@article {pmid41788535,
year = {2026},
author = {Wang, X and Li, H and Li, T and Zhong, S},
title = {Integrating ethics into infectious disease graduate training: a multidimensional framework for public health practice.},
journal = {Frontiers in public health},
volume = {14},
number = {},
pages = {1744330},
pmid = {41788535},
issn = {2296-2565},
mesh = {Humans ; COVID-19 ; *Public Health Practice/ethics ; *Communicable Diseases ; SARS-CoV-2 ; *Public Health/education/ethics ; *Education, Graduate/organization & administration ; },
abstract = {Through a narrative review and synthesis of the global status of Infectious Disease Ethics (IDE) education, this paper proposes positioning IDE as a core competency in graduate training and constructs a three-dimensional integrated model of "Theory-Practice-Assessment." Drawing on the experience of the OPENING project by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), it emphasizes that the ethical framework must adapt to the paradigm shifts brought about by emerging technologies such as genomics. This model not only addresses the gaps in IDE education exposed by COVID-19 but also provides solutions to ethical challenges in fields like digital health and precision medicine, offering a practical pathway for the reform of global infectious disease graduate education.},
}

Humans
COVID-19
*Public Health Practice/ethics
*Communicable Diseases
SARS-CoV-2
*Public Health/education/ethics
*Education, Graduate/organization & administration

@article {pmid41788871,
year = {2025},
author = {Bouchaala, K and Bahloul, M and Bradai, S and Ammar, R and Hamida, CB},
title = {[Effect of awake prone positioning in non-intubated patients with community-acquired pneumonia complicated by hypoxemia].},
journal = {Medecine tropicale et sante internationale},
volume = {5},
number = {4},
pages = {},
pmid = {41788871},
issn = {2778-2034},
mesh = {Humans ; Prone Position ; Community-Acquired Infections/complications/therapy ; *Hypoxia/therapy/etiology ; *COVID-19/complications/therapy ; Wakefulness ; *Patient Positioning/methods ; *Pneumonia/complications/therapy ; *Respiratory Insufficiency/therapy/etiology ; SARS-CoV-2 ; Community-Acquired Pneumonia ; },
abstract = {INTRODUCTION: Several studies have suggested that the early use of awake prone positioning (PP) in patients with acute respiratory failure due to severe community-acquired pneumonia, hemodynamically stable and alert, may improve oxygenation and avoid the need for invasive mechanical ventilation. PP may also help reduce case fatality rate (CFR). The benefits of PP for oxygen-dependent patients hospitalized with non-intubated acute respiratory failure due to SARS-CoV-2 infection have been evaluated. We reviewed the literature to determine if PP could improve hypoxemia and signs of acute respiratory failure in patients with community-acquired or non-community-acquired pneumonia, reduce the need for invasive mechanical ventilation, and reduce CFRin patients with Covid-19.

MATERIALS AND METHODS: We searched with Medline for articles published in French or English containing the keywords "acute respiratory failure" or "acute respiratory distress" and "prone position."Results/Conclusion. Turning into prone position is a simple, inexpensive, and effective technique that improves the prognosis of patients with respiratory distress due to severe community-acquired pneumonia, regardless of the cause. This technique can be easily implemented in low-and middle-income countries, particularly in North Africa, sub-Saharan Africa, Asia, and South America.},
}

Humans
Prone Position
Community-Acquired Infections/complications/therapy
*Hypoxia/therapy/etiology
*COVID-19/complications/therapy
Wakefulness
*Patient Positioning/methods
*Pneumonia/complications/therapy
*Respiratory Insufficiency/therapy/etiology
SARS-CoV-2
Community-Acquired Pneumonia

@article {pmid41789521,
year = {2026},
author = {Zhao, W and Htike, WYM and Kam, YW},
title = {Quantifying the evidence and burden of smoking behaviour on tuberculosis incidence among adult population: a systematic review and meta-analysis.},
journal = {Journal of global health},
volume = {16},
number = {},
pages = {04079},
pmid = {41789521},
issn = {2047-2986},
mesh = {Humans ; Incidence ; *Tuberculosis/epidemiology ; China/epidemiology ; *Smoking/epidemiology/adverse effects ; Adult ; Risk Factors ; COVID-19/epidemiology ; },
abstract = {BACKGROUND: Tuberculosis (TB) remains a major public health challenge in China and worldwide, with smoking being a key modifiable risk factor. Given China's large population and rising smoking rates, this paper aims to examine the link between smoking and TB incidence.

METHODS: We systematically searched six databases from inception for studies reporting smoking exposure, TB outcomes, and smoker-non-smoker comparisons. Two reviewers independently screened records, extracted data, and assessed bias. We analysed smoking-TB associations using random-effects meta-analysis of odds ratios (ORs) and hazard ratios (HRs).

RESULTS: We included 17 studies reporting ORs and 7 studies reporting HRs in the quantitative synthesis. The pooled OR for TB incidence among smokers compared with non-smokers was 1.77 (95% confidence interval (CI) = 1.29-2.43), indicating a statistically significant increase in risk of TB. For studies reporting hazard ratios, the pooled estimate was 2.39 (95% CI = 1.28-4.45), showing a significant association between smoking and increased TB incidence.

CONCLUSIONS: Both active and passive smoking significantly elevate the risk of TB and worsen its outcomes in China. Our result indicate that COVID-19 pandemic may have indirectly exacerbated smoking-related risks through disruptions to TB services, heightened psychosocial stress, and shifts in smoking behaviours, with potential implications for TB risk and outcomes. Thus, integrating smoking cessation strategies into TB programmes, focusing on heavy smokers in especially high-prevalence areas, and raising public awareness could enhance efforts to prevent and control TB worldwide.

REGISTRATION: PROSPERO: CRD420251070123.},
}

Humans
Incidence
*Tuberculosis/epidemiology
China/epidemiology
*Smoking/epidemiology/adverse effects
Adult
Risk Factors
COVID-19/epidemiology

@article {pmid41789942,
year = {2026},
author = {Chan, R and Horst, AK and Prince, E and Medina, A and McIntyre, A},
title = {Supporting Transition and Practice Readiness Through Nursing Clinical Externships: A Scoping Review.},
journal = {The Journal of nursing education},
volume = {65},
number = {6},
pages = {329-338},
doi = {10.3928/01484834-20260130-02},
pmid = {41789942},
issn = {1938-2421},
mesh = {Humans ; *Clinical Competence ; *COVID-19/epidemiology ; *Education, Nursing, Baccalaureate/organization & administration ; *Students, Nursing/psychology ; },
abstract = {BACKGROUND: Globally, new graduate nurses face persistent transition challenges and high turnover rates that threaten workforce stability and patient care quality-issues exacerbated by the COVID-19 pandemic. Clinical nurse externship (CNE) programs have emerged as structured experiential learning models that bridge the academic-practice gap through mentorship and clinical immersion.

METHOD: Following the Joanna Briggs Institute Manual for Evidence Synthesis and Preferred Reporting Items for Systematic reviews and Meta-Analyses-Scoping Reviews framework, a comprehensive literature search was conducted across PubMed, CINAHL, Scopus, MEDLINE (via Ovid), and EBSCO's Nursing & Allied Health Reference Source. Eligible studies involved undergraduate nursing students participating in CNE programs. Two reviewers independently screened, extracted, and thematically analyzed the data.

RESULTS: Twenty-four studies met inclusion criteria, revealing five themes: clinical competence, emotional impact, relationships and support, nursing values, and professional preparedness. CNE participation consistently enhanced competence, confidence, and professional identity while reducing anxiety and transition stress.

CONCLUSION: CNE programs effectively strengthen work-force readiness, retention, and the transition from education to practice, underscoring their value as a strategic element in global nursing education and workforce planning.},
}

Humans
*Clinical Competence
*COVID-19/epidemiology
*Education, Nursing, Baccalaureate/organization & administration
*Students, Nursing/psychology

@article {pmid41790528,
year = {2026},
author = {Gibbs, JL and Vollmer, B and Sheridan, CE and Pinkerton, K and Anthony, RT and Holm, S and Karr, C and Proctor, A and Swenson, A},
title = {Filtering facepiece respirator use among farm youth in the US: A review.},
journal = {Journal of occupational and environmental hygiene},
volume = {23},
number = {3},
pages = {178-190},
pmid = {41790528},
issn = {1545-9632},
support = {U54 OH007548/OH/NIOSH CDC HHS/United States ; U54 OH009568/OH/NIOSH CDC HHS/United States ; },
mesh = {Humans ; *Respiratory Protective Devices/statistics & numerical data ; United States ; *COVID-19/prevention & control ; Adolescent ; *Occupational Exposure/prevention & control ; Equipment Design ; *Farmers ; Child ; SARS-CoV-2 ; },
abstract = {The COVID-19 pandemic underscored the critical need for protective equipment, such as filtering facepiece respirators (FFRs), particularly for youth. This systematic review addresses the significant gap in evidence-based guidance for FFR use among US farm youth, a group potentially exposed to diverse respiratory hazards. Current FFR designs and protocols for FFR use are largely adult-centric. Adhering to PRISMA 2020 guidelines, a multidisciplinary panel reviewed 31 publications published between 1990 and 2023. An independent working group of agricultural safety professionals also contributed by reviewing procedures and publications to check for bias during the review process. Key findings show that while FFRs appear physiologically tolerable by youth study subjects. Subjective discomfort and poor fit of adult-sized respirators remain major barriers to effective use and compliance. Studies highlight the critical need for youth-specific FFR designs based on detailed facial anthropometrics and the development of standardized fit-testing protocols tailored for growing youth. Furthermore, evidence-based guidance on ethical pediatric medical evaluations for respirator use and targeted respiratory health education are urgently needed. This review emphasizes that a concerted effort from manufacturers, researchers, and regulatory bodies is essential to ensure youth on farms can safely use respiratory protection.},
}

Humans
*Respiratory Protective Devices/statistics & numerical data
United States
*COVID-19/prevention & control
Adolescent
*Occupational Exposure/prevention & control
Equipment Design
*Farmers
Child
SARS-CoV-2

@article {pmid41790576,
year = {2026},
author = {Morcos, ZL and Theoharides, TC},
title = {Long COVID neuropathy: The role of mast cells.},
journal = {Journal of neuropathology and experimental neurology},
volume = {85},
number = {5},
pages = {413-424},
doi = {10.1093/jnen/nlag016},
pmid = {41790576},
issn = {1554-6578},
mesh = {Humans ; *Mast Cells/immunology ; *COVID-19/complications/immunology ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; *Peripheral Nervous System Diseases/immunology/etiology ; Animals ; },
abstract = {Postacute sequelae of SARS-CoV-2 infection (PASC), or Long COVID, is estimated to affect over 60 million individuals globally, with almost half of COVID-19 survivors experiencing persistent symptoms such as neuropathic pain, fatigue, and autonomic dysfunction. Despite its prevalence, the pathophysiology of PASC remains poorly understood. This narrative review highlights activation of mast cells (MCs), the unique tissue immune cells as a central contributor to neuropathic manifestations in PASC. Mast cell locations near nerves and vessels allows them to regulate neuroimmune and neurovascular processes. Mast cell activation mirrors patterns seen in small-fiber neuropathy and myalgic encephalomyelitis/chronic fatigue syndrome, suggesting a shared immune-mediated etiology. The SARS-CoV-2 spike protein has been shown to activate MCs via angiotensin-converting enzyme 2 and toll-like receptor 4, triggering release of pro-inflammatory and neurotoxic mediators, including interleukin-1β, interleukin-6, tumor necrosis factor alpha, histamine, and tryptase. Such mediators sensitize peripheral nerves, disrupt the blood-brain barrier, and recruit microglia, ultimately contributing to small-fiber injury, neuroinflammation, and dysautonomia. Emerging reports suggest benefit from MC-directed treatments although responses remain variable. Understanding the role of MCs in PASC may offer a plausible mechanism of pathogenesis and guide targeted therapies. Future studies are needed to validate these findings and improve PASC patient outcomes.},
}

Humans
*Mast Cells/immunology
*COVID-19/complications/immunology
Post-Acute COVID-19 Syndrome
SARS-CoV-2
*Peripheral Nervous System Diseases/immunology/etiology
Animals

@article {pmid41791674,
year = {2026},
author = {Fan, BE and Tang, JKY and Favaloro, EJ},
title = {Safeguarding global anticoagulant supply and access.},
journal = {Journal of thrombosis and haemostasis : JTH},
volume = {24},
number = {5},
pages = {1587-1592},
doi = {10.1016/j.jtha.2026.02.017},
pmid = {41791674},
issn = {1538-7836},
mesh = {Humans ; *Anticoagulants/supply & distribution/therapeutic use ; COVID-19/epidemiology ; *Health Services Accessibility ; SARS-CoV-2 ; Animals ; Global Health ; Pandemics ; },
abstract = {Anticoagulants are essential to health care, yet their global supply is inherently fragile. Reliance on animal-derived heparin creates vulnerability to contamination, animal disease, and logistical disruption, whereas synthetic alternatives like warfarin and direct oral anticoagulants face mounting manufacturing and geopolitical risks. The COVID-19 pandemic exposed how these intersecting threats can converge during a crisis, causing critical shortages. To build resilience, a systemic shift is required: developing nonanimal-derived anticoagulants, diversifying production geographically, establishing protected supply corridors, reducing high-carbon footprint manufacturing processes, and creating equitable allocation frameworks. Anticoagulants must be recognized as essential medical assets, necessitating sustained investment and international coordination to ensure reliable access for all health systems, particularly before the next pandemic or global shock.},
}

Humans
*Anticoagulants/supply & distribution/therapeutic use
COVID-19/epidemiology
*Health Services Accessibility
SARS-CoV-2
Animals
Global Health
Pandemics

@article {pmid41791675,
year = {2026},
author = {Weitz, JI and Harrington, RA and , },
title = {Rationale for the milvexian dosing in the phase 3 LIBREXIA program.},
journal = {Journal of thrombosis and haemostasis : JTH},
volume = {24},
number = {6},
pages = {2158-2169},
doi = {10.1016/j.jtha.2026.02.020},
pmid = {41791675},
issn = {1538-7836},
mesh = {Humans ; *Atrial Fibrillation/drug therapy/blood/diagnosis ; *Acute Coronary Syndrome/drug therapy/blood/diagnosis ; *Stroke/drug therapy/blood/diagnosis ; *Anticoagulants/administration & dosage/adverse effects/pharmacokinetics ; Clinical Trials, Phase III as Topic ; Treatment Outcome ; *Pyrazoles/administration & dosage/adverse effects ; Ischemic Attack, Transient/drug therapy/blood/diagnosis ; Pyridones/administration & dosage/adverse effects ; Administration, Oral ; Hemorrhage/chemically induced ; Pyrimidines ; Triazoles ; },
abstract = {BACKGROUND: Milvexian is an oral, small-molecule inhibitor of factor (F)XIa undergoing evaluation in phase 3 clinical trials.

OBJECTIVES: This manuscript aimed to explain the rationale underpinning the hypothesis that FXIa may be a safer target for anticoagulants than FXa; describe the pharmacology of milvexian; review the results of the phase 2 trials with milvexian; and detail how the phase 2 program informed the dosing regimens for the phase 3 trials.

METHODS: This narrative review addresses the above objectives with the primary focus on addressing how the milvexian dosing regimens were selected for the phase 3 LIBREXIA program, which compares milvexian with apixaban for atrial fibrillation (AF) in the LIBREXIA AF trial (NCT05757869) and with placebo, in addition to background single or dual antiplatelet therapy, in patients with acute coronary syndrome (ACS) in the LIBREXIA ACS trial (NCT05754957), and for noncardioembolic ischemic stroke and high-risk transient ischemic attack in the LIBREXIA Stroke trial (NCT05702034).

RESULTS: The milvexian dose regimen selected for the LIBREXIA AF trial is 100 mg twice daily, and for the LIBREXIA ACS and Stroke trials, it is 25 mg twice daily.

CONCLUSIONS: The phase 3 LIBREXIA program will determine whether these dose regimens afford safe and effective anticoagulation in approximately 50 000 patients with AF, ACS, or prior stroke.},
}

Humans
*Atrial Fibrillation/drug therapy/blood/diagnosis
*Acute Coronary Syndrome/drug therapy/blood/diagnosis
*Stroke/drug therapy/blood/diagnosis
*Anticoagulants/administration & dosage/adverse effects/pharmacokinetics
Clinical Trials, Phase III as Topic
Treatment Outcome
*Pyrazoles/administration & dosage/adverse effects
Ischemic Attack, Transient/drug therapy/blood/diagnosis
Pyridones/administration & dosage/adverse effects
Administration, Oral
Hemorrhage/chemically induced
Pyrimidines
Triazoles

@article {pmid41791686,
year = {2026},
author = {Karwa, PN and Sakle, NS},
title = {RNA therapeutics 2.0: Expanding the landscape from mRNA vaccines to splicing modulators and beyond.},
journal = {Biotechnology advances},
volume = {89},
number = {},
pages = {108862},
doi = {10.1016/j.biotechadv.2026.108862},
pmid = {41791686},
issn = {1873-1899},
mesh = {Humans ; *mRNA Vaccines/therapeutic use ; COVID-19/prevention & control ; SARS-CoV-2 ; *RNA Splicing/drug effects ; COVID-19 Vaccines ; *RNA, Messenger/genetics/therapeutic use ; Oligonucleotides, Antisense/therapeutic use ; },
abstract = {RNA therapeutics have progressed into a disruptive drug class quickly, replacing a variety of primary experimental agents which included vaccines, antisense oligonucleotides (ASOs), small interfering RNAs (siRNAs), aptamers and RNA editing systems. First-generation modalities, demonstrated by fomivirsen and pegaptanib were limited by vulnerability to nuclease attack, inefficient delivery and immune stimulation were treated with clinical feasibility. Recent clinical achievements, including mRNA vaccinations against COVID-19, have been based on developments in backbone chemistry, nucleoside modifications and targeted delivery including N-acetylgalactosamine (GalNAc) conjugation and lipid nanoparticle (LNP) encapsulation. On this basis, it can be stated that the RNA Therapeutics 2.0 is more stable, tunable and can be targeted to organs and tissues. New methodologies such as circular RNA (circRNAs), self-amplifying mRNAs (saRNAs), splice-switching adenosine specific oligonucleotides (ASOs), small-molecule splicing modulators and adenosine deaminase toward RNA (ADAR)-directed base editors. These new generation systems can be used to make durable protein expression, reversible transcript recoding and precision splicing modulation, extending therapeutic applications to oncology, neurology, metabolic disease and rare genetic disorders. Extrahepatic delivery via innovations in delivery that included ligand-targeted LNPs, peptide conjugates and engineered exosomes is surpassing and artificial intelligence (AI) enhanced design is hastening optimization of RNA sequences, chemistries and vectors. RNA therapeutics in combination with gene therapy can be used to produce personalized therapeutics, such as n-of-1 medicines, based on immune regulation and control circuits. This Review describes the development of early oligonucleotide drugs to a diversified arsenal of RNA platforms, the major advancements, obstacles and emerging technology that characterize the next stage of RNA-based precision medicine.},
}

Humans
*mRNA Vaccines/therapeutic use
COVID-19/prevention & control
SARS-CoV-2
*RNA Splicing/drug effects
COVID-19 Vaccines
*RNA, Messenger/genetics/therapeutic use
Oligonucleotides, Antisense/therapeutic use

@article {pmid41792332,
year = {2026},
author = {Guest, J and Moritz, C},
title = {Study design considerations in clinical trials testing transcutaneous stimulation for spinal cord injury.},
journal = {Spinal cord},
volume = {64},
number = {4},
pages = {352-361},
pmid = {41792332},
issn = {1476-5624},
mesh = {*Spinal Cord Injuries/therapy ; Humans ; *Spinal Cord Stimulation/methods ; COVID-19/epidemiology ; *Research Design ; *Clinical Trials as Topic/methods ; *Transcutaneous Electric Nerve Stimulation/methods ; },
abstract = {STUDY DESIGN: Methodological review and expert perspective.

OBJECTIVES: To examine the methodological challenges in designing rigorous clinical trials for transcutaneous spinal cord stimulation (tSCS) in chronic spinal cord injury (SCI), with particular focus on challenges of sham control implementation, and to propose alternative trial design approaches that balance scientific rigor with practical feasibility and ethical considerations.

SETTING: United States.

METHODS: We analyzed the design considerations that influenced the Up-LIFT pivotal trial, examining three critical constraints: the technical limitations of creating safe and convincing sham stimulation for extended protocols; the participant burden associated with traditional sham-controlled designs; and the heightened risks during the COVID-19 pandemic. We reviewed existing literature on placebo effects in neuromodulation, technical challenges of sham tSCS implementation, and ethical considerations specific to the SCI population. Alternative methodological approaches were evaluated, including sequential self-controlled designs, biomarker-guided approaches, and adaptive trial designs.

RESULTS: Traditional sham controls for tSCS face serious technical challenges because participants readily detect stimulation parameters, minimal currents produce detectable neuromodulatory effects, and extended protocols amplify these issues through knowledge sharing and functional feedback. Ethical concerns include substantial participant burden, potential for lessebo effects when a sham is suspected, and erosion of therapeutic relationships through prolonged deception. The COVID-19 pandemic added critical safety considerations for the vulnerable SCI population. Alternative designs, such as sequential self-controlled approaches, as implemented in Up-LIFT, can maintain scientific validity while addressing these constraints.

CONCLUSION: The unique challenges of tSCS clinical trials necessitate innovative methodological approaches beyond traditional placebo-controlled designs. Sequential self-controlled designs, biomarker-guided studies, and adaptive trial methodologies offer scientifically sound alternatives that respect participant welfare while generating robust evidence. Future research should pursue dual paths: developing improved sham paradigms while advancing alternative trial methodologies suitable for neuromodulation-enhanced rehabilitation interventions.},
}

*Spinal Cord Injuries/therapy
Humans
*Spinal Cord Stimulation/methods
COVID-19/epidemiology
*Research Design
*Clinical Trials as Topic/methods
*Transcutaneous Electric Nerve Stimulation/methods

@article {pmid41792534,
year = {2026},
author = {Del Riccio, M and Maggi, S and Wieczorowska-Tobis, K and Newell, K and Czech, M and Botelho-Nevers, E and Michel, JP and Hummers, E and Duque, S and Lundgren, J and Barrat, J and Tan, L and Wysocki, J and Boccalini, S and Bechini, A and Jindal, S and Hendrickx, G and Van Damme, P and Bonanni, P and Pattyn, J},
title = {Advancing Vaccination Strategies for Older Adults: Insights of the Adult Immunization Board Meeting.},
journal = {Drugs & aging},
volume = {43},
number = {3},
pages = {223-237},
pmid = {41792534},
issn = {1179-1969},
mesh = {Humans ; Aged ; *Vaccination/methods ; Middle Aged ; *Immunization Programs ; *Vaccines/administration & dosage ; Europe ; Adult ; Immunization Schedule ; },
abstract = {As Europe's population ages, optimizing vaccination strategies for older adults is an increasing public health priority. Vaccine-preventable infections pose significant risks, including increased morbidity and mortality, reduced quality of life, and substantial healthcare costs. Prevention, particularly adult vaccination, plays a vital role in mitigating these outcomes and supporting healthy ageing. While childhood immunization remains essential, a life-course approach including routine older adult vaccination is needed. Coverage among older adults across Europe remains suboptimal owing to factors such as heterogeneous (sub)national policies, health literacy issues, financial barriers, access issues, and persistent structural and societal barriers. To meet these challenges, the Adult Immunization Board (AIB) convened a technical meeting in May 2025, to discuss strategies for improving vaccination in older adults. The meeting explored how older adults are defined in immunization policies (for the meeting, an operational threshold of ≥ 50 years was used, while acknowledging that many national age-based programs commonly start around 60-65 years) and reviewed current adult vaccines and programmatic implementation across six vaccines. Discussions highlighted the need for a life-course approach with coordinated (inter)national policies, clear adult vaccination schedules, dedicated infrastructure and programs, stronger surveillance, and structured follow-up. Key recommendations included shifting from fragmented efforts to cohesive, system-wide approaches. This approach requires addressing organizational challenges with programmatic strategies such as integrating adult vaccination into routine healthcare, providing co-administration guidance, and adapting successful pediatric models for adult programs. This summary presents insights shared during the AIB meeting, highlighting gaps and promising solutions for advancing older adult immunization in Europe. Vaccination must be recognized as an investment in healthy ageing, which is also able to generate a return in economic terms, as part of a holistic health package for older adults, not as an optional add-on to treatment. With older adults now outnumbering children under 5 years globally, it is time to invest equally in their vaccination.},
}

Humans
Aged
*Vaccination/methods
Middle Aged
*Immunization Programs
*Vaccines/administration & dosage
Europe
Adult
Immunization Schedule

@article {pmid41793162,
year = {2026},
author = {Kim, DH and Lim, S and Eisenhut, M and Kronbichler, A and Kim, E and Kim, MS and Papatheodorou, SI and Stebbing, J and Peng, Y and Oh, SS and Shin, JI and Smith, L},
title = {The Impact of Study Size on COVID-19 Treatment Outcomes: A Meta-Epidemiological Study Comparing Large and Small Randomized Controlled Trials: A Systematic Review and Meta-Analyses.},
journal = {Reviews in medical virology},
volume = {36},
number = {2},
pages = {e70125},
pmid = {41793162},
issn = {1099-1654},
support = {//Yonsei Fellowship/ ; },
mesh = {Humans ; *Randomized Controlled Trials as Topic ; *COVID-19/therapy/epidemiology/virology ; SARS-CoV-2/drug effects ; Treatment Outcome ; *COVID-19 Drug Treatment ; Sample Size ; },
abstract = {Small randomized controlled trials (RCTs) in COVID-19 meta-analyses have been associated with more favourable treatment effects and reduced result stability. This study assessed how trial size impacts effect estimates, statistical stability, and risk of bias. Following PRISMA guidelines, we identified meta-analyses of COVID-19 treatments included in WHO, NIH, and the LIVING Project. Trials were classified by log-scale sample size, and separate pooled meta-analyses were conducted for large-only, small-only, and combined trials. Comparative metrics included the Ratio of Odds Ratios (ROR), Kappa statistics, Fragility Index (FI), Reverse Fragility Index (RFI), and Cochrane Risk of Bias assessments. Sensitivity analyses applied alternative size thresholds (≥ 1000 participants and median-based cutoffs) and stratified results by treatment and outcome type. Across 25 meta-analyses including 221 RCTs (46 large, 175 small), small trials produced more extreme estimates in 19 analyses and wider confidence intervals in 23. The pooled ROR was 0.85 (95% CI: 0.76-0.95; P = 0.004), decreasing to 0.81 (95% CI: 0.68-0.95; P = 0.011) when limited to small trials published before the first large trial. RORs remained below 1 across treatment and outcome types. Agreement between small and large trials was minimal, while large trials showed substantial agreement with overall estimates. Stability and bias profiles favoured large trials (FI: 14.0 vs. 4.0; RFI: 10.0 vs. 5.0). In conclusion, small RCTs tend to overestimate treatment effects and yield less precise, less stable results. Meta-analyses should prioritise large, high-quality trials and interpret small-study findings with caution, particularly in rapidly evolving research contexts.},
}

Humans
*Randomized Controlled Trials as Topic
*COVID-19/therapy/epidemiology/virology
SARS-CoV-2/drug effects
Treatment Outcome
*COVID-19 Drug Treatment
Sample Size

@article {pmid41793747,
year = {2026},
author = {Poole-Wright, K and Woodhall, H and Chalder, T},
title = {Healthcare worker fatigue during COVID-19, SARS, and MERS: a meta-analysis.},
journal = {Occupational medicine (Oxford, England)},
volume = {76},
number = {2},
pages = {132-143},
pmid = {41793747},
issn = {1471-8405},
support = {//National Institute for Health Research Biomedical Research Centre at South London/ ; //Maudsley National Health Service Foundation Trust and King's College London/ ; //National Health Service, National Institute for Health Research, or Department of Health/ ; //National Institute for Health Research/ ; //Biomedical Research Centre at South London and Maudsley/ ; //National Health Service Foundation Trust/ ; //King's College London/ ; //National Health Service/ ; //National Institute for Health Research/ ; /DH_/Department of Health/United Kingdom ; },
mesh = {Humans ; *COVID-19/psychology ; *Health Personnel/psychology/statistics & numerical data ; *Fatigue/epidemiology/etiology ; *Severe Acute Respiratory Syndrome/psychology/complications ; Prevalence ; *Coronavirus Infections/psychology ; SARS-CoV-2 ; Personal Protective Equipment ; Risk Factors ; Occupational Diseases/epidemiology ; },
abstract = {BACKGROUND: The physical and psychological impact of caring for patients during a coronavirus public health emergency had adverse effects on healthcare workers (HCW), including fatigue.

