@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.},
}

*Mucocutaneous Lymph Node Syndrome/complications
Humans
*Coronary Aneurysm/etiology
Bibliometrics
*Biomedical Research/trends

@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.},
}

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

@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.},
}

*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

@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 ; *COVID-19/complications ; Post-Acute COVID-19 Syndrome ; *Autonomic Nerve Block/methods ; *Ganglia, Parasympathetic/drug effects ; *Ganglia, Sympathetic/drug effects ; Pandemics ; SARS-CoV-2 ; *Coronavirus Infections/complications ; },
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.},
}

Humans
*COVID-19/complications
Post-Acute COVID-19 Syndrome
*Autonomic Nerve Block/methods
*Ganglia, Parasympathetic/drug effects
*Ganglia, Sympathetic/drug effects
Pandemics
SARS-CoV-2
*Coronavirus Infections/complications

@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 = {},
doi = {10.3390/ijms27115100},
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.},
}

Humans
*Gene Editing/methods
CRISPR-Cas Systems
*Vascular Diseases/genetics/therapy
*Endothelial Cells/metabolism
Animals
*Precision Medicine/methods
*Genetic Therapy/methods
Endothelium, Vascular/metabolism

@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 = {},
doi = {10.3390/healthcare14111528},
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 = {},
doi = {10.3390/jcm15114016},
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 = {},
doi = {10.3390/jcm15114247},
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 = {},
doi = {10.3390/nu18111680},
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/ ; },
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 = {},
doi = {10.3390/nu18111770},
pmid = {42280413},
issn = {2072-6643},
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 {pmid39973179,
year = {2025},
author = {Segal, NL},
title = {What's in Twins' Names? Mixed Credit Reports/Twin Research Review: Treating Twins with Central Nervous System Infection; Twin Insights into COVID-19; Septal Aneurism in Monozygotic Twins; Twin Births via Assisted Reproduction vs. Natural Conception; Tribute to Dr. Helen E. Fisher/ Human Interest: Twins Rally for Twin Hostages; Tribute to the National Mothers of Twins Clubs Founder; Quadruplet Birth; Identical Twin Politician; Identical Twin Actresses.},
journal = {Twin research and human genetics : the official journal of the International Society for Twin Studies},
volume = {28},
number = {1},
pages = {112-115},
doi = {10.1017/thg.2025.8},
pmid = {39973179},
issn = {1839-2628},
mesh = {Humans ; Female ; *COVID-19/epidemiology/therapy/virology ; *Twins, Monozygotic/genetics ; *Diseases in Twins/therapy/epidemiology/genetics ; SARS-CoV-2/pathogenicity ; Reproductive Techniques, Assisted ; Pregnancy ; *Twins ; },
abstract = {Giving twins similar names places them at increased risk for mixed credit reports as they enter young adulthood and beyond. Attorneys specializing in this area of the law are often required to manage lawsuits againt the agencies responsible for such errors. This overview is followed by summaries of twin research and reports of treating twins with central nervous system infection, twins with COVID-19, and twins with septal aneurism, as well as a review of the comparative outcomes of twins born via assisted reproduction versus natural conception and a tribute to the late Dr Helen E. Fisher. Human interest items include a twins' rally for Israeli twins held hostage in Gaza, a tribute to the founding member of the National Mothers of Twins Clubs (now Multiples of America), a quadruplet birth, an identical twin politician, and identical twin actresses.},
}

Humans
Female
*COVID-19/epidemiology/therapy/virology
*Twins, Monozygotic/genetics
*Diseases in Twins/therapy/epidemiology/genetics
SARS-CoV-2/pathogenicity
Reproductive Techniques, Assisted
Pregnancy
*Twins

@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.},
}

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

@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.},
}

Humans
Child
*DMF Index
*Dental Caries/diagnosis
*Telemedicine
COVID-19/epidemiology
Reproducibility of Results

