-represented contexts and examine the broader implications of these findings across diverse educational and cultural settings.}, }
@article {pmid41377469, year = {2025}, author = {Ali, A and Shariq, K and Ashok Kumar, K and Zakai, A and Mumtaz, K and Ali, Z and Akmal, M and Kailash, SJ}, title = {Analyzing global research trends in hepatology during Coronavirus Disease 2019: a bibliometric analysis.}, journal = {Annals of medicine and surgery (2012)}, volume = {87}, number = {12}, pages = {8376-8384}, pmid = {41377469}, issn = {2049-0801}, abstract = {OBJECTIVE: Analyzing global hepatology trends during Coronavirus Disease 2019 (COVID-19) to accelerate effective treatments and protocols for researchers and healthcare systems.
METHODS: The related papers to COVID-19 and hepatology were extracted from 2019 to 2023. The articles were ranked according to the number of citations and a final list of top 101 most-cited articles were shortlisted. Analysis was carried out on the following: total citation count, publication year, journal name and its Impact factor, gender and their H-index, country of origin, funding information, and content of the articles. Citations per year and citations per author were calculated for all articles.
RESULTS: Between 2019 and 2023, the top 101 cited articles covered various topics. The highest number were published in 2021 (n = 42), with the American Journal of Transplantation contributing the most (n = 23). The University of Pennsylvania had the most influential presence (n = 5). These articles came from 44 countries where the US ranked first with 35 articles. There were a total of 160 authors involved, with each paper having a median and mean of 6 and 7.3 authors, respectively. The articles were categorized into nine main topics, with therapeutic intervention being the most common (n = 26) followed by pathophysiology (n = 20). Males outnumbered females as first and senior authors. A majority (n = 55) received funding, and most (n = 81) did not declare conflicts of interest.
CONCLUSION: Top articles in our analysis focused on liver transplantation, pathophysiology, and healthcare management. It can aid researchers in assessing the effectiveness of different treatment modalities for hepatic impairment in COVID-19 patients.}, }
@article {pmid41377933, year = {2025}, author = {Yang, B and Liu, J and Li, Y and Liu, X}, title = {mRNA Cancer Vaccines: From Pandemic Paradigm to Personalized Oncology Therapeutics.}, journal = {Cancer innovation}, volume = {4}, number = {6}, pages = {e70041}, pmid = {41377933}, issn = {2770-9183}, abstract = {The groundbreaking success of messenger RNA (mRNA) vaccines during the COVID-19 pandemic has significantly accelerated their application in oncology. This review comprehensively synthesizes the recent advancements in mRNA cancer vaccine development, emphasizing three critical domains: mechanistic innovations, clinical translation, and ongoing challenges. Technologically, advancements in nucleotide modification, lipid nanoparticle (LNP) delivery systems, and AI-driven neoantigen selection have significantly improved vaccine stability, immunogenicity, and personalization. Clinically, more than 150 trials have demonstrated the synergistic efficacy of mRNA vaccines (e.g., mRNA-4157/V940, BNT122) in combination with immune checkpoint inhibitors (ICIs), particularly in melanoma, with Phase III trials currently underway. Individualized neoantigen vaccines targeting patient-specific mutations have shown unprecedented response rates (> 50% in certain cohorts), while shared-antigen vaccines are progressing for high-incidence cancers. However, several critical challenges remain: (1) overcoming immunosuppressive tumor microenvironments (TME), (2) addressing systemic toxicities and LNP-related limitations, (3) scaling up cost-effective personalized manufacturing, and (4) optimizing targeted delivery. Future research directions encompass self-amplifying mRNA constructs, novel biomaterial vectors, neoadjuvant applications, and multi-omics integration for next-generation vaccine development. With rapid industrialization and evolving regulatory frameworks, mRNA vaccines are well-positioned to revolutionize precision cancer immunotherapy despite persistent translational barriers.}, }
@article {pmid41378112, year = {2025}, author = {Mijangos, LRR and Harding, SE and Darton, NJ}, title = {Developing high-concentration monoclonal antibody formulations for subcutaneous administration to improve patient treatment.}, journal = {Biophysical reviews}, volume = {17}, number = {4}, pages = {1013-1031}, pmid = {41378112}, issn = {1867-2450}, abstract = {The transition of immunotherapy administration from intravenous infusion to subcutaneous (SC) administration of monoclonal antibody formulations for oncology patients has garnered significant interest. SC administration offers multiple benefits, including potential for at-home administration, enhanced patient compliance, reduced hospital congestion, lowered health care costs, and improved sustainability by reducing drug wastage and minimizing environmental impact. However, for many biologics, the shift to SC administration requires the development of high-concentration monoclonal antibody products (HCmAP) due to the need for large dose volumes. Here we explore the impact of the COVID-19 pandemic on immunotherapy administration and the imperative of adopting SC administration. We discuss challenges encountered throughout the manufacturing, shipping, storage, and delivery of HCmAP. A central hurdle identified involves the biophysical instability and the large increase in viscosity of these biologics due to increased antibody concentration. Further complications can arise from "non-ideality" effects through molecular crowding or co-exclusion effects (macromolecules blocking the free movement in solution of other macromolecules) and elevated macromolecular interactions. For reducing the viscosity for a given concentration of antibody, the main excipients reported are salts and amino acids, with Arg-HCl demonstrating particularly improved formulation viscosity in an HCmAP. However, excipients with viscosity-lowering effects can also impact protein stability. The journey to discover suitable excipient strategies remains ongoing, combined with emerging approaches such as molecular engineering and computational techniques, with the ultimate aim of facilitating the successful integration of SC administration for economic savings, environmental sustainability, and social equity.}, }
@article {pmid41378119, year = {2025}, author = {Shepherd, J and Leake, MC}, title = {Invention, innovation, and commercialisation in British biophysics.}, journal = {Biophysical reviews}, volume = {17}, number = {4}, pages = {1143-1156}, pmid = {41378119}, issn = {1867-2450}, abstract = {British biophysics has a tradition of scientific invention and innovation, resulting in new technologies transforming biological insight, such as rapid DNA sequencing, super-resolution and label-free microscopy, high-throughput and single-molecule bio-sensing, and bio-inspired synthetic materials. Some advances were established through democratised platforms and many have biomedical success, a key example involving the SARS-CoV-2 spike protein during the COVID-19 pandemic. Here, three UK labs made crucial contributions revealing how the spike protein targets human cells and how therapies of vaccines and neutralising nanobodies work, enabled largely through biophysical innovations of cryo-electron microscopy. Here, we discuss leading-edge innovations which resulted from discovery-led British "Physics of Life" research (capturing blends of physical-life sciences research in the UK including biophysics and biological physics) and have matured into wide-reaching sustainable commercial ventures enabling translational impact. We describe the biophysical science which led to these academic spinouts, presenting the scientific questions that were addressed through innovating new techniques and approaches. We consider these examples through the lens of opportunities and challenges for academic biophysics research in partnership with British industry. We highlight how commercial breakthroughs have emerged organically from fundamental research rather than from technology-first approaches but also discuss lessons to learn from past failures. Finally, we propose recommendations concerning future resourcing and structuring of UK biophysics research and the training and support of its researchers to ensure that UK plc punches above its weight in biophysics innovation and a need to educate the policymakers and public that an absence of basic science impoverishes innovation.}, }
@article {pmid41378159, year = {2025}, author = {Mahamadou, D and Abdoul-Aziz, AB and Moustapha, LM and Alkassoum, I and Fils, SA and Hamsatou, B and Bachir, G and Abdourahmane, Y and Farouk, M and Lagare, A and Eric, A and Issifou, D and Hassane, N and Habibatou, I and Eholié, SP}, title = {Resurgence of epidemics in Zinder: effect of the decrease in vaccination coverage and the impacts of climate change.}, journal = {IJID regions}, volume = {17}, number = {}, pages = {100781}, pmid = {41378159}, issn = {2772-7076}, abstract = {OBJECTIVES: Several epidemic outbreaks have affected the Zinder region. These include diseases targeted by the expanded immunization program and other emerging diseases. This study aimed to analyze these epidemics.
METHODS: This is documentary research of the epidemics of meningitis, measles, cholera, COVID-19, and diphtheria, which occurred in the Zinder region from 2015 to 2023, as well as their determinants. The data collection is made from the linear list of notifiable diseases of the Regional Directorate of Health and Public Hygiene of Zinder, associated with literature review on the determinants of the appearance of these epidemics.
RESULTS: The number of meningitis cases has gradually increased in Zinder from 2019 to 2024. A total of 5019 cases were registered during these epidemics, with a mortality rate of 6.31%. Five measles epidemics have been recorded since 2015. A total of 13,887 cases were notified during these epidemics, with a mortality rate of 0.30%. Three cholera epidemics occurred: in 2021, in 2022, and in 2024. During these epidemics, 884 cases were recorded, with 24 deaths or a lethality of 2.71%. The COVID-19 epidemic occurred in 2020, with 364 cases, including 17 deaths, i.e. a mortality rate of 4.67%. Since 2022, the region has been facing a diphtheria epidemic. A total of 3310 cases has been reported, with 173 deaths. The causes of these epidemics are multifaceted; they involve the decline in vaccination coverage, migration, insecurity, the COVID-19 pandemic, and climate change.
CONCLUSIONS: The impact of epidemics on the health of the population and the socio-economic development of regions implies a greater mastery of the root causes mentioned in this study.}, }
@article {pmid41379191, year = {2025}, author = {La Scaléa, ACR and Uehara, SCDSA}, title = {Pain in Long COVID: A scoping review of clinical characteristics and patterns of manifestation.}, journal = {Revista latino-americana de enfermagem}, volume = {33}, number = {}, pages = {e4777}, pmid = {41379191}, issn = {1518-8345}, mesh = {Humans ; *COVID-19/complications ; Female ; *Pain/etiology/diagnosis/epidemiology ; Male ; Pain Measurement ; SARS-CoV-2 ; }, abstract = {to map the available scientific evidence on the clinical characteristics and patterns of pain manifestation (location, frequency, duration, intensity, and quality) in individuals with Long COVID. a scoping review of publications from March 2020 to June 2024, indexed across four databases. Study selection was conducted by two independent, blinded reviewers. Data were extracted using a standardized instrument and analyzed descriptively. nineteen studies were included, indicating that pain affects individuals across all age groups, with higher prevalence among women, primarily involving the head, neck, shoulder, lower back, and hip. Pain frequency ranged from daily to monthly episodes, with duration exceeding one year in some cases. Intensity varied from mild to severe, and pain characteristics were diverse, with descriptors including burning, pressure, colicky, and throbbing pain. the clinical characteristics and patterns of pain manifestation in Long COVID are diverse. However, there is a paucity of studies providing detailed analyses of pain features and the influence of individual variables. These findings should guide future research and clinical practice toward a more comprehensive and contextualized assessment of pain in Long COVID.}, }
@article {pmid41379341, year = {2025}, author = {Mahdizadeh, S and Hamid, KH and Roudsari, MB and Jamil, NY and Alfarttoosi, KH and Taher, SG and Alwan, M and Jawad, M and Mushtaq, H and Soleimani, M and Tabatabaei, SN}, title = {Impact of emerging and re-emerging viral infections on periodontitis progression.}, journal = {Archives of microbiology}, volume = {208}, number = {1}, pages = {59}, pmid = {41379341}, issn = {1432-072X}, mesh = {Humans ; *Periodontitis/virology/microbiology/pathology/immunology ; *COVID-19/complications/virology ; *Virus Diseases/virology/complications ; Disease Progression ; SARS-CoV-2 ; }, abstract = {Periodontitis is a chronic inflammatory disease that progressively destroys the tooth-supporting structures, including the gums, periodontal ligament, and alveolar bone. This destruction is primarily driven not by the bacteria themselves, but by the host's dysregulated immune response to a dysbiotic subgingival biofilm. Bacterial colonization in periodontal disease (PD) triggers both innate and adaptive immune responses. Furthermore, numerous viruses-including human cytomegalovirus (HCMV), Epstein-Barr virus (EBV), and herpes simplex virus (HSV)-have been linked to periodontal disorders and contribute to the etiopathogenesis of periodontitis alongside bacteria. Since its emergence in 2020, COVID-19 has posed a significant global health threat. SARS-CoV-2 infection within the periodontium may induce local inflammation, potentially exacerbating PDs. Given that viral replication and persistence in tissues are thought to increase with the severity of inflammation, the presence of these viruses may be linked to the development and progression of periodontitis. The current study is unique in its synthesis of data on a wide spectrum of viruses associated with periodontitis. This includes common viruses (EBV, HCMV, HSV, human papillomavirus (HPV), and human immunodeficiency virus (HIV)), emerging viruses (Chikungunya, Dengue), and novel viruses such as SARS-CoV-2. By providing a comprehensive overview of viral co-infections in periodontitis, this review advocates for the development of new antiviral diagnostic and therapeutic strategies that adopt a broad, virus-centric approach. We conducted a literature search across PubMed, Google Scholar, and Web of Science using keywords and Medical Subject Headings (MeSH) terms such as "viral infection," "periodontitis," and specific virus names.}, }
@article {pmid41379358, year = {2025}, author = {Gomes, P and de Menêses, AG and Silveira, RCCP and Guerra, ENS and Dos Reis, PED and Ferreira, EB}, title = {Radiation recall dermatitis in cancer patients previously undergoing radiotherapy: a scoping review.}, journal = {Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer}, volume = {34}, number = {1}, pages = {26}, pmid = {41379358}, issn = {1433-7339}, mesh = {Humans ; *Radiodermatitis/etiology/epidemiology ; *Neoplasms/radiotherapy/drug therapy ; Antineoplastic Agents/adverse effects/administration & dosage ; Female ; Radiotherapy/adverse effects ; }, abstract = {PURPOSE: To map the evidence related to radiation recall dermatitis (RRD) in cancer patients previously treated with radiotherapy.
METHODS: A scoping review was conducted following the methodology outlined by the JBI Collaboration. The search was performed in PubMed, CINAHL, LILACS, Scopus, Web of Science Core Collection, Cochrane, and grey literature using Google Scholar and ProQuest on January 28, 2025. Studies published in any language and without restrictions on publication year were included.
RESULTS: This review incorporated 210 studies on RRD in cancer patients, with a predominance of case reports and case series (84.7%). Approximately 48% of cases were reported in breast cancer patients. Among these studies, 92 primary articles documented 201 instances of RRD. A significant association was identified with antineoplastic agents (73.6%), predominantly due to chemotherapy, with docetaxel identified as the most frequently reported agent (13.5%). The radiotherapy doses administered ranged from 8 to 65 Grays, and the time intervals between radiotherapy and the onset of the RRD-triggering agent varied widely, from hours to 40 years. This condition can cause symptoms such as erythema, dry and moist desquamation, edema, itching, pain, ulceration, necrosis, and bleeding.
CONCLUSION: RRD is a significant adverse event, particularly among women with breast cancer, most commonly associated with chemotherapy involving docetaxel and doxorubicin. COVID-19 infection and vaccination have also been reported as potential new triggers of RRD. Further research is needed to clarify the underlying mechanisms and to optimize therapeutic strategies for at-risk patients.}, }
@article {pmid41379362, year = {2025}, author = {Nazarian, E and Sinnige, JS and Bos, LDJ and Smit, MR}, title = {Advances in bedside imaging: lung ultrasound.}, journal = {Intensive care medicine experimental}, volume = {13}, number = {1}, pages = {126}, pmid = {41379362}, issn = {2197-425X}, abstract = {Lung ultrasound has become an indispensable tool in the management of acute respiratory failure, offering real-time, radiation-free bedside imaging. Its portability, repeatability, and high sensitivity for detecting pulmonary abnormalities have made it particularly valuable in critical care settings, especially during the Coronavirus disease 2019 pandemic. This narrative review explores the evolving role of lung ultrasound, examining both its established clinical applications and recent advances in artificial intelligence and imaging analysis. These developments emphasize the growing importance of lung ultrasound not only as a diagnostic tool but also as a platform for innovation, with artificial intelligence-driven approaches to further enhance its clinical utility.}, }
@article {pmid41379427, year = {2026}, author = {Salamh, P and Dilibe-Daramola, F and Flannery, A and Pollard, C and Rocha, R and Lapidow, A and Wooten, L}, title = {Incidence and characteristics among individuals developing frozen shoulder following COVID-19 vaccine administration: A systematic review.}, journal = {Physiotherapy theory and practice}, volume = {42}, number = {7}, pages = {981-988}, doi = {10.1080/09593985.2025.2601894}, pmid = {41379427}, issn = {1532-5040}, mesh = {Humans ; *Bursitis/epidemiology/etiology ; *COVID-19 Vaccines/adverse effects ; Incidence ; COVID-19/prevention & control ; Risk Factors ; *Vaccination/adverse effects ; }, abstract = {PURPOSE: Perform a systematic review to determine incidence and characteristics of vaccine administration of those developing frozen shoulder (FS) following COVID-19 vaccine administration.
METHODOLOGY: Systematic review of the literature (PROSPERO number CRD42024611140). Inclusion criteria; diagnosis of frozen shoulder, published or available in the English language and onset of frozen shoulder linked to COVID-19 vaccination. Studies were excluded if FS was linked to onset outside of vaccination and if data were not separated. Relevant studies were assessed for inclusion and selected studies were identified from PubMed, EMBASE, EBSCOhost, Cochrane Library, Web of Science and CINAHL databases. The search strategy was developed by a biomedical librarian run on August 4, 2025. Data were extracted from retained studies and underwent quality assessment using The Joanna Briggs Institute Critical Appraisal Checklist.
RESULTS: The search resulted in 1,506 studies and 9 retained for appraisal. A total of 140 individuals were identified among the retained studies with past medical history being reported in 6 of these studies identifying diabetes and hypothyroidism among the most common. Vaccine manufacturer and symptom manifestation data were reported in all retained studies. Incidence could not be determined based on available data.
CONCLUSION: In addition to known risk factors associated with vaccinations, those with comorbidities associated with the etiology of FS may also be predisposed to developing FS following COVID-19 vaccination administration. Clinicians evaluating those with suspected FS should be aware of the link between vaccinations and the development of FS. Additionally, clinicians administering COVID-19 vaccinations and boosters need to be aware of potential risk factors that may predispose individuals to developing FS following as well as possible signs and symptoms to be aware of post-vaccination.}, }
@article {pmid41379524, year = {2026}, author = {Colonna, C and Monzani, NA and Moiraghi, A and Tibiletti, A and Aromolo, IF and Cavalli, R}, title = {Pityriasis rubra pilaris triggered by vaccination.}, journal = {Italian journal of dermatology and venereology}, volume = {161}, number = {1}, pages = {65-70}, doi = {10.23736/S2784-8671.25.08304-5}, pmid = {41379524}, issn = {2784-8450}, mesh = {Humans ; *Pityriasis Rubra Pilaris/etiology/chemically induced ; Male ; *COVID-19 Vaccines/adverse effects ; Adult ; *Vaccination/adverse effects ; Middle Aged ; Aged ; Child ; Adolescent ; Aged, 80 and over ; Infant ; Female ; Child, Preschool ; Young Adult ; }, abstract = {INTRODUCTION: Pityriasis rubra pilaris (PRP) is a rare inflammatory papulo-squamous skin disease. To date, the exact etiopathogenesis of PRP is unknown; although the most accepted triggers are viral or bacterial infections, few cases after vaccination have been reported as well.
EVIDENCE ACQUISITION: Our aim is to conduct a systematic review of cases of PRP triggered by vaccination. The PubMed and Scopus databases were searched for articles concerning PRP post-vaccination, published between January 2000 and June 2024. We also added a previously unpublished case that came to our attention.
EVIDENCE SYNTHESIS: Twenty-three articles were included, and 30 cases have been identified. The majority of patients were male (20/30, 66.6%). The median age of onset was 55 years (min 17 months-max 85 years). Most patients (27/30, 90%) were adults vaccinated against SARS-CoV-2, of whom 14/27 (51.9%) received mRNA-based vaccines (9 Comirnaty/Pfizer and 5 Spikevax/Moderna). The three pediatric cases had been vaccinated against Measles-Mumps-Rubella (2 cases) and intramuscular diphtheria-tetanus-pertussis vaccine plus oral poliovirus. The temporal relationship between vaccination and PRP onset varied (median 10 days post-vaccination; min 2-max 30). PRP occurred both after the first dose (14/30, 46.6%) and at subsequent doses of the vaccine. The majority of patients re-exposed to new doses (6/9, 66%) experienced clinical exacerbation. Post-vaccination PRP responds well to both traditional and biologic treatments, with only 4/30 (13.3%) showing no resolution.
CONCLUSIONS: In conclusion, PRP post-vaccination is rare and likely underdiagnosed, but recognizing the association is important to evaluate any new exposures to the trigger. A thorough patient history, including recent vaccinations, is crucial.}, }
@article {pmid41380366, year = {2026}, author = {Sorotos, M and Firmani, G and Mareş, T and Ceccaroni, A and Santanelli di Pompeo, F}, title = {Epidemiology of Breast Implant-Associated Anaplastic Large Cell Lymphoma - A systematic review of literature.}, journal = {Journal of plastic, reconstructive & aesthetic surgery : JPRAS}, volume = {113}, number = {}, pages = {399-410}, doi = {10.1016/j.bjps.2025.11.038}, pmid = {41380366}, issn = {1878-0539}, mesh = {Humans ; *Lymphoma, Large-Cell, Anaplastic/epidemiology/etiology ; *Breast Implants/adverse effects ; Female ; *COVID-19/epidemiology ; Incidence ; *Breast Neoplasms/epidemiology/etiology ; Prevalence ; Global Health ; }, abstract = {INTRODUCTION: Breast Implant Associated - Anaplastic Large Cell Lymphoma (BIA-ALCL) cases are steadily increasing worldwide. When considering only the patients with textured implant as the active population, prevalence appears higher than previously reported, and uncertainty regarding incidence rate (IR) trends. We aimed to provide comprehensive estimates by identifying epidemiologic studies reporting prevalence, risk, and IR.
METHODS: A systematic review was conducted up to November 2024 across PubMed, Google Scholar, and Web of Science. Epidemiological data were extracted from the "Patient Registry and Outcomes for Breast Implants and Anaplastic Large Cell Lymphoma Etiology and Epidemiology" (PROFILE) registry (US-specific), Food and Drug Administration (FDA)-Medical Device Reporting (MDR) (US/global), and BIA-ALCL Global Network (worldwide), providing granular data for 2019-2024, enabling yearly IR analysis. All findings were normalized using textured implants patients as the denominator. Interrupted time-series analysis was used to determine the impact of the COVID-19 pandemic on BIA-ALCL reporting.
RESULTS: Among the 1949 studies, 23 were analyzed.
PREVALENCE: 1.0-397.9/100,000 persons; risk: 1:250-1:99,992; and IR 0.021-124/100.000 persons/year. Nationally (US), PROFILE and FDA-MDR data showed IR peaking in 2020 (16.4 and 25.7/100,000) and then declining. Globally, FDA-MDR estimates peaked in 2021 (0.95/100,000) and plummeted in 2022 (0.14/100,000). Global Network data peaked in 2018 (0.68/100,000), dropped in 2020 (0.18/100,000), but rose again in 2024 (0.73/100,000). Significant IR declines (p = 0.02), were identified during the COVID-19 pandemic (2020-2022). Global data suggest transient underreporting and diagnostic delays.
CONCLUSION: BIA-ALCL IR decreased in 2022, then rose globally in 2023-2024, but not in the US, where it continued declining. IR trends were increasing but were influenced by COVID-19, with differences in absolute values likely reflecting smooth vs. textured implant market share variations. Contextualizing epidemiology by surface type and geography remains fundamental.}, }
@article {pmid41380396, year = {2026}, author = {Ballout, S and Darwish, SA and Kelly, PJ and Keller, T and Shegog, R and Aboul-Enein, BH}, title = {The use of storytelling in COVID-19 vaccine promotion: A scoping review of interventions and campaigns.}, journal = {Vaccine}, volume = {72}, number = {}, pages = {128098}, doi = {10.1016/j.vaccine.2025.128098}, pmid = {41380396}, issn = {1873-2518}, mesh = {Humans ; *COVID-19 Vaccines/administration & dosage ; *COVID-19/prevention & control ; *Vaccination Hesitancy/psychology ; *Health Promotion/methods ; *Narration ; SARS-CoV-2/immunology ; *Health Communication/methods ; Vaccination/psychology ; Public Health ; Communication ; }, abstract = {BACKGROUND: The development of the COVID-19 vaccine, a groundbreaking scientific advancement, also fueled vaccine hesitancy mainly due to vaccine misinformation and the limited public understanding of the new technology and its rapid pace of development and deployment. A variety of public health communication strategies have been used that include engaging the community in identifying and developing messages, using culturally appropriate communication methods, applying behavioral health principles, and storytelling. The purpose of this scoping review was to assess the most relevant evidence from the research literature on storytelling interventions to mitigate COVID vaccine hesitancy during the pandemic.
METHODS: A scoping review was conducted using the PICOS framework and PRISMA-ScR guidelines, examining studies across 16 databases published between 2020 and October 2025.
RESULTS: Twelve studies met inclusion criteria. Studies involved diverse populations and four implementation themes (cultural relevance, emotional engagement, participant involvement and reach) were identified. The experimental and quasi-experimental studies consistently found that narratives elicited greater emotional engagement, heightened perceived credibility, and stronger identification with the messenger.
CONCLUSION: Storytelling is recognized as a critical component of public health campaigns in its ability to leverage the power of community influencers, such as religious leaders, educators, and local advocates who echo community values. Long-term cohort studies, community-based social marketing campaigns, and qualitative studies are needed to assess specific impacts on vaccination behaviors. Storytelling, when tailored to audience, culture, and context, can contribute to promotion of vaccination, particularly in improving trust, empathy, and misinformation.}, }
@article {pmid41380718, year = {2026}, author = {Fuchs, H and Gunst, L and Wendt, A and Becker, S and Grychtol, RM and Vlajnic, D and Aschmann-Muehlhans, D and Wuerfel, C and Steindor, M and Muehlberg, S and Stehling, F}, title = {[Pediatric pneumological aspects in the care of children with Down Syndrome].}, journal = {Klinische Padiatrie}, volume = {238}, number = {2}, pages = {59-64}, doi = {10.1055/a-2748-4649}, pmid = {41380718}, issn = {1439-3824}, mesh = {Humans ; *Down Syndrome/complications/diagnosis/therapy ; Child ; Infant ; Child, Preschool ; *Lung Diseases/therapy/diagnosis/etiology ; Sleep Apnea, Obstructive/therapy/diagnosis ; }, abstract = {Pulmonary problems are common in children with Downsyndrome/trisomy 21, alongside other health issues, but are often given too little attention. The aim of this review is to summarize these aspects for pediatric pulmonologists. Narrow nasal passages, a small pharynx and larynx, in combination with relative macroglossia, other airway malformations, and generalized muscular hypotonia, lead to glossoptosis, which in very young infants frequently causes obstructive sleep apnea syndrome. If left untreated, this is associated with impaired cognitive development. The children also suffer from chronic rhinitis. Together with recurrent silent aspirations resulting from the typical dysphagia of children with Trisomie 21 and immune dysregulation, lower respiratory tract infections are common and often severe. Viral infections caused by RSV, influenza, and SARS-CoV-2 more frequently lead to hospitalizations and have a much higher mortality rate than in healthy children. Children with Down syndrome are also more likely to develop chronic wheezing. The development of pulmonary hypertension may rarely occur even without an associated heart defect. This article summarizes the diagnostic and therapeutic tasks related to pulmonary problems in children with Down syndrome for the pediatric pulmonologist.}, }
@article {pmid41383331, year = {2025}, author = {Okon, MB and Ugwu, OP and Ugwu, CN and Ogenyi, FC and Swase, DT and Anyanwu, CN and Eze, VHU and Ugwu, JN and Akinola, SA and Mujinya, R and Anyanwu, EG}, title = {From pandemics to preparedness: harnessing AI, CRISPR, and synthetic biology to counter biosecurity threats.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1711344}, pmid = {41383331}, issn = {2296-2565}, mesh = {Humans ; *Artificial Intelligence ; *Pandemics/prevention & control ; *Synthetic Biology ; *Biosecurity ; *Bioterrorism/prevention & control ; COVID-19/prevention & control ; *Civil Defense/methods ; Global Health ; }, abstract = {Biosecurity threats, which include natural outbreaks, laboratory accidents, and intentional bioterrorism, are a major issue for global health security. The impact of poor preparedness on the health, social, and economic effects of the 1918 influenza pandemic, the 2001 anthrax attacks, and the COVID-19 crisis is devastating. Standard methods, such as quarantine and serology, as well as traditional inoculations, offered basic defences but were often reactive, slow, and unfair. The recent scientific and technological progress has altered the concept of biosecurity preparedness by providing new instruments of early detection, quick reaction, and fair health solutions. Artificial intelligence-based epidemic prediction, next-generation sequencing, CRISPR-based diagnostics, and digital epidemiology are emerging technologies that enable near-real-time surveillance. New therapeutic agents and vaccines, such as mRNA and DNA platforms, monoclonal antibodies, and nanobody therapies, have enhanced response capabilities. Containment measures based on robotics, biosensors, nanotechnology-based PPE, and portable biocontainment units have simultaneously improved frontline safety. Sensitive health information and enhanced coordination are today secured with the help of digital and cyber-biosecurity tools. Nonetheless, the innovations have ethical, legal, and equity issues, which point to the need to govern responsibly and make them accessible to all. This review brings forth the incorporation of emerging technologies with international cooperation, fair systems, and responsive policies as the keys to developing resilient and future-orientated systems that could help alleviate natural, accidental, and intentional biosecurity threats.}, }
@article {pmid41383618, year = {2025}, author = {Xu, T and Zhang, J and Hou, X and Xie, X and Qi, J and Wang, C and Yan, Y and Kuang, L and Zhu, B}, title = {MIS-C pathogenesis: immune dysregulation & viral triggers.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1624963}, pmid = {41383618}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/immunology/complications ; *SARS-CoV-2/immunology ; *Systemic Inflammatory Response Syndrome/immunology/therapy/etiology/virology ; Child ; Immunity, Innate ; Adaptive Immunity ; Cytokine Release Syndrome/immunology ; }, abstract = {Multisystem Inflammatory Syndrome in Children (MIS-C) is a serious condition emerging during the COVID-19 pandemic, strongly associated with prior SARS-CoV-2 infection. Characterized by systemic inflammation affecting multiple organs, MIS-C presents a complex clinical picture including fever, gastrointestinal distress, cardiac dysfunction, and neurological manifestations. Although its exact pathogenesis remains incompletely understood, immune dysregulation is recognized as a central mechanism. This review examines current understanding of MIS-C pathogenesis, focusing on immune dysfunction and viral triggers, particularly SARS-CoV-2. We analyze both innate and adaptive immune responses, cytokine storm dynamics, molecular mimicry, and virus-induced inflammatory cascades. Additionally, we discuss potential immunomodulatory therapeutic strategies and identify future research directions to improve MIS-C management and treatment outcomes.}, }
@article {pmid41383811, year = {2025}, author = {Manivannan, SN and Diaz Arenas, C and Grubaugh, ND and Ogbunugafor, CB}, title = {The importance of epistasis in the evolution of viral pathogens.}, journal = {Virus evolution}, volume = {11}, number = {1}, pages = {veaf091}, pmid = {41383811}, issn = {2057-1577}, support = {R01 AI168166/AI/NIAID NIH HHS/United States ; }, abstract = {Understanding the genetic and genomic underpinnings of infectious disease outbreaks has emerged as a frontier of epidemiology. Here, we argue that epistasis-where the phenotypic effects of mutations or gene variants are dictated by the presence of other mutations or genes-should become a focus of genomic epidemiology. To demonstrate this, we present the results of a systematic review of the literature on epistasis in viruses, focusing on three major human viral systems: (i) influenza, (ii) SARS-CoV-2, and (iii) human immunodeficiency virus, as well as two other bodies of the literature mainly focusing on nonhuman viruses: (iv) tobacco etch virus and (v) experimental evolution of viruses. Our systematic review of these five bodies of the literature highlights that epistasis is prevalent in host-virus systems of various kinds, manifesting within and between different loci, with effects of different magnitudes and directions, and shaping various phenotypic traits of epidemiological interest. At the same time, our systematic review demonstrates that our ability to draw general conclusions about the direction and magnitude of epistasis in viral evolution is constrained by several factors: the idiosyncrasies of virus-host systems, biases in the underlying data collection exercises, and the limitations of existing methods. Moving forward, we encourage collaborations between genomic epidemiologists and evolutionary biologists to identify and measure epistasis in studying the evolution of viral pathogens.}, }
@article {pmid41383825, year = {2025}, author = {Trulik, KG and Kumar, VA and Wu, W and Varma, M and Patel, MM and Manglani, K and Mathew, TA}, title = {Exploring Stress, Fatigue, Burnout, and Resilience Among Healthcare Personnel in Southern and South-Eastern Asia: A Scoping Review.}, journal = {Public health reviews}, volume = {46}, number = {}, pages = {1608603}, pmid = {41383825}, issn = {0301-0422}, abstract = {OBJECTIVES: This study aims to compare methods used to measure burnout, fatigue, stress, and resilience, as well as resilience-building interventions among healthcare personnel (HCP) in Southern and South-eastern Asia. Even before COVID-19, HCP faced high levels of burnout and stress, exacerbated by the pandemic. Identifying effective resilience-building strategies is essential to supporting a healthier workforce.
METHODS: Studies published from January 2016 to December 2021 focusing on burnout, stress, fatigue, and resilience were included. COVIDENCE software was used for screening.
RESULTS: A total of 55 studies were included in the review. Of these 55 studies, 51 measured burnout, stress, fatigue, or resilience, using 77 different instruments. The MBI-HSS, PSS-10, BRS, Brief-COPE, and CD-RISC were the most common tools to assess burnout, stress, and individual resilience. Four studies evaluated resilience interventions, using mindfulness training, meditation, progressive muscle relaxation, and yoga.
CONCLUSION: There are many studies assessing burnout, stress, and resilience among HCP in Southern and South-eastern Asia, yet gaps remain in identifying effective resilience-building interventions. Further research is needed to assess the impact of individual resilience on health systems resilience.}, }
@article {pmid41384439, year = {2025}, author = {Van Houtte, P and Lamarche, F and Every-Palmer, S}, title = {Effects of face coverings on people and interactions in mental health settings: scoping review.}, journal = {BJPsych open}, volume = {12}, number = {1}, pages = {e11}, pmid = {41384439}, issn = {2056-4724}, abstract = {BACKGROUND: Early in the SARS-CoV-2 pandemic, most jurisdictions implemented mandatory face covering policies across healthcare settings. This intervention, which lasted multiple years, was unprecedented in psychiatry. Masks may affect the delivery of mental healthcare, given its reliance on nuanced communication and establishing a therapeutic alliance.
AIMS: This scoping review aimed to provide an overview of the current literature concerning the impact of face masks in mental health settings beyond infection control and identify research gaps to guide future research and policy.
METHOD: Systematic searches were completed in the MEDLINE, Embase, PsycINFO, Scopus and CINAHL databases on 14 August 2024. Articles were eligible if they described peer-reviewed empirical studies involving people with mental disorders or mental health clinicians that reported on impacts of face coverings.
RESULTS: Twenty-eight studies were selected for inclusion, involving 5385 participants. There was considerable heterogeneity among studies. Negative effects of face masks were reported in 26 studies in at least one domain. Themes from the survey-based literature included face masks negatively affecting communication, the therapeutic relationship and overall assessment quality. Experimental studies using emotion recognition tasks showed that people with mental disorders were disadvantaged by masks when interpreting emotions from facial expressions. The most commonly studied population was people with autism spectrum disorder. Children and people with severe or acute mental illness were underrepresented. Only two studies expressly recruited psychiatrists.
CONCLUSIONS: Policy makers should be aware of adverse impacts of mask-wearing in mental health settings and consider these in evolving risk-benefit analyses. Further research is needed to establish the extent of impacts on population subgroups.}, }
@article {pmid41384659, year = {2025}, author = {Bessalah, S and Sinha, D and Yuan, X and Paul, S and Longet, S}, title = {[Long COVID: therapeutic challenges and opportunities in the face of persistent sequelae].}, journal = {Medecine sciences : M/S}, volume = {41}, number = {11}, pages = {869-876}, doi = {10.1051/medsci/2025185}, pmid = {41384659}, issn = {1958-5381}, mesh = {Humans ; *COVID-19/complications/therapy/epidemiology ; *SARS-CoV-2/physiology ; Post-Acute COVID-19 Syndrome ; Pandemics ; COVID-19 Drug Treatment ; Antiviral Agents/therapeutic use ; Chronic Disease ; }, abstract = {The COVID-19 pandemic, caused by SARS-CoV-2, has not only led to a global health and economic crisis but also renewed attention to a clinical phenomenon of persistent symptoms after viral infection. This phenomenon is defined as long COVID or post-COVID-19 syndrome. Approximately one in eight patients experience persistent symptoms of varying intensity after the acute phase of the infection. This phenomenon, combined with the virus's high transmissibility and rapid mutation rate, poses a major public health challenge. This review examines various therapeutic approaches currently under consideration for treating long COVID, and explores future prospects in this field.}, }
@article {pmid41384913, year = {2026}, author = {Langille, C and Dow, T and Pouramin, P and Grue, B and Wheelock, M}, title = {Telemedicine for triage: A systematic review of virtual consultation in hand trauma.}, journal = {Journal of telemedicine and telecare}, volume = {32}, number = {6}, pages = {493-501}, doi = {10.1177/1357633X251384890}, pmid = {41384913}, issn = {1758-1109}, mesh = {Humans ; *Triage/methods ; *Hand Injuries/diagnosis ; COVID-19 ; *Telemedicine/economics ; Cost-Benefit Analysis ; *Remote Consultation/economics ; Pandemics ; SARS-CoV-2 ; Health Services Accessibility ; }, abstract = {IntroductionTelemedicine involves the use of electronic communication systems to exchange medical information between health professionals or with patients. With the increasing demand for telemedicine delivery, catalyzed by the COVID-19 pandemic, it is important to investigate the use of telemedicine within the field of hand surgery. The aim of this study is to present the current state of telemedicine use in hand trauma, with a particular focus on accuracy of diagnosis, cost effectiveness, and access to care.MethodsAn online systematic review of MEDLINE, EMBASE, Pubmed and The Cochrane Library from inception to 16 May 2025 was completed. Data extracted included telemedicine medium used, accuracy of diagnosis, cost, impact on patient transfer volume, and timeline for assessment. Study quality was assessed using the MINORS scale.ResultsOf the 15 included studies, eight assessed diagnostic accuracy, four evaluated cost savings, four examined patient transfers, five reported on efficiency, and three investigated access to care. All studies assessing accuracy found telemedicine to be an accurate method of triaging and diagnosing patients. All studies assessing cost-effectiveness found telemedicine to be an effective cost-savings instrument. Telemedicine was also demonstrated to improve healthcare efficiency by decreasing the number of unnecessary patient transfers, reducing extra visits and unnecessary consultations and improve access to specialist care for patients in rural communities.ConclusionsThe current literature suggests that the application of telemedicine in initial hand trauma consultation was found appears satisfactory diagnostic accuracy, cost savings, reduced patient transfers, increased efficiency, and improved access to care when compared to traditional face-to-face triaging and diagnosis of hand traumas although evidence is largely observational.}, }
@article {pmid41385334, year = {2025}, author = {Yang, Y and Sun, Y and Kang, X and Wang, Y}, title = {mRNA vaccine platforms and novel delivery systems: From mechanistic principles to clinical translation.}, journal = {Human vaccines & immunotherapeutics}, volume = {21}, number = {1}, pages = {2597629}, pmid = {41385334}, issn = {2164-554X}, mesh = {Humans ; *COVID-19 Vaccines/immunology/administration & dosage ; *Drug Delivery Systems/methods ; *Vaccines, Synthetic/immunology/administration & dosage ; *COVID-19/prevention & control/immunology ; Nanoparticles ; Vaccine Development ; *RNA, Messenger/immunology/administration & dosage/genetics ; *mRNA Vaccines/immunology/administration & dosage ; SARS-CoV-2/immunology ; Vaccines, Virus-Like Particle/administration & dosage/immunology ; }, abstract = {Messenger RNA (mRNA) vaccines have revolutionized the field of vaccinology, offering rapid design flexibility, scalable manufacturing, and strong immunogenicity. The unprecedented success of COVID-19 mRNA vaccines has accelerated research into novel delivery platforms and expanded therapeutic applications beyond infectious diseases to cancer immunotherapy and immune-mediated disorders. This review provides a comprehensive overview of the mechanistic principles underlying mRNA vaccine design, including mRNA engineering strategies, delivery innovations such as lipid nanoparticles (LNPs), polymeric nanoparticles (PNPs), and virus-like particles (VLPs), as well as emerging needle-free administration technologies. We further highlight recent advances in therapeutic areas spanning infectious diseases (e.g. HIV, tuberculosis, respiratory syncytial virus), oncology, and non-traditional indications such as autoimmune disorders. Despite remarkable progress, critical challenges persist in vaccine stability, delivery efficiency, large-scale manufacturing, and global accessibility. Finally, we discuss future research directions integrating artificial intelligence, nanotechnology, and systems immunology to accelerate next-generation mRNA vaccine development and clinical translation.}, }
@article {pmid41385480, year = {2025}, author = {Kardos, P and Becker, S and Heidenreich, KR and Klimek, L and Köhnlein, T and Labenz, J and Mülleneisen, N and Pfeiffer-Kascha, D and Pink, I and Sitter, H and Trinkmann, F and Worth, H and Winterholler, C}, title = {Diagnosis and Treatment of Adult Patients with Cough.}, journal = {Respiration; international review of thoracic diseases}, volume = {}, number = {}, pages = {1-31}, pmid = {41385480}, issn = {1423-0356}, abstract = {This is the 4th edition of the Cough Guidelines of the German Respiratory Society (DGP), written by and for respiratory, internal medicine, allergy, ear-nose-throat, gastroenterology specialists, speech therapists, and physiotherapists. In a modified Delphi process, the authors developed 12 key questions on classification, common causes of acute, subacute, and chronic cough: both as a symptom of respiratory diseases including the upper airways, reflux, and drug-related cough, and as a primary disease, i.e., unexplained chronic cough and refractory chronic cough due to hypersensitivity of the cough reflex. An in-person guideline conference followed to find evidence-based answers and recommendations, which were graded as strong, weak, or insufficient evidence for recommendation. A brief scientific background to the respective questions was then compiled by expert groups of authors. Diagnostic algorithms were created for acute, subacute, and chronic cough and reflux-related cough. The significantly reduced scope and improved overview make it easy to use it in daily practice. The guideline is available in digital form as a smartphone application (currently only in German): https://www.leila.de/de/.}, }
@article {pmid41385537, year = {2025}, author = {Takkar, A and Mahesh, KV and Shree, R and Tigari, B and Chatterjee, D and Ahuja, CK and Lal, V}, title = {Neuro-ophthalmology of Infectious Diseases.}, journal = {Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society}, volume = {45}, number = {3}, pages = {362-377}, pmid = {41385537}, issn = {1536-5166}, mesh = {Humans ; *Ophthalmology/methods ; *Eye Infections/diagnosis ; *Neurology ; }, abstract = {BACKGROUND: According to the World Health Organization, infections, particularly sepsis, are linked to over 20% mortality worldwide and are leading cause of morbidity. A variety of infections have neuro-ophthalmic manifestations. The profile of infectious agents, clinical manifestations, severity, and prognosis of these diseases are highly heterogeneous, and it is therefore difficult to make generalized statements about management.
EVIDENCE ACQUISITION: Available literature with regard to individual infectious agents and their neuroophthalmic manifestations or complications was searched using electronic databases such as PubMed, MEDLINE, Scopus, ProQuest, and Embase. The current study is a review of the literature along with the authors' personal experience in this field.
RESULTS: In this review, we describe the key neuro-ophthalmic manifestations of common bacterial, fungal, viral (except HIV, opportunistic infections, and COVID-19 virus), parasitic, and protozoal infections using illustrative examples.
CONCLUSIONS: Infections may involve the afferent and efferent visual pathways, as well as higher order visual processing functions. They can directly invade the eye and the brain or may cause damage due to inflammation, necrosis, vascular compromise, and postinfective demyelination. With the shifting geographic boundaries and widespread international migration, the spectrum of infectious neuro-ophthalmic diseases is expanding. Clinical details, dedicated imaging, biochemical, serological, and at times histopathological confirmation aids in making prompt diagnosis.}, }
@article {pmid41386679, year = {2026}, author = {Hamel, LP}, title = {Nicotiana benthamiana's Responses to Agroinfiltration, a Treasure Grove of New Avenues to Improve Protein Yields in Plant Molecular Farming.}, journal = {Plant biotechnology journal}, volume = {24}, number = {1}, pages = {5-17}, pmid = {41386679}, issn = {1467-7652}, mesh = {*Nicotiana/genetics/metabolism/microbiology ; Plants, Genetically Modified/metabolism/genetics ; *Molecular Farming/methods ; Agrobacterium tumefaciens/genetics ; *Recombinant Proteins/genetics/metabolism/biosynthesis ; Genetic Vectors ; Plant Leaves/metabolism/genetics ; }, abstract = {Transient expression of recombinant proteins in leaves of Nicotiana benthamiana is routinely employed for both basic research and manufacturing of biopharmaceutical products in plants. Relying on disarmed strains of the bacterial plant pathogen Agrobacterium tumefaciens as a transgene vector, this safe, cost-effective and easily scalable 'plant molecular farming' approach offers a reliable alternative to classical protein expression platforms. Commonly referred to as agroinfiltration, scaled-up versions of this manufacturing process have now become helpful in the fight against global health issues, such as those rapidly evolving virus strains causing influenza or coronavirus disease 2019. In the past decades, considerable efforts have been deployed to improve the efficacy of Agrobacterium-mediated expression, including through the development of new binary vectors, the design of strong promoters, and the deployment of approaches to increase levels and stability of transgene mRNAs. By comparison, much less attention has been given to understanding the effects that agroinfiltration unavoidably has on host plants, including the infiltration process itself, the perception of Agrobacterium and the subsequent accumulation of recombinant products throughout the expression phase. Using the upregulation profiles of plant receptor genes during the heterologous expression of virus-like particles in N. benthamiana leaves, I here describe how some of these host responses interact with each other to form an intricate signalling interplay at the molecular level. I also review host plant's responses to agroinfiltration and highlight strategies that have emerged to improve the efficacy of plant cell biofactories based on the better understanding of this transient expression system.}, }
@article {pmid41386922, year = {2025}, author = {Bhalla, A and Tummalapalli, SL and Silberzweig, J}, title = {Quality Metrics in Dialysis: It Takes a Village.}, journal = {Advances in kidney disease and health}, volume = {32}, number = {5}, pages = {451-459}, pmid = {41386922}, issn = {2949-8139}, support = {K08 HS028684/HS/AHRQ HHS/United States ; }, mesh = {Humans ; *COVID-19/epidemiology ; *Renal Dialysis/standards ; *Kidney Failure, Chronic/therapy ; United States ; *Patient Care Team/organization & administration ; SARS-CoV-2 ; *Quality of Health Care ; Hemodialysis, Home/standards ; }, abstract = {Dialysis is a specialized therapy rendered by a team of interdisciplinary professionals. Federal regulations mandate that dialysis facility staff, at minimum, include a registered nurse, physician, social worker, and dietitian. To ensure that patients on dialysis receive high-quality care, the Centers for Medicare and Medicaid Services introduced the first federally mandated pay for performance program in January 2012: the ESRD Quality Incentive Program. Quality metrics in the ESRD Quality Incentive Program have continuously evolved, necessitating greater involvement from the dialysis interdisciplinary team. In this article, we discuss the interdisciplinary nature of dialysis facility staffing and highlight the critical role of all care team members in attaining high performance on dialysis quality metrics. In the context of the coronavirus disease 2019 pandemic, we highlight recent staffing challenges and propose strategies to alleviate workforce shortages. Finally, we review 2 major trends: (1) an increased emphasis on home dialysis and (2) calls to address social determinants of health, which will require the interdisciplinary team to assume an even larger role in achieving high-quality care.}, }
@article {pmid41387929, year = {2025}, author = {Kanno, H and Liu, Z and Sato, R and Endo, H and Niizuma, K and Goda, K}, title = {Single-pixel imaging flow cytometry for biomedical research.}, journal = {Inflammation and regeneration}, volume = {45}, number = {1}, pages = {36}, pmid = {41387929}, issn = {1880-9693}, abstract = {High-throughput single-cell analysis and screening have become essential tools in life science research. Imaging flow cytometry, in particular, enables large-scale image-based profiling of heterogeneous cell populations, allowing statistical analysis of cellular morphology, subcellular features, and functional responses. However, its analytical capability is often limited by the use of conventional two-dimensional (2D) image sensors. In this review, we highlight recent advances in single-pixel imaging flow cytometry, which replaces 2D image sensors with single-pixel photodetectors. This approach offers advantages in sensitivity, flexibility, and speed in imaging system design and has been implemented in various optical configurations to achieve high-throughput single-cell imaging. We first introduce its key techniques, then outline representative biomedical applications, including cancer and COVID-19 research, and finally discuss current limitations and prospects for future developments. Single-pixel imaging flow cytometry is expected to serve as a versatile platform supporting both basic and translational studies in diverse biomedical applications.}, }
@article {pmid41389117, year = {2026}, author = {Okesanya, OJ and Oso, TA and Adebayo, UO and Obadofin, JA and Abdulghaniy, RO and Bamigbade, AA and Ogaya, JB and Ngwoke, I and Ahmed, MM and Aban, JL}, title = {Transforming public mental health: a review on global trends, challenges, and pathways to change.}, journal = {Health care analysis : HCA : journal of health philosophy and policy}, volume = {34}, number = {1}, pages = {57-85}, pmid = {41389117}, issn = {1573-3394}, mesh = {Humans ; COVID-19 ; *Global Health ; *Mental Disorders/therapy/epidemiology ; *Mental Health ; *Public Health/trends ; *Mental Health Services/organization & administration ; Developing Countries ; SARS-CoV-2 ; }, abstract = {This review synthesizes global trends, persistent challenges, and actionable pathways for overhauling public mental health systems, with a particular focus on low- and middle-income countries (LMICs). Thematic analysis of our review revealed that mental health disorders now affect nearly one in eight people worldwide, yet up to 75% of those in LMICs receive no treatment due to stigma, underfunding, workforce shortages, and fragmented systems, perpetuating a widening "treatment and care gap." Social inequities, harmful cultural norms, conflict, climate change, and gender disparities further amplify the risk and economic burden, projected to exceed US$6 trillion by 2030. Innovative financing approaches, including public-private partnerships and models from countries such as Norway and Australia, offer promising strategies for sustainable investments. The COVID-19 pandemic intensified mental health challenges but also raised global awareness, with leaders such as the United Nations Secretary-General and the United States Surgeon General foregrounding mental health crises in the public consciousness. Advocacy initiatives, including the FundaMentalSDG campaign, Lancet Commissions, Global Mental Health Action Network, and Global Mental Health Peer Network, have been pivotal in elevating mental health within the Sustainable Development Goals (SDGs) and linking it to social determinants. Emerging solutions include rights-based frameworks that emphasize participation and anti-discrimination, scaling up task-sharing and expanded roles for non-specialists through programs such as the World Health Organization's Mental Health Gap Action Programme, community-based interventions like Zimbabwe's Friendship Bench, and integration of mental health into primary care with dedicated counsellors, structured referral pathways, and digital innovations promising improved access and personalization. Sustained progress requires intersectoral collaboration across health, education, labor, and social sectors; embedding mental health into national health information systems; and investing in culturally adapted promotion and prevention interventions throughout the life course. Strengthening political commitment, global-local leadership, financing frameworks, and workforce capacity, particularly through continuous professional development and lived-experience participation, will accelerate progress toward the SDGs, underscoring the imperative for equitable financing and sustained political will globally.}, }
@article {pmid41390653, year = {2025}, author = {Waqqas, HM and Pan, J and Xia, N and Chen, W}, title = {mRNA based vaccines and therapeutics for parasitic infections: a comprehensive review.}, journal = {Journal of nanobiotechnology}, volume = {24}, number = {1}, pages = {23}, pmid = {41390653}, issn = {1477-3155}, support = {SKLRD-OP-202409//Open Project of the State Key Laboratory of Respiratory Disease/ ; }, mesh = {Humans ; *Parasitic Diseases/therapy/prevention & control/immunology ; *RNA, Messenger/immunology/genetics/therapeutic use ; Animals ; COVID-19/prevention & control ; Nanoparticles/chemistry ; SARS-CoV-2 ; *mRNA Vaccines/immunology ; }, abstract = {The success of mRNA vaccines during the COVID-19 pandemic has revealed a revolutionary platform for addressing neglected parasite zoonosis, which represent a continual and significant threat to world health, especially in resource-constrained settings. The current review consolidates recent progress in the development of mRNA-based treatments, vaccines, and diagnostic ways for these pathogens. We elucidate how customized delivery platforms, particularly lipid nanoparticles, augment the stability and immunogenicity of parasite-derived mRNA cargo by safeguarding it from degradation and promoting uptake by antigen-presenting cells. Our findings suggest that mRNA technology provides a particularly adaptable strategy to targeting complicated parasite life cycles and efficiently modulating host immune responses. However, important challenges, such as cold-chain logistics, scalability, clinical trial design for diverse populations, and managing public opinion, must be solved beforehand. Future initiatives must priorities the creation of thermostable formulations and effective community participation strategies. Finally, this review emphasizes that mRNA-based interventions represent a promising, albeit challenging, frontier in the fight against parasitic diseases, urging a collaborative cross-disciplinary effort to translate this potential into tangible health breakthroughs for the world's most vulnerable populations.}, }
@article {pmid41391467, year = {2026}, author = {Rutter, H and Wabnitz, K and Nambiar, D and Garde, A and Benton, TG and Heymann, DL and Yates, R and Friel, S and Hollands, GJ and Cai, W and Chater, N and Bloom, DE and Guinto, RR and El Omrani, O and Wilsdon, J and Amuasi, JH and Butler, C and Tlou, S and Marteau, TM}, title = {The Lancet Commission on improving population health post-COVID-19.}, journal = {Lancet (London, England)}, volume = {407}, number = {10525}, pages = {267-308}, doi = {10.1016/S0140-6736(25)02061-6}, pmid = {41391467}, issn = {1474-547X}, }
@article {pmid41392436, year = {2025}, author = {Celano, R and Urso, F and Bartoli, A and Meschia, A and Masseroli, MM and Cirigliano, F and Colaneri, M and Foschi, A and Gori, A and Cogliati, C and Calloni, M and Taino, A and Scoppettuolo, G and Pittiruti, M and Gidaro, A}, title = {COVID-19 and vascular access: Evidence and lessons for improving the standard of care, a scoping review.}, journal = {The journal of vascular access}, volume = {}, number = {}, pages = {11297298251398421}, doi = {10.1177/11297298251398421}, pmid = {41392436}, issn = {1724-6032}, abstract = {The Coronavirus Disease 2019 (COVID-19) pandemic has significantly impacted intravenous therapy practices, particularly in critically ill patients. Vascular access strategies were adapted to evolving clinical needs, infection control priorities, and resource limitations, with a focus on safety, efficacy, and technological advancements. This scoping review aimed to explore how the COVID-19 pandemic affected vascular access practices and catheter-related complications, with the objective of mapping innovations, identifying emerging trends, and summarizing preventive and therapeutic strategies. The review followed PRISMA-ScR guidelines and was registered in PROSPERO (CRD420251027530). A systematic search was conducted in PubMed[®], EMBASE[®], EBSCO-CINAHL[®], and CENTRAL for English-language studies published between January 2020 and May 2025 addressing catheter-related complications in COVID-19 patients, including catheter-related bloodstream infections (CRBSI), central line-associated bloodstream infections (CLABSI), catheter-related thrombosis (CRT), and accidental catheter removal. Among 521 screened articles, 58 met the inclusion criteria. Most studies reported higher rates of CRBSI, CLABSI, CRT, and accidental removal in COVID-19 patients, especially in critical care settings. Arterial catheters were also associated with elevated risks of thrombosis and infection during the pandemic. Mid-thigh femoral access sites emerged as practical alternatives to reduce central line use and healthcare personnel exposure. Technological advances, including power-injectable catheters, ultrasound-guided insertion, intracavitary ECG for tip confirmation, and securement tools such as cyanoacrylate glue and subcutaneous anchor systems, improved safety and reduced mechanical and infectious complications. Chlorhexidine-based antisepsis, antimicrobial-impregnated devices, and disinfectant caps effectively decreased CRBSI and CLABSI rates. In older, comorbid patients-now representing the majority of COVID-19 hospitalizations-nutritional and anticoagulant therapy must be carefully balanced to minimize bleeding and thrombotic risks. In conclusion, the pandemic catalyzed significant innovation and adaptation in vascular access practices. Integrating portable technologies, infection prevention strategies, and alternative access routes has enhanced patient care and established new standards for managing intravenous therapy in high-risk, resource-constrained settings.}, }
@article {pmid41392882, year = {2026}, author = {de Bruin, O and Maisonneuve, E and Hurley, E and Nordeng, HME and Bérard, A and Sheehy, O and Kaul, P and Shinde, MU and Cosgrove, A and Lyons, JG and Messenger-Jones, E and Kempner, ME and Toh, S and Hua, W and Hernández-Muñoz, JJ and Sahin, L and Cesta, CE and Hägg, D and Gini, R and Paoletti, O and Poblador-Plou, B and Jordan, S and Rodríguez-Bernal, CL and Sánchez-Sáez, F and Lassalle, R and Bernard, MA and Ahmadizar, F and Favre, G and Panchaud, A and Bloemenkamp, KWM and Plueschke, K and de Vries, C and Siiskonen, SJ and Sturkenboom, MCJM and , }, title = {Adverse outcomes among pregnant women with COVID-19 according to hospitalization status: A prospective individual participant data meta-analysis in Europe and North America.}, journal = {International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics}, volume = {173}, number = {3}, pages = {1197-1206}, pmid = {41392882}, issn = {1879-3479}, support = {//European Medicines Agency/ ; /CAPMC/CIHR/Canada ; //Canada Foundation for Innovation/ ; /FD/FDA HHS/United States ; /CAPMC/CIHR/Canada ; /FD/FDA HHS/United States ; }, mesh = {Humans ; Pregnancy ; Female ; *COVID-19/epidemiology/complications/therapy ; *Hospitalization/statistics & numerical data ; Europe/epidemiology ; *Pregnancy Outcome/epidemiology ; *Pregnancy Complications, Infectious/epidemiology/therapy/virology ; Prospective Studies ; North America/epidemiology ; SARS-CoV-2 ; Adult ; Infant, Newborn ; }, abstract = {BACKGROUND: Understanding the varied impact of COVID-19 severity on pregnancy outcomes is crucial for informed clinical management and targeted interventions.
OBJECTIVE: To evaluate the impact of COVID-19 on pregnancy outcomes, distinguishing between pregnant women managed in primary care and those requiring hospitalization.
SEARCH STRATEGY: Regulatory authorities actively promoted global cooperation on COVID-19's impact during pregnancy. Data were obtained through these regulatory bodies and direct researcher communication rather than through systematic searches.
SELECTION CRITERIA: Data sources required secondary population-based data to identify pregnancies with COVID-19, along with hospitalization, diagnostic and medication codes. Eligibility for the meta-analysis was determined through protocol evaluation and researcher consultations.
DATA COLLECTION AND ANALYSIS: PRISMA-IPD and Cochrane guidelines for prospective meta-analysis were followed. Protocols and definitions were standardized across sources, and a common R script was developed. Initially, crude and adjusted relative risks (aRR) with 95% confidence intervals (CI) were calculated to assess adverse outcomes in pregnant women with and without COVID-19 in each data source. Estimates were stratified by trimester at infection and hospitalization status. Subsequently, data were pooled using a random-effects meta-analysis.
MAIN RESULTS: Data from 10 sources across seven countries contributed to the meta-analysis, including 86 210 pregnant women diagnosed with COVID-19, of whom 4.4% were hospitalized. Non-hospitalized pregnant women with COVID-19 had no increased risks of adverse outcomes compared to pregnant women without COVID-19. However, hospitalized women with COVID-19 in each trimester had higher risks of cesarean section, preterm birth, and LBW compared to pregnant women without COVID-19. Hospitalization due to COVID-19 in the third trimester was associated with increased risk of stillbirth (aRR 5.90, 95% CI: 2.22-15.71, I[2] = 0%). First-trimester hospitalizations due to COVID-19 did not show heightened risks of GDM (aRR 2.08, 95% CI: 0.93-4.64, I[2] = 65%), pre-eclampsia (aRR 1.79, 95% CI: 0.48-6.66, I[2] = 71%), or major congenital anomalies (aRR 1.30, 95% CI: 0.55-3.06, I[2] = 0%).
CONCLUSIONS AND RELEVANCE: COVID-19 requiring hospitalization is associated with adverse pregnancy outcomes, emphasizing the need to prevent severe illness during pregnancy. This study also highlights the importance of international collaboration for gathering pregnancy data and shows that building global research networks is essential for responding to future health crises.}, }
@article {pmid41392909, year = {2025}, author = {Pandey, V and Sen, D and Rathee, S and Soni, S and Mishra, S and Jain, SK and Patil, UK}, title = {Unlocking Toll-Like Receptors: Targeting Therapeutics for Respiratory Tract Infections and Inflammatory Disorders.}, journal = {Recent advances in inflammation & allergy drug discovery}, volume = {19}, number = {3}, pages = {303-315}, doi = {10.2174/0127722708329138240926073013}, pmid = {41392909}, issn = {2772-2716}, mesh = {Humans ; *Toll-Like Receptors/immunology/metabolism/antagonists & inhibitors ; COVID-19/immunology ; *Respiratory Tract Infections/drug therapy/immunology ; *Inflammation/drug therapy/immunology ; *COVID-19 Drug Treatment ; Animals ; SARS-CoV-2 ; Signal Transduction/drug effects ; Immunity, Innate/drug effects ; }, abstract = {The Toll-like Receptors (TLRs) family has significantly enhanced the understanding of innate immune responses by identifying and responding to various microbes or host-derived organisms. TLRs contribute to these responses by increasing the levels of cytokines, interleukins, and other inflammatory mediators through multiple pathways. Located both intracellularly and on the surface of various cells and tissues, including vascular smooth muscles (VSMs) and myocardium cells, TLRs play distinct roles in innate immune activation, such as recognizing pathogen-associated molecular patterns (PAMPs) and activating downstream signaling pathways. In the context of COVID-19, TLRs are critically involved in the pathophysiology by mediating excessive inflammatory responses that exacerbate disease severity, influencing both the acute phase and long-term outcomes. It has been observed that inflammatory diseases such as atherosclerosis, viral myocarditis, and other comorbidities associated with the spread of COVID-19 have increased, although the exact mechanisms remain not fully understood. Nonetheless, there is evidence of TLR-mediated increased pro-inflammatory signaling by different mechanisms in these diseases. This review explains the role of TLRs in various inflammatory diseases related to COVID-19, including viral myocarditis, acute lung infections, and atherosclerosis. Furthermore, the review discusses various herbal drugs, such as Platycodon grandiflorum, Acanthopanax senticosus, Scutellaria baicalensis Georgi, and Engelhardia roxburghiana, and their mechanisms of action on TLRs, including NF-κB, MyD88-dependent, MyD88-independent pathways, and Plasmacytoid DCs. Enhanced clarity on TLRs' specific contributions to COVID-19 pathophysiology and stronger evidence supporting herbal interventions targeting TLRs could improve the impact and applicability of these findings in clinical settings.}, }
@article {pmid41394849, year = {2025}, author = {Gabig-Cimińska, M}, title = {Dysregulated TFEB-autophagy-lysosome pathway links acute COVID-19 immunopathology to Long COVID sequelae.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1708364}, pmid = {41394849}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/immunology/pathology/complications ; *Lysosomes/immunology/metabolism ; *Basic Helix-Loop-Helix Leucine Zipper Transcription Factors/metabolism/immunology ; *Autophagy/immunology ; *SARS-CoV-2/immunology ; Animals ; Signal Transduction/immunology ; Immunity, Innate ; }, abstract = {SARS-CoV-2 disrupts cellular homeostasis, including the autophagy-lysosome pathway (ALP), a critical component of innate immunity and viral clearance. By subverting autophagy, SARS-CoV-2 proteins such as ORF3a, ORF7a, and NSP6 inhibit autophagosome-lysosome (APG-L) fusion, generating "incomplete autophagy" that permits viral persistence and drives hyperinflammation. Transcription factor EB (TFEB), a master regulator of lysosomal biogenesis and autophagy, has emerged as a central player in the host response to coronavirus infection. TFEB orchestrates the expression of genes required for lysosomal function and autophagic flux while also shaping immune processes, including cytokine production, interferon-stimulated gene expression, and inflammasome clearance. This mini review synthesizes current knowledge on the TFEB-ALP axis in COVID-19 pathogenesis, highlighting its influence on acute immunopathology and its potential contribution to post-acute sequelae (Long COVID). Restoring TFEB activity and autophagic flux may counteract SARS-CoV-2 evasion strategies and restrain aberrant inflammatory responses. Harnessing the TFEB-autophagy pathway as a host-directed therapeutic strategy could help rebalance immune homeostasis, limit tissue damage during acute infection, and mitigate persistent inflammatory sequelae in Long COVID.}, }
@article {pmid41394882, year = {2025}, author = {Padilla-Blanco, M and García-García, T and Grigas, J and López-Ayllón, BD and Garrido, JJ and Oliva, MA and Montoya, M}, title = {Hidden players of COVID-19: the evolving roles of SARS-CoV-2 accessory proteins.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1726698}, pmid = {41394882}, issn = {1664-3224}, mesh = {Humans ; *SARS-CoV-2/immunology/genetics ; *COVID-19/immunology/virology ; Host-Pathogen Interactions/immunology ; Interferon Type I/immunology/metabolism ; Animals ; *Viral Regulatory and Accessory Proteins/immunology/genetics/metabolism ; Viral Proteins/immunology ; }, abstract = {SARS-CoV-2 accessory proteins (APs), particularly ORF3a and ORF9b, have emerged as key modulators of host-pathogen interaction and potential contributors to long COVID. Of the 13 predicted APs, only nine are expressed during infection - termed Infection-related APs - while the remaining are classified as Putative APs. Despite this distinction, extensive gene overlap among APs underscores the remarkable adaptability of SARS-CoV-2 viral genome. This review delves into the diverse roles of the original Wuhan APs and their Omicron counterparts in shaping host immunity, with an emphasis on their ability to suppress type I interferon (IFN-I) signalling, modulate cellular metabolism, and trigger inflammatory/apoptotic pathways. By integrating immunopathological insights with evolutionary dynamics and structural perspectives, this review provides a comprehensive understanding of the mechanism underlying Omicron's reduced pathogenicity and highlights promising, yet unexplored, therapeutic targets within the SARS-CoV-2 accessory proteome.}, }
@article {pmid41395986, year = {2026}, author = {He, Z and Liu, M and Xie, Q and Lu, H and Guo, C}, title = {Autophagy and ubiquitination in important swine viral infections: Host defense and viral antagonism.}, journal = {Virulence}, volume = {17}, number = {1}, pages = {2605370}, pmid = {41395986}, issn = {2150-5608}, mesh = {Animals ; *Autophagy ; Swine ; *Ubiquitination ; Porcine epidemic diarrhea virus/immunology ; *Host-Pathogen Interactions ; *Swine Diseases/virology/immunology ; African Swine Fever Virus/immunology ; Porcine respiratory and reproductive syndrome virus/immunology ; Virus Diseases/veterinary ; Immune Evasion ; }, abstract = {Swine viral infections continue to impose major economic and animal-health burdens worldwide, with pathogens such as porcine epidemic diarrhea virus (PEDV), African swine fever virus (ASFV), and porcine reproductive and respiratory syndrome virus (PRRSV) causing recurrent outbreaks. Autophagy and ubiquitination are central degradative pathways that act as double-edged swords, serving both host defense and viral exploitation. In this narrative review, we synthesize recent advances showing how these pathogens manipulate ubiquitin - autophagy circuits while host cells counteract through selective autophagy. We propose an autophagy - metabolism - immunity triad that positions autophagy as a hub linking infection, metabolic reprogramming, and immune evasion. This integrated framework moves beyond the traditional view of autophagy as strictly antiviral or pro-viral. Deciphering how viruses hijack ubiquitin - autophagy axes reveals actionable therapeutic targets and translational opportunities for antivirals, adjuvants, and metabolic interventions to reduce the burden of swine viral diseases.}, }
@article {pmid41397310, year = {2026}, author = {Cho, AH and Cho, SY and Kim, S and Lee, S}, title = {Targeting emerging viruses with phage display-driven engineered antibodies: Bridging molecular design and clinical application.}, journal = {Molecular aspects of medicine}, volume = {107}, number = {}, pages = {101441}, doi = {10.1016/j.mam.2025.101441}, pmid = {41397310}, issn = {1872-9452}, mesh = {Humans ; *SARS-CoV-2/immunology ; *Antibodies, Neutralizing/immunology/therapeutic use/genetics ; COVID-19/immunology/virology ; *Antibodies, Viral/immunology/therapeutic use/genetics ; *Cell Surface Display Techniques/methods ; Animals ; *COVID-19 Drug Treatment ; Protein Engineering/methods ; Peptide Library ; }, abstract = {Phage display (PD) is a powerful platform that accelerates the discovery and engineering of therapeutic antibodies across diverse diseases, including emerging and re-emerging viral infections. The COVID-19 pandemic highlighted the urgency for rapid and adaptable antibody development against highly mutable pathogens, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). PD technology enables the rapid and high-throughput identification, optimization, and efficient reformatting of virus-neutralizing antibodies, yielding fully PD-derived antibodies and reformatted derivatives from PD fragments without requiring convalescent samples or animal immunization. This approach supports a proactive and scalable strategy for pandemic preparedness. This review provides a comprehensive overview of PD-derived therapeutic antibodies targeting infectious diseases, focusing on approved agents and candidates in clinical or preclinical development for SARS-CoV-2. We highlight recent case studies, including our own, showing the successful application of PD in generating potent neutralizing and multispecific antibody formats. These offer functional advantages such as enhanced breadth and affinity while also serving as versatile molecular tools for elucidating viral pathogenesis and immune evasion mechanisms. Despite PD's technological strengths, the clinical advancement of PD-derived candidates has been influenced by external circumstances associated with the evolving pandemic landscape, highlighting the need to strategically leverage PD's strengths to accelerate translational outcomes in future outbreaks. This review offers a well-rounded viewpoint on PD, outlining its applications, addressing its challenges, and incorporating emerging innovations into PD workflows. These advances position PD-derived candidates as a strategic, versatile, and rapid-response platform that bridges molecular insights with clinical translation, offering a robust framework for addressing current and future infectious disease challenges.}, }
@article {pmid41397515, year = {2026}, author = {Chen, P and Prosser, M and Phillips, B and Ellison CEng, P and Rangan, A}, title = {Accuracy and reliability of remote shoulder motion capturing methods: a systematic review and meta-analysis.}, journal = {Journal of shoulder and elbow surgery}, volume = {35}, number = {6}, pages = {1570-1586}, doi = {10.1016/j.jse.2025.11.007}, pmid = {41397515}, issn = {1532-6500}, mesh = {Humans ; *Range of Motion, Articular/physiology ; Reproducibility of Results ; *Shoulder Joint/physiology/physiopathology ; *COVID-19/epidemiology ; }, abstract = {BACKGROUND: The COVID-19 pandemic accelerated the demand for remote assessment tools in rehabilitation, especially the need for accurate and reliable technologies to measure shoulder range of motion (ROM) outside of clinical environments. Emerging tools such as smartphone apps, wearable sensors, and markerless motion capture systems are increasingly being adopted, yet their accuracy and reliability compared to reference standards remains unclear.
OBJECTIVE: To systematically evaluate the accuracy and reliability of existing remote shoulder ROM measurement technologies, quantify measurement bias, and assess their agreement with reference standards.
METHODS: A systematic review and meta-analysis was conducted on 26 studies evaluating remote ROM measurement tools. Pooled mean bias (in degrees) was calculated as the primary effect size for agreement, with reliability assessed using intraclass correlation coefficients (ICCs). Subgroup analyses were performed by motion type, technology category, population health status, and data acquisition method. Risk of bias was assessed using the QUADAS-2 tool.
RESULTS: Remote measurement methods showed a small but consistent overestimation of ROM compared to reference standards (pooled mean bias = 2.63°, 95% CI: 1.52-3.74), particularly in flexion, internal rotation, and external rotation. No significant bias was observed in abduction or extension. Both IMU and non-IMU technologies demonstrated comparable levels of overestimation. Pathologic populations exhibited greater variability (bias = 4.33° vs. 2.37° in healthy subjects). Self-measurements showed lower and non-significant bias compared to assessor-guided methods. Reliability was generally high, especially for test-retest assessments (ICCs > 0.90), though more variable in inter-rater and pathological settings.
CONCLUSION: Remote shoulder ROM measurement technologies tend to slightly overestimate joint angles but remain within clinically acceptable limits. These tools are reliable for tracking ROM trends and suitable for remote monitoring in clinical and research settings. However, increased variability in pathologic populations warrants caution. Broader validation in diverse patient cohorts is needed to strengthen clinical implementation.}, }
@article {pmid41398527, year = {2025}, author = {Maleki, F and Hosseinpour, M and Pashaei, MR and Aghdam, ME and Bahardoust, M and Delpisheh, A}, title = {Body mass index in children with newly diagnosed celiac disease: A systematic review and meta-analysis.}, journal = {European journal of pediatrics}, volume = {185}, number = {1}, pages = {18}, pmid = {41398527}, issn = {1432-1076}, mesh = {Humans ; *Celiac Disease/diagnosis/complications/diet therapy/epidemiology ; *Body Mass Index ; Child ; *Thinness/epidemiology ; Prevalence ; Diet, Gluten-Free ; *Pediatric Obesity/epidemiology ; Child, Preschool ; }, abstract = {UNLABELLED: Clinical manifestations of celiac disease (CeD) in children are often associated with malabsorption, malnutrition, and underweight. Recent evidence suggests an increased prevalence in normal-weight and obese children. Under-recognition of patients with normal or high BMI can lead to delayed diagnosis and serious complications. The present study aimed to determine the BMI status of children with CeD at diagnosis and before gluten-free diet (GFD). A systematic review and meta-analysis was conducted following the PRISMA and MOOSE guidelines and after PROSPERO registration (CRD42023390243). The information sources, including PubMed, Scopus, and Web of Science, were systematically searched through 30 September 2025 to identify relevant articles. The study's eligibility criteria included observational studies, such as retrospective, cross-sectional, and prospective designs, with participants whose CeD diagnosis was confirmed by a gastroenterologist and who reported BMI data at the time of diagnosis. Heterogeneity among studies was assessed using the I[2] statistic. Funnel plots and Egger's test were also used to examine publication bias. The risk of bias of studies was assessed using the Newcastle-Ottawa (NOS) scale. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework was used to determine the certainty of the evidence. Overall, 32 studies including 14,169 children with CeD were investigated. The pooled prevalence of underweight and overweight/obesity at diagnosis was 15.3% (10.8-20.4%) and 10.5% (5.7-16.4%), respectively. Subgroup analysis by WHO region revealed a marked heterogeneity (I[2] > 90%), with the highest prevalence of underweight observed in the Eastern Mediterranean Region (EMRO) (31.9%). On the other hand, the highest prevalence of overweight/obesity was observed in the European Region (EURO) (12.0%) and the Western Pacific Region (WPRO) (21.4%). A key finding was a significant difference across World Bank income groups; underweight prevalence was nearly four times higher in low- and middle-income countries (LMICs), 35.48 (24.29, 47.51), compared with high-income countries, 9.58 (6.88, 12.63). The certainty of the evidence for all pooled prevalence estimates was rated as very low due to serious inconsistency and imprecision.
CONCLUSIONS: The prevalence of normal weight and overweight/obesity in children with celiac disease at diagnosis was higher than that of underweight, mainly in high-income countries. This finding challenges the traditional belief about the CeD and emphasizes its diagnosis in children with suspicious symptoms, regardless of their BMI status. This approach will lead to earlier diagnosis, improving clinical outcomes and quality of life for patients in the long term.
WHAT IS KNOWN: • The clinical presentation of celiac disease is evolving, and its association with underweight is inconsistent. • The structural effects of COVID-19 on the developing brain remain poorly understood due to limited pediatric imaging studies.
WHAT IS NEW: • This is the first meta-analysis focused exclusively on children, revealing that the majority (70.2%) present with a normal BMI at diagnosis. • The clinical inconsistency in BMI presentation is strongly linked to income levels; underweight prevalence is nearly four times higher in LMICs (35.5%) than in high-income countries (9.6%).}, }
@article {pmid41398580, year = {2025}, author = {Manarte, R and Henriques, MR}, title = {From exceptionalism to universal testing: an historical review of HIV testing in Portugal.}, journal = {BMC public health}, volume = {25}, number = {1}, pages = {4251}, pmid = {41398580}, issn = {1471-2458}, mesh = {Humans ; *Health Policy ; History, 20th Century ; History, 21st Century ; *HIV Infections/diagnosis ; *HIV Testing/history ; *Mass Screening/history ; Portugal/epidemiology ; *Universal Health Care ; }, abstract = {INTRODUCTION: Portugal has made significant progress over the last 40 years in the response against the Human Immunodeficiency Virus (HIV) infection and the Acquired Immunodeficiency Syndrome (AIDS). However, as of 2021, it remained one of the three Western European countries with the highest rates of new HIV infections and AIDS cases. Initially shaped by HIV exceptionalism, Portugal began transitioning to a universal testing strategy in 2011. This study provides a historical and policy review of the evolution of HIV testing in Portugal, focusing on alignment with international guidelines and national implementation outcomes.
METHODS: We conducted a narrative policy review covering the period from 1998 to 2024. Our analysis drew on scientific literature, national health plans, surveillance reports, and international guidelines. Documents were selected through structured searches in multiple academic databases and government repositories using relevant Portuguese and English search terms. Thematically coded findings were mapped chronologically and assessed against evolving WHO and CDC recommendations.
RESULTS: Portugal gradually moved from a targeted testing approach to a more comprehensive, universal strategy. Key policy shifts occurred in 2011 and 2017, accompanied by an expansion of testing modalities, including self-testing and community-based testing. Despite these developments, implementation has been uneven. The lack of standardized protocols, limited integration into primary healthcare, and regional disparities tied to a contract-based health system have contributed to inconsistent service delivery. Additionally, testing uptake among older adults, migrants, and other key populations remains suboptimal. The COVID-19 pandemic temporarily disrupted testing services but also accelerated the use of self-testing strategies.
DISCUSSION: Portugal's experience illustrates the challenges of operationalizing universal HIV testing within a hybrid public-private healthcare system. Although policies increasingly reflect international best practices, structural barriers continue to hinder equitable implementation.
CONCLUSION: To close existing testing gaps, Portugal must strengthen implementation by standardizing procedures, improve disaggregated data collection in monitoring systems, and ensure greater integration of HIV testing in primary healthcare. Enhanced outreach to underserved populations will be critical to achieving national and international HIV prevention targets. This paper offers a historical and policy perspective to inform more equitable and effective national testing strategies.}, }
@article {pmid41398690, year = {2025}, author = {Serra, G and Pensabene, M and Bacile, D and Pace, MRD and Ferraro, D and Giuffrè, M and Piro, E and Salerno, S and Schierz, IAM and Sergio, M and Corsello, G}, title = {SARS-CoV-2 infection during pregnancy and necrotizing enterocolitis: case report and review of the literature.}, journal = {Italian journal of pediatrics}, volume = {51}, number = {1}, pages = {318}, pmid = {41398690}, issn = {1824-7288}, mesh = {Adult ; Female ; Humans ; Infant, Newborn ; Pregnancy ; *COVID-19/complications/diagnosis ; *Enterocolitis, Necrotizing/diagnosis/virology/therapy ; Fatal Outcome ; *Pregnancy Complications, Infectious/diagnosis/virology ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Necrotizing enterocolitis (NEC) is a severe intestinal disease primarily affecting premature newborns, with high morbidity and mortality. Although typically linked to prematurity and low birth weight, recent reports have suggested a potential association between NEC and maternal SARS-CoV-2 infection during pregnancy. This study aims to explore this relationship through a systematic literature review and the presentation of a novel clinical case. CASE PRESENTATION: A female neonate born at 37 + 2 weeks of gestation to a mother with third-trimester SARS-CoV-2 infection presented with feeding intolerance, abdominal distension, and bloody stool at 8 days of life. Diagnostic evaluation confirmed necrotizing enterocolitis, necessitating multiple surgeries for bowel resection, stoma creation, and repair of perforations. Despite intensive multidisciplinary care, the patient developed severe complications, including short bowel syndrome and intestinal failure, leading to death at 18 months. SARS-CoV-2 IgG positivity in the neonate suggested transplacental antibody transfer after maternal infection, while most of the other possible risk factors were excluded. CONCLUSIONS: The presented case highlights the potential role of maternal SARS-CoV-2 infection in necrotizing enterocolitis pathogenesis. Literature review identified 10 studies documenting similar associations. Cases ranged in severity, with outcomes influenced by gestational age, infection timing, and neonatal risk factors. The proposed mechanisms include virus-induced inflammation, placental dysfunction, and altered neonatal gut microbiota. Our findings emphasize the importance of considering maternal SARS-CoV-2 infection as a contributing factor in NEC, especially in term neonates without known predisposing conditions. Further research is crucial to elucidate the possible link between COVID-19 and NEC, and guide management of affected neonates. Preventive strategies, including vaccination and optimized prenatal care, are essential to mitigate risks.}, }
@article {pmid41401334, year = {2025}, author = {Gabor, M and Schlosserova, A and Korchynska, OO}, title = {Vaccination in pregnancy: a systematic review of current evidence.}, journal = {Wiadomosci lekarskie (Warsaw, Poland : 1960)}, volume = {78}, number = {10}, pages = {2142-2146}, doi = {10.36740/WLek/213601}, pmid = {41401334}, issn = {0043-5147}, mesh = {Humans ; Pregnancy ; Female ; *COVID-19/prevention & control ; *Influenza, Human/prevention & control ; *Pregnancy Complications, Infectious/prevention & control ; *Vaccination ; *Influenza Vaccines/administration & dosage ; *COVID-19 Vaccines/administration & dosage ; *Whooping Cough/prevention & control ; *Pertussis Vaccine ; }, abstract = {OBJECTIVE: Aim: To summarize current recommendations and the state of knowledge on vaccination of pregnant women against influenza, pertussis, and Covid-19, and to highlight evidence on the efficacy and safety of vaccination during pregnancy.
PATIENTS AND METHODS: Materials and Methods: A systematic literature review of studies published between 2014 and 2024 in the PubMed, Science Direct, Google Scholar, and NCBI databases was conducted. Of the total number of 31 studies found, 10 that met our required conditions were included. The inclusion criteria were peer-reviewed articles dealing with vaccination during pregnancy. Data selection and extraction were performed in accordance with PRISMA recommendations.
CONCLUSION: Conclusions: Vaccination of pregnant women appears to be a safe and effective way to protect mothers and their offspring. Emphasis should be placed on raising awareness and education in clinical practice.}, }
@article {pmid41401413, year = {2025}, author = {Miranda Quintero, J and Celis-Amórtegui, M and Arturo Rojas, MC and Mendoza Rosado, L and Grillo-Ardila, CF and Grillo-Ardila, EK and Ramírez-Mosquera, JJ and Lovera, LA and Ramírez-Mosquera, MJ}, title = {Expert consensus on vaccination as a primary prevention strategy for women of reproductive age, pregnant, or adulthood.}, journal = {Revista colombiana de obstetricia y ginecologia}, volume = {76}, number = {2}, pages = {}, pmid = {41401413}, issn = {2463-0225}, mesh = {Humans ; Female ; Pregnancy ; *Vaccination/methods ; Adult ; Colombia ; *Primary Prevention/methods ; Young Adult ; *Vaccines/administration & dosage ; }, abstract = {OBJECTIVE: To generate recommendations for vaccinating women at different stages of their lives, in order to reduce potential variability in current use in Colombia.
MATERIALS AND METHODS: The guideline development group consisted of professionals from the health sector. All participants submitted written conflict-of interest declarations. Answerable clinical questions were formulated, outcomes were graded, and a literature search was conducted in Medline/PubMed, Embase, and LILACS. The search also included grey literature sources and was updated on May 14, 2024, with no restrictions on date or language. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to determine the quality of evidence and the strength of recommendations. Due to the limitations of the retrieved studies—particularly concerning the applicability of the evidence—expert opinion was sought. Formal consensus was achieved following the RAND/UCLA methodology (RAND Corporation/University of California, Los Angeles). Prior to publication, the document underwent peer review.
RESULTS: The following recommendations were developed: 1. The development group suggests that women who are not immune to mumps, measles, or rubella (e.g., IgG negative) should be vaccinated during the preconception period. Quality of evidence: low ⨁⨁◯◯ 2. The development group suggests that all women in the preconception period be vaccinated against varicella if they lack confirmed natural immunity (e.g., negative varicella-zoster virus IgG antibodies). Quality of evidence: very low ⨁◯◯◯ 3. The development group suggests that women living in yellow fever endemic areas be vaccinated during the preconception period if they have not been previously immunized. Quality of evidence: very low ⨁◯◯◯ 4. The development group suggests that adolescent girls and young adult women receive the human papillomavirus (HPV) vaccine , 3 doses (0.2 and 6 months) to reduce cervical cancer incidence and mortality. Quality of evidence: moderate ⨁⨁⨁◯ 5. The development group suggests that pregnant women be immunized against tetanus, diphtheria, and pertussis during pregnancy to reduce infection risk in both the mother and newborn. Quality of evidence: low ⨁⨁◯◯ 6. The development group suggests inf luenza vaccination at any stage of pregnancy to reduce infection risk in the mother and in infants up to six months of age. Quality of evidence: very low ⨁◯◯◯ 7. The development group suggests maternal COVID-19 vaccination at any stage of pregnancy to reduce the risk of hospitalization and death of the mother and the newborn during the first four months of life. Quality of evidence: very low ⨁◯◯◯ 8. The development group suggests vaccination against respiratory syncytial virus (RSV) during pregnancy to reduce hospitalization risk in the newborn. Quality of evidence: very low ⨁◯◯◯ 9. The development group suggests that older adult women be vaccinated against herpes zoster to reduce morbidity associated with this condition. Quality of evidence: moderate ⨁⨁⨁◯ 10. The development group suggests that older adult women receive influenza vaccination to reduce the incidence of acute respiratory infections (ARI). Quality of evidence: moderate ⨁⨁⨁◯ 11. The development group suggests that older adult women be vaccinated against pneumococcus to reduce the incidence of pneumonia and invasive pneumococcal disease. Quality of evidence: low ⨁⨁◯◯ 12. The development group suggests that older adult women be vaccinated against RSV to reduce the incidence of ARI and lower respiratory tract infections. Quality of evidence: low ⨁⨁◯◯ 13. The development group suggests that older adult women living in yellow fever endemic areas be vaccinated if they have not been previously immunized. Quality of evidence: very low ⨁◯◯◯
CONCLUSIONS: Vaccination is recommended as a primary prevention strategy throughout the different stages of a woman's life. Given the quality of the available evidence and the significant limitations in the applicability of some studies—particularly among pregnant women—further research is needed to evaluate the safety and effectiveness of this intervention during this stage of life.}, }
@article {pmid41401760, year = {2026}, author = {Blanco, J and Ferreras, M and Cosido, O}, title = {Predictive modeling of hospital emergency department demand using artificial intelligence: A systematic review.}, journal = {International journal of medical informatics}, volume = {207}, number = {}, pages = {106215}, doi = {10.1016/j.ijmedinf.2025.106215}, pmid = {41401760}, issn = {1872-8243}, mesh = {Humans ; Algorithms ; *Artificial Intelligence ; COVID-19/epidemiology ; *Emergency Service, Hospital/statistics & numerical data ; Forecasting ; *Health Services Needs and Demand ; Machine Learning ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Accurately forecasting patient arrivals in hospital emergency departments (EDs) is critical for hospital capacity and planning and clinical decision-making. Artificial intelligence (AI), particularly machine learning (ML) and deep learning (DL), has shown promising performance over traditional time series approaches. However, the extent to which these models are validated and generalizable remains uncertain.
OBJECTIVE: To systematically review the literature on predictive models for hospital ED demand forecasting, focusing on algorithms used, internal and external variables, validation strategies and limitations pre- and post-pandemic developments.
METHODS: A systematic literature review (SLR) was conducted following PRISMA guidelines. Five databases (PubMed, IEEE, Springer, ScienceDirect, ACM) were searched for peer-reviewed articles published between January 2019 and July 2025. Eligible studies applied predictive algorithms - excluding those focused on COVID-19 - to forecast ED visits. Extracted data included modeling approaches, feature types, evaluation metrics, and validation methods.
RESULTS: Eleven studies met the inclusion criteria. Classical models such as ARIMA and SARIMA remain in use, but ML (e.g., XGBoost, Random Forest) and DL (e.g., LSTM, CNN) showed higher predictive accuracy, especially with high-dimensional, nonlinear data. Incorporating external variables-such as weather (temperature, humidity, wind), air quality, and calendar events-consistently improved performance. Common metrics included Mean Absolute Error (MAE), Root Mean Squared Error (RMSE), and Mean Absolute Percentage Error (MAPE), with MAPE ranging from 3 % to 18 %. Few studies performed external validation, and only a minority employed explainable AI methods (e.g., SHAP) to address interpretability.
CONCLUSIONS: AI-based models offer strong potential for ED demand forecasting, particularly when integrating environmental and temporal features. However, limited external validation and lack of interpretability remain significant barriers to clinical adoption. Future research should prioritize multicenter validation, standardized evaluation, and explainable AI to support reliable, transparent, and scalable use in hospital emergency departments.}, }
@article {pmid41401799, year = {2026}, author = {Monteiro, H and Oliveira, M and Martinho, R and Martins, C}, title = {Managing Data in Screening Programs: Challenges and Solutions.}, journal = {Acta medica portuguesa}, volume = {39}, number = {3}, pages = {208-217}, doi = {10.20344/amp.23363}, pmid = {41401799}, issn = {1646-0758}, mesh = {Humans ; *Mass Screening/organization & administration/methods ; *Big Data ; }, abstract = {Population-based screening programs are vital public health initiatives that enable the early detection of diseases, significantly reducing both morbidity and healthcare costs. As these programs expand, the management of the extensive data they generate becomes increasingly complex, highlighting the need for structured digital solutions. This narrative review article presents a pragmatic framework aimed at clarifying big data analytics tailored to the needs and practices of healthcare professionals and administrators, focusing on effective integration into routine screening workflows. To achieve effective data utilization, the process begins with systematic archiving, which involves cloud-based storage solutions capable of securely maintaining various data formats in compliance with regulatory standards, thus ensuring long-term accessibility and continuity. Subsequent real-time processing of screening data facilitates rapid decision-making and patient management by providing immediate validation and analysis, essential for maintaining the responsiveness of screening services. Transformation processes play a critical role in converting diverse data inputs into standardized, consistent formats, enabling seamless communication and exchange among multiple healthcare systems. Integration further builds upon this standardization, merging data from different healthcare providers and diagnostic centers into centralized analytical platforms. This unified approach enables comprehensive patient monitoring and supports predictive modeling for early identification of at-risk individuals. Advanced analytics, particularly process mining and predictive techniques, reveal inefficiencies within screening workflows, highlighting areas needing improvement. These methods help healthcare managers to streamline operations, optimize resources, and enhance overall program performance. Real-time visualization tools provide administrators with continuous, practical insights into operational dynamics, despite existing challenges related to data governance and system interoperability. This article illustrates these concepts through concrete examples from the colorectal cancer screening program in Northern Portugal and the response to the COVID-19 pandemic. The colorectal cancer screening scenario demonstrates how structured data management significantly boosts operational efficiency and healthcare accessibility. Meanwhile, the COVID-19 experience highlights the importance of having flexible digital infrastructures capable of quickly adapting to unexpected crises. Finally, ongoing investments in digital infrastructure, professional training, and comprehensive data governance are crucial for sustaining these improvements. This review provides clear, actionable knowledge to support healthcare professionals in adopting big data analytics effectively within preventive healthcare programs.}, }
@article {pmid41402837, year = {2025}, author = {Syam, N and Abbas, MZ}, title = {From proposal to compromise: the TRIPS waiver debate and the crisis of WTO decision-making.}, journal = {Globalization and health}, volume = {22}, number = {1}, pages = {9}, pmid = {41402837}, issn = {1744-8603}, mesh = {Humans ; *COVID-19/epidemiology/diagnosis ; *Decision Making ; *Intellectual Property ; *International Cooperation/legislation & jurisprudence ; *Commerce/legislation & jurisprudence ; Pandemics ; SARS-CoV-2 ; Developing Countries ; }, abstract = {The Marrakesh Agreement, which established the World Trade Organization (WTO), permits WTO member countries to jointly decide to temporarily suspend certain obligations under the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS Agreement). The TRIPS Decision adopted at the 12th WTO Ministerial Conference in June 2022, following 20 months of extended negotiations during the COVID-19 pandemic, approved only a limited portion of the waiver proposal originally submitted by India and South Africa. Since the Decision was adopted, WTO members have faced a deadlock over whether to extend its scope to include COVID-19 diagnostics and therapeutics, despite being required by the Decision to reach a conclusion on this issue within six months. This paper re-examines the discussions surrounding the potential expansion of the Decision and argues that including COVID-19 diagnostics and therapeutics within its scope was both appropriate and necessary. In addition, the paper proposes ways to make effective use of TRIPS flexibilities during a pandemic, so that developing countries are not left dependent on unpredictable waiver negotiations. The paper also outlines possible approaches for reforming the waiver decision-making process, aiming to ensure that such decisions are made promptly and efficiently, without prolonged negotiations during times of emergency.Clinical trial number Not applicable.}, }
@article {pmid41403560, year = {2025}, author = {Dandachi, I and Aljabr, W}, title = {MERS-COV in the Middle East, a one health concept approach.}, journal = {One health (Amsterdam, Netherlands)}, volume = {21}, number = {}, pages = {101282}, pmid = {41403560}, issn = {2352-7714}, abstract = {The MERS-COV virus is a zoonotic coronavirus that emerged in 2012 in KSA and caused viral illness with a case fatality rate up to 35 %. Over a decade later, the virus is still evolving and circulating. The aim of this review is to discuss the current epidemiology of MERS-COV both in humans and animals, during and post the COVID-19 pandemic. We have found that MERS-COV is still evolving in camels with new lineages being detected in Saudi Arabia. Although the number of human cases has decreased, there is a gradual resurgence in the number of cases. Furthermore, many cases are being reported without exposure to camels and/or raw products, nor contact with known human cases. This necessitates global efforts in the surveillance of asymptomatic carriers in the community, role of unknown animal reservoirs in the virus spread if any, as well as extensive genomic surveillance of the virus. This is in order to unveil and assess the genetic changes that the virus is undergoing and their according effect on the viral fitness, tropism, and virulence. These efforts are crucial for potential future pandemic preparedness, understanding the modes of transmission, as well as drug and vaccine development for MERS-COV.}, }
@article {pmid41403919, year = {2026}, author = {Regmi, A and Sami, A and Baral, S and Niraula, BB and Jain, VK and Iyengar, KP}, title = {Temporal onset and steroid-associated risk in post-COVID hip avascular necrosis: A systematic review and pooled analysis.}, journal = {Journal of orthopaedics}, volume = {72}, number = {}, pages = {304-311}, pmid = {41403919}, issn = {0972-978X}, abstract = {BACKGROUND: Avascular necrosis (AVN) of the hip has emerged as a post-COVID musculoskeletal complication, likely driven by corticosteroid therapy and virus-induced microvascular injury. This study systematically reviews published evidence on post-COVID AVN, analyzing pooled data on latency, cumulative steroid dose, staging, and management outcomes.
METHODS: A systematic review and pooled analysis were conducted following PRISMA guidelines. PubMed, Embase and Scopus, were searched up to June 2024 using predefined keywords. Studies reporting AVN of the hip following confirmed COVID-19 infection were included. Quantitative pooling of latency (days from infection to AVN diagnosis) and cumulative steroid dose (mg prednisolone equivalent) was performed using a random-effects model.
RESULTS: Seventeen studies encompassing 209 patients (313 hips) were included. The mean age was 43.7 ± 16.2 years, with a male predominance. Pooled analysis showed a mean latency of 126.48 days (95 % CI: 95.5-157.46) from COVID-19 infection to AVN onset and a mean cumulative steroid dose of 1198.44 mg (95 % CI: 860.99-1535.88). Most cases presented at Ficat-Arlet stages II-III. Core decompression and bisphosphonate therapy were effective in early stages, while total hip arthroplasty was required for advanced disease.
CONCLUSION: Post-COVID AVN of the hip is a delayed yet potentially preventable sequela associated with corticosteroid exposure and COVID-related vascular injury. The mean latency of 126 days from infection to AVN onset and an average cumulative corticosteroid exposure of 1198 mg prednisolone equivalent underscores the delayed yet dose-dependent nature of this condition.}, }
@article {pmid41404126, year = {2025}, author = {Serradell, L and Fretta, A and Nachbar, J and Dreyfus, J and Garofalo, D and Lucini, A and Mather, S and Esposito, D and Chabanon, AL and Bauchau, V and Sellers, S}, title = {The use of observed-to-expected analyses as a signal detection tool in COVID-19 vaccine safety surveillance: lessons learned from an industry perspective.}, journal = {Frontiers in drug safety and regulation}, volume = {5}, number = {}, pages = {1650992}, pmid = {41404126}, issn = {2674-0869}, abstract = {During the pandemic, the accelerated review and authorization of coronavirus disease 19 (COVID-19) vaccines by regulatory authorities elicited the need for rapid and thorough worldwide signal detection and evaluation. To meet this need, the European Medicines Agency and other health authorities expected that, in addition to routine signal detection, COVID-19 vaccine manufacturers should leverage observed-to-expected (O/E) analyses unconventionally as a quantitative method for signal detection of adverse events of special interest (AESIs). The objective of O/E analyses in vaccine signal detection was to determine if AESIs were occurring at a higher-than-expected rate in the vaccinated population in comparison with an unexposed population. The use of O/E was intended to mitigate the challenge of analyzing large volumes of individual case safety reports (ICSRs) received over a very short period following mass vaccination campaigns. The "Beyond COVID-19 Monitoring Excellence" (BeCOME) initiative, a non-competitive voluntary initiative launched in 2022 by COVID-19 vaccine Marketing Authorization Holders (MAHs) and key stakeholders, was established to align systems, enhance processes, and foster innovation in post-marketing vaccine monitoring, building on lessons from the pandemic. A dedicated working group was created to review and share MAHs' experience on O/E analyses used as an additional tool for signal detection during the COVID-19 pandemic. This review presents the industry perspective on using O/E analyses for COVID-19 vaccine signal detection, including challenges and limitations encountered, and proposes best practices for future improvement. Despite the priority and resources devoted to O/E analyses, no de novo signals resulting in the identification of safety concerns were detected using this methodology during the COVID-19 pandemic. O/E analyses are most useful when source data are accurate and there is a high level of confidence in the assumptions and parameters used. In the context of the COVID-19 pandemic, confidence in certain assumptions and parameters was low, limiting the value of O/E analyses in signal detection. Nevertheless, O/E analyses applied for signal refinement, as traditionally used, proved to be useful. Industry experiences support maintaining O/E analyses as a tool for signal refinement and standardizing methodological approaches as much as possible to enhance its future application and comparability across stakeholders.}, }
@article {pmid41404505, year = {2025}, author = {Islam, MS and Monir, SB and Haque, N and Vabna, MA and Fan, J and Li, Y and Nime, I and Feroz, F and Acharjee, M and Pan, F}, title = {Immunometabolic crossroads: infections as bidirectional modulators in diabetes and metabolic syndromes.}, journal = {Frontiers in endocrinology}, volume = {16}, number = {}, pages = {1710157}, pmid = {41404505}, issn = {1664-2392}, mesh = {Humans ; *Diabetes Mellitus/immunology/metabolism/therapy ; *Metabolic Syndrome/immunology/metabolism/therapy ; Immunocompetence/immunology ; *Infections/immunology/metabolism/therapy ; Animals ; Inflammation ; Insulin Resistance/immunology ; *Immunomodulation/immunology ; Homeostasis/immunology ; }, abstract = {Diabetes and metabolic disorders represent a global health crisis driven by complex interactions between metabolic, immune, and microbial networks. Beyond their metabolic derangements- hyperglycemia, insulin resistance, and low-grade systemic inflammation-these disorders are now recognized to exist at an immunometabolic interface profoundly influenced by infectious agent The bidirectional relationship between infections and metabolic dysregulation highlighting how acute and chronic infections contribute to insulin resistance, β-cell dysfunction, and systemic inflammation, while metabolic dysregulation impairs immune competence, predisposing individuals to recurrent and severe infections. Pathogens such as Helicobacter pylori Staphylococcus aureus, Escherichia coli, SARS-CoV-2, and hepatitis viruses, alter host metabolic signaling through inflammatory, mitochondrial, and hormonal pathways, reshaping glucose and lipid homeostasis. In turn, diabetic immune impairment amplifies susceptibility to pneumonia, urinary tract infections, and chronic wound infections, reinforcing a pathogenic feedback loop. Emerging therapeutic strategies including nanotechnology enabled, therapeutics, gene, and stem cell based interventions and next-generation incretin agonists- including tirzepatide and CagriSem offer promising avenues to restore both metabolic balance and immune resilience. Additionally, foundational strategies such as lifestyle modifications, medical nutrition therapy, and vaccination remain essential components of disease control. Understanding infections as dynamic modulators of metabolic homeostasis reframes diabetes not merely as an endocrine disorder, but as a systemic immunometabolic disease. This review synthesizes current evidence on infection induced metabolic syndrome, immune impairments, and innovative therapeutic strategies to guide future precision interventions at the infection-metabolism interface.}, }
@article {pmid41405305, year = {2026}, author = {Joo, JY and Liu, MF}, title = {Nursing Faculty Experiences With Emergent Remote Teaching Transitions: A Qualitative Systematic Review.}, journal = {Computers, informatics, nursing : CIN}, volume = {44}, number = {5}, pages = {}, pmid = {41405305}, issn = {1538-9774}, support = {No. RS-2023-0020971812982076870001//National Research Foundation of Korea (NRF) grant funded by the Korea government (Ministry of Science and ICT)/ ; }, mesh = {*Faculty, Nursing/psychology ; Humans ; *COVID-19/epidemiology ; Qualitative Research ; *Education, Distance ; *Education, Nursing ; Pandemics ; SARS-CoV-2 ; Workload ; }, abstract = {BACKGROUND: Information on nursing faculty members' experiences with the emergent transition during the COVID-19 pandemic remains limited.
PURPOSE: This qualitative systematic review aimed to synthesize evidence from qualitative studies exploring nursing faculty members' experiences during the COVID-19 pandemic.
METHODS: Twelve qualitative studies were selected from 5 electronic databases and synthesized. This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered with PROSPERO (CRD42022371092).
RESULTS: Twelve empirical qualitative studies published between 2021 and 2024 were included. These studies were conducted across various regions, including Australia, Jordan, Pakistan, South Korea, and the United States. On the basis of the experiences of 330 nursing faculty members, 5 common themes were identified: (1) concerns regarding changes in traditional nursing pedagogy; (2) overwhelmingly heavy workloads; (3) acceptance of and coping with the pandemic; (4) the need for continuous and diverse forms of support; and (5) opportunities for improving nursing programs.
DISCUSSION AND CONCLUSIONS: These themes can guide educational administrators in identifying ongoing challenges faced by nursing faculty and reforming nursing education. They also provide a foundation for nursing educational associations and institutions to enhance current teaching approaches and develop new learning strategies in preparation for future public health emergencies.}, }
@article {pmid41405493, year = {2025}, author = {McTavish, C and McGillis Hall, L and Price, S and Visekruna, S and Blain, A}, title = {Worsening Shortages, Mass Departures, Intolerable Working Conditions: A Media Analysis of Canada's Nursing Workforce Crisis.}, journal = {International nursing review}, volume = {72}, number = {4}, pages = {e70140}, doi = {10.1111/inr.70140}, pmid = {41405493}, issn = {1466-7657}, support = {WI2 179956/CAPMC/CIHR/Canada ; }, mesh = {Humans ; *COVID-19/epidemiology/nursing ; Canada/epidemiology ; *Mass Media/statistics & numerical data ; Pandemics ; Health Policy ; *Nursing Staff/supply & distribution ; SARS-CoV-2 ; Working Conditions ; }, abstract = {AIM: To explore the nature and content of Canadian media coverage surrounding the COVID-19 pandemic by wave - spanning from 2020 to 2024, identifying health policy and system responses that emerged as strategies in retaining the nursing workforce.
BACKGROUND: COVID-19 was an unprecedented health crisis impacting healthcare delivery and the healthcare workforce globally. It caused tremendous turbulence and strain, testing system capacity due to staff shortages, resource limitations and issues accommodating high volumes and acuity levels of patients. Across Canada, the pandemic resulted in mobilization of policy and system responses to address workforce challenges that emerged.
METHODS: A qualitative content analysis was conducted of online media coverage from nursing organizations and government websites published from January 2020 to March 2024, as well as newspaper articles from the Canadian Newsstream database.
RESULTS: Synthesized findings were categorized according to waves of the pandemic, highlighting key themes surrounding system and policy responses that emerged. Government investments to increase wages, educate additional staff and enhance protection for workers were among the measures employed.
DISCUSSION: This review captures the evolution and progression of the health crisis, its impact on the nursing workforce and associated responses. Workforce development and retention were emphasized through measures to enhance mental health and wellness, improve protection for workers and address safe staffing practices.
CONCLUSION: Nurses played a pivotal role throughout the global pandemic. Multiple system and policy responses were identified as key facets in strengthening, supporting and sustaining the nursing workforce.
Measures implemented illustrate the instrumental role that stakeholders, including the government and nursing organizations, play in building capacity and prioritizing efforts to protect nurses and enhance preparedness for future outbreaks.}, }
@article {pmid41405551, year = {2026}, author = {Wang, L and Lin, C and Chuai, Y and Zhang, Q and Qin, S and Luo, Z and Li, Y}, title = {Home-used coronavirus sensors powered by isothermal amplification.}, journal = {Journal of materials chemistry. B}, volume = {14}, number = {3}, pages = {871-893}, doi = {10.1039/d5tb01673h}, pmid = {41405551}, issn = {2050-7518}, mesh = {*Nucleic Acid Amplification Techniques/methods ; *SARS-CoV-2/isolation & purification/genetics ; *Biosensing Techniques/methods ; Humans ; *COVID-19/diagnosis ; Molecular Diagnostic Techniques ; }, abstract = {The global pandemic caused by coronaviruses, particularly SARS-CoV-2, has highlighted the urgent need for biosensing platforms that enable early and self-administered viral detection. Home-used biosensors enable rapid, accurate, and highly sensitive detection in home settings, reducing the probability of cross-infection while circumventing the temporal, financial, and operational constraints of conventional hospital-based workflows. However, they face limitations in sensitivity. Isothermal nucleic acid amplification strategies under constant or ambient temperature conditions present a transformative solution, leveraging mild reaction conditions and operational simplicity to advance household-compatible diagnostics. In recent years, a variety of innovative at-home sensors with advanced performance have been developed based on different isothermal amplification strategies, including loop-mediated isothermal amplification, clustered regularly interspaced short palindromic repeats, hybridization chain reaction, catalytic hairpin assembly, entropy-driven circuit and so on. Mainly taking the novel coronavirus as an example, this review systematically summarized the latest progress in the construction and application of household coronavirus sensors from three aspects: the targets of detection, the signal amplification strategies, and the biosensing platforms (fluorescence, Raman spectroscopy, surface plasmon resonance, colorimetry, and electrochemistry), as well as emphasized their advantages and challenges. We further delineate persistent challenges and future trajectories for enhancing the accessibility, accuracy, and multiplexing capacity of decentralized diagnostic platforms.}, }
@article {pmid41405643, year = {2025}, author = {Nawrooz, MS and Taher, WM and Alwan, M and Jawad, M and Mushtaq, H and Allela, OQB}, title = {The role of low-density lipoprotein receptors in emerging and reemerging viruses: a review with examples from human metapneumovirus and beyond.}, journal = {Archives of microbiology}, volume = {208}, number = {1}, pages = {79}, pmid = {41405643}, issn = {1432-072X}, mesh = {Humans ; *Receptors, LDL/metabolism ; *Metapneumovirus/physiology ; *Communicable Diseases, Emerging/virology ; *Paramyxoviridae Infections/virology/metabolism ; Animals ; Virus Replication ; Virus Internalization ; SARS-CoV-2 ; Antiviral Agents/pharmacology ; }, abstract = {The frequency of new and re-emerging viral infections is rising, driven by shifts in environmental conditions and altered interactions between hosts, vectors, and pathogens. New treatments may be developed through a better understanding of the molecular processes underlying viral replication. The low-density lipoprotein receptor (LDLR) serves as a critical entry portal for a diverse range of infectious agents, facilitating the initiation and perpetuation of their infection cycles. Furthermore, numerous viruses, such as the dengue virus and the hepatitis C virus (HCV), depend on host cholesterol (CHO) for replication and spread. Consequently, targeting the LDLR with pharmacological agents presents a promising therapeutic strategy for a broad spectrum of viral infections, including those caused by human immunodeficiency virus (HIV), HCV, and severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2). In addition, human metapneumovirus (HMPV) is a leading cause of respiratory infections in young children, underscoring the need for effective treatments. This research investigates the role of the LDLR in HMPV and other emerging viruses. A key finding is that HMPV infection depends on LDLR-mediated pathways, as evidenced by the rapid recovery observed after exogenous CHO administration. Therefore, understanding the mechanism of LDLR in viral entry and replication is crucial and presents a promising avenue for developing novel antiviral therapies.}, }
@article {pmid41405805, year = {2026}, author = {Blair, HA}, title = {Sublingual Cyclobenzaprine: First Approval.}, journal = {Clinical drug investigation}, volume = {46}, number = {1}, pages = {107-114}, pmid = {41405805}, issn = {1179-1918}, mesh = {Humans ; Administration, Sublingual ; *Drug Approval ; *Amitriptyline/analogs & derivatives/administration & dosage/therapeutic use ; United States ; }, abstract = {TONMYA[™] is a sublingual eutectic formulation of cyclobenzaprine being developed by Tonix Pharmaceuticals for the treatment of various conditions, including fibromyalgia, post-traumatic stress disorder (PTSD), acute stress disorder, major depressive disorder, post-acute COVID-19 syndrome, alcohol use disorder, and agitation in Alzheimer's disease. The sublingual formulation was designed for rapid transmucosal absorption to produce diurnal variation in peak-to-trough drug concentrations, making it suitable for long-term bedtime use. On 15 August 2025, sublingual cyclobenzaprine was approved for the treatment of fibromyalgia in adults in the USA. This article summarizes the milestones in the development of sublingual cyclobenzaprine leading to this first approval for fibromyalgia.}, }
@article {pmid41405828, year = {2026}, author = {Constantin, M and Barbu, I and Vrancianu, CO and Chifiriuc, MC and Pitică, IM and Casangiu, A and Ruță, SM and Bleotu, C}, title = {Retroviral Remnants in the Human Genome: Classification, Integration and Regulation.}, journal = {Molecular diagnosis & therapy}, volume = {30}, number = {2}, pages = {219-257}, pmid = {41405828}, issn = {1179-2000}, support = {CNFIS-FDI-2025-F-0364//UB Research Nexus: Transforming Research through Innovation, Digitalization and Exploration at the University of Bucharest/ ; Component C9/Investment no. 8 (I8) - contract CF 68//Ministry of Research, Innovation and Digitalization through the National Recovery and Resilience Plan (PNRR) of Romania, Pillar III/ ; PNRR-III-C9-2023 (I8)- CF 53 - 760231/28.12.2023//Design and Implementation of Base-Relief DNA Origami: A multilevel approach to DNA Nanotechnology/ ; project no. 23020101//The core program within the National Research Development and Innovation Plan, 2022-2027', carried out with the support of the Ministry of Research, Innovation and Digitalization (MCID/ ; Contract no. 7N from 3 January 2023//The core program within the National Research Development and Innovation Plan, 2022-2027', carried out with the support of the Ministry of Research, Innovation and Digitalization (MCID/ ; }, mesh = {Humans ; *Endogenous Retroviruses/genetics/classification/physiology ; *Genome, Human ; *Virus Integration ; Epigenesis, Genetic ; Evolution, Molecular ; }, abstract = {Human endogenous retroviruses (HERVs) are remnants of ancient retroviral infections constituting nearly 8% of the human genome. Far from being inert genetic fossils, HERVs have co-evolved with their hosts, acquiring regulatory and functional roles that influence development, immunity and disease. In this comprehensive review, we examine the origin, evolutionary dynamics and structural diversity of HERVs, emphasising their integration, genomic organisation and mosaic recombination patterns. We further highlight how epigenetic modifications, intracellular factors such as transcriptional regulators, hormones and cytokines, and environmental influences regulate HERV expression. By synthesising current evidence linking HERV activity to immune modulation, tumourigenesis, autoimmunity and neurodegenerative processes, we provide an integrated perspective on their dual role as drivers of pathology and contributors to normal physiology. Our analysis underscores that HERVs are not only markers of past infections but also active genomic elements with potential clinical implications, from biomarker discovery to novel therapeutic targets, making their systematic investigation timely and highly relevant.}, }
@article {pmid41406676, year = {2026}, author = {Ward, J and Gressani, O and Kim, S and Hens, N and Edmunds, WJ}, title = {The epidemiology of pathogens with pandemic potential: A review of key parameters and clustering analysis.}, journal = {Epidemics}, volume = {54}, number = {}, pages = {100882}, doi = {10.1016/j.epidem.2025.100882}, pmid = {41406676}, issn = {1878-0067}, mesh = {Humans ; Cluster Analysis ; *Pandemics ; COVID-19/epidemiology ; Influenza, Human/epidemiology/transmission ; SARS-CoV-2 ; Algorithms ; Monte Carlo Method ; Unsupervised Machine Learning ; }, abstract = {INTRODUCTION: In the light of the COVID-19 pandemic many countries are trying to widen their pandemic planning from its traditional focus on influenza. However, it is impossible to draw up detailed plans for every pathogen with epidemic potential. We set out to try to simplify this process by reviewing the epidemiology of a range of pathogens with pandemic potential and seeing whether they fall into groups with shared epidemiological traits.
METHODS: We reviewed the epidemiological characteristics of 19 different pathogens with pandemic potential (those on the WHO priority list of pathogens, different strains of influenza and Mpox). We extracted data on key parameters (reproduction number serial interval, proportion of presymptomatic transmission, case fatality risk and transmission route) and applied an unsupervised learning algorithm. This combined Monte Carlo sampling with ensemble clustering to classify pathogens into distinct epidemiological archetypes based on their shared characteristics.
RESULTS: From 154 articles we extracted 302 epidemiological parameter estimates. The clustering algorithms categorise these pathogens into six archetypes (1) highly transmissible Coronaviruses, (2) moderately transmissible Coronaviruses, (3) high-severity contact and zoonotic pathogens, (4) Influenza viruses (5) MERS-CoV-like and (6) MPV-like.
CONCLUSION: Unsupervised learning on epidemiological data can be used to define distinct pathogen archetypes. This method offers a valuable framework to allocate emerging and novel pathogens into defined groups to evaluate common approaches for their control.}, }
@article {pmid41406849, year = {2026}, author = {Asokan, S and Choudekar, A and Jagadeesan, A and Sm, R and Ali, A and Napte, SU and Selvam, SA and Verma, G and Das, P and Beniwal, N and Radhamanalan, G and Vijayan, S and Rajeswary, D and Jacob, T}, title = {Molecular diagnostics in clinical microbiology: Advances, applications, and future directions.}, journal = {Diagnostic microbiology and infectious disease}, volume = {114}, number = {3}, pages = {117223}, doi = {10.1016/j.diagmicrobio.2025.117223}, pmid = {41406849}, issn = {1879-0070}, mesh = {Humans ; *Molecular Diagnostic Techniques/methods/trends ; High-Throughput Nucleotide Sequencing ; *Communicable Diseases/diagnosis ; *Pathology, Molecular/trends/methods ; Nucleic Acid Amplification Techniques ; SARS-CoV-2 ; COVID-19/diagnosis ; Polymerase Chain Reaction/methods ; }, abstract = {Molecular diagnostics have transformed clinical microbiology by enabling rapid, accurate, and highly sensitive detection of infectious agents, significantly improving patient outcomes and public health response. Over the past decade, advances in polymerase chain reaction (PCR), next-generation sequencing (NGS), digital PCR, isothermal amplification, and CRISPR-based assays have enhanced pathogen identification, antimicrobial resistance profiling, and outbreak investigation. These technologies have been instrumental in detecting and monitoring emerging and re-emerging viral pathogens such as SARS-CoV-2, Nipah, Zika, H5N1 avian influenza, Mpox, Ebola, Marburg, and MERS-CoV. Molecular diagnostics also play a critical role in antimicrobial resistance surveillance and hospital infection control by enabling high-resolution tracking of resistance genes and pathogen transmission dynamics. Despite these achievements, challenges remain regarding implementation costs, technical expertise, infrastructure, and the need for global standardization. Future directions focus on developing cost-effective, point-of-care molecular platforms, integrating artificial intelligence and bioinformatics for enhanced interpretation, and applying these technologies within One Health and environmental surveillance frameworks. These innovations will be pivotal for early outbreak detection, real-time data-driven decision-making, and equitable access to advanced diagnostics worldwide. Ultimately, molecular diagnostics are poised to remain the cornerstone of precision medicine and infectious disease control in the era of global health challenges.}, }
@article {pmid41406984, year = {2026}, author = {Roster, KIO and White, PJ and Grad, YH}, title = {Why Are Gonorrhea Case Rates Declining in the United States? A Research Agenda.}, journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America}, volume = {82}, number = {6}, pages = {1082-1090}, pmid = {41406984}, issn = {1537-6591}, support = {HHSD200201691779I/CC/CDC HHS/United States ; MR/X020258/1//UK Medical Research Council (MRC) Centre for Global Infectious Disease Analysis/ ; //Global Health EDCTP3 Joint Undertaking/ ; //National Institute for Health and Care Research (NIHR) Health Protection Research Unit (HPRU) in Health Analytics and Modelling/ ; //UK Health Security Agency (UKHSA)/ ; //London School of Hygiene & Tropical Medicine (LSHTM)/ ; NIHR207404//Imperial College London/ ; //NIHR HPRU in Modelling and Health Economics/ ; //UKHSA/ ; NIHR200908//LSHTM/ ; 200-2016-91779//LSHTM/ ; }, mesh = {Humans ; *Gonorrhea/epidemiology/prevention & control ; United States/epidemiology ; Centers for Disease Control and Prevention, U.S. ; Post-Exposure Prophylaxis ; Sexual Behavior ; Mass Screening ; Doxycycline/therapeutic use ; Female ; }, abstract = {After nearly a decade of rising gonorrhea rates, the US Centers for Disease Control and Prevention (CDC) reported a decline in infection rates for 2 years in a row in 2022 and 2023, especially among young adults. While this warrants cautious optimism that control measures have been successful, the reasons for the decline are unknown. We do not know what lessons can be learned about the 4CMenB vaccine with partial protection against gonorrhea, doxycycline postexposure prophylaxis (doxy-PEP), asymptomatic screening, sexual behavior, or other possible drivers. Here, we enumerate potential drivers of the decline in gonorrhea, the evidence that argues for or against each one, and the data needed to clarify their roles. We hope to encourage those with suitable data to perform the analyses we outline, for surveillance systems to provide more detailed data where possible, and for existing and new surveillance and research studies to collect additional data.}, }
@article {pmid41407373, year = {2026}, author = {Inoue, F and Anzai, A and Miura, F and Kinoshita, R and Arai, S and Kamigaki, T and Suzuki, M and Yoneoka, D}, title = {[Error factors and sustainable utility of COVID-19 wastewater surveillance in Japan].}, journal = {[Nihon koshu eisei zasshi] Japanese journal of public health}, volume = {73}, number = {3}, pages = {227-236}, doi = {10.11236/jph.25-048}, pmid = {41407373}, issn = {0546-1766}, mesh = {*COVID-19/epidemiology ; Humans ; Japan/epidemiology ; *Wastewater/virology ; *SARS-CoV-2 ; }, abstract = {Objectives In response to the coronavirus disease 2019 (COVID-19) pandemic, the usefulness of wastewater surveillance has been highlighted. Wastewater surveillance can detect pathogens that circulate throughout society, including asymptomatic infections, thereby allowing early outbreak warnings. However, several error factors must be considered when applying wastewater surveillance for COVID-19. This study examines the key error factors in COVID-19 wastewater surveillance and discusses their future applicability in Japan.Methods A literature search was conducted using PubMed and Ichushi-Web to review the studies on wastewater surveillance for COVID-19. The search included combinations of the keywords "wastewater," "sewage," "COVID-19," "SARS-CoV-2," "fecal/urine," and "surveillance/survey/detection." A narrative review was conducted based on the search results.Results A total of 2,108 articles were identified in PubMed, of which 19 were included in this review. In addition, six academic articles were retrieved from Google Scholar, and two government reports and guidelines were included in this review. The sampling methods and environmental factors such as wastewater temperature, transit time, and composition can be potential sources of error in wastewater surveillance. Furthermore, the standardization of these factors is difficult. The prevalence of COVID-19, population size, and population mobility in the target area also influence data interpretation. Additionally, because wastewater surveillance often lacks detailed patient background information such as age, sex, and exact locations of affected individuals, data interpretation can be more challenging than clinical testing-based surveillance, thus potentially limiting its applicability. However, compared to large-scale clinical screening, wastewater surveillance is significantly more cost-effective, rapid, and suitable for continuous monitoring. With regard to statistical analysis, sample normalization is crucial for accurate comparisons across samples, regions, and time periods. A low signal-to-noise ratio during COVID-19 wastewater surveillance requires significant smoothing procedures to extract meaningful signals.Conclusion Wastewater surveillance for COVID-19 is subject to errors from several sources. Nevertheless, it offers advantages over clinical surveillance that include lower expected costs and capacity for continuous monitoring across broad geographic areas. In conclusion, it is essential to understand the advantages and limitations of both clinical and wastewater surveillance and appropriately integrate both approaches for optimal utilization.}, }
@article {pmid41407484, year = {2025}, author = {Wilson, JC and Liu, KY and Mittelman, E and Bareke, P and Shleifer, E and Howard, R}, title = {Brain fog with long covid and chemotherapy: systematic review and meta-analysis.}, journal = {BMJ mental health}, volume = {28}, number = {1}, pages = {}, pmid = {41407484}, issn = {2755-9734}, mesh = {Humans ; *COVID-19/complications/psychology ; *Antineoplastic Agents/adverse effects ; *Neoplasms/drug therapy ; SARS-CoV-2 ; *Cognitive Dysfunction/etiology ; }, abstract = {QUESTION: What are the cognitive, functional and affective characteristics of brain fog in individuals with long covid and following chemotherapy, and how are these features assessed across studies?
STUDY SELECTION AND ANALYSIS: In March 2024, we conducted a systematic review and meta-analysis of peer-reviewed studies assessing cognition, function or mood in adults (≥18 years) with brain fog after COVID-19 or chemotherapy. PubMed, Embase and Web of Science were searched systematically according to eligibility criteria to March 2024, with an update in May 2025. Random-effects meta-analyses using the 'dmetar' package (V.0.0.9000) in R V.4.3.1 were performed for studies comparing individuals with and without brain fog. Bias was assessed using the National Institutes of Health Study Quality Assessment Tools.
FINDINGS: Of 3077 records screened, 65 studies met inclusion criteria: 40 investigated brain fog in long covid and 25 in chemotherapy populations. Considerable variation in assessment tools was observed. Montreal Cognitive Assessment was the most common cognitive test in long covid studies; Functional Assessment of Cancer Therapy-Cognitive Function was most used in chemotherapy studies. Nine long covid studies were eligible for meta-analysis. Compared with controls, individuals with brain fog had significantly lower cognitive performance (Hedge's g=-0.63, 95% CI -1.15 to -0.12), higher fatigue (Hedge's g=2.64, 95% CI 0.41 to 4.86) and more depressive symptoms (Hedge's g=1.48, 95% CI 0.40 to 2.55). Heterogeneity was high (I[2]>70%). No chemotherapy studies were appropriate for meta-analysis, preventing direct comparison of brain fog features between long covid and chemotherapy groups.
CONCLUSIONS: Brain fog in long covid and chemotherapy populations is associated with cognitive complaints, fatigue and mood disturbance, though assessment methods differ widely. To improve comparability and clinical understanding, we propose adoption of consistent tools and definitions in future studies. This will be a crucial step in generating findings that can be meaningfully compared across populations.
PROSPERO REGISTRATION NUMBER: CRD42024520549.}, }
@article {pmid41407606, year = {2026}, author = {Ouksel, H}, title = {[Long covid pulmonary rehabilitation].}, journal = {Revue des maladies respiratoires}, volume = {43}, number = {1}, pages = {49-56}, doi = {10.1016/j.rmr.2025.12.001}, pmid = {41407606}, issn = {1776-2588}, mesh = {Humans ; *COVID-19/rehabilitation/complications/epidemiology ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Patient Education as Topic ; Respiratory Therapy/methods ; Pandemics ; Exercise Therapy/methods ; }, abstract = {While the SARS-CoV-2 pandemic has left a lasting impression, the long-term effects of this virus, such as persistent symptoms or long COVID, remain unclear. However, recommendations from learned societies for improving these symptoms exist and are being applied by a number of respiratory rehabilitation centers. In this paper, we provide a summary of the specificities of long COVID care in the context of respiratory rehabilitation, particularly as regards respiratory symptoms, fatigue, cognitive disorders, and cardiovascular symptoms and, more specifically, vegetative dysautonomia. The key elements of support are Therapeutic Patient Education (TPE) and activity management and fractionated exercise (PACING). While the effects of respiratory rehabilitation are highly promising, with potential improvement in symptoms and exercise capacity, the level of evidence remains low to moderate. Structured and coordinated multidisciplinary work is of paramount importance as a means of providing for these individuals the best possible support on their road to recovery. Further studies are needed to improve the level of evidence on the effectiveness of rehabilitation in cases of long COVID.}, }
@article {pmid41408029, year = {2025}, author = {Pérez Palacios, AF and Medina Parra, JA and Córdoba Velasco, DS and Zona Rubio, DC and Alves, IA and Aragón Novoa, DM}, title = {New Strategies to Improve Drug Solubility and Its Impact on Bioavailability: A Patent Review (2015-2024).}, journal = {AAPS PharmSciTech}, volume = {27}, number = {1}, pages = {57}, pmid = {41408029}, issn = {1530-9932}, mesh = {Solubility ; Biological Availability ; *Patents as Topic ; Humans ; Pharmaceutical Preparations/chemistry/metabolism ; Drug Delivery Systems/methods ; Animals ; Chemistry, Pharmaceutical/methods ; Drug Development/methods ; Particle Size ; }, abstract = {Poor aqueous solubility is a major barrier in drug development, affecting dissolution, absorption, and systemic bioavailability. Nearly 40% of approved drugs and up to 90% of new chemical entities face this limitation, resulting in therapeutic inefficacy and costly clinical development. This study reviewed patents published between 2015 and 2024 that describe technological strategies to enhance drug solubility and bioavailability, aiming to identify innovation trends and their pharmaceutical impact. A structured search was conducted in the Espacenet database using the keywords "bioavailability" and "solubility" under the IPC code A61K. From 98,111 initial results, duplicates, language restrictions, and patents related to cosmetics, nutrition, or veterinary products were excluded, yielding 29 eligible documents. Extracted data included applicant country, therapeutic indication, BCS classification, formulation approach, manufacturing method, and available in vivo pharmacokinetic results. Descriptive analysis was performed using R software. China led patent registrations (55%), followed by the USA (17%). Patent filings increased steadily from 2016-2020, decreased during the COVID-19 pandemic, and recovered after 2021. Most drugs belonged to BCS Class II (76%), reflecting high permeability but poor solubility. The main strategies included particle size reduction, solid dispersions, self-emulsifying drug delivery systems, cyclodextrin inclusion complexes, and advanced crystallization techniques. When reported, pharmacokinetic data showed significant improvements in Cmax and AUC; however, only 58% of patents included in vivo studies. Overall, patents reveal robust innovation aimed at overcoming solubility challenges.}, }
@article {pmid41408170, year = {2025}, author = {Bissett, M and Aggar, C and Hockings, M and Prassos, T and Baker, JR}, title = {An integrative review of loneliness and quality of life in older adults who lived alone during COVID-19: considerations for supporting reconnection.}, journal = {BMC geriatrics}, volume = {26}, number = {1}, pages = {77}, pmid = {41408170}, issn = {1471-2318}, mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Loneliness/psychology ; *Quality of Life/psychology ; Aged ; *Independent Living/psychology ; *Social Isolation/psychology ; SARS-CoV-2 ; Aged, 80 and over ; Pandemics ; }, abstract = {BACKGROUND: Loneliness and decreased quality of life are associated with decreased life expectancy and are regarded as serious health concerns. Understanding the impact of the pandemic on older adults living alone is essential for informing strategies to decrease loneliness and improve quality of life following the COVID-19 pandemic and in future crises. This integrative review aimed to synthesise the qualitative and quantitative evidence on the factors of the pandemic that influenced loneliness and quality of life of older adults living alone, and examine associated interventions to support this population. METHODS: An integrative review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Six databases (CINAHL Plus, MEDLINE with Full Text, APA PSYCArticles, Psychology & Behavioral Sciences Collection, Academic Search Premier and Proquest Coronavirus Research Database) were searched in February 2024 for peer-reviewed studies on community-dwelling older adults (60+) living alone during COVID-19. Screening and selection were completed in Covidence. The review included 53 articles (39 quantitative, 11 qualitative, and three mixed-methods) published between 2020 and 2023. Study quality was appraised using the Mixed Methods Appraisal Tool. Data were extracted into Excel and synthesised narratively across quantitative, qualitative, and mixed-methods studies to identify factors influencing loneliness, quality of life, and related interventions. RESULTS: Most studies were based on cross-sectional data and represented a broad international experience. Most studies reported increased loneliness and worsened quality of life during the pandemic. Loneliness was associated with isolation, intolerance of uncertainty and anxiety, however being accustomed to isolation, unity through adherence to pandemic measures, and socialising with neighbours were protective factors. Worsened quality of life was associated with poor sleep patterns, stigmatisation from being labelled as an ‘at risk’ population and feeling imprisoned at home. Protective factors included an appreciation for activities and connections, fostering creativity, engaging in hobbies and learning new skills. Lastly, interventions utilised technology via phone calls and socially assisted robots and were shown to help older adults. CONCLUSIONS: Additional meaningful, engaging and accessible strategies are needed to support older adults who live alone during crises. This integrative review offers insight into global experiences of loneliness and quality of life among older adults living alone during the COVID-19 pandemic, with suggestions for effective intervention strategies.}, }
@article {pmid41408194, year = {2025}, author = {Bosquet, A and Affo, C and Happe, F and Helfer, H and Versini, E and Mahé, I}, title = {COVID-19 treatment of hospital patients worldwide at the onset of the pandemic in 2020: a systematic review.}, journal = {BMC infectious diseases}, volume = {26}, number = {1}, pages = {107}, pmid = {41408194}, issn = {1471-2334}, mesh = {Humans ; *COVID-19 Drug Treatment ; Hydroxychloroquine/therapeutic use ; COVID-19/epidemiology ; *Antiviral Agents/therapeutic use ; SARS-CoV-2 ; Global Health ; Adrenal Cortex Hormones/therapeutic use ; Lopinavir/therapeutic use ; Ritonavir/therapeutic use ; Pandemics ; }, abstract = {In early 2020, no drug had proven efficacy to treat COVID-19 in-patients. This work aimed to describe COVID-19 treatment for in-patients worldwide until June, 2020. A PubMed search was performed with the terms "retrospective observational study", "hospital", "treatment" and "COVID" to identify English-written studies describing treatments given to adult in-patients before June 30, 2020. The identified reports were analyzed, with data extracted regarding patient characteristics and treatments across continents and countries. Overall, 178 studies involving 181,510 patients in 28 countries were analyzed, including 484 patients from Africa, 36,840 from Asia, 69,088 from Europa and 68,524 from North America. The most prescribed drugs were hydroxychloroquine (64.3%, i.e. 41.9% of all patients), corticosteroids (31.0%, i.e. 21.0%) and lopinavir/ritonavir (30.8%, i.e. 12.0%). Corticosteroids was used worldwide with similar rates in Asia, Europe and North America. Hydroxychloroquine dominated prescriptions in Africa, Europe and North America. Asia exhibited unique features: less frequent hydroxychloroquine use, higher oseltamivir use and exclusive use of umifenovir. In Europe, repurposed drugs prescription was the highest in Spain and Italy. Our study is not an exhaustive review of the literature on COVID-19 treatment of in-patients early in 2020 but is the first one to provide a comprehensive overview of COVID-19 treatment modalities in such a broad range of countries worldwide. Our work reveals high prescription rates but also heterogeneity across continents and countries in the treatment of COVID-19 in-patients worldwide. These findings emphasize the critical role of international collaboration in generating and disseminating reliable information for managing emerging diseases.}, }
@article {pmid41408488, year = {2026}, author = {Almanaa, TN and Al-Kuraishy, HM and Al-Gareeb, AI and Abdelnaby, MA and Alexiou, A and Papadakis, M and Abo-ElFetoh, IE and Batiha, GE}, title = {SARS-CoV-2 infection and gut-lung axis: the potential role of rifaximin.}, journal = {Inflammopharmacology}, volume = {34}, number = {1}, pages = {255-265}, pmid = {41408488}, issn = {1568-5608}, mesh = {Humans ; *COVID-19/complications ; *Gastrointestinal Microbiome/drug effects ; *Rifaximin/pharmacology/therapeutic use ; Dysbiosis/drug therapy ; *COVID-19 Drug Treatment ; SARS-CoV-2 ; *Lung/drug effects ; Animals ; }, abstract = {Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), leading to global effects. COVID-19 causes pulmonary and extra-pulmonary manifestations. One of the most common extra-pulmonary manifestations is gastrointestinal (GI) manifestation. Enteric COVID-19 triggers changes in the diversity of gut microbiota (dysbiosis). Dysbiosis of gut flora increases gut permeability, resulting in secondary bacterial infections, systemic inflammation, and injury of the peripheral organs. Dysbiosis may affect the immune system and pulmonary response to the SARS-CoV-2 invasion, suggesting a link between the lungs and gut through the gut-lung axis. Intestinal inflammation caused by SARS-CoV-2 infection induces leaky gut with subsequent transmission of toxins and antigens to the systemic circulation, causing further worsening of the septic condition in COVID-19 patients. Therefore, the anti-inflammatory agents' interruption of the gut-lung axis may reduce respiratory complications due to intestinal inflammation in COVID-19. Rifaximin (RXM) is a semi-synthetic antibacterial drug derived from natural rifamycin that acts locally within GI by inhibiting bacterial RNA polymerase and reducing the bacterial population and associated intestinal inflammation. RXM inhibits bacterial adherence to the intestinal epithelial lining and translocation across this GI lining. RXM has anti-inflammatory effects by inhibiting the release of pro-inflammatory cytokines and modulating the gut pregnane X receptor (PXR). RXM acts as a prebiotic in maintaining the growth of gut microbiota and may prevent the development of COVID-19-induced dysbiosis. Therefore, RXM could be effective in managing COVID-19 and associated inflammatory complications. Therefore, this review aims to discuss the potential role of RXM in managing COVID-19.}, }
@article {pmid41409040, year = {2025}, author = {Cao, L and Min, J and Yu, M and Zhang, Z and Yuan, D and Chen, D}, title = {Key Clinical Frontiers of mRNA Loaded Lipid Nanoparticles in Cancer Vaccines.}, journal = {International journal of nanomedicine}, volume = {20}, number = {}, pages = {14935-14953}, pmid = {41409040}, issn = {1178-2013}, mesh = {Humans ; *Cancer Vaccines/administration & dosage/immunology ; *Nanoparticles/chemistry ; *RNA, Messenger/administration & dosage/immunology ; *Lipids/chemistry ; COVID-19 Vaccines/immunology ; *Neoplasms/therapy/immunology ; COVID-19/prevention & control ; Animals ; SARS-CoV-2/immunology ; mRNA Vaccines ; Liposomes ; }, abstract = {Cancer vaccines are promising, but clinical translation is constrained by inefficient antigen delivery and suboptimal immune activation. Lipid nanoparticles (LNPs)-validated for potency and safety in COVID-19 mRNA vaccines-offer a versatile, scalable, and immunogenic platform. Key barriers persist: precise targeting of tumors or lymphoid tissues, efficient intracellular mRNA release, and the immunosuppressive tumor microenvironment. This review synthesizes design principles for mRNA-loaded LNPs, emphasizing lipid chemistry, organ-selective biodistribution, and nano-engineering strategies that strengthen antigen presentation and T-cell priming. We also examine combination approaches with checkpoint blockade, chemotherapy-induced immunogenic cell death, and molecular adjuvants. Clinically, signals of efficacy are emerging-most notably the KEYNOTE-942 study, in which mRNA-4157 combined with pembrolizumab showed a sustained improvement in recurrence-free survival at 5 years compared with pembrolizumab alone-highlighting both the potential and the remaining questions for this modality. Finally, we outline manufacturing and regulatory considerations and map future directions-including thermostable formulations, self-amplifying RNA, and AI-guided lipid discovery-to address translational bottlenecks and expand global access to LNP-based cancer vaccines.}, }
@article {pmid41409541, year = {2025}, author = {Hu, X and Wang, Z and Wang, S and Sun, H and Feng, N and Li, E and Xia, X and Hu, G and Yan, F and Li, B}, title = {Next-Generation Vaccines for Co-Circulating PEDV and TGEV: Integrating Nucleic Acid Platforms, Mucosal Delivery, and AI-Driven Antigen Design.}, journal = {Transboundary and emerging diseases}, volume = {2025}, number = {}, pages = {2014296}, pmid = {41409541}, issn = {1865-1682}, mesh = {Animals ; *Viral Vaccines/immunology ; *Transmissible gastroenteritis virus/immunology ; *Porcine epidemic diarrhea virus/immunology ; Swine ; *Gastroenteritis, Transmissible, of Swine/prevention & control/virology ; *Artificial Intelligence ; Vaccine Development ; *Coronavirus Infections/prevention & control/veterinary ; *Swine Diseases/prevention & control/virology ; Antigens, Viral/immunology ; }, abstract = {Porcine epidemic diarrhea virus (PEDV) and transmissible gastroenteritis virus (TGEV) are causative agents of acute enteric diseases in pigs and have a high contagion potential. These coronaviruses (CoVs) impose substantial economic losses on global pork production, particularly affecting lactating piglets where coinfections occur. Although traditional vaccines offer partial protection, their efficacy is increasingly challenged by the continuous emergence of mutated strains of PEDV and TGEV. This underscores the demand for novel vaccines with improved protective efficacy and cost-effectiveness. Emerging vaccine technologies, such as nucleic acid vaccines, genetically engineered subunit vaccines, and live vector vaccines, have received widespread attention because of their advantages in terms of safety, stability, targeted delivery, economy, and ease of use. This review summarizes recent advances in PEDV and TGEV vaccine development, highlighting both their potential and limitations. More importantly, we prospect novel techniques that may supplement the status gaps and lead to breakthroughs in blocking the transmission of these CoVs. Notable research priorities encompass mucosal immunity mechanisms, vertical transmission prevention strategies, and computational immunogen design leveraging artificial intelligence (AI). Overall, a deeper understanding of the pathogens coupled with technological advances is expected to accelerate the control of and effective response to pathogenic CoVs, thereby safeguarding the stability of animal husbandry.}, }
@article {pmid41409701, year = {2025}, author = {Qi, X}, title = {A systematic review of global COVID-19 vaccine PPPs: drivers and barriers to governance alignment.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1727808}, pmid = {41409701}, issn = {2296-2565}, mesh = {Humans ; *COVID-19 Vaccines/supply & distribution ; *COVID-19/prevention & control ; *Public-Private Sector Partnerships/organization & administration ; Global Health ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Public-private partnerships (PPPs) have emerged as a prominent governance model for vaccine equity in the COVID-19 vaccine supply chain. Previous studies focus on evaluating PPP's performance, lacking multi-dimensional analysis on the drivers and barriers that shape public and private actors' willingness to participate in PPPs.
METHOD: Following the PRISMA 2020 guidelines, a systematic review using the Web of Science (WoS) database was conducted to identify empirical factors influencing stakeholders' preference for PPPs and the alignment between sectors was explored by qualitative content analysis.
RESULTS: Three main categories of private sector drivers were identified, including regulatory facilitation, financial incentives and reputational incentives. While four sets of barriers emerged, including the political environment, economic and logistic constraints, and the contractual obligations. For the public sector, motivations centered on ethical considerations, national interest protection, and institutional advantages, while participation was also constrained by vaccine nationalism and administrative lag. The analysis demonstrates the degree of alignment and misalignment among these governance factors.
CONCLUSION: Based on the analysis of factors, this study proposes the Governance Alignment Framework (GAF) as a conceptual tool to pair the profits of different sectors and guide governments and public sectors to improve the developmental-steering capacities to better align private incentives with public value during the pandemic.}, }
@article {pmid41409950, year = {2025}, author = {Piszka, M and Kwapien, E and Brasse, P and Staszkiewicz, K and Zerdka, J and Staszkiewicz, KK and Bartkowski, J and Czarnecki, F and Kubicka, M}, title = {The Impact of Screen Time on the Health of the Pediatric Population: Short- and Long-Term Consequences for Lifestyle, Ophthalmology, and Mental Health.}, journal = {Cureus}, volume = {17}, number = {11}, pages = {e96944}, pmid = {41409950}, issn = {2168-8184}, abstract = {This review analyzes extensive scientific data linking screen time to a wide range of health problems in the pediatric population and divides them into short-term and long-term health effects. Excessive exposure to screen media negatively affects many aspects of the health of children and adolescents. We can observe negative effects that translate into patients' lifestyles as well as ophthalmological and mental health problems. After analyzing the studies, the most common short-term consequences, such as obesity, sleep disorders, and dry eye syndrome, were identified. Many studies have highlighted the impact of particularly long periods of screen time, more than 3-4 hours. The health consequences that manifest themselves later include hypertension, cardiovascular disease, and myopia. This impact also extends to mental health, where there is a clear correlation between long screen time and a higher incidence of anxiety, depression, and behavioral problems. Evidence indicates an increase in children's screen time since the COVID-19 pandemic. Due to the continuing high level of screen time, associated not only with entertainment but also with the transfer of certain activities to an online format, despite the end of the pandemic, public health interventions and educational strategies are urgently needed to mitigate these negative effects and promote a healthy lifestyle among children, which will translate into the health of the entire population in the future.}, }
@article {pmid41410053, year = {2026}, author = {Sundler Björkman, L and Eswaran, H and Grover, SP}, title = {Therapeutic Potential of C1-Inhibitor in Vascular Diseases and Beyond.}, journal = {Arteriosclerosis, thrombosis, and vascular biology}, volume = {46}, number = {2}, pages = {e323743}, pmid = {41410053}, issn = {1524-4636}, support = {R01 HL171042/HL/NHLBI NIH HHS/United States ; T32 HL007149/HL/NHLBI NIH HHS/United States ; }, mesh = {Humans ; *Complement C1 Inhibitor Protein/therapeutic use/metabolism ; Animals ; COVID-19 ; *Vascular Diseases/drug therapy ; Reperfusion Injury/drug therapy ; Blood Coagulation/drug effects ; Sepsis/drug therapy ; }, abstract = {C1INH (C1-inhibitor) is a multifunctional SERPIN (serine protease inhibitor) that functions as a major negative regulator of the complement, coagulation, and kallikrein-kinin systems. C1INH products were originally developed for the treatment of hereditary angioedema associated with C1INH deficiency. A growing body of literature indicates that C1INH products may find utility in the management of several other disease states. In this review, we detail the key biological activities of C1INH and consider the pathophysiological role of C1INH targets in many conditions. The therapeutic potential of exogenous C1INH is highlighted in the settings of thromboembolism, ischemia-reperfusion injury, sepsis, transplantation, and coronavirus disease 2019.}, }
@article {pmid41410086, year = {2026}, author = {Abdollahimohammad, A and Rahnama, M and Miri, K and Ildarabadi, EH}, title = {Community Health Nurses' Experiences During the COVID-19 Pandemic: A Systematic Review.}, journal = {Public health nursing (Boston, Mass.)}, volume = {43}, number = {2}, pages = {482-496}, doi = {10.1111/phn.70055}, pmid = {41410086}, issn = {1525-1446}, mesh = {Humans ; *COVID-19/nursing/epidemiology ; *Nurses, Community Health/psychology ; Pandemics ; *Community Health Nursing ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Community health nurses (CHNs) played a key role in pandemic crisis management, yet their specific experiences remain poorly documented. This study aims to identify the experiences of CHNs during the COVID-19 pandemic.
METHOD: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant articles were searched in PubMed, Web of Science, and Scopus in 2024. Two independent researchers reviewed titles and abstracts to identify eligible studies based on the inclusion criteria. Data synthesis employed the method of Lizardo et al. Nine articles were included.
RESULTS: Four themes were extracted: (1) awareness and preparation of CHNs, (2) facilitators, (3) various challenges in playing the role of CHNs (including moral dilemmas, organizational challenges, and occupational challenges), and (4) procedural changes and the use of technology.
CONCLUSION: Despite facing numerous challenges, CHNs played a crucial role in enhancing public knowledge and performance to control the pandemic. Comprehensive cooperation and support between health and non-health systems are essential for improving community health preparedness. It is suggested that health system managers use the results of this study to inform their service delivery planning.}, }
@article {pmid41411704, year = {2026}, author = {Thomm, E and Bauer, J and Bromme, R}, title = {The role of expert pertinence for epistemic trust during the COVID-19 pandemic and beyond.}, journal = {Current opinion in psychology}, volume = {68}, number = {}, pages = {102233}, doi = {10.1016/j.copsyc.2025.102233}, pmid = {41411704}, issn = {2352-2518}, mesh = {Humans ; *COVID-19/psychology ; *Trust/psychology ; Pandemics ; SARS-CoV-2 ; *Knowledge ; }, abstract = {The COVID-19 pandemic spotlighted the critical role of scientific expertise in epistemic trust. Diverse experts entered the public arena and became visible in debates, confronting non-experts with the question of whom to trust-especially when experts contradicted each other, changed recommendations, or were intermingled with unreliable voices. This article highlights the pertinence of scientific expertise (i.e., the alignment between a source's expertise and the claims it advances) as key factor for epistemic trust. While judgments of expertise are recognized as essential, little is known about how non-experts assess its pertinence. More research is needed to examine non-experts' skills to assess the pertinence of expertise and how these skills can be enhanced through education and science communication.}, }
@article {pmid41412274, year = {2026}, author = {Zheng, W and Chen, W and Hutvagner, G and Rangel-Sanchez, L and Deng, W}, title = {Advancements in breast cancer mRNA vaccines: Current development and future prospects.}, journal = {Biochimica et biophysica acta. Reviews on cancer}, volume = {1881}, number = {1}, pages = {189515}, doi = {10.1016/j.bbcan.2025.189515}, pmid = {41412274}, issn = {1879-2561}, mesh = {Humans ; *Breast Neoplasms/immunology/therapy/genetics ; *Cancer Vaccines/immunology/therapeutic use/genetics ; Female ; Tumor Microenvironment/immunology ; *mRNA Vaccines/immunology ; *RNA, Messenger/immunology/genetics ; *Vaccine Development ; *Vaccines, Synthetic/immunology ; Antigens, Neoplasm/immunology/genetics ; COVID-19/immunology/prevention & control ; Immunotherapy/methods ; Animals ; SARS-CoV-2/immunology ; }, abstract = {Messenger RNA (mRNA) vaccines have become a transformative approach in immunotherapy and have attracted significant attention owing to their unprecedented success in controlling COVID-19. With their ability to flexibly and specifically encode tumour-associated antigens, along with their favorable safety profiles and scalable manufacturing, mRNA vaccines represent a highly promising platform for cancer treatment. Breast cancer is a heterogeneous disease and many of its subtypes are immunologically cold tumours, which has limited the progress of immunotherapy in this field. Recent studies have highlighted the potential of mRNA vaccines to reshape the tumour immune microenvironment in breast cancer. These vaccines can enhance antigen presentation, activate T cell responses, and convert immunologically cold tumours into immune-active ones. This review provides a comprehensive overview of recent advances in mRNA vaccine development for breast cancer with a focus on antigen selection, mRNA design, and delivery strategies. It also examines findings from both preclinical and clinical studies as well as recent progress in industrial development. Finally, we discuss the current challenges hindering the clinical translation and ethical considerations of mRNA vaccine technology and propose future directions to advance mRNA vaccine-based therapies for breast cancer.}, }
@article {pmid41415293, year = {2025}, author = {Murugan, AK and Alzahrani, AS}, title = {COVID-19 vaccine-induced autoimmune hyperthyroidism: Graves' disease.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1699210}, pmid = {41415293}, issn = {1664-3224}, mesh = {Humans ; *Graves Disease/immunology/etiology ; *COVID-19 Vaccines/adverse effects/immunology ; *SARS-CoV-2/immunology ; *COVID-19/prevention & control/immunology ; Autoantibodies/immunology ; Autoimmunity ; }, abstract = {Graves' disease (GD) is an autoimmune disorder that results in hyperthyroidism, in which the immune system mistakenly targets the thyroid gland, causing it to produce excessive amounts of thyroid hormones. Genetic predisposition, environmental factors such as infections and stress, disruptions in the gut microbiome, excessive iodine intake, and epigenetic changes have all been implicated in the development of GD. The recent pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) posed a serious global health crisis. The emergence of COVID-19 vaccines has been pivotal in combating the viral infection and its spread. However, reports of rare adverse events, including the development of autoimmune disorders such as GD following vaccination, have raised concerns. Autoimmune factors play a critical role in the pathogenesis of GD, particularly through the production of autoantibodies targeting the thyroid gland. In this review, reported cases are critically analyzed to elucidate commonalities and potential triggers for the development of this autoimmune disorder, highlighting the vital role of autoimmune mechanisms in inducing GD. We also discuss the molecular mechanisms underlying vaccine-induced autoimmunity, including antigen presentation, bystander activation, molecular mimicry, and the induction of inflammatory factors following vaccination. Understanding these mechanisms in COVID-19 vaccine-induced GD could enhance patient care and guide vaccination policies.}, }
@article {pmid41415584, year = {2025}, author = {Kvandova, M and Balis, P and Kalocayova, B and Vlkovicova, J and Dobrodenkova, S and Puzserova, A}, title = {Cardiovascular damage and comorbidities related to long COVID: pathomechanisms, prevention, and therapy.}, journal = {Frontiers in cardiovascular medicine}, volume = {12}, number = {}, pages = {1671951}, pmid = {41415584}, issn = {2297-055X}, abstract = {Long COVID (LC) is a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection-associated chronic condition and is present for at least 3 months as a continuous, relapsing and remitting, or progressive disease state that affects one or more organ systems, including cardiovascular. Extensive literature supports an association between SARS-CoV-2 infection and cardiovascular complications and increased cardiovascular risk after infection. The cardiovascular sequelae after SARS-CoV-2 infection have not yet been comprehensively characterized. A growing body of evidence suggests that endothelial dysfunction is a central mechanism in COVID-19 and has also been identified as a key pathogenic mechanism in LC. Although considerable progress has been made in characterizing the epidemiology, clinical course, and biology of LC, many questions remain unanswered. The incomplete understanding of the pathomechanisms of LC has hampered the development of targeted therapies to date. Further research and data are needed to develop effective therapeutic and preventive tools. Based on current literature this review aims to provide an up-to-date overview of the pathomechanisms affecting the cardiovascular system and the potential role of selected micronutrients, vitamins and minerals, and flavonoids as preventive and therapeutic strategies in LC.}, }
@article {pmid41415646, year = {2025}, author = {Choi, CH}, title = {[The Journey of the Clinical Practice Guideline Committee Towards Evidence-Based Radiology: Commemorating the 80th Anniversary of the Korean Society of Radiology].}, journal = {Journal of the Korean Society of Radiology}, volume = {86}, number = {6}, pages = {874-881}, pmid = {41415646}, issn = {2951-0805}, abstract = {In the field of radiology, clinical practice guidelines (CPGs) have been established as a core tool for ensuring consistency in clinical diagnosis and patient safety. In 2012, aligning with the global emphasis on evidence-based medicine that emerged in the early 2000s, the CPG Committee of the Korean Society of Radiology was founded, with the aim of establishing or revising various guidelines across radiology and related medical fields. Since then, the Committee has developed and disseminated diverse CPGs to ensure the appropriateness of radiological examinations and to minimize radiation exposure. This report reviews the Committee's major achievements over the past decade, including the development of justification guidelines, support for subspecialty-led creation of guidelines, safety protocols for contrast media, rapid guidelines for COVID-19 imaging, and integration with clinical decision support systems. Through active collaboration with government agencies and academic institutions, the Committee has enhanced the scientific rigor and clinical relevance of its guidelines. Furthermore, the launch of an online archive has improved accessibility and utilization. Looking forward, the Committee aims to establish AI-integrated guideline frameworks and expand globally through international cooperation and alignment with national health policies.}, }
@article {pmid41416347, year = {2025}, author = {Shokri-Afra, H and Saber Jeyvan, F and Barartabar, Z and Khanicheragh, P and Yousefi Abdolmaleki, E and Ilbeigi, D and Musavi, H and Malekzadegan, Y}, title = {Targeting SIRT1: A Potential Strategy for Combating Severe COVID-19.}, journal = {BioMed research international}, volume = {2025}, number = {}, pages = {9507417}, pmid = {41416347}, issn = {2314-6141}, mesh = {*COVID-19/immunology/virology ; *Sirtuin 1/metabolism ; Humans ; *COVID-19 Drug Treatment/methods ; Angiotensin-Converting Enzyme 2/metabolism ; Resveratrol/pharmacology/therapeutic use ; Antiviral Agents/pharmacology/therapeutic use ; Virus Internalization ; Molecular Targeted Therapy/methods ; Gene Expression Regulation/immunology ; Inflammation/metabolism ; }, abstract = {Sirtuin 1 (SIRT1) is a crucial regulator of cellular processes, including inflammation, metabolism, and stress responses, playing a significant role in the body's defense mechanisms. During SARS-CoV-2 infection, SIRT1 plays a crucial role in modulating the immune response. This protein helps to enhance the antiviral response through deacetylating key transcription factors and regulating proinflammatory cytokines, thereby reducing the cytokine storm (an overwhelming immune response) associated with severe COVID-19 cases. SIRT1 influences the expression of angiotensin-converting enzyme 2 (ACE2), the primary receptor for SARS-CoV-2, thereby potentially mitigating viral entry and replication. Natural activators of SIRT1, such as resveratrol, have been shown to enhance its activity, offering promising avenues for therapeutic interventions aimed at bolstering the immune response during COVID-19. Understanding the multifaceted role of SIRT1 in human defense mechanisms against SARS-CoV-2 could pave the way for innovative strategies to manage COVID-19 and similar viral infections, emphasizing the importance of SIRT1 as a potential target for future therapeutic approaches.}, }
@article {pmid41416679, year = {2025}, author = {Tao, X and Zhang, Z and Liang, L and Xu, S and Du, X and Ren, Z and Yu, X}, title = {Temporal patterns of suicidal ideation prevalence during the COVID-19 pandemic: a systematic review and meta-analysis of cross-sectional and longitudinal studies.}, journal = {Epidemiology and psychiatric sciences}, volume = {34}, number = {}, pages = {e61}, pmid = {41416679}, issn = {2045-7979}, mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Suicidal Ideation ; Cross-Sectional Studies ; Prevalence ; Longitudinal Studies ; Pandemics ; SARS-CoV-2 ; }, abstract = {AIMS: Although extensive research has been conducted on the impact of the COVID-19 pandemic on global mental health, a systematic synthesis of the cross-time dynamics of suicidal ideation (SI) remains lacking. This study aims to systematically synthesise the global aggregated prevalence of SI before and after the pandemic, investigate the potential association between pandemic exposure and the SI risk through meta-regression analysis of longitudinal studies, and explore key moderating factors.
METHODS: A systematic search was conducted in Web of Science, PubMed, PsycINFO and ProQuest databases up to August 2025. Observational studies were included if they employed cross-sectional or longitudinal designs and reported the prevalence of SI before and after the pandemic across global regions.
RESULTS: The analysis included 354 cross-sectional studies (N = 8,247,875) and 27 longitudinal studies. In cross-sectional studies, the pooled prevalence of SI was 13.20% [95% CI 12.06%-14.42%]. Pre-pandemic prevalence was 12.52% [95% CI 8.46%-18.14%], and post-pandemic prevalence was 13.24% [95% CI 12.07%-14.50%], with no significant difference. Meta-regression analysis identified three moderators. Specifically, larger sample sizes (n) were associated with lower prevalence (β = -0.232, P < 0.0001); higher study quality predicted lower prevalence (β = -0.278, P < 0.001); and studies on adults reported significantly lower prevalence than adolescents (β = -0.366, P < 0.05). Conversely, time progression during the pandemic, development level, geographical area, gender and measurement method did not show significant independent effects. Interaction analyses also found no significant moderating effect of economic development level or geographical area on the temporal trend of SI prevalence. Longitudinal analysis found no significant increase in prevalence from the pre-pandemic to the post-pandemic period (P = 0.101). However, a small but significant increase occurred between early and late stages within the pandemic (β = 0.265, P = 0.021). Subgroup analyses showed no significant moderation of these temporal changes.
CONCLUSIONS: The COVID-19 pandemic's impact on SI was dynamic. While no significant prevalence change was found between pre- and post-pandemic periods, a significant increase occurred as the crisis progressed. This deteriorating trend was more pronounced in adolescents, identifying them as a key vulnerable group. Methodologically, findings were moderated by the measurement instrument, study quality and sample size, with evidence suggesting potential small-study effects. These findings underscore the need for robust mental health surveillance and targeted interventions for at-risk populations during prolonged public health crises.The protocol was registered on PROSPERO (CRD42024603151).}, }
@article {pmid41416803, year = {2026}, author = {Kumari, S and Banerjee, A}, title = {Extracellular vesicles: the double-edged sword in viral infections.}, journal = {mBio}, volume = {17}, number = {2}, pages = {e0331625}, pmid = {41416803}, issn = {2150-7511}, support = {EMR/2017/001490//SERB, DST, India/ ; DEC18-319539//UGC, India/ ; }, mesh = {*Extracellular Vesicles/metabolism/virology/immunology ; Humans ; *Virus Diseases/virology/immunology ; Animals ; Biomarkers ; Host-Pathogen Interactions ; Viruses ; }, abstract = {Extracellular vesicles (EVs) are lipid-bound nanocarriers released by various eukaryotic cells and found in diverse bodily fluids. EVs have transitioned from being considered cellular waste disposers to significant players in intercellular communication and signaling. These EVs carry signature cargos of infected cells and thus can be helpful as biomarkers or prognostic markers for infectious diseases. Viruses can manipulate the EV biogenesis machinery in their own dissemination. EVs released from virus-infected cells can carry immune modulatory molecules, thus contributing to disease progression. This comprehensive review collates the information on the impact of EVs on viral infection and disease progression.}, }
@article {pmid41417317, year = {2025}, author = {Oliveira, AM and Cartøgenes, AD and Berni, LC and Amaral, LMB and Machado, RL and Oliveira, RCS}, title = {Impacts of COVID-19 on pediatric patients with congenital heart disease: a small systematic and integrative literature review.}, journal = {Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo}, volume = {43}, number = {}, pages = {e2025073}, pmid = {41417317}, issn = {1984-0462}, mesh = {Humans ; *COVID-19/complications/epidemiology ; *Heart Defects, Congenital/complications/therapy ; Child ; }, abstract = {OBJECTIVE: The objective of this study was to compile primary studies to understand the impacts of COVID-19 on pediatric patients with congenital heart disease.
DATA SOURCE: A systematic review based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) method, with searches conducted in the PubMed, Latin American and Caribbean Health Sciences Literature (LILACS), and Scientific Electronic Library Online (SciELO) databases. Studies published in the last 5 years, open access, and addressing the research question, "What are the main impacts of COVID-19 on pediatric patients with congenital heart disease?" were included. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS) and the Joanna Briggs Institute (JBI) tools.
DATA SYNTHESIS: A total of 377 articles were identified, of which 12 met the inclusion criteria. The NOS tool indicated that two of the eight cohort studies had a risk of bias and lower methodological quality. The JBI tool revealed that three of the four cross-sectional studies had a low risk of bias and good methodological quality. The integrative analysis highlighted three main impacts of COVID-19 on these patients: difficulties in follow-up and treatment, reduced physical activity due to social distancing, and postponement of procedures and surgeries. Infected patients experienced increased complications and hospitalizations, but without a significant change in mortality.
CONCLUSIONS: The COVID-19 pandemic significantly affected the health and management of congenital heart disease, leading to clinical complications and worsening follow-up. Further primary and secondary studies are needed to strengthen the evidence and improve patient management.}, }
@article {pmid41417528, year = {2025}, author = {Miquilussi, PA and Aguiar, TV and Cruz, PLD and Duca, AP and Ribeiro, M and Araújo, CM and Santos, RS and Schroder, AGD and Crippa, ACS}, title = {Impact of SARS-Cov-2 exposure during pregnancy on child neurodevelopment: systematic review and meta-analysis.}, journal = {Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo}, volume = {43}, number = {}, pages = {e2025094}, pmid = {41417528}, issn = {1984-0462}, mesh = {Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Pregnancy ; *Child Development ; *COVID-19/complications/virology ; *Neurodevelopmental Disorders/virology/etiology/epidemiology ; *Pregnancy Complications, Infectious/virology ; *Prenatal Exposure Delayed Effects/epidemiology/virology ; SARS-CoV-2/pathogenicity ; }, abstract = {OBJECTIVE: The objective of this study was to investigate the impact of intrauterine exposure to SARS-CoV-2 on neurodevelopment in children up to 2 years of age.
DATA SOURCE: A combination of keywords and truncations was adapted for five electronic databases: Excerpta Medica Database (EMBASE), Latin American and Caribbean Literature in Health Sciences (LILACS), PubMed/Medline, Scopus, and Web of Science. Additionally, gray literature sources were consulted, including the American Speech-Language-Hearing Association (ASHA), Google Scholar, and ProQuest Dissertations and Theses. The quality of evidence was assessed using the Joanna Briggs Institute's Critical Appraisal Checklist. A random-effects meta-analysis was performed to evaluate the primary outcome using R in R Studio version 1.2.1335 (RStudio Inc., Boston, USA). Study weights were calculated using the Mantel-Haenszel method, and variance, expressed by Tau2 values, employed the DerSimonian-Laird estimator. The Freeman-Tukey double arcsine transformation was applied to approximate a normal data distribution, and 95% confidence intervals were calculated for each meta-analysis.
DATA SYNTHESIS: Nine articles were included in the qualitative synthesis and eight in the quantitative analysis. There was no statistically significant difference in neurodevelopment between infants exposed and unexposed to SARS-CoV-2 during pregnancy [RR=5.10; 95%CI 0.36-71.85; I2=91%]. However, for the "fine motor" domain, the exposed group had a 2.38 times higher risk of deficit [95%CI 1.22-4.68] compared to the non-exposed group, with low heterogeneity in the analysis (I2=0%).
CONCLUSIONS: Exposure to the SARS-CoV-2 virus during the gestational period is not associated with neurodevelopmental delay up to 2 years of age, although it has been linked to an increased risk of delayed fine motor development. However, this evidence remains uncertain due to the limited number of studies on the topic and the heterogeneity of methodologies.}, }
@article {pmid41417766, year = {2025}, author = {Silveira, LC and Santos, KF and Campos, JS and Assunção, LP and Santos, RS and Reis, AAS}, title = {Association of genetic variants with the progression of COVID-19 symptoms in diabetic patients: a systematic review and in silico protein interaction analysis.}, journal = {Brazilian journal of biology = Revista brasleira de biologia}, volume = {85}, number = {}, pages = {e297127}, doi = {10.1590/1519-6984.297127}, pmid = {41417766}, issn = {1678-4375}, mesh = {Humans ; *COVID-19/genetics ; *Diabetes Mellitus/genetics ; *Genetic Variation/genetics ; Angiotensin-Converting Enzyme 2/genetics ; SARS-CoV-2 ; Genetic Predisposition to Disease ; Disease Progression ; Risk Factors ; Computer Simulation ; }, abstract = {Diabetes mellitus is a global public health issue and, at the onset of the COVID-19 pandemic, was identified as a risk factor associated with high morbidity and mortality in cases of acute respiratory infection caused by the SARS-CoV-2 coronavirus. This study investigated genetic variants in diabetic patients with COVID-19 through a systematic analysis of the PubMed/NCBI, EMBASE, Web of Science, SCOPUS, and Virtual Health Library databases, with the protocol registered on the PROSPERO platform (registration number CRD42020181311). Fifteen genetic variants were associated with five specific genes in symptomatic diabetic patients with COVID-19. Inheritance models, diabetic individuals carrying the heterozygous genotype TC (VDR rs4516035) showed ~10-15-fold higher odds of symptomatic COVID-19. Protein-protein interaction (PPI) analysis showed that the proteins ACE, ACE2, IL-6, and IL-17 exhibited strong predicted interactions with each other, as well as with insulin and the TMPRSS2 protease. Limitations include small number of eligible studies, heterogeneity in populations and outcome definitions. These preliminary findings highlight the need for further studies to understand better the relationship between the identified genetic variants and the progression of COVID-19 in diabetic patients.}, }
@article {pmid41418272, year = {2025}, author = {Carmona Pestaña, A and Herrera-Peco, I and Jiménez-Gómez, B and Suárez-Llevat, C}, title = {Internet Memes as Drivers of Health Narratives and Infodemics: Integrative Review.}, journal = {JMIR infodemiology}, volume = {5}, number = {}, pages = {e77029}, pmid = {41418272}, issn = {2564-1891}, mesh = {Humans ; *COVID-19/epidemiology ; *Social Media ; *Narration ; *Health Communication/methods ; *Internet ; SARS-CoV-2 ; Pandemics ; Communication ; }, abstract = {BACKGROUND: Digital media memes have emerged as influential tools in health communication, particularly during the COVID-19 pandemic. While they offer opportunities for emotional engagement and community resilience, they also act as vectors for health misinformation, contributing to the global infodemic. Despite growing interest in their communicative power, the role of memes in shaping public perception and misinformation diffusion remains underexplored in infodemiology.
OBJECTIVE: This integrative review aims to analyze how memes influence emotional, behavioral, and ideological responses to health crises, and to examine their dual role as both contributors to and potential mitigators of infodemics. The paper also explores strategies for integrating memes into public health campaigns and infodemic management.
METHODS: A comprehensive literature search was conducted across 3 major databases (MEDLINE, Scopus, and Web of Science), identifying a total of 386 records. Following duplicate removal and eligibility screening, 14 peer-reviewed studies published between 2020 and 2025 were included. An integrative narrative approach was used to synthesize evidence on social media behavior, misinformation dynamics, and digital health campaigns. The analysis was grounded in infodemiological and infoveillance frameworks as established by Eysenbach, incorporating insights from psychology, media studies, and public health.
RESULTS: Memes function as emotionally salient and visually potent carriers of health-related narratives. While they can simplify complex messages and foster adaptive humor during crises, they are also susceptible to distortion, particularly in echo chambers and conspiracy communities. Findings reveal that misinformation-laden memes often leverage humor and disgust to bypass critical thinking, and their viral potential is linked to emotional intensity. However, memes have also been successfully integrated into prebunking strategies, increasing engagement and reducing susceptibility to false claims when culturally tailored. The review identifies key mechanisms that enhance or hinder the infodemiological value of memes, including political orientation, digital literacy, and narrative framing.
CONCLUSIONS: Memes are a double-edged sword in the context of infodemics. Their integration into infodemic surveillance and digital health campaigns requires a nuanced understanding of their emotional, cultural, and epistemic effects. Public health institutions should incorporate meme analysis into real-time infoveillance systems, apply evidence-based meme formats in prebunking efforts, and foster digital literacy that enables critical meme consumption. Future infodemiology research should further explore the long-term behavioral impacts of memetic misinformation and the scalability of meme-based interventions.}, }
@article {pmid41418501, year = {2026}, author = {Krahé, B}, title = {Situational risk factors for intimate partner violence.}, journal = {Current opinion in psychology}, volume = {68}, number = {}, pages = {102228}, doi = {10.1016/j.copsyc.2025.102228}, pmid = {41418501}, issn = {2352-2518}, mesh = {Humans ; *Intimate Partner Violence/psychology/prevention & control ; Risk Factors ; *COVID-19/psychology ; *Aggression/psychology ; Firearms ; Jealousy ; Stress, Psychological/psychology ; Alcohol Drinking/psychology ; }, abstract = {Intimate partner violence (IPV) is a worldwide problem with a wide range of negative effects, and a broad literature has identified risk factors at the societal, relationship, interpersonal, and individual level associated with relatively stable differences in the likelihood of IPV. In addition, risk factors for IPV may be located within a given situation, promoting the use of violence by one or both partners. Based on two influential theories of aggression, the General Aggression Model and I[3] theory, this article presents evidence on five situational risk factors for IPV: alcohol use, provocation and jealousy, acute stress, the Covid-19 pandemic, and the presence of firearms, and outlines implications for prevention.}, }
@article {pmid41418929, year = {2026}, author = {Liao, ZX and Tseng, SJ}, title = {Evaluating the potential of mRNA technology for cytokine production and delivery in antitumor therapy.}, journal = {Drug discovery today}, volume = {31}, number = {1}, pages = {104590}, doi = {10.1016/j.drudis.2025.104590}, pmid = {41418929}, issn = {1878-5832}, mesh = {Humans ; *Neoplasms/immunology/therapy/drug therapy ; *Cytokines/genetics/administration & dosage/immunology ; Tumor Microenvironment/immunology ; *RNA, Messenger/administration & dosage/genetics ; Animals ; Drug Delivery Systems ; *Antineoplastic Agents/administration & dosage ; COVID-19 ; }, abstract = {Tumors evolve in tandem with their tumor microenvironment (TME), often creating an immunosuppressive state that hinders anticancer responses. Whereas antitumor immunostimulating cytokines can reverse this suppression and trigger effective immunity, their systemic administration causes severe toxicity, limiting their clinical use. mRNA technology, recognized as a medical breakthrough highlighted by COVID-19 vaccines, offers a promising approach. This review posits that local delivery of mRNA-encoded antitumor cytokines to the TME enables targeted, in situ production, maximizing antitumor effects while minimizing systemic toxicity.}, }
@article {pmid41421320, year = {2026}, author = {Soares, L and Davis, H and Spier, E and Walker, T and Davenport, T and Putrino, D and Peluso, M and Vogel, JM}, title = {Recommended long COVID outcome measures and their implications for clinical trial design, with a focus on post-exertional malaise.}, journal = {EBioMedicine}, volume = {123}, number = {}, pages = {106083}, pmid = {41421320}, issn = {2352-3964}, mesh = {Humans ; *COVID-19/complications/therapy ; *Clinical Trials as Topic ; SARS-CoV-2 ; *Research Design ; COVID-19 Drug Treatment ; Treatment Outcome ; Outcome Assessment, Health Care ; }, abstract = {Long COVID has created a worldwide public health crisis and has no approved treatments or validated biomarkers. We summarize the current challenges and considerations of outcome selection in Long COVID trials, along with recommendations for current trial design and future endpoint validation, with a focus on post-exertional malaise (PEM). We make five overarching recommendations for Long COVID clinical trials: 1) thorough characterisation of baseline disease; 2) collection of longitudinal data; 3) design of a placebo arm to enable comparison of treatment effect relative to the disease natural history; 4) accounting for, and when feasible, measuring PEM; 5) balancing severity, duration, and relevant phenotypes across trial arms and within subgroups to be analysed. We present a list of outcomes that may be considered for Long COVID clinical trials, with a focus on PEM. Crucially, the field of Long COVID clinical trials urgently needs funding and research effort investment to develop and validate outcomes concomitantly with clinical trial research.}, }
@article {pmid41421733, year = {2026}, author = {Duggan, MR and Chatila, ZK and Auber, LA and Silberberg, E and Fernandez, JR and Walker, KA and Schultek, NM}, title = {Can the COVID-19 pandemic advance neuroinfectious research?.}, journal = {Brain, behavior, and immunity}, volume = {132}, number = {}, pages = {106233}, doi = {10.1016/j.bbi.2025.106233}, pmid = {41421733}, issn = {1090-2139}, mesh = {Humans ; *COVID-19/complications ; SARS-CoV-2 ; *Biomedical Research/trends/economics ; Pandemics ; *Neurodegenerative Diseases/immunology ; }, abstract = {Investments in SARS-CoV-2 research provide a unique opportunity to explore how microbes may contribute to neurological conditions, an area of investigation that has been chronically underfunded. As exemplified by HIV/AIDS funding, crisis-driven research can yield broader biomedical advances, including spillover effects that address unanticipated and unmet medical needs. Leveraging newly established SARS-CoV-2 funding opportunities to study immune crosstalk and genetic predispositions could reveal therapeutic pathways and biomarkers for individuals who are vulnerable to infection-related dementia risk and neuropsychiatric symptoms. Despite the vast consequences of SARS-CoV-2, research investments following this pandemic may have long lasting benefits for other scientific endeavors, including insights for microbial contributions to neurodegenerative disease.}, }
@article {pmid41422110, year = {2025}, author = {Baichoo, S and Oladeji, O and Villareal, L and Diakabana, H and Okekunle, AP and Marivate, V and Kaggwa, F and Nsoesie, EO}, title = {Scoping review of artificial intelligence via mobile technology and social media for health in Africa.}, journal = {Nature communications}, volume = {16}, number = {1}, pages = {11288}, pmid = {41422110}, issn = {2041-1723}, support = {/WT_/Wellcome Trust/United Kingdom ; }, mesh = {Humans ; Africa/epidemiology ; *Social Media ; *Artificial Intelligence ; *Cell Phone ; COVID-19/epidemiology ; Machine Learning ; Malaria/epidemiology ; SARS-CoV-2 ; }, abstract = {The combination of mobile technologies and social media with Artificial Intelligence (AI) opens new opportunities for multi-modal data generation, analysis, and inference for various health applications. To investigate how these tools are being used for health applications in Africa, we conduct a scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach. We screen 469 articles and synthesize 116. We include 29 studies documenting the use of a broad range of advanced and straightforward machine-learning techniques to study infectious and chronic diseases such as COVID-19 (4 studies, 13.8%), malaria (5, 17.2%), and cervical cancer (2, 6.9%). Countries with high internet and mobile phone penetration have higher representation. Based on identified gaps, we make research and policy recommendations to enhance the contribution of these tools in advancing health in Africa. These include investing in studies on chronic diseases and implementing frameworks to address geographic inequity.}, }
@article {pmid41422184, year = {2026}, author = {Pilia, E and Belletti, A and Finco, G and Landoni, G}, title = {Full-dose heparin anticoagulation as prevention for COVID-19 disease progression in non-critically ill patients: An up-to-date brief meta-analysis.}, journal = {Journal of thrombosis and thrombolysis}, volume = {59}, number = {4}, pages = {1031-1035}, pmid = {41422184}, issn = {1573-742X}, mesh = {Humans ; *Heparin/administration & dosage/adverse effects ; *Anticoagulants/administration & dosage/adverse effects ; *COVID-19/blood/diagnosis ; Disease Progression ; Respiration, Artificial ; *COVID-19 Drug Treatment ; Randomized Controlled Trials as Topic ; SARS-CoV-2 ; }, abstract = {This systematic review and meta-analysis aims to investigate the effect of heparin full-dose anticoagulation on preventing COVID-19 disease progression in non-critically ill COVID-19 adult patients in accordance with the Cochrane methodology and the Preferred Reporting for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched PubMed/Medline, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL) and Clinicaltrials.gov (from inception to September 2025). Multicenter randomized controlled trials (mRCTs) comparing full-dose heparin anticoagulation with no full-dose anticoagulation (including prophylactic or intermediate-dose anticoagulation with heparin). The primary outcome was the need for invasive mechanical ventilation. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with the number CRD42022348993. We included 6 mRCTs in the analysis, randomizing a total of 5777 COVID-19 patients. The rate of need for invasive mechanical ventilation was lower in patients treated with full-dose heparin at 7.9% (226/2842) compared with 9.5% (279/2935) in those receiving prophylactic or intermediate-dose ([RR] = 0.81; 95% [CI] = 0.68–0.96; P = 0.01). The absolute risk (AR) of requiring invasive mechanical ventilation was 77 per 1.000 in patients treated with full-dose heparin, compared with 95 per 1.000 in patients treated with prophylactic or intermediate-dose heparin. According to our updated data analysis of high-quality mRCTs, full-dose anticoagulation with heparin can be considered an important strategy to prevent disease progression and the need for invasive organ support in hospitalized non-critically ill COVID-19 patients.}, }
@article {pmid41422470, year = {2026}, author = {Taha, MK and Weil-Olivier, C and Leng, S and Dinleyici, EC and Yezli, S}, title = {Meningococcal Disease in Older Adults: Challenges in Diagnosis and Management.}, journal = {Infectious diseases and therapy}, volume = {15}, number = {2}, pages = {443-459}, pmid = {41422470}, issn = {2193-8229}, abstract = {Invasive meningococcal disease (IMD) in older adults frequently presents with atypical clinical manifestations, including bacteremic pneumonia, often without classical meningeal signs or sepsis, which presents clinicians with diagnostic challenges, and may delay treatment, which contributes to the high mortality observed in older adults. Within the broader resurgence of IMD observed since relaxation of quarantine measures introduced to mitigate the impact of the COVID-19 pandemic, there has been a notable increase in reporting of such atypical cases. The aim of this review is to summarize epidemiological, diagnostic, and treatment aspects of non-meningeal forms of IMD in older patients, with a focus on meningococcal pneumonia. By convention, laboratory confirmation requires N. meningitidis detection by culture, polymerase chain reaction (PCR), or antigen detection. In most cases, presentation of meningococcal pneumonia is similar to that of other forms of community-acquired pneumonia, and cerebrospinal fluid sampling may be non-informative. This places a premium on early blood culture for N. meningitidis, allied with testing of respiratory samples (e.g., broncho-alveolar washes). Many cases are linked to isolates of serogroups Y and W. When confirmed, treatment with third-generation cephalosporins is generally preferred. Chemoprophylaxis and vaccination of close contacts is essential for controlling onward meningococcal disease transmission and prevention of further cases.}, }
@article {pmid41423526, year = {2025}, author = {Veronese, N and Barratt, J and Coemans, E and Dayananda, P and Del Riccio, M and Fulop, T and Gabutti, G and Gravenstein, S and Hiligsmann, M and Hummers, E and Kassianos, G and Macchia, F and Manzoni, P and Martin, FC and Michel, JP and Morandi, A and Ory, J and Pattyn, J and Peetermans, E and Polidori, MC and Riccò, M and Sieber, CC and Torres, A and van Essen, GA and Maggi, S}, title = {Infectious diseases, infection control, vaccines and long-term care: an European interdisciplinary Council on ageing consensus document.}, journal = {Aging clinical and experimental research}, volume = {38}, number = {1}, pages = {10}, pmid = {41423526}, issn = {1720-8319}, mesh = {Humans ; *Long-Term Care ; *COVID-19/prevention & control/epidemiology ; *Infection Control/methods ; Aged ; Europe ; Vaccination ; *Aging ; SARS-CoV-2 ; }, abstract = {The accelerating ageing of populations worldwide presents profound challenges for public health, particularly within long-term care facilities (LTCFs). Older adults, often burdened by multimorbidity, frailty, and immunosenescence, are highly vulnerable to vaccine-preventable diseases such as influenza, pneumococcal pneumonia, COVID-19, respiratory syncytial virus (RSV), pertussis, and herpes zoster (HZ). Despite the availability of effective vaccines, immunization coverage in LTCFs remains inadequate, hindered by fragmented national policies, insufficient mandates, and systemic neglect of adult vaccination. In many settings, vaccination uptake is not even systematically monitored, leaving policymakers and clinicians without reliable data to identify gaps or measure progress. The COVID-19 pandemic underscored these vulnerabilities, temporarily spurring emergency vaccination efforts but failing to establish sustainable, life-course immunization frameworks. This consensus document, developed by the European Interdisciplinary Council on Ageing (EICA) following the San Servolo (Venice, Italy) 2025 meeting, synthesizes evidence on intrinsic and environmental infection risk factors in LTCFs, the health and economic burden of infections, and the persistent gaps in vaccine uptake among both residents and staff. We highlight the cost-effectiveness of preventive interventions, the critical role of non-pharmacological infection control measures, and the need to address antimicrobial resistance through integrated vaccination strategies. The Council emphasizes that routine adult vaccination must become a structural element of care planning for ageing populations, supported by digital registries, systematic assessments at LTC admission, co-administration strategies, and robust staff engagement. Stronger global and national policy leadership is urgently needed to align LTCF immunization with life-course approaches and primary healthcare integration. Protecting frail older adults from infectious diseases is not only a clinical necessity but also a societal obligation-central to safeguarding dignity, resilience, and healthy ageing in Europe and beyond.}, }
@article {pmid41423992, year = {2026}, author = {Failla, KR and Pelletier, LR and Poeltler, DM}, title = {Newly Licensed Nurse Retention: What a 5-Year Review of Data Tells Us.}, journal = {Nursing administration quarterly}, volume = {50}, number = {1}, pages = {3-8}, pmid = {41423992}, issn = {1550-5103}, mesh = {Humans ; *COVID-19/nursing/epidemiology ; *Personnel Turnover/statistics & numerical data ; *Nurses/supply & distribution ; Job Satisfaction ; United States ; }, abstract = {Although many articles address retention, few define the concept. There is a need for all health care organizations to adopt a standard definition in order to make accurate comparisons. This organization provides a definition of retention, measures pre-COVID and post-COVID retention, and uses psychometrically tested tools to measure the effectiveness of an accredited Nurse Residency Program. Characteristics of nurses who stay and nurses who leave are provided. Evidence-based retention strategies and opportunities for improvement are discussed, as all health care organizations and nurse leaders desire to have a return on their investment of enculturating newly licensed nurses.}, }
@article {pmid41424056, year = {2026}, author = {Vereijken, FR and Frielink, N and Jahoda, A and Embregts, PJCM}, title = {Continued Involvement: A Scoping Review on Family Members' Needs and Experiences Collaborating With Support Staff for Relatives With Intellectual Disabilities Living Outside the Family Home.}, journal = {Journal of intellectual disability research : JIDR}, volume = {70}, number = {6}, pages = {561-578}, pmid = {41424056}, issn = {1365-2788}, support = {329561//Ministerie van Volksgezondheid, Welzijn en Sport/ ; }, mesh = {Humans ; *Intellectual Disability/nursing ; *Family/psychology ; *COVID-19 ; *Caregivers/psychology ; *Professional-Family Relations ; }, abstract = {BACKGROUND: Family members' involvement in the care for their relative often continues after their relative has moved out of the family home. However, little is known about the needs of family members when collaborating specifically with support staff caring for their relative. This scoping review provides an overview of existing literature to inform future research.
METHOD: The review was conducted in accordance with the PRISMA for Scoping Review statement. Seven databases were systematically searched in April 2022 (with a final update in May 2025). Studies that were published in English in peer-reviewed journals and examined the needs and experiences of family members collaborating with support staff in residential care settings were considered for inclusion. The Mixed Methods Appraisal Tool was used to assess risk of bias and a thematic synthesis was conducted to analyse the data.
RESULTS: Ten articles met the inclusion criteria. Four studies focused on family members' experiences following a relative's transition from institutional or hospital settings, one study on sibling-staff collaboration, one on the roles of adult siblings, one exploring family experiences during the COVID-19 pandemic, one on parental perceptions of communication, one on family experiences postabuse inquiry and one focused on collaboration within hospital settings. The studies involved relatives with severe (n = 1), mild, severe and profound (n = 1), severe to profound (n = 1) or profound intellectual disabilities (n = 3). Four did not mention the level of intellectual disability. The synthesis yielded four analytical themes: (1) complexities in building personal relationships amidst changing contexts (n = 8), (2) navigating how to address unmet needs and the vulnerability it exposes (n = 3), (3) a desire for partnership and recognition (n = 10) and (4) a desire for staff to uphold their relative's quality of life (n = 10).
DISCUSSION: This review highlights key areas for future research, including how family characteristics, disability severity and living arrangement can influence needs and experiences when collaborating with support staff. Additionally, further insight is needed on what impacts the dynamic nature of family-staff relationships. Lastly, understanding the views and experiences of support staff regarding family involvement is important, as it can aid the development of collaboration that is sensitive to their specific needs.}, }
@article {pmid41424145, year = {2026}, author = {Tang, P and Xiao, R and Xiao, W and Wen, T and Li, Y and Lu, B and Yang, X}, title = {The impact of the COVID-19 pandemic on osteoporotic fractures: a systematic review and meta-analysis.}, journal = {Annals of medicine}, volume = {58}, number = {1}, pages = {2604391}, pmid = {41424145}, issn = {1365-2060}, mesh = {Humans ; *COVID-19/epidemiology ; *Osteoporotic Fractures/epidemiology ; Incidence ; SARS-CoV-2 ; Male ; Female ; Pandemics ; Spinal Fractures/epidemiology ; Hip Fractures/epidemiology ; }, abstract = {BACKGROUND: Recent reports suggest that the COVID-19 pandemic and associated lockdowns may have influenced the epidemiology of osteoporotic fractures, but results vary across regions and fracture types. The aim of this study was to provide evidence-based insights into the impact of the pandemic on osteoporotic fracture incidence.
METHODS: We searched four databases (PubMed, Embase, Cochrane Library, and Web of Science) up to August 2025 for observational or retrospective studies comparing osteoporotic fracture incidence during the COVID-19 pandemic (2020) with the pre-pandemic period (2019). The primary outcome of interest was the change in fracture incidence, analysed using risk ratios (RR) with 95% confidence intervals (CI) in Review Manager 5.4. Subgroup analyses were performed by sex, geographic region, and fracture type.
RESULTS: Nine studies meeting the inclusion criteria were analysed. Overall, "all types" of osteoporotic fractures showed a significant decrease during the pandemic (RR = 0.85, 95% CI 0.80-0.91, p < 0.0001). Specifically, forearm fractures decreased significantly (RR = 0.87, 95% CI 0.79-0.96, p = 0.002). However, for the most clinically significant fractures, no statistically significant global change was found for hip fractures (RR = 0.93, 95% CI 0.76-1.15, p = 0.14) or vertebral fractures (RR = 1.35, 95% CI 0.85-2.15, p = 0.20). In regional subgroup analysis, hip fracture incidence decreased significantly in South America (RR = 0.79, p = 0.0004) and in both males and females, but no significant change was observed in Europe (RR = 0.92, 95% CI 0.81-1.04, p = 0.17).
CONCLUSION: During the COVID-19 pandemic, there was a decrease in the incidence of minor fractures, such as those of the forearm, likely due to reduced outdoor activity. However, the incidence of major osteoporotic fractures (hip and vertebral) remained stable globally, with significant reductions observed only in specific regions like South America.}, }
@article {pmid41424476, year = {2024}, author = {Dhir, S and Karim, N and Berka, H and Shatkin, J}, title = {Pharmacological management of pediatric insomnia.}, journal = {Frontiers in sleep}, volume = {3}, number = {}, pages = {1389052}, pmid = {41424476}, issn = {2813-2890}, abstract = {Insomnia is the most commonly reported sleep disorder among children and adolescents, impacting their cognitive, emotional, behavioral, and physical development. The prevalence of insomnia generally increases with age, often persisting into adulthood if unaddressed. Insomnia is exceedingly common among those with developmental disabilities and is frequently comorbid with a great range of psychiatric diagnoses. The COVID-19 pandemic has only increased the prevalence of insomnia among children and adolescents. Health care providers are routinely called upon to treat insomnia in the pediatric population. Psychoeducation and behavioral interventions, especially cognitive behavioral therapy for insomnia (CBT-I), remain the first line treatments, given empirical evidence for their efficacy and success in relapse prevention. However, medications are frequently employed in clinical practice, despite the fact that no medications are approved by the Food and Drug Administration (FDA) for the treatment of pediatric insomnia. This review was designed to educate and support practitioners who are treating children and adolescents who struggle with insomnia. A thorough narrative review was completed to identify all published medication studies of pediatric insomnia; the identified studies are described and then graded into four categories according to the strength of the evidence supporting their use, side effect profiles, co-morbidities, and overall risk vs. benefit of each pharmacological treatment. This review will help practitioners in making clinical decisions for their pediatric patients who suffer with insomnia.}, }
@article {pmid41424893, year = {2025}, author = {Bhat, HM and Nazir, R and Kashoo, ZA}, title = {Rising Threats of Viral Infections: Exploring Probiotics as Antiviral Agents.}, journal = {Indian journal of microbiology}, volume = {65}, number = {4}, pages = {1781-1798}, pmid = {41424893}, issn = {0046-8991}, abstract = {Viral infections are the most common etiological agents behind a wide range of human illnesses, with significant and widespread effects on human health. Vaccines have been developed to combat viral infectious diseases in various ways. However, the high rate of mutation in viruses, specifically RNA viruses, makes vaccines and medications for viral infectious diseases ineffective. Meanwhile, published research continues to offer insight into the efficacy of probiotics as antiviral agents. Various clinical findings reveal those specific probiotic strains aid in the prevention of viral and bacterial infections. Probiotics have been used to prevent and treat common viral infections such as rotavirus, coronavirus, hepatitis, human papillomavirus, human immunodeficiency virus, and herpes simplex viruses etc. The studies compiled in this review demonstrate the value of probiotics in the treatment and prevention of several viral infections using in vitro and in vivo trials in both experimental animals and humans and also provide perspectives on probiotics' probable antiviral mechanisms. Although the initial findings are promising, the current research is limited by small sample sizes, short study durations, and a lack of diversity in population groups. Consequently, further research with larger, more diverse cohorts and extended follow-up periods is necessary to thoroughly assess and confirm the effectiveness of this probiotic treatment against these severe infectious diseases.}, }
@article {pmid41424988, year = {2025}, author = {Pourshaban, M and Allahbakhshian, A and Purabdollah, M}, title = {Mapping the Contributing Factors to Missed Nursing Care in Hospital Settings During a Global Health Crisis: A Systematic Scoping Review.}, journal = {Journal of nursing management}, volume = {2025}, number = {}, pages = {7343469}, pmid = {41424988}, issn = {1365-2834}, mesh = {Humans ; *COVID-19/nursing/epidemiology ; Global Health ; *Nursing Care/standards/statistics & numerical data ; Pandemics ; }, abstract = {BACKGROUND: Little foreknowledge and preparation exist for health-related crises, and they do not match the magnitude of the problem. During the COVID-19 pandemic, nursing care in some countries faced more challenges. One of these challenges was missed nursing care. This scoping review aims to identify and map the factors influencing missed nursing care in hospital settings during the COVID-19 pandemic in studies conducted in developed and developing countries.
METHODS: A scoping review was conducted according to methodology recommended by the Joanna Briggs Institute (JBI). We searched five databases-PubMed, Scopus, CINAHL, ProQuest, and Web of Science-as well as the Google Scholar search engine, from December 2019 to July 2025. Keywords of the study were selected according to the Medical Subject Headings (MeSH) and previous research. We included studies in hospital wards that examined missed nursing care and related concepts, specifically those whose data collection periods occurred during the COVID-19 pandemic. Language restrictions were not applied. The factors were derived inductively, considering conceptual similarities, relevance to the core themes, and similarities in meaning, including aspects related to the missed nursing care model, the developed model derived from it related to the factors considered for missed nursing care, and emerging challenges introduced by COVID-19. Findings were reported following the PRISMA-ScR.
FINDINGS: From the 1966 studies, we included 57 articles in the final review. Among them, 50 were cross-sectional, four were qualitative, two were mixed, and one was quasiexperimental. They were conducted mainly in Iran and the hospital units. Four main themes and nine subthemes emerged (1) work environment (structure, work climate), (2) nurse characteristics (individual and professional, personal), (3) workflow characteristics (intensity, predictability, risk), (4) country (developed, developing). Although the lack of human resources was reported in most studies, it was not the most significant contributing factor.
CONCLUSION: These findings can inform the development of strategies to address underlying factors affecting workflow, such as nurses' attitudes and the work environment, thereby enhancing adaptability to future global health crises and serving as a crucial policy foundation for mitigating the missed nursing care during health emergencies.
PRACTICAL IMPLICATIONS: These findings not only complement other global research exploring the reasons behind missed cares in nursing but also offer a framework for understanding and anticipating reported instances of missed care, enabling targeted interventions to address them effectively.}, }
@article {pmid41425583, year = {2025}, author = {Chen, H and Gu, Y and Song, L and Si, L}, title = {Next-generation vaccines against bacterial pathogens: mRNA and beyond.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1709794}, pmid = {41425583}, issn = {1664-3224}, mesh = {Humans ; Animals ; *Bacterial Vaccines/immunology ; COVID-19/immunology/prevention & control ; Vaccine Development ; mRNA Vaccines/immunology ; SARS-CoV-2/immunology ; *Bacterial Infections/immunology/prevention & control ; RNA, Messenger/immunology ; Mycobacterium tuberculosis/immunology ; Nanoparticles ; Vaccines, Synthetic/immunology ; }, abstract = {The global rise of multidrug-resistant (MDR) bacterial infections has exacerbated the need for effective vaccines to prevent these hard-to-treat pathogens. Traditional vaccine approaches have achieved tremendous successes but often fall short for pathogens like Mycobacterium tuberculosis (TB), which evades host immunity through complex mechanisms, and for multidrug-resistant ESKAPE bacteria, where antibiotic resistance and antigenic variability complicate effective vaccine development. The COVID-19 pandemic spurred unprecedented advances in vaccine technology - particularly mRNA vaccines - reviving interest in novel platforms for bacterial diseases. Here we review next-generation vaccine strategies, focusing on nucleic acid-based platforms such as mRNA, DNA, and self-amplifying RNA (saRNA), as well as viral vector vaccines. We also examine nanoparticle technologies that serve as delivery systems or adjuvant platforms across these approaches. We discuss the unique opportunities of mRNA vaccines to induce both robust antibody and T-cell responses required for intracellular infections like TB, as well as the challenges of antigen discovery and delivery (e.g. lipid nanoparticles). Each platform's mechanism, immunogenic profile, current development status, and challenges are analyzed, including comparative insights. We highlight recent progress such as mRNA vaccine candidates against TB entering clinical trials and saRNA prototypes protecting against plague in animals. Finally, we provide a perspective on the future of vaccine strategies to combat antimicrobial resistance (AMR) - emphasizing the integration of multiple platforms, global collaborative efforts, regulatory pathways, and the translational hurdles that must be overcome to bring these next-generation vaccines from bench to bedside.}, }
@article {pmid41426668, year = {2025}, author = {Ding, M}, title = {A critical review of Chinese vaccine enterprises in the global aid market: evolution, drivers, and structural constraints.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1692140}, pmid = {41426668}, issn = {2296-2565}, mesh = {Humans ; China ; *COVID-19/prevention & control/epidemiology ; *COVID-19 Vaccines/economics/supply & distribution ; *Global Health ; *International Cooperation ; SARS-CoV-2 ; *Drug Industry/organization & administration ; Pandemics ; }, abstract = {The Chinese government has assumed an increasingly prominent role in global health governance in recent years, yet the engagement of Chinese enterprises remains underexplored. Existing studies have largely focused on Beijing's major initiatives during the COVID-19 pandemic, overlooking the evolving role of Chinese enterprises as non-state actors. This article provides a comprehensive review of the participation of Chinese vaccine companies in the global aid market, with particular attention to their changing roles, underlying motivations, and persistent challenges as latecomers from the Global South. Drawing on around 80 industry and policy documents, publicly available datasets, and 10 semi-structured interviews with industry and government stakeholders, this study uses documentary synthesis and thematic analysis to show that COVID-19 marked a critical turning point, accelerating Chinese vaccine manufacturers' international engagement while exposing persistent structural barriers. Unlike earlier studies, this review shows that Chinese vaccine enterprises' engagement in the global aid market is shaped not only by strategic market ambitions and alignment with national public health priorities, but also by enduring structural constraints such as geopolitical tensions, institutional mistrust, talent shortages, and reputational vulnerabilities. By situating Chinese enterprises within broader debates on non-state actors in global health, the study advances existing literature and offers policy-relevant insights to strengthen their capacity and influence in promoting equitable vaccine access.}, }
@article {pmid41426687, year = {2025}, author = {Al-Otaibi, FMS and Alotaibi, MT and Altamimi, N and Abu-Dawas, S and Yaqinuddin, A and Alkattan, K}, title = {Social isolation and anxiety disorders during COVID-19: a systematic review.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1688239}, pmid = {41426687}, issn = {2296-2565}, mesh = {Humans ; *Social Isolation/psychology ; *COVID-19/psychology/epidemiology ; *Anxiety Disorders/epidemiology/psychology ; Adult ; SARS-CoV-2 ; Pandemics ; Male ; Anxiety ; Female ; Loneliness/psychology ; }, abstract = {BACKGROUND: This systematic review examines the relationship between prolonged social isolation during the COVID-19 pandemic and anxiety levels in adults, with specific focus on social anxiety. It highlights that enforced distancing measures like lockdowns and reduced social contact significantly contributed to a global rise in psychological distress and anxiety disorders.
OBJECTIVE: To synthesize recent evidence on how social isolation influenced anxiety levels in the general adult population during the COVID-19 pandemic.
METHODOLOGY: This study followed a qualitative systematic review design. Relevant literature was identified through searches in databases including PubMed, MEDLINE, Web of Science, SCOPUS, and others, using combinations of MeSH terms and keywords. Data extraction and quality assessment followed the PRISMA guidelines and used the Downs and Black Checklist to evaluate methodological quality.
RESULTS: Seven studies were included, with a total of 3,014 participants. Findings revealed a consistent positive association between social isolation and anxiety. Perceived isolation was a stronger predictor of anxiety than objective isolation. Older adults showed higher vulnerability when isolated or lacking social support. Students and young adults also experienced elevated anxiety, especially when living alone or facing COVID-related stressors.
CONCLUSION: Social isolation during the pandemic significantly contributed to increased anxiety symptoms across global adult populations. Public health efforts should target loneliness and promote sustainable social connectedness to mitigate long-term psychological consequences.}, }
@article {pmid41427009, year = {2025}, author = {Zhu, Y and Yang, W and Li, N and Yang, J and Yang, J and Zheng, Y and Chen, W and Yang, Y and Liu, Y and Zhao, Y}, title = {Comparative Effectiveness of Non-Pharmacological Interventions for Postpartum Depression and Anxiety: A Network Meta-Analysis.}, journal = {Neuropsychiatric disease and treatment}, volume = {21}, number = {}, pages = {2817-2834}, pmid = {41427009}, issn = {1176-6328}, abstract = {BACKGROUND: Postpartum depression (PPD), a prevalent perinatal mood disorder characterized by persistent depressive and anxiety symptoms, significantly impacts maternal-infant health. The COVID-19 pandemic has further increased the global burden of PPD, emphasizing the need for effective and accessible interventions. Although non-pharmacological interventions are widely used, their comparative efficacy remains uncertain.
METHODS: We searched the Cochrane Library, Web of Science, EMBASE, PubMed, Scopus, CNKI, VIP Database, and Wanfang Database (inception to September 1, 2024) for randomized controlled trials (RCTs). Interventions included acupuncture (ACU), exercise (EXE), psychotherapy (PSY), exercise combined with psychotherapy (ECP), and music therapy (MT). Primary (depression) and secondary (anxiety) outcomes were pooled using mean differences (MD) with 95% credible intervals (CrI). Risk of bias was assessed via Cochrane RoB2. (PROSPERO: CRD42020166801).
RESULTS: Thirty-five RCTs were included (n=4047). Meta-analyses for depressive symptoms (5 interventions, n=4047) showed a statistically significant improvement in the non-pharmacological intervention group compared with the control group (standard care, no intervention, or placebo et al), particularly for the ECP (95% CrI -2.3 to -0.85), followed by ACU (95% CrI -1.8 to -0.44) and EXE (95% CrI -1.7 to -0.48). Similarly, for anxiety symptoms (5 interventions, n=863), the overall effect of the non-pharmacological interventions was superior to that of the control group, with ECP again being the most effective modality (95% CrI -2.3 to -0.18), followed by EXE (95% CrI -2.0 to -0.0021) and ACU (95% CrI -0.96 to -0.052).
CONCLUSION: This study demonstrates the promise of non-pharmacological interventions, particularly exercise, acupuncture, and ECP, for alleviating PPD symptoms, positioning ECP as a potential first-line intervention for mild to moderate cases.}, }
@article {pmid41427721, year = {2026}, author = {Sun, Y and Wong, L-YR and Chang, TL}, title = {ACE2-independent entry factors for SARS-CoV-2 infection and immune activation.}, journal = {mBio}, volume = {17}, number = {2}, pages = {e0189724}, pmid = {41427721}, issn = {2150-7511}, support = {R01 AI136948/AI/NIAID NIH HHS/United States ; R01AI136948//National Institute of Allergy and Infectious Diseases/ ; R21DE033170/DE/NIDCR NIH HHS/United States ; R00AI170966//National Institute of Allergy and Infectious Diseases/ ; R21 DE033170/DE/NIDCR NIH HHS/United States ; }, mesh = {Humans ; *Angiotensin-Converting Enzyme 2/metabolism/immunology ; *SARS-CoV-2/physiology/immunology ; *Virus Internalization ; *COVID-19/immunology/virology ; Spike Glycoprotein, Coronavirus/metabolism/immunology ; Receptors, Virus/metabolism ; }, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), remains a major public health threat, particularly in vulnerable populations. SARS-CoV-2 spike proteins interact with the human angiotensin-converting enzyme 2 (ACE2) receptor, together with accessory molecules that facilitate viral entry, through its spike receptor-binding domain (RBD). Although ACE2 is the primary receptor required for viral replication, its expression patterns do not fully correlate with viral distribution or tissue pathology. Moreover, SARS-CoV-2 has been shown to infect cells and tissues lacking detectable ACE2 expression. Viral entry via ACE2-independent pathways may also confer resistance to some monoclonal antibodies (Abs) targeting the spike RBD that block ACE2-mediated binding. These observations highlight the potential significance of ACE2-independent entry factors in SARS-CoV-2 infection, particularly in vaccinated individuals with Abs directed against ACE2-dependent viral entry. In this review, we discuss the emerging roles of ACE2-independent entry factors in SARS-CoV-2 infection and the immune responses. These factors include CD147, AXL, CD169/Siglec-1, CD209L, CD209, CLEC4G, ASGR1, LDLRAD3, TMEM30A, TMEM106B, transferrin receptor 1, GPR78, integrin α5β1, KREMEN1, LFA-1, and CD4. While ACE2 remains central to viral replication, ACE2-independent entry appears sufficient to elicit immune responses. Therefore, future investigations are warranted to elucidate the roles of ACE2-independent mechanisms in immune-mediated pathology and viral evolution, independent of immune pressure targeting ACE2-mediated entry in previously infected or vaccinated individuals.}, }
@article {pmid41428129, year = {2025}, author = {Zafar, S and Andlib, Z and Fareed, Z and Rehman, MA}, title = {Food Security and Environmental Pollution: Policy Directions in the Face of COVID19.}, journal = {Food and environmental virology}, volume = {18}, number = {1}, pages = {2}, pmid = {41428129}, issn = {1867-0342}, support = {22BJY145//Project name: Research on the blocking mechanism of the risk of large-scale return to poverty by "two types of households" in rural tourism areas. . National Social Science Foundation project/ ; }, mesh = {*COVID-19/epidemiology/economics ; Humans ; *Food Security ; *Environmental Pollution ; Climate Change ; SARS-CoV-2 ; Carbon Dioxide/analysis ; Pandemics ; *Food Supply ; }, abstract = {Even before the COVID-19 pandemic, many countries were experiencing rising levels of acute food insecurity due to many factors, for instance, natural disasters, extreme weather and climate events and socioeconomic conditions. Subsequently, COVID-19 led to substantial and pervasive increases in global food insecurity, impacting vulnerable households worldwide. Owing to these facts, the first empirical study intends to investigate the empirical relationship between COVID-19, environmental pollution, and food shortage. We employ rolling window multiple correlation analysis on worldwide daily data of COVID-19 cases, carbon emissions, and food shortage news index from 22nd January 2020 to 29th November 2021. The results reveal a significant correlation between bivariate and multivariate cases over time. In bivariate cases, we find asymmetric but insignificant correlations between COVID-19 vs. food security and food security vs. CO2 emissions, except for a significant interconnection between COVID-19 vs. CO2 emissions at different periods. In the trivariate case, CO2 emissions and COVID-19 significantly and positively correlated to the food shortage index. This study provides policymakers with critical insights into the global food scarcity crisis driven by COVID-19 and climate change.}, }
@article {pmid41428252, year = {2026}, author = {Yet, M and Teo, HS and Kwa, H and Yeo, J and Wang, SSY}, title = {Long COVID: a review of mechanisms and treatment modalities.}, journal = {Inflammopharmacology}, volume = {34}, number = {2}, pages = {1111-1121}, pmid = {41428252}, issn = {1568-5608}, mesh = {Humans ; *COVID-19/therapy/complications/immunology/physiopathology ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; COVID-19 Drug Treatment ; }, abstract = {Long COVID is defined by the World Health Organisation (WHO) as a condition arising within 3 months of an acute COVID infection with symptoms lasting for a minimum of 2 weeks. However, this syndrome is poorly understood and has been recorded to include many systemic manifestations, including neurological, respiratory, cardiovascular, gastrointestinal, dermatological, psychosocial, and metabolic systems. Constitutional symptoms also include fatigue, insomnia, body weight changes, poor attention span, hair loss, sexual dysfunction, myalgia, and joint pain, with fatigue being the most common. Given the various proposed mechanisms published in the literature, the postulated mechanisms and pathways are discussed in this paper to contribute to the understanding of defining this syndrome. In this review article, the authors first explored how endothelial damage from COVID infection can lead to a hypercoagulable state. In addition, the effects of an insufficient initial immune response can lead to viral persistence alongside a potentially prolonged hyperactive immune response that includes a cytokine storm and mast cell activation syndrome. Furthermore, the viral persistence can be exacerbated by antibody-dependent enhancement or complicated by molecular mimicry. Current pharmacological therapies are explored and evaluated to investigate their efficacy in addressing this complex and chronic presentation. This review article has been written after an extensive literature review to increase the understanding and awareness regarding Long COVID, as a sincere effort to direct further research for an effective diagnosis and management.}, }
@article {pmid41429194, year = {2026}, author = {Huang, Y and Ou, Z and Xue, X and Zhou, H and Xiao, K}, title = {Experimental and computational approaches to adaptive viral evolution: Linking molecular variation to phenotypic outcomes.}, journal = {Journal of microbiological methods}, volume = {241}, number = {}, pages = {107379}, doi = {10.1016/j.mimet.2025.107379}, pmid = {41429194}, issn = {1872-8359}, mesh = {*Evolution, Molecular ; Phenotype ; Genetic Variation ; *Viruses/genetics ; Reverse Genetics ; *Computational Biology/methods ; Genome, Viral ; Mutation ; Cell Surface Display Techniques ; }, abstract = {Viruses pose a persistent global health threat due to their high mutation rates and rapid evolutionary capacity, which drive zoonotic spillover, vaccine escape, and drug resistance. Even single amino acid substitutions might impact viral invasion, receptor binding, immune evasion, or transmissibility, as illustrated by recent influenza, SARS-CoV-2 and other emerging viruses' outbreaks. Understanding these processes requires linking molecular variation to phenotypic consequences. This review summarizes five experimental and computational technologies-pseudovirus systems, minigenome assays, display systems, deep mutational scanning (DMS), and in silico modeling-that together form an iterative framework for studying viral adaptation. A representative integration of DMS with reverse genetics has validated computationally predicted escape mutations and revealed trade-offs between binding and replication that conventional assays could not capture. We discuss each approach's strengths and limitations, highlighting how their coordinated use supports mechanism-based evaluation and data-driven design of vaccines and antiviral strategies.}, }
@article {pmid41430159, year = {2025}, author = {Xu, D and Zhang, M and Zhao, Y and Liang, W and Zhang, Y and Fang, L}, title = {Prevalence of autoantibody responses in COVID-19 patients: a systematic review and meta-analysis.}, journal = {BMC infectious diseases}, volume = {26}, number = {1}, pages = {153}, pmid = {41430159}, issn = {1471-2334}, mesh = {Humans ; *COVID-19/immunology/blood ; *Autoantibodies/blood/immunology ; SARS-CoV-2/immunology ; Prevalence ; Case-Control Studies ; }, abstract = {BACKGROUND: An infection with severe acute respiratory syndrome coronavirus (SARS-CoV-2) may significantly contribute to the pathogenesis of autoimmune rheumatic diseases; interactions between the virus and defence mechanisms may promote the development of autoimmune processes. Studies have reported elevated levels of autoimmune antibodies in patients with Coronavirus Disease-19 (COVID-19), however, the exact prevalence remains poorly undocumented. This study aims to evaluate the prevalence of autoantibodies in COVID-19 patients compared to unaffected individuals. METHODS: Electronic searches were conducted using the Cochrane Library, PubMed, Embase, Web of Science, Chinese Biological Medicine Database (CBM), China National Knowledge Infrastructure (CNKI), WANFANG, and Chinese Weipu (VIP). The case-control studies investigating the presence of autoantibodies in the serum of COVID-19 patients and control subjects published were included in this meta-analysis. The search covered November 2019, to December 2025. Studies were rigorously screened based on predefined inclusion and exclusion criteria. Quality assessment was performed using a modified version of the Newcastle-Ottawa scale (NOS). The odds ratios (ORs) for autoantibody seropositivity were calculated using RevMan 5.3. Sensitivity analysis was conducted to evaluate the stability results, and publication bias was assessed using Egger’s test and funnel plot. RESULTS: A total of 17 studies involving 1652 COVID-19 patients and 1455 control subjects met eligibility criteria for inclusion in the meta-analysis. The overall OR for antinuclear antibodies (ANAs) was 2.90 [95% confidence interval (CI): 1.36–6.18], for anti-cardiolipin antibodies (ACAs) was 3.34 (95% CI: 2.14–5.21), for anti-β2-glycoprotein 1 antibodies (anti-β2GP1) was 1.87 (95% CI: 1.00–3.49) and that for anti-cytoplasmic neutrophil antibodies (ANCAs) was 8.49 (95% CI: 3.38–21.33). Among the 11 studies assessing ANAs, the quality varied widely, resulting in considerable heterogeneity in the meta-analysis results. Heterogeneity across studies on ANAs may partially stem from differences in assay manufacturers as well as variations in the working cut-off dilution used for IIF. Egger’s test reports indicated statistically significant publication bias among the included studies on ANAs. CONCLUSIONS: This study suggests a higher seroprevalence of autoantibodies, including ANAs, ACAs, anti-β2GP1, and ANCAs in COVID-19 patients compared to control subjects. The findings identified a possible association between SARS-CoV-2 infection and autoantibody positivity, contributing to the understanding of COVID-19’s role in autoimmune processes. CLINICAL TRIAL NUMBER: Not applicable.}, }
@article {pmid41430309, year = {2025}, author = {Aladejana, OM and Ayorinde, DF}, title = {The intersection between human metapneumovirus and the respiratory microbiome.}, journal = {Virology journal}, volume = {23}, number = {1}, pages = {21}, pmid = {41430309}, issn = {1743-422X}, mesh = {Humans ; *Metapneumovirus/physiology ; *Paramyxoviridae Infections/virology/microbiology/epidemiology/immunology ; *Microbiota ; *Respiratory Tract Infections/virology/microbiology ; Lung/microbiology/virology ; COVID-19/virology/epidemiology ; China/epidemiology ; SARS-CoV-2 ; }, abstract = {Human metapneumovirus is one of the viral causes of respiratory illness that can range from mild to life-threatening diseases. In December 2024, there was news about increased cases of human metapneumovirus (HMPV) in China, when 6.2% and 5.4% of positive respiratory illnesses and admissions, respectively, were linked to HMPV, surpassing adenovirus, rhinovirus, and COVID-19. There have been concerns about it becoming another epidemic, and by implication, a pandemic, especially as the world is gradually recovering from COVID-19 and its devastating impacts. Currently, there is no directly acting antiviral drug targeting HMPV, and this has left a gap in its treatment and management, especially in the young, elderly, and immunocompromised, who are prone to having severe manifestations. As the immune system is crucial in fighting and eliminating the infection, modulating the immune system directly or indirectly can treat HMPV. The lung that was initially known to be sterile is now found to house different populations of microorganisms, including bacteriome, virome, and mycobiome. The lung microbiome modulates HMPV infection. The presence of pathobionts like H. influenzae enhances HMPV infection and severity. The detection of the microbiome was made possible by the advent of cutting-edge technologies like next-generation sequencing and bioinformatics tools. The combination of Recombinase Polymerase Assay, CRISPR-Cas12a, and Fluorescence Assay has been used in the rapid detection of HMPV in China. The microbiome plays a crucial role in shaping the immune system. Exploring such can be a way of managing HMPV. Probiotics, prebiotics, and postbiotics are ways in which the microbiota can be manipulated to limit adverse drug reactions. These can be explored in HMPV diagnosis, treatment, and prevention.}, }
@article {pmid41431011, year = {2025}, author = {Zhou, X and Li, MR and Sui, XH and Shan, NN}, title = {Multiple myeloma in a man with breast cancer: A case report and literature review.}, journal = {Medicine}, volume = {104}, number = {51}, pages = {e46540}, pmid = {41431011}, issn = {1536-5964}, mesh = {Humans ; Male ; *Multiple Myeloma/diagnosis/therapy/pathology ; Aged ; *Breast Neoplasms, Male/pathology/complications/therapy ; COVID-19 ; Fatal Outcome ; Bone Neoplasms/secondary/diagnosis ; Hematopoietic Stem Cell Transplantation ; Biopsy ; }, abstract = {RATIONALE: The development of multiple myeloma (MM) following male breast cancer is extremely rare and can often be mistaken for bone metastases in the early stages, potentially leading to delays in diagnosis and treatment.
PATIENT CONCERNS: In this case report, we describe a 68-year-old male patient who presented with multiple osteolytic lesions on imaging following breast cancer surgery, and was ultimately diagnosed with MM via bone marrow biopsy.
DIAGNOSES: MM.
INTERVENTIONS: After being diagnosed with MM, the patient was treated with various chemotherapy regimens, with the subsequent emergence of rare extramedullary disease necessitating an adjustment in therapy.
OUTCOMES: The patient successfully underwent autologous hematopoietic stem cell transplantation but later succumbed to a novel coronavirus infection.
LESSONS: This case highlights the diagnostic challenge of misattributing osteolytic lesions to breast cancer and underscores the importance of biopsy in patients with metastatic disease.}, }
@article {pmid41431513, year = {2025}, author = {Mohajer-Bastami, A and Moin, S and Ahmad, S and Ahmed, A and Agarwal, A and Pouwels, S and Hammoda, M and Yang, W and Exadaktylos, AK}, title = {Establishing a Preparedness Program: Lessons From COVID-19 to Strengthen Global Strategies for Future Pandemics.}, journal = {Cureus}, volume = {17}, number = {11}, pages = {e97402}, pmid = {41431513}, issn = {2168-8184}, abstract = {This study aimed to evaluate the global response to the COVID-19 pandemic, identify preparedness gaps, and propose strategies to strengthen resilience for future health crises, drawing on the natural history of SARS-CoV-2 and epidemiological models. The research team conducted a narrative review with a descriptive analysis supported by case examples and modeling. We synthesized published literature, official reports, and surveillance data, analyzing COVID-19 transmission using the epidemiological triangle model. Comparative case studies from South Korea, New Zealand, and the United Kingdom were examined to assess intervention effectiveness. National surveillance systems, outbreak response mechanisms, and public communication strategies were critically reviewed. Our findings show that disparities in testing, data transparency, and infrastructure shaped outcomes globally. Surprisingly, many high-income countries underperformed despite prior preparedness rankings. Countries implementing early lockdowns, equitable vaccine rollouts, and consistent public messaging achieved better control. However, asymptomatic transmission, weak surveillance integration, and delayed policy actions hindered containment. Vaccine inequity and fragmented data systems further limited coordinated response. Future preparedness must emphasize early interventions, sustained surveillance investment, transparent communication, and equitable access to care. Lessons from COVID-19 underscore the value of multidisciplinary response teams, international data sharing, and targeted testing strategies to mitigate the impact of future pandemics.}, }
@article {pmid41431799, year = {2025}, author = {Amlaev, KR and Dakhkilgova, HT and Zakirova, NR and Alimov, BA}, title = {[THE FACTORS AFFECTING MENTAL HEALTH OF MIGRANTS AND WAYS OF ITS AMELIORATION].}, journal = {Problemy sotsial'noi gigieny, zdravookhraneniia i istorii meditsiny}, volume = {33}, number = {6}, pages = {1420-1426}, doi = {10.32687/0869-866X-2025-33-6-1420-1426}, pmid = {41431799}, issn = {0869-866X}, mesh = {Humans ; *Transients and Migrants/psychology ; *Mental Health ; *COVID-19/psychology/epidemiology ; *Mental Disorders/epidemiology ; Russia/epidemiology ; }, abstract = {The article considers international experience of studying mental health of migrants. The actuality of this problem is conditioned by massive migration flow that occurred because of large number of military conflicts and desire of people to ensure better life for themselves and their descendants. The article describes the most common mental disorders among migrants, factors affecting their mental health and barriers they encounter on their way to good mental state. The impact of coronavirus infection pandemic on mental health of migrants is considered. The review indicates measures targeted to improve mental status of displaced persons, including application of participatory approach and implementation of concept of positive mental health. To maintain adequate mental health of migrants, holistic and interdisciplinary approach is required that considers ethnic and cultural characteristics of community of displaced persons.}, }
@article {pmid41432258, year = {2026}, author = {Zacharjasz, A and Anbari, AB}, title = {Rural COVID-19 Vaccine Decision-Making: A Qualitative Meta-Synthesis.}, journal = {Journal of advanced nursing}, volume = {82}, number = {7}, pages = {7183-7199}, doi = {10.1111/jan.70451}, pmid = {41432258}, issn = {1365-2648}, mesh = {Humans ; *COVID-19 Vaccines/administration & dosage ; *Decision Making ; *COVID-19/prevention & control ; *Rural Population/statistics & numerical data ; Qualitative Research ; United States ; Adult ; Female ; Male ; *Vaccination/psychology ; }, abstract = {AIMS: This qualitative meta-synthesis (QMS) aimed to develop a theoretical framework to contextualise the COVID-19 vaccine decision-making processes among rural U.S. individuals, describing complex cognitive, social, and structural influences.
DESIGN: Qualitative meta-synthesis utilising thematic synthesis and diagramming methods.
DATA SOURCES: Searches conducted across PubMed, Scopus, CINAHL, and grey literature databases between January 2020 and September 2024 identified relevant qualitative and mixed-methods studies.
REVIEW METHODS: Studies were screened against inclusion criteria: qualitative or mixed-methods design, U.S. rural adult populations, COVID-19 vaccine focus, and publication after January 2020. Twenty-one studies were selected, data extracted, coded, and analysed thematically to create a conceptual model. Quality appraisal was performed using the Critical Appraisal Skills Programme checklist.
RESULTS: Analysis yielded seven interrelated themes-Information, Beliefs, Trust, Feelings, Institutional, Community, and Culture-with 24 subthemes, highlighting dynamic interactions influencing vaccine decisions. Central factors included communication quality, media influence, institutional trust, social relationships, and cultural values. Decisions were temporal, iterative, and sensitive to evolving information and trust dynamics. Rural-specific barriers such as limited health literacy, systemic inequities, geographic isolation, and misinformation significantly shaped vaccine decisions.
CONCLUSION: This qualitative meta-synthesis provides a nuanced, rural-contextualised theoretical framework emphasising the interplay between information, trust, and social determinants in COVID-19 vaccine decision-making. Vaccine decisions among rural populations are embedded in complex sociocultural and structural contexts, evolving temporally with shifting trust and information landscapes.
IMPACT: The developed framework offers actionable insights to inform tailored public health interventions and policy strategies targeting vaccine hesitancy. Enhancing health literacy, leveraging trusted local communicators, ensuring transparency, and addressing structural inequities can effectively improve vaccine uptake and promote equitable health outcomes in rural communities.
The synthesis incorporates perspectives directly from rural community members, reflecting their lived experiences and contextual realities in vaccine decision-making processes.}, }
@article {pmid41432471, year = {2025}, author = {Azahar, SN and Yong, CK and Fahami, NAM and Ibrahim, IA}, title = {Pathogenesis of alcoholic fatty liver disease: Molecular and cellular changes.}, journal = {The Malaysian journal of pathology}, volume = {47}, number = {3}, pages = {377-400}, pmid = {41432471}, issn = {0126-8635}, mesh = {Humans ; *Fatty Liver, Alcoholic/pathology/metabolism/etiology ; Lipid Metabolism ; Liver/pathology/metabolism ; Oxidative Stress ; Animals ; }, abstract = {Alcohol-related liver disease (ALD) is a significant public health issue, leading to liver injuries, including fatty liver, hepatitis, and cirrhosis. The COVID-19 pandemic has exacerbated the problem by increasing alcohol abuse and hospitalisations for ALD. Since there are no approved therapies for ALD, promoting abstinence from alcohol is the primary approach. However, the mechanisms by which alcohol induces fat accumulation in the liver, the disease's initial stage, are not fully understood. This knowledge gap hampers the development of new treatments for ALD. This review aims to explore research on alcohol-induced fatty liver and compare it with metabolic-associated fatty liver disease. The goal is to merge these findings with current knowledge of ALD and hepatic lipid metabolism, including fatty acid oxidation, lipogenesis, and very-low-density lipoprotein (VLDL) secretion. Besides lipid metabolism, factors like inflammation, oxidative stress, cellular hypoxia, and autophagy also contribute to ALD's development and progression. By identifying gaps in understanding the molecular mechanisms of ALD progression, this review suggests future research directions. It emphasises how alcohol disrupts hepatic lipid metabolism, highlighting mechanisms leading to alcohol-associated fatty liver disease and other harmful effects of alcohol abuse.}, }
@article {pmid41432716, year = {2026}, author = {Yang, EJ and Jin, L and Jiang, HH and Lee, BG and Han, EH and Yun, CH and Na, DH}, title = {An Immunomodulatory Mushroom, Cordyceps militaris, and Its Constituents: A Review of In Vitro/In Vivo Studies and Clinical Trials.}, journal = {Phytotherapy research : PTR}, volume = {40}, number = {2}, pages = {635-665}, doi = {10.1002/ptr.70144}, pmid = {41432716}, issn = {1099-1573}, mesh = {*Cordyceps/chemistry ; Humans ; Animals ; *Immunomodulating Agents/pharmacology ; Clinical Trials as Topic ; *Immunologic Factors/pharmacology ; Polysaccharides/pharmacology ; Deoxyadenosines/pharmacology ; }, abstract = {Cordyceps, known as "winter-worm summer-grass", has been used as a medicinal mushroom to boost energy levels and immune activity. Among cordyceps types, Cordyceps militaris (CM) is the most commercially useful owing to its ease of artificial cultivation for mass production. In contrast, other types, such as Ophiocordyceps sinensis, are expensive and difficult to collect. Therefore, numerous studies have explored the therapeutic potential and active constituents of CM. The therapeutic use of CM is based on its various pharmacological activities, including immunomodulatory, anti-tumor, antioxidant, anti-diabetic, anti-obesity, and neuroprotective activities, of which the immunomodulatory effects have been the most studied. CM contains active constituents such as nucleosides (cordycepin and adenosine), polysaccharides, peptides, proteins, sterols, glycolipids, and carotenoids. Recent studies show that CM extract, cordycepin, and polysaccharides exert immunomodulatory effects in response to the immune environments. They enhance innate and cell-mediated adaptive immunity not only under normal conditions but also in immunosuppressed states induced by cyclophosphamide, interleukin-4, tumor culture supernatant, methotrexate, cancer cell-line-xenografts, influenza virus, and severe acute respiratory syndrome coronavirus 2. Meanwhile, they suppress an overactivated immune system stimulated by factors such as angiotensin II ± vascular endothelial growth factors, concanavalin A, 2,4-dinitrophenyl (DNP)-serum albumin ± DNP-specific immunoglobulin E, lipopolysaccharide (LPS), lipoteichoic acid, phytohemagglutinin, phorbol myristate acetate plus calcium ionophore A23187, calcium chloride, cecal ligation and puncture ± LPS, dextran sodium sulfate, monosodium iodoacetate, ovalbumin, myelin oligodendrocyte glycoprotein 25-35, monosodium urate, and Western diet by ameliorating innate and humoral adaptive immune responses. This study reviewed recent and notable literature evaluating the immunomodulatory potentials of CM extract, cordycepin, and polysaccharides. In vitro, in vivo, and clinical trial results indicate that CM is safe for administration and shows promise for developing functional foods having various efficacies such as immunomodulation, anti-tumor, and neuroprotection.}, }
@article {pmid41433133, year = {2026}, author = {Gunawardena, SA and Chandraratne, A and Jayasekara, TI}, title = {Integrating One Health in human medical curricula: A scoping review of pedagogical strategies and challenges.}, journal = {Medical teacher}, volume = {48}, number = {6}, pages = {1069-1090}, doi = {10.1080/0142159X.2025.2604244}, pmid = {41433133}, issn = {1466-187X}, mesh = {Humans ; *Curriculum ; *Education, Medical/organization & administration ; COVID-19/epidemiology ; *One Health ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Following the COVID-19 pandemic, there has been renewed global attention on One Health (OH) as a framework to address the numerous global health challenges. Despite its growing recognition, the integration of OH into medical education has been limited. Many institutions are still unclear on the best approach to introduce and deliver OH within their academic programs.
AIM: To map the pedagogical strategies, implementation experiences, and challenges in integrating OH into medical curricula.
METHODS: A scoping review was conducted in accordance with PRISMA-ScR guidelines. PubMed and Scopus databases were searched for peer-reviewed studies published between January 2015 and December 2024. Data were charted using a standardized extraction form and synthesized descriptively through thematic content analysis.
RESULTS: A total of 14 articles were found from institutions across North America, Africa, and Europe, representing initiatives ranging from integrated modules and stand-alone courses to extracurricular activities. Many utilized interactive, interdisciplinary pedagogies such as problem-based learning, simulations, capstone projects, and community outreach programs. The expected competencies ranged from interdisciplinary collaboration to recognizing human-animal-environment interconnectedness to applying OH principles in identifying and managing health conditions. Content areas extended beyond zoonotic diseases and environmental health to include broader aspects of health systems and health policy development. All the initiatives emphasized on fostering collaborative competencies and broadening students' perspectives on health. However, implementation was challenged by institutional constraints such as curriculum overload, limited faculty expertise, and logistical barriers to interdisciplinary teaching. Many institutions encountered epistemological resistance and reluctance to move beyond reductionist, human-centric paradigms, which was a likely factor in students finding it difficult to relate OH concepts to their medical practice.
CONCLUSION: The review highlights the importance of faculty capacity building, early introduction of systems thinking, and alignment of clinical training with OH principles to ensure a more sustainable integration of OH in medical education.}, }
@article {pmid41436155, year = {2025}, author = {Blake, SR and Gatzoulis, M}, title = {Technology for better adult congenital heart disease care: the time is now.}, journal = {Open heart}, volume = {12}, number = {2}, pages = {}, pmid = {41436155}, issn = {2053-3624}, mesh = {Humans ; *Heart Defects, Congenital/therapy/diagnosis ; *Telemedicine ; *COVID-19/epidemiology ; Adult ; Artificial Intelligence ; Wearable Electronic Devices ; SARS-CoV-2 ; }, abstract = {BACKGROUND: The growing population of patients with adult congenital heart disease (ACHD) present complex lifelong care needs that traditional health systems are struggling to meet. Without innovation, gaps in access, timeliness and specialist oversight will widen. Digital health technologies, including artificial intelligence (AI), telemedicine, wearable devices and interoperable platforms offer a unique opportunity to transform care, but their potential in ACHD remain underexplored.
CURRENT DEVELOPMENTS: AI-driven prediction models show encouraging performance in mortality and event risk but require external validation and lesion-specific adaptation. Telemedicine, accelerated during the COVID-19 pandemic, has demonstrated safety and high patient satisfaction in selected cohorts, yet robust hybrid pathways are lacking. Wearables can capture rhythm, oxygen saturations and activity in real time, but consumer devices remain poorly validated for complex ACHD physiology. Data integration frameworks, such as federated learning, demonstrate global feasibility but face challenges in governance and interoperability.
FUTURE PRIORITIES: Progress in ACHD digital health will depend on three imperatives: (1) rigorous, prospective validation of digital tools in congenital populations; (2) equitable implementation, addressing digital literacy, infrastructure and reimbursement; (3) governance frameworks that embed specialist oversight, data privacy and cybersecurity from the outset.
CONCLUSION: Digital health is no longer optional in ACHD care. The field risks falling behind broader cardiovascular innovation unless patients, clinicians, technologists and policymakers commit to specialist-led integration. A decisive shift towards validated, equitable and interoperable solutions can transform ACHD management into a more predictive, personalised and preventive discipline. The aim of this viewpoint is to highlight how digital technologies could strengthen ACHD care and define priorities for future adoption.}, }
@article {pmid41437518, year = {2026}, author = {An, L and Xu, H and Fan, Q and Lu, M and Sun, D}, title = {Metabolic control of macrophages in coronavirus disease 2019.}, journal = {Virulence}, volume = {17}, number = {1}, pages = {2609397}, pmid = {41437518}, issn = {2150-5608}, mesh = {Humans ; *COVID-19/immunology/metabolism ; *Macrophages/metabolism/immunology/virology ; *SARS-CoV-2/immunology ; Animals ; }, abstract = {In the context of COVID-19, macrophages are primarily responsible for sensing and responding to the virus, significantly influencing disease outcomes. They are involved in early pathogen recognition, immune activation, and tissue repair. Heterogeneity and phenotypic plasticity of macrophages are dynamically shaped by microenvironmental cues, including metabolites, hypoxia, and pathogen-derived signals. Notably, emerging evidence underscores that cellular metabolism, particularly in macrophages, dictates immune responses to viral infection. This metabolic-immune crosstalk critically determines COVID-19 severity, ranging from viral clearance to hyperinflammation or fibrosis. In this review, we systematically dissect how cell-intrinsic metabolic nodes and extrinsic factors modulate macrophage effector functions, while illustrating the complications associated with macrophage metabolic dysregulation in SARS-CoV-2 infection. These mechanistic insights provide a rational foundation for therapeutic strategies targeting macrophage metabolism to rebalance immune responses and mitigate COVID-19 complications.}, }
@article {pmid41438268, year = {2025}, author = {Zemp, C and Vallières, F and Broecker, F and Haroz, EEE and Kakish, I and Sheaf, G and Lee, JSY and Harrison, S and Siersbaek, R}, title = {Self-harm and suicide prevention in humanitarian and fragile contexts: A systematic scoping review.}, journal = {Global mental health (Cambridge, England)}, volume = {12}, number = {}, pages = {e145}, pmid = {41438268}, issn = {2054-4251}, abstract = {Suicide remains one of the leading causes of death globally, with growing evidence that humanitarian emergencies and fragile states, most of which unfold in low- to middle-income countries (LMICs), are associated with elevated risk of suicide. However, the few suicide-targeted interventions for use in humanitarian contexts remain both sparse and fragmented. This scoping review aims to identify and synthesise evidence from suicide and self-harm prevention interventions implemented in all types of humanitarian settings, globally, that have been evaluated for their effectiveness in improving suicide and self-harm-related outcomes. We systematically searched eight electronic databases, including two grey literature databases, and relevant organisational websites for records published through November 2024 and in any language. Screening was done using the Covidence platform, with each record independently screened by two reviewers. Among other preselected inclusion criteria, studies must have conducted a quantitative evaluation of the effectiveness of an intervention on improving suicide and self-harm-related outcomes during a humanitarian crisis to be included for data extraction. Data extraction and quality assessment were both conducted by two authors. In all, 6,209 records were screened at the title and abstract phase; 104 were included for full text screening; and 23 studies were included for data extraction. Most studies were conducted during the coronavirus disease 2019 pandemic (COVID-19), and in high-income countries. Evaluated interventions encompassed various approaches, including psychotherapeutic, practical, and pharmacological assistance, often employing multiple components. The majority targeted the general population, were delivered via remote modalities and relied on mental health specialists for their administration. Overall, 15 (65.2%) interventions were associated with statistically significant positive effects on suicide and or self-harm-related outcomes. Promising approaches include cognitive behavioural therapy-based text services, skills-building programmes, and strategies that foster supportive environments for high-risk individuals. These findings highlight both promising approaches and critical gaps in suicide prevention efforts in humanitarian settings. The limited evidence base - particularly in LMICs and with particularly at-risk populations - alongside the increasing frequency of humanitarian crises, underscores the urgent need for future implementation and associated research of suicide and self-harm prevention initiatives within humanitarian contexts.}, }
@article {pmid41438827, year = {2025}, author = {Saraç, İA and Uzun, SU}, title = {Human metapneumovirus: an emerging public health threat and harbinger of a new pandemic.}, journal = {GMS hygiene and infection control}, volume = {20}, number = {}, pages = {Doc78}, pmid = {41438827}, issn = {2196-5226}, abstract = {Human metapneumovirus (hMPV), first identified in 2001, has increasingly been recognized as a significant cause of acute respiratory tract infections worldwide. Although often overshadowed by respiratory syncytial virus (RSV) and influenza, hMPV contributes substantially to the global burden of respiratory disease, particularly among young children, older adults, and immunocompromised populations. The COVID-19 pandemic further altered the epidemiology of respiratory viruses, disrupting established seasonal patterns and creating immunity gaps that have fueled unusual hMPV outbreaks in recent years. Despite its clinical relevance, hMPV remains underdiagnosed due to limited awareness, restricted access to reliable diagnostic tools, and frequent co-infections that obscure its contribution to disease severity. Currently, no licensed antivirals or vaccines exist, leaving supportive care as the only treatment option. Ongoing research into monoclonal antibodies, vaccine candidates, and combined RSV-hMPV preventive strategies offers promise but remains in early stages. In the context of global interconnectedness and the demonstrated capacity of respiratory viruses to cause widespread disruption, hMPV raises important concerns as a potential emerging public health threat. While unlikely to cause pandemic-scale disruption, hMPV's endemic circulation and disproportionate impact on vulnerable populations warrant its recognition as an emerging threat demanding proactive public health intervention and sustained investment in prevention strategies. This review examines hMPV's evolving role as a public health threat in the post-COVID-19 landscape, where altered epidemiological patterns and increased surveillance have highlighted its underappreciated impact.}, }
@article {pmid41438927, year = {2025}, author = {Cheng, AL and Barker, R and von Nordheim, D and McQueen, A}, title = {Long COVID: What is it? Who has it? What Are Treatment Resources in Missouri?.}, journal = {Missouri medicine}, volume = {122}, number = {6}, pages = {488-494}, pmid = {41438927}, issn = {0026-6620}, mesh = {Humans ; Missouri/epidemiology ; *COVID-19/epidemiology/complications/therapy ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; }, abstract = {As we pass the five-year mark since the COVID-19 pandemic hit, the prevalence of persistent (and often disabling) symptoms from the SARS-CoV-2 virus is estimated to be on par with the prevalence of heart disease. Yet, these Long COVID symptoms can masquerade as other conditions and/or normal aging, so it is believed that Long COVID is under-diagnosed and, as a result, under-treated. Although there is not yet a true cure for Long COVID, many patients benefit substantially from rehabilitation strategies, medications, and social support resources that are available in Missouri. The purpose of this article is to review the definition and epidemiology of Long COVID, provide practical guidance for Long COVID assessment and management especially in the primary care setting, and increase awareness of regional resources for people in Missouri who are living with Long COVID and for the clinicians who are caring for them.}, }
@article {pmid41439194, year = {2025}, author = {Li, S and Zheng, Y and Cheng, L}, title = {Messenger RNA vaccines in the prevention of allergic diseases.}, journal = {The World Allergy Organization journal}, volume = {18}, number = {12}, pages = {101150}, pmid = {41439194}, issn = {1939-4551}, abstract = {Messenger RNA (mRNA) vaccines are composed of mRNA sequences encoding pathogens. The first coronavirus mRNA vaccine (BNT162B2, Pfizer/BioNTech), approved in the United Kingdom in 2020, had prevented approximately 20 million deaths globally within the first year of use. mRNA vaccines were initially used against tumors and infectious diseases, but recent research has also turned its attention to the prevention of allergic diseases. Here, we summarized the characteristics and outcomes of mRNA vaccines in preventing allergic diseases and analyzed their advantages over traditional inactivated vaccines and DNA vaccines. This review focused on the feasibility, potential mechanisms, and preclinical research results of prophylactic allergen mRNA vaccines in the prevention of type I hypersensitivity reactions, and preliminarily addressed the key issues in clinical trials of allergen mRNA vaccines. Allergen mRNA vaccines hold promise for preventing IgE-mediated allergic diseases, yet their potential uses warrant further clinical investigations.}, }
@article {pmid41439888, year = {2025}, author = {Gong, EJ and Bang, CS and Lee, JJ and Baik, GH}, title = {Smart Ring in Clinical Medicine: A Systematic Review.}, journal = {Biomimetics (Basel, Switzerland)}, volume = {10}, number = {12}, pages = {}, pmid = {41439888}, issn = {2313-7673}, support = {RS-2023-00223501//National Research Foundation of Korea/ ; }, abstract = {BACKGROUND: Smart rings enable continuous physiological monitoring through finger-worn sensors. Despite growing consumer adoption, their clinical utility beyond sleep tracking remains unclear.
OBJECTIVES: To systematically review evidence for smart ring applications in clinical medicine, assess measurement accuracy, and evaluate clinical outcomes.
METHODS: We searched PubMed/MEDLINE, Embase, Cochrane Library, and Web of Science through 31 July 2025. Two reviewers independently screened studies and extracted data. Risk of bias was assessed using ROBINS-I and RoB 2.0.
RESULTS: From 862 citations, 107 studies met inclusion criteria including approximately 100,000 participants. Studies were equally distributed between sleep (47.7%) and non-sleep applications (52.3%). Smart rings demonstrated high accuracy: heart rate r[2] = 0.996, heart rate variability r[2] = 0.980, and sleep detection 93-96% sensitivity. Predictive capabilities included COVID-19 detection 2.75 days pre-symptom (82% sensitivity), inflammatory bowel disease flare prediction 7 weeks early (72% accuracy), and bipolar episode detection 3-7 days early (79% sensitivity). However, 65% of studies had moderate-to-high bias risk. Limitations included small samples, proprietary algorithms (89%), poor diversity reporting (35%), and declining adherence (80% at 3 months to 43% at 12 months).
CONCLUSION: Smart rings have evolved into clinical tools capable of early disease detection. However, algorithmic opacity, population homogeneity, and adherence challenges require attention before widespread implementation.}, }
@article {pmid41439932, year = {2025}, author = {Zuñiga-Jimenez, CT and Rojas-Esguerra, DF and Muñoz-Martinez, AP and Mendoza-Guzman, DC and Daza-Arana, JE}, title = {Musculoskeletal Sequelae of Post-COVID-19 Syndrome: A Systematic Review.}, journal = {Diseases (Basel, Switzerland)}, volume = {13}, number = {12}, pages = {}, pmid = {41439932}, issn = {2079-9721}, abstract = {Background/Objectives: COVID-19 infection is a respiratory illness that affects multiple body systems, including the musculoskeletal system. In August 2024, Colombia reported 6 million infections and a 2.2% mortality rate related to COVID-19. Post-COVID-19 syndrome (PCS) is a chronic condition occurring after the acute infection, typically characterized by fatigue, weakness, pain, and sarcopenia, impacting the patient's quality of life (QoL). This systematic review aimed to identify musculoskeletal sequelae, including peripheral muscle strength, fatigue, and QoL, in patients with PCS. Methods: We searched the PubMed, Scopus, and Web of Science databases for cross-sectional, case-control, and cohort studies focusing on musculoskeletal sequelae in patients with COVID-19 infection published between 2020 and 2025. Study quality and risk of bias were assessed using the MINORS and the ROBINS-E scales, respectively. Results: Thirteen studies (n = 5657 patients) met the eligibility criteria. Seventy-six percent of studies indicated muscle weakness as the most common sequela, primarily in older adults and individuals with comorbidities (obesity, diabetes, and chronic obstructive pulmonary disease). General fatigue (reported in 76% of the studies) significantly influenced patients' daily lives, whereas 90% of patients reported some level of deterioration in their QoL, primarily regarding mental health, bodily pain, and physical performance. Conclusions: Patients with PCS who required mechanical ventilation showed reduced muscle strength and poor physical performance, especially older adults. Inactive individuals had worse musculoskeletal sequelae, while physical activity was associated with better strength levels. Although QoL improved after 12 months, the combination of aerobic exercise with adequate nutrition is essential to promote muscle recovery, reduce fatigue, and improve overall functional capacity in post-COVID-19 patients.}, }
@article {pmid41440051, year = {2025}, author = {Elkoury, E and Yehia, A and Caparelli, EC and Geda, YE and Ortega, D and Yamada, N and Hakhu, S and Beeman, SC and Ross, TJ and Yang, Y and Zhou, Y and Port, JD and Abulseoud, OA}, title = {Brain Volumetric Changes Post-COVID-19: A Systematic Review.}, journal = {Brain sciences}, volume = {15}, number = {12}, pages = {}, pmid = {41440051}, issn = {2076-3425}, abstract = {Background: The potential long-term effects of Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) infection on the brain structure have not yet been fully elucidated. Even though existing studies have reported structural changes in the post-COVID-19 period, the results remain highly inconsistent and controversial. As such, identifying an imaging biomarker for post-COVID brains is still under investigation. This review aims to comprehensively summarize the structural MRI (sMRI) studies that focus on volumetric brain changes at least two weeks following COVID-19 infection. Methods: A systematic literature search was conducted on PubMed, SCOPUS, Web of Science, EMBASE, and Google Scholar up to 9 September 2025. Studies that utilized sMRI to assess volumetric brain changes post-COVID at greater than two weeks following infection were included. Exclusion criteria encompassed research involving pediatric or adolescent populations and imaging modalities other than sMRI. Preprints, reviews, case reports, case series and post-mortem studies were also excluded. Results: Forty-one studies satisfied the inclusion criteria and consisted of 2895 patients and 1729 healthy controls. Despite the wide variability in image acquisition protocols, data processing methods, and comorbidities between studies, multiple studies reported statistically significant volumetric reductions in the hippocampus, amygdala, thalamus, basal ganglia, nucleus accumbens and the cerebellum months to years after infection, especially in older hospitalized patients with severe COVID-19. Conclusions: The emerging literature reports long-term volume changes across various brain regions in individuals previously infected with COVID-19; however, the evidence is inconsistent. Specific imaging biomarkers following exposure to SARS-CoV-2 infection and the underlying mechanisms of these changes are yet to be identified. Future studies with harmonized imaging protocols, longitudinal designs, and integrated biomarker and clinical data are needed to define robust biomarkers and elucidate the pathophysiology of these findings.}, }
@article {pmid41440273, year = {2025}, author = {Fatima, M and Fatima, M and Abbas, N and Park, PG}, title = {Opportunities and Challenges in Gas Sensor Technologies for Accurate Detection of COVID-19.}, journal = {Biosensors}, volume = {15}, number = {12}, pages = {}, pmid = {41440273}, issn = {2079-6374}, support = {GCU-202502820001//Gachon University/ ; }, mesh = {Humans ; *COVID-19/diagnosis ; *Volatile Organic Compounds/analysis ; Breath Tests/methods ; SARS-CoV-2/isolation & purification ; *Biosensing Techniques/methods ; Gases/analysis ; }, abstract = {Gas sensors provide versatile opportunities for detecting volatile organic compounds (VOCs) such as acetone, methanol, ethanol, propanol, isoprene, and aldehydes in exhaled breath (EB) associated with COVID-19 respiratory infections. These VOCs provide valuable information about metabolic markers linked with COVID-19. They have opened opportunities to develop sensors for COVID-19 screening based on breath analysis. These sensors have the potential to provide the rapid detection of viruses in healthcare settings. RT-PCR, as a conventionally adopted diagnostic method, has a detection limit around 10-100 RNA copies/mL, with an accuracy of around 95%. Gas sensors have demonstrated VOC detection limits at the ppm level in COVID-19 EB and have displayed a sensitivity and specificity of 98.2% and 74.3%, respectively. Multiple gas sensors combined with machine learning algorithms have the potential to enhance the specificity of VOC detection. In addition to having an accuracy similar to that of the PCR method, the VOC-based diagnosis of COVID-19 offers unique advantages in terms of non-invasive and rapid detection. This review provides an overview of state-of-the-art gas sensors developed for COVID-19 detection. Despite there being significant developments in this field, there are certain challenges that still need to be addressed-these include the impact of environmental factors, the specificity of detection, the sensing range, and precision limitations, leading to accuracy issues. Despite these existing challenges, the integration of gas sensors with machine learning methods can enhance the accuracy of the detection of COVID-19. Future research directions are proposed to validate and standardize the application of gas sensors for COVID-19 in clinical settings.}, }
@article {pmid41440526, year = {2025}, author = {László, SA and Ianoși, ES and Văsieșiu, AM and Szathmáry, M and Ianoși, MB and Rachiș, DL and Nistor, G and Jimborean, G}, title = {COVID-19 and Lung Cancer Interactions: A Literature Review.}, journal = {Medical sciences (Basel, Switzerland)}, volume = {13}, number = {4}, pages = {}, pmid = {41440526}, issn = {2076-3271}, mesh = {Humans ; *COVID-19/epidemiology/complications/virology ; *Lung Neoplasms/epidemiology/diagnosis/virology ; SARS-CoV-2 ; Incidence ; Pandemics ; }, abstract = {This review aims to discuss the apparent reduction in pulmonary cancer incidence in the general population during and shortly after the COVID-19 pandemic from a biological and pathophysiological mechanistic point of view. While the epidemiological evidence points to a disruption in the early- and mid-stage diagnostic process, which causes a shift to late-stage lung cancer discovery with no impact on its actual prevalence, an alternative hypothesis based on the intersection of viral and cancer biology could have a real effect on lung carcinogenesis as an independent phenomenon. By weaving together population-level trends, mechanistic insights, and translational oncology, we discuss whether the pandemic-associated decline in lung cancer diagnoses reflects primarily a temporary diagnostic artifact or whether it also reveals biologically relevant intersections between SARS-CoV-2 and pulmonary oncogenesis. The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has exerted profound and multifaceted effects on global healthcare systems, altering patterns of disease detection, management, and outcomes across nearly all medical disciplines. These disruptions generated what has been termed a "diagnostic deficit", producing a backlog of undetected cancers that have only partially been recovered in subsequent years. This phenomenon, sometimes described as a "COVID-19 debt" in oncology, is thought to contribute to excess late-stage diagnoses and potentially worse medium-term survival outcomes. Beyond the disruption of medical systems, the pandemic also raised a more speculative but biologically intriguing question: could SARS-CoV-2 infection itself, through direct or indirect mechanisms, influence lung cancer biology? Our review aims to critically synthesize the evidence across seven domains to address this dual hypothesis. (1) We examine the observed effects of the pandemic on cancer incidence, highlighting global registry and health-system data; (2) we review SARS-CoV-2 infection biology, including viral entry, replication, protein functions, and treatment implications; (3) we summarize the pathogenesis of lung cancer; (4) we explore the role of immune checkpoints in tumor immune evasion, followed by (5) analyses of immune dysregulation in acute infection and (6) in long COVID; and (7) finally, we evaluate proposed oncogenic mechanisms of SARS-CoV-2, integrating molecular virology with cancer immunology. We conclude that the "diagnostic deficit" phenomenon was a reality during and immediately post-pandemic. However, a definitive answer to the questions related to the impact of the infection as an independent phenomenon would require advanced research information covering the biology of the viral infection and lung cancer oncogenesis: processes that are not currently implemented in routine clinical laboratory investigations.}, }
@article {pmid41440598, year = {2025}, author = {Mbeye, NM and Chipojola, R and Banda, S and Kaude, P and Mdolo, A and Nwosisi, C and Mounier-Jack, S}, title = {Integration Models for Delivering COVID-19 Vaccines Through HIV Services in Low-and Middle-Income Countries: A Scoping Review.}, journal = {Infectious disease reports}, volume = {17}, number = {6}, pages = {}, pmid = {41440598}, issn = {2036-7430}, abstract = {BACKGROUND: The Coronavirus Disease 2019 (COVID-19) remains a major global public health issue. People living with HIV (PLHIV) are among the vulnerable groups facing a higher risk of severe outcomes. Combining COVID-19 vaccination with HIV services can improve access and utilization of the vaccine among PLHIV although effective methods of delivery are yet to be ascertained. We conducted a scoping review to identify and describe models for delivering COVID-19 vaccines through HIV care services in low- and middle-income countries (LMICs).
METHODS: We used PRISMA-ScR guidelines to conduct the review. On 3rd and 4th February 2025, we searched PubMed, Web of Science, Cochrane Library, and EMBASE for studies on integrated COVID-19 vaccine delivery for PLHIV.
RESULTS: Three studies from sub-Saharan Africa reported call-back strategy, diverse partnership, and mixed service delivery models for implementing COVID-19 vaccination in HIV care services. Key strategies that were used included building capacity, generating demand, managing the supply chain, and involving stakeholders. The outcomes showed significant increases in vaccination coverage among PLHIV and reduced vaccine wastage.
CONCLUSIONS: Integrating COVID-19 vaccination into HIV services is practical and effective in LMICs. It makes use of current infrastructure, partnerships, and local innovations.}, }
@article {pmid41440751, year = {2025}, author = {Wang, J and Ma, N and Mo, G and Qin, X and Zhang, J and Yao, X and Guo, J and Sun, Z}, title = {Hazards and Health Risks of the Antibacterial Agent Triclosan to Fish: A Review.}, journal = {Journal of xenobiotics}, volume = {15}, number = {6}, pages = {}, pmid = {41440751}, issn = {2039-4713}, abstract = {Triclosan (TCS) is a widely used antimicrobial agent found in personal care products and household cleaners. While valued since the 1960s for its ability to inhibit bacterial fatty acid synthesis, its environmental persistence, ecotoxicity, and bioaccumulative potential have raised significant global concern. The increased use of disinfectants during the COVID-19 pandemic has further exacerbated its prevalence as an aquatic pollutant. In the environment, TCS is distributed through water bodies and sediments, undergoing processes such as biodegradation and photochemical degradation. Its bioaccumulation poses a substantial threat to aquatic organisms, particularly fish. A growing body of research indicates that TCS acts as an endocrine disruptor and developmental toxicant, with documented adverse effects encompassing impaired embryonic and larval development, skeletal malformations, and induction of oxidative stress, mitochondrial dysfunction, DNA damage, and inflammatory responses. Furthermore, TCS exposure is linked to reproductive toxicity, including altered sex hormone levels and diminished reproductive capacity. This review consolidates current knowledge on the chemical properties, environmental fate, biodegradation pathways, and ecotoxicological impacts of TCS, with a specific emphasis on its multifaceted health risks to fish. The synthesis aims to provide a foundation for future research, inform environmental risk assessments, and support the development of evidence-based regulatory measures.}, }
@article {pmid41441346, year = {2025}, author = {Cianciulli, A and Santoro, E and Bruno, N and Quagliarella, S and Esposito, S and Manente, R and Santella, B and Ferrara, RF and Pacifico, A and Franci, G and Boccia, G}, title = {The Role of the Family and Community Nurse in Improving Quality of Life and Optimizing Home Care Post-COVID: A Systematic Review with Meta-Analysis.}, journal = {Nursing reports (Pavia, Italy)}, volume = {15}, number = {12}, pages = {}, pmid = {41441346}, issn = {2039-4403}, abstract = {Background/Objectives: The COVID-19 pandemic accelerated the shift toward community- and home-based care models. Within this transformation, Family and Community Nurses (FCNs) have become key in bridging hospital and primary care, supporting continuity, self-care, and quality of life (QoL). Despite increasing recognition, evidence on FCN-led interventions remains fragmented. This systematic review and meta-analysis aimed to synthesize evidence on the impact of FCN interventions on QoL and clinical outcomes in post-COVID and people living with chronic conditions managed in community and home settings. Methods: Following PRISMA 2020 guidelines, we searched PubMed, Scopus, CINAHL, PsycINFO, Embase, and Cochrane Library (January 2020-November 2024). Eligible studies were randomized controlled trials evaluating FCN-led interventions. Primary outcomes were QoL (measured with validated tools) and glycemic control (HbA1c). Secondary outcomes included hospital readmissions, anxiety, depression, and self-care abilities. Risk of bias was assessed using the Cochrane RoB2 tool for randomized controlled trials. Random-effects meta-analyses were performed, with heterogeneity evaluated by I[2]. The protocol was prospectively registered in PROSPERO (CRD42024567890) before data extraction. Results: Seventy-one studies (n = 19,390) were included. Interventions comprised home visits, telehealth, patient education, and case management. Pooled analyses demonstrated significant improvement in QoL (SMD 0.34, 95% CI 0.18-0.50) and reduction in HbA1c (-0.47%, 95% CI -0.69 to -0.25). FCN interventions also reduced hospital readmissions (RR 0.74, 95% CI 0.62-0.89) and improved mental health outcomes. Most studies were judged at low to moderate risk of bias. Conclusions: FCN-led interventions significantly enhance QoL, mental health, and clinical outcomes while reducing hospital readmissions. These findings highlight the strategic importance of integrating FCNs into community-based healthcare models.}, }
@article {pmid41441682, year = {2025}, author = {Wiblin, S and Feldman, C and MacIntyre, CR and Soulsby, N and van Buynder, P and Waterer, G}, title = {Risk Groups for Vaccine-Preventable Respiratory Infections in Children and Adults: An Overview of the Australian Environment.}, journal = {Vaccines}, volume = {13}, number = {12}, pages = {}, pmid = {41441682}, issn = {2076-393X}, abstract = {Respiratory infections are a leading cause of sickness and death in Australia. In Australia, there is a funded immunisation program for both adults and children aimed at preventing and controlling vaccine-preventable respiratory infections (VPRI), such as pneumococcal disease (PD), influenza A/B, respiratory syncytial virus (RSV) infection, and COVID-19. This narrative review outlines the current Australian adult and paediatric immunisation guidance for VPRIs. It also examines the literature that supports the current risk group recommendations, including the clinical and economic burden of VPRIs, vaccination effectiveness, and coverage. Gaps in current risk group definitions, as well as additional risk groups that could be included in vaccine recommendations, are also discussed. Further research is needed to determine the optimum age for vaccination in adults which may enable alignment of age recommendations across different VPRIs. Individuals with multiple risk factors, commonly referred to as risk stacking, are at a greater risk of developing severe disease for VPRIs. This emphasises the importance of vaccinating these individuals. More research is needed to evaluate the effectiveness of vaccines in older adults and to create more effective vaccines for high-risk paediatric groups, such as those with compromised immunity or for children who have undergone haematopoietic stem cell transplantation.}, }
@article {pmid41441691, year = {2025}, author = {Naji, A and El Sahly, HM and Whitaker, JA}, title = {A Review of the Effects of Ipsilateral or Contralateral Vaccine Boosting on the Adaptive Immune Response.}, journal = {Vaccines}, volume = {13}, number = {12}, pages = {}, pmid = {41441691}, issn = {2076-393X}, abstract = {Vaccines have been pivotal in reducing the incidence and severity of infectious diseases, improving population health, and lowering mortality rates globally. While substantial progress has been made in optimizing vaccine formulations, adjuvants, and schedules, comparatively less attention has been given to how the site of vaccination may influence immunologic outcomes. This review examines the impact of the administration of prime and booster vaccine doses in the same (ipsilateral) versus the opposite arms (contralateral) on vaccine immunogenicity. We review animal model and human studies evaluating the impact of ipsilateral versus contralateral COVID-19 and non-COVID-19 vaccine boosting on immunologic outcomes with a focus on the germinal center response, antibody production, and T cell activation. While some studies suggest that ipsilateral administration may enhance the quality of germinal center B cell responses and antibody magnitude, data across different studies have been inconsistent. Relatively few studies have compared ipsilateral versus contralateral boosting, and differences in study design and outcomes have limited the ability to draw conclusions as to whether one is superior to the other. This review highlights a noteworthy and underexplored area in vaccinology and the need for future research to clarify whether ipsilateral/contralateral boosting strategies matter. To answer this question, high-quality, randomized controlled trials evaluating different types of vaccines that consider immunologic mechanisms, capture key time points and appropriate specimens, and evaluate early and long-term immunogenicity endpoints are required.}, }
@article {pmid41441705, year = {2025}, author = {Sun, M and Elliott, K}, title = {StealthX: A Versatile and Potent Exosome-Based Vaccine Platform for the Next Pandemic.}, journal = {Vaccines}, volume = {13}, number = {12}, pages = {}, pmid = {41441705}, issn = {2076-393X}, abstract = {Exosome-based vaccines represent a transformative platform in modern vaccinology, combining nanoscale delivery, biocompatibility, and potent immunogenicity. Among these, the StealthX platform developed by Capricor, Inc. has demonstrated exceptional versatility, enabling antigen presentation at nanogram level doses without the need for adjuvants. Preclinical studies using StealthX have shown strong humoral and cellular immune responses against SARS-CoV-2 variants, including Delta and Omicron, as well as broader applications against influenza and RSV antigens. The platform's ability to accommodate multiple antigens within a single formulation addresses the challenges of viral variation and facilitates multivalent "mix-and-match" immunization strategies. This review offers an in-depth evaluation of the StealthX vaccine platform, covering the biological mechanisms underlying exosome function, the engineering approaches used to load antigens, and preclinical results demonstrated across three pivotal studies. By synthesizing current evidence, this review underscores the platform's applicability for emerging infectious diseases and explores the strategic value of multivalent exosome-based vaccines in global immunization efforts as an emerging next-generation vaccine technology.}, }
@article {pmid41441720, year = {2025}, author = {Puchner, KP and Kondilis, E and Palantza, N and Seretis, S and Mavroudeas, S and Benos, A and Papamichail, D}, title = {Competing Theories on Global and Regional Vaccine Inequities: A Scoping Literature Review Within the Context of the COVID-19 Pandemic.}, journal = {Vaccines}, volume = {13}, number = {12}, pages = {}, pmid = {41441720}, issn = {2076-393X}, abstract = {Background/Objectives: Despite global efforts, COVID-19 revealed severe spatial vaccine inequities, disproportionately affecting low- and middle-income countries (LMICs). Scholars across disciplines proposed numerous-and often competing-terms and theories to explain these disparities. In this review and within the context of the COVID-19 pandemic, we assess the usage, definition, and appropriateness of these terms and their linked theories or frameworks. Methods: We conducted a scoping review aiming to clarify key definitions, concepts, and frameworks of eight prominent terms used in the literature regarding COVID-19 global and/or regional vaccine inequities (i.e., vaccine nationalism, vaccine apartheid, vaccine colonialism, vaccine imperialism, vaccine racism, vaccine diplomacy, vaccine solidarity, and vaccine internationalism). The methodology followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines for Scoping Reviews and included papers from January 2020 to the end of October 2024. Results: We included 79 papers in our study. The majority (71%) were published in 2021-2022, with less than one-quarter authored by scholars from LMICs. Vaccine imperialism was consistently defined but rarely used, while vaccine nationalism and vaccine apartheid appeared more frequently with varied meanings. Yet, in most cases, all of these concepts identified economic interests of vaccine-producing countries as the root cause of the observed vaccine inequities. Vaccine diplomacy showed similar ambiguity, viewed by some as worsening inequities and by others as potentially mitigating them. The terms vaccine racism, vaccine colonialism, and vaccine solidarity were not explicitly identified but appear to be embedded within the definitions of other prominent terms detected. Conclusions: Across the preselected terms examined, we found numerous-and often conflicting-definitions, revealing the fragmented and competing understandings of the major drivers fueling global vaccine inequities. This lack of coherence inhibits evidence synthesis or shared theoretical progress but, most importantly, might undermine current and future efforts to address these inequities.}, }
@article {pmid41441855, year = {2026}, author = {Jacobs, JW and Raza, S and Maynard, S and Shaz, BH and Tobian, AAR and Bloch, EM}, title = {Improving transfusion access through improved policy: a call for a less fragmented blood supply.}, journal = {Expert review of hematology}, volume = {19}, number = {3}, pages = {225-235}, doi = {10.1080/17474086.2025.2610282}, pmid = {41441855}, issn = {1747-4094}, mesh = {Humans ; *Blood Transfusion/legislation & jurisprudence ; *COVID-19/epidemiology ; SARS-CoV-2 ; *Health Policy ; *Health Services Accessibility ; Blood Banks/supply & distribution ; Pandemics ; }, abstract = {INTRODUCTION: Fragmentation across operations, data systems, governance, and regulation leaves many blood supply networks ill-equipped to provide timely, equitable, and crisis-resilient transfusion support. Public health emergencies, such as COVID-19 and natural disasters, have exposed the human and economic costs of these structural flaws, and how variability in practice about who can see and share data still impedes coordination even when the overall blood inventory is adequate.
AREAS COVERED: This Critical Perspective examines blood supply coordination challenges in high-income countries, focusing on governance structures, operational isolation, regulatory inconsistencies, and data system incompatibilities. We analyze evidence from crisis events including pandemics, natural disasters, and mass casualty incidents to illustrate coordination failures and successful response models. The review synthesizes peer-reviewed literature identified through PubMed searches (January 2010 - September 2025), supplemented by regulatory documents, industry reports, and government policy analyses from blood regulatory agencies in the United States, United Kingdom, Canada, and other high-income countries.
EXPERT OPINION: Effective solutions require coordinated interventions across multiple domains rather than isolated or localized improvements. Priority areas include governance structures that enable cross-institutional collaboration, interoperable data systems with standardized sharing protocols, regulatory frameworks that incentivize coordination, and value-based reimbursement models that reward system-wide performance.}, }
@article {pmid41443971, year = {2026}, author = {Josephson, CB and Beniczky, S and Denaxas, S and Ikeda, A and Jehi, L and Mwesige, AK and Jette, N and Jones, GD and Ryvlin, P and Sen, A and Triki, CC and Waters, G and Guekht, A and Cross, JH}, title = {A call for ethical, equitable, and effective artificial intelligence to improve care for all people with epilepsy: A roadmap. A report by the ILAE Global Advocacy Council and Big Data Commission.}, journal = {Epilepsia}, volume = {67}, number = {4}, pages = {1555-1572}, pmid = {41443971}, issn = {1528-1167}, mesh = {Humans ; *Epilepsy/therapy/diagnosis ; *Artificial Intelligence/ethics ; Electroencephalography ; Big Data ; Patient Advocacy ; }, abstract = {The artificial intelligence (AI) revolution is upon us. It will inevitably form a central component of epilepsy workflows and patient advocacy. Therefore, it behooves us as health care providers to ride the crest of this wave and guide its direction for the benefit of all people with epilepsy. Emerging AI-based solutions include decision support tools, automated interpretation of electroencephalography (EEG) and brain imaging, and wearable devices that detect seizures and improve patient safety. Pipelines, including decentralized approaches and federated learning, are now being built that will democratize access and facilitate the next generation of AI tools for the global epilepsy community. Despite this, enduring issues remain incompletely addressed. For example, AI requires high volumes of data, leading to concerns about ethical ownership, stewardship, and privacy. Few AI-based tools have progressed from derivation to validation stages, and only rare exceptions undergo real-world evaluation. Inadvertent harmful algorithmic and decision allocation biases also continue to represent major risks to the global epilepsy population. Additional barriers include geographical disparities in computing resources, proprietary ownership of electronic health records, EEG, and brain-imaging platforms, and greenhouse gas emissions related to the demanding power requirements of AI. Therefore, to fully avail ourselves of the benefits of AI, we assert that ethical, equitable, and effective AI for epilepsy requires collaboration from the entirety of the global epilepsy community. Fundamental to this is early and deliberate engagement of people from low- and middle-income countries to ensure that AI-based solutions do not exacerbate existing global disparities. Ultimately, we advocate for "decision intelligence" approaches to the development of AI-based epilepsy solutions, which involves early engagement of all interest-holders to ensure that the correct questions are addressed and the right technical approaches are deployed to maximize value for the global epilepsy community.}, }
@article {pmid41444262, year = {2025}, author = {Wilson, JE and Gurdasani, D and Helbok, R and Ozturk, S and Fraser, DD and Filipović, SR and Peluso, MJ and Iwasaki, A and Yasuda, CL and Bocci, T and Priori, A and Altmann, D and Alwan, NA and Wesley Ely, E}, title = {COVID-19-associated neurological and psychological manifestations.}, journal = {Nature reviews. Disease primers}, volume = {11}, number = {1}, pages = {91}, pmid = {41444262}, issn = {2056-676X}, mesh = {Humans ; *COVID-19/complications/psychology/physiopathology/epidemiology ; *Nervous System Diseases/etiology/virology ; *Mental Disorders/etiology ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Anxiety/etiology ; Depression/etiology ; }, abstract = {Long COVID is an infection-associated chronic condition that typically occurs within 3 months of acute COVID-19 infection in which symptoms are intermittently or continuously present for at least 3 months. Long COVID is estimated to affect between 80 and 400 million people globally, with an incidence of 5-20% in the community and up to 50% among hospitalized patients following acute SARS-CoV-2 infection. Common neuropsychiatric and mental health symptoms of long COVID include memory deficits, executive dysfunction, anxiety, depression, recurring headaches, sleep disturbances, neuropathies, problems with taste and smell, and dizziness that accompanies erratic heart rates and severe post-exertional malaise. Underlying pathophysiological mechanisms includes SARS-CoV-2 viral persistence, herpesvirus reactivation, microbiota dysbiosis, autoimmunity, clotting and endothelial abnormalities, and chronic immune activation. Owing to the variability in the clinical presentation, management must be tailored based on a patient's presenting symptoms.}, }
@article {pmid41444990, year = {2025}, author = {Barrera, I and Wang, G and Rajakumar, B and Muthupalaniappan, S and Cronin, AE and Chatterjee, A}, title = {Mobile addiction treatment units: a narrative review.}, journal = {Addiction science & clinical practice}, volume = {20}, number = {1}, pages = {99}, pmid = {41444990}, issn = {1940-0640}, mesh = {Humans ; *Mobile Health Units/organization & administration ; United States ; *Opioid-Related Disorders ; Drug Overdose/prevention & control ; *Substance-Related Disorders/therapy ; COVID-19/epidemiology ; Health Services Accessibility ; Program Evaluation ; Telemedicine ; }, abstract = {BACKGROUND: Drug overdose deaths have increased in the last decade, becoming a substantial public health priority. Mobile Addiction Treatment Units (MATU) are vans, vehicles, or portable clinics that provide low-threshold, low-barrier, community-based services for addiction treatment including opioid agonist medications. MATUs are a point of entry for care, particularly for individuals who have faced barriers to access at in-person healthcare facilities.
OBJECTIVE: This narrative review aims to synthesize and conduct a thematic analysis of the research on implementation and outcomes of MATUs in the United States. Our study's primary objectives were threefold: 1) to evaluate MATU program reach, 2) to evaluate MATU program effectiveness, and 3) to evaluate MATU program implementation.
METHODS: We identified studies examining MATUs by searching electronic databases MEDLINE (Ovid), Embase (Elsevier), PsycINFO (EBSCO), and Web of Science Core Collection (Clarivate). Records were selected for full-text review if their abstract referenced any mobile modality for substance use treatments. Exclusion criteria included review articles, opinion articles, theoretical articles, abstracts, dissertations, studies conducted outside of the United States, and studies focused solely on mobile harm-reduction interventions without offering medication treatment for SUD. This review is reported per the Preferred Reporting Items of Systematic Reviews and Meta-Analyses for Scoping Review (PRISMA-ScR) guidelines.
RESULTS: A total of 2,232 articles were screened at the title and abstract level, of which 83 were assessed for full text eligibility. The 34 articles selected for inclusion were varied in methodology, and included randomized controlled trials (RCTs), observational studies, cohort studies, and mixed-methods research. The most common study locations were Baltimore, MD (10 studies), Boston, MA (5 studies), Philadelphia, PA (4 studies), and New Haven, CT (3 studies). Regarding reach, four studies were conducted during the COVID-19 pandemic. Six studies were conducted primarily in a population experiencing homelessness; two studies were conducted primarily in populations with criminal justice involvement; four studies were conducted primarily in youth or young-adult populations; three studies were conducted in rural populations. In these settings, MATUs successfully engaged vulnerable and underserved populations, delivering comprehensive care that combined harm reduction, primary care, and mental health services. These units demonstrated potential to enhance health outcomes, reduce stigma, increase treatment retention rates in marginalized populations compared to office-based programs, and tackle social determinants of health. Common challenges included patient engagement, logistical and regulatory barriers, and financial sustainability, all compounded by limited space, staffing, and resources, while homelessness, encampment removals, and the COVID-19 pandemic further disrupted care continuity (J Subst Abuse Treat 120:108149, 2021; Front Public Health 11:1154813, 2023; J Subst Use Addict Treat 159:209272, 2024; J Subst Use Addict Treat 164, 2024; Health Place 28:153-66, 2014; Addict Sci Clin Pract 18:71, 2023).
CONCLUSION: MATUs proved to be innovative and effective in addressing OUD and related issues for vulnerable populations traditionally lacking access to care. However, ongoing efforts to overcome implementation challenges and ensure sustainable funding and resources are crucial for their continued success and expansion. Future research should focus on large-scale, quantitative studies, particularly in diverse and rural settings, to better understand their long-term impact and sustainability.}, }
@article {pmid41445958, year = {2025}, author = {Xiao, Y and Song, Z and Zhou, L and Lu, W and Fang, W and Xu, J and Li, X}, title = {Coronavirus nucleocapsid proteins: a multifaceted modulator in the innate immune evasion.}, journal = {Frontiers in microbiology}, volume = {16}, number = {}, pages = {1658339}, pmid = {41445958}, issn = {1664-302X}, abstract = {Coronaviruses are capable of inducing diverse infectious diseases that pose significant threats to the public health and the economic development. With a single positive-stranded RNA genome, coronaviruses utilize viral proteins to execute diverse immune escape strategies to facilitate their replication. Of all the identified structural proteins and non-structural proteins within the coronaviruses, nucleocapsid (N) protein is highly conserved and is the most abundant viral protein in infected host cells. N protein regulates the more complex and diverse mechanisms through which viruses suppress host immunity. In this review, we analyzed the basic structure of coronavirus N protein, and further elaborate on its multifaceted regulatory functions in the virion assembly, pathogenesis, host innate immune responses, as well as the innate immunity-related programmed cell death and cell cycle, and also other cell processes. A better understanding of the immune evasion strategy regulated by N protein will help to provide a theoretical basis for the development of broad-spectrum anti-coronavirus drugs targeting N proteins.}, }
@article {pmid41446839, year = {2025}, author = {Jin, T and Peng, J and Peng, R and Hu, Z}, title = {Research trends and hotspots of traditional Chinese medicine for asthenopia: a comprehensive visualization and bibliometric study as of 2024.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1613177}, pmid = {41446839}, issn = {2296-858X}, abstract = {OBJECTIVE: To explore the preventive and therapeutic effects of traditional Chinese medicine (TCM) for asthenopia.
METHODS: The literatures on TCM for asthenopia published in Web of Science, PubMed, China National Knowledge Infrastructure and Wanfang from the inception of each database to December 31, 2024 were retrieved and summarized. Network cluster co-occurrence analysis and qualitative narrative methods were used for this review.
RESULTS: The related research has shown a fluctuating upward trend. The institutions that published more relevant studies were Chinese medicine universities and their affiliated hospitals. The analysis found that the research mainly focused on elucidating the treatment mechanism, optimizing the acupoint stimulation mode of external treatment, and optimizing the systematic regulation of the TCM decoction program.
CONCLUSION: The research on TCM for asthenopia is unevenly distributed among countries and regions, and mainly concentrated in China. However, since the outbreak of COVID-19, the research on asthenopia abroad has gradually increased, which may be related to lifestyle and the development of modern electronic technology. Current research trends mainly focus on the establishment of evidence-based TCM clinical intervention programs and the establishment of a comorbidity model of asthenopia.}, }
@article {pmid41446849, year = {2025}, author = {Kohler, MM and Kolbe, M and Körtgen, B and Angst, S and Barbul, AMS and Seufert, L and Hasal, R and Bührer, L and Held, U and Grande, B}, title = {Efficacy of simulation-based training for airway management in preparing hospitals for the COVID-19 pandemic: a systematic review.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1656737}, pmid = {41446849}, issn = {2296-858X}, abstract = {BACKGROUND: In response to the coronavirus pandemic, hospitals worldwide implemented simulation-based training to help healthcare providers (HCPs) adapt to revised protocols for airway management in patients with infectious coronavirus disease 2019 (COVID-19). We conducted a systematic review of simulation-based studies on airway management in COVID-19 patients, with the aim of analyzing the findings of these studies and consolidating evidence-based recommendations to optimize responses to possible future pandemics.
METHODS: We performed a systematic literature search of PubMed, Embase, Medline, and the Cochrane Library on 25 August 2022. As different studies measured different outcomes (e.g., only confidence, only knowledge, or both) in different ways, a random-effects model was used for meta-analysis and change scores were calculated.
RESULTS: The systematic review included 20 studies after screening 141 articles. The meta-analysis revealed significant improvements in participants' confidence and knowledge after simulation training, as evidenced by negative standardized mean differences (SMDs, Cohen's d). Sensitivity analysis confirmed that the results were robust across various correlation estimates. However, there was a high risk of publication bias, as funnel plots showed asymmetry and studies fell outside the 95% confidence interval.
CONCLUSION: This systematic review highlights the effectiveness of simulation training in improving healthcare providers' confidence and knowledge regarding airway management during pandemics. The findings underscore the positive impact of simulation-based education, as demonstrated by significant improvements from pre-training to post-training assessments. However, the observed publication bias suggests that additional high-quality, unbiased studies are necessary to strengthen the evidence base and inform future training programs for pandemic preparedness.
PROSPERO, CRD42022293708.}, }
@article {pmid41447763, year = {2026}, author = {Zhao, Y}, title = {Research progress and applications of reverse genetics systems for infectious bronchitis virus.}, journal = {Poultry science}, volume = {105}, number = {2}, pages = {106312}, pmid = {41447763}, issn = {1525-3171}, mesh = {*Infectious bronchitis virus/genetics/physiology ; *Reverse Genetics/methods ; Animals ; *Poultry Diseases/virology/prevention & control ; *Coronavirus Infections/veterinary/virology/prevention & control ; Chickens ; Viral Vaccines/immunology ; }, abstract = {Infectious bronchitis virus (IBV) poses a persistent threat to global poultry health, driving the need for advanced molecular tools to study and combat this pathogen. Reverse genetics has emerged as a pivotal technology in IBV research, enabling precise manipulation of the viral genome to investigate pathogenesis, design novel vaccines, and identify potential antiviral targets. This review systematically examines the development, applications, and challenges of reverse genetics platforms for IBV. Established methods, including vaccinia virus supported systems, in vitro ligation and transcription, targeted RNA recombination, bacterial artificial chromosome cloning, transformation associated recombination, and circular polymerase extension reaction are detailed, with their principles, advantages, and limitations highlighted. Furthermore, contributions of these platforms to elucidating gene function, rational vaccine design, and the development of IBV as a viral vector for multipathogen vaccines are discussed. Current technical hurdles, safety considerations, and knowledge gaps are addressed, along with future perspectives integrating CRISPR/Cas9, synthetic biology, and computational approaches. This comprehensive overview aims to guide researchers in selecting appropriate reverse genetics strategies and to inspire innovative solutions for IBV control.}, }
@article {pmid41448305, year = {2026}, author = {Habashy, NH}, title = {Antiviral potential of major royal jelly proteins.}, journal = {International journal of biological macromolecules}, volume = {339}, number = {Pt 1}, pages = {149884}, doi = {10.1016/j.ijbiomac.2025.149884}, pmid = {41448305}, issn = {1879-0003}, mesh = {*Antiviral Agents/pharmacology/chemistry ; Animals ; Humans ; *Fatty Acids/chemistry/pharmacology ; Bees/chemistry ; *Insect Proteins/pharmacology/chemistry ; Virus Replication/drug effects ; Molecular Docking Simulation ; SARS-CoV-2/drug effects ; Viruses/drug effects ; }, abstract = {Royal jelly (RJ), a honeybee secretion, contains nine distinct water-soluble proteins known as major RJ proteins (MRJPs). MRJPs are the primary constituents of RJ and have demonstrated significant potential as antiviral agents. MRJPs exhibit antiviral effects against various viruses, including HCV, HBV, HIV, and SARS-CoV-2. Previous research has indicated that MRJPs can interfere with viral replication by targeting specific stages of the viral life cycle, such as by inhibiting key enzymes, including RNA-dependent RNA polymerase and reverse transcriptase. They also block viral entry into host cells and influence immune responses. In addition to their direct antiviral actions, MRJPs exhibit antioxidant, anti-inflammatory, and immunomodulatory properties, further enhancing their therapeutic potential. Despite these promising preclinical findings, further mechanistic and translational investigations are required to validate and enhance the therapeutic potential of MRJPs. This review presents a narrative and systematic summary of the antiviral effects of MRJPs supplemented by original in silico docking analyses and highlights their potential as natural candidates for antiviral drug development.}, }
@article {pmid41449370, year = {2025}, author = {Onakpoya, IJ and Plüddemann, A and Rosca, EC and Gandini, S and Maltoni, S and Brassey, J and Jefferson, T and Heneghan, CJ and Evans, DH and Conly, JM}, title = {Viral cultures for assessing airborne infectiousness of SARS-CoV-2: a systematic review and meta-analysis.}, journal = {BMC infectious diseases}, volume = {26}, number = {1}, pages = {297}, pmid = {41449370}, issn = {1471-2334}, mesh = {*SARS-CoV-2/isolation & purification/pathogenicity/genetics ; Humans ; *COVID-19/virology/transmission ; *Air Microbiology ; *Virus Cultivation/methods ; }, abstract = {INTRODUCTION: There is uncertainty about the quantification, viability and infectivity of SARS-CoV-2 in air samples. Our objective was to systematically review the evidence for air sample virus infectiousness with high-level confirmatory studies.
METHODS: We conducted literature searches in LitCovid, medRxiv, PubMed, the WHO Covid-19 databases, and Google Scholar. We included studies that assessed viral infectiousness in the air using viral culture or serial qRT-PCR with or without genomic sequencing. Our primary outcome was the proportion of culture-positive air samples of SARS-CoV-2. Secondary outcomes explored the relationship between infectiousness and Cycle threshold (Ct). We used published methods for assessing quality, and R software for meta-analysis.
RESULTS: We included 26 studies that used viral culture to assess air sample positivity of SARS-CoV-2. The overall reporting quality was moderate. The overall pooled frequency of positive viral cultures was 14% (95% CI 7-17, I[2] = 52.3%; p = 0.001). The data were not sufficient to compute a threshold for infectivity, or to explore the relationship between distance and infectiousness.
CONCLUSIONS: The proportion of positive SARS-CoV-2 viral cultures following positive RNA samples in the air is low, suggesting that while viral RNA may be present, the likelihood of detecting culturable, infectious viruses is substantially lower. Our findings underscore the need for standardized guidelines to assess and report the infectivity and potential for transmissibility of airborne viruses, including the consistent reporting of Ct values and methods to mitigate bias.}, }
@article {pmid41449489, year = {2025}, author = {Jarzabek, J and Denny, PW}, title = {Molecular diagnostics for cutaneous leishmaniasis: progress towards fulfilling the WHO target product profile.}, journal = {Parasitology}, volume = {153}, number = {3}, pages = {1-19}, pmid = {41449489}, issn = {1469-8161}, abstract = {Recently, the WHO published a Target Product Profile for a diagnostic test for cutaneous leishmaniasis (CL) and a Roadmap to 2030 for Neglected Tropical Diseases. The documents highlight that existing diagnostic tools for CL are insufficient, whilst setting clear goals for improved sensitivity and reduced cost. The need for species typing in diagnostics is also becoming more pressing with the emergence of drug-resistance, especially of Leishmania tropica. Serological tests are unable to do this, while techniques that can, like PCR, require complex and expensive machinery. Isothermal assays like LAMP offer a promising solution, but more work also remains, as few species-specific LAMP assays have been developed thus far and CL in Ethiopia is particularly neglected. Additionally, since the COVID-19 pandemic, many cheap isothermal diagnostic devices have been produced, which have yet to be tested in the diagnosis of CL. Finally, artificial intelligence presents another avenue for rapid diagnosis by image analysis. In this comprehensive review, we examine the opportunities and challenges inherent to diagnostic development for CL, a priority undertaking that still faces many developmental hurdles.}, }
@article {pmid41449787, year = {2026}, author = {de Bruin, O and Maisonneuve, E and Hurley, E and Nordeng, HME and Bérard, A and Sheehy, O and Kaul, P and Shinde, MU and Cosgrove, A and Lyons, JG and Messenger-Jones, E and Kempner, ME and Toh, S and Hua, W and Hernández-Muñoz, JJ and Sahin, L and Cesta, CE and Hägg, D and Gini, R and Paoletti, O and Poblador-Plou, B and Jordan, S and Thayer, D and Rodríguez-Bernal, CL and Sánchez-Sáez, F and Lassalle, R and Bernard, MA and Alsina, E and Ahmadizar, F and Favre, G and Panchaud, A and Bloemenkamp, KWM and Plueschke, K and de Vries, C and Siiskonen, SJ and Sturkenboom, MCJM and , }, title = {Medications Used Among Nonhospitalized Pregnant Women With COVID-19: A Prospective Individual Patient Data Meta-Analysis in Europe and North America.}, journal = {Pharmacoepidemiology and drug safety}, volume = {35}, number = {1}, pages = {e70303}, pmid = {41449787}, issn = {1099-1557}, support = {EMA/2018/28/PE//European Medicines Agency (EMA)/ ; //Canadian Institutes of Health Research (CIHR)/ ; //Canada Foundation for Innovation (CFI)/ ; //U.S. Food and Drug Administration (FDA)/ ; }, mesh = {Humans ; Female ; Pregnancy ; Europe/epidemiology ; North America/epidemiology ; Prospective Studies ; *COVID-19/epidemiology ; *COVID-19 Drug Treatment ; *Pregnancy Complications, Infectious/drug therapy/epidemiology ; Adult ; SARS-CoV-2 ; }, abstract = {AIM: To estimate the prevalence of medication use in nonhospitalized pregnant women with COVID-19.
METHODS: A prospective two-stage individual patient meta-analysis across 10 data sources in Europe and North America studied medication use among nonhospitalized pregnant women with COVID-19 between January 2020 and December 2022. Comparisons were made between medication use within 30 days pre- and post-COVID-19 diagnosis in this cohort and two comparator groups: pregnant women without COVID-19 and nonpregnant women with COVID-19. Prevalence estimates were pooled using a random-effects model stratified by trimester.
RESULTS: 50 335 nonhospitalized pregnant women with COVID-19 were identified. The pooled prevalence of antibacterial use in the third trimester was higher post-COVID-19 diagnosis (6.8%, 95% confidence interval [CI] = 5.5-8.4, I[2] = 94%) compared with the same women pre-COVID-19 (3.9%, 95% CI = 3.1-4.9, I[2] = 89%). Overall, pregnant women with COVID-19 had higher medication use compared to pregnant women without COVID-19, although the CIs of the prevalence overlapped. Post-COVID-19, antithrombotic prevalence was 4.5% (95% CI = 1.1-16.5, I[2] = 100%) among pregnant women with COVID-19 in the third trimester, compared to 2.1% (95% CI = 1.2-3.6, I[2] = 99%) among those without COVID-19 in the third trimester. Compared to nonpregnant women with COVID-19, pregnant women with COVID-19 were less likely to be prescribed analgesics, antiprotozoals, corticosteroids, psychoanaleptics and psycholeptics, and more likely to be prescribed antithrombotics, cough and cold and nasal preparations, and drugs used in diabetes across all trimesters. High heterogeneity existed in nearly all analyses.