AIMS: To examine the prevalence of fatigue among HCW during severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) or Coronavirus disease 19 (COVID-19) and identify associated risk and protective factors.

METHODS: Systematic searches of Embase, PsycINFO, Ovid-MEDLINE, CINAHL, HMIC and the Cochrane Library were conducted to July 2024. Inclusion criteria were English-language quantitative reports of fatigue in HCW during COVID-19, SARS and MERS. Random-effects meta-analyses were used to estimate pooled prevalence. Subgroup analyses examined fatigue by role, frontline status and personal protective equipment (PPE).

RESULTS: Eighty-eight articles (n = 74 914) met our inclusion criteria; 32 were eligible for meta-analysis. The pooled prevalence of fatigue was 55% (95% CI 46-65%, k = 32). Mental fatigue was reported by 58% (95% CI 17-90%, k = 4), while 53% (95% CI 38-67%, k = 11) experienced fatigue related to PPE use. No significant differences were observed between doctors and nurses (P = 0.327) or frontline and non-frontline staff (P = 0.103). Risk factors included stress, anxiety, depressive symptoms, workload and extended working hours, while resilience, self-efficacy and sufficient rest were protective. Substantial heterogeneity (I2 ∼99%) and reliance on cross-sectional designs limited causal inference.

CONCLUSIONS: Our study indicated that over half of HCW reported fatigue and highlighted its multifactorial nature. Organizational-level interventions, such as optimized shift patterns, mandated rest breaks and psychological support are essential to mitigate fatigue, safeguard wellbeing and ensure safe healthcare provision.},
}

Humans
*COVID-19/psychology
*Health Personnel/psychology/statistics & numerical data
*Fatigue/epidemiology/etiology
*Severe Acute Respiratory Syndrome/psychology/complications
Prevalence
*Coronavirus Infections/psychology
SARS-CoV-2
Personal Protective Equipment
Risk Factors
Occupational Diseases/epidemiology

@article {pmid41794658,
year = {2026},
author = {Nemeh, MN and Tahir, P and Hirschtritt, ME and Kalapatapu, RK},
title = {Psychiatric comorbidity in functional tics: a scoping review.},
journal = {BMC psychiatry},
volume = {26},
number = {1},
pages = {},
pmid = {41794658},
issn = {1471-244X},
abstract = {BACKGROUND: There has been a dramatic rise in the prevalence of functional tics since the COVID-19 pandemic. While the prevalence of various comorbidities has been well defined in primary tic disorders such as Tourette Syndrome, less is known about this topic in patients with functional tics. Therefore, the purpose of this scoping review is to characterize what is known about the prevalence of psychiatric and neurologic comorbidities in patients with functional tics and identify gaps that persist in this literature.

METHODS: A comprehensive search across multiple databases was used for data collection. We included studies that provided original data on the presence of psychiatric comorbidities in patients with a diagnosis of functional tics. Study screening progress was documented in a Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow chart. A total of 150 titles and abstracts were screened, 78 full texts were evaluated for eligibility, and 31 studies were included.

RESULTS: The included studies identified epidemiological data and common psychiatric and neurologic comorbidities in patients with functional tics. Most of the studies reviewed were published after 2020, highlighting the recent uptick in incidence and prevalence of functional tics. Depression and anxiety, followed by attention deficit hyperactivity disorder and obsessive-compulsive disorder, were among the most commonly identified comorbidities.

CONCLUSIONS: Overall, further research on the prevalence of comorbidities in patients with functional tics is needed to inform clinicians’ differential diagnosis and integrated treatment planning. Depression and anxiety are common comorbidities in patients with functional tics and may be underrecognized and underreported. The prevalence of all comorbidities appears to have increased since the COVID-19 pandemic. Future research should further quantitatively define the comorbidity profile in functional tics.

CLINICAL TRIAL NUMBER: Not applicable.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-026-07932-2.},
}

@article {pmid41795913,
year = {2026},
author = {Thorpe, DW and Jones, LA and Martin, AM and Coleman, RA and Allman, C and Peterson, RA and Keating, DJ},
title = {The role of peripheral serotonin in SARS-CoV-2 infectivity, COVID-19 treatment and long COVID.},
journal = {Immunology and cell biology},
volume = {104},
number = {4},
pages = {368-376},
pmid = {41795913},
issn = {1440-1711},
mesh = {Humans ; *Serotonin/metabolism ; *COVID-19/virology/metabolism/complications ; *SARS-CoV-2/physiology/pathogenicity ; Selective Serotonin Reuptake Inhibitors/therapeutic use ; *COVID-19 Drug Treatment ; Virus Internalization ; Gastrointestinal Tract/virology/metabolism ; Animals ; },
abstract = {Gastrointestinal symptoms have emerged as a common, but underappreciated, cause of morbidity in relation to SARS-CoV-2 infection and the COVID-19 pandemic. This manifests as a range of indications including diarrhea, anorexia, nausea, vomiting and abdominal pain. In addition, the gastrointestinal tract may represent a route of viral entry via the epithelial cell layer lining the gut wall. This route of entry could be a significant component of disease pathogenesis, including effects on the nervous system via the gut-brain axis. In this review, we provide an assessment of the effects of COVID-19 on the gastrointestinal system, its involvement in disease severity and potential pathways for viral entry and infection in the gastrointestinal tract. We also examine evidence that gut-derived serotonin is affected by SARS-CoV-2 infection, how this may link to symptoms and disease pathogenesis and the potential link to the efficacy of selective serotonin reuptake inhibitors in reducing COVID-19 severity.},
}

Humans
*Serotonin/metabolism
*COVID-19/virology/metabolism/complications
*SARS-CoV-2/physiology/pathogenicity
Selective Serotonin Reuptake Inhibitors/therapeutic use
*COVID-19 Drug Treatment
Virus Internalization
Gastrointestinal Tract/virology/metabolism
Animals

@article {pmid41796425,
year = {2026},
author = {Peñaherrera-Vásquez, D and Reina, A and Merlo, F and Fajardo-Loaiza, T and Zambrano-Sánchez, G and Rivadeneira, J and Fuenmayor-González, L},
title = {Unveiling the genitourinary phenotype of long COVID: a systematic review and meta-analysis.},
journal = {International urology and nephrology},
volume = {},
number = {},
pages = {},
pmid = {41796425},
issn = {1573-2584},
abstract = {IMPORTANCE: Long COVID has been associated with persistent multisystemic manifestations. However, genitourinary alterations have not been formally recognized as a distinct phenotype despite growing reports suggesting their relevance for long-term morbidity and quality of life.

OBJECTIVES: To determine the frequency and characteristics of genitourinary manifestations in patients with long COVID and to evaluate the evidence supporting the possible emergence of a genitourinary phenotype within long COVID.

DATA SOURCES: For this Systematic review and meta-analysis, a comprehensive search was conducted in PubMed (MEDLINE), Scopus, Web of Science, Embase, SciELO, and Bireme-BvS from inception to October 2025, without language or publication date restrictions. Observational studies (cross-sectional, cohort, or case-control) assessing individuals with one or more genitourinary symptoms-such as menstrual alterations, erectile dysfunction, urinary tract symptoms, or renal function decline-persisting ≥ 12 weeks after SARS-CoV-2 infection were included. Studies addressing only acute-phase manifestations, vaccine-related effects, or pre-existing genitourinary conditions were excluded.

DATA EXTRACTION AND SYNTHESIS: Data extraction was performed independently by two reviewers following PRISMA guidelines. Risk of bias (RoB) was assessed using the Joanna Briggs Institute checklist for prevalence studies. A random-effects meta-analysis using the Freeman-Tukey double arcsine transformation was applied to estimate pooled proportions, and heterogeneity was quantified using the I[2] statistic, Cochran's Q test, and the between-study variance (τ[2]).

MAIN OUTCOMES AND MEASURES: The primary outcomes were the pooled frequencies of genitourinary manifestations in long COVID, including menstrual disorders, erectile dysfunction, and renal function decline.

RESULTS: Nine primary studies encompassing 2332 participants from eight countries were included. Most studies (88.9%) presented a low RoB. The pooled frequency of menstrual disorders was 49% (95% CI 24-74), erectile dysfunction 21% (95% CI 16-28), and renal function decline 29% (95% CI 20-39).

CONCLUSIONS AND RELEVANCE: This systematic review and meta-analysis provide evidence supporting the possible emergence of a genitourinary phenotype of long COVID, encompassing menstrual irregularities, erectile dysfunction, cystitis-like symptoms, and renal impairment. Recognition of this potential phenotype is crucial for improving diagnostic accuracy, patient follow-up, and multidisciplinary management. Further high-quality studies are warranted to elucidate the underlying mechanisms and long-term clinical implications.},
}

@article {pmid41796915,
year = {2026},
author = {Lasagna, A and Del Re, M and Danesi, R and Andreoni, M and Tessitore, D and Di Maio, M and Silvestris, N and Pedrazzoli, P},
title = {Bispecific antibodies in solid tumors: An Italian Association of Medical Oncology (AIOM) multidisciplinary perspective on immunology and vaccination.},
journal = {Critical reviews in oncology/hematology},
volume = {221},
number = {},
pages = {105253},
doi = {10.1016/j.critrevonc.2026.105253},
pmid = {41796915},
issn = {1879-0461},
mesh = {Humans ; *Antibodies, Bispecific/therapeutic use ; *Neoplasms/immunology/therapy/drug therapy ; *Vaccination/methods ; Italy ; Medical Oncology ; *Cancer Vaccines/therapeutic use/immunology ; },
abstract = {The clinical use of bispecific antibodies (BsAbs) in solid tumors is rapidly expanding, yet evidence-based guidance on infection prevention and vaccination in this setting remains limited. We performed a critical narrative review integrating immunological mechanisms, available clinical data, and multidisciplinary expert opinion to inform vaccination strategies for patients with solid tumours treated with BsAbs. BsAbs can induce transient or sustained immune perturbations, including T-cell hyperactivation, lymphocyte redistribution, functional exhaustion, cytokine-mediated immune dysregulation, and, in selected contexts, B-cell impairment. These effects may reduce vaccine-induced humoral and cellular responses and increase vulnerability to infectious complications. Optimization of vaccination status before BsAb initiation is therefore advisable, as pre-treatment immunisation is more likely to achieve effective immune priming. Inactivated vaccines, including influenza, pneumococcal, SARS-CoV-2, hepatitis B (HBV), and recombinant herpes zoster vaccines, can be administered before or, when necessary, during therapy, whereas live attenuated vaccines should be avoided during active treatment. Vaccination timing during BsAb therapy should be individualised, taking into account the treatment schedule and immune recovery. Current recommendations rely largely on indirect evidence from haematological malignancies and other T-cell redirecting therapies. These considerations are essential to support treatment continuity, reduce preventable morbidity, and guide future prospective studies in patients with solid tumors treated with BsAbs.},
}

Humans
*Antibodies, Bispecific/therapeutic use
*Neoplasms/immunology/therapy/drug therapy
*Vaccination/methods
Italy
Medical Oncology
*Cancer Vaccines/therapeutic use/immunology

@article {pmid41797310,
year = {2026},
author = {Campbell, LA and Canales, MK and Spiser, K and Lopez, T and Mattimoe, G},
title = {Building Community Trust: A Rural Health Department's Journey Toward Health Equity.},
journal = {Public health nursing (Boston, Mass.)},
volume = {},
number = {},
pages = {},
doi = {10.1111/phn.70104},
pmid = {41797310},
issn = {1525-1446},
abstract = {BACKGROUND: Rural health departments face unique challenges in advancing health equity, particularly during times of political polarization. These challenges intensified during the COVID-19 pandemic, highlighting the complex interplay between public health authorities, political dynamics, and community trust.

OBJECTIVE: To document how a rural local county health department (LCHD) navigated political barriers and systemic inequities to conduct a community health assessment (CHA) during and after the COVID pandemic.

APPROACH: This CHA, conducted during 2021-2023, employed mixed methods data collection strategies: a bilingual community survey, listening sessions in English and Spanish, and informal interviews. Utilizing a health equity lens, the analysis focused on identifying power dynamics, systemic barriers, and community perspectives on health.

RESULTS: Survey data revealed differences between Hispanic and non-Hispanic respondents' health concerns and perceived barriers. Healthcare access was the only statistically significant barrier for Hispanic respondents. Lessons learned from the CHA process are provided.

CONCLUSION: The strategies employed during the CHA demonstrate how rural health departments can advance health equity while navigating complex political landscapes. Success requires careful attention to language, strategic coalition building, and persistent focus on elevating marginalized voices. The LCHD built community trust despite political resistance by modifying language around equity issues and strategic coalitions.},
}

@article {pmid41798257,
year = {2026},
author = {Liu, J and Wu, X},
title = {Fecal microbiota transplantation in ulcerative colitis: evidence, mechanisms, and practice considerations.},
journal = {Therapeutic advances in gastroenterology},
volume = {19},
number = {},
pages = {17562848261426284},
pmid = {41798257},
issn = {1756-283X},
abstract = {Ulcerative colitis (UC) is a chronic inflammatory bowel disease strongly associated with intestinal dysbiosis, reduced microbial diversity, and disrupted microbial metabolite profiles. Fecal microbiota transplantation (FMT) aims to restore microbial homeostasis and has shown a signal of benefit for induction of remission in some trials, but results are heterogeneous and long-term maintenance efficacy remains uncertain. In this narrative review, we synthesize randomized controlled trials (RCTs), systematic reviews/meta-analyses, and recent guideline and regulatory updates on FMT in UC, and integrate mechanistic insights from microbiome and metabolomics research. Across RCTs, intensive lower-gastrointestinal regimens using pooled, multidonor material, and/or anaerobic processing have most consistently achieved modestly higher steroid-free clinical and endoscopic remission than placebo in mild-to-moderate UC (approximately 25%-32% vs 5%-10% in representative studies), whereas upper-gastrointestinal delivery or oral lyophilized formulations and highly restrictive donor selection have yielded mixed or negative results. Mechanistically, responders commonly demonstrate engraftment of short-chain fatty acid producing taxa and restoration of secondary bile acid pathways. Safety profiles in trials are generally comparable to placebo for common mild adverse events, but rare severe transmissions (e.g., multidrug-resistant Escherichia coli and SARS-CoV-2) have driven stricter donor screening and have limited routine use outside regulated programs. Current guidelines recommend against FMT for UC outside clinical trials. Future work should prioritize standardized protocols, biomarker-guided personalization, combination strategies (diet/priming), and development of defined microbial therapeutics to improve efficacy and safety.},
}

@article {pmid41798379,
year = {2025},
author = {Newnham, A and Tattersall, T and Odendaal, J},
title = {Do Medical Schools Need to Adapt Their Curriculum in Order to Teach Medical Students 'Webside' Manner? A Systematic Review.},
journal = {Medical science educator},
volume = {35},
number = {6},
pages = {3173-3183},
pmid = {41798379},
issn = {2156-8650},
abstract = {BACKGROUND: Remote consulting was exponentially implemented secondary to the COVID-19 pandemic, and remains a staple of modern healthcare. Telemedicine consulting requires a different set of consultation skills collectively coined 'webside manner'. Evidence suggests inadequate training is a barrier to effective teleconsulting. This review aims to systematically assess the effect of telemedicine consultation skills training for medical students.

METHODS: A systematic literature search was conducted using MEDLINE, PsycINFO, and EMBASE. Two independent reviewers screened articles from 1 January 2010 onwards. A mixed-methods approach was undertaken. Thematic analysis identified three reporting themes. Quantitative data was reported within these themes using descriptive statistics. Study quality was assessed using the MERSQI score.

FINDINGS: In total, 241 articles were obtained, 38 extracted for full text review, and 11 included. Three themes were identified: communication skills, doctor-patient relationship, and confidence in performing virtual consultations. Six out of seven studies reported improved communication skills following telemedicine training. Three studies report a positive impact on the doctor-patient relationship. Student confidence showed improvement in all reporting studies.

CONCLUSION: This review demonstrates a positive association between telemedicine training and improved virtual consultation skills for medical students. The results are limited by the low quality and heterogeneity of included studies.},
}

@article {pmid41798405,
year = {2026},
author = {Singh, G and Hartnett, R and Silva, BM and Fekrat, SMM and Prasad, S and Gill, G and Gunturu, S},
title = {Comparison of Antipsychotics in the Treatment of COVID-19-Induced First-Episode Psychosis: A Review of Case Studies.},
journal = {Cureus},
volume = {18},
number = {2},
pages = {e103021},
pmid = {41798405},
issn = {2168-8184},
abstract = {This study aims to systematically review COVID-19-associated first-episode psychosis cases, comparing antipsychotic selection, dosing strategies, treatment response timelines, adverse effects, and relapse rates to inform evidence-based pharmacological management. We conducted a structured narrative review of published case reports and series describing COVID-19-Induced first-episode psychosis treated with antipsychotics. A comprehensive search of PubMed and Google Scholar (Jan 2020-Apr 2023) identified 42 eligible cases based on predefined inclusion/exclusion criteria. Data were extracted using a standardized template and summarized descriptively due to clinical heterogeneity. Variables included demographics, psychiatric features, antipsychotic(s) used, clinical course, and outcomes. First-episode psychosis (FEP) was higher in males (24, 57.1%) and the 30-39 age group (10, 23.8%). Olanzapine was the most commonly used single antipsychotic (6, 28.6%), while the combination of haloperidol and aripiprazole was the most frequently used antipsychotic regimen (4, 19.0%). Atypical antipsychotics were preferred (54.8%), with olanzapine (23, 54.8%) being the most commonly used at a mean dose of 10.9 mg/day. Reported side effects included fatigue, weight gain, akathisia, leukocytosis, and QT-interval prolongation (5, 11.9%), with a relapse rate of (2, 4.8%). This review evaluates the treatment methods for COVID-19 FEP and develops a deeper understanding of various antipsychotics used in managing psychosis and its outcomes.},
}

@article {pmid41798556,
year = {2026},
author = {Armstrong, JL and Bennis, S and Smock, JN and Kesselman, MM},
title = {Teledermatology for Older Adults With a Focus on Nursing Home Residents: A Scoping Review of Clinical and System-Level Benefits.},
journal = {Cureus},
volume = {18},
number = {2},
pages = {e102891},
pmid = {41798556},
issn = {2168-8184},
abstract = {Teledermatology (TD), which involves providing dermatology services, including diagnosis and management, remotely, has grown as a result of the COVID-19 pandemic, becoming a critical tool for delivering dermatologic care, especially to aging populations. Specifically, for nursing home residents who often face mobility and cognitive limitations, multimorbidity, and an increased risk of complications, TD may allow for earlier diagnoses, improved access to care and quality of life, and timely management. A scoping review of studies published between 2015 and 2025 was conducted to evaluate clinical and system-level outcomes. A comprehensive search was conducted by three independent researchers using multiple databases, including Ovid MEDLINE, EMBASE, and Web of Science. To analyze the most common dermatologic diagnoses in nursing homes, the inclusion criteria included geriatric patients (>60 years old), nursing home patients, and studies published in English between 2015 and 2025. For analyzing the overall benefits of using TD, the inclusion criteria were identical except that dermatology patients of any age were eligible. Exclusion criteria for analyzing the most common dermatologic diagnoses in nursing homes and the benefits of using TD included articles that were older than 15 years and case reports. Overall, this review will provide a comprehensive analysis of the benefits of using TD as a diagnostic and management tool for dermatologic conditions in the elderly nursing home setting.},
}

@article {pmid41798665,
year = {2026},
author = {Maruyama, T and Hieda, M and Fukata, M},
title = {Current Trends and Future Perspectives of Bradycardia, Renal Failure, Atrioventricular Nodal Blockade, Shock, and Hyperkalemia (BRASH) Syndrome: A Narrative Review.},
journal = {Cureus},
volume = {18},
number = {3},
pages = {e104731},
pmid = {41798665},
issn = {2168-8184},
abstract = {BRASH syndrome is defined as a clinical condition in which bradycardia, renal failure, atrioventricular (AV) nodal blockade, shock, and hyperkalemia interact to form a self-perpetuating negative spiral. Geriatric practitioners are increasingly likely to encounter elderly patients with this syndrome who are taking AV nodal blocking agents, such as calcium channel blockers (CCBs) or β-blockers. However, it remains unclear how the heart failure (HF) pandemic and coronavirus disease 2019 (COVID-19) have influenced the incidence, triggers, management, and clinical course of BRASH syndrome. Therefore, open-access databases were searched for publications from 1980 to 2025, identifying 41 eligible articles reporting a total of 54 patients with BRASH syndrome. The mean age of affected patients was 69.0 ± 15.1 years. Hypertension (HTN, 74%), chronic kidney disease (CKD, 61%), and diabetes (54%) were the most common comorbidities. More than half of the patients (52%) were prescribed angiotensin-suppressing agents (angiotensin-converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARB), or angiotensin receptor-neprilysin inhibitors (ARNI)) for HTN or HF. Two elderly patients were diagnosed with BRASH syndrome triggered by COVID-19. This literature review clarifies that BRASH syndrome commonly occurs in elderly patients with HTN or CKD and is often associated with everyday clinical events such as anorexia, vomiting, diarrhea, bleeding, and infection, including COVID-19. Our database search supports recognizing BRASH syndrome as an important clinical entity in geriatric emergency medicine. Geriatric practitioners should be aware of this condition to enable early diagnosis and appropriate management in the modern HF and post-COVID-19 era.},
}

@article {pmid41798883,
year = {2026},
author = {Timpka, T and Gursky, EA and Nyce, JM},
title = {Making US public health a good idea again.},
journal = {Lancet regional health. Americas},
volume = {57},
number = {},
pages = {101423},
pmid = {41798883},
issn = {2667-193X},
abstract = {The stress test the COVID-19 pandemic imposed on the US public health system illuminated predictable yet surprisingly unplanned for fault lines. A perceived lack of choice associated with nonpharmaceutical and pharmaceutical interventions led many Americans to question both measures and processes for mitigating disease consequences, such as masking and mass vaccination. A cultural-historical examination shows that a central impediment for US efforts to control the pandemic was the limited sense of common good. Many factors and beliefs, including also that the scientific-biotechnological innovation system did not serve the interests of all people equally, and the public health community's equating disease with how people perceived illness, weakened vaccination acceptance and disease control efforts. We conclude that US public health must renegotiate the social contract with the American people to recover a shared understanding of its relevance and to effectively respond to future health challenges and pandemics.},
}