@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 ; *Olfactory Training ; *Olfaction Disorders/therapy/etiology ; *Ethanolamines/therapeutic use ; *Palmitic Acids/therapeutic use ; *COVID-19/complications ; *Amides/therapeutic use ; *Luteolin/therapeutic use ; *Anti-Inflammatory Agents/therapeutic use ; Dietary Supplements ; },
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.},
}

Humans
*Olfactory Training
*Olfaction Disorders/therapy/etiology
*Ethanolamines/therapeutic use
*Palmitic Acids/therapeutic use
*COVID-19/complications
*Amides/therapeutic use
*Luteolin/therapeutic use
*Anti-Inflammatory Agents/therapeutic use
Dietary Supplements

@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.},
}

Humans
*COVID-19/epidemiology/psychology
Female
*Depression, Postpartum/epidemiology
Prevalence
Risk Factors
Pregnancy
SARS-CoV-2
Pandemics
Global Health

@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.},
}

Humans
India
*COVID-19/therapy/epidemiology
*Medicine, Ayurvedic
SARS-CoV-2
*COVID-19 Drug Treatment

@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.},
}

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

@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.},
}

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

@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.},
}

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

@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.},
}

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

@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.},
}

Humans
*Single-Cell Analysis/methods
Single-Cell Gene Expression Analysis
*Sequence Analysis, RNA/methods
Computational Biology/methods
COVID-19/genetics/virology

@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.},
}

*Sustainable Development
Humans
*Global Health
COVID-19/epidemiology
*Goals
Pandemics
SARS-CoV-2

@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.},
}

Humans
*Middle East Respiratory Syndrome Coronavirus/genetics
Animals
*Coronavirus Infections/epidemiology/virology/veterinary
Africa/epidemiology
Camelus/virology
Genome, Viral
Seroepidemiologic Studies
Phylogeny
Genomics
Prevalence

@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.},
}

Humans
*Education, Pharmacy/methods
*Clinical Competence/standards
*Education, Distance/methods
Curriculum/trends
Teaching

@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.},
}

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

@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.},
}

Humans
*von Willebrand Factor/immunology/metabolism
*Hemostasis/immunology
*Inflammation/immunology/blood
Immunity, Innate
Animals
COVID-19/immunology/blood

@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.},
}

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

@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.},
}

*Disinfection/methods
*Ultraviolet Rays
*Aircraft
Humans
COVID-19/prevention & control
SARS-CoV-2/radiation effects

@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 ; *RNA, Messenger/therapeutic use ; mRNA Vaccines ; SARS-CoV-2/immunology ; },
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.},
}

Humans
*Clinical Trials as Topic/statistics & numerical data
*RNA, Messenger/therapeutic use
mRNA Vaccines
SARS-CoV-2/immunology

@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.},
}

Humans
*Brain Concussion/epidemiology/diagnosis
*Football/injuries
Incidence
*Athletic Injuries/epidemiology/diagnosis
Male
Female

@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.},
}

Humans
Digital Health
*Cardiovascular Diseases/prevention & control
*Health Personnel
*Secondary Prevention/methods
Telemedicine
Attitude of Health Personnel
*Primary Prevention/methods

@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 {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 ; *Toll-Like Receptors/immunology/metabolism ; *Signal Transduction/drug effects/immunology ; *Analgesics, Opioid/pharmacology ; *Receptors, Purinergic P2X/immunology/metabolism ; SARS-CoV-2 ; Immunity, Innate/drug effects ; Animals ; },
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.},
}

Humans
*COVID-19/immunology/metabolism
*Toll-Like Receptors/immunology/metabolism
*Signal Transduction/drug effects/immunology
*Analgesics, Opioid/pharmacology
*Receptors, Purinergic P2X/immunology/metabolism
SARS-CoV-2
Immunity, Innate/drug effects
Animals

