@article {pmid41843918,
year = {2026},
author = {Sevilla, JP and Knee, JS and Burnes, D and Meier, G and Yang, J and Di Fusco, M and Hu, T and Bloom, DE},
title = {The full value of mRNA seasonal influenza and endemic-stage COVID-19 combination vaccines: a taxonomy.},
journal = {Journal of medical economics},
volume = {29},
number = {1},
pages = {848-870},
doi = {10.1080/13696998.2026.2638676},
pmid = {41843918},
issn = {1941-837X},
mesh = {Humans ; *COVID-19 Vaccines/economics/administration & dosage ; *Influenza Vaccines/economics/administration & dosage ; *COVID-19/prevention & control/epidemiology ; Middle Aged ; Adult ; *Influenza, Human/prevention & control ; Aged ; Adolescent ; Vaccines, Combined/economics ; Young Adult ; },
abstract = {AIMS: Seasonal influenza and COVID-19 pose significant ongoing threats to global health. Vaccination remains central to their prevention. Messenger RNA combination influenza and COVID-19 vaccines (mRNA combo vaccines) are in development. Payers will soon need to make value-for-money (VfM) assessments and coverage decisions regarding these vaccines. Value taxonomies play an important role in VfM assessments and coverage decisions. However, no taxonomy exists that captures the full value of mRNA combo vaccines. We aimed to construct a taxonomy of the full value, from a societal perspective, of mRNA combo vaccines in working-age (18-64 years) and older adults (65+ years).

METHODS: We (1) performed a targeted literature review (TLR) of existing value taxonomies and value attributes of COVID-19, influenza, other mRNA, and other combination vaccines; and (2) synthesized the value elements found in the TLR into a comprehensive taxonomy specific to mRNA combo vaccines.

RESULTS: Of 1851 identified studies, 57 contained relevant value elements. We constructed a taxonomy distinguishing narrow health-related from broader societal values, and traditional from novel values. Value elements in the taxonomy included improved health and reduced treatment costs; improved productivity; improved strain selection, raising vaccine efficacy; greater compliance with vaccine schedules, increasing uptake; improved patient and caregiver health and reduced treatment costs from such greater efficacy and uptake; reduced adverse events, anxiety and vaccination costs from reduced doses; process utilities from increased convenience; higher patient and provider acceptability; increased equity; and health-related R&D spillovers.

LIMITATIONS: The TLR was non-systematic. We do not address potential redundancies or the relative importance of different values.

CONCLUSIONS: Many value elements in the taxonomy are traditional narrow values and fit within a health payer perspective, but the taxonomy also captures broader societal values. This taxonomy can support more comprehensive valuations of mRNA combo vaccines in national vaccine recommendation and funding decisions.},
}

Humans
*COVID-19 Vaccines/economics/administration & dosage
*Influenza Vaccines/economics/administration & dosage
*COVID-19/prevention & control/epidemiology
Middle Aged
Adult
*Influenza, Human/prevention & control
Aged
Adolescent
Vaccines, Combined/economics
Young Adult

@article {pmid41844030,
year = {2026},
author = {Zhang, Q and Gao, C and Ge, X and Sun, Y and Liu, P and Zhang, XX},
title = {Tracking viral variants by wastewater surveillance, from laboratory diagnosis towards on-site monitoring: lessons learned from the SARS-CoV-2 pandemic.},
journal = {Journal of environmental management},
volume = {404},
number = {},
pages = {129353},
doi = {10.1016/j.jenvman.2026.129353},
pmid = {41844030},
issn = {1095-8630},
mesh = {*SARS-CoV-2/genetics/isolation & purification ; *COVID-19/epidemiology/virology/diagnosis ; *Wastewater/virology ; Humans ; *Wastewater-Based Epidemiological Monitoring ; Pandemics ; Mutation ; },
abstract = {Wastewater-based epidemiology (WBE) provides a scalable, population-level biosurveillance layer that complements clinical testing for monitoring SARS-CoV-2 circulation, particularly when diagnostic participation, access, or representativeness is limited. As SARS-CoV-2 continues to evolve, wastewater surveillance has expanded beyond quantifying total viral RNA to also resolving signature mutations and mixed lineage compositions in complex matrices. This review synthesizes end-to-end workflows for variants-directed WBE, spanning sample collection and viral signal enrichment, sequencing-dependent approaches (tiled-amplicon and hybrid-capture sequencing coupled with lineage deconvolution of mixed samples), and sequencing-independent approaches based on targeted mutation detection, including RT-dPCR, allele-specific RT-qPCR, and nested-PCR coupled with LC-MS. We compare these modalities in terms of resolution, sensitivity, turnaround time, and operational constraints, and highlight recurrent bottlenecks such as uneven genome coverage, low-frequency mutation detection, primer/assay drift, and the need for robust quality control and benchmarking under real wastewater conditions. To reduce end-to-end latency and improve sustainability, we outline requirements and research priorities for integrated, automated on-site (or near-site) monitoring systems, emphasizing compact enrichment/extraction modules, field-deployable detection chemistries, and rapid reporting pipelines. Finally, we extend the COVID-era framework beyond SARS-CoV-2, discussing how wastewater and environmental surveillance can be institutionalized as a multi-hazard public health intelligence platform supporting multiplex respiratory panels, pathogen-agnostic sequencing for anomaly detection, mobility-linked sentinel networks, and One Health applications such as antimicrobial resistance monitoring.},
}

*SARS-CoV-2/genetics/isolation & purification
*COVID-19/epidemiology/virology/diagnosis
*Wastewater/virology
Humans
*Wastewater-Based Epidemiological Monitoring
Pandemics
Mutation

@article {pmid41844087,
year = {2026},
author = {Gupta, J and Kumar, R},
title = {A comprehensive review on artificial intelligence driven approaches for vaccine development: Current advances, challenges, and future prospects.},
journal = {Current research in translational medicine},
volume = {74},
number = {2},
pages = {103577},
doi = {10.1016/j.retram.2026.103577},
pmid = {41844087},
issn = {2452-3186},
abstract = {Artificial intelligence (AI) has emerged as an exemplified tool in the field of modern biomedical technology. The unprecedent COVID-19 pandemic and other infectious disease crises have highlighted the critical need for rapid and accurate vaccine development processes. The traditional method of vaccine development methods are often time-consuming, costly, and inefficient. On contrary to this, the AI streamlines vaccine development from antigen prediction to clinical trial optimization by integrating computational biology, machine learning, structural bioinformatics, and immunoinformatic. AI has many potential applications in vaccine research, and this review covers all of the bases, from the fundamentals of AI in biology to immunogen design, clinical trial data mining, efficacy prediction modelling modelling, and adjuvant optimization. The review also investigates potential unknown issues, ethical concerns, and future developments in AI-driven vaccine development. This paper emphasizes the potential of AI to transform global preparedness against infectious diseases by combining evidence from various disciplines in vaccine development.},
}

@article {pmid41845433,
year = {2026},
author = {Yadanar, and Thu, MS and Tipayamongkholgul, M},
title = {Equitable utilization of non-communicable disease services in low- and middle-income countries; associated factors and intervention effects: a systematic review and meta-analysis.},
journal = {BMC health services research},
volume = {26},
number = {1},
pages = {},
pmid = {41845433},
issn = {1472-6963},
abstract = {BACKGROUND: With aging populations, a double burden of disease, and post-COVID-19 economic strain, managing non-communicable diseases (NCDs) has become a major challenge in low- and middle-income countries (LMICs). While most studies examine inequities in general healthcare utilization, few focus specifically on NCDs services. This review addresses that gap by synthesizing evidence on associated factors of equitable NCDs service utilization and assessing interventions to improve utilization. METHODS: A systematic review and meta-analysis were conducted following PRISMA-Equity guidelines, including studies published between 2014 and 2024. Eligible studies examined socioeconomic and demographic associated factors of NCDs service utilization or evaluated interventions to reduce inequities. In the meta-analysis, pooled estimates for NCDs service utilization were performed using a random effects model. Heterogeneity among studies was assessed using I[2] statistics. RESULTS: Twenty-three studies were included. Overall, NCDs service utilization showed a clear pro-rich pattern, with wealthier groups consistently utilizing more services. The pooled outpatient NCD service utilization was 52.84% (95% CI: 41.04–64.64). Compared with the poorest wealth quintile, higher wealth status was significantly associated with greater NCDs service utilization (AOR = 1.44; 95% CI: 1.18–1.74). Socioeconomic status was the strongest associated factor, while gender, rural residence, and insurance status showed no consistent effects. Interventions such as patient-centered care, provider training, system-level reforms, and digital health integration showed promising outcomes. CONCLUSION: This review highlights that inequities in NCDs service utilization are driven primarily by poverty and structural barriers, not demographic factors alone. By focusing specifically on NCDs, it adds new evidence to equity literature that has previously concentrated on general healthcare use. Targeted pro-poor strategies and innovative interventions are essential to reduce disparities and improve NCD outcomes in LMICs.},
}

@article {pmid41846399,
year = {2026},
author = {Al-Hetari, HY and Al-Rumaima, MA and Ghazi, HH and Al-Naggar, NQ and Ali, EA and Alameri, A},
title = {A single compartment model to describe lung functionality: A comprehensive study.},
journal = {Physiological reports},
volume = {14},
number = {6},
pages = {e70832},
pmid = {41846399},
issn = {2051-817X},
mesh = {Humans ; *Lung/physiology/physiopathology ; *Models, Biological ; *Respiration, Artificial/methods ; Airway Resistance ; Respiratory Mechanics ; *COVID-19/physiopathology/therapy ; },
abstract = {Mechanical Ventilation (MV) is a critical medical intervention used to support patients with impaired lung function caused by severe conditions such as pneumonia or COVID-19. Model-based Methods, particularly computational models, are employed to simulate and analyze lung mechanics under MV. Among these, the Single Compartment Lung Model (SCLM) remains the most commonly adopted framework for replicating lung behavior during MV, facilitating optimal treatment strategies. This review critically analyzes existing literatures on SCLM applications, focusing on key parameters such as lung elastance (E), airway resistance (Rrs), and Dynamic Functional Residual Capacity (dFRC). Methodologies, evaluation metrics, and clinical applications were examined to identify common trends, inconsistences, and research gaps. The findings indicate that E has been the primary focus due to its relevance in assessing lung mechanism, especially under MV. This parameter often evaluated alongside variables like Positive End-Expiratory Pressure (PEEP), Peak Inspiratory Pressure (PIP), Peak Inspiratory Volume (PIV), and Tidal Volume (Vt). Additionally, FRC and Rrs are also considered in some models. The review emphasizes the need for standardized evaluation protocols, simplified input models, and disease-specific adaptations to enhance clinical applicability. Our findings provide valuable guidance for future research aiming to refine SCLM-based approaches and improve personalized mechanical ventilation strategies.},
}

Humans
*Lung/physiology/physiopathology
*Models, Biological
*Respiration, Artificial/methods
Airway Resistance
Respiratory Mechanics
*COVID-19/physiopathology/therapy

@article {pmid41846833,
year = {2026},
author = {Alghrably, M and Sukareh, F and Khamis, LM and Kahfi, J and Dhahri, M and Emwas, AH and Jaremko, M and Lachowicz, JI},
title = {Physiological responses to mask-associated CO2 exposure: a narrative review of acid-base balance, aging, and amyloidogenic stress.},
journal = {Frontiers in public health},
volume = {14},
number = {},
pages = {1759011},
pmid = {41846833},
issn = {2296-2565},
mesh = {Humans ; *Carbon Dioxide/adverse effects ; *Aging/physiology ; *Acid-Base Equilibrium/physiology ; *Masks/adverse effects ; *COVID-19 ; Aged ; },
abstract = {BACKGROUND: During the COVID-19 pandemic, prolonged mask use exposed billions of people to repeatedly elevated inhaled CO2 levels for extended periods. While these exposures typically produce only small pH shifts in healthy adults, older individuals exhibit age-related declines in respiratory, renal, metabolic, and proteostatic resilience that reduce their ability to buffer such disturbances. Because even mild acidosis can influence protein folding and accelerate amyloid formation under conditions of impaired homeostasis, aging populations may be disproportionately susceptible to downstream effects of chronic low-grade CO2 exposure.

METHODS: This narrative review synthesizes data on age-related changes in ventilation, acid-base regulation, metabolic buffering, and proteostasis, integrating these with biochemical pathways of pH-dependent amyloidogenesis. Evidence from mask-related CO2 exposure studies, protein-misfolding research, and gerontological physiology was analyzed to evaluate whether age-specific vulnerability could plausibly modulate amyloidogenic risk.

RESULTS: Across multiple studies, mask wearing increases inhaled CO2 concentrations and produces small but measurable reductions in blood pH in some conditions. Although these changes remain within normal physiological range in healthy adults, aging is associated with impaired ventilatory responsiveness to hypercapnia, diminished renal compensation, reduced muscle-based buffering due to sarcopenia, and mitochondrial and proteostatic decline. These changes lower physiological reserve and may magnify the biological impact of minor pH fluctuations. Experimental literature consistently demonstrates that acidity accelerates amyloid formation in proteins relevant to aging disorders-including Aβ, α-synuclein, IAPP, and β2-microglobulin-while older adults also accumulate comorbidities (chronic kidney disease, diabetes, neurodegeneration) that themselves predispose to acidosis and amyloidogenic stress.

CONCLUSIONS: Although mask-associated CO2 elevations appear insufficient to induce amyloid formation in isolation, the combination of age-related physiological decline, chronic inflammation, impaired proteostasis, and reduced buffering capacity may heighten vulnerability in older adults. Given global demographic aging, further age-stratified research is needed to clarify long-term implications of repeated low-grade hypercapnia, refine diagnostic approaches for early detection of proteostatic stress, and develop prevention strategies tailored to aging physiology.},
}

Humans
*Carbon Dioxide/adverse effects
*Aging/physiology
*Acid-Base Equilibrium/physiology
*Masks/adverse effects
*COVID-19
Aged

@article {pmid41847505,
year = {2026},
author = {Chagay, N and Tamadon, A and Kim, S and Dossimov, A and Issanguzhina, Z and Tulegenova, G and Kuldeeva, G and Puxovikova, N and Kim, I and Mussin, NM and Sharoffidin, RS},
title = {Pediatric-related post-COVID condition (long COVID) research and its foundational influences: a bibliometric analysis (2020-2025).},
journal = {Frontiers in pediatrics},
volume = {14},
number = {},
pages = {1677983},
pmid = {41847505},
issn = {2296-2360},
abstract = {BACKGROUND: The COVID-19 pandemic significantly influenced healthcare systems worldwide. The long-term consequences of the infection in children, the phenomenon of post-COVID-19 syndrome, have been attracting increasing attention of the scientific community. The present study is a bibliometric analysis of publications addressing post-COVID (long COVID) complications in pediatric population over the period 2020-2025.

METHODS AND MATERIALS: The analysis covers 1,292 records retrieved from Scopus and Web of Science (search date: June 2025). Records were retrieved using post-COVID condition/long COVID terminology combined with pediatric-related keywords; therefore, the corpus includes pediatric-focused studies as well as influential general PCC publications indexed with pediatric terms and frequently cited in pediatric research. The search strategy combined post-COVID condition/long COVID terminology with pediatric terms (child/infant/adolescent), applying filters for English language, publication years 2020-2025, and document type (articles and reviews). Data were merged and analyzed in R using bibliometrix/Biblioshiny to describe productivity, collaboration, citations, and thematic structure.

RESULTS: The retrieved corpus included 1,292 publications from 84 countries/regions. The United States led productivity with 270 publications (20.9%), followed by the United Kingdom (114; 8.8%) and China (90; 7.0%). The most frequent author keywords included "COVID-19" (n = 900) and "long COVID" (n = 818). Highly cited items predominantly consisted of general or mixed-age PCC frameworks, indicating that foundational long COVID literature substantially shapes citation patterns within pediatric-tagged publications. Thematic mapping showed symptom-focused clusters as dominant, while MIS-C and cognitive impairment were less prominent in author-keyword frequency and thematic clustering within the retrieved dataset.

CONCLUSION: The findings describe the pediatric-term-indexed PCC research landscape and highlight substantial gaps in pediatric-specific evidence, definitions, and longitudinal data.},
}

@article {pmid41848079,
year = {2026},
author = {Abdoli, E and Eini, P and Farashi, S and Farhadian, M},
title = {Optimizing Intubation Prediction in Pneumonia Patients: A Systematic Review and Meta-Analysis of Machine Learning Algorithms.},
journal = {Pulmonary medicine},
volume = {2026},
number = {1},
pages = {e6670267},
pmid = {41848079},
issn = {2090-1844},
mesh = {Humans ; *Intubation, Intratracheal/statistics & numerical data ; *Machine Learning ; *Pneumonia/therapy ; COVID-19/therapy ; Algorithms ; Community-Acquired Infections/therapy ; },
abstract = {BACKGROUND: Pneumonia, including influenza, COVID-19, and community-acquired pneumonia, is a major global health burden associated with high morbidity, mortality, and frequent progression to respiratory failure requiring intubation. Early identification of patients at risk of endotracheal intubation is essential to improve outcomes and optimize ICU resource allocation, yet existing prognostic tools remain limited in predicting this need. This study evaluated the performance of machine learning (ML) algorithms in predicting endotracheal intubation among patients with pneumonia during hospital stay.

METHODS: We systematically searched five databases to evaluate the diagnostic accuracy of ML models. Pooled estimates of area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity were calculated. Subgroup analysis and meta-regression were conducted. Risk of bias was assessed using PROBAST+AI and certainty of evidence with GRADE.

RESULTS: This systematic review of 34 studies (26 in meta-analysis) included 195,214 pneumonia patients. The pooled AUROC was 0.79 (95% CI: 0.75-0.82), with sensitivity of 0.74 (95% CI: 0.61-0.84), specificity of 0.71 (95% CI: 0.50-0.86), and a DOR of 7 (95% CI: 2-20), indicating moderate diagnostic accuracy. Heterogeneity was substantial across analyses (I[2] = 90.45% for sensitivity and 94.58% for specificity). Risk of bias was lowest in development (59%) and highest in application domains (41% high risk). Despite a nonsignificant Deeks' test (p = 0.252), the funnel plot suggests selective publication of positive results, likely inflating the pooled AUROC. GRADE rated the evidence as moderate to low due to heterogeneity and imprecision.

CONCLUSION: ML algorithms demonstrate a modest and highly variable accuracy in predicting the need for endotracheal intubation among pneumonia patients. High heterogeneity and methodological variability highlight the need for standardized ML approaches before clinical adoption.},
}

Humans
*Intubation, Intratracheal/statistics & numerical data
*Machine Learning
*Pneumonia/therapy
COVID-19/therapy
Algorithms
Community-Acquired Infections/therapy

@article {pmid41848189,
year = {2026},
author = {Shrewsbury, SB},
title = {DHE - past, present, and future: a narrative review.},
journal = {Pain management},
volume = {16},
number = {6},
pages = {645-659},
pmid = {41848189},
issn = {1758-1877},
mesh = {Humans ; *Migraine Disorders/drug therapy ; *Dihydroergotamine/administration & dosage/therapeutic use/history ; *Analgesics, Non-Narcotic/administration & dosage/therapeutic use ; Administration, Inhalation ; },
abstract = {Dihydroergotamine (DHE) was first approved in 1946 for the acute treatment of migraine. Its efficacy when administered as an intravenous (IV) injection explains its enduring use in the management of migraine today. More recently, attention has been focused on the development of formulations delivered by the inhalational route to either the nasal mucosa or lung with the objective of providing a product that enables easy, needle-free, "at-home" use that is rapidly effective. Three new DHE products for migraine (two administered by nasal delivery) have been Food and Drug Administration (FDA) approved in the past five years with two others using pulmonary delivery in clinical development attempting to optimize outcomes for subjects requiring "at-home" migraine treatment. This narrative review describes those DHE development programs, and others that have failed, with the objective of providing a broad perspective on various approaches, including those that may be more likely to achieve the goals of high efficacy rates, rapid relief, and convenience of use. In addition, DHE has been investigated for potential repurposing of other indications. These too are described.},
}

Humans
*Migraine Disorders/drug therapy
*Dihydroergotamine/administration & dosage/therapeutic use/history
*Analgesics, Non-Narcotic/administration & dosage/therapeutic use
Administration, Inhalation

@article {pmid41848669,
year = {2026},
author = {Peyser, T and Pyke, NM and Hoerger, M},
title = {Key Changes in Palliative Care Delivery and Patient and Family Experiences in the 5 Years since the COVID-19 Pandemic Onset: A Systematic Review.},
journal = {Journal of palliative medicine},
volume = {},
number = {},
pages = {10966218261418980},
doi = {10.1177/10966218261418980},
pmid = {41848669},
issn = {1557-7740},
abstract = {BACKGROUND: Palliative care improves quality of life for patients and families. More research is needed to understand how care delivery and patient and family experiences have changed in the 5 years since the COVID-19 pandemic onset.

OBJECTIVE: To systematically review the delivery of palliative care and patient and family experiences in palliative care since the COVID-19 pandemic onset.

METHODS: The search examined articles indexed in Medline, Science Direct, and Scopus, published between January 2020 and April 2025. Articles were included if they were peer-reviewed and included hospital and home-based palliative care for pediatric and adult patients and their families and examined changes in (a) patient experiences, (b) family experiences, or (c) aspects of service delivery regarding palliative care since the COVID-19 pandemic onset.

RESULTS: Of 529 abstracts screened, 10 met the inclusion criteria for review. The most common patient and family experiences among the studies included caregiver social isolation (80%) and increased distress (70%). Among the studies, delivery changes included precautions on infection control (100%) and telehealth (90%). Most studies focused on adults (70.0%), typically cancer or COVID-19 populations (20% and 30%, respectively), and heterogeneous, seriously ill populations (50%). No study commented on the impact of COVID-19 using data collected after 2022, 10% were prospective, and 20% of studies reported on participants' race or ethnicity.

CONCLUSIONS: This systematic review shows that since the COVID-19 pandemic onset, studies of palliative care programs have found that caregivers experience more distress and isolation, and programs have modified infection control precautions and increased the availability of telehealth. Implications for the future of family-centered palliative care are discussed.},
}

@article {pmid41849011,
year = {2026},
author = {Pan, M and Jia, Z and Zhou, M and Chen, J and Qiu, H and Luo, X and Zhang, Y and Shi, Z and Wu, S and Wang, D and Yang, Q},
title = {The Application of Single-cell RNA Sequencing Technology in the Research of Sino-Nasal Diseases.},
journal = {Clinical reviews in allergy & immunology},
volume = {69},
number = {1},
pages = {},
pmid = {41849011},
issn = {1559-0267},
}

@article {pmid41849024,
year = {2026},
author = {Dalamaga, M and Emfietzoglou, R and Petropoulou, D and Kypraiou, M and Kounatidis, DC and Vallianou, NG and Karras, S and Magkos, F and Karampela, I},
title = {Vitamin D and Health Outcomes: State-of-the-Art Review of Triangulated Evidence and Ongoing Controversies.},
journal = {Current nutrition reports},
volume = {15},
number = {1},
pages = {},
pmid = {41849024},
issn = {2161-3311},
abstract = {PURPOSE OF REVIEW: Vitamin D is a pleiotropic hormone with an established role in skeletal integrity and broader actions in immune regulation, inflammation, cellular proliferation, and energy homeostasis. Despite decades of research, its extra-skeletal effects remain controversial, largely due to discordant findings across observational studies, Mendelian randomization studies (MRS), and randomized controlled trials (RCTs). Unlike many prior reviews, this state-of-the-art review synthesizes triangulated evidence across these study designs to clarify outcome-specific causal relationships and ongoing controversies. RECENT FINDINGS: Triangulated evidence provides strong and consistent support for a causal role of vitamin D in skeletal health, particularly in the prevention and treatment of rickets and osteomalacia, and in fracture risk reduction among vitamin D–deficient and older populations. For selected extra-skeletal outcomes, modest and threshold-dependent benefits are observed, including reductions in cancer mortality, protection against autoimmune disorders, most convincingly multiple sclerosis, and decreased risk of acute respiratory infections, including COVID-19, primarily in individuals with low baseline 25(OH)D concentrations. In contrast, associations with cardiovascular disease, metabolic disorders, obesity, and most neuropsychiatric outcomes are not consistently supported by genetic or interventional evidence, suggesting limited or non-causal effects. Across outcomes, evidence indicates a non-linear relationship between vitamin D status and health, with increased risk concentrated at low 25-hydroxyvitamin D concentrations and limited benefit beyond sufficiency. All-cause mortality shows a modest, threshold-dependent association, with supplementation benefits largely confined to deficient or older populations. Key challenges include assay variability, non-linear dose–response relationships, and RCT designs that frequently enroll vitamin D–replete populations, resulting in substantial methodological heterogeneity and limiting causal inference. Overall, the presented triangulated model may reconcile longstanding inconsistencies by reframing vitamin D as a context-dependent determinant of health. These findings argue against indiscriminate population-wide supplementation and support targeted strategies focused on the identification and correction of deficiency. Vitamin D should be regarded neither as a universal panacea nor as a trivial supplement, but as a context-dependent hormone whose clinical value lies in outcome-specific correction of deficiency.},
}

@article {pmid41849116,
year = {2026},
author = {Piquero-Casals, J and Bertold, C and Alomar, A and Morgado-Carrasco, D and Gilaberte, Y and López-Estebaranz, JL and Massa, A and de Castro, CS and Leone, G and Lim, HW and Krutmann, J and Ezzedine, K and Passeron, T},
title = {Exposome Risk Factors for Vitiligo: A Systematic Evidence Review.},
journal = {American journal of clinical dermatology},
volume = {27},
number = {3},
pages = {465-478},
pmid = {41849116},
issn = {1179-1888},
mesh = {Humans ; *Vitiligo/etiology/epidemiology/immunology ; Risk Factors ; *Exposome ; COVID-19/epidemiology/immunology/complications ; *Environmental Exposure/adverse effects ; Disease Progression ; Immune Checkpoint Inhibitors/adverse effects ; },
abstract = {BACKGROUND: Vitiligo is a multi-factorial autoimmune skin disorder often triggered by environmental exposures. Although the exposome has gained attention, no systematic review has fully assessed its role in vitiligo.

OBJECTIVE: We aimed to evaluate evidence linking exposomal factors to vitiligo onset and progression, focusing on quantifiable associations and study quality.

METHODS: A systematic search of PubMed and Embase (inception to 25 August, 2024) followed PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) 2020 guidelines and was registered in PROSPERO (CRD42024529828). Eligible studies reported associations between environmental exposures and vitiligo onset, flares, or progression. Observational studies, case series, clinical trials, and pharmacovigilance reports were included. Findings were synthesized narratively.

RESULTS: Of 8377 records, 496 studies met inclusion criteria. Drug-associated vitiligo, particularly from immune checkpoint inhibitors, was the most robustly supported association (7-25% in patients with melanoma). Phenol-based chemicals were consistently linked to melanocyte toxicity. Coronavirus disease 2019 infection modestly increased risk (hazard ratio ≈ 1.11), while vaccination did not. Other factors such as stress (n = 113), trauma, sunburn, smoking, diet, and sleep were frequently cited but supported by lower-level evidence. Study heterogeneity, a lack of standardized outcomes, and the predominance of observational designs limited meta-analysis and causal inference.