@article {pmid41799381,
year = {2026},
author = {Raheel, H and Ferguson, A and Leslie, SL and Guardado-Menjivar, V and Chen, K and Merceron, A and Arciniegas, J and Lovvorn, AE and Higgins, M and Barr, DB and Saikawa, E and Handley, MA and Thompson, LM},
title = {Behavioral interventions related to plastic waste management in low-and middle-income countries: a systematic review using the behavior change wheel and the theoretical domains framework.},
journal = {Environmental research letters : ERL [Web site]},
volume = {21},
number = {5},
pages = {053003},
pmid = {41799381},
issn = {1748-9326},
abstract = {Addressing the mounting plastic waste problem requires system-level solutions, along with interventions that promote behavioral change. In low-resource countries, inadequate, if not absent, waste management systems lead to unsafe disposal practices, including open burning. While theory-informed approaches are essential for identifying enablers and barriers to target behavior change, their application is limited in these settings. Given the lack of a theory-driven synthesis of behavioral strategies to address plastic waste, this systematic review aimed to: (1) synthesize behavioral interventions related to plastic waste management in low-resource countries; (2) map these interventions to the behavior change wheel (BCW), using the capability-opportunity-motivation-behavior model, and the theoretical domains framework (TDF); and (3) classify implementation strategies to inform theory-driven intervention design. This review is the first to use the BCW to examine behavioral interventions related to plastic waste management in low-resource countries. Nine bibliographic databases: APA PsycInfo, CINAHL, Embase, Environment Complete, Global Health, GreenFile, Health Source: Nursing Academic, PubMed, and Web of Science Core Collection were searched. We included English-language human studies up to 9 April 2025, that evaluated interventions or policies targeting individual- or community-level behaviors related to plastic waste management in low-, lower-middle, or upper-middle income countries. We excluded studies from high-income countries, and those focused on environmental impacts, industrial or municipal waste streams, ecosystems or animals without human behavioral components, COVID-19-specific waste, or hypothetical modeling without real-life interventions. Forty-three studies met the inclusion criteria. Study quality was assessed using the mixed methods appraisal Tool. Interventions spanned 27 low-resource countries and targeted diverse populations, including schoolchildren, households, market vendors, and community organizations. Education was the most frequent BCW intervention function (76.7%), followed by environmental restructuring, incentivization, persuasion, and training. Mapping revealed that behavioral interventions relied most frequently on the TDF domains of environmental context, knowledge, skills, and social influences. Some domains, such as beliefs about capabilities, reinforcement, and identity, received moderate attention, while appealing to emotion or the use of behavioral regulation, were underutilized. Behavioral interventions for plastic waste management in low-resource countries have predominantly emphasized awareness-raising but insufficiently leveraged other BCW intervention functions and TDF domains. Integration of motivational, emotional, and identity-based strategies alongside structural support can enhance the sustainability of behavior change.},
}

@article {pmid41799482,
year = {2026},
author = {Leon-Rojas, JE},
title = {Tele-neurology in Latin America: digital solutions for a treatment gap.},
journal = {Frontiers in public health},
volume = {14},
number = {},
pages = {1779415},
pmid = {41799482},
issn = {2296-2565},
mesh = {Humans ; *Telemedicine/organization & administration ; Latin America ; COVID-19/epidemiology ; *Neurology/methods/organization & administration ; *Health Services Accessibility ; *Nervous System Diseases/therapy ; SARS-CoV-2 ; Ecuador ; },
abstract = {Neurological disorders remain a leading cause of disability across Latin America, yet access to specialist care is affected by important workforce shortages, geographic disparities, and under-resourced health systems. Tele-neurology has emerged as a promising strategy to mitigate these barriers, particularly in the wake of the COVID-19 pandemic, which resulted in rapid digital health adoption. This review article examines the development and implementation of tele-neurology initiatives across Latin America, with a focus on Ecuador; drawing on examples such as TeleEEG, telestroke networks, and Project ECHO, I illustrate how digital tools have expanded the reach of neurological services in underserved regions. Despite demonstrable benefits, challenges persist, including uneven digital infrastructure, regulatory gaps, and disparities in access. I argue that tele-neurology must be deliberately integrated into national public health strategies, not merely as a pandemic contingency but as a potential long-term solution for health equity, if done properly. Strategic investments in broadband access, clinician training, sustainable financing, and regional collaboration are essential to scale these innovations. When anchored in strong policy frameworks and aligned with global neurological health goals, tele-neurology could offer a path toward closing the treatment gap and advancing equitable neurological care throughout Latin America.},
}

Humans
*Telemedicine/organization & administration
Latin America
COVID-19/epidemiology
*Neurology/methods/organization & administration
*Health Services Accessibility
*Nervous System Diseases/therapy
SARS-CoV-2
Ecuador

@article {pmid41800523,
year = {2026},
author = {Esposito, N and Buonomo, AR and Di Filippo, I and Forte, E and Trucillo, E and Gentile, I and Schiano Moriello, N},
title = {Lessons from examining the safety of drugs for COVID-19 during pregnancy.},
journal = {Expert opinion on drug safety},
volume = {},
number = {},
pages = {1-11},
doi = {10.1080/14740338.2026.2637649},
pmid = {41800523},
issn = {1744-764X},
abstract = {INTRODUCTION: Pregnant women represent a vulnerable population during the COVID-19 pandemic, facing increased risks of severe disease and adverse obstetric outcomes, yet they have been largely excluded from pivotal therapeutic clinical trials, leaving a critical evidence gap for treatment decisions.

AREAS COVERED: This review examines the available evidence on the safety and efficacy of COVID-19 therapies during pregnancy, including oral antivirals (nirmatrelvir/ritonavir, molnupiravir), intravenous remdesivir, monoclonal antibodies, corticosteroids, and immunomodulators (tocilizumab, baricitinib). A literature search was conducted using MEDLINE/PubMed for English-language articles published from March 2020 to December 2023, including studies of any design reporting maternal and neonatal outcomes.

EXPERT OPINION: The COVID-19 pandemic exposed a critical gap in clinical research through the systematic exclusion of pregnant women from therapeutic trials. Current evidence, though largely observational, supports vaccination as the primary preventive strategy, nirmatrelvir/ritonavir for outpatients at risk of progression, and remdesivir plus corticosteroids for hospitalized patients requiring oxygen supplementation.},
}

@article {pmid41800915,
year = {2026},
author = {Kato, TA},
title = {Hikikomori in the urban digital era: a psychodynamic, transdiagnostic model and multimodal interventions.},
journal = {Current opinion in psychiatry},
volume = {39},
number = {3},
pages = {234-241},
pmid = {41800915},
issn = {1473-6578},
mesh = {Humans ; *Social Isolation/psychology ; Urban Population ; *Mental Disorders/therapy/psychology ; Object Attachment ; *COVID-19/psychology ; },
abstract = {PURPOSE OF REVIEW: Hikikomori (prolonged social withdrawal) was first described in Japan and was initially regarded as culture-bound. It is now recognized as a global mental health concern, more prevalent in urban settings and frequently comorbid with psychiatric disorders. In the post - COVID - 19 era, home - centered lifestyles have become increasingly normative, prompting a reconceptualization of hikikomori beyond reduced outing frequency. Drawing on over two decades of clinical and research experience, we propose a psychodynamic (developmental and attachment-informed), transdiagnostic, and multidimensional framework and outline assessment and intervention strategies for urban digital societies.

RECENT FINDINGS: International frameworks distinguish pathological from non-pathological hikikomori based on psychological distress and functional impairment. Emerging evidence implicates attachment insecurity, early adversity, and transdiagnostic biological pathways involving inflammation, and neurodevelopmental mechanisms. Early-phase pathological hikikomori is associated with increased risk of depression and gaming disorder, with possible relevance of modern-type depression. Digital tools, including online engagement and virtual reality based interventions, may provide low-threshold gateways to reach otherwise hard-to-reach individuals.

SUMMARY: In contemporary urban life, physical isolation per se is not necessarily pathological. Translating a biopsychosocial-cultural model integrating psychopathology and attachment into structured assessment, family-based approaches, clinical care, and digital interventions is essential to prevent long-term pathological hikikomori.},
}

Humans
*Social Isolation/psychology
Urban Population
*Mental Disorders/therapy/psychology
Object Attachment
*COVID-19/psychology

@article {pmid41802499,
year = {2026},
author = {Sheehan, C and Liu, TJ and Zhang, P and Wang, H and Chang, A},
title = {Excipients: New opportunities for complex challenges - USP's approaches.},
journal = {European journal of pharmaceutics and biopharmaceutics : official journal of Arbeitsgemeinschaft fur Pharmazeutische Verfahrenstechnik e.V},
volume = {223},
number = {},
pages = {115045},
doi = {10.1016/j.ejpb.2026.115045},
pmid = {41802499},
issn = {1873-3441},
mesh = {*Excipients/chemistry/standards ; Humans ; *Pharmacopoeias as Topic/standards ; Drug Delivery Systems/methods ; COVID-19 Vaccines/administration & dosage/chemistry ; Nanomedicine/methods ; Polymers/chemistry ; COVID-19/prevention & control ; },
abstract = {The quality of excipients is important since they can make up to about 90% of the total mass/volume of the drug product. Traditionally, excipients specifications were established with a focus on quality for intended use in the drug product and less on excipient composition, and physical and chemical properties, however, the increasing demand for high quality excipients used in the development of nanomedicines and novel delivery systems requires higher quality and purity, e.g., use of phospholipids in development of Covid-19 vaccine nanomedicine delivery systems. USP is collaborating with stakeholders to address the lack of standardized test methods for complex/polymeric type excipients (e.g., phospholipids/LG polymers) offering new solutions and help with excipient compositional and variability issues along with associated environmental aspects. By expanding its offerings through its "emerging standards" new model for stakeholder engagement, USP is more flexible in its solutions offerings that favor earlier interaction in the genesis of quality standards in a more iterative way. This publication will provide an overview of evolving compendial approaches (e.g., standalone chapters) and expanded solutions and offerings (use of analytical reference materials (ARMS), associated application (App) notes, and technical guides).},
}

*Excipients/chemistry/standards
Humans
*Pharmacopoeias as Topic/standards
Drug Delivery Systems/methods
COVID-19 Vaccines/administration & dosage/chemistry
Nanomedicine/methods
Polymers/chemistry
COVID-19/prevention & control

@article {pmid41802806,
year = {2026},
author = {Tan, JH and Mainali, P and Zhang, W and Ow, DS},
title = {Armored RNA technology as a clinical diagnostics tool for future pandemic preparedness.},
journal = {Journal of microbiology (Seoul, Korea)},
volume = {64},
number = {2},
pages = {e2510016},
doi = {10.71150/jm.2510016},
pmid = {41802806},
issn = {1976-3794},
support = {//Agency for Science, Technology and Research/ ; M24N8c0107//Young Investigator Research/ ; },
mesh = {Humans ; *COVID-19/diagnosis/virology ; *SARS-CoV-2/genetics/isolation & purification ; *RNA, Viral/genetics ; Pandemics ; *Molecular Diagnostic Techniques/methods ; Nucleic Acid Amplification Techniques/methods ; Pandemic Preparedness ; },
abstract = {The COVID-19 pandemic highlighted the critical role of reliable molecular diagnostics in outbreak response and the vulnerabilities of existing systems to delays and reagent instability. Armored RNA technology, which packages RNA within bacteriophage-derived capsids, offers a robust solution by combining nuclease resistance, safety, and versatility into a single platform. Armored RNA has become a trusted internal and external control for RT-qPCR and RT-LAMP, enabling accurate detection across a wide range of viral pathogens. Also, recent advances in alternative expression systems, such as plant-based and cell-free platforms, as well as the use of more stable scaffolds from bacteriophage Qβ, are enhancing yield, stability, and accessibility of armored RNA. Engineering innovations, including capsid polymorphism and optimized downstream purification, further improve efficiency and broaden possible applications. Looking ahead, armored RNA holds promise not only as a diagnostic standard but also as a delivery vehicle for vaccines and therapeutics. Encapsulation of self-amplifying RNA, small interfering RNA, or microRNA could open new pathways for rapid-response vaccines and targeted therapies, aligning this technology with the future of precision medicine. By uniting stability, scalability, and adaptability, armored RNA represents a critical component of global health preparedness, with the potential to strengthen diagnostic resilience and accelerate biomedical countermeasures in future pandemics.},
}

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

@article {pmid41804969,
year = {2026},
author = {Branfield, S},
title = {The interface of hemostasis and inflammation: endothelial-platelet dynamics in thrombosis.},
journal = {Current opinion in hematology},
volume = {33},
number = {3},
pages = {88-94},
doi = {10.1097/MOH.0000000000000918},
pmid = {41804969},
issn = {1531-7048},
mesh = {Humans ; *Blood Platelets/metabolism/pathology ; *COVID-19/blood/complications/pathology ; *Thrombosis/pathology/metabolism/drug therapy/etiology/blood ; *Hemostasis ; *SARS-CoV-2 ; *Inflammation/pathology/metabolism ; von Willebrand Factor/metabolism ; Animals ; },
abstract = {PURPOSE OF REVIEW: This review summarizes current understanding of platelet-endothelial contributions to thrombosis, emphasizing molecular crosstalk [von Willebrand factor (VWF)/ADAMTS13 balance, P-selectin, platelet glycoprotein VI (GPVI), integrins, extracellular vesicles, neutrophil extracellular traps (NETs)], high-risk clinical settings, and translational advances. Highlighting GPVI-directed therapeutics, the VWF/ADAMTS13 axis in COVID-19, and opportunities and challenges for targeting the platelet-endothelial interface.

RECENT FINDINGS: Clinical and translational studies support the safety and potential efficacy of targeting platelet-endothelial interfaces. GPVI inhibitors (Glenzocimab, Revacept) have advanced through phase I/II studies with reassuring bleeding profiles and suggest benefit in ischemic stroke and lesion-directed settings. Direct interruption of platelet-VWF interactions (Caplacizumab) is established in immune thrombotic thrombocytopenic purpura (TTP), while studies show a persistent VWF/ADAMTS13 imbalance in severe COVID-19 and inflammatory states linked to microthrombosis and worse outcomes. Antiadhesion strategies (P-selectin blockade) and modulators of immunothrombosis (NET inhibitors, targeting extracellular vesicle) are also in evaluation.

SUMMARY: Targeting platelet-endothelial crosstalk has potential to reduce pathologic thrombosis while preserving hemostasis. Clinical proof of principle exists for focused approaches (anti-VWF in TTP; P-selectin blockade in vaso-occlusion; emerging GPVI inhibitors). Priorities are: defining disease contexts and timing where interface targeting is effective; validating biomarkers (VWF/ADAMTS13 ratio, soluble P-selectin, platelet activation signatures) for patient selection; and conducting adequately powered trials with rigorous bleeding endpoints.},
}

Humans
*Blood Platelets/metabolism/pathology
*COVID-19/blood/complications/pathology
*Thrombosis/pathology/metabolism/drug therapy/etiology/blood
*Hemostasis
*SARS-CoV-2
*Inflammation/pathology/metabolism
von Willebrand Factor/metabolism
Animals

@article {pmid41805007,
year = {2026},
author = {Bhattacharjee, M and Bérubé, J and Durand, M and Rousseau, S and Zawati, MH},
title = {The Biobanque Québécoise de la COVID-19: Anticipate to Innovate.},
journal = {Biopreservation and biobanking},
volume = {},
number = {},
pages = {19475535261429759},
doi = {10.1177/19475535261429759},
pmid = {41805007},
issn = {1947-5543},
abstract = {The COVID-19 pandemic underscored the urgent need for strong biobanking infrastructures to facilitate rapid research and innovation in public health emergencies. The COVID-19 Québec Biobank (BQC19), launched in March 2020, serves as a pioneering initiative to address this demand, enabling the collection, storage, and sharing of biological samples and data to advance diagnostics, therapeutics, and epidemiological research. This article examines the development and operational framework of BQC19, highlighting five key themes central to its success. First, BQC19's anticipatory governance model emphasizes adaptability, leveraging strategic foresight to maintain ethical and efficient operations during the pandemic. Second, the initiative's harmonized yet flexible consent processes ensured participant autonomy and compliance with evolving clinical and public health contexts. Third, BQC19's collaborative governance framework facilitated seamless interinstitutional cooperation, supported by standardized operating procedures and localized manuals of procedures. Fourth, streamlined data access mechanisms, managed by an independent data access committee, promoted ethical and equitable data sharing, balancing privacy considerations with research accessibility. Last, BQC19 demonstrates the transferability of its infrastructure to other health challenges, providing a scalable, ethical, and collaborative model for future public health crises. Through centralized data management, preestablished legal agreements, and tiered access protocols, BQC19 has significantly reduced response times and operational inefficiencies. Its achievements showcase the potential of biobanks in fostering global health collaboration, enabling rapid research mobilization, and addressing emerging health threats. BQC19's legacy lies in its ability to integrate innovation, ethics, and collaboration into a sustainable framework for public health preparedness.},
}

@article {pmid41805020,
year = {2026},
author = {Uddin, ME and Asaduzzaman, M and Ahmad, T and Ahmed, S and Kundu, SK and Khan, MMH and Islam, MM and Hossen, MM and Sheikh, MR and Sheikh, MMI},
title = {Vitamin D and Zinc in SARS-CoV-2 Infection: Immunomodulatory Mechanisms and Clinical Evidence.},
journal = {Viral immunology},
volume = {39},
number = {3},
pages = {97-112},
doi = {10.1177/08828245261426982},
pmid = {41805020},
issn = {1557-8976},
mesh = {Humans ; *Vitamin D/therapeutic use/immunology ; *Zinc/therapeutic use/immunology ; *COVID-19/immunology/epidemiology ; *SARS-CoV-2/immunology ; *COVID-19 Drug Treatment ; Dietary Supplements ; Immunomodulation ; Animals ; },
abstract = {The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in approximately 778 million reported cases and over 7 million deaths worldwide as of August 2025 (WHO COVID-19 Dashboard), predominantly due to variable acute and chronic lung infections accompanied by inflammatory responses within the pulmonary tract and vasculature. Despite ongoing research, no definitive cure has been identified. Preventive measures, including vaccines and monoclonal antibody-based interventions, have been developed to protect vulnerable populations, and hundreds of therapeutic candidates have been evaluated worldwide. Complementing these strategies, vitamin D and zinc (Zn) supplementation have emerged as promising, accessible adjunctive strategies due to their immunomodulatory and anti-inflammatory properties. This review synthesizes current experimental, clinical, and epidemiological evidence on the roles of vitamin D and Zn in modulating immune responses relevant to SARS-CoV-2 infection. Available data suggest that adequate vitamin D and Zn status may support immune function, reduce excessive inflammation, and potentially mitigate disease severity, particularly in deficient individuals. However, clinical trial outcomes remain heterogeneous. Overall, vitamin D and Zn supplementation may be considered supportive, adjunctive preventive measures. Further well-designed randomized controlled trials are required to define their optimal use in COVID-19 prevention and management.},
}

Humans
*Vitamin D/therapeutic use/immunology
*Zinc/therapeutic use/immunology
*COVID-19/immunology/epidemiology
*SARS-CoV-2/immunology
*COVID-19 Drug Treatment
Dietary Supplements
Immunomodulation
Animals

@article {pmid41806061,
year = {2026},
author = {Moyue, X and Liang, S and Ying, X and Yang, Y and Dongang, Z},
title = {Research progress of nucleocapsid protein of novel coronavirus: structure, function and targeted therapy.},
journal = {Archives of virology},
volume = {171},
number = {4},
pages = {},
pmid = {41806061},
issn = {1432-8798},
support = {National Natural Science Foundation of China//National Natural Science Foundation of China/ ; },
}

@article {pmid41806408,
year = {2026},
author = {Atluri, S and Al Masud, A and Islam, MS and Duong, MC and Seale, H},
title = {Examining the proposed role of civil society and non-governmental organisations in the implementation of AMR national action plans: A global policy review.},
journal = {Public health},
volume = {254},
number = {},
pages = {106237},
doi = {10.1016/j.puhe.2026.106237},
pmid = {41806408},
issn = {1476-5616},
mesh = {Humans ; *Organizations ; *Health Policy ; Global Health ; *Drug Resistance, Microbial ; },
abstract = {OBJECTIVES: Civil Society Organisations (CSOs) and Non-Governmental Organisations (NGOs) have long supported public health programs by delivering services, raising awareness, and advocating for policy change. Despite their key role in addressing complex health issues like HIV and COVID-19, their involvement in antimicrobial resistance (AMR) strategies remains underexplored. This study reviews how CSOs and NGOs are framed within AMR National Action Plans (NAPs) to better understand their role in mitigating AMR.

STUDY DESIGN: Policy review.

METHODS: A content analysis of publicly available AMR NAPs was conducted using key terms related to CSOs and NGOs. Relevant excerpts were coded across seven focus areas of engagement, with multiple reviewers to ensure consistency. Data were analysed thematically to identify patterns in CSO and NGO involvement across countries.

RESULTS: Of the 194 WHO member states, 129 (63%) AMR National Action Plans (NAPs) were available and reviewed, with 27% inclusive of 2025. References to CSOs appeared in 40% of NAPs, and NGOs in 51%, though the extent and specificity of their roles varied widely. CSO involvement was most commonly associated with advocacy, particularly in low-and-middle-income countries (LMICs), while education, prevention, surveillance, and resource mobilisation were less frequently addressed. Participation in government committees and policy-making was limited.

CONCLUSIONS: The study revealed that referenced CSO and NGO involvement is often broad and lacks specificity. These findings underscore the need for more precise and context-specific inclusion of CSOs in AMR strategies to enhance their contribution to policy implementation and community-level action.},
}

Humans
*Organizations
*Health Policy
Global Health
*Drug Resistance, Microbial

@article {pmid41807825,
year = {2026},
author = {Ott, PA},
title = {The promises and challenges of neoantigen cancer vaccines.},
journal = {Nature biotechnology},
volume = {44},
number = {5},
pages = {740-751},
pmid = {41807825},
issn = {1546-1696},
support = {R01 CA229261/CA/NCI NIH HHS/United States ; R01 CA229261/CA/NCI NIH HHS/United States ; },
mesh = {Humans ; *Cancer Vaccines/immunology/therapeutic use ; *Antigens, Neoplasm/immunology/genetics ; *Neoplasms/immunology/therapy ; COVID-19 ; SARS-CoV-2/immunology ; },
abstract = {Transformational advances in genomic sequencing capabilities, vastly improved HLA class I epitope prediction algorithms and powerful delivery platforms have facilitated the clinical development of vaccines targeting neoantigens encoded by tumor mutations. Early clinical trials indicate that vaccination against neoantigens can induce robust and durable T cell immunity that may persist for decades. mRNA vaccines, originally developed for cancer applications, have demonstrated considerable promise due to their efficacy and scalable production, as evidenced during the SARS-CoV-2 pandemic. However, the optimal cancer vaccine platform and delivery strategy is not yet known, as current approaches have not been compared head-to-head and substantial technological advances to improve immunogenicity and potentially clinical efficacy are achievable. For example, lipid-based formulations, while necessary for the effective delivery of mRNA vaccines, may also improve the immunogenicity of peptides and other delivery strategies. Here we review the current state of neoantigen vaccines in the clinic and highlight emerging opportunities for advancement in the field.},
}

Humans
*Cancer Vaccines/immunology/therapeutic use
*Antigens, Neoplasm/immunology/genetics
*Neoplasms/immunology/therapy
COVID-19
SARS-CoV-2/immunology

@article {pmid41808188,
year = {2026},
author = {Mahon, N and Hays, LMC and Coy, E and Ainscough, K and Burrell, A and Gordon, AC and Rochwerg, B and Wang, CM and Harvey, D and Parekh, D and Goligher, E and Toal, F and Saito, H and Marshall, JC and Stewart, J and Gobat, N and Webb, S and Tolppa, T and McAuley, DF and Nichol, AD},
title = {Views on consent approaches used in emergency and critical care research: a rapid, systematic review.},
journal = {Trials},
volume = {27},
number = {1},
pages = {},
pmid = {41808188},
issn = {1745-6215},
support = {NIHR155209//Health Technology Assessment Programme/ ; NIHR154493//Efficacy and Mechanism Evaluation Programme/ ; CTN-2021-010/HRBI_/Health Research Board/Ireland ; DIFA-2023-025/HRBI_/Health Research Board/Ireland ; APRO-2023-017/HRBI_/Health Research Board/Ireland ; },
mesh = {Humans ; *Informed Consent/ethics ; *Critical Care/ethics ; *COVID-19/epidemiology ; SARS-CoV-2 ; },
abstract = {BACKGROUND: Obtaining informed consent can be challenging in emergency and critical care research due to the acute and severe nature of the patient's condition. However, such research is urgently needed to inform practice and optimise patient outcomes. While alternative consent approaches have been commonly used, opinions may vary, particularly among diverse and underserved patient groups and in the context of the recent COVID-19 pandemic. The objective of this review was to assess views of alternative consent methods in emergency and critical care research.

METHODS: We conducted a rapid systematic review to understand diverse opinions of alternative consent models used in emergency and critical care research with searches of MEDLINE, EMBASE, PsycINFO, Web of Science and CENTRAL carried out to July 31, 2024. We included quantitative and qualitative studies and summarised findings using narrative synthesis. We specifically investigated underserved groups and consent in the pandemic setting.

RESULTS: From 9974 citations, we screened 289 full-text articles, and included 145 eligible studies from 26 countries. Consent methods included prospective informed consent, deferred consent, surrogate decision maker consent, healthcare professional consent and waived consent. Groups represented included previous trial participants, relatives of trial participants, patients, members of the general public, healthcare providers, researchers, site staff, and research ethics committees. It was recognised that prospective informed consent from the patient is not possible in all scenarios. In general, alternative consent models were acceptable, with emphasis on the inclusion of the patient and relatives in the decision-making process whenever possible. Acceptability of alternative consent models was influenced by previous research participation, experience of critical or emergency illness, perceived risk of participation, and invasiveness of the intervention. Study staff highlighted potential limitations of some alternative consent models, such as unavailability of relatives. Pandemic studies showed an increased need for alternative consent methods, and greater preparedness and engagement with ethics committees to facilitate implementation. Sub-analysis evaluating the views of underserved groups did not show consensus, and accommodations were largely not reported.

CONCLUSION: Alternative consent models used for emergency, critical care and pandemic research including deferred consent, relative/surrogate decision maker consent, and physician consent were generally acceptable.