CONCLUSION: This international meta-analysis reveals low medication use and country-specific variations, enhancing insight into the management of COVID-19 in nonhospitalized pregnant women. Higher antithrombotic use post-COVID-19 suggests prophylactic treatment in this population, but variation between countries emphasizes the challenges of combining multinational data.}, }
@article {pmid41450139, year = {2026}, author = {Singh, E and Nishi, N and Tripathi, M and Prakash, K}, title = {SARS-CoV-2 Genome and S2 Spike Protein: IRF-Driven Interferon Regulation and Host Cell Responses.}, journal = {Reviews in medical virology}, volume = {36}, number = {1}, pages = {e70094}, doi = {10.1002/rmv.70094}, pmid = {41450139}, issn = {1099-1654}, mesh = {Humans ; *Spike Glycoprotein, Coronavirus/genetics/immunology/metabolism ; *SARS-CoV-2/genetics/immunology/pathogenicity ; *COVID-19/immunology/virology ; *Interferon Regulatory Factor-1/genetics/immunology ; Animals ; *Interferons/immunology ; Genome, Viral ; *Interferon Regulatory Factor-2/genetics/immunology ; Angiotensin-Converting Enzyme 2/genetics ; Host-Pathogen Interactions/immunology ; Virus Internalization ; *Interferon Regulatory Factors/immunology/genetics ; }, abstract = {Coronaviruses, members of the betacoronavirus genus. They are mostly enveloped and has +ve sense RNA which infects a wide range of hosts, including mammals and birds. This SARS-CoV-2 in December 2019 triggered a global pandemic, with transmission primarily occurring through respiratory droplets. SARS-CoV-2 comprises four structural proteins namely: spike, membrane, envelope and nucleocapsid protein (S, M, E, and N respectively) along with multiple non-structural proteins (nsp1-nsp16) essential for infections. The trimeric S protein, composed of S1 and S2 subunits which helps in virus entry into the cell after attachment to the ACE2 recpetor of host cell. Interferon regulatory factors (IRF-1 and IRF-2) are critical transcription factors in antiviral immune responses, yet their specific roles in SARS-CoV-2 infection remain insufficiently understood. Disruption of their regulatory functions may compromise host antiviral defenses and influence disease progression. Elucidating the mechanistic roles of IRF-1 and IRF-2 could facilitate the production of novel therapeutic strategies which further modulates the immune responses, mitigates the viral pathogenicity, and hence clinical outcomes will be improved. A deep insight of these immune pathways is pivotal for designing targeted interventions to strengthen host resilience against coronavirus infections.}, }
@article {pmid41450491, year = {2025}, author = {Mukherjee, D and Sagar, K and Kobialka, RM and Ghosh, P and Weidmann, M and Savareh, BA and Joardar, SN and Truyen, U and Abd El Wahed, A and Ceruti, A}, title = {Filling the gap: artificial intelligence-driven one health integration to strengthen pandemic preparedness in resource-limited settings.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1707306}, pmid = {41450491}, issn = {2296-2565}, mesh = {Humans ; *Artificial Intelligence ; *Pandemics/prevention & control ; *One Health ; COVID-19/epidemiology ; *Developing Countries ; Health Resources ; Resource-Limited Settings ; Pandemic Preparedness ; }, abstract = {Emerging zoonotic pathogens like SARS-CoV-2 and Nipah virus demonstrate the critical need for integrated surveillance systems connecting human, animal, and environmental health. This review examines how artificial intelligence can address One Health integration gaps in pandemic surveillance, focusing on resource-limited settings. While global digitization levels now support Artificial Intelligence (AI)-powered platforms, LMICs face barriers including limited resources and fragmented data systems. Current AI tools remain domain-specific and designed for high-income settings, limiting its applicability to pandemic preparedness in low-resource settings. Existing AI-tools and gaps are described and put into perspective within an AI-driven One Health framework, specifically for LMICs. The framework exemplifies resource optimization, governance, sectoral collaboration, capacity building, health system integration, geographic accessibility, and prioritization. The framework also features an exemplified dual solution combining Graph Neural Networks for integrated risk assessment with offline-first mobile applications for community surveillance. AI technologies offer substantial potential for pandemic preparedness through automated data harmonization, predictive modeling, and resource optimization. However, successful implementation requires concurrent digitization, cultural adaptation, and local capacity building. Prioritizing mobile solutions with minimal infrastructure requirements alongside community engagement will be essential for creating equitable AI-based surveillance systems in LMICs.}, }
@article {pmid41450745, year = {2025}, author = {Putra, BA}, title = {Digital Technologies in a Post-Pandemic Southeast Asia: Measures for Enhancing Regional Approaches.}, journal = {F1000Research}, volume = {14}, number = {}, pages = {623}, pmid = {41450745}, issn = {2046-1402}, mesh = {Asia, Southeastern/epidemiology ; Humans ; *Telemedicine ; *Digital Technology ; *Pandemics ; *COVID-19/epidemiology ; Health Policy ; }, abstract = {The Association of Southeast Asian Nations (ASEAN) has taken some measures to advance collective action to accelerate telehealth in the region. Still, it has encountered the problem of digital readiness and digital health preparedness disparities within the region. To maintain the consolidation of digital health utilization across ASEAN member states, this article offers policy recommendations to address the diverse approaches taken and compensate for capacity differences among members. Drawing on insights from published official policies, government health ministry websites of Southeast Asian nations, and ASEAN's digital health policies, the article first reviews the diversities of digital technologies in a post-pandemic Southeast Asia and then assesses measures to enhance regional approaches. Several recommendations are presented: First, ASEAN can standardize regional frameworks for telehealth by sharing digital health transformation blueprints and leveraging ASEAN and ASEAN Plus forums to bridge divergent understandings and advance the region's digital health initiatives. Second, ASEAN facilitates investment through a telehealth sandbox and fosters collaboration among stakeholders. Although the recommendations are consistent with the 'ASEAN Way,' lingering concerns in Southeast Asia's telehealth landscape include different commitments and expectations, risks of privacy infringements, and the misuse of technology in the region's authoritarian states.}, }
@article {pmid41451228, year = {2025}, author = {Galvan, C and Ovsyannikova, IG and Kennedy, RB}, title = {Glycosylation as a strategic mechanism for measles virus and mumps virus immune evasion.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1716829}, pmid = {41451228}, issn = {1664-3224}, mesh = {Glycosylation ; *Measles virus/immunology ; *Mumps virus/immunology ; Humans ; *Immune Evasion ; *Mumps/immunology/virology ; *Measles/immunology/virology ; Animals ; }, abstract = {Glycosylation of viral surface proteins by host cell factors is one strategy paramyxoviruses employ to evade the host's immune system during infection. Viral glycosylation thus has the potential for innate and adaptive immune modulation. However, an adequate assessment of the effects glycosylation has on immune recognition and response for two important paramyxoviruses, Measles virus (MeV) and Mumps virus (MuV), is lacking. This review aims to provide a comparison of epitope-site sequence changes in the surface glycoproteins MeV-H, MeV-F, MuV-HN, and MuV-F across different wild type and vaccine strains of measles and mumps. Such changes may alter glycosylation patterns at antigenic sites, thus altering the virus' efficiency to induce an immune response as well. Further investigation of measles and mumps viral glycosylation studies will aid the development of specific therapeutics that modulate viral glycosylation during immune diseases, viral infections, and oncolytic treatments. Moreover, determining how glycosylation affects measles and mumps immune responses may pave the way for the development of novel vaccine strains for the improved immunogenicity and immune durability of measles and mumps vaccines.}, }
@article {pmid41451231, year = {2025}, author = {Tamura, M and Yagi, Y and Hanayama, S and Yoshizaki, S and Shibuya, K and Masuda, H and Mori, M}, title = {MRI-negative myelitis, especially after COVID-19: a case report and literature review.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1708018}, pmid = {41451231}, issn = {1664-3224}, mesh = {Humans ; Female ; *COVID-19/complications ; Magnetic Resonance Imaging ; Young Adult ; SARS-CoV-2 ; *Myelitis/therapy/diagnostic imaging/etiology/diagnosis ; Methylprednisolone/therapeutic use/administration & dosage ; Evoked Potentials, Somatosensory ; Plasma Exchange ; Spinal Cord/diagnostic imaging ; Betacoronavirus ; }, abstract = {BACKGROUND: Neurological sequelae of coronavirus disease 2019 (COVID-19) include inflammatory myelopathies. Among these, magnetic resonance imaging (MRI)-negative myelitis- defined as normal spinal cord MRI findings despite compatible clinical features-presents diagnostic and therapeutic challenges.
CASE PRESENTATION: A 22-year-old Japanese woman developed progressive distal paresthesia, gait disturbance, bladder and rectal dysfunction, and sensory loss approximately three months after COVID-19. Neurological examination presented with pyramidal tract signs and sensory deficits in both lower limbs. Cerebrospinal fluid oligoclonal bands were positive. Brain MRI showed subtle corticospinal tract hyperintensities, whereas spinal MRI findings remained normal throughout the course. Somatosensory-evoked potentials (SEP) demonstrated absent right N20 and bilateral P37 responses, localizing dysfunction to the thoracic cord. Treatment with intravenous methylprednisolone pulse therapy with plasma exchange resulted in marked clinical recovery and SEP normalization, with only mild residual paresthesia at two-year follow-up.
DISCUSSION: The present case illustrates the clinical utility of SEPs for monitoring disease activity and establishing objective criteria for treatment escalation in post-COVID-19 MRI-negative myelitis. Although MRI-negative myelitis can be observed in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), lupus myelitis, and glial fibrillary acidic protein (GFAP) astrocytopathy, post-COVID-19 myelitis lacks specific biomarkers, complicating both diagnosis and treatment. A review of 20 reported cases of post-COVID-19 MRI-negative myelitis revealed a mean age of 54.4 years, a male-to-female ratio of 3:2, frequent bladder and rectal disturbances and paresis (85% each), high severity (63.2%), a median infection-to-neurological interval of 28 days, oligoclonal bands in 25% (4/16), multiple immunotherapies in 66.7%, and marked improvement or recovery in 66.7%.
CONCLUSION: In post-COVID-19 MRI-negative myelitis, SEPs offer critical diagnostic and prognostic information. Early recognition and timely escalation of combination immunotherapy may optimize neurological outcomes.}, }
@article {pmid41451353, year = {2025}, author = {Chaudhary, V and Bhadola, P}, title = {Artificial Intelligence-Powered Nanosensor Platforms for Non-Invasive Breathomic Diagnostics.}, journal = {Nanotechnology, science and applications}, volume = {18}, number = {}, pages = {611-641}, pmid = {41451353}, issn = {1177-8903}, abstract = {Global healthcare settings are increasingly burdened by critical diseases, where conventional diagnostics are often expensive, invasive, time-consuming and centralised. It creates a critical gap for rapid, accessible, portable and non-invasive health assessment. AI-powered Nanosensors for Breathomics Diagnostics (AND) platforms have emerged as a transformative solution to this complex global problem, integrating highly sensitive nanomaterials with advanced machine intelligence to detect disease biomarkers in exhaled breath. These platforms have already demonstrated high performance, with reports of 90-95% diagnostic accuracy for conditions such as lung cancer and achieving sub-ppb detection limits. These platforms are not limited to controlled laboratory settings but have been employed to monitor a spectrum of diseases, including cancer, asthma, diabetes, coronavirus disease, and renal failure. Their integration into wearable systems, smartphones, smart masks and multimodal laboratory systems further extends their applications in predictive analytics, personalised medicine and real-time human-machine interaction. However, challenges related to data standardisation, sensor selectivity, ethical AI, and clinical validation have limited their commercialization. It necessitates solutions such as Explainable AI, physics-informed modelling, network theory, and the development of large-scale clinical breath databases to enhance clinical reliability, model robustness, diagnose sensor drift, and attain transparency. This article critically details the recent progress and charts a new path forward for translating AND platforms from research to clinical reality as next-generation healthcare.}, }
@article {pmid41452424, year = {2025}, author = {Tzang, CC and Sheng, H and Kuo, VF and Luo, CA and Lin, TA and Lee, YT and Huang, ES and Wu, PH and Tzang, BS and Hsu, TC}, title = {Association between COVID-19 and New-Onset Autoimmune Diseases: Updated Systematic Review and Meta-Analysis of 97 Million Individuals.}, journal = {Clinical reviews in allergy & immunology}, volume = {68}, number = {1}, pages = {111}, pmid = {41452424}, issn = {1559-0267}, mesh = {Humans ; *Autoimmune Diseases/epidemiology/immunology/etiology ; *COVID-19/epidemiology/immunology/complications ; Risk Factors ; }, abstract = {SARS-CoV-2 infection may induce long-term immune dysregulation; however, its contribution to the development of autoimmune disease remains disputed. We aim to quantify the relative risk of new-onset autoimmune diseases following COVID-19 and its modifiers through a systematic review and meta-analysis of population-based cohort studies. MEDLINE, Embase, Cochrane Library, and Web of Science were searched to March 31, 2025, for cohort studies comparing individuals with and without confirmed COVID-19. Random-effects meta-analysis estimated pooled hazard ratios (HRs) with 95% CIs. Subgroup analyses examined the severity of acute COVID-19, vaccination status, and demographics. Risk of bias was evaluated with the Newcastle-Ottawa Scale, certainty of evidence with GRADE, and publication bias with funnel plots and Egger's test. The review protocol was prospectively registered in PROSPERO (CRD42025646186). Seventeen cohort studies, including over 250 million person-years, were included. COVID-19 was associated with a 49% increased risk of new-onset autoimmune-related diseases (AIRD; HR = 1.49, 95% CI: 1.21-1.83; p = 0.0002). Significant associations (p < 0·05) were observed for 17 of 23 outcomes, with the strongest risks in antiphospholipid syndrome (HR = 2·16), ANCA-associated vasculitis (HR = 2·15), mixed connective tissue disease (HR = 2·12), and immune thrombocytopenic purpura (HR = 1·87). Risk was higher after severe infection (HR = 1.70), but was reduced in vaccinated individuals (HR = 0.56, compared to 1.42 in unvaccinated individuals). The certainty of evidence was moderate for conditions with large effect sizes, but low overall, reflecting heterogeneity across studies and the non-randomized design of the included studies. SARS-CoV-2 infection increases the risk of autoimmune diseases, particularly those affecting vascular and connective tissue. Risk is amplified by severe infection and attenuated by vaccination. These findings highlight the necessity of vaccination and targeted follow-up in severe COVID survivors.}, }
@article {pmid41452653, year = {2026}, author = {Agorsor, PI and Eze, MO}, title = {Early Detection of Infectious Diseases: A Review of Recent Advances in Pathogen Identification, Molecular Tools, and Metabolomics-Driven Biomarker Discovery.}, journal = {Journal of proteome research}, volume = {25}, number = {2}, pages = {525-538}, doi = {10.1021/acs.jproteome.5c01014}, pmid = {41452653}, issn = {1535-3907}, mesh = {Humans ; *Metabolomics/methods ; Biomarkers/analysis/metabolism ; *COVID-19/diagnosis/virology/metabolism ; SARS-CoV-2/isolation & purification ; Early Diagnosis ; *Communicable Diseases/diagnosis/metabolism ; Mass Spectrometry/methods ; Gas Chromatography-Mass Spectrometry/methods ; Chromatography, Liquid ; }, abstract = {The recent COVID-19 pandemic has heightened public interest in noninvasive methods for early diagnosis of infectious diseases. In addition, various government agencies have implemented "infectious disease preparedness" to mitigate future outbreaks. This review highlights conventional and advanced methods for infectious disease diagnosis with an emphasis on emerging mass spectrometry methods. Conventional methods for pathogen identification, such as culture-based techniques and molecular methods, have limitations with respect to sensitivity, specificity, and turnaround time. Recent advances in high-resolution mass spectrometry have revolutionized the field of infectious disease biomarker discovery. These techniques enable the comprehensive profiling of metabolites in various biological samples, identification of disease-specific biomarkers, and elucidation of complex host-pathogen interactions. While liquid chromatography-mass spectrometry has been extensively used to identify metabolic alterations in diseases, such as COVID-19, tuberculosis, pneumonia, and influenza, this often requires the use of body fluids. On the other hand, advances in gas chromatography-high resolution mass spectrometry are enabling noninvasive detection of infectious diseases by means of breath-based volatile organic compounds. These methods offer high sensitivity and specificity, enabling the detection of low-abundance biomolecules and the elucidation of complex biological pathways. This review further examines the limitations of each approach while emphasizing the essential applications of metabolomics in infectious disease diagnosis.}, }
@article {pmid41454589, year = {2025}, author = {Gillespie, LK and Richards, TN and Whitehouse, E}, title = {Remote and Hybrid Work in Crime Victim Services: A Scoping Review.}, journal = {Trauma, violence & abuse}, volume = {}, number = {}, pages = {15248380251397414}, doi = {10.1177/15248380251397414}, pmid = {41454589}, issn = {1552-8324}, abstract = {Remote and hybrid options for crime victim services grew slowly during the late 20th and early 21st centuries, followed by rapid expansion on the heels of the COVID-19 pandemic. While there has been significant focus on remote work in other sectors such as healthcare and tech industries, there have been no scoping reviews on remote service delivery in crime victim services. Using the PRISMA-ScR framework for scoping reviews, we identified 27 studies on remote or hybrid services in victim service agencies that met our inclusion criteria (empirical studies on remote and/or hybrid work in community- and/or systems-based victim service agencies, written in English). Studies were examined regarding the (a) methods and data used in empirical studies; (b) provider-level and client-level challenges and benefits; and (c) recommendations. Findings show that most studies were exploratory or descriptive in nature, collected qualitative data from service providers, and were conducted, at least in part, to learn about the impact of the COVID-19 pandemic. Common provider-level challenges included technological barriers, concerns about the security of online services, and the development of rapport with clients virtually, while strengths included personal-professional flexibility, new collaborations, and work productivity/efficiency. Client-level challenges included technology access, digital literacy, and confidentiality and safety concerns, while strengths included increased access to services, reduced cost, and increased anonymity of online services. Results suggest that we need additional, rigorous evaluation research to understand how processes and outcomes differ between remote and in-person services for crime victims and victim service providers.}, }
@article {pmid41454642, year = {2026}, author = {Yüksekol, A and Kaplan Serin, E}, title = {Technology in pandemic period and future nursing practices: a literature review.}, journal = {Hospital topics}, volume = {104}, number = {2}, pages = {208-216}, doi = {10.1080/00185868.2025.2604713}, pmid = {41454642}, issn = {1939-9278}, mesh = {Humans ; COVID-19 ; *Digital Health ; Pandemics ; Robotics/trends ; *Nursing/trends ; }, abstract = {Rapid advancements in science and technology have led to intense yet often hidden competition across various fields. Innovations in the technologies used within healthcare services both influence and are influenced by the nursing profession and its practices. These technological developments help create new roles, support nurses in fulfilling their responsibilities, and enable the delivery of more efficient and safer patient care. To meet the demands of the future, nurses must adapt to emerging technologies and provide evidence-based care using these innovations. For instance, future gerontological nurses may act as care supervisors, overseeing robots tasked with monitoring vital signs, checking blood glucose levels, detecting pressure ulcers, or assessing fall risks. While technological advancements may reduce the demand for nursing labor, they also offer protective benefits. During the COVID-19 pandemic, the use of humanoid robots helped minimize the exposure of healthcare workers, including nurses, to the virus-thus reducing physical contact while maintaining essential care. In Wuhan, where the outbreak was first reported, robots were employed to perform tasks traditionally carried out by healthcare professionals, such as taking oral swabs, conducting basic diagnostics (e.g., using ultrasound or stethoscopes), cleaning and disinfecting patients, administering medications, delivering meals, and monitoring vital signs and body temperature. Despite a potential decrease in the number of nurses required for routine procedures, the demand for professional nurses to manage complex tasks and provide emotional care will increase. Therefore, this study aims not only to inform readers about the impact of technology on nursing practice and the profession but also to support future research in this area. To adequately prepare the nurses of tomorrow, it is essential for nurse educators, administrators, and students both undergraduate and graduate to embrace technology and actively work to expand their knowledge. Enhancing technological literacy is critical to ensuring competent and future-ready nursing professionals.}, }
@article {pmid41454648, year = {2026}, author = {Montiel-Nava, C and Montenegro, MC and Ramirez, AC and Villarreal, V and Murillo Chacko, L and Dixon, P and Dababnah, S}, title = {Scoping review: Facilitators, barriers, and cultural adaptations in the caregiver skills training program for children with developmental concerns.}, journal = {Autism : the international journal of research and practice}, volume = {30}, number = {3}, pages = {668-681}, pmid = {41454648}, issn = {1461-7005}, mesh = {Humans ; *Caregivers/education ; Child ; *Developmental Disabilities/therapy ; }, abstract = {Autism interventions are predominantly developed in high-income countries, limiting access for families in low- and middle-income countries due to systemic, cultural, and logistical barriers. The Caregiver Skills Training program aims to address this disparity by equipping caregivers with practical skills. This scoping review examines the cultural adaptations, facilitators, and barriers to the implementation of Caregiver Skills Training, focusing on its accessibility, feasibility, and acceptability. A comprehensive search of ERIC, PsycINFO, PubMed, and Web of Science identified eligible studies that reported cultural or linguistic adaptations of Caregiver Skills Training. Forward searches and manual reference checks supplemented the review. Data were extracted using the Cultural Adaptation Checklist framework and analyzed for patterns in adaptation, training, barriers, and facilitators. Seventeen studies across Asia, Africa, Europe, and North America highlighted diverse adaptations in language, content, and delivery methods. Facilitators included community partnerships and task-shifting with non-specialists, while barriers involved logistical challenges, stigma, and resource constraints. Caregiver Skills Training's flexible, culturally responsive framework makes it a viable model for scaling autism interventions globally. Tailored adaptations and strong support systems for facilitators are essential to overcoming systemic challenges and ensuring equitable access in low- and middle-income countries.Lay abstractHow the Caregiver Skills Training Program Helps Families WorldwideThe Caregiver Skills Training program was designed to help families of children with autism and other developmental challenges in low-resource settings. Caregiver Skills Training empowers parents and caregivers by teaching them practical strategies to improve their child's communication, social interaction, and daily living skills. This program is unique because it does not require a formal diagnosis and is designed to be delivered by trained non-specialists, such as community health workers. A review of 17 studies from different countries examined how the Caregiver Skills Training program was adapted to fit the cultural and practical needs of families in each region. For example, materials were translated, simplified, and paired with visual aids to help parents with lower literacy levels. Non-specialist facilitators helped make the program more accessible, and online or hybrid delivery methods increased participation during the COVID-19 pandemic. However, challenges remain. Families often face barriers like limited transportation, stigma, and lack of Internet access, which can prevent them from fully participating in the program. Facilitators also need more training and support to maintain program quality. Despite these obstacles, Caregiver Skills Training shows promise as a global solution to bridge the gap in autism care, especially in underserved communities. This review highlights the importance of adapting programs like Caregiver Skills Training to meet the unique needs of families worldwide, ensuring that every child has the opportunity to thrive, regardless of where they live.}, }
@article {pmid41454696, year = {2026}, author = {Yang, XM and Bian, H and Chen, ZN}, title = {CD147/Basigin: From Integrative Molecular Hub to Translational Therapeutic Target.}, journal = {Advanced science (Weinheim, Baden-Wurttemberg, Germany)}, volume = {13}, number = {8}, pages = {e18884}, pmid = {41454696}, issn = {2198-3844}, support = {92169211//National Natural Science Foundation of China/ ; 82130084//National Natural Science Foundation of China/ ; 2023-JC-YB-166//Shaanxi Natural Science Foundation/ ; }, mesh = {*Basigin/metabolism/genetics/chemistry ; Humans ; Neoplasms/metabolism ; COVID-19/metabolism ; Animals ; SARS-CoV-2 ; Epithelial-Mesenchymal Transition ; }, abstract = {CD147 (Basigin/EMMPRIN), a multifunctional member of the immunoglobulin superfamily (IgSF), is a critical regulator of tumor progression, immune modulation, and metabolic adaptation. Under physiological conditions, it acts as a dynamic scaffold, interacting with monocarboxylate transporters (MCTs), integrins, and cyclophilin A (CyPA) to orchestrate spermatogenesis, embryo implantation, and neural network function. Pathological overexpression of CD147 induces the secretion of matrix metalloproteinases (MMPs), epithelial-mesenchymal transition (EMT), metabolic reprogramming, and immune evasion, functioning as an independent prognostic biomarker in multiple malignancies. Beyond oncology, CD147 is exploited as an entry receptor for pathogens, including SARS‑CoV‑2, HIV‑1, Plasmodium falciparum, and contributes mechanistically to cardiovascular, autoimmune, and neurodegenerative diseases. Notably, CD147 acts as a fundamental "Energy-Structure Coupler," coordinating metabolic flux (via MCTs) with morphogenetic plasticity (via integrins/MMPs) to maintain cellular homeostasis. This review summarizes current insights into CD147's molecular structure, isoforms, post-translational modifications, and signaling pathways, highlighting its pivotal roles across cancer, infection, autoimmunity, and cardiovascular disease. Finally, we discuss challenges such as the "specificity paradox" and propose emerging strategies to exploit CD147 as a precision biomarker and therapeutic target across diverse diseases.}, }
@article {pmid41455394, year = {2026}, author = {Reid, JC and Semrau, JS and O'Grady, HK and Hoogenes, J and Gill, J and Hasan, H and von Teichman, S and Bogdanova, Y and McKenney, S and Sokol, O and Pereira, TJ and Dannenberg, VC and Farley, C and Junior, JC and Deis, A and Williamson, D and Herridge, M and Kho, M}, title = {Rehabilitation in critically ill patients with COVID-19 infection: A systematic review and meta-analysis.}, journal = {Australian critical care : official journal of the Confederation of Australian Critical Care Nurses}, volume = {39}, number = {1}, pages = {101500}, doi = {10.1016/j.aucc.2025.101500}, pmid = {41455394}, issn = {1036-7314}, mesh = {Humans ; *Critical Illness/rehabilitation ; *COVID-19/rehabilitation ; Intensive Care Units ; }, abstract = {INTRODUCTION: Before the pandemic, intensive care unit rehabilitation was common. However, for critically ill patients with COVID-19 infection, rehabilitation became secondary to lifesaving measures and managing scarce resources.
OBJECTIVE: In this systematic review, we investigated the impact of rehabilitation for critically ill adults with COVID-19 infection on outcomes.
DATA SOURCES: Five electronic databases from 2020 to 2024 were searched for this study.
STUDY SELECTION: Randomised controlled trials (RCTs) and nonrandomised studies of critically ill adults with COVID-19 infection receiving in-hospital rehabilitation interventions were included in this study.
DATA EXTRACTION AND SYNTHESIS: Two independent reviewers screened titles/abstracts and full texts. Intervention types were organised into 13 categories. We assessed completeness of study reporting using the Strengthening the Reporting of Observational Studies in Epidemiology guidelines and intervention reporting using the Consensus on Exercise Reporting Template. For RCTs, we assessed risk of bias, conducted meta-analyses using random-effect models, and evaluated certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach.
MAIN OUTCOMES AND MEASURES: There were 11 prespecified outcomes including physical function and resource utilisation.
RESULTS: Sixty-eight studies (n = 50 observational, 8 RCTs, 4 experimental non-RCTs, and 6 other designs) enrolling 23,630 participants met inclusion criteria. Thirty-one reported interventions; mobility was the most common activity (74% of studies). Authors used 87 outcome measures at 57 reported time points. Strengthening the Reporting of Observational Studies in Epidemiology scores were adequate with >75% items reported. Mean Consensus on Exercise Reporting Template reporting for intervention (n = 45) was moderate (54% [23%]), and that for control groups (n = 11) was poor (48% [20%]). Risk of bias was low; very-low-certainty evidence showed that multidisciplinary functional and respiratory rehabilitation and bed cycling + tilt table may result in shorter duration of mechanical ventilation (2 RCTs, n = 116, intervention = 9.1 days, control = 11.7 days; standardised mean difference: 0.44 days [95% confidence interval: -0.81 to-0.07]) and shorter hospital length of stay (three RCTs, n = 116, intervention = 17.6-days, control = 26.2-days; standardised mean difference: 2 days [95% confidence interval: -4.22 to 0.04]).
CONCLUSIONS AND RELEVANCE: Based on very-low-certainty evidence, rehabilitation may lead to shorter mechanical ventilation duration and hospital length of stay. Substantial heterogeneity across interventions, outcomes, and time points limited evidence synthesis. This review may aid in planning future rehabilitation studies with critically ill patients and for future pandemics where rehabilitation will have an important role.
PROSPERO REGISTRATION: CRD42023340256.}, }
@article {pmid41455447, year = {2026}, author = {Albertson, FA and Alnakhi, W and Barksdale, S and Taylor, SS and Criss, S and Friedman, DB and Kemper, KA and Donelle, L and Thompson, W and MacGilvray, P and Natafgi, N}, title = {Teach-back techniques in telehealth: A review and insights for future directions.}, journal = {Patient education and counseling}, volume = {144}, number = {}, pages = {109453}, doi = {10.1016/j.pec.2025.109453}, pmid = {41455447}, issn = {1873-5134}, mesh = {Humans ; *Telemedicine ; *COVID-19 ; *Communication ; SARS-CoV-2 ; *Patient Education as Topic/methods ; Pandemics ; }, abstract = {BACKGROUND AND OBJECTIVES: The rapid expansion of telehealth during the COVID-19 pandemic has created new challenges in patient-provider communication due to the absence of in-person interactions and visual cues. Teach-back, a method where patients repeat information to confirm understanding, is a promising tool for improving communication in virtual care. This review evaluates the effectiveness of teach-back techniques in telehealth settings.
METHODS: A search of four databases (CINAHL, EMBASE, PsycINFO, PubMed) was conducted, yielding 10 studies that met the inclusion criteria. The article inclusion/exclusion criteria consisted of the following: (1) telehealth services topic; (2) direction provision related to teach-back; and (3) English, peer-reviewed, empirical journal publication. Risk of bias in included studies was assessed using established tools for randomized controlled trials (RCTs), non-randomized controlled trials (NRCTs), and qualitative studies. Data synthesis followed the PICO framework, and thematic analysis was used to compare outcomes across studies.
RESULTS: Included studies which varied in design, modality, and telehealth specialty. Teach-back was consistently associated with improved patient knowledge, confidence, and self-management, as well as clinical outcomes such as better glycemic control and medication adherence. Overall evidence quality was moderate, with common limitations including small sample sizes and brief follow-up periods.
Teach-back is effective in enhancing patient understanding and outcomes in telehealth settings. However, variability in study design and implementation highlights the need for standardized protocols and additional research. Provider training in effective virtual teach-back strategies may enhance patient comprehension, strengthen communication, and advance health equity in telehealth delivery.}, }
@article {pmid41455627, year = {2026}, author = {Yasuda, H and Ando, J and Ando, M}, title = {Persistent COVID-19 in Patients With Hematological Malignancies: A Focused Review in the Omicron Era.}, journal = {Clinical lymphoma, myeloma & leukemia}, volume = {26}, number = {3}, pages = {e385-e396}, doi = {10.1016/j.clml.2025.11.009}, pmid = {41455627}, issn = {2152-2669}, mesh = {Humans ; *COVID-19/therapy/epidemiology/complications/diagnosis ; *Hematologic Neoplasms/complications/therapy ; *SARS-CoV-2 ; COVID-19 Vaccines ; Antiviral Agents/therapeutic use ; }, abstract = {COVID-19 is a threat to patients with hematological malignancies (HM) even in the Omicron era, because mortality rates are still high in HM patients, and a significant number of patients develop a protracted disease course called "persistent COVID-19 (pCOVID-19)" which can continue for weeks to months. pCOVID-19 can be life-threatening by itself, but also drastically affects the disease course of the underlying HM by delaying or terminating chemotherapy. Also, patients with pCOVID-19 can be potentially contagious, and timing of ending isolation is a dilemma the hematology ward faces. Furthermore, pCOVID-19 has been reported to lead to acquisition of SARS-CoV-2 multidrug-resistant mutations, which is an alarming issue for both the patient and public health. The optimal management method of pCOVID-19 is currently unknown, and because HM patients are excluded from randomized clinical trials, evidence is limited to case reports and small case series. We carried out a comprehensive literature review of Omicron pCOVID-19 occurring in HM patients, compiled the scattered evidence, and provide practical recommendations which can be of guide to clinicians. Main topics discussed within this review include efficacy of vaccinations in HM patients, risk factors for developing pCOVID-19 (B-cell depleting agents, bendamustine + rituximab therapy, bispecific T-cell engagers, etc.), treatment of pCOVID-19 including extended/sequential/combination therapy incorporating antivirals (nirmatrelvir/ritonavir, remdesivir, molnupiravir, and ensitrelvir) and convalescent plasma/intravenous immunoglobulin therapy, monitoring pCOVID-19 with reverse transcription (RT)-PCR, and optimal target cycle threshold values as goals of therapy.}, }
@article {pmid41456509, year = {2026}, author = {Lopez-Villalba, B and Tortosa, F and Castrodeza-Sanz, J and Prada, C and Sued, O}, title = {Systematic review and meta-analysis of respiratory virus infections in HIV-positive and HIV-negative patients.}, journal = {Diagnostic microbiology and infectious disease}, volume = {114}, number = {3}, pages = {117238}, doi = {10.1016/j.diagmicrobio.2025.117238}, pmid = {41456509}, issn = {1879-0070}, mesh = {Humans ; *HIV Infections/complications/virology ; *Respiratory Tract Infections/virology/mortality/epidemiology/complications ; Hospitalization/statistics & numerical data ; Hospital Mortality ; Coinfection/virology ; *Virus Diseases/mortality/virology/epidemiology ; }, abstract = {BACKGROUND: Respiratory virus infections are a major cause of morbidity and mortality globally, particularly among people living with HIV.
OBJECTIVES: To evaluate the impact of respiratory virus infections on clinical outcomes in HIV-positive individuals compared with HIV-negative individuals.
STUDY DESIGN: We conducted a systematic review and meta-analysis of 19 studies comparing HIV-positive and HIV-negative individuals infected with common respiratory viruses (excluding SARS-CoV-2).
RESULTS: HIV-positive individuals had significantly higher odds of in-hospital mortality, prolonged hospitalization, and antibiotic use at admission. No significant differences were observed in intensive care unit admission, initial hospitalization, mechanical ventilation, or oxygen therapy. The most severe outcomes were associated with adenovirus, respiratory syncytial virus, and influenza. The certainty of evidence was moderate but limited by study heterogeneity and risk of bias.
CONCLUSIONS: These findings underscore the need for improved diagnostic tools, infection control strategies, and tailored clinical management for HIV-positive populations. Further prospective, multicenter studies are essential to inform evidence-based guidelines in both high- and low-resource settings.}, }
@article {pmid41456955, year = {2025}, author = {Hao, H and Chen, D and Qian, C and Zhou, X and Peng, X and Wang, G and Tang, J and Liu, HX}, title = {Immune Inflammation at the Crossroads of Atherosclerosis and Ischemic Stroke: Mechanisms, Trends, and Translational Perspectives.}, journal = {CNS neuroscience & therapeutics}, volume = {31}, number = {12}, pages = {e70712}, pmid = {41456955}, issn = {1755-5949}, support = {2024PY-NS-027//the National Natural Science Foundation of China Cultivation Project/ ; 2024ZYYC113//National Administration of Traditional Chinese Medicine/ ; }, mesh = {Humans ; *Ischemic Stroke/immunology ; *Atherosclerosis/immunology ; *Inflammation/immunology ; *Translational Research, Biomedical/trends ; Animals ; }, abstract = {BACKGROUND: Atherosclerosis is a chronic inflammatory disorder and a major cause of ischemic stroke. Immune-mediated mechanisms are increasingly recognized as central in this continuum, yet the global research landscape and its clinical translation remain insufficiently characterized.
METHODS: We conducted a multi-level bibliometric analysis using the Web of Science Core Collection and MEDLINE. Searches targeted atherosclerosis, ischemic stroke, and immunity, restricted to English-language articles and reviews. After screening, 1760 WoSCC records and 708 human-only MEDLINE articles were analyzed with VOSviewer, CiteSpace, and Bibliometrix. Comparative assessment between China and the United States examined differences in research output, thematic focus, and methodological orientation.
RESULTS: Global publications rose steadily from 1999 to 2025, peaking in 2022. Inflammation, atherosclerosis, and ischemic stroke were the dominant themes, with growing interest in causal inference (e.g., Mendelian randomization) and translational biomarkers. China showed rapid post-2015 growth with focus on immune-cell mechanisms, while the United States maintained leadership in scholarly impact, clinical orientation, and collaboration. Human-only studies confirmed these patterns and highlighted emerging topics such as microRNAs, COVID-19, insulin resistance, and lipoprotein(a).
CONCLUSIONS: Research has shifted from associative links to mechanistic insights and early translational strategies. However, gaps remain between molecular and clinical domains, and causal pathways are underdeveloped. Future work should emphasize molecular-clinical integration, expand immunological targets, apply multi-omics and AI approaches, and strengthen international collaboration-particularly between China and the United States-to advance precision prevention and intervention in atherosclerotic ischemic stroke.}, }
@article {pmid41458164, year = {2025}, author = {Richardson, T and Ashworth, S and Sood, M and McKell, E and Maguire, N and Alwan, NA and Smith, D}, title = {The relationship between financial disruption during the COVID-19 pandemic and mental health: A systematic review and meta-analysis.}, journal = {Journal of public health research}, volume = {14}, number = {4}, pages = {22799036251395263}, pmid = {41458164}, issn = {2279-9028}, abstract = {OBJECTIVE: Financial difficulties are associated with poor mental health. This paper aimed to systematically review the impact of COVID-19 related financial difficulties on mental health in adults.
METHODS: A systematic search was conducted across Web of Science, Medline, and PsycINFO, from March 2020 to March 2023 to identify studies examining the mental health impact of COVID-19 related financial disruption in adults. We performed two meta-analyses to quantify the effect of income loss due to the pandemic on anxiety and depression. Studies were rated using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies from the National Heart, Lung and Blood Institute was used.
RESULTS: A total of 2659 papers were identified of which 76 (59 cross-sectional and 17 longitudinal) met inclusion criteria. The results show that COVID-19 related financial disruption (income loss and financial stress) negatively impact mental health across a range of adult populations globally, including the general population, students, and other specific groups. The meta-analyses examined data from 278,854 participants from 15 studies indicated that those who lost income reported greater anxiety levels than those who did not experience income loss. Similarly for 268,128 participants across 16 studies, a meta-analysis showed greater depression symptoms for those experiencing income loss.
CONCLUSION: COVID-related financial constraints, both objective and subjective, are associated with poor mental health outcomes (particularly anxiety and depression) in various populations around the world. The results highlight the need for targeted clinical interventions for those experiencing mental health problems linked to financial problems during global crises.}, }
@article {pmid41458293, year = {2025}, author = {Fagundes Silva, JK and Lins-Kusterer, L and Moreira, MBA and Carvalho, FM}, title = {Burnout in Dentists and the COVID-19 Pandemic: A Systematic Review.}, journal = {Clinical practice and epidemiology in mental health : CP & EMH}, volume = {21}, number = {}, pages = {e17450179400081}, pmid = {41458293}, issn = {1745-0179}, abstract = {INTRODUCTION: This study aimed to identify and analyze research on burnout in dentists, measured both prior to and during the COVID-19 pandemic, using the Maslach Burnout Inventory (MBI).
METHODS: A systematic literature review was conducted across five databases using the search terms "Dentists" and "Burnout, Psychological." Articles published between 1981 and December 2024 that utilized the MBI were included. Studies were classified based on the time of data collection: either prior to or during the COVID-19 pandemic (defined as January 30, 2020, to May 5, 2023).
RESULTS: We selected 15 of the 1,486 articles identified. Eleven of these reported means and standard deviations for the burnout scales. Among them, eight calculated scale means and standard deviations according to the guidelines recommended in the MBI manual; six studies were conducted prior to the pandemic, and two during it. An initial analysis suggests that mean levels of Emotional Exhaustion and Depersonalization increased during the pandemic, while mean levels of Personal Accomplishment remained comparable to pre-pandemic levels. However, five studies used different cutoff points to define low, moderate, or high burnout levels for each scale, limiting comparability across studies.
DISCUSSION: Few articles have adequately utilized the MBI to assess burnout in dental surgeons either before or during the COVID-19 pandemic.
CONCLUSION: Theoretical arguments suggest that the COVID-19 pandemic may have adversely affected burnout levels in dentists. However, the studies we analyzed offer only limited evidence supporting an increase in the burnout dimensions of Emotional Exhaustion and Depersonalization during the pandemic.}, }
@article {pmid41458637, year = {2025}, author = {Mohamed, A and Elasad, A and Fuad, U and Pengas, IP and Abdelazim, M}, title = {The Rise of Telemedicine in Orthopaedic Trauma Follow-Up Care and Its Long-Term Outcomes: A Narrative Review.}, journal = {Cureus}, volume = {17}, number = {11}, pages = {e97896}, pmid = {41458637}, issn = {2168-8184}, abstract = {Telemedicine has rapidly transformed healthcare delivery, especially following the COVID-19 pandemic, which accelerated its use across nearly all medical specialties. Virtual consultations have become an integral part of patient follow-up and management in orthopedic trauma care. This review explores the evolution and current applications of telemedicine in orthopaedic trauma, highlighting its implementation and patient and clinician responses. We examine evidence comparing virtual and in-person care in terms of clinical outcomes, cost-effectiveness, and accessibility. This review also discusses the common barriers to adoption, practical solutions, and strategies that promote successful integration. Finally, we consider the long-term sustainability of telemedicine platforms and outline future directions for virtual orthopaedic trauma services. Together, these insights aim to guide ongoing efforts to optimize patient care delivery in the digital era.}, }
@article {pmid41458994, year = {2025}, author = {Malaeb, D and Mansour, S and Dia, N and Kassem, NM and Haddad, C and Dabbous, M and Ismail, O and Adel, F and Gamal, M and Lucca, JM and El Khatib, S and Salameh, P and Hallit, S and Hosseini, H}, title = {Scoping review about pathogenesis, risk factors, and treatment of venous and arterial thrombosis in coronavirus infection.}, journal = {Frontiers in cardiovascular medicine}, volume = {12}, number = {}, pages = {1688115}, pmid = {41458994}, issn = {2297-055X}, abstract = {INTRODUCTION: Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, is now understood as a systemic illness marked by a distinctive coagulopathy that extends beyond its primary respiratory manifestations. Direct viral injury to the endothelium and an exaggerated inflammatory "cytokine storm" and complement activation disrupt normal hemostasis and create a prothrombotic environment. This scoping review aims to synthesize and compare the mechanisms, risk factors, and antithrombotic strategies associated with venous and arterial thrombosis in COVID-19.
METHODS: A scoping review of English-language studies indexed in PubMed/Medline, OVID, and Wiley Library was conducted from January 2020 to June 2024. Search terms related to COVID-19, thrombotic complications, pathophysiological mechanisms, and antithrombotic therapies were included. Clinical trials, cohort and retrospective observational studies, systematic reviews, meta-analyses, and case reports are included. Two reviewers independently screened titles, abstracts, and full texts for relevance and extracted data to map current evidence on venous and arterial thrombosis in COVID-19.
RESULTS: COVID-19-related coagulation problems can cause both venous and arterial thrombosis. Venous thromboembolism, which includes deep vein thrombosis and pulmonary embolism, occurs in about 4% to 15% of hospitalized patients and can increase to 30% in those in intensive care, even with standard prevention. Elevated D-dimer levels are strongly associated with a higher risk of clot formation. Arterial clots, like strokes or heart damage, are less common but generally more serious, caused by platelet activation, inflammation, and small vessel blockage rather than just slow blood flow in veins. Evidence indicates that low-molecular-weight heparin is the preferred anticoagulant because it reduces both inflammation and clotting. Therapeutic doses may be especially beneficial for high-risk patients, and continuing clot prevention after hospital discharge helps lower the risk of late clots without significantly increasing bleeding risk.
CONCLUSION: Recognition of COVID-19-associated coagulopathy underscores the necessity of early risk stratification and individualized anticoagulation to mitigate thrombotic events and improve outcomes. Extended post-discharge prophylaxis appears promising in reducing late thrombotic complications. Future research should aim to refine optimal anticoagulant regimens and determine ideal prophylaxis duration for COVID-19-related thrombosis to reduce morbidity and mortality rates.}, }
@article {pmid41461134, year = {2026}, author = {Neumann, EJ and Hall, WF}, title = {Systematic review of transmission factors, management interventions, and elimination techniques related to porcine epidemic diarrhea.}, journal = {Journal of the American Veterinary Medical Association}, volume = {264}, number = {5}, pages = {1-10}, doi = {10.2460/javma.25.09.0626}, pmid = {41461134}, issn = {1943-569X}, mesh = {Animals ; Swine ; *Swine Diseases/prevention & control/transmission/virology/epidemiology ; *Porcine epidemic diarrhea virus/physiology ; *Coronavirus Infections/veterinary/prevention & control/transmission/epidemiology ; Risk Factors ; Animal Husbandry ; }, abstract = {BACKGROUND: Porcine epidemic diarrhea virus (PEDV) is a highly contagious enteric coronavirus that has caused severe economic losses in the swine industry worldwide. The virus spreads rapidly through fecal-oral transmission and contaminated fomites. Despite extensive research on vaccines, biosecurity, and inactivation strategies, PEDV remains endemic in the US. This systematic review evaluated the key epidemiological factors relevant to the feasibility of regional or national PEDV eradication.
METHODS: A systematic review of peer-reviewed literature published since 1990 was conducted with PubMed and similar bibliographic databases. Studies were selected based on their relevance to PEDV transmission, biosecurity interventions, and disease-control measures, including vaccination, antivirals, epidemiological modelling, and inactivation methods; studies of other porcine coronaviruses were excluded. A narrative summary of the included studies was developed to describe current knowledge and identify gaps.
RESULTS: Across 412 included studies, risk factors such as shedding duration, transportation-related contamination, and feed transmission were identified, all complicating eradication efforts. Epidemiological modelling indicated that localized control can reduce outbreaks, but national-level eradication remains difficult. Biosecurity and disinfection aid control, yet transportation networks remain a weak point in PEDV containment.
CLINICAL RELEVANCE: National PEDV eradication may not be feasible, but improved biosecurity, feed decontamination, and surveillance can reduce transmission and losses. Vaccines can help control disease but do not provide complete immunity, and other complementary control strategies are required for an industry-level control program. Future research should focus on improving biosecurity compliance, information-sharing during outbreaks, and epidemiological modelling to understand the role of vaccines during an eradication program.}, }
@article {pmid41461731, year = {2025}, author = {Wu, Z and Li, Y and Chen, J and Guo, Q and Pan, Y and Liu, S and Liu, J and Luo, C}, title = {The occurrence of thromboembolism among patients with coronavirus disease 2019: A systematic review and meta-analysis.}, journal = {Scientific reports}, volume = {15}, number = {1}, pages = {44783}, pmid = {41461731}, issn = {2045-2322}, support = {X202410417056//the Jiangxi College Students Innovation and Entrepreneurship Training Program and the Science/ ; }, mesh = {Humans ; *COVID-19/complications/epidemiology ; Pulmonary Embolism/epidemiology/etiology ; Risk Factors ; SARS-CoV-2/isolation & purification ; *Thromboembolism/epidemiology/etiology ; *Venous Thromboembolism/epidemiology/etiology ; }, abstract = {The results of reported thrombosis occurrences in patients with COVID-19 are inconsistent. Objectives To elucidate the occurrence of thromboembolism in COVID-19 patients with different types. The search was conducted up to May 10, 2024. The observational studies reporting the occurrence of venous thromboembolism (VTE) and/or arterial thromboembolism (ATE) in COVID-19 patients were included, which were independently evaluated by two researchers. The outcomes were VTE and ATE, including deep vein thrombosis, pulmonary embolism, myocardial infarction, and stroke. The effect sizes were combined using a random-effects model with inverse variance weighting, and a 95% confidence interval was calculated through arcsine transformation. A total of 224 studies was included. The occurrence of VTE was 5.8% (95% CI, 5.0%-6.7%, I2 = 99.912%; 91 studies; 4,545,285 patients). The occurrence of VTE was higher in the intensive care unit compared to the ward (13.2%, 95% CI, 11.7%-14.7%; I2 = 96.840%; 47 studies; 172,571 patients, vs. 3.2%, 95% CI, 2.9%-3.5%; I2 = 95.714%; 40 studies; 1,046,738 patients; P < 0.001), and was even lower among outpatient and discharged cohorts (0.0%, 95% CI, 0.0%-0.0%; I2 = 99.410%; 10 studies; 2,566,194 patients, vs. 0.7%, 95% CI, 0.4%-1.1%; I2 = 98.924%; 16 studies; 828,884 patients; P < 0.001). In contrast, the occurrence of ATE was lower, which was 2.6% (95% CI, 1.8%-3.5%, I2 = 99.924%; 44 studies; 2,884,839 patients). This study found that COVID-19 patients had a relatively high risk of VTE and ATE, but with significant variations among different types. Consequently, the selection of anticoagulant measures for them should be careful.}, }
@article {pmid41462105, year = {2025}, author = {Zhang, J and Cai, L and Zhu, H and Geng, M and Zheng, Y and Wang, L}, title = {Disease burden of norovirus-associated diarrhea among children under 5 years old in China: a meta-analysis.}, journal = {BMC infectious diseases}, volume = {25}, number = {1}, pages = {1805}, pmid = {41462105}, issn = {1471-2334}, support = {L232011//Beijing Natural Science Foundation/ ; }, mesh = {Humans ; China/epidemiology ; *Norovirus/genetics ; *Caliciviridae Infections/epidemiology/virology ; *Diarrhea/epidemiology/virology ; Child, Preschool ; Infant ; Incidence ; Cost of Illness ; }, abstract = {OBJECTIVE: Norovirus (NoV) represents a major cause of acute diarrhea among children under 5 years old in China, yet its overall disease burden is frequently underestimated in systematic reporting. This meta-analysis aimed to provide a comprehensive assessment of the burden of NoV-related diarrhea in Chinese children under 5 years of age based on published literature between 2020 and 2024. METHODS: We conducted a systematic search across PubMed, Web of Science, CNKI, and WanFang Data, identifying 60 eligible studies. The quality of these studies was assessed using the STROBE checklist. Heterogeneity was evaluated through Cochran’s Q test and the I[2] statistic, while publication bias was examined using Egger’s test and funnel plots. Pooled positivity rates were analyzed employing a random-effects model. All analyses were done at 95% confidence interval (CI) and a p < 0.05 was considered significant. RESULTS: Only one study provided incidence data, reporting a rate of 5,133.68 cases per 100,000 children. The overall pooled positivity rate of NoV among children under five was 15.76%, with the highest rate observed in the 1–3 years age group (21.29%). During the COVID-19 pandemic (2020–2021), the positivity rate declined to 15.74%; following the alleviating of containment measures, it rebounded rapidly to 20.75% in 2022–2023. followed by an increase to 20.75% in the 2022–2023 period. Seasonal increases were detected in spring (19.95%) and autumn (20.91%). Geographically, the highest positivity rate was found in Northwest China (17.24%). Genotype distribution revealed a predominance of GII strains (89.98%), with GII.4 Sydney (34.74%) and GII.4 Sydney [P31] (33.15%) being the most common variants. CONCLUSION: This study offers essential baseline information on the burden of NoV related diarrhea in China, underscoring the necessity for standardized incidence research, ongoing strain surveillance, and expedited vaccine development.}, }
@article {pmid41462874, year = {2025}, author = {Halas, RG and Berceanu Vaduva, DM and Radulescu, M and Bredicean, AC and Mateescu, DM and Toma, AO and Cotet, IG and Guse, CE and Marginean, A and Margan, MM and Lazureanu, VE}, title = {Long COVID Prevalence and Risk Factors: A Systematic Review and Meta-Analysis of Prospective Cohort Studies.}, journal = {Biomedicines}, volume = {13}, number = {12}, pages = {}, pmid = {41462874}, issn = {2227-9059}, abstract = {Background: Long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), affects millions globally, with persistent symptoms impacting quality of life. This meta-analysis synthesizes prospective cohort studies to estimate the prevalence of Long COVID symptoms and identify risk factors. Methods: We systematically searched PubMed for prospective cohort studies (2020-2025) on Long COVID, focusing on prevalence and risk factors. Studies with ≥100 participants and follow-up ≥3 months were included. Data were extracted on symptom prevalence (e.g., fatigue, dyspnoea) and risk factors (e.g., sex, hospitalization). Random-effects models were used to pool prevalence and odds ratios (OR). Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). Results: Fourteen prospective studies (n = 168,679) were included. Pooled prevalence of Long COVID was 18.0% (95% CI: 12.5-23.5%, I[2] = 9.8%) among survivors followed for ≥6 months. Fatigue (41.0%, 95% CI: 33.2-49.4%) and dyspnoea (22.5%, 95% CI: 15.6-29.8%) were the most common symptoms. Female sex (OR = 1.52, 95% CI: 1.25-1.92) and prior hospitalization (OR = 2.35, 95% CI: 1.98-2.90) were significant risk factors. High heterogeneity (I[2] > 90%) was noted. Conclusions: Long COVID affects over one-fifth of SARS-CoV-2 survivors, with fatigue and dyspnoea persisting in many. Female sex and severe acute infection increase risk. Standardized definitions and longer follow-up are needed.}, }
@article {pmid41462903, year = {2025}, author = {Młynarska, E and Hossa, K and Krupińska, N and Pietruszewska, H and Przybylak, A and Włudyka, K and Rysz, J and Franczyk, B}, title = {Atrial Fibrillation in COVID-19: Mechanisms, Clinical Impact, and Monitoring Strategies.}, journal = {Biomedicines}, volume = {13}, number = {12}, pages = {}, pmid = {41462903}, issn = {2227-9059}, abstract = {The coronavirus disease 2019 (COVID-19) pandemic has revealed a close and multifaceted relationship between viral infection, systemic inflammation, and cardiovascular health. Among the cardiac complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), atrial fibrillation (AF)-especially new-onset atrial fibrillation (NOAF)-has emerged as a major determinant of disease severity and prognosis. Clinical studies and meta-analyses show that 5-10% of hospitalized COVID-19 patients develop AF, with markedly higher rates in critically ill individuals. Both pre-existing and NOAF are independently associated with increased risks of intensive care admission, mechanical ventilation, thromboembolic events, and mortality. The underlying mechanisms involve a combination of cytokine-mediated inflammation, endothelial dysfunction, microvascular injury, and dysregulation of the renin-angiotensin-aldosterone system (RAAS). Viral downregulation of angiotensin-converting enzyme 2 (ACE2) receptors contributes to myocardial fibrosis, while hypoxia, oxidative stress, and autonomic imbalance further promote electrical remodeling and arrhythmogenesis. Post-infectious studies indicate that atrial structural changes and autonomic dysfunction may persist for months, predisposing survivors to recurrent arrhythmias. Technological advances in telecardiology and digital medicine have provided new tools for early detection and long-term monitoring. Wearable electroencephalography (ECG) devices, implantable loop recorders (ILRs), and artificial intelligence (AI)-based diagnostic algorithms enable continuous rhythm surveillance and individualized management, improving outcomes in post-COVID patients. This review summarizes current evidence on the epidemiology, pathophysiology, clinical implications, and monitoring strategies of AF in COVID-19. It underscores the importance of integrating telemedicine and AI-assisted diagnostics into cardiovascular care to mitigate the long-term arrhythmic and systemic consequences of SARS-CoV-2 infection.}, }
@article {pmid41462936, year = {2025}, author = {Haralović, V and Mokos, M and Špoljar, S and Dolački, L and Šitum, M and Lugović-Mihić, L}, title = {Hypochlorous Acid: Clinical Insights and Experience in Dermatology, Surgery, Dentistry, Ophthalmology, Rhinology, and Other Specialties.}, journal = {Biomedicines}, volume = {13}, number = {12}, pages = {}, pmid = {41462936}, issn = {2227-9059}, abstract = {Background: Hypochlorous acid (HOCl) is an integral component of the human innate immune system. It possesses antimicrobial properties and is available in solution, dermal spray, and scar gel forms. Objectives/Methods: This review presents data from studies on the clinical use of HOCl in various specialties, including dermatology, surgery, dentistry, ophthalmology, and rhinology. Results: Due to its anti-inflammatory/antimicrobial/immunomodulatory and healing properties, HOCl is advantageous in treating various skin disorders: ulcus cruris (and wound care), diabetic ulcers, atopic dermatitis, seborrheic dermatitis, pruritus, acne vulgaris, etc. Also, the application of a HOCl spray/gel after surgical procedures may prevent infection, reduce inflammation, and accelerate healing. HOCl is also effective and safe for the prevention and treatment of hypertrophic and keloid scars. Growing evidence shows a broader role for HOCl in limiting cancer cell survival and slowing tumor growth. It is also important in treating various viral infections like SARS-CoV-2 (coronavirus), influenza, and herpes, thereby helping to prevent the spread of aerosols. In addition, since HOCl is an endogenous compound naturally present in mammals with a high safety profile, it may be an effective bacterial disinfectant in dental waterlines. In ophthalmology, adjuvant treatment with HOCl ophthalmic spray can reduce the duration of antibiotic/corticosteroid use, even in severe blepharitis. To fully harness the protective/therapeutic properties of HOCl, future advancements will rely on the development of new chemical compounds and sophisticated pharmaceutical formulations. Conclusions: The majority of clinical studies have confirmed that HOC1 is useful in therapy, although the results are not entirely consistent. Further research is essential to optimize HOCl dosing and to develop controlled-release systems aimed at maximizing its anti-inflammatory and photoprotective effects while minimizing tissue irritation and damage.}, }
@article {pmid41463036, year = {2025}, author = {Andriankaja, OM and Whiteheart, S and Mattos, MBA}, title = {Biological Plausibility Between Long-COVID and Periodontal Disease Development or Progression.}, journal = {Biomedicines}, volume = {13}, number = {12}, pages = {}, pmid = {41463036}, issn = {2227-9059}, abstract = {Background: Long COVID (LC) is a multi-system disorder with persistent symptoms following SARS-CoV-2 infection. The presence of SARS-CoV-2 in the oral cavity and periodontium raises questions about its potential impact on periodontal health. Methods: A comprehensive literature search was conducted in PubMed using terms related to LC (e.g., "long-COVID," "post-acute sequelae of SARS-CoV-2 infection," "PASC," "post-COVID-19," "long-haul COVID") and oral/periodontal diseases (e.g., "periodontal disease," "periodontitis," "gingiva," "oral disease," "dental"), filtered for English-language full-text articles published from 2019 to 2024. The search yielded 260 articles, which were supplemented with targeted searches on pathogenesis, immune mechanisms, microbiome alterations, and clinical outcomes, resulting in approximately 248 studies included in this review. Results: LC exhibits systemic immunoinflammatory dysregulation, including neutrophil activation, elevated pro-inflammatory cytokines, and complement activation, overlapping with mechanisms implicated in periodontitis. LC also leads to gastrointestinal and pulmonary dysbiosis, with potential effects on oral microbial communities. Gingival epithelium and periodontal ligament cells express ACE2, which is increased in periodontitis, facilitating viral entry. LC has been associated with reactivation of herpesviruses, such as Epstein-Barr virus, which are linked to autoimmune disorders and periodontitis. Conclusions: LC may act as a systemic risk factor for periodontitis. This review provides the theoretical foundation for the interactions between LC and oral health and highlights priorities for future epidemiologic and mechanistic research to better understand these relationships.}, }
@article {pmid41463124, year = {2025}, author = {Fleser, RC and Necula, V and Ujvary, LP and Osman, A and Orasan, A and Maniu, AA}, title = {Hearing Loss in Young Adults: Risk Factors, Mechanisms and Prevention Models.}, journal = {Biomedicines}, volume = {13}, number = {12}, pages = {}, pmid = {41463124}, issn = {2227-9059}, abstract = {Hearing loss is increasingly recognized as a major public health concern among young adults, who are traditionally considered a low-risk group. This narrative review synthesizes recent evidence on risk and aggravating factors of early-onset hearing impairment, including recreational and occupational noise exposure, genetic susceptibility, infections, ototoxic medications, and lifestyle contributors. Pathophysiological mechanisms include cochlear synaptopathy, oxidative stress, excitotoxicity, vascular compromise, and immune-mediated injury. Global Burden of Disease data and World Health Organization reports indicate that more than one billion young people are at risk due to unsafe listening practices. Studies highlight emerging risk factors such as hidden hearing loss, extended high-frequency impairment and associations with COVID-19. Aggravating factors include delayed diagnosis, cumulative exposures and lack of preventive strategies. Early detection via advanced audiological assessments, such as extended high-frequency audiometry, otoacoustic emissions, speech-in-noise testing and auditory brainstem responses, is critical to prevent permanent damage. Public health interventions-particularly safe listening campaigns, early screening and monitoring in high-risk populations-are essential to reduce long-term disability.}, }
@article {pmid41464319, year = {2025}, author = {Raycheva, R and Kostadinov, K and Rangelova, V and Kevorkyan, A}, title = {Economic Analyses of COVID-19 Interventions: A Narrative Review of Global Evidence.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {24}, pages = {}, pmid = {41464319}, issn = {2227-9032}, abstract = {Background/Objectives: The coronavirus disease 2019 (COVID-19) pandemic imposed an unprecedented global health and economic burden, prompting rapid implementation of diverse public health interventions. This review aimed to synthesize global evidence on the cost-effectiveness of key COVID-19 control strategies, including vaccination, testing, and social distancing and to identify methodological, contextual, and equity-related determinants of their economic value. Methods: A narrative literature review was conducted using peer-reviewed studies published between January 2020 and September 2025 and indexed in PubMed, Scopus, and Web of Science. Eligible studies included economic evaluations and modeling analyses addressing COVID-19 interventions in healthcare, community, or educational settings. Data on costs, outcomes, and methodological features were extracted and synthesized descriptively. Results: Across 74 included studies, vaccination-particularly with messenger RNA (mRNA) platforms-emerged as the most cost-effective intervention across all settings, often cost-saving among high-risk populations. Combined or layered strategies integrating vaccination, testing, and selective social distancing consistently outperformed single interventions in both health and economic outcomes. Early and targeted implementation yielded the highest cost-effectiveness by preventing exponential transmission and healthcare overload. However, heterogeneity in modeling assumptions, analytic perspectives, and outcome measures limited comparability. Few studies applied extended or distributional cost-effectiveness frameworks to address equity, while indirect and long-term effects such as productivity losses and "long COVID" were frequently omitted. Conclusions: COVID-19 interventions are most efficient when early, targeted, and adaptive to local epidemiologic conditions. Integrating equity, methodological consistency, and broader societal impacts into future evaluations will strengthen evidence-based, economically sustainable pandemic preparedness and response strategies.}, }
@article {pmid41464401, year = {2025}, author = {Wright, T and Smith, R and Sah, RK and Keys, C and Keval, H and Onyejekwe, C}, title = {The Impact of COVID-19 on Racialised Minority Populations: A Systematic Review of Experiences and Perspectives.}, journal = {International journal of environmental research and public health}, volume = {22}, number = {12}, pages = {}, pmid = {41464401}, issn = {1660-4601}, mesh = {Humans ; *COVID-19/ethnology/epidemiology/psychology ; Health Status Disparities ; *Minority Groups/psychology ; Racism ; SARS-CoV-2 ; }, abstract = {Racialised minority populations were disproportionately affected by COVID-19 and saw the highest rate of COVID-19 infections and mortality. Low socioeconomic status, working as frontline workers, temporary employment, precarious immigration status and pre-existing medical conditions were factors that contributed to disadvantaged experiences. This systematic review looked at the impact of COVID-19 on racialised minority populations globally, recognising their experiences, perspectives and the effects on their physical and mental health. Eight electronic databases were searched (MEDLINE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Social Sciences Citation Index (SSCI), Social Policy and Practice (SPP), Applied Social Sciences Index and Abstracts (ASSIA), MedRxiv and Research Square) for English language qualitative studies. Reference lists of relevant literature reviews and reference lists of articles were hand-searched for additional potentially relevant articles. Duplicates were removed, and articles were screened for titles and abstracts, followed by full-text screening. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of the included studies (n = 70). Data were synthesised using thematic synthesis. Seven major and three minor themes were identified. The major themes related to (i) children and young people's experiences of COVID-19; (ii) exacerbated pre-existing disparities relating to income, employment and housing security, health insurance and immigration status; (iii) lack of knowledge and information about COVID-19 and COVID-19 misinformation; (iv) racial history of medicine and treatment of racialised populations; (v) contemporary experiences of racism; (vi) impact on physical and mental health and wellbeing; (vii) concerns about safety at work. Minor themes related to (a) experiences of intercommunity mutual aid; (b) adherence to preventative guidance/COVID-19 restrictions; (c) the role of faith. Research needs to focus on developing and testing interventions that support transformation of social, cultural and economic systems towards equity of access to healthcare and healthcare knowledge. Research should be cognisant of interventions that have worked in shifting the equity dial in the past, implement these and use them to inform new approaches. Policy and practice should be mechanisms for enabling the implementation of interventions.}, }
@article {pmid41464441, year = {2025}, author = {Abdel-Motaal, KA and El Kheir-Mataria, WA and Chun, S}, title = {Global Health Governance and the WHO Pandemic Agreement: A Scoping Review of Challenges and Analysis of Reforms.}, journal = {International journal of environmental research and public health}, volume = {22}, number = {12}, pages = {}, pmid = {41464441}, issn = {1660-4601}, mesh = {Humans ; *COVID-19/epidemiology/prevention & control ; *Global Health ; *International Cooperation ; *Pandemics/prevention & control ; SARS-CoV-2 ; *World Health Organization ; }, abstract = {BACKGROUND: The COVID-19 pandemic exposed persistent weaknesses in global health governance, particularly in preparedness, equity, and accountability. The WHO Pandemic Agreement, adopted in May 2025, aims to address these systemic gaps through a binding international framework.
OBJECTIVE: To identify key challenges in global pandemic preparedness and health governance reported in the literature (2019-2024) through a systematic scoping review, and to evaluate how these challenges are addressed in the provisions of the WHO Pandemic Agreement via qualitative document analysis.
METHODS: Using Joanna Briggs Institute methodology and PRISMA-ScR guidelines, we systematically identified and thematically analyzed 52 peer-reviewed studies published between 2020 and 2024. The thematic results informed a qualitative document analysis of the WHO Pandemic Agreement text to assess the extent to which its provisions address the identified challenges.
RESULTS: Persistent gaps in governance (limited enforceability, fragmented coordination), equity (inequitable access to medical countermeasures), capacity (technology transfer and financing), and accountability were identified. Health systems in low- and middle-income countries continue to face critical resource constraints and lack robust mechanisms to ensure accountability and continuous learning. Document analysis showed the WHO Pandemic Agreement addresses coordination and financing but offers limited advances in enforcement, technology transfer, and independent monitoring.
CONCLUSION: The WHO Pandemic Agreement introduces important institutional and financing measures, but persistent gaps remain in enforcement, technology transfer, and inclusive implementation. Strengthening these domains is crucial to achieving equitable and resilient preparedness. By systematically linking evidence from the pandemic preparedness literature to Treaty provisions, this study offers a novel analytical framework for assessing how global health treaties respond to research-identified challenges.}, }
@article {pmid41464475, year = {2025}, author = {Jia, Y and Turcu, C}, title = {Climate, Health, and Urban Green Infrastructure: The Evidence Base and Implications for Urban Policy and Spatial Planning.}, journal = {International journal of environmental research and public health}, volume = {22}, number = {12}, pages = {}, pmid = {41464475}, issn = {1660-4601}, mesh = {Humans ; Cities ; *City Planning ; *Climate Change ; }, abstract = {Urban green infrastructure (UGI) is widely used to adapt to the impacts of climate change. Its multiple benefits are well documented, with health-related benefits receiving growing attention, especially post-COVID-19. However, the existing evidence remains fragmented and limited to narrow disciplinary perspectives, offering only partial insights into the intersection of UGI and climate adaptation measures with health co-benefits. This paper addresses these gaps by providing an interdisciplinary review of the field. It presents a systematic literature review of studies between 2015 and 2025, assessing the extent of documented evidence and drawing out key policy implications. The review adopts the PRISMA framework and synthesizes evidence from 178 primary research articles across seven databases. Health co-benefits are reported across ten types of UGI: residential greenery, urban vegetation, school greenery, trees, urban parks, urban forests, green roofs and walls, green streets, grasslands, and community or private gardens. Building on the review's findings and additional literature, the paper discusses seven key implications for urban policy and spatial planning, which are relevant to climate adaptation policymakers, urban planners, and public health authorities working in cities.}, }
@article {pmid41464674, year = {2025}, author = {Duque-Clavijo, V and Doan, HQ and Tyring, SK}, title = {A Review of Cutaneous Viral Infections and Their Potential Role in Neurologic Diseases.}, journal = {Journal of clinical medicine}, volume = {14}, number = {24}, pages = {}, pmid = {41464674}, issn = {2077-0383}, abstract = {Background: Cutaneous viral infections, defined as viral pathogens that either primarily affect the skin (e.g., herpesviruses, enteroviruses) or frequently produce dermatologic manifestations despite systemic tropism (e.g., HIV, SARS-CoV-2), can trigger systemic inflammatory and neurotropic responses that extend their impact to the nervous system. A growing body of evidence suggests that viruses with dermatologic manifestations may play a significant role in the pathogenesis of neurologic disorders. Summary: Although individual viruses have been studied in isolation, the skin-brain axis in viral infections remains incompletely characterized. This review synthesizes existing knowledge and highlights gaps in understanding the mechanisms linking cutaneous viral infections to neurologic disease. We explore the principal mechanisms linking viral skin infections to central and peripheral nervous system damage, including direct neuroinvasion, immune-mediated injury, and vascular or endothelial dysfunction. Particular attention is given to herpesviruses, retroviruses, enteroviruses, and respiratory viruses, which have been associated with conditions such as dementia, multiple sclerosis, myelopathies, Guillain-Barré syndrome, and the post-acute neurologic sequelae of COVID-19. Furthermore, we discuss the role of neuroinflammation in viral-associated neurodegeneration and highlight emerging evidence supporting the recombinant zoster vaccine (Shingrix) as a potential modulator of neuroinflammatory processes and a protective factor against dementia. Conclusions: Cutaneous viral infections extend beyond local skin pathology, contributing to a broad spectrum of neurologic complications through intertwined infectious and inflammatory mechanisms. A clearer understanding of how peripheral viral activity shapes central nervous system vulnerability remains a major unmet need. A multidisciplinary approach integrating dermatologic and neurologic perspectives is essential for early recognition and prevention. While observational studies suggest that zoster vaccination may reduce viral reactivation and modulate neuroinflammatory pathways, definitive evidence of neuroprotection is still lacking. Future studies should clarify causal relationships, test mechanistic hypotheses regarding skin-brain immune crosstalk, and explore vaccine-mediated neuroprotection as a novel therapeutic strategy.}, }
@article {pmid41465254, year = {2025}, author = {Guria, K and Melnikov, I and Shtelmakh, V and Avtaeva, Y and Okhota, S and Saburova, O and Kozlov, S and Gabbasov, Z}, title = {Fibrin Monomer in Thrombosis and Haemostasis: A Clinical Biomarker and Beyond.}, journal = {International journal of molecular sciences}, volume = {26}, number = {24}, pages = {}, pmid = {41465254}, issn = {1422-0067}, support = {24-15-00092//the Russian Science Foundation/ ; }, mesh = {Humans ; Biomarkers/blood/metabolism ; *Hemostasis ; *Thrombosis/metabolism/blood/diagnosis ; COVID-19/blood/complications ; *Fibrin Fibrinogen Degradation Products/metabolism ; SARS-CoV-2 ; Fibrin/metabolism ; Blood Coagulation ; Fibrinolysis ; }, abstract = {Fibrin monomer (FM) is a transient intermediate of blood coagulation that functions as both an active regulator of haemostasis and a sensitive biomarker for prothrombotic states. Clinically, FM is measured indirectly as its derivative, soluble fibrin monomer complexes (SFMC), which is also often referred to as FM throughout the clinical literature. FM participates in a complex regulatory network modulating thrombin generation and fibrinolysis, interacting with platelet receptors, including integrin αIIbβ3 and GPVI, and engaging GPIb-vWF interactions. This comprehensive review examines FM's molecular mechanisms in haemostatic regulation and evaluates clinical evidence for FM as a biomarker. Particular focus is placed on FM's utility for risk stratification across thrombotic conditions, including disseminated intravascular coagulation, venous thromboembolism, ischemic stroke, myocardial infarction, and COVID-19-associated coagulopathy. Current challenges, including assay standardization and universal cut-off values, are discussed. By synthesizing mechanistic insights with clinical data, this integrated perspective may accelerate the translation of FM biology into improved risk assessment tools and novel therapeutic strategies.}, }
@article {pmid41465600, year = {2025}, author = {Ben Khlifa, E and Campese, A and Corsi, A and Bombieri, C and Romanelli, MG and Valenti, MT and Zipeto, D and Castelli, M and Lievens, PM and Ruggiero, A}, title = {Post-Translational Modifications in Respiratory Virus Infection: Recent Insights into the Development of In Vitro Models.}, journal = {International journal of molecular sciences}, volume = {26}, number = {24}, pages = {}, pmid = {41465600}, issn = {1422-0067}, support = {CUP B53D23003290001//the PRIN 2022 (NextGenerationEU, MUR n. 972)/ ; CUP B53D23003410006//NextGenerationEU, MUR n. 972/ ; Department of Neuroscience, Biomedicine and Movement Sciences of the University of Verona//MUR - Excellence Project 2023-2027/ ; }, mesh = {Humans ; *Protein Processing, Post-Translational ; SARS-CoV-2/metabolism ; Influenza A virus/metabolism ; Animals ; Host-Pathogen Interactions ; *Respiratory Tract Infections/virology/metabolism ; COVID-19/virology/metabolism ; *Respiratory Syncytial Virus Infections/metabolism/virology ; Virus Replication ; }, abstract = {Post-translational modifications (PTMs) are crucial chemical alterations occurring on proteins post-synthesis, impacting various cellular processes. During viral infections, PTMs are shown to play a multitude of roles in viral replication, host interaction, and immune evasion. Thus, these modifications can influence infectivity, with direct impact on the anti-viral host immune responses and potentially viral adaptation across species. This field is still scarcely explored, whilst understanding PTMs is not only important to advance the knowledge of virus pathology but also potentially to provide insights for vaccine development. In this review, we attempt to summarize the latest findings mainly published over the last 10 years, focusing on the roles of PTMs involved in virus infection and anti-viral immune responses, in the context of relevant human respiratory infections: influenza A virus (IAV), respiratory syncytial virus (RSV), and SARS-CoV-2. We decided to concentrate on these three viruses because they currently represent a global health problem due to recurrent outbreaks and pandemic potential. A deeper characterization of the PTMs may help in understanding virus-host interaction with possible implications on curative strategies. Further, we will report on cutting-edge technologies to study in vitro virus infection in different cellular-based systems. In particular, we describe and discuss the application of 2D and 3D lung organoid cell-culture systems as in vitro models to mimic respiratory environments and to study the PTMs in a controlled setting. Finally, we will discuss the importance of PTMs in the context of next-generation vaccine design, especially for their potential role to offer effective protection against respiratory viruses.}, }
@article {pmid41465787, year = {2025}, author = {Tiwari, S and Dhakal, T and Kim, BJ and Jang, GS and Oh, Y}, title = {Genomics in Epidemiology and Disease Surveillance: An Exploratory Analysis.}, journal = {Life (Basel, Switzerland)}, volume = {15}, number = {12}, pages = {}, pmid = {41465787}, issn = {2075-1729}, support = {RS-2023-KH140418//Government-wide R&D to Advance Infectious Disease Prevention and Control, Republic of Korea/ ; }, abstract = {Genomics has revolutionized epidemiology and disease surveillance by providing powerful tools for identifying, tracking, and analyzing pathogens at the molecular level. This exploratory analysis examines the integration of genomic with traditional epidemiological approaches, highlighting the role of whole-genome sequencing as a key method for pathogen identification, outbreak investigation, and understanding transmission dynamics. By enabling the detection of mutations and monitoring of antimicrobial resistance, genomics allows for precise mapping of infection sources and transmission pathways, thereby improving the timeliness and accuracy of public health responses. Furthermore, genomic surveillance supports the early detection of emerging variants, such as those observed during viral outbreaks like COVID-19, facilitating proactive intervention strategies. Despite its transformative potential, challenges related to data privacy, infrastructure, and interdisciplinary collaboration persist. This analysis emphasizes the importance of genomics in building resilient surveillance systems to address future infectious disease threats and advocates for sustained investment in genomic technologies to advance global health security.}, }
@article {pmid41466823, year = {2026}, author = {Arjun, MM and Sreekanth, GP}, title = {Engineering Nipah virus: Reverse genetics as a gateway to novel drug discovery.}, journal = {New microbes and new infections}, volume = {69}, number = {}, pages = {101682}, pmid = {41466823}, issn = {2052-2975}, abstract = {Nipah virus (NiV) is a highly pathogenic and re-emerging virus that requires containment in biosafety level 4 (BSL-4) laboratories. The limited accessibility of these high-security facilities poses major obstacles to investigating immunopathogenesis and developing effective antiviral treatments. Reverse genetics allows manipulation of viral genomes without the need to handle the wild-type virus and has become instrumental in understanding NiV pathogenesis and advancing therapeutic research. These tools have proven vital for other high-containment viruses, notably during the SARS-CoV-2 pandemic, and have been adapted effectively for NiV. Reverse genetics-derived systems were used to evaluate the drug candidates in the preclinical studies of NiV, with several candidates in the development pipeline. This narrative review summarizes established reverse genetics and pseudotyping methodologies for NiV, highlighting their contributions to understanding viral pathogenesis and accelerating vaccine and therapeutic development.}, }
@article {pmid41467021, year = {2025}, author = {Sun, D and Tan, W and Zhao, J and Tian, Y and Li, S and Zhang, Z and Dong, X and Liu, X and Liu, N and Jiao, P and Ma, J}, title = {Delivery of nucleic acid drugs for tumor therapy: Opportunities and challenges.}, journal = {Fundamental research}, volume = {5}, number = {6}, pages = {2948-2959}, pmid = {41467021}, issn = {2667-3258}, abstract = {The global pandemic of COVID-19 has underscored the huge potential of nucleic acid drugs in effective and rapid vaccine development. Hence, it is significant to accelerate the research and clinical transformation of nucleic acid drugs. However, when administered systemically, nucleic acid molecules are vulnerable to degradation by nucleases, and their structural hydrophilicity hampers cellular entry, limiting their efficacy. Moreover, free nucleic acid drugs may cause some side effects in vivo, and the application of small nucleic acid drugs is largely restricted by intratumoral or peritumoral administration. Currently, the design and preparation of nucleic acid delivering systems face many scientific problems and technical challenges. Breaking through the technical bottlenecks in intraneous delivery of nucleic acid molecules is anticipated to open a new era of efficient, precise and safe nucleic acid drugs. This program, based on the new advances in nanotechnology and biomedical engineering, aims to advance the nucleic acid nano drug delivery systems (NDDS) and overcome intraneous delivery barriers. This review explores the barriers in nucleic acid drug delivery and presents methods for enhancing intracellular uptake, offering guidance for the design of nucleic acid carriers. Furthermore, it discusses the latest advancements in applying NDDS to nucleic acid drugs.}, }
@article {pmid41467276, year = {2025}, author = {Petrov, S and Donkov, D and Orbetzova, M}, title = {AI and telemedicine in management of diabetes.}, journal = {Folia medica}, volume = {67}, number = {6}, pages = {}, doi = {10.3897/folmed.67.e153728}, pmid = {41467276}, issn = {1314-2143}, mesh = {Humans ; *Telemedicine ; *Artificial Intelligence ; *Diabetes Mellitus/therapy/diagnosis ; COVID-19/epidemiology ; SARS-CoV-2 ; Deep Learning ; Decision Support Systems, Clinical ; Machine Learning ; Natural Language Processing ; }, abstract = {This review explores how two cutting-edge technologies-telemedicine and artificial intelligence (AI)-are reshaping diabetes care. Diabetes remains one of healthcare's toughest challenges, demanding round-the-clock monitoring and treatments that adapt to each patient's needs. During COVID-19, telemedicine proved its worth as a vital tool for maintaining patient care and improving health outcomes. Meanwhile, AI-through machine learning (ML) and deep learning (DL)-brings fresh capabilities for catching diabetes early, assessing patient risk, and spotting complications like eye and nerve damage before they become serious. We examined recent research on these technologies, particularly their roles in predicting who might develop diabetes, using Natural Language Processing (NLP) to decode messy patient records, and supporting doctors through clinical decision support systems (CDSS). Our findings reveal that telemedicine works-it helps patients control their blood sugar better and keeps them satisfied with their care. However, not everyone has equal access to technology, and some healthcare providers remain skeptical. AI diagnostic tools, especially for eye screening, now match human doctors in accuracy. Though merging these technologies could revolutionize personalized diabetes care, we first need to tackle real-world obstacles: ensuring fair access for all patients, protecting sensitive health data, and making different systems work together seamlessly.}, }
@article {pmid41467992, year = {2026}, author = {Mendlovic, F and Plett, T and Santiago-Olivares, C and Avila-Ramírez, G and Flisser, A and Rivera-Toledo, E}, title = {Immune and Virological Factors Influencing Human Respiratory Syncytial Virus Circulation and Increased Prevalence During and After the COVID-19 Pandemic.}, journal = {Viral immunology}, volume = {39}, number = {1}, pages = {1-10}, doi = {10.1177/08828245251407618}, pmid = {41467992}, issn = {1557-8976}, mesh = {Humans ; *COVID-19/epidemiology/immunology/virology ; *Respiratory Syncytial Virus Infections/epidemiology/immunology/virology/transmission ; *Respiratory Syncytial Virus, Human/immunology/genetics ; Prevalence ; *SARS-CoV-2/immunology ; Infant ; Child ; Antibodies, Viral/immunology/blood ; Adult ; Pandemics ; }, abstract = {Human respiratory syncytial virus (hRSV) is a leading cause of respiratory infections in infants and older adults. The COVID-19 pandemic disrupted hRSV transmission due to non-pharmaceutical interventions (NPI), resulting in atypical circulation patterns, earlier seasonal peaks, and increased post-pandemic prevalence. Two key factors are proposed to underlie these changes: a reduced specific immune response due to decreased viral exposure and the emergence of novel hRSV variants. These factors contributed to a larger cohort of immunologically naïve children and lower levels of maternally derived antibodies, increasing susceptibility to severe hRSV disease, particularly in infants and children. Additionally, adults experienced waning immunity following prolonged periods of limited hRSV circulation. The post-pandemic resurgence was accompanied by the emergence of novel hRSV variants with altered transmissibility and virulence, such as GB5.0.6a in Europe and B.D.E.1 in China. These variants may reflect mutations driven by the reduced immunity, though further research is needed to assess their pathogenicity. Understanding the interplay between the reduced immunity due to NPI and virological factors is essential for addressing hRSV epidemiology. Enhanced molecular surveillance and immunological monitoring are crucial for guiding vaccination strategies and protecting vulnerable populations against future hRSV outbreaks.}, }
@article {pmid41469295, year = {2025}, author = {Collins, N and Devon, C and Bentley, S and Dixon, E and Jones, D and Kenny, S and Makhecha, S and Moledina, S and Murray, N and Puckey, M and Worger, C and Balfour-Lynn, IM}, title = {Home intravenous antibiotics for cystic fibrosis - setting up a hospital @home service.}, journal = {Paediatric respiratory reviews}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.prrv.2025.12.002}, pmid = {41469295}, issn = {1526-0550}, abstract = {This paper reviews the use of home intravenous antibiotics (IVABs) in children with cystic fibrosis (CF). We outline a program we developed during the COVID-19 pandemic for enhancing the experience for children and families by involving full multidisciplinary follow up via video for the duration of the antibiotic course. We did find though, that the majority of families were unsuitable for home IVABs. We hope that this information will be useful for other CF units considering setting up a hospital at home service.}, }
@article {pmid41471153, year = {2025}, author = {Ramasamy, R}, title = {Perspective Overview of Changing Population Immunity to COVID-19 in the Context of Infection, Vaccination, and Emerging SARS-CoV-2 Variants.}, journal = {Pathogens (Basel, Switzerland)}, volume = {14}, number = {12}, pages = {}, pmid = {41471153}, issn = {2076-0817}, mesh = {Humans ; *COVID-19/immunology/prevention & control/epidemiology/virology/transmission ; *SARS-CoV-2/immunology/genetics ; *COVID-19 Vaccines/immunology ; Vaccination ; Immune Evasion ; }, abstract = {The changing state of protective immunity to COVID-19 in the global population in the six years since COVID-19's origin in 2019 is examined in the context of the (i) circulation of SARS-CoV-2 in the population, (ii) widespread use of different types of COVID-19 vaccines beginning in December 2020 and continuing to the present time, and (iii) ongoing evolution of SARS-CoV-2 to produce mutant viruses with greater infectivity, replication rate, evasion of immunity, and transmissibility. The outlook, and possible vaccine strategies, for the future control of COVID-19 are also examined.}, }
@article {pmid41471393, year = {2025}, author = {Shaer, NA and Mohamed, AA and Schnug, E}, title = {Potential of Artemisia annua Bioactives as Antiviral Agents Against SARS-CoV-2 and Other Health Complications.}, journal = {Pharmaceuticals (Basel, Switzerland)}, volume = {18}, number = {12}, pages = {}, pmid = {41471393}, issn = {1424-8247}, abstract = {This review highlights Artemisia annua, a medicinal plant which grows in the Kingdom of Saudi Arabia, known for its abundant therapeutic properties. A. annua serves as a rich source of various bioactive compounds, including sesquiterpenoid lactones, flavonoids, phenolic acids, and coumarins. Among these, artemisinin and its derivatives are most extensively studied due to their potent antimalarial properties. Extracts and isolates of A. annua have demonstrated a range of therapeutic effects, such as antioxidant, anticancer, anti-inflammatory, antimicrobial, antimalarial, and antiviral properties. Given its significant antiviral activity, A. annua could be investigated for the development of new nutraceutical bioactive compounds to combat SARS-CoV-2. Artificial Intelligence (AI) can assist in drug discovery by optimizing the selection of more effective and safer natural bioactives, including artemisinin. It can also predict potential clinical outcomes through in silico modeling of protein-ligand interactions. In silico studies have reported that artemisinin and its derivatives possess a strong ability to bind with the Lys353 and Lys31 hotspots of the SARS-CoV-2 spike protein, demonstrating their effective antiviral effects against COVID-19. This integrated approach may accelerate the identification of effective and safer natural antiviral agents against COVID-19.}, }
@article {pmid41472136, year = {2025}, author = {Liu, Y and Lu, H and Li, J and Xie, Y and Hu, G and Pang, S and Lian, S and Liu, J and Zhu, G and Ding, X}, title = {A Comprehensive View on the Mechanisms of Coronavirus Escaping Innate Immunity.}, journal = {Veterinary sciences}, volume = {12}, number = {12}, pages = {}, pmid = {41472136}, issn = {2306-7381}, support = {32503083//National Natural Science Foundation of China/ ; HN2024113//Henan Postdoctoral Research Foundation/ ; 22nya08//Science and Technology Plan Project of Taizhou/ ; }, abstract = {Coronaviruses are a group of widespread infectious pathogens that pose a serious threat to human and animal health. Corona Virus Disease 2019, instigated by severe acute respiratory SARS-CoV-2, has presented an unprecedented challenge to global public health in recent years. The host innate immune system is the first line of defense against pathogens, which plays a key role in inhibiting the initial infection of viruses and regulating the initiation and development of acquired immunity. However, coronaviruses can suppress the host's innate immune response through their unique immune escape mechanisms, which is one of the key strategies for coronavirus pathogenesis. This review focuses on the host's innate immune sensors, innate antiviral immune responses, and the mechanisms employed by coronaviruses to evade and suppress the innate immune system. And we hope that it will contribute to a comprehensive understanding of the escape mechanism of coronaviruses regarding innate immunity and the pathogenesis of coronaviruses.}, }
@article {pmid41472204, year = {2025}, author = {Dong, J and He, X and Bao, S and Wei, Z}, title = {Diagnostic Methods for Bovine Coronavirus: A Review of Recent Advancements and Challenges.}, journal = {Viruses}, volume = {17}, number = {12}, pages = {}, pmid = {41472204}, issn = {1999-4915}, support = {KJZC-2024-15//Gansu Provincial Department of Agriculture and Rural Affairs Science and Technology Support Project/ ; }, mesh = {Animals ; Cattle ; *Coronavirus, Bovine/genetics/isolation & purification ; *Cattle Diseases/diagnosis/virology ; *Molecular Diagnostic Techniques/methods ; *Coronavirus Infections/diagnosis/veterinary/virology ; Nucleic Acid Amplification Techniques/methods ; Sensitivity and Specificity ; CRISPR-Cas Systems ; }, abstract = {Bovine coronavirus(BCoV) is a significant pathogen causing substantial economic losses in the cattle industry through increased calf mortality, reduced growth performance, and decreased milk yield. Rapid and accurate diagnostic methods are therefore essential for controlling BCoV transmission. Current diagnostic methods comprise two primary categories: conventional techniques and cutting-edge innovations. Conventional approaches, including molecular methods like RT-PCR/qRT-PCR and immunological assays such as ELISA and neutralization tests, remain the main diagnostic methods. However, they are limited by laboratory dependency as well as the necessary balance between speed and sensitivity. These limitations have promoted the development of innovative methods, including isothermal amplification, CRISPR/Cas systems, droplet digital PCR, and integrated platforms. This review comprehensively analyzes the advantages, limitations, and applications of current diagnostic methods, highlighting integrated platforms such as RPA-CRISPR-LFA and microfluidics-based LFA. These innovations bridge critical performance gaps by enhancing sensitivity and specificity while enabling field application, demonstrating significant potential as next-generation point-of-care diagnostics for managing this economically critical pathogen.}, }
@article {pmid41472292, year = {2025}, author = {Ariza, ME and Mena Palomo, I and Williams, MV}, title = {Does Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Represent a Poly-Herpesvirus Post-Virus Infectious Disease?.}, journal = {Viruses}, volume = {17}, number = {12}, pages = {}, pmid = {41472292}, issn = {1999-4915}, support = {R01 AI084898/AI/NIAID NIH HHS/United States ; R01 A1084898//National Institute of Health/ ; }, mesh = {*Fatigue Syndrome, Chronic/virology/etiology ; Humans ; *Herpesviridae/physiology/pathogenicity ; *Herpesviridae Infections/virology/complications ; Virus Replication ; Animals ; Virus Latency ; }, abstract = {Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating multisystem illness with unknown etiology. An estimated 17-24 million people representing approximately 1% of the population are afflicted worldwide. In over half of cases, ME/CFS onset is associated with acute "flu-like" symptoms, suggesting a role for viruses. However, no single virus has been identified as the only etiological agent. This may reflect the approach employed or more strongly the central dogma associated with herpesviruses replication, which states that a herpesvirus exists in two states, either lytic or latent. The purpose of this review is to address the role that abortive lytic replication may have in the pathogenesis of ME/CFS and other post-acute viral infections and also to raise awareness that these syndromes might be poly-herpesviruses mediated diseases.}, }
@article {pmid41472297, year = {2025}, author = {Liu, J and Luo, W and Li, J and Cai, B and Lei, Z and Lin, S and Chen, Z and Yue, Z and Chen, X and Li, Y and Luo, Z and Zhang, Q and Chen, X}, title = {A Review of Receptor Recognition Mechanisms in Coronaviruses.}, journal = {Viruses}, volume = {17}, number = {12}, pages = {}, pmid = {41472297}, issn = {1999-4915}, support = {82072834, 32400132, 2023A1515010318, 2021A1515011065//the National Natural Science Foundation of China , Guangdong Natural Science Foundation/ ; }, mesh = {Humans ; *Coronavirus/physiology/genetics/metabolism ; *Receptors, Virus/metabolism/genetics/chemistry ; Animals ; Host-Pathogen Interactions ; *Coronavirus Infections/virology/metabolism ; }, abstract = {Cellular receptor recognition exerts fundamental roles during coronavirus infection. Clarifying the regulatory mechanism of virus receptor helps to better understand viral infection, transmission and pathogenesis; predict potential host and how viral escape from immune system; prevent coronavirus infection or develop treatment therapy. Herein, we summarize current understanding of host receptor recognition mechanisms in the different genera of coronavirus family. And we also review diverse methodologies of identification and clarification of virus receptors. The integration of structural biology, multi-omics, computational predictions, synthetic biology and artificially engineered viral receptors, provide a powerful framework for elucidating coronavirus-receptor interactions. This also supports the development of broad-spectrum antiviral agents, smart biosensors, and intervention strategies against emerging coronaviruses.}, }
@article {pmid41472518, year = {2025}, author = {Boulton, O and Farquharson, B and Hoyle, L}, title = {The Complexity of Emergency Nurse Retention and Turnover Pre- and Post-Covid 19: A Scoping Review.}, journal = {Journal of advanced nursing}, volume = {}, number = {}, pages = {}, doi = {10.1111/jan.70467}, pmid = {41472518}, issn = {1365-2648}, abstract = {AIMS: To examine factors influencing emergency nurse turnover and retention pre- and post-COVID-19 and inform planned Participatory Systems Mapping research.
DESIGN: A scoping review of the literature reporting reasons emergency nurses leave, intend to leave or stay.
METHODS: Following the Joanna Briggs Institute methodology and a pre-registered protocol, databases and grey literature were systematically searched in January 2025 (updated August 2025). Literature published after 1st January 2010, was included. Two reviewers independently screened records, and 10% of extractions were cross-checked. Data were grouped thematically on a visual coding system using the Miro platform. Pre- and post-COVID-19 sources were categorised and analysed using a two-dimensional framework of intensity and frequency.
DATA SOURCES: MedLine, CINAHL, PsycINFO, Web of Science, Cochrane and grey literature.
RESULTS: Ninety-three sources were included. Burnout, workload, staffing and workplace violence (WPV) were linked across study designs to turnover, while job satisfaction, supportive leadership and team cohesion appeared to support retention. Problem-focused and resilience-based coping were associated with retention across study designs (n = 5); emotion-focused strategies were linked with poorer outcomes (n = 3). In a subset of 86 sources, traditional protective factors (leadership support and team camaraderie) appeared weakened post-COVID-19. A novel theme of moral obligation to remain, despite personal risk, emerged. Adaptive coping gave way to downshifting and emotional suppression.
CONCLUSION: The included evidence indicates that multiple, interacting factors shape emergency nurse turnover and retention, whilst systemic strategies aligning operational demands with psychological safety and core nursing values may contribute to sustainable retention.
Workforce interventions should address the psychological legacy of COVID-19 and focus on rebuilding trust, flexibility and moral sustainability in emergency departments.
IMPACT: While individual drivers of turnover are known, their complex interplay and retention factors are underexplored. This review identifies themes transcending boundaries and recurring across the turnover pathway, underscoring the need for multi-level interventions relevant to both nurse managers and policy makers.
REPORTING METHOD: Reporting follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines (PRISMA-ScR).
This study did not include patient or public involvement in its design, conduct or reporting.}, }
@article {pmid41474629, year = {2026}, author = {Nikanjam, M and Kato, S and Nishizaki, D and Miyashita, H and Pabla, S and Nesline, MK and Ko, H and Conroy, JM and Naing, A and Kurzrock, R}, title = {Inducible T-Cell Co-Stimulator (ICOS) and ICOS Ligand: Dealing With a Two-Faced Cancer Immunoregulatory System.}, journal = {Cancer medicine}, volume = {15}, number = {1}, pages = {e71467}, pmid = {41474629}, issn = {2045-7634}, support = {5U01CA180888-08/NH/NIH HHS/United States ; 5UG1CA233198-05/NH/NIH HHS/United States ; }, mesh = {Humans ; *Inducible T-Cell Co-Stimulator Protein/metabolism/antagonists & inhibitors/immunology ; *Inducible T-Cell Co-Stimulator Ligand/metabolism/immunology/antagonists & inhibitors ; *Neoplasms/immunology/drug therapy/metabolism ; Signal Transduction ; Animals ; }, abstract = {BACKGROUND: ICOS (inducible T-cell co-stimulator) and ICOS ligand (ICOSL) are part of an important, complex pathway that can lead to both immune stimulation and suppression. ICOS and ICOSL have heterogeneous expression patterns between and within tumor types.
METHODS: This review provides an overview of ICOS and ICOSL, their mechanisms of action, expression in cancer and other diseases, and clinical trials exploring therapies targeting ICOS.
RESULTS: Because of the bidirectional immune impact of the ICOS/ICOSL signaling pathway, both ICOS agonists and antagonists are under development and evaluation in clinical trials. The majority of clinical trials have focused on the development of ICOS agonists, with only one study exploring an ICOS antagonist; there have been no clinical trials developing ICOSL agonists or antagonists in oncology. ICOS can be expressed on immune-activating effector T-cell and immunosuppressive regulatory T-cell (Tregs). Thus, it is critical to determine where and how ICOS is expressed in order to evaluate the role for agonists versus antagonists. To date, ICOS agonists have shown limited activity in patients with malignancies, perhaps because of the lack of biomarker-based trials. However, an ICOS antagonist demonstrated a 44% response rate in angioimmunoblastic T-cell lymphoma; ICOS is highly expressed on T-follicular helper cells (type of CD4 cell) and proliferation of these cells may be a pathogenic mechanism for these lymphomas. A role for the ICOS/ICOSL signaling pathway has also been implicated outside of oncology, including in viral infections such as COVID-19, and in autoimmune conditions such as asthma and systemic lupus erythematosus.
CONCLUSION: Biomarker-driven approaches will be important to individualize therapy and ascertain which cancer patients will derive the greatest benefit from ICOS-directed combination therapy approaches.}, }
@article {pmid41475009, year = {2026}, author = {Stein, MV and Brooks, SK and Smith, LE and Rubin, GJ and Amlôt, R and Greeberg, N and Martin, AF}, title = {The impact of COVID-19 self-isolation on healthcare workers' psychological wellbeing: a systematic review.}, journal = {Occupational medicine (Oxford, England)}, volume = {76}, number = {2}, pages = {100-107}, pmid = {41475009}, issn = {1471-8405}, support = {//National Institute for Health and Care Research Health Protection Research Unit/ ; //National Institute for Health and Care Research/ ; //Health Protection Research Unit/ ; //Emergency Preparedness and Response/ ; //UK Health Security Agency, King's College London/ ; //University of East Anglia/ ; /WT_/Wellcome Trust/United Kingdom ; //British Academy/ ; SRG2324\240763//Leverhulme Small Research Grants Scheme/ ; //Emergency Preparedness and Response Unit/ ; NIHR200890//NIHR/ ; //UKHSA/ ; //Department of Health and Social Care/ ; }, mesh = {Humans ; *COVID-19/psychology/epidemiology/prevention & control ; *Health Personnel/psychology ; SARS-CoV-2 ; Mental Health ; *Social Isolation/psychology ; }, abstract = {BACKGROUND: Self-isolation is a key public health strategy for infectious disease control. Globally implemented during the COVID-19 pandemic, self-isolation remains an essential strategy in ongoing mitigation efforts. Healthcare workers (HCWs) often face isolation due to occupational exposure to infectious diseases and may face unique psychological challenges.
AIMS: This systematic review synthesized evidence on (i) the impact of self-isolation on HCWs' psychological wellbeing, (ii) factors associated with wellbeing, and (iii) the effectiveness of interventions to improve wellbeing during or after isolation for COVID-19.
METHODS: A pre-registered systematic review (PROSPERO: CRD42024559971) was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and Cochrane guidelines. Searches in PsycInfo, Embase, MEDLINE, PubMed and grey literature included studies on HCWs' psychological wellbeing during or after self-isolation. Risk of bias was assessed using ROBINS-E (Risk of Bias in Non-randomized Studies for Exposure) or CASP (Critical Appraisal Skills Programme) tools.
RESULTS: From 20,798 records screened, 19 studies (10 quantitative, 7 qualitative, 2 mixed methods) were included. Quantitative findings on anxiety, depressive and stress symptoms were inconsistent. Qualitative studies consistently reported distress, loneliness and stigma. Factors associated with wellbeing included socio-cultural influences and protective factors. No studies assessed interventions targeting wellbeing during self-isolation.
CONCLUSIONS: Self-isolation appears to have variable effects on HCWs' wellbeing, including significant challenges and opportunities for resilience. Public health strategies should prioritize timely, clear communication, accessible evidence-based psychological support and practical resources. Future research should prioritize evaluation of interventions to mitigate psychological harm and support HCWs during infectious disease outbreaks.}, }
@article {pmid41475153, year = {2026}, author = {Daniel, N and Smith, C and Miah, N and Akroyd, C and Bingham, T and Brooks, H and Chowdhury, MA and Kaur, G and Kundra, R and Prendergast, M and Chantkowski, M and Galiza, E and Nakafero, G and Milton, C and Mejia, M and Murphy, D and Ramanan, A and Rex, D and Wilkinson, S and Owera, S and Khunti, K and Faust, SN and Ramasamy, MN and , }, title = {Enablers and barriers to participation in vaccine trials: a narrative synthesis.}, journal = {Vaccine}, volume = {73}, number = {}, pages = {128183}, doi = {10.1016/j.vaccine.2025.128183}, pmid = {41475153}, issn = {1873-2518}, mesh = {Humans ; *Clinical Trials as Topic ; *COVID-19/prevention & control ; Female ; *COVID-19 Vaccines ; Pregnancy ; SARS-CoV-2 ; }, abstract = {OBJECTIVE: To synthesise evidence on barriers and enablers to participation in vaccine clinical trials (2010-2024), with a focus on underserved populations, to support the design of more inclusive vaccine trials.
MATERIALS AND METHODS: A rapid narrative review was conducted using PubMed, identifying 145 peer-reviewed studies published between 2010 and 2024. Data extraction captured study design, participant population, and factors influencing trial enrolment. Findings were thematically analysed, with subgroup synthesis for underserved populations, including pregnant individuals, parents, ethnic minority groups, and LGBTQ+ communities.
RESULTS: Analysis of the 145 included studies identified five themes for enablers and four themes for barriers. Safety concerns were the most frequent deterrent, particularly for proxy decision-makers such as parents and pregnant participants. Institutional mistrust and misinformation were consistent barriers, with the COVID-19 pandemic heightening distrust of governments and pharmaceutical companies and amplifying misinformation through social media. Additional barriers included sociocultural expectations and logistical burdens, particularly in low-resource settings. Enrolment was enabled by altruistic motivations, perceived personal or community benefit, transparent safety communication, logistical ease, and community engagement. Community-led engagement, culturally concordant staff, and proportionate incentives were consistently associated with improved enrolment.
CONCLUSIONS: Vaccine trial participation is shaped by a dynamic risk-benefit calculus that manifests differently across populations. Addressing inequities requires sustained community partnerships, culturally competent trial design, proportionate material support, and proactive communication strategies to counter misinformation. These findings provide actionable guidance for designing more inclusive vaccine trials.}, }
@article {pmid41476292, year = {2025}, author = {Sasikumar, S and Patidar, S}, title = {Progressive fibrotic interstitial lung diseases in India: national challenges and implications for global health policies.}, journal = {Health research policy and systems}, volume = {24}, number = {1}, pages = {8}, pmid = {41476292}, issn = {1478-4505}, mesh = {Humans ; India/epidemiology ; *Health Policy ; *Lung Diseases, Interstitial/epidemiology/diagnosis/therapy ; *Idiopathic Pulmonary Fibrosis/epidemiology/diagnosis ; Disease Progression ; COVID-19/epidemiology ; Global Health ; Quality of Life ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Interstitial lung diseases (ILDs) constitute a heterogeneous group of diffuse parenchymal lung disorders characterized by varying degrees of inflammation and fibrosis. Global estimates indicate that the incidence of ILDs has risen by over 50% in the recent years. In India, epidemiological data remain limited and inconsistent due to heterogeneity in diagnostic criteria and regional disparities, impeding accurate burden estimation and policy prioritization.
MAIN TEXT: Among ILDs, progressive fibrotic forms, idiopathic pulmonary fibrosis (IPF) in particular, cause substantial morbidity and mortality. Many ILDs progress to irreversible fibrosis, leading to declining lung function, impaired quality of life and shortened survival. Timely and precise diagnosis of progressive fibrotic (PF)-ILDs is imperative to facilitate early therapeutic intervention and potentially slow down fibrotic progression. Diagnostic evaluation necessitates high-resolution computed tomography, histopathological examination and multidisciplinary team consensus, all of which are often unavailable or prohibitively expensive outside tertiary care centres in India. Therapeutic options are confined primarily to two antifibrotic agents approved for IPF, which modestly attenuate disease progression but do not significantly improve survival in patients. Access to these therapies is limited by cost, lack of proper insurance coverage and non-uniform healthcare infrastructure. Clinical presentation is often delayed owing to low disease awareness and referral gaps. Although, pulmonary fibrosis following novel coronavirus disease 2019 has attracted recent attention, it constitutes a minor fraction of the PF-ILD burden. Despite the high morbidity and mortality associated with PF-ILDs, these conditions are inadequately represented in India's health policy instruments, research agendas and funding priorities.
CONCLUSIONS: The burden of PF-ILDs in India demands an urgent policy response, which involves integrating ILDs into national non-communicable disease frameworks, expanding diagnostic capacity in secondary care, improving affordability and access to antifibrotic drugs and supporting multicentre registries for surveillance and research. Addressing these gaps could reduce disease impact domestically and provide a model for other low- and middle-income countries confronting similar challenges in tackling fibrotic lung diseases.}, }
@article {pmid41476373, year = {2026}, author = {Joshi, R and Sharma, S and Kapoor, DU and Prajapati, BG and Huanbutta, K and Sriamornsak, P}, title = {mRNA-Based Therapeutics: Advances in Drug Delivery, Comparative Innovations, and Biomedical Applications.}, journal = {Molecular pharmaceutics}, volume = {23}, number = {2}, pages = {583-621}, doi = {10.1021/acs.molpharmaceut.5c00774}, pmid = {41476373}, issn = {1543-8392}, mesh = {Humans ; *Drug Delivery Systems/methods ; *RNA, Messenger/administration & dosage/therapeutic use/genetics/chemistry ; Nanoparticles/chemistry ; Animals ; Lipids/chemistry ; SARS-CoV-2 ; COVID-19 ; Liposomes ; }, abstract = {mRNA-based therapeutics represent a major advancement in modern medicine, offering programmable and nonintegrating treatment options for infectious diseases, malignancies, and hereditary disorders. This review addresses the chronological evolution, structural optimization, and delivery challenges of mRNA drugs, highlighting developments such as nucleoside modifications and lipid nanoparticle (LNP) platforms that improve the stability and promote cellular entry. Comparative analysis highlights the benefits of mRNA over DNA-, siRNA-, and protein-based medicine in safety, scalability, and rapid rearrangement. Applications vary from COVID-19 vaccines to individualized cancer immunotherapy and protein replacement strategies. New methods, including self-amplifying mRNA (saRNA), CRISPR-Cas9 gene editing, and tissue-specific delivery systems, enhance the therapeutic potential. While mRNA technology faces challenges in terms of immunogenicity, multiple dosing, and durability of safety considerations, it offers unparalleled precision, transient expression, and swift manufacturability. This review emphasizes the comparative design principles of mRNA delivery systems, bridging formulation innovation with translational biomedical applications. By integrating lipid-based and nonlipid nanocarrier insights, it highlights critical advances shaping next-generation mRNA therapeutics.}, }
@article {pmid41476648, year = {2025}, author = {Li, Q and Xing, H and Naeem, A and Zhang, K and Zheng, A and Huang, Y and Lu, M}, title = {Extracellular Vesicle-Based mRNA Therapeutics and Vaccines.}, journal = {Exploration (Beijing, China)}, volume = {5}, number = {6}, pages = {20240109}, pmid = {41476648}, issn = {2766-2098}, abstract = {Messenger RNA (mRNA) therapeutics and vaccines have recently gained particular prominence following the COVID-19 epidemic. However, clinical translation of mRNAs is critically dependent on efficient and safe delivery in vivo. Currently, a plethora of mRNA delivery technology platforms (such as lipid nanoparticles) have been developed and have achieved stunning success. Nevertheless, many challenges remain to be overcome, including immunogenicity and toxicities, excessive liver accumulation, limited endosomal escape ability, low tissue bioavailability, poor mucosal immunity, and the need for cold chain storage. In recent years, extracellular vesicles (EVs) have emerged as an attractive mRNA delivery platform due to their favorable properties, such as low immunogenicity, natural capability to deliver RNAs, intrinsic targeting capacity, and the ability to negotiate with physiological barriers. In this review, we discuss the latest efforts to harness EVs for mRNA delivery and elaborate the behind mechanisms, aiming to offering insights into the rational design of effective and safe EV-based mRNA therapeutics and vaccines for biomedical applications. Additionally, we provide an overview of EV biogenesis, composition, cellular internalization, and their superiorities and challenges for mRNA delivery, with special emphasis on the state-of-the-art methodologies for packaging EVs with mRNAs.}, }
@article {pmid41476768, year = {2025}, author = {Dommer, AC and Amaro, RE and Prather, KA}, title = {Understanding Aerosol-Mediated Disease Transmission.}, journal = {ACS central science}, volume = {11}, number = {12}, pages = {2319-2328}, pmid = {41476768}, issn = {2374-7943}, abstract = {This Outlook aims to update the longstanding treatment of airborne disease transmission through an interdisciplinary lens combining biology, surface chemistry, and aerosol physics, drawing parallels between environmental and human-generated infectious aerosols and examining their effects on human and ecosystem health. By recasting the lung surface as a dynamic interface akin to the ocean surface, this Outlook illustrates the importance of a multidisciplinary approach to elucidate the mechanisms of disease transmission at a depth that enables practical mitigation strategies. The urgency of this analysis is motivated by the evolving nature of airborne pathogens of concern, such as SARS-CoV-2 and influenza, and the global impact of dynamic environments on the poorly understood airborne microbiome.}, }
@article {pmid41476798, year = {2025}, author = {Wang, L and Zhang, H and Jiang, H}, title = {Phosphorylation Modifications and Their Role in Viral Pneumonia: Mechanisms and Therapeutic Implications.}, journal = {Infection and drug resistance}, volume = {18}, number = {}, pages = {6915-6933}, pmid = {41476798}, issn = {1178-6973}, abstract = {Advances in diagnostic technologies have led to the identification of an increasing number of viruses associated with pneumonia, thereby drawing significant attention to viral pneumonia. The primary viral pathogens implicated in pneumonia include influenza virus, respiratory syncytial virus, coronavirus, adenovirus, parainfluenza virus, human metapneumovirus, and enterovirus. Post-translational modifications, especially phosphorylation, are pivotal in the lifecycle of these viruses. Phosphorylation affects key processes such as viral replication, transcription, assembly, and release, thereby influencing their propagation in host cells. Viral infection can also trigger kinase-associated pathways within host cells, activating host cell phosphatases and related signaling cascades. This results in alterations to host phosphorylation states, aggravating cellular pathology and facilitating viral proliferation. This review examines the common viral pathogens involved in pneumonia and highlights the role of phosphorylation in viral proliferation. Additionally, we explore the potential of phosphorylation inhibitors in controlling viral infections, with the aim of advancing our understanding of viral phosphorylation and promoting the use of these inhibitors in the treatment of viral pneumonia.}, }
@article {pmid41476991, year = {2025}, author = {Asadikaram, M and Bahrampour, S and Rahimi Naiini, M and Jafarzadeh, A and Rosen, C and Asadikaram, G}, title = {Prolactin: A Key Immunoregulator in Viral Infections and Autoimmune Diseases.}, journal = {International journal of endocrinology}, volume = {2025}, number = {}, pages = {2312675}, pmid = {41476991}, issn = {1687-8337}, abstract = {Prolactin (PRL) is secreted by various cells in the anterior pituitary gland, mammary glands, placenta, uterus, ovaries, testes, skin, adipose tissue, endothelial cells, immune system, and central nervous system. The expression and secretion of PRL are influenced by several factors such as suckling, thyrotropin-releasing hormone (TRH), cytokines, dopamine, estrogen, and vasoactive intestinal polypeptide. It operates through a complex receptor, which is expressed in mammary gland cells, pancreatic beta cells, adipocytes, and immune cells. PRL is essential for various physiological functions, in particular milk production, breast development, metabolism, and immune regulation. Serum PRL levels fluctuate daily and can be affected by exercise, diet, and stress. Hyperprolactinemia is linked to autoimmune diseases and viral infections. In viral infections such as HIV, HCMV, HCV, and COVID-19, PRL levels are often increased, which may influence the immune responses. PRL can modulate the activity of various immune cells, including T cells, B cells, natural killer cells, and macrophages, mounting an effective immune response against viral infections. Moreover, PRL influences the production of cytokines that mediate and regulate immunity and inflammation. PRL stimulates B cells to produce antivirus antibodies that are essential for neutralizing viruses and preventing their spread within the body. PRL levels, varying by sex and life stage, may affect immune responses and susceptibility to viral infections. Moreover, overexpression of PRL was indicated in various autoimmune diseases. Overall, PRL is a complex hormone with significant implications for endocrine function, immune regulation, and immune responses to viral infections, highlighting the need for further research into its diverse roles in health and disease. This review summarizes current knowledge of the immunomodulatory effects of PRL in human viral infections and possibly its contribution to the development of autoimmune diseases.}, }
@article {pmid41477135, year = {2025}, author = {Syamal, M}, title = {The Effects of COVID-19 on Voice.}, journal = {World journal of otorhinolaryngology - head and neck surgery}, volume = {11}, number = {4}, pages = {524-529}, pmid = {41477135}, issn = {2589-1081}, abstract = {The COVID-19 pandemic had profound effects on vocal health, impacting both infected individuals, professional voice users and essential workers. The objective of this paper was to explore the multifaceted nature of dysphonia associated with COVID-19, arising from both direct and indirect consequences of the pandemic. Prevalence rates of dysphonia among COVID-19 patients range widely from 25% to 79%, with significant underreporting. Factors contributing to voice changes include laryngeal inflammation, respiratory function impairment, treatment-related interventions, and increased vocal strain from masking and virtual communication. Professional voice users, such as teachers and singers, experienced unique challenges, including increased voice fatigue and apprehension regarding aerosol transmission during singing. For the voice clinician, videolaryngoscopic examination remains the critical tool for capturing the broad landscape of diagnoses that can range from inflammation to surgically emergent airway stenoses. Innovations with voice also emerged, utilizing artificial intelligence voice analysis for COVID-19 detection. Overall, understanding the relationship between COVID-19 and voice health is crucial for appropriate diagnosis and treatment of dysphonic patients. Continued research is necessary to further delineate the long-term implications and optimal treatment approaches for those affected.}, }
@article {pmid41477779, year = {2025}, author = {Vildanov, TR and Lukyanov, NG and Kozlov, KL and Vlasenko, SV and Shcherbak, SG and Vorobyovsky, DA}, title = {[Complexities of myocardial revascularization in patients over 75 years with acute coronary syndrome.].}, journal = {Advances in gerontology = Uspekhi gerontologii}, volume = {38}, number = {4}, pages = {546-552}, pmid = {41477779}, issn = {1561-9125}, mesh = {Humans ; *Acute Coronary Syndrome/surgery/diagnosis ; *Myocardial Revascularization/methods ; Aged ; *COVID-19/epidemiology ; Aged, 80 and over ; Geriatric Assessment/methods ; Prognosis ; SARS-CoV-2 ; }, abstract = {Acute myocardial infarction is the leading cause of hospitalization and mortality in elderly patients. The objective of this review is to demonstrate the importance of a comprehensive geriatric examination in cardiology, a balanced approach to choosing a myocardial revascularization method and postoperative patient management. The results of modern studies in emergency cardiology practice were studied and analyzed in such electronic bibliographic databases as Web of Science, Scopus, PubMed, Elibrary. This review presents known surgical strategies for myocardial revascularization, therapeutic options for postoperative management, the impact of geriatric syndromes and COVID-19 on the prognosis and outcome of the disease, clinical and angiographic difficulties in managing elderly patients with myocardial infarction.}, }
@article {pmid41479106, year = {2026}, author = {Karageorgou, E and Adam, S and Doukakis, S and Vlamos, P}, title = {Digital Accessibility for Students with Disabilities and Inclusive Learning in Education.}, journal = {Advances in experimental medicine and biology}, volume = {1490}, number = {}, pages = {417-424}, pmid = {41479106}, issn = {0065-2598}, mesh = {Humans ; *Persons with Disabilities/education ; *COVID-19/epidemiology ; *Students ; SARS-CoV-2 ; Artificial Intelligence ; *Learning ; *Education, Distance ; }, abstract = {The rapid advancement of digital technologies has reshaped education, yet significant barriers persist in ensuring equitable access for students with disabilities. Digital accessibility in education extends beyond technological solutions, requiring institutional commitment, policy reform, and faculty preparedness. This study examines the challenges and opportunities associated with digital accessibility in higher education and workplace inclusion, emphasizing systemic barriers such as inadequate assistive technologies, inaccessible Learning Management Systems (LMSs), and insufficient faculty training. The findings highlight the transformative potential of adaptive learning strategies, including artificial intelligence (AI), extended reality (XR), and human-computer interaction (HCI), in fostering personalized and inclusive learning environments. However, ethical concerns, algorithmic biases, and inconsistent implementation pose substantial obstacles to their effectiveness. The COVID-19 pandemic further exposed critical shortcomings in digital accessibility policies, disproportionately affecting students and employees with disabilities and underscoring the need for inclusive digital literacy initiatives. Addressing these challenges necessitates a holistic approach that integrates universal design principles, strengthens faculty training programs, and fosters interdisciplinary collaboration between educators, policymakers, and technologists. Through this review, sustained investment in assistive technologies is advocated, along with regulatory frameworks mandating digital inclusivity, and the development of digital learning ecosystems. By embedding accessibility as a fundamental component of educational and employment policies, institutions can mitigate the digital divide and advance equitable opportunities for all learners.}, }
@article {pmid41479918, year = {2025}, author = {Dhar, R and Singh, S and Sahoo, OS and Chandra, N and Gul, A and Mukherjee, I and Karmakar, S and Amanullah, M and Karmakar, S}, title = {The placental battlefield: viral strategies and immune countermeasures.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1667601}, pmid = {41479918}, issn = {1664-3224}, mesh = {Humans ; Pregnancy ; Female ; *Placenta/immunology/virology ; *Pregnancy Complications, Infectious/immunology/virology ; SARS-CoV-2/immunology ; *COVID-19/immunology/transmission/virology ; *Virus Diseases/immunology/transmission/virology ; Zika Virus Infection/immunology/transmission ; Zika Virus/immunology ; Animals ; Infectious Disease Transmission, Vertical ; }, abstract = {The placenta plays an essential role in connecting the maternal and fetal environments. It acts as both a protective barrier and a selective transport system during pregnancy. Despite its importance, we still do not fully understand how the placenta responds to viral infections, leaving a notable gap in maternal-fetal medicine. This review looks at how viral pathogens interact with placental tissue. It explores how viruses are transmitted, how the placenta's immune system responds, and how infections affect pregnancy outcomes. We examined recent findings on how viruses can penetrate placental barriers, the molecular processes that lead to placental damage, and the long-term effects on fetal development. We gathered evidence from SARS-CoV-2, Zika virus, cytomegalovirus, and other viral infections to highlight common pathways and point out possible treatment targets. As new viral threats continue to challenge healthcare systems worldwide, understanding placental virology is crucial for safeguarding both maternal and fetal health. This review outlines potential future research paths and emphasizes the urgent need for placenta-specific antiviral strategies as new infectious diseases emerge.}, }
@article {pmid41479924, year = {2025}, author = {Wan, X and Wang, X and Liu, Y and Hong, L and Zhao, Z and Guo, P}, title = {Ferroptosis in human reproductive tract infections and associated disorders: mechanisms and emerging therapeutic opportunities.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1713074}, pmid = {41479924}, issn = {1664-3224}, mesh = {Humans ; *Ferroptosis/immunology ; *Reproductive Tract Infections/immunology/metabolism/pathology ; Female ; Iron/metabolism ; COVID-19 ; Animals ; SARS-CoV-2 ; Male ; }, abstract = {Ferroptosis, an iron-dependent form of regulated cell death driven by lipid peroxidation, is closely associated with mitochondrial damage, diminished glutathione peroxidase 4 activity, dysfunction of the System Xc[-] cystine/glutamate antiporter, and disruptions in iron metabolism. Infections of the human reproductive system and associated reproductive disorders pose a significant global public health challenge, characterized by diverse pathogens and complex pathogenic mechanisms. Recent research has revealed that ferroptosis plays a critical role in the pathological processes of many of these infections. This review systematically elaborates on the central mechanistic role of ferroptosis in various pathologies of the reproductive system. These include CD4[+] T cell depletion and immunological non-response in Human Immunodeficiency Virus (HIV) infection, the development of Human Papillomavirus (HPV)-associated cervical cancer, Staphylococcus aureus-induced endometritis and mastitis, as well as male infertility, pre-eclampsia, and ovarian cancer linked to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. Despite the diversity of the pathogens, they can all trigger ferroptosis through common mechanisms, such as disrupting the Nrf2/GPX4 antioxidant axis, impairing the System Xc[-]-GSH-GPX4 pathway, and inducing dysregulation of iron metabolism. Furthermore, ferroptosis interacts intricately with pyroptosis and apoptosis, forming a complex network that collectively regulates the outcome of infections and the extent of tissue damage. Notably, ferroptosis plays a context-dependent dual role in various reproductive system infections. During the initial phases of infection, it exerts a protective effect by eliminating pathogens and curbing infection progression. In contrast, during advanced or chronic stages, ferroptosis exacerbates tissue injury and promotes disease pathogenesis. The ferroptosis pathway holds great therapeutic promise, either through inhibitors that safeguard host cells or inducers that eradicate drug-resistant bacteria by triggering a "ferroptosis-like" state. Nevertheless, challenges remain for clinical translation, as the ferroptosis network is incompletely understood, and the tissue selectivity and long-term safety of targeted drugs are unverified. Future studies must elucidate host-pathogen interactions to develop precise targeted therapies.}, }
@article {pmid41480252, year = {2025}, author = {Salas, RL and la Asunción, M and Vásquez-Soto, C and Orta-Visbal, K and Serrano, V and Villarreal, E and Sepúlveda, S and Montalvo, MJ and Nuñez, JA and Borja, J}, title = {Scoping review of the emerging definition of long COVID: implications for future research and clinical practice.}, journal = {Revista de salud publica (Bogota, Colombia)}, volume = {27}, number = {6}, pages = {122127}, pmid = {41480252}, issn = {2539-3596}, mesh = {Humans ; *COVID-19/complications/diagnosis ; *Terminology as Topic ; Biomedical Research ; SARS-CoV-2 ; }, abstract = {INTRODUCTION: Long COVID, Post-COVID19 syndrome and prolonged COVID-19, are concepts classified as the set of signs and symptoms that persist after an acute episode of COVID-19 disease.
OBJECTIVE: To describe what definitions have been published for the term "long COVID".
METHODS: The PRISMA ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) was used as a base for a scoping review, as suggested by Joanna Briggs Institute. A search of databases, Medline via PubMed, Embase, SciELO and The Cochrane Library was undertaken. The data registry and synthesis of the results was carried out independently by two reviewers.
RESULTS: Following removal of duplicates, 896 articles were retrieved of which 91 met the eligibility principles and 51 of which included a definition. At least four characteristics of the definitions were identified: time or term, organs affected, symptoms and clinical manifestations.
CONCLUSIONS: The review identified many concepts and definitions of "long COVID". These findings show that there is lack of consensus on the definition of long COVID-19.}, }
@article {pmid41480483, year = {2026}, author = {Safeer, F and Murali, TS}, title = {Extracellular vesicles in viral disease management.}, journal = {Current research in microbial sciences}, volume = {10}, number = {}, pages = {100527}, pmid = {41480483}, issn = {2666-5174}, abstract = {INTRODUCTION/BACKGROUND: Extracellular vesicles (EVs) are non-replicating lipid-bilayered bodies that are naturally released by a cell that aid in various biological functions including cell-to-cell communication. They resemble the cells that they originate from, mimicking their composition and contents. The shared Endosomal Sorting Complex Required for Transport (ESCRT) mechanism between virions and EVs allows EVs to aid in the dispersion and infection of viruses.
SCOPE/OBJECTIVES: The aim of this review is to encapsulate important studies that highlight the potential use of EVs in diagnosis and therapeutics against viral diseases. It also discusses their benefits and limitations compared to currently available anti-virals, for their use in the medical sector.
SUMMARY OF KEY FINDINGS: Virus-infected host cells release extracellular vesicles that are markedly different from EVs secreted by a healthy host cell. Increase in certain biomarker levels in EVs prove to be highly beneficial in diagnostics. Depending on the cell source, EVs also exhibit the natural ability to defend against viral diseases. This innate ability to defend against viral infections, can thus be exploited to produce potent anti-viral responses in infected hosts.
CONCLUSION/IMPLICATIONS: By navigating the challenges associated with EVs, they can be utilised to prepare alternatives to anti-viral drugs currently available in the market that show low specificity and high toxicity, thus helping mitigate and manage viral diseases.}, }
@article {pmid41480490, year = {2026}, author = {Berhe, TT and Jara, D and Kifle, D}, title = {Health Misinformation in Ethiopia: Myths, Media Dynamics, Public Response, and Policy Implications: A Narrative Review.}, journal = {Public health challenges}, volume = {5}, number = {1}, pages = {e70181}, pmid = {41480490}, issn = {2769-2450}, abstract = {BACKGROUND: Health misinformation in Ethiopia undermines public trust and weakens the effectiveness of health interventions. Cultural beliefs, religious influences, and the expansion of digital media contribute to myths that fuel vaccine hesitancy, stigma, and delayed health-seeking behavior.
OBJECTIVE: To synthesize evidence on the scope, drivers, and impacts of health misinformation in Ethiopia and to highlight actionable strategies for improving public health communication.
METHODS: A narrative literature review was conducted using PubMed, Scopus, and African Journals Online, supplemented with grey literature from the Ministry of Health, World Health Organization (WHO), United Nations Children's Fund (UNICEF), and Regional fact checking organizations. Sources published between 2010 and 2025 that addressing misinformation, communication channels, or public responses in Ethiopia were included. Findings were summarized using descriptive narrative synthesis.
RESULT: Misconceptions related to traditional remedies, vaccine safety, COVID-19 cures, and modern contraceptives are widespread. Narratives spread rapidly across social media, particularly Facebook and Telegram, whereas oral traditions reinforce misinformation in rural communities. These Documented impacts include reduced uptake of immunization and maternal services, delayed treatment for diseases such as TB and HIV, and persistent stigma. Interventions involving community health workers, religious leaders, and youth-led campaigns have proven effective in countering misinformation.
CONCLUSION: Health misinformation remains a significant barrier to Ethiopia's health targets. Strengthening media literacy, engaging trusted community actors, and building partnerships between government, civil society, and digital platforms are crucial to mitigate health misinformation and improve public health outcomes.}, }
@article {pmid41480662, year = {2026}, author = {Dhawan, S and Pan-Ngum, W and MacIntyre, CR and Blacksell, SD}, title = {Epidemiological indicators of accidental laboratory-origin outbreaks.}, journal = {Epidemiology and infection}, volume = {154}, number = {}, pages = {e16}, pmid = {41480662}, issn = {1469-4409}, support = {/WT_/Wellcome Trust/United Kingdom ; 220211/Z/20/Z/WT_/Wellcome Trust/United Kingdom ; }, mesh = {Humans ; *Disease Outbreaks ; COVID-19/epidemiology ; *Laboratories ; SARS-CoV-2 ; }, abstract = {Accidental escapes of pathogens from laboratories continue to cause outbreaks in the community today, posing significant risks to the general public, animal communities and the environment. These incidents, as well as the uncertainties surrounding the origins of the COVID-19 pandemic, highlight the need to consider unnatural origins as part of emerging outbreak surveillance and detection. Identifying recurring patterns and distinctive factors of laboratory-associated disease outbreaks can aid in successfully preventing and mitigating these occurrences. Seventy incidents of laboratory-associated leaks that led to outbreaks in the wider public have been reported (Supplementary Appendix S1). Seven renowned cases that have been comprehensively studied were selected for review: (i) 1955 Polio vaccine incident in western USA, (ii) 1977 H1N1 influenza virus re-emergence in China and the Soviet Union, (iii) 1979 Anthrax release in Sverdlovsk, Soviet Union, (iv) 1995 Venezuelan equine encephalitis epidemics in Venezuela and Colombia, (v) 2003-4 SARS-CoV-1 escapes from Singapore, Taiwan and China, (vi) 2007 Foot-and-Mouth disease virus outbreak in Pirbright, England and (vii) 2019 Brucella leak in Lanzhou, China. These outbreaks were selected because data on their geographical spread, genetics, phylogeny, epidemiological factors (including attack rates, infectious dose, time, location and season of spread) and governmental and institutional responses to the incidents had been previously analysed and published. Thematic analysis of these lines of evidence revealed seven recurring insights described in historically confirmed laboratory-associated outbreaks: unusual strain characteristics, peculiar clinical manifestations or affected demographics, unusual geographical features, atypical epidemiological patterns, delayed government action and communication to the public, misinformation and disinformation spread to the public and biosafety concerns/incidents predating the event. The outbreaks exhibited between 13 and 19 retrospectively identified indicators. These indicators were used to develop preliminary risk criteria intended to support structured, hypothesis-generating assessment of outbreaks, rather than to establish origin.}, }
@article {pmid41480694, year = {2026}, author = {Zhang, YC and Zhang, L and Zhou, PT and Xie, ZH and Zhang, WJ and Fan, M and Han, YX and Liu, YH and Liu, YC}, title = {Environmental exposure to air pollution and climate: Intersecting the impact on ear and nose health and chemosensory function (Review).}, journal = {International journal of molecular medicine}, volume = {57}, number = {3}, pages = {}, pmid = {41480694}, issn = {1791-244X}, mesh = {Humans ; *Air Pollution/adverse effects ; *Environmental Exposure/adverse effects ; Climate Change ; *Nose Diseases/etiology/epidemiology ; *Climate ; COVID-19/epidemiology ; *Ear Diseases/etiology/epidemiology ; }, abstract = {Air pollution, an emerging global environmental issue, alongside extreme meteorological conditions exacerbated by climate change, threaten the sustainability of modern society and contribute to the onset and progression of various ear and nose diseases. Nonetheless, the impact of these environmental factors on ear and nose diseases and related dysfunctions remain inadequately explored. The present review involved a comprehensive search of PubMed, Web of Science, the Cochrane Library and Embase for relevant epidemiological and experimental data. How environmental factors contribute to olfactory and auditory system dysfunctions as well as the potential underlying mechanisms from the perspectives of immunity and inflammation were examined in the present review. It was found that air pollution and meteorological factors significantly influence the prevalence of major ear and nose diseases, including allergic rhinitis, otitis media and sudden sensorineural hearing loss. Of note, the present review also provides an examination of the interaction between severe acute respiratory syndrome coronavirus 2 and environmental factors in ear and nose diseases, highlighting how environmental stressors may worsen disease progression. In conclusion, the present review underscores the burden of multimorbidity caused by air pollution and extreme weather and emphasizes the need for more targeted prevention and management strategies for ear and nose diseases.}, }
@article {pmid41481750, year = {2026}, author = {Hamilton, DO and Simpson, V and Fox, T and Lutje, V and Kohl, A and Ferreira, DM and Morton, B}, title = {Attenuated viral strains of priority pathogens for potential use in controlled human infection model studies: A scoping review.}, journal = {PLoS neglected tropical diseases}, volume = {20}, number = {1}, pages = {e0013243}, pmid = {41481750}, issn = {1935-2735}, mesh = {Humans ; *Virus Diseases/virology/prevention & control ; Chikungunya virus/immunology ; Rift Valley fever virus/immunology ; *Viral Vaccines/immunology/administration & dosage ; *Viruses/genetics ; Animals ; }, abstract = {BACKGROUND: There are several known pathogens and families identified as high risk for pandemic potential. It is essential to study these pathogens and develop medical countermeasures to mitigate disease prior to potential pandemics. Controlled human infection models (CHIMs) using attenuated viral strains may offer an efficient and safe way to do this.
OBJECTIVE: Our aim was to systematically examine the literature for attenuated, but replication competent, strains of Coalition for Epidemic Preparedness Innovations (CEPI) identified priority pathogens (Ebola, Lassa virus, Nipah virus, Rift Valley fever virus, chikungunya virus and Middle East respiratory syndrome-related coronavirus) that have been administered to humans.
DESIGN: A comprehensive literature search of multiple databases was performed by an information specialist. All search results were screened by two authors against inclusion/exclusion criteria from a pre-specified protocol. The primary outcome was confirmation that the administered viral strain could subsequently be recovered from participants. The secondary outcome was attenuated virus safety.
RESULTS: Our searches yielded 13078 results and 5998 articles remained for screening after removing duplicates and animal studies. Subsequently, 351 articles were selected for full text review and nine were included for data extraction. Four distinct attenuated strains were identified across two priority pathogens - TSI-GSD-218 and VLA1553 for chikungunya virus and MP-12 and hRVFV-4s for Rift Valley Fever virus. Attenuated virus was recovered for each strain except hRVFV-4s. There were no major safety concerns for these identified strains in Phase 1-3 studies.
CONCLUSIONS: We have identified three attenuated viral strains that may be amenable to development into novel CHIMs for two priority pathogens. Of these, VLA1553 for chikungunya is a licenced and commercially available vaccine product suitable for use in CHIM. There is a research gap for the creation of new attenuated mutants that could be utilised in CHIM for other priority pathogens.}, }
@article {pmid41482169, year = {2026}, author = {Kwon, CY and Won, J and Lee, B}, title = {The health effects of diaphragmatic breathing: A systematic review.}, journal = {Complementary therapies in medicine}, volume = {96}, number = {}, pages = {103317}, doi = {10.1016/j.ctim.2025.103317}, pmid = {41482169}, issn = {1873-6963}, mesh = {Humans ; *Breathing Exercises/methods ; Randomized Controlled Trials as Topic ; Gastroesophageal Reflux/therapy ; COVID-19/therapy ; Adult ; Diaphragm ; Anxiety/therapy ; }, abstract = {BACKGROUND: Diaphragmatic breathing (DB) is widely used clinically, but a comprehensive synthesis of randomized controlled trial (RCT) evidence on its health effects is lacking. This systematic review evaluated the health effects of DB interventions in adults based on RCT evidence.
METHODS: Six electronic databases were searched through January 2025 for RCTs comparing DB to control conditions in adults. Two reviewers independently selected studies, extracted data, and assessed risk of bias (Cochrane RoB 2). A narrative synthesis was performed due to substantial heterogeneity across studies.
RESULTS: We included 48 RCTs. DB protocols were highly heterogeneous, with parameters varying widely in breathing frequency (2-10 breaths/min), session duration (3-45 min), and total duration (single session to 12 weeks). Methodological quality was a significant concern (only 2.12 % of outcomes low risk of bias). Consistent benefits were found for gastroesophageal reflux disease (GERD) (including reduced medication use), anxiety, post-COVID-19 syndrome, and gestational diabetes). In healthy adults, DB showed acute cardiovascular benefits. However, evidence was inconsistent for chronic obstructive pulmonary disease, and DB was less effective than standard care after cardiac surgery. Safety was underreported (18.75 % of studies), but no serious adverse events were noted.
CONCLUSIONS: DB is a promising complementary therapy for specific conditions, including GERD, but the evidence base is constrained by methodologically weak and heterogeneous primary studies. Future research requires rigorous, standardized trial designs to establish its clinical value. Despite these limitations, DB is a low-cost, accessible, and apparently safe intervention for select conditions.}, }
@article {pmid41482260, year = {2026}, author = {Ticinesi, A and Zuliani, G and Spaggiari, R and Volpato, S and Maggi, S and Franceschi, C}, title = {The social microbiome of older people.}, journal = {Ageing research reviews}, volume = {115}, number = {}, pages = {103008}, doi = {10.1016/j.arr.2025.103008}, pmid = {41482260}, issn = {1872-9649}, mesh = {Humans ; *Gastrointestinal Microbiome/physiology ; *Dysbiosis/microbiology ; Aged ; *Aging/psychology/physiology ; *COVID-19 ; Animals ; Social Isolation ; Frailty/microbiology ; }, abstract = {The human gut microbiome (GM) is increasingly recognized as one of the main systems influencing the aging trajectory. Age-related dysbiosis, with imbalance between symbionts and pathobionts, can in fact fuel chronic inflammation (inflammaging) and promote frailty. In older individuals, GM composition is characterized by marked inter-individual variability and consistently influenced by environmental exposures. Studies conducted in animals and closed human communities suggest that social contacts are associated with horizontal transmission of commensal bacteria, enhancing biodiversity and preventing dysbiosis. Recent studies also suggest transmission of intestinal commensal bacteria from animals to humans sharing the same household. Bacterial populations residing on environmental surfaces may also have an influence on GM composition. In this framework, impoverishment of social relationships in older individuals may not be only associated with cognitive and emotional disengagement, but also with unfavorable changes in GM composition, driven by isolation and top-down neuromodulation of intestinal function. In fact, studies conducted during forced social distancing in the COVID-19 pandemic suggest GM changes pointing towards dysbiosis. Therefore, the detrimental consequences of social isolation for health outcomes of older individuals, including frailty progression towards disability, could be at least partly mediated by GM dysbiosis. Conversely, interventions aimed at restoring sociality, including animal-assisted activities, could expose older individuals to a range of novel bacterial species helping to counteract GM dysbiosis. This perspective article critically discusses the concept of social microbiome, its possible relevance for maintenance of good health in human beings, and its implications for the care of older patients.}, }
@article {pmid41482689, year = {2026}, author = {Yang, YJ and Kim, KH and Park, JH and Ro, YS and Song, KJ and Shin, SD}, title = {Impact of the COVID-19 Pandemic on the Mortality of Traumatic Brain Injury Patients Transported by Emergency Medical Services.}, journal = {Asia-Pacific journal of public health}, volume = {38}, number = {1}, pages = {55-64}, doi = {10.1177/10105395251407042}, pmid = {41482689}, issn = {1941-2479}, mesh = {Humans ; *COVID-19/epidemiology ; *Brain Injuries, Traumatic/mortality/therapy ; Male ; Female ; Middle Aged ; *Hospital Mortality/trends ; *Emergency Medical Services/statistics & numerical data ; Adult ; Aged ; Retrospective Studies ; Pandemics ; }, abstract = {The purpose of this study was to investigate the effects of the COVID-19 pandemic on the mortality of traumatic brain injury (TBI) patients transported by emergency medical services (EMS). Adult TBI patients who were assessed and transported by EMS between January 2018 and December 2021 were analyzed. The main exposure was during the COVID-19 pandemic period at the time of the event. The primary outcome was in-hospital mortality. A total of 18 988 patients were analyzed. The in-hospital mortality in the COVID-19 era group was 1812 (20.9%), and that in the non-COVID-19 era group was 2040 (19.8%). Multivariate logistic regression analysis revealed a significantly greater probability of in-hospital mortality in the COVID-19-era group; adjusted odds ratio of 1.16. Compared with non-COVID-19 era patients, TBI patients who were assessed and transported during the COVID-19 era were more likely to have higher in-hospital mortality.}, }
@article {pmid41482705, year = {2026}, author = {Sabeena, S and Beynon, C}, title = {The Impact of the COVID-19 Pandemic on HPV Vaccination Coverage Among Adolescents From High-Income Countries and Challenges: A Scoping Review.}, journal = {Reviews in medical virology}, volume = {36}, number = {1}, pages = {e70102}, doi = {10.1002/rmv.70102}, pmid = {41482705}, issn = {1099-1654}, mesh = {Humans ; Adolescent ; *COVID-19/epidemiology/virology ; *Papillomavirus Vaccines/administration & dosage ; *Papillomavirus Infections/prevention & control/virology/epidemiology ; Female ; *Vaccination Coverage/statistics & numerical data ; Developed Countries ; Vaccination ; Male ; SARS-CoV-2 ; Patient Acceptance of Health Care ; Uterine Cervical Neoplasms/prevention & control/virology ; Vaccination Hesitancy ; Health Knowledge, Attitudes, Practice ; }, abstract = {Persistent high-risk Human Papillomavirus (HPV) infection causes anogenital and oropharyngeal cancers across all genders. The primary cancer associated with HPV is cervical cancer and the HPV vaccination before sexual exposure is recommended for cervical cancer elimination globally. This scoping review aims to map the preliminary evidence regarding the determinants of adolescent HPV vaccine acceptance and hesitancy during the COVID-19 pandemic in high income countries. A scoping review was conducted as per the updated Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR) checklist. Using the PCC (Population, Concept, and Context) framework, search keywords and search strategies were developed. Electronic databases were searched using specific search terms and the last search date noted as February 8, 2025. A thematic content analysis was carried out to identify the themes and subthemes by a deductive approach. Fourteen studies were included as the potential sources of evidence in this review. The study population included 493,819 adolescents from Australia, Hong Kong, Italy, Poland, Saudi Arabia, and the USA. The themes identified were inequity, attitude and behaviour, knowledge and communication, and engagement and influence. The COVID-19 pandemic generated a negative parental attitude towards HPV vaccines for a brief period. The adolescent HPV vaccine acceptance mainly depended on strong parental support and appropriate access to healthcare professionals and vaccination services. Travel restrictions, lockdowns, school closures, and social distancing contributed to significant HPV vaccine hesitancy in high income countries.}, }
@article {pmid41482979, year = {2026}, author = {Hecht, JD and Heitkemper, EM and Danesh, V and Clark, AP and Yoder, LH}, title = {A Concept Analysis of Expertise Associated With Practicing Clinical Nurses in Hospital Settings.}, journal = {Journal of advanced nursing}, volume = {82}, number = {8}, pages = {7803-7814}, pmid = {41482979}, issn = {1365-2648}, mesh = {Humans ; *Clinical Competence/standards ; *Nursing Staff, Hospital/standards ; Female ; *Nurse Clinicians/standards ; Concept Formation ; Male ; }, abstract = {AIM: Analyse the concept of expertise among practicing clinical nurses in hospital settings.
BACKGROUND: The generational loss of expert clinical nurses was exacerbated globally by the novel coronavirus. This ongoing loss combined with the increased complexity of hospitalised patients has prompted an urgent need to understand expertise among clinical nurses who practice in hospital settings.
METHODS: Walker and Avant's concept analysis method was used. PubMed, Medline, CINAHL and Access Medicine were searched (1982-2025) for research studies and literature reviews published in English that addressed clinical nursing expertise in hospitals.
RESULTS: Expertise is the knowledge and skills that are enculturated from immersion in a domain. Common attributes include obtaining salient information from different sources, interpreting patient situations rapidly and holistically, and performing actions that are individualised, immediate and appear instinctive. Common antecedents include deliberate accumulation of relevant experience and contextual connections within the hospital. Facilitating improved outcomes and facilitating improved outcomes are common consequences.
CONCLUSION: The attributes, antecedents and consequences of clinical nursing expertise are complementary and cross specialties. Experts' apparently instinctive actions are not intuitive but rather related to relevant past experiences, pattern recognition and skilled know-how. The requirements to develop expertise have evolved with the increased volume of available knowledge.
Expertise requires cultivating relevant experiences through active engagement with patients and creating contextual connections with others regarding hospital systems and processes. Experts should be formally included when developing processes and guidelines. Low-fidelity proxy measures like years of experience should be replaced with psychometrically validated instruments to measure expertise.
IMPACT: This concept analysis addresses the ambiguity of clinical nursing expertise by synthesising over 40 years of literature and provides insights for clinical nurses and researchers regarding the importance of context and the growing complexity of care delivery.
No patient or public involvement.}, }
@article {pmid41483690, year = {2026}, author = {Farmer, MS and Herbert, D and Torrisi, C and Zacharjasz, A and Castaneda, G and Schomberg, T and Dardis, M and Montgomery, N and Melvin, ME}, title = {Digital equity in nursing research: A methodological review of nursing studies requiring internet connection.}, journal = {Nursing outlook}, volume = {74}, number = {1}, pages = {102667}, doi = {10.1016/j.outlook.2025.102667}, pmid = {41483690}, issn = {1528-3968}, mesh = {Humans ; *Nursing Research/methods ; *COVID-19/epidemiology ; *Internet ; *Internet Access/statistics & numerical data ; Research Design ; }, abstract = {BACKGROUND: Shifting external factors, including public health emergencies and changes in funding, can prompt nurse scientists to modify study protocols, adopting internet-required methods for recruitment or data collection. Reliance on these methods could exclude populations, with significant implications for nursing, its science, practice, and policy. The onset of the COVID-19 pandemic provides a temporal dividing point to assess the impact on these methodological decisions.
PURPOSE: This methodological review aimed to (a) quantify the prevalence of internet-required methods in nursing research before and after March 2020, and (b) evaluate their impact on participant inclusivity among digitally disconnected populations.
METHODS: We analyzed the participant recruitment and data collection methods of a random sample of 232 peer-reviewed nursing studies published in 2021. We assessed whether the methods required internet access or not, then calculated the proportional difference between studies before and after March 2020.
DISCUSSION: Studies requiring internet access increased from 18.0% pre pandemic to 52.5% post pandemic onset. Internet-required methods also increased for nurses (54.4%), the general population (18.9%), and students (36.3%).
CONCLUSION: The percentage of internet-required studies in nursing research increased significantly after March 2020. In a shifting research environment, nurse scientists and leaders must proactively address the impact of methodological changes on participant inclusion, ensuring that bridging the digital divide remains a focus of policy and practice.}, }
@article {pmid41484272, year = {2026}, author = {Liu, X and Zou, Y and Jin, C and Wang, Y and Zhang, J and Yan, M and Xie, Y and Ding, M and Wang, K and Liu, L and Ding, C and Chen, X}, title = {Viral infections are associated with apical periodontitis: A meta-analysis of prevalence, clinical symptoms, and lesion sizes across 31 clinical studies.}, journal = {Clinical oral investigations}, volume = {30}, number = {1}, pages = {37}, pmid = {41484272}, issn = {1436-3771}, support = {HB2023093//Top Talent Support Program for young and middle-aged people of Wuxi Health Committee/ ; A20210056//Health and Science Project of Hangzhou/ ; 2023WJC034//Hangzhou Biological Medicine and Health Industry Development Support Science and Technology Project/ ; 2021WJCY131//Hangzhou Biological Medicine and Health Industry Development Support Science and Technology Project/ ; 2024ZL724//Zhejiang Science and Technology Program of Chinese Medicine/ ; 20211231Y028//Guided Project of Science and Technology of Hangzhou/ ; }, mesh = {Humans ; *Periapical Periodontitis/virology/epidemiology/pathology ; Prevalence ; *Virus Diseases/complications/epidemiology ; }, abstract = {OBJECTIVE: Bacteria and viruses are components of the oral microbiome and are linked to various oral diseases. Clinical observations indicate a higher prevalence of apical periodontitis (AP) during viral epidemics. However, research on this association is limited. This meta-analysis aimed to explore the relationship between viral infections and AP.
METHODS: This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Relevant studies were identified through systematic database searches, and data were extracted for eligible studies. Three validated quality assessment tools were used to ensure rigor. The pooled odds ratio (OR) with 95% confidence interval (CI) was calculated to quantify the strength of the association.
RESULTS: Out of 427 screened records, 31 studies comprising 1,341,636 participants met the inclusion criteria. The meta-analysis revealed that the prevalence of AP was 2.78 times higher in patients with viral infections compared to controls (95% CI = 1.88-4.12, p < 0.001). Infected individuals demonstrated more severe clinical symptoms (OR = 3.49, 95% CI = 2.07-5.90, p < 0.001) and significantly larger periapical lesions (OR = 3.84, 95% CI = 1.08-13.67, p < 0.05).
CONCLUSIONS: The evidence suggests a significant association between viral infections and AP, particularly in cases of viral co-infections.
CLINICAL RELEVANCE: These findings suggest that evaluating viral infections, particularly herpesviruses, could inform the clinical management of AP. However, further research is required to establish causality.}, }
@article {pmid41484399, year = {2026}, author = {Mols, F and van Cappellen-van Maldegem, S and Hoedjes, M and Horevoorts, N and Oerlemans, S and de Rooij, BH and Ezendam, N and de Theije, C and Hageman, G and Schoormans, D}, title = {Remote blood collection among cancer patients and age- and sex-matched controls for biomarker and genetic analyses using the PROFILES registry.}, journal = {Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer}, volume = {34}, number = {1}, pages = {61}, pmid = {41484399}, issn = {1433-7339}, mesh = {Humans ; *Neoplasms/blood/genetics ; Registries ; *Blood Specimen Collection/methods ; Male ; Female ; Patient Reported Outcome Measures ; Case-Control Studies ; *Biomarkers, Tumor/blood ; Cohort Studies ; Cancer Survivors ; }, abstract = {Studies on patient-reported outcomes (PROs) among cancer survivors are increasing but are most often limited to PRO and clinical data. To better understand the underlying biological mechanisms that mediate a decline in health after cancer, several PROFILES-registry studies were enriched with biological data. This paper summarizes lessons learned from collecting blood samples to obtain biomarker data among survivors and controls in large-scale ambulatory cohort studies. These lessons address financial challenges, ethical issues, insurance, legal matters, standardization of assessment, recruitment, communication with participants, lab facilities and protocols, transportation, the need for a biobank, and the value of a normative population. We also describe our experiences with collecting remote blood samples in these studies among cancer patient populations and a study in our normative population to illustrate these issues further.}, }
@article {pmid41484775, year = {2026}, author = {Dhuria, M and VanderEnde, K and Tanwar, S and Vaze, A and Yadav, S and Choudhary, S and Yadav, R and Desai, M and Bahl, A and Jain, SK and Singh, SK and Chauhan, H and Goel, A}, title = {Rapid expansion of the Frontline Field Epidemiology Training Program across 124 districts in India, 2021-2023.}, journal = {Health research policy and systems}, volume = {24}, number = {1}, pages = {11}, pmid = {41484775}, issn = {1478-4505}, mesh = {India/epidemiology ; Humans ; *COVID-19/epidemiology ; *Epidemiology/education ; SARS-CoV-2 ; *Public Health/education ; Pandemics ; Mentors ; }, abstract = {BACKGROUND: India conducts all three tiers of the Field Epidemiology Training Program (FETP). During the coronavirus disease 2019 (COVID-19) pandemic, the country committed to rapid scale-up of its frontline public health workforce capacity through the 3-month in-service Frontline FETP.
Between January 2021 and May 2023, 300 district-level public health workers and 73 mentors were trained across 124 districts in eight states. Frontline FETP officers successfully completed 236 field assignments, nearly half of which were surveillance systems evaluations or surveillance data analyses and another half of which were case, cluster or outbreak investigations. Acute diarrhoeal disease (ADD) was the most frequently assessed or investigated condition and was one of many diseases exemplifying how FETP officers may need to work across multiple sectors (for example, health, water and sanitation) to help mitigate the public health impact of disease on the affected communities. Challenges (for example, time-consuming process of tailoring learning content, attrition, identification of qualified mentors and task-shifting) and lessons learned (for example, pivoting to a self-paced learning model, using case studies with real-world examples, and a blended learning approach) are described.
CONCLUSION: This paper portrays the feasibility of not only implementing a 3-month FETP in India's diverse context but, given the complexity of health challenges in an increasingly interconnected environment, its flexibility to be naturally transitioned towards One Health FETP (named SectorConnect in India). It highlights a milestone in India's journey towards realizing the goals set under the One India FETP Roadmap for having at least one trained field epidemiologist per district.}, }
@article {pmid41485125, year = {2026}, author = {Miao, G and Lu, R and Pipanmekaporn, T and Kacha, S and Supphapipat, A and Phothikun, N and Jewprasertpan, P and Chittawatanarat, K}, title = {Association Between Blood Glucose Variability and Clinical Outcomes in Patients With Sepsis: A Systematic Review and Meta-Analysis.}, journal = {Diabetes/metabolism research and reviews}, volume = {42}, number = {1}, pages = {e70119}, doi = {10.1002/dmrr.70119}, pmid = {41485125}, issn = {1520-7560}, mesh = {Humans ; *Sepsis/mortality/blood ; *Blood Glucose/analysis ; Prognosis ; Hospital Mortality ; }, abstract = {AIMS: Glycaemic variability (GV) has emerged as an important prognostic indicator in critical illness, yet its predictive value among patients with sepsis remains unclear. This systematic review and meta-analysis aimed to evaluate the association between GV metrics and mortality outcomes in adult patients with sepsis.
METHODS: Cohort studies enrolling septic patients and reporting in-hospital, 28-day, or 30-day mortality in relation to GV were identified through PubMed, Embase, Cochrane Library, Scopus, CNKI, and Wanfang databases. Pooled odds ratios (ORs) were calculated using a random-effects model. Sensitivity analyses were performed to assess the robustness of the findings.
RESULTS: Ten studies comprising 18,337 patients were included. For categorical analysis, high-GV patients had nearly twice the mortality risk (OR = 1.99, 95% CI: 1.66-2.40, p < 0.0001; I[2] = 45%). For continuous analysis, all 4 GV metrics showed significant associations with mortality: CoV (OR = 1.050, I[2] = 76.6%), SD (OR = 1.0037, I[2] = 83.5%), GLI (OR = 1.0171, I[2] = 0.0%), and MAGE (OR = 1.0062, I[2] = 0.0%). High GV was associated with prolonged ICU stay (0.95 days, p = 0.0018). Sensitivity analyses confirmed the result robustness.
CONCLUSIONS: Elevated GV is independently linked to an increased risk of death among patients with sepsis. GLI and MAGE are the most reliable GV metrics for prognostic assessment, whereas CoV and SD are less consistent. Standardised GV measurement and prospective studies are warranted to evaluate whether interventions targeting GV can improve outcomes in this population.}, }
@article {pmid41485706, year = {2026}, author = {Salmanton-García, J and Nóbrega de Almeida, J and Colombo, AL}, title = {Candidozyma auris (formerly Candida auris): resistant, long lasting, and everywhere.}, journal = {Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases}, volume = {32}, number = {3}, pages = {374-381}, doi = {10.1016/j.cmi.2025.12.022}, pmid = {41485706}, issn = {1469-0691}, mesh = {Humans ; *Candida auris/drug effects/classification ; *Antifungal Agents/pharmacology/therapeutic use ; Cross Infection/epidemiology/microbiology ; *Drug Resistance, Fungal ; Disease Outbreaks ; Global Health ; }, abstract = {BACKGROUND: Invasive fungal diseases represent a significant global health concern, with Candidozyma auris (formerly Candida auris) emerging as a major healthcare-associated pathogen. Its multidrug resistance, environmental persistence, prolonged skin colonization, and efficient nosocomial transmission have driven sustained outbreaks and endemicity worldwide, and recent taxonomic changes have further complicated surveillance and diagnostics.
OBJECTIVES: This narrative review summarizes current evidence on the taxonomy, epidemiology, clinical impact, antifungal resistance, transmission, and infection prevention and control (IPC) of C. auris, highlighting outbreak drivers, regional endemicity, and key gaps relevant to surveillance and policy.
SOURCES: We conducted a structured narrative review of peer-reviewed and grey literature published between 2009 and 2025, drawing from PubMed/MEDLINE, Embase, Scopus, Web of Science, and major public health websites, such as the WHO, the CDC, the European Centre for Disease Prevention and Control, the UK Health Security Agency, and national surveillance portals.
CONTENT: C. auris has rapidly evolved into an endemic healthcare threat across multiple continents, with substantial regional variation in incidence, outbreak dynamics, antifungal resistance, and control capacity. Candidemia mortality averages ∼30% but differs by region and patient population. Azole resistance is widespread in several clades, whereas resistance to amphotericin B and echinocandins is increasingly reported, particularly in high-endemic settings. Outbreaks are sustained by environmental persistence, prolonged skin colonization, and healthcare-associated transmission, amplified by intensive care exposure, antimicrobial pressure, and system strain during the COVID-19 pandemic. Despite broadly aligned IPC guidance, major challenges persist in screening, decolonization, laboratory identification, and long-term outbreak control.
IMPLICATIONS: The continued global expansion of C. auris has major clinical, economic, and public health implications. Effective control requires sustained investment in laboratory capacity, standardized nomenclature adoption, active surveillance, genomic monitoring, and rigorous IPC measures tailored to the pathogen's unique biology. Without coordinated regional and international responses, C. auris is likely to continue shifting from epidemic emergence to entrenched endemicity in diverse healthcare systems worldwide.}, }
@article {pmid41486189, year = {2026}, author = {Terrones-Campos, C and Gallardo-Pizarro, A and Martinez-Urrea, A and Castiella, A and Vergara, A and Gonzalez, A and Egri, N and Garcia-Vidal, C}, title = {Invasive pulmonary aspergillosis in the ICU: the corticosteroid link.}, journal = {Pneumonia (Nathan Qld.)}, volume = {18}, number = {1}, pages = {2}, pmid = {41486189}, issn = {2200-6133}, support = {SGR 01324 Q5856414G//Agencia de Gestión de Ayudas Universitarias y de Investigación de Catalunya/ ; }, abstract = {Invasive pulmonary aspergillosis (IPA) is a life-threatening fungal infection traditionally associated with severely immunocompromised hosts, particularly those with hematologic malignancies. However, its epidemiological profile has shifted in recent years, with a rising incidence among critically ill patients in intensive care units (ICUs), many of whom lack classical risk factors. This change is driven by increased use of corticosteroids and immunomodulatory therapies, the growing prevalence of chronic lung disease, and severe viral pneumonias such as influenza and COVID-19. In these patients, airway epithelial injury, immune dysregulation, and mechanical ventilation facilitate fungal invasion even in the absence of profound immunosuppression. Corticosteroids play a central role in IPA pathogenesis. While they limit hyperinflammation, they simultaneously impair fungal clearance by suppressing NF-κB signaling, downregulating TNF-α production, and promoting IL-10 secretion, resulting in a Th2-skewed immune profile. Neutrophil recruitment persists but becomes dysregulated, contributing to tissue injury rather than effective pathogen elimination. Corticosteroids may also directly enhance Aspergillus growth, further compounding risk. Diagnosis of IPA in ICU patients remain challenging because radiological hallmarks such as the halo sign are uncommon, and distinguishing colonization from invasive disease is difficult. Serum and bronchoalveolar lavage galactomannan, β-D-glucan assays, and PCR can improve early detection, but no single test is definitive in this heterogeneous population. As much as possible, high-quality lower respiratory tract samples should be obtained. Furthermore, effective treatment requires not only timely diagnosis, but also careful selection of antifungal taking into consideration pharmacologic challenges of ICU patients and pharmacodynamics of antifungals. Recognition of high-risk patients such as those receiving corticosteroids, those with chronic lung disease, severe viral pneumonia, or requiring invasive ventilation is critical to improve outcomes. Mortality in this group can exceed that of neutropenic patients, underscoring the need for heightened clinical suspicion and timely antifungal therapy. A deeper understanding of the immunopathogenesis of IPA in non-neutropenic patients, particularly the dual effects of corticosteroids on inflammation and host defense, may inform risk stratification and guide earlier intervention. Enhanced surveillance, prompt diagnostic workup, and judicious use of immunomodulatory therapy represent key strategies to mitigate the rising burden of this devastating infection in ICU settings.}, }
@article {pmid41486437, year = {2025}, author = {Park, WB and Hwang, YH and Kwon, KT and Noh, JY and Park, SH and Song, JY and Choo, EJ and Choi, MJ and Choi, JY and Heo, JY and Choi, WS and , }, title = {COVID-19 Vaccination Recommendations for 2025-2026 in Korea.}, journal = {Infection & chemotherapy}, volume = {57}, number = {4}, pages = {472-477}, pmid = {41486437}, issn = {2093-2340}, abstract = {The Korean Society of Infectious Diseases has regularly updated its adult immunization guidelines, including the coronavirus disease 2019 (COVID-19) vaccination recommendations in 2023 and the 2024-2025 seasonal update. This article provides a comprehensive update as of September 2025, reflecting the latest evidence and international guidance. Focusing on the 2025-2026 season, it reviews vaccines currently authorized in Korea and their effectiveness against predominant JN.1 sublineage variants, including LP.8.1, NB.1.8.1, and XFG. The updated recommendations prioritize vaccination with LP.8.1-adapted vaccines for high-risk groups-adults aged 65 years and older, individuals aged 6 months and older at increased risk for severe disease, and residents of facilities vulnerable to infection-while vaccination remains available for all individuals aged 6 months and older. A single-dose strategy is generally recommended, although older adults and immunocompromised individuals may consider an additional dose at 6-month intervals in consultation with healthcare professionals. These updates aim to refine Korea's COVID-19 vaccination strategy and sustain protection in high-risk populations, with recommendations remaining subject to revision as new evidence and epidemiological conditions evolve.}, }
@article {pmid41486438, year = {2025}, author = {Seo, JW and Seo, YB and Kim, SE and Kim, Y and Kim, EJ and Kim, T and Kim, T and Lee, SH and Lee, E and Lee, J and Jeong, YH and Jung, YH and Choi, YJ and Song, JY}, title = {Clinical Practice Guideline Recommendations for Post-Acute Sequelae of COVID-19.}, journal = {Infection & chemotherapy}, volume = {57}, number = {4}, pages = {478-521}, pmid = {41486438}, issn = {2093-2340}, support = {HD22C2045//Korea Health Industry Development Institute/Republic of Korea ; }, abstract = {The guidelines presented herewith are based on the "Clinical Practice Guideline Recommendations for Post-Acute Sequelae of COVID-19 (PASC)" published in Infection & Chemotherapy in March 2024; these guidelines have been refined by incorporating the most recent Korean and international research findings and clinical evidence published since then. In the context of patients experiencing various physical and mental symptoms that persist long after the acute phase of coronavirus disease 2019 (COVID-19) infection, the diagnosis and management of PASC has emerged as a novel public health challenge. These guidelines are intended to provide standardized diagnostic and management recommendations applicable to the Korean healthcare setting and were developed through a comprehensive review of existing guidelines from organizations such as the World Health Organization, the United States National Institutes of Health, the United Kingdom National Institute for Health and Care Excellence, and the European Society of Clinical Microbiology and Infectious Diseases, along with the latest meta-analyses and Korean cohort studies. PASC is defined as the persistent presence of symptoms and signs lasting more than 3 months after COVID-19 diagnosis for which the symptoms cannot be explained by alternative diagnoses. The revised guidelines emphasize the importance of integrated management for patients with PASC, including a multidisciplinary approach considering risk groups, symptom-specific assessment, and rehabilitation and psychological interventions, based on a total of 32 key questions. This revision reflects rapidly evolving research trends regarding the long-term effects of COVID-19 and is expected to serve as an evidence-based standard guideline for future patient care, clinical research, and health policy development in Korea.}, }
@article {pmid41486819, year = {2026}, author = {Gupta, T and Verma, JK}, title = {Critical appraisal of methodological rigor in a systematic review on post-COVID-19 vaccination-associated olfactory dysfunction.}, journal = {Rhinology}, volume = {64}, number = {2}, pages = {285-286}, doi = {10.4193/Rhin25.440}, pmid = {41486819}, issn = {0300-0729}, mesh = {Humans ; *Olfaction Disorders/etiology ; *COVID-19 Vaccines/adverse effects ; *COVID-19/prevention & control ; SARS-CoV-2 ; *Vaccination/adverse effects ; }, abstract = {We read with keen interest the article by Kawabata et al. titled "Olfactory disorder after COVID-19 vaccination" which explores 16 cases of olfactory dysfunction temporally associated with vaccination. The paper addresses an important and under-recognized topic; however, several methodological aspects warrant clarification to aid accurate interpretation. First, the inclusion of five institutional cases within a review otherwise presented as PRISMA-compliant raises questions regarding methodological consistency. Under PRISMA, all included studies should be identified through transparent and reproducible database searches. Clarifying whether institutional data were processed separately from literature-derived cases would strengthen transparency and avoid confusion about the evidence level.}, }
@article {pmid41487586, year = {2025}, author = {Fan, H and Wang, L and Zhai, L and Deng, S and Li, Y and Niu, H and Zhao, B and Gao, J and Gao, X}, title = {Mapping three decades of air pollution-lung cancer research: trends, hotspots, and networks (1990-2025).}, journal = {Frontiers in oncology}, volume = {15}, number = {}, pages = {1698246}, pmid = {41487586}, issn = {2234-943X}, abstract = {BACKGROUND: The relationship between air pollution and lung cancer has attracted considerable attention from researchers worldwide. To systematically assess the scholarly landscape and pinpoint research fronts, this study employs bibliometric analysis to delineate global trends, collaborative networks, and key publications within this field.
METHODS: Publications from 1990 to 2025 were extracted from Web of Science Core Collection and Scopus databases. Bibliometric tools including VOSViewer, Citespace, and Bibliometrix R were used to examine trends, key contributors, research themes, and prominent journals.
RESULTS: Among 4,238 publications, citation rates rose significantly. China produced the most publications, with leading institutions such as Harvard University and the Chinese Academy of Sciences. Key researchers included Lan Q, Rothman N, and Vermeulen R. Major journals were Environmental Health Perspectives and Atmospheric Environment. Frequently used keywords like "Lung Cancer" and "Particulate Matter" indicate core themes, while emerging terms such as "Covid-19" and "Machine Learning" reflect evolving interests.
CONCLUSION: Fine particulate matter is an established environmental risk factor for lung cancer, and research on polycyclic aromatic hydrocarbons and asbestos remains active. The field has shifted from exposure assessment to mechanistic investigations focusing on oxidative stress, gene expression, and machine learning applications, defining key future research directions.}, }
@article {pmid41488032, year = {2026}, author = {Suresh, RR and Abuduani, T and Kasthuri, M and Chen, Z and Tber, Z and Loubidi, M and Zhang, H and Zhou, L and Zhou, S and Li, C and Kumari, A and Tao, S and Wiseman, JM and Hurwitz, SJ and Amblard, F and Schinazi, RF}, title = {Prodrug strategies in developing antiviral nucleoside analogs.}, journal = {RSC medicinal chemistry}, volume = {17}, number = {1}, pages = {105-131}, pmid = {41488032}, issn = {2632-8682}, support = {P30 AI050409/AI/NIAID NIH HHS/United States ; }, abstract = {Prodrug strategies are used to enhance the physicochemical and pharmaceutical properties of drug candidates that may not be suitable for specific delivery or are limited by formulation options. A prodrug derivative is converted into its active pharmaceutical ingredient (drug) through enzymatic or chemical reactions within the body. Antiviral nucleoside prodrugs have garnered considerable interest in drug discovery, leading to the approval of key drugs such as remdesivir (SARS-CoV-2), Sovaldi (hepatitis C virus, HCV), and tenofovir disoproxil fumarate [hepatitis B virus (HBV) and human immunodeficiency viruses (HIV)]. Their success lies in improving the oral bioavailability and delivering the parent drug to the targeted tissues. This review focuses on the prodrugs of antiviral nucleosides evaluated in humans (approved, in development or terminated), providing an overview of the different approaches utilized and discussing their in vitro and in vivo benefits.}, }
@article {pmid41488148, year = {2025}, author = {Shitaye, G and Getie, M and Mekonnen, Z and D'Abrosca, G and Fattorusso, R and Isernia, C and Amuamuta, A and Malgieri, G}, title = {Molecular analysis of long COVID and new-onset diabetes mellitus: pathobiological relationships and current mechanistic views.}, journal = {Frontiers in endocrinology}, volume = {16}, number = {}, pages = {1737894}, pmid = {41488148}, issn = {1664-2392}, mesh = {Humans ; *COVID-19/complications/metabolism/pathology/epidemiology ; *SARS-CoV-2 ; *Diabetes Mellitus, Type 2/epidemiology/etiology/virology/metabolism/pathology ; *Diabetes Mellitus, Type 1/epidemiology/metabolism/etiology/virology ; Renin-Angiotensin System ; Post-Acute COVID-19 Syndrome ; Insulin Resistance ; }, abstract = {Long COVID, or post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC), refers to a range of persistent health effects associated with SARS-CoV-2 infection. Long COVID is a complex, multisystem disorder that can affect nearly every organ system and is strongly linked with the incidence of diabetes and other chronic conditions. Increasing evidence also connects persistent SARS-CoV-2 infection with the development of new-onset diabetes and other metabolic disorders. In this review, we assess the current evidence and discuss the incidence of new-onset diabetes, along with the pathobiological mechanisms by which SARS-CoV-2 may contribute to the progression of both new-onset type 1 and type 2 diabetes mellitus (T1DM and T2DM). We summarize the latest understanding of the molecular and cellular mechanisms underlying SARS-CoV-2-associated new-onset diabetes. Potential mechanisms include direct damage to pancreatic β-cells, inflammation, insulin resistance, and autoimmune responses. Dysregulation of the ACE2/renin-angiotensin system (RAS) pathway has been linked to multiple inter-organ pathologies, and increased inflammatory cytokines together with dysregulation of interferon regulatory factors (IRFs)-such as overexpression of IRF1-appear to represent key mechanistic links to widespread tissue damage and metabolic alterations. Moreover, the presence of viral RNA or viral RNA fragments may directly damage pancreatic islets, contributing to insulin resistance and β-cell dysfunction that, in turn, may promote the development of new-onset diabetes. In light of these findings, this review further examines evidence supporting the persistence of SARS-CoV-2 RNA in PASC reservoir tissues, including the pancreas, and its potential association with the development of new-onset diabetes mellitus.}, }
@article {pmid41488264, year = {2025}, author = {Kumar, C and Akhileshwar, and Kumar Neeraj, R and Hameed, S and Husain, N and Roy, SS and Mohan, L and Anantsaznam, }, title = {Systematic Review and Meta-Analysis of the Incidence of Myocarditis and Guillain-Barré Syndrome in Adolescents Receiving COVID-19 mRNA Vaccine.}, journal = {Cureus}, volume = {17}, number = {11}, pages = {e98208}, pmid = {41488264}, issn = {2168-8184}, abstract = {This study aimed to evaluate the incidence and risk of rare long-term adverse events, specifically myocarditis and Guillain-Barré syndrome (GBS), in adolescents (12-19 years) following COVID-19 mRNA vaccination. We systematically searched MEDLINE, Embase, Cochrane CENTRAL, and Scopus, supplemented by trial registries and reference lists (PROSPERO: CRD420251045173). Eligible studies included randomized controlled trials (RCTs), cohort studies, case-control studies, self-controlled case series, and pharmacovigilance database analyses reporting myocarditis or GBS outcomes in adolescents receiving BNT162b2 or mRNA-1273. The search was conducted in June 2025, and all published studies were included. Risk of bias was assessed using the Cochrane RoB-2 tool, Newcastle-Ottawa Scale, or adapted criteria for pharmacovigilance studies. Effect measures were expressed as incidence rate or incidence rate ratios (IRRs) with 95% confidence intervals (CIs). Meta-analyses were conducted using random-effects models. Ten studies met the inclusion criteria. Myocarditis incidence was elevated in adolescent and young adult males, particularly after the second dose. Pooled analyses indicated a higher risk with mRNA-1273 compared to BNT162b2 (pooled IRR ≈ 3.9), although heterogeneity was very high (I[2] > 95%). For GBS, global pharmacovigilance data suggested only a modest association with mRNA vaccines (ROR 9.66), substantially weaker than for adenoviral vector or influenza vaccines. COVID-19 mRNA vaccination in adolescents is associated with a small but measurable increased risk of myocarditis, particularly in males, after the second dose, with a higher incidence following mRNA-1273. No consistent evidence of increased GBS risk was observed. Absolute risks remain low, and outcomes are generally favorable compared to SARS-CoV-2 infection. Continued surveillance and long-term follow-up are warranted.}, }
@article {pmid41488437, year = {2025}, author = {Pluetrattanabha, N and Direksunthorn, T}, title = {Mobile Health Clinics and Telehealth Outreach in Thailand: A Focus on Elderly Care and NCDs.}, journal = {Journal of multidisciplinary healthcare}, volume = {18}, number = {}, pages = {8321-8331}, pmid = {41488437}, issn = {1178-2390}, abstract = {BACKGROUND: Thailand faces a rapidly aging population alongside a high burden of non-communicable diseases (NCDs). Ensuring equitable healthcare access for older adults with NCDs is a pressing challenge. Mobile health clinics and telehealth services have emerged as key strategies to reach underserved elderly populations and maintain continuity of NCD care in remote or resource-limited settings.
OBJECTIVE: To examine current mobile clinic initiatives and telehealth outreach in Thailand focused on elderly care and NCD management, and to evaluate their impact on healthcare access and outcomes for older adults.
METHODS: We conducted a narrative review of published literature, policy reports, and program descriptions on mobile health clinics and telehealth interventions in Thailand, with emphasis on applications for older adults and chronic disease care (eg, diabetes, hypertension). A comprehensive search (2010-2025) of PubMed, Google Scholar, and Thai government/organization websites identified relevant sources. Data on intervention models, settings, target populations, and reported outcomes were extracted. In total, 15 key publications and reports were reviewed, from which 8 major mobile clinic or telehealth initiatives were identified.
RESULTS: Mobile health clinics have expanded primary care access for vulnerable elderly in both urban and rural areas. The Thai Red Cross Society's mobile clinic serves remote mountainous communities and provides primary care, NCD screenings, vaccinations, and medications to about 5,000 underserved people annually. Past mobile outreach programs have uncovered many untreated cases-in one survey, 58% of hypertensive and 75% of diabetic elderly were first diagnosed via a mobile unit. Telehealth services have likewise grown substantially. During the COVID-19 pandemic, telemedicine was rapidly adopted for routine consultations and chronic disease follow-ups. The National Health Security Office (NHSO) introduced a nationwide telemedicine service under the Universal Coverage Scheme, enabling remote consultations and medication deliveries for stable chronic NCD patients, ensuring continuity of care during lockdowns. Numerous telehealth applications emerged (public and private); for example, smartphone apps like MorDee ("Good Doctor") gained wide usage in Thailand. In an urban pilot "Dusit Telemedicine" model, integrating community clinics with a tertiary hospital, over 300 elderly patients received teleconsultations, reducing overcrowding. An acceptance study in this Bangkok pilot found older generations significantly less likely to adopt telemedicine than younger people - perceived ease of use was a strong predictor of acceptance (adjusted OR 3.95 for usability). Community-based telehealth pilots in rural areas, such as a Chiang Mai program using Community Health Leaders, demonstrated high satisfaction (≥90%) and successful NCD risk screenings, but also highlighted the need for training and support for both health workers and patients.
CONCLUSION: Mobile clinics and telehealth are complementary strategies for enhancing healthcare delivery to elderly Thais with NCDs. Mobile clinics physically bring essential services to those unable to travel, while telehealth connects patients to providers for continuous care and monitoring. The Thai experience illustrates that integrating these innovations into primary healthcare systems can enhance equity of care for aging populations. Continued support, digital literacy training for seniors, and policy integration of telehealth into the health system are recommended to ensure healthy aging under universal health coverage.}, }
@article {pmid41488438, year = {2025}, author = {Maulana, I and Shalahuddin, I and Eriyani, T and Pebrianti, S}, title = {"Exploring Psychosocial Interventions to Improve Mental Health Outcomes Among Healthcare Workers": Scoping Review.}, journal = {Journal of multidisciplinary healthcare}, volume = {18}, number = {}, pages = {8293-8303}, pmid = {41488438}, issn = {1178-2390}, abstract = {BACKGROUND: Healthcare workers (HCWs) face heightened risks of stress, anxiety, depression, and burnout, particularly during and after the COVID-19 pandemic. Psychosocial interventions have been increasingly implemented, yet the evidence remains fragmented across diverse settings and modalities. This scoping review aimed to map current psychosocial interventions designed to improve mental health outcomes among HCWs.
METHODS: Guided by the PRISMA-ScR framework, five databases (PubMed, Scopus, ScienceDirect, EBSCOhost, Google Scholar) were searched from January 2000 to September 2025. Eligible studies involved HCWs, assessed psychosocial interventions, and reported mental health outcomes. The Joanna Briggs Institute (JBI) appraisal tool was applied, and only studies scoring ≥70% were retained. Although multiple designs were eligible, only randomized controlled trials (RCTs) met the quality threshold and were included. Data were synthesized descriptively and thematically.
RESULTS: Of 312 identified records, 15 RCTs (2021-2025) were included. Interventions were grouped into mindfulness and meditation programs (n=6), digital and mHealth approaches (n=5), and coaching or AI-assisted resilience training (n=4). Specifically, mindfulness interventions reduced stress and anxiety by up to 30% and consistently improved well-being. Notably, digital modalities-including mobile apps and internet-delivered cognitive behavioral therapy (CBT)-were widely used during the pandemic and demonstrated benefits for burnout, sleep quality, and resilience. Across all studies, coaching and AI-assisted interventions improved work engagement and reduced exhaustion, particularly in non-pandemic contexts.
CONCLUSION: Psychosocial interventions demonstrate strong potential to improve HCWs' mental health. Digital programs offer scalable support, while resilience-based approaches promote long-term well-being. Future research should examine implementation in low-resource settings, compare digital versus in-person modalities, and explore organizational-level strategies to complement individual interventions.}, }
@article {pmid41488474, year = {2025}, author = {Yamin, M and Alsahafi, N and Abdulal, RH and Asad, M and Bosaeed, M and Zohaib, A}, title = {Non-coding RNAs in the viral host-pathogen interaction: molecular regulation and therapeutic potential.}, journal = {Frontiers in cellular and infection microbiology}, volume = {15}, number = {}, pages = {1734182}, pmid = {41488474}, issn = {2235-2988}, mesh = {Humans ; *Host-Pathogen Interactions/genetics ; *RNA, Untranslated/genetics ; COVID-19/virology ; SARS-CoV-2/genetics ; MicroRNAs/genetics/antagonists & inhibitors ; RNA, Circular/genetics ; Hepacivirus/genetics ; RNA, Long Noncoding/genetics ; Virus Replication ; *Virus Diseases/virology/genetics ; Antiviral Agents/therapeutic use ; Animals ; }, abstract = {Non-coding RNAs (ncRNAs), including microRNA (miRNA), long non-coding RNA (lncRNA) and circular RNA (circRNA), serve as key regulatory molecules in the context of viral infection. They play dual roles by modulating host immune responses and influencing viral replication, persistence, and disease progression. Numerous ncRNAs have been implicated in infections caused by viruses such as HCV, DENV and SARS-CoV. This review highlights the biogenesis and multifaceted functions of both host-encoded and virus-encoded ncRNAs in shaping host-pathogen interactions. It also examines their potential as novel biomarkers and therapeutic agents for viral infections. We discuss translational applications such as Miravirsen, a miRNA inhibitor that reached clinical trials for Hepatitis C Virus (HCV) and diagnostic relevance of lncRNA NEAT1 in SARS-CoV-2 infection. In the end, we have also addressed the current challenges and limitations involved in translating research observations of ncRNAs to clinical outcomes.}, }
@article {pmid41488618, year = {2025}, author = {Rodrigues, T and Beltrão, GS and Girardi, H and Pinto, AR}, title = {Viral reprogramming of glial metabolism as a driver of neuroinflammation.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1686774}, pmid = {41488618}, issn = {1664-3224}, mesh = {Humans ; *Neuroinflammatory Diseases/metabolism/virology/immunology ; *SARS-CoV-2/immunology ; Animals ; *COVID-19/immunology/metabolism/virology ; *Neuroglia/metabolism/virology/immunology ; Astrocytes/virology/metabolism/immunology ; HIV-1 ; Microglia/metabolism/virology/immunology ; Glycolysis ; Zika Virus/immunology ; }, abstract = {Considerable attention has been recently devoted to the involvement of immune cells in the central nervous system (CNS) during infections with neurotropic viruses, such as SARS-CoV-2, HIV-1, and ZIKV. These viruses are capable of infecting astrocytes and microglia, the main glial cells in the CNS, responsible for regulating neuronal activity. Here, we discuss how viral infections lead to metabolic reprogramming toward aerobic glycolysis in these cells, enhancing pro-inflammatory pathways, such as inflammasome activation, resulting in the secretion of inflammatory cytokines that favor the development of neuroinflammation. In this mini review, we discuss the pivotal interplay between metabolism and immunity towards viral pathogenesis in the CNS, pointing out the relevance of therapeutic strategies targeting both metabolic and immunological pathways to enhance antiviral and neuroprotective responses.}, }
@article {pmid41488628, year = {2025}, author = {Yin, L and Sun, CY and Chen, GL and Xiang, Z and Hu, BQ and Zhou, F and Wang, Q}, title = {Modular mastery of inflammation: umbilical cord mesenchymal stem cells as a therapeutic frontier.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1721947}, pmid = {41488628}, issn = {1664-3224}, mesh = {Humans ; *Mesenchymal Stem Cells/immunology ; *Umbilical Cord/cytology ; *Mesenchymal Stem Cell Transplantation/methods ; *COVID-19/therapy/immunology ; *Inflammation/therapy/immunology ; SARS-CoV-2 ; *Inflammatory Bowel Diseases/therapy/immunology ; Graft vs Host Disease/therapy/immunology ; Animals ; }, abstract = {Inflammation operates as a dual-edged sword in physiological defense and pathological damage, driving conditions from diabetes to neurodegeneration. Current anti-inflammatory therapies-NSAIDs, corticosteroids, and biologics-face clinical bottlenecks including non-specific toxicity, therapeutic ceiling effects, and drug resistance. Umbilical cord mesenchymal stem cells (UC-MSCs) emerge as a transformative alternative, leveraging three synergistic modules: Immune reprogramming, Inflammasome inhibition, Intercellular communication. Clinical trials demonstrate efficacy in inflammatory bowel disease, COVID-19 ARDS, and graft-versus-host disease. UC-MSCs outperform conventional therapies by multi-pathway modulation and tissue-regenerative capacity, though challenges persist in cell heterogeneity and long-term safety. Future work must standardize dosing protocols and validate scalable production for clinical translation.}, }
@article {pmid41488667, year = {2025}, author = {Zheng, Y and Liu, C and Li, Y and Wang, W and Dou, Q}, title = {The dual role of thrombospondin-1 in inflammatory regulation during acute respiratory distress syndrome: a mini-review.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1699900}, pmid = {41488667}, issn = {1664-3224}, mesh = {Humans ; *Thrombospondin 1/metabolism/immunology ; *Respiratory Distress Syndrome/immunology/metabolism/pathology ; *COVID-19/immunology ; Animals ; *Inflammation/immunology/metabolism ; *SARS-CoV-2/immunology ; }, abstract = {Inflammation serves as a fundamental defense against tissue injury and infection, yet dysregulation can lead to pathological outcomes. Thrombospondin-1 (Thbs1/TSP1), a multifunctional glycoprotein significantly upregulated during inflammation, exemplifies a dualistic regulator with context-dependent roles. Through modulation of cytokine networks and inflammatory cell activity (notably macrophages), Thbs1 critically governs inflammatory responses. Acute respiratory distress syndrome (ARDS), a life-threatening condition fueled by systemic inflammation secondary to infection or trauma, presents complex pathophysiology requiring elucidation. COVID-19 research highlights elevated Thbs1 expression in severe patients, where it demonstrates protective effects against pulmonary damage primarily via extracellular matrix protection, inhibition of neutrophil serine proteases, and TGF-β-dependent repair pathways. However, paradoxical evidence indicates that dysregulated Thbs1 can also contribute to ARDS pathogenesis, potentially by amplifying inflammation, promoting thromboinflammation, or driving fibrosis. Mechanistic insights reveal Thbs1's influence on ARDS progression through ECM remodeling, serine protease inhibition, and TGF-β activation. While significant progress has been made in understanding Thbs1 signaling, the precise mechanisms dictating its context-dependent switch between protective and pathogenic functions in inflammatory pathways remain a critical area for future investigation.}, }
@article {pmid41488929, year = {2025}, author = {Du, S and Cui, Z and Xu, X and Liu, T and Ye, J}, title = {Clinical efficacy of exercise in the treatment of post-COVID-19 syndrome: a systematic review and network meta-analysis.}, journal = {Frontiers in physiology}, volume = {16}, number = {}, pages = {1656713}, pmid = {41488929}, issn = {1664-042X}, abstract = {BACKGROUND: Post-COVID-19 syndrome (PCS) describes a constellation of persistent or new symptoms lasting beyond the acute phase of SARS-CoV-2 infection. Emerging evidence suggests that exercise is a cost-effective and accessible intervention that may enhance pulmonary function, improve cardiopulmonary circulation, regulate emotional status, and alleviate symptoms of PCS. However, robust evidence supporting the efficacy of exercise therapy in PCS remains limited. This systematic review and meta-analysis aimed to elucidate the therapeutic potential of exercise therapy in PCS.
METHOD: A search of the PubMed, Embase, Web of Science, and Ovid databases up to March 25, 2025 yielded 33 randomized controlled trials (with 2,895 participants) for meta-analysis.
RESULT: The results showed that exercise therapy significantly improved the multi-dimensional outcomes of patients with PCS. Bayesian network meta-analysis indicated that the combination of aerobic exercise and respiratory muscle training had the best effect on lung function. Multimodal exercise significantly improved the results of the six-minute walk test, the dyspnea score, and peak oxygen uptake. Mental Health and Mental Component Summary scores improved significantly in the group that received exercise therapy (P<0.01).
CONCLUSION: The results of this meta-analysis confirm that exercise can significantly improve quality of life and the emotional state of patients with PCS. They also provide evidence for a treatment strategy in patients with post-COVID-19 sequelae.
https://www.crd.york.ac.uk/PROSPERO/#myprospero, identifier CRD420251034187.}, }
@article {pmid41489056, year = {2026}, author = {Boesen, K and Hemkens, LG and Janiaud, P and Hirt, J}, title = {Topic-specific living databases of clinical trials: A scoping review of public databases.}, journal = {Clinical trials (London, England)}, volume = {23}, number = {2}, pages = {198-209}, pmid = {41489056}, issn = {1740-7753}, mesh = {Humans ; *Clinical Trials as Topic ; COVID-19 ; *Databases, Factual ; SARS-CoV-2 ; Information Storage and Retrieval ; }, abstract = {INTRODUCTION: Conducting systematic reviews of clinical trials is time-consuming and resource-intensive. One potential solution is to design databases that are continuously and automatically populated with clinical trial data from harmonised and structured datasets. This scoping review aimed to identify and map publicly available, continuously updated, topic-specific databases of clinical trials.
METHODS: We systematically searched PubMed, Embase, the preprint servers medRxiv, arXiv, Open Science Framework, and Google. We characterised each database using seven predefined features (access model, database type, data input sources, retrieval methods, data-extraction methods, trial presentation, and export options) and narratively summarised the results.
RESULTS: We identified 14 continuously updated databases of clinical trials, seven related to COVID-19 (initiated in 2020) and seven non-COVID-19 databases (initiated as early as in 2009). All databases, except one, were publicly funded and accessible without restrictions. Most relied on traditional methods used in static article-based systematic reviews sourcing data from journal publications and trial registries. The COVID-19 databases and some non-COVID-19 databases implemented semi-automated features of data import, which combined automated and manual data curation, whereas the non-COVID-19 databases mainly relied on manual workflows. Most reported information was metadata, such as author names, years of publication, and link to publication or trial registry. Only two databases included trial appraisal information (such as risk of bias assessments). Six databases reported aggregate group-level results, but only one database provided individual participant data on request.
DISCUSSION: Continuously updated topic-specific databases of clinical trials remain limited in number, and existing initiatives mainly employ traditional static systematic review methodologies. A key barrier to developing truly living platforms is the lack of accessible, machine-readable, and standardised clinical trial data.}, }
@article {pmid41490687, year = {2026}, author = {Sousa Almeida, PR and Sarmento, G and Gruner, H and Veríssimo, R and Duque, S}, title = {[Vaccination of Older Adults in Portugal: Recommendations from the Geriatrics Study Group of the Portuguese Society of Internal Medicine].}, journal = {Acta medica portuguesa}, volume = {39}, number = {3}, pages = {223-234}, doi = {10.20344/amp.23786}, pmid = {41490687}, issn = {1646-0758}, mesh = {Humans ; Aged ; Portugal ; Influenza Vaccines/administration & dosage ; *Vaccination/standards ; Middle Aged ; Pneumococcal Vaccines/administration & dosage ; Geriatrics ; *COVID-19 Vaccines/administration & dosage ; Aged, 80 and over ; COVID-19/prevention & control ; Influenza, Human/prevention & control ; }, abstract = {Older persons are more susceptible to infections and have a higher risk of serious complications, with a worse functional and vital prognosis. Vaccination is an effective strategy with a favorable safety profile for preventing infections and promoting healthy aging. In view of the clinical evidence and the vaccines available in Portugal in the first half of 2025, the Geriatrics Study Group of the Portuguese Society of Internal Medicine presents a proposal for vaccination of adults aged 65 years or older. The experts also point out the need to create a national lifelong vaccination program that includes older people to increase vaccination coverage and reduce the impact of infections in this population. Although the document focuses on people aged 65 years or older, vaccination against some diseases should start earlier. This article outlines five main recommendations: 1) Annual influenza and COVID-19 vaccination for all adults aged 50 years or older, with those aged 65 years or older receiving the high-dose trivalent influenza vaccine; 2) Respiratory syncytial virus vaccination for all adults aged 60 years or older and adults aged 18 - 59 years with risk factors, prioritizing people aged 75 years or older and those aged 50 years or older with risk factors; 3) Pneumococcal vaccination with the 20-valent or 21-valent pneumococcal conjugate vaccine for all adults aged 50 years or older and adults aged 18 - 49 years with risk factors; 4) Herpes zoster vaccination with the recombinant vaccine for all adults aged 50 years or older and adults aged 18 - 49 years at high risk of herpes zoster; 5) From the age of 65 years, booster vaccination against tetanus, diphtheria and pertussis every 10 years.}, }
@article {pmid41491167, year = {2026}, author = {Liao, Y and Liu, Y and Xu, S and Yang, J and Chen, Y}, title = {Incomplete Kawasaki disease associated with acute icteric hepatitis and Torque teno virus infection: a case report and literature review.}, journal = {BMC pediatrics}, volume = {26}, number = {1}, pages = {14}, pmid = {41491167}, issn = {1471-2431}, support = {0102018005//the 2024 Guangdong Renowned Traditional Chinese Medicine Practitioner Inheritance Studio Construction Project- Xu Youjia/ ; E43729//the State Administration of Traditional Chinese Medicine, under the project "a project for Chinese Medicine on Ying Lv's Renowned Expert Inheritance Studio"/ ; 2023B1111020004//the Department of Science and Technology of Guangdong Province, under the project "Efficacy and safety of the Jianer Jiedu Formula for the treatment of novel coronavirus infections in children- a real-world and randomized controlled study"/ ; 2024A03J0125//Bureau of Science and Technology of Guangzhou Municipality, under the project "Mechanism Study on the Regulation of NLRP3-mediated Pyroptosis by Jianer Jiedu Formula for the Treatment of RSV Pneumonia in Children Based on the Lingnan DampHeat Theory"/ ; }, mesh = {Humans ; Male ; *Mucocutaneous Lymph Node Syndrome/complications/diagnosis ; Infant ; *Torque teno virus/isolation & purification ; *DNA Virus Infections/complications/diagnosis ; *Jaundice/etiology ; Acute Disease ; *Hepatitis/diagnosis/complications ; Immunoglobulins, Intravenous/therapeutic use ; }, abstract = {INTRODUCTION: Kawasaki disease (KD) is an acute, self-limiting vasculitis that primarily affects children under five years of age. Its classic clinical features include prolonged fever, bilateral conjunctival injection, changes in the lips and oral cavity, cervical lymphadenopathy, rash, and extremity changes. Acute jaundice and liver dysfunction are atypical manifestations of KD. Cases in which jaundice is the initial presenting symptom-especially when accompanied by Torque Teno Virus (TTV) infection-are rarely reported.
CASE PRESENTATION: We describe a 17-month-old boy diagnosed with incomplete Kawasaki disease (IKD), who initially presented with persistent fever, jaundice, and elevated liver enzymes. At disease onset, characteristic mucocutaneous signs of KD were absent. As the illness progressed, the patient developed dorsal foot edema, erythematous lips, and cervical lymphadenopathy. On the ninth day of illness, echocardiography revealed dilation of the left coronary artery, confirming a retrospective diagnosis of IKD. Additionally, high-throughput sequencing of peripheral blood identified TTV type 28. The patient was treated with intravenous immunoglobulin, methylprednisolone, and hepatoprotective agents. Following treatment, his fever resolved, jaundice subsided, liver function normalized, and coronary artery dimensions gradually returned to within the normal range.
CONCLUSIONS: This case highlights an atypical presentation of IKD, characterized by early-onset jaundice and later development of coronary artery dilation, in a patient also infected with TTV. To our knowledge, this is the first reported case of IKD associated with acute icteric hepatitis and TTV infection. This case may inform clinical evaluation in similar presentations and contribute to future research on the etiology of KD.}, }
@article {pmid41492414, year = {2026}, author = {Govorchin, A and Leduc, M and Atleo, CG and Hoogeveen, D and Borgos, I and Patrick, L}, title = {The right to health: indigenous data sovereignty in Canada during and beyond the COVID-19 pandemic.}, journal = {Lancet regional health. Americas}, volume = {54}, number = {}, pages = {101335}, pmid = {41492414}, issn = {2667-193X}, abstract = {The COVID-19 pandemic disproportionately impacted Indigenous Peoples in Canada, highlighting preexisting health inequities. These disparities were exacerbated by inadequate data management policies across Canadian governments, which contribute to inaccurate health information and access challenges for Indigenous Nations. Indigenous data sovereignty, which recognizes the right of Indigenous Peoples to govern their own data, has been identified as essential for achieving self-determination and improving health outcomes. We focus on British Columbia (BC) given its unique health and data governance structure with First Nations. This policy paper examines the challenges related to health data management that arose during COVID-19 in BC, and the regulatory barriers hindering Indigenous health equity. We present four policy recommendations that address data issues as a promising avenue to reducing health inequities in Canada. This includes supporting research by and with Indigenous Peoples, promoting ethical responsibilities of non-Indigenous researchers, implementing anti-racism policies, and adopting Indigenous data management frameworks.}, }
@article {pmid41493182, year = {2026}, author = {Oliveira, T and Naranjo-Zolotov, M and Martins, R and Karatzas, S}, title = {Adoption of Internet of Things in Health Care: Weighted and Meta-Analytical Review of Theoretical Frameworks and Predictors.}, journal = {Journal of medical Internet research}, volume = {28}, number = {}, pages = {e64091}, pmid = {41493182}, issn = {1438-8871}, mesh = {Humans ; COVID-19/epidemiology ; *Delivery of Health Care ; *Internet of Things ; SARS-CoV-2 ; Telemedicine ; *Bibliometrics ; }, abstract = {BACKGROUND: The integration of the Internet of Things (IoT) into health care is transforming the industry by enhancing disease care and management, as well as supporting self-health management. The COVID-19 pandemic has accelerated the adoption of IoT devices, particularly wearable medical devices, which enable real-time health monitoring and advanced remote health management. Globally, the increased adoption of IoT in health care has improved efficiency, enhanced patient care, and generated substantial economic value.
OBJECTIVE: This review aims to conduct a comprehensive meta- and weight analysis of quantitative studies to identify the most influential predictors and theoretical frameworks explaining the adoption of IoT in health care.
METHODS: We searched databases, including Web of Science and PubMed, for quantitative studies on IoT health care adoption, with the last search conducted in early July 2025. Inclusion criteria comprised peer-reviewed articles written in English that employed a quantitative approach to IoT health care technology adoption. Studies were excluded if they did not report the significance of relationships, involved technologies without IoT features or were outside the scope, or examined target variables irrelevant to the analysis. The weight analysis identified the pathways with the most significant effects. A meta-analysis using a random-effects model was conducted to estimate combined effect sizes and their statistical significance. The results from both methods were then integrated to visualize the most frequently used theoretical frameworks. Risk of bias and heterogeneity were assessed using a funnel plot, Egger regression test, the I2 statistic, and subgroup analysis, which indicated no strong evidence of publication bias but revealed a high level of heterogeneity.
RESULTS: Analysis of 115 datasets from 109 papers identified the Technology Acceptance Model and the Unified Theory of Acceptance and Use of Technology (UTAUT) as the primary frameworks for explaining IoT adoption in health care. Incorporating context-specific variables-such as health consciousness, innovativeness, and trust-into these traditional technology acceptance frameworks enhances the understanding of IoT adoption. Although high heterogeneity suggests a need to refine theoretical models to account for regional contexts, universal adoption drivers such as performance expectancy and effort expectancy remain consistent.
CONCLUSIONS: Behavioral intention is the most frequently studied variable in IoT health care adoption, whereas attitude, performance expectancy, effort expectancy, and task-technology fit remain underexplored. While adoption theories from the information systems field, such as the TAM, are predominantly used, integrating context-specific constructs and theories-such as trust and innovativeness-can provide deeper insights into IoT adoption in health care. The strongest and most consistent predictors of behavioral intention were attitude, performance expectancy, habit, self-efficacy, functional congruence, and benefits. Additionally, social influence, facilitating conditions, trust, and aesthetic appeal demonstrated promising or strong effects. By contrast, variables such as privacy and security, barriers, vulnerability, severity, compatibility, financial cost, health, and technology anxiety were generally inconsistent or not statistically significant.}, }
@article {pmid41493556, year = {2026}, author = {Pathak, R and Vandeliwala, M and Patel, P and Patel, N and Patel, K}, title = {Resurgence of human metapneumovirus: an overview of past and current trends.}, journal = {Archives of microbiology}, volume = {208}, number = {2}, pages = {93}, pmid = {41493556}, issn = {1432-072X}, mesh = {*Metapneumovirus/physiology/genetics/pathogenicity ; Humans ; *Paramyxoviridae Infections/epidemiology/virology/diagnosis/drug therapy ; Antiviral Agents/therapeutic use ; *Respiratory Tract Infections/virology/epidemiology ; Host-Pathogen Interactions ; }, abstract = {Human metapneumovirus (HMPV) is a major respiratory pathogen belonging to the Pneumoviridae family that primarily affects children, the elderly, and immunocompromised individuals. Since its discovery in 2001, HMPV has been recognized as a significant cause of acute respiratory infections (ARIs) worldwide, exhibiting seasonal peaks and recurring outbreaks. In recent years, the virus has shown an unusual resurgence, particularly in the post-COVID-19 era, emphasizing the need for renewed clinical and epidemiological attention. This review provides a comprehensive overview of HMPV, encompassing its epidemiology, virion structure, replication mechanisms, host-pathogen interaction, clinical manifestations, diagnostic strategies, and current therapeutic approaches. Special attention is given to recent epidemiological trends, molecular insights derived from structural studies of viral proteins, and the challenges faced in developing vaccines and antiviral agents. Additionally, the review discusses the potential of plant-derived bioactive compounds as alternative or complementary therapeutic options. By consolidating the latest global data and highlighting existing knowledge gaps, the work aims to facilitate a better understanding of HMPV pathogenesis and guide future research directions for improved surveillance, diagnosis, and management of HMPV infections.}, }
@article {pmid41494094, year = {2026}, author = {Cao-Lei, L and Vrantsidis, D and Giesbrecht, GF}, title = {Epigenetic Insights into the Impact of Disaster-Related Prenatal Stress: A Narrative Review.}, journal = {Harvard review of psychiatry}, volume = {34}, number = {1}, pages = {7-22}, doi = {10.1097/HRP.0000000000000446}, pmid = {41494094}, issn = {1465-7309}, mesh = {Humans ; Pregnancy ; *Prenatal Exposure Delayed Effects/genetics ; *Stress, Psychological/genetics ; Female ; *Epigenesis, Genetic ; *Disasters ; DNA Methylation ; *Pregnancy Complications/genetics ; }, abstract = {Disaster-related prenatal maternal stress, whether due to natural or human-made crises, can have profound effects on offspring health and development. This narrative review synthesizes research findings on the epigenetic mechanisms through which prenatal maternal stress influences long-term offspring health outcomes. Focusing primarily on DNA methylation, we examine how exposure to stress during gestation alters the epigenetic profile and may contribute to mental, cognitive, and physical health vulnerabilities. Studies were categorized based on disaster type, including time-limited events such as hurricanes, floods, and earthquakes, and stressors like the COVID-19 pandemic and famine. Key findings highlight the timing of exposure, sex-specific epigenetic effects, and the potential for epigenetic markers to mediate stress-induced health outcomes. While considerable progress has been made, our review emphasizes the need for further research on how epigenetics may mediate mental health outcomes and the development of interventions that target these molecular mechanisms.}, }
@article {pmid41494304, year = {2026}, author = {Kung, PJ and Chen, CM and Lin, EC and Shu, BC and Tew, Y and He, J and Fang, CJ and Reynolds, NR and Ornstein, KA}, title = {Ethical challenges around mandatory vaccination among nurses: A systematic review of qualitative and quantitative evidence.}, journal = {International journal of nursing studies}, volume = {175}, number = {}, pages = {105313}, doi = {10.1016/j.ijnurstu.2025.105313}, pmid = {41494304}, issn = {1873-491X}, mesh = {Humans ; *COVID-19/prevention & control ; *Mandatory Vaccination/ethics ; *Nurses/psychology ; Qualitative Research ; *Vaccination/ethics ; }, abstract = {BACKGROUND: Mandatory vaccination policies have sparked global ethical debates, particularly in the context of COVID-19. Among healthcare workers, nurses-the largest segment of the frontline workforce-face distinct tensions between professional responsibilities and personal autonomy. Yet, the ethical challenges these policies pose from nurses' perspectives remain insufficiently examined.
AIM: This review examines the ethical challenges of mandatory vaccination from nurses' perspectives, informs ethical policymaking, and provides insights to navigate similar future scenarios.
DESIGN: A mixed-methods systematic review guided by the Joanna Briggs Institute methodology.
DATA SOURCES: Final searches of five databases-Embase, MEDLINE, CINAHL, Web of Science, and Scopus-were conducted in September 2025. Additional records were identified through citation tracking and supplementary searches.
METHODS: Empirical studies published from 2019 onward were screened for relevance and assessed for methodological quality using standardized critical appraisal tools. Studies were included if they examined nurses' experiences, attitudes, or ethical perspectives regarding mandatory vaccination. A narrative synthesis approach was applied to integrate qualitative, quantitative, and mixed-methods findings.
RESULTS: Twenty-eight studies were included (19 quantitative, 5 qualitative, and 4 mixed methods). Four themes emerged: (1) Walking a Tightrope-Between Vaccine Safety and Effectiveness; (2) Silent Burden-Navigating Stigma in the Shadows; (3) Navigating the Fine Line-Balancing Rights and Public Health in Times of Crisis; and (4) Strengthening Leadership and Communication.
CONCLUSIONS: While mandatory vaccination policies may serve public health goals, they can also generate ethical distress, undermine trust, and increase stigmatization among nurses who remain unvaccinated. Future policies should move beyond enforcement toward fostering ethical alignment through education, open dialog, and respectful engagement.
REGISTRATION: PROSPERO registration number: CRD42024551112, registered 03/06/2024.}, }
@article {pmid41494305, year = {2026}, author = {Pupillo, E and Leone, MA and Amato, A and Bianchi, E and Damian, MS and Dyck, J and Garcia-Azorin, D and Giussani, G and Guekht, A and Koike, H and Khadilkar, S and Lehmann, H and Pochigaeva, K and Povolnova, J and Tumurov, D and Vetrov, F and de Visser, M and Winkler, AS and Grisold, W}, title = {Prevalence and trajectories of post-COVID-19 neuromuscular conditions: A systematic-review and meta-analysis.}, journal = {Journal of the neurological sciences}, volume = {481}, number = {}, pages = {125710}, doi = {10.1016/j.jns.2025.125710}, pmid = {41494305}, issn = {1878-5883}, mesh = {Humans ; *COVID-19/complications/epidemiology ; Prevalence ; *Neuromuscular Diseases/epidemiology/etiology ; Guillain-Barre Syndrome/epidemiology ; }, abstract = {INTRODUCTION: Neuromuscular diseases (NMDs) are a significant component of the post-acute sequelae of COVID-19. However, their long-term prevalence and trajectories remain poorly defined. This systematic review and meta-analysis aimed to determine the long-term prevalence in COVID-19 survivors of fourteen specific NMDs and related symptoms: cranial nerve diseases, Guillain-Barré syndrome, small fiber neuropathy, (poly)radiculopathies, (poly)neuropathies, plexopathies, motor neuron disease, myasthenia gravis, Lambert-Eaton syndrome, neuropathic pain, sarcopenia, myalgia, myalgia associated with other symptoms, and of other muscle diseases.
METHODS: We searched MEDLINE, Embase, and the Cochrane Library (January 2020 through November 2024) for studies with at least 3 months of follow-up. Pooled prevalence estimates were calculated at multiple time points (acute phase to 24 months) using random effects models.
RESULTS: Among 180 unique studies representing 15,865,322 cases (54 % female, mean age 50.0 years), the pooled prevalence for individuals with at least one NMD or related symptoms decreased from 36 % in the acute phase to 8 % at 24 months. Myalgia prevalence steadily declined from 35 % to 8 % by two years. A trend towards lower prevalences across the time points was observed also for Guillain-Barré syndrome, and other muscle diseases, while other conditions showed a more erratic pattern. The prevalence of neuropathic pain remained high and persisted almost unchanged through the follow-up period (from 31 % in the acute phase to 25 % at 12 months).
CONCLUSIONS: NMDs and related symptoms are common following COVID-19, but their general prevalence decreases with time. However, trajectories varied depending on the type of NMD or symptom.}, }
@article {pmid41494490, year = {2026}, author = {Messina, A and Bella, F and Maccarone, G and Avincola, G and Signorelli, MS}, title = {Astrocyte-mediated hippocampal damage in the pathogenesis of dysexecutive syndrome following COVID-19: A narrative review.}, journal = {Journal of psychiatric research}, volume = {194}, number = {}, pages = {164-173}, doi = {10.1016/j.jpsychires.2026.01.007}, pmid = {41494490}, issn = {1879-1379}, mesh = {Humans ; *COVID-19/complications/immunology/pathology ; *Astrocytes/pathology/immunology/metabolism ; *Hippocampus/pathology/physiopathology/metabolism/virology/immunology ; SARS-CoV-2 ; *Neuroinflammatory Diseases ; *Cognitive Dysfunction/etiology ; *Executive Function/physiology ; }, abstract = {SARS-CoV-2 infection has been implicated in hippocampal damage, contributing to the pathogenesis of dysexecutive syndrome observed in post-COVID-19 patients. Given the growing prevalence of long-COVID worldwide, understanding how SARS-CoV-2 affects hippocampal structure and function has become an urgent scientific and clinical priority. The hippocampus-crucial for memory, emotional regulation, and executive functioning-is especially susceptible to viral-driven neuroinflammatory cascades. SARS-CoV-2 triggers astrocyte and microglia activation, disrupts blood-brain barrier integrity, and induces cytokine-mediated neurotoxicity, ultimately impairing neuroplasticity and neurogenesis. These mechanisms converge to produce cognitive and affective disturbances-most notably fatigue, apathy, low mood, and executive dysfunction-that typify dysexecutive syndrome in long-COVID. This review synthesizes current evidence from clinical and experimental studies, integrating findings on viral neurotropism, hippocampal hypometabolism, and astrocyte-mediated neurodegeneration. Distinctions between depressive symptoms driven by neuroinflammation and classical depressive disorders are clarified to improve diagnostic accuracy and guide personalized treatment. Emerging data on the neuroprotective role of COVID-19 vaccination-particularly its capacity to modulate microglial activation and support hippocampal neurogenesis-are also examined. Overall, the findings underscore the need for targeted therapeutic strategies aimed at modulating neuroinflammation and supporting hippocampal plasticity, including cognitive rehabilitation approaches. Longitudinal studies are essential to elucidate the enduring impact of SARS-CoV-2 on hippocampal function and to inform effective clinical interventions.}, }
@article {pmid41496089, year = {2026}, author = {Lu, YX and Wan, DL}, title = {Burnout in nursing during the COVID-19 pandemic: A bibliometric analysis of global research (2020-2023).}, journal = {Medicine}, volume = {105}, number = {1}, pages = {e46125}, pmid = {41496089}, issn = {1536-5964}, mesh = {*COVID-19/epidemiology/psychology/nursing ; *Bibliometrics ; *Burnout, Professional/epidemiology ; Humans ; Pandemics ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Burnout is an occupational phenomenon characterized by professionals experiencing a complete loss of concern and emotional connection towards the individuals they work with, resulting in their treatment in a detached or dehumanized manner. Extensive research has been conducted on burnout syndrome within the healthcare environment, however, prior to addressing this urgent public health issue, it is crucial to examine the existing literature on burnout among nurses during the COVID-19 pandemic and identify relevant variables explored in recent articles.
METHODS: An extensive literature search was conducted in the Web of Science Core Collection database to identify all relevant studies on nursing burnout during the COVID-19 pandemic.
RESULTS: According to the search strategy, a total of 1051 eligible publications were collected from the time of January 01, 2020 to December 31, 2023 in Web of Science Core Collection database. Finally, 946 eligible publications, including 865 articles and 81 reviews, were included in the subsequent analysis. In the inaugural year of the COVID-19 pandemic in 2020, a mere 48 articles were dedicated to examining the correlation between the pandemic and nursing staff burnout. However, this figure surged to 215 publications in 2021 and further escalated to an impressive count of 380 articles in 2022.
CONCLUSION: In summary, this is the first comprehensive analysis of publications related to nursing burnout in the context of COVID-19 from 2020 to 2023 through bibliometrics. Our results show the COVID-19 pandemic has certainly had a significant impact on the occupational burnout of nurses.}, }
@article {pmid41496808, year = {2025}, author = {Woods, JA and Hutchinson, NT and Powers, SK and Gomez-Cabrera, MC and Radak, Z and Leeuwenburgh, C and Cacciatore, S and Marzetti, E and Zhang, T and Garza, R and Sidebottom, C and Anderson, E and Durstine, JL and Sun, J and Ji, LL}, title = {Physical activity during COVID-19 pandemic: A 5-year retrospect.}, journal = {Sports medicine and health science}, volume = {7}, number = {6}, pages = {405-418}, pmid = {41496808}, issn = {2666-3376}, abstract = {The purpose of this article is to provide a follow-up review of the impact of the SARS-CoV-2 Disease or Coronavirus Disease 2019 (COVID-19) pandemic on human health and the role of physical activity (PA) during the 5-year pandemic. We aim to cover the immune system, the cardiopulmonary system, the musculoskeletal system, and the central nervous system (brain function), particularly among older adults, college students, and individuals with post-acute sequelae of COVID-19 (Long-COVID). The COVID-19 pandemic has given us many lessons, learned from the death of six million lives and tremendous disturbance to human life. First, we need to continue to investigate cellular and molecular mechanisms that mediate various organistic failures resulting from the viral infection. Such investigations are the only way to completely understand the etiology of the diseases and to develop new drugs and vaccines. The molecular pathways that transmit the signals of viral infection to each organ system are different requiring both basic and clinical research. Available evidence suggests that mitochondrial dysfunction, reduced microcirculation and latent immune activation play a major role, eventually impairing cardiovascular tolerance and peripheral bioenergetics. Second, the COVID-19 pandemic has manifested major disturbances to human lifestyles with reduced PA and exercise standing out as a major factor. Conversely, physical inactivity due to social confinement and mental/psychological stresses has been clearly linked to intensified pathogenic symptoms and amplification of adverse effects on multiple physiological systems. If not intervened, this interaction can lead to Long-COVID, a dangerous futile circle to cause systemic failure. Finally, the COVID-19 pandemic has exerted differential impacts on different populations. Thus, the strategy to develop and conduct to cope with the negativity of pandemic needs to be specific, flexible and tailored to fit different patient populations.}, }
@article {pmid41497070, year = {2026}, author = {Obeagu, EI}, title = {Immunomodulatory strategies for managing cytokine storms in chronic COVID: mechanisms, therapeutic targets, and clinical advances.}, journal = {Annals of medicine and surgery (2012)}, volume = {88}, number = {1}, pages = {653-659}, pmid = {41497070}, issn = {2049-0801}, abstract = {Chronic COVID, characterized by persistent symptoms following acute SARS-CoV-2 infection, is increasingly linked to sustained immune dysregulation, particularly cytokine storms that drive chronic inflammation and multi-organ complications. Understanding the mechanisms underlying cytokine dysregulation in chronic COVID is essential for developing effective therapeutic strategies aimed at restoring immune balance and mitigating long-term morbidity. This review critically examines current immunomodulatory strategies for managing cytokine storms in chronic COVID, including corticosteroids, cytokine-specific biologics, Janus kinase inhibitors, and emerging cell-based therapies. Additionally, the role of biomarker-guided precision medicine in personalizing treatment to optimize efficacy and safety is discussed. Challenges such as patient heterogeneity, timing and duration of therapy, and potential adverse effects are also addressed. Future research directions emphasize the need for robust clinical trials, novel therapeutic development, and integrated multidisciplinary care to improve patient outcomes. By tailoring immunomodulatory approaches based on individual immune profiles, it is possible to enhance the management of cytokine-driven inflammation in chronic COVID and advance the field toward more effective, personalized treatments.}, }
@article {pmid41497304, year = {2025}, author = {Fadaei, MR and Fadaei, MS and Kheirieh, AE and Hatami, H and Rahmanian-Devin, P and Tayebi-Khorrami, V and Fathabadi, MF and Baradaran Rahimi, V and Askari, VR}, title = {Overview of dendrimers as promising drug delivery systems with insight into anticancer and anti-microbial applications.}, journal = {International journal of pharmaceutics: X}, volume = {10}, number = {}, pages = {100390}, pmid = {41497304}, issn = {2590-1567}, abstract = {Dendrimers are tree-like polymeric molecules that have three main compartments: the core, branching units, and functional end groups. They are nanosized and monodispersed, with an almost spherical shape. For the past few decades, dendrimers have been evaluated in numerous studies as a promising category of candidates for gene delivery and diagnostic applications. Nowadays, some advanced dendrimers are considered promising anticancer delivery systems due to the vast types and applicable modifications. They also showed their effectiveness as antibacterial and antiviral agents. Smart dendrimers with pH-, redox-, or directly tumor microenvironment-responsive properties are investigated. pH-sensitive dendrimers enhance drug release in the tumor's acidic environment and inhibit release at physiological pH, thereby increasing the hemocompatibility of these chemical agents. Dendrimers have been examined for years to prevent sexually transmitted diseases, such as HIV, HPV, HSV, etc. In this regard, some studies yielded encouraging results and opened new avenues. Following the onset of the COVID-19 pandemic, researchers have shifted their focus toward seeking remedies to prevent and treat this viral disease. Dendrimers have already demonstrated favorable efficacy in protection against COVID-19 and other respiratory viral diseases. Furthermore, they may mitigate the neuroinflammatory manifestations of COVID-19 in individuals experiencing a critical disease state.}, }
@article {pmid41497535, year = {2025}, author = {Yang, Y and Wang, K and Chen, S}, title = {Effects of Hypoglycemic Agents on Pulmonary Diseases: A Comprehensive Narrative Review.}, journal = {Journal of inflammation research}, volume = {18}, number = {}, pages = {18053-18078}, pmid = {41497535}, issn = {1178-7031}, abstract = {Beyond glycemic control, hypoglycemic agents exhibit multifaceted effects that may influence pulmonary health in patients with diabetes mellitus. This narrative review synthesizes available evidence from preclinical and clinical studies on the impact of major hypoglycemic drug classes-including biguanides, sulfonylureas, thiazolidinediones, α-glucosidase inhibitors, DPP-4 inhibitors, SGLT-2 inhibitors, GLP-1 receptor agonists, and insulin-on pulmonary diseases. Evidence suggests that these agents exert class-specific, and often conflicting, effects: preclinical studies support their protective potential in acute lung injury, while clinical data indicate variable efficacy in asthma, COPD, and respiratory infections including COVID-19. Conversely, some agents may be associated with increased risks of lung cancer or COPD exacerbations, underscoring the need for context-specific prescribing. Mechanistic insights from animal models primarily involve modulation of inflammatory, oxidative, and immune pathways. This narrative review aims to provide a clinical framework for personalizing hypoglycemic therapy in patients with comorbid pulmonary conditions, while underscoring the need for well-designed prospective studies to resolve existing controversies.}, }
@article {pmid41497729, year = {2025}, author = {Liu, T and Li, M and Zhu, L and Liang, R and Zhang, P and Liu, X}, title = {Ocular Lesions Related to COVID-19 and Its Vaccines.}, journal = {Journal of ophthalmology}, volume = {2025}, number = {}, pages = {7078264}, pmid = {41497729}, issn = {2090-004X}, abstract = {OBJECTIVE: To review COVID-19 infection and COVID-19 vaccine-related ocular lesions.
METHODS: We carried out a systematic search in PubMed, Web of Science, Embase, and the Cochrane Library on COVID-19 and ophthalmology and reviewed the incidence, specific manifestations, and risk factors for COVID-19-related eye diseases and the relationship between the detection of COVID-19 in the conjunctiva and tears and eye involvement.
RESULTS: Conjunctivitis was the most common ocular lesion caused by 2019-nCoV infection, followed by uveitis and retinopathy. Conjunctivitis can be the first manifestation of COVID-19 infection and may be clinically related to the severity of pneumonia caused by COVID-19. In particular, conjunctivitis that occurs after pneumonia suggests that the patient has severe systemic disease. COVID-19 infection can cause uveitis, but the infection rate of COVID-19 in patients with uveitis is similar to that of the general population. Patients with uveitis need to reduce the dosage of systemic hormones and discontinue biological agents after being infected with COVID-19. Retinopathy caused by COVID-19 infection is mainly manifested as retinal microvascular disease, and the prognosis is good. SARS-CoV-2 detection in the conjunctiva and tears has high sensitivity and is of great value for disease diagnosis. Eye lesions caused by the COVID-19 vaccine, similar to other vaccines, have a low incidence and a good prognosis.
CONCLUSION: COVID-19-related ocular lesions are mainly manifested as conjunctivitis, uveitis, and retinal microvascular changes. These diseases are somewhat self-limiting and have a good prognosis.}, }
@article {pmid41497937, year = {2025}, author = {Idahor, CO and Ogunfuwa, O and Ogbonna, N and Ogbeide, OA and Abe, O and Oore-Ofe, O}, title = {Transforming Emergency Care Through Telemedicine: A Narrative Review.}, journal = {Cureus}, volume = {17}, number = {12}, pages = {e98481}, pmid = {41497937}, issn = {2168-8184}, abstract = {Telemedicine has fleetly evolved from a niche result to a central pillar in modern emergency and critical care systems. This narrative review delves into the multifaceted role of telemedicine in emergency settings, tracing its historical development, present applications, and future possibilities. It examines how telemedicine islands geographical and infrastructural gaps, particularly in underserved communities, by enabling timely access to specialist care similar to telestroke services and remote ferocious care. Substantiation highlights advancements in clinical outcomes, functional effectiveness, and patient satisfaction, with global case studies demonstrating successful perpetration across both high- and low-resource settings. Despite these advances, challenges persist. Technological restrictions, regulatory barriers, digital knowledge gaps, and unlikeness in assent continue to hamper wide relinquishment. This review discusses these obstacles and underscores the significance of strategic investment, cross-sector collaboration, and policy reform. Arising inventions, including artificial intelligence, wearable devices, and scalable telehealth platforms, signal promising directions for perfecting reach and adaptability in emergency systems. Additionally, this paper identifies crucial areas for unborn research, including long-term outgrowth assessment and telemedicine's part in disaster and pandemic response. By synthesizing current substantiation and practical perceptivity, this review aims to inform clinicians, health system leaders, and policymakers about the transformative eventuality and ongoing challenges of telemedicine in emergency care. Eventually, it calls for sustained invention, equity-concentrated perpetration, and cooperative sweats to completely realize telemedicine's pledge in erecting a more accessible, responsive, and flexible emergency care geography.}, }
@article {pmid41498242, year = {2026}, author = {Kuperwasser, C and El-Deiry, WS}, title = {COVID vaccination and post-infection cancer signals: Evaluating patterns and potential biological mechanisms.}, journal = {Oncotarget}, volume = {17}, number = {}, pages = {1-29}, pmid = {41498242}, issn = {1949-2553}, mesh = {Humans ; *COVID-19/prevention & control/epidemiology/immunology ; *Neoplasms/epidemiology/etiology/immunology ; *COVID-19 Vaccines/adverse effects ; *Vaccination/adverse effects ; SARS-CoV-2/immunology ; Incidence ; }, abstract = {A growing number of peer-reviewed publications have reported diverse cancer types appearing in temporal association with COVID-19 vaccination or infection. To characterize the nature and scope of these reports, a systematic literature search from January 2020 to October 2025 was conducted based on specified eligibility criteria. A total of 69 publications met inclusion criteria: 66 article-level reports describing 333 patients across 27 countries, 2 retrospective population-level investigations (Italy: ~300,000 cohort, and Korea: ~8.4 million cohort) quantified cancer incidence and mortality trends among vaccinated populations, and one longitudinal analysis of ~1.3 million US miliary service members spanning the pre-pandemic through post-pandemic periods. Most of the studies documented hematologic malignancies (non-Hodgkin's lymphomas, cutaneous lymphomas, leukemias), solid tumors (breast, lung, melanoma, sarcoma, pancreatic cancer, and glioblastoma), and virus-associated cancers (Kaposi and Merkel cell carcinoma). Across reports, several recurrent themes emerged: (1) unusually rapid progression, recurrence, or reactivation of preexisting indolent or controlled disease, (2) atypical or localized histopathologic findings, including involvement of vaccine injection sites or regional lymph nodes, and (3) proposed immunologic links between acute infection or vaccination and tumor dormancy, immune escape, or microenvironmental shifts. The predominance of case-level observations and early population-level data demonstrates an early phase of potential safety-signal detection. These findings underscore the need for rigorous epidemiologic, longitudinal, clinical, histopathological, forensic, and mechanistic studies to assess whether and under what conditions COVID-19 vaccination or infection may be linked with cancer.}, }
@article {pmid41498334, year = {2026}, author = {Azasi, E and Asamoah, PE and Diaconu, K}, title = {Understanding the needs and key determinants of maternal, newborn, and child health among migrants in transit: a scoping review.}, journal = {Global health action}, volume = {19}, number = {1}, pages = {2607905}, pmid = {41498334}, issn = {1654-9880}, mesh = {Humans ; Female ; Pregnancy ; *Transients and Migrants/statistics & numerical data ; Health Services Accessibility ; Infant, Newborn ; *Child Health ; *Maternal Health ; *Health Services Needs and Demand ; Child ; }, abstract = {The global surge in migration has exposed pregnant women and children in transit to heightened risk of maternal and child health (MCH) challenges, driven by systemic barriers and unstable conditions. Evidence on how these transitory factors influence MCH remains limited. This scoping review examined the health needs and key determinants affecting migrant populations in transit, specifically pregnant women and children travelling from their countries of origin to their intended destination countries, with the aim of identifying major barriers and proposing strategies for improved health outcomes. We screened 1202 sources of evidence using five databases (PubMed, Scopus, Europe PMC, CINAHL, and Medline) as well as grey literature. Seven studies met the inclusion criteria. Data were drawn from peer-reviewed literature, charted using a standardized framework, and analysed thematically. Key barriers included financial constraints, language obstacles, and limited access to healthcare services. Although humanitarian organizations offered some support, significant unmet needs remain, including exposure to transactional sex, absence of respectful maternity care, and restricted access to essential health services. These challenges are exacerbated in conflict and crisis settings. The review underscores the importance of addressing key determinants, including location, language, financial capacity, and community support, to improve health outcomes for pregnant women and children under five on the move. This review recommends strengthening community mobilization, leveraging technology, and ensuring equitable access irrespective of users' cultural or financial constraints.}, }
@article {pmid41498391, year = {2026}, author = {Zhang, X and Han, X and Xu, J and Li, G}, title = {Disease-associated adipose browning: current evidence and perspectives.}, journal = {Adipocyte}, volume = {15}, number = {1}, pages = {2610540}, pmid = {41498391}, issn = {2162-397X}, mesh = {Humans ; *Adipose Tissue, Brown/metabolism/pathology ; Animals ; Energy Metabolism/physiology ; Adipose Tissue, White/metabolism ; Thermogenesis/physiology ; COVID-19/metabolism/pathology ; }, abstract = {Brown and beige adipose tissue represent evolutionary adaptations in mammals, functioning as specialized thermogenic organs to maintain body temperature. Over the past two decades, researches have demonstrated that white adipose tissue (WAT) browning is an effective strategy to enhance energy expenditure. However, a growing body of evidence indicates that the browning process frequently occurs in a variety of chronic disease states, though its pathophysiological significance remains unclear. This review summarized evidence of pathological browning observed in human diseases and animal models, including breast cancer, colorectal cancer (CRC), clear cell renal cell carcinoma (ccRCC), kidney health, burn injury, atherosclerotic, SARS-CoV-2 and sepsis. Despite distinct pathological contexts, adipose tissue browning is consistently observed. This suggests that browning may not simply serve its classical metabolically protective role, but instead reflect an atypical response to pathological stress. It is currently unclear whether this is a compensatory mechanism by the organism in a diseased state or merely a byproduct of the disease process. Whether this response is adaptive or a cause of disease progression remains unresolved. Future research should therefore focus on identifying the triggers and functional outcomes of pathological browning to better understand adipocyte plasticity and its role in disease progression.}, }
@article {pmid41499907, year = {2026}, author = {Ruan, T and Li, M}, title = {The inverse relationship between post-traumatic growth and job burnout among medical staff during the COVID-19 normalization period: A systematic review.}, journal = {Asian journal of psychiatry}, volume = {116}, number = {}, pages = {104814}, doi = {10.1016/j.ajp.2025.104814}, pmid = {41499907}, issn = {1876-2026}, mesh = {Humans ; *Burnout, Professional/psychology/epidemiology ; *COVID-19 ; *Medical Staff/psychology ; *Posttraumatic Growth, Psychological ; }, abstract = {OBJECTIVE: To synthesize empirical evidence on the association between post-traumatic growth (PTG) and job burnout among medical staff across varied healthcare settings during the COVID-19 normalization period (2022 onward).
METHODS: Following PRISMA guidelines, a database indexing over 126 million records was searched, yielding 499 records for screening, and 11 studies that measured both PTG and burnout in active healthcare professionals. Data on study design, setting, instruments, sample characteristics, and key findings were extracted.
RESULTS: Nine quantitative (seven cross-sectional, one longitudinal, one unspecified design) and two qualitative studies met inclusion criteria, encompassing nurses, physicians, psychiatrists, paramedics, and medical rescuers in eight countries. Standardized instruments (e.g., Post-Traumatic Growth Inventory variants; Maslach Burnout Inventory variants) were most common. Eight studies reported a significant inverse correlation between PTG and burnout (e.g., odds ratio= 0.653, 95 % CI= 0.525-0.812, p < 0.001; r = -0.276, p = 0.034). Five studies identified PTG as a mediator or moderator of stress-burnout pathways. Qualitative analyses described a trajectory from acute stress through cognitive restructuring to growth, with burnout linked to unresolved trauma.
CONCLUSIONS: Consistent evidence indicates that higher PTG protects against burnout in medical staff post-pandemic peak. Psychological resources-resilience, self-compassion, adaptive coping, meaning in work, and job satisfaction-emerge as key mediators or moderators. Interventions fostering PTG and its correlates may mitigate burnout in healthcare workers.}, }
@article {pmid41499962, year = {2026}, author = {Wang, B and Fu, Y and Duan, F and Pan, S and Zheng, Y}, title = {Decoding emerging viral sepsis: Molecular crosstalk, dysregulation, and precision strategies.}, journal = {Molecular aspects of medicine}, volume = {107}, number = {}, pages = {101442}, doi = {10.1016/j.mam.2025.101442}, pmid = {41499962}, issn = {1872-9452}, mesh = {Humans ; *Sepsis/virology/immunology/therapy ; SARS-CoV-2/pathogenicity ; *COVID-19/virology/complications/immunology ; Host-Pathogen Interactions ; *Virus Diseases/virology/immunology ; Influenza, Human ; HIV Infections ; Precision Medicine ; Animals ; }, abstract = {Emerging and re-emerging viral pathogens pose a major challenge to global public health systems. One of the most significant complications associated with these viruses is viral sepsis, a severe condition characterized by organ dysfunction resulting from an unregulated host response to a viral infection. The present review comprehensively describes the molecular mechanisms underlying viral sepsis induced by emerging and re-emerging viral pathogens, such as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), influenza virus, dengue virus (DENV), Ebola virus (EBOV), and human immunodeficiency virus (HIV). It discusses the complex molecular interactions between particular viral factors and host cellular pathways, highlighting significant dysregulations in various immune responses, metabolic reprogramming, and endothelial integrity that induce sepsis development. Furthermore, this review thoroughly addresses nascent precision strategies, including advanced diagnostics, targeted therapeutics, and immunomodulatory interventions, carefully tailored to distinct viral etiologies and host endotypes. By shedding light on the intricate molecular landscape of viral sepsis, this review aims to provide a robust framework for future mechanistic research and accelerate the development of effective, personalized interventions to combat this challenging complication.}, }
@article {pmid41501207, year = {2026}, author = {Murata, A and Tanaka, M and Takayoshi, M and Matsuyama, Y and Sato, R and Ishida, Y and Teragaki, M and Iwanari, S and Ikeda, M and Takeoka, H}, title = {Osmotic nephropathy as a potentially underrecognized cause of acute kidney injury during SGLT2 inhibitor therapy: a case report and literature review.}, journal = {CEN case reports}, volume = {15}, number = {1}, pages = {16}, pmid = {41501207}, issn = {2192-4449}, mesh = {Humans ; Male ; Aged ; *Acute Kidney Injury/etiology/chemically induced/therapy/diagnosis ; *Diabetes Mellitus, Type 2/drug therapy/complications ; *Sodium-Glucose Transporter 2 Inhibitors/adverse effects/therapeutic use ; *Benzhydryl Compounds/adverse effects ; Glucosides/adverse effects ; Renal Dialysis ; *Renal Insufficiency, Chronic/drug therapy/complications ; Diabetic Nephropathies ; Creatinine/blood ; Kidney Tubules, Proximal/pathology ; }, abstract = {In recent years, sodium-glucose cotransporter 2 (SGLT2) inhibitors have become essential therapeutic agents in the management of chronic kidney disease (CKD), owing to their established renoprotective effects. Although acute kidney injury (AKI) may occasionally occur during SGLT2 inhibitor therapy, its pathological features remain incompletely understood. Here, we report a case of AKI caused by osmotic nephropathy in a patient with underlying CKD following the initiation of an SGLT2 inhibitor. We also review previously reported cases of SGLT2 inhibitor-associated osmotic nephropathy. A 71-year-old man with type 2 diabetes and CKD developed oliguric AKI, with his serum creatinine level increasing from 2.0 to 8.3 mg/dL, one month after initiating dapagliflozin. During this period, he experienced transient appetite loss associated with a COVID-19 infection. Despite initial management for presumed prerenal AKI, his renal function did not improve with intravenous fluid therapy, and he required hemodialysis. Kidney biopsy revealed characteristic features of osmotic nephropathy, including numerous isometric vacuoles within the epithelial cells of proximal tubules with preserved brush borders. His renal function began to improve approximately two weeks after discontinuation of the SGLT2 inhibitor, and eventually returned to baseline. This case and literature review highlight the potential for osmotic nephropathy as a rare but reversible complication of SGLT2 inhibitor therapy, which may be triggered by volume depletion, particularly in diabetic patients with pre-existing renal dysfunction. Recognition of this underdiagnosed entity is crucial for timely diagnosis and appropriate management.}, }
@article {pmid41502328, year = {2026}, author = {Gimmon, Y and Gordon, CR}, title = {Neuro-vestibular rehab: new developments.}, journal = {Current opinion in neurology}, volume = {39}, number = {1}, pages = {83-87}, doi = {10.1097/WCO.0000000000001441}, pmid = {41502328}, issn = {1473-6551}, mesh = {Humans ; *Reflex, Vestibulo-Ocular/physiology ; *Vestibular Diseases/rehabilitation/physiopathology ; *Adaptation, Physiological/physiology ; Telemedicine ; *Neurological Rehabilitation/methods/trends ; Digital Health ; Virtual Reality ; }, abstract = {PURPOSE OF REVIEW: This review highlights recent advances in neuro-vestibular rehabilitation, with emphasis on vestibular adaptation and emerging mobile technologies. It summarizes developments in promoting vestibular plasticity and discusses novel tools such as virtual reality, wearable sensors, and telehealth platforms that enhance access, engagement, and outcomes. The scope is broad, focusing on general principles rather than specific populations.
RECENT FINDINGS: New methods to enhance vestibulo-ocular reflex (VOR) adaptation include incremental adaptation devices and gamified exercises. Inducing VOR gain-down adaptation temporarily increases postural sway, which normalizes via sensory reweighting, demonstrating central compensation. Portable tools like StableEyes show promise in boosting VOR gain with brief sessions. Concurrently, technology-driven approaches are gaining traction. Gamified mobile applications and wearable sensors allow home-based rehabilitation with remote supervision and monitoring, showing promising results in conditions like multiple sclerosis. Virtual reality interventions and telehealth models accelerated during the COVID-19 era, expanding therapy delivery to underserved populations. Adjunctive methods such as vibrotactile feedback and galvanic vestibular stimulation are emerging as complementary therapies.
SUMMARY: Recent developments are advancing vestibular rehabilitation by refining adaptive training techniques and leveraging digital tools to overcome barriers in access and adherence. These innovations point to a more personalized, technology-enabled approach to optimizing neuro-vestibular recovery.}, }
@article {pmid41502909, year = {2026}, author = {El Rassi, C and El Darzi, R and Abou Mansour, M and Arabi, M}, title = {MIS-C: Diagnosis, Management, and Outcomes.}, journal = {Open forum infectious diseases}, volume = {13}, number = {1}, pages = {ofaf762}, pmid = {41502909}, issn = {2328-8957}, abstract = {Multisystem inflammatory syndrome in children (MIS-C) is an emergent postinfectious hyperinflammatory disorder predominantly affecting the pediatric population following COVID-19 infection. Clinically, it is characterized by persistent fever, shock, multiorgan involvement, and potentially severe cardiovascular involvement. This comprehensive review synthesizes current evidence on the epidemiology, pathophysiology, clinical presentation, diagnostic criteria, with particular emphasis on the management of MIS-C. We also stress on the importance of distinguishing MIS-C from phenotypically similar entities. Acute-phase management centers on supportive care, hemodynamic stabilization, and targeted immunomodulation, with intravenous immunoglobulin, corticosteroids, and biologic forming the therapeutic cornerstone. Thromboprophylaxis is frequently warranted due to the elevated thromboembolic risk, and long-term follow-up is essential to monitor for cardiac, gastrointestinal, and neurologic complications. Additional considerations include postrecovery vaccination protocols and the use of extracorporeal membrane oxygenation in cases of refractory cardiorespiratory failure. Despite advancements in clinical outcomes, diagnostic ambiguity and heterogeneous management guidelines continue to pose significant challenges.}, }
@article {pmid41503324, year = {2025}, author = {Dameche, K and Shams, S and AlMesallam, MS}, title = {Herpes Zoster (HZ) Over the Past 10 Years: A Systematic Review on Trends, Triggers, and Post-COVID-19 Impact.}, journal = {Cureus}, volume = {17}, number = {12}, pages = {e98556}, pmid = {41503324}, issn = {2168-8184}, abstract = {Herpes zoster (HZ) is a reactivation of varicella-zoster virus (VZV), which has been traditionally associated with aging and immunosuppression. However, new data indicate that the coronavirus disease 2019 (COVID-19) pandemic has changed HZ epidemiology, with a higher incidence of HZ in post-COVID-19 patients and vaccinated subjects. This systematic review assesses the trends and triggers of HZ as well as the impact after the pandemic, focusing on the changes in the incidence rate among adult and pediatric patients during the last 10 years. All studies published between the years of 2014 and 2024 were accrued, based on a systematic review conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant articles were identified from searches of databases and other sources. Eligibility criteria of studies were applied, and qualitative and quantitative syntheses of studies were performed. A total of 11 studies were included in the review, which examined the association between COVID-19, vaccination, and HZ risk. Several studies suggested that psychological stress and immune dysfunction could be risk factors for HZ incidence. HZ cases after COVID-19 vaccination have been reported, although causation is not established. Based on countries in which COVID-19 was diagnosed, hospitalizations are estimated at 14.4 per 100,000 inhabitants (0.6 to 32.9 per 100,000), and mortality was 1.3 per 100,000, points in this IR Batch (assuming that these are of all diagnosed cases). The risk of HZ reactivation may be increased following COVID-19 infection and vaccination. Higher hospitalization rates with higher mortality risks and neurological consequences were also observed in some populations. Strengthening HZ vaccination programs and studying post-COVID-19 immune responses further can be essential for reducing long-term health risks.}, }
@article {pmid41504094, year = {2025}, author = {Galuia, M and Hussain, A and Ahmad, S}, title = {Biosimilars in Gynecologic Cancers: Basic Principles and New Horizons.}, journal = {Frontiers in bioscience (Elite edition)}, volume = {17}, number = {4}, pages = {33415}, doi = {10.31083/FBE33415}, pmid = {41504094}, issn = {1945-0508}, mesh = {Humans ; *Biosimilar Pharmaceuticals/therapeutic use/economics ; Female ; *Genital Neoplasms, Female/drug therapy ; Cost-Benefit Analysis ; *Antineoplastic Agents/therapeutic use ; }, abstract = {Biological therapies have transformed cancer treatment by targeting the molecular mechanisms involved in carcinogenesis. However, higher costs, limited accessibility, and supply chain disruptions-such as those caused by COVID-19 in recent years-underscore the need for cost-effective alternatives. Biosimilars, which are drugs that are highly similar to their reference biologics in terms of safety, efficacy, and quality, offer a viable solution (as these demonstrate clinically meaningful outcomes). This review article examines the role of biosimilars, mainly in gynecological cancers. The primary focus of this article is to compare the efficacy, safety, and cost-effectiveness of biosimilars, as well as to explore the barriers that restrict their widespread adoption. A comprehensive literature review was conducted, analyzing various studies, regulatory guidelines, and the latest data on biosimilars for the treatment of gynecological cancers. Pivotal trials, such as the GOG-0218, ICON7, and RUBY, were reviewed to assess the efficacy, safety, and cost-effectiveness of these biosimilars. This review highlights key oncologic therapies, including bevacizumab, trastuzumab, pembrolizumab, and their biosimilars, mainly for gynecological cancers. Additionally, this review considers the challenges of immunogenicity, interchangeability, and clinician awareness. After reviewing the latest peer-reviewed literature and related online materials, we found that biosimilars demonstrate comparable efficacy and safety to their reference biologics while also being more cost-effective. Recent clinical trials support the role of biosimilars in limiting the progression of disease and improving overall survival while reducing the financial burden of cancer treatments.}, }
@article {pmid41504442, year = {2026}, author = {Masters, PS}, title = {Coronavirus genome packaging and nucleocapsid assembly.}, journal = {Journal of virology}, volume = {100}, number = {2}, pages = {e0133025}, pmid = {41504442}, issn = {1098-5514}, support = {R01 AI064603/AI/NIAID NIH HHS/United States ; }, mesh = {*Virus Assembly ; *Nucleocapsid/metabolism/genetics ; *Genome, Viral ; *Viral Genome Packaging ; RNA, Viral/genetics/metabolism ; *Coronavirus/genetics/physiology ; Humans ; Phosphorylation ; Nucleocapsid Proteins/metabolism ; SARS-CoV-2/genetics/physiology ; Animals ; }, abstract = {Coronaviruses are a family of positive-strand RNA viruses that exhibit highly selective packaging of their genomic RNA (gRNA) into assembled virions, despite the presence of a large excess of subgenomic viral RNA species and host RNA in infected cells. While this high selectivity is critical to evading host innate immune responses, surprisingly, it is not essential for virion assembly. This review focuses on four main topics: (i) coronavirus genome packaging signals (PSs)-how they are found and the function they serve; (ii) the viral components that recognize the PS in order to bring about selective gRNA packaging; (iii) coronavirus nucleocapsid structure and assembly; and (iv) the relationship between nucleocapsid protein phosphorylation and nucleocapsid assembly versus RNA synthesis. Current understanding of these areas has benefited immensely from advances made by recent studies, most of which were performed in response to the emergence of the coronavirus responsible for the COVID-19 pandemic. Throughout this review, emphasis is placed on the counterintuitive distinction between coronavirus selective gRNA packaging and nucleocapsid assembly.}, }
@article {pmid41504815, year = {2026}, author = {Doyle, P and McHugh, S and O'Neill, D}, title = {Nursing home research in Ireland before and after the pandemic.}, journal = {Irish journal of medical science}, volume = {195}, number = {2}, pages = {1159-1162}, pmid = {41504815}, issn = {1863-4362}, mesh = {*Nursing Homes ; Ireland/epidemiology ; Humans ; *COVID-19/epidemiology ; Pandemics ; Bibliometrics ; Nursing Home Residents ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Nursing home residents in Ireland experienced a disproportionate burden of illness and death during the COVID-19 pandemic, highlighting longstanding systemic deficiencies in governance, staffing, and research engagement. Prior to the pandemic, this vulnerable population, characterised by high levels of multimorbidity and disability, received limited research attention. A subgroup from the National Clinical Programme for Older People recommended the development of a research agenda in nursing homes, including resident involvement. This study aimed to characterise the extent and nature of Irish nursing home research from 1966 to 2024. METHODS: A bibliometric review was conducted using PubMed to identify publications related to Irish nursing homes from January 1966 to March 2020 (pre-pandemic) and April 2020 to July 2024 (post-pandemic). Data extracted included publication type, number of authors, institutional affiliations, countries of origin, disciplines involved, and acknowledgement of nursing home staff or residents. Descriptive analysis was performed using Excel and SPSS. RESULTS: A total of 144 publications were identified. Most papers (n = 106; 73.6%) were published pre-pandemic, while 38 (26.4%) appeared in the shorter post-pandemic period, showing a substantial increase in publication rate (1.9 to 9.5/year). Original research comprised 81.3% of papers Interdisciplinary authorship was common (53%), yet only 12.5% of papers listed a nursing home as an author affiliation, primarily from public or voluntary sectors. Less than 40% of papers acknowledged staff or resident contributions. While COVID-19-focused publications increased markedly post-2020, broader topics in nursing home care remained underrepresented. CONCLUSION: Irish nursing home research remains limited, especially in the private sector. A national strategy is needed to expand stakeholder involvement and research breadth. Better use of the interRAI system, the national assessment tool since 2011, could substantially strengthen quality improvement and research capacity. Long-term investment will be essential to guide evidence-based policy and care.}, }
@article {pmid41504868, year = {2026}, author = {Khan, S and Tang, P and Yang, P and Li, J and Wu, H}, title = {Dual-function cytokines as modulators of autophagy: reprogramming inflammatory resolution in severe COVID-19.}, journal = {Inflammation research : official journal of the European Histamine Research Society ... [et al.]}, volume = {75}, number = {1}, pages = {11}, pmid = {41504868}, issn = {1420-908X}, mesh = {Humans ; *Autophagy/immunology ; *Cytokines/immunology/physiology ; *COVID-19/immunology ; SARS-CoV-2 ; Inflammation/immunology ; Animals ; *Coronavirus Infections/immunology/pathology ; *Pneumonia, Viral/immunology/pathology ; *Betacoronavirus ; }, abstract = {BACKGROUND: Acute respiratory distress syndrome (ARDS) and systemic immune-mediated damage are two of the severe COVID-19 outcomes that are primarily caused by cytokine storms triggered by dysregulated immune responses. The limited benefits of current immunosuppressive treatments highlight the need for mechanistic understanding to direct focused interventions.
OBJECTIVE: The dual functions of cytokines in controlling autophagy during SARS-CoV-2 infection are examined in this review, along with the potential for autophagy modulation to limit hyperinflammation and restore immune homeostasis.
KEY FINDINGS: Emerging evidence suggests that autophagy critically modulates the balance between pro- and anti-inflammatory cytokines in COVID-19. Through anti-inflammatory feedback mechanisms, cytokines contribute to resolution while promoting inflammation in the early stages. The IRE1α-XBP1 axis is activated by SARS-CoV-2-induced endoplasmic reticulum stress, which increases cytokine production and modifies autophagic flux. Concurrently, extracellular vesicles containing cytokines, damage-associated molecular patterns, and viral components are released as secretory autophagy reroutes cytoplasmic cargo toward multivesicular bodies and amphisomes, increasing paracrine immune activation. Suppressed degradative autophagy and increased secretory autophagy-mediated inflammatory signaling are the hallmarks of this pathological state.
CONCLUSIONS: In severe COVID-19, targeted autophagy restoration is a promising therapeutic approach to restore immune responses, reduce excessive inflammation, and encourage the resolution of cytokine storms. Restoring immune homeostasis through more targeted immunointerventions may be made possible by modifying autophagy pathways.}, }
@article {pmid41506147, year = {2026}, author = {Huai, Y and Wang, X and Yan, J and Li, S and Zhao, H and Liao, B}, title = {Emerging viroporins, RBP dynamics, and skeletal remodeling: Targeting liquid-liquid phase separation for dual antiviral and bone-protective therapies.}, journal = {Molecular aspects of medicine}, volume = {107}, number = {}, pages = {101445}, doi = {10.1016/j.mam.2026.101445}, pmid = {41506147}, issn = {1872-9452}, mesh = {Humans ; *Antiviral Agents/pharmacology/therapeutic use ; Phase Separation ; *Bone Remodeling/drug effects ; *RNA-Binding Proteins/metabolism ; Animals ; SARS-CoV-2 ; Stress Granules/metabolism ; }, abstract = {Emerging and re-emerging viral pathogens, particularly Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), Zika virus (ZIKV), and Chikungunya virus (CHIKV), are currently recognized as a significant global public health issue, commonly leading to devastating persistent complications including inflammatory bone disorders and long-lasting arthralgia. Although systemic cytokine storm has been reported as a significant factor, the particular intracellular processes through which these viruses affect bone homeostasis are still poorly understood. Recent studies underscore Liquid-Liquid Phase Separation (LLPS) and RNA-Binding Proteins (RBPs) as significant regulatory mechanisms manipulated by these viruses. Particularly, the SARS-CoV-2 Nucleocapsid protein exploits its intrinsically disordered regions to promote LLPS, facilitating viral assembly by the active inhibition of a key host anti-viral mechanism, known as host Stress Granules. Studies suggest that this biophysical interaction can affect the stability of the HuR RBD, impairing the nuclear β-catenin localization and then Wnt-mediated osteogenesis. Despite increasing recognition of post-viral musculoskeletal complications, the mechanistic links between viral persistence, host RBP dysfunction, and impaired bone remodeling remain poorly defined. This review incorporates viral LLPS, stress granule impairment, and osteogenic signaling into a unified 'Two-Hit' pathogenic framework. It also addresses key knowledge gaps, including the lack of longitudinal clinical validation and in vivo evidence associating LLPS impairment to skeletal disorders. Interestingly, this framework represents translational opportunities for dual-action therapeutic strategies that simultaneously impair viral condensates and recover host RBP-associated osteogenic signaling. Targeting the virus-host phase interface can introduce a potential approach not only for antiviral therapies but also for inhibiting post-viral musculoskeletal complications.}, }
@article {pmid41506494, year = {2026}, author = {Tran, MT and Doan, TD and Wu, HC and Chu, CY}, title = {Vaccine development for porcine epidemic diarrhea virus and porcine Deltacoronavirus: Updated progress, challenges, and future perspectives.}, journal = {Microbial pathogenesis}, volume = {212}, number = {}, pages = {108286}, doi = {10.1016/j.micpath.2026.108286}, pmid = {41506494}, issn = {1096-1208}, mesh = {Animals ; Swine ; *Porcine epidemic diarrhea virus/immunology ; *Viral Vaccines/immunology ; *Swine Diseases/prevention & control/virology/immunology ; *Coronavirus Infections/prevention & control/veterinary/immunology/virology ; *Vaccine Development/trends ; *Deltacoronavirus/immunology ; Vaccine Efficacy ; Antibodies, Viral/immunology ; Immunity, Mucosal ; Cross Protection ; }, abstract = {Porcine Epidemic Diarrhea Virus (PEDV) and Porcine Deltacoronavirus (PDCoV) are considered the greatest threats to the world swine industry since they cause a very high morbidity rate in piglets. Although vaccines with various formulations have been tested and validated in different settings, they still cannot be considered to provide long-lasting, comprehensive protection against these pathogens under real-world conditions. This review provides a comprehensive and critical overview of parallel efforts to develop vaccines against PEDV and PDCoV, with particular emphasis on vaccine formulation strategies, virus strains used in challenge studies, and the geographical applicability of these vaccines. Recent advances in vaccine development are discussed, highlighting the use of newly developed adjuvants and advanced delivery systems to enhance vaccine efficacy, especially in terms of inducing mucosal immune responses. Rather than merely summarizing progress in vaccine development to date, this review presents challenges, including viral diversity, lack of cross-protection, and maternal antibody interference, which reduce vaccine efficacy. Additionally, we discuss novel directions for future research on broadly protective next-generation antigen-detection systems and integrated approaches targeting different porcine coronaviruses. Thus, this review offers an up-to-date, in-depth overview of the current state of PEDV and PDCoV vaccine research, while also outlining future perspectives to drive innovation toward practical and sustainable disease control.}, }
@article {pmid41506930, year = {2026}, author = {He, WT and Jiang, ZW and Veit, M and Merits, A and Zhang, FN and Wang, D and Su, S}, title = {Multiscale imaging of RNA virus: bridging structural mapping and functional insights.}, journal = {Trends in microbiology}, volume = {34}, number = {3}, pages = {305-317}, doi = {10.1016/j.tim.2025.12.002}, pmid = {41506930}, issn = {1878-4380}, mesh = {*RNA Viruses/ultrastructure/physiology ; *Cryoelectron Microscopy/methods ; Humans ; Electron Microscope Tomography/methods ; Animals ; SARS-CoV-2/ultrastructure ; }, abstract = {RNA viruses, exemplified by the COVID-19 pandemic, pose a significant threat to global health. Their rapid mutation and host adaptability highlight the need for advanced tools for efficient viral studies and timely countermeasure development. Imaging technologies, such as cryo-electron microscopy and super-resolution microscopy, have been pivotal in advancing our understanding of viral structures, infection mechanisms, and virus-host interactions. However, each technique has limitations in the field of view or resolution. Recent advancements have focused on developing integrated multiscale imaging to better understand RNA virus pathogenesis. In this review, we examine recent progress in RNA virus imaging across molecular, cellular, and tissue scales, including cryo-electron tomography and correlative multiscale imaging, which link structural mapping with functional insights.}, }
@article {pmid41509876, year = {2026}, author = {Ärlebrant, L and Schimmer, R and Edin-Liljegren, A}, title = {Patients' experiences of video consultations: A qualitative systematic review.}, journal = {Digital health}, volume = {12}, number = {}, pages = {20552076251404513}, pmid = {41509876}, issn = {2055-2076}, abstract = {INTRODUCTION: Video consultation (VC) became vital for improving healthcare access during COVID-19 pandemic and remains so. Despite evidence of effectiveness, concerns including technology literacy and inconsistencies in experience highlight the need for larger, patient-focused studies. While patients appreciate the convenience of VC, challenges during complex issues and patients' preferences for in-person care persists. Synthesising qualitative studies offers insights into the fragmented understanding of patient experiences with VC. This review explores adult patients' experiences of VC.
METHODS: A systematic literature search was conducted for studies published between 2011 and 2024 and reported according to the PRISMA statement. Study quality was assessed using the CASP checklist, and data were analysed through thematic synthesis. Confidence in the findings was evaluated using GRADE-CERQual.
RESULTS: In total, 3203 unique studies were retrieved; 13 were included in the final synthesis, resulting in four main themes: (1) suitable for less complex issues when technical problems can be solved; (2) feeling secure, relaxed, and having mutual focus in an equitable partnership; (3) limitations regarding personal needs and practical help; and (4) increased vulnerability and lack of emotional feedback.
CONCLUSION: VC is experienced as ideal for managing less complex issues but is challenging for emotional topics due to technical concerns. It empowers patients by providing a neutral place for focused conversations but can create vulnerability and distance that can challenge the patient-professional relationship. Success requires technological adaptation, sufficient time during VC, and emotional support. VC should complement - not replace - traditional care, with its use determined in dialogue with patients.}, }
@article {pmid41510348, year = {2025}, author = {Tachibana, S and Bourgeois Yoshioka, CK}, title = {Take Fatigue or Fatigues into Account in Physiotherapy Interventions? A Rapid Scoping Review.}, journal = {Physical therapy research}, volume = {28}, number = {3}, pages = {157-173}, pmid = {41510348}, issn = {2189-8448}, abstract = {Fatigue is one of the most common symptoms encountered in rehabilitation and during physical therapy interventions. Although this phenomenon is known and experienced by everyone, its assessment is not straightforward. The lack of consensus on its definition, complex etiology, and multidimensional nature means that a large number of outcomes exist and continue to be reviewed. However, it seems essential that its assessment be better defined and standardized to understand the effects of physical therapy. To provide an initial exploratory overview, we conducted a rapid scoping review of the various fatigue assessments used in physiotherapy interventions or performed by physical therapists. A total of 139 articles published between 2020 and July 31, 2025 were included and explored. We found 43 different outcomes used across 46 population groups. While the most well-known chronic conditions such as cancer, multiple sclerosis (MS), and coronavirus disease 2019 (COVID-19) are representative, their assessment methods do not appear to be harmonized. These findings from the study support the idea that fatigue remains a complex phenomenon to assess. However, it appears that the lack of justification for the choice of an outcome prevents a better understanding of the reproducible effects on fatigue in physiotherapy interventions.}, }
@article {pmid41512080, year = {2026}, author = {Lee, D and Malathi, K and Okano, T and Nakajima, K and Cobat, A and Morio, T and Casanova, JL and Zhang, SY}, title = {The OAS-RNase L pathway: Insights from experiments of nature.}, journal = {Science immunology}, volume = {11}, number = {115}, pages = {eads9407}, pmid = {41512080}, issn = {2470-9468}, support = {/HHMI/Howard Hughes Medical Institute/United States ; R21 AI160576/AI/NIAID NIH HHS/United States ; UL1 TR001866/TR/NCATS NIH HHS/United States ; }, mesh = {Humans ; *2',5'-Oligoadenylate Synthetase/genetics/metabolism/immunology ; *Endoribonucleases/metabolism/immunology/genetics ; Animals ; *SARS-CoV-2/immunology/physiology ; Inflammation/immunology ; Virus Replication ; Signal Transduction ; }, abstract = {The 2'-5' oligoadenylate synthetases (OASs) are type I interferon-inducible enzymes that, with ribonuclease L (RNase L), have been studied in the context of their coupled action as antiviral effectors. RNase L degrades host and viral ssRNA, affecting diverse cellular processes including translational arrest, interferon response, and apoptosis, all of which are thought to restrict viral replication. Recent studies of recessive inborn errors of human OAS1, OAS2, and RNase L, however, revealed that for SARS-CoV-2 infection, the main protective action of this pathway in natura may be through restricting phagocyte-driven postviral inflammation rather than restricting early viral replication in the respiratory tract. This finding is consistent with the identification of gain-of-function OAS1 mutations in humans with autoinflammation also driven by myeloid cells. Here, we retrace the investigation of the OAS-RNase L pathway, focusing on these recent in natura studies in humans that reposition the pathway as a determinant of the inflammatory response under natural conditions of infection.}, }
@article {pmid41512436, year = {2026}, author = {Chau, MT and Spuur, KM and Vu, H}, title = {Health human resources shortages in radiography and sustainable workforce development in Australia.}, journal = {Radiography (London, England : 1995)}, volume = {32}, number = {2}, pages = {103319}, doi = {10.1016/j.radi.2025.103319}, pmid = {41512436}, issn = {1532-2831}, mesh = {Humans ; Australia ; *Health Workforce ; COVID-19/epidemiology ; Pandemics ; SARS-CoV-2 ; Sustainable Development ; }, abstract = {OBJECTIVES: Health Human Resources (HHR) are critical for the effective functioning of healthcare systems, yet significant shortages exist, particularly in radiography. The increasing demand for diagnostic radiography services, driven by advancements in medical technology, an aging population, and the prevalence of chronic diseases, exacerbates these shortages. The COVID-19 pandemic further highlighted workforce vulnerabilities, increasing workloads and burnout. This review examines HHR shortages in radiography in Australia and proposes strategies for sustainable workforce development.
KEY FINDINGS: The aging radiography workforce, with a significant portion nearing retirement, intensifies HHR shortages. The pandemic disrupted education and training, delaying the entry of new professionals and increasing turnover intentions among existing staff. The result being delayed imaging services, increased wait times, and potentially compromised patient outcomes. To address these challenges, a multifaceted strategy is proposed. Policy changes and government initiatives, including funding educational programs and recognizing internationally trained radiographers, can provide immediate relief. Expanding enrolment capacities and developing new training programs are essential. Retention strategies, including improving working conditions and career advancement opportunities, are crucial for workforce stability. Promoting advanced practice models can optimize task distribution and better utilize specialized skills. Leveraging technology, such as artificial intelligence and telehealth, can enhance productivity and extend service reach.
CONCLUSION: A comprehensive approach combining policy changes, educational initiatives, retention strategies, technology integration, international recruitment, and awareness campaigns is essential for addressing HHR shortages in radiography. By implementing these strategies, the radiography workforce can be better equipped to meet the growing demands of healthcare, ensuring optimal patient outcomes and the sustainability of health services.
IMPLICATIONS FOR PRACTICE: Strengthening the radiography workforce will ensure timely and effective healthcare delivery, support health interventions, and progress towards universal health coverage and Sustainable Development Goals.}, }
@article {pmid41513512, year = {2026}, author = {Llanes, AC and Bandhlish, A and Pipavath, S and Lima, APS}, title = {Refining the Radiologic Recognition of Pulmonary Alveolar Proteinosis: A Crazy-Paving Pattern Approach.}, journal = {Seminars in roentgenology}, volume = {61}, number = {}, pages = {150961}, doi = {10.1053/j.ro.2025.09.004}, pmid = {41513512}, issn = {1558-4658}, mesh = {Humans ; *Pulmonary Alveolar Proteinosis/diagnostic imaging/pathology ; *Tomography, X-Ray Computed/methods ; Diagnosis, Differential ; COVID-19/diagnostic imaging ; SARS-CoV-2 ; Lung/diagnostic imaging ; Lung Diseases, Interstitial/diagnosis ; }, abstract = {Pulmonary alveolar proteinosis (PAP) is a rare airspace disease classically associated with the crazy-paving pattern on high-resolution computed tomography (HRCT). While highly suggestive, this imaging pattern is not pathognomonic and appears across a wide spectrum of pulmonary pathologies. In this review, we adopt a phenotype-first approach, using representative imaging cases to walk the reader through the differential diagnosis of crazy-paving, with attention to radiologic distribution, clinical context, and disease acuity. We emphasize distinguishing features between PAP and its mimics-including pulmonary edema, diffuse alveolar hemorrhage, organizing pneumonia, mucinous adenocarcinoma, exogenous lipoid pneumonia, acute fulminant PAP, and COVID-19 pneumonia-using side-by-side imaging and contextual pearls. Special attention is given to the radiologic clues favoring autoimmune versus secondary PAP, including geographic distribution of ground-glass opacities, subpleural sparing, and lower lobe predominance. The review concludes with a summary of diagnostic strategies, pathologic correlation, and treatment options, including insights from post-pandemic diagnostic pitfalls. This pattern-based framework is designed for the radiologist and serves as a practical guide for recognizing PAP within the broader spectrum of airspace diseases.}, }
@article {pmid41513611, year = {2026}, author = {Nunes, M and Kell, L and Slaghekke, A and Wüst, RC and Fielding, BC and Kell, DB and Pretorius, E}, title = {Virus-induced endothelial senescence as a cause and driving factor for ME/CFS and long COVID: mediated by a dysfunctional immune system.}, journal = {Cell death & disease}, volume = {17}, number = {1}, pages = {16}, pmid = {41513611}, issn = {2041-4889}, support = {NNF20CC0035580//Novo Nordisk Fonden (Novo Nordisk Foundation)/ ; }, mesh = {Humans ; *COVID-19/immunology ; *Cellular Senescence ; SARS-CoV-2 ; *Fatigue Syndrome, Chronic/immunology/virology/pathology ; Post-Acute COVID-19 Syndrome ; *Coronavirus Infections/immunology/virology/pathology ; Animals ; *Endothelial Cells/pathology/virology/immunology ; *Betacoronavirus ; *Endothelium, Vascular/immunology/pathology/virology ; *Immune System ; }, abstract = {Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long COVID are two post-viral diseases, which share many common symptoms and pathophysiological alterations. Yet a mechanistic explanation of disease induction and maintenance is lacking. This hinders the discovery and implementation of biomarkers and treatment options, and ultimately the establishment of effective clinical resolution. Here, we propose that acute viral infection results in (in)direct endothelial dysfunction and senescence, which at the blood-brain barrier, cerebral arteries, gastrointestinal tract, and skeletal muscle can explain symptoms. The endothelial senescence-associated secretory phenotype (SASP) is proinflammatory, pro-oxidative, procoagulant, primed for vasoconstriction, and characterized by impaired regulation of tissue repair, but also leads to dysregulated inflammatory processes. Immune abnormalities in ME/CFS and long COVID can account for the persistence of endothelial senescence long past the acute infection by preventing their clearance, thereby providing a mechanism for the chronic nature of ME/CFS and long COVID. The systemic and tissue-specific effects of endothelial senescence can thus explain the multisystem involvement in and subtypes of ME/CFS and long COVID, including dysregulated blood flow and perfusion deficits. This can occur in all tissues, but especially the brain as evidenced by findings of reduced cerebral blood flow and impaired perfusion of various brain regions, post-exertional malaise (PEM), gastrointestinal disturbances, and fatigue. Paramount to this theory is the affected endothelium, and the bidirectional sustainment of immune abnormalities and endothelial senescence. The recognition of endothelial cell dysfunction and senescence as a core element in the aetiology of both ME/CFS and Long COVID should aid in the establishment of effective biomarkers and treatment regimens.}, }
@article {pmid41514815, year = {2026}, author = {Vasinioti, VI and Lucente, MS and Catella, C and Buonavoglia, C and Decaro, N and Pratelli, A and Capozza, P}, title = {Feline Infectious Peritonitis: A Challenging Diagnostic and Therapeutic Labyrinth.}, journal = {Animals : an open access journal from MDPI}, volume = {16}, number = {1}, pages = {}, pmid = {41514815}, issn = {2076-2615}, abstract = {Feline coronaviruses (FCoVs) are ubiquitous pathogens, exhibiting high prevalence across feline populations worldwide. Although the virulent mutated biotype feline infectious peritonitis virus (FIPV) is observed in only a small percentage of cats, it causes a systemic and often fatal disease. Diagnosis of feline infectious peritonitis (FIP) is challenging due to its non-specific clinical signs and the difficulty in differentiating between the two biotypes, feline enteric coronavirus (FECV) and FPIV. Currently, veterinarians rely on a combination of diagnostic methods, integrating laboratory tests, anamnesis and clinical signs to improve the diagnostic accuracy of FIP. Once considered untreatable, FIP now benefits from recent pharmacological advances that suggest promising therapeutic options, including antiviral drugs and immunomodulatory therapies. Despite these developments, the lack of an effective vaccine and definitive curative treatment highlights the need for continued research. This review provides a comprehensive analysis of the current literature on diagnostic and treatment approaches for FIP. The aim is to improve understanding of the available options and strategies for FIP to mitigate its severe consequences.}, }
@article {pmid41515644, year = {2026}, author = {Azman, SA and Kennedy, MP}, title = {Single-Use Flexible Bronchoscopy: Advances in Technology and Applications.}, journal = {Diagnostics (Basel, Switzerland)}, volume = {16}, number = {1}, pages = {}, pmid = {41515644}, issn = {2075-4418}, abstract = {With advances in scope and imaging technology, the use of single-use flexible bronchoscopy (SUFB) has broadened beyond intensive care units and operating rooms to bronchoscopy units, with an expanding body of literature suggesting adequate and comparable procedure outcomes, including airway inspection, bronchoalveolar lavage, endobronchial brushing and endobronchial biopsy, in comparison to standard reusable flexible bronchoscopy (RFB). Advantages such as mobility, ease of use and lack of requirement for cleaning staff during the COVID-19 pandemic led to a global increase in usage, with many companies developing SUFB as part of their bronchoscopy portfolio. In parallel, there has been more attention and initiatives to minimise the risk of infection transmission related to bronchoscopy. RFB requires maximum adherence to manufacturer-recommended cleaning protocols. However, evidence of transmissible organisms after cleaning is reported in healthcare settings of all types. After initial benchtop, retrospective and single-arm studies, comparative bronchoscopy studies are identifying that SUFB are as versatile and non-inferior to RFB. However, cost-effectiveness and sustainability factors have to be included in deciding the use of SUFB in routine practice.}, }
@article {pmid41516024, year = {2025}, author = {Cuppen, JJM and Savelkoul, HFJ}, title = {Immune Delay, Beyond Immune Evasion, as a Driver of Pathogen Propagation Competence Through Neutrophil Dysregulation, to be Mitigated by Low-Frequency Electromagnetic Fields (LF-EMF).}, journal = {International journal of molecular sciences}, volume = {27}, number = {1}, pages = {}, pmid = {41516024}, issn = {1422-0067}, mesh = {*Neutrophils/immunology/radiation effects ; Humans ; *Electromagnetic Fields ; *Immune Evasion/immunology ; Animals ; *Bacterial Infections/immunology ; *Virus Diseases/immunology ; Neutrophil Activation/immunology/radiation effects ; Host-Pathogen Interactions/immunology ; }, abstract = {This paper proposes that immune delay, beyond immune evasion, is key in the propagation competence of major viral and bacterial infections, and that the dynamics of infection and immune response suggest possibilities for mitigating the ensuing infectious diseases. Recent data show a critical role of neutrophils at various stages of viral and bacterial infections, revealing how early activation of neutrophils could help mitigate infectious diseases. It could prevent the gradual overactivation of subclasses of neutrophils and probably not induce it. In respiratory virus infections, an immune delay of several days allows the development of a high viral load supporting infectivity towards further hosts when a delayed and increased immune response takes place. Virus variants will optimize immune delay towards highest infectivity, supporting pandemic potential. The influenza virus, coronavirus, and several major bacterial infections exhibit such immune delay capability. Recurrent urinary tract infections (rUTI) are common, often associated with the causative uropathogenic E. coli (UPEC) that has this capability, suggesting that immune delay is crucial in the pathogenesis of rUTI and other widespread bacterial infections. Counteracting immune delay, therefore, is a promising approach for mitigating infectious diseases with epidemic and pandemic presence or potential. Previously proven low-frequency electromagnetic field (LF-EMF)-induced neutrophil activation is such an approach.}, }
@article {pmid41516027, year = {2025}, author = {Yang, J and Qu, Y and Yuan, Z and Lun, Y and Kuang, J and Shao, T and Qi, Y and Li, Y and Zhu, L}, title = {Targeting Host Dependency Factors: A Paradigm Shift in Antiviral Strategy Against RNA Viruses.}, journal = {International journal of molecular sciences}, volume = {27}, number = {1}, pages = {}, pmid = {41516027}, issn = {1422-0067}, mesh = {Humans ; *RNA Viruses/drug effects/physiology ; *Antiviral Agents/pharmacology/therapeutic use ; *Host-Pathogen Interactions/drug effects ; Virus Replication/drug effects ; Animals ; *RNA Virus Infections/drug therapy/virology ; Host-Directed Therapy ; Virus Internalization/drug effects ; }, abstract = {RNA viruses, such as SARS-CoV-2 and influenza, pose a persistent threat to global public health. Their high mutation rates undermine the effectiveness of conventional direct-acting antivirals (DAAs) and facilitate drug resistance. As obligate intracellular parasites, RNA viruses rely extensively on host cellular machinery and metabolic pathways throughout their life cycle. This dependency has prompted a strategic shift in antiviral research-from targeting the mutable virus to targeting relatively conserved host dependency factors (HDFs). In this review, we systematically analyze how RNA viruses exploit HDFs at each stage of infection: utilizing host receptors for entry; remodeling endomembrane systems to establish replication organelles; hijacking transcriptional, translational, and metabolic systems for genome replication and protein synthesis; and co-opting trafficking and budding machinery for assembly and egress. By comparing strategies across diverse RNA viruses, we highlight the broad-spectrum potential of HDF-targeting approaches, which offer a higher genetic barrier to resistance, providing a rational framework for developing host-targeting antiviral therapies.}, }
@article {pmid41516190, year = {2025}, author = {Mcmillan, P and Turner, AJ and Uhal, BD}, title = {The Central Role of Macrophages in Long COVID Pathophysiology.}, journal = {International journal of molecular sciences}, volume = {27}, number = {1}, pages = {}, pmid = {41516190}, issn = {1422-0067}, mesh = {Humans ; *Macrophages/immunology/pathology ; *COVID-19/immunology/physiopathology/pathology/virology ; Post-Acute COVID-19 Syndrome ; Macrophage Activation ; Immunity, Innate ; SARS-CoV-2/immunology ; Epigenesis, Genetic ; Animals ; Spike Glycoprotein, Coronavirus/metabolism ; }, abstract = {This review article attempts to provide a unifying hypothesis to explain the myriad of symptoms and predispositions underlying the development of PASC (Postacute Sequelae of COVID), often referred to as Long COVID. The hypothesis described here proposes that Long COVID is best understood as a disorder of persistent immune dysregulation, with chronic macrophage activation representing the fundamental underlying pathophysiology. Unlike transient post-viral syndromes, Long COVID involves a sustained innate immune response, particularly within monocyte-derived macrophages, driven by persistent spike protein (peripherally in MAIT cells and centrally in Microglial cells), epigenetic imprinting, and gut-related viral reservoirs. These macrophages are not merely activated temporarily but also become epigenetically "trained" into a prolonged inflammatory state, as demonstrated by enduring histone acetylation markers such as H3K27acDNA Reprogramming. It is proposed that recognizing macrophage activation as the central axis of Long COVID pathology offers a framework for personalized risk assessment, targeted intervention, and therapeutic recalibration.}, }
@article {pmid41516301, year = {2025}, author = {Stojanovic, M and Djuric, M and Nenadic, I and Bojic, S and Andrijevic, A and Popovic, A and Pesic, S}, title = {Vascular Complications of Long COVID-From Endothelial Dysfunction to Systemic Thrombosis: A Systematic Review.}, journal = {International journal of molecular sciences}, volume = {27}, number = {1}, pages = {}, pmid = {41516301}, issn = {1422-0067}, mesh = {Humans ; *COVID-19/complications/pathology ; *Thrombosis/etiology/pathology ; *Endothelium, Vascular/physiopathology/pathology ; SARS-CoV-2 ; }, abstract = {Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated not only with respiratory illness but also with profound vascular and coagulation disturbances. Long COVID (LC) is characterized by persistent symptoms such as fatigue, dyspnea, cognitive impairment, and palpitations. Mechanistically, SARS-CoV-2 induces direct endothelial injury, promotes a pro-inflammatory cytokine milieu, and activates platelets, leading to immunothrombosis and impaired fibrinolysis. Consequently, patients exhibit microthrombosis, elevated plasma D-dimer, fibrinogen dysregulation, and persistent hypercoagulability. Clinically, this translates into an increased risk of venous thromboembolism, including deep vein thrombosis and pulmonary embolism, as well as arterial thrombotic events such as myocardial infarction and stroke, which may persist months after acute infection. Understanding the interplay between endothelial injury, inflammation, and coagulation is crucial for risk stratification and the development of preventive and therapeutic strategies. We conducted a systematic narrative review of the literature, including human clinical and mechanistic studies identified through PubMed, Scopus and Web of Science up to 30 September 2025. This review synthesizes current evidence on vascular complications in LC, highlighting endothelial dysfunction as a central pathophysiological nexus linking the acute phase of SARS-CoV-2 infection with chronic LC manifestations.}, }
@article {pmid41516418, year = {2026}, author = {Barajas, A and Riquelme-Alacid, G and Vera-Montecinos, A and Ramos, B}, title = {Cognition, Cytokines, Blood-Brain Barrier, and Beyond in COVID-19: A Narrative Review.}, journal = {International journal of molecular sciences}, volume = {27}, number = {1}, pages = {}, pmid = {41516418}, issn = {1422-0067}, support = {PI21/00059//Instituto de Salud Carlos III/ ; }, mesh = {Humans ; *Blood-Brain Barrier/metabolism ; *COVID-19/complications ; *Cytokines/blood/metabolism ; SARS-CoV-2/isolation & purification ; *Cognition/physiology ; *Cognitive Dysfunction/etiology ; Post-Acute COVID-19 Syndrome ; }, abstract = {Numerous studies report cognitive impairment in COVID-19 patients from the acute to post-acute phases, linked to blood inflammation affecting blood-brain barrier (BBB) permeability and causing leakage of glial and neuronal proteins. However, a clear classification of these cognitive deficits and molecular blood events over time is still lacking. This narrative review summarizes the neuropsychological consequences of COVID-19 and evidence of altered cytokines and BBB disruption as potential mediators of cognitive impairment across post-infection phases. Post-COVID-19 cognitive dysfunction appears to follow a temporal course, evolving from acute focal deficits in attention, working memory, and executive function to more persistent multidomain impairments. We reviewed key cytokines released into the blood during COVID-19 infection, including antiviral (IFNγ, CXCL1, CXCL10), inflammatory (IL-1β, IL-2, IL-4, IL-6, IL-7, IL-8, IL-10, GM-CSF, TNFα), and monocyte chemoattractants (MCP1/CCL2, MCP3/CCL7, MIP-1α/CCL3, GM-CSF, G-CSF). This analysis shows that several inflammatory and viral cytokines remain elevated beyond the acute phase and are associated with cognitive deficits, including IL-6, IL-13, IL-8, IL-1β, TNFα, and MCP1 in long-term post-COVID-19 patients. In addition, we examined studies analyzing changes over time in neurovascular unit proteins as biomarkers of BBB disruption, including extracellular matrix proteins (PPIA, MMP-9), astrocytes (S100β, GFAP), and neurons (NFL). These proteins are elevated in acute COVID-19 but generally return to control levels within six months, suggesting BBB restoration. However, in patients followed for over a year, BBB disruption persists only in those with cognitive impairment and is associated with systemic inflammation, with TGFβ as a related biomarker. Although cognitive sequelae can persist for over 12 months after SARS-CoV-2 infection, further studies are needed to investigate long-term neurocognitive outcomes and their link to sustained proinflammatory cytokine elevation and brain impact.}, }
@article {pmid41516981, year = {2025}, author = {Huang, WH and Ho, YF and Yeh, JY and Liu, PY and Huang, PH}, title = {Hospital Influenza Outbreak Management in the Post-COVID Era: A Narrative Review of Evolving Practices and Feasibility Considerations.}, journal = {Healthcare (Basel, Switzerland)}, volume = {14}, number = {1}, pages = {}, pmid = {41516981}, issn = {2227-9032}, abstract = {Background: Hospital-acquired influenza remains a persistent threat that amplifies morbidity, mortality, length of stay, and operational strain, particularly among older and immunocompromised inpatients. The COVID-19 era reshaped control norms-normalizing N95 use during surges, ventilation improvements, and routine multiplex PCR-creating an opportunity to strengthen hospital outbreak management. Methods: We conducted a targeted narrative review of WHO/CDC/Infectious Diseases Society of America (IDSA) guidance and peer-reviewed studies (January 2015-August 2025), emphasizing adult inpatient care. This narrative review synthesizes recent evidence and discusses theoretical implications for practice, rather than establishing formal guidelines. Evidence was synthesized into pragmatic practice statements on detection, diagnostics, isolation/cohorting, antivirals, chemoprophylaxis, vaccination, surveillance, and communication. Results: Early recognition and test-based confirmation are pivotal. For inpatients, nucleic-acid amplification tests are preferred; negative antigen tests warrant PCR confirmation, and lower-respiratory specimens improve yield in severe disease. A practical outbreak threshold is ≥2 epidemiologically linked, laboratory-confirmed cases within 72 h on the same ward. Effective control may require immediate isolation or cohorting with dedicated staff, strict droplet/respiratory protection, and daily active surveillance. Early oseltamivir (≤48 h from onset or on admission) reduces mortality and length of stay; short-course post-exposure prophylaxis for exposed patients or staff lowers secondary attack rates. Integrated vaccination efforts for healthcare personnel and high-risk patients reinforce workforce resilience and reduce transmission. Conclusions: A standardized, clinician-led bundle-early molecular testing, do-not-delay antivirals, decisive cohorting and Personal protective equipment (PPE), targeted chemoprophylaxis, vaccination, and disciplined communication- could help curb transmission, protect vulnerable patients and staff, and preserve capacity. Hospitals should codify COVID-era layered controls for seasonal influenza and rehearse unit-level outbreak playbooks to accelerate response and recovery. These recommendations target clinicians and infection-prevention leaders in acute-care hospitals.}, }
@article {pmid41517347, year = {2025}, author = {Boccatonda, A and Brighenti, A and D'Ardes, D and Vetrugno, L}, title = {High-Flow Nasal Cannula Outside the ICU: A Systematic Review and Meta-Analysis.}, journal = {Journal of clinical medicine}, volume = {15}, number = {1}, pages = {}, pmid = {41517347}, issn = {2077-0383}, abstract = {Background: Use of high-flow nasal cannula (HFNC) expanded from ICUs to internal medicine/respiratory wards during and after the COVID-19 pandemic, but safety and effectiveness in non-ICU settings remain uncertain. Methods: We performed a systematic review and meta-analysis of adults (≥18 years) initiated on HFNC in non-ICU wards. Primary outcomes were in-hospital (or 28-day) mortality and ICU transfer; where available, we compared mortality for HFNC vs. conventional oxygen therapy (COT) in do-not-intubate (DNI) cohorts. Observational studies and trials were eligible. Random-effects models synthesized proportions and risk ratios; risk of bias (ROBINS-I/RoB 2) and certainty (GRADE) were assessed. Results: Ten studies met the inclusion criteria for any-ward HFNC; subsets contributed data to pooled analyses. Across all non-ICU wards (general wards plus step-up IMCU/HDU), pooled mortality was 14.0% (95% CI 4.6-35.5; I[2] ≈ 92%). Pooled ICU transfer after ward/step-up HFNC start was 20.0% (95% CI 6.3-48.1; I[2] ≈ 97%). Restricted to internal medicine/respiratory wards, pooled mortality was 19.8% (95% CI 7.1-44.2; I[2] ≈ 95%) and ICU transfer 31.2% (95% CI 9.9-65.0; I[2] ≈ 97%). In step-up units (IMCU/HDU), ICU transfer appeared lower and less variable (22.0% [95% CI 16.5-28.8]; I[2] ≈ 10%), suggesting environment-dependent outcomes. In a multicenter DNI COVID-19 cohort, HFNC vs. COT showed no clear mortality difference (RR ≈ 0.90, 95% CI 0.75-1.08; adjusted OR ≈ 0.72, 95% CI 0.34-1.54). Certainty of evidence for all critical outcomes was very low due to observational design, high inconsistency, and imprecision. Conclusions: HFNC outside the ICU is feasible, but it is related to nontrivial mortality and frequent escalation-particularly on general wards-while step-up units demonstrate more reproducible trajectories. Outcomes appear strongly conditioned by care environment, staffing, monitoring, and escalation pathways. Given very low certainty and substantial heterogeneity, institutions should pair ward HFNC with protocolized reassessment and rapid response/ICU outreach, and future research should prospectively compare ward HFNC pathways against optimized COT/NIV using standardized outcomes.}, }
@article {pmid41517591, year = {2026}, author = {Cotet, IG and Mateescu, DM and Gavrilescu, DM and Marginean, A and Serban, S and Ilie, AC and Guse, C and Pah, AM and Badalica-Petrescu, M and Iurciuc, S and Craciun, ML and Avram, A and Tudoran, C}, title = {Surgical Timing and Safety of Breast Cancer Operations After COVID-19: A Prospective-Only Meta-Analysis of Cohort Studies.}, journal = {Journal of clinical medicine}, volume = {15}, number = {1}, pages = {}, pmid = {41517591}, issn = {2077-0383}, support = {Victor Babeș University of Medicine and Pharmacy Timișoara//Victor Babeș University of Medicine and Pharmacy Timișoara/ ; }, abstract = {Background: The COVID-19 pandemic raised uncertainties regarding the safe timing of breast cancer surgery after SARS-CoV-2 infection, and robust prospective evidence has remained limited. Methods: We conducted a systematic review and meta-analysis of prospective cohort studies (2020-2024) investigating postoperative outcomes in breast cancer patients with confirmed SARS-CoV-2 infection ≤90 days before surgery versus contemporaneous non-infected controls treated at the same institutions and in the same period. PROSPERO CRD420251174613. Random-effects models (DerSimonian-Laird with Hartung-Knapp adjustment) were used to pool odds ratios (ORs) and 95% confidence intervals (CIs). Study quality was assessed with the Newcastle-Ottawa Scale, and certainty of evidence was rated using GRADE. Results: Twelve prospective cohort studies, including 7812 patients, compared breast cancer surgery after recent confirmed SARS-CoV-2 infection over 90 days with contemporaneous non-infected controls treated at the same centres. Overall, recent infection was associated with higher 30-day postoperative complications (Clavien-Dindo ≥ II) compared to. non-infected patients (OR 2.01, 95% CI 1.44-2.81) and increased venous thromboembolism (3.6%vs. 1.2%; OR 3.12, 95% CI 1.29-7.55). Early surgery 14 days after infection carried the highest risk of complications (OR 4.38, 95 CI 2.31-8.30), whereas operations performed ≥6 weeks yielded outcomes comparable to non-infected controls (OR 1.03, 95 CI 0.81-1.31); 30-day mortality remained very low (0.3). Conclusions: Breast cancer surgery after SARS-CoV-2 infection is associated with excess perioperative risk only when performed within the first two weeks. Delaying surgery to approximately six weeks minimises complications and VTE without compromising short-term safety.}, }
@article {pmid41517681, year = {2026}, author = {Escobar-Segovia, K and Domínguez-Salas, S and García-Iglesias, JJ and López-López, D and Allande-Cussó, R and Ruiz-Frutos, C and Artero-García, A and Gómez-Salgado, J}, title = {Psychological distress in Spanish-speaking countries during the COVID-19 pandemic: A systematic review and meta-analysis.}, journal = {Medicine}, volume = {105}, number = {2}, pages = {e47062}, pmid = {41517681}, issn = {1536-5964}, mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Psychological Distress ; *Stress, Psychological/epidemiology ; Prevalence ; SARS-CoV-2 ; Female ; Pandemics ; Spain/epidemiology ; }, abstract = {BACKGROUND: Psychological distress (PD) has increased significantly during the coronavirus disease 2019 (COVID-19) pandemic. In Spanish-speaking countries, with their cultural, social, and economic diversity, this phenomenon has become particularly relevant and has been aggravated by factors such as socioeconomic inequalities and unequal access to mental health services. The aim of this systematic review was to consolidate the available knowledge on PD in Spanish-speaking population groups by assessing both the prevalence of symptoms and the associated factors in different demographic groups and geographic contexts, during the COVID-19 pandemic.
METHODS: A systematic review following the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement was conducted in the Web of Science, PubMed, and Scopus electronic databases in January 2025. The search included studies published from the beginning of the pandemic until May 2023. The Joanna Briggs Institute's critical assessment tool was used to evaluate the chosen studies' methodological quality.
RESULTS: A total of 53 studies were included in the review, which involved research conducted in Spain, Peru, Chile, Ecuador, Argentina, and Colombia. The results revealed a high prevalence of PD in these countries, especially among healthcare workers, women, and young people. The assessment methods used included the General Health Questionnaire (GHQ, GHQ-12, and GHQ-28 versions), the Kessler scale (K-6 and K-10 versions), and the 90-symptom checklist questionnaire (SCL-90-R), that allowed obtaining various dimensions of PD. The studies also highlighted the importance of the sense of coherence and work engagement as protective factors.
CONCLUSIONS: In the COVID-19 pandemic, PD was analyzed to be severe in Spanish-speaking countries, pointing to the need for specific and culturally adapted interventions to address this public mental health crisis. This is why public health policies must focus on the prevention and treatment of PD, with special attention to the most vulnerable groups.}, }
@article {pmid41518867, year = {2026}, author = {Amirav, I and Ben Yosef, H and Zelniker, N and Be'er, M and Dennett, L and Besor, O and Lavie, M and Pillay, J}, title = {Risk of small-volume nebulizer treatments in the transmission of bacteria and viruses: a systematic review.}, journal = {The Journal of hospital infection}, volume = {168}, number = {}, pages = {144-160}, doi = {10.1016/j.jhin.2025.10.022}, pmid = {41518867}, issn = {1532-2939}, mesh = {Humans ; *Nebulizers and Vaporizers ; *Cross Infection/transmission ; *Bacterial Infections/transmission ; Aerosols ; COVID-19/transmission ; }, abstract = {BACKGROUND: Nebulized aerosol therapy is widely used for treating respiratory diseases, including those caused by severe acute respiratory syndrome coronavirus-2. During pandemics, some guidelines recommend avoiding nebulizers, yet supporting evidence is limited.
OBJECTIVE: To undertake a systematic review of evidence on the risk of cross-infection linked to nebulizer use in healthcare settings.
DATA SOURCES: Databases including Medline and Embase were searched from June 2020 to February 2024. Two independent reviewers conducted study selection and data extraction; discrepancies were resolved by a third reviewer.
DATA EXTRACTION: Risk of bias was assessed using the Newcastle-Ottawa Scale for case-control and cohort studies, an adapted version for cross-sectional studies, and a custom tool for experimental/simulation studies. Meta-analysis was performed on comparative clinical data. Certainty of evidence was rated using the Grading of Recommendation, Assessment, Development and Evaluation approach.