CONCLUSIONS: These findings highlight the environmental triggers of vitiligo onset and progression. Drugs, chemicals, and infections are key triggers; lifestyle factors require further study.},
}

Humans
*Vitiligo/etiology/epidemiology/immunology
Risk Factors
*Exposome
COVID-19/epidemiology/immunology/complications
*Environmental Exposure/adverse effects
Disease Progression
Immune Checkpoint Inhibitors/adverse effects

@article {pmid41849944,
year = {2026},
author = {Mostafa, NY and Dutta, D and Das, B and Bora, BR and Gogoi, N and Das, AK and Kaishap, PP},
title = {Tryptanthrin: Synthetic advances and therapeutic horizons of a privileged scaffold.},
journal = {European journal of medicinal chemistry},
volume = {309},
number = {},
pages = {118767},
doi = {10.1016/j.ejmech.2026.118767},
pmid = {41849944},
issn = {1768-3254},
mesh = {*Quinazolines/chemistry/pharmacology/chemical synthesis/therapeutic use ; Humans ; *Antineoplastic Agents/pharmacology/chemistry/chemical synthesis/therapeutic use ; Structure-Activity Relationship ; Anti-Bacterial Agents/pharmacology/chemistry/chemical synthesis ; COVID-19 Drug Treatment ; Neurodegenerative Diseases/drug therapy ; SARS-CoV-2/drug effects ; Molecular Structure ; Animals ; },
abstract = {Tryptanthrin (indolo[2,1-b]quinazoline-6,12-dione) is a privileged scaffold distinguished by its rigid tetracyclic framework and exceptional pharmacological breadth. This review critically analyzes advancements in the chemistry and biology of tryptanthrin, prioritizing post-2020 literature. We elucidate its natural occurrence and innovative synthetic strategies, spanning from classical condensation to sustainable photochemical and electrochemical methods. The review examines the therapeutic landscape of tryptanthrin chemotypes, highlighting anticancer efficacy via kinase and topoisomerase modulation. Furthermore, we explore emerging utility against multidrug-resistant bacteria, SARS-CoV-2, and neurodegenerative conditions. By integrating structure-activity relationship data with mechanistic insights, this work underscores tryptanthrin as a versatile pharmacophore for the rational design of next-generation therapeutics.},
}

*Quinazolines/chemistry/pharmacology/chemical synthesis/therapeutic use
Humans
*Antineoplastic Agents/pharmacology/chemistry/chemical synthesis/therapeutic use
Structure-Activity Relationship
Anti-Bacterial Agents/pharmacology/chemistry/chemical synthesis
COVID-19 Drug Treatment
Neurodegenerative Diseases/drug therapy
SARS-CoV-2/drug effects
Molecular Structure
Animals

@article {pmid41849981,
year = {2026},
author = {Wang, Q and Zhang, G and Yue, G and Liu, X},
title = {Job satisfaction and burnout among emergency nurses: A bibliometric and visualized analysis.},
journal = {International emergency nursing},
volume = {86},
number = {},
pages = {101802},
doi = {10.1016/j.ienj.2026.101802},
pmid = {41849981},
issn = {1878-013X},
mesh = {*Job Satisfaction ; *Burnout, Professional/psychology ; *Bibliometrics ; *Emergency Nursing ; Humans ; },
abstract = {INTRODUCTION: The purpose of this study is to map the intellectual structure and evolutionary trends of research on burnout and job satisfaction among emergency nurses through a bibliometric and visual analysis.

METHODS: Publications related to job satisfaction and burnout among emergency nurses were retrieved from the Web of Science Core Collection database. RStudio 4.5.0, VOSviewer 1.6.20, CiteSpace 6.4, and Scimago Graphica 1.0.50 were used for bibliometric analysis and visualization.

RESULTS: A total of 346 articles were selected for this study. These articles were published across 61 countries from 2003 to 2025, with the United States, China, and Australia leading in publication output. These articles were featured in 159 journals, with the International Emergency Nursing publishing the most (n = 21). Adriaenssens Jef is both the most prolific author and among the most frequently cited in this field. Keyword clustering analysis identified 4 distinct research themes, the most frequently used keyword in the studies was "burnout," which was commonly associated with all other keywords. In addition, keyword burst analysis revealed emerging trend topics, notably "COVID-19."

DISCUSSION: This paper presents the first comprehensive bibliometric and visualization analysis of research on job satisfaction and burnout among emergency nurses, summarizing developments, trends, research frontiers, and hotspots. This research emphasizes understanding burnout and job satisfaction is crucial for managers and policymakers, as effective policies and support initiatives can boost satisfaction and reduce burnout.},
}

*Job Satisfaction
*Burnout, Professional/psychology
*Bibliometrics
*Emergency Nursing
Humans

@article {pmid41850438,
year = {2026},
author = {Chiba, S},
title = {Therapeutic mechanisms of early oseltamivir administration in the management of mild COVID-19 through the sympathetic nervous system: A scoping review.},
journal = {Journal of virological methods},
volume = {343},
number = {},
pages = {115386},
doi = {10.1016/j.jviromet.2026.115386},
pmid = {41850438},
issn = {1879-0984},
mesh = {Humans ; *Oseltamivir/therapeutic use/administration & dosage ; *Antiviral Agents/therapeutic use/administration & dosage ; *COVID-19 Drug Treatment ; SARS-CoV-2/drug effects ; *Sympathetic Nervous System/drug effects ; COVID-19 ; },
abstract = {PURPOSE: This scoping review summarizes the proposed mechanisms by which oseltamivir may improve clinical outcomes in COVID-19. Although SARS-CoV-2 lacks neuraminidase, several studies have reported reduced fever duration, shorter hospitalization, and faster viral clearance with oseltamivir administration. This review integrates current evidence regarding antiviral, immunomodulatory, and autonomic-nervous-system-related mechanisms.

METHODS: A structured literature search was conducted in PubMed, Scopus, and Google Scholar. Studies addressing oseltamivir's antiviral activity, neutrophil modulation, antipyretic effects, or influence on sympathetic nervous system activity in COVID-19 were included.

RESULTS: Oseltamivir may exert therapeutic effects through inhibition of SARS-CoV-2 proliferation, reduction of neutrophil overactivation, attenuation of sympathetic nervous system hyperactivity, and modulation of fever pathways.

CONCLUSION: This scoping review identifies multiple mechanisms through which oseltamivir may influence COVID-19 pathophysiology. Although evidence remains heterogeneous, findings suggest that oseltamivir may have broader biological effects beyond neuraminidase inhibition. Further clinical studies are needed to clarify its therapeutic role, optimal timing, and potential benefits in unvaccinated or high-risk populations.},
}

Humans
*Oseltamivir/therapeutic use/administration & dosage
*Antiviral Agents/therapeutic use/administration & dosage
*COVID-19 Drug Treatment
SARS-CoV-2/drug effects
*Sympathetic Nervous System/drug effects
COVID-19

@article {pmid41851274,
year = {2026},
author = {Appay, V and Yamamoto, T and Sáez-Cirión, A},
title = {Renaissance of antiviral CD8[+] T cell immunity in vaccination and disease.},
journal = {Nature reviews. Immunology},
volume = {},
number = {},
pages = {},
pmid = {41851274},
issn = {1474-1741},
abstract = {Over the past 20 years, the limited efficacy of CD8[+] T cell-based vaccines against viruses in clinical trials has shifted attention away from such strategies. However, recent findings have brought renewed appreciation for the central importance of CD8[+] T cells in controlling both acute and chronic viral infections and in preventing severe or progressive disease. This work highlights shared features, such as effector functions and stemness properties, of effective CD8[+] T cell responses against diverse viruses such as SARS-CoV-2 and HIV. A deeper understanding and simpler interpretation of the functional workings of CD8[+] T cell-mediated immunity, combined with advances in immunological and biotechnological tools, are opening new avenues for eliciting optimal T cell responses, both for prophylactic and for therapeutic applications. Collectively, these developments revive optimism that vaccines and immunotherapies designed to harness robust CD8[+] T cell responses could have a major role in combating emerging viral threats and in achieving long-term suppression of persistent infections such as HIV-1 to undetectable levels.},
}

@article {pmid41851644,
year = {2026},
author = {Doran, C and Sheku, M and Nakada, Y and Lopman, B and Nelson, K},
title = {Relevance of social contact definitions for use in infectious disease transmission modeling: a systematic review and recommendations.},
journal = {BMC infectious diseases},
volume = {26},
number = {1},
pages = {},
pmid = {41851644},
issn = {1471-2334},
support = {CDC-RFA-FT-23-0069//Insight Net Cooperative Agreement, CDC Center for Forecasting and Analytics/ ; K01AI166093-01A1//NIH/NIAID/ ; },
abstract = {BACKGROUND: Social mixing studies provide crucial evidence for parameterizing mathematical models of infectious disease transmission, and their validity for use in models is dependent on their study design and how well the contacts they capture map to the transmission routes of the pathogen of interest. This systematic review aims to catalogue contact definitions used in social mixing studies from 2005 to 2024 and evaluate their conceptual alignment to three archetypal pathogens. METHODS: We searched Ovid Medline, Embase, Scopus, and Global Index Medicus for studies of human-to-human interactions that collected data via survey, diary, or interview published between January 2005 and August 2024. We excluded studies that focused on sexually-transmitted or food/water/vector-borne pathogens or used only GPS or sensor data. We excluded studies of contact tracing as a public health effort. Screening and data collection were conducted in Covidence. Contact definitions were presented verbatim and qualitatively coded to identify key elements. Results were stratified by prospective or retrospective design. We used the Mixed Methods Appraisal Tool to evaluate risk of bias. RESULTS: We included 112 eligible studies, half (52.7%) of which began during pandemic periods (H1N1 [2009] or COVID-19 [2020]), commonly in the United States (18%) or United Kingdom (16%). Most (68%) had a retrospective design in which participants were asked to recall contacts that occurred prior to survey administration and 73% used a single-survey cross sectional design using random (16%) or stratified random (44%) sampling. Relevant contacts were often defined by an exchange of words (77%) or physical touch (59%). A minority of studies differentiated between contacts that occurred outdoors vs. indoors (28%) or allowed participants to report large group contacts separately from individually named contacts (28%). Contact definitions and attributes conceptually aligned with the transmission biology of influenza, tuberculosis, and norovirus in 77%, 6%, and 50% of studies respectively. CONCLUSIONS: Contact studies were limited in their global scope and non-pandemic representativeness. Critical modifiers of transmission risk such as location, household membership, and shared space with large numbers of people were under-measured. Future modeling and social mixing studies should align measured contact rates to the target transmission routes by incorporating these elements.},
}

@article {pmid41851794,
year = {2026},
author = {Hudu, SA and Jimoh, AO and Amin-Nordin, S and Syed Hassan, S},
title = {Environmental degradation as a recipe for emerging viral diseases: implications for global health.},
journal = {One health outlook},
volume = {8},
number = {1},
pages = {},
pmid = {41851794},
issn = {2524-4655},
support = {NBU-FPEJ-2025-ID-XX//the Deanship of Scientific Research at Northern Border University, Arar, KSA/ ; },
abstract = {The rise of new viral illnesses poses a substantial risk to global public health, as their incidence and impact have increased over the past few decades. This article thoroughly examines the complex connection between environmental degradation and the development of new viral diseases. Human activities, such as deforestation, urbanization, and industrial agriculture, have significantly altered ecosystems, increasing the likelihood of virus transmission from animals to humans. The alteration of natural environments brings wildlife species that serve as hosts for several viruses into closer proximity to human populations, thereby promoting the transmission of zoonotic diseases. In addition, climate change and pollution worsen the susceptibility of both animal and human societies to viral epidemics by compromising immune responses and changing the distribution of disease carriers. This paper examines how environmental degradation is associated with viral emergence, drawing on case studies including HIV, Ebola virus disease, and COVID-19, to illustrate shared spillover mechanisms. Evidence from major zoonotic outbreaks, including HIV, Ebola virus disease, and COVID-19, indicates that environmental degradation acts through shared mechanisms, notably habitat fragmentation, biodiversity loss, and intensified human–animal interfaces. Epidemiological and ecological investigations suggest that forest encroachment, wildlife exploitation, and land-use change consistently increase opportunities for viral spillover, underscoring environmental stewardship as a critical component of pandemic prevention. This emphasizes the importance of adopting comprehensive strategies that combine environmental protection with public health efforts to lower the risk of future pandemics. It highlights the need for coordinated global action that integrates ecosystem conservation with public health preparedness to reduce future zoonotic disease risk.},
}

@article {pmid41852906,
year = {2026},
author = {Ramzuni, G and Rahim, RK and Hamsal, M and Furinto, A and Gunadi, W},
title = {Tracing 25 years of employee agility research: the missing links and future directions.},
journal = {Frontiers in sociology},
volume = {11},
number = {},
pages = {1735781},
pmid = {41852906},
issn = {2297-7775},
abstract = {Over the past two decades, the growing turbulence of the VUCA era, accelerated by the COVID-19 pandemic and digital transformation, has compelled organizations to develop agility as a vital capability for survival and adaptation. However, while organizational agility has received considerable scholarly attention, research on employee agility as its micro-foundation remains limited and fragmented, leaving substantial gaps in understanding the individual-level factors that shape organizational adaptability. This study presents a comprehensive bibliometric review of research on employee agility over the past 25 years, aiming to map its intellectual, conceptual, and social structures, identify gaps in the existing literature, and outline future research directions. The analysis encompasses 319 publications indexed in Scopus and Web of Science, spanning the period from 2000 to 2025. Using Biblioshiny and VOSviewer, the study examines publication trends, citation networks, thematic structures, and emerging research frontiers. The results reveal a sharp increase in publications since 2020, driven by the COVID-19 pandemic and digital transformation pressures. Three main clusters dominate the field: (1) organisational responses to change and disruption, (2) HRM practices and individual-level mechanisms, and (3) collaboration, knowledge sharing, and digital platforms. Despite these developments, significant gaps remain, including the limited integration of leadership, weak linkage between employee agility and innovation, the divide between HR-driven and digital-driven agility, and the underrepresentation of studies in the public sector and Southeast Asia. By synthesising fragmented insights across two major databases, this study highlights employee agility as a micro-foundation of organisational agility and proposes future research directions focusing on leadership, digital competence, innovation, psychological factors, and public sector contexts. These contributions position employee agility as not only a short-term adaptive capability but also a strategic enabler of innovation and sustainability in dynamic environments.},
}

@article {pmid41853148,
year = {2026},
author = {Campbell, EA and Goodtree, H and Gillani, S and Oyefolu, O and Kelly, A and Rivers, C and Watson, C},
title = {Impact, use, and implications of artificial intelligence in public health decision making by elected officials: a scoping review.},
journal = {Frontiers in public health},
volume = {14},
number = {},
pages = {1745684},
pmid = {41853148},
issn = {2296-2565},
mesh = {Humans ; *COVID-19/prevention & control/epidemiology ; *Public Health ; *Artificial Intelligence ; *Decision Making ; *Policy Making ; *Politics ; SARS-CoV-2 ; },
abstract = {INTRODUCTION: Artificial intelligence (AI) offers considerable promise for strengthening governmental public health decision making by supporting rapid, comprehensive analysis of complex data. Although AI applications have been widely examined in clinical and academic settings, their use in public health agencies and policymaking remains less well understood.

METHODS: This scoping review assessed how AI has been applied to support decision making by public health professionals and elected officials in both routine and crisis contexts. Using PRISMA-ScR guidelines, we searched PubMed, OAISTER, and Web of Science for literature published between 2014 and 2024. From 13,239 records identified, seven studies met final inclusion criteria.

RESULTS: The identified evidence base is primarily descriptive and exploratory, with limited empirical evaluation of outcomes or effectiveness. All included studies described AI use during the COVID-19 pandemic, focusing on vaccination decision support, contact tracing, quarantine enforcement, and/or movement restrictions, which limits generalizability to other public health contexts and decision-making scenarios. Findings highlight a small but emerging evidence base, with most applications developed in response to emergencies rather than embedded in routine practice.

DISCUSSION: Future opportunities for AI include advancing surveillance, communication, and resource allocation. However, critical challenges remain regarding governance, equity, and implementation. Further research is needed to evaluate AI interventions in diverse contexts and establish sustainable pathways for adoption by governmental public health agencies.},
}

Humans
*COVID-19/prevention & control/epidemiology
*Public Health
*Artificial Intelligence
*Decision Making
*Policy Making
*Politics
SARS-CoV-2

@article {pmid41853560,
year = {2024},
author = {Navalkele, BD and Chopra, T},
title = {Clinical application of live biotherapeutic products in infectious diseases.},
journal = {Frontiers in microbiomes},
volume = {3},
number = {},
pages = {1415083},
pmid = {41853560},
issn = {2813-4338},
abstract = {Live biotherapeutics products (LBP) are a novel range of therapeutic options in medicine. In this review, authors discuss basic composition and mechanism of action of LBP, provide a comprehensive focused overview of published in vitro and in vivo studies on efficacy of LBP for prevention and treatment of infectious diseases such as viral (HIV, COVID-19), bacterial (C.difficile infection, bacterial vaginosis, multi-drug resistant organisms) and fungal (Candida) organisms. This review should be of interest to clinicians to understand the broad application of LBP in infectious diseases world beyond recurrent C.difficile infection and to researchers on unexplored prospects of LBP and the need for further investigation in this emerging field to improve its clinical application.},
}

@article {pmid41854197,
year = {2026},
author = {Ye, P and Huang, C and Liu, Y and Feng, X and Cai, P and Wang, M and Chen, X},
title = {Myopic Progression of Children Before and During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis.},
journal = {Ophthalmic epidemiology},
volume = {},
number = {},
pages = {1-10},
doi = {10.1080/09286586.2026.2645112},
pmid = {41854197},
issn = {1744-5086},
abstract = {PURPOSE: This study aimed to investigate the progression of myopia in children before and during the COVID-19 pandemic.

METHODS: Online databases were searched for original studies reporting changes in the spherical equivalent refraction (SER) and axial length (AL) of children, both before and during the COVID-19 pandemic.

RESULTS: Twelve eligible studies were identified after database search and screening. In all eligible studies, the annual changes in SER and AL were larger during the COVID-19 pandemic than during the pre-pandemic period. The pooled differences in SER and AL before and during the COVID-19 pandemic were -1.25 standard deviation (SD) and 0.27 SD, respectively. Pooled SER difference before and during the COVID-19 pandemic were -1.47 SD for cohorts with 100% children with myopia, -1.03 SD for cohorts with <100% children with myopia, -1.17 SD for cohorts from East Asia, -1.32 SD for cohorts from the other regions, -1.37 SD for younger cohorts, -1.30 SD for older cohorts, -1.79 SD for cohorts with shorter online education time, and -1.39 SD for cohorts with longer online education time.

CONCLUSION: Home confinement during the COVID-19 pandemic has accelerated the progression of myopia in children, especially in those with myopia or from regions other than East Asia. This systematic review protocol was registered with PROSPERO [CRD420251061387].},
}

@article {pmid41855953,
year = {2026},
author = {Tantum, L and Anderson, DM and Jones, EP and Cronk, R},
title = {Mapping the evidence on environmental health services in healthcare facilities in low- and middle-income countries: A systematic literature inventory of over 4,000 studies.},
journal = {International journal of hygiene and environmental health},
volume = {274},
number = {},
pages = {114786},
pmid = {41855953},
issn = {1618-131X},
support = {T32 ES007018/ES/NIEHS NIH HHS/United States ; },
mesh = {*Developing Countries ; *Health Facilities ; *Environmental Health ; Humans ; Sanitation ; Hygiene ; COVID-19 ; },
abstract = {BACKGROUND: Environmental health services in healthcare facilities-including water, sanitation, hygiene, waste management, cleaning, and infection control-prevent disease and strengthen healthcare delivery. Yet environmental health services are inadequate in many low- and middle-income countries (LMICs). Despite the importance of monitoring and improving services, no comprehensive evidence map exists to describe knowledge and gaps for action. The study objective was to comprehensively catalog published literature on environmental health services in healthcare facilities in LMICs by service domain, study type, and relevance to policy and practice.

METHODS: We conducted a systematic literature search in 2023 and updated it in 2025. After performing database searches, we used a machine learning process to prioritize studies for manual title-abstract screening. Through a title/abstract tagging process, we developed a literature inventory that categorized studies by topic, design, and relevance to policy and practice objectives.

RESULTS: The literature inventory included 4381 studies. Fifty-eight percent of the studies were baseline assessments of environmental health services, 36% involved formative research (e.g., qualitative methods), and 13% evaluated interventions or implementation strategies. Most studies (62%) examined hygiene at points of care, while 9% examined water and 6% sanitation. Twenty-seven percent of studies examined services during the COVID-19 pandemic.

CONCLUSIONS: There is little evidence for effective interventions and implementation strategies to improve and sustain environmental health services, especially for water and sanitation services. Formative research on under-studied services can help policymakers set investment priorities. Findings can inform the development of research agendas and practical guidelines for improving access to safe healthcare environments.},
}

*Developing Countries
*Health Facilities
*Environmental Health
Humans
Sanitation
Hygiene
COVID-19

@article {pmid41856071,
year = {2026},
author = {Chelan, EM and Parhizkar, A and Nemati, M and Kiani, J and Almassian, B and Moghaddam, HG and Zarebkohan, A and Pourseif, MM},
title = {Targeted cytosolic delivery of mRNA immunotherapeutics: From vaccine delivery to protein replacement.},
journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie},
volume = {198},
number = {},
pages = {119181},
doi = {10.1016/j.biopha.2026.119181},
pmid = {41856071},
issn = {1950-6007},
mesh = {Humans ; *RNA, Messenger/administration & dosage/genetics ; *Immunotherapy/methods ; Animals ; *COVID-19/prevention & control/immunology ; *Drug Delivery Systems/methods ; *COVID-19 Vaccines/administration & dosage ; *Cytosol/metabolism ; mRNA Vaccines/administration & dosage ; SARS-CoV-2/immunology ; Vaccines, Synthetic/administration & dosage ; },
abstract = {The advent of mRNA-based immunotherapeutics has fundamentally changed the nature of modern medicine. Although mRNA therapeutics initially developed to enhance vaccination platforms, they have rapidly expanded into gene editing and protein replacement applications. The rapid development and global deployment of mRNA vaccines during the COVID-19 pandemic emphasized the versatility and clinical potential of this modality and enabled swift progresses to infectious diseases and genetic disorders. mRNA work by exploiting the ability of the host cell system to produce desired proteins, however, clinical translation of mRNA immunotherapeutics remains constrained by challenges such as intrinsic instability, limited cellular uptake, inefficient endosomal escape, and suboptimal protein expression. Nanotechnology-based delivery systems have partially addressed these barriers over the past two decades and enabeled improved protection, targeting, and intracellular release. In this review, we conceptualize targeted mRNA delivery as a multistep process defined by Circulation-Internalization-Endosomal Escape-Expression (CIEE). We examine advances in systemic biodistribution control, organ-specific targeting, and precision delivery to antigen-presenting cells (APCs), and we discuss emerging strategies to optimize cytosolic transfection efficiency in immunotherapeutic applications. Advanced targeting strategies from organ-level biodistribution to cellular-level precision targeting of APCs are elucidated in details. From all the above, it follows that a solid knowledge in molecular biology, nanotechnology, and immunology is required for fine-tuned immunotherapeutic design. The current review attempt to serve as a reference to further advance optimizing targeted delivery of mRNA Immunotherapeutics.},
}

Humans
*RNA, Messenger/administration & dosage/genetics
*Immunotherapy/methods
Animals
*COVID-19/prevention & control/immunology
*Drug Delivery Systems/methods
*COVID-19 Vaccines/administration & dosage
*Cytosol/metabolism
mRNA Vaccines/administration & dosage
SARS-CoV-2/immunology
Vaccines, Synthetic/administration & dosage

@article {pmid41856461,
year = {2026},
author = {Farokhnia, A and Faro, LK and Tian, Y and Frischknecht, L and Eimer, J and Brosh-Nissimov, T and Nilsson, J},
title = {Extended nirmatrelvir-ritonavir for persistent COVID-19: Systematic review with individual patient data.},
journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases},
volume = {167},
number = {},
pages = {108558},
doi = {10.1016/j.ijid.2026.108558},
pmid = {41856461},
issn = {1878-3511},
mesh = {Humans ; *Ritonavir/therapeutic use/administration & dosage ; *COVID-19 Drug Treatment ; *Antiviral Agents/therapeutic use/administration & dosage ; Middle Aged ; SARS-CoV-2/drug effects ; Male ; Immunocompromised Host ; Female ; Drug Therapy, Combination ; *COVID-19/virology ; Aged ; Treatment Outcome ; },
abstract = {OBJECTIVES: To summarize individual patient data (IPD) on extended-duration nirmatrelvir-ritonavir (NMV-r) for persistent SARS-CoV-2 infection in immunocompromised adults and describe outcomes by regimen.

METHODS: We conducted a systematic review with IPD synthesis (PRISMA-IPD; PROSPERO CRD42025642455), searching databases through December 2025 and restricting eligible reports to January 1, 2022, through December 31, 2025 (Omicron-era focus). IPD were obtained for 39 patients from four low-risk-of-bias cohort studies (n = 30) and institutional cases (n = 9) meeting predefined criteria for persistent infection. We summarized outcomes after last-line extended NMV-r and report exploratory, unadjusted subgroup descriptions for monotherapy (n = 27) and combination regimens (n = 12).

RESULTS: Median age was 63 years. Patients had prolonged viral replication (median 58 days) before receiving extended NMV-r (median 10 days). Persistent infection after last-line extended therapy occurred in 5/38 (13.2%) evaluable patients. Persistence was observed in 2/26 (7.7%) evaluable monotherapy and 3/12 (25.0%) combination-therapy recipients; because regimen selection was nonrandom and baseline risk differed between groups, these subgroup proportions are descriptive and should not be interpreted as comparative effectiveness. All-cause mortality and adverse events (AEs) were rare (each 1/39; 2.6%).