@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.},
}

Humans
*Nanoparticles/chemistry
*Lipids/chemistry
*Polymers/chemistry
RNA, Small Interfering/chemistry
Animals
*RNA/chemistry/administration & dosage

@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 ; *Drug Repositioning/methods ; *Antiviral Agents/therapeutic use/pharmacology/pharmacokinetics ; *COVID-19 Drug Treatment ; *SARS-CoV-2/drug effects ; Animals ; Hydroxychloroquine/therapeutic use/pharmacology/pharmacokinetics ; COVID-19/virology ; },
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.},
}

Humans
*Drug Repositioning/methods
*Antiviral Agents/therapeutic use/pharmacology/pharmacokinetics
*COVID-19 Drug Treatment
*SARS-CoV-2/drug effects
Animals
Hydroxychloroquine/therapeutic use/pharmacology/pharmacokinetics
COVID-19/virology

@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 ; Humans ; *COVID-19/epidemiology ; Adaptation, Physiological ; Animals ; 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.},
}

*Islets of Langerhans/physiology
Humans
*COVID-19/epidemiology
Adaptation, Physiological
Animals
SARS-CoV-2

@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.},
}

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

@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 ; *Genetic Predisposition to Disease ; *Virus Diseases/prevention & control/immunology/genetics/virology ; Vaccination ; Human Genetics ; 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.},
}

Humans
*Vaccines, Attenuated/immunology/administration & dosage/adverse effects
*Viral Vaccines/immunology/administration & dosage/adverse effects
*Genetic Predisposition to Disease
*Virus Diseases/prevention & control/immunology/genetics/virology
Vaccination
Human Genetics
Animals

@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 ; *Global Health/statistics & numerical data ; *Disease Outbreaks/statistics & numerical data ; *COVID-19/epidemiology ; *Pandemics/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.},
}

Humans
*Global Health/statistics & numerical data
*Disease Outbreaks/statistics & numerical data
*COVID-19/epidemiology
*Pandemics/statistics & numerical data
SARS-CoV-2

@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},
doi = {10.1111/nbu.70047},
pmid = {41703981},
issn = {1467-3010},
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 {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 ; *COVID-19/epidemiology ; *Trust/psychology ; *Politics ; Pandemics ; 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.},
}

Humans
*COVID-19/epidemiology
*Trust/psychology
*Politics
Pandemics
SARS-CoV-2

@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.},
}

Humans
*Fatigue Syndrome, Chronic/diagnosis/therapy/etiology
*COVID-19/complications

@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 ; 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.},
}

Humans
*Pulmonary Diffusing Capacity
*Nitric Oxide/metabolism
*Lung/physiopathology/metabolism
*COVID-19/physiopathology
Predictive Value of Tests

@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 ; COVID-19/prevention & control ; *Efficiency, Organizational ; SARS-CoV-2 ; },
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.},
}

Humans
*Anti-Bacterial Agents/supply & distribution
*Vaccines/supply & distribution
COVID-19/prevention & control
*Efficiency, Organizational
SARS-CoV-2

@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 ; *Social Stigma ; *Disease Outbreaks/prevention & control ; COVID-19/psychology/epidemiology ; Hemorrhagic Fever, Ebola/psychology/epidemiology ; Severe Acute Respiratory Syndrome/psychology/epidemiology ; *Communicable Diseases/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.},
}

Humans
*Social Stigma
*Disease Outbreaks/prevention & control
COVID-19/psychology/epidemiology
Hemorrhagic Fever, Ebola/psychology/epidemiology
Severe Acute Respiratory Syndrome/psychology/epidemiology
*Communicable Diseases/psychology/epidemiology

@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 ; Africa/epidemiology ; *Vaccine Efficacy ; SARS-CoV-2 ; *COVID-19 Vaccines/immunology ; *Pandemics/prevention & control ; Pandemic Preparedness ; },
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.},
}