SYNTHESIS: Twenty-six studies met the inclusion criteria (six case-control, three cohort, one cross-sectional, four case series, 12 experimental/simulation). None of them reported that nebulizer use is free from risk of cross-infection. Meta-analysis of 10 comparative clinical studies (N=8536) found an association between nebulizer use and increased risk of infection (odds ratio 3.20, 95% confidence interval 1.59-6.44; P=0.0001), although certainty was low. Nine of 12 experimental/simulation studies demonstrated aerosol dispersion of particles or pathogens.
CONCLUSIONS: Nebulizer exposure may elevate the risk of infection compared with non-exposure. Nebulizer use in hospital settings should be limited during pandemics or when cross-infection is a concern. When necessary, additional precautions are warranted.}, }
@article {pmid41519993, year = {2026}, author = {Azhar, LE and Samkari, DA and Hassan, AM and Alsayed, SM and Azhar, EI}, title = {The Emergence and Characterization of SARS-CoV-2 Variant XFG ("Stratus"): Comparative Virological, Epidemiological, and Public-Health Perspectives.}, journal = {Journal of epidemiology and global health}, volume = {16}, number = {1}, pages = {8}, pmid = {41519993}, issn = {2210-6014}, mesh = {Humans ; *COVID-19/epidemiology/virology/immunology ; *SARS-CoV-2/genetics/immunology ; Public Health ; }, abstract = {BACKGROUND: SARS-CoV-2 continues to diversify under the selective pressure of population immunity, with recombination increasingly contributing to the emergence of new lineages. The recombinant lineage XFG (“Stratus”), detected in early 2025, has attracted attention because it combines genetic features from distinct Omicron descendants and has expanded across multiple regions.SARS-CoV-2 continues to diversify under the selective pressure of population immunity, with recombination increasingly contributing to the emergence of new lineages. The recombinant lineage XFG (“Stratus”), detected in early 2025, has attracted attention because it combines genetic features from distinct Omicron descendants and has expanded across multiple regions. OBJECTIVE: To synthesize the current virological, immunological, epidemiological, and clinical evidence on XFG, and to contextualize its public-health significance through comparison with the closely related Omicron-derived lineages JN.1 and NB.1.8.1.… APPROACH: This narrative review integrates available molecular and immune data with surveillance observations and emerging clinical reports, translating technical findings into implications that are relevant for healthcare systems and the people they serve. KEY FINDINGS: Across available datasets, XFG shows modest immune escape and a moderate growth advantage, yet there is no signal of increased clinical severity compared with recent Omicron sublineages. Current evidence supports the continued effectiveness of vaccines and antivirals, reinforcing that incremental viral adaptation is compatible with stable clinical outcomes in immunologically experienced populations. CONCLUSIONS: XFG exemplifies ongoing, “quiet” SARS-CoV-2 evolution—more consistent with antigenic fine-tuning than a shift toward greater virulence. For individuals, the practical message remains steady: stay updated with vaccination when eligible and seek timely care when at higher risk. For health systems, sustained genomic surveillance, targeted protection of vulnerable groups, and measured risk communication remain central to resilient coexistence with SARS-CoV-2.}, }
@article {pmid41521058, year = {2026}, author = {Keefer, S and Lorenzo-Leal, AC and Bach, H}, title = {Advancements in nanotrap technology for the prevention, diagnosis and treatment of infectious diseases.}, journal = {Nanomedicine (London, England)}, volume = {21}, number = {3}, pages = {375-385}, pmid = {41521058}, issn = {1748-6963}, mesh = {Humans ; *Communicable Diseases/diagnosis/therapy/drug therapy ; *Nanoparticles/chemistry/therapeutic use ; Animals ; Nanotechnology/methods ; SARS-CoV-2/isolation & purification ; Bacterial Infections/diagnosis/prevention & control ; Nanomedicine/methods ; COVID-19/prevention & control/diagnosis ; Virus Diseases/diagnosis/prevention & control/therapy ; }, abstract = {Nanotraps are particles designed to capture and concentrate target molecules and have numerous applications in infectious diseases. This review outlines how nanotrap technologies may improve the detection and treatment of bacterial and viral pathogens, including Mycobacterium tuberculosis, Borrelia burgdorferi, Yersinia pestis, HIV, SARS-CoV-2, and others. Nanotraps can enhance the sensitivity of diagnostic tools and support treatment by neutralizing bacterial toxins, capturing inflammatory mediators, and preserving viral proteins for detection. Nanotraps have also been investigated for vaccine development. While results from in vitro and in vivo models are encouraging, there is significant room for further research regarding safety and other unexplored applications of these technologies. Nanotraps offer a flexible platform with the potential to improve how we diagnose and manage a multitude of infectious diseases.}, }
@article {pmid41521363, year = {2026}, author = {Singh, D}, title = {mRNA-Encoded antibodies as a next-generation therapeutic paradigm: a rapid and adaptive platform for the prevention and treatment of emerging and re-emerging infectious diseases - A critical review.}, journal = {Immunologic research}, volume = {74}, number = {1}, pages = {7}, pmid = {41521363}, issn = {1559-0755}, mesh = {Humans ; SARS-CoV-2/immunology ; Animals ; COVID-19/immunology/prevention & control ; *Antibodies, Neutralizing/genetics/therapeutic use/immunology ; *Antibodies, Viral/genetics/therapeutic use/immunology ; *Communicable Diseases, Emerging/therapy/prevention & control/immunology ; *RNA, Messenger/genetics/immunology ; Spike Glycoprotein, Coronavirus/immunology ; Nanoparticles ; Pandemics/prevention & control ; *Coronavirus Infections/therapy/prevention & control/immunology ; Betacoronavirus/immunology ; Liposomes ; }, abstract = {Messenger RNA (mRNA)-encoded antibodies represent a transformative therapeutic platform with the potential to rapidly combat emerging infectious diseases by enabling in situ expression of potent neutralizing antibodies directly in the patient's body. Unlike conventional monoclonal antibody (mAb) therapies, which rely on labor-intensive and time-consuming cell culture production, mRNA-encoded antibodies offer a faster, scalable, and cell-free approach that bypasses protein purification and cold-chain constraints. This strategy has demonstrated considerable promise during the COVID-19 pandemic, where Moderna's mRNA-1940, an mRNA-based neutralizing antibody targeting the SARS-CoV-2 spike protein, entered preclinical and early-phase trials within months of viral emergence, underscoring the potential for rapid response in outbreak settings. The platform leverages advances in nucleoside-modified mRNA, codon optimization, and lipid nanoparticle (LNP) delivery systems to achieve transient, high-level expression of functional antibodies with reduced innate immune activation. Beyond COVID-19, mRNA-encoded antibody approaches have been explored in preclinical models of Zika virus, Ebola virus, and rabies, where a single intramuscular dose provided prophylactic and therapeutic benefits in animal models. As the world faces recurrent viral threats, the development of mRNA-encoded antibodies as a plug-and-play system offers a compelling, adaptable, and clinically feasible strategy for infectious disease preparedness. This review explores the mechanistic foundation, delivery technologies, translational progress, case studies, safety considerations, and future clinical potential of mRNA-encoded antibodies in combating both pandemic and endemic infections.}, }
@article {pmid41522108, year = {2025}, author = {Liu, X and Cai, Q and Lin, L and Deng, H and Zeng, R and Shi, J and Huang, L and Liu, H and Li, C and Li, J and Cheng, B and Liu, H and Thiery, JP and Liang, W and He, J}, title = {Novel insights into diagnosis and management of hyperreactivity: a narrative review.}, journal = {Journal of thoracic disease}, volume = {17}, number = {12}, pages = {11429-11453}, pmid = {41522108}, issn = {2072-1439}, abstract = {BACKGROUND AND OBJECTIVE: Hyperreactivity (HR) refers to an exaggerated biological response to a given stimulus that is within the normal physiological range, resulting from a lowered activation threshold of the involved system or effector cells. It commonly occurs after surgery, lung transplantation, and coronavirus disease 2019 (COVID-19) infection but lacks a unified concept and systematic understanding. This review aims to elucidate the concept, mechanisms, and disease spectrum of HR as an independent clinical entity, systematically explore its roles in postoperative conditions, lung transplantation, and COVID-19, and develop a biomarker-based hierarchical management framework, thereby providing a new paradigm for its precise recognition and intervention.
METHODS: We systematically searched the PubMed, Web of Science, Scopus, and China National Knowledge Infrastructure databases for literature published from January 1, 1968, to November 1, 2025, including reviews, randomized controlled trials, and observational studies, human or animal studies related to HR mechanisms or clinical phenotypes, while excluding non-peer-reviewed materials such as case reports and conference abstracts.
KEY CONTENT AND FINDINGS: This study first proposes that HR arises from a four-dimensional imbalance across the nervous, endocrine, immune, and microenvironmental systems, characterized by thoroughness, early onset/persistence, and individual variability. The mechanisms underlying HR in postoperative, transplant-related, and COVID-19 conditions are systematically summarized, and a hierarchical, biomarker-based management framework is developed, highlighting the need for marker validation and trajectory modeling.
CONCLUSIONS: HR represents an independent clinical entity that transcends traditional disease boundaries. This review provides a new paradigm for its precise recognition and intervention and is expected to advance the conceptual and practical development of this field. Future research, clinical practice, and policy formulation should be individualized and mechanism-driven.}, }
@article {pmid41522210, year = {2026}, author = {Zhang, Z and Fang, X and Gao, J and Sun, H and Xu, T and Wang, J}, title = {Efficacy and Safety of Pirfenidone for Mitigation of Interstitial Lung Abnormalities in COVID-19 Patients: A Meta-Analysis.}, journal = {Canadian respiratory journal}, volume = {2026}, number = {}, pages = {8812779}, pmid = {41522210}, issn = {1916-7245}, mesh = {Humans ; *Pyridones/therapeutic use/adverse effects ; *COVID-19/complications ; *Lung Diseases, Interstitial/drug therapy/etiology ; *COVID-19 Drug Treatment ; SARS-CoV-2 ; *Antifibrotic Agents/therapeutic use ; Treatment Outcome ; }, abstract = {BACKGROUND: Although post-COVID-19 interstitial lung abnormalities (ILAs) are common, the use of antifibrotic agents to prevent their onset and progression is controversial. We aimed to investigate the effectiveness and safety of pirfenidone to mitigate the onset and progression of ILAs in patients with severe COVID-19.
METHODS: We systematically searched literature published before July 21, 2025, from PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, China Biology Medicine, Weipu, and Wanfang databases, without language limitation. Randomized controlled trials and cohort studies that evaluated the effect of pirfenidone on COVID-19-induced ILAs were included. Risk of bias was determined using the Revised Cochrane Randomized Trial Risk Bias Tool Version 2 and the Newcastle-Ottawa Scale. The efficacy and safety of pirfenidone for ILAs in COVID-19 were analyzed by Review Manager 5.4 software.
RESULTS: Eight studies were included, comprising 335 patients in pirfenidone treatment groups and 302 controls. Risk of bias ranged from low to moderate. Pirfenidone significantly decreased chest high-resolution CT (HRCT) scores during early- and late-stage COVID-19 and significantly improved forced expiratory volume in 1 s, especially in late-stage COVID-19. Pirfenidone treatment was associated with statistically nonsignificant trends toward improved forced vital capacity and decreased all-cause mortality. Furthermore, HRCT scores, pulmonary function, and inflammatory cytokine levels following pirfenidone treatment were superior to those obtained after glucocorticoid therapy. The incidence of gastrointestinal adverse events was higher in the pirfenidone than the control group, but no serious adverse events or fatalities occurred.
CONCLUSION: Pirfenidone therapy may mitigate ILAs and preserve pulmonary function among survivors of COVID-19 pneumonia. Furthermore, pirfenidone exhibited acceptable safety and tolerability profiles.}, }
@article {pmid41522489, year = {2026}, author = {Ren, Q and Wang, Y and Ma, H and Xie, J and Jin, J and Tian, R and Yu, H and Gao, X and Chen, N}, title = {Recent Advances in Lateral Flow Immunoassay for Rapid Diagnosis of Viral Diseases.}, journal = {Transboundary and emerging diseases}, volume = {2026}, number = {}, pages = {5701806}, pmid = {41522489}, issn = {1865-1682}, mesh = {Animals ; Immunoassay/methods/veterinary ; *Virus Diseases/diagnosis/veterinary/virology ; Humans ; Rapid Diagnostic Tests ; }, abstract = {Viral diseases are a major threat to human and animal health, as illustrated by recent pandemics like COVID-19 and African swine fever (ASF). Timely, accurate detection of viral infections is critical for effective disease control. Among diverse diagnostic techniques, lateral flow immunoassay (LFIA) has become a widely used on-site testing tool, owing to its speed, simplicity, affordability, and portability. The application of LFIA for detecting human and animal viruses is feasible, which highlights its practical utility in veterinary settings. This review summarizes key advances in LFIA for the rapid diagnosis of viral diseases over the past decade, focusing on its technical principles, practical applications, core advantages, existing limitations, and potential effective strategies to provide comprehensive knowledge for virus detection.}, }
@article {pmid41523846, year = {2025}, author = {Fraga, RO and Fraga, ASA and Conte, AAM and Skupien, JA and Schuch, NJ}, title = {Prevalence of burnout among Brazilian Army soldiers during the COVID-19 pandemic: a cross-sectional analysis.}, journal = {Revista brasileira de medicina do trabalho : publicacao oficial da Associacao Nacional de Medicina do Trabalho-ANAMT}, volume = {23}, number = {4}, pages = {e20251467}, pmid = {41523846}, issn = {1679-4435}, abstract = {INTRODUCTION: The COVID-19 pandemic significantly impacted the mental health of frontline workers, including military personnel.
OBJECTIVES: To determine the prevalence of burnout syndrome among Brazilian Army personnel during the pandemic and identify associated predictive variables.
METHODS: A cross-sectional study was conducted with 602 volunteer military personnel in the city of Santa Maria, Brazil. The Maslach Burnout Inventory was used to assess burnout syndrome, defined by high levels of emotional exhaustion, depersonalization, or low personal accomplishment. Logistic regression was performed to identify associated factors.
RESULTS: The prevalence ofburnout syndrome was 48.7%. High levels of emotional exhaustion, depersonalization, and low personal accomplishment were found in 53.8%, 58.4%, and 27.0% of participants, respectively. Emotional exhaustion was more common in those with over 10 years of service (p = 0.001), higher rank (p < 0.001), and age > 40 years (p = 0.008). Low personal accomplishment was associated with lower rank (p = 0.007) and administrative duties (p = 0.032).
CONCLUSIONS: Burnout syndrome was highly prevalent among military personnel in Brazil during the pandemic, with findings similar to those observed in other professional groups.}, }
@article {pmid41524162, year = {2025}, author = {Maleev, VV and Fomin, VV and Manakhov, KM and Volkova, OS}, title = {[Cardio-renal syndrome: perspectives of research in infectious diseases].}, journal = {Terapevticheskii arkhiv}, volume = {97}, number = {11}, pages = {902-907}, doi = {10.26442/00403660.2025.11.203463}, pmid = {41524162}, issn = {0040-3660}, mesh = {Humans ; *Cardio-Renal Syndrome/epidemiology/etiology/therapy/physiopathology/diagnosis ; *COVID-19/complications/epidemiology ; *Hemorrhagic Fever with Renal Syndrome/epidemiology/therapy ; SARS-CoV-2 ; Prognosis ; }, abstract = {Clinical and prognostic significance of cardio-renal syndrome in various infectious diseases are discussed. Incidence and prognosis, as well as pathogenesis of cardio-renal syndrome in patients with infectious diseases, admitted to ICU of infectious hospitals, as well as hemorrhagic fever with renal syndrome and in COVID-19 are reviewed.}, }
@article {pmid41525173, year = {2026}, author = {Umstattd Meyer, MR and Wende, ME and Stroope, J and Kellstedt, DK and Johnson, AM and Gamble, A and Edwards, MB and Beck, AM and Moore, JB and Abshire, DA and Anderson, RE and Aytur, SA and Balis, LE and Davis, K and Gabbert, KD and Gustat, J and John, D and Maruca, DL and King, KA and Needham-Arnold, BD and Orzech, KM and Pickett, AC and Rhoades, RR and Riveron, N and Slater, SJ and Smock, CR and Villwock-Witte, NM and Wilson, K and Baskin, ML and Perry, CK and Abildso, CG}, title = {Rural Active Living: A Call to Action 2.0, 10-Year Review and Recommendations to Advance the Field.}, journal = {Journal of public health management and practice : JPHMP}, volume = {32}, number = {2}, pages = {197-213}, pmid = {41525173}, issn = {1550-5022}, support = {K01 HL171860/HL/NHLBI NIH HHS/United States ; P50 MD017338/MD/NIMHD NIH HHS/United States ; U48 DP006381/DP/NCCDPHP CDC HHS/United States ; }, mesh = {Humans ; *Rural Population/statistics & numerical data/trends ; *Exercise/psychology ; United States ; *Health Promotion/methods/trends ; }, abstract = {CONTEXT OBJECTIVE: Written a decade ago, the 2015 Rural Active Living: A Call to Action (published in 2016) described rural-specific efforts in the fields of active living and physical activity (PA) and identified 8 recommendations to guide rural active living research and practice. Given that rural populations continue to experience a higher burden of PA-related chronic health conditions, the objective of this review was to revisit the 8 Rural Active Living Calls to Action, reassess the evidence base, summarize advances in each area, and identify emerging areas that warrant examination or further study.
METHODS: We leveraged expertise from researchers and practitioners within the CDC-funded Physical Activity Policy Research and Evaluation Network Rural Active Living Workgroup and reviewed literature published since the original call to action. Teams were formed for each of the original 8 calls to action. Each team reviewed the literature, synthesized findings, and developed recommendations for future research.
RESULTS: Academic and practice-based progress was evident across multiple of the original calls to action. Despite these findings, the need persists for rural-specific national surveillance data scaled to small geographies (census tract and block group) that accounts for differences within and across rural communities, various forms of rural governance, and how these factors interplay with active living opportunities. Six emerging areas of research (best practices, social issues, COVID-19 effects, collaboration, implementation science, and implications of rural health-related funding changes) are discussed and warrant further study.
CONCLUSIONS: In summarizing progress since the original Call to Action, we recommend strategies to continue advancing rural active living and identify emerging focus areas.}, }
@article {pmid41525859, year = {2026}, author = {Kumar, P and Ahir, P and Sharma, S and Thakur, V and Verma, P and Kumar, I and Bharti, V and Kumar, S}, title = {Exploring molecular interactions of drugs in different biologically active solvents: A comprehensive review for safe and efficient drug delivery systems.}, journal = {International journal of biological macromolecules}, volume = {340}, number = {Pt 2}, pages = {150197}, doi = {10.1016/j.ijbiomac.2026.150197}, pmid = {41525859}, issn = {1879-0003}, mesh = {*Solvents/chemistry ; Humans ; *Drug Delivery Systems/methods ; COVID-19 Drug Treatment ; Solubility ; SARS-CoV-2 ; Antiviral Agents/chemistry ; COVID-19 ; Pharmaceutical Preparations/chemistry ; }, abstract = {In this review, the interactions between drugs and biologically active solvents have been extensively investigated due to their importance in optimizing pharmaceutical formulation performance for effective therapeutic efficacy and safe drug delivery. These interactions determine the molecular stability, reactivity and solubility of drugs in different biocompatible solvents. The knowledge about their absorption, distribution, metabolism, transport and bioavailability can be enhanced from their molecular interactions data. There have been reports of improved solubility and stability of drugs like metformin hydrochloride and hydralazine hydrochloride in aqueous solutions of carbohydrates and amino acids, which has an immediate effect on their bioavailability and treatment efficacy. Moreover, the COVID-19 pandemic has reestablished the importance of this review, as some drugs were clinically approved after proving their activity and efficacy during this phase. The antivirals favipiravir, remdesivir and two repurposed drugs, antimalarial hydroxychloroquine and metabolic inhibitor 2-deoxy-d-glucose (2-DG) were approved during this phase based on their available physicochemical data. These results established the clinical efficacy and dependency of drugs on their solvation environment, highlighting the pharmacological importance of studying molecular interactions in addition to their theoretical significance. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) model was adopted to conduct this systematic review, covering scientific articles from 2000 to 2025 to ensure a careful evaluation of recent advancements. This review focuses on the molecular interactions of various drugs with different biological solvent systems, using physicochemical, spectroscopic, and computational methods. It critically examines drug-solvent interactions by specifying quantitative physicochemical (free energy changes), spectral (binding constant) and computational metrics (binding affinity). This integrated approach provides a novel molecular-level insight into the structural, solvation, and interaction behavior of drugs under physiological conditions. The integration of molecular dynamics, artificial intelligence/machine learning tools, and experimental validation represents a prospective approach for addressing current limitations, contributing to the development of precision in drug delivery strategies for personalized medications. This review could be substantial for biochemical and medicinal sectors with important implications in formulation, stability, bioavailability, and solubility of drugs in clinical pharmacology. The outcome may provide an important basis for advanced research in future, serving the scientific community in understanding pharmacokinetics and pharmacodynamics of drug interactions. This can further strengthen the advanced research in future, involving drug-solvent interactions, which ultimately improves the safety, treatment efficacy and delivery performance of the drugs.}, }
@article {pmid41526978, year = {2026}, author = {Munteanu, V and Saldana, MA and Dreifuss, D and Ouyang, WO and Ferdous, J and Mohebbi, F and Roseberry, JS and Ciorba, D and Bostan, V and Gordeev, V and Drabcinski, N and Su, JM and Kasianchuk, N and Sharma, NK and Knyazev, S and Aßmann, E and Lobiuc, A and Covasa, M and Crandall, KA and Wu, NC and Mason, CE and Tierney, BT and Lucaci, AG and Ophoff, RA and Gibas, C and Rzymski, P and Skums, P and Solo-Gabriele, H and Niko, B and Zelikovsky, A and Hölzer, M and Smith, A and Mangul, S}, title = {SARS-CoV-2 wastewater genomic surveillance: approaches, challenges, and opportunities.}, journal = {Genome biology}, volume = {27}, number = {1}, pages = {1}, pmid = {41526978}, issn = {1474-760X}, mesh = {Humans ; *SARS-CoV-2/genetics ; *Wastewater/virology ; *Genome, Viral ; *COVID-19/virology ; *Genomics/methods ; Computational Biology ; }, abstract = {Wastewater-based genomic surveillance (WWGS) has proven effective for monitoring SARS-CoV-2 and other viruses within communities. It enables rapid detection of known and emerging mutations and provides insights into circulating lineages. Despite its advantages, WWGS faces challenges in sample processing and computational analysis, particularly in distinguishing similar lineages and identifying novel ones. Recent methods for wastewater sequencing (WWS) analysis remain largely untested amid declining clinical surveillance and ongoing viral evolution. This review examines opportunities and limitations of WWGS, focusing on sample preparation, sequencing technologies, and bioinformatics approaches, and highlights its potential to strengthen public health monitoring systems.}, }
@article {pmid41527398, year = {2026}, author = {Glock, M and Erdekian, A and Rueb, M and Uhl, F and Husemann, R and Stoffers-Winterling, J and Lindner, S and Tüscher, O and Hölzel, LP and Lieb, K and Adorjan, K and Wiegand, HF}, title = {Utilization of mental health services during the first year of the COVID-19 pandemic - a systematic review and meta-analysis.}, journal = {European psychiatry : the journal of the Association of European Psychiatrists}, volume = {69}, number = {1}, pages = {e10}, pmid = {41527398}, issn = {1778-3585}, support = {01KX2021//Bundesministerium für Bildung und Forschung/ ; 01KX2121//Bundesministerium für Bildung und Forschung/ ; }, mesh = {Humans ; *COVID-19/psychology ; Emergency Service, Hospital/statistics & numerical data ; *Mental Disorders/therapy ; *Mental Health Services/statistics & numerical data ; *Patient Acceptance of Health Care/statistics & numerical data ; SARS-CoV-2 ; Telemedicine/statistics & numerical data ; }, abstract = {BACKGROUND: The COVID-19 pandemic presented significant challenges to infectious disease management and mental health services (MHS). Service demand and delivery changed due to fear of infection, economic hardships, and the psychological effects of protective measures. This systematic review with meta-analysis aims to quantify these impacts on different mental health service settings.
METHODS: Comprehensive searches were conducted in PubMed, Embase, and PsycINFO, focusing on studies published from the initial outbreak of COVID-19, starting in November 2019. Studies were included comparing the utilization of mental health inpatient, emergency department (ED), and outpatient services (including telemedicine and medication prescriptions) before and during the COVID-19 pandemic. A random-effects model was employed to estimate pooled effects, with study quality assessed using a modified Newcastle-Ottawa Scale.
RESULTS: Among 128 studies, significant decreases in utilization were observed during the initial phase of the pandemic for inpatient services (RR: 0.75, 95% CI: 0.67 to 0.85) and ED visits (RR: 0.87, 95% CI: 0.69 to 1.10). Outpatient services showed a similar decline (RR: 0.78, 95% CI: 0.66 to 0.92), while no significant change was found in psychotropic medication prescriptions (RR: 0.90, CI: 0.77 to 1.05). In contrast, telemedicine utilization increased significantly (RR: 7.57, 95% CI: 3.63 to 15.77).
CONCLUSIONS: The findings reveal substantial shifts in mental health service utilization during the pandemic, with the largest reductions in inpatient services and significant increases in telemedicine use. These results emphasize the need for flexible healthcare models. Further research is essential to evaluate the consequences of reduced MHS utilization.}, }
@article {pmid41527944, year = {2026}, author = {Wang, QH and Ye, JJ and Chen, ZY and Zhang, CC and Liao, XY and Zheng, L and Chen, K and Tu, X and Liu, LR and Wei, Q and Bao, YG}, title = {Current risk factors for male infertility and semen parameters: an umbrella review of systematic reviews and meta-analyses.}, journal = {Asian journal of andrology}, volume = {28}, number = {3}, pages = {284-296}, pmid = {41527944}, issn = {1745-7262}, mesh = {Humans ; Male ; *Infertility, Male/etiology/epidemiology ; Meta-Analysis as Topic ; Risk Factors ; Semen Analysis ; Sperm Count ; Sperm Motility ; Systematic Reviews as Topic ; }, abstract = {Male infertility poses a substantial healthcare challenge and severely impacts the lives of patients. We aimed to investigate the risk factors for infertility and abnormal semen parameters. We conducted a comprehensive search of the articles published in Web of Science, MEDLINE, and Embase databases from January 2000 to February 2025. Infertility, semen volume, sperm concentration, sperm count, sperm morphology, sperm motility, and sperm progressive motility were used as endpoints to evaluate the relevance of risk factors. A total of 43 studies were included, covering 67 risk factors associated with infertility and abnormal sperm parameters. A total of 249 effect sizes were scored individually using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool, of which 136 (54.6%) were classified as "very low", 59 (23.7%) as "low", and 54 (21.7%) as "moderate". Suffering from type 1 diabetes, metabolic syndrome, hyperthyroidism, systemic lupus erythematosus, chronic prostatitis, and leukocytospermia may increase the risk of abnormal semen parameters. Poor lifestyle habits (obesity, sleep disorders, and smoking), exposure to pollutants and various compounds (carbon disulfide, organophosphates, and lead), the use of medications (sulfasalazine, mesalazine, and selective serotonin reuptake inhibitors), and even some viral infections (severe acute respiratory syndrome coronavirus 2, human papillomavirus, and hepatitis viruses) were associated with decreased semen quality. Regular physical exercise, nut consumption, and adherence to a healthy dietary pattern may reverse this process. An increasing number of factors are associated with infertility; however, some of the aforementioned studies lack verification of causal relationships. Future studies need to be well designed to further confirm these relationships.}, }
@article {pmid41528042, year = {2026}, author = {Ye, J and Xu, T and Xu, C and Liu, X and Chen, Y}, title = {Fluorescence Resonance Energy Transfer Assay at the Crossroad: Urgent Reexamination of Assay Design for Severe Acute Respiratory Syndrome Coronavirus 2 Main Protease Inhibitors.}, journal = {Journal of medical virology}, volume = {98}, number = {1}, pages = {e70801}, doi = {10.1002/jmv.70801}, pmid = {41528042}, issn = {1096-9071}, support = {2024AH051890//University Natural Science Research Project of Anhui Province, China/ ; 2022yjsds052//Outstanding Young Graduate Supervisors Program of Anhui Province, China/ ; }, mesh = {Humans ; *Antiviral Agents/pharmacology ; Coronavirus 3C Proteases/antagonists & inhibitors ; COVID-19 ; *COVID-19 Drug Treatment ; *Fluorescence Resonance Energy Transfer/methods ; High-Throughput Screening Assays/methods ; *Protease Inhibitors/pharmacology ; *SARS-CoV-2/drug effects/enzymology ; }, abstract = {The main protease (Mpro) from coronaviruses represents an attractive therapeutic target for antiviral development. The fluorescence resonance energy transfer (FRET) assay is widely used for high-throughput screening (HTS) of Mpro inhibitors, but there has been a significant increase in false positives stemming from flawed assay design in previous studies. Here, we provide an overview of the FRET assay, discuss the key points of this method design, and highlight the corresponding solutions. We hope that this issue should receive increased attention from researchers.}, }
@article {pmid41529879, year = {2026}, author = {Lotfi, M and Kaderali, L}, title = {Data-driven strategies for model-informed decision-making during the COVID-19 pandemic: a systematic review.}, journal = {BMJ open}, volume = {16}, number = {1}, pages = {e107660}, pmid = {41529879}, issn = {2044-6055}, mesh = {Humans ; *COVID-19/prevention & control/epidemiology ; *Decision Making ; SARS-CoV-2 ; *Pandemics/prevention & control ; }, abstract = {OBJECTIVES: To systematically review data-driven modelling studies that evaluated the effectiveness of interventions implemented during the COVID-19 pandemic and to identify which measures were most frequently reported as effective in controlling disease spread.
DESIGN: Systematic review of modelling studies focused on data-driven, model-informed decision-making for COVID-19 interventions.
DATA SOURCES: A comprehensive literature search was conducted in PubMed, Web of Science and Embase, covering publications from 1 January 2020 to 16 October 2024.
ELIGIBILITY CRITERIA: Studies were included if they: (1) used real-world data; (2) had sufficient sample sizes and (3) assessed at least one intervention with measurable outcomes.Meta-analyses and purely theoretical modelling studies were excluded. Papers were further filtered using a structured screening process to ensure empirical and intervention-based modelling.
DATA EXTRACTION AND SYNTHESIS: Data were extracted from eligible studies and categorised according to modelling approaches, data sources, intervention types and reported effectiveness. Descriptive synthesis was performed to summarise modelling trends and intervention performance. Studies were classified into major intervention categories, including tracing, testing and isolation (TTI); physical and social distancing (PSD); vaccination; lockdowns; mask-wearing; home office or stay-at-home (HOSH) and health infrastructure enhancement (HIE).
RESULTS: Out of 2297 studies identified, 126 met inclusion criteria. Compartmental models were the most frequently used approach, primarily relying on case and death counts to assess intervention impact. The most commonly reported effective interventions were TTI, PSD, vaccination, lockdowns, mask-wearing and HOSH. When considering effectiveness relative to study frequency, the top six interventions were TTI, HOSH, mask-wearing, HIE, PSD and lockdowns. The relatively lower representation of vaccination reflects that most included studies were conducted during the early stages of the pandemic, before widespread vaccine rollout and availability of empirical vaccination data.
CONCLUSIONS: This review highlights the critical role of data-driven models in guiding COVID-19 response strategies. Evidence supports the combined effectiveness of non-pharmaceutical interventions, robust testing and tracing systems and health infrastructure strengthening. Real-world impact, however, remains dependent on local healthcare capacity, socioeconomic conditions and cultural contexts. Continued research is essential to refine adaptive modelling approaches and strengthen preparedness for future public health emergencies.}, }
@article {pmid41530799, year = {2026}, author = {Zhang, Y and Dong, Z and Zheng, F and Zhu, H}, title = {Crossed cerebellar diaschisis in a COVID-19 patient with hemiconvulsion-hemiplegia syndrome: a case report and literature review.}, journal = {Italian journal of pediatrics}, volume = {52}, number = {1}, pages = {8}, pmid = {41530799}, issn = {1824-7288}, support = {Y202148132//Scientific Research Fund of the Zhejiang Provincial Education Department/ ; Y20220270//Science and Technology Plan Project of Wenzhou Municipality/ ; }, mesh = {Humans ; Male ; *COVID-19/complications ; Infant ; *Hemiplegia/diagnosis/etiology/complications ; *Cerebellar Diseases/diagnosis/diagnostic imaging/etiology ; Fatal Outcome ; Magnetic Resonance Imaging ; *Coronavirus Infections/complications/diagnosis ; SARS-CoV-2 ; *Systemic Inflammatory Response Syndrome/complications ; *Pneumonia, Viral/complications/diagnosis ; Pandemics ; *Betacoronavirus ; }, abstract = {BACKGROUND: Crossed cerebellar diaschisis (CCD) is rare in patients with hemiconvulsion-hemiplegia syndrome (HHS). This report presents a novel and instructive case of CCD combined with HHS in a 7-month-old infant with coronavirus disease 2019 (COVID-19) and multisystem inflammatory syndrome in children (MIS-C). MAIN BODY: A previously healthy 7-month-old male infant presented with high-grade fever, frequent left-sided seizures, and subsequent left-sided paralysis. Diagnosed with COVID-19 and MIS-C, he exhibited critical hyperinflammation and multi-organ dysfunction. Brain magnetic resonance imaging (MRI) was pivotal, revealing unilateral cytotoxic edema in the right cerebral hemisphere and restricted diffusion in the contralateral cerebellum, confirming the diagnoses of HHS and CCD. Despite management with anticonvulsants and immunomodulation, his condition deteriorated rapidly, leading to death within 45 h. The pathophysiology is proposed to center on the MIS-C-triggered cytokine storm, which likely creates a substrate for excitotoxic injury and diaschisis. CONCLUSION: This case represents, to our knowledge, the first documented fatal instance of CCD associated with HHS in a pediatric patient with acute COVID-19 and MIS-C. It underscores the potential for severe neurological complications in this population and broadens the recognized spectrum of neurovascular injuries linked to COVID-19. The early detection of CCD in such settings may serve as a critical radiological marker for a high-risk disease course.}, }
@article {pmid41532066, year = {2026}, author = {Feng, X and Wang, Y and Li, Y and Long, J and Liu, F and Yang, H}, title = {Application of the humanized mouse model in research into SARS-CoV-2 infection (Review).}, journal = {Medicine international}, volume = {6}, number = {1}, pages = {9}, pmid = {41532066}, issn = {2754-1304}, abstract = {The coronavirus disease 2019 (COVID-19) pandemic triggered by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had a profound impact on global public health. The complexity of its pathogenic mechanisms and host interactions urgently requires high-fidelity animal models to support research. Humanized mouse models break the species barrier through gene editing and immune reconstitution technologies, providing a key tool to simulate human infection characteristics and pathological processes. A number of studies have reported the application of humanized mouse models in the fields of COVID-19 research, such as SARS-CoV-2 pathogenesis, anti-SARS-CoV-2 drug discovery and vaccine development, etc. The present review aimed to systematically document the latest advances in the application of humanized mouse models based on different construction strategies, such as receptor humanization, immune system humanization and composite humanization. These models have not only elucidated the pathogenicity differences and immune escape mechanisms of SARS-CoV-2 variants, but have also validated the efficacy of broad-spectrum anti-SARS-CoV-2 strategies, including angiotensin-converting enzyme 2-targeted therapies, antibody cocktail regimens and mucosal vaccines. Additionally, humanized mouse models have played a pivotal role in investigating the mechanisms underlying long COVID. By revealing the multi-system pathogenic mechanisms of pulmonary fibrosis, neurodegeneration and intestinal microbiota dysregulation, these models provide a theoretical foundation for the development of targeted intervention strategies.}, }
@article {pmid41532626, year = {2025}, author = {Pechanova, O and Paulis, L}, title = {Nitric Oxide at the Nexus of ACE2 Biology and COVID-19: Implications for Cardiovascular and Neurodegenerative Comorbidities.}, journal = {Physiological research}, volume = {74}, number = {Suppl 2}, pages = {S171-S184}, pmid = {41532626}, issn = {1802-9973}, mesh = {Humans ; *Nitric Oxide/metabolism ; *COVID-19/metabolism/epidemiology/virology ; *Angiotensin-Converting Enzyme 2/metabolism ; *Cardiovascular Diseases/metabolism/epidemiology ; *Neurodegenerative Diseases/metabolism/epidemiology ; Animals ; *SARS-CoV-2 ; Renin-Angiotensin System ; Comorbidity ; }, abstract = {SARS-CoV-2 engages ACE2 for cell entry, perturbing the counter-regulatory ACE2/Ang-(1-7)/Mas axis and shifting the renin angiotensin system toward ACE/Ang II/AT1 signaling, with a concomitant reduction in nitric oxide (NO) bioavailability. NO sits at the crossroads of these pathways, acting both as an antiviral modulator of spike-ACE2 interactions and as a downstream mediator of Mas-dependent endothelial protection. This review summarizes evidence on NO across three layers: (i) viral entry (S nitrosylation of spike/ACE2, protease modulation), (ii) cardiovascular comorbidities (hypertension, obesity, diabetes) where ACE2 downregulation impairs endothelial NO synthase (eNOS)-dependent NO production and promotes thrombosis and microvascular dysfunction, and (iii) neurovascular/ neurodegenerative sequelae, in which renin-angiotensin-aldosterone system (RAAS) dysregulation along with imbalance between protective eNOS/nNOS and inflammatory iNOS fosters blood-brain barrier disruption, microthrombosis, and cognitive impairment. Shared mechanisms - endotheliitis, microvascular dysfunction, and neuroinflammation may explain convergent risks for cardiac injury and cognitive decline in long COVID-19. Putative therapeutic strategies may include restoring physiological NO (via Mas agonism, Ang-(1-7), inhibition of Ang 1-7 degradation and recombinant ACE2), pulmonary-selective inhaled NO, hybrid S nitrosylated agents, and selective attenuation of iNOS/peroxynitrite alongside endothelial support. Targeted modulation - enhancing eNOS/nNOS while constraining iNOS offers a unified framework to mitigate both cardiovascular and neurodegenerative consequences of COVID-19.}, }
@article {pmid41533521, year = {2026}, author = {Zhang, Y}, title = {Comparative analysis of point-of-care diagnostic techniques for respiratory infectious diseases. Lessons we learned from the COVID-19 pandemic and future consideration on more competent alternatives.}, journal = {Pathogens and global health}, volume = {120}, number = {3}, pages = {160-177}, pmid = {41533521}, issn = {2047-7732}, mesh = {Humans ; *COVID-19/diagnosis ; SARS-CoV-2/isolation & purification ; *Point-of-Care Systems ; Rapid Diagnostic Tests ; Surface Plasmon Resonance/methods ; Pandemics ; *Point-of-Care Testing ; COVID-19 Testing/methods ; }, abstract = {Our unpreparedness in responding to the prompt emergence of COVID-19 in its early stage of outbreak, especially the lack of rapid and early diagnostic techniques for mass screening which should have been prioritized, contributed to the virus' spread alongside other factors. This article provides an overview of the common diagnostic techniques with special focus on the reported and/or authorized point-of-care methods for early COVID-19 diagnosis, including lateral flow assays and localized surface plasmon resonance-based approaches. The inherent limitations of these techniques are critically examined. We then propose a potentially more competent alternative, i.e. direct detection of viral particles with aptamer-conjugated gold nanoparticles in liquid solution in combination with noninvasive breath sampling or saliva sampling, for further improvement in early diagnostic capability for infectious respiratory diseases like COVID-19. In addition, an integration of air sampling with in-situ direct colorimetric detection of viral particles could represent a potential option for airborne virus detection, thus minimizing the transmission of infectious diseases and their impact on the economy and life in the future.}, }
@article {pmid41534044, year = {2026}, author = {Lampert, R and Harmon, KG}, title = {Sudden Cardiac Arrest in Athletes.}, journal = {The New England journal of medicine}, volume = {394}, number = {3}, pages = {268-280}, doi = {10.1056/NEJMra2312555}, pmid = {41534044}, issn = {1533-4406}, mesh = {Humans ; *Athletes/statistics & numerical data ; COVID-19/complications/diagnosis/epidemiology ; *Death, Sudden, Cardiac/prevention & control/etiology/epidemiology ; Incidence ; Mass Screening/standards ; Primary Prevention/methods/standards ; Return to Sport ; Risk Factors ; Sports/standards ; Cardiomyopathies/complications/diagnosis/mortality/therapy ; Arrhythmias, Cardiac/complications/diagnosis/mortality/therapy ; Coronary Vessel Anomalies/complications/diagnosis/mortality/therapy ; Practice Guidelines as Topic ; }, abstract = {The incidence of sudden cardiac arrest in athletes varies according to age, race and ethnic group, sex, sport, and social determinants of health. The common causes of sudden cardiac arrest include cardiomyopathies, electrical disorders, coronary-artery anomalies, and other cardiac structural abnormalities. There has not been an increase in the incidence of sudden cardiac arrest in athletes during the time frame of the coronavirus disease 2019 (Covid-19) pandemic. Primary prevention is based on cardiovascular screening before participation, and secondary prevention on implementation of emergency action plans. Diagnostic evaluation of athletes who survive sudden cardiac arrest should mirror that of age-matched nonathletes, with additional sport-specific considerations, and should be performed by medical professionals with expertise in the interpretation of test results in the context of athletic adaptation. An increasing body of evidence indicates that many athletes can return to play after disease-specific treatment, without an increase in risk, and professional societies now consider return to participation in sports to be reasonable or appropriate through shared decision making for numerous cardiac conditions.}, }
@article {pmid41535509, year = {2026}, author = {da Silva Ebone, R and Doleski, PH and Jantsch, MH and da Silveira, RP and Leal, DBR}, title = {P2Y14 receptor activation and neutrophil signaling: linking inflammation to systemic pathophysiology.}, journal = {Purinergic signalling}, volume = {22}, number = {1}, pages = {5}, pmid = {41535509}, issn = {1573-9546}, support = {88887.902884/2023-00//Coordenação de Aperfeiçoamento de Pessoal de Nível Superior/ ; 409156/2024-8//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; }, mesh = {Humans ; *Neutrophils/metabolism/immunology ; *Inflammation/metabolism/immunology/physiopathology ; *Signal Transduction/physiology ; *Receptors, Purinergic P2/metabolism ; Animals ; }, abstract = {Neutrophils are essential effector cells of the innate immune system, acting as the first line of defense against infection and tissue injury. Among the purinergic receptors expressed in these cells, P2Y14 has gained increasing attention in recent years for its role in modulating neutrophil recruitment and activation in inflammatory contexts. This receptor is activated mainly by uridine diphosphoglucose (UDP-glucose) and other UDP-sugars released during cellular stress or damage. Through the activation of G protein-coupled pathways, particularly via Gi/o and RhoA signaling, P2Y14 influences key neutrophil functions, including chemotaxis, cytoskeletal rearrangements, and oxidative responses. Despite its pro-inflammatory potential, and the increasing amount of literature data in recent years, P2Y14's complete physiological and pathological roles remain underexplored. Literature data also highlight its involvement in diseases like glioblastoma and COVID-19, where, due to increased neutrophil infiltration, it exacerbates inflammation, tissue damage, and stress. Therefore, targeting P2Y14 may be a promising strategy to modulate neutrophil chemotaxis and mitigate unwanted harmful inflammatory responses. This review discusses the characteristics and signaling mechanisms of P2Y14 in neutrophils, as well as the relevant implications of this pathway for neutrophil function.}, }
@article {pmid41536535, year = {2025}, author = {García, CF and Cantero-García, M and Dorta-Afonso, D and Rueda-Extremera, M}, title = {Factors associated with suicidal ideation in healthcare personnel: a systematic review.}, journal = {Frontiers in psychology}, volume = {16}, number = {}, pages = {1717231}, pmid = {41536535}, issn = {1664-1078}, abstract = {AIM: This paper investigates suicidal ideation among healthcare professionals, a growing concern that affects their mental well-being and the quality of healthcare delivery. The study aims to identify key risk factors, such as work-related stress, exposure to death, and lack of institutional support, that contribute to suicidal ideation in this population. It also explores protective factors, including resilience, social support, and institutional resources, that may mitigate these risks.
METHOD: A systematic review was conducted on studies published between 2020 and 2024. The literature search spanned databases such as PubMed, Scopus, Web of Science, PsycINFO, Dialnet, and Scielo. The review followed the PRISMA guidelines to ensure thoroughness and transparency in study selection. To assess the quality of the included studies, standardized tools like the Newcastle-Ottawa Scale were applied.
RESULTS: The review identified that the COVID-19 pandemic has intensified factors leading to suicidal ideation among healthcare professionals, with a notable increase in prevalence during this period. Identified risk factors included high levels of occupational stress, frequent exposure to death and suffering, and insufficient institutional support. Conversely, protective factors like resilience, social support, and access to institutional resources were found to reduce susceptibility to suicidal ideation.
CONCLUSION: The findings highlight an urgent need for comprehensive prevention strategies and support programs targeting healthcare personnel. Recommendations for interventions span individual, organizational, and public policy levels. Enhancing resilience and providing institutional support could be crucial steps in reducing the incidence of suicidal ideation in this vulnerable group, ultimately improving both their mental health and the quality of healthcare services.}, }
@article {pmid41538482, year = {2026}, author = {Silva, JH and Brito, ALA and Taiar, R and Moraes, BA and Xavier, AB and Leite, WS and Araújo, MDGR and Brandão, DC and Andrade, AFD and Campos, SL}, title = {Effect of non-invasive ventilation and high-flow nasal cannula on hospital mortality in COVID-19-induced acute respiratory failure: a meta-analysis.}, journal = {Einstein (Sao Paulo, Brazil)}, volume = {24}, number = {}, pages = {eRW0695}, pmid = {41538482}, issn = {2317-6385}, mesh = {Humans ; *COVID-19/mortality/complications/therapy ; *Noninvasive Ventilation/methods/mortality ; *Oxygen Inhalation Therapy/methods ; *Hospital Mortality ; *Respiratory Insufficiency/therapy/mortality/virology/etiology ; Cannula ; SARS-CoV-2 ; Intubation, Intratracheal/statistics & numerical data ; Adult ; }, abstract = {BACKGROUND: Non-invasive respiratory support strategies, such as high-flow nasal cannula therapy and non-invasive ventilation, were widely employed during the coronavirus disease 2019 (COVID-19) pandemic, yet their comparative effectiveness remains uncertain.
OBJECTIVE: To compare the effects of high-flow nasal cannula therapy, non-invasive ventilation, and conventional oxygen therapy on intubation rates and hospital mortality in adults with COVID-19-related acute respiratory failure.
METHODS: A systematic review and meta-analysis was conducted following PRISMA and Cochrane guidelines, with searches performed in nine databases for publications up to May 2023. Eligible studies were those on adults (≥18 years) with confirmed severe acute respiratory syndrome coronavirus 2 infection and that included intubation and mortality as primary outcomes. Risk of bias was assessed using the National Institutes of Health Quality Assessment Tool for Observational Cohorts and the Cochrane Risk of Bias tool. Pooled results were reported as odds ratios (ORs) with 95% confidence intervals (95%CIs).
RESULTS: Forty-one studies were included in the review and ten in the meta-analysis (2,843 patients). High-flow nasal cannula therapy did not differ from non-invasive ventilation in terms of the intubation rate (OR=1.07, 95%CI=0.89-1.29, p=0.45) but was superior to oxygen therapy (OR=0.79, 95%CI=0.64-0.97, p=0.02). High-flow nasal cannula therapy was also associated with lower mortality than non-invasive ventilation (OR=0.62, 95%CI=0.51-0.76, p<0.0001) but did not differ from oxygen therapy (OR=1.06, 95%CI=0.84-1.33, p=0.64). Substantial heterogeneity was observed in the subgroup analyses (I2=64%-90%).
INTERPRETATION: High-flow nasal cannula therapy may reduce the need for intubation compared with oxygen therapy and may lower the hospital mortality rate compared with non-invasive ventilation. However, heterogeneity in the studies suggests that patient-specific factors and disease severity may influence outcomes.
CONCLUSION: High-flow nasal cannula therapy shows potential benefits over oxygen therapy and non-invasive ventilation for COVID-19-related acute respiratory failure, particularly in the mortality rate. Clinical use of these therapies should be context-specific, given the need for cautious interpretation of our results and for further high-quality trials.
ID CRD 42020226936.}, }
@article {pmid41539672, year = {2026}, author = {Rickard, NS and Kurt, P and Meade, T}, title = {Navigating the Digital Landscape for Potential Use of Mental Health Apps in Clinical Practice: Scoping Review.}, journal = {JMIR mental health}, volume = {13}, number = {}, pages = {e75640}, pmid = {41539672}, issn = {2368-7959}, mesh = {Humans ; *Attitude of Health Personnel ; COVID-19 ; Mental Disorders/therapy ; *Mental Health Services ; *Mobile Applications ; Smartphone ; Telemedicine ; }, abstract = {BACKGROUND: The global demand for mental health services has significantly increased over the past decade, exacerbated by the COVID-19 pandemic. Digital resources, particularly smartphone apps, offer a flexible and scalable means of addressing the research-to-practice gap in mental health care. Clinicians play a crucial role in integrating these apps into mental health care, although practitioner-guided digital interventions have traditionally been considered more effective than stand-alone apps.
OBJECTIVE: This scoping review explored mental health practitioners' views on potential use or integration of smartphone apps into clinical practice. We asked, "What is known about how mental health practitioners view the integration of smartphone apps into their practice?" Further, this scoping review explored the factors that might influence integration of smartphone apps into practice, such as practitioner and client characteristics, app design and functionality, and practitioner views.
METHODS: We conducted a systematic search of 3 databases that yielded 38 studies published between 2018 and 2025, involving 1894 participants across various mental health disciplines, most predominantly psychologists and psychiatrists. Data were collected on practitioner and client characteristics, app functionality, and factors deemed important or influencing practitioners' opinions about app integration.
RESULTS: The included studies were most likely to explore use of apps outside the clinical session and focused on self-management apps for mental health monitoring and tracking, and for collecting data from the patient. Fewer studies explored use of apps within-session, or practitioner-guided apps. Practitioners prioritized app features aligned with the American Psychological Association's evaluation criteria, with practitioners prioritizing engagement and interoperability, but also noted the importance of training and resourcing to support integration.
CONCLUSIONS: While practitioners recognize the potential of apps in mental health care, integration into clinical practice remains limited. This study highlights the need for further research on practical implementation, clinical effectiveness, and practitioner training to facilitate the transition from potential to actual use of apps in mental health care settings. Recommendations include evaluating effectiveness of app integration through experimental studies and developing training modules to develop practitioners' digital competencies and confidence in app use.}, }
@article {pmid41539985, year = {2026}, author = {Mija, C and Sberna, G and Maggi, F}, title = {Microplastics and Nanoplastics as Carriers for Viral Transmission: Effects on Viral Properties, Infection, Immune Response, and Public Health.}, journal = {Reviews in medical virology}, volume = {36}, number = {1}, pages = {e70106}, pmid = {41539985}, issn = {1099-1654}, support = {Ricerca Corrente-Linea 1//Ministero della Salute/ ; }, mesh = {Humans ; *Microplastics/adverse effects ; Public Health ; *COVID-19/transmission/virology/immunology ; Animals ; *Virus Diseases/transmission/virology ; SARS-CoV-2 ; *Plastics/adverse effects ; }, abstract = {The extensive use of plastics since the industrial revolution has raised significant environmental and health concerns. Despite their advantages in terms of durability, affordability, and ease of production, the accumulation of plastics has resulted in considerable pollution. The SARS-CoV-2 pandemic further exacerbated plastic consumption, particularly in medical supplies, intensifying the plastic waste crisis. The majority of plastics are not recycled and eventually degrade into microplastics (MPs) and nanoplastics (NPs), which pose substantial risks to ecosystems and human health. MPs and NPs enter the body through inhalation, ingestion, or skin contact and have been found in biological samples such as blood, faeces, and lung fluids. Their presence has been linked to diseases affecting the lungs, cardiovascular system, and intestines, as well as cancer and viral infections. This review highlights how MPs and NPs contribute to the spread of infectious diseases by creating a habitat called the "plastisphere," which promotes microbial growth and serves as a reservoir for pathogens, emphasising their effects on viral persistence, infection dynamics, and immune modulation. Unlike previous reviews mainly focused on toxicological or microbiological aspects, this work integrates environmental, virological, and immunological evidence to outline how MPs/NPs may reshape virus-host interactions. By identifying critical knowledge gaps, such as the quantitative impact of MPs/NPs on viral stability and immune disruption, this review provides a background for future experimental and epidemiological research. This value-added perspective not only advances scientific understanding but also supports policy development in waste management.}, }
@article {pmid41540524, year = {2025}, author = {Bhattacharya, S and Easmin, N and Panja, A and Nayak, A and Sur, D}, title = {mRNA-Based Cancer Vaccines: A Review of the Current Scenario and Future Prospects.}, journal = {Protein and peptide letters}, volume = {32}, number = {11}, pages = {776-790}, doi = {10.2174/0109298665402963251022054441}, pmid = {41540524}, issn = {1875-5305}, mesh = {Humans ; *Cancer Vaccines/immunology/therapeutic use/genetics ; *Neoplasms/therapy/immunology ; Antigens, Neoplasm/immunology/genetics ; Nanoparticles/chemistry ; *RNA, Messenger/immunology/genetics/therapeutic use ; Animals ; Immunotherapy/methods ; mRNA Vaccines/immunology ; Nanovaccines ; COVID-19/prevention & control/immunology ; SARS-CoV-2/immunology ; Liposomes ; }, abstract = {Messenger RNA (mRNA) has gained increasing attention as a valuable tool to cure various human diseases, particularly malignant tumors. Such growing interest has been triggered largely by the phenomenal clinical success of mRNA vaccines developed using lipid nanoparticle (LNP) technology against COVID-19. mRNA may be used to produce cancer immunotherapies in numerous different ways, including cancer vaccines to induce or enhance immunity to tumor-specific antigens (TSAs) or tumor-associated antigens (TAAs). mRNA can also be used to adoptively transfer T-cells for the expression of antigen receptors, such as chimeric antigen receptors (CARs), therapeutic antibodies, and immunomodulatory proteins to re-engineer the tumor microenvironment. However, the therapeutic potential of mRNA-based cancer immunotherapy is not fully utilized due to a few limitations, such as mRNA instability, production of immunogenicity, and a lack of efficient in-vivo delivery methods. This review provides an overview of the current advancements and future directions of mRNA-based cancer therapies, including various delivery routes and therapeutic platforms. It addresses the mechanistic basis of mRNA cancer vaccines, non-replicating and self-amplifying mRNA, as well as their clinical development, personalized vaccines, and applications of mRNA for encoding antigen receptors, antibodies, and immunomodulatory proteins. Moreover, the review addresses nanoparticle-based platforms, such as lipid nanoparticles (LNPs), polymeric nanoparticles, and peptide-based nanoparticles, all used to improve the therapeutic effectiveness of mRNA-based drugs by improving their targeted delivery to tissues. This review aims to provide insights into the use of state-of-the-art mRNA-based cancer immunotherapy.}, }
@article {pmid41540891, year = {2026}, author = {Chen, IC and Chen, YH and Phanumartwiwath, A}, title = {Community-Based Care Interventions for Frail Older Adults: A Scoping Review of Multidimensional Strategies Across Pandemic Eras.}, journal = {Public health nursing (Boston, Mass.)}, volume = {43}, number = {2}, pages = {511-520}, doi = {10.1111/phn.70071}, pmid = {41540891}, issn = {1525-1446}, mesh = {Humans ; *Frail Elderly ; COVID-19 ; *Pandemics ; Aged ; *Community Health Services/organization & administration ; Quality of Life ; SARS-CoV-2 ; Telemedicine ; Aged, 80 and over ; *Geriatric Nursing ; }, abstract = {OBJECTIVE: This scoping review evaluates the effectiveness of community-based interventions addressing frailty's multidimensional impacts (physical, nutritional, and psychosocial) in older adults, emphasizing nurses' roles in crisis-responsive care during pandemics.
DESIGN: A scoping review was conducted using Arksey & O'Malley's framework and PRISMA-ScR guidelines.
SAMPLE: Thirty-one studies were from 2019 to 2023, sourced from PubMed and Scopus, spanning five continents.
MEASUREMENTS: Study quality was assessed with the Newcastle-Ottawa Scale; outcomes included frailty reduction and quality-of-life metrics.
INTERVENTION: Interventions included physical rehabilitation (e.g., Otago Exercise Program), nutritional optimization, psychosocial support, technology-enhanced models (e.g., telemedicine), and social engagement.
RESULTS: Multicomponent interventions outperformed single-domain approaches, improving gait speed, reducing frailty progression, and mitigating depression. Telemedicine maintained 78% care continuity during lockdowns. Asian family-centered models excelled, but 84% of evidence came from high-income countries, highlighting low- and middle-income country (LMIC) gaps.
CONCLUSIONS: Gerontological nurses are pivotal in delivering culturally adapted care by coordinating interprofessional home-based teams, integrating gerotechnology in resource-limited settings, and advocating for policy reforms to bridge urban-rural disparities. These findings underscore nursing's role in equitable, resilient frailty management.}, }
@article {pmid41541110, year = {2023}, author = {Layug, EJV and Apor, ADAO and Kuhn, RV and Tan, MA}, title = {Mechanisms of pediatric ischemic strokes in COVID-19: a systematic review.}, journal = {Frontiers in stroke}, volume = {2}, number = {}, pages = {1197714}, pmid = {41541110}, issn = {2813-3056}, abstract = {BACKGROUND: Coronavirus disease 2019 (COVID-19) has been shown to cause vasculopathic and hemostatic derangements predisposing to cerebrovascular and thrombotic disorders in adults. Data in children, however, are limited to case reports and series. Given the unique risk factors and potential pathomechanisms in children, it is imperative to characterize stroke in children with COVID-19. Understanding these mechanisms is essential in drafting an appropriate management protocol to improve outcomes in a population where stroke carries higher disability-adjusted life years.
METHODS: A systematic literature search was done in MEDLINE, EMBASE, Web of Science and Google Scholar using the terms "pediatric ischemic stroke," "cerebral sinovenous thrombosis," "SARS-CoV-2," and "COVID-19." Patient demographics, clinical profile, stroke risk factors, neuroimaging findings, interventions and outcomes were recorded.
RESULTS: The search produced 776 records. After preliminary review of titles, abstracts and selected full texts, 52 articles comprising of 74 patients were studied. The cohort has slight female predominance (51.5%), with mean age of 9.2 years (±2SD 5.6). Pediatric ischemic strokes were categorized as arterial ischemic strokes (82.40%), cerebral sinovenous thrombosis (12.20%) and combined arterial and venous strokes (5.41%). Mechanisms of ischemic stroke included thrombophilia (47.3%), vasculopathies (27%) and cardioembolism (6.8%). Twenty cases (27%) had comorbidities predisposing to stroke and only 18.9% met the criteria for multisystem inflammatory syndrome in children (MIS-C). Outcomes ranged from complete recoveries (13/58), residual deficits (35/58), and mortalities (10/58).
CONCLUSION: This study presents a comprehensive summary of the currently available published literature on pediatric ischemic strokes in the background of COVID-19. The clinical profiles and outcomes of patients reviewed support prior hypotheses that the virus can cause both a vasculopathy and induce a derangement in the coagulation system, predisposing to ischemic strokes.
STUDY REGISTRATION: This paper's protocol has been registered in PROSPERO with ID number CRD42022315219.}, }
@article {pmid41542888, year = {2026}, author = {Tzigkounakis, G and Brown, J}, title = {From ancient remedy to modern COVID-19 adjunct: a narrative review of mechanistic, in vitro, and clinical evidence on propolis.}, journal = {Journal of complementary & integrative medicine}, volume = {23}, number = {2}, pages = {240-252}, pmid = {41542888}, issn = {1553-3840}, mesh = {*Propolis/therapeutic use/pharmacology ; Humans ; *COVID-19 Drug Treatment ; *Antiviral Agents/therapeutic use/pharmacology ; *SARS-CoV-2/drug effects ; Anti-Inflammatory Agents/therapeutic use/pharmacology ; Animals ; COVID-19 ; }, abstract = {INTRODUCTION: Despite the global rollout of COVID-19 vaccines, limited access, vaccine hesitancy, and the emergence of viral variants continue to underscore the need for complementary antiviral strategies. Propolis, a resinous bee product widely used in traditional medicine, has attracted scientific interest due to its reported antiviral, anti-inflammatory, immunomodulatory, and antioxidant properties.
CONTENT: This narrative review examines the therapeutic potential of propolis as a candidate adjunctive treatment for COVID-19, focusing on mechanistic, in vitro, and clinical evidence. A comprehensive review was conducted using PubMed, Scopus, and Europe PMC (January 2020 to May 2025), covering molecular docking reports, in vitro assays, and human clinical studies evaluating propolis or its key constituents against SARS-CoV-2. In silico reports describe interactions of more than forty propolis constituents with key host and viral targets, providing mechanistic context. In vitro evidence demonstrates inhibition at entry and replication targets alongside attenuation of inflammatory signaling. Limited clinical data, spanning seven studies and two case reports, suggest milder symptoms and shorter hospital stays, with no serious adverse events observed.
SUMMARY AND OUTLOOK: Preclinical and early clinical evidence suggest propolis may be a useful adjunct in COVID-19 therapy. Large, placebo-controlled trials with well characterized and standardized extracts are needed to confirm efficacy and safety.}, }
@article {pmid41543095, year = {2026}, author = {Cho, HE and Lee, JJ and Cho, SY}, title = {Serum Calprotectin - What is the Scope of Clinical Application?.}, journal = {Clinical laboratory}, volume = {72}, number = {1}, pages = {}, doi = {10.7754/Clin.Lab.2025.250516}, pmid = {41543095}, issn = {1433-6510}, mesh = {Humans ; *Leukocyte L1 Antigen Complex/blood ; Biomarkers/blood ; *Inflammation/blood/diagnosis ; COVID-19/blood/diagnosis ; Prognosis ; Arthritis, Rheumatoid/blood/diagnosis ; Inflammatory Bowel Diseases/blood/diagnosis ; SARS-CoV-2 ; Severity of Illness Index ; }, abstract = {BACKGROUND: Calprotectin (CLP), a heterodimer of S100A8 and S100A9, is a calcium-binding protein with key intracellular and extracellular roles, especially in inflammatory processes. Predominantly expressed by neutrophils and monocytes, CLP is released in response to infection or inflammation and serves as a potent antimicrobial and pro-inflammatory mediator.
METHODS: We performed a systematic search of electronic databases to identify studies evaluating serum CLP in inflammatory diseases.
RESULTS: Serum CLP levels are elevated in numerous inflammatory conditions, making it a valuable biomarker for disease activity, prognosis, and therapeutic monitoring. In rheumatoid arthritis (RA), CLP reflects disease severity more accurately than conventional markers like CRP and ESR, correlates with radiographic progression, and is strongly expressed at inflammation sites. In juvenile idiopathic arthritis (JIA), serum CLP levels are significantly higher in active, treatment-naïve patients and correlate well with clinical activity. In spondyloarthritis (SpA), especially ankylosing spondylitis, CLP levels tend to be elevated, though results vary among studies. In inflammatory bowel disease (IBD), CLP is proposed as a non-invasive marker for disease burden and response to treatment. It is especially useful in systemic inflammation assessment. Elevated CLP levels are also observed in psoriasis, Behçet's disease, ANCA-associated vasculitis, and preeclampsia. CLP has emerged as a promising prognostic marker in bacterial infection and coronavirus disease 2019 (COVID-19), with higher levels correlating with ICU admission and disease severity.
CONCLUSIONS: Serum CLP is a promising inflammatory biomarker, though disease specificity remains limited.}, }
@article {pmid41543642, year = {2026}, author = {Blandi, L and Del Riccio, M}, title = {From breath to brain: influenza vaccination as a pragmatic strategy for dementia prevention.}, journal = {Aging clinical and experimental research}, volume = {38}, number = {1}, pages = {72}, pmid = {41543642}, issn = {1720-8319}, mesh = {Humans ; *Dementia/prevention & control ; *Influenza Vaccines ; *Influenza, Human/prevention & control/complications ; *Vaccination ; }, abstract = {Aging populations require scalable strategies to delay or prevent dementia. Beyond the prevention of neurological injury associated with seasonal influenza, vaccination may help mitigate vascular and neuroinflammatory injury underlying cognitive impairment. Influenza infection can cause a marked short‑term increase in myocardial infarction risk, and acute infections have also been associated with transient increases in stroke risk. Experimental models show prolonged microglial activation and synaptic loss even from non-neurotropic strains - processes likely modulated by vaccination. Epidemiologic data consistently support this evidence; a 2023 meta-analysis, including observational studies, of ~ 2.09 million adults identified a 31% lower risk of incident dementia; US matched cohorts demonstrated 40% lower risk of Alzheimer's disease (absolute decrease 3.4%); Veterans Health data showed a 0.86 hazard ratio for dementia; and UK Biobank data showed lower risk for all-cause (0.83 h), and vascular dementia (0.58 h) with a dose-response association by vaccination term. Randomized trials suggest fewer adverse cardiovascular events in vaccine recipients giving even more biological plausibility to this concept. Despite that, prevention through influenza vaccination is not fully realized in older adults due to low levels of perceived risk, vaccine confidence, and variations in clinical practice guidance. This public health perspective reviews the physiopathological and epidemiological evidence in support of influenza vaccination as a pragmatic, dementia risk-modifying intervention within healthy aging strategies and encourages the inclusion of vaccination status in hospital discharge and chronic-care pathways, integration of cognitive outcomes in monitoring, and equity-centered research to eliminate barriers to behavioral and implementation.}, }
@article {pmid41543809, year = {2026}, author = {Bozkir, C and Kartal, T and Hokelek, B}, title = {Obesity and Nutritional Vulnerability in long COVID: A Neuroinflammatory and Cognitive Perspective.}, journal = {Current nutrition reports}, volume = {15}, number = {1}, pages = {5}, pmid = {41543809}, issn = {2161-3311}, mesh = {Humans ; *Obesity/complications/physiopathology ; *COVID-19/complications/physiopathology ; *Neuroinflammatory Diseases/etiology ; Post-Acute COVID-19 Syndrome ; *Nutritional Status ; *Cognition Disorders/etiology ; *Cognition ; SARS-CoV-2 ; *Malnutrition/complications ; Inflammation ; }, abstract = {PURPOSE OF REVIEW: To examine the interplay between obesity, nutritional vulnerability, and long COVID, with a particular focus on neuroinflammatory and cognitive outcomes. This review synthesizes emerging evidence on shared pathophysiological pathways and evaluates the therapeutic potential of dietary and weight management strategies.
RECENT FINDINGS: Cognitive symptoms such as brain fog and memory deficits are among the most persistent and disabling features of long COVID. Obesity is associated with more severe manifestations through pathways involving chronic systemic inflammation, compromised blood-brain barrier integrity, and neuroimmune dysregulation. Concurrently, malnutrition and poor diet quality including low intake of antioxidants, omega-3 fatty acids, and micronutrients may impair neuroplasticity and delay recovery. Interventions such as Mediterranean and ketogenic dietary patterns, as well as structured weight loss programs, show promise in reducing inflammation and improving cognitive outcomes. Obesity and suboptimal nutritional status amplify the neurocognitive burden of long COVID through shared pathophysiological mechanisms. Integrated care models that incorporate metabolic screening, nutritional assessment, and individualized dietary interventions may improve recovery trajectories. Public health strategies that address food quality, obesity prevention, and equitable access to nutrition care are essential for long-term resilience in the post-COVID era.}, }
@article {pmid41544597, year = {2026}, author = {Nasrin, N and Hasan Mumu, A and Hasan Pranto, A and Islam, MR}, title = {The emergence of JN.1 variant resurgent COVID-19 wave in India and South Asia is a global public health concern.}, journal = {Journal of infection and public health}, volume = {19}, number = {3}, pages = {103146}, doi = {10.1016/j.jiph.2026.103146}, pmid = {41544597}, issn = {1876-035X}, mesh = {Humans ; *SARS-CoV-2/genetics/pathogenicity/immunology ; *COVID-19/epidemiology/transmission/virology/immunology/prevention & control ; India/epidemiology ; Public Health ; Asia, Southern/epidemiology ; Mutation ; Immune Evasion ; Spike Glycoprotein, Coronavirus/genetics ; Global Health ; Antiviral Agents/therapeutic use ; }, abstract = {The emergence of the JN.1 variant of SARS-CoV-2 has heightened global health concerns. Here, we aimed to evaluate viral characteristics, epidemiology, transmissibility, infectivity, immune evasion, effectiveness of current antiviral therapies, immunization options, genomic surveillance and public awareness against the stealthy JN.1. We searched across key databases to identify recent insights regarding JN.1 variant. This review provides a comprehensive overview of the virological characteristics and public health implications. Early genomic analyses reveal notable mutations in the spike protein, which may enhance viral transmissibility and immune escape. The findings indicate JN.1 to exhibit greater infectivity and enhanced ability to circumvent immune defenses attributable to one mutation identified as L455S. Public health agencies worldwide are enhancing monitoring, genomic surveillance, data sharing, revising containment strategies, promoting booster vaccination campaigns Furthermore, it is imperative to promote public adherence and global collaboration in encouraging the practice of preventive strategies to mitigate potential threat posed by JN.1.}, }
@article {pmid41544794, year = {2026}, author = {Shen, H and Cheng, D and Liu, L and Li, M and Zhou, Y and Bai, D and Huangyang, P and Feng, H}, title = {RNAi therapy targeting coronavirus genomes, pulmonary delivery strategies and design principles: A review.}, journal = {International journal of biological macromolecules}, volume = {341}, number = {Pt 2}, pages = {150223}, doi = {10.1016/j.ijbiomac.2026.150223}, pmid = {41544794}, issn = {1879-0003}, mesh = {Humans ; *RNA, Small Interfering/genetics/administration & dosage/therapeutic use ; *RNA Interference ; *Genome, Viral ; SARS-CoV-2/genetics ; COVID-19/therapy ; *RNAi Therapeutics/methods ; Animals ; *Betacoronavirus/genetics ; *Coronavirus Infections/therapy/virology ; Virus Replication/genetics/drug effects ; Lung/virology/metabolism ; *Coronavirus/genetics ; }, abstract = {With the persistent global outbreak of Coronavirus Disease 2019 (COVID-19), the development of effective antiviral strategies has become a top priority in public health. RNA interference (RNAi), an effective gene-silencing technique, presents a novel therapeutic approach to combat coronavirus replication. RNA interference (RNAi) is a potent gene-silencing approach that offers a therapeutic route to suppress coronavirus replication. Clinical translation of small interfering RNA (siRNA), however, faces substantial obstacles, notably cross-strain universality, off-target effects, and targeted delivery. This review summarizes recent advances in RNAi-mediated inhibition of coronaviruses at the genomic level, emphasizing RNAi applications to impede SARS-CoV-2 replication and transmission. By evaluating RNAi strategies aimed at specific viral components-RNA-dependent RNA polymerase (RdRp), spike protein (S), envelope protein (E), membrane protein (M), nucleocapsid protein (N), and other essential genes-we illustrate the distinct specificity and efficacy of RNAi across binding sites and identify candidate universal targets for human-transmitted coronaviruses. We also assess the strengths and limitations of delivery platforms, including liposomes, polymers, nanoparticles, and viral vectors. Finally, we highlight inhalation-based and other targeted delivery approaches as promising routes for siRNA therapeutics against COVID-19 and other pulmonary diseases. Advances in gene editing and nanotechnology continue to broaden the prospects for effective siRNA delivery.}, }
@article {pmid41545629, year = {2026}, author = {Heidler, P and Dam, L and King, I and Hamza, N and Abdeljawad, MM and Alaraby, D and Fahlevi, M and Anjum, T and Marzo, RR and Wagner, M and Bhattacharya, S and Chahal, P}, title = {Is anybody out there? Tackling intimate partner violence as a hidden pandemic during COVID times and beyond: factors, impact, and recommendations, a systematic review and meta-analyses.}, journal = {Archives of women's mental health}, volume = {29}, number = {1}, pages = {20}, pmid = {41545629}, issn = {1435-1102}, mesh = {Humans ; *COVID-19/epidemiology/psychology ; *Intimate Partner Violence/psychology/statistics & numerical data/prevention & control ; Female ; SARS-CoV-2 ; Pandemics ; Male ; }, abstract = {PURPOSE: Intimate partner violence is a pervasive issue deeply affecting public health, and its escalation during the COVID-19 pandemic has raised serious concerns. While the escalating impact of intimate partner violence during the COVID-19 pandemic has been widely acknowledged, there remains a need for a comprehensive systematic review that synthesizes existing literature. This review seeks to address this gap by providing an inclusive assessment of the global landscape of intimate partner violence during and after the pandemic, thereby informing more effective prevention and intervention strategies.
METHODS: A systematic literature search was conducted on PubMed, Google Scholar, and Scopus databases using different MeSH terms. A total of 445 relevant articles were identified initially, and after thorough screening, 54 articles were included in the review.
RESULTS: The lockdown had several negative consequences, including job losses, economic vulnerability, and health issues due to prolonged loneliness and uncertainty. An increase in emergency hotline or Women's Helpline calls was observed. Globally, intimate partner violence surged during the lockdown and persisted into 2023, causing severe and lasting health, psychological, and reproductive consequences for victims. Our results showed that COVID-19 increased the risk of partner violence: post-COVID intimate partner violence risk greater than pre-COVID risk (0.33 vs. 0.28, respectively).
CONCLUSION: Although COVID-19 increased the risk of intimate partner violence, this review also stresses a high global prevalence of intimate partner violence, not restricted to the pandemic and lockdowns. To prevent partner violence and reduce long-lasting severe health, psychological, and reproductive consequences of partner violence, broad cooperation between governments, communities, health professionals, and the media is necessary.}, }
@article {pmid41547457, year = {2026}, author = {Petakh, P and Halabitska, I and Petrecka, H and Huber, W and Kamyshnyi, O}, title = {Complex interactions between stress, nutrition, gut microbiota, and infectious diseases and their impact on health in global conflicts: A narrative review.}, journal = {The Journal of nutritional biochemistry}, volume = {151}, number = {}, pages = {110267}, doi = {10.1016/j.jnutbio.2026.110267}, pmid = {41547457}, issn = {1873-4847}, mesh = {Humans ; *Gastrointestinal Microbiome ; *Stress, Psychological/microbiology ; *Nutritional Status ; *Communicable Diseases/microbiology ; *COVID-19/epidemiology ; Diet ; SARS-CoV-2 ; Feeding Behavior ; }, abstract = {Following the global recovery from the COVID-19 pandemic, wars and conflicts have escalated to levels unseen since the Cold War. It is well known that conflict is accompanied not only by significant losses among both military personnel and civilians but also by rising levels of stress and stress-related disorders within the general population. Stress is bidirectionally connected with the state of the gut microbiota through the gut-brain axis. Dietary factors and eating behaviours also play crucial roles in shaping gut microbiota composition. On the one hand, conflict negatively affects food availability and dietary patterns, leading to reduced meal frequency and potentially diminishing microbiota diversity. On the other hand, stress-induced alterations in eating behaviour, such as bulimia or anorexia, can further impair gut microbiota composition. Additionally, individuals in conflict zones face heightened risks of infectious diseases due to disrupted vaccination schedules, poor sanitation, and limited access to clean drinking water. Stress-related immune changes may increase susceptibility to infections and raise the likelihood of adverse outcomes. Moreover, the frequent use of antibiotics to treat infections during conflicts contributes to reduced gut microbiota diversity. This review narratively examines the complex interactions among stress, immune responses, dietary patterns, infectious diseases, and gut microbiota in conflict-affected areas, and provides new perspectives on the role of artificial intelligence in modelling such comorbid pathologies.}, }
@article {pmid41548364, year = {2026}, author = {Taba, M and Fajardo, MA and Ferguson, E and Keast, R and Basseal, JM and McCaffery, K and Bonner, C}, title = {Science translation strategies to the public during health emergencies: A systematic review of RCTs.}, journal = {Patient education and counseling}, volume = {145}, number = {}, pages = {109479}, doi = {10.1016/j.pec.2026.109479}, pmid = {41548364}, issn = {1873-5134}, mesh = {Humans ; *COVID-19/psychology/epidemiology ; Randomized Controlled Trials as Topic ; SARS-CoV-2 ; *Translational Science, Biomedical ; *Public Health ; *Emergencies ; Pandemics ; }, abstract = {INTRODUCTION: Effective science translation is essential during public health emergencies. During the COVID-19 pandemic, rapidly evolving research had to be translated to the public under challenging conditions.
OBJECTIVES: This review aimed to identify randomised trials of COVID-19 science translation strategies targeting the public and evaluated their effectiveness in improving psychological, behavioural and/or health outcomes.
METHODS: A literature search was done across PubMed, Embase, Scopus, CINAHL, and PsycINFO in July 2023 and November 2024. Studies were screened and extracted according to PRISMA guidelines. Interventions reporting behavioural outcomes were coded using the Behaviour Change Technique (BCT) taxonomy and the Cochrane risk-of-bias tool was used to assess study quality.
RESULTS: Of 345 records screened, 48 eligible studies were included. Most were online experiments testing message framing, with a smaller number conducted in applied settings such as health professional-delivered education. Significant positive effects were reported in most studies; 30 out of 40 studies with psychological outcomes (e.g. knowledge), 28 out of 40 studies with behavioural outcomes (e.g. intention to mask). Only one study measured a health outcome, with no significant effect. Effective features commonly included video and animation formats and messages from health experts and credible sources. The most frequent BCTs were 'information about health consequences' (33 studies) and 'credible source' (19 studies). Risk of bias was low in 42 studies.
CONCLUSIONS: These findings highlight a diverse range of strategies that improved outcomes during the COVID-19 pandemic. Better use of behavioural science taxonomies and core outcome sets could help researchers advance the field further during future emergencies.
PRACTICE IMPLICATIONS: This review provides insights for a range of stakeholders involved in science translation during emergencies (i.e. scientists and researchers, healthcare providers, health communicators and government officials) and highlights areas requiring further investigation.
PROSPERO REGISTRATION NUMBER: CRD42023446093.}, }
@article {pmid41549659, year = {2026}, author = {Okinaka, K and Schiffer, JT}, title = {Strategies for mitigating severe COVID-19 in patients with haematological malignancy during the omicron era.}, journal = {The Journal of antimicrobial chemotherapy}, volume = {81}, number = {2}, pages = {}, pmid = {41549659}, issn = {1460-2091}, mesh = {Humans ; *Hematologic Neoplasms/complications/immunology ; *COVID-19/prevention & control/complications ; Antiviral Agents/therapeutic use ; SARS-CoV-2 ; Immunocompromised Host ; Pre-Exposure Prophylaxis/methods ; *Pandemics/prevention & control ; Antibodies, Monoclonal/therapeutic use ; Betacoronavirus ; }, abstract = {Despite a decrease in disease severity since the emergence of the severe acute respiratory syndrome coronavirus 2 Omicron variant, coronavirus disease-2019 (COVID-19) continues to pose a significant threat to patients with haematological malignancies (HM). Although repeated booster vaccinations enhance protection against severe illnesses in immunocompromised individuals, they remain at heightened risk of adverse outcomes. This underscores the crucial need for effective pharmacologic strategies to prevent and treat infection. This review examines current strategies for preventing severe COVID-19 in patients with HM, focusing on pre-exposure prophylaxis and early treatment of COVID-19. New monoclonal antibodies have been developed, offering effective pre-exposure prophylaxis. Antiviral agents and monoclonal antibodies demonstrated efficacy in limiting severe COVID-19 outcomes in patients with HM, though some patients, particularly the elderly, remain at risk of critical illness and death. Prolonged infection over months is also common, particularly in patients with lymphoid malignancies. Sustained viral shedding and ongoing mutation may be associated with chronic symptoms and is the likely source of several novel variants of concern that prolonged the pandemic. While HM subtype and advanced age are risk factors for severe or persistent COVID-19, there are no accurate tools for predicting individual risk. Given this uncertainty, prompt medical consultation, timely prescription of antiviral agents, and close monitoring are essential to minimize the risk of adverse outcomes in this vulnerable population.}, }
@article {pmid41550658, year = {2025}, author = {Wang, M and Jia, H and Liu, X and Zhan, P}, title = {Conquering viral drug resistance: Structural and mechanistic paradigms for antiresistance drug design.}, journal = {Pharmaceutical science advances}, volume = {3}, number = {}, pages = {100094}, pmid = {41550658}, issn = {2773-2169}, abstract = {Viral drug resistance remains a critical challenge in antiviral therapy. This perspective highlights five studies on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), human immunodeficiency virus type 1 (HIV-1), monkeypox virus (MPXV), influenza A virus (IAV), and Hepatitis B virus (HBV), revealing novel resistance mechanisms and innovative strategies. For SARS-CoV-2, GC376's flexible benzyl group overcomes nirmatrelvir resistance. HIV-1's non-nucleoside reverse transcriptase inhibitors (NNRTIs) 5i3 adapts to resistant mutants via a quinazoline scaffold, while MPXV's tecovirimat acts as a "molecular glue" stabilizing F13 dimers. Expanding these paradigms, we present groundbreaking insights: An indazole-based IAV inhibitor (compound 24) disrupts the conserved PA-PB1 heterodimer, showing sub-micromolar potency against resistant strains. For HBV, a hydrophobic tagging degrader (HyT-S7) induces HBc degradation, bypassing resistance mutations impairing traditional capsid modulators. Key strategies include dynamic flexibility, multivalent interactions, and oligomerization control, integrated with AI-driven design and real-time surveillance. This perspective bridges structural insights with translational applications, offering a roadmap for next-generation, mutation-resilient antivirals.}, }
@article {pmid41550683, year = {2026}, author = {Piazza, M and Gori, A and Capristo, C and Boner, AL}, title = {Bronchiolitis and recurrent respiratory infections: The role of oxidative stress from early life inflammation to long-term outcomes - A narrative review.}, journal = {The World Allergy Organization journal}, volume = {19}, number = {1}, pages = {101162}, pmid = {41550683}, issn = {1939-4551}, abstract = {Bronchiolitis, primarily caused by respiratory syncytial virus (RSV), is a common respiratory infection in infants and a known precursor to recurrent wheezing and asthma. This review explores the role of oxidative stress and trace element deficiencies in the pathogenesis of bronchiolitis and its long-term sequelae. Infants with reduced lung function due to prematurity or congenital airway anomalies exhibit heightened susceptibility to RSV infection. Growing evidence implicates oxidative stress and deficiencies in zinc, selenium, and magnesium as significant contributors to disease progression. Impaired antioxidant defenses exacerbate viral inflammatory responses, leading to prolonged symptoms and recurrent wheezing with potential developmental delays. Studies consistently demonstrate that children with bronchiolitis exhibit elevated oxidative stress markers and reduced antioxidant capacity, with trace element deficiencies correlating with disease severity. Reduced defenses against oxidative stress may be associated with recurrent wheezing episodes, which are more frequent after rhinovirus bronchiolitis than after RSV bronchiolitis. Thus, RSV and rhinovirus (RV) bronchiolitis may unmask pre-existing vulnerabilities rather than directly causing long-term damage associated with later asthma. Micronutrient supplementation, particularly zinc and selenium, has shown potential in reducing respiratory infection duration and severity. COVID-19 pandemic evidence further supports nutritional status as a key modulator of respiratory disease outcomes, with nutraceuticals like curcumin and flavonoids demonstrating anti-inflammatory benefits. Given the safety and accessibility of micronutrient supplementation, early nutritional assessment and intervention in high-risk infants may offer a cost-effective strategy to improve long-term respiratory outcomes. Bronchiolitis should be viewed as a clinical signal warranting proactive, holistic pediatric care rather than merely an acute illness.}, }
@article {pmid41550947, year = {2025}, author = {Hotchkiss, RS and DiPersio, JF and Yee, C and Pachynski, RK and Van Den Brink, MRM}, title = {IL-7: a potential next-generation adjuvant for immune cell therapies.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1736931}, pmid = {41550947}, issn = {1664-3224}, support = {P30 CA015704/CA/NCI NIH HHS/United States ; P50 CA171963/CA/NCI NIH HHS/United States ; P01 AG052359/AG/NIA NIH HHS/United States ; UM1 CA154967/CA/NCI NIH HHS/United States ; R35 GM126928/GM/NIGMS NIH HHS/United States ; U01 CA154967/CA/NCI NIH HHS/United States ; R35 CA210084/CA/NCI NIH HHS/United States ; }, mesh = {Humans ; *Interleukin-7/therapeutic use/immunology ; Animals ; Immunotherapy, Adoptive/methods ; *Adjuvants, Immunologic/therapeutic use ; *Neoplasms/therapy/immunology ; SARS-CoV-2/immunology ; *Cell- and Tissue-Based Therapy/methods ; }, abstract = {Cell-based immune therapies ranging from CAR-T cells to tumor infiltrating lymphocytes (TILs) and endogenous T-cell products, have produced unprecedented clinical responses in hematologic malignancies and are currently under active investigation for solid tumors. Nevertheless, several key challenges continue to limit the durability and breadth of clinical benefit. IL-7 is a pleiotropic cytokine that increases both the number and function of lymphocytes. Although not yet clinically approved, IL-7 has been used in over 620 adult and pediatric patients for a variety of reasons including, for example, to hasten bone marrow recovery after allogenic stem cell transplantation, to reverse lymphopenia due to HIV and idiopathic etiologies, to treat patients with various malignancies, and to boost vaccine responses. IL-7 is generally well-tolerated and effective in producing a durable increase in the number and function of CD4 and CD8 T cells. Recently, IL-7 has been used clinically in multiple myeloma patients receiving CAR-T cell therapy, in patients with urothelial cancer who are receiving checkpoint inhibitors, in patients undergoing endogenous lymphocyte cell therapy, and in critically-ill lymphopenic patients with COVID-19. The authors, all of whom have used IL-7 clinically, discuss how IL-7 effectively addresses all the major problems currently limiting adoptive cell therapies. Peering into the future, we believe that IL-7 will be a major advance as an adjuvant treatment in many cell therapies and hope that this commentary will expedite IL-7's testing in multiple clinical settings.}, }
@article {pmid41551283, year = {2025}, author = {Agyapong-Opoku, N and Agyapong-Opoku, F and Agyapong, B and Greenshaw, AJ}, title = {Anxiety and depressive symptoms among medical students-A scoping review of systematic reviews and meta-analyses.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1710333}, pmid = {41551283}, issn = {2296-2565}, mesh = {Humans ; *Anxiety/epidemiology ; *Depression/epidemiology ; Meta-Analysis as Topic ; Prevalence ; *Students, Medical/psychology/statistics & numerical data ; Systematic Reviews as Topic ; }, abstract = {BACKGROUND: Medical schools are globally recognized as higher education institutions requiring extreme dedication from students. The intensive nature of physician training demands heavy workloads, inconsistent sleep, and study-leisure imbalances. Such stressors are linked to poor student mental health, with anxiety and depression symptoms among the most documented disorders. These burdens negatively affect academic performance and are associated with dropout intentions, misconduct, burnout, and suicidal ideation.
OBJECTIVE: This scoping review summarizes recent evidence on the prevalence of anxiety and depression symptoms among medical students and identifies correlated factors.
METHODS: The review followed PRISMA guidelines and Arksey and O'Malley's five-stage methodological framework. Searches were conducted on July 5, 2025, in PubMed, MEDLINE, Web of Science, Scopus, and PsycINFO. Boolean operators combined terms related to prevalence, and correlates of depressive and anxiety symptoms, and medical students, limited to systematic reviews and meta-analyses published in English between January 2021 and July 2025. Sixteen studies met the inclusion criteria after screening. Data were charted for study characteristics, prevalence estimates, contributing factors, and methodological approaches.
RESULTS: The studies included in this review reported wide-ranging prevalence estimates, with the prevalence of depression symptoms in the included meta-analysis ranging from lowest of 18.1% to highest of 50.0% and anxiety symptoms from 17 to 54% although there was high heterogeneity in the screening instruments or measurement scales Biological sex differences in prevalence were frequently noted, with most studies reporting a higher prevalence among females; however, findings varied by region. Regional disparities were additionally observed, with some continents and countries reporting significantly higher prevalence rates than others. Factors associated with increased risk included early years of study, poor sleep quality, and academic stress. During COVID-19, most studies reported a higher prevalence of depression and anxiety symptoms than pre-pandemic levels.
CONCLUSIONS: Anxiety and depressive symptoms remain widespread among medical students, driven by individual and contextual factors. Targeted interventions and early preventive strategies are urgently needed to address mental health challenges and protect student wellbeing.}, }
@article {pmid41552096, year = {2025}, author = {Li, X and Liu, Y and Xu, S and Liu, H and Zeng, C and Wang, R and Yue, Y and Wang, X}, title = {Progress in the Application of Pirfenidone in Post-COVID-19 Pulmonary Fibrosis: A Review.}, journal = {Cureus}, volume = {17}, number = {12}, pages = {e99490}, pmid = {41552096}, issn = {2168-8184}, abstract = {Pulmonary fibrosis following infection with the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has emerged as a significant long-term complication among survivors of coronavirus disease 2019 (COVID-19), profoundly affecting their quality of life and clinical outcomes. This review provides a comprehensive overview of the pathophysiological mechanisms underlying post-COVID-19 pulmonary fibrosis and elucidates the pharmacological actions of pirfenidone, a multi-targeted antifibrotic agent in this context. We summarize the current clinical evidence on the efficacy and safety of pirfenidone for managing fibrosis secondary to SARS-CoV-2 infection, drawing on recent advances in basic and clinical research. Furthermore, we discuss existing challenges, unresolved questions, and prospective directions for optimizing antifibrotic therapy in COVID-19 convalescents. By systematically analyzing these aspects, this article aims to offer theoretical support and practical guidance to clinicians and researchers addressing the management of post-COVID-19 pulmonary fibrosis.}, }
@article {pmid41552427, year = {2026}, author = {Wang, H and Patzi-Churqui, M and Andius, LD and Nyström, K and Lagging, M}, title = {Genetic insights into hepatitis E virus through environmental surveillance in Europe.}, journal = {One health (Amsterdam, Netherlands)}, volume = {22}, number = {}, pages = {101302}, pmid = {41552427}, issn = {2352-7714}, abstract = {Zoonotic hepatitis E has been a growing public health concern in Europe, but the transmission of its causative agent, hepatitis E virus (HEV), remains incompletely understood. Environmental surveillance, particularly through wastewater monitoring, has proven valuable for tracking viral circulation and variant shift during the COVID-19 pandemic, yet its application to HEV is still limited. In this review, we systematically analyzed HEV sequences across Europe, focusing on environmental sources from a genetic perspective. Of more than 13,100 HEV sequences deposited in the NCBI database, only 2.4 % (316/13,118) originated from environmental samples, including wastewater, surface water, and biosolids. Additional typing data from the literature revealed highly uneven geographic distribution, with 97 % of environmental sequences reported from Italy, France, the United Kingdom (UK), Spain, Sweden, and Germany. HEV-3 was the dominant genotype, while HEV-1 and HEV-4 were occasionally detected. Subtypes 3c and 3f were most common, but their prevalence varied across countries and sample types. Some countries, such as France, Sweden, and the UK, exhibited divergent subtype patterns between humans, animals, and environmental sources, whereas others, such as Spain and Germany, showed more consistent distributions. These findings highlight the importance of integrating clinical, veterinary, and environmental surveillance to better understand HEV transmission in Europe under a One Health framework. However, the scarcity of environmental data, technical challenges in sequencing, and lack of standardized protocols limit comprehensive assessment of HEV circulation. Expanding sequencing efforts, improving detection methods, and coordinating international surveillance frameworks will be critical to strengthen HEV monitoring and preparedness against emerging HEV threats.}, }
@article {pmid41553427, year = {2026}, author = {Zhu, R and Oh, YJ and Hinterdorfer, P}, title = {Single molecule force spectroscopy for evaluating inhibitors of SARS-CoV-2 variants of concern.}, journal = {European biophysics journal : EBJ}, volume = {}, number = {}, pages = {}, pmid = {41553427}, issn = {1432-1017}, abstract = {The binding between the SARS-CoV-2 Spike protein and its cellular receptor ACE2 is essential for viral entry and infection and, therefore, represents a critical target for antiviral intervention. Single-molecule force spectroscopy (SMFS), conducted using atomic force microscopy (AFM), allows direct investigation of Spike–ACE2 interactions at the single-molecule level, providing insights into binding mechanisms not easily captured by conventional methods. This review discusses recent applications of SMFS to assess molecular inhibitors of Spike–ACE2 interactions, focusing specifically on soluble ACE2 and glycan-binding lectins (Clec4g, hCLEC4G, and engineered H84T-Banlec). These inhibitors demonstrated potent, concentration-dependent activity against multiple SARS-CoV-2 variants, including Delta and Omicron, achieving IC50 values in the low nanomolar range (soluble ACE2: 0.25–0.38 nM; Clec4g/hCLEC4G: 36–58 nM; H84T-Banlec: 2.6–5.2 nM). Notably, single-molecule IC50 measurements closely correlated with EC50 values from cell-based assays, validating the physiological relevance and predictive capability of the SMFS method. Collectively, these findings underscore the utility of AFM-SMFS as a powerful approach for inhibitor evaluation and antiviral discovery, particularly for strategies targeting conserved structural features of the Spike protein to achieve broad-spectrum efficacy against current and emerging viral variants.}, }
@article {pmid41553516, year = {2026}, author = {Herpertz, G and Roesch, F and Abramovich, I and Trinks, A and Ghezel-Ahmadi, V and Nowak-Machen, M and Becke-Jakob, K}, title = {[Work-related fatigue in anesthesia and intensive care medicine : Review article on a structural problem].}, journal = {Die Anaesthesiologie}, volume = {75}, number = {2}, pages = {117-124}, pmid = {41553516}, issn = {2731-6866}, mesh = {Humans ; *Fatigue/epidemiology/prevention & control/psychology/etiology ; *Critical Care ; COVID-19/epidemiology ; Germany/epidemiology ; Work Schedule Tolerance ; *Anesthesiology ; Shift Work Schedule ; *Occupational Diseases/prevention & control ; }, abstract = {Work-related fatigue is a serious psychophysiological phenomenon characterized by exhaustion, impaired concentration, reduced alertness and diminished decision-making capacity. It often results from disrupted sleep patterns and shift work and increases the risk of critical incidents in the clinical practice. Anesthetists are particularly affected as irregular working hours and frequent night shifts disrupt their circadian rhythms. Although fatigue is reversible with appropriate measures, it remains largely unrecognized as a structural issue within the German healthcare system.Over recent decades the working conditions across European healthcare settings have steadily deteriorated, a trend that culminated during the COVID-19 pandemic. This period clearly highlighted the urgent need to prioritize the well-being of healthcare professionals. The aim of this review article is to raise awareness of fatigue and provide insights into effective management strategies. It explores both international concepts and local solutions relevant to the German system.This review and analysis are based on studies and material developed as part of the European "Fatigue Project" and the "Fight Fatigue" campaign. It examines the effects of fatigue across all career stages and identifies practical strategies for risk reduction.The results show that fatigue affects anesthetists at all stages of their careers. Structured fatigue management is therefore a vital component of sustainable healthcare provision. In particular, fatigue risk management systems and optimized shift work planning have proven effective in reducing the burden on personnel and enhancing patient safety.}, }
@article {pmid41554283, year = {2026}, author = {Oskvarek, JJ and Leubitz, A and Rahman, N and Sure, B and Pines, JM}, title = {Emergency department crowding in the modern era: a systematic review (2018-2025).}, journal = {Clinical and experimental emergency medicine}, volume = {13}, number = {2}, pages = {119-139}, pmid = {41554283}, issn = {2383-4625}, abstract = {OBJECTIVE: This study systematically reviews the causes, effects, and potential solutions to emergency department (ED) crowding, with emphasis on challenges amplified by the COVID-19 pandemic.
METHODS: Following PRISMA guidelines, we searched MEDLINE, CINAHL, and the Web of Science for peer reviewed studies published from January 1, 2018, to January 31, 2025, that investigated ED crowding. Studies were included if they evaluated crowding causes, consequences, or interventions, using metrics such as ED length of stay, boarding, or left without being seen. Four reviewers independently screened titles, abstracts, and full texts. Study quality was assessed using the SIGN critical appraisal tools. This review was registered in PROSPERO (No. CRD420251117676).
RESULTS: Of 23,408 studies identified, 226 met inclusion criteria. Most studies were retrospective (83%) and of low (62%) or acceptable (35%) quality. Crowding was primarily driven by input (high patient volumes, limited primary care access), throughput (staffing shortages, laboratory and imaging delays), and output (boarding, late discharges) factors. Adverse effects included increased mortality, treatment delays, prolonged inpatient stays, higher rates of patients leaving without being seen, and reduced patient satisfaction. Effective strategies included provider-in-triage, nurse-initiated orders, and split-flow models. Output-focused interventions, such as active bed management and early discharge protocols, required system-wide coordination. The COVID-19 pandemic shifted patient volumes and led to innovative solutions such as drivethrough clinics and repurposed spaces to alleviate surges.
CONCLUSION: ED crowding is a persistent global issue with significant clinical and operational consequences. While promising interventions exist, high-quality evidence remains limited, underscoring the need for system-level and multifaceted solutions.}, }
@article {pmid41555196, year = {2025}, author = {D'angelo, MA and Nicolai, R and Di Nicolantonio, S and Pietropaoli, D and Monaco, A and Ortu, E}, title = {Comparison of Teledentistry and Traditional Clinical Examination for Detection of DMFT Index in Children: A Systematic Review.}, journal = {Pediatric dentistry}, volume = {47}, number = {6}, pages = {380-387}, pmid = {41555196}, issn = {1942-5473}, mesh = {Humans ; Child ; *DMF Index ; *Dental Caries/diagnosis ; *Telemedicine ; COVID-19/epidemiology ; Reproducibility of Results ; }, abstract = {Purpose: This study systematically analyzed the published literature to evaluate the reliability of the caries experience index detection conducted in children (younger than 18 years of age) through teledental systems, comparing it with data obtained through traditional dental consultations. The question to be explored was whether dentists could use teledentistry to assess the caries risk index by calculating the DMFT (decayed, missing, and filled permanent teeth) score, thereby potentially reducing consultation time. Methods: A systematic English-language literature review was conducted, including the period from 2014 to 2024, that included the MeSH terms (("telemedicine"[Mesh]) AND "dental caries"[Mesh]) AND "DMF index"[Mesh]). Inclusion and exclusion criteria were defined according to the PICO methodology. A total of 11 manuscripts met the inclusion criteria. The methodological quality of these studies was assessed using the Newcastle-Ottawa Scale (NOS) with specific tools for cross-over studies. Results: From the 11 studies reviewed, it was suggested that teledentistry, through the use of intraoral photographs or video recordings, may represent a reliable, noninvasive, and efficient alternative for the detection of the caries experience index, compared to clinical examinations performed according to the traditional method. In most cases, the results were comparable between the two approaches. Conclusion: Incorporating teledentistry in combination with regular dental appointments could streamline clinical processes, enable effective treatment planning, and facilitate remote monitoring of the oral health status of patients, making it a timely and contemporary solution for a connected and health-conscious society-which is particularly valuable during public health crises such as the COVID-19 pandemic.}, }
@article {pmid41555409, year = {2026}, author = {Baseri, S and Izadi, M and Alimohammadi, M and Khoshnazar, SM and Nikdel, R and Hushmandi, K}, title = {Effects of atorvastatin on inflammatory markers, lipid profile, liver enzymes, and pulmonary function in patients with lung diseases: a systematic review and meta-analysis of randomized controlled trials.}, journal = {European journal of medical research}, volume = {31}, number = {1}, pages = {111}, pmid = {41555409}, issn = {2047-783X}, mesh = {Humans ; *Atorvastatin/therapeutic use/pharmacology ; Randomized Controlled Trials as Topic ; Biomarkers/blood ; *Lung Diseases/drug therapy/physiopathology/blood ; Respiratory Function Tests ; *Lipids/blood ; Liver/enzymology/drug effects ; }, abstract = {BACKGROUND: Pulmonary diseases are important causes of morbidity globally. Atorvastatin's pleiotropic effects, which include anti-inflammatory and lipid-lowering properties, may be beneficial for individuals with respiratory diseases. This meta-analysis evaluated the atorvastatin's effect on inflammatory biomarkers, lipid profile, liver enzymes, and pulmonary function in lung disease patients.
METHODS: We systematically searched PubMed/MEDLINE, Scopus, Web of Science, Embase, CENTRAL, and Google Scholar for English-language RCTs until March 2025. The study evaluated inflammatory markers (CRP, IL-6, TNF-α), lipid profile (LDL, HDL, TC, TG), liver enzymes (ALT, AST), pulmonary function tests, and physical performance. Pooled weighted mean differences (WMDs) with 95% confidence intervals were calculated using random-effects models. Subgroup, heterogeneity, and publication bias analyses were conducted.
RESULTS: Seventeen RCTs (22 datasets; n = 1,344) on asthma, COPD, COVID-19, pulmonary hypertension, and associated disorders were analyzed. Atorvastatin substantially decreased TNF-α (WMD: - 0.20 pg/mL; 95% CI - 0.28 to - 0.11), LDL cholesterol (WMD: - 21.48 mg/dL; 95% CI - 30.82 to - 12.14), and TC (WMD: - 15.24 mg/dL; 95% CI - 28.28 to - 2.20), while improving 6MWD (WMD: 0.71; 95% CI 0.24 to 1.17) and FEF25-75 in COPD subgroups. Evening peak expiratory flow (PEF) was considerably lower (WMD: - 8.72; 95% CI - 14.96 to - 2.47), indicating worsening in airway airflow throughout the evening. There were no significant overall effects for CRP, IL-6, triglycerides, HDL, FEV1, FVC, or oxygen saturation.
CONCLUSIONS: Atorvastatin demonstrates anti-inflammatory and lipid-lowering efficacy in pulmonary disease patients, with mild functional respiratory benefits and modest improvements in physical performance. Additional large-scale studies are needed to validate clinical benefits and effective treatment methods.}, }
@article {pmid41558303, year = {2026}, author = {Kalgutkar, AS and Eng, H and Dantonio, AL and Kadar, EP and Di, L and Walker, GS and Boras, B and Obach, RS}, title = {Absorption, distribution, metabolism, and excretion tactics toward the expedited discovery and development of the severe acute respiratory syndrome coronavirus-2 main protease inhibitor nirmatrelvir.}, journal = {Drug metabolism and disposition: the biological fate of chemicals}, volume = {54}, number = {2}, pages = {100226}, doi = {10.1016/j.dmd.2025.100226}, pmid = {41558303}, issn = {1521-009X}, mesh = {Humans ; *Drug Discovery/methods ; *COVID-19 Drug Treatment ; *SARS-CoV-2/drug effects/enzymology ; *Proline/analogs & derivatives/pharmacokinetics ; *Antiviral Agents/pharmacokinetics/administration & dosage ; Animals ; Ritonavir/administration & dosage ; *Coronavirus 3C Proteases/antagonists & inhibitors/metabolism ; Tissue Distribution ; *Protease Inhibitors/pharmacokinetics ; Drug Development/methods ; Pyrrolidinones ; Azabicyclo Compounds ; }, abstract = {The severe acute respiratory syndrome coronavirus-2 main protease inhibitor PF-07321332 (nirmatrelvir), in combination with ritonavir (Paxlovid), has been approved by the US Food and Drug Administration as an oral treatment option for coronavirus disease 2019 patients. In this perspective, we share the expediated absorption, distribution, metabolism, and excretion strategies, which were incorporated as part of discovery efforts, to design orally active severe acute respiratory syndrome coronavirus-2 main protease inhibitors. PF-07321332 (nirmatrelvir) emerged as a potential oral clinical candidate within ∼ 6 months from the time discovery efforts were first initiated. The review also delves into a discussion around the successful use of quantitative fluorine-19 nuclear magnetic resonance spectroscopy in the characterization of the human mass balance and excretion pathways of nirmatrelvir. Human absorption, distribution, metabolism, and excretion data that emerged from the fluorine-19 nuclear magnetic resonance study were used to support the Emergency Use Authorization and new drug application filing, which was accepted by regulatory agencies worldwide. Efficient operational and technical strategies, incorporating the elements of speed without sacrificing data quality, which were crucial to the success of the program, are highlighted. SIGNIFICANCE STATEMENT: This perspective discusses the expedited absorption, distribution, metabolism, and excretion efforts utilized in the discovery and development of the orally active severe acute respiratory syndrome coronavirus-2 main protease inhibitor nirmatrelvir, which in combination with the cytochrome P450 3A inhibitor ritonavir (Paxlovid), is used in the oral treatment of COVID-19. Paxlovid was granted an Emergency Use Authorization by global regulatory agencies in less than 2 years from the initiation of the discovery program and has since been fully approved by the US Food and Drug Administration.}, }
@article {pmid41558692, year = {2026}, author = {Richie, RC}, title = {Evaluating Cardiovascular Disease Risk.}, journal = {Journal of insurance medicine (New York, N.Y.)}, volume = {53}, number = {1}, pages = {90-97}, doi = {10.17849/insm-53-1-1-8.2}, pmid = {41558692}, issn = {0743-6661}, mesh = {Humans ; *Cardiovascular Diseases/epidemiology/mortality ; Risk Assessment/methods ; Heart Disease Risk Factors ; Risk Factors ; COVID-19/epidemiology ; }, abstract = {There was a steady decrease in cardiovascular disease (CVD ischemic heart disease and stroke) mortality from 1960 to 2020, but since then, this decline has reversed. There have been over 228,000 excess CVD deaths through 2022,1 undoubtedly partially due to the COVID-19 pandemic, but the mortality rate continues to rise (arguably due to the rising epidemic of obesity and diabetes). CVD remains the leading cause of death in developed countries, accounting for over 30% of deaths, and risk estimation is a cornerstone approach to guiding CVD prevention in clinical medicine. Data from the CDC reveal that 36% of US adults have no CVD risk factors, 35% have 1, and 29% have 2 or more risk factors. The age-adjusted percentage of adults with 2 or more CVD risk factors has increased between 2013-2014 to August 2021-August 2023, especially in older age groups.2 Assessing the risk for CVD mortality is essential for the disability and life insurance industry required to assess that risk at a single point in time (at the issuance of an insurance policy). Evaluating this risk requires careful attention to modifiable and non-modifiable factors, including hypertension and other co-morbidities, abnormal lipid profiles, and lifestyle inequalities. The goal of this treatise is to evaluate the various CVD calculators, but also to review other risk factors that may not be routinely sought in estimating CVD risk. The importance of apolipoproteinB (apoB) and lipoprotein A (LpA) as better risk predictors than just elevated LDL levels will be emphasized, and evidence of systemic inflammation and insulin resistance will be proposed as essential early indicators of future cardiovascular disease.}, }
@article {pmid41559316, year = {2026}, author = {Shi, Y and Li, B and Zheng, Y and Xue, C and Zhu, J}, title = {Therapeutic effect of anti-neuroinflammatory supplement combined with olfactory training on post-covid olfactory dysfunction: a systematic review and meta-analysis.}, journal = {European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery}, volume = {283}, number = {6}, pages = {3503-3512}, pmid = {41559316}, issn = {1434-4726}, mesh = {Humans ; *Amides/therapeutic use ; Anti-Inflammatory Agents/therapeutic use ; *COVID-19/complications ; Dietary Supplements ; *Ethanolamines/therapeutic use ; *Luteolin/therapeutic use ; *Olfaction Disorders/therapy/etiology ; *Olfactory Training ; *Palmitic Acids/therapeutic use ; }, abstract = {BACKGROUND: There is no established specific treatment for post-COVID olfactory dysfunction (PCOD) currently. Olfactory training (OT) is the only effective intervention supported by clinical evidence. The anti-neuroinflammatory supplement palmitoylethanolamide and luteolin (PEA-LUT) has shown potential in alleviating the symptoms of post-COVID, but its therapeutic effect on olfactory dysfunction and the gain effect when combined with OT remain to be evaluated.
METHODS: We comprehensively searched the online databases EMBASE, PubMed, ScienceDirect, Web of Science, Cochrane Library, Google Scholar, and ClinicalTrials.govfor the literature related to the treatment of PCOD, identified studies reporting the efficacy of PEA-LUT combined with OT, extracted the treatment outcome data, and performed data synthesis.
RESULTS: A total of 7 eligible RCTs published between 2021 and 2024 were included, comprising 525 patients with PCOD. Of the seven studies, five (71.4%) used the full Threshold-Discrimination-Identification (TDI) scoresystem to assess olfactory function, while two (28.6%) used only the Identification ("I") subscale; 332 patients (63.2%) received PEA-LUT + OT therapy and 203 (38.8%) received OT alone. Meta-analysis of these studies showed that patients receiving PEA-LUT combined with OT had significantly higher TDI scores compared to those receiving OT alone (Standard mean difference (SMD) = 0.90; 95% CI: 0.24-1.58; P < 0.01). The overall response rate was also significantly higher in the combination group (Risk difference (RD) = 0.33; 95% CI: 0.01-0.64; P = 0.04).
CONCLUSION: The neuroprotective properties of PEA-LUT appear to enhance recovery from post-COVID olfactory dysfunction. When combined with olfactory training, this treatment shows promising potential as a novel therapeutic approach.}, }
@article {pmid41559432, year = {2026}, author = {Arziman, S and Aydemir, S and Bozok, V}, title = {Decoding miRNA-Mediated Immunoregulation in SARS-CoV-2, HBV, HIV, and HSV Infections.}, journal = {Genes and immunity}, volume = {27}, number = {1}, pages = {1-12}, pmid = {41559432}, issn = {1476-5470}, mesh = {Humans ; *MicroRNAs/genetics/immunology ; Signal Transduction ; *HIV Infections/immunology/genetics ; *COVID-19/immunology/genetics ; SARS-CoV-2/immunology ; *Hepatitis B/immunology/genetics ; *Herpesviridae Infections/immunology/genetics ; Hepatitis B virus/immunology ; }, abstract = {Eukaryotic cells regulate gene expression through multiple checkpoints, including post-transcriptional mechanisms mediated by microRNAs (miRNAs). These small non-coding RNAs inhibit translation by binding to target mRNAs, often within a complex regulatory network involving other RNA species such as circular RNAs and long non-coding RNAs. miRNAs are now recognised as central players in the pathogenesis, immune modulation, and progression of infectious diseases. In this review, we thoroughly examine studies published over the past five years, focusing on miRNAs involved in immune regulation during four major viral infections: severe acute respiratory syndrome coronavirus 2, hepatitis B virus, human immunodeficiency virus, and herpes simplex virus. Our analysis centres on the core signalling pathways most frequently targeted by miRNAs: NF-κB, MAPK, JAK-STAT, TGF-β/Smad, and pattern-recognition receptor-associated cascades. Among the miRNAs most prominently implicated are miR-21, miR-146a, miR-150, and miR-155. These miRNAs modulate key signalling pathways, thereby influencing macrophage polarisation, T- and natural killer cell activity, antigen presentation, and inflammatory cytokine production. In addition, virus-encoded miRNAs and ceRNA or extracellular vesicle-mediated interactions are discussed where mechanistically validated, illustrating virus-specific regulatory layers. Collectively, this integrative synthesis underscores the pivotal roles of miRNAs in orchestrating antiviral immunity and highlights their potential as biomarkers and therapeutic targets in viral infections. A better understanding of miRNA-mediated immunoregulation may pave the way for precision interventions aimed at improving immune control and patient outcomes.}, }
@article {pmid41559622, year = {2026}, author = {Galletta, MAK and Hashimoto, AS and de Almeida Estrambk, G and Verardo, IPS and Cantagalli, MHI and Peres, SV and Francisco, RPV}, title = {Prevalence of postpartum depression in the COVID-19 pandemic and associated factors: systematic review and meta-analysis.}, journal = {BMC pregnancy and childbirth}, volume = {26}, number = {1}, pages = {157}, pmid = {41559622}, issn = {1471-2393}, mesh = {Humans ; *COVID-19/epidemiology/psychology ; Female ; *Depression, Postpartum/epidemiology ; Prevalence ; Risk Factors ; Pregnancy ; SARS-CoV-2 ; Pandemics ; Global Health ; }, abstract = {BACKGROUND: The COVID-19 pandemic created a disruptive scenario with an increase in the prevalence of postpartum depression (PPD) and new associated risk factors, which deserve to be better studied, in different global contexts, which led to the present systematic review study.
METHODS: Observational studies published in English, Portuguese, and Spanish between 2020 and 2025 were included, and a meta-analysis was conducted using a random-effects model.
RESULTS: An initial survey of 1741 articles, of which 90 studies were selected with a total of 64,6994 women evaluated for PPD, with a range between 50 (1) and 5,134 (2) women. The overall prevalence of postpartum depression during the COVID-19 pandemic was 28.48% (25.14-31.94), with rates of 23.52% (18.961-28.40) in studies that used the Edinburgh Postnatal Depression Scale (EPDS) as a diagnostic instrument with a cutoff point ≥ 13. Studies from 31 countries were included, with higher prevalence observed in Latin America (34.08%), with lower rates in Europe (31.50%), the Middle East (29.31%), USA/Canada (24.26%), and Asia (22.32%). There was a higher prevalence of PPD in countries with a lower Human Development Index (HDI) (30.95%), with higher COVID-19 CFR (32.56%), higher maternal mortality (30.43%); and with the highest Gender Inequality Index (GII) (35.41%). PPD rates increased with postpartum time, varying between 18.31% (up to 1 month), 20.78% (up to 3 months), 34.67% (up to 6 months) and 36.55% (up to 12 months). Additionally, 11 protective factors and 53 risk factors were identified, most related to the pandemic, but also with the presence of factors already consolidated in the literature before the pandemic.
DISCUSSION: There was a global increase in the prevalence of PPD during the pandemic, with an intensification of pre-existing regional differences, causing the impact of the pandemic to be different according to the region.
CONCLUSIONS: The social and health crisis of the pandemic negatively impacted postpartum mental health, with significant regional differences.
TRIAL REGISTRATION: The study was registered in PROSPERO with the code CRD42023392973.}, }
@article {pmid41559816, year = {2026}, author = {Ahmad, A and Gundeti, MS and R, M and Wilson, E and Itrat, M and Javed, G and Quamri, MA and Chalia, DS and Yadav, P and P, AT and P, KK and S, AC and S, MH and Dileep, A and P, SS and R, G}, title = {Status of evidence on efficacy and safety of Indian traditional medicine (Ayush) for COVID-19: a qualitative review and evidence map synthesis.}, journal = {Systematic reviews}, volume = {15}, number = {1}, pages = {}, pmid = {41559816}, issn = {2046-4053}, mesh = {Humans ; India ; *COVID-19/therapy/epidemiology ; *Medicine, Ayurvedic ; SARS-CoV-2 ; *COVID-19 Drug Treatment ; }, abstract = {BACKGROUND: The novel coronavirus (COVID-19), caused by SARS-CoV-2, was first reported in Wuhan, China, in December 2019. Its rapid spread, high mutation rate, and challenges in containment led the WHO to declare it a global pandemic on March 11, 2020. Traditional medicine played a supportive role during the COVID-19 pandemic by offering immune-boosting and symptom-relieving remedies, especially in regions with limited access to conventional healthcare. Several countries, including India, have integrated traditional therapies with modern treatment protocols to enhance patient outcomes and reduce disease burden.
OBJECTIVES: This review aims to critically synthesize the existing evidence on the efficacy and safety of Ayush interventions in the management of COVID-19 in India. It seeks to qualitatively analyze published literature and clinical trial data, and to develop an evidence map categorizing interventions by type and associated clinical outcomes.
METHODS: A comprehensive literature search was conducted across seven electronic databases, including the National Repository on R&D Initiatives of the Ministry of Ayush, WHO COVID-19 dashboard for clinical trials, AYUSH Research Portal, PubMed, Cochrane Library, WHO ICTRP, and CTRI. Studies published between 2019 and June 2024 were considered. A total of 3626 records were identified (2572 from indexed databases and 1054 from trial registries). After removing 640 duplicates, 2986 studies were screened for title and abstract. Following exclusion of 802 records, full-text assessment was performed on the remaining studies. After screening, 304 studies were included in the final review (178 Ayurveda, 22 Siddha, 31 Homeopathy, 22 Unani, and 51 Yoga). Risk of bias was assessed using the ROB 2 and ROBINS-I tools. Data extraction and collation were performed in accordance with the PRISMA guidelines. The study protocol was registered in PROSPERO.
RESULTS: A total of 304 studies were included, comprising 58 (19.1%) prophylaxis studies, 151 (49.7%) treatment studies, and 17 (5.6%) post-COVID rehabilitation studies across different Ayush systems. Ayurveda accounted for the largest proportion of publications (n = 178), followed by Yoga (n = 51). Among the randomized controlled trials, approximately half were assessed as having low-to-moderate risk of bias, whereas the remaining studies exhibited high or unclear risk of bias, primarily due to inadequate reporting of randomization procedures, allocation concealment, and blinding. Considerable methodological variability was observed across studies, including differences in intervention type, duration, outcome measures, and quality assessment scores.
CONCLUSION: While there is significant data on Ayush and COVID-19, current studies vary too widely to be definitive. Future research must prioritize rigorous scientific standards if these systems are to be effectively integrated into public health responses.}, }
@article {pmid41560849, year = {2026}, author = {McKeague, S and Seymour, JF}, title = {Triplet regimens for frontline treatment of CLL-Great company or just a crowd?.}, journal = {HemaSphere}, volume = {10}, number = {1}, pages = {e70303}, pmid = {41560849}, issn = {2572-9241}, abstract = {Standard frontline treatment of chronic lymphocytic leukemia (CLL) is with fixed-duration venetoclax-based doublets or indefinite covalent Bruton tyrosine kinase inhibitor (BTKI). Although these approaches achieve excellent results, venetoclax doublets have diminished efficacy in high-risk biological subgroups, and indefinite covalent Bruton tyrosine kinase inhibitor (cBTKI) is associated with cumulative cardiovascular and infectious toxicity. Triplet regimens for treatment of CLL involve simultaneous use of cBTKI, venetoclax, and anti-CD20 monoclonal antibody. Three major frontline Phase 3 trials (CLL-13/GAIA, AMPLIFY, and A041702) have demonstrated higher rates of undetectable minimal residual disease (uMRD) and longer remissions with triplets than doublets, particularly in patients with IGHV-unmutated (IGHV-U) disease. However, this comes at the cost of increased infectious toxicity, particularly with COVID-19, and thus has translated into a variable impact on progression-free survival (PFS) and, to-date, no overall survival (OS) benefit. Although there are promising Phase 2 data for triplets in patients with TP53 aberrant or relapsed disease, the heterogeneity of treatment duration/MRD definition, lack of control arm, and potential increased toxicity make it premature to use triplets in these groups. We recommend considering triplets in treatment naïve CLL patients with IGHV-U, TP53 wild type, anticipated low incidence/good tolerance of Gr ≥ 3 infection (<70 years old, no major comorbidity and fully immunized) who are well informed and prioritize maximal time off therapy at the expense of increased short-term logistical complexity. Future triplet research should focus on randomized trials in specific genomic subgroups, incorporating novel agents (e.g., non-covalent BTKI, BTK degrader, and next-generation BCL2 inhibitors) and new ways of adapting treatment duration to maximize efficacy and minimize toxicity.}, }
@article {pmid41561503, year = {2025}, author = {Bravo-Valenzuela, NJM and Panizzi, TT and de Souza, KA and Stutz, GB and Aurelio, RVM and Rodrigues, MCF and de Almeida, RG and Lemos, FMCF and Araújo, AL and Sztajnbok, FR and Fonseca, AR}, title = {Cardiovascular abnormalities in multisystem inflammatory syndrome in children related to COVID-19.}, journal = {Frontiers in pediatrics}, volume = {13}, number = {}, pages = {1635723}, pmid = {41561503}, issn = {2296-2360}, abstract = {INTRODUCTION: The COVID-19 pandemic began with the identification of SARS-CoV-2 in December 2019. Although children usually have milder acute symptoms, they can develop severe systemic symptoms termed pediatric multisystem inflammatory syndrome (MIS-C). This study reviews research in children and adolescents diagnosed with MIS-C, focusing on cardiovascular abnormalities.
METHODOLOGY: This systematic review was conducted following PRISMA guidelines. The review protocol was prospectively registered in the Prospective Register of Systematic Reviews (PROSPERO; registration number: CDR420251232497). A search strategy was constructed to identify the studies focusing on cardiovascular abnormalities in children and adolescents with MIS-C published in Portuguese and English at PubMed and Scielo from January 2020 to February 2025. The eligibility criteria and data extraction strategy were guided by the PICO framework.
CONCLUSIONS: Myocardial dysfunction and coronary abnormalities are the most frequent cardiovascular features in patients with MIS-C. Strain technology in echocardiography identifies early myocardial dysfunction, with studies showing persistent subclinical injuries. Despite ejection fraction and coronary anomalies returning to normal short to medium term, long-term cardiovascular effects of MIS-C remain uncertain, necessitating ongoing cardiology monitoring.}, }
@article {pmid41561654, year = {2026}, author = {Bakare, IS and Olaiya, VO and Badero, OJ and Okirie, CF}, title = {Neurological Complications Associated With COVID-19 Compared to Other Viral Infections: A Systematic Review of Current Evidence.}, journal = {Cureus}, volume = {18}, number = {1}, pages = {e101817}, pmid = {41561654}, issn = {2168-8184}, abstract = {Neurological complications have become one of the most concerning features of COVID-19, yet clinicians still lack a clear comparison between these findings and what is seen in other viral infections. Understanding where SARS-CoV-2 fits, whether it behaves like influenza and dengue or follows an entirely different pattern, is essential for diagnosis, management, and planning long-term care. We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO: CRD420251064831). Searches across PubMed, Scopus, and Web of Science (2000-2025) identified 24 eligible studies, including observational cohorts, clinical trials, case series, autopsy work, and national surveillance data. Because of the wide variation in study design and reporting, a narrative synthesis was used. Across the 24 studies, COVID-19 exhibited the widest and most severe spectrum of neurological involvement. Reported central nervous system complications included ischemic stroke, encephalopathy or encephalitis, seizures, and extensive microglial and white-matter injury in fatal cases. Peripheral complications were also prominent, such as anosmia, demyelinating neuropathies, Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyneuropathy, functional movement disorders, and persistent abnormalities on nerve conduction testing long after recovery. In contrast, neurological complications from influenza were less frequent and mostly involved encephalitis/encephalopathy, seizures, meningitis, GBS, or myelitis, with generally low mortality. Dengue virus has been associated with a spectrum of direct neurotropic effects and immune-mediated syndromes, including encephalitis, GBS, myelitis, brachial neuritis, and myositis. Most patients recovered, and mortality remained low. Compared with influenza and dengue, COVID-19 stands out for both the breadth and severity of its neurological manifestations, as well as the persistence of symptoms in many survivors. These findings highlight the need for early neurological evaluation in COVID-19, structured follow-up after recovery, and more consistent research methods to allow better comparisons across viral infections.}, }
@article {pmid41561870, year = {2025}, author = {Huang, W and Xing, Y and Zhao, F and Wang, Y}, title = {Mobile apps, AI, and teletherapy: a comprehensive review of digital mental health tools for nurses.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1686766}, pmid = {41561870}, issn = {2296-2565}, mesh = {Humans ; *Mobile Applications ; Mental Health Teletherapy ; COVID-19/epidemiology ; Digital Health ; Burnout, Professional/prevention & control ; Telemedicine ; *Nurses/psychology ; Mental Health ; Depression ; }, abstract = {Chronic understaffing, workplace violence, moral distress, rotating shifts, and administrative burdens have created a global mental health crisis for nurses. Around half to two-thirds of nurses report symptoms of burnout, and large surveys have found high levels of depression and anxiety among nursing staff. The COVID-19 pandemic exacerbated these issues, increasing absenteeism, turnover, and error rates. Barriers to care-such as stigma, cost, and limited access in rural areas-mean that many nurses remain untreated. Digital mental health interventions (DMHIs) offer scalable, flexible, and often anonymous support tailored to nurses' schedules and risks. These include teletherapy platforms, AI-driven chatbots and support systems, mobile mental health apps, and hybrid digital-human models. Recent studies (2020-2025) suggest DMHIs can reduce anxiety, depression, and burnout while improving resilience, job satisfaction, and retention. However, obstacles such as unequal access, variable digital literacy, privacy concerns, and limited long-term evidence slow adoption. This review synthesizes current research on DMHI types and efficacy, and examines factors affecting their accessibility and integration into nursing practice. We also discuss cultural and ethical considerations and strategies for involving nurses in designing these tools. Our analysis identifies gaps and opportunities for developing nurse-centered digital mental health solutions that strengthen the workforce and improve patient care.}, }
@article {pmid41562595, year = {2026}, author = {Kotsias-Konopelska, S and Thielecke, M}, title = {Infections After International Travel: Relevant Diagnoses in Children and Adolescents.}, journal = {Deutsches Arzteblatt international}, volume = {123}, number = {3}, pages = {84-92}, pmid = {41562595}, issn = {1866-0452}, mesh = {Humans ; Child ; *Travel ; Adolescent ; Germany/epidemiology ; *Communicable Diseases/epidemiology/diagnosis ; Female ; Child, Preschool ; }, abstract = {BACKGROUND: Families can acquire infections that are rare or nonexistent in Germany by international travel for business or private reasons and by migration between countries. Children and adolescents have special risk profiles, and their course of illness may be nonspecific and/or severe. A structured travel history is essential so that regionally specific infections will not be overlooked.
METHODS: This narrative review is based on publications of the last 25 years that were retrieved by a PubMed search on infections after international travel, with an emphasis on retrospective and prospective studies and on articles with separate data on minors. Further information from books, guidelines, surveillance studies, reports of the Federal Statistical Office of Germany, meta-analyses, reviews, and position statements was considered as well.
RESULTS: Reported case numbers of infectious diseases imported from abroad fell during the COVID-19 pandemic and have since risen again. Among diseases that are usually or exclusively acquired abroad, those most commonly affecting children and adolescents were giardiasis, tuberculosis, hepatitis A and malaria, with 695, 372, 344, and 128 cases in 2024. Less common ones included dengue fever (81 cases) and typhoid fever/paratyphoid fever (45 cases).
CONCLUSION: Regionally specific infections should be considered in the differential diagnosis of fever, gastrointestinal disturbances, and skin conditions in children and adolescents after international travel. It is critical that relevant diseases including malaria and typhoid fever/paratyphoid fever must be promptly diagnosed or ruled out. Because resistance patterns differ across regions of the globe, targeted determination of the pathogenic organism including a resistogram is important. The possibility of chronic infection should be considered in particular after long stays abroad.}, }
@article {pmid41562685, year = {2026}, author = {Ghibu, AM and Maniu, I and Birlutiu, V}, title = {Severity Scores in SARS-CoV-2 Infection-A Comprehensive Bibliometric Review and Visualization Analysis.}, journal = {Epidemiologia (Basel, Switzerland)}, volume = {7}, number = {1}, pages = {}, pmid = {41562685}, issn = {2673-3986}, abstract = {BACKGROUND/OBJECTIVES: Discovered in 2019, COVID-19 spread rapidly worldwide, leading from mild forms of the disease to critical forms or death, predominantly among vulnerable patients. Severity scores help clinicians in stratifying the risk of complications and death among patients diagnosed with SARS-CoV-2 infection.
METHODS: This study aims to identify the severity scores used in this type of infection, while bibliometric analysis carried out provided a comprehensive overview of global research patterns, trends, and cooperation in scientific literature on the chosen topic.
RESULTS: We conducted a literature screening to identify severity scores used in SARS-CoV-2 infection. Scores including CURB-54, COVID-GRAM, NEWS, APACHE II, SOFA, qSOFA, CALL, MuLBSTA, ISARIC 4C, and PADUA were identified with different performance indices.
CONCLUSIONS: There were different results obtained depending on the geographical area of applicability, patient groups analyzed, and individual patient characteristics.}, }
@article {pmid41562814, year = {2025}, author = {Hattori, T}, title = {Neutrophil-Galectin-9 Axis Linking Innate and Adaptive Immunity in ATL, Sézary Syndrome, COVID-19, and Psoriasis: An AI-Assisted Integrative Review.}, journal = {Reports (MDPI)}, volume = {9}, number = {1}, pages = {}, pmid = {41562814}, issn = {2571-841X}, abstract = {Beyond their traditional role as short-lived antimicrobial cells, neutrophils are increasingly recognized as key regulators of adaptive immunity and tumor progression. This AI-assisted integrative review investigated the neutrophil-T-cell axis, particularly the role of Galectin-9 (Gal-9), across adult T-cell leukemia/lymphoma (ATL), Sézary syndrome (SS), coronavirus disease 2019 (COVID-19), and psoriasis. Leveraging AI tools (GPT-5 and Adobe Acrobat AI Assistant) for literature synthesis (2000-2025) and expert validation, we aimed to identify common immunological mechanisms. Across all conditions, neutrophils displayed persistent activation, elevated Gal-9 expression, and modulated T-cell interactions. In ATL and SS, neutrophilia correlated with poor survival and TCR signaling dysregulation, suggesting Gal-9-mediated immune modulation. In COVID-19 and psoriasis, neutrophil-derived Gal-9-linked innate hyperactivation to T-cell exhaustion and IL-17-driven inflammation. These findings define a recurring neutrophil-Gal-9 regulatory module connecting innate and adaptive immune responses. This study underscores the feasibility of combining AI-driven literature synthesis with expert review to identify unifying immunological mechanisms and therapeutic targets across malignancy and inflammation.}, }
@article {pmid41563477, year = {2026}, author = {Giesen, N and Mellinghoff, SC and Khatamzas, E and Korell, F and Hentrich, M and Einsele, H and Henze, L and Heußel, CP and Hohmann, C and Jensen, BO and Monin, MB and Schafhausen, P and Schalk, E and Spiekermann, K and Voigt, S and von Lilienfeld-Toal, M and Teschner, D and Cornely, OA and Rieger, C and Busch, E}, title = {Prevention, diagnosis and management of community acquired respiratory virus infections including COVID-19 in patients with cancer: 2025 updated evidence-based guideline of the infectious diseases working party (AGIHO) of the German society for hematology and medical oncology (DGHO).}, journal = {Annals of hematology}, volume = {105}, number = {2}, pages = {46}, pmid = {41563477}, issn = {1432-0584}, mesh = {Humans ; *Community-Acquired Infections/diagnosis/prevention & control/therapy ; *COVID-19/prevention & control/diagnosis/therapy/epidemiology/complications ; Evidence-Based Medicine ; Germany/epidemiology ; Hematology/standards ; Immunocompromised Host ; Medical Oncology/standards ; *Neoplasms/complications/therapy ; *Respiratory Tract Infections/diagnosis/prevention & control/therapy ; Societies, Medical ; }, abstract = {Community-acquired respiratory viruses (CARV), such as influenza-, parainfluenza- or respiratory syncytial virus, pose a significant threat to immunocompromised patients with cancer. Following the COVID-19 pandemic, SARS-CoV-2 has now joined the ranks of endemic respiratory viruses and continues to be a cause of significant morbidity and mortality in patients with cancer. Strategies to protect this vulnerable patient population both by prevention of infection and by early therapeutic intervention in case of infectious disease are therefore of utmost importance. This guideline provides updated evidence-based recommendations on diagnosis, prophylaxis and treatment of CARV infections including COVID-19 in patients with solid tumors or hematologic malignancies to support clinicians in offering optimal care. The guideline is based on a systematic review of currently available data and was developed until the beginning of 2025 by an expert panel of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO).}, }
@article {pmid41563924, year = {2026}, author = {Taylor, FE and Guo, H and Patel, T and Burns, F}, title = {A mixed methods systematic review on the impact of COVID-19 on healthcare workers' knowledge, attitudes and practices of infection prevention and control in the UK.}, journal = {The Journal of hospital infection}, volume = {167}, number = {}, pages = {124-136}, doi = {10.1016/j.jhin.2025.10.011}, pmid = {41563924}, issn = {1532-2939}, mesh = {Humans ; *COVID-19/prevention & control/epidemiology ; *Health Personnel/psychology/statistics & numerical data ; *Health Knowledge, Attitudes, Practice ; United Kingdom/epidemiology ; *Infection Control/methods ; Personal Protective Equipment ; SARS-CoV-2 ; *Attitude of Health Personnel ; Cross Infection/prevention & control ; }, abstract = {Coronavirus disease 2019 (COVID-19) continues to cause healthcare-associated infections (HCAIs) in the UK. It is important to understand if infection prevention and control (IPC) guidelines are being followed to prevent future outbreaks and improve preparedness for the emergence of infectious disease. This mixed-methods systematic review aimed to explore the COVID-19 IPC knowledge, attitudes and practices (KAP) of healthcare workers (HCWs) within the UK. Database searches carried out during April 2023 and July 2024 revealed 24 eligible papers (12 quantitative, eight qualitative, four mixed methods). A convergent integrated approach was used during qualitative synthesis. Doctors were most represented, followed by nurses then pharmacists. Personal protective equipment (PPE) was the most reported IPC measure. In terms of knowledge, articles reported moderate-to-poor knowledge of correct aerosol-generating procedures (range 33-35%), and donning and doffing procedures (range 3-82%). Intensive care workers and doctors tended to have better knowledge compared with other settings or HCWs. Regarding attitudes, PPE and gatekeeping visitation caused strain, and some HCWs felt that guidance lacked relevance to their setting. Finally, regarding practices, this review found that HCWs would risk assess what PPE to wear. An enhanced level of PPE than advised was worn when patients were symptomatic. However, HCWs would remove PPE when they felt it reduced effective communication or patient safety was at risk. Clearer communication of the evidence behind IPC guidance and tailored guidance for each setting may improve HCWs' KAP and thus reduce HCAIs. Future research should determine KAP of other IPC apart from PPE. Non-medical HCWs should also be included as they constitute a significant proportion of patient-facing staff.}, }
@article {pmid41564096, year = {2025}, author = {Rae-Dupree, J}, title = {From Melanoma Detection to Diabetes Monitoring: The Promise of Microneedle Patches.}, journal = {IEEE pulse}, volume = {16}, number = {5}, pages = {13-16}, doi = {10.1109/MPULS.2025.3618457}, pmid = {41564096}, issn = {2154-2317}, mesh = {Humans ; *Needles ; *Melanoma/diagnosis ; Biosensing Techniques/instrumentation ; *Blood Glucose Self-Monitoring/instrumentation ; Continuous Glucose Monitoring ; *Diabetes Mellitus/diagnosis/blood ; Microneedle Drug Delivery ; Digital Health ; }, abstract = {Postage-stamp-sized arrays of infinitesimal needles are being developed that may one day provide the foundation for at-home cancer detection kits and wearable biosensors that can alert diabetes patients in real time as their blood sugar fluctuates. Microneedle arrays-medical patches embedded with micro-scale projections-are an emerging class of devices that are creating pain-free access to the interstitial fluid that surrounds cells just under the surface of the skin. Packed with the same enzymes and metabolites as blood, interstitial fluid also contains many unique biomarkers not found in blood. Researchers have demonstrated that the arrays can be used for inexpensive, biopsy-free melanoma detection, reported using a test strip similar to at-home COVID-19 detectors, and in a diabetes management wristband that combines continuous glucose monitoring with other chemical and cardiovascular signals to alert patients to dangerous trends that today's glucose monitors would miss.}, }
@article {pmid41564537, year = {2026}, author = {Asokan, S and Damilare, II and Kumar, S and Pandey, RK and Verma, G and Banerjee, N and Radhamanalan, G and Vijayan, S and Jacob, T and Rajeswary, D}, title = {From pandemic influenza to novel coronaviruses: emerging infectious diseases of the 21st century.}, journal = {Diagnostic microbiology and infectious disease}, volume = {114}, number = {4}, pages = {117277}, doi = {10.1016/j.diagmicrobio.2026.117277}, pmid = {41564537}, issn = {1879-0070}, mesh = {Humans ; *Communicable Diseases, Emerging/epidemiology/virology ; Animals ; *Pandemics ; *Influenza, Human/epidemiology ; *Coronavirus Infections/epidemiology ; Zoonoses/epidemiology ; SARS-CoV-2 ; COVID-19 ; }, abstract = {Emerging infectious diseases have risen significantly in the twenty-first century as ecological disruption, climate change, expanding human-animal interfaces, and global mobility intensify opportunities for pathogen transmission. This review synthesizes historical and contemporary evidence across viral, bacterial, fungal, and parasitic threats to characterize how diverse pathogens emerge and spread. Foundational events such as the 1918 influenza pandemic, mid-century influenza pandemics, the emergence of HIV/AIDS, and the eradication of smallpox provide context for understanding modern disease dynamics. In recent decades, coronaviruses including SARS, MERS, and SARS-CoV-2, pandemic H1N1, avian influenza subtypes, and major arboviruses such as dengue, chikungunya, Zika, West Nile virus, and yellow fever have demonstrated the rapidity with which zoonotic pathogens can disseminate globally. Viral hemorrhagic fevers including Ebola, Marburg, Lassa, and Crimean-Congo hemorrhagic fever remain critical threats, especially in regions with limited health-care capacity. Concurrently, antimicrobial resistance, the emergence of Candida auris, and the climate-driven expansion of endemic mycoses involving Histoplasma, Coccidioides, and Blastomyces highlight the increasing importance of fungal pathogens. Parasitic diseases such as artemisinin-resistant malaria, zoonotic trypanosomiasis, and expanding Leishmania transmission reflect shifting ecological conditions. These patterns are shaped by intersecting drivers including deforestation, wildlife trade, agricultural intensification, urban crowding, conflict, and rapid microbial evolution that enable spillover and sustained transmission. Although advances in genomic surveillance, metagenomic diagnostics, mRNA vaccines, monoclonal antibodies, and broad-spectrum antivirals have strengthened global response capacity, substantial gaps persist in equity, surveillance, and access to countermeasures. Strengthening One Health systems and resilient public health infrastructures is essential to anticipate and mitigate emerging infectious threats.}, }
@article {pmid41564655, year = {2026}, author = {Joseph, SS and Al-Jarrah, L and Ahmed, MH and El-Menyar, A and Khan, NA and Abdelrahman, H and Consunji, R and Abdulrahman, Y and Rizoli, S and Al-Thani, H}, title = {Scoping review on motorcycle crashes patterns, risk factors, and potential in setting policy priorities in the gulf cooperation council countries (GCC).}, journal = {Injury}, volume = {57}, number = {3}, pages = {113017}, doi = {10.1016/j.injury.2026.113017}, pmid = {41564655}, issn = {1879-0267}, mesh = {Humans ; *Motorcycles/statistics & numerical data ; *Accidents, Traffic/statistics & numerical data/prevention & control/mortality ; Risk Factors ; Middle East/epidemiology ; *Wounds and Injuries/epidemiology/prevention & control ; Head Protective Devices/statistics & numerical data ; Craniocerebral Trauma/epidemiology/prevention & control ; Male ; }, abstract = {BACKGROUND: Although road traffic injuries (RTIs) pose a significant public health burden in the Gulf Cooperation Council countries (GCC), the true extent of motorcycle crash injuries (MCCIs) remains unclear because of limited published data from this region. Emerging evidence suggests that MCCIs are on the rise because of the growing use of motorcycles for transport and delivery services, even though road safety overall has improved. We sought to review regional evidence on MCCIs' patterns, key risk factors, and temporal trends to inform policy interventions and research priorities for effective prevention.
METHODS: A scoping review was conducted in accordance with the PRISMA-ScR guidelines. Articles on GCC MCCIs published from July 2008 to October 2025, examining injury patterns, mortality, and safety practices, were included in the review. Search was conducted across PubMed, Scopus, Google Scholar, and grey literature sources. The GCC consists of six countries: Saudi Arabia (KSA), Qatar, Kuwait, the United Arab Emirates (UAE), Bahrain, and Oman.
RESULTS: Of 1344 studies identified, 9 met the inclusion criteria and were analyzed. The GCC has seen an increase in the number of motorcycles registered, resulting in higher MCC rates over time. During the COVID-19 pandemic, these rates surged again as the delivery sector grew. MCCI victims were mainly young males (mean age of 29 years). Extremity injuries were the most frequent (two-thirds), followed by head injuries (20-41%), often associated with poor helmet use compliance (range 13-17%). Delivery riders represented a high-risk subgroup, reflecting occupational exposure, fatigue, and time pressure. Despite advances in trauma care, geographic gaps persist. Helmet use non-compliance, alcohol use, and inadequate documentation remain significant risk factors. Extremity injuries were the most common in the GCC.
CONCLUSION: MCCIs in the GCC are on the rise with high rates of extremity and head trauma. Poor helmet use compliance is a significant factor. Therefore, we suggest strengthening helmet use laws and safety standards, increasing community efforts, and establishing motorcycle lanes with lower speed limits. Protection for riders at work should be enhanced. Road infrastructure and robust data systems also need improvement.}, }
@article {pmid41564840, year = {2026}, author = {Faijue, DD and Bouaddi, O and Mackey, K and Deal, A and Cinar, EN and Morais, B and Bojang, S and Al-Sharabi, I and Seale, H and Ssali, A and Le Doare, K and Hargreaves, S}, title = {Strategies, interventions, and uptake of catch-up vaccination among adolescent and adult migrants, refugees, and internally displaced persons (IDPs) in low- and middle-income countries (LMICs): A systematic review.}, journal = {Vaccine}, volume = {75}, number = {}, pages = {128249}, doi = {10.1016/j.vaccine.2026.128249}, pmid = {41564840}, issn = {1873-2518}, mesh = {Humans ; *Refugees/statistics & numerical data ; Adolescent ; Developing Countries ; *Vaccination/methods/statistics & numerical data ; *Transients and Migrants/statistics & numerical data ; Adult ; COVID-19/prevention & control ; Vaccination Coverage ; *Immunization Programs ; Child ; }, abstract = {BACKGROUND: Catch-up vaccination helps close immunity gaps among migrants, refugees and internally displaced people (IDPs) in low- and middle-income countries (LMICs). Despite immunisation life-course policies and global guidelines promoting catch-up vaccination of arriving migrants, vaccination strategies for adolescent and adult populations are poorly described. We synthesised evidence on catch-up vaccination strategies and interventions, delivery platforms, uptake and coverage, and contextual barriers and enablers in LMICs.
METHODS: We searched Embase, Medline, PsycINFO, Global Health, Web of Science and grey literature sources (including websites of international and national public health organisations and agencies) for primary studies and reports on catch-up vaccination strategies and interventions, delivery platforms, uptake and coverage, and contextual barriers and enablers targeting adolescents (9-18 years) and, or adults (≥19 years) in migrants (foreign-born, including refugees) and internally displaced people (IDPs; displaced within national borders) across 136 LMICs, (from January 1st 2000 to February 1st 2025; all languages). Study quality was accessed using ROBINS-I, CASP, AACODS and, AGREE II tools.
RESULTS: Thirty-seven records met the inclusion criteria (13 peer-reviewed, 24 grey literature), reporting catch-up vaccination activities across 16 LMICs. Most studies were conducted in Uganda (n = 6), Bangladesh (n = 4), Lebanon (n = 3), and Kenya (n = 3). Interventions reached ≥48,000 migrants, refugees, and IDPs (primarily Rohingya refugees in Bangladesh during COVID-19 catch-up campaigns). Populations targeted included mostly refugees (n = 16 studies; 43.2%), general migrants (n = 14; 37.8%), and IDPs (n = 5; 13.5%), with a smaller number involving mixed or other migrant groups (n = 4; 10.8%). The most frequently delivered vaccines were measles-rubella (n = 12; 32.4%), COVID-19 primary-series catch-up (n = 9; 24.3%), HPV (n = 6; 16.2%), polio OPV/IPV (n = 5; 13.5%), and Hepatitis B (n = 3; 8.1%). Catch-up vaccine delivery most commonly occurred through primary care via opportunistic offers (n = 11) and mobile/outreach delivery (n = 11), with additional implementation in fixed posts in camps/settlements (n = 7), supplemental immunisation activities (SIAs) (n = 6), school-linked delivery (n = 5), and hospital/outpatient opportunistic vaccination (n = 4). High uptake (≥85%) was reported where access barriers were minimised (e.g., walk-in availability, extended hours) was paired with community or peer engagement and simple recall systems (SMS or e-booking). Reported barriers included documentation/entitlement checks, language barriers, and fragmented or non-interoperable vaccination records.
CONCLUSIONS: Migrants remain at risk of under-immunisation, and greater emphasis must be placed on promotion of vaccination across the life-course for missed vaccines, doses, and boosters. Strengthening catch-up vaccination in adolescents and adults, and improving migration-disaggregated data and delivery systems, are urgently needed.}, }
@article {pmid41564895, year = {2026}, author = {Gray, GC and Vlasova, AN and Lednicky, JA and Nguyen-Tien, T and Shittu, I and Li, F}, title = {Emerging Respiratory Virus Threats from Influenza D and Canine Coronavirus HuPn-2018.}, journal = {Emerging infectious diseases}, volume = {32}, number = {1}, pages = {1-6}, pmid = {41564895}, issn = {1080-6059}, mesh = {Animals ; Humans ; *Coronavirus, Canine ; Dogs ; *Coronavirus Infections/epidemiology/virology/veterinary ; *Communicable Diseases, Emerging/epidemiology/virology ; *Deltainfluenzavirus ; *Orthomyxoviridae Infections/epidemiology/virology ; *Influenza, Human/epidemiology/virology ; *Dog Diseases/virology/epidemiology ; *Respiratory Tract Infections/virology/epidemiology ; }, abstract = {In 2009 and again in 2019, public health warnings were confirmed by the emergence, rapid widespread transmission, and lethality of novel influenza and coronaviruses. The world continues to suffer disease from these respiratory viruses. Two newly recognized emergent respiratory viruses, influenza D and canine coronavirus HuPn-2018, have been shown to have considerable potential for causing future human epidemics, but diagnostics and surveillance for the viruses are lacking. We reviewed data regarding influenza D virus and coronavirus canine coronavirus HuPn-2018. Those data strongly indicate that these viruses are major newly recognized threats. However, little is being done to respond to or prevent disease associated with these viruses, warranting the question of whether we will learn from previous pandemics.}, }
@article {pmid41565938, year = {2026}, author = {Bingham-Hendricks, C and Peters-Mosquera, A and Aronowitz, SV and Woods, C and Aronowitz, T}, title = {Narrative Review of Opioid Use Disorder Treatment Changes During the COVID-19 Pandemic and Their Impact on American Indian/Alaska Native Communities.}, journal = {Nursing open}, volume = {13}, number = {1}, pages = {e70437}, pmid = {41565938}, issn = {2054-1058}, mesh = {Humans ; *American Indian or Alaska Native/statistics & numerical data ; *COVID-19/epidemiology ; Drug Overdose ; Health Services Accessibility ; *Opiate Substitution Treatment/methods ; *Opioid-Related Disorders/drug therapy/ethnology/therapy ; Pandemics ; United States/epidemiology ; }, abstract = {BACKGROUND: The United States (US) declared drug overdose a public health emergency in 2017. Despite this, two million people reported having an opioid use disorder (OUD) in 2018. However, following the beginning of COVID-19 there was a 53% increase in overdose deaths, with American Indian/Alaska Native (AI/AN) individuals experiencing the highest rates of all racial groups. In response to the COVID-19 pandemic and OUD treatment access challenges, OUD treatment policies were changed to improving access to care.
PURPOSE: This review examines how the state- and federal-level policies impacted access to medications for opioid use disorder (MOUD) during the COVID-19 pandemic. Due to the devastating impact of overdose and COVID-19 on AI/AN communities, as a secondary aim, we examined the inclusion of these populations in the samples of the included studies.
METHODS: We completed a narrative review using a data-based convergent synthesis design.
RESULTS: Forty-four studies met the inclusion criteria. Most of the studies were quantitative descriptive studies (n = 25). Only two studies offer AI/AN as a category for ethnicity and both had less that 4% of the sample that identified as an AI/AN individual.
CONCLUSION AND IMPLICATIONS: Telehealth OUD treatment increased initiation and retention for patients taking buprenorphine. No increase in overdose rates was associated with allowing for additional take-home doses of methadone. However, access to treatment, even telehealth, remains difficult for individuals due to a lack of OUD treatment providers and access to the internet. More needs to be done to address the opioid overdose crisis, especially among AI/AN communities. Research focused on cultural strategies to address this health disparity is desperately needed. We included nursing implications in response to this health disparity among AI/AN individuals.}, }
@article {pmid41566283, year = {2026}, author = {Jiang, ZJ and Jin, PF and Zhang, MR and Jiang, GL and Hu, L and Niu, Q and Zhang, ZJ and Li, JX}, title = {[Progress in research of influence of gene polymorphisms on vaccine immune response].}, journal = {Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi}, volume = {47}, number = {1}, pages = {180-186}, doi = {10.3760/cma.j.cn112338-20250709-00473}, pmid = {41566283}, issn = {0254-6450}, support = {2023YFC2307601//National Key Research and Development Program of China/ ; }, mesh = {Humans ; *Polymorphism, Genetic ; *HLA Antigens/genetics ; *Vaccines/immunology ; COVID-19 Vaccines/immunology ; Influenza Vaccines/immunology ; COVID-19/prevention & control ; SARS-CoV-2 ; }, abstract = {To introduce the recent progress in the research of gene polymorphisms and differences in vaccine immune responses, this paper systematically summarizes current findings of the associations between human leukocyte antigen (HLA) polymorphisms and other key immunoregulatory gene variations with vaccine responses across different domains, including COVID-19 and influenza vaccines. Furthermore, it discusses the impact of different genotypes on antibody production, immune protection, and the risk for breakthrough infections. To address the challenges posed by genetic polymorphisms, this paper further summarizes several key strategies for vaccine optimization, including conserved epitope targeting, multivalent vaccine design, and peptide-carrier conjugation approaches. Although genomics has laid a theoretical foundation for precise vaccine design, multiple challenges still persist in current research, such as the complexity of gene-environment interactions and ethical concerns regarding data sharing and privacy protection. Future investigations should further evaluate the effects of specific gene polymorphisms, such as detailed HLA subtypes, on the variations in vaccine immune responses, and elucidate underlying mechanisms by integrating functional studies Exploring and establishing genomics and multi-omics-based precise immunization strategies will provide more effective solutions for vaccine-preventable diseases.}, }
@article {pmid41566983, year = {2026}, author = {Rahmadina, F and Ahmad, RA and Ramadona, AL}, title = {Association of Particulate Matter (PM2.5) With COVID-19 Infection and Mortality in Low-and Middle-income Asian Countries: A Systematic Review and Meta-analysis.}, journal = {Journal of preventive medicine and public health = Yebang Uihakhoe chi}, volume = {59}, number = {1}, pages = {12-24}, pmid = {41566983}, issn = {2233-4521}, mesh = {*Particulate Matter/adverse effects/analysis ; Humans ; Asia/epidemiology ; *COVID-19/mortality/epidemiology ; Developing Countries ; SARS-CoV-2 ; *Environmental Exposure/adverse effects ; Pandemics ; Air Pollution/adverse effects ; Air Pollutants/adverse effects ; }, abstract = {OBJECTIVES: Low-income and middle-income countries in Asia bear a disproportionate burden of particulate matter with an aerodynamic diameter of 2.5 micrometers or less (PM2.5) pollution, yet data remain scarce. This systematic review and meta-analysis aimed to quantify the association between PM2.5 exposure and the risks of coronavirus disease 2019 (COVID-19) infection and mortality in this vulnerable region.
METHODS: A systematic search was conducted in PubMed, Scopus, and other major databases for studies published up to December 31, 2024. We included observational studies reporting associations between PM2.5 and COVID-19 outcomes in low-income and middle-income Asian countries. Pooled effect sizes and 95% confidence intervals (CIs) were calculated using a random-effects model. The study was registered with PROSPERO (CRD42022316008).
RESULTS: Fourteen studies met the inclusion criteria. Separate analyses demonstrated statistically significant positive associations between PM2.5 exposure and COVID-19 infection for both short-term exposure (pooled risk ratio [RR], 1.12; 95% CI, 1.07 to 1.18) and long-term exposure (pooled RR, 1.41; 95% CI, 1.28 to 1.56). For mortality, the analysis identified a statistically non-significant positive association with short-term exposure (pooled RR, 1.37; 95% CI, 0.80 to 2.33). Substantial heterogeneity was observed across all analyses (I²>75%); however, sensitivity analyses confirmed that the findings for infection were robust.
CONCLUSIONS: Our findings provide robust evidence that PM2.5 exposure is a significant risk factor for COVID-19 infection in low-income and middle-income Asian countries. The available evidence was insufficient to establish a clear association with mortality. These results underscore the urgent need for strengthened air quality control policies as a critical component of public health strategies to mitigate the burden of respiratory pandemics.}, }
@article {pmid41567206, year = {2025}, author = {Zhou, K and Chen, Y and Pang, J and Zhang, J and Lu, J}, title = {The endothelial-immunothrombotic storm in viral sepsis: lessons from COVID-19.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1681764}, pmid = {41567206}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/immunology/complications/pathology ; *Sepsis/immunology/virology/pathology ; *SARS-CoV-2/immunology ; *Cytokine Release Syndrome/immunology ; *Endothelial Cells/immunology/pathology/virology ; Animals ; *Endothelium, Vascular/immunology/pathology ; *Thrombosis/immunology ; Complement Activation ; T-Cell Exhaustion ; }, abstract = {Taking COVID-19 as an illustrative example, this review systematically elucidates the central pathological mechanism of viral sepsis, termed the endothelial-immunothrombotic storm. This mechanism is initiated by the direct viral infection of endothelial cells, which provokes excessive immune activation and disrupts coagulation through immunothrombosis, including cytokine storms, NETosis, and complement activation. Meanwhile, these processes establish a vicious cycle leading to multiple organ failure. Compared with classical bacterial sepsis, viral sepsis exhibits distinctive features such as interferon dysregulation, direct endothelial damage, a hypercoagulable state, and T-cell exhaustion. This review integrates the latest research findings, contrasts the pathophysiological differences between viral and bacterial sepsis, and proposes precision strategies focused on endothelial protection, immune modulation, and anticoagulation. Finally, we discuss the clinical translational prospects of these approaches and suggests directions for future research.}, }
@article {pmid41567315, year = {2025}, author = {Vargas Cornejo, HM and Jiménez Prado, CA and Guillén Galarza, MF}, title = {Glossopharyngeal neuralgia after SARS-CoV-2 infection: A case report.}, journal = {Journal of clinical and experimental dentistry}, volume = {17}, number = {12}, pages = {e1550-e1553}, pmid = {41567315}, issn = {1989-5488}, abstract = {Glossopharyngeal neuralgia (GN) is a rare neuropathic disorder characterized by sudden, unilateral, electric shock-like pain in the areas innervated by the glossopharyngeal nerve. Its diagnosis is frequently delayed because of its clinical overlap with odontogenic and otorhinolaryngological conditions. In the context of the COVID-19 pandemic, different cranial neuropathies have been reported, suggesting possible post-infectious mechanisms. We describe the case of a 54-year-old male dentist, without relevant medical history, who developed recurrent episodes of intense pain in the right pharynx and base of tongue after confirmed SARS-CoV-2 infection. Symptoms were triggered by swallowing, coughing, and salivary stimulation, reaching maximum intensity on the visual analogue scale (EVA 10/10). Brain and neck magnetic resonance imaging revealed no structural abnormalities. Treatment with carbamazepine (600 mg/day) partially reduced frequency and severity of attacks, while pregabalin (300 mg/day) showed no benefit. This case highlights the need to consider SARS-CoV-2 infection as a potential trigger of GN, underscores the importance of recent infectious history in the differential diagnosis, and emphasizes the relevance of early pharmacological management in clinical improvement.}, }
@article {pmid41567360, year = {2026}, author = {Shahid, F and Farooq, H and Abeer, H and Mahmood, GM and Sheikh, H and Ameer, MZ and Fatima, L and Ameer, F and Amjad, Z and Ahmad, TZ and Rehman, G and Rehman, AU}, title = {The Association of Polymyalgia Rheumatica and Giant Cell Arteritis With COVID-19 Vaccination: A Systematic Review.}, journal = {Clinical medicine insights. Arthritis and musculoskeletal disorders}, volume = {19}, number = {}, pages = {11795441251414673}, pmid = {41567360}, issn = {1179-5441}, abstract = {BACKGROUND: Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are interrelated inflammatory conditions, and evidence suggests that infection and vaccination might act as a trigger for these conditions. This descriptive systematic review summarizes the published case reports and case series on new-onset PMR and GCA following COVID-19 vaccination, highlighting their clinical features, diagnostic findings, and treatment outcomes.
OBJECTIVES: To do a systematic analysis of available literature regarding the association between COVID-19 vaccination and the first onset or flare of PMR and/or GCA.
DESIGN: Systematic review of case reports and case series.
DATA SOURCES AND METHODS: A systematic literature search was conducted using PubMed/MEDLINE, Cochrane, ScienceDirect, and Google Scholar. Data on patient demographics, clinical features, outcomes, and latency periods were extracted and analyzed. Quality assessment of included studies was performed using the Joanna Briggs Institute Critical Appraisal Tool.
RESULTS: A total of 32 articles, documenting 50 new-onset cases (30 PMR and 20 GCA), were identified for inclusion. The mean age for patients with PMR was 71.06 years, and 72.85 years for GCA. A slight female predominance was observed (60%) for both PMR and GCA. Pfizer-BioNTech (48%) and AstraZeneca (38%) vaccines were most frequently associated with disease onset. The mean latency period from vaccination to symptom onset was 11.03 days for PMR and 5.3 days for GCA, indicating a temporal relationship. Most of these studies originated from North America and Europe mimicking the global scale of vaccination. Most patients responded well to symptomatic treatment with corticosteroids.
CONCLUSIONS: There exists a temporal association between COVID-19 mRNA or viral vector-based vaccines and the onset of PMR and GCA. While causality is not proven, this review underscores the need for clinicians to be aware of this potential association to ensure timely diagnosis and treatment, particularly as booster vaccinations continue to be administered. Larger epidemiological studies with long-term follow-up are essential to further explore this association.}, }
@article {pmid41567375, year = {2025}, author = {Bouayad, A}, title = {An overview of HLA variants in COVID-19 vaccine-induced autoimmunity.}, journal = {International journal of molecular epidemiology and genetics}, volume = {16}, number = {3}, pages = {16-41}, pmid = {41567375}, issn = {1948-1756}, abstract = {COVID-19 vaccination, both in healthy individuals and those with comorbid medical disorders, has proven highly effective in mitigating critical disease progression and mortality rates. Nevertheless, although rare, induction of autoantibodies and new-onset autoimmune conditions in apparently healthy individuals receiving COVID-19 vaccination have been documented. These autoimmune phenomena can be broadly classified into organ-specific autoimmune disorders (e.g., subacute thyroiditis (SAT)) and systemic autoimmune disorders, with many being generally transient (e.g., vaccine-induced thrombotic thrombocytopenia (VITT)) and others causing chronic disability (e.g., systemic vasculitis). Recent studies have highlighted significant associations between COVID-19 vaccine-associated autoimmunity and human leukocyte antigen (HLA) loci. For example, HLA class I alleles such as HLA-B*35 and HLA-C*04 have been associated with COVID-19 vaccine-induced SAT, while HLA class II alleles, including HLA-DRB1*11:04, HLA-DQA1*05:01, HLA-DQB1*02:01, and HLA-DPB1*17:01, have been linked to VITT. This review synthesizes the reported associations between classical HLA loci and COVID-19 vaccine-induced autoimmunity, providing insights into potential mechanisms and clinical implications.}, }
@article {pmid41567412, year = {2026}, author = {Ssebibubbu, S and Ssekamwa, F and Muhumuza, N and Mulumba, M}, title = {Reforming Uganda's digital health data systems: A policy analysis for inclusive, equitable, and decolonised data governance.}, journal = {Digital health}, volume = {12}, number = {}, pages = {20552076251408532}, pmid = {41567412}, issn = {2055-2076}, abstract = {Uganda has rapidly digitised many health services, but persistent challenges in data governance - including fragmented systems, variable data quality, and the exclusion of vulnerable populations - hinder effective care and equity. This analysis reviews recent developments (2023-2025) in Uganda's digital health policy and practice, drawing on strategy documents, conference reports, and stakeholder input. It highlights how the COVID-19 pandemic accelerated innovation while exposing systemic weaknesses. For example, the Ministry of Health's (MoH) 2023 strategy explicitly targets data accessibility and integration, and the 2024 guidelines standardise management across the sector. Yet, execution gaps remain due to resource constraints and organisational silos. This article proposes an inclusive data governance framework with five pillars (inclusive governance, equity, interoperability, privacy, and capacity) and recommends concrete actions. By adopting these reforms, Uganda can transform its digital health systems into people-centred, equitable platforms that build trust, protect rights, and advance universal health coverage.}, }
@article {pmid41567589, year = {2026}, author = {Safi, D and El Rassi, C and Abou Mansour, M and Sleem, B and El Rassi, I and Arabi, M}, title = {Kawasaki Disease Versus Multisystem Inflammatory Syndrome in Children: Exploring the Complexities of Pediatric Cardiac Inflammatory Disorders.}, journal = {Sage open pediatrics}, volume = {13}, number = {}, pages = {30502225251411149}, pmid = {41567589}, issn = {3050-2225}, abstract = {Kawasaki disease (KD) and multisystem inflammatory syndrome in children (MIS-C) are both pediatric inflammatory conditions that pose significant challenges in diagnosis and management due to their overlapping clinical features and distinct pathophysiological profiles. KD is a well-established acute vasculitis that primarily affects children under 5. In contrast, MIS-C is a recently identified condition associated with SARS-CoV-2 infection, typically affecting older children and adolescents. Reported mortality for MIS-C remains below 2%, compared with less than 0.1% for KD, although both can result in significant cardiac morbidity if untreated. This review highlights the critical differences between KD and MIS-C, including their genetic underpinnings, clinical manifestations, and responses to treatment. While KD has a well-established treatment protocol involving intravenous immunoglobulin and aspirin, MIS-C treatment is still evolving. The manuscript underscores the importance of distinguishing between these conditions for accurate diagnosis and tailored treatment, which is crucial for improving patient outcomes.}, }
@article {pmid41568029, year = {2025}, author = {Shao, F and Zhu, X and Yi, M and Gao, H and Wu, J and Fang, R and Xie, Y and Han, J and Lu, H}, title = {TLR agonists as adjuvants for viral vaccines: mechanisms, applications, and future directions.}, journal = {Frontiers in microbiology}, volume = {16}, number = {}, pages = {1740572}, pmid = {41568029}, issn = {1664-302X}, abstract = {Toll-like receptors (TLRs) play a pivotal role in the innate immune system by recognizing pathogen-associated molecular patterns (PAMPs) and damage-associated molecular patterns (DAMPs), thereby initiating immune responses against viral infections. TLR agonists have emerged as promising adjuvants to enhance the efficacy of viral vaccines by modulating immune responses, improving antigen presentation, and promoting both humoral and cellular immunity. This review comprehensively summarizes the classification, signaling mechanisms, and immunomodulatory functions of cell-surface and intracellular TLRs. It further discusses the application of TLR agonists as adjuvants in vaccines against major viruses, including HBV, HCV, HIV, SARS-CoV-2, influenza, and flaviviruses. Key findings from preclinical and clinical studies highlight the potential of TLR agonists to overcome immune tolerance, enhance vaccine immunogenicity, and provide broad-spectrum protection. Finally, it points toward the "integration of precision adjuvants with novel vaccine platforms" as a core future direction, laying a theoretical and applied foundation for TLR agonists to become the next generation of viral vaccine adjuvants.}, }
@article {pmid41569003, year = {2026}, author = {Chopra, I and Yang, J and Yehoshua, A and Mendoza, CF and Di Fusco, M}, title = {Incorporating underreporting of epidemiological burden in COVID-19 models: a targeted literature review.}, journal = {Journal of medical economics}, volume = {29}, number = {1}, pages = {193-212}, doi = {10.1080/13696998.2026.2613591}, pmid = {41569003}, issn = {1941-837X}, mesh = {Humans ; *COVID-19/epidemiology/economics/mortality ; Hospitalization/statistics & numerical data ; *Cost of Illness ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Underreporting of infections, hospitalizations, and deaths can pose challenges to accurately estimating the true burden of COVID-19. Consequently, health burden assessments and economic evaluations may underestimate the public health impact of interventions such as vaccination.
METHODS: This targeted literature review summarized economic evaluations of COVID-19 that reported having adjusted for underreporting of epidemiological burden. Searches were performed in PubMed through 08/31/2025 with no geographic restrictions. Key study characteristics extracted: country, time period, population, parameters adjusted for underreporting, and the adjustment multipliers used. A high-level quality assessment of evidence was conducted, building on Drummond checklist and CHEERS. Given the qualitative nature of the question and the expected heterogeneity in study designs, the results were summarized qualitatively.
RESULTS: A total of 20 studies met the inclusion criteria. Of these, 14 (70%) reported numerical adjustment factors, and the remaining 30% did not report a numerical factor. The studies covered diverse geographic regions and time frames, with adjustments applied to parameters such as infections, hospitalizations, and mortality. The study quality was moderate to high. The multipliers used ranged widely across studies: 1 to 5 for mortality, 1 to 5 for hospitalizations, and 1 to 10 for infections, where a value higher than 1.0 reflects an adjustment factor for underreporting. The methodologies used to estimate underreporting varied, including comparisons to excess mortality data, Monte Carlo simulations, and validation against external datasets.
LIMITATIONS: Most studies used pandemic time horizons.
CONCLUSIONS: This review identified 14 modelling studies reporting numerical adjustment factors. The studies used diverse approaches and adjustment factors, reflecting variability in data availability and estimation methods. Recognizing and standardizing these adjustments is crucial for improving the accuracy and comparability of health economic analyses that inform policy decisions. Further research could refine underreporting estimates and assess their impact on economic model outcomes.}, }
@article {pmid41569327, year = {2026}, author = {Al-Shbailat, SA and Alqato, S and Alkhalaileh, AY and Suleiman, R and Zein Eddin, S and Karajeh, A and Al-Shbeilat, RG and Hussein, R and Hatamleh, H and Jaradat, JH and Alsagarat, K and Asfour, LK}, title = {Risk Factors and Outcomes of Immunoglobulin A Vasculitis in Patients with Inflammatory Bowel Disease and vice versa: A Systematic Review of the current literature.}, journal = {Current gastroenterology reports}, volume = {28}, number = {1}, pages = {6}, pmid = {41569327}, issn = {1534-312X}, mesh = {Humans ; *Inflammatory Bowel Diseases/complications/immunology/drug therapy ; Risk Factors ; COVID-19 ; *IgA Vasculitis/immunology/etiology/epidemiology ; *Immunoglobulin A/immunology ; }, abstract = {PURPOSE OF REVIEW: This systematic review sought to thoroughly investigate the relationship between Inflammatory Bowel Disease (IBD) and Immunoglobulin A Vasculitis (IgAV), pinpointing both factors that increase risk and those that provide protection, laying the groundwork for future studies on specific treatments approaches to enhance the wellbeing of patients with IgAV and / or IBD.
RECENT FINDINGS: There is a new and quickly expanding body of literature on this subject, indicating a rising interest in it. Recent research has sought to investigate the connection between newly emerged viruses, such as COVID-19, or medications like Anti-Tumor Necrosis Factor Alpha (anti-TNF-α), and the development, progression, and treatment approaches of IgAV in IBD patients, and vice versa. Certain recent research is centered on a particular age groups or the condition of the initial illness. IgAV has been observed for numerous years following the diagnosis of IBD, displaying manifestations in the skin, joints, kidneys, and gastrointestinal tract. IBD encompassing Crohn's disease and ulcerative colitis, and IgAV share immunological overlaps via dysregulated IgA production, genetic loci like HLA-DQA1/DQB1, and environmental triggers such as infections amid gut dysbiosis. IgAV often emerges as an IBD sequela or anti-TNF-α therapy complication, with TNF blockade potentially disrupting B-cell maturation, fostering Gd-IgA1 complexes, and neutrophil-driven inflammation. (31) studies encompassing (83) patients with co-occurring IBD and IgAV, predominantly males (60.2%) and younger individuals with confirmed dual diagnoses (95.2%). Compared to UC, more severe CD phenotypes and extended disease duration correlate with increased IgAV risk. Anti-TNF inhibitors appear to substantially contribute to IgAV onset in IBD patients. Most affected individuals develop IBD initially, followed by IgAV, whereas only a minority experience IBD subsequent to IgAV diagnosis. Ceasing anti-TNF-α therapy post-IgAV diagnosis may lead to IgAV resolution but could also trigger disease recurrence. The study's limited sample size has hindered the researchers from reaching conclusions via a meta-analysis. Additionally, the criteria utilized for IBD diagnosis have displayed inconsistency across all studies. Patients with IBD are at higher risk of developing IgAV, thus a high level of suspicion and prompt diagnostic assessment are crucial. To date, there have been no previous systematic reviews or meta-analyses highlighting a link between IgAV and IBD. Therefore, this systematic review is a pivotal endeavor to elucidate the complex relationship between these conditions, shaping future research in this area.}, }
@article {pmid41569498, year = {2026}, author = {Killassy, N and Arbuthnot, P and Maepa, MB}, title = {Structural mimics of SARS-CoV-2.}, journal = {Infection}, volume = {54}, number = {2}, pages = {575-588}, pmid = {41569498}, issn = {1439-0973}, mesh = {Humans ; *SARS-CoV-2/immunology ; *COVID-19/prevention & control/virology ; COVID-19 Vaccines/immunology ; Antiviral Agents/therapeutic use/pharmacology ; Pandemics/prevention & control ; Animals ; Viral Vaccines/immunology ; Spike Glycoprotein, Coronavirus/immunology/chemistry ; }, abstract = {Since its first detection in 2019, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has infected approximately 778 million people and claimed 7.1 million lives globally. A deeper understanding of the biology of SARS-CoV-2 was instrumental in facilitating the development of protective vaccines and new therapeutics, as well as evaluating the impact of drug re-purposing to limit the pandemic. To date, approximately 13.64 billion vaccine doses have been administered; with approximately 67% of the global population having completed their primary series of COVID-19 vaccinations. The FDA has authorised the use of several repurposed drugs to combat the disease and while these developments have been instrumental in curbing the pandemic, the approved therapies have shown poor efficacy in cases of severe disease. Furthermore, several vaccine candidates received FDA approval following clinical trials where they proved to be both safe and efficacious. These vaccines were sanctioned for emergency roll-out to the global population, conferring herd immunity and reducing both infections and related mortalities. However, these vaccines are not without flaws and are limited by short term immune responses and poor efficacy against emerging variants, which has resulted in slip-through infections. Hence, efforts to develop potent drugs and vaccines are continuing. In these efforts, physiologically relevant models of SARS-CoV-2 infection are critical. This review describes available SARS-CoV-2 particle mimics, their contribution to COVID-19 research and the development of new vaccines and therapies.}, }
@article {pmid41569821, year = {2026}, author = {Hesketh, KR and Smith, AD and Amichay, Y and van Sluijs, EMF}, title = {Correlates of Parental Physical Activity: A Quantitative Systematic Review.}, journal = {Journal of physical activity & health}, volume = {23}, number = {5}, pages = {618-638}, doi = {10.1123/jpah.2025-0604}, pmid = {41569821}, issn = {1543-5474}, mesh = {Humans ; *Parents/psychology ; *Exercise ; Child ; Cross-Sectional Studies ; Child, Preschool ; Self Report ; Female ; Adolescent ; Infant ; }, abstract = {BACKGROUND: Despite the benefits of physical activity (PA), evidence suggests around 25% of adults fail to meet PA guidelines, parents, and mothers in particular, and engage in less PA on average than their childless peers. This review sought to determine the correlates of parental PA, stratifying evidence by self-report and device-based measures.
METHODS: Quantitative studies (cross-sectional and longitudinal) investigating associations between correlates and parental PA (ie, parents with children aged 0-18 y) were identified across 4 databases (MEDLINE, EMBASE, PsycINFO and Scopus) up to October 2024. Correlates (assessed in 3 or more studies) and direction of associations were extracted, described, and synthesized narratively according to the socioecological model (individual, interpersonal, organizational, environmental, societal).
RESULTS: Of 4632 studies identified, 269 full texts were assessed and 105 studies included in the review. A total of 117 correlates were identified across all studies (103 for self-report measures, 55 for device-based). 53 correlates were assessed in 3/+ independent associations (n = 51 self-report, n = 14 device, n = 12 both). Consistently, partner PA was positively associated with parent PA regardless of measure used. Child PA, pet ownership, and environmental aesthetics were positively associated with (mothers') PA, whereas car ownership was negatively associated with PA. Only one policy-level factor (COVID-19 restrictions) was assessed, being negatively associated with parental PA.
CONCLUSIONS: Family-based correlates of PA were positively associated with parental PA, suggesting these may support wider family engagement in PA. Evidence from fathers and from low- and middle-income countries is needed to gain a better understanding of parental PA in these groups.}, }
@article {pmid41572466, year = {2026}, author = {Kothandan, SV and Basu, S and Singh, S}, title = {Dry Eye Disease After Ocular or Systemic Infection: A Systematic Review.}, journal = {Eye & contact lens}, volume = {52}, number = {2}, pages = {83-91}, doi = {10.1097/ICL.0000000000001236}, pmid = {41572466}, issn = {1542-233X}, support = {N/A//Hyderabad Eye Research Foundation/ ; }, mesh = {Humans ; *Dry Eye Syndromes/etiology/diagnosis ; *Eye Infections/complications ; COVID-19/complications ; Tears ; }, abstract = {PURPOSE: To study the characteristics of dry eye disease (DED) secondary to ocular or systemic infections.
METHODS: PubMed, Scopus, and Cochrane databases were systematically reviewed for DED development after systemic and ocular infections. The severity of DED symptoms and signs, type of infection, and management outcomes were analyzed.
RESULTS: Of the 28 included studies, eight were related to HIV infection, five had hepatitis C, four to COVID-19, and 11 studies had DED secondary to herpes keratitis, Mycoplasma pneumoniae, viral conjunctivitis, Chlamydia infection, Mycobacterium leprae, and Chikungunya infections. The organisms implicated in conjunctivitis associated with DED were Coxsackie A24virus, Staphylococcus, and Mycoplasma. There were no immunocompromised patients in any of the studies except HIV. Nine studies established DED diagnosis based on symptoms alone, seven on signs alone, and 12 on symptoms and signs (at least abnormal Schirmer or tear break-up time, but not DEWS II criteria). The severity of DED symptoms was usually mild. HIV and hepatitis C showed no difference in tear volume and stability between cases and healthy controls. Advanced stages of hepatitis (stage 4 to stage 6) showed worse tear film parameters than the initial stages. Tear volume and stability were affected in 1/5th of patients post-COVID-19. Absolute tear deficiency (zero Schirmer) was reported in two patients after Epstein-Barr virus and HIV infection that improved with intravenous acyclovir, cyclosporin A, and prednisolone in EBV infection only. Very few studies reported the management of postinfectious DED with artificial tears and had fair outcomes.
CONCLUSION: Bacterial and viral infections can have DED as sequelae, although the infectious agent has not been isolated from the ocular surface in reported studies. DED is usually mild to moderate symptomatically, and tear film parameter levels do not meet DEWS II diagnostic criteria. The nonuniformity in reporting disease duration, tear film changes, and DED symptoms makes it difficult to understand the role of infection in causing DED.}, }
@article {pmid41573202, year = {2025}, author = {Zhang, Y and Chen, Z and Sun, L and Guo, W}, title = {An overview of hypopituitarism's causes.}, journal = {Frontiers in endocrinology}, volume = {16}, number = {}, pages = {1695833}, pmid = {41573202}, issn = {1664-2392}, mesh = {Humans ; *Hypopituitarism/etiology/diagnosis/therapy ; Pituitary Neoplasms/complications ; COVID-19/complications ; Adenoma/complications ; Immunotherapy/adverse effects ; }, abstract = {The widespread application of tumor therapies such as immune checkpoint inhibitors and the emergence of new infectious diseases such as COVID-19 are promoting the continued expansion of the cause spectrum of hypopituitarism, making its scope significantly beyond traditional causes such as pituitary tumors and craniocerebral trauma. Faced with this evolution, a comprehensive and in-depth understanding of its etiology has become a top priority, which has also put forward new requirements for clinical diagnosis and differential diagnosis. This review aims to systematically sort out and deeply explore the etiology and pathogenesis of this disease. The content not only covers traditional factors such as pituitary tumors, radiation injury, and pituitary surgery, but also the latest progress in emerging fields such as immunotherapy, new infections, and autoimmunity. It aims to provide reliable reference for clinicians' diagnosis and treatment practice and lay a theoretical foundation for future research in this field.}, }
@article {pmid41573445, year = {2025}, author = {Verma, M and Maan, HS and Konatam, S and Verma, Y and Kumar, R and Chaurasia, D and Dave, L and Sharma, S}, title = {Geographical and Ecological Drivers of Zoonotic Viral Spillover: A Review of Emerging and Re-emerging Outbreaks.}, journal = {Cureus}, volume = {17}, number = {12}, pages = {e99820}, pmid = {41573445}, issn = {2168-8184}, abstract = {Over the past two decades, outbreaks of zoonotic viruses have become increasingly frequent and severe, posing substantial threats to public health systems and the global economy. The viruses responsible for these outbreaks, such as SARS-CoV, MERS-CoV, Zika, Ebola, Nipah, avian influenza, and, most recently, SARS-CoV-2, typically originate in wildlife, highlighting the complex relationship between ecological systems and human activities. Human-wildlife interactions have markedly increased due to disruptions in environmental and geographic boundaries, primarily driven by urbanization, deforestation, intensified agricultural practices, and climate change. These factors contribute to an environment that facilitates zoonotic transmission spillover. This narrative review summarizes current research on the ecological, geographic, and human factors influencing zoonotic virus transmissions. It emphasizes how these viruses adapt to human hosts and cross species barriers via direct contact, vector-borne transmission, intermediate carriers, and environmental contamination. Moreover, the review discusses how the genomic plasticity of viruses enhances their transmissibility and facilitates adaptation to new hosts, thereby increasing the risk of epidemics and pandemics. The review further underscores the importance of ecological boundaries in mitigating spillover events and advocates for a One Health approach that integrates human, animal, and environmental health. This approach is essential for predicting, detecting, and preventing future outbreaks. In conclusion, the review emphasizes the importance of interdisciplinary research, proactive surveillance, habitat preservation, and policy interventions that address the underlying ecological factors contributing to zoonotic outbreaks. Restoring ecological barriers and implementing sustainable practices to minimize the interaction between wildlife and humans, while bolstering global biosecurity, are essential measures to mitigate the risk of future pandemics.}, }
@article {pmid41573565, year = {2025}, author = {Chiyyeadu, A and Khan, B and Ehrhardt, K and Büning, H and Morgan, M and Schambach, A}, title = {Therapeutic antibody delivery: vector tools to boost efficacy and affordability.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1714390}, pmid = {41573565}, issn = {1664-3224}, mesh = {Humans ; *Genetic Vectors/genetics ; *SARS-CoV-2/immunology ; Animals ; *COVID-19/immunology/therapy ; *Gene Transfer Techniques ; Genetic Therapy/methods ; Dependovirus/genetics ; Lentivirus/genetics ; }, abstract = {Antibody (Ab)-based therapeutics have become powerful tools across diverse disease areas, with advances in bioengineering giving rise to next-generation molecules designed to outperform conventional Abs. Yet, large-scale production and purification of such complex proteins remain costly and can restrict patient access. A promising alternative is to improve in vivo expression capabilities, which will reduce manufacturing burdens and improve safety and tolerability. Multiple gene delivery platforms - ranging from mRNA and viral vectors to engineered cell therapies - have matured considerably, as a direct result of years of clinical experience and growing regulatory confidence. The rapid deployment of mRNA vaccines against SARS-CoV-2, the clinical success of adeno-associated virus (AAV)- and lentiviral-based interventions, and the approval of chimeric antigen receptor (CAR)-T cell therapies highlight the potential of these technologies to transform how we deliver Ab therapeutics. While these approaches hold the promise to treat genetic aberrations in patients, they may also contribute considerably to advancing conventional Ab therapeutics against viral infections and other diseases through local persistence of the proteins. Looking forward, in situ expression may confer even more benefits for engineered Ab-like molecules, thereby compensating for possibly shorter half-lives and overcoming challenges in in vitro production and purification. Therefore, in this review, we critically evaluate how these established and emerging gene therapy platforms can be harnessed to expand access, and discuss possibilities to improve in situ availability through the choice of transient or stable expression systems to increase the efficacy of Abs and other therapeutic proteins. Furthermore, we explore the current landscape of technological advancements, identify key translational challenges, and project future directions for optimizing these approaches towards widely applicable clinical interventions.}, }
@article {pmid41573583, year = {2025}, author = {Liu, S and Zhao, Z and Li, Y and Tan, Y and Tian, H and Xie, F}, title = {When viral infections meet the anti-MDA5 antibody-positive dermatomyositis.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1649489}, pmid = {41573583}, issn = {1664-3224}, mesh = {Humans ; *Interferon-Induced Helicase, IFIH1/immunology ; *Dermatomyositis/immunology ; *Autoantibodies/immunology/blood ; *SARS-CoV-2/immunology ; *Virus Diseases/immunology/complications ; Lung Diseases, Interstitial/immunology ; *COVID-19/immunology/complications ; Animals ; }, abstract = {Anti-melanoma differentiation-related gene 5 (MDA5) antibody-positive dermatomyositis (anti-MDA5[+] DM) is recognized as a distinct subtype of dermatomyositis, characterized by its frequent association with interstitial lung disease (ILD), particularly rapidly progressive ILD (RP-ILD), which is associated with a poor prognosis and high mortality. MDA5 functions as a cytoplasmic sensor for viral double-stranded RNA. The expression level of anti-MDA5 antibodies is positively correlated with disease severity. Notably, anti-MDA5 antibodies have been detected in patients infected with SARS-CoV-2. While the mechanisms underlying the generation of anti-MDA5 antibodies and their pathogenic role remain incompletely understood, accumulating data support the hypothesis that viral infections may trigger the production of these antibodies. This review provides a comprehensive analysis of the interplay between anti-MDA5 antibodies and viral infections in patients with anti-MDA5[+] dermatomyositis (DM), with a focus on the potential mechanisms by which viral infections induce autoantibody formation.}, }
@article {pmid41573792, year = {2025}, author = {Kiggundu, R and Waswa, JP and Mwanja, H and Hope, M and Kambugu, A and Kakooza, F and Byonanebye, DM}, title = {Leveraging disease outbreak news to strengthen the global response to antimicrobial resistance: a call for action.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1710596}, pmid = {41573792}, issn = {2296-2565}, mesh = {Humans ; COVID-19/epidemiology ; *Disease Outbreaks/prevention & control ; *Drug Resistance, Microbial ; *Global Health ; Public Health ; World Health Organization ; }, abstract = {Antimicrobial resistance (AMR) is an escalating global health threat, with low- and middle-income countries (LMICs) bearing the greatest burden as healthcare facilities become breeding grounds for resistant pathogens, leading to increased morbidity, mortality, and straining of already limited resources. The World Health Organization's Disease Outbreak News (DONs) has proven invaluable for early warnings and coordinated responses to infectious disease outbreaks like Ebola and COVID-19, yet AMR events remain largely absent from this system, leading to under-detection, limited global visibility, and ineffective interventions. In this paper, we review the historical evolution of DONs, its supporting frameworks, and the dynamics of AMR outbreaks in LMIC healthcare settings to explore how DONs could be adapted for AMR. We recommend standardizing AMR outbreaks reporting, integrating DONs into response efforts, linking AMR surveillance to DONs workflows, and expanding the definition of Public Health Emergencies of International Concern (PHEIC) to include high-morbidity AMR events, steps that would elevate AMR from a "silent pandemic" to a visible priority.}, }
@article {pmid41576591, year = {2026}, author = {Ali, M and Younis, AB and Duru, CI and Sherchan, SP}, title = {A review of AI/ML approaches in wastewater surveillance advancement.}, journal = {The Science of the total environment}, volume = {1015}, number = {}, pages = {181364}, doi = {10.1016/j.scitotenv.2026.181364}, pmid = {41576591}, issn = {1879-1026}, mesh = {*Artificial Intelligence ; *Wastewater/virology ; *Machine Learning ; Predictive Learning Models ; Random Forest ; *Wastewater-Based Epidemiological Monitoring ; Long Short Term Memory ; COVID-19/epidemiology ; Prediction Algorithms ; *Environmental Monitoring/methods ; Humans ; Data Analytics ; }, abstract = {Wastewater-based epidemiology (WBE) has emerged as a powerful tool for early detection and monitoring of infectious diseases, particularly during pandemics such as COVID-19. This study systematically evaluates the application of artificial intelligence (AI) and machine learning (ML) models in WBE over the past five years, focusing on their effectiveness in pathogen detection and disease trend forecasting. Various supervised, unsupervised, deep learning, and time-series models were compared based on their predictive accuracy, scalability, interpretability, computational demands, and real-time feasibility. Comparative analysis showed that Random Forest (RF) achieved R[2] values of 0.80 and Root Mean Square Error (RMSE) 0.54 for COVID-19 trend forecasting, outperforming linear regression. Support Vector Machines (SVM) improved pathogen classification accuracy by ∼20% compared with traditional analytical techniques. Artificial Neural Networks (ANN) estimated pathogen prevalence with R = 0.81-0.92 and mean squared, while Long Short-Term Memory (LSTM) networks achieved R[2] ≈ 0.81 (test) and 0.94 (train) for multi-community forecasting. Time-series machine learning models (TSML) frameworks consistently produced lower RMSE and Mean Absolute Error (MAE) values than ARIMAX models, confirming their real-time prediction power. Unsupervised models like K-means clustering supported outbreak pattern identification, when labeled data were limited. Additionally, a decision-support framework was proposed to guide model selection based on prediction objectives, data type, and temporal dependencies. The findings emphasize the importance of integrating hybrid modeling approaches and environmental metadata to enhance WBE systems, and they offer a foundation for real-time, adaptive surveillance strategies.}, }
@article {pmid41577338, year = {2026}, author = {Yang, Z and Yan, H and Wang, S and Liu, Y and Luo, Y and Tang, Y and Zhang, T}, title = {Moral injury in nurses during COVID-19: A systematic review and meta-analysis.}, journal = {Nursing ethics}, volume = {33}, number = {3}, pages = {945-962}, doi = {10.1177/09697330251407217}, pmid = {41577338}, issn = {1477-0989}, mesh = {Humans ; *COVID-19/psychology/nursing ; *Nurses/psychology ; *Morals ; SARS-CoV-2 ; }, abstract = {BackgroundThe COVID-19 pandemic has posed unprecedented challenges for nurses, including resource shortages, heavier workloads, and ethical decision-making pressures, putting them at high risk for moral injury. This threatens their physical and mental health, job stability, and the quality of care.AimThe aim was to systematically assess the level of moral injury among nurses during the COVID-19 pandemic.MethodsA comprehensive search was conducted on 12 databases (PubMed, Web of Science, MEDLINE, ProQuest, Embase, CINAHL, Scopus, PsycINFO, CBM, CNKI, VIP, WanFang Data) for cross-sectional studies published up to 20 July 2025, that reported the level of moral injury among nurses using the Moral Injury Symptoms Scale-Health Professionals Version. A systematic review and meta-analysis were conducted. Two researchers independently screened the literature, extracted data, and assessed methodological quality. The pooled mean score was calculated using random-effects or fixed-effects models, with subgroup analysis to explore heterogeneity.Ethical considerationsEthical approval was not required as the review synthesized publicly available data.ResultsThis study included 16 articles, involving 5824 participants. The meta-analysis showed that the pooled mean total MISS-HP score for nurses was 42.12 (95% CI: 40.70-43.53). Among the dimensions, the pooled mean score for Loss of religion/spiritual faith was the highest at 5.68 (95% CI: 4.61-6.74), while the pooled mean score for religious struggles was the lowest at 2.26 (95% CI: 1.13-3.40). Subgroup analysis results indicated significant differences in moral injury levels among nurses based on Survey year and department (p < .001).ConclusionsUnder the context of the COVID-19 pandemic, nurses experienced moderate to high levels of moral injury, particularly during the early stages of the pandemic in 2020, with emergency department nurses being most affected. To support nurses' well-being and mental health, healthcare institutions should strengthen ethical support systems, improve management, and consider the role of religion/spiritual faith in alleviating moral injury.}, }
@article {pmid41577399, year = {2026}, author = {José Álvarez García, F and Iofrío de Arce, A and Álvarez Aldeán, J and Garrote Llanos, E and López Granados, L and Navarro Gómez, ML and Pineda Solas, V and Rivero Calle, I and Ruiz-Contreras, J and Salamanca de la Cueva, I and Serrano Marchuet, P and , }, title = {Vaccination and immunization schedule of the Pediatric Spanish Association: 2026 recommendations.}, journal = {Anales de pediatria}, volume = {104}, number = {1}, pages = {504051}, doi = {10.1016/j.anpede.2025.504051}, pmid = {41577399}, issn = {2341-2879}, mesh = {Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; *Immunization Schedule ; Pediatrics ; Spain ; *Vaccination/standards ; Male ; }, abstract = {The 2026 Vaccination and Immunization Schedule recommended by the Spanish Association of Pediatrics (AEP) for children, adolescents and pregnant women residing in Spain includes the following new features: introduction of routine vaccination against hepatitis A with a single-dose schedule at 12-15 months; universal vaccination against influenza in children from 6 months and adolescents up to 17 years of age; catch-up vaccination and reengagement campaigns added to the routine immunization schedule and a new table featuring the vaccinations recommended for specific chronic diseases or risk conditions. The following recommendations from the 2025 schedule, among others, are maintained: immunization with nirsevimab in infants younger than 6 months, or up to 12 months in the case of preterm infants born before 35 weeks of gestation and up to 24 months in children with risk factors; routine vaccination against meningococcal disease (MenB in infancy [starting at 2 months] and at 12 years, plus booster doses for those vaccinated in childhood with 4CMenB; MenACWY at 4 months, 12 months and 12 years); advancing the second doses of MMR and varicella vaccines to 24 months and the Tdap at 10-12 years; and vaccination against SARS-CoV-2 for children older than 6 months with risk factors. During pregnancy, vaccination with Tdap and against influenza and COVID-19 is indicated. Vaccination against RSV in pregnant women is available, although not funded, as it is not currently approved as a public health strategy.}, }
@article {pmid41577420, year = {2026}, author = {Schuster, AM and Alwan, NA and Callard, F and Chen, EYH and Gilbody, S and Graham, BM and Hatch, SL and Jones, E and Jordan, A and Knapp, M and López-Jaramillo, C and Nakimuli-Mpungu, E and Pathare, S and Ressler, KJ and Wessely, S and White, LA and , and Jones, PB}, title = {The implications of the COVID-19 pandemic for clinical mental health care.}, journal = {The lancet. Psychiatry}, volume = {13}, number = {2}, pages = {140-161}, doi = {10.1016/S2215-0366(25)00247-0}, pmid = {41577420}, issn = {2215-0374}, mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Mental Health Services/organization & administration ; *Mental Disorders/therapy/epidemiology ; SARS-CoV-2 ; Mental Health ; Post-Acute COVID-19 Syndrome ; Pandemics ; }, abstract = {A Position Paper published in The Lancet Psychiatry in 2020 suggested an agenda for research about the effects of the COVID-19 pandemic on mental health, following which an interdisciplinary Lancet Psychiatry standing commission was established in 2022 to examine the emerging evidence and refine recommendations for more research. In this first Series paper from the standing commission, we focus on changes in the delivery of clinical mental health care during the COVID-19 pandemic. The second paper in the Series focuses on public mental health and policy perspectives, and the third will address neuropsychiatric consequences of infection by SARS-CoV-2. Evidence from high-quality longitudinal studies with pre-pandemic baseline data, controlled intervention trials, or systematic reviews took time to accrue. During the early months of the COVID-19 pandemic, symptoms of anxiety and depression became more prevalent, and many mental health services were compromised by pandemic-related factors; however, whether the COVID-19 pandemic accelerated pre-existing long-term trends of increasing incidence of mental health disorders, especially in children and adolescents, is unclear. Little research has been done in low-income and middle-income countries, or regarding post-COVID-19 condition (also known as long COVID), which emerged as a multisystem condition with mental health implications. Vulnerable populations, including socioeconomically disadvantaged and minoritised groups, faced disproportionate mental health impacts and limited access to care during the COVID-19 pandemic, reflecting systemic, pre-pandemic inequalities. Bold implementation of existing evidence-based mental health support for vulnerable communities, ambitious trials of novel interventions, and systematic pooling of rapidly accumulating evidence about best healh care should be priorities in future pandemics.}, }
@article {pmid41577421, year = {2026}, author = {Nakimuli-Mpungu, E and Arango, C and Dandona, R and Ford, T and John, A and Jordan, A and Cherop, R and Kola, L and López-Jaramillo, C and Schuster, AM and Knapp, M and Walbaum, M and Opiepie, K and Musoro, F and White, LA and Martsenkovskyi, D and Michael, BD and O'Connor, R and , and Jones, PB}, title = {Policy and public health implications for mental health after the COVID-19 pandemic.}, journal = {The lancet. Psychiatry}, volume = {13}, number = {2}, pages = {162-174}, doi = {10.1016/S2215-0366(25)00358-X}, pmid = {41577421}, issn = {2215-0374}, mesh = {Humans ; *COVID-19/epidemiology/psychology ; *Public Health ; *Mental Health Services/organization & administration ; *Mental Health ; *Health Policy ; SARS-CoV-2 ; Public Health Infrastructure ; Pandemics ; }, abstract = {The COVID-19 pandemic revealed essential weaknesses in mental health systems and intensified existing inequities, highlighting the need for a comprehensive assessment of policy responses and strategies for future resilience. Guided by four questions relating to system adaptations, approaches to inequities, financing strategies, and evidence gaps, we synthesised evidence from a structured literature search (2020-24), expert consultation, and lived experience. We found that public health systems embedded infodemic management, expanded digital services, and mobilised community workforces, but responses varied in equity and effectiveness. Although gender, age, socioeconomic, and racial disparities worsened during the COVID-19 pandemic, social protection, gender-sensitive policies, school-based services, and culturally adapted interventions showed promise. High-income countries buffered shocks with welfare measures while low-income and middle-income countries faced sharp fiscal constraints. Few studies evaluated cost-effectiveness or equity impacts of psychosocial interventions. Building resilient, equitable mental health systems requires integrated policies spanning communication, digital and community care, gender-responsive and youth-responsive strategies, and sustainable financing, alongside investment in longitudinal and cross-national research.}, }
@article {pmid41577930, year = {2026}, author = {Ochoa-Gutierrez, V and Saiko, G}, title = {Pulse Oximeters: Accuracy and Artifacts.}, journal = {Advances in experimental medicine and biology}, volume = {1498}, number = {}, pages = {277-283}, pmid = {41577930}, issn = {0065-2598}, mesh = {Humans ; *Oximetry/instrumentation/methods/standards ; *Artifacts ; *COVID-19/blood/epidemiology ; SARS-CoV-2 ; Skin Pigmentation ; Calibration ; Oxygen Saturation ; *Oxygen/blood ; Reproducibility of Results ; }, abstract = {Oximetry is used to quantify the presence of oxygen in human blood within soft tissues of the human body. Among multiple implementations of this technology, pulsatile oxygen saturation (SpO2) is a core medical technology and is being rapidly adopted in consumer health. However, despite its long history of clinical use, recent findings indicate that the accuracy of pulse oximetry may be affected by various factors and biases. For example, the COVID-19 pandemic showed that pulse oximeters exhibited flaws in accuracy due to the skin pigmentation of patients with darker skin. Thus, the future of this technology, particularly in consumer health devices, needs to be built on foundations that account for such biases. This chapter reviews the principles of pulse oximetry, sources of its artifacts, calibration methods, and the factors that may cause inaccuracy in pulse oximeters, particularly pertinent to two-wavelength pulse oximetry. Drawing upon recent research and clinical insights, we review the multifaceted nature of pulse oximetry biases, including motion artifacts, skin pigmentation, body mass index, environmental variables, device calibration, and nail polish, among others.}, }
@article {pmid41578296, year = {2026}, author = {Rubini, E and Trentin, M and Maffi, P and Aammar, B and Gaievskyi, S and Bahattab, A and Lamine, H and Kordi-Kaiser, M and Staub, K and Ragazzoni, L}, title = {Challenges in healthcare facilities' response to past outbreaks: a systematic review of reviews.}, journal = {BMC health services research}, volume = {26}, number = {1}, pages = {141}, pmid = {41578296}, issn = {1472-6963}, support = {101168124//HORIZON EUROPE Framework Programme/ ; }, mesh = {Humans ; *Disease Outbreaks/prevention & control ; COVID-19/epidemiology ; Europe/epidemiology ; *Health Facilities ; Pandemic Preparedness ; Pandemics ; SARS-CoV-2 ; Surge Capacity ; }, abstract = {INTRODUCTION: The frequency of infectious diseases outbreaks is increasing, but these challenges are not always thoroughly investigated. To date, no systematic reviews of reviews have comprehensively mapped the challenges and gaps faced during past epidemics and pandemics in Europe at healthcare facility level. This systematic review of reviews aims at filling this gap and at contributing to documenting the challenges and informing policy recommendations. METHODS : This review was conducted within the Horizon Europe project PREPSHIELD. The search was conducted in October 2024 on PubMed, Scopus, and Web of Science. Reviews published in English between the years 2009–2024, reporting data on COVID-19, H1N1, influenza or seasonal flu, measles, or Mpox, and documenting gaps or challenges in the response to these outbreaks at healthcare facility level were included. RESULTS : A total of 21 reviews were included: they were systematic, scoping, narrative, rapid, or integrative. The studies included in the reviews were mostly conducted in the United Kingdom, Italy, Spain, and France. The studies included different levels of healthcare facilities, namely hospitals, primary healthcare, and prehospital settings. Findings were classified according to the 4S surge capacity framework and were related to staff (n = 18), stuff (n = 14), space (n = 7), and system (n = 18). The most reported challenges in the included reviews were increased workload, mental health, and task shifting or redeployment, resource shortages, intensive care unit/emergency department space limitations and repurposing, and telemedicine challenges. CONCLUSION : Key issues described highlight the need for training, peer-to-peer support mechanisms, and improved inter-institutional collaboration. Technology was described as both an opportunity and a challenge in pandemic response if not adequately supported by health staff training. A whole-of-society strategy, combining all-hazards and hazard-specific approaches, and moving beyond crisis mode, can strengthen future outbreak preparedness and response.}, }
@article {pmid41578455, year = {2026}, author = {Ghoshal, UC and Singh, R and Goenka, MK}, title = {Post-Coronavirus Disease (COVID)-19 Irritable Bowel Syndrome: What We've Learned So Far.}, journal = {Neurogastroenterology and motility}, volume = {38}, number = {1}, pages = {e70250}, doi = {10.1111/nmo.70250}, pmid = {41578455}, issn = {1365-2982}, mesh = {Humans ; *Irritable Bowel Syndrome/epidemiology/physiopathology/etiology ; *COVID-19/complications ; SARS-CoV-2 ; Pandemics ; Post-Infectious Disorders ; Post-Acute COVID-19 Syndrome ; }, abstract = {BACKGROUND: The COVID-19 pandemic has unveiled a hidden epidemic of disorders of gut-brain interaction (DGBIs), notably post-infection irritable bowel syndrome (PI-IBS), driven by SARS-CoV-2 GI tropism and pandemic stressors.
PURPOSE: This review synthesizes and critically appraises current evidence on the prevalence, clinical spectrum, and predictors of post-COVID-19 IBS, integrating mechanistic insights. Topics discussed in this review will advance understanding of pathophysiological mechanisms, identify therapeutic targets, inform phenotype-tailored management and clinical care, and outline research priorities for post-COVID-19 IBS.
METHODS: A narrative review was performed by the authors.
KEY RESULTS: Recent evidence indicates that approximately 7.2% of individuals develop IBS after SARS-CoV-2 infection, with 2.6-fold higher odds vs. non-infected controls. At the population level, a nationally representative U.S. survey (> 160,000 adults) showed a pandemic-era surge in IBS prevalence (predominantly IBS-M) and a modest increase in chronic idiopathic constipation (CIC), while other Rome IV DGBIs remained stable. Mechanisms are multifactorial, involving ACE2-linked epithelial/neuromuscular effects, persistent low-grade inflammation, microbiota dysbiosis with reduced short-chain fatty acids, altered serotonin signaling, barrier dysfunction, and psychosocial stress acting along the gut-brain axis. Emerging data indicate dyspnea and depression further mediate the COVID-19-to-IBS pathway, underscoring biopsychosocial endotypes.
CONCLUSIONS AND INFERENCES: This review indicates that following infection with SARS-CoV-2, DGBI, particularly IBS, occurs in 7.2% patients on follow-up. Clinically, a positive diagnosis framework and phenotype-tailored, multidisciplinary care are recommended. Future studies on post-infection IBS including post-COVID-19 IBS should be undertaken using upcoming Rome V criteria, controlling for confounding factors, and defining mechanistic endotypes to unlock precision therapies.}, }
@article {pmid41579008, year = {2026}, author = {Vera-Cáceres, CH and García-Huguet, M and Gil de Genover, A and Sagula, SD and Martín Muñóz, L and López Domínguez, D}, title = {Dysautonomia after COVID-19 infection: A case report.}, journal = {Neurologia}, volume = {41}, number = {1}, pages = {101891}, doi = {10.1016/j.nrleng.2025.101891}, pmid = {41579008}, issn = {2173-5808}, mesh = {Humans ; COVID-19/complications ; Female ; Middle Aged ; *Primary Dysautonomias/etiology ; SARS-CoV-2 ; *Guillain-Barre Syndrome/complications/etiology/diagnosis ; Pandemics ; *Coronavirus Infections/complications ; *Pneumonia, Viral/complications ; Magnetic Resonance Imaging ; *Betacoronavirus ; Posterior Leukoencephalopathy Syndrome/etiology/diagnostic imaging ; Tomography, X-Ray Computed ; Inappropriate ADH Syndrome/etiology ; }, abstract = {INTRODUCTION: This case report discusses a case of a patient who experienced acute autonomic dysfunction during the parainfectious phase of COVID-19, attributed to Guillain-Barre Syndrome (GBS). This is the first well-documented case of such an association.
CASE PRESENTATION: A 64-year-old woman, previously infected with COVID-19, was admitted to the emergency department due to altered mental status. Brain computed tomography (CT) revealed bilateral occipital diffuse hypodensity. Throughout her hospitalization, she exhibited elevated blood pressure necessitating intravenous treatment. The initial brain MRI revealed T2-weighted image hyperintensity at the parietal and occipital levels, indicative of vasogenic edema. These neuroimaging findings were suggestive of posterior reversible encephalopathy syndrome (PRES). Euvolemic hyponatremia with concurrent low serum osmolality and high urine osmolality and sodium was observed, indicating a syndrome of inappropriate antidiuretic hormone (SIADH). Throughout the patient's stay, her level of consciousness exhibited significant improvement. However, she developed ascending symmetrical limb weakness and progressive loss of reflexes, along with a severe motor deficit and gait disturbance, accompanied by arterial blood pressure fluctuations and other signs of autonomic dysfunction. Clinical manifestations, neurophysiological findings, and laboratory results were indicative of Guillain-Barre Syndrome (GBS), leading to a conclusive diagnosis of GBS with dysautonomia triggered by a COVID-19 infection.
CONCLUSION: This case reveals the relevance of diagnosing autonomic dysfunction (including PRES) as the initial manifestation of GBS linked to COVID-19 infection and the importance of early diagnosis to prevent potential complications.}, }
@article {pmid41579048, year = {2026}, author = {Chao, CM and Liu, JW and Tang, HJ and Lai, CC}, title = {The escalating threat of multidrug-resistant organisms: COVID-19 impact, global burden, and the Taiwanese experience.}, journal = {Expert review of anti-infective therapy}, volume = {24}, number = {1}, pages = {63-73}, doi = {10.1080/14787210.2026.2623135}, pmid = {41579048}, issn = {1744-8336}, mesh = {Humans ; Taiwan/epidemiology ; *COVID-19/epidemiology ; *Anti-Bacterial Agents/therapeutic use ; Pandemics ; *Drug Resistance, Multiple, Bacterial ; SARS-CoV-2 ; Cross Infection/epidemiology/drug therapy/microbiology ; Global Health ; Antimicrobial Stewardship ; Infection Control/methods ; *Coronavirus Infections/epidemiology ; }, abstract = {INTRODUCTION: The COVID-19 pandemic has intensified global health challenges, including a silent but escalating crisis: multidrug-resistant organisms (MDROs). As healthcare systems strained under viral outbreaks, infection control and antimicrobial stewardship efforts suffered, accelerating the spread of antimicrobial resistance (AMR).
AREAS COVERED: This review examines the indirect effects of the COVID-19 pandemic on AMR, emphasizing changes in antibiotic utilization, healthcare-associated infections, and resistance trends. Global and regional epidemiological data are presented, with a special focus on Taiwan's evolving MDROs landscape, clinical burden, and strategic responses.
EXPERT OPINION: COVID-19 has both exposed and intensified vulnerabilities in AMR control. While the pandemic fostered certain infection control practices, it also disrupted antimicrobial oversight, leading to surges in MDROs prevalence. Taiwan's experience underscores the value of coordinated guidelines, real-time diagnostics, and artificial intelligence-driven stewardship. Rebuilding and future-proofing AMR responses requires integrated global policies, sustained surveillance, and innovation in diagnostics and therapeutics. Unless comprehensive action is taken, MDROs may emerge as the defining post-pandemic threat to modern medicine.}, }
@article {pmid41580734, year = {2026}, author = {Fang, H and Wang, Q}, title = {The silent epidemic within the pandemic: pathophysiology and prediction of post-COVID-19 diabetes.}, journal = {Journal of translational medicine}, volume = {24}, number = {1}, pages = {266}, pmid = {41580734}, issn = {1479-5876}, mesh = {Humans ; *COVID-19/complications/epidemiology ; SARS-CoV-2 ; Pandemics ; *Diabetes Mellitus/epidemiology/physiopathology/etiology ; *Diabetes Mellitus, Type 2/epidemiology/physiopathology ; *Coronavirus Infections/epidemiology/complications ; Post-Acute COVID-19 Syndrome ; *Pneumonia, Viral/epidemiology/complications ; Risk Factors ; Betacoronavirus ; Biomarkers/metabolism ; }, abstract = {BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has presented extraordinary challenges to global public health, with impacts reaching beyond acute respiratory manifestations to include long-term metabolic disturbances. Emerging evidence indicates a significant link between SARS-CoV-2 infection and the onset of diabetes mellitus, establishing this condition as a major element of the post-acute sequelae of COVID-19, often referred to as Long COVID. MAIN BODY: This review synthesizes epidemiological findings that demonstrate a elevated incidence of new-onset diabetes following COVID-19, particularly among certain high-risk demographic groups. We examine the molecular mechanisms underpinning this association, such as viral entry into pancreatic β-cells via ACE2 receptors, systemic inflammation leading to insulin resistance, and the potential diabetogenic effects of glucocorticoids used in COVID-19 treatment. Furthermore, this review outlines biomarker profiles that distinguish COVID-19-associated diabetes from traditional type 2 diabetes, underscoring important pathophysiological differences. Additionally, we evaluate advances and ongoing challenges in developing predictive risk models that combine clinical and molecular data to identify individuals at elevated risk for post-COVID diabetes. CONCLUSIONS: By integrating multidisciplinary evidence, this comprehensive narrative review aims to guide future research and shape clinical approaches for early detection, prevention, and management of diabetes following COVID-19, thereby confronting a latent health crisis emerging within the broader pandemic context.}, }
@article {pmid41581920, year = {2026}, author = {Morimoto, Y and Higashi, H and Izumi, H and Tomonaga, T and Nishida, C and Yamato, H and Eguchi, H and Kawanami, S and Suzuki, K and Yatera, K and Nakata, A}, title = {[Factors that contribute to the death/severity and onset of COVID-19 infection in working generation: Investigation of general health examination items by narrative review].}, journal = {Sangyo eiseigaku zasshi = Journal of occupational health}, volume = {68}, number = {2}, pages = {39-54}, doi = {10.1539/sangyoeisei.2025-023-A}, pmid = {41581920}, issn = {1349-533X}, mesh = {Humans ; *COVID-19/mortality/epidemiology ; *Pandemics/prevention & control ; Risk Factors ; SARS-CoV-2 ; *Occupational Health ; Japan/epidemiology ; *Workplace ; Working Conditions ; Sex Factors ; *Pneumonia, Viral/mortality/prevention & control/epidemiology ; Smoking/adverse effects ; *Coronavirus Infections/mortality/epidemiology/prevention & control ; Alcohol Drinking/adverse effects ; Severity of Illness Index ; Obesity ; }, abstract = {The coronavirus disease 2019 (COVID-19) pandemic that affected Japan remains vivid in our collective memory. Currently classified as a Category 5 virus (for which medical institutions and individuals primarily implement preventive measures independently, without significant administrative intervention such as isolation), COVID-19 infections continue to peak biannually, currently driven by the Nimbus variant, a derivative of the Omicron strain. This situation necessitates ongoing vigilance in infection prevention efforts. While it is well-established that environmental factors, such as proper ventilation, are crucial in mitigating the risk of COVID-19 transmission, it has become evident that variations in individual susceptibility exist; some individuals contract the virus while others do not, even in identical environments. Personal factors, including pre-existing medical conditions, influence this disparity. This narrative review examines personal factors related to general health assessments within the workplace, incorporating data from systematic reviews and meta-analyses, as well as insights from both international and domestic academic societies. Although the strength of evidence varies, factors such as male gender, smoking, alcohol consumption, obesity, inadequate sleep, insufficient physical activity, hypertension, hyperlipidemia, diabetes, and chronic obstructive pulmonary disease have been identified as contributors to the severity and onset of COVID-19, as well as its associated mortality.}, }
@article {pmid41581933, year = {2026}, author = {Malemnganba, T and Baghel, K and Mehrotra, S and Prajapati, VK}, title = {Unlocking the power of antimicrobial peptides to combat infectious agents.}, journal = {Advances in protein chemistry and structural biology}, volume = {149}, number = {}, pages = {203-244}, doi = {10.1016/bs.apcsb.2024.11.013}, pmid = {41581933}, issn = {1876-1631}, mesh = {Humans ; *Antimicrobial Peptides/pharmacology/therapeutic use/chemistry ; Animals ; *Anti-Infective Agents/pharmacology/therapeutic use ; Bacteria/drug effects ; SARS-CoV-2/drug effects ; COVID-19 Drug Treatment ; }, abstract = {The rapid rise of antibiotic-resistant bacteria has become a major clinical challenge, creating an urgent need for alternative therapeutic strategies. Antimicrobial peptides (AMPs) have emerged as promising candidates in the fight against these resistant pathogens. Naturally produced by a wide variety of organisms, AMPs are a crucial part of the innate immune system, offering a broad-spectrum antimicrobial effect against bacteria, fungi, viruses, and parasites. Unlike traditional antibiotics, AMPs primarily target microbial membranes, which reduces the likelihood of resistance development. Beyond their pathogen-destroying properties, AMPs enhance immune responses, aid in wound healing, and exhibit anticancer properties. Their ability to act swiftly and in synergy with the host immune system offers a distinct advantage over conventional antibiotics. Furthermore, AMPs hold the potential to be developed into novel treatments for infections that have become resistant to all available therapies. However, bacterial resistance mechanisms to AMPs-such as membrane modifications, protease production, and biofilm formation-underscore the complex interactions between hosts and pathogens. Despite these challenges, AMPs present an exciting avenue across multiple sectors, including medicine, agriculture, and food safety. Recent research also highlights their potential in treating viral infections, including COVID-19, showcasing their versatile applications. This chapter discusses the role of AMPs in addressing antibiotic resistance, their mechanisms of action, and their diverse therapeutic applications beyond bacterial infections.}, }
@article {pmid41583170, year = {2025}, author = {Hassan Awaji, HH and Sahli, RN and Albalwi, FB and Albalawi, WS and Muhawish, TA and Albalawi, HM and Alsubiti, AK and Alanazi, JS and Hamdi, A and Alshehri, N and Qarni, FS and Abu Salem, N and Albalawi, FN}, title = {The Impact of Bacillus Calmette-Guérin (BCG) Revaccination on COVID-19 Infection Among Healthcare Workers: A Systematic Review and Meta-Analysis.}, journal = {Cureus}, volume = {17}, number = {12}, pages = {e99986}, pmid = {41583170}, issn = {2168-8184}, abstract = {The Bacillus Calmette-Guérin (BCG) vaccine has been hypothesized to confer nonspecific immune protection against viral infections, including coronavirus disease 2019 (COVID-19). This meta-analysis evaluates the protective role of BCG vaccination in preventing COVID-19 among healthcare workers (HCWs). A systematic review and meta-analysis were conducted of randomized controlled trials (RCTs) that reported the effect of BCG vaccination for COVID-19 prevention in HCWs compared with placebo. Nine RCTs were included, with a total of 10,295 HCWs. Pooled odds ratios (ORs) and mean differences (MDs) were calculated using random- and fixed-effects models to assess the impact on symptomatic COVID-19, severe disease, hospitalization, seropositivity, duration of illness, and serious adverse events. Heterogeneity was evaluated using I[2] statistics. BCG vaccination did not significantly reduce the risk of symptomatic COVID-19 (OR = 1.05, 95% CI: 0.94-1.17, p = 0.43, I[2] = 47%), severe COVID-19 (OR = 1.20, 95% CI: 0.97-1.48, p = 0.09, I[2] = 0%), or hospitalization (OR = 1.04, 95% CI: 0.71-1.50, p = 0.86, I[2] = 0%). There was no significant difference in the duration of symptomatic illness (MD = 0.09 days, 95% CI: -1.41-1.59, p = 0.90, I[2] = 80%) or in rates of COVID-19 seropositivity (OR = 1.27, 95% CI: 0.81-1.98, p = 0.30, I[2] = 76%). The incidence of serious adverse events was not significantly different between groups (OR = 1.43, 95% CI: 0.34-5.97, p = 0.62, I[2] = 81%). This meta-analysis found no significant protective effect of BCG vaccination against any clinical or serological endpoint of COVID-19 in HCWs. The results do not support the use of BCG as a preventive measure against COVID-19 in this population.}, }
@article {pmid41583464, year = {2025}, author = {Grunst, MW and Li, W and Mothes, W}, title = {Viral glycoprotein-mediated entry and antibody-mediated immunity in HIV-1 and SARS-CoV-2 infection.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1733684}, pmid = {41583464}, issn = {1664-3224}, support = {T32 AI055403/AI/NIAID NIH HHS/United States ; R01 AI194920/AI/NIAID NIH HHS/United States ; F31 AI176650/AI/NIAID NIH HHS/United States ; R01 AI163395/AI/NIAID NIH HHS/United States ; R37 AI150560/AI/NIAID NIH HHS/United States ; }, mesh = {Humans ; *Virus Internalization ; *SARS-CoV-2/immunology/physiology ; *HIV-1/immunology/physiology ; *COVID-19/immunology/virology ; *HIV Infections/immunology/virology ; Antibodies, Neutralizing/immunology ; *Antibodies, Viral/immunology ; Animals ; *Viral Fusion Proteins/immunology ; }, abstract = {Enveloped viruses such as Human Immunodeficiency Virus (HIV-1) and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) have caused some of the deadliest pandemics in human history. These viruses utilize Class 1 viral fusion glycoproteins to bind their host receptor and subsequently fuse the virus and host cell membranes to mediate entry. Viral fusion glycoproteins are prominent antigens on the surface of virions and are essential for the virus life cycle. Therefore, they are a primary target for the humoral immune system and the basis for the design of vaccines. Antibodies which target viral fusion glycoproteins can neutralize viral infectivity and activate the immune system in several distinct ways. In this review, we compare mechanisms of how class 1 viral fusion glycoproteins mediate viral entry and cover diverse ways in which antibodies targeting these glycoproteins can neutralize viruses and activate the immune system to clear virus-infected cells.}, }
@article {pmid41584182, year = {2025}, author = {Efremova, MI and Cho, Y and Miglietta, E and Pinto da Costa, M}, title = {Burnout scales used in healthcare workers during the COVID-19 pandemic and their psychometric properties: a systematic review.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1661548}, pmid = {41584182}, issn = {2296-2565}, mesh = {Humans ; *Psychometrics ; *COVID-19/psychology/epidemiology ; *Burnout, Professional/diagnosis/psychology ; *Health Personnel/psychology ; Pandemics ; Reproducibility of Results ; Surveys and Questionnaires ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Burnout has been assessed by a variety of screening instruments worldwide. This systematic review investigated the characteristics and psychometric properties of these scales used during the COVID-19 pandemic to assess burnout among healthcare workers.
METHODS: A systematic literature search and review was conducted based on four operational criteria: burnout scales, healthcare workers, psychometric properties, and COVID-19. We retrieved records from APA PsycInfo, APA PsycArticles, MEDLINE, Academic Search Complete, and EMBASE. All peer reviewed articles that assessed burnout in healthcare workers during COVID-19 were included.
RESULTS: A total of 794 articles met the inclusion criteria, and 27 burnout scales were identified, two of which were developed during the pandemic. The scales varied in number of items, subscales, response options, language, and country of development. At least one psychometric property was reported for 19 of the 27 scales, and 15 scales demonstrated desirable internal consistency in this novel context. For validity, 9 out of 27 scales reported at least one psychometric property. This was predominantly for measures on structural validity.
CONCLUSION: Although a wide range of scales were used to assess burnout in healthcare workers during COVID-19, the psychometric properties reported were predominantly on reliability rather than validity. The findings of this review can be used to guide appropriate instrument selection for burnout in crisis contexts such as the COVID-19 pandemic.
PROSPERO registration database: CRD42023414070.}, }
@article {pmid41584279, year = {2025}, author = {Wang, C and Fan, Y and Li, C and Chang, B and Wang, J and Cao, X and Liang, G and Liang, Y and Sun, K}, title = {The prevalence of orthostatic intolerance, postural orthostatic tachycardia syndrome and orthostatic hypotension in post-acute sequelae of COVID-19.}, journal = {Frontiers in cardiovascular medicine}, volume = {12}, number = {}, pages = {1679252}, pmid = {41584279}, issn = {2297-055X}, abstract = {BACKGROUND: The COVID-19 pandemic has resulted in over 776 million confirmed cases worldwide, with post-acute sequelae of COVID-19 now recognized as a significant public health concern. Autonomic dysfunction-including orthostatic intolerance (OI), postural orthostatic tachycardia syndrome (POTS), and orthostatic hypotension (OH)-constitutes a major complication of post-acute sequelae of COVID-19. However, reliable epidemiological estimates remain scarce. As a result, we aim to provide the first global prevalence estimates of autonomic dysfunction in post-acute sequelae of COVID-19.
METHODS: This systematic review and meta-analysis adhered to PRISMA 2020 guidelines, including 21 observational studies. Random-effects models were utilized to estimate pooled prevalence, and sensitivity and meta-regression analyses were conducted to explore heterogeneity. GRADE assessments evaluated evidence certainty.
RESULTS: The pooled prevalence estimates demonstrated 70.6% for OI, 36.2% for POTS, and 18.6% for OH. Advancing age exhibited a significant negative association with POTS and OH. In contrast, prolonged post-acute sequelae of COVID-19 duration and female sex showed no significant association with the incidence rates of these conditions. Subgroup analyses indicated higher POTS and OH incidence in mild vs. moderate or severe COVID-19 cases. Publication bias was minimal for OH but evident for POTS.
CONCLUSION: This study provides the first global prevalence estimates of autonomic dysfunction in post-acute sequelae of COVID-19, highlighting its disproportionate burden among younger populations and non-linear temporal trends. The findings advance epidemiological understanding and inform evidence-based public health strategies to address post-COVID complications.
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=556546, PROSPERO CRD42024556546.}, }
@article {pmid41584416, year = {2025}, author = {Soica, IL and Kupeli, N and Eyitayo-Olonade, K and Davies, N}, title = {A Systematic Review of Advance Care Planning with People Living with Dementia: Learnings from the Covid-19 Pandemic.}, journal = {Current health sciences journal}, volume = {51}, number = {3}, pages = {299-310}, pmid = {41584416}, issn = {2067-0656}, abstract = {This study focused on exploring the experiences of people with dementia (PD) with advance care planning (ACP) during the pandemic. We analyzed the barriers and facilitators to implementing ACP and made recommendations for research, practice and policy. Regarding the design, the review followed Joanna Briggs Institute (JBI) guidelines. The protocol was registered on PROSPERO. Three databases (CINAHL, PUBMED, Embase) were searched, and records from 2019-2023 were screened against eligibility criteria. The experiences of PD in various international settings, including care homes, community hospitals, tertiary health settings and research facilities were explored. More precisely, we followed PD and their carers who engaged with ACP tools during the pandemic, while applying qualitative and quantitative measurements. The results were based on nine studies that were included. Themes related to timing of ACP, methods used to conduct ACP during the pandemic and the topics discussed. The pandemic prompted discussions about goals of care and PD found digital interventions to be a viable alternative to in-person ACP. Barriers to this included accessibility issues, difficulty with using technology, and lack of electronic means. In conclusion, digital ACP interventions are a viable method of delivering ACP, but they should be adapted and used alongside in-person consultations.}, }
@article {pmid41585255, year = {2025}, author = {Wang, Y and Liu, X and Cui, W and Hu, Y and Song, W and Zhu, L and Wang, Z and Ji, X and Wang, Y}, title = {Visualization of childhood allergic diseases based on VOSviewer and CiteSpace.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1615154}, pmid = {41585255}, issn = {2296-858X}, abstract = {INTRODUCTION: Childhood allergic diseases, such as eczema, allergic rhinitis, bronchial asthma, and cough-variant asthma, are a growing health concern around the world. There is a lot of research about these diseases, but a clear and complete study is still needed to better understand them and help guide future research.
METHODS: This study used a bibliometric analysis of research on childhood allergic diseases from 2014 to 2024. The main goal was to find patterns in publications, main researchers, research focuses, teamwork between groups, and new topics. Data were collected from Web of Science, Scopus, and PubMed. The study included English-language articles and reviews only. The tools VOSviewer and CiteSpace were used to study publication patterns, where research was done, which authors and journals worked together, how often papers were cited together, which papers were cited the most, and how keywords appeared and formed groups.
RESULTS: The amount of research was different for each disease. Eczema got the most attention and kept growing. Cough-variant asthma had fewer studies. The United States and China were the main countries that did most of the work and had well-known authors. The focus of studies changed from general studies about disease spread to more detailed topics like the microbiome, genetics, special treatments, environmental causes, other health problems that happen together, and the effects of COVID-19. The way researchers worked together was not the same for all diseases. This showed that research was more developed and better connected for some diseases and less developed for others, mainly for cough-variant asthma.
CONCLUSION: This study gives a short look at recent research on childhood allergic diseases. It shows that eczema research is growing fast, but cough-variant asthma is still studied much less, with only 110 papers in 10 years. This big difference shows a clear lack of knowledge. These results can help make better research plans and improve medical care in this field.}, }
@article {pmid41585361, year = {2025}, author = {Wakai, TN and Yensii, NG and Kernyuy, FB and Bella-Omunagbe, M and Chinedu, SN and Afolabi, IS}, title = {Global research landscape of telomere biology in infectious diseases: mechanistic links between host-pathogen interactions and immune ageing.}, journal = {Frontiers in aging}, volume = {6}, number = {}, pages = {1729868}, pmid = {41585361}, issn = {2673-6217}, abstract = {Telomeres, nucleoprotein structures located at the ends of chromosomes, maintain genomic stability and regulate cellular lifespan, particularly in immune cells. Telomere shortening, driven by cell division and limited telomerase activity, accelerates immune ageing and increases susceptibility to infectious diseases. Chronic infections like HIV and tuberculosis exacerbate telomere attrition through sustained immune activation and oxidative stress. This study presents a bibliometric review of research on telomere length and infectious diseases from 2005 to 2025. Data from the Web of Science Core Collection were analysed using VOSviewer and CiteSpace, software tools for visualising co-authorship, citation, and keyword networks, to assess publication trends, collaborations, and themes. A total of 123 publications were identified, showing steady growth with a 60% increase in publications from 2020 to 2022 during the COVID-19 pandemic. Leading journals included Frontiers in Immunology, PLoS ONE, and Scientific Reports. The United States produced the largest share of publications, followed by Canada and Spain, with notable contributions from the University of British Columbia and Université de Montréal. Influential authors such as Côté HCF, Pick N, and Maan EJ have advanced research, particularly in the areas of HIV and tuberculosis. Keyword analysis highlighted two dominant themes: immune ageing and infection-related stress. Malaria research was comparatively scarce, underscoring a gap for future investigation. These findings inform future research on telomere-targeted interventions and epidemiological studies aimed at enhancing infectious disease management. This review provides a comprehensive overview of the field's progress and identifies key areas for future investigation.}, }
@article {pmid41585373, year = {2025}, author = {Koyou, HL and Ramachandran, V and Salleh, MN and Wan Sulaiman, WA and Mohamed, MH and Mohd Badrin, MJQ and Jelemie, CS}, title = {S100 Protein and Interleukin Biomarkers Among COVID-19 Subjects With and Without Pneumonia: A Systematic Review and Meta-Analysis.}, journal = {British journal of biomedical science}, volume = {82}, number = {}, pages = {15355}, pmid = {41585373}, issn = {2474-0896}, mesh = {Humans ; *COVID-19/blood ; Biomarkers/blood ; *S100 Proteins/blood ; SARS-CoV-2 ; *Interleukins/blood ; Interleukin-10/blood ; Severity of Illness Index ; Interleukin-6/blood ; }, abstract = {BACKGROUND: The global spread of COVID-19, caused by SARS-CoV-2, has resulted in a wide spectrum of clinical manifestations, ranging from asymptomatic cases to severe complications, such as pneumonia, acute respiratory distress syndrome (ARDS), and multiple organ failure. Identifying effective biomarkers is essential for predicting disease severity and improving patient management.
OBJECTIVES: This meta-analysis aims to assess the significance of S100 proteins (S100A4, S100A8, S100A9, S100A12, S100B, S100P) and interleukins (IL) (IL-6, IL-8, IL-10, IL-17, IL-1β) in COVID-19 patients, comparing those with and without pneumonia or organ failure.
METHODS: A systematic literature search was conducted on different databases, yielding 47 relevant studies published between 2020 and 2024. Data on the prevalence of IL and S100 protein levels were extracted and analyzed using pooled standardized mean differences (SMD) and heterogeneity (I[2]) to evaluate their associations with disease severity.
RESULTS: IL-6 and IL-10 levels were significantly elevated in COVID-19 patients suffering from pneumonia or organ failure. IL-6 levels were notably higher in pneumonia patients compared to those without (SMD = 0.34 [95% CI: 0.17, 0.52], I[2] = 29%). Similarly, elevated S100B levels were observed in severe cases (SMD = 0.51 [95% CI: 0.19, 0.83], I[2] = 0%). While IL-10 levels showed high variability (I[2] = 90%), they remained consistently linked with worse outcomes.
CONCLUSION: This meta-analysis underscores the potential of IL-6, IL-10, and S100 proteins as important biomarkers in evaluating COVID-19 severity, offering valuable insights to help clinical management.}, }
@article {pmid41586005, year = {2025}, author = {Martín-Rodríguez, A and González-Prieto, N}, title = {Influence of physical activity on perceived stress and mental health in university students: a systematic review.}, journal = {Frontiers in sports and active living}, volume = {7}, number = {}, pages = {1710832}, pmid = {41586005}, issn = {2624-9367}, abstract = {University students are a population particularly vulnerable to stress, anxiety, and reduced wellbeing. Physical activity has been proposed as a protective factor, but existing findings are heterogeneous. This systematic review examined the relationship between physical activity and mental health in university students, focusing on perceived stress, anxiety, depression, and psychological wellbeing. It was conducted in accordance with PRISMA guidelines, and the study protocol was registered in PROSPERO (CRD420251179614). A total of 38 studies published between 2020 and 2025 were analyzed, involving more than 20,000 participants from various countries. Most studies were cross-sectional, although some longitudinal and quasi-experimental studies were also included. The results showed a consistent association between higher levels of physical activity and lower levels of stress, depression, and anxiety, as well as an increase in subjective wellbeing. In addition, mediators such as sleep quality and resilience, and moderators such as gender or internet use, were identified. The effects were more significant when physical activity was combined with other healthy habits such as good sleep and low sedentary behavior. Although most of the studies were not experimental, the evidence suggested a possible beneficial causal effect of exercise. The need for comprehensive interventions in universities was highlighted, promoting physical activity as a preventive and therapeutic strategy to improve the mental health of students. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251179614, PROSPERO, CRD420251179614.}, }
@article {pmid41586257, year = {2025}, author = {Heendeniya, SN and Chen, S and Bhatti, S and Zahra, QUA and Rahimizadeh, K and Poudel, BH and Wilton, SD and Veedu, RN}, title = {Beginning of a new era of synthetic messenger RNA therapeutics: Comprehensive insights on mRNA drug design, development and applications.}, journal = {Experimental biology and medicine (Maywood, N.J.)}, volume = {250}, number = {}, pages = {10784}, pmid = {41586257}, issn = {1535-3699}, mesh = {Humans ; *RNA, Messenger/therapeutic use/genetics ; *Drug Design ; *COVID-19 Vaccines/genetics/immunology/therapeutic use ; *SARS-CoV-2/genetics/immunology ; COVID-19/genetics/immunology ; Animals ; }, abstract = {Messenger RNA (mRNA) therapeutics have significantly transformed contemporary medicine, particularly through their role as the active component in the SARS-CoV-2 vaccine. This remarkable achievement is the culmination of extensive research conducted over many years by scientists. The widespread administration of the COVID-19 vaccine has further accelerated research into the precise therapeutic potential of mRNA technologies. Since mRNA doesn't integrate with the host genome, the safety and versatility of mRNA-based therapeutics make them an iconic candidate in targeted therapies. Due to a surge in innovation efforts, biomodification of the molecular signatures of mRNAs like the 5'cap, untranslated regions (UTRs), and the poly(A) tail are being developed to increase translation efficacy. Recent advancements in chemical modifications, codon optimization techniques, and targeted delivery methods have significantly enhanced the stability of synthetic mRNAs while concurrently reducing their immunogenicity. Various mRNA manufacturing and synthesizing methods are investigated in this review, focusing on their scalability and limitations. mRNA therapeutic strategies can be divided into protein replacement, immune modulation, and cellular modulation. This review explores mRNA's molecular landscape and comprehensive utility, including applications in both clinical trials and commercial sectors.}, }
@article {pmid41588352, year = {2026}, author = {Du, R and Yang, J and Yang, W and Liao, P}, title = {The efficacy and safety of convalescent plasma for COVID-19 patients: a meta-analysis based on double-blinded parallel-arm randomized placebo-controlled trials.}, journal = {BMC infectious diseases}, volume = {26}, number = {1}, pages = {147}, pmid = {41588352}, issn = {1471-2334}, mesh = {Humans ; *COVID-19/therapy/mortality ; *COVID-19 Serotherapy/adverse effects/methods ; Double-Blind Method ; Hospitalization/statistics & numerical data ; Immunization, Passive/adverse effects/methods ; Randomized Controlled Trials as Topic ; Respiration, Artificial/statistics & numerical data ; SARS-CoV-2/immunology ; Treatment Outcome ; }, abstract = {BACKGROUND: Convalescent plasma (CP) showed promising benefits in previous coronavirus pandemics regarding efficacy and safety. However, the efficacy of CP from COVID-19 patients remains controversial and uncertain based on current randomized controlled trials (RCTs). There is an urgent need to establish the efficacy and safety of CP for COVID-19 patients as soon as possible.
OBJECTIVE: To verify the efficacy and safety of CP using high-quality, double-blinded, parallel-arm, placebo-controlled randomized clinical trials, and to provide evidence-based support for the clinical application of CP against COVID-19.
METHODS: Electronic databases such as Embase, PubMed, and Web of Science were searched from inception to October 18, 2024. This meta-analysis synthesized dichotomous outcomes, including 28-day mortality, hospitalization rates, invasive mechanical ventilation, adverse events (AEs), and serious AEs, using an intention-to-treat (ITT) analysis. Statistical analysis was performed using Review Manager (RevMan) 5.4.1, the Mantel-Haenszel (M-H) statistical method, and a random effects (RE) analysis model. Risk ratios (RRs) and their 95% confidence intervals (CIs) were used as effect measures. Two reviewers independently searched, screened, and included eligible clinical trials, extracted relevant data, and assessed risks of bias (ROB) using the Cochrane ROB tool 1.0 and RevMan 5.4.1. The RRs and 95% CIs in this meta-analysis were computed as dichotomous outcomes. Statistical heterogeneity, subgroup analysis, and sensitivity analysis were conducted to explore heterogeneities and their causes. The quality of evidence was evaluated, and recommendations for clinical practice were based on the GRADE approach. The prospective meta-analysis protocol was registered on PROSPERO.
RESULTS: A total of 996 references were identified through database and manual searches. Nine eligible double-blinded, parallel-arm, placebo-controlled randomized clinical trials, involving 1898 subjects in the intervention group and 1696 in the control group, were included in the meta-analysis. Seven, four, three, three, and three trials were judged as low ROB for mortality, hospitalization rates, invasive mechanical ventilation, AEs, and serious AEs, respectively. The remaining trials were deemed high-risk for their respective outcomes. The meta-analysis on hospitalization rates was abandoned due to high heterogeneity (I²=92%) among the included trials. The RRs, 95% CIs, and P-values were as follows: 0.78 [0.62, 0.97], P = 0.03 for mortality; 0.84 [0.50, 1.42], P = 0.51 for invasive mechanical ventilation; 1.01 [0.78, 1.32], P = 0.92 for AEs; and 0.96 [0.73, 1.28], P = 0.80 for serious AEs, all with low or medium levels of heterogeneity. These results suggest that CP infusion in COVID-19 patients reduced mortality by 22% and exhibited excellent safety without reducing the incidence of invasive mechanical ventilation. Sensitivity analysis on mortality, using the combined effect measure (RR 0.83 [0.66, 1.06], I²=0%, Z = 1.46, P = 0.14) after excluding the study by O'Donnell, showed no significant difference between the intervention and control groups, implying that the excluded study might have a stronger effect in reducing mortality. Subgroup analysis based on age indicated that CP therapy in COVID-19 patients aged ≤ 60 years reduced mortality by 36%. Sensitivity and subgroup analyses for other outcomes demonstrated robust pooled results. The PROSPERO registration code is CRD42022324324.
CONCLUSIONS: Administration of CP to COVID-19 patients, especially those aged ≤ 60 years, may reduce mortality with excellent safety without more AEs, and serious AEs, but does not reduce the incidence of invasive mechanical ventilation.}, }
@article {pmid41589019, year = {2026}, author = {Murugavel, A and Ramakrishnan, J}, title = {Virulence and pathogenicity of secondary fungal infections.}, journal = {Critical reviews in microbiology}, volume = {52}, number = {1}, pages = {139-158}, doi = {10.1080/1040841X.2025.2537423}, pmid = {41589019}, issn = {1549-7828}, mesh = {Humans ; Virulence ; Virulence Factors/metabolism/genetics ; *Mycoses/microbiology ; *COVID-19/complications/microbiology/immunology ; *Candida/pathogenicity/genetics ; Aspergillus/pathogenicity/genetics ; *Mucorales/pathogenicity/genetics ; Immunocompromised Host ; *Coinfection/microbiology ; SARS-CoV-2 ; }, abstract = {Fungal infections pose a significant global health threat, particularly among immunocompromised individuals facing life-threatening complications. The severity of secondary fungal infections is driven by the expression of virulence factors in immunocompromised individuals. The COVID-19 pandemic has highlighted the susceptibility of immunocompromised patients to secondary fungal infections, prompting a closer examination of the underlying mechanisms. This review provides a comprehensive overview of the virulence mechanisms of major fungal pathogens (Aspergillus, Candida, and Mucorales) in COVID-19-associated secondary infections. The review systematically categorizes key virulence factors, including thermotolerance, adhesins, hydrolytic enzymes, mycotoxins, and biofilm formation, and explores their interplay with the host's immune status, particularly under corticosteroid therapy. Focusing on the intersection of fungal pathogenesis and COVID-19, the article examines molecular mechanisms underlying Aspergillus, Mucorales, and Candida pathogenicity, including iron metabolism, spore coat proteins, and immune evasion strategies. Followed by linking the molecular mechanisms to therapeutic strategies and clinical outcomes.}, }
@article {pmid41589190, year = {2025}, author = {Alrehaili, RS and Almuzaini, S and Alrajhi, J and Dashti, A and Alsuroor, O and Alzahrani, F and Albishri, A and Almousa, M and Homdi, L and Alshammakhy, R and Alfaifi, F and Alkharfi, A and Aldhafeeri, G and Alzahrani, TM}, title = {Teledentistry in the Era of Digital Dentistry: Clinical Applications, Patient Experience, and Equity-Oriented Policy Implications.}, journal = {Cureus}, volume = {17}, number = {12}, pages = {e100137}, pmid = {41589190}, issn = {2168-8184}, abstract = {Teledentistry has shifted from small pilot projects and emergency use during the COVID-19 pandemic to a realistic option for delivering parts of routine oral healthcare. However, its role in long-term service models, equity, and health-system performance remains incompletely defined. This narrative review aimed to provide an up-to-date synthesis of the evidence on teledentistry across clinical specialties, populations, and settings, and to discuss implications for practice, policy, and future research. Electronic databases were searched from inception to December 2025 for studies evaluating teledentistry or related digital remote dental services. Eligible sources included observational and interventional studies, reviews, economic evaluations, implementation reports, and key professional or policy documents. Data were organized thematically around clinical effectiveness, patient and provider experience, cost and resource use, equity and access, regulatory frameworks, and emerging technologies. Across settings, teledentistry supports accurate diagnosis and triage for selected indications, particularly in orthodontics, pediatric dentistry, and community-based screening. Most studies report gains in access, reduced need for travel, and high levels of patient satisfaction, especially in rural, institutionalized, and otherwise underserved groups. Evidence for long-term clinical outcomes, cost-effectiveness, and the impact on oral-health inequities is promising but remains heterogeneous and often limited by small samples, short follow-up, and methodological constraints. Successful programs depend on reliable infrastructure, integration with electronic records, clear clinical protocols, appropriate training, and supportive legal and reimbursement frameworks, while concerns persist about data protection, medico-legal responsibility, and the potential for digital services to widen rather than narrow gaps between population groups. Overall, teledentistry should be viewed as a component of planned hybrid oral healthcare models rather than a substitute for in-person care. Future work needs pragmatic comparative studies, robust economic analyses, and equity-focused evaluations. Under these conditions, teledentistry has the potential to contribute meaningfully to more accessible, continuous, and person-centered oral healthcare.}, }
@article {pmid41590208, year = {2026}, author = {Parikh, RR and Shetty, NU and Singhal, C and Patel, P and Manghani, P and Pillai, AA and Chocontá-Piraquive, LA and Butler, ME}, title = {Telehealth for Sexual and Reproductive Healthcare: Evidence Map of Effectiveness, Patient and Provider Experiences and Preferences, and Patient Engagement Strategies.}, journal = {Clinics and practice}, volume = {16}, number = {1}, pages = {}, pmid = {41590208}, issn = {2039-7275}, abstract = {OBJECTIVE: The aim of this study was to systematically map evidence to inform best practices for sexual and reproductive healthcare delivered via telehealth (TeleSRH) in United States-based Title X-funded clinics.
METHODS: We searched three databases (2017-2025) for studies evaluating effectiveness, harms, patient and provider experiences, barriers/facilitators, and engagement strategies encompassing TeleSRH for sexually transmitted infections (STIs), contraceptive care/family planning (CC/FP), and sexual wellness, in countries with a human development index of ≥0.8.
RESULTS: From 5963 references and 436 articles, we included 142 eligible publications. TeleSRH use declined since the COVID-19 pandemic's peak but remains higher than pre-pandemic. Evidence comes mostly from poor-quality studies. TeleSRH increases access and adherence to STI prevention (e.g., pre-exposure prophylaxis for HIV). Tele-follow-up may safely facilitate HIV care continuity. For CC/FP, TeleSRH is comparable to in-person care for patient satisfaction and uptake; patients are less likely to select long-acting reversible contraception but post-initiation tele-follow-up may increase its continuation rates. Vasectomy completion rates may be similar between pre-procedural counseling via telehealth versus in-person. TeleSRH's potential benefits might include reduced travel time, wait times, no-show rates, and clinic human resource burden (via tele-triaging) and increased preventative screening rates for STIs and non-communicable diseases, prescription refill rates, ability to receive confidential care in preferred settings, and rural/marginalized community outreach. Implementation challenges span technological and capital constraints, provider availability, staff capability building, restrictive policies, language incompatibility, and patient mistrust. Supplementing synchronous TeleSRH with asynchronous communication (e.g., mobile application) may improve continued patient engagement.
CONCLUSIONS: Preventive, diagnostic, and therapeutic TeleSRH can be effective, with high patient acceptability; however, effectiveness and adoption hinge on contextual factors outlined in this review.}, }
@article {pmid41590554, year = {2025}, author = {Klimonda, A and Kowalska, I}, title = {From Environmental Threat to Control: A Review of Technologies for Removal of Quaternary Ammonium Compounds from Wastewater.}, journal = {Membranes}, volume = {16}, number = {1}, pages = {}, pmid = {41590554}, issn = {2077-0375}, support = {825 305 0501//Wrocław University of Science and Technology/ ; }, abstract = {Cationic surfactants from the group of quaternary ammonium compounds (QACs) are widely used in disinfectants, cosmetics, and household and industrial products. Their strong antimicrobial activity and chemical stability make them valuable in applications but also highly persistent and toxic when released into aquatic environments. This problem has become increasingly relevant during and after the COVID-19 pandemic, when global use of QAC-based disinfectants increased drastically, resulting in their frequent detection in municipal, hospital, and industrial effluents. The concentrations of QACs reported in wastewater range from trace levels to several mg/L, often reaching inhibitory thresholds for biological treatment processes. Although surfactants are not listed in any current European directive, the revised Directive (EU) 2024/1440 classifies micropollutants as a priority group, imposing stricter environmental quality standards and mandatory monitoring requirements. Within this regulatory framework, QACs are recognized as compounds of emerging concern, and their effective removal from wastewater has become a critical challenge. This review summarizes the current knowledge on conventional treatment technologies (coagulation, adsorption, ion exchange, advanced oxidation, and biological processes) and membrane-based methods (ultrafiltration, nanofiltration, reverse osmosis, forward osmosis, and hybrid systems) for the removal of cationic surfactants from water and wastewater. Mechanisms of separation, performance, and operational limitations are discussed.}, }
@article {pmid41591417, year = {2026}, author = {Faria, C and Daneshi, K and Baser, A and Mauersberger, H and G-Medhin, A and Soneson, E and White, S and Anderson, J and Ford, T}, title = {The global prevalence of eating disorders in children and young people: a systematic review and meta-analysis.}, journal = {European child & adolescent psychiatry}, volume = {35}, number = {4}, pages = {1093-1106}, pmid = {41591417}, issn = {1435-165X}, support = {(NIHR203312//National Institute for Health and Care Research/ ; }, mesh = {Adolescent ; Child ; Humans ; *COVID-19/epidemiology ; *Feeding and Eating Disorders/epidemiology ; *Global Health/statistics & numerical data ; Prevalence ; Young Adult ; }, abstract = {The increase in eating disorder (ED) presentations among children and young people (CYP) during the Covid-19 pandemic represents a global health concern, given the associated morbidity and mortality associated with these conditions. We conducted a meta-analysis to estimate the worldwide pooled prevalence of EDs in CYP at a population level. We searched MEDLINE, EMBASE, PsycINFO and LILACS for all English-language studies reporting population level ED prevalence data between January 2013 to February 27th, 2024. The primary outcome was overall prevalence of EDs. We used a random-effects model for the meta-analysis, I[2] statistics to assess heterogeneity, and the Hoy scale for quality assessment. This study is registered with PROSPERO, number CRD42022333223. Sixteen studies including 77,714 children and young people from 12 countries met eligibility criteria and were included in the systematic review, whilst twelve studies with 56,758 participants provided data suitable for inclusion in the meta-analysis. Study quality was moderate; ten studies were classified with a low risk of bias, one with moderate and five with high. The global point prevalence for any ED was 5.23% (95% confidence interval (CI) 0.41 to 10.05, I[2]= 99.95%). The commonest type was Other Specified Feeding or ED (point prevalence of 4.88%, 95% CI 1.46 to 8.30, I[2]= 99.42%), which, like all types of ED was more common among girls (5.25%, 95% CI 0.32 to 10.18, I[2]= 99.69%) than boys (3.97%, 95% CI 0.45 to 7.49, I[2]= 97.77%), although confidence intervals overlapped. Our findings illustrate the urgent need to expand service provision as well as to evaluate and develop strategies for early ED identification in children and young people, given a global prevalence of 1 in 20.}, }
@article {pmid41592222, year = {2026}, author = {Song, X and Lian, Z and Wang, R and Li, R and Yang, Z and Luo, X and Feng, L and Ma, Z and Pu, Z and Wang, Q and Ge, L and Li, C and Chen, Y and Yang, K and Lavis, J}, title = {The Phases of Living Evidence Synthesis Using AI AI: Living Evidence Synthesis (Version 1).}, journal = {Journal of medical Internet research}, volume = {28}, number = {}, pages = {e76130}, pmid = {41592222}, issn = {1438-8871}, mesh = {*Artificial Intelligence ; Humans ; SARS-CoV-2 ; COVID-19 ; }, abstract = {BACKGROUND: Living evidence (LE) synthesis refers to the method of continuously updating systematic evidence reviews to incorporate new evidence. It has emerged to address the limitations of the traditional systematic review process, particularly the absence of or delays in publication updates. The emergence of COVID-19 accelerated the progress in the field of LE synthesis, and currently, the applications of artificial intelligence (AI) in LE synthesis are expanding rapidly. However, in which phases of LE synthesis should AI be used remains an unanswered question.
OBJECTIVE: This study aims to (1) document the phases of LE synthesis where AI is used and (2) investigate whether AI improves the efficiency, accuracy, or utility of LE synthesis.
METHODS: We searched Web of Science, PubMed, the Cochrane Library, Epistemonikos, the Campbell Library, IEEE Xplore, medRxiv, COVID-19 Evidence Network to support Decision-making, and McMaster Health Forum. We used Covidence to facilitate the monthly screening and extraction processes to maintain the LE synthesis process. Studies that used or developed AI or semiautomated tools in the phases of LE synthesis were included.
RESULTS: A total of 24 studies were included, including 17 on LE syntheses, with 4 involving tool development, and 7 on living meta-analyses, with 3 involving tool development. First, a total of 34 AI or semiautomated tools were involved, comprising 12 AI tools and 22 semiautomated tools. The most frequently used AI or semiautomated tools were machine learning classifiers (n=5) and the Living Interactive Evidence synthesis platform (n=3). Second, 20 AI or semiautomated tools were used for the data extraction or collection and risk of bias assessment phase, and only 1 AI tool was used for the publication update phase. Third, 3 studies demonstrated the improvement in efficiency achieved based on time, workload, and conflict rate metrics. Nine studies applied AI or semiautomated tools in LE synthesis, obtaining a mean recall rate of 96.24%, and 6 studies achieved a mean F1-score of 92.17%. Additionally, 8 studies reported precision values ranging from 0.2% to 100%.
CONCLUSIONS: AI and semiautomated tools primarily facilitate data extraction or collection and risk of bias assessment. The use of AI or semiautomated tools in LE synthesis improves efficiency, leading to high accuracy, recall, and F1-scores, while precision varies across tools.}, }
@article {pmid41592552, year = {2026}, author = {Song, J and Lee, JH and Park, H and Jang, MJ and Yoon, SH}, title = {Long-Term Pulmonary Function and Radiologic Abnormalities Up to 3 Years After COVID-19: A Systematic Review and Meta-Analysis.}, journal = {Korean journal of radiology}, volume = {27}, number = {2}, pages = {174-185}, pmid = {41592552}, issn = {2005-8330}, mesh = {Humans ; *COVID-19/physiopathology/diagnostic imaging/complications ; *Tomography, X-Ray Computed/methods ; Respiratory Function Tests ; *Lung/diagnostic imaging/physiopathology ; SARS-CoV-2 ; Male ; Middle Aged ; Female ; Time Factors ; }, abstract = {OBJECTIVE: To systematically evaluate the long-term trajectory of pulmonary function test (PFT) and CT findings in COVID-19 survivors.
MATERIALS AND METHODS: A systematic literature search of PubMed and EMBASE was performed to identify studies published from January 2020 to June 2024 reporting PFT and/or chest CT outcomes at ≥6 months post-COVID-19, up to 36 months. The reference lists of relevant articles were also manually reviewed. Two investigators independently extracted study characteristics, patient demographics, and PFT and CT outcomes at prespecified follow-up intervals (6, 12, 24, and 36 months). Multivariate meta-analyses were conducted to evaluate temporal trends in lung function and radiological abnormalities. Sensitivity analyses, including stratification by disease severity and pooled analyses of studies with multiple follow-up time points, were performed to confirm the robustness of the findings.
RESULTS: In total, 152 studies (n = 25,766; mean age, 56.7 ± 13.2 years; 14,999 men) were included: 133 reporting PFT outcomes and 80 reporting CT findings. Diffusion capacity (DLCO) impairment was the most common abnormality, showing gradual improvement from 42% at 6 months to 35% at 36 months (P = 0.008) with a corresponding increase in the % predicted DLCO. Similarly, the prevalence of forced vital capacity (FVC) impairment decreased over time, accompanied by an increase in the % predicted FVC. On chest CT, the proportion of patients with no relevant findings remained stable at 30%-40% (P = 0.14). The prevalence of ground-glass opacities (GGO) decreased from 32% at 6 months to 20% at 36 months (P = 0.01), while that of fibrosis persisted at 27%-47% without a significant change (P = 0.28). Subgroup analysis based on disease severity revealed similar temporal trends in both low-severity and high-severity cohorts.
CONCLUSION: DLCO, FVC, and GGO findings improved gradually up to 36 months post-COVID-19; however, over one-third of the patients continued to exhibit reduced DLCO. Fibrosis persists with limited evidence of resolution over a 3-year period, suggesting a stable but nonprogressive pattern.}, }
@article {pmid41592662, year = {2026}, author = {Dağdeviren, İ and Uygur, MM and Keleş, EÇ}, title = {The impact of thyroid dysfunction on COVID-19 severity and mortality: A systematic review and Meta-Analysis.}, journal = {Clinica chimica acta; international journal of clinical chemistry}, volume = {584}, number = {}, pages = {120851}, doi = {10.1016/j.cca.2026.120851}, pmid = {41592662}, issn = {1873-3492}, mesh = {Humans ; COVID-19/mortality ; Severity of Illness Index ; *Thyroid Diseases/mortality/complications/blood/diagnosis ; Triiodothyronine/blood ; SARS-CoV-2 ; Pandemics ; *Coronavirus Infections/mortality/blood ; Thyrotropin/blood ; *Pneumonia, Viral/mortality/blood ; }, abstract = {Thyroid function abnormalities have been increasingly reported in patients with coronavirus disease 2019 (COVID-19), yet the clinical significance of these alterations remains uncertain. Because early identification of individuals at risk for severe illness is essential, this study systematically evaluated the association between thyroid dysfunction and COVID-19 severity. A comprehensive search of major databases identified 4260 records, of which 13 observational studies met the eligibility criteria, yielding a total of 2829 patients from diverse geographical regions. Mild, moderate, and non-ICU patients were categorized as the non-severe group, while the severe-to-critical group included patients classified as severe or critical, those requiring ICU admission, or hospitalized in dedicated COVID-19 wards according to the criteria used in the original studies. The pooled analysis demonstrated that total and free triiodothyronine (TT3 and FT3) levels were consistently lower in patients with more severe disease, and thyroid dysfunction was associated with 4.8-fold higher odds of severe-to-critical COVID-19. Although thyroid-stimulating hormone (TSH) levels were reduced in patients with COVID-19 compared with non-infected individuals, TSH alone did not predict disease severity. Higher TT3 and FT3 concentrations were consistently associated with a milder clinical course. These findings suggest that thyroid function tests may provide useful prognostic information in patients with COVID-19. The observed hormonal patterns may reflect alterations along the hypothalamic-pituitary-thyroid axis; however, this interpretation remains hypothetical and requires confirmation through studies incorporating direct pituitary hormone assessment. Low TT3 and FT3 levels appear to be associated with worse clinical outcomes in COVID-19 patients, suggesting their potential utility as prognostic indicators. However, further prospective studies are needed before recommending routine monitoring for clinical management.}, }
@article {pmid41592860, year = {2026}, author = {Sullivan, DJ and Reik, R and Prichard, A and Pagan, M and Tobian, AAR and Caturegli, P and Pekosz, A and Klein, SL and Bloch, EM and Shoham, S and Gebo, KA and Joyner, MJ and Senefeld, JW and Franchini, M and Focosi, D and Pandey, S and Lane, K and McBee, NA and Pirofski, LA and Casadevall, A and Hanley, DF}, title = {COVID-19 convalescent plasma safety and efficacy analysis for biologics license application approval.}, journal = {Expert review of anti-infective therapy}, volume = {24}, number = {1}, pages = {97-111}, pmid = {41592860}, issn = {1744-8336}, support = {R01 AI152078/AI/NIAID NIH HHS/United States ; U24 TR001609/TR/NCATS NIH HHS/United States ; }, mesh = {Humans ; COVID-19 Serotherapy ; *COVID-19/therapy/immunology ; Immunization, Passive/methods ; *SARS-CoV-2/immunology ; *Antibodies, Viral/blood/therapeutic use/immunology ; Drug Approval ; United States ; Antibodies, Neutralizing ; Immunocompromised Host ; Randomized Controlled Trials as Topic ; United States Food and Drug Administration ; }, abstract = {INTRODUCTION: COVID-19 convalescent plasma with high anti-SARS-CoV-2 antibody levels transfused within 6 months from donor collection was formally approved by the Food and Drug Administration in December 2024 for COVID-19 treatment in immunocompromised patients. Here we summarize the safety and efficacy data submitted for the Biologics License Application.
AREAS COVERED: Safety evaluation in over 100,000 individuals in the expanded access program and 24,000 in randomized controlled trials, showed no serious adverse event increases. Robust randomized controlled trials established efficacy in four distinct disease stages: outpatient, inpatient, newly mechanically ventilated, and in those immunocompromised to prevent acute disease progression or eliminate persistent viral carriage. Pharmacokinetics revealed a three-liter distribution volume with viral specific antibody effective dose near 2-50 mg. Major SARS-CoV-2 antibody-mediated antiviral actions included direct neutralization by viral-binding interference to cell receptors and fragment-crystallizable mediated antiviral effects that reduce virions. Virus neutralization correlated with high anti-Spike antibody levels and antibody levels in the top donor plasma deciles retains therapeutic neutralization against future variants.
EXPERT OPINION: With pandemic progression, the COVID-19 convalescent plasma safety and efficacy evidence quality increased. Ultimate regulatory approval required robust randomized control efficacy data. Future infectious disease outbreaks require randomized controlled trials in the convalescent plasma roadmap.}, }
@article {pmid41593575, year = {2026}, author = {Güzel, S and Baysal, HY and Türkoğlu, N and Polat, H and Arslan, MA and Kurşun, E}, title = {Factors ınfluencing vaccine refusal in children: an umbrella review on COVID-19 and childhood vaccinations.}, journal = {BMC public health}, volume = {26}, number = {1}, pages = {680}, pmid = {41593575}, issn = {1471-2458}, mesh = {Humans ; *COVID-19/prevention & control/epidemiology ; *Vaccination Refusal/psychology/statistics & numerical data ; Child ; *Vaccination Hesitancy/psychology/statistics & numerical data ; *COVID-19 Vaccines/administration & dosage ; *Parents/psychology ; *Vaccination/psychology ; }, abstract = {Vaccination is a fundamental public health intervention that saves millions of lives and extends human lifespan. However, vaccine hesitancy and refusal have grown into a global threat due to misinformation. The COVID-19 pandemic has highlighted the critical role of vaccines in reducing mortality rates and controlling outbreaks. Parents' attitudes toward vaccines directly affect children's health and vaccination rates in the community. Therefore, understanding the underlying reasons for parents' refusal of childhood vaccines and the COVID-19 vaccine is of great importance for combating epidemics and public health. The umbrella review method was used in this study. Systematic reviews and meta-analyses conducted between January 1, 2020, and December 30, 2024, were examined in this context. The pandemic period and recent history were considered due to the increase in systematic reviews examining the rapidly rising rates of vaccine refusal after the COVID-19 pandemic. Studies published in English in the PubMed, Wos, and Scopus databases were searched. Fifteen studies were included in the research. In conclusion, socio-demographic factors were found to be a major factor in COVID-19 vaccine refusal, whereas factors such as the "information factor," "vaccine-related factors," and "Cognitive Factors" were found to be more prominent in childhood vaccine refusal.}, }
@article {pmid41593595, year = {2026}, author = {Abusbaitan, HA and Gondwe, KW and Pirsch, A and Eyadat, A and Alshakhshir, NS and Vilakazi, N and Nkhoma-Mussa, Y and Hearst, MO and Mkandawire-Valhmu, L and Lopez, AA and Schadewald, DM and Dressel, A}, title = {Food insecurity and gender-based violence against women during the COVID-19 pandemic: a systematic review.}, journal = {BMC public health}, volume = {26}, number = {1}, pages = {668}, pmid = {41593595}, issn = {1471-2458}, mesh = {Humans ; *Food Insecurity ; *COVID-19/epidemiology ; Female ; *Gender-Based Violence/statistics & numerical data ; Pandemics ; }, abstract = {BACKGROUND: Gender-based violence (GBV) and food insecurity are conditions that affect women and may also exacerbate each other, as women experience disproportionately higher levels of both globally. Both of these conditions also increased during the COVID-19 pandemic. The purpose of this systematic review was to describe how the association between food insecurity and GBV across multiple global regions during the COVID-19 pandemic impacted women. The review aims to inform equity-driven interventions and policy development in the event for use during future emergency crises.
METHODS: The social-ecological model (SEM) and the intersectionality framework were the frameworks used for this systematic review. The PRISMA guidelines guided this systematic review methodology. The literature search was conducted using the APA PsycINFO, CINAHL, MEDLINE, PubMed, and Web of Science databases in November 2025. The inclusion criteria were as follows: (1) studies conducted during the COVID-19 pandemic; (2) studies that assessed the association between food insecurity and GBV among women during the COVID-19 pandemic; and (3) studies published in English in peer-reviewed journals. The exclusion criterion was any study that was not primary research. The Quality Assessment Tool for Studies with Diverse Designs (QATSDD) was used for quality appraisal. Thematic analysis, guided by Hennink and colleagues (2020), was used to synthesize the results.
RESULTS: Thirty-two studies were included in the data analysis. At the individual level, food insecurity and GBV during the COVID-19 pandemic were associated with a greater likelihood of reporting mental health conditions such as anxiety and depression. Additionally, being an immigrant was associated with a high risk of experiencing food insecurity and GBV. At the relationship level, food insecurity and GBV were associated with household instability and family dysfunction. At the community level, the association was influenced by poverty and limited employment opportunities. At the societal level, restrictive COVID-19 policies and prevailing cultural norms contributed to intensifying food insecurity and GBV.
CONCLUSION: This study offers support for strengthening crisis‒response systems across socio-ecological levels that incorporate gender-sensitive food security and violence prevention strategies during public health emergencies. New policies are needed to create effective support systems to promote women's health, especially marginalized groups, who experience the greatest vulnerability.}, }
@article {pmid41594447, year = {2026}, author = {Ortello, C and Pace, L and Farina, D and Manzulli, V and Rondinone, V and Cipolletta, D and Galante, D}, title = {Suidae Coronaviruses: Epidemiology, Transmission, and Molecular Diagnosis.}, journal = {Animals : an open access journal from MDPI}, volume = {16}, number = {2}, pages = {}, pmid = {41594447}, issn = {2076-2615}, support = {PE00000007//EU funding within the NextGeneration EU-MUR PNRR/ ; }, abstract = {The emergence and spread of swine coronaviruses represent a growing challenge for both veterinary medicine and public health. These viruses exhibit high mutation rates, recombination potential, and the capacity for cross-species transmission. Among the most relevant pathogens are PEDV, TGEV, PRCV, PHEV, PDCoV, and SADS-CoV, which have caused significant outbreaks in swine production systems worldwide, with severe economic consequences. Recent evidence demonstrates coronavirus circulation in wild boar populations across Europe, including Italy, Spain, and Germany. Although wild boars are not confirmed as primary reservoirs, their ecological behavior and increasing overlap with domestic pigs raise concern over their potential role in maintaining viral circulation. Future research priorities should focus on developing a more integrated and coordinated system for the control of swine coronaviruses, including strengthened surveillance in both domestic pigs and wild boar populations, the use of molecular epidemiology techniques to identify emerging variants, and structured collaboration among veterinary, ecological, health, and regulatory sectors. Finally, investment is needed in the development of next-generation vaccines and diagnostic tools to address the considerable genetic variability of swine coronaviruses and to improve the prevention and early detection of and response to future epidemic threats.}, }
@article {pmid41594651, year = {2026}, author = {Lefebvre, M and Chahinian, H and Yahi, N and Fantini, J}, title = {The Enigmatic Conserved Q134-F135-N137 Triad in SARS-CoV-2 Spike Protein: A Conformational Transducer?.}, journal = {Biomolecules}, volume = {16}, number = {1}, pages = {}, pmid = {41594651}, issn = {2218-273X}, mesh = {*Spike Glycoprotein, Coronavirus/chemistry/metabolism/genetics ; *SARS-CoV-2 ; Humans ; Protein Domains ; Gangliosides/metabolism/chemistry ; Protein Conformation ; Models, Molecular ; COVID-19/virology ; }, abstract = {Lipid raft-associated gangliosides facilitate the early stages of SARS-CoV-2 entry by triggering the exposure of the receptor-binding domain (RBD) within the trimeric spike protein, which is initially sequestered. A broad range of in silico, cryoelectron microscopy and physicochemical approaches indicate that the RBD becomes accessible after a ganglioside-induced conformational rearrangement originating in the N-terminal domain (NTD) of one protomer and propagating to the neighboring RBD. We previously identified a triad of amino acids, Q134-F135-N137, as a strictly conserved element on the NTD. In the present review, we integrate a series of structural and experimental data revealing that this triad may act as a conformational transducer connected to a chain of residues that are capable of transmitting an internal conformational wave within the NTD. This wave is generated at the triad level after physical interactions with lipid raft gangliosides of the host cell membrane. It propagates inside the NTD and collides with the RBD of a neighboring protomer, triggering its unmasking. We also identify a chain of aromatic residues that are capable of controlling electron transfer through the NTD, leading us to hypothesize the existence of a dual conformational/quantum wave. In conclusion, the complete conservation of the Q134-F135-N137 triad despite six years of extensive NTD remodeling underscores its critical role in the viral life cycle. This triad represents a potential Achilles' heel within the hyper-variable NTD, offering a stable target for therapeutic or vaccinal interventions to disrupt the conformational wave and prevent infection. These possibilities are discussed.}, }
@article {pmid41594655, year = {2026}, author = {Baindara, P and Dinata, R and Kumar, R}, title = {Yeast-Based Vaccine Platforms: Applications and Key Insights from the COVID-19 Era.}, journal = {Biomolecules}, volume = {16}, number = {1}, pages = {}, pmid = {41594655}, issn = {2218-273X}, mesh = {Humans ; *COVID-19 Vaccines/immunology ; *COVID-19/prevention & control/immunology ; SARS-CoV-2/immunology ; *Saccharomyces cerevisiae/genetics/immunology ; Protein Subunit Vaccines ; Pandemics/prevention & control ; Vaccine Development ; Vaccines, Synthetic/immunology ; Vaccines, Subunit/immunology ; Saccharomycetales/genetics ; }, abstract = {The COVID-19 pandemic accelerated vaccine innovation but also exposed weaknesses in global access and manufacturing. Yeast-based platforms, particularly Saccharomyces cerevisiae and Pichia pastoris, also known as Komagataella phaffii, offer a practical complement to vector systems. These eukaryotic microorganisms combine safety, scalability, and cost-effectiveness with the ability to express complex antigens and assemble virus-like particles. Building on the success of the recombinant hepatitis B vaccine, recent advances in glycoengineering, CRISPR-based host optimization, and surface display technologies have expanded the utility of yeast-based platforms for the rapid development of vaccines. Yeast-derived SARS-CoV-2 receptor-binding domain (RBD) subunit vaccines, such as Corbevax and Abdala (CIGB-66), demonstrate that affordable, immunogenic, and thermostable products are feasible at scale. Emerging innovations in glycan humanization, thermostable formulations, and oral or mucosal delivery highlight the potential of yeast-based vaccines for decentralized manufacturing and equitable pandemic preparedness. This review summarizes recent technical and clinical progress in yeast-based vaccine research, positioning these platforms as accessible and adaptable tools for future outbreak responses and global immunization strategies.}, }
@article {pmid41594661, year = {2026}, author = {Förster, CY and Shityakov, S}, title = {A Possible Role for the Vagus Nerve in Physical and Mental Health.}, journal = {Biomolecules}, volume = {16}, number = {1}, pages = {}, pmid = {41594661}, issn = {2218-273X}, support = {Fo-315/5-1//Deutsche Forschungsgemeinschaft/ ; }, mesh = {Humans ; *Vagus Nerve Stimulation/methods ; *Vagus Nerve/physiology ; Animals ; *Mental Health ; Mental Disorders/therapy ; }, abstract = {For decades, researchers have explored the therapeutic potential of the vagus nerve through vagus nerve stimulation (VNS). Initially developed for epilepsy, VNS has since been applied to treat resistant depression, stroke recovery, and inflammatory conditions. Transcutaneous VNS (tVNS) now offers a noninvasive alternative, fueling clinical trials in disorders ranging from rheumatoid arthritis and migraines to long COVID-19. Mechanistic studies suggest that afferent and efferent vagal fibers modulate immune responses, mood regulation, and neurotransmitter systems. The SPARC initiative has accelerated mapping of vagal circuits, enabling more precise approaches to stimulation. Despite progress, the results remain mixed: while some patients experience lasting symptom relief, others respond no better than to placebo. Depression studies, in particular, highlight both the promise and the complexity of VNS, as inflammation, motivation circuits, and gut-brain signaling emerge as key modulators. Next-generation closed-loop devices and circuit-specific targeting may improve efficacy and reduce adverse effects. VNS research thus lies at the intersection of neuromodulation, psychiatry, and immunology-offering hope for hard-to-treat conditions, yet demanding rigorous trials to separate myths from medicine. In this article, we review the current clinical and experimental applications of tVNS, analyze its mixed efficacy across psychiatric, immunological, and neurological disorders, and highlight the mechanistic insights, stimulation parameters, and emerging technologies that may shape next-generation therapies.}, }
@article {pmid41594835, year = {2026}, author = {Kostev, K and Konrad, M and Bohlken, J}, title = {Real-World Evidence for Psychiatric Disorders from the German Disease Analyzer Database: A Narrative Review.}, journal = {Brain sciences}, volume = {16}, number = {1}, pages = {}, pmid = {41594835}, issn = {2076-3425}, abstract = {The German IQVIA Disease Analyzer (DA) database has become an increasingly important source of real-world evidence for psychiatric research. Over the past decade, and particularly since 2020, DA-based studies have addressed a broad spectrum of psychiatric outcomes including depression, anxiety disorders, schizophrenia, bipolar disorder, dementia, sleep disorders, and the mental health consequences of chronic somatic diseases and of contracting COVID-19. Using large, representative outpatient cohorts, these studies have examined factors associated with the incidence of psychiatric disorders, patterns of psychiatric and somatic comorbidity, treatment trajectories, and long-term outcomes under routine care conditions. The DA database's longitudinal structure, nationwide coverage, and inclusion of multiple medical specialties enable it to capture psychiatric disorders throughout patient lifetimes and across different clinical contexts. This narrative review summarizes psychiatric research using the DA database that has been published since 2020, focusing on study design, main findings, methodological strengths and limitations, and implications for future psychiatric epidemiology and clinical research.}, }
@article {pmid41595814, year = {2025}, author = {Lim, L and Mukasheva, A and Alegbe, AO and Emehel, AN and Aubakirova, B and Semenova, Y}, title = {Public Health Communication Challenges in Eastern Europe and Central Asia: A Scoping Review.}, journal = {International journal of environmental research and public health}, volume = {23}, number = {1}, pages = {}, pmid = {41595814}, issn = {1660-4601}, support = {001/WHO_/World Health Organization/International ; }, mesh = {Humans ; *Public Health ; Asia, Central ; Europe, Eastern ; *Health Communication ; COVID-19/epidemiology ; *Communication ; }, abstract = {This scoping review examines public health communication across nine Eastern European and Central Asian states-Armenia, Azerbaijan, Belarus, Kazakhstan, Kyrgyzstan, Russia, Tajikistan, Turkmenistan, and Uzbekistan-highlighting how these systems have transitioned from Soviet-era legacies to contemporary practices. Eligibility criteria included the English- and Russian-language literature published from 1998 onwards, focusing on nine post-Soviet states. Sources of evidence comprised searches in Google Scholar, ScienceDirect, SSRN, Heliyon, MEDLINE/PubMed, and official government websites. Data were charted by three independent reviewers using a standardized form, with discrepancies resolved by senior reviewers. The review identifies persistent gaps in communication during health crises, with a particular focus on the COVID-19 pandemic, where centralized and hierarchical information flows often undermine transparency and responsiveness, as well as further increased health inequalities between rural and urban health outcomes. Despite ongoing reforms, the communication dimension of healthcare systems remains underdeveloped. Findings reveal that centralized and top-down communication remains a dominant feature across the region, hindering timely dissemination of information and limiting the capacity to counter misinformation, as both misinformation and disinformation sometimes emerge from the government. Ultimately, this review contributes a critical analysis of these systematic communication failures and underscores the need to strengthen public health communication and reduce health inequalities. To do it, governments must prioritize transparency, disclose decision-making processes, and rely on evidence-based messaging to build trust. Effective crisis response requires not only government leadership but also the active engagement of the medical and patient communities, supported by civil society and independent media. This review points out the need for more inclusive, transparent, and trust-oriented communication strategies to enhance public health preparedness and resilience in nine Eastern European and Central Asian contexts.}, }
@article {pmid41595987, year = {2025}, author = {Morelli, S and Giansanti, D}, title = {Recent Advances in AI-Driven Mobile Health Enhancing Healthcare-Narrative Insights into Latest Progress.}, journal = {Bioengineering (Basel, Switzerland)}, volume = {13}, number = {1}, pages = {}, pmid = {41595987}, issn = {2306-5354}, abstract = {BACKGROUND: The integration of artificial intelligence (AI) into mobile health (mHealth) applications has been accelerated by the widespread adoption of smartphones and recent technological advances, particularly in the wake of the COVID-19 pandemic. This experience has expanded the role of AI-powered apps in real-time health monitoring, early detection, and personalized treatment pathways.
AIM: This review aims to summarize recent evidence on the use of AI in healthcare-related mobile applications, with a focus on clinical trends, practical implications, and future directions.
METHODS: Studies were prioritized based on methodological rigor, with systematic reviews forming the core of the analysis. Additional literature was considered to capture emerging trends and applications where a relevant rigorous screening and scoring procedure was applied to ensure methodological quality and relevance. Only studies addressing healthcare applications, rather than computational or computer science frameworks, were included to reflect the journal's clinical scope.
RESULTS AND DISCUSSION: Fifty-six secondary studies were analyzed in detail. Thematic synthesis revealed a post-pandemic shift toward applications targeting mental health, chronic care management, and preventive services. Additional screening showed that, despite their increasing use in clinical contexts, few AI-based apps were formally classified as medical devices. This highlights a gap between technological innovation and regulatory oversight. Ethical concerns-including algorithm transparency, clinical responsibility, and data protection-were frequently reported across studies.