CONCLUSION: In this selected observational IPD cohort, clearance after last-line extended NMV-r-containing therapy was commonly reported, and serious AEs were uncommon. Comparative inferences are limited by small sample size, imprecision, and confounding by indication; prospective studies are needed. PROSPERO registration CRD42025642455.},
}

Humans
*Ritonavir/therapeutic use/administration & dosage
*COVID-19 Drug Treatment
*Antiviral Agents/therapeutic use/administration & dosage
Middle Aged
SARS-CoV-2/drug effects
Male
Immunocompromised Host
Female
Drug Therapy, Combination
*COVID-19/virology
Aged
Treatment Outcome

@article {pmid41856882,
year = {2026},
author = {Malewana, RD and Corbett-Helaire, KS},
title = {The dual-adjuvant logic of mRNA vaccines.},
journal = {Trends in immunology},
volume = {47},
number = {4},
pages = {243-245},
doi = {10.1016/j.it.2026.01.012},
pmid = {41856882},
issn = {1471-4981},
mesh = {*Adjuvants, Vaccine ; *mRNA Vaccines/immunology ; Humans ; *Immunity, Humoral ; Animals ; *Nanovaccines/immunology ; },
abstract = {Deciphering how mRNA vaccines generate humoral immunity could accelerate next-generation vaccine design. Castaño et al. reveal that mRNA-lipid nanoparticle vaccines employ a dual-adjuvant mechanism: nucleoside-modified mRNA triggers type I interferons to mature dendritic cells, while lipid nanoparticles induce a pro-T follicular helper cell program, together promoting robust germinal center responses.},
}

*Adjuvants, Vaccine
*mRNA Vaccines/immunology
Humans
*Immunity, Humoral
Animals
*Nanovaccines/immunology

@article {pmid41857693,
year = {2026},
author = {Williams, BA and Fitzsimmons, PM and Lewis, LM and Tornos, J and Kimmel, L and True, JM and Siwik, PJ and Ryall, M and Mullett, K},
title = {The 100 Days Mission: a perspective on accelerating vaccine manufacturing for future pandemics.},
journal = {BMC global and public health},
volume = {4},
number = {1},
pages = {},
pmid = {41857693},
issn = {2731-913X},
abstract = {The "100 Days Mission" aims to compress the timeline for delivering safe and effective vaccines in response to future pandemics. Here, we present insights from Pfizer leaders involved in the COVID-19 vaccine effort on key enablers for rapid large-scale manufacture of pandemic vaccines to achieve this ambitious goal. For pharmaceutical companies, these enablers include robust governance models, secure supply chains, innovative production strategies, and maintained "warm" manufacturing capacity. Additionally, we examine the crucial role of government support through regulatory harmonization, enhanced global surveillance, and improved logistics. By addressing these critical factors, the global community can better prepare for rapid vaccine manufacturing in response to future pandemic threats.},
}

@article {pmid41857720,
year = {2026},
author = {Zhang, H and Guo, Z and Peng, Q},
title = {Prevalence of sleep disturbance among chinese college students: an updated meta-analysis.},
journal = {BMC psychiatry},
volume = {26},
number = {1},
pages = {},
pmid = {41857720},
issn = {1471-244X},
support = {sztsjh-2024-8-11//Anhui Provincial Department of Education 2024 Comprehensive Education and Ideological-Political Capacity Enhancement Project: "Ying Shan Hong" Counselor Master Teacher Studio/ ; 2025AHGXSK30457//Anhui Provincial Department of Education 2025 Key Humanities and Social Sciences Project for Higher Education Institutions: Coupling Mechanisms and Optimization Pathways for Cultivating a Sense of Community for the Chinese Nation through Cultural and Museum Research and Study under the Perspective of Cultural Embedding: An Empirical Study Based on Anhui-Xinjiang Practices/ ; },
abstract = {BACKGROUND: Sleep disturbance is common among college students. However, the prevalence and associated factors among Chinese college students require an updated synthesis. This study aimed to estimate the pooled prevalence of sleep disturbance in this population and to examine potential sources of between-study variation.

METHODS: A systematic search was conducted in four Chinese databases (CNKI, Wanfang, VIP, and Sinomed) and five international databases (PubMed, EMBASE, Web of Science, Cochrane Library, and PsycINFO) from inception to December 22, 2025. The study protocol was pre-registered in PROSPERO (CRD420251270413). Cross-sectional studies reporting sleep disturbance among Chinese college students assessed using the Pittsburgh Sleep Quality Index were included, with no restrictions on cut-off thresholds. Recall timeframes included the past month, 1–2 weeks, or several months. Random-effects meta-analysis was used to pool prevalence estimates with 95% confidence intervals, and a 95% prediction interval was additionally reported for the overall pooled estimate to reflect between-study heterogeneity. Statistical heterogeneity was assessed using the I² statistic. Subgroup analyses were performed to explore methodological and population-level factors, and between-group differences were tested using chi-square statistics.

RESULTS: A total of 232 studies involving 495,641 undergraduate students were included. The pooled prevalence of sleep disturbance was 26.4% (95% confidence interval: 24.6% to 28.3%, 95% prediction interval: 7.4% to 59.1%), with substantial heterogeneity (I² = 99.57%). Methodological factors were significantly associated with prevalence estimates, particularly the Pittsburgh Sleep Quality Index cut-off score and the recall timeframe (both P < 0.001). Prevalence was highest during the COVID-19 pandemic (33.5%), compared with the pre-pandemic period (24.1%) and the post-pandemic period (21.0%) (P = 0.001). Higher pooled estimates were observed in more recent publication periods, increasing from 22.9% in 2014 and earlier to 28.7% in 2020 and later (P = 0.018). No statistically significant differences were identified across gender, academic year, major, region, or only-child status. Higher prevalence was observed among smokers, drinkers, and students reporting poorer family economic status, although these differences did not reach statistical significance.

CONCLUSIONS: Sleep disturbance, as defined by the Pittsburgh Sleep Quality Index, is prevalent among Chinese college students. Estimates should be interpreted cautiously because of extreme heterogeneity and reliance on self-reported, predominantly cross-sectional data. The findings underscore the public health relevance of sleep health on campuses and support continued monitoring and health promotion, as well as more standardized measurement in future studies.

CLINICAL TRIAL NUMBER: Not applicable.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-026-07997-z.},
}

@article {pmid41858416,
year = {2026},
author = {Sinuraya, RK and Suwantika, AA and Puspitasari, IM},
title = {Strengthening Health Systems to Overcome Respiratory Infectious Diseases in Indonesia: A Comprehensive Review.},
journal = {Risk management and healthcare policy},
volume = {19},
number = {},
pages = {564998},
pmid = {41858416},
issn = {1179-1594},
abstract = {Respiratory infectious diseases (RIDs) remain a persistent public health challenge in Indonesia, a vast archipelago with complex healthcare delivery and marked regional inequities. The COVID-19 pandemic revealed critical weaknesses in the country's surveillance systems, diagnostic capacity, and outbreak response, underscoring the urgent need for stronger pandemic preparedness and a transition from a reactive, crisis-driven model to a proactive, prevention-focused health system. This study synthesizes existing literature, policy documents, and recent evaluation reports to assess Indonesia's health system performance in RID management and to identify evidence-based priorities for reform. The analysis is structured around five health system components: (1) surveillance and early warning, (2) diagnostic and laboratory capacity, (3) healthcare workforce, (4) public health infrastructure and primary care, and (5) governance and financing. Indonesia demonstrates important strengths, including a nationwide network of more than 10,000 Primary Health Centers (Puskesmas) and proven vaccination campaign capacity. However, significant gaps persist: during COVID-19, Early Warning Alert and Response System (EWARS) reporting completeness dropped from 75% to 53%, rural and remote areas remain underserved by diagnostics, and health workforce distribution continues to be inequitable Priority reforms include scaling up point-of-care diagnostics across all Puskesmas, integrating fragmented surveillance platforms through SatuSehat, empowering community health workers with digital tools, and ensuring sustainable financing for preparedness. Medium-term strategies focus on workforce redistribution and the establishment of regional health security centers, while long-term priorities emphasize predictive health intelligence, resilient supply chains, and nationwide facility upgrades. Building a resilient, prevention-oriented system will require sustained political commitment, innovative financing, and cross-sectoral collaboration, positioning Indonesia not only to strengthen domestic health security but also to serve as a regional leader in epidemic preparedness.},
}

@article {pmid41861257,
year = {2026},
author = {Madhugiri, R and Slanina, H and Saleem-Batcha, R and Ziebuhr, J},
title = {The Coronavirus Replication-Transcription Complex.},
journal = {Annual review of biochemistry},
volume = {},
number = {},
pages = {},
doi = {10.1146/annurev-biochem-052621-091439},
pmid = {41861257},
issn = {1545-4509},
abstract = {Coronaviruses (family Coronaviridae, order Nidovirales) include major human and animal pathogens. They have exceptionally large RNA genomes and use complex strategies to replicate and express these genomes. Intensive research activities in recent years have significantly advanced our knowledge of the molecular mechanisms involved in coronavirus RNA synthesis. Here, we briefly review these mechanisms and focus in particular on the structures and functions of the core replication-transcription complex (RTC) and other enzyme functions that can be recruited to this complex to fulfil additional functions, for example, in the context of 5' capping of viral mRNAs or in the context of mechanisms that control the processivity, replication fidelity, and backtracking of RTCs. Some of these recent studies provided fundamentally new insight into specific roles of previously identified genetic markers of coronaviruses and other nidoviruses, including specific functions in an unconventional RNA capping mechanism and potential roles in proofreading and discontinuous negative-strand RNA synthesis.},
}

@article {pmid41862100,
year = {2026},
author = {Cordeiro, J and Macela, C and Kleiner, R and Vaskovich-Koubi, D and Moura, LIF and Satchi-Fainaro, R and Florindo, HF},
title = {Harnessing the power of microbiome, nanotechnology, and immunity against cancer.},
journal = {Journal of controlled release : official journal of the Controlled Release Society},
volume = {394},
number = {},
pages = {114839},
doi = {10.1016/j.jconrel.2026.114839},
pmid = {41862100},
issn = {1873-4995},
mesh = {Humans ; *Neoplasms/immunology/therapy/microbiology ; *Microbiota/immunology ; Nanotechnology ; Animals ; Immunotherapy/methods ; Tumor Microenvironment/immunology ; Drug Delivery Systems ; },
abstract = {The human microbiome has emerged as a key player in health and disease, including cancer, which remains one of the leading causes of mortality worldwide. Although advances in understanding the tumor immune microenvironment and the development of immunotherapies have transformed cancer treatment, clinical efficacy remains limited by suboptimal response rates and severe side effects. Recent integrative research in cancer biology, immune-oncology, and cancer microbiome research, enabled by omics technologies and advanced bioinformatics, has begun to reveal intricate links between the microbiome, cancer progression, and immune modulation. These findings underscore the microbiome's pivotal role in shaping both therapeutic efficacy and resistance mechanisms. Currently, nanotechnology, propelled into mainstream success through the development of COVID-19 mRNA vaccines, is offering new tools for precision oncology. Nanomaterials are now being explored not only for targeted drug delivery but also for monitoring and modulating the microbiome, with significant potential for biomarker discovery and personalized medicine. In this article, we explore the role of the microbiota in tumorigenesis and cancer therapy, with a particular focus on its crosstalk with the immune system. We highlight emerging microbiota-targeted therapeutic strategies and discuss how nanotechnology-based systems are being designed to modulate the microbiome-immune-cancer axis. Finally, we discuss future directions in leveraging the convergence of microbiome science, nanotechnology, and immunotherapy to advance cancer treatment.},
}

Humans
*Neoplasms/immunology/therapy/microbiology
*Microbiota/immunology
Nanotechnology
Animals
Immunotherapy/methods
Tumor Microenvironment/immunology
Drug Delivery Systems

@article {pmid41862360,
year = {2026},
author = {Sinha, D and Coquant, G and Yuan, X and Paul, S and Longet, S},
title = {Postpandemic adjuvants to tailor vaccine-induced immunity.},
journal = {Trends in immunology},
volume = {47},
number = {5},
pages = {423-435},
doi = {10.1016/j.it.2026.01.001},
pmid = {41862360},
issn = {1471-4981},
mesh = {Humans ; *Adjuvants, Immunologic ; Animals ; *Adjuvants, Vaccine ; Immunity, Mucosal ; Immunogenicity, Vaccine ; *COVID-19 Vaccines/immunology ; *COVID-19/prevention & control/immunology ; *SARS-CoV-2/immunology ; *Vaccines/immunology ; Pandemics/prevention & control ; Immunity, Humoral ; Immunity, Cellular ; },
abstract = {Adjuvants are critical to improving the magnitude, breadth, functionality, and durability of vaccine immunogenicity. Despite advances in vaccinology, long-term immunity, variant cross-protection, and robust mucosal responses remain unmet goals. These challenges underscore the need for novel, safe, and effective adjuvants. This review explores emerging adjuvants targeting specific immune pathways. We highlight clinical and preclinical studies focusing on adjuvants that enhance durable and persistent humoral, cellular, and mucosal immunity. Current trends are discussed alongside tailored approaches for children and the elderly. Finally, the aim of this review is to highlight novel vaccine adjuvants currently in preclinical and clinical development, with the potential to generate a vaccine platform fit for the necessary yet unmet needs of public health in a postpandemic era.},
}

Humans
*Adjuvants, Immunologic
Animals
*Adjuvants, Vaccine
Immunity, Mucosal
Immunogenicity, Vaccine
*COVID-19 Vaccines/immunology
*COVID-19/prevention & control/immunology
*SARS-CoV-2/immunology
*Vaccines/immunology
Pandemics/prevention & control
Immunity, Humoral
Immunity, Cellular

@article {pmid41862909,
year = {2026},
author = {Khalid, K and Abdullah, ADI and Lim, HX and Ali, RAR},
title = {Pharmacological and non-pharmacological management of long COVID.},
journal = {Virology journal},
volume = {23},
number = {1},
pages = {},
pmid = {41862909},
issn = {1743-422X},
mesh = {Humans ; *COVID-19/complications/therapy ; Probiotics/therapeutic use ; SARS-CoV-2 ; Dysbiosis/therapy ; *COVID-19 Drug Treatment ; Gastrointestinal Microbiome ; Post-Acute COVID-19 Syndrome ; },
abstract = {Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a major global health burden in terms of acute infection and long-term consequences. Approximately 10% of infected experience autonomic dysfunction, cardiovascular complications, and neurological impairments. While immune dysregulation, persistent viral reservoirs, chronic inflammation, gut dysbiosis, and vascular dysfunction are implicated, the exact pathophysiological mechanisms of Long COVID remain unclear. Additionally, treatment options are limited and challenging to prescribe due to symptom heterogeneity. Non-pharmacological interventions such as increased salt intake, elimination diets for gastrointestinal symptoms, and cognitive pacing for fatigue may not be sufficient for severe symptoms. Moreover, pharmacological interventions such as β-blockers, calcium channel blockers, pyridostigmine, antihistamines, and low-dose naltrexone can improve tachycardia, fatigue, and brain fog but there are no standardized guidelines. In light of evidence supporting a strong association of Long COVID with gut dysbiosis, probiotics have emerged as a promising intervention. Clinical studies have shown that Bacillus coagulans, Bacillus subtilis, Lactobacillus acidophilus, and Bifidobacterium species can improve fatigue, gastrointestinal health, and overall physical and mental well-being in Long COVID patients. Large-scale randomized controlled trials are warranted to validate probiotic efficacy in Long COVID and reduce burden on individual health and healthcare institutions.},
}

Humans
*COVID-19/complications/therapy
Probiotics/therapeutic use
SARS-CoV-2
Dysbiosis/therapy
*COVID-19 Drug Treatment
Gastrointestinal Microbiome
Post-Acute COVID-19 Syndrome

@article {pmid41862917,
year = {2026},
author = {Luo, S and Zheng, Z and Karimi, L and Plebanski, M and Lankatillake, C and Sheahan, J and Anderson, K and Jovanovski, N and Seal, EL and Cockshaw, W and Wollersheim, D and Cleary, S and El-Ansary, D and Flanagan, KL and Jessup, R and Abrahamson, S and Whyler, N and Fineberg, D and Scoullar, MJL and Seeley, MC and Tippett, E and Xenos, S and Itsiopoulos, C},
title = {Between silence and solutions: a global guideline review of long COVID care and services in Australia.},
journal = {BMC health services research},
volume = {26},
number = {1},
pages = {},
pmid = {41862917},
issn = {1472-6963},
abstract = {BACKGROUND: As the acute response to the COVID-19 pandemic shifts to long-term management, the lasting effects of infection are becoming increasingly evident. Long COVID continues to challenge healthcare systems, with many healthcare professionals reporting uncertainty about assessment and referral pathways. This updated review examines recent international guidelines alongside Australian services to identify gaps between guidelines and practice. METHODS: Between April and October 2025, we searched for guidelines on Long COVID published in English and assessed their quality by applying the AGREE II appraisal tool. We also conducted a grey literature search to profile active Australian services providing Long COVID care. RESULTS: Three new or updated guidelines were published in the United States, Canada, and New South Wales, Australia. Together with the World Health Organisation, United Kingdom and New Zealand guidelines identified in the previous review, all emphasise integrated, primary care-led approaches. Notably, Australian service delivery remains fragmented, with a growing number of primary health practitioner-led private services operating largely under a fee-for-service model, leading to variations in access and affordability. Many hospital-based outpatient clinics have been absorbed into existing chronic-disease services. The most fundamental challenge is statistical invisibility: without an activated diagnostic code, services cannot reliably identify or follow people living with Long COVID. This invisibility limits both surveillance and service planning. DISCUSSION AND CONCLUSIONS: Australia is currently developing national clinical best-practice guidelines for ME/CFS, which may also benefit Long COVID; however, Australia remains behind comparable nations such as Canada, the United Kingdom, and the United States in developing and implementing the integrated, multidisciplinary care models recommended internationally. This has significant implications, namely that the rapid transition from hospital-based Long COVID clinics to primary care-led services has resulted in fragmented and uncoordinated care. Strengthening Australia’s response will require national leadership and investment in workforce training, sustainable funding for care coordination, improved public and professional awareness, the establishment of primary care-led multidisciplinary pathways, and the activation of a dedicated diagnostic code. Also importantly, shifting to a patient-centred approach and patient-practitioner collaborative model of care is essential to prepare the health system for managing Long COVID and future complex, multi-system conditions.},
}

@article {pmid41863157,
year = {2026},
author = {Mori, Y and Silwal, S and Wan Mohd Yunus, WMA and Sourander, A},
title = {Long-Term Trends in Screen Time Use Among Children and Adolescents: A Systematic Review Including Pre- and Post-COVID Periods.},
journal = {Clinical child psychology and psychiatry},
volume = {},
number = {},
pages = {13591045261432532},
doi = {10.1177/13591045261432532},
pmid = {41863157},
issn = {1461-7021},
abstract = {The rapid rise in internet access and smartphone use has significantly changed how children and adolescents engage in screen-based activities. To date, no systematic review has examined long-term trends in screen time use among children and adolescents that cover periods before and after the onset of the COVID-19 pandemic. This systematic review examined repeated cross-sectional studies to determine whether screen time use among children and adolescents changed over time. This systematic review was registered with PROSPERO (ID: CRD42021243869). The Web of Science, PubMed, Embase, and PsycINFO databases were searched to identify peer-reviewed studies that had been published in English, included data from at least two time points, and focused on children and adolescents between 0 and 19 years of age. The search was conducted without any restrictions on publication year. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality was assessed using the Quality Assessment Tool for Studies with Diverse Designs. A narrative synthesis was conducted following the Synthesis Without Meta-analysis guidelines. This review identified 60 studies covering the period 1991-2022. The findings indicate that traditional TV watching declined while the use of computers and video games grew. Screen time increased significantly over the years, especially after the COVID-19 pandemic started. The studies reviewed varied in how they defined and measured screen time. The review underscores the importance of continued research and evidence-based policies to guide responsible technology use in the lives of young people.},
}

@article {pmid41863427,
year = {2026},
author = {Barzoki, MG and Farahmand, M and Mahmodi, MJ and Amirjannati, N and Malekshahi, SS},
title = {The Impact of SARS-CoV-2 on Male Infertility: A Systematic Review and Meta-Analysis of Cohort Studies.},
journal = {Reviews in medical virology},
volume = {36},
number = {2},
pages = {e70128},
doi = {10.1002/rmv.70128},
pmid = {41863427},
issn = {1099-1654},
support = {4021102//National Institute for Medical Research Development/ ; },
mesh = {Humans ; Male ; *Infertility, Male/virology/epidemiology/pathology ; *COVID-19/complications/virology ; SARS-CoV-2/pathogenicity ; Sperm Motility ; Spermatozoa/virology/pathology ; Sperm Count ; Semen Analysis ; DNA Fragmentation ; Semen/virology ; Cohort Studies ; },
abstract = {Several conclusions have emerged regarding the impact of COVID-19 on the male reproductive system. This systematic review and meta-analysis aimed to provide a comprehensive update on the relationship between COVID-19 and male reproductive health. We investigated the effects of SARS-CoV-2 on various semen parameters, including semen volume, sperm concentration, sperm total count, total motility, progressive motility, morphology, and DNA fragmentation index (DFI). A literature review was conducted on all studies evaluating the impact of SARS-CoV-2 infection on male infertility from the beginning of 2019 through December 2023. Main electronic databases such as PubMed, Scopus, Cochrane Library, and Web of Science were used. The research question was based on the PECO framework, focusing on (Population) exposed to SARS-CoV-2 (Exposure), compared to uninfected men (Comparator), with conventional sperm parameters as the measured Outcome. The studies were divided into two groups for analysis: between-group comparisons, which compared sperm parameters of men recovered from COVID-19 to uninfected controls, and within-subject comparisons, which assessed sperm parameters in the same individuals before and after infection. Standardized mean differences (SMD) were calculated as effect sizes with 95% confidence intervals (CI) for each outcome. The DerSimonian-Laird method estimated between-study variance (τ[2]), while the Jackson method calculated confidence intervals for τ[2] and τ. Publication bias was assessed using funnel plots and Egger's test. This meta-analysis included two types of cohort studies: single-arm studies and those with a control group. In the single-arm studies, a statistically significant decrease in semen volume (p = 0.0023) was observed. Additionally, in the cohort studies with controls, there were statistically significant reductions in sperm concentration (p < 0.0001), total count (p = 0.0001), total motility (p = 0.0009), progressive sperm motility (0.0391), and DFI (0.04). This is the most up-to-date systematic review and meta-analysis incorporating cohort study data. The findings provide compelling evidence that SARS-CoV-2 infection adversely affects male reproductive health, particularly in terms of semen quality. The analysis reveals significant reductions in key semen parameters, including sperm count, concentration, total motility, and progressive motility. Adult maleand DFI.},
}

Humans
Male
*Infertility, Male/virology/epidemiology/pathology
*COVID-19/complications/virology
SARS-CoV-2/pathogenicity
Sperm Motility
Spermatozoa/virology/pathology
Sperm Count
Semen Analysis
DNA Fragmentation
Semen/virology
Cohort Studies

@article {pmid41864480,
year = {2026},
author = {Rauf, M and Naveed, A and Asghar, MU},
title = {Post-acute sequelae of COVID-19: A disorder of impaired innate immune resolution - A narrative review.},
journal = {Clinical immunology (Orlando, Fla.)},
volume = {285},
number = {},
pages = {110701},
doi = {10.1016/j.clim.2026.110701},
pmid = {41864480},
issn = {1521-7035},
mesh = {Humans ; *COVID-19/immunology/complications ; *Immunity, Innate/immunology ; *SARS-CoV-2/immunology ; Post-Acute COVID-19 Syndrome ; Alarmins/immunology ; Inflammation/immunology ; },
abstract = {Post-acute sequelae of COVID-19 (PASC) affect millions of people worldwide and are increasingly recognized as a disorder of failed innate immune resolution rather than a persistent viral infection. Emerging evidence shows that residual SARS-CoV-2 antigens, host-derived alarmins, reactivated latent viruses, and mucosal microbiome-derived products from oral-nasopharyngeal and gut reservoirs sustain the chronic activation of pattern-recognition receptors, inflammasomes, and complement pathways. In parallel, deficits in specialized pro-resolving mediators, impaired efferocytosis, and persistent tissue injury prevent physiological termination of inflammation. These unresolved cues drive long-lasting epigenetic and metabolic reprogramming of hematopoietic stem cells and myeloid lineages, creating maladaptive trained immunity states characterized by hyper-responsiveness or exhaustion of these cells. Thromboinflammatory processes, including aberrant NETosis and sustained interface signalingling, further reinforce self-perpetuating inflammatory circuits. Together, these pathways give rise to reproducible molecular endotypes, including thromboinflammatory, interferon-driven, and neuroinflammatory phenotypes, which explain clinical heterogeneity. Framing PASC as a disorder of impaired immune resolution within a mucosal microbial viral context provides a unifying mechanistic scaffold for biomarker identification and host-directed therapies. This review proposes that restoring active resolution programs, rebalancing metabolic-epigenetic networks, and dismantling pathogenic innate feedback loops are promising strategies for reversing the chronic immune imprint of PASC.},
}

Humans
*COVID-19/immunology/complications
*Immunity, Innate/immunology
*SARS-CoV-2/immunology
Post-Acute COVID-19 Syndrome
Alarmins/immunology
Inflammation/immunology

@article {pmid41865876,
year = {2026},
author = {Prichett, LM and Young, AS and Wu, EG and Yolken, RH and Severance, EG and Prandovszky, E and Carmichael, D and Badio, J and Kumra, T},
title = {Uneven Recovery: Intersectional Disparities in Youth Mental Health After COVID-19.},
journal = {Academic pediatrics},
volume = {26},
number = {4},
pages = {103299},
doi = {10.1016/j.acap.2026.103299},
pmid = {41865876},
issn = {1876-2867},
}

@article {pmid41866483,
year = {2026},
author = {Liu, HQ and Liu, Y and Gu, KN and Song, YLQ},
title = {Meta-analysis of factors influencing depression in the elderly before and after the COVID-19 pandemic in 2023.},
journal = {BMC geriatrics},
volume = {26},
number = {1},
pages = {},
pmid = {41866483},
issn = {1471-2318},
abstract = {OBJECTIVE: This study aimed to explore and summarize the changes in depressive symptoms and their influencing factors among the elderly before and after the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, so as to provide evidence-based references for the prevention and management of depression in the elderly. METHOD: By searching published in PubMed, EBSCOhost, Springer Link, Web of Science, Taylor and Francis databases, the literature on depression in older adults was collected using the 15-item Geriatric Depression Scale (GDS-15), Depression Scale (CDS-11) questionnaire and diagnostic interview (CDI-SF) as a tool. Among them, in the included literature, before January 2023 was identified as the pre-outbreak of the COVID-19 pandemic, and due to the differences in the time of full liberalization of countries, the beginning of 2023 to now was identified as the late outbreak of the COVID-19 pandemic, and Stata17 was used for meta-analysis. RESULTS: Thirteen pre-COVID-19 pandemic and seven post-COVID-19 pandemic literatures were included. A total of seven influencing factors were included. Before the COVID-19 pandemic: Before the COVID-19 pandemic, trends in potential risks for depression among older adults included: being female (OR = 1.464, 95% CI: 1.164~1.840,p < 0.001), being divorced or widowed (OR = 2.126, 95% CI: 1.170~3.862, P = 0.013), and having a chronic disease (OR = 1.174, 95% CI: 1.023~1.347, P = 0.022), age ≥ 70 years (OR = 1.336,95%CI: 0.850~2.102, P = 0.210), loneliness (OR = 2.450,95%CI: 2.445~2.455, P = < 0.001) and the junior middle school and the following qualifications (OR＝1.145, 95% CI:0.873~1.501, p＝0.327) were trends in potential risks for depression in older adults. Living alone (OR = 0.939, 95%CI: 0.417~2.116, P = 0.88), high school education or above (OR = 0.904,95%CI: 0.640~1.276, P = 0.564) were the lower risks. After the outbreak: being female (OR = 1.156, 95% CI: 0.675 ~ 1.980, P = 0.596), the junior middle school and the following qualifications (OR = 1.05, 95% CI: 0.964 ~ 1.143, P = 0.264), having a chronic disease (OR = 1.269, 95% CI: 1.003 ~ 1.605, P = 0.047), age ≥ 70 years (OR = 1.472, 95% CI: 0.861 ~ 2.517, P = 0.158), there is loneliness (OR = 2.913, 95% CI: 2.372 ~ 3.578, p < 0.001), live alone (OR = 1.627, 95% CI: 0.798 ~ 3.318, P = 0.180), high school education or above (OR = 1.053,95%CI:0.757 ~ 1.465, P = 0.757) were trends in potential risks for depression in older adults, divorce or widowed (OR = 0.482,95%CI:0.041 ~ 5.704, P = 0.563) were lower risks. CONCLUSIONS: The study found that the association patterns between depression in the elderly and five factors (divorced or widowed status, aged ≥ 70 years, loneliness, living alone, and high school education or above) exhibited distinct characteristics before and after the pandemic. Among these, loneliness and chronic diseases were consistently significant risk factors for depression in the elderly, and the strength of the association between loneliness and depression was further enhanced in the post-pandemic period. Notably, the significant association between female gender and depression observed in the pre-pandemic period no longer existed in the post-pandemic period. This change is speculated to be related to adjustments in the coverage of social support after the pandemic, which requires further verification in subsequent studies. Based on the above association characteristics, targeted intervention measures can be adopted in the post-pandemic period, such as striving to alleviate loneliness in the elderly, strengthening health monitoring for key groups including the elderly living alone and those aged ≥ 70 years, and promoting the organic integration of chronic disease management and psychological assessment, so as to effectively reduce the risk of depression in the elderly.},
}