TRIAL REGISTRATION: PROSPERO CRD42023408305 (April 19, 2023).},
}

Humans
*Informed Consent/ethics
*Critical Care/ethics
*COVID-19/epidemiology
SARS-CoV-2

@article {pmid41809272,
year = {2026},
author = {Zarkadi, A and Katotomichelakis, M and Chaidas, K},
title = {Long-Term Olfactory Dysfunction in COVID-19 Patients: A Systematic Review.},
journal = {Cureus},
volume = {18},
number = {2},
pages = {e103143},
pmid = {41809272},
issn = {2168-8184},
abstract = {Olfactory dysfunction (OD) emerged early in the COVID-19 pandemic as a prevalent and often persistent symptom. While most individuals recover within weeks, a significant proportion continue to suffer from long-term impairments, including both quantitative and qualitative sensory deficits. Our review aimed to summarize current evidence on long-term post-COVID-19 OD with a duration of at least three months, including prevalence, recovery trajectory, and prognostic factors. The PubMed and Scopus databases were searched for relevant studies up to August 2024 following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Twenty-one studies were ultimately included, involving over 4,000 individuals. A remarkable proportion of patients continue to experience persistent dysfunction post-infection for a period ranging from several months to over two years. Qualitative disorders, such as parosmia and phantosmia, frequently appeared during recovery. Prognosis seemed to be related to age, initial severity, duration of OD, co-existing symptoms, and potentially sex. A consistent discrepancy between subjective reports and objective psychophysical test results was observed. Methodological heterogeneity limited comparability across studies. Olfactory dysfunction is a significant and often overlooked long-term complication of COVID-19. Standardized diagnostic criteria, validated outcome measures, and prospective longitudinal research are urgently needed to guide evidence-based management and improve patient outcomes.},
}

@article {pmid41809895,
year = {2025},
author = {Shi, Y and Sun, K and Hu, Y and Lou, Z and Wang, Y and You, J},
title = {The strategies and advances of mRNA translation booster.},
journal = {Asian journal of pharmaceutical sciences},
volume = {20},
number = {6},
pages = {101090},
pmid = {41809895},
issn = {2221-285X},
abstract = {The therapeutic efficacy and safety of mRNA-based drugs in immunological and nonimmunological applications are critically dependent on the translated protein yield, which requires precise modulation of mRNA expression kinetics. Among the factors influencing mRNA translation, immunogenicity and stability are pivotal in determining the longevity of protein production. Current optimization strategies have integrated (1) molecular engineering (e.g., modified nucleotides), (2) advanced delivery systems (e.g., lipid nanoparticles), and (3) adjuvant drug synergy. This review focuses on co-delivered adjuvant drugs and introduces the concept of "mRNA translation boosters" for the first time. mRNA translation boosters are classified as small-molecule compounds and macromolecular agents that improve translational fidelity through mechanisms including blockade of pattern recognition receptors, modulation of inflammatory cascades, facilitation of endosomal escape, and protection against enzymatic degradation. As clinically validated with COVID-19 mRNA vaccines, these boosters have now demonstrated expanded utility in gene editing therapies and protein replacement applications. This review addresses the immunological challenges encountered during mRNA transfection and translation while summarizing existing mRNA translation boosters that optimize protein expression kinetics. By establishing a mechanistic framework for booster selection and employment, this work provides translational guidance for advancing nucleic acid therapeutics towards their maximum clinical potential.},
}

@article {pmid41810312,
year = {2026},
author = {Lihemo, G and Blunt, M and Dadari, I and Underwood, T and Ochoa Toasa, AE and Velias, A and Hopkins, KL and Thomson, A and Kanwagi, R and Gillespie, A and Pokharel, DR and Singh, S},
title = {The impact of COVID-19 on general vaccine acceptance in low- and middle-income countries: a systematic review.},
journal = {Frontiers in public health},
volume = {14},
number = {},
pages = {1764389},
pmid = {41810312},
issn = {2296-2565},
mesh = {Humans ; *COVID-19/prevention & control/epidemiology ; *Vaccination Hesitancy/psychology/statistics & numerical data ; *Developing Countries ; *COVID-19 Vaccines/administration & dosage ; *Patient Acceptance of Health Care/psychology ; *Vaccination/psychology/statistics & numerical data ; },
abstract = {BACKGROUND: The COVID-19 pandemic caused a major decline in childhood vaccination, especially in low- and middle-income countries (LMICs). However, its specific impact on vaccine hesitancy in the immediate post-pandemic years, particularly toward non-COVID-19 vaccines, remains unclear. Understanding the social and behavioral factors influencing vaccine acceptance following a public health emergency such as the COVID-19 pandemic is critical to improving immunization coverage. This systematic review examined the impact of the COVID-19 pandemic on general vaccine acceptance in LMICs to inform strategies to improve vaccine uptake.

METHODS: This systematic review assessed people's thinking and feeling, motivations, practical issues, and social processes around vaccination, conceptualized by the World Health Organization's Behavioural and Social Drivers framework. Studies were included if they were interventional or observational in design, examined the impact of the COVID-19 pandemic on vaccine hesitancy or acceptance for non-COVID-19 vaccines, and were published in English between 2020 and 2023.

RESULTS: A total of 23 studies were included in the review, with most studies conducted in middle-income settings and focused on healthcare workers or parents/caregivers of children. Findings belonging to the "Thinking and Feeling" category were the most commonly reported in 91% (n = 21/23) of studies. Over half (61%) of studies reported findings relating to the 'Motivation' construct, while 43% of studies reported outcomes related to 'Practical Issues' and 'Social Processes'. Studies reported both increases and decreases in vaccine hesitancy and intention to vaccinate due to the pandemic. Overall, studies most commonly reported that the COVID-19 pandemic had a negative or neutral effect on attitudes, intentions, and actions regarding vaccine acceptance.

CONCLUSION: This systematic review illustrates how the COVID-19 pandemic influenced vaccine acceptance and decision-making in complex, context-dependent ways, impacting people's thinking and feeling, motivations, practical issues, and social processes around vaccination. The findings highlight the need to understand the specific drivers of vaccine acceptance to design more effective, targeted strategies to improve immunization uptake. The insights from this study can be used to inform evidence-based vaccination catch-up strategies to regain pandemic losses and mitigate factors that deter individuals from seeking vaccination.},
}

Humans
*COVID-19/prevention & control/epidemiology
*Vaccination Hesitancy/psychology/statistics & numerical data
*Developing Countries
*COVID-19 Vaccines/administration & dosage
*Patient Acceptance of Health Care/psychology
*Vaccination/psychology/statistics & numerical data

@article {pmid41810466,
year = {2026},
author = {Egorova, VS and Kolesova, EP and Voronina, MV and Denisova, ER and Syrocheva, AO and Pallaeva, T and Hakemi, MG and Zamyatnin, AA and Ivanov, KI and Kostyushev, D and Brezgin, S and Kostyusheva, A and Parodi, A},
title = {From bench to bedside: Unveiling the background and benefits of nanovaccines tested in clinics.},
journal = {Asian journal of pharmaceutical sciences},
volume = {21},
number = {1},
pages = {101116},
pmid = {41810466},
issn = {2221-285X},
abstract = {Despite the growing body of literature on nanovaccines, focused analyses of platforms tested in and undergoing clinical investigation remain limited. This review addresses this gap by critically examining recent advancements and highlighting nanovaccine technologies that have undergone human clinical trials. Using an extensive search on clinicaltrials.org, we explored the diverse applications of nanovaccines, including leading SARS-CoV-2 candidates and platforms targeting other infectious diseases and cancers. We also highlighted foundational research that has enabled clinical investigation of nanovaccines over the past decade, highlighting their potential to address a range of medical conditions. While many technologies have been developed to combat SARS-CoV-2, several key innovations targeted a broader spectrum of diseases. This review details these technologies, focusing on their materials and mechanisms of action in inducing immune protection, while also exploring how nanomedicine facilitates nanovaccine development and introduces novel adjuvant concepts. Finally, we provided a retrospective analysis of the development journey of these platforms, offering insights into the intellectual and technological efforts behind their clinical translation. By bridging the gap between research and application, this review aims to give readers a comprehensive understanding of how nanovaccines progress from the laboratory to clinical practice.},
}

@article {pmid41812294,
year = {2026},
author = {Shaver, N and Colijn, C and Heffernan, J and Asamoah, GD and Piggott, T and Cooper, C and Bagheri, S and Crawley, AM and Kagina, BM and Bowdish, DME and Langlois, MA and Little, J},
title = {Lack of harmonisation in immunological data: challenges in synthesising data during the COVID-19 pandemic.},
journal = {EBioMedicine},
volume = {126},
number = {},
pages = {106204},
pmid = {41812294},
issn = {2352-3964},
mesh = {Humans ; *COVID-19/immunology/epidemiology/prevention & control/virology ; *SARS-CoV-2/immunology ; Pandemics ; *COVID-19 Vaccines/immunology ; Immunogenicity, Vaccine ; },
abstract = {The COVID-19 pandemic drove the rapid development of assays to ascertain immune responses, and laboratories were required to adapt to difficult and quickly changing circumstances. While flexibility and innovation were essential, they also introduced heterogeneity in methods, reagents, and reporting practices between labs. This lack of harmonisation made it difficult to compare findings across studies, slowing evidence synthesis, and limiting the usefulness of data for modelling efforts and policy guidance. Drawing on our team's experience synthesising and modelling vaccine immunogenicity data during the pandemic, we discuss the long-term challenges of standardising human immunology research that were highlighted by the COVID-19 pandemic. We argue that vaccine immunogenicity studies require standardised reporting and quality assessment tools. We propose practical solutions to support comparability of laboratory-based practices, while preserving methodological diversity. By implementing changes before the next public health crisis, future research can avoid waste, strengthen certainty, and maximise policy and practice impact.},
}

Humans
*COVID-19/immunology/epidemiology/prevention & control/virology
*SARS-CoV-2/immunology
Pandemics
*COVID-19 Vaccines/immunology
Immunogenicity, Vaccine

@article {pmid41813354,
year = {2026},
author = {Silva, AL and Segundo, MA and Prior, JAV},
title = {Advances in virus detection using carbon and quantum dot technologies: a review.},
journal = {Analytica chimica acta},
volume = {1398},
number = {},
pages = {345252},
doi = {10.1016/j.aca.2026.345252},
pmid = {41813354},
issn = {1873-4324},
mesh = {*Quantum Dots/chemistry ; *Carbon/chemistry ; *Biosensing Techniques/methods ; Humans ; *Viruses/isolation & purification ; SARS-CoV-2/isolation & purification ; },
abstract = {BACKGROUND: The diagnosis of viral infections still depends largely on traditional lab methods like PCR and ELISA, which are often costly, time-consuming, and unsuitable for large-scale or low-resource testing. Because of these issues, researchers are exploring new approaches using nanotechnology. Quantum dots (QDs) and carbon dots (CDs) are two types of fluorescent nanodots with special optical and surface properties, becoming promising tools for detecting viruses. However, their different physical and chemical characteristics, biocompatibility, and integration potential lead to distinct analytical performances, highlighting the need for a comparative assessment of their applicability in viral biosensing.

RESULTS: This review systematically analyses recent advances in QD- and CD-based biosensors for viral detection, covering both nucleic acid- and protein-based assays. QDs show advanced techniques, with integration into fluorescence, FRET, ECL, PEC, and lateral-flow formats, enabling multiplexed detection of several viruses, including dengue, HAV, HBV, and SARS-CoV-2. In contrast, CDs are mainly used for single-target fluorescence or electrochemical assays, indicating they are in an earlier stage of development. Comparative studies reveal that QDs-based viral assays can detect targets such as HIV-1 nucleic acids at levels as low as 6.5 × 10[-16] M, which is generally one order of magnitude lower than CDs, though the latter show better biocompatibility and stability. QDs offer a wider range of sensitivity and performance, while CDs provide safer, simpler, and more sustainable sensing options. These differing features define their unique analytical roles and potential for practical use.

SIGNIFICANCE: By bringing together findings from recent literature studies, this review bridges fundamental nanochemistry with practical virus diagnostics. It explains how QDs and CDs contribute differently to sensitivity, multiplexing, and biosensor integration, providing guidance for selecting suitable nanomaterials in analytical design. The comparative insights highlight pathways for developing cost-effective, safe, and portable viral detection platforms, supporting the transition of nanodot-based assays from the laboratory to clinical and field applications.},
}

*Quantum Dots/chemistry
*Carbon/chemistry
*Biosensing Techniques/methods
Humans
*Viruses/isolation & purification
SARS-CoV-2/isolation & purification

@article {pmid41813522,
year = {2026},
author = {Davidson, M and Schnell, N and Sickbert-Bennett, E},
title = {Optimizing Hand Hygiene Compliance.},
journal = {Infectious disease clinics of North America},
volume = {40},
number = {2},
pages = {269-282},
doi = {10.1016/j.idc.2025.12.005},
pmid = {41813522},
issn = {1557-9824},
mesh = {Humans ; *Hand Hygiene/standards/methods ; *COVID-19/prevention & control ; *Guideline Adherence ; *Infection Control/methods/standards ; SARS-CoV-2 ; *Cross Infection/prevention & control ; Hand Disinfection ; },
abstract = {Although hand hygiene is considered a fundamental defense against infection spread, maintaining high, consistent compliance remains an ongoing challenge. Even after the COVID-19 pandemic placed hand hygiene in the spotlight, initially high compliance levels dropped, facilitating the spread of multidrug-resistant pathogen transmission in some settings. This article details the various methodologies for monitoring hand hygiene with diverse solutions for feedback. Ultimately, infection preventionists and hospital epidemiologists must consider what will be most effective for their facility when determining how to optimize hand hygiene based on the capabilities, opportunities, and motivations of their staff.},
}

Humans
*Hand Hygiene/standards/methods
*COVID-19/prevention & control
*Guideline Adherence
*Infection Control/methods/standards
SARS-CoV-2
*Cross Infection/prevention & control
Hand Disinfection

@article {pmid41814505,
year = {2026},
author = {Tovar, V and Sánchez, IP and Rugeles, MT and Taborda, NA and Hernandez, JC},
title = {Cellular Immune Response Induced by mRNA Vaccines Against SARS-CoV-2.},
journal = {Immunity, inflammation and disease},
volume = {14},
number = {3},
pages = {e70375},
pmid = {41814505},
issn = {2050-4527},
support = {//Universidad Cooperativa de Colombia/ ; //Corporación Universitaria Remington/ ; //Universidad de Antioquia/ ; },
mesh = {Humans ; *SARS-CoV-2/immunology ; *COVID-19/immunology/prevention & control ; *COVID-19 Vaccines/immunology ; *Immunity, Cellular ; mRNA Vaccines/immunology ; *T-Lymphocytes/immunology ; Vaccines, Synthetic/immunology ; },
abstract = {The disease caused by SARS-CoV-2 is known as COVID-19, and it can range from mild symptoms to severe clinical manifestations, including respiratory failure, pneumonia, and organ failure. Since its emergence in 2019, more than 7 million deaths have been reported worldwide. Vaccines have been the most effective strategy for preventing severe illness and death in patients who acquire the infection. Vaccines induce both humoral and cell-mediated immune responses; the latter is crucial in the immune response against SARS-CoV-2, as the effector mechanisms of T-cells are less affected by the high mutation rate of the virus and prevail through memory phenotypes, ensuring long-term protection. mRNA vaccines have been primarily used worldwide to control the COVID-19 pandemic. This platform can protect against different circulating variants and is characterized by generating a robust T-cell response. This review discusses the immune response of T-cells induced by mRNA vaccines against SARS-CoV-2. It explores their effect on different population groups, including people with special clinical conditions, such as cancer and organ transplant recipients with a compromised immune system.},
}

Humans
*SARS-CoV-2/immunology
*COVID-19/immunology/prevention & control
*COVID-19 Vaccines/immunology
*Immunity, Cellular
mRNA Vaccines/immunology
*T-Lymphocytes/immunology
Vaccines, Synthetic/immunology

@article {pmid41814520,
year = {2026},
author = {Avila, T and Jefferies, D and Ramjan, LM},
title = {The Impact, Role and Experiences of Nurses Working in Medical Quarantine During the COVID-19 Pandemic: A Narrative Review.},
journal = {Nursing open},
volume = {13},
number = {3},
pages = {e70463},
pmid = {41814520},
issn = {2054-1058},
mesh = {Humans ; *COVID-19/nursing/epidemiology/prevention & control ; *Quarantine/psychology ; *Nurse's Role/psychology ; SARS-CoV-2 ; Pandemics ; *Nurses/psychology ; },
abstract = {AIM: To understand the impact, role and experience of nurses working in medical hotel quarantine during the COVID-19 pandemic.

BACKGROUND: Medical Hotel Quarantine was staffed predominantly by nurses to prevent the spread of COVID-19 when people who were COVID-19 positive were unable to isolate safely in their communities.

REVIEW METHODS: A narrative review was conducted to understand how nurses made meaning of their experience. Seven databases were searched (Google Scholar, CINAHL, COCHRANE, MEDLINE, Joanna Briggs Institute, PsychInfo and Scopus) following the PRISMA Methodological Guideline (between August 2021 and January 2022). A summary table was developed with the headings: author and year, country, study design and data collection, participants, critical appraisal rating and results. Using a Critical Realist lens, the data were analysed using thematic analysis and a stratified ontology of the Real, the Actual and the Empirical domains in medical hotel quarantine to understand how the complex nature of nursing care worked within this unique environment.

RESULTS: Nurses were pivotal to the success of medical hotel quarantine. The Critical realist lens demonstrated how this was a stressful environment as health information was updated and policies and requirements changed. Although there were reports of stigma outside work, many nurses reported that they felt a sense of duty caring for patients experiencing isolation.

DISCUSSION: There is little research about nurses working in medical hotel quarantine during COVID-19.

CONCLUSION: Further research is required to understand how nurses managed these facilities to protect the community when future pandemics occur.

It is important that the lessons from medical hotel quarantine are recorded so that future nurses can be guided by the experience of nurses who worked in hotel quarantine if they are required to work in this unique area of practice.},
}

Humans
*COVID-19/nursing/epidemiology/prevention & control
*Quarantine/psychology
*Nurse's Role/psychology
SARS-CoV-2
Pandemics
*Nurses/psychology

@article {pmid41814525,
year = {2026},
author = {Schoene, D and Deckert, S and Barlinn, K and Huttner, HB and Kösters, M and Siepmann, T},
title = {Neurocardiac Autonomic Dysfunction in Patients With Post-COVID-19 Condition: A Systematic Review and Meta-Analysis.},
journal = {European journal of neurology},
volume = {33},
number = {3},
pages = {e70561},
pmid = {41814525},
issn = {1468-1331},
mesh = {Humans ; *COVID-19/complications/physiopathology ; *Heart Rate/physiology ; *Autonomic Nervous System Diseases/physiopathology/etiology ; SARS-CoV-2 ; Pandemics ; },
abstract = {BACKGROUND: Neurocardiac autonomic impairment with reduced heart rate variability (HRV) has been linked to SARS-CoV-2 infection and may persist in patients with post-COVID-19 syndrome. We synthesised meta-analytic data on HRV in post-COVID-19 syndrome.

METHODS: Our systematic review and meta-analysis were guided by PRISMA standards. We used MEDLINE, Embase and Web of Science to identify non-randomised studies of HRV in patients with post-COVID-19 syndrome, conducted more than 3 months after infection and compared with healthy controls. The search covered the period from 01/2020 to 09/2023. We pooled data on the following HRV parameters: standard deviation of normal-to-normal intervals (SDNN), root mean square of successive differences (rMSSD) and low-frequency to high-frequency ratio (LF/HF ratio). We applied a random effects model to account for heterogeneity. Risk of bias was assessed.

RESULTS: From 856 initially identified records, we included 11 studies with a total of 1162 participants (593 post-COVID-19 patients and 565 healthy controls). We observed a trend toward lower HRV in post-COVID patients compared to controls, with small to medium effects for SDNN (SMD: 0.26, 95% CI: -0.03 to 0.56, p = 0.09), rMSSD (SMD: 0.11, 95% CI: -0.15 to 0.36, p = 0.41) and LF/HF ratio (SMD: -0.271, 95% CI: -0.61 to 0.07, p = 0.12). Moderate to high statistical heterogeneity of the effects was observed (I[2] = 83% for SDNN and 78% for rMSSD) and nine of 11 studies had a high risk of bias.

CONCLUSION: This meta-analysis suggests a possible association between post-COVID condition and alterations in neurocardiac autonomic function.},
}

Humans
*COVID-19/complications/physiopathology
*Heart Rate/physiology
*Autonomic Nervous System Diseases/physiopathology/etiology
SARS-CoV-2
Pandemics

@article {pmid41814585,
year = {2026},
author = {Caliman-Sturdza, OA and Gheorghita, R and Lobiuc, A and Filip, R and Soldanescu, I and Mangul, S and Dimian, M},
title = {Management of long COVID-19 in children and adolescents: from diagnosis to therapeutically approaches.},
journal = {Annals of medicine},
volume = {58},
number = {1},
pages = {2642510},
pmid = {41814585},
issn = {1365-2060},
mesh = {Humans ; *COVID-19/therapy/complications/diagnosis ; Child ; Adolescent ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; },
abstract = {INTRODUCTION: Long Coronavirus disease 2019 (COVID-19), also termed post-acute sequelae of severe acute respiratory syndrome coronavirus 2 infection (PASC), has emerged as a complex multisystem condition in children and adolescents worldwide. It can occur even after mild or asymptomatic acute infections, with symptoms that may persist, fluctuate, or relapse over time. This review aims to comprehensively explore the characteristic manifestations, management and current therapeutic possibilities of pediatric Long COVID-19 (L-C19).

METHODS: A systematic search was conducted in multiple databases such as PubMed, Scopus, Web of Science, and Google Scholar, for literature published between January 2020 and October 2025.

RESULTS: Diagnosing pediatric L-C19 is challenging due to the heterogeneity of symptoms and lack of specific diagnostic biomarkers. Most young patients experience gradual improvement over months, but a significant subset remains symptomatic for >1 year with substantial disability, underscoring the need for timely diagnosis and intervention. Current clinical consensus emphasizes an individualized, multidisciplinary management approach focused on symptom relief and functional rehabilitation. No definitive cure exists for L-C19; thus, care is tailored to each patient's predominant issues. Therapeutic strategies combine supportive self-management (e.g. energy conservation and pacing) with both non-pharmacological and pharmacological interventions. Multimodal rehabilitation programs - including graded exercise therapy and cognitive behavioral therapy - have shown promise in improving fatigue, mental health, and overall quality of life. Targeted treatments for specific sequelae (such as autonomic dysfunction or chronic pain) are applied on a case-by-case basis, although high-quality evidence for medications remains limited. Globally, interdisciplinary collaborations have been established to provide harmonized diagnostic and treatment protocols, and major research initiatives are underway to evaluate novel therapies and include children in L-C19 clinical trials.

CONCLUSION: Ongoing international efforts to develop standardized diagnostic tools, outcome measures, and evidence-based interventions are crucial to optimize care and long-term outcomes for children and adolescents affected by L-C19.},
}

Humans
*COVID-19/therapy/complications/diagnosis
Child
Adolescent
SARS-CoV-2
Post-Acute COVID-19 Syndrome

@article {pmid41814863,
year = {2026},
author = {Fix, J and Lee, S and Nachbar, J and Sadadia, P and Lövgren Bengtsson, K and Stertman, L and Palm, AE and Walker, R and Draghia Akli, R and Sellers, S},
title = {Safety of Matrix-M-adjuvanted COVID-19, seasonal influenza, combination influenza-COVID-19, and malaria vaccines: a review of the evidence.},
journal = {Expert review of vaccines},
volume = {25},
number = {1},
pages = {2638828},
doi = {10.1080/14760584.2026.2638828},
pmid = {41814863},
issn = {1744-8395},
mesh = {Humans ; *Influenza Vaccines/adverse effects/immunology/administration & dosage ; *Adjuvants, Immunologic/administration & dosage/adverse effects ; *COVID-19 Vaccines/adverse effects/immunology/administration & dosage ; *Malaria Vaccines/adverse effects/administration & dosage/immunology ; *COVID-19/prevention & control/immunology ; *Influenza, Human/prevention & control/immunology ; *Adjuvants, Vaccine/administration & dosage/adverse effects ; Saponins/administration & dosage/adverse effects ; },
abstract = {INTRODUCTION: The saponin-based Matrix-M adjuvant induces potent and durable immunity through producing long-lasting memory B-cells and broad-based T-cell immunity, across a variety of vaccine platforms. Matrix-M-adjuvanted vaccines have a history of successful development for protection against a broad range of infectious diseases with high public health urgency. Two authorized Matrix-M-adjuvanted vaccines, NUVAXOVID (COVID-19) and R21/Matrix-M (Plasmodium falciparum malaria), have been administered to >10 million people worldwide.

AREAS COVERED: This review is a comprehensive evaluation of published reactogenicity and safety data from 66 clinical trials and post-marketing studies of Matrix-M-adjuvanted COVID-19, seasonal influenza, combination COVID-19-influenza (CIC), and malaria vaccines retrieved from PubMed and Embase with no restricted start date and last search on 1 November 2025.