CONCLUSIONS: This review underscores the growing impact of AI in mobile health, while drawing attention to unresolved challenges related to regulation, safety, and clinical accountability. A more robust integration into health systems will require clearer governance frameworks, validation standards, and interdisciplinary dialogue between developers, clinicians, and regulators.}, }
@article {pmid41596113, year = {2025}, author = {Țocu, G and Ștefănescu, BI and Stavăr Matei, L and Țocu, L}, title = {Phagocyte NADPH Oxidase NOX2-Derived Reactive Oxygen Species in Antimicrobial Defense: Mechanisms, Regulation, and Therapeutic Potential-A Narrative Review.}, journal = {Antioxidants (Basel, Switzerland)}, volume = {15}, number = {1}, pages = {}, pmid = {41596113}, issn = {2076-3921}, abstract = {ROS derived from NADPH oxidase, particularly NOX2, are central to antimicrobial defense, coupling direct pathogen killing with redox signaling that shapes inflammation. This narrative review integrates recent advances on NOX2 structure, assembly, and spatiotemporal control in phagocytes, and outlines how ROS interact with NF-κB, MAPK, and Nrf2 networks to coordinate microbicidal activity and immune modulation. We summarize evidence that both ROS deficiency, as in chronic granulomatous disease, and uncontrolled excess, as in sepsis and severe COVID-19, drive clinically significant pathology, emphasizing the need for precise redox balance. Emerging therapeutic strategies include selective NOX2 inhibitors that limit pathological oxidative bursts, redox-modulating peptides that disrupt upstream activation cues, and Nrf2 activators that enhance endogenous antioxidant capacity, with attention to dosing challenges that preserve host defense while mitigating tissue injury. Key gaps remain in biomarker standardization, real-time in vivo ROS monitoring, and translation from animal models to patients, motivating personalized, combination approaches to redox medicine in infectious diseases.}, }
@article {pmid41596124, year = {2026}, author = {Ayyubova, G and Bablu, FE and Rahimli, N and Aghayeva, L and Springer, EM and Alghenaim, FA and Suzuki, YJ}, title = {Roles of Reactive Oxygen Species in Relationships Between Viral Infections and Alzheimer's Disease and Related Dementia.}, journal = {Antioxidants (Basel, Switzerland)}, volume = {15}, number = {1}, pages = {}, pmid = {41596124}, issn = {2076-3921}, abstract = {Emerging evidence suggests that viral infections may contribute to the onset and progression of Alzheimer's disease (AD) and other forms of dementia. Understanding the mechanism of viral involvement in the pathogenesis of AD and related dementia (ADRD) could contribute to reducing the burden caused by these conditions, which affect a large portion of the aging population. Some studies indicate the link between AD and viral infections, notably coronaviruses and herpesviruses. In AD, excessive production of reactive oxygen species (ROS) results in the modifications of lipids, proteins, and nucleic acids, contributing to synaptic dysfunction and cognitive impairments. Experimental evidence suggests that viral infections linked to ADRD induce the cellular production of ROS, possibly contributing to the pathogenesis of these conditions. Despite significant advances in defining the roles of ROS in neurological disorders and viral infections, the specific roles of ROS in virus-associated ADRD have not been thoroughly investigated. The main objective of this review article is to comprehensively provide information on the experimental evidence for the production of ROS by viruses to help the readers investigate the role of ROS in the relationship between viral infections with ADRD.}, }
@article {pmid41596316, year = {2026}, author = {Hayashi, H and Kubo, Y and Tanaka, Y}, title = {Host Responses to SARS-CoV-2 with an Emphasis on Cytokines.}, journal = {International journal of molecular sciences}, volume = {27}, number = {2}, pages = {}, pmid = {41596316}, issn = {1422-0067}, mesh = {Humans ; *Cytokines/immunology/metabolism ; SARS-CoV-2 ; COVID-19/immunology ; Pandemics ; *Coronavirus Infections/immunology/virology ; *Pneumonia, Viral/immunology/virology ; *Betacoronavirus/immunology ; Animals ; Cytokine Release Syndrome/immunology ; Immunity, Innate ; Interferons/immunology ; }, abstract = {The COVID-19 pandemic has profoundly affected societies around the world. Although the emergency phase of coronavirus disease 2019 (COVID-19) has ended, the threat it poses remains persistent. This review aims to clarify the mechanisms of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection to support effective management of the disease. A central focus is the host cellular response to the viral infection, with particular emphasis on the role of cytokines. Cytokines play a dual role in antiviral defense: they contribute to the inhibition of viral replication and facilitate the clearance of pathogens, yet dysregulated cytokine responses can result in severe immunopathology. Interferons (type I, type II, and type III) and other cytokines are pivotal in activating intracellular antiviral mechanisms and in orchestrating the recruitment of immune cells through extracellular signaling. Effective immune responses to viral infections are governed not only by primary immune cells-such as dendritic cells, T lymphocytes, and B lymphocytes-but also by the local cytokine milieu shaped by infected and neighboring cells. Given the presence of endogenous inhibitors and autoantibodies in vivo, it is essential to evaluate the functional activity of cytokines in clinical samples. We propose a novel approach to quantify biologically active cytokine levels.}, }
@article {pmid41596537, year = {2026}, author = {Muntean, ST and Cozac-Szoke, AR and Tinca, AC and Kosovski, IB and Vultur, S and Vultur, M and Cotoi, OS and Sin, AI}, title = {Molecular Aspects of Viral Pathogenesis in Emerging SARS-CoV-2 Variants: Evolving Mechanisms of Infection and Host Response.}, journal = {International journal of molecular sciences}, volume = {27}, number = {2}, pages = {}, pmid = {41596537}, issn = {1422-0067}, mesh = {Humans ; *SARS-CoV-2/pathogenicity/genetics/physiology ; *COVID-19/virology/immunology/pathology ; Virus Internalization ; Spike Glycoprotein, Coronavirus/genetics/chemistry/metabolism ; Serine Endopeptidases/metabolism/genetics ; Host-Pathogen Interactions ; Mutation ; Viral Nonstructural Proteins/genetics/metabolism ; Neuropilin-1/metabolism/genetics ; }, abstract = {Although the SARS-CoV-2 pandemic no longer poses a global emergency, the virus continues to diversify and acquire immunoevasive properties. Understanding the molecular pathways that shape SARS-CoV-2 pathogenesis has become essential. In this paper, we summarize the most recent current evidence on how the spike protein structurally evolves, on changes in key non-structural proteins, such as nsp14, and on host factors, such as TMPRSS2 and neuropilin-1. These changes, together, shape viral entry, replication fidelity and interferon antagonism. Given the emerging Omicron variants of SARS-CoV-2, recent articles in the literature, cryo-EM analyses, and artificial intelligence-assisted mutational modeling were analyzed to infer and contextualize mutation-driven mechanisms. It is through these changes that the virus adapts and evolves, such as optimizing angiotensin-converting enzyme binding, modifying antigenic surfaces, and accumulating mutations that affect CD8[+] T-cell recognition. Multi-omics data studies further support SARS-CoV-2 pathogenesis through convergent evidence linking viral adaptation to host immune and metabolic reprogramming, as occurs in myocarditis, liver injury, and acute kidney injury. By integrating proteomic, transcriptomic, and structural findings, this work presents how the virus persists and dictates disease severity through interferon antagonism (ORF6, ORF9b, and nsp1), adaptive immune evasion, and metabolic rewiring. All these insights underscore the need for next-generation interventions that provide a multidimensional framework for understanding the evolution of SARS-CoV-2 and guiding future antiviral strategies.}, }
@article {pmid41596670, year = {2026}, author = {Smola-Dmochowska, A and Śmigiel-Gac, N and Jelonek, K and Lewicka-Brzoza, K and Bojdol, J and Dobrzyński, P}, title = {Antithrombotic Polymers: A Narrative Review on Current and Future Strategies for Their Design, Synthesis, and Application.}, journal = {International journal of molecular sciences}, volume = {27}, number = {2}, pages = {}, pmid = {41596670}, issn = {1422-0067}, mesh = {Humans ; *Polymers/chemistry/chemical synthesis/therapeutic use/pharmacology ; *Fibrinolytic Agents/chemistry/therapeutic use/chemical synthesis/pharmacology ; *Thrombosis/drug therapy/prevention & control ; Animals ; COVID-19/complications ; Drug Design ; SARS-CoV-2 ; }, abstract = {Bleeding and thromboembolism are among the leading causes of mortality worldwide. Thrombosis encompasses both arterial forms-primarily associated with atherosclerosis and leading to heart attacks or strokes-and venous forms. Microvascular thrombosis typically arises in the context of sepsis or systemic inflammation, and it became particularly prominent during the COVID-19 pandemic, substantially contributing to increased mortality. Given this burden, the rapid development of new therapies using advanced techniques and materials to prevent and treat these conditions is essential. This review summarizes recent advances in the design of antithrombotic polymers, discussing mechanisms of action, surface-modification strategies, and current clinical and preclinical applications. It also outlines criteria for evaluating hemocompatibility, describes in vitro and in vivo testing methods, and highlights key barriers to translating these materials into clinical practice. The review concludes by identifying promising directions for future research, including multifunctional approaches that combine antifouling properties, controlled drug release, and bioresistance strategies with the greatest potential to reduce thromboembolic complications associated with medical materials. It further evaluates the progress made to date in combating thrombotic diseases and identifies remaining gaps in the development and clinical implementation of new antithrombotic materials.}, }
@article {pmid41596677, year = {2026}, author = {Smith, E and Scholey, J}, title = {The Renin Angiotensin System: Insights into the Role of ACE2 in Glomerular Injury Including SARS-CoV-2 Infection.}, journal = {International journal of molecular sciences}, volume = {27}, number = {2}, pages = {}, pmid = {41596677}, issn = {1422-0067}, mesh = {Humans ; *Angiotensin-Converting Enzyme 2/metabolism ; *Renin-Angiotensin System/physiology ; *COVID-19/pathology/metabolism ; *Kidney Glomerulus/pathology/metabolism/injuries ; *Peptidyl-Dipeptidase A/metabolism ; SARS-CoV-2 ; Animals ; Angiotensin II/metabolism ; Receptors, Virus/metabolism ; }, abstract = {The circulating renin-angiotensin-aldosterone system (RAAS) plays a key role in regulating blood volume and electrolyte levels. While important for the maintenance of intravascular volume systemically, the local activation of tissue RAAS and the generation of angiotensin II contribute to inflammation and fibrosis. In the kidney, angiotensin II plays a key role in the development and progression of glomerular injury. Angiotensin-converting enzyme 2 (ACE2), an enzyme that degrades angiotensin II, is expressed in the glomerulus, focusing attention not only on the complexity of the RAAS but also identifying a potential new determinant of glomerular injury. Accordingly, we performed a narrative review using the search terms ACE2 and glomerulus in PubMed and Google Scholar to summarize the current understanding of the role of ACE2 in glomerular injury. We also discuss the role of ACE2 as a cellular receptor for SARS-CoV-2 and the potential impact of this function on glomerular injury in the setting of COVID-19.}, }
@article {pmid41596805, year = {2026}, author = {Głuchowski, A and Czarniecka-Skubina, E and Pielak, M}, title = {Effect of the Sous-Vide Method on the Quality of Vegetables-A Review.}, journal = {Foods (Basel, Switzerland)}, volume = {15}, number = {2}, pages = {}, pmid = {41596805}, issn = {2304-8158}, abstract = {Modern gastronomy strives to combine high-quality food with the preservation of nutritional value, microbiological safety, and the sustainable use of raw materials. With the development of culinary technologies, precise heat treatment methods are gaining increasing importance, enabling better process control and more consistent quality results. This analysis aims to present the effects of the sous-vide (SV) method on the quality of vegetables in comparison with conventional heat treatment methods, such as boiling in water, steaming, cooking under increased pressure, cooking in a microwave oven, baking, grilling, and the cook-vide method. Analysis of the scientific literature has shown that the sous-vide method usually allows for the retention of greater amounts of vitamins (especially vitamin C), phenolic compounds and minerals, resulting in products with higher nutritional value and bioavailability of bioactive ingredients. Maintaining a controlled, low temperature in a vacuum environment reduces the loss of water and volatile components, which has a positive impact on the process yield as well as the color, texture, and aroma of vegetables. SV processing enhances product digestibility, preserves natural appearance, and improves food safety. Due to its hermetic packaging and limited oxygen access, this method ensures good microbiological quality and extends product shelf life. In the food service industry, SV allows for repeatable results, high sensory and technological quality, and reduced food waste. In the context of contemporary nutritional challenges and the experiences of the COVID-19 pandemic, sous-vide technology is gaining importance as a method supporting food safety, sustainability, and efficient resource management in the food service industry.}, }
@article {pmid41597083, year = {2026}, author = {Alhumaid, S and Alkhamees, AA and Al Dossary, N and Almuslim, AA and Majzoub, RA and Alalwan, QM and Alsaeed, MJ and Aljowaisem, FM and Alqahtani, MA and Alamer, AI and ALDuhailan, MI and Al Nasser, DA and Almuhanna, MS and Al-Kamees, MA and Alhadab, HA and Alsultan, AA and Bukhamseen, AN and Alabdullah, AA and Alhaddad, KS and Alhumaid, MA and Almusabeh, HM and Almubarak, YS and AlShayeb, RA and Alnami, DA and Alatiyyah, YY and Al Alawi, Z and Alabdulqader, M}, title = {Long-Term Kidney Outcomes After SARS-CoV-2 Infection in Children Aged 0-12 Years: A Systematic Review.}, journal = {Children (Basel, Switzerland)}, volume = {13}, number = {1}, pages = {}, pmid = {41597083}, issn = {2227-9067}, abstract = {Background: Acute kidney injury (AKI) is increasingly recognised in children with acute COVID-19 and multisystem inflammatory syndrome in children (MIS-C), yet the long-term renal consequences in younger paediatric populations remain unclear. Most studies focus on acute illness or mixed-age cohorts, with limited data specific to children aged 0-12 years. Objectives: This study aimed to systematically identify, evaluate, and synthesise evidence on post-acute (≥30 days) and long-term (≥90 days) kidney outcomes following SARS-CoV-2 infection or MIS-C in children aged 0-12 years, including chronic kidney disease (CKD), eGFR decline, proteinuria, haematuria, hypertension, and need for kidney replacement therapy. Methods: We searched MEDLINE, Embase, CINAHL, and PubMed (December 2019-30 November 2025), following PRISMA 2020 guidelines and a registered PROSPERO protocol (CRD420251241949). Observational studies reporting kidney outcomes ≥30 days post-infection in children aged 0-12 years were included. Risk of bias was assessed using the Newcastle-Ottawa Scale or ROBINS-I. Owing to heterogeneity and absence of ≥3 comparable datasets, a narrative synthesis was performed. Results: Seven studies met inclusion criteria (five MIS-C cohorts, two acute COVID-19 cohorts). Only a subset provided extractable data specific to children aged 0-12 years. Follow-up ranged from 30 days to 12 months; four studies reported outcomes ≥ 180 days. Across all studies, no incident CKD, sustained eGFR decline, or kidney replacement therapy were reported among children completing long-term follow-up; however, most long-term outcome data were derived from MIS-C cohorts with median ages around 8-11 years that included some adolescents, rather than exclusively children aged 0-12 years. One MIS-C study reported long-term hypertension in 14% of children. A cross-sectional Italian cohort of mild COVID-19 demonstrated hyperfiltration, proteinuria, and microhaematuria at ~3 months, though chronicity could not be assessed due to absence of baseline values. A large US EHR-based cohort identified increased CKD risk after COVID-19 in the broader < 21-year population; however, 0-12-year-specific event counts were not reported, preventing quantitative synthesis for young children. Conclusions: Evidence on long-term kidney outcomes after SARS-CoV-2 infection in children aged 0-12 years remains limited, and only a small subset of studies provided extractable, age-specific data. On the other hand, MIS-C cohorts generally show favourable renal recovery, small sample sizes, lack of control groups, and short follow-up restrict confidence in these findings. Large paediatric EHR studies suggest potential long-term renal risk in broader paediatric populations, highlighting the need for age-stratified, prospective cohorts with serial eGFR, urine studies, and blood pressure assessments. Until definitive evidence emerges, structured renal follow-up may be warranted for children with AKI or MIS-C during COVID-19.}, }
@article {pmid41597107, year = {2026}, author = {Álvarez-Fernández, ML and Rodríguez, C}, title = {Socio-Emotional Wellbeing in Parents of Children with Neurodevelopmental Disorders: A Systematic Review.}, journal = {Children (Basel, Switzerland)}, volume = {13}, number = {1}, pages = {}, pmid = {41597107}, issn = {2227-9067}, support = {PID2021-1244011NB-I00//Spanish Ministry of Science and Innovation 444 (MCIN/AEI/10.13039/501100011033/FEDER, UE)/ ; }, abstract = {Background/Objectives: Neurodevelopmental disorders (NDDs) require contextual approaches emphasizing family roles. Parents of children with NDDs face a complex socio-emotional reality. They may experience high levels of stress, fatigue, depression, and feelings of guilt and uncertainty, and they are often left feeling isolated and unsupported. All of these factors increase their socio-emotional vulnerability and affect their children's wellbeing. A significant part of the available evidence has focused on parents of typically developing children or on a single construct. For these reasons, and considering the impact of the COVID-19 pandemic, the aim of this study was to review interventions targeting the improvement of the socio-emotional wellbeing of parents of children with NDDs, in order to characterise recent research, the specific constructs addressed, and the effectiveness of interventions. Methods: No prior protocol/registration. ERIC and Web of Science databases (selected for their broad multidisciplinary coverage in psychology and social sciences) were searched from 2020-2025 (last search: 7 September 2025), limited to English/Spanish publications. Inclusion criteria encompassed parents/primary family caregivers of children with NDDs receiving socio-emotional programs. Two independent reviewers screened the titles/abstracts and full texts, resolving disagreements through discussion. Following PRISMA 2020 guidelines, this systematic review employed narrative synthesis without risk-of-bias assessment and included 16 studies (approximately, 1100 participants). Results: The analysis indicated a scarce but growing scientific output, with a complex methodological landscape showing promising preliminary convergence in intervention outcomes. Interventions effects appeared mediated by cultural suitability, accessibility, and contextual alignment. Conclusions: Future work should pursue multisystemic approaches engaging diverse societal contexts and agents to optimize child and family wellbeing.}, }
@article {pmid41597174, year = {2026}, author = {Sisk, CK and Turner, LM and Meraj, S and Yusuf, N}, title = {Advances in mRNA-Based Melanoma Vaccines: A Narrative Review of Lipid Nanoparticle and Dendritic Cell Delivery Platforms.}, journal = {Cells}, volume = {15}, number = {2}, pages = {}, pmid = {41597174}, issn = {2073-4409}, mesh = {Humans ; *Dendritic Cells/immunology ; *Cancer Vaccines/immunology/administration & dosage/therapeutic use ; *Melanoma/immunology/therapy ; *Nanoparticles/chemistry ; *RNA, Messenger/immunology ; *Lipids/chemistry ; Animals ; mRNA Vaccines ; Antigens, Neoplasm/immunology ; Nanovaccines ; Liposomes ; }, abstract = {Melanoma remains one of the deadliest cutaneous malignancies worldwide, and despite advances in systemic therapy, recurrence and treatment resistance remain frequent challenges. Following the success of COVID-19 mRNA vaccines, mRNA-based cancer vaccines targeting melanoma antigens have emerged as a promising therapeutic direction. This review summarizes current evidence on mRNA melanoma vaccines, focusing on two leading delivery platforms: lipid nanoparticles (LNPs) and dendritic cell (DC) vaccines. A comprehensive search of MEDLINE, Embase, and Scopus from 2015 to 2025 identified clinical trials, preclinical studies, and review articles evaluating mRNA vaccine constructs and delivery strategies. Completed clinical studies demonstrate that personalized LNP-formulated mRNA vaccines can enhance neoantigen-specific T-cell responses and improve recurrence-free survival, particularly when combined with immune checkpoint inhibitors. DC-based mRNA vaccines also show potent immunogenicity, with stronger responses observed when DC maturation is optimized. Ongoing trials continue to investigate next-generation LNP formulations, DC priming strategies, and personalized neoantigen approaches. Overall, current evidence indicates that both LNP and DC platforms can augment antitumor immunity by broadening T-cell responses and enhancing checkpoint inhibition. Continued refinement of delivery vehicles, neoantigen selection, and scalable manufacturing processes will be essential to realizing the full clinical potential of mRNA vaccines in melanoma.}, }
@article {pmid41597249, year = {2026}, author = {Stigliano, E and Tocci, A and Florio, R and Arena, V and Amadoro, G}, title = {Olfactory Dysfunction and Cognitive Deterioration in Long COVID: Pathomechanisms and Clinical Implications in Development of Alzheimer's Disease.}, journal = {Cells}, volume = {15}, number = {2}, pages = {}, pmid = {41597249}, issn = {2073-4409}, support = {RF-2021-12374//Italian Ministry of Health/ ; 971925//Alzheimer's Association Research Grant/ ; FOE D.M865/2019//Fondo Ordinario Enti/ ; }, mesh = {Humans ; *COVID-19/complications ; *Alzheimer Disease/virology/etiology ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; *Olfaction Disorders/virology ; *Cognitive Dysfunction/virology ; Anosmia ; }, abstract = {Complete or partial loss of smell (anosmia), sometimes in association with distorted olfactory perceptions (parosmia), is a common neurological symptom affecting nearly 60% of patients suffering from post-acute neurological sequelae of COronaVIrus Disease of 2019 (COVID-19) syndrome, called long COVID. Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) may gain access from the nasal cavity to the brain (neurotropism), and the olfactory route has been proposed as a peripheral site of virus entry. COVID-19 is a risk factor for developing Alzheimer's Disease (AD), an age-dependent and progressive neurodegenerative disorder characterized in affected patients by early olfaction dysfunction that precedes signs of cognitive decline associated with neurodegeneration in vulnerable brain regions of their limbic system. Here, we summarize the recent literature data supporting the causal correlation between the persistent olfactory deterioration following SARS-CoV-2 infection and the long-delayed manifestation of AD-like memory impairment. SARS-CoV-2 infection of the olfactory neuroepithelium is likely to trigger a pattern of detrimental events that, directly and/or indirectly, affect the anatomically interconnected hippocampal and cortical areas, thus resulting in tardive clinical dementia. We also delineate future advancement on pharmacological and rehabilitative treatments to improve the olfactory dysfunction in patients recovering even from the acute/mild phase of COVID-19. Collectively, the present review aims at highlighting the physiopathological nexus between COVID-19 anosmia and post-pandemic mental health to favor the development of best-targeted and more effective therapeutic strategies in the fight against the long-term neurological complications associated with SARS-CoV-2 infection.}, }
@article {pmid41597308, year = {2025}, author = {Carbone, RG and Nagoti, S and Monselise, A and Wille, KM and Puppo, F and Shah, PL}, title = {COVID-19 and Interstitial Lung Disease.}, journal = {Medicina (Kaunas, Lithuania)}, volume = {62}, number = {1}, pages = {}, pmid = {41597308}, issn = {1648-9144}, mesh = {Humans ; *Lung Diseases, Interstitial/etiology/therapy/diagnosis/physiopathology/virology ; *COVID-19/complications ; Tomography, X-Ray Computed ; Risk Factors ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Lung/pathology ; Respiratory Function Tests ; }, abstract = {Background and Objectives: COVID-19 is an infection caused by the SARS-CoV-2 coronavirus that may develop several complications. Interstitial lung disease (ILD) is the major long-term complication of COVID-19 disease leading to progressive lung fibrosis and reduced respiratory function. The aim of this narrative review is to provide an updated overview of post-COVID-19 ILD by examining research publications and clinical guidelines selected from PubMed, Web of Science, and major respiratory medicine journals from 2020 to 2025. Methods: ILDs are diagnosed by medical history, physiological examination, pulmonary function tests, and chest X-ray or high-resolution computed tomography (HRCT) scan. Lung biopsy, especially cryobiopsy or video-assisted thoracoscopic (VATS) biopsy, can be performed to define histological patterns and confirm the diagnosis. Results: Post-COVID-19 ILD is a chronic condition characterized by long-term respiratory symptoms, radiological findings, and reduced lung function. Fibrotic injury is a consequence of the initial infection and could be influenced by persistent inflammation and dysregulated tissue repair. Risk factors include severe acute illness, advanced age, male sex, and smoking. Clinical course and prognosis of post-COVID-19 ILD is uncertain, as most patients experience gradual improvement or stability, whereas others develop progressive lung function decline. Treatment of post-COVID-19 ILD is not presently defined by guidelines but comprises corticosteroids, antifibrotics (including new drugs such as nerandomilast), supportive oxygen, pulmonary physiotherapy rehabilitation, smoking cessation, and vaccination. Conclusions: ILD represents a significant long-term complication of COVID-19 infection. Further investigations are required to better understand its pathophysiology and clinical management. As research progresses, more effective diagnostic and therapeutic strategies are expected to emerge.}, }
@article {pmid41597563, year = {2025}, author = {Usserbayev, B and Zhugunissov, K and Smekenov, I and Akmyrzayev, N and Abdykalyk, A and Abeuov, K and Zhumadil, B and Melisbek, A and Shirinbekov, M and Zhaksylyk, S and Nagymzhanova, Z and Seidakhmetova, A and Beltramo, C and Peletto, S and Kerimbaev, A and Nurabaev, S and Chervyakova, O and Kozhabergenov, N}, title = {Alpha- and Beta-Coronaviruses in Humans and Animals: Taxonomy, Reservoirs, Hosts, and Interspecies Transmission.}, journal = {Microorganisms}, volume = {14}, number = {1}, pages = {}, pmid = {41597563}, issn = {2076-2607}, support = {IRN BR24992948//Development of new diagnostic test systems for particularly dangerous viral infections (2024-2026) (IRN BR24992948) with the support of the Science Committee of the Ministry of Science and Higher Education of the Republic of Kazakhstan./ ; }, abstract = {The Coronaviridae family represents a broad group of RNA-containing viruses that infect humans and animals. This family belongs to the order Nidovirales and is divided into four main genera: α-CoV, β-CoV, γ-CoV and δ-CoV. It is particularly noteworthy that representatives of β-CoV have caused serious epidemics in humans, such as the outbreaks of SARS-CoV, MERS-CoV, and COVID-19 caused by SARS-CoV-2. Although the clinical manifestations of CoVs can range from mild cold-like symptoms to severe respiratory diseases, they share common features in their structure, modes of transmission, and natural reservoirs. Identifying natural reservoirs, as well as establishing intermediate hosts, is crucial for understanding the mechanisms of interspecies transmission of CoVs. These processes are often mediated by molecular interactions between viral spike (S) proteins and cellular receptors of different species, which contribute to zoonotic outbreaks. Thus, the interaction of various species and the study of these processes of viral spread, cross-species transmission, and pathogen evolution play a key role in ensuring global biological safety. Therefore, we conducted this review to summarize the data from existing studies focused on the taxonomy of CoVs, their main types, natural reservoirs, intermediate hosts, pathways of interspecies transmission, and the significance of the One Health concept as an interdisciplinary approach to monitoring, prevention and control of CoV infections at the intersection of human, animal, and environmental health. We examined databases such as PubMed, Science Direct, Web of Science, and Google Scholar to identify relevant scientific articles in English available for such a review. The aim of this work is to study the taxonomy and classification of coronaviruses, as well as to identify their natural reservoirs, intermediate hosts, and applicable control measures. A review of human and animal coronaviruses has revealed their evolutionary diversity, their main natural reservoirs, their intermediate hosts, and their interactions with cellular receptors. This information allows for a better understanding of the mechanisms by which the viruses are transmitted from animals to humans. The concept of One Health demonstrated the interconnections between human, animal and environmental factors.}, }
@article {pmid41597670, year = {2026}, author = {Soyfoo, M and Sarrand, J}, title = {Plasmablast Storms: Microbial Drivers of Acute and Chronic Autoimmune Flares.}, journal = {Microorganisms}, volume = {14}, number = {1}, pages = {}, pmid = {41597670}, issn = {2076-2607}, abstract = {Autoimmune flares are often accompanied by abrupt surges of circulating plasmablasts-short-lived, high-output antibody-secreting cells generated through extrafollicular B-cell activation in response to microbial cues. Three categories of microbial input appear to repeatedly trigger these "plasmablast storms": latent herpesvirus reactivations (Epstein-Barr virus, cytomegalovirus, human herpesvirus-6, varicella-zoster virus), acute respiratory or gastrointestinal infections including SARS-CoV-2, and chronic oral or gut dysbiosis. Although biologically distinct, these stimuli converge on innate sensing pathways driven by pathogen-associated molecular patterns such as unmethylated CpG DNA, single-stranded RNA, lipopolysaccharide, and bacterial lipoglycans. Through Toll-like receptors and type I interferon signalling, microbial signatures accelerate class switching, amplify inflammatory cytokine milieus, and lower B-cell activation thresholds, enabling rapid plasmablast mobilisation. Dysbiosis further maintains B cells in a hyper-responsive state by disrupting mucosal homeostasis and altering microbial metabolite profiles, thereby reducing the stimulus required to trigger plasmablast bursts. Once generated, these waves of oligoclonal plasmablasts home to inflamed tissues, where chemokine and adhesion landscapes shape their retention during flares. Emerging evidence suggests that such episodic plasmablast expansions promote autoantibody diversification, somatic hypermutation, and epitope spreading, progressively eroding tolerance. This review synthesizes these insights into a unified model in which infections and dysbiosis promote microbe-licensed plasmablast storms that influence the tempo and severity of autoimmune disease.}, }
@article {pmid41597712, year = {2026}, author = {Mour, G and Paudel, SD and Modi, P and Goswami, U and Shubeilat, J and Ptak, L and Parajuli, S}, title = {The Role of Vaccination in Adult Solid Organ Transplantation: Updated Reviews with Recent Guidelines.}, journal = {Microorganisms}, volume = {14}, number = {1}, pages = {}, pmid = {41597712}, issn = {2076-2607}, abstract = {Vaccination remains a cornerstone of infection prevention in adult solid organ transplant (SOT) recipients, a population at heightened risk for vaccine-preventable diseases due to chronic immunosuppression and comorbidities. Updated guidelines from the American Society of Transplantation Infectious Diseases Community of Practice (AST IDCOP) and other international bodies emphasize the need for timely and comprehensive vaccination strategies before and after transplantation. This review synthesizes current literature and practice guidelines on vaccination in adult solid organ transplant (SOT) candidates and recipients. Published peer-reviewed studies, clinical trials, and consensus guidelines were evaluated, with emphasis on vaccination timing, safety, immunogenicity, dosing strategies, and serologic response monitoring in the SOT population. Comprehensive vaccination planning before transplantation, combined with appropriate post-transplant booster strategies, remains vital to improving long-term outcomes in SOT recipients. This review provides clinicians with an updated, evidence-based framework for integrating evolving vaccination guidelines into the care of adult transplant patients.}, }
@article {pmid41598213, year = {2025}, author = {Park, JY and Lee, HM}, title = {PEDV Structural Proteins with Emphasis on M Protein as an Immunomodulatory Factor in Porcine Innate Immunity.}, journal = {Life (Basel, Switzerland)}, volume = {16}, number = {1}, pages = {}, pmid = {41598213}, issn = {2075-1729}, support = {RS-2025-25400025//National Research Foundation of Korea/ ; }, abstract = {Porcine epidemic diarrhea virus (PEDV) is an enteric alphacoronavirus that causes severe diarrhea and high mortality in neonatal pigs, leading to substantial economic loss in the porcine industry. Previous studies have primarily focused on the spike protein because of its role in viral entry and induction of neutralizing antibody responses. However, accumulating evidence indicates that other viral components also contribute to host immune modulation and pathogenesis. This review summarizes the current knowledge on PEDV structural proteins, with an emphasis on membrane proteins as regulators of porcine innate immune responses. The molecular characteristics and intracellular localization of membrane proteins were described, and the reported effects on interferon signaling, inflammatory pathways, and cellular stress responses were examined. Findings from related coronaviruses were incorporated to highlight the conserved features and virus-specific differences in membrane protein-mediated host modulation. Available evidence suggests that membrane protein-associated interference with innate immune signaling may contribute to intestinal immune dysregulation and disease severity in neonatal piglets. The implications of these observations on PEDV pathogenesis and intervention strategies are also discussed. By shifting attention from spike-centered frameworks to structural protein-driven host interactions, this review highlights membrane proteins as an underexplored but biologically relevant factor in porcine coronavirus research.}, }
@article {pmid41598316, year = {2026}, author = {Vieru, AM and Radulescu, D and Streba, L and Trasca, ET and Cazacu, SM and Statie, RC and Popa, P and Ciurea, T}, title = {Learning from an Emerging Infection: How the COVID-19 Pandemic Reshaped Gastric Cancer Care.}, journal = {Life (Basel, Switzerland)}, volume = {16}, number = {1}, pages = {}, pmid = {41598316}, issn = {2075-1729}, abstract = {Background/Objectives: The COVID-19 pandemic profoundly disrupted gastric cancer care, reducing access to screening, delaying diagnosis, and altering therapeutic pathways worldwide. Beyond clinical challenges, it exposed structural weaknesses in healthcare systems but also accelerated innovation. Methods: We conducted a narrative review supported by a structured literature search (PubMed/MEDLINE, Scopus, Web of Science; 1 January 2014-30 November 2025), with a narrative synthesis of observational studies, registry analyses, and meta-analyses addressing COVID-19-related changes in gastric cancer epidemiology, diagnosis, treatment, vaccination, and telemedicine. A PRISMA-style flow diagram was used to illustrate study selection. Results: Elective endoscopy volumes fell by up to 80%, leading to diagnostic backlogs and increased proportions of advanced-stage gastric cancer. Surgical postponements, modified chemotherapy and radiotherapy schedules, and reduced molecular/genetic testing further compromised outcomes. Conversely, vaccination, telemedicine, capsule endoscopy, and adaptive triage frameworks enabled partial recovery of services. Geographical variations were observed in the recovery of gastric cancer care services, with regions that had established screening infrastructure generally resuming activity more rapidly, whereas others experienced ongoing delays and diagnostic backlogs. Conclusions: This review integrates epidemiological, diagnostic, and therapeutic evidence to demonstrate how COVID-19 redefined gastric cancer care. By highlighting regional disparities and outlining a conceptual model for oncologic resilience, it provides an innovative framework for future crisis preparedness. The lessons of the pandemic-digital health integration, flexible treatment protocols, and international collaboration-represent a foundation for more robust, equitable gastric cancer management in the post-pandemic era.}, }
@article {pmid41598392, year = {2026}, author = {Vaira, LA and Micheluzzi, V and Lechien, JR and Maniaci, A and Maglitto, F and Cammaroto, G and Troise, S and Chiesa-Estomba, CM and Consorti, G and Cirignaco, G and Saibene, AM and Iannella, G and Navarro-Cuéllar, C and Soro, GM and Salzano, G and Casu, G and De Riu, G}, title = {Telemedicine in Oral and Maxillofacial Surgery: A Narrative Review of Clinical Applications, Outcomes and Future Directions.}, journal = {Journal of clinical medicine}, volume = {15}, number = {2}, pages = {}, pmid = {41598392}, issn = {2077-0383}, support = {00000038//Ministero dell'università e della ricerca/ ; }, abstract = {Objectives: Telemedicine has rapidly expanded in oral and maxillofacial surgery (OMFS), especially during the COVID-19 pandemic, but its specific roles and limitations across the care pathway remain unclear. This narrative review aimed to map telemedicine modalities and indications in OMFS, summarize reported outcomes, and identify priorities for future research. Methods: A narrative synthesis was undertaken after a systematic search of medical and engineering databases to 10 October 2025. Studies applying telemedicine, telehealth, telepresence or teleradiology to OMFS practice were eligible, including trials, observational cohorts, technical reports and surveys. Data were extracted in duplicate and organized thematically; heterogeneity precluded meta-analysis. Results: Fifty studies met the inclusion criteria. Telemedicine was mainly used for preoperative consultation and triage, postoperative follow-up, trauma teleradiology and tele-expertise, oncologic and oral medicine follow-up, temporomandibular disorders, and education or humanitarian work. In low-risk outpatient and postoperative settings, remote consultations showed high concordance with in-person plans, similar complication or reattendance rates, reduced travel, and high satisfaction. In trauma networks, telemedicine supported timely triage and reduced unnecessary inter-hospital transfers. Evidence in oral oncology and complex mucosal disease was more cautious, favouring hybrid models and escalation to face-to-face assessment. Data on cost-effectiveness and impacts on equity were limited. Conclusions: Telemedicine in OMFS has moved from niche innovation to a pragmatic adjunct across the clinical pathway. Current evidence supports its use for selected pre- and postoperative care and trauma triage within risk-stratified hybrid models, while underscoring the need for stronger comparative and implementation studies, clear governance on equity and data protection, and alignment with wider digital and AI-enabled health systems.}, }
@article {pmid41598742, year = {2026}, author = {Vink, M and Vink-Niese, A}, title = {An Overview of Severe Myalgic Encephalomyelitis.}, journal = {Journal of clinical medicine}, volume = {15}, number = {2}, pages = {}, pmid = {41598742}, issn = {2077-0383}, abstract = {In this article, we have reviewed the literature on severe myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). ME/CFS is a clinical diagnosis in the absence of a diagnostic test. However, in research settings and disability disputes, 2-day cardiopulmonary exercise testing can be used to diagnose and document the abnormal response to exercise. Biomedical research into this disease has been scarce and underfunded for decades. Consequently, there are no effective treatments. In its most severe form, it is more disabling than many other diseases, and patients are bedbound 24/7, dependent on carers, and spend their days in dark and quiet rooms. Even the soft sound of a human voice can lead to further deterioration. Some of the very severely ill suffer from life-threatening malnutrition and need to be tube-fed. The COVID-19 pandemic has led to a sharp increase in the number of patients with post-infectious diseases, and many of them fulfill ME/CFS criteria. Dedicated, focused research using advanced medical technologies is needed to gain further understanding of the underlying disease mechanism. This will enable us to find effective pharmacological treatments and address the unmet medical needs of these very ill people.}, }
@article {pmid41599016, year = {2025}, author = {Gonepudi, NK and Baffour Awuah, H and Xu, W and Katte, RH and Lu, M}, title = {Structure-Guided Design of Peptide Inhibitors Targeting Class I Viral Fusion Proteins.}, journal = {Pathogens (Basel, Switzerland)}, volume = {15}, number = {1}, pages = {}, pmid = {41599016}, issn = {2076-0817}, support = {R01 AI181600/AI/NIAID NIH HHS/United States ; R35 GM151169/GM/NIGMS NIH HHS/United States ; R35GM151169/GM/NIGMS NIH HHS/United States ; R01AI181600//National Institute of Allergy and Infectious Diseases/ ; }, mesh = {*Viral Fusion Proteins/chemistry/antagonists & inhibitors/metabolism ; Humans ; *Peptides/chemistry/pharmacology ; Virus Internalization/drug effects ; *Antiviral Agents/pharmacology/chemistry ; *Viral Fusion Protein Inhibitors/chemistry/pharmacology ; *Drug Design ; }, abstract = {Viral fusion proteins are indispensable mediators of viral entry that orchestrate the fusion of viral and host membranes, making them primary targets for antiviral interventions. Class I fusion proteins, displayed on the surface of enveloped viruses (such as HIV-1, RSV, SARS-CoV-2, Nipah, influenza, and Ebola viruses), share conserved structural features, including the fusion peptide or loop and heptad repeat regions. These elements are essential for the formation of the post-fusion six-helix bundle during membrane fusion. Peptide inhibitors that mimic heptad repeat motifs have consequently emerged as an effective strategy for blocking the fusion process. This review summarizes design strategies for such inhibitors and highlights how sequence and structural insights have enabled their optimization via α-helical stabilization, hydrocarbon stapling, lactam bridges, lipid conjugation, macrocyclization, and multivalency. Using representative examples across major viral systems, this review illustrates how these strategies have led to the development of potent, stable, and even broad-spectrum antiviral peptides. This review provides insights to guide the rational design of next-generation peptide-based fusion inhibitors targeting viral membrane fusion.}, }
@article {pmid41599045, year = {2026}, author = {Abdul Jabar, K and Romli, NIA and Vellasamy, KM and Pallath, V and Al-Maleki, AR}, title = {Predictors of Mortality in Pseudomonas aeruginosa Bloodstream Infections: A Scoping Review.}, journal = {Pathogens (Basel, Switzerland)}, volume = {15}, number = {1}, pages = {}, pmid = {41599045}, issn = {2076-0817}, mesh = {Humans ; *Pseudomonas aeruginosa/drug effects ; *Pseudomonas Infections/mortality/microbiology/drug therapy ; Risk Factors ; *Bacteremia/mortality/microbiology ; COVID-19/mortality ; Anti-Bacterial Agents/therapeutic use ; SARS-CoV-2 ; Drug Resistance, Multiple, Bacterial ; }, abstract = {Pseudomonas aeruginosa bloodstream infections (PABSIs) are a major clinical challenge due to their association with significant mortality and antimicrobial resistance mechanisms. The COVID-19 pandemic changed antimicrobial practices, intensive care management, and patient risk profiles, potentially influencing the epidemiology and outcomes of PABSIs. In the post-pandemic period, practices were expected to revert to normal. The objective of this scoping review was to identify and summarize reported mortality rates and risk factors for PABSIs in studies published between 2023 and 2025. Literature searches were conducted across PubMed, Web of Science, Embase, and Scopus. Screening was performed in accordance with PRISMA-ScR guidelines. Twenty-two eligible studies were included. Mortality rates varied across the study setting and populations; however, several consistent predictors were consistently identified, including carbapenem exposure, multidrug-resistant Pseudomonas aeruginosa, hematologic disease or malignancy, corticosteroid therapy, sepsis or septic shock, mechanical ventilation, and higher severity-of-illness scores. Few studies have linked molecular mechanisms to patient outcomes, highlighting important gaps in knowledge. Notably, only a small number of studies included the post-pandemic period but did not analyze the data separately. Despite limited available evidence, critically ill and immunocompromised patients remain at greatest risk of death from PABSIs. This review highlights the need for a broader comparative analysis in future.}, }
@article {pmid41599072, year = {2026}, author = {Dave, RS and Fox, HS}, title = {Synergy of SARS-CoV-2 and HIV-1 Infections in the Human Brain.}, journal = {Pathogens (Basel, Switzerland)}, volume = {15}, number = {1}, pages = {}, pmid = {41599072}, issn = {2076-0817}, mesh = {Humans ; *Brain/virology/pathology ; *HIV Infections/pathology/virology/complications ; *COVID-19/pathology/virology/complications/epidemiology ; *HIV-1/pathogenicity ; *SARS-CoV-2 ; Microglia/virology/pathology ; Cytokines/metabolism ; Coinfection/virology ; }, abstract = {This review explores the interplay between SARS-CoV-2 and HIV-1 infections within the human brain, highlighting the significant neurological implications of these viral infections. SARS-CoV-2 can infect the central nervous system (CNS), with evidence of the virus detected in various brain regions, including the hypothalamus, cerebellum, and olfactory bulb. This infection is linked to microglial activation and neuroinflammation, which can lead to severe neurological outcomes in affected individuals. Autopsy studies revealed microglial changes, including downregulation of the P2RY12 receptor, indicating a shift from homeostatic to inflammatory phenotype. Similar changes in microglia are found in the brains of people with HIV-1 (PWH). In SARS-CoV-2, the correlation between inflammatory cytokines, such as IL-1, IL-6, and MCP-1, found in cerebrospinal fluid and brain tissues, indicates significant neurovascular inflammation. Astrogliosis and microglial nodules were observed, further emphasizing the inflammatory response triggered by the viral infections, again in parallel to those found in the brains of PWH. Epidemiologic data indicate that although SARS-CoV-2 infection rates in PWH mirror those in People without HIV (PWoH) populations, Long-COVID prevalence is markedly higher among PWH. Evidence of overlapping cognitive impairment, mental health burden, and persistent neuroinflammation highlights diagnostic complexity and therapeutic gaps. Despite plausible mechanistic synergy, direct neuropathological confirmation remains scarce, warranting longitudinal, biomarker-driven studies. Understanding these interactions is critical for developing targeted interventions to mitigate CNS injury and improve outcomes.}, }
@article {pmid41599373, year = {2026}, author = {Wan, X and Cui, X and Liang, K and Huang, J and Chen, K and Chen, W and Song, G}, title = {The Emerging Promise of Pentacyclic Triterpenoid Derivatives as Novel Antiviral Agents Against SARS-CoV-2 Variants.}, journal = {Molecules (Basel, Switzerland)}, volume = {31}, number = {2}, pages = {}, pmid = {41599373}, issn = {1420-3049}, support = {2025A1515010495//Guangdong Basic and Applied Basic Research Foundation/ ; 2024KQNCX197//Youth Innovative Talents Project from the Department of Education of Guangdong Province/ ; }, mesh = {*Antiviral Agents/chemistry/pharmacology/therapeutic use ; *SARS-CoV-2/drug effects ; Humans ; *Pentacyclic Triterpenes/chemistry/pharmacology/therapeutic use ; *COVID-19 Drug Treatment ; Spike Glycoprotein, Coronavirus/metabolism ; Saponins/chemistry/pharmacology ; }, abstract = {The continuous emergence of SARS-CoV-2 variants, especially the Omicron strain with its heightened transmissibility, has posed ongoing challenges to the efficacy of existing vaccine and drug regimens. This situation highlights the pressing demand for antiviral drugs employing novel mechanisms of action. Pentacyclic triterpenoids (PTs), a structurally varied group of compounds derived from plants, exhibit both antiviral and anti-inflammatory activities, making them attractive candidates for further therapeutic development. These natural products, along with their saponin derivatives, show broad-spectrum inhibitory effects against multiple SARS-CoV-2 variants (from Alpha to Omicron) via interactions with multiple targets, such as the spike protein, main protease (Mpro), RNA-dependent RNA polymerase (RdRp), and inflammatory signaling pathways. This review consolidates recent findings on PTs and their saponins, emphasizing their influence on the key structural features required for inhibiting viral attachment, membrane fusion, reverse transcription, and protease function. We systematically summarized the structure-activity relationships and their antiviral results of PTs based on different target proteins in existing studies. Furthermore, this work points toward new strategies for designing multi-target PT-based inhibitors with improved efficacy against Omicron and future variants.}, }
@article {pmid41600411, year = {2026}, author = {Tiwari, AK and Gupta, MK and Mishra, SK and Meena, R and Patolsky, F and Narayan, RJ}, title = {Nanobiosensors: A Potential Tool to Decipher the Nexus Between SARS-CoV-2 Infection and Gut Dysbiosis.}, journal = {Sensors (Basel, Switzerland)}, volume = {26}, number = {2}, pages = {}, pmid = {41600411}, issn = {1424-8220}, mesh = {Humans ; *Dysbiosis/virology/diagnosis/microbiology ; *COVID-19/diagnosis ; SARS-CoV-2 ; *Biosensing Techniques/methods ; *Gastrointestinal Microbiome ; *Nanotechnology/methods ; Pandemics ; Betacoronavirus ; *Pneumonia, Viral/diagnosis/virology ; *Coronavirus Infections/diagnosis/virology ; }, abstract = {The emergence of SARS-CoV-2 posed a great global threat and emphasized the urgent need for diagnostic tools that are rapid, reliable, sensitive and capable of real-time monitoring of SARS-CoV-2 infections. Recent investigations have identified a potential connection between SARS-CoV-2 infection and gut dysbiosis, highlighting the sophisticated interplay between the virus and the host microbiome. This review article discusses the eminence of nanobiosensors, as state-of-the-art tools, to investigate and clarify the connection between SARS-CoV-2 pathogenesis and gut microbiome imbalance. Nanobiosensors are uniquely advantageous owing to their sensitivity, selectivity, specificity, and reliable monitoring capabilities, making them well-suited for identifying both viral particles and microbial markers in biological samples. We explored a range of nanobiosensor platforms and their potential use for concurrently monitoring the gut dysbiosis induced by different pathological conditions. Additionally, we explore how advanced sensing technologies can shed light on the mechanisms driving virus-induced dysbiosis, and the implications for disease progression and patient outcomes. The integration of nanobiosensors with microfluidic devices and artificial intelligence algorithms has also been explored, highlighting the potential of developing point-of-care diagnostic tools that provide comprehensive insights into both viral infection and gut health. Utilizing nanotechnology, scientists and healthcare professionals may gain a more profound insight into the complex interaction dynamics between SARS-CoV-2 infection and the gut microenvironment. This could pave the way for enhanced diagnostic and prognostic approaches, treatment courses, and patient care for COVID-19.}, }
@article {pmid41600776, year = {2025}, author = {Giuliani, AAM and Chen, V and Law, N}, title = {Respiratory Viral Infection Prophylaxis and Treatment in the Transplant Population.}, journal = {Viruses}, volume = {18}, number = {1}, pages = {}, pmid = {41600776}, issn = {1999-4915}, mesh = {Humans ; Antiviral Agents/therapeutic use ; Respiratory Syncytial Virus Infections/prevention & control/drug therapy ; Antibodies, Monoclonal/therapeutic use ; *Respiratory Tract Infections/prevention & control/drug therapy/virology ; Influenza, Human/prevention & control ; COVID-19/prevention & control ; SARS-CoV-2 ; *Virus Diseases/prevention & control/drug therapy ; *Transplant Recipients ; Post-Exposure Prophylaxis ; }, abstract = {Transplant patients experience high morbidity and mortality caused by respiratory viral infections (RVIs). In the past decade, numerous methods of prophylaxis and treatment have rapidly developed and continue to expand, with dozens of novel agents in preclinical and clinical trials. This includes recent scientific breakthroughs in virus structure, which have enabled the creation of respiratory syncytial virus (RSV) vaccines. While new vaccines, antivirals, monoclonal antibodies, and non-vaccine agents are becoming more available, their utility and safety in the transplant populations are often uncertain. This review summarizes the current landscape of RVIs in the transplant population, including approaches to pre- and post-exposure prophylaxis and treatment. We discuss the data behind vaccine timing, safety, and efficacy and current pre- and post-transplant recommendations, with a particular focus on influenza, SARS-CoV-2, and RSV. We also examine the potential benefits of antivirals, monoclonal antibodies, and novel agents used as prophylaxis, treatment, or adjuncts. While there remain many knowledge gaps, these new methods and ongoing advancements in RVI treatment and prevention promise to improve transplant patient outcomes.}, }
@article {pmid41600815, year = {2025}, author = {Hamza, IA and Mao, K and Gao, C and Hamza, H and Zhang, H}, title = {Elements of Viral Outbreak Preparedness: Lessons, Strategies, and Future Directions.}, journal = {Viruses}, volume = {18}, number = {1}, pages = {}, pmid = {41600815}, issn = {1999-4915}, support = {FS-2024-34//CAS-ANSO/ ; 2023415//Chinese Academy of Sciences/ ; 24291703Z//Hebei Provincial Science and Technology Projects/ ; Qiankehe Platform Talents-GCC [2023] 046//Guizhou Provincial Science and Technology Projects/ ; }, mesh = {Humans ; *Disease Outbreaks/prevention & control ; Animals ; Pandemics/prevention & control ; Pandemic Preparedness ; COVID-19/prevention & control/epidemiology ; SARS-CoV-2 ; *Virus Diseases/prevention & control/epidemiology/diagnosis ; Public Health Infrastructure ; Public Health ; Communicable Diseases, Emerging/prevention & control/epidemiology ; }, abstract = {Emerging and re-emerging viruses continue to pose major threats to public health. Their ability to adapt, cross species barriers, and spread rapidly can trigger severe outbreaks or even pandemics. Strengthening preparedness with comprehensive and efficient strategies is therefore essential. Here, we explore the key components of viral outbreak preparedness, including surveillance systems, diagnostic capacity, prevention and control measures, non-pharmaceutical interventions, antiviral therapeutics, and research and development. We emphasize the increasing importance of genomic surveillance, wastewater-based surveillance, real-time data sharing, and the One Health approach to better anticipate zoonotic spillovers. Current challenges and future directions are also discussed. Effective preparedness requires transparent risk communication and equitable access to diagnostics, vaccines, and therapeutics. The COVID-19 pandemic highlighted both the promise of next-generation vaccine platforms and the necessity of maintaining diagnostic capacity, as early testing delays hindered containment efforts. Countries adopted various non-pharmaceutical interventions: risk communication and social distancing proved to be the most effective, while combined workplace infection-prevention measures outperformed single strategies. These experiences highlight the importance of early detection, rapid response, and multisectoral collaboration in mitigating the impact of viral outbreaks. By applying best practices and lessons learned from recent events, global health systems can strengthen resilience and improve readiness for future viral threats.}, }
@article {pmid41600887, year = {2026}, author = {Maslov, DE and Osipov, ID and Zabelina, DS and Pak, AA and Netesov, SV}, title = {Respiratory Syncytial Virus Prevalence and Genotypic Distribution in the Countries of the Former Soviet Union: A Systematic Review and Meta-Analysis.}, journal = {Viruses}, volume = {18}, number = {1}, pages = {}, pmid = {41600887}, issn = {1999-4915}, support = {FSUS-2025-0017 and FSUS-2025-0012//Ministry of Science and Higher Education, Russian Federation/ ; The "Prioritet-2030" program//Novosibirsk State University/ ; }, mesh = {Adult ; Child ; Child, Preschool ; Humans ; Infant ; COVID-19/epidemiology/virology ; Genotype ; Prevalence ; *Respiratory Syncytial Virus Infections/epidemiology/virology ; *Respiratory Syncytial Virus, Human/genetics/classification ; Seasons ; USSR/epidemiology ; }, abstract = {Respiratory syncytial virus (RSV) is among leading global causes of lower respiratory tract infections, yet data from Russia and other states of the Former Soviet Union (FSU) remain fragmented and structurally inconsistent. This systematic review aims to map and synthesize existing evidence on RSV epidemiology and genotypic distribution across the FSU. Published studies from eLIBRARY and PubMed databases queried for RSV prevalence data, together with public health surveillance datasets, were used to summarize RSV prevalence research across eight FSU countries. Random-effects meta-analysis across age strata showed high prevalence in children before 6 (21%) and a progressive decline with age, which is in agreement with global data. Prevalence estimates showed a high degree of variability partially explained by study scope and clinical presentation. We observed COVID-19-related seasonal disruptions of RSV seasonality, followed by gradual post-pandemic stabilization. Genotypic data reflects global trends with two cosmopolitan clades, A.D and B.D, and their descendants, dominating in the region. The review is limited by uneven geographical and temporal coverage, and scarce data on adults. The review provides the first integrated summary of RSV epidemiology across the FSU and underscores the need for expanded regional surveillance and genomic reporting.}, }
@article {pmid41600927, year = {2025}, author = {Esposito, S and Aurelio, C and Cifaldi, M and Lazzara, A and Viafora, F and Principi, N}, title = {Prevention of Respiratory Infections in Children with Congenital Heart Disease: Current Evidence and Clinical Strategies.}, journal = {Vaccines}, volume = {14}, number = {1}, pages = {}, pmid = {41600927}, issn = {2076-393X}, abstract = {Background: Children with congenital heart disease (CHD) are at substantially increased risk for respiratory infections, which occur more frequently and with greater severity than in healthy peers. This heightened vulnerability stems from multifactorial immune impairment, including defects in innate and adaptive immunity, chronic inflammation related to abnormal hemodynamics and hypoxia, reduced thymic function, and genetic syndromes affecting both cardiac and immune development. Viral pathogens-particularly respiratory syncytial virus (RSV), influenza viruses, and SARS-CoV-2-account for most infections, although bacterial pathogens remain relevant, especially in postoperative settings. Methods: This narrative review summarizes current evidence on infection susceptibility in children with CHD, the epidemiology and clinical relevance of major respiratory pathogens, and the effectiveness of available preventive measures. Literature evaluating immunological mechanisms, infection burden, vaccine effectiveness, and passive immunization strategies was examined, along with existing national and international immunization guidelines. Results: Children with CHD consistently exhibit higher rates of hospitalization, intensive care unit admission, mechanical ventilation, and mortality following respiratory infections. RSV, influenza, and SARS-CoV-2 infections are particularly severe in this population, while bacterial infections, though less common, contribute substantially to postoperative morbidity. Preventive options-including routine childhood vaccines, pneumococcal and Haemophilus influenzae type b vaccines, influenza vaccines, COVID-19 mRNA vaccines, and RSV monoclonal antibodies-demonstrate strong protective effects. New long-acting RSV monoclonal antibodies and maternal vaccination markedly enhance prevention in early infancy. However, vaccine coverage remains insufficient due to parental hesitancy, provider uncertainty, delayed immunization, and limited CHD-specific evidence. Conclusions: Respiratory infections pose a significant and preventable health burden in children with CHD. Enhancing the use of both active and passive immunization is essential to reduce morbidity and mortality. Strengthening evidence-based guidelines, improving coordination between specialists and primary care providers, integrating immunization checks into routine CHD management, and providing clear, condition-specific counseling to families can substantially improve vaccine uptake and clinical outcomes in this vulnerable population.}, }
@article {pmid41600988, year = {2026}, author = {Alkhidir, M and Sridharan, K}, title = {Efficacy and Safety of mRNA-Based COVID-19 Vaccines in Solid Organ Transplant Recipients: A Systematic Review and Meta-Analysis.}, journal = {Vaccines}, volume = {14}, number = {1}, pages = {}, pmid = {41600988}, issn = {2076-393X}, abstract = {BACKGROUND: Solid organ transplant recipients (SOTRs) are highly vulnerable to severe COVID-19 infection, yet initial vaccine trials provided limited data on efficacy and safety in this immunocompromised population. Heterogeneous seroconversion rates and conflicting safety reports complicate the formulation of clear clinical guidelines. This systematic review and meta-analysis aim to aggregate existing evidence to determine the precise seroconversion and safety profiles of COVID-19 vaccines and identify key factors influencing immune response in SOTRs.
METHODS: A comprehensive literature search was conducted identifying 125 studies evaluating WHO/FDA-authorized vaccines in SOTRs. Outcomes were the pooled seroconversion proportion and safety profile. Subgroup analyses were performed based on vaccine type, transplanted organ, number of doses, and prior SARS-CoV-2 infection status, confirmed by leave-one-out sensitivity analysis and bootstrap methods.
RESULTS: Most studies assessed mRNA-based vaccines (123/125, 98.4%). The overall pooled seroconversion proportion across all SOTRs was significantly blunted at 0.49 (95% CI, 0.43 to 0.55), demonstrating high heterogeneity (I[2] = 94.2%). Seroconversion showed a clear positive dose-response relationship, increasing from 27% after one dose to 84% after four doses. Prior COVID-19 infection was the strongest predictor of a response, resulting in a pooled seroconversion of 0.90 (95% CI, 0.82 to 0.94; I[2] = 0%). Organ-specific analyses revealed the highest response in Liver recipients (0.80) and the lowest in Lung recipients (0.29). Vaccine platform analysis showed that the highest response was with mRNA-1273 (0.55) and the lowest with CoronaVac (0.29). The safety profile was limited.
CONCLUSIONS: SOTRs exhibit profound hypo responsiveness to COVID-19 vaccines; however, the extreme heterogeneity observed across studies necessitates a cautious interpretation of pooled seroconversion estimates. While the data indicates a significant dose-response relationship favoring an aggressive, multi-dose strategy, the apparent safety profile may reflect under-reporting and limited follow-up rather than confirmed safety equivalence. Rare but clinically critical outcomes, such as acute allograft rejection, remain inadequately characterized in the current literature. Consequently, while the prioritization of multi-dose regimens and hybrid immunity is supported to maximize protection, clinicians must recognize that individual responses remain highly variable, and the long-term immunological impact of repeated stimulation requires further standardized investigation.}, }
@article {pmid41601020, year = {2026}, author = {See, KC}, title = {Vaccination Against Respiratory Infections in Adults with Cancer: A Concise Guide for Clinicians.}, journal = {Vaccines}, volume = {14}, number = {1}, pages = {}, pmid = {41601020}, issn = {2076-393X}, abstract = {Global cancer incidence reached 20 million new cases across 185 countries in 2022, with approximately 10 million cancer-related deaths annually. Among adults with solid tumors and hematological malignancies, infections are a major contributor to morbidity and mortality, with respiratory infections playing a particularly significant role. These infections not only reduce life expectancy but can also delay cancer therapy, negatively affect treatment outcomes, and increase healthcare costs. In recent years, the burden of respiratory infections in this population has been driven by influenza virus, SARS-CoV-2, respiratory syncytial virus, Streptococcus pneumoniae, and Bordetella pertussis. Effective vaccines are available for all these pathogens and are recommended for adults with cancer, yet vaccination uptake remains suboptimal despite their heightened vulnerability. This review provides practical guidance for healthcare professionals on vaccinating adults with cancer against respiratory infections, summarizing key information to help clinicians address vaccination-related complacency, confidence, and convenience. Evidence from studies in both the general population and cancer patients consistently shows that vaccination benefits outweigh potential risks, with adverse event rates comparable to those seen in individuals without cancer. Early vaccination is encouraged, as there is limited justification for delaying immunization even when immune responses may be reduced. Vaccine dosing aligns with recommendations for the general population, with important exceptions. Live attenuated vaccines should be avoided because of the risk of replication and disease in immunocompromised patients, and selected groups may require booster doses to achieve adequate protection. Notably, cancer immunotherapy does not appear to impair vaccine-induced immune responses.}, }
@article {pmid41602864, year = {2025}, author = {Dasgupta, T and Russell, E and Carbajal, C and Horgan, G and Peterson, L and Mistry, HD and Buabeng, R and Wilson, M and Smith, V and Boulding, H and Sheen, KS and Van Citters, AD and Nelson, EC and Duncan, EL and von Dadelszen, P and , and Silverio, SA and Magee, LA}, title = {Seeking digital maternity healthcare during the pandemic health system shock: a systematic review of women's experiences in low- and middle-income countries.}, journal = {Frontiers in reproductive health}, volume = {7}, number = {}, pages = {1734456}, pmid = {41602864}, issn = {2673-3153}, abstract = {BACKGROUND: The pandemic created global disruption acting as a health system shock not seen before in living memory. As a consequence, there were significant implications for healthcare delivery in low- and middle-income countries. Challenges such as lockdown restrictions created substantial modifications to the delivery of maternity care. This review aims to explore the experiences of maternity care by women, specifically in low- and middle-income countries, during the pandemic global health system shock.
METHODS: A systematic search was conducted for qualitative literature published about maternity healthcare experiences during the pandemic. Studies which provided qualitative data on women's experiences of digital healthcare, and other maternity care reconfigurations in low- and middle-income countries were included. The studies underwent quality assessment using twelve criteria adapted from the quality appraisal tool developed by the Evidence for Policy & Practice Information (EPPI) Centre. Thematic synthesis was employed.
RESULTS: Of the 21,860 records identified, 30 met the inclusion criteria for this review. Across the 4 key predetermined areas of study: (1) Care seeking and experience; (2) Digital health; (3) Vaccination; and (4) Ethical future of maternity services; 10 concepts were reported upon, namely: (1.1) Emotional challenges and uncertainty, (1.2) Disruption of services, (1.3) Stigma and discrimination, and (1.4) Changing support systems; (2.1) Safety and reassurance, (2.2) Locus of responsibility; (3.1) Vaccine understanding and acceptance; and (4.1) Improvements for maternity care delivery, (4.2) Implementation of virtual care, (4.3) Education and empowerment.
CONCLUSION: Our findings suggest emotional challenges, isolation, and limited access to maternity services were prominent among pregnant individuals in low- and middle-income countries. This synthesis provides insights into how pandemic associated adaptations, which have been retained beyond, such as digital health solutions were experienced by women within constrained health systems, revealing both opportunities and persistent gaps in digital health access and equity. Although a review of low- and middle-income countries-there is learning to be taken from these settings which could easily be applied not only across low- and middle-income countries, but also in high-income settings, in the form of reverse (or "trickle-up") innovation to improve maternity care as we recover and re-build from the pandemic and offer more resilient ways of providing maternity care through future health system shocks. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42022355948, identifier CRD42022355948.}, }
@article {pmid41603321, year = {2026}, author = {Silveira, IB and Silva, GP and Sampaio, AVH and Tomé, MR and Chen, JE and de Jesus, AVS and Cançado, GGL}, title = {Synchronous Telemedicine Versus In-Person Care in Hepatitis C Treatment: A Systematic Review and Meta-Analysis.}, journal = {Journal of viral hepatitis}, volume = {33}, number = {3}, pages = {e70144}, pmid = {41603321}, issn = {1365-2893}, mesh = {Humans ; *Telemedicine ; *Antiviral Agents/therapeutic use ; Sustained Virologic Response ; *Hepatitis C/drug therapy ; *Hepatitis C, Chronic/drug therapy ; COVID-19 ; Health Services Accessibility ; Treatment Outcome ; }, abstract = {Inequitable access to HCV treatment persists, particularly for rural and marginalised populations. Synchronous telemedicine (TM) could mitigate access barriers, but its comparative effectiveness versus in-person care is uncertain. We performed a systematic review and meta-analysis comparing synchronous TM with in-person care for HCV. The primary outcome was sustained virologic response (SVR); secondary outcomes were treatment initiation and completion. Subgroup analyses examined study design, therapy era (interferon vs. direct-acting antivirals [DAAs]), and setting (rural vs. non-rural). Narrative synthesis addressed people who use drugs (PWUD), incarcerated populations, pandemic-era cohorts, and economic evaluations. Fifteen studies involving 7.459 patients (2 RCTs, 13 observational) were included (13 meta-analysed). For SVR, the pooled effect showed no significant difference between interventions (odds ratio [OR] 1.60, 95% CI 0.69-3.68). Treatment initiation and completion were also not significantly different overall (initiation OR 7.59, 95% CI 0.79-72.81; completion OR 2.50, 95% CI 0.76-8.25), although exclusion of single influential studies yielded significant benefits for TM in sensitivity analyses. Subgroups suggested context-specific advantages: TM favoured SVR in rural settings (OR = 4.19, 95% CI 1.28-13.73) and in RCTs (OR = 10.42, 95% CI 7.41-14.67). Narrative evidence indicated that TM improved linkage and cure among PWUD and incarcerated individuals, preserved efficacy during COVID-19, and reduced costs. Overall, synchronous TM seems comparable to in-person care overall and may be superior in rural and marginalised populations.}, }
@article {pmid41604346, year = {2026}, author = {Cénat, JM and Darius, WP and Moshirian Farahi, SMM and Kibret, TC and Samson, E and Chen, R and Kuk, SW and Ogbuaku Jnr, K and Steacy, E and Labelle, PR and Madigan, S and Dalexis, RD}, title = {Prevalence and Correlates of Post-Traumatic Stress Disorder Symptoms During the COVID-19 Pandemic in Canada: A Systematic Review and Meta-analysis: Prévalence et corrélats des symptômes du trouble de stress post-traumatique pendant la pandémie de COVID-19 au Canada : Revue systématique et méta-analyse.}, journal = {Canadian journal of psychiatry. Revue canadienne de psychiatrie}, volume = {}, number = {}, pages = {7067437251408179}, pmid = {41604346}, issn = {1497-0015}, abstract = {BackgroundInfectious disease outbreaks have been associated with significant psychological distress and trauma. In Canada, the COVID-19 pandemic's social disruptions have heightened mental health risks. While global studies report elevated posttraumatic stress disorder (PTSD) symptoms, Canadian findings remain limited and inconsistent. This meta-analysis estimated pooled prevalence of PTSD symptoms in Canada during the COVID-19 pandemic and examined potential moderators.MethodsA comprehensive search strategy was executed by research librarians across five databases (APA PsycInfo, CINAHL, Embase, MEDLINE and Web of Science) and on LitCovid. The PRISMA guidelines were used for data extraction and reporting. Random-effects meta-analyses were conducted to estimate pooled PTSD symptoms prevalence and explore potential moderators using the metaprop command in STATA/SE 19.5.ResultsThirty studies conducted between 2020 and 2022, with 52,565 participants aged 18 and older were included (65% weighted women). The pooled prevalence of PTSD symptoms was 22.2% (95% CI, 15.7% to 29.4%; I[2]=99.69). Prevalence was 32.1% in women, 26.1% in men (p = 0.399) and ranged from 16.1% in Quebec to 29.7% in Ontario (p = 0.091). Meta-regressions showed lower PTSD symptoms prevalence in Quebec (B=-0.16, p = 0.029). No significant differences in PTSD symptoms were found according to sex, healthcare worker status, assessment tool used, or data collection year.ConclusionsThis meta-analysis reveals a concerning prevalence of PTSD symptoms in the Canadian population during the COVID-19 pandemic. Contrary to expectations, no significant differences were found by sex or healthcare worker status, suggesting widespread psychological distress across the population. However, the substantial heterogeneity across studies limits the interpretation of these findings in the context of the COVID-19 pandemic. The results emphasize the need for inclusive and accessible mental health responses and further research on post-pandemic Canadians' mental health. Future studies should better disaggregate data by sex, age and race to address disparities and inform targeted public health policies and interventions.}, }
@article {pmid41604358, year = {2026}, author = {Palacio Varona, J and Rojas Manjarres, AM and Gómez-Buitrago, MI and Castro-Caro, J and Gonzalez-Parra, JD and Del Portillo, MC and Prada, A and Villegas-Gomez, GA}, title = {Global, regional and national patterns in ROP research up to the pre-COVID-19 era: A systematic bibliometric review between 1950 to 2020.}, journal = {European journal of ophthalmology}, volume = {36}, number = {3}, pages = {542-552}, doi = {10.1177/11206721261415977}, pmid = {41604358}, issn = {1724-6016}, mesh = {Humans ; *Bibliometrics ; *Retinopathy of Prematurity/epidemiology ; *Biomedical Research/trends/statistics & numerical data ; *COVID-19/epidemiology ; Global Health ; Infant, Newborn ; SARS-CoV-2 ; }, abstract = {Retinopathy of prematurity (ROP) is a leading cause of preventable childhood blindness, predominantly affecting preterm infants. Global disparities in neonatal care and research capacity influence the volume and visibility of scientific production devoted to ROP across regions. This systematic bibliometric review aimed to characterize global, regional, and national patterns of ROP research published between 1950 and 2020, including temporal trends, geographic distribution, thematic focus, and citation impact. A systematic search of PubMed, Scopus, Web of Science, and SciELO identified 4,932 eligible articles. Most publications originated from the Region of the Americas (Pan American Health Organization, PAHO; 44.2%), the European Region (EURO; 28.0%), and the Western Pacific Region (WPRO; 16.0%). High-income countries accounted for 73.4% of the total output, whereas lower-middle- and low-income countries were markedly underrepresented. The most frequent research themes were risk/protective factors (25.0%) and treatment and outcomes (23.5%), while studies addressing surveillance and public health policies were scarce (6.3%). Scientific output increased markedly after the 1980s, with particularly rapid growth in recent decades in the Western Pacific and South-East Asia Regions. Citation analysis revealed substantial regional inequalities, with publications from high-income regions accounting for the majority of global citations and higher per-article impact. Overall, ROP research remains highly concentrated in high-income settings, reflecting persistent global disparities in scientific production and visibility. Strengthening research capacity and output in underrepresented regions is essential to promote more equitable evidence generation and to support informed decision-making in global eye health.}, }
@article {pmid41604670, year = {2026}, author = {Sun, M and Tang, F and Min, L and Wen, S and Wang, S and Jiang, H}, title = {Effects of Telehealth Interventions for People With Parkinson Disease: Systematic Review and Meta-Analysis of Randomized Controlled Trials.}, journal = {JMIR mHealth and uHealth}, volume = {14}, number = {}, pages = {e70994}, pmid = {41604670}, issn = {2291-5222}, mesh = {Humans ; *Parkinson Disease/therapy/psychology ; *Telemedicine/standards/statistics & numerical data ; Quality of Life/psychology ; Randomized Controlled Trials as Topic ; Activities of Daily Living/psychology ; COVID-19/epidemiology ; Depression ; }, abstract = {BACKGROUND: The global integration of telehealth into the management of Parkinson disease (PD) addresses critical gaps in health care access, especially for patients with limited mobility in underserved regions. Despite accelerated adoption during the COVID-19 pandemic, evidence regarding telehealth's multidimensional efficacy remains inconsistent. Previous meta-analyses reported conflicting outcomes for quality of life (QOL), motor symptoms, and neuropsychiatric comorbidities.
OBJECTIVE: This study aimed to quantitatively synthesize the effects of telehealth interventions across six core PD domains: (1) QOL, (2) depression, (3) anxiety, (4) motor symptoms, (5) activities of daily living (ADL), and (6) cognition.
METHODS: PubMed, Embase, Cochrane Library, Scopus, and Web of Science were systematically searched until June 21, 2024. In adherence to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, English-language randomized controlled trials evaluating telehealth interventions for PD were included. Study quality was assessed using the Cochrane Risk of Bias tool. A dual analytical approach using random-effects models was applied to address heterogeneity. Studies reporting a single effect size were analyzed using the Hartung-Knapp-Sidik-Jonkman correction. Studies with multiple dependent effect sizes were analyzed using a 3-level random-effects meta-analysis with t-distribution inference, accounting for sampling, within-study, and between-study variance. Effect sizes were expressed as standardized mean differences (SMD) with 95% CIs. Heterogeneity was quantified using the τ[2]; prediction intervals were not calculated due to the limited number of studies. Prespecified subgroup analyses examined intervention types (digital vs traditional telehealth) and follow-up durations. Sensitivity analyses and assessments for small-study effects (multilevel Egger tests, funnel plots) were conducted.
RESULTS: A total of 15 randomized controlled trials (765 participants) demonstrated significant telehealth benefits: QOL significantly improved on the Medical Outcomes Study 36-Item Short Form Health Survey and Brunnsviken Brief Quality of Life Scale (SMD 0.39, 95% CI 0.06-0.72; P=.03), with marginal improvement on the Parkinson Disease Questionnaire-8 (SMD -0.42, 95% CI -0.88 to 0.03; P=.07). Telephone-based interventions outperformed digital approaches (P=.002). Depression symptoms were significantly reduced (SMD -0.64, 95% CI -0.93 to 0.34; P<.001), particularly with traditional telehealth (P<.001). Anxiety also decreased significantly (SMD -0.64, 95% CI -0.92 to 0.35; P=.003) with negligible heterogeneity (I[2]=0%). Motor symptoms improved (SMD -0.46, 95% CI -0.69 to 0.24; P=.001), and ADL showed substantial impairment reduction (SMD -0.79, 95% CI -1.04 to -0.54; P=.002). Cognition was significantly enhanced (SMD 1.12, 95% CI 0.03 to 2.20; P=.045) though with moderate heterogeneity (I[2]=52.3%) and significant publication bias (P<.001). Follow-up duration did not significantly moderate effects.
CONCLUSIONS: Telehealth interventions significantly enhance multiple PD domains, with traditional (telephone/tablet-based) approaches demonstrating particular advantages for QOL and depression. Digital interventions showed more limited efficacy. These findings support telehealth as a multifaceted management tool for PD, although cognition outcomes require further investigation.
TRIAL REGISTRATION: PROSPERO CRD42024520169; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024520169.}, }
@article {pmid41604674, year = {2026}, author = {Jahanaray, M and Pasha, A and Jahanaray, A}, title = {Burnout and psychological distress across U.S. postgraduate trainees, fellows, and students: A comprehensive meta-analysis.}, journal = {Journal of American college health : J of ACH}, volume = {74}, number = {6}, pages = {1772-1785}, doi = {10.1080/07448481.2025.2611276}, pmid = {41604674}, issn = {1940-3208}, mesh = {Humans ; United States/epidemiology ; COVID-19/psychology/epidemiology ; *Burnout, Professional/psychology/epidemiology ; *Psychological Distress ; *Students, Medical/psychology/statistics & numerical data ; Emotional Exhaustion ; *Stress, Psychological/epidemiology ; }, abstract = {Objective: This meta-analysis explored the relationship between burnout and psychological distress across different academic disciplines, measurement tools, institutional contexts, and the pandemic. Method: We synthesized 76 effect sizes from 29 studies involving 20,037 students, residents, and fellows in the United States. Results: The correlation between burnout and psychological distress was (r = 0.44), with stress showing the strongest correlation (r = 0.48). Notably, the correlations were higher during the pandemic (r = 0.46) compared to pre-pandemic (r = 0.44). Our subgroup analysis indicated that medical students exhibited a stronger association (r = 0.5) than fellows and residents. Additionally, samples from a multiple organization yielded higher correlations (r = 0.46). Conclusions: Among the dimensions of burnout, emotional exhaustion demonstrated a stronger correlation with psychological distress. Meta-regression confirmed that the students' disciplines, sample locations, and COVID-19 moderated the overall effect size. Findings highlight the urgent need for targeted interventions to address environmental stressors within medical training.}, }
@article {pmid41604899, year = {2026}, author = {Saxena, SK and Yadav, J and Kishan, H and Harnam, AS and Kumar, S and Maurya, VK and Ansari, S and Paweska, JT and Ratho, RK}, title = {Pathogenesis and current advancement in treatment and prevention strategies for Human metapneumovirus.}, journal = {Virology}, volume = {617}, number = {}, pages = {110798}, doi = {10.1016/j.virol.2026.110798}, pmid = {41604899}, issn = {1096-0341}, mesh = {Humans ; *Metapneumovirus/pathogenicity/genetics/immunology/drug effects/physiology ; *Paramyxoviridae Infections/prevention & control/therapy/virology/drug therapy/diagnosis/epidemiology ; Antiviral Agents/therapeutic use ; Viral Vaccines/immunology ; Animals ; }, abstract = {Human metapneumovirus (HMPV) is a well-identified paramyxovirus that has emerged as a significant global health threat, particularly following recent outbreaks in 2024-2025. It preferentially infects the respiratory epithelium and affects infants, the elderly, and immunocompromised populations. The clinical manifestations of the HMPV range from mild upper respiratory symptoms to severe diffuse bronchopneumonia. As of late 2024 and early 2025, HMPV has been responsible for 6.2% of positive respiratory illness tests and 5.4% of respiratory-associated hospitalizations in China, surpassing COVID-19, rhinovirus, and adenovirus. HMPV is a non-segmented, negative-sense single-stranded RNA virus with a genome of about 13.3 kb, and it is genetically related to Orthopneumovirus, particularly respiratory syncytial virus (RSV). Its transmission occurs primarily within households, and the virus poses significant risks to vulnerable populations. Immunologic responses to HMPV infections are diverse, with limited lasting immunity, leading to frequent reinfections. Diagnosis is problematic due to overlapping clinical manifestations of the disease alongside other respiratory viruses like RSV and influenza. Presently, no vaccines or antiviral treatments are available for HMPV, though several vaccine candidates are under investigation, including mRNA-1653 and IVX-A12, which have shown promising results in Phase I and Phase II clinical trials. Recent advances in understanding HMPV's molecular biology and immune modulation have led to exploring new therapeutic strategies, including monoclonal antibodies, fusion inhibitors, and RNA interference-based therapies.}, }
@article {pmid41605062, year = {2026}, author = {Mattedi, FZ and Ribeiro, HS and Busatto, GF and Carvalho, CRR and Zanetta, DMT and Burdmann, EA and , }, title = {Acute respiratory distress syndrome and acute kidney injury in critically ill patients: A scoping review on this lung-kidney crosstalk.}, journal = {Journal of critical care}, volume = {93}, number = {}, pages = {155445}, doi = {10.1016/j.jcrc.2026.155445}, pmid = {41605062}, issn = {1557-8615}, mesh = {Humans ; *Respiratory Distress Syndrome/complications/physiopathology/epidemiology ; *Acute Kidney Injury/epidemiology/physiopathology/therapy/etiology ; *Critical Illness ; Risk Factors ; Renal Replacement Therapy ; Hospital Mortality ; }, abstract = {INTRODUCTION: The incidence of acute kidney injury (AKI) in patients with acute respiratory distress syndrome (ARDS) is high; nonetheless, the lung-kidney crosstalk remains unclear.
OBJECTIVE: Describe the association between ARDS and AKI in critically ill patients.
METHODS: This scoping review was conducted according to the JBI and PRISM-ScR and included studies that investigated critically ill patients with ARDS (Participants), described AKI-related outcomes (Concept), and were conducted in hospitals (Context). MEDLINE, Embase, and LILACS databases were searched for articles published up to January 2024. Only observational studies were considered. Data on the diagnosis of ARDS-AKI and other kidney-related outcomes were extracted.
RESULTS: A total of 2943 studies were screened, of which 28 were included in this review. Most studies were prospective and the majority originated from Europe. AKI was diagnosed using the KDIGO criteria in most studies and the pooled overall rate of AKI development across the studies was 46.8% (95% CI: 40.8-52.8). Two reports identified ARDS as an independent risk factor for AKI. Kidney replacement therapy was described in 17 studies. AKI recovery was described in only three studies. Seventeen studies evaluated hospital mortality, specifically in patients with ARDS-AKI, and found a greater mortality risk as compared to only ARDS.
CONCLUSIONS: This scoping review emphasizes the variability of the evidence, which hinders definitive conclusions about the association between ARDS and AKI, despite their common occurrence in critically ill patients. Therefore, a significant gap remains in our understanding of this lung-kidney interaction.}, }
@article {pmid41605119, year = {2026}, author = {Groen, K and Hale, BG}, title = {Human autoantibodies against type I interferons in severe viral disease.}, journal = {Current opinion in virology}, volume = {74}, number = {}, pages = {101511}, doi = {10.1016/j.coviro.2026.101511}, pmid = {41605119}, issn = {1879-6265}, mesh = {Humans ; *Interferon Type I/immunology ; *Virus Diseases/immunology/virology ; *Autoantibodies/immunology ; Animals ; Antibodies, Neutralizing/immunology ; }, abstract = {Type I interferons (IFN-Is) are critical antiviral cytokines that restrict viral replication and limit viral disease. A remarkable recent discovery is that human autoantibodies (autoAbs) neutralizing the activities of IFN-Is phenocopy inborn errors of immunity and markedly exacerbate susceptibility to life-threatening infections. Development of these pathogenic autoAbs in humans is strongly linked to genetic and nongenetic factors affecting thymic function, and they are estimated to be present in >100 million people worldwide with a prevalence that increases with age. Here, we review major advances from the last few years that have improved our mechanistic understanding of human IFN-I autoAb development and function, as well as their association with a significant proportion of different severe viral diseases. In particular, we highlight how neutralizing IFN-I autoAbs can persist in individuals for decades, compromising IFN-I-mediated defenses, and underlying subsequent critical infections with diverse pathogens, including SARS-CoV-2, West Nile virus, tick-borne encephalitis virus, seasonal influenza viruses, herpesviruses, and rare zoonoses caused by MERS-CoV, flaviviruses, and avian H5N1 influenza A virus. Furthermore, we discuss how neutralizing IFN-I autoAbs facilitate severe adverse events with live-attenuated viral vaccines, such as the yellow fever or chikungunya virus vaccines, and suggest how implementation of IFN-I autoAb diagnostics in at-risk populations may be clinically beneficial with current prophylactic or therapeutic options. Finally, in the context of new experimental insights into how autoAbs block the ability of IFN-Is to engage with the IFNAR1/IFNAR2 receptors, we detail future opportunities to design advanced novel therapeutic strategies that might specifically mitigate IFN-I autoAb pathogenic effects.}, }
@article {pmid41605546, year = {2026}, author = {Dunn, M and 't Hoen, E and Boulet, P and Mara, K and Perehudoff, K}, title = {TRIPS flexibilities help change policy and practice to increase access to medicines: evidence from 2001 to 2024.}, journal = {BMJ global health}, volume = {11}, number = {1}, pages = {}, pmid = {41605546}, issn = {2059-7908}, mesh = {Humans ; *Health Services Accessibility/legislation & jurisprudence ; *Intellectual Property ; *Health Policy ; Developing Countries ; Patents as Topic/legislation & jurisprudence ; Pharmaceutical Preparations/supply & distribution ; Developed Countries ; COVID-19 ; }, abstract = {INTRODUCTION: Millions of people lack access to safe and effective pharmaceuticals because they are unaffordable or unavailable, particularly in 'developing' and 'least-developed' countries (DCs, LDCs), and increasingly in high-income countries (HICs). Management of intellectual property (IP) related to new medicines has a significant impact on access to safe, affordable and effective medicines. The Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) provides the international legal framework for IP protection and mandates 20-year patents in all technological fields, including pharmaceuticals. TRIPS contains flexibilities, such as compulsory licensing (CL) and transition provisions for LDCs, which governments can use to facilitate access to health technologies. The use of these flexibilities is underreported in the literature, and a thorough analysis has not been undertaken since the COVID-19 pandemic.
METHODS: A scoping review of three medical and legal databases and temporal analysis of all known instances of use or potential use of CLs and the LDC pharmaceutical transition measure between 2001-2024.
RESULTS: 61% of the 149 CL instances were executed. The relative rates of CL use between countries have shifted: HICs represent over half of CL instances in the last decade. CLs are increasingly considered for chronic, non-communicable and rare diseases. The threat of CL use continues to provide impetus for price negotiations, voluntary licences or other measures to improve access. Almost all eligible countries have invoked the right to use the LDC transition measure.
CONCLUSIONS: TRIPS flexibilities have been used to facilitate access to medicines (including vaccines) over the quarter-century since the adoption of the World Trade Organization's Doha Declaration on TRIPS and Public Health. The flexibilities play a vital role in ensuring that new medicines are affordable and are likely to continue to be in a future where geopolitical forces have drastically altered the financing structures of medicines provision in DCs and LDCs.}, }
@article {pmid41605610, year = {2026}, author = {Oreskovic, E and Petzold, A and Petropoulos, IN and Hau, S}, title = {Corneal confocal microscopy as a paraclinical test in neurodegenerative disease: a scoping review.}, journal = {The British journal of ophthalmology}, volume = {}, number = {}, pages = {}, doi = {10.1136/bjo-2025-328181}, pmid = {41605610}, issn = {1468-2079}, abstract = {Corneal confocal microscopy (CCM) is a non-invasive imaging technique that enables quantification of the corneal sub-basal nerve plexus and has emerged as a potential surrogate biomarker for peripheral neurodegeneration. This scoping review evaluated current evidence on the use of CCM in assessing corneal nerve fibre changes across neurodegenerative diseases (NDDs) and explored its potential as a paraclinical diagnostic and monitoring tool. A comprehensive search of PubMed and Scopus was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines to identify studies reporting quantitative CCM metrics, including corneal nerve fibre density (CNFD), corneal nerve branch density (CNBD) and corneal nerve fibre length (CNFL). Both cross-sectional and longitudinal studies of patients with NDDs were included, and findings were narratively synthesised. 50 studies were included: Parkinson's disease (n=13), multiple sclerosis (n=11), cerebrovascular accidents (n=7), post-COVID-19 neuropathy (n=5), amyotrophic lateral sclerosis (n=4), chronic inflammatory demyelinating polyneuropathy (n=4), Alzheimer's disease (n=3), Fabry disease (n=2) and neurofibromatosis type 1 (n=1). CNFL and CNFD were consistently reduced in Parkinson's disease, multiple sclerosis, cerebrovascular accidents, amyotrophic lateral sclerosis, chronic inflammatory demyelinating polyneuropathy and post-COVID-19 neuropathy, whereas CNBD results were inconsistent. The strongest evidence supported the role of CCM in Parkinson's disease and multiple sclerosis. CNFL and CNFD emerged as the most reliable CCM-derived metrics across NDDs, supporting their potential as objective biomarkers for neurodegeneration. While findings support the potential of CCM as a paraclinical diagnostic tool, methodological heterogeneity in image acquisition, analysis software and study design limited comparability. Standardised imaging and analysis protocols are needed to enable broader clinical application and validation across NDDs.}, }
@article {pmid41605818, year = {2026}, author = {Keels, JN and LaPlante, RD and Lee, CS and Dwyer, AA}, title = {Prevalence of new-onset diabetes following COVID-19 infection: A systematic review and meta-analysis.}, journal = {Diabetes, obesity & metabolism}, volume = {28}, number = {4}, pages = {3182-3192}, pmid = {41605818}, issn = {1463-1326}, support = {1F31NR021624-01/NR/NINR NIH HHS/United States ; }, mesh = {Humans ; *COVID-19/complications/epidemiology ; Prevalence ; *Diabetes Mellitus, Type 2/epidemiology/virology ; SARS-CoV-2 ; Female ; Adult ; Pandemics ; *Diabetes Mellitus, Type 1/epidemiology ; *Coronavirus Infections/complications/epidemiology ; *Betacoronavirus ; *Pneumonia, Viral/complications/epidemiology ; Post-Acute COVID-19 Syndrome ; }, abstract = {AIM: To estimate the prevalence of new-onset diabetes in adults (≥ 18 years) following SARS-CoV-2 infection.
MATERIALS AND METHODS: This meta-analysis includes studies written in English that measured the number of adults (≥ 18 years) diagnosed with diabetes following SARS-CoV-2 infection. Studies underwent dual independent review; quality was assessed by using the New Castle Ottawa Scale. A random-effects meta-analysis was conducted to obtain the pooled estimate of new-onset diabetes. To understand the relationship between patient characteristics (age, sex) and study variable (duration of follow-up), a random effects meta-regression was used.
RESULTS: A total of 33 articles were retained for analysis. The overall estimated prevalence of new-onset diabetes (combined T1DM and T2DM or undefined) was 8.33% (95% CI 7.47, 9.18%, z = 19.04, p < 0.001; Q = 6791.24, I[2], 99.68%). The overall estimated prevalence of new-onset T2DM in COVID-19 was 8.92% (95% CI 7.88%, 9.96%, z = 16.77, p < 0.001; Q = 27659.74; p < 0.001, I[2] = 99.96%). The overall estimated prevalence of new-onset T1DM was 0.86% (95% CI 0.0072%, 0.0099%, z = 12.59, p < 0.001; Q = 9456.28; p < 0.001, I[2] = 99.94%). At the study level, there was no significant relationship identified with age, sex, or follow-up duration.
CONCLUSIONS: This systematic review and meta-analysis revealed a notable increase in T2DM or combined (T1DM, T2DM, or undefined) conditions. As such, it may be important to understand the underlying factors contributing to increased prevalence.}, }
@article {pmid41606213, year = {2026}, author = {Ferreira, AGS and Garcia, HWC and da Silva, SS and da Silva, FAMF and Ferreira, JWL and da Silva Lopes, IMS}, title = {The role of sense of control and locus of control in depressive and anxious symptoms during COVID-19: an integrative review.}, journal = {Psicologia, reflexao e critica : revista semestral do Departamento de Psicologia da UFRGS}, volume = {39}, number = {1}, pages = {5}, pmid = {41606213}, issn = {0102-7972}, abstract = {BACKGROUND: The COVID-19 pandemic triggered a series of psychological impacts, resulting in significant increases in anxiolytic and depressive disorders, influenced by isolation measures, health insecurity, and abrupt social changes. Two key concepts for understanding emotional responses during this period include Sense of Control (SoC) and Locus of Control (LoC). The SoC refers to the general perception of personal agency, while the LoC is a more specific framework that classifies control perceptions as either internal (believing one has control over life events) or external (attributing outcomes to external forces). Previous studies indicate that a more external LoC and a low SoC are associated with greater psychological vulnerability in stressful contexts, such as during the pandemic, which can amplify symptoms of anxiety and depression. This integrative review aims to gather and synthesize studies that explore the relationship between LoC and/or SoC and symptoms of anxiety and depression during the COVID-19 pandemic. MAIN TEXT: A systematic search was conducted in PubMed, Scopus, and BVS databases, focusing on studies published within the last 5 years. Quantitative studies with adult samples were considered eligible while excluding those with specific pre-existing conditions. After removing duplicates, titles and abstracts were screened, resulting in 12 full-text studies to be reviewed. Of these, nine met inclusion and exclusion criteria and were included in the analysis. An emerging pattern showed that individuals with external LoC and low SoC had higher levels of anxiety and depression during the COVID-19 pandemic. The role of LoC and SoC as moderators of psychological distress was documented, reinforcing prior evidence that individuals with an external LoC are more vulnerable to mental health challenges in times of crisis. Furthermore, these constructs influenced behavioral responses to the pandemic, with higher SoC and internal LoC associated with more proactive and responsible coping strategies. CONCLUSION: Both LoC and SoC play critical roles in understanding the psychological impacts of the pandemic. Despite populational and methodological diversity, most studies point to a clear correlation between perception of control and levels of anxiety and depression, highlighting the importance of interventions that increase the perception of personal control to reduce psychological distress.}, }
@article {pmid41606239, year = {2026}, author = {Salem, GM and Azamor, T and Familiar-Macedo, D and Onwubueke, C and Cambou, MC and Chen, W and Nielsen-Saines, K and Foo, SS}, title = {Mechanistic insights into the impact of prenatal viral infections on maternal and offspring immunity.}, journal = {Npj viruses}, volume = {4}, number = {1}, pages = {7}, pmid = {41606239}, issn = {2948-1767}, support = {N/A//Cleveland Clinic/ ; }, abstract = {Global outbreaks of human immunodeficiency virus (HIV) and respiratory viruses - severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza, accounted for ~50 million infections in 2024. Prenatal exposure to these viruses poses substantial risks to maternal and fetal health, yet the underlying immunological mechanisms remain incompletely understood. Despite differences in viral biology and transmission, mounting evidence reveals a convergent theme of maternal immune activation during pregnancy. Even without vertical transmission, virus-elicted maternal immune responses alter the maternal-fetal interface and gut microbiome, reshaping fetal immunity and birth outcomes. These immune perturbations increase susceptibility to infections, neurodevelopmental disorders, and immune-mediated diseases later in life. Here, we discuss viral immune evasion strategies that modulate maternal immunity and review current clinical and emerging therapeutic approaches aimed at mitigating long-term consequences in exposed children. Understanding how prenatal viral exposure shapes lifelong health is critical for developing targeted interventions and reducing postnatal disease burden.}, }
@article {pmid41606631, year = {2026}, author = {Kyriakopoulos, AM and McCullough, PA and Seneff, S}, title = {Taurine intake ameliorates lactic acidosis and hyperferritinemia occurring after mRNA SARS-CoV-2 vaccination in a patient with β-thalassemia trait: a case report and review of literature.}, journal = {Journal of medical case reports}, volume = {20}, number = {1}, pages = {}, pmid = {41606631}, issn = {1752-1947}, support = {6950759//Quanta Computer, Inc./ ; }, mesh = {Humans ; Male ; Adult ; *Taurine/therapeutic use/administration & dosage ; *beta-Thalassemia/complications ; *Acidosis, Lactic/etiology/drug therapy ; *Hyperferritinemia/etiology/drug therapy ; *COVID-19/prevention & control ; *COVID-19 Vaccines/adverse effects ; Ferritins/blood ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Taurine is a powerful antioxidant necessary for mitochondrial function. Lactic acidosis is a complication encountered in the condition mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS), which can be successfully treated with supplemental taurine. Furthermore, taurine regulates the production of iron-dependent proteins such as ferritin that can act as chelating agents to sequester labile iron.
CASE PRESENTATION: A 38-year-old Greek male with a β-zero thalassemia trait developed multiple severe symptoms soon after his first and only mRNA (Pfizer) SARS-CoV-2 vaccination that included hematological stress to be a candidate for blood transfusion. Amongst the hematological readings, the patient had lactate levels > 4 mmol/ml, indicating lactic acidosis, and ferritin levels > 820 ng/ml, representing hyperferritinemia. Moreover, the patient has organic acid and plasma metabolite levels in the urine that are indicative of mitochondrial dysfunction. Regular taurine intake (500 mg/day) for years helped the patient control lactate and ferritin levels and avoid more serious clinical decompensation.
CONCLUSION: Regular taurine intake helps to avoid lactic acidosis and reverse hyperferritinemia after mRNA SARS-CoV-2 vaccination in a patient with β-zero thalassemia trait with no obvious genetic trait linked to mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes. Taurine seemed to be protective for mitochondria.}, }
@article {pmid41606968, year = {2026}, author = {, }, title = {[Expert consensus on quality management of multi-pathogen surveillance for acute respiratory infectious diseases].}, journal = {Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine]}, volume = {60}, number = {2}, pages = {135-145}, doi = {10.3760/cma.j.cn112150-20251114-01080}, pmid = {41606968}, issn = {0253-9624}, mesh = {Humans ; Acute Disease ; Consensus ; COVID-19 ; Quality Control ; *Respiratory Tract Infections/epidemiology/prevention & control ; SARS-CoV-2 ; *Sentinel Surveillance ; }, abstract = {Since 2024, the National Disease Control and Prevention Administration has implemented sentinel surveillance for acute respiratory infectious (ARI) diseases to monitor the epidemiology and etiology of multiple pathogens such as influenza virus and SARS-CoV-2. To ensure scientific rigor, standardized procedures, accurate and reliable data, and the efficient operation of network laboratories, a multidisciplinary expert panel-including representatives from the disease control and prevention system, sentinel hospitals, schools of public health, and research institutes-jointly developed the Expert Consensus on Quality Management for Sentinel Surveillance of ARI Diseases. The consensus was formulated through multiple rounds of discussion, investigation, and public consultation, incorporating national surveillance protocols, technical guidelines, scientific evidence, and practical experience. Focusing on establishing a comprehensive quality control system for the entire multi-pathogen surveillance process for ARI diseases, the consensus outlines key components covering all stages: target population definition; specimen collection, transport, aliquoting, and storage; laboratory infrastructure and equipment management; multiplex pathogen detection and gene sequencing; quality assurance of test results; biosafety; personnel training and assessment; and data management and analysis. This document aims to provide end-to-end technical guidance for quality control in ARI sentinel surveillance in China.}, }
@article {pmid41607097, year = {2026}, author = {Han, Z and Han, J and Zhao, Y and Xu, C and Leng, X and Jia, B and Diao, N and Liu, F and Cui, C and Liang, J and Jiang, Y and Du, R}, title = {Research Progress of Coronavirus Reverse Genetics Technology.}, journal = {Journal of medical virology}, volume = {98}, number = {2}, pages = {e70792}, doi = {10.1002/jmv.70792}, pmid = {41607097}, issn = {1096-9071}, support = {2023DJ07//Research and Demonstration on Key Technologies for Prevention and Control of Important Diseases and Antibiotic-Free Breeding of Sika Deer/ ; 20230204010YY//Jilin Provincial Department of Human Resources and Social Security - Innovative and Entrepreneurial Talents and the Analysis of Pathogen Diversity in Sika Deer Breeding Environment and Integration and Demonstration of Supporting Prevention and Control Technology System/ ; //Jilin Provincial Department of Science and Technology - Key Research and Development/ ; }, mesh = {*Reverse Genetics/methods ; Humans ; SARS-CoV-2/genetics ; Genome, Viral ; *Coronavirus/genetics ; Animals ; COVID-19/virology ; *Betacoronavirus/genetics ; Coronavirus Infections/virology ; }, abstract = {In recent years, coronavirus, a kind of virus with a wide host range and high variability, has a large and complex genome. Research on the reverse genetics of coronaviruses has always been a hot spot. Coronavirus cannot only infect mammals, but also infect humans, showing its wide host adaptability. The mutation ability of the coronavirus is extremely strong. Recently, the rapid mutation rate of SARS-CoV-2 has made the development of vaccines and therapeutic methods face great challenges. At present, reverse genetics technology is a molecular biology tool. This process primarily involves cloning the full-length genome cDNA of the virus onto a vector, and then reproducing the modified progeny virus in the cell to achieve accurate modification of the virus's genetic characteristics. This technology can explore the external characteristics of mutants and the evolution of their traits through artificial operations, such as knockout and site-directed mutagenesis of specific genes, and then reveal the biological functions of genes. This article will review the research progress of the coronavirus reverse genetic operating system. In the past research, reverse genetics technology has made remarkable progress in the field of coronavirus research. Researchers have successfully constructed various reverse genetic systems for coronaviruses, including IBV, SARS-CoV-2, and MERS-CoV. In addition, the reverse genetic system has also been used to study the cross-species transmission capacity of the virus, which is of great significance for preventing possible future novel coronavirus epidemics.}, }
@article {pmid41607599, year = {2025}, author = {Sahoo, DP}, title = {Advancing Precision Medicine in Adult-Onset Still's Disease: Insights into Biomarkers, Therapies, and COVID-19 Impacts.}, journal = {Mediterranean journal of rheumatology}, volume = {36}, number = {4}, pages = {509-523}, pmid = {41607599}, issn = {2529-198X}, abstract = {Adult-onset Still's disease (AOSD) is a rare autoinflammatory disorder characterized by spiking fevers, arthralgia, and a transient salmon-pink rash, with an incidence of 0.16-0.4 per 100,000. AOSD shares overlapping clinical and immunological features with systemic juvenile idiopathic arthritis (sJIA), supporting a disease continuum and shared treatment approaches. The COVID-19 pandemic has impacted AOSD care, with SARS-CoV-2 infection and vaccination occasionally triggering disease flares, necessitating adaptive management strategies. Driven by innate immune dysregulation and overproduction of proinflammatory cytokines (IL-1, IL-6, IL-18), AOSD presents in systemic and articular phenotypes, with severe complications like macrophage activation syndrome (MAS), fulminant hepatitis, and parenchymal lung disease. Diagnosis, based on Yamaguchi or Fautrel criteria and biomarkers (ferritin, IL-18), is challenging due to nonspecific symptoms. Biologic therapies (anakinra, canakinumab, tocilizumab) achieve remission in 80-90% of systemic cases. This review synthesises diagnostic challenges, novel biomarkers (e.g., gasdermin D), and emerging therapies (e.g., IL-18 binding protein), emphasising precision medicine and future research needs.}, }
@article {pmid41607619, year = {2026}, author = {Aguiar, CEO and Costa, JMC and Oliveira, MMGL and Lopes, CF and Lima, PHM and Dietrich, VC and Grenfell, RFQ and de Melo, FF}, title = {Cardiovascular burden of long coronavirus disease: Clinical challenges and emerging biomarkers.}, journal = {World journal of cardiology}, volume = {18}, number = {1}, pages = {112466}, pmid = {41607619}, issn = {1949-8462}, abstract = {Long coronavirus disease (LC) is a condition characterized by a persistent state, with recurrent/remitting or progressive episodes, that may affect one or multiple organ systems following severe acute respiratory syndrome coronavirus 2 infection. The cardiovascular system is particularly impacted by this condition. This review aims to discuss the cardiovascular implications in LC and its potential mechanisms. We offer an updated summary of established and emerging biomarkers with clinical potential for diagnosis, risk stratification, and therapy monitoring. Conventional markers with established clinical roles, such as cardiac troponins, natriuretic peptides (B-type natriuretic peptide/N-terminal pro-B-type natriuretic peptide), D-dimer, and inflammatory markers (e.g., C-reactive protein, interleukin-6), coexist with less established but promising biomarkers, such as growth differentiation factor-15, galectin-3, von Willebrand factor, endothelin-1, and circulating microRNAs. The incomplete understanding of the mechanisms and their diverse clinical manifestations, underscores the urgent need for efficient diagnostic tests and predictive models. In this context, besides the lack of standardization in biomarker testing and the absence of validated longitudinal predictive models, the use of biomarker-based strategies represents a potential tool to improve early detection of high-risk patients, enable personalized follow-up, and support more effective prevention of cardiovascular complications in LC patients in clinical practice.}, }
@article {pmid41609696, year = {2026}, author = {Gouveia, A and Buclin, CP and Hibbert, D and Mbadu Mbuzi, E and Mussard, L and Kokkinakis, I and Selby, K and Von Plessen, C and Clair, C and Bodenmann, P}, title = {[2025 scientific breakthroughs in ambulatory general internal medicine].}, journal = {Revue medicale suisse}, volume = {22}, number = {947}, pages = {204-209}, doi = {10.53738/REVMED.2026.22.947.48272}, pmid = {41609696}, issn = {1660-9379}, mesh = {Humans ; *Internal Medicine/trends ; COVID-19/prevention & control ; *General Practice/trends ; *Ambulatory Care/trends/methods ; COVID-19 Vaccines/administration & dosage ; }, abstract = {In this article, we present eight studies published in the last 2 years that are likely to influence the practice of general practitioners in 2026. The key messages highlight the effectiveness of metformin for knee pain treatment, recent advances in the management of poorly controlled asthma, and the absence of contraindications to administering influenza and Covid-19 vaccines simultaneously. In addition, several articles describe the association between sleep duration and hypertension, blood pressure measurement protocols, the effects of vitamin K2 on nocturnal leg cramps, and the effects of intermittent fasting on weight loss. Finally, the Thrombosis Risk Prediction in Patients with Cast Immobilization Score can be used to assess whether therapeutic anticoagulation is indicated in cases of lower-limb immobilization.}, }
@article {pmid41611193, year = {2026}, author = {Kharkivska, Y and Shkel, O and Kim, YK}, title = {Syntenins at the crossroads of host-virus interactions.}, journal = {Methods (San Diego, Calif.)}, volume = {247}, number = {}, pages = {175-183}, doi = {10.1016/j.ymeth.2026.01.009}, pmid = {41611193}, issn = {1095-9130}, mesh = {*Syntenins/metabolism/genetics ; Humans ; Animals ; PDZ Domains ; *Host-Pathogen Interactions ; *Virus Diseases/virology/metabolism ; Coronavirus ; Human Papillomavirus Viruses ; Virus Replication ; }, abstract = {Syntenin is a multifunctional PDZ-domain adaptor protein that orchestrates membrane trafficking, cytoskeletal remodeling, and exosome biogenesis. Initially identified as a syndecan-binding molecule, syntenin has since emerged as a central hub connecting membrane receptors to intracellular signaling pathways that regulate adhesion, motility, immune signaling, and cellular plasticity. While extensively studied in cancer and neural development, recent discoveries reveal that a wide range of viruses exploit syntenin to facilitate their replication, assembly, or dissemination. This review consolidates current evidence across diverse viral infections to elucidate the molecular mechanisms underlying the interaction between syntenin and viruses. Coronaviruses utilize syntenin to link PDZ-binding motifs to p38 MAPK-driven inflammation and endosomal entry. Papillomaviruses and Epstein-Barr virus hijack the CD63-syntenin-ALIX complex to control vesicle-mediated trafficking. Hepatitis C virus employs it to secrete E2-coated, antibody-resistant exosomes. Dengue virus harnesses its mosquito homolog AeSyntenin to package sfRNA for transmission. Human T-cell leukemia virus type 1 employs its Tax-1 oncoprotein to bind the PDZ domains of syntenin, remodel extracellular vesicle cargo, and promote viral spread. In contrast, during human immunodeficiency virus infection, syntenin restricts viral fusion at the plasma membrane, though the nucleocapsid mimics its PDZ tandem to promote virion release. Collectively, these findings establish syntenin as a dynamic regulator at the host-virus interface, capable of exerting both proviral and antiviral effects. Emerging pharmacological strategies targeting syntenin PDZ domains further underscore its potential as a broad-spectrum, host-directed antiviral target.}, }
@article {pmid41612083, year = {2026}, author = {Grant, A and Kabbani, D and Vuong, A and Skidmore, B and Hsu, AT and Sanmugalingham, G and de Vries, R and Logan, S and Gongal, P and Piotrowski, CC and Thavorn, K and , }, title = {Value of Emerging and Existing Pre-prophylaxis and Therapeutic Options for COVID-19 in Transplant Recipients: A Systematic Review of Economic Evaluations.}, journal = {PharmacoEconomics - open}, volume = {10}, number = {3}, pages = {423-455}, pmid = {41612083}, issn = {2509-4254}, abstract = {BACKGROUND: High-risk populations, including transplant recipients, are at increased risk of severe Coronavirus disease 2019 (COVID-19) outcomes. Certain treatments and pre-exposure prophylaxis (PrEP) have been approved to reduce the risk of severe illness. However, data on the cost effectiveness of currently approved COVID-19 therapeutics and preventative treatments are limited for those at high-risk of severe disease.
OBJECTIVE: The aim of this study was to systematically review the cost effectiveness of COVID-19 treatments and PrEP in high-risk, immunocompromised, and transplant populations.
METHODS: Electronic databases were searched from inception to September 2025 for studies comparing costs and effectiveness of monoclonal antibodies PrEP or COVID-19 therapeutics in high-risk, immunocompromised or transplant populations. Two reviewers independently screened studies, extracted data, and critically appraised them using the Joanna Briggs Institute checklist for economic evaluations. Cost data are presented in 2025 US dollars.
RESULTS: Of 8905 studies identified, 60 met inclusion criteria, with seven focused on or including transplant populations. Most studies were cost-utility analyses published between 2020 and 2025. Nirmatrelvir-ritonavir, tixagevimab-cilgavimab, casirivimab-imdevimab, sotrovimab, remdesivir, molnupiravir, and fluvoxamine were compared with no prophylaxis or standard of care. Among transplant populations, the incremental cost-effectiveness ratio (ICER) for tixagevimab-cilgavimab PrEP following vaccination was US$76,024 per quality-adjusted life year (QALY), while ICERs for COVID-19 therapeutics ranged from US$440 to US$126,676 per QALY.
CONCLUSION: Cost effectiveness varied widely across studies due to differences in variant periods, population risk profiles, model assumptions, and healthcare systems. Future research should integrate variant-specific effectiveness, real-world vaccine responsiveness, long-term COVID-19 outcomes, and adverse events to better inform resource allocation for transplant and other high-risk populations.}, }
@article {pmid41612314, year = {2026}, author = {Roshdi, G and Motealleh, A}, title = {Telerehabilitation in the management of urinary incontinence in women: a narrative review.}, journal = {BMC women's health}, volume = {26}, number = {1}, pages = {}, pmid = {41612314}, issn = {1472-6874}, mesh = {Humans ; Female ; *Urinary Incontinence/rehabilitation ; *Telerehabilitation ; Exercise Therapy/methods ; }, abstract = {Urinary incontinence (UI) is a prevalent condition affecting millions worldwide, particularly women, with significant impacts on physical, psychological, and socioeconomic aspects of life (Haylen et al., Neurourol Urodyn 29:4–20, 2010; Aoki et al., Nat Rev Dis Primers 3:1–20, 2017). Conventional management includes behavioral therapy, pelvic floor muscle training (PFMT), and pharmacological interventions, but barriers such as social stigma, access to specialists, and poor treatment adherence persist (Nitti Rev Urol 3, 2001; Sinclair et al., Obstet Gynaecol 13:143-8, 2011; Minassian et al., 111:324-31, 2008; Milsom et al., Eur Urol 65:79-95, 2014). Telerehabilitation—defined as the delivery of rehabilitation services via electronic information and communication technologies (e.g., video conferencing and phone calls for improved access; mobile apps, websites, and virtual reality (VR) for enhanced engagement and self-management)—offers a potentially promising alternative to overcome these obstacles (Buckingham et al., JMIRx Med 3:e30516, 2022). This narrative review synthesizes evidence from studies conducted between January 2000 and November 6, 2025 on telerehabilitation’s role in UI management in women, focusing on stress UI, PFMT efficacy, and comparative outcomes with in-person therapy. It addresses gaps in prior systematic reviews by focusing on patient-centered designs and cultural adaptations. Key findings from 25 included studies indicate that telerehabilitation is feasible, effective in reducing UI symptoms, improving quality of life (QoL), and enhancing adherence, particularly through mobile apps and group-based interventions (Asklund et al., Neurourol Urodyn 36:1369-76, 2017; Sjostrom et al., BJU Int 112:362-72, 2013; Hoffman et al., Gynecol Scand 96:1180-7, 2017). However, limitations include heterogeneity in interventions, small sample sizes in many studies, lack of long-term data, absence of male participants, limited validation in rural or cognitively impaired populations, and insufficient cultural adaptations for diverse groups. Recommendations include developing tailored telerehabilitation programs incorporating biofeedback and interdisciplinary approaches to address UI holistically. This review highlights telerehabilitation’s potential as a scalable, cost-effective intervention, particularly post-COVID-19, and calls for further research in diverse female populations.}, }
@article {pmid41612572, year = {2026}, author = {Viana, IRMN and Peixoto, HM}, title = {Vaccination Coverage and Factors Associated With Incomplete Vaccination Schedules in Children Under 5 in a Peripheral Area of the Federal District of Brazil.}, journal = {Public health nursing (Boston, Mass.)}, volume = {43}, number = {3}, pages = {543-553}, pmid = {41612572}, issn = {1525-1446}, support = {//Institute for Health Assessment and Translation for Chronic and Neglected Diseases of High Relevance/ ; //Coordination for the Improvement of Higher Education Personnel/ ; }, mesh = {Humans ; Brazil ; Male ; Cross-Sectional Studies ; Child, Preschool ; *Vaccination Coverage/statistics & numerical data ; Infant ; Female ; *Immunization Schedule ; *COVID-19/prevention & control/epidemiology ; Surveys and Questionnaires ; Vaccination/statistics & numerical data ; }, abstract = {OBJECTIVE: To estimate vaccination coverage (VC) and analyze the factors associated with the incomplete vaccination schedule (IVS) in children under 5 years of age in two Basic Health Units in the Federal District of Brazil.
DESIGN: A cross-sectional study.
SAMPLE: The study included 162 children in two Basic Health Units; 54.94% were male, and all were under 5 years of age.
MEASUREMENTS: Guardians were interviewed using a structured questionnaire, and their vaccination booklets were photographed. VC was estimated and prevalence ratios (PR) were calculated using Poisson regression analysis.
RESULTS: Twenty percent of the children had an IVS. None of the vaccines evaluated reached the VC considered correct in terms of age and interval between doses. Factors associated with IVS were age under 2 years (adjusted PR: 2.55; 95% CI: 1.53-4.24), difficulties arising from the COVID-19 pandemic (adjusted PR: 2.71; 95% CI: 1.51-4.86) and a negative response when asked whether all vaccines were administered in the same location (adjusted PR: 1.97; 95% CI: 1.13-3.44).
CONCLUSIONS: A high proportion of children presented IVS, associated with factors such as age, lack of continuity of vaccination in the same location and difficulties caused by the COVID-19 pandemic.}, }
@article {pmid41613329, year = {2025}, author = {Cherian, JJ and Das, S and Bagepally, BS and Eerike, M and Nath, S and Khadwal, A}, title = {Efficacy and safety of stem cell therapy vs. standard of care in patients diagnosed with acute respiratory distress syndrome: an updated systematic review and meta-analysis of randomized controlled trials.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1674720}, pmid = {41613329}, issn = {2296-858X}, abstract = {OBJECTIVES: This systematic review and meta-analysis aimed to evaluate the efficacy and safety of stem cell therapies as compared to the standard of care (SOC) in patients with acute respiratory distress syndrome (ARDS).
METHODS: Search of PubMed, Embase, Cochrane CENTRAL, and Web of Science databases for randomized controlled trials was performed. The protocol was registered in PROSPERO (ID: CRD42023467612). The primary outcomes were all-cause mortality on day 28 and serious adverse events. Risk ratios (RR) and mean differences were pooled using Stata software version 17.0. Quality of the evidence was assessed by GRADE approach.
RESULTS: Out of 5,537 articles screened, 17 were included. Treatment with stem cells led to no significant difference in the risk of 28-day mortality [RR, 0.809 (95% CI: 0.651-1.005), p = 0.06; I [2] = 0%] or the risk of serious adverse events [RR, 0.94 (95% CI: 0.80-1.12), p = 0.36; I [2]= 8.58%] as compared to treatment with SOC. Additionally, no significant differences were observed in the duration of hospitalization, the number of ventilator-free days till day 28, 60-day all-cause mortality, intensive care unit (ICU)-free days till day 28, change in quality-of-life (QoL) score, and the duration of ICU stay, PaO2/FiO2 ratio, change in SOFA score, and change in serum interleukin 6 and 8 levels. The GRADE of evidence was low or very low for the critical outcomes.
CONCLUSION: There was no significant improvement in critical outcomes following stem cell therapy as compared to the SOC in ARDS. The certainty of evidence was low to very low, indicating limited confidence in the findings.
SYSTEMATIC TRIAL REGISTRATION: PROSPERO (ID: CRD42023467612).}, }
@article {pmid41613493, year = {2026}, author = {Danchenko, P and Rudenko, K and Rzhanyi, M and Hrubiak, L and Ishchenko, M and Kozhanov, M}, title = {Contemporary surgical treatment of hypertrophic obstructive cardiomyopathy: insights from the Ukrainian National Referral Center.}, journal = {Indian journal of thoracic and cardiovascular surgery}, volume = {42}, number = {2}, pages = {282-290}, pmid = {41613493}, issn = {0970-9134}, abstract = {PURPOSE: Hypertrophic obstructive cardiomyopathy (HOCM) remains a prevalent and clinically significant condition with a global prevalence of 1:200 to 1:500. In Ukraine, the estimated burden is approximately 75,000 patients, although national data remain limited. Since 2016, the Amosov National Institute of Cardiovascular Surgery in Kyiv has been a leading center for HOCM surgery, primarily performing septal myectomy (SM) with concomitant mitral valve (MV) repair. This review summarizes the evolution of the Institute's surgical program, outcomes, and challenges faced under extraordinary circumstances.
METHODS: Institutional experience with SM and MV repair between 2016 and 2025 was reviewed. Preoperative evaluation included transthoracic echocardiography (TTE), cardiac magnetic resonance (CMR) imaging, and/or computed tomography (CT). A refined transaortic SM technique was applied to optimize septal resection, relieve left ventricular outflow tract (LVOT) obstruction, and address dynamic mitral regurgitation (MR).
RESULTS: SM consistently reduced LVOT gradients and eliminated MR in the majority of patients. In-hospital mortality remained below 1%, with a low incidence of major complications directly attributable to myectomy. Despite significant external pressures, including the coronavirus disease 2019 (COVID-19) pandemic and the ongoing full-scale war in Ukraine, surgical activity continued without interruption. Innovations in operative techniques and perioperative management further enhanced safety and outcomes.
CONCLUSION: The Amosov Institute has established a high-performing national program for HOCM surgery, demonstrating durable results despite unprecedented challenges. Ongoing refinement of minimally invasive strategies and strengthened international collaboration remain essential to address the global shortage of experienced myectomy surgeons and ensure wider access to advanced surgical care.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12055-025-02125-0.}, }
@article {pmid41613884, year = {2025}, author = {Rozhnova, TM and Starynina, DV and Bubnova, AM and Vinnik, YY and Moiseeva, AV and Kostyuk, SV and Rozhnova, KS and Nikolenko, VN and Orlov, YL}, title = {The COVID-19 pandemic and its consequences on men's reproductive health.}, journal = {Biophysical reviews}, volume = {17}, number = {5}, pages = {1643-1650}, pmid = {41613884}, issn = {1867-2450}, abstract = {The COVID-19 pandemic has significantly impacted global health; key questions remain regarding its effects on male reproductive function. Male infertility represents both a biomedical challenge and a societal concern. Our review considers COVID-19's biophysical mechanisms affecting the male reproductive system and focuses on the prognostic implication. Current evidence highlights two primary pathways of SARS-CoV-2 impact: hyperthermia and oxidative stress. The first pathway, as reported, significantly increases sperm aneuploidy and, as a result, has adverse effects on spermatogenesis and causes sperm DNA breaks. The second pathway of coronavirus impact on infertility is oxidative stress. During it, the level of formation of reactive oxygen species (ROS) increases and damages sperm membrane by lipid peroxidation. These mechanisms are interrelated, as fever-induced oxidative stress may alter redox-active metal homeostasis, further exacerbating cellular damage. Understanding these pathogenic processes enables targeted therapeutic development and preventive strategies for COVID-19-related male reproductive dysfunction.}, }
@article {pmid41614075, year = {2025}, author = {Zhang, Z and Li, X and Zhou, J and Li, Y}, title = {Xuebijing injection in the treatment of COVID-19: An update on clinical studies, potentially active metabolites and mechanisms.}, journal = {Frontiers in pharmacology}, volume = {16}, number = {}, pages = {1667022}, pmid = {41614075}, issn = {1663-9812}, abstract = {INTRODUCTION: Coronavirus disease 2019 (COVID-19) is an epidemic respiratory disease caused due to the infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In China, the National Health Commission of China announced that patients with COVID-19 who were treated with traditional Chinese medicines (TCMs) combined with antiviral drugs effectively alleviated their symptoms and recovered. Among these TCMs, Xuebijing (XBJ) injection plays an important role in the treatment of patients with COVID-19. However, this was a puzzle that what will be the clinical efficacy and safety of XBJ injection for COVID-19 treatment, and what are the potential mechanisms behind XBJ injection?
METHODS: To search for articles on "Xuebijing injection in the treatment of COVID-19" in PubMed, use the following query: (Xuebijing injection OR Xuebijing) AND (COVID-19 OR SARS-CoV-2 OR severe pneumonia). We added filters for "Clinical Trial," "Randomized Controlled Trial," or "Review" to focus on specific study types, and limit the search to recent years (2010-2025) and English-language articles for more targeted results.
RESULTS: XBJ injection in combination with regular therapy has been shown to improve overall efficacy, reduce 28-day mortality, improve lung CT recovery and reduce pro-inflammatory markers in patients with COVID-19. The high affinity for angiotensin converting enzyme 2, inhibition of neutrophil extracellular trap release and prevention of cell death and inflammation may be the main molecular mechanisms of XBJ injection in the treatment of COVID-19.
CONCLUSION: This review synthesizes the current evidence on the clinical efficacy and safety of XBJ injection in the treatment of COVID-19. Our analysis indicates that XBJ injection, when used in combination with standard therapy, significantly improves overall efficacy, reduces 28-day mortality, enhances lung CT recovery, and decreases pro-inflammatory markers such as C-reactive protein (CRP) and interleukin-6 (IL-6). These findings suggest that Xuebijing injection is a promising adjunctive treatment for COVID-19, particularly in severe cases, although it must be confirmed through rigorous pharmacological and clinical studies.}, }
@article {pmid41614415, year = {2026}, author = {Zhamaliyeva, L and Batyrova, A and Ablakimova, N and Veklenko, G and Malsova, B and Tautanova, A and Grjibovski, AM}, title = {Global research trends on depression-related stigma in the 21st century: a bibliometric analysis.}, journal = {Global health action}, volume = {19}, number = {1}, pages = {2612390}, pmid = {41614415}, issn = {1654-9880}, mesh = {Humans ; *Bibliometrics ; *Social Stigma ; *Depression/psychology ; *Global Health ; *Research/trends ; }, abstract = {BACKGROUND: Depression is a leading contributor to the global burden of diseases. Stigma associated with mental illness significantly hinders help-seeking, diagnosis, treatment, and recovery. While research on mental health stigma has expanded over the past two decades, a systematic examination of its evolution, particularly in the context of depression, is almost non-existent.
OBJECTIVE: To map and analyze global research on depression stigma, focusing on publication trends, leading contributors, international collaborations, and thematic developments.
METHODS: We analyzed 947 peer-reviewed articles indexed in the Scopus database using bibliometric software in R-studio. Quantitative indicators included annual publication growth, citation analysis, leading countries, institutions, and authors, as well as international collaboration patterns. Additionally, keyword co-occurrence and thematic evolution analyses were conducted to explore conceptual developments within the field.
RESULTS: The number of publications steadily increased from 2013 to 2025. The United States, China, the UK, and Canada accounted for the highest research and citation impact, while contributions from low- and middle-income countries (LMIC) remained limited despite these regions carrying most of the global disease burden. Thematic mapping revealed a strong focus on clinical and psychosocial dimensions, with increasing attention to concepts such as resilience, social support, and the mental health effects of the COVID-19 pandemic in recent years.
CONCLUSIONS: The volume of research on depression stigma has grown, yet significant geographical and conceptual disparities continue to persist. Strengthening collaboration, supporting LMIC research capacity, and integrating stigma reduction into global mental health frameworks are essential to achieving equitable mental health outcomes worldwide.}, }
@article {pmid41614579, year = {2026}, author = {Okasha, T and Shaker, NM and Abdel Aziz, K and Aly El-Gabry, D}, title = {Egypt's innovations in mental health: bridging cultural heritage and digital psychiatry.}, journal = {International review of psychiatry (Abingdon, England)}, volume = {}, number = {}, pages = {1-12}, doi = {10.1080/09540261.2026.2621823}, pmid = {41614579}, issn = {1369-1627}, abstract = {Egypt's mental-health landscape represents a unique continuum in which ancient cultural heritage, community-based healing traditions, and contextually adapted psychiatric strategies intersect with modern psychiatric innovations. This review explores how deeply rooted explanatory models continue to define help-seeking pathways and patient expectations. These cultural foundations exist alongside contemporary systemic challenges. In response, Egypt has pioneered contextually grounded adaptive approaches, such as task shifting, integrating mental health into primary care, and developing culturally-adapted psychosocial interventions led by trained non-specialists. The COVID-19 pandemic accelerated this trajectory of modernization. Telepsychiatry services, nationwide psychosocial support hotlines, AI-driven tools, and the establishment of Egypt's dedicated psychiatric COVID-19 hospital highlight the country's capacity for rapid, context-sensitive adaptation to innovate while remaining anchored in its cultural fabric. Together, these developments illustrate how mental health systems can evolve by embracing tradition as a resource rather than a barrier, and by leveraging technology to expand equity, accessibility, and cultural relevance. This review positions Egypt as a powerful case study of how cultural heritage and adaptive, problem-driven strategies can be innovatively harmonized to shape the future of mental health care in the region, where originality lies in contextual responses rather than technological novelty.}, }
@article {pmid41614609, year = {2026}, author = {Chigozie, VU and Nnamani, MN and Igwe, KN and Ogbonna, BO}, title = {Integrating infodemiology and infodemics management to address antimicrobial resistance and vaccine hesitancy challenges in Nigeria/Africa.}, journal = {Journal of communication in healthcare}, volume = {19}, number = {2}, pages = {131-153}, doi = {10.1080/17538068.2026.2623348}, pmid = {41614609}, issn = {1753-8076}, mesh = {Humans ; Nigeria ; *Vaccination Hesitancy ; *Infodemic ; *Drug Resistance, Microbial ; COVID-19/prevention & control ; Africa ; Health Literacy ; }, abstract = {BACKGROUND: Antimicrobial resistance (AMR) and vaccine hesitancy (VH) are significant public health threats in Nigeria/Africa, due to limited healthcare infrastructure and health literacy, thus encouraging misinformation, which further exacerbates these issues.
METHODS: This review examines recent literature to explore how Infodemiology and Infodemics management can be integrated into strategies addressing AMR and VH in Nigeria and Africa. A narrative review methodology was employed, sourcing studies mostly from 2020 onwards to ensure contemporary relevance.
RESULTS: Infodemiology offers tools for addressing the dual public health threats of AMR and VH in Nigeria/Africa. Evidence reveals AMR behaviors are strongly influenced by misconceptions about antibiotics, such as their efficacy against viral infections, perpetuated by social media and word-of-mouth misinformation. Similarly, VH is fueled by cultural beliefs and mistrust in health systems, amplified during the COVID-19 pandemic, where myths about infertility and harmful ingredients led to skepticism. Infodemiology enables real-time tracking of misinformation trends through digital tools, allowing health authorities to identify hotspots and intervene with targeted campaigns.
CONCLUSION: Integrating infodemiology into AMR and VH management strategies enhances public health outcomes by addressing misinformation at its roots and promoting evidence-based practices. By leveraging digital tools and engaging trusted local figures, health systems can foster trust and literacy among communities. African governments must invest in digital health infrastructure, establish supportive policies, and foster partnerships with social media platforms to sustainably manage infodemics. These strategies are ivotal for reducing AMR and increasing vaccine acceptance, ultimately safeguarding health across human, animal, and environmental domains.}, }
@article {pmid41614748, year = {2025}, author = {Altamura, C and Marinaccio, L and Dimiccoli, V and Mollica, A and Stefanucci, A}, title = {Contribution of [18]F-Fluorodeoxyglucose to the Identification of Dubious Lesions Caused by SARS-CoV-2.}, journal = {Current issues in molecular biology}, volume = {47}, number = {12}, pages = {}, pmid = {41614748}, issn = {1467-3045}, abstract = {Coronavirus disease, caused by the SARS-CoV-2 virus, has caused a global health crisis. While RT-PCR remains the gold standard for diagnosis, its limited sensitivity, especially in the early stages, has highlighted the need for complementary diagnostic tools. Among these, [[18]F]FDG PET/CT has gained attention for its potential role in detecting inflammation and metabolic activity associated with COVID-19. This review aims to provide an overview of current diagnostic techniques for COVID-19 and to explore the application of [[18]F]FDG PET/CT imaging in the detection and monitoring of SARS-CoV-2 infection. A comprehensive literature review was conducted on molecular, serological, and imaging-based diagnostic techniques for COVID-19, with a focus on the biological mechanism, clinical applications, and diagnostic performance of [[18]F]FDG PET/CT in COVID-19 patients. [[18]F]FDG PET/CT has demonstrated the ability to detect increased metabolic activity in COVID-19 associated pulmonary lesions, particularly ground-glass opacities, often preceding detectable morphological changes on CT. The imaging also revealed uptake in lymph nodes, bone marrow, and extrapulmonary tissues, reflecting systemic inflammation. [[18]F]FDG PET/CT represents a promising additional tool for the evaluation of inflammation and disease progression in COVID-19. However, further studies are required to define its role, optimize protocols, and assess its risk-benefit profile in the clinical setting.}, }
@article {pmid41614763, year = {2025}, author = {Stoimeni, A and Gkiourtzis, N and Karatisidou, V and Charitakis, N and Makedou, K and Tramma, D and Panagopoulou, P}, title = {Neutrophil Extracellular Traps in Pediatric Infections: A Systematic Review.}, journal = {Current issues in molecular biology}, volume = {47}, number = {12}, pages = {}, pmid = {41614763}, issn = {1467-3045}, abstract = {BACKGROUND: Neutrophil extracellular traps (NETs) are granule- and nucleus-derived structures that support innate immunity. While the contribution of NETs to adult infections and autoimmune diseases is well studied, evidence in children is still inconsistent. This review aimed to summarize current findings on NETs in pediatric infections.
METHODS: This study followed the Cochrane Handbook for Systematic Reviews of Interventions and adhered to the PRISMA guidelines. A search was conducted in major databases (MEDLINE/PubMed and Scopus) from inception until 5 September 2025. The study quality was evaluated using the modified Newcastle-Ottawa Scale.
RESULTS: Eleven studies were included in the systematic review. In respiratory disease, the role of NETs was well described and their formation correlated with severity. Patients with febrile urinary tract infections showed elevated urinary NET-associated markers. In COVID-19 infection, NET levels were unchanged in uncomplicated cases but elevated in multisystem inflammatory syndrome in children. Findings in sepsis were inconsistent.
CONCLUSIONS: This systematic review presents the published evidence on NET formation in the pediatric population, assessing the current knowledge and identifying the gaps to guide research. Future studies should aim to standardize NET detection methods, evaluate their prognostic value in large prospective cohorts, and explore the various NET-associated mechanisms in children.}, }
@article {pmid41615621, year = {2026}, author = {Martins, C and Mitchell, MJ and Peer, D and Perrie, Y and Siegwart, DJ and Alonso, MJ and Aparicio-Blanco, J}, title = {The RNA delivery dilemma-lipid versus polymer nanoparticle platforms.}, journal = {Drug delivery and translational research}, volume = {16}, number = {6}, pages = {1667-1684}, pmid = {41615621}, issn = {2190-3948}, mesh = {Humans ; *Nanoparticles/chemistry/administration & dosage ; *Polymers/chemistry/administration & dosage ; *Lipids/chemistry/administration & dosage ; *RNA/administration & dosage ; Animals ; *RNA, Small Interfering/administration & dosage ; Gene Transfer Techniques ; Liposomes ; }, abstract = {Since the first market authorization of RNA therapies, just eight years ago, the field has witnessed an extraordinary expansion, ranging from hepatic delivery for rare genetic diseases to global-scale vaccination during the COVID-19 pandemic, and now to cutting-edge cancer vaccines and gene editing strategies entering late-stage clinical trials. In parallel, the RNA therapeutics landscape has evolved rapidly, progressing from small interfering RNAs to next-generation and combinatorial RNA modalities. None of these breakthroughs would have been possible without the development of sophisticated RNA delivery technologies capable of navigating complex biological environments, enabling precise cellular targeting, and facilitating efficient intracellular trafficking. In this Editorial Note, we take a step back to reflect on key lessons learned throughout the RNA delivery journey. Featuring insights from leading and experienced voices in the field, this manuscript highlights critical milestones, persistent challenges, and the roles of lipid nanoparticles (LNPs) and polymer nanoparticles (PNPs) as RNA delivery platforms. These experts reflect on the features that have positioned LNPs as the current RNA delivery gold standard, while also exploring the untapped potential and distinctive advantages of polymer-based nanosystems. Collectively, these perspectives underscore a striking truth: we are only beginning to unlock the full therapeutic potential of RNA, and nanomedicine will certainly continue to shape the future clinical translation of RNA-based therapies.}, }
@article {pmid41615790, year = {2025}, author = {Beran, J and Slíva, J}, title = {The last ten years with inosine pranobex - from an "old" therapeutic agent to vaccine research, including anti-cancer vaccines.}, journal = {Casopis lekaru ceskych}, volume = {164}, number = {7-8}, pages = {321-323}, pmid = {41615790}, issn = {0008-7335}, mesh = {Humans ; *Inosine Pranobex/therapeutic use/pharmacology ; *Cancer Vaccines/therapeutic use ; Adjuvants, Immunologic/therapeutic use ; }, abstract = {Inosine pranobex (IP), also known as inosine pranobex dimepranol, is an immunomodulatory drug with a history spanning more than fifty years. It was first introduced in the 1970s and has since been licensed in more than 50 countries around the world. It was originally considered a potential drug for AIDS, which raised high hopes at the time of the discovery of the HIV virus. However, after initial interest, its use in this area declined, and for a long time, IP was no longer discussed significantly in professional literature or clinical practice. Renewed interest came only in the last decade, when IP began to reappear in connection with the treatment of acute respiratory infections, diseases caused by human papillomavirus (HPV), and other viral diseases, including COVID-19. It also began to be used as an adjuvant in the foot-and-mouth disease vaccine, and research began on an IP-based anti-tumor vaccine.}, }
@article {pmid41617522, year = {2026}, author = {Alias, A and Idrus, IAM and Daring, D and Azhar, N and Lotfi, WHWM and Ramdzan, AR and Rahim, AIA}, title = {Challenges in delivering healthcare services among immigrants from Southeast Asia: A scoping review.}, journal = {The Medical journal of Malaysia}, volume = {81}, number = {1}, pages = {163-171}, pmid = {41617522}, issn = {0300-5283}, mesh = {Humans ; Asia, Southeastern ; *Emigrants and Immigrants ; *Health Services Accessibility ; *Delivery of Health Care ; COVID-19/epidemiology ; Southeast Asian People ; }, abstract = {INTRODUCTION: Cross-border migration presents increasing challenges to healthcare systems globally. Ensuring equitable healthcare access for immigrant populations, particularly in Southeast Asia, requires a thorough understanding of the barriers to effective service delivery. This scoping review aimed to synthesize the existing literature on the challenges related to the delivery of healthcare services to immigrant communities from Southeast Asia. While previous studies (e.g., Brandenberger et al., 2019) applied the 3C framework to migrants and refugees globally, this review generates new insights by focusing specifically on Southeast Asia, a region underrepresented in the literature. By applying the 3C model in this context, our review identifies region-specific challenges, such as immigration policies, financial barriers, and COVID-19 impacts, that extend beyond the findings of earlier global reviews.
MATERIALS AND METHODS: A comprehensive search was conducted in ProQuest, PubMed, ScienceDirect, and Scopus databases on October 13, 2024, for studies published between January 1, 2011, and October 13, 2024. The search strategy used tailored keywords, including "challenges," "healthcare services," "immigrants," and "Asia." Inclusion criteria focused on peer-reviewed, English-language articles reporting on challenges in healthcare service delivery among immigrant populations in Southeast Asia. Data extraction and synthesis were guided by the 3C model: communication, continuation of care, and confidence in the healthcare system.
RESULTS: The search identified 656 records, of which 7 studies met the inclusion criteria after a multi-stage screening process. Key challenges identified across the included studies were: Communication barriers, including language differences, cultural misunderstandings, and limited health literacy; Issues with continuation of care, such as poor health literacy, difficulties navigating healthcare systems, barriers to accessing services (e.g., due to legal status or financial constraints), and lack of coordination between healthcare and social services; and Lack of confidence in the healthcare system, stemming from distrust, lack of understanding, and negative experiences, including perceived discrimination.
CONCLUSION: This review highlights the complex challenges in delivering healthcare services to immigrants from Southeast Asia. These challenges, encompassing communication, continuation of care, and confidence, necessitate targeted and multifaceted interventions. Addressing these issues through culturally competent care, enhanced communication strategies, and policy reforms that promote equitable access is crucial for improving the health and well-being of immigrant populations and fostering more inclusive healthcare systems within the region.}, }
@article {pmid41618047, year = {2026}, author = {Seet, SM and Tan, YZ and Koh, BMS and Koh, YZ and Aoyama, R and Leow, O and Wang, F and Lin, JB and Ong, HT and Ramasamy, Y and Saini, AG and Ng, NBH and Han, VX}, title = {Comparison of febrile seizures associated with SARS-CoV-2 infection in pre-Omicron and Omicron-predominant periods: a systematic review and meta-analysis.}, journal = {European journal of pediatrics}, volume = {185}, number = {2}, pages = {115}, pmid = {41618047}, issn = {1432-1076}, mesh = {Humans ; *Seizures, Febrile/epidemiology/virology ; *COVID-19/complications/epidemiology ; Incidence ; SARS-CoV-2 ; Child ; Pandemics ; Child, Preschool ; Infant ; }, abstract = {UNLABELLED: Emerging studies suggest increased febrile seizures during the Omicron period of SARS-CoV-2. This study compares the incidence of seizures before and during the Omicron variant period to determine if certain variants increase risk. Using PRISMA-P protocol, four databases (PubMed, Embase, Scopus, Web of Science) were searched. Cohort studies reporting febrile seizures in children (up to 18 years of age) with confirmed SARS-CoV-2 infection were included. We provide descriptive summaries of the incidence of febrile seizures across hospital, emergency, and community settings, as well as a meta-analysis between Omicron-predominant and pre-Omicron periods. We included 36 studies comprising 82,591 children with SARS-CoV-2 infection, of whom 2051 experienced febrile seizures. In 29 studies of hospitalized children with SARS-CoV-2, the incidence of febrile seizures varied widely, with a median of 7 per 100 (range 1.06-25.54) children. High heterogeneity was observed, and studies from emergency and community settings were underpowered. Seven studies found that unvaccinated children hospitalized with SARS-CoV-2 had more febrile seizures during the Omicron-predominant (median 11.8 per 100) than during the pre-Omicron period (median 0.7 per 100). The pooled incidence was 11.27 per 100 cases for the Omicron-predominant and 0.66 per 100 for the pre-Omicron period (p < 0.0001).
CONCLUSION: There was a trend toward more reported febrile seizures among hospitalized children with SARS-CoV-2 during the Omicron-predominant than the pre-Omicron period. However, estimates are limited by small samples and moderate heterogeneity and should not be considered population-based incidences. We hypothesize that SARS-CoV-2 variants may influence febrile seizure risk in children; larger studies are needed to better understand this association. PROSPERO registration: CRD420251054193.
WHAT IS KNOWN: • Neurological complications, including febrile seizures, occur in children with SARS-CoV-2 infection. • Prior to the Omicron variant, febrile seizures were relatively uncommon in pediatric COVID-19 cases.
WHAT IS NEW: • There was a trend toward more reported febrile seizures among hospitalized children with SARS-CoV-2 during the Omicron-predominant period compared to the pre-Omicron period. • There are potential associations between SARS-CoV-2 variants and febrile seizure risks.}, }
@article {pmid41618273, year = {2026}, author = {Zou, H and Huang, S and Mu, Z and Luo, G and An, W}, title = {Comparative efficacy of medications and compound interventions against porcine epidemic diarrhea virus replication in vitro: a systematic review and meta-analysis.}, journal = {BMC veterinary research}, volume = {22}, number = {1}, pages = {}, pmid = {41618273}, issn = {1746-6148}, support = {KQN202503510//scientific research project of chongqing municipal education commission/ ; sxyc202410//"three gorges talent" modern animal husbandry faculty innovation team, chongqing three gorges vocational college/ ; sxzybs-202401//scientific research start-up project for doctoral talent introduction of chongqing three gorges vocational college/ ; }, mesh = {*Porcine epidemic diarrhea virus/drug effects/physiology ; Animals ; *Antiviral Agents/pharmacology/therapeutic use ; *Virus Replication/drug effects ; Swine ; *Coronavirus Infections/drug therapy/veterinary/virology ; *Swine Diseases/drug therapy/virology ; }, abstract = {BACKGROUND: Porcine epidemic diarrhea virus (PEDV) infection induces severe intestinal disease in neonatal piglets, resulting in substantial economic losses to the swine industry. Despite the availability of vaccines, their limited efficacy and the lack of effective antiviral treatments underscore the need for alternative therapeutic approaches. Several studies have reported the antiviral activity of various drugs and compounds against PEDV. To systematically compare the efficacy of these agents, we conducted a systematic review and meta-analysis to evaluate the inhibitory effects of various drugs or compounds on PEDV replication in vitro using cell based- models. METHODS: A comprehensive literature search was conducted in PubMed, Web of Science and ScienceDirect, encompassing publications from the inception of each database to May 30,2025. Eligible studies primarily focused on the effects of pharmacological and combination interventions on PEDV replication in vitro. Changes in the tissue culture infectious dose (TCID50) served as the primary outcome measure, with standardized mean difference (SMD) used to quantify effect sizes. RESULTS: Thirty-two eligible studies involving 41 distinct drugs and 63 effect sizes were analyzed. A random-effects model revealed an overall SMD of -12.30 (95% confidence interval: -13.64 to -10.95) for the antiviral efficacy of drugs at safe concentrations. Moderate heterogeneity was observed (I[2]=64.2%, P < 0.001), with subgroup analyses identifying cell type, viral strain, genotype, drug concentration and intervention duration as significant influencing factors (P < 0.05). Intrinsic antiviral activity emerged as the primary source of heterogeneity. Quality assessment using BRISQ guidelines rated 15 studies as high quality and 17 as medium quality, while modified ROBINS-I classified 26 studies as low risk of bias and 6 as moderate risk. Publication bias was suggested by funnel plots and egger’s test. However, sensitivity analyses confirmed the robustness of the results. CONCLUSION: Forty-one of drugs and compounds demonstrate effective inhibition of PEDV replication in vitro, with antiviral efficacy influenced by experimental variables and predominantly determined by intrinsic antiviral activity. These findings offer valuable guidance for optimizing the design of PEDV antiviral studies and contribute insights for future in vivo efficacy and mechanistic research. SYSTEMATIC REVIEW REGISTRATION: Open science framework (https://doi.org/10.17605/OSF.IO/V4C8Y).}, }
@article {pmid41618506, year = {2026}, author = {Abbasi, M and Najafizadeh, K and Latifi, M and Ghobadi, O and Sadeghi, MH and Zali, A}, title = {Impact of opt-in versus opt-out organ donation legislation on donation rates: A systematic review.}, journal = {Journal of perioperative practice}, volume = {}, number = {}, pages = {17504589251390742}, doi = {10.1177/17504589251390742}, pmid = {41618506}, issn = {2515-7949}, abstract = {PURPOSE: This systematic review analyses existing studies on organ donation rates from various countries to provide insights that may inform policy decisions and improve organ donation rates globally.
DESIGN/METHODOLOGY/APPROACH: A systematic search was initially conducted on 3 October 2024 and updated on 20 October 2024 across electronic databases including PubMed, Scopus, Cochrane, and Science Direct. Following an initial pilot screening, all unique references were screened by title and abstract, then full text, by at least two independent reviewers against predefined inclusion criteria. Disagreements between reviewers were resolved by double-checking at each step. Extracted data were compiled and summarised.
FINDING: Fifteen studies on organ donation policies were identified, with 13 high-quality studies included after rigorous screening. Based on these studies, opt-out consent systems show mixed outcomes across countries. Policy effectiveness varies significantly between nations. The COVID-19 pandemic substantially disrupted organ donation rates. Factors beyond legislation, such as public awareness, cultural attitudes, media campaigns, and health care infrastructure, also influence donation success.Practical impact:While presumed consent may increase deceased donor rates, it is not a universal solution. Effective organ donation strategies require a holistic approach involving public education, trust-building, and nuanced policy implementation tailored to specific national contexts.}, }
@article {pmid41618987, year = {2026}, author = {Lee, AH and Downs, J and Parlatini, V and Zhang, S and Simonoff, E and Ching, BC}, title = {Ethnic and socioeconomic inequalities in the mental health of children and young people with pre-existing mental health and neurodevelopmental conditions during the COVID-19 pandemic: a systematic review of longitudinal studies.}, journal = {European child & adolescent psychiatry}, volume = {35}, number = {5}, pages = {1589-1603}, pmid = {41618987}, issn = {1435-165X}, mesh = {Adolescent ; Child ; Humans ; *COVID-19 ; *Ethnicity/psychology/statistics & numerical data ; Longitudinal Studies ; Low Socioeconomic Status ; *Mental Disorders/ethnology ; *Mental Health/ethnology ; *Neurodevelopmental Disorders/ethnology/epidemiology ; Socioeconomic Disparities in Health ; }, abstract = {The COVID-19 pandemic may have amplified existing inequalities and disproportionately impacted the mental health of children and young people (CYP) with pre-existing mental health and neurodevelopmental conditions. Evidence suggests the mental health impact on this clinical group was heterogeneous, but the role of ethnicity and socioeconomic position on longitudinal mental health outcomes is unclear. This systematic review investigates the longitudinal association between ethnic and socioeconomic inequalities and the mental health outcomes of CYP with pre-existing conditions during the pandemic. OVID Medline, EMBASE, APA PsycInfo, and Global Health databases were searched between January 2020 and November 2025 (PROSPERO CRD42024611865). Eligible papers included longitudinal studies that assessed mental health outcomes at multiple timepoints before and/or during the pandemic in CYP with pre-existing conditions and examined the effect of ethnicity and socioeconomic position on outcomes. Included studies were narratively synthesised. Ten studies (N = 3,887) were included. We found evidence that CYP from lower income brackets and who experienced financial hardship reported greater levels of internalising, neurodevelopmental, post-traumatic stress, and obsessive-compulsive symptoms. Weak associations were found between ethnicity and internalising symptoms. However, the findings were inconsistent across mental health outcomes, timepoints, and ethnic and socioeconomic position groups. There is some evidence for the association between lower socioeconomic position and increased mental health outcomes in CYP with pre-existing conditions during the pandemic. Further robust longitudinal research is warranted to examine the long-term consequences of the pandemic to better understand how ethnic and socioeconomic inequalities contribute to mental health outcomes.}, }
@article {pmid41619215, year = {2026}, author = {Nesari, AM and MotieGhader, H and Ghorbian, S}, title = {Advances and challenges in single-cell RNA sequencing data analysis: a comprehensive review.}, journal = {Briefings in bioinformatics}, volume = {27}, number = {1}, pages = {}, pmid = {41619215}, issn = {1477-4054}, mesh = {Humans ; *Single-Cell Analysis/methods ; Single-Cell Gene Expression Analysis ; *Sequence Analysis, RNA/methods ; Computational Biology/methods ; COVID-19/genetics/virology ; }, abstract = {Single-cell RNA sequencing (scRNA-seq) has transformed the resolution of cellular heterogeneity, offering insights into dynamic biological processes from tumor evolution to immune regulation. However, its clinical translation is limited by challenges such as data sparsity, batch effects (differences caused by technical variation rather than biology), and the absence of standardized benchmarks for core pipelines like Seurat and Scanpy. This review outlines emerging computational strategies that address these limitations: (A) robust preprocessing, including SCTransform for zero-inflation(an excess of zero counts in gene-expression data) correction and Harmony for batch integration-achieving 30% faster alignment than BBKNN in cohorts exceeding 100,000 cells; (B) transformer-based annotation tools such as scGPT and CellTypist, which reach >95% accuracy in immune profiling using models pretrained on 33 million cells; and (C) multimodal integration with spatial transcriptomics (e.g., 10x Visium, cell2location v2), which delineate microenvironmental niches and rare CX3CR1+ T-cell subsets in disease contexts like glioblastoma and severe COVID-19. We further assess how scANVI bridges scRNA-seq and ATAC-seq to uncover epigenetic mechanisms underlying therapy resistance, and how spatial methods elucidate tumor-immune crosstalk at subcellular resolution. Despite these advances, ethical risks remain, particularly around re-identification of rare patient-derived clones such as pre-metastatic cells. To promote clinical adoption, we propose a roadmap that prioritizes benchmarked workflows (e.g., scverse ecosystem), privacy-aware data sharing via federated learning, and causal AI approaches to disentangle biological signal from technical artifact. By synthesizing computational innovations with translational case studies, this review equips researchers to navigate both the analytical and ethical complexities of scRNA-seq in pursuit of actionable diagnostics.}, }
@article {pmid41620360, year = {2026}, author = {López-Padilla, D and Poberezhets, V and Roche, N and Moor, CC and Bruyneel, M and Ribeiro, C and Pinnock, H}, title = {Telemonitoring in Respiratory Diseases: Current Evidence, Clinical Experience, and Future Challenges.}, journal = {Archivos de bronconeumologia}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.arbres.2026.01.001}, pmid = {41620360}, issn = {1579-2129}, abstract = {This narrative review summarizes current evidence and clinical experience regarding telemonitoring across major respiratory diseases and care settings, including chronic obstructive pulmonary disease (COPD), asthma, interstitial lung diseases, obstructive sleep apnea, as well as non-invasive ventilation and pulmonary rehabilitation programmes. Advances in connectivity, artificial intelligence (AI), and wearable devices are facilitating the early detection of clinical deterioration, personalized interventions, and improved self-management, thereby optimizing the use of healthcare resources. Strong evidence supports the benefits of telemonitoring in COPD, particularly in reducing exacerbations and hospital admissions, whereas results are more heterogeneous in asthma and emerging conditions such as interstitial lung diseases. Telemonitoring systems leverage AI-driven analytical frameworks and interoperable digital platforms to process and interpret large volumes of patient data, enabling both automated responses and targeted human interventions. Key challenges include ensuring patient engagement, addressing digital literacy and inequities in access, safeguarding data privacy, and integrating digital solutions into standard care and reimbursement frameworks. The COVID-19 pandemic accelerated the adoption of telemonitoring, confirming its feasibility and acceptability, but also revealed persistent gaps in long-term cost-effectiveness and implementation strategies. Future directions should focus on integrating telemonitoring with AI-supported, coordinated clinical decision-making, enhancing system interoperability, and above all, prioritizing equitable access to digital care. Telemonitoring is poised to become a central component of respiratory patient management, although its large-scale implementation will require overcoming existing technical, ethical, and organizational barriers to fully realize its clinical potential.}, }
@article {pmid41620714, year = {2026}, author = {Xie, H and Pan, S and Zhang, Z and Fan, J and Zhang, H and Wang, J and Tian, X}, title = {Antifungal prophylaxis among critically ill COVID-19 patients: a meta-analysis and systematic review.}, journal = {BMC infectious diseases}, volume = {26}, number = {1}, pages = {}, pmid = {41620714}, issn = {1471-2334}, mesh = {Humans ; *Antifungal Agents/therapeutic use/administration & dosage ; Critical Illness ; *COVID-19/complications/mortality ; Intensive Care Units ; Amphotericin B/therapeutic use/administration & dosage ; *Pulmonary Aspergillosis/prevention & control/mortality ; SARS-CoV-2 ; Triazoles/therapeutic use/administration & dosage ; }, abstract = {BACKGROUND: COVID-19-associated pulmonary aspergillosis (CAPA) affects a significant proportion of patients admitted to the ICU and is associated with increased mortality, underscoring the need for effective prophylaxis. While observational studies suggest a benefit from antifungal prophylaxis, its efficacy remains unconfirmed by randomized trials, and its impact on clinical outcomes is unclear. METHODS: We conducted a systematic review and meta-analysis (PROSPERO: CRD42023462988) of nine ICU-based studies, comparing antifungal prophylaxis (primarily inhaled amphotericin B or systemic posaconazole) with standard care. The primary outcome was CAPA incidence; secondary outcomes included mortality, time to CAPA onset, and ICU length of stay. Risk of bias was assessed using ROBINS-I, with publication bias evaluated via Egger’s test and funnel plot symmetry. Subgroup and sensitivity analyses were performed to assess heterogeneity and robustness. RESULTS: Among 1,321 patients included, antifungal prophylaxis significantly reduced CAPA incidence (RR 0.21, 95% CI 0.14–0.33; p < 0.001) and CAPA risk (OR 0.22, 95% CI 0.12–0.40; p < 0.001). Inhaled amphotericin B demonstrated consistent benefit (RR 0.18, 95% CI 0.06–0.52; p = 0.001), whereas systemic posaconazole showed variable results. No significant effects were observed on mortality (RR 1.05; p = 0.69), time to CAPA onset (MD −0.33 days; p = 0.73), or ICU stay duration (MD 1.59 days; p = 0.34). Efficacy was most evident in retrospective cohorts and among patients receiving invasive mechanical ventilation. Sensitivity analyses excluding high-bias studies confirmed the findings. CONCLUSION: This meta-analysis suggests a potential role for antifungal prophylaxis, especially topical amphotericin B, in reducing the risk of CAPA among critically ill COVID-19 patients, albeit survival or ICU stay was unaffected. The favorable profile of topical amphotericin B necessitates direct comparison with systemic azoles in future trials. Prospective, randomized studies are imperative to validate these findings for universal application, refine prophylactic regimens for broader populations, and assess long-term clinical and economic impacts.}, }
@article {pmid41621349, year = {2026}, author = {De Los Reyes, A and Talbott, E and Yusuf, A and Dryburgh, NSJ and Goodman, KL}, title = {Lack of improvements in youth psychotherapies or lack of investments in detecting improvements? Future directions in psychological assessment.}, journal = {Clinical psychology review}, volume = {124}, number = {}, pages = {102705}, doi = {10.1016/j.cpr.2026.102705}, pmid = {41621349}, issn = {1873-7811}, mesh = {Humans ; *Psychotherapy/standards/methods ; *Mental Disorders/therapy/diagnosis ; *COVID-19 ; Adolescent ; *Mental Health Services/standards ; }, abstract = {Youth were experiencing mental health crises before the onset of the COVID-19 pandemic. Following this onset, their needs for mental health services have only increased. Yet, researchers encounter barriers to confronting these crises. The effects of therapies tested in controlled trials in the present day appear to be no more potent than those of their predecessors tested in trials conducted decades ago. Across these decades of scholarly work, researchers have invested far more of their efforts toward improving technologies for therapies than they have toward improving technologies for the assessment tools used to estimate therapeutic effects. The tools used today look a lot like those used in the 1970s-mainly surveys and interviews-and our strategies for integrating the data these tools produce focus on the sliver of their data that converge or yield the same results about youth mental health. Decades of work reveal that these integration strategies are incompatible with the data conditions that typify youth mental health assessments. We must invest in innovative assessment tools and integration strategies that capitalize on all the valid data produced by these conditions. This paper details pioneering directions in future research about psychological assessment. We describe the conceptual foundations underlying these research directions and highlight recent work by the authors and others supporting this pursuit. If we empower the assessment researchers of today to develop technologically innovative assessment tools and integration strategies, then we equip the therapy researchers of tomorrow to demonstrate that investing in therapy technologies pays off.}, }
@article {pmid41621370, year = {2026}, author = {Mogensen, TH}, title = {Inborn errors of autophagy underlying severe viral infections in humans.}, journal = {Current opinion in virology}, volume = {75}, number = {}, pages = {101510}, doi = {10.1016/j.coviro.2026.101510}, pmid = {41621370}, issn = {1879-6265}, mesh = {Humans ; *Autophagy/genetics/immunology ; *Virus Diseases/immunology/genetics ; COVID-19/immunology/genetics ; SARS-CoV-2/immunology ; }, abstract = {Inborn errors of immunity can underlie susceptibility to severe viral infection in humans. and the majority relate to defective induction of or response to antiviral type I interferon (IFN). However there is increasing awareness of defects in other cellular processes, that can predispose to severe infectious disease. Recently, defects in autophagy-related genes or -processes have been demonstrated to predispose to life-threatening viral diseases, including defects in autophagy-related genes in patients with herpes simplex virus and varicella zoster virus infections in the central nervous system, as well as impairment of noncanonical antiviral immunity in critical COVID-19. However, the molecular mechanisms and complex intersections between autophagy, metabolism, cell death, and inflammation, and how defects in autophagy-related proteins may interfere with these cellular processes, are only now starting to emerge. This review presents the current knowledge on inborn errors of autophagy discovered in patients with severe viral infection and discusses some of the remaining knowledge gaps in our understanding of how autophagy processes act against viruses, how immunopathology and lack of viral control ensues when they fail, and how these insights may be translated into clinical medicine.}, }
@article {pmid41621401, year = {2026}, author = {Ramatsokotla, S and Soul, B and Duah, E and Sekwele, L and Thompson, G and Maluleke, K and Mbonambi, L and Mashamba-Thompson, T}, title = {Evidence of point-of-care diagnostics in forensic death investigations: A scoping review.}, journal = {Journal of forensic and legal medicine}, volume = {118}, number = {}, pages = {103086}, doi = {10.1016/j.jflm.2026.103086}, pmid = {41621401}, issn = {1878-7487}, mesh = {Humans ; *Point-of-Care Systems ; *Forensic Medicine ; *Point-of-Care Testing ; Triage ; Rapid Diagnostic Tests ; *Forensic Sciences ; Cause of Death ; }, abstract = {BACKGROUND: Point-of-care (POC) diagnostics represent promising health-technology tools capable of providing rapid, on-site analytical support for forensic investigations. This scoping review aimed to systematically map the available evidence on applying POC diagnostics in forensic investigations. The focus is on their potential ability to act as rapid screening and triage tools to assist in determining the cause of death and exploring the challenges and opportunities associated with their implementation on a global scale.
METHODS: A comprehensive literature search was conducted across multiple databases, including PubMed, ProQuest Central, Academic Search Complete, Africa Wide, CINAHL, MEDLINE, and Web of Science. Out of the 7603 records screened, four studies met the eligibility criteria and were included in the review. Reporting adhered to the PRISMA-ScR guidelines.
RESULTS: These studies demonstrated the expanding role of POC devices in various aspects of forensic investigations, including rapid triage in overdose cases, malaria diagnosis in travel-related deaths, SARS-CoV-2 screening, and hemoglobin testing in child deaths. These studies also highlighted the limitations of POC devices in the postmortem context, emphasizing the need for careful calibration, confirmation, and interpretation of the results. This review identified POC diagnostics as a potential bridge between forensic investigations and public health surveillance, with findings indicating both cause-of-death determination and broader public health strategies. Operational, ethical, and policy considerations for using POC devices in forensic investigations were also discussed.
CONCLUSION: This review revealed challenges in ensuring the standardization, accuracy, and integration of POC diagnostics into established forensic practices. Further research is required to evaluate the diagnostic accuracy, cost-effectiveness, and performance of POC tools in forensic settings. Comprehensive guidelines and standardized operating procedures should be developed to ensure the successful implementation of POC diagnostics in forensic investigations. Given the limited and heterogeneous evidence, POC devices in forensic death investigations should be seen as preliminary aids rather than diagnostic instruments.}, }
@article {pmid41621452, year = {2026}, author = {Waclawovsky, AJ and de Oliveira, J and de Carvalho, CP and Adornes, ME and Dos Santos, E and Wolf, S and Cristi-Montero, C and Teychenne, M and Stubbs, B and Deslandes, AC and Schuch, FB}, title = {Higher physical activity is associated with reduced odds of depressive symptoms among university students: A meta-analysis of over 66,000 participants.}, journal = {Journal of affective disorders}, volume = {401}, number = {}, pages = {121319}, doi = {10.1016/j.jad.2026.121319}, pmid = {41621452}, issn = {1573-2517}, mesh = {Humans ; *Students/psychology/statistics & numerical data ; *Exercise/psychology ; Universities ; *Depression/epidemiology/psychology ; Female ; Young Adult ; COVID-19/psychology ; Male ; }, abstract = {Depression is highly prevalent among university students, who also exhibit low levels of physical activity. Although physical activity is associated with a lower likelihood of depressive symptoms, the magnitude of its effect in this population has not been systematically assessed. This study reviewed and performed a meta-analysis of the association between physical activity and depressive symptoms in university students. The Embase, PubMed, Web of Science, PsycINFO, and SPORTDiscus databases were searched from inception to January 24, 2025, for relevant studies. Random-effects meta-analyses were used to calculate adjusted (aOR) and unadjusted (OR) odds ratios for depressive symptoms based on physical activity levels. The protocol was registered in PROSPERO (CRD42024591429). Twenty-two studies, involving 66,683 students (median age: 21 years, 56.5% female), were included. Students with higher levels of physical activity had lower odds of depressive symptoms compared to those with lower levels (adjusted OR = 0.614, 95% CI: 0.540-0.698, I[2] = 47.5%). Subgroup analyses revealed no differences between studies conducted during or outside the COVID-19 pandemic. Among students in health sciences programs, higher physical activity was associated with a 34% lower likelihood of depressive symptoms (adjusted OR = 0.66, 95% CI: 0.49-0.88, I[2] = 33.2%). These findings indicate that increased physical activity is associated with a lower likelihood of depressive symptoms in university students, supporting its promotion as a mental health intervention.}, }
@article {pmid41621991, year = {2026}, author = {Milner, KA and Marmo, S}, title = {Open Visitation: Enabling Family Presence, Centered Care, and Engagement in Intensive Care Unit.}, journal = {Critical care nursing clinics of North America}, volume = {38}, number = {1}, pages = {151-164}, doi = {10.1016/j.cnc.2025.10.007}, pmid = {41621991}, issn = {1558-3481}, mesh = {Humans ; *Intensive Care Units/organization & administration ; COVID-19 ; *Visitors to Patients/psychology ; *Family/psychology ; *Patient-Centered Care ; Pandemics ; *Professional-Family Relations ; }, abstract = {Family-centered care (FCC) emphasizes collaboration, dignity, respect, and shared decision-making between families and health care teams. In the ICU, FCC relies on family presence at the bedside, facilitated by open visitation policies. However, the COVID-19 pandemic disrupted this model, as restrictive visitation policies eliminated family presence, leading to adverse outcomes such as loneliness and delirium in patients, distress and grief among families, and moral injury and burnout in staff. As health systems recover, there is a need to reestablish FCC by prioritizing open visitation while balancing infection control and operational demands.}, }
@article {pmid41622196, year = {2026}, author = {Sun, S and Zhang, Y and Ma, J and Chen, L and Wang, Y}, title = {Clinical characteristics and treatment outcomes in thymoma- related aplastic anemia: a case report and literature review.}, journal = {Journal of cardiothoracic surgery}, volume = {21}, number = {1}, pages = {}, pmid = {41622196}, issn = {1749-8090}, mesh = {Humans ; Female ; *Thymoma/complications/surgery/diagnosis ; *Anemia, Aplastic/etiology/therapy/diagnosis ; Middle Aged ; *Thymus Neoplasms/complications/surgery ; *Thymectomy/adverse effects ; Treatment Outcome ; Fatal Outcome ; Hematopoietic Stem Cell Transplantation ; }, abstract = {Thymoma-related aplastic anemia is a rare entity. This article retrospectively analyzes the clinical features and treatment course of a patient who developed aplastic anemia (AA) post-thymectomy, complemented by a systematic review of relevant literature. A 47-year-old female was diagnosed with thymoma, myasthenia gravis (MG), and severe AA (SAA). SAA onset occurred two weeks after total thymectomy, and the patient ultimately succumbed to concurrent COVID-19 infection following allogeneic hematopoietic stem cell transplantation (allo-HSCT). We also reviewed the clinical characteristics, treatment strategies, and prognosis of 47 thymoma-related aplastic anemia patients reported in the literature. AA may present prior to thymoma diagnosis, concurrently with thymoma, or post-thymectomy. Some patients progress to pure red cell aplasia (PRCA) and/or megakaryocytic aplasia, often following prior chemotherapy or radiotherapy. Similar to Good syndrome and PRCA, thymectomy fails to alleviate AA, and spontaneous improvement is rare. Treatment options for thymoma-related aplastic anemia include cyclosporine A (CsA) monotherapy, CsA combined with glucocorticoids, thrombopoietin receptor agonists (TPO-RAs), and allo-HSCT. However, regimens of cyclophosphamide plus methylprednisolone and glucocorticoid monotherapy show limited efficacy. The overall one-year mortality rate is alarmingly high at 29.8%. For young thymoma-related aplastic anemia patients with SAA and suitable donors, allo-HSCT remains the preferred treatment.}, }
@article {pmid41622815, year = {2026}, author = {Hussain, I and Rasul, A and Hassan, M and Rawat, R and Tutar, Y}, title = {Lariciresinol: a potent natural compound with diverse therapeutic and health benefits.}, journal = {Natural product research}, volume = {}, number = {}, pages = {1-16}, doi = {10.1080/14786419.2025.2611424}, pmid = {41622815}, issn = {1478-6427}, abstract = {Scientific research has identified lariciresinol among lignan types, which shows potential against cancer development and bacterial infections in addition to serving as an antioxidant that affects oestrogen activity while blocking inflammation. The review analyses the detailed medical and biological properties of lariciresinol. The two Brassicaceae plant genera Isatis indigotica and Brassica oleracea contain this substance, which exists in various plant types. The compound demonstrated anticancer properties through its mechanisms of stopping cancer cell multiplication and triggering programmed cell death. Recent research found that lariciresinol can block the function of the virus that causes COVID-19 by reducing its ability to enter the cells and proliferate. Lariciresinol antiviral actions have been shown to reduce RNA and viral protein production. The diverse impacts indicate that lariciresinol is a potential compound for novel health solutions and future therapeutic innovations.}, }
@article {pmid41622853, year = {2026}, author = {Ferrari, F and Goulart, CDL and Franzoni, LT and Cipriano, G and Stein, R}, title = {Effects of different exercise training modalities in post-COVID-19 individuals: a systematic review of randomized controlled trials.}, journal = {Disability and rehabilitation}, volume = {}, number = {}, pages = {1-15}, doi = {10.1080/09638288.2026.2619815}, pmid = {41622853}, issn = {1464-5165}, abstract = {PURPOSE: Although the COVID-19 pandemic has ended, long-term effects persist. Exercise training (ET) supports recovery, but evidence on optimal modalities is limited. This study evaluated the effects of different ET modalities in post-COVID-19 individuals.
METHODS: A systematic search identified randomized controlled trials (RCTs) up to 23 September 2025, involving adults with COVID-19. Studies compared ≥4-week interventions-aerobic training, high-intensity interval training (HIIT), or combined training (aerobic plus resistance training)-with usual care (UC). Risk of bias and certainty of evidence were assessed using RoB 2.0 and GRADE.
RESULTS: Eighteen RCTs (N = 1171) were included. Interventions varied in intensity and duration. Most studies had "some concerns" regarding bias, and overall certainty of evidence was low to very low. Overall, ET modalities were associated with improvements in functional capacity (VO2peak or six-minute walk distance) and muscle strength, although not all studies showed significant differences vs. UC. HIIT demonstrated the greatest VO2peak gain (mean difference: 6.17 ml.kg[-1].min[-1]). Effects on quality of life, anxiety, and depression were inconsistent. Most cardiopulmonary parameters (VE/VCO2 slope, OUES) showed no significant changes, with mixed results for O2 pulse and ventilation.
CONCLUSIONS: Despite heterogeneous protocols and low certainty of evidence, structured ET appears beneficial for post-COVID-19 recovery. Multiple ET approaches may be effective rather than a single "optimal" approach.}, }
@article {pmid41623340, year = {2025}, author = {Sumo, R and Jong, S}, title = {Use of Blockchain Technology to Accelerate Digital Health Transformation Programs.}, journal = {Blockchain in healthcare today}, volume = {8}, number = {2}, pages = {}, pmid = {41623340}, issn = {2573-8240}, abstract = {Disruptive digital health technologies are reshaping how patients interact with health professionals, how data are shared among providers, and how treatment plans and health outcomes are determined. While the COVID-19 pandemic has accelerated the adoption of digital technologies, challenges remain in realizing the potential of digital transformation programs in healthcare. Specifically, health data need to remain secure, usable, and shareable across multiple stakeholder groups in a world where silos between organizations and information systems persist. The implementation of innovative and disruptive digital technologies such as blockchain can offer a solution to these challenges. This article explores how blockchain technology can be used to accelerate digital health transformation programs. It provides an overview of the technology applications (i.e. data management, Internet of Medical Things [IoMT], supply chain management, and health insurance) and key players based on a literature review and secondary data. It also identifies challenges and success factors in implementing blockchain in healthcare. At the organizational level, we discuss the careful planning and specialized expertise required to overcome the technical, regulatory, and adoption-related hurdles associated with implementing blockchain technology. At the system level, the authors discuss the regulatory constraints, standardization and interoperability issues, and stakeholder engagement challenges linked to implementing blockchain technology.}, }
@article {pmid41623576, year = {2026}, author = {Birla, S and Angural, A and Madathumchalil, A and Shende, RV and Shastry, SV and Shekar, PK and Mahadevappa, M and Vishwanath, P and Prashant, A}, title = {"Bridging the clinical, molecular and genetic perspectives on myocarditis in post-COVID-19 era".}, journal = {International journal of cardiology. Cardiovascular risk and prevention}, volume = {28}, number = {}, pages = {200576}, pmid = {41623576}, issn = {2772-4875}, abstract = {Myocarditis is a non-familial inflammatory manifestation of the myocardium, primarily induced by viral infections, but it may also stem from bacterial pathogens, autoimmune disorders, or adverse drug reactions. Its diagnosis remains challenging due to heterogeneous and often non-specific clinical presentations. Recent epidemiological studies have indicated a markedly increased incidence of myocarditis following SARS-CoV-2 infection and mRNA COVID-19 vaccinations (to a lesser extent) compared to pre-pandemic statistics. While a significant number of cases follow a mild and self-limiting disease course, severe manifestations can lead to arrhythmias, heart failure, or even sudden cardiac death. Importantly, accumulating evidence indicates that even mild myocarditis confers an elevated long-term risk of adverse cardiovascular outcomes. Beyond clinical and imaging-based observations, recent advances highlight a critical role for host genetic susceptibility in modulating immune responses, myocardial injury, and disease severity. This review provides a comprehensive synthesis of the etiology, pathophysiological mechanisms, clinical spectrum, diagnostic approaches, and evidence-based management of COVID-19-associated myocarditis, while critically integrating emerging genetic and transcriptomic insights that may explain disease heterogeneity, variable inter-individual susceptibility, and long-term prognosis. By bridging clinical aspects with molecular and genetic frameworks, this review underscores the importance of personalized risk stratification, vigilant post-recovery surveillance, and targeted preventive strategies in the post-pandemic era.}, }
@article {pmid41623712, year = {2026}, author = {Shang, S and Wang, X and Zhang, E and Zhang, Y and Li, Y and Fang, Q}, title = {Digital interventions to promote vaccine uptake among older adults: A systematic review and network meta-analysis.}, journal = {Digital health}, volume = {12}, number = {}, pages = {20552076261416313}, pmid = {41623712}, issn = {2055-2076}, abstract = {OBJECTIVE: To systematically evaluate the effect of digital intervention on improving routine vaccination in the elderly and to conduct a comparative analysis of different intervention modalities using network meta-analysis (NMA).
METHODS: PubMed, Web of Science, The Cochrane Library, Embase, Scopus, CINAHL, and WanFang Data were searched for randomized controlled trials (RCTs) using digital interventions to promote vaccination in older populations from inception to 15 June 2024. We performed a final update of the literature search in May 2025; no additional eligible studies were identified. Two researchers independently screened the literature, extracted data, and assessed the risk of bias in the included studies, and an NMA was performed using RevMan 5.4 and R Studio, PROSPERO Registration Number: CRD42024527483.
RESULTS: Eleven RCTs were included. The traditional meta-analysis demonstrated a small but statistically significant increase in influenza vaccination rates (RR = 1.01, 95% CI [1.01, 1.01], P < 0.00001), accompanied by substantial heterogeneity (I [2] = 86%). Pneumococcal vaccine uptake was significantly enhanced (RR = 1.11, 95% CI [1.03, 1.18], P < 0.01), with moderate heterogeneity (I [2] = 46%). The single study on the herpes zoster vaccine reported a statistically significant effect, whereas COVID-19 vaccine reminder interventions showed no significant efficacy. In the NMA, video-based interventions ranked first based on the surface under the cumulative ranking curve, but all pairwise comparisons between different intervention modes crossed the null value.
CONCLUSION: Digital interventions show a significant, yet highly heterogeneous, positive impact on vaccination rates in older adults. While video-based education showed the highest ranking probability, the current evidence is insufficient to conclude that any specific digital modality is statistically superior to others. Due to the limited included studies, the findings need to be supplemented by more high-quality studies. Future research should focus on newer digital technologies to help the older population keep up with the "digital intelligence era."}, }
@article {pmid41623887, year = {2025}, author = {Bradway, M and Wang, B and Nybakke, HL and Ingebrigtsen, SA and Dyb, K and Rødseth, E}, title = {Rethinking the digital divide in health: a critical interpretive synthesis of research literature.}, journal = {Frontiers in digital health}, volume = {7}, number = {}, pages = {1683565}, pmid = {41623887}, issn = {2673-253X}, abstract = {BACKGROUND: The digital divide in health has rapidly expanded during and after the COVID-19 pandemic, with fragmented understanding and an unclear implementation process, for the formal integration of digital health into the healthcare system, which challenges actionable policy development.
METHODS: This critical interpretive synthesis (CIS) of the literature aimed to capture the complexity of the digital divide in health. This began with a scoping review of literature published between 2013 and 2023 describing the digital divide in health within the WHO's European Region, in Web of Science, Medline (via Ovid), PsycInfo (via Ovid), and Sociological Abstract (via ProQuest). Three sets of two reviewers independently conducted the selection, and all contributed to the synthesis process.
RESULTS: Of 4,967 original articles identified, 49 articles were included for review. Results revealed a synthesizing argument that the digital divide should be considered as more of a dynamic, entangled, and reciprocal collection of "areas" of phenomenon affecting service users, rather than "levels". Results describe the three synthetic constructs that describe this synthesizing argument.
CONCLUSION: Findings suggest that digital health solutions should respectfully consider the pace of human healing, long-term user engagement and adaptability. We call for the importance of inter- and multidisciplinary collaboration to ensure effective and context-sensitive implementation in future studies.}, }
@article {pmid41624230, year = {2026}, author = {Kokubun, K}, title = {Workplace Safety Management Practices, Fear, Resources, and Employee Involvement During the COVID-19 Pandemic: A Narrative Review.}, journal = {AJPM focus}, volume = {5}, number = {2}, pages = {100456}, pmid = {41624230}, issn = {2773-0654}, abstract = {INTRODUCTION: There are important workplace health lessons to be learned from the pandemic.
METHODS: This study summarizes the relationships between workplace safety practices, fear, resources, and employee engagement during the COVID-19 pandemic through a narrative review on articles published between January 2020 and June 2025 using a primary literature search base.
RESULTS: Organizations have had to implement workplace safety management practices aligned with their occupational safety and health management systems in response to COVID-19. Safety management practices include safety initiatives and training as well as employee involvement. Methods to increase employee involvement include fear and anxiety. However, although fear and anxiety promote safety compliance and safe behavior, they also wear down employees and increase their work distraction and turnover intentions. Therefore, social and psychological resources need to be strengthened to overcome this dilemma. These resources can also help safety management practices today as the pandemic begins to wind down.
CONCLUSIONS: Future research should focus on identifying ways to strengthen employees' social and psychological resources without relying on disasters. To this end, an integration of conservation of resource theory and behavioral theory may be useful.}, }
@article {pmid41624517, year = {2026}, author = {Navid Talemi, M and Ramezani Farani, M and Alipour Eskandani, N and Mirzaee, D and Alipourfard, I and Huh, YS}, title = {Programmable lipid nanoparticles for RNA therapeutics: Design principles and clinical translation.}, journal = {Materials today. Bio}, volume = {37}, number = {}, pages = {102774}, pmid = {41624517}, issn = {2590-0064}, abstract = {RNA therapeutics have come of age as clinically validated modalities including mRNA, siRNA, antisense oligonucleotides (ASOs), and in vivo genome editing, with lipid nanoparticles (LNPs) as the main non-viral delivery system. This review defines programmable LNPs as systems whose composition and interfacial chemistry are tuned to control organ tropism, cell specificity, intracellular trafficking, and immune interactions. We summarize design rules across four core components (ionizable lipid, phospholipid, cholesterol, PEG-lipid) and highlight levers like apparent pKa optimization (∼6-7 for hepatic delivery), biodegradable linkers, PEG-anchor-dependent shedding, ligands (e.g., GalNAc), and selective organ-targeting (SORT) lipids that redirect biodistribution beyond the liver. We survey advances in data-guided formulation, including DNA-barcoded in vivo libraries, machine learning, and physics-based prediction, plus scalable manufacturing (microfluidics, confined impinging-jet mixing, tangential-flow filtration) and Quality-by-Design with process-analytical technologies. A comprehensive characterization toolkit (size/ζ-potential, cryo-EM/SAXS, RNA encapsulation and integrity, apparent pKa, in vivo barcoding) maps to critical quality attributes. Applications span vaccines, protein replacement, siRNA/ASO delivery, and CRISPR platforms, with clinical examples like patisiran, COVID-19 and RSV mRNA vaccines, in-human transthyretin (TTR) editing, and individualized melanoma vaccination. We analyze translational constraints like endosomal escape, reactogenicity and anti-PEG immunity, complement activation, and lot-to-lot control, plus success factors: corona-aware design, dose-efficient potency at low lipid burden, redosing strategies, and fit-for-purpose biomarkers. Together, programmable LNPs offer a generalizable path to extrahepatic, cell-aware RNA medicine when coupled to rigorous analytics and platform manufacturing.}, }
@article {pmid41625501, year = {2024}, author = {Avcı, E and Muharremoğlu, ZD and Bozkurt, ENN and Kaygusuz, S}, title = {Changing Epidemiology of Tuberculosis and Actions Taken in the World and Türkiye.}, journal = {Journal of clinical practice and research}, volume = {46}, number = {5}, pages = {421-430}, pmid = {41625501}, issn = {2980-2156}, abstract = {Tuberculosis (TB) is an airborne, contagious illness caused by Mycobacterium tuberculosis, which can affect all tissues and organs, primarily the lungs. Tuberculosis remains a significant public health problem worldwide, with 10 million people contracting the disease and 1.5 million deaths annually. It is the second most common cause of death from communicable diseases globally, following Coronavirus Disease 2019 (COVID-19). To combat tuberculosis globally, the Global Tuberculosis Program is carried out by the World Health Organization (WHO). The WHO began the Directly Observed Treatment Strategy in 1995, the Stop Tuberculosis Strategy in 2006, and the End Tuberculosis Strategy in 2015. The End Tuberculosis Strategy aims to end the global tuberculosis epidemic by 2035. Due to the COVID-19 pandemic, global tuberculosis goals were missed or off-target. The fight against TB requires continuity. The National Tuberculosis Control Program, which includes the End Tuberculosis Strategy, has been implemented successfully for many years in alignment with global targets in Türkiye. In this article, the changing epidemiology of TB in the world and Türkiye is evaluated, and control activities carried out within the scope of combating TB are included.}, }
@article {pmid41625593, year = {2026}, author = {Bai, Y and Ma, Y and Li, X}, title = {The research progress of ferroptosis in acute lung injury.}, journal = {Biochemistry and biophysics reports}, volume = {45}, number = {}, pages = {102434}, pmid = {41625593}, issn = {2405-5808}, abstract = {Ferroptosis, an iron-dependent form of regulated cell death driven by lipid peroxidation, is increasingly recognized as a pivotal mechanism in the pathogenesis of acute lung injury (ALI) and its severe form, acute respiratory distress syndrome (ARDS). Its core molecular machinery, including glutathione peroxidase 4 (GPX4), acyl-CoA synthetase long-chain family member 4 (ACSL4), and the cystine/glutamate antiporter system Xc-, becomes dysregulated across various ALI subtypes, such as sepsis, ischemia-reperfusion, and COVID-19.This review delineates how ferroptosis contributes to ALI through iron overload, uncontrolled lipid peroxidation, and failure of antioxidant defenses, ultimately leading to pulmonary endothelial and epithelial cell death. We further summarize subtype-specific mechanisms and evaluate emerging therapeutic strategies, including ferroptosis inhibitors (e.g., liproxstatin-1), Nrf2 activators, and iron chelators, highlighting their potential for targeted intervention in ALI/ARDS.}, }
@article {pmid41626197, year = {2026}, author = {Chikuse, D and Badacho, AS and Uwimana-Nicol, J and Hendricks, L and Nyasulu, JCY}, title = {The Landscape on Access to Maternal and Child Health Services During the COVID-19 Pandemic in South Africa: A Scoping Review.}, journal = {Interdisciplinary perspectives on infectious diseases}, volume = {2026}, number = {}, pages = {9065224}, pmid = {41626197}, issn = {1687-708X}, abstract = {BACKGROUND: In early March 2020, the World Health Organization (WHO) declared COVID-19 a pandemic. In South Africa, the first case was confirmed in early March 2020. According to the WHO, disruptions in essential services due to the COVID-19 pandemic occurred worldwide. The COVID-19 pandemic affected access to maternal and child health (MCH) services in many countries, including South Africa. The study aimed to map and describe the existing evidence on the impact of the COVID-19 pandemic on the access to and delivery of maternal, neonatal, and child health (MNCH) services in South Africa.
METHODOLOGY: This was a scoping review of studies published between 2020 and 2023. We searched databases such as PubMed, MEDLINE, EBSCOhost, and Google Scholar. Data were exported to the Rayyan software, where screening, checking of duplicates, and selection of final studies for review were performed. The information from the identified studies was exported to ATLAS.ti 23.1 software for analysis. Content analysis was performed, and data were presented in predetermined themes using the MCH cascade.
RESULTS: The results from 25 articles showed a mixed view, whereby some studies showed a decrease at the beginning of the pandemic in April 2020, in the uptake of family planning, antenatal care, labor and delivery, postnatal care, under-five immunizations, and cervical cancer screening services. However, other studies found increased uptake of family planning, antenatal care, labor and delivery, and under-five immunization services. Some studies showed resilience in the overall first antenatal visits, adolescents' visits to family planning, and postnatal care, as they remained constant.
CONCLUSION: The findings show both positive and negative impacts of the COVID-19 pandemic on MNCH services in South Africa. While the pandemic significantly disrupted access to essential services, some areas demonstrated resilience, with increased visits for antenatal care, adolescent family planning, and postnatal services. These insights are critical for guiding decision-makers, health managers, and frontline healthcare workers in preparing for future public health emergencies. Ensuring continuity of MNCH services during crises must be a priority. Strengthening the health system and building resilience are essential to safeguard MCH, even in the face of disruptions.}, }
@article {pmid41626364, year = {2025}, author = {de Jong, M and de Korne-Elenbaas, J and Fanoy, E and Medema, G and de Graaf, M and Prins, M and van der Loeff, MFS and Daams, J and Husman, AMR and Heijne, JCM}, title = {Public health actions in response to pathogen detection in wastewater and the environment: a scoping review.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1675742}, pmid = {41626364}, issn = {2296-2565}, support = {U24 AI183840/AI/NIAID NIH HHS/United States ; }, mesh = {Humans ; *Wastewater/microbiology/virology ; *Public Health ; *Environmental Monitoring/methods ; COVID-19/prevention & control ; SARS-CoV-2 ; }, abstract = {INTRODUCTION: Rapid detection of infectious disease agents is crucial for timely public health responses. Wastewater and environmental surveillance (WES) offers a complementary approach by detecting pathogens shed by infected individuals, including asymptomatic cases. This scoping review provides an overview of reported public health actions in response to WES for human pathogens. It also summarizes sampling and analysis methods and offers insights for future implementation.
METHODS: The protocol for this review was registered in the PROCEED open-access registry. A systematic search was conducted in MEDLINE, EMBASE, and Web of Science for peer-reviewed literature published up to 31 July 2024. Studies were included if they reported public health actions in response to WES related to infectious diseases in human populations. Two reviewers independently screened studies and extracted data on public health responses, sampling, and analytical methods.
RESULTS: Of the 6,630 articles screened, 49 met the inclusion criteria. Most studies (92%) were published between 2021 and 2024, with SARS-CoV-2 as the primary focus (82%), followed by poliovirus (16%). Research was largely conducted in high-income regions: North America (51%), Asia (22%), and Europe (14%). Target populations included urban residents (57%) and on-campus students (31%) and local authorities were more often involved in WES efforts than national agencies (51% vs. 33%). In 75% of studies, at least two public health actions were implemented, and 20% reported five or more. The most common actions related to reactive disease control (n = 69), including testing, isolation, and contact tracing. Proactive disease control actions (n = 33) and public health communication (n = 22) were also described. Weekly sampling (57%) and composite methods (67%) were most used. Manhole sampling, despite equal frequency with treatment plant sampling (35%), led to significantly more public health actions (61 vs. 35). Long-term surveillance was often reported but rarely sustained. Quantitative and molecular analyses dominated; sequencing was rarely used (4%).
CONCLUSION: While reporting on public health actions following WES remains limited, this review illustrates its potential to inform timely, local interventions. Future studies should broaden pathogen targets, embed public health action planning in study design, and expand WES use in low-resource settings.}, }
@article {pmid41626890, year = {2026}, author = {Maxwell, L and Shreedhar, P and Merson, L and Levis, B and Debray, TPA and de Jong, VMT and Ximenes, RAA and Jaenisch, T and Gustafson, P and Carabali, M}, title = {How to conduct an individual participant data meta-analysis in response to an emerging pathogen: Lessons learned from Zika and COVID-19.}, journal = {Research synthesis methods}, volume = {17}, number = {1}, pages = {1-29}, pmid = {41626890}, issn = {1759-2887}, support = {01886-000//Institute of Genetics/ ; 825746//H2020 Health/ ; }, mesh = {Humans ; *Meta-Analysis as Topic ; *COVID-19/epidemiology ; *Zika Virus Infection/epidemiology ; SARS-CoV-2 ; Data Interpretation, Statistical ; *Communicable Diseases, Emerging/epidemiology ; Zika Virus ; Research Design ; }, abstract = {Sharing, harmonizing, and analyzing participant-level data is of central importance in the rapid research response to emerging pathogens. Individual participant data meta-analyses (IPD-MAs), which synthesize participant-level data from related primary studies, have several advantages over pooling study-level effect estimates in a traditional meta-analysis. IPD-MAs enable researchers to more effectively separate spurious heterogeneity related to differences in measurement from clinically relevant heterogeneity from differences in underlying risk or distribution of factors that modify disease progression. This tutorial describes the steps needed to conduct an IPD-MA of an emerging pathogen and how IPD-MAs of emerging pathogens differ from those of well-studied exposures and outcomes. We discuss key statistical issues, including participant- and study-level missingness and complex measurement error, and present recommendations. We review how IPD-MAs conducted during the COVID-19 response addressed these statistical challenges when harmonizing and analyzing participant-level data related to an emerging pathogen. The guidance presented here is based on lessons learned in our conduct of IPD-MAs in the research response to emerging pathogens, including Zika virus and COVID-19.}, }
@article {pmid41627487, year = {2026}, author = {Malik, J and Singh, S and Shrivastav, D and Verma, VV and Pal, RK and Mishra, MK and Sharma, VK}, title = {Therapeutic milestones against multidrug resistant Acinetobacter baumannii: from legacy antibiotics to Zosurabalpin.}, journal = {Archives of microbiology}, volume = {208}, number = {4}, pages = {177}, pmid = {41627487}, issn = {1432-072X}, mesh = {*Acinetobacter baumannii/drug effects/genetics ; *Drug Resistance, Multiple, Bacterial ; *Anti-Bacterial Agents/therapeutic use/pharmacology ; Humans ; *Acinetobacter Infections/drug therapy/microbiology ; Carbapenems/pharmacology/therapeutic use ; Biofilms/drug effects ; }, abstract = {Antimicrobial resistance (AMR) in Acinetobacter baumannii represents a critical global health challenge, particularly in intensive care settings where the pathogen causes severe, refractory infections. As a leading member of the ESKAPE group, A. baumannii has accumulated extensive resistance to multiple antibiotic classes, including carbapenems, resulting in the widespread emergence of multidrug-resistant (MDR), extensively drug-resistant (XDR), and pan-drug-resistant (PDR) strains. This review provides a chronological overview of the evolution of antimicrobial therapies used against A. baumannii, spanning the early era of penicillins and tetracyclines to contemporary agents such as eravacycline and ceftazidime-avibactam. We delineate the molecular mechanisms underlying resistance development, including carbapenemase production, robust RND efflux systems, horizontal gene transfer, biofilm formation, and the global dissemination of high-risk international clones (IC1-IC9). The compounding impact of the COVID-19 pandemic on the spread of carbapenem-resistant A. baumannii (CRAB) is also examined. A special emphasis is placed on Zosurabalpin, a first-in-class macrocyclic peptide antibiotic with a unique mechanism of action that targets the LptB2FG complex essential for lipooligosaccharide (LOS) transport and outer membrane assembly. Preclinical data and emerging clinical findings highlight its potent activity against highly resistant CRAB strains and its ability to circumvent conventional resistance pathways, marking it as a promising candidate in the antimicrobial pipeline. Finally, we evaluate the limitations of current treatment modalities and explore emerging strategies, including phage therapy, novel target discovery, and non-traditional therapeutics, offering a forward-looking perspective on restoring and sustaining effective anti-Acinetobacter interventions.}, }
@article {pmid41627575, year = {2026}, author = {Abu-Raddad, LJ and Chemaitelly, H and Wald, A and Johnston, C}, title = {Herpes Simplex Virus Type 2 Screening in Persons with and Without HIV: Evidence, Challenges, and Future Directions.}, journal = {Current HIV/AIDS reports}, volume = {23}, number = {1}, pages = {3}, pmid = {41627575}, issn = {1548-3576}, mesh = {Humans ; *Herpesvirus 2, Human/isolation & purification/immunology ; *Herpes Genitalis/diagnosis/epidemiology ; *HIV Infections/complications/prevention & control ; *Mass Screening/methods ; Female ; Pregnancy ; }, abstract = {PURPOSE OF REVIEW: Herpes simplex virus type 2 (HSV-2) infection is one of the most prevalent sexually transmitted infections worldwide, with implications for HIV acquisition, transmission, and disease progression. This review synthesizes current evidence and guidance on HSV-2 serologic screening, emphasizing its relevance for HIV prevention and care. RECENT FINDINGS: International guidelines advise against routine general population-level serologic screening for HSV-2 in asymptomatic persons. Key limitations include poor test specificity, the absence of potent antivirals or therapeutic vaccines, lack of curative therapy, no demonstrated population-level benefit, and psychosocial harms associated with diagnosis. Current practice instead emphasizes diagnostic testing in symptomatic persons and targeted screening in defined contexts—such as among people with HIV in specific clinical situations, sex partners of those with HSV-2 infection, certain pregnant women, persons seeking sexual health care, and persons with recurrent or atypical symptoms—where results may directly inform management. Emerging technologies, including highly specific assays, novel potent antivirals, therapeutic vaccines, and curative strategies, may eventually shift the cost–benefit balance of general screening. Evidence supports targeted rather than general population-level screening to maximize clinical benefit while minimizing harm. New evidence demonstrating that interventions can achieve measurable population-level reductions in disease burden or transmission, together with future advances in diagnostics and therapeutics, may eventually justify integrating routine HSV-2 screening into broader contexts, including into HIV prevention and care.}, }
@article {pmid41629068, year = {2026}, author = {Kshatriya, M and Syal, R and Als, D and Muralidharan, O and Akindole, B and Padhani, ZA and Das, J and Bhutta, ZA}, title = {Implementation of health and health-related sustainable development goals: progress, challenges and opportunities-a systematic literature review update.}, journal = {BMJ global health}, volume = {11}, number = {2}, pages = {}, pmid = {41629068}, issn = {2059-7908}, mesh = {*Sustainable Development ; Humans ; *Global Health ; COVID-19/epidemiology ; *Goals ; Pandemics ; SARS-CoV-2 ; }, abstract = {INTRODUCTION: A prior systematic review assessed progress in health and health-related sustainable development goals (HHSDGs) from 2015 to 2019, identifying an important need for countries to strengthen implementation of multisectoral work, capacity building, financial stability and data availability. We undertook an updated systematic review to assess additional progress, challenges and opportunities for HHSDG implementation from 2019 to 2025, including the pandemic periods. This update aims to assess where countries are presently in HHSDG implementation and if further recommendations can be made in the final stretch to the 2030 targets.
METHODS: We followed a comparable comprehensive search strategy as the first review, focusing on implementation and acceleration strategies for HHSDGs. We undertook a qualitative synthesis from peer-reviewed and grey literature for specific databases, including studies and reports published from June 2019 to January 2025.
RESULTS: A total of 192 publications were included in the review of which 150 provided national-level information and 42 provided multicountry or regional information. Findings suggest a high level of political commitment in most countries and many HHSDG efforts being aligned with existing national development strategies. There was a noteworthy shift towards decentralised, subnational approaches to provide contextually relevant interventions. Multisectoral, multistakeholder, integrated approaches for implementation are increasing and proving to be effective. Diverse monitoring and evaluation strategies were employed, and (cross-country) knowledge sharing was instrumental to SDG policy and programme planning. Service disruptions incurred by the COVID-19 pandemic, lack of quality data and obtaining sustainable funding were frequently cited challenges to implementation.
CONCLUSIONS: Ensuring continuous financial investments and strengthening data availability are essential to accelerate HHSDG implementation. Recommendations for progress include strengthening primary healthcare, fostering multisectoral collaboration and addressing deep-rooted societal perceptions around gender inequity. Future research should examine the interplay of multiple SDGs, and the impact of factors such as cost-effective cross-regional approaches for project implementation.}, }
@article {pmid41629862, year = {2026}, author = {Meşe, EA and Basmaci, F and Bulut, AC and Topallı, D and Şenel, F and Cagiltay, NE}, title = {The role of extended reality technologies in hygiene education and training: a systematic review of applications, benefits, and challenges.}, journal = {BMC infectious diseases}, volume = {26}, number = {1}, pages = {272}, pmid = {41629862}, issn = {1471-2334}, mesh = {Humans ; *Virtual Reality ; *Hygiene/education ; *Augmented Reality ; *Infection Control/methods ; *Health Personnel/education ; COVID-19/prevention & control ; }, abstract = {BACKGROUND: The emergence of the Metaverse and Extended Reality (XR) technologies, including Virtual Reality (VR), Augmented Reality (AR), and Mixed Reality (MR), has created innovative opportunities for healthcare education and training. These immersive technologies show promise in enhancing infection prevention and control, especially during infectious disease outbreaks. OBJECTIVES: This systematic review aims to evaluate the current application of XR technologies in infection control education, identifying key trends, benefits, and limitations of VR and AR-based interventions. METHODS: A comprehensive literature search was conducted on January 12, 2025, for the Web of Science and PubMed databases using keywords related to hygiene, infection prevention, and XR technologies. An initial pool of 162 articles was screened, resulting in 38 studies that met inclusion criteria. These studies were descriptively analyzed to assess their contributions, focus areas, and outcomes. RESULTS: The review indicates most studies show XR tools effectively improve practical skills, behaviors, or attitudes, while a smaller number reveal limited or no significant gains, especially in knowledge and compliance. This result shows that XR tools have the potential to improve knowledge retention, practical skills, and provide real-time feedback, outperforming traditional training methods. XR tools specifically enhanced hand hygiene, proper use of personal protective equipment, and emergency response training, areas critical during outbreaks like COVID-19. Nevertheless, widespread adoption remains limited due to the need for more long-term efficacy data and strategies for integrating XR into standard curricula. To fully realize this potential, it is essential to address existing limitations related to cost, safety, and validation, while establishing robust frameworks for curriculum integration and policy implementation. CONCLUSION: XR technologies play a crucial role in advancing infection control education by offering potential benefits for healthcare training and education. Future research should prioritize evaluating long-term outcomes and developing effective implementation strategies to facilitate broader adoption, maximize their educational impact and, and mitigate potential barriers. CLINICAL TRIAL NUMBER: Not applicable.}, }
@article {pmid41630128, year = {2026}, author = {Halabi, S and Arora, N and Durran, A and Qian, Q and Ummer, S and Ginsbach, K and Aneja, K}, title = {No fault vaccine injury compensation after COVID-19: A systematic literature review and proposed typology.}, journal = {Human vaccines & immunotherapeutics}, volume = {22}, number = {1}, pages = {2620849}, pmid = {41630128}, issn = {2164-554X}, mesh = {Humans ; *Compensation and Redress ; *COVID-19 Vaccines/adverse effects/economics ; *COVID-19/prevention & control ; *Liability, Legal ; SARS-CoV-2 ; }, abstract = {The COVID-19 pandemic brought about a unique and rapid period of global vaccine innovation. It revealed structural challenges not only in global vaccine affordability and distribution but in the liability and indemnity structures that can both impede access and affect fair outcomes for the small number of people who suffer severe side effects. This review examines vaccine injury and compensation mechanisms, including no-fault compensation schemes, aimed at addressing both the liability and indemnity concerns of developers and the compensation due those suffering severe side effects. The ultimate aim of the review is to provide a classification of systems for those countries that are considering adopting NFCS as part of their broader public health readiness and preparedness strategies.}, }
@article {pmid41630161, year = {2026}, author = {Quagliarini, E and Pozzi, D and Caracciolo, G}, title = {From RNA to DNA: How Cargo Identity Reprograms Lipid Nanoparticle Architecture and Function.}, journal = {Advanced healthcare materials}, volume = {15}, number = {16}, pages = {e05261}, pmid = {41630161}, issn = {2192-2659}, mesh = {*Nanoparticles/chemistry ; *Lipids/chemistry ; Humans ; *DNA/chemistry ; *RNA/chemistry ; Liposomes/chemistry ; Animals ; COVID-19 Vaccines/chemistry ; SARS-CoV-2 ; Gene Transfer Techniques ; }, abstract = {Lipid nanoparticles (LNPs) have become the leading platform for delivering genetic material, gaining global recognition through the success of mRNA-based COVID-19 vaccines such as mRNA-1273 (SpikeVax, Moderna) and BNT162b2 (Comirnaty, BioNTech/Pfizer). Yet, while RNA-LNPs have reached clinical maturity, their DNA counterparts remain comparatively underexplored, despite holding great promise for gene replacement and genome-editing therapies. In this review, we turn the spotlight on DNA-loaded LNPs, examining how their structure, composition, and biological behavior differ from RNA-LNPs, their natural point of reference, and from earlier lipid-based systems such as cationic liposome/DNA complexes (lipoplexes). DNA-LNPs tend to form larger, more heterogeneous, and often multilamellar particles due to the intrinsic stiffness and high charge density of DNA. These distinctive features call for dedicated design strategies, including the use of cationic lipids, pre-condensation agents, and optimized PEGylation schemes. Moreover, DNA profoundly influences the biomolecular corona that forms in biological fluids, which in turn shapes immune recognition, circulation, and tissue targeting. By highlighting these unique physical and biological challenges, this review underscores the need to move beyond simply adapting RNA-based formulations. Instead, a cargo-informed design approach will be key to unlocking the full therapeutic potential of DNA-LNPs in next-generation gene delivery.}, }
@article {pmid41630338, year = {2026}, author = {Fan, C and Dai, Y and Du, H and Su, T and Guo, X and Yan, Z and Fang, H and Yao, Y and Zhou, X}, title = {Successful treatment of severe cerebral malaria with artificial liver blood purification technology: A case report.}, journal = {Medicine}, volume = {105}, number = {5}, pages = {e47528}, pmid = {41630338}, issn = {1536-5964}, mesh = {Humans ; Male ; *Malaria, Cerebral/therapy/complications ; Adult ; *Malaria, Falciparum/complications/therapy ; *Continuous Renal Replacement Therapy/methods ; Antimalarials/therapeutic use ; Plasmodium falciparum/isolation & purification ; Acute Kidney Injury/therapy ; Treatment Outcome ; Artemether/therapeutic use ; }, abstract = {RATIONALE: Plasmodium falciparum infection can lead to acute thrombocytopenia, severe hemolytic anemia, and acute liver and kidney failure, among which the fatality rate of cerebral malaria is as high as 20% to 30%. Continuous bedside blood purification technology is an important intervention measure for severe malaria. The artificial liver blood purification technology, with its multimode clearance advantage, is widely used in the treatment of critical conditions such as liver failure, sepsis, and novel coronavirus infection. We described a case of severe cerebral malaria complicated with severe liver and kidney injury, cerebral edema and heart failure. The patient was cured after treatment with artificial liver blood purification technology. A literature review was also conducted.
PATIENT CONCERNS: A 43-year-old male patient was admitted to our hospital due to fever and confusion. The patient had frequently traveled to Nigeria on business in the past 10 years. Three days ago, he developed high fever and confusion. Blood smear examination revealed infection with Plasmodium falciparum. He also suffered from acute liver and kidney function impairment, severe thrombocytopenia, coagulation dysfunction, cerebral edema, and anuria.
DIAGNOSES: Peripheral blood smear, for the diagnosis of malignant malaria parasite infection.
INTERVENTIONS: The patient received treatments such as artemether for antimalarial parasites, artificial liver blood purification, and ICU support.
OUTCOMES: Through continuous renal replacement therapy combined with artificial liver blood purification technology for fluid management, immune complex clearance, and correction of water, electrolyte and acid-base disorders, the patient was successfully treated.
LESSONS: The integration of artificial liver blood purification with continuous renal replacement therapy may serve as an effective rescue therapy for severe malaria with multi-organ failure, potentially by mitigating the systemic inflammatory response and supporting organ recovery. This case highlights the potential of combined extracorporeal support in managing critical tropical infections.}, }
@article {pmid41630899, year = {2026}, author = {Nicolai, M and Ullrich, A and Ruck, J and Jaspers, B and Bialobrzeski, A and Degutsch, R and Oechsle, K and Radbruch, L and Gágyor, I and Hettich-Damm, N}, title = {Unraveling the complexities: A scoping review of the collateral effects on informal caregivers during and beyond the COVID-19 pandemic.}, journal = {Palliative care and social practice}, volume = {20}, number = {}, pages = {26323524251399233}, pmid = {41630899}, issn = {2632-3524}, abstract = {Due to the COVID-19 pandemic, various infection control measures were introduced that had a profound effect on caregiving dynamics and created burdens in the daily lives of informal caregivers (ICs). A scoping review was conducted to identify burden and support factors for ICs during and beyond the pandemic. Studies were included when they examined ICs' care work during the official time period of the COVID-19 pandemic (March 2020-May 2023) and care hours worked per day or week were specified. Only studies with adult participants and studies in German or English language were incorporated. The scoping review considered quantitative cross-sectional and longitudinal studies involving randomized/quasi-randomized controlled trials, cohort studies, case studies, mixed-methods, and qualitative studies as well as reviews and meta-analyses. The electronic databases PubMed, the Cochrane COVID-19 Study Register, and EBSCO Host were systematically searched. The search was limited to articles published between 2020 and 2024. The scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews. Overall, 42 studies with 51,183individuals met the inclusion criteria and were included in the scoping review. Main findings suggested that the pandemic-related measures caused additional care burden for ICs and worsened the already poor situation of informal care. In particular, the lack of support from health services and the increase in care hours were described as burdensome. Additionally, studies indicated an increase in rates of depression and overall poor mental health, particularly affecting female ICs. Social and formal care support were mentioned as main support factors. Consequently, preparation of future crises should focus on formal health services and structures to promote social support and mental health of ICs during pandemics.}, }
@article {pmid41631378, year = {2026}, author = {Berger do Rosário, M and da Silva, DW and Wawrzeniak, IC and Ziegelmann, PK and Rios Vieira, SR and Boniatti, MM and Teixeira, C and Oliveira, VM}, title = {Extended Prone Positioning in ARDS: A Systematic Review and Meta-Analysis.}, journal = {Respiratory care}, volume = {71}, number = {4}, pages = {417-425}, doi = {10.1177/19433654251405270}, pmid = {41631378}, issn = {1943-3654}, mesh = {Humans ; Prone Position ; *Respiratory Distress Syndrome/therapy/mortality ; *Respiration, Artificial/methods ; *COVID-19/complications/therapy ; *Patient Positioning/methods ; Time Factors ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Prone positioning is a recommended therapy for patients with moderate-to-severe ARDS; however, the optimal duration of this maneuver is still unknown.
METHODS: We performed a systematic review and meta-analysis comparing clinical outcomes of extended (≥24 h) versus traditional prone positioning (16-24 h) of adults with moderate-to-severe ARDS receiving invasive mechanical ventilation.
RESULTS: Ten studies involving 2,412 subjects met the inclusion criteria, including one randomized controlled trial and 9 observational studies, all with COVID-19-related ARDS. Extended prone positioning was associated with reduced mortality compared with the traditional approach (risk ratio [RR]: 0.76, 95% CI 0.66-0.86, I[2] = 12.8%). Sensitivity and subgroup analyses confirmed consistency across risk of bias, baseline PaO2/FiO2, and PEEP levels. No differences were found in duration of mechanical ventilation (mean difference [MD]: 2.43 days, 95% CI -1.06 to 5.92, I[2] = 70%) or ICU stay (MD: 1.31 days, 95% CI -1.07 to 3.68, I[2] = 55%). The extended strategy was associated with a higher incidence of pressure injuries (RR: 1.30, 95% CI 1.02-1.65, I[2] = 56%) but no differences in device displacement or hemodynamic instability. Certainty of evidence was rated as low to very low.
CONCLUSIONS: Extended prone positioning was associated with reduced mortality in ARDS but increased risk of pressure injuries, without impact on ventilator duration or ICU stay. While this strategy appears feasible and potentially beneficial, further randomized trials are warranted to confirm its role in routine practice.
TRIAL REGISTRATION: PROSPERO no. CRD42024529311.}, }
@article {pmid41631916, year = {2026}, author = {Goss, AL}, title = {Neurologic Complications of Drug and Alcohol Use.}, journal = {Continuum (Minneapolis, Minn.)}, volume = {32}, number = {1}, pages = {277-309}, doi = {10.1212/cont.0000000000001676}, pmid = {41631916}, issn = {1538-6899}, mesh = {Humans ; *Substance-Related Disorders/complications ; *Nervous System Diseases/etiology/chemically induced ; COVID-19/complications ; Male ; Female ; }, abstract = {OBJECTIVE: This article reviews the neurologic syndromes associated with substance use and suggests an approach for identifying and managing substance use disorders.
LATEST DEVELOPMENTS: Substance use and overdose mortality, largely associated with fentanyl, rose sharply during the COVID-19 pandemic. Although recent data indicate modest decreases, current rates of overdose remain higher than before the pandemic. A wide variety of opioid-related toxic encephalopathies have been identified recently. Many novel psychoactive substances are unregulated and easily obtained online or in stores; several have been associated with seizures and other neurologic complications. The use of cannabis and hallucinogens is rising as more states legalize or decriminalize their use, and some studies suggest an independent association between cannabis use and ischemic stroke.
ESSENTIAL POINTS: Neurologists often encounter severe complications of substance use and have an opportunity to guide patients with substance use disorders toward treatment.}, }
@article {pmid41633725, year = {2026}, author = {Cavanna, AE}, title = {Clinical presentation of tics and Gilles de la Tourette syndrome.}, journal = {Handbook of clinical neurology}, volume = {215}, number = {}, pages = {11-27}, doi = {10.1016/B978-0-443-13554-5.00013-4}, pmid = {41633725}, issn = {0072-9752}, mesh = {Humans ; *Tourette Syndrome/diagnosis/physiopathology/epidemiology ; *Tics/diagnosis/physiopathology ; *Tic Disorders/diagnosis ; Diagnosis, Differential ; COVID-19/epidemiology ; }, abstract = {Tics are the most common hyperkinetic manifestations during development. The clinical phenomenology of motor tics ranges from mild twitches affecting a single facial muscle to orchestrated contractions of different muscular districts resembling purposeful behaviors. Likewise, the repertoire of vocal tics (also called phonic tics) covers the whole spectrum between isolated grunting noises and meaningful strings of words. Simple and complex tics arguably sit on a continuum of symptom severity and respond to the same treatment interventions. The diagnosis of Gilles de la Tourette syndrome (GTS) is based on the presence of multiple motor tics plus at least one vocal tic, with onset before the age of 18 years and chronic course. It has been argued that the different tic disorders belong to a spectrum of increasing complexity, from the transient form (provisional tic disorder), through persistent motor or vocal tic disorder, to GTS. However, the clinical phenotype of GTS stands out because of the frequent association with specific behavioral problems, ranging from tic-related obsessive-compulsive disorder to other neurodevelopmental conditions. The diagnosis of tic disorders is based on clinical observation and requires expertise. The recent outbreak of functional tics, documented across several countries during the COVID-19 pandemic, introduced unprecedented challenges to the differential diagnosis of neurodevelopmental tics.}, }
@article {pmid41633747, year = {2026}, author = {Alruwaita, AA and Lang, AE and Ganos, C}, title = {Functional tics and tic-like behaviors.}, journal = {Handbook of clinical neurology}, volume = {215}, number = {}, pages = {55-62}, doi = {10.1016/B978-0-443-13554-5.00017-1}, pmid = {41633747}, issn = {0072-9752}, mesh = {Humans ; *Tic Disorders/diagnosis/physiopathology/therapy ; *Tics/diagnosis/physiopathology ; Diagnosis, Differential ; COVID-19 ; }, abstract = {Functional tics and tic-like behaviors belong to the wide spectrum of functional movement disorders. Until the early 2010s, functional tic disorders were rather uncommon in the differential diagnosis of tics, and only few cases describing their features had been published. However, over the past 10 years there has been a steady increase in the frequency of these cases that peaked throughout the COVID-19 pandemic. On the one hand, the rise in functional tic cases created new challenges of diagnosis and treatment. At the same time, it also pushed the field forward to delineate helpful clinical clues, as well as to work toward specific consensus diagnostic criteria for functional tics and tic-like behaviors. Here, we first provide a historical summary on the debate between neurodevelopmental and functional tics. We then track relevant literature on functional tics and tic-like cases and discuss their salient features, such as an acute onset with severe symptoms and complex repetitive behaviors that typically occur in late adolescence or early adulthood, a large variability of symptoms including spontaneous symptom remissions and re-emergence, and a high prevalence of phonations and vocalizations with the common use of swearwords or variable sentences. In addition, it is common to see an overlap with additional functional neurologic symptoms, such as functional tremor or nonepileptic seizures. In diagnostically challenging cases, neurophysiologic evaluation, including surface electromyography and electroencephalography, may be useful, and markers such as the premotor potential (Bereitschaftspotential) and event-related desynchronization/synchronization may hold promise. Effective management of functional tics begins with an accurate diagnosis and often requires a multidisciplinary approach. Cognitive-behavioral therapy and the Comprehensive Behavioral Intervention for Tics may be particularly useful, alongside addressing comorbid psychiatric conditions. Currently there is an absence of standardized treatment protocols; individualized care plans tailored to each patient's specific needs are generally the most effective approach.}, }
@article {pmid41634606, year = {2026}, author = {Migliaccio-Walle, K and Mugwagwa, T and Cha-Silva, AS and Gong, CL and Campbell, D and Quercia, R and Bergroth, T and Veenstra, DL and Moran, MM and Dzingina, M}, title = {Real-world untreated risk of hospitalization and death in a nirmatrelvir/ritonavir treatment-eligible population with mild-to-moderate COVID-19 in the United States: a systematic literature review.}, journal = {BMC infectious diseases}, volume = {26}, number = {1}, pages = {}, pmid = {41634606}, issn = {1471-2334}, mesh = {Humans ; *Hospitalization/statistics & numerical data ; *Ritonavir/therapeutic use ; United States/epidemiology ; *COVID-19 Drug Treatment ; *COVID-19/mortality ; SARS-CoV-2 ; Drug Combinations ; *Lopinavir/therapeutic use ; *Antiviral Agents/therapeutic use ; Female ; Male ; Aged ; }, abstract = {BACKGROUND: No study has systematically reviewed published estimates of real-world risk of hospitalization and death among untreated COVID-19 patients. We aimed to characterize the risk of hospitalization and death in real-world US clinical practice for untreated patients at high-risk for progression to severe COVID-19 and critically assess differences in patient populations. METHODS: We conducted a systematic literature review to identify US real-world evidence studies (December 21, 2021 – January 30, 2024) of patients aged 12 years and older diagnosed with mild-to-moderate COVID-19, at high risk for progression to severe COVID-19, and treated with nirmatrelvir/ritonavir (NMV/r) or untreated/best supportive care. Primary outcomes were reported risks of all-cause hospitalization, death, and hospitalization or death at 1 month. To account for heterogeneity across studies and confounding within studies, outcomes were estimated as: 1) observed risk, untreated risk as reported, 2) within-study adjusted risk, applying an adjusted treatment effect within studies to calculate risk in the untreated population, and 3) adjusted and standardized estimate, using the relative risk reduction for all-cause hospitalization or death from the study with highest validity. RESULTS: Of 1023 studies screened, we retained 23 for data extraction after applying inclusion and exclusion criteria (384,793 NMV/r patients from 22 studies; 1,062,757 no treatment from 14 studies). Studies were heterogenous, primarily retrospective, utilizing claims (e.g., TriNetX) and integrated health system data (e.g., Veterans Affairs). Most (n = 21, 91%) were US only; 20 (87%) were cohorts from December 2021 onward. Risk of all-cause hospitalization ranged from 0.9–7.7% (observed), 0.8–2.0% (within-study adjusted), and 2.3–6.9% (adjusted and standardized). Hospitalization or death ranged from 0.6–10.2% (observed), 0.4–5.6% (within-study adjusted), and 1.0–15.6% (adjusted and standardized). Death risk ranged from 0.1–3.1% (observed) and 0.0–0.9% (within-study adjusted). CONCLUSIONS: Estimating the risk of hospitalization and death for untreated high-risk COVID-19 patients from the literature is limited by inherent differences in study designs, patient populations, and reporting. Observed risk of hospitalization ranges from 1 to 8%, and the risk of death from 0 to 3%. Understanding the hospitalization risk among untreated patients provides context for the clinical and economic value of current antiviral treatments. This study was sponsored by Pfizer, Inc.}, }
@article {pmid41634728, year = {2026}, author = {Tang, Z and Zha, L and Liang, R and Li, T}, title = {Lung cancer vaccines to enhance immune checkpoint inhibitor therapy: evidence and future perspectives.}, journal = {Journal of hematology & oncology}, volume = {19}, number = {1}, pages = {15}, pmid = {41634728}, issn = {1756-8722}, support = {I01 BX003895/BX/BLRD VA/United States ; CU000157/L0008//VA-Lung Precision Oncology Program/ ; I01BX003895//Office of Research and Development/ ; }, mesh = {Humans ; *Cancer Vaccines/therapeutic use/immunology ; *Lung Neoplasms/immunology/therapy/drug therapy ; *Immune Checkpoint Inhibitors/therapeutic use ; Immunotherapy/methods ; Antigens, Neoplasm/immunology ; Animals ; Tumor Microenvironment/immunology ; }, abstract = {Immune checkpoint inhibitors (ICIs) have transformed the treatment landscape of lung cancer over the past decade, markedly improving antitumor responses, overall survival, and quality of life. However, durable clinical benefit is achieved in only a subset of patients, and resistance to ICIs remains a major clinical challenge. Mechanistically, resistance arises from multiple, often overlapping processes, including inadequate tumor antigen presentation, dysfunctional T-cell priming and expansion, and the presence of physical and immunosuppressive barriers within the tumor microenvironment that limit immune cell infiltration and effector function. Cancer vaccines have re-emerged as a rational immunotherapeutic strategy to overcome these obstacles by inducing de novo or amplifying pre-existing tumor-specific immune responses, thereby enhancing long-term immunological memory while maintaining a favorable safety profile. Advances in antigen discovery, neoantigen prediction, and vaccine platforms have accelerated the development of both personalized and off-the-shelf neoantigen vaccines. Although personalized neoantigen vaccines have gained considerable attention following the success of mRNA-based COVID-19 vaccines, off-the-shelf approaches offer advantages in scalability, cost, and manufacturing timelines, facilitating broader clinical implementation. Accumulating preclinical and clinical evidence suggests that cancer vaccines are more effective in the adjuvant setting than in the metastatic setting, where high tumor burden and an immunosuppressive tumor microenvironment constrain vaccine-induced immune responses. Consistent with their limited efficacy as monotherapy, contemporary clinical trials increasingly evaluate cancer vaccines in combination with ICIs or other immunotherapeutic agents to enhance T-cell activation, reverse immune suppression, and restore antitumor immunity. This review synthesizes current mechanistic insights, highlights ongoing clinical efforts, and discusses future directions for rational cancer vaccine development in lung cancer, with an emphasis on overcoming resistance to ICI.}, }
@article {pmid41635308, year = {2025}, author = {Liu, G and Tan, R and Wu, Y and Wang, M and Huang, B and Tan, W}, title = {Advances in the development of infectious clones of human coronaviruses and related applications.}, journal = {Biosafety and health}, volume = {7}, number = {1}, pages = {59-73}, pmid = {41635308}, issn = {2590-0536}, abstract = {Coronaviruses can infect humans, mammals, and birds, leading to respiratory, gastrointestinal, and neurological diseases. These viruses are significant zoonotic pathogens with nine known types capable of infecting humans. The coronavirus genome, approximately 30 kb in size, is the largest known ribonucleic acid (RNA) virus genome, and its complexity makes assembly and manipulation time-consuming and labor-intensive. Reverse genetic systems are widely used to engineer recombinant viruses that can be adapted at Biosafety Level 2 (BSL-2) for studying viral gene function, replication, pathogenesis, vaccines, and therapeutics. The infectious clones, which enabled the recovery of various viruses after DNA recombinant technology, were indispensable tools for the reverse genetics of viruses. Various techniques for constructing infectious clones of human coronaviruses (HCoV) have been developed, encompassing methods such as vaccinia virus vectors method, in vitro ligation, bacterial artificial chromosome systems, yeast artificial chromosome systems, circular polymerase extension reaction, and the recently reported infectious sub-genomic amplicons technology. This review summarizes the status of various techniques for constructing infectious clones of human coronaviruses and related applications.}, }
@article {pmid41635346, year = {2026}, author = {Pawar, B and Loganathan, S and Mukkatira Belliappa, K and Ranganathan, LB and Thekdi, KP and Hiware, SD}, title = {A Comprehensive Review of Vaccine Development: From Traditional Platforms to Messenger RNA (mRNA) Technologies.}, journal = {Cureus}, volume = {18}, number = {1}, pages = {e100608}, pmid = {41635346}, issn = {2168-8184}, abstract = {The trend of vaccine development over the last few years is that the traditional platform has been abandoned and moved towards newer modalities, and the current COVID-19 pandemic has accelerated this shift. Classical approaches (such as inactivated, live attenuated, and recombinant) can be shown to have reduced the burden of infectious diseases; however, they are also limited by their inability to scale production and prolonged development, as well as cold-chain limitations. The lacks became apparent through the pandemic and drove the demand for more agile, adaptive technology that COVID-19 has highlighted. The current review questions the goal of streamlining the immunization approaches in the face of emerging pathogens through a structured narrative comparison of immunogenicity, safety, efficacy, and platform stability of modern vaccination platforms within a narrative review framework. This analysis is anchored by a narrative synthesis of immunological, regulatory, and clinical literature between 2018 and 2025. Messenger RNA (mRNA)-based vaccines have demonstrated strong immunogenicity and practical efficacy in the real world, as well as varying safety profiles across platforms and the potential of new modalities that will be developed both to treat infectious diseases and to be applied in other contexts. The discussion also dwells upon the flexibility of regulation, unequal distribution, and surveillance-based pharmacovigilance. This review can be used to compile a thoroughly comparative view of modern vaccines, based on bringing together mechanistic insights and implementation barriers, which can guide future innovation and policy reconciliation and global resilience. It makes inferences in support of the more progressive, equity-based paradigm of pandemic preparedness and immunization strategy in the 21st century. This review highlights how mRNA technology has transformed the landscape of vaccinology, offering a foundation for faster, safer, and more equitable global immunization strategies in the post-pandemic era.}, }
@article {pmid41635704, year = {2025}, author = {Montgomery, MP and Praphasiri, P and Ditsungnoen, D and Akarasewi, P and Chittaganpitch, M and Puthavathana, P and Limpakarnjanarat, K and Wirachwong, P and Chotpitayasunondh, T and Sawanpanyalert, N and Sonthichai, C and Davis, WW and Olsen, SJ and Chunsuttiwat, S}, title = {Influenza surveillance and vaccine policy in Thailand-a historical perspective.}, journal = {The Lancet regional health. Southeast Asia}, volume = {41}, number = {}, pages = {100663}, pmid = {41635704}, issn = {2772-3682}, abstract = {Prior to 2000, influenza burden in Thailand and other low- and middle-income countries was underappreciated, and influenza vaccination was uncommon. For the last two decades, Thailand Ministry of Public Health (MOPH) and U.S. Centers for Disease Control and Prevention have collaborated to understand influenza burden and the costs and benefits of influenza vaccination in Thailand. Built on a long-standing national disease notification system, Thailand MOPH established robust surveillance platforms for pneumonia and influenza, which provided insights into seasonality, disease incidence, and populations at risk for severe disease. In 2004, human cases of avian influenza brought attention to influenza's pandemic potential. Concern for an influenza pandemic combined with evidence of the cost effectiveness of influenza vaccination accelerated vaccine policy. Surveillance and vaccination policy were leveraged for and strengthened by the 2009 influenza H1N1 and COVID-19 pandemics. This personal view documents Thailand's experience in developing influenza surveillance and influenza vaccination policy.}, }
@article {pmid41637169, year = {2026}, author = {Göldel, JM and Warschburger, P}, title = {Psychological adjustment in parents of children and adolescents with chronic health conditions during the COVID-19 pandemic - a meta-analysis.}, journal = {Health psychology review}, volume = {20}, number = {2}, pages = {453-481}, doi = {10.1080/17437199.2026.2616461}, pmid = {41637169}, issn = {1743-7202}, mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Parents/psychology ; Child ; Chronic Disease/psychology ; *Stress, Psychological/epidemiology/psychology ; Anxiety/epidemiology/psychology ; Depression/epidemiology/psychology ; Adolescent ; *Adaptation, Psychological ; Parenting/psychology ; Prevalence ; }, abstract = {Caring for a child with a chronic health condition (CC) involves numerous challenges, which may have multiplied during the COVID-19 pandemic. Therefore, this meta-analysis aimed (1) to quantify the prevalence of clinically elevated anxiety, depression, general stress, and parenting stress symptoms in afflicted parents, (2) to examine potential moderator variables, and (3) to compare the outcomes between parents of children with and without CCs. A systematic literature search was conducted across four databases (PsycInfo, PubMed, CENTRAL, PSYNdex). A total of 79 studies were included. The pooled prevalence estimates of clinically elevated anxiety, depression, general and parenting stress symptoms were 31.04%, 27.37%, 64.27%, and 26.70%, respectively. Significant moderators were identified only for anxiety symptoms, namely geopolitical region, child CC, and child age. Anxiety and depression, but not general and parenting stress, were significantly higher in parents of children with than without CCs. Compared to published data from before the pandemic, prevalence rates of clinically elevated anxiety and depression symptoms decreased, while stress levels no longer differed between parents of children with and without CCs. We hypothesise that parents of children with CCs experienced some beneficial effects during the COVID-19 pandemic and had already acquired resilience to buffer its psychosocial impact.}, }
@article {pmid41637737, year = {2026}, author = {Siegel, ZM and Quinkert, E and Pai, J and Miller, CH and Lewis, MW}, title = {Lessons Learned About Digital Health Tool Acceptability Among Rural Older Adults: Systematic Review Guided by the Technology Acceptance Model.}, journal = {JMIR aging}, volume = {9}, number = {}, pages = {e70012}, pmid = {41637737}, issn = {2561-7605}, mesh = {Humans ; Digital Health ; Aged ; *Telemedicine ; *Rural Population/statistics & numerical data ; *COVID-19/epidemiology ; *Patient Acceptance of Health Care/statistics & numerical data ; Middle Aged ; }, abstract = {BACKGROUND: Digital health tools are increasingly vital in rural health care due to widespread hospital closures and the rapid adoption of telehealth during the COVID-19 pandemic. Rural older adults, a uniquely vulnerable population, face barriers to accessing these tools due to rurality and usability challenges. Although a growing body of literature examines the acceptability and usability of digital tools among rural older adults, no study has synthesized this research to establish best practices.
OBJECTIVE: This study aims to review existing literature on digital health tools for rural older adults, highlighting key lessons learned about their acceptability and identifying strategies to improve usability for this population.
METHODS: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, this study reviewed literature that investigated the role of digital health tools on the health outcomes of rural older adults (ie, at least 60 years old). The literature was retrieved from 5 electronic databases through June 2023. This study and all reviewed literature were conducted in the United States. Guided by a systematic process, 2 reviewers assessed relevant articles for eligibility, analyzed data, and extracted relevant content. The extracted findings were organized according to the evidence-based technology acceptance model, which assesses the acceptability of a technology by its usefulness, ease of use, and intention to use.
RESULTS: The preliminary title review produced 7728 results, and 38 eligible manuscripts were included in the final review. Studies included both rural older adults and providers of rural older adults as participants. Digital health tools included, but were not limited to, videoconferencing, phone calls, telehealth monitoring, telemedicine appointments, and computer-based interventions. Findings on the usefulness of digital health tools by rural older adults were mixed. While digital health tools were useful for overcoming barriers to accessing care, these tools were less useful for rural older adults with limited digital literacy. Additionally, some studies described that the technology was easy but difficult to use when faced with environmental barriers, equipment issues, and discomfort with the technology. Rural older adults often reported an intention to use the technology after the study. Yet, on a few occasions, participants who preferred in-person care visits or did not have buy-in on the technology reported no intention to use the technology again.
CONCLUSIONS: Our review highlights that rural older adults and their providers generally view digital health tools as acceptable for delivering care and, in some cases, as a viable alternative to in-person clinic visits. While certain barriers impacted the acceptance of these tools among rural older adults, many of these challenges were not directly linked to their age or rural location; thus, they are potentially applicable to urban older adults.
TRIAL REGISTRATION: PROSPERO CRD42021287924; https://www.crd.york.ac.uk/PROSPERO/view/CRD42021287924.}, }
@article {pmid41638514, year = {2026}, author = {Jalili, M and Jalilian, FA}, title = {A review of targeting microRNAs as potential therapeutic strategies against respiratory viruses: Current insights and future directions.}, journal = {Microbial pathogenesis}, volume = {213}, number = {}, pages = {108346}, doi = {10.1016/j.micpath.2026.108346}, pmid = {41638514}, issn = {1096-1208}, mesh = {*MicroRNAs/genetics/metabolism ; Humans ; *Respiratory Tract Infections/virology/therapy/genetics/drug therapy ; Animals ; Virus Replication/genetics ; Host-Pathogen Interactions/genetics ; Immunity, Innate ; Antiviral Agents/therapeutic use/pharmacology ; *Virus Diseases/therapy/genetics ; }, abstract = {Respiratory viruses such as influenza viruses, respiratory syncytial virus (RSV), and coronaviruses continue to impose a global health burden due to their high transmissibility and limited antiviral options. MicroRNAs (miRNAs) have emerged as critical regulators of host pathogen interactions by modulating innate immunity, inflammatory signaling, and viral replication. This review focuses on respiratory RNA and DNA viruses that primarily infect the airways, including influenza viruses, RSV, human metapneumovirus, rhinoviruses, adenoviruses, and SARS-CoV-2. Several miRNAs, including miR-155 and miR-146a, are upregulated during infections with SARS-CoV-2, influenza, and RSV, where they fine-tune interferon and NF-κB signaling pathways. In contrast, downregulation of miR-21, miR-223, and let-7 family members has been linked to enhanced viral replication and dysregulated immune responses. Moreover, miR-122, miR-29a, and miR-124 have gained attention as potential therapeutic targets or prognostic biomarkers due to their roles in modulating viral load, cytokine production, and tissue injury. This review synthesizes current evidence on miRNA-mediated regulation of respiratory viruses, evaluates their promise as therapeutic candidates and diagnostic tools, and discusses delivery systems designed for targeted miRNA modulation. Despite promising advances, challenges remain in achieving tissue-specific delivery, avoiding immune off-target effects, and validating efficacy in clinical settings. Most of the available data are derived from in vitro or animal models and heterogeneous clinical cohorts, so conclusions about causality and therapeutic efficacy should be viewed as provisional and highlight significant translational gaps. Finally, we outline major challenges and future research directions needed to translate miRNA-targeted therapies into clinically viable antiviral strategies. Insights from these emerging studies position miRNA-targeted interventions as a potential new class of antiviral therapeutics and underscore the need for rigorous, translational research to realize their clinical utility.}, }
@article {pmid41638540, year = {2026}, author = {Nuber-Champier, A and Bréville, G and Lalive, PH and Assal, F and Péron, JA}, title = {Immune-cognitive relationships across viral infections: A transnosological systematic review.}, journal = {Neuroscience and biobehavioral reviews}, volume = {184}, number = {}, pages = {106588}, doi = {10.1016/j.neubiorev.2026.106588}, pmid = {41638540}, issn = {1873-7528}, mesh = {Humans ; *Virus Diseases/immunology/psychology/complications ; *Cognition/physiology ; Cytokines/immunology ; *COVID-19/immunology ; *Cognition Disorders/immunology ; }, abstract = {The emergence of SARS-CoV-2 has renewed interest in the relationship between immunity and cognition. Despite decades of work, the impact of viral exposure, mainly in the field of HIV, herpes and hepatitis infections, on distinct cognitive processes remains unclear, as most studies use global screening tools (e.g., MoCA) in isolation in each infectious context. This systematic narrative review adopts a transnosological approach, summarizing previously reported immune-cognition relationships across viral infections. Of 931 studies, 32 met inclusion criteria (N = 25,325) spanning SARS-CoV-2, HIV, herpes, hepatitis, Epstein-Barr virus, and multiple infections. Reported studies on immuno-cognitive relationships reveal several consistent findings. Elevated circulating CD14[+]CD16[+] intermediate monocytes correlated with slower processing speed, reduced episodic memory and mental flexibility. Higher CD4[+] T cells were associated with better processing speed, while reduced T cells and B cells levels together with elevated IgG predicted deficits in memory and attention. Most proinflammatory cytokines (e.g., IL-6, TNF-α, IFN-γ) were associated with impairments in overlapping cognitive domains (e.g., memory), whereas IL-10, an anti-inflammatory cytokine, consistently supported executive and memory performance.}, }
@article {pmid41639496, year = {2026}, author = {Berra, L and Kamenshchikov, N and Tal, A and Safaee Fakhr, B and Rezoagli, E and Thomson, R and Yu, B and , }, title = {The therapeutic potential of high-dose inhaled nitric oxide for antimicrobial effects: a narrative review and future directions.}, journal = {Intensive care medicine experimental}, volume = {14}, number = {1}, pages = {13}, pmid = {41639496}, issn = {2197-425X}, abstract = {Inhaled nitric oxide (iNO), long used as a selective pulmonary vasodilator, has demonstrated potential antimicrobial and antiviral properties when administered at high concentrations (> 20 parts per million, ppm). While definitive evidence is still lacking, this narrative review synthesizes the emerging clinical and mechanistic properties supporting high-dose iNO as a potential therapeutic strategy for lower respiratory tract infections, including drug-resistant bacterial pneumonias, COVID-19, nontuberculous mycobacteria, and bronchiolitis. We summarize safety data from laboratory studies, Phase I trials, clinical findings from 27 predominantly early-phase studies, and highlight its as both hospital-based and home-based therapy. High-dose iNO acts through multiple pathways, including direct microbial killing, biofilm disruption, immune modulation, and mucociliary enhancement, and holds promise in addressing unmet needs in respiratory infection management. We also propose a roadmap for future research to optimize dosing, delivery, and efficacy endpoints in well-defined patient populations.}, }
@article {pmid41639776, year = {2026}, author = {Aboulwafa, A and Lebbe, A and Khalil, A and Bayraktar, N and Mushannen, B and Ayoub, S and Sarker, S and Abdalla, MN and Laws, S and Mohammed, I and Yagan, L and Mushannen, M and Zakaria, D}, title = {New onset of severe and long-term hepatobiliary diseases post-COVID-19 infection: a systematic review.}, journal = {BMC infectious diseases}, volume = {26}, number = {1}, pages = {253}, pmid = {41639776}, issn = {1471-2334}, mesh = {Humans ; *COVID-19/complications ; *Liver Diseases/etiology/virology ; *Biliary Tract Diseases/etiology/virology ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; }, abstract = {BACKGROUND: The COVID-19 pandemic has resulted in a surge of reports linking the virus to various systemic complications, including hepatobiliary disorders. Understanding the spectrum and severity of hepatobiliary diseases following COVID-19 infection is crucial for comprehensive patient management and long-term health outcomes. METHODS: A systematic review was conducted to identify studies reporting on hepatobiliary manifestations post-COVID-19 infection. PubMed, Medline, Embase, Scopus, Web of Science, Science Direct and Cochrane Library databases were searched in October 2023, with set inclusion and exclusion criteria in place to select papers documenting new onset hepatobiliary diseases following COVID-19 infection. RESULTS: A total of 23 studies met the inclusion criteria, covering a diverse range of hepatobiliary conditions such as acute hepatitis, cholestasis, autoimmune liver diseases, and gallbladder pathology. CONCLUSION: This systematic review underscores the emerging evidence of severe and long-term hepatobiliary diseases following COVID-19 infection. Healthcare providers should maintain a high index of suspicion for hepatobiliary complications in patients recovering from COVID-19, emphasizing the need for prolonged monitoring and specialized management strategies to mitigate long-term morbidity and mortality."}, }
@article {pmid41639856, year = {2026}, author = {Walker, KA and Craig, S and Anderson, T and Stark, P and Brown Wilson, C and Carter, G and McEvoy, C and Creighton, L and Henderson, E and Porter, S and Alhalaiqa, F and Ferranti, E and Murali, KP and Zheng, Y and Sammut, R and Shaban, MM and Tam, HL and Buzás, N and Leidl, D and Mitchell, G}, title = {Diabetes educational interventions in care homes: a scoping review.}, journal = {BMC medical education}, volume = {26}, number = {1}, pages = {}, pmid = {41639856}, issn = {1472-6920}, support = {SB\ZA\101010662\898090//Burdett Trust for Nursing/ ; COM/5755/23//Health and Social Care Northern Ireland/ ; }, mesh = {Humans ; *Nursing Homes ; *Diabetes Mellitus/therapy ; Nursing Home Residents ; *Patient Education as Topic ; }, abstract = {BACKGROUND: Diabetes affects approximately 10.5% of the global adult population and is more prevalent in care homes due to residents’ advanced age and multimorbidity. Effective diabetes management in these settings is essential to prevent complications and maintain quality of life, yet evidence addressing the specific needs of this population remains limited. High-quality care relies on access to appropriate clinical education. This scoping review will synthesise evidence on educational interventions to support diabetes care provision in care home settings. METHODS: This scoping review was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A comprehensive literature search was conducted across three electronic databases: CINAHL Plus, Medline, and PsycINFO. Methodological quality of the included primary studies was assessed using the Mixed Methods Appraisal Tool (MMAT). RESULTS: In total, 10 studies were included in the review, encompassing evidence from a range of international contexts. Analysis revealed three prominent themes; Firstly, educating nurses about diabetes can improve practice and behaviour. Secondly, educational interventions can increase staff knowledge and confidence, which is linked to enhancing the quality of care. Finally, a range of facilitators and barriers influencing the delivery of diabetes training in care homes were identified. DISCUSSION: The review suggests that educational interventions in care homes can enhance diabetes care. However, while the current evidence is encouraging, there are a lack of empirically tested educational interventions for diabetes education in this setting. Further, current educational programmes appear to lack key detail including footcare, eye care and COVID-19. To ensure the provision of high-quality diabetic care, it is therefore important to enhance the training and education of staff members.}, }
@article {pmid41639918, year = {2026}, author = {Carpenteri, F and Cilloniz, C and Torres, A}, title = {Corticosteroids in severe community-acquired pneumonia: friend, foe or both?.}, journal = {Pneumonia (Nathan Qld.)}, volume = {18}, number = {1}, pages = {5}, pmid = {41639918}, issn = {2200-6133}, support = {CIBERES CB06/06/0028//Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública/ ; }, abstract = {In most patients with CAP, corticosteroids should be avoided due to complications such as immunosuppression and hyperglycaemia. Studies of hydrocortisone have shown corticosteroids might be of benefit in patients with severe CAP and high inflammation measured by CRP. Differences in results between trials of corticosteroid therapy suggest heterogenicity in study populations and the need for future studies in standardized populations. Scientific evidence shows corticosteroid use can reduce short-term mortality and the need for mechanical ventilation in hospitalized patients with severe CAP. However, this approach should not be generalized to all patients with CAP. Use should be guided by biomarkers such as CRP to identify patients who will benefit the most. Corticosteroids should not be routinelly used in viral pneumonia, with the exception of hypoxemic SARS-CoV-2 pneumonia, in which their benefit is well established.}, }
@article {pmid41640416, year = {2025}, author = {Pompilio, A and Di Bonaventura, G}, title = {The COVID-19 pandemic: an underlying factor for increased Stenotrophomonas maltophilia infections-A literature review and case study analysis.}, journal = {Frontiers in microbiology}, volume = {16}, number = {}, pages = {1746742}, pmid = {41640416}, issn = {1664-302X}, abstract = {Stenotrophomonas maltophilia is increasingly recognized as a major cause of healthcare-associated infections in intensive care units. It presents serious risks for immunocompromised patients and can cause severe lung infections in individuals with cystic fibrosis. Recent studies have documented a rising occurrence of S. maltophilia infections among hospitalized COVID-19 patients. However, understanding of these infections in this setting remains limited or inconsistent, with only one review specifically examining S. maltophilia infections in COVID-19 patients. This review critically evaluates all relevant studies from the literature, along with a case series, to explore the clinical significance of S. maltophilia infections in patients with COVID-19. In particular, the review discusses the prevalence, risk factors, phenotypic traits, clinical consequences, and treatment options for S. maltophilia infections in this clinical context.}, }
@article {pmid41640608, year = {2026}, author = {Velikova, T and Ali, H and Batselova, H and Chervenkov, L and Miteva, D and Peruhova, M and Gulinac, M and Tomov, L and Mitova-Mineva, Y and Velev, V}, title = {Interplay between viral infections and gut microbiota dysbiosis: Mechanisms and therapeutic potential.}, journal = {World journal of gastroenterology}, volume = {32}, number = {3}, pages = {112437}, pmid = {41640608}, issn = {2219-2840}, mesh = {Humans ; *Dysbiosis/therapy/immunology/microbiology/virology ; Fecal Microbiota Transplantation ; COVID-19/immunology ; Probiotics/therapeutic use ; SARS-CoV-2 ; *Gastrointestinal Microbiome/immunology ; Prebiotics/administration & dosage ; *Virus Diseases/immunology/microbiology/therapy ; *Coronavirus Infections/immunology/therapy/microbiology ; Betacoronavirus/immunology ; Animals ; Pandemics ; *Pneumonia, Viral/immunology/therapy/microbiology ; Host-Pathogen Interactions ; }, abstract = {Viral infections, particularly those triggered by emerging pathogens like severe acute respiratory syndrome coronavirus 2, are increasingly recognized for their profound impact on the gut microbiota, causing dysbiosis, a condition characterized by an imbalance in microbial communities. Recent studies suggest that alterations in gut microbiota can influence disease progression, immune responses, and clinical outcomes. The bidirectional relationship between the gut microbiota and the host immune system is crucial in shaping responses to infection. Furthermore, dysbiosis has been linked to exacerbated inflammation, impaired mucosal barrier function, and altered drug metabolism, thereby complicating both disease pathogenesis and treatment efficacy. This review examines the interplay between viral infections and gut microbiota dysbiosis, with a focus on the underlying mechanisms and potential therapeutic strategies to modulate host immunity. We also evaluate the potential of microbiome-based interventions, such as probiotics, prebiotics, and fecal microbiota transplantation, as therapeutic strategies for restoring microbial balance and mitigating the severity of infections. The paper underscores the need for further research to optimize microbiota-targeted therapies and integrate them into clinical practice, offering a comprehensive approach to managing dysbiosis in viral infectious diseases.}, }
@article {pmid41641003, year = {2025}, author = {Leclerc, L and Poudrier, J and Power, C and Lam, GY and Falcone, EL}, title = {Intestinal barrier compromise, viral persistence, and immune dysregulation converge on neurological sequelae in Long COVID.}, journal = {Frontiers in aging neuroscience}, volume = {17}, number = {}, pages = {1744415}, pmid = {41641003}, issn = {1663-4365}, abstract = {Long COVID (LC) is a multisystem, post-infectious conditions diagnosed ≥3 months after acute SARS-CoV-2 infection and marked by relapsing, persistent, or progressive symptoms, especially fatigue, post-exertional symptom exacerbation and neuropsychiatric syndromes. We synthesized evidence suggesting that LC arises from intersecting pathways including viral persistence, intestinal dysbiosis and barrier compromise with microbial translocation, innate immune activation with neutrophil extracellular traps (NET) and thromboinflammation, and immune dysregulation with features of exhaustion and autoimmunity. These processes adversely impact blood-brain barrier (BBB) function and lead to neuroinflammation. We propose a mechanistic model in which viral antigens and translocated microbial products amplify pro-inflammatory networks promoting immunothrombosis and tissue hypoperfusion. Hematogenous and gut-brain pathways may then deliver inflammatory mediators to the central nervous system (CNS), resulting in BBB disruption and glial activation that underpin nervous system disorders in LC. Treatment regimens aimed at lowering antigen load, restoring mucosal barrier integrity and modulating myeloid/coagulation pathways may warrant investigation as novel therapeutic strategies to treat LC.}, }
@article {pmid41641244, year = {2025}, author = {Wang, D and Yang, T and Cui, Y and Qu, Y and Feng, C and Sun, Z and Zhang, M}, title = {From tradition to healing: the promise of acupuncture in managing chronic fatigue syndrome.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1724290}, pmid = {41641244}, issn = {2296-858X}, abstract = {Chronic fatigue syndrome (CFS) is a global public health problem affecting more than 65 million patients worldwide. The combined prevalence rate of CFS was 45.2% after 4 weeks in patients with novel coronavirus. Women, people over 40 years of age, and low-income people are susceptible groups, which have a significant impact on immune, nervous, endocrine, and other system functions. First, from the perspective of epidemiology, this paper reviews the global epidemic trend of CFS, the differences in incidence and prevalence in different regions and populations, and risk factors such as heredity, infection, and childhood trauma. Second, the development of diagnostic techniques for CFS, including the evolution of clinical diagnostic criteria, research progress on immune and metabolic biomarkers, and the application of MRI and other imaging techniques in the diagnosis of CFS, is described, followed by an in-depth discussion of the genetics of CFS, including genetic susceptibility, genomic association, and familial aggregation. The pathophysiological mechanism of CFS was also analyzed, revealing abnormalities in NK cell function and immune factors in the immune system, dysfunction of the hypothalamic-pituitary-adrenal axis in the neuroendocrine system, and disorders of energy and lipid metabolism in the metabolic system. This paper focuses on the study of acupuncture and moxibustion treatment of CFS, traces back to the historical application of acupuncture and moxibustion treatment of CFS, analyzes the relationship between the pathological mechanism of CFS and acupuncture and moxibustion intervention, expounds the theoretical basis of traditional Chinese medicine and modern mechanism of action of acupuncture and moxibustion treatment, and introduces the results of clinical trials, efficacy evaluation methods, and individualized treatment strategies for acupuncture and moxibustion treatment of CFS. The innovative application of acupuncture techniques, such as electroacupuncture and acupoint catgut embedding, as well as the synergistic effect of acupuncture combined with traditional Chinese medicine and psychotherapy, are shown. At the same time, disputes and challenges in the efficacy, safety, and ethics of acupuncture treatment for CFS were pointed out, and future research directions, potential breakthroughs, and international cooperation opportunities of acupuncture treatment for CFS are discussed. This study provides a comprehensive reference for clinical treatment and research on CFS.}, }
@article {pmid41641375, year = {2026}, author = {Zhang, J and Liu, Y and Ren, S and Wang, Z and Li, Y and Peng, L and Fang, R}, title = {Natural Products as Potential Resource Library for Control of Major Swine Enteric Viruses.}, journal = {Transboundary and emerging diseases}, volume = {2026}, number = {}, pages = {4368881}, pmid = {41641375}, issn = {1865-1682}, mesh = {Animals ; Swine ; *Swine Diseases/virology/prevention & control/drug therapy ; *Biological Products/pharmacology/therapeutic use ; *Antiviral Agents/pharmacology ; Transmissible gastroenteritis virus/drug effects ; Porcine epidemic diarrhea virus/drug effects ; Deltacoronavirus/drug effects ; }, abstract = {Major swine enteric viruses (SEVs), including porcine epidemic diarrhea virus (PEDV), porcine deltacoronavirus (PDCoV), transmissible gastroenteritis virus (TGEV), swine acute diarrhea syndrome coronavirus (SADS-CoV), and porcine rotavirus (PoRV), cause severe gastrointestinal diseases in pigs, leading to huge economic losses to the swine industry around the world. In the absence of specific drugs and vaccines for controlling SEVs in the pig production, this review summarizes the inhibitory effects of natural products against these major porcine enteric viruses. Specifically, it focuses on recent studies regarding the anti-SEVS activities of traditional Chinese medicine (TCM) compound formulas, herbal extracts, pharmaceutical monomers, and natural metabolites. The review elaborates on how these natural products exert antiviral activities against SEVs, highlighting their potential as alternative or complementary agents for controlling porcine enteric viral infections. Overall, this work provides a comprehensive overview of the research progress in natural products against porcine enteric viruses and demonstrates the new strategies for medicine discovery, which will be helpful for further development of effective antiviral strategies in the swine industry.}, }
@article {pmid41643087, year = {2026}, author = {Di Líbero, E and Duarte, A and Kaneshiro, V and Gañete, M and Aronson, S and López Furst, MJ}, title = {[Management of Community-Acquired Pneumonia in Adults - Argentine Society of Infectious Diseases].}, journal = {Medicina}, volume = {86}, number = {1}, pages = {145-165}, pmid = {41643087}, issn = {1669-9106}, mesh = {Adult ; Humans ; Anti-Bacterial Agents/therapeutic use ; Antiviral Agents/therapeutic use ; Argentina ; *Community-Acquired Pneumonia/drug therapy/diagnosis ; COVID-19 ; Influenza, Human/drug therapy ; }, abstract = {Community-acquired pneumonia (CAP) is responsible for substantial morbidity and mortality worldwide. Epidemiological surveillance indicates that Streptococcus pneumoniae remains the most frequent etiological agent and the leading cause of mortality. However, with the advent of new diagnostic techniques, viral etiology has gained priority. Chest X-ray is considered mandatory to confirm the diagnosis and establish the spread. Microbiological, antigen, molecular, biomarker, and carriage tests have specific indications and a role to play in reconsidering empirical treatments. Severity scales are useful for defining the site of care, and the most validated prognostic models are PSI and CURB-65. When antibacterial treatment is appropriate, aminopenicillins ± beta-lactamase inhibitors are the preferred treatment, with the addition of a macrolide in severe cases. Pseudomonas and methicillin-resistant Staphylococcus aureus should be considered primarily in patients with a history of prior infection/colonization or severe structural lung disease. Shortened courses have gained support in the literature, and once clinical stability is achieved, it is suggested that treatment be continued for 3-5 days for CAP managed in an outpatient/general ward setting, and 5-7 days for CAP requiring intensive care. The role of corticosteroids in reducing mortality has been documented in severe forms. The benefit of neuraminidase inhibitors for influenza is of low certainty and relatively marginal. Treatments that have had an impact on reducing mortality from severe-critical COVID-19 are corticosteroids, IL-6 receptor blockers, and baricitinib.}, }
@article {pmid41643088, year = {2026}, author = {Beltramino, MF and Gasser, FB and Stassi, AF and Ortega, HH and Baravalle, ME}, title = {[Evaluation of reproductive and developmental toxicity: its importance in the preclinical phase of new vaccines].}, journal = {Medicina}, volume = {86}, number = {1}, pages = {166-178}, pmid = {41643088}, issn = {1669-9106}, mesh = {Animals ; *Reproduction/drug effects ; Drug Evaluation, Preclinical/methods ; Humans ; Female ; *COVID-19 Vaccines/toxicity/adverse effects ; Pregnancy ; COVID-19/prevention & control ; *Vaccines/toxicity ; }, abstract = {Preclinical trials in laboratory animals, particularly those aimed at evaluating potential effects on reproduction and offspring development, have gained importance in recent years due to the development of new drugs and vaccines intended for both children and individuals of reproductive age. The current challenge lies in the need for reliable and rapidly obtainable data to enable the transition of new compounds to clinical phases and eventual approval. Since pregnant and breastfeeding women are often excluded from clinical vaccine trials, including those assessing toxicity, there is limited knowledge about this vulnerable population and their offspring. In this context, preclinical studies designed to assess the effects of vaccine and therapeutic candidates on reproduction and development must rely on in vivo models that accurately replicate key aspects of the pathogenesis observed in human disease. When evaluating the reproductive toxicity of vaccines, it is essential not only to assess potential effects on fertility, embryogenesis, development, and reproduction, but also to consider the interactions of the vaccine with the immune system of both the mother and her offspring. This review updates and describes preclinical studies in laboratory animals for new vaccines, particularly those developed against COVID-19, highlighting published studies on reproductive and developmental toxicity, as well as the current regulatory framework governing such studies.}, }
@article {pmid41643233, year = {2026}, author = {Anderson, SA and Smith, ER and Wan, Z and Amend, KL and Secora, A and Djibo, DA and Kazemi, K and Song, J and Parlett, LE and Seeger, JD and Selvam, N and McMahill-Walraven, CN and Hu, M and Chillarige, Y and Forshee, RA}, title = {Febrile seizure risk following monovalent COVID-19 mRNA vaccination in US children aged 2-5 years.}, journal = {Vaccine}, volume = {75}, number = {}, pages = {128225}, doi = {10.1016/j.vaccine.2026.128225}, pmid = {41643233}, issn = {1873-2518}, mesh = {Humans ; *Seizures, Febrile/epidemiology/etiology ; Child, Preschool ; Male ; United States/epidemiology ; Vaccination/adverse effects ; BNT162 Vaccine/adverse effects ; Female ; *COVID-19/prevention & control ; Incidence ; *2019-nCoV Vaccine mRNA-1273/adverse effects ; SARS-CoV-2/immunology ; *COVID-19 Vaccines/adverse effects/administration & dosage ; }, abstract = {OBJECTIVE: To evaluate febrile seizure risk following monovalent COVID-19 mRNA vaccination among children aged 2-5 years.
METHODS: The primary analysis evaluated children who had a febrile seizure outcome in the 0-1 days following COVID-19 vaccination. A self-controlled case series analysis was performed in three commercial insurance databases to compare the risk of seizure in the risk interval (0-1 days) to a control interval (8-63 days). The exposure of interest was receipt of dose 1 and/or dose 2 of monovalent COVID-19 mRNA vaccinations. The primary outcome was febrile seizure (0-1 day risk interval). A conditional Poisson regression model was used to compare outcome rates in risk and control intervals and estimate incidence rate ratios (IRR) and 95% confidence intervals (CIs). Meta-analyses were used to pool results across databases.
RESULTS: The primary meta-analysis found a statistically significant increased incidence of febrile seizure, in the 0-1 days following mRNA-1273 vaccination compared to the control interval (IRR: 2.52, 95% CI: 1.35 to 4.69, risk difference (RD)/100,000 doses = 3.22 (95% CI -0.31 to 6.75)). For the BNT162b2 vaccination, the IRR was elevated but not statistically significant (IRR: 1.41, 95% CI: 0.48 to 4.11, RD/100,000 doses = -0.25 (95% CI -2.75 to 2.24).
CONCLUSIONS: Among children aged 2-5 years, the analysis showed a small elevated incidence rate ratio of febrile seizures in the 0-1 days following the mRNA-1273 vaccination.}, }
@article {pmid41644038, year = {2026}, author = {Ogoti, B and Riitho, V and Wildemann, J and Mutono, N and Mureithi, M and Oyugi, J and Rodon, J and Corman, VM and Drosten, C and Thumbi, SM and Müller, MA}, title = {Epidemiology and genomic features of MERS coronavirus in Africa: a systematic and meta-analysis review.}, journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases}, volume = {165}, number = {}, pages = {108456}, doi = {10.1016/j.ijid.2026.108456}, pmid = {41644038}, issn = {1878-3511}, mesh = {Humans ; *Middle East Respiratory Syndrome Coronavirus/genetics ; Animals ; *Coronavirus Infections/epidemiology/virology/veterinary ; Africa/epidemiology ; Camelus/virology ; Genome, Viral ; Seroepidemiologic Studies ; Phylogeny ; Genomics ; Prevalence ; }, abstract = {OBJECTIVES: We explored factors contributing to the low human MERS-CoV prevalence in Africa by assessing MERS-CoV epidemiological and genomic features.
METHODS: We followed the PRISMA guidelines. We searched for articles on epidemiological and virological MERS-CoV characteristics in humans and camels in Africa until August 2025. We used a generalised linear mixed-effects model to calculate pooled proportions. We identified relevant polymorphisms in African MERS-CoV lineages compared with the prototypic EMC/2012 and contemporary Arabian MERS-CoV (clade B5).
RESULTS: We included 53 articles, with 31 used in the meta-analysis. Kenya, Egypt, and Ethiopia contributed to 66.03% of all included studies. Pooled MERS-CoV RNA positivity in African dromedaries was 6.09%, with juveniles (15.29%) having a higher incidence than adults (4.51%). The pooled MERS-CoV seroprevalence was 73.67%, with adults (80.96%) higher than juveniles (36.02%). In human-focused studies, only nine PCR-confirmed MERS cases were reported, six travel-associated and three autochthonous cases, despite a pooled seroprevalence of 2.4%. Genomic analyses identified MERS-CoV clade C-specific polymorphisms in the Spike and accessory genes with putative phenotypic impact.
CONCLUSION: We found the highest MERS-CoV RNA positivity in young dromedaries. Elevated MERS-CoV seroprevalence in mainly asymptomatic camel-exposed humans suggests an underestimation of MERS-CoV infections in Africa. The ongoing MERS-CoV evolution emphasises the need for active genomic surveillance to monitor signatures of human adaptation.}, }
@article {pmid41644304, year = {2026}, author = {Fung, IC and Liang, H and Pierce, KJ and Kraay, ANM and Kwok, KO and Akhmetzhanov, AR and Baiden, FE and Unwin, HJT and Kengne, FB and Alhassan, F and Chowell, G}, title = {Excess mortality in Mainland China after the end of the Zero COVID policy: A systematic review.}, journal = {Epidemiology and infection}, volume = {154}, number = {}, pages = {e29}, pmid = {41644304}, issn = {1469-4409}, mesh = {Humans ; China/epidemiology ; *COVID-19/mortality/epidemiology ; Pandemics ; }, abstract = {After the Zero COVID policy ended on December 7, 2022, ~90% of mainland Chinese were infected in a COVID-19 wave. This systematic review synthesized research estimating excess mortality during that wave in mainland China. We searched seven databases in May 2024 and updated our search in July-August 2025. Peer-reviewed research (Chinese or English), published since January 1, 2023, estimating excess deaths in the COVID-19 wave post-Zero-COVID was included. Risk of bias was assessed using a modified Newcastle-Ottawa Scale. Two authors independently conducted abstract screening, full-text review, data extraction, and risk-of-bias assessment. Seven articles were included. Two studies analysed the death records of a town and a district in Shanghai, estimating the excess mortality rates of 153.6% and 174.3%, respectively. Using indirect methods, four studies estimated national excess mortality (range: 0.71-1.87 million). Another study estimated excess mortality in Taiyuan. Studies used diverse methods to estimate excess deaths, resulting in widely varying and uncertain estimates. Choice of reference period, seasonality, and other factors affect expected mortality estimates.}, }
@article {pmid41645649, year = {2026}, author = {Loubet, P and Fourati, S}, title = {An evaluation of sipavibart for pre-exposure prophylaxis of COVID-19 in immunocompromised individuals.}, journal = {Expert review of anti-infective therapy}, volume = {24}, number = {1}, pages = {89-96}, doi = {10.1080/14787210.2026.2624614}, pmid = {41645649}, issn = {1744-8336}, mesh = {Humans ; *COVID-19/prevention & control/immunology ; *SARS-CoV-2/immunology/drug effects ; *Immunocompromised Host ; *Pre-Exposure Prophylaxis/methods ; *Antibodies, Monoclonal/therapeutic use/pharmacology ; Spike Glycoprotein, Coronavirus/immunology ; Animals ; }, abstract = {INTRODUCTION: The COVID-19 pandemic has disproportionately affected immunocompromised individuals, who remain at risk for severe disease despite widespread vaccination efforts. Poor vaccine-induced humoral responses in this population necessitate additional preventive strategies. Sipavibart (AZD3152) is a next-generation long-acting monoclonal antibody designed to target the receptor-binding domain (RBD) of the SARS-CoV-2 Spike protein and provide broad-spectrum neutralization against divergent variants.
AREAS COVERED: This review evaluates sipavibart's preclinical pharmacology, pivotal and supportive clinical trial data, and early real-world evidence, including the SUPERNOVA Phase 3 trial and national early-access programs. We discuss its safety profile, variant-specific activity, and resistance challenges.
EXPERT OPINION: Sipavibart was the first monoclonal antibody to show efficacy and safety in preventing symptomatic COVID-19 among immunocompromised individuals, protecting for up to six months. However, the widespread circulation of variants harboring S:F456L currently limits its clinical utility, and use should be restricted. Maintaining access to Sipavibart remains justified, as future antigenic shifts could restore its activity. Its deployment should rely on genomic surveillance and local epidemiology. At the same time, next-generation mAbs should prioritize conserved spike regions and multi-epitope cocktails to counter viral evolution and prolong therapeutic value.}, }
@article {pmid41646510, year = {2026}, author = {Melo-Oliveira, MES and Lourenço, RA and Louzada, EB and Moutinho, M and Barbosa, AF and Moreira, VG and Porto, LC}, title = {Systematic Review of Dyspnea and Chronic Fatigue in Patients With Long COVID: Clinical Characteristics and Associated Laboratory Parameters.}, journal = {Pulmonary medicine}, volume = {2026}, number = {}, pages = {5426125}, pmid = {41646510}, issn = {2090-1844}, mesh = {Humans ; *Dyspnea/etiology/physiopathology ; *Fatigue/etiology/physiopathology ; *Fatigue Syndrome, Chronic/etiology/physiopathology ; *Post-Acute COVID-19 Syndrome/complications/physiopathology ; Quality of Life ; }, abstract = {ABSTRACT: Dyspnea and chronic fatigue stand out as prevalent manifestations in the postacute phase of COVID, resulting in substantial adverse effects on patients' quality of life and functional capacity. Although these symptoms have been widely documented, there is no clear consensus on the pathophysiological mechanisms that underlie them. The available literature reveals a dispersion of clinical and laboratory data, and the variability in the methods of assessment of fatigue and dyspnea, as well as in the laboratory variables examined, limits the standardized understanding of this complex condition.
OBJECTIVE: This study was aimed at identifying and synthesizing the evidence on the main clinical and laboratory characteristics related to dyspnea and fatigue in patients during long COVID from 2021 onwards.
METHODS: The main databases used to select the studies were PubMed and Medline, also using LitCovid and Embase.
RESULTS: A total of 42 articles that met the inclusion criteria were included, covering a total population of 30,682 patients diagnosed with COVID-19. The findings underscore the significant impact of long COVID on patients' quality of life, with persistent symptoms such as fatigue and dyspnea affecting a considerable proportion of individuals for durations ranging from 1 to 24 months.
CONCLUSION: The heterogeneity in research approaches highlights the urgent need for collaborative initiatives to elucidate the determinants of long COVID symptomatology and create more consistent evaluation protocols.}, }
@article {pmid41646984, year = {2025}, author = {Müller, L and Gebicka, P and Handtke, S and Schönborn, L and Thiele, T}, title = {Advances in our understanding of anti-PF4 related immunothrombosis.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1724207}, pmid = {41646984}, issn = {1664-3224}, mesh = {Humans ; *Platelet Factor 4/immunology ; *Thrombosis/immunology ; *SARS-CoV-2/immunology ; COVID-19/immunology/prevention & control ; Animals ; Blood Platelets/immunology ; *Autoantibodies/immunology/blood ; COVID-19 Vaccines/adverse effects/immunology ; *Thrombocytopenia/immunology ; Platelet Activation/immunology ; Heparin/adverse effects ; }, abstract = {This article focuses on the central role of antibodies against platelet factor 4 (PF4) in mediating immunothrombosis, from classical heparin-induced thrombocytopenia (HIT) to vaccine-induced immune thrombocytopenia and thrombosis (VITT). The latter condition gained international attention during the rollout of vaccines against SARS-CoV-2. Since then, an increased awareness for anti-PF4 mediated disorders arose and patients were recognized with anti-PF4 disorders occurring without prior heparin or adenoviral vector vaccine exposure. These disorders include various acute and chronic VITT-like conditions, i.e. post-viral VITT, diaplacentally transmitted anti-PF4 antibodies in neonatal stroke, monoclonal gammopathies of thrombotic significance (MGTS) and chronic autoimmune VITT of unknown origin. All anti-PF4 related disorders share key serological and immunopathological features with VITT, such as the formation of immune complexes and platelet activation via the Fcγ receptor IIA (FcγRIIA). Via their activation, platelets form procoagulant, aggregatory and secretory phenotypes shaping their interplay with neutrophils, monocytes, and coagulation factors to amplify thrombotic responses. Integrating recent mechanistic insights, clinical observations and diagnostic developments, this review proposes an updated conceptual framework for anti PF4-related immunothrombosis. We aim to raise awareness among clinicians and researchers, to promote early diagnosis and encourage further translational research towards improved therapeutic strategies in this clinically significant area.}, }
@article {pmid41647062, year = {2025}, author = {Ghorbani Shirkouhi, S and Khatami, SS and Niroomand, Z and Sadigh-Eteghad, S and Yousefzadeh-Chabok, S and Andalib, S}, title = {Molecular and Cellular Mechanisms Underlying Neurological and Neuropsychological Manifestations of COVID-19.}, journal = {Innovations in clinical neuroscience}, volume = {22}, number = {10-12}, pages = {14-23}, pmid = {41647062}, issn = {2158-8333}, abstract = {OBJECTIVE: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated with a wide range of neurological symptoms and neuropsychiatric conditions. SARS-CoV-2 shows various degrees of neurotropism. SARS-CoV-2 primarily targets respiratory and gastrointestinal tracts; however, it can affect other organs. Neurological and neuropsychological manifestations of COVID-19 have been reported. Several mechanisms are involved in these manifestations in COVID-19. Therefore, the present narrative review will take account of mechanisms underlying the neurological and neuropsychological manifestations in COVID-19.
METHODS: A literature search for relevant articles in different databases was made with a focus on recent publications for this narrative review.
RESULTS: Inflammation and thrombosis have been suggested to be mechanisms contributing to these manifestations. Also, renin-angiotensin system (RAS), transmembrane serine protease 2 (TMPRSS2), cathepsin B and L, furin, neuropilin-1 (NRP1), and sterile alpha motif and HD domain-containing protein 1 (SAMHD1) have been proposed to be involved in pathogenesis of SARS-CoV-2. Moreover, cluster of differentiation 147 (CD147) and dipeptidyl peptidase 4 (DPP4) have been suggested to have a role in SARS-CoV-2 entry into the central nervous system (CNS).
CONCLUSION: Further investigation on the underlying mechanisms leading to SARS-CoV-2-associated neurological and neuropsychological manifestations is pivotal. Insights into these mechanisms will help the treatment strategies for patients with COVID-19 and such manifestations.}, }
@article {pmid41648868, year = {2026}, author = {Zhu, T and Wang, L and Yan, C}, title = {Local and systemic host responses to influenza and concurrent or sequential SARS-CoV-2 infection.}, journal = {Frontiers in cellular and infection microbiology}, volume = {16}, number = {}, pages = {1725731}, pmid = {41648868}, issn = {2235-2988}, mesh = {Humans ; *Influenza, Human/immunology/pathology/virology/complications ; *Coinfection/immunology/virology/pathology ; SARS-CoV-2 ; *COVID-19/immunology/pathology ; Pandemics ; Lung/pathology/virology/immunology ; *Coronavirus Infections/immunology/pathology/virology ; *Pneumonia, Viral/immunology/pathology/virology ; Animals ; Betacoronavirus/immunology ; }, abstract = {Influenza is an acute respiratory infectious disease caused by the influenza virus, which has been circulating in humans for over a century. In contrast, COVID-19, caused by the novel SARS-CoV-2, emerged recently in December 2019. Following nearly four years of pandemic, the acute phase of SARS-CoV-2 has transitioned towards an endemic state, suggesting a trend of long-term coexistence with humans. Concurrent or sequential coinfection with influenza and SARS-CoV-2 has been clinically observed to exacerbate pulmonary pathology and systemic inflammation in affected individuals. This review discusses the impact and elucidates the potential underlying mechanisms by which influenza and SARS-CoV-2 coinfection aggravates local lung injury and systemic host responses, aiming to inform improved prevention and clinical management strategies.}, }
@article {pmid41648943, year = {2026}, author = {Song, F and Liu, Y and Zhao, Z and Shang, X and Wang, Y and Lai, M and He, M and Chen, Y}, title = {Clinical manifestations, prevalence, and risk factors of asthenopia: a systematic review and meta-analysis.}, journal = {Journal of global health}, volume = {16}, number = {}, pages = {04053}, pmid = {41648943}, issn = {2047-2986}, mesh = {Humans ; *Asthenopia/epidemiology/etiology ; Risk Factors ; Prevalence ; *COVID-19/epidemiology ; }, abstract = {BACKGROUND: This meta-analysis aims to determine the clinical manifestations, prevalence, and risk factors of asthenopia across diverse populations.
METHODS: We systematically searched PubMed up to April 2024 for studies published within the last five years on asthenopia, without language or design restrictions. Reference lists were also reviewed. The study quality was evaluated using the Newcastle-Ottawa Scale. A random-effects meta-analysis was conducted to calculate proportions, prevalence rates, odds ratios (ORs) and their 95% confidence intervals (CIs).
RESULTS: Overall, 63 studies were included. The pooled prevalence of asthenopia detected via questionnaires or symptom report was 51% (95% CI = 50%, 52%). Subgroup analyses showed high prevalence among digital device users (90%) and computer workers (77%). During the COVID-19 pandemic, prevalence rose among adults (39%-45%), university students (36%-57%), and school-aged children (45%-64%). The most frequent ocular symptoms were eye tiredness (65%, 95% CI = 46%, 84%), eye strain (47%, 95% CI = 37%, 58%), and burning/irritation (43%, 95% CI = 35%, 51%). Musculoskeletal symptoms, including neck pain (45%, 95% CI = 28%, 62%) and shoulder pain (30%, 95% CI = 12%, 48%) were also prevalent. Neuropsychological symptoms included headache (50%, 95% CI = 41%, 59%) and difficulty concentrating (44%, 95% CI = 32%, 56%). Risk factors included short sleep duration (OR = 1.28; 95% CI = 1.04, 1.57), prior eye disease (OR = 2.59; 95% CI = 1.43, 4.69), prolonged screen time (OR = 1.15; 95% CI = 1.09, 1.21), and ambient conditions like air conditioning use (OR = 23.02; 95% CI = 4.94, 107.18). Protective measures included anti-glare filters (OR = 0.34; 95% CI = 0.19, 0.64), regular breaks (OR = 0.21; 95% CI = 0.09, 0.51), and computer use knowledge (OR = 0.20; 95% CI = 0.13, 0.30).
CONCLUSIONS: Asthenopia is prevalent across diverse populations, characterised by a wide range of symptoms and influenced by modifiable risk factors. Our findings support a unified definition to improve clinical recognition and offer preliminary evidence to help shape future research on preventive strategies.
REGISTRATION: PROSPERO: CRD42024536841.}, }
@article {pmid41650498, year = {2026}, author = {Keenan Chong, WH and Dan Ong, WJ and Khan, FA and Sajeed, S and Souza, JD and Kansal, MG and Kansal, A}, title = {Clinical benefits of prolonged versus standard prone positioning in mechanically ventilated COVID-19 patients with acute respiratory distress syndrome: A systematic review, meta-analysis, and trial-sequential analysis.}, journal = {Australian critical care : official journal of the Confederation of Australian Critical Care Nurses}, volume = {39}, number = {2}, pages = {101531}, doi = {10.1016/j.aucc.2026.101531}, pmid = {41650498}, issn = {1036-7314}, mesh = {Humans ; Prone Position ; *COVID-19/therapy ; *Respiration, Artificial ; *Respiratory Distress Syndrome/therapy ; *Patient Positioning/methods ; Time Factors ; }, abstract = {OBJECTIVES: The optimal duration of prone positioning for improving outcomes in acute respiratory distress syndrome remains uncertain. This meta-analysis compared clinical outcomes of prolonged versus standard prone positioning in adult coronavirus disease 2019 patients with moderate-to-severe acute respiratory distress syndrome.
METHODS: PubMed, SCOPUS, and Cochrane databases were systematically searched for randomised controlled trials (RCTs) and observational studies. Prolonged prone positioning was defined as a mean duration >24 h per session and standard as ≤ 24 h. Outcomes included mortality, pressure injuries, oxygenation, and respiratory parameters. A trial sequential analysis was conducted for mortality and pressure injuries.
RESULTS: Seven studies (six observational and one RCT) involving 996 patients (592 prolonged and 404 standard) were included in the study. Prolonged prone positioning showed a nonsignificant trend towards lower mortality (33.8% vs. 39.8%, RR: 0.81, 95% confidence interval: 0.60-1.09; P = 0.16) and a borderline increase in pressure injuries (30.2% vs. 26.2%; relative risk (RR) 1.27, 95% confidence interval: 1.00-1.62; P = 0.05). The trial sequential analysis indicated that current evidence is insufficient to confirm benefit or harm. No significant differences were observed in intensive care unit length of stay (mean difference [MD]: 2.74 days; P = 0.13) or changes in positive end-expiratory pressure or driving pressure in both groups. Oxygenation improved significantly during (partial pressure of arterial oxygen-to-fraction of inspired oxygen ratio MD: 17.42 mmHg; P = 0.003) and after prone positioning (partial pressure of arterial oxygen-to-fraction of inspired oxygen ratio MD: 23.83 mmHg; P = 0.008).
CONCLUSION: Prolonged prone positioning was associated with trends towards lower mortality and higher frequency of pressure injury risk, but evidence remains inconclusive. While oxygenation improved, clinical outcomes of intensive care unit length of stay and respiratory parameters were unchanged. Additional high-quality RCTs are needed to clarify the balance of benefits and risks and guide future recommendations.}, }
@article {pmid41650532, year = {2026}, author = {Labied, S and Atifi, F and Wahnou, H and Mabrouk, M and Jeddoub, O and Allaoui, A and Jalali, F and Zaid, Y}, title = {Megakaryocytes and afucosylated IgG in post-acute COVID-19: Bridging immune dysregulation and vascular pathology - A narrative review.}, journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie}, volume = {196}, number = {}, pages = {119049}, doi = {10.1016/j.biopha.2026.119049}, pmid = {41650532}, issn = {1950-6007}, mesh = {Humans ; *COVID-19/immunology/complications/pathology ; *Megakaryocytes/immunology/pathology ; Post-Acute COVID-19 Syndrome ; *Immunoglobulin G/immunology ; SARS-CoV-2/immunology ; Glycosylation ; Animals ; }, abstract = {Post-acute sequelae of SARS-CoV-2 infection (PASC), also referred to as long COVID, encompasses a constellation of persistent symptoms lasting for at least three months after acute SARS-CoV-2 infection and not explained by alternative diagnoses. The multifactorial pathophysiology underlying PASC remains incompletely understood, limiting the development of effective management strategies. Increasing evidence suggests that both immune dysregulation and hemostatic imbalance play central roles in post-COVID-19 complications. Megakaryocytes, key regulators of platelet production and coagulation, have emerged as potential contributors to sustained thrombo-inflammatory processes following SARS-CoV-2 infection. In parallel, afucosylated IgG antibodies have been strongly implicated in exaggerated immune activation and hyperinflammatory responses during acute COVID-19. The persistence of such antibody glycosylation patterns beyond the acute phase raises the possibility that they may also contribute to chronic immune and vascular alterations observed in PASC. This narrative review explores the potential interplay between megakaryocyte dysfunction and afucosylated IgG antibodies in the pathogenesis of PASC. By examining mechanisms identified during acute SARS-CoV-2 infection, we discuss how prolonged immune-hemostatic crosstalk may promote persistent inflammation, endothelial dysfunction, and microvascular abnormalities. Understanding these interconnected pathways may provide mechanistic insight into the heterogeneity of PASC manifestations and help identify novel therapeutic targets for long-term post-COVID-19 sequelae.}, }
@article {pmid41651428, year = {2026}, author = {Wang, Y and Zhao, F and Zhao, Q and Du, S and Wen, Y and Wu, R and Cao, S and Cong, F and Huang, X}, title = {Cell entry mechanisms of porcine enteric coronaviruses.}, journal = {The Journal of biological chemistry}, volume = {302}, number = {3}, pages = {111250}, pmid = {41651428}, issn = {1083-351X}, mesh = {Animals ; Swine ; *Coronavirus/physiology ; *Virus Internalization ; Humans ; *Coronavirus Infections/virology ; Transmissible gastroenteritis virus/physiology ; Deltacoronavirus/physiology ; *Swine Diseases/virology ; Porcine epidemic diarrhea virus/physiology ; Alphacoronavirus ; }, abstract = {Porcine enteric coronaviruses, including transmissible gastroenteritis virus (TGEV), porcine epidemic diarrhea virus (PEDV), swine acute diarrhea syndrome coronavirus (SADS-CoV), and porcine deltacoronavirus (PDCoV), cause severe watery diarrhea, vomiting, dehydration, and high mortality in piglets, leading to enormous economic losses in the swine industry worldwide. They have the capability to infect a variety of cell lines from pigs, humans, and other animals, with high risks of interspecies transmission and potential threats to public health. These viruses employ their spike glycoproteins to engage with various receptors, coreceptors, cofactors, and other host factors that further mediate membrane fusion to accomplish the entry process. This review summarizes the recent findings regarding the pathways, receptors, coreceptors, cofactors, and other host factors utilized by TGEV, PEDV, SADS-CoV, and PDCoV for cellular entry. Several important targets for antiviral therapeutics and some key aspects of the entry process for these viruses that await discovery are highlighted. A comprehensive understanding of the entry mechanisms of porcine enteric coronaviruses will provide new insight into the development of novel antiviral therapeutic strategies.}, }
@article {pmid41652425, year = {2026}, author = {Halder, P and Khaiwal, R and Goel, S and Kumar, N and Sarkar, M and Soni, M and Nongkynrih, B and Prabhakar, MC and Mamgai, A and Rathor, S}, title = {Burden of chronic obstructive pulmonary disease among Indian adults: systematic review and meta‑analysis.}, journal = {BMC pulmonary medicine}, volume = {26}, number = {1}, pages = {}, pmid = {41652425}, issn = {1471-2466}, mesh = {*Pulmonary Disease, Chronic Obstructive/epidemiology/diagnosis ; Humans ; India/epidemiology ; Prevalence ; Spirometry ; Adult ; *Cost of Illness ; }, abstract = {BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is a long-standing respiratory illness marked by ongoing airflow obstruction and inflammation. It continues to be a major contributor to global disease, and death, with low- and middle-income countries (LMICs) experiencing a disproportionate impact. India, as one of the largest LMICs, plays a significant role in global COPD-related mortality and disability-adjusted life years (DALYs). In India, COPD continues to be underrecognized owing to limited spirometry availability, inconsistent diagnostic approaches, and weak surveillance systems. Previous prevalence estimates are both outdated and methodologically inconsistent, while the COVID-19 pandemic may have further shifted disease trends. This systematic review and meta-analysis seeks to bridge these gaps by delivering current, standardized, and comprehensive prevalence data. OBJECTIVE: To estimate the pooled prevalence of spirometry-confirmed COPD among Indian adults and identify key demographic and environmental correlates through a systematic review and meta-analysis of observational studies. METHODS: This systematic review and meta-analysis aimed to determine the prevalence of spirometry-confirmed COPD among Indian adults. The study was registered in PROSPERO (CRD420251140678) and conducted in accordance with PRISMA guidelines. Literature searches were carried out in PubMed, EMBASE, Scopus, and Web of Science up to June 9, 2025, using relevant MeSH terms and keywords on COPD, prevalence, and India. Eligible studies included observational designs reporting spirometry-based COPD prevalence in adults; studies relying on non-spirometry diagnosis, qualitative designs, interventions, or non-English publications were excluded. Three reviewers independently screened records, extracted study and population data, and evaluated methodological quality using the Joanna Briggs Institute (JBI) checklist. Pooled prevalence was calculated using a random-effects model. Heterogeneity was assessed with I2 and Cochran’s Q, complemented by Baujat and Galbraith plots. Subgroup and sensitivity analyses examined variations by diagnostic criteria, demographics, and exposures, while publication bias was tested using funnel plots, Egger’s and Begg’s methods, and trim-and-fill analysis. RESULTS: Twenty-three studies comprising 27,319 Indian adults were included. The pooled prevalence of COPD was 13% (95% CI: 9%–18%), with substantial heterogeneity (I2 = 99.8%). Higher prevalence was observed among smokers (37%), elderly adults (≥ 60 years: 27%), males (16%), and biomass fuel users (8%). Studies using GOLD criteria reported a higher prevalence (15%) than those using FEV1/FVC < LLN (10%). Hospital-based studies showed a greater prevalence (27%) than community-based ones (12%). Regional variation was notable, with North India reporting the highest prevalence (19%) and West India the lowest (7%). Sensitivity analyses confirmed the robustness of findings; publication bias was minimal and did not significantly affect pooled estimates. CONCLUSION: COPD remains a significant and underrecognized public health challenge in India. As all included studies were appraised as good quality using the JBI tool, the evidence base is strong and supports reliable pooled estimates. Therefore, our conclusions emphasize the importance of routine spirometry-based screening, targeted interventions for high-risk groups, and integration of COPD surveillance into India’s NCD framework, while reinforcing gender-sensitive strategies and clean fuel initiatives as evidence-based measures to reduce disease burden and guide policy planning.}, }
@article {pmid41653012, year = {2026}, author = {Asis, A and Rodríguez, A and Reyes, LF and Díaz, E and Nseir, S and Martín-Loeches, I}, title = {The double threat: bacterial and fungal co-/superinfection in viral pneumonia.}, journal = {Expert review of respiratory medicine}, volume = {20}, number = {7}, pages = {847-858}, doi = {10.1080/17476348.2026.2629003}, pmid = {41653012}, issn = {1747-6356}, mesh = {Humans ; *Superinfection/epidemiology/diagnosis/microbiology ; COVID-19 ; *Pneumonia, Viral/epidemiology/diagnosis/drug therapy ; *Coinfection/epidemiology/diagnosis ; *Pneumonia, Bacterial/epidemiology/diagnosis ; Influenza, Human/epidemiology ; SARS-CoV-2 ; Pandemics ; Intensive Care Units ; *Coronavirus Infections/epidemiology ; *Pulmonary Aspergillosis/epidemiology/diagnosis ; Antimicrobial Stewardship ; }, abstract = {INTRODUCTION: Respiratory viral pneumonias are a leading cause of severe respiratory failure and intensive care unit (ICU) admission worldwide. Although viral infection itself drives significant morbidity and mortality, secondary bacterial and fungal superinfections represent a critical 'double threat' in critically ill adults, exacerbating lung injury, prolonging organ dysfunction, and complicating antimicrobial management. Experience from the Influenza A (H1N1) pdm09 and SARS-CoV-2 pandemics highlights a persistent mismatch between low documented bacterial co-infection rates and widespread empiric antibiotic exposure, underscoring diagnostic uncertainty and antimicrobial stewardship challenges in the ICU.
AREAS COVERED: This review examines the epidemiology, immunopathogenesis, and diagnostic approaches to bacterial and fungal superinfection in adult ICU patients with severe viral pneumonia. Evidence is synthesized from large ICU cohorts, pandemic data, and established consensus definitions for influenza- and COVID-19-associated pulmonary aspergillosis (IAPA, CAPA). The review discusses advances in molecular diagnostics, lower respiratory tract sampling, bronchoalveolar lavage - based mycology, and biomarker-guided strategies, with a focused literature search of ICU-specific studies.
EXPERT OPINION: Bacterial and fungal superinfections, while infrequent, carry substantial clinical impact in severe viral pneumonia. A multimodal, ICU-adapted diagnostic strategy integrating pathogen detection with host-response assessment is essential to support timely therapy, enable antimicrobial de-escalation, and align superinfection management with stewardship principles.}, }
@article {pmid41653115, year = {2026}, author = {Hu, Q and Mai, Z and Wang, B and Sun, N and Zhu, W and Wang, J and Ge, J and Gao, M}, title = {Trained Immunity Empowers Vaccine Design and Application.}, journal = {ACS infectious diseases}, volume = {12}, number = {3}, pages = {913-936}, doi = {10.1021/acsinfecdis.5c00840}, pmid = {41653115}, issn = {2373-8227}, mesh = {*Trained Immunity ; Humans ; *Vaccine Development/methods ; *COVID-19 Vaccines/immunology ; *COVID-19/prevention & control/immunology ; Animals ; *SARS-CoV-2/immunology ; Adjuvants, Immunologic ; Cross Protection/immunology ; }, abstract = {The COVID-19 pandemic has exposed the limitations of traditional vaccine development models: these approaches rely excessively on pathogen-specific antigen design, feature lengthy development cycles, and struggle to address threats from rapidly mutating pathogens and emerging pathogens. Even before the pandemic, certain traditional vaccines (such as BCG) demonstrated "cross-protection" effects beyond their target diseases. The trained immunity (TRIM) theory offers a promising path to develop broad-spectrum, effective, and durable vaccines. This review summarizes core advances in TRIM within vaccinology, systematically outlining vaccine design strategies based on this concept for the first time. These strategies encompass vaccine-mediated cross-protection, methods to enhance vaccine potency and persistence, pathways to achieve broad-spectrum effects, and regulatory characteristics involving immune recognition, antigen delivery, safety, and tolerability. This study explores the synergistic effects and application prospects of TRIM adjuvants such as β-glucan and Toll-like receptor (TLR) agonists. The impact of transgenerational immune effects on offspring immune function provides a crucial direction for future research. It also highlights current limitations in studies regarding persistence, individual variability, and risks of excessive inflammation. Existing vaccines capable of inducing TRIM will inspire next-generation vaccine development. Innovative applications of this vaccine category can propel the advancement of trained immunity-based vaccines (TIbVs). This review proposes an innovative approach─the "Vaccine Immunity Foundation Hypothesis." This lays the groundwork for designing next-generation vaccines and advancing the clinical translation of TRIM therapies, establishing a theoretical foundation for developing broad-spectrum, highly effective, durable, and safe immune protection strategies.}, }
@article {pmid41653615, year = {2026}, author = {Honchar, O and Мykhailenko, O and Holovchenko, O and Georgiyants, V}, title = {Pelargonium sidoides - from ethnopharmacology to evidence-based medicine: a systematic review.}, journal = {Phytomedicine : international journal of phytotherapy and phytopharmacology}, volume = {153}, number = {}, pages = {157880}, doi = {10.1016/j.phymed.2026.157880}, pmid = {41653615}, issn = {1618-095X}, mesh = {*Pelargonium/chemistry ; Humans ; *Plant Extracts/pharmacology/chemistry/therapeutic use ; Ethnopharmacology ; Evidence-Based Medicine ; Phytotherapy ; Respiratory Tract Infections/drug therapy ; Phytochemicals/pharmacology ; Plant Roots/chemistry ; }, abstract = {BACKGROUND: Pelargonium sidoides DC. (Geraniaceae) has a long history of traditional use among indigenous peoples of Southern Africa for treating respiratory and gastrointestinal disorders. Its transformation into the modern pharmaceutical product Umckaloabo (EPs® 7630) exemplifies the transition from traditional medicine to evidence-based therapeutics.
PURPOSE: To provide a systematic analysis of P. sidoides, spanning from its botanical characteristics and ethnobotanical roots to its development as a regulated phytomedicine. The review focuses on the plant's unique phytochemical profile and provides a detailed synthesis of its molecular and systems-biological mechanisms of action, cultivation sustainability, and clinical efficacy in managing respiratory tract infections.
STUDY DESIGN AND METHODS: A systematic search was conducted across PubMed, Scopus, and Cochrane Library up to December 2025 following PRISMA guidelines. Sources included scientific articles, pharmacopoeias, patents, and ethnobotanical records in English and Ukrainian.
RESULTS: The systematic synthesis of identified records characterizes the chemical diversity of P. sidoides, focusing on specialized metabolites such as highly substituted benzopyranones, prodelphinidins, and unique coumarin sulfates. The review discusses modern cultivation practices, sustainability issues, and comparative extraction techniques, while analytical methods such as HPLC, LC-MS, and TLC for standardization are summarized. The pharmacological profile is defined by multi-target activity, encompassing immunomodulatory, antibacterial, and antiviral effects, including studies on SARS-CoV-2 and other respiratory pathogens. Analysis of available clinical data validates the therapeutic use of P. sidoides root preparations for managing acute bronchitis, rhinosinusitis, and tonsillopharyngitis.
CONCLUSION: This study demonstrates that the integration of P. sidoides into modern healthcare is supported by the synergy between traditional knowledge and molecular and clinical validation. By mapping the developmental trajectory - from wild harvesting to systems-biological evidence - this review identifies P. sidoides as a model for the pharmaceutical translation of ethnobotanical resources into standardized, evidence-based phytomedicines.}, }
@article {pmid41654195, year = {2026}, author = {Shan, Z and Li, J and Ye, Z and Chen, Y and Chen, J and Chen, Y and Wang, X and Gao, C and Jiang, S and Zhang, N}, title = {Advances in human respiratory organoid models for studying the pathogenesis and intervention strategies of COVID-19.}, journal = {Virologica Sinica}, volume = {41}, number = {1}, pages = {23-34}, pmid = {41654195}, issn = {1995-820X}, mesh = {Humans ; *Organoids/virology/pathology ; SARS-CoV-2 ; *COVID-19 ; *Respiratory System/virology/pathology ; Antiviral Agents/pharmacology ; Microphysiological Systems ; COVID-19 Drug Treatment ; }, abstract = {Coronavirus Disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), affects multiple organ systems, with the respiratory system being the primary target. Respiratory organoids, which closely mimic the structure and function of the human respiratory tract, have emerged as essential tools for studying SARS-CoV-2 infection. This review summarizes current methods for generating various respiratory organoids, including nasal, tonsil, airway, bronchial, and alveolar organoids, and highlights their application in investigating the mechanism of SARS-CoV-2 infection and evaluating potential therapeutic agents. Meanwhile, this review also introduces respiratory organoid-on-a-chip technology, which can precisely regulate culture conditions and incorporate vascularization and immune cells to enhance physiological complexity, thereby providing crucial support for investigating SARS-CoV-2-induced lung injury, immune responses, and conducting high-throughput drug screening. The aim of this review is to provide valuable insights for further research into the pathogenesis and intervention strategies of COVID-19.}, }
@article {pmid41655454, year = {2026}, author = {Chen, K and Xu, Q and Li, J and Wu, G and Wu, H and Tie, X and Xu, J and Li, J and Zhang, Y}, title = {Cytokine storm divergence in viral infections of the upper respiratory tract.}, journal = {Cytokine & growth factor reviews}, volume = {88}, number = {}, pages = {108-123}, doi = {10.1016/j.cytogfr.2026.01.008}, pmid = {41655454}, issn = {1879-0305}, mesh = {Humans ; *Cytokine Release Syndrome/immunology/virology ; *Cytokines/immunology ; *Respiratory Tract Infections/immunology/virology ; SARS-CoV-2/immunology ; Animals ; COVID-19/immunology ; *Virus Diseases/immunology ; }, abstract = {Cytokine storm (CS) is a pathological state of dysregulated, hyperactive host immunity that arises in the context of infection, malignancy, or immunotherapy. CS is characterized by the sustained, markedly elevated release of multiple pro-inflammatory mediators, ultimately leading to tissue damage and multi-organ dysfunction. Upper respiratory viral infections, including SARS, MERS, SARS-CoV-2, influenza, adenovirus, and respiratory syncytial virus (RSV), are among the most prominent CS triggers. Inflammatory storms triggered by different pathogens exhibit distinct variations in their cytokine profiles and downstream immune signaling pathways. Underlying comorbidities-such as diabetes, obesity, and cardiovascular disease-together with complications such as coagulopathies and secondary infections, can profoundly alter both the threshold and the magnitude of the cytokine storm. This review systematically compares cytokine profiles elicited by distinct upper respiratory pathogens, with population stratification by age and underlying comorbidities, to clarify how these patterns relate to disease severity and complication risk. Collectively, the available evidence supports a shared inflammatory backbone across respiratory virus-induced cytokine storms, overlaid by pathogen-specific cytokine fingerprints and host-dependent plasticity that shapes clinical trajectories and outcomes.}, }
@article {pmid41656017, year = {2026}, author = {Temte, JL}, title = {Primary Care Clinics and Surveillance of Infectious Diseases.}, journal = {Primary care}, volume = {53}, number = {1}, pages = {17-29}, doi = {10.1016/j.pop.2025.09.003}, pmid = {41656017}, issn = {1558-299X}, mesh = {Humans ; *Primary Health Care/organization & administration ; Influenza, Human/epidemiology ; *Communicable Diseases/epidemiology ; COVID-19/epidemiology ; Public Health Infrastructure ; }, abstract = {Public health surveillance for infectious diseases is highly compatible with the practice of primary care medicine and is enhanced by contextual and population-based elements when grounded in primary care. Moreover, there have been long and successful partnerships between primary care and public health for influenza monitoring. Surveillance programs can be based on sentinel, laboratory, or mechanistic approaches and need to reflect the needs of clinicians and the realities of the primary care environment. Participation in, and access to, surveillance information improves patient care through situational awareness, improving diagnostic acuity, and improving antimicrobial stewardship.}, }
@article {pmid41656465, year = {2025}, author = {Kazachinskaia, EI and Zibareva, LN and Kononova, YV and Shestopalov, AM and Voevoda, MI and Chepurnov, AA}, title = {Antiviral Activity of Plant-Based Preparations against SARS-CoV-2 and Herpes Simplex Virus Type 2 In Vitro: A Review of Experimental Findings.}, journal = {Bulletin of experimental biology and medicine}, volume = {180}, number = {1}, pages = {1-10}, pmid = {41656465}, issn = {1573-8221}, mesh = {*Antiviral Agents/pharmacology/chemistry/isolation & purification ; *Plant Extracts/pharmacology/chemistry ; *Herpesvirus 2, Human/drug effects ; *SARS-CoV-2/drug effects ; Humans ; Animals ; Plant Leaves/chemistry ; COVID-19 Drug Treatment ; }, abstract = {We reviewed published data on the efficacy of plant-derived preparations, including the authors' original in vitro findings on the antiviral activity of aqueous and dry ethanol extracts against the RNA virus SARS-CoV-2 and the DNA virus herpes simplex virus type 2 (HSV-2). The study evaluates the activity of an aqueous extract prepared from fermented leaves of Epilobium angustifolium L., as well as dry ethanol extracts obtained from clove spice (Syzygium aromaticum L.), black and green tea (Camellia sinensis L.), leaves of Rhaponticum carthamoides, the basidiomycete fungus chaga (Inonotus obliquus (Ach. ex Pers.) Pil.), and four lichen species: Cetraria islandica L., Usnea L., Pseudevernia furfuracea L., and Cladonia stellaris Opiz. HPLC analysis of several dry ethanol extracts suggests that their antiviral activity may be attributed to polyphenolic compounds and ecdysteroids. These findings may serve as a basis both for the identification of individual bioactive plant-derived compounds and for the development of cost-effective therapeutic or prophylactic agents against COVID-19 and for reducing the recurrence rate of chronic genital herpes.}, }
@article {pmid41656612, year = {2026}, author = {Gauffin, K}, title = {Who is worthy of protection? Revisiting a theoretical model on the social origins of health inequities during the COVID-19 pandemic.}, journal = {Scandinavian journal of public health}, volume = {54}, number = {4}, pages = {397-408}, pmid = {41656612}, issn = {1651-1905}, mesh = {Humans ; *COVID-19/epidemiology ; *Models, Theoretical ; Socioeconomic Disparities in Health ; *Health Status Disparities ; *Pandemics ; }, abstract = {AIMS: This article examines how the Diderichsen model has been used and adapted in research on health inequalities during COVID-19, and explores how the pandemic has prompted further theoretical development. This review therefore addresses the question of how a well-established theoretical framework has helped researchers understand pandemic-related health inequalities and what opportunities exist for its continued refinement.
METHODS: A narrative literature review was conducted using Google Scholar, Web of Science, PubMed and Scopus. Included studies cited a key publication presenting the Diderichsen model and addressed COVID-19 as a central topic. After screening 298 articles, 24 were included for full analysis. The studies were categorised by how they engaged with the model - conceptually, empirically or through further development.
RESULTS: The Diderichsen model was commonly used to frame discussions of health inequality or to interpret pandemic-related disparities in exposure, vulnerability and outcomes. Several studies emphasised occupational and housing-related exposure, class-based comorbidities and the unequal social consequences of COVID-19. A smaller number of studies proposed expanded frameworks, incorporating multilevel and temporal dimensions and introducing new mechanisms related to pandemic responses. These adaptations often focused on migrants, ethnic minorities and other particularly affected groups.
CONCLUSIONS: The review confirms the ongoing relevance of the Diderichsen model in pandemic health inequality research. It argues that the model can be further strengthened by explicitly incorporating concepts of political decision-making, symbolic recognition and social justice. This would improve its capacity to capture the full complexity of health inequalities in times of crisis.}, }
@article {pmid41656850, year = {2026}, author = {Hatchett, RJ}, title = {Best Practices in Preparing for the Worst Case.}, journal = {Disaster medicine and public health preparedness}, volume = {20}, number = {}, pages = {e34}, doi = {10.1017/dmp.2025.10201}, pmid = {41656850}, issn = {1938-744X}, mesh = {Humans ; COVID-19/epidemiology/prevention & control ; *Civil Defense/methods/standards/trends ; Pandemic Preparedness ; *Disaster Planning/methods ; Disease Outbreaks/prevention & control ; }, abstract = {The convergence of nuclear and radiological preparedness with epidemic and pandemic response, reveals valuable opportunities for cross-disciplinary learning and capability development. Insights from the extensive career of Dr. C. Norman Coleman illustrate how methodologies from radiation medical countermeasures can inform strategies for managing emerging infectious diseases. While nuclear incidents are infrequent, infectious disease outbreaks occur regularly, underscoring the need for sustained, adaptable capabilities to detect and respond to such threats. To draw on some examples, case studies on the development and deployment of vaccines against filoviruses highlight measurable advances in response speed and efficacy, while persistent challenges related to equitable access to medical countermeasures during public health emergencies can be addressed drawing lessons from the COVID-19 pandemic. Iterative improvement, strategic planning and performance optimization is very important, as is, the value of understanding the structure of a problem to find its solution.}, }
@article {pmid41656855, year = {2026}, author = {Lazarus, R and Williams, V and Cochrane, H and Rees, S and Seale, H}, title = {Attitudes to vaccine co-administration in adults: A scoping review of qualitative evidence.}, journal = {Human vaccines & immunotherapeutics}, volume = {22}, number = {1}, pages = {2616140}, pmid = {41656855}, issn = {2164-554X}, mesh = {Adult ; Humans ; *Health Knowledge, Attitudes, Practice ; *Vaccination/psychology ; *Vaccines/administration & dosage ; }, abstract = {Providing multiple vaccinations to adults at a single appointment, known as co-administration, could help increase vaccine coverage by making the process more convenient for the public. Despite vaccine co-administration policies, there are many missed opportunities to offer multiple vaccines. A qualitative understanding of the public attitude to co-administration may allow the development of interventions to increase implementation of co-administration policies. We undertook a scoping review following the Joanna Briggs Institute framework to collate the available qualitative literature to identify barriers, and facilitators to vaccine co-administration as well as potential research gaps. We created and used an iterative search strategy to retrieve articles published between 1/10/2010 and 11/12/2024 in three scientific databases. None of the articles retrieved fulfilled the inclusion criteria. There were nine articlesthat used quantitative surveys to measure attitudes, barriers and facilitators. Qualitative studies to understand barriers and facilitators to vaccine co-administration are needed to inform future policy implementation.}, }
@article {pmid41656902, year = {2026}, author = {Biswas, R and Roy, A and Kayal, T and Basu, S and Ghosh, S and Ramaiah, S and Anbarasu, A}, title = {Waning immunity and the future of booster vaccination strategies in global vaccine programs post COVID-19.}, journal = {Human vaccines & immunotherapeutics}, volume = {22}, number = {1}, pages = {2626088}, pmid = {41656902}, issn = {2164-554X}, mesh = {Humans ; *Immunization, Secondary/methods/trends ; *COVID-19/prevention & control/immunology ; *Immunization Programs ; Global Health ; Vaccination/methods ; COVID-19 Vaccines/immunology ; SARS-CoV-2/immunology ; Influenza, Human/prevention & control/immunology ; Pandemics/prevention & control ; Whooping Cough/prevention & control/immunology ; }, abstract = {The problem of waning immunity is a major global concern of vaccine programs, with immunity against diseases such as COVID-19 (reduction in efficacy by ~25% in six months), pertussis (waning in 4-12 y), and influenza (annual updates needed) expected to decrease with time. While boosters reduce serious results in high-risk categories, these effects are short-term (4-6 months) and encourage global imbalances, where low-income areas lag in primary vaccination (<2%). Computational models have shown that primary vaccination in underserved regions prevents ~60% of hospitalizations worldwide, surpassing booster-focused measures (~47%). To maintain protection, variant-responsive boosters, rapid booster-design pipelines, universal vaccine platforms (including pan-coronavirus vaccines), and equity-based solutions (decentralized production) need to be integrated. Aligning with frameworks like the Immunization Agenda 2030 of the World Health Organization, plans should balance the expansion of high-risk groups while broadening primary access, providing infrastructure investment, and real-time surveillance to address evolving pathogens and systemic disparities.}, }
@article {pmid41657321, year = {2026}, author = {Zhang, Z and Ong, YH and Yang, B and Fan, B and Yang, YY and Ni, Q}, title = {Chemical engineering strategies to enhance mRNA-LNP stability for therapeutic applications.}, journal = {Biomaterials science}, volume = {14}, number = {6}, pages = {1370-1392}, doi = {10.1039/d5bm01635e}, pmid = {41657321}, issn = {2047-4849}, mesh = {*RNA Stability ; Humans ; *RNA, Messenger/chemistry/genetics/immunology ; *Chemical Engineering/methods ; *COVID-19 Vaccines/chemistry/genetics/immunology ; mRNA Vaccines ; Animals ; COVID-19/prevention & control ; SARS-CoV-2/genetics ; }, abstract = {The inception of mRNA vaccines for COVID-19 has catalyzed a transformative shift in the field of vaccination, offering expeditious, scalable, and potent countermeasures to a global health emergency. Despite significant advances, mRNA remains inherently unstable under physiological conditions due to its susceptibility to degradation by ubiquitous ribonucleases and physicochemical factors, making its storage, transport and clinical application challenging. This review explores the critical determinants influencing mRNA stability and discusses how chemical engineering strategies are suited to enhance mRNA stability, including 5' cap modification, poly(A) tail engineering, optimization of untranslated regions, as well as coding sequence refinements, reversible 2'-OH acylation, the development of circular RNA constructs and self-amplifying RNA systems. We also discuss efforts towards mRNA immunogenicity regulation and advanced mRNA delivery systems, along with progress in storage and transport solutions, which have further contributed to addressing stability concerns. Finally, we discuss the remaining challenges in clinical translation and provide forward-looking perspectives on emerging mRNA-based technologies.}, }
@article {pmid41657453, year = {2026}, author = {Yang, T and Hu, Y and Bao, Y}, title = {Psychological impact and intervention strategies for unaccompanied patients in pediatric intensive care units: a narrative review.}, journal = {Translational pediatrics}, volume = {15}, number = {1}, pages = {20}, pmid = {41657453}, issn = {2224-4344}, abstract = {BACKGROUND AND OBJECTIVE: The pediatric intensive care unit (PICU) is a high-stress medical environment. Family-Centered Care (FCC), which ensures parental presence and participation, is recognized as the standard of practice to mitigate psychological distress and trauma in critically ill children. However, infection control mandates [most notably during the coronavirus disease 2019 (COVID-19) pandemic] and resource limitations often necessitate restrictive visitation policies, leaving children in an "unaccompanied" state. This separation from parents constitutes a significant deviation from the standard care model and poses a unique psychological risk. A systematic synthesis of the specific psychological impacts of this parental absence and adaptive strategies to effectively intervene within this context remains underdeveloped. This narrative review aims to analyze the primary psychological consequences of parental absence for children in the PICU and to explore the intervention strategies adapted to mitigate these effects.