@article {pmid41866665,
year = {2026},
author = {Tao, S and Zhou, Z and Li, X and Wang, XW and Liu, X and Kang, D},
title = {Recent Advances of Non-Nucleoside Polymerase Inhibitors With Broad-Spectrum Antiviral Activities.},
journal = {Medicinal research reviews},
volume = {46},
number = {4},
pages = {945-965},
doi = {10.1002/med.70041},
pmid = {41866665},
issn = {1098-1128},
support = {tsqn 202408055//Taishan Scholar Program of Shandong Province/ ; 2023YFC2308900//National Key Research and Development Program/ ; 2023YFE0206500//National Key Research and Development Program/ ; SYS202205//Shandong Laboratory Program/ ; //Qilu Young Scholars Program of Shandong University/ ; },
mesh = {*Antiviral Agents/pharmacology/chemistry/therapeutic use ; Humans ; *Enzyme Inhibitors/pharmacology/chemistry ; Animals ; SARS-CoV-2/drug effects/enzymology ; },
abstract = {A tremendous and painful price has been paid in the fight against pandemic viruses in the global health field. Emerging and re-emerging viruses serve as primary drivers of severe pandemics, such as influenza virus (IV), respiratory syncytial virus (RSV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Viral polymerases are highly conserved among viruses of the same genus. Inhibitors targeting polymerases often exhibit broad-spectrum antiviral activity against these same genus viruses, playing a crucial role in antiviral therapies. Non-nucleoside polymerase inhibitors demonstrate their superiority in terms of safety and anti-mutation ability out of nucleoside/nucleotide polymerase inhibitors. This review presents an overview of non-nucleoside polymerase inhibitors along with their relative antiviral activities and mechanisms of action, providing a reference for the development of novel antiviral drugs with broad-spectrum activities.},
}

*Antiviral Agents/pharmacology/chemistry/therapeutic use
Humans
*Enzyme Inhibitors/pharmacology/chemistry
Animals
SARS-CoV-2/drug effects/enzymology

@article {pmid41867155,
year = {2026},
author = {Valero-Gaspar, T and Garriga, C and Unim, B and Feteira-Santos, R and Palmieri, L and Díaz, A and Rodríguez-Blázquez, C and Forjaz, MJ},
title = {Indirect impact of COVID-19 pandemic on health and wellbeing: a narrative review.},
journal = {Annali dell'Istituto superiore di sanita},
volume = {62},
number = {1},
pages = {53-66},
doi = {10.4415/ANN_26_01_08},
pmid = {41867155},
issn = {2384-8553},
mesh = {Humans ; *COVID-19/economics/psychology/epidemiology ; *Quality of Life ; Mental Health ; Pandemics ; Cost of Illness ; Life Expectancy ; *Health Status ; SARS-CoV-2 ; Disability-Adjusted Life Years ; },
abstract = {INTRODUCTION: The COVID-19 pandemic had a profound impact on global health, notably affecting patients with non-COVID-19 conditions, who faced substantial disruptions in their treatment and care. The aim of this narrative review was to identify the main indicators used in literature to evaluate the indirect impact of COVID-19 on health and wellbeing.

METHOD: A literature search was conducted using PubMed from January 2021 to November 2022. The indicators were categorized into five main groups: burden of disease (BoD), life expectancy (LE), health-related quality of life (HRQoL), cost of illness and mental health status and were retrieved from 20 scientific articles.

RESULTS: Disability-adjusted life years (DALYs) revealed substantial health losses; a decrease in LE was observed, with inequalities across population subgroups; HRQoL showed impairments in physical functioning, daily activities and emotional well-being; productivity losses were economically relevant and varied by context and elevated symptoms of anxiety and depression were reported.

DISCUSSION: The compiled indicators may contribute to the development of sustainable pandemic mitigation policies.},
}

Humans
*COVID-19/economics/psychology/epidemiology
*Quality of Life
Mental Health
Pandemics
Cost of Illness
Life Expectancy
*Health Status
SARS-CoV-2
Disability-Adjusted Life Years

@article {pmid41868370,
year = {2026},
author = {Li, H and Wang, T and Xiang, T and Xu, L and Zheng, Z and Zheng, X},
title = {Secondary fungal infections in severe acute viral diseases: clinical features and underlying immune mechanisms.},
journal = {Frontiers in microbiology},
volume = {17},
number = {},
pages = {1780547},
pmid = {41868370},
issn = {1664-302X},
abstract = {Secondary fungal infections are increasingly recognized as critical factors in the prognosis of severe acute viral infections, including influenza, SARS-CoV-2, Severe Fever with Thrombocytopenia Syndrome virus, and Dengue. This review outlines the clinical features of fungal complications, proposing a "virus-driven immune reprogramming" framework. It highlights how viral infections disrupt immune barriers, impair the Th17-IL-17 antifungal axis, attenuate platelet immune function, and involve unique pathogen interactions, creating a host immune microenvironment that is more susceptible to fungal invasion. Understanding these immune-injury mechanisms underscores the clinical importance of earlier surveillance of secondary fungal disease and informs the development of mechanism-guided therapeutic approaches to improve patient outcomes.},
}

@article {pmid41869111,
year = {2026},
author = {Bartley, G and Waugh, S and Gopalan, V},
title = {Evaluating Study Techniques for Australian Medical Students During Clinical Placement: A Scoping Review.},
journal = {Cureus},
volume = {18},
number = {2},
pages = {e103802},
pmid = {41869111},
issn = {2168-8184},
abstract = {Transitioning from pre-clinical to clinical phases of medical education represents a unique challenge as students learn most content through self-directed learning (SDL), rather than the more prescriptive pre-clinical curriculum. There is a range of SDL study techniques employed by medical students on placement. The COVID-19 pandemic accelerated the adoption of digital resources, prompting a need to reassess the study techniques that best support clinical-year medical students. However, there is a lack of research on which study techniques Australian clinical-year medical students find most effective. The objective of this study is to evaluate the evidence on student-perceived utility of common study techniques for SDL whilst on clinical placement in Australia. A qualitative scoping review of literature on PubMed and Medline Ovid was performed in 2024. Study inclusion criteria for articles were published articles, English language, publication within 20 years, and focus on clinical-year medical students. Exclusion criteria were review articles, investigations focusing on a specific educational intervention, and studies including only pre-clinical students. Studies were qualitatively appraised and synthesised by tabulation in Microsoft Excel (Microsoft Corp., Redmond, WA, US). Risk of bias analysis was not performed. Nine studies from Australia, the USA, the UK, Thailand, Saudi Arabia, and Malaysia were analysed. This included seven cross-sectional, one mixed-methods, and one qualitative analysis. Sample size ranged from 12 to 350 students. Only two studies were conducted after the COVID-19 pandemic. Overall, the results of the included studies demonstrate a consistent trend towards third-party online tools, including question banks, mobile applications, and revision courses for SDL. The strength of evidence on students' perceived efficacy of study techniques in the post-pandemic era presented is limited due to the small number of included studies and the lack of formal study appraisal. There is also poor generalisability of pre-pandemic and international studies to the contemporary Australian context. As there is a lack of a standardised tool to evaluate study technique utility, comparison between studies is difficult. Ongoing research is required to develop evidence-based guidelines that can assist students in commencing SDL whilst on clinical placement.},
}

@article {pmid41869535,
year = {2026},
author = {Singh, H and Tripathi, G and Khan, AA and Verma, A and Singh, A},
title = {Autophagy, telomerase, and endothelial dysfunction in COVID-19-induced cardiac injury: an evidence-graded genetic and epigenetic synthesis.},
journal = {Frontiers in cardiovascular medicine},
volume = {13},
number = {},
pages = {1769828},
pmid = {41869535},
issn = {2297-055X},
abstract = {BACKGROUND: Cardiac injury is a frequent and severe complication of COVID-19, yet the molecular mechanisms driving myocardial involvement remain incompletely understood. Dysregulated autophagy, telomerase/telomere biology, and endothelial dysfunction have emerged as biologically plausible and potentially interconnected contributors to COVID-19-associated cardiac injury.

METHODS: We conducted a narrative, evidence-graded review of literature retrieved from PubMed and EMBASE, with Google Scholar used selectively as a supplementary source to capture emerging or cross-disciplinary studies. Eligible studies included human investigations and relevant animal models reporting genetic, epigenetic, or molecular alterations in autophagy, telomerase, or endothelial pathways with cardiovascular relevance. Non-English publications, studies lacking primary data, and reports unrelated to cardiovascular or systemic disease mechanisms were excluded. Evidence was stratified as Level I (direct evidence in COVID-19-associated cardiac injury), Level II (COVID-19 systemic or vascular evidence with plausible cardiac relevance), and Level III (non-COVID cardiovascular or systemic disease; hypothesis-generating).

FINDINGS: Across viral, cardiovascular, and systemic contexts, key candidate genes, including ATG5, ATG7, Beclin-1, TERT, ICAM1, and eNOS -emerged as potential mediators of COVID-19-related cardiac injury. While endothelial activation is supported by relatively consistent clinical and molecular evidence, direct cardiac-tissue data linking autophagy and telomerase pathways to COVID-19-associated myocardial injury remain limited. These gaps highlight substantial uncertainty regarding causal mechanisms and inter-individual susceptibility.

CONCLUSION: Autophagy dysregulation, telomere attrition, and endothelial dysfunction represent convergent and biologically plausible mechanisms contributing to COVID-19-associated cardiac injury; however, current evidence remains largely indirect and derived from systemic or vascular compartments rather than cardiac tissue. Cardiac-specific, longitudinal genetic and epigenetic studies are required before these pathways can be considered for biomarker development or therapeutic targeting.},
}

@article {pmid41869602,
year = {2026},
author = {Frodsham, C and Harvey, SB and Collins, D and Krakue, K and Dalgaard, VL and Lipscomb, R and Hotopf, M and Deady, M and Bryant, R and Gayed, A},
title = {Prevalence of post-traumatic stress disorder in healthcare workers before and during COVID-19: a systematic review and meta-analysis.},
journal = {Frontiers in public health},
volume = {14},
number = {},
pages = {1735552},
pmid = {41869602},
issn = {2296-2565},
mesh = {Humans ; *Stress Disorders, Post-Traumatic/epidemiology ; *COVID-19/epidemiology/psychology ; *Health Personnel/psychology/statistics & numerical data ; Prevalence ; Risk Factors ; SARS-CoV-2 ; Pandemics ; },
abstract = {UNLABELLED: The COVID-19 pandemic exacerbated many known risk factors for post-traumatic stress disorder (PTSD) among healthcare workers. This systematic review and meta-analysis examines pooled prevalence estimates of probable PTSD among this cohort prior to COVID-19 compared to during COVID-19 and investigates time trends in prevalence. Systematic multi-database literature searches were conducted to identify studies published between January 2017 and July 2023. Included studies reported the prevalence of probable PTSD, measured by validated screening tools, in clinical healthcare workers. Two reviewers independently conducted study screening, data extraction, and quality assessment. Random-effects meta-analyses were performed to estimate pooled prevalence of probable PTSD among healthcare workers in each time period. Subgroup analyses were carried out for year, profession, quality of study, COVID-19 mortality rates, and income level within the country of study. Screening identified 21 papers comprising 11,838 healthcare workers published in the 3 years preceding the pandemic, and 129 papers reporting on 130,363 healthcare workers during the pandemic. The pooled prevalence estimate of probable PTSD prior to the pandemic was 15.5% (95% CI: 12.3-19.3%) and this significantly increased during the pandemic to 24.8% (95% CI: 22.0-27.8%), peaking early in the pandemic in 2020 before returning to pre-pandemic levels in 2022. During the pandemic, prevalence estimates were significantly higher among nurses and those in countries with high COVID-19 mortality rates, whilst no significant difference was observed between studies conducted in high-income versus low- and middle-income countries. Substantial heterogeneity was observed. The findings of this review suggest that prevalence of PTSD among healthcare workers significantly increased following the COVID-19 outbreak. By the third year of the pandemic, probable PTSD prevalence rates appear to return to pre-pandemic levels, although these levels remain concerningly high. These findings support the call for targeted interventions to protect healthcare worker wellbeing, particularly during healthcare emergencies.

https://www.crd.york.ac.uk/PROSPERO/view/CRD42022364955, unique identifier is CRD42022364955.},
}

Humans
*Stress Disorders, Post-Traumatic/epidemiology
*COVID-19/epidemiology/psychology
*Health Personnel/psychology/statistics & numerical data
Prevalence
Risk Factors
SARS-CoV-2
Pandemics

@article {pmid41869844,
year = {2026},
author = {Weiss, SL and Peters, MJ and Oczkowski, SJW and Belley-Cote, E and Buysse, C and Choong, KLM and Deep, A and Inwald, DP and Flori, HR and Kneyber, MCJ and Menon, K and Murthy, S and Nunnally, ME and Parker, MM and Schlapbach, LJ and Oliveira, CF and Sorce, LR and Agus, M and Argent, AC and Balamuth, F and Bansal, A and Bem, RA and Brierley, J and Burns, KEA and Carlton, EF and Carrol, ED and Carroll, CL and Carter, MJ and Conlon, TW and Daniels, R and De Luca, D and Di Nardo, M and Dulfer, K and Faust, SN and Fernandez-Sarmiento, J and Fitzgerald, JC and Hall, M and Hsu, BS and Javouhey, E and Joosten, K and Karam, O and Kelly, SP and Lang, HJ and Lee, JH and Lemson, J and MacLaren, G and Manning, JC and Mehta, N and Morin, L and Morrow, BM and Nadel, S and Nishisaki, A and Pong, S and Raman, S and Randolph, AG and Ranjit, S and Ray, S and Remy, KE and Scott, HF and Sick-Samuels, AC and Souza, DC and Swan, T and Tibby, SM and Valla, FV and Watson, RS and Wiens, MO and Wolf, J and Zimmerman, JJ and Tissieres, P and Kissoon, N},
title = {Surviving Sepsis Campaign International Guidelines for the Management of Sepsis and Septic Shock in Children 2026.},
journal = {Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies},
volume = {27},
number = {4},
pages = {379-434},
doi = {10.1097/PCC.0000000000003927},
pmid = {41869844},
issn = {1529-7535},
mesh = {Humans ; *Shock, Septic/therapy ; Child ; *Sepsis/therapy ; Infant ; Adolescent ; Child, Preschool ; Evidence-Based Medicine ; },
abstract = {OBJECTIVES: To update evidence-based management recommendations for clinicians caring for children (including infants, school-aged children, and adolescents) with sepsis or septic shock.

DESIGN: A panel of 68 international experts, representing 13 international organizations, as well as six methodologists, was convened. A formal conflict-of-interest policy was developed at the onset of the process and applied throughout. Teleconferences and electronic-based discussion among the chairs, co-chairs, methodologists, and subgroup leads as well as within subgroups, served as an integral part of the guideline development process.

METHODS: New priority topics and recommendations from the prior guideline iteration were used to identify Population, Intervention, Control, and Outcomes (PICO) questions likely to have new or updated evidence. We conducted a systematic review to identify the best available evidence, summarized the evidence, and then assessed the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation approach. We used the evidence-to-decision framework to formulate recommendations as strong or conditional, or as a good practice statement. "In our practice," statements were included when evidence was inconclusive to issue a recommendation but the panel felt that some guidance based on practice patterns may be appropriate.

RESULTS: The panel provided 61 statements on the management of children with sepsis or septic shock. Overall, five were strong recommendations, 24 were conditional recommendations, and ten were good practice statements. For 22 PICO questions, no recommendations could be made, but, for seven of these, "in our practice" statements were provided. Compared with the 2020 guidelines, 20 recommendations were new, 13 were updated for clarity and/or new evidence, six were reviewed but not changed, and 22 were carried forward based on consensus of the panel that new evidence was not available. Only three recommendations were based on high or moderate certainty of evidence.

CONCLUSIONS: Updated management guidelines were issued by a panel of international experts for the best care of children with sepsis or septic shock, acknowledging that most aspects of care continue to have relatively low quality of evidence.},
}

Humans
*Shock, Septic/therapy
Child
*Sepsis/therapy
Infant
Adolescent
Child, Preschool
Evidence-Based Medicine

@article {pmid41870078,
year = {2026},
author = {Bayurova, E and Kostyushev, D and Tikhonov, A and Chulanov, V and Gordeychuk, I},
title = {Broad-acting antivirals: the pursuit of pan-viral therapeutics in the era of pandemics.},
journal = {Journal of virology},
volume = {100},
number = {5},
pages = {e0007726},
pmid = {41870078},
issn = {1098-5514},
support = {25-65-00010//Russian Science Foundation/ ; },
mesh = {Humans ; *Antiviral Agents/therapeutic use/pharmacology ; *COVID-19 Drug Treatment ; SARS-CoV-2/drug effects ; COVID-19/virology ; Pandemics ; Drug Repositioning ; },
abstract = {The ever-present threat of new viral epidemics makes the scientific community relentlessly work on the development of universal methods of antiviral therapy. The development of broad-spectrum antivirals (BSAs) focuses either on substances acting directly on viral proteins (direct-acting antivirals [DAA]) or on substances directed at the cell's own proteins (host-targeting antivirals [HTA]). Decades of development have led to the market entry of a number of DAAs with a wide range of antiviral activities; however, their clinical approval has been obtained for individual infections. HTAs have a number of advantages over DAAs, such as a wider range of antiviral activities and a high genetic barrier to viral resistance, which is undoubtedly important when preparing for a battle with an unknown pathogen. The COVID-19 pandemic has allowed for multiple clinical trials for repurposed HTAs, previously licensed for the treatment of other diseases, including cancer. Despite the enormous work done, the arsenal of BSAs capable of protecting against future pandemics caused by pathogen X is very limited. In this review, we described data on the most studied DAAs and HTAs, effective against at least two unrelated viral pathogens, focusing on those that have been studied in late preclinical and clinical trials. In the end, we highlighted alternative new approaches such as CRISPR-Cas therapy.},
}

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

@article {pmid41870559,
year = {2026},
author = {Weiss, SL and Peters, MJ and Oczkowski, SJW and Belley-Cote, E and Buysse, C and Choong, KLM and Deep, A and Inwald, DP and Flori, HR and Kneyber, MCJ and Menon, K and Murthy, S and Nunnally, ME and Parker, MM and Schlapbach, LJ and Oliveira, CF and Sorce, LR and Agus, M and Argent, AC and Balamuth, F and Bansal, A and Bem, RA and Brierley, J and Burns, KEA and Carlton, EF and Carrol, ED and Carroll, CL and Carter, MJ and Conlon, TW and Daniels, R and De Luca, D and Di Nardo, M and Dulfer, K and Faust, SN and Fernandez-Sarmiento, J and Fitzgerald, JC and Hall, M and Hsu, BS and Javouhey, E and Joosten, K and Karam, O and Kelly, SP and Lang, HJ and Lee, JH and Lemson, J and MacLaren, G and Manning, JC and Mehta, N and Morin, L and Morrow, BM and Nadel, S and Nishisaki, A and Pong, S and Raman, S and Randolph, AG and Ranjit, S and Ray, S and Remy, KE and Scott, HF and Sick-Samuels, AC and Souza, DC and Swan, T and Tibby, SM and Valla, FV and Watson, RS and Wiens, MO and Wolf, J and Zimmerman, JJ and Tissieres, P and Kissoon, N},
title = {Surviving Sepsis Campaign International Guidelines for the Management of Sepsis and Septic Shock in Children 2026.},
journal = {Intensive care medicine},
volume = {52},
number = {5},
pages = {937-983},
pmid = {41870559},
issn = {1432-1238},
mesh = {Humans ; *Shock, Septic/therapy ; *Sepsis/therapy ; Child ; Evidence-Based Medicine ; *Practice Guidelines as Topic ; Adolescent ; Infant ; Child, Preschool ; },
abstract = {OBJECTIVE: To update evidence-based management recommendations for clinicians caring for children (including infants, school-aged children, and adolescents) with sepsis or septic shock.

DESIGN: A panel of 68 international experts, representing 13 international organizations, as well as six methodologists, was convened. A formal conflict-of-interest policy was developed at the onset of the process and applied throughout. Teleconferences and electronic-based discussion among the chairs, co-chairs, methodologists, and subgroup leads, as well as within subgroups, served as an integral part of the guideline development process.

METHODS: New priority topics and recommendations from the prior guideline iteration were used to identify Population, Intervention, Control, and Outcomes (PICO) questions likely to have new or updated evidence. We conducted a systematic review to identify the best available evidence, summarized the evidence, and then assessed the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation approach. We used the evidence-to-decision framework to formulate recommendations as strong or conditional, or as a good practice statement. "In our practice," statements were included when evidence was inconclusive to issue a recommendation, but the panel felt that some guidance based on practice patterns may be appropriate.

RESULTS: The panel provided 61 statements on the management of children with sepsis or septic shock. Overall, five were strong recommendations, 24 were conditional recommendations, and ten were good practice statements. For 22 PICO questions, no recommendations could be made, but for seven of these, "in our practice" statements were provided. Compared with the 2020 guidelines, 20 recommendations were new, 13 were updated for clarity and/or new evidence, six were reviewed but not changed, and 22 were carried forward based on consensus of the panel that new evidence was not available. Only three recommendations were based on high or moderate certainty of evidence.

CONCLUSIONS: Updated management guidelines were issued by a panel of international experts for the best care of children with sepsis or septic shock, acknowledging that most aspects of care continue to have relatively low quality of evidence.},
}

Humans
*Shock, Septic/therapy
*Sepsis/therapy
Child
Evidence-Based Medicine
*Practice Guidelines as Topic
Adolescent
Infant
Child, Preschool

@article {pmid41871039,
year = {2026},
author = {Kubica, J and Topoliński, T and Gajda, R and Musz, P and Kubica, A and Szarpak, Ł and Nowicki, K and Ziółkowski, M and Meszyński, S and Grzelak, S and Sokolov, O and Ratajczak, J and Umińska, JM and Niezgoda, P and Grzelakowska, K and Podhajski, P and Obońska, K and Laskowska, E and Piotrowicz, R and Tycińska, A and Specchia, G and Frantz, S and Störk, S and Navarese, EP},
title = {Artificial intelligence as the missing integrator in heart failure care - from remote monitoring to personalized therapy.},
journal = {Cardiology journal},
volume = {33},
number = {},
pages = {e00226032},
pmid = {41871039},
issn = {1898-018X},
mesh = {Humans ; *Heart Failure/therapy/diagnosis ; *Artificial Intelligence ; *COVID-19/epidemiology ; *Precision Medicine/methods ; Telemedicine ; SARS-CoV-2 ; Monitoring, Physiologic/methods ; },
abstract = {Heart failure (HF) remains a leading cause of morbidity, mortality, and healthcare utilization worldwide, despite the availability of effective evidence-based therapies. The principal challenge is no longer the absence of treatment options but the limited capacity of traditional care models to deliver guidelinedirected medical therapy (GDMT) consistently and at scale. The COVID-19 pandemic exposed the fragility of hospital-centered HF care, highlighting the need for more resilient, patient-centered management strategies. Remote monitoring (RM) has been proposed as a solution, yet its clinical impact has been inconsistent due to fragmented data streams, declining patient adherence, and heavy reliance on continuous human oversight. Artificial intelligence (AI) offers an opportunity to address these limitations by integrating multidimensional clinical data, enabling earlier detection of deterioration, supporting adherence, and prioritizing clinically meaningful interventions. Emerging evidence suggests that AI-assisted workflows can accelerate GDMT optimization and improve surrogate and clinical outcomes when implemented within supervised care pathways. This has led to the concept of next-generation remote monitoring (NGRM), in which AI analyzes longitudinal physiological and behavioral signals to generate context-aware alerts and actionable recommendations while reducing clinical workload. Successful implementation, however, requires rigorous validation, clear governance, integration with clinical workflows, and safeguards for safety, equity, and accountability. When embedded within structured HF care pathways, AI-enabled monitoring may help bridge the persistent gap between evidence and real-world implementation.},
}

Humans
*Heart Failure/therapy/diagnosis
*Artificial Intelligence
*COVID-19/epidemiology
*Precision Medicine/methods
Telemedicine
SARS-CoV-2
Monitoring, Physiologic/methods