EXPERT OPINION: 64,101 participants received ≥1 Matrix-M-adjuvanted vaccine dose (143,170 doses): 55,939 COVID-19, 2477 influenza, 1422 CIC, and 4263 malaria vaccines. All authorized and candidate vaccines within each disease area were well-tolerated, including among a wide geographical distribution, immunocompromised populations, and children. Active-comparator clinical trials and post-marketing studies demonstrate favorable reactogenicity profiles of Matrix-M-adjuvanted vaccines versus licensed vaccines for the same diseases, particularly, lower reactogenicity rates post-NUVAXOVID versus mRNA COVID-19 vaccination. Research is ongoing to better characterize Matrix-M immune-stimulating mechanisms, continue technology improvements, and identify new applications to enhance vaccines and therapeutics.},
}

Humans
*Influenza Vaccines/adverse effects/immunology/administration & dosage
*Adjuvants, Immunologic/administration & dosage/adverse effects
*COVID-19 Vaccines/adverse effects/immunology/administration & dosage
*Malaria Vaccines/adverse effects/administration & dosage/immunology
*COVID-19/prevention & control/immunology
*Influenza, Human/prevention & control/immunology
*Adjuvants, Vaccine/administration & dosage/adverse effects
Saponins/administration & dosage/adverse effects

@article {pmid41815827,
year = {2026},
author = {Nath, D and Al Noman, A and Pradhan, S and Sharma, PD and Ahmed, S and Begum, F and Al Hafiz, M and Abdallah, EM},
title = {Receptor-mediated mechanisms underlying neurological complications in COVID-19: from viral entry to neuroinflammation.},
journal = {3 Biotech},
volume = {16},
number = {4},
pages = {128},
pmid = {41815827},
issn = {2190-572X},
abstract = {Neurological complications of COVID-19 encompass acute syndromes and persistent post-acute sequelae, yet their mechanistic basis remains incompletely defined. Integrated clinical, neuropathological, neuroimaging, and molecular evidence indicates that SARS-CoV-2-associated neurological injury is driven predominantly by receptor-mediated immune and vascular mechanisms rather than widespread productive central nervous system infection. Angiotensin-converting enzyme 2 (ACE2) remains the principal viral entry receptor, while neuropilin-1 (NRP1) facilitates neurovascular and olfactory access in specific contexts. In contrast, CD147 and dipeptidyl peptidase-4 (DPP4) appear to exert indirect modulatory roles through endothelial dysfunction and immune activation rather than acting as dominant neurotropic entry receptors. Toll-like receptors, particularly TLR2, TLR4, and TLR7, amplify neuroinflammatory signaling and contribute to blood-brain barrier disruption, microvascular injury, and sustained microglial activation. Cerebrospinal fluid biomarkers and neuroimaging findings consistently support a dual-pathway model combining limited direct viral presence with predominant immune-mediated injury. Current therapeutic strategies targeting receptor-mediated entry and neuroinflammation remain largely investigational, underscoring the need for biomarker-guided and phase-specific interventions. These findings refine the mechanistic framework of NeuroCOVID and identify translational priorities for acute and long-term neurological management.},
}

@article {pmid41816346,
year = {2026},
author = {Liu, L and Zhao, H and Qiao, J and Liu, N and Tao, W and Wei, S},
title = {Relationship between COVID-19 and "three inflammations and one deafness": a systematic review and meta-analysis.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1690788},
pmid = {41816346},
issn = {1664-3224},
mesh = {Humans ; *COVID-19/epidemiology/complications ; *SARS-CoV-2 ; *Deafness/epidemiology ; *Inflammation ; *Tinnitus/epidemiology ; *Otitis Media/epidemiology ; *Rhinitis, Allergic/epidemiology ; },
abstract = {BACKGROUND: The relationship between "three inflammations and one deafness" (allergic rhinitis, pharyngitis, otitis media, tinnitus, and deafness) and coronavirus disease 2019 (COVID-19) is currently unclear, and this study aims to investigate their correlation.

METHODS: We searched the relevant literature in three databases (Embase, Cochrane Library, and PubMed) from their inception through July 2024, and the investigator strictly reviewed the literature according to the screening criteria to determine the included studies. We extracted relevant data information and conducted quality assessment and meta-analysis.

RESULTS: From 5,950 records screened, five cohort studies were included. The pooled analysis using a random-effects model showed no statistically significant association between COVID-19 and "three inflammations and one deafness" (OR = 1.03, 95% CI: 0.85-1.26, P = 0.74), with substantial heterogeneity (I² = 89%, P < 0.001). Critically, subgroup analyses revealed that the diagnostic criteria for "three inflammations and one deafness" were a key source of this heterogeneity. A significant association was observed in studies using physician-diagnosed outcomes (OR = 1.30, 95% CI: 1.08-1.56, P = 0.006, I² = 0%), whereas no significant association was found in studies based on self-reported symptoms (OR = 0.89, 95% CI: 0.69-1.15, P = 0.38, I² = 96%). Analyses by specific conditions yielded mixed results: No significant association was observed for hearing loss (OR = 0.93, 95% CI: 0.69-1.25, P = 0.62). For allergic rhinitis (OR = 1.19, 95% CI: 0.47-3.02, P = 0.71) and tinnitus (OR = 1.11, 95% CI: 0.88-1.39, P = 0.38), the point estimates suggested potential positive trends, but the associations were not statistically significant, and confidence intervals were wide. Subgroup analyses by some regions and COVID-19 diagnostic criteria did not reveal consistent significant associations.

CONCLUSIONS: This meta-analysis found no consistent association between COVID-19 and "three inflammations and one deafness," primarily due to significant heterogeneity. Evidence suggests a link between COVID-19 and physician-diagnosed "three inflammations and one deafness," which strongly depends on the rigor of outcome assessment, highlighting the need for standardized clinical diagnoses in future research.

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023438076.},
}

Humans
*COVID-19/epidemiology/complications
*SARS-CoV-2
*Deafness/epidemiology
*Inflammation
*Tinnitus/epidemiology
*Otitis Media/epidemiology
*Rhinitis, Allergic/epidemiology

@article {pmid41816349,
year = {2026},
author = {González-Rivera, L and Luna-Gutiérrez, R and Cárdenas, S and Merino-González, C and Handy, A and Pepper, I and López, MN},
title = {Regulatory T cells in hypoxic environments.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1755928},
pmid = {41816349},
issn = {1664-3224},
mesh = {Humans ; *T-Lymphocytes, Regulatory/immunology/metabolism ; *Hypoxia/immunology/metabolism ; Animals ; Cell Differentiation ; Cellular Microenvironment/immunology ; },
abstract = {Oxygen availability is considered as an important determinant of immune regulation, yet its impact on regulatory T cells remains incompletely understood. In this review, we synthesize current evidence on how chronic and intermittent hypoxia influence the differentiation, stability and function of regulatory T cells across diverse physiological and pathological settings. We describe the main cellular pathways engaged during hypoxic adaptation, with emphasis on the role of hypoxia-inducible factors in shaping regulatory T cell metabolism and lineage integrity. We then evaluate findings from clinical contexts characterized by sustained or cyclical oxygen deprivation, including chronic lung disease, sleep-disordered breathing and severe viral infection. Across these conditions, hypoxia is associated with alterations in regulatory T cell phenotype and its suppressive function, although patterns vary according to microenvironment and disease stage. A clearer understanding of how distinct hypoxic patterns modulate regulatory T cell biology will be essential for identifying therapeutic strategies aimed at restoring immune balance in hypoxia-associated disease.},
}

Humans
*T-Lymphocytes, Regulatory/immunology/metabolism
*Hypoxia/immunology/metabolism
Animals
Cell Differentiation
Cellular Microenvironment/immunology

@article {pmid41816409,
year = {2026},
author = {Chai, X and Qi, H and Liu, X and Zhou, F and Jiang, Y and Wu, M and Lian, S and Wang, L and Bao, Y},
title = {A narrative review of SARS-CoV-2 variants and long COVID.},
journal = {Journal of thoracic disease},
volume = {18},
number = {2},
pages = {164},
pmid = {41816409},
issn = {2072-1439},
abstract = {BACKGROUND AND OBJECTIVE: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since the onset of the pandemic, there has been a continuous rise in cases of both COVID-19 and long COVID. It is acknowledged that long COVID is a multisystem disorder with a wide range of symptoms; its primary symptoms and indicators include fatigue, dyspnea, anosmia, myalgia, cough, and hyposmia. SARS-CoV-2 has continuously evolved since the wild strain first appeared, resulting in numerous genetic variants. These strains exhibit significant differences in terms of pathogenicity and immune evasion. Key scientific questions remain regarding whether and how these variations influence the development and clinical course of long COVID. This review aims to examine associations between SARS-CoV-2 strains and long COVID, synthesize current evidence, identify research gaps, and provide recommendations for subsequent rehabilitation treatments.

METHODS: Literature searches were conducted using PubMed, focusing on publications from January 2020 to August 2025. Relevant literature on long COVID and SARS-CoV-2 variants was systematically reviewed and summarized, and included in this review.

KEY CONTENT AND FINDINGS: This review highlights the ongoing genetic evolution of SARS-CoV-2 as a key temporal dynamic during the pandemic. Different SARS-CoV-2 variants result in varying severity of long COVID. Anti-inflammatory treatments demonstrate significant efficacy for long COVID patients. COVID-19 vaccination prior to SARS-CoV-2 infection reduces the risk of long COVID, and another successful treatment option for persistent COVID symptoms is physical therapy.

CONCLUSIONS: Long COVID remains a significant public health challenge. The relationship between SARS-CoV-2 variants and long COVID requires further elucidation. This condition may cause significant economic and medical burdens in the future. To completely protect the physical and mental health of long COVID patients, it is essential to broaden therapeutic options and create individualized therapy programs. Therefore, understanding the connection between long COVID and SARS-CoV-2 variants is crucial. Based on this knowledge, effective strategies must be designed to empower individuals in proactively addressing and managing long COVID.},
}

@article {pmid41817243,
year = {2026},
author = {Ragagnin, K and da Silva-Oolup, S and Yu, H and Balaji, S and Côté, P and Hogg-Johnson, S and Murnaghan, K and Wong, JJ},
title = {Burden and Associated Factors of Unmet Health Care Needs in Individuals With Osteoarthritis: A Systematic Review.},
journal = {ACR open rheumatology},
volume = {8},
number = {3},
pages = {e90007},
doi = {10.1002/acr2.90007},
pmid = {41817243},
issn = {2578-5745},
abstract = {OBJECTIVE: This systematic review aimed to describe the prevalence, incidence, and associated factors of unmet health care needs among adults with osteoarthritis.

METHODS: We searched Medline (Ovid), Embase (Ovid), CINAHL (EBSCO), and PsycINFO (Ovid) from inception through May 15, 2024. Eligible studies were cross-sectional, cohort, and case-control studies investigating the prevalence, incidence, associated factors, or risk factors of unmet health care needs in adults with osteoarthritis. We restricted to articles published in English, French, Italian, and Chinese for feasibility. Reviewers independently screened articles, assessed risk of bias using the Joanna Briggs Institute Checklists, and extracted data. We descriptively synthesized results from low/moderate risk-of-bias studies, stratifying results by age (<60 vs ≥60 years).

RESULTS: Of 3,589 citations screened, 7 cross-sectional studies with low/moderate risk-of-bias were included in the synthesis (3 from South Korea, 4 from the United States). In South Korea, the 12-month prevalence of unmet health care needs was 31.6% (95% confidence interval [CI] 29.9%-33.3%) among adults aged ≥50 years with osteoarthritis and 31% (95% CI 30.9%-31.1%) among those aged ≥65 years with arthritis. In the United States, the 12-month prevalence of unmet needs in the general population due to unaffordability ranged from 15% to 30% in adults with osteoarthritis or arthritis. Prevalence was higher among those who exclusively used complementary and alternative medicine and varied during the COVID-19 pandemic, peaking in the summer of 2020. Evidence suggests that unmet needs are associated with lower income, no insurance, and activity limitations.

CONCLUSION: Unmet health care needs are common in adults with osteoarthritis, particularly those facing socioeconomic disadvantages or functional limitations. Given the paucity of high-quality studies, additional research is needed.},
}

@article {pmid41818779,
year = {2026},
author = {Greco, AA and Faiz, SA and Kaul, V and Reitzner, J and MacGregor, D and Garbarino, A and , },
title = {Best practices from the Association of Pulmonary and Critical Care Medicine Program Directors for social media use with emphasis on virtual recruitment.},
journal = {ATS scholar},
volume = {7},
number = {1},
pages = {67-73},
pmid = {41818779},
issn = {2690-7097},
mesh = {*Social Media ; Humans ; *Personnel Selection/methods ; COVID-19/epidemiology ; *Pulmonary Medicine/education ; *Critical Care ; SARS-CoV-2 ; },
abstract = {Since the COVID-19 pandemic, the need to develop innovative strategies for virtual engagement and interaction has emerged. There has been a growing emphasis on online recruitment strategies for most medical specialties. For the last several interview seasons, many national organizations have recommended that fellowship interviews be conducted virtually for all applicants. Social media represents a powerful tool for both the program and the applicants. However, there remains a paucity of data published on social media use for virtual recruitment in pulmonary and critical care medicine (PCCM). Here, we review the available data for virtual recruitment and propose best practices for PCCM programs. Our social media strategy outlines specific and practical steps that form the framework for a social media charter including defining the goal and audience, following institutional guidelines, choosing appropriate platform(s), identifying and defining an account management plan, devising a strategy for content generation and posting, and continuing to reassess and optimize the process. Our best practices provide a practice framework for PCCM programs, both novice and advanced, for social media use. They also emphasize a need for more research on social media's impact on future recruitment cycles while providing a better understanding of current practices for applicant program selection and virtual recruitment.},
}

*Social Media
Humans
*Personnel Selection/methods
COVID-19/epidemiology
*Pulmonary Medicine/education
*Critical Care
SARS-CoV-2

@article {pmid41818888,
year = {2026},
author = {Paudel, KR and Hegarty, KJ and Shrestha, J and Budden, KF and Awatade, NT and Sadaf, T and Malyla, V and Waters, S and Papagianis, PC and Bourke, JE and Wark, PA and Hansbro, PM},
title = {Innovative methodologies for elucidating bushfire smoke-induced pathophysiological mechanism.},
journal = {The Science of the total environment},
volume = {1025},
number = {},
pages = {181645},
doi = {10.1016/j.scitotenv.2026.181645},
pmid = {41818888},
issn = {1879-1026},
mesh = {*Smoke/adverse effects ; Humans ; COVID-19 ; Animals ; *Air Pollutants/adverse effects ; *Wildfires ; SARS-CoV-2 ; },
abstract = {Over the last century, the awareness of air pollution awareness and its harm to public health have resulted in the implementation of new protective measures to try and limit exposure. Bushfires generate waves of air pollution with orders of magnitudes higher than normal background pollution, necessitating studies to understand the physiological impact. Previous work has strongly linked bushfire smoke to respiratory disease (chronic obstructive pulmonary disease COPD, asthma, lung cancer) cardiovascular disease (myocardial infarction, stroke), and increased susceptibility to infection (COVID-19). Nevertheless, the underlying mechanisms of pathogenesis remain unclear. There is little consensus on what in vitro and in vivo techniques are best used to examine disease mechanisms. Individual investigations are useful but a lack of standard methods creates variability and makes comparisons difficult. Developing adaptable in vitro and in vivo models that are replicable, physiologically relevant, and affordable may reduce variability enabling comparisons. These models should also be capable of integrating multiple types of pollutants or reference materials to develop standards that other studies can follow, facilitating comparisons. Here, we discuss advance in vitro and in vivo experimental models to study the impact of bushfire smoke exposure induced pathophysiology. The goal is to improve comparison and translation across studies, and to lay the groundwork for future research into the mechanisms that underpin bushfire smoke-induced pathogenesis to enable the development of preventative measures and effective therapies.},
}

*Smoke/adverse effects
Humans
COVID-19
Animals
*Air Pollutants/adverse effects
*Wildfires
SARS-CoV-2

@article {pmid41819160,
year = {2026},
author = {Lugtu, EJ and Iv, DYP and Cabunoc, MH and Bautista, JL and Pleta, FM and Ng, JA and Shahid, F and Carandang, THDC and Lippi, G and Henry, BM and Fernández-de-Las-Peñas, C and Notarte, KI},
title = {Prevalence of post-COVID symptoms across variants of concern and follow-up periods: A systematic review and meta-analysis.},
journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases},
volume = {166},
number = {},
pages = {108522},
doi = {10.1016/j.ijid.2026.108522},
pmid = {41819160},
issn = {1878-3511},
mesh = {Humans ; *COVID-19/epidemiology/complications/virology ; Prevalence ; *SARS-CoV-2/pathogenicity ; Fatigue/epidemiology ; Post-Acute COVID-19 Syndrome ; Adult ; Dyspnea/epidemiology ; },
abstract = {OBJECTIVES: The interaction between SARS-CoV-2 variants of concern (VoC) and post-COVID symptom duration remains unexplored. This is the first study to evaluate post-COVID prevalence stratified by VoC and follow-up periods.

METHODS: Six databases were searched (12/2019-12/2024) for studies of adults with laboratory-confirmed SARS-CoV-2 and symptoms lasting ≥3 months. Data were stratified by VoC (Alpha through Omicron) and follow-up (<6 vs ≥6 months) to estimate pooled prevalence using random-effects models.

RESULTS: Pooled prevalence across 35 studies (n = 159,000) was 28.5% (95% CI: 21.6-36.0), higher in pre-Omicron (35.5%) than Omicron (22.8%) eras (P = 0.04). Symptoms persisted beyond 6 months in 29.9% of cases. Fatigue was the most prevalent symptom across all VoCs and follow-ups followed by brain fog, dyspnea, and sleep impairment. Pre-Omicron variants were linked to dyspnea and anosmia, while Omicron was associated with brain fog and paresthesia. Most symptoms showed no significant reduction beyond 6 months. Sleep problems were higher in early pre-Omicron cohorts but improved over time; conversely, palpitations and ocular manifestations increased in later pre-Omicron follow-ups.

CONCLUSION: Post-COVID condition remains a burden despite vaccination. Distinct symptomatology patterns across VoC and timelines highlight the need for tailored management strategies to mitigate long-term global impacts.},
}

Humans
*COVID-19/epidemiology/complications/virology
Prevalence
*SARS-CoV-2/pathogenicity
Fatigue/epidemiology
Post-Acute COVID-19 Syndrome
Adult
Dyspnea/epidemiology

@article {pmid41819358,
year = {2026},
author = {Liu, W and Liu, W and Rong, Z and Song, S and Zhou, Y and Pang, X},
title = {Therapeutic strategies for the fatty-acid-binding pocket of the spike protein: advances and perspectives.},
journal = {Drug discovery today},
volume = {31},
number = {3},
pages = {104638},
doi = {10.1016/j.drudis.2026.104638},
pmid = {41819358},
issn = {1878-5832},
abstract = {The trimeric spike protein plays a crucial part in the lifecycle of SARS-CoV-2 by facilitating viral entry. The SARS-CoV-2 spike protein harbors a fatty-acid-binding pocket (FABP) at the interface between two adjacent receptor-binding domains. Ligand engagement at the FABP locks the spike into a non-infectious, closed conformation, thereby impairing the virus's ability to infect new cells. Herein, we summarize the small-molecule inhibitors targeting the FABP that have been described to date, analyzing their binding modes, SAR and mechanisms of action. Because this pocket is conserved across highly pathogenic coronaviruses, targeting it offers a promising strategy for developing novel antivirals with broad-spectrum anti-coronavirus activity. We hope this review will stimulate further research on FABP inhibitors and promote the discovery of broad-spectrum anti-SARS-CoV-2 therapeutics.},
}

@article {pmid41819640,
year = {2026},
author = {Janssen, RS and Coffman, RL},
title = {A narrative review of immune-mediated adverse events in clinical trials of CpG oligonucleotide toll-like receptor 9 agonists.},
journal = {Vaccine},
volume = {79},
number = {},
pages = {128437},
doi = {10.1016/j.vaccine.2026.128437},
pmid = {41819640},
issn = {1873-2518},
mesh = {Humans ; *Oligodeoxyribonucleotides/adverse effects ; *Toll-Like Receptor 9/agonists ; *Adjuvants, Immunologic/adverse effects ; *COVID-19 Vaccines/adverse effects/immunology ; COVID-19/prevention & control/immunology ; Hepatitis B Vaccines/adverse effects/immunology ; Neoplasms/drug therapy/immunology ; Clinical Trials as Topic ; SARS-CoV-2/immunology ; *Adjuvants, Vaccine/adverse effects ; Immune Checkpoint Inhibitors/adverse effects/therapeutic use ; },
abstract = {There is a concern that stimulating the innate immune system with vaccine adjuvants could, hypothetically, lead to autoimmunity; however, evidence is lacking to support these concerns. We review and evaluate immune-mediated adverse events from three sets of clinical studies using toll-like receptor 9 (TLR9) agonists (CpG-ODN) as vaccine adjuvants and therapeutic agents in patients with cancer: 1) a comparison of immune-mediated adverse events across phase 1-3 clinical trials of the hepatitis B vaccine HEPLISAV-B (HepB-CpG) with the alum-adjuvanted hepatitis B vaccine (HepB-alum); 2) an analysis of the rates of immune-mediated adverse events across clinical trials of COVID-19 vaccines using the CpG 1018 adjuvant; and 3) the rates of immune-mediated conditions in a study of the CpG-ODN nelitolimod (SD-101) combined with the immune checkpoint inhibitor pembrolizumab in patients with advanced melanoma or head and neck cancer, compared with rates in historical studies of pembrolizumab monotherapy. In the current analysis, the rate of potential immune-mediated adverse events was similar for HepB-CpG (0.32%) and HepB-alum (0.38%). Few adverse events of special interest (including immune-mediated events) were observed with any of the CpG 1018-adjuvanted COVID-19 vaccines (0-2.1% across studies), and rates were similar to placebo (0.6-3.3%). The rate of immune-mediated events for patients who received nelitolimod and pembrolizumab was 21.8% versus 19.8% for those who received pembrolizumab alone. No increased risk of potential immune-mediated adverse events was observed with HepB-CpG or CpG 1018-adjuvanted COVID-19 vaccines. In patients with cancer treated with programmed cell death protein 1 blockade, repeated treatment with nelitolimod did not increase the frequency of such events. Data evaluated in this review show no increased risk for potential autoimmune disorders with HepB-CpG or CpG 1018-adjuvanted COVID-19 vaccines. Combining CpG-ODN with a checkpoint inhibitor did not increase the rate of immune-mediated conditions.},
}

Humans
*Oligodeoxyribonucleotides/adverse effects
*Toll-Like Receptor 9/agonists
*Adjuvants, Immunologic/adverse effects
*COVID-19 Vaccines/adverse effects/immunology
COVID-19/prevention & control/immunology
Hepatitis B Vaccines/adverse effects/immunology
Neoplasms/drug therapy/immunology
Clinical Trials as Topic
SARS-CoV-2/immunology
*Adjuvants, Vaccine/adverse effects
Immune Checkpoint Inhibitors/adverse effects/therapeutic use

@article {pmid41819709,
year = {2026},
author = {Khatami, SG and Baumkötter, R and Petersen, J and Ten Cate, V and Wild, PS},
title = {The relation between socioeconomic status and societal development with cardiovascular disease - A systematic review and meta-analysis on global data.},
journal = {Atherosclerosis},
volume = {415},
number = {},
pages = {120697},
doi = {10.1016/j.atherosclerosis.2026.120697},
pmid = {41819709},
issn = {1879-1484},
mesh = {Humans ; *Cardiovascular Diseases/epidemiology/diagnosis ; *Social Class ; Global Health ; Educational Status ; *Social Determinants of Health ; Income ; Male ; Occupations ; },
abstract = {BACKGROUND: While socioeconomic status (SES) is recognized as a significant determinant of cardiovascular disease (CVD), the strength and direction of this association vary across studies and with stages of societal development. This meta-analysis of global data aimed to evaluate the relationship between SES domains and CVD outcome while examining the influence of measures on country-level for social development.

METHODS: The PubMed database was systematically searched for studies published between January 2000 and October 2024, investigating associations between SES domain (income, education, and occupation) and cardiovascular outcome, including stroke and myocardial infarction. The analysis incorporated macro-level determinants, including the Gini index, global quality infrastructure index, median age, and life expectancy. Multivariate meta-regression models was used to account for effect size dependencies, and heterogeneity was assessed using I[2] statistics. The systematic review and meta-analysis was pre-registered at http://www.crd.york.ac.uk (registration number: 651376).

RESULTS: The analysis included 50 studies encompassing >7 million individuals with some degree of overlap. Education showed the strongest association with CVD outcomes (β = 0.40, 95%CI [0.37; 0.43], p < 0.0001), followed by occupation (β = 0.30, 95%CI [0.23; 0.38], p < 0.0001), income (β = 0.27, 95%CI [0.23; 0.30], p < 0.0001) and the composite score of SES domains (β = 0.17, 95%CI [0.14; 0.19], p = p < 0.0001). In multivariable analysis of country-level measures for social development, Gini index, median age and global quality infrastructure index emerged as significant interactors with the relation of socioeconomic inequalities with presence of CVD, while life expectancy did not. Substantial heterogeneity was observed across studies (I[2] ranging from 81.5% to 96.7%).

CONCLUSIONS: Among SES domains, educational attainment demonstrates the most robust association with cardiovascular outcomes. The influence of societal development on country-level on the relation of socioeconomic inequalities with cardiovascular disease underscores the importance of considering multiple societal factors simultaneously. These findings suggest that measures targeting educational access and comprehensive societal development are crucial for reducing cardiovascular health inequalities.},
}

Humans
*Cardiovascular Diseases/epidemiology/diagnosis
*Social Class
Global Health
Educational Status
*Social Determinants of Health
Income
Male
Occupations

@article {pmid41819980,
year = {2026},
author = {Mahmud, S and van Zandvoort, K and Guo, L and Li, Y and Nair, H and Feikin, DR and Sparrow, E and Chowdhury, F and Cohen, C and Dbaibo, GS and Gentile, A and Gill, CJ and Gordon, A and Horton, KC and Cao, Q and Stolyarov, K and Clark, AD and , },
title = {Age distribution of respiratory syncytial virus disease in children younger than 5 years in low-income and middle-income countries: a systematic review and meta-analysis.},
journal = {The Lancet. Child & adolescent health},
volume = {10},
number = {4},
pages = {245-254},
doi = {10.1016/S2352-4642(25)00349-9},
pmid = {41819980},
issn = {2352-4650},
mesh = {Humans ; *Respiratory Syncytial Virus Infections/epidemiology ; Infant ; *Developing Countries ; Child, Preschool ; Age Distribution ; Infant, Newborn ; Hospitalization/statistics & numerical data ; Bayes Theorem ; },
abstract = {BACKGROUND: Low-income and middle-income countries (LMICs) bear the greatest burden of respiratory syncytial virus (RSV) disease. WHO recommends passive immunisation to protect infants younger than 6 months and, in some strategies, infants up to age 12 months, but detailed age data are needed to determine optimal timing and impact. Our study estimates age distributions for the full range of RSV outcomes among children younger than 5 years in LMICs.

METHODS: We conducted a systematic review and meta-analysis of RSV age distributions for seven health or health-care outcomes (hereafter, RSV outcomes): community cases, outpatient or clinic visits, emergency room visits, inpatient ward admissions, intensive care unit (ICU) admissions, facility deaths, and non-facility deaths. Inclusion required at least 30 laboratory-confirmed counts of RSV disease in children younger than 5 years, for a single RSV outcome from a single LMIC in the pre-COVID-19 decade (Jan 1, 2010, to Dec 31, 2019). We invited authors of included studies to share RSV counts by week or month of age. Using a Bayesian hierarchical model, we fitted parametric age distributions (by week for children <5 years) to each dataset, and derived pooled estimates of the mode, median, and mean age for each RSV outcome. The study was registered with PROSPERO (CRD42023435080).