METHODS: We reviewed journal articles from the past 15 years (2010-2024) that analyze and discuss the psychological impact and intervention strategies of unaccompanied patients in pediatric intensive care units.
KEY CONTENT AND FINDINGS: Our analysis indicates that an unaccompanied state is a significant, independent risk factor for psychological morbidity in PICU patients, markedly exacerbating separation anxiety, fear, loneliness, and depressive symptoms, which may also impede physiological recovery. Effective interventions must focus on mitigating the trauma of separation. The core strategy identified is "Virtual Family-Centered Care" (e.g., re-establishing family connection and participation in rounds via video technology). Other critical interventions include alternative socio-emotional support from the healthcare team (especially Child Life Specialists), professional psychological therapies, and environmental optimization to reduce threat perception.
CONCLUSIONS: We conclude that while parental presence is irreplaceable, PICUs must adopt innovative interventions, particularly technology-assisted virtual connections, to protect the psychological well-being of unaccompanied children whenever visitation is necessarily restricted.}, }
@article {pmid41657702, year = {2026}, author = {Liu, S and Zhou, T and Wang, M and Xiang, W and Wu, J}, title = {Global landscape of mRNA vaccine clinical trials: a systematic analysis of ClinicalTrials.gov data.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1738942}, pmid = {41657702}, issn = {2296-2565}, mesh = {Humans ; *Clinical Trials as Topic/statistics & numerical data ; *COVID-19/prevention & control/epidemiology ; *COVID-19 Vaccines ; *mRNA Vaccines ; Vaccines, Synthetic ; Registries ; RNA, Messenger ; SARS-CoV-2 ; }, abstract = {mRNA vaccines, as a novel vaccine platform, have rapidly become a global research hotspot driven by the COVID-19 pandemic. This study employs a systematic analysis method based on clinical trial registries to conduct a descriptive statistical analysis of mRNA vaccine-related trials registered in the ClinicalTrials.gov database from March 2000 to July 2025. We compared characteristics such as the number of trials, geographical distribution, study type, funding sources, trial design, and indications, and used chi-square tests and Fisher's exact tests for inter-group difference analysis. The results show that the number of mRNA vaccine clinical trials has experienced explosive growth after the pandemic, presenting obvious pandemic-driven characteristics and geographical differences. There are significant differences in registration characteristics and trial design among China, the United States, and Europe (p<0.01). Indications have rapidly expanded from infectious diseases to multiple fields such as tumors, autoimmune diseases, and metabolic diseases, indicating that mRNA technology is transforming from an infectious disease prevention tool into a platform technology with broad therapeutic potential. From the perspective of clinical trial registration, this study provides empirical evidence for understanding the global research status, regional strategy differences, and future development directions of mRNA vaccines. It offers insights for vaccine development planning, international regulatory coordination, and global clinical trial strategic planning, assisting researchers, enterprises, and policymakers in making optimal decisions.}, }
@article {pmid41658241, year = {2026}, author = {Gil Arias, BS and Blandón Andrade, JC and Sidorov, G and Morales-Ríos, A}, title = {Computational methods for the identification of suicidal ideation: a systematic review.}, journal = {Frontiers in artificial intelligence}, volume = {9}, number = {}, pages = {1704818}, pmid = {41658241}, issn = {2624-8212}, abstract = {INTRODUCTION: Suicide is one of the leading causes of death among young people, to the extent that in many countries it is considered a public health issue. It is important to attempt to reduce the growth of this trend, especially among susceptible individuals, considering that it increased because of the COVID-19 pandemic. Natural language processing (NLP) provides various tools that allow for the analysis of texts to predict the presence of suicidal ideation. This work aims to conduct a systematic literature review to extract the computational techniques for identifying suicidal ideation in texts written in natural language.
METHODS: The PRISMA 2020 method was used, which was divided into nine phases, and three inclusion criteria and two exclusion criteria were established for the selection of studies. The searches were conducted through high-level academic databases such as Scopus, IEEE Xplore, ACM Digital Library, Springer, and Web of Science. The risk of bias was assessed using AMSTAR 2. Potential biases identified include a lack of linguistic and cultural diversity and the predominance of data from social networks. A narrative synthesis was used to analyze and compare the findings qualitatively.
RESULTS: In the end, 25 studies related to computational methods for detecting suicidal ideation in texts written in natural language were identified. The techniques mainly focus on transformer-based models such as BERT and hybrid methods, which combine this architecture with neural networks such as CNN and LSTM. There are also approaches with hierarchical attention mechanisms. Some studies employed additional techniques such as feature extraction with TF-IDF and pre-trained embeddings to improve model performance.
DISCUSSION: Limitations in the evidence include the lack of linguistic and cultural diversity and the predominance of data from social networks. These results indicate that computational techniques have high potential to support early prevention strategies for suicidal ideation. However, expanding the diversity of linguistic contexts and improving understanding of the models among non-experts, such as physicians and other interested individuals, is necessary.}, }
@article {pmid41658735, year = {2026}, author = {Lakhani, HA and Baidya, OP and Alex, A and Binorkar, SV and Das, D and Hazra, A}, title = {New-Onset and Flare Episodes of Adult-Onset Still's Disease Following COVID-19 Vaccination: A Systematic Review of Published Case Reports.}, journal = {Cureus}, volume = {18}, number = {1}, pages = {e100889}, pmid = {41658735}, issn = {2168-8184}, abstract = {This systematic review provides a descriptive synthesis of published case reports documenting new-onset or flare episodes of adult-onset Still's disease (AOSD) temporally occurring after COVID-19 vaccination. A comprehensive search of PubMed, Scopus, Web of Science, and Google Scholar identified 13 eligible case reports published between 2020 and 2024. Because all available evidence consisted solely of individual case descriptions without comparator groups, the review followed PRISMA 2020 guidelines and employed qualitative narrative synthesis rather than meta-analysis. Across the included cases, patients consistently presented with hallmark features of AOSD, including high spiking fever, arthritis or arthralgia, markedly elevated ferritin levels, and, in several instances, the characteristic salmon-colored rash. Symptom onset typically occurred within four to fifteen days following vaccination. Although these cases demonstrate recognisable clinical patterns, the absence of denominator data, lack of population-based studies, and inherent publication bias prevent estimation of incidence or risk, and no causal relationship with vaccination can be inferred. All reported patients responded favorably to corticosteroids, with some requiring biologic therapy for disease control. These findings highlight the importance of clinician awareness when evaluating persistent febrile or inflammatory symptoms in recently vaccinated individuals, while emphasising that COVID-19 vaccination remains overwhelmingly safe. Larger registries, pharmacovigilance data, and controlled studies are needed to clarify potential risk factors and guide future revaccination decisions.}, }
@article {pmid41660233, year = {2026}, author = {Sakkos, A and Saint-John, B and Tyml, T and Myskova, E and Aureli, L and Inman, JL and Snijders, AM and Mouncey, NJ and Mukundan, H and Schulz, F}, title = {Agnostic capture of pathogens for the detection and diagnostics of emerging threats.}, journal = {iScience}, volume = {29}, number = {2}, pages = {114684}, pmid = {41660233}, issn = {2589-0042}, abstract = {The continued emergence of pathogens, whether novel, re-emerging, or engineered, poses a persistent global biosecurity and public health challenge. Recent outbreaks, including COVID-19, Lassa fever, Marburg virus, mpox, and avian influenza, underscore the urgent need for robust systems that enable rapid surveillance, early diagnosis, and timely countermeasures before widespread human transmission occurs. In this article, we focus on early detection technologies and systematically evaluate current diagnostic and sensing modalities. We highlight sequencing and spectroscopy as two complementary approaches capable of providing broad, agnostic detection and rich biological insight. Our analysis emphasizes that scientific innovation alone is insufficient: effective preparedness also requires improved data curation, integration, and sharing to build AI-ready resources that accelerate future responses. We argue for coordinated advances in both technological capabilities and supporting infrastructure to enable the rapid identification and characterization of emerging pathogens and to fully leverage modern science against evolving infectious threats.}, }
@article {pmid41661491, year = {2026}, author = {Garg, RK and Jain, A and Pandey, S and Paliwal, V and Suresh, V and Singhal, S}, title = {Infection-associated Opsoclonus: A Systematic Review.}, journal = {Cerebellum (London, England)}, volume = {25}, number = {1}, pages = {16}, pmid = {41661491}, issn = {1473-4230}, mesh = {Humans ; *Ocular Motility Disorders/therapy/etiology/diagnosis/epidemiology ; *COVID-19/complications ; *Virus Diseases/complications ; }, abstract = {Opsoclonus is a chaotic, multidirectional eye movement characterized by rapid saccades. We aimed to systematically review infection-associated opsoclonus to define its pathogen spectrum, clinical features, treatments, and outcomes. PRISMA 2020 compliant review, PROSPERO registered (CRD420251161567). PubMed, Embase, Scopus and Google Scholar were searched. All search results were imported into EndNote 21 for deduplication. Two reviewers independently conducted screening and data extraction. Quality was assessed by Murad et al. and Newcastle–Ottawa Scales. In this analysis of 210 published cases of opsoclonus, the mean age was 35 years, with Asia contributing 43% of reports and India being the most frequent reporting country. Most patients were immunocompetent or presumed immunocompetent (78%). Viral infections predominated (63%), led by Severe Acute Respiratory Syndrome Coronavirus 2 (30%), followed by scrub typhus, Human Immunodeficiency Virus, West Nile virus, Borrelia, Epstein–Barr virus, Mycoplasma pneumoniae, and dengue virus. Latency was short, with 62% presenting within two weeks, supporting a para-infectious immune mechanism. Cerebrospinal fluid was normal in 43% and magnetic resonance imaging in 67%, indicating that normal investigations should not delay treatment. Management was mainly immunotherapy-based, with corticosteroids alone (40%) or combined with intravenous immunoglobulin (24%). Outcomes were favourable, with 43% recovering within one week and 41% within eight weeks. Immune mediation was inferred in 78%, a pattern consistently reproduced across sixteen cohort studies. Infection-associated opsoclonus is a treatable neurological syndrome arising from a broad infectious spectrum, predominantly viral. Early diagnosis and prompt immunotherapy are associated with rapid clinical improvement.}, }
@article {pmid41661551, year = {2026}, author = {Sundaram, ME}, title = {Vaccine safety for individuals receiving immune checkpoint inhibitor therapy: A narrative review of current literature and recommendations for future research.}, journal = {Human vaccines & immunotherapeutics}, volume = {22}, number = {1}, pages = {2607893}, pmid = {41661551}, issn = {2164-554X}, mesh = {Humans ; *Immune Checkpoint Inhibitors/adverse effects/therapeutic use ; *Neoplasms/drug therapy/immunology ; *COVID-19 Vaccines/adverse effects/administration & dosage/immunology ; *Influenza Vaccines/adverse effects/administration & dosage ; COVID-19/prevention & control ; Vaccination/adverse effects ; }, abstract = {Some individuals with cancer may receive immunomodulatory treatment such as immune checkpoint inhibitors (ICIs). ICIs are now part of standard of care for many cancers and have improved survival for cancer patients. However, they are also associated with immune-related adverse events (irAEs), which can affect any organ or system, and can range from mild to severe. It has been hypothesized that vaccination of these individuals could increase the risk of irAEs or other vaccine-associated adverse events. This narrative review of 28 primary research articles presents findings from existing literature on vaccine safety for individuals receiving ICIs, and makes recommendations for future research on this topic. The existing evidence suggests that influenza and COVID-19 vaccines are safe for individuals receiving ICIs and do not pose additional risks of irAEs beyond baseline risks associated with ICI therapy.}, }
@article {pmid41662196, year = {2026}, author = {Sirohi, A and Trivedi, YV and Katoch, T and Walters, B and Bansal, V and Pahal, S and Jain, R}, title = {The resurgence of Tuberculosis in the United States: Health implications, pathophysiological and clinical insights, emerging trends, strategic responses, and post-COVID-19 challenges.}, journal = {Chronic illness}, volume = {22}, number = {1}, pages = {17-35}, doi = {10.1177/17423953261417345}, pmid = {41662196}, issn = {1745-9206}, mesh = {Humans ; United States/epidemiology ; *COVID-19/epidemiology ; *Tuberculosis/epidemiology/diagnosis/therapy/drug therapy ; Latent Tuberculosis/epidemiology/diagnosis ; Health Services Accessibility ; SARS-CoV-2 ; Socioeconomic Disparities in Health ; Social Stigma ; Antitubercular Agents/therapeutic use ; Social Determinants of Health ; }, abstract = {ObjectivesTo address the challenges of tuberculosis (TB) control in the United States post-COVID-19, focusing on high-risk populations, current diagnostic and treatment strategies, and the importance of addressing clinical and social determinants of health to achieve TB elimination goals.MethodsA review of the latest evidence-based guidelines and literature on TB diagnostics, treatment regimens, and latent TB infection (LTBI) management was conducted. Key public health challenges and interventions targeting socioeconomic disparities, stigma, and healthcare access among high-risk populations were analyzed.ResultsHigh-risk groups, including immigrants and ethnic minorities, continue to bear a disproportionate burden of TB due to socioeconomic disparities and comorbidities. Advancements in diagnostic modalities and treatment regimens offer promising outcomes, but gaps remain in LTBI screening and management. Addressing social determinants, such as healthcare access and stigma, is essential for enhancing TB control efforts.DiscussionEffective TB elimination requires collaborative efforts among healthcare professionals, policymakers, and communities to implement evidence-based strategies. Prioritizing both clinical precision and social interventions is critical for overcoming barriers and achieving national TB control and elimination goals.}, }
@article {pmid41662535, year = {2026}, author = {Valabhji, J}, title = {Banting memorial lecture 2025: Aligning clinical practice, policy and research.}, journal = {Diabetic medicine : a journal of the British Diabetic Association}, volume = {43}, number = {6}, pages = {e70245}, pmid = {41662535}, issn = {1464-5491}, mesh = {Humans ; *Diabetes Mellitus, Type 2/therapy/epidemiology/prevention & control ; *Health Policy ; *COVID-19/epidemiology ; State Medicine/organization & administration ; England/epidemiology ; SARS-CoV-2 ; *Biomedical Research ; }, abstract = {National clinical leadership, on a background of clinical practice and clinical research, provides unique perspectives. I have focused the Banting Memorial Lecture 2025 on the implementation of national programmes across England since 2013, for which, along with colleagues at NHS England, I successfully made the case for investment, led the implementation of interventions applied at scale across the country and used routinely collected healthcare data to demonstrate clinical effectiveness in the real world. Through specific examples of implemented programmes, including the NHS Diabetes Prevention Programme and the NHS Type 2 Diabetes Path to Remission Programme, I highlight important fundamental principles when making the case for, and implementing, national policy. First, ensure granular data collection to support evaluation and exploit data linkages to harness the power of real-world datasets. Second, where good evidence exists, implement evidence-based policy; where good evidence does not exist but political pressures to implement are being brought to bear, pilot and evaluate. Third, when the opportunity arises, rapidly translate new high-quality evidence into policy and practice. And fourth, support and protect the workload of healthcare professionals, particularly of those working in primary care. Then, through an epidemiological lens, I highlight: how the COVID-19 pandemic further unlocked the potential of national routinely collected electronic healthcare datasets; how, through application of these datasets, it has been possible to demonstrate improvements in diabetes complications and mortality through routine care delivery; and how it has been possible to demonstrate the next epidemiological transition in the global diabetes epidemic to multimorbidity/multiple long-term conditions.}, }
@article {pmid41662710, year = {2026}, author = {Sommer, I and Dobrescu, A and Gadinger, A and Sharifan, A and Pinte, L and Fangmeyer, M and Klerings, I and Gartlehner, G}, title = {Outpatient Treatment of Confirmed COVID-19: A Living, Rapid Review for the American College of Physicians (Version 3).}, journal = {Annals of internal medicine}, volume = {179}, number = {4}, pages = {524-534}, doi = {10.7326/ANNALS-25-03691}, pmid = {41662710}, issn = {1539-3704}, mesh = {Humans ; *Antiviral Agents/therapeutic use/adverse effects ; COVID-19 ; SARS-CoV-2 ; *Ambulatory Care ; *COVID-19 Drug Treatment ; Pandemics ; Betacoronavirus ; *Coronavirus Infections/drug therapy ; }, abstract = {BACKGROUND: Clinicians and patients need updated information on antiviral treatments for COVID-19.
PURPOSE: To provide a final update on the benefits and harms of COVID-19 antiviral treatments in adult outpatients.
DATA SOURCES: Ovid/MEDLINE, Epistemonikos COVID-19 L·OVE platform, and iSearch COVID-19 portfolio (22 January 2025); Ovid/MEDLINE (24 September 2025).
STUDY SELECTION: Two reviewers screened 20% of abstracts and full texts, then single screening. Randomized controlled trials were included for benefits and harms, and cohort studies were included for harms.
DATA EXTRACTION: One reviewer extracted data and assessed risk of bias and certainty of evidence (CoE); a second reviewer verified.
DATA SYNTHESIS: Seven studies from the Omicron period were included. 125 mg of ensitrelvir may not reduce time to recovery and may result in no difference in serious adverse events (both low CoE) but may increase adverse events (44.2% vs. 24.8%; low CoE). Molnupiravir probably improves recovery (31.8% vs. 22.6%) and reduces time to recovery (9 vs. 15 median days) and persistent symptoms from 3 to 6 months (8.5% vs. 11.0%), with no effect on mortality, hospitalization, serious adverse events, and adverse events (all moderate CoE). Nirmatrelvir-ritonavir may increase recovery (70.7% vs. 53.6%; low CoE) and reduce time to recovery (no data, P = 0.011; low CoE) but probably increases adverse events (1.3% vs. 1.0%; moderate CoE). Simnotrelvir-ritonavir reduces time to recovery (-35.8 median hours; high CoE) and probably increases adverse events (28.9% vs. 21.6%; moderate CoE). There was no difference in recovery between molnupiravir and favipiravir (high CoE) and nirmatrelvir-ritonavir and molnupiravir (low CoE).
LIMITATION: Evidence for many outcomes is limited.
CONCLUSION: Three COVID-19 antivirals improved or accelerated recovery, with varying adverse event profiles. Molnupiravir probably offers long-term benefits.
PRIMARY FUNDING SOURCE: American College of Physicians. (PROSPERO: CRD420251029146; OSF: https://osf.io/ywp6u).}, }
@article {pmid41662713, year = {2026}, author = {Qaseem, A and Obley, AJ and Yost, J and Abraham, GM and Andrews, RA and Jokela, JA and Miller, MC and Humphrey, LL and , and Haeme, R and Krain, A and Poonacha, T and Saini, SD and Wilt, TJ and Carroll, K and Etxeandia-Ikobaltzeta, I and Harrod, CS and Shamliyan, T and Vigna, C}, title = {Outpatient Treatment of Confirmed COVID-19 in Symptomatic Adults: Living, Rapid Practice Points From the American College of Physicians (Version 3).}, journal = {Annals of internal medicine}, volume = {179}, number = {4}, pages = {559-563}, doi = {10.7326/ANNALS-25-03766}, pmid = {41662713}, issn = {1539-3704}, mesh = {Humans ; *Antiviral Agents/therapeutic use ; COVID-19 ; *Ambulatory Care ; SARS-CoV-2 ; *COVID-19 Drug Treatment ; *Pneumonia, Viral/drug therapy ; Pandemics ; Adult ; *Coronavirus Infections/drug therapy ; Betacoronavirus ; United States ; }, abstract = {DESCRIPTION: The American College of Physicians (ACP) maintains living, rapid practice points on antiviral treatment in the outpatient setting for COVID-19.
METHODS: The Population Health and Medical Science Committee (PHMSC) developed this version 3 based on evidence from a focused update of a living, rapid review conducted by the ACP Center for Evidence Reviews at Cochrane Austria. This version addresses the SARS-CoV-2 Omicron variant and reaffirms previous practice points on the use of antiviral treatments of confirmed COVID-19 in unvaccinated or vaccinated and symptomatic patients in the outpatient setting.
PRACTICE POINT 1: Consider nirmatrelvir-ritonavir combination therapy to treat symptomatic patients with confirmed mild to moderate COVID-19 in the outpatient setting who are within 5 days of the onset of symptoms and at a high risk for progressing to severe disease.
PRACTICE POINT 2: Consider molnupiravir to treat symptomatic patients with confirmed mild to moderate COVID-19 in the outpatient setting who are within 5 days of the onset of symptoms and at a high risk for progressing to severe disease.
PRACTICE POINT 3: Do not use ivermectin to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting.
PRACTICE POINT 4: Do not use sotrovimab to treat patients with confirmed mild to moderate COVID-19 in the outpatient setting.
RETIREMENT FROM LIVING STATUS: The PHMSC is retiring this topic from living status considering that this update and previous surveillance have not yielded important changes to the practice points.}, }
@article {pmid41663803, year = {2026}, author = {Karimi, F and Rajaie, S and Azari, S and Abbaszadeh, MS and Karimi, Z}, title = {Economic evaluation of direct oral anticoagulants (DOACs) for venous thromboembolism with different etiologies: a systematic review.}, journal = {Health economics review}, volume = {16}, number = {1}, pages = {}, pmid = {41663803}, issn = {2191-1991}, abstract = {BACKGROUND: Venous thromboembolism (VTE) imposes significant clinical and economic burdens. While direct oral anticoagulants (DOACs) offer favorable efficacy and safety, their cost-effectiveness across diverse VTE etiologies remains incompletely synthesized. OBJECTIVE: To systematically evaluate the cost-effectiveness of DOACs versus comparators for VTE management stratified by etiology. METHODS: A PRISMA-compliant systematic search was conducted in MEDLINE, Web of Science, Scopus, and NHS EED (2020–2025). Economic evaluations reporting cost-effectiveness or cost-utility outcomes were included. Study quality was assessed using the Drummond checklist. RESULTS: Twenty studies were included (9 CAT, 3 post-surgical, 6 hospitalized VTE, 2 COVID-19). DOACs were cost-effective or dominant in 18/20 studies. For cancer-associated thrombosis (CAT), DOACs dominated LMWHs and were cost-effective versus placebo (ICERs: $5,794–$11,947/QALY). DOACs were also dominant for post-surgical prophylaxis and in general hospitalized VTE (ICERs: -$1,862/QALY to $125.68/QALY), while rivaroxaban was cost-effective for post-COVID-19 prophylaxis (ICER: $5,386/QALY). CONCLUSION: DOACs, particularly apixaban and rivaroxaban, are an economically dominant strategy for VTE across most etiologies. Their adoption as a first-line therapy can improve patient outcomes while significantly reducing healthcare costs.}, }
@article {pmid41665282, year = {2026}, author = {Oda, M and Yoshimori, Y and Yamada, T and Amagasa, S and Fukuda, Y}, title = {Health of teleworkers: a scoping review on the assessment of the work-from-home environment.}, journal = {Journal of occupational health}, volume = {68}, number = {1}, pages = {}, pmid = {41665282}, issn = {1348-9585}, mesh = {Humans ; Working Conditions ; *Teleworking ; *Occupational Health ; COVID-19/epidemiology ; SARS-CoV-2 ; Workplace ; }, abstract = {OBJECTIVES: Inappropriate telework environments, including work-from-home (WFH) settings, have been linked to physical and mental health problems. However, no systematic assessment has been conducted regarding the WFH environment (WFH-E). The aim of this study was to clarify the current methods used to assess the WFH-E and its association with health- and work-related outcomes through a scoping review.
METHODS: We searched PubMed, Web of Science, and Ichushi for literature published since 2010 on WFH-E assessment. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines, assessment methods were summarized using 18 items categorized into 9 domains. Additionally, associations between the WFH-E and health- and work-related outcomes were reviewed.
RESULTS: Of 1669 articles collected, 37 studies published from 2020 were ultimately included in this review. Thirty-four articles involved subjective assessments, and 9 involved objective assessments. The most frequently assessed item was artificial lighting, followed by thermal conditions and noise. Items such as color, greenery, building materials, and odor were rarely assessed. Most studies showed significant associations between the WFH-E and health- and work-related outcomes.
CONCLUSIONS: Studies on the WFH-E increased following the COVID-19 pandemic, showing significant associations between the WFH-E and health- and work-related outcomes. However, most assessments were subjective, with objective assessments remaining rare. Additionally, the assessment items were limited and biased, indicating that interior design elements were insufficiently assessed. Developing additional objective and comprehensive methods for assessing the WFH-E is needed.}, }
@article {pmid41665459, year = {2026}, author = {Gomez Rial, J and Redondo, E and Rivero-Calle, I and Mascarós, E and Ocaña, D and Jimeno, I and Gil, Á and Linares, M and Onieva-García, MÁ and González-Romo, F and Yuste, J and Martinón-Torres, F}, title = {Immunofitness in the elderly: The role of vaccination in promoting healthy aging.}, journal = {Human vaccines & immunotherapeutics}, volume = {22}, number = {1}, pages = {2624234}, pmid = {41665459}, issn = {2164-554X}, mesh = {Humans ; *Vaccination/methods ; *Immunosenescence/immunology ; *Healthy Aging/immunology ; Aged ; Trained Immunity ; COVID-19 Vaccines/immunology/administration & dosage ; Pneumococcal Vaccines/immunology/administration & dosage ; Influenza Vaccines/immunology ; *Aging/immunology ; Herpes Zoster Vaccine/immunology ; Adjuvants, Immunologic/administration & dosage ; Vaccines/immunology ; COVID-19/prevention & control/immunology ; Respiratory Syncytial Virus Vaccines/immunology ; }, abstract = {Aging reshapes immunity through immunosenescence and inflammaging, increasing susceptibility to infection, exacerbating chronic conditions, and blunting vaccine responses. This review frames "immunofitness" as a practical goal of healthy aging and examines how adult vaccination builds immune resilience. Vaccination strengthens adaptive memory, leverages adjuvants to optimize antigen presentation, and can reprogramme innate cells (trained immunity), yielding heterologous benefits beyond target pathogens. We integrate evidence in older adults for influenza, respiratory syncytial virus, pneumococcal, COVID-19, and recombinant zoster vaccines, including reductions in respiratory events, cardiovascular outcomes, hospitalization, and mortality. We highlight emerging platforms and precision vaccinology to tailor schedules by immune age, comorbidity, and frailty. Integrating routine, age-appropriate vaccination with lifestyle measures is a feasible, high-impact strategy to promote immunofitness.}, }
@article {pmid41665756, year = {2026}, author = {Karaçam, Z and Ofei, P and Uzunoğlu, G and Güneş Öztürk, G}, title = {The effect of prenatal education on the fear of childbirth: A systematic review and meta-analysis.}, journal = {Archives of women's mental health}, volume = {29}, number = {1}, pages = {37}, pmid = {41665756}, issn = {1435-1102}, mesh = {Humans ; Female ; *Fear/psychology ; Pregnancy ; *Prenatal Education/methods ; *Parturition/psychology ; *Pregnant People/psychology ; COVID-19/epidemiology ; *Prenatal Care ; *Delivery, Obstetric/psychology ; Postpartum Period ; }, abstract = {PURPOSE: To evaluate the effect of prenatal education on the fear of childbirth among pregnant women based on previously conducted studies.
METHODS: A systematic review and meta-analysis of randomized controlled trials and quasi-experimental studies was conducted following the PRISMA guidelines. The data were pooled through meta-analysis. ROBINS-I and RoB2 were used to assess the quality of the studies. The GRADE approach was used for evaluating the certainty of evidence.
RESULTS: The meta-analysis included 28 studies and the total sample size of the studies was 3073. The results showed that statistically, prenatal education significantly reduced the fear of childbirth during both the antepartum and postpartum period (SMD: -1.12, z = 9.14, p < 0.001; MD: -24.35, z = 6.18, p < 0.001 respectively). The meta-regression performed indicated that the study design, the course of the COVID-19 pandemic, data collection tools, the countries of the studies and features of education had no effect on the results of fear of childbirth in pregnancy. Moreover, the meta-analyses showed that prenatal education increased the likelihood of vaginal birth and the preference for vaginal birth approximately by two times and three times respectively (OR: 2.00, z = 4.82, p < 0.001; OR: 2.87, z = 3.89, p = 0.001 respectively). The certainty of evidence was low for fear of childbirth during pregnancy, moderate for fear of childbirth in the postpartum period and high for vaginal birth and preference for vaginal birth.
CONCLUSION: This study revealed that prenatal education was effective for reducing the fear of childbirth and therefore, increasing vaginal births.
REGISTRATION NUMBER: CCRD42022378547.}, }
@article {pmid41666787, year = {2026}, author = {Cao, Q and Du, S and Yang, K and Liu, M and Xiao, L and Wang, Q and Fu, J and Zhu, H}, title = {Assessing the impact of SARS-CoV-2 infection and vaccination on fertility and assisted reproductive techniques outcomes: an umbrella review.}, journal = {Vaccine}, volume = {76}, number = {}, pages = {128293}, doi = {10.1016/j.vaccine.2026.128293}, pmid = {41666787}, issn = {1873-2518}, mesh = {Humans ; *COVID-19/prevention & control/complications ; Male ; Female ; *Fertility ; Pregnancy ; *Reproductive Techniques, Assisted/statistics & numerical data ; *COVID-19 Vaccines/adverse effects/administration & dosage ; *Vaccination/adverse effects ; SARS-CoV-2 ; Semen Analysis ; Sperm Count ; Sperm Motility ; }, abstract = {OBJECTIVE: To assess the impact of SARS-CoV-2 infection and vaccination on fertility and assisted reproductive technology (ART) outcomes.
STUDY DESIGN: This is an Umbrella Review of Meta-analyses. We searched major databases until December 30, 2023. The quality of evidence was assessed by a Measurement Tool to Assess Systematic Reviews and the Grading of Recommendations, Assessment, Development and Evaluation.
RESULTS: Of 647 studies identified, 14 studies with 40 outcomes were included. COVID-19 infection may decrease semen quality in men, including semen volume (WMD, -0.48 ml; 95% CI, -0.59 to -0.36 ml), total sperm count (WMD, -34.84 × 10^6; 95% CI, -43.51 to -26.17 × 10^6), sperm concentration (WMD, -16.23 × 10^6/ml; 95% CI, -25.56 × 10^6 to -6.89 × 10^6), viability (SMD, -0.66; 95% CI, -1.27 to -0.06), and total sperm motility (SMD, -0.61; 95% CI, -0.96 to -0.25), and elevated levels of estradiol (SMD 0.652; 95% CI, 0.254 to 1.049; p = 0.001) and prolactin (SMD 0.305; 95% CI, 0.045 to 0.566; p = 0.022). However, it did not significantly affect testosterone levels. Notably, even after recovery (over 90 days), sperm concentration and motility remained lower compared to uninfected individuals. Conversely, COVID-19 showed minimal impact on female ovarian reserve (including antral follicle count, AMH) or ART outcomes (including oocyte number and quality, embryo quality, implantation rates, clinical pregnancy rates and miscarriage rates). Vaccination also had minimal effects on both sexes. Evidence quality was generally very low, highlighting the need for high-quality, long-term studies.
CONCLUSION: SARS-CoV-2 infection primarily affects male fertility, leading to reductions in sperm quality, count, and motility. However, female fertility and ART outcomes show little to no impact. COVID-19 vaccination shows minimal impact on fertility and ART outcomes. The quality of evidence is rated as very low to low. High-quality prospective studies with longer follow-up periods are needed.}, }
@article {pmid41666990, year = {2026}, author = {Mahroum, N and Elsalti, A and Alsharif, M and Jabri, A and Ouban, A}, title = {Autoimmunity in the era of immune checkpoint inhibitors: the evolving epidemiology of autoimmune diseases and the possible impact of COVID-19.}, journal = {Autoimmunity reviews}, volume = {25}, number = {3}, pages = {104002}, doi = {10.1016/j.autrev.2026.104002}, pmid = {41666990}, issn = {1873-0183}, mesh = {Humans ; *Immune Checkpoint Inhibitors/adverse effects/therapeutic use ; *Autoimmune Diseases/epidemiology/immunology ; *COVID-19/immunology/epidemiology/complications ; *Autoimmunity/drug effects ; *SARS-CoV-2/immunology ; Female ; *Neoplasms/drug therapy/immunology ; COVID-19 Drug Treatment ; }, abstract = {Immune checkpoint inhibitors (ICIs) have markedly improved the prognosis of previously fatal malignancies, as evidenced by substantial gains in overall and progression-free survival in multiple clinical trials. The mechanism of action of ICIs is based on altering the immune response while the reported side effects display clear autoimmune features. Designated as immune-related adverse events (irAEs) affect nearly every organ system, including the gastrointestinal tract, liver, and thyroid gland, and share features with autoimmune disorders of the same organs. The severity of irAEs ranges from mild to life-threatening reactions. Many cases require systemic corticosteroids, hospitalization, and in many instances the discontinuation of ICI therapy. In this review, we present the history of ICIs, their indications, and the reported irAEs in a systematic manner. We then focus on the autoimmune nature of these side effects, with particular attention to the epidemiology of autoimmune diseases, including their female preponderance in certain age groups. In the final sections, we discuss how irAEs may be altering the epidemiology of autoimmune disease and address the possible effect of COVID-19 as a potential trigger.}, }
@article {pmid41668135, year = {2026}, author = {Mayers, T and Terunuma, Y and Inokuchi, R and Guantai, F and Ring, HZ and Akashi, J}, title = {Barriers and facilitators to healthcare access for refugee, immigrant, and migrant populations during the COVID-19 pandemic: an overview of reviews.}, journal = {BMC health services research}, volume = {26}, number = {1}, pages = {}, pmid = {41668135}, issn = {1472-6963}, mesh = {Humans ; *COVID-19/epidemiology ; *Health Services Accessibility ; *Refugees/statistics & numerical data ; *Emigrants and Immigrants/statistics & numerical data ; *Transients and Migrants/statistics & numerical data ; SARS-CoV-2 ; Pandemics ; }, abstract = {BACKGROUND: Refugee, immigrant, and migrant (RIM) populations experienced unique obstacles to healthcare during the COVID-19 pandemic. Already facing displacement, insecure legal status, and economic instability, RIM populations were further affected by service disruptions, discrimination, and systemic weaknesses. The objective of this overview of reviews was to synthesize evidence on barriers and facilitators to healthcare access for RIM populations during the COVID-19 pandemic. METHODS: This review followed the PRISMA 2020 guidelines and the protocol was registered in PROSPERO (CRD42024552590). Systematic searches of Embase, CINAHL, MEDLINE, PubMed, CENTRAL, Web of Science, and Google Scholar (January 2020 onward) identified systematic reviews addressing healthcare access for RIM during COVID-19. Two reviewers independently screened studies, extracted data, and assessed methodological quality using AMSTAR 2. Narrative synthesis was used to categorize barriers and facilitators into cross-cutting domains following a socio-ecological model framework. RESULTS: Nine systematic reviews (published 2021–2024) met inclusion criteria, encompassing 14–256 primary studies each, and spanning low-, middle-, and high-income settings across the Americas, Europe, Africa, the Middle East, and Asia. Nine interacting domains of barriers and facilitators emerged involving legal constraints, economic concerns, service provision, physical and digital access, trust and confidence, information and communication, cultural and social influences, psychological and perceptual factors, and structural/systemic weaknesses. Common barriers included fear of deportation, exclusion from national health or social protection systems, job and income loss, high direct and indirect costs, service closures, overcrowded housing, discrimination, and misinformation. Facilitators included suspension of exclusionary policies, telemedicine and digital tools, mobile clinics, multilingual and culturally appropriate communication, messaging from trusted clinicians and community leaders, and civil society engagement. CONCLUSIONS: This overview shows that the pandemic both intensified long-standing barriers and prompted innovative solutions for RIM healthcare access. Lessons from the pandemic can help guide future sustainable, inclusive health systems for displaced populations.}, }
@article {pmid41668138, year = {2026}, author = {Parks, OB and Kalavacharla, A and Williams, JV}, title = {Respiratory virus immune response in the aged host.}, journal = {Immunity & ageing : I & A}, volume = {23}, number = {1}, pages = {10}, pmid = {41668138}, issn = {1742-4933}, support = {R21 AI180460/AI/NIAID NIH HHS/United States ; R01 AI085062/AI/NIAID NIH HHS/United States ; F30 HL159915/HL/NHLBI NIH HHS/United States ; HL159915/HL/NHLBI NIH HHS/United States ; AI085062//National Institute of Allergy and Infectious Diseases/ ; T32 GM008208/GM/NIGMS NIH HHS/United States ; }, abstract = {Viruses are a major cause of acute respiratory illness in older adults and pose a substantial burden as the elderly population continues to grow. In the current COVID-19 global health crisis, achieving a better understanding of the aging immune system proves to be an imperative step in preventing and treating respiratory viral infections in older patients. Furthermore, many common respiratory viruses infecting older adults, including human metapneumovirus and parainfluenza virus, do not have licensed vaccines, thereby increasing the risk of severe infection in the aged host. Moreover, given the slowed immune response of older adults, vaccine efficacy for respiratory viruses such as influenza in older adults is minimal, indicating the need to develop more potent vaccines. A better understanding of the aging immune system would allow vaccines to target immunological deficits in the aged host. Three aspects of the aging immune system affect the response to respiratory viruses and vaccines: [1] innate immunity [2], the “inflammaging” hypothesis, and [3] the adaptive immune response. Several innate immune cells (neutrophils, macrophages, dendritic cells, and natural killer cells) as well as adaptive immune cells (T and B lymphocytes) exhibit significant functional impairment in older adults. The inflammaging hypothesis bridges the innate and adaptive arms of the immune system. This review aims to consolidate current knowledge and fill gaps in our understanding of the aged immune response to respiratory viruses.}, }
@article {pmid41668155, year = {2026}, author = {Tiwary, P and Oswal, K and Tzvetkov, NT and Litvinova, O and Atanasov, AG and Varghese, R}, title = {Travel microbiota: a novel frontier in travel medicine exploring microbial shifts across transportation modes.}, journal = {Tropical diseases, travel medicine and vaccines}, volume = {12}, number = {1}, pages = {9}, pmid = {41668155}, issn = {2055-0936}, abstract = {BACKGROUND: 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.
METHODS: 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.
CONCLUSION: 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.}, }
@article {pmid41668172, year = {2026}, author = {Kim, DY and Youn, J and Kang, N and Cho, SI and Ha, IH}, title = {Potential application of brain-gut axis-based treatments in Long COVID and ME/CFS: a case-based systematic review.}, journal = {Journal of translational medicine}, volume = {24}, number = {1}, pages = {}, pmid = {41668172}, issn = {1479-5876}, mesh = {Humans ; *COVID-19/therapy/complications ; *Fatigue Syndrome, Chronic/therapy/physiopathology ; Post-Acute COVID-19 Syndrome ; Electroacupuncture ; *Brain-Gut Axis/physiology ; SARS-CoV-2 ; Adult ; *Brain ; Female ; Male ; Middle Aged ; }, abstract = {BACKGROUND: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and Long COVID share clinical features including persistent fatigue, post-exertional malaise (PEM), and gastrointestinal (GI) dysfunction. Growing evidence implicates brain-gut axis dysregulation, characterized by dysbiosis, neuroinflammation within the central nervous system (CNS), increased intestinal permeability, and microbial translocation in their pathophysiology. However, therapeutic strategies targeting these pathways remain poorly defined.
METHODS: We report a case of post-COVID ME/CFS successfully treated with electroacupuncture (EA)-based deep peroneal nerve stimulation which was employed to potentiate the vagal reflex. Fatigue trajectories were assessed using the Multidimensional Fatigue Inventory over 12 weeks. Based on the case, a systematic review of randomized controlled trials (RCTs) evaluating brain-gut axis-modulating interventions in ME/CFS or Long COVID was conducted.
RESULTS: The patient exhibited a significant reduction in total fatigue, with early improvements in motivation and mental fatigue, and delayed improvement in physical fatigue following transient systemic symptom flares. Across included RCTs (n = 8, 790 participants), four investigated gut microbiome-modulating therapies and four employed nerve stimulation. Synbiotic and herbal interventions demonstrated benefits for fatigue or PEM, accompanied by alterations in specific bacterial populations or CNS metabolisms. Regarding nerve stimulation, transcranial direct current stimulation (tDCS) combined with exercise program improved fatigue, whereas standalone tDCS, auricular or peripheral TENS showed limited efficacy.
CONCLUSION: Brain-gut axis-based interventions may alleviate fatigue in ME/CFS and Long COVID by potentially modulating neuroinflammation, restoring microbiome balance, and improving epithelial barrier function. EA-based vagal stimulation represents a feasible option for patients with severe or treatment-resistant symptoms. Larger mechanistic studies and rigorously designed RCTs are needed to establish therapeutic targets and optimize intervention strategies.}, }
@article {pmid41671715, year = {2026}, author = {Antunez Martinez, OF and Vallejo Bustamante, YI and Varela Zuniga, NO}, title = {Mapping the advanced practice nursing in emergency and intensive care units: A scoping review.}, journal = {International emergency nursing}, volume = {85}, number = {}, pages = {101764}, doi = {10.1016/j.ienj.2026.101764}, pmid = {41671715}, issn = {1878-013X}, mesh = {Humans ; *Advanced Practice Nursing/methods ; *Intensive Care Units/organization & administration ; *Nurse's Role ; *Emergency Service, Hospital/organization & administration ; Clinical Competence ; Leadership ; Nurse Practitioners ; }, abstract = {BACKGROUND: Advanced Practice Nurses (APNs), including Nurse Practitioners and Clinical Nurse Specialists, contribute significantly to quality, efficiency, and leadership in emergency departments (EDs) and intensive care units (ICUs). However, role variability, inconsistent regulation, and limited post-pandemic evidence remain challenges.
PURPOSE: To synthesize recent global evidence on APN roles, competencies, outcomes, and implementation challenges in EDs and ICUs, and identify strategies for effective integration.
METHOD: A scoping review, following Arksey and O'Malley's framework and PRISMA-ScR guidelines, searched six databases. Eligible sources focused on APNs in EDs or ICUs. Two reviewers independently screened, extracted, and synthesized data descriptively and thematically.
FINDINGS: Twenty-five studies were included, showing APNs' main competences as advanced clinical reasoning, procedural skills, leadership, and evidence-based practice. Challenges involved role ambiguity, regulatory gaps, and limited autonomy. Post-COVID-19 developments expanded APN responsibilities but exposed workforce and educational gaps. Solutions proposed included standardized competencies, policy reform, postgraduate education, and interprofessional collaboration.
CONCLUSIONS: APNs enhance outcomes and efficiency in EDs and ICUs, but variability in role definitions limits impact. The current body of evidence surrounding APN practice in ICUs and EDs is primarily based on studies with low levels of evidence. Future implementation should be accompanied by rigorous evaluations to generate robust statistical evidence that supports the transferability of APN-led models.}, }
@article {pmid41672424, year = {2026}, author = {Gracidas, C and Levy, R and Varon, J and Halma, M}, title = {Lactate, Capnia, and Fat Oxidation as Therapeutic Axes for SARS-CoV-2 Spike Protein-Induced Sequelae.}, journal = {Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme}, volume = {58}, number = {3}, pages = {90-102}, doi = {10.1055/a-2794-9646}, pmid = {41672424}, issn = {1439-4286}, mesh = {Humans ; Oxidation-Reduction ; *COVID-19/metabolism ; *Lactic Acid/metabolism ; *Spike Glycoprotein, Coronavirus/metabolism ; Post-Acute COVID-19 Syndrome ; *SARS-CoV-2/metabolism ; *Carbon Dioxide/metabolism ; Lipid Metabolism ; *Fatty Acids/metabolism ; Energy Metabolism ; }, abstract = {Metabolic alterations characterize a large subset of those with post-acute COVID-19 syndrome, and similar symptoms affect those with post-acute COVID-19 vaccination syndrome. These symptoms are characterized by the triumvirate of post-acute COVID-19 (vaccination) syndrome symptoms: post-exertional malaise, fatigue, and cognitive impairment, commonly referred to as brain fog. These symptoms can be recreated through perturbations that disrupt mitochondria, and spike protein has been observed to disrupt mitochondria in vitro, providing mechanistic support for this relationship. Post-acute COVID-19 (vaccination) syndrome patients suffer from a severely decreased lactate threshold and can experience symptoms of overexertion even at low power output. Furthermore, biopsies have revealed disrupted mitochondria, and energetics and physiological studies have shown that lipid oxidation constitutes a significantly reduced fraction of total energy production/consumption in post-acute COVID-19 (vaccination) syndrome patients. This review explores the therapeutic axes of lactate, carbon dioxide, and fatty acid oxidation for resolving the energy production challenges in post-acute COVID-19 (vaccination) syndrome, suggesting interventions that increase the lactate threshold, increase tissue oxygenation (paradoxically through increasing partial pressure of CO2), and increase the rates at which lipids are oxidized relative to carbohydrates. Analogies from the world of exercise science are introduced, comparing post-acute COVID-19 (vaccination) syndrome to an overabundance of fast-twitch muscle fibers, with oxygenation similar to that experienced at high altitude, and presenting as an inverse 'fat adaptation' phenomenon, as observed in endurance athletes, especially those adopting low-carbohydrate diets.}, }
@article {pmid41673122, year = {2026}, author = {Pan, Q and Wang, W and Janssen, HLA and Zhong, Z}, title = {Status and outlook of mRNA therapeutics for viral diseases.}, journal = {EMBO molecular medicine}, volume = {18}, number = {3}, pages = {861-872}, pmid = {41673122}, issn = {1757-4684}, support = {12K0323N//Fonds Wetenschappelijk Onderzoek (FWO)/ ; 91719300//ZonMw (Netherlands Organisation for Health Research and Development)/ ; }, mesh = {Humans ; *Virus Diseases/therapy ; *RNA, Messenger/therapeutic use/genetics ; Animals ; SARS-CoV-2/genetics ; COVID-19/therapy/immunology ; Antiviral Agents/therapeutic use ; }, abstract = {Endemic and emerging viral diseases continue to impose significant health, economic, and societal burdens worldwide. Vaccines and therapeutics represent two key pillars in the fight against these threats. Since the clinical success of mRNA vaccines during the COVID-19 pandemic, mRNA therapeutics have rapidly evolved from a niche innovation into a validated and versatile medical platform. While early efforts focused primarily on vaccine development, recent advances have expanded the scope to antiviral applications of in vitro-transcribed mRNA. Emerging strategies include in vivo expression of neutralizing antibodies for passive immunization, delivery of innate immune effectors such as interferons and antiviral peptides, and programmable CRISPR-based antiviral systems. In parallel, progress in mRNA delivery technologies has enabled clinical translation, although challenges related to stability, specificity, and immunogenicity remain. In this Perspective article, we review recent preclinical and clinical advances in mRNA therapeutics for viral infections. We also highlight key scientific, technical, and regulatory challenges, and propose strategic solutions to address the pressing need for controlling endemic viral diseases and enhancing global pandemic preparedness.}, }
@article {pmid41673927, year = {2026}, author = {Gasmi, M and Torabinasab, K and Williams-Hooker, R and Marsigliante, S and Muscella, A}, title = {The neutrophil-to-lymphocyte ratio as a marker of immunosenescence and COVID-19 outcomes in the elderly: A narrative review.}, journal = {Physiological reports}, volume = {14}, number = {3}, pages = {e70682}, pmid = {41673927}, issn = {2051-817X}, mesh = {Humans ; *Immunosenescence ; *COVID-19/immunology/blood ; *Neutrophils/immunology ; *Lymphocytes/immunology ; Biomarkers/blood ; Aged ; *Aging/immunology ; SARS-CoV-2 ; Lymphopenia/immunology/blood ; }, abstract = {Older adults are highly vulnerable to severe COVID-19. Unlike our previous work on broad immunosenescence, this review focuses on peripheral hematological markers as practical indicators of risk. To examine lymphopenia, neutrophilia, and the neutrophil-to-lymphocyte ratio (NLR) as clinically accessible markers of immune aging and COVID-19 severity in older adults. Literature search of PubMed, Scopus, and Web of Science (up to 2025) for studies on aging, immunosenescence, lymphopenia, neutrophilia, NLR, and COVID-19. These markers consistently correlate with worse COVID-19 outcomes; NLR is a simple, reliable indicator of immune dysregulation, systemic inflammation, and mortality risk. Lymphopenia, neutrophilia, and elevated NLR are low-cost, readily measurable markers associated with COVID-19 severity, highlighting their prognostic value and complementing prior immunosenescence research.}, }
@article {pmid41674460, year = {2026}, author = {McTiernan, K and Hughes, C and Gilheaney, Ó}, title = {Cognitive Communication, Voice and Swallowing Difficulties Experienced by Adults With Long-COVID: A Scoping Review.}, journal = {Health expectations : an international journal of public participation in health care and health policy}, volume = {29}, number = {1}, pages = {e70595}, pmid = {41674460}, issn = {1369-7625}, mesh = {Humans ; *COVID-19/complications ; *Deglutition Disorders/etiology ; Post-Acute COVID-19 Syndrome ; *Voice Disorders/etiology ; SARS-CoV-2 ; Adult ; *Communication Disorders/etiology ; Pandemics ; *Communication ; }, abstract = {BACKGROUND: Adults with Long-COVID frequently experience impairments in cognitive-communication, voice and swallowing, however, few comprehensive reviews of the existing literature has yet to be conducted to map the current research landscape. To go some way toward addressing this gap, this scoping review collected and analysed relevant published studies to identify reported symptoms related to cognitive communication, voice and swallowing in post COVID-19 patients and the assessments used to identify these difficulties.
OBJECTIVE: This study aimed to systematically map the existing literature on cognitive-communication, voice and swallowing difficulties in individuals living with Long-COVID and the assessments used to identify these difficulties.
METHODS: Four databases were searched to identify original research articles aligned with the study's objectives. Studies meeting the inclusion criteria were selected, and the findings were analysed with a specific focus on three key symptom domains: cognitive-communication, voice and swallowing.
RESULTS: Nineteen studies met the inclusion criteria. A broad range of assessments were used, and a broad range of symptoms were identified related to cognitive-communication, voice and swallowing difficulties in patients with Long-COVID-19. The symptoms reported most frequently in the selected studies included memory deficits, incomplete or inefficient glottic closure, paradoxical vocal fold motion during inspiration, episodes of choking, globus sensation, premature spillage and pyriform sinus residue.
CONCLUSION: Despite limited prior research in this area, the findings underscore the significant impact that COVID-19 infection may have on cognitive communication, voice and swallowing functions. Post-COVID-19 patients report a wide array of challenges in these domains. As a result, further clinical research is essential to develop patient-centred care strategies and to equip healthcare professionals with the expertise required for effective management of this group of patients.}, }
@article {pmid41675121, year = {2026}, author = {Elizabeth, L and Shanthi, B and Cherupanakkal, C and Joseph, JJ and Anirudhan, A and Vaidyanathan, K}, title = {Exploring the Interplay Between Micronutrients and Cytokine Storm in Children with Multisystem Inflammatory Syndrome: 'A Potential Mechanical Insight'.}, journal = {Indian journal of clinical biochemistry : IJCB}, volume = {41}, number = {1}, pages = {5-16}, pmid = {41675121}, issn = {0970-1915}, abstract = {Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious condition linked to SARS-CoV-2 infection. MIS-C is characterized by inflammation in several organ systems, including the heart, lungs, kidneys, brain, skin, and eyes. Although MIS-C symptoms can vary widely, typical symptoms include fever, stomach ache, nausea, vomiting, diarrhea, rash, red eyes, and exhaustion. Although the pathogenesis of MIS-C is not yet fully understood, studies have shown that an uncontrolled immunological response known as a "cytokine storm" may play a role in the development of MIS-C. Several studies have related micronutrient deficiencies to chronic immunological activation, increased inflammation, increased cytokine production, and increased chance of developing a persistent viral infection. Studies have shown that children with MIS-C had lower micronutrients, including vitamin D, C, and zinc, than do healthy kids. Deficits in these nutrients, which are crucial for controlling the immunological response, may make the immune system less able to fight off infections and cause MIS-C. In conclusion, research on the connection between MIS-C and micronutrient deficiencies is still in its early stages. Although there is some evidence linking the two, additional research is required to determine a cause and effect.}, }
@article {pmid41675728, year = {2026}, author = {Ahsan, A and Ibrahim, O and Ayesha, M and Hassni, AA and Saif, S and Mahin, FE and Khan, S and Tague, C}, title = {Fusion of molecular mimicry, epigenetic predisposition, and new onset GBS: a narrative review of current understanding and future directions.}, journal = {Annals of medicine and surgery (2012)}, volume = {88}, number = {2}, pages = {1532-1540}, pmid = {41675728}, issn = {2049-0801}, abstract = {Guillain-Barré syndrome (GBS) is a severe immune-driven polyneuropathy marked by the acute onset of flaccid paralysis, areflexia, and in severe cases, life-threatening autonomic or respiratory failure. Although the clinical presentation and diagnostic criteria are widely established, the precise mechanisms underlying GBS are complex and poorly understood. This review summarizes current literature on the interplay of post-infectious triggers, molecular mimicry, and host susceptibility as influenced by genetic and epigenetic variables. Infectious pathogens such as Campylobacter jejuni, cytomegalovirus, Epstein-Barr virus, and, more recently, Zika and SARS-CoV-2 operate as initiators via molecular mimicry, in which pathogen antigens imitate peripheral nerve components, triggering the formation of autoreactive antibody and T-cell responses. Acute inflammatory demyelinating polyneuropathy (AIDP) is characterized by demyelination and inflammatory cytokine responses, whereas acute motor axonal neuropathy (AMAN) is associated with ganglioside-targeting antibodies and axonal loss. Genetic polymorphisms, such as those in HLA, TLR4, MMP9, and CD1A, influence vulnerability to the disease and its progression. Given that many patients experience persistent sensory, motor, and autonomic dysfunction despite treatment, the identification of long-term complications highlights the necessity of customized rehabilitation and long-term follow-up. Traditional therapeutic techniques, such as plasma exchange and intravenous immunoglobulin, remain in use, but current trials on complement inhibitors, antibody-degrading enzymes, and mesenchymal stem cell therapies indicate a move toward mechanism-driven approaches. Despite these advances, significant knowledge gaps remain regarding predictors of poor outcomes and underlying causes of persistent disabilities and complications, highlighting the need for continued translational and clinical research.}, }
@article {pmid41675944, year = {2026}, author = {Madi, M}, title = {Viral Contributions to Periodontal and Peri-implant Disease: A Narrative Review.}, journal = {Saudi journal of medicine & medical sciences}, volume = {14}, number = {1}, pages = {14-22}, pmid = {41675944}, issn = {2321-4856}, abstract = {Periodontal diseases, particularly periodontitis, are chronic inflammation with complex microbial and immunological etiologies. While bacterial pathogens such as Porphyromonas gingivalis are well-known contributors, emerging evidence indicates the role of viruses, especially herpesviruses, in the onset and progression of periodontal tissue destruction. In this review, the interplay between viral infections and periodontal health was explored, with an emphasis on the immunopathological mechanisms in which different viruses such as human herpesvirus, Epstein-Barr virus, and human cytomegalovirus aggravate periodontal tissue destruction. These viruses impair host defenses, promote bacterial colonization, and alter cytokine responses, leading to periodontal tissue damage. The review also addresses the impact of systemic viral infections, such as HIV and COVID-19, on periodontal diseases. Elevation in inflammatory mediators, including interleukin-6, link periodontitis with adverse clinical outcomes in viral infections. Moreover, interactions between P. gingivalis and respiratory viruses suggest oral pathogens may also influence systemic disease severity. Advances in diagnosis using molecular technology have improved viral detection in periodontal tissues, and previous studies support the use of antiviral therapies and gene-targeted interventions as potential adjuncts to traditional periodontal care. The integration of preventive strategies, such as vaccination and enhanced oral hygiene, is crucial in reducing the systemic consequences of viral-periodontal interactions. This review highlights the need for interdisciplinary collaboration and continued research to fully comprehend the virological dimensions of periodontal disease and develop effective, targeted therapeutic approaches.}, }
@article {pmid41677601, year = {2026}, author = {Muir, KC and Harris, DD and Kanuparthy, M and Hu, J and Nho, JW and Stone, C and Banerjee, D and Sellke, FW and Feng, J}, title = {Cellular and Molecular Mechanisms of SARS-CoV-2 Spike Protein-Induced Endothelial Dysfunction.}, journal = {Cells}, volume = {15}, number = {3}, pages = {}, pmid = {41677601}, issn = {2073-4409}, support = {P20GM103652/GF/NIH HHS/United States ; 1R56HL169501-01/GF/NIH HHS/United States ; R01HL179089/GF/NIH HHS/United States ; 1R01HL176640-01/GF/NIH HHS/United States ; T32HL16051703/GF/NIH HHS/United States ; R01HL46716/GF/NIH HHS/United States ; R01HL128831/GF/NIH HHS/United States ; }, mesh = {Humans ; *Spike Glycoprotein, Coronavirus/metabolism ; *COVID-19/virology ; SARS-CoV-2 ; *Endothelium, Vascular/metabolism/pathology/virology/physiopathology ; Angiotensin-Converting Enzyme 2/metabolism ; Animals ; *Betacoronavirus/metabolism ; Endothelial Cells/metabolism/pathology ; Signal Transduction ; }, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is initiated by the viral spike proteins, which are key structural components that mediate host cell binding and entry and alter downstream signaling through multiple interactions with endothelial surface receptors. Endothelial dysfunction is a central consequence of COVID-19, contributing to vascular inflammation, barrier disruption, thrombosis, and multi-organ injury affecting the pulmonary, cardiovascular, cerebral, and renal systems. Emerging evidence demonstrates that spike protein-mediated effects, independent of productive viral infection, disrupt endothelial homeostasis through angiotensin-converting enzyme 2 (ACE2) dysregulation, integrin engagement, altered calcium signaling, junctional protein remodeling, oxidative stress, and pro-inflammatory and pro-apoptotic pathways. This review is intentionally focused on spike (S) protein-driven mechanisms of endothelial dysfunction; pathogenic vascular effects attributed to other SARS-CoV-2 structural proteins, including the nucleocapsid (N) protein, are beyond the scope of this discussion. In this review, we synthesize current experimental and translational data detailing the molecular mechanisms by which the SARS-CoV-2 spike protein drives endothelial dysfunction across multiple organ systems and discuss potential therapeutic strategies aimed at preserving endothelial integrity in acute COVID-19 and its long-term vascular sequela.}, }
@article {pmid41678053, year = {2026}, author = {Lewis, MG and Lone, MA and Chowdhury, OR and Ghosh, P and Talukdar, R and Nair, NS and Das, S and Kanungo, S}, title = {Mortality among Children Aged 1-59 Months in India: Evidence from a Systematic Review and Meta-Analysis (2009-2024).}, journal = {Journal of epidemiology and global health}, volume = {16}, number = {1}, pages = {}, pmid = {41678053}, issn = {2210-6014}, support = {INTR-IG-2024-01-0020//Indian Council of Medical Research/ ; }, mesh = {Humans ; India/epidemiology ; Infant ; Child, Preschool ; *Infant Mortality/trends ; *Child Mortality/trends ; Female ; Cause of Death/trends ; Risk Factors ; *Hospital Mortality/trends ; Male ; }, abstract = {BACKGROUND: Mortality among Indian children aged 1–59 months remains a concern, yet evidence arises from hospital and community settings that reflect different populations and metrics. A setting-specific synthesis is needed to clarify mortality trends, causes, and associated factors. METHODS: We reviewed observational studies (2009–2024) on deaths, causes, or risk factors among children aged 1–59 months. Two reviewers independently extracted data. Hospital and community studies were analyzed separately, using setting-specific mortality definitions. Random-effects GLM models pooled mortality and risk factors. Cause-of-death distributions and trends were synthesized only for hospital studies due to limited community data. FINDINGS: Sixty-seven studies were included: 50 hospital-based, 11 community-based, and six case-control. The pooled in-hospital mortality was 8.1%, with substantial heterogeneity (0.1%-65%); largely reflecting cohorts restricted to critically ill children. Pneumonia (38%), congenital anomalies (32%) and central nervous system infections (23%), accounted for most clinically ascertained deaths. Deaths declined over time (2.4%) particularly during the pre-COVID period; while post-COVID trends were imprecise; a regional decline (3%) was detected only in northern India. Community mortality was highly heterogeneous, with a pooled estimate of 3.3% and data were insufficient for trend analysis. Female sex and lack of immunization were significantly associated with in hospital mortality, while no significant risk factors were identified in community analyses. CONCLUSION: India achieved meaningful reductions in child mortality, although recent trends remain uncertain following the COVID-19 period. Persistent heterogeneity across settings and sex differences in hospital-based mortality underscore the need for strengthened community surveillance and standardized reporting to sustain and accelerate national gains.}, }
@article {pmid41678250, year = {2026}, author = {Lebel, RD and Sanders, J and Menges, JI}, title = {Beyond positivity: A review of the functional outcomes of negative emotions at work.}, journal = {Journal of occupational health psychology}, volume = {31}, number = {1}, pages = {1-15}, doi = {10.1037/ocp0000422}, pmid = {41678250}, issn = {1939-1307}, mesh = {Humans ; *Emotions ; *COVID-19/psychology ; *Workplace/psychology ; SARS-CoV-2 ; }, abstract = {Organizational scholars examining the effects of emotions on employees generally assume that negative emotions produce negative outcomes. However, a nascent body of research challenges this view, suggesting that negative emotions can help employees navigate work demands arising from disruptive external events. We draw on the COVID-19 pandemic-a salient, prolonged event that stimulated widespread negative emotions-as a theoretically meaningful context to explore when and why negative emotions may yield beneficial outcomes. Specifically, we provide an integrative conceptual review synthesizing research from applied and social psychology conducted during the pandemic that identifies two pathways through which negative emotions produce functional individual-level outcomes at work. The first pathway captures direct effects driven by the unique action tendencies associated with discrete negative emotions. The second pathway, informed by the personality systems interaction theory, highlights contingent effects shaped by self-regulatory factors and external support from leaders, teams, or organizational policies. Our findings challenge and extend discrete emotion and affective shift theories by detailing how and under what conditions negative emotions from disruptive events can have functional outcomes. We bring necessary nuance to prevailing emotion theories and offer practical implications for leaders and organizations seeking to manage negative emotions during the times of hardship. (PsycInfo Database Record (c) 2026 APA, all rights reserved).}, }
@article {pmid41678920, year = {2026}, author = {Ogawa, T and Sunyi, J and Kawachi, K and Murakami, J and Masuta, S and Fukuchi, J and Yoshida, S and Sawanobori, K and Matsukura, Y}, title = {Regulatory approaches for platform-based vaccine development in Japan: Insights from PMDA's experience with COVID-19 and RSV vaccines.}, journal = {Vaccine}, volume = {76}, number = {}, pages = {128315}, doi = {10.1016/j.vaccine.2026.128315}, pmid = {41678920}, issn = {1873-2518}, mesh = {Humans ; Japan/epidemiology ; *COVID-19 Vaccines/immunology ; *Vaccine Development/legislation & jurisprudence/methods ; COVID-19/prevention & control ; *Respiratory Syncytial Virus Vaccines/immunology ; *Respiratory Syncytial Virus Infections/prevention & control/immunology ; SARS-CoV-2/immunology ; Vaccines, Synthetic/immunology ; Drug Approval ; Pandemics/prevention & control ; }, abstract = {The concept of a "platform" in vaccine development and regulatory evaluation has emerged as a strategic framework for accelerating responses to infectious disease outbreaks. By leveraging prior knowledge and applying consistent manufacturing and analytical procedures across multiple products-such as mRNA, viral vector and recombinant protein vaccines-platform approaches enable streamlined development and efficient regulatory reviews. This article presents a Japanese regulatory perspective on platform-based vaccine development, drawing on the Pharmaceuticals and Medical Devices Agency (PMDA)'s experience with both emergency and routine evaluations. Through case-based analyses of COVID-19 vaccines reviewed under emergency conditions and the subsequent post-pandemic evaluation of RSV vaccines under standard timelines, we illustrate how prior knowledge and regulatory flexibility supported timely and robust reviews. These insights contribute to the global dialogue on regulatory science and offer practical considerations for future vaccine innovation.}, }
@article {pmid41678951, year = {2026}, author = {Lailaturrahmi, L and Caliph, S and Vu, T and Larson, I}, title = {Teaching clinical skills online in pharmacy education: a scoping review.}, journal = {Currents in pharmacy teaching & learning}, volume = {18}, number = {5}, pages = {102607}, doi = {10.1016/j.cptl.2026.102607}, pmid = {41678951}, issn = {1877-1300}, mesh = {Humans ; *Education, Pharmacy/methods ; *Clinical Competence/standards ; *Education, Distance/methods ; Curriculum/trends ; Teaching ; }, abstract = {Background The integration of online teaching and learning in pharmacy curricula has increased since the worldwide rapid transition to remote teaching during the COVID-19 pandemic. However, how clinical skills were taught online in pharmacy education, including the types of skills, approaches and technologies used, and the outcomes remain poorly understood. Objective To provide an overview of the types of clinical skills taught online in pharmacy education; and to identify the purposes, teaching strategies, technologies used, educational settings, enabling and limiting factors, and reported outcomes to inform future curriculum development in pharmacy education. Methods The scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) Scoping Review methodology. A systematic literature search was conducted in MEDLINE, CINAHL, and ERIC databases using predefined inclusion and exclusion criteria, and the records were independently screened by four reviewers. Any discrepancies during the screening process were resolved through discussion. The data were extracted and then analyzed using content analysis and thematic analysis. Results A total of 349 studies were retrieved and proceeded to title and abstract screening. After applying the inclusion and exclusion criteria, 152 full-text articles were assessed for eligibility, of which sixty-four articles were included in the final review. Online synchronous, asynchronous, and blended learning were implemented in pharmacy education to teach clinical skills, including communication skills and therapeutic decision-making skills. Clinical skills were most often taught online to improve the learning process. Learning outcomes measured by self-assessment or by educators were most commonly reported. Enablers, including institutional readiness and technology infrastructure, and barriers, including institutional unpreparedness and inadequate design, were also identified. Conclusion This scoping review provides guiding information to integrate online teaching and learning into pharmacy curricula, particularly for clinical skills development. By including multiple stakeholders' perspectives, this review offers useful insight for academics and faculty leaders to successfully teach clinical skills online to pharmacy students.}, }
@article {pmid41681438, year = {2026}, author = {Ibrahim, YM and Liu, C and Yu, Y and Yang, L and Chen, Q and Ma, W and Werid, GM and Li, S and Luo, J and Gao, S and Zhang, S and Fu, L and Wang, Y}, title = {Swine Enteric Coronaviruses: An Updated Overview of Epidemiology, Diagnosis, Prevention, and Control.}, journal = {Animals : an open access journal from MDPI}, volume = {16}, number = {3}, pages = {}, pmid = {41681438}, issn = {2076-2615}, support = {(cstc2022ycjh-bgzxm0183 and 22509C) and (2024YFHZ0110)//this work was supported by grants from the National Center of Technology Innovation for Pigs (NCTIP-XD/B19); the Chongqing Talent plan "contract system" project (cstc2022ycjh-bgzxm0183 and 22509C); the Sichuan Provincial Regional Innovation Cooperation Pr/ ; }, abstract = {Swine enteric coronaviruses (SECoVs), including transmissible gastroenteritis virus (TGEV), porcine epidemic diarrhea virus (PEDV), porcine deltacoronavirus (PDCoV), and swine acute diarrhea syndrome coronavirus (SADS-CoV), are major enteric pathogens causing severe diarrhea, dehydration, high neonatal mortality, and substantial global economic losses. Rapid viral evolution and recombination continually generate antigenically diverse variants that limit cross-protection and undermine vaccine efficacy, particularly for PEDV genogroup II strains that now dominate worldwide circulation. This review synthesizes current knowledge on epidemiology, diagnostic innovations, and emerging vaccine platforms, with emphasis on advances since 2022. Recent progress includes molecular surveillance tools, rapid point-of-care diagnostics, and next-generation vaccine technologies such as mRNA-based and virus-like particle platforms. However, significant knowledge gaps persist regarding viral evolution dynamics, co-infection synergies, and zoonotic spillover potential, particularly following documented human infections with PDCoV. Effective long-term control requires integrated genomic surveillance, strengthened farm-level biosecurity, rationally designed multivalent vaccines targeting conserved epitopes, and harmonized international surveillance systems to reduce outbreak risk and enhance pandemic preparedness at the human-animal interface.}, }
@article {pmid41682696, year = {2026}, author = {Grosu, IA and Dobrin, ME and Marginean, C and Esanu, IM and Melinte, OE and Stavarache, IE and Dumitrache-Rujinski, S and Cioroiu, IB and Crisan-Dabija, RA and Vicol, C and Trofor, AC}, title = {Integrated Approach of Hematological Parameters and Glutathione as Predictors of Pulmonary TB Evolution: A Comprehensive Review.}, journal = {Journal of clinical medicine}, volume = {15}, number = {3}, pages = {}, pmid = {41682696}, issn = {2077-0383}, abstract = {In recent decades, the burden of TB has been gradually declining; however, with the emergence of COVID-19 and ongoing political conflicts, including the war in Ukraine, the proper functioning of healthcare services and TB control programs has been jeopardized. Recently, research has emphasized the importance of hematological parameters associated with inflammation, which can be easily analyzed through routine blood tests. Combining these parameters may have predictive value for various diseases, including pulmonary tuberculosis and even help monitor the effectiveness of treatment. Since there is no single hematological or inflammatory biomarker that provides precise and dynamic information about the success or failure of treatment, identifying individual markers or sets of biomarkers with higher sensitivity and specificity is essential. This is particularly important since sputum culture conversion at two months remains insufficiently sensitive and microscopy conversion has limited sensitivity and specificity in detecting treatment failure. Also, the analysis of the impact of the standard directly observed treatment, short-course regimen on pathogenic mechanisms also focuses on how it influences the interaction between inflammation and oxidative tissue degradation, by measuring plasma levels of glutathione. Utilizing a combination of hematological, inflammatory, and antioxidant biomarkers offers significant insights into systemic inflammatory responses in pulmonary tuberculosis patients, both before commencing treatment and during the entire duration of antituberculosis therapy. Combining different inflammatory parameters into a multiple biomarker can significantly enhance the accuracy of predicting prognosis and response to antibiotic chemotherapy. Identifying an optimal combination of biomarkers with predictive value is crucial for assessing treatment response and evaluating the effectiveness of anti-TB medication. Rather than developing or testing a composite prediction model, this review summarizes reported performance metrics from individual studies and highlights priorities for future prospective validation of integrated biomarker panels.}, }
@article {pmid41682807, year = {2026}, author = {Carlini, F and Chiesa, AM and Verzina, M and Sassetti, C and Rigante, D and Esposito, S}, title = {Cutaneous Clues in Kawasaki Disease: Clinical Implications and Differential Diagnosis with Multisystem Inflammatory Syndrome in Children.}, journal = {Journal of clinical medicine}, volume = {15}, number = {3}, pages = {}, pmid = {41682807}, issn = {2077-0383}, abstract = {Kawasaki disease (KD) and multisystem inflammatory syndrome in children (MIS-C) are pediatric inflammatory conditions with overlapping mucocutaneous features that may complicate early diagnosis. We performed a narrative review of the literature to characterize and compare cutaneous manifestations reported in children with KD and MIS-C and to assess their diagnostic relevance. Published studies describing dermatologic findings in patients aged 0-18 years were reviewed. The analysis revealed a broad heterogeneity of skin manifestations in both conditions, ranging from classic polymorphous rash and acral erythema to atypical presentations, including annular, psoriasiform, vesiculobullous, urticarial, and erythema nodosum-like lesions. Reactivation at Bacillus Calmette-Guérin vaccination sites and associated mucocutaneous findings, such as conjunctivitis and oral changes, emerged as supportive diagnostic clues, particularly for incomplete KD. Considerable overlap in cutaneous phenotypes between KD and MIS-C was observed, especially in patients with persistent fever and systemic inflammation, highlighting the risk of diagnostic delay. These findings underscore the importance of recognizing atypical dermatologic patterns as part of an integrated diagnostic approach, as delayed identification may increase the risk of cardiovascular complications. Early recognition of cutaneous clues can support timely initiation of immunomodulatory therapy and improve clinical outcomes.}, }
@article {pmid41683451, year = {2026}, author = {Wang, J and Xu, Y and Yang, Y and Zhang, B and Chen, S and Li, Z and Zhu, H and Yang, H and Wang, H and Zhou, Y and Cao, P and Zhai, B and Gong, Y}, title = {Structural Basis and Inhibitor Development of SARS-CoV-2 Papain-like Protease.}, journal = {Molecules (Basel, Switzerland)}, volume = {31}, number = {3}, pages = {}, pmid = {41683451}, issn = {1420-3049}, support = {KZ202210005001//R&D Program of Beijing Municipal Education Commission/ ; 242102311178//Science and technology project of Henan Province/ ; 252102520079//Henan Provincial International Science and Technology Cooperation Project/ ; }, mesh = {*SARS-CoV-2/enzymology/drug effects ; Humans ; *Antiviral Agents/chemistry/pharmacology ; Ligands ; *Protease Inhibitors/chemistry/pharmacology ; Binding Sites ; Models, Molecular ; *Coronavirus 3C Proteases/chemistry/antagonists & inhibitors/metabolism ; *Viral Nonstructural Proteins/antagonists & inhibitors/chemistry/metabolism ; COVID-19 Drug Treatment ; Catalytic Domain ; Coronavirus Papain-Like Proteases ; }, abstract = {Papain-like protease (PLpro), a crucial functional domain of the SARS-CoV-2 non-structural protein 3 (nsp3), plays a dual role in both hydrolyzing viral polyprotein precursors and modulating host immune responses. These critical functions position PLpro as a key target in the ongoing development of antiviral therapies for SARS-CoV-2. This review analyzes more than 100 PLpro-ligand co-crystal structures and summarizes the major binding modes between these ligands and PLpro. Most of these ligands bind to sites analogous to those targeted by the classical non-covalent inhibitor GRL0617, primarily involving the P3 and P4 subsites and the BL2 loop. Based on these structural insights, optimized inhibitors have expanded targeting beyond the canonical binding site to auxiliary regions such as the BL2 groove and the Val70 site, and in some cases toward the catalytic Cys111 buried within a narrow pocket. Certain ligands identified through various screening approaches bind to non-canonical or allosteric regions, such as the S1 and S2 sites or the zinc-finger domain, engaging PLpro through distinct interaction modes and thereby offering additional opportunities for PLpro inhibitor design. The review also discusses potential strategies for future PLpro inhibitor development informed by recent structural advances. Taken together, these structural and functional insights support ongoing efforts in the structure-guided design and optimization of PLpro inhibitors.}, }
@article {pmid41683516, year = {2026}, author = {Leka, K and Mamede, L and Vandeberg, E and Garigliany, MM and Ledoux, A}, title = {Natural Alkaloids as Antiviral Agents Against RNA Viruses: A Comprehensive and Mechanistic Review.}, journal = {Molecules (Basel, Switzerland)}, volume = {31}, number = {3}, pages = {}, pmid = {41683516}, issn = {1420-3049}, support = {40009257//Fund for Scientific Research/ ; 40021286//Fund for Scientific Research/ ; }, mesh = {*Antiviral Agents/pharmacology/chemistry/therapeutic use ; Humans ; *Alkaloids/pharmacology/chemistry/therapeutic use ; *RNA Viruses/drug effects ; Animals ; Virus Replication/drug effects ; *RNA Virus Infections/drug therapy/virology ; SARS-CoV-2/drug effects ; *Biological Products/pharmacology/chemistry ; }, abstract = {RNA viruses pose a persistent global threat due to their high mutation rates, zoonotic potential, and rapid adaptability. Emergence events have risen steadily, as demonstrated by major outbreaks caused by Influenza A, Ebola, Zika, and Chikungunya viruses, followed by the coronavirus epidemics of Severe Acute Respiratory Syndrome coronavirus (SARS-CoV-1) and Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and culminating in the COVID-19 pandemic. These characteristics frequently compromise the durability of existing vaccines and antiviral therapies, highlighting the urgent need for new antiviral agents. Alkaloids, a structurally diverse class of nitrogen-containing natural compounds, have gained attention for their ability to interfere with multiple stages of the viral life cycle, including entry, replication, protein synthesis, and host immune modulation. To our knowledge, this review compiles all currently reported alkaloids with antiviral activity against RNA viruses and summarizes their proposed mechanisms of action, distinguishing evidence from in vitro, in vivo, and in silico studies. Quaternary alkaloids are discussed separately because their permanent ionic charge enables distinctive interactions with membranes and host pathways. Although many findings are promising, clinical translation remains limited by incomplete mechanistic validation, scarce in vivo data, suboptimal bioavailability, narrow therapeutic windows, and inconsistent experimental methodologies. To advance the field, future research should prioritize RT-qPCR-based antiviral evaluation to accurately quantify viral replication, incorporate mechanistic assays to clarify modes of action, apply structure-activity relationship (SAR) approaches for rational optimization, and expand in vivo pharmacokinetic and efficacy studies to assess therapeutic feasibility. Overall, alkaloids represent a promising yet underdeveloped reservoir for next-generation antiviral discovery against rapidly evolving RNA viruses.}, }
@article {pmid41683812, year = {2026}, author = {Mahajan, S and Mahajan, S and Gusain, A}, title = {Interleukins in COVID-19 and SARS-CoV-2 Variants: Immunopathogenesis, Therapeutic Perspectives and Vaccine-Induced Immune Responses.}, journal = {International journal of molecular sciences}, volume = {27}, number = {3}, pages = {}, pmid = {41683812}, issn = {1422-0067}, mesh = {Humans ; *COVID-19/immunology/pathology/therapy/virology ; *SARS-CoV-2/immunology ; *Interleukins/immunology/metabolism ; *COVID-19 Vaccines/immunology ; }, abstract = {The Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is characterized by profound immune dysregulation where interleukins play a central role in determining disease severity and response to interventions. This review summarizes the role of interleukins in the immunopathogenesis of COVID-19, with particular emphasis on differences observed across major SARS-CoV-2 variants. Pro-inflammatory interleukins like IL-1β, IL-6, IL-2, IL-17 and IL-18 are critically involved in cytokine storm, hyperinflammation, and acute respiratory distress syndrome, whereas anti-inflammatory cytokines like IL-10 contribute to immune regulation and resolution of inflammation. Elevated levels of IL-1α, IL-1β, IL-4, IL-8, IL-9, IL-16, IL-18 have been documented in the Delta variant as compared with the Omicron variant, with IL-6 being the most frequent interleukin reported to be increased across all SARS-CoV-2 variants relative to the ancestral Wuhan strain. Elevated IL-2, IL-4, IL-6, and IL-10 levels have been associated with Omicron sub-variants. The review encompasses interleukin-based therapeutic strategies, where several IL-1 and IL-6 inhibitors were studied across clinical trials, but only tocilizumab has shown some promise against severe COVID-19. IL-2, IL-6, IL-15 and IL-21 levels were positively correlated with IgG and neutralizing antibody activity after vaccination with longevity of post-vaccination immunity being determined by IL-2 and IL-7.}, }
@article {pmid41683839, year = {2026}, author = {Chen, JJ and Hsu, CW and Wang, HY and Stubbs, B and Chen, TY and Liang, CS and Chen, YW and Zeng, BS and Tseng, PT}, title = {Audiovestibular Dysfunction Related to Long COVID-19 Syndrome: A Systematic Review of Characteristics, Pathophysiology, Diagnosis, and Management.}, journal = {International journal of molecular sciences}, volume = {27}, number = {3}, pages = {}, pmid = {41683839}, issn = {1422-0067}, mesh = {Humans ; *COVID-19/complications/physiopathology ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2/isolation & purification ; *Vestibular Diseases/diagnosis/therapy/etiology/physiopathology ; }, abstract = {Long COVID-19 syndrome (or so-called post-COVID-19) is indicated by miscellaneous symptoms, usually starting 3 months from the COVID-19 infection and lasting for at least 2 months, which cannot be explained by an alternative diagnosis. There has been more and more reports addressing the audiovestibular dysfunction related to long COVID-19 syndrome. Emerging evidence suggests that the linkage between audiovestibular dysfunction and long COVID-19 syndrome might rely on (a) direct inner ear system damage related to viral invasion and consequent inflammation, (b) micro thromboembolic events, which might result from the COVID-19-induced autoimmune reaction against endothelial cells, and consequent transient-ischemia and hypoxia of the auditory pathways, (c) the disturbed nerve conduction in vestibulocochlear nerves due to viral invasion, and finally (d) altered auditory cortex function, either imbalanced central gain or neurotransmitter disturbance. However, most of the aforementioned mechanism remained hypothetic and still needed further studies to approve or refute. This systematic review synthesizes current evidence on the characteristics, pathophysiology, diagnostic approaches, and management of audiovestibular dysfunction related to long COVID-19 syndrome. Literature searches across PubMed, Embase, ClinicalKey, Web of Science, and ScienceDirect (up to 15 December 2025) were conducted in accordance with PRISMA guidelines. Through this systematic review, we provided a schematic diagram of the physiopathology of long COVID-19 syndrome-related audiovestibular dysfunction. Further, we summarized the currently available diagnostic tools to explore the audiovestibular function in such patients. The currently available treatment, either pharmacotherapy or nonpharmacotherapy, mainly tackles idiopathic audiovestibular dysfunction but not specifically long COVID-19 syndrome-related audiovestibular dysfunction. Timely recognition and intervention may prevent progression to permanent hearing loss or vestibular disability, improving quality of life. Trial registration: PROSPERO CRD420251265741.}, }
@article {pmid41684026, year = {2026}, author = {Oh, H and Thi Thuy Tien, V and Ahmed, S and Choi, J and Ryu, KJ and Yang, J}, title = {Host Glycan-Lectin Interplay in SARS-CoV-2 Infection.}, journal = {International journal of molecular sciences}, volume = {27}, number = {3}, pages = {}, pmid = {41684026}, issn = {1422-0067}, support = {RS-2023-00219399//National Research Foundation of Korea/ ; RS-2025-02214302//Korea Health Industry Development Institute/Republic of Korea ; }, mesh = {Humans ; *Polysaccharides/metabolism/chemistry ; SARS-CoV-2/physiology ; *Lectins/metabolism/chemistry ; *Spike Glycoprotein, Coronavirus/metabolism/chemistry ; COVID-19/metabolism/virology ; Virus Internalization ; Virus Attachment ; Host-Pathogen Interactions ; *Betacoronavirus/physiology/metabolism ; *Coronavirus Infections/virology/metabolism ; Animals ; *Pneumonia, Viral/virology/metabolism ; }, abstract = {Glycan-mediated processes can be critical determinants of viral attachment and entry, yet for enveloped RNA viruses, including SARS-CoV-2, their mechanistic roles remain incompletely defined. This review synthesizes current structural and functional evidence for glycan engagement during SARS-CoV-2 attachment and entry. We describe the general viral entry pathways and their reliance on glycan recognition, followed by the interactions of the SARS-CoV-2 spike glycoprotein with host glycans, including ABO(H) blood group antigens, sialylated glycans, and endogenous lectins. Based on structural biology, glycobiology, and virology, we focus on how the spike protein exploits both glycan motifs and lectin receptors to enhance attachment, promote cellular uptake, or modulate host tropism. We contextualize these mechanisms by comparing glycan dependencies across other human viruses, including the influenza virus, HIV, and norovirus. Finally, we provide a comparative virological perspective to derive broad evolutionary insights into how enveloped viruses exploit the host glycans.}, }
@article {pmid41684611, year = {2026}, author = {Phanphairoj, K and Wisesrith, W and Chumwichan, S}, title = {Mapping research trends and competency domains in nursing-related digital and artificial intelligence technologies: A bibliometric analysis.}, journal = {International journal of nursing sciences}, volume = {13}, number = {1}, pages = {36-44}, pmid = {41684611}, issn = {2352-0132}, abstract = {OBJECTIVES: This study aimed to explore the research trends, thematic structures, and core competency domains in the field of nursing-related digital and artificial intelligence (AI) technologies.
METHODS: A bibliometric analysis was conducted in accordance with the PRISMA 2020 statement. Peer-reviewed articles published in English from 2015 to 2025 were retrieved from Scopus, Web of Science, and PubMed. Thematic clustering was conducted using the Louvain algorithm and cosine similarity. A subset of 66 frequently cited articles was then qualitatively synthesized to capture core competencies across clusters.
RESULTS: A total of 83,807 articles were included for bibliometric analysis. Of these, 66 articles were chosen for thematic analysis. Five major thematic clusters were identified: remote care in primary settings, oncology and palliative care, nurse education and training, safety and quality in nursing practice, and geriatric and dementia care. Additionally, four competency domains were identified: telehealth and remote communication, health systems and informatics, digital tools in practice, and AI-powered decision support. A clear shift in research focus was observed, with the emphasis transitioning from foundational digital skills before the COVID-19 pandemic to more advanced competencies during the post-pandemic digital transformation, encompassing ethical reasoning, immersive technology use, and AI integration.
CONCLUSIONS: Integrating digital and AI technologies is reshaping nursing practice across various thematic areas and competency domains, highlighting a transition from foundational digital tasks to AI-supported decision-making and ethically informed technology use. This study provides a structured overview of evolving competencies in digital nursing and synthesizes evidence to support future research, curriculum design, and policy planning.}, }
@article {pmid41685028, year = {2026}, author = {Gabunia, L and Khetsuriani, S and Gamkrelidze, N and Gvajaia, N and Ratiani, L and Janigashvili, G}, title = {Pathogenesis and Pharmacotherapy of Acute Respiratory Distress Syndrome Induced by Pandemic Viral Infections: A Narrative Review.}, journal = {Cureus}, volume = {18}, number = {1}, pages = {e101316}, pmid = {41685028}, issn = {2168-8184}, abstract = {Acute respiratory distress syndrome (ARDS) is a severe, life-threatening condition characterized by acute hypoxemic respiratory failure, bilateral pulmonary infiltrates, and non-cardiogenic pulmonary edema caused by increased alveolar-capillary permeability. ARDS is highly heterogeneous, with diverse etiologies and clinical presentations that complicate diagnosis and management. Viral infections, including influenza A (H1N1 and H5N1) and coronaviruses such as SARS-CoV-2, are major contributors to ARDS and can trigger severe lung injury, hyperinflammation, and dysregulated immune responses. Ongoing viral evolution and periodic emergence of novel strains continue to pose a substantial threat to global public health. This narrative review analyzes pandemic-associated viral causes of ARDS, summarizes key mechanisms of pathogenesis, and evaluates current and emerging pharmacotherapeutic approaches. A comprehensive literature search was conducted using PubMed, supplemented by additional sources where appropriate. The review highlights that the increasing prominence of viral pneumonia as a cause of ARDS requires both established supportive care and tailored therapeutic strategies that target the underlying mechanisms of lung injury. Despite progress, virus-associated ARDS remains a major clinical challenge with high morbidity and mortality and may require management approaches distinct from those used for other ARDS etiologies.}, }
@article {pmid41685167, year = {2026}, author = {Su, K and Qiu, J and Xu, T and Liu, S}, title = {Artificial intelligence-guided design of lipid nanoparticles for mRNA delivery.}, journal = {Acta pharmaceutica Sinica. B}, volume = {16}, number = {2}, pages = {709-727}, pmid = {41685167}, issn = {2211-3835}, abstract = {Lipid nanoparticles (LNPs) hold significant potential for mRNA-based therapeutics, as evidenced by their successful use in SARS-CoV-2 mRNA vaccines. LNPs effectively protect and transport mRNA to target sites, thereby ensuring its stability and efficient transfection. Despite the progress, some challenges remain in the development of mRNA-LNP delivery systems, such as limited targeting specificity, the complexity of formulations, and the time-consuming and high-throughput screening process. Artificial intelligence (AI) has emerged as a powerful tool to address these challenges, accelerating the design and optimization process of LNPs. AI-guided approaches can improve the efficiency of lipid structure and formulation screening by rapidly identifying key design parameters and employing predictive modeling to optimize LNP properties. The combination of AI and LNP technology offers significant advantages, including enabling the design of more personalized and precise delivery systems, streamlining the development process, and reducing the cost. This review discusses recent advancements in AI-guided mRNA-LNP delivery systems and highlights their potential to revolutionize mRNA therapeutics.}, }
@article {pmid41687973, year = {2026}, author = {Milligan, T and Nair, R and Cowansage, K and Boyd, C and Morgan, MA and Kotzab, D and Bellanti, DM and Shank, LM and Berman, DE and Chari, S and Evatt, DP and Kelber, MS}, title = {Mental health risk factors for psychological disorders after COVID-19 infection: A systematic review and meta-analysis.}, journal = {Journal of affective disorders}, volume = {402}, number = {}, pages = {121377}, doi = {10.1016/j.jad.2026.121377}, pmid = {41687973}, issn = {1573-2517}, mesh = {Humans ; *COVID-19/psychology ; Risk Factors ; *Stress Disorders, Post-Traumatic/psychology/etiology/epidemiology ; *Adjustment Disorders/psychology/etiology ; Depression/psychology/etiology ; Anxiety/psychology ; Post-Acute COVID-19 Syndrome ; Mental Health ; SARS-CoV-2 ; }, abstract = {The coronavirus disease 2019 (COVID-19) global pandemic was a time of uncertainty and rapid change that has had demonstrable effects on the mental health of those who experienced it. For individuals who contracted the illness, some types of risk factors for adverse mental health post-COVID have been examined (e.g., demographics), but how pre-COVID psychiatric risk factors may have contributed to worsened outcomes has not been systematically evaluated. This systematic review and meta-analysis examines mental health risk factors (e.g., general psychiatric history, trauma history) for depression, anxiety, posttraumatic stress disorder (PTSD), and adjustment disorder in individuals after resolution of acute COVID-19 infection. We searched three databases (PubMed, PsycInfo, Scopus) and included 27 studies (15 cohort, 12 cross-sectional). Studies were dually extracted and assessed for quality. We conducted meta-analyses by study design and outcome for the risk factor of a general psychiatric history. Medium-to-large effect sizes were found for psychiatric history on post-COVID infection depression, anxiety, and PTSD. No studies examined adjustment disorder as an outcome. Studies of mental health risk factors that could not be incorporated into the meta-analyses (e.g., history of trauma) showed small-to-large effect sizes on post-COVID mental health. These results consistently show that mental health factors predict worse psychological health after acute COVID-19 infection. More robust study designs would improve this body of research.}, }
@article {pmid41688142, year = {2026}, author = {Le Bui, N and Nguyen, KL and Phan Van, B and Khuong, YN and Chu, DT}, title = {Cell-free systems for vaccine production.}, journal = {Progress in molecular biology and translational science}, volume = {219}, number = {}, pages = {93-106}, doi = {10.1016/bs.pmbts.2025.08.001}, pmid = {41688142}, issn = {1878-0814}, mesh = {Humans ; Cell-Free System ; *Vaccines/biosynthesis ; Animals ; *Vaccine Development/methods ; }, abstract = {Cell-free (CF) systems is harness cellular components including tRNAs, ribosomes, and polymerase to synthesize proteins in vitro. Owing to their significant CF systems offer substantial advantages over traditional cell-based systems, including higher speed, biosafety, and portability. As a result, CF systems have emerged as a powerful platform for biomedical research, with particularly promising applications in biosensing and diagnostics, protein production, synthetic biology and vaccine development. In this chapter, we provided a comprehensive overview of CF system applications in the field of biomedical sciences, with an emphasis on vaccine development and production. We also discussed their successful applications in the expression of antigens from challenging pathogens, such as Plasmodium falciparum, Chlamydia muridarum, and SARS-CoV-2. Moreover, this chapter proposed several promising innovations to address current limitations of CF platforms such as the shortage of post-translational modifications, endotoxin presence, and high production cost. Emerging solutions include glycoengineering to introduce functional glycosylation, freeze-drying for improving storage and distribution, exosome-based delivery for designing next generation vaccines, and even machine learning integration, to optimize the production pipelines.}, }
@article {pmid41689404, year = {2026}, author = {Pereira-Dias, F and de Espíndola, MB}, title = {Integrating Digital Technologies Into Biochemistry Education: A Decade of Efforts, Pandemic Impacts, and Emerging Insights.}, journal = {Biochemistry and molecular biology education : a bimonthly publication of the International Union of Biochemistry and Molecular Biology}, volume = {54}, number = {2}, pages = {195-216}, pmid = {41689404}, issn = {1539-3429}, support = {//Fundação de Amparo à Pesquisa e Inovação do Estado de Santa Catarina/ ; }, mesh = {Humans ; *Biochemistry/education ; Digital Media ; *Digital Technology ; Education, Distance ; *Pandemics ; }, abstract = {This review critically examines the integration of Digital Information and Communication Technologies (TDICs) in biochemistry education over the past decade, highlighting both the benefits and challenges from a critical theoretical perspective. A systematic review was conducted to identify relevant literature, followed by thematic analysis and a detailed synthesis of the findings. Grounded in Feenberg's critical theory of technology and Selwyn's scholarship on education and digital technology, this review examines the implications of virtual laboratories, augmented reality, gamification, and online platforms in biochemistry education, as well as their implications related to the pandemic. We observed that digital technologies can enhance certain aspects of student engagement and learning outcomes; however, they can also hinder equitable access and hands-on laboratory skills. This review also highlights the key elements of critical reflection on the socio-political and ethical implications of digital technologies in biochemistry education, with a particular focus on pandemic-era concerns, including data privacy, algorithmic bias, and the commercialization of teaching practices. Future research should focus on these dimensions to ensure that technological advancements do not perpetuate or amplify educational inequities.}, }
@article {pmid41689447, year = {2026}, author = {Coker, KL and Morgan, EL}, title = {High-Risk HPV in Men: A Hidden Threat to Public Health?.}, journal = {Reviews in medical virology}, volume = {36}, number = {2}, pages = {e70115}, pmid = {41689447}, issn = {1099-1654}, mesh = {Humans ; *Papillomavirus Infections/epidemiology/prevention & control/virology/transmission ; Male ; *Human Papillomavirus Viruses/genetics/pathogenicity ; *Public Health ; Papillomavirus Vaccines/administration & dosage/immunology ; Prevalence ; Vaccination ; Risk Factors ; Uterine Cervical Neoplasms/prevention & control/virology ; }, abstract = {High-risk human papillomavirus (HR-HPV) infection is a leading cause of several cancers, including those of the genital and oropharyngeal regions. While public health efforts have largely focused on women due to its link to cervical cancer, HPV also poses significant risks to men, particularly in the oropharyngeal regions. HR-HPV prevalence in men is high, with global estimates of 21% for male genital infections. While the HPV vaccination programme has expanded to include boys, challenges remain, including a decline in vaccine uptake due to COVID-19 disruptions, vaccine hesitancy, and misinformation. These barriers hinder the full potential of vaccination efforts. Furthermore, HPV transmission is complex and multifactorial, making it difficult to track, while its prevalence, clearance, and persistence vary based on factors such as sexual behaviour and immune status. Additionally, data from lower socio-economic regions is limited, highlighting a critical gap in research. Specific data on these epidemiological characteristics for male patients is lacking, prompting the need for gender-balanced approaches. Here, we explore the prevalence, risks, and public health implications of high-risk HPV (HR-HPV) in men. We suggest a more inclusive approach to HPV prevention, emphasising the need for targeted vaccination and screening programs for men. A gender-neutral approach is crucial to reducing the global burden of HPV-related diseases and moving closer to the goal of eradicating HPV infections worldwide.}, }
@article {pmid41690153, year = {2026}, author = {Ortiz-Tallo, A and Izquierdo, A and Calvo, A and Lara, E and Ayuso-Mateos, JL and Cabello, M}, title = {A systematic review of the bidirectional relationship between psychosis and loneliness.}, journal = {Journal of psychiatric research}, volume = {196}, number = {}, pages = {115-122}, doi = {10.1016/j.jpsychires.2026.02.018}, pmid = {41690153}, issn = {1879-1379}, mesh = {Humans ; *Loneliness/psychology ; *Psychotic Disorders/psychology/epidemiology ; Risk Factors ; }, abstract = {BACKGROUND: and hypothesis: Loneliness, defined as a subjective feeling of isolation, has been significantly correlated with psychotic experiences in general and clinical populations, although less is known about the direction of this relationship. This paper aims to systematically review the longitudinal relationship between loneliness and psychosis spectrum continuum, addressing two fundamental questions: (1) is loneliness a risk factor for the development of psychosis, and (2) does psychosis increase the risk of experiencing loneliness?
STUDY DESIGN: A comprehensive search of 5 electronic databases yielded a total of 4386 records, from which 10 observational studies were finally included.
STUDY RESULTS: Six studies investigated the first research question, and all of them identified a significant association between loneliness and the subsequent incidence of psychosis (question 1). Conversely, 4 studies explored the second research question, with 3 suggesting that individuals within the psychosis spectrum may face heightened susceptibility to loneliness (question 2). The remaining study, conducted during the COVID-19 pandemic, did not yield significant findings. Assessment of methodological quality indicated predominantly moderate-to-high-quality studies.
CONCLUSIONS: The findings underscore the need for further research, particularly longitudinal prospective studies, to clarify whether the observed association between loneliness and psychosis is direct or whether it is instead moderated or mediated by other variables. Overall, the available evidence provides stronger support for loneliness as a potential risk factor for the onset of psychosis, although the number of longitudinal studies addressing this question remains very limited. Addressing these gaps in knowledge could inform the development of targeted prevention programs and interventions for people with psychotic spectrum disorders.}, }
@article {pmid41690197, year = {2026}, author = {Shang, X and Zheng, J and Liu, X and Guo, K and Zhang, N and He, R and Gan, Y and Zhang, WH and Jia, P and Yang, L and Zhu, B}, title = {Climatic factors drive global viral respiratory infections with regional heterogeneity: A systematic review and meta-analysis.}, journal = {Environment international}, volume = {208}, number = {}, pages = {110120}, doi = {10.1016/j.envint.2026.110120}, pmid = {41690197}, issn = {1873-6750}, mesh = {Humans ; *Respiratory Tract Infections/epidemiology/virology ; *Climate ; *Climate Change ; Temperature ; Humidity ; *Virus Diseases/epidemiology ; }, abstract = {BACKGROUND: Climate change is altering global respiratory virus transmission, yet pathogen-specific climate sensitivities remain unclear across diverse geographical settings.
METHODS: We searched six databases (inception-10 May 2024) for studies quantifying associations between climate factors and virus respiratory infections (VRIs). Random-effects models pooled relative risks (RRs) per unit increase in temperature, relative humidity, precipitation, and wind speed, with climate sensitivity assessed by Köppen-Geiger zones.
RESULTS: From 108 studies comprising 9.22 million VRI cases, three climate patterns emerged. First, temperature was the dominant driver: each 1°C increase reduced respiratory syncytial virus (RSV; RR 0.13, 95% CI 0.08-0.22), influenza virus (IV; RR 0.37, 95% CI 0.23-0.58), human metapneumovirus (HMPV; RR 0.48, 95% CI 0.32-0.73), SARS-CoV-2 (RR 0.52, 95% CI 0.35-0.78), and human coronavirus (HCoV; RR 0.21, 95% CI 0.07-0.61) risks, but increased parainfluenza virus (PIV; RR 2.35, 95% CI 1.46-3.77) and human bocavirus (HBoV; RR 1.86, 95% CI 1.04-3.32) risks. Second, other climate factors showed selective effects: higher humidity decreased IVB risk (RR 0.61, 95% CI 0.40-0.94) but increased enterovirus risk (RR 2.21, 95% CI 1.08-4.51); precipitation decreased IV risk (RR 0.67, 95% CI 0.51-0.89) but increased PIV risk (RR 1.91, 95% CI 1.21-2.99); wind speed amplified IV (RR 1.51, 95% CI 1.01-2.27) and HCoV transmission (RR 5.36, 95% CI 3.43-8.38). Third, climate-zone analyses revealed substantial heterogeneity: in temperate regions, low temperature and humidity increased the risk of most infections (except PIV and HBoV); risks of SARS-CoV-2 and SARS-CoV risks decreased in temperate but increased in continental regions; RSV and HMPV showed greater sensitivity in tropical regions; while in arid regions, MERS-CoV risk increased with temperature but decreased with humidity and wind speed.
CONCLUSION: This analysis identified climate-sensitive VRIs with temperature as key predictor, pathogen-specific sensitivities, and distinct regional patterns, informing targeted climate-based intervention strategies.}, }
@article {pmid41691687, year = {2026}, author = {Pawłuszkiewicz, K and Augustynowicz, G and Paluch, E and Porebska, B and Bielenin, Z and Faltus, AM and Madziarska, K and Kluz, J and Bronowicka-Szydelko, A}, title = {COVID-19 Impact on Lipid Profile and Metabolome in Patients with Type 2 Diabetes Mellitus: Mini-Review.}, journal = {Current diabetes reviews}, volume = {22}, number = {7}, pages = {e15733998404775s}, doi = {10.2174/0115733998404775251202121401}, pmid = {41691687}, issn = {1875-6417}, mesh = {Humans ; *Diabetes Mellitus, Type 2/metabolism/complications/blood ; *COVID-19/metabolism/complications ; *Metabolome/physiology ; *Lipid Metabolism/physiology ; SARS-CoV-2 ; *Lipids/blood ; }, abstract = {AIM: This review aims to explore the pathophysiological mechanisms by which SARS-- CoV-2 affects lipid metabolism and the metabolome in patients with Type 2 Diabetes Mellitus (T2DM). It compares these alterations with those observed in non-diabetic individuals and proposes strategies to mitigate potential long-term metabolic complications.
METHODS: A narrative review was conducted using PubMed, Scopus, and Google Scholar to identify studies published between 2004 and 2025 concerning adult T2DM patients during or after COVID-19 infection. The analysis focused on lipid profiles, including total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides, along with hemoglobin A1C levels and COVID-19 severity. Search terms included: (Post-COVID-19) AND (Diabetes Mellitus Type 2), ((Post-COVID-19) AND (Diabetes Mellitus Type 2)) AND (Lipid Profile), ((- COVID-19) AND (Lipid Profile)) AND (Diabetes Mellitus Type 2), (Post-COVID-19) AND (Lipid Metabolism), (COVID-19) AND (Lipid Metabolism), (Post-COVID-19) AND (Metabolome), (COVID-19) AND (Metabolome).
RESULTS: Post-COVID-19, patients with T2DM exhibit persistent disturbances in lipid metabolism and broader metabolic pathways. SARS-CoV-2 infection amplifies metabolic dysregulation, leading to decreased levels of total cholesterol, HDL, and LDL, while triglyceride levels remain variable. Mechanistically, the virus disrupts lipid homeostasis by upregulating genes such as CD36 and peroxisome proliferator-activated receptor gamma (PPAR-γ) and by altering amino acid metabolism, particularly within the tryptophan-kynurenine and glutamine pathways.
DISCUSSION: Enhanced oxidative stress and lipid peroxidation contribute to systemic inflammation and endothelial dysfunction. Furthermore, glycemic control worsens due to increased insulin resistance and pancreatic interactions involving angiotensin-converting enzyme 2 (ACE2).
CONCLUSION: COVID-19 significantly alters lipid metabolism and the metabolomic profile in individuals with T2DM. Longitudinal studies are warranted to clarify the duration and clinical impact of these changes and to develop personalized therapeutic strategies for this high-risk population.}, }
@article {pmid41693062, year = {2026}, author = {Deane-King, J and Howell, J and Maguire, R}, title = {Experiences of Individuals With Chronic Obstructive Pulmonary Disease and Their Caregivers During the Pandemic: A Systematic Review.}, journal = {Nursing open}, volume = {13}, number = {2}, pages = {e70462}, pmid = {41693062}, issn = {2054-1058}, mesh = {Humans ; *Pulmonary Disease, Chronic Obstructive/psychology ; *Caregivers/psychology ; *COVID-19/psychology/epidemiology ; SARS-CoV-2 ; Pandemics ; Mental Health ; }, abstract = {AIM: To explore the experiences of individuals with Chronic Obstructive Pulmonary Disease (IwCOPD) and their caregivers during the COVID-19 pandemic.
DESIGN: Systematic review, adhering to PRISMA guidelines (PROSPERO ID: CRD42022327424).
DATA SOURCES: PsycINFO, PubMed, EMBASE and Web of Science.
METHODS: Databases were searched in April 2022 using keywords relating to COPD, caregivers/patients and COVID-19. Studies collecting data on experiences of IwCOPD or their informal caregivers during the COVID-19 pandemic were included. Following screening and quality appraisal by two reviewers, a qualitative synthesis was conducted.
RESULTS: Of 2931 abstracts screened, 24 articles met the inclusion criteria. For IwCOPD, pandemic impacts on physical and mental health were found, including fears of contracting COVID-19, changes in exacerbation levels, reductions in physical activity, and increases in depression and anxiety. Changes to healthcare management, including access to telemedicine, and positive adaptations, such as increased medication adherence, self-preservation and self-care, were also reported in the studies reviewed. Caregivers expressed fear of their care recipient contracting COVID-19 and changes in the home environment.
CONCLUSION: While the pandemic led to considerable negative experiences for IwCOPD, review findings suggest that some positive experiences were also reported.
Findings may help inform the development of physical and mental health supports for IwCOPD and their caregivers.
IMPACT: This study sheds light on the limited evidence regarding experiences of IwCOPD and their caregivers during the height of the COVID-19 pandemic. As many IwCOPD continue to be impacted by COVID-19, these findings have the potential to inform healthcare providers how they may better support IwCOPD and their caregivers in numerous aspects of their healthcare management and their daily lives.
The lead author's experience as a COPD caregiver acted as Public and Patient involvement input. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: (1) The review sheds light on the considerable impact the pandemic had on the mental and physical health of IwCOPD. (2) It identifies vulnerable areas where support could be improved for IwCOPD and their caregivers, and how support could be improved.
RELEVANCY TO NURSING OPEN: People with chronic obstructive pulmonary disease require considerable care and support from nursing professionals. This review highlights the care needs and support that may be beneficial for this group and is relevant to Nursing Open on nursing practice and research.}, }
@article {pmid41694172, year = {2026}, author = {Chatzidou, P and Stratos, A and Chint, M and Niakou, A and Pissiotis, A and Kamalakidis, S}, title = {Denture-Associated Candidiasis and Mucormycosis in Post-COVID-19 Older Adults Managed Through an Integrated Prosthodontic and Infectious Disease Approach: A Narrative Review.}, journal = {Cureus}, volume = {18}, number = {2}, pages = {e103448}, pmid = {41694172}, issn = {2168-8184}, abstract = {The COVID-19 pandemic has exposed significant vulnerabilities among older adults, particularly denture wearers, to opportunistic fungal infections, including mucormycosis and oral candidiasis. This narrative review, following PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Narrative Reviews) guidelines, collected evidence from 2020 to 2025 to examine the connection between denture use, systemic comorbidities, and fungal complications in elderly individuals after COVID-19. A total of 21 of 104 studies were included, covering case-control, cross-sectional, cohort, and retrospective studies from India, Europe, the Middle East, and North America. Several studies have reported higher rates of oral fungal colonization among denture wearers,with Candida albicans being the most frequently isolated species, followed by resistant strains such as Candida auris. However, these observations are primarily derived from heterogeneous observational studies and should therefore be interpreted as associative rather than causal. COVID-19-related mucormycosis (CAM) was primarily reported as rhino-orbito-cerebral disease, with oral manifestations including palatal necrosis, gingival ulcers, and tooth mobility. Key risk factors identified include diabetes mellitus, corticosteroid therapy, prolonged intensive care unit (ICU) stays, and poor denture hygiene. Mortality related to CAM ranged from 18% to 56%, while candidiasis, though less deadly, significantly affected oral function, nutrition, and overall quality of life. Diagnostic methods included clinical and intraoral examinations, microbiological cultures, imaging techniques, and emerging salivary biomarkers. Treatments included systemic antifungal medications, surgical removal, and prosthesis disinfection, highlighting the important role of prosthodontists in prevention and rehabilitation. Knowledge gaps remain regarding the predictive value of oral lesions for systemic infections, the long-term effects of COVID-19 on the oral microbiome, and the need to standardize denture hygiene protocols. This review emphasizes the importance of integrated dental and medical care in reducing morbidity and mortality among denture-wearing older adults recovering from COVID-19, while recognizing that early oral findings may serve as warning indicators rather than definitive predictors of systemic infection.}, }
@article {pmid41695592, year = {2026}, author = {Ince, I and Sposito, F and Charras, A and McCann, LJ and Hedrich, CM}, title = {How loss-of-function mutations in IFIH1 contribute to infectious and/or inflammatory disease - a systematic review.}, journal = {Journal of translational autoimmunity}, volume = {12}, number = {}, pages = {100353}, pmid = {41695592}, issn = {2589-9090}, abstract = {The IFIH1 gene encodes for the cytoplasmic innate immune receptor Melanoma Differentiation-Associated protein 5 (MDA5) that detects viral double-stranded RNA to initiate type I interferon (IFN) responses. While gain-of-function mutations in IFIH1 have been linked with systemic inflammatory diseases, loss-of-function remains less well understood. This systematic review, following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidance, explored how IFIH1/MDA5 loss-of-function affects susceptibility to virus infections and/or contributes to inflammatory diseases. Sixteen loss-of-function variants affecting IFIH1 were discussed across 33 studies. Loss-of-function variants were consistently associated with increased susceptibility and/or severity of virus infections, including severe acute respiratory syndrome coronavirus (SARS-CoV2) and human immunodeficiency virus (HIV). Several rare biallelic IFIH1 mutations lead to profound immunodeficiency, while heterozygous mutations associate with milder clinical presentations. Likely through dampening IFN responses, several variants protect from the development of inflammatory diseases, including type 1 diabetes and hypothyroidism. However, IFIH1 deficiency is also implicated in the development of inflammatory diseases, including inflammatory bowel disease. Moreover, the presence of inactivating anti-MDA5 antibodies may alter the clinical phenotypes and prognosis of dermatomyositis and infections with SARS-CoV2. Though their exact impact on MDA5 function has not been confirmed experimentally, anti-MDA5 antibodies may result in loss-of-function and impaired host defence against viruses. Loss of IFIH1/MDA5 activity has diverse effects on anti-viral immunity, associated damage and susceptibility to inflammatory disease, but also protection against organ-specific immune-mediated pathology. Findings highlight the importance of IFIH1 in immune regulation and warrant future studies exploring its potential as a diagnostic and therapeutic target.}, }
@article {pmid41695980, year = {2026}, author = {Hanifian, H and Nateghpour, M}, title = {Iran's Journey Through Malaria: From Past Challenges to Future Elimination-A Narrative Review.}, journal = {Journal of tropical medicine}, volume = {2026}, number = {}, pages = {4251955}, pmid = {41695980}, issn = {1687-9686}, abstract = {BACKGROUND: Malaria remains a persistent public health concern in Iran, particularly in southeastern regions bordering Afghanistan and Pakistan. Despite substantial progress over recent decades, challenges such as cross-border transmission, insecticide resistance, and health system disruptions continue to threaten elimination goals.
METHODS: This narrative review synthesized evidence from the World Health Organization (WHO) World Malaria Reports, national surveillance summaries, and peer-reviewed publications indexed in PubMed and Scopus from 2000 to 2025. Emphasis was placed on case trends, intervention coverage, and cross-border dynamics.
RESULTS: Iran reduced indigenous malaria cases dramatically from thousands in the early 2000s to fewer than 300 annually by the mid-2010s and subsequently recorded multiple consecutive years with zero indigenous transmission, according to the WHO surveillance reports. Key achievements included integrated vector management, community engagement, and strengthened cross-border initiatives. However, interruptions during the COVID-19 pandemic and a resurgence of malaria in 2022, largely associated with imported infections, operational disruptions, and emerging vector threats, highlighted vulnerabilities in elimination-phase systems. Additional challenges such as insecticide resistance and the spread of Anopheles stephensi further complicate the elimination trajectory.
CONCLUSION: Iran's experience illustrates the need for adaptive, multisectoral approaches to malaria control in complex socioecological settings. While elimination remains within reach, achieving the WHO certification will require transparent surveillance metrics, reinforce cross-border collaboration, and sustain political and financial commitment.}, }
@article {pmid41696091, year = {2026}, author = {Rezaei, Z and Khorraminia, A and Shi, D and Banad, YM}, title = {Network-based artificial intelligence in mental healthcare: A systematic review of chatbots, artificial intelligence/machine learning models and ethical considerations in global healthcare networks.}, journal = {Digital health}, volume = {12}, number = {}, pages = {20552076261421688}, pmid = {41696091}, issn = {2055-2076}, abstract = {OBJECTIVE: This systematic review examines how artificial intelligence (AI), including machine learning (ML) models and AI-powered chatbots, contributes to the diagnosis, treatment and ethical governance of mental healthcare. It explores how AI-driven systems form interconnected healthcare networks that enhance accessibility, personalization and resilience of mental health services, aligning with the United Nations Sustainable Development Goal 3: Good Health and Well-Being.
METHODS: A comprehensive search across PubMed, IEEE Xplore and Google Scholar (2017-2024) was conducted using Boolean combinations of "AI," "machine learning," "chatbots" and "mental health." Screening followed Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines, yielding 37 high-quality studies for qualitative synthesis. Extracted data were categorized into three domains: (1) AI- and ML-based diagnostic models, (2) chatbot-enabled mental health support systems and (3) ethical and privacy considerations. Analytical dimensions included algorithmic performance, clinical outcomes, data governance and equity of access.
RESULTS: AI-driven interventions improved accessibility, diagnostic accuracy and therapeutic personalization. Chatbots such as Woebot, Wysa and Tess effectively reduced symptoms of depression and anxiety, increased user engagement and provided scalable support, particularly during the COVID-19 pandemic. ML models, including MentalBERT, MentalRoBERTa and SR-BERT, achieved F1 scores of 68-93% in mental health classification tasks. However, limitations included dataset bias, lack of longitudinal evidence and limited cross-cultural generalizability. Ethical analyses revealed persistent challenges concerning privacy, informed consent, algorithmic bias and accountability.
CONCLUSION: AI technologies, when integrated with human oversight, offer transformative potential for global mental health systems by creating interconnected and adaptive care networks. These technologies can enhance efficiency, reduce barriers to care and support data-driven public health strategies. However, successful deployment depends on clear ethical frameworks that promote transparency, respect cultural contexts and preserve human oversight. Future research should prioritize longitudinal studies, inclusive datasets and ethical frameworks that maintain human-centered values in AI-enabled mental health systems.}, }
@article {pmid41696228, year = {2026}, author = {de Araújo, AB and S Azul, FVC and Carneiro, YC and de Sousa, CNS and de Vasconcelos, SMM and Rios, FJ and Leal, LKAM}, title = {Neuroinflammation and Oxidative Stress in Parkinson's Disease, Alzheimer's Disease, and COVID-19: Microglia-Neutrophil Interaction.}, journal = {ACS omega}, volume = {11}, number = {5}, pages = {6922-6938}, pmid = {41696228}, issn = {2470-1343}, abstract = {Abnormal activation of the immune system and oxidative stress are crucial factors in neurodegenerative disorders, such as Parkinson's disease and Alzheimer's disease. Microglia, neutrophils, oxidative stress mediators such as reactive oxygen species (ROS), lipid peroxidation products (e.g., malondialdehyde), and nitrosative stress markers (e.g., nitrite and nitrate) play important roles in neuroinflammatory mechanisms. Microglial cells acquire a proinflammatory phenotype through interactions with endogenous or exogenous compounds, including cell debris, abnormally modified proteins (including Aβ species and alpha-synuclein), and pathogens (e.g., SARS-CoV-2). They produce many inflammatory mediators and promote the activation of adjacent brain cells and leukocyte infiltration, including polymorphonuclear neutrophils. Accumulation of neutrophils in the central nervous system (CNS) leads to the secretion of more proinflammatory mediators, such as cytokines, proteases, and oxidants, and the formation of neutrophil extracellular traps (NETs). These processes are associated with the pathological activation of microglial cells, cell death, consequent influence on neuronal functions, or even neuronal death, which is a hallmark of CNS disorders. In this review, we address the importance of inflammatory mechanisms and oxidative stress in the CNS associated with Parkinson's disease, Alzheimer's disease, and the neuronal effects observed in coronavirus disease 2019 (COVID-19), as observed by the abnormal activation of central and peripheral immune cells, such as microglia and neutrophils. We also discuss emerging evidence linking SARS-CoV-2 infection to neuroinflammatory mechanisms that could contribute to neurodegenerative complications.}, }
@article {pmid41696621, year = {2026}, author = {Nguyen Hai, C}, title = {Invasive pulmonary aspergillosis in the post-COVID-19 era: diagnosis, treatment, and what lies ahead.}, journal = {Therapeutic advances in infectious disease}, volume = {13}, number = {}, pages = {20499361251406189}, pmid = {41696621}, issn = {2049-9361}, abstract = {Invasive pulmonary aspergillosis (IPA) is a severe opportunistic fungal infection that predominantly affects immunocompromised individuals, including those with hematologic malignancies, organ transplants, and, more recently, patients with post-COVID-19 immune dysregulation. Despite advancements in medical mycology, IPA continues to pose significant diagnostic and therapeutic challenges, contributing to high global morbidity and mortality. Diagnostic accuracy remains limited due to nonspecific clinical manifestations and the suboptimal performance of conventional tools such as bronchoalveolar lavage culture and galactomannan testing. However, recent innovations including polymerase chain reaction-based molecular assays, lateral flow devices, and immuno-positron emission tomography/magnetic resonance imaging offer improved sensitivity, specificity, and speed. Therapeutically, triazoles remain the cornerstone of IPA management, complemented by echinocandins and liposomal amphotericin B in refractory cases. The role of combination therapy and antifungal susceptibility testing is growing in response to rising azole resistance. Additionally, novel antifungal agents and immunotherapeutic approaches are currently under clinical investigation. Effective management of IPA requires a timely, multidisciplinary approach that combines advanced diagnostics with personalized antifungal strategies. Continued research is essential to standardize molecular techniques, refine immunotherapy, and expand access to next-generation antifungals to reduce the global burden of this life-threatening infection. This review aims to synthesize current evidence on the diagnosis and treatment of IPA, critically evaluate the strengths and limitations of existing diagnostic and therapeutic approaches, and explore emerging strategies to enhance clinical outcomes in the context of rising antifungal resistance.}, }
@article {pmid41696692, year = {2025}, author = {Badran, EF and Rayyan, A and Al Jaberi, M and Azzam, M and Ramadan, R and Khader, Y and Alqutob, R and Bakri, FG and Qasrawi, R and Yacoub, T and Sharaqa, A and Fraihat, N and Trigui, H and Sokhn, E and Tayyem, R and Musa, E and Kong, JD}, title = {Infectious disease burden and surveillance challenges in Jordan and Palestine: a systematic review and meta-analysis.}, journal = {Frontiers in digital health}, volume = {7}, number = {}, pages = {1713089}, pmid = {41696692}, issn = {2673-253X}, abstract = {BACKGROUND: Jordan and Palestine face public health challenges due to infectious diseases, with the added detrimental factors of long-term conflict, forced relocation, and lack of resources. Added to these are the increased rates of morbidity and mortality from having limited healthcare services available due to a lack of funding, poor disease surveillance systems, and entrenched systemic weaknesses. The purpose of this systematic review was to report the prevalence of infectious diseases in Jordan and Palestine in order to inform the development of targeted public health programs that use both standard and novel approaches to reduce the region's disease burden.
METHOD: As defined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the review included prospective, retrospective, cross-sectional, and case series studies published from January 2021 to February 2024. Non-English studies were excluded due to resource limitations, as were studies published before the COVID-19 pandemic (i.e., before January 2021) to focus on post-COVID-19-pandemic trends. We used diagnostic techniques (screening, laboratory, and confirmatory tests) to test for microorganisms in adults and children from at-risk populations in Jordan and Palestine. Test-negative controls were contrasted with patients who had positive test results. A manual reference screening process was added to a systematic search of PubMed and Scopus. Full-text, English-language publications published after January 2021 were eligible; protocols, reviews, case reports, and articles written in languages other than English were not. The Rayyan platform was used by two reviewers to independently screen studies. Infection type, causative microorganism, symptoms, mortality, risk factors, seasonal fluctuations, and study details (author, year, location, design, and participant characteristics) were among the extracted data. The Hoy 2012 Checklist was used to evaluate the risk of bias. Open Meta (Analyst) was used to analyze the 13 studies that satisfied the inclusion criteria. Study design, risk of bias, heterogeneity, publication bias, indirection, imprecision, effect size, and residual confounding were all considered when grading the quality of the evidence using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.
RESULTS: The results revealed that four studies addressed the prevalence of Brucella infection in Jordan and Palestine. The pooled estimate was 42.2% (95% CI: 18.8%-65.6%, I [2]: 99.7%, P: 0.001, n = 4 studies, 4,483 patients). In the studies that addressed diarrhea, in 31 of 159 (19.5%) cases, 20 were caused by Entamoeba (12.6%), 10 were caused by Blastocystis (6.3%), and 1 (0.6%) was caused by Cryptosporidium. As some cases had more than one parasite, the certainty of evidence (COE) was assessed as very low. The pooled estimate for viral causative agents of respiratory tract infections was 60% (95% CI: 11.8%-100%), while for bacterial causes, the pooled estimate was 24.4% (95% CI: 0%-68.3%). Respiratory syncytial virus (RSV) was the most common agent, with a pooled estimate of 57.9% (95% CI: 29.8%-85.9%), while influenza had a pooled estimate of 28.4% (95% CI: 5.3%-51.5%). Furthermore, two studies addressed the prevalence of meningitis in pediatric patients. In adult patients, of 192 patients known to have meningitis, a causative agent was identified in only 86 cases, with 83 (49%) classified as aseptic meningitis.
CONCLUSION: The review addressed the limitations of diagnostic capacity, reporting systems, and population-level data concerning high-burden and emerging pathogens within Jordan and Palestine. Specifically, the growth in the number of cases with respiratory tract infections, protozoal diarrheal diseases, and brucellosis indicates that improvements in surveillance systems and diagnostic processes need to be standardized and implemented throughout Jordan and Palestine to provide accurate and reliable diagnoses. In addition, improving the quality and quantity of the data and incorporating new technologies and other innovative approaches as a complement to existing public health indicators within Jordan and Palestine would be beneficial for better detecting these diseases at the earliest possible time and would provide the opportunity to establish evidence-based disease management strategies within the region.}, }
@article {pmid41696706, year = {2025}, author = {Yu, P and Zhu, P and Kudiza, A and Kaburu, FM and Intizar, M and Tong, C and Zhang, R and Jiang, J and Yu, X and Kuang, Q and Chen, R and da Veiga, CP and Xiang, YT and Su, Z}, title = {Help, near and far: a systematic review of post-COVID digital mental health solutions for domestic violence victims.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1687396}, pmid = {41696706}, issn = {2296-2565}, mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Domestic Violence/psychology ; Digital Health ; *Mental Health ; Digital Media ; *Crime Victims/psychology ; *Survivors/psychology ; SARS-CoV-2 ; }, abstract = {INTRODUCTION: Domestic violence (DV), as a global pandemic, poses a significant challenge within the field of public health, gravely impacting the mental and physical health of victims. Modern digital technologies have been proposed as promising interventions for DV-related mental health problems. We therefore evaluated their effectiveness.
OBJECTIVE: To systematically review digital interventions targeting the mental health of DV survivors and to summarize implications for health professionals and policy makers.
METHODS: We searched PubMed, EBSCO, and Web of Science (January 1, 2020-April 23, 2024) following PRISMA guidelines. Two reviewers independently screened records, applied predefined eligibility criteria, and extracted data. Owing to heterogeneity, we performed a narrative synthesis. Meanwhile, based on the results of the literature review, this paper proposes a series of policy recommendations from a post-COVID-19 era perspective, integrating societal context and relevant policies.
RESULTS: Nine studies met the inclusion criteria. Three reported no significant mental-health benefits, whereas the remainder showed improvements in outcomes such as depression, anxiety, PTSD symptoms, emotion regulation, perceived support, or safety preparedness using tools including mobile apps, web-based programs, virtual reality, chatbots, and video adjuncts.
CONCLUSION: Digital interventions show promise for improving mental-health outcomes among DV survivors, but their implementation requires attention to safety, engagement, cultural adaptation, and integration with offline services.
PROSPERO, https://www.crd.york.ac.uk/PROSPERO/view/CRD42023488560.}, }
@article {pmid41696833, year = {2026}, author = {Martinez-Morga, M and Garrigos, D and Martinez-Morga, S and Martinez, S}, title = {[Consequences of congenital COVID-19 on the cognitive development of affected children].}, journal = {Medicina}, volume = {86 Suppl 1}, number = {}, pages = {2-7}, pmid = {41696833}, issn = {1669-9106}, mesh = {Humans ; *COVID-19/congenital/complications ; Pregnancy ; Female ; *Pregnancy Complications, Infectious/virology ; Infant, Newborn ; *Developmental Disabilities/virology/etiology/epidemiology ; SARS-CoV-2 ; Infectious Disease Transmission, Vertical ; Neurodevelopment ; *Neurodevelopmental Disorders/virology/etiology ; *Coronavirus Infections/congenital/complications/transmission ; *Pneumonia, Viral/congenital/complications/transmission ; Pandemics ; *Prenatal Exposure Delayed Effects/virology ; *Child Development ; Child ; }, abstract = {Congenital COVID-19 refers to infection with the SARS-CoV-2 virus acquired in utero as a result of maternal infection during pregnancy. Although vertical transmission of the virus from mother to fetus appears to be relatively infrequent, growing clinical and epidemiological evidence indicates that prenatal exposure to SARSCoV-2, as well as to the maternal immune response it elicits, may have significant implications for early neurological development. Therefore, understanding the potential cognitive consequences of congenital COVID-19 is essential for the long-term monitoring of child health in affected individuals and for the implementation of early intervention strategies. This post-pandemic perspective on the consequences for neural development has been supported by observations showing that neonates exposed to congenital COVID-19 infection have a tenfold higher incidence of developmental delay compared with those not exposed to the virus. In this review, we examine the pathogenic mechanisms that may explain the increased incidence of neurodevelopmental alterations.}, }
@article {pmid41697443, year = {2026}, author = {Camara, B and Buonsenso, D}, title = {Biomarkers of long COVID in children and young adults: a scoping review.}, journal = {European journal of pediatrics}, volume = {185}, number = {3}, pages = {132}, pmid = {41697443}, issn = {1432-1076}, mesh = {Humans ; *Biomarkers/blood ; Child ; *COVID-19/complications/diagnosis ; Adolescent ; Post-Acute COVID-19 Syndrome ; Young Adult ; SARS-CoV-2 ; }, abstract = {UNLABELLED: Following the SARS-CoV-2 pandemic, a significant percentage of people are now experiencing long-term symptoms, despite a continuing lack of concrete documentation of physiological and risk profiles that hinders diagnosis and treatment, particularly in pediatric contexts. This review aims to highlight the existing evidence for measurable physiological markers for post-acute sequelae of SARS-CoV-2 infection (long COVID) in children, adolescents, and young adults. Titles providing data related to measurable biomarkers distinguishing young long COVID patients from controls were compiled and analyzed. Results were displayed in table and diagram form for optimal qualitative evaluation of the relationship between markers and symptomatology within the context of each organ system. Only human studies published in English, Italian, Portuguese, German, and Spanish between the 5th of February 2025 and the 31st of December 2025 were considered, and no other time constraints were applied. Following search and criteria evaluation, nine studies were included, totaling 41 occurrences identified in diseased patients with statistically significant variation from healthy controls. Markers suggest the presence of organic manifestations based on published literature, although more data and future studies will be necessary to establish clear connections.
CONCLUSION: The data compiled for this review adds to the body of evidence indicating a physiological manifestation of long COVID and its consequences. Further investigation into potential risk factors, pre- and post-pubescent manifestations, and specific inflammatory and immune pathways will be necessary for a more concrete understanding of long COVID and its effects on children, adolescents, and young adults.
WHAT IS KNOWN: • Long COVID is estimated to affect a significant population of patients, despite the lack of concrete physiological diagnostic and prognostic measures. • Pediatric incidence of the disease is still largely debated, and published data are scarce.
WHAT IS NEW: • A total of 41 biomarker occurrences were identified by selected studies, which were consistent with expected physiology behind reported symptoms. • The body of data discussed suggests the presence of physiological phenomena behind the long-term symptoms experienced by pediatric long- COVID patients.}, }
@article {pmid41697483, year = {2026}, author = {Sheikholeslami, MA and Parvardeh, S and Ghafghazi, S and Zarei, M}, title = {Modulation of immune responses by opioids through toll-like and P2X receptor signaling in COVID-19.}, journal = {Purinergic signalling}, volume = {22}, number = {2}, pages = {22}, pmid = {41697483}, issn = {1573-9546}, mesh = {Humans ; *COVID-19/immunology/metabolism ; *Signal Transduction/drug effects/immunology ; *Toll-Like Receptors/immunology/metabolism ; *Analgesics, Opioid/pharmacology ; *Receptors, Purinergic P2X/immunology/metabolism ; Animals ; SARS-CoV-2 ; Immunity, Innate/drug effects ; }, abstract = {The pathogenesis of COVID-19 involves complex interactions between viral replication and host immune dysregulation, mediated by toll-like receptors (TLRs) and P2X receptors (P2XRs). These receptors detect pathogen- and damage-associated molecular patterns (PAMPs and DAMPs), triggering inflammatory cascades. Opioids, beyond their analgesic role, modulate innate and adaptive immune responses via opioid receptors and indirectly through TLR and P2X signaling. This narrative review integrates experimental, clinical, and bioinformatic evidence to explore the mechanistic crosstalk between opioid signaling, TLRs (notably TLR2, TLR4, TLR9), and P2XRs (notably P2X4 and P2X7) in COVID-19 immunopathology. Chronic opioid exposure may either enhance or suppress inflammation depending on dose, duration, and immune context. In COVID-19, the hyperactivation of TLR4, TLR7, and TLR9 drives cytokine storms, while the release of ATP from damaged cells activates P2X7, thereby amplifying the inflammatory response. ATP breakdown into adenosine further modulates immunity via A2A and A2B receptors. Targeting TLR4 and P2X7 offers a promising therapeutic strategy to mitigate hyperinflammation and improve outcomes in COVID-19 and related inflammatory diseases. In addition, we outline how the Contact System, the Kallikrein-Kinin System (KKS), the Renin-Angiotensin System (RAS), and the NLRP3 inflammasome provide the innate inflammatory backdrop through which opioids and P2 receptor signaling may shape immune dysregulation in COVID-19. Notably, direct clinical evidence for opioid-P2 receptor interactions in COVID-19 remains limited, highlighting the need for targeted translational studies.}, }
@article {pmid41697791, year = {2026}, author = {Ayalew, AF and Delie, AM and Tiruneh, C and Mulat, S and Fornah, L and Ma, W}, title = {Safety knowledge gaps among Ethiopian health professionals: A systematic review and meta-analysis.}, journal = {Work (Reading, Mass.)}, volume = {84}, number = {3}, pages = {680-694}, doi = {10.1177/10519815261420215}, pmid = {41697791}, issn = {1875-9270}, mesh = {Humans ; COVID-19/prevention & control ; Ethiopia ; *Health Knowledge, Attitudes, Practice ; *Health Personnel/psychology/statistics & numerical data ; }, abstract = {BackgroundThere are knowledge gaps regarding safety measures among healthcare professionals (HPs) in Ethiopia. Safety measures are critical for safeguarding HPs and clients.ObjectiveTo assess the pooled knowledge and areas of gaps related to safety measures among HPs in Ethiopia.MethodsThis systematic review and meta-analysis included published Ethiopian studies as of August 2024, sourced from June 1 to August 30, 2024. Databases included PubMed, Web of Science, Epistemonikos, Semantic Scholar, and Google Scholar. Data were extracted using Microsoft Excel and analyzed using STATA 17. A random-effects model was used to estimate pooled knowledge, and heterogeneity was assessed using the I[2] statistic (I[2] = 98.68%, p < 0.001). Publication bias was assessed using funnel plots, Egger's test (P = 0.3239), and Begg's test (P = 0.2465). We used subgroup analyses to see variation across different variables.ResultsWe included 64 studies involving 23,257 HPs. The pooled knowledge was 67.19% (95% CI: 63%-72.81%). In subgroup analysis, 77.39% were aware of COVID-19 prevention measures, and 76.55% were aware of hospital-acquired infections. Knowledge was lower for HIV prophylaxis (57.12%) and healthcare waste management (56.52%). Key consistent influencing factors included training, guideline availability, work experience, professional role, and education.ConclusionsEthiopian HPs had moderate knowledge of safety measures and relatively low knowledge of HIV prophylaxis and healthcare waste management. We recommended standardized assessment tools, targeted training interventions, and expanded coverage to underrepresented regions.}, }
@article {pmid41698791, year = {2026}, author = {Saiding, Q and Xiao, F and Khan, MM and Kong, N and Huang, X and Tao, W}, title = {Lipid-Polymer Hybrid Nanoparticles (LPHNPs) for RNA Delivery.}, journal = {Accounts of chemical research}, volume = {59}, number = {5}, pages = {762-775}, doi = {10.1021/acs.accounts.5c00874}, pmid = {41698791}, issn = {1520-4898}, mesh = {Humans ; *Nanoparticles/chemistry ; *Lipids/chemistry ; *Polymers/chemistry ; RNA, Small Interfering/chemistry ; Animals ; *RNA/chemistry/administration & dosage ; }, abstract = {RNA-based therapeutics are now revolutionizing modern medicine, with examples like COVID-19 mRNA vaccines and the siRNA drug Leqvio, validating their potential in infectious diseases and chronic diseases. However, the broad clinical translation of RNA therapeutics remains critically dependent on the development of safe and effective delivery systems that are capable of overcoming physiological barriers and achieving precise spatiotemporal upregulation or downregulation of target proteins. Lipid nanoparticles (LNPs) have attracted significant attention due to their clinical success, yet they still struggle to overcome context-specific delivery barriers, such as poor stability in blood or gastrointestinal fluids, lack of disease-microenvironment responsiveness, and insufficient cell-type targeting, which hinder the full implementation of RNA therapeutics across a broad spectrum of diseases. To tackle the unmet needs in RNA-based therapeutics, developing new types of delivery platforms with different nanoparticle structures is therefore highly attractive and needed. Over the past decade, our group has focused on developing novel lipid-polymer hybrid nanoparticles (LPHNPs) for the delivery of RNA therapeutics across diverse biomedical applications. By incorporating biodegradable polymers with tailored properties, for example, poly(lactic-co-glycolic acid) (PLGA) for structural stability, hyaluronic acid (HA) for CD44-mediated targeted delivery, and l-cysteine-based poly(disulfide amide) (Cys-PDSA) for redox-responsive release in the tumor microenvironment, these LPHNPs exhibit highly tunable architectures that integrate efficient RNA encapsulation, site-specific delivery, and controlled RNA release, providing more tools and choices for RNA delivery. In this Account, we summarize recent advances from our group in the design and synthesis of LPHNPs for RNA therapeutics, as well as their translational applications across diverse disease contexts. We highlight rational material pairings and design principles that optimize key performance metrics, including colloidal stability, RNA loading, cellular uptake, endosomal escape, and targeting efficacy. We also provide case studies demonstrating the translational potential of RNA-LPHNPs across various administration routes and disease models, including oral, inhaled, intravenous, and intravesical delivery, using the LPHNP platforms developed in our laboratory. These platforms have achieved promising therapeutic efficacy in models of cancers, inflammatory diseases, and respiratory conditions by enabling local or systemic delivery of mRNA or siRNA to immune cells, epithelial cells, and tumor microenvironments. By outlining optimized design strategies and future challenges, this Account aims to serve as a roadmap for researchers seeking to develop next-generation RNA delivery platforms that are modular, functionally versatile, and translatable.}, }
@article {pmid41699407, year = {2026}, author = {Ben Ghezala, I and Peiffer-Smadja, N and Solas, C and Nougairède, A and Touret, F and Bardou, M}, title = {How Can Pharmacology Help Us Overcome the Challenges of Drug Repositioning as Antivirals to Treat Emerging Pathogens? The Example of Covid-19.}, journal = {Clinical and translational science}, volume = {19}, number = {2}, pages = {e70505}, pmid = {41699407}, issn = {1752-8062}, mesh = {Humans ; *Antiviral Agents/therapeutic use/pharmacology/pharmacokinetics ; *Drug Repositioning/methods ; Animals ; SARS-CoV-2 ; *COVID-19 Drug Treatment ; COVID-19 ; Pandemics ; Hydroxychloroquine/pharmacology/therapeutic use/pharmacokinetics ; *Coronavirus Infections/drug therapy/virology ; *Pneumonia, Viral/drug therapy/virology ; *Betacoronavirus/drug effects ; Clinical Trials as Topic ; Azithromycin/pharmacology/therapeutic use/pharmacokinetics ; Adenosine Monophosphate/analogs & derivatives/pharmacokinetics/pharmacology ; }, abstract = {The Covid-19 pandemic highlighted the urgent need for effective therapies against emerging pathogens. Drug repurposing, defined as the use of existing medications for new therapeutic purposes, was extensively pursued for SARS-CoV-2 but has not yielded successful treatments. This narrative review critically examines the pharmacological and methodological factors that contributed to these unsuccessful outcomes, paying particular attention to tests of azithromycin and hydroxychloroquine. There are many reasons the promise of repurposed drugs was not realized. Many repurposed compounds displayed promising in vitro antiviral activity that did not translate into clinical efficacy. Major pharmacokinetic (PK) limitations, for example, poor oral bioavailability, low concentrations in pulmonary tissue, and extensive plasma protein binding, prevented these drugs from reaching therapeutic levels in humans. Preclinical research often relied on non-human cell lines and animal models that inadequately reflected human physiology, leading to misleading experimental outcomes. Clinical trials were often undermined by methodological limitations, including endpoints with uncertain clinical significance, suboptimal comparators, and insufficient attention paid to key PK and pharmacodynamic (PD) parameters such as half maximal effective concentration (EC50) values. This narrative review emphasizes the importance of integrating comprehensive PK/PD assessments, relevant experimental models, and rigorous trial design to strengthen drug development during future health crises. The relative success of antivirals including molnupiravir, nirmatrelvir, and remdesivir, which were either novel or previously unapproved compounds, suggests the value of designing and developing targeted antivirals. We must coordinate global research, develop pharmacologically sound strategies, and use evidence-based decision-making to effectively prepare for future pandemics and quickly produce effective treatments.}, }
@article {pmid41700931, year = {2026}, author = {Dhawan, S and Hughes, J and Matveyenko, AV and Poitout, V}, title = {Staying Functional Through Connection and Adaptation: When Islets Inspire Islet Biologists.}, journal = {Diabetes}, volume = {75}, number = {4}, pages = {596-602}, pmid = {41700931}, issn = {1939-327X}, support = {//J.W. Kieckhefer Foundation/ ; R01DK140088/DK/NIDDK NIH HHS/United States ; //Diabetes Canada/ ; R01DK138974/DK/NIDDK NIH HHS/United States ; RGPIN-2022-03732//Natural Sciences and Engineering Research Council of Canada/ ; R01DK140365/DK/NIDDK NIH HHS/United States ; R01DK098468/DK/NIDDK NIH HHS/United States ; PJT-469193//Institute of Nutrition, Metabolism and Diabetes/ ; R01DK132597/DK/NIDDK NIH HHS/United States ; R01 DK140088/DK/NIDDK NIH HHS/United States ; }, mesh = {*Islets of Langerhans/physiology/metabolism ; Humans ; Animals ; COVID-19 ; Adaptation, Physiological/physiology ; SARS-CoV-2 ; }, abstract = {In response to the lockdowns and travel bans during the coronavirus disease 2019 pandemic, Peter C. Butler at the University of California, Los Angeles (UCLA), started a virtual islet biology seminar series. After the authors of this article joined him as co-organizers, this initiative became the Islet Research Seminar Series (IRSS). Like islets of Langerhans adapt to their changing environment, the islet biology community quickly embraced this new format. The IRSS evolved into a lasting scientific forum that convenes weekly and is attended by islet biologists from the U.S., Canada, Europe, and Israel. The series covers a range of topics in islet biology, with presentations from scientists representing all career stages. It has proven particularly valuable for trainees and early-stage investigators in exposing them to a variety of topics in islet biology without travel required and facilitating more spontaneous interactions with senior scientists than at in-person meetings. While the online format is not meant to replace live scientific conferences, we believe that the IRSS plays a unique role in keeping the islet biology community connected and abreast of the most recent scientific discoveries in our field. The success of this platform stands as a testament to the scientific community to adapt and thrive through challenges. This article is dedicated to Peter C. Butler, UCLA, who initiated the IRSS.}, }
@article {pmid41702131, year = {2026}, author = {Wang, Z and Ren, B and Rawaf, S and Tabche, C}, title = {Impact of the COVID-19 pandemic on cancer screening in Europe: A systematic review of disruptions, barriers, and policy responses.}, journal = {Cancer treatment and research communications}, volume = {47}, number = {}, pages = {101115}, doi = {10.1016/j.ctarc.2026.101115}, pmid = {41702131}, issn = {2468-2942}, mesh = {Humans ; Europe/epidemiology ; *COVID-19/epidemiology ; *Early Detection of Cancer/statistics & numerical data/methods ; *Neoplasms/diagnosis/epidemiology ; SARS-CoV-2 ; Health Policy ; Pandemics ; Mass Screening ; }, abstract = {BACKGROUND: Cancer screening is a cornerstone of cancer control, but the COVID-19 pandemic caused unprecedented disruption to preventive healthcare worldwide. In Europe, national screening programmes were severely affected, with consequences extending beyond screening to diagnosis, treatment, and equity. While several country-specific studies exist, cross-regional syntheses remain scarce. Understanding the scale, determinants, and outcomes of these disruptions is crucial to building resilient, equiTable screening systems.
AIM/OBJECTIVE: This systematic review synthesises evidence on the impact of the COVID-19 pandemic on cancer screening across Europe, examining differences by cancer type, screening modality, and national context. It also explores downstream effects, barriers, enablers, and policy responses to guide future preparedness.
METHODS: Following PRISMA guidelines, six databases and grey literature sources were searched for studies published between December 2019 and January 2025. Eligible studies included quantitative and qualitative analyses of screening activity during the pandemic. Data were extracted on study characteristics, outcomes, and contextual factors. Given the heterogeneity of measures, findings were summarised using descriptive statistics and thematic synthesis.
RESULT: Forty-five studies from 18 European countries revealed a 30-60 % reduction in screening participation at peak disruption, varying by cancer type and country. Consequences included delayed diagnoses, stage migration, increased projected mortality, and widening inequalities. Major barriers included service suspension, staff redeployment, and fear of infection. Enablers comprised adaptive communication, safety protocols, and digital innovations.
CONCLUSION: COVID-19 caused substantial and uneven disruption to European cancer screening. Protecting continuity, institutionalising innovations, and addressing inequities are critical to enhancing resilience for future health crises.}, }
@article {pmid41702338, year = {2026}, author = {Hazenberg, P and Duncan, CJ}, title = {Human genetics of susceptibility to live-attenuated viral vaccines.}, journal = {Current opinion in virology}, volume = {75}, number = {}, pages = {101512}, doi = {10.1016/j.coviro.2026.101512}, pmid = {41702338}, issn = {1879-6265}, mesh = {Humans ; *Vaccines, Attenuated/immunology/administration & dosage/adverse effects ; *Viral Vaccines/immunology/administration & dosage/adverse effects/genetics ; *Virus Diseases/prevention & control/immunology/genetics/virology ; *Genetic Predisposition to Disease ; Vaccination ; Animals ; }, abstract = {Alongside the development of antibiotics, vaccination is the medical innovation with arguably the greatest impact on human health. Testament to its success is the eradication of infectious diseases, such as smallpox, that devastated human populations for almost 4000 years. Live-attenuated vaccines (LAV), which retain the capacity for infection and replication, were the first to be developed and remain highly efficacious, underpinning successful human vaccination campaigns (e.g. polio virus, measles virus, yellow fever virus). The cost of this success is the capacity of LAVs to cause disease in a small proportion of recipients, typically owing to overt or previously unappreciated immunodeficiency. From the careful investigation of such rare events, major clinical and scientific lessons about human antiviral immunity have been drawn. Here, we review features of pathogenic LAV dissemination, which continue to inform our understanding of critical steps in the immune control of LAVs. We discuss recent data on specific variants identified in geographically isolated populations and reflect on more common phenocopies of these monogenic defects, with potential implications for vaccine practice and policy. Collectively, these insights may inform approaches to the growing population of individuals rendered more vulnerable to LAVs by aging, multimorbidity or medical intervention. They also serve to highlight the clinical need for therapeutic strategies to combat pathogenic LAV dissemination.}, }
@article {pmid41702386, year = {2026}, author = {Yadegari, H}, title = {Von Willebrand Factor at the Crossroads of Hemostasis and Inflammation.}, journal = {Hamostaseologie}, volume = {46}, number = {1}, pages = {34-43}, doi = {10.1055/a-2755-5477}, pmid = {41702386}, issn = {2567-5761}, mesh = {Humans ; *von Willebrand Factor/immunology/metabolism ; *Hemostasis/immunology ; *Inflammation/immunology/blood ; Immunity, Innate ; Animals ; COVID-19/immunology/blood ; }, abstract = {Von Willebrand factor (VWF) is a large multimeric glycoprotein critical for hemostasis, mediating platelet adhesion to injured vessels and stabilizing circulating factor VIII. However, accumulating evidence reveals a complex, context-dependent role for VWF in inflammation and innate immunity that extends well beyond coagulation. VWF acts not only as a biomarker of endothelial activation but also as an active participant in immune responses. VWF directly interacts with major immune cell types-including macrophages, polymorphonuclear leukocytes (neutrophils), and dendritic cells-through both its endothelial-anchored and plasma forms. VWF facilitates leukocyte recruitment and transmigration across the vessel wall, while its interactions also promote macrophage and neutrophil activation as well as NET formation. VWF's immunomodulatory functions are further highlighted by its binding to extracellular DNA, smooth muscle cells, complement components (C1q and C3), and bacterial pathogens under flow conditions. Furthermore, VWF indirectly influences inflammation via its crucial role in Weibel-Palade body formation, a process that co-packages vital inflammatory mediators like P-selectin and angiopoietin-2. Markedly elevated VWF levels are consistently observed across acute and chronic inflammatory conditions such as sepsis, COVID-19, and autoimmune disorders, confirming its relevance as both a diagnostic marker and a therapeutic target. A comprehensive understanding of VWF's diverse functions in vascular inflammation is crucial for developing targeted therapeutics-including nanobodies, ADAMTS13 variants, and VWF interaction inhibitors-capable of modulating pathological thrombo-inflammation while preserving physiological hemostasis.}, }
@article {pmid41702637, year = {2026}, author = {Torres Munguía, JA and Martínez-Zarzoso, I}, title = {Global trends of pandemic-prone and epidemic-prone disease outbreaks in 2024.}, journal = {BMJ global health}, volume = {11}, number = {2}, pages = {}, pmid = {41702637}, issn = {2059-7908}, mesh = {Humans ; *Pandemics ; COVID-19/epidemiology ; *Disease Outbreaks/statistics & numerical data ; *Global Health/statistics & numerical data ; SARS-CoV-2 ; }, abstract = {During 2024, the number of pandemic-prone and epidemic-prone disease outbreaks worldwide was estimated at 301. The data highlight a shift in disease outbreak patterns, with a decline in the number of countries reporting public health events of concern linked to COVID-19 and a rise in those reporting outbreaks of viral diseases transmitted by vectors.About 90% of the outbreaks in 2024 were associated with COVID-19, dengue, yellow fever, Oropouche virus disease and influenza (linked to identified zoonotic or pandemic influenza virus). Although disease outbreaks can affect any country anywhere, they tend to disproportionately occur in countries facing many other socio-economic development, climatic and humanitarian challenges. In this regard, sub-Saharan Africa and the subregion of Latin America and the Caribbean-home to just 23.3% of the world's population-reported the highest number of disease outbreaks in 2024 with about 57% of the total. Particularly, the sub-Saharan Africa region has been the site of nearly 32% of recorded outbreaks since 1996. Future research should include efforts to improve the quality and availability of disease outbreaks data-particularly in the most exposed or vulnerable regions-and to promote the scientific use of such information for foresight purposes and for forecasting future health events of concern to support anticipatory action.}, }
@article {pmid41703981, year = {2026}, author = {Tuschick, E and Smith, J and Harrison, B and Youngman, M and Giles, EL}, title = {Food Insecurity in Families With Children or Young People With Autism: A Systematic Review and Meta-Analysis.}, journal = {Nutrition bulletin}, volume = {51}, number = {2}, pages = {185-199}, pmid = {41703981}, issn = {1467-3010}, mesh = {Humans ; *Food Insecurity ; Child ; Adolescent ; COVID-19/epidemiology ; *Autism Spectrum Disorder ; *Autistic Disorder ; Prevalence ; *Family ; Feeding Behavior ; Caregivers/psychology ; SARS-CoV-2 ; Child, Preschool ; }, abstract = {Food insecurity is frequently reported among families of children with autism spectrum conditions (ASC), yet there is limited evidence synthesising its prevalence and impact. This systematic review aimed to examine and meta-analyse the existing literature on food insecurity in families of children and young people with ASC. A comprehensive search across nine databases identified 39 papers, of which 11 met the inclusion criteria. Studies were included if they involved autistic children or young people under the age of 25 (and/or their family members) and focused on food insecurity. Eligible studies were critically appraised, and data were synthesised using both narrative and meta-analytic approaches. Meta-analyses of nine studies estimated a pooled prevalence of food insecurity at 29% (SE: 5%; 95% CI: 17%-40%; z = 5.35, p < 0.001), which increased to 31% following adjustment for publication bias. The review also found that food insecurity worsened during the COVID-19 pandemic, contributing to increased caregiver stress and disruptions in eating behaviours. This review demonstrates the high prevalence of food insecurity among families of children with ASC and the complex interplay of social, economic and behavioural challenges they face. Addressing food insecurity in autistic households requires policy responses that extend beyond financial aid to consider the sensory, behavioural and nutritional needs specific to ASC. Future research should adopt standardised measures and prioritise the development and evaluation of inclusive, tailored food support systems that reflect the lived experiences of neurodiverse families.}, }
@article {pmid41704166, year = {2026}, author = {Gerrie, A and Bellman, S and Pollock, D}, title = {Experiences of people with diabetes mellitus during the COVID-19 pandemic utilizing telehealth for diabetes management: a qualitative systematic review.}, journal = {JBI evidence synthesis}, volume = {24}, number = {6}, pages = {1102-1155}, doi = {10.11124/JBIES-25-00355}, pmid = {41704166}, issn = {2689-8381}, mesh = {Humans ; *Telemedicine ; *COVID-19 ; *Diabetes Mellitus/therapy ; Pandemics ; SARS-CoV-2 ; Qualitative Research ; Digital Health ; *Coronavirus Infections/epidemiology ; Betacoronavirus ; *Pneumonia, Viral/epidemiology ; }, abstract = {OBJECTIVE: The objective of this review was to explore the experiences of people with diabetes mellitus who utilized telehealth for diabetes management due to COVID-19 pandemic.
INTRODUCTION: COVID-19 intensified globally from January 2020, eliciting a multinational response to infection control for health preservation, including social distancing in public areas and health. The outcome had significant impact on the health care system, where persons with chronic diseases such as diabetes were required to transition a majority of their care to telehealth to align with social restrictions. To date, research has not addressed a synthesis or critical analysis in systematic reviews addressing the experiences of people with diabetes mellitus receiving care, and what effect this rapid shift to telehealth had compared with traditional in-person consultations.
ELIGIBILITY CRITERIA: This review included primary qualitative or mixed methods studies of any research design that examined the experiences of adult with diabetes transitioning from in-person consultations to telehealth during the COVID-19 pandemic. Exclusions included quantitative studies; secondary, tertiary, and gray literature; and literature pre-COVID-19.
METHODS: This review was conducted according to JBI guidance on qualitative systematic reviews. A search of CINAHL (EBSCOhost), Scopus, Embase, Emcare (Ovid), PubMed, and ProQuest Central was conducted. Studies from January 2020 onward in any language were assessed for eligibility. Two reviewers independently screened studies and assessed the methodological quality of the included studies using the JBI Qualitative Critical Appraisal Tool. The included studies were synthesized using JBI meta-aggregation, and the confidence in the findings was assessed with ConQual.
RESULTS: The reviewers screened 1491 titles and abstracts, and 9 studies were selected for inclusion. Three synthesized findings were identified: i) The provision of care and diabetes self-management capabilities utilizing telehealth was based on the awareness and acceptance of services, the perceived quality of communication, and the ability for patients to access safe and quality health assessments and care; ii) Telehealth was seen as logistically convenient, saving effort, money, and time through reduced travel for patients; and iii) Telehealth requires user-friendly infrastructure that considers accessibility, connectivity, compatibility, and digital health literacy.
CONCLUSIONS: The review validates the existing utilization of telehealth for diabetes care, further suggesting implementation of formalized telehealth as a hybrid model service for diabetes care delivery beyond the pandemic.
REVIEW REGISTRATION: PROSPERO CRD4202342466.}, }
@article {pmid41705169, year = {2025}, author = {Dost, G}, title = {Belongingness and loneliness in higher education: a meta-analysis of pre- and post-pandemic trends.}, journal = {Frontiers in psychology}, volume = {16}, number = {}, pages = {1625957}, pmid = {41705169}, issn = {1664-1078}, abstract = {INTRODUCTION: This meta-analysis seeks to explore how the complex relationship between loneliness and belongingness in higher education students can be explained by a set of pre- and post-COVID-19 pandemic dynamics.
METHODS: A meta-analysis including 56 studies and involving a total of 30,062 participants was conducted, and the review explores direct relations and moderation through age, education, and country.
RESULTS: Results indicate a moderate-to-strong negative relationship between loneliness and belongingness (r = -0.48, 95% CI [-0.529, -0.422]), such that a consistent association was found across situations such that increases in one's level of loneliness is associated with decreases in one's level of belongingness. Nevertheless, there was no small-degree of inter-study heterogeneity (Q = 1058.86, p < 0.0001, I[2] = 94.33%), which is a potential reason for the differences in the study populations and methods, employing a random-effects model to account for these discrepancies. After further scrutiny of the results, location, and year of study, and country did not moderate the effect size, which in turn reflects the stability of the association across context and time. In the subgroup analysis the effect size of the relationship between the level of the Information Technology (IT) usage and the externalisation was lower in the time of the pandemic than in the time preceding the pandemic. The effect size of the pre-pandemic group is -0.515 (95% CI: -0.589 to -0.441, p < 0.001 < 0.001) and the effect size of pandemic group is slightly smaller with -0.427 (95% CI: -0.502 to -0.352, p < 0.001 < 0.001). This means that although the level of loneliness have normalised, there have been a subtonic influence on perceived belonging of the novelty stressor caused by breakdowns in social connection from pandemic-level influences. In addition, no significant publication bias was observed.
DISCUSSION: Overall, these findings confirm the strong negative association between loneliness and sense of belonging and emphasise the important role in providing community support for students, especially during social disruptions.}, }
@article {pmid41707545, year = {2026}, author = {Goren, T and Vashdi, DR and Beeri, I}, title = {Political trust and health compliance during a health crisis: A systematic literature review from the COVID-19 pandemic.}, journal = {Social science & medicine (1982)}, volume = {395}, number = {}, pages = {119093}, doi = {10.1016/j.socscimed.2026.119093}, pmid = {41707545}, issn = {1873-5347}, mesh = {Humans ; *Trust ; COVID-19 ; *Politics ; *Pandemics/prevention & control ; *Pneumonia, Viral/epidemiology ; *Coronavirus Infections/epidemiology ; SARS-CoV-2 ; }, abstract = {Political trust is considered crucial for enhancing civic compliance with government policies and instructions, particularly during a health crisis. However, evidence from the COVID-19 pandemic, a major global health crisis, suggest a more nuanced relationship. Aiming to explore and clarify the nature of and the conditions for the political trust and civic compliance relationship in the context of a health crisis in the general population, at the overall societal-level, this study systematically reviews relevant literature from the COVID-19 pandemic, across 62 countries. Our findings indicate that the positive relationship between political trust and compliance is not self-evident, as 42% of the reviewed studies (63 of 151) report non-significant, mixed or negative results. Moreover, conceptual and methodological features seem to affect the likelihood of this association, such as the object of trust and compliance behavior, the behavior's execution timeframe and its legal status, and the manner in which political trust and compliance are measured. Potential consequences are discussed.}, }
@article {pmid41707618, year = {2026}, author = {Xu, Q and Zhao, M and Wang, Q and He, Y and Ye, G and Yang, J and Huang, W and Ren, J}, title = {Chronic fatigue syndrome: From etiology and mechanism to diagnosis and treatment.}, journal = {Journal of psychiatric research}, volume = {196}, number = {}, pages = {171-184}, doi = {10.1016/j.jpsychires.2026.02.026}, pmid = {41707618}, issn = {1879-1379}, mesh = {Humans ; *Fatigue Syndrome, Chronic/diagnosis/therapy/etiology ; *COVID-19/complications ; }, abstract = {Myalgic encephalomyelitis (ME), commonly known as chronic fatigue syndrome (CFS), is a long-lasting neurological disease. The cause of ME remains uncertain, characterized by unrelenting or recurring fatigue not alleviated by rest. In recent times, CFS incidence has been on the rise annually, showing a tendency towards younger sufferers. Especially post-COVID-19, its prevalence has surged, posing a significant threat to 21st-century health. CFS symptoms are intricate and diverse. Patients typically endure extreme fatigue lasting over six months, accompanied by physical and neuropsychiatric symptoms like sore throat, muscle/joint pain, anxiety, and distress. These severely disrupt daily life and work, heightening illness risks and financial strain. With the unknown etiology, current treatments have limited success and may induce psychological issues such as anxiety and depression. This paper delivers an extensive and thorough overview of the latest developments in the studies concerning the pathogenesis, diagnostic standards, and therapeutic approaches for chronic fatigue syndrome. Integrating and assessing the existing knowledge body related to this field systematically, we aim to facilitate continuous research and gain a deeper understanding of this complex medical problem whose mechanism remains largely unknown. Moreover, valuable insights and practical recommendations for future related treatments and research are also provided.}, }
@article {pmid41708119, year = {2026}, author = {Radtke, T and Pham-Ngoc, H and Hua-Huy, T and Hsia, CCW and Dressel, H and Dinh-Xuan, AT}, title = {Pulmonary diffusing capacity for nitric oxide in disease: a scoping review.}, journal = {European respiratory review : an official journal of the European Respiratory Society}, volume = {35}, number = {179}, pages = {}, pmid = {41708119}, issn = {1600-0617}, mesh = {Humans ; *Pulmonary Diffusing Capacity ; *Nitric Oxide/metabolism ; *Lung/physiopathology/metabolism ; *COVID-19/physiopathology ; *Lung Diseases/physiopathology/diagnosis/metabolism ; Predictive Value of Tests ; }, abstract = {OBJECTIVE: This scoping review aims to map the available studies on single-breath pulmonary diffusing capacity for nitric oxide (D LNO) in various clinical diseases and identify gaps for future research.
METHODS: We followed the JBI methodology for scoping reviews. A systematic literature search was conducted in Embase, MEDLINE (EBSCOhost), PubMed, Scopus, Web of Science and the Cochrane Library to identify studies on D LNO from 1983 to 2025. Two reviewers screened abstracts using Rayyan software and extracted data using standardised templates implemented into REDCap (Research Electronic Data Capture).
RESULTS: We identified 1638 studies, of which 69 met the eligibility criteria. These studies represented respiratory (n=22), immunological/genetic/systemic (n=14), post-COVID-19 sequelae (n=13), cardiovascular (n=9), metabolic/endocrine/renal (n=6), environmental-related (n=3) and other (n=2) conditions. There was substantial heterogeneity in disease categories, sample sizes and reporting methods. Nearly half of the studies (49.3%) used convenience sampling, where participant selection processes are often poorly described; 62.3% included <50 participants. Only 18.8% reported a sample size calculation, and 10.1% registered or published a study protocol. Disparate findings within disease categories were often difficult to interpret; and small sample sizes limited generalisability. In some specific conditions, D LNO showed sensitivity in detecting interstitial and fibrotic changes compared to conventional single-breath pulmonary diffusing capacity for carbon monoxide (D LCO) while simultaneous D LNO-D LCO measurements permitted the detection of pulmonary vascular-haematological perturbations.
CONCLUSION: Single-breath D LNO-D LCO may provide additional pathophysiological insight by assessing the relative contributions from membrane and blood resistance of diffusion. Larger studies are required to clarify its interpretation across disease states.}, }
@article {pmid41709444, year = {2026}, author = {Park, JJ and Na, SH and Park, H and Lee, J and Seo, Y}, title = {Layout Types and Efficiency Improvement Strategies for Open Points of Dispensing in Vaccine and Antibiotic Distribution: A Scoping Review.}, journal = {Prehospital and disaster medicine}, volume = {41}, number = {1}, pages = {e1}, doi = {10.1017/S1049023X26108838}, pmid = {41709444}, issn = {1945-1938}, mesh = {Humans ; *Anti-Bacterial Agents/supply & distribution ; *Vaccines/supply & distribution ; *Efficiency, Organizational ; COVID-19/prevention & control ; Workflow ; Pandemics/prevention & control ; }, abstract = {INTRODUCTION: Regarding pandemics or bioterrorism incidents, prompt and secure distribution of vaccines and prophylactic antibiotics is crucial. Open Points of Dispensing (PODs) are established to serve the public, and their effectiveness depends on the internal spatial layout and operational workflow design. However, studies on systematic classifications of open POD configurations and comprehensive syntheses of strategies for enhancing operational efficiency are lacking.
STUDY OBJECTIVE: This scoping review aimed to classify open POD layout types used for vaccine and antibiotic distribution and to consolidate strategies that improve efficiency across various workflow stations.
METHODS: A scoping review was conducted following the PRISMA-ScR guidelines. A comprehensive literature search was conducted across PubMed, Embase, and Web of Science databases, spanning from January 2001 through July 2025. The search strategy involved incorporating keyword combinations related to "points of dispensing," "mass vaccination," "mass prophylaxis," and specific pathogens such as anthrax, influenza, and COVID-19. Extracted data included the POD layout typologies, process designs, and efficiency metrics. The findings were synthesized using a narrative approach.
RESULTS: Nineteen studies met the inclusion criteria and were analyzed. Vaccine PODs were classified into four primary layouts, namely station-based sequential-flow, cell-based, fixed-seat service, and pop-up PODs. Antibiotic PODs were categorized into two types, namely sequential processing and selective-expedited processing. Each layout exhibited unique operational characteristics, including sequential versus integrated clinical stations (for vaccine PODs) and standard versus expedited dispensing lines (for antibiotic PODs). Efficiency enhancement strategies across workflow stations included task integration, use of digital tools, simplification of documentation, optimization of medication preparation, and staffing adjustments guided by simulation modeling.
CONCLUSION: This review provides a systematic classification of open POD layouts and summarizes the strategies for improving efficiency across workflow stations. The derived insights offer practical guidance for planning and operating PODs in future public health emergency responses.}, }
@article {pmid41709949, year = {2026}, author = {Vatankhah, H and Vatanparast, M and Royani, Z and Mansouri, G}, title = {Lessons from a Low-Resource Country: A Narrative Review of Virtual Learning Adoption and Challenges in Medical Education in Iran During COVID-19.}, journal = {Advances in medical education and practice}, volume = {17}, number = {}, pages = {561822}, pmid = {41709949}, issn = {1179-7258}, abstract = {OBJECTIVE: The global COVID-19 pandemic has had a profound impact on the education system. Education shifted to virtual methods, while there was not enough time to plan and choose a proper educational platform. In this study, we present an up-to-date review of the most commonly used virtual education platforms in Iran during the COVID-19 pandemic.
METHODS: This narrative review systematically searched Persian and English articles (2020-2024) in Medline, EMBASE, Scopus, Web of Science, ERIC, SID, CIVILICA, and PubMed using keywords: "COVID-19", "virtual learning", "online learning", "distance learning", "post-COVID infection", "real and virtual simulation", and "educational platforms".
RESULTS: Virtual classes have become increasingly popular during the pandemic. Adobe Connect, Sky Room, Skype, Big Blue Button, Google Meet, Gharar, Zoom, and Navaid System were the most commonly used platforms during the COVID pandemic in Iran. The most frequently utilized systems included Shad (predominant in general education and training) and Navid (leading in medical sciences). Shad had excelled in scalability and institutional integration but faced connectivity issues in rural areas. Despite its technical strengths, Navid was criticized because of insufficient interactivity and misalignment with learner needs in medical English.
DISCUSSION: During COVID-19, online medical education in Iran relied mainly on domestic platforms, which have some limitations. To ensure future equity and competency, a shift toward hybrid models incorporating offline-capable Learning Management Systems (LMS), simulation, and digital literacy training is essential.}, }
@article {pmid41710161, year = {2026}, author = {Andreadis, I and Vasilopoulou, S}, title = {The populism-euroscepticism nexus in a contested Europe: The EUPopLink COST Action.}, journal = {Open research Europe}, volume = {6}, number = {}, pages = {27}, pmid = {41710161}, issn = {2732-5121}, abstract = {The EUPopLink COST Action (CA23102) addresses the complex and changing relationship between populism and Euroscepticism in contemporary Europe. While often viewed as "two sides of the same coin," the nexus between these two phenomena is contingent and strategic rather than deterministic. Not all populists are Eurosceptic, and Euroscepticism is not always populist in nature. This publication synthesizes current scholarly debates, highlighting how the European Union (EU) is frequently framed as the populist "other", i.e., a remote, technocratic elite standing in opposition to the "pure people". The nature of this opposition varies significantly across the ideological spectrum, e.g. right-wing populism targets the EU primarily through a "traditionalist-authoritarian-nationalist" (TAN) lens, viewing it as a threat to national sovereignty and cultural identity, while left-wing populism critiques the EU based on socio-economic cleavages, challenging neoliberal governance and austerity while often advocating for a more democratic "Social Europe". The analysis further explores how the polycrisis era-marked by financial instability, the COVID-19 pandemic, and geopolitical conflict-has led to a sophisticated two-level strategy among populist actors. This involves increased institutional pragmatism coupled with radicalized, opportunistic communication, particularly on social media. Finally, the publication outlines the EUPopLink mandate, which seeks to standardize conceptual frameworks and generate an unprecedented body of comparative data through forthcoming country reports. By linking the supply and demand sides of electoral competition, the project aims to provide policymakers and scholars with the tools necessary to mitigate the negative consequences of these disruptive political forces.}, }
@article {pmid41710305, year = {2026}, author = {Paterson, A and Spies, R and Zauchenberger, CZ and Cheyne, A and Olliaro, PL and Rojek, A}, title = {Effectiveness of stigma reduction interventions and outbreak response adaptations in infectious disease outbreaks: a systematic review.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1755092}, pmid = {41710305}, issn = {2296-2565}, mesh = {Humans ; *Disease Outbreaks/prevention & control ; *Social Stigma ; *COVID-19/psychology/epidemiology ; Severe Acute Respiratory Syndrome/psychology/epidemiology ; SARS-CoV-2 ; Hemorrhagic Fever, Ebola/psychology/epidemiology ; }, abstract = {INTRODUCTION: Stigma is a common and recurring feature of infectious disease outbreaks where it may have detrimental effects on individual wellbeing and undermine outbreak response. This systematic review explores stigma reduction interventions in infectious disease outbreaks.
METHODS: Eligible studies were searched for in Medline, Embase, PsycINFO, and Global Health databases and through reference screening. Risk of bias was assessed using study design-specific tools and the results of included studies underwent narrative synthesis.
RESULTS: Eleven studies conducted across coronavirus disease 2019 (COVID-19), Ebola disease, mpox, severe acute respiratory syndrome (SARS), and a hypothetical infectious-disease scenario, met the inclusion criteria. Five studies reported reductions in stigma, four reported mixed or null results, and two reported increases in stigma. The most promising strategies for outbreak-related stigma reduction were embedding anti-stigma messaging within health communication, providing psychosocial support, and fostering genuinely participatory community involvement.
DISCUSSION: Evidence on how to effectively reduce stigma during outbreaks remains limited. Strengthening the theoretical foundations, measurement tools, and evaluation designs of stigma-reduction interventions will be essential to inform evidence-based outbreak preparedness and response policies. This would help decision-makers ensure that risk communication, community engagement, and service delivery minimise stigma and improve uptake of testing, care, and preventive measures.}, }
@article {pmid41710320, year = {2026}, author = {Kerai, T and Woolhouse, M and Nyazema, NZ and Mutapi, F}, title = {A narrative review of heterogeneity in SARS-CoV-2 infection outcomes and vaccine efficacy: strategizing pandemic preparedness in Africa.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1761547}, pmid = {41710320}, issn = {2296-2565}, mesh = {Humans ; *COVID-19/epidemiology/prevention & control/immunology ; Pandemic Preparedness ; Africa/epidemiology ; *Vaccine Efficacy ; *COVID-19 Vaccines/immunology ; SARS-CoV-2 ; Pandemics/prevention & control ; }, abstract = {Disease epidemiology during the COVID-19 pandemic differed greatly across the globe. In contrast to early pandemic predictions, Africa recorded the fewest SARS-CoV-2 related hospitalizations and deaths. Hypotheses proposed to explain this paradox include underreporting, age demographics, climate, national mitigation strategies, lifestyle factors, pre-existing cross-reactive protection, and host genetic determinants. This traditional, narrative review evaluates these hypotheses investigated in the published literature, and highlights knowledge gaps which limit our understanding and obscure validation of potential explanations. It also discusses how responses to vaccines, the primary intervention sought to control infectious disease outbreaks, may vary both within the African population and across other continents. Potential explanations in the literature include pre-existing immunity, poor nutrition, immune modulating co-infections, comorbidities, microbiome composition, genetic polymorphisms, and demographic factors. Previous studies have shown that pre-existing (infection-derived) immunity or cross-reactive immune responses can augment vaccine-elicited positive responses and can protect against reinfection in a way similar to immunization. Conversely, there are also studies showing that prior immunity interferes with the efficacy of new vaccines through mechanisms like original antigenic sin and immune imprinting. Thus, there is need for more immunology studies to understand the relative contribution of pre-existing cross-reactive immune responses to the epidemiology of new pathogens. These studies are particularly essential to understand the differences between pandemic preparedness and population vulnerability, as well as to inform vaccine development and vaccine effectiveness monitoring studies. SARS-CoV-2 serves as an important case study to understand heterogeneity between and within populations in immune responses to both the pathogen and to vaccination. This understanding is crucial in informing vaccine research and development aimed at supporting the 100-day mission for when the next pandemic threat emerges.}, }
@article {pmid41710557, year = {2025}, author = {Muzard, C and Seguin, J and Bonnefoy, J and Salkini, N and Serra, V and Alhareth, K and Lemdani, K and Mignet, N}, title = {Pre-clinical evaluation of mRNA-lipid nanoparticles' potency and toxicity: current practices and future directions.}, journal = {In vitro models}, volume = {4}, number = {3-4}, pages = {177-194}, pmid = {41710557}, issn = {2731-3441}, abstract = {Over the last few years, the success of COVID-19 mRNA vaccines has resulted in the emergence of RNA lipid nanoparticles (LNPs) with promising prospects for the prevention and treatment of various diseases. The context of the SARS-CoV-2 pandemic has led to the rapid development of vaccines with abbreviated non-clinical programs. However, there are currently no official guidelines defining the required standards for global marketing of mRNA based therapeutic products. Nevertheless, to guarantee a well-controlled product, it is essential to characterize both the drug substance and the final product in terms of their structure, composition, formulation, physico-chemical features, potency, and safety. This lack of guidance has resulted in a wide variety of heterogeneous in vitro tests being used to assess the potency and cytotoxicity of RNA-LNP. This review discusses the commonly used in vitro assays, primarily 2D monolayer assays, employed to evaluate the biological properties of RNA-LNP. We then explore novel alternative methods to bridge the gap between in vitro and in vivo results. We summarize (i) co-culture models, (ii) multilayer 3D assays and (iii) in vivo replacement models, exploring their potential applications in assessing the potency and safety of RNA-LNPs. Finally, we discuss the use of in silico and machine learning as models for optimizing and predicting the biological behavior of RNA-LNPs.}, }
@article {pmid41710600, year = {2026}, author = {Almohammadi, AA}, title = {The role of vaccination and infection prevention in reducing perioperative complications: A public health-anesthesia nexus.}, journal = {Saudi journal of anaesthesia}, volume = {20}, number = {1}, pages = {166-173}, pmid = {41710600}, issn = {1658-354X}, abstract = {The intersection of vaccination strategies, infection prevention protocols, and perioperative care represents a critical nexus in modern anesthetic practice and public health. This comprehensive review examines the evolving role of immunization and infection control measures in reducing perioperative complications, with particular emphasis on the Saudi Arabian healthcare context. The coronavirus disease 2019 pandemic has highlighted the importance of vaccination timing in relation to elective surgery, while established infection prevention practices continue to form the cornerstone of safe perioperative care. In Saudi Arabia, national initiatives have demonstrated significant improvements in healthcare-associated infection rates, with central line-associated bloodstream infections decreasing from 2.5 per 1000 catheter-days in 2021 to 1.28 per 1000 catheter-days by 2024. The implementation of evidence-based vaccination protocols and comprehensive infection prevention strategies has shown measurable benefits in reducing surgical site infections, respiratory complications, and overall perioperative morbidity. Anesthesiologists play a pivotal role in this public health framework, serving as key stakeholders in perioperative optimization through vaccination status assessment, infection control adherence, and risk stratification. The Saudi healthcare system's commitment to infection prevention excellence, aligned with Vision 2030 objectives, provides a unique model for integrating public health principles into anesthetic practice. Current evidence supports the strategic timing of vaccinations relative to elective procedures, with recommendations for postponing elective surgery 3-7 days after inactivated vaccines and 14-21 days following live vaccines. This review synthesizes current evidence, identifies best practices, and proposes future directions for optimizing the vaccination-infection prevention-anesthesia nexus to improve patient outcomes and advance public health goals within the Saudi healthcare landscape.}, }
@article {pmid41710641, year = {2026}, author = {Alabdulhadi, O and Almashari, Y and Alharbi, M}, title = {Virtual hospitals in the Kingdom of Saudi Arabia: A scoping review.}, journal = {Saudi journal of anaesthesia}, volume = {20}, number = {1}, pages = {188-196}, pmid = {41710641}, issn = {1658-354X}, abstract = {Virtual health hospitals have been on the rise significantly since COVID-19 globally. The Kingdom of Saudi Arabia has established several initiatives as part of Vision 2030, where Tele/Virtual Health is key part of this vision. The purpose of this review is to evaluate and establish the expected challenges and the potential value in virtual hospitals in Saudi Arabia. It also aims to identify and analyze gaps in existing knowledge to ideally aid the planning and commissioning of future research on this subject. Results of this review highlight several themes from the literature evolved as follow: 1) need for improvement in Saudi healthcare, 2) emergence of virtual healthcare due to COVID-19, 3) Virtual healthcare has many pros and cons to consider, and, 4) Virtual healthcare has many challenges.}, }
@article {pmid41710827, year = {2026}, author = {Chapman, SR and Willner, L and Abouafech, A and Roberti, C and Willner, C}, title = {Diagnostic Performance of Artificial Intelligence in Detecting COVID-19 Pneumonia on Chest Imaging.}, journal = {Cureus}, volume = {18}, number = {1}, pages = {e101775}, pmid = {41710827}, issn = {2168-8184}, abstract = {The COVID-19 pandemic highlighted the need for rapid, accurate, and accessible diagnostic tools. Chest imaging modalities, including chest radiography (CXR) and computed tomography (CT), provided valuable diagnostic information and prompted the development of artificial intelligence (AI) systems to support image interpretation and improve workflow efficiency. This literature review synthesizes current evidence on the diagnostic performance, limitations, and clinical implications of AI models in COVID-19 pneumonia detection through CXR and CT evaluation. A PubMed search was conducted through October 2025 to identify studies evaluating AI systems for the detection of COVID-19 pneumonia using CXR and CT. Studies reporting diagnostic performance metrics, including sensitivity, specificity, accuracy, or area under the curve (AUC), were included. Study quality and risk of bias were assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Eleven studies met the inclusion criteria. CXR-based AI systems demonstrated sensitivities from 80% to 98% and specificities from 82% to 96%, often comparable to radiologist performance. CT-based AI models achieved accuracies between 90% and 96%. AI models demonstrated strong internal diagnostic performance on CXR and CT but showed reduced accuracy with external validation, underscoring limitations related to generalizability and retrospective study designs. AI models demonstrate promising diagnostic performance for detecting COVID-19 pneumonia on chest imaging and may enhance radiologist efficiency. However, challenges related to generalizability, model adaptability, and clinician trust remain. Future research should prioritize external validation and transparent reporting to ensure the safe and effective integration of AI into clinical practice.}, }
@article {pmid41710955, year = {2026}, author = {Anderson, AS}, title = {Vaccines against antimicrobial resistance.}, journal = {Philosophical transactions of the Royal Society of London. Series B, Biological sciences}, volume = {381}, number = {1944}, pages = {}, doi = {10.1098/rstb.2025.0007}, pmid = {41710955}, issn = {1471-2970}, support = {//Pfizer/ ; GAMRIF//UKRI/MRC Wellcome/ ; GAMRIF//UK Department of Health and Social Care/ ; }, mesh = {*Drug Resistance, Bacterial ; *Bacterial Vaccines ; Humans ; *Viral Vaccines ; Anti-Bacterial Agents/pharmacology ; *Drug Resistance, Microbial ; }, abstract = {Antimicrobial resistance (AMR) is a global clinical and economic threat due to the impact that it has on how potentially deadly infections can be treated. Without intervention, it is estimated that AMR will be responsible for 10 million deaths a year by 2050, with a cost of 100 trillion USD. Sustainable prevention strategies are urgently needed to control the spread of AMR in communities and healthcare settings. Vaccines play an important role, not only in protection against emerging drug-resistant pathogens, but also in reducing antibiotic consumption by preventing infections before antimicrobial intervention begins. This review provides an overview of several existing bacterial and viral vaccines that have demonstrated effectiveness in reducing this burden and discusses the importance of development of further vaccines to tackle AMR, with a particular focus on Clostridioides difficile and group B streptococcus, for which long-awaited vaccines may be on the horizon. This article is part of the Royal Society Science+ meeting issue 'Vaccines and antimicrobial resistance: from science to policy'.}, }
@article {pmid41710956, year = {2026}, author = {Hatchett, R and MacLennan, CA}, title = {Lessons from COVID-19: the 100 Days Mission and antimicrobial resistance.}, journal = {Philosophical transactions of the Royal Society of London. Series B, Biological sciences}, volume = {381}, number = {1944}, pages = {}, doi = {10.1098/rstb.2025.0008}, pmid = {41710956}, issn = {1471-2970}, support = {GAMRIF//UK Department of Health and Social Care/ ; GAMRIF//UKRI/MRC Wellcome/ ; }, mesh = {Humans ; *COVID-19/prevention & control/epidemiology ; Pandemic Preparedness ; *SARS-CoV-2 ; *Drug Resistance, Microbial ; Pandemics ; }, abstract = {The COVID-19 pandemic demonstrated the capacity of the world to rapidly mobilize resources and political will when faced with an immediate, visible global threat. The accelerated development of effective vaccines inspired the Coalition for Epidemic Preparedness Innovations to promote the 100 Days Mission (100DM), an initiative to enable deployment of medical countermeasures within 100 days of identifying a pandemic threat. The success of the 100DM in uniting stakeholders highlights the power of framing challenges to inspire collective action. On the other hand, antimicrobial resistance (AMR) has had insufficient visibility and urgency to galvanize similar levels of political action. Framing AMR in a way that highlights the urgency, aligns incentives and builds multisectoral coalitions can help overcome some of these barriers. Ultimately, pandemic preparedness and AMR are both collective action problems, requiring sustained political will and systemic change. The AMR community must build systems that are agile and resilient and, by creating a unifying vision for AMR analogous to the 100DM, may promote global commitment to combating this slow-moving but devastating health crisis. This article is part of the Royal Society Science+ meeting issue 'Vaccines and antimicrobial resistance: from science to policy'.}, }
@article {pmid41712028, year = {2026}, author = {Chakraborty, C and Bhattacharya, M and Chatterjee, S and Lee, SS}, title = {Long COVID-associated neurological symptoms and brain fog: Understanding the mechanism of neuroinflammation, BBB disruption, diagnostics, and therapeutics.}, journal = {Molecular biology reports}, volume = {53}, number = {1}, pages = {401}, pmid = {41712028}, issn = {1573-4978}, mesh = {Humans ; Post-Acute COVID-19 Syndrome ; *Blood-Brain Barrier/pathology/metabolism ; *COVID-19/complications ; *Neuroinflammatory Diseases/diagnosis/therapy/virology ; SARS-CoV-2 ; Animals ; *Nervous System Diseases/diagnosis/therapy/etiology/virology ; Brain/pathology ; Pandemics ; Betacoronavirus ; *Coronavirus Infections/complications ; }, abstract = {Long COVID affects at least 10% of those with severe disease, and many experience neurological symptoms and brain fog. More than 200 symptoms are reported, yet a detailed understanding remains limited. This article summarizes current knowledge of neurological symptoms, brain fog, molecular mechanisms, neuroinflammation, blood-brain barrier disruption, diagnostics, and available therapeutics. Our review highlights the lack of diagnostics and treatments for these patients. We catalog the ongoing clinical trials, identify the urgent need for further therapeutics, and stress that advances in understanding pathophysiology will drive new treatments. We urge prioritizing animal model studies and improving diagnostics to accelerate the discovery and delivery of effective treatments for long COVID neurological symptoms.}, }
@article {pmid41712936, year = {2026}, author = {Jamieson, DJ and Munoz, FM and Rasmussen, SA}, title = {Maternal Immunization.}, journal = {Obstetrics and gynecology}, volume = {147}, number = {5}, pages = {661-678}, pmid = {41712936}, issn = {1873-233X}, mesh = {Humans ; Female ; Pregnancy ; *Immunity, Maternally-Acquired ; *Pregnancy Complications, Infectious/prevention & control ; *Immunization/methods ; *Vaccination/methods ; }, abstract = {Vaccines administered to women during pregnancy can provide protection against serious infectious diseases for the mother, the child, or both. Maternal immunization boosts the concentration of maternal antibodies that can be transferred across the placenta to directly protect children too young to be immunized. In addition, indirect protection through prevention of maternal infection and breast-milk antibodies can be achieved through maternal immunization. In general, inactivated vaccines are considered safe for pregnant women and fetuses, whereas live attenuated vaccines are avoided due to the theoretical potential risk of infection to the fetus. However, the potential risks of vaccines need to be weighed against the risk of the disease itself and the benefits of vaccination in terms of protection of the mother and child against infectious disease. Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap); influenza; coronavirus disease 2019 (COVID-19); and respiratory syncytial virus (RSV) vaccines are routinely recommended for all pregnant women in the United States. Maternal immunization has the potential to improve the health of mothers and young children; therefore, other diseases of relevance during this period are now targets of active research and vaccine development, including group B streptococcus (GBS). Similarly, several vaccines can be administered during pregnancy in special circumstances when maternal health, travel, or other special situations arise. This article reviews the current recommendations for vaccination of women during pregnancy.}, }
@article {pmid41712960, year = {2026}, author = {Wang, X and Xie, Y and Chen, X and Yang, J and Li, R and Gao, W and Yan, Z and Zhou, H and Ye, Z}, title = {Securing Federated Learning With Blockchain in the Medical Field: Systematic Literature Review.}, journal = {Journal of medical Internet research}, volume = {28}, number = {}, pages = {e79052}, pmid = {41712960}, issn = {1438-8871}, mesh = {*Federated Learning ; *Blockchain ; Humans ; Computer Security ; Information Dissemination ; Telemedicine ; }, abstract = {BACKGROUND: The exponential growth of medical data and advancements in artificial intelligence (AI) have accelerated the development of data-driven health care. However, the secure and efficient sharing of sensitive medical data across institutions remains a major challenge due to privacy concerns, data silos, and regulatory restrictions. Traditional centralized systems are prone to data breaches and single points of failure, while existing privacy-preserving techniques face high computational and communication costs.
OBJECTIVE: This study aims to provide a comprehensive review of the recent advances in blockchain-based federated learning (BCFL) within the medical field. By exploring the synergistic integration of federated learning and blockchain, this review evaluates how BCFL enhances data security, supports privacy-preserving cross-institutional collaboration, and facilitates practical applications in health care, including medical data sharing, Internet of Medical Things, public health surveillance, and telemedicine.
METHODS: We conducted a systematic literature review using databases such as PubMed, IEEE Xplore, Web of Science, and Google Scholar. Boolean logic and domain-specific keywords were used to retrieve studies from 2018 to 2025. After automated deduplication and multistage manual screening, over 100 high-quality papers were included. These works cover BCFL's theoretical foundations, system architectures, application domains, limitations, and future directions.
RESULTS: BCFL frameworks combine the decentralized trust and auditability of blockchain with the privacy-preserving collaborative learning capabilities of federated learning. This integration mitigates risks such as model tampering, data leakage, and a lack of incentives in federated systems. Applications span across cross-institutional medical data sharing, Internet of Medical Things, epidemic forecasting, and telemedicine. Architectures including fully coupled, flexibly coupled, and loosely coupled models offer varying trade-offs between efficiency, scalability, and security.
CONCLUSIONS: BCFL represents a transformative paradigm for secure, collaborative, and privacy-preserving medical AI. By combining decentralized trust, incentive-driven participation, and privacy-enhancing machine learning, BCFL paves the way for next-generation smart health care systems. Despite current technical and practical challenges, BCFL demonstrates strong potential to support precision medicine, global health data collaboration, and large-scale AI deployment in health care.}, }
@article {pmid41713622, year = {2026}, author = {Zhang, X and Xu, Y and Jiang, Y and Huang, J and Li, X}, title = {From 2020 to 2025: Comprehensive review Decoding novel structural inhibitors for M[pro] of SARS-CoV-2.}, journal = {Biochemical pharmacology}, volume = {248}, number = {}, pages = {117791}, doi = {10.1016/j.bcp.2026.117791}, pmid = {41713622}, issn = {1873-2968}, mesh = {Humans ; *Antiviral Agents/chemistry/pharmacology ; *SARS-CoV-2/drug effects/enzymology ; *Protease Inhibitors/chemistry/pharmacology ; *Coronavirus 3C Proteases/antagonists & inhibitors/metabolism/chemistry ; *COVID-19 Drug Treatment ; Peptidomimetics/chemistry/pharmacology ; Proteolysis Targeting Chimera ; Drug Design ; COVID-19/virology ; }, abstract = {While the immediate global threat of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has subsided, the virus remains a persistent cause of regional outbreaks and public health concerns. The main protease (M[pro]), essential for viral polyprotein processing and replication, remains one of the most validated and strategically important antiviral targets. In this comprehensive review, we critically evaluate the landscape of M[pro] inhibitor development from 2020 to 2025, encompassing four key categories: peptidomimetic inhibitors, non-peptide small molecules, natural product-derived compounds, and proteolysis-targeting chimeras (PROTACs). By integrating mechanistic insights with structural and technological advancements, this work highlights emerging opportunities for the rational design of next-generation M[pro]-targeted antivirals capable of addressing both current and future coronavirus threats.}, }
@article {pmid41713871, year = {2026}, author = {Dalrymple, WA and Ratliff, JB}, title = {A New Dawn: Resident Recruitment in the United States in the Post-COVID Era.}, journal = {Seminars in neurology}, volume = {46}, number = {3}, pages = {263-274}, doi = {10.1055/a-2794-0336}, pmid = {41713871}, issn = {1098-9021}, mesh = {Humans ; United States ; *COVID-19 ; *Internship and Residency ; *Personnel Selection/methods ; Pandemics ; *Interviews as Topic ; }, abstract = {The widespread adoption of virtual residency interviews in response to the COVID-19 pandemic led to an explosion in literature comparing the pros and cons of virtual and in-person interviews, but also led to an explosion in already-high residency application and interview volumes. While virtual interviews were substantially cheaper for all involved, there is fear that applicants and programs cannot judge one another as well as during in-person interviews. Likewise, increases in application volumes have made holistic application review more challenging for program directors, but the recent rise in "preference signaling" seems to be an optimal solution to that issue. 2020 also saw increased awareness of systemic inequities in the United States, and medical education and residency recruitment was not immune from scrutiny. Finally, the rise of artificial intelligence could again fundamentally change the resident selection process. It is imperative that the GME community continues to adapt to a changing world.}, }
@article {pmid41714597, year = {2026}, author = {Kasai, M and Sakuma, H and Suzuki, M and Nishiyama, M and Kawata, N and Lin, JJ and Lin, KL and Han, V and Mohammad, SS and Dale, RC and Thomas, T and Muramatsu, K and Mitani, O and Kobayashi, Y and Ishida, K and Abe, Y and Kuki, I and Takanashi, JI}, title = {Life-Threatening SARS-CoV-2-Associated Encephalopathy and Multiorgan Failure in Children, Asia and Oceania, 2022-2024.}, journal = {Emerging infectious diseases}, volume = {32}, number = {2}, pages = {169-179}, pmid = {41714597}, issn = {1080-6059}, mesh = {Humans ; *Multiple Organ Failure/epidemiology/virology/etiology/mortality ; Female ; Male ; Child, Preschool ; *Brain Diseases/virology/epidemiology/etiology/mortality ; *COVID-19/complications/epidemiology/mortality ; Child ; *SARS-CoV-2 ; Infant ; Brain Edema ; Asia/epidemiology ; Australia/epidemiology ; Taiwan/epidemiology ; Japan/epidemiology ; Adolescent ; Singapore/epidemiology ; Cytokines/blood ; }, abstract = {SARS-CoV-2 infections in children occasionally manifest with severe neurologic signs. We report a case series of life-threatening encephalopathy associated with SARS-CoV-2 in 25 children in Australia, Japan, Singapore, and Taiwan during February 2022-January 2024. All children had severe encephalopathy develop, characterized by rapidly progressive cerebral edema, conditions known as acute shock with encephalopathy and multiorgan failure or acute fulminant cerebral edema. Among the 25 patients, 22 (88%) eventually died; 11 (44%) children died within 24 hours of hospitalization. In addition, 18 (72%) had illness manifest with shock, and 14 (56%) had multiorgan failure develop within 6 hours of neurologic onset. Serum concentrations of cytokines/chemokines including interleukin 6 and tumor necrosis factor-α were significantly higher within 24 hours of onset than for controls. SARS-CoV-2-associated encephalopathy cases such as those described here represent an emerging neurologic crisis with high mortality rate resulting from rapidly progressive brain edema and multiorgan failure.}, }
@article {pmid41715908, year = {2026}, author = {Qtait, M and Farajalla, F and Alqaissi, N and Jaradat, Y}, title = {Implementation and Impact of Tele-Intensive Care Unit (Tele-ICU) Models on Critical Care Outcomes: A Systematic Review.}, journal = {Nursing in critical care}, volume = {31}, number = {2}, pages = {e70401}, doi = {10.1111/nicc.70401}, pmid = {41715908}, issn = {1478-5153}, mesh = {Humans ; *Telemedicine/organization & administration ; *Intensive Care Units/organization & administration ; *Critical Care/organization & administration ; *COVID-19/epidemiology ; *Critical Care Outcomes ; }, abstract = {BACKGROUND: Tele-Intensive Care Unit (Tele-ICU) models have expanded rapidly in response to global critical care workforce shortages, rising patient acuity and the demands of the COVID-19 pandemic. Contemporary evidence shows substantial variation in Tele-ICU configurations and outcomes, underscoring the need for an updated synthesis that evaluates clinical, staff-related and system-level effects across diverse settings.
AIM: To examine the implementation and impact of Tele-ICU models on critical care outcomes and to compare results across hub-and-spoke, hybrid, consultative and tele-recovery configurations.
STUDY DESIGN: A systematic review was conducted and reported according to PRISMA 2020 and Joanna Briggs Institute guidelines. PubMed, CINAHL, Scopus, Web of Science and Google Scholar were searched for peer-reviewed studies published between January 2020 and October 2025. Owing to heterogeneity in Tele-ICU models, outcomes and effect measures, a narrative synthesis was performed.
RESULTS: Sixteen studies published between 2020 and 2025 were included, comprising quantitative, qualitative and mixed-methods designs conducted across high-, middle- and low-resource healthcare settings. Overall, Tele-ICU implementation was associated with reductions in ICU and hospital mortality, improved adherence to evidence-based clinical protocols, enhanced interprofessional communication and reduced clinician documentation burden. Hub-and-spoke and hybrid Tele-ICU models demonstrated the most consistent clinical and workforce benefits, whereas consultative and low-cost models primarily improved access to specialist care in resource-limited contexts. Across studies, nursing roles expanded to include digital patient surveillance, tele-round coordination, protocol facilitation and virtual family communication. Evidence regarding long-term sustainability and cost-effectiveness was limited and inconsistently reported.
CONCLUSIONS: Tele-ICU models enhance clinical performance, support nursing practice and improve system-level responsiveness across diverse contexts. While benefits are consistent, outcomes vary by model design, local infrastructure and implementation readiness. Longitudinal and economic evaluations are needed to inform sustainable, scalable Tele-ICU strategies.
Tele-ICU models support bedside nurses by improving access to specialist input, strengthening adherence to evidence-based care and enhancing patient safety. Evidence shows that Tele-ICU reduces workload, improves communication and enables nurses to coordinate digital monitoring and family updates, contributing to more consistent and equitable critical care delivery, particularly in high-acuity and resource-limited settings.}, }
@article {pmid41716011, year = {2026}, author = {Roe, K}, title = {Lymphocyte Suppression and Exhaustion, Conventional, and Accelerated.}, journal = {APMIS : acta pathologica, microbiologica, et immunologica Scandinavica}, volume = {134}, number = {2}, pages = {e70175}, doi = {10.1111/apm.70175}, pmid = {41716011}, issn = {1600-0463}, mesh = {Humans ; T-Cell Exhaustion ; *COVID-19/immunology ; Killer Cells, Natural/immunology ; Animals ; B-Lymphocytes/immunology ; T-Lymphocytes/immunology ; SARS-CoV-2/immunology ; Immune System Exhaustion ; *Lymphocytes/immunology ; }, abstract = {The essential mammalian immune system lymphocytes include T cells, B cells, and natural killer cells. Any impairments of their functionalities can have severe consequences, since these lymphocytes each contribute as an interactive team in responding to pathogen infections or cancers. Such impairments include lymphocyte exhaustion, such as T cell, B cell, or natural killer cell exhaustion, or lymphocyte suppression impairing one or more of these cells. Lymphocyte exhaustion can have any intensity from mild to severe, having a severity scale worsened by various exposures and time periods of constant antigenic activation. Lymphocyte exhaustion can potentially have a conventional timing pathway or a hypothesized accelerated (pipelined) timing pathway. Lymphocyte suppressions initiated from pathogen infections are also possible, and this can also impair multiple types of lymphocytes. Finally, accelerated T cell exhaustion is possible, and this can explain several puzzling characteristics of virulent viral pandemics, especially in individuals having pathogen or cancer comorbidities. For instance, accelerated T cell exhaustion can explain a substantial percentage of the SARS-CoV-2 pandemic fatalities and also explain the relatively small, but significant, numbers of hyperinflammatory diseases or autoimmune diseases which were initiated in small percentages of individuals by SARS-CoV-2 infections.}, }
@article {pmid41716714, year = {2026}, author = {Bannister-Tyrrell, M and Teague, K and Strachan, DL and Barrett, A and Marthias, T and Strachan, CE and Doungngern, P and Thakur, N and Kamal, M and Brindle, H and Jinnai, Y and Kato, M and Vogt, F}, title = {Performance and utility of contact tracing for COVID-19 in the WHO South-East Asia Region: implications for future pandemic preparedness.}, journal = {The Lancet regional health. Southeast Asia}, volume = {45}, number = {}, pages = {100728}, pmid = {41716714}, issn = {2772-3682}, abstract = {UNLABELLED: Contact tracing was widely implemented during the COVID-19 pandemic, but its real-world performance and utility for decision-making remain poorly understood. A qualitative study was conducted to appraise the performance and utility of contact tracing for COVID-19 in the WHO South-East Asia Region, based on interviews with government and non-governmental organisation technical staff and decision makers in Indonesia, Nepal and Thailand. Our findings highlight the good performance of contact tracing when sufficiently resourced and when case load is low, but reveal declining utility as case incidence increases. This study presents key definitions and a pragmatic approach for appraising contact tracing performance and utility throughout a major health emergency response. Countries should prospectively define objectives for contact tracing, establish monitoring and evaluation frameworks, adjust their contact tracing approaches informed by risk assessments, and consider other available public health interventions when its performance and utility decline.
FUNDING: Governments of Germany and Australia.}, }
@article {pmid41716970, year = {2026}, author = {Palwankar, P and Palaniappan, J and Kuttappan, K and Pandey, R and Verma, S and Bhardwaj, A and Shunmugavelu, K}, title = {Oral and maxillofacial manifestations of COVID-19.}, journal = {GMS hygiene and infection control}, volume = {21}, number = {}, pages = {Doc05}, pmid = {41716970}, issn = {2196-5226}, abstract = {An overview of oral and maxillofacial manifestations associated with COVID-19 is provided. The symptoms range from white, red and mixed inflamed mucosal areas, necrosis, swelling, ulcers, vesicle, bulla, pustule, pigmentation, depapillated and fissured tongue and bleeding in the ulcers. Pre-COVID symptoms included complete loss of taste, along with reduced sense of taste and alterations in the taste perception.}, }
@article {pmid41717886, year = {2026}, author = {Cucunawangsih, C and Ansori, ANM and Vatvani, AD and Hariyanto, TI}, title = {Impact of nirmatrelvir/ritonavir on the risk of long COVID in outpatients: a systematic review and meta-analysis.}, journal = {Expert review of anti-infective therapy}, volume = {24}, number = {2}, pages = {271-284}, doi = {10.1080/14787210.2026.2636175}, pmid = {41717886}, issn = {1744-8336}, mesh = {Humans ; *Ritonavir/therapeutic use/administration & dosage ; Post-Acute COVID-19 Syndrome ; *COVID-19 Drug Treatment ; *COVID-19/epidemiology/prevention & control ; SARS-CoV-2 ; Outpatients ; Drug Combinations ; *Antiviral Agents/therapeutic use ; }, abstract = {BACKGROUND: This study systematically synthesized existing evidence to evaluate whether outpatient treatment with nirmatrelvir/ritonavir during the acute phase reduces the incidence of long COVID.
METHODS: We conducted a systematic search of Europe PMC, Medline, Scopus, and the Cochrane Library from inception to 15 September 2025. Eligible studies compared COVID-19 outpatients prescribed nirmatrelvir/ritonavir during the acute phase with those who did not receive the drug. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model.
RESULTS: Nineteen studies met inclusion criteria. Overall, nirmatrelvir/ritonavir use during acute infection was associated with a significant reduction in the likelihood of developing post-COVID-19 condition (OR 0.85; 95% CI: 0.80-0.91; p < 0.00001; I[2] = 99%). Protective effects were consistently observed across multiple clinical domains, including cardiovascular (arrhythmia, ischemic disease, heart failure), pulmonary (dyspnea, COPD), thromboembolic (DVT, PE), neurological (stroke, cognitive impairment, headache), psychiatric (depression), gastrointestinal, metabolic (new-onset diabetes), renal (AKI), and general symptoms (malaise and fatigue). Conversely, no significant differences were noted for cough, asthma, dysautonomia, anxiety, PTSD, sleep disturbances, musculoskeletal pain, or olfactory/gustatory dysfunction.
CONCLUSIONS: Early outpatient treatment with nirmatrelvir/ritonavir may mitigate the risk of developing several domains of long COVID, though its benefits are not uniform across all symptom categories.}, }
@article {pmid41718064, year = {2026}, author = {Trimarco, V and Gallo, P and Ghazihosseini, S and Izzo, A and Rozza, PI and Spinelli, A and Cristiano, S and De Rosa, C and Rozza, F and Morisco, C}, title = {The Role of L-Arginine and Liposomal Vitamin C Supplementation as an Adjunct in Seasonal Respiratory Viral Infection Recovery.}, journal = {Advances in respiratory medicine}, volume = {94}, number = {1}, pages = {}, pmid = {41718064}, issn = {2543-6031}, mesh = {Humans ; *Ascorbic Acid/therapeutic use/administration & dosage ; *Arginine/therapeutic use ; Dietary Supplements ; Liposomes ; *Respiratory Tract Infections/drug therapy/virology ; Seasons ; Influenza, Human/drug therapy ; *Vitamins/therapeutic use ; }, abstract = {Respiratory seasonal viral infections remain one of the most important issues in community medicine. The heterogeneity of etiological agents and the characteristics of the hosts airway antiviral defenses account for the complex management of these infections. The clinical consequence of this picture is that, despite the widespread use of vaccination as the primary prevention strategy, the rates of acute respiratory complications remain still high. In addition, they determine post-infectious fatigue and organ dysfunction. Inflammation and oxidative stress are the principal pathogenic mechanisms responsible for clinical complications during respiratory seasonal viral infections. Nowadays, a growing body of evidence indicates that adjunctive nutritional support can contribute to relieve the symptoms during the acute and subacute phases of respiratory viral infections. We assess the data in the literature regarding the combination of L-Arginine and Liposomal Vitamin C as adjuvant treatment for respiratory seasonal viral infections. The database of the National Library of Medicine (PubMed) was searched using the keywords "L-Arginine, Vitamin C, dietary supplements, seasonal respiratory viral infections". The treatment of symptoms during acute and post-acute respiratory viral infections requires an integrated approach that includes vitamins and nutritional supplementation. The combination of L-Arginine and Liposomal Vitamin C seems to represent a nutritional support able to mitigate symptoms occurring during the acute or post-acute phase of infection.}, }
@article {pmid41718104, year = {2026}, author = {Nebuwa, CN and Orjichukwu, CK and Orjichukwu, RO and Akpunonu, PK and Ugwu, PC and Nnabuife, SG}, title = {Cardiovascular Complications of Seasonal Influenza in the Pre- and Post-COVID-19 Era: Epidemiology, Mechanisms, and Clinical Implications.}, journal = {Medical sciences (Basel, Switzerland)}, volume = {14}, number = {1}, pages = {}, pmid = {41718104}, issn = {2076-3271}, mesh = {Humans ; *Influenza, Human/epidemiology/complications ; *COVID-19/epidemiology/complications ; *Cardiovascular Diseases/epidemiology/etiology ; Pandemics ; SARS-CoV-2 ; Seasons ; }, abstract = {Influenza has long been a well-documented contributor to cardiovascular morbidity and mortality, particularly among high-risk groups. COVID-19 has notably altered the seasonality and natural history of pandemic influenza, with broad implications for related cardiac complications. This review examines the interaction between influenza and cardiovascular illness, especially myocardial infarction, congestive heart failure, stroke, and other acute cardiac events. We review the impact of the COVID-19 pandemic on influenza transmission dynamics, public health policy, and the evolving burden of cardiovascular complications. New evidence indicates that both diseases exacerbate endothelial dysfunction, systemic inflammation, and prothrombotic states, thereby increasing cardiovascular risk. A comparative analysis of pre- and post-COVID-19 influenza-related cardiac complications clarifies evolving trends and guides future preventive strategies. In light of the recent resurgence of influenza following the relaxation of COVID-19 mitigation measures, maximizing vaccine coverage and collaborating to manage viral infections in patients with cardiovascular disease are critical. This review focuses on key research needs to understand long-term cardiac consequences and the urgent requirement for targeted public health strategies to counter viral-mediated cardiovascular threats. In the post-COVID era, integrating influenza and COVID-19 vaccination strategies into cardiovascular risk management may represent a critical opportunity to reduce virus-triggered cardiovascular morbidity and mortality.}, }
@article {pmid41718141, year = {2026}, author = {Manole, OM and Petre, BA and Onofrei, V}, title = {Proteomic Insights into Venous Thromboembolism.}, journal = {Medical sciences (Basel, Switzerland)}, volume = {14}, number = {1}, pages = {}, pmid = {41718141}, issn = {2076-3271}, mesh = {Humans ; *Proteomics/methods ; *Venous Thromboembolism/metabolism/diagnosis ; Pulmonary Embolism/diagnosis/metabolism ; Venous Thrombosis/diagnosis/metabolism ; Biomarkers/blood/metabolism ; COVID-19/complications ; Prognosis ; }, abstract = {Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT), remains a major cause of morbidity and mortality worldwide, with significant clinical challenges in diagnosis and risk stratification. Traditional diagnostic tools, including clinical prediction scores, D-dimer testing, and imaging, are limited by suboptimal specificity or sensitivity. In this context, proteomics-based approaches have emerged as powerful tools to elucidate the molecular mechanisms of VTE and to identify novel diagnostic and prognostic biomarkers. This review synthesizes recent advances in proteomic research relevant to VTE. We searched four databases (PubMed, ScienceDirect, Springer Nature, and Wiley) using the keywords "acute pulmonary embolism", "acute venous thromboembolism", and "proteomics". Thirty proteomic studies investigating VTE were examined. Across these studies, proteomic profiling consistently revealed alterations in pathways related to coagulation, inflammation, platelet activation, endothelial dysfunction, and fibrin clot structure. Multiple protein classes, including acute-phase reactants, complement components, coagulation factors, and platelet-derived proteins, have demonstrated potential value in improving diagnostic accuracy and refining prognostic stratification. Proteomic analyses have also revealed distinct molecular signatures between isolated PE and isolated DVT, supporting the concept of biologically heterogeneous VTE phenotypes. Furthermore, emerging evidence from COVID-19-associated thrombosis, cancer-associated VTE, and non-invasive sources such as exhaled breath condensate underscores the expanding clinical relevance of proteomic approaches. Although technical limitations and heterogeneity across studies remain challenges, the integration of proteomic data with clinical and genetic information holds promise for advancing precision medicine in VTE.}, }
@article {pmid41718962, year = {2026}, author = {Sheikhi, RA and Heidari, M and Kahrizsangi, MB}, title = {Mosques as Community Resilience Centers During Disasters: A Systematic Review of COVID-19 Interventions.}, journal = {Journal of community health}, volume = {51}, number = {3}, pages = {400-412}, pmid = {41718962}, issn = {1573-3610}, support = {6867//Sahrekord University of Medical Sciences/ ; }, mesh = {Humans ; *COVID-19/prevention & control ; *Pandemics/prevention & control ; *Resilience, Psychological ; SARS-CoV-2 ; *Pneumonia, Viral/epidemiology/prevention & control ; *Coronavirus Infections/epidemiology/prevention & control ; *Disasters ; Disaster Planning ; }, abstract = {OBJECTIVE: This systematic review seeks to delineate the multifaceted functions of mosques during the Coronavirus Disease 2019 (COVID-19) pandemic. Furthermore, it proposes evidence-based strategies to enhance their integration into formal disaster management frameworks and leverage their latent potential for bolstering community resilience. METHOD: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The primary databases used for literature searches were PubMed, Web of Science (WOS), Scopus, ProQuest, and Google Scholar. To identify relevant published literature, the title of this systematic review was divided into two key components: keywords related to COVID-19 and mosque, along with their synonyms. Equivalent terms were derived from Medical Subject Headings (MeSH) and expert opinions and extracted from related articles. RESULTS: Out of 82 initially identified articles, 19 met the inclusion criteria and were analyzed qualitatively. Four major themes emerged: the preventive role of mosques in curbing COVID-19 through education, support, healthcare collaboration, and vaccination efforts; religious adaptation through modified rituals and flexible jurisprudence; contributions to economic resilience via aid distribution, employment programs, and financial support; and the critical influence of spiritual leadership, highlighting both constructive and controversial responses during the pandemic. CONCLUSION: Mosques have emerged as multifaceted institutions capable of delivering integrated public health interventions, psychosocial support, and spiritual guidance during the COVID-19 crisis. Evidence suggests that institutionalizing mosque-based crisis response mechanisms through structured preparedness planning and cross-sectoral collaboration (with healthcare systems and government agencies) could substantially improve community resilience and optimize faith-based responses to future public health emergencies.}, }
@article {pmid41718988, year = {2026}, author = {Wang, Y and Gandy, S}, title = {Golgi Fragmentation as a Potential Link Between SARS-CoV-2 Infection and Alzheimer's Disease: Mechanisms and Implications for Neurodegeneration in Long COVID.}, journal = {Sub-cellular biochemistry}, volume = {111}, number = {}, pages = {463-482}, pmid = {41718988}, issn = {0306-0225}, mesh = {Humans ; *Alzheimer Disease/pathology/metabolism/virology ; *Golgi Apparatus/pathology/metabolism/virology ; *COVID-19/metabolism/pathology/complications ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Pandemics ; *Betacoronavirus ; *Coronavirus Infections/pathology/complications/metabolism ; *Pneumonia, Viral/pathology/complications/metabolism ; }, abstract = {The COVID-19 pandemic has impacted millions of people worldwide, and recent studies have shown that SARS-CoV-2 infection can lead to an Alzheimer's-like neuropathological and biomarker phenotype, as well as clinical symptoms of "brain fog". This raises an intriguing question: "How and where might the molecular pathways underlying SARS-CoV-2 infection and Alzheimer's disease (AD) converge?" One common feature of both SARS-CoV-2 infection and AD is the alteration of the endomembrane system, particularly the fragmentation of the Golgi apparatus. In this review article, we summarize the existing literature on SARS-CoV-2 infection biology and speculate about the potential mechanisms linking Golgi defects, SARS-CoV-2 infection, and neurodegeneration.}, }
@article {pmid41719175, year = {2026}, author = {Martins Bruno, AC and José de Castro Moura Duarte, F}, title = {Designing Hybrid Work Organization in the Post-Pandemic Era: A Systematic Literature Review.}, journal = {Work (Reading, Mass.)}, volume = {}, number = {}, pages = {10519815261423140}, doi = {10.1177/10519815261423140}, pmid = {41719175}, issn = {1875-9270}, abstract = {BackgroundIn the post-COVID-19 context, hybrid work (HW) expanded rapidly, often without systematic organizational design or alignment to task demands, generating conceptual ambiguities and limited guidance for configuring HW as an organizational system.ObjectiveTo update the conceptualization of HW and identify elements for designing hybrid work organization (HWO) from a task-based perspective.MethodsA systematic literature review was conducted from June to August 2025 following PRISMA guidelines. Peer-reviewed English-language articles (2020-2025) were retrieved from Scopus, and grey literature (2022-2025) was incorporated through complementary searches and snowballing. Research quality was appraised using MMAT and AACODS tools. Of 363 records screened, 110 full texts were assessed, and 25 met inclusion criteria.ResultsHW emerges as a sociotechnical phenomenon embedded in the digital transformation of work. A multidimensional lens - spatial, temporal, digital/virtual, and social - applied to task categories (individual, collaborative, coordination) identified key designable elements for HWO. Findings indicate that HW extends beyond fixed remote-on-site ratios, emphasizing intentional alternation, task-fit configurations, and dynamic adjustments as work evolves.ConclusionsHWO is context-specific and adaptive, shaped by task requirements rather than predefined schedules or locations. No single model prevails; instead, tailored configurations reflect the variability of real work. Advancing HW as a sociotechnical system requires rethinking organizational culture and management logic, shifting from presence and control-oriented paradigms toward flexible, task-driven, and performance-focused approaches. Progress depends on treating organizational design as a participatory process that aligns arrangements with demands.}, }
@article {pmid41719449, year = {2026}, author = {Nilormi, A and Bensimon, CM and Thomas, M and Wiles, S and Wilson, K}, title = {A scoping review of vaccine certificate implementation in Canada and OECD countries during the COVID-19 pandemic: Outcomes and lessons learned.}, journal = {Human vaccines & immunotherapeutics}, volume = {22}, number = {1}, pages = {2622178}, pmid = {41719449}, issn = {2164-554X}, mesh = {Humans ; *COVID-19/prevention & control/epidemiology ; Canada/epidemiology ; *COVID-19 Vaccines/administration & dosage ; Organisation for Economic Co-Operation and Development ; Public Health ; *Vaccination ; SARS-CoV-2/immunology ; Pandemics/prevention & control ; }, abstract = {Vaccine certificates were introduced during the COVID-19 pandemic to document vaccination status, promote uptake and enable safer reopening of society. While these policies supported public health efforts, their implementation raised operational, ethical and legal concerns, sparking debate about their future use in health emergencies. We conducted a scoping review to synthesize the implementation processes, challenges and outcomes of vaccine certificate systems in Canada and other OECD countries. An academic search was conducted in August 2024, across Ovid MEDLINE, Embase and Scopus using controlled vocabulary and key words for sources published from 2020 onward. Grey literature was searched using Google and targeted government and organizational websites. Data were synthesized descriptively and analyzed deductively based on three pre-identified themes - public health, technological, and ethical-legal considerations - derived from the UK Royal Society's framework on COVID-19 vaccine certificate design. The search captured 128 sources (72 academic and 56 gray literature), covering all OECD countries except Chile, Colombia, Costa Rica, Mexico and Norway. Identified subthemes included: (1) purpose and trade-offs; (2) public health, socio-economic and health system impacts, (3) technological infrastructure and data security; (4) equity and accessibility; (5) privacy and surveillance; and (6) public acceptance and trust. Vaccine certificates aimed to support public health goals but posed challenges in digital implementation, particularly in creating secure and interoperable systems and raised concerns around equity, discrimination and privacy. Vaccine certificates show promise for future public health use. However, their success will depend on addressing ethical concerns, ensuring interoperability and strengthening digital infrastructure, regulations and public trust.}, }
@article {pmid41719864, year = {2026}, author = {Chandra, LA and Nugroho, DB and Thobari, JA and Dimaguila, GL and Buttery, J}, title = {Active surveillance methods to identify adverse events of special interest (AESIs) following vaccination against pandemic diseases: A scoping review.}, journal = {Vaccine}, volume = {77}, number = {}, pages = {128341}, doi = {10.1016/j.vaccine.2026.128341}, pmid = {41719864}, issn = {1873-2518}, mesh = {Humans ; Adverse Drug Reaction Reporting Systems ; COVID-19/prevention & control ; *COVID-19 Vaccines/adverse effects ; *Influenza Vaccines/adverse effects/administration & dosage ; Influenza, Human/prevention & control ; Pandemics/prevention & control ; *Product Surveillance, Postmarketing/methods ; *Vaccination/adverse effects ; }, abstract = {INTRODUCTION: Active post-vaccination surveillance is vital for ensuring vaccine safety, particularly in monitoring Adverse Events of Special Interest (AESIs). This scoping review synthesises evidence on methodologies employed in active surveillance studies, with a focus on influenza and COVID-19 vaccines.
METHODS: Literature was identified via PubMed, Embase, Web of Science, Scopus, Google Scholar, and manual searches, using key terms including influenza, COVID-19, vaccine, and AESI. Two authors independently screened studies and extracted data on study characteristics, methods, and outcomes. Findings were synthesised narratively and presented in tables and figures, following the PRISMA-ScR guideline.
RESULTS: Of 427 included studies, most were published after 2020 (74.0%) and focused on COVID-19 vaccines (69.3%), particularly mRNA platforms (51.3%). The majority were conducted in North America and Europe, with 85.5% from high-income countries; multinational studies accounted for 6.6%, and single-centre studies with national or subnational coverage for 63.0%. Cohort designs predominated (40.5%), mostly retrospective (74.2%), utilising registries (24.0%) and electronic health records (22.4%), including artificial intelligence for signal detection and prediction (2.7%). Nearly half (49.6%) linked multiple data sources, though outcome verification was reported in fewer than half (45.9%). Incidence rates (16.5%) and risk/hazard ratios (14.8%) were the most reported measures. Neurological (21.8%) and cardiac (21.3%) AESIs, particularly Guillain-Barré Syndrome and myocarditis, were most frequently investigated.
CONCLUSION: Active surveillance for vaccine safety has increased but remains concentrated in high-income countries. Methodological approaches to detection, verification, and validation vary widely. Introducing active surveillance methodologies in low- and middle-income countries is crucial to achieving more equitable global monitoring of vaccine safety.}, }
@article {pmid41721085, year = {2026}, author = {Alvarado-Gamarra, G and Alcala-Marcos, K and Celis, CR and Balmaceda-Nieto, P and Cieza, L and Morán-Mariños, C and Grados-Espinoza, P and Alva-Díaz, C and Ecker, L and Ochoa, TJ and Franchi, LM and Howard, LM and Grijalva, CG and Lanata, CF}, title = {Post-MIS-C cardiovascular outcomes: a systematic review.}, journal = {European journal of pediatrics}, volume = {185}, number = {3}, pages = {}, pmid = {41721085}, issn = {1432-1076}, support = {D43 TW012468/TW/FIC NIH HHS/United States ; D43TW012468/TW/FIC NIH HHS/United States ; }, mesh = {Humans ; *Systemic Inflammatory Response Syndrome/complications ; *COVID-19/complications ; *Cardiovascular Diseases/etiology ; Child ; }, abstract = {Limited knowledge and variability in findings exist regarding the resolution of cardiovascular outcomes following Multisystem Inflammatory Syndrome in Children (MIS-C). We conducted a systematic review to estimate the frequency of cardiovascular outcomes following MIS-C. A systematic search was conducted in Pubmed/Medline, Scopus, Embase, SciELO, LILACS, Cochrane Library, Web of Science, and medRxiv were searched up to February 2024. We included studies reporting cardiovascular events that began in acute MIS-C and persisted after discharge. Screening and data extraction were performed by independent reviewers. We performed a random-effects meta-analysis and assessed the certainty of the evidence using the GRADE approach. Eighty-four studies (n = 4,778) were included; seven had a comparator group. The frequency of cardiovascular outcomes-including coronary abnormalities (Z-score ≥ 2), left ventricle ejection fraction < 55%, diastolic dysfunction, myocarditis, and pericardial effusion-decreased over time, with most resolving by 6 to 9 months. However, cardiac magnetic resonance imaging studies identified myocardial edema and/or fibrosis persisting up to 12 months, and two studies reported coronary abnormalities at 18- to 24-month follow-up. Evidence certainty was very low. Compared to children with COVID-19 or healthy controls, MIS-C showed more cardiovascular events and greater subclinical myocardial dysfunction, as assessed by strain analysis, during a 6-month follow-up. Compared with other etiologies of myocarditis, MIS-C myocarditis was associated with better cardiovascular outcomes but shorter exercise duration and lower aerobic capacity on stress testing. Conclusions: Cardiovascular outcomes following MIS-C improved over time, but certain subclinical cardiac abnormalities persisted up to 12 to 24 months. These findings may support long-term follow-up after MIS-C.Trial registration: Protocol registration number: PROSPERO, CRD42022336784.}, }
@article {pmid41721422, year = {2026}, author = {Abuhay, AE and Assaye, MM and Zeleke, TA and Mihret, SA and Getahun, AB and Zeleke, ME and Defersha, KK and Asrie, AE and Anteneh, DE and Mengistie, BA}, title = {Knowledge and attitude toward monkeypox (mpox) among healthcare providers in Sub-Saharan Africa: a systematic review and meta-analysis.}, journal = {Systematic reviews}, volume = {15}, number = {1}, pages = {}, pmid = {41721422}, issn = {2046-4053}, mesh = {Humans ; Africa South of the Sahara/epidemiology ; *Health Knowledge, Attitudes, Practice ; *Health Personnel/psychology ; *Mpox, Monkeypox/epidemiology/prevention & control ; *Attitude of Health Personnel ; Sub-Saharan African People ; }, abstract = {BACKGROUND: Mpox is an emerging global health threat with increasing frequency and geographic spread recently. Healthcare providers play a pivotal role in outbreak prevention, early detection, isolation, and response. This systematic review and meta-analysis aimed to assess the pooled prevalence of knowledge and attitude toward Mpox among healthcare providers in Sub-Saharan Africa (SSA).
METHODS: This systematic review and meta-analysis was conducted in accordance with the PRISMA guidelines. A comprehensive literature search was performed in PubMed, ScienceDirect, Hinari, and Google Scholar to identify eligible studies published between 2 July 2015 and 2 July 2025. Data were extracted and managed using Microsoft Excel and analyzed using STATA version 17. Pooled prevalence estimates were calculated using a random-effects model. The methodological quality of included studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Publication bias was examined using funnel plots and Egger's regression test, and statistical heterogeneity was assessed using the I[2] statistic. The review protocol was registered in PROSPERO (CRD420251123652).
RESULTS: This systematic review and meta-analysis included seven studies from Sub-Saharan Africa, comprising a total of 3379 healthcare providers. The pooled prevalence of adequate knowledge and a positive attitude toward Mpox was 40.52% (95% CI, 30.17-50.88) and 51.20% (95% CI, 44.48-57.91), respectively, with high heterogeneity (I[2] > 90%). Factors associated with higher knowledge included age over 40 years (AOR = 5.90; 95% CI, 1.27-27.41), being married (AOR = 1.58; 95% CI, 1.24-2.01), being a physician (AOR = 6.82; 95% CI, 1.38-33.56), having 5-10 years of work experience (AOR = 7.02; 95% CI, 1.51-32.74), prior information about Mpox (AOR = 1.82; 95% CI, 1.11-2.97), and a history of COVID-19 vaccination (AOR = 1.98; 95% CI, 1.47-2.68). Regarding attitude, higher education (AOR = 2.09; 95% CI, 1.38-3.18) and male sex (AOR = 1.50; 95% CI, 1.12-1.91) were positively associated. Prevalence was pooled through meta-analysis, while associated factors were reported individually from each study, as pooling adjusted odds ratios was not appropriate due to differences in covariates and outcome definitions. These findings should be interpreted with caution due to high heterogeneity, the small number of studies, and uneven geographic representation.
CONCLUSIONS: The findings of this systematic review and meta-analysis indicate that knowledge and attitudes toward Mpox among healthcare providers in Sub-Saharan Africa are generally suboptimal. However, these results should be interpreted with caution due to high heterogeneity across studies, the limited number of included studies, and uneven geographic representation. Nonetheless, the findings underscore the need for context-specific capacity-building interventions, including targeted training, improved access to up-to-date clinical guidelines, and enhanced preparedness strategies to support healthcare providers in responding to Mpox and other emerging infectious diseases.}, }
@article {pmid41722060, year = {2026}, author = {Mousavi, T and Moosazadeh, M and Jalali, H}, title = {Comparison of Azvudine and Nirmatrelvir-Ritonavir in Hospitalised Patients With COVID-19: A Systematic Review and Meta-Analysis.}, journal = {Reviews in medical virology}, volume = {36}, number = {2}, pages = {e70114}, doi = {10.1002/rmv.70114}, pmid = {41722060}, issn = {1099-1654}, mesh = {Humans ; *Ritonavir/therapeutic use ; *COVID-19 Drug Treatment ; SARS-CoV-2/drug effects ; *Antiviral Agents/therapeutic use ; COVID-19/virology/mortality ; Hospitalization ; }, abstract = {Azvudine is a nucleoside reverse transcriptase inhibitor (NRTI) and belongs to the family of 2', 3'-dideoxynucleoside (ddNs) that can mimic natural nucleosides and block viral DNA or RNA chain synthesis and prevent viral replication. Since the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, Azvudine has been used to treat patients with COVID-19. Therefore, the objective of this meta-analysis study was to compare Azvudine and Nirmatrelvir-Ritonavir in hospitalised patients. The global online databases were used to identify relevant studies published between January 2019 and October 2024. The quality of all articles was determined using the Newcastle-Ottawa Scale (NOS) checklist. In this study, heterogeneity assay was assessed using the Cochran's Q-test and the I2 index, and STATA software version.14 (StataCorp) was used for statistical analysis. Egger's test, Begg's test, and funnel plot were performed to estimate of the publication bias, and the impact of each study on the overall estimate was assessed using sensitivity analysis. In this study, 19 studies were included in this meta-analysis. The results of the meta-analysis showed that the relative risk of death in the Azvudine treatment group compared with the Nirmatrelvir-Ritonavir treatment group was 0.64 (95% CI: 0. 44, 0. 93). These results suggest that treatment with Azvudine may provide significant clinical benefit in patients hospitalised with COVID-19.}, }
@article {pmid41723336, year = {2026}, author = {Huang, X and Huang, D and Wang, W and Huang, Y and Huang, C and Wang, G}, title = {Prevalence, risk factors, and early prediction of refractory pneumonia caused by Mycoplasma pneumoniae in children: a systematic review and meta-analysis.}, journal = {European journal of pediatrics}, volume = {185}, number = {3}, pages = {}, pmid = {41723336}, issn = {1432-1076}, support = {2024B1020//Social Public Welfare and Basic Research Special Project of Zhongshan City, Guangdong Province, China/ ; }, mesh = {Humans ; *Pneumonia, Mycoplasma/epidemiology/drug therapy/diagnosis ; Risk Factors ; Prevalence ; Child ; *Mycoplasma pneumoniae ; Anti-Bacterial Agents/therapeutic use ; Child, Preschool ; Infant ; }, abstract = {UNLABELLED: Refractory Mycoplasma pneumoniae pneumonia (rMPP) poses significant challenges in pediatric care due to delayed recognition and limited systematic evidence. This meta-analysis evaluates the prevalence, risk factors, and predictive accuracy of models for rMPP. We systematically searched PubMed, Cochrane Library, and Web of Science until November 2024 for observational studies involving children aged 0-18 years with rMPP. Study quality was assessed using Newcastle-Ottawa and JBI scales. Data were analyzed via R4.4.2. Fifty-three studies (n = 35,275) revealed an overall rMPP prevalence of 37.8% (95% CI 30.5-45.5%), with significant temporal variation: 33.1% pre-COVID-19, 42.0% during, and 86.5% post-pandemic. Independent risk factors included elevated lactate dehydrogenase (OR = 1.018), C-reactive protein (OR = 1.106), procalcitonin (OR = 1.825), interleukin-6 (OR = 2.440), neutrophil count (OR = 2.955), pleural effusion (OR = 4.469), mucus plugs (OR = 5.456), and older age (OR = 1.188). Eleven prediction models demonstrated high accuracy, with ROC-AUCs of 0.913 (training) and 0.895 (validation).
CONCLUSION: The prevalence of rMPP in children is significant and has increased markedly since the COVID-19 pandemic. Key biomarkers and clinical features facilitate early risk stratification, and validated predictive models improve clinical decision-making. These findings highlight the urgent need for targeted surveillance and customized interventions for high-risk populations.
WHAT IS KNOWN: • Pneumonia caused by Mycoplasma pneumoniae in children can be effectively controlled by first-line macrolide therapy. • However, there is still a proportion of children who do not respond well to this treatment regimen and develop refractory Mycoplasma pneumoniae due to macrolide resistance.
WHAT IS NEW: • This review and meta-analysis show the incidence of refractory Mycoplasma pneumonia and its potential risk factors. • Finding the feasibility of constructing a predictive model that facilitates early prediction, to provide evidence-based evidence for further in-depth clinical understanding of this disease.}, }
@article {pmid41723349, year = {2026}, author = {Wu, D and Li, Y and Chen, P and Zhu, K and Cao, C}, title = {Comparison of the efficacy and safety of selective COX-2 inhibitors and non-steroidal anti-inflammatory drugs in the treatment of COVID-19 patients: a systematic review and network meta-analysis.}, journal = {BMC infectious diseases}, volume = {26}, number = {1}, pages = {}, pmid = {41723349}, issn = {1471-2334}, mesh = {Humans ; *Cyclooxygenase 2 Inhibitors/therapeutic use/adverse effects ; *Anti-Inflammatory Agents, Non-Steroidal/therapeutic use/adverse effects ; *COVID-19 Drug Treatment ; COVID-19/mortality ; SARS-CoV-2 ; Respiration, Artificial ; Treatment Outcome ; }, abstract = {BACKGROUND: The global epidemic of novel coronaviruses remains severe, and COX-2 selective inhibitors have attracted attention due to their promising clinical potential. METHODS: Pertinent articles published up to 1 April 2025 were systematically searched and retrieved, including randomized controlled trials and cohort studies. To assess the efficacy of COX-2 selective inhibitors versus other NSAIDs, we analysed five aspects, including death, mechanical ventilation, ICU admission, oxygen uptake, and composite adverse effects. RESULTS: The results showed that COX-2 selective inhibitors significantly reduced the risk of death, with third-highest SUCRA ranking. Regarding the risk of mechanical ventilation, COX-2 inhibitors were associated with a reduced risk and ranked first according to SUCRA compared with other interventions. COX-2 inhibitors were also effective in reducing the risk of ICU admission and endotracheal intubation, again ranking first by SUCRA. In addition, COX-2 inhibitors demonstrated therapeutic potential in reducing the risk of composite adverse effects compared with other NSAIDs. CONCLUSION: Although this study shows that COX-2 inhibitors have good promise for the treatment of COVID-19, there is still a lack of high-quality RCTs to support the conclusions, and there is still room for improvement. TRIAL REGISTRATION: (PROSPERO. CRD CRD42023445987) THE CLINICAL TRIAL NUMBER: Not applicable.}, }
@article {pmid41723405, year = {2026}, author = {Tosanguan, K and Kessomboon, N and Udomaksorn, K and Nerapusee, O and Laichapis, M and Sakulbumrungsil, R}, title = {Bridging public health emergency and pharmaceutical supply chain preparedness: a scoping review and framework synthesis.}, journal = {BMC health services research}, volume = {26}, number = {1}, pages = {}, pmid = {41723405}, issn = {1472-6963}, mesh = {Humans ; *Public Health ; Pharmaceutical Preparations/supply & distribution ; Public Health Infrastructure ; COVID-19/epidemiology ; *Disaster Planning/organization & administration ; *Civil Defense/organization & administration ; }, abstract = {BACKGROUND: Recent public health emergencies, including the COVID-19 pandemic and large-scale natural disasters, have exposed vulnerabilities in pharmaceutical and health-product supply chains. These events demonstrate that preparedness relies not only on surveillance or clinical capacity but also on the effective management of medicine logistics systems. This scoping review aimed to identify existing assessment tools for public health emergency (PHE) preparedness and health supply chain (HSC) management and to develop an integrated framework that links these two areas to support more comprehensive evaluation of system readiness. METHODS: A scoping review was conducted following the Arksey and O’Malley framework and PRISMA-ScR guidelines. MEDLINE (PubMed) and Scopus were searched for records published between January 2002 and July 2024, complemented by grey literature searches and expert consultation. Predefined inclusion and exclusion criteria were applied, and data were mapped using the Flower Framework, which combines domains of PHE management with pharmaceutical supply chain functions. RESULTS: Of 3,965 records identified (3,920 from databases and 45 from grey literature), 23 assessment tools met the inclusion criteria. Fourteen tools were developed in academic or research settings and nine in policy or programmatic grey literature. Instruments focused on PHE preparedness tended to emphasize governance, coordination, and core public health capacities, whereas HSC tools highlighted forecasting, procurement, inventory management, and warehousing. Only a few instruments bridged both perspectives. CONCLUSION: This scoping review reveals that no single instrument currently provides a comprehensive assessment of pharmaceutical system readiness across governance, regulatory, and operational dimensions. While existing tools offer situational benchmarking, they often fail to capture functional synergy and pharmaceutical-specific requirements like cold-chain integrity and regulatory constraints. Synthesizing findings through the Flower Framework, this study proposes an integrated model that bridges the gap between static capacity and real-world resilience, emphasizing the need for functional evaluations—such as stress tests and simulations—to more accurately reflect system adaptability during crises.}, }
@article {pmid41723461, year = {2026}, author = {Mulumba, M and Oga, J and Baguma, C and Nantaba, J and Ruano, AL}, title = {Health equity and the global social contract: beyond incrementalism and illusionary solidarity.}, journal = {International journal for equity in health}, volume = {25}, number = {1}, pages = {}, pmid = {41723461}, issn = {1475-9276}, mesh = {Humans ; *Health Equity ; *Social Justice ; *Global Health ; Sustainable Development ; COVID-19 ; *International Cooperation ; }, abstract = {The Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs) have been celebrated as global social contracts, yet their reliance on voluntary commitments and aspirational targets conceals a structural flaw. By divorcing poverty and inequity from colonial histories, debt regimes, and extractive global finance, these frameworks function as a neocolonial placebo: soothing global conscience while entrenching asymmetries of power and resources. Drawing on examples from debt distress, vaccine apartheid, and intellectual property monopolies during COVID-19, this commentary demonstrates that global health governance operates less as solidarity than as economic containment. Reparative justice provides the necessary rupture. A post-2030 Global Social Contract must impose enforceable obligations on former colonial powers, embed structural restitution through debt and tax justice, and democratise health governance under the principle of Common but Differentiated Responsibilities. Anything less risks reproducing selective generosity while abandoning equity to the logics of extraction and impunity.}, }
@article {pmid41723495, year = {2026}, author = {Abreu, AR and Gonçalves, F and Oliveira, S and Ribeiro, I}, title = {Workplace violence against healthcare workers: a scoping review of reporting practices, barriers to reporting and institutional responses (2020-2025).}, journal = {BMC health services research}, volume = {26}, number = {1}, pages = {}, pmid = {41723495}, issn = {1472-6963}, mesh = {Humans ; *Health Personnel/statistics & numerical data/psychology ; *Workplace Violence/statistics & numerical data/prevention & control ; Portugal ; Working Conditions ; }, abstract = {BACKGROUND: Violence against healthcare workers (HCWs) is a widespread global problem that has gained increasing attention due to its substantial impact on HCWs well-being and the quality of care they provide. This scoping review aimed to identify current reporting practices, institutional and organisational barriers to reporting violent incidents against HCWs, and critical research gaps in this area, integrating global evidence with a specific focus on Portugal. METHODS: Following the methodological framework of Arksey and O’Malley (2005), refined by Levac et al. (2010), and reported per PRISMA-ScR (2018) guidelines, a comprehensive search was conducted in PubMed, Scopus, and Web of Science (January 2020–June 2025). Studies in English, Portuguese, or Spanish addressing reporting practices, barriers to reporting, digital platforms, or policies regarding WPV against HCWs were included. Two reviewers independently screened and extracted data using a structured matrix, resolving discrepancies by consensus. Results were summarized narratively with frequency analysis. RESULTS: From the initial 232 records, 35 studies met inclusion criteria, from 19 geographic areas across 5 continents. Most studies originated from Asia and Europe. Verbal violence was the most frequently reported form (20–91%), and over half reported underreporting rates exceeding 50%. The most frequently reported individual barrier was the belief that reporting is ineffective (60%), while the most cited systemic barrier was ineffective reporting systems (63%). National digital platforms reporting included the WVIRS system (California), the Synergic system (Sweden), the White Code system (Turkey), and the NOTIFICA, SAGRIS and HER+ systems (Portugal). Effective strategies to reporting combined staff training with awareness campaigns, supported by leadership engagement and policy frameworks. The COVID-19 pandemic intensified workplace tensions and may have influenced both the occurrence and reporting of violent incidents. CONCLUSION: Underreporting of workplace violence persists despite the existence of policies and reporting platforms. This review highlights persistent barriers to reporting workplace violence among HCWs and emphasizes the need for user-friendly and supportive reporting systems. Findings call for institutional accountability, better feedback mechanisms, and targeted policies to foster a culture of safety and transparency, both globally and in Portugal.}, }
@article {pmid41723921, year = {2026}, author = {Li, R and Vafeiadis, M and Shen, F and Hou, Z}, title = {The role of health beliefs in COVID-19 vaccination acceptance: A Meta-analysis.}, journal = {Vaccine}, volume = {77}, number = {}, pages = {128379}, doi = {10.1016/j.vaccine.2026.128379}, pmid = {41723921}, issn = {1873-2518}, mesh = {Humans ; *COVID-19/prevention & control/psychology ; *COVID-19 Vaccines/administration & dosage ; *Vaccination/psychology ; *Vaccination Hesitancy/psychology ; *Patient Acceptance of Health Care/psychology ; *Health Belief Model ; SARS-CoV-2 ; *Health Knowledge, Attitudes, Practice ; Pandemics/prevention & control ; }, abstract = {This study employed a meta-analytic approach to examine the relationships between the Health Belief Model (HBM) constructs and COVID-19 vaccination acceptance. A comprehensive literature search identified 77 eligible studies with a combined sample size of 83,995 participants. Quantitative synthesis of the extracted data revealed that perceived benefits (r = 0.40) was the strongest positive predictor of individuals' vaccine acceptance, indicating a medium-to-large effect. Perceived severity (r = 0.17) and susceptibility (r = 0.18) to COVID-19 were also significant positive predictors, each with small-to-medium effect sizes. Cues to action (r = 0.11) and self-efficacy (r = 0.10) were also positively associated with vaccine acceptance, although the effects were small. In contrast, perceived barriers to vaccination (r = -0.25) were negatively associated with vaccine acceptance, approaching a medium effect in size. Several of these associations were moderated by study characteristics, including how the variables were operationalized (intention, hesitancy, refusal, etc.), the vulnerability of the study sample, the respondent type (parents vaccinating children vs. adults vaccinating themselves), the vaccine development stage, and the variant phase. Overall, these findings contribute to a deeper understanding of the psychological mechanisms underlying vaccine acceptance and hesitancy, and offer practical implications for developing targeted communication strategies to promote COVID-19 and other vaccinations.}, }
@article {pmid41724028, year = {2026}, author = {Moreta-Gil, E and Rivera-Picón, C and Conty-Serrano, R and Polonio-López, B and Martín-Conty, JL and Martín-Rodríguez, F and Sanz-García, A}, title = {Prehospital early warning scores for predicting clinical deterioration of COVID-19 patients: An integrative review.}, journal = {Enfermeria intensiva}, volume = {37}, number = {2}, pages = {500584}, doi = {10.1016/j.enfie.2026.500584}, pmid = {41724028}, issn = {2529-9840}, mesh = {Humans ; *COVID-19/diagnosis ; *Early Warning Score ; *Clinical Deterioration ; SARS-CoV-2 ; *Pneumonia, Viral/diagnosis ; Pandemics ; *Coronavirus Infections/diagnosis ; *Emergency Medical Services ; *Betacoronavirus ; }, abstract = {INTRODUCTION: Triage, and in particular scales, are a tool that allows patients with clinical risk to be managed for early, effective and efficient care.
OBJECTIVE: To identify the most precise and specific prehospital score for the detection of clinical worsening risk in COVID19 patients.
METHODS: The protocol followed for the integrative review was the PRISMA method 2020. A literature search was performed in five databases: Scopus, Cochrane Library, Pubmed, Embase, Prospero and Lit covid-nih-nlm. Based on 19 keywords, 5 inclusion and 5 exclusion points. Finally, 22 articles were selected.
RESULTS: Twenty-two studies were identified that addressed effective outcomes for early measures such as telephone triage, web, protocols or tools such as scales. We compared the functionality of 12 scales in patients with Covid-19, showing that the most important variables for this early assessment of clinical worsening were systolic blood pressure, temperature, oxygen saturation and the need for oxygen supplementation. The best predictive value for clinical deterioration and mortality was obtained by NEWS score, with sensitivities and specificities ranging from 77% to 88%.
CONCLUSIONS: Prehospital scales are still under development, with few research studies and a relative confidence in their statistical values. Nonetheless, it has been observed that the scale that best fit the covid-19 was NEWS with an optimal prediction for patients. This could pave the way for its use under other relevant clinical scenarios, such as acute respiratory infections, exacerbations of chronic diseases or future health emergencies.}, }
@article {pmid41724302, year = {2026}, author = {Pascual-Alonso, I and Arrebola-Sánchez, Y and Almeida-García, F and Frómeta-Fuentes, T and Acén-Ravelo, T and Del Valle-Pelaiz, S and Escandel-Barreto, A and Ojeda Del Sol, D and Valdés-Tresanco, ME and Sánchez-Ramírez, B and Bergado, G and Chao, L and Fundora Barrios, T and Melchy, E and Chipres-Naranjo, LE and Gutiérrez-Mariscal, M and Charli, JL and Rosenstein, Y}, title = {Biochemistry, physiology and implications in human diseases of mammalian aminopeptidase N: A review.}, journal = {International journal of biological macromolecules}, volume = {350}, number = {}, pages = {151030}, doi = {10.1016/j.ijbiomac.2026.151030}, pmid = {41724302}, issn = {1879-0003}, mesh = {Humans ; Animals ; *CD13 Antigens/chemistry/metabolism/genetics/antagonists & inhibitors ; Neoplasms/enzymology ; }, abstract = {Aminopeptidases are proteases that selectively hydrolyze an amino acid residue from the amino terminus of proteins and peptides, leading to their activation or inactivation. These enzymes are predominantly metallopeptidases. One of them, membrane alanyl aminopeptidase, also known as aminopeptidase N (APN, EC 3.4.11.2), a M1 family metallo-aminopeptidase, plays essential roles in mammals. APN regulates pain sensitivity, central nervous system control of blood pressure, the final steps of protein degradation, cell motility and adhesion, and coronavirus entry. Furthermore, upregulated expression of APN has been implicated in the pathogenesis of various human disorders, including cancers, inflammation, and pressure dysregulation. APN is a multifunctional protein, and its ligation or inhibition of enzymatic activity may have therapeutic applications. Here, we focus on human and porcine enzymes as models to review the most important structural and functional features of mammalian APN, its roles in mammalian physiology, and the pathophysiological aspects in humans, with particular emphasis on cancer. We illustrate how APN is a tool for diagnosing and monitoring cancer and other pathologies, and discuss the obstacles to the therapeutic use of its inhibitors.}, }
@article {pmid41724536, year = {2026}, author = {Carbotti, G and van den Berg, DM and Carvalho, AL and Senore, C and Heijnsdijk, EA and de Koning, HJ and Lansdorp-Vogelaar, I and , }, title = {Developments in the roll-out and performance of CRC screening in Europe.}, journal = {Best practice & research. Clinical gastroenterology}, volume = {80}, number = {}, pages = {102043}, doi = {10.1016/j.bpg.2025.102043}, pmid = {41724536}, issn = {1532-1916}, mesh = {Humans ; Europe/epidemiology ; *Colorectal Neoplasms/diagnosis/epidemiology/mortality ; *Early Detection of Cancer/methods/trends ; Incidence ; *Mass Screening/trends/methods/organization & administration ; }, abstract = {The heterogeneous implementation of colorectal cancer screening programs across Europe makes performance comparison challenging. This study computed and analyzed seven key indicators of screening performance for eighteen European programs between 2011 and 2022. Trends in colorectal cancer incidence and mortality were also examined in relation to when each screening program was introduced. Coverage indicators showed considerable variation across programs but generally increased until the onset of the COVID pandemic. Yield indicators remained stable overall, whereas jumps were associated to protocol changes. In most countries, a decline in incidence followed the introduction of the screening program, whereas the connection of screening with mortality was less evident. The analysis of comparable screening performance indicators over time allows for cross-country and longitudinal monitoring of the programs. The observed decline in incidence following the implementation of fully rolled-out programs highlights the importance and effectiveness of well-organized screening in reducing the burden of the disease.}, }
@article {pmid41724540, year = {2026}, author = {de Jonge, L and Lansdorp-Vogelaar, I and Doria-Rose, VP and Portillo, I and Novak Mlakar, D and Buron, A and Quintin, C and Espinàs, JA and Plaine, J and Škrjanec, AL and Kofol Bric, T and Binefa, G and Font, R and Bulliard, JL and Chubak, J and Ziebell, R and McCurdy, BR and Rabeneck, L and Senore, C and , }, title = {Global impact of COVID-19 on organized CRC screening programs: lessons learned.}, journal = {Best practice & research. Clinical gastroenterology}, volume = {80}, number = {}, pages = {102047}, doi = {10.1016/j.bpg.2025.102047}, pmid = {41724540}, issn = {1532-1916}, mesh = {Humans ; *Colorectal Neoplasms/diagnosis/epidemiology ; *COVID-19/epidemiology ; *Early Detection of Cancer/statistics & numerical data/methods/trends ; *Mass Screening/organization & administration ; Retrospective Studies ; SARS-CoV-2 ; Pandemics ; Global Health ; }, abstract = {Using a standardized data template, this study retrospectively collected data about colorectal cancer (CRC) screening activity in 2020 and 2021 to estimate the impact of the COVID-19 pandemic compared to the pre-pandemic period (2018 or 2019). Data were collected from 17 programs in 14 countries of which 15 were population-based programs. Invitation coverage was decreased by up to 53.7 % in 2020. Participation among those invited was similar in both periods for all programs. The maximum backlog in invitations was less than 7.4 months in 2020 and 3.3 months for 2021. Nine out of 15 programs observed a decrease in the number of detected CRCs in 2020. Four programs showed a positive percentage change in CRCs detected in 2021 relative to the pre-pandemic period. Half of the countries observed a worse stage-distribution in 2020/2021. Overall, organized CRC screening programs operated at lower screening activity, but screening outcomes were similar compared to the pre-pandemic period.}, }
@article {pmid41725107, year = {2026}, author = {Belland, KM and DeJohn, CA}, title = {Comprehensive Review: Ultraviolet-C (UVC) Disinfection in Aircraft Cabins.}, journal = {Health security}, volume = {24}, number = {1}, pages = {35-38}, doi = {10.1177/23265094261424116}, pmid = {41725107}, issn = {2326-5108}, mesh = {*Disinfection/methods ; *Ultraviolet Rays ; *Aircraft ; Humans ; COVID-19/prevention & control ; SARS-CoV-2/radiation effects ; }, abstract = {Ultraviolet-C (UVC) disinfection has gained considerable attention as a continuous, real-time method to mitigate the transmission of airborne pathogens within aircraft cabins. Recent investigations have demonstrated its potential to inactivate viruses such as SARS-CoV-2, influenza, and other emerging infectious agents in situ, thereby reducing both immediate infection risks and broader public health burdens. This commentary evaluates how continuous UVC disinfection-applied in tandem with established preventive measures-may effectively curtail disease transmission, reassure passengers, and inform the future direction of in-flight health and safety standards.}, }
@article {pmid41727479, year = {2026}, author = {Parra-González, M and Nájera-Maldonado, L and Peralta-Cuevas, E and Gutierrez-Onofre, A and Jaimes-López, LA and Juarez-Antonio, JA and Degollado-Hernández, NY and Garcia-Atutxa, I and Villanueva-Flores, F}, title = {Dengue-SARS-CoV-2 interactions: immune crosstalk, variant emergence, and clinical outcomes.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1650425}, pmid = {41727479}, issn = {1664-3224}, mesh = {Humans ; *Dengue/immunology/epidemiology/virology ; *COVID-19/immunology/epidemiology/virology ; *SARS-CoV-2/immunology/genetics ; *Coinfection/immunology ; *Dengue Virus/immunology/genetics ; Antibody-Dependent Enhancement/immunology ; Cross Reactions/immunology ; Animals ; Cytokines/immunology ; Host-Pathogen Interactions ; }, abstract = {This review aims to provide an overview of dengue-COVID-19 co-infection, emphasizing recently described immunological, genomic, and eco-epidemiological interactions that may influence clinical outcomes and viral evolution. It brings together molecular evidence, immunological perspectives, and epidemiological insights to summarize current hypotheses and working models of these complex disease interactions. We summarize and critically discuss evidence on antibody-dependent enhancement (ADE), cross-reactive immune responses, and cytokine amplification pathways, and propose mechanisms that could underlie exacerbated disease severity. Published clinical data indicate heterogeneity in co-infection outcomes globally, from mild presentations to severe complications, such as hemorrhagic stroke, acute kidney injury, and increased mortality, particularly among populations with prior dengue exposure. Diagnostic complexities arising from serological cross-reactivity underscore the need for simultaneous molecular testing to ensure accurate pathogen identification. Additionally, we review current evidence on reciprocal selective pressures between SARS-CoV-2 variants and dengue serotypes, highlighting potential evolutionary impacts arising from their co-circulation. The available evidence suggests that co-infection may exacerbate inflammatory pathways, lead to increased vascular and organ damage, and complicate patient management. However, definitive clinical evidence for ADE remains inconclusive, underscoring an ongoing need for targeted mechanistic studies. By outlining significant knowledge gaps and summarizing proposed research directions, this review aims to provide a valuable reference for clinicians, immunologists, epidemiologists, and policymakers managing concurrent dengue and COVID-19 outbreaks.}, }
@article {pmid41727556, year = {2026}, author = {Millar, BC and Cates, MJ and Torrisi, MS and Round, AJ and Warde, A and Lowery, CJ and Moore, JE}, title = {Antimicrobial Resistance: The Answers.}, journal = {British journal of biomedical science}, volume = {83}, number = {}, pages = {15559}, pmid = {41727556}, issn = {2474-0896}, mesh = {Humans ; *Anti-Bacterial Agents/therapeutic use/pharmacology ; SARS-CoV-2 ; COVID-19 ; Pandemics ; *Drug Resistance, Bacterial ; *Drug Resistance, Microbial ; Betacoronavirus ; *Bacterial Infections/drug therapy ; }, abstract = {Antimicrobial resistance (AMR) has caused a global public health crisis, contributing to approximately five million deaths in 2019 and predicted deaths of approximately ten million annually by 2050. This equates to approximately 1.4-fold more deaths annually from AMR in 2050 than the entire COVID-19 pandemic to date. To tackle this AMR pandemic, regulatory and policy frameworks have been prepared at local, national and international levels with multi-faceted proposals and advances encompassing surveillance, diagnostics, infection prevention, antibiotic prescribing and variation of existing and novel treatment approaches. This narrative review primarily focuses on research and development which have been documented over the last five years in relation to therapeutic approaches at various stages in clinical development and the potential role that vaccines can play in the fight against AMR. This review provides an overview on antibacterial drugs, including novel classes of antibiotics, which have been recently approved, as well as combination antibiotic therapy and the potential of repurposed drugs. The potential role of novel antimicrobial, antibiofilm and quorum sensing inhibitors, such as antimicrobial peptides, nanomaterials and compounds from the extreme and natural environments, as well as ethnopharmacology including the antimicrobial effects of plants, spices, honey and venoms are explored. Novel therapeutic approaches are critically discussed in terms of their realistic clinical potential, detailing recent and ongoing trials to highlight the current interest of these approaches, including immunotherapy, bacteriophage therapy, antimicrobial photodynamic therapy (aPDT), antimicrobial sonodynamic therapy (aSDT), nitric oxide therapy and microbiome manipulation including faecal microbiota transplantation (FMT). The potential of predatory bacteria as living antimicrobial agents is also discussed. Importantly, there have been many technological developments which have enhanced bioprospecting and research and development of novel antimicrobials which this review draws attention to, including artificial intelligence, machine learning and Organ-on-a-Chip devices. Finally, key messages from the recent World Health Organization report into the role of vaccines against AMR provides an interesting perspective relating to prevention which can be of significance in tackling the AMR burden.}, }
@article {pmid41728596, year = {2026}, author = {Tang, CT and Lim, LJH and Lee, CTM and Heah, AJE and Yeo, DST and Tan, SM}, title = {The utilization of virtual reality in the training of de-escalation of aggression for both providers and users of public and healthcare services from the new millennium to the COVID-19 era: a systematic review.}, journal = {Frontiers in medicine}, volume = {13}, number = {}, pages = {1657986}, pmid = {41728596}, issn = {2296-858X}, abstract = {INTRODUCTION: Virtual reality (VR) is a promising modality for the effective delivery of training in the de-escalation of aggression. This review aims to assess how VR has been utilized in training for the de-escalation of aggression among both providers and users of public and healthcare services from the new millennium to the COVID-19 era (2000-2022).
METHODS: A systematic review was conducted in accordance with a pre-registered protocol and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Seven key databases were searched, yielding 2373 studies for screening, of which 15 were included. Quality appraisal was performed using the widely used Critical Appraisal Skills Programme (CASP) tool.
RESULTS: VR training for the de-escalation of aggression was implemented using a variety of approaches, ranging from verbal interaction and emotion-recognition tasks to selection from multiple-choice response menus. Most studies assessed participants' responses to the intervention, but none evaluated whether VR training had an impact at the organizational level. Overall, VR training content, modes of interaction, and reported improvements in participants' confidence were viewed positively. However, some studies reported limitations related to the emotional impact, realism of virtual characters, and learning effectiveness. Additional features that may enhance the VR experience were discussed, with personalized, context-specific scenarios identified as an important area for development.
CONCLUSION: Larger-scale studies are required to determine which specific training domains may benefit most from VR-based approaches, given the heterogeneity of populations and methodologies across studies conducted between 2000 and 2022.
https://www.crd.york.ac.uk/PROSPERO/view/CRD42022307138, identifier CRD42022307138.}, }
@article {pmid41729334, year = {2026}, author = {Gaddafi, MS and Lawal, H and Musawa, IA and Garba, B and Goni, MD and Jolayemi, KO and El-Yakub, AU and Jibril, AH and Saeed, SI and Bitrus, AA and Salman, M and Fasina, FO and Yakubu, Y}, title = {Serological and virological evidence of MERS-CoV infection among dromedary camels in Africa: a systematic review and Meta-analysis.}, journal = {Veterinary research communications}, volume = {50}, number = {2}, pages = {}, pmid = {41729334}, issn = {1573-7446}, mesh = {Animals ; *Camelus/virology ; *Middle East Respiratory Syndrome Coronavirus/isolation & purification ; *Coronavirus Infections/veterinary/epidemiology/virology ; Seroepidemiologic Studies ; Africa/epidemiology ; Zoonoses/virology/epidemiology ; Female ; Risk Factors ; }, abstract = {Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is a zoonotic pathogen of major public health concern due to its pandemic potential. Dromedary camels are the principal reservoir, and Africa harbors over 60% of the global dromedary population. This systematic review and meta-analysis assessed the serological, molecular, and geographical distribution of MERS-CoV infection and associated risk factors among African dromedary camels over the past decade. A systematic search of Web of Science, PubMed, Scopus, and African Journals Online (AJOL) was conducted for studies published between 2012 and 2025, following PRISMA 2020 guidelines. Thirty-nine eligible studies from 13 African countries were included, predominantly from East Africa, followed by North and West Africa. The pooled seroprevalence and viral RNA prevalence of MERS-CoV among dromedaries were 75.1% (95% CI: 68.2%-82.0%; I2 = 99.4) and 6.2% (95% CI: 3.5%-8.9%; I2 = 99.7), respectively, indicating extensive exposure history. Subgroup analysis showed regional variation, with the highest pooled seroprevalence in North Africa and highest viral RNA prevalence in West Africa (5.5%). Adult camels had higher seroprevalence (78.5%) than juvenile camels (42.5%), while viral RNA detection was slightly higher in young (5.5%). Female camels showed slightly higher (descriptive) pooled seroprevalence (69.7%) than males (65.8%), whereas males had slightly higher pooled viral RNA prevalence (5.1%) compared to females (4.0%). Nine studies examined human infection among camel handlers, yielding a pooled prevalence of 12.3% (95% CI: 1.4%-25.9%; I2 = 99.9). These findings highlight widespread MERS-CoV circulation in African camels and the urgent need for coordinated One Health surveillance to mitigate zoonotic risks.}, }
@article {pmid41729563, year = {2026}, author = {Li, Q and Zeng, M and Lv, W and Ye, J and Wu, S}, title = {Current landscape of clinical trials for mRNA-based therapeutics.}, journal = {Human vaccines & immunotherapeutics}, volume = {22}, number = {1}, pages = {2635868}, pmid = {41729563}, issn = {2164-554X}, mesh = {Humans ; *Clinical Trials as Topic/statistics & numerical data ; *mRNA Vaccines/therapeutic use ; *RNA, Messenger/therapeutic use ; }, abstract = {Beyond coronavirus disease 2019 (COVID-19) vaccines, messenger RNA (mRNA)-based therapeutics have increasingly demonstrated potential across other treatment areas. To summarize the clinical research landscape for such products and provide valuable references for researchers working in related fields, mRNA clinical trials registered on ClinicalTrials.gov (CTg) and the Chinese Clinical Trial Registry (ChiCTR) up to June 7, 2025, were analyzed. Twelve key items, including registration number, study title, target disease, interventions, blinding, sponsor, phases, enrollment, funder type, study type and start date, and locations, were analyzed to describe trial characteristics. A total of 557 clinical trials of mRNA-based therapeutics were identified. Most of these studies were conducted in phases 0-3 (n = 412, 73.97%), primarily focusing on infectious diseases (n = 410, 73.61%), and predominantly open-label designs (n = 338, 60.68%). Interventional studies accounted for 85.82% (n = 478) of all registered trials. Industry sponsors were the primary source of funding (n = 299, 53.68%). Approximately 45.06% of the projects (n = 251) aimed to enroll 0-100 participants. Most of the studies involved mRNA vaccines (n = 507, 91.02%). Further, 22 trials investigated mRNA-based therapeutics for rare diseases. Among the newly registered projects in 2024 and 2025, the proportion of phase 0-1 trials significantly increased, accounting for 61.67% and 78.13%, respectively. The top three regions that conducted mRNA clinical studies were North America (n = 186; primarily the United States [n = 178]), Asia (n = 184; China [n = 72]), and Europe (n = 90), based on studies registered in both CTg and ChiCTR. Most mRNA products remain in preapproval clinical trials. Further phase 3 clinical evidence will be essential to support its broader application.}, }
@article {pmid41729699, year = {2026}, author = {Hoy-Schulz, YE and Damhorst, GL and Lam, WA}, title = {Accelerating Diagnostics for Pandemic Preparedness.}, journal = {Annual review of analytical chemistry (Palo Alto, Calif.)}, volume = {19}, number = {1}, pages = {279-306}, doi = {10.1146/annurev-anchem-082824-031734}, pmid = {41729699}, issn = {1936-1335}, mesh = {Humans ; Pandemic Preparedness ; *COVID-19/diagnosis/epidemiology ; SARS-CoV-2/isolation & purification/genetics ; Pandemics ; *COVID-19 Testing/methods ; }, abstract = {Diagnostics are central to pandemic preparedness, guiding surveillance, clinical care, and public health response. The COVID-19 pandemic exposed limitations in diagnostic infrastructure but also accelerated innovation across assay types, created accessible testing mechanisms, and demonstrated the value of public-private partnerships. This review outlines the critical roles diagnostics play across pandemic phases, from early detection to post recovery surveillance. We review the current diagnostic landscape for pandemic priority pathogens and unmet needs and challenges and examine recent advances in analytical technologies, including isothermal amplification, CRISPR-based methods, alternative sample types, and novel platforms, with a focus on their potential for rapid deployment and field use. We also explore the emergence of diagnostic accelerators and biorepositories that support assay validation and global test availability. For analytical chemists, pandemic preparedness presents a call to action: to develop, validate, and translate innovative tools that can adapt to meet urgent diagnostic needs during future health emergencies.}, }
@article {pmid41729872, year = {2026}, author = {Bhattacharya, K and Sharma, D}, title = {Surgery in the shadow of Nipah: Preparedness, precautions, and protocols.}, journal = {Tropical doctor}, volume = {56}, number = {3}, pages = {453-455}, doi = {10.1177/00494755261425726}, pmid = {41729872}, issn = {1758-1133}, mesh = {Humans ; Nipah Virus ; *Henipavirus Infections/prevention & control/transmission/epidemiology ; Animals ; COVID-19 ; Pandemics/prevention & control ; Cross Infection/prevention & control ; *Infection Control/methods ; SARS-CoV-2 ; Disease Outbreaks/prevention & control ; *Coronavirus Infections/prevention & control/epidemiology/transmission ; *Pneumonia, Viral/prevention & control/epidemiology/transmission ; Operating Rooms ; Pandemic Preparedness ; }, abstract = {Nipah virus (NiV) is a highly lethal zoonotic infection with a case fatality rate of 70-75% and is recognized by the World Health Organization as a priority pathogen with epidemic potential. Recent cases in India highlight the ongoing risk of re-emergence, particularly in resource-constrained health systems. While surveillance and outbreak containment are often emphasized, the implications of NiV for surgical and perioperative care remain less often discussed. Operating rooms are high-risk environments for nosocomial transmission owing to aerosol-generating procedures and exposure to body fluids. Drawing on lessons from past infectious disease outbreaks and recent global experiences with COVID-19, we wish to outline perioperative risks, evidence-informed precautions, and system-level preparedness strategies tailored for surgical teams.}, }
@article {pmid41730209, year = {2026}, author = {Dobrescu, A and Pinte, L and Sharifan, A and Gadinger, A and Moser, I and Cooper, C and Gartlehner, G}, title = {Effectiveness, Comparative Effectiveness, and Harms of COVID-19 Vaccines in Adults Who Are Not Pregnant or Immunocompromised: A Rapid Review for the American College of Physicians.}, journal = {Annals of internal medicine}, volume = {179}, number = {5}, pages = {673-684}, doi = {10.7326/ANNALS-25-05044}, pmid = {41730209}, issn = {1539-3704}, mesh = {Humans ; *COVID-19 Vaccines/adverse effects ; *COVID-19/prevention & control ; *Vaccine Efficacy ; Adult ; SARS-CoV-2 ; Hospitalization/statistics & numerical data ; }, abstract = {BACKGROUND: The SARS-CoV-2 Omicron variant continues to pose a global health burden.
PURPOSE: To assess the effectiveness, comparative effectiveness, and harms of COVID-19 vaccines in nonpregnant, nonimmunocompromised adults.
DATA SOURCES: Medline via Ovid and DynaMedex from January 2022 to September 2025.
STUDY SELECTION: Two reviewers independently selected English-language randomized controlled trials (RCTs) and nonrandomized studies of interventions (NRSIs).
DATA EXTRACTION: One reviewer extracted data and assessed the certainty of evidence (CoE), and a second reviewer verified; 2 reviewers independently assessed risk of bias.
DATA SYNTHESIS: Five RCTs and 18 NRSIs were included. In adults of all ages, Omicron-adapted vaccination probably reduces all-cause mortality (vaccine effectiveness [VE] ranged from 26.6% [95% CI, 5.5% to 42.3%] to 75.2% [CI, 70.6% to 79.9%]; moderate CoE) and COVID-19-related hospitalization (VE ranged from 16.6% [CI, 6.5% to 25.8%] to 67.8% [CI, 63.1% to 72.5%]; moderate CoE) compared with no Omicron-adapted vaccination. When administered more than 365 days after the prior vaccine, it probably reduces all-cause mortality (VE, 36.1% [CI, 14.8% to 54.1%]; moderate CoE) and COVID-19-related hospitalization (VE, 22.2% [CI, 11.4% to 32.0%]; moderate CoE). When administered earlier, it may result in no difference in COVID-19-related hospitalization. Omicron-adapted vaccination may increase myocarditis (incidence rate ratio, 2.7 [CI, 1.0 to 7.0]; low CoE) in adults aged 50 years or older. The mRNA-1283.222 bivalent vaccine probably results in no difference in all-cause mortality or serious adverse events compared with mRNA-1273.222 in adults of all ages.
LIMITATIONS: No RCTs assessed the effectiveness of Omicron-adapted versus no Omicron-adapted vaccination. Evidence on harms was limited.
CONCLUSION: Omicron-adapted vaccines improve protection compared with no Omicron-adapted vaccines, particularly when administered more than 365 days after the prior vaccination.
PRIMARY FUNDING SOURCE: American College of Physicians. (PROSPERO: CRD420251136017).}, }
@article {pmid41730216, year = {2026}, author = {Qaseem, A and Obley, AJ and Harrod, CS and Wilt, TJ and Carroll, K and Humphrey, LL and , and Haeme, R and Krain, A and Poonacha, T and Saini, SD and Vigna, C}, title = {COVID-19 Vaccines for 2025-2026 in Adults Who Are Not Pregnant or Immunocompromised: Rapid Practice Points From the American College of Physicians.}, journal = {Annals of internal medicine}, volume = {179}, number = {5}, pages = {728-733}, doi = {10.7326/ANNALS-25-05026}, pmid = {41730216}, issn = {1539-3704}, mesh = {Humans ; *COVID-19 Vaccines/adverse effects ; Adult ; *COVID-19/prevention & control/epidemiology ; Middle Aged ; Aged ; Female ; Adolescent ; Young Adult ; United States ; Vaccine Efficacy ; SARS-CoV-2 ; }, abstract = {DESCRIPTION: The American College of Physicians (ACP) developed these rapid practice points addressing the effectiveness, comparative effectiveness, and harms of Omicron-adapted COVID-19 vaccines in adults (aged ≥18 years) who are not pregnant or immunocompromised.
METHODS: The ACP Population Health and Medical Science Committee developed the rapid practice points on the basis of a rapid review by the ACP Center for Evidence Reviews at Cochrane Austria and national disease surveillance data on the epidemiology and baseline risks for COVID-19.
UNLABELLED: The following practice points apply to those who are not pregnant or immunocompromised.
PRACTICE POINT 1: Adults aged 65 years or older should receive an updated 2025-2026 mRNA-based COVID-19 vaccine.
PRACTICE POINT 2: Adults aged 18 to 64 years at increased risk for severe COVID-19 should receive an updated 2025-2026 mRNA-based COVID-19 vaccine.
PRACTICE POINT 3: Adults aged 18 to 64 years who are not at increased risk for severe COVID-19 may consider receiving an updated 2025-2026 mRNA-based COVID-19 vaccine.}, }
@article {pmid41730897, year = {2026}, author = {Soriano, JB and Lumbreras, S}, title = {The rise of artificial intelligence in respiratory primary care and pulmonology: a scoping review.}, journal = {NPJ primary care respiratory medicine}, volume = {36}, number = {1}, pages = {}, pmid = {41730897}, issn = {2055-1010}, mesh = {Humans ; *Artificial Intelligence ; *Primary Health Care ; *Pulmonary Medicine/methods/trends ; COVID-19 ; Pandemics ; SARS-CoV-2 ; Digital Health ; *Coronavirus Infections/diagnosis ; Betacoronavirus ; }, abstract = {Artificial intelligence (AI) is rapidly advancing respiratory disease management, from diagnosis to population lung health. This scoping review synthesizes the most promising uses of AI in respiratory medicine, with a particular focus on pulmonologists and family physicians interested in lung health. In diagnostics, deep-learning systems streamline chest-imaging workflows by triaging radiographs, detecting COVID-19 pneumonia, and classifying lung nodules on CT. In pulmonary function testing, algorithms detect technical errors and classify spirometric patterns, some claiming to outperforming pulmonologists. Acoustic analysis of cough, breathing, and speech captured on smartphones or wearables offers non-invasive decision support. For monitoring and prediction, AI helps shorten weaning from mechanical ventilation and guides closed-loop strategies for acute respiratory distress. In chronic care, connected devices integrated with environmental data help to forecast asthma and COPD exacerbations, while telehealth and predictive models enable earlier, more personalized interventions. Additional gains are emerging in paediatrics, sleep medicine, lung ultrasounds, and public health. Realizing these benefits will require rigorous multicentre validation and real-world evidence. It will also require proactive bias detection and mitigation with inclusive sampling and equity audits. High-quality, interoperable data and explainable models are needed to enable human oversight. Practical issues such as digital literacy, device access, and usability for children, older adults, and other vulnerable populations also matter for applications requiring patient interaction. With sustained collaboration among clinicians, engineers, AI experts, industry, regulators, and scientific societies, AI can increase the time invested in a satisfactory clinician-patient relationship. With all likelihood, AI can also measurably improve efficiency and accuracy across multiple domains of respiratory care.}, }
@article {pmid41732619, year = {2026}, author = {Manoukian, G and Kundukulam, S and Asatorian, G and Johnson, DM and Masood, MH and Venugopal, A and Manoukian, M and Aswathappa, S}, title = {Post-COVID Syndrome in Patients With Comorbid Hypertension or Diabetes: A Narrative Review of Long-Term Outcomes.}, journal = {Cureus}, volume = {18}, number = {1}, pages = {e102117}, pmid = {41732619}, issn = {2168-8184}, abstract = {Post-COVID syndrome (PCS), or long COVID, refers to a cluster of enduring symptoms that extend beyond the acute phase of the initial SARS-CoV-2 infection. Acute infection predominantly impacts the respiratory tract, but there is growing evidence for the multisystem involvement, such as cardiovascular, metabolic, and neurological, to be responsible for the prolonged presentation in PCS. Underlying cardiometabolic vulnerability may contribute to a high degree of susceptibility in patients with comorbidities like hypertension (HTN) and diabetes mellitus (DM). This narrative review summarizes current literature regarding PCS in patients with HTN and/or DM, focusing on proposed pathophysiological mechanisms, clinical manifestations, and reported long-term outcomes. In these populations, PCS has been linked across studies to processes including endothelial dysfunction, chronic low-grade inflammation, autonomic imbalance, and potential dysregulation of the renin-angiotensin-aldosterone system (RAAS). Persistent cardiovascular, metabolic, and neurocognitive symptoms are reported, but the magnitude and patterns of risk vary across studies, while comparative findings across HTN and DM remain heterogeneous. Symptoms reported frequently include fatigue, cognitive impairment ("brain fog"), and psychological distress, supporting the multisystem complexity of PCS. Although, previous work has indicated that cardiometabolic comorbidities could interact and moderate PCS severity and persistence, there is an important shortfall of both causality and prognosis, as well as the management of PCS. Longitudinal studies are needed for future research regarding risk stratification, disease course, and targeted interventions in individuals with PCS with comorbid high blood pressure and diabetes.}, }
@article {pmid41733130, year = {2026}, author = {Tang, JW}, title = {The landscape of aerosol transmission after COVID-19.}, journal = {Current opinion in pulmonary medicine}, volume = {32}, number = {3}, pages = {182-187}, doi = {10.1097/MCP.0000000000001263}, pmid = {41733130}, issn = {1531-6971}, mesh = {Humans ; *COVID-19/transmission/prevention & control ; SARS-CoV-2 ; Aerosols ; *Pandemics/prevention & control ; *Infection Control/methods ; *Pneumonia, Viral/transmission/prevention & control/epidemiology ; *Coronavirus Infections/transmission/prevention & control/epidemiology ; Betacoronavirus ; }, abstract = {PURPOSE OF REVIEW: This review describes how the COVID-19 pandemic stimulated a radical shift around the concepts and definitions of aerosol transmission, and how this new understanding led to a rethink around related infection control interventions that were vital to reduce the spread of SARS-CoV-2, and, potentially, other respiratory viruses.
RECENT FINDINGS: A revision of the terminology for aerosol-transmitted pathogens by the WHO, together with its accompanying open access platform (ARIA), to allow users to define their own exposure scenarios and calculate related transmission risks, are just two of many multidisciplinary collaborations that have paved the way for a more effective pandemic response in the future, for aerosol-transmitted, novel pathogens.
SUMMARY: A multipronged approach is needed for any next pandemic, including expertise from laboratory microbiologists and virologists, clinical infectious diseases and infection control teams, public health physicians and epidemiologists, aerosol scientists and engineers. We need to develop a rapid evidence pipeline to collate robust scientific data about any new pathogen, how it is transmitted, how it infects and affects humans, and how to control, treat and prevent it. This article briefly outlines how far we have come and proposes some options to better prepare for the next pandemic.}, }
@article {pmid41733396, year = {2026}, author = {Henjeroei, FM and Nosratabadi, N and Pourghadamyari, H and Anaeigoudari, A and Sedghy, F and Nosratabadi, R}, title = {Neutrophils in Coronavirus Disease 2019: Guardians or Triggers of Immunopathology?.}, journal = {Cell biochemistry and function}, volume = {44}, number = {2}, pages = {e70186}, doi = {10.1002/cbf.70186}, pmid = {41733396}, issn = {1099-0844}, mesh = {Humans ; *Neutrophils/immunology/pathology ; *COVID-19/immunology/pathology ; SARS-CoV-2/immunology ; Immunity, Innate ; Extracellular Traps/immunology ; Reactive Oxygen Species/metabolism/immunology ; *Pneumonia, Viral/immunology/pathology/virology ; *Coronavirus Infections/immunology/pathology ; Pandemics ; *Betacoronavirus/immunology ; Animals ; }, abstract = {COVID-19 (coronavirus disease 2019) is a respiratory viral disease with a wide range of clinical symptoms that emerged in December 2019. Innate immunity serves as a rapid immune system that can fight off pathogens before they can spread and cause an active infection. Neutrophils, the most abundant innate immune cells, are the first cells to migrate to the site of infection, where they defend against invading pathogens. Once activated at the inflammatory site, neutrophils mediate host protection through multiple mechanisms, including the phagocytosis of pathogens, the release of antimicrobial and pro-inflammatory enzymes, the production of reactive oxygen species (ROS), and the extrusion of their chromatin to form neutrophil extracellular traps (NETs) that bind to extracellular pathogens. Furthermore, neutrophils can move toward the source of the stimulus through a mechanism called chemotaxis, which is mediated by adhesion molecules and chemokine-chemokine receptor axes. However, neutrophil overactivation can have deleterious effects on various organs through the induction of cytokine storms, ROS production, and NET formation. Moreover, the contribution of distinct neutrophil subsets and their plasticity over the course of infection and recovery remain poorly understood. This review summarizes the current knowledge of the interplay between neutrophils and SARS-CoV-2, highlighting the most important mechanisms involved in the pathogenesis of COVID-19, to advance our understanding of this disease.}, }
@article {pmid41733677, year = {2026}, author = {Wang, X and Schröder, HC and Neufurth, M and Müller, WEG}, title = {Mucosal Wound Repair: Reinforcement of Respiratory Mucus Barrier Function by Inorganic Polyphosphate.}, journal = {Progress in molecular and subcellular biology}, volume = {63}, number = {}, pages = {175-207}, pmid = {41733677}, issn = {0079-6484}, mesh = {Humans ; *Polyphosphates/pharmacology/therapeutic use ; Animals ; *Mucus/drug effects/metabolism ; *Wound Healing/drug effects ; *Respiratory Mucosa/drug effects/pathology ; Mucins/metabolism ; Nanoparticles/chemistry ; }, abstract = {Epithelial cell damage affects not only the skin, which covers the external surface of the human body, but also the non-keratinized epithelia, the mucosa, that lines the surfaces of internal organs, including the nasopharynx and lungs. This mucosa is characterized by a moist surface formed by the mucus overlying the epithelial cells. In the respiratory tract in particular, mucosa cells are constantly exposed to large amounts of environmental pathogens and stressors, including bacteria and viruses inhaled as aerosols. Therefore, mucins, a group of glycoproteins that constitute a major component of the mucus, play an important role in the innate immune defense provided by the protective mucus shield. This barrier function of the mucus can be disrupted by a number of agents, such as fine dust (particulate matter). Recent results have shown that inorganic polyphosphate (polyP), which can be administered, for example, in the form of a nasopharyngeal spray, offers a promising way to strengthen or repair impaired mucus function. This chapter describes the structure and formation of the mucus and its mucin building blocks, as well as the mode of action of polyP and drug-loaded polyP nanoparticles in restoring the mucus barrier, particularly with regard to their protective function against coronavirus infection.}, }
@article {pmid41734323, year = {2026}, author = {Löwy, I}, title = {[Long Covid: a long story].}, journal = {Medecine sciences : M/S}, volume = {42}, number = {2}, pages = {187-193}, doi = {10.1051/medsci/2026017}, pmid = {41734323}, issn = {1958-5381}, mesh = {Humans ; Post-Acute COVID-19 Syndrome ; *COVID-19/psychology/complications ; *Psychophysiologic Disorders/psychology/diagnosis/etiology ; SARS-CoV-2 ; }, abstract = {Patients with long Covid experience multiple, often very debilitating symptoms, yet their test results frequently appear normal. In the absence of objective indicators of a recognized disease, some professionals may conclude that the patient is suffering from a psychosomatic disorder. These patients face an epistemic injustice, that is, a failure to recognize their suffering as real. This injustice is rooted in a longstanding history of medically invisible disorders, which are diagnosed mainly on the basis of the patient's own narrative. The difficulties experienced by patients with long Covid cannot be dissociated from this history.}, }
@article {pmid41734553, year = {2025}, author = {Xiao, K and Li, L and Zhang, X and Ye, Y and Yao, Y and Liu, Y and Chen, W and Wang, X and Gu, C and He, M and Liang, L and Liu, YC and Zhu, Z}, title = {Global prevalence of dry Eye: A systematic review and meta-analysis.}, journal = {Contact lens & anterior eye : the journal of the British Contact Lens Association}, volume = {49}, number = {2}, pages = {102627}, doi = {10.1016/j.clae.2026.102627}, pmid = {41734553}, issn = {1476-5411}, mesh = {*Dry Eye Syndromes/epidemiology ; Humans ; Prevalence ; COVID-19/epidemiology ; Global Health/statistics & numerical data ; *Pandemics ; SARS-CoV-2 ; *Pneumonia, Viral/epidemiology ; Female ; *Betacoronavirus ; }, abstract = {OBJECTIVE: Dry eye significantly impacts global quality of life and productivity, yet existing epidemiological data remain fragmented and outdated, hindering effective prevention and management strategies. This study aimed to estimate the global prevalence of dry eye and examine variations across regions, demographics, diagnostic criteria, study settings, and the COVID-19 pandemic.
METHODS: A systematic search of PubMed, Web of Science, Embase, and Cochrane Library identified 119 cohort or cross-sectional studies involving 15,251,528 participants. Two reviewers independently screened records, extracted data, and assessed study quality using the Joanna Briggs Institute checklist. A random-effects model pooled prevalence estimates, with subgroup analyses exploring heterogeneity.
RESULTS: The global pooled prevalence of dry eye was 34.6% (95% CI: 30.2%-39.4%). Regional disparities were pronounced, with the highest prevalence in Africa 43.9% (95% CI: 31.5%-57.2%) and the lowest in North America 20.9% (95% CI: 8.2%-43.8%). Higher rates were observed in females 39.1% (95% CI: 32.8%-45.8%) vs. males 30.8% (95% CI: 24.8%-37.7%), individuals aged > 40 years 37.0% (95% CI: 29.1%-45.7%) vs. ≤ 40 years 35.0% (95% CI: 25.4%-46.0%), institutional settings 45.2% (95% CI: 36.2%-54.5%), and during COVID-19 44.5% (95% CI: 28.0%-62.2%). Diagnostic criteria significantly influenced estimates, ranging from 6.9% (95% CI: 1.9%-21.7%) (ICD-9-based) to 53.8% (95% CI: 46.7%-60.8%) (OSDI ≥ 13).
CONCLUSIONS: Dry eye represents a major global public health challenge, with prevalence shaped by geographic, demographic, environmental, and methodological factors. The pandemic exacerbated dry eye burden, underscoring the urgency for standardized diagnostic protocols and targeted interventions to mitigate its growing impact.}, }
@article {pmid41734932, year = {2026}, author = {Dræbel, TA and Birhanu, Z and Lien, L and Soerensen, JB and Andersen, LS and Terefe Tucho, G and Mekonnen, H}, title = {Mental health impact of the COVID-19 pandemic on frontline healthcare workers in Ethiopia: a scoping review of associated mental health risk and protective factors.}, journal = {BMJ open}, volume = {16}, number = {2}, pages = {e107175}, pmid = {41734932}, issn = {2044-6055}, mesh = {Humans ; Ethiopia/epidemiology ; *COVID-19/psychology/epidemiology ; *Frontline Workers/psychology ; *Mental Health ; Risk Factors ; Protective Factors ; SARS-CoV-2 ; *Health Personnel/psychology ; Pandemics ; Female ; }, abstract = {OBJECTIVES: The mental health impacts of COVID-19 on frontline healthcare workers have been reported globally; however, there is limited evidence from low-income countries such as Ethiopia. We reviewed the literature to understand how COVID-19 impacted the mental health of frontline healthcare workers, including the associated risk and protective factors.
DESIGN: A scoping review of peer-reviewed research was conducted between 2020-2025 to explore the mental health and well-being of frontline healthcare workers in Ethiopia during COVID-19. The process adhered to the guidelines for data extraction outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Our search identified 35 studies, of which 29 studies were included in the final synthesis.
DATA SOURCES: Three online databases, PubMed, Web of Science and PsycInfo, were systematically searched for data.
ELIGIBILITY CRITERIA: Studies were considered for inclusion in the review if they focused on mental health conditions and psychosocial well-being among healthcare workers during COVID-19 in Ethiopia. Studies were only included if published in English and excluded if they were conference abstracts, case studies, reviews, commentaries, contained incomplete data or lacked variables of interest.
DATA EXTRACTION AND SYNTHESIS: Data extraction was conducted manually by two reviewers by using a data extraction sheet created in Excel.
RESULTS: Most frontline healthcare workers experienced symptoms of insomnia, psychological distress, stress, anxiety, post-traumatic stress disorder and depression during COVID-19. Female frontline healthcare workers, nurses, midwives and laboratory technicians reported higher rates of adverse mental health outcomes. Our results found that being married, living together with a spouse and having a high educational level were risk factors for adverse mental health outcomes.