@article {pmid41871621,
year = {2026},
author = {Sartori, F and Crisafulli, E and Cariqueo, M and Di Chiara, C and Sartori, G and Fantin, A and Torres, A},
title = {Role of Vaccination in the Prevention of ECOPD.},
journal = {Seminars in respiratory and critical care medicine},
volume = {47},
number = {3},
pages = {323-333},
doi = {10.1055/a-2837-8778},
pmid = {41871621},
issn = {1098-9048},
mesh = {Humans ; *Pulmonary Disease, Chronic Obstructive/prevention & control/complications/immunology/physiopathology ; *Vaccination/methods ; Pneumococcal Vaccines/therapeutic use ; COVID-19 Vaccines/therapeutic use ; Influenza Vaccines/therapeutic use ; Respiratory Syncytial Virus Vaccines/therapeutic use ; COVID-19/prevention & control ; *Respiratory Tract Infections/prevention & control ; Influenza, Human/prevention & control ; Disease Progression ; },
abstract = {Exacerbations of chronic obstructive pulmonary disease (ECOPD) represent key events in the natural history of COPD and are associated with several adverse outcomes. Respiratory infections are major and potentially modifiable triggers of ECOPD, with viral pathogens such as the influenza virus, respiratory syncytial virus (RSV), and SARS-CoV-2, as well as bacterial infections caused by Streptococcus pneumoniae, playing a central role. This narrative review examines the current evidence supporting vaccination as a preventive strategy for ECOPD and discusses its translation into clinical practice. The biological rationale for vaccination in COPD is reviewed, including disease-related immune dysregulation, impaired mucociliary clearance, and increased susceptibility to respiratory pathogens. Evidence from randomized clinical trials, observational studies, meta-analyses, and real-world data is summarized for pneumococcal, influenza, SARS-CoV-2, and RSV vaccines. Pneumococcal vaccination has been shown to reduce the burden of community-acquired pneumonia and invasive pneumococcal disease, with conjugate and higher-valent vaccines providing enhanced immunogenicity in older and high-risk adults. Influenza vaccination consistently reduces severe exacerbations, hospitalizations, and mortality, with additional cardioprotective effects of relevance in COPD. SARS-CoV-2 vaccination markedly lowers the risk of severe COVID-19 and related respiratory deterioration in COPD, while recently licensed RSV vaccines offer a novel opportunity to prevent RSV-associated lower respiratory tract disease and potentially reduce exacerbation risk. Patient populations most likely to benefit from vaccination include frequent exacerbators, older adults, individuals with severe airflow limitation, multimorbidity, immune dysfunction, infection-prone phenotypes, and socially vulnerable groups. Future perspectives include precision vaccination strategies, novel vaccine platforms, coadministration approaches, and interventions to improve vaccine uptake. Vaccination emerges as a cornerstone of ECOPD prevention, with substantial potential to reduce exacerbation burden and improve long-term outcomes in COPD.},
}

Humans
*Pulmonary Disease, Chronic Obstructive/prevention & control/complications/immunology/physiopathology
*Vaccination/methods
Pneumococcal Vaccines/therapeutic use
COVID-19 Vaccines/therapeutic use
Influenza Vaccines/therapeutic use
Respiratory Syncytial Virus Vaccines/therapeutic use
COVID-19/prevention & control
*Respiratory Tract Infections/prevention & control
Influenza, Human/prevention & control
Disease Progression

@article {pmid41871844,
year = {2026},
author = {Mullen, AK and Richardson, ET and Bassett, MT and Darity, WA},
title = {A plan for black American reparations.},
journal = {BMJ global health},
volume = {11},
number = {Suppl 1},
pages = {},
pmid = {41871844},
issn = {2059-7908},
mesh = {Humans ; *Black or African American ; United States ; *Enslavement ; Politics ; *Racism ; *Health Status Disparities ; White ; },
abstract = {The frequent criticism of a programme of reparations for Black Americans is that, however justified, no feasible blueprint exists for its implementation. We provide a detailed outline of a viable plan for reparations for Black American descendants of persons enslaved in the USA. Central to the plan are monetary payments calculated to eliminate the racial wealth gap, the foremost economic indicator of the cumulative, intergenerational effects of White supremacy. Closing the racial wealth gap can, in turn, contribute significantly to reducing racial disparities in health, including overall life expectancy. By providing a comprehensive and actionable plan, it becomes clear that the primary obstacle to adoption of reparations by the US Congress is political resistance. The article concludes with a discussion of the current political climate regarding reparations in the USA and an assessment of whether there are grounds for optimism for progress in the reparations movement.},
}

Humans
*Black or African American
United States
*Enslavement
Politics
*Racism
*Health Status Disparities
White

@article {pmid41873169,
year = {2026},
author = {Abunijela, S and Greiner, T and Haas, W and Kerber, R and Pütz, P and Schattschneider, A and Schumacher, J and Buchholz, U},
title = {Frequency, dynamics, and duration of faecal shedding in SARS-CoV-2-infected individuals, a scoping review.},
journal = {Epidemiology and infection},
volume = {154},
number = {},
pages = {e44},
pmid = {41873169},
issn = {1469-4409},
support = {//Bundesministerium für Gesundheit/ ; },
mesh = {Humans ; *Virus Shedding ; *COVID-19/virology/epidemiology ; *Feces/virology ; *SARS-CoV-2/physiology/isolation & purification ; Viral Load ; },
abstract = {To estimate illness incidence or prevalence from wastewater data, modelling approaches may benefit from incorporating faecal shedding parameters. We systematically searched PubMed and a public repository on shedding data and included 33 studies that met at least one of our objectives. Among 32 studies, the proportion of SARS-CoV-2-infected individuals with detectable virus in stool ranged from 18 to 100%, with a pooled estimate of 54% (95% CI: 52-56%). Stratification by four clinical severity categories, ranging from asymptomatic to critically ill, showed no significant differences among categories (p-value = 0.49). The proportion of individuals with detectable SARS-CoV-2 RNA in stool was higher in children (61%) than in adults (53%; p-value = 0.02). In half of the individuals who initially shed the virus in stool, it remained detectable for an estimated 22 days post-symptom onset. Three studies documented viral load kinetics, indicating a peak between days 3 and 9. Twenty-five studies reported maximum shedding durations ranging from 2 to 12 weeks. Our review summarizes the frequency, dynamics, and duration of SARS-CoV-2 shedding in stool and may serve as a valuable foundation for modelling efforts involving faecal shedding indicators.},
}

Humans
*Virus Shedding
*COVID-19/virology/epidemiology
*Feces/virology
*SARS-CoV-2/physiology/isolation & purification
Viral Load

@article {pmid41873421,
year = {2026},
author = {Zhang, D and Wang, Y},
title = {The research progress on the role of glucose-6-phosphate dehydrogenase in immune regulation.},
journal = {PeerJ},
volume = {14},
number = {},
pages = {e20971},
pmid = {41873421},
issn = {2167-8359},
mesh = {Humans ; *Glucosephosphate Dehydrogenase/immunology/metabolism ; *Glucosephosphate Dehydrogenase Deficiency/immunology ; Autoimmune Diseases/immunology/enzymology ; Animals ; Macrophages/immunology ; Immunity, Innate ; Neoplasms/immunology/enzymology ; },
abstract = {Glucose-6-phosphate dehydrogenase (G6PD), the rate-limiting enzyme of the pentose phosphate pathway (PPP), plays a pivotal role in immune regulation by regulating metabolic reprogramming and redox homeostasis of immune cells. It mediates the production of nicotinamide adenine dinucleotide phosphate (NADPH) and ribose-5-phosphate (R5P), which are essential for the activation, proliferation, and effector function of T lymphocytes, B lymphocytes, macrophages, and neutrophils-specifically promoting T/B cell-mediated adaptive immunity and macrophage/neutrophil-mediated innate immune responses. Abnormal G6PD activity (deficiency or overexpression) is closely associated with the pathogenesis of immune-related diseases: G6PD deficiency increases susceptibility to autoimmune diseases (e.g., rheumatoid arthritis, systemic lupus erythematosus) and infectious diseases (e.g., hepatitis, malaria, COVID-19) by inducing oxidative stress and immune cell dysfunction; in tumor immunity, G6PD dualistically promotes tumor cell proliferation while regulating anti-tumor immunity via modulating cytoxic D8[+] T cell exhaustion and macrophage polarization. Additionally, G6PD-targeted immunotherapies, including small-molecule inhibitors and gene therapy, have shown promising preclinical potential for treating immune-related diseases. These findings highlight G6PD as a key metabolic-immune hub, providing critical theoretical basis for understanding immune regulation mechanisms and developing novel diagnostic and therapeutic strategies for autoimmune diseases, infectious diseases, and tumors.},
}

Humans
*Glucosephosphate Dehydrogenase/immunology/metabolism
*Glucosephosphate Dehydrogenase Deficiency/immunology
Autoimmune Diseases/immunology/enzymology
Animals
Macrophages/immunology
Immunity, Innate
Neoplasms/immunology/enzymology

@article {pmid41873444,
year = {2026},
author = {Kim, T},
title = {Lessons From the Coronavirus Disease 2019 Pandemic: Implications for Antimicrobial Stewardship for COVID-19 Management.},
journal = {Journal of Korean medical science},
volume = {41},
number = {11},
pages = {e72},
pmid = {41873444},
issn = {1598-6357},
mesh = {Humans ; *Antimicrobial Stewardship ; *COVID-19/epidemiology ; SARS-CoV-2 ; *Anti-Bacterial Agents/therapeutic use ; Pandemics ; COVID-19 Drug Treatment ; Coinfection/drug therapy ; },
abstract = {The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in millions of deaths worldwide and has now become a major respiratory infectious disease. Beyond the direct effects of the viral infection, one of the most significant and concerning issues to emerge is the exacerbated threat of antimicrobial resistance (AMR) by the indirect impacts of COVID-19. Early in the pandemic, widespread empirical antibiotic prescribing occurred despite low bacterial co-infection rates. In addition, azithromycin, whose antiviral effect remains unproven, was frequently used. This high, often unnecessary consumption, coupled with disrupted antimicrobial stewardship (AMS) and infection prevention and control (IPC) programs, created conditions favoring the emergence and spread of AMR. In patients with severe COVID-19, multidrug-resistant organisms were frequently implicated in secondary infections, particularly in intensive care units (ICUs). Nevertheless, previous studies analyzing AMR metrics before and during the COVID-19 pandemic have shown inconsistent results. Strategies to mitigate the COVID-19 pandemic, such as enhanced surveillance, social distancing resulting in lower respiratory infections, and strengthened IPC and targeted AMS interventions, could play protective roles to inhibit the development of AMR. Additionally, targeted interventions-such as prospective audit and feedback, biomarker-guided antibiotic discontinuation, diagnostic stewardship using a rapid molecular test to distinguish viral from bacterial infections, embedding AMS decision support into electronic medical records, and tailoring interventions to high-risk settings such as ICUs-demonstrated the feasibility of reducing unnecessary antimicrobial use (AMU) even during crisis conditions. Also, vaccination against SARS-CoV-2 may indirectly reduce AMU and AMR by lowering the incidence of severe disease and secondary bacterial infections. Future COVID-19-specific AMS frameworks must integrate these experiences during the pandemic. This review synthesizes current evidence on the interplay between COVID-19, AMR, and AMU, and outlines stewardship strategies to reduce AMR in COVID-19 management.},
}

Humans
*Antimicrobial Stewardship
*COVID-19/epidemiology
SARS-CoV-2
*Anti-Bacterial Agents/therapeutic use
Pandemics
COVID-19 Drug Treatment
Coinfection/drug therapy

@article {pmid41873445,
year = {2026},
author = {Choe, YJ},
title = {Pediatric COVID-19 in Korea: Lessons and Strategies for Future Disease-X Preparedness.},
journal = {Journal of Korean medical science},
volume = {41},
number = {11},
pages = {e75},
pmid = {41873445},
issn = {1598-6357},
mesh = {Humans ; *COVID-19/epidemiology/prevention & control ; Republic of Korea/epidemiology ; Child ; SARS-CoV-2 ; Child, Preschool ; Adolescent ; COVID-19 Vaccines ; Pandemics/prevention & control ; Vaccination ; },
abstract = {The coronavirus disease 2019 (COVID-19) pandemic has had distinct public health and societal impacts on children worldwidely, prompting calls to prepare for the next pandemic by incorporating children's needs. Republic of Korea's experience provides insights into pediatric-focused pandemic response. This review analyzes the impact of COVID-19 on children in Korea and evaluates the national response. This review encompasses the Korea Disease Control and Prevention Agency COVID-19 response white paper, National Medical Center response report, Ministry of Education and Seoul Metropolitan Office of Education white papers, focusing on pediatric data and policies. Key findings were supplemented with international studies on pediatric COVID-19 epidemiology, vaccination, and educational impacts. Children in Korea accounted for a substantial number of COVID-19 cases during omicron wave, yet severe outcomes remained rare. Surveillance adaptations included dedicated monitoring of pediatric multisystem inflammatory syndrome through antibody testing. The healthcare system rapidly adjusted to pediatric needs by allowing home isolation for mild cases and by permitting caregiver accompaniment during pediatric hospital isolation. Vaccine rollout for adolescents began in 2021 and for ages 5-11 in 2022, with an initial policy focusing on high-risk children and voluntary uptake for others. In the education sector, Korea implemented remote learning infrastructure, distributing devices and expanding internet access to bridge the digital divide. Korea's pandemic response illustrates the importance of pediatric-specific strategies: surveillance, child-friendly healthcare protocols, risk communication to improve vaccine acceptance, and treating schools and child services as essential infrastructure.},
}

Humans
*COVID-19/epidemiology/prevention & control
Republic of Korea/epidemiology
Child
SARS-CoV-2
Child, Preschool
Adolescent
COVID-19 Vaccines
Pandemics/prevention & control
Vaccination

@article {pmid41873446,
year = {2026},
author = {Choi, JY},
title = {Severe COVID-19 in the Republic of Korea: Epidemiology, Risk Factors, Therapeutics, and Prognostic Models From Nationwide Data.},
journal = {Journal of Korean medical science},
volume = {41},
number = {11},
pages = {e96},
pmid = {41873446},
issn = {1598-6357},
support = {RS-2024-00439160/NRF/National Research Foundation/Korea ; },
mesh = {Humans ; *COVID-19/epidemiology/therapy ; Republic of Korea/epidemiology ; Risk Factors ; Prognosis ; SARS-CoV-2 ; Antiviral Agents/therapeutic use ; COVID-19 Vaccines ; Severity of Illness Index ; COVID-19 Drug Treatment ; Comorbidity ; },
abstract = {Severe coronavirus disease 2019 (COVID-19) has posed ongoing clinical and public health challenges worldwide, with Korea providing a unique perspective due to its comprehensive surveillance system and extensive real-world data. This review summarizes evidence from nationwide registries, cohort studies, and clinical trials in Korea, alongside global findings, to describe the epidemiology, risk factors, therapeutic interventions, and prognostic models for severe COVID-19. Between January 2020 and August 2023, Korea reported more than 34 million confirmed cases, with 38,112 classified as severe and 35,608 deaths, yielding one of the lowest case fatality rates among member countries comprising the Organisation for Economic Co-operation and Development. Severity was strongly associated with advanced age and comorbidities such as cardiovascular disease, diabetes mellitus, cancer, psychiatric disorders, and immunocompromised states, including solid organ transplantation and hematologic malignancies. Other risk modifiers included obesity, chronic kidney disease, asthma, and prolonged glucocorticoid therapy. Protective factors included vaccination, regular physical activity, and, in some studies, specific pharmacologic agents. The effectiveness of vaccines was consistently demonstrated, with booster doses markedly reducing hospitalization and mortality, including in high-risk groups such as pregnant women, patients with cancer, and transplant recipients. Antiviral therapies, notably nirmatrelvir/ritonavir and molnupiravir, significantly reduced severe outcomes, while immunomodulators such as dexamethasone and tocilizumab improved recovery in patients with severe disease. Advanced interventions, including extracorporeal membrane oxygenation and lung transplantation, were used for refractory respiratory failure, with favorable survival observed in selected patients. Prognostic models integrating clinical, radiological, and machine learning approaches have been developed to predict disease progression, supporting early risk stratification and resource allocation. The rapid generation of evidence on predicting, preventing, and treating severe disease is a critical element of pandemic preparedness. Although COVID-19 has transitioned to an endemic disease, sustaining and advancing the research expertise and infrastructure developed during the pandemic remains essential for responding to future emerging infectious disease outbreaks.},
}

Humans
*COVID-19/epidemiology/therapy
Republic of Korea/epidemiology
Risk Factors
Prognosis
SARS-CoV-2
Antiviral Agents/therapeutic use
COVID-19 Vaccines
Severity of Illness Index
COVID-19 Drug Treatment
Comorbidity

@article {pmid41873447,
year = {2026},
author = {Jang, Y and Jung, J and Peck, KR},
title = {Integrated Clinical and Social Impacts of the COVID-19 Pandemic in Korea: A Combined Systematic and Narrative Review.},
journal = {Journal of Korean medical science},
volume = {41},
number = {11},
pages = {e103},
pmid = {41873447},
issn = {1598-6357},
support = {HD22C2045//Korea Health Industry Development Institute/Republic of Korea ; },
mesh = {Humans ; *COVID-19/epidemiology/mortality/psychology ; Republic of Korea/epidemiology ; SARS-CoV-2 ; Pandemics ; Public Health ; Comorbidity ; },
abstract = {Coronavirus disease 2019 (COVID-19) imposed substantial health and social burdens worldwide, disrupting healthcare delivery and challenging public health governance. Korea's early, coordinated response was associated with low mortality and maintained essential services, yet the prolonged pandemic exposed structural inequalities, workforce strain, and psychosocial impacts. To comprehensively understand these multidimensional effects, this review synthesizes systematic and narrative evidence on the clinical, epidemiologic, and societal consequences of COVID-19 in Korea. We conducted a combined systematic and narrative review of Korean evidence (2020-2025). The systematic review included studies from PubMed, Embase, KoreaMed, and KMbase, supplemented by manual journal searches. Eligible studies addressed key epidemiologic indicators, including seroprevalence, mortality among patients with comorbidities, severe outcomes in high-risk groups, and vaccination coverage by comorbidity. Quality was assessed using Joanna Briggs Institute tools. We additionally examined government white papers, national reports, policy briefs, and peer-reviewed articles to contextualize epidemiologic findings, synthesizing materials across health burden, healthcare system changes, social consequences, and policy responses. Twenty-four epidemiologic studies and 72 narrative sources were included. Seroprevalence remained below 1% during the early pandemic, increasing sharply after omicron's emergence. Patients with chronic illnesses consistently experienced higher risks of severe outcomes and mortality, while high-risk groups showed elevated odds of intensive care use and complications. Alongside clinical patterns, national data documented substantial reductions in outpatient visits, elective procedures, emergency care, and pediatric services. Burnout and psychological distress intensified among healthcare workers, while prolonged distancing and economic disruption contributed to widening social fatigue. Policy responses and vaccination improved population outcomes, although gaps persisted in communication strategies and addressing disparities across age, socioeconomic status, and comorbidity groups. Korea's experience underscores that preparedness must align clinical efficiency with social equity. Strengthening primary and emergency care, ensuring fair compensation and workforce protection, and maintaining transparent risk communication are essential for building a resilient, inclusive public health system to withstand future pandemics.},
}

Humans
*COVID-19/epidemiology/mortality/psychology
Republic of Korea/epidemiology
SARS-CoV-2
Pandemics
Public Health
Comorbidity

@article {pmid41873448,
year = {2026},
author = {Hwang, YH and Park, WB},
title = {COVID-19 Vaccination Strategy and Evidence in Korea.},
journal = {Journal of Korean medical science},
volume = {41},
number = {11},
pages = {e114},
pmid = {41873448},
issn = {1598-6357},
support = {/SNU/Seoul National University/Korea ; },
mesh = {Humans ; Republic of Korea/epidemiology ; *COVID-19 Vaccines/immunology/adverse effects/administration & dosage ; *COVID-19/prevention & control/epidemiology ; SARS-CoV-2/immunology ; *Vaccination ; },
abstract = {Coronavirus disease 2019 (COVID-19) has created major global challenges, with vaccination remaining the most effective measure to reduce severe outcomes and mortality. In Korea, six vaccines were approved, and the rapid rollout initiated in February 2021 contributed to comparatively low global mortality. As the epidemiological landscape of COVID-19 evolved and evidence on vaccine immunogenicity and safety accumulated, Korea adapted its vaccination strategies. During the 2024-2025 season, two mRNA vaccines (Pfizer-BioNTech and Moderna) and one recombinant protein vaccine (Novavax) targeting JN.1 lineage were administered primarily to high-risk groups. Beginning in October 2025, two mRNA vaccines (Pfizer-BioNTech and Moderna) adapted to LP.8.1 variant have been introduced as the updated 2025-2026 season formulations. Although safety concerns arose initially, Korean studies confirmed that COVID-19 vaccines provided strong effectiveness and acceptable safety, consistent with international findings. To enhance preparedness for future pandemics and epidemics, sustaining surveillance systems and maintaining updated vaccination policies are critical to ensure effective public health responses.},
}

Humans
Republic of Korea/epidemiology
*COVID-19 Vaccines/immunology/adverse effects/administration & dosage
*COVID-19/prevention & control/epidemiology
SARS-CoV-2/immunology
*Vaccination

@article {pmid41873479,
year = {2026},
author = {Drake, JM and Rohani, P and Winter, A},
title = {Can vaccine-preventable disease resurgence be anticipated? Leading indicators and tipping points.},
journal = {Future microbiology},
volume = {21},
number = {3},
pages = {321-327},
pmid = {41873479},
issn = {1746-0921},
mesh = {Humans ; *Vaccine-Preventable Diseases/epidemiology/prevention & control ; Vaccination ; Disease Outbreaks/prevention & control ; Computer Simulation ; *Vaccines/administration & dosage/immunology ; },
abstract = {Vaccination programs have averted millions of childhood deaths, yet vaccine-preventable diseases (VPDs) continue to resurge as coverage declines and pathogen evolution undermines previously successful vaccines. Anticipating resurgence is a public health priority. We review theoretical and empirical advances in the study of early warning signals (EWS) of epidemic transitions, with a focus on critical slowing down (CSD) - a phenomenon in which recovery from perturbations becomes slower near the epidemic threshold. We summarize the mechanisms that generate CSD, indicators that can be extracted from surveillance data, and the conditions under which signals may be detectable. We then examine case studies to illustrate the opportunities and challenges of applying EWS to VPD resurgence. Theory and computer simulations show that CSD can precede both elimination and resurgence, with increases in variance and autocorrelation calculated from disease surveillance reports emerging as consistent indicators. Empirical evidence supports this potential, though performance depends on noise structure, seasonality, spatial clustering, and outbreak responses. Case studies highlight both successful applications and contexts where signals were weak or absent. EWS offer a promising framework for anticipating VPD resurgence, but further research is required to refine methods, integrate mechanistic and social-behavioral drivers, and evaluate applicability across pathogens and settings.},
}

Humans
*Vaccine-Preventable Diseases/epidemiology/prevention & control
Vaccination
Disease Outbreaks/prevention & control
Computer Simulation
*Vaccines/administration & dosage/immunology

@article {pmid41873550,
year = {2025},
author = {Smatana, M and Löffler, Ľ and Pažitný, P and Kandilaki, D and Shuftan, N},
title = {Slovakia: Health System Review.},
journal = {Health systems in transition},
volume = {27},
number = {2},
pages = {1-300},
pmid = {41873550},
issn = {1817-6127},
mesh = {Slovakia/epidemiology ; Humans ; COVID-19/epidemiology ; *Delivery of Health Care/organization & administration/economics ; *Health Care Reform/organization & administration ; SARS-CoV-2 ; Universal Health Insurance/organization & administration ; },
abstract = {This analysis of the Slovak health system reviews developments in governance, organization, financing and delivery of care, health reforms and health system performance. Slovakia, a central European country with a population of 5.4 million, continues to face significant health and health care system challenges. Slovakia's health system is founded on universal coverage with compulsory health insurance, a broad benefits package and a competitive insurance model. Although life expectancy improved between 2000 and 2019, the COVID-19 pandemic reversed gains, and in 2023 Slovak life expectancy remained three years below the European Union (EU) average. Circulatory diseases and cancer are the leading causes of death, and noncommunicable diseases such as diabetes and mental illness are rising. Nearly one third of all mortality is linked to behavioural risk factors, including poor diet, high smoking rates, low physical activity and obesity. Slovakia's health care system features competition among three insurers - one state-owned (Všeobecná zdravotná poisťovňa, VšZP) and two private. Since major reforms in 2004, the system has decentralized responsibilities and adopted selective contracting to enhance efficiency. However, structural weaknesses remain, particularly in financial sustainability, accessibility and equity. Health spending from public sources was 8.3% of gross domestic product (GDP) in 2024, yet out-of-pocket (OOP) payments account for nearly 19% of expenditures, disproportionately burdening low-income households. Workforce shortages, especially in nursing and primary care, are worsened by emigration and an ageing staff. Urban-rural disparities persist, with modern infrastructure and specialized services concentrated in cities. Digital health advancements, such as the National Health Information System (NHIS), aim to modernize care and facilitate telemedicine, though implementation is uneven. Ongoing reforms target cost containment, infrastructure optimization and integration of long-term care (LTC). Key priorities include addressing regional disparities, improving workforce retention, reducing waiting times and enhancing eHealth adoption. Despite universal coverage, Slovakia must address persistent gaps in health outcomes, resource distribution and system resilience to meet the needs of its population.},
}

Slovakia/epidemiology
Humans
COVID-19/epidemiology
*Delivery of Health Care/organization & administration/economics
*Health Care Reform/organization & administration
SARS-CoV-2
Universal Health Insurance/organization & administration

@article {pmid41873735,
year = {2026},
author = {Ali, T and McConnell, A and Gill, CR and Powell, T and Stangl, KA},
title = {Healing the Divide: Bridging Physicians and Healthcare Administrators for Value-Based Care.},
journal = {American journal of medical quality : the official journal of the American College of Medical Quality},
volume = {41},
number = {3},
pages = {151-159},
doi = {10.1097/JMQ.0000000000000299},
pmid = {41873735},
issn = {1555-824X},
mesh = {Humans ; COVID-19/epidemiology ; *Physicians/psychology ; Burnout, Professional/prevention & control ; *Hospital Administrators/psychology/organization & administration ; United States ; SARS-CoV-2 ; Organizational Culture ; },
abstract = {Misalignment between physicians and hospital administrators has long challenged US healthcare systems. The COVID-19 pandemic magnified these tensions, with physicians reporting increased burnout and administrators grappling with severe financial pressures. This narrative review synthesizes findings from peer-reviewed studies, national surveys, organizational case examples, and policy reports to evaluate physician-administrator relationships. The analysis identifies 6 thematic areas: shared vision and transparency, governance engagement, incentive alignment, administrative burden, physician well-being, technology and innovation, and organizational trust and culture. The literature consistently documents the persistence of misalignment: physicians cite loss of autonomy and administrative overload, while administrators must manage costs and ensure compliance. Evidence from health systems such as Mayo Clinic, Cleveland Clinic, and rural hospitals demonstrates that structured engagement strategies can mitigate these divides. Bridging the physician-administrator divide is critical for value-based care. In rural areas where hospital closures and workforce shortages are acute, collaborative models are urgently needed. The proposed framework highlights actionable strategies to reduce burnout, enhance retention, and strengthen patient-centered outcomes.},
}

Humans
COVID-19/epidemiology
*Physicians/psychology
Burnout, Professional/prevention & control
*Hospital Administrators/psychology/organization & administration
United States
SARS-CoV-2
Organizational Culture