Humans
*COVID-19/epidemiology/prevention & control/immunology
Africa/epidemiology
*Vaccine Efficacy
SARS-CoV-2
*COVID-19 Vaccines/immunology
*Pandemics/prevention & control
Pandemic Preparedness

@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 {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'.},
}

Humans
*COVID-19/prevention & control/epidemiology
Pandemic Preparedness
*SARS-CoV-2
*Drug Resistance, Microbial
Pandemics

@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 ; *Blood-Brain Barrier/pathology/metabolism/virology ; *COVID-19/complications/diagnosis/therapy ; *Neuroinflammatory Diseases/diagnosis/therapy/virology ; SARS-CoV-2 ; Animals ; Brain/pathology/virology ; *Nervous System Diseases/diagnosis/therapy/etiology ; Post-Acute COVID-19 Syndrome ; },
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.},
}

Humans
*Blood-Brain Barrier/pathology/metabolism/virology
*COVID-19/complications/diagnosis/therapy
*Neuroinflammatory Diseases/diagnosis/therapy/virology
SARS-CoV-2
Animals
Brain/pathology/virology
*Nervous System Diseases/diagnosis/therapy/etiology
Post-Acute COVID-19 Syndrome

@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.},
}

Humans
Female
Pregnancy
*Immunity, Maternally-Acquired
*Pregnancy Complications, Infectious/prevention & control
*Immunization/methods
*Vaccination/methods

@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.},
}

*Federated Learning
*Blockchain
Humans
Computer Security
Information Dissemination
Telemedicine

@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 ; *SARS-CoV-2/drug effects/enzymology ; *Antiviral Agents/pharmacology/chemistry ; *Coronavirus 3C Proteases/antagonists & inhibitors/metabolism/chemistry ; *COVID-19 Drug Treatment ; *Protease Inhibitors/pharmacology/chemistry ; COVID-19 ; Peptidomimetics/pharmacology/chemistry ; },
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.},
}

Humans
*SARS-CoV-2/drug effects/enzymology
*Antiviral Agents/pharmacology/chemistry
*Coronavirus 3C Proteases/antagonists & inhibitors/metabolism/chemistry
*COVID-19 Drug Treatment
*Protease Inhibitors/pharmacology/chemistry
COVID-19
Peptidomimetics/pharmacology/chemistry

@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 ; *COVID-19/complications/epidemiology ; *Multiple Organ Failure/virology/epidemiology/etiology/mortality ; SARS-CoV-2 ; Male ; Female ; Child ; Child, Preschool ; *Brain Diseases/virology/epidemiology ; Infant ; Brain Edema/virology/etiology ; Adolescent ; Pandemics ; Asia/epidemiology ; Japan/epidemiology ; Australia/epidemiology ; Singapore/epidemiology ; Taiwan/epidemiology ; },
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.},
}

Humans
*COVID-19/complications/epidemiology
*Multiple Organ Failure/virology/epidemiology/etiology/mortality
SARS-CoV-2
Male
Female
Child
Child, Preschool
*Brain Diseases/virology/epidemiology
Infant
Brain Edema/virology/etiology
Adolescent
Pandemics
Asia/epidemiology
Japan/epidemiology
Australia/epidemiology
Singapore/epidemiology
Taiwan/epidemiology

@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 ; *COVID-19/epidemiology ; *Critical Care/organization & administration ; *Critical Care Outcomes ; SARS-CoV-2 ; Critical Care Nursing ; },
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.},
}

Humans
*Telemedicine/organization & administration
*Intensive Care Units/organization & administration
*COVID-19/epidemiology
*Critical Care/organization & administration
*Critical Care Outcomes
SARS-CoV-2
Critical Care Nursing

@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 ; *COVID-19/immunology ; SARS-CoV-2/immunology ; T-Lymphocytes/immunology ; Killer Cells, Natural/immunology ; Animals ; Neoplasms/immunology ; B-Lymphocytes/immunology ; *Lymphocytes/immunology ; Pandemics ; },
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.},
}