FINDINGS: We included 160 datasets with 131 124 RSV counts in children younger than 5 years. The mode (peak) age was 3 weeks (95% credible interval 1-6) for non-facility deaths (57% <6 months), 4 weeks (1-8) for facility deaths (57% <6 months), 7 weeks (6-8) for ICU admissions (60% <6 months), 17 weeks (14-19) for inpatient ward admissions (41% <6 months), 10 weeks (5-17) for emergency room visits (40% <6 months), 28 weeks (22-32) for outpatient or clinic visits (19% <6 months), and 22 weeks (17-28) for community cases (26% <6 months). Considering the most severe RSV outcomes, 20% of ICU admissions and 23% of facility deaths were in infants younger than 8 weeks.

INTERPRETATION: Our findings reaffirm the importance of immunising the youngest infants who bear the greatest burden of severe RSV outcomes. Our estimates should allow more precise quantification of the potential impact of RSV prevention strategies across the full range of RSV disease severity in children younger than 5 years.

FUNDING: WHO.},
}

Humans
*Respiratory Syncytial Virus Infections/epidemiology
Infant
*Developing Countries
Child, Preschool
Age Distribution
Infant, Newborn
Hospitalization/statistics & numerical data
Bayes Theorem

@article {pmid41820161,
year = {2026},
author = {Yang, Q and Yang, Y and Liu, B and Xu, L and Ma, Y and Zhou, J and Wang, Y and Hao, C and Jiang, W},
title = {Global perspectives on pertussis epidemiology, macrolide resistance, and management in the post-COVID-19 era (2020-2024).},
journal = {Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.jmii.2026.03.002},
pmid = {41820161},
issn = {1995-9133},
abstract = {Pertussis, caused by Bordetella pertussis, remains a substantial public health threat despite long-standing vaccination programs. Widespread non-pharmaceutical interventions (NPIs) during COVID-19 were accompanied by marked declines in reported pertussis activity in many settings. However, relaxation of containment measures has been followed by resurgence, characterized by atypical outbreak patterns and shifts in case distribution, bacterial genotypes, and affected populations. Emerging evidence suggests that these changes are multifactorial, including altered contact patterns and immunity gap, disruptions and recovery in routine immunization and surveillance, waning or suboptimal vaccine-induced protection, pathogen adaptation, and improved case detection through expanded diagnostic capabilities. Addressing these challenges will require coordinated strategies to restore and optimize immunization delivery, strengthen surveillance and laboratory capacity (including resistance monitoring), and update clinical management guidance in the context of macrolide-resistant B. pertussis. Continued research is needed to define setting-specific drivers and to inform next-generation vaccines and integrated control strategies in the post-pandemic era.},
}

@article {pmid41821384,
year = {2026},
author = {Daniyarova, KR and Sarkulova, ZN and Tamadon, A and Tokshilykova, AB and Sarkulov, MN and Kalieva, BM and Mussin, NM and Sharoffidin, RS},
title = {Global Research Trends on Endothelial Glycocalyx in Sepsis: A Bibliometric Analysis.},
journal = {BioMed research international},
volume = {2026},
number = {1},
pages = {e9720166},
pmid = {41821384},
issn = {2314-6141},
mesh = {*Sepsis/metabolism/pathology ; Humans ; *Glycocalyx/metabolism/pathology ; *Bibliometrics ; COVID-19 ; *Biomedical Research/trends ; SARS-CoV-2 ; Biomarkers/metabolism ; },
abstract = {BACKGROUND: Sepsis remains a major global health challenge, with glycocalyx dysfunction playing an important role in its pathogenesis. Recent research highlights EG degradation as a key contributor to vascular permeability, inflammation, and organ failure. Despite growing interest, a comprehensive bibliometric analysis of global research trends on EG in sepsis is lacking.

METHODS: We conducted a bibliometric analysis using data from Web of Science and Scopus (2005-2025). Inclusion criteria were original English-language research articles. Bibliometrix R-package was employed to analyze publication trends, citation metrics, collaboration networks, and keyword co-occurrence.

RESULTS: Among 217 publications, research output increased 13-fold (2005-2023), with Shock and Critical Care as leading journals. The United States, Japan, and Australia were top contributors, with strong international collaborations. Key themes included EG biomarkers, microcirculatory dysfunction, and therapeutic strategies. Emerging trends involved COVID-19-associated EG injury and novel imaging techniques.

CONCLUSION: This study maps the evolution of EG research in sepsis, highlighting exponential growth, key contributors, and thematic shifts. Future directions include validating EG biomarkers, developing targeted therapies, and enhancing global research equity.},
}

*Sepsis/metabolism/pathology
Humans
*Glycocalyx/metabolism/pathology
*Bibliometrics
COVID-19
*Biomedical Research/trends
SARS-CoV-2
Biomarkers/metabolism

@article {pmid41821660,
year = {2026},
author = {Kapoor, G and Bhutani, R},
title = {Propolis: a brief overview of its diverse pharmacological functions.},
journal = {3 Biotech},
volume = {16},
number = {4},
pages = {132},
pmid = {41821660},
issn = {2190-572X},
abstract = {Propolis, a natural wax-like resinous substance present in bee hives, has been extensively used in dietary supplements and as folk medicine for the treatment of several diseases, including neurological disorders. Propolis has been used as a traditional medicine for the treatment of depression and other neurological disorders. This review aims to investigate the clinical studies and various therapeutic potentials associated with propolis, direct the future scope of research, and discuss possible clinical implications. A total of 143 papers were selected using a database comprising Google Scholar, Scopus, PubMed, and Web of Science. Diverse keywords, such as propolis, bee, phytochemistry, pharmacology, and clinical study, were used to search the content. This review highlights the diverse biological activities of propolis, as evidenced by preclinical and clinical studies. In experimental models, propolis extract exhibited antidepressant-like and vasculoprotective effects, primarily through its anti-inflammatory and antioxidant potential. These benefits were associated with the suppression of pro-inflammatory cytokines, chemokines, and angiogenic factors. Propolis extract was found to delay the progression of atherosclerosis by improving lipid metabolism and modulating apoptosis. Furthermore, both in vitro and in vivo investigations suggest that propolis may protect vascular endothelial function due to its antiproliferative activity. Notably, anticancer potential was observed against the ovarian cancer cell line M12.C3.F6. Clinical studies also provided encouraging findings. In patients with type 2 diabetes mellitus, propolis extract has been shown to improve wound healing parameters in diabetic foot ulcers. Another trial reported promising outcomes with propolis extract formulated as niosomal oromucosal-adhesive films for recurrent aphthous ulcers. Overall, these results underline the multifaceted therapeutic promise of propolis across neurological, vascular, oncological, and wound-healing domains. This review summarizes clinical and experimental evidence on the therapeutic potential of propolis. It highlights its immunomodulatory, antioxidant, antimicrobial, antifungal, anticancer (skin, oral, lung, breast, cervical), antidepressant, anxiolytic, cardiovascular, chemopreventive, and anti-angiogenic properties. Several studies, including clinical trials, suggest its potential role in combating COVID-19 and other health conditions. Overall, findings indicate that propolis possesses significant medicinal promise and may serve as a lead candidate for developing novel therapeutic agents.},
}

@article {pmid41821730,
year = {2026},
author = {Gao, SX and Gao, J},
title = {Unveiling the hidden link: diabetes mellitus as a catalyst for orbital apex syndrome.},
journal = {Frontiers in endocrinology},
volume = {17},
number = {},
pages = {1770045},
pmid = {41821730},
issn = {1664-2392},
mesh = {Humans ; *COVID-19/epidemiology/complications ; *Orbital Diseases/epidemiology/etiology ; *Diabetes Mellitus/epidemiology ; SARS-CoV-2 ; *Diabetes Complications/epidemiology ; Syndrome ; },
abstract = {BACKGROUND: Orbital Apex Syndrome (OAS) is a disease of multiple brain nerves at the orbital apex leading to vision loss and neurological impairments. Diabetes Mellitus (DM), a metabolic disorder with cardiovascular, immunological and neurological effects, is involved in OAS pathogenesis. However, the association between DM and OAS is not well studied. DM and OAS are poorly understood and may not be diagnosed correctly, especially when outbreaks such as COVID-19 are being investigated.

METHODS: A systematic review of 33 studies published between 2000 and 2025 was conducted to analyze DM-related OAS epidemiology, pathophysiology, clinical phenotypes, and treatment outcomes, focusing on the mechanistic links, pandemic trends, and glycemic control effect on therapeutic effectiveness.

RESULTS: Chronic hyperglycemia induced orbital apex microvascular damage (endothelial dysfunction, thrombosis, vascular senescence), immunosuppression induced opportunistic infections (mostly mucormycosis), and diabetic neuropathy induced neuromuscular dysfunction. During COVID-19, diabetic patients had the highest OAS incidence (more than 70% of cases involved rhino-orbital mucormycosis). Optimal glycemic control is associated with a 32% higher antifungal treatment effectiveness and a 28% lower rate of surgical complications. Epidemiological data showed that DM was the main predisposing factor, with 71.4%-81.8% infectious OAS cases occurred in diabetic populations.

CONCLUSION: DM is underreported as a critical catalyst for OAS with complications directly increasing severity and progression. Routine DM screening (e.g., glycated hemoglobin monitoring) and integrated glycemic management are essential for OAS prevention and treatment. Long-term studies on inflammatory factors and personalized multidisciplinary care are needed to address mechanistic gaps and improve visual and neurological outcomes in high-risk diabetic patients.},
}

Humans
*COVID-19/epidemiology/complications
*Orbital Diseases/epidemiology/etiology
*Diabetes Mellitus/epidemiology
SARS-CoV-2
*Diabetes Complications/epidemiology
Syndrome

@article {pmid41822480,
year = {2026},
author = {Wasilewski, A and Serrafi, A},
title = {Identification of metabolic signatures of immune response following mRNA and inactivated vaccines against COVID-19: a systematic review.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1783878},
pmid = {41822480},
issn = {1664-3224},
mesh = {Humans ; *COVID-19 Vaccines/immunology ; Vaccines, Inactivated/immunology ; *SARS-CoV-2/immunology ; *COVID-19/immunology/prevention & control/metabolism ; mRNA Vaccines/immunology ; Metabolomics ; Vaccination ; Kynurenine/metabolism ; *Metabolome ; Biomarkers ; Antibodies, Viral/blood ; },
abstract = {BACKGROUND: Metabolomic profiling offers insights into immune responses, yet a synthesis of systemic metabolic changes after COVID-19 vaccination is lacking. This review aims to characterize vaccination-induced metabolomic alterations and identify correlative biomarkers of responsiveness.

METHODS: Following PRISMA 2020 guidelines (PROSPERO 1181037), four databases (PubMed, Embase, Scopus, Web of Science) were searched for studies using LC-MS, GC-MS, or NMR to analyse venous blood after COVID-19 vaccination. Inclusion criteria focused on original human studies. Risk of bias was assessed using ROBINS-I and RoB 2.

RESULTS: Ten studies (n > 1,200) evaluating mRNA and inactivated vaccines were included. Vaccination consistently altered amino acid pathways, specifically glutamine, phenylalanine, and tryptophan. Early activation of the kynurenine pathway (1-2 days post-dose) emerged as a predictor of stronger antibody responses. Inactivated vaccines triggered a "Warburg-like" metabolic switch, characterized by increased glycolysis and reduced TCA intermediates. Lipidomic changes were prominent; high baseline ceramides predicted low response, while sphingomyelins and short-chain fatty acids associated with positive immunity. Most studies showed a moderate risk of bias due to post-hoc grouping and confounding factors.

CONCLUSIONS: COVID-19 vaccination induces reproducible changes in amino acid, energy, and lipid metabolism. Kynurenine activity, baseline amino acids, and sphingolipid signatures are potential predictors of vaccine efficacy, supporting personalized immunization strategies.},
}

Humans
*COVID-19 Vaccines/immunology
Vaccines, Inactivated/immunology
*SARS-CoV-2/immunology
*COVID-19/immunology/prevention & control/metabolism
mRNA Vaccines/immunology
Metabolomics
Vaccination
Kynurenine/metabolism
*Metabolome
Biomarkers
Antibodies, Viral/blood

@article {pmid41822497,
year = {2026},
author = {Bakacs, T and Chumakov, K},
title = {Host-targeted oral avian vaccine virus demonstrates broad antiviral activity and safety in patients.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1760109},
pmid = {41822497},
issn = {1664-3224},
mesh = {Humans ; Animals ; *Viral Vaccines/immunology/administration & dosage/adverse effects ; *Infectious bursal disease virus/immunology ; Administration, Oral ; COVID-19/immunology/prevention & control ; Antiviral Agents ; SARS-CoV-2/immunology ; },
abstract = {The absence of an immediately deployable, broad-spectrum antiviral remains a critical vulnerability in global pandemic preparedness. Host-directed agents that activate innate immunity offer a pathogen-agnostic strategy, yet no such therapy is currently stockpiled or authorized for emergency use. Infectious Bursal Disease Virus (IBDV)-a non-replicating avian dsRNA vaccine virus with a 60-year safety record in poultry-induces robust interferon responses in mammals and has been administered orally in marmosets and more than 50 human patients with hepatitis A, B, C, SARS-CoV-2, and herpes zoster infections. These observations include a randomized phase II trial in 84 acute HBV/HCV patients. Although the evidence base is limited, the consistency of clinical responses and absence of serious safety signals justify renewed scientific examination. This review synthesizes the mechanistic rationale, comparative advantages over synthetic Pattern Recognition Receptor (PRR) agonists, clinical observations, One Health implications, and regulatory precedents relevant to evaluating IBDV as a temporary, compassionate-use antiviral during pandemics while the reverse-engineered human candidate (IBDV-R903/78) progresses through formal development. The goal is not to endorse clinical deployment, but to initiate a rigorous, multidisciplinary debate on whether an established veterinary dsRNA vaccine virus could serve as an off-the-shelf host-directed live viral adjuvant therapy in future public health emergencies.},
}

Humans
Animals
*Viral Vaccines/immunology/administration & dosage/adverse effects
*Infectious bursal disease virus/immunology
Administration, Oral
COVID-19/immunology/prevention & control
Antiviral Agents
SARS-CoV-2/immunology

@article {pmid41822849,
year = {2026},
author = {Hintermeier, M and Bozorgmehr, K and Gottlieb, N and Mohsenpour, A and Sarma, N and Biallas, R and Biddle, L},
title = {Unintended Consequences of COVID-19 Public Health and Social Measures in Camps and Camp-Like Settings: A Systematic Review and Conceptual Analysis.},
journal = {Public health reviews},
volume = {47},
number = {},
pages = {1608732},
pmid = {41822849},
issn = {0301-0422},
abstract = {OBJECTIVES: This study examines unintended consequences (UIC) of public health and social measures (PHSM) in camps and camp-like settings and assesses the pathways through which these UIC arise.

METHODS: We conducted a systematic review and conceptual analysis of UIC from PHSM aimed at preventing SARS-CoV-2 spread in these settings. PHSM were classified using the WHO taxonomy and the CONSEQUENT framework to analyse UIC pathways. The most frequent PHSM groups were: a) surveillance and response, b) social and physical distancing, and c) operational measures.

RESULTS: We identified 113 predominantly negative UIC impacting physical and mental health, healthcare access, economic stability, and social interactions. UIC occurred in both high- and low-income countries. Key mechanisms linking PHSM to UIC included mistrust, increased risk factors, lack of information, and uncertainty.

CONCLUSION: This study reveals the complex interactions between PHSM and UIC and their broad mostly negative effects on marginalised populations. To reduce UIC in future health emergencies, they must be considered in pandemic planning with all stakeholders. Trust-building should be central in health interventions and PHSM design for more effective and equitable responses.

https://www.crd.york.ac.uk/PROSPERO/view/CRD42022384673.},
}

@article {pmid41823400,
year = {2026},
author = {Abrahamsen, C and Beadsworth, M and Bostock, W and Chalder, T and Flottorp, S and Fors, EA and Garner, P and Hadfield, S and Kennedy, B and Kuehn, R and Landmark, L and Launes, G and Liira, H and Linnestad, L and Rotkirch Virrantaus, H and Vangelova-Korpinen, V},
title = {Persistent physical symptoms not explained by structural abnormalities or disease processes: a primary care approach to promote recovery.},
journal = {Scandinavian journal of primary health care},
volume = {44},
number = {1},
pages = {2633765},
pmid = {41823400},
issn = {1502-7724},
mesh = {Humans ; *Primary Health Care ; Quality of Life ; *Medically Unexplained Symptoms ; Fatigue ; Pain ; *Somatoform Disorders/therapy/diagnosis ; Headache ; },
abstract = {Background: A substantial proportion of people consulting primary care practitioners have symptoms that persist even after structural problems and diseases have been excluded. They experience distressing somatic complaints - such as fatigue, pain, headaches, and brain fog - lasting months or longer which impair quality of life and workability. In this article, we refer to these as persistent physical symptoms (PPS). When diagnosis, advice and care are based solely on a biomedical interpretation of symptoms, patients may not improve. This can result in repeated and often frustrating consultations and investigations. Aim: To outline contemporary theories around PPS for general practitioners, and offer practical, evidence-informed pathways to use in primary care. Methods: Narrative literature review and consensus development with experienced practitioners. Synopsis:Contemporary theories Contemporary theories of PPS provide a coherent framework for understanding symptom persistence and guide treatment. These theories propose that symptoms may arise from brain-based responses to perceived threat, influenced by expectations and learned associations. Such responses can become unhelpful when benign sensations are interpreted as dangerous. Biopsychosocial factors unique to each individual influence these mechanisms which need to be considered when assessing PPS and working towards symptom resolution with the patient. Evidence-informed pathways Key strategies include validating patients' symptoms and emotional experiences, providing clear explanations of symptom persistence, and developing personalised management plans that combine biological, psychological, and social approaches. Such strategies can reduce or resolve symptoms, foster hope and a sense of agency, and often lead to recovery.},
}

Humans
*Primary Health Care
Quality of Life
*Medically Unexplained Symptoms
Fatigue
Pain
*Somatoform Disorders/therapy/diagnosis
Headache

@article {pmid41823417,
year = {2026},
author = {Biering, SB and Puerta-Guardo, H and Pahmeier, F and Kril, V and Harris, E},
title = {The contribution of viral toxins to infection and pathogenesis.},
journal = {mBio},
volume = {17},
number = {4},
pages = {e0042125},
pmid = {41823417},
issn = {2150-7511},
support = {U19 AI181977/AI/NIAID NIH HHS/United States ; },
mesh = {Humans ; Viral Tropism ; Animals ; *Viruses/pathogenicity ; *Viral Proteins/metabolism ; *Virus Diseases/virology ; *Host-Pathogen Interactions ; },
abstract = {The process by which viruses cause disease, viral pathogenesis, is the result of both infection of cells and the host immune response. A less studied but equally important contributor to viral pathogenesis is viral dissemination, the capacity of a virus to move from the primary site of infection, traverse physiological barriers, and gain access to secondary sites of infection. This dictates viral tropism and pathogenesis, but the mechanisms governing barrier crossing are incompletely understood. While the presence of viral receptors on cells is a major determinant of viral tropism and a prerequisite for infection, it does not completely explain the capacity of viruses to enter a tissue. Our recent work has begun to characterize the contribution of soluble viral proteins, acting as "viral toxins," to viral dissemination, tissue tropism, and overall pathogenesis within an infected host. In this review, we discuss the characteristics of these viral toxins, which are soluble or surface-exposed viral proteins that can interact with endothelial and/or epithelial barriers, as well as immune cells, to trigger signaling pathways, resulting in the transient breakdown of cellular structures maintaining barrier integrity. The disruption of these barriers induces vascular leak and facilitates virus dissemination, influencing viral tropism and pathogenesis. Importantly, blocking this process prevents leak, viral dissemination, and severe disease during infection, highlighting the value of therapeutic intervention against viral toxin activity. Here, we summarize our current understanding of recently discovered viral toxins from the Flaviviridae, Coronaviridae, Nairoviridae, and Filoviridae.},
}

Humans
Viral Tropism
Animals
*Viruses/pathogenicity
*Viral Proteins/metabolism
*Virus Diseases/virology
*Host-Pathogen Interactions

@article {pmid41823941,
year = {2026},
author = {Slimovitch, J and Lockey, RF and Arroyo, AC and Smith, A and Ballow, M and Baptist, AP and Teng, M and Nanda, A and Mullur, J and Allakhverdi, Z and Nyenhuis, SM and Cardet, JC},
title = {Recommended Vaccines for Immunocompetent Older Adults: A Work Group Report of the AAAAI Asthma, Allergic & Immunologic Diseases in Older Adults Committee.},
journal = {The journal of allergy and clinical immunology. In practice},
volume = {14},
number = {4},
pages = {791-801},
doi = {10.1016/j.jaip.2025.09.040},
pmid = {41823941},
issn = {2213-2201},
mesh = {Humans ; Aged ; *Vaccination ; United States/epidemiology ; *Vaccines ; COVID-19/prevention & control/epidemiology ; Practice Guidelines as Topic ; SARS-CoV-2 ; Immunocompetence ; Advisory Committees ; Aged, 80 and over ; },
abstract = {Adults 65 years or older are more susceptible to infectious diseases, representing a significant public health concern worldwide. Although newer vaccines have been developed for older adults, confusion over frequently changing guidelines often contributes to vaccine hesitancy and low vaccination rates. An American Academy of Allergy, Asthma & Immunology work group was convened to provide a clearer summary of these guidelines from the Advisory Committee on Immunization Practices and the Centers for Disease Control and Prevention. This article reviews the epidemiology and pathology of key infectious diseases in older adults, the mechanism of action of the vaccines targeting these diseases, commercially available vaccines, their potential side effects, and current vaccination recommendations for adults 65 years or older. The primary focus of this work is on adults 65 years or older; however, when possible, newer vaccination recommendations that begin at age 50 years have also been included. The diseases covered in this review include coronavirus disease 2019, pneumococcal pneumonia, respiratory syncytial virus, influenza, shingles, and tetanus. A summary table of vaccination guidelines is also included in Table III.},
}

Humans
Aged
*Vaccination
United States/epidemiology
*Vaccines
COVID-19/prevention & control/epidemiology
Practice Guidelines as Topic
SARS-CoV-2
Immunocompetence
Advisory Committees
Aged, 80 and over

@article {pmid41823998,
year = {2026},
author = {Lee, J and Strachman, FB and Szendrő, G and Fekete, M and Varga, JT},
title = {Virtual reality in pulmonary rehabilitation: A systematic review of clinical outcomes in COPD and post-COVID conditions.},
journal = {Physiology international},
volume = {113},
number = {1},
pages = {34-63},
doi = {10.1556/2060.2026.00811},
pmid = {41823998},
issn = {2498-602X},
mesh = {Humans ; *Pulmonary Disease, Chronic Obstructive/rehabilitation/physiopathology ; *COVID-19/rehabilitation/complications/physiopathology ; *Virtual Reality ; Quality of Life ; Treatment Outcome ; Exercise Tolerance ; Randomized Controlled Trials as Topic ; Post-Acute COVID-19 Syndrome ; Exercise Therapy/methods ; Lung/physiopathology ; },
abstract = {BACKGROUND: Chronic obstructive pulmonary disease (COPD) and post-COVID syndrome cause persistent dyspnea and exercise intolerance. Traditional pulmonary rehabilitation (PR) improves outcomes. Virtual reality (VR)-based PR has been proposed as an engaging alternative. We systematically reviewed randomized trials of VR-based PR programs to evaluate its efficacy and feasibility.

METHODS: Following PRISMA guidelines, we searched PubMed, Web of Science, CENTRAL and Google Scholar (2014-Feb 2025) for RCTs comparing VR-assisted PR versus standard PR in patients with COPD or post-COVID conditions. Based on the selection criteria nine trials (primary search total n = 552; 488 COPD and 64 post-COVID patients) were included. Six domains were considered: lung function, exercise capacity (6MWT, STST), dyspnea, quality of life, mental health, and cognitive function.

RESULTS: Across nine RCTs (n = 552), VR-based pulmonary rehabilitation resulted improvements in exercise capacity in all studies, with several reporting greater gains in VR groups. A long-duration trial showed meaningful FEV1 improvement with VR, while shorter trials showed limited changes. Dyspnea and functional scores improved in both groups without consistent between-group differences. VR tended to yield greater reductions in anxiety and depression scores, and one trial showed better cognitive function in post-intervention. Quality-of-life outcomes improved in both groups.

CONCLUSION: VR-based PR was feasible and produced functional gains at least equal to those of traditional PR. VR's capacity for remote supervised training and gamification holds promise to improve access and adherence. However, evidence is limited by small, short-term trials. Larger, longer RCTs are needed to confirm these benefits, optimize VR protocols, and evaluate cost-effectiveness.},
}

Humans
*Pulmonary Disease, Chronic Obstructive/rehabilitation/physiopathology
*COVID-19/rehabilitation/complications/physiopathology
*Virtual Reality
Quality of Life
Treatment Outcome
Exercise Tolerance
Randomized Controlled Trials as Topic
Post-Acute COVID-19 Syndrome
Exercise Therapy/methods
Lung/physiopathology

@article {pmid41824815,
year = {2026},
author = {Hasen, AA and Seid, AA and Mohammed, AA and Mamed, GE and Wolde, AD and Tadesse, EC and Mulugeta, G and Seid, HA},
title = {Teenage pregnancy and its associated factors through COVID-19 in East Africa: Systematic review and meta-analysis.},
journal = {Medicine},
volume = {105},
number = {11},
pages = {e48069},
pmid = {41824815},
issn = {1536-5964},
mesh = {Humans ; *Pregnancy in Adolescence/statistics & numerical data ; *COVID-19/epidemiology ; Pregnancy ; Adolescent ; Female ; Africa, Eastern/epidemiology ; Prevalence ; Risk Factors ; SARS-CoV-2 ; },
abstract = {BACKGROUND: In East Africa, COVID-19 has impacted the lives of girls and women. COVID-19 control measures were considered as major factors of teenage pregnancy. It is essential to provide comprehensive evidence and to focus on the well-being of teenagers during COVID-19 and future emergency situation in East Africa. The present study aimed to explore the pooled prevalence and associated factors of teenage pregnancy during COVID-19 in East Africa.