@article {pmid41873998,
year = {2026},
author = {Goh, GK and Foster, JA and Uversky, VN},
title = {Clues to Long COVID Linked to Virulence and Infectivity Found in Shell Proteins.},
journal = {Advances in respiratory medicine},
volume = {94},
number = {2},
pages = {},
pmid = {41873998},
issn = {2543-6031},
mesh = {Humans ; *COVID-19/virology ; *SARS-CoV-2/pathogenicity ; Virulence ; Animals ; },
abstract = {Clinical, experimental, and computational evidence of COVID-19 virulence and infectivity has been linked to SARS-CoV-2 shell disorder. A strong link was first discovered using an AI disorder-predicting tool, which detected an unusually hard (low disorder) outer shell among all SARS-CoV-2-related viruses but not in the 2003 SARS-CoV-1. This could account for the high infectivity found in SARS-CoV-2-but not in SARS-CoV-1-as it is believed that hard shells protect viral particles from the onslaught of the antimicrobial enzymes present in the respiratory system and saliva. As a result, much larger quantities of particles are shed by COVID-19 patients. Abnormally hard outer shells (M) are associated with burrowing animals, e.g., pangolins, and SARS-CoV-2 likely acquired these shells due to its long-term evolutionary interactions with pangolins. As for virulence, the inner shell of SARS-CoV-2 (N) has been found to exhibit lower disorder than that of SARS-CoV-1. This lower disorder is consistent with the fact that SARS-CoV-2 is less virulent than SARS-CoV-1, as higher disorder in the inner shell is associated with more efficient protein-protein binding during replication. The link between N/M disorder and virulence or infectivity falls under the umbrella of shell disorder models (SDMs), which can connect virulence, infectivity, and long COVID under one coherent concept. Evidence of the reliability and reproducibility of SDMs as applied to COVID-19 is examined. The hard M that is resisting the antimicrobial enzymes in the respiratory system can be extended to immunological enzymes, especially those found in phagocytes such as macrophages, which can therefore become a reservoir for the virus.},
}

Humans
*COVID-19/virology
*SARS-CoV-2/pathogenicity
Virulence
Animals

@article {pmid41874029,
year = {2026},
author = {Benucci, M and Cioffi, E and Li Gobbi, F and Cassarà, EAM and Terenzi, R and Russo, E and Grossi, V and Lari, B and Infantino, M and Manfredi, M},
title = {Dermatomyositis with Anti-MDA5 Autoantibodies After SARS-CoV-2 mRNA Vaccination Treated with Tofacitinib: Integrating Literature Evidence and a Novel Observation.},
journal = {Antibodies (Basel, Switzerland)},
volume = {15},
number = {2},
pages = {},
pmid = {41874029},
issn = {2073-4468},
abstract = {COVID-19 mRNA vaccines activate type I interferon pathways and in genetically or immunologically predisposed individuals may trigger autoimmune responses, including autoantibodies against melanoma differentiation-associated protein 5 (MDA5). Although cases of dermatomyositis (DM), particularly anti-MDA5-positive DM, have been increasingly reported after SARS-CoV-2 vaccination, its clinical spectrum and management remain incompletely defined. We conducted a narrative review of the literature on post-vaccination dermatomyositis, focusing on clinical features, autoantibody profiles, therapeutic approaches, and outcomes. The review was enriched by the inclusion of a new case: a 60-year-old woman who developed anti-MDA5-positive dermatomyositis two weeks after receiving her fourth dose of the BNT162b2 (Pfizer/BioNTech) vaccine. She presented predominantly with cutaneous and articular manifestations in the absence of interstitial lung disease. Treatment with oral prednisone, intravenous alprostadil, and the Janus kinase inhibitor tofacitinib resulted in marked clinical improvement. This case, together with the literature review, illustrates both typical and atypical presentations of vaccine-associated anti-MDA5 DM, highlights diagnostic challenges without lung involvement, and suggests JAK inhibition as a potential therapeutic option, contributing to a more comprehensive understanding of post-vaccination dermatomyositis.},
}

@article {pmid41874324,
year = {2026},
author = {Stoop, MHP and Driessen, GJA and Cohen, AF and Kruizinga, MD},
title = {Digital diagnostics, biomarkers and therapeutics in an evolving healthcare system: From promise to practice.},
journal = {British journal of clinical pharmacology},
volume = {},
number = {},
pages = {},
doi = {10.1002/bcp.70527},
pmid = {41874324},
issn = {1365-2125},
abstract = {Health care is shifting towards a digital-guided system, integrating digital diagnostics, biomarkers and therapeutics in many care pathways. However, despite rapid technological advancement and preliminary adoption accelerated by the COVID-19 pandemic, a significant implementation gap persists. This narrative review explores the causes of this gap, highlighting several examples from early development to final implementation. These show that technical validation alone is insufficient. Success depends on alignment with clinical need, robust external validation, patient empowerment and sustainable funding models. Furthermore, other systemic barriers include data privacy concerns and lack of transparency by commercial companies. To improve adoption and translate promise to practice, more international alignment of regulations and international collaboration is needed. Lessons must be learned from promising initiatives that did not reach clinical care, as much as from their successful counterparts. Ultimately, a comprehensive redesign of healthcare will be undertaken, with digital diagnostics and therapeutics both embedded as critical components rather than add-ons. This demands a multi-stakeholder effort involving governments, regulatory bodies, insurance providers, industry, research funders, hospital leadership, clinicians and, most importantly, patients.},
}

@article {pmid41874331,
year = {2026},
author = {Mathias, K and de Rezende, VL and Dal Bó Tiscoski, A and Dallefe, L and Dal-Pizzol, F and Barichello, T and Petronilho, F},
title = {From lungs to brain: the neuroimmune impact of respiratory microbiota.},
journal = {Expert review of respiratory medicine},
volume = {},
number = {},
pages = {1-10},
doi = {10.1080/17476348.2026.2648109},
pmid = {41874331},
issn = {1747-6356},
abstract = {INTRODUCTION: The bidirectional communication between the lungs and the central nervous system, known as the lung-brain axis, has emerged as an important framework for understanding systemic mechanisms influencing neurological health. Increasing evidence indicates that pulmonary inflammation, respiratory microbiota alterations, and environmental exposures can modulate neuroinflammation, blood-brain barrier integrity, and microglial activation.

AREAS COVERED: This review summarizes current experimental and clinical evidence describing the molecular, microbial, and neuroimmune mechanisms underlying the lung-brain axis. Particular emphasis is placed on the role of the respiratory microbiota across the upper and lower airways and its interaction with immune signaling pathways. In addition, the neurological consequences of pulmonary diseases and infections, including asthma and COVID-19, are discussed, highlighting neuroanatomical, humoral, and immunological routes linking pulmonary and brain physiology.

EXPERT OPINION: Emerging data suggest that the respiratory system functions as an immunometabolic interface capable of influencing neuroimmune regulation and brain function. Integrative approaches combining respiratory microbiota profiling, immune biomarkers, and neuroimaging may help clarify causal mechanisms and support the development of novel diagnostic and therapeutic strategies for neurological and post-infectious conditions.},
}

@article {pmid41874370,
year = {2026},
author = {Liu, C and Dan, L and Wang, X and Chen, L and Yuan, X},
title = {Gut microbiota impact on lung diseases: a mini review of clinical evidence.},
journal = {Infection and immunity},
volume = {94},
number = {4},
pages = {e0043025},
pmid = {41874370},
issn = {1098-5522},
support = {202557-011//Youth Talent Cultivation Program of the China Association of Chinese Medicine/ ; 2023SJZC040//Science and Technology Project of Lishui/ ; },
mesh = {Humans ; *Gastrointestinal Microbiome/physiology ; *Lung Diseases/microbiology/therapy ; *Dysbiosis/microbiology ; COVID-19/microbiology ; Probiotics/therapeutic use ; SARS-CoV-2 ; Fecal Microbiota Transplantation ; Pulmonary Disease, Chronic Obstructive/microbiology ; Cystic Fibrosis/microbiology ; Prebiotics ; },
abstract = {The gut-lung axis represents a bidirectional communication network through which the gut microbiota (GM) influences respiratory health. This mini-review synthesizes clinical evidence on the role of the GM in lung diseases. We focused exclusively on human clinical trials, randomized controlled trials, meta-analyses, and systematic reviews, sourced from major databases after duplicate removal. The evidence indicates that GM dysbiosis is a significant risk factor for the susceptibility and severity of various respiratory conditions, including asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis (CF), and infections, such as COVID-19 and pneumonia. Specific microbial signatures and metabolic profiles, particularly involving short-chain fatty acids (SCFAs), are associated with disease states and outcomes. Interventions like probiotics, prebiotics, synbiotics, and fecal microbiota transplantation (FMT) show promise in modulating the GM and improving clinical parameters, though their efficacy can be inconsistent and influenced by confounding factors. In conclusion, the GM is a promising therapeutic target for lung diseases. However, future research must prioritize large-scale, longitudinal clinical trials and deeper mechanistic investigations to establish causality and develop effective, personalized microbiome-based therapies.},
}

Humans
*Gastrointestinal Microbiome/physiology
*Lung Diseases/microbiology/therapy
*Dysbiosis/microbiology
COVID-19/microbiology
Probiotics/therapeutic use
SARS-CoV-2
Fecal Microbiota Transplantation
Pulmonary Disease, Chronic Obstructive/microbiology
Cystic Fibrosis/microbiology
Prebiotics

@article {pmid41874968,
year = {2026},
author = {Chen, L and Lan, H and Liu, W and Zuo, C and Kemp, GJ and Wang, S and Gong, Q and Suo, X},
title = {Widespread structural and functional brain alterations in COVID-19: a systematic review of MRI studies.},
journal = {Cerebral cortex (New York, N.Y. : 1991)},
volume = {36},
number = {3},
pages = {},
doi = {10.1093/cercor/bhag022},
pmid = {41874968},
issn = {1460-2199},
support = {82001800//National Natural Science Foundation of China/ ; 2021QNRC001//Young Elite Scientists Sponsorship Program/ ; 2022YFC2009904/2022YFC2009900//National Key Research and Development Program of China/ ; },
mesh = {Humans ; *COVID-19/diagnostic imaging/physiopathology ; Magnetic Resonance Imaging/methods ; *Brain/diagnostic imaging/physiopathology/pathology ; SARS-CoV-2 ; Neuroimaging/methods ; },
abstract = {The coronavirus disease 2019 (COVID-19) pandemic has not only challenged global public health but also generated interest in its neurological basis. A growing number of neuroimaging studies have used quantitative magnetic resonance imaging (MRI) to quantify brain alterations in COVID-19 patients. We conducted a comprehensive review to synthesize brain regions with abnormal MRI metrics of microstructure and function in COVID-19 patients compared to healthy controls. Drawing upon 49 studies sourced from PubMed, Embase, and Web of Science databases, our review showcases structural and functional brain abnormalities across many brain regions in COVID-19. Across multimodal MRI studies, alterations were predominantly in frontal regions, temporal regions, parietal regions, limbic system, and subcortical nuclei. Our findings may help understanding of the neurophysiological basis of acute neurological symptoms and long-term neurological sequelae associated with COVID-19.},
}

Humans
*COVID-19/diagnostic imaging/physiopathology
Magnetic Resonance Imaging/methods
*Brain/diagnostic imaging/physiopathology/pathology
SARS-CoV-2
Neuroimaging/methods

@article {pmid41875911,
year = {2026},
author = {Duquenne, P and Liposits, G and Vonnes, CO and Navarrete, E and Serrano, AG and Canoui-Poitrine, F and Marinho, J and Akagündüz, B and Haase, KR and Verduzco-Aguirre, HC and Li, J and Eochagáin, CM and Soto-Perez-de-Celis, E and Ayala, AP and Baltussen, JC and Kantilal, K and Kantilal, K and Wing-Lok, C and de Acha, AP and Meckstroth, S and Perez, ACT and Güven, DC and Zhao, Y and Puts, M and Beauplet, B and Lund, JL and Pilleron, S and , },
title = {Prediction models for overall survival and all-cause mortality risk in older adults with cancer: a systematic review.},
journal = {The lancet. Healthy longevity},
volume = {7},
number = {3},
pages = {100829},
doi = {10.1016/j.lanhl.2026.100829},
pmid = {41875911},
issn = {2666-7568},
mesh = {Humans ; Aged ; *Neoplasms/mortality ; Risk Assessment/methods ; Aged, 80 and over ; },
abstract = {Mortality risk prediction models can support decision making in older adults with cancer; however, existing models are associated with a high risk of bias. This systematic review assessed published prediction models for overall and all-cause mortality in adults with cancer aged 65 years or older. We searched for publications in Ovid Embase, Ovid Medline, Cochrane CENTRAL, and EBSCO CINAHL on Nov 25, 2022, and updated the search on Feb 24, 2024. We included 250 studies, of which 182 (72·8%) reported both model development and internal validation. 176 (70·4%) of 250 models predicted overall survival; 40 (16·0%) models focused on lung cancer and 30 (12·0%) models on colorectal cancer. 43 (17·2%) models were specifically developed for older adults; 138 (55·2%) models did not incorporate geriatric variables such as comorbidities, nutrition, and cognition. Risk of bias was high in all models, largely owing to inappropriate handling of continuous predictors, univariable selection of predictors, and inadequate control for overfitting. These limitations preclude clinical use. Future models predicting overall and all-cause mortality in older adults with cancer should adhere to existing methodological guidelines and incorporate geriatric domains.},
}

Humans
Aged
*Neoplasms/mortality
Risk Assessment/methods
Aged, 80 and over

@article {pmid41877640,
year = {2026},
author = {Van Aswegen, R and Lanigan, S and Lyne, JP and McDonald, C and Hallahan, B},
title = {The impact of the COVID-19 pandemic on psychiatric morbidity and emergency mental health presentations in Ireland: a systematic review.},
journal = {Irish journal of psychological medicine},
volume = {},
number = {},
pages = {1-14},
doi = {10.1017/ipm.2026.10185},
pmid = {41877640},
issn = {2051-6967},
abstract = {OBJECTIVES: To examine the impact the COVID-19 pandemic in Ireland on symptoms and functioning in individuals across a range of mental health disorders.

METHODS: A systematic bibliographic search of case reports, cross-sectional and longitudinal studies was conducted between March 12[th], 2020, and December 20[th], 2024, among studies evaluating the impact of the COVID-19 pandemic on symptoms and functioning for individuals with pre-existing mental health disorders and for those who presented with self-harm or died by probable suicide in the Republic of Ireland. Studies were independently screened by two reviewers according to inclusion and exclusion criteria, with selected variables extracted and summarised. Risk of bias assessments and narrative synthesis of included studies were conducted.

RESULTS: Twenty-eight studies met inclusion criteria. Findings were heterogeneous and disorder specific. An increase in presentations of self-harm, anxiety disorders, and eating disorders to child and adolescent mental health services and emergency departments was noted, with relative stability of symptoms in other cohorts including bipolar disorder and treatment-resistant schizophrenia. Significant symptom deterioration, with poor quality of life and functioning was demonstrated in individuals with emotionally unstable personality disorder both cross-sectionally and longitudinally.

CONCLUSIONS: Most people with pre-existing mental disorders did not experience significant exacerbation associated with the pandemic, with exception of those with eating disorders and EUPD.},
}

@article {pmid41877761,
year = {2026},
author = {Zekis, T and Grammatopoulou, E and Tsimouris, D and Sakellari, V and Patsaki, I},
title = {The effectiveness of respiratory training as a preventive strategy against cognitive decline: a mini review.},
journal = {Frontiers in rehabilitation sciences},
volume = {7},
number = {},
pages = {1778837},
pmid = {41877761},
issn = {2673-6861},
abstract = {Cognitive decline and dementia represent a growing global health burden, particularly among older adults and populations with cardiopulmonary and vascular risk factors. While physical exercise has been shown to exert protective effects on cognition, the role of respiratory muscle training (RMT) remains unclear. The aim of this review was to investigate the effects of RMT on cognitive function and cognitive decline. Respiratory muscle training has been implemented in older adults with elevated blood pressure, post-COVID-19 patients, patients with chronic obstructive pulmonary disease (COPD), and patients with obstructive sleep apnea (OSA). There is only preliminary evidence regarding the effectiveness of inspiratory muscle training (IMT) on cognitive function, with only one study reporting statistically significant between-group differences (i.e., respiratory muscle training vs. control) in specific cognitive domains. Although respiratory muscle training appears to be a potentially promising intervention for improving cognitive function, the current evidence is limited. Further well-designed randomized controlled trials are required to draw definitive conclusions regarding its preventive role in cognitive decline and dementia.},
}

@article {pmid41877964,
year = {2026},
author = {Chalghaf, N and Chokri, I and Dhahbi, W and Ceylan, Hİ and Bragazzi, NL and Muntean, RI and Stefanica, V and Guelmami, N and Dergaa, I},
title = {Burnout Across Healthcare, Educational, and Professional Populations: A Comprehensive Scoping Review.},
journal = {Journal of multidisciplinary healthcare},
volume = {19},
number = {},
pages = {564113},
pmid = {41877964},
issn = {1178-2390},
abstract = {BACKGROUND: Burnout, defined by emotional exhaustion, depersonalization, and reduced personal accomplishment, is increasingly recognized as a significant threat to staff wellbeing, organizational performance, and patient safety in healthcare and related sectors. Although research on burnout has grown rapidly, the evidence base remains fragmented, limiting understanding of cross-population patterns, measurement approaches, and the effectiveness of interventions.

OBJECTIVE: This scoping review systematically maps and synthesizes the existing literature on burnout among healthcare workers, students, teachers, night shift workers, and other professional populations, with particular emphasis on its implications for staff well-being and quality of care.

METHODS: Following Arksey and O'Malley's framework and PRISMA-ScR guidelines, systematic searches were conducted in MEDLINE, Embase, PsycINFO, CINAHL, Scopus, Web of Science, and Cochrane from inception to December 2024. Eligible studies used validated instruments to assess burnout. Data synthesis employed narrative thematic analysis and systematic literature mapping.

RESULTS: Sixty-five studies were included (healthcare workers n=29; students n=18; teachers n=9; night shift workers n=6; other populations n=3). Six key themes emerged: prevalence variations (25-72%), with healthcare workers demonstrating the highest rates (35-68%) and strongest associations with compromised patient safety; diversity of measurement tools; intervention effectiveness patterns, wherein combined individual-organizational approaches demonstrated superiority over single-component strategies (effect size d=0.67, 95% CI: 0.42-0.91 at 12-month follow-up); organizational versus individual risk factors; temporal trends including COVID-19 impacts; and implementation challenges. Methodological heterogeneity limited cross-population comparability and the standardization of interventions.

CONCLUSION: Burnout represents a critical occupational health and patient safety concern. This scoping review highlights significant gaps in cross-population research, the need for standardized measurement approaches, and the importance of multilevel, evidence-based interventions. The findings provide essential insights for researchers, healthcare administrators, and policymakers aiming to design sustainable strategies to protect staff wellbeing and ensure safe, high-quality care.},
}

@article {pmid41878230,
year = {2026},
author = {Choi, S and Huda, MN and John, JR and Eapen, V},
title = {The Effectiveness of Non-Pharmacological Interventions in Treating Adolescents and Young Adults with Neuropsychiatric Symptoms of Long COVID: A Systematic Review and Meta-Analysis.},
journal = {Neuropsychiatric disease and treatment},
volume = {22},
number = {},
pages = {570223},
pmid = {41878230},
issn = {1176-6328},
abstract = {BACKGROUND: The management of persistent symptoms for long COVID (eg, fatigue, concentration difficulties, sleep difficulties, loss of appetite and taste, depression, and anxiety) has not been widely studied among adolescents and young adults (AYA). This systematic review and meta-analysis aimed to synthesise and review evidence on the effectiveness of non-pharmacological interventions for AYA aged 13-25 years, presenting with long COVID symptoms.

METHODS: A systematic literature search was conducted in four electronic databases (PubMed, EMBASE, PsycInfo, and ProQuest) in addition to manual searches for studies from January 2020 to May 2025 (PROSPERO: CRD42024516016). The studies were screened for eligibility, and methodological quality was assessed using the Joanne Briggs Institute Critical Appraisal tool by two independent reviewers. Findings were summarised using a narrative synthesis approach, and where possible, a meta-analysis was conducted using a random effects model with standardised mean differences (SMD) and a 95% confidence interval (CI).

RESULTS: Of the 325 screened articles, seven studies were included, which discussed six interventions. Three studies reported on the effectiveness of three multidisciplinary rehabilitation programs (eg, neuropsychological rehabilitation program, multidisciplinary post-COVID rehabilitation program, micro-choice-based concentrated group rehabilitation), three on alternative medicine practices (eg, forest bathing, traditional Thai Medicine), and one on mechanical therapy (eg, enhanced external counterpulsation). Findings suggested that interventions, although varied in duration and follow-up, were effective in improving mental health (SMD: 0.64, 95%, p<0.0497). There were also non-statistical improvements in fatigue (SMD: 1.74, 95%, p = 0.1307), quality of life (SMD: -1.34, 95%, p = 0.2787), and cognitive function (SMD: 1.05, p = 0.2989).

CONCLUSION: This review's findings suggest that non-pharmacological interventions may effectively treat neuropsychiatric symptoms of long COVID in AYA, ensuring better outcomes. Nevertheless, further research must be conducted with longer-term follow-up and robust methodology to explore sustained benefits, which may better inform treatment decisions.

TRIAL REGISTRATION: This systematic review is registered in Prospero (CRD42024516016).},
}

@article {pmid41878337,
year = {2026},
author = {Kayesh, MEH and Kohara, M and Tsukiyama-Kohara, K},
title = {Therapeutic potential of pycnogenol: antioxidant, anti-inflammatory, immunomodulatory, antiviral, and anticancer effects.},
journal = {Frontiers in pharmacology},
volume = {17},
number = {},
pages = {1755175},
pmid = {41878337},
issn = {1663-9812},
abstract = {Pycnogenol (PYC), a standardized extract derived from the bark of the French maritime pine (Pinus pinaster ssp. atlantica), exhibits a broad spectrum of biological activities, including antioxidant, anti-inflammatory, immunomodulatory, antiviral, and anticancer effects. These effects are attributed to the rich profile of polyphenolic compounds, which confer potent antioxidant and anti-inflammatory properties. Viral infections frequently induce oxidative stress, inflammation, and immune dysregulation, thereby posing substantial challenges to global public health. Accordingly, the development of effective antiviral agents applicable across diverse viral outbreak settings remains a critical goal. PYC has demonstrated antioxidant, anti-inflammatory, and antiviral potential against several viruses, including hepatitis C virus, dengue virus, and severe acute respiratory syndrome coronavirus 2. In addition, PYC exhibited anticancer activity by modulating cell signaling pathways, inhibiting tumor cell proliferation, inducing apoptosis, and suppressing angiogenesis. However, further research and clinical validation are required to confirm its therapeutic applications. Accordingly, this review summarizes the current understanding regarding the antioxidant, anti-inflammatory, and anticancer mechanisms of PYC. Moreover, the review highlights its immunomodulatory properties to inform future antiviral and anticancer drug development and therapeutic strategies.},
}

@article {pmid41878421,
year = {2026},
author = {Araújo, M and Gurjar, D and Grandchamp, N and Saha, B and Silvestre, R},
title = {GenIV vaccines: bridging innovation to equity in neglected tropical diseases.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1756570},
pmid = {41878421},
issn = {1664-3224},
mesh = {Humans ; *Neglected Diseases/prevention & control/immunology ; *COVID-19/prevention & control/immunology ; SARS-CoV-2/immunology ; Tropical Medicine ; COVID-19 Vaccines/immunology ; Leishmaniasis/prevention & control/immunology ; Vaccine Development ; },
abstract = {Recent breakthroughs in molecular vaccinology have defined a new generation of vaccines that integrate synthetic mRNA, self-amplifying RNA, and nanomaterial-based platforms. These fourth-generation vaccines offer exceptional adaptability, rapid design, and strong immunogenicity, as demonstrated during the COVID-19 pandemic. Their potential now extends to neglected tropical diseases (NTDs), where conventional vaccine strategies have failed to deliver durable protection. This review traces the evolution from whole-pathogen to precision molecular vaccines, highlighting the mechanisms, delivery systems, and translational advances that underpin the GenIV paradigm. Using leishmaniasis as a case study, we discuss how these technologies can bridge innovation and equity through technology transfer, regional manufacturing, and global collaboration. By integrating scientific, ethical, and implementation perspectives, this work outlines how next-generation vaccines can transform both epidemic preparedness and the equitable control of endemic diseases.},
}

Humans
*Neglected Diseases/prevention & control/immunology
*COVID-19/prevention & control/immunology
SARS-CoV-2/immunology
Tropical Medicine
COVID-19 Vaccines/immunology
Leishmaniasis/prevention & control/immunology
Vaccine Development

@article {pmid41878671,
year = {2025},
author = {Zhang, C and Jiang, F and Li, J and Shen, H and Wang, H and Huang, Y},
title = {Exploring the role of trained surgical care nurses in cricothyrotomy and other emergency procedures: a systematic review and meta-analysis.},
journal = {Frontiers in surgery},
volume = {12},
number = {},
pages = {1562039},
pmid = {41878671},
issn = {2296-875X},
abstract = {BACKGROUND: There is a severe shortage of healthcare professionals, emphasized in a stark manner by the recent COVID-19 pandemic, where the mortality rate was primarily a consequence of medical professionals lacking the technical know-how for conducting specialized procedures. Therefore, this systematic review and meta-analysis aimed to evaluate the success rates of nurse-performed emergency surgeries, focusing on trauma care (e.g., cricothyrotomy), rural obstetric emergencies (e.g., caesarean section, hysterectomy), and general procedures (e.g., laparotomy, appendectomy).

METHODS: A systematic search was conducted across eight major databases (PubMed, Embase, CINAHL, Scopus, Web of Science, PsycINFO, Cochrane Library, ProQuest) following PRISMA guidelines. Four eligible studies were identified, and data were pooled using a fixed-effects model.

RESULTS: The synthesis of data across the four selected studies revealed a pooled relative risk (RR) of 0.88 (95% CI: 0.78, 1.00) and odds ratio (OR) of 0.80 (95% CI: 0.65, 0.99) about the efficacy in emergency surgeries conducted by nurses. These four studies were the only ones meeting our strict inclusion criteria of reporting outcome data on nurse-performed emergency procedures. An analysis of heterogeneity demonstrated minimal variability among the studies, with a Chi[2] value of 1.54, df = 3, P = 0.67, and I[2] = 0%. The test for overall effect yielded a statistically significant Z statistic of 2.03 (P = 0.04), indicating a meaningful finding. The observed inferences also showed that the surgical procedures exhibited minimal complications.