Humans
*COVID-19/immunology
SARS-CoV-2/immunology
T-Lymphocytes/immunology
Killer Cells, Natural/immunology
Animals
Neoplasms/immunology
B-Lymphocytes/immunology
*Lymphocytes/immunology
Pandemics

@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/administration & dosage ; *COVID-19 Drug Treatment ; *COVID-19/prevention & control/epidemiology ; Outpatients ; *Antiviral Agents/administration & dosage ; Drug Combinations ; },
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.},
}

Humans
*Ritonavir/administration & dosage
*COVID-19 Drug Treatment
*COVID-19/prevention & control/epidemiology
Outpatients
*Antiviral Agents/administration & dosage
Drug Combinations

@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 ; *COVID-19/epidemiology/complications ; *Influenza, Human/complications/epidemiology ; *Cardiovascular Diseases/epidemiology/etiology ; Seasons ; SARS-CoV-2 ; Pandemics ; },
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.},
}

Humans
*COVID-19/epidemiology/complications
*Influenza, Human/complications/epidemiology
*Cardiovascular Diseases/epidemiology/etiology
Seasons
SARS-CoV-2
Pandemics

@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 ; *Venous Thromboembolism/metabolism/diagnosis ; *Proteomics/methods ; Biomarkers/metabolism/blood ; Pulmonary Embolism/diagnosis/metabolism ; Venous Thrombosis/diagnosis/metabolism ; COVID-19/complications ; },
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.},
}

Humans
*Venous Thromboembolism/metabolism/diagnosis
*Proteomics/methods
Biomarkers/metabolism/blood
Pulmonary Embolism/diagnosis/metabolism
Venous Thrombosis/diagnosis/metabolism
COVID-19/complications

@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/ ; },
}

@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 {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 ; *COVID-19 Vaccines/adverse effects/administration & dosage ; *Influenza Vaccines/adverse effects/administration & dosage ; *COVID-19/prevention & control ; *Vaccination/adverse effects ; Influenza, Human/prevention & control ; Adverse Drug Reaction Reporting Systems ; *Product Surveillance, Postmarketing/methods ; Pandemics/prevention & control ; SARS-CoV-2 ; *Drug-Related Side Effects and Adverse Reactions/epidemiology ; },
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.},
}

Humans
*COVID-19 Vaccines/adverse effects/administration & dosage
*Influenza Vaccines/adverse effects/administration & dosage
*COVID-19/prevention & control
*Vaccination/adverse effects
Influenza, Human/prevention & control
Adverse Drug Reaction Reporting Systems
*Product Surveillance, Postmarketing/methods
Pandemics/prevention & control
SARS-CoV-2
*Drug-Related Side Effects and Adverse Reactions/epidemiology

@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 ; Child ; *COVID-19/complications ; *Systemic Inflammatory Response Syndrome/complications ; *Cardiovascular Diseases/etiology/epidemiology ; SARS-CoV-2 ; },
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.},
}

Humans
Child
*COVID-19/complications
*Systemic Inflammatory Response Syndrome/complications
*Cardiovascular Diseases/etiology/epidemiology
SARS-CoV-2

@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 ; Hospitalization ; Drug Combinations ; COVID-19/virology ; Lactams ; Leucine ; Nitriles ; Proline ; },
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.},
}

Humans
*Ritonavir/therapeutic use
*COVID-19 Drug Treatment
SARS-CoV-2/drug effects
*Antiviral Agents/therapeutic use
Hospitalization
Drug Combinations
COVID-19/virology
Lactams
Leucine
Nitriles
Proline

@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/diagnosis/drug therapy ; Risk Factors ; Child ; Prevalence ; Child, Preschool ; Infant ; *Mycoplasma pneumoniae ; Adolescent ; COVID-19/epidemiology ; Anti-Bacterial Agents/therapeutic use ; },
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.},
}