METHODS: Systematic searches were conducted in PubMed, Google Scholar, and African journals online and included articles published from December 2019 to June 2024. The quality of eligible studies was assessing using Newcastle-Ottawa Scale. A DerSimonian-Laird random-effects meta-analysis was used to estimate the pooled effect size of the outcome measures with their 95% confidence interval. Stata version 14.0 (StataCorp, College Station, Texas) was used for statistical analysis.

RESULTS: A total of 4 studies reported the prevalence of teenage pregnancy during COVID-19 in East Africa is 37% (95% confidence interval: 0.07-66.70, I2 = 99.4%, P = .000. The prevalence of teenage pregnancy during the COVID-19 pandemic in East Africa is not homogeneous across countries, publication years and sampling methods. In addition, key determinants contributing to the prevalence of teenage pregnancy are systematically summarized.

CONCLUSION: The prevalence of teenage pregnancies in East Africa during the COVID-19 pandemic has increased due to various factors such as disrupted access to sexual and reproductive health services, increased poverty, and decreased access to education. Proper and timely interventions to minimize the effects of public health and related crises on teenagers are vital.},
}

Humans
*Pregnancy in Adolescence/statistics & numerical data
*COVID-19/epidemiology
Pregnancy
Adolescent
Female
Africa, Eastern/epidemiology
Prevalence
Risk Factors
SARS-CoV-2

@article {pmid41825988,
year = {2026},
author = {Puri, N and Yohannes, S},
title = {Organization and Management of Critical Care Services: Unexpected Challenges in Leading a Critical Care Organization.},
journal = {Critical care clinics},
volume = {42},
number = {2},
pages = {425-440},
doi = {10.1016/j.ccc.2025.11.005},
pmid = {41825988},
issn = {1557-8232},
mesh = {Humans ; *Critical Care/organization & administration ; *Leadership ; Organizational Culture ; COVID-19 ; *Intensive Care Units/organization & administration ; },
abstract = {Uncertainty is the only constant in critical care medicine leadership, ranging from unexpected staff attrition to global pandemics. Developing skills to retain experienced staff, manage conflict, and handle failure are essential to be effective. Successful leaders have knowledge of the challenges experienced by front-line clinicians and clearly communicate with their teams. By creating a culture of safety and making clinicians feel valued, leaders can help their Critical Care Organization not just survive, but thrive.},
}

Humans
*Critical Care/organization & administration
*Leadership
Organizational Culture
COVID-19
*Intensive Care Units/organization & administration

@article {pmid41826433,
year = {2026},
author = {Kapischke, T and Herrmann, ST and Bertzbach, LD and Pfaender, S and Kaderali, L},
title = {Ordinary differential equation models of SARS-CoV-2 replication dynamics and antiviral drug efficacies.},
journal = {Npj viruses},
volume = {4},
number = {1},
pages = {},
pmid = {41826433},
issn = {2948-1767},
support = {462165342//Deutsche Forschungsgemeinschaft/ ; 462165342//Deutsche Forschungsgemeinschaft/ ; 101191666//HORIZON EUROPE European Research Council/ ; 101191666//HORIZON EUROPE European Research Council/ ; },
abstract = {There is a critical need for precise analysis of virus-host interactions to improve our understanding of infection processes. The integration of quantitative measurements with dynamic mathematical modeling has changed how we perceive cellular infection processes, offering profound insights into how viruses function at the cellular level. Here, we systematically review target cell-limited (TCL) ordinary differential equation (ODE) models related to SARS-CoV-2. We examine the spectrum of available models from basic TCL frameworks to more complex models incorporating antiviral treatments-and highlight key findings, discuss strengths and limitations, and identify a shortage of comprehensive datasets, emphasizing structural identifiability issues.},
}

@article {pmid41826848,
year = {2026},
author = {Saito, H and Inada, M and Miike, S and Yoshida, M and Tsuzuki, S and Ichimura, Y and Ohki, U and Kimura, N and Yoshimi, I and Kawano, K and Hashimoto, Y and Moriuchi, A and Kurisu, M and Yoshida, H and Kamata, K and Ujiie, M and Jindai, K and Ichihara, N},
title = {A scoping review of randomized controlled trials in the early phase of the COVID-19 pandemic: country-level research response to COVID-19 therapeutics and vaccines.},
journal = {BMC infectious diseases},
volume = {26},
number = {1},
pages = {},
pmid = {41826848},
issn = {1471-2334},
support = {JPMJPR23R7//PRESTO, Japan Science and Technology Agency/ ; },
mesh = {Humans ; *COVID-19/prevention & control/therapy/epidemiology ; *COVID-19 Vaccines/therapeutic use ; *Randomized Controlled Trials as Topic ; SARS-CoV-2 ; *COVID-19 Drug Treatment ; Developing Countries ; Pandemics ; },
abstract = {BACKGROUNDS: Clinical trials are central in pandemic preparedness and response (PPR). This scoping review aimed to illustrate the landscape of COVID-19-related randomized controlled trials (RCTs), focusing on the countries' capacity to conduct and coordinate RCTs, and on the operational features.

METHODS: RCTs on COVID-19 therapeutics and vaccines that were published between November 1, 2019 and November 30, 2021 were identified through EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, and CINAHL. Data were collected on study design; intervention; participating countries; responsible party; funding source; and design and operational features, such as platform trial, informed consent, and decentralization. We compared the differences based on whether the study was led by high-income countries (HICs) or low- and middle-income countries (LMICs).

RESULTS: The final analysis included 328 of the 22,392 screened trials, including 47 multi-country trials, majority of which (46, 97.9%) were led by HICs. Both for therapeutics and vaccines, trials led by HICs enrolled a larger number of study participants than those by LMICs (median 207 vs. 57.5 for therapeutics, and 805 vs. 334 for vaccines). Intervention duplication was observed in 68.6% (81/118) of therapeutic interventions in trials led by HICs and 85.8% (133/155) in those led by LMICs (p-value = 0.001). Of the 42 investigational new drugs trials on therapeutics, 26 and 16 were led by HICs and LMICs, respectively, with a larger proportion led by HICs (odds ratio 2.5, 95% confidence interval 1.3-4.8). Among the 29 platform trials, 28 were led by HICs, all of which focused on therapeutics. Decentralization approaches and consent methods other than the written format were utilized in 15.5% and 19.2% of the trials, respectively.

CONCLUSIONS: Globally, LMICs were under-represented among the published trials during the first two years of the pandemic. Global collaboration and coordination are essential to improve clinical trial ecosystem during health emergencies, and pragmatic approaches and improved design and operational features of clinical trials can strengthen the global clinical trial infrastructure.

CLINICAL TRIAL: Not applicable.},
}

Humans
*COVID-19/prevention & control/therapy/epidemiology
*COVID-19 Vaccines/therapeutic use
*Randomized Controlled Trials as Topic
SARS-CoV-2
*COVID-19 Drug Treatment
Developing Countries
Pandemics

@article {pmid41828536,
year = {2026},
author = {Semyachkina-Glushkovskaya, O and Sursaev, V and Poluektov, M and Diduk, S and Rychkova, L and Madaeva, I and Yakubova, L and Kurths, J},
title = {New Strategies for the Prevention and Therapy of Alzheimer's Disease Based on Stimulation of Brain Drainage and Lymphatic Clearance.},
journal = {International journal of molecular sciences},
volume = {27},
number = {5},
pages = {},
pmid = {41828536},
issn = {1422-0067},
support = {23-75-30001//Russian Science Foundation/ ; },
mesh = {*Alzheimer Disease/therapy/prevention & control/metabolism ; Humans ; *Brain/metabolism/pathology ; *Lymphatic Vessels/metabolism ; Amyloid beta-Peptides/metabolism ; COVID-19 ; Low-Level Light Therapy/methods ; Animals ; },
abstract = {Alzheimer's disease (AD) is a serious medical challenge, representing an incurable and insidious disease. Current treatments can slow AD progression but cannot cure it. Promising new methods for AD therapy are essential for addressing the growing number of people with dementia, especially after the COVID-19 pandemic. The review highlights pioneering approaches to AD treatment based on innovative methods for the stimulation of brain drainage and clearance, in which the meningeal lymphatic vessels (MLVs) play a key role. Clinically promising noninvasive technologies using photobiomodulation for the effective clearance of metabolites, including amyloid beta (Aβ), and for the improvement of cognitive impairment during AD progression are discussed. An interesting part of the review is its analysis of innovative methods of improving the efficacy of anti-Aβ immunotherapy by stimulating MLV growth. The review is also focused on lifestyle, including sleep and physical exercises, discussing their support for the efficient lymphatic removal of waste products from the brain. Overall, the review provides an important, informative platform to excite the interest of a wide range of readers in the development of promising and clinically significant strategies for the treatment of AD, based on new strategies for the stimulation of brain drainage and clearance.},
}

*Alzheimer Disease/therapy/prevention & control/metabolism
Humans
*Brain/metabolism/pathology
*Lymphatic Vessels/metabolism
Amyloid beta-Peptides/metabolism
COVID-19
Low-Level Light Therapy/methods
Animals

@article {pmid41830448,
year = {2026},
author = {Papatheodosiou, D and Giamarellos-Bourboulis, EJ and Tsoukas, C},
title = {Current status of immunomodulatory therapies in adult sepsis patients: where do we stand?.},
journal = {Expert review of anti-infective therapy},
volume = {24},
number = {2},
pages = {239-257},
doi = {10.1080/14787210.2026.2646192},
pmid = {41830448},
issn = {1744-8336},
mesh = {Humans ; *Sepsis/therapy/immunology ; Biomarkers/metabolism ; *Immunotherapy/methods ; Precision Medicine/methods ; *Immunomodulation ; Adult ; Algorithms ; },
abstract = {INTRODUCTION: Despite advances, sepsis remains a leading cause of morbidity and mortality worldwide. Dysregulated host responses are known to characterize sepsis, and while numerous clinical trials using immunomodulatory strategies have been attempted, most fail to show benefit. An important reason for their failure can be attributed to the heterogeneity of the host immune responses. Based on improvements in endotype characterization, personalized precision immunotherapy approaches now show promise.

AREAS COVERED: This review covers personalized approaches to sepsis, with a focus on the use of biomarker-guided immunomodulatory treatments. A literature search of clinical trials on sepsis immunomodulatory therapies was conducted using the PubMed database. Ongoing clinical trials on sepsis immunomodulation were also identified and reviewed.

EXPERT OPINION: Precision immunotherapy may represent the next step in sepsis management. Recent breakthrough studies have led to the identification of biomarkers that classify patients into distinct endotypes and predict response to treatment. These biomarkers need to guide us through the proper selection of patients, the timely initiation and cessation of treatment, and sometimes even the adaptation to another endotype. The integration of serial immune monitoring, adaptive clinical trial designs, and endotype-specific treatment algorithms has the potential to move the field forward.},
}

Humans
*Sepsis/therapy/immunology
Biomarkers/metabolism
*Immunotherapy/methods
Precision Medicine/methods
*Immunomodulation
Adult
Algorithms

@article {pmid41830552,
year = {2026},
author = {Shim, M and Park, SG and Smith, D and Uhler, E and Lacson, C},
title = {Tele-Dance Interventions for Health Outcomes: A Scoping Review.},
journal = {Telemedicine journal and e-health : the official journal of the American Telemedicine Association},
volume = {32},
number = {6},
pages = {547-565},
doi = {10.1177/15305627261427355},
pmid = {41830552},
issn = {1556-3669},
mesh = {Humans ; *COVID-19/epidemiology ; *Telemedicine/organization & administration ; Digital Health ; SARS-CoV-2 ; },
abstract = {INTRODUCTION: The rapid expansion of telehealth, particularly during the COVID-19 pandemic, accelerated the development of technology-mediated movement interventions to support physical and psychological health. Among these, tele-dance interventions (TDI) emerged as accessible and scalable models of care; however, a comprehensive synthesis of the evidence supporting these interventions remains limited. This scoping review maps existing literature on the feasibility, acceptability, and health-related outcomes of TDI across diverse populations.

METHODS: Guided by Arksey and O'Malley's framework and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines, we conducted a systematic search of 6 electronic databases and identified 26 eligible studies employing quantitative, qualitative, or mixed-methods designs. Methodological quality was appraised using the Mixed Methods Appraisal Tool. All interventions were delivered synchronously via videoconferencing platforms and were primarily adapted from established in-person dance programs, typically incorporating warm-up activities, structured or improvisational movement, and cool-down phases.

RESULTS: Across studies, TDI were consistently feasible and well accepted among older adults, individuals with neurological conditions, and people living with chronic illness. Psychosocial benefits, including enhanced social connection, improved mood, and reduced loneliness, were commonly reported. Physical outcomes such as improvements in balance, gait, and strength were also observed, suggesting potential functional benefits relevant to rehabilitation and health promotion.

CONCLUSION: TDI offer important advantages, including increased accessibility, flexible delivery formats, and scalability beyond in-person care. However, limitations include methodological heterogeneity, small sample sizes, underrepresentation of diverse populations, and limited long-term follow-up. Overall, TDI represent a promising telehealth modality, warranting future research emphasizing methodological rigor, inclusive design, hybrid delivery models, and implementation-focused evaluations.},
}

Humans
*COVID-19/epidemiology
*Telemedicine/organization & administration
Digital Health
SARS-CoV-2

@article {pmid41830693,
year = {2026},
author = {Giovanatti, A and Shapiro, AE},
title = {Anticipating tuberculosis vaccine acceptability in Kenya and South Africa: a narrative review of behavioral and social drivers and strategies to optimize acceptability.},
journal = {Vaccine},
volume = {79},
number = {},
pages = {128457},
pmid = {41830693},
issn = {1873-2518},
support = {K23 AI140918/AI/NIAID NIH HHS/United States ; T32 AI007044/AI/NIAID NIH HHS/United States ; },
mesh = {Humans ; Kenya/epidemiology ; *Tuberculosis Vaccines/administration & dosage/immunology ; South Africa/epidemiology ; *Tuberculosis/prevention & control ; *Vaccination Hesitancy/psychology ; *Patient Acceptance of Health Care/psychology ; Adolescent ; Adult ; Vaccination/psychology ; COVID-19/prevention & control ; Health Knowledge, Attitudes, Practice ; },
abstract = {Tuberculosis (TB) remains the leading infectious cause of death worldwide, yet the only vaccine currently available is the pediatric BCG, which has poor effectiveness in preventing TB in adolescents and adults. A TB vaccine for this older age group is projected to prevent 4.6-8.5 million deaths by 2050 and increase gross domestic product by US$1.6 trillion by 2080, making this a priority investment for global stakeholders. In response to the World Health Organization's End TB Strategy, several TB vaccine candidates are now in phase III clinical trials, many of which target adolescents and adults. However, research on attitudes towards a TB vaccine is limited and urgently needed among these key populations to inform vaccine demand creation, scale up needs, and implementation strategies, particularly given global trends of increased vaccine hesitancy following the introduction of novel COVID-19 vaccines. To address this gap, a literature search was conducted for published studies evaluating socio-behavioral predictors of acceptability of HPV, COVID, and childhood immunizations as proxy indicators since there is a lack of published data on TB vaccine acceptability. We focused our search within Kenya and South Africa between January 2015 and July 2025 to represent high TB burden countries. Findings were supplemented with emerging data from unpublished conference abstracts on TB vaccine attitudes. Significant predictors of vaccine acceptability included higher perceived risk of disease, older age, a sense of collective responsibility, accurate and sufficient knowledge of the vaccine, trust in government or health authorities, and confidence in vaccine safety, side effects, and efficacy. Corresponding strategies to improve TB vaccine acceptability included early and accurate public communication, engagement of community influencers and youth, and use of diverse communication platforms.},
}

Humans
Kenya/epidemiology
*Tuberculosis Vaccines/administration & dosage/immunology
South Africa/epidemiology
*Tuberculosis/prevention & control
*Vaccination Hesitancy/psychology
*Patient Acceptance of Health Care/psychology
Adolescent
Adult
Vaccination/psychology
COVID-19/prevention & control
Health Knowledge, Attitudes, Practice

@article {pmid41830818,
year = {2026},
author = {Wang, M and Zhang, Z and Jian, E and Jiang, H and Li, X and Yang, J and Yu, X and Cai, P},
title = {Exploring the evolving relationship between children and youth obesity and depression: A bibliometric analysis (1976-2025).},
journal = {Acta psychologica},
volume = {265},
number = {},
pages = {106641},
doi = {10.1016/j.actpsy.2026.106641},
pmid = {41830818},
issn = {1873-6297},
mesh = {Humans ; *Bibliometrics ; Child ; *Pediatric Obesity/epidemiology/psychology ; *Depression/epidemiology ; Adolescent ; Female ; },
abstract = {OBJECTIVES: Depression, a prevalent mental disorder characterized by prolonged low mood and diminished interest in activities, involves complex interactions among genetic, biological, psychosocial, and environmental factors in its pathogenesis. Notably, the dramatic global surge in children and youth obesity prevalence over recent decades has emerged as a major public health challenge, with growing evidence suggesting potential associations between this metabolic disorder and the development of depression. This study aims to evaluate the research progression in this field via bibliometric methods.

METHODS: We utilized the Web of Science Core Collection database to retrieve articles pertaining to children and youth obesity and depression published between 1976 and 2025. Bibliometric analysis was performed using VOSviewer, CiteSpace, and R Studio.

RESULTS: 4550 articles were identified based on the predetermined criteria. The USA and the University of Minnesota have the highest number of publications. Tanofsky-Kraff, Marian was the most productive author, and the journal with the most articles published was BMC Public Health. The most frequently used keywords were "obesity," "depression," and "children", and the most cited articles were written by Stice, E. The keywords that have emerged recently are "weight stigma", "students", "anxiety", "polycystic ovary syndrome", and "gut microbiota".

CONCLUSION: This study, revealed the evolving trends in the field of research on childhood obesity and depression. The research focus shifted from early topics such as mental health and eating disorders to weight stigma, gut microbiota, and COVID-19. Future research should focus on the biological mechanisms between obesity and depression, and gender differences.},
}

Humans
*Bibliometrics
Child
*Pediatric Obesity/epidemiology/psychology
*Depression/epidemiology
Adolescent
Female

@article {pmid41831107,
year = {2026},
author = {Jahanshahi, A and Mohammadi, S and Salehi, MA and Dolatshahi, M and Mirakhori, S and Frounchi, N and Zakavi, SS and Harandi, H and Ghasempour, H and Raji, CA},
title = {Brain microstructural alterations in COVID-19: a systematic review of diffusion weighted imaging studies.},
journal = {Brain imaging and behavior},
volume = {20},
number = {2},
pages = {},
pmid = {41831107},
issn = {1931-7565},
abstract = {INTRODUCTION: Following its emergence in Wuhan, COVID-19 has been associated with neurological sequalae, pathophysiological basis of which has been under investigation from the early reports. Herein, we aim to provide a comprehensive overview on white matter microstructural findings in COVID-19 patents.

METHODS: We performed a systematic literature search on PubMed, Scopus, Web of Science, and EMBASE databases on February 9th, 2025, using the combination of keywords related to COVID-19, DTI, and NODDI. Study selection and data extraction was performed to provide a qualitative synthesis of the data.

RESULTS: Mean diffusivity (MD) and fractional anisotropy (FA) were the most reported diffusion parameters. Significant alterations in diffusion parameters of longitudinal fasciculi, thalamic radiations, corpus callosum (CC), fronto-occipital fasciculus (FOF), cortico-spinal tract (CST) and uncinate fasciculi (UF) were repeatedly reported among in the studies, of which the results on changes in CR and LF were almost consistent.

CONCLUSION: The observed changes in white matter microstructural integrity are associated with the psychiatric and cognitive symptoms in post-COVID-19 phase. This observation warrants long-term follow-up of COVID-19 patients for the potential neurological sequalae of this disease.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11682-026-01084-3.},
}

@article {pmid41831154,
year = {2026},
author = {Begum, RF and Mathew, M and Doshi, PP and Suresh, S},
title = {Adapting covid-19 vaccination through targeted approaches: FDA-approved vaccines for the 2025-2026 season.},
journal = {Immunologic research},
volume = {74},
number = {1},
pages = {},
pmid = {41831154},
issn = {1559-0755},
}

@article {pmid41831236,
year = {2026},
author = {Croak, B and Lamb, D and Bhundia, R and Rafferty, AM and Greenberg, N and Stevelink, SAM},
title = {Moral injury in healthcare workers: causes & interventions.},
journal = {British medical bulletin},
volume = {157},
number = {1},
pages = {},
pmid = {41831236},
issn = {1471-8391},
support = {//NIHR Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust/ ; NIHR300592//NIHR via an NIHR Advanced Fellowship/ ; //NIHR Applied Research Collaborative North Thames/ ; },
mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Health Personnel/psychology ; SARS-CoV-2 ; *Morals ; Pandemics ; Psychological Distress ; },
abstract = {BACKGROUND: Moral injury (MI), characterized by psychological distress from morally transgressive events, has been predominantly studied in military personnel but has gained increased attention in healthcare workers (HCWs) since the COVID-19 pandemic.

SOURCES OF DATA: In this review, we narratively synthesize literature on the causes, risks, consequences, and interventions of MI in HCWs.

AREAS OF AGREEMENT: There is consensus that the COVID-19 pandemic presented HCWs with unique challenges such as fear of infection and patients dying without family, which increased the risk of MI in HCWs.

AREAS OF CONTROVERSY: Broader healthcare experiences, not unique to a pandemic, are less well understood. In this review, we discuss evidence of such experiences including restrictive practices in psychiatric settings and experiences of discrimination.

GROWING POINTS: Recent studies have highlighted the importance of addressing MI through organizational change, training, and peer support initiatives. Emerging evidence also underscores the need to consider broader systemic factors, such as workplace culture and leadership, in mitigating MI.

Future research should focus on longitudinal studies to explore in more detail risk factors for MI in HCWs. Additionally, there is a need for robust evaluations of interventions to prevent and treat MI and related disorders, including randomized controlled trials. Investigating the morally injurious effects of systemic issues like understaffing is particularly urgent as the field evolves beyond pandemic-specific challenges.},
}

Humans
*COVID-19/psychology/epidemiology
*Health Personnel/psychology
SARS-CoV-2
*Morals
Pandemics
Psychological Distress

@article {pmid41831387,
year = {2026},
author = {Asokan, S and Isiaka, ID and Jacob, T and Vijayan, S and Rajeswary, D},
title = {Middle east respiratory syndrome coronavirus (MERS-CoV): An underestimated betacoronavirus with pandemic potential.},
journal = {Diagnostic microbiology and infectious disease},
volume = {115},
number = {3},
pages = {117367},
doi = {10.1016/j.diagmicrobio.2026.117367},
pmid = {41831387},
issn = {1879-0070},
mesh = {Humans ; *Middle East Respiratory Syndrome Coronavirus/genetics/isolation & purification/pathogenicity/classification ; Animals ; *Coronavirus Infections/epidemiology/virology/diagnosis/transmission ; Camelus/virology ; Pandemics ; Zoonoses/epidemiology/virology ; Dipeptidyl Peptidase 4/metabolism ; Spike Glycoprotein, Coronavirus ; },
abstract = {Middle East respiratory syndrome coronavirus (MERS-CoV) is a zoonotic beta coronavirus identified in 2012 that circulates in dromedary camels and occasionally infects humans. Although community spread is limited, the disease shows a high case fatality rate near 36 percent and has caused hospital outbreaks such as the 2015 South Korea event. The viral spike binds the DPP4 (CD26) receptor, enabling entry into airway epithelial and selected immune cells, while accessory proteins suppress early innate immunity. Genetic studies indicate continuing evolution with clades A, B, and C across the Arabian Peninsula and Africa. Human infection is linked to camel contact, farm exposure, or raw camel products, with secondary spread mainly in healthcare settings. Diagnosis uses rRT-PCR and serology; treatment is supportive, and vaccines and antivirals are under study. A One Health approach is vital for surveillance, early detection, and control.},
}

Humans
*Middle East Respiratory Syndrome Coronavirus/genetics/isolation & purification/pathogenicity/classification
Animals
*Coronavirus Infections/epidemiology/virology/diagnosis/transmission
Camelus/virology
Pandemics
Zoonoses/epidemiology/virology
Dipeptidyl Peptidase 4/metabolism
Spike Glycoprotein, Coronavirus

@article {pmid41832484,
year = {2026},
author = {Vizuete-Aldave, N and Arrieta, H and Zarrazquin, I and Kortajarena, M and Labaka, A},
title = {Gender disparities in hospital admission patterns during the COVID-19 health emergency: a systematic review.},
journal = {BMC public health},
volume = {26},
number = {1},
pages = {},
pmid = {41832484},
issn = {1471-2458},
abstract = {BACKGROUND: Sex/gender differences influence health outcomes, healthcare access, and hospital use. The COVID-19 pandemic disrupted health systems and may have exacerbated existing disparities. This systematic review was conducted to examine whether sex/gender disparities exist across diagnostic categories and hospital admission routes, and to determine whether these differences were altered following the declaration of the COVID-19 pandemic.

METHODS: This review was conducted according to the PRISMA guidelines. Searches were conducted in PubMed, Web of Science and Cochrane Library to identify studies published in English or Spanish between 2020 and 2024 examining hospital admissions before and during the COVID-19 pandemic, with sex-disaggregated data.

RESULTS: A total of 41 studies met the inclusion criteria, revealing gender-related differences in hospital admissions during the pandemic. The articles were classified according to ICD-10 chapters. During the pandemic, among adults and across all age groups, there was a notable increase in hospitalisations among women for acute burns, alcohol-associated hepatitis, resected lung cancer, malignant melanoma, and others. Women also showed increased emergency visits for infections, mental health problems, and injuries. In contrast, men experienced an increase in admissions for gastrointestinal bleeding. Additionally, studies reported rises in sexual abuse of girls, higher self-harm rates among boys, and more admissions for mental health problems among girls.