CONCLUSION: This study suggests that trained nurses can safely and effectively perform selected emergency surgical procedures. While encouraging, the limited number of studies highlights the need for further research to confirm these findings and guide clinical practice.},
}

@article {pmid41879110,
year = {2026},
author = {Isshak, R and Habib, R and Sorathia, AZ and Li, Z and Muppidi, V and Tamimi, M and Manoharan, R and Mercado, I and Modi, JP and Mohtadi, M and Ebeid, K and Ismail, M},
title = {"First Reported Case of Rapidly Progressive Pyogenic Liver Abscess with Isolation of Priestia megaterium: Case Report and Literature Review".},
journal = {Journal of investigative medicine high impact case reports},
volume = {14},
number = {},
pages = {23247096261436690},
pmid = {41879110},
issn = {2324-7096},
mesh = {Humans ; Female ; Aged ; *Liver Abscess, Pyogenic/microbiology/diagnosis ; *Bacillus megaterium/isolation & purification ; Fatal Outcome ; Anti-Bacterial Agents/therapeutic use ; *Gram-Positive Bacterial Infections/microbiology/diagnosis/complications ; Tomography, X-Ray Computed ; Diabetes Mellitus, Type 2/complications ; Immunocompromised Host ; },
abstract = {Priestia megaterium (formerly Bacillus megaterium) is a Gram-positive, spore-forming environmental bacillus rarely associated with human infection. In this report, we present a case of a rapidly progressive polymicrobial pyogenic liver abscess with subsequent isolation of P. megaterium in a 69-year-old woman with type II diabetes mellitus, chronic kidney disease, metabolic liver disease, and extensive antibiotic allergies. She initially presented with progressive abdominal pain and fever, with negative early imaging studies. Three weeks later, computed tomography (CT) demonstrated new hepatic abscesses. Interventional radiology drainage cultures initially grew Streptococcus intermedius, guiding targeted antimicrobial therapy; however, the patient clinically deteriorated with recurrent abscess formation despite drainage and broad-spectrum coverage. Subsequent aspirate cultures from the abscess fluid later grew P. megaterium, though this result was finalized after the patient's death on day 12 of admission despite intensive care and source control attempts. This case suggests that P. megaterium, traditionally regarded as nonpathogenic, may be recovered in severe infections in immunocompromised hosts; however, alternative explanations-including polymicrobial infection, antibiotic-mediated suppression of co-pathogens, iatrogenic introduction during drainage procedures, or culture contamination-must be carefully considered. Contributing factors likely included her underlying comorbidities, concurrent COVID-19 infection, delayed pathogen identification, and restrictions imposed by multiple drug allergies. Diagnostic challenges underscore the importance of repeated culture sampling, careful interpretation of microbiology results, and awareness of rare organisms when standard therapy is unsuccessful. This report expands the spectrum of diseases associated with P. megaterium. It emphasizes the need for multidisciplinary collaboration and heightened clinical vigilance in cases of rapidly progressive intra-abdominal infections that are unresponsive to conventional treatment.},
}

Humans
Female
Aged
*Liver Abscess, Pyogenic/microbiology/diagnosis
*Bacillus megaterium/isolation & purification
Fatal Outcome
Anti-Bacterial Agents/therapeutic use
*Gram-Positive Bacterial Infections/microbiology/diagnosis/complications
Tomography, X-Ray Computed
Diabetes Mellitus, Type 2/complications
Immunocompromised Host

@article {pmid41879706,
year = {2025},
author = {Boubakri, S and Barkous, B and Ben Lazreg, N and Talbi, I and Touré, M and Ben Saad, H},
title = {Reconsidering isolated FEV1 reduction: A case report of early-stage asthma with bronchial hyperreactivity and literature review.},
journal = {La Tunisie medicale},
volume = {103},
number = {10},
pages = {1525-1530},
doi = {10.62438/tunismed.v103i10.6028},
pmid = {41879706},
issn = {2724-7031},
mesh = {Humans ; Adult ; Female ; *Asthma/diagnosis/physiopathology/complications ; *Bronchial Hyperreactivity/diagnosis/physiopathology ; Forced Expiratory Volume/physiology ; Bronchial Provocation Tests/methods ; Spirometry/methods ; COVID-19/complications/diagnosis ; Skin Tests ; },
abstract = {INTRODUCTION: Isolated low forced expiratory volume in one second (FEV1) spirometric impairment (ILFSI) is characterized by a decreased FEV1 while both forced vital capacity (FVC) and the FEV1/FVC ratio remain within normal ranges. This pattern may hide an underlying respiratory disorder that warrants further examination. Notably, the 2022 European respiratory society/American thoracic society (2022-ERS/ATS) guidelines do not classify ILFSI as pathological, a stance that has sparked some controversy. This teaching report discussed the case of a woman with ILFSI who developed mild bronchial hyperreactivity after undergoing a methacholine bronchial challenge test (MBCT) and exhibited positive skin prick tests (SPTs) for dust mites.

OBSERVATION: A 28-year-old professional interior designer, who has no history of smoking or exposure to wood smoke and allergens, and who previously experienced a mild case of coronavirus disease-2019, consulted a pulmonologist for chronic cough, sputum production, and recurrent sneezing episodes. Asthma was suspected, leading to the performance of SPTs, spirometry, and either a bronchodilator test (in case of an obstructive ventilatory impairment) or MBCT (in case of a normal spirometry) as requested in the pulmonologist referral letter. The spirometry results indicated ILFSI, with a low FEV1 (z-score = -1.74, 79%) while FVC (z-score = -0.97, 88%) and the FEV1/FVC ratio (z-score = -1.35) remained normal. According to the 2022-ERS/ATS guidelines, these findings are considered normal spirometry because of the maintained FVC and FEV1/FVC ratio. The MBCT confirmed mild bronchial hyperreactivity, showing a 20% drop in FEV1 at a dose of 96 µg. Furthermore, SPTs were positive for dust mites (Dermatophagoides pteronyssinus and farinae).

CONCLUSION: The results of this report suggested a possible association between ILFSI and early allergic asthma, indicating that ILFSI should be re-examined in future revisions of the 2022-ERS/ATS guidelines for interpreting spirometric tests.},
}

Humans
Adult
Female
*Asthma/diagnosis/physiopathology/complications
*Bronchial Hyperreactivity/diagnosis/physiopathology
Forced Expiratory Volume/physiology
Bronchial Provocation Tests/methods
Spirometry/methods
COVID-19/complications/diagnosis
Skin Tests

@article {pmid41880671,
year = {2026},
author = {Garriga-Salvó, C and Navarro, E and Lidón-Moyano, C and Arévalo, A and Roca, R and Morera, M and Llistosella, M},
title = {Psychological interventions for individuals with long COVID: a systematic review and meta-analysis.},
journal = {Health psychology review},
volume = {},
number = {},
pages = {1-22},
doi = {10.1080/17437199.2026.2646179},
pmid = {41880671},
issn = {1743-7202},
abstract = {Introduction: Long COVID involves a variety of persistent symptoms after initial SARS-CoV-2 infection, affects multiple functional areas and requires multidisciplinary treatment. Objective: This study aimed to explore the available evidence about psychological interventions for individuals with long COVID and their effectiveness in reducing some prevalent symptoms, such as fatigue, anxiety or depression, among others, and improving patient quality of life. Methodology: A systematic review and meta-analysis were conducted following the PRISMA 2020 guidelines. Two independent reviewers performed study selection and data extraction using Web of Science, Scopus, and PubMed databases prior to March 2024. Data synthesis was performed via random-effects meta-analysis, with heterogeneity assessed using the I2 statistic. Results: Of the 1041 articles obtained, 19 were included in the systematic review and 14 in the meta-analysis. Results showed significant reductions in symptoms of anxiety [SMD = -0.64 (95% CI: -1.18 to -0.10)], depression [SMD = -0.41 (95% CI: -0.73 to -0.10)] and fatigue [SMD = -1.37 (95% CI: -2.48 to -0.26)]. Significant improvements were only registered in self-perceived health-related quality of life [SMD = 7.59 (95% CI: 3.70-11.48)]. Conclusion: Results showed improvements in anxiety, depression or fatigue, highlighting the potential role of psychological interventions in patient recovery.},
}

@article {pmid41880835,
year = {2026},
author = {Alturki, MS and Gomaa, MS},
title = {Medicinal chemistry strategies targeting viral proteases: From classical design to next-generation therapeutics.},
journal = {European journal of medicinal chemistry},
volume = {310},
number = {},
pages = {118779},
doi = {10.1016/j.ejmech.2026.118779},
pmid = {41880835},
issn = {1768-3254},
mesh = {Humans ; *Drug Design ; *SARS-CoV-2/enzymology/drug effects ; *Antiviral Agents/pharmacology/chemistry ; Chemistry, Pharmaceutical ; COVID-19 Drug Treatment ; *Coronavirus 3C Proteases/metabolism/antagonists & inhibitors ; *Viral Proteases/metabolism ; },
abstract = {Viral proteases are central targets in antiviral drug discovery and development because they play essential roles in viral replication and maturation. Although protease inhibitors have achieved major clinical success, traditional design strategies face challenges, including resistance development, poor oral exposure of early peptidomimetics, and off-target toxicity of highly reactive covalent warheads. Classical approaches, such as peptidomimetics, macrocyclization, and covalent warhead engineering, are discussed alongside contemporary strategies, including allosteric modulation and targeted protease degradation via proteolysis-targeting chimeras (PROTAC) technology. Particular emphasis is placed on how these strategies address key obstacles, such as resistance evolution, selectivity, metabolic stability, and oral bioavailability. Several quantitative case studies have also demonstrated the growing significance of computational tools in contemporary antiviral discovery. For SARS-CoV-2 main protease (Mpro), these workflows were enabled by the rapid availability of high-resolution experimental crystal structures of the target protein. The evolution of a weak fragment (Kd ≈ 1.7 mM; ΔG ≈ -3.6 kcal/mol) into a covalent inhibitor (QUB-00006-Int-07) with enzymatic inhibition (IC50 ≈ 830 nM) was successfully guided by molecular dynamics (MD) simulations and absolute binding free energy calculations. This was subsequently confirmed experimentally using NMR, ESI-MS, and FRET assays. Furthermore, out of 25 computationally prioritized candidates with Ki values less than 4 μM, 15 active Mpro inhibitors were identified using accelerated free-energy perturbation-based repurposing campaigns. Long-range allosteric pathways connecting the catalytic site to resistance-associated regions and experimentally verified allosteric pockets have also been discovered using dynamic nonequilibrium MD. Together, these integrated in silico approaches enable the early prioritization of high-affinity ligands, mechanistic understanding of resistance, and significant reduction of late-stage attrition in antiviral drug discovery. Through detailed case studies on SARS-CoV-2 main protease (Mpro), Zika virus NS2B-NS3 protease, and Dengue virus NS2B-NS3 protease, the review illustrates how medicinal chemistry principles translate molecular insights into clinically relevant antivirals. Finally, a forward-looking development roadmap is proposed that integrates potency, selectivity, pharmacokinetics, manufacturability, and resistance management toward the goal of broad-spectrum, durable, and adaptable protease-targeted therapeutics development.},
}

Humans
*Drug Design
*SARS-CoV-2/enzymology/drug effects
*Antiviral Agents/pharmacology/chemistry
Chemistry, Pharmaceutical
COVID-19 Drug Treatment
*Coronavirus 3C Proteases/metabolism/antagonists & inhibitors
*Viral Proteases/metabolism

@article {pmid41881062,
year = {2026},
author = {Safir, AH and Bird, MM and Orczykowski, ME},
title = {Development of effective 3D digital models for first-time learners of musculoskeletal anatomy.},
journal = {Anatomical sciences education},
volume = {},
number = {},
pages = {},
doi = {10.1002/ase.70220},
pmid = {41881062},
issn = {1935-9780},
abstract = {Musculoskeletal anatomy is a critical component of allied health curricula. With the ubiquity of technology in the classroom and the recent COVID-19 pandemic creating accessibility barriers for students, there is a need for viable digital resources to enhance learning by supplementing traditional textbook studying. This article describes the creation of an annotated, interactive, three-dimensional digital model and presents preliminary data on its effectiveness for students learning musculoskeletal structures of the hip and knee for the first time. The 3D model was developed in Blender using open-source files and was uploaded to the Sketchfab platform. Eighty-one students in the musculoskeletal anatomy course at a large midwestern university took an assessment to measure their baseline anatomical knowledge, studied the testable structures from either the model or textbook images for 10 min, and took a follow-up assessment. Students in the 3D Model Group saw greater increases from their baseline scores and also reported higher confidence in what they had learned, increased ability to visualize anatomical structures, and greater enjoyment of their resource than students who used textbook images. The findings presented here suggest that creating effective, accessible 3D digital resources is feasible for educators without training in technology-related fields and that having access to these resources can be beneficial to first-time learners of anatomy.},
}

@article {pmid41882484,
year = {2026},
author = {Yeo, HY and Hung, TM and Nghiem, N and Albrecht, S and Turner, N and McIntyre, P},
title = {The Economic Value of Non-pharmaceutical Interventions for Influenza and COVID-19: A Systematic Review.},
journal = {Applied health economics and health policy},
volume = {24},
number = {4},
pages = {655-670},
pmid = {41882484},
issn = {1179-1896},
support = {3725363//Flu Lab/ ; },
mesh = {Humans ; *Influenza, Human/prevention & control/economics/therapy ; *COVID-19/prevention & control/economics ; Cost-Benefit Analysis ; Cost-Effectiveness Analysis ; },
abstract = {BACKGROUND: Non-pharmaceutical interventions (NPIs) are central to mitigating COVID-19 and influenza, yet comparative economic evaluations remain scarce. This systematic review assessed the cost effectiveness and reporting quality of NPI evaluations across both diseases. The study was registered with PROSPERO (CRD42024552613).

METHODS: Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, we searched five medical (PubMed, Scopus, EMBASE, CINAHL, and EconLit) and four health technology assessment databases (NHS HTA, CRD DARE, NHS EED, and INAHTA) up to December 2025, including only full economic evaluations. The search strategy incorporated four domains-'influenza,' 'COVID-19,' 'NPIs,' and 'economic evaluation'-and was guided by the WHO NPI framework, encompassing five domains: personal protective, environmental, physical distancing, travel-related, and educational measures. Reporting quality was assessed using the Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) checklist.

RESULTS: Thirty-three studies (13 influenza, 20 COVID-19), predominantly from high-income countries, were included. School closures, the most frequently evaluated NPI, were generally not cost effective except during severe pandemics or bundled with other measures. Workforce and business closures were cost effective only in high-severity influenza, with inconsistent findings for COVID-19. Social distancing was cost effective for COVID-19 but not for H1N1 influenza. Isolation, lockdowns, and travel restrictions were cost effective only when implemented early. Face masks and hand hygiene, assessed solely for COVID-19, were generally cost effective when implemented alongside other measures. The median CHEERS score was 75.0%, with one study rated excellent.

CONCLUSION: Our review highlights heterogeneity in cost effectiveness by pandemic severity, intervention type, bundling of measures, and timing. Strategies that combined low-cost NPIs like masks or hand hygiene demonstrated better value, while socially disruptive measures like school and business closure incurred high costs with inconsistent cost-effectiveness outcomes. Integration with vaccines or antivirals further enhanced cost effectiveness. Evidence gaps include the scarcity of evaluations from low-resource settings and variability in country-specific value thresholds. Addressing these gaps is essential for guiding efficient and cost-effective pandemic preparedness.},
}

Humans
*Influenza, Human/prevention & control/economics/therapy
*COVID-19/prevention & control/economics
Cost-Benefit Analysis
Cost-Effectiveness Analysis

@article {pmid41882505,
year = {2026},
author = {Lima, GG and Segati, AF and Oliveira, GS and de Melo, NS and da Cunha, TN and De Gaspari, E},
title = {COVID-19 and Pregnancy: Key Findings.},
journal = {Scandinavian journal of immunology},
volume = {103},
number = {4},
pages = {e70109},
pmid = {41882505},
issn = {1365-3083},
support = {305301/2022-5//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; 131308/2021-1//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; 132059/2025-8//Conselho Nacional de Desenvolvimento Científico e Tecnológico/ ; Finance code 001//Coordenação de Aperfeiçoamento de Pessoal de Nível Superior/ ; 18/04202-0//Fundação de Amparo à Pesquisa do Estado de São Paulo/ ; 2021/11936-3//Fundação de Amparo à Pesquisa do Estado de São Paulo/ ; },
mesh = {Humans ; Pregnancy ; *COVID-19/immunology/prevention & control/transmission ; Female ; *SARS-CoV-2/immunology ; *Pregnancy Complications, Infectious/immunology/prevention & control/virology ; *Infectious Disease Transmission, Vertical/prevention & control ; *COVID-19 Vaccines/immunology ; Placenta/immunology/pathology/virology ; Antibodies, Viral/immunology ; Vaccination ; Immunity, Maternally-Acquired ; },
abstract = {Pregnant individuals were prioritised for COVID-19 research due to concerns about increased susceptibility and limited clinical trial data. This narrative review synthesises evidence on maternal infection, immunological adaptations, placental susceptibility, and antibody transfer following maternal SARS-CoV-2 vaccination. Symptomatic COVID-19 during pregnancy increases risks of severe outcomes, whereas vertical transmission remains rare. Placental pathology is characterised mainly by maternal vascular malperfusion and inflammation, with limited evidence of direct viral infection. Maternal vaccination-particularly with mRNA vaccines-induces robust IgG responses with efficient transplacental and lactational transfer, conferring passive neonatal protection. Key uncertainties include optimal vaccine timing, durability of neonatal immunity, and variant-specific responses. Strengthening standardised research and ensuring inclusion of pregnant individuals is essential for global maternal health policy.},
}

Humans
Pregnancy
*COVID-19/immunology/prevention & control/transmission
Female
*SARS-CoV-2/immunology
*Pregnancy Complications, Infectious/immunology/prevention & control/virology
*Infectious Disease Transmission, Vertical/prevention & control
*COVID-19 Vaccines/immunology
Placenta/immunology/pathology/virology
Antibodies, Viral/immunology
Vaccination
Immunity, Maternally-Acquired

@article {pmid41882567,
year = {2026},
author = {Eliseev, P and Bayrakova, A and Vakhrusheva, D and Kazyulina, A and Samoilova, A and Vasilieva, I},
title = {Prevalence of non-tuberculous mycobacteria in various regions of the Russian Federation.},
journal = {BMC infectious diseases},
volume = {26},
number = {1},
pages = {},
pmid = {41882567},
issn = {1471-2334},
support = {123022100022-1//Ministry of Health of the Russian Federation/ ; },
mesh = {Russia/epidemiology ; *Nontuberculous Mycobacteria/genetics/classification/isolation & purification ; *Mycobacterium Infections, Nontuberculous/epidemiology/microbiology/diagnosis ; Humans ; Prevalence ; Whole Genome Sequencing ; Genotype ; },
abstract = {BACKGROUND: Non-tuberculous mycobacteria (NTM) are increasingly recognized as significant pathogens causing pulmonary and extrapulmonary diseases worldwide, including Russia. Despite a rising incidence, comprehensive data on the geographic distribution and species diversity of NTM across Russia remain limited. This study aims to analyze the prevalence and NTM species diversity in various Russian regions, highlighting regional variability and diagnostic challenges.

METHODS: A systematic review and analysis of published data and regional studies on NTM detection in different regions of Russia from 2010 to 2024 were conducted. Identification methods included GenoType Mycobacterium CM/AS assays, PCR, mass spectrometry (MALDI-TOF MS) and whole-genome sequencing. Data from multiple regions, including Moscow, Saint Petersburg, the Siberian Federal District and others, were analyzed to assess species diversity and epidemiological patterns.

RESULTS: The species spectrum of NTM in Russia is broad and heterogeneous. M. avium is the predominant species with an average frequency of 30-40%. A secondary group, including M. gordonae (13-25%) and M. intracellulare (12-20%), demonstrates significant prevalence. The remaining species, such as M. fortuitum, M. lentiflavum, M. kansasii, and M. abscessus, exhibit lower but notable frequencies ranging from 3% to 20%. Other species such as M. malmoense, M. xenopi, M. simiae etc. were less common, with frequencies below 5%. Regional differences in species prevalence were pronounced, with M. avium-intracellulare complex dominating in many areas reaching more than 50% of all NTM, while species like M. lentiflavum were more common in specific regions such as the Republic of Komi (44% of all NTM in the region). The COVID-19 pandemic (2020-2023) impacted epidemiological surveillance but did not substantially alter species diversity. Advanced molecular techniques, including whole-genome sequencing, revealed subspecies-level diversity, notably among M. avium and M. abscessus complexes.

CONCLUSIONS: This study underscores the significant geographic variability and species diversity of NTM in the Russian Federation. The detection rates and species spectrum depend on the diagnostic methods employed, highlighting the need for standardized, advanced molecular diagnostics. Continued surveillance and molecular characterization are crucial for improving diagnosis, guiding therapy, and understanding the epidemiology of NTM infections in Russia.},
}

Russia/epidemiology
*Nontuberculous Mycobacteria/genetics/classification/isolation & purification
*Mycobacterium Infections, Nontuberculous/epidemiology/microbiology/diagnosis
Humans
Prevalence
Whole Genome Sequencing
Genotype

@article {pmid41882857,
year = {2025},
author = {Nishimura, H},
title = {[The multidisciplinary study, "Aerosol virology/Aerovirology"-A new frontier].},
journal = {Uirusu},
volume = {75},
number = {2},
pages = {121-134},
doi = {10.2222/jsv.75.121},
pmid = {41882857},
issn = {0042-6857},
mesh = {Humans ; *Virology/trends ; Aerosols ; COVID-19/transmission ; SARS-CoV-2 ; *Interdisciplinary Research ; Pandemics ; *Interdisciplinary Studies ; *Air Microbiology ; },
abstract = {The COVID-19 pandemic has spurred vigorous research in a field that is old but new, a fusion of aerosol science and virology, each with its own history. I tentatively refer to this interdisciplinary field as "aerosol virology". This review article aims to convey the appeal of research in this field to virologists unfamiliar with aerosol science, covering fundamental knowledge of aerosols. In fact, preceding this article, I had published in the Japanese Journal of Aerosol Science a companion review with this, titled "An Introduction to Aerosol Virology"1）, which included basic virological knowledge for members less familiar with viruses, aiming to spark their interest in the field. To advance "aerosol virology", it is necessary to approach research goals with knowledge of both aerosol science and virology, not just one field. This represents a largely unexplored frontier even for virology. I hope members of the Virology Society will venture into this frontier. Both reviews were written with this aspiration in mind.},
}

Humans
*Virology/trends
Aerosols
COVID-19/transmission
SARS-CoV-2
*Interdisciplinary Research
Pandemics
*Interdisciplinary Studies
*Air Microbiology

@article {pmid41882974,
year = {2026},
author = {Yang, B and Leader, J and Bowes, B and Aiyer, H and Dunn, H and Adams, SJ and O'Connell, ME and McIntyre, L and Dani, H and Johnson, R and Mendez, I and Lovo, S},
title = {Implementation and Evaluation of Virtual Care in Canadian Health Care Systems: A Scoping Review.},
journal = {Telemedicine journal and e-health : the official journal of the American Telemedicine Association},
volume = {},
number = {},
pages = {15305627261425160},
doi = {10.1177/15305627261425160},
pmid = {41882974},
issn = {1556-3669},
abstract = {OBJECTIVE: This scoping review examined available evidence in implementation and evaluation of virtual care in Canada. Virtual care saw recent uptake due to the COVID-19 pandemic; however, to ensure quality of care, rigorous implementation and evaluation frameworks are needed.

METHODS: Peer-reviewed and gray literature were searched to determine extent, range, and nature of evidence surrounding implementation and evaluation of virtual care based on the guidelines of the Joanna Briggs Institute. Although virtual care can encompass synchronous and asynchronous modalities, this review focused on synchronous virtual care, defined as real-time interactions between patients and providers via videoconferencing or telephone. Search included MEDLINE, EMBASE, Psych Info, and CINAHL databases and national and provincial health system, professional organization, and regulatory websites. Inclusion criteria included videoconferencing or telephone and English and French Canadian sources. Citations were screened by two researchers at title, abstract, and full-text levels.

RESULTS: Two hundred and eight (208) manuscripts were included for analysis. High numbers of studies on patient satisfaction, process outcomes, and barriers were identified, with underrepresentation of health and systems outcomes and impact evaluations. There were very few studies examining hybrid care, planetary health, and use of virtual care with equity-deserving groups.