CONCLUSION: The mental health and well-being of frontline healthcare workers is at risk during a global health crisis; however, there is a limited understanding of how to protect the mental health of frontline healthcare workers in low-income countries, such as Ethiopia, at such a critical time. Additional research is needed to better inform mental health preparedness interventions for frontline healthcare workers in these contexts, particularly given predictions of another pandemic occurring within the next decade.}, }
@article {pmid41735249, year = {2026}, author = {Du, S and Hu, X and Li, P and Xu, S and Kim, M and Liu, X and Zhan, P}, title = {Antiviral drug discovery and development: challenges and future directions.}, journal = {Signal transduction and targeted therapy}, volume = {11}, number = {1}, pages = {}, pmid = {41735249}, issn = {2059-3635}, mesh = {Humans ; *Antiviral Agents/therapeutic use/chemistry ; *Drug Discovery/trends/methods ; SARS-CoV-2/drug effects ; COVID-19 ; Pandemics ; *Betacoronavirus/drug effects/pathogenicity ; *COVID-19 Drug Treatment ; *Coronavirus Infections/drug therapy/virology ; Artificial Intelligence ; }, abstract = {The coronavirus disease 2019 (COVID-19) pandemic has stimulated extensive endeavors toward the development of therapeutic interventions targeting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and human proteins for viral infection control, encompassing numerous potential drugs and thousands of patients participating in clinical trials. These concerted efforts have resulted in significant advancements in antiviral drug discovery and development. In this review, we present a comprehensive timeline detailing the development of antiviral drugs, tracing the progression from early viral inhibitors to modern broad-spectrum antiviral agents. We also outline the current status of advancements in antiviral drug discovery, encompassing target-based strategies, innovative mechanism-based approaches, and pharmacokinetic optimization. Furthermore, we discuss the challenges and future prospects gained from COVID-19 and other infectious diseases, covering knowledge of artificial intelligence strategies, the utilization of medicinal chemistry tools, and advancements in nanotechnology applications. The application of artificial intelligence in drug discovery is increasingly prevalent, particularly in the areas of protein structure prediction, drug target identification, and bioactivity forecasting. Nanotechnology has played a crucial role in the delivery of antiviral drugs and the development of vaccines, exemplified by the use of lipid nanoparticles in mRNA vaccines. Additionally, we highlight potential future directions for drug discovery, such as targeting membraneless organelles (liquid‒liquid phase separation).}, }
@article {pmid41735932, year = {2026}, author = {Medeiros, MC and Martins, EB and Guaraldo, L and Calvet, GA}, title = {Cerebral venous thrombosis in non-bacterial infections: a systematic review.}, journal = {BMC neurology}, volume = {26}, number = {1}, pages = {}, pmid = {41735932}, issn = {1471-2377}, mesh = {Humans ; *Venous Thrombosis/etiology ; *Intracranial Thrombosis/etiology ; *Virus Diseases/complications ; }, abstract = {BACKGROUND: This systematic review summarizes evidence on cerebral venous thrombosis (CVT) following non-bacterial (viral, fungal, parasitic) infections, excluding COVID-19, by describing etiology, clinical features, management, and outcomes. METHODS: Following PRISMA guidelines and PROSPERO registration (CRD42023445694), we searched MEDLINE/PubMed, Scopus, Web of Science, Embase, and LILACS from inception to July 31, 2025. Two reviewers independently performed study selection, data extraction, and quality assessment using Joanna Briggs Institute tools. RESULTS: From 14,127 records, 278 publications from 1958 to 2025 (262 case reports and 16 case series), encompassing 322 patients were included. Median age was 39 years (IQR 25–55); 54% were male. Viral infections (35%; primarily varicella zoster and HIV) and fungal mucormycosis (35%) were the most common etiologies. While neuroimaging was performed in 95% of cases, specific pathogen identification (biopsy, culture, PCR) was used in fewer than half. Mucormycosis typically involved the cavernous sinus and was observed alongside high mortality (68%). Viral infections often affected multiple sinuses and were reported in association with more favorable outcomes (54% favorable). Anticoagulants were administered in 93% of viral cases, but were administered less frequently in mucormycosis (25%). Direct oral anticoagulants (DOACs) were prescribed for only nine patients. Recanalization was reported in 17% of cases, although follow-up data were unavailable or unreported for most (81%). CONCLUSIONS: Non-bacterial infections, notably viral pathogens and mucormycosis, are significant causes of CVT with distinct clinical profiles. Management strategies varied substantially by specific etiology, emphasizing urgent diagnostic intervention. Future guidelines should prioritize specific pathogen diagnostics and investigate the role of DOACs for infectious CVT.}, }
@article {pmid41735986, year = {2026}, author = {Lutz, CS and Zhang, H and Knoll, MD and Sparrow, EG and Chen, H and Feikin, DR}, title = {Respiratory syncytial virus positivity among hospital admissions for acute respiratory illness in children younger than 5 years of age in low- and middle-income countries: a systematic review and meta-analysis.}, journal = {BMC public health}, volume = {26}, number = {1}, pages = {}, pmid = {41735986}, issn = {1471-2458}, support = {INV-005318/GATES/Gates Foundation/United States ; }, mesh = {Humans ; *Respiratory Syncytial Virus Infections/epidemiology ; *Developing Countries/statistics & numerical data ; Infant ; *Hospitalization/statistics & numerical data ; Child, Preschool ; *Respiratory Tract Infections/epidemiology/virology ; Infant, Newborn ; Acute Disease ; }, abstract = {OBJECTIVES: To estimate the proportion RSV-positive among children aged < 5 years hospitalized with ARI in low- and middle-income countries (LMIC), where 97% of RSV mortality occurs. METHODS: We conducted a systematic literature search for studies conducted pre-COVID-19 and published 2010—2022 (PROSPERO registration CRD42022361351). We estimated the RSV percent positivity and 95% confidence interval (CI) using random-effects meta-analyses. We assessed heterogeneity in RSV percent positivity using subgroup analyses and univariable meta-regression models. We assessed the influence of study sample size in sensitivity analyses. RESULTS: Seventy-three studies conducted in 37 LMICs were included. The summary estimate of percent RSV-positive from the meta-analysis of children < 5 years hospitalized with ARI was 26.2% (95% CI: 24.3–28.3%), ranging from 18.9% (16.4–21.6%) among children 6– < 60 months to 41.3% (36.4–46.4%) among children 0– < 6 months. Only five studies included children aged < 2 months, but RSV positivity was high among this group (40.2% [35.8–44.7%]). Percent positivity stratified by WHO region ranged from 23.6% in the Africa and Southeast Asian regions to 37.5% in the European region. RSV positivity was similar across country income groups. Univariable meta-regression models indicated that there was significant heterogeneity in RSV percent positivity across subgroups defined by mid-year of the study period, WHO region, number of study sites, recruitment method, hospital type, and specimen type (p < 0.05). CONCLUSIONS: RSV detection was high among children aged < 5 years hospitalized with ARI in LMICs across all WHO regions, especially among infants aged < 6 months, among whom RSV may account for almost up to one-half of all ARI hospital admissions. Recent WHO-recommended RSV immunization for all countries may protect young infants aged < 6 months against severe RSV disease.}, }
@article {pmid41736116, year = {2026}, author = {Saikat, S and Shivji, S and Seifeldin, R and Zhang, Y and Shah, A and Schmets, G and Sreedharan, R and Chungong, S}, title = {Health policy, collaboration and investment in the post-COVID era: a review from UHC and health security integration perspective.}, journal = {Globalization and health}, volume = {22}, number = {1}, pages = {}, pmid = {41736116}, issn = {1744-8603}, mesh = {Humans ; *COVID-19 ; *Health Policy ; *Universal Health Insurance/organization & administration ; Pandemics ; Global Health ; SARS-CoV-2 ; Public Health Infrastructure ; International Cooperation ; *Cooperative Behavior ; }, abstract = {BACKGROUND: The COVID-19 pandemic exposed weaknesses in health systems globally, highlighting chronic underinvestment, fragmentation, and a lack of preparedness with catastrophic impact on public health, economies and societies. Lessons learned reconfirmed the necessity to build health systems resilience, integrating efforts to achieve Universal Health Coverage (UHC) and health security in tandem. RESULTS: This study identified 63 global and regional policies, collaborations, and investments (collectively termed “initiatives”) that came out post-COVID-19 and reviewed them in reference to their focus on integration of UHC and health security through the lens of WHO’s seven policy recommendations for building resilient health systems. The findings indicate that while efforts to align UHC and health security are evident at global and regional levels, they vary in depth and coherence. 81% of initiatives align with at least four of the seven WHO policy recommendations. While there is emphasis for health security preparedness, focus on primary care and health promotion is less pronounced. Policy initiatives show stronger alignment with WHO policy recommendations compared to Collaborations or Investments, indicating synergies between policies, while apparently a gap between policy and practice. Multilateral groups, including UN agencies, and government-affiliated organizations show greater alignment with the WHO policy recommendations too, while there is less alignment with those from non-governmental and other entities. CONCLUSIONS: This review shows that while post COVID-19 policies increasingly articulate visions for integrated health systems strengthening, existing collaborations and investments have not demonstrated comparable commitment to the implementation of these visions. This underscores a prevailing disconnect among global health actors and the mostly reactive and short-term nature of external investments and partnerships. In low-income and fragile health system contexts, this misalignment risks the inefficient use of global support and may perpetuate foundational weaknesses in health systems. Moreover, this is particularly problematic given worsening fiscal constraints from reductions in overseas development assistance and country-level economic contractions. By (re)orienting global health policies, collaborations, and investments toward more unified approaches to achieving UHC and health security, the international community can more effectively support countries in building health systems capable of withstanding future crises, maintaining essential health services and safeguarding gains in health equity.}, }
@article {pmid41736159, year = {2026}, author = {Soriano Puig, A and Monforte, V and Camprubí-Rimblas, M and Artigas, A and Ceccato, A}, title = {Biomarker-guided use of corticosteroids in pneumonia.}, journal = {Pneumonia (Nathan Qld.)}, volume = {18}, number = {1}, pages = {}, pmid = {41736159}, issn = {2200-6133}, abstract = {Community-acquired pneumonia (CAP) is one of the leading causes of death worldwide. Although corticosteroids have been proposed as immunomodulatory, controversies surrounding the results of clinical trials have limited their widespread use. This review aims to determine which biomarker-guided corticosteroid treatment for CAP is generally agreed upon in the latest published studies and to discuss the main aspects to be taken into consideration based on lessons learnt from patients with conditions such as influenza, SARS-CoV-2 infection or the recently identified subphenotypes in acute respiratory distress syndrome (ARDS). Most studies have demonstrated that high C-reactive protein concentrations at the time of admission are associated with a hyperinflammatory state and that patients are more likely to benefit from corticosteroid treatment if they have high concentrations. High levels of C-reactive protein (CRP) were used as an inclusion criterion in one clinical trial, demonstrating that treatment failure was reduced in the corticosteroid group. A post-hoc analysis of the results of several studies also showed that CRP levels above 200 mg/L were associated with benefits in patients receiving corticosteroids. Recent guidelines have proposed the use of corticosteroids in patients with severe CAP or septic shock. Corticosteroids could be more beneficial for patients with a hyperinflammatory subphenotype; however, there are currently no prospective studies evaluating this approach. Further studies are needed to clarify the role of biomarkers in personalised medicine for patients with CAP. In the meantime, patients with severe CAP or high CRP levels should be treated with corticosteroids.}, }
@article {pmid41736351, year = {2026}, author = {V Rey-Matias, BM and S Ignacio, ML and D Leochico, CF and Rathore, FA}, title = {Telerehabilitation for the Evaluation and Management of a Dizzy Patient: A Mini-Review.}, journal = {JPMA. The Journal of the Pakistan Medical Association}, volume = {76}, number = {1}, pages = {118-120}, doi = {10.47391/JPMA.26-08}, pmid = {41736351}, issn = {0030-9982}, mesh = {Humans ; *Telerehabilitation ; *Dizziness/rehabilitation ; *COVID-19/epidemiology ; Quality of Life ; SARS-CoV-2 ; *Vertigo/rehabilitation ; }, abstract = {Dizziness and vertigo are common, disabling symptoms, especially in older adults. They can negatively affect quality of life and independence of the person. Vestibular rehabilitation is a key treatment, but access is often limited by physical, geographic, and socioeconomic factors. Telerehabilitation has emerged as a viable alternative, particularly during the COVID-19 pandemic. This mini review synthesizes available evidence on vestibular telerehabilitation, focussing on feasibility, delivery methods, outcomes, and future directions. We have included commonly used outcomes measures like balance, gait, gaze stability, dizziness, psychological health, and quality of life. Findings suggest telerehabilitation is an effective alternative to in-person therapy. However, further research is needed to standardize protocols, evaluate cognitive outcomes, and ensure inclusivity across diverse populations. Digital innovations are a promising options for more accessible, patient-centered vestibular care.}, }
@article {pmid41736688, year = {2026}, author = {İşcan, G and Çöme, O}, title = {Security and privacy in e-health technologies: a scoping review of challenges and strategies in primary care.}, journal = {Family practice}, volume = {43}, number = {2}, pages = {}, doi = {10.1093/fampra/cmag006}, pmid = {41736688}, issn = {1460-2229}, mesh = {Humans ; *Primary Health Care ; *Telemedicine ; Digital Health ; *Computer Security ; *Confidentiality ; Electronic Health Records ; COVID-19/epidemiology ; *Privacy ; SARS-CoV-2 ; }, abstract = {BACKGROUND: The rapid integration of e-health technologies-such as telehealth, mobile health (mHealth), and electronic health records-has transformed primary care delivery, especially during the COVID-19 pandemic. However, this transformation has revealed significant vulnerabilities in data privacy and security, particularly in decentralized and resource-limited primary care settings. This scoping review aims to map current evidence on privacy and security concerns related to e-health technologies in primary care and to identify mitigation strategies and research gaps.
METHODS: A systematic search was conducted in PubMed, ACM, Scopus, and Web of Science for studies published between 2019 and 2024. Eligible studies addressed both privacy/security issues and e-health technology use in primary care. A two-stage screening process and full-text review were applied. Data were extracted and thematically synthesized.
RESULTS: Fifty-two studies were included. E-health technologies examined included teleconsultations, patient portals, digital decision support tools, and artificial intelligence (AI)-based systems. Among included studies, telehealth accounted for 28%, mHealth and wearables 20%, electronic health records 16%, and AI applications 6%. Common concerns involved data breaches, insufficient encryption, lack of interoperability, consent ambiguity, and challenges in securing virtual consultations. Vulnerable groups-such as older adults and low-literacy populations-faced higher risks. Recommended strategies included privacy-by-design principles, secure infrastructure, user-centered design, clearer governance policies, provider training, and hybrid care models.
CONCLUSION: Addressing privacy and security in e-health requires more than technical solutions. Equitable, safe, and trustworthy systems must incorporate legal, ethical, and human-centered approaches. In primary care, privacy must be positioned as a core element of digital health equity, not an optional enhancement.}, }
@article {pmid41736834, year = {2026}, author = {Souza, ECSG and Dos Santos Junior, AG and Félix, AMS and Borges, JPA and de Oliveira, LB and Carneiro, LM and de Sousa, AFL}, title = {Use of Artificial Intelligence in Public Health Education for Pandemic Preparedness and Response.}, journal = {Annals of global health}, volume = {92}, number = {1}, pages = {21}, pmid = {41736834}, issn = {2214-9996}, mesh = {Humans ; *Artificial Intelligence ; *Public Health/education ; *Pandemic Preparedness ; *Health Education/methods ; COVID-19 ; *Pandemics/prevention & control ; }, abstract = {Background: The rapid evolution of artificial intelligence (AI) has enabled new approaches for health education, particularly during public health emergencies. However, evidence remains fragmented on how AI-based educational strategies support preparedness, response, and recovery phases of pandemics and epidemics. Objective: To map the use of AI-based technologies in health education strategies addressing preparedness, response, and recovery during public health emergencies, identifying target populations, intervention characteristics, outcomes, scalability, and knowledge gaps. Methods: This scoping review followed Joanna Briggs Institute methodology and PRISMA-ScR guidelines. Searches were conducted in PubMed/MEDLINE, Scopus, Web of Science, Embase, IEEE Xplore, and LILACS, complemented by gray literature from Google Scholar. Studies published from 2010 onward in English, Portuguese, or Spanish were included. Eligible designs comprised primary studies, methodological or implementation research, and reviews with explicit educational components. Data extraction covered context, populations, AI modalities, educational purposes, delivery channels, supervision requirements, pandemic-cycle phase, scalability, outcomes, and evidence gaps. Results: Forty-one studies met the inclusion criteria. Conversational AI (chatbots and large language models) and algorithmic curation tools using machine learning and natural language processing predominated. Most interventions supported health literacy, risk communication, and misinformation management; others addressed personalized learning, microtraining, and clinical simulation for students and health professionals. Delivery channels included mobile applications, messaging platforms, websites/YouTube, and clinical AI systems. Human oversight (expert validation and curation) was consistently reported as essential for safety and reliability. Interventions mainly targeted the response phase, with emerging applications for preparedness. Major gaps included standardized learning measures, cost-effectiveness evaluations, equity analyses, and governance frameworks ensuring privacy, transparency, and bias control. Conclusions: AI-enabled educational technologies can strengthen rapid, scalable, and personalized learning during health emergencies. Future research should prioritize multicenter studies using standardized indicators, economic and equity assessments, and robust governance frameworks to ensure ethical, safe, and inclusive adoption.}, }
@article {pmid41737288, year = {2026}, author = {Muto, T and Machida, S and Imaizumi, S and Kamoi, K}, title = {Relationship Between COVID-19 and Retinal Artery Occlusions.}, journal = {Journal of ophthalmology}, volume = {2026}, number = {}, pages = {5545707}, pmid = {41737288}, issn = {2090-004X}, abstract = {The relationship between coronavirus disease 2019 (COVID-19) infection or vaccination and retinal artery occlusions (RAOs) remains controversial. COVID-19 infection or vaccination can sometimes cause thrombin formation. RAOs occur due to thrombin in the retinal artery. The average age of occurrence after COVID-19 infection was 48.7 ± 17.2 years in central RAO (CRAO) and 41.3 ± 17.8 years in branch RAO (BRAO). After COVID-19 vaccination, the average age was 54.7 ± 17.1 years in CRAO and 62.3 ± 21.2 years in BRAO. The mean time from COVID-19 diagnosis to symptom onset was 10.5 ± 9.3 days in CRAO and 48.3 ± 39.6 days in BRAO. After vaccination, the mean time was 7.3 ± 6.8 days in CRAO and 21.0 ± 24.9 days in BRAO. Initial visual acuity (VA) after COVID-19 infection was 2.53 ± 0.65 in CRAO and 0.09 ± 0.07 in BRAO. Final VA was 2.73 ± 0.12 in CRAO, but data for BRAO were unavailable. After vaccination, initial VA was 2.28 ± 0.97 in CRAO and -0.02 ± 0.16 in BRAO. Final VA was 2.12 ± 1.24 in CRAO and could not be calculated in BRAO. The relationship between COVID-19 or its vaccination and RAOs was investigated through past case reports. Two types of reports existed regarding RAO incidence after the COVID-19 pandemic-some indicated an increase, while others found no change. No reports suggested a decrease in RAO occurrence. The current evidence does not clarify the relationship between COVID-19 or its vaccine and RAOs. However, this relationship cannot be ruled out. Further investigations are necessary, as future infectious disease pandemics may occur.}, }
@article {pmid41737593, year = {2026}, author = {Thangaleela, S and Wang, CK}, title = {Impact of nutrition on long COVID.}, journal = {Sports medicine and health science}, volume = {8}, number = {2}, pages = {128-144}, pmid = {41737593}, issn = {2666-3376}, abstract = {Long COVID is characterized by a group of persistent symptoms following the acute SARS-COV2 infection, which presented a multifaceted challenge to the healthcare systems all over the globe. The long COVID symptoms span various organ systems including the respiratory, cardiovascular, gastrointestinal, and neurological manifestations. Mitochondrial dysfunction and immune dysregulation play crucial roles in the long COVID pathophysiology. Recently nutritional intervention gained much attention in managing post-viral syndromes. Effective interventions like supplementation of omega-3 fatty acid, macro and micro nutrients, and vitamins help to reduce systemic inflammation and counteract muscle wasting. Other approaches like nutritional recovery, dietetic interventions, continuous nutritional care post-hospital discharge, nutritional rehabilitation programs, whole-diet approaches like Mediterranean diet, plant-based diet, and caloric optimization, improve overall functional recovery. Physical activity and exercise regimes have been shown to improve fatigue, dyspnea, and cognitive function. Tailored exercise regimes may promote safe rehabilitation. Certain ineffective interventions, such as non-personalized approaches, high dose of antioxidants, use of herbal products that are not clinically validated need to be addressed. Dietary interventions such as personalized nutritional counseling have been demonstrated to improve physical performance in long COVID patients. Further research is needed to refine protocols and identify optimal combinations of dietary and movement-based therapies to support the recovery of long-COVID patients. This narrative review focuses on the ongoing researches that reveals the intricate relationship between nutrition and long COVID recovery and also establishes effective protocols for nutritional care.}, }
@article {pmid41738365, year = {2026}, author = {Akhavan, M and Yousefi, P and Tabibzadeh, A}, title = {Exacerbations and Management of Asthma in Viral Lower Respiratory Tract Infections: The Significance of Immunoglobulin E.}, journal = {Immunity, inflammation and disease}, volume = {14}, number = {2}, pages = {e70386}, pmid = {41738365}, issn = {2050-4527}, mesh = {Humans ; *Asthma/immunology/therapy ; *Immunoglobulin E/immunology/blood ; *Respiratory Tract Infections/immunology/complications/virology ; *COVID-19/immunology/complications ; *SARS-CoV-2/immunology ; Th2 Cells/immunology ; }, abstract = {BACKGROUND: Viral-respiratory infections are the most prevalent illness among humans. A viral infection affecting lower respiratory tract infections (LRTI) is a critical health concern worldwide. The COVID-19 pandemic has significantly impacted respiratory health, particularly in individuals with asthma. Other viral respiratory infections and asthma are critical concerns, either. The current study aimed to discuss how elevated IgE levels can influence viral LRTI and potentially exacerbate asthma symptoms, as well as biological treatments targeting IgE in managing asthma.
MATERIALS AND METHODS: The search was conducted in electronical databases (including PubMed, Scopus, Google Scholar, and so on). all obtained documents were listed and reviewed by two independent authors. All relevant studies were included and used for final assessment and data collection.
RESULTS: IgE is a crucial mediator in the pathophysiology of asthma, particularly in type 2-high (T2-high) asthma, where it drives allergic responses and airway inflammation. The interaction between COVID-19 and asthma has illustrated that asthmatic patients may experience increased respiratory symptoms following COVID-19 infection. Interestingly, T2-high asthmatics may have had some protection against severe COVID-19 outcomes, highlighting the need for a nuanced understanding of asthma management during and after the pandemic.
CONCLUSION: Viral infections, particularly those caused by human rhinoviruses, are a significant trigger for asthma exacerbations. These infections can lead to heightened serum IgE levels, which play a vital role in the immune response and the worsening of asthma symptoms. The Th2 inflammatory pathway is frequently upregulated during these infections, associated with increased production of cytokines such as IL-4, IL-5, and IL-13, which aggravate asthma symptoms. Additionally, viral infections can compromise the airway epithelium, resulting in greater exposure to allergens and irritants, and disrupt the balance between Th1 and Th2 cytokines, leading to more severe exacerbations.}, }
@article {pmid41739653, year = {2026}, author = {Sharma, L and Maheshwari, N and Maheshwari, N and Teli, G and Chelvam, V}, title = {Therapeutic Approaches to Treat SARS-CoV-2.}, journal = {ChemMedChem}, volume = {21}, number = {4}, pages = {e202500387}, doi = {10.1002/cmdc.202500387}, pmid = {41739653}, issn = {1860-7187}, support = {IITI 2023-25//Indian Institute of Technology Indore/ ; }, abstract = {Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), also known as COVID-19, spread across the globe, leading to a pandemic. Initially, the drug remdesivir is approved by the FDA for the treatment of SARS-CoV-2. Significant efforts have been directed toward epidemiology of the SARS-CoV-2 virus to discover potential drug targets that may contribute to the development of effective prevention and treatment strategies. The structure and functions of SARS-CoV-2 proteins that may be potential drug targets, including the spike protein, main protease, papain-like protease, RNA-dependent RNA polymerase, host proteins like angiotensin-converting enzyme 2, and transmembrane protease and serine 2, have been thoroughly studied. Biological screening platforms and repurposing have resulted in the discovery of drugs such as nirmatrelvir-ritonavir (Paxlovid), remdesivir (Veklury), molnupiravir (Lagevrio), anakinra (Kineret), vilobelimab (Gohibic), baricitinib (Olumiant), and tocilizumab (Actemra). The present analysis provides details on the pathogenesis, prevention, diagnosis, clinical characteristics, and potential treatment options currently available worldwide.}, }
@article {pmid41740281, year = {2026}, author = {Dandotiya, J and Sadhu, S and Chandwaskar, RR and Awasthi, A}, title = {Emerging roles of IL-9 and Th9 cells in respiratory viral illnesses.}, journal = {Seminars in immunology}, volume = {81}, number = {}, pages = {102017}, doi = {10.1016/j.smim.2026.102017}, pmid = {41740281}, issn = {1096-3618}, mesh = {*Interleukin-9/immunology/metabolism/genetics ; Animals ; Humans ; *T-Lymphocytes, Helper-Inducer/immunology ; *COVID-19/immunology ; *SARS-CoV-2/immunology ; *Respiratory Tract Infections/immunology ; Receptors, Interleukin-9/genetics ; Cell Differentiation ; }, abstract = {Upon antigenic stimulation and cytokine cues, CD4[+] T cells differentiate into specialized helper subsets, giving rise to Th1, Th2, Th9 and Th17 cell lineages. These subsets orchestrate distinct immune functions that protect the host but can also drive immunopathology when dysregulated. The classical Th1-Th2 paradigm expanded with the discovery of Th17 and Th9 cells, revealing greater diversity and complexity in Th cell biology. Th9 cells, generated under the influence of TGF-β and IL-4, are defined by robust production of interleukin-9 (IL-9). IL-9 is now recognized as a multifunctional mediator produced by Th9 cells, mast cells, ILC2s, Tregs and certain Th17 subsets. Fate-mapping and reporter mouse models have improved our understanding of IL-9-producing immunocytes, though limitations remain in defining temporal and tissue-specific dynamics. As shown earlier, IL-9 promotes mastcell proliferation, mucus hypersecretion, epithelial changes and airway remodelling in allergic inflammation and asthma. Genetic studies have linked IL-9/IL-9 receptor variants to increased susceptibility to allergic diseases such as asthma. Similarly, during respiratory viral infections, including RSV and COVID-19, IL-9 amplifies type 2 inflammation, granulocyte recruitment and mucus production, exacerbating airway obstruction. In fact, emerging evidence implicates a Foxo1-IL-9 axis in COVID-19, where IL-9 enhances lung inflammation and impairs antiviral interferon-stimulated gene responses. Collectively, IL-9 represents a context-dependent driver of virus-induced lung pathology and a promising therapeutic target requiring deeper mechanistic and translational investigation.}, }
@article {pmid41740316, year = {2026}, author = {Spedding, M and Aerts, J and Alexander, S and Bellozzi Woestelandt, AG and Chiricozzi, E and Henriques, A and Lledo, PM and Loeffler, JP and Perera, R and Platt, FM and Pradat, PF and Rene, F and Schapira, A and St Clair, L and Talbot, K and Taquet, M and Toborek, M and Turner, B and Zandi, M and Gressens, P}, title = {Links between COVID-19, long COVID, and neurodegeneration: The role of glycosphingolipids.}, journal = {Pharmacological reviews}, volume = {78}, number = {2}, pages = {100113}, doi = {10.1016/j.pharmr.2026.100113}, pmid = {41740316}, issn = {1521-0081}, support = {T32AI007417-28//NIH/National Institute of Health NIAID/ ; F32AI186453-01//NIH/National Institute of Health NIAID/ ; L70AG084124-01//NIH National Institute of Health /NIA/ ; }, mesh = {Humans ; *Neurodegenerative Diseases/metabolism/virology/etiology ; *COVID-19/metabolism/complications ; *Glycosphingolipids/metabolism ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; Animals ; Pandemics ; G(M1) Ganglioside/metabolism ; }, abstract = {Glycosphingolipids (GSLs) play major roles in viral infections by mediating viral entry and egress from cells in lipid rafts; however, GSLs are also important in neurodegenerative diseases. The role of GSLs in acute COVID-19 infection is critical but remains less-studied in the sequelae of long COVID (post-COVID condition); because the same enzymes that regulate GSL metabolism are critical for viral entry and exit, neuromuscular junctions, neurological function, and cellular metabolism, it is important to determine whether long COVID may increase the risk of subsequent neurodegeneration. SARS-CoV-2 infection alters lipid metabolism and oxygen use and can bind to and modify the expression of neurotrophic GSLs such as GM1 ganglioside. GM1 (N-acetylneuraminic acid) is human-specific and probably evolved as a result of a pandemic 3-2.5 million years ago that drove its selection. GM1 functions as a coreceptor with angiotensin-converting enzyme 2 for SARS-CoV-2 while also being a neurotrophin. Viral multiplication takes place in the endoplasmic reticulum/Golgi apparatus, where GSLs are synthesized. This review defines the complex interaction between viruses, GSLs, and neurodegeneration, which provides new perspectives on the interlinked metabolic changes. A European working group has been set up to assess the risks of neurodegeneration with long COVID, based on potential GSL-mediated mechanisms. SIGNIFICANCE STATEMENT: The SARS-CoV-2 pandemic has resulted in a large number of subjects living with long-term consequences (long COVID). Glycosphingolipids and gangliosides are involved in both viral infections and neurodegeneration; hence, it is important to evaluate whether long COVID may increase the risk of neurodegeneration via this route. This study is the result of a European consortium formed to evaluate this possibility.}, }
@article {pmid41740458, year = {2026}, author = {Sohn, WY and Goody, SMG and Reid, DW and Edwards, DK and Urdaneta, V and Doyle, BP and Straus, WL and Henry, C and Rizkalla, B}, title = {Evidence-based assessment of safety and mechanistic questions Related to mRNA COVID-19 Vaccines.}, journal = {Vaccine}, volume = {77}, number = {}, pages = {128394}, doi = {10.1016/j.vaccine.2026.128394}, pmid = {41740458}, issn = {1873-2518}, mesh = {Humans ; *COVID-19 Vaccines/adverse effects/immunology ; *COVID-19/prevention & control ; SARS-CoV-2/immunology ; Animals ; mRNA Vaccines/adverse effects ; Vaccines, Synthetic/adverse effects/immunology ; RNA, Messenger ; 2019-nCoV Vaccine mRNA-1273 ; Pandemics/prevention & control ; }, abstract = {Messenger RNA (mRNA) COVID-19 vaccines have been administered globally at unprecedented scale and have demonstrated strong effectiveness against severe disease, hospitalization, and death. Extensive safety monitoring across randomized clinical trials, national surveillance systems, and global pharmacovigilance programs has consistently supported a favorable benefit-risk profile for these vaccines. Despite this evidence, a range of questions and mechanistic hypotheses continue to circulate, including assertions of increased risk of malignancies, autoimmune diseases, and all-cause mortality, as well as proposed mechanisms involving product-related impurities (e.g. DNA contamination), biodistribution and antigen persistence, non-canonical translation (e.g. ribosomal frame-shifting), and immune modulation. This targeted narrative review synthesizes nonclinical, clinical, pharmacoepidemiologic, and regulatory evidence relevant to these mechanistic and safety related questions. Published literature, regulatory assessments, and surveillance data were qualitatively evaluated in the context of biological plausibility, methodological rigor, and consistency across independent data sources. Across the body of evidence, findings do not support increased long-term mortality, malignancy, autoimmune disease, genotoxicity or other long-term safety issues attributable to mRNA COVID-19 vaccination. On the contrary, several large population-based studies have reported lower all-cause mortality among vaccinated individuals. Residual DNA levels are within established regulatory limits when measured using validated methods, and no credible mechanism supports genomic integration. Biodistribution studies demonstrate expected localization to the injection site and lymphoid tissues with no persistence. Immunologic findings, including IgG4 subclass responses, have not been associated with impaired protection in real-world vaccine effectiveness studies. Collectively, the evidence supports the safety and effectiveness of mRNA COVID-19 vaccines. Ongoing surveillance and rigorous evaluation remain essential to inform public health policy. Importantly, vaccine safety questions should be assessed using transparent, structured frameworks that systematically weigh benefits, harms, quality of evidence, values, and feasibility.}, }
@article {pmid41740848, year = {2026}, author = {Lee, GM and Yun, S and Jung, YW and Kim, JH and Chae, YM}, title = {Cancer care disruptions among vulnerable populations during the COVID-19 pandemic: A scoping review.}, journal = {Journal of cancer policy}, volume = {48}, number = {}, pages = {100716}, doi = {10.1016/j.jcpo.2026.100716}, pmid = {41740848}, issn = {2213-5383}, mesh = {Humans ; *COVID-19/epidemiology ; *Vulnerable Populations/statistics & numerical data ; *Neoplasms/therapy/diagnosis/epidemiology ; SARS-CoV-2 ; Female ; Pandemics ; Patient Acceptance of Health Care/statistics & numerical data ; Socioeconomic Disparities in Health ; Early Detection of Cancer ; }, abstract = {BACKGROUND: Infectious disease outbreaks, particularly COVID-19, have disrupted cancer care worldwide and disproportionately affected vulnerable populations.
OBJECTIVE: To identify vulnerable groups and characterize patterns of disruption in cancer screening and treatment during the COVID-19 pandemic.
METHODS: Following the Arksey and O'Malley framework, we conducted a scoping review of studies published between 2002 and 2023. Searches were performed in MEDLINE, EMBASE, the Cochrane Library, and Google Scholar. Thirty-four studies were included and analyzed with a focus on healthcare utilization, screening delays, and treatment disruptions across the cancer care continuum.
RESULTS: Older adults, women, immigrant and ethnic minority populations, individuals with low income or education, and patients with comorbidities were most frequently identified as vulnerable. Screening disruptions were more commonly associated with lower educational attainment, whereas treatment delays were concentrated among low-income individuals, newly diagnosed patients, and those with comorbidities. Health system strain, mobility restrictions, fear of infection, and socioeconomic barriers were key contributing factors.
CONCLUSION: This review demonstrates that vulnerability in cancer care during the COVID-19 pandemic is stage-specific and shaped by both population-level and health system-level factors. Mapping these patterns provides evidence to inform stage-specific and population-sensitive strategies to protect cancer care continuity during future public health emergencies.}, }
@article {pmid41741003, year = {2026}, author = {Michaelchuk, W and Soril, LJJ and Chiarieri-Hirsch, D and Giroux, E and Shatto, J and Gershon, AS and Gupta, S and Stickland, MK and Lam, GY}, title = {Assessment and management of post-COVID-19 pulmonary complications: a rapid review.}, journal = {European respiratory review : an official journal of the European Respiratory Society}, volume = {35}, number = {179}, pages = {}, pmid = {41741003}, issn = {1600-0617}, mesh = {Humans ; *COVID-19/complications/therapy/epidemiology/diagnosis ; *Lung Diseases/therapy/diagnosis/etiology ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; }, abstract = {The rising global prevalence of post-COVID-19 condition (PCC) underscores the substantial and ongoing burden faced by individuals following severe acute respiratory syndrome coronavirus 2 infection. The volume of emerging evidence regarding pulmonary-related PCC complications highlights the urgent need for current, evidence-informed guidelines to ensure timely assessment and effective treatment for those affected by PCC. Thus, the aim of this review was to synthesise existing research on the management and treatment of pulmonary complications in individuals with PCC. A rapid review of published and grey literature focused on pulmonary-related PCC complications was completed in November 2023 and updated in June 2025, in accordance with PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines. We identified 73 unique articles, including 12 guidance documents, 24 secondary studies (including 11 systematic reviews with meta-analyses, eight systematic reviews and three scoping reviews) and 37 primary research studies (13 randomised controlled trials) and narratively synthesised their findings. Guidance documents addressed workup and management for pulmonary-related PCC complications, recommending the use of pulmonary function testing with diffusing capacity and the importance of ruling out other conditions. Although evidence regarding the use of medical and pharmacological interventions for treatment of pulmonary-related PCC complications were limited and inconclusive, the current evidence base suggested potential effectiveness of a multidisciplinary rehabilitation approach for pulmonary-related PCC treatment, involving specialist consultations and tailored rehabilitation programmes. The heterogeneity in study quality and risk of bias warrants cautious interpretation of the findings. The current evidence and evolving healthcare landscape suggest the need for updated, evidence-informed clinical guidance.}, }
@article {pmid41741975, year = {2026}, author = {Hou, L and Sha, Y and Feng, L and Liang, C and Hui, X and Lian, Z and Li, Y and Zhang, Y and Ge, L and Yang, K}, title = {Analysis of the Conceptualization, Frameworks, and Operationalization of Health System Resilience in Empirical Research.}, journal = {Journal of evidence-based medicine}, volume = {19}, number = {1}, pages = {e70122}, doi = {10.1111/jebm.70122}, pmid = {41741975}, issn = {1756-5391}, support = {19ZDA142//Major Project of the National Social Science Fund of China/ ; 21JZD037//Ministry of Education philosophy and social science research major project/ ; }, mesh = {Humans ; *Empirical Research ; *COVID-19/epidemiology ; *Delivery of Health Care/organization & administration ; *Resilience, Psychological ; SARS-CoV-2 ; }, abstract = {AIM: Health system resilience (HSR) has gained prominence in response to acute shocks and chronic stressors, particularly following the COVID-19 pandemic. This study aimed to analyze the conceptualization, frameworks, and operationalization of HSR in empirical research.
METHODS: We searched PubMed, Web of Science, and Global Health databases from inception to January 26, 2024 to identify empirical HSR studies. We screened studies independently, and systematically extracted data. Analyzed were conducted across study characteristics, shocks/stressors types, conceptualizations/definitions, framework traditions, and methodological approaches.
RESULTS: A total of 125 empirical studies were included, with a marked increase from 2020 onward. Most studies examined acute shocks (84%), with the largest share in the Europe (23.3%) and Africa (16.8%). HSR was predominantly conceptualized as a system capacity to absorb and adapt to shocks, while learning and transformation were less frequently operationalized. Health system-specific frameworks (e.g., Kruk; Blanchet) were most commonly used, primarily as analytical lenses rather than measurement tools. Qualitative methods predominated, although mixed-methods approaches are emerging. Evidence on continuity of essential functions and everyday resilience remained limited.
CONCLUSIONS: Despite growing conceptual sophistication, empirical HSR research remains constrained by fragmented frameworks use and limited operationalization. Advancing the field requires clearer conceptual boundaries, improved methodological integration, and greater attention to how resilience is enacted in routine system functioning.}, }
@article {pmid41742211, year = {2026}, author = {Ortiz-Prado, E and Cadena-Padilla, MP and Vélez-Páez, JL and Vasconez-Gonzalez, J and Izquierdo-Condoy, JS and Vergara, M and Viscor, G}, title = {Chronic hypoxia adaptation at high altitude: a perspective on Its potential role in mortality in viral pneumonia-associated ARDS and implications for personalized critical care.}, journal = {Critical care (London, England)}, volume = {30}, number = {1}, pages = {}, pmid = {41742211}, issn = {1466-609X}, mesh = {Humans ; *Altitude ; *Respiratory Distress Syndrome/mortality/etiology/physiopathology/therapy ; *Hypoxia/physiopathology/mortality ; *Pneumonia, Viral/mortality/complications ; *Critical Care/methods ; COVID-19 ; *Adaptation, Physiological/physiology ; Precision Medicine/methods ; Pandemics ; *Coronavirus Infections/mortality/complications ; }, abstract = {Acute respiratory distress syndrome (ARDS) secondary to viral pneumonias, predominantly COVID-19 but also influenza and adenovirus, remains a major ICU mortality driver, with rates exceeding 40%. Chronic high-altitude adaptation (≥ 2,500 m) modifies human pulmonary physiology through hypoxia-inducible factor (HIF-1α/2α) stabilization, ACE2 downregulation, enhanced capillary recruitment, and anti-inflammatory shifts, potentially reducing ARDS severity. Across published observational studies, findings remain heterogeneous; however, several cohorts have reported lower mortality at moderate-to-high altitude (approximately 30–50% in some reports), along with proposed altitude-appropriate SpO2 targets (89–93%) and alternative interpretations of oxygenation indices (e.g., barometric pressure–adjusted P/F ratios). Protection is strongest in younger, comorbidity-free patients, but attenuates in diabetics/hypertensives. In this perspective, we critically examine the evidence on how altitude may influence the clinical course and survival of critically ill patients, exploring potential pulmonary adaptive mechanisms and reflecting on their implications for monitoring and management in intensive care units.}, }
@article {pmid41742356, year = {2026}, author = {Ogbu-Nwobodo, L and Hwong, AR and Murphy, K and Goldman, ML and Dilley, JW}, title = {Long COVID in Populations With Serious Mental Illness: Clinical and Policy Implications.}, journal = {Psychiatric services (Washington, D.C.)}, volume = {77}, number = {5}, pages = {449-456}, doi = {10.1176/appi.ps.20240457}, pmid = {41742356}, issn = {1557-9700}, mesh = {Humans ; *COVID-19/psychology/epidemiology/complications ; *Mental Disorders/therapy/epidemiology ; Post-Acute COVID-19 Syndrome ; Health Policy ; Comorbidity ; Quality of Life ; SARS-CoV-2 ; }, abstract = {As the world recovers from the height of the COVID-19 pandemic with ongoing plans for a strengthened behavioral health infrastructure-from crisis services to long-term care-one of the health conditions that has emerged is long COVID. This multisystem condition is characterized by persistent symptoms that develop after the acute phase of COVID-19 infection. Although the full clinical and scientific understanding of long COVID's neuropsychiatric impact is still evolving, a sizable cohort of patients has emerged with various long-term and often confusing symptoms, which can include cognitive impairment, mood dysregulation (e.g., anxiety or depression), sleep disturbances, posttraumatic symptoms, and chronic fatigue. Recognizing long COVID's debilitating impact on quality of life and wide-ranging societal consequences, the authors sought to summarize current knowledge about long COVID among individuals with a preexisting serious mental illness and to propose care and treatment recommendations for clinicians and public policy makers.}, }
@article {pmid41743132, year = {2026}, author = {Qu, J and Liu, M and Zhou, C}, title = {Rewriting the viral script: post-translational modifications orchestrating SARS-CoV-2 pathogenesis and immune evasion.}, journal = {Frontiers in microbiology}, volume = {17}, number = {}, pages = {1748470}, pmid = {41743132}, issn = {1664-302X}, abstract = {SARS-CoV-2 reprograms host cell biology not solely through its genomic content but also through a sophisticated arsenal of post-translational modifications (PTMs) that modulate viral protein function, host signaling networks, and immune responses. Despite increasing recognition of PTMs as dynamic regulators of infection, their full functional breadth and therapeutic potential remain incompletely defined. Here, we provide a comprehensive, PTM-centric synthesis of SARS-CoV-2 pathogenesis, detailing how phosphorylation, ubiquitination, SUMOylation, glycosylation, acetylation, succinylation, ISGylation, and ADP-ribosylation cooperatively shape virus-host interplay. We dissect the mechanistic roles of individual modifications, such as phosphorylation-mediated transitions in nucleocapsid function, ubiquitin-driven degradation of immune factors, and SUMOylation-guided viral assembly, while revealing higher-order regulatory circuits and crosstalk among PTMs. Additionally, we highlight emerging computational tools for PTM site prediction and identify shared enzymatic nodes exploitable for host-directed antiviral strategies. This integrative framework positions PTMs as not merely bystanders but as central modulators of viral fitness and host vulnerability, offering novel avenues for therapeutic intervention against SARS-CoV-2 and future pandemic threats.}, }
@article {pmid41743347, year = {2026}, author = {Miyano, S and Nozaki, I and Hachiya, M and Miyamoto, T and Takei, T}, title = {Regional health security architecture in ASEAN countries: Lessons from regional CDC models and Japan's strategic partnership for ACPHEED development.}, journal = {Global health & medicine}, volume = {8}, number = {1}, pages = {1-7}, pmid = {41743347}, issn = {2434-9194}, abstract = {The COVID-19 pandemic exposed critical gaps in regional health security mechanisms, prompting ASEAN to establish the ASEAN Centre for Public Health Emergencies and Emerging Diseases (ACPHEED), with functions distributed across Indonesia, Thailand, and Vietnam. This policy analysis examines strategic development approaches for ACPHEED through comprehensive benchmarking of the European Centre for Disease Prevention and Control (ECDC), Africa Centres for Disease Control and Prevention (Africa CDC), and Gulf CDC, supported by consultations in Indonesia (2024) and Sweden (2025) involving ASEAN member states and international partners. A comparative analysis reveals distinct organizational models: the ECDC operates within European Union (EU) institutional frameworks emphasizing functional specialization; the Africa CDC employs decentralized Regional Coordination Centers; and the Gulf CDC implements hybrid governance via Permanent Communication Networks. Each model offers valuable lessons for ACPHEED's development, particularly concerning governance structures that balance regional coordination with national sovereignty. ACPHEED faces unique challenges due to ASEAN's consensus-based, nonlegislative institutional nature and its tri-country operational structure. Critical success factors include phased surveillance emphasizing a defined scope and capacity building; inclusive governance mechanisms ensuring equitable member-state ownership; and operational frameworks applying subsidiarity principles to complement existing ASEAN mechanisms. Sustainable financing remains paramount given ASEAN's limited budgetary authority. Japan's strategic partnership should capitalize on its technical expertise in laboratory systems, digital surveillance, and disaster preparedness through comprehensive institutional support. ACPHEED's success depends on sustained political commitment, realistic financial arrangements, and effective integration into global health security architectures. This analysis provides a strategic roadmap for ACPHEED's preparatory phase so that it can serve as a regional health security leader while addressing ASEAN-specific institutional constraints.}, }
@article {pmid41743408, year = {2026}, author = {Bsat, D and Safi, D and Arabi, M}, title = {Remdesivir in COVID-19: A Focus on Pediatric Cardiac Patients.}, journal = {The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale}, volume = {2026}, number = {}, pages = {4700812}, pmid = {41743408}, issn = {1712-9532}, abstract = {The coronavirus disease 2019 (COVID-19) pandemic has presented a significant global health challenge that necessitated the immediate search for various therapeutic modalities. Remdesivir, an antiviral drug inhibiting RNA-dependent RNA polymerase (RdRp), was among the most heavily used drugs against COVID-19. Of the several randomized controlled trials studying the efficacy of remdesivir, the vast majority were studied on the adult population. Results remain contradictory, with some studies supporting the high efficacy of remdesivir while others highlighting the lack of significance of its antiviral effects. Given the lack of focus on the pediatric population, the antiviral effects of remdesivir in cardiac pediatric patients, who are particularly vulnerable, remain especially under-investigated. This literature review explores current literature on remdesivir's mechanism of action and efficacy against COVID-19, especially in the pediatric cardiac population. Therefore, by combining results of studies from randomized controlled trials and retrospective studies in the adult and pediatric populations, this literature review underlines current knowledge gaps and highlights the need for studies targeting specific ages and comorbidities to effectively treat patients at higher risk of adverse events.}, }
@article {pmid41743708, year = {2026}, author = {Tang, W and Gai, Q and Yang, J and Chen, J and Lyu, Z}, title = {PhIP-Seq: unveiling the complexity of antibody repertoires in health and disease.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1735735}, pmid = {41743708}, issn = {1664-3224}, mesh = {Humans ; *High-Throughput Nucleotide Sequencing/methods ; Peptide Library ; Animals ; SARS-CoV-2/immunology ; Autoantigens/immunology ; Cell Surface Display Techniques ; Lupus Erythematosus, Systemic/immunology/genetics ; COVID-19/immunology ; Multiple Sclerosis/immunology/genetics ; Plasmodium falciparum/immunology ; Antigens, Neoplasm/immunology ; }, abstract = {Phage-Immunoprecipitation Sequencing (PhIP-Seq) merges phage display with next-generation sequencing to enable high-throughput profiling of antibody repertoires. This review synthesizes the technical evolution of the PhIP-Seq platform, critically assessing the workflow from peptide library design and immunoprecipitation to bioinformatics analysis. We evaluate strategies for optimizing library diversity and minimizing non-specific binding, while addressing inherent limitations such as the detection of conformational epitopes and post-translational modifications. The clinical utility of PhIP-Seq is examined through its application in identifying novel autoantigens in systemic lupus erythematosus and multiple sclerosis, mapping viral epitopes in SARS-CoV-2 and Plasmodium falciparum, and detecting tumor-associated antigens. Finally, we discuss the trajectory of the field toward integration with multi-omics datasets and the development of point-of-care diagnostic tools.}, }
@article {pmid41744151, year = {2026}, author = {Domachowske, JB and Zimet, GD and Hanage, W and Beck, E and Sule, P and Wahid, R and Vicic, N}, title = {Preventing COVID-19 in at-risk populations: moving toward next-generation mRNA-1283 COVID-19 vaccine to address current challenges.}, journal = {Expert review of vaccines}, volume = {25}, number = {1}, pages = {2632657}, doi = {10.1080/14760584.2026.2632657}, pmid = {41744151}, issn = {1744-8395}, mesh = {Humans ; *COVID-19/prevention & control/immunology ; *COVID-19 Vaccines/immunology/administration & dosage ; *SARS-CoV-2/immunology ; 2019-nCoV Vaccine mRNA-1273 ; Vaccine Efficacy ; Spike Glycoprotein, Coronavirus/immunology ; Vaccines, Synthetic/immunology ; Immunogenicity, Vaccine ; }, abstract = {INTRODUCTION: Next-generation COVID-19 vaccines hold promise to reduce severe outcomes in populations most at risk. While the original mRNA COVID-19 vaccine, mRNA-1273, targets the full-length SARS-CoV-2 spike protein, mRNA-1283 is a novel next-generation mRNA COVID-19 vaccine that specifically targets immunodominant domains within the spike protein.
AREAS COVERED: This review summarizes literature on the development of mRNA-1283, from its design and preclinical evaluation to phase 1-3 clinical trial findings, with a particular focus on immunogenicity and efficacy in at-risk populations, specifically older adults and adults with comorbidities. The potential public health impact of this next-generation vaccine is explored, along with ongoing challenges facing COVID-19 vaccination.
EXPERT OPINION: Phase 1-3 clinical trials demonstrated that mRNA-1283 was well-tolerated and no safety concerns were identified. Furthermore, mRNA-1283 demonstrated higher point estimates of immunogenicity and relative vaccine efficacy than mRNA-1273, including among older adults and individuals with underlying conditions who are most susceptible to severe COVID-19. Initial modeling studies indicate that mRNA-1283 could prevent more hospitalizations than current COVID-19 vaccines. Evidence to date suggests that the novel next-generation mRNA-1283 vaccine holds promise to advance progress in reducing the ongoing burden of COVID-19 across vulnerable populations.}, }
@article {pmid41744170, year = {2026}, author = {Domnich, A and Pariani, E}, title = {Beyond the laboratory: how COVID-19 reshaped specimen collection, testing workflows, and diagnostic algorithms.}, journal = {Expert review of molecular diagnostics}, volume = {26}, number = {2}, pages = {127-139}, doi = {10.1080/14737159.2026.2638743}, pmid = {41744170}, issn = {1744-8352}, mesh = {Humans ; *COVID-19/diagnosis/virology/epidemiology ; *Specimen Handling/methods ; *SARS-CoV-2/isolation & purification ; Algorithms ; Workflow ; Pandemics ; *COVID-19 Testing/methods ; Rapid Diagnostic Tests ; }, abstract = {INTRODUCTION: The SARS-CoV-2 pandemic forced a radical expansion of essential public health laboratory services that went beyond basic testing. This perspective highlights key shifts in laboratory function, specifically toward decentralized testing, self-sampling, less invasive specimen types, point-of-care devices, and novel surveillance strategies.
AREAS COVERED: The surge in testing demand favored decentralized solutions, including rapid lateral flow tests, due to their flexibility, speed, and affordability. However, several challenges arose from the variable diagnostic accuracy of rapid self-tests and alternative specimen types when compared to reference laboratory-based molecular assays using nasopharyngeal swabs. For instance, the use of self-collected saliva, which is often preferred by patients, was hindered by a lack of internationally standardized processing protocols. A post-pandemic rebound in the circulation of respiratory pathogens other than SARS-CoV-2 was likely driven by both immunity debt and increased testing, including of less severe cases, commonly performed through more costly multiplex respiratory panels.
EXPERT OPINION: Moving forward, while over-the-counter self-tests for common respiratory viruses are now common, stricter regulatory oversight and improved data connectivity are essential. Local decision-makers must weigh the trade-offs between broad testing access and clinical performance, and implement robust diagnostic stewardship programs for acute respiratory infections.}, }
@article {pmid41744596, year = {2026}, author = {Barbinta-Patrascu, ME and Negut, I and Bita, B}, title = {Virus Biomimetic-Delivery Systems for the Production of Vaccines.}, journal = {Biomimetics (Basel, Switzerland)}, volume = {11}, number = {2}, pages = {}, pmid = {41744596}, issn = {2313-7673}, abstract = {The persistent emergence of infectious diseases has underscored the critical demand for next-generation vaccine technologies that are safe, effective, and scalable. This review explores virus biomimetic delivery systems, focusing on virus-like particles (VLPs) and virosomes as promising platforms for vaccine and therapeutic development. VLPs are self-assembled nanostructures composed of viral structural proteins that mimic native virions without carrying genetic material, while virosomes are reconstituted viral envelopes that retain functional glycoproteins but lack a nucleocapsid. Both systems provide strong immunogenicity and safety by mimicking viral architecture while eliminating the risk of replication. The paper examines various expression platforms for VLP production, including bacterial, yeast, insect, mammalian, and plant-based systems, highlighting their respective advantages, challenges, and optimization strategies. Mechanistic insights into antigen presentation, immune activation, and cellular uptake pathways are discussed to explain their superior performance in eliciting humoral and cellular immune responses. Furthermore, current applications of VLPs and virosomes in vaccines against major pathogens such as SARS-CoV-2, influenza, Newcastle disease virus, malaria, hepatitis, and respiratory syncytial virus are reviewed, demonstrating their versatility and clinical potential. By integrating molecular engineering, nanotechnology, and biofabrication strategies, virus biomimetic systems represent a transformative frontier in vaccinology, immunotherapy, and targeted drug delivery.}, }
@article {pmid41745098, year = {2026}, author = {Zoccali, F and Fratini, C and Pennacchia, F and Cascone, F and de Vincentiis, M and Petrella, C and Barbato, C and Minni, A}, title = {Hyperbaric Oxygen Therapy on Long COVID Symptoms: A Breath of Fresh Air.}, journal = {Diseases (Basel, Switzerland)}, volume = {14}, number = {2}, pages = {}, pmid = {41745098}, issn = {2079-9721}, abstract = {Long COVID is defined as "the continuation or development of new symptoms 3 months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least 2 months with no other explanations", as reported by the World Health Organization. A growing number of people are dealing with a variety of lingering symptoms even after recovering from an acute infection. These can include fatigue, muscle pain, shortness of breath, headaches, cognitive issues, neurodegenerative symptoms, anxiety, depression, and a feeling of hopelessness, and therapeutic options for long COVID are investigated. The potential of hyperbaric oxygen therapy (HBOT) to improve chronic fatigue, cognitive impairments, and neurological disorders has been established; therefore, the use of HBOT to treat long COVID has also been studied. The aim of this literature search is to analyze the state of the art of a potential role of HBOT to improve chronic fatigue, cognitive impairments and neurological disorders. A literature analysis was performed, focusing on the clinical efficacy of HBOT for treating long COVID symptoms. The results from January 2021 to October 2025, using a standard registry database, showed 21 studies, including one case report, ten randomized controlled trial, eight systematic reviews and three studies regarding the molecular mechanism and markers changing after HBOT. They suggested that HBOT can improve quality of life, fatigue, cognition, neuropsychiatric symptoms and cardiopulmonary functions. HBOT is a safe treatment and has shown some benefits for long COVID symptoms. To precisely define indications, protocols, and post-treatment evaluations, we need to conduct more in-depth, large-scale studies.}, }
@article {pmid41745309, year = {2026}, author = {Kostev, K and Konrad, M and Luedde, M}, title = {Real-World Cardiovascular Research Using the German IQVIA Disease Analyzer Database: Methods, Evidence, and Limitations (2000-2025).}, journal = {Journal of cardiovascular development and disease}, volume = {13}, number = {2}, pages = {}, pmid = {41745309}, issn = {2308-3425}, abstract = {Cardiovascular diseases (CVDs) remain the leading cause of morbidity and mortality worldwide. This increases the demand for real-world evidence to complement findings from randomized controlled trials. The German IQVIA Disease Analyzer (DA) database, which is populated with anonymized electronic medical records from general practitioners and specialists, has become an increasingly valuable source for cardiovascular research. Over the past two decades, and especially between 2020 and 2025, numerous epidemiological studies have used this database to explore associations between cardiovascular risk factors, comorbidities, therapeutic patterns, and cardiovascular outcomes in large, broadly representative outpatient populations. This review synthesizes evidence from 13 selected DA-based studies examining atrial fibrillation, heart failure, cardiometabolic disease, lipid management, non-alcoholic fatty liver disease (NAFLD)-related cardiovascular risks, cerebrovascular complications, COVID-19-associated vascular events, and modifiable behavioral and anthropometric factors. These studies were selected based on predefined criteria including cardiovascular relevance, methodological rigor, large sample size, and representativeness of key disease domains across the 2000-2025 period. Eligible studies were identified through targeted searches of peer-reviewed literature using the German IQVIA Disease Analyzer database and were selected to reflect major cardiovascular disease domains, risk factors, and therapeutic areas. Across disease domains, the reviewed studies consistently demonstrate the DA database's capacity to identify reproducible associations between cardiometabolic risk factors, comorbidities, and cardiovascular outcomes in routine outpatient care. While causal inference is not possible, the database enables the identification of clinically meaningful associations that inform hypothesis generation, help quantify disease burden, and highlight gaps in prevention or treatment. The database's strengths include large sample sizes (often exceeding 100,000 patients), long follow-up periods, and high external validity, while limitations relate to coding accuracy, residual confounding, and the absence of detailed clinical measures. Collectively, the evidence underscores the importance of the DA database as a crucial platform for real-world cardiovascular research.}, }
@article {pmid41746040, year = {2026}, author = {Timmer, MSM and Connor, LM and Stocker, BL}, title = {Targeting the MR1-MAIT Cell Axis for Vaccination Against Infectious Disease.}, journal = {Vaccines}, volume = {14}, number = {2}, pages = {}, pmid = {41746040}, issn = {2076-393X}, support = {24-VUW-152//Royal Society Te Apārangi/ ; }, abstract = {Mucosal-associated invariant T (MAIT) cells exist in high numbers in the body and have a unique and highly conserved T cell receptor (TCR). They can be activated in a TCR-dependent manner by ligands presented on the monomorphic protein MHC class I-related protein 1 (MR1) which is found on many cell types, including professional antigen presenting cells (APCs) and epithelial cells. This has sparked interest in the potential to exploit the MR1-MAIT cell axis for the development of vaccines against infectious disease. Within this context an MR1 ligand, typically 5-(2-oxopropylideneamino)-d-ribitylaminouracil (5-OP-RU), is administered with or without a Toll-like receptor (TLR) ligand or cytokine in a pan vaccination approach that would prime the immune response to provide protection against a variety of bacterial and viral pathogens. This strategy has led to enhanced protection in murine models of Legionella longbeachae, Francisella tularensis, Klebsiella pneumoniae, Streptococcus pneumoniae and influenza infection. However, studies against Mycobacterium tuberculosis infection have proven less successful. The second vaccination approach involves pairing the MR1 ligand with more conventional antigens that could activate CD4[+] and/or CD8[+] T cells. This approach has been successful in murine models of cholera, influenza, and SARS-CoV-2, including in the context of subunit vaccines. However, there are several challenges when using MR1-MAIT cell-mediated vaccine adjuvants. These include the inherent instability of 5-OP-RU and the need for more advanced studies to better understand how the use of MR1 ligands would translate to applications in humans. This review will discuss these aspects and highlight the mechanistic studies that have been undertaken to understand how MAIT cells might elicit their effects within the context of MAIT cell-mediated vaccines for infectious disease.}, }
@article {pmid41746075, year = {2026}, author = {Sarabia, LE and Williams, E and Date, K and Méroc, E and Eeuwijk, J and Gessner, B and Bresee, J and Fry, A and Begier, E}, title = {Vaccination Strategies Against Respiratory Pathogens in the Adult Population: A Narrative Review.}, journal = {Vaccines}, volume = {14}, number = {2}, pages = {}, pmid = {41746075}, issn = {2076-393X}, support = {NA//Pfizer (United Kingdom)/ ; }, abstract = {Respiratory infections cause substantial morbidity and mortality in older adults and other at-risk adult populations. Despite the availability of effective vaccines, adult vaccination coverage remains suboptimal. This narrative review examines strategies designed to improve vaccine uptake among non-pregnant adults aged ≥18 years and inform future adult vaccination strategies. We conducted a targeted literature search using keywords for vaccination, respiratory diseases, strategy/program/implementation, and adults in PubMed database and CDC, WHO, and ECDC websites, between 2014 and 2024. A snowball search of literature reviews and key references was also performed to identify additional relevant studies. Eligible publications focused on vaccination strategies against influenza, COVID-19, and pneumococcal disease targeting non-pregnant adults (≥18 years). We categorized the strategies by intervention type to describe their influence on vaccination campaigns and vaccine uptake/coverage. We included 45 publications, encompassing strategies focused on individual decision-making, healthcare system functions, and national policy. Educational and awareness interventions (such as healthcare worker/provider recommendations during consultation, phone calls, letters, text messages, and social media outreach) reportedly raised vaccination rates. Access-related factors, including convenient vaccination sites and free or subsidized vaccines, were reported to be important factors in improving coverage in underserved communities. Within healthcare settings, strategies such as continuous vaccine provider training and workflow/process optimization were shown to enhance vaccination delivery. At the local or national policy levels, legislation governing program targets shaped immunization efforts and facilitated collaborations and partnerships to expand campaign reach. The findings may inform policymakers and public health/immunization practitioners in designing context-specific immunization initiatives that effectively reach adult populations.}, }
@article {pmid41746079, year = {2026}, author = {Oh, T}, title = {Advances in Spatial Transcriptomics for Infectious Disease Research: Insight for Vaccine Development.}, journal = {Vaccines}, volume = {14}, number = {2}, pages = {}, pmid = {41746079}, issn = {2076-393X}, support = {2025//Dankook University/ ; }, abstract = {Spatial transcriptomics (ST) enables genome-wide gene expression profiling while preserving tissue architecture, bridging the gap between bulk, single-cell, and histological analyses. Originating in 2016 and rapidly evolving since, ST has transformed infectious disease research by mapping host-pathogen interactions directly within intact tissues. Current platforms fall into two categories: sequencing-based methods (Visium, GeoMx, Stereo-seq) offering whole-transcriptome coverage at modest resolution and imaging-based platforms (Xenium, CosMx, MERFISH) providing single-cell or subcellular detail with targeted gene panels. These technologies reveal spatially organized immune responses, local tissue remodeling, and pathogen niches across viruses, bacteria, and parasites. In viral infection, ST uncovered heterogeneity in COVID-19 lung microenvironments, spatial immune activation in lymphoid tissues, and variant-specific inflammatory patterns. In bacterial disease, ST delineated granuloma architecture in tuberculosis and mapped vaccine-induced lung responses in Shigella studies. Parasitic infection studies identified localized inflammatory hotspots and microenvironmental control of T-cell differentiation in malaria. Despite powerful insights, ST faces constraints including RNA quality limitations, tradeoffs between resolution and transcript breadth, high cost, and analytical complexity. Nonetheless, ST increasingly informs vaccine design by identifying tissue-specific immune programs and protective microenvironments and is poised to become a standard tool for infectious disease biology.}, }
@article {pmid41746093, year = {2026}, author = {Karczmarzyk, K and Kęsik-Brodacka, M}, title = {Challenges and Prospects in the Development of a Universal SARS-CoV-2 Vaccine.}, journal = {Vaccines}, volume = {14}, number = {2}, pages = {}, pmid = {41746093}, issn = {2076-393X}, support = {2019/35/B/NZ6/04002//National Science Centre/ ; }, abstract = {The development of a universal SARS-CoV-2 vaccine holds great promise for achieving broad and durable protection against existing and future coronavirus variants. The identification, selection, and rational redesign of conserved viral epitopes constitute the direct immunological foundation of universal SARS-CoV-2 vaccine development. The breadth and durability of protection are therefore primarily determined at the level of antigen and epitope design, whereas adjuvants, delivery platforms, and routes of administration serve as enabling and amplifying components rather than primary drivers of universality. Accordingly, this review discusses key determinants of universal vaccine design, including antigen selection, adjuvant utilization, and route of administration. The spike protein, particularly its receptor-binding domain, is a major antigenic target, but its high mutation rate challenges long-term vaccine efficacy. Strategies focusing on conserved epitopes in antigen designs show potential to elicit cross-neutralizing immune responses. Nanoparticle-based vaccines capable of presenting multiple homologous or heterologous antigens have demonstrated enhanced immunogenicity, broad protection in preclinical models and safety in clinical trials. The addition of next-generation adjuvants further amplifies humoral and cellular immunity beyond the capabilities of traditional aluminum-based adjuvants. Moreover, mucosal vaccine delivery may provide superior local protection at viral entry sites and limit transmission. Importantly, integrating these technological advances with epitope-centered antigen design and immunological data from vaccinated individuals will accelerate the identification of conserved epitopes and inform future vaccine design. A multidisciplinary approach combining optimized antigen engineering, novel adjuvant systems, and innovative delivery strategies is essential for the realization of a broadly protective universal SARS-CoV-2 vaccine.}, }
@article {pmid41747602, year = {2026}, author = {Cui, Y and Song, P and Zhao, X and Tong, Z and Gao, GF}, title = {Virus-induced onychomadesis: Exploring the role of viral infection in nail shedding.}, journal = {Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology}, volume = {183}, number = {}, pages = {105928}, doi = {10.1016/j.jcv.2026.105928}, pmid = {41747602}, issn = {1873-5967}, mesh = {Humans ; *Nail Diseases/virology/etiology ; *Nails/virology/pathology ; *Hand, Foot and Mouth Disease/virology/complications ; *Virus Diseases/complications/virology ; }, abstract = {Onychomadesis, characterized by proximal detachment of the nail plate due to temporary arrest of matrix proliferation, has been increasingly recognized as a complication following viral infections. Enterovirus-associated hand-foot-and-mouth disease (HFMD) is the most frequently reported cause. Recent studies demonstrate that some enteroviruses, including Coxsackievirus A10, utilize the host receptor KREMEN1 (KRM1) to impair Wnt/β-catenin signaling and suppress nail stem cell differentiation, thereby providing a molecular basis for infection-induced nail shedding. Additionally, cases of onychomadesis linked to other viral infections, including KRM1-independent enteroviruses, influenza virus, SARS-CoV-2, varicella-zoster virus, and co-infections involving HIV and mpox, have also been documented. Despite growing recognition of the virus-induced onychomadesis, in most cases the exact pathogeneses are yet elusive, thereof lack of approved treatments. Understanding the molecular mechanisms of onychomadesis and other sequelae can enhance diagnostics and therapies, guiding future drug development for virus-induced nail disorders and related complications. A comprehensive literature search was conducted using PubMed up to Dec 2025, including the search terms: onychomadesis, Beau's line, infection or virus, and follow-up. This review aims to explore the molecular pathophysiology of virus-induced onychomadesis and to examine the underlying molecular mechanisms, including the roles of viral receptors and signaling pathways in nail stem cell differentiation. It scrutinizes the currently available literatures of link between viral infections, particularly HFMD, and onychomadesis, focusing on the molecular mechanisms involved, and explores potential therapeutic insights.}, }
@article {pmid41748273, year = {2026}, author = {Evaborhene, NA and Oga, J and Adebisi, YA and Udokanma, EE and Runyowa, N and Kafuko, Z and Bandara, S and Onyeaghala, C}, title = {The WHO pandemic agreement-securing Africa's leadership in a fragmenting global order.}, journal = {BMJ global health}, volume = {11}, number = {2}, pages = {}, pmid = {41748273}, issn = {2059-7908}, mesh = {Humans ; *COVID-19/epidemiology ; *Leadership ; *Pandemics/prevention & control ; *International Cooperation ; Africa/epidemiology ; *World Health Organization ; SARS-CoV-2 ; *Global Health ; Pandemic Preparedness ; *Health Policy ; *Pneumonia, Viral/epidemiology ; }, abstract = {In May 2025, the World Health Assembly adopted the historic WHO Pandemic Agreement, aimed at strengthening global pandemic preparedness and equity. This legally binding treaty emerged from years of negotiation shaped by the COVID-19 pandemic's stark inequities-particularly those experienced by African nations. While the treaty introduces important innovations, notably the Pathogen Access and Benefit-Sharing system, significant challenges remain. Ambiguities in equity commitments, geopolitical fragmentation and rising nationalism threaten effective implementation. For Africa, realising the treaty's promise requires robust legal frameworks, enhanced manufacturing and regulatory capacities and sustainable financing mechanisms that reduce donor dependency. This analysis critically examines the treaty's provisions and political economy, emphasising the need for enforceable obligations, continental leadership and multi-sectoral accountability. We propose the establishment of a Pandemic Peer Review Mechanism to embed political accountability at national and regional levels. Only through coordinated African leadership, institutional investment and global solidarity can the Pandemic Agreement deliver equitable health outcomes in a fracturing global order.}, }
@article {pmid41748726, year = {2026}, author = {Smith, EA and Fleming, DF and Lackritz, EM and Ulrich, AK}, title = {Inequities and global declines in SARS-CoV-2 genomic data availability hinder response to emerging variants.}, journal = {Npj viruses}, volume = {4}, number = {1}, pages = {}, pmid = {41748726}, issn = {2948-1767}, abstract = {Genomic epidemiology has transformed the way public health scientists detect, monitor, and respond to infectious disease threats such as SARS-CoV-2 on a global scale. Early in the COVID-19 pandemic, vast inequities in whole-genome sequence data availability between high- and low-income countries were highlighted, but the persistence of these disparities five years into a global pandemic has not been quantified. Also, while it is generally known that genomic surveillance of SARS-CoV-2 largely declined following the end of the COVID-19 public health emergency, this has not been formally measured, and how it impacts our ability to detect and characterize new variants, remains unknown. Therefore, we performed an analysis of SARS-CoV-2 sequence submissions on the Global Initiative for Sharing All Influenza Data (GISAID) platform from 2020 to 2025, by country and World Bank income classification. There were large differences in SARS-CoV-2 sequence submissions by income classification, indicating a disparity in our ability to monitor SARS-CoV-2 evolution worldwide, which has important consequences for preventative measures such as vaccine strain selection. Nevertheless, there are important barriers to sustainable sharing of SARS-CoV-2 sequence data, which we discuss in detail, along with their relevance to other pathogens of public health importance. Also, the decrease in sequence submissions in high income countries from 577 million at the peak of the pandemic, to under 50 million in 2024, represents a loss of capacity to monitor SARS-CoV-2 evolution in countries with known capabilities. Ultimately, data drive the impact of genomic epidemiology, and long-term investments in genomic surveillance programs, as well as incentives for timely data sharing, are urgently needed to detect and characterize new viral variants worldwide.}, }
@article {pmid41749676, year = {2026}, author = {Farì, G and Quarta, F and Bressi, F and La Russa, R and Paolucci, T and Bernetti, A}, title = {Effects of Exercise-Based Telerehabilitation for Knee Osteoarthritis: A Systematic Review and a Study Protocol.}, journal = {Bioengineering (Basel, Switzerland)}, volume = {13}, number = {2}, pages = {}, pmid = {41749676}, issn = {2306-5354}, abstract = {BACKGROUND: Knee osteoarthritis causes considerable pain and disability. Telerehabilitation has emerged as a promising treatment option, especially after the Coronavirus Disease 2019 pandemic, but it still faces challenges regarding solid scientific evidence about its multiple benefits. This systematic review aimed to analyze the reported beneficial effects of telerehabilitation based on therapeutic exercise for the management of knee osteoarthritis. Methodsː PubMed, PEDro, Web of Science and Cochrane Library databases were used to identify eligible studies. This review followed the PRISMA guidelines and was registered at PROSPERO (n° CRD42024579836). The selected studies underwent a qualitative assessment using the Modified Jadad Score.
RESULTS: Ten studies, including a total of 1354 participants, were included. From the selected studies, a wide variety of outcome measures emerged to evaluate the efficacy of telerehabilitation in the relief of pain and its clinical consequences. Seven studies specifically assessed pain, with four showing significant improvements in pain reduction in the intervention group compared with the control group. Telerehabilitation was found to be more effective or non-inferior to traditional rehabilitation in relieving pain, as reported across various pain scales. Limitations include the heterogeneity of interventions, the exclusion of non-recent studies, and the exclusive focus on therapeutic exercise. Conclusionsː The results of this systematic review suggest that telerehabilitation provides pain relief, improves physical function, and enhances quality of life, while preliminary evidence indicates potential cost-related advantages. However, some studies did not find TR to be superior to control interventions, highlighting mixed evidence. Additional high-quality studies are required to better support this promising rehabilitation approach.}, }
@article {pmid41750353, year = {2026}, author = {Makki, R and Kassem-Moussa, S and Al Nemer, F and El Majzoub, R and Fayyad-Kazan, H and Rachidi, W and Badran, B and Fayyad-Kazan, M}, title = {MicroRNAs in Long COVID: Key Regulators, Biomarkers, and Therapeutic Targets of Post-SARS-CoV-2 Sequelae.}, journal = {Biomolecules}, volume = {16}, number = {2}, pages = {}, pmid = {41750353}, issn = {2218-273X}, mesh = {Humans ; *MicroRNAs/genetics/metabolism/blood ; *COVID-19/genetics ; Biomarkers/blood/metabolism ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; }, abstract = {COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), is clinically defined by persistent symptoms that endure beyond acute infection and affect multiple organ systems, including the immune, cardiopulmonary, neurological, and metabolic axes. The underlying mechanisms remain poorly resolved, limiting the development of targeted diagnostics and therapeutics. MicroRNAs (miRNAs), as key post-transcriptional regulators of gene expression, control inflammatory networks, antiviral responses, mitochondrial bioenergetics, and fibrotic pathways, all of which are implicated in long COVID pathogenesis. Recent studies show durable changes in circulating miRNA signatures months after recovery from the acute phase, suggesting a role in maintaining chronic immune activation and metabolic dysfunction. Importantly, circulating miRNAs are stable, quantifiable in biofluids, and reflect systems-level dysregulation, positioning them as promising biomarker candidates for patient stratification, symptom clustering, and disease monitoring. Moreover, miRNA-directed interventions, such as mimics and antagomiRs, represent an emerging precision-medicine strategy to correct sustained molecular disturbances. This review summarizes current evidence linking miRNAs to long COVID, highlights their biomarker potential, and discusses therapeutic avenues that may help advance mechanism-based interventions for this globally emerging chronic condition.}, }
@article {pmid41750595, year = {2026}, author = {Dawi, J and Affa, S and Misakyan, Y and Gonzalez, E and Affa, S and Venketaraman, V}, title = {Glutathione-Mediated Redox Regulation of Immune Dysfunction in COVID-19 and Tuberculosis.}, journal = {Antioxidants (Basel, Switzerland)}, volume = {15}, number = {2}, pages = {}, pmid = {41750595}, issn = {2076-3921}, support = {R15 HL143545/HL/NHLBI NIH HHS/United States ; }, abstract = {Tuberculosis and coronavirus disease 2019, also known as COVID-19, remain major global health challenges that disproportionately affect individuals with metabolic disorders, chronic inflammation, and limited access to healthcare. Although these diseases are caused by different pathogens, they share important host-related determinants of severity, including immune dysfunction, oxidative stress, endothelial injury, and maladaptive inflammatory responses. Glutathione, the primary intracellular antioxidant and a key regulator of redox balance, has emerged as an important host factor connecting these processes across infectious diseases. This review integrates experimental, translational, and clinical evidence supporting the role of glutathione in regulating immune function, oxidative stress, and tissue damage in tuberculosis and COVID-19. In tuberculosis, glutathione deficiency compromises macrophage antimicrobial activity, disrupts granuloma structure, and alters T helper cell responses, leading to impaired immune containment and disease progression. In COVID-19, reduced glutathione levels are associated with redox imbalance, excessive cytokine signaling, endothelial dysfunction, and thromboinflammatory complications, especially in high-risk populations. In both diseases, glutathione depletion reduces host resilience and increases vulnerability to severe outcomes through shared immune and vascular pathways. By unifying disease-specific findings within a host-directed framework, this review highlights glutathione and redox signaling as common vulnerability pathways that help explain overlapping risk profiles for severe tuberculosis and COVID-19. It also places glutathione biology within the broader context of host-directed immunotherapy, emphasizing its potential role in prevention-focused and resilience-based strategies that complement pathogen-targeted treatments. Although current evidence does not support simple claims of disease prevention, it provides strong mechanistic justification for further investigation of glutathione as a modifiable host factor in high-risk populations.}, }
@article {pmid41751338, year = {2026}, author = {Notarte, KI and Catahay, JA and Velasco, JV and Ver, AT and Lee, J and Rizk, JG and Lippi, G and Fernández-de-Las-Peñas, C}, title = {Complement System Dysregulation in the Immunopathogenesis of Long COVID: Systematic Evidence Synthesis.}, journal = {Biomedicines}, volume = {14}, number = {2}, pages = {}, pmid = {41751338}, issn = {2227-9059}, abstract = {Background/Objective: Long COVID is an important cause of disability following SARS-CoV-2 infection; yet, its underlying mechanisms are not completely understood. One proposed mechanism is the long-lasting dysregulation of the immune complement system. This systematic review is the first to summarize the current evidence and evaluate the potential role of long-lasting complement activation in people with long COVID. Methods: A systematic electronic search on PubMed, MEDLINE, CINAHL, and Embase was conducted up to 15 October 2025, to identify studies investigating complement activation in people with the post-COVID-19 condition. The Newcastle-Ottawa Scale was used to evaluate the risk of bias and methodological quality. Results: Among the 247 studies initially identified, eleven met the inclusion criteria, comprising 1435 individuals (age: 48.5 years, 70% females) with long COVID and 1124 controls (age: 43.6 years, 60% females). All studies were of a high quality, with scores ranging from 7 to 8 stars (mean: 7.6 ± 0.5). The activation of the classical complement pathway was investigated in nine studies, whereas the lectin, alternative, and terminal complement pathways were each assessed in three studies. Multiple studies investigated several complement pathways. The results were heterogeneous since several markers of complement activation spanning the classical (C2, C4a, C4b, and C1s-C1INH), alternative (Ba, iC3b, and Factor D), and terminal (C5bC6, C5a, C9, and TCC) pathways were elevated, whereas other markers were not significantly different (C3, C4, and C4d) between patients with/without long COVID. In addition, markers spanning the lectin complement pathway (MBL, and MASP1-C1INH) were not significantly different between individuals with and without long COVID. Conclusions: The current evidence suggests potential long-lasting complement system dysregulation in individuals with long COVID, although the clinical significance remains controversial, due to heterogenous findings. Specific post-COVID symptom clusters, such as fatigue, dyspnea, or brain fog, have been linked to a distinct pattern of complement dysregulation. Substantial methodological heterogeneity, including differences in follow-up periods, complement markers, assessment methods, and control groups, along with the small number of available studies, underscores the need for further research to clarify the mechanisms linking complement dysregulation to long COVID.}, }
@article {pmid41751767, year = {2026}, author = {Zieniuk, B and Wierzchowska, K and Jasińska, K and Kobus, J and Piotrowicz, A and Uğur, Ş and Fabiszewska, A}, title = {Yeast as a Model for Human Disease.}, journal = {International journal of molecular sciences}, volume = {27}, number = {4}, pages = {}, pmid = {41751767}, issn = {1422-0067}, mesh = {Humans ; Neurodegenerative Diseases/metabolism/genetics/pathology ; Saccharomyces cerevisiae/genetics/metabolism ; *Models, Biological ; Mitochondrial Diseases/metabolism/genetics ; Animals ; *Yeasts/metabolism/genetics ; Metabolic Diseases/metabolism/genetics ; }, abstract = {Yeasts, especially the conventional species Saccharomyces cerevisiae and Schizosaccharomyces pombe, as well as some unconventional species such as Pichia pastoris, Kluyveromyces marxianus and Yarrowia lipolytica, have become fundamental model organisms for understanding the molecular mechanisms underlying human diseases. Their eukaryotic cell organization, genetic simplicity, and strong conservation of essential biological pathways make them indispensable in biomedical research. This review provides a comprehensive overview of the role of different yeast species in modeling human disorders, highlighting historical milestones and groundbreaking discoveries that have shaped current knowledge. The article discusses the applications of yeast models in studying neurodegenerative diseases such as Alzheimer's and Huntington's, as well as metabolic diseases, infectious diseases and mitochondrial disorders, and their growing importance in cancer research and drug discovery. Special attention is given to humanized yeast models, which enable the expression and functional analysis of human genes and the heterologous synthesis of human proteins within yeast cells. Finally, the paper addresses the limitations and challenges of yeast as a model system while outlining future directions and emphasizing the organism's continued relevance in personalized medicine and functional genomics.}, }
@article {pmid41752261, year = {2026}, author = {Van Assche, J}, title = {The Social-Psychological Consequences of COVID-19: An Integrative Review and Research Agenda.}, journal = {International journal of environmental research and public health}, volume = {23}, number = {2}, pages = {}, pmid = {41752261}, issn = {1660-4601}, mesh = {*COVID-19/psychology ; Humans ; *Mental Health ; Resilience, Psychological ; SARS-CoV-2 ; Pandemics ; }, abstract = {The COVID-19 pandemic has revealed profound social-psychological vulnerabilities and strengths across societies worldwide. Beyond its immediate health implications, the pandemic has triggered a wave of mental health issues, disrupted social cohesion, and challenged community resilience. This paper synthesizes the current literature, critically discusses five recent studies as part of the Special Issue "Mental Health Consequences of COVID-19: The Role of Social Determinants", and articulates an agenda for future research within a social-psychological framework. Moving beyond mere negative effects such as anxiety, this review highlights the role of resilience, prosocial behavior, (digital) mental health interventions, and community social capital. Correspondingly, I advocate for interdisciplinary efforts to enhance awareness, preparedness, and adaptive capacity during health crises, emphasizing the need for a clearer focus on vulnerable social groups. In sum, recognizing the evolving global landscape, this work underscores the urgency of integrating psychological insights into public health policies to build resilient societies capable of confronting future pandemics and health emergencies.}, }
@article {pmid41752703, year = {2026}, author = {Hostiuc, S and Gherghiceanu, F}, title = {Burnout, PTSD, and Medical Error: The Medico-Legal Implications of the Mental Health Crisis Among Frontline Healthcare Professionals During COVID-19.}, journal = {Medicina (Kaunas, Lithuania)}, volume = {62}, number = {2}, pages = {}, pmid = {41752703}, issn = {1648-9144}, mesh = {Humans ; *Stress Disorders, Post-Traumatic/epidemiology/psychology ; *COVID-19/psychology/epidemiology ; *Burnout, Professional/epidemiology/psychology ; *Medical Errors/psychology/statistics & numerical data ; Frontline Workers/psychology ; *Health Personnel/psychology ; Prevalence ; SARS-CoV-2 ; Mental Health ; Pandemics ; Emotional Exhaustion ; }, abstract = {Background and Objectives: The COVID-19 pandemic has led to an unprecedented mental health crisis among workers in the healthcare field, with average burnout rates increasing from about 32% before the pandemic to 46-52% during peak times and post-traumatic stress disorder (PTSD) affecting 24-34% of frontline staff. The primary objective of this article is to synthesize evidence on the prevalence of burnout and PTSD among healthcare workers before and during the COVID-19 pandemic. The secondary objectives are: (a) to examine the mechanisms and empirical evidence linking clinician mental health to medical errors and patient safety outcomes and (b) to analyze the medico-legal implications of this relationship, including malpractice liability, institutional responsibility, and opportunities for policy reform. Materials and Methods: We conducted a narrative review searching PubMed (November 2025-January 2026) using predefined keyword combinations. Inclusion criteria comprised original research, systematic reviews, and meta-analyses examining mental health outcomes or patient safety among clinical staff. Data were synthesized narratively across five thematic domains. Results: Burnout prevalence increased from approximately 32% pre-pandemic to 46-52% during peak periods, with emotional exhaustion reaching 67.5% in some settings. PTSD rates rose to 24-34% among frontline staff, exceeding pre-pandemic levels of 15-20%, with ICU staff particularly affected (27-40%). Substantial overlap exists between conditions (86-98% comorbidity). Physician burnout is associated with 2.72 times higher odds of self-reported errors (95% CI: 2.19-3.37), with each point increase in emotional exhaustion raising the error risk by 5-11%. Mechanisms include cognitive impairment (reduced executive function, g = -0.39; impaired working memory, g = -0.36) and sleep disturbance. Malpractice litigation compounds psychological harm, increasing depression and suicidal ideation. Conclusions: This review, synthesizing data from over 500,000 healthcare workers, demonstrates bidirectional relationships among burnout, PTSD, and medical errors with significant medico-legal ramifications. Addressing this crisis requires systemic interventions including workload management, psychological support, blame-free reporting cultures, and policy reforms balancing accountability with recognition of system-level contributors to error.}, }
@article {pmid41752709, year = {2026}, author = {Pah, AM and Gavrilescu, DM and Mateescu, DM and Cotet, IG and Craciun, ML and Florescu, E and Crisan, S and Avram, A}, title = {Association of Chronic Hyperglycemia and Glycemic Variability with Mortality in COVID-19: Meta-Analysis of Cohort Studies.}, journal = {Medicina (Kaunas, Lithuania)}, volume = {62}, number = {2}, pages = {}, pmid = {41752709}, issn = {1648-9144}, support = {Victor Babeș University of Medicine and Pharmacy Timișoara//Victor Babeș University of Medicine and Pharmacy Timișoara/ ; }, mesh = {Humans ; *COVID-19/mortality/complications/blood ; *Hyperglycemia/mortality/complications/blood ; *Blood Glucose/analysis ; Cohort Studies ; SARS-CoV-2 ; Intensive Care Units ; Chronic Disease ; Glycemic Control ; }, abstract = {Background and Objectives: Dysglycemia is a major determinant of adverse outcomes in COVID-19, yet the separate contributions of poor glycemic control and glycemic variability (GV) remain incompletely defined. We conducted a systematic review and meta-analysis of observational cohort studies (both prospective and retrospective) to quantify the impact of chronic hyperglycemia and glucose instability on disease severity, intensive care requirements, and mortality in patients with COVID-19. Materials and Methods: We searched PubMed, Scopus, and Web of Science from January 2020 to October 2024 for observational cohort studies reporting clinically relevant COVID-19 outcomes stratified by glycemic control or GV. Dysglycemia definitions varied across studies (HbA1c-based chronic hyperglycemia, fasting glucose, or admission/in-hospital hyperglycemia). GV was assessed using metrics including mean amplitude of glycemic excursions (MAGE), standard deviation (SD), coefficient of variation (CV), or maximum daily glucose difference. Twelve studies met inclusion criteria and were included in qualitative synthesis; five studies were eligible for quantitative synthesis of clinical outcomes. Random-effects DerSimonian-Laird models were applied due to anticipated clinical heterogeneity. Heterogeneity was evaluated using Cochran's Q, τ[2], and I[2] statistics. Results: Overall, 12 observational studies (9 prospective and 3 retrospective cohorts; n = 1,008,310 patients) were included. In quantitative analyses of five eligible cohorts, poor glycemic control was associated with a significantly increased risk of severe or critical COVID-19 (pooled RR = 1.75, 95% CI: 1.45-2.11; I[2] = 29%), ICU admission (RR = 1.54, 95% CI: 1.18-2.01), and mechanical ventilation (RR = 1.72, 95% CI: 1.31-2.26). Three studies evaluating GV demonstrated a strong association with adverse outcomes (pooled RR = 2.07, 95% CI: 1.71-2.50; I[2] = 0%); this low heterogeneity should be interpreted cautiously given the limited number of studies. GV remained associated with mortality in multivariable models, indicating that glycemic variability is separately associated with mortality as a clinically relevant prognostic risk marker in hospitalized COVID-19 patients. Conclusions: Both chronic hyperglycemia and elevated glycemic variability are each associated with increased risk of severe COVID-19 outcomes. Glycemic variability appeared to be a consistent, low-heterogeneity prognostic marker of mortality, being separately associated with higher death risk in hospitalized COVID-19 patients, highlighting its potential utility as a dynamic metabolic biomarker. Early identification and targeted management of dysglycemia-especially glucose instability-may improve prognosis in hospitalized COVID-19 patients. PROSPERO: CRD420251250718.}, }
@article {pmid41752904, year = {2026}, author = {Siliste, RN and Benea, S and Homentcovschi, C and Deaconu, T and Caruntu, C and Savulescu-Fiedler, I}, title = {Myocardial and Vascular Involvement in COVID-19 and Post-Vaccination States: Understanding Injury Pathways and Clinical Implications.}, journal = {Life (Basel, Switzerland)}, volume = {16}, number = {2}, pages = {}, pmid = {41752904}, issn = {2075-1729}, abstract = {Myocardial and vascular injury secondary to SARS-CoV-2 infection and vaccination has emerged as a clinically relevant phenomenon, with distinct but overlapping mechanisms. Myocardial injury in COVID-19 results from a complex interplay between direct viral effects and immune-mediated inflammation, supported by histopathological studies revealing macrophage-rich infiltrates, microthrombosis, and supporting fibrosis in isolated areas. In contrast, vaccine-associated myocarditis-reported predominantly following mRNA vaccines-has a self-limiting clinical course, with mechanisms likely involving molecular mimicry, aberrant immune activation, or hypersensitivity reactions, although these pathways require further validation. Although mRNA vaccines have been associated with a small increase in myocarditis, particularly in young men, the risk is significantly lower than that associated with COVID-19 infection, and the cardiovascular benefits of vaccination far outweigh these rare adverse events in most populations. After the end of the pandemic, the number of patients with severe forms of COVID-19 has decreased significantly, but we consider that cardiac involvement remains an important issue for the acute and long-term prognosis of patients with SARS-CoV-2 infection. Our paper synthesizes the latest epidemiological and mechanistic evidence on the link between COVID-19, vaccination, and myocardial and/or vascular injuries, highlighting the clinical implications and providing practical recommendations for management, as well as future perspectives on risk assessment, targeted immunotherapy, advanced diagnostic tools, and long-term monitoring.}, }
@article {pmid41753016, year = {2026}, author = {Cadena Barberis, ED and Oh, HR and Vélez Ordóñez, LD and Calvopiña, VS and Rodas, JA and Leon-Rojas, JE}, title = {Relationship Between Substance Use and Suicide Behavior During the COVID-19 Pandemic: A Systematic Review and Random-Effects Proportions Meta-Analysis.}, journal = {Journal of clinical medicine}, volume = {15}, number = {4}, pages = {}, pmid = {41753016}, issn = {2077-0383}, support = {592.A.XVII.25//Universidad de Las Américas/ ; }, abstract = {Background/Objectives: The COVID-19 pandemic disrupted social structures, healthcare access, and psychological well-being, potentially intensifying substance use and suicidal behavior. Although both phenomena have been independently studied, their co-occurrence during the pandemic has not been systematically synthesized. To evaluate the prevalence and patterns of suicidal behavior among individuals with substance use during the COVID-19 pandemic through a systematic review and random-effects proportions meta-analysis. Methods: A systematic search of PubMed, Scopus, Web of Science, and EBSCO Host was conducted from 11 March 2020 to 15 October 2022 for studies published between March 2020 and October 2022. Eligible studies included observational designs reporting substance use and suicidal behavior in adults during the pandemic. Risk of bias was assessed using National Institutes of Health tools. Proportional meta-analyses were performed using a random-effects model with Freeman-Tukey double arcsine transformation. Heterogeneity was quantified using the I[2] statistic. Results: Twenty studies comprising 70,684 individuals were included. Substance use during the pandemic was reported in 24.6 percent of participants, while 30.7 percent exhibited suicidal behavior. A total of 16.1 percent presented with both substance use and suicidal behavior. The pooled prevalence of any suicidal behavior among individuals with substance use was 33.8 percent (95 percent CI, 22.8 to 45.7), with substantial heterogeneity. Alcohol showed a pooled prevalence of 36.2 percent, cannabis 48.1 percent, and tobacco 11.5 percent. Suicidal ideation was the most frequent outcome, with a pooled prevalence of 36.8 percent among substance users. Most studies reported an increased association between substance use and suicidal behavior compared with pre-pandemic periods. Conclusions: Substance use and suicidal behavior frequently co-occurred during the COVID-19 pandemic, particularly suicidal ideation and alcohol use. These findings highlight the need for integrated mental health and substance use interventions during public health crises.}, }
@article {pmid41753114, year = {2026}, author = {Kloni, M and Heraclides, A and Panteli, T and Klonis, A and Rentzias, P and Karagiannis, C}, title = {Incentive Spirometer in COVID-19: A Systematic Review.}, journal = {Journal of clinical medicine}, volume = {15}, number = {4}, pages = {}, pmid = {41753114}, issn = {2077-0383}, abstract = {Background/Objectives: COVID-19 and its sequelae have affected millions worldwide, with many individuals experiencing persistent symptoms such as dyspnea, fatigue and reduced quality of life. Respiratory physiotherapy is commonly used to support patients with pulmonary conditions. This systematic review aimed to evaluate the effects of the incentive spirometer on cardiopulmonary, functional and patient-reported outcomes in adults during the acute and post-COVID-19 phases. Methods: A systematic literature search was conducted in PubMed, CINAHL, Scopus, Clinical Trials.gov and Google Scholar to identify studies published between January 2020 and April 2025. Owing to substantial heterogeneity in study design, populations, interventions and outcome measures, quantitative synthesis was not feasible and findings were synthesized narratively. Results: Twelve studies involving 573 participants were included. Within-group analyses showed improvements in pulmonary outcomes (including FEV1, FVC, and oxygen saturation), reductions in dyspnea, and improvements in quality of life following incentive spirometer. Improvements in pulmonary function were reported primarily in post-COVID-19 populations, whereas reductions in anxiety and improvements in quality of life were reported mainly in acute COVID-19 settings. Between-group comparisons demonstrated statistically significant differences in favor of the incentive spirometer for selected pulmonary and functional outcomes (including FVC, DLCO, oxygen saturation, six-minute walk test, and 30 s sit-to-stand test), while no significant differences were observed for other outcomes such as peak expiratory flow, respiratory rate, or heart rate variability. Randomized controlled trials were judged to have a moderate risk of bias, non-randomized studies a moderate-to-serious risk, and certainty of evidence ranged from very low to moderate. Conclusions: Incentive spirometer may support respiratory, functional, and psychological recovery in adults during the acute and post-COVID-19 phases. However, effects vary across outcomes and comparator interventions, and the overall certainty of evidence is low to moderate. Further high-quality research is required to confirm effectiveness and guide optimal clinical use.}, }
@article {pmid41753604, year = {2026}, author = {Chen, M and Ren, W and Wu, X and Khan, JM and Nazir, H and Rehman, SU and Ali, F and Li, J}, title = {Insights into Monkeypox Virus: Host Immunity, Viral Immune Evasion, Recent Advances in Vaccines, Therapeutic Development, and Future Perspectives.}, journal = {Microorganisms}, volume = {14}, number = {2}, pages = {}, pmid = {41753604}, issn = {2076-2607}, abstract = {Monkeypox (Mpox), a zoonotic viral disease caused by the Monkeypox Virus (MPXV), has gained significant attention in recent years due to its increasing incidence and the grave threat it poses to global health. MPXV has spread at a rapid pace during the COVID-19 pandemic, causing 10,000+ confirmed cases and ~300 fatalities in 122 countries. This virus comprises two major clades, Clade I (Central African), which is evidently more virulent, and Clade II (West African), which has caused the recent outbreaks across the world and caused fewer deaths. Clinically, Mpox presents as a milder form with fever, lymphadenopathy, and vesiculopustular rash similar to smallpox. Diagnostic measures such as polymerase chain reaction (PCR) are the main diagnostic confirmatory tools. Advanced diagnostics involve electronic microscopy, serology, and immunohistochemistry. Alternative drugs like tecovirimat and brincidofovir have demonstrated potential for treating smallpox, but there is scanty evidence on their efficacy against MPXV. Most recent advancements in the study of vaccines have resulted in the creation and introduction of MVA-BN (JYNNEOS/Imvanex/Imvamune) and ACAM2000 vaccines, which conferred cross-protection against MPXV. MVA-BN is suggested to perform better than other types due to its enhanced safety and immunogenicity. Researchers are also developing DNA and protein subunit vaccines against Mpox to induce specific immune responses by presenting viral proteins. The discovery of novel vaccine candidates and antiviral treatments will be needed to prevent future outbreaks and reduce the global health burden of Mpox. This review focuses on the characterization of MPXV, summarizing current knowledge on its genomic structure, pathogenesis, replication, potential targets of anti-MPXV drugs, clinical features, and epidemiological patterns, along with recent advances in vaccine development.}, }
@article {pmid41753974, year = {2026}, author = {Haimi, M}, title = {Nurse-Led Telephone Triage in Contemporary Healthcare: Bridging the Gap Between Patient Need and Resource Allocation.}, journal = {Healthcare (Basel, Switzerland)}, volume = {14}, number = {4}, pages = {}, pmid = {41753974}, issn = {2227-9032}, abstract = {Background: Nurse teletriage has emerged as a component of modern healthcare delivery, utilizing telecommunication technologies to assess patient conditions remotely and guide appropriate care decisions. As healthcare systems face increasing demand and the need for cost-effective care delivery, teletriage services have expanded, particularly following the COVID-19 pandemic. Objective: This narrative review examines the current state of nurse teletriage practice, its effectiveness, safety outcomes, and implementation considerations. A comparative analysis with physician-led teletriage models is provided, and the emerging role of artificial intelligence is explored. Methods: A narrative review of the literature was conducted through searches of multiple databases including PubMed/MEDLINE, CINAHL, Cochrane Library, Embase, Web of Science, and Google Scholar. This approach was selected due to the heterogeneous nature of the teletriage literature, which spans diverse study designs, populations, and outcomes that are not amenable to formal systematic synthesis. Peer-reviewed articles published between 1970 and 2024 examining safety outcomes, effectiveness, and implementation frameworks were reviewed. Results: The available evidence suggests that nurse-led teletriage systems, particularly when supported by computerized decision support systems, can improve patient access to care while maintaining safety standards. Studies indicate that telephone triage nursing does not increase mortality, hospitalization rates, or emergency department referrals when properly implemented. One well-documented physician-led model in Israel reported diagnosis accuracy rates of 98.5% and decision reasonableness rates of 92%, though generalizability across settings requires caution. Key success factors appear to include the use of evidence-based protocols, staff training, technology infrastructure, and quality assurance programs. While these findings are promising, the heterogeneous nature of the included studies and absence of formal quality assessment warrant cautious interpretation. Conclusions: Nurse teletriage appears to be an effective and safe approach to healthcare delivery that addresses challenges in modern healthcare systems. The choice between nurse-led and physician-led models should consider population complexity, case types, available resources, and economic factors. Artificial intelligence technologies offer potential opportunities to enhance teletriage, though careful validation is essential. Future research should focus on long-term outcomes, comparative effectiveness across healthcare systems, and rigorous evaluation of AI applications. Highlights: Telephone triage services, where nurses or physicians assess patients remotely and guide them to appropriate care, have become increasingly important in modern healthcare. This narrative review examines the evidence on nurse-led telephone triage, comparing it with physician-led models and exploring emerging technologies like artificial intelligence. The available evidence suggests that nurse-led systems, when supported by appropriate protocols and training, can safely improve patient access to care while reducing healthcare costs. Physician-led models may offer advantages for complex cases but at higher costs. While artificial intelligence shows promise for enhancing triage accuracy, current evidence specific to telephone triage remains limited. Healthcare organizations should carefully consider their population needs, available resources, and local context when implementing teletriage services.}, }
@article {pmid41754057, year = {2026}, author = {Malik, Z and Skapetis, T}, title = {A Contemporary Mini-Review of Interprofessional Education and Technology-Assisted Management of Dental Emergencies in the Emergency Department.}, journal = {Healthcare (Basel, Switzerland)}, volume = {14}, number = {4}, pages = {}, pmid = {41754057}, issn = {2227-9032}, abstract = {BACKGROUND: Dental emergencies are increasing in frequency. Numerous studies have reported minimal knowledge and/or skills by emergency department staff regarding dental emergencies. The COVID-19 pandemic has prompted a paradigm shift in emergency dental care management away from traditional management approaches. However, there have been no reviews of contemporary literature pertaining to either technology-assisted or interprofessional education and dental emergency management in the emergency department setting. This mini-review aimed to synthesise current evidence of interprofessional education, utilising technology-assisted modalities, for the management of dental emergencies in hospital emergency departments.
METHODS: A comprehensive search was carried out across four electronic databases, Medline, Embase, CINAHL, and Google Scholar from 2018 to 2025.
RESULTS: A total of three papers were identified and included in the mini-review. Two of the three papers addressed the subject of dental emergencies in the emergency department as a primary finding.
DISCUSSION: Included papers were of low-quality evidence and referenced simulation-based education, tele-dentistry, and artificial intelligence as contemporary approaches relating to dental emergency management.
CONCLUSIONS: This mini-review revealed minimal advances in contemporary approaches relating to both the use of technology-assisted modalities and interprofessional education for the management of dental emergencies within the hospital emergency department setting. This review provides a timely literature update for both the medical and dental professions and identifies a large gap in research surrounding this topic.}, }
@article {pmid41754151, year = {2026}, author = {Caliman-Sturdza, OA and Gheorghita, RE and Soldanescu, I and Dimian, M and Mangul, S}, title = {Vitamin D in Infectious Diseases: A Narrative Review Focusing on COVID-19, Long COVID, and Influenza.}, journal = {Nutrients}, volume = {18}, number = {4}, pages = {}, pmid = {41754151}, issn = {2072-6643}, mesh = {Humans ; *Vitamin D/therapeutic use/blood/analogs & derivatives/administration & dosage/immunology ; *Influenza, Human/immunology/drug therapy ; *COVID-19/immunology ; Post-Acute COVID-19 Syndrome ; *Vitamin D Deficiency/immunology/complications/drug therapy ; SARS-CoV-2 ; Immunity, Innate/drug effects ; Dietary Supplements ; Pandemics ; Coronavirus Infections ; }, abstract = {Vitamin D is a secosteroid hormone traditionally recognized for its role in bone and mineral metabolism, but it is increasingly understood to also function as an important immunomodulator influencing susceptibility to and outcomes of infectious diseases. This narrative review summarizes current evidence on the immunological, clinical, and preventive effects of vitamin D in the context of novel coronavirus disease (COVID-19), post-acute sequelae of SARS-CoV-2 infection (long COVID), and influenza. Mechanistically, vitamin D enhances innate immune defenses through the induction of antimicrobial peptides, including cathelicidin and defensins, and modulates adaptive immunity by suppressing maladaptive Th1/Th17 responses while promoting regulatory T-cell activity. Observational studies have frequently associated vitamin D deficiency with more severe COVID-19 outcomes; however, these associations may be influenced by confounding factors and reverse causality. Some meta-analyses suggest that vitamin D supplementation reduced rates of intensive care unit admission and ventilatory support, particularly among older adults and individuals with low baseline serum 25-hydroxyvitamin D concentrations. Emerging evidence also indicates that inadequate vitamin D status may be associated with an increased risk and symptom burden of long COVID, although causality has not been established. In the case of influenza, a limited number of randomized controlled trials (RCTs) and meta-analyses report a modest but statistically significant reduction in infection risk, especially with daily or weekly vitamin D supplementation in populations with low baseline vitamin D levels. Clinical guidelines consistently recommend maintaining adequate vitamin D status for general health but do not endorse high-dose vitamin D as a treatment for COVID-19 due to inconsistent trial findings. Overall, vitamin D should not be considered a standalone therapeutic agent; rather, maintaining sufficient vitamin D levels represents a low-risk, potentially beneficial strategy to support immune resilience against respiratory viral infections.}, }
@article {pmid41754496, year = {2026}, author = {Federico, M}, title = {Potential Impact of SARS-CoV-2 Spike Protein on HIV-1 Reservoir in People Living with HIV.}, journal = {Viruses}, volume = {18}, number = {2}, pages = {}, pmid = {41754496}, issn = {1999-4915}, support = {RIP-1//Ministry of Health, Italy/ ; }, mesh = {Humans ; *Spike Glycoprotein, Coronavirus/immunology/genetics ; *HIV-1/physiology ; *HIV Infections/virology/immunology ; Virus Latency ; *SARS-CoV-2/immunology/physiology ; *COVID-19 Vaccines/immunology ; *COVID-19/prevention & control/virology/immunology ; Virus Activation ; }, abstract = {People living with HIV-1 (PLWH) are part of the so-called "fragile" populations to which COVID-19 vaccines were/are strongly recommended. The fact that most widely used COVID-19 vaccines rely on the production of a biologically active SARS-CoV-2 Spike protein expressed by synthetic mRNA poses the relevant question of whether and how this vaccination influences the fate of the HIV-1 reservoir. This report presents a detailed analysis of the literature data on the effects of SARS-CoV-2 Spike and COVID-19 vaccines on HIV-1 latently infected cells. Despite being limited in number, the experimental evidences consistently indicate that vaccine mRNA and/or SARS-CoV-2 Spike can effectively reactivate latent HIV-1. This conclusion has been drawn after "in vitro", "ex vivo", and "in vivo" assays, and with virus-associated Spike, soluble Spike, or its intracellular expression, as well as with COVID-19 mRNA vaccines. On the other hand, real-world observations on vaccinated PLWH under antiretroviral therapy (ART) provided evidence of HIV-1 reactivation almost exclusively in PLWH with unsuppressed viremia, as measured in terms of size of the HIV-1 reservoir. Although several issues still need to be clarified through urgent additional investigations, these data suggest the possibility that the Spike protein and/or the vaccine mRNA molecules affect the HIV-1 latency in PLWH.}, }
@article {pmid41754526, year = {2026}, author = {Siniscalchi, C and Basaglia, M and Imbalzano, E and Di Micco, P}, title = {The Platelet-Virus Axis in Human Disease.}, journal = {Viruses}, volume = {18}, number = {2}, pages = {}, pmid = {41754526}, issn = {1999-4915}, mesh = {Humans ; *Blood Platelets/virology/immunology ; *Host-Pathogen Interactions/immunology ; *Virus Diseases/immunology/virology ; Platelet Activation ; Immunity, Innate ; Thrombosis/virology ; SARS-CoV-2 ; }, abstract = {Platelets have traditionally been viewed as passive cellular elements involved in hemostasis and vascular integrity. However, growing evidence over the last decade has radically changed this paradigm, revealing platelets as dynamic immune and inflammatory effectors that actively participate in host-pathogen interactions. In viral infections, platelets are not merely innocent bystanders but represent key players in a bidirectional and tightly regulated platelet-virus axis that influences viral dissemination, immune activation, endothelial dysfunction, and the development of thrombotic and hemorrhagic complications. Several clinically relevant viruses, including SARS-CoV-2, influenza virus, HIV, dengue virus, and viral hemorrhagic fever-associated pathogens, have been shown to directly or indirectly interact with platelets through surface receptors, immune complexes, and inflammatory mediators, leading to platelet activation, phenotypic reprogramming, and accelerated clearance. These processes contribute to the paradoxical coexistence of thrombocytopenia and hypercoagulability that characterizes many severe viral diseases. Moreover, platelets can act as immune sentinels by sensing viral components, releasing cytokines and chemokines, forming platelet-leukocyte aggregates, and modulating both innate and adaptive immune responses, thereby shaping the clinical course of infection. In this review, we synthesize current evidence on the molecular and cellular mechanisms governing virus-platelet interactions, with particular emphasis on their role in immune-thrombosis, endothelial injury, and organ dysfunction. We further discuss the clinical implications of platelet dysregulation in viral infections, including its potential value as a biomarker of disease severity and as a therapeutic target. Understanding the platelet-virus axis provides a unifying framework to explain the thrombo-inflammatory phenotype of viral diseases and may open new avenues for risk stratification and targeted interventions in affected patients.}, }
@article {pmid41754548, year = {2026}, author = {Deák, G and Lupu, L and Prangate, R}, title = {A Systematic Review of Methodological Approaches to SARS-CoV-2 Wastewater Surveillance.}, journal = {Viruses}, volume = {18}, number = {2}, pages = {}, pmid = {41754548}, issn = {1999-4915}, support = {Support to Member States for the establishment of national systems, local collection points and digital infrastructure for the monitoring of COVID-19 and its variants in wastewater-Romania//This work was supported by the European Commission DG Environment [060701/2021/864662/SUB/ENV]. C2] Emergency Support under Council Regulation (EU) 2016/369 as amended by Council Regulation (EU) 2020/521/ ; }, mesh = {Humans ; *SARS-CoV-2/isolation & purification/genetics ; *Wastewater/virology ; *COVID-19/epidemiology/virology/transmission ; RNA, Viral/isolation & purification/genetics ; *Wastewater-Based Epidemiological Monitoring ; }, abstract = {Following the COVID-19 pandemic, researchers have increasingly focused on monitoring the spread of the virus and improving methods to detect changes in the SARS-CoV-2 genome. Although clinical surveillance provides direct and reliable results, it has limited applicability. Wastewater-based epidemiology (WBE) has therefore emerged as a valuable, non-invasive complementary tool for disease surveillance. It provides a comprehensive picture of virus circulation in a population, including asymptomatic individuals and those who do not seek healthcare. In addition, it facilitates early detection of outbreaks and the collection of epidemiologic data at the community level. However, WBE also presents technical challenges, including variations in sampling and testing protocols, the presence of inhibitors that affect viral RNA extraction, and the need for standardised procedures between studies. These challenges should be addressed for possible future infectious disease outbreaks. One of the challenges facing researchers was to develop efficient methods that could overcome the extraction and detection problems related to inhibitors present in wastewater. To this aim, this systematic review highlights the potential use of WBE, the variety of techniques, and the most effective methods for the detection and quantification of SARS-CoV-2 in wastewater samples. A reproducible electronic search of the literature was conducted in the Web of Science (WoS) and PubMed databases for articles published between 2020 and 2024. Our search revealed that the majority of observed WBE applications emphasised a correlation between SARS-CoV-2 RNA concentration trends in wastewater and epidemiological data. Another relevant issue that the articles often discussed and compared was the techniques used in different steps of sample processing, such as sample collection, concentration and detection, hence the lack of standardised procedures. This paper provides a framework regarding previous research on WBE to gain a better understanding that will lead to functional solutions.}, }
@article {pmid41754590, year = {2026}, author = {De Stefanis, S and Colavita, F and Maggi, F and Antonioli, M}, title = {SARS-CoV-2 Persistence and the Gut Microbiota: New Insights into Long COVID Pathogenesis.}, journal = {Viruses}, volume = {18}, number = {2}, pages = {}, pmid = {41754590}, issn = {1999-4915}, support = {Ricerca Corrente Linea 1 - Progetto 1 to IRCCS INMI L. Spallanzani//Ministero della Salute/ ; Ricerca di Ateneo 2024- Dipartimento di Biologia (AutoCuRC)//University of Rome Tor Vergata/ ; }, mesh = {Humans ; *COVID-19/microbiology ; *Gastrointestinal Microbiome ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Dysbiosis ; Pandemics ; Gastrointestinal Tract/microbiology/virology ; Inflammatory Bowel Diseases ; Inflammation ; }, abstract = {In December 2019, the world experienced the emergence of a new virus, SARS-CoV-2, which caused the 2020 pandemic. SARS-CoV-2 causes COVID-19, primarily affecting the respiratory system, as well as the gastrointestinal tract. Remarkably, one in eight COVID-19 patients develops Long COVID, which is linked to SARS-CoV-2 persistence in the gastrointestinal tract, resulting in chronic inflammation and microbiota dysregulation. Given that gut microbiota dysbiosis plays a pivotal role in antiviral defense and gastrointestinal conditions, here we examine emerging evidence on how persistent SARS-CoV-2 infection may contribute to the aetiology of enteric disorders. In particular, we emphasise the intricate connection between chronic inflammation caused by persistent SARS-CoV-2 infection (e.g., irritable bowel syndrome and inflammatory bowel disease) and the possible development of diseases such as Crohn's disease and ulcerative colitis.}, }
@article {pmid41754983, year = {2026}, author = {Anaya, BJ and Osorio-Vargas, E and Monterrosa-Moreno, S and Tirado, DF and González-Burgos, E and Serrano, DR}, title = {Pulmonary Drug Delivery for Infectious Diseases: Cutting-Edge Formulations and Manufacturing Technologies.}, journal = {Pharmaceutics}, volume = {18}, number = {2}, pages = {}, pmid = {41754983}, issn = {1999-4923}, support = {PID2024-156769OB-I00//Ministerio de Ciencia, Innovación y Universidades/ ; 971089//universidad complutense de Madrid/ ; Call No. 885 of 2020//Ministerio de Ciencia, Tecnología e Innovación/ ; }, abstract = {Pulmonary drug delivery has emerged as a powerful strategy for the treatment of respiratory infectious diseases, including bacterial, fungal, and viral infections such as influenza and COVID-19, by enabling high local drug concentrations while minimizing systemic exposure. However, the clinical success of inhaled anti-infective therapies critically depends on the precise engineering of particle properties that govern lung deposition, cellular targeting, and therapeutic efficacy. In this review, we provide a comprehensive and technology-driven overview of cutting-edge formulation and manufacturing strategies for pulmonary drug delivery, with particular emphasis on the key process and formulation parameters required to generate effective inhalable systems for the treatment of infectious diseases. Advanced particle-engineering approaches, including spray drying, spray freeze drying, jet milling, and supercritical fluid technologies are discussed as enabling tools to tightly control aerodynamic particle size, morphology, and solid-state properties. In parallel, emerging platforms such as nanoparticle-based delivery systems are examined for their ability to target specific lung cell populations, including epithelial cells and alveolar macrophages, thereby enhancing antimicrobial efficacy. Finally, innovative manufacturing concepts such as microfluidics and three-dimensional (3D) printing are highlighted as promising strategies to improve particle size uniformity, reproducibility, and formulation customization. By integrating formulation science with advanced manufacturing technologies, this review identifies the critical design and processing parameters that underpin effective pulmonary delivery of anti-infective therapies and outlines future directions for the development of next-generation inhaled treatments.}, }
@article {pmid41755466, year = {2026}, author = {Zang, N and Wu, Y and Li, P and Liu, Y and Wang, S and Leng, J and Zhan, L and Lyu, X and Pang, L and Wang, J}, title = {Viral Pathogens and Pulmonary Fibrosis: EMT-Driven Mechanisms and Insights From Traditional Chinese Medicine.}, journal = {Reviews in medical virology}, volume = {36}, number = {2}, pages = {e70118}, pmid = {41755466}, issn = {1099-1654}, mesh = {Humans ; *Epithelial-Mesenchymal Transition/drug effects ; *Medicine, Chinese Traditional ; Signal Transduction/drug effects ; *Idiopathic Pulmonary Fibrosis/virology/drug therapy/pathology ; SARS-CoV-2/pathogenicity/drug effects ; Animals ; COVID-19/virology/complications ; *Virus Diseases/virology/drug therapy/complications ; *Pulmonary Fibrosis/virology/drug therapy ; }, abstract = {Idiopathic pulmonary fibrosis (IPF) is a serious progressive complication of the respiratory system, which is profoundly associated with persistent extracellular matrix (ECM) deposition, fibrosis, and disrupted tissue regeneration. Emerging evidence shows that epithelial-mesenchymal transition (EMT) acts as a key factor in the pathogenesis of this idiopathic interstitial lung disease by connecting long-lasting epithelial damage to fibroblast accumulation and fibrotic processes. Viral pathogens, particularly emerging and re-emerging viruses, such as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), Influenza Virus, and Dengue Virus (DENV) and also those with oncogenic potential such as Epstein-Barr Virus (EBV), Cytomegalovirus (CMV), and Hepatitis C Virus (HCV), have been demonstrated to be significantly associated with impaired epithelial signalling, persistent inflammation, and EMT induction. This underscores the presence of potential mechanistic overlap between viral infections and fibrotic complications of the respiratory system. On the other hand, investigations have also suggested the capacity of Traditional Chinese Medicine (TCM) agents to modulate various EMT-linked pathways, which are simultaneously involved in both viral infections and IPF development. These common signalling pathways include TGF-β, Wnt/β-catenin, PI3K/AKT, and NF-κB signalling, acting as potential therapeutic targets against fibrotic complications such as IPF. The present review aims to comprehensively describe current evidence on the dynamic cross-talk between viral pathogens, particularly SARS-CoV-2, Influenza Virus, and DENV, EMT, and lung fibrosis. Additionally, it critically discusses how TCM-derived bioactive agents can interfere with these interconnected processes. This review elucidates the mechanistic basis and therapeutic potential of TCM compounds in lung fibrosis, considering the wider context of virus-related EMT dysregulation.}, }
@article {pmid41755747, year = {2026}, author = {Zuccotti, G and Sassi, R and Vertemati, M and Calcaterra, V}, title = {Advances in pediatrics: new technologies in clinical practice.}, journal = {La Pediatria medica e chirurgica : Medical and surgical pediatrics}, volume = {48}, number = {1}, pages = {}, doi = {10.4081/pmc.2026.380}, pmid = {41755747}, issn = {2420-7748}, mesh = {Humans ; *Pediatrics/trends/methods ; *Telemedicine/trends ; *COVID-19/epidemiology ; Digital Health ; Artificial Intelligence ; Child ; }, abstract = {Over the past decades, digital innovation has profoundly transformed pediatric care, promoting more integrated, personalized, and continuous models of assistance across hospital, community, and home settings. This contribution explores the impact of three key technological domains: telemedicine, virtual and augmented reality, and artificial intelligence. Telemedicine has expanded access to healthcare services, improved monitoring of chronic conditions, and strengthened communication between healthcare professionals and families. Its rapid development during the COVID-19 pandemic demonstrated its value in ensuring continuity of care and supporting vulnerable pediatric populations. Virtual and augmented reality offer new possibilities in surgical planning, medical training, rehabilitation, and psychological support, helping reduce anxiety and pain during procedures while enhancing understanding of clinical pathways. Artificial intelligence enables the analysis of large volumes of clinical and behavioral data, supporting early diagnosis, predictive modeling, and personalized clinical decision-making. Despite these opportunities, the integration of emerging technologies into pediatric practice requires careful attention to ethical, organizational, and educational issues, including data security, equitable access, and professional training. Overall, digital technologies are reshaping pediatrics toward more accessible, efficient, family-centered care.}, }
@article {pmid41756288, year = {2026}, author = {Guan, C and Zhang, R and Zhao, P and Zhang, Y and Yu, L and Cui, H and Jiang, L and Wu, T and Liu, F and Wu, Y and Huang, L and Nan, H and Wang, J and Xu, P}, title = {Association between vaccination and myasthenia gravis: a systematic review and meta-analysis.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1739730}, pmid = {41756288}, issn = {1664-3224}, mesh = {Humans ; *Myasthenia Gravis/immunology/epidemiology ; *Vaccination/adverse effects ; *COVID-19/prevention & control/immunology ; *COVID-19 Vaccines/immunology/adverse effects ; *SARS-CoV-2/immunology ; Vaccine Efficacy ; }, abstract = {BACKGROUND: Myasthenia gravis (MG) is a rare autoimmune disorder characterized by fluctuating muscle weakness due to impaired neuromuscular transmission. Vaccination remains a cornerstone of infectious disease prevention, yet concerns persist regarding potential autoimmune exacerbation in susceptible individuals. This systematic review and meta-analysis aimed to synthesize available evidence on the association between vaccination and MG, evaluating both vaccine effectiveness and safety in this population.
METHODS: Observational studies in cohort or case-control formats were identified through systematic searches of PubMed, Web of Science, Embase, Cochrane Library, SinoMed, CNKI, Wanfang, and VIP databases from inception to June 24, 2025. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated using fixed- or random-effects models based on heterogeneity. Publication bias was assessed using funnel plots and Egger's test.
RESULTS: Five studies encompassing 27,193 participants (22,618 vaccinated and 4,575 unvaccinated) met inclusion criteria. Meta-analysis demonstrated a significant protective effect of vaccination against COVID-19 infection (fixed-effects model: OR = 0.23, 95% CI [0.20-0.26], P < 0.001). Conversely, vaccination was not associated with a statistically significant increase in MG exacerbation (random-effects model: OR = 0.67, 95% CI [0.10-4.54], P = 0.68).
CONCLUSIONS: This study provides quantitative evidence that COVID-19 vaccination effectively reduces infection risk without significantly increasing MG exacerbation. These findings support the safety and clinical utility of vaccination in MG patients, emphasizing the need for individualized risk-benefit assessment and ongoing pharmacovigilance in this population.
https://www.crd.york.ac.uk/prospero/, identifier CRD420251078995.}, }
@article {pmid41756780, year = {2026}, author = {Ferriero, AM and Di Lella, R and Farroni, C and Aiello, A and Giarratano, A and Todaro, M and Bocci, MG and Nicastri, E and Goletti, D}, title = {Host-pathogen interaction in community-acquired pneumonia: a focus on the immune response.}, journal = {Frontiers in cellular and infection microbiology}, volume = {16}, number = {}, pages = {1731074}, pmid = {41756780}, issn = {2235-2988}, mesh = {Humans ; *Community-Acquired Pneumonia/immunology/microbiology/epidemiology/diagnosis/virology ; Adaptive Immunity ; *Host-Pathogen Interactions/immunology ; Immunity, Innate ; *Pneumonia, Viral/immunology/epidemiology ; *Pneumonia, Bacterial/immunology/microbiology ; Streptococcus pneumoniae/pathogenicity/immunology ; SARS-CoV-2 ; *Community-Acquired Infections/immunology ; }, abstract = {Community-acquired pneumonia (CAP) remains one of the leading causes of morbidity and mortality worldwide, affecting individuals of all ages. Various pathogens can cause this condition, and growing antibiotic resistance makes treatment more difficult while raising the risk of severe outcomes. Despite substantial advances in diagnostics, antimicrobial therapy, and supportive care, CAP continues to represent a significant clinical and public health challenge. In this review, we provide a comprehensive overview of CAP, summarizing key aspects of its epidemiology, pathogen frequency, and recent progress in diagnostic tools and biomarkers. We also describe the innate and adaptive immune responses involved in CAP, with a particular focus on pneumonia caused by Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, respiratory syncytial virus, severe acute respiratory syndrome coronavirus 2, and Influenza A and B viruses. A deeper understanding of CAP immunopathogenesis may support the development of improved diagnostic and therapeutic approaches for pneumonia management.}, }
@article {pmid41757222, year = {2026}, author = {Ravinetto, R and Bottieau, E and Fusco, D and Marrone, R and Van Den Broucke, S and Tarrafeta-Sayas, MB and Rinaldi, L and Losada-Galván, I and Calleri, G and Albonico, M}, title = {Inequitable access to medicines for neglected tropical diseases in Europe: health system vulnerabilities and a call for coordinated action.}, journal = {The Lancet regional health. Europe}, volume = {63}, number = {}, pages = {101616}, pmid = {41757222}, issn = {2666-7762}, abstract = {The COVID-19 pandemic has exposed the vulnerability of the European medicine supply systems, but the lack of access to medicines for diseases of poverty, including neglected tropical diseases (NTDs), is unfrequently brought to the attention of the European policy makers. As a result, clinicians in Europe are forced to "bricolage solutions" to treat NTDs: ad hoc donations from companies, product-specific donations via the World Health Organization (WHO) or WHO collaborating centres, case-by-case importation -sometimes from poorly regulated countries-, and possibly the recourse to compounding pharmacies. Noteworthy, NTDs are unlikely to decrease in the next years in Europe, due to increasing global mobility, and climate change expanding the parasites' habitat. This serious but neglected problem was discussed at the 2025 European Congress in Tropical Medicine and International Health (ECTMIH) in Hamburg, Germany. This viewpoint analyses the availability, affordability and accessibility challenges in some countries in Europe, and their consequences at patient and health system level. It also proposes a set of interconnected recommendations and policy measures to make quality-assured medicines for NTDs sustainably available and affordable across Europe. Restoring access to these essential and sometimes life-saving medicines is critical for restoring the right to health for all in Europe, while protecting continental public health.}, }
@article {pmid41758633, year = {2026}, author = {Marefat, M and Tran, D and Watson, RM and Abdulghani, H and Fortino, M}, title = {A practical model for integrated temporomandibular disorder assessment in the routine oral examination.}, journal = {General dentistry}, volume = {74}, number = {2}, pages = {57-61}, pmid = {41758633}, issn = {0363-6771}, mesh = {Humans ; *Temporomandibular Joint Disorders/diagnosis ; Facial Pain/diagnosis/etiology ; Physical Examination ; }, abstract = {The COVID-19 era has seen an increase in orofacial pain related to temporomandibular disorders (TMDs). The increased relevance and awareness of these conditions, including the enactment of accreditation standards dictating the inclusion of TMD education in dental school curricula, highlights the need for a simplified TMD screening and evaluation model. A literature review was conducted to establish whether a widely accepted, comprehensive, and clinically practical approach to screening and evaluation for TMDs during routine oral examination was available. Previous studies and available medical and dental history forms were reviewed. While medical and dental history forms currently available to practitioners contain TMD-related questions, they are presented in a nonsequential, sporadic manner that may not lead to intuitive diagnosis from the dental practitioner. This article introduces a proposed model and questionnaire for incorporating TMD examinations into routine examinations. The inclusion of a more practical TMD screening and evaluation model in routine examination is intended to facilitate the dentist's identification and assessment of TMD signs and symptoms, leading to a more targeted approach in diagnosis and referral. This proposed model has not yet been validated clinically; the next steps include further development, implementation within a clinical setting, and evaluation of its effectiveness.}, }
@article {pmid41758637, year = {2026}, author = {Kozdrowicki, M and Szczepaniak, P and Kyslyi, V and Carnevale, L and Carnevale, D and Lembo, G and Guzik, TJ and Mikołajczyk, TP}, title = {The impact of inflammation, neuromodulation, and gut microbiota on developing cardiac fibrosis and hypertension.}, journal = {Cardiovascular research}, volume = {122}, number = {6}, pages = {681-706}, pmid = {41758637}, issn = {1755-3245}, support = {ERA-CVD/NEMO/7/2019//Polish National Centre for Research and Development/ ; ERA-CVD/Gut-brain/8/2021//Polish National Centre for Research and Development/ ; ERA-CVD/JTC2020/25/ImmuneHyper/Cog/2022//Polish National Centre for Research and Development/ ; //Ministry of Health/ ; }, mesh = {Humans ; *Hypertension/physiopathology/metabolism/immunology/microbiology/therapy ; Animals ; Fibrosis ; *Myocardium/pathology/metabolism/immunology ; *Gastrointestinal Microbiome ; *Inflammation Mediators/metabolism ; Signal Transduction ; *Blood Pressure ; *Inflammation/physiopathology/metabolism ; *Heart Failure/physiopathology/pathology/metabolism ; Epigenesis, Genetic ; }, abstract = {Cardiovascular diseases (CVD) are the leading cause of premature mortality worldwide. Due to pressure overload and cardiac fibrosis, CVD often begin with hypertension and gradually progress to heart failure. Cardiac fibrosis reduces the number of functional cardiomyocytes and the force of contraction while increasing oxygen demand. It has been noted that myofibroblasts, which produce excessive amounts of extracellular matrix in the failing heart, express specific proteins such as periostin, tenascin C, thrombospondin, and osteopontin. Their activation involves immune cells that have a well-documented effect on the pathogenesis of hypertension. Moreover, dysregulation of the autonomic nervous system and sympathetic hyperactivity heightens peripheral inflammation and fosters fibrosis. In this review, we outline and summarize the most significant and recent findings concerning the molecular pathways of immune activation, neuromodulation, epigenetic modifications, and the impact of gut microbiota on myofibroblast activation and fibrosis in the heart, as well as potential therapeutic options (e.g. experimental anti-inflammatory treatments, epigenetic modulators, and vagus nerve stimulation). We will also highlight how current heart failure treatments, including renin-angiotensin-aldosterone system (RAA) inhibitors, β-adrenergic receptor (β-AR) antagonists, sodium-glucose co-transporter 2 (SGLT2) inhibitors, the Dietary Approaches to Stop Hypertension (DASH), and the Mediterranean diet, affect these processes at a molecular level. A comprehensive understanding of the neuroimmune mechanisms involved in the pathogenesis of heart failure and hypertension is particularly crucial in light of the increased risk of CVD following the COVID-19 pandemic, which resulted from the 'cytokine storm' during SARS-CoV-2 infection.}, }
@article {pmid41758742, year = {2026}, author = {Al-Talhi, AA and AlRajhi, B and Almalki, AHS and Alqazenli, M and AlGhamdi, MA and Munhish, FA and Sumaily, I}, title = {Effectiveness of Intranasal Insulin for the Treatment of Olfactory Dysfunction: A Systematic Review.}, journal = {ORL; journal for oto-rhino-laryngology and its related specialties}, volume = {}, number = {}, pages = {1-11}, doi = {10.1159/000550990}, pmid = {41758742}, issn = {1423-0275}, abstract = {INTRODUCTION: The aim of the study was to assess the effectiveness and safety of intranasal insulin (INI) for the treatment of olfactory dysfunction (OD) in patients with anosmia and/or hyposmia compared to placebo or no treatment.
METHODS: We searched four databases: Medline, Scopus, Directory of Open Access Journals (DOAJ), and Springer Nature. The study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (ID: CRD42023456891). The protocol design was in accordance with the PRISMA. Participants with hyposmia or anosmia aged ≥18 years were included. Patients with an altered sense of smell due to anatomical malformations, trauma, neurodegenerative diseases, surgery, or intranasal lesions were excluded from the study.
RESULTS: Five studies with 131 participants were included. There were 131 participants, of whom 63 were men and 68 were women. The participants' ages ranged from 16 to 56 years. Almost all studies used a dose of 40 IU, except one that used different doses for different participants. Glycemic assessment was performed in three studies, which showed a very slight decrease in glucose, except in one study in which the drop in glucose reached 10.4 mg/dL. All studies agreed that olfactory function improved after INI administration.
CONCLUSION: This systematic review concluded that INI can be an effective treatment option for patients with OD. However, further well-designed clinical trials are required to establish robust clinical recommendations.}, }
@article {pmid41759027, year = {2026}, author = {Hussein, R and Shafiai, N and Fakrurrozi, A and Sabbagh, J}, title = {The impact of COVID-19 on dental practice and care: Adapting to unprecedented times.}, journal = {Wiadomosci lekarskie (Warsaw, Poland : 1960)}, volume = {79}, number = {1}, pages = {223-231}, doi = {10.36740/WLek/216768}, pmid = {41759027}, issn = {0043-5147}, mesh = {Humans ; *COVID-19 ; Pandemics ; *Dental Care ; SARS-CoV-2 ; Dentist-Patient Relations ; *Pneumonia, Viral/epidemiology ; *Coronavirus Infections/epidemiology ; Telemedicine ; }, abstract = {OBJECTIVE: Aim: This review aims to shed light on the ways dental practices and patient care strategies have evolved in response to the pandemic. It also investigates how patients' perspectives and dentist-patient dynamics have shifted, highlighting lessons for the future of dental healthcare systems.
PATIENTS AND METHODS: Materials and methods: The study is based on a comprehensive analysis of previously published research articles and clinical reports on how dental practitioners adapted their practices during the COVID-19 pandemic. It includes qualitative and quantitative data reflecting both professional and patient experiences. The pandemic led to the rapid adoption of new technologies, heightened hygiene protocols, and increased mental health burdens on both patients and practitioners. Tele-dentistry, limited in-person visits, and stricter sterilization practices became the norm. Patients expressed both fear and appreciation for enhanced safety, altering their expectations of dental care, resilience and adaptability in dental settings.
CONCLUSION: Conclusions The lessons learned from COVID-19 experience underline the importance of incorporating dentistry into broader public health strategies. Moving forward, there is a need to invest in innovative technologies, uphold rigorous hygiene standards, and provide mental workers and patients. These steps are essential to prepare for future health emergencies and ensure the sustainability of dental care delivery.}, }
@article {pmid41759616, year = {2026}, author = {Girndt, M}, title = {Vaccinations to Prevent Infections in Adult Individuals With CKD and After Kidney Transplantation: A Review.}, journal = {American journal of kidney diseases : the official journal of the National Kidney Foundation}, volume = {87}, number = {6}, pages = {841-851}, doi = {10.1053/j.ajkd.2025.10.021}, pmid = {41759616}, issn = {1523-6838}, mesh = {Humans ; *Kidney Transplantation/adverse effects ; *Vaccination/methods ; *Renal Insufficiency, Chronic/immunology/surgery/complications/therapy ; Adult ; Influenza, Human/prevention & control ; Immunosuppressive Agents ; Influenza Vaccines ; Respiratory Syncytial Virus Infections/prevention & control ; }, abstract = {Patients with chronic kidney disease (CKD), especially those undergoing dialysis, are at high risk of infections that lead to hospitalizations, morbidity, and mortality. Influenza, pneumococcal pneumonia, and respiratory syncytial virus infections account for a significant proportion of typical infectious complications and are preventable by vaccination. The immune system is weakened in CKD, reducing vaccination efficacy. Additionally, some patients with CKD receive immunosuppressive medications. The reduced seroreactivity to various vaccines must be considered when selecting vaccines, vaccine doses, and schedules for patients with CKD. Vaccinations are generally safe in CKD and should be widely used in accordance with public health recommendations to reduce morbidity. Immunosuppression after kidney transplant further impairs vaccination responses. Nevertheless, vaccinations can still be effective and provide protection in a relevant number of patients. Patients who have received transplants should generally not receive live vaccines because of the risk of vaccine-induced complications. Vaccination is usually recommended 6 months after transplant, when immunosuppression is less intense than in the early months. This approach may conflict with seasonal vaccinations, which are often omitted. Data show that at least the influenza vaccination can be administered as early as 4 weeks after transplant without additional risk. In all patients with CKD or posttransplant status, omitting recommended vaccinations is a missed opportunity to prevent relevant infectious complications.}, }
@article {pmid41760558, year = {2026}, author = {Laudani, C and Bujak, K and Occhipinti, G and Rinaldi, R and Imbesi, A and Sanchez, JS and Galli, M and Abbate, A and Ortega-Paz, L and Capodanno, D and Angiolillo, DJ}, title = {Safety and Efficacy of Colchicine across the Spectrum of Coronary Artery Disease: A Systematic Review and Meta-Analysis of 20 Randomized Trials.}, journal = {Clinical pharmacology and therapeutics}, volume = {119}, number = {6}, pages = {1431-1439}, doi = {10.1002/cpt.70246}, pmid = {41760558}, issn = {1532-6535}, mesh = {Humans ; *Colchicine/adverse effects/therapeutic use ; Randomized Controlled Trials as Topic ; *Coronary Artery Disease/drug therapy/mortality/diagnosis ; Treatment Outcome ; }, abstract = {Recent evidence questioned the overall safety and efficacy of colchicine in patients with coronary artery disease (CAD), as novel evidence focusing on acute coronary syndromes (ACSs) gave neutral results, while trials focusing on chronic coronary syndrome supported colchicine administration to improve long-term outcomes. However, no study has ever explored whether there is a true therapeutic difference across the populations or these discrepancies are due to additional confounders. Against this background, we performed a systematic review and meta-analysis of randomized trials of colchicine in patients with CAD. The primary endpoints were trial-defined major adverse cardiovascular events (MACE) and serious adverse events (SAEs). Secondary endpoints included all-cause death, measures of ischemia (cardiovascular death, myocardial infarction [MI], any revascularization, stroke) and measures of safety (serious infections or sepsis and gastrointestinal adverse events). All analyses included an interaction term for the clinical presentation. Sensitivity analyses were performed to explore sources of heterogeneity. After literature search, 20 trials encompassing a total of 21,486 patients (65.4% ACS) were included. Colchicine significantly reduced MACE (incidence rate ratio [IRR]: 0.70; 95% CI 0.55-0.87) without increasing risk for SAEs. Colchicine also reduced MI (IRR 0.81; 95% CI 0.70-0.94) and any revascularization (IRR 0.71; 95% CI 0.51-0.99), while increasing the risk of gastrointestinal adverse events (IRR 1.68; 95% CI 1.23-2.28). No statistically significant interaction was noted for clinical presentation for any endpoint, but a significant interaction for the drug dosage administered and the relationship with the COVID-19 pandemic was noted. In conclusion, the use of colchicine in patients with CAD reduces MACE without significantly increasing SAEs compared to control, although increasing gastrointestinal adverse events, without interaction by clinical presentation.}, }
@article {pmid41761197, year = {2026}, author = {Yu, E and Wang, M and Berdugo, J and Towheed, S and Yang, J and Moosavi, I and Lalji-Mawji, S and Czapla, CS and Ostermeyer, BK and Olagunju, AT}, title = {Mental health issues and associated factors amongst healthcare workers in US forensic-correctional settings: a systematic review of literature since the COVID-19 pandemic.}, journal = {BMC health services research}, volume = {26}, number = {1}, pages = {}, pmid = {41761197}, issn = {1472-6963}, mesh = {Humans ; *COVID-19/epidemiology/psychology ; United States/epidemiology ; *Health Personnel/psychology ; *Mental Health ; Risk Factors ; *Mental Disorders/epidemiology ; SARS-CoV-2 ; Frontline Workers ; Working Conditions ; Pandemics ; *Prisons ; Female ; }, abstract = {BACKGROUND: Healthcare professionals provide essential services to populations in the criminal justice system, often at the expense of their own well-being. This review synthesized literature findings on mental health challenges faced by healthcare professionals working in the US forensic-correctional settings since the COVID-19 pandemic. We investigated the prevalence of mental health conditions, their risk-protective factors, the impacts of these mental health issues on workplace retention, and highlighted relevant recommendations.
METHODS: This study followed PRISMA guidelines. A comprehensive search of major databases (PubMed/MEDLINE, PsycINFO, Web of Science, CINAHL, and Embase) was conducted and supplemented with citation chaining to identify eligible reports spanning January 1st 2020 up to March 18th, 2025. Article screening, full-text review, and data extraction were completed by two independent investigators. Study quality was assessed using the NIH tool for quantitative studies and the Critical Appraisal Skills Program (CASP) framework for qualitative studies.
RESULTS: A total of 10,005 identified reports were screened, with seven fair-to-good eligible studies included in the final review. Both quantitative (n = 4) and qualitative (n = 3) studies were included, and spanned multiple states, with most studies (n = 3, 42.9%) conducted in California. Healthcare workers reported various mental health conditions such as depression (48%), anxiety (18.8-51.1%), sleep disorders (17.4%), burnout (47.2%) and PTSD (49.3%), albeit significant heterogeneity constrains comparative analysis. Qualitatively, workers experienced considerable isolation, personality shifts, and cognitive dissonance. Risk factors predictive of mental health conditions included increased workload (β = 0.18, p < 0.001), workplace conflict (β = 0.15, p < 0.001), female sex (β = 0.10, p = 0.04), younger age, chronic medical conditions (β = 0.09, p = 0.03), fears around COVID-19 (β = 0.14, p < 0.001), and a lack of pandemic safety training (p = 0.033). Protective factors included resilience, administrator and peer support, access to needed resources, and a sense of fulfilment and purpose from working with populations in forensic-correctional settings.
CONCLUSIONS: Systemic reforms including decreased mandatory overtime, staffing, workload distribution, organizational support, training, improved communication, access to adequate resources and psychosocial interventions may help promote wellness and optimize the ability of healthcare workers to provide care in forensic-correctional settings. However, the preliminary nature of the study findings suggests caution in their interpretations. Further high-quality research is needed to support evidence-informed decision-making and translation.}, }
@article {pmid41761217, year = {2026}, author = {Lim, O and Ling, RR and Mak, V and Lim, SL and Ramanathan, K and Orosz, J and Pound, G and Jones, D and Subramaniam, A}, title = {Prevalence and outcomes of in-hospital cardiac arrest in the intensive care unit: a systematic review and meta-analysis.}, journal = {Critical care (London, England)}, volume = {30}, number = {1}, pages = {}, pmid = {41761217}, issn = {1466-609X}, mesh = {Humans ; *Intensive Care Units/statistics & numerical data/organization & administration ; *Heart Arrest/epidemiology/mortality ; Prevalence ; Hospital Mortality ; COVID-19/epidemiology/complications ; Critical Illness ; }, abstract = {BACKGROUND: Cardiac arrest in the intensive care unit (ICU-CA) is distinct from other in-hospital cardiac arrests, involving critically ill patients in monitored settings. Its prevalence and outcomes remain unclear. This systematic review and meta-analysis aimed to fill this evidence gap and identify areas for future research to improve outcomes in this patient population. METHODS: We searched MEDLINE, Embase and Scopus databases from inception until 26 November 2025 for studies reporting on ICU-CA in adults. We performed random effects meta-analyses with the generalised linear mixed model. We used the Joanna Briggs Institute Checklist to assess risk of bias and the GRADE approach to assess the certainty of evidence. The primary outcome was the prevalence of patients with ICU-CA; secondary outcomes included ICU and in-hospital mortality. We performed subgroup analyses based on geographical region (continent), study source (registry vs. non-registry), and COVID-19 status (infected vs. non-infected). RESULTS: We included 35 observational studies including 36 cohorts in the meta-analysis. The pooled proportion of ICU-CA was 3.23% (95% CI: 2.08–4.98, moderate certainty). The proportion of ICU-CA was significantly higher (p < 0.001) in patients with COVID-19 (10.6%, 95%-CI: 5.4–19.7) compared with non-COVID-19 cohorts (2.3%, 95%-CI: 1.5–3.5). Pooled ICU mortality was 74.0% (95%-CI: 63.7–82.1, moderate certainty) and in-hospital mortality was 82.0% (95%-CI: 75.9–86.9, high certainty). Meta-regression found that proportion of shockable rhythm was inversely associated with ICU mortality, but not in-hospital mortality. CONCLUSION: Cardiac arrest in the ICU was associated with poor survival, with a higher prevalence in patients with COVID-19. Future studies should focus on peri-arrest characteristics to guide prognostication and management of individuals who experience ICU-CA.}, }
@article {pmid41761653, year = {2026}, author = {Gavor, E and Choong, YK and Singh, S and Sivaraman, H and Yin, ES and Sivaraman, J}, title = {Structural Basis of MERS-CoV Receptor Interactions and Antibody Neutralisations.}, journal = {Reviews in medical virology}, volume = {36}, number = {2}, pages = {e70113}, pmid = {41761653}, issn = {1099-1654}, support = {//J.S. acknowledges partial support from Ministry of Education, Singapore grants R154-000-A72114, R-154-000-B03-112, and R-154-000-697-112./ ; }, mesh = {*Middle East Respiratory Syndrome Coronavirus/immunology/genetics/chemistry ; Humans ; *Antibodies, Neutralizing/immunology ; *Antibodies, Viral/immunology ; *Coronavirus Infections/virology/immunology/prevention & control ; Animals ; *Receptors, Virus/chemistry/metabolism/immunology ; *Spike Glycoprotein, Coronavirus/immunology/chemistry/genetics/metabolism ; }, abstract = {Increasing outbreaks of coronaviruses underscore the importance of antivirals and vaccines that can combat a wide range of coronaviruses. Neutralising antibodies (nAbs), along with vaccines and small-molecule drugs, are among the most promising treatments and prevention options against coronaviruses. Here, we focus on Middle East Respiratory Syndrome coronavirus (MERS-CoV) and discuss receptor usage and current progress in antibody research against MERS-CoV infections. First detected in Saudi Arabia and Jordan in 2012, MERS-CoV is a lethal zoonotic pathogen. MERS-CoV infections have been reported by 27 countries between April 2012 till now, with 953 deaths (∼35% mortality) (5 new infections and 4 fatalities reported as of 1 October 2024). WHO identified MERS-CoV as a high-threat pathogen due to its severity, high mortality rate, and potential for epidemic or pandemic spread with recent outbreaks and deaths raising more concerns amidst the COVID-19 pandemic. As of now, there is no antiviral drugs or vaccine against MERS-CoV available. Here we provide a perspective on receptor usage, the risk of MERS-CoV and other CoVs evolution on future pandemics, and the mechanisms of MERS-CoV-derived nAbs. We offer insight into how these antibodies cross-react and cross-neutralise by analysing available structures of spike glycoprotein-antibody complexes. This review provides an update and a basis for the development of antibodies and vaccines for MERS-CoV, and possibly for the designing of next-generation pan-coronavirus vaccines and antivirals.}, }
@article {pmid41761906, year = {2026}, author = {Morand-Grondin, D and Berthod, J and Sigouin, J and Beaulieu-Bonneau, S and Kairy, D}, title = {Paving the road for more ethical and equitable policies and practices in telerehabilitation in psychology and neuropsychology: A rapid review.}, journal = {Health informatics journal}, volume = {32}, number = {1}, pages = {14604582261431026}, doi = {10.1177/14604582261431026}, pmid = {41761906}, issn = {1741-2811}, mesh = {Humans ; *Neuropsychology/methods/ethics ; *Telerehabilitation/ethics ; COVID-19/epidemiology ; Telemedicine/ethics ; *Psychology ; SARS-CoV-2 ; Canada ; }, abstract = {BackgroundTelerehabilitation (TR) has been increasingly used to deliver psychological and neuropsychological care remotely, especially since the COVID-19 pandemic. As health services continue to shift toward telehealth, ensuring ethical and equitable TR delivery is essential to establish sustainable TR models.ObjectiveThe objective of this review is to synthesize existing evidence on the ethical and equity-related benefits and pitfalls associated with the use of TR in a psychological and neuropsychological context for individuals with physical disabilities.MethodsThis rapid review included reviews (2010-2020) and original studies (2020-2023) that focused on TR interventions for people with physical disabilities in the context of psychology and neuropsychology rehabilitation.ResultsA total of 16 reviews and 82 original articles were included. Key ethical concerns centered around privacy, confidentiality, caregiver burden, and clinician-patient relationship quality. Equity concerns centered around access disparities (e.g., geographic location, income), digital literacy, and demographic underrepresentation.ConclusionThis review is part of a pan-Canadian initiative aimed at informing policy development and clinical practice in TR. Findings highlight the need for clear guidelines and targeted interventions to ensure that TR in psychology and neuropsychology is both ethically sound and equitable.}, }
@article {pmid41762078, year = {2026}, author = {Wimalasundera, MO and Mohammad, ZMW and Choudhury, S and Mandour, Y}, title = {Understanding E-Consent in Anaesthesia: A Review of Clinical, Legal, and Ethical Dimensions.}, journal = {British journal of hospital medicine (London, England : 2005)}, volume = {87}, number = {2}, pages = {50953}, doi = {10.31083/BJHM50953}, pmid = {41762078}, issn = {1759-7390}, mesh = {Humans ; *Informed Consent/legislation & jurisprudence/ethics ; *COVID-19/epidemiology ; *Anesthesia ; *Anesthesiology/legislation & jurisprudence/ethics ; SARS-CoV-2 ; }, abstract = {The integration of electronic consent (e-consent) into anaesthetic practice has accelerated since the Coronavirus Disease 2019 (COVID-19) pandemic, offering new opportunities to enhance patient autonomy, documentation fidelity, and clinical efficiency. This review examines the clinical, legal, and ethical dimensions of e-consent, situating it within the statutory and common law frameworks, such as the Mental Capacity Act 2005 and the principles established in Montgomery v Lanarkshire Health Board. It further interrogates the challenges posed by digital exclusion, cybersecurity vulnerabilities, and the environmental implications of transitioning to digital platforms. The emerging role of artificial intelligence in tailoring and strengthening consent processes is explored, while highlighting the imperative to preserve ethical integrity and legal validity.}, }
@article {pmid41762443, year = {2026}, author = {Balakrishnar, K and Long, BS and Lo, J and Fiorini, LA and Gohar, B and Nowrouzi-Kia, B}, title = {Assessing the antecedents behind after-hours work in teleworkers: a scoping review.}, journal = {Journal of public health (Oxford, England)}, volume = {48}, number = {2}, pages = {582-593}, pmid = {41762443}, issn = {1741-3850}, mesh = {Humans ; *Teleworking/statistics & numerical data ; *COVID-19/epidemiology ; Working Conditions ; Work Schedule Tolerance ; }, abstract = {BACKGROUND: Since the start of the COVID-19 pandemic, telework arrangements have become increasingly prevalent, driven by benefits such as greater autonomy, reduced work-related stress, decreased commuting time and cost, and enhanced flexibility. Despite these advantages, teleworkers are more likely to engage in after-hours work, creating additional strain that may impact health and organizational outcomes.
METHODS: A systematic search was conducted across seven online databases: Medline via OVID, Embase via OVID, APA PsycINFO via OVID, International Bibliography of Social Sciences via ProQuest, Sociological Abstracts via ProQuest, Business Source Premier via EBSCOhost, and CINAHL via EBSCOhost. Studies were included if they were empirical, peer-reviewed, published between 2010 and 2024, examined the antecedents of after-hours work, and focused on adults aged 18 to 65 engaged in telework. Descriptive thematic analysis was conducted to develop themes and sub-themes.
RESULTS: Findings: A total of 17 studies were included in the review: 13 cross-sectional studies, three qualitative studies, and one longitudinal study. Using the Person-Environment-Occupation framework, three overarching themes were identified: (i) misalignment between personal capacities and occupational demands; (ii) environmental constraints that undermine healthy role balance; and (iii) occupational role strain in the context of remote work.
CONCLUSIONS: These findings may help to inform the development of targeted interventions that reduce cases of after-hours work among teleworkers and promote their overall health and well-being. Future research should examine these antecedents in non-Western contexts and explore the interplay between the individual, environmental, and occupational factors shaping after-hours work behaviors.}, }
@article {pmid41762542, year = {2026}, author = {Sagués, T and Ferrer, A and Delgado, JF and Julià, G and Rodríguez-González, R and Ruiz, À and Estrada, F and Soria, V and Palao, DJ and Labad, J and Montalvo, I}, title = {Clozapine use and COVID-19 risk: A systematic review, meta-analysis, and retrospective cohort evidence.}, journal = {Psychiatry research}, volume = {359}, number = {}, pages = {117040}, doi = {10.1016/j.psychres.2026.117040}, pmid = {41762542}, issn = {1872-7123}, mesh = {Humans ; *Clozapine/adverse effects/therapeutic use ; *Antipsychotic Agents/adverse effects/therapeutic use ; *COVID-19/epidemiology ; Retrospective Studies ; *Schizophrenia, Treatment-Resistant/drug therapy ; Severity of Illness Index ; }, abstract = {BACKGROUND: Clozapine's immune-modulating effects, including neutropenia and suppression of adaptive immunity, have raised concerns about its potential impact on SARS-CoV-2 infection risk and COVID-19 severity in individuals with treatment-resistant schizophrenia. Findings in the literature remain inconsistent.
METHODS: First, we conducted a longitudinal retrospective study in which we analysed 995 outpatients with severe mental disorders receiving antipsychotic treatment to assess the association between clozapine use and SARS-CoV-2 infection and disease severity. Secondly, we performed a systematic review of the literature and searched for studies published up to July 2025 examining the link between clozapine exposure and SARS-CoV-2 infection. Eight cohort studies plus our dataset were meta-analysed using a random-effects model.
RESULTS: In our cohort, clozapine users demonstrated a higher rate of SARS-CoV-2 infection (18% vs. 10%, p < 0.001) and increased COVID-19 severity compared to non-users. The meta-analysis comprised 155,945 participants, with individual study ORs ranging from 0.40 to 2.80. The pooled random-effects OR was 1.53 (95% CI: 1.02-2.30, p = 0.044), indicating a significant association between clozapine exposure and increased infection risk. However, high heterogeneity (I² = 91.2%) suggests variation in effects across studies.
CONCLUSIONS: Clozapine treatment is associated with an increased risk and severity of SARS-CoV-2 infection. Although meta-analytic results support this association, substantial heterogeneity in pooled estimates highlights the need for further research to clarify underlying clinical and methodological factors influencing risk.}, }
@article {pmid41763558, year = {2026}, author = {Li, M and Sharma, K and Chon, JE and Yehia, NA and Retnakaran, R and Harris, SB and Hanley, AJ}, title = {The impact of COVID-19 illness on metabolic phenotypes underlying type 2 diabetes mellitus: a systematic review.}, journal = {Diabetes research and clinical practice}, volume = {235}, number = {}, pages = {113163}, doi = {10.1016/j.diabres.2026.113163}, pmid = {41763558}, issn = {1872-8227}, mesh = {Humans ; *Diabetes Mellitus, Type 2/metabolism/complications/epidemiology ; *COVID-19/metabolism/complications/epidemiology ; *Insulin Resistance/physiology ; *Insulin-Secreting Cells/metabolism ; SARS-CoV-2 ; Phenotype ; }, abstract = {We aimed to systematically review literature investigating the impact of COVID-19 on insulin resistance and beta-cell dysfunction in humans. Ovid MEDLINE and Embase were searched for studies published between December 2019 and May 2024. Observational studies examining adults with no history of type 2 diabetes comparing the development of insulin resistance and beta-cell dysfunction between COVID-19 exposed groups vs. controls were included. Risk of bias was assessed using adapted Newcastle-Ottawa and Joanna Briggs Institute scales. Among 6901 studies screened, 10 met the inclusion criteria. Across these studies, 37 individual measures of insulin resistance and beta-cell dysfunction were reported. Insulin resistance worsened significantly in 16 of 25 (64.0%) comparisons, whereas beta-cell dysfunction worsened significantly in 7 of 12 (58.3%) measures among COVID-19 patients when compared to controls. Five studies were considered low risk of bias. COVID-19 was associated with worsened insulin resistance and beta-cell dysfunction, suggesting infection may be a metabolic stressor that overwhelms gluco-regulatory mechanisms. Results, especially those for beta-cell function, should be interpreted cautiously given methodological limitations in the utilized measures. These findings highlight the pathophysiological aspects of type-2 diabetes impacted by COVID-19 infection and support the development of targeted monitoring and therapeutic strategies.}, }
@article {pmid41764591, year = {2026}, author = {Çivilidağ, A and Durmaz, Ş}, title = {The relationship of flexible working arrangements on work-family conflict, work-life balance and organizational commitment: a systematic review and meta-analysis.}, journal = {BMC psychology}, volume = {14}, number = {1}, pages = {}, pmid = {41764591}, issn = {2050-7283}, mesh = {*Work-Life Balance ; Humans ; *Work Schedule Tolerance/psychology ; Role Conflict ; *Employment/psychology ; *Personnel Loyalty ; Working Conditions ; }, abstract = {BACKGROUND: Technological advances and the COVID–19 pandemic have fundamentally reshaped the global work landscape, establishing flexible work arrangements (FWAs)—such as schedule flexibility and remote work—as a permanent feature of contemporary employment. This shift necessitates a rigorous quantitative synthesis of how FWAs relate to critical employee and organizational outcomes. This study examines the associations between FWAs and work–life balance (WLB), work–family conflict (WFC), and organizational commitment (OC). METHODS: A systematic review and meta–analysis was conducted across five electronic databases. Initially, 3,777 records were identified. Following the application of strict inclusion and quality criteria, 38 studies from 19 countries (N = 83,951) were selected for analysis. Data were synthesized using the Comprehensive Meta–Analysis (CMA 3.0) software, employing a random–effects model to calculate pooled effect sizes. RESULTS: The findings revealed significant and relatively large positive correlations between FWAs and WLB (r = .39, p < .001) and between FWAs and OC (r = .29, p < .001). Conversely, while the correlation between FWAs and WFC was positive (r= .25), it was statistically non–significant (p > .05). Meta–regression identified between countries the level of economic development as a significant moderator (p < .001), with the positive relationship of flexibility being significantly more pronounced in developed countries compared to developing nations. CONCLUSION: This meta–analysis provides robust evidence that FWAs are an effective strategic tool for enhancing WLB and substantially strengthening OC. However, their impact on reducing WFC remains less conclusive and is highly context–sensitive. Organizations are encouraged to formally adopt and support FWAs to improve employee well–being and foster loyalty, while remaining mindful of the macro–level institutional frameworks that shape flexibility outcomes.}, }
@article {pmid41765322, year = {2026}, author = {Yezli, S and Bonanni, P and Dinleyici, EC and Divyesh, T and Kumar, V and Leng, S and Coste, F and Taha, MK}, title = {Invasive meningococcal disease rebound in older adults post-COVID-19 pandemic: A targeted literature and surveillance review.}, journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases}, volume = {166}, number = {}, pages = {108502}, doi = {10.1016/j.ijid.2026.108502}, pmid = {41765322}, issn = {1878-3511}, mesh = {Humans ; *COVID-19/epidemiology ; Aged ; *Meningococcal Infections/epidemiology/mortality ; Incidence ; Neisseria meningitidis/classification ; Aged, 80 and over ; SARS-CoV-2 ; Pandemics ; }, abstract = {OBJECTIVES: Invasive meningococcal disease (IMD), caused by Neisseria meningitidis, remains a significant public health concern due to its rapid progression, high case fatality rate (CFR), and evolving epidemiology. Recent trends suggest a demographic shift toward older adults. This review examined post-COVID-19 changes in IMD epidemiology among adults aged ≥65 years, including regional variations, serogroup distribution, and mortality.
METHODS: A targeted literature review was conducted using OVID (Embase, MEDLINE) following PICOS-T criteria, including full-text English-language studies published between January 2021 and June 2024, supplemented by surveillance reports.
RESULTS: Of 1639 records screened, four peer-reviewed publications and ten surveillance reports met inclusion criteria. During the COVID-19 pandemic, IMD incidence declined sharply across all age groups, including older adults. Post-pandemic data indicate a re-emergence of IMD among older populations, with incidence in several regions returning to or exceeding pre-pandemic levels by 2023. Across multiple locations, serogroup Y emerged as the dominant or increasingly prevalent serogroup among older adults. CFR varied by region and serogroup and consistently remained high in this age group.
CONCLUSION: These findings demonstrate the re-emergence of IMD among older adults and highlight the need for strengthened IMD surveillance and serogroup monitoring in this population, to guide prevention strategies and inform public health policy.}, }
@article {pmid41765382, year = {2026}, author = {Ratnasabesar, V and Kunadian, V}, title = {Health inequalities across England and their impact on cardiovascular diseases.}, journal = {Heart (British Cardiac Society)}, volume = {}, number = {}, pages = {}, doi = {10.1136/heartjnl-2025-327508}, pmid = {41765382}, issn = {1468-201X}, abstract = {Cardiovascular disease (CVD) remains one of the leading causes of mortality in England, with its burden disproportionately concentrated in the North. Studies in the last few decades have highlighted that factors such as low education, high levels of unemployment, poor housing and reduced access to healthy food are strongly associated with the higher incidence of lifestyle risks-smoking, obesity and physical inactivity. These in turn increase rates of hypertension, dyslipidaemia and diabetes in the population. Beyond lifestyle factors, psychosocial mechanisms such as chronic stress and associated increase in allostatic load, due to long-standing deprivation, contribute to the biological risk of CVD. Early life disadvantage, ethnic and gender inequalities, and delayed management of intermediate risk factors further exacerbate the regional divide in England. Furthermore, the long-term impacts of COVID-19 and healthcare-associated national policies, including austerity-related funding deductions, have intensified pre-existing disparities. Evidence demonstrates that current preventative strategies, such as the National Health Service Health Check, have had limited success in reaching underserved communities, highlighting the need for targeted therapies. The National Institute of Health and Care Research Inequalities Challenge is a remarkable opportunity for the United Kingdom's (UK) leading research organisations to help tackle these inequalities associated with CVD and make a significant difference. Without such efforts, the excess CVD burden is likely to persist, perpetuating entrenched health inequalities. This review examines the different social determinants of health underlying these disparities, with a particular focus on socioeconomic deprivation, lifestyle risk factors, environmental and structural issues.}, }
@article {pmid41765774, year = {2026}, author = {Andoh, JE and Fu, J and Nwanyanwu, KH}, title = {Impact of United States federal funding on equity and vision research: lessons from history, justice, and politics, 1968-2025.}, journal = {Current opinion in ophthalmology}, volume = {37}, number = {3}, pages = {162-167}, doi = {10.1097/ICU.0000000000001212}, pmid = {41765774}, issn = {1531-7021}, mesh = {United States ; Humans ; *Biomedical Research/economics ; *Politics ; *Financing, Government/history ; History, 20th Century ; Diversity, Equity, Inclusion ; *Health Equity ; History, 21st Century ; *Ophthalmology ; COVID-19/epidemiology ; }, abstract = {PURPOSE OF REVIEW: Federal policy has long shaped the scope and inclusivity of vision research in the United States. This narrative review and opinion article evaluates the evolution of equity in vision research over time, from the landmark National Institutes of Health Revitalization Act of 1993 to the direct impact of federal policies in today's political landscape.
RECENT FINDINGS: Equity in vision research originated from early epidemiologic studies identifying social and behavioral determinants of health in the 1970s. The post-2020 period accelerated attention to structural disparities in healthcare, catalyzed by the COVID-19 pandemic and a national conversation on race. However, recent executive orders have reversed equity oriented federal policies, restricted terminology and data access, and changed research funding operations. These ongoing developments pose risks to progress in all areas of research.
SUMMARY: Equity in vision research in the United States remains vulnerable to federal priorities that serve to support or destabilize. The current political environment underscores the need for the ophthalmologic research community to safeguard data integrity, sustain diverse participation, and continue methodologically rigorous protocols to ensure continued progress toward equitable vision health.}, }
@article {pmid41766004, year = {2026}, author = {Halawi, M}, title = {Disparities in Outpatient and Short-Stay Arthroplasty Surgery: a Critical Review and Proposed Equity-Centered Framework.}, journal = {Current reviews in musculoskeletal medicine}, volume = {19}, number = {1}, pages = {}, pmid = {41766004}, issn = {1935-973X}, abstract = {PURPOSE OF REVIEW: Over the past decade, outpatient and short-stay total joint arthroplasty (TJA) has transitioned from exception to expectation, driven by enhanced recovery protocols, regulatory changes, and the COVID-19 pandemic. This review synthesizes evidence from 2015 to 2025 regarding inequities in this transition, clarifies key definitions and methodological challenges, and examines the contributing factors and controversies surrounding equitable access to ambulatory surgery. RECENT FINDINGS: Evidence indicates a widening gap in access and outcomes based on race, ethnicity, and gender. Black and Hispanic patients remain significantly less likely than White patients to undergo outpatient TJA, even when controlling for clinical comorbidities. Recent data also suggests that residence in socioeconomically disadvantaged neighborhoods is associated with longer lengths of stay and higher early healthcare utilization. Furthermore, sex-based differences have emerged in postoperative pain management, with women demonstrating higher rates of opioid exposure and persistence. While younger, healthier, and privately insured patients have disproportionately benefited from outpatient pathways, those with public insurance or higher comorbidity burdens face persistent structural barriers to candidacy and safe discharge. Achieving equitable outpatient TJA requires a shift from exclusionary risk-screening to an equity-centered framework. This proposed model spans inclusive candidacy, optimization through prehabilitation, care navigation, and the use of site-of-service metrics. Ultimately, mitigating these disparities will require coordinated, multilevel action across policy reform, clinical practice innovation, and community engagement to ensure that the benefits of surgical innovation are accessible to all patient populations.}, }
@article {pmid41766236, year = {2026}, author = {Chen, S and Li, H and Jiang, Z and Liang, J and Zhou, A}, title = {Effects of Traditional Chinese Medicine on Restoroing the immune balance of mild-to-moderate Patients with new coronavirus.}, journal = {Indian journal of pharmacology}, volume = {58}, number = {2}, pages = {114-125}, pmid = {41766236}, issn = {1998-3751}, mesh = {Humans ; COVID-19/immunology ; *Medicine, Chinese Traditional ; *Drugs, Chinese Herbal/therapeutic use ; SARS-CoV-2 ; *Coronavirus Infections/immunology/drug therapy ; *Pneumonia, Viral/immunology/drug therapy ; *COVID-19 Drug Treatment ; Pandemics ; }, abstract = {OBJECTIVE: Coronavirus disease 2019 (COVID-19) which brings the epidemic situation to the public has spread rapidly and produce multiple variations. At present, Western medicine still lacks the specific medicine or vaccines for coronavirus. However, amount of evidence shows that traditional Chinese medicine (TCM) has advantages in releasing the symptoms of mild-to-moderate COVID patients. Those treatments are not only improving the course of the primary disease but also curb progress to severe pneumonia or acute respiratory distress syndrome. Therefore, taking TCM intervention or combined treatments appropriately to prevent worsening illness is of vital significance. This study mainly focuses on the data analysis on the effects of TCM in restoring the immune balance of COVID patients. By collecting clinical data from mild to moderate patients, we expected to figure out if TCM only plays the role of curbing inflammation or having a two-way influence in balancing the immune microenvironment.
METHODS: Seven digital databases including PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, China Science and Technology Journal Database (VIP), Wanfang Database, and China Biology Medicine were searched from December 2019 to August 2022 nothingness of language restrictions. The studies retrieved from the database were selected and the data extracted to assess the methodological quality of the included randomized controlled trials (RCTs). Statistical analysis was completed. Pulmonary computed tomography, clinical cure rate, rate of conversion to severe cases, length of hospital stay, and scores of TCM syndrome were defined as the primary outcomes, the secondary outcomes were white blood cell count, lymphocyte (LYM) count, and C-reactive protein (CRP). This study was registered with PROSPERO (CRD42022341482).
RESULTS: Nine eligible RCTs including 1159 participants were included in this meta-analysis. Compared with Western medicine treatment alone, our meta-analyses found that traditional Chinese combined Western medicine treatment has a higher clinical cure rate, better absorption of lung inflammation, and significantly shorter hospital stay. In terms of inflammatory factors, TCM can significantly reduce the CRP content compared with Western medicine methods, but the leukocyte and LYM content was not significantly different between the two treatments. In some research, TCM even has a trend accelerating the inflammation process on some specific stages of the disease.
CONCLUSION: Chinese herbal medicine combined with conventional therapy is significantly effective and invulnerable in the treatment of mild-to-moderate COVID-19. In terms of control inflammation, TCM does not only block the disease onset by simply inhibiting inflammation but balancing the human environment through bidirectional regulation of inflammatory cells. However, considering of the lack of research into how TCM could activate the natural immune response, the discussion of the mechanism cannot be stretched, more high-quality RCTs are still needed in the future.}, }
@article {pmid41766239, year = {2026}, author = {Meena, J and Agarwal, A and Sandhu, A and Pradhan, P and Singh, M}, title = {Efficacy and safety of remdesivir for patients with severe acute respiratory syndrome coronavirus 2 infection: A systematic review of randomized controlled trials.}, journal = {Indian journal of pharmacology}, volume = {58}, number = {2}, pages = {137-141}, pmid = {41766239}, issn = {1998-3751}, mesh = {Humans ; *Adenosine Monophosphate/analogs & derivatives/therapeutic use/adverse effects ; *Alanine/analogs & derivatives/therapeutic use/adverse effects ; *Antiviral Agents/therapeutic use/adverse effects ; Randomized Controlled Trials as Topic ; COVID-19 Drug Treatment ; COVID-19 ; SARS-CoV-2 ; Treatment Outcome ; Pandemics ; *Coronavirus Infections/drug therapy ; *Pneumonia, Viral/drug therapy ; *Betacoronavirus ; }, abstract = {In view of the pandemic of coronavirus disease 2019 (COVID-19), there is a need to identify a specific antiviral therapy. We performed this systematic review to assess the efficacy of remdesivir in the treatment of COVID-19. We searched three electronic databases for clinical trials investigating remdesivir for COVID-19 and included this systematic review. Five trials evaluating 13,558 participants were eligible for this study. Remdesivir, as compared to standard care, increases the rate of clinical improvement at 2 weeks (risk ratio: 1.10; 95% confidence interval: 1.04-1.18). Time to clinical recovery was shorter in the remdesivir group than the standard care group. The mortality rate was lower at 2 weeks in the remdesivir group, but no difference was observed at 4 weeks postrandomization. Extending the duration of remdesivir from 5 days to 10 days did not improve efficacy but increased the risk of adverse events. Findings from this systematic review suggested that remdesivir may slightly improve recovery time and rate of clinical improvement.}, }
@article {pmid41766448, year = {2026}, author = {Taxiarchis, A and Pruner, I}, title = {Messengers of coagulopathy: complement-carrying extracellular vesicles in SARS-CoV-2 infection.}, journal = {Current opinion in hematology}, volume = {33}, number = {3}, pages = {105-112}, doi = {10.1097/MOH.0000000000000916}, pmid = {41766448}, issn = {1531-7048}, mesh = {Humans ; *COVID-19/blood/complications/immunology ; *Extracellular Vesicles/metabolism/immunology/pathology ; *Complement Activation ; *SARS-CoV-2 ; *Complement System Proteins/metabolism ; *Blood Coagulation Disorders/etiology/blood ; Complement Membrane Attack Complex/metabolism ; Blood Platelets/metabolism ; }, abstract = {PURPOSE OF REVIEW: SARS-CoV-2 disease (COVID-19) is increasingly recognized as a thromboinflammatory vascular disorder characterized by dysregulated complement activation, endothelial injury, and sustained hypercoagulability. This review examines emerging evidence that extracellular vesicles act as key intermediaries linking complement activation to coagulation in acute and postacute COVID-19 infection.
RECENT FINDINGS: Recent studies demonstrate that extracellular vesicles released from platelets, endothelial cells, and neutrophils are markedly increased in COVID-19 and exhibit a combined procoagulant and complement-active phenotype. Sub-lytic complement attack, particularly membrane attack complex (MAC) deposition, triggers phosphatidylserine exposure and extracellular vesicle shedding, generating vesicles that support thrombin generation and propagate complement activity in the circulation. Extracellular vesicle-associated complement components, including C1q, C3 fragments, MASP2, and preassembled MACs, promote tissue factor decryption, platelet activation, and assembly of the prothrombinase complex, establishing a self-amplifying thromboinflammatory loop. Proteomic profiling further reveals compartment-specific extracellular vesicle signatures, with systemic extracellular vesicles enriched in complement and coagulation pathways. Importantly, complement-bearing and tissue factor-bearing extracellular vesicles persist beyond acute infection and are increasingly implicated in postacute sequelae of COVID-19.
SUMMARY: Extracellular vesicles serve as mobile platforms integrating complement activation with coagulation, providing a mechanistic framework for acute and chronic immunothrombosis in COVID-19. Targeting extracellular vesicle-mediated complement-coagulation crosstalk may offer novel diagnostic and therapeutic opportunities.}, }
@article {pmid41766626, year = {2026}, author = {Jones, M and Krockow, EM and Tromans, SJ and Mukaetova-Ladinska, EB}, title = {Antidepressant prescribing trends for adult patients in the UK and Ireland during the COVID-19 pandemic: systematic review.}, journal = {BJPsych open}, volume = {12}, number = {2}, pages = {e77}, pmid = {41766626}, issn = {2056-4724}, abstract = {BACKGROUND: Recent decades have seen a steady increase in antidepressant prescribing, but little is known about prescribing trends during and following the COVID-19 pandemic.
AIMS: This preregistered systematic review, following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, aimed to investigate antidepressant prescribing trends for adults in the UK and Republic of Ireland during and after the pandemic. It also compared prescriptions by drug and location.
METHOD: We searched six databases: APA PsycInfo, CINAHL, MEDLINE, Scopus, medRxiv and Preprints.org. The review included primary research articles reporting trends in antidepressant prescriptions, including at least one time point after March 2020 in the UK and Republic of Ireland. This review has been preregistered on PROSPERO (ID: CRD42024498503).
RESULTS: We identified 7,320 studies, of which ten met the search criteria for the review. Studies were grouped on the basis of time period (2020: n = 5; 2021: n = 3; 2022: n = 2), location (England, Scotland, Northern Ireland, Republic of Ireland, UK) and drug type (serotonin-noradrenaline reuptake inhibitors, selective serotonin reuptake inhibitors, tricyclics, and others (e.g. monoamine oxidase inhibitors)). Most studies (eight of ten) demonstrated increased antidepressant prescribing over time. Two studies highlighted a decrease between March and May 2020. Demographic variables reflected higher rates of prescribing for women, and the modal group receiving antidepressants comprised middle-aged adults.
CONCLUSIONS: The commonly reported increase in antidepressant prescribing corroborates pre-pandemic trends and may suggest further, increased demands for mental health support to meet the unique challenges of the pandemic. Future research is required to evaluate the appropriateness of treatment decisions and to explore psychosocial factors that influence individual prescribing choices.}, }
@article {pmid41766628, year = {2026}, author = {Szemray, H and Lawler, NG and Lodge, S and Wist, J and Whiley, L}, title = {Dynamic Lipidomic Responses to Inflammation and Physical Insult: A Comparative Review Across Blunt Force Trauma, Thermal Burn Injury, and Viral Infection.}, journal = {Expert reviews in molecular medicine}, volume = {28}, number = {}, pages = {e11}, pmid = {41766628}, issn = {1462-3994}, support = {//Dementia Australia Research Foundation/ ; }, mesh = {Humans ; *Burns/metabolism/pathology/blood ; *Lipidomics/methods ; *COVID-19/metabolism/pathology ; *Inflammation/metabolism ; *Brain Injuries, Traumatic/metabolism/blood/pathology ; SARS-CoV-2 ; *Wounds, Nonpenetrating/metabolism ; Lipid Metabolism ; Lipoproteins/blood ; Biomarkers/blood ; *Lipids/blood ; }, abstract = {Acute insults ranging from blunt force trauma and thermal injury to pathogenic infection elicit systemic inflammatory cascades intended to limit further tissue damage. These responses are accompanied by metabolic disturbances that generate distinct biochemical signatures measurable through advanced analytical platforms, such as mass spectrometry and nuclear magnetic resonance spectroscopy (NMR). Although numerous studies have examined these metabolic alterations, findings remain fragmented across clinical and analytical disciplines, leaving it unclear whether the systemic metabolic response to acute insult is fundamentally conserved or insult-specific. In this comparative review, we consolidate evidence across diverse injury and infection contexts to identify shared metabolic patterns, context-dependent differences, and critical gaps in current understanding. Here, we focus on lipid and lipoprotein profiling of blood plasma and serum. We present exemplar case studies spanning traumatic brain injury, burn injury, and SARS-CoV-2 infection to illustrate how lipid and lipoprotein perturbations differ or converge across insult types. Notable observations include consistently elevated palmitic acid (16:0) and reduced phosphatidylcholine species across all three conditions, suggesting these features may represent cross-condition biomarkers and highlighting the value of comparative metabolic profiling. By integrating evidence across diverse contexts, we propose a framework describing the interplay between lipid metabolism, lipoprotein dynamics, and inflammatory activation. Finally, we discuss the translational potential of metabolic phenotyping in enhancing patient stratification, refining prognostic modelling, and improving patient outcomes.}, }
@article {pmid41767143, year = {2026}, author = {Liu, SC and Cheah, KSL and Syed Ali, SKB and Qu, HM and Wang, ZL}, title = {A bibliometric and visualization analysis for global research trends in Wushu and mental health (1981-2024).}, journal = {Frontiers in psychiatry}, volume = {17}, number = {}, pages = {1737574}, pmid = {41767143}, issn = {1664-0640}, abstract = {BACKGROUND: Mental health has become one of the most urgent public health issues in the 21st century, and the COVID-19 pandemic has significantly increased this problem. As a traditional mind-body practice, Wushu (e.g., Tai Chi, Qigong) is increasingly recognized for its therapeutic potential in mental health. However, bibliometric studies in this eld remain scarce.
METHODS: This study aims to visualize the Wushu and mental health (WMH) related research through bibliometric analysis of the Web of Science database (1981-2024). It examines publication trends, core journals, international collaboration, leading authors, and thematic evolution. A systematic search using Boolean operators identified 536 articles. To conduct a complementary analysis of the findings, this study compared the 23 clinical trials identified from PubMed (2020-2024) with the research trends obtained from the bibliometric analysis.
RESULTS: The study found that the number of published articles and cited times increased significantly in the past five years, which confirmed the influence of COVID-19 in this field. China and the United States, represented by Harvard University, are the main pushing forces in this area. The research focus has shifted from rehabilitation orientation to comprehensive mental and public health perspectives. Future development trends may include strengthening international cooperation, standardizing intervention programs, and cross-cultural research.
CONCLUSION: This multi-database analysis provides researchers and policymakers with a scientific reference for the WMH field. It clearly reflects current research trends and future research directions in WMH.}, }
@article {pmid41767314, year = {2026}, author = {González, S and Arellano, J and Reza-Zaldivar, EE and Mena-Munguía, S and Minjarez, B and Rodríguez-Yáñez, Y}, title = {Viral mechanisms, tropism, and clinical relevance regarding the ophthalmic manifestations of SARS-CoV-2 infection.}, journal = {International journal of ophthalmology}, volume = {19}, number = {3}, pages = {619-629}, pmid = {41767314}, issn = {2222-3959}, abstract = {To explore the mechanisms underlying ocular infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), we conducted a comprehensive review of current literature, focusing on viral entry pathways, receptor expression in ocular tissues, and associated clinical manifestations. This review encompasses studies published within the last five years with a focus on original research and systematic reviews that provide molecular, histological, or clinical evidence. The findings show that SARS-CoV-2 can infect ocular tissues through multiple receptors beyond angiotensin-converting enzyme 2 (ACE2), including transmembrane serine protease 2 (TMPRSS2), CD147, alanyl aminopeptidase N (ANPEP), dipeptidyl peptidase 4 (DPP4), angiotensin II receptor type 2 (AGTR2), and polymeric immunoglobulin receptor (PIGR), which are expressed in retinal, conjunctival, corneal, limbal, and photoreceptor cells. The virus may also reach ocular structures via neurovascular invasion. Clinically, patients with coronavirus disease 2019 (COVID-19) may present with a broad spectrum of ophthalmic manifestations, including conjunctivitis, hyperreflective lesions in the inner retinal layers, flame-shaped hemorrhages, cotton-wool spots, retinal pallor, hard exudates, and various forms of maculopathy, such as paracentral acute middle maculopathy and acute macular neuroretinopathy (AMN). These signs reflect both direct viral damage and secondary effects of systemic inflammation and microvascular injury. Understanding the molecular and clinical spectrum of ocular involvement is essential for early diagnosis, appropriate ophthalmologic care, and the prevention of long-term visual sequelae in patients affected by COVID-19.}, }
@article {pmid41767650, year = {2026}, author = {Birdi, S and Patel, A and Rabet, R and Singh, N and Durant, S and Vosoughi, T and Kapra, F and Shergill, M and Mesfin, E and Ziegler, C and Ali, S and Buckeridge, D and Ghassemi, M and Gibson, J and John-Baptiste, A and Macklin, J and Mccradden, M and Mckenzie, K and Mishra, S and Naraei, P and Owusu-Bempah, A and Rosella, L and Shaw, J and Upshur, R and Pinto, AD}, title = {Machine Learning Used in Communicable Disease Control: A Scoping Review.}, journal = {Public health reviews}, volume = {47}, number = {}, pages = {1608074}, pmid = {41767650}, issn = {0301-0422}, abstract = {OBJECTIVES: Communicable diseases continue to threaten global health, with COVID-19 as a recent example. Rapid data analysis using machine learning (ML) is crucial for detecting and controlling outbreaks. We aimed to identify how ML approaches have been applied to achieve public health objectives in communicable disease control and to explore algorithmic biases in model design, training, and implementation, and strategies to mitigate these biases.
METHODS: We searched MEDLINE, Embase, Cochrane Central, Scopus, ACM DL, INSPEC, and Web of Science to identify peer-reviewed studies from 1 January 2000, to 15 July 2022. Included studies applied ML models in population and public health to address ten communicable diseases with high prevalence.
RESULTS: 28,378 citations were retrieved, and 209 met our inclusion criteria. ML for communicable diseases has risen since 2020, particularly for SARS-CoV-2 (n = 177), followed by malaria, HIV, and tuberculosis. Eighteen studies (8.61%) considered bias, and only eleven implemented mitigation strategies.
CONCLUSION: A growing number of studies used ML for disease surveillance. Addressing biases in model design should be prioritized in future research to improve reliability and equity in public health outcomes.}, }
@article {pmid41767904, year = {2026}, author = {Jagasia, K and Malyan, HH and Kim, J and Kabakibi, M and Moore, AA and Nguyen, AL}, title = {Cannabis Use Among Caregivers of Older Adults: A Systematic Literature Review.}, journal = {Sage open aging}, volume = {12}, number = {}, pages = {30495334261426511}, pmid = {41767904}, issn = {3049-5334}, abstract = {As the global population ages, the number of caregivers has risen accordingly. Though caregiving has many rewards, it may also cause psychological stress. To manage this burden, caregivers may adopt various coping strategies, including cannabis use. This systematic review aimed to synthesize existing literature on cannabis use among caregivers for older adults. A database search in PubMed, PsycINFO, and CINAHL identified 357 unique peer-reviewed articles to screen and five were included in the review. Studies were included if they reported empirical data on cannabis use among caregivers for older adults. Of the five included studies, four studies found that caregivers reporting high stress or emotional burden used cannabis to cope, with two finding new or increased use during the COVID-19 pandemic. One study found that using cannabis improved caregivers' self-reported health and well-being; another found positive caregiver attitudes toward recreational cannabis. Two studies found higher caregiver anxiety was associated with increased cannabis use. Despite limited research, these studies underscore the role of cannabis as a potential coping mechanism for caregivers of older adults experiencing emotional burden. Additional research should seek to characterize longitudinal patterns of cannabis use among caregivers and its potential impact on both caregiver and care recipients.}, }
@article {pmid41768578, year = {2026}, author = {Castellanos-Hernández, DI and Mayoral-Chávez, MA and Matias-Cervantes, CA and Alpuche, J}, title = {Association between nucleic acid COVID-19 vaccines and acute myocardial infarction in adults: a systematic review.}, journal = {Frontiers in cardiovascular medicine}, volume = {13}, number = {}, pages = {1752169}, pmid = {41768578}, issn = {2297-055X}, abstract = {BACKGROUND: Post-marketing surveillance has documented cardiovascular adverse events following COVID-19 vaccination, including acute myocardial infarction (AMI); however, evidence regarding causal associations remains contradictory.
OBJECTIVE: To determine whether a causal association exists between nucleic acid-based COVID-19 vaccines (mRNA and DNA platforms) and AMI in adults aged 18-80 years.
METHODS: A systematic review following PRISMA 2020 guidelines searched PubMed, Cochrane CENTRAL, and Google Scholar for studies evaluating mRNA vaccines (Pfizer-BioNTech, Moderna) and DNA-based vaccines (AstraZeneca) with AMI as primary outcome. Quality assessment used the Newcastle-Ottawa Scale.
RESULTS: Twenty-nine studies from 16 countries were analyzed, including 14 population-based cohorts (>142.5 million individuals, >130,000 AMI cases), 12 case reports (54 AMI events), and three pharmacovigilance studies. Large cohorts demonstrated no significant association between nucleic acid vaccines and AMI. A Swedish study (8.1 million) showed protective effects (HR: 0.81; 95% CI: 0.74-0.89 for third dose). A Malaysian study (22.2 million) found no significant increase after BNT162b2 (dose 1 IRR: 0.97; dose 2 IRR: 1.08) or ChAdOx1 (dose 1 IRR: 1.02; dose 2 IRR: 1.58). Case reports documented temporal associations but had substantial methodological limitations. Quality assessment revealed low-to-moderate bias in population studies but high bias in case reports and pharmacovigilance data.
CONCLUSIONS: High-quality population-based evidence from 14 independent cohorts does not support a causal association between nucleic acid-based COVID-19 vaccines and AMI. Case reports lack the methodological rigor to establish causality. The documented protective effects after booster doses and consistency across diverse populations demonstrate vaccine cardiovascular safety, supporting continued vaccination policies.}, }
@article {pmid41769275, year = {2025}, author = {Mohammad, K and Mohaddeseh, B and Amir Hossein, M}, title = {COVID-19 and ACE2 Receptor in Different Tissues: From Pathophysiologic Function To Therapeutic Responses.}, journal = {Archives of Razi Institute}, volume = {80}, number = {3}, pages = {591-604}, pmid = {41769275}, issn = {2008-9872}, mesh = {Humans ; *Angiotensin-Converting Enzyme 2/metabolism ; *COVID-19 ; *SARS-CoV-2/physiology ; *Receptors, Virus/metabolism ; *Peptidyl-Dipeptidase A/metabolism ; Pandemics ; Animals ; *Betacoronavirus/physiology ; Virus Internalization ; }, abstract = {SARS-CoV-2, the virus responsible for COVID-19, is characterized by its high transmission rate, leading to a global pandemic. Millions of people have lost their lives due to the infection caused by this virus. The ability of the virus to spread rapidly and infect large numbers of people has highlighted the need to understand its mechanisms of infection. Angiotensin-converting enzyme 2 (ACE2) is an essential receptor for SARS-CoV-2 cell entry. SARS-CoV-2 exhibits a high affinity to this receptor and shows high infectivity, leading to an explosive increase in patients infected with COVID-19. ACE2 is the carboxypeptidase homolog of ACE, which produces angiotensin II, the main active peptide of the renin-angiotensin system. From a pathophysiological perspective, this system regulates vital processes across different organs. Additionally, ACE2 enzyme activity could play a protective role against acute respiratory distress syndrome (ARDS) caused by viral pneumonia. Upon infection, SARS-CoV-2 downregulates the expression of ACE2, which is possibly related to the pathogenesis of ARDS. Since this receptor is present in various other tissues such as the heart, kidney, gastrointestinal tract, reproductive system, and sensory organs, it may contribute to pathological symptoms in these organs. Thus, ACE2 is not only a receptor for SARS-CoV-2 but may also play a crucial role in various aspects of the pathogenesis of COVID-19 and potential post-COVID-19 syndromes. Administering ACE2 could competitively bind to SARS-CoV, thereby reducing viral spike protein from attaching to transmembrane ACE2 and consequently reducing viral cell entry into cells and COVID-19 symptoms. In this review, we first examine the role of ACE2 in the pathophysiology of SARS-CoV-2 across different tissues and propose treatment strategies for COVID-19 that involve ACE2.}, }
@article {pmid41769292, year = {2025}, author = {Abdol Ghaffar, E and Zeliha, S and Hamdia Yousif, I and Elifsena Canan, AA and Shahid, A}, title = {Next-Generation Vaccines and Antiviral Platforms: Molecular Advancements in the Struggle against Emerging Zoonotic and Viral Diseases.}, journal = {Archives of Razi Institute}, volume = {80}, number = {3}, pages = {555-568}, pmid = {41769292}, issn = {2008-9872}, mesh = {Animals ; Humans ; *Viral Vaccines/immunology ; *Virus Diseases/prevention & control/virology ; *Zoonoses/prevention & control/virology ; *Viral Zoonoses/prevention & control/virology ; Antiviral Agents ; *Communicable Diseases, Emerging/prevention & control/virology ; Vaccine Development ; }, abstract = {The ongoing occurrence of zoonotic and viral diseases, such as SARS-CoV-2, H5N1, Nipah, and Ebola viruses, underscores the requirement for transformative innovations in vaccine and antiviral development. Classic vaccine technologies like inactivated or live-attenuated virus products have lengthy production cycles, cold-chain storage, and are poorly suited to reacting rapidly to emerging threats This review synthesizes the most recent advances in molecular virology, immunogen design, and biotechnology that will propel the next generation of prevention and treatment tools. We begin with the genomic and structural characteristics of high-consequence zoonotic viruses, highlighting the molecular determinants for virulence, host switching, and immune evasion. The review then provides a comparative review of the emerging vaccine platforms such as mRNA, DNA, viral vector, subunit, and inactivated vaccines based on design rationale, delivery systems, immunogenicity profiles, and global rollouts. At the same time, molecular mechanisms of antiviral drugs acting against viral polymerases, proteases, and entry mechanisms are discussed, and the new challenge of resistance evolution is emphasized. We also highlight recently developed molecular diagnostic tools like CRISPR-based tools, nanopore sequencing, and isothermal amplification technologies that are transforming real-time pathogen diagnosis in veterinary and human medicine. Last, the One Health aspect is introduced through veterinary applications of vaccines to zoonotic spillover prevention and antimicrobial resistance. In conclusion, this review gives a vision-orientated account of molecular strategies that bring together human and animal medicine to combat future pandemics. Our aggregated tables and visualizations are an asset for researchers, clinicians, and policymakers interested in the improvement of epidemic preparedness and cross-species disease surveillance.}, }
@article {pmid41769697, year = {2026}, author = {Rouhana El Feghali, Y and Rabih, L and Abdul Khalek, J and Arabi, M}, title = {Remdesivir in COVID-19: pros and cons.}, journal = {Frontiers in pharmacology}, volume = {17}, number = {}, pages = {1731244}, pmid = {41769697}, issn = {1663-9812}, abstract = {BACKGROUND: Beginning in late 2019, the COVID-19 pandemic caused by SARS-CoV-2 rapidly evolved into a global health crisis. High rates of severe illness, hospitalizations, and long-term complications highlighted an urgent need for effective therapeutic agents. This necessity drove unprecedented efforts in drug discovery and repurposing. Remdesivir, developed by Gilead Sciences in 2009, was initially designed as a broad-spectrum antiviral targeting Ebola virus disease. Following observations of broad antiviral activity against coronaviruses, remdesivir was granted Emergency Use Authorization by the FDA in May 2020 for hospitalized patients with severe COVID-19. The FDA subsequently issued full approval in October 2020, expanding remdesivir's use to hospitalized adults and pediatric patients aged 12 years or older and weighing at least 40 kg.
AIM: This paper aims to assess the advantages and limitations of remdesivir in the treatment of COVID-19, drawing on evidence from clinical trials and examining its application in patients with congenital heart disease (CHD).
METHODS: The literature review was conducted until September 2025 using PubMed and Google Scholar searching for recent clinical trials in addition to relevant reviews.
RESULTS AND CONCLUSION: Remdesivir has been shown to shorten recovery time and lower mortality risk, particularly in patients at an early stage of infection with mild disease severity or requiring oxygen support. Although early guidelines advised against its use in patients with severe renal impairment, subsequent studies confirmed its safety prompting an FDA label update to allow use regardless of renal function. While some trials reported limited effects, the overall body of evidence supports remdesivir's role in improving clinical outcomes in COVID-19 treatment. In patients with CHD, the uncertain effects of both COVID-19 and remdesivir highlight a key research gap, emphasizing the need to refine existing therapies while following National Institutes of Health (NIH) treatment guidelines.}, }
@article {pmid41769699, year = {2026}, author = {Wan, C and Liu, X and Xu, Y and Kang, L and Yu, X and Wang, M and Zhao, M and Li, X and Chen, Z and Wu, J and Liu, L and Xu, X}, title = {Polydatin in respiratory diseases: multi-target mechanisms and therapeutic potential.}, journal = {Frontiers in pharmacology}, volume = {17}, number = {}, pages = {1752467}, pmid = {41769699}, issn = {1663-9812}, abstract = {Respiratory diseases constitute a heterogeneous group of disorders that primarily involve the lungs. Driven by worsening air pollution, tobacco use, occupational exposures, the COVID-19 pandemic, and population aging, they show persistently high incidence with rising mortality and disability, posing a major global public-health challenge. Current pharmacotherapies-principally antibiotics, glucocorticoids, β2-adrenoceptor agonists, and antiviral agents-yield only limited benefit and are constrained by adverse reactions such as gastrointestinal disturbances and hepatorenal toxicity, alongside the escalating problem of drug resistance. The development of safer and more effective therapeutics is therefore of considerable clinical and socioeconomic importance. Plant-derived natural products have attracted increasing interest in the management of respiratory diseases. Polydatin (resveratrol-3-O-β-D-glucoside; also known as piceid; PD) is a stilbenoid polyphenol of plant origin that is widely distributed in Polygonum cuspidatum (Japanese knotweed), Polygonum multiflorum, grapes, peanuts, mulberries, blueberries, and rhubarb. Accumulating evidence indicates that PD exerts anti-inflammatory, antioxidant, antimicrobial, immunomodulatory, and metabolic-regulatory activities and shows potential therapeutic value in pulmonary fibrosis, acute lung injury/acute respiratory distress syndrome, pneumonia, lung cancer, and asthma. This review provides a comprehensive synthesis of the multi-target and multi-pathway mechanisms by which PD acts against respiratory diseases, offering a mechanistic rationale and evidence base to support its clinical development.}, }
@article {pmid41771782, year = {2026}, author = {DiFrancesco, R and Wood, TD and Cha, R and Hochreiter, JS and Rosenkranz, SL and Farhad, M and Whitson, KR and Gould, CE and Hill, LE and Hale, LL and Lindhorst, PH and Ghazal, D and Taylor, CR and Quraishi, M and Siminski, SM and Cramer, Y and Sprenger, HL and Morse, GD}, title = {Clinical Pharmacology Quality Assurance Program for Global HIV and Co-Infection Drug Development.}, journal = {Clinical pharmacology and therapeutics}, volume = {119}, number = {5}, pages = {1205-1215}, pmid = {41771782}, issn = {1532-6535}, mesh = {Humans ; *HIV Infections/drug therapy ; *Pharmacology, Clinical/standards ; *Coinfection/drug therapy ; *Drug Development/standards/methods ; United States ; Quality Control ; *Anti-HIV Agents/therapeutic use ; *Quality Assurance, Health Care ; }, abstract = {When the acquired immunodeficiency syndrome emerged in the 1980s, the United States National Institutes of Health established research networks to conduct clinical trials with the pharmaceutical industry to identify effective antiretroviral therapeutics. The clinical trials networks included laboratory centers with academic pharmacology laboratories measuring drug concentrations to allow for the estimation of pharmacokinetic parameters and correlation with pharmacodynamic outcomes. Adoption of comprehensive quality assurance initiatives was key to ensuring the integrity of pharmacology sampling and laboratory data provided by clinical sites and laboratories. Subsequently, this infrastructure facilitated rapid responses to co-infection pathogens such as hepatitis C virus, Mycobacterium tuberculosis, and severe acute respiratory syndrome coronavirus 2. In 2008, the Center for Integrated Global Biomedical Sciences at the University at Buffalo was awarded the initial National Institute of Allergy and Infectious Diseases contract for the Clinical Pharmacology Quality Assurance Program. Since 2015, over 4,500 tutorial certificates for research staff and laboratories have been awarded on topics including the conduct of clinical pharmacology research protocols and bioanalytical method validation for antiretroviral assays. A bioanalytical peer review program for ensuring the quality of the assay methods has approved over 350 assays for > 100 analytes in 21 human biological matrices. An ISO-17043 accredited external proficiency testing program has completed 35 rounds for 15 analytes. Also, a laboratory assessment program was established that utilizes international laboratory and regulatory standards, and multiple mechanisms for training, assistance and guidance to participants. This report summarizes the development of the CPQA program over the last decade.}, }
@article {pmid41772834, year = {2026}, author = {Kucharska, K and Ali, AH and Moriarty, F}, title = {Exploring perspectives of interest-holders on the use of health and genomic data from deceased participants in research: An updated systematic review.}, journal = {Journal of genetic counseling}, volume = {35}, number = {2}, pages = {e70186}, pmid = {41772834}, issn = {1573-3599}, mesh = {Humans ; *Information Dissemination ; *Genomics ; COVID-19/epidemiology ; *Research Subjects/psychology ; }, abstract = {The use of research biobanks and databases often involves prolonged storage of data, meaning that an increasing amount of deceased participants' data is being used in research. Research participants are not always informed of the intent to continue using their data post-mortem, and using such data affects the privacy of decedents and their surviving relatives. It is therefore important to assess the perspectives of interest-holders in this respect, considering the rapid progress of big-data technologies, new privacy regulations in the EU and unprecedented data sharing during the COVID-19 pandemic. This paper aimed to update a systematic review by Bak et al., to investigate the views of interest-holders on post-mortem data sharing in research. This systematic review followed the same search strategy and inclusion criteria as the previous review, focusing on new empirical evidence on the views of interest-holders regarding the post-mortem sharing or re-use of genetic or health data of research participants, from studies published in 2019-2025. It is reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRIMSA) statement. Findings of included studies were narratively synthesized. The updated systematic review identified seven studies involving 2151 participants, which were of high quality. The main themes of these studies related to perceived acceptability of post-mortem data sharing, aspects of consent (including broad consent), sharing clinical findings with relatives, and barriers and facilitators to data sharing. The findings illustrate that post-mortem genetic and health-related data use remains a relatively under-explored subject, with evident gaps in legislation and guidance.}, }
@article {pmid41773392, year = {2026}, author = {Muzamhindo, DN and Chironda, G and Tsoka-Gwegweni, JM}, title = {Implementation of malaria control programmes during the COVID-19 pandemic in the Southern African Development Community Elimination 8 countries: A scoping review.}, journal = {African journal of primary health care & family medicine}, volume = {18}, number = {1}, pages = {e1-e12}, pmid = {41773392}, issn = {2071-2936}, mesh = {Humans ; *COVID-19/epidemiology ; *Malaria/prevention & control/epidemiology ; *Pandemics ; Africa, Southern/epidemiology ; SARS-CoV-2 ; *Disease Eradication ; Evidence Gaps ; }, abstract = {BACKGROUND: Malaria is one of the communicable diseases affecting the whole world. The World Health Organization (WHO) African Region is the most affected, with the Southern African Development Community (SADC) and the Malaria Elimination 8 (E8) countries accounting for 90% and 95% of the cases, respectively. The WHO tasked the SADC Malaria E8 countries to eliminate malaria by 2030, yet the COVID-19 pandemic response disrupted health programmes.
AIM: The review aims to map and synthesise the evidence on malaria control programmes during the COVID-19 pandemic in the SADC E8 countries to identify gaps, inform policy, enhance planning for future pandemics and promote the attainment of the SADC 2030 Malaria E8 goal.
METHOD: The reviewers conducted this review using the Joanna Briggs Institute (JBI) methodology. The population, concept and context (PCC) guided inclusion and exclusion criteria. Information relevant to the review questions was extracted using data extraction tools.
RESULTS: Of the 658 articles retrieved, only 7 met the inclusion criteria. Half of the publications were done in 2021, and nothing was published in 2020. The publishers were predominantly public health experts.
CONCLUSION: There is limited research on the malaria programmes during the COVID-19 pandemic in the Malaria E8 countries.Contribution: The review brings out the need for research on the topic, policies that promote the continuation of malaria programmes during a pandemic and the employment of coping strategies.}, }
@article {pmid41773597, year = {2026}, author = {Alsulami, AS and Al-Kuraishy, HM and Waheeb, TS and El-Saber Batiha, G}, title = {Colchicine in COVID-19: Mechanistic Insights and Clinical Uncertainties.}, journal = {Reviews in medical virology}, volume = {36}, number = {2}, pages = {e70126}, doi = {10.1002/rmv.70126}, pmid = {41773597}, issn = {1099-1654}, mesh = {Humans ; *Colchicine/therapeutic use/adverse effects ; COVID-19/immunology/virology ; SARS-CoV-2/drug effects ; *COVID-19 Drug Treatment ; Autophagy/drug effects ; Oxidative Stress/drug effects ; *Coronavirus Infections/drug therapy/immunology ; }, abstract = {Coronavirus Disease 2019 (COVID-19) which caused by the novel coronavirus SARS-CoV-2 has been emerged as a global health crisis characterised by severe immune dysregulation and inflammatory complications. The hyper-activation of the immune response in COVID-19 patients is associated with disease progression and severity. As a result, immunomodulatory therapies such as colchicine have been suggested to control exaggerated immune response in COVID-19. However, the therapeutic role of colchicine in COVID-19 remains a subject of debate due to conflicting evidence. This review highlights both the beneficial and potentially harmful effects of colchicine in the context of COVID-19. Notably, the therapeutic advantages of colchicine are linked to the suppression of immune cell over-activation, attenuation of oxidative stress, and prevention of thrombo-inflammatory events. Conversely, colchicine may exert negative effects by disrupting microtubule function, impairing autophagic processes, and inducing mitochondrial dysfunction in COVID-19. In conclusion, the overall clinical impact of colchicine plays a critical role in the management of COVID-19. However, its dual effects underscore the need for well-designed clinical studies to confirm its safety and efficacy in COVID-19 management.}, }
@article {pmid41774181, year = {2026}, author = {Sundaram, K and Rathinam, S}, title = {Advances in functional transcriptome analysis of Mycobacterium tuberculosis: a review.}, journal = {Molecular genetics and genomics : MGG}, volume = {301}, number = {1}, pages = {}, pmid = {41774181}, issn = {1617-4623}, mesh = {*Mycobacterium tuberculosis/genetics/immunology/pathogenicity ; Humans ; *Gene Expression Profiling/methods ; MicroRNAs/genetics ; RNA, Messenger/genetics ; *Transcriptome ; *Tuberculosis/genetics/microbiology/immunology ; RNA, Circular/genetics ; Animals ; RNA, Competitive Endogenous ; RNA, Long Noncoding/genetics ; }, abstract = {Drug-resistant tuberculosis poses a significant global challenge necessitating the prompt advancement of novel therapeutic options. Nonetheless, disease prognosis is contingent upon multiple factors. mRNA and other small RNAs are essential for gene regulation and disease progression. Additionally, they are essential for the advancement of TB mRNA therapies. The review aims to evaluate the functions of mRNA and various small RNAs, including lncRNA, miRNA, circRNA, and ceRNA, as interconnected components within the mRNA-miRNA-circRNA axis in Mycobacterium tuberculosis. In this context, the analysis of various genes expressed during transcription is essential; however, the TB group’s mRNA expression levels of the CXCL10, CXCL9, IL1B, and PLA2G2D genes were substantially higher compared to the control group. In addition, EspC, MetE, and PPE15 increased IgG levels. Besides, the inadequate IgG responses to m-ESAT6 and m-EsxI present a noteworthy research opportunity. Evidence that neutralizing antibodies provide protection against viral infections targeted by mRNA vaccines during the COVID-19 pandemic supports this research. mRNA-based vaccination analogues offer potential therapeutic advantages following BCG administration. Mycobacterium avium and Mycobacterium tuberculosis are efficiently inhibited by the mRNA therapy, namely the repRNA-ID91/ID91 + GLA-SE vaccination, which elicits humoral and cellular immune responses. Therefore, the therapeutic use of mRNA, as demonstrated by numerous studies, suggests its potential as an efficacious therapeutic vaccine subsequent to BCG treatment. Also, investigating the ceRNA network and the relationships among miRNA, circRNA, lncRNA, and mRNA in TB study will improve the management of this infection.}, }
@article {pmid41774375, year = {2026}, author = {He, S and Ibrahim, NA and Kang, MS}, title = {Evaluating the Multilingual Accessibility of Health Websites for Immigrants and Ethnic Minorities: A Methodological Systematic Review.}, journal = {Journal of immigrant and minority health}, volume = {}, number = {}, pages = {}, pmid = {41774375}, issn = {1557-1920}, abstract = {Offering multilingual options on health websites is crucial, as it facilitates access to online health information for immigrants and ethnic minorities. In response to the necessity of research in this field and the growing scholarly interest, this study reviewed recent empirical studies on the multilingual accessibility of health websites to offer methodological insights into this research field while highlighting existing research gaps. Three databases, namely, Web of Science, PubMed, and CINAHL, were searched for studies published between 1 March 2014 and 1 March 2024. Fifty-three eligible studies were included. Data were extracted from nine dimensions and synthesized to address four research questions: conceptual orientations, research gaps, research pathways, and website selection methods. The data synthesis revealed that: (i) research gaps exist, particularly with COVID-19 as the predominant health topic; (ii) the reviewed studies were geographically focused on only 12 regions, with the United States receiving the most extensive attention (54.5%); (iii) only 16 studies (30.2%) specifically targeted immigrants or ethnic minorities; (iv) only five different languages appeared as source languages of the studied websites, and 86.8% of studies focused on websites originally prepared in English; and (v) common criteria for evaluating multilingual accessibility included the presence of multilingual options, languages offered, translation methods, and the quantity of multilingual information. This review offers insights into the research gaps and methodologies for evaluating the multilingual accessibility of health websites. Future studies could focus on empirical research across diverse health websites, regions, and language pairs. A ready-to-use checklist of criteria for evaluating multilingual accessibility is needed.}, }
@article {pmid41774995, year = {2026}, author = {Sahu, JK and Coan, AC and Chan, J and Jocic-Jakubi, B and Dhir, P and Niveditha, M and Devi, N and Singh, MB and Shafer, PO and Hsiang-Yu, Y and Ali, A and Yoo, JY and Zelano, J and Sarfo, FS and Pablo Sebastián, F and Gwer, SA and Rivera, Y and Kissani, N and Caraballo, RH and Bansal, D and Trinka, E and Cross, JH and Samia, P}, title = {Applications and impact of telemedicine for persons with epilepsy: a scoping review.}, journal = {Seizure}, volume = {136}, number = {}, pages = {107-116}, doi = {10.1016/j.seizure.2026.01.016}, pmid = {41774995}, issn = {1532-2688}, mesh = {Humans ; *Epilepsy/therapy/diagnosis ; *Telemedicine/economics ; COVID-19 ; Cost-Benefit Analysis ; }, abstract = {Telemedicine is emerging as a promising strategy to overcome geographical and specialist access constraints in epilepsy care. This scoping review, conducted by the International League Against Epilepsy (ILAE) Telemedicine Task Force, aimed to map the existing evidence on the applications, effectiveness, and challenges of telemedicine in epilepsy management. A systematic search of PubMed, Embase, and Web of Science, conducted up to May 2025 without language restrictions, identified original studies evaluating telemedicine for epilepsy diagnosis, management, or follow-up. Data were extracted and synthesized narratively. Of the 201 included studies, approximately 70% originated from high-income settings. Evidence demonstrated diagnostic accuracy ranging from 75% to 97%, cost savings of about US$30 per consultation, and high satisfaction levels among patients (87-95%) and physicians (74-94%). Telemedicine also reduced no-shows by 45%, ensuring continuity of care during healthcare disruptions such as the COVID-19 pandemic. Overall, telemedicine is a feasible adjunct to conventional epilepsy care, enhancing access, accuracy, and cost-effectiveness. To substantiate its role in diverse settings, well-designed randomized controlled trials are needed to evaluate long-term outcomes, equity, and sustainability.}, }
@article {pmid41775098, year = {2026}, author = {Zhang, Y and Di, S and Kabir, J and Kaburu, FM and Yang, X and Kudiza, A and Tong, C and Zhu, P and Intizar, M and Jiang, J and McDonnell, D and Bentley, BL and Cheshmehzangi, A and Ahmad, J and Šegalo, S and Nie, JB and da Veiga, CP and Xiang, YT and Su, Z}, title = {Mental health challenges in older women: A systematic review of post-COVID technology-based interventions.}, journal = {Asian journal of psychiatry}, volume = {118}, number = {}, pages = {104906}, doi = {10.1016/j.ajp.2026.104906}, pmid = {41775098}, issn = {1876-2026}, mesh = {Humans ; Female ; *COVID-19 ; Aged ; Pandemics ; *Mental Health ; Digital Health ; *Mental Disorders/therapy ; *Coronavirus Infections ; *Pneumonia, Viral ; Randomized Controlled Trials as Topic ; *Mental Health Services ; *Women's Health ; }, abstract = {BACKGROUND: Older women face disproportionate health challenges, exacerbated by multiple unprecedented challenges such as global aging, disease outbreaks, and geopolitical as well as technological upheavals. This study examines technology-based mental health interventions for this demographic, aiming to inform policy.
METHODS: A systematic review of randomized controlled trials (RCTs) targeting older women's mental health post-COVID-19 was conducted using databases like Web of Science and PubMed, adhering to PRISMA guidelines and registered with PROSPERO (CRD42020194003).
RESULTS: A total of 3463 articles were screened for eligibility, among which, 17 RCTs met the inclusion criteria. The review results show that 17 RCTs were conducted in middle-income and high-income countries. Fifteen RCTs generated statistically significant outcomes and reported specific aspects of their interventions to improve the mental health of older women.
CONCLUSION: Technology-based interventions show promise for improving older women's mental health. Policy recommendations include establishing comprehensive mental health centers, implementing universal healthcare, promoting digital literacy, and strengthening public awareness campaigns.}, }
@article {pmid41776570, year = {2026}, author = {Sakai, K and Yoshida, T and Chiba, T and Yamaga, M and Takemoto, M}, title = {Pitfalls in the management of undiagnosed secondary adrenal insufficiency: a case report and review of the literature.}, journal = {Journal of medical case reports}, volume = {20}, number = {1}, pages = {}, pmid = {41776570}, issn = {1752-1947}, mesh = {Humans ; Male ; Middle Aged ; *Adrenal Insufficiency/diagnosis/drug therapy/complications ; *Hydrocortisone/administration & dosage/therapeutic use/adverse effects ; *Hyponatremia/etiology ; Fluid Therapy/methods ; Treatment Outcome ; Refeeding Syndrome ; }, abstract = {BACKGROUND: Prolonged cortisol deficiency in undiagnosed central adrenal insufficiency can lead to severe hypotonic hyponatremia due to inappropriate vasopressin secretion and malnutrition caused by inhibition of orexigenic signals. Notably, although hydrocortisone-induced recovery can trigger osmotic demyelination and refeeding syndromes, no previous report has simultaneously described these complications and documented significant decreases in vasopressin levels, along with changes in urine osmolality and volume before and after hydrocortisone administration.
CASE PRESENTATION: A 48-year-old Japanese man presented with fever, severe nausea, and oliguria and was brought to our hospital by ambulance due to impaired consciousness. Physical examination and laboratory analysis showed severe euvolemic hypotonic hyponatremia and low-normal glucose value. Low adrenocorticotrophic hormone and cortisol levels, undetectable 24-hour urinary free cortisol, and minimal response to corticotropin-releasing hormone indicated secondary adrenal insufficiency. Magnetic resonance imaging revealed slight pituitary swelling, suggesting hypophysitis. Treatment started with a 200 mg hydrocortisone infusion over 24 hours, and 6 hours later, the patient experienced a marked decrease in vasopressin levels, accompanied by significant dilute urine excretion and an excessively rapid increase in blood sodium levels, which posed a risk of osmotic demyelination. Rehydration with 5% dextrose and desmopressin was used to prevent this risk. Carefully adjusting plasma osmolality successfully prevented osmotic demyelination syndrome. Hydrocortisone replacement significantly increased the patient's appetite, leading to refeeding hypophosphatemia and disorientation; however, these resolved with intravenous sodium phosphate replacement. The patient developed a fever on day 12 and was confirmed to have coronavirus disease 2019. The fever subsided by day 16 with molnupiravir treatment and hydrocortisone dose adjustment, and he was discharged on day 23 with a maintenance dose of hydrocortisone.
CONCLUSION: Careful management is required while administering hydrocortisone in patients with undiagnosed adrenal insufficiency, as it may cause osmotic demyelination syndrome or refeeding syndrome due to sudden changes in blood electrolytes.}, }
@article {pmid41776637, year = {2026}, author = {Wang, L and Wang, F and Wang, X and Chen, X and Li, C and Shan, K and Zhou, H and Wu, G and Xu, Z and Kong, X and Wei, P}, title = {The lung-brain axis: elucidating the mechanisms of pulmonary-driven neurological disorders.}, journal = {Journal of neuroinflammation}, volume = {23}, number = {1}, pages = {}, pmid = {41776637}, issn = {1742-2094}, support = {22201164//National Natural Science Foundation of China/ ; 82571352//National Natural Science Foundation of China/ ; QDZDZK-2025064//the Qingdao Key Health Discipline Development Fund/ ; ZR2024QH041//the Natural Science Foundation of Shandong Province/ ; QDKY2023ZD02//the Scientific Research Foundation of Qilu Hospital of Shandong University/ ; 2024M761822//China Postdoctoral Science Foundation/ ; }, mesh = {Humans ; *Brain/metabolism/physiopathology ; *Lung Diseases/complications/physiopathology/metabolism ; *Nervous System Diseases/physiopathology/metabolism/etiology ; Animals ; *Lung/metabolism/physiopathology ; Blood-Brain Barrier/metabolism ; }, abstract = {The brain and lungs represent two of the most vital organs in the human body. The conceptualization of the lung-brain axis has advanced our understanding of the bidirectional communication between the respiratory and central nervous systems. Accumulating evidence indicates that pulmonary diseases, including chronic obstructive pulmonary disease, asthma, acute respiratory distress syndrome and infections such as bacterial pneumonia, influenza and Coronavirus Disease 2019, along with airborne environmental exposures, constitute significant risk factors for various neurological disorders. The lung-brain axis is primarily mediated by microbial, immune, neural, metabolic and hormonal pathways. These mechanisms contribute to the disruption of blood-brain barrier integrity, the activation of neuroglial cells and the dysfunction of the cerebrovascular system, ultimately causing neuronal injury and diverse neurological conditions. Environmental factors, notably airborne particulate matter and chemical pollutants, further amplify the crosstalk among these mechanisms, extending the neurological risk. Here, we summarize the current knowledge regarding the association between pulmonary dysfunction and the development and progression of neurodegenerative diseases (such as Alzheimer’s disease and Parkinson’s disease), stroke, anxiety/depression, epilepsy, and migraine. Additionally, potential therapeutic strategies targeting the lung–brain axis are discussed to foster further research in this emerging field. Elucidating the complex interactions within the lung–brain axis will not only deepen our understanding of the shared pathophysiological mechanisms but also open novel avenues for the early diagnosis, prevention, and treatment of related neurological diseases.}, }
@article {pmid41776658, year = {2026}, author = {Oh, E and Mueller-Alcazar, A and Kottysch, S and Groth, N and Mahlke, CI}, title = {Effects of digital communication tools on patients, family members and health care professionals in adult ICUs: a mixed-methods systematic review.}, journal = {Critical care (London, England)}, volume = {30}, number = {1}, pages = {}, pmid = {41776658}, issn = {1466-609X}, mesh = {Humans ; *Intensive Care Units/organization & administration ; *Family/psychology ; *COVID-19/epidemiology/psychology ; *Health Personnel/psychology ; *Communication ; Digital Media ; Digital Health ; SARS-CoV-2 ; Adult ; }, abstract = {OBJECTIVE: The COVID-19 pandemic accelerated the rapid adoption of digital communication tools in clinical settings. This review aims to identify, synthesize, and critically appraise evidence on digital communication methods or interventions in adult intensive care units (ICUs) intended to promote the psychological and physical well-being of patients and their families, and to explore the associated impacts on healthcare professionals. DESIGN: Mixed-methods systematic review (MMSR). INFORMATION SOURCES: A systematic search was conducted in MEDLINE, CINAHL, PsycINFO, PSYNDEX, the Cochrane Library, and PROSPERO from 2010 to September 2023 and updated to July 2025. Reference lists and trial registries were screened for additional and ongoing studies. METHODS: Following the JBI convergent integrated approach and PRISMA 2020 guidelines, quantitative data from randomized controlled trials (RCTs) were pooled in random-effects meta-analyses for family satisfaction and patient anxiety. Numerical findings from non-RCTs were qualitized and synthesized narratively. The qualitative data were subjected to thematic synthesis. All results were integrated into a single line of argument. RESULTS: Fifty-four studies were included, comprising 22 qualitative, 25 quantitative, and 7 mixed-methods designs from 19 countries; 92% were conducted during the COVID-19 pandemic. Over half of the studies examined virtual visiting or video communication (57%, n = 31), whereas the others evaluated structured patient-status updates, family support teams, dynamic interaction platforms, or interventions for mechanically ventilated or delirious patients. Methodological quality was moderate to high in 96% of the studies. The meta-analysis of three RCTs demonstrated a moderate to strong improvement in family satisfaction (standardized mean difference = 0.76, 95% CI 0.45–1.06, p < .001) with virtual communication compared with usual care. Pooled effects on patient anxiety (mean difference = -2.19, 95% CI -4.62 to 0.23) and depression were nonsignificant, although qualitative findings consistently described perceived reductions in anxiety, loneliness, and emotional distress. Across study types, digital communication enhanced information sharing, supported shared decision-making, and increased family involvement. Key barriers included technical difficulties, privacy concerns, and staff workload, whereas facilitators comprised user-friendly technology, structured preparation, and continuity through a dedicated contact person. CONCLUSIONS: Digital communication in adult ICUs is feasible, acceptable, and beneficial for patients, relatives, and healthcare professionals. Virtual tools improve family satisfaction and complement patient- and family-centred care, but sustainable integration requires clear protocols, staff training, and ethical frameworks beyond pandemic conditions.}, }
@article {pmid41776692, year = {2026}, author = {Muhetaer, Y and Zhang, SM and Moming, A and Liu, K and Zhong, M}, title = {Prediction of high-flow nasal cannula failure in critically ill patients: a narrative review.}, journal = {Journal of intensive care}, volume = {14}, number = {1}, pages = {}, pmid = {41776692}, issn = {2052-0492}, abstract = {High-flow nasal cannula (HFNC) therapy is widely used for respiratory support in critically ill patients, offering benefits such as improved oxygenation and reduced respiratory rate. However, HFNC failure can lead to adverse outcomes, including increased mortality. This narrative review examines predictive factors and indices for HFNC failure, including respiratory rate, P/F and S/F ratios, the ROX index, HACOR score, and emerging indices, such as VOX and FOX. Among these, the ROX index and HACOR score currently provide the most robust predictive value, whereas newer tools such as VOX and FOX require further validation. The ROX index, combining oxygenation and respiratory rate, has shown significant predictive value, particularly in COVID-19 patients, though its thresholds and timing for assessment remain variable. Modified versions of the ROX index, incorporating heart rate and PaO2, have improved predictive accuracy. The HACOR score, initially developed for non-invasive ventilation, also predicts HFNC failure but may be less discriminative in emergency settings. Emerging indices such as VOX and FOX offer novel approaches but face clinical application challenges due to measurement complexities. Risk stratification models, scoring systems, ultrasound techniques, and machine learning methods show promise but require further validation. This review highlights the importance of integrating multiple predictive tools and tailoring assessments to individual patient conditions. Future strategies must also account for nursing quality variables to enhance prediction accuracy in real-world settings. Comprehensive training for healthcare professionals and future multicenter, large-scale studies is essential to refine these predictive strategies and improve patient care quality.}, }
@article {pmid41777372, year = {2025}, author = {Akazili, J and Anaseba, D and Chatio, S and Amenah, MA and Achala, DM and Beshah, SA and Nwosu, CO and Masuka, N and Tlhakanelo, JT and Chikezie, I and Adote, ENA and Muriithi, GN and Ataguba, JE}, title = {Factors affecting equitable access and uptake of COVID-19 vaccines in Ghana: a scoping review.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1610765}, pmid = {41777372}, issn = {2296-2565}, mesh = {Humans ; Ghana/epidemiology ; *COVID-19 Vaccines/administration & dosage/supply & distribution ; *COVID-19/prevention & control/epidemiology ; *Health Services Accessibility ; *Vaccination/statistics & numerical data ; Vaccination Hesitancy ; SARS-CoV-2 ; }, abstract = {BACKGROUND: The coronavirus disease (COVID-19) emerged as one of the most serious pandemics that impacted health systems and world economies. Vaccination against the pandemic was considered as an effective tool for the prevention and containment of the virus. Following the outbreak of the Coronavirus pandemic, efforts were made to enhance procurement and distribution of vaccines across countries with the view to containing the pandemic. However, evidence suggested that several factors hindered access, acceptance and use of the COVID-19 vaccines across the globe. This scoping review, thus, explored factors that influenced access, acceptance and use of the COVID-19 vaccines among Ghanaians and strategies that were needed to improve vaccine uptake especially for the vulnerable populations.
METHODS: We adopted the five-stage analytic framework developed by Arksey and O'Malley to map existing literature on what has been done and documented on the subject. We searched various electronic databases such as PubMed, Cochrane, African journal online (AJOL), and Google Scholar for relevant articles for the review.
RESULTS: In all, fifty-four (54) articles retrieved met our eligibility criteria and were included in this review. Health system factors including untimely payment of vaccinators allowances, shortfalls in logistics and vaccines, lack of transport and long queues at vaccination centers affected access and uptake of the COVID-19 vaccines in Ghana. Additionally, beliefs and perceptions including myths, misconceptions and misinformation around the virus and the vaccines affected people's decision-making to participate in the vaccination exercise. Also, negative reportage through social media platforms created mistrust in COVID-19 vaccine intensions.
CONCLUSION: Even though Ghana made significant progress in addressing the Coronavirus pandemic, hesitancy factors played a crucial role in diminishing Ghana's effort towards meeting global targets in containing the virus and reducing its impact. Strengthening Ghana's public health preparedness and response strategy, through a community-based approach and multi-stakeholder engagement, could improve immunization programs and vaccines uptake in addressing future pandemics.}, }
@article {pmid41777703, year = {2026}, author = {Ekanayake Mudiyanselage, D and Ouyang, CE and Jin, RD and Velmurugan, S and Jiang, Y and Sun, J and Ma, D}, title = {Vitamin D deficiency and disease conditions relevant to: Orthopaedic translation.}, journal = {Journal of orthopaedic translation}, volume = {57}, number = {}, pages = {101061}, pmid = {41777703}, issn = {2214-031X}, abstract = {UNLABELLED: Vitamin D, traditionally known for its role in calcium-phosphate homeostasis and bone health, is now recognised as a pleiotropic hormone with critical effects on multiple physiological processes. It exists primarily as ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3), which are biologically inactive until undergoing a sequential hydroxylation in the liver to form 25-hydroxyvitamin D (calcidiol), and subsequently in kidney to form the active metabolite 1,25-dihydroxyvitamin D (calcitriol). By engaging the vitamin D receptor, it exerts immunomodulatory, neuroprotective, and anti-frailty functions. Deficiency in vitamin D has been implicated in a wide range of disorders, including musculoskeletal weakness, frailty, cognitive decline, autoimmune diseases, and respiratory infections. Vitamin D deficiency affects nearly half of the global population and remains a widespread public health challenge, and effective interventions such as food fortification and targeted supplementation should be prioritized in future strategies.
Vitamin D deficiency represents a modifiable risk factor with implicated effects across systemic, neurocognitive and musculoskeletal systems. Epidemiological evidence links deficiency to increased risk of infection, cognitive decline, frailty and orthopaedic morbidity. In orthopaedic and geriatric populations, maintaining sufficient vitamin D supplementation may reduce fracture and fall risk as well as postoperative complications and infections. These factors are also influenced by vitamin D deficiency-related effects on neurocognition. Vitamin D status may also be relevant in the management of infectious diseases, including respiratory illnesses and COVID-19. This review also discusses mechanistic and practical rationales for clinical translation. Potential interventions include vitamin D co-supplementation, dietary fortification and optimised sun exposure. However, limitations in existing randomised trials underscore the need for consistency in dosing, appropriate formulation, targeted population, as well as baseline deficiency progression status. These insights can guide clinicians, public health policy makers and researchers in developing evidence-based protocols and interventions to reduce vitamin D deficiency-related morbidity.}, }
@article {pmid41779027, year = {2026}, author = {Laufs, U and Blankenberg, S and Schunkert, H and Thiele, H and Frey, N and Baldus, S}, title = {[Prevention and screening in cardiovascular medicine].}, journal = {Innere Medizin (Heidelberg, Germany)}, volume = {67}, number = {Suppl 1}, pages = {44-47}, pmid = {41779027}, issn = {2731-7099}, mesh = {Humans ; *Cardiovascular Diseases/prevention & control/diagnosis/epidemiology ; *Mass Screening ; Female ; Adult ; Male ; Germany ; Risk Factors ; Heart Disease Risk Factors ; Middle Aged ; COVID-19/prevention & control ; }, abstract = {Cardiovascular diseases are the most frequent cause of death for both women and men in Germany. A proportion of 50-70% of the morbidity and mortality of these diseases would be avoidable by the timely recognition and modification of the risk factors smoking, high blood pressure, hypercholesterolemia, diabetes and lack of physical activity. Therefore, there is a major opportunity in a comprehensive lifelong risk management, which includes individual risk stratification and holistic preventive measures. Definite possibilities for improvement are provided by, e.g., targeted statutory measures for reduction of nicotine consumption and early check-ups in young adulthood (25, 35 and 50 years) for detection of hypertension and other risk factors, screening for familial hypercholesterolemia in children and promotion of vaccination against influenza, pneumococci, severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) and respiratory syncytial virus (RSV), especially for people with heart disease. The combination of behavioral and individual prevention can effectively prevent cardiovascular diseases, increase the quality of life and reduce healthcare costs.}, }
@article {pmid41779259, year = {2026}, author = {Casaletto, E and Morse, L and Miller, D and Deliz-Gonzalez, J and Larson, D}, title = {Update on the Pathophysiology and Management of Tics.}, journal = {Current neurology and neuroscience reports}, volume = {26}, number = {1}, pages = {}, pmid = {41779259}, issn = {1534-6293}, mesh = {Humans ; *Tics/physiopathology/therapy/genetics ; Tourette Syndrome/physiopathology/therapy/genetics ; *Tic Disorders/physiopathology/therapy/genetics ; COVID-19 ; }, abstract = {PURPOSE OF REVIEW: This review aims to collate takeaways from the most recent and relevant literature related to tics, from genetic studies to case studies elucidating Functional tic like behaviors (FTLBs) and clinical trials of novel drugs in development. RECENT FINDINGS: Recent genome-wide association studies (GWAS) and functional neuroimaging studies have enhanced the understanding of genetic and structural links to Tourette Syndrome (TS). The rise of FTLBs during the Covid-19 pandemic heightened our understanding of this phenomenon and led to the identification of social media’s influence on tics. New studies have identified sex-related difference in TS and common psychiatric co-morbidities. Tic treatment is evolving away from traditional anti-psychotics toward newer compounds including VMAT-2 inhibitors, Ecopipam, and cannabinoid formulations, as well as novel transcranial stimulation approaches. Our understanding of tic etiology and pathophysiology as well tics’ functional counterpart FTLBs and social media impact is expanding along with our ability to manage tics with novel treatments in development.}, }
@article {pmid41779576, year = {2026}, author = {Bragagnolo, LM and Avarca, CAC and Tofani, LFN and Bigal, AL and Moura, GHDS and Chioro, A and Guimarães, CF and Andreazza, R}, title = {[Resilience and technological care arrangements in hospital settings during the COVID-19 pandemic: an integrative literature review].}, journal = {Ciencia & saude coletiva}, volume = {31}, number = {2}, pages = {e08452024}, doi = {10.1590/1413-81232026312.08452024}, pmid = {41779576}, issn = {1678-4561}, mesh = {Humans ; *COVID-19 ; Pandemics ; *Delivery of Health Care/organization & administration ; Digital Health ; *Hospitals ; }, abstract = {This integrative review analyzed scientific literature to identify technological arrangements for care management (CM) in hospitals used during the COVID-19 pandemic, with the goal of understanding whether and how these arrangements contributed to the resilience of services and systems. A literature search was conducted in three databases for studies published between January 1, 2020, and May 10, 2023. Data analysis was guided by Cecílio's (2011) classification of CM into family, professional, and organizational dimensions. Within the family dimension, relational strategies were found to enhance hospital resilience. In the professional and organizational dimensions, shared decision-making and dialogical interactions among technologies supported resilient and comprehensive care. Information and communication technologies (ICT) played a key role in enabling hospital reorganization while preserving light technologies essential to humanized care. Health systems such as the SUS may benefit from integrating ICT with CM to strengthen coordination among families, professionals, and institutions.}, }
@article {pmid41780104, year = {2026}, author = {Wang, X and Patel, C and Sharma, K and Giles, ML and Burns, P and Macartney, K and Flanagan, KL and Teh, BW and Williams, PCM}, title = {Immunisation against vaccine-preventable diseases in individuals receiving immunosuppressive targeted therapies.}, journal = {Vaccine}, volume = {78}, number = {}, pages = {128399}, doi = {10.1016/j.vaccine.2026.128399}, pmid = {41780104}, issn = {1873-2518}, mesh = {Humans ; *Immunosuppressive Agents/therapeutic use/adverse effects ; *Vaccine-Preventable Diseases/prevention & control/immunology ; *Vaccination ; *Immunocompromised Host ; Vaccine Efficacy ; Immunogenicity, Vaccine ; COVID-19 Vaccines/immunology ; Influenza Vaccines/immunology ; Pneumococcal Vaccines/immunology ; }, abstract = {The availability and clinical use of biological and small molecule targeted therapies is rapidly expanding. The intricate nature of their mechanisms and the impact of the underlying condition make it challenging for clinicians to anticipate the infectious risks and vaccination outcomes for individuals prescribed these therapies. We aimed to summarise the current evidence focusing on the risk of infections, vaccine efficacy and vaccine safety in patients receiving targeted therapies. Our review revealed variable infection risks and vaccine responses in patients on targeted therapies, ranging from dramatic (e.g., alemtuzumab, rituximab) to negligible (e.g., mepolizumab, imatinib). Higher risks of serious infection were associated with receipt of concomitant immunosuppressive medications. Vaccine immunogenicity data were predominantly restricted to COVID-19, influenza, and pneumococcal vaccines, with fewer studies on herpes zoster and hepatitis B vaccines. Vaccine responses were often impaired by many targeted therapies, but rarely eliminated. Therapies with lymphocyte-depleting effects, however, can result in inadequate vaccine responses, and were often affected by underlying conditions and concomitant immunosuppressants. Live vaccine safety remains a prominent concern for patients prescribed targeted therapies, though serious adverse events are rare. Current evidence is largely based on non-randomised trials and observational studies, which limits the strength of conclusions that can be drawn. To address this gap and ensure accurate evaluation of vaccine immunogenicity, clinical efficacy and safety, it is essential that future trials include immunocompromised individuals. Better prediction models or biomarkers for stratifying risk and predicting vaccine efficacy are also important further steps.}, }
@article {pmid41780168, year = {2026}, author = {Hakim, MS and Widyaningsih, SA and Ikram, A and Goeijenbier, M and Morita, A and Yin, YB}, title = {Fundamental concepts of convergent (parallel) evolution in human-pathogenic viruses and their implications for global health.}, journal = {Virology}, volume = {618}, number = {}, pages = {110854}, doi = {10.1016/j.virol.2026.110854}, pmid = {41780168}, issn = {1096-0341}, mesh = {Humans ; *Evolution, Molecular ; Global Health ; SARS-CoV-2/genetics ; *Viruses/genetics/pathogenicity ; Hepacivirus/genetics ; *Virus Diseases/virology ; Selection, Genetic ; HIV/genetics ; Adaptation, Biological ; COVID-19/virology ; }, abstract = {Various environmental conditions force viruses to continuously evolve to survive. Evolving viruses with improved fitness are subject to positive selection and will pass on their genetic information to the next generation. If virus populations experience similar environmental pressure, they may undergo a dynamic process of molecular adaptation, which is known as convergent or parallel evolution (parallelism). Noteworthy, these phenomena are among the underlying mechanisms of cross-species transmission and emergence of novel viruses in the human population with a significant impact on global health. Therefore, it is essential to comprehend the fundamental concept of parallelism as well as its molecular identification. This will contribute to a better preparedness against future viral epidemics and pandemics. In this review, we first describe the basic concept of parallelisms and various selective pressures that drive this process. We highlight viruses that commonly infect humans, including hepatitis C virus (HCV), human immunodeficiency virus (HIV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as examples of rapidly evolving viruses undergoing this evolutionary process. Understanding these molecular mechanisms not only improves our knowledge of viral evolution but also informs surveillance strategies and public health responses. Continuous research in this area is crucial to anticipate and mitigate future viral threats.}, }
@article {pmid41780665, year = {2026}, author = {Maithania, H and Tiwary, P and Oswal, K and Varghese, R}, title = {Lipid-based nanocarriers for antiviral drug delivery: A review of the advances, manufacturing technologies, therapeutic mechanisms, and clinical applications.}, journal = {Chemistry and physics of lipids}, volume = {275}, number = {}, pages = {105574}, doi = {10.1016/j.chemphyslip.2026.105574}, pmid = {41780665}, issn = {1873-2941}, mesh = {Humans ; *Antiviral Agents/chemistry/therapeutic use/pharmacology/administration & dosage ; *Lipids/chemistry ; *Nanoparticles/chemistry ; *Drug Carriers/chemistry ; Animals ; *Drug Delivery Systems ; Liposomes/chemistry ; SARS-CoV-2/drug effects ; }, abstract = {BACKGROUND: The persistent global burden of viral infections, compounded by the emergence of resistance and suboptimal therapeutic efficacy, underscores the urgency for innovative treatment strategies. Recent viral outbreaks such as COVID-19, Human metapneumovirus (HMPV), Zika, Ebola, Nipah, and various influenza viral strains have highlighted the limitations of conventional antivirals. This necessitates the need for targeted, adaptable, and innovative drug delivery platforms. In light of this, LNCs have emerged as versatile systems capable of enhancing drug stability, biodistribution, and cellular uptake. With their tunable architecture and ability to encapsulate diverse antiviral agents, these nanocarriers offer a promising avenue to overcome pharmacological barriers, improve therapeutic efficacy, and enable effective intervention against both established and emerging viral pathogens.
METHOD: To gather supporting evidence, publications were identified on Google Scholar, PubMed, and ScienceDirect with specific search terms such as "antivirals", "drug loading", "encapsulation efficiency", "lipid nanocarriers", "liposomes", "solid lipid nanoparticles (SLNs)", "nanostructured lipid carriers (NLCs)", "cubosomes", "virus", "viral disease", and "resistance". We did not impose any restrictions on the publication date during the selection of papers. However, it is imperative to highlight that the initial reports containing specified keywords began publication in 1964; it is noteworthy that a majority of these publications were 2000 or beyond.
CONCLUSION: LNCs, including SLNs, NLCs, liposomes, and cubosomes, etc, demonstrated improved antiviral efficacy by enhancing drug stability, targeted delivery, and bioavailability. Several formulations showed superior pharmacokinetics and reduced toxicity compared to conventional therapies. Additionally, in vivo studies supported enhanced lymphatic uptake and therapeutic outcomes across multiple viral models. Despite notable progress, challenges in scalability, stability, and regulatory compliance limit their clinical translation. Hence, techniques such as microfluidics and other continuous manufacturing approaches improve reproducibility and process control. Moreover, artificial intelligence is revolutionizing LNC development by enabling rapid optimization, in silico prediction of pharmacokinetics, and real-time quality monitoring. Incorporating AI-enabled quality-by-design frameworks with state-of-the-art analytics may streamline regulatory approval. Moving forward, translating LNC technologies from bench to bedside will require scalable production methods, standardized characterization, and regulatory alignment.}, }
@article {pmid41780690, year = {2026}, author = {Zuo, X and Xiao, X and Dong, X and Wang, J and Lei, X}, title = {Direct-acting antivirals and beyond: emerging approaches to targeting viral RNA and ribonucleoprotein complexes.}, journal = {Antiviral research}, volume = {249}, number = {}, pages = {106383}, doi = {10.1016/j.antiviral.2026.106383}, pmid = {41780690}, issn = {1872-9096}, mesh = {*Antiviral Agents/pharmacology/therapeutic use ; Humans ; *RNA, Viral/metabolism/drug effects/genetics ; Virus Replication/drug effects ; *Ribonucleoproteins/antagonists & inhibitors/metabolism/drug effects ; Animals ; SARS-CoV-2/drug effects ; Drug Discovery ; *RNA Viruses/drug effects/genetics ; }, abstract = {RNA viruses, particularly respiratory-transmitted pathogens like SARS-CoV-2 and influenza, pose a significant and persistent threat to global public health. While vaccines and antiviral drugs have made substantial progress in preventing and controlling these infections, the threat remains, highlighting the need for novel therapeutic strategies. Small molecule and proteins-based therapeutics remain the primary forms of clinical interventions and a mainstay of drug development. Traditionally, these agents target viral or host proteins, including enzymes, receptors, ion channels, and other host factors. However, the landscape of antiviral drug discovery is expanding. Recent research has increasingly highlighted viral RNA (vRNA) and its associated binding proteins as critical and promising therapeutic targets. Beyond its role as a carrier of genetic information, vRNA is actively involved in essential steps of the viral life cycle, including transcription, translation, replication and interactions with host proteins. Therefore, a detailed understanding of vRNA structure and the proteins involved in its synthesis and processing is vital for rational drug design. This review focuses on the development of antiviral drugs and explores the potential of targeting the vRNA genome and vRNA binding proteins for therapeutic interventions.}, }
@article {pmid41781075, year = {2026}, author = {Martins-Pfeifer, C and Bhosale, AS and Zhang, L and Urquhart, O and Verdugo-Paiva, F and Glick, M and Carrasco-Labra, A}, title = {Development of living evidence-informed guidelines, part 1: Framework for the conduct of living systematic reviews and guidelines.}, journal = {Journal of the American Dental Association (1939)}, volume = {157}, number = {3}, pages = {247-256}, doi = {10.1016/j.adaj.2025.09.014}, pmid = {41781075}, issn = {1943-4723}, mesh = {Humans ; *Practice Guidelines as Topic ; *Systematic Reviews as Topic ; *Evidence-Based Dentistry/standards ; COVID-19 ; }, abstract = {BACKGROUND: Living guidelines integrate continuous and dynamic updates of systematic reviews to support timely, evidence-informed recommendations. This approach addresses the limitations of static guidelines in rapidly evolving clinical and public health contexts. Living evidence-informed guidelines enable clinicians to implement the most trustworthy and up-to-date research for the benefit of their patients.
TYPES OF STUDIES REVIEWED: The living framework draws on methodological literature, case studies from international living guideline initiatives, and experiential reports. Sources include published guidance on living systematic reviews; Grading of Recommendations Assessment, Development and Evaluation methodology; and real-world applications from organizations like the National Institute for Health and Care Excellence and the Australian Living Evidence Collaboration's COVID-19 Taskforce, illustrating operational strategies across planning, production, dissemination, and updating processes.
RESULTS: The framework outlines the following 5 core domains for developing living guidelines: planning, production, reporting, dissemination, and implementation. Key components include topic prioritization, guideline panel composition, continuous evidence monitoring, and decision-making processes guided by the Grading of Recommendations Assessment, Development and Evaluation Evidence-to-Decision framework. Artificial intelligence facilitates literature monitoring and data extraction. Criteria are proposed for transitioning between living and standard recommendation modes. Transparency in reporting updates and structured external review enhance living guideline trustworthiness. Digital dissemination platforms support timely access and interest-holder engagement.
This framework provides practical guidance for organizations developing living guidelines, offering strategies to enhance responsiveness, methodological rigor, and user engagement in rapidly evolving clinical and policy environments. Living evidence-informed guidelines developed following these methods provide updated and reliable evidence for clinicians, patients, and interest-holders, bringing transparency and accessibility of the history of all formulated recommendations.}, }
@article {pmid41781347, year = {2026}, author = {Moschioni, M and Siraji, RA and Dissard, R and Segafredo, G and Mutungi, H and Jain, A and Thakur, R and Maurya, N and James, I}, title = {mRNA vaccines and therapeutics beyond COVID-19: A review of the global clinical development landscape, low- and middle-income countries involvement and relevance to their contexts.}, journal = {Human vaccines & immunotherapeutics}, volume = {22}, number = {1}, pages = {2628424}, pmid = {41781347}, issn = {2164-554X}, mesh = {Humans ; Developing Countries ; *Vaccine Development ; *COVID-19/prevention & control ; *Vaccines, Synthetic/therapeutic use ; *mRNA Vaccines/therapeutic use ; SARS-CoV-2/immunology ; COVID-19 Vaccines ; Global Health ; }, abstract = {mRNA vaccines demonstrated transformative potential during the COVID-19 pandemic, yet global access to mRNA research, development, and manufacturing capacity remains unequal. This review systematically maps the global mRNA clinical development landscape beyond COVID-19, based on publicly available sources. A total of 244 vaccine and therapeutic candidates were identified: 123 targeting 23 communicable diseases and 121 targeting 69 non-communicable diseases, including 102 cancer-focused candidates. Two hundred and twenty-seven candidates (93%) were in early clinical development phases and 12 in late-stage development. Eighty-five developers (50 companies, 35 institutes/hospitals) are engaged in this space. Low- and Middle-Income Countries (LMICs) participation was limited to 57 candidates, primarily in upper-middle-income countries. This study reveals a rapidly expanding pipeline for diverse diseases, many aligned with LMIC public health priorities, yet with limited LMIC participation. Equitable inclusion, and collaborations are vital for sustainable global development. This study could inform future LMIC-led mRNA development and manufacturing initiatives.}, }
@article {pmid41781975, year = {2026}, author = {Mótyán, JA and Golda, M and Mahdi, M and Nashed, NT and Louis, JM and Tőzsér, J}, title = {Molecular mechanisms of protease precursor autoprocessing of RNA viruses: a comprehensive review.}, journal = {Virology journal}, volume = {23}, number = {1}, pages = {}, pmid = {41781975}, issn = {1743-422X}, mesh = {Humans ; *RNA Viruses/enzymology ; *Peptide Hydrolases/metabolism ; Polyproteins/metabolism ; *SARS-CoV-2/enzymology ; *Viral Proteins/metabolism ; Proteolysis ; HIV-1/enzymology ; }, abstract = {Many viruses express their proteins in the form of large polyproteins comprising structural and non-structural (e.g. enzymatic) units that are released from the precursor through ordered proteolysis. Proteolytic processing of polyproteins is an indispensable regulatory step for virus maturation and replication that is carried out by the virus-encoded and/or cellular proteases. The activity of a viral protease that is expressed as a part of a polyprotein is controlled in part by the self-cleavage (autoprocessing) from the precursor. The mechanism of protease precursor processing has been established at the molecular level for various RNA virus proteases, including human immunodeficiency virus (HIV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Both viral protease precursors are processed via intra- (in cis) and intermolecular (in trans) cleavages at the N- and C-termini, respectively, yielding the mature enzyme. The remarkably similar activation mechanisms of HIV and SARS-CoV-2 PRs suggest that other viral proteases are activated similarly. In this review, we provide a detailed overview on the protease precursor autoprocessing mechanism of HIV-1 and SARS-CoV-2 proteases and compare those to the activation mechanism of non-viral proteases from their zymogens. Also, we review the activation mechanism of other ss(+)RNA viruses that utilize the polyprotein pathway for their replication. Based on such comparison, it appears that the protease activation mechanisms of most enveloped ss(+)RNA viruses from their precursors share many common features, although they do not correlate directly with the evolutionary relationships, the presence or absence of viral envelope or the catalytic mechanism of the viral protease.}, }
@article {pmid41782074, year = {2026}, author = {Gordon, M and Ramirez, P}, title = {The role of corticosteroids in severe viral pneumonia: lessons from COVID-19 and influenza.}, journal = {Pneumonia (Nathan Qld.)}, volume = {18}, number = {1}, pages = {}, pmid = {41782074}, issn = {2200-6133}, abstract = {BACKGROUND: Corticosteroids have long been used as immunomodulatory agents in viral respiratory infections, but their role in influenza and COVID-19 remains controversial. While both diseases share overlapping pathogenic mechanisms involving hyperinflammation and immune dysregulation, clinical evidence suggests divergent outcomes in response to corticosteroid therapy. OBJECTIVE: This review critically examines the evidence regarding corticosteroid use in influenza and COVID-19, focusing on their impact on mortality, disease progression, and secondary infections. METHODS: A narrative review was conducted including randomized controlled trials, meta-analyses, and major observational studies published between 2000 and 2025. Data were analyzed comparatively for influenza (seasonal and pandemic strains) and SARS-CoV-2 infection. RESULTS: In influenza, most studies associate corticosteroid administration—particularly at high doses or prolonged courses—with increased mortality, delayed viral clearance, and higher rates of secondary bacterial pneumonia. Conversely, in COVID-19, randomized trials such as RECOVERY demonstrated that low-to-moderate doses of dexamethasone significantly reduce mortality in patients requiring oxygen or mechanical ventilation, without clear benefit in mild disease. These opposing outcomes highlight the importance of timing, dosing, and patient selection, reflecting distinct immunopathological trajectories between the two infections. CONCLUSIONS: Corticosteroid therapy exerts context-dependent effects in viral pneumonia. While detrimental in most cases of influenza, it is beneficial in severe COVID-19 when guided by systemic inflammation. Future strategies should focus on personalized and real-time immune monitoring to tailor immunomodulatory interventions to each patient’s inflammatory and virological status.}, }
@article {pmid41782085, year = {2026}, author = {Heugno, VJN and Kamdem, OL and Same, EGE and Lele, ECB and Biloa, YM and Ayina, CA and Guyot, J and Bongue, B and Mandengue, SH and Moukoko, CEE}, title = {Factors associated with long COVID in sub-Saharan Africa: a scoping review.}, journal = {BMC infectious diseases}, volume = {26}, number = {1}, pages = {}, pmid = {41782085}, issn = {1471-2334}, support = {ANRS283//ANRS - Agence Nationale de la Recherche / Emerging Infectious Diseases/ ; }, mesh = {Female ; Humans ; Africa South of the Sahara/epidemiology ; Comorbidity ; *COVID-19/epidemiology/complications ; *Post-Acute COVID-19 Syndrome/epidemiology/etiology ; Risk Factors ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Long COVID is a condition characterized by persistent symptoms of COVID-19 that continue to occur in patients after apparent recovery. Given that, these symptoms may vary from person to person due to clinical, demographic, and genetic factors as well as comorbidities, our review aims to identify and analyze risk factors associated with persistent symptoms of COVID-19 (long COVID) in the specific context of sub-Saharan Africa.
METHODS: Article searches were conducted in the PubMed, Scopus, African Journals Online (AJOL), Science Direct and Google Scholar databases using the keywords "long COVID" or "long-term COVID-19" or "post-COVID condition" or "post-acute sequelae of COVID-19" and "sub-Saharan Africa" or "sub-Saharan Africans". The obtained data were entered into software for duplication checking. Two reviewers selected and extracted the data. Due to substantial heterogeneity in definitions and study designs, a narrative synthesis approach was adopted. Fifteen studies were included in this review, totaling 8,233 participants previously infected with SARS-CoV-2, with approximately 2,011 patients with long COVID from six countries. Six studies were cross-sectional, three were retrospective, three were cohort studies, two were case-control, and one was a case report.
RESULTS: The review found that the prevalence of long COVID in sub-Saharan Africa ranged from 2% in Ghana to 66.7% in South Africa. The persistent COVID-19 symptoms most commonly experienced by people living in sub-Saharan Africa were fatigue (reported in 12 studies, 25-66% of patients), cough (7 studies, 9-86%), chest pain (9 studies, 9%-29%), dyspnea (10 studies, 15-45%), palpitations (4 studies, 10-30%), headache (9 studies, 12-38%), and cognitive impairment (6 studies, 8-20%). The main risk factors for the occurrence of persistent COVID-19 symptoms were older age (˃ 60 years), female sex, low education level, hypertension, type 2 diabetes, cardiovascular disease, length of hospitalization during the acute episode, number of initial COVID-19 symptoms, and initial disease severity.
CONCLUSION: Long COVID is a reality in sub-Saharan Africa. Fatigue and hypertension have proven to be the most common symptom and risk factor, respectively. The heterogeneity of long COVID definitions across studies limits direct prevalence comparisons. Given the socio-economic challenges, pre-existing comorbidities and differences in health systems in the sub-Saharan region, it is therefore necessary to develop new strategies for care, rehabilitation and treatment (specific to the realities of the sub-Saharan region) targeted at each persistent symptom of COVID-19 in order to resolve this emerging problem and allow patients to have a good quality of life.
CLINICAL TRIAL NUMBER: Not applicable.}, }
@article {pmid41782288, year = {2026}, author = {Ramklass, SS and Zhandire, T and Gordon, M}, title = {Pandemic preparedness and response among global healthcare workers using an interprofessional health practice framework: a scoping review protocol.}, journal = {Journal of interprofessional care}, volume = {40}, number = {3}, pages = {587-594}, doi = {10.1080/13561820.2026.2640469}, pmid = {41782288}, issn = {1469-9567}, mesh = {Humans ; *COVID-19/epidemiology ; *Pandemics ; *Health Personnel/education ; Pandemic Preparedness ; Scoping Reviews as Topic ; SARS-CoV-2 ; *Interprofessional Relations ; Cooperative Behavior ; Global Health ; }, abstract = {The COVID-19 pandemic exposed significant gaps in healthcare systems' preparedness and response capabilities including workforce coordination and collaborative practice. Although pandemic preparedness is often framed in terms of infrastructure and policy, the pandemic highlighted that health system responsiveness depends on how healthcare workers are educated and trained to collaborate, adapt, and make decisions. Healthcare workers operate within volatile, uncertain, complex, and ambiguous (VUCA) environments, necessitating new approaches to education and practice. In this scoping review we will examine how health professional education and education-linked practice initiatives adapted to the VUCA conditions of the COVID-19 pandemic, with particular focus on interprofessional education and collaborative practice (IPECP) as a mechanism for strengthening pandemic response. Following JBI scoping review methodology and PRISMA-ScR guidelines, seven electronic databases will be searched for literature published between January 2022 and 2025. Empirical studies examining educational adaptations and practice-embedded interprofessional strategies implemented during COVID-19 will be included. Two independent reviewers will conduct screening and data extraction, with findings synthesized narratively. IPECP and VUCA frameworks provide an analytical lens for examining identifying of educational and practice adaptations associated with coordinated healthcare responses. Findings are intended to enforce workforce resilience and future preparedness efforts. This protocol has been registered on OSF doi: https://doi.org/10.17605/OSF.IO/A6F3D.}, }
@article {pmid41782516, year = {2026}, author = {Chen, IJ and Tzeng, YS and Wu, SY and Chang, FC}, title = {Effect of Yoga Intervention for Health Care Workers During the COVID-19 Pandemic: A Systematic Review.}, journal = {Journal of integrative and complementary medicine}, volume = {32}, number = {7}, pages = {559-572}, doi = {10.1177/27683605261419365}, pmid = {41782516}, issn = {2768-3613}, mesh = {*Yoga/psychology ; Humans ; *COVID-19/psychology/epidemiology ; *Health Personnel/psychology ; Anxiety/therapy ; SARS-CoV-2 ; Depression/therapy ; Stress, Psychological/therapy ; Mental Health ; Meditation ; Pandemics ; }, abstract = {BACKGROUND: Health care workers (HCWs) faced unprecedented stress, anxiety, and burnout during the COVID-19 pandemic. Yoga, a mind-body practice combining physical postures, breathing, and meditation, has demonstrated benefits for mental and physical resilience. This systematic review evaluated the effectiveness of yoga interventions in addressing mental health challenges and promoting overall well-being among HCWs during the pandemic.
METHODS: This review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Comprehensive searches of PubMed, EMBASE, and Cochrane CENTRAL were conducted up to November 2024 using terms including "yoga," "COVID-19," and "health care workers." Eligible studies involved HCWs receiving yoga interventions compared with nonyoga controls. Outcomes included stress, anxiety, depression, sleep quality, and physiological parameters. Randomized controlled trials, cohort studies, and observational studies were included. Quality assessment was performed using the Cochrane Risk of Bias Tool (RoB 1.0). Certainty of evidence assessment was conducted with Grading of Recommendations Assessment, Development and Evaluation.
RESULTS: Of 134 studies identified, 11 met the inclusion criteria. Participants included HCWs from India, Turkey, and the United States, with intervention durations ranging from 2 to 12 weeks. Yoga consistently reduced stress, anxiety, and depression, with improvements in sleep quality and quality of life. Physiological benefits included enhanced autonomic function and reduced levels of inflammatory markers. App-based and tailored yoga protocols showed potential for scalability and accessibility. The overall quality of the included studies was moderate.
CONCLUSION: Yoga interventions demonstrated significant benefits in mitigating mental health challenges and enhancing overall well-being in HCWs during the COVID-19 pandemic. These findings underscore the value of yoga as a holistic support for HCWs in high-stress environments.}, }
@article {pmid41783149, year = {2025}, author = {Lobukulu Lolimo, G and Khonde, R and Matondo, H and Kabele, J and Musawu K, Y and Beshah, SA and Achala, DM and Njeri Muriithi, G and Adote, ENA and Zegeye, EA and Mbachu, CO and Ataguba, JE and Yaya Bocoum, FIK and Manitu, SM}, title = {Reasons for hesitancy and acceptance of COVID-19 vaccination among the Congolese population: a scoping review.}, journal = {Frontiers in health services}, volume = {5}, number = {}, pages = {1647147}, pmid = {41783149}, issn = {2813-0146}, abstract = {INTRODUCTION: Despite over 9.6 billion COVID-19 vaccine doses administered globally, vaccination access remains highly unequal. North America and Western Europe have over 50% vaccination coverage, contrasting sharply with African nations, like the Democratic Republic of Congo (DRC), which has under 10%. This scoping review explores the key factors contributing to the low COVID-19 vaccination rate in the Congolese population.
METHODS: We conducted a scoping review using the Arksey and O'Malley framework, searching PubMed, ProQuest, and Scopus databases for peer-reviewed manuscripts published between 2019 and 2023. Six studies met the inclusion criteria, and focused on the factors of COVID-19 vaccine acceptance, hesitancy, and access in the DRC.
RESULTS: Although surveys indicated a high willingness on the part of the people to get vaccinated, only 2.7% of the population were fully vaccinated. The primary barrier to vaccination was safety concerns, specifically, perceptions of the vaccine as new and experimental (84.4%) and fear of side effects (83.3%). Additional hesitancy factors included mistrust in vaccine effectiveness (60.4%) and a general lack of confidence (60.0%). Facilitators of acceptance included prior family vaccination, perceived risk of infection, belief in the existence of the virus, and awareness of vaccination strategies. Sociodemographic factors such as being a healthcare professional or male also positively influenced uptake.
DISCUSSION: These findings highlight the gap between vaccine willingness and actual coverage in the DRC. Addressing safety concerns and building trust through targeted outreach, especially among key professional groups, may improve vaccine acceptance and equity.}, }
@article {pmid41783176, year = {2026}, author = {Horowitz, MA and Sussman, JH and Zomalan, B and Rendler, J and Singh, A and Birouty, N and Seaton, M and Patel, S and Gendreau, JL and Abraham, ME}, title = {Vagus nerve stimulation: An update of currently registered clinical trials on ClinicalTrials.gov.}, journal = {Surgical neurology international}, volume = {17}, number = {}, pages = {64}, pmid = {41783176}, issn = {2229-5097}, abstract = {BACKGROUND: Vagus nerve stimulation (VNS) is currently approved for conditions such as drug-resistant epilepsy and stroke with promising results. In addition, it is also being investigated for many other conditions. The goal of this study is to review the scope of VNS clinical trials.
METHODS: We conducted a retrospective review of active and completed clinical trials using ClinicalTrials.gov, with "Vagus Nerve Stimulation" as the search term. The number of studies taking place over time was assessed using Pearson correlation coefficient.
RESULTS: An examination of ClinicalTrials.gov revealed 440 clinical trials, with 346 meeting our inclusion criteria. The number of VNS clinical trials increased annually from 2000 to 2024, demonstrating exponential growth after 2015 (P < 0.001, R[2] = 0.924). Of these, 42.5% were completed, with published results being available for 9.8% of the completed trials. Completed trials were predominantly from the United States, spanning various conditions including a wide variety of disorders such as cardiovascular diseases (n = 38), chronic pain disorders (n = 31), gastrointestinal disorders (n = 24), autoimmune disorders (n = 23), neurodegenerative diseases (n = 19), COVID-19 (n = 13) and diabetes (n = 11). Among the included trials, 86% were non-invasive with 91% of trials with results reporting improvements in symptoms.
CONCLUSION: This increasing number of trials assessing a wide breadth of clinical disorders suggests the promising future of VNS as from the currently approved treatments. Physicians should familiarize themselves with these results and potentially upcoming indications for VNS.}, }
@article {pmid41783454, year = {2026}, author = {Washif, JA and Trabelsi, K and Pagaduan, J and Perreras, MSL and Moussa-Chamari, I and Yousfi, N and Pyne, DB and Chamari, K}, title = {Changes in physical fitness and body composition of athletes after the COVID-19 lockdown: a systematic review, meta-analysis, and meta-regression, with assessment of the certainty of evidence.}, journal = {Biology of sport}, volume = {43}, number = {}, pages = {463-488}, pmid = {41783454}, issn = {0860-021X}, abstract = {This systematic review with meta-analysis analysed the effects of COVID-19 lockdowns on physical fitness and body composition in athletes. A comprehensive search was conducted in three databases (PubMed, Web of Science, and Scopus) up to January 2025 (included). Studies were included based on PICO criteria, involving adult athletes, original articles, and any quantitative assessment of physical fitness and/or body composition conducted within one month before and two weeks after the lockdown. The Joanna Briggs Institute Critical Appraisal Checklist was used to assess the risk of bias, while the Cochrane Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach evaluated the certainty of evidence. A total of 14 studies (261 athletes) with a low risk of bias met the inclusion criteria. Narrative synthesis revealed that the effects of lockdowns on athletes' physical fitness and body composition were varied, with consistent impairments (e.g., endurance-related fitness), relative stability (e.g., body mass, CMJ height, maximal strength), and mixed results (e.g., sprinting). A meta-analysis of 11 studies indicated a non-significant effect of lockdown on body mass (effect size [ES]=-0.115, 95% confidence interval [CI] -0.214 to 0.164, P=0.797). Similarly, 10 studies showed a variable, non-significant reduction in CMJ height (ES=-0.303, 95% CI -0.655 to 0.045, P=0.097). However, CMJ relative peak power (six studies) demonstrated a trivial-small negative effect (ES=-0.199, 95% CI -0.341 to -0.058, P=0.019). These findings should be interpreted with caution as the certainty of evidence was very low. While evidence remains limited, targeted and individualised training might help mitigate some of the detraining effects observed during a lockdown, particularly in endurance-related fitness outcomes.}, }
@article {pmid41783584, year = {2026}, author = {Oesterle, TS and Bormann, NL}, title = {Digital Therapies for Substance Use Disorders: Recent Advances and Engagement Strategies.}, journal = {Substance abuse and rehabilitation}, volume = {17}, number = {}, pages = {560350}, pmid = {41783584}, issn = {1179-8467}, abstract = {BACKGROUND: Substance use disorders (SUDs) are highly prevalent, chronic conditions that often go untreated. Technology-driven interventions, including digital therapeutics, web-based programs, and mobile applications, have expanded treatment access. The COVID-19 pandemic accelerated the adoption of digital approaches, and national policy calls for enhanced use of telehealth and app-based recovery support. However, user engagement with SUD apps remains a challenge.
OBJECTIVE: This narrative review summarizes evidence on digital interventions for SUDs, emphasizing mobile apps. It examines what differentiates effective interventions, drawing on insights from the broader context of general mobile app use. It also proposes strategies to enhance engagement in digital therapeutics.
METHODS: We reviewed the literature (2013-2025) on SUD digital interventions, including randomized trials, systematic reviews, and large observational studies of SUD-focused apps. Key findings on clinical efficacy and engagement were extracted, along with examining engagement tactics from mobile gaming and other app domains to inform potential improvements.
RESULTS: Several apps have demonstrated efficacy in reducing substance use or supporting abstinence, particularly those that integrate evidence-based therapy content, provide personalized feedback, offer craving-management tools, and facilitate connectivity to peer or clinician support. In contrast, apps with minimal interactive content often show no added benefit. A major barrier is sustaining user engagement, as many SUD apps experience a steep drop-off in use after the initial download. Strategies such as gamification, contingency management (utilizing incentives), social networking features, and integration with ongoing care can significantly enhance engagement. Early data suggest that blending these strategies into SUD apps yields higher retention and better clinical results.
CONCLUSION: Mobile apps are emerging as valuable adjuncts for SUD treatment, but their real-world impact depends on users' engagement with compelling content. By incorporating tangible rewards, personalized and timely interventions, social support, and provider involvement, digital therapies for SUDs enhance engagement and, consequently, improve long-term recovery outcomes.}, }
@article {pmid41783665, year = {2025}, author = {Giri, B and Gurung, M and Adnani, QES and Chattu, VK}, title = {Mental Health of Nepalese Migrant Workers: A Call for Action in South Korea.}, journal = {JNMA; journal of the Nepal Medical Association}, volume = {63}, number = {288}, pages = {636-640}, pmid = {41783665}, issn = {1815-672X}, mesh = {Humans ; *Transients and Migrants/psychology/statistics & numerical data ; Nepal/ethnology ; COVID-19 ; *Mental Health ; Republic of Korea/epidemiology ; Pandemics ; *Mental Disorders/epidemiology ; *Pneumonia, Viral/epidemiology/psychology ; *Coronavirus Infections/epidemiology/psychology ; SARS-CoV-2 ; Betacoronavirus ; }, abstract = {Mental health problems among migrants is a serious issue around the globe. Nepalese migrant workers in South Korea are facing serious mental health problem that affects not only the people involved but also the society at large. Moreover, the COVID-19 pandemic has worsened the already dire mental health situation of Nepali workers. Global health diplomacy can be a key factor in addressing mental health by engaging actors from various domains to evaluate mental health in global health priorities. This article reviews the current state of mental health and discusses the recent development in mental health among Nepalese migrant workers in South Korea.}, }
@article {pmid41784841, year = {2026}, author = {Wang, C and Evangelista, JF and Vidal, AKN and Islamuddin, M and Chen, Y and Xu, D and Qin, X}, title = {The emerging role of TLR7-mediated signaling in respiratory viral infections and autoimmune diseases.}, journal = {Cellular and molecular life sciences : CMLS}, volume = {83}, number = {1}, pages = {}, pmid = {41784841}, issn = {1420-9071}, support = {165265/HL/NHLBI NIH HHS/United States ; 962950//American Heart Association/ ; }, mesh = {Humans ; *Toll-Like Receptor 7/immunology/metabolism ; *Signal Transduction/immunology ; Animals ; *Autoimmune Diseases/immunology ; SARS-CoV-2/immunology ; Lupus Erythematosus, Systemic/immunology/pathology ; *Respiratory Tract Infections/immunology/virology ; COVID-19/immunology/pathology/virology ; Immunity, Innate ; Innate Immunity Recognition ; Interferon Type I ; *Virus Diseases/immunology ; }, abstract = {Toll-like receptor 7 (TLR7) is a key endosomal sensor that detects single-stranded RNA, linking innate and adaptive immunity through the induction of type I interferons and proinflammatory cytokines. Recent studies have underscored the pivotal role of TLR7 in shaping immune responses to respiratory viral infections, including SARS-CoV-2, influenza A virus, and respiratory syncytial virus (RSV), as well as in the pathogenesis of systemic autoimmune diseases such as systemic lupus erythematosus (SLE), which can be triggered by the respiratory viral infections. In COVID-19, TLR7 deficiency is associated with severe disease, particularly in males, due to impaired interferon responses and antibody production. In influenza, TLR7 enhances humoral and cytotoxic responses, though its overactivation may contribute to immunopathology. The role of TLR7 in RSV remains controversial, with both protective and detrimental effects reported depending on host and experimental context. In contrast, TLR7 plays a pathogenic role in SLE by amplifying type I interferon signaling and promoting autoreactive B cell activation. This review synthesizes current knowledge on TLR7-mediated signaling across these diseases, highlighting its context-dependent functions and dualistic nature in immunity and disease. We will discuss mechanistic insights, clinical relevance, and emerging therapeutic strategies targeting TLR7, emphasizing the need for precision modulation of this pathway in the treatment of viral infections and autoimmune disorders.}, }
@article {pmid41785015, year = {2026}, author = {Zhou, S and Kwizera, R and Bongomin, F and Okema, L and Okot, J and Alcanzo, EM and Ekeng, BE and Kang, Y and Denning, DW and de Hoog, S and Ahmed, SA}, title = {Global distribution of fungal rhinosinusitis.}, journal = {Rhinology}, volume = {64}, number = {3}, pages = {301-311}, pmid = {41785015}, issn = {0300-0729}, mesh = {Humans ; *Global Health/statistics & numerical data ; *Mycoses/epidemiology ; *Rhinosinusitis/epidemiology/microbiology ; }, abstract = {BACKGROUND: Fungal rhinosinusitis (FRS) comprises subtypes with varying epidemiology and outcomes. Global comparative data remain limited.
METHODS: Following PRISMA guidelines (CRD42023481670), a systematic review and meta-analysis was conducted. Cases were categorized into seven subtypes to assess variation across regions.
RESULTS: 2,031 studies (40,860 cases, 77 countries) were included. Non-invasive forms accounted for 60% (n=24,582) of cases, mainly fungal ball (35%, n=14,280) and allergic FRS (25%, n=10,302). Invasive subtypes were more frequent in tropical climates, with the hyperacute rhino-orbito-cerebral mucormycosis predominating. This subtype differed from acute and subacute invasive FRS in risk factors (diabetes and COVID-19 vs. leukemia) and geography. Aspergillus species appeared in ~60% of cases: A. fumigatus dominated in temperate/continental zones, while A. flavus was frequent in dry/tropical regions. Non-invasive FRS showed high surgical cure rates (>64%), whereas invasive forms had substantial morbidity and mortality.
CONCLUSIONS: FRS represents a substantial yet underrecognized global health concern. Non-invasive forms are predominating, while invasive subtypes cause major morbidity and mortality, especially in tropical regions. Notably, our findings reveal distinct geographic and climatic preferences for Aspergillus species: A. fumigatus in temperate/continental zones and A. flavus in dry/tropical regions. This ecological divergence underscores the importance of environmental surveillance and climate-informed diagnostic strategies.}, }
@article {pmid41785785, year = {2026}, author = {Gonzalez, A}, title = {From evidence gaps to action: Strengthening surveillance, research and social safety nets to address child maltreatment.}, journal = {Child abuse & neglect}, volume = {174}, number = {}, pages = {107971}, doi = {10.1016/j.chiabu.2026.107971}, pmid = {41785785}, issn = {1873-7757}, mesh = {Humans ; *Child Abuse/prevention & control/statistics & numerical data ; COVID-19 ; Child ; Pandemics ; Evidence Gaps ; SARS-CoV-2 ; *Population Surveillance/methods ; *Coronavirus Infections/epidemiology ; *Pneumonia, Viral/epidemiology ; Betacoronavirus ; }, abstract = {The COVID-19 pandemic increased risk factors for family violence, including economic hardship, caregiver stress, social isolation, and service disruptions. Despite extensive research over the past five years, evidence remains mixed on whether child maltreatment rates increased, decreased, or remained stable. This commentary synthesizes emerging findings, specifically highlighting two recent reviews in this special issue. Recommendations are suggested on ways to strengthen surveillance ecosystems that integrate administrative data and population-based surveys to generate timely, comprehensive, and actionable information. Equally important is sustained investment in social safety nets, such as income supports, housing programs, and paid family leave, which have demonstrated protective effects in both crisis and non-crisis contexts. Strengthening these systems is critical to a prevention-focused public health approach that protects children's safety and well-being.}, }
@article {pmid41786461, year = {2026}, author = {Caffrey, M and Paprotny, I and Smith, R}, title = {Challenges and progress toward real-time detection of airborne viral pathogens.}, journal = {Critical reviews in biotechnology}, volume = {46}, number = {4}, pages = {694-706}, doi = {10.1080/07388551.2026.2628597}, pmid = {41786461}, issn = {1549-7801}, mesh = {Humans ; Animals ; *Air Microbiology ; *Viruses/isolation & purification ; *Virus Diseases/virology ; Swine ; SARS-CoV-2 ; }, abstract = {Airborne viruses pose significant health, social and economic threats to humans and animals. Moreover, zoonotic transfer of viruses among animals and humans is a concern. Detection methods to identify viruses present in air before causing outbreaks in humans or agricultural animals is highly desirable. In this review we discuss airborne viruses that currently threaten humans and the agricultural industry and the possibility of emerging and reemerging viruses. Examples of airborne viruses threatening human health include influenza and SARS-CoV2; examples of airborne viruses threatening agricultural animals include: influenza, Porcine Reproductive and Respiratory Syndrome Virus (PRRSV), Porcine Epidemic Diarrhea Virus (PEDV), and Foot and Mouth Disease virus (FMDV). In addition, we discuss the potential of real-time detection of airborne viruses with a focus on current models, desired properties, current techniques, challenges, and progress to date. Finally, we discuss possible mitigation strategies and future opportunities.}, }
@article {pmid41788251, year = {2025}, author = {Marsh, D}, title = {Daily profile of COVID-19 infections in Europe - a biophysical perspective.}, journal = {Biophysical reviews}, volume = {17}, number = {6}, pages = {1717-1734}, pmid = {41788251}, issn = {1867-2450}, abstract = {Progression of the European COVID-19 pandemic is monitored using daily cases and associated deaths, reported in Italy, Germany and England. Weekly periodicity in reporting is filtered out with a moving average over a 7-day window. This reveals underlying stages of exponential growth and decay, and changes in response to preventative interventions. Exponential rate constants r t , combined with different serial-interval distributions, yield estimates for the basic reproduction number R0 and instantaneous R t , and characterize the emergence of successive dominant viral variants. Rates of testing are discussed in detail, and corrected for. COVID-associated deaths are linked with daily cases, and fatality/case ratios (cfr) used to estimate the extent of under-reporting in the early stages. Reproduction numbers, R0 and R t , provide estimates of vaccine coverage required to reach population-level immunity, and subsequent modifications needed during the vaccination programme. Hence, we obtain a straightforward integrated description of the pandemic that is essentially biophysical.}, }
@article {pmid41788334, year = {2026}, author = {Jiang, S and Yuan, J and Li, Q and Song, Z and Cao, L and Song, Z and Zhang, X}, title = {The structure and function of membrane protein in coronavirus infection and its applications in the development of vaccines and therapeutic drugs.}, journal = {Frontiers in microbiology}, volume = {17}, number = {}, pages = {1762041}, pmid = {41788334}, issn = {1664-302X}, abstract = {Coronaviruses have long posed significant harm to human and animal health, causing a variety of diseases. The membrane (M) protein of coronaviruses is one of the four major structural proteins and a key component of the viral structure, playing an important role in viral assembly, budding, and immunomodulation. In this paper, we systematically reviewe the structural and functional characteristics of the M protein, including its three transmembrane domains, N-terminal glycosylation and C-terminal oligomerization domain. In terms of function, we focus on the mechanistic roles of the M protein in viral envelope formation and the nucleocapsid packaging, as well as the newly discovered immune evasion strategy of regulating host innate immune signaling pathways. In addition, we also summarize the applications of M protein in preventing and controlling coronavirus infection and mitigating its adverse effects.}, }
@article {pmid41788535, year = {2026}, author = {Wang, X and Li, H and Li, T and Zhong, S}, title = {Integrating ethics into infectious disease graduate training: a multidimensional framework for public health practice.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1744330}, pmid = {41788535}, issn = {2296-2565}, mesh = {Humans ; *Public Health Practice/ethics ; *Education, Medical, Graduate ; COVID-19 ; *Communicable Diseases ; Curriculum ; SARS-CoV-2 ; *Public Health/ethics/education ; *Education, Graduate ; Digital Health ; }, abstract = {Through a narrative review and synthesis of the global status of Infectious Disease Ethics (IDE) education, this paper proposes positioning IDE as a core competency in graduate training and constructs a three-dimensional integrated model of "Theory-Practice-Assessment." Drawing on the experience of the OPENING project by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), it emphasizes that the ethical framework must adapt to the paradigm shifts brought about by emerging technologies such as genomics. This model not only addresses the gaps in IDE education exposed by COVID-19 but also provides solutions to ethical challenges in fields like digital health and precision medicine, offering a practical pathway for the reform of global infectious disease graduate education.}, }
@article {pmid41788871, year = {2025}, author = {Bouchaala, K and Bahloul, M and Bradai, S and Ammar, R and Hamida, CB}, title = {[Effect of awake prone positioning in non-intubated patients with community-acquired pneumonia complicated by hypoxemia].}, journal = {Medecine tropicale et sante internationale}, volume = {5}, number = {4}, pages = {}, pmid = {41788871}, issn = {2778-2034}, mesh = {Humans ; Prone Position ; *Community-Acquired Pneumonia/complications/therapy ; COVID-19/complications ; *Hypoxia/therapy/etiology ; Wakefulness ; *Patient Positioning/methods ; *Pneumonia, Viral/complications/therapy ; Community-Acquired Infections/complications ; Respiratory Insufficiency/therapy/etiology ; Pandemics ; SARS-CoV-2 ; }, abstract = {INTRODUCTION: Several studies have suggested that the early use of awake prone positioning (PP) in patients with acute respiratory failure due to severe community-acquired pneumonia, hemodynamically stable and alert, may improve oxygenation and avoid the need for invasive mechanical ventilation. PP may also help reduce case fatality rate (CFR). The benefits of PP for oxygen-dependent patients hospitalized with non-intubated acute respiratory failure due to SARS-CoV-2 infection have been evaluated. We reviewed the literature to determine if PP could improve hypoxemia and signs of acute respiratory failure in patients with community-acquired or non-community-acquired pneumonia, reduce the need for invasive mechanical ventilation, and reduce CFRin patients with Covid-19.
MATERIALS AND METHODS: We searched with Medline for articles published in French or English containing the keywords "acute respiratory failure" or "acute respiratory distress" and "prone position."Results/Conclusion. Turning into prone position is a simple, inexpensive, and effective technique that improves the prognosis of patients with respiratory distress due to severe community-acquired pneumonia, regardless of the cause. This technique can be easily implemented in low-and middle-income countries, particularly in North Africa, sub-Saharan Africa, Asia, and South America.}, }
@article {pmid41789521, year = {2026}, author = {Zhao, W and Htike, WYM and Kam, YW}, title = {Quantifying the evidence and burden of smoking behaviour on tuberculosis incidence among adult population: a systematic review and meta-analysis.}, journal = {Journal of global health}, volume = {16}, number = {}, pages = {04079}, pmid = {41789521}, issn = {2047-2986}, mesh = {Humans ; Incidence ; China/epidemiology ; *Tuberculosis/epidemiology ; *Smoking/epidemiology/adverse effects ; Risk Factors ; Adult ; COVID-19/epidemiology ; }, abstract = {BACKGROUND: Tuberculosis (TB) remains a major public health challenge in China and worldwide, with smoking being a key modifiable risk factor. Given China's large population and rising smoking rates, this paper aims to examine the link between smoking and TB incidence.
METHODS: We systematically searched six databases from inception for studies reporting smoking exposure, TB outcomes, and smoker-non-smoker comparisons. Two reviewers independently screened records, extracted data, and assessed bias. We analysed smoking-TB associations using random-effects meta-analysis of odds ratios (ORs) and hazard ratios (HRs).
RESULTS: We included 17 studies reporting ORs and 7 studies reporting HRs in the quantitative synthesis. The pooled OR for TB incidence among smokers compared with non-smokers was 1.77 (95% confidence interval (CI) = 1.29-2.43), indicating a statistically significant increase in risk of TB. For studies reporting hazard ratios, the pooled estimate was 2.39 (95% CI = 1.28-4.45), showing a significant association between smoking and increased TB incidence.
CONCLUSIONS: Both active and passive smoking significantly elevate the risk of TB and worsen its outcomes in China. Our result indicate that COVID-19 pandemic may have indirectly exacerbated smoking-related risks through disruptions to TB services, heightened psychosocial stress, and shifts in smoking behaviours, with potential implications for TB risk and outcomes. Thus, integrating smoking cessation strategies into TB programmes, focusing on heavy smokers in especially high-prevalence areas, and raising public awareness could enhance efforts to prevent and control TB worldwide.
REGISTRATION: PROSPERO: CRD420251070123.}, }
@article {pmid41789942, year = {2026}, author = {Chan, R and Horst, AK and Prince, E and Medina, A and McIntyre, A}, title = {Supporting Transition and Practice Readiness Through Nursing Clinical Externships: A Scoping Review.}, journal = {The Journal of nursing education}, volume = {65}, number = {6}, pages = {329-338}, doi = {10.3928/01484834-20260130-02}, pmid = {41789942}, issn = {1938-2421}, mesh = {Humans ; *Clinical Competence ; *COVID-19/epidemiology ; *Education, Nursing, Baccalaureate/organization & administration ; *Students, Nursing/psychology ; }, abstract = {BACKGROUND: Globally, new graduate nurses face persistent transition challenges and high turnover rates that threaten workforce stability and patient care quality-issues exacerbated by the COVID-19 pandemic. Clinical nurse externship (CNE) programs have emerged as structured experiential learning models that bridge the academic-practice gap through mentorship and clinical immersion.
METHOD: Following the Joanna Briggs Institute Manual for Evidence Synthesis and Preferred Reporting Items for Systematic reviews and Meta-Analyses-Scoping Reviews framework, a comprehensive literature search was conducted across PubMed, CINAHL, Scopus, MEDLINE (via Ovid), and EBSCO's Nursing & Allied Health Reference Source. Eligible studies involved undergraduate nursing students participating in CNE programs. Two reviewers independently screened, extracted, and thematically analyzed the data.
RESULTS: Twenty-four studies met inclusion criteria, revealing five themes: clinical competence, emotional impact, relationships and support, nursing values, and professional preparedness. CNE participation consistently enhanced competence, confidence, and professional identity while reducing anxiety and transition stress.
CONCLUSION: CNE programs effectively strengthen work-force readiness, retention, and the transition from education to practice, underscoring their value as a strategic element in global nursing education and workforce planning.}, }
@article {pmid41790528, year = {2026}, author = {Gibbs, JL and Vollmer, B and Sheridan, CE and Pinkerton, K and Anthony, RT and Holm, S and Karr, C and Proctor, A and Swenson, A}, title = {Filtering facepiece respirator use among farm youth in the US: A review.}, journal = {Journal of occupational and environmental hygiene}, volume = {23}, number = {3}, pages = {178-190}, pmid = {41790528}, issn = {1545-9632}, support = {U54 OH007548/OH/NIOSH CDC HHS/United States ; U54 OH009568/OH/NIOSH CDC HHS/United States ; }, mesh = {Humans ; *Respiratory Protective Devices/statistics & numerical data/standards ; United States ; Adolescent ; *Occupational Exposure/prevention & control ; *COVID-19/prevention & control ; Equipment Design ; Child ; *Farmers ; SARS-CoV-2 ; }, abstract = {The COVID-19 pandemic underscored the critical need for protective equipment, such as filtering facepiece respirators (FFRs), particularly for youth. This systematic review addresses the significant gap in evidence-based guidance for FFR use among US farm youth, a group potentially exposed to diverse respiratory hazards. Current FFR designs and protocols for FFR use are largely adult-centric. Adhering to PRISMA 2020 guidelines, a multidisciplinary panel reviewed 31 publications published between 1990 and 2023. An independent working group of agricultural safety professionals also contributed by reviewing procedures and publications to check for bias during the review process. Key findings show that while FFRs appear physiologically tolerable by youth study subjects. Subjective discomfort and poor fit of adult-sized respirators remain major barriers to effective use and compliance. Studies highlight the critical need for youth-specific FFR designs based on detailed facial anthropometrics and the development of standardized fit-testing protocols tailored for growing youth. Furthermore, evidence-based guidance on ethical pediatric medical evaluations for respirator use and targeted respiratory health education are urgently needed. This review emphasizes that a concerted effort from manufacturers, researchers, and regulatory bodies is essential to ensure youth on farms can safely use respiratory protection.}, }
@article {pmid41790576, year = {2026}, author = {Morcos, ZL and Theoharides, TC}, title = {Long COVID neuropathy: The role of mast cells.}, journal = {Journal of neuropathology and experimental neurology}, volume = {85}, number = {5}, pages = {413-424}, doi = {10.1093/jnen/nlag016}, pmid = {41790576}, issn = {1554-6578}, mesh = {Humans ; *Mast Cells/immunology ; *COVID-19/complications/immunology ; Post-Acute COVID-19 Syndrome ; *Peripheral Nervous System Diseases/immunology/etiology ; Animals ; SARS-CoV-2 ; Neuralgia/immunology ; }, abstract = {Postacute sequelae of SARS-CoV-2 infection (PASC), or Long COVID, is estimated to affect over 60 million individuals globally, with almost half of COVID-19 survivors experiencing persistent symptoms such as neuropathic pain, fatigue, and autonomic dysfunction. Despite its prevalence, the pathophysiology of PASC remains poorly understood. This narrative review highlights activation of mast cells (MCs), the unique tissue immune cells as a central contributor to neuropathic manifestations in PASC. Mast cell locations near nerves and vessels allows them to regulate neuroimmune and neurovascular processes. Mast cell activation mirrors patterns seen in small-fiber neuropathy and myalgic encephalomyelitis/chronic fatigue syndrome, suggesting a shared immune-mediated etiology. The SARS-CoV-2 spike protein has been shown to activate MCs via angiotensin-converting enzyme 2 and toll-like receptor 4, triggering release of pro-inflammatory and neurotoxic mediators, including interleukin-1β, interleukin-6, tumor necrosis factor alpha, histamine, and tryptase. Such mediators sensitize peripheral nerves, disrupt the blood-brain barrier, and recruit microglia, ultimately contributing to small-fiber injury, neuroinflammation, and dysautonomia. Emerging reports suggest benefit from MC-directed treatments although responses remain variable. Understanding the role of MCs in PASC may offer a plausible mechanism of pathogenesis and guide targeted therapies. Future studies are needed to validate these findings and improve PASC patient outcomes.}, }
@article {pmid41791674, year = {2026}, author = {Fan, BE and Tang, JKY and Favaloro, EJ}, title = {Safeguarding global anticoagulant supply and access.}, journal = {Journal of thrombosis and haemostasis : JTH}, volume = {24}, number = {5}, pages = {1587-1592}, doi = {10.1016/j.jtha.2026.02.017}, pmid = {41791674}, issn = {1538-7836}, mesh = {Humans ; *Anticoagulants/supply & distribution/therapeutic use ; COVID-19/epidemiology ; Animals ; *Health Services Accessibility ; Global Health ; SARS-CoV-2 ; }, abstract = {Anticoagulants are essential to health care, yet their global supply is inherently fragile. Reliance on animal-derived heparin creates vulnerability to contamination, animal disease, and logistical disruption, whereas synthetic alternatives like warfarin and direct oral anticoagulants face mounting manufacturing and geopolitical risks. The COVID-19 pandemic exposed how these intersecting threats can converge during a crisis, causing critical shortages. To build resilience, a systemic shift is required: developing nonanimal-derived anticoagulants, diversifying production geographically, establishing protected supply corridors, reducing high-carbon footprint manufacturing processes, and creating equitable allocation frameworks. Anticoagulants must be recognized as essential medical assets, necessitating sustained investment and international coordination to ensure reliable access for all health systems, particularly before the next pandemic or global shock.}, }
@article {pmid41791675, year = {2026}, author = {Weitz, JI and Harrington, RA and , }, title = {Rationale for the milvexian dosing in the phase 3 LIBREXIA program.}, journal = {Journal of thrombosis and haemostasis : JTH}, volume = {24}, number = {6}, pages = {2158-2169}, doi = {10.1016/j.jtha.2026.02.020}, pmid = {41791675}, issn = {1538-7836}, mesh = {Humans ; *Atrial Fibrillation/drug therapy/blood/diagnosis ; *Acute Coronary Syndrome/drug therapy/blood/diagnosis ; *Stroke/drug therapy/blood/diagnosis ; *Anticoagulants/administration & dosage/adverse effects/pharmacokinetics ; Clinical Trials, Phase III as Topic ; Treatment Outcome ; *Pyrazoles/administration & dosage/adverse effects ; Ischemic Attack, Transient/drug therapy/blood/diagnosis ; Pyridones/administration & dosage/adverse effects ; Administration, Oral ; Hemorrhage/chemically induced ; Pyrimidines ; Triazoles ; }, abstract = {BACKGROUND: Milvexian is an oral, small-molecule inhibitor of factor (F)XIa undergoing evaluation in phase 3 clinical trials.
OBJECTIVES: This manuscript aimed to explain the rationale underpinning the hypothesis that FXIa may be a safer target for anticoagulants than FXa; describe the pharmacology of milvexian; review the results of the phase 2 trials with milvexian; and detail how the phase 2 program informed the dosing regimens for the phase 3 trials.
METHODS: This narrative review addresses the above objectives with the primary focus on addressing how the milvexian dosing regimens were selected for the phase 3 LIBREXIA program, which compares milvexian with apixaban for atrial fibrillation (AF) in the LIBREXIA AF trial (NCT05757869) and with placebo, in addition to background single or dual antiplatelet therapy, in patients with acute coronary syndrome (ACS) in the LIBREXIA ACS trial (NCT05754957), and for noncardioembolic ischemic stroke and high-risk transient ischemic attack in the LIBREXIA Stroke trial (NCT05702034).
RESULTS: The milvexian dose regimen selected for the LIBREXIA AF trial is 100 mg twice daily, and for the LIBREXIA ACS and Stroke trials, it is 25 mg twice daily.
CONCLUSIONS: The phase 3 LIBREXIA program will determine whether these dose regimens afford safe and effective anticoagulation in approximately 50 000 patients with AF, ACS, or prior stroke.}, }
@article {pmid41791686, year = {2026}, author = {Karwa, PN and Sakle, NS}, title = {RNA therapeutics 2.0: Expanding the landscape from mRNA vaccines to splicing modulators and beyond.}, journal = {Biotechnology advances}, volume = {89}, number = {}, pages = {108862}, doi = {10.1016/j.biotechadv.2026.108862}, pmid = {41791686}, issn = {1873-1899}, mesh = {Humans ; *mRNA Vaccines/therapeutic use ; *RNA Splicing/drug effects ; Animals ; RNA Editing ; SARS-CoV-2/genetics ; RNA, Small Interfering/therapeutic use ; *RNA, Messenger ; *RNAi Therapeutics/methods ; }, abstract = {RNA therapeutics have progressed into a disruptive drug class quickly, replacing a variety of primary experimental agents which included vaccines, antisense oligonucleotides (ASOs), small interfering RNAs (siRNAs), aptamers and RNA editing systems. First-generation modalities, demonstrated by fomivirsen and pegaptanib were limited by vulnerability to nuclease attack, inefficient delivery and immune stimulation were treated with clinical feasibility. Recent clinical achievements, including mRNA vaccinations against COVID-19, have been based on developments in backbone chemistry, nucleoside modifications and targeted delivery including N-acetylgalactosamine (GalNAc) conjugation and lipid nanoparticle (LNP) encapsulation. On this basis, it can be stated that the RNA Therapeutics 2.0 is more stable, tunable and can be targeted to organs and tissues. New methodologies such as circular RNA (circRNAs), self-amplifying mRNAs (saRNAs), splice-switching adenosine specific oligonucleotides (ASOs), small-molecule splicing modulators and adenosine deaminase toward RNA (ADAR)-directed base editors. These new generation systems can be used to make durable protein expression, reversible transcript recoding and precision splicing modulation, extending therapeutic applications to oncology, neurology, metabolic disease and rare genetic disorders. Extrahepatic delivery via innovations in delivery that included ligand-targeted LNPs, peptide conjugates and engineered exosomes is surpassing and artificial intelligence (AI) enhanced design is hastening optimization of RNA sequences, chemistries and vectors. RNA therapeutics in combination with gene therapy can be used to produce personalized therapeutics, such as n-of-1 medicines, based on immune regulation and control circuits. This Review describes the development of early oligonucleotide drugs to a diversified arsenal of RNA platforms, the major advancements, obstacles and emerging technology that characterize the next stage of RNA-based precision medicine.}, }
@article {pmid41792332, year = {2026}, author = {Guest, J and Moritz, C}, title = {Study design considerations in clinical trials testing transcutaneous stimulation for spinal cord injury.}, journal = {Spinal cord}, volume = {64}, number = {4}, pages = {352-361}, pmid = {41792332}, issn = {1476-5624}, mesh = {Humans ; *Spinal Cord Injuries/therapy ; *Research Design ; COVID-19 ; *Clinical Trials as Topic/methods ; *Transcutaneous Electric Nerve Stimulation/methods ; *Spinal Cord Stimulation/methods ; Pandemics ; SARS-CoV-2 ; *Coronavirus Infections/epidemiology ; }, abstract = {STUDY DESIGN: Methodological review and expert perspective.