CONCLUSIONS: This systematic review identified differences in hospital admissions for various conditions and highlighted social and health inequalities exacerbated by lockdown. These findings undersore the importance of integrating a gender perspective into public health strategies and responses during health emergencies.

TRIAL REGISTRATION: The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 22 August 2025 (CRD420251038282).},
}

@article {pmid41832744,
year = {2026},
author = {Nyame, P and Okoh, OS and Yalley, AK and Nii-Trebi, NI},
title = {Towards Ending HIV/AIDS by 2030: Trajectory of Sub-Saharan Africa-A Post-COVID-19 (2019-2024) Review.},
journal = {Reviews in medical virology},
volume = {36},
number = {2},
pages = {e70138},
doi = {10.1002/rmv.70138},
pmid = {41832744},
issn = {1099-1654},
mesh = {Humans ; *COVID-19/epidemiology/virology ; Africa South of the Sahara/epidemiology ; *HIV Infections/epidemiology/drug therapy/prevention & control/diagnosis ; SARS-CoV-2 ; Delivery of Health Care ; *Acquired Immunodeficiency Syndrome/epidemiology/drug therapy/prevention & control ; Pandemics ; },
abstract = {Globally, the COVID-19 pandemic perturbed HIV services, jeopardising progress towards the Joint United Nations Programme on HIV/AIDS (UNAIDS) 95-95-95 targets in sub-Saharan Africa (SSA). This review is an evaluation of sub-Saharan Africa's progress towards attaining the UNAIDS target of ending HIV/AIDS by the year 2030 in the context of COVID-19. Data from UNAIDS, the World Health Organisation (WHO), and peer-reviewed literature were analysed to assess HIV service delivery in SSA from 2019 to 2024, with special attention to regional disparities and health system adaptations before, during, and after the pandemic. Before the COVID-19 pandemic, Southern and Eastern Africa were nearing the 90-90-90 goals while West and Central Africa made slower progress because of weaker health systems and other situational challenges. Between 2020 and 2022, lockdowns and service disruptions reduced HIV testing, delayed the start of antiretroviral therapy (ART), and led to fewer viral load analyses. To adapt, health systems provided ART for longer periods, offered more community-based care, expanded health worker roles, and used digital tools to maintain services, especially where infrastructure was strong. By 2023 and 2024, most countries in Southern and Eastern Africa were closer to achieving the 95-95-95 targets, while West and Central Africa continued to recover more slowly. The pandemic revealed both strengths and weaknesses in the HIV response in sub-Saharan Africa. Institutionalising innovations developed during the pandemic and addressing persistent regional disparities, which reflect uneven progress across the sub-region, are essential to sustaining progess and achieving epidemic control by 2030.},
}

Humans
*COVID-19/epidemiology/virology
Africa South of the Sahara/epidemiology
*HIV Infections/epidemiology/drug therapy/prevention & control/diagnosis
SARS-CoV-2
Delivery of Health Care
*Acquired Immunodeficiency Syndrome/epidemiology/drug therapy/prevention & control
Pandemics

@article {pmid41833428,
year = {2026},
author = {Clarkson, J and Walsh, T and Lewis, S and Riley, P and O'Malley, L and Glenny, AM},
title = {CELEBRATING 30 YEARS OF COCHRANE ORAL HEALTH: A LEGACY OF EVIDENCE AND IMPACT.},
journal = {The journal of evidence-based dental practice},
volume = {26},
number = {1},
pages = {102227},
doi = {10.1016/j.jebdp.2026.102227},
pmid = {41833428},
issn = {1532-3390},
mesh = {Humans ; *Oral Health ; *Evidence-Based Dentistry/history ; COVID-19 ; *Systematic Reviews as Topic ; History, 21st Century ; History, 20th Century ; },
abstract = {In 2024, Cochrane Oral Health (COH) celebrated its 30th anniversary, marking 3 decades of advancing global oral health through rigorous evidence synthesis. Based at The University of Manchester, COH has become a cornerstone of trusted health information, contributing to clinical practice, policy, and patient care. COH's mission centers on producing accessible, high-quality systematic reviews to inform decision-making and promote equitable oral health. Its prioritization strategy, involving diverse stakeholders, ensures relevance and impact. COH exemplifies methodological excellence and innovation, adhering to Cochrane methodological standards and promoting transparency through protocol publication and freely available plain language summaries. Our reviews are widely cited in international guidelines and policy documents, with notable contributions to evidence synthesis and knowledge translation in the areas of fluoride interventions, antimicrobial use, oral cancer management, and infection control during COVID-19. COH has embraced innovation through the conduct of a diverse range of review methodologies including living reviews, diagnostic test accuracy reviews and overviews of systematic reviews, AI-assisted synthesis, and commissioned evidence synthesis. Cochrane Oral Health's legacy is defined by its commitment to methodological rigor, stakeholder engagement, and global impact. As it enters its fourth decade, COH continues to evolve, addressing emerging challenges and advancing oral health through trusted evidence. Its strategic goals of expanding reach, innovating methods, promoting equity, and effective knowledge translation position COH as a leader in evidence-based oral healthcare.},
}

Humans
*Oral Health
*Evidence-Based Dentistry/history
COVID-19
*Systematic Reviews as Topic
History, 21st Century
History, 20th Century

@article {pmid41834872,
year = {2026},
author = {Han, Z and Wang, H and Liu, X and Tian, Z and Gong, Q and Zhang, X and Li, X and Du, R and Hu, X and Xu, C},
title = {Cross-species transmission alert: a novel canine-raccoon dog coronavirus infecting an Amur Tiger in China.},
journal = {Frontiers in microbiology},
volume = {17},
number = {},
pages = {1764349},
pmid = {41834872},
issn = {1664-302X},
abstract = {Canine coronavirus (CCoV) is an important enteric alphacoronavirus primarily affecting canids. Here, we detected canine coronavirus RNA in a captive 9-year-old Amur tiger (Panthera tigris altaica) in China. The complete viral genome was obtained using metagenomic next-generation sequencing. Phylogenetic and recombination analyses were then performed to investigate its evolutionary relationship with canine and feline coronaviruses. The identified CCoV strain clustered within established canine coronavirus lineages and showed sequence evidence of recombination involving coronavirus strains previously reported in other carnivore species. Although the detection of viral RNA alone does not establish a causal relationship between CCoV infection and disease outcome, this study provides molecular evidence that Amur tigers are susceptible to canine coronavirus infection. These findings expand the known host range of CCoV and contribute to understanding the evolution and cross-species transmission potential of coronaviruses among carnivores.},
}

@article {pmid41834940,
year = {2026},
author = {Kalsi, P and Aggarwal, N and Shukla, KK and Sharma, J and Goyal, G and Prasad, R and Sharma, H},
title = {SARS-CoV-2 Associated Impact on Reproductive Health: A Global Perspective.},
journal = {Indian journal of clinical biochemistry : IJCB},
volume = {41},
number = {2},
pages = {188-199},
pmid = {41834940},
issn = {0970-1915},
abstract = {The outbreak of the novel coronavirus disease due to the SARS-CoV-2 virus originated in Wuhan in December 2019, and emerged as a considerable global pandemic threat, with serious impact on different aspects of people's health and lives. Though, the disease is no longer considered a global emergency, its potential risks for long-term reproductive health remain a concern. Various guidelines and precautionary measures such as suspension of non-essential medical services were adopted for the containment of this deadly virus. Although such restrictions were proven to be an effective tool in preventing the spread of novel coronavirus, however, this has also negatively impacted society, including infertile couples undergoing fertility treatment. During the period of the pandemic, females experienced changes in menstrual cycles, thyroid dysfunction, and stress-associated loss in libido and other related sexual dysfunctions, leading to consequential effects on their reproductive and mental health. The SARS-CoV-2-associated defects are not only limited to female reproductive dysfunction rather the male reproductive organs were found to be equally impacted by this SARS-CoV-2 virus. The expression of ACE2 in the male reproductive count is a major factor for significant alterations observed in male reproductive function. In this current article, we have focused on the impact of SARS-CoV-2 on reproductive health, and the challenges of assisted reproductive technology (ART) during the pandemic outbreak.},
}

@article {pmid41835055,
year = {2025},
author = {Hsu, CY and Abdulazez, AA and Almajidi, YQ and Kareem, AK and Aseeri, AA and Prasad, K and Al-Khafaji, ZK and Al-Mashhadani, ZI and Bokhoor, SN and Hasan, RN},
title = {Delivery Systems of mRNA Vaccines in the Treatment of Infectious Diseases: From Lipid Nanoparticles to Next-Generation Platforms.},
journal = {Advanced pharmaceutical bulletin},
volume = {15},
number = {4},
pages = {717-734},
pmid = {41835055},
issn = {2228-5881},
abstract = {The historic accomplishment of mRNA vaccines against SARS-CoV-2 has provided a massive shift in vaccinology, providing a quick, nimble, and powerful platform for infectious disease prevention. This success, however, does not simply stem from the mRNA sequence but equally depends on the delivery vehicle-the lipid nanoparticle (LNP). The delivery system has evolved from a passive transporter into an active immunomodulatory component, a critical component that (1) protects the inherently fragile mRNA payload, (2) allows cellular uptake and endosomal escape, and (3) adds its own inherent adjuvant properties to shape the immune response. This review provides a comprehensive summary of the current advancements in mRNA vaccine delivery technologies. We first deconstruct the structure, mechanisms, advantages, and disadvantages of the clinically validated LNP platform. Following this discussion, we highlight the emerging landscape of new systems, including chemically diverse polymeric nanoparticles, biologically-inspired peptide-based carriers, and endogenous extracellular vesicles, potentially overcome current limitations in these delivery systems, including issues with thermostability and targeted delivery. After this, we summarize how these new delivery technologies are being leveraged clinically for a continuum of high-priority infectious diseases, including influenza, RSV, CMV, HIV, Zika, and Rabies. This discussion also illustrates how the design of vaccine prototypes is being rational to address the immune-mediated strategies exploited by each distinct pathogen.},
}

@article {pmid41835098,
year = {2026},
author = {Dos Santos, LPM and Leão, JV and Silva, KYBM and Dos Santos, DL and Batista, CN and Barros, JA and Paranhos, ACM and Dias, ÁRN and Falcão, LFM},
title = {Transcranial stimulation as a possible therapeutic proposal in long COVID.},
journal = {Frontiers in rehabilitation sciences},
volume = {7},
number = {},
pages = {1766757},
pmid = {41835098},
issn = {2673-6861},
abstract = {The COVID-19 pandemic triggered an unprecedented global health crisis, with significant repercussions on the mental and neurological health of millions of individuals. Long COVID, characterized by persistent and debilitating symptoms, including chronic fatigue, pain, cognitive impairment, and mood swings, represents a substantial therapeutic challenge. In this context, neuromodulation emerges as a promising therapeutic strategy, offering new perspectives for the management of refractory neurological symptoms. This article aims to critically review the current evidence on the use of neuromodulation in patients with long COVID.},
}

@article {pmid41835195,
year = {2026},
author = {Chen, R and Xu, Z},
title = {Doxycycline for Macrolide-Resistant Mycoplasma pneumoniae Pneumonia in Children: Clinical Updates and Therapeutic Insights Post-COVID-19.},
journal = {Infection and drug resistance},
volume = {19},
number = {},
pages = {593954},
pmid = {41835195},
issn = {1178-6973},
abstract = {Mycoplasma pneumoniae (MP) is a leading cause of community-acquired pneumonia (CAP) in children. Macrolides have long been first-line therapy due to favorable safety profiles and low minimum inhibitory concentrations (MICs) in pediatric populations. However, the global surge in macrolide-resistant MP (MRMP) has compromised conventional treatments, creating an urgent need for alternative agents. Mounting evidence supports doxycycline, a second-generation tetracycline, as an effective therapy for pediatric MRMP, particularly post-COVID-19. Compared to azithromycin, doxycycline shortens disease duration, accelerates the resolution of fever and cough, promotes pulmonary infiltrate absorption, and yields robust outcomes in children ≥8 years old. It also reduces corticosteroid use and exhibits a favorable safety profile. For refractory MP pneumonia (RMPP), combination therapy with doxycycline and corticosteroids (eg, methylprednisolone) enhances therapeutic effects. Ongoing research explores innovative combinations and personalized dosing to mitigate resistance. This narrative overview synthesizes recent advances in doxycycline use for pediatric MRMP since the COVID-19 pandemic, aiming to inform evidence-based practice. It also highlights the need for large-scale, well-designed trials to confirm long-term safety and efficacy, supporting standardized clinical implementation.},
}

@article {pmid41836534,
year = {2026},
author = {Scirocco, E and Paganoni, S and Brizzi, K},
title = {Approaching Serious Illness Conversations in Amyotrophic Lateral Sclerosis Using Telehealth: A Practical Guide.},
journal = {Neurology. Clinical practice},
volume = {16},
number = {2},
pages = {e200600},
pmid = {41836534},
issn = {2163-0402},
abstract = {PURPOSE OF REVIEW: Given the lack of consensus on serious illness conversations (SIC) in amyotrophic lateral sclerosis (ALS) by using telehealth, we aim to provide practical strategies in this setting.

RECENT FINDINGS: Over the past 5 years, there has been substantial growth in telehealth, especially after the global COVID-19 pandemic. In ALS, telehealth has become an increasingly used tool for providing clinical care, especially as the disease progresses, when travel becomes challenging and geographic constraints arise. As ALS advances, clinicians often have SIC with individuals living with ALS and their caregivers using telehealth. In the literature, few recommendations are available to improve telehealth communication in the neuropalliative setting.

SUMMARY: We present 3 case scenarios showcasing telehealth strategies for SICs, with specific considerations for individuals living with ALS. We provide a strategy, CARE in ALS, to support telehealth communication in individuals with speech impairments. We hope to provide practical guidance for health care clinicians in this specific setting.},
}

@article {pmid41836927,
year = {2026},
author = {Baptista, SN and Atkins, T and Chakraborty, S and Bakhit, M and Glasziou, P and Byambasuren, O},
title = {Candidate treatments for long COVID: a narrative review of expert and patient-driven priorities.},
journal = {Frontiers in medicine},
volume = {13},
number = {},
pages = {1734600},
pmid = {41836927},
issn = {2296-858X},
abstract = {OBJECTIVE: To map the existing evidence for candidate treatments for long COVID that were prioritised by clinicians and people with lived experience, and to characterise their feasibility, acceptability and safety.

STUDY DESIGN: The study was conducted as a narrative review using pragmatic methods including iterative stakeholder-informed decision-making a monthly-updated evidence search, rapid lay evidence summaries and a structured research prioritisation process.

DATA SOURCES: Potential candidate treatments were identified via a combination of database and trial registry searches. These were then ranked by clinicians and people with lived experience using surveys. Evidence summaries for the top 14 interventions (low-dose naltrexone, antivirals, metformin, nicotine, vagus nerve stimulation, antihistamines, guanfacine, colchicine, nattokinase, intravenous immunoglobulins, monoclonal antibodies, coenzyme Q10, multicomponent rehabilitation packages, and exercise training) were created. Prioritised treatments were collated first by searching a collaborative living evidence database (updated monthly) of relevant systematic reviews and randomised controlled trials and then by conducting supplementary searches of other study designs.

DATA SYNTHESIS: Six of 14 interventions had long-COVID-specific randomised controlled trial (RCT) evidence (exercise [16 RCTs], multicomponent packages [5 RCTs], coenzyme Q10 [2 RCTs], antivirals [1 RCT], vagus nerve stimulation [1 pilot RCT], monoclonal antibodies [1 small RCT]); the remainder relied on indirect or very low-certainty data (e.g., uncontrolled studies or mechanistic rationale). Across interventions, evidence certainty was mostly low to very low, and safety/feasibility varied.

CONCLUSION: This review prioritises and maps candidate treatments for long COVID. There was insufficient direct evidence to inform clinical recommendations. Rather, the treatments presented in this review represent those that could be rigorously tested in clinical trials as they show biological plausibility and/or are feasible and acceptable to people with lived experience and clinicians.

REGISTRATION: A review protocol was not prospectively registered because the review adopted an iterative approach to support priority setting rather than clinical guidance.},
}

@article {pmid41837342,
year = {2026},
author = {Yilmaz, S and Göktaş, B and Ateş, İ and Çelik, M},
title = {Ivermectin Toxicity in Humans and Animals: Clinical Spectrum, Mechanisms, and Management.},
journal = {Journal of applied toxicology : JAT},
volume = {46},
number = {6},
pages = {1856-1870},
pmid = {41837342},
issn = {1099-1263},
mesh = {*Ivermectin/toxicity/pharmacokinetics ; Humans ; Animals ; *Antiparasitic Agents/toxicity/pharmacokinetics ; Blood-Brain Barrier/drug effects/metabolism ; *Neurotoxicity Syndromes/etiology ; },
abstract = {Ivermectin is a widely used macrocyclic lactone with established efficacy against a broad range of parasitic infections in humans and animals and a long-standing reputation for clinical safety. However, increasing evidence indicates that ivermectin can produce clinically relevant toxicity under specific conditions, particularly involving the central nervous system. This review integrates findings from controlled human trials, pharmacovigilance data, clinical case reports, experimental animal studies, and environmental investigations to comprehensively characterize the toxicological profile of ivermectin. Early randomized, placebo-controlled studies in healthy volunteers demonstrated that ivermectin is generally well tolerated, even at doses substantially exceeding approved therapeutic levels, with predominantly mild and transient adverse events and no significant neurological toxicity under controlled conditions. In contrast, post-marketing surveillance and real-world clinical reports have identified rare but severe neurotoxic events, including encephalopathy, seizures, coma, and death, occurring after supratherapeutic exposure and, in susceptible individuals, even at standard therapeutic doses. Converging human and animal evidence highlights impairment or saturation of blood-brain barrier protection, particularly dysfunction of P-glycoprotein (ABCB1/MDR1)-mediated efflux, as a central determinant of ivermectin neurotoxicity. Animal studies further demonstrate marked species-, breed-, age-, dose-, and route-dependent susceptibility, with neonatal animals, genetically predisposed dog breeds, and models exposed to transporter inhibition or repeated high-dose regimens showing pronounced vulnerability. While neurotoxicity is often functional and reversible at lower exposures, high or cumulative dosing can lead to structural neuropathology and multi-organ injury. The COVID-19 pandemic amplified these risks through widespread off-label use, especially of veterinary formulations, resulting in a substantial increase in toxic exposures without demonstrated clinical benefit. Overall, ivermectin toxicity emerges as a predictable consequence of interactions between pharmacokinetics, transporter biology, exposure patterns, and host-specific factors rather than an inherent contradiction of its therapeutic value.},
}

*Ivermectin/toxicity/pharmacokinetics
Humans
Animals
*Antiparasitic Agents/toxicity/pharmacokinetics
Blood-Brain Barrier/drug effects/metabolism
*Neurotoxicity Syndromes/etiology

@article {pmid41840407,
year = {2026},
author = {Chase, NM},
title = {Vaccinating patients on biologics for atopic disease: Clinical considerations and evidence-based recommendations.},
journal = {Allergy and asthma proceedings},
volume = {47},
number = {2},
pages = {85-91},
doi = {10.2500/aap.2026.47.260001},
pmid = {41840407},
issn = {1539-6304},
mesh = {Humans ; *Biological Products/therapeutic use/adverse effects ; *Vaccination ; Antibodies, Monoclonal, Humanized/therapeutic use ; Evidence-Based Medicine ; *Hypersensitivity, Immediate/drug therapy/immunology ; },
abstract = {Background: Biologics that target type 2 inflammation have transformed the management of atopic diseases, but questions remain with regard to vaccine administration in these patients. Current product labeling recommends caution with vaccine administration in patients taking these medications, particularly live-attenuated vaccines, despite limited evidence of actual risk. Objective: The objective was to review clinical concerns and available evidence, and to provide practical recommendations for vaccination in patients receiving biologics for atopic diseases, with a focus on dupilumab. Methods: A comprehensive PubMed/MEDLINE literature search was conducted to identify relevant studies and clinical guidance with regard to vaccination strategies in patients receiving biologic therapy. The primary search terms included the following: "biologic therapy" or "biologic therapy" or "monoclonal antibodies" combined with "vaccination" or "immunization" or "vaccine response" or "live vaccines" or "inactivated vaccines." Priority was given to randomized controlled trials, large observational studies, and registry data published within the past 10 years. Results: For non-live vaccines, evidence supports safety and efficacy, although results of some studies suggest moderately reduced responses. A randomized controlled trial found comparable antibody responses between dupilumab and placebo groups for tetanus (83.3% versus 83.7%) and meningococcal vaccines (86.7% versus 87.0%). Coronavirus disease 2019 (COVID-19) vaccine studies show mixed results, with some reporting lower antibody levels and neutralization capacity in patients on biologics. For live-attenuated vaccines, emerging evidence challenges traditional prohibitions. Conclusion: Current evidence supports the safety and efficacy of non-live vaccines in patients receiving biologics for atopic diseases, although responses may be moderately reduced. Analysis of emerging data suggests certain live-attenuated vaccines may be safer than previously thought, particularly in pediatric patients on dupilumab. Vaccination decisions should be individualized based on risk-benefit assessment. Further research is needed to establish definitive guidelines, particularly for live vaccines and long-term immunity.},
}

Humans
*Biological Products/therapeutic use/adverse effects
*Vaccination
Antibodies, Monoclonal, Humanized/therapeutic use
Evidence-Based Medicine
*Hypersensitivity, Immediate/drug therapy/immunology

@article {pmid41841055,
year = {2026},
author = {Sidiropoulou, M},
title = {The Current Landscape of Ophthalmology Training in Europe.},
journal = {Cureus},
volume = {18},
number = {2},
pages = {e103487},
pmid = {41841055},
issn = {2168-8184},
abstract = {Ophthalmology training across Europe has undergone a significant transformation over the last two decades. Although individual countries retain distinct systems for resident recruitment, training structure, and surgical exposure, the overarching goal has been to converge toward competency-based education guided by the European Board of Ophthalmology (EBO) and the European Union of Medical Specialists (UEMS). This narrative review draws on official EBO and UEMS policy documents, recent peer-reviewed literature, national curricula, and surveys of residents and educators. It examines the structure and duration of training, curriculum reforms, surgical exposure, simulation, fellowship opportunities, and the influence of European legislation on professional mobility. Residency programs in Europe vary in length from four to six years, with considerable heterogeneity in surgical case volume, fellowship opportunities, and access to simulation. The 2024 European Training Requirements (ETR) introduced Entrustable Professional Activities (EPAs), programmatic assessment, and e-portfolios, providing a common reference for national curricula. The EBO Diploma (EBOD) serves as a recognized benchmark for harmonization. Simulation-based cataract training has moved from optional to integral, though adoption remains inconsistent. Pressures such as the European Working Time Directive (EWTD) and the COVID-19 pandemic have altered clinical exposure, while digital education and mobility programs offer compensatory mechanisms. European ophthalmology training is moving toward harmonized outcomes but retains structural variation between countries. Achieving consistency will require aligning national curricula with the ETR, mandating simulation milestones, investing in faculty development, and formalizing fellowship standards to ensure equitable access and readiness for independent practice.},
}

@article {pmid41841485,
year = {2026},
author = {Ahn, SN},
title = {Evidence from a Narrative Review of Altered Intervention Methods and Behavioral Goals for Children with ASD in Relation to COVID-19.},
journal = {Restorative neurology and neuroscience},
volume = {},
number = {},
pages = {9226028261430326},
doi = {10.1177/09226028261430326},
pmid = {41841485},
issn = {1878-3627},
abstract = {Environmental changes in response to COVID-19 may negatively impact the development, behavior, and mental health of children with Autism spectrum disorder (ASD). Thus, it is necessary to investigate the changed behavioral goals provided.This narrative review examined studies that investigated changes in intervention methods and behavioral goals for children with ASD during COVID-19. This study searched five databases and identified ten articles meeting the inclusion criteria. These articles were evaluated for risk of bias and quality of evidence level. Behavioral goals and intervention methods were reviewed.The selected articles included two non-randomized single-group studies, six single-experiment studies, and two case studies. Behavioral goals included mask wearing, social participation and play, and behavioral regulation. Interventions included telehealth, social participation training, play-based sibling intervention, early intensive behavioral, differential reinforcement, and treatment extension for tolerating.This review identifies the need to change in intervention methods and behavioral goals for children with ASD to adapt to environmental changes due to COVID-19.},
}

@article {pmid41841644,
year = {2026},
author = {Borst, A and Choorapoikayil, S and Stuhlmann, S and Zacharowski, K and Meybohm, P},
title = {Advances in the understanding and management of hospital-acquired anemia.},
journal = {Current opinion in anaesthesiology},
volume = {39},
number = {3},
pages = {401-408},
pmid = {41841644},
issn = {1473-6500},
mesh = {Humans ; *Anemia/therapy/etiology/epidemiology ; Blood Transfusion ; Incidence ; Iatrogenic Disease/epidemiology/prevention & control ; Length of Stay ; },
abstract = {PURPOSE OF REVIEW: Hospital-acquired anemia (HAA) is a common complication associated with adverse outcomes, including increased transfusion requirements and prolonged hospital length of stay. The precise etiology of HAA remains elusive, and preventive or therapeutic strategies are inconsistently applied or lacking altogether. This review summarizes current evidence on the incidence, underlying mechanism, clinical consequences, and available interventions for HAA.

RECENT FINDINGS: The causes of HAA are multifactorial involving procedural or diagnostic blood loss, impaired erythropoiesis, coagulation abnormalities, nutritional deficiencies, and hemolysis. Measures such as small volume tubes and closed blood collection devices have proven safe and effective for reducing the volume of drawn blood. Recent studies suggest that the incidence of HAA can be diminished by implementing systematic, patient-centered approaches.

SUMMARY: HAA remains prevalent despite long-standing recognition of its clinical consequences. Although awareness has continuously increased, treatment and prevention strategies are still not widely established.},
}

Humans
*Anemia/therapy/etiology/epidemiology
Blood Transfusion
Incidence
Iatrogenic Disease/epidemiology/prevention & control
Length of Stay