Humans
*Pneumonia, Mycoplasma/epidemiology/diagnosis/drug therapy
Risk Factors
Child
Prevalence
Child, Preschool
Infant
*Mycoplasma pneumoniae
Adolescent
COVID-19/epidemiology
Anti-Bacterial Agents/therapeutic use

@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},
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.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-026-12883-w.},
}

@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},
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.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-026-14176-z.},
}

@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},
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},
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.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-026-14244-4.},
}

@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 Hesitancy/psychology ; *Vaccination/psychology ; *Patient Acceptance of Health Care/psychology ; SARS-CoV-2/immunology ; *Health Knowledge, Attitudes, Practice ; *Health Belief Model ; Adult ; },
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.},
}

Humans
*COVID-19/prevention & control/psychology
*COVID-19 Vaccines/administration & dosage
*Vaccination Hesitancy/psychology
*Vaccination/psychology
*Patient Acceptance of Health Care/psychology
SARS-CoV-2/immunology
*Health Knowledge, Attitudes, Practice
*Health Belief Model
Adult

@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},
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.},
}

Humans
Animals
*CD13 Antigens/chemistry/metabolism/genetics/antagonists & inhibitors
Neoplasms/enzymology

@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 ; *Colorectal Neoplasms/diagnosis/epidemiology/mortality ; Europe/epidemiology ; *Early Detection of Cancer/trends/methods/standards ; *COVID-19/epidemiology ; Incidence ; *Mass Screening ; },
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.},
}

Humans
*Colorectal Neoplasms/diagnosis/epidemiology/mortality
Europe/epidemiology
*Early Detection of Cancer/trends/methods/standards
*COVID-19/epidemiology
Incidence
*Mass Screening

@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 ; *COVID-19/epidemiology ; *Colorectal Neoplasms/diagnosis/epidemiology ; *Early Detection of Cancer/statistics & numerical data/trends/methods ; Retrospective Studies ; Global Health ; *Mass Screening/organization & administration/statistics & numerical data ; SARS-CoV-2 ; Male ; Middle Aged ; Pandemics ; Aged ; Female ; },
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.},
}

Humans
*COVID-19/epidemiology
*Colorectal Neoplasms/diagnosis/epidemiology
*Early Detection of Cancer/statistics & numerical data/trends/methods
Retrospective Studies
Global Health
*Mass Screening/organization & administration/statistics & numerical data
SARS-CoV-2
Male
Middle Aged
Pandemics
Aged
Female

@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 ; *COVID-19/immunology/epidemiology/virology ; *SARS-CoV-2/immunology/genetics/physiology ; *Dengue/immunology/epidemiology/virology ; *Dengue Virus/immunology ; *Coinfection/immunology/virology ; Antibody-Dependent Enhancement ; Cross Reactions ; },
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.},
}

Humans
*COVID-19/immunology/epidemiology/virology
*SARS-CoV-2/immunology/genetics/physiology
*Dengue/immunology/epidemiology/virology
*Dengue Virus/immunology
*Coinfection/immunology/virology
Antibody-Dependent Enhancement
Cross Reactions

@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 ; *Drug Resistance, Bacterial ; COVID-19/epidemiology ; SARS-CoV-2 ; },
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.},
}

Humans
*Anti-Bacterial Agents/therapeutic use/pharmacology
*Drug Resistance, Bacterial
COVID-19/epidemiology
SARS-CoV-2

@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},
}

@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 ; *COVID-19/diagnosis/virology ; *Pandemics ; *SARS-CoV-2/isolation & purification/genetics ; Nucleic Acid Amplification Techniques ; Molecular Diagnostic Techniques/methods ; COVID-19 Testing/methods ; Pandemic Preparedness ; },
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.},
}

Humans
*COVID-19/diagnosis/virology
*Pandemics
*SARS-CoV-2/isolation & purification/genetics
Nucleic Acid Amplification Techniques
Molecular Diagnostic Techniques/methods
COVID-19 Testing/methods
Pandemic Preparedness