OBJECTIVES: To examine the methodological challenges in designing rigorous clinical trials for transcutaneous spinal cord stimulation (tSCS) in chronic spinal cord injury (SCI), with particular focus on challenges of sham control implementation, and to propose alternative trial design approaches that balance scientific rigor with practical feasibility and ethical considerations.
SETTING: United States.
METHODS: We analyzed the design considerations that influenced the Up-LIFT pivotal trial, examining three critical constraints: the technical limitations of creating safe and convincing sham stimulation for extended protocols; the participant burden associated with traditional sham-controlled designs; and the heightened risks during the COVID-19 pandemic. We reviewed existing literature on placebo effects in neuromodulation, technical challenges of sham tSCS implementation, and ethical considerations specific to the SCI population. Alternative methodological approaches were evaluated, including sequential self-controlled designs, biomarker-guided approaches, and adaptive trial designs.
RESULTS: Traditional sham controls for tSCS face serious technical challenges because participants readily detect stimulation parameters, minimal currents produce detectable neuromodulatory effects, and extended protocols amplify these issues through knowledge sharing and functional feedback. Ethical concerns include substantial participant burden, potential for lessebo effects when a sham is suspected, and erosion of therapeutic relationships through prolonged deception. The COVID-19 pandemic added critical safety considerations for the vulnerable SCI population. Alternative designs, such as sequential self-controlled approaches, as implemented in Up-LIFT, can maintain scientific validity while addressing these constraints.
CONCLUSION: The unique challenges of tSCS clinical trials necessitate innovative methodological approaches beyond traditional placebo-controlled designs. Sequential self-controlled designs, biomarker-guided studies, and adaptive trial methodologies offer scientifically sound alternatives that respect participant welfare while generating robust evidence. Future research should pursue dual paths: developing improved sham paradigms while advancing alternative trial methodologies suitable for neuromodulation-enhanced rehabilitation interventions.}, }
@article {pmid41792451, year = {2026}, author = {Annadurai, P}, title = {Rapid growth and thematic shifts in mRNA therapeutics research catalyzed by the COVID-19 pandemic.}, journal = {Naunyn-Schmiedeberg's archives of pharmacology}, volume = {399}, number = {8}, pages = {12785-12791}, pmid = {41792451}, issn = {1432-1912}, mesh = {*RNA, Messenger/therapeutic use ; Humans ; *COVID-19/epidemiology ; *COVID-19 Drug Treatment ; *Biomedical Research/trends ; SARS-CoV-2 ; Animals ; Pandemics ; }, abstract = {Messenger RNA (mRNA) therapeutics emerged as a clinically validated therapeutic approach during the COVID-19 pandemic. Unlike conventional small-molecule drugs or biologics, mRNA therapeutics exert their pharmacological effects indirectly by modulating intracellular protein expression and the immune system. However, the clinical demands that occurred during the COVID-19 pandemic rapidly accelerated mRNA therapeutics research and its clinical translation. Therefore, the present study examines how the COVID-19 pandemic reshaped global mRNA therapeutics research by comparing the pre-pandemic (2015-2019) and pandemic/post-pandemic (2020-2025) periods. A systematic analysis of peer-reviewed literature indexed in the Scopus database was conducted following PRISMA guidelines. The research activity increased markedly, with a nearly 13-fold rise in publications on mRNA therapeutics after the onset of the COVID-19 pandemic. Moreover, the analysis revealed a shift from oncology-oriented studies to vaccine-focused therapeutic research. The foundational studies on nucleoside-modified mRNA and lipid-based delivery systems aligned with large-scale clinical trial evidence. These trials validated the technology by demonstrating reproducible efficacy and acceptable safety profiles. Further, the collaboration patterns evolved from a predominantly US-centered structure to a globally interconnected research network led by the USA, China, and Germany. Overall, these findings provide quantitative evidence of significant shifts in global mRNA research activity and direction during the COVID-19 period.}, }
@article {pmid41792534, year = {2026}, author = {Del Riccio, M and Maggi, S and Wieczorowska-Tobis, K and Newell, K and Czech, M and Botelho-Nevers, E and Michel, JP and Hummers, E and Duque, S and Lundgren, J and Barrat, J and Tan, L and Wysocki, J and Boccalini, S and Bechini, A and Jindal, S and Hendrickx, G and Van Damme, P and Bonanni, P and Pattyn, J}, title = {Advancing Vaccination Strategies for Older Adults: Insights of the Adult Immunization Board Meeting.}, journal = {Drugs & aging}, volume = {43}, number = {3}, pages = {223-237}, pmid = {41792534}, issn = {1179-1969}, mesh = {Humans ; *Vaccination/methods ; Aged ; *Immunization Programs ; *Vaccines/administration & dosage ; Europe ; Immunization Schedule ; }, abstract = {As Europe's population ages, optimizing vaccination strategies for older adults is an increasing public health priority. Vaccine-preventable infections pose significant risks, including increased morbidity and mortality, reduced quality of life, and substantial healthcare costs. Prevention, particularly adult vaccination, plays a vital role in mitigating these outcomes and supporting healthy ageing. While childhood immunization remains essential, a life-course approach including routine older adult vaccination is needed. Coverage among older adults across Europe remains suboptimal owing to factors such as heterogeneous (sub)national policies, health literacy issues, financial barriers, access issues, and persistent structural and societal barriers. To meet these challenges, the Adult Immunization Board (AIB) convened a technical meeting in May 2025, to discuss strategies for improving vaccination in older adults. The meeting explored how older adults are defined in immunization policies (for the meeting, an operational threshold of ≥ 50 years was used, while acknowledging that many national age-based programs commonly start around 60-65 years) and reviewed current adult vaccines and programmatic implementation across six vaccines. Discussions highlighted the need for a life-course approach with coordinated (inter)national policies, clear adult vaccination schedules, dedicated infrastructure and programs, stronger surveillance, and structured follow-up. Key recommendations included shifting from fragmented efforts to cohesive, system-wide approaches. This approach requires addressing organizational challenges with programmatic strategies such as integrating adult vaccination into routine healthcare, providing co-administration guidance, and adapting successful pediatric models for adult programs. This summary presents insights shared during the AIB meeting, highlighting gaps and promising solutions for advancing older adult immunization in Europe. Vaccination must be recognized as an investment in healthy ageing, which is also able to generate a return in economic terms, as part of a holistic health package for older adults, not as an optional add-on to treatment. With older adults now outnumbering children under 5 years globally, it is time to invest equally in their vaccination.}, }
@article {pmid41793162, year = {2026}, author = {Kim, DH and Lim, S and Eisenhut, M and Kronbichler, A and Kim, E and Kim, MS and Papatheodorou, SI and Stebbing, J and Peng, Y and Oh, SS and Shin, JI and Smith, L}, title = {The Impact of Study Size on COVID-19 Treatment Outcomes: A Meta-Epidemiological Study Comparing Large and Small Randomized Controlled Trials: A Systematic Review and Meta-Analyses.}, journal = {Reviews in medical virology}, volume = {36}, number = {2}, pages = {e70125}, pmid = {41793162}, issn = {1099-1654}, support = {//Yonsei Fellowship/ ; }, mesh = {Humans ; *Randomized Controlled Trials as Topic ; *COVID-19/epidemiology/therapy ; Treatment Outcome ; SARS-CoV-2/drug effects ; Sample Size ; *COVID-19 Drug Treatment ; *Antiviral Agents/therapeutic use ; }, abstract = {Small randomized controlled trials (RCTs) in COVID-19 meta-analyses have been associated with more favourable treatment effects and reduced result stability. This study assessed how trial size impacts effect estimates, statistical stability, and risk of bias. Following PRISMA guidelines, we identified meta-analyses of COVID-19 treatments included in WHO, NIH, and the LIVING Project. Trials were classified by log-scale sample size, and separate pooled meta-analyses were conducted for large-only, small-only, and combined trials. Comparative metrics included the Ratio of Odds Ratios (ROR), Kappa statistics, Fragility Index (FI), Reverse Fragility Index (RFI), and Cochrane Risk of Bias assessments. Sensitivity analyses applied alternative size thresholds (≥ 1000 participants and median-based cutoffs) and stratified results by treatment and outcome type. Across 25 meta-analyses including 221 RCTs (46 large, 175 small), small trials produced more extreme estimates in 19 analyses and wider confidence intervals in 23. The pooled ROR was 0.85 (95% CI: 0.76-0.95; P = 0.004), decreasing to 0.81 (95% CI: 0.68-0.95; P = 0.011) when limited to small trials published before the first large trial. RORs remained below 1 across treatment and outcome types. Agreement between small and large trials was minimal, while large trials showed substantial agreement with overall estimates. Stability and bias profiles favoured large trials (FI: 14.0 vs. 4.0; RFI: 10.0 vs. 5.0). In conclusion, small RCTs tend to overestimate treatment effects and yield less precise, less stable results. Meta-analyses should prioritise large, high-quality trials and interpret small-study findings with caution, particularly in rapidly evolving research contexts.}, }
@article {pmid41793747, year = {2026}, author = {Poole-Wright, K and Woodhall, H and Chalder, T}, title = {Healthcare worker fatigue during COVID-19, SARS, and MERS: a meta-analysis.}, journal = {Occupational medicine (Oxford, England)}, volume = {76}, number = {2}, pages = {132-143}, pmid = {41793747}, issn = {1471-8405}, support = {//National Institute for Health Research Biomedical Research Centre at South London/ ; //Maudsley National Health Service Foundation Trust and King's College London/ ; //National Health Service, National Institute for Health Research, or Department of Health/ ; //National Institute for Health Research/ ; //Biomedical Research Centre at South London and Maudsley/ ; //National Health Service Foundation Trust/ ; //King's College London/ ; //National Health Service/ ; /DH_/Department of Health/United Kingdom ; }, mesh = {Humans ; *COVID-19/epidemiology/psychology ; *Health Personnel/psychology/statistics & numerical data ; *Fatigue/epidemiology/etiology ; *Severe Acute Respiratory Syndrome/epidemiology ; Prevalence ; Frontline Workers ; Personal Protective Equipment ; SARS-CoV-2 ; *Coronavirus Infections ; Risk Factors ; }, abstract = {BACKGROUND: The physical and psychological impact of caring for patients during a coronavirus public health emergency had adverse effects on healthcare workers (HCW), including fatigue.
AIMS: To examine the prevalence of fatigue among HCW during severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) or Coronavirus disease 19 (COVID-19) and identify associated risk and protective factors.
METHODS: Systematic searches of Embase, PsycINFO, Ovid-MEDLINE, CINAHL, HMIC and the Cochrane Library were conducted to July 2024. Inclusion criteria were English-language quantitative reports of fatigue in HCW during COVID-19, SARS and MERS. Random-effects meta-analyses were used to estimate pooled prevalence. Subgroup analyses examined fatigue by role, frontline status and personal protective equipment (PPE).
RESULTS: Eighty-eight articles (n = 74 914) met our inclusion criteria; 32 were eligible for meta-analysis. The pooled prevalence of fatigue was 55% (95% CI 46-65%, k = 32). Mental fatigue was reported by 58% (95% CI 17-90%, k = 4), while 53% (95% CI 38-67%, k = 11) experienced fatigue related to PPE use. No significant differences were observed between doctors and nurses (P = 0.327) or frontline and non-frontline staff (P = 0.103). Risk factors included stress, anxiety, depressive symptoms, workload and extended working hours, while resilience, self-efficacy and sufficient rest were protective. Substantial heterogeneity (I2 ∼99%) and reliance on cross-sectional designs limited causal inference.
CONCLUSIONS: Our study indicated that over half of HCW reported fatigue and highlighted its multifactorial nature. Organizational-level interventions, such as optimized shift patterns, mandated rest breaks and psychological support are essential to mitigate fatigue, safeguard wellbeing and ensure safe healthcare provision.}, }
@article {pmid41794658, year = {2026}, author = {Nemeh, MN and Tahir, P and Hirschtritt, ME and Kalapatapu, RK}, title = {Psychiatric comorbidity in functional tics: a scoping review.}, journal = {BMC psychiatry}, volume = {26}, number = {1}, pages = {}, pmid = {41794658}, issn = {1471-244X}, mesh = {Humans ; Attention Deficit Disorder with Hyperactivity/epidemiology ; Comorbidity ; COVID-19/epidemiology ; *Mental Disorders/epidemiology ; Obsessive-Compulsive Disorder/epidemiology ; Prevalence ; *Tic Disorders/epidemiology/psychology ; *Tics/epidemiology ; Tourette Syndrome/epidemiology ; }, abstract = {BACKGROUND: There has been a dramatic rise in the prevalence of functional tics since the COVID-19 pandemic. While the prevalence of various comorbidities has been well defined in primary tic disorders such as Tourette Syndrome, less is known about this topic in patients with functional tics. Therefore, the purpose of this scoping review is to characterize what is known about the prevalence of psychiatric and neurologic comorbidities in patients with functional tics and identify gaps that persist in this literature. METHODS: A comprehensive search across multiple databases was used for data collection. We included studies that provided original data on the presence of psychiatric comorbidities in patients with a diagnosis of functional tics. Study screening progress was documented in a Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow chart. A total of 150 titles and abstracts were screened, 78 full texts were evaluated for eligibility, and 31 studies were included. RESULTS: The included studies identified epidemiological data and common psychiatric and neurologic comorbidities in patients with functional tics. Most of the studies reviewed were published after 2020, highlighting the recent uptick in incidence and prevalence of functional tics. Depression and anxiety, followed by attention deficit hyperactivity disorder and obsessive-compulsive disorder, were among the most commonly identified comorbidities. CONCLUSIONS: Overall, further research on the prevalence of comorbidities in patients with functional tics is needed to inform clinicians’ differential diagnosis and integrated treatment planning. Depression and anxiety are common comorbidities in patients with functional tics and may be underrecognized and underreported. The prevalence of all comorbidities appears to have increased since the COVID-19 pandemic. Future research should further quantitatively define the comorbidity profile in functional tics. CLINICAL TRIAL NUMBER: Not applicable.}, }
@article {pmid41795913, year = {2026}, author = {Thorpe, DW and Jones, LA and Martin, AM and Coleman, RA and Allman, C and Peterson, RA and Keating, DJ}, title = {The role of peripheral serotonin in SARS-CoV-2 infectivity, COVID-19 treatment and long COVID.}, journal = {Immunology and cell biology}, volume = {104}, number = {4}, pages = {368-376}, pmid = {41795913}, issn = {1440-1711}, mesh = {Humans ; *Serotonin/metabolism ; *COVID-19/virology/metabolism ; *SARS-CoV-2/physiology/pathogenicity ; Post-Acute COVID-19 Syndrome ; Selective Serotonin Reuptake Inhibitors/therapeutic use ; *COVID-19 Drug Treatment ; Animals ; *Gastrointestinal Tract/virology/metabolism ; Virus Internalization/drug effects ; }, abstract = {Gastrointestinal symptoms have emerged as a common, but underappreciated, cause of morbidity in relation to SARS-CoV-2 infection and the COVID-19 pandemic. This manifests as a range of indications including diarrhea, anorexia, nausea, vomiting and abdominal pain. In addition, the gastrointestinal tract may represent a route of viral entry via the epithelial cell layer lining the gut wall. This route of entry could be a significant component of disease pathogenesis, including effects on the nervous system via the gut-brain axis. In this review, we provide an assessment of the effects of COVID-19 on the gastrointestinal system, its involvement in disease severity and potential pathways for viral entry and infection in the gastrointestinal tract. We also examine evidence that gut-derived serotonin is affected by SARS-CoV-2 infection, how this may link to symptoms and disease pathogenesis and the potential link to the efficacy of selective serotonin reuptake inhibitors in reducing COVID-19 severity.}, }
@article {pmid41796425, year = {2026}, author = {Peñaherrera-Vásquez, D and Reina, A and Merlo, F and Fajardo-Loaiza, T and Zambrano-Sánchez, G and Rivadeneira, J and Fuenmayor-González, L}, title = {Unveiling the genitourinary phenotype of long COVID: a systematic review and meta-analysis.}, journal = {International urology and nephrology}, volume = {}, number = {}, pages = {}, pmid = {41796425}, issn = {1573-2584}, abstract = {IMPORTANCE: Long COVID has been associated with persistent multisystemic manifestations. However, genitourinary alterations have not been formally recognized as a distinct phenotype despite growing reports suggesting their relevance for long-term morbidity and quality of life.
OBJECTIVES: To determine the frequency and characteristics of genitourinary manifestations in patients with long COVID and to evaluate the evidence supporting the possible emergence of a genitourinary phenotype within long COVID.
DATA SOURCES: For this Systematic review and meta-analysis, a comprehensive search was conducted in PubMed (MEDLINE), Scopus, Web of Science, Embase, SciELO, and Bireme-BvS from inception to October 2025, without language or publication date restrictions. Observational studies (cross-sectional, cohort, or case-control) assessing individuals with one or more genitourinary symptoms-such as menstrual alterations, erectile dysfunction, urinary tract symptoms, or renal function decline-persisting ≥ 12 weeks after SARS-CoV-2 infection were included. Studies addressing only acute-phase manifestations, vaccine-related effects, or pre-existing genitourinary conditions were excluded.
DATA EXTRACTION AND SYNTHESIS: Data extraction was performed independently by two reviewers following PRISMA guidelines. Risk of bias (RoB) was assessed using the Joanna Briggs Institute checklist for prevalence studies. A random-effects meta-analysis using the Freeman-Tukey double arcsine transformation was applied to estimate pooled proportions, and heterogeneity was quantified using the I[2] statistic, Cochran's Q test, and the between-study variance (τ[2]).
MAIN OUTCOMES AND MEASURES: The primary outcomes were the pooled frequencies of genitourinary manifestations in long COVID, including menstrual disorders, erectile dysfunction, and renal function decline.
RESULTS: Nine primary studies encompassing 2332 participants from eight countries were included. Most studies (88.9%) presented a low RoB. The pooled frequency of menstrual disorders was 49% (95% CI 24-74), erectile dysfunction 21% (95% CI 16-28), and renal function decline 29% (95% CI 20-39).
CONCLUSIONS AND RELEVANCE: This systematic review and meta-analysis provide evidence supporting the possible emergence of a genitourinary phenotype of long COVID, encompassing menstrual irregularities, erectile dysfunction, cystitis-like symptoms, and renal impairment. Recognition of this potential phenotype is crucial for improving diagnostic accuracy, patient follow-up, and multidisciplinary management. Further high-quality studies are warranted to elucidate the underlying mechanisms and long-term clinical implications.}, }
@article {pmid41796915, year = {2026}, author = {Lasagna, A and Del Re, M and Danesi, R and Andreoni, M and Tessitore, D and Di Maio, M and Silvestris, N and Pedrazzoli, P}, title = {Bispecific antibodies in solid tumors: An Italian Association of Medical Oncology (AIOM) multidisciplinary perspective on immunology and vaccination.}, journal = {Critical reviews in oncology/hematology}, volume = {221}, number = {}, pages = {105253}, doi = {10.1016/j.critrevonc.2026.105253}, pmid = {41796915}, issn = {1879-0461}, mesh = {Humans ; *Antibodies, Bispecific/therapeutic use/immunology/adverse effects ; *Neoplasms/immunology/drug therapy/therapy ; *Vaccination/methods ; Medical Oncology ; Italy ; *Cancer Vaccines/therapeutic use ; }, abstract = {The clinical use of bispecific antibodies (BsAbs) in solid tumors is rapidly expanding, yet evidence-based guidance on infection prevention and vaccination in this setting remains limited. We performed a critical narrative review integrating immunological mechanisms, available clinical data, and multidisciplinary expert opinion to inform vaccination strategies for patients with solid tumours treated with BsAbs. BsAbs can induce transient or sustained immune perturbations, including T-cell hyperactivation, lymphocyte redistribution, functional exhaustion, cytokine-mediated immune dysregulation, and, in selected contexts, B-cell impairment. These effects may reduce vaccine-induced humoral and cellular responses and increase vulnerability to infectious complications. Optimization of vaccination status before BsAb initiation is therefore advisable, as pre-treatment immunisation is more likely to achieve effective immune priming. Inactivated vaccines, including influenza, pneumococcal, SARS-CoV-2, hepatitis B (HBV), and recombinant herpes zoster vaccines, can be administered before or, when necessary, during therapy, whereas live attenuated vaccines should be avoided during active treatment. Vaccination timing during BsAb therapy should be individualised, taking into account the treatment schedule and immune recovery. Current recommendations rely largely on indirect evidence from haematological malignancies and other T-cell redirecting therapies. These considerations are essential to support treatment continuity, reduce preventable morbidity, and guide future prospective studies in patients with solid tumors treated with BsAbs.}, }
@article {pmid41797310, year = {2026}, author = {Campbell, LA and Canales, MK and Spiser, K and Lopez, T and Mattimoe, G}, title = {Building Community Trust: A Rural Health Department's Journey Toward Health Equity.}, journal = {Public health nursing (Boston, Mass.)}, volume = {43}, number = {4}, pages = {972-982}, doi = {10.1111/phn.70104}, pmid = {41797310}, issn = {1525-1446}, mesh = {Humans ; COVID-19/epidemiology ; *Health Equity ; Health Services Accessibility ; Hispanic or Latino/statistics & numerical data ; Politics ; *Rural Health Services/organization & administration ; Surveys and Questionnaires ; *Trust ; }, abstract = {BACKGROUND: Rural health departments face unique challenges in advancing health equity, particularly during times of political polarization. These challenges intensified during the COVID-19 pandemic, highlighting the complex interplay between public health authorities, political dynamics, and community trust.
OBJECTIVE: To document how a rural local county health department (LCHD) navigated political barriers and systemic inequities to conduct a community health assessment (CHA) during and after the COVID pandemic.
APPROACH: This CHA, conducted during 2021-2023, employed mixed methods data collection strategies: a bilingual community survey, listening sessions in English and Spanish, and informal interviews. Utilizing a health equity lens, the analysis focused on identifying power dynamics, systemic barriers, and community perspectives on health.
RESULTS: Survey data revealed differences between Hispanic and non-Hispanic respondents' health concerns and perceived barriers. Healthcare access was the only statistically significant barrier for Hispanic respondents. Lessons learned from the CHA process are provided.
CONCLUSION: The strategies employed during the CHA demonstrate how rural health departments can advance health equity while navigating complex political landscapes. Success requires careful attention to language, strategic coalition building, and persistent focus on elevating marginalized voices. The LCHD built community trust despite political resistance by modifying language around equity issues and strategic coalitions.}, }
@article {pmid41798257, year = {2026}, author = {Liu, J and Wu, X}, title = {Fecal microbiota transplantation in ulcerative colitis: evidence, mechanisms, and practice considerations.}, journal = {Therapeutic advances in gastroenterology}, volume = {19}, number = {}, pages = {17562848261426284}, pmid = {41798257}, issn = {1756-283X}, abstract = {Ulcerative colitis (UC) is a chronic inflammatory bowel disease strongly associated with intestinal dysbiosis, reduced microbial diversity, and disrupted microbial metabolite profiles. Fecal microbiota transplantation (FMT) aims to restore microbial homeostasis and has shown a signal of benefit for induction of remission in some trials, but results are heterogeneous and long-term maintenance efficacy remains uncertain. In this narrative review, we synthesize randomized controlled trials (RCTs), systematic reviews/meta-analyses, and recent guideline and regulatory updates on FMT in UC, and integrate mechanistic insights from microbiome and metabolomics research. Across RCTs, intensive lower-gastrointestinal regimens using pooled, multidonor material, and/or anaerobic processing have most consistently achieved modestly higher steroid-free clinical and endoscopic remission than placebo in mild-to-moderate UC (approximately 25%-32% vs 5%-10% in representative studies), whereas upper-gastrointestinal delivery or oral lyophilized formulations and highly restrictive donor selection have yielded mixed or negative results. Mechanistically, responders commonly demonstrate engraftment of short-chain fatty acid producing taxa and restoration of secondary bile acid pathways. Safety profiles in trials are generally comparable to placebo for common mild adverse events, but rare severe transmissions (e.g., multidrug-resistant Escherichia coli and SARS-CoV-2) have driven stricter donor screening and have limited routine use outside regulated programs. Current guidelines recommend against FMT for UC outside clinical trials. Future work should prioritize standardized protocols, biomarker-guided personalization, combination strategies (diet/priming), and development of defined microbial therapeutics to improve efficacy and safety.}, }
@article {pmid41798379, year = {2025}, author = {Newnham, A and Tattersall, T and Odendaal, J}, title = {Do Medical Schools Need to Adapt Their Curriculum in Order to Teach Medical Students 'Webside' Manner? A Systematic Review.}, journal = {Medical science educator}, volume = {35}, number = {6}, pages = {3173-3183}, pmid = {41798379}, issn = {2156-8650}, abstract = {BACKGROUND: Remote consulting was exponentially implemented secondary to the COVID-19 pandemic, and remains a staple of modern healthcare. Telemedicine consulting requires a different set of consultation skills collectively coined 'webside manner'. Evidence suggests inadequate training is a barrier to effective teleconsulting. This review aims to systematically assess the effect of telemedicine consultation skills training for medical students.
METHODS: A systematic literature search was conducted using MEDLINE, PsycINFO, and EMBASE. Two independent reviewers screened articles from 1 January 2010 onwards. A mixed-methods approach was undertaken. Thematic analysis identified three reporting themes. Quantitative data was reported within these themes using descriptive statistics. Study quality was assessed using the MERSQI score.
FINDINGS: In total, 241 articles were obtained, 38 extracted for full text review, and 11 included. Three themes were identified: communication skills, doctor-patient relationship, and confidence in performing virtual consultations. Six out of seven studies reported improved communication skills following telemedicine training. Three studies report a positive impact on the doctor-patient relationship. Student confidence showed improvement in all reporting studies.
CONCLUSION: This review demonstrates a positive association between telemedicine training and improved virtual consultation skills for medical students. The results are limited by the low quality and heterogeneity of included studies.}, }
@article {pmid41798405, year = {2026}, author = {Singh, G and Hartnett, R and Silva, BM and Fekrat, SMM and Prasad, S and Gill, G and Gunturu, S}, title = {Comparison of Antipsychotics in the Treatment of COVID-19-Induced First-Episode Psychosis: A Review of Case Studies.}, journal = {Cureus}, volume = {18}, number = {2}, pages = {e103021}, pmid = {41798405}, issn = {2168-8184}, abstract = {This study aims to systematically review COVID-19-associated first-episode psychosis cases, comparing antipsychotic selection, dosing strategies, treatment response timelines, adverse effects, and relapse rates to inform evidence-based pharmacological management. We conducted a structured narrative review of published case reports and series describing COVID-19-Induced first-episode psychosis treated with antipsychotics. A comprehensive search of PubMed and Google Scholar (Jan 2020-Apr 2023) identified 42 eligible cases based on predefined inclusion/exclusion criteria. Data were extracted using a standardized template and summarized descriptively due to clinical heterogeneity. Variables included demographics, psychiatric features, antipsychotic(s) used, clinical course, and outcomes. First-episode psychosis (FEP) was higher in males (24, 57.1%) and the 30-39 age group (10, 23.8%). Olanzapine was the most commonly used single antipsychotic (6, 28.6%), while the combination of haloperidol and aripiprazole was the most frequently used antipsychotic regimen (4, 19.0%). Atypical antipsychotics were preferred (54.8%), with olanzapine (23, 54.8%) being the most commonly used at a mean dose of 10.9 mg/day. Reported side effects included fatigue, weight gain, akathisia, leukocytosis, and QT-interval prolongation (5, 11.9%), with a relapse rate of (2, 4.8%). This review evaluates the treatment methods for COVID-19 FEP and develops a deeper understanding of various antipsychotics used in managing psychosis and its outcomes.}, }
@article {pmid41798556, year = {2026}, author = {Armstrong, JL and Bennis, S and Smock, JN and Kesselman, MM}, title = {Teledermatology for Older Adults With a Focus on Nursing Home Residents: A Scoping Review of Clinical and System-Level Benefits.}, journal = {Cureus}, volume = {18}, number = {2}, pages = {e102891}, pmid = {41798556}, issn = {2168-8184}, abstract = {Teledermatology (TD), which involves providing dermatology services, including diagnosis and management, remotely, has grown as a result of the COVID-19 pandemic, becoming a critical tool for delivering dermatologic care, especially to aging populations. Specifically, for nursing home residents who often face mobility and cognitive limitations, multimorbidity, and an increased risk of complications, TD may allow for earlier diagnoses, improved access to care and quality of life, and timely management. A scoping review of studies published between 2015 and 2025 was conducted to evaluate clinical and system-level outcomes. A comprehensive search was conducted by three independent researchers using multiple databases, including Ovid MEDLINE, EMBASE, and Web of Science. To analyze the most common dermatologic diagnoses in nursing homes, the inclusion criteria included geriatric patients (>60 years old), nursing home patients, and studies published in English between 2015 and 2025. For analyzing the overall benefits of using TD, the inclusion criteria were identical except that dermatology patients of any age were eligible. Exclusion criteria for analyzing the most common dermatologic diagnoses in nursing homes and the benefits of using TD included articles that were older than 15 years and case reports. Overall, this review will provide a comprehensive analysis of the benefits of using TD as a diagnostic and management tool for dermatologic conditions in the elderly nursing home setting.}, }
@article {pmid41798665, year = {2026}, author = {Maruyama, T and Hieda, M and Fukata, M}, title = {Current Trends and Future Perspectives of Bradycardia, Renal Failure, Atrioventricular Nodal Blockade, Shock, and Hyperkalemia (BRASH) Syndrome: A Narrative Review.}, journal = {Cureus}, volume = {18}, number = {3}, pages = {e104731}, pmid = {41798665}, issn = {2168-8184}, abstract = {BRASH syndrome is defined as a clinical condition in which bradycardia, renal failure, atrioventricular (AV) nodal blockade, shock, and hyperkalemia interact to form a self-perpetuating negative spiral. Geriatric practitioners are increasingly likely to encounter elderly patients with this syndrome who are taking AV nodal blocking agents, such as calcium channel blockers (CCBs) or β-blockers. However, it remains unclear how the heart failure (HF) pandemic and coronavirus disease 2019 (COVID-19) have influenced the incidence, triggers, management, and clinical course of BRASH syndrome. Therefore, open-access databases were searched for publications from 1980 to 2025, identifying 41 eligible articles reporting a total of 54 patients with BRASH syndrome. The mean age of affected patients was 69.0 ± 15.1 years. Hypertension (HTN, 74%), chronic kidney disease (CKD, 61%), and diabetes (54%) were the most common comorbidities. More than half of the patients (52%) were prescribed angiotensin-suppressing agents (angiotensin-converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARB), or angiotensin receptor-neprilysin inhibitors (ARNI)) for HTN or HF. Two elderly patients were diagnosed with BRASH syndrome triggered by COVID-19. This literature review clarifies that BRASH syndrome commonly occurs in elderly patients with HTN or CKD and is often associated with everyday clinical events such as anorexia, vomiting, diarrhea, bleeding, and infection, including COVID-19. Our database search supports recognizing BRASH syndrome as an important clinical entity in geriatric emergency medicine. Geriatric practitioners should be aware of this condition to enable early diagnosis and appropriate management in the modern HF and post-COVID-19 era.}, }
@article {pmid41798883, year = {2026}, author = {Timpka, T and Gursky, EA and Nyce, JM}, title = {Making US public health a good idea again.}, journal = {Lancet regional health. Americas}, volume = {57}, number = {}, pages = {101423}, pmid = {41798883}, issn = {2667-193X}, abstract = {The stress test the COVID-19 pandemic imposed on the US public health system illuminated predictable yet surprisingly unplanned for fault lines. A perceived lack of choice associated with nonpharmaceutical and pharmaceutical interventions led many Americans to question both measures and processes for mitigating disease consequences, such as masking and mass vaccination. A cultural-historical examination shows that a central impediment for US efforts to control the pandemic was the limited sense of common good. Many factors and beliefs, including also that the scientific-biotechnological innovation system did not serve the interests of all people equally, and the public health community's equating disease with how people perceived illness, weakened vaccination acceptance and disease control efforts. We conclude that US public health must renegotiate the social contract with the American people to recover a shared understanding of its relevance and to effectively respond to future health challenges and pandemics.}, }
@article {pmid41799381, year = {2026}, author = {Raheel, H and Ferguson, A and Leslie, SL and Guardado-Menjivar, V and Chen, K and Merceron, A and Arciniegas, J and Lovvorn, AE and Higgins, M and Barr, DB and Saikawa, E and Handley, MA and Thompson, LM}, title = {Behavioral interventions related to plastic waste management in low-and middle-income countries: a systematic review using the behavior change wheel and the theoretical domains framework.}, journal = {Environmental research letters : ERL [Web site]}, volume = {21}, number = {5}, pages = {053003}, pmid = {41799381}, issn = {1748-9326}, abstract = {Addressing the mounting plastic waste problem requires system-level solutions, along with interventions that promote behavioral change. In low-resource countries, inadequate, if not absent, waste management systems lead to unsafe disposal practices, including open burning. While theory-informed approaches are essential for identifying enablers and barriers to target behavior change, their application is limited in these settings. Given the lack of a theory-driven synthesis of behavioral strategies to address plastic waste, this systematic review aimed to: (1) synthesize behavioral interventions related to plastic waste management in low-resource countries; (2) map these interventions to the behavior change wheel (BCW), using the capability-opportunity-motivation-behavior model, and the theoretical domains framework (TDF); and (3) classify implementation strategies to inform theory-driven intervention design. This review is the first to use the BCW to examine behavioral interventions related to plastic waste management in low-resource countries. Nine bibliographic databases: APA PsycInfo, CINAHL, Embase, Environment Complete, Global Health, GreenFile, Health Source: Nursing Academic, PubMed, and Web of Science Core Collection were searched. We included English-language human studies up to 9 April 2025, that evaluated interventions or policies targeting individual- or community-level behaviors related to plastic waste management in low-, lower-middle, or upper-middle income countries. We excluded studies from high-income countries, and those focused on environmental impacts, industrial or municipal waste streams, ecosystems or animals without human behavioral components, COVID-19-specific waste, or hypothetical modeling without real-life interventions. Forty-three studies met the inclusion criteria. Study quality was assessed using the mixed methods appraisal Tool. Interventions spanned 27 low-resource countries and targeted diverse populations, including schoolchildren, households, market vendors, and community organizations. Education was the most frequent BCW intervention function (76.7%), followed by environmental restructuring, incentivization, persuasion, and training. Mapping revealed that behavioral interventions relied most frequently on the TDF domains of environmental context, knowledge, skills, and social influences. Some domains, such as beliefs about capabilities, reinforcement, and identity, received moderate attention, while appealing to emotion or the use of behavioral regulation, were underutilized. Behavioral interventions for plastic waste management in low-resource countries have predominantly emphasized awareness-raising but insufficiently leveraged other BCW intervention functions and TDF domains. Integration of motivational, emotional, and identity-based strategies alongside structural support can enhance the sustainability of behavior change.}, }
@article {pmid41799482, year = {2026}, author = {Leon-Rojas, JE}, title = {Tele-neurology in Latin America: digital solutions for a treatment gap.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1779415}, pmid = {41799482}, issn = {2296-2565}, mesh = {Humans ; *Telemedicine/organization & administration ; COVID-19/epidemiology ; Latin America ; Digital Health ; *Neurology/organization & administration/methods ; Pandemics ; *Nervous System Diseases/therapy ; SARS-CoV-2 ; *Health Services Accessibility ; }, abstract = {Neurological disorders remain a leading cause of disability across Latin America, yet access to specialist care is affected by important workforce shortages, geographic disparities, and under-resourced health systems. Tele-neurology has emerged as a promising strategy to mitigate these barriers, particularly in the wake of the COVID-19 pandemic, which resulted in rapid digital health adoption. This review article examines the development and implementation of tele-neurology initiatives across Latin America, with a focus on Ecuador; drawing on examples such as TeleEEG, telestroke networks, and Project ECHO, I illustrate how digital tools have expanded the reach of neurological services in underserved regions. Despite demonstrable benefits, challenges persist, including uneven digital infrastructure, regulatory gaps, and disparities in access. I argue that tele-neurology must be deliberately integrated into national public health strategies, not merely as a pandemic contingency but as a potential long-term solution for health equity, if done properly. Strategic investments in broadband access, clinician training, sustainable financing, and regional collaboration are essential to scale these innovations. When anchored in strong policy frameworks and aligned with global neurological health goals, tele-neurology could offer a path toward closing the treatment gap and advancing equitable neurological care throughout Latin America.}, }
@article {pmid41800523, year = {2026}, author = {Esposito, N and Buonomo, AR and Di Filippo, I and Forte, E and Trucillo, E and Gentile, I and Schiano Moriello, N}, title = {Lessons from examining the safety of drugs for COVID-19 during pregnancy.}, journal = {Expert opinion on drug safety}, volume = {}, number = {}, pages = {1-11}, doi = {10.1080/14740338.2026.2637649}, pmid = {41800523}, issn = {1744-764X}, abstract = {INTRODUCTION: Pregnant women represent a vulnerable population during the COVID-19 pandemic, facing increased risks of severe disease and adverse obstetric outcomes, yet they have been largely excluded from pivotal therapeutic clinical trials, leaving a critical evidence gap for treatment decisions.
AREAS COVERED: This review examines the available evidence on the safety and efficacy of COVID-19 therapies during pregnancy, including oral antivirals (nirmatrelvir/ritonavir, molnupiravir), intravenous remdesivir, monoclonal antibodies, corticosteroids, and immunomodulators (tocilizumab, baricitinib). A literature search was conducted using MEDLINE/PubMed for English-language articles published from March 2020 to December 2023, including studies of any design reporting maternal and neonatal outcomes.
EXPERT OPINION: The COVID-19 pandemic exposed a critical gap in clinical research through the systematic exclusion of pregnant women from therapeutic trials. Current evidence, though largely observational, supports vaccination as the primary preventive strategy, nirmatrelvir/ritonavir for outpatients at risk of progression, and remdesivir plus corticosteroids for hospitalized patients requiring oxygen supplementation.}, }
@article {pmid41800915, year = {2026}, author = {Kato, TA}, title = {Hikikomori in the urban digital era: a psychodynamic, transdiagnostic model and multimodal interventions.}, journal = {Current opinion in psychiatry}, volume = {39}, number = {3}, pages = {234-241}, pmid = {41800915}, issn = {1473-6578}, mesh = {Humans ; *Social Isolation/psychology ; Digital Media ; Urban Population ; *Mental Disorders/therapy ; }, abstract = {PURPOSE OF REVIEW: Hikikomori (prolonged social withdrawal) was first described in Japan and was initially regarded as culture-bound. It is now recognized as a global mental health concern, more prevalent in urban settings and frequently comorbid with psychiatric disorders. In the post - COVID - 19 era, home - centered lifestyles have become increasingly normative, prompting a reconceptualization of hikikomori beyond reduced outing frequency. Drawing on over two decades of clinical and research experience, we propose a psychodynamic (developmental and attachment-informed), transdiagnostic, and multidimensional framework and outline assessment and intervention strategies for urban digital societies.
RECENT FINDINGS: International frameworks distinguish pathological from non-pathological hikikomori based on psychological distress and functional impairment. Emerging evidence implicates attachment insecurity, early adversity, and transdiagnostic biological pathways involving inflammation, and neurodevelopmental mechanisms. Early-phase pathological hikikomori is associated with increased risk of depression and gaming disorder, with possible relevance of modern-type depression. Digital tools, including online engagement and virtual reality based interventions, may provide low-threshold gateways to reach otherwise hard-to-reach individuals.
SUMMARY: In contemporary urban life, physical isolation per se is not necessarily pathological. Translating a biopsychosocial-cultural model integrating psychopathology and attachment into structured assessment, family-based approaches, clinical care, and digital interventions is essential to prevent long-term pathological hikikomori.}, }
@article {pmid41801477, year = {2026}, author = {Váscones-Román, FF and Hemeryth-Rengifo, MA and Rodriguez-Aguilar, NA and Vilca-Salas, MI and Barrios-Trujillo, LCR}, title = {Burnout among neurosurgical professionals: a systematic review and meta-analysis of prevalence and determinants.}, journal = {Neurosurgical review}, volume = {49}, number = {1}, pages = {}, pmid = {41801477}, issn = {1437-2320}, mesh = {Humans ; *Burnout, Professional/epidemiology/psychology ; Prevalence ; *Neurosurgery ; *Neurosurgeons/psychology ; Emotional Exhaustion ; }, abstract = {INTRODUCTION: Burnout is a major concern in neurosurgery, residents and attending neurosurgeons and linked to impaired performance and patient safety. OBJECTIVE: To estimate the prevalence of burnout among neurosurgical professionals, summarize Maslach Burnout Inventory (MBI) subscale scores, and explore geographic, temporal, and determinant patterns. METHODS: We performed a PRISMA 2020–compliant systematic review and meta-analysis of observational studies reporting burnout in neurosurgical residents and/or attendings using validated instruments, searched through April 2025. The primary analysis pooled studies using a standardized MBI-based definition (emotional exhaustion ≥ 27 or depersonalization ≥ 10). Random-effects models (restricted maximum likelihood, Hartung–Knapp adjustment) were applied to logit-transformed prevalences, reporting pooled prevalence with 95% confidence intervals (CI), 95% prediction intervals (PI), and I[2]. Risk of bias was assessed with Joanna Briggs Institute checklists. RESULTS: Twenty-nine studies including 8,063 neurosurgical professionals were identified, of whom 6,077 contributed to the primary MBI-based meta-analysis. The pooled prevalence of burnout was 45% (95% CI 36–55%), with extreme heterogeneity (I[2] = 97.4%; τ[2] = 0.53) and a wide 95% PI (14–80%), indicating marked variability across settings. Point estimates were higher among residents than attending neurosurgeons, but uncertainty was substantial and subgroup differences were not supported under random-effects models. Differences across pre-, during, and post–COVID-19 periods were inconclusive. Excessive workload, long working hours, sleep deprivation, poor work–life balance, and limited institutional support were the most frequent risk factors, while protective factors were less consistently reported. CONCLUSION: Burnout is common among neurosurgical professionals worldwide, but prevalence estimates vary widely, and extreme between-study heterogeneity indicates that the dominant signal in the literature is methodological inconsistency rather than a single universal prevalence. More standardized measurement and context-sensitive, system-level interventions are urgently needed to mitigate burnout and safeguard neurosurgeon well-being, patient safety, and the long-term sustainability of the neurosurgical workforce.}, }
@article {pmid41801631, year = {2026}, author = {Tian, Y and Zheng, Q and Yin, J and Liu, T and Zhang, W and Ban, Y and Zheng, L and Tang, W and Kang, H}, title = {Glycocalyx degradation: exploring related mechanisms, pathophysiological significance, and therapeutic prospects.}, journal = {Journal of physiology and biochemistry}, volume = {82}, number = {1}, pages = {}, pmid = {41801631}, issn = {1877-8755}, support = {No. BYSYDL2023004//Clinical Cohort Construction Program of Peking University Third Hospita/ ; Grant No. 2024YFA1108603//Grants-in-Aid from the National Key R&D Program of China/ ; No.32271368//National Natural Science Foundation of China/ ; QY25235//Beijing Natural Science Foundation/ ; }, mesh = {*Glycocalyx/metabolism/pathology/drug effects ; Humans ; Animals ; Hyaluronic Acid/metabolism ; Heparan Sulfate/metabolism ; Signal Transduction ; Cardiovascular Diseases/metabolism/pathology/drug therapy ; Syndecans/metabolism ; Endothelium, Vascular/metabolism/pathology ; Diabetes Mellitus/metabolism/pathology ; Endothelial Cells/metabolism/pathology ; Sepsis/metabolism/pathology ; SARS-CoV-2 ; }, abstract = {The glycocalyx is a fuzzy structure covering the luminal surface of vascular endothelial cells. Its name was first proposed by Bennett, derived from the Latin word meaning ‘sweet shell’. This was confirmed by Luft in 1966 through ruthenium red staining under electron microscopy. In recent years, the role of the glycocalyx in the pathophysiological processes of various diseases, such as cardiovascular diseases, chronic kidney disease, sepsis, COVID-19 infection, and diabetes, has gradually attracted widespread attention, and its importance has been increasingly recognized. In these acute and chronic clinical situations, the endothelium surface may lose syndecans, heparan sulfate (HS), and hyaluronan (HA), the primary constituents of the glycocalyx, a process involving multiple degrading enzymes. This review aims to start from the mechanisms of glycocalyx degradation, systematically elaborate on the factors related to degradation, enzymes involved in the degradation process, and signaling pathways. It also explores pharmacological drugs with the potential to reduce glycocalyx shedding, as found in current laboratory and clinical studies. In this review, it is expected to provide a reference for a deeper understanding of the role of glycocalyx in physiological and pathological processes and to offer new ideas and targets for the development of diagnostic, therapeutic, and preventive strategies for related diseases.}, }
@article {pmid41802499, year = {2026}, author = {Sheehan, C and Liu, TJ and Zhang, P and Wang, H and Chang, A}, title = {Excipients: New opportunities for complex challenges - USP's approaches.}, journal = {European journal of pharmaceutics and biopharmaceutics : official journal of Arbeitsgemeinschaft fur Pharmazeutische Verfahrenstechnik e.V}, volume = {223}, number = {}, pages = {115045}, doi = {10.1016/j.ejpb.2026.115045}, pmid = {41802499}, issn = {1873-3441}, mesh = {*Excipients/chemistry/standards ; Chemistry, Pharmaceutical/methods ; Humans ; Polymers/chemistry ; *Pharmacopoeias as Topic/standards ; Drug Delivery Systems/methods ; Nanomedicine/methods ; }, abstract = {The quality of excipients is important since they can make up to about 90% of the total mass/volume of the drug product. Traditionally, excipients specifications were established with a focus on quality for intended use in the drug product and less on excipient composition, and physical and chemical properties, however, the increasing demand for high quality excipients used in the development of nanomedicines and novel delivery systems requires higher quality and purity, e.g., use of phospholipids in development of Covid-19 vaccine nanomedicine delivery systems. USP is collaborating with stakeholders to address the lack of standardized test methods for complex/polymeric type excipients (e.g., phospholipids/LG polymers) offering new solutions and help with excipient compositional and variability issues along with associated environmental aspects. By expanding its offerings through its "emerging standards" new model for stakeholder engagement, USP is more flexible in its solutions offerings that favor earlier interaction in the genesis of quality standards in a more iterative way. This publication will provide an overview of evolving compendial approaches (e.g., standalone chapters) and expanded solutions and offerings (use of analytical reference materials (ARMS), associated application (App) notes, and technical guides).}, }
@article {pmid41802806, year = {2026}, author = {Tan, JH and Mainali, P and Zhang, W and Ow, DS}, title = {Armored RNA technology as a clinical diagnostics tool for future pandemic preparedness.}, journal = {Journal of microbiology (Seoul, Korea)}, volume = {64}, number = {2}, pages = {e2510016}, doi = {10.71150/jm.2510016}, pmid = {41802806}, issn = {1976-3794}, support = {//Agency for Science, Technology and Research/ ; M24N8c0107//Young Investigator Research/ ; }, mesh = {Pandemic Preparedness ; Humans ; *COVID-19/diagnosis ; SARS-CoV-2/genetics/isolation & purification ; *RNA, Viral/genetics ; *Molecular Diagnostic Techniques/methods ; }, abstract = {The COVID-19 pandemic highlighted the critical role of reliable molecular diagnostics in outbreak response and the vulnerabilities of existing systems to delays and reagent instability. Armored RNA technology, which packages RNA within bacteriophage-derived capsids, offers a robust solution by combining nuclease resistance, safety, and versatility into a single platform. Armored RNA has become a trusted internal and external control for RT-qPCR and RT-LAMP, enabling accurate detection across a wide range of viral pathogens. Also, recent advances in alternative expression systems, such as plant-based and cell-free platforms, as well as the use of more stable scaffolds from bacteriophage Qβ, are enhancing yield, stability, and accessibility of armored RNA. Engineering innovations, including capsid polymorphism and optimized downstream purification, further improve efficiency and broaden possible applications. Looking ahead, armored RNA holds promise not only as a diagnostic standard but also as a delivery vehicle for vaccines and therapeutics. Encapsulation of self-amplifying RNA, small interfering RNA, or microRNA could open new pathways for rapid-response vaccines and targeted therapies, aligning this technology with the future of precision medicine. By uniting stability, scalability, and adaptability, armored RNA represents a critical component of global health preparedness, with the potential to strengthen diagnostic resilience and accelerate biomedical countermeasures in future pandemics.}, }
@article {pmid41803812, year = {2026}, author = {Wang, K and Ma, CH and Khoramjoo, M and Kung, JY and Oudit, GY}, title = {Taurine supplementation as a therapeutic strategy for cellular senescence and chronic inflammation in long COVID: a systematic review and meta-analysis.}, journal = {BMC infectious diseases}, volume = {26}, number = {1}, pages = {}, pmid = {41803812}, issn = {1471-2334}, mesh = {*Taurine/therapeutic use/administration & dosage/blood/pharmacology ; Humans ; *Inflammation/drug therapy ; *COVID-19/complications ; *Cellular Senescence/drug effects ; Post-Acute COVID-19 Syndrome ; Dietary Supplements ; SARS-CoV-2 ; Oxidative Stress/drug effects ; *COVID-19 Drug Treatment ; }, abstract = {BACKGROUND: SARS-CoV-2 infection can induce cellular senescence, resulting in chronic inflammation and senescence-associated secretory phenotype observed in post-acute sequalae of COVID-19 (PASC). Taurine, a conditionally essential amino acid with potent anti-inflammatory and antioxidant properties, is naturally upregulated during COVID-19 convalescence. Preclinical evidence suggests taurine protects against cellular senescence, telomerase deficiency, DNA damage, and mitochondrial dysfunction, indicating its potential therapeutic role in PASC. METHODS: We systemically searched MEDLINE, Embase, Cochrane Library, and Scopus through 21st March 2025 for clinical trials investigating taurine supplementation in systemic perturbations associated with PASC. Outcomes of interest included markers of glycemic control, lipid metabolism, inflammation, oxidative stress, cardiopulmonary function, and neurocognition. In a parallel analysis, we systematically searched six databases (MEDLINE, Embase, Cochrane Library, CINAHL, Web of Science, and Scopus) for studies reporting plasma taurine levels during COVID-19 convalescence. Random-effects models were used to pool effect sizes, and meta-regression was employed to explore study heterogeneity. RESULTS: Analysis of 27 clinical trials (n = 1,030) demonstrated that taurine supplementation significantly improved markers of metabolic dysfunction (including hemoglobin A1c, fasting blood glucose, fasting insulin, HOMA-IR, total cholesterol, triglycerides, and low-density lipoprotein), inflammation (C-reactive protein, TNF-⍺, and IL-6), and oxidative stress (malondialdehyde). Supplementation also improved blood pressure and exercise capacity, though no significant effects on neurocognition were observed. Given the dose-response relationship identified between taurine and inflammatory markers TNF-⍺ and IL-6, a daily dose of 3,000 mg appears to offer an optimal balance between clinical efficacy and tolerability. Furthermore, a pooled analysis of six studies (n = 308) revealed significantly lower plasma taurine levels in individuals with PASC compared to recovered, symptom-free counterparts (SMD - 0.35, 95% CI: -0.63 to -0.08). CONCLUSIONS: Taurine supplementation effectively ameliorates key pathological features of PASC, including metabolic perturbation, endothelial dysfunction, and oxidative stress. The observed relative taurine deficiency in individuals with PASC further supports its potential as a therapeutic strategy to reduce senescence burden and chronic inflammation underlying this debilitating condition. TRIAL REGISTRATION: CRD420251011508 (Registration Date: 16 March 2025).}, }
@article {pmid41804969, year = {2026}, author = {Branfield, S}, title = {The interface of hemostasis and inflammation: endothelial-platelet dynamics in thrombosis.}, journal = {Current opinion in hematology}, volume = {33}, number = {3}, pages = {88-94}, doi = {10.1097/MOH.0000000000000918}, pmid = {41804969}, issn = {1531-7048}, mesh = {Humans ; *Blood Platelets/metabolism/pathology ; *Hemostasis ; *Thrombosis/drug therapy/pathology/blood/metabolism ; *COVID-19/blood/complications/pathology ; *Inflammation/pathology/blood/drug therapy/metabolism ; von Willebrand Factor/metabolism ; *SARS-CoV-2 ; Platelet Membrane Glycoproteins/metabolism/antagonists & inhibitors ; ADAMTS13 Protein/metabolism ; *Endothelial Cells/metabolism/pathology ; Extracellular Traps/metabolism ; }, abstract = {PURPOSE OF REVIEW: This review summarizes current understanding of platelet-endothelial contributions to thrombosis, emphasizing molecular crosstalk [von Willebrand factor (VWF)/ADAMTS13 balance, P-selectin, platelet glycoprotein VI (GPVI), integrins, extracellular vesicles, neutrophil extracellular traps (NETs)], high-risk clinical settings, and translational advances. Highlighting GPVI-directed therapeutics, the VWF/ADAMTS13 axis in COVID-19, and opportunities and challenges for targeting the platelet-endothelial interface.
RECENT FINDINGS: Clinical and translational studies support the safety and potential efficacy of targeting platelet-endothelial interfaces. GPVI inhibitors (Glenzocimab, Revacept) have advanced through phase I/II studies with reassuring bleeding profiles and suggest benefit in ischemic stroke and lesion-directed settings. Direct interruption of platelet-VWF interactions (Caplacizumab) is established in immune thrombotic thrombocytopenic purpura (TTP), while studies show a persistent VWF/ADAMTS13 imbalance in severe COVID-19 and inflammatory states linked to microthrombosis and worse outcomes. Antiadhesion strategies (P-selectin blockade) and modulators of immunothrombosis (NET inhibitors, targeting extracellular vesicle) are also in evaluation.
SUMMARY: Targeting platelet-endothelial crosstalk has potential to reduce pathologic thrombosis while preserving hemostasis. Clinical proof of principle exists for focused approaches (anti-VWF in TTP; P-selectin blockade in vaso-occlusion; emerging GPVI inhibitors). Priorities are: defining disease contexts and timing where interface targeting is effective; validating biomarkers (VWF/ADAMTS13 ratio, soluble P-selectin, platelet activation signatures) for patient selection; and conducting adequately powered trials with rigorous bleeding endpoints.}, }
@article {pmid41805007, year = {2026}, author = {Bhattacharjee, M and Bérubé, J and Durand, M and Rousseau, S and Zawati, MH}, title = {The Biobanque Québécoise de la COVID-19: Anticipate to Innovate.}, journal = {Biopreservation and biobanking}, volume = {}, number = {}, pages = {19475535261429759}, doi = {10.1177/19475535261429759}, pmid = {41805007}, issn = {1947-5543}, abstract = {The COVID-19 pandemic underscored the urgent need for strong biobanking infrastructures to facilitate rapid research and innovation in public health emergencies. The COVID-19 Québec Biobank (BQC19), launched in March 2020, serves as a pioneering initiative to address this demand, enabling the collection, storage, and sharing of biological samples and data to advance diagnostics, therapeutics, and epidemiological research. This article examines the development and operational framework of BQC19, highlighting five key themes central to its success. First, BQC19's anticipatory governance model emphasizes adaptability, leveraging strategic foresight to maintain ethical and efficient operations during the pandemic. Second, the initiative's harmonized yet flexible consent processes ensured participant autonomy and compliance with evolving clinical and public health contexts. Third, BQC19's collaborative governance framework facilitated seamless interinstitutional cooperation, supported by standardized operating procedures and localized manuals of procedures. Fourth, streamlined data access mechanisms, managed by an independent data access committee, promoted ethical and equitable data sharing, balancing privacy considerations with research accessibility. Last, BQC19 demonstrates the transferability of its infrastructure to other health challenges, providing a scalable, ethical, and collaborative model for future public health crises. Through centralized data management, preestablished legal agreements, and tiered access protocols, BQC19 has significantly reduced response times and operational inefficiencies. Its achievements showcase the potential of biobanks in fostering global health collaboration, enabling rapid research mobilization, and addressing emerging health threats. BQC19's legacy lies in its ability to integrate innovation, ethics, and collaboration into a sustainable framework for public health preparedness.}, }
@article {pmid41805020, year = {2026}, author = {Uddin, ME and Asaduzzaman, M and Ahmad, T and Ahmed, S and Kundu, SK and Khan, MMH and Islam, MM and Hossen, MM and Sheikh, MR and Sheikh, MMI}, title = {Vitamin D and Zinc in SARS-CoV-2 Infection: Immunomodulatory Mechanisms and Clinical Evidence.}, journal = {Viral immunology}, volume = {39}, number = {3}, pages = {97-112}, doi = {10.1177/08828245261426982}, pmid = {41805020}, issn = {1557-8976}, mesh = {Humans ; *Vitamin D/therapeutic use/administration & dosage ; *Zinc/therapeutic use/administration & dosage ; *COVID-19/immunology/epidemiology ; *SARS-CoV-2/immunology ; Dietary Supplements ; *COVID-19 Drug Treatment ; Immunologic Factors/therapeutic use ; *Immunomodulating Agents/therapeutic use ; Anti-Inflammatory Agents/therapeutic use ; Animals ; Immunomodulation ; }, abstract = {The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in approximately 778 million reported cases and over 7 million deaths worldwide as of August 2025 (WHO COVID-19 Dashboard), predominantly due to variable acute and chronic lung infections accompanied by inflammatory responses within the pulmonary tract and vasculature. Despite ongoing research, no definitive cure has been identified. Preventive measures, including vaccines and monoclonal antibody-based interventions, have been developed to protect vulnerable populations, and hundreds of therapeutic candidates have been evaluated worldwide. Complementing these strategies, vitamin D and zinc (Zn) supplementation have emerged as promising, accessible adjunctive strategies due to their immunomodulatory and anti-inflammatory properties. This review synthesizes current experimental, clinical, and epidemiological evidence on the roles of vitamin D and Zn in modulating immune responses relevant to SARS-CoV-2 infection. Available data suggest that adequate vitamin D and Zn status may support immune function, reduce excessive inflammation, and potentially mitigate disease severity, particularly in deficient individuals. However, clinical trial outcomes remain heterogeneous. Overall, vitamin D and Zn supplementation may be considered supportive, adjunctive preventive measures. Further well-designed randomized controlled trials are required to define their optimal use in COVID-19 prevention and management.}, }
@article {pmid41806061, year = {2026}, author = {Moyue, X and Liang, S and Ying, X and Yang, Y and Dongang, Z}, title = {Research progress of nucleocapsid protein of novel coronavirus: structure, function and targeted therapy.}, journal = {Archives of virology}, volume = {171}, number = {4}, pages = {}, pmid = {41806061}, issn = {1432-8798}, support = {National Natural Science Foundation of China//National Natural Science Foundation of China/ ; }, mesh = {Humans ; Antiviral Agents/pharmacology/therapeutic use ; SARS-CoV-2 ; *Coronavirus Nucleocapsid Proteins/chemistry/metabolism ; *Nucleocapsid Proteins/chemistry/metabolism ; COVID-19 ; *Betacoronavirus/physiology/chemistry/drug effects ; Virus Replication ; *Coronavirus Infections/drug therapy/virology ; *Pneumonia, Viral/drug therapy/virology ; Virus Assembly ; Phosphoproteins/chemistry/metabolism ; Pandemics ; Immune Evasion ; }, abstract = {The outbreak of COVID-19 caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). SARS-CoV-2 poses an ongoing threat to global public health security. The continuous evolution of viruses (e.g., Delta, Omicron) has increased the risk of viral transmissibility, infectivity, and the risk of immune escape. As highly conserved structural proteins of viruses, nucleocapsid proteins (N proteins) play a central role in the viral life cycle, and the study of their functional mechanisms and targeted therapeutics is crucial for the development of antiviral strategies. In this paper, we systematically describe the structural characterization, functional mechanism, and targeted therapy of the SARS-CoV-2 N protein, analyze its key roles in viral packaging, replication, and immune escape, and discuss the challenges and future directions of drug development for the N protein.}, }
@article {pmid41806408, year = {2026}, author = {Atluri, S and Al Masud, A and Islam, MS and Duong, MC and Seale, H}, title = {Examining the proposed role of civil society and non-governmental organisations in the implementation of AMR national action plans: A global policy review.}, journal = {Public health}, volume = {254}, number = {}, pages = {106237}, doi = {10.1016/j.puhe.2026.106237}, pmid = {41806408}, issn = {1476-5616}, mesh = {*Organizations ; Humans ; *Health Policy ; *Drug Resistance, Microbial ; Global Health ; Social Group ; }, abstract = {OBJECTIVES: Civil Society Organisations (CSOs) and Non-Governmental Organisations (NGOs) have long supported public health programs by delivering services, raising awareness, and advocating for policy change. Despite their key role in addressing complex health issues like HIV and COVID-19, their involvement in antimicrobial resistance (AMR) strategies remains underexplored. This study reviews how CSOs and NGOs are framed within AMR National Action Plans (NAPs) to better understand their role in mitigating AMR.
STUDY DESIGN: Policy review.
METHODS: A content analysis of publicly available AMR NAPs was conducted using key terms related to CSOs and NGOs. Relevant excerpts were coded across seven focus areas of engagement, with multiple reviewers to ensure consistency. Data were analysed thematically to identify patterns in CSO and NGO involvement across countries.
RESULTS: Of the 194 WHO member states, 129 (63%) AMR National Action Plans (NAPs) were available and reviewed, with 27% inclusive of 2025. References to CSOs appeared in 40% of NAPs, and NGOs in 51%, though the extent and specificity of their roles varied widely. CSO involvement was most commonly associated with advocacy, particularly in low-and-middle-income countries (LMICs), while education, prevention, surveillance, and resource mobilisation were less frequently addressed. Participation in government committees and policy-making was limited.
CONCLUSIONS: The study revealed that referenced CSO and NGO involvement is often broad and lacks specificity. These findings underscore the need for more precise and context-specific inclusion of CSOs in AMR strategies to enhance their contribution to policy implementation and community-level action.}, }
@article {pmid41807825, year = {2026}, author = {Ott, PA}, title = {The promises and challenges of neoantigen cancer vaccines.}, journal = {Nature biotechnology}, volume = {44}, number = {5}, pages = {740-751}, pmid = {41807825}, issn = {1546-1696}, support = {R01 CA229261/CA/NCI NIH HHS/United States ; }, mesh = {*Cancer Vaccines/immunology/therapeutic use ; Humans ; *Antigens, Neoplasm/immunology/genetics ; *Neoplasms/immunology/therapy ; Animals ; COVID-19/immunology/prevention & control ; mRNA Vaccines/immunology ; SARS-CoV-2/immunology ; Protein Subunit Vaccines ; }, abstract = {Transformational advances in genomic sequencing capabilities, vastly improved HLA class I epitope prediction algorithms and powerful delivery platforms have facilitated the clinical development of vaccines targeting neoantigens encoded by tumor mutations. Early clinical trials indicate that vaccination against neoantigens can induce robust and durable T cell immunity that may persist for decades. mRNA vaccines, originally developed for cancer applications, have demonstrated considerable promise due to their efficacy and scalable production, as evidenced during the SARS-CoV-2 pandemic. However, the optimal cancer vaccine platform and delivery strategy is not yet known, as current approaches have not been compared head-to-head and substantial technological advances to improve immunogenicity and potentially clinical efficacy are achievable. For example, lipid-based formulations, while necessary for the effective delivery of mRNA vaccines, may also improve the immunogenicity of peptides and other delivery strategies. Here we review the current state of neoantigen vaccines in the clinic and highlight emerging opportunities for advancement in the field.}, }
@article {pmid41808188, year = {2026}, author = {Mahon, N and Hays, LMC and Coy, E and Ainscough, K and Burrell, A and Gordon, AC and Rochwerg, B and Wang, CM and Harvey, D and Parekh, D and Goligher, E and Toal, F and Saito, H and Marshall, JC and Stewart, J and Gobat, N and Webb, S and Tolppa, T and McAuley, DF and Nichol, AD}, title = {Views on consent approaches used in emergency and critical care research: a rapid, systematic review.}, journal = {Trials}, volume = {27}, number = {1}, pages = {}, pmid = {41808188}, issn = {1745-6215}, support = {NIHR155209//Health Technology Assessment Programme/ ; NIHR154493//Efficacy and Mechanism Evaluation Programme/ ; CTN-2021-010/HRBI_/Health Research Board/Ireland ; DIFA-2023-025/HRBI_/Health Research Board/Ireland ; APRO-2023-017/HRBI_/Health Research Board/Ireland ; }, mesh = {Humans ; *Informed Consent/ethics ; *COVID-19/epidemiology ; *Critical Care/ethics ; Third-Party Consent ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Obtaining informed consent can be challenging in emergency and critical care research due to the acute and severe nature of the patient's condition. However, such research is urgently needed to inform practice and optimise patient outcomes. While alternative consent approaches have been commonly used, opinions may vary, particularly among diverse and underserved patient groups and in the context of the recent COVID-19 pandemic. The objective of this review was to assess views of alternative consent methods in emergency and critical care research.
METHODS: We conducted a rapid systematic review to understand diverse opinions of alternative consent models used in emergency and critical care research with searches of MEDLINE, EMBASE, PsycINFO, Web of Science and CENTRAL carried out to July 31, 2024. We included quantitative and qualitative studies and summarised findings using narrative synthesis. We specifically investigated underserved groups and consent in the pandemic setting.
RESULTS: From 9974 citations, we screened 289 full-text articles, and included 145 eligible studies from 26 countries. Consent methods included prospective informed consent, deferred consent, surrogate decision maker consent, healthcare professional consent and waived consent. Groups represented included previous trial participants, relatives of trial participants, patients, members of the general public, healthcare providers, researchers, site staff, and research ethics committees. It was recognised that prospective informed consent from the patient is not possible in all scenarios. In general, alternative consent models were acceptable, with emphasis on the inclusion of the patient and relatives in the decision-making process whenever possible. Acceptability of alternative consent models was influenced by previous research participation, experience of critical or emergency illness, perceived risk of participation, and invasiveness of the intervention. Study staff highlighted potential limitations of some alternative consent models, such as unavailability of relatives. Pandemic studies showed an increased need for alternative consent methods, and greater preparedness and engagement with ethics committees to facilitate implementation. Sub-analysis evaluating the views of underserved groups did not show consensus, and accommodations were largely not reported.
CONCLUSION: Alternative consent models used for emergency, critical care and pandemic research including deferred consent, relative/surrogate decision maker consent, and physician consent were generally acceptable.
TRIAL REGISTRATION: PROSPERO CRD42023408305 (April 19, 2023).}, }
@article {pmid41809272, year = {2026}, author = {Zarkadi, A and Katotomichelakis, M and Chaidas, K}, title = {Long-Term Olfactory Dysfunction in COVID-19 Patients: A Systematic Review.}, journal = {Cureus}, volume = {18}, number = {2}, pages = {e103143}, pmid = {41809272}, issn = {2168-8184}, abstract = {Olfactory dysfunction (OD) emerged early in the COVID-19 pandemic as a prevalent and often persistent symptom. While most individuals recover within weeks, a significant proportion continue to suffer from long-term impairments, including both quantitative and qualitative sensory deficits. Our review aimed to summarize current evidence on long-term post-COVID-19 OD with a duration of at least three months, including prevalence, recovery trajectory, and prognostic factors. The PubMed and Scopus databases were searched for relevant studies up to August 2024 following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Twenty-one studies were ultimately included, involving over 4,000 individuals. A remarkable proportion of patients continue to experience persistent dysfunction post-infection for a period ranging from several months to over two years. Qualitative disorders, such as parosmia and phantosmia, frequently appeared during recovery. Prognosis seemed to be related to age, initial severity, duration of OD, co-existing symptoms, and potentially sex. A consistent discrepancy between subjective reports and objective psychophysical test results was observed. Methodological heterogeneity limited comparability across studies. Olfactory dysfunction is a significant and often overlooked long-term complication of COVID-19. Standardized diagnostic criteria, validated outcome measures, and prospective longitudinal research are urgently needed to guide evidence-based management and improve patient outcomes.}, }
@article {pmid41809895, year = {2025}, author = {Shi, Y and Sun, K and Hu, Y and Lou, Z and Wang, Y and You, J}, title = {The strategies and advances of mRNA translation booster.}, journal = {Asian journal of pharmaceutical sciences}, volume = {20}, number = {6}, pages = {101090}, pmid = {41809895}, issn = {2221-285X}, abstract = {The therapeutic efficacy and safety of mRNA-based drugs in immunological and nonimmunological applications are critically dependent on the translated protein yield, which requires precise modulation of mRNA expression kinetics. Among the factors influencing mRNA translation, immunogenicity and stability are pivotal in determining the longevity of protein production. Current optimization strategies have integrated (1) molecular engineering (e.g., modified nucleotides), (2) advanced delivery systems (e.g., lipid nanoparticles), and (3) adjuvant drug synergy. This review focuses on co-delivered adjuvant drugs and introduces the concept of "mRNA translation boosters" for the first time. mRNA translation boosters are classified as small-molecule compounds and macromolecular agents that improve translational fidelity through mechanisms including blockade of pattern recognition receptors, modulation of inflammatory cascades, facilitation of endosomal escape, and protection against enzymatic degradation. As clinically validated with COVID-19 mRNA vaccines, these boosters have now demonstrated expanded utility in gene editing therapies and protein replacement applications. This review addresses the immunological challenges encountered during mRNA transfection and translation while summarizing existing mRNA translation boosters that optimize protein expression kinetics. By establishing a mechanistic framework for booster selection and employment, this work provides translational guidance for advancing nucleic acid therapeutics towards their maximum clinical potential.}, }
@article {pmid41810312, year = {2026}, author = {Lihemo, G and Blunt, M and Dadari, I and Underwood, T and Ochoa Toasa, AE and Velias, A and Hopkins, KL and Thomson, A and Kanwagi, R and Gillespie, A and Pokharel, DR and Singh, S}, title = {The impact of COVID-19 on general vaccine acceptance in low- and middle-income countries: a systematic review.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1764389}, pmid = {41810312}, issn = {2296-2565}, mesh = {Humans ; *COVID-19/prevention & control/epidemiology ; *Developing Countries ; *Vaccination Hesitancy/psychology/statistics & numerical data ; *COVID-19 Vaccines/administration & dosage ; *Vaccination/psychology ; *Patient Acceptance of Health Care/psychology/statistics & numerical data ; SARS-CoV-2 ; Pandemics ; }, abstract = {BACKGROUND: The COVID-19 pandemic caused a major decline in childhood vaccination, especially in low- and middle-income countries (LMICs). However, its specific impact on vaccine hesitancy in the immediate post-pandemic years, particularly toward non-COVID-19 vaccines, remains unclear. Understanding the social and behavioral factors influencing vaccine acceptance following a public health emergency such as the COVID-19 pandemic is critical to improving immunization coverage. This systematic review examined the impact of the COVID-19 pandemic on general vaccine acceptance in LMICs to inform strategies to improve vaccine uptake.
METHODS: This systematic review assessed people's thinking and feeling, motivations, practical issues, and social processes around vaccination, conceptualized by the World Health Organization's Behavioural and Social Drivers framework. Studies were included if they were interventional or observational in design, examined the impact of the COVID-19 pandemic on vaccine hesitancy or acceptance for non-COVID-19 vaccines, and were published in English between 2020 and 2023.
RESULTS: A total of 23 studies were included in the review, with most studies conducted in middle-income settings and focused on healthcare workers or parents/caregivers of children. Findings belonging to the "Thinking and Feeling" category were the most commonly reported in 91% (n = 21/23) of studies. Over half (61%) of studies reported findings relating to the 'Motivation' construct, while 43% of studies reported outcomes related to 'Practical Issues' and 'Social Processes'. Studies reported both increases and decreases in vaccine hesitancy and intention to vaccinate due to the pandemic. Overall, studies most commonly reported that the COVID-19 pandemic had a negative or neutral effect on attitudes, intentions, and actions regarding vaccine acceptance.
CONCLUSION: This systematic review illustrates how the COVID-19 pandemic influenced vaccine acceptance and decision-making in complex, context-dependent ways, impacting people's thinking and feeling, motivations, practical issues, and social processes around vaccination. The findings highlight the need to understand the specific drivers of vaccine acceptance to design more effective, targeted strategies to improve immunization uptake. The insights from this study can be used to inform evidence-based vaccination catch-up strategies to regain pandemic losses and mitigate factors that deter individuals from seeking vaccination.}, }
@article {pmid41810466, year = {2026}, author = {Egorova, VS and Kolesova, EP and Voronina, MV and Denisova, ER and Syrocheva, AO and Pallaeva, T and Hakemi, MG and Zamyatnin, AA and Ivanov, KI and Kostyushev, D and Brezgin, S and Kostyusheva, A and Parodi, A}, title = {From bench to bedside: Unveiling the background and benefits of nanovaccines tested in clinics.}, journal = {Asian journal of pharmaceutical sciences}, volume = {21}, number = {1}, pages = {101116}, pmid = {41810466}, issn = {2221-285X}, abstract = {Despite the growing body of literature on nanovaccines, focused analyses of platforms tested in and undergoing clinical investigation remain limited. This review addresses this gap by critically examining recent advancements and highlighting nanovaccine technologies that have undergone human clinical trials. Using an extensive search on clinicaltrials.org, we explored the diverse applications of nanovaccines, including leading SARS-CoV-2 candidates and platforms targeting other infectious diseases and cancers. We also highlighted foundational research that has enabled clinical investigation of nanovaccines over the past decade, highlighting their potential to address a range of medical conditions. While many technologies have been developed to combat SARS-CoV-2, several key innovations targeted a broader spectrum of diseases. This review details these technologies, focusing on their materials and mechanisms of action in inducing immune protection, while also exploring how nanomedicine facilitates nanovaccine development and introduces novel adjuvant concepts. Finally, we provided a retrospective analysis of the development journey of these platforms, offering insights into the intellectual and technological efforts behind their clinical translation. By bridging the gap between research and application, this review aims to give readers a comprehensive understanding of how nanovaccines progress from the laboratory to clinical practice.}, }
@article {pmid41812294, year = {2026}, author = {Shaver, N and Colijn, C and Heffernan, J and Asamoah, GD and Piggott, T and Cooper, C and Bagheri, S and Crawley, AM and Kagina, BM and Bowdish, DME and Langlois, MA and Little, J}, title = {Lack of harmonisation in immunological data: challenges in synthesising data during the COVID-19 pandemic.}, journal = {EBioMedicine}, volume = {126}, number = {}, pages = {106204}, pmid = {41812294}, issn = {2352-3964}, mesh = {Humans ; *COVID-19/immunology ; SARS-CoV-2/immunology ; *Pandemics/prevention & control ; COVID-19 Vaccines/immunology ; *Coronavirus Infections/immunology/prevention & control/epidemiology/virology ; *Betacoronavirus/immunology ; Immunogenicity, Vaccine ; }, abstract = {The COVID-19 pandemic drove the rapid development of assays to ascertain immune responses, and laboratories were required to adapt to difficult and quickly changing circumstances. While flexibility and innovation were essential, they also introduced heterogeneity in methods, reagents, and reporting practices between labs. This lack of harmonisation made it difficult to compare findings across studies, slowing evidence synthesis, and limiting the usefulness of data for modelling efforts and policy guidance. Drawing on our team's experience synthesising and modelling vaccine immunogenicity data during the pandemic, we discuss the long-term challenges of standardising human immunology research that were highlighted by the COVID-19 pandemic. We argue that vaccine immunogenicity studies require standardised reporting and quality assessment tools. We propose practical solutions to support comparability of laboratory-based practices, while preserving methodological diversity. By implementing changes before the next public health crisis, future research can avoid waste, strengthen certainty, and maximise policy and practice impact.}, }
@article {pmid41812517, year = {2026}, author = {Saad, S and DeCesare, J and Meadows, R and Golden, M and Hannah, D}, title = {Effect of COVID-19 infection on maternal and fetal outcomes of Pregnancy: A systematic review.}, journal = {Pregnancy hypertension}, volume = {44}, number = {}, pages = {101432}, doi = {10.1016/j.preghy.2026.101432}, pmid = {41812517}, issn = {2210-7797}, mesh = {Humans ; Female ; Pregnancy ; *Pregnancy Complications, Infectious/epidemiology/virology ; *COVID-19/epidemiology/complications ; *Pregnancy Outcome/epidemiology ; Infant, Newborn ; Fetal Growth Retardation/epidemiology ; Premature Birth/epidemiology ; Hypertension, Pregnancy-Induced/epidemiology ; SARS-CoV-2 ; Risk Factors ; Maternal Mortality ; }, abstract = {OBJECTIVES: This study aims to investigate the rates and statistical significance of maternal and neonatal complications in subjects with a positive COVID-19 diagnosis in pregnancy in comparison to subjects without a diagnosis of COVID-19 in pregnancy. We aim to improve the literature and patient information regarding the impact of COVID-19 on maternal and fetal outcomes to help draw conclusions or guide management.
STUDY DESIGN: Clinical outcomes were identified using International Classification of Diseases, Tenth Revision (ICD-10) billing codes. The control group included a sample of 15,000 patients delivered between 4/1/2019-12/31/2019. The COVID group included 10,608 patients from 4/1/2020-4/1/2022 who were confirmed COVID-19 positive within the 9 months prior to delivery. Binary logistic regression, Chi-square, and Fisher's exact test were used for statistical analysis.
RESULTS: Having COVID-19 during pregnancy is significantly associated with increased risk for preterm delivery (PTD), placental abnormalities, hypertensive disorders, and neonatal intensive care (NICU) admission. Rates of maternal mortality, fetal growth restriction (FGR) and intrauterine growth restriction (IUGR) were not significantly impacted by COVID-19. While the overall rate of FGR was not impacted, patients with 2nd trimester infection are at increased risk for FGR compared to patients with 3rd trimester infection.
CONCLUSIONS: This study demonstrates a statistically significant increased rate of preterm delivery, hypertensive disorders, placental abnormalities, and NICU admission for pregnancies affected by COVID-19. These findings can help guide recommendations for increased surveillance and counseling in pregnancies affected by COVID-19.}, }
@article {pmid41813354, year = {2026}, author = {Silva, AL and Segundo, MA and Prior, JAV}, title = {Advances in virus detection using carbon and quantum dot technologies: a review.}, journal = {Analytica chimica acta}, volume = {1398}, number = {}, pages = {345252}, doi = {10.1016/j.aca.2026.345252}, pmid = {41813354}, issn = {1873-4324}, mesh = {*Biosensing Techniques/methods ; Humans ; Carbon Quantum Dots/chemistry ; *Quantum Dots/chemistry ; *Viruses/isolation & purification ; *Carbon/chemistry ; }, abstract = {BACKGROUND: The diagnosis of viral infections still depends largely on traditional lab methods like PCR and ELISA, which are often costly, time-consuming, and unsuitable for large-scale or low-resource testing. Because of these issues, researchers are exploring new approaches using nanotechnology. Quantum dots (QDs) and carbon dots (CDs) are two types of fluorescent nanodots with special optical and surface properties, becoming promising tools for detecting viruses. However, their different physical and chemical characteristics, biocompatibility, and integration potential lead to distinct analytical performances, highlighting the need for a comparative assessment of their applicability in viral biosensing.
RESULTS: This review systematically analyses recent advances in QD- and CD-based biosensors for viral detection, covering both nucleic acid- and protein-based assays. QDs show advanced techniques, with integration into fluorescence, FRET, ECL, PEC, and lateral-flow formats, enabling multiplexed detection of several viruses, including dengue, HAV, HBV, and SARS-CoV-2. In contrast, CDs are mainly used for single-target fluorescence or electrochemical assays, indicating they are in an earlier stage of development. Comparative studies reveal that QDs-based viral assays can detect targets such as HIV-1 nucleic acids at levels as low as 6.5 × 10[-16] M, which is generally one order of magnitude lower than CDs, though the latter show better biocompatibility and stability. QDs offer a wider range of sensitivity and performance, while CDs provide safer, simpler, and more sustainable sensing options. These differing features define their unique analytical roles and potential for practical use.
SIGNIFICANCE: By bringing together findings from recent literature studies, this review bridges fundamental nanochemistry with practical virus diagnostics. It explains how QDs and CDs contribute differently to sensitivity, multiplexing, and biosensor integration, providing guidance for selecting suitable nanomaterials in analytical design. The comparative insights highlight pathways for developing cost-effective, safe, and portable viral detection platforms, supporting the transition of nanodot-based assays from the laboratory to clinical and field applications.}, }
@article {pmid41813522, year = {2026}, author = {Davidson, M and Schnell, N and Sickbert-Bennett, E}, title = {Optimizing Hand Hygiene Compliance.}, journal = {Infectious disease clinics of North America}, volume = {40}, number = {2}, pages = {269-282}, doi = {10.1016/j.idc.2025.12.005}, pmid = {41813522}, issn = {1557-9824}, mesh = {Humans ; *Hand Hygiene/standards/methods ; COVID-19/prevention & control ; *Guideline Adherence ; SARS-CoV-2 ; *Infection Control/methods/standards ; *Pandemics/prevention & control ; Cross Infection/prevention & control ; *Pneumonia, Viral/prevention & control ; Betacoronavirus ; *Coronavirus Infections/prevention & control ; }, abstract = {Although hand hygiene is considered a fundamental defense against infection spread, maintaining high, consistent compliance remains an ongoing challenge. Even after the COVID-19 pandemic placed hand hygiene in the spotlight, initially high compliance levels dropped, facilitating the spread of multidrug-resistant pathogen transmission in some settings. This article details the various methodologies for monitoring hand hygiene with diverse solutions for feedback. Ultimately, infection preventionists and hospital epidemiologists must consider what will be most effective for their facility when determining how to optimize hand hygiene based on the capabilities, opportunities, and motivations of their staff.}, }
@article {pmid41814338, year = {2026}, author = {Hurndall, KH and Lunova, T and Clarke, J and Neves, AL and Darzi, A}, title = {Mapping strategies for reducing inequalities in adult elective surgical care in the United Kingdom: a living scoping review.}, journal = {BMC health services research}, volume = {26}, number = {1}, pages = {}, pmid = {41814338}, issn = {1472-6963}, mesh = {Humans ; United Kingdom ; *Elective Surgical Procedures/statistics & numerical data ; *Healthcare Disparities ; State Medicine ; *COVID-19/epidemiology ; Adult ; Waiting Lists ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Health inequalities persist within the National Health Service (NHS), with pre-existing disparities in health outcomes exacerbated by the COVID-19 pandemic. To mitigate further inequality, the NHS seeks to recover its elective backlog inclusively, particularly in surgical care. This review aims to examine interventions, across the elective surgery patient pathway, aimed at mitigating inequalities. Interventions, and their impact on inequalities, are described, while identifying existing knowledge gaps. METHODS: Online peer-reviewed academic databases and grey literature resources were searched with no time limit set. Articles were screened by two independent reviewers, with data extraction performed by one reviewer and verified by a second. Included articles described interventions successful in, or aiming to, reduce inequalities in elective adult surgery in the United Kingdom with description of the intervention’s impact on patient outcomes. A qualitative content analysis of the primary focus of interventions was performed to identify core themes of intervention. RESULTS: Twenty-two studies were included with interventions predominantly targeting secondary care, particularly orthopaedics. Across the patient pathway, four foci of intervention were identified: patient choice (n = 4); waiting list management (n = 7); treatment accessibility (n = 5), and alternative care delivery models (n = 4). National interventions (n = 11) included patient choice and waiting time initiatives, and increased utilisation of the independent sector, however there were minimal reductions in inequalities. Local interventions (n = 8) showed potential for reducing inequalities, particularly for marginalised groups, through local waiting list initiatives (n = 3) and improving treatment accessibility (n = 5). CONCLUSION: Specifically designed, targeted interventions seemed effective in addressing inequalities in elective surgery. Several gaps in the literature were evident, however, particularly the effectiveness of interventions in non-orthopaedic specialties and the impact of emerging care models, including surgical hubs, on equality of access and outcomes. REGISTRATION: This living scoping review is registered with the Open Science Framework (https://osf.io/z3k76). The study protocol was published in advance.}, }
@article {pmid41814505, year = {2026}, author = {Tovar, V and Sánchez, IP and Rugeles, MT and Taborda, NA and Hernandez, JC}, title = {Cellular Immune Response Induced by mRNA Vaccines Against SARS-CoV-2.}, journal = {Immunity, inflammation and disease}, volume = {14}, number = {3}, pages = {e70375}, pmid = {41814505}, issn = {2050-4527}, support = {//Universidad Cooperativa de Colombia/ ; //Corporación Universitaria Remington/ ; //Universidad de Antioquia/ ; }, mesh = {Humans ; *SARS-CoV-2/immunology ; *COVID-19/prevention & control/immunology ; *Immunity, Cellular ; *COVID-19 Vaccines/immunology ; T-Lymphocytes/immunology ; mRNA Vaccines/immunology ; Vaccines, Synthetic/immunology ; Animals ; }, abstract = {The disease caused by SARS-CoV-2 is known as COVID-19, and it can range from mild symptoms to severe clinical manifestations, including respiratory failure, pneumonia, and organ failure. Since its emergence in 2019, more than 7 million deaths have been reported worldwide. Vaccines have been the most effective strategy for preventing severe illness and death in patients who acquire the infection. Vaccines induce both humoral and cell-mediated immune responses; the latter is crucial in the immune response against SARS-CoV-2, as the effector mechanisms of T-cells are less affected by the high mutation rate of the virus and prevail through memory phenotypes, ensuring long-term protection. mRNA vaccines have been primarily used worldwide to control the COVID-19 pandemic. This platform can protect against different circulating variants and is characterized by generating a robust T-cell response. This review discusses the immune response of T-cells induced by mRNA vaccines against SARS-CoV-2. It explores their effect on different population groups, including people with special clinical conditions, such as cancer and organ transplant recipients with a compromised immune system.}, }
@article {pmid41814520, year = {2026}, author = {Avila, T and Jefferies, D and Ramjan, LM}, title = {The Impact, Role and Experiences of Nurses Working in Medical Quarantine During the COVID-19 Pandemic: A Narrative Review.}, journal = {Nursing open}, volume = {13}, number = {3}, pages = {e70463}, pmid = {41814520}, issn = {2054-1058}, mesh = {Humans ; *COVID-19/nursing/epidemiology/prevention & control ; *Quarantine/psychology ; SARS-CoV-2 ; *Nurse's Role/psychology ; Pandemics ; }, abstract = {AIM: To understand the impact, role and experience of nurses working in medical hotel quarantine during the COVID-19 pandemic.
BACKGROUND: Medical Hotel Quarantine was staffed predominantly by nurses to prevent the spread of COVID-19 when people who were COVID-19 positive were unable to isolate safely in their communities.
REVIEW METHODS: A narrative review was conducted to understand how nurses made meaning of their experience. Seven databases were searched (Google Scholar, CINAHL, COCHRANE, MEDLINE, Joanna Briggs Institute, PsychInfo and Scopus) following the PRISMA Methodological Guideline (between August 2021 and January 2022). A summary table was developed with the headings: author and year, country, study design and data collection, participants, critical appraisal rating and results. Using a Critical Realist lens, the data were analysed using thematic analysis and a stratified ontology of the Real, the Actual and the Empirical domains in medical hotel quarantine to understand how the complex nature of nursing care worked within this unique environment.
RESULTS: Nurses were pivotal to the success of medical hotel quarantine. The Critical realist lens demonstrated how this was a stressful environment as health information was updated and policies and requirements changed. Although there were reports of stigma outside work, many nurses reported that they felt a sense of duty caring for patients experiencing isolation.
DISCUSSION: There is little research about nurses working in medical hotel quarantine during COVID-19.
CONCLUSION: Further research is required to understand how nurses managed these facilities to protect the community when future pandemics occur.
It is important that the lessons from medical hotel quarantine are recorded so that future nurses can be guided by the experience of nurses who worked in hotel quarantine if they are required to work in this unique area of practice.}, }
@article {pmid41814525, year = {2026}, author = {Schoene, D and Deckert, S and Barlinn, K and Huttner, HB and Kösters, M and Siepmann, T}, title = {Neurocardiac Autonomic Dysfunction in Patients With Post-COVID-19 Condition: A Systematic Review and Meta-Analysis.}, journal = {European journal of neurology}, volume = {33}, number = {3}, pages = {e70561}, pmid = {41814525}, issn = {1468-1331}, mesh = {Humans ; *COVID-19/complications/physiopathology ; *Autonomic Nervous System Diseases/physiopathology/etiology ; *Heart Rate/physiology ; Post-Acute COVID-19 Syndrome ; *Autonomic Nervous System/physiopathology ; }, abstract = {BACKGROUND: Neurocardiac autonomic impairment with reduced heart rate variability (HRV) has been linked to SARS-CoV-2 infection and may persist in patients with post-COVID-19 syndrome. We synthesised meta-analytic data on HRV in post-COVID-19 syndrome.
METHODS: Our systematic review and meta-analysis were guided by PRISMA standards. We used MEDLINE, Embase and Web of Science to identify non-randomised studies of HRV in patients with post-COVID-19 syndrome, conducted more than 3 months after infection and compared with healthy controls. The search covered the period from 01/2020 to 09/2023. We pooled data on the following HRV parameters: standard deviation of normal-to-normal intervals (SDNN), root mean square of successive differences (rMSSD) and low-frequency to high-frequency ratio (LF/HF ratio). We applied a random effects model to account for heterogeneity. Risk of bias was assessed.
RESULTS: From 856 initially identified records, we included 11 studies with a total of 1162 participants (593 post-COVID-19 patients and 565 healthy controls). We observed a trend toward lower HRV in post-COVID patients compared to controls, with small to medium effects for SDNN (SMD: 0.26, 95% CI: -0.03 to 0.56, p = 0.09), rMSSD (SMD: 0.11, 95% CI: -0.15 to 0.36, p = 0.41) and LF/HF ratio (SMD: -0.271, 95% CI: -0.61 to 0.07, p = 0.12). Moderate to high statistical heterogeneity of the effects was observed (I[2] = 83% for SDNN and 78% for rMSSD) and nine of 11 studies had a high risk of bias.
CONCLUSION: This meta-analysis suggests a possible association between post-COVID condition and alterations in neurocardiac autonomic function.}, }
@article {pmid41814585, year = {2026}, author = {Caliman-Sturdza, OA and Gheorghita, R and Lobiuc, A and Filip, R and Soldanescu, I and Mangul, S and Dimian, M}, title = {Management of long COVID-19 in children and adolescents: from diagnosis to therapeutically approaches.}, journal = {Annals of medicine}, volume = {58}, number = {1}, pages = {2642510}, pmid = {41814585}, issn = {1365-2060}, mesh = {Humans ; *COVID-19/therapy/diagnosis/complications ; Adolescent ; Post-Acute COVID-19 Syndrome ; Child ; SARS-CoV-2 ; }, abstract = {INTRODUCTION: Long Coronavirus disease 2019 (COVID-19), also termed post-acute sequelae of severe acute respiratory syndrome coronavirus 2 infection (PASC), has emerged as a complex multisystem condition in children and adolescents worldwide. It can occur even after mild or asymptomatic acute infections, with symptoms that may persist, fluctuate, or relapse over time. This review aims to comprehensively explore the characteristic manifestations, management and current therapeutic possibilities of pediatric Long COVID-19 (L-C19).
METHODS: A systematic search was conducted in multiple databases such as PubMed, Scopus, Web of Science, and Google Scholar, for literature published between January 2020 and October 2025.
RESULTS: Diagnosing pediatric L-C19 is challenging due to the heterogeneity of symptoms and lack of specific diagnostic biomarkers. Most young patients experience gradual improvement over months, but a significant subset remains symptomatic for >1 year with substantial disability, underscoring the need for timely diagnosis and intervention. Current clinical consensus emphasizes an individualized, multidisciplinary management approach focused on symptom relief and functional rehabilitation. No definitive cure exists for L-C19; thus, care is tailored to each patient's predominant issues. Therapeutic strategies combine supportive self-management (e.g. energy conservation and pacing) with both non-pharmacological and pharmacological interventions. Multimodal rehabilitation programs - including graded exercise therapy and cognitive behavioral therapy - have shown promise in improving fatigue, mental health, and overall quality of life. Targeted treatments for specific sequelae (such as autonomic dysfunction or chronic pain) are applied on a case-by-case basis, although high-quality evidence for medications remains limited. Globally, interdisciplinary collaborations have been established to provide harmonized diagnostic and treatment protocols, and major research initiatives are underway to evaluate novel therapies and include children in L-C19 clinical trials.
CONCLUSION: Ongoing international efforts to develop standardized diagnostic tools, outcome measures, and evidence-based interventions are crucial to optimize care and long-term outcomes for children and adolescents affected by L-C19.}, }
@article {pmid41814863, year = {2026}, author = {Fix, J and Lee, S and Nachbar, J and Sadadia, P and Lövgren Bengtsson, K and Stertman, L and Palm, AE and Walker, R and Draghia Akli, R and Sellers, S}, title = {Safety of Matrix-M-adjuvanted COVID-19, seasonal influenza, combination influenza-COVID-19, and malaria vaccines: a review of the evidence.}, journal = {Expert review of vaccines}, volume = {25}, number = {1}, pages = {2638828}, doi = {10.1080/14760584.2026.2638828}, pmid = {41814863}, issn = {1744-8395}, mesh = {Humans ; *Influenza Vaccines/immunology/adverse effects/administration & dosage ; *Malaria Vaccines/adverse effects/immunology/administration & dosage ; *Adjuvants, Immunologic/administration & dosage/adverse effects ; *COVID-19 Vaccines/adverse effects/immunology/administration & dosage ; *Influenza, Human/prevention & control/immunology ; *COVID-19/prevention & control/immunology ; Adjuvants, Vaccine/adverse effects/administration & dosage ; Saponins ; Nanoparticles ; }, abstract = {INTRODUCTION: The saponin-based Matrix-M adjuvant induces potent and durable immunity through producing long-lasting memory B-cells and broad-based T-cell immunity, across a variety of vaccine platforms. Matrix-M-adjuvanted vaccines have a history of successful development for protection against a broad range of infectious diseases with high public health urgency. Two authorized Matrix-M-adjuvanted vaccines, NUVAXOVID (COVID-19) and R21/Matrix-M (Plasmodium falciparum malaria), have been administered to >10 million people worldwide.
AREAS COVERED: This review is a comprehensive evaluation of published reactogenicity and safety data from 66 clinical trials and post-marketing studies of Matrix-M-adjuvanted COVID-19, seasonal influenza, combination COVID-19-influenza (CIC), and malaria vaccines retrieved from PubMed and Embase with no restricted start date and last search on 1 November 2025.
EXPERT OPINION: 64,101 participants received ≥1 Matrix-M-adjuvanted vaccine dose (143,170 doses): 55,939 COVID-19, 2477 influenza, 1422 CIC, and 4263 malaria vaccines. All authorized and candidate vaccines within each disease area were well-tolerated, including among a wide geographical distribution, immunocompromised populations, and children. Active-comparator clinical trials and post-marketing studies demonstrate favorable reactogenicity profiles of Matrix-M-adjuvanted vaccines versus licensed vaccines for the same diseases, particularly, lower reactogenicity rates post-NUVAXOVID versus mRNA COVID-19 vaccination. Research is ongoing to better characterize Matrix-M immune-stimulating mechanisms, continue technology improvements, and identify new applications to enhance vaccines and therapeutics.}, }
@article {pmid41815827, year = {2026}, author = {Nath, D and Al Noman, A and Pradhan, S and Sharma, PD and Ahmed, S and Begum, F and Al Hafiz, M and Abdallah, EM}, title = {Receptor-mediated mechanisms underlying neurological complications in COVID-19: from viral entry to neuroinflammation.}, journal = {3 Biotech}, volume = {16}, number = {4}, pages = {128}, pmid = {41815827}, issn = {2190-572X}, abstract = {Neurological complications of COVID-19 encompass acute syndromes and persistent post-acute sequelae, yet their mechanistic basis remains incompletely defined. Integrated clinical, neuropathological, neuroimaging, and molecular evidence indicates that SARS-CoV-2-associated neurological injury is driven predominantly by receptor-mediated immune and vascular mechanisms rather than widespread productive central nervous system infection. Angiotensin-converting enzyme 2 (ACE2) remains the principal viral entry receptor, while neuropilin-1 (NRP1) facilitates neurovascular and olfactory access in specific contexts. In contrast, CD147 and dipeptidyl peptidase-4 (DPP4) appear to exert indirect modulatory roles through endothelial dysfunction and immune activation rather than acting as dominant neurotropic entry receptors. Toll-like receptors, particularly TLR2, TLR4, and TLR7, amplify neuroinflammatory signaling and contribute to blood-brain barrier disruption, microvascular injury, and sustained microglial activation. Cerebrospinal fluid biomarkers and neuroimaging findings consistently support a dual-pathway model combining limited direct viral presence with predominant immune-mediated injury. Current therapeutic strategies targeting receptor-mediated entry and neuroinflammation remain largely investigational, underscoring the need for biomarker-guided and phase-specific interventions. These findings refine the mechanistic framework of NeuroCOVID and identify translational priorities for acute and long-term neurological management.}, }
@article {pmid41816346, year = {2026}, author = {Liu, L and Zhao, H and Qiao, J and Liu, N and Tao, W and Wei, S}, title = {Relationship between COVID-19 and "three inflammations and one deafness": a systematic review and meta-analysis.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1690788}, pmid = {41816346}, issn = {1664-3224}, mesh = {Humans ; *Tinnitus/epidemiology ; *Deafness/epidemiology ; *COVID-19/epidemiology/complications ; *Pharyngitis/epidemiology ; *Otitis Media/epidemiology ; *Rhinitis, Allergic/epidemiology ; *SARS-CoV-2 ; *Inflammation/epidemiology ; }, abstract = {BACKGROUND: The relationship between "three inflammations and one deafness" (allergic rhinitis, pharyngitis, otitis media, tinnitus, and deafness) and coronavirus disease 2019 (COVID-19) is currently unclear, and this study aims to investigate their correlation.
METHODS: We searched the relevant literature in three databases (Embase, Cochrane Library, and PubMed) from their inception through July 2024, and the investigator strictly reviewed the literature according to the screening criteria to determine the included studies. We extracted relevant data information and conducted quality assessment and meta-analysis.
RESULTS: From 5,950 records screened, five cohort studies were included. The pooled analysis using a random-effects model showed no statistically significant association between COVID-19 and "three inflammations and one deafness" (OR = 1.03, 95% CI: 0.85-1.26, P = 0.74), with substantial heterogeneity (I² = 89%, P < 0.001). Critically, subgroup analyses revealed that the diagnostic criteria for "three inflammations and one deafness" were a key source of this heterogeneity. A significant association was observed in studies using physician-diagnosed outcomes (OR = 1.30, 95% CI: 1.08-1.56, P = 0.006, I² = 0%), whereas no significant association was found in studies based on self-reported symptoms (OR = 0.89, 95% CI: 0.69-1.15, P = 0.38, I² = 96%). Analyses by specific conditions yielded mixed results: No significant association was observed for hearing loss (OR = 0.93, 95% CI: 0.69-1.25, P = 0.62). For allergic rhinitis (OR = 1.19, 95% CI: 0.47-3.02, P = 0.71) and tinnitus (OR = 1.11, 95% CI: 0.88-1.39, P = 0.38), the point estimates suggested potential positive trends, but the associations were not statistically significant, and confidence intervals were wide. Subgroup analyses by some regions and COVID-19 diagnostic criteria did not reveal consistent significant associations.
CONCLUSIONS: This meta-analysis found no consistent association between COVID-19 and "three inflammations and one deafness," primarily due to significant heterogeneity. Evidence suggests a link between COVID-19 and physician-diagnosed "three inflammations and one deafness," which strongly depends on the rigor of outcome assessment, highlighting the need for standardized clinical diagnoses in future research.
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023438076.}, }
@article {pmid41816349, year = {2026}, author = {González-Rivera, L and Luna-Gutiérrez, R and Cárdenas, S and Merino-González, C and Handy, A and Pepper, I and López, MN}, title = {Regulatory T cells in hypoxic environments.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1755928}, pmid = {41816349}, issn = {1664-3224}, mesh = {Humans ; *T-Lymphocytes, Regulatory/immunology/metabolism ; *Hypoxia/immunology ; Animals ; COVID-19/immunology ; SARS-CoV-2/immunology ; }, abstract = {Oxygen availability is considered as an important determinant of immune regulation, yet its impact on regulatory T cells remains incompletely understood. In this review, we synthesize current evidence on how chronic and intermittent hypoxia influence the differentiation, stability and function of regulatory T cells across diverse physiological and pathological settings. We describe the main cellular pathways engaged during hypoxic adaptation, with emphasis on the role of hypoxia-inducible factors in shaping regulatory T cell metabolism and lineage integrity. We then evaluate findings from clinical contexts characterized by sustained or cyclical oxygen deprivation, including chronic lung disease, sleep-disordered breathing and severe viral infection. Across these conditions, hypoxia is associated with alterations in regulatory T cell phenotype and its suppressive function, although patterns vary according to microenvironment and disease stage. A clearer understanding of how distinct hypoxic patterns modulate regulatory T cell biology will be essential for identifying therapeutic strategies aimed at restoring immune balance in hypoxia-associated disease.}, }
@article {pmid41816409, year = {2026}, author = {Chai, X and Qi, H and Liu, X and Zhou, F and Jiang, Y and Wu, M and Lian, S and Wang, L and Bao, Y}, title = {A narrative review of SARS-CoV-2 variants and long COVID.}, journal = {Journal of thoracic disease}, volume = {18}, number = {2}, pages = {164}, pmid = {41816409}, issn = {2072-1439}, abstract = {BACKGROUND AND OBJECTIVE: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since the onset of the pandemic, there has been a continuous rise in cases of both COVID-19 and long COVID. It is acknowledged that long COVID is a multisystem disorder with a wide range of symptoms; its primary symptoms and indicators include fatigue, dyspnea, anosmia, myalgia, cough, and hyposmia. SARS-CoV-2 has continuously evolved since the wild strain first appeared, resulting in numerous genetic variants. These strains exhibit significant differences in terms of pathogenicity and immune evasion. Key scientific questions remain regarding whether and how these variations influence the development and clinical course of long COVID. This review aims to examine associations between SARS-CoV-2 strains and long COVID, synthesize current evidence, identify research gaps, and provide recommendations for subsequent rehabilitation treatments.
METHODS: Literature searches were conducted using PubMed, focusing on publications from January 2020 to August 2025. Relevant literature on long COVID and SARS-CoV-2 variants was systematically reviewed and summarized, and included in this review.
KEY CONTENT AND FINDINGS: This review highlights the ongoing genetic evolution of SARS-CoV-2 as a key temporal dynamic during the pandemic. Different SARS-CoV-2 variants result in varying severity of long COVID. Anti-inflammatory treatments demonstrate significant efficacy for long COVID patients. COVID-19 vaccination prior to SARS-CoV-2 infection reduces the risk of long COVID, and another successful treatment option for persistent COVID symptoms is physical therapy.
CONCLUSIONS: Long COVID remains a significant public health challenge. The relationship between SARS-CoV-2 variants and long COVID requires further elucidation. This condition may cause significant economic and medical burdens in the future. To completely protect the physical and mental health of long COVID patients, it is essential to broaden therapeutic options and create individualized therapy programs. Therefore, understanding the connection between long COVID and SARS-CoV-2 variants is crucial. Based on this knowledge, effective strategies must be designed to empower individuals in proactively addressing and managing long COVID.}, }
@article {pmid41817243, year = {2026}, author = {Ragagnin, K and da Silva-Oolup, S and Yu, H and Balaji, S and Côté, P and Hogg-Johnson, S and Murnaghan, K and Wong, JJ}, title = {Burden and Associated Factors of Unmet Health Care Needs in Individuals With Osteoarthritis: A Systematic Review.}, journal = {ACR open rheumatology}, volume = {8}, number = {3}, pages = {e90007}, doi = {10.1002/acr2.90007}, pmid = {41817243}, issn = {2578-5745}, abstract = {OBJECTIVE: This systematic review aimed to describe the prevalence, incidence, and associated factors of unmet health care needs among adults with osteoarthritis.
METHODS: We searched Medline (Ovid), Embase (Ovid), CINAHL (EBSCO), and PsycINFO (Ovid) from inception through May 15, 2024. Eligible studies were cross-sectional, cohort, and case-control studies investigating the prevalence, incidence, associated factors, or risk factors of unmet health care needs in adults with osteoarthritis. We restricted to articles published in English, French, Italian, and Chinese for feasibility. Reviewers independently screened articles, assessed risk of bias using the Joanna Briggs Institute Checklists, and extracted data. We descriptively synthesized results from low/moderate risk-of-bias studies, stratifying results by age (<60 vs ≥60 years).
RESULTS: Of 3,589 citations screened, 7 cross-sectional studies with low/moderate risk-of-bias were included in the synthesis (3 from South Korea, 4 from the United States). In South Korea, the 12-month prevalence of unmet health care needs was 31.6% (95% confidence interval [CI] 29.9%-33.3%) among adults aged ≥50 years with osteoarthritis and 31% (95% CI 30.9%-31.1%) among those aged ≥65 years with arthritis. In the United States, the 12-month prevalence of unmet needs in the general population due to unaffordability ranged from 15% to 30% in adults with osteoarthritis or arthritis. Prevalence was higher among those who exclusively used complementary and alternative medicine and varied during the COVID-19 pandemic, peaking in the summer of 2020. Evidence suggests that unmet needs are associated with lower income, no insurance, and activity limitations.
CONCLUSION: Unmet health care needs are common in adults with osteoarthritis, particularly those facing socioeconomic disadvantages or functional limitations. Given the paucity of high-quality studies, additional research is needed.}, }
@article {pmid41818779, year = {2026}, author = {Greco, AA and Faiz, SA and Kaul, V and Reitzner, J and MacGregor, D and Garbarino, A and , }, title = {Best practices from the Association of Pulmonary and Critical Care Medicine Program Directors for social media use with emphasis on virtual recruitment.}, journal = {ATS scholar}, volume = {7}, number = {1}, pages = {67-73}, pmid = {41818779}, issn = {2690-7097}, mesh = {*Social Media ; Humans ; COVID-19 ; *Personnel Selection/methods ; *Critical Care ; *Pulmonary Medicine/education ; Pandemics ; SARS-CoV-2 ; Digital Media ; }, abstract = {Since the COVID-19 pandemic, the need to develop innovative strategies for virtual engagement and interaction has emerged. There has been a growing emphasis on online recruitment strategies for most medical specialties. For the last several interview seasons, many national organizations have recommended that fellowship interviews be conducted virtually for all applicants. Social media represents a powerful tool for both the program and the applicants. However, there remains a paucity of data published on social media use for virtual recruitment in pulmonary and critical care medicine (PCCM). Here, we review the available data for virtual recruitment and propose best practices for PCCM programs. Our social media strategy outlines specific and practical steps that form the framework for a social media charter including defining the goal and audience, following institutional guidelines, choosing appropriate platform(s), identifying and defining an account management plan, devising a strategy for content generation and posting, and continuing to reassess and optimize the process. Our best practices provide a practice framework for PCCM programs, both novice and advanced, for social media use. They also emphasize a need for more research on social media's impact on future recruitment cycles while providing a better understanding of current practices for applicant program selection and virtual recruitment.}, }
@article {pmid41818888, year = {2026}, author = {Paudel, KR and Hegarty, KJ and Shrestha, J and Budden, KF and Awatade, NT and Sadaf, T and Malyla, V and Waters, S and Papagianis, PC and Bourke, JE and Wark, PA and Hansbro, PM}, title = {Innovative methodologies for elucidating bushfire smoke-induced pathophysiological mechanism.}, journal = {The Science of the total environment}, volume = {1025}, number = {}, pages = {181645}, doi = {10.1016/j.scitotenv.2026.181645}, pmid = {41818888}, issn = {1879-1026}, mesh = {*Smoke/adverse effects ; Humans ; Animals ; *Wildfires ; COVID-19 ; Air Pollutants ; }, abstract = {Over the last century, the awareness of air pollution awareness and its harm to public health have resulted in the implementation of new protective measures to try and limit exposure. Bushfires generate waves of air pollution with orders of magnitudes higher than normal background pollution, necessitating studies to understand the physiological impact. Previous work has strongly linked bushfire smoke to respiratory disease (chronic obstructive pulmonary disease COPD, asthma, lung cancer) cardiovascular disease (myocardial infarction, stroke), and increased susceptibility to infection (COVID-19). Nevertheless, the underlying mechanisms of pathogenesis remain unclear. There is little consensus on what in vitro and in vivo techniques are best used to examine disease mechanisms. Individual investigations are useful but a lack of standard methods creates variability and makes comparisons difficult. Developing adaptable in vitro and in vivo models that are replicable, physiologically relevant, and affordable may reduce variability enabling comparisons. These models should also be capable of integrating multiple types of pollutants or reference materials to develop standards that other studies can follow, facilitating comparisons. Here, we discuss advance in vitro and in vivo experimental models to study the impact of bushfire smoke exposure induced pathophysiology. The goal is to improve comparison and translation across studies, and to lay the groundwork for future research into the mechanisms that underpin bushfire smoke-induced pathogenesis to enable the development of preventative measures and effective therapies.}, }
@article {pmid41819160, year = {2026}, author = {Lugtu, EJ and Iv, DYP and Cabunoc, MH and Bautista, JL and Pleta, FM and Ng, JA and Shahid, F and Carandang, THDC and Lippi, G and Henry, BM and Fernández-de-Las-Peñas, C and Notarte, KI}, title = {Prevalence of post-COVID symptoms across variants of concern and follow-up periods: A systematic review and meta-analysis.}, journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases}, volume = {166}, number = {}, pages = {108522}, doi = {10.1016/j.ijid.2026.108522}, pmid = {41819160}, issn = {1878-3511}, mesh = {Humans ; *COVID-19/epidemiology/complications ; Prevalence ; *SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Symptom Burden ; Fatigue/epidemiology ; }, abstract = {OBJECTIVES: The interaction between SARS-CoV-2 variants of concern (VoC) and post-COVID symptom duration remains unexplored. This is the first study to evaluate post-COVID prevalence stratified by VoC and follow-up periods.
METHODS: Six databases were searched (12/2019-12/2024) for studies of adults with laboratory-confirmed SARS-CoV-2 and symptoms lasting ≥3 months. Data were stratified by VoC (Alpha through Omicron) and follow-up (<6 vs ≥6 months) to estimate pooled prevalence using random-effects models.
RESULTS: Pooled prevalence across 35 studies (n = 159,000) was 28.5% (95% CI: 21.6-36.0), higher in pre-Omicron (35.5%) than Omicron (22.8%) eras (P = 0.04). Symptoms persisted beyond 6 months in 29.9% of cases. Fatigue was the most prevalent symptom across all VoCs and follow-ups followed by brain fog, dyspnea, and sleep impairment. Pre-Omicron variants were linked to dyspnea and anosmia, while Omicron was associated with brain fog and paresthesia. Most symptoms showed no significant reduction beyond 6 months. Sleep problems were higher in early pre-Omicron cohorts but improved over time; conversely, palpitations and ocular manifestations increased in later pre-Omicron follow-ups.
CONCLUSION: Post-COVID condition remains a burden despite vaccination. Distinct symptomatology patterns across VoC and timelines highlight the need for tailored management strategies to mitigate long-term global impacts.}, }
@article {pmid41819358, year = {2026}, author = {Liu, W and Liu, W and Rong, Z and Song, S and Zhou, Y and Pang, X}, title = {Therapeutic strategies for the fatty-acid-binding pocket of the spike protein: advances and perspectives.}, journal = {Drug discovery today}, volume = {31}, number = {3}, pages = {104638}, doi = {10.1016/j.drudis.2026.104638}, pmid = {41819358}, issn = {1878-5832}, mesh = {*Spike Glycoprotein, Coronavirus/metabolism/chemistry ; Humans ; Binding Sites/drug effects ; *Antiviral Agents/pharmacology/therapeutic use ; SARS-CoV-2 ; Animals ; *Fatty Acid-Binding Proteins/metabolism/antagonists & inhibitors ; COVID-19 ; *Fatty Acids/metabolism ; COVID-19 Drug Treatment ; }, abstract = {The trimeric spike protein plays a crucial part in the lifecycle of SARS-CoV-2 by facilitating viral entry. The SARS-CoV-2 spike protein harbors a fatty-acid-binding pocket (FABP) at the interface between two adjacent receptor-binding domains. Ligand engagement at the FABP locks the spike into a non-infectious, closed conformation, thereby impairing the virus's ability to infect new cells. Herein, we summarize the small-molecule inhibitors targeting the FABP that have been described to date, analyzing their binding modes, SAR and mechanisms of action. Because this pocket is conserved across highly pathogenic coronaviruses, targeting it offers a promising strategy for developing novel antivirals with broad-spectrum anti-coronavirus activity. We hope this review will stimulate further research on FABP inhibitors and promote the discovery of broad-spectrum anti-SARS-CoV-2 therapeutics.}, }
@article {pmid41819640, year = {2026}, author = {Janssen, RS and Coffman, RL}, title = {A narrative review of immune-mediated adverse events in clinical trials of CpG oligonucleotide toll-like receptor 9 agonists.}, journal = {Vaccine}, volume = {79}, number = {}, pages = {128437}, doi = {10.1016/j.vaccine.2026.128437}, pmid = {41819640}, issn = {1873-2518}, mesh = {Humans ; *Oligodeoxyribonucleotides/adverse effects/immunology ; Toll-Like Receptor Agonists ; *Toll-Like Receptor 9/agonists/immunology ; COVID-19 Vaccines/adverse effects/immunology ; *Adjuvants, Immunologic/adverse effects ; COVID-19/prevention & control/immunology ; Hepatitis B Vaccines/adverse effects/immunology ; Clinical Trials as Topic ; Neoplasms/drug therapy/immunology ; SARS-CoV-2/immunology ; Adjuvants, Vaccine/adverse effects ; }, abstract = {There is a concern that stimulating the innate immune system with vaccine adjuvants could, hypothetically, lead to autoimmunity; however, evidence is lacking to support these concerns. We review and evaluate immune-mediated adverse events from three sets of clinical studies using toll-like receptor 9 (TLR9) agonists (CpG-ODN) as vaccine adjuvants and therapeutic agents in patients with cancer: 1) a comparison of immune-mediated adverse events across phase 1-3 clinical trials of the hepatitis B vaccine HEPLISAV-B (HepB-CpG) with the alum-adjuvanted hepatitis B vaccine (HepB-alum); 2) an analysis of the rates of immune-mediated adverse events across clinical trials of COVID-19 vaccines using the CpG 1018 adjuvant; and 3) the rates of immune-mediated conditions in a study of the CpG-ODN nelitolimod (SD-101) combined with the immune checkpoint inhibitor pembrolizumab in patients with advanced melanoma or head and neck cancer, compared with rates in historical studies of pembrolizumab monotherapy. In the current analysis, the rate of potential immune-mediated adverse events was similar for HepB-CpG (0.32%) and HepB-alum (0.38%). Few adverse events of special interest (including immune-mediated events) were observed with any of the CpG 1018-adjuvanted COVID-19 vaccines (0-2.1% across studies), and rates were similar to placebo (0.6-3.3%). The rate of immune-mediated events for patients who received nelitolimod and pembrolizumab was 21.8% versus 19.8% for those who received pembrolizumab alone. No increased risk of potential immune-mediated adverse events was observed with HepB-CpG or CpG 1018-adjuvanted COVID-19 vaccines. In patients with cancer treated with programmed cell death protein 1 blockade, repeated treatment with nelitolimod did not increase the frequency of such events. Data evaluated in this review show no increased risk for potential autoimmune disorders with HepB-CpG or CpG 1018-adjuvanted COVID-19 vaccines. Combining CpG-ODN with a checkpoint inhibitor did not increase the rate of immune-mediated conditions.}, }
@article {pmid41819709, year = {2026}, author = {Khatami, SG and Baumkötter, R and Petersen, J and Ten Cate, V and Wild, PS}, title = {The relation between socioeconomic status and societal development with cardiovascular disease - A systematic review and meta-analysis on global data.}, journal = {Atherosclerosis}, volume = {415}, number = {}, pages = {120697}, doi = {10.1016/j.atherosclerosis.2026.120697}, pmid = {41819709}, issn = {1879-1484}, mesh = {Humans ; *Cardiovascular Diseases/epidemiology ; *Social Class ; Socioeconomic Disparities in Health ; Educational Status ; Income ; Risk Factors ; Occupations ; Global Health ; Social Determinants of Health ; Heart Disease Risk Factors ; }, abstract = {BACKGROUND: While socioeconomic status (SES) is recognized as a significant determinant of cardiovascular disease (CVD), the strength and direction of this association vary across studies and with stages of societal development. This meta-analysis of global data aimed to evaluate the relationship between SES domains and CVD outcome while examining the influence of measures on country-level for social development.
METHODS: The PubMed database was systematically searched for studies published between January 2000 and October 2024, investigating associations between SES domain (income, education, and occupation) and cardiovascular outcome, including stroke and myocardial infarction. The analysis incorporated macro-level determinants, including the Gini index, global quality infrastructure index, median age, and life expectancy. Multivariate meta-regression models was used to account for effect size dependencies, and heterogeneity was assessed using I[2] statistics. The systematic review and meta-analysis was pre-registered at http://www.crd.york.ac.uk (registration number: 651376).
RESULTS: The analysis included 50 studies encompassing >7 million individuals with some degree of overlap. Education showed the strongest association with CVD outcomes (β = 0.40, 95%CI [0.37; 0.43], p < 0.0001), followed by occupation (β = 0.30, 95%CI [0.23; 0.38], p < 0.0001), income (β = 0.27, 95%CI [0.23; 0.30], p < 0.0001) and the composite score of SES domains (β = 0.17, 95%CI [0.14; 0.19], p = p < 0.0001). In multivariable analysis of country-level measures for social development, Gini index, median age and global quality infrastructure index emerged as significant interactors with the relation of socioeconomic inequalities with presence of CVD, while life expectancy did not. Substantial heterogeneity was observed across studies (I[2] ranging from 81.5% to 96.7%).
CONCLUSIONS: Among SES domains, educational attainment demonstrates the most robust association with cardiovascular outcomes. The influence of societal development on country-level on the relation of socioeconomic inequalities with cardiovascular disease underscores the importance of considering multiple societal factors simultaneously. These findings suggest that measures targeting educational access and comprehensive societal development are crucial for reducing cardiovascular health inequalities.}, }
@article {pmid41819980, year = {2026}, author = {Mahmud, S and van Zandvoort, K and Guo, L and Li, Y and Nair, H and Feikin, DR and Sparrow, E and Chowdhury, F and Cohen, C and Dbaibo, GS and Gentile, A and Gill, CJ and Gordon, A and Horton, KC and Cao, Q and Stolyarov, K and Clark, AD and , }, title = {Age distribution of respiratory syncytial virus disease in children younger than 5 years in low-income and middle-income countries: a systematic review and meta-analysis.}, journal = {The Lancet. Child & adolescent health}, volume = {10}, number = {4}, pages = {245-254}, doi = {10.1016/S2352-4642(25)00349-9}, pmid = {41819980}, issn = {2352-4650}, mesh = {Humans ; *Respiratory Syncytial Virus Infections/epidemiology ; *Developing Countries/statistics & numerical data ; Infant ; Child, Preschool ; Age Distribution ; Infant, Newborn ; Hospitalization/statistics & numerical data ; }, abstract = {BACKGROUND: Low-income and middle-income countries (LMICs) bear the greatest burden of respiratory syncytial virus (RSV) disease. WHO recommends passive immunisation to protect infants younger than 6 months and, in some strategies, infants up to age 12 months, but detailed age data are needed to determine optimal timing and impact. Our study estimates age distributions for the full range of RSV outcomes among children younger than 5 years in LMICs.
METHODS: We conducted a systematic review and meta-analysis of RSV age distributions for seven health or health-care outcomes (hereafter, RSV outcomes): community cases, outpatient or clinic visits, emergency room visits, inpatient ward admissions, intensive care unit (ICU) admissions, facility deaths, and non-facility deaths. Inclusion required at least 30 laboratory-confirmed counts of RSV disease in children younger than 5 years, for a single RSV outcome from a single LMIC in the pre-COVID-19 decade (Jan 1, 2010, to Dec 31, 2019). We invited authors of included studies to share RSV counts by week or month of age. Using a Bayesian hierarchical model, we fitted parametric age distributions (by week for children <5 years) to each dataset, and derived pooled estimates of the mode, median, and mean age for each RSV outcome. The study was registered with PROSPERO (CRD42023435080).
FINDINGS: We included 160 datasets with 131 124 RSV counts in children younger than 5 years. The mode (peak) age was 3 weeks (95% credible interval 1-6) for non-facility deaths (57% <6 months), 4 weeks (1-8) for facility deaths (57% <6 months), 7 weeks (6-8) for ICU admissions (60% <6 months), 17 weeks (14-19) for inpatient ward admissions (41% <6 months), 10 weeks (5-17) for emergency room visits (40% <6 months), 28 weeks (22-32) for outpatient or clinic visits (19% <6 months), and 22 weeks (17-28) for community cases (26% <6 months). Considering the most severe RSV outcomes, 20% of ICU admissions and 23% of facility deaths were in infants younger than 8 weeks.
INTERPRETATION: Our findings reaffirm the importance of immunising the youngest infants who bear the greatest burden of severe RSV outcomes. Our estimates should allow more precise quantification of the potential impact of RSV prevention strategies across the full range of RSV disease severity in children younger than 5 years.
FUNDING: WHO.}, }
@article {pmid41820161, year = {2026}, author = {Yang, Q and Yang, Y and Liu, B and Xu, L and Ma, Y and Zhou, J and Wang, Y and Hao, C and Jiang, W}, title = {Global perspectives on pertussis epidemiology, macrolide resistance, and management in the post-COVID-19 era (2020-2024).}, journal = {Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.jmii.2026.03.002}, pmid = {41820161}, issn = {1995-9133}, abstract = {Pertussis, caused by Bordetella pertussis, remains a substantial public health threat despite long-standing vaccination programs. Widespread non-pharmaceutical interventions (NPIs) during COVID-19 were accompanied by marked declines in reported pertussis activity in many settings. However, relaxation of containment measures has been followed by resurgence, characterized by atypical outbreak patterns and shifts in case distribution, bacterial genotypes, and affected populations. Emerging evidence suggests that these changes are multifactorial, including altered contact patterns and immunity gap, disruptions and recovery in routine immunization and surveillance, waning or suboptimal vaccine-induced protection, pathogen adaptation, and improved case detection through expanded diagnostic capabilities. Addressing these challenges will require coordinated strategies to restore and optimize immunization delivery, strengthen surveillance and laboratory capacity (including resistance monitoring), and update clinical management guidance in the context of macrolide-resistant B. pertussis. Continued research is needed to define setting-specific drivers and to inform next-generation vaccines and integrated control strategies in the post-pandemic era.}, }
@article {pmid41821384, year = {2026}, author = {Daniyarova, KR and Sarkulova, ZN and Tamadon, A and Tokshilykova, AB and Sarkulov, MN and Kalieva, BM and Mussin, NM and Sharoffidin, RS}, title = {Global Research Trends on Endothelial Glycocalyx in Sepsis: A Bibliometric Analysis.}, journal = {BioMed research international}, volume = {2026}, number = {1}, pages = {e9720166}, pmid = {41821384}, issn = {2314-6141}, mesh = {*Glycocalyx/metabolism/pathology ; Humans ; *Sepsis/metabolism/pathology ; *Bibliometrics ; COVID-19 ; SARS-CoV-2 ; *Biomedical Research/trends ; Biomarkers/metabolism ; Microcirculation ; }, abstract = {BACKGROUND: Sepsis remains a major global health challenge, with glycocalyx dysfunction playing an important role in its pathogenesis. Recent research highlights EG degradation as a key contributor to vascular permeability, inflammation, and organ failure. Despite growing interest, a comprehensive bibliometric analysis of global research trends on EG in sepsis is lacking.
METHODS: We conducted a bibliometric analysis using data from Web of Science and Scopus (2005-2025). Inclusion criteria were original English-language research articles. Bibliometrix R-package was employed to analyze publication trends, citation metrics, collaboration networks, and keyword co-occurrence.
RESULTS: Among 217 publications, research output increased 13-fold (2005-2023), with Shock and Critical Care as leading journals. The United States, Japan, and Australia were top contributors, with strong international collaborations. Key themes included EG biomarkers, microcirculatory dysfunction, and therapeutic strategies. Emerging trends involved COVID-19-associated EG injury and novel imaging techniques.
CONCLUSION: This study maps the evolution of EG research in sepsis, highlighting exponential growth, key contributors, and thematic shifts. Future directions include validating EG biomarkers, developing targeted therapies, and enhancing global research equity.}, }
@article {pmid41821660, year = {2026}, author = {Kapoor, G and Bhutani, R}, title = {Propolis: a brief overview of its diverse pharmacological functions.}, journal = {3 Biotech}, volume = {16}, number = {4}, pages = {132}, pmid = {41821660}, issn = {2190-572X}, abstract = {Propolis, a natural wax-like resinous substance present in bee hives, has been extensively used in dietary supplements and as folk medicine for the treatment of several diseases, including neurological disorders. Propolis has been used as a traditional medicine for the treatment of depression and other neurological disorders. This review aims to investigate the clinical studies and various therapeutic potentials associated with propolis, direct the future scope of research, and discuss possible clinical implications. A total of 143 papers were selected using a database comprising Google Scholar, Scopus, PubMed, and Web of Science. Diverse keywords, such as propolis, bee, phytochemistry, pharmacology, and clinical study, were used to search the content. This review highlights the diverse biological activities of propolis, as evidenced by preclinical and clinical studies. In experimental models, propolis extract exhibited antidepressant-like and vasculoprotective effects, primarily through its anti-inflammatory and antioxidant potential. These benefits were associated with the suppression of pro-inflammatory cytokines, chemokines, and angiogenic factors. Propolis extract was found to delay the progression of atherosclerosis by improving lipid metabolism and modulating apoptosis. Furthermore, both in vitro and in vivo investigations suggest that propolis may protect vascular endothelial function due to its antiproliferative activity. Notably, anticancer potential was observed against the ovarian cancer cell line M12.C3.F6. Clinical studies also provided encouraging findings. In patients with type 2 diabetes mellitus, propolis extract has been shown to improve wound healing parameters in diabetic foot ulcers. Another trial reported promising outcomes with propolis extract formulated as niosomal oromucosal-adhesive films for recurrent aphthous ulcers. Overall, these results underline the multifaceted therapeutic promise of propolis across neurological, vascular, oncological, and wound-healing domains. This review summarizes clinical and experimental evidence on the therapeutic potential of propolis. It highlights its immunomodulatory, antioxidant, antimicrobial, antifungal, anticancer (skin, oral, lung, breast, cervical), antidepressant, anxiolytic, cardiovascular, chemopreventive, and anti-angiogenic properties. Several studies, including clinical trials, suggest its potential role in combating COVID-19 and other health conditions. Overall, findings indicate that propolis possesses significant medicinal promise and may serve as a lead candidate for developing novel therapeutic agents.}, }
@article {pmid41821730, year = {2026}, author = {Gao, SX and Gao, J}, title = {Unveiling the hidden link: diabetes mellitus as a catalyst for orbital apex syndrome.}, journal = {Frontiers in endocrinology}, volume = {17}, number = {}, pages = {1770045}, pmid = {41821730}, issn = {1664-2392}, mesh = {Humans ; *COVID-19/epidemiology/complications ; SARS-CoV-2 ; Syndrome ; *Diabetes Complications/epidemiology ; *Diabetes Mellitus/epidemiology ; *Orbital Diseases/epidemiology/etiology ; }, abstract = {BACKGROUND: Orbital Apex Syndrome (OAS) is a disease of multiple brain nerves at the orbital apex leading to vision loss and neurological impairments. Diabetes Mellitus (DM), a metabolic disorder with cardiovascular, immunological and neurological effects, is involved in OAS pathogenesis. However, the association between DM and OAS is not well studied. DM and OAS are poorly understood and may not be diagnosed correctly, especially when outbreaks such as COVID-19 are being investigated.
METHODS: A systematic review of 33 studies published between 2000 and 2025 was conducted to analyze DM-related OAS epidemiology, pathophysiology, clinical phenotypes, and treatment outcomes, focusing on the mechanistic links, pandemic trends, and glycemic control effect on therapeutic effectiveness.
RESULTS: Chronic hyperglycemia induced orbital apex microvascular damage (endothelial dysfunction, thrombosis, vascular senescence), immunosuppression induced opportunistic infections (mostly mucormycosis), and diabetic neuropathy induced neuromuscular dysfunction. During COVID-19, diabetic patients had the highest OAS incidence (more than 70% of cases involved rhino-orbital mucormycosis). Optimal glycemic control is associated with a 32% higher antifungal treatment effectiveness and a 28% lower rate of surgical complications. Epidemiological data showed that DM was the main predisposing factor, with 71.4%-81.8% infectious OAS cases occurred in diabetic populations.
CONCLUSION: DM is underreported as a critical catalyst for OAS with complications directly increasing severity and progression. Routine DM screening (e.g., glycated hemoglobin monitoring) and integrated glycemic management are essential for OAS prevention and treatment. Long-term studies on inflammatory factors and personalized multidisciplinary care are needed to address mechanistic gaps and improve visual and neurological outcomes in high-risk diabetic patients.}, }
@article {pmid41822480, year = {2026}, author = {Wasilewski, A and Serrafi, A}, title = {Identification of metabolic signatures of immune response following mRNA and inactivated vaccines against COVID-19: a systematic review.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1783878}, pmid = {41822480}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/prevention & control/immunology ; *COVID-19 Vaccines/immunology ; *SARS-CoV-2/immunology ; Vaccines, Inactivated/immunology ; Vaccination ; Metabolomics ; Biomarkers ; *Metabolome ; mRNA Vaccines/immunology ; Vaccines, Synthetic/immunology ; }, abstract = {BACKGROUND: Metabolomic profiling offers insights into immune responses, yet a synthesis of systemic metabolic changes after COVID-19 vaccination is lacking. This review aims to characterize vaccination-induced metabolomic alterations and identify correlative biomarkers of responsiveness.
METHODS: Following PRISMA 2020 guidelines (PROSPERO 1181037), four databases (PubMed, Embase, Scopus, Web of Science) were searched for studies using LC-MS, GC-MS, or NMR to analyse venous blood after COVID-19 vaccination. Inclusion criteria focused on original human studies. Risk of bias was assessed using ROBINS-I and RoB 2.
RESULTS: Ten studies (n > 1,200) evaluating mRNA and inactivated vaccines were included. Vaccination consistently altered amino acid pathways, specifically glutamine, phenylalanine, and tryptophan. Early activation of the kynurenine pathway (1-2 days post-dose) emerged as a predictor of stronger antibody responses. Inactivated vaccines triggered a "Warburg-like" metabolic switch, characterized by increased glycolysis and reduced TCA intermediates. Lipidomic changes were prominent; high baseline ceramides predicted low response, while sphingomyelins and short-chain fatty acids associated with positive immunity. Most studies showed a moderate risk of bias due to post-hoc grouping and confounding factors.
CONCLUSIONS: COVID-19 vaccination induces reproducible changes in amino acid, energy, and lipid metabolism. Kynurenine activity, baseline amino acids, and sphingolipid signatures are potential predictors of vaccine efficacy, supporting personalized immunization strategies.}, }
@article {pmid41822497, year = {2026}, author = {Bakacs, T and Chumakov, K}, title = {Host-targeted oral avian vaccine virus demonstrates broad antiviral activity and safety in patients.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1760109}, pmid = {41822497}, issn = {1664-3224}, mesh = {Humans ; Animals ; *Viral Vaccines/immunology/administration & dosage/adverse effects ; *Infectious bursal disease virus/immunology ; Administration, Oral ; Host-Directed Therapy ; *Antiviral Agents ; Immunity, Innate ; *Birnaviridae Infections/immunology/prevention & control ; }, abstract = {The absence of an immediately deployable, broad-spectrum antiviral remains a critical vulnerability in global pandemic preparedness. Host-directed agents that activate innate immunity offer a pathogen-agnostic strategy, yet no such therapy is currently stockpiled or authorized for emergency use. Infectious Bursal Disease Virus (IBDV)-a non-replicating avian dsRNA vaccine virus with a 60-year safety record in poultry-induces robust interferon responses in mammals and has been administered orally in marmosets and more than 50 human patients with hepatitis A, B, C, SARS-CoV-2, and herpes zoster infections. These observations include a randomized phase II trial in 84 acute HBV/HCV patients. Although the evidence base is limited, the consistency of clinical responses and absence of serious safety signals justify renewed scientific examination. This review synthesizes the mechanistic rationale, comparative advantages over synthetic Pattern Recognition Receptor (PRR) agonists, clinical observations, One Health implications, and regulatory precedents relevant to evaluating IBDV as a temporary, compassionate-use antiviral during pandemics while the reverse-engineered human candidate (IBDV-R903/78) progresses through formal development. The goal is not to endorse clinical deployment, but to initiate a rigorous, multidisciplinary debate on whether an established veterinary dsRNA vaccine virus could serve as an off-the-shelf host-directed live viral adjuvant therapy in future public health emergencies.}, }
@article {pmid41822849, year = {2026}, author = {Hintermeier, M and Bozorgmehr, K and Gottlieb, N and Mohsenpour, A and Sarma, N and Biallas, R and Biddle, L}, title = {Unintended Consequences of COVID-19 Public Health and Social Measures in Camps and Camp-Like Settings: A Systematic Review and Conceptual Analysis.}, journal = {Public health reviews}, volume = {47}, number = {}, pages = {1608732}, pmid = {41822849}, issn = {0301-0422}, abstract = {OBJECTIVES: This study examines unintended consequences (UIC) of public health and social measures (PHSM) in camps and camp-like settings and assesses the pathways through which these UIC arise.
METHODS: We conducted a systematic review and conceptual analysis of UIC from PHSM aimed at preventing SARS-CoV-2 spread in these settings. PHSM were classified using the WHO taxonomy and the CONSEQUENT framework to analyse UIC pathways. The most frequent PHSM groups were: a) surveillance and response, b) social and physical distancing, and c) operational measures.
RESULTS: We identified 113 predominantly negative UIC impacting physical and mental health, healthcare access, economic stability, and social interactions. UIC occurred in both high- and low-income countries. Key mechanisms linking PHSM to UIC included mistrust, increased risk factors, lack of information, and uncertainty.
CONCLUSION: This study reveals the complex interactions between PHSM and UIC and their broad mostly negative effects on marginalised populations. To reduce UIC in future health emergencies, they must be considered in pandemic planning with all stakeholders. Trust-building should be central in health interventions and PHSM design for more effective and equitable responses.
https://www.crd.york.ac.uk/PROSPERO/view/CRD42022384673.}, }
@article {pmid41823400, year = {2026}, author = {Abrahamsen, C and Beadsworth, M and Bostock, W and Chalder, T and Flottorp, S and Fors, EA and Garner, P and Hadfield, S and Kennedy, B and Kuehn, R and Landmark, L and Launes, G and Liira, H and Linnestad, L and Rotkirch Virrantaus, H and Vangelova-Korpinen, V}, title = {Persistent physical symptoms not explained by structural abnormalities or disease processes: a primary care approach to promote recovery.}, journal = {Scandinavian journal of primary health care}, volume = {44}, number = {1}, pages = {2633765}, pmid = {41823400}, issn = {1502-7724}, mesh = {Humans ; *Primary Health Care ; *Medically Unexplained Symptoms ; Fatigue ; Quality of Life ; Headache ; Pain ; Symptom Burden ; }, abstract = {Background: A substantial proportion of people consulting primary care practitioners have symptoms that persist even after structural problems and diseases have been excluded. They experience distressing somatic complaints - such as fatigue, pain, headaches, and brain fog - lasting months or longer which impair quality of life and workability. In this article, we refer to these as persistent physical symptoms (PPS). When diagnosis, advice and care are based solely on a biomedical interpretation of symptoms, patients may not improve. This can result in repeated and often frustrating consultations and investigations. Aim: To outline contemporary theories around PPS for general practitioners, and offer practical, evidence-informed pathways to use in primary care. Methods: Narrative literature review and consensus development with experienced practitioners. Synopsis:Contemporary theories Contemporary theories of PPS provide a coherent framework for understanding symptom persistence and guide treatment. These theories propose that symptoms may arise from brain-based responses to perceived threat, influenced by expectations and learned associations. Such responses can become unhelpful when benign sensations are interpreted as dangerous. Biopsychosocial factors unique to each individual influence these mechanisms which need to be considered when assessing PPS and working towards symptom resolution with the patient. Evidence-informed pathways Key strategies include validating patients' symptoms and emotional experiences, providing clear explanations of symptom persistence, and developing personalised management plans that combine biological, psychological, and social approaches. Such strategies can reduce or resolve symptoms, foster hope and a sense of agency, and often lead to recovery.}, }
@article {pmid41823417, year = {2026}, author = {Biering, SB and Puerta-Guardo, H and Pahmeier, F and Kril, V and Harris, E}, title = {The contribution of viral toxins to infection and pathogenesis.}, journal = {mBio}, volume = {17}, number = {4}, pages = {e0042125}, pmid = {41823417}, issn = {2150-7511}, support = {U19 AI181977/AI/NIAID NIH HHS/United States ; }, mesh = {Humans ; Animals ; *Viral Proteins/metabolism ; Viral Tropism ; *Virus Diseases/virology ; *Viruses/pathogenicity/metabolism ; Host-Pathogen Interactions ; }, abstract = {The process by which viruses cause disease, viral pathogenesis, is the result of both infection of cells and the host immune response. A less studied but equally important contributor to viral pathogenesis is viral dissemination, the capacity of a virus to move from the primary site of infection, traverse physiological barriers, and gain access to secondary sites of infection. This dictates viral tropism and pathogenesis, but the mechanisms governing barrier crossing are incompletely understood. While the presence of viral receptors on cells is a major determinant of viral tropism and a prerequisite for infection, it does not completely explain the capacity of viruses to enter a tissue. Our recent work has begun to characterize the contribution of soluble viral proteins, acting as "viral toxins," to viral dissemination, tissue tropism, and overall pathogenesis within an infected host. In this review, we discuss the characteristics of these viral toxins, which are soluble or surface-exposed viral proteins that can interact with endothelial and/or epithelial barriers, as well as immune cells, to trigger signaling pathways, resulting in the transient breakdown of cellular structures maintaining barrier integrity. The disruption of these barriers induces vascular leak and facilitates virus dissemination, influencing viral tropism and pathogenesis. Importantly, blocking this process prevents leak, viral dissemination, and severe disease during infection, highlighting the value of therapeutic intervention against viral toxin activity. Here, we summarize our current understanding of recently discovered viral toxins from the Flaviviridae, Coronaviridae, Nairoviridae, and Filoviridae.}, }
@article {pmid41823941, year = {2026}, author = {Slimovitch, J and Lockey, RF and Arroyo, AC and Smith, A and Ballow, M and Baptist, AP and Teng, M and Nanda, A and Mullur, J and Allakhverdi, Z and Nyenhuis, SM and Cardet, JC}, title = {Recommended Vaccines for Immunocompetent Older Adults: A Work Group Report of the AAAAI Asthma, Allergic & Immunologic Diseases in Older Adults Committee.}, journal = {The journal of allergy and clinical immunology. In practice}, volume = {14}, number = {4}, pages = {791-801}, doi = {10.1016/j.jaip.2025.09.040}, pmid = {41823941}, issn = {2213-2201}, mesh = {Humans ; Aged ; *Vaccination ; United States ; COVID-19/prevention & control ; Immunocompetence ; *Vaccines/immunology ; Practice Guidelines as Topic ; COVID-19 Vaccines ; Influenza Vaccines ; SARS-CoV-2 ; Influenza, Human/prevention & control ; Pneumonia, Pneumococcal/prevention & control ; }, abstract = {Adults 65 years or older are more susceptible to infectious diseases, representing a significant public health concern worldwide. Although newer vaccines have been developed for older adults, confusion over frequently changing guidelines often contributes to vaccine hesitancy and low vaccination rates. An American Academy of Allergy, Asthma & Immunology work group was convened to provide a clearer summary of these guidelines from the Advisory Committee on Immunization Practices and the Centers for Disease Control and Prevention. This article reviews the epidemiology and pathology of key infectious diseases in older adults, the mechanism of action of the vaccines targeting these diseases, commercially available vaccines, their potential side effects, and current vaccination recommendations for adults 65 years or older. The primary focus of this work is on adults 65 years or older; however, when possible, newer vaccination recommendations that begin at age 50 years have also been included. The diseases covered in this review include coronavirus disease 2019, pneumococcal pneumonia, respiratory syncytial virus, influenza, shingles, and tetanus. A summary table of vaccination guidelines is also included in Table III.}, }
@article {pmid41823998, year = {2026}, author = {Lee, J and Strachman, FB and Szendrő, G and Fekete, M and Varga, JT}, title = {Virtual reality in pulmonary rehabilitation: A systematic review of clinical outcomes in COPD and post-COVID conditions.}, journal = {Physiology international}, volume = {113}, number = {1}, pages = {34-63}, doi = {10.1556/2060.2026.00811}, pmid = {41823998}, issn = {2498-602X}, mesh = {Humans ; *Pulmonary Disease, Chronic Obstructive/rehabilitation/physiopathology/psychology ; *COVID-19/physiopathology/rehabilitation/complications ; *Virtual Reality ; Treatment Outcome ; Quality of Life ; Post-Acute COVID-19 Syndrome ; Exercise Tolerance ; Randomized Controlled Trials as Topic ; }, abstract = {BACKGROUND: Chronic obstructive pulmonary disease (COPD) and post-COVID syndrome cause persistent dyspnea and exercise intolerance. Traditional pulmonary rehabilitation (PR) improves outcomes. Virtual reality (VR)-based PR has been proposed as an engaging alternative. We systematically reviewed randomized trials of VR-based PR programs to evaluate its efficacy and feasibility.
METHODS: Following PRISMA guidelines, we searched PubMed, Web of Science, CENTRAL and Google Scholar (2014-Feb 2025) for RCTs comparing VR-assisted PR versus standard PR in patients with COPD or post-COVID conditions. Based on the selection criteria nine trials (primary search total n = 552; 488 COPD and 64 post-COVID patients) were included. Six domains were considered: lung function, exercise capacity (6MWT, STST), dyspnea, quality of life, mental health, and cognitive function.
RESULTS: Across nine RCTs (n = 552), VR-based pulmonary rehabilitation resulted improvements in exercise capacity in all studies, with several reporting greater gains in VR groups. A long-duration trial showed meaningful FEV1 improvement with VR, while shorter trials showed limited changes. Dyspnea and functional scores improved in both groups without consistent between-group differences. VR tended to yield greater reductions in anxiety and depression scores, and one trial showed better cognitive function in post-intervention. Quality-of-life outcomes improved in both groups.
CONCLUSION: VR-based PR was feasible and produced functional gains at least equal to those of traditional PR. VR's capacity for remote supervised training and gamification holds promise to improve access and adherence. However, evidence is limited by small, short-term trials. Larger, longer RCTs are needed to confirm these benefits, optimize VR protocols, and evaluate cost-effectiveness.}, }
@article {pmid41824149, year = {2026}, author = {van der Feltz-Cornelis, CM}, title = {Cognition and Long COVID: a Review.}, journal = {Current neurology and neuroscience reports}, volume = {26}, number = {1}, pages = {}, pmid = {41824149}, issn = {1534-6293}, mesh = {Humans ; *COVID-19/complications/psychology ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; Pandemics ; *Cognition Disorders/etiology ; *Cognition/physiology ; *Cognitive Dysfunction/etiology ; Neuropsychological Tests ; }, abstract = {PURPOSE OF REVIEW: Provide an overview of current knowledge regarding cognitive issues in patients with long COVID, also termed brain fog or cognitive COVID. RECENT FINDINGS: Subjective cognitive symptoms in long COVID patients are common but often go undetected by traditional standardised cognitive test batteries. This discrepancy poses a major clinical and societal problem, given the prevalence, protracted course and impact of cognitive COVID on work functioning. New, online assessment methods for cognitive function are feasible and corroborate subjective self-report symptoms, finding executive function impairments in cognitive COVID. As vaccination protects against brain fog and not against anxiety and depression in long COVID, brain fog can be seen as a core symptom of long COVID, concerning executive functioning, and a direct effect of neurotropic viral brain infiltration. Depression and anxiety are comorbid conditions due to indirect factors associated with the pandemic, such as increased social isolation and loss of work. Ongoing vaccination programs should not only target the elderly, but also working-age people. Online cognitive assessment batteries are recommended for assessment and treatment monitoring in long COVID. Integrated care is recommended given the high rate of multimorbidity. Future research might explore the effects of antiviral medication, modulation of the immune response, and GLP-1 agonists in long COVID.}, }
@article {pmid41824815, year = {2026}, author = {Hasen, AA and Seid, AA and Mohammed, AA and Mamed, GE and Wolde, AD and Tadesse, EC and Mulugeta, G and Seid, HA}, title = {Teenage pregnancy and its associated factors through COVID-19 in East Africa: Systematic review and meta-analysis.}, journal = {Medicine}, volume = {105}, number = {11}, pages = {e48069}, pmid = {41824815}, issn = {1536-5964}, mesh = {Humans ; Female ; Pregnancy ; Africa, Eastern/epidemiology ; *COVID-19/epidemiology ; *Pregnancy in Adolescence/statistics & numerical data ; Adolescent ; Prevalence ; SARS-CoV-2 ; Risk Factors ; East African People ; }, abstract = {BACKGROUND: In East Africa, COVID-19 has impacted the lives of girls and women. COVID-19 control measures were considered as major factors of teenage pregnancy. It is essential to provide comprehensive evidence and to focus on the well-being of teenagers during COVID-19 and future emergency situation in East Africa. The present study aimed to explore the pooled prevalence and associated factors of teenage pregnancy during COVID-19 in East Africa.
METHODS: Systematic searches were conducted in PubMed, Google Scholar, and African journals online and included articles published from December 2019 to June 2024. The quality of eligible studies was assessing using Newcastle-Ottawa Scale. A DerSimonian-Laird random-effects meta-analysis was used to estimate the pooled effect size of the outcome measures with their 95% confidence interval. Stata version 14.0 (StataCorp, College Station, Texas) was used for statistical analysis.
RESULTS: A total of 4 studies reported the prevalence of teenage pregnancy during COVID-19 in East Africa is 37% (95% confidence interval: 0.07-66.70, I2 = 99.4%, P = .000. The prevalence of teenage pregnancy during the COVID-19 pandemic in East Africa is not homogeneous across countries, publication years and sampling methods. In addition, key determinants contributing to the prevalence of teenage pregnancy are systematically summarized.
CONCLUSION: The prevalence of teenage pregnancies in East Africa during the COVID-19 pandemic has increased due to various factors such as disrupted access to sexual and reproductive health services, increased poverty, and decreased access to education. Proper and timely interventions to minimize the effects of public health and related crises on teenagers are vital.}, }
@article {pmid41826433, year = {2026}, author = {Kapischke, T and Herrmann, ST and Bertzbach, LD and Pfaender, S and Kaderali, L}, title = {Ordinary differential equation models of SARS-CoV-2 replication dynamics and antiviral drug efficacies.}, journal = {Npj viruses}, volume = {4}, number = {1}, pages = {}, pmid = {41826433}, issn = {2948-1767}, support = {462165342//Deutsche Forschungsgemeinschaft/ ; 462165342//Deutsche Forschungsgemeinschaft/ ; 101191666//HORIZON EUROPE European Research Council/ ; 101191666//HORIZON EUROPE European Research Council/ ; }, abstract = {There is a critical need for precise analysis of virus-host interactions to improve our understanding of infection processes. The integration of quantitative measurements with dynamic mathematical modeling has changed how we perceive cellular infection processes, offering profound insights into how viruses function at the cellular level. Here, we systematically review target cell-limited (TCL) ordinary differential equation (ODE) models related to SARS-CoV-2. We examine the spectrum of available models from basic TCL frameworks to more complex models incorporating antiviral treatments-and highlight key findings, discuss strengths and limitations, and identify a shortage of comprehensive datasets, emphasizing structural identifiability issues.}, }
@article {pmid41826848, year = {2026}, author = {Saito, H and Inada, M and Miike, S and Yoshida, M and Tsuzuki, S and Ichimura, Y and Ohki, U and Kimura, N and Yoshimi, I and Kawano, K and Hashimoto, Y and Moriuchi, A and Kurisu, M and Yoshida, H and Kamata, K and Ujiie, M and Jindai, K and Ichihara, N}, title = {A scoping review of randomized controlled trials in the early phase of the COVID-19 pandemic: country-level research response to COVID-19 therapeutics and vaccines.}, journal = {BMC infectious diseases}, volume = {26}, number = {1}, pages = {}, pmid = {41826848}, issn = {1471-2334}, support = {JPMJPR23R7//PRESTO, Japan Science and Technology Agency/ ; }, mesh = {Humans ; *Randomized Controlled Trials as Topic ; *COVID-19/prevention & control/epidemiology ; *COVID-19 Vaccines/therapeutic use ; SARS-CoV-2 ; Pandemics ; *COVID-19 Drug Treatment ; Developing Countries ; Developed Countries ; }, abstract = {BACKGROUNDS: Clinical trials are central in pandemic preparedness and response (PPR). This scoping review aimed to illustrate the landscape of COVID-19-related randomized controlled trials (RCTs), focusing on the countries' capacity to conduct and coordinate RCTs, and on the operational features.
METHODS: RCTs on COVID-19 therapeutics and vaccines that were published between November 1, 2019 and November 30, 2021 were identified through EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, and CINAHL. Data were collected on study design; intervention; participating countries; responsible party; funding source; and design and operational features, such as platform trial, informed consent, and decentralization. We compared the differences based on whether the study was led by high-income countries (HICs) or low- and middle-income countries (LMICs).
RESULTS: The final analysis included 328 of the 22,392 screened trials, including 47 multi-country trials, majority of which (46, 97.9%) were led by HICs. Both for therapeutics and vaccines, trials led by HICs enrolled a larger number of study participants than those by LMICs (median 207 vs. 57.5 for therapeutics, and 805 vs. 334 for vaccines). Intervention duplication was observed in 68.6% (81/118) of therapeutic interventions in trials led by HICs and 85.8% (133/155) in those led by LMICs (p-value = 0.001). Of the 42 investigational new drugs trials on therapeutics, 26 and 16 were led by HICs and LMICs, respectively, with a larger proportion led by HICs (odds ratio 2.5, 95% confidence interval 1.3-4.8). Among the 29 platform trials, 28 were led by HICs, all of which focused on therapeutics. Decentralization approaches and consent methods other than the written format were utilized in 15.5% and 19.2% of the trials, respectively.
CONCLUSIONS: Globally, LMICs were under-represented among the published trials during the first two years of the pandemic. Global collaboration and coordination are essential to improve clinical trial ecosystem during health emergencies, and pragmatic approaches and improved design and operational features of clinical trials can strengthen the global clinical trial infrastructure.
CLINICAL TRIAL: Not applicable.}, }
@article {pmid41826921, year = {2026}, author = {Hurley, KL and Alving-Jessep, EL and Boelens, M and Clarke, J and Clohessy, S and Jones, HM and Murphy, M and Oyebode, O and van der Velde, LA}, title = {Interventions to address individual/household food insecurity in Europe since COVID-19: a scoping review.}, journal = {BMC public health}, volume = {26}, number = {1}, pages = {}, pmid = {41826921}, issn = {1471-2458}, support = {Birmingham-Leiden Strategic Collaboration Fund//University of Birmingham/ ; Birmingham-Leiden Strategic Collaboration Fund//Universiteit Leiden/ ; }, mesh = {Humans ; *Food Insecurity ; Europe/epidemiology ; *COVID-19/epidemiology ; Family Characteristics ; }, abstract = {BACKGROUND: Since 2020, Europe has faced several system shocks which have led to a cost-of-living crisis and an increase in prevalence of food insecurity. These events have sparked a rise and diversification of local and national responses to household food insecurity throughout the region. This scoping review aimed to identify the interventions that have been examined in the scientific literature targeted at individuals/households experiencing food insecurity in Europe since 2020 and understand the extent to which their impact has been evaluated. METHODS: Searches were conducted in Web of Science, PsychINFO, MEDLINE and Applied Social Sciences Index & Abstracts (ASSIA), the WHO Institutional Repository for Information Sharing (IRIS), International Standard Randomised Controlled Trial Number (ISRCTN) Registry, MedRxiv (https://www.medrxiv.org/) and Google. Searches were limited to 2020-present and conducted between February-May 2025. Titles and abstracts were screened by two reviewers. Half of full texts were screened by two reviewers and half by a single reviewer. One reviewer extracted the data and analysed according to the PAGER framework. RESULTS: After removal of duplicates, 10,903 articles were screened, of which 166 were assessed for eligibility. A total of 34 studies met the inclusion criteria, which represented 10 intervention types across three countries. This review identified the most evidence in the UK and over half of the identified articles explored policy-level interventions targeted at children and adolescents. Of the community-level interventions, most were classified as ‘capacity building’ interventions, with relatively few published studies at the ‘catching’ level or as ‘self-organised community change’. Few articles had directly measured the intervention’s impact on food insecurity and there was varied reporting of the sociodemographic profile of participants. CONCLUSION: Whilst continuing advocacy for more preventative solutions to tackle food insecurity, there is also a need for future research to conduct robust evaluations of the impact of food insecurity interventions in Europe. These evaluations must consider not only the feasibility and acceptability of the interventions according to services users, service providers and policy makers, but also the longer term and any unintended impacts of the interventions. REGISTRATION: The review protocol was registered on the Open Science Framework (https://osf.io/pv24n/).}, }
@article {pmid41828536, year = {2026}, author = {Semyachkina-Glushkovskaya, O and Sursaev, V and Poluektov, M and Diduk, S and Rychkova, L and Madaeva, I and Yakubova, L and Kurths, J}, title = {New Strategies for the Prevention and Therapy of Alzheimer's Disease Based on Stimulation of Brain Drainage and Lymphatic Clearance.}, journal = {International journal of molecular sciences}, volume = {27}, number = {5}, pages = {}, pmid = {41828536}, issn = {1422-0067}, support = {23-75-30001//Russian Science Foundation/ ; }, mesh = {Humans ; *Alzheimer Disease/prevention & control/therapy/metabolism ; *Brain/metabolism/pathology ; Amyloid beta-Peptides/metabolism ; *Lymphatic Vessels/metabolism ; Low-Level Light Therapy/methods ; Animals ; COVID-19 ; }, abstract = {Alzheimer's disease (AD) is a serious medical challenge, representing an incurable and insidious disease. Current treatments can slow AD progression but cannot cure it. Promising new methods for AD therapy are essential for addressing the growing number of people with dementia, especially after the COVID-19 pandemic. The review highlights pioneering approaches to AD treatment based on innovative methods for the stimulation of brain drainage and clearance, in which the meningeal lymphatic vessels (MLVs) play a key role. Clinically promising noninvasive technologies using photobiomodulation for the effective clearance of metabolites, including amyloid beta (Aβ), and for the improvement of cognitive impairment during AD progression are discussed. An interesting part of the review is its analysis of innovative methods of improving the efficacy of anti-Aβ immunotherapy by stimulating MLV growth. The review is also focused on lifestyle, including sleep and physical exercises, discussing their support for the efficient lymphatic removal of waste products from the brain. Overall, the review provides an important, informative platform to excite the interest of a wide range of readers in the development of promising and clinically significant strategies for the treatment of AD, based on new strategies for the stimulation of brain drainage and clearance.}, }
@article {pmid41830448, year = {2026}, author = {Papatheodosiou, D and Giamarellos-Bourboulis, EJ and Tsoukas, C}, title = {Current status of immunomodulatory therapies in adult sepsis patients: where do we stand?.}, journal = {Expert review of anti-infective therapy}, volume = {24}, number = {2}, pages = {239-257}, doi = {10.1080/14787210.2026.2646192}, pmid = {41830448}, issn = {1744-8336}, mesh = {Humans ; *Sepsis/immunology/therapy/drug therapy ; Biomarkers/metabolism ; *Immunotherapy/methods ; Precision Medicine/methods ; *Immunologic Factors/therapeutic use ; Immunomodulation ; COVID-19/immunology ; *Immunomodulating Agents/therapeutic use ; }, abstract = {INTRODUCTION: Despite advances, sepsis remains a leading cause of morbidity and mortality worldwide. Dysregulated host responses are known to characterize sepsis, and while numerous clinical trials using immunomodulatory strategies have been attempted, most fail to show benefit. An important reason for their failure can be attributed to the heterogeneity of the host immune responses. Based on improvements in endotype characterization, personalized precision immunotherapy approaches now show promise.
AREAS COVERED: This review covers personalized approaches to sepsis, with a focus on the use of biomarker-guided immunomodulatory treatments. A literature search of clinical trials on sepsis immunomodulatory therapies was conducted using the PubMed database. Ongoing clinical trials on sepsis immunomodulation were also identified and reviewed.
EXPERT OPINION: Precision immunotherapy may represent the next step in sepsis management. Recent breakthrough studies have led to the identification of biomarkers that classify patients into distinct endotypes and predict response to treatment. These biomarkers need to guide us through the proper selection of patients, the timely initiation and cessation of treatment, and sometimes even the adaptation to another endotype. The integration of serial immune monitoring, adaptive clinical trial designs, and endotype-specific treatment algorithms has the potential to move the field forward.}, }
@article {pmid41830552, year = {2026}, author = {Shim, M and Park, SG and Smith, D and Uhler, E and Lacson, C}, title = {Tele-Dance Interventions for Health Outcomes: A Scoping Review.}, journal = {Telemedicine journal and e-health : the official journal of the American Telemedicine Association}, volume = {32}, number = {6}, pages = {547-565}, doi = {10.1177/15305627261427355}, pmid = {41830552}, issn = {1556-3669}, mesh = {Humans ; *COVID-19/epidemiology ; *Telemedicine/organization & administration ; Digital Health ; SARS-CoV-2 ; }, abstract = {INTRODUCTION: The rapid expansion of telehealth, particularly during the COVID-19 pandemic, accelerated the development of technology-mediated movement interventions to support physical and psychological health. Among these, tele-dance interventions (TDI) emerged as accessible and scalable models of care; however, a comprehensive synthesis of the evidence supporting these interventions remains limited. This scoping review maps existing literature on the feasibility, acceptability, and health-related outcomes of TDI across diverse populations.
METHODS: Guided by Arksey and O'Malley's framework and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines, we conducted a systematic search of 6 electronic databases and identified 26 eligible studies employing quantitative, qualitative, or mixed-methods designs. Methodological quality was appraised using the Mixed Methods Appraisal Tool. All interventions were delivered synchronously via videoconferencing platforms and were primarily adapted from established in-person dance programs, typically incorporating warm-up activities, structured or improvisational movement, and cool-down phases.
RESULTS: Across studies, TDI were consistently feasible and well accepted among older adults, individuals with neurological conditions, and people living with chronic illness. Psychosocial benefits, including enhanced social connection, improved mood, and reduced loneliness, were commonly reported. Physical outcomes such as improvements in balance, gait, and strength were also observed, suggesting potential functional benefits relevant to rehabilitation and health promotion.
CONCLUSION: TDI offer important advantages, including increased accessibility, flexible delivery formats, and scalability beyond in-person care. However, limitations include methodological heterogeneity, small sample sizes, underrepresentation of diverse populations, and limited long-term follow-up. Overall, TDI represent a promising telehealth modality, warranting future research emphasizing methodological rigor, inclusive design, hybrid delivery models, and implementation-focused evaluations.}, }
@article {pmid41830693, year = {2026}, author = {Giovanatti, A and Shapiro, AE}, title = {Anticipating tuberculosis vaccine acceptability in Kenya and South Africa: a narrative review of behavioral and social drivers and strategies to optimize acceptability.}, journal = {Vaccine}, volume = {79}, number = {}, pages = {128457}, pmid = {41830693}, issn = {1873-2518}, support = {K23 AI140918/AI/NIAID NIH HHS/United States ; T32 AI007044/AI/NIAID NIH HHS/United States ; }, mesh = {Humans ; *Tuberculosis Vaccines/administration & dosage ; South Africa/epidemiology ; *Tuberculosis/prevention & control ; *Patient Acceptance of Health Care/psychology ; *Vaccination Hesitancy/psychology ; Kenya/epidemiology ; Adolescent ; Vaccination/psychology ; COVID-19/prevention & control ; Adult ; }, abstract = {Tuberculosis (TB) remains the leading infectious cause of death worldwide, yet the only vaccine currently available is the pediatric BCG, which has poor effectiveness in preventing TB in adolescents and adults. A TB vaccine for this older age group is projected to prevent 4.6-8.5 million deaths by 2050 and increase gross domestic product by US$1.6 trillion by 2080, making this a priority investment for global stakeholders. In response to the World Health Organization's End TB Strategy, several TB vaccine candidates are now in phase III clinical trials, many of which target adolescents and adults. However, research on attitudes towards a TB vaccine is limited and urgently needed among these key populations to inform vaccine demand creation, scale up needs, and implementation strategies, particularly given global trends of increased vaccine hesitancy following the introduction of novel COVID-19 vaccines. To address this gap, a literature search was conducted for published studies evaluating socio-behavioral predictors of acceptability of HPV, COVID, and childhood immunizations as proxy indicators since there is a lack of published data on TB vaccine acceptability. We focused our search within Kenya and South Africa between January 2015 and July 2025 to represent high TB burden countries. Findings were supplemented with emerging data from unpublished conference abstracts on TB vaccine attitudes. Significant predictors of vaccine acceptability included higher perceived risk of disease, older age, a sense of collective responsibility, accurate and sufficient knowledge of the vaccine, trust in government or health authorities, and confidence in vaccine safety, side effects, and efficacy. Corresponding strategies to improve TB vaccine acceptability included early and accurate public communication, engagement of community influencers and youth, and use of diverse communication platforms.}, }
@article {pmid41830818, year = {2026}, author = {Wang, M and Zhang, Z and Jian, E and Jiang, H and Li, X and Yang, J and Yu, X and Cai, P}, title = {Exploring the evolving relationship between children and youth obesity and depression: A bibliometric analysis (1976-2025).}, journal = {Acta psychologica}, volume = {265}, number = {}, pages = {106641}, doi = {10.1016/j.actpsy.2026.106641}, pmid = {41830818}, issn = {1873-6297}, mesh = {Humans ; *Bibliometrics ; Child ; *Depression/epidemiology ; Adolescent ; *Pediatric Obesity/epidemiology/psychology ; Female ; }, abstract = {OBJECTIVES: Depression, a prevalent mental disorder characterized by prolonged low mood and diminished interest in activities, involves complex interactions among genetic, biological, psychosocial, and environmental factors in its pathogenesis. Notably, the dramatic global surge in children and youth obesity prevalence over recent decades has emerged as a major public health challenge, with growing evidence suggesting potential associations between this metabolic disorder and the development of depression. This study aims to evaluate the research progression in this field via bibliometric methods.
METHODS: We utilized the Web of Science Core Collection database to retrieve articles pertaining to children and youth obesity and depression published between 1976 and 2025. Bibliometric analysis was performed using VOSviewer, CiteSpace, and R Studio.
RESULTS: 4550 articles were identified based on the predetermined criteria. The USA and the University of Minnesota have the highest number of publications. Tanofsky-Kraff, Marian was the most productive author, and the journal with the most articles published was BMC Public Health. The most frequently used keywords were "obesity," "depression," and "children", and the most cited articles were written by Stice, E. The keywords that have emerged recently are "weight stigma", "students", "anxiety", "polycystic ovary syndrome", and "gut microbiota".
CONCLUSION: This study, revealed the evolving trends in the field of research on childhood obesity and depression. The research focus shifted from early topics such as mental health and eating disorders to weight stigma, gut microbiota, and COVID-19. Future research should focus on the biological mechanisms between obesity and depression, and gender differences.}, }
@article {pmid41831107, year = {2026}, author = {Jahanshahi, A and Mohammadi, S and Salehi, MA and Dolatshahi, M and Mirakhori, S and Frounchi, N and Zakavi, SS and Harandi, H and Ghasempour, H and Raji, CA}, title = {Brain microstructural alterations in COVID-19: a systematic review of diffusion weighted imaging studies.}, journal = {Brain imaging and behavior}, volume = {20}, number = {2}, pages = {}, pmid = {41831107}, issn = {1931-7565}, mesh = {Humans ; *COVID-19/diagnostic imaging/complications ; *Brain/diagnostic imaging/pathology ; *Diffusion Magnetic Resonance Imaging/methods ; *White Matter/diagnostic imaging/pathology ; SARS-CoV-2 ; Diffusion Tensor Imaging ; }, abstract = {INTRODUCTION: Following its emergence in Wuhan, COVID-19 has been associated with neurological sequalae, pathophysiological basis of which has been under investigation from the early reports. Herein, we aim to provide a comprehensive overview on white matter microstructural findings in COVID-19 patents. METHODS: We performed a systematic literature search on PubMed, Scopus, Web of Science, and EMBASE databases on February 9th, 2025, using the combination of keywords related to COVID-19, DTI, and NODDI. Study selection and data extraction was performed to provide a qualitative synthesis of the data. RESULTS: Mean diffusivity (MD) and fractional anisotropy (FA) were the most reported diffusion parameters. Significant alterations in diffusion parameters of longitudinal fasciculi, thalamic radiations, corpus callosum (CC), fronto-occipital fasciculus (FOF), cortico-spinal tract (CST) and uncinate fasciculi (UF) were repeatedly reported among in the studies, of which the results on changes in CR and LF were almost consistent. CONCLUSION: The observed changes in white matter microstructural integrity are associated with the psychiatric and cognitive symptoms in post-COVID-19 phase. This observation warrants long-term follow-up of COVID-19 patients for the potential neurological sequalae of this disease.}, }
@article {pmid41831154, year = {2026}, author = {Begum, RF and Mathew, M and Doshi, PP and Suresh, S}, title = {Adapting covid-19 vaccination through targeted approaches: FDA-approved vaccines for the 2025-2026 season.}, journal = {Immunologic research}, volume = {74}, number = {1}, pages = {}, pmid = {41831154}, issn = {1559-0755}, mesh = {Humans ; *COVID-19 Vaccines/immunology ; *COVID-19/prevention & control/immunology ; *SARS-CoV-2/immunology ; United States ; Vaccination/methods ; Antibodies, Neutralizing ; United States Food and Drug Administration ; }, abstract = {Since the identification of SARS-CoV-2 in late 2019, the continuous evolution of viral variants has represented a challenge to vaccination efforts worldwide. The recent emergence of Omicron viral sublineages has urged the need for updated vaccine formulations in order to maintain efficacy, especially among high-risk populations who are susceptible to severe COVID-19 manifestations. This review aims to comprehend how COVID-19 vaccination strategies evolved and to accentuate FDA-approved vaccines for the 2025–2026 season. The 2025–2026 FDA-approved vaccines- Pfizer-BioNTech’s Comirnaty® LP.8.1, Moderna’s Spikevax LP.8.1 (and mNEXSPIKE), and Novavax’s Nuvaxovid LP.8.1-target the JN.1 variant and elicit strong neutralising antibody responses. Real-world results suggest a relatively low risk of hospitalisation and mortality connected to COVID-19 among persons aged 65 years and older. Safety profiles were consistent with previous formulations, and no new safety concerns were noted. Economic models further add to the cost-effectiveness of vaccination in lowering hospitalisations and healthcare burden in high-risk groups. COVID-19 Vaccinations updated for the 2025–2026 season are highly immunogenic and well protective against severe COVID manifestations in a high-risk cohort. Targeted vaccination strategies, tuned to the variants’ changing dynamics, are required to diminish COVID-19’s global impact while ensuring equity in protection for the most vulnerable population segments.}, }
@article {pmid41831236, year = {2026}, author = {Croak, B and Lamb, D and Bhundia, R and Rafferty, AM and Greenberg, N and Stevelink, SAM}, title = {Moral injury in healthcare workers: causes & interventions.}, journal = {British medical bulletin}, volume = {157}, number = {1}, pages = {}, pmid = {41831236}, issn = {1471-8391}, support = {//NIHR Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust/ ; NIHR300592//NIHR via an NIHR Advanced Fellowship/ ; //NIHR Applied Research Collaborative North Thames/ ; }, mesh = {Humans ; *COVID-19 ; *Health Personnel/psychology ; SARS-CoV-2 ; Pandemics ; *Coronavirus Infections/psychology/epidemiology ; *Pneumonia, Viral/psychology/epidemiology ; Betacoronavirus ; Morals ; Frontline Workers ; }, abstract = {BACKGROUND: Moral injury (MI), characterized by psychological distress from morally transgressive events, has been predominantly studied in military personnel but has gained increased attention in healthcare workers (HCWs) since the COVID-19 pandemic.
SOURCES OF DATA: In this review, we narratively synthesize literature on the causes, risks, consequences, and interventions of MI in HCWs.
AREAS OF AGREEMENT: There is consensus that the COVID-19 pandemic presented HCWs with unique challenges such as fear of infection and patients dying without family, which increased the risk of MI in HCWs.
AREAS OF CONTROVERSY: Broader healthcare experiences, not unique to a pandemic, are less well understood. In this review, we discuss evidence of such experiences including restrictive practices in psychiatric settings and experiences of discrimination.
GROWING POINTS: Recent studies have highlighted the importance of addressing MI through organizational change, training, and peer support initiatives. Emerging evidence also underscores the need to consider broader systemic factors, such as workplace culture and leadership, in mitigating MI.
Future research should focus on longitudinal studies to explore in more detail risk factors for MI in HCWs. Additionally, there is a need for robust evaluations of interventions to prevent and treat MI and related disorders, including randomized controlled trials. Investigating the morally injurious effects of systemic issues like understaffing is particularly urgent as the field evolves beyond pandemic-specific challenges.}, }
@article {pmid41831387, year = {2026}, author = {Asokan, S and Isiaka, ID and Jacob, T and Vijayan, S and Rajeswary, D}, title = {Middle east respiratory syndrome coronavirus (MERS-CoV): An underestimated betacoronavirus with pandemic potential.}, journal = {Diagnostic microbiology and infectious disease}, volume = {115}, number = {3}, pages = {117367}, doi = {10.1016/j.diagmicrobio.2026.117367}, pmid = {41831387}, issn = {1879-0070}, mesh = {Humans ; Animals ; *Coronavirus Infections/epidemiology/diagnosis/virology/transmission ; *Middle East Respiratory Syndrome Coronavirus/genetics/classification/pathogenicity ; Camelus/virology ; Zoonoses/epidemiology/virology ; Pandemics ; Spike Glycoprotein, Coronavirus/metabolism ; Dipeptidyl Peptidase 4/metabolism ; }, abstract = {Middle East respiratory syndrome coronavirus (MERS-CoV) is a zoonotic beta coronavirus identified in 2012 that circulates in dromedary camels and occasionally infects humans. Although community spread is limited, the disease shows a high case fatality rate near 36 percent and has caused hospital outbreaks such as the 2015 South Korea event. The viral spike binds the DPP4 (CD26) receptor, enabling entry into airway epithelial and selected immune cells, while accessory proteins suppress early innate immunity. Genetic studies indicate continuing evolution with clades A, B, and C across the Arabian Peninsula and Africa. Human infection is linked to camel contact, farm exposure, or raw camel products, with secondary spread mainly in healthcare settings. Diagnosis uses rRT-PCR and serology; treatment is supportive, and vaccines and antivirals are under study. A One Health approach is vital for surveillance, early detection, and control.}, }
@article {pmid41832484, year = {2026}, author = {Vizuete-Aldave, N and Arrieta, H and Zarrazquin, I and Kortajarena, M and Labaka, A}, title = {Gender disparities in hospital admission patterns during the COVID-19 health emergency: a systematic review.}, journal = {BMC public health}, volume = {26}, number = {1}, pages = {}, pmid = {41832484}, issn = {1471-2458}, mesh = {Humans ; *COVID-19/epidemiology ; Female ; Male ; Sex Factors ; *Hospitalization/statistics & numerical data ; *Patient Admission/statistics & numerical data ; *Healthcare Disparities/statistics & numerical data ; SARS-CoV-2 ; *Health Status Disparities ; Pandemics ; }, abstract = {BACKGROUND: Sex/gender differences influence health outcomes, healthcare access, and hospital use. The COVID-19 pandemic disrupted health systems and may have exacerbated existing disparities. This systematic review was conducted to examine whether sex/gender disparities exist across diagnostic categories and hospital admission routes, and to determine whether these differences were altered following the declaration of the COVID-19 pandemic. METHODS: This review was conducted according to the PRISMA guidelines. Searches were conducted in PubMed, Web of Science and Cochrane Library to identify studies published in English or Spanish between 2020 and 2024 examining hospital admissions before and during the COVID-19 pandemic, with sex-disaggregated data. RESULTS: A total of 41 studies met the inclusion criteria, revealing gender-related differences in hospital admissions during the pandemic. The articles were classified according to ICD-10 chapters. During the pandemic, among adults and across all age groups, there was a notable increase in hospitalisations among women for acute burns, alcohol-associated hepatitis, resected lung cancer, malignant melanoma, and others. Women also showed increased emergency visits for infections, mental health problems, and injuries. In contrast, men experienced an increase in admissions for gastrointestinal bleeding. Additionally, studies reported rises in sexual abuse of girls, higher self-harm rates among boys, and more admissions for mental health problems among girls. CONCLUSIONS: This systematic review identified differences in hospital admissions for various conditions and highlighted social and health inequalities exacerbated by lockdown. These findings undersore the importance of integrating a gender perspective into public health strategies and responses during health emergencies. TRIAL REGISTRATION: The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 22 August 2025 (CRD420251038282).}, }
@article {pmid41832744, year = {2026}, author = {Nyame, P and Okoh, OS and Yalley, AK and Nii-Trebi, NI}, title = {Towards Ending HIV/AIDS by 2030: Trajectory of Sub-Saharan Africa-A Post-COVID-19 (2019-2024) Review.}, journal = {Reviews in medical virology}, volume = {36}, number = {2}, pages = {e70138}, doi = {10.1002/rmv.70138}, pmid = {41832744}, issn = {1099-1654}, mesh = {Humans ; Africa South of the Sahara/epidemiology ; *COVID-19/epidemiology ; *HIV Infections/epidemiology/prevention & control/drug therapy ; Sub-Saharan African People ; SARS-CoV-2 ; Pandemics ; Delivery of Health Care ; *Acquired Immunodeficiency Syndrome/epidemiology/drug therapy/prevention & control ; }, abstract = {Globally, the COVID-19 pandemic perturbed HIV services, jeopardising progress towards the Joint United Nations Programme on HIV/AIDS (UNAIDS) 95-95-95 targets in sub-Saharan Africa (SSA). This review is an evaluation of sub-Saharan Africa's progress towards attaining the UNAIDS target of ending HIV/AIDS by the year 2030 in the context of COVID-19. Data from UNAIDS, the World Health Organisation (WHO), and peer-reviewed literature were analysed to assess HIV service delivery in SSA from 2019 to 2024, with special attention to regional disparities and health system adaptations before, during, and after the pandemic. Before the COVID-19 pandemic, Southern and Eastern Africa were nearing the 90-90-90 goals while West and Central Africa made slower progress because of weaker health systems and other situational challenges. Between 2020 and 2022, lockdowns and service disruptions reduced HIV testing, delayed the start of antiretroviral therapy (ART), and led to fewer viral load analyses. To adapt, health systems provided ART for longer periods, offered more community-based care, expanded health worker roles, and used digital tools to maintain services, especially where infrastructure was strong. By 2023 and 2024, most countries in Southern and Eastern Africa were closer to achieving the 95-95-95 targets, while West and Central Africa continued to recover more slowly. The pandemic revealed both strengths and weaknesses in the HIV response in sub-Saharan Africa. Institutionalising innovations developed during the pandemic and addressing persistent regional disparities, which reflect uneven progress across the sub-region, are essential to sustaining progess and achieving epidemic control by 2030.}, }
@article {pmid41833428, year = {2026}, author = {Clarkson, J and Walsh, T and Lewis, S and Riley, P and O'Malley, L and Glenny, AM}, title = {CELEBRATING 30 YEARS OF COCHRANE ORAL HEALTH: A LEGACY OF EVIDENCE AND IMPACT.}, journal = {The journal of evidence-based dental practice}, volume = {26}, number = {1}, pages = {102227}, doi = {10.1016/j.jebdp.2026.102227}, pmid = {41833428}, issn = {1532-3390}, mesh = {*Oral Health/history ; Humans ; *Evidence-Based Dentistry ; COVID-19 ; *Systematic Reviews as Topic ; History, 21st Century ; History, 20th Century ; SARS-CoV-2 ; }, abstract = {In 2024, Cochrane Oral Health (COH) celebrated its 30th anniversary, marking 3 decades of advancing global oral health through rigorous evidence synthesis. Based at The University of Manchester, COH has become a cornerstone of trusted health information, contributing to clinical practice, policy, and patient care. COH's mission centers on producing accessible, high-quality systematic reviews to inform decision-making and promote equitable oral health. Its prioritization strategy, involving diverse stakeholders, ensures relevance and impact. COH exemplifies methodological excellence and innovation, adhering to Cochrane methodological standards and promoting transparency through protocol publication and freely available plain language summaries. Our reviews are widely cited in international guidelines and policy documents, with notable contributions to evidence synthesis and knowledge translation in the areas of fluoride interventions, antimicrobial use, oral cancer management, and infection control during COVID-19. COH has embraced innovation through the conduct of a diverse range of review methodologies including living reviews, diagnostic test accuracy reviews and overviews of systematic reviews, AI-assisted synthesis, and commissioned evidence synthesis. Cochrane Oral Health's legacy is defined by its commitment to methodological rigor, stakeholder engagement, and global impact. As it enters its fourth decade, COH continues to evolve, addressing emerging challenges and advancing oral health through trusted evidence. Its strategic goals of expanding reach, innovating methods, promoting equity, and effective knowledge translation position COH as a leader in evidence-based oral healthcare.}, }
@article {pmid41834872, year = {2026}, author = {Han, Z and Wang, H and Liu, X and Tian, Z and Gong, Q and Zhang, X and Li, X and Du, R and Hu, X and Xu, C}, title = {Cross-species transmission alert: a novel canine-raccoon dog coronavirus infecting an Amur Tiger in China.}, journal = {Frontiers in microbiology}, volume = {17}, number = {}, pages = {1764349}, pmid = {41834872}, issn = {1664-302X}, abstract = {Canine coronavirus (CCoV) is an important enteric alphacoronavirus primarily affecting canids. Here, we detected canine coronavirus RNA in a captive 9-year-old Amur tiger (Panthera tigris altaica) in China. The complete viral genome was obtained using metagenomic next-generation sequencing. Phylogenetic and recombination analyses were then performed to investigate its evolutionary relationship with canine and feline coronaviruses. The identified CCoV strain clustered within established canine coronavirus lineages and showed sequence evidence of recombination involving coronavirus strains previously reported in other carnivore species. Although the detection of viral RNA alone does not establish a causal relationship between CCoV infection and disease outcome, this study provides molecular evidence that Amur tigers are susceptible to canine coronavirus infection. These findings expand the known host range of CCoV and contribute to understanding the evolution and cross-species transmission potential of coronaviruses among carnivores.}, }
@article {pmid41834940, year = {2026}, author = {Kalsi, P and Aggarwal, N and Shukla, KK and Sharma, J and Goyal, G and Prasad, R and Sharma, H}, title = {SARS-CoV-2 Associated Impact on Reproductive Health: A Global Perspective.}, journal = {Indian journal of clinical biochemistry : IJCB}, volume = {41}, number = {2}, pages = {188-199}, pmid = {41834940}, issn = {0970-1915}, abstract = {The outbreak of the novel coronavirus disease due to the SARS-CoV-2 virus originated in Wuhan in December 2019, and emerged as a considerable global pandemic threat, with serious impact on different aspects of people's health and lives. Though, the disease is no longer considered a global emergency, its potential risks for long-term reproductive health remain a concern. Various guidelines and precautionary measures such as suspension of non-essential medical services were adopted for the containment of this deadly virus. Although such restrictions were proven to be an effective tool in preventing the spread of novel coronavirus, however, this has also negatively impacted society, including infertile couples undergoing fertility treatment. During the period of the pandemic, females experienced changes in menstrual cycles, thyroid dysfunction, and stress-associated loss in libido and other related sexual dysfunctions, leading to consequential effects on their reproductive and mental health. The SARS-CoV-2-associated defects are not only limited to female reproductive dysfunction rather the male reproductive organs were found to be equally impacted by this SARS-CoV-2 virus. The expression of ACE2 in the male reproductive count is a major factor for significant alterations observed in male reproductive function. In this current article, we have focused on the impact of SARS-CoV-2 on reproductive health, and the challenges of assisted reproductive technology (ART) during the pandemic outbreak.}, }
@article {pmid41835055, year = {2025}, author = {Hsu, CY and Abdulazez, AA and Almajidi, YQ and Kareem, AK and Aseeri, AA and Prasad, K and Al-Khafaji, ZK and Al-Mashhadani, ZI and Bokhoor, SN and Hasan, RN}, title = {Delivery Systems of mRNA Vaccines in the Treatment of Infectious Diseases: From Lipid Nanoparticles to Next-Generation Platforms.}, journal = {Advanced pharmaceutical bulletin}, volume = {15}, number = {4}, pages = {717-734}, pmid = {41835055}, issn = {2228-5881}, abstract = {The historic accomplishment of mRNA vaccines against SARS-CoV-2 has provided a massive shift in vaccinology, providing a quick, nimble, and powerful platform for infectious disease prevention. This success, however, does not simply stem from the mRNA sequence but equally depends on the delivery vehicle-the lipid nanoparticle (LNP). The delivery system has evolved from a passive transporter into an active immunomodulatory component, a critical component that (1) protects the inherently fragile mRNA payload, (2) allows cellular uptake and endosomal escape, and (3) adds its own inherent adjuvant properties to shape the immune response. This review provides a comprehensive summary of the current advancements in mRNA vaccine delivery technologies. We first deconstruct the structure, mechanisms, advantages, and disadvantages of the clinically validated LNP platform. Following this discussion, we highlight the emerging landscape of new systems, including chemically diverse polymeric nanoparticles, biologically-inspired peptide-based carriers, and endogenous extracellular vesicles, potentially overcome current limitations in these delivery systems, including issues with thermostability and targeted delivery. After this, we summarize how these new delivery technologies are being leveraged clinically for a continuum of high-priority infectious diseases, including influenza, RSV, CMV, HIV, Zika, and Rabies. This discussion also illustrates how the design of vaccine prototypes is being rational to address the immune-mediated strategies exploited by each distinct pathogen.}, }
@article {pmid41835098, year = {2026}, author = {Dos Santos, LPM and Leão, JV and Silva, KYBM and Dos Santos, DL and Batista, CN and Barros, JA and Paranhos, ACM and Dias, ÁRN and Falcão, LFM}, title = {Transcranial stimulation as a possible therapeutic proposal in long COVID.}, journal = {Frontiers in rehabilitation sciences}, volume = {7}, number = {}, pages = {1766757}, pmid = {41835098}, issn = {2673-6861}, abstract = {The COVID-19 pandemic triggered an unprecedented global health crisis, with significant repercussions on the mental and neurological health of millions of individuals. Long COVID, characterized by persistent and debilitating symptoms, including chronic fatigue, pain, cognitive impairment, and mood swings, represents a substantial therapeutic challenge. In this context, neuromodulation emerges as a promising therapeutic strategy, offering new perspectives for the management of refractory neurological symptoms. This article aims to critically review the current evidence on the use of neuromodulation in patients with long COVID.}, }
@article {pmid41835195, year = {2026}, author = {Chen, R and Xu, Z}, title = {Doxycycline for Macrolide-Resistant Mycoplasma pneumoniae Pneumonia in Children: Clinical Updates and Therapeutic Insights Post-COVID-19.}, journal = {Infection and drug resistance}, volume = {19}, number = {}, pages = {593954}, pmid = {41835195}, issn = {1178-6973}, abstract = {Mycoplasma pneumoniae (MP) is a leading cause of community-acquired pneumonia (CAP) in children. Macrolides have long been first-line therapy due to favorable safety profiles and low minimum inhibitory concentrations (MICs) in pediatric populations. However, the global surge in macrolide-resistant MP (MRMP) has compromised conventional treatments, creating an urgent need for alternative agents. Mounting evidence supports doxycycline, a second-generation tetracycline, as an effective therapy for pediatric MRMP, particularly post-COVID-19. Compared to azithromycin, doxycycline shortens disease duration, accelerates the resolution of fever and cough, promotes pulmonary infiltrate absorption, and yields robust outcomes in children ≥8 years old. It also reduces corticosteroid use and exhibits a favorable safety profile. For refractory MP pneumonia (RMPP), combination therapy with doxycycline and corticosteroids (eg, methylprednisolone) enhances therapeutic effects. Ongoing research explores innovative combinations and personalized dosing to mitigate resistance. This narrative overview synthesizes recent advances in doxycycline use for pediatric MRMP since the COVID-19 pandemic, aiming to inform evidence-based practice. It also highlights the need for large-scale, well-designed trials to confirm long-term safety and efficacy, supporting standardized clinical implementation.}, }
@article {pmid41836534, year = {2026}, author = {Scirocco, E and Paganoni, S and Brizzi, K}, title = {Approaching Serious Illness Conversations in Amyotrophic Lateral Sclerosis Using Telehealth: A Practical Guide.}, journal = {Neurology. Clinical practice}, volume = {16}, number = {2}, pages = {e200600}, pmid = {41836534}, issn = {2163-0402}, abstract = {PURPOSE OF REVIEW: Given the lack of consensus on serious illness conversations (SIC) in amyotrophic lateral sclerosis (ALS) by using telehealth, we aim to provide practical strategies in this setting.
RECENT FINDINGS: Over the past 5 years, there has been substantial growth in telehealth, especially after the global COVID-19 pandemic. In ALS, telehealth has become an increasingly used tool for providing clinical care, especially as the disease progresses, when travel becomes challenging and geographic constraints arise. As ALS advances, clinicians often have SIC with individuals living with ALS and their caregivers using telehealth. In the literature, few recommendations are available to improve telehealth communication in the neuropalliative setting.
SUMMARY: We present 3 case scenarios showcasing telehealth strategies for SICs, with specific considerations for individuals living with ALS. We provide a strategy, CARE in ALS, to support telehealth communication in individuals with speech impairments. We hope to provide practical guidance for health care clinicians in this specific setting.}, }
@article {pmid41836927, year = {2026}, author = {Baptista, SN and Atkins, T and Chakraborty, S and Bakhit, M and Glasziou, P and Byambasuren, O}, title = {Candidate treatments for long COVID: a narrative review of expert and patient-driven priorities.}, journal = {Frontiers in medicine}, volume = {13}, number = {}, pages = {1734600}, pmid = {41836927}, issn = {2296-858X}, abstract = {OBJECTIVE: To map the existing evidence for candidate treatments for long COVID that were prioritised by clinicians and people with lived experience, and to characterise their feasibility, acceptability and safety.
STUDY DESIGN: The study was conducted as a narrative review using pragmatic methods including iterative stakeholder-informed decision-making a monthly-updated evidence search, rapid lay evidence summaries and a structured research prioritisation process.
DATA SOURCES: Potential candidate treatments were identified via a combination of database and trial registry searches. These were then ranked by clinicians and people with lived experience using surveys. Evidence summaries for the top 14 interventions (low-dose naltrexone, antivirals, metformin, nicotine, vagus nerve stimulation, antihistamines, guanfacine, colchicine, nattokinase, intravenous immunoglobulins, monoclonal antibodies, coenzyme Q10, multicomponent rehabilitation packages, and exercise training) were created. Prioritised treatments were collated first by searching a collaborative living evidence database (updated monthly) of relevant systematic reviews and randomised controlled trials and then by conducting supplementary searches of other study designs.
DATA SYNTHESIS: Six of 14 interventions had long-COVID-specific randomised controlled trial (RCT) evidence (exercise [16 RCTs], multicomponent packages [5 RCTs], coenzyme Q10 [2 RCTs], antivirals [1 RCT], vagus nerve stimulation [1 pilot RCT], monoclonal antibodies [1 small RCT]); the remainder relied on indirect or very low-certainty data (e.g., uncontrolled studies or mechanistic rationale). Across interventions, evidence certainty was mostly low to very low, and safety/feasibility varied.
CONCLUSION: This review prioritises and maps candidate treatments for long COVID. There was insufficient direct evidence to inform clinical recommendations. Rather, the treatments presented in this review represent those that could be rigorously tested in clinical trials as they show biological plausibility and/or are feasible and acceptable to people with lived experience and clinicians.
REGISTRATION: A review protocol was not prospectively registered because the review adopted an iterative approach to support priority setting rather than clinical guidance.}, }
@article {pmid41837342, year = {2026}, author = {Yilmaz, S and Göktaş, B and Ateş, İ and Çelik, M}, title = {Ivermectin Toxicity in Humans and Animals: Clinical Spectrum, Mechanisms, and Management.}, journal = {Journal of applied toxicology : JAT}, volume = {46}, number = {6}, pages = {1856-1870}, pmid = {41837342}, issn = {1099-1263}, mesh = {Humans ; Animals ; *Ivermectin/toxicity/pharmacokinetics ; *Antiparasitic Agents/toxicity/pharmacokinetics ; *Neurotoxicity Syndromes/etiology ; Blood-Brain Barrier/drug effects/metabolism ; }, abstract = {Ivermectin is a widely used macrocyclic lactone with established efficacy against a broad range of parasitic infections in humans and animals and a long-standing reputation for clinical safety. However, increasing evidence indicates that ivermectin can produce clinically relevant toxicity under specific conditions, particularly involving the central nervous system. This review integrates findings from controlled human trials, pharmacovigilance data, clinical case reports, experimental animal studies, and environmental investigations to comprehensively characterize the toxicological profile of ivermectin. Early randomized, placebo-controlled studies in healthy volunteers demonstrated that ivermectin is generally well tolerated, even at doses substantially exceeding approved therapeutic levels, with predominantly mild and transient adverse events and no significant neurological toxicity under controlled conditions. In contrast, post-marketing surveillance and real-world clinical reports have identified rare but severe neurotoxic events, including encephalopathy, seizures, coma, and death, occurring after supratherapeutic exposure and, in susceptible individuals, even at standard therapeutic doses. Converging human and animal evidence highlights impairment or saturation of blood-brain barrier protection, particularly dysfunction of P-glycoprotein (ABCB1/MDR1)-mediated efflux, as a central determinant of ivermectin neurotoxicity. Animal studies further demonstrate marked species-, breed-, age-, dose-, and route-dependent susceptibility, with neonatal animals, genetically predisposed dog breeds, and models exposed to transporter inhibition or repeated high-dose regimens showing pronounced vulnerability. While neurotoxicity is often functional and reversible at lower exposures, high or cumulative dosing can lead to structural neuropathology and multi-organ injury. The COVID-19 pandemic amplified these risks through widespread off-label use, especially of veterinary formulations, resulting in a substantial increase in toxic exposures without demonstrated clinical benefit. Overall, ivermectin toxicity emerges as a predictable consequence of interactions between pharmacokinetics, transporter biology, exposure patterns, and host-specific factors rather than an inherent contradiction of its therapeutic value.}, }
@article {pmid41838245, year = {2026}, author = {Manchikanti, L and Pampati, V and Kaye, AD and Abd-Elsayed, A and Shekoohi, S and Sanapati, MR and Soin, A and Hirsch, JA}, title = {An Updated Review of Utilization Patterns of Sacroiliac Joint Interventions in the Fee-for-service (ffs) Medicare Population from 2000 to 2022.}, journal = {Current pain and headache reports}, volume = {30}, number = {1}, pages = {}, pmid = {41838245}, issn = {1534-3081}, mesh = {United States ; Humans ; *Sacroiliac Joint/surgery ; *Medicare/trends ; *Fee-for-Service Plans/trends ; COVID-19 ; *Low Back Pain/therapy ; }, abstract = {PURPOSE OF THE REVIEW: This updated review evaluates utilization patterns of sacroiliac joint (SIJ) interventions, including SIJ injections, radiofrequency neurolysis, and SIJ fusion, using data from the Centers for Medicare and Medicaid Services (CMS) and Physician Supplier Procedure Summary (PSPS) database. RECENT FINDINGS: Between 2019 and 2022, Medicare data revealed a notable significant decline in SIJ intervention utilization, with a cumulative drop of 28.9% and an annual decrease of 10.7% per 100,000 beneficiaries. This represents a stark contrast to the minimal 0.4% annual decline observed from 2010 to 2019. The most significant reduction occurred from 2019 to 2020 (− 18.7%), coinciding with the onset of the COVID-19 pandemic. Utilization declined slightly from 2020 to 2021 (− 1.1%), then more sharply again from 2021 to 2022 (− 11.5%). These patterns mirror trends seen in similar studies on epidural and facet joint interventions, which often evaluate SIJ procedures in tandem. While the Medicare population increased by 63.3% from 2000 to 2022, SIJ injections rose by 281% overall during the same period, with an annual increase of 6.3%. However, post-COVID-19 (2019–2022), there was a 13.5% overall decrease in SIJ procedures, averaging a 4.7% annual decline. The largest drop occurred in 2020 (− 19.2%), followed by an 8.3% rebound in 2021, and a subsequent 1.2% decline in 2022. These findings highlight shifting trends in interventional pain management, particularly in response to public health and economic disruptions.}, }
@article {pmid41840407, year = {2026}, author = {Chase, NM}, title = {Vaccinating patients on biologics for atopic disease: Clinical considerations and evidence-based recommendations.}, journal = {Allergy and asthma proceedings}, volume = {47}, number = {2}, pages = {85-91}, doi = {10.2500/aap.2026.47.260001}, pmid = {41840407}, issn = {1539-6304}, mesh = {Humans ; *Biological Products/therapeutic use/adverse effects ; *Vaccination/methods ; Vaccines, Attenuated ; Antibodies, Monoclonal, Humanized/therapeutic use ; *Hypersensitivity, Immediate/drug therapy/immunology ; *Vaccines ; Evidence-Based Medicine ; }, abstract = {Background: Biologics that target type 2 inflammation have transformed the management of atopic diseases, but questions remain with regard to vaccine administration in these patients. Current product labeling recommends caution with vaccine administration in patients taking these medications, particularly live-attenuated vaccines, despite limited evidence of actual risk. Objective: The objective was to review clinical concerns and available evidence, and to provide practical recommendations for vaccination in patients receiving biologics for atopic diseases, with a focus on dupilumab. Methods: A comprehensive PubMed/MEDLINE literature search was conducted to identify relevant studies and clinical guidance with regard to vaccination strategies in patients receiving biologic therapy. The primary search terms included the following: "biologic therapy" or "biologic therapy" or "monoclonal antibodies" combined with "vaccination" or "immunization" or "vaccine response" or "live vaccines" or "inactivated vaccines." Priority was given to randomized controlled trials, large observational studies, and registry data published within the past 10 years. Results: For non-live vaccines, evidence supports safety and efficacy, although results of some studies suggest moderately reduced responses. A randomized controlled trial found comparable antibody responses between dupilumab and placebo groups for tetanus (83.3% versus 83.7%) and meningococcal vaccines (86.7% versus 87.0%). Coronavirus disease 2019 (COVID-19) vaccine studies show mixed results, with some reporting lower antibody levels and neutralization capacity in patients on biologics. For live-attenuated vaccines, emerging evidence challenges traditional prohibitions. Conclusion: Current evidence supports the safety and efficacy of non-live vaccines in patients receiving biologics for atopic diseases, although responses may be moderately reduced. Analysis of emerging data suggests certain live-attenuated vaccines may be safer than previously thought, particularly in pediatric patients on dupilumab. Vaccination decisions should be individualized based on risk-benefit assessment. Further research is needed to establish definitive guidelines, particularly for live vaccines and long-term immunity.}, }
@article {pmid41841055, year = {2026}, author = {Sidiropoulou, M}, title = {The Current Landscape of Ophthalmology Training in Europe.}, journal = {Cureus}, volume = {18}, number = {2}, pages = {e103487}, pmid = {41841055}, issn = {2168-8184}, abstract = {Ophthalmology training across Europe has undergone a significant transformation over the last two decades. Although individual countries retain distinct systems for resident recruitment, training structure, and surgical exposure, the overarching goal has been to converge toward competency-based education guided by the European Board of Ophthalmology (EBO) and the European Union of Medical Specialists (UEMS). This narrative review draws on official EBO and UEMS policy documents, recent peer-reviewed literature, national curricula, and surveys of residents and educators. It examines the structure and duration of training, curriculum reforms, surgical exposure, simulation, fellowship opportunities, and the influence of European legislation on professional mobility. Residency programs in Europe vary in length from four to six years, with considerable heterogeneity in surgical case volume, fellowship opportunities, and access to simulation. The 2024 European Training Requirements (ETR) introduced Entrustable Professional Activities (EPAs), programmatic assessment, and e-portfolios, providing a common reference for national curricula. The EBO Diploma (EBOD) serves as a recognized benchmark for harmonization. Simulation-based cataract training has moved from optional to integral, though adoption remains inconsistent. Pressures such as the European Working Time Directive (EWTD) and the COVID-19 pandemic have altered clinical exposure, while digital education and mobility programs offer compensatory mechanisms. European ophthalmology training is moving toward harmonized outcomes but retains structural variation between countries. Achieving consistency will require aligning national curricula with the ETR, mandating simulation milestones, investing in faculty development, and formalizing fellowship standards to ensure equitable access and readiness for independent practice.}, }
@article {pmid41841485, year = {2026}, author = {Ahn, SN}, title = {Evidence from a Narrative Review of Altered Intervention Methods and Behavioral Goals for Children with ASD in Relation to COVID-19.}, journal = {Restorative neurology and neuroscience}, volume = {}, number = {}, pages = {9226028261430326}, doi = {10.1177/09226028261430326}, pmid = {41841485}, issn = {1878-3627}, abstract = {Environmental changes in response to COVID-19 may negatively impact the development, behavior, and mental health of children with Autism spectrum disorder (ASD). Thus, it is necessary to investigate the changed behavioral goals provided.This narrative review examined studies that investigated changes in intervention methods and behavioral goals for children with ASD during COVID-19. This study searched five databases and identified ten articles meeting the inclusion criteria. These articles were evaluated for risk of bias and quality of evidence level. Behavioral goals and intervention methods were reviewed.The selected articles included two non-randomized single-group studies, six single-experiment studies, and two case studies. Behavioral goals included mask wearing, social participation and play, and behavioral regulation. Interventions included telehealth, social participation training, play-based sibling intervention, early intensive behavioral, differential reinforcement, and treatment extension for tolerating.This review identifies the need to change in intervention methods and behavioral goals for children with ASD to adapt to environmental changes due to COVID-19.}, }
@article {pmid41841644, year = {2026}, author = {Borst, A and Choorapoikayil, S and Stuhlmann, S and Zacharowski, K and Meybohm, P}, title = {Advances in the understanding and management of hospital-acquired anemia.}, journal = {Current opinion in anaesthesiology}, volume = {39}, number = {3}, pages = {401-408}, pmid = {41841644}, issn = {1473-6500}, mesh = {Humans ; *Anemia/therapy/etiology/epidemiology/diagnosis ; *Iatrogenic Disease/epidemiology/prevention & control ; Blood Transfusion/methods/statistics & numerical data ; Incidence ; Length of Stay/statistics & numerical data ; Blood Loss, Surgical/prevention & control ; }, abstract = {PURPOSE OF REVIEW: Hospital-acquired anemia (HAA) is a common complication associated with adverse outcomes, including increased transfusion requirements and prolonged hospital length of stay. The precise etiology of HAA remains elusive, and preventive or therapeutic strategies are inconsistently applied or lacking altogether. This review summarizes current evidence on the incidence, underlying mechanism, clinical consequences, and available interventions for HAA.
RECENT FINDINGS: The causes of HAA are multifactorial involving procedural or diagnostic blood loss, impaired erythropoiesis, coagulation abnormalities, nutritional deficiencies, and hemolysis. Measures such as small volume tubes and closed blood collection devices have proven safe and effective for reducing the volume of drawn blood. Recent studies suggest that the incidence of HAA can be diminished by implementing systematic, patient-centered approaches.
SUMMARY: HAA remains prevalent despite long-standing recognition of its clinical consequences. Although awareness has continuously increased, treatment and prevention strategies are still not widely established.}, }
@article {pmid41842771, year = {2025}, author = {Diaz, F}, title = {[Kawasaki Disease and Pediatric Multisystem Inflammatory Syndrome in the Aftermath of the Pandemic].}, journal = {Andes pediatrica : revista Chilena de pediatria}, volume = {96}, number = {4}, pages = {447-456}, doi = {10.32641/andespediatr.v96i4.5361}, pmid = {41842771}, issn = {2452-6053}, mesh = {Humans ; *Mucocutaneous Lymph Node Syndrome/diagnosis/therapy/physiopathology ; *Systemic Inflammatory Response Syndrome/diagnosis/therapy/physiopathology ; *COVID-19/complications ; Child ; Pandemics ; *Coronavirus Infections/complications/epidemiology/diagnosis ; *Pneumonia, Viral/complications/epidemiology ; SARS-CoV-2 ; }, abstract = {Following the initial months of the COVID-19 pandemic, Multisystem Inflammatory Syndrome in Children (MIS-C) was identified as an entity associated with SARS-CoV-2 infection. In addition to the viral epidemiological shift, many factors contributed to MIS-C being exceptionally rare today. The similarities to other diseases previously described in the pediatric population have made its clinical management challenging in the post-pandemic era. However, given its potential severity, it is essential to incorporate the different phenotypes into the diagnostic and therapeutic approach to common pediatric diseases and syndromes to minimize both underdiagnosis and overtreatment. The Kawasaki disease phenotype of MIS-C (fKD/MIS-C) and Kawasaki disease (KD) require special attention, as they share multiple clinical and pathophysiological characteristics. While the current evidence on KD is robust regarding treatment, severity, and outpatient follow-up, MIS-C management relies predominantly on expert recommendations. It is crucial to recognize the key common and distinctive features of these entities to optimize diagnosis, identify at-risk groups, and improve therapy during the acute phase and outpatient follow-up. Nonetheless, the long-term implications of fKD/MIS-C have not yet been fully elucidated.}, }
@article {pmid41843918, year = {2026}, author = {Sevilla, JP and Knee, JS and Burnes, D and Meier, G and Yang, J and Di Fusco, M and Hu, T and Bloom, DE}, title = {The full value of mRNA seasonal influenza and endemic-stage COVID-19 combination vaccines: a taxonomy.}, journal = {Journal of medical economics}, volume = {29}, number = {1}, pages = {848-870}, doi = {10.1080/13696998.2026.2638676}, pmid = {41843918}, issn = {1941-837X}, mesh = {Humans ; *COVID-19 Vaccines/economics/administration & dosage ; *Influenza Vaccines/economics/administration & dosage ; *COVID-19/prevention & control/epidemiology ; Middle Aged ; Adult ; *Influenza, Human/prevention & control ; Aged ; Adolescent ; Vaccines, Combined/economics ; Young Adult ; }, abstract = {AIMS: Seasonal influenza and COVID-19 pose significant ongoing threats to global health. Vaccination remains central to their prevention. Messenger RNA combination influenza and COVID-19 vaccines (mRNA combo vaccines) are in development. Payers will soon need to make value-for-money (VfM) assessments and coverage decisions regarding these vaccines. Value taxonomies play an important role in VfM assessments and coverage decisions. However, no taxonomy exists that captures the full value of mRNA combo vaccines. We aimed to construct a taxonomy of the full value, from a societal perspective, of mRNA combo vaccines in working-age (18-64 years) and older adults (65+ years).
METHODS: We (1) performed a targeted literature review (TLR) of existing value taxonomies and value attributes of COVID-19, influenza, other mRNA, and other combination vaccines; and (2) synthesized the value elements found in the TLR into a comprehensive taxonomy specific to mRNA combo vaccines.
RESULTS: Of 1851 identified studies, 57 contained relevant value elements. We constructed a taxonomy distinguishing narrow health-related from broader societal values, and traditional from novel values. Value elements in the taxonomy included improved health and reduced treatment costs; improved productivity; improved strain selection, raising vaccine efficacy; greater compliance with vaccine schedules, increasing uptake; improved patient and caregiver health and reduced treatment costs from such greater efficacy and uptake; reduced adverse events, anxiety and vaccination costs from reduced doses; process utilities from increased convenience; higher patient and provider acceptability; increased equity; and health-related R&D spillovers.
LIMITATIONS: The TLR was non-systematic. We do not address potential redundancies or the relative importance of different values.
CONCLUSIONS: Many value elements in the taxonomy are traditional narrow values and fit within a health payer perspective, but the taxonomy also captures broader societal values. This taxonomy can support more comprehensive valuations of mRNA combo vaccines in national vaccine recommendation and funding decisions.}, }
@article {pmid41844030, year = {2026}, author = {Zhang, Q and Gao, C and Ge, X and Sun, Y and Liu, P and Zhang, XX}, title = {Tracking viral variants by wastewater surveillance, from laboratory diagnosis towards on-site monitoring: lessons learned from the SARS-CoV-2 pandemic.}, journal = {Journal of environmental management}, volume = {404}, number = {}, pages = {129353}, doi = {10.1016/j.jenvman.2026.129353}, pmid = {41844030}, issn = {1095-8630}, mesh = {*SARS-CoV-2/genetics/isolation & purification ; *Wastewater/virology ; *COVID-19/epidemiology/virology ; Humans ; *Wastewater-Based Epidemiological Monitoring ; RNA, Viral ; Pandemics ; Environmental Monitoring/methods ; Mutation ; }, abstract = {Wastewater-based epidemiology (WBE) provides a scalable, population-level biosurveillance layer that complements clinical testing for monitoring SARS-CoV-2 circulation, particularly when diagnostic participation, access, or representativeness is limited. As SARS-CoV-2 continues to evolve, wastewater surveillance has expanded beyond quantifying total viral RNA to also resolving signature mutations and mixed lineage compositions in complex matrices. This review synthesizes end-to-end workflows for variants-directed WBE, spanning sample collection and viral signal enrichment, sequencing-dependent approaches (tiled-amplicon and hybrid-capture sequencing coupled with lineage deconvolution of mixed samples), and sequencing-independent approaches based on targeted mutation detection, including RT-dPCR, allele-specific RT-qPCR, and nested-PCR coupled with LC-MS. We compare these modalities in terms of resolution, sensitivity, turnaround time, and operational constraints, and highlight recurrent bottlenecks such as uneven genome coverage, low-frequency mutation detection, primer/assay drift, and the need for robust quality control and benchmarking under real wastewater conditions. To reduce end-to-end latency and improve sustainability, we outline requirements and research priorities for integrated, automated on-site (or near-site) monitoring systems, emphasizing compact enrichment/extraction modules, field-deployable detection chemistries, and rapid reporting pipelines. Finally, we extend the COVID-era framework beyond SARS-CoV-2, discussing how wastewater and environmental surveillance can be institutionalized as a multi-hazard public health intelligence platform supporting multiplex respiratory panels, pathogen-agnostic sequencing for anomaly detection, mobility-linked sentinel networks, and One Health applications such as antimicrobial resistance monitoring.}, }
@article {pmid41844087, year = {2026}, author = {Gupta, J and Kumar, R}, title = {A comprehensive review on artificial intelligence driven approaches for vaccine development: Current advances, challenges, and future prospects.}, journal = {Current research in translational medicine}, volume = {74}, number = {2}, pages = {103577}, doi = {10.1016/j.retram.2026.103577}, pmid = {41844087}, issn = {2452-3186}, mesh = {Humans ; *Artificial Intelligence/trends ; *Vaccine Development/methods/trends ; *COVID-19 Vaccines ; *COVID-19/prevention & control/immunology/epidemiology ; Immunoinformatics ; SARS-CoV-2/immunology ; Clinical Trials as Topic ; Machine Learning ; Computational Biology ; }, abstract = {Artificial intelligence (AI) has emerged as an exemplified tool in the field of modern biomedical technology. The unprecedent COVID-19 pandemic and other infectious disease crises have highlighted the critical need for rapid and accurate vaccine development processes. The traditional method of vaccine development methods are often time-consuming, costly, and inefficient. On contrary to this, the AI streamlines vaccine development from antigen prediction to clinical trial optimization by integrating computational biology, machine learning, structural bioinformatics, and immunoinformatic. AI has many potential applications in vaccine research, and this review covers all of the bases, from the fundamentals of AI in biology to immunogen design, clinical trial data mining, efficacy prediction modelling modelling, and adjuvant optimization. The review also investigates potential unknown issues, ethical concerns, and future developments in AI-driven vaccine development. This paper emphasizes the potential of AI to transform global preparedness against infectious diseases by combining evidence from various disciplines in vaccine development.}, }
@article {pmid41845433, year = {2026}, author = {Yadanar, and Thu, MS and Tipayamongkholgul, M}, title = {Equitable utilization of non-communicable disease services in low- and middle-income countries; associated factors and intervention effects: a systematic review and meta-analysis.}, journal = {BMC health services research}, volume = {26}, number = {1}, pages = {}, pmid = {41845433}, issn = {1472-6963}, mesh = {Humans ; *Noncommunicable Diseases/therapy ; *Developing Countries ; *Healthcare Disparities/statistics & numerical data ; *Patient Acceptance of Health Care/statistics & numerical data ; Socioeconomic Disparities in Health ; Socioeconomic Factors ; }, abstract = {BACKGROUND: With aging populations, a double burden of disease, and post-COVID-19 economic strain, managing non-communicable diseases (NCDs) has become a major challenge in low- and middle-income countries (LMICs). While most studies examine inequities in general healthcare utilization, few focus specifically on NCDs services. This review addresses that gap by synthesizing evidence on associated factors of equitable NCDs service utilization and assessing interventions to improve utilization. METHODS: A systematic review and meta-analysis were conducted following PRISMA-Equity guidelines, including studies published between 2014 and 2024. Eligible studies examined socioeconomic and demographic associated factors of NCDs service utilization or evaluated interventions to reduce inequities. In the meta-analysis, pooled estimates for NCDs service utilization were performed using a random effects model. Heterogeneity among studies was assessed using I[2] statistics. RESULTS: Twenty-three studies were included. Overall, NCDs service utilization showed a clear pro-rich pattern, with wealthier groups consistently utilizing more services. The pooled outpatient NCD service utilization was 52.84% (95% CI: 41.04–64.64). Compared with the poorest wealth quintile, higher wealth status was significantly associated with greater NCDs service utilization (AOR = 1.44; 95% CI: 1.18–1.74). Socioeconomic status was the strongest associated factor, while gender, rural residence, and insurance status showed no consistent effects. Interventions such as patient-centered care, provider training, system-level reforms, and digital health integration showed promising outcomes. CONCLUSION: This review highlights that inequities in NCDs service utilization are driven primarily by poverty and structural barriers, not demographic factors alone. By focusing specifically on NCDs, it adds new evidence to equity literature that has previously concentrated on general healthcare use. Targeted pro-poor strategies and innovative interventions are essential to reduce disparities and improve NCD outcomes in LMICs.}, }
@article {pmid41846399, year = {2026}, author = {Al-Hetari, HY and Al-Rumaima, MA and Ghazi, HH and Al-Naggar, NQ and Ali, EA and Alameri, A}, title = {A single compartment model to describe lung functionality: A comprehensive study.}, journal = {Physiological reports}, volume = {14}, number = {6}, pages = {e70832}, pmid = {41846399}, issn = {2051-817X}, mesh = {Humans ; *Lung/physiology/physiopathology ; *Models, Biological ; *Respiration, Artificial/methods ; Airway Resistance ; Respiratory Mechanics ; *COVID-19/physiopathology/therapy ; }, abstract = {Mechanical Ventilation (MV) is a critical medical intervention used to support patients with impaired lung function caused by severe conditions such as pneumonia or COVID-19. Model-based Methods, particularly computational models, are employed to simulate and analyze lung mechanics under MV. Among these, the Single Compartment Lung Model (SCLM) remains the most commonly adopted framework for replicating lung behavior during MV, facilitating optimal treatment strategies. This review critically analyzes existing literatures on SCLM applications, focusing on key parameters such as lung elastance (E), airway resistance (Rrs), and Dynamic Functional Residual Capacity (dFRC). Methodologies, evaluation metrics, and clinical applications were examined to identify common trends, inconsistences, and research gaps. The findings indicate that E has been the primary focus due to its relevance in assessing lung mechanism, especially under MV. This parameter often evaluated alongside variables like Positive End-Expiratory Pressure (PEEP), Peak Inspiratory Pressure (PIP), Peak Inspiratory Volume (PIV), and Tidal Volume (Vt). Additionally, FRC and Rrs are also considered in some models. The review emphasizes the need for standardized evaluation protocols, simplified input models, and disease-specific adaptations to enhance clinical applicability. Our findings provide valuable guidance for future research aiming to refine SCLM-based approaches and improve personalized mechanical ventilation strategies.}, }
@article {pmid41846833, year = {2026}, author = {Alghrably, M and Sukareh, F and Khamis, LM and Kahfi, J and Dhahri, M and Emwas, AH and Jaremko, M and Lachowicz, JI}, title = {Physiological responses to mask-associated CO2 exposure: a narrative review of acid-base balance, aging, and amyloidogenic stress.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1759011}, pmid = {41846833}, issn = {2296-2565}, mesh = {Humans ; *Carbon Dioxide/adverse effects ; *Aging/physiology ; *Acid-Base Equilibrium/physiology ; *COVID-19/prevention & control ; }, abstract = {BACKGROUND: During the COVID-19 pandemic, prolonged mask use exposed billions of people to repeatedly elevated inhaled CO2 levels for extended periods. While these exposures typically produce only small pH shifts in healthy adults, older individuals exhibit age-related declines in respiratory, renal, metabolic, and proteostatic resilience that reduce their ability to buffer such disturbances. Because even mild acidosis can influence protein folding and accelerate amyloid formation under conditions of impaired homeostasis, aging populations may be disproportionately susceptible to downstream effects of chronic low-grade CO2 exposure.
METHODS: This narrative review synthesizes data on age-related changes in ventilation, acid-base regulation, metabolic buffering, and proteostasis, integrating these with biochemical pathways of pH-dependent amyloidogenesis. Evidence from mask-related CO2 exposure studies, protein-misfolding research, and gerontological physiology was analyzed to evaluate whether age-specific vulnerability could plausibly modulate amyloidogenic risk.
RESULTS: Across multiple studies, mask wearing increases inhaled CO2 concentrations and produces small but measurable reductions in blood pH in some conditions. Although these changes remain within normal physiological range in healthy adults, aging is associated with impaired ventilatory responsiveness to hypercapnia, diminished renal compensation, reduced muscle-based buffering due to sarcopenia, and mitochondrial and proteostatic decline. These changes lower physiological reserve and may magnify the biological impact of minor pH fluctuations. Experimental literature consistently demonstrates that acidity accelerates amyloid formation in proteins relevant to aging disorders-including Aβ, α-synuclein, IAPP, and β2-microglobulin-while older adults also accumulate comorbidities (chronic kidney disease, diabetes, neurodegeneration) that themselves predispose to acidosis and amyloidogenic stress.
CONCLUSIONS: Although mask-associated CO2 elevations appear insufficient to induce amyloid formation in isolation, the combination of age-related physiological decline, chronic inflammation, impaired proteostasis, and reduced buffering capacity may heighten vulnerability in older adults. Given global demographic aging, further age-stratified research is needed to clarify long-term implications of repeated low-grade hypercapnia, refine diagnostic approaches for early detection of proteostatic stress, and develop prevention strategies tailored to aging physiology.}, }
@article {pmid41847505, year = {2026}, author = {Chagay, N and Tamadon, A and Kim, S and Dossimov, A and Issanguzhina, Z and Tulegenova, G and Kuldeeva, G and Puxovikova, N and Kim, I and Mussin, NM and Sharoffidin, RS}, title = {Pediatric-related post-COVID condition (long COVID) research and its foundational influences: a bibliometric analysis (2020-2025).}, journal = {Frontiers in pediatrics}, volume = {14}, number = {}, pages = {1677983}, pmid = {41847505}, issn = {2296-2360}, abstract = {BACKGROUND: The COVID-19 pandemic significantly influenced healthcare systems worldwide. The long-term consequences of the infection in children, the phenomenon of post-COVID-19 syndrome, have been attracting increasing attention of the scientific community. The present study is a bibliometric analysis of publications addressing post-COVID (long COVID) complications in pediatric population over the period 2020-2025.
METHODS AND MATERIALS: The analysis covers 1,292 records retrieved from Scopus and Web of Science (search date: June 2025). Records were retrieved using post-COVID condition/long COVID terminology combined with pediatric-related keywords; therefore, the corpus includes pediatric-focused studies as well as influential general PCC publications indexed with pediatric terms and frequently cited in pediatric research. The search strategy combined post-COVID condition/long COVID terminology with pediatric terms (child/infant/adolescent), applying filters for English language, publication years 2020-2025, and document type (articles and reviews). Data were merged and analyzed in R using bibliometrix/Biblioshiny to describe productivity, collaboration, citations, and thematic structure.
RESULTS: The retrieved corpus included 1,292 publications from 84 countries/regions. The United States led productivity with 270 publications (20.9%), followed by the United Kingdom (114; 8.8%) and China (90; 7.0%). The most frequent author keywords included "COVID-19" (n = 900) and "long COVID" (n = 818). Highly cited items predominantly consisted of general or mixed-age PCC frameworks, indicating that foundational long COVID literature substantially shapes citation patterns within pediatric-tagged publications. Thematic mapping showed symptom-focused clusters as dominant, while MIS-C and cognitive impairment were less prominent in author-keyword frequency and thematic clustering within the retrieved dataset.
CONCLUSION: The findings describe the pediatric-term-indexed PCC research landscape and highlight substantial gaps in pediatric-specific evidence, definitions, and longitudinal data.}, }
@article {pmid41848079, year = {2026}, author = {Abdoli, E and Eini, P and Farashi, S and Farhadian, M}, title = {Optimizing Intubation Prediction in Pneumonia Patients: A Systematic Review and Meta-Analysis of Machine Learning Algorithms.}, journal = {Pulmonary medicine}, volume = {2026}, number = {1}, pages = {e6670267}, pmid = {41848079}, issn = {2090-1844}, mesh = {Humans ; *Intubation, Intratracheal/statistics & numerical data/methods ; *Machine Learning ; Prediction Algorithms ; COVID-19/therapy ; *Pneumonia/therapy ; Predictive Learning Models ; Algorithms ; *Pneumonia, Viral/therapy ; SARS-CoV-2 ; Sensitivity and Specificity ; Community-Acquired Pneumonia ; ROC Curve ; Pandemics ; }, abstract = {BACKGROUND: Pneumonia, including influenza, COVID-19, and community-acquired pneumonia, is a major global health burden associated with high morbidity, mortality, and frequent progression to respiratory failure requiring intubation. Early identification of patients at risk of endotracheal intubation is essential to improve outcomes and optimize ICU resource allocation, yet existing prognostic tools remain limited in predicting this need. This study evaluated the performance of machine learning (ML) algorithms in predicting endotracheal intubation among patients with pneumonia during hospital stay.
METHODS: We systematically searched five databases to evaluate the diagnostic accuracy of ML models. Pooled estimates of area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity were calculated. Subgroup analysis and meta-regression were conducted. Risk of bias was assessed using PROBAST+AI and certainty of evidence with GRADE.
RESULTS: This systematic review of 34 studies (26 in meta-analysis) included 195,214 pneumonia patients. The pooled AUROC was 0.79 (95% CI: 0.75-0.82), with sensitivity of 0.74 (95% CI: 0.61-0.84), specificity of 0.71 (95% CI: 0.50-0.86), and a DOR of 7 (95% CI: 2-20), indicating moderate diagnostic accuracy. Heterogeneity was substantial across analyses (I[2] = 90.45% for sensitivity and 94.58% for specificity). Risk of bias was lowest in development (59%) and highest in application domains (41% high risk). Despite a nonsignificant Deeks' test (p = 0.252), the funnel plot suggests selective publication of positive results, likely inflating the pooled AUROC. GRADE rated the evidence as moderate to low due to heterogeneity and imprecision.
CONCLUSION: ML algorithms demonstrate a modest and highly variable accuracy in predicting the need for endotracheal intubation among pneumonia patients. High heterogeneity and methodological variability highlight the need for standardized ML approaches before clinical adoption.}, }
@article {pmid41848128, year = {2025}, author = {Hajji, H and Kalai, A and Chaabeni, A and Migaou, H and Jebali, B and Ben Salah Frih, Z and Ben Saad, H and Jellad, A}, title = {Beyond the basics: exploring non-conventional treatment for fatigue in post-acute COVID-19 syndrome.}, journal = {La Tunisie medicale}, volume = {103}, number = {9}, pages = {1265-1271}, doi = {10.62438/tunismed.v103i9.5926}, pmid = {41848128}, issn = {2724-7031}, mesh = {Humans ; *COVID-19/complications/therapy ; *Fatigue/therapy/etiology ; Post-Acute COVID-19 Syndrome ; *Complementary Therapies/methods ; Dietary Supplements ; SARS-CoV-2 ; Acupuncture Therapy/methods ; }, abstract = {INTRODUCTION: Post-acute 2019 coronavirus disease syndrome (PACS) is a multifaceted, multisystem disorder affecting an estimated 75 million individuals globally (in May 2024). Defined by symptoms persisting beyond four weeks post-infection, PACS manifests in subacute (4-12 weeks) and chronic (>12 weeks) phases, with fatigue being a prominent and debilitating feature. Comprehensive management of PACS-associated fatigue needs diverse therapeutic strategies extending beyond conventional rehabilitation.
AIM: This narrative review explored non-conventional interventions for PACS-related fatigue, focusing on treatments involving nutritional rehabilitation, physical modalities, and other innovative therapies.
METHODS: Narrative review.
RESULTS: Treatments reported in the literature include melatonin, QingjinYiqi, nutritional supplements, aromatherapy, antioxidants, Tai Chi, acupuncture, yoga, singing, hyperbaric oxygen therapy (HBOT), pulsed electromagnetic field therapy, and whole-body vibration. Melatonin and QingjinYiqi have shown notable improvements in fatigue and overall health. Nutritional supplements such as vitamin-minerals combinations have demonstrated enhancements in muscle strength, physical performance, and quality of life. Tai Chi, acupuncture, and yoga have shown positive effects on fatigue, muscle strength, and overall well-being. Aromatherapy, singing, HBOT, pulsed electromagnetic field therapy, and whole-body vibration effectively reduce fatigue while enhancing physical and cognitive functions.
CONCLUSION: These non-conventional treatments offer promising supplementary benefits to conventional rehabilitation.}, }
@article {pmid41848189, year = {2026}, author = {Shrewsbury, SB}, title = {DHE - past, present, and future: a narrative review.}, journal = {Pain management}, volume = {16}, number = {6}, pages = {645-659}, pmid = {41848189}, issn = {1758-1877}, mesh = {Humans ; *Migraine Disorders/drug therapy ; *Dihydroergotamine/administration & dosage/therapeutic use/history ; *Analgesics, Non-Narcotic/administration & dosage/therapeutic use ; Administration, Inhalation ; }, abstract = {Dihydroergotamine (DHE) was first approved in 1946 for the acute treatment of migraine. Its efficacy when administered as an intravenous (IV) injection explains its enduring use in the management of migraine today. More recently, attention has been focused on the development of formulations delivered by the inhalational route to either the nasal mucosa or lung with the objective of providing a product that enables easy, needle-free, "at-home" use that is rapidly effective. Three new DHE products for migraine (two administered by nasal delivery) have been Food and Drug Administration (FDA) approved in the past five years with two others using pulmonary delivery in clinical development attempting to optimize outcomes for subjects requiring "at-home" migraine treatment. This narrative review describes those DHE development programs, and others that have failed, with the objective of providing a broad perspective on various approaches, including those that may be more likely to achieve the goals of high efficacy rates, rapid relief, and convenience of use. In addition, DHE has been investigated for potential repurposing of other indications. These too are described.}, }
@article {pmid41848669, year = {2026}, author = {Peyser, T and Pyke, NM and Hoerger, M}, title = {Key Changes in Palliative Care Delivery and Patient and Family Experiences in the 5 Years since the COVID-19 Pandemic Onset: A Systematic Review.}, journal = {Journal of palliative medicine}, volume = {}, number = {}, pages = {10966218261418980}, doi = {10.1177/10966218261418980}, pmid = {41848669}, issn = {1557-7740}, abstract = {BACKGROUND: Palliative care improves quality of life for patients and families. More research is needed to understand how care delivery and patient and family experiences have changed in the 5 years since the COVID-19 pandemic onset.
OBJECTIVE: To systematically review the delivery of palliative care and patient and family experiences in palliative care since the COVID-19 pandemic onset.
METHODS: The search examined articles indexed in Medline, Science Direct, and Scopus, published between January 2020 and April 2025. Articles were included if they were peer-reviewed and included hospital and home-based palliative care for pediatric and adult patients and their families and examined changes in (a) patient experiences, (b) family experiences, or (c) aspects of service delivery regarding palliative care since the COVID-19 pandemic onset.
RESULTS: Of 529 abstracts screened, 10 met the inclusion criteria for review. The most common patient and family experiences among the studies included caregiver social isolation (80%) and increased distress (70%). Among the studies, delivery changes included precautions on infection control (100%) and telehealth (90%). Most studies focused on adults (70.0%), typically cancer or COVID-19 populations (20% and 30%, respectively), and heterogeneous, seriously ill populations (50%). No study commented on the impact of COVID-19 using data collected after 2022, 10% were prospective, and 20% of studies reported on participants' race or ethnicity.
CONCLUSIONS: This systematic review shows that since the COVID-19 pandemic onset, studies of palliative care programs have found that caregivers experience more distress and isolation, and programs have modified infection control precautions and increased the availability of telehealth. Implications for the future of family-centered palliative care are discussed.}, }
@article {pmid41849011, year = {2026}, author = {Pan, M and Jia, Z and Zhou, M and Chen, J and Qiu, H and Luo, X and Zhang, Y and Shi, Z and Wu, S and Wang, D and Yang, Q}, title = {The Application of Single-cell RNA Sequencing Technology in the Research of Sino-Nasal Diseases.}, journal = {Clinical reviews in allergy & immunology}, volume = {69}, number = {1}, pages = {}, pmid = {41849011}, issn = {1559-0267}, mesh = {Humans ; *Single-Cell Analysis/methods ; Single-Cell Gene Expression Analysis ; *Sequence Analysis, RNA/methods ; *Rhinosinusitis/genetics/diagnosis ; Animals ; *Nose Diseases/diagnosis/genetics ; Multiomics ; *Rhinitis, Allergic/genetics/diagnosis ; Transcriptome ; }, abstract = {Single-cell RNA sequencing (scRNA-seq) has revolutionized rhinology by enabling the high-resolution dissection of nasal pathophysiology at the genetic level. This article provides a comprehensive overview of scRNA-seq technology and discusses the progressive developments in its application for diagnosing diseases in rhinology, chiefly infective nasal diseases and chronic inflammatory states. It has been instrumental in identifying infection-related genes, linking cellular dynamics to clinical variables such as age and smoking, and deconvoluting complex diseases like chronic rhinosinusitis (CRS) and allergic rhinitis(AR) by defining key pathogenic cells (e.g., ALOX15+ macrophages) and novel pathways like glycolysis. The integration of scRNA-seq with spatial transcriptomics and multi-omics approaches is also discussed in this article, promising deeper insights into nasal biology and future therapeutic strategies, while current technological limitations are acknowledged.}, }
@article {pmid41849024, year = {2026}, author = {Dalamaga, M and Emfietzoglou, R and Petropoulou, D and Kypraiou, M and Kounatidis, DC and Vallianou, NG and Karras, S and Magkos, F and Karampela, I}, title = {Vitamin D and Health Outcomes: State-of-the-Art Review of Triangulated Evidence and Ongoing Controversies.}, journal = {Current nutrition reports}, volume = {15}, number = {1}, pages = {}, pmid = {41849024}, issn = {2161-3311}, mesh = {Humans ; *Vitamin D/blood/therapeutic use/administration & dosage ; *Vitamin D Deficiency/complications/drug therapy ; COVID-19 ; Cardiovascular Diseases/prevention & control ; Autoimmune Diseases/prevention & control ; Neoplasms/prevention & control ; Dietary Supplements ; Rickets/prevention & control ; Osteomalacia/prevention & control ; Mendelian Randomization Analysis ; Fractures, Bone/prevention & control ; Randomized Controlled Trials as Topic ; }, abstract = {PURPOSE OF REVIEW: Vitamin D is a pleiotropic hormone with an established role in skeletal integrity and broader actions in immune regulation, inflammation, cellular proliferation, and energy homeostasis. Despite decades of research, its extra-skeletal effects remain controversial, largely due to discordant findings across observational studies, Mendelian randomization studies (MRS), and randomized controlled trials (RCTs). Unlike many prior reviews, this state-of-the-art review synthesizes triangulated evidence across these study designs to clarify outcome-specific causal relationships and ongoing controversies. RECENT FINDINGS: Triangulated evidence provides strong and consistent support for a causal role of vitamin D in skeletal health, particularly in the prevention and treatment of rickets and osteomalacia, and in fracture risk reduction among vitamin D–deficient and older populations. For selected extra-skeletal outcomes, modest and threshold-dependent benefits are observed, including reductions in cancer mortality, protection against autoimmune disorders, most convincingly multiple sclerosis, and decreased risk of acute respiratory infections, including COVID-19, primarily in individuals with low baseline 25(OH)D concentrations. In contrast, associations with cardiovascular disease, metabolic disorders, obesity, and most neuropsychiatric outcomes are not consistently supported by genetic or interventional evidence, suggesting limited or non-causal effects. Across outcomes, evidence indicates a non-linear relationship between vitamin D status and health, with increased risk concentrated at low 25-hydroxyvitamin D concentrations and limited benefit beyond sufficiency. All-cause mortality shows a modest, threshold-dependent association, with supplementation benefits largely confined to deficient or older populations. Key challenges include assay variability, non-linear dose–response relationships, and RCT designs that frequently enroll vitamin D–replete populations, resulting in substantial methodological heterogeneity and limiting causal inference. Overall, the presented triangulated model may reconcile longstanding inconsistencies by reframing vitamin D as a context-dependent determinant of health. These findings argue against indiscriminate population-wide supplementation and support targeted strategies focused on the identification and correction of deficiency. Vitamin D should be regarded neither as a universal panacea nor as a trivial supplement, but as a context-dependent hormone whose clinical value lies in outcome-specific correction of deficiency.}, }
@article {pmid41849116, year = {2026}, author = {Piquero-Casals, J and Bertold, C and Alomar, A and Morgado-Carrasco, D and Gilaberte, Y and López-Estebaranz, JL and Massa, A and de Castro, CS and Leone, G and Lim, HW and Krutmann, J and Ezzedine, K and Passeron, T}, title = {Exposome Risk Factors for Vitiligo: A Systematic Evidence Review.}, journal = {American journal of clinical dermatology}, volume = {27}, number = {3}, pages = {465-478}, pmid = {41849116}, issn = {1179-1888}, mesh = {Humans ; *Vitiligo/epidemiology/etiology/immunology ; Risk Factors ; *Environmental Exposure/adverse effects ; Disease Progression ; *Exposome ; }, abstract = {BACKGROUND: Vitiligo is a multi-factorial autoimmune skin disorder often triggered by environmental exposures. Although the exposome has gained attention, no systematic review has fully assessed its role in vitiligo.
OBJECTIVE: We aimed to evaluate evidence linking exposomal factors to vitiligo onset and progression, focusing on quantifiable associations and study quality.
METHODS: A systematic search of PubMed and Embase (inception to 25 August, 2024) followed PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) 2020 guidelines and was registered in PROSPERO (CRD42024529828). Eligible studies reported associations between environmental exposures and vitiligo onset, flares, or progression. Observational studies, case series, clinical trials, and pharmacovigilance reports were included. Findings were synthesized narratively.
RESULTS: Of 8377 records, 496 studies met inclusion criteria. Drug-associated vitiligo, particularly from immune checkpoint inhibitors, was the most robustly supported association (7-25% in patients with melanoma). Phenol-based chemicals were consistently linked to melanocyte toxicity. Coronavirus disease 2019 infection modestly increased risk (hazard ratio ≈ 1.11), while vaccination did not. Other factors such as stress (n = 113), trauma, sunburn, smoking, diet, and sleep were frequently cited but supported by lower-level evidence. Study heterogeneity, a lack of standardized outcomes, and the predominance of observational designs limited meta-analysis and causal inference.
CONCLUSIONS: These findings highlight the environmental triggers of vitiligo onset and progression. Drugs, chemicals, and infections are key triggers; lifestyle factors require further study.}, }
@article {pmid41849944, year = {2026}, author = {Mostafa, NY and Dutta, D and Das, B and Bora, BR and Gogoi, N and Das, AK and Kaishap, PP}, title = {Tryptanthrin: Synthetic advances and therapeutic horizons of a privileged scaffold.}, journal = {European journal of medicinal chemistry}, volume = {309}, number = {}, pages = {118767}, doi = {10.1016/j.ejmech.2026.118767}, pmid = {41849944}, issn = {1768-3254}, mesh = {*Quinazolines/chemistry/pharmacology/chemical synthesis/therapeutic use ; Humans ; *Antineoplastic Agents/pharmacology/chemistry/chemical synthesis/therapeutic use ; Structure-Activity Relationship ; Anti-Bacterial Agents/pharmacology/chemistry/chemical synthesis ; COVID-19 Drug Treatment ; Neurodegenerative Diseases/drug therapy ; SARS-CoV-2/drug effects ; Molecular Structure ; Animals ; }, abstract = {Tryptanthrin (indolo[2,1-b]quinazoline-6,12-dione) is a privileged scaffold distinguished by its rigid tetracyclic framework and exceptional pharmacological breadth. This review critically analyzes advancements in the chemistry and biology of tryptanthrin, prioritizing post-2020 literature. We elucidate its natural occurrence and innovative synthetic strategies, spanning from classical condensation to sustainable photochemical and electrochemical methods. The review examines the therapeutic landscape of tryptanthrin chemotypes, highlighting anticancer efficacy via kinase and topoisomerase modulation. Furthermore, we explore emerging utility against multidrug-resistant bacteria, SARS-CoV-2, and neurodegenerative conditions. By integrating structure-activity relationship data with mechanistic insights, this work underscores tryptanthrin as a versatile pharmacophore for the rational design of next-generation therapeutics.}, }
@article {pmid41849981, year = {2026}, author = {Wang, Q and Zhang, G and Yue, G and Liu, X}, title = {Job satisfaction and burnout among emergency nurses: A bibliometric and visualized analysis.}, journal = {International emergency nursing}, volume = {86}, number = {}, pages = {101802}, doi = {10.1016/j.ienj.2026.101802}, pmid = {41849981}, issn = {1878-013X}, mesh = {*Job Satisfaction ; *Burnout, Professional/psychology ; *Bibliometrics ; *Emergency Nursing ; Humans ; }, abstract = {INTRODUCTION: The purpose of this study is to map the intellectual structure and evolutionary trends of research on burnout and job satisfaction among emergency nurses through a bibliometric and visual analysis.
METHODS: Publications related to job satisfaction and burnout among emergency nurses were retrieved from the Web of Science Core Collection database. RStudio 4.5.0, VOSviewer 1.6.20, CiteSpace 6.4, and Scimago Graphica 1.0.50 were used for bibliometric analysis and visualization.
RESULTS: A total of 346 articles were selected for this study. These articles were published across 61 countries from 2003 to 2025, with the United States, China, and Australia leading in publication output. These articles were featured in 159 journals, with the International Emergency Nursing publishing the most (n = 21). Adriaenssens Jef is both the most prolific author and among the most frequently cited in this field. Keyword clustering analysis identified 4 distinct research themes, the most frequently used keyword in the studies was "burnout," which was commonly associated with all other keywords. In addition, keyword burst analysis revealed emerging trend topics, notably "COVID-19."
DISCUSSION: This paper presents the first comprehensive bibliometric and visualization analysis of research on job satisfaction and burnout among emergency nurses, summarizing developments, trends, research frontiers, and hotspots. This research emphasizes understanding burnout and job satisfaction is crucial for managers and policymakers, as effective policies and support initiatives can boost satisfaction and reduce burnout.}, }
@article {pmid41850438, year = {2026}, author = {Chiba, S}, title = {Therapeutic mechanisms of early oseltamivir administration in the management of mild COVID-19 through the sympathetic nervous system: A scoping review.}, journal = {Journal of virological methods}, volume = {343}, number = {}, pages = {115386}, doi = {10.1016/j.jviromet.2026.115386}, pmid = {41850438}, issn = {1879-0984}, mesh = {Humans ; *Oseltamivir/therapeutic use/administration & dosage ; *Antiviral Agents/therapeutic use/administration & dosage ; *COVID-19 Drug Treatment ; SARS-CoV-2/drug effects ; *Sympathetic Nervous System/drug effects ; COVID-19 ; }, abstract = {PURPOSE: This scoping review summarizes the proposed mechanisms by which oseltamivir may improve clinical outcomes in COVID-19. Although SARS-CoV-2 lacks neuraminidase, several studies have reported reduced fever duration, shorter hospitalization, and faster viral clearance with oseltamivir administration. This review integrates current evidence regarding antiviral, immunomodulatory, and autonomic-nervous-system-related mechanisms.
METHODS: A structured literature search was conducted in PubMed, Scopus, and Google Scholar. Studies addressing oseltamivir's antiviral activity, neutrophil modulation, antipyretic effects, or influence on sympathetic nervous system activity in COVID-19 were included.
RESULTS: Oseltamivir may exert therapeutic effects through inhibition of SARS-CoV-2 proliferation, reduction of neutrophil overactivation, attenuation of sympathetic nervous system hyperactivity, and modulation of fever pathways.
CONCLUSION: This scoping review identifies multiple mechanisms through which oseltamivir may influence COVID-19 pathophysiology. Although evidence remains heterogeneous, findings suggest that oseltamivir may have broader biological effects beyond neuraminidase inhibition. Further clinical studies are needed to clarify its therapeutic role, optimal timing, and potential benefits in unvaccinated or high-risk populations.}, }
@article {pmid41851274, year = {2026}, author = {Appay, V and Yamamoto, T and Sáez-Cirión, A}, title = {Renaissance of antiviral CD8[+] T cell immunity in vaccination and disease.}, journal = {Nature reviews. Immunology}, volume = {}, number = {}, pages = {}, pmid = {41851274}, issn = {1474-1741}, abstract = {Over the past 20 years, the limited efficacy of CD8[+] T cell-based vaccines against viruses in clinical trials has shifted attention away from such strategies. However, recent findings have brought renewed appreciation for the central importance of CD8[+] T cells in controlling both acute and chronic viral infections and in preventing severe or progressive disease. This work highlights shared features, such as effector functions and stemness properties, of effective CD8[+] T cell responses against diverse viruses such as SARS-CoV-2 and HIV. A deeper understanding and simpler interpretation of the functional workings of CD8[+] T cell-mediated immunity, combined with advances in immunological and biotechnological tools, are opening new avenues for eliciting optimal T cell responses, both for prophylactic and for therapeutic applications. Collectively, these developments revive optimism that vaccines and immunotherapies designed to harness robust CD8[+] T cell responses could have a major role in combating emerging viral threats and in achieving long-term suppression of persistent infections such as HIV-1 to undetectable levels.}, }
@article {pmid41851644, year = {2026}, author = {Doran, C and Sheku, M and Nakada, Y and Lopman, B and Nelson, K}, title = {Relevance of social contact definitions for use in infectious disease transmission modeling: a systematic review and recommendations.}, journal = {BMC infectious diseases}, volume = {26}, number = {1}, pages = {}, pmid = {41851644}, issn = {1471-2334}, support = {CDC-RFA-FT-23-0069//Insight Net Cooperative Agreement, CDC Center for Forecasting and Analytics/ ; K01AI166093-01A1//NIH/NIAID/ ; }, mesh = {Humans ; *Contact Tracing/methods ; *Communicable Diseases/transmission/epidemiology ; COVID-19/transmission/epidemiology ; Models, Theoretical ; *Disease Transmission, Infectious ; }, abstract = {BACKGROUND: Social mixing studies provide crucial evidence for parameterizing mathematical models of infectious disease transmission, and their validity for use in models is dependent on their study design and how well the contacts they capture map to the transmission routes of the pathogen of interest. This systematic review aims to catalogue contact definitions used in social mixing studies from 2005 to 2024 and evaluate their conceptual alignment to three archetypal pathogens. METHODS: We searched Ovid Medline, Embase, Scopus, and Global Index Medicus for studies of human-to-human interactions that collected data via survey, diary, or interview published between January 2005 and August 2024. We excluded studies that focused on sexually-transmitted or food/water/vector-borne pathogens or used only GPS or sensor data. We excluded studies of contact tracing as a public health effort. Screening and data collection were conducted in Covidence. Contact definitions were presented verbatim and qualitatively coded to identify key elements. Results were stratified by prospective or retrospective design. We used the Mixed Methods Appraisal Tool to evaluate risk of bias. RESULTS: We included 112 eligible studies, half (52.7%) of which began during pandemic periods (H1N1 [2009] or COVID-19 [2020]), commonly in the United States (18%) or United Kingdom (16%). Most (68%) had a retrospective design in which participants were asked to recall contacts that occurred prior to survey administration and 73% used a single-survey cross sectional design using random (16%) or stratified random (44%) sampling. Relevant contacts were often defined by an exchange of words (77%) or physical touch (59%). A minority of studies differentiated between contacts that occurred outdoors vs. indoors (28%) or allowed participants to report large group contacts separately from individually named contacts (28%). Contact definitions and attributes conceptually aligned with the transmission biology of influenza, tuberculosis, and norovirus in 77%, 6%, and 50% of studies respectively. CONCLUSIONS: Contact studies were limited in their global scope and non-pandemic representativeness. Critical modifiers of transmission risk such as location, household membership, and shared space with large numbers of people were under-measured. Future modeling and social mixing studies should align measured contact rates to the target transmission routes by incorporating these elements.}, }
@article {pmid41851794, year = {2026}, author = {Hudu, SA and Jimoh, AO and Amin-Nordin, S and Syed Hassan, S}, title = {Environmental degradation as a recipe for emerging viral diseases: implications for global health.}, journal = {One health outlook}, volume = {8}, number = {1}, pages = {}, pmid = {41851794}, issn = {2524-4655}, support = {NBU-FPEJ-2025-ID-XX//the Deanship of Scientific Research at Northern Border University, Arar, KSA/ ; }, abstract = {The rise of new viral illnesses poses a substantial risk to global public health, as their incidence and impact have increased over the past few decades. This article thoroughly examines the complex connection between environmental degradation and the development of new viral diseases. Human activities, such as deforestation, urbanization, and industrial agriculture, have significantly altered ecosystems, increasing the likelihood of virus transmission from animals to humans. The alteration of natural environments brings wildlife species that serve as hosts for several viruses into closer proximity to human populations, thereby promoting the transmission of zoonotic diseases. In addition, climate change and pollution worsen the susceptibility of both animal and human societies to viral epidemics by compromising immune responses and changing the distribution of disease carriers. This paper examines how environmental degradation is associated with viral emergence, drawing on case studies including HIV, Ebola virus disease, and COVID-19, to illustrate shared spillover mechanisms. Evidence from major zoonotic outbreaks, including HIV, Ebola virus disease, and COVID-19, indicates that environmental degradation acts through shared mechanisms, notably habitat fragmentation, biodiversity loss, and intensified human–animal interfaces. Epidemiological and ecological investigations suggest that forest encroachment, wildlife exploitation, and land-use change consistently increase opportunities for viral spillover, underscoring environmental stewardship as a critical component of pandemic prevention. This emphasizes the importance of adopting comprehensive strategies that combine environmental protection with public health efforts to lower the risk of future pandemics. It highlights the need for coordinated global action that integrates ecosystem conservation with public health preparedness to reduce future zoonotic disease risk.}, }
@article {pmid41852906, year = {2026}, author = {Ramzuni, G and Rahim, RK and Hamsal, M and Furinto, A and Gunadi, W}, title = {Tracing 25 years of employee agility research: the missing links and future directions.}, journal = {Frontiers in sociology}, volume = {11}, number = {}, pages = {1735781}, pmid = {41852906}, issn = {2297-7775}, abstract = {Over the past two decades, the growing turbulence of the VUCA era, accelerated by the COVID-19 pandemic and digital transformation, has compelled organizations to develop agility as a vital capability for survival and adaptation. However, while organizational agility has received considerable scholarly attention, research on employee agility as its micro-foundation remains limited and fragmented, leaving substantial gaps in understanding the individual-level factors that shape organizational adaptability. This study presents a comprehensive bibliometric review of research on employee agility over the past 25 years, aiming to map its intellectual, conceptual, and social structures, identify gaps in the existing literature, and outline future research directions. The analysis encompasses 319 publications indexed in Scopus and Web of Science, spanning the period from 2000 to 2025. Using Biblioshiny and VOSviewer, the study examines publication trends, citation networks, thematic structures, and emerging research frontiers. The results reveal a sharp increase in publications since 2020, driven by the COVID-19 pandemic and digital transformation pressures. Three main clusters dominate the field: (1) organisational responses to change and disruption, (2) HRM practices and individual-level mechanisms, and (3) collaboration, knowledge sharing, and digital platforms. Despite these developments, significant gaps remain, including the limited integration of leadership, weak linkage between employee agility and innovation, the divide between HR-driven and digital-driven agility, and the underrepresentation of studies in the public sector and Southeast Asia. By synthesising fragmented insights across two major databases, this study highlights employee agility as a micro-foundation of organisational agility and proposes future research directions focusing on leadership, digital competence, innovation, psychological factors, and public sector contexts. These contributions position employee agility as not only a short-term adaptive capability but also a strategic enabler of innovation and sustainability in dynamic environments.}, }
@article {pmid41853148, year = {2026}, author = {Campbell, EA and Goodtree, H and Gillani, S and Oyefolu, O and Kelly, A and Rivers, C and Watson, C}, title = {Impact, use, and implications of artificial intelligence in public health decision making by elected officials: a scoping review.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1745684}, pmid = {41853148}, issn = {2296-2565}, mesh = {Humans ; *COVID-19/prevention & control/epidemiology ; *Public Health ; *Artificial Intelligence ; *Decision Making ; *Policy Making ; *Politics ; SARS-CoV-2 ; }, abstract = {INTRODUCTION: Artificial intelligence (AI) offers considerable promise for strengthening governmental public health decision making by supporting rapid, comprehensive analysis of complex data. Although AI applications have been widely examined in clinical and academic settings, their use in public health agencies and policymaking remains less well understood.
METHODS: This scoping review assessed how AI has been applied to support decision making by public health professionals and elected officials in both routine and crisis contexts. Using PRISMA-ScR guidelines, we searched PubMed, OAISTER, and Web of Science for literature published between 2014 and 2024. From 13,239 records identified, seven studies met final inclusion criteria.
RESULTS: The identified evidence base is primarily descriptive and exploratory, with limited empirical evaluation of outcomes or effectiveness. All included studies described AI use during the COVID-19 pandemic, focusing on vaccination decision support, contact tracing, quarantine enforcement, and/or movement restrictions, which limits generalizability to other public health contexts and decision-making scenarios. Findings highlight a small but emerging evidence base, with most applications developed in response to emergencies rather than embedded in routine practice.
DISCUSSION: Future opportunities for AI include advancing surveillance, communication, and resource allocation. However, critical challenges remain regarding governance, equity, and implementation. Further research is needed to evaluate AI interventions in diverse contexts and establish sustainable pathways for adoption by governmental public health agencies.}, }
@article {pmid41853560, year = {2024}, author = {Navalkele, BD and Chopra, T}, title = {Clinical application of live biotherapeutic products in infectious diseases.}, journal = {Frontiers in microbiomes}, volume = {3}, number = {}, pages = {1415083}, pmid = {41853560}, issn = {2813-4338}, abstract = {Live biotherapeutics products (LBP) are a novel range of therapeutic options in medicine. In this review, authors discuss basic composition and mechanism of action of LBP, provide a comprehensive focused overview of published in vitro and in vivo studies on efficacy of LBP for prevention and treatment of infectious diseases such as viral (HIV, COVID-19), bacterial (C.difficile infection, bacterial vaginosis, multi-drug resistant organisms) and fungal (Candida) organisms. This review should be of interest to clinicians to understand the broad application of LBP in infectious diseases world beyond recurrent C.difficile infection and to researchers on unexplored prospects of LBP and the need for further investigation in this emerging field to improve its clinical application.}, }
@article {pmid41854197, year = {2026}, author = {Ye, P and Huang, C and Liu, Y and Feng, X and Cai, P and Wang, M and Chen, X}, title = {Myopic Progression of Children Before and During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis.}, journal = {Ophthalmic epidemiology}, volume = {33}, number = {4}, pages = {483-492}, doi = {10.1080/09286586.2026.2645112}, pmid = {41854197}, issn = {1744-5086}, mesh = {Humans ; *COVID-19/epidemiology ; Disease Progression ; SARS-CoV-2 ; Child ; *Myopia/epidemiology/physiopathology ; Refraction, Ocular/physiology ; *Pandemics ; *Betacoronavirus ; Axial Length, Eye ; *Coronavirus Infections/epidemiology ; *Pneumonia, Viral/epidemiology ; }, abstract = {PURPOSE: This study aimed to investigate the progression of myopia in children before and during the COVID-19 pandemic.
METHODS: Online databases were searched for original studies reporting changes in the spherical equivalent refraction (SER) and axial length (AL) of children, both before and during the COVID-19 pandemic.
RESULTS: Twelve eligible studies were identified after database search and screening. In all eligible studies, the annual changes in SER and AL were larger during the COVID-19 pandemic than during the pre-pandemic period. The pooled differences in SER and AL before and during the COVID-19 pandemic were -1.25 standard deviation (SD) and 0.27 SD, respectively. Pooled SER difference before and during the COVID-19 pandemic were -1.47 SD for cohorts with 100% children with myopia, -1.03 SD for cohorts with <100% children with myopia, -1.17 SD for cohorts from East Asia, -1.32 SD for cohorts from the other regions, -1.37 SD for younger cohorts, -1.30 SD for older cohorts, -1.79 SD for cohorts with shorter online education time, and -1.39 SD for cohorts with longer online education time.
CONCLUSION: Home confinement during the COVID-19 pandemic has accelerated the progression of myopia in children, especially in those with myopia or from regions other than East Asia. This systematic review protocol was registered with PROSPERO [CRD420251061387].}, }
@article {pmid41854286, year = {2026}, author = {Phukuntsi, MA and Monyama, MC and Taioe, MO and Tsotetsi-Khambule, AM}, title = {A systematic review of experimental evidence on microbial pathogen transmission by Stomoxys spp.}, journal = {Parasite (Paris, France)}, volume = {33}, number = {}, pages = {13}, pmid = {41854286}, issn = {1776-1042}, mesh = {Animals ; *Insect Vectors/microbiology/virology ; *Muscidae/microbiology/virology ; Camelus/parasitology ; Humans ; Mammals/parasitology ; }, abstract = {Vector-borne microbial pathogens previously isolated from Stomoxys spp. are currently considered to be emerging or re-emerging threats to public health and the veterinary sector. Transmission of pathogens by flies in the Stomoxys genus is largely mechanical, indicating that they can transmit a wide range of pathogens to a variety of hosts. This study evaluated the diversity of pathogens demonstrably transmitted by a variety of Stomoxys flies, concerning species diversity, host diversity, and geographic distribution. Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were applied to screen studies based on pathogen type, host species, and experimental transmission outcomes. Journal articles published from 1973 to 2025 were sourced from six electronic databases. After evaluation, 30 studies were eligible for this review. Of these studies, 20% (6/30) reported negative outcomes. Three pathogens (Middle East respiratory syndrome coronavirus, Neorickettsia risticii, and Escherichia coli) were not transmitted by the flies in the experiments. Stomoxys spp. transmitted pathogens to a wide range of hosts (9 mammals) and substrates (blood and tissue culture), but the recorded experiments in camels failed. Three out of ten Stomoxys spp. reported in the studies (S. transvittatus, S. inornatus, and S. omega) failed to transmit pathogens in all attempts. The majority of experimental studies were on S. calcitrans, with very limited studies on other Stomoxys species, highlighting the dearth of information on other species occurring in Africa and Asia. Our study has consolidated the evidence regarding the experimental pathogen transmission by Stomoxys spp., highlighting and demonstrating their epidemiological significance and the need for surveillance and control/prevention strategies.}, }
@article {pmid41854333, year = {2026}, author = {Ronco, I and Horvat, B}, title = {Role of myeloid cells expressing CD169/Siglec-1 in host-pathogen interactions.}, journal = {FEMS microbiology reviews}, volume = {50}, number = {}, pages = {}, pmid = {41854333}, issn = {1574-6976}, support = {101057302//Institut National de la Santé et de la Recherche Médicale/ ; //DGA/ ; }, mesh = {*Sialic Acid Binding Ig-like Lectin 1/immunology/metabolism/genetics ; Humans ; *Host-Pathogen Interactions/immunology ; *Myeloid Cells/immunology/metabolism/virology ; Animals ; Virus Diseases/immunology ; }, abstract = {CD169/Siglec-1 is a type-I transmembrane lectin receptor expressed on subcapsular sinus macrophages and activated monocytes, which plays a key role in innate immune surveillance and orchestration of adaptive immunity. As a sialic acid-binding immunoglobulin-like lectin (Siglec), CD169 recognizes sialylated gangliosides and glycoconjugates present on surface of several viral envelopes, including HIV-1, SARS-CoV-2, and Ebola virus as well as sialylated bacterial capsules such as those of Neisseria meningitidis and Campylobacter jejuni. Moreover, different viruses were shown to be captured by CD169+ cells which could play distinctive role during infections: they could enhance efficient immune responses, but also facilitate pathogen dissemination through viral capture and transfer to permissive cells. This last mechanism has been well documented for HIV-1, where CD169 mediates viral trans-infection of CD4[+] T-cells. CD169 expression is rapidly induced by type-I interferons during acute viral infections and has emerged as a valuable biomarker to distinguish viral from bacterial infection, particularly for COVID-19 and influenza. Detectable by flow cytometry, CD169 represents a solid biomarker in clinical settings and possible target in the development of novel prophylactic and therapeutic strategies. Its dual role, protective in host defence yet exploitable by certain pathogens, highlights the need for careful consideration in future therapeutic approaches.}, }
@article {pmid41855953, year = {2026}, author = {Tantum, L and Anderson, DM and Jones, EP and Cronk, R}, title = {Mapping the evidence on environmental health services in healthcare facilities in low- and middle-income countries: A systematic literature inventory of over 4,000 studies.}, journal = {International journal of hygiene and environmental health}, volume = {274}, number = {}, pages = {114786}, pmid = {41855953}, issn = {1618-131X}, support = {T32 ES007018/ES/NIEHS NIH HHS/United States ; }, mesh = {*Developing Countries ; Humans ; *Health Facilities ; *Environmental Health ; Sanitation ; Evidence Gaps ; Hygiene ; COVID-19/epidemiology/prevention & control ; Resource-Limited Settings ; }, abstract = {BACKGROUND: Environmental health services in healthcare facilities-including water, sanitation, hygiene, waste management, cleaning, and infection control-prevent disease and strengthen healthcare delivery. Yet environmental health services are inadequate in many low- and middle-income countries (LMICs). Despite the importance of monitoring and improving services, no comprehensive evidence map exists to describe knowledge and gaps for action. The study objective was to comprehensively catalog published literature on environmental health services in healthcare facilities in LMICs by service domain, study type, and relevance to policy and practice.
METHODS: We conducted a systematic literature search in 2023 and updated it in 2025. After performing database searches, we used a machine learning process to prioritize studies for manual title-abstract screening. Through a title/abstract tagging process, we developed a literature inventory that categorized studies by topic, design, and relevance to policy and practice objectives.
RESULTS: The literature inventory included 4381 studies. Fifty-eight percent of the studies were baseline assessments of environmental health services, 36% involved formative research (e.g., qualitative methods), and 13% evaluated interventions or implementation strategies. Most studies (62%) examined hygiene at points of care, while 9% examined water and 6% sanitation. Twenty-seven percent of studies examined services during the COVID-19 pandemic.
CONCLUSIONS: There is little evidence for effective interventions and implementation strategies to improve and sustain environmental health services, especially for water and sanitation services. Formative research on under-studied services can help policymakers set investment priorities. Findings can inform the development of research agendas and practical guidelines for improving access to safe healthcare environments.}, }
@article {pmid41856071, year = {2026}, author = {Chelan, EM and Parhizkar, A and Nemati, M and Kiani, J and Almassian, B and Moghaddam, HG and Zarebkohan, A and Pourseif, MM}, title = {Targeted cytosolic delivery of mRNA immunotherapeutics: From vaccine delivery to protein replacement.}, journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie}, volume = {198}, number = {}, pages = {119181}, doi = {10.1016/j.biopha.2026.119181}, pmid = {41856071}, issn = {1950-6007}, mesh = {Humans ; Animals ; *RNA, Messenger/administration & dosage ; *Cytosol/metabolism ; *COVID-19 Vaccines/administration & dosage ; *Immunotherapy/methods ; *mRNA Vaccines/administration & dosage ; COVID-19/prevention & control/immunology ; *Drug Delivery Systems/methods ; }, abstract = {The advent of mRNA-based immunotherapeutics has fundamentally changed the nature of modern medicine. Although mRNA therapeutics initially developed to enhance vaccination platforms, they have rapidly expanded into gene editing and protein replacement applications. The rapid development and global deployment of mRNA vaccines during the COVID-19 pandemic emphasized the versatility and clinical potential of this modality and enabled swift progresses to infectious diseases and genetic disorders. mRNA work by exploiting the ability of the host cell system to produce desired proteins, however, clinical translation of mRNA immunotherapeutics remains constrained by challenges such as intrinsic instability, limited cellular uptake, inefficient endosomal escape, and suboptimal protein expression. Nanotechnology-based delivery systems have partially addressed these barriers over the past two decades and enabeled improved protection, targeting, and intracellular release. In this review, we conceptualize targeted mRNA delivery as a multistep process defined by Circulation-Internalization-Endosomal Escape-Expression (CIEE). We examine advances in systemic biodistribution control, organ-specific targeting, and precision delivery to antigen-presenting cells (APCs), and we discuss emerging strategies to optimize cytosolic transfection efficiency in immunotherapeutic applications. Advanced targeting strategies from organ-level biodistribution to cellular-level precision targeting of APCs are elucidated in details. From all the above, it follows that a solid knowledge in molecular biology, nanotechnology, and immunology is required for fine-tuned immunotherapeutic design. The current review attempt to serve as a reference to further advance optimizing targeted delivery of mRNA Immunotherapeutics.}, }
@article {pmid41856461, year = {2026}, author = {Farokhnia, A and Faro, LK and Tian, Y and Frischknecht, L and Eimer, J and Brosh-Nissimov, T and Nilsson, J}, title = {Extended nirmatrelvir-ritonavir for persistent COVID-19: Systematic review with individual patient data.}, journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases}, volume = {167}, number = {}, pages = {108558}, doi = {10.1016/j.ijid.2026.108558}, pmid = {41856461}, issn = {1878-3511}, mesh = {Humans ; *Ritonavir/therapeutic use/administration & dosage ; *COVID-19 Drug Treatment ; SARS-CoV-2/drug effects ; *Antiviral Agents/therapeutic use/administration & dosage ; COVID-19 ; Middle Aged ; Immunocompromised Host ; Female ; Treatment Outcome ; Male ; Aged ; }, abstract = {OBJECTIVES: To summarize individual patient data (IPD) on extended-duration nirmatrelvir-ritonavir (NMV-r) for persistent SARS-CoV-2 infection in immunocompromised adults and describe outcomes by regimen.
METHODS: We conducted a systematic review with IPD synthesis (PRISMA-IPD; PROSPERO CRD42025642455), searching databases through December 2025 and restricting eligible reports to January 1, 2022, through December 31, 2025 (Omicron-era focus). IPD were obtained for 39 patients from four low-risk-of-bias cohort studies (n = 30) and institutional cases (n = 9) meeting predefined criteria for persistent infection. We summarized outcomes after last-line extended NMV-r and report exploratory, unadjusted subgroup descriptions for monotherapy (n = 27) and combination regimens (n = 12).
RESULTS: Median age was 63 years. Patients had prolonged viral replication (median 58 days) before receiving extended NMV-r (median 10 days). Persistent infection after last-line extended therapy occurred in 5/38 (13.2%) evaluable patients. Persistence was observed in 2/26 (7.7%) evaluable monotherapy and 3/12 (25.0%) combination-therapy recipients; because regimen selection was nonrandom and baseline risk differed between groups, these subgroup proportions are descriptive and should not be interpreted as comparative effectiveness. All-cause mortality and adverse events (AEs) were rare (each 1/39; 2.6%).
CONCLUSION: In this selected observational IPD cohort, clearance after last-line extended NMV-r-containing therapy was commonly reported, and serious AEs were uncommon. Comparative inferences are limited by small sample size, imprecision, and confounding by indication; prospective studies are needed. PROSPERO registration CRD42025642455.}, }
@article {pmid41856882, year = {2026}, author = {Malewana, RD and Corbett-Helaire, KS}, title = {The dual-adjuvant logic of mRNA vaccines.}, journal = {Trends in immunology}, volume = {47}, number = {4}, pages = {243-245}, doi = {10.1016/j.it.2026.01.012}, pmid = {41856882}, issn = {1471-4981}, mesh = {*Adjuvants, Vaccine ; *mRNA Vaccines/immunology ; Humans ; *Immunity, Humoral ; Animals ; *Nanovaccines/immunology ; }, abstract = {Deciphering how mRNA vaccines generate humoral immunity could accelerate next-generation vaccine design. Castaño et al. reveal that mRNA-lipid nanoparticle vaccines employ a dual-adjuvant mechanism: nucleoside-modified mRNA triggers type I interferons to mature dendritic cells, while lipid nanoparticles induce a pro-T follicular helper cell program, together promoting robust germinal center responses.}, }
@article {pmid41857693, year = {2026}, author = {Williams, BA and Fitzsimmons, PM and Lewis, LM and Tornos, J and Kimmel, L and True, JM and Siwik, PJ and Ryall, M and Mullett, K}, title = {The 100 Days Mission: a perspective on accelerating vaccine manufacturing for future pandemics.}, journal = {BMC global and public health}, volume = {4}, number = {1}, pages = {}, pmid = {41857693}, issn = {2731-913X}, abstract = {The "100 Days Mission" aims to compress the timeline for delivering safe and effective vaccines in response to future pandemics. Here, we present insights from Pfizer leaders involved in the COVID-19 vaccine effort on key enablers for rapid large-scale manufacture of pandemic vaccines to achieve this ambitious goal. For pharmaceutical companies, these enablers include robust governance models, secure supply chains, innovative production strategies, and maintained "warm" manufacturing capacity. Additionally, we examine the crucial role of government support through regulatory harmonization, enhanced global surveillance, and improved logistics. By addressing these critical factors, the global community can better prepare for rapid vaccine manufacturing in response to future pandemic threats.}, }
@article {pmid41857720, year = {2026}, author = {Zhang, H and Guo, Z and Peng, Q}, title = {Prevalence of sleep disturbance among chinese college students: an updated meta-analysis.}, journal = {BMC psychiatry}, volume = {26}, number = {1}, pages = {}, pmid = {41857720}, issn = {1471-244X}, support = {sztsjh-2024-8-11//Anhui Provincial Department of Education 2024 Comprehensive Education and Ideological-Political Capacity Enhancement Project: "Ying Shan Hong" Counselor Master Teacher Studio/ ; 2025AHGXSK30457//Anhui Provincial Department of Education 2025 Key Humanities and Social Sciences Project for Higher Education Institutions: Coupling Mechanisms and Optimization Pathways for Cultivating a Sense of Community for the Chinese Nation through Cultural and Museum Research and Study under the Perspective of Cultural Embedding: An Empirical Study Based on Anhui-Xinjiang Practices/ ; }, mesh = {Humans ; *Students/statistics & numerical data/psychology ; Prevalence ; *Sleep Wake Disorders/epidemiology ; China/epidemiology ; Universities ; Young Adult ; Female ; }, abstract = {BACKGROUND: Sleep disturbance is common among college students. However, the prevalence and associated factors among Chinese college students require an updated synthesis. This study aimed to estimate the pooled prevalence of sleep disturbance in this population and to examine potential sources of between-study variation. METHODS: A systematic search was conducted in four Chinese databases (CNKI, Wanfang, VIP, and Sinomed) and five international databases (PubMed, EMBASE, Web of Science, Cochrane Library, and PsycINFO) from inception to December 22, 2025. The study protocol was pre-registered in PROSPERO (CRD420251270413). Cross-sectional studies reporting sleep disturbance among Chinese college students assessed using the Pittsburgh Sleep Quality Index were included, with no restrictions on cut-off thresholds. Recall timeframes included the past month, 1–2 weeks, or several months. Random-effects meta-analysis was used to pool prevalence estimates with 95% confidence intervals, and a 95% prediction interval was additionally reported for the overall pooled estimate to reflect between-study heterogeneity. Statistical heterogeneity was assessed using the I[2] statistic. Subgroup analyses were performed to explore methodological and population-level factors, and between-group differences were tested using chi-square statistics. RESULTS: A total of 232 studies involving 495,641 undergraduate students were included. The pooled prevalence of sleep disturbance was 26.4% (95% confidence interval: 24.6% to 28.3%, 95% prediction interval: 7.4% to 59.1%), with substantial heterogeneity (I[2] = 99.57%). Methodological factors were significantly associated with prevalence estimates, particularly the Pittsburgh Sleep Quality Index cut-off score and the recall timeframe (both P < 0.001). Prevalence was highest during the COVID-19 pandemic (33.5%), compared with the pre-pandemic period (24.1%) and the post-pandemic period (21.0%) (P = 0.001). Higher pooled estimates were observed in more recent publication periods, increasing from 22.9% in 2014 and earlier to 28.7% in 2020 and later (P = 0.018). No statistically significant differences were identified across gender, academic year, major, region, or only-child status. Higher prevalence was observed among smokers, drinkers, and students reporting poorer family economic status, although these differences did not reach statistical significance. CONCLUSIONS: Sleep disturbance, as defined by the Pittsburgh Sleep Quality Index, is prevalent among Chinese college students. Estimates should be interpreted cautiously because of extreme heterogeneity and reliance on self-reported, predominantly cross-sectional data. The findings underscore the public health relevance of sleep health on campuses and support continued monitoring and health promotion, as well as more standardized measurement in future studies. CLINICAL TRIAL NUMBER: Not applicable.}, }
@article {pmid41858416, year = {2026}, author = {Sinuraya, RK and Suwantika, AA and Puspitasari, IM}, title = {Strengthening Health Systems to Overcome Respiratory Infectious Diseases in Indonesia: A Comprehensive Review.}, journal = {Risk management and healthcare policy}, volume = {19}, number = {}, pages = {564998}, pmid = {41858416}, issn = {1179-1594}, abstract = {Respiratory infectious diseases (RIDs) remain a persistent public health challenge in Indonesia, a vast archipelago with complex healthcare delivery and marked regional inequities. The COVID-19 pandemic revealed critical weaknesses in the country's surveillance systems, diagnostic capacity, and outbreak response, underscoring the urgent need for stronger pandemic preparedness and a transition from a reactive, crisis-driven model to a proactive, prevention-focused health system. This study synthesizes existing literature, policy documents, and recent evaluation reports to assess Indonesia's health system performance in RID management and to identify evidence-based priorities for reform. The analysis is structured around five health system components: (1) surveillance and early warning, (2) diagnostic and laboratory capacity, (3) healthcare workforce, (4) public health infrastructure and primary care, and (5) governance and financing. Indonesia demonstrates important strengths, including a nationwide network of more than 10,000 Primary Health Centers (Puskesmas) and proven vaccination campaign capacity. However, significant gaps persist: during COVID-19, Early Warning Alert and Response System (EWARS) reporting completeness dropped from 75% to 53%, rural and remote areas remain underserved by diagnostics, and health workforce distribution continues to be inequitable Priority reforms include scaling up point-of-care diagnostics across all Puskesmas, integrating fragmented surveillance platforms through SatuSehat, empowering community health workers with digital tools, and ensuring sustainable financing for preparedness. Medium-term strategies focus on workforce redistribution and the establishment of regional health security centers, while long-term priorities emphasize predictive health intelligence, resilient supply chains, and nationwide facility upgrades. Building a resilient, prevention-oriented system will require sustained political commitment, innovative financing, and cross-sectoral collaboration, positioning Indonesia not only to strengthen domestic health security but also to serve as a regional leader in epidemic preparedness.}, }
@article {pmid41859113, year = {2026}, author = {Devine, J and Jacobs, B and Leroux-Roels, I and Leroux-Roels, G and van der Most, R}, title = {Infection, vaccination and risk of dementia: a proposed immunological model.}, journal = {Frontiers in immunology}, volume = {17}, number = {}, pages = {1748535}, pmid = {41859113}, issn = {1664-3224}, mesh = {Humans ; *Dementia/immunology/prevention & control/epidemiology ; *Vaccination ; Animals ; *Models, Immunological ; SARS-CoV-2/immunology ; Trained Immunity ; Immunity, Innate ; Risk Factors ; BCG Vaccine/immunology ; COVID-19/immunology ; }, abstract = {With ageing populations, the prevalence of different types of dementias is increasing. The pathology of Alzheimer's disease (AD), the most common form of dementia, has been linked to the presence of plaques and neurofibrillary tangles in the central nervous system of patients. There are growing indications that risk of developing dementia correlates with several infectious agents, including human herpes viruses, flaviviruses and SARS-CoV-2. This has led to a proposition that AD and other dementias could be considered as having an infectious disease etiology. Whilst the mechanisms behind this remain unclear, intriguing epidemiological data suggest that several vaccinations are correlated with reduced risk for dementia. Intravesicular administration of the tuberculosis vaccine strain Bacille Calmette-Guérin (BCG) has been associated with decreased risk of dementia in bladder cancer patients. This has led to the hypothesis that non-specific effects of vaccinations, mediated through trained innate immunity, provide a mechanistic explanation. Over the last few years, the AS01-adjuvanted recombinant shingles vaccine has also been associated with reduced risk in several studies. Moreover, in a recent study, immunization with the adjuvanted RSV vaccine, also containing AS01, was shown to reduce risk of dementia. Integrating data on BCG and mechanistic hypotheses, recent findings on the AS01 adjuvant, and the role of trained innate immunity, we describe here an immunological model that connects vaccine and adjuvant mode of action with risk of dementia. This immunological model can help shape a research roadmap to further elucidate the mechanisms behind the collective epidemiological data.}, }
@article {pmid41859255, year = {2026}, author = {Presa, J and Spitz, D and Balmer, P and Snow, V and Dooling, K}, title = {Epidemiology of invasive meningococcal disease in the United States: review of recent data and identified risk factors.}, journal = {Frontiers in public health}, volume = {14}, number = {}, pages = {1694023}, pmid = {41859255}, issn = {2296-2565}, mesh = {Humans ; United States/epidemiology ; Risk Factors ; *Meningococcal Infections/epidemiology ; Incidence ; Male ; Child ; Adolescent ; Infant ; Child, Preschool ; *COVID-19/epidemiology ; Adult ; Female ; Young Adult ; Middle Aged ; Population Surveillance ; }, abstract = {INTRODUCTION: Tracking the spread of invasive meningococcal disease (IMD) in the United States is important for identifying risk factors and devising public health strategies to prevent infection.
METHODS: The epidemiology of IMD in the United States before, during, and after the COVID-19 pandemic (2016-2024) was assessed using surveillance data from the National Notifiable Diseases Surveillance System (NNDSS) and the Enhanced Meningococcal Disease Surveillance program (EMDS).
RESULTS: IMD case numbers declined during the pandemic (2020-2021) to 208 in 2021 but rebounded to 312 in 2022 and have continued to increase through 2024 (provisionally 477 cases). In 2022, serogroup C was the predominant serogroup (107 cases), followed by serogroup B (61 cases). Except during the pandemic, IMD cases were higher among those attending versus not attending college. During and after the pandemic, groups with the highest IMD incidence were those <1 year of age (range, 0.38-0.56 cases per 100,000 persons) and within the Black population (range, 0.09-0.19 cases per 100,000 persons). The percentage of IMD cases occurring after the pandemic in men who have sex with men and those with HIV increased substantially from during the pandemic. The percentage of IMD cases that occurred among people experiencing homelessness (PEH) was relatively high, ranging from 2.4-6.3%.
CONCLUSION: The data indicate a rebound in IMD after the COVID-19 pandemic, highlighting the importance of strengthening surveillance and vaccination among high-risk populations.}, }
@article {pmid41860005, year = {2026}, author = {Zou, H and An, WT and Huang, SL and Luo, G and Mu, ZP}, title = {Advances in the application of natural bioactive compounds for the prevention and control of porcine epidemic diarrhea virus via the oxidative stress pathway.}, journal = {Polish journal of veterinary sciences}, volume = {29}, number = {1}, pages = {165-174}, doi = {10.24425/pjvs.2026.158513}, pmid = {41860005}, issn = {2300-2557}, mesh = {Animals ; *Porcine epidemic diarrhea virus ; *Swine Diseases/prevention & control/virology ; Swine ; *Oxidative Stress/drug effects ; *Coronavirus Infections/veterinary/prevention & control ; Antioxidants ; }, abstract = {The porcine epidemic diarrhea virus (PEDV) represents a critical challenge to the global swine industry due to its profound adverse effects on pig health and production efficiency. A key pathological outcome of PEDV infection is the induction of oxidative stress, which significantly exacerbates intestinal injury and accelerates disease progression. Natural bioactive compounds, sourced from plants, animals, and microorganisms, have been extensively studied for their diverse biological properties, including potent antioxidant, anti-inflammatory, and antiviral activities. These compounds demonstrate significant potential in alleviating oxidative stress and playing a pivotal role in the prevention and management of PEDV infections. This review provides a comprehensive analysis of the mechanisms by which natural bioactive compounds enhance the antioxidant defence system and suppress PEDV replication. Current evidence indicates that these compounds alleviate oxidative stress primarily through the modulation of antioxidant enzyme systems, such as superoxide dismutase (SOD) and glutathione peroxidase (GPx), and the activation of key signalling pathways, including the Nrf2/ARE axis. These actions collectively contribute to reduced viral loads and improved health outcomes in PEDV-infected pigs. Although these findings underscore the potential of natural bioactive compounds, several critical challenges persist, particularly the incomplete elucidation of their mechanisms of action and the substantial costs associated with large-scale applications. Addressing these challenges necessitates further research aimed at uncovering the precise molecular pathways underlying their effects and developing cost-effective strategies to facilitate their practical implementation in the swine industry.}, }
@article {pmid40928692, year = {2025}, author = {Wehbe, R and Khoshman, N and Ousseily, Z and Al-Tameemi, SA and Majzoub, RE and Najar, M and Merimi, M and Fayyad-Kazan, H and Badran, B and Fayyad-Kazan, M}, title = {Emerging SARS-CoV-2 variants: genomic shifts, immune evasion, and therapeutic perspectives.}, journal = {Molecular biology reports}, volume = {52}, number = {1}, pages = {886}, pmid = {40928692}, issn = {1573-4978}, mesh = {Humans ; *SARS-CoV-2/genetics/immunology ; *COVID-19/immunology/virology/prevention & control/therapy/epidemiology ; *Immune Evasion ; *COVID-19 Vaccines/immunology ; Antiviral Agents/therapeutic use ; Antibodies, Neutralizing/immunology/therapeutic use ; Antibodies, Monoclonal/therapeutic use ; Antibodies, Viral/immunology ; COVID-19 Drug Treatment ; Genome, Viral ; Pandemics ; }, abstract = {The COVID-19 pandemic, caused by the continuously evolving SARS-CoV-2 virus, has presented persistent global health challenges. As novel variants emerge, many with enhanced transmissibility and immune evasion capabilities, concerns have intensified regarding the efficacy of existing vaccines and therapeutics. This review provides a comprehensive overview of the current landscape of COVID-19 vaccination, including the development and performance of monovalent and bivalent boosters, and examines their effectiveness against newly emerging variants of interest (VOIs) and variants under monitoring (VUMs), such as JN.1, KP.2, and XEC. We also explore real-world vaccine effectiveness, antibody neutralization studies, and the latest updates from WHO advisory groups. Beyond vaccines, we discuss evolving treatment approaches, including the use of monoclonal antibodies (mAbs), small-molecule antivirals, and host-targeted therapies. As resistance to antiviral agents and mAbs continues to emerge, combination therapies and next-generation broadly neutralizing antibodies offer promising avenues. This review underscores the importance of ongoing surveillance, rapid vaccine reformulation, and the development of adaptive treatment strategies to mitigate the impact of emerging SARS-CoV-2 variants and protect vulnerable populations.}, }
@article {pmid40929000, year = {2025}, author = {Zhang, L and Srisawat, N and Lee, CC and Lee, DH and Lee, K and Liu, Z and Mohamad Nor, FS and Mustafar, RB and Peerapornratana, S and Pham, HM and Sewa, SDW and Tang, GKY and Yeh, YC and Zhu, M and Yao, Q and Wang, M and Bellomo, R}, title = {Extracorporeal Blood Purification with the oXiris® Filter for Patients with Sepsis and Hyperinflammatory Conditions: The Asia-Pacific oXiris Expert Meeting 2024 Consensus Statements.}, journal = {Blood purification}, volume = {54}, number = {11}, pages = {621-638}, pmid = {40929000}, issn = {1421-9735}, mesh = {Humans ; Acute Kidney Injury/therapy/blood/etiology ; Asia ; *COVID-19/therapy/blood/complications ; *Hemofiltration/instrumentation/methods ; *Inflammation/therapy/blood ; SARS-CoV-2/isolation & purification ; *Sepsis/therapy/blood ; }, abstract = {Extracorporeal blood purification is a technique for reducing elevated levels of inflammatory mediators and/or endotoxins in critically ill patients with sepsis or other hyperinflammatory conditions. The oXiris filter combines endotoxin adsorption, cytokine adsorption, hemofiltration, and anti-thrombosis, and an emerging body of evidence demonstrates its use in critical care patients with hyperinflammatory conditions and acute kidney injury (AKI). A group of Asia-Pacific experts convened to formulate consensus statements for the use of the oXiris filter based on a comprehensive review of publications. After evaluation using a Delphi methodology, 17 statements achieved consensus (three recommendations and 14 practice points). These offer guidance on the initiation, monitoring, and evaluation of treatment with the oXiris filter in patients with sepsis, septic shock, severe COVID-19, or other hyperinflammatory states. We also recommend using the oXiris filter in patients undergoing cardiopulmonary bypass for cardiac surgery who are at risk for developing AKI. Other statements discuss modality, dosage, filter lifespan, anticoagulation, and combining the oXiris filter set with other extracorporeal therapies. Taken together, our statements offer targeted guidance for clinicians on the use of the oXiris filter across different patient populations. Additionally, we highlight the limitations of the current evidence base and identify key areas requiring further research.}, }
@article {pmid40929471, year = {2025}, author = {Schultz, MJ and Ball, L and Bernardi, M and Battaglini, D and Buiteman, LA and Ferreira, JC and Abreu, MG and Rosa, S and Hemmes, SN and Huhle, R and Mazzinari, G and Meenen, DMPV and Nasa, P and Serpa Neto, A and Pelosi, P and Paulus, F and Robba, C and Rocco, PRM and Scharffenberg, M and Tschernko, E and Wittenstein, J}, title = {The PROtective VEntilation (PROVE) Network - advancing research and collaboration in mechanical ventilation.}, journal = {Critical care science}, volume = {37}, number = {}, pages = {e20250399}, pmid = {40929471}, issn = {2965-2774}, mesh = {Humans ; *Respiration, Artificial/methods ; *COVID-19/therapy ; *Biomedical Research/organization & administration ; SARS-CoV-2 ; }, abstract = {The PROtective VEntilation (PROVE) Network is a globally-recognized collaborative research group dedicated to advancing research, education, and collaboration in the field of mechanical ventilation. Established to address critical questions in intraoperative and intensive care ventilation, the network focuses on improving outcomes for patients undergoing mechanical ventilation in diverse settings, including operating rooms, intensive care units, burn units, and resource-limited environments in low- and middle-income countries. The PROVE Network is committed to generating high-quality evidence through a comprehensive portfolio of investigations, including randomized clinical trials, observational research, and meta-analyses. Its work has significantly contributed to understanding optimal ventilation strategies in critically ill patients, such as those with COVID-19, and in exploring innovative approaches like closed-loop ventilation systems. The network has spearheaded pioneering studies that have shaped clinical practice worldwide by integrating expertise from a wide range of disciplines. A defining feature of the PROVE Network is its emphasis on mentorship and collaboration. It fosters a supportive environment where junior researchers are guided by experienced mentors, ensuring the transfer of knowledge and promoting inclusivity. The network prioritizes gender balance and diversity, recognizing the value of varied perspectives in driving meaningful innovation and advancing research excellence. This paper reviews the history, key projects, and leadership of the PROVE Network, highlighting its impactful contributions to the field of mechanical ventilation. By uniting researchers globally, the PROVE Network exemplifies the power of collaboration in addressing complex clinical challenges, including personalized ventilation and the use of Artificial Intelligence, and improving patient care.}, }
@article {pmid40930047, year = {2025}, author = {Sanftenberg, L and Kraeker, L and Walter, F and Tsiligianni, I and Bouloukaki, I and Roos, M and Gensichen, J}, title = {Associations between common mental disorders and vaccination readiness against seasonal influenza and Covid-19 of chronically ill adult patients in primary care - a systematic review.}, journal = {Vaccine}, volume = {64}, number = {}, pages = {127682}, doi = {10.1016/j.vaccine.2025.127682}, pmid = {40930047}, issn = {1873-2518}, mesh = {Adult ; Humans ; Chronic Disease/psychology ; *COVID-19/prevention & control/psychology/epidemiology ; COVID-19 Vaccines/administration & dosage ; *Influenza Vaccines/administration & dosage ; *Influenza, Human/prevention & control ; *Mental Disorders/epidemiology/psychology ; Primary Health Care ; SARS-CoV-2/immunology ; Seasons ; *Vaccination/psychology ; *Vaccination Hesitancy/psychology ; }, abstract = {BACKGROUND: Chronically ill are advised to receive annual vaccinations against Covid-19 and seasonal influenza. Furthermore, chronically ill show an increased prevalence of comorbid common mental disorders (CMDs), like depression, anxiety, and somatoform disorders. With vaccination rates remaining insufficient among these vulnerable patients, prior research assumes an association between CMDs and vaccination readiness. As diagnoses, treatment and vaccination of those patients are performed mainly in general practice, the aim of this review is to describe associations between CMDs and vaccination readiness against seasonal Influenza and Covid-19 in chronically ill adult patients in primary care.
METHODS: A systematic literature search was conducted in Medline, Embase, PsycINFO, the Cochrane Library and ERIC. Randomized controlled trials (RCTs), clustered RCTs and observational studies were considered. Two authors screened the studies and assessed the risk of bias independently (Cochrane Risk of Bias 2-Tool). We followed the PRISMA guideline. The study protocol was published in PROSPERO (CRD42024621413). The results were synthesized narratively.
RESULTS: Of 9820 identified studies, seven observational studies met the inclusion criteria. Regarding Covid-19, three studies could show, that CMDs might lead to decreased vaccination readiness in adults. Regarding seasonal influenza, no significant association between vaccination readiness and CMDs occurred. In terms of vaccination rates, no significant association between vaccinations against Covid-19 and CMDs could be identified. Two studies identified a significant association between decreasing vaccination rates against seasonal influenza and CMDs.