DISCUSSION: This scoping review identified areas of importance for future research, including the use of virtual care in rural and remote regions, inpatient, long-term, and emergency settings, hybrid care, economic and planetary health impacts, and artificial intelligence. As well, enhancing standardization of implementation and evaluation guidelines will optimize quality of care and best practice.},
}

@article {pmid41883910,
year = {2026},
author = {Montoya, S and Alvarez Ramirez, D and Chavarría, R and Zamora, EL and Soto Cordero, CA},
title = {Anesthesia in Patients With Long COVID or Post-infectious Respiratory Sequelae Undergoing Emergency Surgery: Clinical Challenges and Perioperative Strategies.},
journal = {Cureus},
volume = {18},
number = {2},
pages = {e104067},
pmid = {41883910},
issn = {2168-8184},
abstract = {The COVID-19 pandemic has left lasting health consequences that extend beyond the acute infection phase, with long COVID emerging as a complex multisystem condition that poses significant challenges in the perioperative setting. Patients with post-infectious respiratory or cardiovascular sequelae present an increased anesthetic risk due to persistent inflammation, pulmonary fibrosis, reduced lung compliance, and myocardial dysfunction. These alterations predispose to hypoxemia, arrhythmias, and hemodynamic instability during surgery, making preoperative assessment and individualized anesthetic planning essential. Comprehensive evaluation, including functional tests, cardiac and pulmonary imaging, and laboratory analysis, allows early identification of residual organ dysfunction that can compromise perioperative safety. Anesthetic management must be adapted to the patient's physiological condition, emphasizing lung-protective ventilation, cautious fluid therapy, and close hemodynamic monitoring. Regional anesthesia is preferred when feasible to minimize airway manipulation and reduce respiratory complications, while total intravenous anesthesia represents a safer option when general anesthesia is required. Postoperative care focuses on extended respiratory monitoring, multimodal analgesia to limit opioid use, and the implementation of pulmonary physiotherapy and antithrombotic prophylaxis to prevent complications. Psychological support is also recommended to address post-COVID anxiety and fatigue, contributing to holistic recovery. Although clinical guidelines provide useful recommendations, current evidence remains limited and heterogeneous. Further research is required to clarify the pathophysiological mechanisms of long COVID, evaluate anesthetic drug interactions, and develop validated risk stratification tools. Establishing standardized, evidence-based perioperative protocols is essential to improve outcomes and ensure patient safety in individuals with long COVID undergoing emergency surgery.},
}

@article {pmid41884447,
year = {2026},
author = {Panda, PK and Garg, R},
title = {Rethinking COVID-19 seasonality: A summer respiratory virus in the tropics, contrast to influenza.},
journal = {World journal of virology},
volume = {15},
number = {1},
pages = {116492},
pmid = {41884447},
issn = {2220-3249},
abstract = {This opinion challenges the conventional view that coronavirus disease 2019 behaves as a uniformly winter-dominant respiratory infection. Analysis of multi-year surveillance data across hemispheres reveals that severe acute respiratory syndrome coronavirus-2 exhibits seasonal divergence, with consistent summer surges in tropical regions, such as India, and winter peaks in temperate climates. We propose that this pattern arises primarily from human (host) behavioural responses to multi-animal tropism to climatic (environment) extremes, which recreate high-risk indoor transmission settings under both heat and cold. Unlike influenza, severe acute respiratory syndrome coronavirus-2 (agent) combines thermal resilience, broad tissue tropism, and efficient pre-symptomatic transmission, allowing persistence beyond classical winter bounds. Recognizing coronavirus disease 2019 as a behaviourally modulated (through agent-host-environment triad) seasonal virus may help tailor regional surveillance, ventilation, and vaccination strategies in an era of accelerating climatic change.},
}

@article {pmid41884458,
year = {2026},
author = {Younas, S and Farooq, S and Sahu, S and Mwita, RP and Özdemir, Ö},
title = {Next-generation mucosal vaccines for respiratory viruses: Immunological correlates, platform design and clinical translation.},
journal = {World journal of virology},
volume = {15},
number = {1},
pages = {116939},
pmid = {41884458},
issn = {2220-3249},
abstract = {Influenza, respiratory syncytial virus (RSV), and severe acute respiratory syndrome coronavirus 2 continue to cause substantial morbidity and mortality. Currently licensed intramuscular (IM) vaccines effectively reduce severe disease and death but only partially suppress infection and transmission because they induce limited immunity in the respiratory mucosa. This minireview summarizes next-generation mucosal vaccines for respiratory viruses, focusing on the immunological correlates of protection, platform design, and clinical translation. The literature was identified through focused searches of PubMed and Scopus, prioritizing human studies and late-stage preclinical data published between 2000 and 2025. We outline the key mucosal immune correlates required to block viral entry at the airway epithelium, including secretory IgA and tissue-resident memory T cells, and review advances across major vaccine platforms. Current clinical experience with coronavirus disease 2019, influenza, and RSV mucosal vaccines is discussed, along with challenges related to immune measurement, delivery optimization, evaluation of transmission outcomes, and scalable global implementation, including heterologous systemic-mucosal prime-boost strategies. Overall, accumulating evidence positions mucosal vaccination as a promising complement to IM vaccines, with the potential to shift respiratory virus control from disease mitigation to prevention of infection and transmission.},
}

@article {pmid41884461,
year = {2026},
author = {Capobianco, M and Cappellani, F and Visalli, F and Avitabile, A and Gagliano, G and Nicolosi, SG and Khouyyi, M and D'Esposito, F and Gagliano, C and Zeppieri, M},
title = {Phlyctenular keratoconjunctivitis with viral triggers.},
journal = {World journal of virology},
volume = {15},
number = {1},
pages = {117124},
pmid = {41884461},
issn = {2220-3249},
abstract = {Phlyctenular keratoconjunctivitis (PKC) goes beyond limbal nodules. This pediatric ocular surface condition caused by delayed-type hypersensitivity to microbial antigens. The trigger is context-dependent: Mycobacterial antigens in tuberculosis-endemic areas; staphylococcal eyelid disease and rosacea in high-income areas. Although classically bacterial-driven, virus-associated presentations like herpes simplex virus (HSV)-linked phlyctenular disease, pediatric PKC during acute coronavirus disease 2019 (COVID-19) infection, and molluscum contagiosum-driven keratoconjunctivitis suggest the same antigen-mediated pathway. Photophobia and discomfort are prevalent, and corneal involvement can cause neovascularization, scarring, amblyopia, and perforation. This minireview combines epidemiologic, clinical, and immunopathologic data to identify causes and update care. Practical takeaways: (1) Treat the antigen source (blepharitis/rosacea, chlamydia, parasites) and screen for tuberculosis when risk factors exist. Consider viral triggers when history or exam suggest HSV, recent COVID-19, or eyelid molluscum; (2) Suppress inflammation promptly with a short, carefully tapered course of topical corticosteroids; (3) Use topical cyclosporine as a steroid-sparing agent in recurrent or steroid-dependent disease; and (4) Reduce antigen load with lid hygiene and targeted antimicrobials. Start antitubercular treatment for tuberculosis. If a viral cause is anticipated, add antiviral medication or molluscum lesion eradication to the steroid-sparing regimen. Trigger-focused, steroid-sparing treatment reduces recurrences, vision-threatening consequences, and steroid exposure.},
}

@article {pmid41884491,
year = {2026},
author = {Ayoubkhani, D and Atchison, CJ and Banerjee, A and Brightling, C and Calvert, M and Diamond, I and Eggo, RM and Elliott, P and Evans, RA and Haroon, S and Herrett, E and Nafilyan, V and O'Mahoney, LL and Pinto Pereira, SM and Routen, A and Shafran, R and Stephenson, T and Sterne, J and Ward, H and Zaccardi, F and Khunti, K},
title = {Considerations for epidemiological studies investigating emerging post-acute infection syndromes: Long Covid as a case study.},
journal = {EClinicalMedicine},
volume = {94},
number = {},
pages = {103833},
pmid = {41884491},
issn = {2589-5370},
abstract = {Epidemiological research studies into Long Covid, currently defined by prolonged symptoms after SARS-CoV-2 infection, have reported widely varying prevalence estimates. As well as rapidly evolving scientific knowledge of Long Covid, these differences are partly driven by substantial methodological heterogeneity between studies, including the outcome definition of Long Covid; duration of follow-up; study design, period and population; sampling frame; data source; and the statistical techniques employed. Having a robust understanding of the prevalence of and risk factors for Long Covid is essential for informing treatment pathways, service provision and policy decisions. In preparation for the public health response to future epidemics and pandemics, this review outlines key epidemiological and statistical considerations and recommendations when designing studies of emerging post-acute infection syndromes, focussing on Long Covid as a case study.},
}

@article {pmid41886256,
year = {2026},
author = {Bilezikian, JP and di Filippo, L and Bianchi, A and Bikle, DD and Binkley, N and Bouillon, R and Fassio, A and Frara, S and Jones, G and Latella, G and Laterza, L and Graniel, IP and Taccari, F and Trasciatti, S and White, JH and Giustina, A},
title = {Vitamin D in Gut and Systemic Immune Tolerance and in Infections' Risk: An International Evidence-Based Consensus Statement.},
journal = {Reviews in endocrine & metabolic disorders},
volume = {27},
number = {2},
pages = {183-200},
pmid = {41886256},
issn = {1573-2606},
abstract = {Vitamin D, classically linked to calcium-phosphate metabolism and skeletal health, is increasingly recognized as a pleiotropic hormone with effects on gastrointestinal and systemic immune functions. This International Consensus aims to critically evaluate the role of vitamin D in gastrointestinal homeostasis, infection prevention, and immune regulation. A multidisciplinary panel of experts conducted a comprehensive review of the literature, distinguishing between associative evidence from observational studies and causal inferences derived from interventional trials addressing gut barrier integrity, dysbiosis, intestinal cancer prevention, respiratory infections, and autoimmune diseases. While vitamin D deficiency has been consistently associated with alterations in gut microbiota composition, increased intestinal permeability, impaired immune tolerance, and increased susceptibility to infections and autoimmune conditions, evidence from interventional studies remains more variable. Clinical outcomes are influenced by baseline 25(OH)D status, supplementation dose and formulation, timing of intervention, and disease context. Vitamin D supplementation has shown potential benefits in selected settings (i.e., autoimmune diseases and acute respiratory infections), and particularly in cases of documented deficiency. Given its pleiotropic role and favourable safety profile, appropriate screening and optimization of vitamin D represent a low-cost and potentially impactful strategy to support gut barrier function and immune competence. While further research is needed to define these therapeutic applications, maintaining vitamin D concentrations above 20 or 30 ng/mL in individuals at skeletal or immunological risk emerges as a reasonable clinical target. This Consensus Panel supports the integration of vitamin D assessment and correction into routine care for at-risk populations and calls for greater awareness of its extra-skeletal relevance.},
}

@article {pmid41887023,
year = {2026},
author = {Rosso, A and Riccio, M and Renzi, E and Patania, F and Baccolini, V and Kaisy, AM and Marzuillo, C and De Vito, C and Villari, P and Massimi, A},
title = {The role of school-based health education in promoting childhood and adolescent vaccination: A systematic review and Meta-analysis.},
journal = {Vaccine},
volume = {79},
number = {},
pages = {128479},
doi = {10.1016/j.vaccine.2026.128479},
pmid = {41887023},
issn = {1873-2518},
mesh = {Humans ; Adolescent ; Child ; Health Knowledge, Attitudes, Practice ; *Health Education/methods ; *Vaccination/psychology ; Schools ; *School Health Services ; Papillomavirus Vaccines/administration & dosage ; Vaccination Hesitancy ; Students ; Randomized Controlled Trials as Topic ; },
abstract = {BACKGROUND: Childhood and adolescent vaccination is a cornerstone of public health, yet coverage has stagnated or declined in several regions, partly due to vaccine hesitancy. Schools offer a unique setting to promote vaccination by reaching children and adolescents during formative years. This systematic review and meta-analysis aimed to synthesize evidence on the effectiveness of school-based health education interventions in improving vaccine-related knowledge, attitudes, intentions, and uptake.

METHODS: Following PRISMA guidelines, we searched six databases up to August 2024 for interventional studies evaluating school-based educational programmes targeting students aged 6-18 years. Randomized controlled trials and quasi-experimental studies assessing outcomes related to vaccine knowledge, attitudes, intention to vaccinate, or uptake were included. Studies focusing on COVID-19 vaccination were excluded. Risk of bias was assessed using validated tools. A random-effects meta-analysis was conducted for HPV vaccination uptake.

RESULTS: Thirty-eight studies (1985-2024) were included: 9 RCTs/cluster-RCTs, 14 controlled quasi-experimental studies, and 15 pre-post studies. HPV vaccination was the most frequently studied vaccine (26/38). Most interventions significantly improved vaccine knowledge, while effects on attitudes and intention were less consistent. Eleven studies assessed vaccine uptake, with most reporting post-intervention increases. Meta-analysis of randomized trials showed a significant effect on HPV uptake (RR 4.18, 95% CI 1.41-12.37), although heterogeneity was high and methodological quality varied.

CONCLUSIONS: School-based health education appears to improve vaccine knowledge and may contribute to increased uptake, particularly for HPV. However, evidence is limited by heterogeneity and risk of bias. More rigorous, theory-informed, and sustainable whole-school approaches are needed.},
}

Humans
Adolescent
Child
Health Knowledge, Attitudes, Practice
*Health Education/methods
*Vaccination/psychology
Schools
*School Health Services
Papillomavirus Vaccines/administration & dosage
Vaccination Hesitancy
Students
Randomized Controlled Trials as Topic

@article {pmid41887024,
year = {2026},
author = {Silva, LL and Lopes, VDS and da Silva, DCB and Nemer, CRB and Sartori, AL and Lima, JC and Freitas, BHBM},
title = {Global overview of vaccine trust: Evidence from a scoping review.},
journal = {Vaccine},
volume = {79},
number = {},
pages = {128482},
doi = {10.1016/j.vaccine.2026.128482},
pmid = {41887024},
issn = {1873-2518},
mesh = {Humans ; *Trust/psychology ; *COVID-19/prevention & control/epidemiology/psychology ; *COVID-19 Vaccines/administration & dosage ; *Vaccination Hesitancy/psychology ; *Vaccination/psychology ; Health Personnel/psychology ; SARS-CoV-2 ; Immunization Programs ; Health Knowledge, Attitudes, Practice ; Health Literacy ; },
abstract = {BACKGROUND: Vaccine trust is essential for achieving high coverage rates and sustaining immunization programs worldwide. However, hesitancy intensified by the COVID-19 pandemic and the spread of misinformation has challenged trust in vaccines, healthcare professionals, and institutions. This scoping review maps global evidence on the determinants, challenges, and strategies to strengthen vaccine trust.

METHOD: The review followed the JBI Brazilian Centre for Evidence-Based Health Care methodology and the PRISMA-ScR guidelines, with a protocol registered on the Open Science Framework. Searches were conducted in seven databases and additional sources. Studies that directly addressed vaccine trust in any population were included. Data extraction and analysis combined descriptive statistics with narrative synthesis.

RESULTS: A total of 66 studies published between 2020 and 2024 were included, most of them conducted in the United States and focused on COVID-19. Vaccine trust was found to be influenced by perceptions of safety and effectiveness, trust in health systems, professionals, and institutions, as well as individual beliefs and cultural factors. The pandemic increased uncertainty but also encouraged new strategies for community engagement. Health literacy and the involvement of trusted professionals were identified as key elements in strengthening trust. Evidence gaps remain concerning groups such as adolescents, older adults, migrants, and populations in vulnerable situations. Several measurement instruments were mapped, but standardization remains limited.

CONCLUSION: Vaccine trust is a complex and context-dependent phenomenon. Strengthening it requires clear communication, context-specific strategies, active community engagement, and the involvement of healthcare professionals as trusted sources. Future research should include understudied populations, use validated instruments, and assess trust-building interventions to inform more equitable and effective immunization policies.},
}

Humans
*Trust/psychology
*COVID-19/prevention & control/epidemiology/psychology
*COVID-19 Vaccines/administration & dosage
*Vaccination Hesitancy/psychology
*Vaccination/psychology
Health Personnel/psychology
SARS-CoV-2
Immunization Programs
Health Knowledge, Attitudes, Practice
Health Literacy

@article {pmid41888606,
year = {2026},
author = {Zheng, Y and Li, Y and Zeyneloglu, C and Tian, W and Babayev, H and D'Avino, P and He, Y and Ogulur, I and Bicer, C and Lu, G and Li, Y and Zhao, B and Li, S and Chang, L and Li, M and Liu, X and Huang, X and Cheng, H and Göksel, O and Göksel, T and Agache, I and Khaitov, M and Kudlay, D and Nadeau, K and Cheng, L and Shamji, M and Torres, MJ and Zhang, L and Akdis, M and Gao, YD and Akdis, CA},
title = {Risk and Protective Factors for Infection, Severe Disease, and Mortality in Epidemic Respiratory Viruses.},
journal = {Allergy},
volume = {81},
number = {5},
pages = {1397-1432},
doi = {10.1111/all.70314},
pmid = {41888606},
issn = {1398-9995},
support = {72204214,82400012//National Natural Science Foundation of China/ ; LTGY24H260001,LQN25H030006//Zhejiang Provincial Natural Science Foundation of China/ ; CXTD202501015//Zhejiang Clinovation Pride/ ; BQD2306//Start-up Research fund by The First Affiliated Hospital of Zhejiang University School of Medicine/ ; No.2023M743729//China Postdoctoral Science Foundation/ ; 2023SKY138//Shaoxing Health Commission/ ; JJKH20221077KJ//Scientific Research Project of Education Department of Jilin Province/ ; },
mesh = {Humans ; Risk Factors ; *Respiratory Tract Infections/epidemiology/mortality/virology ; *COVID-19/epidemiology/mortality ; SARS-CoV-2 ; Protective Factors ; *Virus Diseases/epidemiology/mortality ; Severity of Illness Index ; },
abstract = {The post-COVID pandemic era has witnessed a concerning resurgence of respiratory viruses, driving a global increase in acute respiratory infections. This trend may stem from relaxed non-pharmaceutical interventions, waning herd immunity, immunological imprinting limiting heterosubtypic protection, or viral antigenic evolution. This review aims to identify and characterize risk and protective factors associated with infection, hospitalization, severe illness, and mortality, while elucidating the drivers of the rising incidence of respiratory virus infections post-pandemic. Evidence on SARS-CoV-2 sublineages, influenza, respiratory syncytial virus, rhinovirus, adenovirus, human metapneumovirus, human parainfluenza virus, human coronaviruses, and cytomegalovirus has been collected and identified. Identified risk factors include demographic characteristics such as pediatrics and older age, male sex, race (Black, Hispanic, American Indian or Alaska native), preterm birth, and HLA-DQA1, IFNAR2, ST6GAL, and B3GALT5 genetic susceptibility. Behavioral, socioeconomic (low socioeconomic status, crowded living conditions), environmental influences (cold seasons, pollution), smoking, obesity and malnutrition could also exacerbate the risk of infection and adverse outcomes. Comorbidities, such as chronic conditions and immunocompromised states, significantly increase the risk of severe disease and hospitalization. Laboratory indices linked to severe disease outcomes include neutrophilia or neutropenia, lymphopenia, eosinopenia, and elevated C-reactive protein. Viral subtypes, viral load kinetics, vaccination status, and antiviral therapies further delineate risk profiles. Epithelial barrier impairment and underlying chronic airway diseases characterized by type 2 immunity also play a detrimental role in the development and severity of respiratory viral infections. Our findings highlight the need for stratified prevention strategies, which combine universal measures targeting shared determinants with virus-specific interventions addressing unique virological and transmission dynamics. It will provide a critical framework for optimizing precision public health strategies to counter repeated respiratory threats in the evolving post-COVID-19 pandemic landscape.},
}

Humans
Risk Factors
*Respiratory Tract Infections/epidemiology/mortality/virology
*COVID-19/epidemiology/mortality
SARS-CoV-2
Protective Factors
*Virus Diseases/epidemiology/mortality
Severity of Illness Index

@article {pmid41888810,
year = {2026},
author = {Lam, CHM and Cheung, KC and Mason, T and Hollingsworth, B},
title = {COVID-19's disruptions to cancer care pathways and widening of health inequalities in the UK: a systematic review.},
journal = {BMC health services research},
volume = {26},
number = {1},
pages = {},
pmid = {41888810},
issn = {1472-6963},
abstract = {BACKGROUND: The COVID-19 pandemic has significantly impacted cancer care services in the United Kingdom (UK), potentially exacerbating pre-existing health inequalities. While emerging studies have documented service disruptions, a comprehensive synthesis of how these disruptions have widened disparities remains absent. This systematic review examines the extent to which the pandemic disrupted the cancer care pathway and intensified existing disparities across the UK, identifying key sociodemographic and geographical factors influencing access to services. METHODS: A systematic search of PubMed, Scopus, and CINAHL was conducted for studies published between January 2020 and October 2024. Eligible studies included observational and empirical research examining disparities in cancer screening, diagnosis, treatment, and outcomes during the COVID-19 pandemic, as well as the corresponding mitigation strategies. Data extraction followed a structured approach using a custom-developed extraction form designed for this review. Study quality was appraised using a bespoke scoring system, classifying studies as high, moderate, or low importance. Narrative synthesis, following the framework outlined by Popay et al., was then employed to identify key themes and explore relationships between findings. RESULTS: 30 out of 457 studies met the inclusion criteria. The review found that socioeconomic status (SES) emerged as the most significant determinant, with individuals from deprived areas experiencing greater barriers to screening, urgent referrals, and treatment access, leading to poorer patient outcomes. Ethnic minorities, particularly Black patients, faced disproportionate reductions in hospital admissions and cancer screening participation. Age-related disparities were also evident, as older adults maintained higher screening rates but faced greater COVID-19 risks, while younger adults from lower-income backgrounds encountered delays in diagnosis and treatment. CONCLUSIONS: The review highlights that the COVID-19 pandemic has exacerbated existing inequalities in UK cancer care, with SES, ethnicity, and age emerging as key determinants. Targeted interventions are essential, including the establishment of COVID-free “cold sites”, deployment of mobile screening units, and culturally tailored outreach programmes for ethnic minority communities. Strengthening regional healthcare capacity and conducting longitudinal assessments will be crucial in addressing disparities and ensuring equitable cancer care. Future research should focus on the long-term consequences of these disruptions on cancer outcomes and healthcare resilience. SYSTEMATIC REVIEW REGISTRATION: The protocol for this systematic review was registered on PROSPERO under the ID CRD42024602280.},
}

@article {pmid41890193,
year = {2026},
author = {Zhu, B and Qu, S and Li, J and Deng, W and Shen, WJ and Chen, J},
title = {The mechanisms underlying COVID-19 induced insulin resistance: a narrative review.},
journal = {Frontiers in endocrinology},
volume = {17},
number = {},
pages = {1781679},
pmid = {41890193},
issn = {1664-2392},
mesh = {Humans ; *Insulin Resistance/physiology ; *COVID-19/complications/metabolism ; SARS-CoV-2 ; Gastrointestinal Microbiome ; Diabetes Mellitus/etiology/metabolism ; },
abstract = {The COVID-19 pandemic, caused by SARS-CoV-2, has resulted in a significant increase in insulin resistance and new-onset diabetes among recovered individuals. This review examines the multifactorial mechanisms underlying these metabolic complications, including activation of the immune system and inflammatory cascades, lifestyle changes, nutritional deficiencies, imbalances in amino acid metabolism, alterations in ketogenesis, disruptions in the gut microbiome, psychological impacts, and COVID-19 vaccines. We discuss how these factors collectively contribute to insulin resistance, particularly in the context of COVID-19, and highlight potential therapeutic strategies, such as dietary interventions and ACE2 activators, that may mitigate these effects. Our analysis underscores the need for targeted approaches to prevent and treat insulin resistance in post-COVID-19 patients, emphasizing the importance of understanding the pandemic's long-term metabolic consequences.},
}

Humans
*Insulin Resistance/physiology
*COVID-19/complications/metabolism
SARS-CoV-2
Gastrointestinal Microbiome
Diabetes Mellitus/etiology/metabolism

@article {pmid41890586,
year = {2025},
author = {Sadat Hoseini, AS and Divani, A and Nadali, J and Zare, L},
title = {Social Stigma Associated with COVID-19 in Healthcare Workers: A Concept Analysis.},
journal = {Journal of caring sciences},
volume = {14},
number = {4},
pages = {278-292},
pmid = {41890586},
issn = {2251-9920},
abstract = {INTRODUCTION: Despite the presence of "COVID-19-related social stigma" in health literature, there is no clear definition of this concept in healthcare setting. It is often confused with related terms such as shame, discrimination, and prejudice, leading to imprecise research questions and ineffective evaluations. The aim of this study was to elucidate the concept of social stigma associated with COVID-19 in healthcare workers using Rodgers' evolutionary concept analysis method.

METHODS: Rodgers' evolutionary method of concept analysis was employed to clarify COVID-19-related social stigma in healthcare workers. A literature review was conducted using key terms "COVID-19", "social stigma", and related terms in PubMed, Scopus, Cochrane, ProQuest databases, and Google Scholar from January 2019 to September 2024. Among 3993 studies found, 46 were selected for analysis. Data were analyzed using thematic analysis.

RESULTS: COVID-19-related social stigma among healthcare workers is a multidimensional concept characterized by three primary attributes: Alienation, Humiliation, and Ignorance. The antecedents identified include Fear, Fake news, and the Contagious Nature of the virus. Consequences of this stigma encompass Psychological Issues, Feelings of Worthlessness, Impaired Functionality, and Job Attrition.

CONCLUSION: Social stigmatization associated with COVID-19 exerts significant pressure on healthcare workers. It is crucial to understand the factors that exacerbate this issue. Identifying the dimensions of this stigma can provide valuable insights for policymakers and the media. The implementation of preventive measures, such as clear protocols tailored to the public's educational level and addressing fears of contamination, can improve the situation and reduce the financial strain caused by the loss of healthcare personnel, ultimately enhancing the quality of care.},
}

@article {pmid41890759,
year = {2026},
author = {Zhang, K and Zhu, S and Zhang, M and Hu, H and Qin, S and Li, H and Zhao, P and Xu, Y},
title = {Convergent hub pathways targeted by IAV, SARS-CoV-2, and RSV in type II alveolar epithelial cells: molecular mechanisms and therapeutic implications.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1781447},
pmid = {41890759},
issn = {1664-3224},
mesh = {Humans ; *Alveolar Epithelial Cells/virology/immunology/metabolism ; *SARS-CoV-2/immunology/physiology ; *COVID-19/immunology/virology/metabolism ; *Influenza A virus/immunology/physiology ; Signal Transduction ; Animals ; *Respiratory Syncytial Virus Infections/immunology/virology ; Immunity, Innate ; },
abstract = {Type II alveolar epithelial cells (AEC2s) maintain surfactant homeostasis, support distal-lung repair, and contribute to antiviral innate defense. Influenza A virus (IAV), SARS-CoV-2, and respiratory syncytial virus (RSV) use distinct entry receptors, yet severe disease is repeatedly marked by AEC2 dysfunction, alveolar barrier failure, and dysregulated inflammation. We synthesize cross-virus evidence for convergence on a small set of host hubs: innate sensing and interferon signaling, mitochondria-centered immunometabolism and oxidative stress, post-translational signaling modules, barrier and surfactant programs, and regulated cell-death checkpoints. We summarize structural and post-translational mechanisms by which viral proteins disrupt pattern recognition receptor (PRR)-mitochondrial antiviral signaling protein (MAVS) signaling, couple mitochondrial injury to weakened antiviral responses, and bias epithelial fate toward inflammatory lytic injury. Where AEC2-specific evidence is incomplete, especially for integrated PANoptosis-like programs, we label these elements as working models and highlight validation needs. We compare model systems used to study AEC2 infection, including ALI cultures, organoids, lung-on-chip platforms, and single-cell or network analyses. Finally, we discuss host-directed therapeutic opportunities along the cascade, separating near-term approaches from longer-term platform strategies such as targeted protein degradation and targeted nanodelivery, and noting constraints in distal-lung delivery, onset kinetics, and safety. This AEC2-centered convergence framework supports mechanism-driven interpretation of severe viral pneumonia and guides broader-spectrum intervention concepts.},
}

Humans
*Alveolar Epithelial Cells/virology/immunology/metabolism
*SARS-CoV-2/immunology/physiology
*COVID-19/immunology/virology/metabolism
*Influenza A virus/immunology/physiology
Signal Transduction
Animals
*Respiratory Syncytial Virus Infections/immunology/virology
Immunity, Innate

@article {pmid41891493,
year = {2026},
author = {Nakae, A and Matsubara, T and Hattori, T and Ohga, S and Shimo, K and Kumazaki, H and Oi, H and Takeda, K and Sumioka, H},
title = {Telework-related health outcomes in Japan and globally: Implications for avatar-based work standards.},
journal = {Work (Reading, Mass.)},
volume = {},
number = {},
pages = {10519815261434906},
doi = {10.1177/10519815261434906},
pmid = {41891493},
issn = {1875-9270},
abstract = {BackgroundThe COVID-19 pandemic has driven a global shift in teleworking, serving as a real-world experiment in remote labor. As workplaces advance toward technologically mediated environments, including avatar-based systems for remote interaction, understanding the health implications of teleworking is crucial for future occupational health standards.ObjectiveThis review examined the health-related outcomes of teleworking during the pandemic, comparing Japan and other countries to inform health-supportive remote work systems.MethodsA structured narrative review was conducted using MEDLINE (PubMed) and IEEE Xplore through January 9, 2026. Studies were included if they examined teleworking in adult workplace environments and reported physical, mental, behavioral, or performance-related outcomes. Data from 67 eligible studies (12 from Japan and 55 from other countries) were analyzed for the physical health, mental health, lifestyle factors, and work performance domains. Cultural and institutional factors were examined to understand the regional differences.ResultsTelework has been linked to musculoskeletal discomfort, sedentary behavior, psychological stress, and unhealthy lifestyle choices. Japanese and international studies have identified these challenges, although the manifestations vary by context. In Japan, inflexible teleworking, inadequate home infrastructure, and an office-centric culture exacerbate negative outcomes, particularly for women and caregivers. International studies have highlighted the benefits of flexible scheduling and organizational support. Cultural norms and institutional readiness mediated these effects.ConclusionsThis review demonstrates the need for evidence-based health standards for next-generation remote work environments including avatar-based systems. We propose recommendations incorporating ergonomic design, health monitoring, organizational flexibility, and cultural adaptation. As remote work technologies evolve, policy frameworks must prioritize worker well-being.},
}