@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/mortality ; *Vaccine Efficacy ; Adult ; SARS-CoV-2 ; Hospitalization/statistics & numerical data ; United States ; Immunocompromised Host ; Female ; },
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).},
}

Humans
*COVID-19 Vaccines/adverse effects
*COVID-19/prevention & control/mortality
*Vaccine Efficacy
Adult
SARS-CoV-2
Hospitalization/statistics & numerical data
United States
Immunocompromised Host
Female

@article {pmid41730387,
year = {2026},
author = {Lefere, S and Koot, BGP and Mann, JP and Bufler, P and De Bruyne, R and Hudert, CA},
title = {Update in clinical science: MASLD in children and adolescents.},
journal = {Journal of hepatology},
volume = {84},
number = {6},
pages = {1164-1177},
doi = {10.1016/j.jhep.2026.02.016},
pmid = {41730387},
issn = {1600-0641},
mesh = {Humans ; Child ; Adolescent ; *Fatty Liver/epidemiology/therapy/diagnosis/etiology ; Risk Factors ; Prevalence ; COVID-19/complications ; Systemic Inflammatory Response Syndrome ; },
abstract = {Paediatric metabolic dysfunction-associated steatotic liver disease (MASLD) is an increasingly common liver disease, with an estimated global prevalence of up to 7.5% and growing concern regarding hepatic and extrahepatic complications even in early life. In this paper, we review recent advances in epidemiology, genetics, early-life risk factors, natural history and comorbidities, focusing on emerging data published in the last 3 years. We also outline a practical approach to the management of MASLD in children, integrating newly developed non-invasive tests. Lastly, we highlight key research questions to be studied in the coming years.},
}

Humans
Child
Adolescent
*Fatty Liver/epidemiology/therapy/diagnosis/etiology
Risk Factors
Prevalence
COVID-19/complications
Systemic Inflammatory Response Syndrome

@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 {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 ; *COVID-19/immunology/pathology ; *Neutrophils/immunology/pathology ; *SARS-CoV-2/immunology ; Extracellular Traps/immunology ; Immunity, Innate ; Reactive Oxygen Species/metabolism/immunology ; },
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.},
}

Humans
*COVID-19/immunology/pathology
*Neutrophils/immunology/pathology
*SARS-CoV-2/immunology
Extracellular Traps/immunology
Immunity, Innate
Reactive Oxygen Species/metabolism/immunology

@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 = {Humans ; *Dry Eye Syndromes/epidemiology ; Prevalence ; *Global Health/statistics & numerical data ; *COVID-19/epidemiology ; SARS-CoV-2 ; Female ; Male ; Pandemics ; },
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.},
}

Humans
*Dry Eye Syndromes/epidemiology
Prevalence
*Global Health/statistics & numerical data
*COVID-19/epidemiology
SARS-CoV-2
Female
Male
Pandemics

@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 Drug Treatment ; *COVID-19/virology ; Artificial Intelligence ; *Drug Development ; },
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).},
}

Humans
*Antiviral Agents/therapeutic use/chemistry
*Drug Discovery/trends/methods
*SARS-CoV-2/drug effects
*COVID-19 Drug Treatment
*COVID-19/virology
Artificial Intelligence
*Drug Development

@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 ; INV-005318/GATES/Gates Foundation/United States ; },
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.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-026-26743-4.},
}

@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 {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 ; *Pandemics/prevention & control ; *Public Health/education ; *Health Education/methods ; COVID-19 ; *Disaster Planning ; Civil Defense/education ; Pandemic Preparedness ; },
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.},
}

Humans
*Artificial Intelligence
*Pandemics/prevention & control
*Public Health/education
*Health Education/methods
COVID-19
*Disaster Planning
Civil Defense/education
Pandemic Preparedness

@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.},
}