CONCLUSION: CMDs tend to be associated with decreased vaccination readiness, however vaccination rates were not automatically affected as well. This could indicate a potential intention-behavior gap.}, }
@article {pmid40930270, year = {2025}, author = {Walker, TA and Kohler, JZ and Haddad, MM}, title = {Long COVID: Current landscape of neurocognitive sequalae and opportunities to improve care management.}, journal = {Brain, behavior, and immunity}, volume = {130}, number = {}, pages = {106108}, doi = {10.1016/j.bbi.2025.106108}, pmid = {40930270}, issn = {1090-2139}, }
@article {pmid40931272, year = {2025}, author = {Iodice, F and Cuffaro, L and Romoli, M and Bianchini, E and Sparaco, M and Arighi, A and Cerami, C and Salemme, S and Reale, G and Orologio, I and Lavorgna, L and Padovani, A}, title = {A comprehensive guide to digital neurology. An update on current development on digital neurology derived from the Digital Neuro Hub project.}, journal = {Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology}, volume = {46}, number = {12}, pages = {6167-6179}, pmid = {40931272}, issn = {1590-3478}, mesh = {Humans ; *Neurology/methods/trends ; *Telemedicine/trends ; COVID-19 ; Artificial Intelligence ; Wearable Electronic Devices ; Italy ; }, abstract = {The rapid evolution of digital tools in recent years after COVID-19 pandemic has transformed diagnostic and therapeutic practice in neurology. This shift has highlighted the urgent need to integrate digital competencies into the training of future specialists. Key innovations such as telemedicine, artificial intelligence, and wearable health technologies have become central to improving healthcare delivery and accessibility. In response, the Digital Neurology group of the Italian Society of Neurology convened during the Italian Digital Neuro Hub meeting to define the essential digital skills and knowledge areas for tomorrow's neurologists. This paper outlines four primary domains of focus: wearable devices, telemedicine, AI applications, and the ethical implications of digital medicine in neurology.}, }
@article {pmid40931721, year = {2025}, author = {Parodi, JF and Runzer-Colmenares, FM and Cano-Gutiérrez, C and Dinamarca-Montecinos, JL and de La Torre, PB and Boas, PFV and Flores-Cohaila, JA and Urrunaga-Pastor, D and Gutiérrez-Robledo, LM}, title = {Developing a Latin American Delphi Consensus on Vaccination for Respiratory Diseases in Older Adults.}, journal = {Annals of geriatric medicine and research}, volume = {29}, number = {4}, pages = {440-449}, pmid = {40931721}, issn = {2508-4909}, support = {//Academia Latinoamericana de Medicina del Adulto Mayor/ ; }, mesh = {Humans ; Latin America ; Delphi Technique ; Aged ; *Vaccination/standards ; COVID-19/prevention & control ; Influenza Vaccines/administration & dosage ; Pneumococcal Vaccines/administration & dosage ; COVID-19 Vaccines/administration & dosage ; SARS-CoV-2 ; Aged, 80 and over ; Male ; Female ; }, abstract = {BACKGROUND: Respiratory infections significantly impact older adults in Latin America, highlighting the need for regionally adapted consensus-based vaccination recommendations to guide preventive strategies. This study aimed to develop a consensus among Latin American experts on vaccination against respiratory diseases in older adults in the region, including influenza, Streptococcus pneumoniae pneumonia, coronavirus disease 2019 (COVID-19), respiratory syncytial virus (RSV), and pertussis.
METHODS: A two-round Delphi methodology was employed, involving 35 specialists from various medical fields. A rapid evidence review was conducted using scientific databases and clinical practice guideline repositories. Participants evaluated each recommendation on a 1-to-5 scale; recommendations with 80% acceptance (score of 4 or higher) were approved.
RESULTS: The consensus resulted in recommendations for administering Tdap (tetanus, diphtheria, and pertussis) boosters every 10 years for pertussis and annual influenza vaccination in adults aged 65 years or older, using high-dose or adjuvanted formulations. Additionally, primary and annual booster COVID-19 vaccinations were recommended, along with a single dose of RSV vaccine for individuals aged 75 years and older, providing protection for at least two winter seasons. Routine administration of pneumococcal conjugate vaccine 15 (PCV15) or PCV20 was also recommended for adults aged 65 years or older who had not previously received a PCV.
CONCLUSIONS: The consensus provides a vaccination guide tailored to the Latin American context, aiming to bridge gaps in vaccination coverage among older adults in the region. This effort seeks to reduce the burden of respiratory diseases on frail healthcare systems and promote healthy aging in Latin America.}, }
@article {pmid40933738, year = {2025}, author = {Kemoun, G and Demoule, A}, title = {High-flow nasal oxygen is the reference treatment in acute hypoxemic respiratory failure: Con.}, journal = {Journal of intensive medicine}, volume = {5}, number = {3}, pages = {230-236}, pmid = {40933738}, issn = {2667-100X}, abstract = {Over the past decade and boosted by the coronavirus disease 2019 (COVID-19) pandemic, high-flow nasal oxygen (HFNO) has been increasingly used in the intensive care unit (ICU) to treat acute hypoxemic respiratory failure (AHRF). In this review, we show that despite this wide and rapid increase in the use of HFNO to treat AHRF, HFNO does not fulfill all the criteria of a "reference treatment". First, there are some inconsistencies between the studies that provided a positive signal toward the possible benefit of HFNO in AHRF. The two high-quality studies were negative in terms of primary outcome although they provided promising signals in favor of HFNO in terms of secondary outcomes or unplanned secondary analysis. The significance of the only positive study suffers from notable limitations and other trials, conducted in COVID-19 and in immunocompromised patients, are definitely negative and do not even provide promising signals in favor of HFNO. Of note, authors of some of the large randomized controlled trials (RCTs) on HFNO have received grants or personal fees from manufacturers of HFNO devices. Second, meta-analyses do not show positive results regarding the efficacy of HFNO on mortality and recent guidelines do not support its use to improve this outcome, although they recommend HFNO use to reduce intubation rate. Third, HFNO is associated with risks that should be accounted for. There are concerns that HFNO may delay intubation, which is in turn associated with higher mortality and prolonged length of stay. In addition, with HFNO, high inspiratory effort may generate high lung strain and overstretch, a phenomenon termed patient self-inflicted lung injury (P-SILI). Fourth, there are concerns regarding access to HFNO in resource-limited settings. Fifth, there are also concerns regarding the deleterious environmental impact of HFNO due to the high volume of consumables and high oxygen flow, which remain to be precisely quantified and balanced with the potential reduction in intubation rate. Considering all these limitations, HFNO is not yet the reference treatment for AHRF.}, }
@article {pmid40934489, year = {2025}, author = {Garcia Gonzalez-Moral, S and Pennock, E and Ewedairo, O and Green, E and Elgey, J and Mkwashi, A}, title = {Horizon Scanning Methods for Health Care Technology Innovation Identification: Rapid Scoping Review of Patent Research Studies.}, journal = {Interactive journal of medical research}, volume = {14}, number = {}, pages = {e70323}, pmid = {40934489}, issn = {1929-073X}, abstract = {BACKGROUND: Patents are an early sign of innovation, yet their role in horizon scanning for health care remains unclear.
OBJECTIVE: This study investigates the role of, and methods for, patent analysis in advancing health care technology innovation in a sector that is characterized by diverse health care technologies and significant research investment. Patents are critical early indicators of innovation, supporting horizon scanning and weak signal detection. The study aimed to identify intellectual property sources, evaluate methods for patent retrieval and analysis, and outline objectives for using patent data to anticipate trends and inform health care strategies.
METHODS: A rapid scoping review was conducted following Cochrane Rapid Review Methods recommendations and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, with a preregistered protocol on the Open Science Framework. Searches in Embase, IEEE Xplore, and Web of Science targeted records published 2020 onward to capture the most recent sources, methods, and tools. Three independent reviewers screened studies using Rayyan (Qatar Computing Research Institute). We included any study type published since 2020 that provided patent sources data, methods, and tools applied to the study of health care technologies. Our data extraction included bibliographic details, study characteristics, and methodological information. Risk of bias assessments were not undertaken. Narrative and tabular methods, supplemented by visual charts, were used to synthesize findings.
RESULTS: Our searches identified 1741 studies, of which 124 were included after title, abstract, and full-text screening, with 54% being original research, 43.5% reviews, and the remainder being conference abstracts (2.5%). Most studies (68%) relied solely on patent databases, while others searched the gray and published literature. Research objectives of the included studies were grouped into 10 themes, with trend analysis (50%) and the provision of recommendations for future research, policy, and strategy development (20%) being the most common. Our review identified up to 47 patent databases, with 27% of studies using multiple sources. Whenever time limits were reported, the mean time horizon for patent searches was 24.6 years, ranging from 1900 to 2019. Automated approaches, used in 33% (n=43) of studies, frequently used tools such as Gephi (Gephi Consortium) for network visualization. Disease mapping based on National Institute for Health and Care Excellence classification indicated that cancer (19%) and respiratory conditions (16%), particularly COVID-19, were key areas.
CONCLUSIONS: Patent data are valuable for identifying technological trends and informing policy and research strategies. While patents provide crucial insights into emerging technologies, inconsistent deduplication practices across studies pose the risk of data inflation, accentuating the need for transparency and rigor. Finally, this review emphasized the importance of data transformation and visualization in detecting emerging trends, with Python and R being the most commonly used programming languages for developing custom tools.}, }
@article {pmid40934937, year = {2026}, author = {Wilhelm, F and Cadamuro, J and Mink, S}, title = {Autoantibodies in long COVID: a systematic review.}, journal = {The Lancet. Infectious diseases}, volume = {26}, number = {4}, pages = {e220-e230}, doi = {10.1016/S1473-3099(25)00411-6}, pmid = {40934937}, issn = {1474-4457}, mesh = {Humans ; *COVID-19/immunology/complications/diagnosis ; *Autoantibodies/blood/immunology ; SARS-CoV-2/immunology ; Biomarkers/blood ; Prognosis ; Antibodies, Antinuclear/blood/immunology ; }, abstract = {Post-COVID-19 condition (also known as long COVID) affects a substantial proportion of individuals who have been infected with SARS-CoV-2, profoundly affecting their daily lives and work. Diagnosis and prognosis of long COVID are complex and hindered by heterogeneous symptoms and the absence of validated biomarkers. This systematic review synthesises current evidence on the association between autoantibodies and long COVID, with the goal of evaluating their prognostic and diagnostic utility. Studies published in the PubMed and MEDLINE databases between Jan 1, 2020, and June 10, 2025, were considered. Study selection and quality assessment were done independently by two researchers. Of the 1113 publications screened, 44 studies met the inclusion criteria, with a total of 7571 participants, including 3372 individuals with long COVID. 31 (71%) studies reported an association between autoantibodies and long COVID; however, there was substantial heterogeneity in study design, type and timing of antibody measurements, and long COVID definitions. Several autoantibodies have been associated with long COVID occurrence, symptoms, and severity. Antinuclear antibodies, and autoantibodies targeting G protein-coupled receptors and chemokines, have emerged as potential biomarkers for aiding in the diagnosis, prognosis, and assessment of disease severity in long COVID. However, larger studies are needed to confirm the diagnostic and prognostic utility of these autoantibodies in the context of long COVID.}, }
@article {pmid40935100, year = {2025}, author = {Chen, L and Zhao, S and Li, X and Wang, X and Yu, G}, title = {Synergistic effects of microplastics and bioaerosols: emerging trends in urban air pollution complexification and public health implications.}, journal = {Environmental research}, volume = {286}, number = {Pt 1}, pages = {122808}, doi = {10.1016/j.envres.2025.122808}, pmid = {40935100}, issn = {1096-0953}, mesh = {*Microplastics/analysis/adverse effects ; Humans ; Aerosols/analysis ; *Air Pollutants/analysis/adverse effects ; *Public Health ; *Air Pollution/adverse effects/analysis ; *Air Microbiology ; COVID-19 ; }, abstract = {Urban air is increasingly contaminated with complex mixtures of microplastics (MPs) and bioaerosols (BAs), whose co-exposure may pose unique health risks. This review highlights the synergistic interaction between MPs and BAs during atmospheric transport and human exposure. We summarized the sources and physicochemical characteristics of airborne MPs (fragments and fibers from urban waste and textiles) and BAs (bacteria, fungi, and viruses from soil, water, and human activity) and their shared dispersion pathways via wind and resuspension. Both pollutants deposit in the respiratory tract upon inhalation. Notably, MPs may function as potential microbial carriers. Laboratory and field data indicate that airborne plastics harbor distinct microbial biofilms (often with antibiotic-resistant bacteria/genes) and may prolong virus survival (e.g., SARS-CoV-2 on plastic surfaces). These MP-microbe aggregates can enhance pathogen persistence and increase host exposure. In lung models, inhaled MPs disrupt epithelial barriers and surfactant layers, inhibit cell proliferation, and trigger inflammation (tumor necrosis factor-alpha, interleukin-6, IL-1β, and tumor growth factor-beta) and oxidative stress (depleting SOD/CAT and generating reactive oxygen species). Assessing this co-pollution requires advanced methods. Standard spectroscopic tools (micro-Fourier-transform infrared spectroscopy and micro-Raman) and emerging methods such as laser direct infrared imaging enable polymer identification and MP sizing. Similarly, culture-independent high-throughput sequencing techniques (e.g., 16S/18S rRNA gene profiling) elucidate airborne microbial diversity. Novel real-time aerosol counters (e.g., UV-LIF optical sensors) and machine learning analytics are being applied to monitor BA load. Finally, we discussed implications for vulnerable subpopulations (children, the elderly, and individuals with chronic respiratory conditions) who may be more susceptible to combined MP/BA effects. The review proposes future directions, which include developing integrated toxicological models, multi-omics analyses of particle-microbe interactions, and establishing coordinated environmental health surveillance to track this emerging urban pollutant mixture.}, }
@article {pmid40935562, year = {2025}, author = {Wormser, J and Romanet, C and Cachanado, M and Youinou, M and Chatellier, G and Torres Sánchez, I and Philippart, F}, title = {Virtual reality in adults with respiratory diseases experiencing dyspnoea: a systematic review and meta-analysis.}, journal = {BMJ open respiratory research}, volume = {12}, number = {1}, pages = {}, pmid = {40935562}, issn = {2052-4439}, mesh = {Humans ; *Dyspnea/therapy/etiology/physiopathology ; Quality of Life ; *Virtual Reality ; Exercise Tolerance ; Adult ; }, abstract = {OBJECTIVES: Our aim was to evaluate virtual reality's effects in dyspnoea's management.
METHODS: Information sources: Trials were identified through a systematic search carried out on MEDLINE, Web of Science, Scopus and CINAHL until 17 March 2025.
ELIGIBILITY CRITERIA: Eligible studies were controlled trials including adults with dyspnoea associated with respiratory diseases, for whom virtual reality was implemented and compared with another intervention. Risk of bias: Risk of bias (ROB) was assessed using the ROB 2 tool.
SYNTHESIS OF RESULTS: The primary outcome was dyspnoea. Secondary outcomes included exercise capacity, health-related quality of life (HRQOL) and muscle function. Effect size was expressed using standardised mean difference (SMD) or MD for primary and secondary outcomes, respectively (random-effects model). We used the Grading of Recommendations Assessment, Development and Evaluation approach to judge the certainty of evidence.
RESULTS: Included studies: 13 studies were selected, including 483 adults and using non-immersive tools (n=7) or immersive tools (n=6). Risk of bias in these studies was low (n=1), some concerns (n=8) and high risk (n=4).
SYNTHESIS OF RESULTS: No difference was found in dyspnoea (8 studies, 224 participants; SMD 0.02, 95% CI -0.82 to 0.86, I[2]=88.2%), exercise capacity (5 studies, 183 participants; MD 3.62, 95% CI -19.39 to 26.63, I[2]=39.8%) and in HRQOL (4 studies, 127 participants; MD -11.81, 95% CI -42.95 to 19.33, I[2]=98.9%). The data available were insufficient to conduct a pooled analysis for muscle function.
CONCLUSIONS: Limitations of evidence: The evidence is very uncertain about virtual reality's effects on dyspnoea due to risk of bias, imprecision and heterogeneity.
INTERPRETATION: Further studies are needed and should explore various aspects of the application of immersive virtual reality.
PROSPERO REGISTRATION NUMBER: CRD42023443280.}, }
@article {pmid40936368, year = {2025}, author = {Caffery, LJ and Taylor, ML and Abbott, LM and Janda, M and Guitera, P and Mar, V and Bennett, H and Arnold, C and Shumack, S and Caccetta, T and Miller, R and Soyer, HP}, title = {Practice Guidelines for Teledermatology in Australia: 2025 Update.}, journal = {The Australasian journal of dermatology}, volume = {66}, number = {8}, pages = {e553-e564}, pmid = {40936368}, issn = {1440-0960}, support = {//Australasian College of Dermatologists/ ; }, mesh = {Humans ; *Dermatology/standards/methods ; Australia ; COVID-19/epidemiology/prevention & control ; *Telemedicine/standards ; Remote Consultation/standards ; *Skin Diseases/diagnosis ; Patient Selection ; SARS-CoV-2 ; Confidentiality ; Informed Consent ; }, abstract = {In 2020, [the Australasian College of Dermatologists] released its first teledermatology practice guidelines for Australia, with a commitment to regular updates. This article presents the revised guidelines, aimed at educating dermatologists on the benefits and limitations of telehealth, while promoting safer, higher-quality patient care. The updated guidelines harmonise with the Medical Board of Australia's 2023 telehealth guidelines. They address the growing use of telephone consultations-boosted by Medicare subsidies introduced during the COVID-19 pandemic. The latest guidelines provide recommendations on the appropriate choice of modality (telephone versus video) for teleconsultation. They also include updated guidance on clinical image acquisition. The guidelines are divided into two parts: (1) core recommendations and (2) supporting notes for practical application. Topics covered include teledermatology modalities, patient selection and consent, imaging standards, quality and safety, privacy and security, communication, and documentation, including image retention.}, }
@article {pmid40936649, year = {2025}, author = {Schumann, A and Di Giuliano, M and Schulz, S and de la Cruz, F and Kreuder, T and Seifert, G and Bär, KJ}, title = {Mapping the brain's fatigue network: a transdiagnostic systematic review and meta-analysis on functional correlates of mental fatigue.}, journal = {Brain communications}, volume = {7}, number = {5}, pages = {fcaf315}, pmid = {40936649}, issn = {2632-1297}, abstract = {Mental fatigue is a significant psychopathological symptom that has recently gained attention, particularly in chronic fatigue syndrome/myalgic encephalomyelitis and Post-COVID-19 condition. However, fatigue is a clinically relevant symptom across a wide range of mental and neurological disorders. To identify a transdiagnostic functional network associated with fatigue, we conducted an activation likelihood estimation meta-analysis of neuroimaging studies. The primary inclusion criterion was studies involving any medical condition where patients exhibited significantly higher levels of fatigue compared to healthy controls. A systematic literature review across three major scientific databases identified 46 eligible neuroimaging studies, including a total of 2603 individuals. The meta-analysis of these studies revealed a widespread cortical-subcortical network involving frontal, limbic, basal ganglia and parietal structures. Three main clusters were highlighted: a frontal-striatal-limbic cluster, a frontal-cingulate cluster and a parietal cluster, with regions implicated in cognitive, emotional and somatosensory symptoms associated with mental fatigue. Quality analysis indicated a moderate risk of bias in the majority of the included studies. Overall, our findings provide scientific evidence for a transdiagnostic mental fatigue network in the brain, with key nodes located in the lateral frontal cortex, cingulate cortex, insula, thalamus, precuneus and caudate. These results support the theory of thalamic-striatal-cortical dysfunction, which may impair compensatory mechanisms related to mental fatigue. Additionally, abnormal activation of limbic and parietal regions may contribute to cognitive, emotional and attentional impairments linked to fatigue.}, }
@article {pmid40936739, year = {2025}, author = {Rastogi, S and Gupta, S and Deepak, D and Mishra, BN and Gore, R and Singh, V}, title = {A Systematic Literature Review on Anxiety Among Undergraduate Students: Causes and Coping Strategies.}, journal = {Annals of neurosciences}, volume = {}, number = {}, pages = {09727531251366078}, pmid = {40936739}, issn = {0972-7531}, abstract = {BACKGROUND: Anxiety is a prevalent mental health concern among undergraduate students, adversely affecting academic performance, social functioning and emotional well-being. Its multifactorial causes and coping strategies, particularly in the context of global disruptions such as the COVID-19 pandemic, warrant a comprehensive synthesis.
PURPOSE: This systematic review aims to analyse empirical studies on the causes of anxiety and the effectiveness of coping strategies among undergraduate students from 2010 to 2025.
METHODS: A systematic review was conducted using Scispace.ai, selecting 40 empirical studies published between 2010 and 2025. Keywords used included 'anxiety', 'undergraduate students' and 'coping strategies'. Thematic analysis was performed to categorise findings into major focus areas.
RESULTS: Seven key themes emerged: Prevalence (16%), academic stress (18%), social anxiety (16%), emotional comorbidities (16%), demographic differences (12%), coping mechanisms (14%) and contextual stressors such as COVID-19 (8%). Social judgement, academic pressure and fear of failure were primary causes of anxiety, often co-occurring with depression and emotional dysregulation. Female students and first-year undergraduates were identified as more vulnerable groups. Effective coping strategies included mindfulness practices, yoga, peer support and biofeedback; however, utilisation was limited by stigma and inadequate mental health services. The COVID-19 pandemic further intensified anxiety levels due to social isolation and academic uncertainty.
CONCLUSION: This review underscores the urgent need for inclusive support systems, integration of digital mental health tools and culturally sensitive interventions within educational institutions. Future research should explore longitudinal trends and develop context-specific strategies to improve mental health outcomes among undergraduate students.}, }
@article {pmid40937306, year = {2025}, author = {Ucciferri, C and Chiappini, F and Vecchiet, J and Falasca, K}, title = {From Legacy to Innovation: Pidotimod's Expanding Therapeutic Horizon.}, journal = {Mediterranean journal of hematology and infectious diseases}, volume = {17}, number = {1}, pages = {e2025057}, pmid = {40937306}, issn = {2035-3006}, abstract = {Pidotimod, a synthetic dipeptide, has been utilized for over three decades as an immunomodulatory agent to prevent recurrent respiratory infections, particularly in immunocompromised populations such as children and the elderly. Originally developed for its ability to enhance innate and adaptive immune responses, pidotimod is now being revisited in light of new clinical insights and emerging therapeutic needs. Recent studies have expanded its potential beyond traditional indications, with evidence supporting its role in patients with chronic respiratory diseases, such as chronic obstructive pulmonary disease (COPD), allergic rhinitis, and even viral infections, including SARS-CoV-2. Pidotimod exerts its effects by stimulating dendritic cells, enhancing toll-like receptor (TLR) expression, and promoting cytokine production, including IL-2 and IFN-γ, thereby supporting both cellular and humoral immunity. This broad-spectrum immune modulation makes pidotimod a promising adjunct in managing immune-mediated diseases and infections in both immunocompetent and immunocompromised individuals. In this review, we examine pidotimod's pharmacodynamics, summarize clinical evidence from recent studies, and explore its evolving role in modern therapeutic strategies for infectious diseases. Given its safety profile and oral administration, pidotimod holds significant promise not only for preventing infections but also as part of a broader immunomodulatory approach in complex disease management.}, }
@article {pmid40937475, year = {2026}, author = {Smith, LK and Khor, K and McGrail, M and Lizarondo, L and Ford, M and Sangelaji, B and Martin, P}, title = {Organisational professional support measures to enhance mental health and wellbeing in female healthcare workers: an umbrella review.}, journal = {Journal of health organization and management}, volume = {40}, number = {3}, pages = {567-594}, doi = {10.1108/JHOM-04-2025-0181}, pmid = {40937475}, issn = {1758-7247}, mesh = {Humans ; *Health Personnel/psychology ; Female ; *Mental Health ; *Social Support ; }, abstract = {PURPOSE: This study aims to synthesise evidence on organisational professional support measures that enhance female healthcare workers' mental health and wellbeing. Female healthcare workers face high rates of mental health challenges, impacting their ability to provide optimal care.
DESIGN/METHODOLOGY/APPROACH: This umbrella review adhered to the nine-step pathway to conducting umbrella reviews by Cant et al. (2022) and reported following the Preferred Reporting Items for Overview of Reviews checklist (Pollock, 2019). A search of Embase, Medline, CINAHL via EBSCO and the Cochrane Library for English language papers from January 2011 onwards was conducted (search date: February 2024). Following an identification of relevant papers and data extraction, themes were developed using a narrative synthesis approach.
FINDINGS: In total, 32 systematic reviews met the inclusion criteria. From the data synthesis, four themes were developed, namely lack of studies specific to female healthcare workers, diversity and variability of interventions, interventions best related to staff outcomes versus organisational outcomes and social connections at work can be supportive or stressful.
ORIGINALITY/VALUE: Evidence supports that person-directed interventions including cognitive-behavioural therapy and relaxation measures may enhance staff-level outcomes. In contrast, organisation-directed interventions such as clinical supervision and mentoring, or a combination of person- and organisation-centred interventions, appear to enhance both staff and organisational outcomes. Limitations in existing studies highlight the need for improved research conduct and reporting.}, }
@article {pmid40939094, year = {2025}, author = {Wang, Y and Zhang, C and Zhang, Y and Zhang, Z}, title = {The Cerebral Haemorrhage and SARS-CoV-2: An Emerging Virus From a Meta-Analysis Perspective.}, journal = {Reviews in medical virology}, volume = {35}, number = {5}, pages = {e70069}, pmid = {40939094}, issn = {1099-1654}, mesh = {Humans ; *Cerebral Hemorrhage/epidemiology/virology/etiology ; *COVID-19/complications/virology/epidemiology ; Risk Factors ; *SARS-CoV-2/pathogenicity ; }, abstract = {The central nervous system is a potential target of the COVID-19 virus, and one of the devastating neurological consequences of this infection is cerebral haemorrhage (ICH). Cerebral haemorrhage is a leading cause of death worldwide. This study aimed to systematically review and analyse the existing literature on this topic and provide insights into the potential neurological consequences of COVID-19. A comprehensive search was conducted across the PubMed, Scopus, Web of Science, and Embase databases to extract relevant published data up to February 2025. This meta-analysis included 11 studies involving a total of 197,060 individuals. Subgroup analyses were performed based on the year of publication, hospital sampling wards, and study design. A critical appraisal was carried out using the Newcastle-Ottawa Scale (NOS) score. Risk was utilised as a measure of pooled effect size based on a random-effects model. In this analysis, we identified 11 articles that directly assessed the risk of cerebral haemorrhage. The reported risk of cerebral haemorrhage was five cases per 10,000 COVID-19 patients [0.005 (95% CI: 0.002-0.009), p < 0.001]. Notably, studies published in 2022 and 2023 indicated a significantly higher risk of cerebral haemorrhage compared to earlier years. COVID-19 patients admitted to the intensive care unit (ICU) faced an increased risk of cerebral haemorrhage compared to those admitted to general wards. Meta-regression analysis revealed a statistically significant association between the risk of cerebral haemorrhage and the type of wards in a hospital [0.0089 (95% CI: 0.0067-0.0112), p < 0.001], as well as the year of publication [0.0004 (95% CI: 0.0003-0.0008), p = 0.048]. Therefore, it is essential to evaluate COVID-19 patients admitted to the ICU in recent years for the potential occurrence of cerebral haemorrhage.}, }
@article {pmid40939529, year = {2025}, author = {Saidoune, F and Yatim, A and Di Domizio, J and Gilliet, M}, title = {Skin manifestations of SARS-CoV-2 infection and its vaccination.}, journal = {Current opinion in immunology}, volume = {97}, number = {}, pages = {102656}, doi = {10.1016/j.coi.2025.102656}, pmid = {40939529}, issn = {1879-0372}, mesh = {Humans ; *COVID-19/immunology/prevention & control/complications ; *SARS-CoV-2/immunology ; *COVID-19 Vaccines/immunology/adverse effects ; Vaccination/adverse effects ; Interferon Type I/immunology/metabolism ; *Skin/immunology/pathology/virology ; Animals ; Dendritic Cells/immunology ; *Skin Diseases/immunology/etiology ; }, abstract = {SARS-CoV-2 infection and vaccination are associated with a broad range of skin manifestations, including chilblains, urticaria, morbilliform and papulovesicular rashes, purpuric-necrotic lesions, and autoimmune flares. These patterns reflect differences in the timing and nature of type I interferon (IFN-I) responses. Rapid TLR7-mediated IFN-I production by plasmacytoid dendritic cells (pDCs) in the upper airways restricts viral replication; hyperresponsive pDCs protect from severe infection but may cause chilblain-like lesions through exaggerated local inflammation. When early IFN-I responses are weak, viral spread to the lungs triggers endothelial cell death, mitochondrial DNA release, and cyclic GMP-AMP synthase (cGAS)-stimulator of interferon genes (STING) activation, producing a late IFN-I surge that amplifies inflammation, mirrored by morbilliform, vesicular, or necrotic skin lesions. mRNA and viral vector vaccines can similarly activate nucleic acid sensors, inducing IFN-I-driven rashes, and promote spike-specific T cells that cross-react with skin antigens. Recognizing these cutaneous signs offers insight into the balance between protective and pathogenic immunity in COVID-19.}, }
@article {pmid40939863, year = {2025}, author = {Filipczak, N and Yalamarty, SSK and Li, X and Pathrikar, TV and Pinapati, R and Vanjara, B and Torchilin, V}, title = {Neutrophil extracellular traps: Formation, pathological roles, and nanoparticle-based therapeutic targeting strategies.}, journal = {Journal of controlled release : official journal of the Controlled Release Society}, volume = {387}, number = {}, pages = {114220}, doi = {10.1016/j.jconrel.2025.114220}, pmid = {40939863}, issn = {1873-4995}, mesh = {*Extracellular Traps/drug effects/immunology ; Humans ; Animals ; *Neutrophils/immunology/drug effects ; *Nanoparticles/administration & dosage ; Inflammation/drug therapy/immunology ; Drug Delivery Systems ; }, abstract = {Neutrophil extracellular traps (NETs) are large, web-like DNA structures released by neutrophils, coated with histones and antimicrobial proteins. They serve as a crucial defense mechanism for neutrophils against microbial invasion, playing a significant role in eliminating microorganisms such as bacteria, fungi, and viruses. While NETs are primarily recognized for their role in microbial defense, growing evidence indicates that excessive NET formation, triggered by physical and chemical stimuli, pathogens, or pathological factors, can worsen inflammation and cause organ damage. Understanding NETs' presence in various tissues and body fluids is crucial for elucidating their contribution to disease etiopathogenesis. By designing nanoparticles that can either prevent NET formation or facilitate their degradation, researchers aim to mitigate the harmful effects of excessive NETs. These nanotechnological interventions can be tailored to specifically target the molecular components of NETs, enhancing treatment precision and efficacy. Furthermore, nanoparticles can deliver therapeutic agents directly to inflammation sites, reducing systemic side effects and improving patient outcomes. This review summarizes the role of NETs in various pathologies, focusing on strategies to inhibit NETosis, including mechanisms of pathogen evasion, and the use of nanodelivery systems to enhance the efficiency of NETs inhibition or removal.}, }
@article {pmid40940092, year = {2025}, author = {Saadi, S and Nacer, NE and Boughellout, H and Benyahia, FA and Faiza, A and Anwar, F and Ariffin, AA and Boudjellal, A and Ghazali, HM and Saari, N and Mohammed, AS}, title = {Advances in microbial C-reactive peptides as pro-sensors for antibiotic release and membrane driving potentials.}, journal = {Advances in food and nutrition research}, volume = {116}, number = {}, pages = {409-500}, doi = {10.1016/bs.afnr.2025.04.012}, pmid = {40940092}, issn = {1043-4526}, mesh = {*Anti-Bacterial Agents/pharmacology/analysis ; Humans ; *C-Reactive Protein/metabolism ; Animals ; Biomarkers ; }, abstract = {The involvement of C-reactive proteins in triggering antibiotic release is important in figuring out the underlaying mechanisms of cellular biomarkers involving the immune reaction and inflammation. Thus, the existence of microbial C-reactive proteins or peptides are getting logical acceptance due to the presence of some homologue peptides into microbes capable in triggering same inflammatory response levels like to that happening into mammalian cells. The objective of this chapter is to study in depth the mechanization of microbial C-reactive proteins/peptides for allowing the release of de novo antibiotics capable in competing the penicillin mechanism of action. Therefore, series of plasmo-dynamic markers are beared in mind and studied including the role of anti-inflammatory peptides, peptide transporters, opioid peptides, cell penetrating peptides and other static membrane markers including Toll-like receptor, and G-protein coupled receptors. These cellular biomarkers are studied in light of their mechanizations toward the release of commonly known classes of antibiotics including antiviral, antifungal, and antimicrobial ones. The chapter is also covering the availability of antibiotics in foods, microbes, biological matrices and in animal cells and tissues as well as the methods of detection and quantification of antibiotics and also the commonly methods used in mitigating those antibiotics when they are present in excessive doses in food materials. In this regard, some engineered models have been developed in order to remove residual traces of antibiotics as mode for food safety purposes. The domain applications of antibiotics as putative cores and therapies used for preventing the burden diseases like Covid-19 pandemia and other complicated transient diseases are also covered. The chapter is shedding light on the mechanization of peptides like antibiotics, microbial resistance against antibiotics, mechanism of antibiotic sensing, peptides-antibiotic interaction, and antibiotic resistance, by projecting lights on some developed biosensors used in detecting these type of substances.}, }
@article {pmid40941488, year = {2025}, author = {Compañ-Gabucio, LM and Moreno-Morente, G and Company-Devesa, V and Torres-Collado, L and García-de-la-Hera, M}, title = {Occupational Therapy Interventions in Mental Health During Lockdown: A Scoping Review.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {17}, pages = {}, pmid = {40941488}, issn = {2227-9032}, abstract = {Lockdown derived from the COVID-19 pandemic posed significant challenges to mental health care, prompting the adaptation of therapeutic practices. The objective of this study was to describe the characteristics and objectives of occupational therapy (OT) interventions conducted in the field of mental health during the COVID-19 lockdown. A scoping review was conducted following PRISMA-ScR guidelines. A systematic search was carried out in the following databases: PubMed, Scopus, Embase, OTSeeker, PsycINFO, and Web of Science. We included randomized or non-randomized intervention studies, published in English or Spanish, that explored OT interventions in mental health during the COVID-19 period and/or lockdown. Data were extracted using pre-designed tables in accordance with the recommendations of the Cochrane Handbook. We included seven articles. OT interventions were conducted via video call (n = 4) and in person (n = 3). These were carried out with adults, adolescents, and children, lasting from 1 to 32 weeks, with the number of sessions ranging from 7 to 22 and lasting 20 to 90 min. The most frequently addressed outcomes were quality of life (n = 4), anxiety or depression (n = 4), and sleep (n = 4). During lockdown, OT interventions were mainly applied via telerehabilitation with the aim of increasing activity participation and addressing emotional issues. These results could help occupational therapists to implement mental health interventions when in-person application is compromised.}, }
@article {pmid40941682, year = {2025}, author = {Cocuz, IG and Niculescu, R and Popelea, MC and Cocuz, ME and Sabău, AH and Tinca, AC and Cozac-Szoke, AR and Chiorean, DM and Budin, CE and Cotoi, OS}, title = {Current Trends and Future Directions of Digital Pathology and Artificial Intelligence in Dermatopathology: A Scientometric-Based Review.}, journal = {Diagnostics (Basel, Switzerland)}, volume = {15}, number = {17}, pages = {}, pmid = {40941682}, issn = {2075-4418}, abstract = {Background: Digital Pathology (DP) and Artificial Intelligence (AI) have strongly developed in recent years, especially in pathology, with a high interest in dermatopathology. Accelerated by the COVID-19 pandemic, DP and AI are now integrated in pathology, research and education, bringing value to histopathological diagnoses, telepathology and personalized medicine. This narrative review presents a comprehensive literature review by defining three research directions, using scientometric analysis, of the current state of DP and AI in pathology and dermatopathology. Methods: The research was conducted through the Pubmed and Web of Science databases, within the research period of January 2019-July 2025: a two-phase methodology. Four independent pathologists selected the articles in accordance with the inclusion and exclusion criteria, and the synthesis of the articles was based on three research directions. Results: The research shows that CNN (Convolutional Neural Network), AI powered diagnostic platforms and telepathology strongly contribute to increasing the speed and accuracy of diagnostics, especially on cutaneous malignant skin tumors. There are still several challenges and limitations in terms of validation, interoperability, initial high implementation costs, ethics and transparency in AI and equity in healthcare. Conclusions: DP and AI are essential pillars of modern dermatopathology, with a high necessity of standardization, regulation and a multidisciplinary approach.}, }
@article {pmid40942842, year = {2025}, author = {Kinyua, DM and Memeu, DM and Mugo Mwenda, CN and Ventura, BD and Velotta, R}, title = {Advancements and Applications of Lateral Flow Assays (LFAs): A Comprehensive Review.}, journal = {Sensors (Basel, Switzerland)}, volume = {25}, number = {17}, pages = {}, pmid = {40942842}, issn = {1424-8220}, mesh = {Humans ; *COVID-19/diagnosis ; SARS-CoV-2/isolation & purification ; Immunoassay/methods ; *Biosensing Techniques/methods ; Limit of Detection ; Nanoparticles/chemistry ; Pandemics ; Nanotechnology ; }, abstract = {Over a decade ago, WHO introduced the ASSURED (Affordable, Sensitive, Specific, User-friendly, Rapid and Robust, Equipment-free, and Deliverable to end-users) criteria to guide diagnostic assay development. Today, lateral flow assays (LFAs) best meet these standards, evolving from simple rapid tests to advanced diagnostics integrating AI and nanotechnology for precise, quantitative results. Notably, nanoparticle-enhanced LFAs have achieved limits of detection (LOD) as low as 0.01 pg/mL (a 100-fold improvement over conventional methods), while AI algorithms have reduced interpretation errors by 40% in low-contrast conditions. The COVID-19 pandemic underscored the societal impact of LFAs, with over 3 billion antigen tests deployed globally, demonstrating 98% specificity in real-world surveillance. Beyond infectious diseases, LFAs are revolutionizing cancer screening through liquid biopsy, achieving a 92% concordance rate with gold-standard assays, food safety and environmental monitoring. Despite these advancements, challenges remain in scalability, reproducibility, sustainable manufacturing, and how to enhance the sensitivities and lower the LOD. However, innovations in biodegradable materials, roll-to-roll printing, CRISPR-integrated multiplexing, and efficient functionalization methods like photochemical immobilization technique offer promising solutions, with projected further cost reductions and scalability. This review highlights the technological evolution, diverse applications, and future trajectories of LFAs, highlighting their critical role in democratizing diagnostics.}, }
@article {pmid40943488, year = {2025}, author = {Patel, S and Foster, C and Patel, K and Hunter, M and Isales, CM and Fulzele, S}, title = {Musculoskeletal Complications in COVID-19: Exploring the Role of Key Biomarkers.}, journal = {International journal of molecular sciences}, volume = {26}, number = {17}, pages = {}, pmid = {40943488}, issn = {1422-0067}, support = {P01 AG036675/AG/NIA NIH HHS/United States ; 3P01AG036675-03/NH/NIH HHS/United States ; }, mesh = {Humans ; *COVID-19/complications/metabolism ; *Biomarkers/metabolism/blood ; *Musculoskeletal Diseases/etiology/metabolism/diagnosis ; SARS-CoV-2 ; Cartilage Oligomeric Matrix Protein/metabolism ; Hyaluronic Acid ; }, abstract = {The COVID-19 pandemic has revealed significant secondary complications affecting musculoskeletal (MSK) health, especially in patients with pre-existing conditions. This review synthesizes data from clinical and experimental studies on key MSK biomarkers, including cartilage oligomeric matrix protein (COMP), hyaluronic acid (HA), osteocalcin, alkaline phosphatase (ALP), procollagen type I N-terminal peptide (PINP), osteopontin (OPN), matrix metalloproteinases (MMP-3 and MMP-9), myostatin, IGF-1, follistatin, and creatine kinase. COVID-19 is associated with decreased COMP and osteocalcin levels, indicating cartilage degradation and impaired bone formation, alongside elevated HA, ALP, PINP, OPN, and MMPs, reflecting increased joint inflammation, bone remodeling, and tissue breakdown. Changes in myostatin, IGF-1, follistatin, and creatine kinase levels have been shown to be linked with COVID-19-related sarcopenia. These biomarker alterations provide insight into the underlying mechanisms of MSK damage in COVID-19 patients and highlight the potential for using these markers in early diagnosis and management of post-COVID musculoskeletal disorders. Further longitudinal research is essential to develop targeted therapies aimed at mitigating long-term MSK complications in affected individuals.}, }
@article {pmid40943770, year = {2025}, author = {Var, SR and Maeser, N and Blake, J and Zahs, E and Deep, N and Vasilakos, Z and McKay, J and Johnson, S and Strell, P and Chang, A and Korthas, H and Krishna, V and Narayanan, M and Arju, T and Natera-Rodriguez, DE and Roman, A and Schulz, SJ and Shetty, A and Vernekar, M and Waldron, MA and Person, K and Cheeran, M and Li, L and Low, WC}, title = {Pulmonary and Immune Dysfunction in Pediatric Long COVID: A Case Study Evaluating the Utility of ChatGPT-4 for Analyzing Scientific Articles.}, journal = {Journal of clinical medicine}, volume = {14}, number = {17}, pages = {}, pmid = {40943770}, issn = {2077-0383}, support = {R01 AG077772/AG/NIA NIH HHS/United States ; RF1 AG077772/AG/NIA NIH HHS/United States ; AG077772/NH/NIH HHS/United States ; }, abstract = {Coronavirus disease 2019 (COVID-19) in adults is well characterized and associated with multisystem dysfunction. A subset of patients develop post-acute sequelae of SARS-CoV-2 infection (PASC, or long COVID), marked by persistent and fluctuating organ system abnormalities. In children, distinct clinical and pathophysiological features of COVID-19 and long COVID are increasingly recognized, though knowledge remains limited relative to adults. The exponential expansion of the COVID-19 literature has made comprehensive appraisal by individual researchers increasingly unfeasible, highlighting the need for new approaches to evidence synthesis. Large language models (LLMs) such as the Generative Pre-trained Transformer (GPT) can process vast amounts of text, offering potential utility in this domain. Earlier versions of GPT, however, have been prone to generating fabricated references or misrepresentations of primary data. To evaluate the potential of more advanced models, we systematically applied GPT-4 to summarize studies on pediatric long COVID published between January 2022 and January 2025. Articles were identified in PubMed, and full-text PDFs were retrieved from publishers. GPT-4-generated summaries were cross-checked against the results sections of the original reports to ensure accuracy before incorporation into a structured review framework. This methodology demonstrates how LLMs may augment traditional literature review by improving efficiency and coverage in rapidly evolving fields, provided that outputs are subjected to rigorous human verification.}, }
@article {pmid40943962, year = {2025}, author = {Păcurar, D and Dinulescu, A and Prejmereanu, A and Palcău, AC and Dijmărescu, I and Pavelescu, ML}, title = {Neurodevelopmental Outcomes in Children Born to Mothers Infected with SARS-CoV-2 During Pregnancy: A Narrative Review.}, journal = {Journal of clinical medicine}, volume = {14}, number = {17}, pages = {}, pmid = {40943962}, issn = {2077-0383}, abstract = {Background: The potential impact of maternal SARS-CoV-2 infection during pregnancy on the neurodevelopment of offspring has raised considerable concern. Emerging studies have evaluated various developmental domains in exposed infants, yet findings remain inconsistent. Objective: To synthesize current evidence regarding neurodevelopmental outcomes in infants born to mothers with confirmed SARS-CoV-2 infection during pregnancy. Methods: We conducted a narrative review following PRISMA guidelines. A literature search was performed in PubMed, Cochrane, and ScienceDirect using keywords including "COVID-19", "pregnancy", "neurodevelopment", and "SARS-CoV-2". Nineteen studies were included. Data were extracted regarding study design, sample size, timing of exposure, age at assessment, developmental tools used, and key findings. Study quality was assessed using the Newcastle-Ottawa Scale. Results: Among 19 included studies, 12 reported at least some neurodevelopmental delays, particularly in motor and language domains. However, these delays were generally mild, domain-specific, and often not statistically significant. Seven studies, most of which were high-quality and low-risk, reported no significant differences between exposed and unexposed groups. Assessment tools and follow-up durations varied widely, limiting comparability. Conclusions: Current evidence does not support a consistent association between in utero SARS-CoV-2 exposure and an unfavorable neurodevelopmental outcome up to 24 months. However, heterogeneity in methods and short-term follow-up warrant further high-quality longitudinal research.}, }
@article {pmid40944962, year = {2025}, author = {Yong, SJ and Kenny, TA and Halim, A and Munipalli, B and Alhashem, YN and AlSaihati, H and Al-Subaie, MF and Al Kaabi, NA and Al Fares, MA and Garout, M and Sabour, AA and Alshiekheid, MA and Almansour, ZH and Alotaibi, J and Alrasheed, HA and Alamri, AA and Albayat, H and Alamodi, AS and Tombuloglu, H and Mohapatra, RK and Hazazi, A and Rabaan, AA}, title = {Post-COVID-19 Vaccination (or Long Vax) Syndrome: Putative Manifestation, Pathophysiology, and Therapeutic Options.}, journal = {Reviews in medical virology}, volume = {35}, number = {5}, pages = {e70070}, doi = {10.1002/rmv.70070}, pmid = {40944962}, issn = {1099-1654}, mesh = {Humans ; *COVID-19 Vaccines/adverse effects ; *COVID-19/prevention & control/immunology ; *Vaccination/adverse effects ; SARS-CoV-2/immunology ; Fatigue Syndrome, Chronic ; Syndrome ; }, abstract = {With the global rollout of COVID-19 vaccines, vaccine safety remains a priority. Emerging concerns have raised the potential risk of a long COVID-like syndrome following vaccination, informally called long Vax and provisionally termed post-COVID-19 vaccination syndrome (PCVS). Our narrative review describes the putative manifestation, pathophysiology, and therapeutic approaches of PCVS based on the available evidence, mostly from case reports/series and observational studies. Our review noted that PCVS typically manifests within days to weeks post-vaccination, with symptoms lasting months to years. PCVS may present as recognized diagnoses such as postural orthostatic tachycardia syndrome (POTS), small-fibre neuropathy (SFN), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), or as long-term sequelae of myocarditis, vaccine-induced thrombotic thrombocytopaenia (VITT), or immune thrombocytopaenia purpura (ITP). Symptomatically, PCVS overlaps with long COVID, such as fatigue and brain fog, but PCVS may involve more frequent paraesthesia and less dyspnoea. We also review pathophysiological hypotheses of PCVS, focussing on the vaccine-derived spike protein and related immune responses. Finally, we discuss potential therapies used to treat patients with PCVS or related conditions, primarily documented in case reports/series, which could guide future clinical research. Overall, PCVS remains a poorly understood condition that requires more research to elucidate its prevalence, prognosis, risk factors, and treatments.}, }
@article {pmid40945038, year = {2025}, author = {Li, Y and Fan, G and He, H}, title = {Urogenital manifestations of SARS-CoV-2, MPXV and Zika virus: A comprehensive review.}, journal = {Molecular aspects of medicine}, volume = {106}, number = {}, pages = {101399}, doi = {10.1016/j.mam.2025.101399}, pmid = {40945038}, issn = {1872-9452}, mesh = {Humans ; SARS-CoV-2 ; *COVID-19/complications/virology ; *Zika Virus/pathogenicity/physiology ; *Zika Virus Infection/complications/virology/pathology ; *Urogenital System/virology/pathology ; Angiotensin-Converting Enzyme 2/metabolism ; Male ; Pandemics ; }, abstract = {The current century has been associated with the outbreaks of emerging and re-emerging viral infections such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), monkeypox virus (MPXV), and Zika virus (ZIKV). Although their common clinical manifestations are currently well-known, the urogenital system is gaining attention as a significant, though often underappreciated, anatomical site for emerging and re-emerging viral infections, disease development, and transmission. The present review aims to comprehensively discuss the urogenital complications linked to the infections caused by these viruses, with a primary focus on describing their suggested and established roles in the development of urogenital sequelae. It reviews various molecular and cellular mechanisms, such as direct viral pathogen cytopathic activity, virally-mediated inflammation, and the nephrotoxic side effects of specific medications, by which SARS-CoV-2, MPXV, and ZIKV may affect various parts of the urogenital system. In this context, SARS-CoV-2 uses angiotensin-converting enzyme 2 (ACE2) for cell entry, which is frequently present in the urogenital tissues, resulting in urogenital injuries. Zika virus exhibits a distinct tropism for the male reproductive tract, demonstrating prolonged viral persistence in semen that facilitates sexual transmission and is linked to testicular damage and adverse congenital outcomes. The present study also addresses diagnostic considerations and therapeutic strategies in the context of urogenital sequelae associated with these viruses. Understanding the intricate molecular basis of these viral-caused sequelae is crucial for improving differential diagnosis and introducing targeted therapeutic strategies.}, }
@article {pmid40945384, year = {2025}, author = {Muzaffar, U and Fakiruddin, KS and Talebiashtiany, Y and Abdullah, S}, title = {Delving deeper in the eye of the hurricane: Immunopathogenesis & molecular characterization of cytokine storm in COVID-19, association with disease severity & the therapeutic regimens.}, journal = {Cytokine}, volume = {195}, number = {}, pages = {157025}, doi = {10.1016/j.cyto.2025.157025}, pmid = {40945384}, issn = {1096-0023}, mesh = {Humans ; *COVID-19/immunology/complications/pathology/therapy ; *Cytokine Release Syndrome/immunology/therapy/pathology ; *SARS-CoV-2/immunology ; Cytokines/immunology/metabolism ; Severity of Illness Index ; Immunity, Innate ; }, abstract = {The COVID-19 pandemic elicited by SARS-CoV-2 has led to a world-wide crisis, affecting a substantial percentage of the entire global population, and has engendered profound morbidity and fatalities. SARS-CoV-2 mediates its entry into human respiratory epithelial cells via interaction between viral Spike protein (S) and ACE2 receptor and enacts the host cell tropism by numerous molecular factors and inflammatory signaling pathways. The complex molecular immunopathogenesis involves loss of regulatory control of the generation & release of proinflammatory cytokines at both local as well as systemic levels. Excessive secretion of pro-inflammatory cytokines and chemokines leads to the dysregulation of the innate immune system leading to the cytokine storm. Owing to the enormous release of inflammatory factors and active mediators, cytokine storm induces severe damage to secondary tissues, leading to Acute Respiratory Distress Syndrome (ARDS) or multiple-organ failure, which evokes aggravation of the disease and eventually death. Comparisons amid COVID-19 cytokine storm and several other types of cytokine storm associated diseases, gives proper insights about the etiology of cytokine storm in COVID-19. Various genetic and physiological factors contribute to severe disease progression and aggravation of the disease. In that view, several immunoregulatory therapies have been tailored to curb the cytokine storm, which might be crucial in improving the success rates of various treatment strategies as well as in lowering the mortality rate in COVID-19 patients. This review elucidates the hallmarks of COVID-19 cytokine storm, immunopathogenesis, disease progression, biomarkers, and therapeutic interventions.}, }
@article {pmid40945593, year = {2026}, author = {Cao, Z and Soleimani Samarkhazan, H}, title = {Immature platelet fraction in cardiology.}, journal = {Clinica chimica acta; international journal of clinical chemistry}, volume = {579}, number = {}, pages = {120600}, doi = {10.1016/j.cca.2025.120600}, pmid = {40945593}, issn = {1873-3492}, mesh = {Humans ; *Blood Platelets/metabolism/cytology ; *Cardiovascular Diseases/blood/diagnosis ; COVID-19/blood ; *Cardiology ; Biomarkers/blood ; }, abstract = {Cardiovascular diseases (CVDs) remain a leading global cause of mortality, necessitating biomarkers that enhance risk stratification and therapeutic personalization. The Immature Platelet Fraction (IPF), representing young, RNA-rich platelets (also known as reticulated platelets, RP) released from bone marrow, has emerged as a dynamic biomarker linking platelet turnover to cardiovascular pathophysiology. Clinically, elevated IPF is associated with adverse outcomes in acute coronary syndromes (ACS), myocardial infarction, and post-cardiac surgery, particularly when measured 24-72 hours after the event or post-operatively. It correlates with infarct size, recurrent thrombosis, and major adverse cardiovascular events (MACE), though its predictive value is inconsistent at the initial clinical encounter. Its rise reflects compensatory thrombopoiesis in hypercoagulable states like diabetes, COVID-19, and malignancy. IPF also informs antiplatelet therapy, high IPF correlates with clopidogrel resistance but not ticagrelor, guiding agent selection and dual antiplatelet therapy (DAPT) duration. Despite standardization challenges across measurement platforms (flow cytometry vs. automated analyzers), IPF outperforms mean platelet volume (MPV) in tracking platelet activity. Future directions include point-of-care IPF devices, multi-marker panels, and novel therapies targeting thrombopoiesis. Integrating IPF into clinical practice promises refined risk assessment, personalized treatment, and improved prognostic precision in cardiology, bridging translational innovation to patient care. This review synthesizes current evidence on IPF's role in CVDs, highlighting its molecular characteristics, elevated prothrombotic mediators (e.g., thromboxane A2, P-selectin), heightened reactivity, and rapid response to inflammatory stimuli.}, }
@article {pmid40946682, year = {2025}, author = {de Castro, AA and Assis, LC and Appel, RJC and da Cunha, EFF and Nepovimova, E and Kuca, K and Ramalho, TC and La Porta, FA}, title = {Nanoparticles and bioactive materials against COVID-19 and its variants: Hints from a computational-materials design perspective.}, journal = {Computers in biology and medicine}, volume = {197}, number = {Pt B}, pages = {111046}, doi = {10.1016/j.compbiomed.2025.111046}, pmid = {40946682}, issn = {1879-0534}, mesh = {Humans ; *COVID-19/virology ; *SARS-CoV-2/drug effects ; Pandemics ; *Nanoparticles/chemistry/therapeutic use ; *Antiviral Agents/therapeutic use/chemistry ; *COVID-19 Drug Treatment ; *Pneumonia, Viral/drug therapy/virology ; *Coronavirus Infections/drug therapy ; Drug Design ; *Betacoronavirus/drug effects ; }, abstract = {Society currently faces many challenges caused by the coronavirus outbreak, known as SARS-CoV-2, and in addition, its variant strains tend to be still more aggressive. Therefore, there is an enormous need to accelerate the development of novel remediation techniques against SARS-CoV-2. A literature review focusing on key terms such as 'COVID-19', 'SARS-CoV-2', 'pharmacotherapy', 'pandemic', 'nanotechnology' and 'computational-materials design', accentuates the increased role played by in silico models in developing prevention, diagnosis, and the treatment strategies. In an attempt to help in the front line, computational repositioning of drugs has intensively been explored as a well-established strategy in preclinical research in order to discover an effective therapy for SARS-CoV-2 infection. Furthermore, computational-materials design-which integrates principles of materials science, physics, chemistry, and computer science-has emerged as an indispensable approach in the fight against COVID-19, accelerating the development of novel nanomaterials and bioactive compounds, and optimizing existing drugs for enhanced efficacy against the virus and its variants. Overall, in this review, we have demonstrated the vital role of computational-materials design strategies in diverse applications (such as diagnostics, vaccines, and treatments, as well as in understanding the fundamental mechanisms of the virus and its interactions with various advanced materials) to handle the current pandemic and pave the way toward future preparedness against emerging infectious disease outbreaks.}, }
@article {pmid40947117, year = {2025}, author = {Weber, SB}, title = {Grappling with Judicial Discretion in Complex Times.}, journal = {The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics}, volume = {53}, number = {3}, pages = {433-434}, doi = {10.1017/jme.2025.10152}, pmid = {40947117}, issn = {1748-720X}, mesh = {Humans ; *COVID-19/epidemiology ; United States/epidemiology ; SARS-CoV-2 ; Pandemics ; *Judicial Role ; }, abstract = {When areas of the law are ambiguous or untested, such as in the compassionate release cases that proliferated during the height of the COVID-19 pandemic, district judges must rely on their discretion to fill in legal gaps. Discretion can be beneficial, because it means that it allows district judges to consider factors that may lead to potentially harmful outcomes for litigants or their communities. But discretion is imperfect, particularly in the face of ethically or factually complex problems. Perhaps a place to start with addressing this difficulty is greater transparency about the benefits and limitations of discretion.}, }
@article {pmid40947624, year = {2025}, author = {Liu, S and Shao, C and Ding, Y and Wang, Y and Jin, L and Tan, DA and Li, S and Deng, X and Zhou, Y and Xia, Z}, title = {Ubiquitination: A Double-Edged Mechanism in Coronavirus Infections.}, journal = {Journal of medical virology}, volume = {97}, number = {9}, pages = {e70589}, doi = {10.1002/jmv.70589}, pmid = {40947624}, issn = {1096-9071}, support = {//This study was supported by the National Natural Science Foundation of China (U21A20384), the Science and Technology Innovation Program of Hunan Province (2024WZ9001), China Tobacco Hunan Indtstrial Co. Ltd. (KY2024JC0008), Beijing Life Science Academy (BLSA) (2024100CB0170), and the Central South University Graduate Research Innovation Project (2023ZZTS0944, 2025ZZTS0927)./ ; }, mesh = {Humans ; *Ubiquitination ; *SARS-CoV-2/pathogenicity ; *COVID-19/virology/metabolism ; Host-Pathogen Interactions ; Ubiquitin/metabolism ; Virus Replication ; Proteasome Endopeptidase Complex/metabolism ; *Coronavirus Infections/virology/metabolism ; Animals ; Immunity, Innate ; Protein Processing, Post-Translational ; Viral Proteins/metabolism ; Antiviral Agents/pharmacology/therapeutic use ; }, abstract = {The emergence of SARS-CoV-2 in late 2019 had a profound impact on public health, leading to the global COVID-19 pandemic. This viral outbreak has significantly heightened interest in coronaviruses, accelerating research into their pathogenesis. Ubiquitination, a common Posttranslational protein modification, plays a crucial role in processes such as protein localization, metabolism, and degradation. During coronavirus invasion and disease progression, complex interactions involving ubiquitination are at play. On one hand, the host utilizes ubiquitination to activate innate immune signaling pathway or degrade crucial viral proteins via the ubiquitin-proteasome pathway, thereby inhibiting viral replication. On the other hand, coronaviruses manipulate ubiquitination to suppress the activation of key antiviral molecules or promote their degradation. Thus, both the host and virus leverage ubiquitination to their advantage. Thus, investigating the role of ubiquitination in coronavirus infection provides crucial insights into viral infection mechanisms and pathogenesis, potentially facilitating the development of novel antiviral drugs, particularly those targeting ubiquitination regulation, such as PROTAC. This paper offers a comprehensive examination of the regulatory function of ubiquitination in coronavirus infection, with the potential to advance research in the field and open new avenues for the effective control of coronaviruses, especially SARS-CoV-2.}, }
@article {pmid40948395, year = {2025}, author = {González Corralejo, C and Culebras López, E and Martínez Rodríguez, M and Delgado-Iribarren García-Campero, A}, title = {Analysis of Respiratory Syncytial Virus cases at Hospital Clínico San Carlos in Madrid during 2018-2025.}, journal = {Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia}, volume = {38}, number = {5}, pages = {426-430}, pmid = {40948395}, issn = {1988-9518}, mesh = {Humans ; *Respiratory Syncytial Virus Infections/epidemiology/prevention & control ; Spain/epidemiology ; Infant ; Incidence ; Child, Preschool ; COVID-19/epidemiology ; Seasons ; Child ; Aged, 80 and over ; Aged ; Respiratory Syncytial Virus, Human ; Infant, Newborn ; Adolescent ; Middle Aged ; Male ; Female ; Adult ; }, abstract = {Respiratory syncytial virus (RSV) infection is one of the main causes of morbidity and mortality in infants under 6 months of age; however, it can cause respiratory infection at other stages of life. In the period 2018-2025, the number of cases has risen considerably, with positivity mainly concentrated in children under 24 months of age. The SARS-CoV2 pandemic caused modifications in affected population groups and seasonality. The percentage of RSV in children under 6 months of age in the period 2024-2025 was significantly lower than in the 2023-2024 season. In contrast, in the elderly population, especially those over 86 years of age, the percentage of positive cases has increased significantly. From 2022 onwards, the incidence of virus positivity shows a more stable and sustained pattern from October to April compared to previous years. The aim of this review is to assess the evolution of the type of patient diagnosed with RSV infection and to determine early whether the beginning of the vaccination campaign has reduced the incidence in the susceptible population. The availability of epidemiological information to guide decision-making is of great importance for evaluating the effectiveness of these measures and adopting changes in the use of vaccination in the general population.}, }
@article {pmid40948783, year = {2025}, author = {Tabakov, DV and Maznina, AA and Astakhova, EA and Egorova, AE and Zakharova, EN and Glushkova, OV and Petriaikina, ES and Svetlichnyy, DV and Krupinova, JA and Bogdanov, VP and Yudin, VS and Keskinov, AA and Yudin, SM and Woroncow, M and Skvortsova, VI and Volchkov, PY}, title = {Diagnosis of cancer, autoimmune and infectious diseases and prediction of the therapy effectiveness based on the individual's immunotype.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1658970}, pmid = {40948783}, issn = {1664-3224}, mesh = {Humans ; *Neoplasms/diagnosis/immunology/therapy ; *Autoimmune Diseases/diagnosis/immunology/therapy ; COVID-19/immunology/diagnosis ; *Communicable Diseases/diagnosis/immunology/therapy ; SARS-CoV-2/immunology ; Biomarkers ; Prognosis ; Treatment Outcome ; Immunotherapy ; }, abstract = {Immune system plays a central role in the pathogenesis of cancer and autoimmune diseases. An entire field has emerged to identify separate minor cell subpopulations carrying potential molecular targets or activation markers to study their prognostic role in disease progression and severity or predictive potential to use immunotherapy. However, the biomarker potential of minor populations is limited, as it does not take into account systemic interactions between populations of the immune system. A number of studies in the COVID era have shown that the certain balance between immune cell populations in donor's blood, called 'immunotype', can predict the outcome of treatment and the onset of a cytokine storm. This observation was extended to other diseases, including cancer and autoimmunity. It was shown that the immunotype can be used to diagnose both the presence of the disease itself, as well as its form or progression, to stratify patients in the risk groups and to predict the effectiveness of therapy. The most important advantages of immunotype-based diagnostics are its low invasiveness, the possibility of multiple biomaterial sampling, and the complexity of the analysis by the simultaneous assessment of blood cell composition and their functional activity. In this review, we summarize currently available studies of immunotypes and defined key subpopulations, their possible impact in diagnostics and personalization of the therapy in clinical routine practice in various diseases.}, }
@article {pmid40949107, year = {2025}, author = {Mbambara, S and Modipane, N and Serite, T and Sathekge, M and Kgatle, M}, title = {The role of aryl hydrocarbon receptor signalling in COVID-19 pathology and its therapeutic potential.}, journal = {Frontiers in molecular medicine}, volume = {5}, number = {}, pages = {1599785}, pmid = {40949107}, issn = {2674-0095}, abstract = {Coronavirus disease 2019 (COVID-19), caused by the betacoronavirus SARS-CoV-2, emerged in Wuhan, China, and rapidly evolved into a global health crisis. Recent evidence highlights the activation of the aryl hydrocarbon receptor (AHR) pathway following SARS-CoV-2 infection, implicating AHR in facilitating viral replication and impairing antiviral immunity. As a ligand-dependent transcription factor, AHR regulates immune responses, cellular differentiation, and proliferation, and is frequently exploited by viruses to evade host defences. In relation to COVID-19, AHR activation drives immune suppression, systemic inflammation, and metabolic disturbances, intensifying disease severity. Notably, in individuals with comorbidities such as obesity and diabetes, AHR overactivity exacerbates insulin resistance, oxidative stress, endothelial dysfunction, and thrombotic risk, contributing to cardiovascular complications. AHR also promotes airway remodelling and mucus hypersecretion, fostering respiratory dysfunction and fibrotic progression. This review synthesizes current insights into the mechanistic role of AHR signalling in SARS-CoV-2 pathogenesis and discusses its potential as a target for host-directed therapeutic interventions.}, }
@article {pmid40949164, year = {2025}, author = {Roczkowsky, A and Rachubinski, RA and Hobman, TC and Power, C}, title = {Peroxisomes as emerging clinical targets in neuroinflammatory diseases.}, journal = {Frontiers in molecular neuroscience}, volume = {18}, number = {}, pages = {1642590}, pmid = {40949164}, issn = {1662-5099}, abstract = {Peroxisomes are membrane-bounded organelles that contribute to a range of physiological functions in eukaryotic cells. In the central nervous system (CNS), peroxisomes are implicated in several vital homeostatic functions including, but not limited to, reactive oxygen species signaling and homeostasis; generation of critical myelin sheath components (including ether phospholipids); biosynthesis of neuroprotective docosahexaenoic acid; breakdown of neurotoxic metabolites (such as very-long chain fatty acids); and, intriguingly, glial activation and response to inflammatory stimuli. Indeed, peroxisomes play a critical role in modulating inflammatory responses and are key regulators of the mitochondrial antiviral signaling (MAVS) protein-mediated response to infections. The importance of peroxisomes in CNS physiology is exemplified by the peroxisome biogenesis disorders (PBDs), a spectrum of inherited disorders of peroxisome assembly and/or abundance, that are characterized in part by neurological manifestations ranging from severe cerebral malformations to vision and hearing loss, depending on the individual disorder. Recently, peroxisome dysfunction has been implicated in neurological diseases associated with neuroinflammation including Alzheimer's disease, amyotrophic lateral sclerosis, multiple sclerosis, and Parkinson's disease while also contributing to the pathogenesis of neurotropic viruses including SARS-CoV-2, Human Pegivirus, HIV-1 and Zika virus. In the present review, we examine the diverse roles that peroxisomes serve in CNS health before reviewing more recent studies investigating peroxisome dysfunction in inflammatory brain disorders and also highlight potential peroxisomal targets for diagnostic biomarkers and therapeutic interventions.}, }
@article {pmid40949166, year = {2025}, author = {Albazah, NIJ and Tiong, JS and Yoshana, M and Aishath, A and Yeo, YT and Elhariri, S}, title = {Prognosis of patients with coronavirus disease with or without anosmia: A systematic review.}, journal = {Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia}, volume = {20}, number = {}, pages = {54}, pmid = {40949166}, issn = {1985-207X}, abstract = {INTRODUCTION: According to numerous research, anosmia has been reported more frequently as one of coronavirus disease (COVID-19) symptoms. However, whether anosmia is a relevant prognostic factor of COVID-19 outcomes is still unknown. A systematic review and meta-analysis were conducted to evaluate the relationship between anosmia and COVID-19 prognosis.
METHODS: PubMed, PubMed Central, Google Scholar and the WHO COVID-19 Research Database were scanned for published literature from September 2021 to December 2022 about the prognosis of patients positive for COVID-19 with anosmia. 'COVID-19' and 'prognosis' were among the search terms used. Pooled estimates of odds ratios (ORs) were then calculated by comparing patients with and without anosmia in terms of intensive care unit (ICU) admission and death.
RESULTS: A total of 16 full-text articles were included in this systematic review. There were a total of 40 deaths among the patients with olfactory dysfunction and 1681 deaths among those without olfactory dysfunction, with an OR of 0.19 (95% confidence interval: 0.10, 0.34; P<0.0001), indicating that the patients with COVID-19 with olfactory dysfunction had a decreased mortality rate.
CONCLUSION: The good prognosis of patients with COVID-19 with anosmia is demonstrated in our study by the low mortality rate in those with anosmia. However, there is no association between the prognosis and ICU admission among patients with COVID-19 with anosmia.}, }
@article {pmid40949643, year = {2024}, author = {Ramathebane, MM and Maja, LJ and Lets'olo, M and Monts'i, S}, title = {Reviewing the availability and integration of community health information system for HIV/AIDS in Lesotho.}, journal = {Journal of the colleges of medicine of South Africa}, volume = {2}, number = {1}, pages = {3}, pmid = {40949643}, issn = {2960-110X}, abstract = {BACKGROUND: Universal Health Coverage (UHC) is an integral part of the Sustainable Development Goals, with community-based services playing a crucial role. Various stakeholders contribute to human immunodeficiency virus (HIV) interventions, which must be documented and shared with others for informed decision-making.
AIM: This study aims to review the availability of a community health information system (CHIS) in Lesotho and its integration between the Ministry of Health (MOH) and the National AIDS Commission (NAC).
SETTING: The study is based on the Ministry of Health and the National AIDS Commission in Maseru, Lesotho.
METHOD: A scoping review used peer-reviewed articles, documents from MOH and NAC, and other relevant reports from non-governmental organisations. The community information systems were examined for inclusion of clinical and non-clinical information. Possible linkages of information between MOH and NAC were reviewed.
RESULTS: Clinical information from CSOs is recorded in DHIS2 at the MOH facilities, while non-clinical information is reported in LOMSHA. However, clinical information from VHWs is currently not included in DHIS2 and formal reporting tools are being developed. There are no links between MOH and NAC, which limits information sharing.
CONCLUSION: Although a CHIS exists, it lacks the necessary linkages. Community-based information from VHWs is not reported through DHIS2. Therefore, the country does not benefit fully from community-based health information.
CONTRIBUTION: Community health information systems review has never been conducted in Lesotho before. Therefore, this review will raise awareness about its importance and use in decision-making.}, }
@article {pmid40950566, year = {2025}, author = {Carvajal-Tello, N and Segura-Ordóñez, A and García-Muñoz, H and Sánchez-Montoya, LJ and Cambindo-Larrahondo, LM and Muñoz-Chaux, V and Barahona-Guzmán, JP and Caballero-Lozada, AF}, title = {Systematic review of the effects of neuromuscular electrical stimulation in post-coronavirus disease.}, journal = {The South African journal of physiotherapy}, volume = {81}, number = {1}, pages = {2132}, pmid = {40950566}, issn = {2410-8219}, abstract = {BACKGROUND: Neuromuscular electrical stimulation (NMES) has demonstrated its efficacy in improving strength, muscle development, optimising microcirculation, reducing frailty and mortality risk. A better understanding of its prescription and effects in patients with coronavirus syndrome post (COVID-19) could favour its use.
OBJECTIVES: To find evidence that compares the effectiveness of NMES in the increasing muscle mass, muscle strength and functional independence of patients in post-intensive care unit (ICU) with COVID-19 syndrome.
METHOD: A systematic search was carried out in electronic databases: PubMed, Science Direct, Scopus, Ovid and Cochrane from 22 May 2022 to 30 April 2023, without language restriction, including clinical controlled trials (CCTs) and prospective longitudinal studies (PLS). Prospero registration (CRD42022332036).
RESULTS: A total of 1718 scientific articles were found; four articles met the inclusion criteria. For NMES dosing, intervention time ranged from 9 days to 30 days, the stimulus frequency was between 20 Hz and 121 Hz and the pulse width was between 350 µs and 1400 µs. The application time ranged from 30 min to 60 min, the intensity was between 20 mA and 250 mA and the stimulated muscle groups were quadriceps, tibialis anterior, hamstrings and gluteus.
CONCLUSION: The use of NMES after COVID-19 such as integral complementary strategy improves muscle mass, strength and functionality of the patients optimising recovery results.
CLINICAL IMPLICATIONS: The addition of NMES to standard physical therapy might have a positive impact on the recovery of individuals who have survived COVID-19.}, }
@article {pmid40950999, year = {2025}, author = {Zhuang, Z and Bo, Y}, title = {Self-management and role of nurses of diabetic patients: a critical narrative literature review during COVID-19 pandemic.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1626447}, pmid = {40950999}, issn = {2296-858X}, abstract = {BACKGROUND: During COVID-19 and the postepidemic phase, the concept of a frontline emergency response team was gradually expanded [based on a previous clinical trial, https://clinicaltrials.gov/, identifier (ChiCTR2500103976)]. The professional scope of nurses gradually expanded towards the digital. We selected the digital interventions implemented by nurses during the COVID-19 pandemic and self-management by diabetes patients as the research context.
AIMS: To synthesise a framework for the module-intensity-outcome of digitalised care during COVID-19.
METHODS: We searched the PubMed database for literature related to the role of nurses and self-management of diabetes patients during the COVID-19 pandemic, and then used these literature as 'seed literature' for a snowball search. We synthesised all the evidence using a directional evidence synthesis method, a narrative description method, and a visual presentation method.
RESULTS: A total of 10 publications were retrieved from the PubMed database, involving a cumulative total of 5,834 adults. This indicates that using these 10 'seed literature' for secondary literature retrieval enhances the persuasiveness of this method. Using these 'seed literature', an additional 28 literature were retrieved using the snowball method. Digital nursing has developed rapidly during the COVID-19 pandemic due to challenges in patient self-management. During the COVID-19 pandemic, patients sought digital nursing services from nurses due to disrupted healthcare services, surging mental health issues, and unhealthy lifestyles. In this model, nurses serve as a bridge between digital nursing services, the healthcare system, and patients. Digital nursing services not only bridge the gap in nursing services during healthcare crises but also expand the scope of nurses' professional roles.
CONCLUSION: Nurse-led digital care with a clear mix of "modules and intensity" may have directional benefits for diabetes self-management and metabolic outcomes.}, }
@article {pmid40951566, year = {2025}, author = {Rashki Ghalenoo, S and Azhdari, K and Khosravi, F and Hamzeh, S and Bayat, Z and Talebi Mehrdar, M and Dahmardeh, N and Hassanshahian, M}, title = {Manufacturing Technology and Effectiveness of Corona Vaccines: A Bibliometric Review.}, journal = {Archives of Razi Institute}, volume = {80}, number = {1}, pages = {11-18}, pmid = {40951566}, issn = {2008-9872}, mesh = {*COVID-19 Vaccines/standards/immunology ; Humans ; *COVID-19/prevention & control ; *Bibliometrics ; SARS-CoV-2/immunology ; *Vaccine Efficacy ; }, abstract = {The etiology of "Covid-19," a respiratory illness, was first identified in late 2019 as the causative agent of the novel coronavirus. The conclusion of the pandemic was declared in 2023, and during this interval, a range of vaccines employing diverse strategies were developed. The effectiveness and other immunological characteristics of these vaccines have been thoroughly evaluated. The publication of documents related to the vaccines has persisted even after the conclusion of the pandemic. This study was conducted to investigate the research process and published documents related to the manufacturing technology and effectiveness of the vaccines. The documents published in the Scopus database in early 2024 were collected using restrictions in four subject areas and the English language. The bibliographic analysis was conducted using the Bibliometrix package in Rstudio and VOSviewer. A total of 2,810 documents were reviewed. The majority of these documents were articles and reviews, with 2,320 and 394 documents falling into these categories, respectively. Peptides and capillary electrophoresis emerged as prominent subjects in 2024. Furthermore, elasomeran, covilo, and tozinameran emerged as more recent than other keywords based on their temporal distribution. This study examines the documents published in one of the most reliable databases of vaccines against the novel strain of severe acute respiratory syndrome (SARS-CoV-2) from a bibliometric perspective. The findings of this study are expected to provide valuable insights and direction for future research initiatives, opportunities, and challenges in this field.}, }
@article {pmid40951570, year = {2025}, author = {A Razzak Mahmood, A and Rani, VI and Yadav, P and Patil, SS}, title = {Advanced Therapeutic Interventions Targeting Mycobacterium Tuberculosis.}, journal = {Archives of Razi Institute}, volume = {80}, number = {1}, pages = {19-35}, pmid = {40951570}, issn = {2008-9872}, mesh = {Humans ; *COVID-19/epidemiology ; *Mycobacterium tuberculosis ; *Tuberculosis/epidemiology/drug therapy/diagnosis/prevention & control ; Artificial Intelligence ; *Antitubercular Agents/therapeutic use ; }, abstract = {Tuberculosis infection (TBI), caused by Mycobacterium tuberculosis (M.tb), presents with or without clinical signs of active TB and is a persistent global threat despite efforts to eradicate it. The emergence of HIV/AIDS is one of the problems to complete eradication. Recent research has focused on vaccines, diagnostics, and treatment. This review examines vulnerable populations, high-risk groups, and socio-economic factors influencing TBI prevalence. It also explores the intersection of TBI and the COVID-19 pandemic, including healthcare disruptions and transmission dynamics. Advances in TBI diagnosis, biomarkers, prophylactic therapies, and combination treatments are discussed, along with the integration of artificial intelligence (AI) in TBI therapy to optimize treatment and personalize care. Vulnerability to TBI varies based on age, socio-economic status, and immune status. High-risk groups include those with compromised immune systems, the elderly, and those in crowded or poorly ventilated settings. Socioeconomic factors such as poverty and limited healthcare access also contribute to TBI prevalence. The COVID-19 pandemic has disrupted TBI diagnosis and treatment, with limited healthcare access impacting outcomes. Changes in healthcare delivery, like telemedicine, may have long-term impacts on TBI care. Improved biomarkers, like interferon-gamma release assays (IGRAs), offer faster TBI diagnosis. Prophylactic therapies, such as isoniazid preventive therapy (IPT), reduce active TB risk in high-risk groups. Combination treatments are being evaluated for drug-resistant strains. AI integration in TBI therapy could lead to better outcomes by analyzing patient data for personalized treatment plans. In conclusion, TBI remains a global health threat requiring ongoing research and innovative approaches for diagnosis and treatment. Advances in diagnosis, prophylactic therapies, and combination treatments, along with AI integration, offer hope for improved outcomes and better patient care, In conclusion, traumatic brain injury (TBI) persists as a significant global health concern, necessitating sustained research efforts and the development of innovative diagnostic and therapeutic approaches. Advancements in diagnostic methods, prophylactic therapies, combination treatments, and the integration of artificial intelligence hold promise for enhancing outcomes and enhancing patient care.}, }
@article {pmid40951905, year = {2025}, author = {Khumbudzo, M and Duah, E and Grobler, E and Maluleke, K}, title = {The Role of Mathematical Modelling in Predicting and Controlling Infectious Disease Outbreaks in Underserved Settings: A Systematic Review and Meta-Analysis.}, journal = {Public health challenges}, volume = {4}, number = {3}, pages = {e70116}, pmid = {40951905}, issn = {2769-2450}, abstract = {BACKGROUND AND AIM: Mathematical modelling plays an important role in public health by enabling the prediction of disease outbreaks, assessment of transmission dynamics and evaluation of intervention strategies. Although widely applied in high-resource settings, its use in underserved contexts remains underexplored. This review aimed to examine and synthesize current evidence on the application of mathematical modelling for predicting and controlling infectious diseases in underserved settings.
METHODS: A comprehensive and reproducible search was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and population, intervention, comparison and outcome (PICO) frameworks across databases, including PubMed, Scopus, Medline, ScienceDirect and EBSCOhost. Keywords and Medical Subject Headings (MeSH) terms related to mathematical modelling and infectious disease control were applied. Two reviewers independently screened titles, abstracts and full texts, with a third resolving discrepancies. Thematic analysis and meta-analysis were used for synthesis.
RESULTS: Out of 838 studies screened, 27 (3.2%) met inclusion criteria. Deterministic models were most used, followed by stochastic and agent-based models. Diseases modelled included COVID-19, malaria, tuberculosis (TB), Ebola, Zika, chikungunya, dengue, diphtheria, respiratory infections, visceral leishmaniasis (VL) and Mpox. Modelling predicted the impact of interventions on transmission, with pooled effect size (Ro) of 1.32 (θ = 1.3, p < 0.0001). However, challenges, such as data underreporting, gaps and inconsistencies, were common, potentially affecting model accuracy and real-world applicability.
CONCLUSION: Mathematical modelling has demonstrated value in supporting infectious disease control in underserved settings. However, the predominance of deterministic models limits adaptability across diverse contexts. Poor data quality further constrains reliability. Future work should focus on expanding modelling approaches, strengthening data infrastructure and addressing a broader range of diseases. These findings can guide public health policy by supporting data-driven decision-making, improving resource allocation and integrating modelling into outbreak preparedness and response strategies in underserved settings.}, }
@article {pmid40952530, year = {2025}, author = {Bulygin, AA and Kuznetsov, NA}, title = {Prospects for the structure‒function evolution of SARS-CoV-2 main protease inhibitors.}, journal = {Journal of computer-aided molecular design}, volume = {39}, number = {1}, pages = {78}, pmid = {40952530}, issn = {1573-4951}, support = {#121112900214-2//Russian state/ ; #121112900214-2//Russian state/ ; }, mesh = {*SARS-CoV-2/enzymology/drug effects ; Humans ; Molecular Dynamics Simulation ; *Coronavirus 3C Proteases/antagonists & inhibitors/chemistry/metabolism ; *Protease Inhibitors/chemistry/pharmacology ; *COVID-19 Drug Treatment ; Structure-Activity Relationship ; *Antiviral Agents/chemistry/pharmacology ; COVID-19/virology ; Lactams ; Leucine ; Nitriles ; Proline ; }, abstract = {The COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become the third case of widespread coronavirus infection. Together with the other two viruses, the SARS-CoV-2 virus is highly pathogenic, and some strains have a mortality rate of more than 1%. Moreover, it has become clear that coronaviruses mutate quite often, which reduces the effectiveness of available vaccines and forces the regular creation of new ones. The main viral protease M[pro] is a suitable target for direct-acting drugs. Currently, there is only one recommended anticoronavirus drug, nirmatrelvir, which, however, does not have all the properties necessary for widespread and effective use. Thus, the development of a highly selective and effective protease inhibitor that can be taken orally still remains relevant. In this work, we performed an in-depth literature review of M[pro] inhibitor studies and conducted extensive molecular dynamics simulations of M[pro]-inhibitor complexes with computational prediction of binding ability and ADME (absorption, distribution, metabolism and excretion) properties of new compounds. On the basis of the literature review we composed a set of criteria that a potent inhibitor must meet. Then we created a set of possible inhibitors and their parts, which presumably allows all the necessary properties, namely, high affinity for the viral enzyme, selectivity, bioavailability and solubility, to be achieved.}, }
@article {pmid40953098, year = {2026}, author = {Hassani, M and Karanikas, N}, title = {Scoping review of studies on work-related musculoskeletal disorders: Quality of evidence, coverage of risk factors and types of risk assessment tools used.}, journal = {Work (Reading, Mass.)}, volume = {83}, number = {2}, pages = {271-289}, doi = {10.1177/10519815251374641}, pmid = {40953098}, issn = {1875-9270}, mesh = {Humans ; *Musculoskeletal Diseases/epidemiology/etiology ; Risk Assessment/methods ; Risk Factors ; *Occupational Diseases/epidemiology/etiology ; COVID-19/epidemiology ; }, abstract = {BackgroundDespite continual efforts globally in preventing work-related musculoskeletal disorders (WMSDs), they remain one of the most common occupational injuries with individual, organisational and societal impacts.ObjectiveThis scoping review analysed 265 studies on WMSDs published between January 2013 and December 2024, aiming to assess the quality of evidence, identify risk factors, and examine risk assessment tools used.MethodsA systematic search in Embase, PubMed, Web of Science, EBSCO, and Scopus, including subscription-based and open-access journals identified relevant studies. Inclusion criteria focused on WMSD risk assessment in occupational settings. Data extraction covered study characteristics, risk factors, assessment tools, and methodological quality.ResultsThe review revealed a significant increase in WMSD research in recent years, particularly from 2021 to 2024, possibly influenced by the COVID-19 pandemic's impact on work tasks and conditions. Lower back, neck, and shoulder pain were the most prevalent WMSDs reported. The review identified 79 risk factors across five categories. Physical task factors were most frequently investigated, while psychosocial and environmental factors were underrepresented. Self-report tools, particularly the Nordic Questionnaire, were the most commonly used assessment methods. Our review also highlights the need for more comprehensive risk assessment approaches that consider the interconnected nature of WMSD risk factors. Additionally, about 28% of the reviewed studies did not meet adequate quality of evidence criteria, indicating a need for improved research methodologies.ConclusionsThis review provides valuable insights for researchers and practitioners in occupational health and safety, emphasising the importance of holistic approaches to WMSD risk assessment and management.}, }
@article {pmid40954187, year = {2025}, author = {van der Bie, J and Coleon, A and Visser, D and Bogers, WM and den Dunnen, J and Spronk, HMH and Langermans, JAM and Willemen, HLDM and De Melo, GD and Middeldorp, J and Stammes, MA}, title = {Post Pandemic Problem, is there an animal model suitable to investigate PASC.}, journal = {Npj imaging}, volume = {3}, number = {1}, pages = {41}, pmid = {40954187}, issn = {2948-197X}, support = {11080012310002/ZONMW_/ZonMw/Netherlands ; }, abstract = {Although the COVID-19 pandemic is no longer a global health emergency, many patients still suffer from long-term effects, known as post-acute sequelae of COVID-19 (PASC) or long COVID. Understanding its complex pathophysiology requires animal models replicating the post-acute phase, which may aid in developing, the urgently needed, therapeutics. Our review assessed and summarized 81 studies from 1979 manuscripts. In addition, a second table summarizing the imaging findings of 26 studies related to this topic was added, based on a separate literature search of 797 manuscripts. In humans a SARS-CoV-2 infection, the sequelae and possible development of PASC is heterogenic. The same holds true for experimental animal models. While several models are suitable to address different research questions, no single model can fully replicate all aspects of PASC. Imaging plays a crucial role in visualizing these aspects, especially since questionnaires, the primary diagnostic tool in humans, cannot be used in animals. Thus, imaging allows the investigation of pathophysiology in a controlled setting, offering valuable insights. This review summarizes the available animal models and imaging modalities used in PASC research. Our aim is to provide researchers with guidance on selecting the most appropriate model and imaging technique to address their specific research questions.}, }
@article {pmid40955521, year = {2026}, author = {Shang, W and Wang, G and Han, D}, title = {Benefits of Nanocurcumin on Mortality in Patients with COVID-19: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.}, journal = {Journal of integrative and complementary medicine}, volume = {32}, number = {1}, pages = {40-46}, doi = {10.1177/27683605251379004}, pmid = {40955521}, issn = {2768-3613}, mesh = {Humans ; Randomized Controlled Trials as Topic ; *COVID-19/mortality ; *COVID-19 Drug Treatment ; SARS-CoV-2 ; *Curcumin/therapeutic use ; Interleukin-6 ; Nanoparticles ; }, abstract = {BACKGROUND: The Coronavirus disease-2019 (COVID-19) pandemic continues, and the death toll continues to surge. This systematic review and meta-analysis aimed to determine the efficacy of nanocurcumin on mortality in patients with COVID-19.
METHODS: A systematic search was performed in PubMed, Embase, Cochrane Library, and clinicaltrials.gov up to November 2024, without language restrictions.
INCLUSION CRITERIA: (1) inclusion of hospitalized patients with COVID-19 who are 18 years or older; (2) polymerase chain reaction positive for severe acute respiratory syndrome coronavirus-2; and (3) use of a randomized controlled design to make a comparison of nanocurcumin with placebo. The Cochrane risk-of-bias tool for randomized trials was used to assess the risk of bias. Studies were pooled to risk ratios (RRs) and standardized mean differences (SMDs), with 95% confidence intervals (CIs).
RESULTS: Six trials (enrolling 333 participants) met the inclusion criteria. Nanocurcumin therapy showed significant improvements on mortality (RR 0.47, 95% CI 0.25-0.88; p = 0.02), interleukin-6 (IL-6) (SMD -0.30, 95% CI -0.56 to -0.04; p = 0.02), tumor necrosis factor-α (TNF-α) (SMD -0.63, 95% CI -1.16 to -0.10; p = 0.02), and IL-1β (SMD -0.88, 95% CI -1.37 to -0.39; p = 0.0004).
CONCLUSIONS: Nanocurcumin significantly reduced mortality, IL-6, TNF-α, and IL-1β in hospitalized patients with COVID-19. Given the lack of safety data and concerns about the risk of bias, the use of nanocurcumin in COVID-19 requires further research.}, }
@article {pmid40955938, year = {2025}, author = {Rastogi, A and Sahoo, JP and Sivasubramanian, S and Mukhopadhyay, S and Shukla, R and Ramakrishnan, S and Shaikh, S and Abhyankar, M and Prasad, A and Kale, S}, title = {Evaluation of Deficiency of Vitamin D and Advantages of Supplementation of Vitamin D in COVID-19 Infections: A Narrative Review.}, journal = {The Journal of the Association of Physicians of India}, volume = {73}, number = {9}, pages = {e38-e47}, doi = {10.59556/japi.73.1169}, pmid = {40955938}, issn = {0004-5772}, mesh = {Humans ; *Vitamin D Deficiency/complications/drug therapy/epidemiology ; *Vitamin D/therapeutic use/administration & dosage ; *COVID-19/mortality/complications ; *Dietary Supplements ; *Vitamins/therapeutic use ; SARS-CoV-2 ; *COVID-19 Drug Treatment ; Severity of Illness Index ; }, abstract = {Continuously evolving literature has helped to understand the vitamin D contribution to the coronavirus disease 2019 (COVID-19) manifestations and the associated clinical outcomes in different patient populations. Evidence suggests a widespread occurrence of deficiency of vitamin D among patients presenting COVID-19 and a possible link between vitamin D insufficiency and disease progression or mortality. Furthermore, studies worldwide have reported that supplements of vitamin D have a beneficial effect on COVID-19 outcomes. Contradictory data, however, suggest that there is no association between levels of vitamin D and the likelihood of COVID-19 infections. Therefore, a comprehensive search of the published literature is conducted to better understand any harmful effects of vitamin D deficiency (VDD), advantages of vitamin D supplementation, and the relationship between status of vitamin D and risk, severity, and mortality in patients with COVID-19. The information was gathered from the PubMed database published between January 2020 and July 2022 regarding the function of vitamin D in the immune system, the link between deficiency of vitamin D and COVID-19 infection, severity, risk of mortality of COVID-19, and the impact of vitamin D treatment on outcomes of COVID-19. Vitamin D modulates the immune system by elevating the levels of cathelicidins and β-defensin in the body. Deficiency of vitamin D is markedly attributed to the risk of acute respiratory distress syndrome (ARDS), which determines the severity of disease in patients with COVID-19. Levels of vitamin D below 20 ng/mL in patients with COVID-19 are linked to an increased mortality and morbidity. Vitamin D concentration of >30 ng/mL can diminish the COVID-19 severity and risk of mortality. Supplementation with vitamin D to maintain a serum concentration of 30 ng/mL would mitigate the incidence of COVID-19 and poor prognostic outcomes.}, }
@article {pmid40956089, year = {2025}, author = {Williams, T and McCaw, JM and Osborne, JM}, title = {Spatially structured models of viral dynamics: a scoping review.}, journal = {Microbiology and molecular biology reviews : MMBR}, volume = {89}, number = {4}, pages = {e0028324}, pmid = {40956089}, issn = {1098-5557}, support = {DP210101920//Australian Research Council/ ; DP230100380//Australian Research Council/ ; FT230100352//Australian Research Council/ ; }, mesh = {Humans ; *COVID-19/virology/epidemiology ; *SARS-CoV-2/physiology ; *Models, Biological ; }, abstract = {SUMMARYThere is growing recognition in both the experimental and modeling literature of the importance of spatial structure to the dynamics of viral infections within the host. Aided by the evolution of computing power and motivated by recent biological insights, there has been an explosion of new, spatially explicit models for within-host viral dynamics in recent years. This development has only been accelerated in the wake of the COVID-19 pandemic. Spatially structured models offer improved biological realism and can account for dynamics that cannot be well-described by conventional, mean-field approaches. However, despite their growing popularity, spatially structured models of viral dynamics are underused in biological applications. One major obstacle to the wider application of such models is the huge variety in approaches taken, with little consensus as to which features should be included and how they should be implemented for a given biological context. Previous reviews of the field have focused on specific modeling frameworks or on models for particular viral species. Here, we instead apply a scoping review approach to the literature of spatially structured viral dynamics models as a whole to provide an exhaustive update of the state of the field. Our analysis is structured along two axes, methodology and viral species, in order to examine the breadth of techniques used and the requirements of different biological applications. We then discuss the contributions of mathematical and computational modeling to our understanding of key spatially structured aspects of viral dynamics and suggest key themes for future model development to improve robustness and biological utility.}, }
@article {pmid40956318, year = {2026}, author = {Starcevic, V and Janca, A}, title = {Conspiracy theories, personality dimensions and personality disorders.}, journal = {Current opinion in psychiatry}, volume = {39}, number = {1}, pages = {42-46}, doi = {10.1097/YCO.0000000000001037}, pmid = {40956318}, issn = {1473-6578}, mesh = {Humans ; *Personality Disorders/psychology ; *Personality ; *COVID-19/psychology ; *Deception ; }, abstract = {PURPOSE OF REVIEW: Conspiracy theories are not a recent phenomenon, but their dissemination has been facilitated by the internet and modern means of communication such as social media. This article reviews personality-based factors that increase the likelihood of endorsing conspiracy theories.
RECENT FINDINGS: Most studies used a correlational approach and examined personality traits and dimensions rather than personality disorders. The strongest and most consistent relationships were found between endorsement of conspiracy theories and suspiciousness and paranoid ideation, pseudoscientific tendencies and beliefs, schizotypal personality traits and narcissism. Similar personality characteristics were identified as correlates of the endorsement of the specific COVID-19 conspiracy theories, but antisocial personality traits have also been reported in this context. Epistemic mistrust has emerged as arguably the key factor that facilitates endorsement of conspiracy theories. Schizotypal, paranoid, antisocial, borderline, and narcissistic personality disorders were more likely to accompany endorsement of conspiracy theories than other types of personality disorders.
SUMMARY: Although correlation does not imply causation, recent work has identified personality-related characteristics that confer an increased risk of espousing conspiracy theories. Further research is necessary to ascertain how this vulnerability could be decreased, thus minimizing the harms of conspiracy theories that are inflicted on their adherents and broader society.}, }
@article {pmid40956349, year = {2025}, author = {Corrêa-Dias, LC and Lopes-Ribeiro, Á and Mendes, GER and Marques-Ferreira, G and Wilker-Teixeira, C and Clarindo, FA and de Melo Rocha, V and Martuchele-Félix, ME and Retes, HM and Santos, TAP and Azevedo, GLA and Pereira, VEV and de Fátima Silva Moraes, T and de Sousa Reis, EV and Gomes-de-Pontes, L and Rabelo, LF and Dos Santos, EAS and Pereira, CLD and Coelho, FDS and Coelho, RP and Santos, RA and Coelho, GP and da Fonseca, FG and Coelho-Dos-Reis, JGA}, title = {A pain from the nose to the head: neurological commitment during long COVID.}, journal = {Inflammation research : official journal of the European Histamine Research Society ... [et al.]}, volume = {74}, number = {1}, pages = {127}, pmid = {40956349}, issn = {1420-908X}, mesh = {Humans ; *COVID-19/complications/immunology ; *Neuroinflammatory Diseases/immunology/etiology ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; }, abstract = {BACKGROUND: Long COVID is a debilitating illness with multi-systemic symptoms that affects at least 10% of individuals who have had COVID-19. Symptoms include respiratory, dermatological, gastrointestinal, cardiovascular, and most frequently reported, neurological sequelae. The most common neurological manifestations include fatigue, brain fog, memory issues, attention disorder, and headaches.
METHODS: In this review, we explore the current literature and highlight key findings regarding not only the clinical presentations of neurological commitment during long COVID but mainly the mechanisms that culminate in neuroinflammation, such as autoimmunity, viral reservoirs, and lack of surveillance of T-cells.
RESULTS: Neuroinflammation is a complex multicellular response that directly impacts microglial cells and includes inflammasome activation, trafficking of immune cells, and increased circulating autoantibodies, cytokines, and chemokines in the central nervous system, directly impacting the tissue homeostasis. This review provides important information beyond the clinical manifestations of long COVID. Here, we highlight multifactorial neuroinflammation as the main mechanism involved in long COVID, bringing together several studies that address the different mechanisms that culminate in inflammation of the central nervous system, and highlight possible biomarkers involved in this syndrome and potential therapeutic approaches that have been studied.
CONCLUSION: Thus, this review strengthens research into long COVID and provides new possibilities for future studies.}, }
@article {pmid40956375, year = {2025}, author = {Naushad, Z and Malik, J and Mishra, AK and Singh, S and Shrivastav, D and Sharma, CK and Verma, VV and Pal, RK and Roy, B and Sharma, VK}, title = {Artificial Intelligence in Cardiovascular Health: Insights into Post-COVID Public Health Challenges.}, journal = {High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension}, volume = {32}, number = {5}, pages = {475-494}, pmid = {40956375}, issn = {1179-1985}, mesh = {Humans ; *COVID-19/epidemiology ; *Cardiovascular Diseases/diagnosis/epidemiology/therapy ; *Artificial Intelligence ; *Public Health ; Risk Assessment ; SARS-CoV-2/pathogenicity ; Risk Factors ; }, abstract = {Cardiovascular diseases (CVDs) continue to be the topmost cause of the worldwide morbidity and mortality. Risk factors such as diabetes, hypertension, obesity and smoking are significantly worsening the situation. The COVID-19 pandemic has powerfully highlighted the undeniable connection between viral infections and cardiovascular health. Current literature highlights that SARS-CoV-2 contributes to myocardial injury, endothelial dysfunction, thrombosis, and systemic inflammation, increasing the severity of CVD outcomes. Long COVID has also been associated with persistent cardiovascular complications, including myocarditis, arrhythmias, thromboembolic events, and accelerated atherosclerosis. Addressing these challenges requires continued research and public health strategies to mitigate long-term risks. Artificial intelligence (AI) is changing cardiovascular medicine and community health through progressive machine learning (ML) and deep learning (DL) applications. AI enhances risk prediction, facilitates biomarker discovery, and improves imaging techniques such as echocardiography, CT, and MRI for detecting coronary artery disease and myocardial injury on time. Remote monitoring and wearable devices powered by AI enable real-time cardiovascular assessment and personalized treatment. In public health, AI optimizes disease surveillance, epidemiological modeling, and healthcare resource allocation. AI-driven clinical decision support systems improve diagnostic accuracy and health equity by enabling targeted interventions. The integration of AI into cardiovascular medicine and public health offers data-driven, efficient, and patient-centered solutions to mitigate post-COVID cardiovascular complications.}, }
@article {pmid40956864, year = {2026}, author = {Olagunju, A and Perazzolo, S and Stephen, ZR and Ryan, M and Xu, X and Venkatasubramanian, P and Atoyebi, S and Fratte, RD and Owen, A and Flexner, C and Ho, RJY}, title = {The Promises and Prospects of Long-Acting Therapeutics for Treatment and Prevention of Infectious Diseases.}, journal = {Annual review of pharmacology and toxicology}, volume = {66}, number = {1}, pages = {87-112}, pmid = {40956864}, issn = {1545-4304}, support = {R01 AI134091/AI/NIAID NIH HHS/United States ; 227288/WT_/Wellcome Trust/United Kingdom ; R33 AI149665/AI/NIAID NIH HHS/United States ; R01 AI179309/AI/NIAID NIH HHS/United States ; UM1 AI120176/AI/NIAID NIH HHS/United States ; }, mesh = {Humans ; *Communicable Diseases/drug therapy ; Delayed-Action Preparations ; COVID-19/prevention & control ; Animals ; COVID-19 Drug Treatment ; Global Health ; }, abstract = {Long-acting (LA) therapeutics have emerged as a key component of infectious disease treatment and prevention strategies, their uptake fueled by the need to bridge notable gaps with short-acting drug formulations. In this review, we present the key drivers and summarize the enabling technologies. Focusing on infections with significant global disease burden (HIV, hepatitis B and C, tuberculosis, malaria, and COVID-19), the current state of knowledge on approved LA therapeutics and promising innovations currently in development are summarized. The potential role of LA therapeutics as countermeasures for diseases of pandemic potential and new approaches using computational modeling to accelerate their development for pediatric and perinatal health are discussed. Due to complexities in manufacturing, and the diversity of patent-protected technologies, barriers exist for global access to LA products and in upscaling intricate LA formulations. A multipronged strategic framework, including acceleration of equitable access through generic product manufacture, is proposed to realize the full potential of LA therapeutics for global health.}, }
@article {pmid40957014, year = {2025}, author = {Karve, Z and Calpey, J and Machado, C and Knecht, M and Mejia, MC}, title = {New Doc on the Block: Scoping Review of AI Systems Delivering Motivational Interviewing for Health Behavior Change.}, journal = {Journal of medical Internet research}, volume = {27}, number = {}, pages = {e78417}, pmid = {40957014}, issn = {1438-8871}, mesh = {*Motivational Interviewing/methods ; Humans ; *Health Behavior ; *Artificial Intelligence ; COVID-19 ; }, abstract = {BACKGROUND: Artificial intelligence (AI) is increasingly used in digital health, particularly through large language models (LLMs), to support patient engagement and behavior change. One novel application is the delivery of motivational interviewing (MI), an evidence-based, patient-centered counseling technique designed to enhance motivation and resolve ambivalence around health behaviors. AI tools, including chatbots, mobile apps, and web-based agents, are being developed to simulate MI techniques at scale. While these innovations are promising, important questions remain about how faithfully AI systems can replicate MI principles or achieve meaningful behavioral impact.
OBJECTIVE: This scoping review aimed to summarize existing empirical studies evaluating AI-driven systems that apply MI techniques to support health behavior change. Specifically, we examined the feasibility of these systems; their fidelity to MI principles; and their reported behavioral, psychological, or engagement outcomes.
METHODS: We systematically searched PubMed, Embase, Scopus, Web of Science, and Cochrane Library for empirical studies published between January 1, 2018, and February 25, 2025. Eligible studies involved AI-driven systems using natural language generation, understanding, or computational logic to deliver MI techniques to users targeting a specific health behavior. We excluded studies using AI solely for training clinicians in MI. Three independent reviewers screened and extracted data on study design, AI modality and type, MI components, health behavior focus, MI fidelity assessment, and outcome domains.
RESULTS: Of the 1001 records identified, 15 (1.5%) met the inclusion criteria. Of these 15 studies, 6 (40%) were exploratory feasibility or pilot studies, and 3 (20%) were randomized controlled trials. AI modalities included rule-based chatbots (9/15, 60%), LLM-based systems (4/15, 27%), and virtual or mobile agents (2/15, 13%). Targeted behaviors included smoking cessation (6/15, 40%), substance use (3/15, 20%), COVID-19 vaccine hesitancy, type 2 diabetes self-management, stress, mental health service use, and opioid use during pregnancy. Of the 15 studies, 13 (87%) reported positive findings on feasibility or user acceptability, while 6 (40%) assessed MI fidelity using expert review or structured coding, with moderate to high alignment reported. Several studies found that users perceived the AI systems as judgment free, supportive, and easier to engage with than human counselors, particularly in stigmatized contexts. However, limitations in empathy, safety transparency, and emotional nuance were commonly noted. Only 3 (20%) of the 15 studies reported substantially significant behavioral changes.
CONCLUSIONS: AI systems delivering MI show promise for enhancing patient engagement and scaling behavior change interventions. Early evidence supports their usability and partial fidelity to MI principles, especially in sensitive domains. However, most systems remain in early development, and few have been rigorously tested. Future research should prioritize randomized evaluations; standardized fidelity measures; and safeguards for LLM safety, empathy, and accuracy in health-related dialogue.
TRIAL REGISTRATION: OSF Registries 10.17605/OSF.IO/G9N7E; https://osf.io/g9n7e.}, }
@article {pmid40957159, year = {2025}, author = {Siem, TT and Nguyen, HTT and Luc, PT}, title = {Work-life balance in higher education: A review based on bibliographic coupling analysis.}, journal = {Acta psychologica}, volume = {260}, number = {}, pages = {105567}, doi = {10.1016/j.actpsy.2025.105567}, pmid = {40957159}, issn = {1873-6297}, mesh = {Humans ; *Work-Life Balance ; *COVID-19/psychology ; Bibliometrics ; Universities ; }, abstract = {This study provides an overview of higher education's work-life balance (WLB) structure by employing bibliographic coupling analysis to explore key research clusters. Data was collected from the Web of Science database, resulting in 203 publications retained for analysis, with VOS viewer software used to construct and visualize the bibliographic coupling network. The bibliometric analysis revealed eight clusters, notably including "The Impact of COVID-19 on Work-Life Balance and Well-being in Higher Education", "Impact of Work-Life Balance on Work Outcomes", "The Career Paths of Academics", and "Institutional and Personal Pressures Affecting Academic WLB". Despite existing bibliographic analyses of WLB policy across multiple disciplines and WLB dynamics during the pandemic, a dedicated in-depth analysis mapping the WLB research landscape specifically within the higher education sector has been notably absent. Therefore, this study uniquely contributes by offering a comprehensive overview of the WLB structure in higher education, identifying key research groups, and suggesting future directions, which will primarily benefit academic institutions, policymakers, and educators. Future research on academic well-being and WLB should adopt longitudinal and intersectional approaches, exploring experiences across diverse populations defined by gender, race, and career stage. Key areas include examining technology's impact, developing tailored mental health interventions and robust institutional support mechanisms, and emphasizing comparative analyses across global contexts as well as exploring generational differences in perceptions of WLB. In addition, refining theoretical frameworks for emerging work models is essential to inform equitable and sustainable policies.}, }
@article {pmid40957172, year = {2025}, author = {Barkat, MQ and Li, Q and Manzoor, M and Xu, C and Hussain, N and Salawi, A and Yang, H and Hussain, M}, title = {Sepsis-induced ALI/ARDS beyond supportive care: molecular mechanisms and cutting-edge therapies.}, journal = {International immunopharmacology}, volume = {166}, number = {}, pages = {115495}, doi = {10.1016/j.intimp.2025.115495}, pmid = {40957172}, issn = {1878-1705}, mesh = {Humans ; *COVID-19/complications/immunology/therapy ; *Sepsis/complications/therapy/immunology ; SARS-CoV-2 ; *Respiratory Distress Syndrome/therapy/etiology/immunology ; *Acute Lung Injury/therapy/etiology/immunology ; Animals ; Signal Transduction ; Cytokine Release Syndrome ; }, abstract = {Sepsis-induced ALI/ARDS are severe conditions driven by complex molecular and cellular mechanisms, including endothelial dysfunction, immunological dysregulation, epigenetic changes, and oxidative stress. These factors disrupt endothelial integrity and promote cell death, worsening lung injury and respiratory failure. COVID-19-related ARDS, similar to sepsis-induced ALI, is more severe, involving immune dysregulation, cytokine storms, and microthrombi. Despite extensive research, sepsis-induced ALI/ARDS has gained the status of the Bermuda Triangle, as no effective pharmacological treatments are currently available, and supportive therapies remain the mainstay of treatment. Consequently, a critical need exists to explore innovative treatment options. This review highlights the molecular and cellular mechanisms of sepsis-induced ALI/ARDS, key cellular signaling pathways in sepsis-induced ALI/ARDS, clinical insights into COVID-19-related ALI/ARDS, existing and emerging treatments, and the limitations of current therapies. It emphasizes the need for innovative approaches to improve patient outcomes and underscores the importance of advancing research to enhance understanding and treatment development.}, }
@article {pmid40957223, year = {2025}, author = {Mohus, RM and Gustad, LT and Damås, JK and Drakesmith, H}, title = {Iron-sepsis associations in population health revealed by epidemiology.}, journal = {EBioMedicine}, volume = {120}, number = {}, pages = {105927}, pmid = {40957223}, issn = {2352-3964}, mesh = {Humans ; *Iron/blood/metabolism ; *Sepsis/epidemiology/etiology/metabolism ; *COVID-19/epidemiology/metabolism ; SARS-CoV-2 ; Population Health ; Hepcidins/genetics/metabolism ; Risk Factors ; Iron Overload/epidemiology ; Mendelian Randomization Analysis ; Hospitalization/statistics & numerical data ; }, abstract = {Sepsis is a leading cause of death and disability worldwide, so identifying preventable risk factors is important. Iron is essential for immune function and microbial growth, and iron status varies substantially between individuals, across demographics, and is therapeutically modifiable. Here, we review the current understanding of iron status and associated risks of bloodstream infection, sepsis and severe COVID-19 highlighting relevant population-based studies and Mendelian randomisation studies. Both low and high iron status are associated with increased risk of sepsis. Low iron status is associated with sepsis, bloodstream infections and pneumonia. High iron status and mutations affecting hepcidin regulation are linked to increased risk of bloodstream infections, sepsis and COVID-19. Both iron status pathologies and sepsis are global health issues, and the epidemiological studies described indicate they may be linked. More population-scale investigations on iron status, infection and immunity, especially in areas of high iron deficiency and infectious burden are warranted.}, }
@article {pmid40957683, year = {2025}, author = {Caruso, BA and Snyder, JS and O'Brien, LA and LaFon, E and Files, K and Shoaib, DM and Prasad, SK and Rogers, HK and Cumming, O and Esteves Mills, J and Gordon, B and Wolfe, MK and Freeman, MC}, title = {Behavioural factors influencing hand hygiene practices across domestic, institutional and public community settings: a systematic review and qualitative meta-synthesis.}, journal = {BMJ global health}, volume = {10}, number = {Suppl 7}, pages = {}, pmid = {40957683}, issn = {2059-7908}, support = {001/WHO_/World Health Organization/International ; }, mesh = {Humans ; *Hand Hygiene ; Qualitative Research ; COVID-19/prevention & control ; *Health Behavior ; }, abstract = {INTRODUCTION: This systematic review sought to understand barriers and enablers to hand hygiene in community settings.
METHODS: Eligible studies addressed hand hygiene in a community setting, included a qualitative component, and were published in English between 1 January 1980 and 29 March 2023. Studies were excluded if in healthcare settings or were animal research. We searched PubMed, Web of Science, EMBASE, CINAHL, Global Health, Cochrane Library, Global Index Medicus, Scopus, Public Affairs Information Service Index, WHO Institutional Repository for Information Sharing, UN Digital Library and World Bank eLibrary, manually searched relevant systematic reviews' reference lists, and consulted experts. We used MaxQDA software to code papers, using the COM-B (Capability, Opportunity, Motivation and Behaviour) framework to classify barriers and enablers. We used thematic analysis to describe each COM-B subtheme identified, GRADE-CERQual to assess confidence in evidence for thematic findings and the Mixed Method Appraisal Tool (MMAT) to assess risk of study bias.
RESULTS: 80 studies were included; most took place in Africa (31; 39%), South-East Asia (31; 39%) and domestic settings (54; 68%). The mean MMAT score was 4.86 (good quality). Barriers and/or enablers were reported across all COM-B constructs and subconstructs. The most reported barriers aligned with Physical Opportunity (eg, soap availability), Reflective Motivation (eg, hand hygiene not prioritised) and Automatic Motivation (eg, no habit). In contrast, the most reported enablers aligned with Automatic Motivation (ie, habit) and Reflective Motivation (ie, perception of health risk).
CONCLUSION: Findings confirm that a lack of necessary resources for hand hygiene hinders practice, even when people are motivated. Results may explain why hand hygiene increases when there are acute health risks (eg, COVID-19), but decreases when risks are perceived to fade. The qualitative methodology used among the studies may have revealed a broader array of barriers and enablers than what might have been found by quantitative, researcher-driven studies, but representativeness may be limited. Evidence was also limited on alcohol-based hand rubs. Findings can inform the design of future hand hygiene initiatives.
PROSPERO REGISTRATION NUMBER: CRD42023429145.}, }
@article {pmid40958240, year = {2025}, author = {Jin, M and Zhu, Z and Zhou, P and Liu, S}, title = {Extensive deep neck abscess caused by middle ear cholesteatoma complicating Proteus vulgaris infection: A case report and literature review.}, journal = {Medicine}, volume = {104}, number = {37}, pages = {e44463}, pmid = {40958240}, issn = {1536-5964}, support = {SCU10370//the Reform Project of Higher Education Teaching at Sichuan University/ ; }, mesh = {Humans ; Male ; *Abscess/etiology/microbiology ; Adult ; *Neck ; COVID-19/complications ; *Proteus Infections/complications/diagnosis ; *Cholesteatoma, Middle Ear/complications ; Tomography, X-Ray Computed ; Drainage/methods ; SARS-CoV-2 ; }, abstract = {RATIONALE: Middle ear cholesteatoma (MEC) is a non-neoplastic cystic lesion that can cause severe complications if untreated. While subperiosteal abscesses, neck abscesses, and sigmoid sinus thrombophlebitis have been reported, an extensive deep neck abscess extending to the axillary fossa due to MEC has not been previously documented. This case highlights a deep neck abscess complicated by Proteus vulgaris infection during coronavirus disease 2019 (COVID-19) recovery, underscoring the importance of individualized management strategies based on pathogen characteristics.
PATIENT CONCERNS: A 27-year-old man with a history of left ear purulent otorrhea for > 20 years presented with neck swelling for 5 days during COVID-19 recovery.
DIAGNOSES: Examination revealed: the left neck, up to the mastoid process, down to the ipsilateral armpit and lateral chest wall, and back to the trapezius muscle, was widely erythematous and swollen, with elevated skin temperature. Computed tomography revealed soft tissue density shadows in the left mastoid process, along with gas and pus accumulation in the left neck, pharynx, and axillary fossa. Culture results confirmed P vulgaris infection. The diagnosis was MEC complicated by a deep neck abscess and P vulgaris infection.
INTERVENTIONS: The patient underwent a modified radical mastoidectomy and incision and drainage of a left maxillofacial cervical multi-gap abscess. Postoperatively, the neck cavity was sutured, and negative pressure drainage tubes were placed. Due to subsequent parapharyngeal swelling and respiratory distress with a difficult airway, a tracheotomy was performed, followed by additional drainage of an abscess in the posterior oropharyngeal wall. Extensive necrosis of the cervical soft tissue necessitated reopening the neck incision and placement of Penrose drains for continued drainage.
OUTCOMES: The patient recovered well following surgical interventions and tailored wound management, with no further complications.
LESSONS: This case underscores the importance of timely and appropriate abscess drainage and wound management tailored to the causative organism's characteristics. It also highlights the need for aggressive treatment of the primary pathology (MEC) to prevent severe complications. Clinicians should be vigilant for unusual presentations of deep neck abscesses, especially in patients with recent infections such as COVID-19, which may complicate the clinical course.}, }
@article {pmid40958923, year = {2025}, author = {Feiz-Haddad, MH and Khorami, S}, title = {A Comprehensive Review of Epidemiology, Environmental Factors, and Control Strategies for Zoonotic Cutaneous Leishmaniasis in Iran: Challenges and Prospects.}, journal = {Advanced biomedical research}, volume = {14}, number = {}, pages = {90}, pmid = {40958923}, issn = {2277-9175}, abstract = {Zoonotic cutaneous leishmaniasis (ZCL) remains a significant public health challenge in Iran, which reported an incidence rate of 15.8 cases per 100,000 individuals in 2019. Among the countries of the Eastern Mediterranean region, Iran bears a disproportionate burden of this neglected tropical disease, with 18 out of its 31 provinces affected. ZCL is especially prevalent in rural and semiurban areas, where ecological and environmental factors create suitable conditions for disease transmission. Rodent reservoirs, particularly Meriones species, and specific vectors, such as Phlebotomus sandflies, play critical roles in the epidemiology of ZCL in Iran. Recent studies have highlighted dynamic changes in the distribution of ZCL in Iran, with newly identified hotspots in regions such as Beyza district (Fars province), Isfahan, and Razavi Khorasan. These shifts are attributed to climate change, urbanization, and altered land use patterns, which influence vector habitats and reservoir dynamics. Notably, the COVID-19 pandemic has exacerbated the spread of ZCL, redirecting health priorities and increasing the vulnerability of already high-risk areas. The interplay between these ecological factors underscores the importance of understanding localized transmission patterns. Despite the growing prevalence of ZCL, research remains limited in its focus on epidemiological aspects specific to Iran. This review aims to address this gap by examining the geographic distribution, reservoirs, vectors, and ecological drivers of ZCL within Iran. By identifying high-risk provinces and emerging trends, such as those in Fars, Isfahan, and Razavi Khorasan, this study provides a foundation for designing targeted control strategies. Effective interventions, informed by these findings, are crucial in mitigating the future burden of ZCL, particularly as vector habitats are expected to expand due to climatic changes.}, }
@article {pmid40959053, year = {2025}, author = {Saleem, M and Chang, CW and Qadeer, A and Asiri, M and Alzahrani, FM and Alzahrani, KJ and Alsharif, KF and Chen, CC and Hussain, S}, title = {The emerging role of extracellular vesicles in viral transmission and immune evasion.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1634758}, pmid = {40959053}, issn = {1664-3224}, mesh = {Humans ; *Extracellular Vesicles/immunology/virology ; *Immune Evasion ; *Virus Diseases/immunology/transmission/therapy/virology ; Animals ; SARS-CoV-2/immunology ; Host-Pathogen Interactions/immunology ; COVID-19/immunology ; }, abstract = {Extracellular vesicles (EVs) are membrane-bound structures that serve as major mediators of intercellular communication, playing a crucial role in various physiological and pathological processes. These membrane-bound vesicles are involved in several biological processes and are essential because they play a vital role in regulating viral infections. Given the global burden of viral diseases, understanding the interaction between EVs and viruses is crucial for the development of novel diagnostic tools and therapeutic strategies. This review provides a comprehensive examination of the structure and nature of EVs, as well as their biogenesis and molecular components, distinguishing between exosomes, microvesicles, and apoptotic bodies. We discuss the relationship between EVs and viral diseases, as well as their roles in viral pathogenesis and the dissemination of infections. Moreover, based on the ability of viruses to modulate host immune responses at both the innate and adaptive levels, the involvement of EVs in immune evasion is described. Additionally, the ability of EVs to diagnose viral illnesses and their therapeutic applications, such as using EVs for vaccines, immunotherapy, and the delivery of antiviral drugs, will also be discussed. Various viral diseases, including HIV, hepatitis B and C, and influenza, as well as emerging viruses such as SARS-CoV-2, are reviewed to capture the multifaceted functions of EVs in viral diseases. Finally, the review discusses the limitations of EV research, factors that affect the standardization of the technique, and the outlook for clinical applications. Based on a synthesis of current literature knowledge, this review aimed to identify and highlight the potential of EVs as diagnostic and therapeutic agents in the prevention and treatment of viral infections, thereby paving the way for further research and innovation.}, }
@article {pmid40959313, year = {2025}, author = {Preetam, S and Lata, S and Aditi, and Bora, J and Thapliyal, S and Mehta, S and Ramniwas, S and Deshwal, R and Rustagi, S and Talukdar, N and Malik, S}, title = {Exosome-driven biohybrid nanorobots: bridging nature and nanotechnology in biomedical innovation.}, journal = {RSC advances}, volume = {15}, number = {40}, pages = {33390-33409}, pmid = {40959313}, issn = {2046-2069}, abstract = {Exosome- and extracellular vesicle (EV)-based biohybrid nanorobots represent a cutting-edge approach in nanomedicine, combining the natural targeting, immune tolerance, and molecular transport capabilities of EVs with the functional versatility of engineered nanomaterials. These hybrid systems can be designed for guided or autonomous navigation, enabling site-specific drug delivery with minimal cytotoxicity. Recent advances have integrated magnetic, photothermal, or drug-loaded components into EVs, transforming them into innovative nanoscale delivery systems. As naturally secreted vesicles from most cell types, EVs facilitate intercellular communication and are increasingly recognized for their clinical potential in treating conditions like Crohn's disease, type 1 diabetes, and COVID-19. Biohybrid EV nanorobots offer enhanced biodistribution, stability, and cellular uptake compared to traditional nanoparticles. Key design challenges include ensuring reproducibility, size control, and functional stability. This next-generation drug delivery platform holds promise for overcoming limitations of conventional systems while advancing targeted therapy and personalized medicine.}, }
@article {pmid40959555, year = {2025}, author = {Deng, Q and Liu, Y and Rong, H and Liu, Q and Yang, R}, title = {Association Between Gut Microbiota and Pneumonia Risk: A Systematic Review and Mendelian Randomization.}, journal = {International journal of medical sciences}, volume = {22}, number = {14}, pages = {3511-3527}, pmid = {40959555}, issn = {1449-1907}, mesh = {Humans ; *COVID-19/microbiology/genetics/epidemiology ; *Gastrointestinal Microbiome/genetics ; Mendelian Randomization Analysis ; *Pneumonia/microbiology ; Risk Factors ; SARS-CoV-2 ; }, abstract = {Background: The gut-lung axis represents a critical pathway potentially modulating COVID-19 pathogenesis. We employed meta-analysis to investigate the Mendelian randomization (MR) studies for the putative causal relationships between gut microbiota composition/metabolites and COVID-19 severity. Methods: Adhering to PRISMA 2020 guidelines, we conducted a systematic review of MR studies (PubMed/Web of Science/Embase/Scopus/Cochrane; inception to June 2024). Data from 11 studies (aggregating 32,748,274 participants; 1,487 SNPs) underwent meta-analysis across four COVID-19 severity strata including susceptibility, infection, hospitalization, and critical disease. Study quality was evaluated using a validated MR framework assessing 32 core assumptions. Results: Elevated COVID-19 susceptibility risk was associated with Actinobacteria (OR 1.16, 95% CI 1.06-1.26) and Negativicutes (1.06, 1.03-1.09), whereas protective effects emerged for Oxalobacter (0.84, 0.71-0.99) and Ruminococcaceae UCG014 (0.88, 0.78-0.99). For COVID-19 infection, Negativicutes conferred increased risk (1.13, 1.02-1.26), while the Ruminococcus torques group (0.54, 0.39-0.74) and Parasutterella (0.90, 0.83-0.97) demonstrated protection. Hospitalization risk elevated with MollicutesRF9 (1.13, 1.04-1.22) and Alloprevotella (1.25, 1.07-1.45), contrasting with butyrate (0.97, 0.94-0.99) and Ruminiclostridium6 (0.81, 0.69-0.94) showing protective associations. Severe COVID-19 risk increased with Actinobacteria (1.20, 1.01-1.42), Bifidobacterium (2.09, 1.15-3.81), and Alloprevotella (1.66, 1.36-2.01), while Oxalobacter (0.84, 0.76-0.92) and Subdoligranulum (0.82, 0.76-0.89) exhibited protection. Notably, Actinobacteria, Negativicutes, and Alloprevotella constituted consistent risk factors across severity strata, whereas Oxalobacter and Parasutterella showed trans-stage protective effects. Butyrate production specifically attenuated hospitalization risk, and Bifidobacterium demonstrated strikingly elevated critical disease risk, contrasting with typical probiotic associations. Conclusions: This meta-analysis of MR studies provides robust evidence for severity-specific causal effects of the gut microbiota on COVID-19 outcomes. The identified microbial taxa and metabolites provide potential biomarkers for clinical risk stratification and targets for novel adjuvant therapeutic strategies.}, }
@article {pmid40959656, year = {2025}, author = {Martínez-Líbano, J and Reyes, JMA and Passalacqua, AS and Molina, JAC and Bulnes, JG}, title = {Prevalence and post-pandemic consequences of body dysmorphic disorder: a systematic review with meta-analysis.}, journal = {Health psychology report}, volume = {13}, number = {3}, pages = {215-225}, pmid = {40959656}, issn = {2353-5571}, abstract = {Body dysmorphic disorder (BDD) has had a growing impact in Western cultures, manifesting itself in social pressures to achieve physical standards, affecting both men and women. Media influences have magnified these ideals, promoting a standardized body appearance, which has generated an increase in appearance-related disorders. The COVID-19 pandemic exacerbated body concerns. Therefore, we aimed to determine the post-pandemic prevalence and its consequences. For these purposes, a systematic review was carried out based on the PRISMA strategy to identify relevant studies between 2019 and 2023 in databases such as Web of Science and Scopus. Selection criteria were applied, including cross-sectional or longitudinal studies that focused on populations without a previous diagnosis of BDD and used clinical instruments. Of the 52 articles identified, 10 met the inclusion criteria and were selected. Four were used for the systematic review and 6 to carry out the meta-analysis. The prevalence of BDD was high, at 20.8% (6 studies, logOR = 0.208 [95% CI: 0.121-0.294], Z = 4.69, p < .001, I [2] = 98.51%). In conclusion, the restrictions caused by the COVID-19 pandemic such as remaining in isolation, the closure of beauty services, and the increase in the use of social networks and video calls increased anxiety and stress levels in patients diagnosed with BDD and also in people with symptoms related to BDD.}, }
@article {pmid40959931, year = {2025}, author = {Kondakova, O and Tsybina, A and Evtushenko, E and Ryabchevskaya, E and Granovskiy, D and Kovalenko, A and Arkhipenko, M and Nikitin, N and Karpova, O}, title = {Farm animal coronaviruses: the solution is in vaccines.}, journal = {The veterinary quarterly}, volume = {45}, number = {1}, pages = {1-29}, pmid = {40959931}, issn = {1875-5941}, mesh = {Animals ; *Viral Vaccines/immunology ; *Coronavirus Infections/prevention & control/veterinary/transmission/epidemiology ; Livestock ; Animals, Domestic ; *Coronavirus/immunology ; Poultry ; Poultry Diseases/prevention & control/virology ; Humans ; COVID-19 ; Vaccination/veterinary ; }, abstract = {RNA-containing coronaviruses are widespread in nature and can infect a number of vertebrates. Animals are potential sources of human coronaviruses diseases, and interspecies infection by animal coronaviruses has been recorded several times. Such a transmission may have caused the COVID-19 pandemic. The study and control of the spread of farm animals' coronavirus infections is very important, due to the constant close contact between humans and farm animals. Vaccination remains the key to preventing animal diseases and limiting the further spread and transmission of coronavirus infections among poultry and livestock. This review considers coronavirus infections in farm animals, which pose a serious challenge to animal husbandry, and their zoonotic potential and epidemiological features. The review also discusses current vaccines and their limitations, as well as the latest developments and trends in veterinary vaccines aimed at preventing coronavirus infections in poultry and livestock.}, }
@article {pmid40959961, year = {2026}, author = {Kadam, Y and Dagli, N and Venugopal, R and Raj, S and Goel, S}, title = {Global Trends and Emerging Themes in Tele-Ophthalmology Research: A Bibliometric Analysis (1993 to 2024).}, journal = {Seminars in ophthalmology}, volume = {41}, number = {3}, pages = {439-449}, doi = {10.1080/08820538.2025.2559842}, pmid = {40959961}, issn = {1744-5205}, mesh = {*Ophthalmology/trends ; Humans ; *Telemedicine/trends ; *Bibliometrics ; *Biomedical Research/trends ; Global Health ; *Eye Diseases/therapy/diagnosis ; }, abstract = {BACKGROUND: Tele-ophthalmology is transforming eye care delivery, particularly in remote and underserved areas, where specialist shortages and geographic barriers prevent millions from receiving timely diagnosis and treatment for preventable blindness. Tele-ophthalmology has emerged as a critical solution to bridge these care gaps, with applications ranging from remote screening, diagnosis, and monitoring of conditions like diabetic retinopathy and glaucoma. Despite rapid technological advances and growing implementation, the research landscape lacks literature providing an overview of global trends, collaborative patterns, and emerging innovations in this field, hindering strategic research planning and evidence-based policy development for expanding digital eye care services. This study aims to analyse global trends and emerging themes in tele-ophthalmology research to fill this knowledge void and provide strategic insights for researchers, clinicians, and policymakers.
METHODS: A comprehensive online literature search was conducted using the Scopus database, retrieving English-language publications related to tele-ophthalmology up to 31st December 2024. Data were extracted and analysed using Biblioshiny in R Studio and VOSviewer. The study assessed annual publication trends, top journals' contributions, authors' contributions, authors' collaboration, keyword co-occurrence, and thematic evolution.
RESULTS: A total of 5,498 publications were identified, with an annual growth rate of 9.55%, and nearly 800 articles published in 2023 alone. The United States led in publication output and international collaborations. Dr. Michael F. Chiang published the highest number of articles, with the highest total link strength (174), followed by Dr. R.V. Paul Chan and Dr. J. Peter Campbell (122). Telemedicine and E-Health was the leading journal, followed by the Journal of Telemedicine and Telecare and the Indian Journal of Ophthalmology. Common keywords included "telemedicine," "diabetic retinopathy," "artificial intelligence," and "COVID-19," reflecting major research themes. Thematic analysis showed a shift toward AI integration and digital health solutions in ophthalmology.
CONCLUSION: The field of teleophthalmology has experienced significant and rapid growth in research activity. Recent trends indicate growing integration of artificial intelligence and digital health tools. This bibliometric study provides a comprehensive overview that can inform future research and policy efforts to enhance digital eye care delivery.}, }
@article {pmid40960573, year = {2025}, author = {Urquiaga, M and Winthrop, KL and Curtis, JR}, title = {Vaccination Update and Specific Concerns for RA.}, journal = {Current rheumatology reports}, volume = {27}, number = {1}, pages = {37}, pmid = {40960573}, issn = {1534-6307}, support = {P30 AR072583/AR/NIAMS NIH HHS/United States ; P30AR072583//National Institute of Arthritis and Musculoskeletal and Skin Disease/ ; }, mesh = {Humans ; *Arthritis, Rheumatoid/drug therapy/immunology ; *Vaccination ; *Antirheumatic Agents/therapeutic use ; *COVID-19 Vaccines ; Pneumococcal Vaccines ; *COVID-19/prevention & control ; Immunocompromised Host ; Practice Guidelines as Topic ; }, abstract = {PURPOSE OF REVIEW: We present information on the burden of vaccine-preventable diseases in people with rheumatoid arthritis (RA), the latest evidence on vaccine immunogenicity in disease-modifying antirheumatic drug (DMARD) users, and expert and guideline-based immunization recommendations. We focus on infections with the highest morbidity and mortality, and those relevant due to new developments or current outbreaks.
RECENT FINDINGS: Following the license expansion for two respiratory syncytial virus (RSV) vaccines, GSK's Arexvy and Pfizer's Abrysvo, the Advisory Committee for Immunization Practices (ACIP) expanded the recommendation for vaccination in adults at increased risk of severe RSV disease. In the spring of 2025, the Center for Disease Control lowered the cutoff for immunization in high-risk groups from ≥ 60 to ≥ 50 years. There are new 2024-2025 SARS-CoV-2 vaccines and updated ACIP recommendations for SARS-CoV-2 immunization that address new viral strains and the known waning immunity from vaccines. All individuals who are moderately to severely immunocompromised (including those with RA) should receive at least one additional vaccine dose compared to the general population. The ACIP has updated its recommendations for pneumococcal immunization, aiming to lower pneumococcal disease incidence in adults. Following the approval of the 21-valent pneumococcal conjugate vaccine, designed to target the serotypes commonly affecting adults, the cutoff for vaccination in the general population changed from ≥ 65 to ≥ 50 years. Recommendations for vaccination in RA patients (everyone age ≥ 18 years) remain unchanged. Vaccine recommendations for RA patients constantly evolve as new DMARDs and vaccines are developed, and our understanding of their interaction with DMARDs vis a vis immunogenicity improves. It is essential to stay current with the latest recommendations from the ACIP and rheumatologic society guidelines.}, }
@article {pmid40961807, year = {2025}, author = {Coombs, LA and Kim, M}, title = {Effectiveness of web-based interventions on depression and anxiety in older adults: a systematic review and meta-analysis of randomized controlled trials.}, journal = {Archives of gerontology and geriatrics}, volume = {139}, number = {}, pages = {106025}, doi = {10.1016/j.archger.2025.106025}, pmid = {40961807}, issn = {1872-6976}, mesh = {Humans ; Randomized Controlled Trials as Topic ; Aged ; *Depression/therapy ; *Anxiety/therapy ; *Internet-Based Intervention ; Middle Aged ; COVID-19/psychology/epidemiology ; }, abstract = {OBJECTIVE: This study examined the effects of web-based interventions on depression and anxiety in older adults.
METHODS: We conducted a systematic search of PubMed, CINAHL, Cochrane, Embase, PsycINFO, and Web of Science from their inception to March 05, 2025. We included randomized controlled trials (RCTs) examining the effects of web-based interventions on depression and anxiety in individuals aged 60 and older. The quality of included studies was evaluated using the revised Cochrane risk-of-bias tool for RCTs. A random-effects model was applied for the meta-analysis, with pooled standardized mean differences (SMD) used to estimate intervention effects. Heterogeneity was quantified using the I² statistic, and subgroup and meta-regression analyses were performed to investigate potential moderators.
RESULTS: A total of 19 studies were included in the final analysis. The meta-analysis showed that web-based interventions significantly reduced depression (SMD = -0.48, 95 % CI = -0.72 to -0.24) and anxiety (SMD = -0.70, 95 % CI = -0.97 to -0.43) in older adults. Subgroup analyses indicated that participant characteristics and publication year significantly moderated heterogeneity, while meta-regression analysis revealed that mean age significantly moderated the intervention effect.
CONCLUSION: This meta-analysis confirmed that web-based interventions effectively reduce depression and anxiety in older adults. The effects were particularly pronounced among older adults with existing or diagnosed symptoms of depression or anxiety. Furthermore, the observed reduction in intervention effectiveness after COVID-19 highlights the need to investigate the underlying causes of this decline.}, }
@article {pmid40961897, year = {2025}, author = {Tran, LB and Michita, RT and Kumar, D and Mysorekar, IU}, title = {Intercellular highways of viral spread: tunneling nanotubes and extracellular vesicles at the maternal-fetal interface.}, journal = {Current opinion in virology}, volume = {73}, number = {}, pages = {101490}, doi = {10.1016/j.coviro.2025.101490}, pmid = {40961897}, issn = {1879-6265}, mesh = {Humans ; *Extracellular Vesicles/virology ; Pregnancy ; Female ; *Placenta/virology/immunology ; Infectious Disease Transmission, Vertical ; *Maternal-Fetal Exchange ; *Virus Diseases/transmission/virology ; *Nanotubes/virology ; Animals ; *Pregnancy Complications, Infectious/virology ; Cell Communication ; SARS-CoV-2 ; Viruses ; Immune Evasion ; }, abstract = {The placenta serves as both a conduit and a barrier, facilitating nutrient exchange while shielding the fetus from pathogens. Despite these defenses, several viruses, including ZIKV, CMV, HSV, HIV, LCMV, and HBV, can breach the placental barrier, while others like SARS-CoV-2 and RSV infect placental cells without consistent vertical transmission. Emerging evidence highlights two underexplored intercellular communication mechanisms, tunneling nanotubes (TNTs) and extracellular vesicles (EVs), as critical pathways exploited by viruses to disseminate, modulate immunity, and disrupt placental homeostasis. This review discusses how virally hijacked TNTs and EVs facilitate transmission and immune evasion at the maternal-fetal interface, emphasizing the need to further understand these mechanisms in the context of pregnancy and fetal health.}, }
@article {pmid40962199, year = {2025}, author = {Butt, NU and Baytas, SN}, title = {Indole therapeutics: Latest FDA updates, ongoing trials, and future directions.}, journal = {Drug discovery today}, volume = {30}, number = {10}, pages = {104471}, doi = {10.1016/j.drudis.2025.104471}, pmid = {40962199}, issn = {1878-5832}, mesh = {Humans ; *Indoles/therapeutic use/pharmacology/chemistry ; United States ; United States Food and Drug Administration ; Drug Approval ; *COVID-19 Drug Treatment ; Antiviral Agents/therapeutic use/pharmacology ; Antineoplastic Agents/therapeutic use/pharmacology ; Clinical Trials as Topic ; Animals ; Drug Repositioning ; COVID-19 ; SARS-CoV-2 ; }, abstract = {Indole-based compounds serve as versatile pharmacophores across anticancer, antiviral, neurological, antimicrobial, and metabolic therapies. This review systematically analyses FDA-approved, withdrawn, and investigational indole-containing drugs over the past decade, focusing on evolving clinical outcomes, regulatory decisions, and therapeutic repositioning. It explores the shift from cytotoxic to targeted anticancer agents, the rise of indole-based antivirals in response to the COVID-19 pandemic, and the expanding interest in neuroactive indoles, particularly psychedelic compounds. Additionally, it highlights the underrepresentation of indole-based antibiotics and outlines progress in epigenetic and metabolic modulators. Through a detailed evaluation of pharmacological classes, clinical trial data, and structural characteristics, this review presents a comprehensive framework to guide future optimization and multi-target development of indole scaffolds.}, }
@article {pmid40962401, year = {2025}, author = {Juarez-Martinez, EL and Araia, A and Prasad, D and Dhar, S and Nandoliya, K and Sherrington, IG and Zhao, C and Wescott, A and Pickens, CI and Wunderink, RG and Kimchi, EY}, title = {Five-decade prevalence of delirium in pneumonia, risk factors and associated mortality: a systematic review and meta-analysis.}, journal = {European respiratory review : an official journal of the European Respiratory Society}, volume = {34}, number = {177}, pages = {}, pmid = {40962401}, issn = {1600-0617}, support = {U19 AI181102/AI/NIAID NIH HHS/United States ; U19 AI135964/AI/NIAID NIH HHS/United States ; R01 AG078261/AG/NIA NIH HHS/United States ; P01 HL154998/HL/NHLBI NIH HHS/United States ; T32 TR005124/TR/NCATS NIH HHS/United States ; }, mesh = {Humans ; COVID-19/mortality ; *Delirium/epidemiology/mortality/diagnosis ; *Pneumonia/mortality/diagnosis/epidemiology/complications ; Prevalence ; Prognosis ; Risk Assessment ; Risk Factors ; }, abstract = {BACKGROUND: Delirium can occur in patients with pneumonia, but its prevalence is inconsistent across studies. Unreliable estimates and uncertainty regarding the significance of patient-specific versus microbiological risk factors hinder delirium management and prognosis. Here, we provide robust estimates of delirium prevalence in patients with pneumonia, associated risk factors and association with mortality.
METHODS: We searched five databases (Medline, Cochrane Library, Embase, PsycINFO and Scopus), from inception to 6 August 2024. We included studies in adults hospitalised with pneumonia reporting delirium, encephalopathy or altered mental status. Two investigators extracted data and assessed risk of bias. Summary rates were calculated using random-effects models. We performed prespecified analyses for diagnostic methods, microbiologic factors, clinical factors and mortality, with sensitivity analysis among studies at low risk of bias. The review protocol was registered with PROSPERO: CRD42023385571.
RESULTS: Delirium prevalence across 126 studies was 22% (95% CI 18-26%) and higher in studies at low risk of bias (40%, 95% CI 24%-58%; n=11). Standardised assessments yielded higher rates than symptom- or International Classification of Diseases code-based assessments (p<0.05). Surprisingly, delirium rates did not differ by microbiological aetiology (p=0.63), including COVID-19, nor by pneumonia origin (p=0.14). Predisposing factors included older age and neurologic and systemic comorbidities. Delirium was associated with increased mortality (odds ratio 4.3, 95% CI 3.24-5.76; p<0.001), without change over five decades (p=0.32).
INTERPRETATION: Delirium is highly prevalent and enduring in pneumonia, with nearly double the estimated prevalence when standardised diagnostic methods for both pneumonia and delirium are used. Our results emphasise patient- and care-related factors over microbiological causes, including COVID-19. Delirium's entrenched association with mortality, even considering covariates, reinforces the need to manage delirium as a convergent syndrome in pneumonia.}, }
@article {pmid40963624, year = {2025}, author = {Lattarulo, S and Centrone, F and Chironna, M}, title = {Anti-MDA5+ dermatomyositis following SARS-COV-2 infections: a systematic review.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1565803}, pmid = {40963624}, issn = {1664-3224}, mesh = {Humans ; *Interferon-Induced Helicase, IFIH1/immunology ; *COVID-19/immunology/complications ; *Dermatomyositis/immunology/etiology ; *SARS-CoV-2/immunology ; *Autoantibodies/blood/immunology ; }, abstract = {BACKGROUND: Anti-MDA5+ dermatomyositis (DM), also called anti-MDA5+ syndrome, or clinically amyopathic dermatomyositis (CADM), is characterized by extra-muscular DM manifestations such as skin rash, arthralgia, and rapid progressive-interstitial lung disease. Between 2020 and 2024, an increase in serum titer of anti-MDA5 autoantibodies (AABs) and MDA5+ DM cases was registered among the general population. Given the role of MDA5 as a viral-RNA sensor, it is considered a key molecule in rheumatological disorders, as studies show its activity is triggered by viral infection. Here, we conducted a systematic review of studies reporting an unambiguous temporal link between SARS-CoV-2 infections and development of MDA5+ DM. The aim was to clarify our understanding of this idiopathic rheumatic nature.
METHODS: This review meets Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (PRISMA). The Google Scholar, PubMed, Scopus and ScienceDirect were searched using appropriate keywords to identify relevant studies published from 2020-2025. Twenty-nine studies concerning the development of MDA5+ DM in COVID-19 patients, as well as molecular pathogenetic mechanisms and pharmaceutical treatments were included.
RESULTS: Anti-MDA5 antibodies have been detected in patients with COVID-19, as well as in sera from post-COVID patients, and their presence correlates positively with disease severity. The onset of MDA5+ DM, in different phenotypic variants, increased during the COVID-19 pandemic, paralleled by an increase in the incidence of juvenile idiopathic inflammatory myopathies (JIIM). The literature here reported shows that MDA5+ DM arises after primary SARS-CoV-2 infection, which could stimulate an antiviral pathway overactivation, leading to innate and adaptive immune cells recruiting, cytokine storm, and synthesis of autoantibodies.
CONCLUSION: This review provides evidence for a link between primary SARS-CoV-2 infections, anti-MDA5 AABs synthesis and emergence of MDA5+ DM in phenotypically different variants such as MIP-C, driven by the virus's inclination to trigger type-I interferonopathy in genetically predisposed individuals.
https://www.crd.york.ac.uk/prospero/, identifier 1129317.}, }
@article {pmid40964194, year = {2025}, author = {Fetriani, U and Zakiawati, D}, title = {Viral Triggers Exposed: A Systematic Review of Virus-Induced Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis.}, journal = {Journal of inflammation research}, volume = {18}, number = {}, pages = {12575-12588}, pmid = {40964194}, issn = {1178-7031}, abstract = {AIM: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe skin conditions characterized by widespread epidermal necrolysis and mucous membrane involvement. SJS affects less than 10% of the body surface area, while TEN involves over 30%, with cases between 10% and 30% classified as SJS/TEN overlap. Drug hypersensitivity reactions, especially to antibiotics, anticonvulsants, and non-steroidal anti-inflammatory medications, are the most common and well-established causes of SJS/TEN. In addition, infections, including viral ones like herpes simplex virus (HSV), influenza virus, varicella-zoster virus, and human immunodeficiency virus (HIV), have also been implicated as potential inducers, complicating management and requiring careful clinical vigilance.
PURPOSE: This review aims to investigate and compile information on reported cases of SJS/TEN potentially linked to virus infections.
METHODS: Literature from PubMed, NCBI, ScienceDirect, and Cochrane Library databases was searched. The inclusion criteria were studies reporting details of patients diagnosed with SJS, TEN, or SJS/TEN overlap, potentially induced by viral infections. Cases were included if the viral infection occurred within one week before the rash onset, emphasizing the association between these infections and severe skin reactions.
RESULTS: Ten studies were included in this systematic review, most of which demonstrated fair to good methodological quality. The review encompassed cases of virus-induced SJS/TEN, including herpes virus infection, influenza virus infection, varicella-zoster virus, HIV infection, COVID-19, and coxsackie infection, each with distinct manifestations.
CONCLUSION: The evidence strongly suggests that viral infections contribute to the development of SJS/TEN, yet the precise mechanisms remain unclear and warrant further research. Awareness of this risk is crucial, particularly in regions experiencing outbreaks of these viruses.}, }
@article {pmid40964609, year = {2025}, author = {Ibarz Pavon, AB and Clemens, J and Craviotto, A and Crump, JA and Garrett, DO and Gordon, MA and John, J and Keddy, KH and Laurens, MB and Liu, X and Marks, F and Pollard, AJ and Saha, S and Wilder-Smith, A}, title = {WHO preferred product characteristics for bivalent Salmonella Typhi/Paratyphi A vaccine for comprehensive protection against enteric fever- key considerations and research gaps.}, journal = {Gates open research}, volume = {9}, number = {}, pages = {71}, pmid = {40964609}, issn = {2572-4754}, support = {001/WHO_/World Health Organization/International ; }, mesh = {Humans ; *Typhoid Fever/prevention & control/epidemiology ; *Typhoid-Paratyphoid Vaccines/immunology ; *Paratyphoid Fever/prevention & control/epidemiology ; *Salmonella paratyphi A/immunology ; *Salmonella typhi/immunology ; World Health Organization ; Child, Preschool ; Evidence Gaps ; }, abstract = {In 2021, Salmonella Paratyphi A caused >2 million illnesses, resulting in >14,000 deaths, most of which occurred among children under 5 years of age in socioeconomically deprived populations. Both typhoid fever and paratyphoid fever occur in such areas, but paratyphoid fever is currently concentrated in South Asia. Typhoid conjugate vaccines are recommended for the control of enteric fever in typhoid-endemic settings; however, there are increasing demands for the development of vaccines that can address enteric fever more broadly by including protection against paratyphoid fever. The WHO preferred product characteristics (PPC) and a research and development (R&D) technology roadmap are normative documents developed with the guidance and contribution of a multidisciplinary expert group following a standard methodological framework. In this paper, we summarize the PPC and R&D roadmap presenting the key attributes for a bivalent Salmonella enterica serovar Typhi and Paratyphi A vaccine, and discuss the identified key research and data gaps needed to optimize vaccine value and to inform public health and policy decisions, with a particular focus in paratyphoid and enteric fever endemic countries.}, }
@article {pmid40965740, year = {2025}, author = {Alhasan, MS and Alhasan, AS}, title = {Technical requirements and optimization strategies for home-based teleradiology workstations: a review article.}, journal = {Insights into imaging}, volume = {16}, number = {1}, pages = {198}, pmid = {40965740}, issn = {1869-4101}, abstract = {Teleradiology has advanced from an occasional modality to a cornerstone of modern radiology practice, with the COVID-19 pandemic catalyzing widespread adoption of home-based reading environments. This review synthesizes current literature and expert recommendations on hardware and software optimization for effective home-based teleradiology implementation. Available data indicate 65% of institutions established home workstations during the pandemic, with 74% transitioning routine daytime shifts to internal teleradiology. We reviewed key components of successful remote reading environments, including diagnostic display specifications, environmental controls, ergonomic considerations, computational infrastructure, and network architecture. Evidence suggests that properly configured remote workstations maintain diagnostic performance equivalent to hospital reading rooms while enhancing radiologist satisfaction and productivity. We found that 65% of radiologists reported reduced stress levels when working from home, and 96% observed similar or improved report turnaround times. Essential technical specifications include display luminance standards, ambient lighting levels between 25 and 75 lux, acoustic conditions below 40 decibels, and temperature control within 20-24 °C. Computational requirements include a minimum sustained bandwidth of 50-100 Mbps. We review multi-layered security architectures and workflow integration strategies supporting distributed reading environments. Our review concludes that properly implemented home-based teleradiology is a viable practice model extending specialized expertise across geographic boundaries while promoting radiologist well-being. However, knowledge gaps remain in technical standardization, regulatory harmonization, and long-term clinical outcomes, underscoring the need for further research to support confident, data-driven teleradiology implementation. CRITICAL RELEVANCE STATEMENT: This review critically evaluates the technical, ergonomic, and operational requirements for home-based teleradiology, offering evidence-based recommendations that address current practice gaps and support the development of sustainable, high-performance remote reading environments in modern clinical radiology. KEY POINTS: Home teleradiology maintains diagnostic quality while improving radiologist well-being; 65% report reduced stress and 96% show similar or improved report turnaround times. Optimal implementation requires medical-grade displays, a controlled environment (25-75 lux lighting), 50-100 Mbps bandwidth, and robust security measures. Standardization varies across jurisdictions; some countries have protocols, but gaps persist in cross-border teleradiology and long-term outcomes assessment.}, }
@article {pmid40966381, year = {2025}, author = {Espitia Angel, JM and Agudelo-Pérez, S and Olarte Bermúdez, LM and Chaparro Rojas, DDP and Bonilla Herrera, SD and Gómez Merchán, M}, title = {Characterization of Omics Components in Human Milk: A Systematic Review.}, journal = {Journal of mother and child}, volume = {29}, number = {1}, pages = {126-142}, pmid = {40966381}, issn = {2719-535X}, mesh = {Humans ; *Milk, Human/chemistry/metabolism ; Female ; Infant, Newborn ; Metabolomics ; Lactation/metabolism ; Proteomics ; Glycomics ; Metabolome ; COVID-19 ; Lipidomics ; }, abstract = {BACKGROUND/AIMS: The proteome, lipidome, glycome, and metabolome of human milk are critical for newborn nutrition and health, and offer personalised, non-pharmacological interventions. This systematic review aims to characterise the omics components of human milk according to maternal health and lactation phases, summarising current knowledge based on high-resolution analytical techniques.
METHODS: We conducted a systematic review according to the PRISMA 2020 guidelines. The search was performed between August and September 2022 using Medline, EMBASE, Scopus, LILACS, and Web of Science. Observational studies that analysed human milk at any lactation stage using mass spectrometry or nuclear magnetic resonance to characterise nutrients, biomolecules, or bioactive compounds were included. In total, 55 full-text articles were included in this study.
RESULTS: Glycomics is the most frequently studied omics, followed by proteomics, metabolomics, and lipidomics. Analyses revealed that maternal comorbidities and lactation phases influence the composition of human milk. Fucosylated HMOs showed a protective role against infectious diseases, while elevated levels of protease inhibitors were found in milk from allergic mothers and elevated immunoglobulins were present in milk from mothers with COVID-19. Endocannabinoid profile is associated with improved neonatal sucking ability, while fatty acid-derived metabolites are correlated with infant growth. Distinct omics patterns have also been identified in mothers with diabetes, hypothyroidism, and obesity.
CONCLUSION: Understanding the omics profile of human milk can guide precise nutrition and improve human milk substitutes. Further research integrating omics data with maternal and infant outcomes will be essential to advance knowledge and support infant health.}, }
@article {pmid40966450, year = {2025}, author = {Bell, M and Krasnodembskaya, AD}, title = {Distal lung organoids derived from adult stem cells as novel tools in deciphering mechanisms of lung regeneration, infection, and cancer.}, journal = {Stem cells translational medicine}, volume = {14}, number = {9}, pages = {}, pmid = {40966450}, issn = {2157-6580}, mesh = {*Organoids/cytology/physiology/pathology ; Humans ; *Regeneration ; *Lung/physiology/pathology/cytology ; COVID-19/pathology ; *Adult Stem Cells/cytology ; SARS-CoV-2 ; *Lung Neoplasms/pathology ; Animals ; }, abstract = {While lung research has made great strides in understanding lung physiology, lung pathology still presents a major burden to patients and healthcare systems globally. To develop new effective therapeutics to improve lung regeneration, prevent spread of infections, or treat lung cancers, obscured fundamental processes of the lung must be dissected. Current understanding of lung cell cross talk has been limited due to a lack of accessible and representative models. Since the COVID-19 pandemic, many new foundational methodologies for distal organoid formation have been published, which eliminate difficulty in distal organoid longevity and donor cell extraction efficiency. This review describes how recent advances within distal lung organoid technology have been used to investigate lung regeneration, fibrosis, infection trafficking, personalized medicine, and mechanism of chronic lung pathology using donor cells. Additionally, the applicability of distal lung organoids to investigation of the roles of endothelium and previously unknown distal epithelial and mesenchymal cell populations is discussed. Finally, new techniques and methods for tackling current challenges within the field, such as integration of immune cells and vascularization of organoids are highlighted. This overview will therefore illustrate the potential of distal lung organoids to be tissue representative models, which will be crucial for evolving scientific knowledge of lung physiology.}, }
@article {pmid40966832, year = {2025}, author = {Gochicoa-Rangel, L and Torre-Bouscoulet, L and Salles Rojas, A and Guzmán-Valderrábano, C and Esperanza Benítez-Pérez, R and Salas Escamilla, I and Monráz-Pérez, S and Manuel Grosso-Espinosa, J and , }, title = {Functional respiratory evaluation in the coronavirus disease-19 era: The role of pulmonary function test laboratories.}, journal = {Revista de investigacion clinica; organo del Hospital de Enfermedades de la Nutricion}, volume = {77}, number = {4}, pages = {100011}, doi = {10.24875/RIC.20000250}, pmid = {40966832}, issn = {2564-8896}, mesh = {Humans ; *COVID-19/physiopathology ; *Respiratory Function Tests/standards/methods ; *Laboratories/standards ; Adult ; Quality Control ; Child ; }, abstract = {The pandemic character of coronavirus disease-19 (COVID-19) requires strategy changes designed to guarantee the safety of patients and health-care professionals. We are greatly concerned by the limitations in the operation of pulmonary function test (PFT) laboratories, since there is a high risk of disease progression in patients with chronic pulmonary diseases, and we are now faced by the influx of a new group of individuals in the recovery phase of post-COVID-19-syndrome that requires evaluation and follow-up of their respiratory function. To reestablish the operation of PFT laboratories limiting the risk of cross-contamination, we herein present the consensus reached by a group of experts in respiratory physiology, most of whom work in PFT laboratories in several Latin-American countries, on the applicable recommendations for severe acute respiratory syndrome coronavirus 2 pneumonia survivors when undergoing PFT. We present the safety and hygiene measures that must be adopted in laboratories or centers where PFT is conducted in adults and/or children. These recommendations answer the following questions: which PFT is most recommended in subjects that have recovered from COVID-19; what quality control and safety measures should PFT laboratories implement during this pandemic? And how should we approach non-COVID-19 patients requiring PFT?}, }
@article {pmid40967275, year = {2026}, author = {Renard, M and Bell, Z and Jamshidvand, M and Mai, Z and McCloat, A and Mooney, E and Hollywood, L and Lavelle, F}, title = {Domestic cooking and food behaviours during the COVID-19 pandemic and the cost-of-living crisis: A scoping review.}, journal = {Appetite}, volume = {216}, number = {}, pages = {108311}, doi = {10.1016/j.appet.2025.108311}, pmid = {40967275}, issn = {1095-8304}, mesh = {Humans ; *COVID-19/economics/epidemiology ; *Cooking/economics ; SARS-CoV-2 ; Pandemics ; Family Characteristics ; *Feeding Behavior ; Consumer Behavior ; United Kingdom ; }, abstract = {This scoping review examined how the COVID-19 pandemic and cost-of-living crisis have influenced domestic cooking and food-related behaviours. Following PRISMA-ScR, a systematic search across five databases and grey literature sources identified 4955 records. After screening, 98 studies published between 2020 and 2024 were included. Most studies were conducted in the UK (22.4 %) and USA (18.4 %) and employed cross-sectional (94.9 %) and quantitative (73.5 %) methods. The review identified widespread increases in home cooking, with 50-78 % of participants reporting greater cooking frequency. Changes in food shopping were also prominent, including reduced in-person visits (reported by 40-74 % of participants) and increased online grocery use (25-61.8 %). Budgeting behaviours adapted to financial constraints, with many households reducing the quality and quantity of food purchased, substituting fresh with shelf-stable options. Improvements in hand hygiene were widely reported (74-90 %); however, unsafe practices such as consuming expired foods or mishandling leftovers, remained common. Only 4.1 % of studies received a positive quality rating, with frequent use of non-validated tools and self-reported measures. Future research should employ longitudinal designs to assess the sustainability of these behaviours. Structural policy actions are needed to ensure access to affordable, nutritious foods and support sustainable food practices during ongoing economic challenges.}, }
@article {pmid40967602, year = {2026}, author = {Dequin, PF and Confalonieri, M}, title = {Glucocorticoid Treatment in Community-Acquired Pneumonia.}, journal = {Seminars in respiratory and critical care medicine}, volume = {47}, number = {1}, pages = {66-76}, pmid = {40967602}, issn = {1098-9048}, mesh = {Humans ; *Community-Acquired Infections/drug therapy ; *Glucocorticoids/therapeutic use ; *COVID-19 Drug Treatment ; *Pneumonia/drug therapy ; COVID-19 ; SARS-CoV-2 ; Intensive Care Units ; Randomized Controlled Trials as Topic ; Community-Acquired Pneumonia ; }, abstract = {Despite a fairly large number of comparative trials (which are, however, very heterogeneous), the role of corticosteroids in the adjuvant treatment of community-acquired pneumonia remains controversial. Nevertheless, recent randomized trials with adequate power in intensive care unit patients, albeit with conflicting results, have contributed to clarifying our understanding of this issue. More accurate phenotyping of patients likely to benefit from corticosteroid treatment must now be performed. In COVID-19 pneumonia, their benefit is not in question. For certain specific pathogens, including viral pathogens, their indications must be refined. They are still not recommended for influenza. They appear generally safe for short-term use in select populations.}, }
@article {pmid40967971, year = {2025}, author = {Odoom, A and Obeng, EM and Dzuvor, CKO}, title = {Multivalent decoy receptor therapeutics to combat viral pandemics and evolution.}, journal = {Trends in pharmacological sciences}, volume = {46}, number = {10}, pages = {935-939}, doi = {10.1016/j.tips.2025.08.010}, pmid = {40967971}, issn = {1873-3735}, mesh = {Humans ; Pandemics/prevention & control ; Animals ; *Antiviral Agents/therapeutic use/pharmacology ; SARS-CoV-2 ; *Virus Diseases/drug therapy ; }, abstract = {Viruses are likely to cause future pandemics due to their inherent ability to evolve and spread rapidly, with limited treatment options. Engineered multivalent decoy receptors (EMDRs) offer a broad-spectrum alternative treatment option. We propose and evaluate EMDRs and their delivery methods to guide future efforts toward pandemic preparedness.}, }
@article {pmid40968401, year = {2025}, author = {Reinhardt, J and Linde, K and Kersting, A}, title = {Prevalence of posttraumatic stress symptoms among physicians - A meta-analysis.}, journal = {European psychiatry : the journal of the Association of European Psychiatrists}, volume = {68}, number = {1}, pages = {e132}, pmid = {40968401}, issn = {1778-3585}, mesh = {Humans ; *COVID-19/epidemiology/psychology ; *Occupational Stress/epidemiology ; *Physicians/psychology/statistics & numerical data ; Prevalence ; *Stress Disorders, Post-Traumatic/epidemiology ; }, abstract = {BACKGROUND: The medical profession is associated with high demands and occupational stressors - including confrontation with illness and death, extended work hours, and high workload - which may increase the risk of traumatization and posttraumatic stress disorder (PTSD). This systematic review aimed to synthesize evidence on prevalence of PTSD among physicians and examine potential moderators, including the COVID-19 pandemic, specialties, and geographic regions.
METHODS: A systematic search was conducted in PubMed, Web of Science, PsychINFO, and PubPsych up to April 2025. Included studies were English-language, peer-reviewed, observational studies, reporting PTSD prevalence in physicians, using validated instruments. Studies focusing on preselected PTSD cases or mixed healthcare samples were excluded. Data extraction included study methodology, measurement tools, geographic region, specialty, and survey timing (pre-/"post"-COVID). Risk of bias was assessed using the JBI critical appraisal checklist for prevalence studies. Quantitative synthesis and moderator analyses were performed. The review was registered with PROSPERO (ID CRD42023401984).
RESULTS: Based on 81 studies (N = 41,051), the pooled PTSD prevalence using a random-effects model was 14.9% (95% CI [0.132-0.168]). Prevalence estimates were lower in high-income (13.6%) compared to middle-income countries (21.1%) (p < 0.036). Studies employing brief screening tools (≤10 items) yielded significantly lower prevalence estimates (10.2%) than those using longer instruments (16.4%) (p < 0.027). No other significant moderators were identified.
CONCLUSION: PTSD prevalence among physicians is elevated relative to the general population, with notable variation across regions and measurement approaches. Future research should address gaps in representativeness and geographic coverage to improve prevalence estimates and guide prevention strategies.}, }
@article {pmid40968958, year = {2025}, author = {Muddaloor, P and Baraskar, B and Shah, H and Gopalakrishnan, K and Sood, D and Pasupuleti, PC and Singh, A and Mitra, D and Hoskote, SS and Iyer, VN and Helgeson, SA and Arunachalam, SP}, title = {The Human Voice as a Digital Health Solution Leveraging Artificial Intelligence.}, journal = {Sensors (Basel, Switzerland)}, volume = {25}, number = {11}, pages = {}, pmid = {40968958}, issn = {1424-8220}, mesh = {Humans ; *Artificial Intelligence ; *Voice/physiology ; COVID-19/diagnosis ; Machine Learning ; Neural Networks, Computer ; SARS-CoV-2 ; Digital Health ; }, abstract = {The human voice is an important medium of communication and expression of feelings or thoughts. Disruption in the regulatory systems of the human voice can be analyzed and used as a diagnostic tool, labeling voice as a potential "biomarker". Conversational artificial intelligence is at the core of voice-powered technologies, enabling intelligent interactions between machines. Due to its richness and availability, voice can be leveraged for predictive analytics and enhanced healthcare insights. Utilizing this idea, we reviewed artificial intelligence (AI) models that have executed vocal analysis and their outcomes. Recordings undergo extraction of useful vocal features to be analyzed by neural networks and machine learning models. Studies reveal machine learning models to be superior to spectral analysis in dynamically combining the huge amount of data of vocal features. Clinical applications of a vocal biomarker exist in neurological diseases such as Parkinson's, Alzheimer's, psychological disorders, DM, CHF, CAD, aspiration, GERD, and pulmonary diseases, including COVID-19. The primary ethical challenge when incorporating voice as a diagnostic tool is that of privacy and security. To eliminate this, encryption methods exist to convert patient-identifiable vocal data into a more secure, private nature. Advancements in AI have expanded the capabilities and future potential of voice as a digital health solution.}, }
@article {pmid40969583, year = {2025}, author = {Astete-Cornejo, J and Burgos-Flores, MA and Cruz-Ausejo, L and Cainamarks-Alejandro, JA and Ambrosio-Melgarejo, JI and Rosales-Rimache, J}, title = {Implementation of occupational safety and health services and telehealth in Peru: a narrative review.}, journal = {Revista brasileira de medicina do trabalho : publicacao oficial da Associacao Nacional de Medicina do Trabalho-ANAMT}, volume = {23}, number = {2}, pages = {e20251405}, pmid = {40969583}, issn = {1679-4435}, abstract = {Although occupational health aims to protect the well-being of workers, challenges persist in workplaces, such as the provision of occupational safety and health services and the availability of occupational telehealth. This study's objective was to examine the implementation of occupational safety and health services and telehealth in Peru. A review was conducted of technical documents and regulations related to occupational safety and health services and occupational telehealth applicable to the Peruvian context. Forty percent of Peruvian workplaces lack occupational safety and health services, reflecting a similar issue across Latin America and Europe. Barriers such as corporate commitment and financing were identified. Occupational telehealth was utilized during the COVID-19 pandemic, highlighting its potential to strengthen occupational safety and health services. The lack of occupational safety and health services and occupational telehealth can be overcome through regulatory support, enforcement, and incentives for employers.}, }
@article {pmid40969755, year = {2025}, author = {Gupta, S and Hemeg, HA and Afrin, F}, title = {Immuno-epigenetic paradigms in coronavirus infection.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1596135}, pmid = {40969755}, issn = {1664-3224}, mesh = {Humans ; *Epigenesis, Genetic/immunology ; *SARS-CoV-2/immunology/physiology/genetics ; *COVID-19/immunology/genetics/virology ; Host-Pathogen Interactions/immunology/genetics ; Animals ; Virus Replication ; }, abstract = {Coronavirus Disease 2019 (COVID-19) is caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), a novel member of the Coronaviridae family. The viral genome encodes both structural proteins, such as spike, membrane, hemagglutinin, and envelope, as well as non-structural proteins that include auxiliary proteins and replicase essential for viral replication. While immunization campaigns have mitigated the spread of the virus, therapeutic interventions remain critical for managing outbreaks and preventing long-term health consequences. Despite extensive global research into the genome, structure, entry process, and replication mechanisms of SARS-CoV-2, key aspects such as the roles of membrane lipids in viral entry, packaging, and release, as well as the metabolic alterations in infected cells, remain poorly understood. Epigenetics, the study of heritable phenotypic changes driven by genetic and non-genetic factors, plays a pivotal role in shaping host responses to SARS-CoV-2 infection. Epigenetic modifications, such as histone methylation and acetylation, DNA and RNA methylation, chromatin remodeling, and non-coding RNA regulation, significantly influence gene expression in infected host cells. These reversible changes orchestrate the host's antiviral responses and potentially alter susceptibility to COVID-19. This review delves into the immuno-epigenetic modifications occurring in hosts infected with SARS-CoV-2, providing insights into how these changes trigger viral replication and infection processes. By examining the current state of research on the immune-epigenetic landscape of SARS-CoV-2 infections, we highlight the mechanisms by which these modifications affect the host-viral interplay. Furthermore, we propose potential therapeutic targets within the immune-epigenetic pathways that could enhance ongoing efforts to combat COVID-19. Understanding these mechanisms will not only provide a deeper perspective on the virus's pathogenic strategies but also offer innovative approaches to improve therapeutic interventions. By addressing the gaps in knowledge surrounding immune-epigenetic factors, this review aims to contribute to the development of novel strategies for preventing and managing coronavirus infections and its variants.}, }
@article {pmid40969915, year = {2025}, author = {Yuri, E and Chung, HY and Chen, FS}, title = {Reframing SpO2 tolerance as a physiological switch: implications for hypoxic adaptation and exercise regulation.}, journal = {Frontiers in physiology}, volume = {16}, number = {}, pages = {1667238}, pmid = {40969915}, issn = {1664-042X}, abstract = {Blood oxygen saturation (SpO2) is a widely used oxygenation index in clinical and physiological settings. However, recent phenomena, such as asymptomatic hypoxia in COVID-19 and the superior performance of athletes in high-altitude conditions under hypoxia, have highlighted the significant variability in individual tolerance to blood oxygen saturation. Age, health status, disease, and hypoxic adaptation influence it. This brief review introduces the concept of the SpO2 switch as a dynamic. We also proposed a physiological compensatory response of SpO2 switch to SpO2 criticality that triggers compensatory responses, including ventilatory, autonomic, cardiovascular, and metabolic adaptations. Furthermore, individuals can exhibit markedly different responses to hypoxia at the same SpO2 value. It reflects a "threshold switch mechanism" driven by an individual's internal physiological settings. This suggests that the SpO2 value demonstrates the onset of hypoxia symptoms and reacts to the body's difference in compensatory capacity. This reconceptualisation shifts the focus from static thresholds to dynamic response analysis, offering new perspectives for precision health, mountain medicine, and personalised risk assessment of hypoxia.}, }
@article {pmid40970030, year = {2025}, author = {Hughes, B and Mirza, S and Ponamala, M and Sagaser, J and Paredes, R and Hematillake, N and Tailor, C and Khan, R and Pemminati, S}, title = {Exploring the Therapeutic Potential of Ketamine and Psilocybin in Comparison to Current Treatment Regimens for Treatment-Resistant Depression, Mood Disorders, and Post-traumatic Stress Disorder in the Pediatric Population: A Narrative Review.}, journal = {Cureus}, volume = {17}, number = {8}, pages = {e90425}, pmid = {40970030}, issn = {2168-8184}, abstract = {The stresses of the Coronavirus Disease of 2019 (COVID-19) pandemic highlighted the burden of psychiatric disorders within the pediatric population, revealing a pre-existing need for rapid-onset therapies that have since driven efforts to expand effective therapeutic interventions. In this narrative review, we utilized the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines to direct our report and study selection. We explored the current-state efficacy and therapeutic potential of ketamine and psilocybin in comparison to current treatment regimens for pediatric non-psychotic disorders, including Treatment-Resistant Depression (TRD), mood disorders like anxiety and bipolar disorder, and Post-Traumatic Stress Disorder (PTSD). We chose these pediatric disorders to eliminate concerns regarding reality orientation and the use of dissociative and/or psychedelic medicines in patients who are experiencing symptoms of psychosis. Also, we briefly discuss ketamine's more widely accepted utilization by medical providers as a pediatric anesthetic, and how this gives credence to further evaluation of ketamine's multifaceted indications in pediatric psychiatry. Recent studies have shed light on the involvement of glutamate pathways in the pathophysiology of TRD, mood disorders, and PTSD, and both ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, and psilocybin, a 5-hydroxytryptamine receptor 2A (5-HT2A) agonist, have emerged as promising options due to their ability to augment glutamate release. Ketamine's use for pediatric TRD demonstrated rapid-onset relief for signs and symptoms of depression in children and adolescents, and psilocybin also decreased symptoms in patients with longstanding or refractory depression. Ketamine has been well tolerated and exhibited symptom improvements for youth with mood disorders such as anxiety and bipolar depression, while psilocybin showed promise in fostering emotional processing. In youth suffering from PTSD, ketamine-assisted psychotherapy (KAP) brought about decreases in PTSD symptom severity, though outcomes varied across populations. Psilocybin enhanced neural plasticity, allowing patients to revisit and reframe memories under therapeutic guidance, especially for those with complex or treatment-resistant PTSD. Ethical considerations are involved in the use of dissociative and hallucinogenic therapies like ketamine and psilocybin in the pediatric population, and we explore some ethical issues regarding their use. Further research exploring specific brain locations and mechanisms of action underlying glutamate modulation by ketamine and psilocybin, and the subsequent rapid-acting relief of psychiatric symptoms offered by these substances, could pave the way for innovative treatments targeting pediatric mental health disorders.}, }
@article {pmid40970676, year = {2026}, author = {Reilly, JJ and Glendenning, L and Govan, L}, title = {Impact of the COVID-19 pandemic on motor competence in children and adolescents: A systematic review.}, journal = {Journal of sports sciences}, volume = {44}, number = {1}, pages = {105-116}, doi = {10.1080/02640414.2025.2555122}, pmid = {40970676}, issn = {1466-447X}, mesh = {Humans ; *COVID-19 ; Child ; *Motor Skills/physiology ; Adolescent ; *Pandemics ; Child, Preschool ; SARS-CoV-2 ; Male ; Female ; }, abstract = {This systematic review aimed to investigate COVID-19 impacts on motor competence (MC) in children and adolescents. SportDiscus, APAPsycInfo, CINAHL, Scopus, PubMed, Web of Science, Medline were searched in November 2024. Studies were included if they were in English; from 2015; measured actual MC pre and post COVID-19; in apparently healthy 3- to 19-year olds. Risk of bias assessment used the Effective Public Health Practice Project instrument. Eligible studies were synthesised narratively due to heterogeneity, and with Vote Counting to assess pre-post COVID-19 trend. Of the 568 studies, 278,536 participants, mean ages 5-11 years, took part in 11 eligible studies (4 longitudinal, 7 cross sectional): from Europe (7), Asia (2) and South America (2). Ten studies found a reduction in MC following the pandemic (Sign Test p = 0.01) with declines in: stability (one study, effect size, ES -0.30), locomotor domain (6 studies, ES -0.10 to -0.53), object control (3 studies, ES -0.07 to -0.25), composite MC (one study ES -0.65 in boys to -0.88 in girls). Seven studies were rated weak for selection bias, 8 for attrition and 6 for data collection methods. MC declined post-pandemic but there is a need for more global evidence. Funding: Scottish Funding Council. PROSPERO CRD42023467766.}, }
@article {pmid40971149, year = {2026}, author = {Cotter, TG and Anouti, A and VanWagner, LB and Verna, EC and Goldberg, DS and Keyes, KM and Schaefer, N and Lee, M and Fernandez, A and Rady, ED and Mitchell, MC and Mellinger, JL and , }, title = {Early liver transplantation in alcohol-associated liver disease-Evolution of practice, patient selection, management, and outcomes.}, journal = {Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society}, volume = {32}, number = {3}, pages = {428-443}, pmid = {40971149}, issn = {1527-6473}, support = {R01 AA030956/AA/NIAAA NIH HHS/United States ; R01 AA030968/AA/NIAAA NIH HHS/United States ; }, mesh = {Humans ; *Liver Transplantation/methods ; *Liver Diseases, Alcoholic/surgery/mortality/psychology/epidemiology ; *Patient Selection ; Alcohol Abstinence ; Treatment Outcome ; COVID-19/epidemiology ; *Alcoholism ; Time-to-Treatment ; }, abstract = {Early liver transplantation (eLT) for alcohol-associated liver disease (ALD), defined as transplantation with less than 6 months of alcohol abstinence, has emerged as a standard intervention for carefully selected patients unresponsive to medical therapy. Rising ALD prevalence, driven by increased alcohol use, particularly among patients in early adulthood, and exacerbated by the COVID-19 pandemic, has led to an increased demand for eLT for ALD. Recent studies have demonstrated that eLT can yield survival outcomes comparable to standard liver transplantation, although patient selection remains challenging, with return to drinking (RTD) after transplant a primary concern. Various psychosocial evaluation tools can help identify candidates at lower risk for RTD, but predictive accuracy remains limited due to the complex, individualized nature of alcohol use disorder among ALD patients. Multidisciplinary approaches to managing alcohol use disorder, such as integrated care models, are increasingly being adopted to improve outcomes and achieve sustained alcohol abstinence after transplant. Despite the recent increase in eLT for ALD, international practices vary widely, with countries like the United States, France, and Belgium leading in adoption, whereas others still impose strict sobriety requirements. Notably, racial, ethnic, and geographic disparities in access to eLT for ALD have emerged, highlighting the need for more standardized and equitable practices. This review traces the development and expansion of eLT in ALD, addressing selection and management challenges, while proposing a biopsychosocial framework to optimize patient and graft outcomes across the liver transplantation continuum.}, }
@article {pmid40971252, year = {2025}, author = {Shahiwala, A}, title = {Integrating the design thinking approach into pharmaceutical product development: emphasizing nanomedicine innovation.}, journal = {Drug development and industrial pharmacy}, volume = {51}, number = {12}, pages = {1662-1672}, doi = {10.1080/03639045.2025.2563633}, pmid = {40971252}, issn = {1520-5762}, mesh = {Humans ; *Nanomedicine/methods/trends ; *Drug Development/methods ; *Drug Design ; }, abstract = {OBJECTIVE: To perform a narrative review that critically examines the application of design thinking (DT) in pharmaceutical product development, with emphasis on its role in advancing nanomedicine innovation and patient-centric drug design.
SIGNIFICANCE OF REVIEW: DT offers a human-centered, iterative alternative to the traditional linear R&D model. Its integration into pharmaceutical development addresses challenges such as high attrition rates, limited patient input, regulatory complexity, and scalability, thereby improving translational success. This review adopts a conceptual and narrative approach, analyzing the five stages of DT, Empathize, Define, Ideate, Prototype, and Test, within the context of pharmaceutical development.
KEY FINDINGS: The application of DT fosters tangible benefits in pharmaceutical innovation, including empathy-driven product design, targeted problem framing, and iterative prototyping aligned with user and regulatory needs. Case studies such as Doxil[®], ABRAXANE[®], and mRNA-based COVID-19 vaccines illustrate established successes, while emerging examples, including CRISPR-based therapeutics and extracellular vesicle (EV) nanocarriers, underscore the forward-looking potential of this methodology. Together, these examples highlight how DT accelerates development timelines, mitigates risk, and enhances patient and regulatory alignment.
CONCLUSIONS: Integrating DT into pharmaceutical product development enhances innovation by fostering interdisciplinary collaboration, reducing costs, and increasing the likelihood of successful translation to market. Its strategic application in nanomedicine provides a transformative pathway for next-generation therapies that are safer, more effective, and aligned with patient expectations and evolving regulatory frameworks.}, }
@article {pmid40971535, year = {2025}, author = {Maeda, T and Komine, G and Noda, R and Komatsu, M and Sakai, M and Takeyama, Y and Soejima, S and Maruyama, A and Akahoshi, M and Koarada, S and Tada, Y}, title = {Adult-onset Still's disease following COVID-19: a case report and literature review.}, journal = {Modern rheumatology case reports}, volume = {9}, number = {2}, pages = {}, doi = {10.1093/mrcr/rxaf059}, pmid = {40971535}, issn = {2472-5625}, mesh = {Humans ; Male ; Middle Aged ; *COVID-19/complications ; Ferritins/blood ; Glucocorticoids/therapeutic use ; Immunosuppressive Agents/therapeutic use ; Methotrexate/therapeutic use ; SARS-CoV-2 ; *Still's Disease, Adult-Onset/drug therapy/etiology/diagnosis ; }, abstract = {A 59-year-old man developed adult-onset Still's disease 11 days after contracting COVID-19. He presented with high fever, polyarthritis, erythema, sore throat, and high levels of C-reactive protein and ferritin; treatment with glucocorticoids and methotrexate led to disease remission. We reviewed the clinical characteristics of 12 cases (11 from the literature and the present case) of adult-onset Still's disease following COVID-19. Eight cases involved females, with a median age of 54 years (19-59 years), and the median time from COVID-19 to Still's disease onset was 12.5 days. Frequencies of high fever, arthralgia, typical skin lesion, sore throat, liver damage, and increased neutrophil count did not differ from cases of non-COVID-related adult-onset Still's disease. Serum ferritin levels were increased in all cases (median 6354 ng/ml). Complications were infrequent, with macrophage activation syndrome reported in one case. Immunosuppressive drugs and biologic agents were used in five and three cases, respectively, and all cases had good outcomes. Our review suggests that adult-onset Still's disease develops early after COVID-19, presenting with clinical findings similar to non-COVID-19-related cases, and has few severe complications and a good prognosis.}, }
@article {pmid40971749, year = {2025}, author = {Juan Ribelles, A and Felix, A and Benavent, N and Escrivá-Fernández, J and Brahmi, M and Gaspar, N and Gatz, SA and Grünewald, TG and Linder-Stragliotto, C and Palmerini, E and Pantziarka, P and Strauss, S and Surdez, D and Berlanga, P and McCabe, MG}, title = {Recurrent and Refractory Ewing Sarcoma Phase I/II Trials: Current Perspective From the Euro-Ewing Consortium.}, journal = {JCO precision oncology}, volume = {9}, number = {}, pages = {e2500377}, doi = {10.1200/PO-25-00377}, pmid = {40971749}, issn = {2473-4284}, mesh = {Humans ; *Sarcoma, Ewing/therapy ; Clinical Trials, Phase I as Topic ; Clinical Trials, Phase II as Topic ; *Bone Neoplasms/therapy ; *Neoplasm Recurrence, Local/therapy ; Europe ; Immunotherapy ; }, abstract = {PURPOSE: Updated analysis of phase I/II trials in recurrent/refractory (R/R) Ewing sarcoma (EwS) over the past 11 years.
METHODS: A systematic review was performed to identify phase I/II trials for R/R EwS in three databases (WHO, US National Library of Medicine, and European Clinical Trials Database) and/or published in PubMed/ASCO/European Society for Medical Oncology websites from 2014 to 2024. The search criteria included EwS OR bone sarcoma OR sarcoma AND Phase-I OR Phase-II. Eligibility and data extraction were performed independently by three reviewers, with priority given to trials with EwS specified data. Trials were categorized by therapeutic intervention, including targeted therapies, immunotherapy, chemotherapy, and combined therapies.
RESULTS: One hundred eight trials met inclusion criteria, predominantly academic (70%) and multicenter (81.5%), with significant US and European collaboration. Trial designs were mainly single-arm, with an increase in multiarm trials in the recent years and increased focus on the pediatric population. Trial modalities emphasized targeted therapies with tyrosine kinase, poly-ADP ribose polymerase, EWSR1::FLI1, and cell cycle inhibitors. Immunotherapy with monoclonal antibodies and CAR-T cells as primary agents is also under investigation. The COVID-19 pandemic coincided with a marked reduction in trial initiation in 2020. Among evaluable data, disease control rates averaged 44% and response rates 8%.
CONCLUSION: This review highlights evolving therapeutic directions in R/R EwS, with increased emphasis on targeted therapies and immunotherapies. Despite pandemic-related delays, trials have progressed in exploring novel targets, including EWSR1::FLI1 oncogenic fusion and DNA repair pathways. These findings underscore ongoing global efforts to address critical unmet needs in EwS treatment, offering a foundation for future trial designs, especially international, randomized phase-II trials across all age ranges.}, }
@article {pmid40971880, year = {2026}, author = {Björk, J and Rasmussen, G and Johansson, S and Dagerhamn, J and Olofsson, H and Wilbe Ramsay, K}, title = {Non-pharmaceutical interventions to prevent community transmission of infectious diseases with pandemic potential-an umbrella review and evidence map.}, journal = {European journal of public health}, volume = {36}, number = {1}, pages = {200-207}, doi = {10.1093/eurpub/ckaf170}, pmid = {40971880}, issn = {1464-360X}, support = {//Swedish Agency for Health Technology Assessment and Assessment of Social Services/ ; 2022-06358//Swedish Research council/ ; 2022-06358//Swedish Research Council/ ; }, mesh = {Humans ; *COVID-19/prevention & control/transmission/epidemiology ; *Pandemics/prevention & control ; *Communicable Disease Control/methods ; SARS-CoV-2 ; Influenza, Human/prevention & control/transmission ; Severe Acute Respiratory Syndrome/prevention & control/transmission ; Hemorrhagic Fever, Ebola/prevention & control/transmission ; }, abstract = {During the COVID-19 pandemic, most countries implemented non-pharmaceutical interventions (NPIs) to mitigate virus transmission and decrease morbidity and mortality. The aim of this umbrella review was to identify and map systematic reviews on the effectiveness of NPIs to reduce widespread community transmission of infectious diseases with pandemic potential. We searched electronic databases (Medline, Embase, Scopus, INAHTA [International Network of Agencies for Health Technology Asseesment], and World Health Organization COVID-19) and websites (January 2024). Systematic reviews on NPIs during outbreaks, epidemics, or pandemics of COVID-19, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), influenza, or Ebola were included and organized in an interactive evidence map grouped by type of intervention (individual/population/environmental), disease, risk of bias, and search date. Five of the 132 included reviews were assessed as having low, 43 moderate, and 84 high risk of bias. COVID-19 was targeted in 100 reviews, influenza 66, SARS 39, MERS 34, and Ebola in five reviews. The most frequently investigated NPIs were use of face masks, hand washing, physical distancing, travel restrictions, restrictions on public gatherings, and school closures. The five reviews at low risk of bias concluded at low level of evidence about the effectiveness of most NPIs, with exceptions of hand hygiene and some measures in school settings where low- to moderate-certainty evidence was found. There is substantial lack of evidence regarding the effectiveness of several commonly used NPIs, including restrictions on public gatherings, travel restrictions, and visiting restrictions in long-term care facilities. There is a paucity not only of systematic reviews but also of primary studies at low risk of bias.}, }
@article {pmid40972736, year = {2025}, author = {Kumar, R and Maji, S and Tiwari, S and Misra, J and Gupta, J and Kumar, N and Gupta, R and Jha, NK}, title = {Precision vaccine design targeting the prefusion state of viral glycoproteins: advances in structural vaccinology.}, journal = {Biochemical pharmacology}, volume = {242}, number = {Pt 2}, pages = {117349}, doi = {10.1016/j.bcp.2025.117349}, pmid = {40972736}, issn = {1873-2968}, mesh = {Humans ; *Vaccinology/methods/trends ; SARS-CoV-2/immunology ; *Glycoproteins/immunology/chemistry ; COVID-19/prevention & control/immunology ; *Viral Vaccines/immunology/chemistry ; *Vaccine Development/methods ; *COVID-19 Vaccines/immunology/chemistry ; Animals ; Protein Conformation ; *Viral Proteins/immunology/chemistry ; *Precision Medicine/methods/trends ; Drug Design ; }, abstract = {The prefusion conformation of viral glycoproteins is a key target for vaccine development because it can induce strong neutralizing antibody responses. Nevertheless, these structures are frequently metastable and susceptible to conformational alterations that diminish immunogenic efficacy. Progress in structural vaccinology has facilitated the meticulous design of viral proteins to maintain their prefusion conformation, thus improving vaccination effectiveness. This study emphasizes essential methodologies in precision vaccine design focused on preserving the structural integrity, solubility, and immunogenicity of viral glycoproteins. Methods include cavity-filling mutations, proline insertions, and disulfide bond engineering have demonstrated efficacy in enhancing structural stiffness and inhibiting unwanted post-fusion rearrangements. Hydrophobic surface residues are frequently substituted with polar or charged residues to boost solubility and minimize aggregation, while the development of salt bridges and helix-stabilizing substitutions further augment heat stability. The removal of proteolytic cleavage sites and the enhancement of hydrophobic core packing facilitate sustained conformational integrity. Alterations to the fusion peptide, an essential conserved area for viral entry, can inhibit early conformational changes, whereas charge-balancing alterations mitigate electrostatic stress. Glycan shielding conceals non-neutralizing or immunodominant epitopes, steering immune reactions towards conserved, protective areas. Collectively, these structure-guided interventions constitute a thorough molecular toolset, facilitating the creation of prefusion-stabilized immunogens for advanced vaccines. Successfully implemented in vaccine candidates for Respiratory Syncytial Virus (RSV), Human Immunodeficiency Virus (HIV), and Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), these methodologies establish a solid basis for the swift and logical generation of vaccines against emerging viral threats.}, }
@article {pmid40973410, year = {2025}, author = {Mehra, R and Thakur, S}, title = {The structure-based approaches to computing viral fitness.}, journal = {Advances in protein chemistry and structural biology}, volume = {147}, number = {}, pages = {461-498}, doi = {10.1016/bs.apcsb.2024.11.004}, pmid = {40973410}, issn = {1876-1631}, mesh = {Humans ; *SARS-CoV-2/genetics/chemistry ; *Spike Glycoprotein, Coronavirus/chemistry/genetics/metabolism ; Mutation ; Angiotensin-Converting Enzyme 2/chemistry/metabolism/genetics ; }, abstract = {Viral fitness presents a complex challenge that requires a deep understanding of evolution and selection pressures. The swift emergence of mutations in viruses makes them ideal models for studying evolutionary dynamics. Recent advancements in biophysical methods and structural biology have facilitated insights into how these mutations influence evolutionary trajectories at the structural level. Computationally guided structural techniques are particularly valuable for analyzing the mutational landscape across all possible mutations in viral proteins under selection pressure. The virus often interacts via the receptor binding domain (RBD) of its surface protein with the receptor protein of the host cell. This binding is a key step for the viral entry in host cell and infection. In response, the host immune response or vaccines generate antibodies to neutralize the virus particles. This creates a competitive scenario where the viral surface protein competes for binding between host cell receptor and antibodies. The viral mutations supposedly evolve to effectively bind to host receptors while evading the antibody recognition. The differential binding affinity of the viral surface protein, preferably via RBD, between host receptor and antibodies may aid in defining the molecular level viral fitness function. The present chapter explores these dynamics through the lens of severe acute respiratory syndrome coronavirus 2 spike protein, binding to human angiotensin-converting enzyme 2 and circulating antibodies. Interestingly, this strategy utilized the wealth of protein structural data from cryo-electron microscopy and biochemical data on mutations.}, }
@article {pmid40974632, year = {2025}, author = {Macedo, PLG and Taborda, M and Oliveira, VF and Magri, ASGK and Frutuoso, LL and Oliveira, GM and Martins, ST and Santos, DWCL and Carlesse, FAMC and Cavassin, FB and Eulálio, KD and Andréa, ML and Freitas, AD and Vidal, JE and Freitas, DFS and Garnica, M and Leitão, TDMJS and Zancopé-Oliveira, RM and Melhem, MSC and Telles, FQ and Shikanai-Yasuda, MA and Costa, FD and Millington, MA and Magri, MMC}, title = {Brazilian task force for the management of mucormycosis.}, journal = {The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases}, volume = {29}, number = {6}, pages = {104579}, pmid = {40974632}, issn = {1678-4391}, mesh = {Humans ; *Antifungal Agents/therapeutic use ; Brazil/epidemiology ; COVID-19/epidemiology ; *Mucormycosis/diagnosis/drug therapy/epidemiology/surgery ; }, abstract = {BACKGROUND: Mucormycosis is a rare but life‑threatening fungal infection that has shown an increased incidence in Brazil, especially during the COVID‑19 pandemic.
OBJECTIVE: To provide an evidence‑based, context‑specific guideline for the diagnosis and management of mucormycosis within the Brazilian healthcare system.
CLINICAL FEATURES: Rhino‑orbito‑cerebral disease predominates, followed by pulmonary, cutaneous, gastrointestinal and disseminated forms; delayed recognition dramatically increases mortality.
EPIDEMIOLOGY: The global incidence of mucormycosis is increasing, particularly among patients with diabetes mellitus, hematologic malignancies, transplantation, and corticosteroid exposure. The most frequently isolated species is Rhizopus arrhizus, and regional variations in species distribution may be present. In Brazil, comprehensive epidemiological data remain scarce.
TREATMENT: Early, aggressive surgical debridement plus induction with liposomal amphotericin B (5-10 mg/kg/day) followed by isavuconazole or posaconazole is recommended; strict control of hyperglycemia and immunosuppression is essential.
CONCLUSION: Standardized national guidance, improved rapid diagnostics, systematic surveillance and equitable drug availability are critical to reduce Brazil's mucormycosis burden.}, }
@article {pmid40974857, year = {2025}, author = {Gajecki, D and Kiczak, L and Majda, J and Banasiak, W and Doroszko, A}, title = {Unravelling Thymidine phosphorylase: Mechanisms and multifunctional impact on cardiovascular system - from bench to bedside.}, journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie}, volume = {192}, number = {}, pages = {118577}, doi = {10.1016/j.biopha.2025.118577}, pmid = {40974857}, issn = {1950-6007}, mesh = {Humans ; *Thymidine Phosphorylase/metabolism ; Animals ; *Cardiovascular System/enzymology ; *Cardiovascular Diseases/enzymology ; COVID-19/enzymology ; }, abstract = {Thymidine phosphorylase (TYMP) is a multifunctional enzyme responsible for pyrimidine metabolism. Interestingly, its impact extends beyond that function. This review aims at summarising the role of TYMP in different biological processes, with particular attention paid to the cardiovascular system. TYMP regulates platelet activation and, within the vascular wall, promotes cell migration by modulating focal adhesion. Moreover, it affects cellular defence mechanisms activated under oxidative stress, thereby preventing vascular injury. Additionally, by modulating several pivotal signalling cascades, TYMP promotes tumour growth, and exerts anti-apoptotic action. Furthermore, the TYMP activation status correlates with outcomes of pharmacological treatment during chemotherapy with microtubule-interfering agents. TYMP is also expressed in the central nervous system, where it regulates transmembrane proteins essential in maintaining the blood-brain barrier. The thoroughly described pathophysiological basis of TYMP activity corresponds with the pathological mechanisms of numerous disorders. Modulating its actions may serve as an attractive novel therapeutic target in: the COVID-19-associated thrombotic complications, resistance to myocardial infarction-associated cardiomyocyte damage, aneurysm development, atherosclerosis progression, and neurological diseases, including stroke.}, }
@article {pmid40975587, year = {2025}, author = {Sinha, SS and Bari, S and Tripathi, P and Kant, S and Tripathi, SM}, title = {Neuropsychiatric manifestations of long COVID.}, journal = {The Indian journal of tuberculosis}, volume = {72}, number = {4}, pages = {532-536}, doi = {10.1016/j.ijtb.2025.02.020}, pmid = {40975587}, issn = {0019-5707}, mesh = {Humans ; *COVID-19/psychology/complications ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; *Mental Disorders/etiology ; *Nervous System Diseases/etiology ; }, abstract = {In 2019 after the COVID-19 outbreak, a subset of patients was observed to be experiencing unusual symptoms and prolonged illness following SARS-CoV-2 infection and were labeled as "Long-haulers". Various terms like Long COVID, and Post-COVID-19 Conditions (PCC) were used to describe symptoms extending four weeks or more. Long COVID encompasses a range of persistent symptoms with a multisystemic nature, exhibiting a relapsing-remitting pattern. Various theories explaining Long COVID such as direct neuro-invasion, systemic effects of the virus, and neuroimmune dysregulation have been suggested. Clinical manifestations of Long COVID include diverse symptoms with fatigue, dyspnea, and cognitive impairment being common symptoms reported. Neurological manifestations are more prevalent in severe COVID-19 cases. Non-specific neurological manifestations include loss of taste and smell while specific neurological manifestations include hemiplegia and large artery ischemic stroke. COVID-19 medications may also cause neurological symptoms. Psychiatric manifestations include depression, anxiety, panic disorders, post-traumatic stress disorder (PTSD), psychosis, and cognitive symptoms such as attention and executive function deficits. Psychological symptoms vary among different social groups like frontline health workers, young individuals, and the elderly. Social isolation exerts a substantial impact on the psychological presentations of Long COVID through mechanisms such as Hypothalamic-Pituitary-Adrenal axis (HPA) hyperactivation, epigenetic modifications, increased steroid concentrations, immune system suppression, and reactivation of latent infections. Conclusively, neuroimmune dysregulation, social isolation and associated factors serve as the link between SARS-CoV-2 virus, long COVID and its neuropsychiatric manifestations.}, }
@article {pmid40976415, year = {2026}, author = {Kang, J and Lee, KR and Choi, IY and Lee, D and Chang, H and Kim, M}, title = {A systematic review of knowledge assessment instruments for isolation precautions among health care personnel.}, journal = {American journal of infection control}, volume = {54}, number = {3}, pages = {335-343}, doi = {10.1016/j.ajic.2025.09.010}, pmid = {40976415}, issn = {1527-3296}, mesh = {Humans ; *Health Personnel ; *COVID-19/prevention & control ; *Infection Control/methods/standards ; *Health Knowledge, Attitudes, Practice ; SARS-CoV-2 ; Personal Protective Equipment ; *Patient Isolation ; *Cross Infection/prevention & control ; Guideline Adherence ; }, abstract = {BACKGROUND: Health care personnel (HCP) knowledge of isolation precautions (IPs) is essential for preventing health care-associated infections. HCP adherence to IP guidelines remains suboptimal worldwide, often due to knowledge gaps. Post-COVID-19 challenges highlight the need for standardized tools. This study systematically reviews IP knowledge instruments.
METHODS: Following PRISMA guidelines, 5 databases were searched for studies published between 2007 and 2024. Eligible studies used instruments with more than 10 items covering Centers for Disease Control and Prevention-recommended domains. Instruments were evaluated for content coverage, psychometric properties, and methodological quality.
RESULTS: Twenty-seven studies met inclusion criteria. All instruments assessed standard precautions, while transmission-based precautions and fundamental elements were under-represented. A total of 608 items were identified, most focusing on personal protective equipment and hand hygiene. Response formats and scoring systems varied widely, with inconsistent benchmarks. Knowledge of transmission-based precautions was consistently lower than standard precautions. Only 14 studies (51.9%) reported both validity and reliability, indicating limited psychometric rigor. Few studies were high quality, though those published after 2020 showed modest improvement.
CONCLUSIONS: Current HCP IP knowledge instruments show significant variation, incomplete scope, and limited validation. Standardized tools with balanced coverage and stronger psychometric evaluation are needed to support education, enable comparability, and guide interventions in diverse health care settings.}, }
@article {pmid40976713, year = {2026}, author = {Leon-Icaza, SA and Vergé, R and Mazars, R and Berry, L and Cougoule, C}, title = {Lung organoids as a human system for Mycobacteria infection modeling and drug testing.}, journal = {The FEBS journal}, volume = {293}, number = {6}, pages = {1587-1611}, pmid = {40976713}, issn = {1742-4658}, support = {RF20210502852/1/1/48//Association Grégory Lemarchal/ ; RF20230503250//Association Grégory Lemarchal/ ; 101080462//HORIZON EUROPE Health/ ; 21402; AO 2021-2 CSS 11//Agence Nationale de Recherches sur le Sida et les Hépatites Virales/ ; RF20210502852/1/1/48//Association Vaincre la Mucoviscidose/ ; RF20230503250//Association Vaincre la Mucoviscidose/ ; }, mesh = {Humans ; *Organoids/microbiology/drug effects/pathology ; *Lung/microbiology/pathology/drug effects ; Mycobacterium tuberculosis/pathogenicity/drug effects ; COVID-19 ; *Mycobacterium Infections, Nontuberculous/drug therapy/microbiology/pathology ; SARS-CoV-2/pathogenicity ; }, abstract = {Mycobacterial infections remain a global public health challenge. Each year, high rates of morbidity and mortality worldwide are a consequence of chronic respiratory infections due to Mycobacteria. According to the World Health Organization (WHO), in 2023, 10.8 million individuals fell ill with Mycobacterium tuberculosis (Mtb), resulting in an estimated 1.25 million deaths. This positions tuberculosis (TB) as the leading cause of death from a single pathogen worldwide after the coronavirus disease (COVID-19) pandemic. On the other hand, the cases of people affected by nontuberculous mycobacteria (NTM) have risen globally, but the precise incidence and prevalence of both pulmonary and extrapulmonary disease remain unknown. In Europe, nontuberculous mycobacterial pulmonary diseases affect between 0.2 and 2.9 per 100 000 individuals, mainly patients with cystic fibrosis (CF) and non-CF bronchiectasis. The diagnosis and treatment of mycobacterial infections are challenging and complex, frequently requiring long-duration treatments with several antibiotics, which in most cases leads to poor patient outcomes. As the role of immune cells has been extensively assessed, in this Review, we summarize the current knowledge about the contribution of epithelial cells in the early steps of Mycobacteria infections. Additionally, we describe how human lung organoid technology provides new tools to better understand host-Mycobacteria interactions in the airways and test new therapeutic targets.}, }
@article {pmid40977416, year = {2025}, author = {Liu, C and Song, Y and Niu, S and Jiang, Y and Zhu, T and Li, X and Cui, R and Deng, Q}, title = {COVID-19 Infection Confirmed by Bronchoalveolar Lavage Fluid Metagenomics -Next-Generation Sequencing Instead of Pharyngeal Swabs in Follicular Lymphoma: Three-Case Report and Literature Review.}, journal = {Journal of clinical laboratory analysis}, volume = {39}, number = {20}, pages = {e70103}, pmid = {40977416}, issn = {1098-2825}, support = {TJWJ2023ZD003//Tianjin Municipal Health Commission/ ; Y-NCJH202201-0027//Beijing Xisike Clinical Oncology Research Foundation/ ; Y-2022YMJN/MS-0001//Beijing Xisike Clinical Oncology Research Foundation/ ; }, mesh = {Humans ; *COVID-19/diagnosis/complications/virology ; *Lymphoma, Follicular/complications/virology ; *Bronchoalveolar Lavage Fluid/virology ; High-Throughput Nucleotide Sequencing/methods ; Male ; *SARS-CoV-2/genetics/isolation & purification ; Middle Aged ; Female ; Aged ; Metagenomics/methods ; Pharynx/virology ; }, abstract = {BACKGROUND: Hematologic malignancy patients with B lymphocytopenia after anti-CD20 monoclonal antibody or anti-CD19 chimeric antigen receptor (CAR) T cell therapy often face prolonged SARS-CoV-2 positivity on pharyngeal swabs and persistent or recurrent COVID-19 infection, resulting in high mortality.
METHODS: Here, we describe three follicular lymphoma (FL) patients with persistent fever, cough, and hypoxemia, but they were ruled out for bacterial, viral, fungal, and other pathogen infections, and the throat swabs were consistently SARS-CoV-2 negative. These FL patients with B lymphocyte deficiency who were diagnosed with COVID-19 infection confirmed by bronchoalveolar lavage fluid (BALF) metagenomics next-generation sequencing (mNGS). Their COVID-19 infection was characterized by differences in viral load in the upper and lower respiratory tracts. When this particular COVID-19 infection occurred, although their percentages and absolute values of CD8[+] T cells and CD4[+] T cells were normal, they all had B lymphocyte deficiency and hypogammaglobulinemia. They all had low expression of interleukin (IL)-6 in peripheral blood inconsistent with clinical infection symptoms.
RESULTS: The patients received a combination therapy of molnupiravir and methylprednisolone; then their symptoms were relieved over the next 2 weeks-2 months.
CONCLUSION: Therefore, for immunocompromised patients, especially those with B lymphocyte deficiency, hypogammaglobulinemia, and low expression of IL-6 in peripheral blood inconsistent with clinical infection symptoms, mNGS for BALF should be performed as soon as possible in this particular condition to confirm the diagnosis of COVID-19 infection.}, }
@article {pmid40977695, year = {2025}, author = {Lee, SM and Kim, EH}, title = {The role of cell death pathways in respiratory viral infection and vaccination: two sides of the same coin.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1650960}, pmid = {40977695}, issn = {1664-3224}, mesh = {Humans ; Animals ; Cell Death ; *Respiratory Tract Infections/immunology/prevention & control/virology ; *Virus Diseases/immunology/prevention & control ; Viral Vaccines/immunology ; Signal Transduction ; Alarmins/immunology ; Vaccination ; }, abstract = {Cell death pathways play contrasting roles in physiological processes such as responses to viral infections and vaccinations, potentially exerting either detrimental or beneficial effects. On one hand, uncontrolled cell death accompanied by the release of damage-associated molecular patterns (DAMPs) can lead to excessive inflammation and tissue damage. On the other hand, when properly regulated, these processes help establish an immunocompetent environment by activating innate immunity, which in turn stimulate antiviral immune responses. These mechanisms have emerged as promising targets for the development of effective antiviral therapeutics, immunotherapies, and vaccines. Recent advances have elucidated key aspects of cell death and DAMP pathways, highlighting their association with upstream viral sensors, their capacity to regulate immune responses, and their potential as therapeutic targets in the context of respiratory viral infections such as influenza virus and SARS-CoV-2. In this review, we discuss the advantages and disadvantages of cell death and DAMP pathways, focusing on their roles in antiviral immunity and pathogenesis of respiratory viral infections, and vaccine immunogenicity.}, }
@article {pmid40978734, year = {2025}, author = {Bravo, FJ and Mena, J and Mejía Reyes, Á and Schäfer, C and Núñez-Rojas, N and Blamey-Fredes, C and Acuña-Castillo, C and Barrera-Avalos, C}, title = {The impact of Panx1 on inflammation, immunity, and cancer: a comprehensive review.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1572418}, pmid = {40978734}, issn = {2296-858X}, abstract = {Pannexin 1 (Panx1) is a widely expressed membrane channel that regulates ATP release and purinergic signaling, playing essential roles in inflammation, immunity, and tumor progression. This review provides a comprehensive analysis of its structure, activation mechanisms, and its functional relevance in both innate and adaptive immunity. Panx1 has been implicated in inflammasome activation, neutrophil and dendritic cell regulation, and modulation of immune responses against infections, including SARS-CoV-2. Additionally, Panx1 plays a dual role in tumor progression, acting either as a promoter or a suppressor depending on the cellular and microenvironmental context. Pharmacological inhibition of Panx1 has shown therapeutic benefits in preclinical models of inflammatory, cardiovascular, and neurodegenerative diseases, establishing it as a promising and versatile therapeutic target. This review underscores the need for further research into Panx1's molecular mechanisms and the development of targeted interventions to effectively address inflammatory and autoimmune diseases with precision and efficacy.}, }
@article {pmid40979395, year = {2024}, author = {Smaardijk, VR and Jajou, R and Kant, A and van Hunsel, FPAM}, title = {Menstrual disorders following COVID-19 vaccination: a review using a systematic search.}, journal = {Frontiers in drug safety and regulation}, volume = {4}, number = {}, pages = {1338466}, pmid = {40979395}, issn = {2674-0869}, abstract = {Introduction:Menstrual disorders are commonly reported after COVID-19 vaccination and heavy menstrual bleeding was added to the product information of the COVID-19 vaccines of Moderna and Pfizer. The aim of this review, using a systematic search, is to provide an overview of available literature on the risk of menstrual disorders after COVID-19 vaccination. Methods: The review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. A PubMed search was performed on 15 August 2023, including solely quantitative studies in English and Dutch. Results: A total of 61 studies were included, of which 40 were cross-sectional studies, 18 cohort studies, and three self-controlled case series. Outcomes included a wide variety of menstrual disorders, including changes in cycle length (n = 54), changes in the amount of bleeding (n = 44), changes in menses length (n = 30), changes in the experience of (pre)menstrual pain (n = 21), and breakthrough bleeding (n = 18). All included studies found a higher percentage of at least one menstrual disorder in the first cycle after different types of COVID-19 vaccination and after different doses. Discussion: In conclusion, evidence suggests that COVID-19 vaccines may cause menstrual changes in women of reproductive age. However, there is a need for more longitudinal studies because of important limitations in the study designs of many of the included studies. Although menstrual changes are short-lived and predominantly mild, it is important for women and healthcare professionals to be informed about these potential adverse reactions and to assess these events in clinical trials on vaccines.}, }
@article {pmid40980097, year = {2023}, author = {Ruddock, MW and Watt, J and Kurth, MJ and Lamont, JV and Mooney, L and Fitzgerald, P}, title = {A review of the prescribing culture of anti-depressants across government districts in Northern Ireland.}, journal = {Frontiers in drug safety and regulation}, volume = {3}, number = {}, pages = {1303572}, pmid = {40980097}, issn = {2674-0869}, abstract = {Introduction: The COVID-19 pandemic has caused a significant increase in mental health issues which general practitioners are now witnessing and managing in communities across Northern Ireland. Unfortunately, this new tsunami of patients with mental health issues has put tremendous strain on our already overburdened health system. As a result, Northern Ireland currently holds the unenviable record for prescribing more anti-anxiety and anti-depressant medication than any other country in the world. Methods: Data was obtained from the Northern Ireland Statistics and Research Agency (NISRA), Family Practitioner Services, General Pharmaceutical Services, Annual Statistics 2020/2021 (published June 2021) and 2021/2022 (published June 2022). Data was analysed by age, gender, district, and socioeconomic class on prescription medication [according to the British National Formulary (BNF)]. Results: From 2020/2021 to 2021/2022, the prescribing culture for anti-anxiety and/or anti-depressant medication in Northern Ireland did not abate (24% vs. 14%, female to male, respectively). The postcode and index of multiple deprivation (IMD) was analysed and a mean IMD for each constituency was taken as an estimate of the overall IMD to establish if money spent per patient was related to the IMD in each constituency. North Down, South Antrim, and East Antrim were least deprived, as indicated by their high IMD. Whereas, Foyle, and Belfast West were most deprived (low IMD). The cost of mood and anxiety medication per patient was compared against constituency; patients in Belfast West and Belfast North, followed by Foyle, had the highest costs per patient, and the lowest IMD (most deprived). Conclusion: This review concludes that there has been no change in the prescribing culture for anti-anxiety or anti-depressants across Northern Ireland (2020-2022). The cost of mood and anxiety medication per patient did not correlate with the index of multiple deprivation (IMD). Areas of low IMD trended to have higher spend. Is it now time to review the prescribing culture in Northern Ireland and offer greater support to our GPs to initiate a program of deprescribing and manage the wellbeing of our citizens?}, }
@article {pmid40980411, year = {2025}, author = {Beshah, SA and Adem, JB and Degefa, MB and Ayalew, M and Lakew, Y and Garoma, S and Adote, ENA and Achala, DM and Muriithi, GN and Mbachu, CO and Akazili, J and Ifeanyi, C and Zegeye, EA and Nwosu, CO and Ataguba, JE}, title = {COVID-19 vaccine hesitancy in Ethiopia: a scoping review for equitable vaccine access.}, journal = {Frontiers in health services}, volume = {5}, number = {}, pages = {1609752}, pmid = {40980411}, issn = {2813-0146}, abstract = {INTRODUCTION: COVID-19 vaccines are crucial for preventing severe illness from the virus. Despite their effectiveness; vaccine hesitancy, unequal access, and economic disparities hinder vaccination programs across Africa, posing significant challenges in Ethiopia.
METHOD: This scoping review followed the methodological guidelines outlined in the Joanna Briggs Institute Reviewer's and employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - Extension for Scoping Reviews (PRISMA-ScR) checklist and explanation to ensure transparency. To analyze the data, we developed tailored search strategies for key databases [HINARI, PubMed, Cochrane, African Journals Online (AJOL), and Science Direct] and gray literature sources. These strategies combined controlled vocabulary and relevant keywords. A descriptive thematic analysis was then employed to identify and categorize the various findings within the included studies. The results are presented in a narrative format, summarizing the key themes and providing a clear and comprehensive overview of the current evidence base.
RESULTS AND RECOMMENDATIONS: A review of 34 Ethiopian studies revealed significant COVID-19 vaccine hesitancy, with rates exceeding 50% in over 40% of the studies. The lowest hesitancy was found in adults from Addis Ababa (19.1%), while the highest rates were seen among healthcare workers in Oromia (69.7%) and pregnant women in Southwest Ethiopia (68.8%). Factors contributing to vaccine hesitancy in Ethiopia include being female, having only primary education, residing in rural areas, younger age, limited knowledge about the vaccine, reduced trust in authorities, and misperceptions about the risk of the virus. To address this challenge effectively, policymakers should prioritize interventions that build public trust, enhance awareness of the vaccine's benefits, and counter misinformation.}, }
@article {pmid40980413, year = {2025}, author = {Ifeanyi, C and Okechukwu, E and Tosin, O and Hyacinth, I and Ataguba, JE and Muriithi, GN and Achala, DM and Adote, ENA and Mbachu, CO and Beshah, SA and Nwosu, CO and Tlhakanelo, JT and Akazili, J and Masuka, N}, title = {Assessing the determinants of uptake and hesitancy in accessing COVID 19 vaccines in Nigeria: a scoping review.}, journal = {Frontiers in health services}, volume = {5}, number = {}, pages = {1609418}, pmid = {40980413}, issn = {2813-0146}, abstract = {The coronavirus disease (COVID-19) is one of the largest public health threats in recent times, with significant health, economic, and social consequences globally. The WHO reported that over 651 million cases and 6.6 million deaths were attributed to COVID-19 globally. The Nigeria Centre for Disease Control (NCDC) in 2022 revealed that 266,057 cases with 3,155 deaths were reported. All the thirty-six states and the Federal Capital Territory (FCT) of Nigeria were affected, but Lagos and the FCT reported the highest number of cases. However, it is possible that these numbers do not accurately reflect the severity of COVID-19 disease in Nigeria because the country had only tested 5,160,280 people as at 2022, despite a population of around 200 million. Nigeria did not meet its 2021 vaccination target, prompting the need to identify the contextual factors affecting vaccine access and uptake as well as vaccine hesitancy in Nigeria and document the approaches that can be deployed to reduce opposition to vaccination as well as improve advocacy for vaccine equity. This scoping review, conducted using Arksey and O'Malley's framework, aimed to explore the factors influencing COVID-19 vaccine hesitancy and uptake in Nigeria. A comprehensive literature search was conducted across electronic databases, including Google Scholar and PubMed, with studies from Nigeria published in English. The review included 25 studies on vaccine hesitancy, uptake, and willingness to accept COVID-19 vaccination, identifying barriers at the national, community, and individual levels. The results indicated that 90% of the studies showed low vaccine acceptance and uptake, with barriers related to vaccine availability, misinformation, cultural and religious influences, socioeconomic factors, and lack of trust in the health system. Socio-demographic factors such as gender, age, education, and income were identified as key influences. The findings highlight the need for targeted, evidence-based strategies to address vaccine hesitancy, improve vaccine distribution, and engage diverse population groups to enhance vaccination uptake across Nigeria.}, }
@article {pmid40980513, year = {2025}, author = {Pettemeridou, E and Loizidou, M and Trajkovic, J and Constantinou, M and De Smet, S and Baeken, C and Sack, AT and Williams, SCR and Constantinidou, F}, title = {Cognitive and Psychological Symptoms in Post-COVID-19 Condition: A Systematic Review of Structural and Functional Neuroimaging, Neurophysiology, and Intervention Studies.}, journal = {Archives of rehabilitation research and clinical translation}, volume = {7}, number = {3}, pages = {100461}, pmid = {40980513}, issn = {2590-1095}, abstract = {OBJECTIVE: To investigate the structural, functional, and neurophysiological brain changes associated with post-COVID-19 condition (PCC)-related cognitive and psychological issues and evaluate the efficacy of noninvasive brain stimulation (NIBS) and cognitive rehabilitation interventions.
DATA SOURCES: Electronic databases, including Web of Science, PubMed, and Embase, were systematically searched for articles published before February 1, 2025, using terms such as "post-COVID-19 condition," "cognitive dysfunction," "brain changes," "noninvasive brain stimulation," and "cognitive rehabilitation." Language was restricted to English, and only studies involving human participants were included.
STUDY SELECTION: Studies with human participants aged ≥18 years diagnosed with PCC, employing magnetic resonance imaging, functional magnetic resonance imaging, positron emission tomography, and electroencephalography, and interventions such as NIBS and cognitive rehabilitation were included. Articles were selected through independent review by multiple authors, with consensus resolving discrepancies. Of the 123 studies initially identified, 78 met the inclusion criteria.
DATA EXTRACTION: Data on participant demographics, methodologies, neurophysiological changes, and intervention outcomes were extracted by 2 independent reviewers using predefined guidelines. Study quality was assessed using the Newcastle-Ottawa Scale and Critical Appraisal Skills Program tools.
DATA SYNTHESIS: Seventy-eight studies with over 5900 participants met the inclusion criteria. Significant cognitive impairments were observed in attention, executive function, and memory (N=78). Key findings included mixed evidence of gray matter (N=16) and white matter volume changes (N=20), cortical thickness alterations (N=9), variations in functional connectivity (N=14), electrophysiology (N=9), and blood flow (N=8). NIBS, including transcranial magnetic stimulation (N=8) and transcranial direct current stimulation (N=2), showed potential benefits for managing depression and cognitive impairments. Although cognitive rehabilitation (N=3) showed promise, it requires further investigation.
CONCLUSIONS: This review highlights the complex neurologic underpinnings of PCC and the potential of NIBS and cognitive rehabilitation as interventions. Further research is essential to refine these interventions and establish evidence-based strategies for addressing long-term cognitive and psychological effects of PCC.}, }
@article {pmid40981424, year = {2025}, author = {Westhoven, S and Bertzbach, LD and Kloehn, M and Mahncke, C and Heinen, N and Brown, RJP and Pfaender, S}, title = {From zoonotic spillover to endemicity: the broad determinants of human coronavirus tropism.}, journal = {mBio}, volume = {16}, number = {11}, pages = {e0243725}, pmid = {40981424}, issn = {2150-7511}, support = {524774169//Deutsche Forschungsgemeinschaft/ ; 101191666//HORIZON EUROPE Health/ ; VIRASCREEN (01KI2113)//Bundesministerium für Bildung und Forschung/ ; }, mesh = {Humans ; *Viral Tropism ; Animals ; *Coronavirus/physiology ; *Zoonoses/virology/epidemiology ; *Coronavirus Infections/virology/epidemiology/transmission ; Host Specificity ; *Viral Zoonoses/virology/epidemiology/transmission ; }, abstract = {Given the recurring threat of coronavirus outbreaks, understanding the specificity of coronaviruses in terms of their host, tissue, and cell tropism is crucial. This review consolidates and critically assesses the current literature on the tropism of endemic, epidemic, and pandemic coronaviruses. We explore different levels of tropism, including species tropism (virus preference for specific host species), host cell tropism (virus specificity for particular cell types), and tissue tropism (specificity for certain tissues or organs). This review compiles extensive basic research, particularly from recent years, to provide critical insights into the viral mechanisms that are key to improving future pandemic preparedness.}, }
@article {pmid40981769, year = {2025}, author = {Choong, C and Dharma, M and Barmanray, RD}, title = {Not all hyperglycaemia in hospitalised pneumonia is created equal.}, journal = {Internal medicine journal}, volume = {55}, number = {11}, pages = {1955-1957}, doi = {10.1111/imj.70208}, pmid = {40981769}, issn = {1445-5994}, mesh = {Humans ; *Hyperglycemia/chemically induced ; COVID-19/mortality/complications ; Community-Acquired Infections/drug therapy/mortality/blood ; Hospitalization ; *Adrenal Cortex Hormones/adverse effects/therapeutic use ; *Pneumonia ; Blood Glucose/metabolism ; SARS-CoV-2 ; }, abstract = {Community-acquired pneumonia (CAP) remains a major cause of hospitalisation and mortality worldwide. Corticosteroid therapy reduces 30-day mortality in hospitalised patients with CAP but nearly doubles the risk of hyperglycaemia. It may appear that hyperglycaemia can arise from distinct mechanisms: "inflammation-mediated hyperglycaemia," which signals disease severity and predicts worse outcomes, and "corticosteroid-induced hyperglycaemia," a side effect of beneficial treatment that may appear not to increase mortality risk. Evidence from COVID-19 cohorts supports this distinction, showing that hyperglycaemia following corticosteroid use correlates with disease severity and longer hospital stays but not with increased mortality. Early glycaemic control reduces complications such as healthcare-associated infections in the context of hyperglycaemia due to inflammatory mediators and in the absence of corticosteroids, yet its role in corticosteroid-induced hyperglycaemia remains unclear. The lack of a standardised definition of hyperglycaemia further complicates research and clinical management. Understanding the differential impacts and optimal glucose targets for these potential hyperglycaemia subtypes is critical. Future research should focus on evaluating the effects of glucose control on outcomes in corticosteroid-associated hyperglycaemia, determining optimal glycaemic thresholds and evaluating suitable therapeutic management strategies in this clinical context.}, }
@article {pmid40982817, year = {2025}, author = {Litta, A and Vacca, A and Mino, MV and Franza, F and Pastore, F}, title = {PROMOTING ADOLESCENT MENTAL HEALTH THROUGH SCHOOL-BASED LITERACY INITIATIVES: BEYOND THE STIGMA.}, journal = {Psychiatria Danubina}, volume = {37}, number = {Suppl 1}, pages = {165-168}, pmid = {40982817}, issn = {0353-5053}, mesh = {Humans ; Adolescent ; *Health Literacy ; Male ; Female ; *Social Stigma ; Italy ; *Mental Health ; *COVID-19/psychology ; *Health Knowledge, Attitudes, Practice ; Pilot Projects ; Surveys and Questionnaires ; *School Health Services ; *Health Promotion/methods ; *Students/psychology ; }, abstract = {BACKGROUND: Adolescent mental health has become an increasingly urgent concern, particularly in the aftermath of the COVID-19 pandemic. Mental Health Literacy (MHL) is emerging as a critical construct to promote psychological well-being, reduce stigma, and encourage the early recognition of psychological distress.
METHODS: This study presents baseline data from a school-based pilot initiative conducted in a secondary school in Southern Italy. The aim was to assess students' knowledge beliefs, and attitudes toward mental health prior to implementing targeted educational interventions. A total of 85 fifth-year students (mean age = 17.7 years) completed the Italian version of the Mental Health Literacy Questionnaire - short form (MHLq-short), administered anonymously via an online platform. Statistical analyses included descriptive measures and non-parametric tests to explore the association between MHL scores and familiarity with mental health problems.
RESULTS: Students who reported knowing someone with mental health issues exhibited a trend toward higher mental health literacy scores. In contrast, those who reported no such exposure or expressed uncertainty demonstrated lower average ranks, possibly reflecting limited awareness or emotional disengagement.
CONCLUSIONS: These findings highlight the potential role of personal experience in shaping mental health literacy and reinforce the need for structured, school-based interventions. To our knowledge, this study represents the first application of the MHLq-short in Italy and supports its feasibility in identifying literacy gaps among adolescents. Future initiatives could aim to replicate and scale this model across diverse educational settings and inform national strategies to integrate MHL into school curricula.}, }
@article {pmid40982878, year = {2025}, author = {Khairetdinov, O and Rubakova, L and Pavlova, M and Asatryan, E and Tavormina, G and Vlasov, A}, title = {APPLICATION OF TELEMEDICINE TECHNOLOGIES IN THE DIAGNOSIS OF AUTISM SPECTRUM DISORDERS IN CHILDREN: A NARRATIVE REVIEW.}, journal = {Psychiatria Danubina}, volume = {37}, number = {Suppl 1}, pages = {85-90}, pmid = {40982878}, issn = {0353-5053}, mesh = {Humans ; *Autism Spectrum Disorder/diagnosis ; *Telemedicine ; Child ; *COVID-19 ; }, abstract = {BACKGROUND: The application of telemedicine technologies in providing psychiatric care to children with autism spectrum disorders (ASD) became widespread during the COVID-19 pandemic. This review aims to describe the types, structure, and features of tools used for the remote diagnosis of ASDs in children, based on contemporary scientific literature and our own experience.
METHODS: We conducted a descriptive review of scientific studies published from January 2013 to December 2024. Works presented in the electronic databases PubMed, Web of Science, and eLibrary were analyzed. Descriptive analysis was used to summarize the obtained data.
RESULTS: The analysis convincingly demonstrates a sufficient representation of remote tools for screening, assessment scales, and structured diagnostic procedures for ASD across various countries, exhibiting high levels of specificity and sensitivity.
CONCLUSIONS: The use of telemedicine diagnostic methods in clinical practice contributes to the early detection of ASDs, potentially enhancing the timeliness and effectiveness of medical and correctional interventions.}, }
@article {pmid40983056, year = {2025}, author = {Yin, H and Zhang, PS and Chen, Y and Kong, BB and Zhang, CG and Wu, S}, title = {Death caused by transdermal ivermectin poisoning: A case report and literature review.}, journal = {The Journal of international medical research}, volume = {53}, number = {9}, pages = {3000605251377690}, pmid = {40983056}, issn = {1473-2300}, mesh = {Humans ; Administration, Cutaneous ; *Antiparasitic Agents/poisoning/administration & dosage ; COVID-19 ; *Drug Overdose ; Fatal Outcome ; *Ivermectin/poisoning/administration & dosage ; }, abstract = {Ivermectin is a classic antiparasitic drug that is widely used around the world. After the outbreak of coronavirus disease 2019, many studies have reported the potential effectiveness of ivermectin against coronavirus disease 2019; however, it is not recommended by the World Health Organization because of insufficient evidence and significant adverse effects. Owing to the abovementioned findings, the number of reports of poisoning and other serious reactions caused by ivermectin abuse have increased in recent years. Notably, no previous cases of transdermal ivermectin poisoning with documented blood concentrations has been reported to date. We report a rare fatal case of ivermectin misuse with a review of recent literature. The patient suffered from ivermectin poisoning due to transdermal overdose. The patient's plasma concentration was 27 ng/mL. The main clinical manifestations were gastrointestinal symptoms in the early stage and diffuse cerebral edema and intracranial hypertension in the later stage. Despite active treatment, including hemoperfusion and cardiorespiratory support, the patient died. Many recent in vitro studies have shown that ivermectin has the potential to become a new anticancer drug. If clinical research proves its effectiveness against cancer, it may also lead to ivermectin overuse. This study aimed to raise awareness regarding ivermectin poisoning among clinicians and the public, thereby preventing drug abuse.}, }
@article {pmid40983473, year = {2025}, author = {Kass-Gergi, S and Holcomb, NP and Maiden, MM and Eisenlohr, LC and Vaughan, AE}, title = {Scar wars: the viral menace.}, journal = {American journal of physiology. Lung cellular and molecular physiology}, volume = {329}, number = {5}, pages = {L555-L569}, pmid = {40983473}, issn = {1522-1504}, support = {R01 HL164350/HL/NHLBI NIH HHS/United States ; }, mesh = {Humans ; *COVID-19/complications/virology/pathology/immunology ; SARS-CoV-2 ; *Pulmonary Fibrosis/virology/pathology/etiology/immunology ; *Influenza, Human/complications/virology/pathology ; Respiratory Distress Syndrome/virology/pathology ; Lung/virology/pathology ; Animals ; }, abstract = {Pulmonary fibrosis (PF) is a severe consequence of respiratory infections, characterized by excessive extracellular matrix deposition and irreversible lung architectural damage. Once considered a rare condition, PF is now increasingly recognized in the wake of viral infections, particularly among survivors of viral-induced acute respiratory distress syndrome (ARDS). The COVID-19 pandemic has highlighted in bold relief the observation that many survivors of severe viral pneumonia do not recover fully but develop chronic fibrotic changes that impair lung function. This review examines the clinical evidence and underlying mechanisms linking viral infections-COVID-19, influenza, and other respiratory viruses-to the onset of pulmonary fibrosis. By probing the mechanisms of cellular injury, immune dysregulation, and aberrant repair mechanisms, we aim to illuminate the pathways that transform an acute viral insult into a chronic, fibrotic disease.}, }
@article {pmid40984136, year = {2025}, author = {Francis, Y and Lantry, FJ and Echeverry, M and Siddiq, M}, title = {Effective Countermeasures to Health Misinformation and Disinformation for Global Health Engagement Practitioners: A Rapid Review.}, journal = {Military medicine}, volume = {190}, number = {Supplement_2}, pages = {478-482}, doi = {10.1093/milmed/usaf237}, pmid = {40984136}, issn = {1930-613X}, support = {HU00012420029//Assistant Secretary of Defense, Health Affairs/ ; }, mesh = {Humans ; *Global Health/education ; COVID-19/epidemiology/psychology/prevention & control ; *Communication ; *Disinformation ; United States ; }, abstract = {INTRODUCTION: Awareness and education about the risks posed by health misinformation and disinformation (mis/dis) to the U.S. Department of Defense's (DoD) health-related activities are currently insufficient, highlighting the need for effective counterstrategies. This issue became particularly evident during the COVID-19 pandemic, affecting U.S. DoD Global Health Engagement (GHE) activities. It is also increasingly significant as Combatant Commands expand their DoD GHE and Global Health Security activities to align with strategic priorities.
MATERIALS AND METHODS: To address this gap, the Center for Global Health Engagement at the Uniformed Services University of the Health Sciences conducted a rapid systematic review of literature on countering health mis/dis. The review examined English-language papers indexed in PubMed, Web of Science, and Embase from 2013 to 2023.
RESULTS: The rapid review revealed that while much of the literature on health mis/dis focuses on major institutional actors, there is a growing body of research on countermeasures designed for individuals. The most frequently studied strategy was debunking, which involves directly correcting false or misleading information. Other effective, though context-specific, strategies highlighted included prebunking, fact-checking, and health literacy training. Additionally, the review found that most existing studies focused on COVID-19, followed by childhood vaccines and vaccine hesitancy.
CONCLUSION: Debunking, prebunking, and health literacy strategies were identified as effective tools for addressing health-related mis/dis in the context of DoD GHE. Global Health Engagement practitioners and planners should be aware of these techniques and integrate them into their engagements and activities. However, there is no one-size-fits-all solution; the effectiveness of countering mis/dis depends heavily on the context in which the information is propagated. Further research is needed to develop educational materials on mis/dis countermeasures and to improve communication about the threats posed by health mis/dis within the GHE landscape.}, }
@article {pmid40984753, year = {2025}, author = {Denman, DS and Dalhaimer, P}, title = {The curious case of anti-PEG antibodies.}, journal = {Nanoscale}, volume = {17}, number = {39}, pages = {22594-22605}, doi = {10.1039/d5nr02301g}, pmid = {40984753}, issn = {2040-3372}, mesh = {*Polyethylene Glycols/chemistry ; Humans ; Animals ; *Nanoparticles/chemistry ; Immunoglobulin M/immunology ; Mice ; COVID-19/immunology/prevention & control ; *Antibodies/immunology ; Immunoglobulin G/immunology ; SARS-CoV-2/immunology ; Doxorubicin/analogs & derivatives/chemistry ; COVID-19 Vaccines/immunology/chemistry ; Liposomes/chemistry ; }, abstract = {The components of nanoparticles can trigger the production of antibodies in patients and in model mammals such as mice. We focus on antibodies made against poly-ethylene-glycol (PEG), the most common polymer component of nanoparticles. Humans are frequently exposed to free PEG in processed foods, cosmetics, and over-the-counter drugs. These PEG-containing products trigger varying amounts of anti-PEG antibody production in consumers. In addition to consumer product usage, human exposure to PEG was greatly increased when millions were vaccinated with SARS-CoV-2 vaccine nanoparticles, which contained a PEGylated lipid. Thus, the chances of humans having anti-PEG antibodies is high and the ramifications of the presence of such antibodies must be addressed. The resulting antibodies could bind and negatively affect PEG-containing nanoparticles that are subsequently administered to patients. For example, a patient administered the PEGylated liposome DOXIL could have "pre-existing" anti-PEG antibodies from cosmetic products. The anti-PEG antibodies could bind the PEG component of DOXIL and take it to professional phagocytes. This would greatly reduce its ability to localize to cancer cells. In this review, we discuss the possible mechanisms by which PEG could generate immunoglobulin M (IgM) and how PEG could trigger a stronger and more mechanistically complex immunoglobulin G (IgG) response. We assess PEG-antibody binding. We discuss the various mechanisms by which PEG-containing nanoparticles may bind immune cells. We address gaps in our knowledge of the mechanisms of anti-PEG antibody formation. We discuss strategies for determining whether PEG triggers antibody production and how strong the antibody will interact with the PEG.}, }
@article {pmid40985351, year = {2025}, author = {Peters, LER and Charnley, GEC and Roberts, S and Kelman, I}, title = {Public health disinformation, conflict, and disease outbreaks: a global narrative integrative review to guide new directions for health diplomacy.}, journal = {Global health action}, volume = {18}, number = {1}, pages = {2562380}, pmid = {40985351}, issn = {1654-9880}, mesh = {Humans ; *Global Health ; *Disease Outbreaks ; *Public Health ; *COVID-19/epidemiology ; *Diplomacy ; Pandemics ; SARS-CoV-2 ; International Cooperation ; }, abstract = {The COVID-19 pandemic laid bare the unpreparedness of global and public health systems to respond to large-scale health crises, while simultaneously revealing the entangled nature of disinformation and poor global and public health outcomes. This research challenges the common treatment of public health disinformation - deliberately false information - as an emergent and technical threat, and instead situates it as a more systemic and nuanced challenge for global health governance to address. This article presents an integrative narrative literature review on the interlinkages between public health disinformation, conflict, and disease outbreaks, demonstrating mutually influencing connections between them. In doing so, the analysis raises critical questions around how reactive responses, such as doubling down on information authority, can paradoxically fuel the uptake of both disinformation especially amidst global trends towards increasing conflict and decreasing cooperation. In this evolving sociopolitical landscape for global health, the discussion explores the potential to harness health diplomacy to strengthen critical public engagement and deliberation. This reimagined approach to health diplomacy offers pathways to mitigate the harmful effects of disinformation rather than seeking to eliminate false information. This article contributes to deepening an understanding of this rapidly expanding topic for global and public health in two pathways. First, by investigating the root causes and impacts of public health disinformation that intersect with conflict. Second, by exploring how health diplomacy can foster cooperative global health governance through transparency and inclusion. This research offers a new direction to strengthen preparedness for future global and public health crises amidst disinformation.}, }
@article {pmid40986167, year = {2026}, author = {Vester, P and Boudouroglou-Walter, S and Schreyögg, J and Wieting, C and Blome, C}, title = {Burden of Disease in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A Scoping Review.}, journal = {Applied health economics and health policy}, volume = {24}, number = {1}, pages = {147-161}, pmid = {40986167}, issn = {1179-1896}, support = {GRK 2805/1//German Academic Research Foundation (DFG),/ ; }, mesh = {Humans ; *Fatigue Syndrome, Chronic/economics/epidemiology ; *Cost of Illness ; COVID-19/epidemiology ; Female ; Male ; Prevalence ; Disability-Adjusted Life Years ; Global Health ; }, abstract = {OBJECTIVE: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a serious chronic and complex multi-system disease characterised by symptoms such as post-exertional malaise, fatigue, cognitive impairment and pain. Diagnosis is based on international consensus criteria, and no curative treatment is available. In the USA, its prevalence is estimated at 0.42% among adults, with women affected three times as often as men. Prevalence is expected to increase due to the COVID-19 pandemic. In addition to its severe symptoms, ME/CFS has a substantial economic impact. This scoping review aimed to systematically examine the global health, social and economic burden of ME/CFS.
METHODS: We conducted a systematic literature search following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) guidelines in six databases and supplemented it with a citation search. We assessed study quality using a modified version of the Mixed Methods Appraisal Tool.
RESULTS: We included 20 studies that assessed costs (n = 16), disability-adjusted life years (DALYs) (n = 3), employment rates (n = 1), and school attendance (n = 1) as indicators of disease burden. Reported costs per patient ranged from USD 2,916 to USD 119,611, with indirect costs accounting for the largest proportion. DALYs reported for the USA ranged from 0.714 million in 2016 to 5.77 million in 2022.
CONCLUSION: ME/CFS imposes a substantial health, social and economic burden of disease. Discrepancies in estimates are probably due to differences in study samples, methodologies, cost components, and healthcare systems. Because ME/CFS is assumed to be underdiagnosed, its true burden may be even higher.}, }
@article {pmid40987023, year = {2025}, author = {Yang, J and Zhong, W and Li, Q and Zhang, W and Lin, W and Fan, X and He, Y and Ma, N}, title = {Sphingosine-1-phosphate signaling in respiratory diseases: mechanisms and therapeutic perspectives.}, journal = {International immunopharmacology}, volume = {166}, number = {}, pages = {115578}, doi = {10.1016/j.intimp.2025.115578}, pmid = {40987023}, issn = {1878-1705}, mesh = {Humans ; *Lysophospholipids/metabolism ; *Sphingosine/analogs & derivatives/metabolism ; Signal Transduction/drug effects ; Animals ; Sphingosine-1-Phosphate Receptors/metabolism ; COVID-19/metabolism ; Phosphotransferases (Alcohol Group Acceptor)/antagonists & inhibitors/metabolism ; *Respiratory Tract Diseases/metabolism/drug therapy ; SARS-CoV-2 ; Aldehyde-Lyases/antagonists & inhibitors/metabolism ; Sphingosine Kinase ; }, abstract = {Sphingosine-1-phosphate (S1P) is a pivotal bioactive sphingolipid functioning as both a structural membrane component and a signaling mediator. It orchestrates diverse physiological and pathological processes including cellular proliferation, migration, differentiation, and immune regulation. The biological efficacy of S1P is controlled by metabolic networks that coordinate its biosynthesis, transport, and degradation to maintain intra/extracellular homeostasis and to activate cell surface S1P receptors (S1PRs) to initiate downstream signaling. Contemporary research increasingly has increasingly revealed the multifaceted roles of S1P signaling in respiratory pathologies, including asthma, chronic obstructive pulmonary disease (COPD), pulmonary malignancies, and especially infectious lung diseases such as COVID-19 and influenza. Particularly, S1P levels are significantly correlated with the severity and prognosis of the disease. These findings indicate that pharmacological modulation of the S1P signaling axis, through sphingosine kinase (SPHK1/2) inhibition, S1P lyase (SPL) inhibition, or the S1PR modulation represents a promising therapeutic approach. However, incomplete understanding of the S1P signaling mechanisms presents significant challenges for clinical applications. This review systematically consolidates recent advances in S1P signaling research in respiratory medicine, with particular emphasis on delineating cellular and molecular mechanisms and evaluating the translational potential of targeted therapeutics.}, }
@article {pmid40987100, year = {2025}, author = {Verdoni, L and Mazza, A and Martelli, L and Gervasoni, A and Amoroso, A and Marcora, SA and Brambilla, P and Bonanomi, E and Carioli, G and D'Antiga, L}, title = {The outcome of severe MIS-C managed at the Italian epicenter of the SARS-CoV-2 epidemic: a follow-up study of 50 consecutive patients.}, journal = {Current opinion in immunology}, volume = {97}, number = {}, pages = {102659}, doi = {10.1016/j.coi.2025.102659}, pmid = {40987100}, issn = {1879-0372}, mesh = {Humans ; *COVID-19/epidemiology/therapy/diagnosis/complications ; Female ; Male ; *SARS-CoV-2 ; Child ; Follow-Up Studies ; *Systemic Inflammatory Response Syndrome/therapy/diagnosis/epidemiology ; Italy/epidemiology ; Child, Preschool ; Prognosis ; Adolescent ; Severity of Illness Index ; Ferritins/blood ; }, abstract = {BACKGROUND: During the SARS-CoV-2 pandemic, we described a peak of a Kawasaki-like disease in children, later renamed multisystem inflammatory syndrome in children (MIS-C). We report the long-term outcomes of MIS-C patients who presented to our center.
METHODS: We recorded clinical features and outcomes in patients with MIS-C admitted to our institution (February 2020-February 2022), focusing on the long-term outcome of those with a severe course.
RESULTS: A total of 50 MIS-C patients (mean age 8.8 ± 4.3 years, 16 females) were admitted. In univariate analysis, the predictors of high-risk disease were older age; high CRP, neutrophils, ferritin, D-dimer, and transaminases; and low white blood cells, lymphocytes, platelets, albumin, and sodium. In multivariate analysis, a more severe course of the disease was associated with sodium ≤133 or ferritin >684. In two months, the symptoms disappeared. No relapses occurred during four years of surveillance.
CONCLUSION: The prognosis of MIS-C is favorable, even in severe cases. MIS-C resolves completely as early as eight weeks from onset and is not associated with other events over four years of observation. In our experience, careful and correct stratification in the initial phases has proven essential in setting up the correct treatment, with full recovery in all cases.}, }
@article {pmid40987329, year = {2025}, author = {Shaw, KE and Peterson, JK and Jalali, N and Ratnavale, S and Alkuzweny, M and Barbera, C and Costello, A and Emerick, L and Espana, G and Meyer, A and Mowry, S and Poterek, M and de Souza Moreira, C and Morgan, EL and Moore, S and Perkins, A}, title = {Co-circulating pathogens of humans: a systematic review of mechanistic transmission models.}, journal = {Proceedings. Biological sciences}, volume = {292}, number = {2055}, pages = {20251453}, pmid = {40987329}, issn = {1471-2954}, support = {/GM/NIGMS NIH HHS/United States ; }, mesh = {Humans ; *COVID-19/transmission/virology/epidemiology ; SARS-CoV-2/physiology ; HIV Infections/transmission ; *Coinfection/virology ; *Communicable Diseases/transmission/virology/epidemiology ; *Models, Biological ; Models, Theoretical ; }, abstract = {Historically, most mathematical models of infectious disease dynamics have focused on a single pathogen, despite the ubiquity of co-circulating pathogens in the real world. We conducted a systematic review of 326 published papers that included a mechanistic, population-level model of co-circulating human pathogens. We identified the types of pathogens represented in this literature, techniques used and motivations for conducting these studies. We also created an interaction index to quantify the degree to which co-circulating pathogen models include across scale and/or pathogen-pathogen interactions. We found that the emergence of new pathogens, such as HIV and SARS-CoV-2, precipitated modelling activity of the emerging pathogen with established pathogens. Pathogen characteristics also tended to drive modelling activity; for example, HIV suppresses the immune response, eliciting interesting dynamics when it is modelled with other pathogens. The motivations driving these studies were varied but could be divided into two major categories: exploration of dynamics and evaluation of interventions. Future potential avenues of research we identified include investigating the effects of misdiagnosis of clinically similar co-circulating pathogens and characterizing the impacts of one pathogen on public health resources available to curtail the spread of other pathogens.}, }
@article {pmid40987438, year = {2026}, author = {Koyou, HL and Ramachandran, V and Salleh, MN}, title = {Meta-Data Analysis to Explore the Interaction of the Hub-Genes interlinking SARS-CoV-2 and Cardiovascular Diseases.}, journal = {Pneumologie (Stuttgart, Germany)}, volume = {80}, number = {4}, pages = {271-282}, doi = {10.1055/a-2698-0433}, pmid = {40987438}, issn = {1438-8790}, support = {UCMI/ TNCPP/RMC/Geran/2024 (63)//Tun Ahmad Sarji Endowment Fund (TASREF)/ ; }, mesh = {Humans ; *Cardiovascular Diseases/genetics/epidemiology ; *COVID-19/genetics/epidemiology ; *SARS-CoV-2/genetics ; Gene Expression Profiling ; Protein Interaction Maps/genetics ; }, abstract = {The impact of the pandemic of SARS-CoV-2 infections in the population has caused many diseases onset, post the recovery. The most common is Cardiac injury, which causes further complications that lead to cardiovascular diseases (CVD). This study aimed to analyse the hub genes with a high correlation between SARS-CoV-2 and cardiovascular diseases.The datasets were obtained from the already available GSE196822, GSE196656, and GSE169241 data sets. DESec 2 in R was used for differentially expressed genes, and enriched pathway analysis was performed. Further, Cytoscape used the protein-protein interactions by STRING and hub genes for the common DEGs.The transcriptome analysis of GSE196822 revealed that 7,376 upregulated and 3,673 downregulated genes were the differentially expressed genes (DEGs) among the three selected datasets. Combining the overlap of these data sets for the common genes involved in COVID-19 and CVD, 169 upregulated and 123 downregulated DEGs were observed. These DEGs are further examined with GO (Gene Ontology) and KEGG (Kyoto Encyclopedia of Genes and Genomes). The KEGG pathway revealed 21 upregulated and 11 downregulated pathways, where the highest count was recorded in transcriptional misregulations in cancer and metabolic pathways, respectively. The top 10 hub genes analysis and PPI network analysis revealed their interlinings for upregulation and downregulations, respectively. The top three upregulated genes (TIMP1, MPO, NFKBIA) and downregulated genes (ACSS1, OXCT1, ADHFE1) identified by differential expression analysis were validated by qRT-PCR, confirming their significant and consistent expression changes under the experimental conditions.The 9 out of 10 hub genes with elevated co-expressibility of linked genes between COVID-19 and CVD showed complications consistent with previous reports. Our findings further suggest that these hub genes may serve dual purposes: as indicators of early viral infection, including COVID-19 and related viral illnesses, and as potential predictors of cardiovascular disease (CVD) onset following COVID-19 infection. This work strongly urges health policymakers to implement screening for COVID-19 complications, especially CVDs, in the general public.}, }
@article {pmid40988261, year = {2025}, author = {Gao, Y and Wang, X and Su, X and Liu, W and Zhang, Q}, title = {Acupuncture for hiccups: Case reports and literature review.}, journal = {Medicine}, volume = {104}, number = {38}, pages = {e44036}, pmid = {40988261}, issn = {1536-5964}, support = {ZKYB2410//the Hospital-level Project of Zhejiang Rehabilitation Medical Center/ ; (2022)NO:239//The National Program For Talents In Traditional Chinese Medicine/ ; }, mesh = {Aged ; Aged, 80 and over ; Humans ; Male ; *Acupuncture Therapy/methods ; *Hiccup/therapy ; }, abstract = {RATIONALE: Persistent hiccups following a stroke are a common complication that can adversely affect the patient's condition and rehabilitation. Certain refractory cases fail to respond adequately to pharmacological treatment. We report 2 cases of successful treatment of persistent hiccups with acupuncture and a medical electromagnetic device (trade name, TDP, an abbreviation of the Chinese phrase "Te-ding Dian-ci-bo Pu").
PATIENT CONCERNS: The first patient was a 94-year-old male who had experienced continuous hiccups for 7 days. His comorbidities included Alzheimer disease, cardiac arrhythmia following pacemaker implantation, chronic kidney disease, glaucoma, and recent COVID-19 infection complicated by pneumonia. The second patient was a 70-year-old male who had experienced hiccups for 10 days. He had a history of cerebellar and brainstem infarction, hypertension, and hypopharyngeal carcinoma.
DIAGNOSES: Both patients were diagnosed with persistent hiccups.
INTERVENTIONS: Both patients received combined treatment with acupuncture and TDP.
OUTCOMES: Following treatment, hiccups were alleviated to different degrees, and no recurrence was observed at follow-up.
LESSONS: Neuroexcitatory imbalance and thoracoabdominal pressure asymmetry are considered underlying causes of persistent hiccups. Acupuncture combined with TDP may modulate periumbilical arteriovenous networks and abdominal pressure, thereby relieving hiccups. This case series suggests a novel, easily implemented, well-tolerated therapeutic option for the management of persistent hiccups.}, }
@article {pmid40988320, year = {2025}, author = {Yin, X and Hou, X and Feng, J}, title = {Role of Ferroptosis on Lung Epithelial Cells in Disease Progression and Treatment: A Review.}, journal = {Medical science monitor : international medical journal of experimental and clinical research}, volume = {31}, number = {}, pages = {e948226}, pmid = {40988320}, issn = {1643-3750}, mesh = {*Ferroptosis/physiology/drug effects ; Humans ; *Epithelial Cells/pathology/metabolism ; Disease Progression ; *Lung/pathology/metabolism ; Epithelial-Mesenchymal Transition ; Oxidative Stress ; *Lung Diseases/pathology ; COVID-19/pathology ; Animals ; Lung Neoplasms/pathology ; SARS-CoV-2 ; Pulmonary Disease, Chronic Obstructive/pathology ; Lipid Peroxidation ; }, abstract = {Lung epithelial cells, including bronchial and alveolar epithelial cells, serve as the frontline barrier of the respiratory tract and play essential roles in maintaining pulmonary homeostasis and immune defense. Dysfunction of these epithelial cells contributes significantly to the development and progression of various lung diseases. Ferroptosis, an iron-dependent form of regulated cell death characterized by lipid peroxidation and glutathione depletion, has emerged as a key mechanism in pulmonary pathology. It plays distinct roles in benign and malignant lung conditions. In chronic obstructive pulmonary disease and asthma, ferroptosis promotes bronchial epithelial damage, oxidative stress, and persistent inflammation. Pathogens, such as Pseudomonas aeruginosa and SARS-CoV-2, induce ferroptosis to exacerbate epithelial injury. In pulmonary fibrosis, ferroptosis of alveolar epithelial cells contributes to tissue remodeling through oxidative stress and epithelial-mesenchymal transition. In lung cancer, ferroptosis affects carcinogenesis, therapy resistance, and response to radiotherapy. Emerging therapeutic strategies target ferroptosis using inhibitors, such as ferrostatin-1 and deferoxamine, or inducers, such as erastin and sulfasalazine, to modulate cell fate in a disease-specific manner. Natural compounds, such as curcumin, resveratrol, and nanomaterials, further enhance ferroptosis-based treatment potential. Ferroptosis thus offers a novel perspective on lung disease mechanisms and treatment. This article aims to review the role of epithelial cell ferroptosis in benign and malignant lung diseases.}, }
@article {pmid40988745, year = {2025}, author = {Montrucchio, G and Traversi, R and Arrigo, G and Bonetto, C and Sales, G and Busca, A and Fanelli, V and Filippini, C and Brazzi, L}, title = {Hemophagocytic Lymphohistiocytosis in the adult critically ill: a narrative review of case reports and case series.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1622770}, pmid = {40988745}, issn = {2296-858X}, abstract = {BACKGROUND: Hemophagocytic Lymphohistiocytosis (HLH) is a rare life-threatening syndrome characterized by hyperinflammation caused by abnormally activated macrophages and cytotoxic T cells overlapping with sepsis and multi-organ disfunction (MOD). Its frequency is probably underestimated.
METHODS: Patients' data were extracted from a literature search performed on PubMed (MEDLINE) and EMBASE using the following search terms: "Hemophagocyitic Lymphohistiocytosis" OR "HLH" OR "MACROPHAGE ACTIVATING SYNDROME" OR "MAS" AND "Intensive Care Unit" OR "Critical Care" OR "ICU." Search was limited to articles published after 2014, when HScore was proposed.
RESULTS: We found 126 case reports and case series for a total of 148 patients with an overall mortality of 47.5%. Main triggers were infections (111 patients; 88.1%) followed by dysimmune disorders (29 patients; 19.7%) and hematological malignancies (20 patients; 13.6%). The following factors were associated with increased ICU mortality: viral infection (76 patients; 52.8%) p = 0.0071 and p = 0.0086 at multivariate analysis for SARS-CoV-2, hematological malignancies (p = 0.0035 at univariate analysis; p = 0.0083 at multivariate analysis), invasive mechanical ventilation (116 patients; 83.3%) p = 0.0060 at univariate analysis not confirmed in multivariate analysis (p = 0.0599). Corticosteroids were associated with reduced ICU mortality at univariate analysis (86 patients; 59.7% p = 0.0250) not confirmed at multivariate analysis (p = 0.7196).
CONCLUSION: Evidence from our analysis confirms the severity and rapid evolution of HLH, suggesting the importance of prompt clinical suspicion. Since HLH can be found in different hospital settings, including ICU, we believe that this syndrome should be considered in differential diagnosis for all patients presenting with MOD with unclear etiology. Development of specific diagnostic and therapeutic schemes should be considered a priority.}, }
@article {pmid40989546, year = {2025}, author = {Cruz Neto, J and Fiuza Olivindo, CV and Guimarães Dos Santos, JA and Araujo da Silva, MA and de Oliveira Sales Junior, R}, title = {Cardiometabolic factors related to post-COVID-19 conditions: a scoping review.}, journal = {Revista Cuidarte}, volume = {16}, number = {2}, pages = {e4290}, pmid = {40989546}, issn = {2346-3414}, abstract = {INTRODUCTION: Post-COVID syndrome is a pathology that involves multiple sequelae. It is important to identify cardiometabolic risk factors as a way of preventing complications.
OBJECTIVE: To map the scientific evidence related to cardiometabolic factors in long post-COVID-19 conditions.
MATERIALS AND METHODS: Scoping review with the guiding question: What scientific evidence relates cardiometabolic factors to patients with long post-Covid-19 syndrome? The sources of information used were six databases via the CAPES journal portal. For the gray literature, we used the CAPES catalog of theses and dissertations, the Brazilian Digital Library of Theses and Dissertations, the Who Library Database and the medRxiv and OpenGrey repositories. The following descriptors were used: Adult, heart disease risk factors, Syndrome, SARS-CoV-2 and Covid 19 crossed using the Boolean operators AND and OR.
RESULTS: 14 studies were included. The cardiometabolic factors found were: abnormal levels of triglycerides, glycated hemoglobin, ferritin, inflammatory processes, decreased platelets, phospholipids and endothelial cells, oxidative stress, higher concentrations of monosaccharides and reduced polysaccharides, increased LDL, ALT, AST and bilirubin, with reduced GFR.
DISCUSSION: Patients with long-term COVID report persistent and debilitating symptoms that affect recovery, quality of life, economic and social activities. In addition to increased resting heart rate, tachycardia, palpitations, hypotension, syncope, orthostatic tachycardia, angina and heart attack.
CONCLUSION: Cardiometabolic factors expose the vulnerability of individuals affected by long Covid-19, so strategies are needed to reduce the systemic inflammatory impact of the disease and its clinical consequences.}, }
@article {pmid40989868, year = {2025}, author = {Patel, JJ and Fine, KS and O'Shea, AW and Wirth, PJ and Shaffrey, EC and Attaluri, PK and Rao, VK}, title = {Gloving the Surgeon: A Practical Review of Surgical Glove Material Properties, Safety, and Waste.}, journal = {Annals of surgery open : perspectives of surgical history, education, and clinical approaches}, volume = {6}, number = {3}, pages = {e600}, pmid = {40989868}, issn = {2691-3593}, abstract = {Surgical gloves are a staple in every surgeon's daily routine, yet their full lifecycle is not always well understood. This paper outlines the journey of a surgical glove from manufacturing to disposal, with particular emphasis on clinically relevant properties such as durability, perforation rates, and allergy risk. It begins with a review of the historical context of sterile surgical gloves, followed by a detailed overview of the manufacturing process and the materials used, including latex and various synthetic alternatives. These various materials may differ in barrier protection, fit, tactile sensitivity, and allergenic potential. Data presented here suggests that synthetic alternatives to latex, while hypoallergenic, may be more prone to microperforations or decreased dexterity. The logistics of glove sourcing and inventory management are also examined, providing insights to help surgical teams and hospital administrators prepare for supply chain disruptions, such as those experienced during the COVID-19 pandemic. Finally, best practices for glove disposal and the environmental impact of surgical gloves are explored. By examining the clinical and logistical aspects of glove use, this article offers insights to optimize surgical safety, resource management, and sustainability.}, }
@article {pmid40991037, year = {2025}, author = {Fichtner, F and Kluge, S and Laudi, S and Moerer, O and Weber-Carstens, S and Sander, M}, title = {[Ten key messages of the German S3 guideline on invasive ventilation and use of extracorporeal techniques in patients with acute respiratory failure].}, journal = {Medizinische Klinik, Intensivmedizin und Notfallmedizin}, volume = {120}, number = {8}, pages = {677-679}, pmid = {40991037}, issn = {2193-6226}, }
@article {pmid40991173, year = {2025}, author = {Zhang, X and Tong, X and Hou, R and Wang, P and Mo, Y and Zhang, L}, title = {Unveiling the secret of cellular metamorphosis: the crucial role of EndMT mechanisms in COVID-19-induced pulmonary fibrosis.}, journal = {Inflammopharmacology}, volume = {33}, number = {10}, pages = {6251-6260}, pmid = {40991173}, issn = {1568-5608}, support = {2022NSFSC1394//Natural Science Foundation of Sichuan province/ ; 2023-GH02-00092-HZ//International Science and Technology Cooperation Project of Chengdu/ ; Q21018//Youth Innovation Project of Sichuan Medical Association/ ; 2022516//Chengdu Medical Research Projects/ ; 2023666//Chengdu Medical Research Projects/ ; }, mesh = {Humans ; *COVID-19/complications/pathology ; *Pulmonary Fibrosis/virology/pathology/etiology/metabolism ; Animals ; *Epithelial-Mesenchymal Transition/physiology ; Endothelial Cells/pathology/metabolism ; SARS-CoV-2 ; Endothelial-Mesenchymal Transition ; }, abstract = {The COVID-19 pandemic has resulted in several long-term complications, with COVID-19-induced pulmonary fibrosis being a significant concern. Despite increasing recognition, the mechanisms underlying its development, effective treatment strategies, and long-term outcomes remain poorly understood. Emerging research highlights the direct impact of SARS-CoV-2 on vascular endothelial cells, identifying endothelial-mesenchymal transition (EndMT) as a key factor in the progression of COVID-19-induced pulmonary fibrosis. However, there is a notable lack of comprehensive reviews addressing the link between EndMT and COVID-19-induced pulmonary fibrosis. This review seeks to fill that gap by providing an in-depth analysis of the relationship between EndMT and fibrosis, examining relevant risk factors and molecular pathways. Our findings offer critical insights that could inform the development of targeted anti-fibrotic therapies aimed at mitigating COVID-19-related pulmonary fibrosis. Ultimately, this review aims to advance understanding of the role of EndMT in pulmonary fibrosis and to guide future research and treatment approaches.}, }
@article {pmid40992230, year = {2025}, author = {Ortega-Paz, L and Talasaz, AH and Sadeghipour, P and Rashedi, S and Connors, JM and Angiolillo, DJ and Cavallari, LH and Jimenez, D and Bastidas, G and Lorenzi, E and Berry, LR and Hills, T and McAuley, DF and Shah, T and Lansky, AJ and Deepti, S and Gaitán-Duarte, HG and Potpara, TS and Galli, M and Dixon, DL and Piazza, G and Lip, GYH and Mehran, R and Libby, P and Krumholz, HM and Bikdeli, B}, title = {Safety and effectiveness of statins in hospitalized patients with COVID-19: Systematic review and collaborative meta-analysis of randomized controlled trials.}, journal = {Thrombosis research}, volume = {255}, number = {}, pages = {109484}, doi = {10.1016/j.thromres.2025.109484}, pmid = {40992230}, issn = {1879-2472}, mesh = {Humans ; *Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use/adverse effects ; Randomized Controlled Trials as Topic ; *COVID-19 Drug Treatment ; *COVID-19/mortality ; Hospitalization ; SARS-CoV-2 ; Female ; Male ; Muscular Diseases/chemically induced ; Treatment Outcome ; }, abstract = {AIMS: Statins may impact COVID-19 outcomes through lipid-mediated and lipid-independent pathways. However, the clinical impact of statin therapy among hospitalized patients with COVID-19 remains unclear due to the limited power of existing randomized controlled trials (RCTs).
METHODS: A systematic search of PubMed, Embase, and clinicaltrials.gov was conducted through July 17th, 2024. RCTs were included if they compared statin therapy to control (placebo or standard care) in hospitalized COVID-19 patients and enrolled at least 250 randomized participants. Studies with co-treatment were considered in sensitivity analyses. The primary effectiveness outcome was 30-day all-cause death. The main safety outcomes were myopathy and rise in liver enzymes.
RESULTS: Three RCTs were included in the main analysis (3882 statin-naive patients, 33.7 % female, average follow-up duration 37 days). Compared with control, statin therapy was associated with reduced all-cause death (20.9 % vs. 23.8 %; odds ratio [OR]: 0.82, 95 % confidence interval [CI] 0.70-0.96; P = 0.01), with a small but significant increase in myopathy (0.6 % vs. 0 %; risk difference: 0.00, 95 % CI -0.00; 0.01), and no significant difference in liver enzyme abnormalities (1.0 % vs. 1.4 %; OR 1.00, 95 % CI: 0.25-3.99). A sensitivity analysis including two additional RCTs that included randomized co-treatments yielded similar findings. There were no significant interactions for effectiveness by disease severity (critically vs. non-critically ill, P = 0.38) or sex (males vs. females, P = 0.83).
CONCLUSION: Among hospitalized patients with COVID-19, statin therapy was associated with a significant reduction in 30-day all-cause death compared with control and exhibited an excellent safety profile.
STUDY REGISTRATION: This study is registered in PROSPERO (CRD42023478764).}, }
@article {pmid40994423, year = {2025}, author = {Greenleaf, MN and Damhorst, GL and Vogel, EM and Martin, GS and Lam, WA}, title = {From startup to shutdown: the dramatic rise and fall of the first at-home combo test for flu and COVID-19.}, journal = {Lab on a chip}, volume = {25}, number = {20}, pages = {5115-5121}, pmid = {40994423}, issn = {1473-0189}, support = {U54 EB027690/EB/NIBIB NIH HHS/United States ; UL1 TR002378/TR/NCATS NIH HHS/United States ; }, mesh = {Humans ; *COVID-19/diagnosis ; *Influenza, Human/diagnosis ; SARS-CoV-2/isolation & purification ; United States ; *COVID-19 Testing/methods ; United States Food and Drug Administration ; }, abstract = {This article explores the development and commercialization of Lucira Health's innovative at-home molecular diagnostic test, which detects influenza A or B and SARS-CoV-2. Launched amidst the urgent demand for accessible testing solutions, Lucira's product represented a significant breakthrough, becoming the first over-the-counter combination test authorized by the US Food and Drug Administration (FDA). The narrative tracks Lucira's journey from its origins in microfluidics at the University of California-Berkeley, through development challenges, business success and failure. It also contrasts the distinct motivations and technical challenges of pre-pandemic versus pandemic era diagnostics, emphasizing test-to-treat strategies versus rapid results for containment. Despite early successes, Lucira faced insurmountable regulatory and financial hurdles, culminating in bankruptcy just days before FDA authorization. The case offers critical insights into diagnostics product development, regulatory navigation, product diversification, and strategic risk management in push towards home and point of care diagnostics.}, }
@article {pmid40994755, year = {2025}, author = {Ducas, J and Daneau, C and Bouqartacha, S and Lecours, A and Abboud, J and Marchand, AA and Descarreaux, M}, title = {The impact of telework on absenteeism, presenteeism, and return to work among workers with health conditions: a scoping review.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1655200}, pmid = {40994755}, issn = {2296-2565}, mesh = {Humans ; *Absenteeism ; *Presenteeism/statistics & numerical data ; *Return to Work/statistics & numerical data ; COVID-19/epidemiology ; *Teleworking/statistics & numerical data ; Adult ; Workplace ; SARS-CoV-2 ; Health Status ; }, abstract = {INTRODUCTION: Telework has become increasingly prominent as a flexible work arrangement, particularly since the COVID-19 pandemic. For workers managing health conditions, it may support continued employment by influencing key work-related phenomena such as absenteeism, presenteeism and return to work (RTW) process. However, current evidence on the impact of telework on the work-related outcome to manage health condition in the workplace remains limited and fragmented.
OBJECTIVE: This scoping review aimed to map the existing literature on the impact of telework on absenteeism, presenteeism, and RTW outcomes among adult workers with health conditions.
METHODS: Included studies were either qualitative, quantitative, or mixed methods, published in English or French, including adults with any physical or psychological health conditions. At least one outcome domain (absenteeism, presenteeism, or RTW) was required. Eight databases were searched from inception to May 2025: Medline, CINAHL, APA PsycINFO, Academic Search Complete, Business Source Complete, Scopus, Sociological Abstracts, and ABI/INFORM Global. Data extraction focused on study design, objectives, variables/definitions, sample size, health status, demographic characteristics, individual characteristics, organizational factors and results. Data were synthesized by the outcome domain (absenteeism, presenteeism, RTW) and stratified by study type (quantitative vs. qualitative).
RESULTS: From 4,093 records, 21 studies were included. The majority of studies suggest that telework contributes to reduced absenteeism by increasing work flexibility. Telework is also consistently associated with facilitating RTW, particularly following surgery or in the context of chronic illness, by supporting work reintegration and shortening the duration of sick leave. In contrast, findings on presenteeism are conflicting: some studies report that telework increases the likelihood of working while sick, others suggest a decrease, and some report no significant impact or conflicting results. These outcomes appear to be influenced by contextual factors, including health status, demographic variables, individual characteristics, and organizational context.
CONCLUSION: Telework appears to offer flexibility that can reduce absenteeism and facilitate RTW. However, its impact on presenteeism is less consistent and may even encourage working while sick if not properly supervised. Future studies should examine which policies most effectively maximize the benefits of telework while minimizing potential drawbacks.}, }
@article {pmid40995868, year = {2025}, author = {Lindfors, O and Josefsson, A and Sjöström, C}, title = {[Time to modernise healthcare regarding functional disorders].}, journal = {Lakartidningen}, volume = {122}, number = {}, pages = {}, pmid = {40995868}, issn = {1652-7518}, mesh = {Humans ; *COVID-19/complications/psychology/therapy ; Sweden ; Denmark ; Practice Guidelines as Topic ; Post-Acute COVID-19 Syndrome ; }, abstract = {The Swedish guideline on post covid-19 and related syndromes classify six overlapping conditions. A functional perspective, as used in Denmark, distinguishes physiological reactions from diseases, aiding understanding and treatment. Functional symptoms arise from dysregulated adaptation systems reacting excessively. This dysregulation can persist, leading to various symptoms. Effective treatment focuses on stabilizing these systems through knowledge, behavioral changes and gradual exposure to discomfort. A biopsychosocial model addressing biological, psychological, and social factors is key. Denmark's structured approach has improved care, and similar competence-building efforts in Sweden could enhance treatment for post-infectious and long term functional conditions.}, }
@article {pmid40997395, year = {2025}, author = {Moisi, M and Bowers, C and Shah, S and Zoghi, S and Venero, C and Arora, S and Mirza, S and Haridas, A and Vahdat, N and Foroughi, M and Mahdavi, SB and Sourani, A}, title = {A systematic review on COVID-19 and spinal strokes, the end of an era.}, journal = {Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia}, volume = {142}, number = {}, pages = {111639}, doi = {10.1016/j.jocn.2025.111639}, pmid = {40997395}, issn = {1532-2653}, mesh = {Humans ; *COVID-19/complications ; *Ischemic Stroke ; *Spinal Cord Ischemia/etiology/diagnostic imaging ; }, abstract = {AIM: To investigate the association of the COVID-19 virus with hemorrhagic and ischemic spinal strokes.
, BACKGROUND: COVID-19 has extensive extrapulmonary manifestations. Myelitis, demyelinating syndromes, hemorrhagic and ischemic presentations have been reported. To date, there is no comprehensive study to delineate an evidence-based correlation between COVID-19 and spinal strokes comprehensively.
MATERIALS AND METHODS: A PRISMA-based systematic review.
RESULTS: In the final review, 8 data sets for ischemia and 11 for hemorrhagic lesions were included. The mean age for ischemia and hemorrhagic lesions was 52 and 47 years old, respectively. Patients with cord ischemia had more severe COVID-19 pneumonia as compared to hemorrhagic (62 % vs 27 %). Lab results showed 75 % coagulation abnormalities in cord ischemia patients while there was no coagulopathy in the hemorrhage group. Somatosensory deficits were the most prevalent neurological presentations in both groups. MRI showed that the anterior spinal artery and central ischemia were the most common patterns of COVID-19 spinal ischemia. MRI images also revealed epidural and intramedullary hematomas were the most common type of hemorrhagic lesions with cervical and thoracic preferences. The most common on-admission neurological status was American Spinal Injury Association (ASIA) impairment scale A-B(ischemia) and ASIA B-D(hemorrhage). All of the ischemic patients received conservative management. In hemorrhagic patients, there were 4 laminectomies, 6 conservative management, and 1 combined approach. Post-intervention clinical outcomes in ischemia were unfavorable but in the hemorrhagic spinal strokes, it had more promising results.
CONCLUSION: COVID-19 can cause both ischemia and hemorrhagic spinal strokes. Coagulopathy may be a precipitating factor in cord ischemia development while other neuropathogenesis mechanisms may precipitate spinal hemorrhage. Early surgical or conservative management is the key factor in determining long-term outcomes.}, }
@article {pmid40997476, year = {2025}, author = {Porcel, JM and Porcel, L and Campo-Linares, R}, title = {Point-of-care ultrasound in pulmonary and pleural infections.}, journal = {Medicina clinica}, volume = {165}, number = {5}, pages = {107191}, doi = {10.1016/j.medcli.2025.107191}, pmid = {40997476}, issn = {1578-8989}, mesh = {Humans ; Ultrasonography/methods ; *Point-of-Care Systems ; COVID-19/diagnostic imaging ; Pleural Effusion/diagnostic imaging ; *Pleural Diseases/diagnostic imaging ; *Pneumonia/diagnostic imaging ; }, abstract = {Point-of-care ultrasound (POCUS) is a rapid bedside imaging modality available to clinicians for the diagnosis of pleuropulmonary infections. Compared with chest radiography, POCUS is more sensitive in identifying pneumonia and its complications (parapneumonic pleural effusions, necrosis, and abscesses). The most common sonographic features of pneumonia are consolidation (with irregular margins and dynamic air bronchograms), B-lines, and pleural effusion. POCUS also has prognostic applications, for example, to determine the severity of COVID-19 pneumonia or to predict residual pleural thickening in a tuberculous effusion. Finally, the presence of a complex septated ultrasound pattern in the context of pleural infection is indicative of the need for drainage, which is performed using a thoracostomy tube and instillation of intrapleural enzyme therapy.}, }
@article {pmid40997530, year = {2025}, author = {Rees, GH and Willis, G and Scotter, C}, title = {Health workforce planning should be strategy or policy-driven: From linear forecasts to normative futures.}, journal = {Health policy (Amsterdam, Netherlands)}, volume = {161}, number = {}, pages = {105440}, doi = {10.1016/j.healthpol.2025.105440}, pmid = {40997530}, issn = {1872-6054}, mesh = {Humans ; *Health Workforce/organization & administration/trends ; Forecasting/methods ; *Health Policy ; *Health Planning/organization & administration ; COVID-19 ; Pandemics ; }, abstract = {Health workforce planning (HWP) remains persistently ineffective, a weakness that was starkly exposed during the pandemic and amplified in today's ongoing health permacrisis. Despite the development of increasingly sophisticated workforce models and planning techniques, outcomes continue to fall short. We argue that a central reason lies in how the HWP problem is framed: the dominant reliance on linear, forward-looking forecasting methods constrains both the scope of planning and the relevance of its outputs. We propose reframing HWP through the use of normative futures methods, which begin with a desired future and then work backwards to identify the steps needed to reach it. Such approaches are well established in other complex policy domains and are particularly suited to HWP's long-term horizon, multi-stakeholder setting, and inherent uncertainties. By aligning workforce planning with the strategic directions already articulated in national health strategies, normative backcasting offers three key advantages: (1) improved integration of drivers of change into workforce modelling, (2) more meaningful stakeholder engagement and ownership, and (3) stronger governance through clearer milestones, responsibilities, and monitoring. As a result, HWP is more likely to deliver actionable, timely, and resource-efficient plans. We therefore call on policymakers and planners to shift from linear forecasting toward normative futures approaches to enable more reliable decisions and achieve the health workforce needed for resilient health systems.}, }
@article {pmid40997838, year = {2025}, author = {Frisoni, GB and Hansson, O and Nichols, E and Garibotto, V and Schindler, SE and van der Flier, WM and Jessen, F and Villain, N and Arenaza-Urquijo, EM and Crivelli, L and Fortea, J and Grinberg, LT and Ismail, Z and Minoshima, S and Ossenkoppele, R and Zetterberg, H and Petersen, RC and Dubois, B}, title = {New landscape of the diagnosis of Alzheimer's disease.}, journal = {Lancet (London, England)}, volume = {406}, number = {10510}, pages = {1389-1407}, doi = {10.1016/S0140-6736(25)01294-2}, pmid = {40997838}, issn = {1474-547X}, mesh = {Humans ; *Alzheimer Disease/diagnosis/cerebrospinal fluid ; Biomarkers/cerebrospinal fluid/blood ; Amyloid beta-Peptides/metabolism/cerebrospinal fluid ; tau Proteins/cerebrospinal fluid/metabolism ; Diagnosis, Differential ; Positron-Emission Tomography ; }, abstract = {Alzheimer's disease involves a drastic departure from the cognitive, functional, and behavioural trajectory of normal ageing, and is both a dreaded and highly prevalent cause of disability to individuals, and a leading source of health and social care expenditure for society. Before the advent of biomarkers, post-mortem examination was the only method available to establish a definitive diagnosis. In this first paper of the Series, we review state-of-the-art diagnostic practices and the typical patient journey in specialist settings, where clinicians engage in a differential diagnosis to establish whether Alzheimer's pathology (cerebral deposition of β-amyloid and hyperphosphorylated tau) is a contributor to cognitive impairment. Biomarkers indicating dysregulation of β-amyloid and tau homeostasis, measured with PET and cerebrospinal fluid analysis, allow a molecular-level diagnosis-a mandatory step in defining eligibility for the recently approved anti-amyloid treatments. We anticipate that easily accessible blood biomarkers, already available in some countries, will lead to a new diagnostic revolution and bring about major changes in health-care systems worldwide.}, }
@article {pmid40998072, year = {2025}, author = {Sheervalilou, M and Ghanei, M and Arabfard, M}, title = {Single-cell RNA sequencing in high-burden viral respiratory infections: Decoding immune cell subsets and immune-related differential gene expression.}, journal = {Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases}, volume = {135}, number = {}, pages = {105834}, doi = {10.1016/j.meegid.2025.105834}, pmid = {40998072}, issn = {1567-7257}, mesh = {Humans ; *Single-Cell Analysis/methods ; Animals ; *COVID-19/immunology/genetics/virology ; Sequence Analysis, RNA/methods ; *Respiratory Tract Infections/immunology/virology/genetics ; SARS-CoV-2/immunology ; *Influenza, Human/immunology/genetics/virology ; }, abstract = {Respiratory infections remain a major global health burden, ranking among the leading causes of mortality worldwide. Single-cell RNA sequencing (scRNA-seq) has emerged as a transformative technology for dissecting the cellular and molecular complexity of these infections. This review focuses on recent scRNA-seq studies investigating the immune landscape of high-burden viral respiratory infections, particularly COVID-19 and influenza, which are characterized by high transmissibility and clinical impact. We provide an overview of publicly available scRNA-seq datasets derived from human peripheral blood and bronchoalveolar lavage fluid (BALF), as well as lung tissues and explants from murine models, emphasizing their value in profiling immune heterogeneity. scRNA-seq has revealed significant remodeling of immune cell populations during infection, including the identification of novel subsets such as CD4[+] c13-MKI67[+] CCL5[low] T cells, CD8[+] CXCR3[high] GZMA[+] T cells, and CD56[high] CD16[-] GZMB[+] NK cells. These subsets are frequently associated with differential expression of cytokines, chemokines, and interferon-stimulated genes that reflect disease severity and progression. In addition, scRNA-seq has highlighted key pathogen-induced pathways, including type I interferon, NF-κB, and JAK/STAT signaling, and has identified emerging immune-related biomarkers-such as PTX3, MCEMP1, CXCR4, IFIT1, ISG15, and STAT1-with potential diagnostic and prognostic utility. While scRNA-seq applications in respiratory infections of other microbial origins are limited, its role in mapping immune responses and guiding biomarker discovery in viral infections is rapidly expanding. This review synthesizes these findings to inform future translational research and immunodiagnostic strategies.}, }
@article {pmid40998263, year = {2026}, author = {Wijaya, D and Bittar, R and Shah, P and Al-Manaseer, F and Hagele, A and Courtad, I and Guo, M and Akhtari, M}, title = {Comparison of Fresh Versus Frozen Allogenic Peripheral Blood Stem Cell Grafts in Hematopoietic Stem Cell Transplantation: A Meta-Analysis and Systematic Review.}, journal = {Transplantation and cellular therapy}, volume = {32}, number = {2}, pages = {215.e1-215.e14}, doi = {10.1016/j.jtct.2025.09.035}, pmid = {40998263}, issn = {2666-6367}, mesh = {Humans ; *Cryopreservation/methods ; *Hematopoietic Stem Cell Transplantation/methods ; *Peripheral Blood Stem Cell Transplantation/methods ; Transplantation, Homologous ; Graft Survival ; COVID-19 ; *Peripheral Blood Stem Cells/cytology ; }, abstract = {The COVID-19 pandemic led to the widespread adoption of cryopreserved peripheral blood stem cell (PBSC) grafts in allogeneic hematopoietic stem cell transplantation (HSCT), diverging from the traditional preference for fresh grafts. Although cryopreservation ensures graft availability during logistical disruptions, its impact on transplantation outcomes remains uncertain. Existing studies report mixed findings, and no consensus has been established regarding long-term outcomes. In the present study, we compared clinical outcomes of fresh versus cryopreserved allogeneic PBSC grafts in patients undergoing HSCT, with a focus on engraftment and survival outcomes, and evaluated the consistency of reported effects across studies, through a meta-analysis and systematic review of retrospective cohort studies published between 2005 and 2025. PubMed and Embase were searched through May 10, 2025. Primary outcomes included composite, primary, and secondary graft failure; secondary outcomes included engraftment times, overall survival (OS), and relapse-free survival (RFS). Random-effects and fixed-effects models were conducted using R, and Kaplan-Meier curves were digitized when necessary. Thirteen studies were included in the meta-analysis, and 19 studies were included in the systematic review. Fresh grafts were associated with significantly lower odds of composite graft failure (odds ratio [OR], 0.58), primary graft failure (OR, 0.60), and secondary graft failure (OR, 0.46), all with low heterogeneity. Neutrophil and platelet engraftment times were similar, although platelet engraftment showed a nonsignificant trend favoring fresh grafts (-1.34 days; P = .058). One-year and 2-year OS favored fresh grafts in fixed-effects models (OR, 1.15 and 1.16, respectively), but these associations were not significant under random-effects models owing to substantial heterogeneity. One-year RFS also favored fresh grafts in the fixed-effects model (OR, 1.25) but lost significance in the random-effects model. In contrast, 2-year RFS consistently favored fresh grafts across both models (OR, 1.21; 95% CI, 1.08 to 1.35; I[2] = 0%). Our findings indicate that fresh PBSC grafts are associated with significantly lower rates of graft failure and may confer long-term survival benefits compared to cryopreserved grafts. While survival outcomes varied by statistical model because of heterogeneity, no studies reported superior outcomes with cryopreserved products. These findings support the preferential use of fresh grafts when feasible. Preclinical and clinical studies are needed to further improve the cryopreservation process. Subgroup analyses also may help identify patient populations most likely to benefit from fresh grafts.}, }
@article {pmid40998585, year = {2026}, author = {Spurway, C and Williams, I and Ayinde, OC and Bohm, C and Burns, F and Gibbs, J and Josh, J and Munro, H and Woode Owusu, M and Solomon, D and Ross, JD and Jackson, LJ}, title = {Remote consultations in sexual and reproductive health services: a systematic review of evidence on effectiveness, cost-effectiveness, experiences, access and equity.}, journal = {Sexually transmitted infections}, volume = {102}, number = {2}, pages = {109-122}, pmid = {40998585}, issn = {1472-3263}, mesh = {Humans ; *Reproductive Health Services/economics ; *Health Services Accessibility/economics ; COVID-19/epidemiology ; Cost-Benefit Analysis ; *Sexual Health ; *Remote Consultation/economics ; SARS-CoV-2 ; Female ; Health Equity ; Cost-Effectiveness Analysis ; }, abstract = {OBJECTIVES: Timely access to sexual health screening and contraception is an important public health issue. Substantial funding reductions for sexual and reproductive health services (SRHS) and COVID-19 have led to significant changes in service delivery, including the rapid introduction of remote consultations, as a substitute for in-person contact. There is limited evidence relating to the barriers to remote consultations and how these may impact sexual health outcomes and wider health inequalities. This study synthesises existing evidence on remote consultations to examine effectiveness, cost-effectiveness, experiences, access and equity.
METHODS: Eighteen electronic databases were systematically searched to locate relevant studies published from OECD (Organisation for Economic Co-operation and Development) countries after 2010. The Mixed Methods Appraisal Tool was used to evaluate the quality of the studies.
RESULTS: Out of 8690 studies identified, 48 met the inclusion criteria. The included studies were heterogeneous and covered a range of topics; however, few focused on health inequalities and remote consultations, with satisfaction and quality of care being the most common outcome measures. Many of the studies were completed post-2020 in response to COVID-19 and were of medium to low quality. Access to technology and communication challenges were found to impact inequality when accessing SRHS via remote consultations, although they enhance convenience for service users and service providers.
CONCLUSIONS: Overall, the review shows that a range of studies have investigated remote consultations in SRHS, but there remains limited evidence on the impact on health inequalities and sexual health outcomes. The surge in post-2020 research, spurred by COVID-19, indicates the necessity for further high-quality research into equitable SRHS delivery in the post-COVID era, particularly in addressing technological and communication barriers. There is a need to further optimise access and the delivery of remote consultations in SRHS, considering the needs of service users, and minimising inequality (observed differences) and inequity (unfair differences).CRD42023397288.}, }
@article {pmid40999389, year = {2025}, author = {Li, Y and Lu, Y and Tang, H and Spector, EA and Wen, X and Germinal, K and Milfort, A and Guo, Y and Bost, S and Shenkman, E and Bian, J and Hu, H and Guo, J}, title = {Neonatal outcomes among pregnant women with COVID-19: a systematic scoping review and meta-analysis.}, journal = {BMC pregnancy and childbirth}, volume = {25}, number = {1}, pages = {948}, pmid = {40999389}, issn = {1471-2393}, support = {CDRN-1501-26692/PCORI/Patient-Centered Outcomes Research Institute/United States ; R21 ES032762/ES/NIEHS NIH HHS/United States ; R21ES032762/ES/NIEHS NIH HHS/United States ; UL1 TR001427/TR/NCATS NIH HHS/United States ; UL1TR001427/TR/NCATS NIH HHS/United States ; }, mesh = {Humans ; Pregnancy ; Female ; *COVID-19/epidemiology/transmission ; *Pregnancy Complications, Infectious/epidemiology/virology ; Infant, Newborn ; *Infectious Disease Transmission, Vertical/statistics & numerical data ; *Pregnancy Outcome/epidemiology ; SARS-CoV-2 ; Intensive Care Units, Neonatal/statistics & numerical data ; }, abstract = {BACKGROUND: Current findings on the neonatal outcomes among pregnant women infected with COVID-19 remain inconclusive. The purpose of this systematic scoping review and meta-analysis was to summarize the literature regarding this topic and provide an overview of the methodologies and results present in current research.
METHODS: PubMed was searched up to December 2022 to identify observational studies that reported neonatal outcomes among children delivered by mothers diagnosed with COVID-19 during pregnancy. Outcomes of interest included vertical transmission to neonates, neonatal intensive care unit (NICU) admission, and neonatal death. Qualitative analysis and meta-analysis were applied to summarize and synthesize the results.
RESULTS: Out of an initial selection of 13,387 studies, 187 were included in this systematic scoping review. There was high heterogeneity in the epidemiologic study design, sample size, and outcomes of interest. Most studies focused on neonatal outcomes from birth to day 14 rather than the full neonatal period. Conflicting conclusions were drawn regarding outcomes among neonates delivered by COVID-19-positive mothers. Results of meta-analysis revealed that maternal COVID-19 infection was moderately associated with the risk of vertical transmission to neonates (Incidence Rate [IR], 2.66%; 95%CI, 2.11-3.35%), neonatal intensive care unit admission (IR, 16.43%; 95%CI, 14.59-18.45%), and neonatal death (IR, 1.29%; 95%CI, 0.95-1.74%), and these risks seemed to be increased with the severity of maternal COVID-19.
CONCLUSIONS: This review identified heterogeneity in the epidemiologic studies. Maternal COVID-19 infection was associated with the risk of adverse neonatal outcomes and these risks seemed to be increased with the severity of maternal COVID-19.}, }
@article {pmid41000059, year = {2025}, author = {Diedericks, C and Crossley, KJ and Davies, IM and Blank, DA and Cramer, SJE and Wallace, MJ and Te Pas, AB and Kitchen, MJ and Hooper, SB}, title = {Role of the Chest Wall in Newborn Respiratory Function at Birth.}, journal = {FASEB journal : official publication of the Federation of American Societies for Experimental Biology}, volume = {39}, number = {19}, pages = {e71064}, pmid = {41000059}, issn = {1530-6860}, support = {2012443//Federal Government | DHAC | National Health and Medical Research Council (NHMRC)/ ; 2021055//Federal Government | DHAC | National Health and Medical Research Council (NHMRC)/ ; APP20262322//Federal Government | DHAC | National Health and Medical Research Council (NHMRC)/ ; //Australian Government Research Training Program/ ; }, mesh = {Humans ; *Thoracic Wall/physiology ; Infant, Newborn ; Respiratory Mechanics/physiology ; *Respiration ; Lung/physiology ; Respiratory Muscles/physiology ; COVID-19 ; }, abstract = {The chest wall significantly impacts respiratory function after birth, but its role in the newborn remains poorly understood as it is structurally and functionally different from adults. In neonates, the chest wall is highly compliant, which allows it to expand to accommodate the incoming air and the lung liquid cleared into the pulmonary interstitium during lung aeration. However, the high neonatal chest wall compliance predisposes it to distortion, which reduces breathing efficiency and necessitates respiratory muscle activation to stabilize it. This increases the work of breathing and, when combined with fewer fatigue-resistant Type I muscle fibers (slow twitch, high oxidative capacity) in the diaphragm muscle, the risk of respiratory fatigue is increased. Nevertheless, as the chest wall is highly compliant in the newborn, recent studies have demonstrated that extra-thoracic pressures can influence chest wall mechanics. Positive extra-thoracic pressures (such as those applied with tight swaddling) limit chest wall expansion, whereas a small constant negative extra-thoracic pressure stabilizes the chest wall and improves oxygenation in neonates. In this review, we aim to summarize the current evidence on chest wall function in fetuses and neonates, particularly during lung liquid clearance, lung aeration, and breathing after birth. Furthermore, we will explore how knowledge from newborn respiratory physiology may inform our understanding of the respiratory consequences of pulmonary oedema in adults, such as occurred during the initial stages of the COVID-19 pandemic.}, }
@article {pmid41000340, year = {2025}, author = {Larsson, M and Ho, DM and Kirschner, M and Seifritz, E and Manoliu, A}, title = {Digital resilience interventions for healthcare workers: a systematic review.}, journal = {Frontiers in psychiatry}, volume = {16}, number = {}, pages = {1519670}, pmid = {41000340}, issn = {1664-0640}, abstract = {INTRODUCTION: Burnout among healthcare professionals is rising, exacerbated by increased workloads and the Covid-19 pandemic. Affected individuals face stress, depression, and anxiety, adversely impacting both personal well-being and patient care. Resilience has emerged as a key focus for targeted interventions, with online delivery gaining relevance due to the digital transformation and the need for flexibility in busy healthcare schedules.
METHODS: A systematic review was conducted by searching PubMed, Embase, and Web of Science for eligible studies from April 2014 to April 2024, using search terms related to resilience, online/blended interventions, and healthcare professionals. A total of 7,619 records were identified and screened by two independent reviewers (ML, AM). Final inclusion was based on predefined criteria for online or blended interventions aimed at enhancing resilience in healthcare professionals. The Effective Public Health Practice Project (EPHPP) assessed risk of bias. PRISMA guidelines were followed.
RESULTS: Fifty-five studies were selected, employing various interventions such as psychoeducation, meditation, mindfulness, and elements of cognitive-behavioral therapy (CBT) and acceptance and commitment therapy (ACT). Interventions were delivered online through websites, apps, audio files, etc. or in blended formats complementing in-person sessions. Most studies reported significant improvements in resilience, alongside reductions in stress, burnout, depression, and anxiety. However, only three studies in the online group involving mindfulness or CBT interventions received a strong global rating in the risk of bias assessment by fulfilling the methodological quality criteria. Among these, mindfulness, compared to a waitlist control or a psychoeducational brochure, significantly improved resilience and reduced burnout, while the CBT intervention, compared to bibliotherapy, led to a significant reduction in stress. Compared to the other studies, these three stood out due to minimal selection bias, low attrition rates, a robust study design, and at least partial blinding.
DISCUSSION: This review indicates that digital interventions may enhance resilience and associated factors in healthcare personnel. However, caution is advised due to the heterogeneity of interventions and varied measurement methods. Only three studies met methodological quality criteria, limiting the reliability of other findings. Future research should standardize resilience concepts and adhere to methodological criteria to ensure valid conclusions.
https://www.crd.york.ac.uk/PROSPERO/view/CRD42024542758 PROSPERO, identifier CRD42024542758.}, }
@article {pmid41000376, year = {2025}, author = {Rotolo, A and Mason, NJ and Exley, MA}, title = {Innate iNKT cells: from biological insight to clinical impact.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1653183}, pmid = {41000376}, issn = {1664-3224}, mesh = {Humans ; *Natural Killer T-Cells/immunology/metabolism ; Animals ; *Immunity, Innate ; Antigens, CD1d/immunology/metabolism ; Receptors, Antigen, T-Cell/immunology ; }, abstract = {Over the past 30 years, work of immunologists worldwide has phenotypically and functionally defined "Natural Killer T cells" (NKT) and their subsets, including "invariant Natural Killer T cells" (iNKT). NKT cells make up a substantial fraction of T cells that express NK cell markers and have TCRs restricted to either conventional MHC molecules or the monomorphic CD1d molecule. Among these, iNKT cells are CD1d-restricted and more common within NKT cells than T cells without NK markers. While the definition of NKT cells, whether based on phenotype, function, or both, remains a topic of debate, iNKT cells represent a distinct T cell population characterized by a recurrent, conserved TCR rearrangement (TRAV10-TRAJ18 in humans) paired with a limited Vβ repertoire (mostly encoded by TRBV25-1 in humans). iNKT cells are restricted by CD1d, which, unlike CD1a-c molecules, is expressed not only on professional antigen-presenting cells and thymocytes but also on certain non-hematopoietic somatic tissues, both normal and neoplastic. Like all CD1 family members, CD1d presents various lipid antigens by accommodating their long hydrophobic tails in deep binding pockets, in contrast to the shallow peptide grooves of conventional MHC molecules. However, the ligand repertoire of CD1d is distinct from that of CD1a-c. This review focuses on CD1d-restricted iNKT cells. Activation of iNKT cells via their semi-invariant TCR, often in synergy with NK receptors and other co-stimulatory molecules, triggers a rapid, polyfunctional response. Unlike conventional MHC-restricted T cells, individual iNKT cells can simultaneously produce both Th1-