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

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

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

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

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

@article {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 {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 = {},
number = {},
pages = {e0043025},
doi = {10.1128/iai.00430-25},
pmid = {41874370},
issn = {1098-5522},
abstract = {The gut-lung axis represents a bidirectional communication network through which the gut microbiota (GM) influences respiratory health. This mini-review synthesizes clinical evidence on the role of the GM in lung diseases. We focused exclusively on human clinical trials, randomized controlled trials, meta-analyses, and systematic reviews, sourced from major databases after duplicate removal. The evidence indicates that GM dysbiosis is a significant risk factor for the susceptibility and severity of various respiratory conditions, including asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis (CF), and infections, such as COVID-19 and pneumonia. Specific microbial signatures and metabolic profiles, particularly involving short-chain fatty acids (SCFAs), are associated with disease states and outcomes. Interventions like probiotics, prebiotics, synbiotics, and fecal microbiota transplantation (FMT) show promise in modulating the GM and improving clinical parameters, though their efficacy can be inconsistent and influenced by confounding factors. In conclusion, the GM is a promising therapeutic target for lung diseases. However, future research must prioritize large-scale, longitudinal clinical trials and deeper mechanistic investigations to establish causality and develop effective, personalized microbiome-based therapies.},
}

@article {pmid41874968,
year = {2026},
author = {Chen, L and Lan, H and Liu, W and Zuo, C and Kemp, GJ and Wang, S and Gong, Q and Suo, X},
title = {Widespread structural and functional brain alterations in COVID-19: a systematic review of MRI studies.},
journal = {Cerebral cortex (New York, N.Y. : 1991)},
volume = {36},
number = {3},
pages = {},
doi = {10.1093/cercor/bhag022},
pmid = {41874968},
issn = {1460-2199},
support = {82001800//National Natural Science Foundation of China/ ; 2021QNRC001//Young Elite Scientists Sponsorship Program/ ; 2022YFC2009904/2022YFC2009900//National Key Research and Development Program of China/ ; },
mesh = {Humans ; *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 = {},
number = {},
pages = {100829},
doi = {10.1016/j.lanhl.2026.100829},
pmid = {41875911},
issn = {2666-7568},
abstract = {Mortality risk prediction models can support decision making in older adults with cancer; however, existing models are associated with a high risk of bias. This systematic review assessed published prediction models for overall and all-cause mortality in adults with cancer aged 65 years or older. We searched for publications in Ovid Embase, Ovid Medline, Cochrane CENTRAL, and EBSCO CINAHL on Nov 25, 2022, and updated the search on Feb 24, 2024. We included 250 studies, of which 182 (72·8%) reported both model development and internal validation. 176 (70·4%) of 250 models predicted overall survival; 40 (16·0%) models focused on lung cancer and 30 (12·0%) models on colorectal cancer. 43 (17·2%) models were specifically developed for older adults; 138 (55·2%) models did not incorporate geriatric variables such as comorbidities, nutrition, and cognition. Risk of bias was high in all models, largely owing to inappropriate handling of continuous predictors, univariable selection of predictors, and inadequate control for overfitting. These limitations preclude clinical use. Future models predicting overall and all-cause mortality in older adults with cancer should adhere to existing methodological guidelines and incorporate geriatric domains.},
}

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

@article {pmid41878421,
year = {2026},
author = {Araújo, M and Gurjar, D and Grandchamp, N and Saha, B and Silvestre, R},
title = {GenIV vaccines: bridging innovation to equity in neglected tropical diseases.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1756570},
pmid = {41878421},
issn = {1664-3224},
mesh = {Humans ; *Neglected Diseases/prevention & control/immunology ; *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},
abstract = {Viral proteases are central targets in antiviral drug discovery and development because they play essential roles in viral replication and maturation. Although protease inhibitors have achieved major clinical success, traditional design strategies face challenges, including resistance development, poor oral exposure of early peptidomimetics, and off-target toxicity of highly reactive covalent warheads. Classical approaches, such as peptidomimetics, macrocyclization, and covalent warhead engineering, are discussed alongside contemporary strategies, including allosteric modulation and targeted protease degradation via proteolysis-targeting chimeras (PROTAC) technology. Particular emphasis is placed on how these strategies address key obstacles, such as resistance evolution, selectivity, metabolic stability, and oral bioavailability. Several quantitative case studies have also demonstrated the growing significance of computational tools in contemporary antiviral discovery. For SARS-CoV-2 main protease (Mpro), these workflows were enabled by the rapid availability of high-resolution experimental crystal structures of the target protein. The evolution of a weak fragment (Kd ≈ 1.7 mM; ΔG ≈ -3.6 kcal/mol) into a covalent inhibitor (QUB-00006-Int-07) with enzymatic inhibition (IC50 ≈ 830 nM) was successfully guided by molecular dynamics (MD) simulations and absolute binding free energy calculations. This was subsequently confirmed experimentally using NMR, ESI-MS, and FRET assays. Furthermore, out of 25 computationally prioritized candidates with Ki values less than 4 μM, 15 active Mpro inhibitors were identified using accelerated free-energy perturbation-based repurposing campaigns. Long-range allosteric pathways connecting the catalytic site to resistance-associated regions and experimentally verified allosteric pockets have also been discovered using dynamic nonequilibrium MD. Together, these integrated in silico approaches enable the early prioritization of high-affinity ligands, mechanistic understanding of resistance, and significant reduction of late-stage attrition in antiviral drug discovery. Through detailed case studies on SARS-CoV-2 main protease (Mpro), Zika virus NS2B-NS3 protease, and Dengue virus NS2B-NS3 protease, the review illustrates how medicinal chemistry principles translate molecular insights into clinically relevant antivirals. Finally, a forward-looking development roadmap is proposed that integrates potency, selectivity, pharmacokinetics, manufacturability, and resistance management toward the goal of broad-spectrum, durable, and adaptable protease-targeted therapeutics development.},
}

@article {pmid41407373,
year = {2026},
author = {Inoue, F and Anzai, A and Miura, F and Kinoshita, R and Arai, S and Kamigaki, T and Suzuki, M and Yoneoka, D},
title = {[Error factors and sustainable utility of COVID-19 wastewater surveillance in Japan].},
journal = {[Nihon koshu eisei zasshi] Japanese journal of public health},
volume = {73},
number = {3},
pages = {227-236},
doi = {10.11236/jph.25-048},
pmid = {41407373},
issn = {0546-1766},
mesh = {*COVID-19/epidemiology ; Humans ; Japan/epidemiology ; *Wastewater/virology ; *SARS-CoV-2 ; },
abstract = {Objectives In response to the coronavirus disease 2019 (COVID-19) pandemic, the usefulness of wastewater surveillance has been highlighted. Wastewater surveillance can detect pathogens that circulate throughout society, including asymptomatic infections, thereby allowing early outbreak warnings. However, several error factors must be considered when applying wastewater surveillance for COVID-19. This study examines the key error factors in COVID-19 wastewater surveillance and discusses their future applicability in Japan.Methods A literature search was conducted using PubMed and Ichushi-Web to review the studies on wastewater surveillance for COVID-19. The search included combinations of the keywords "wastewater," "sewage," "COVID-19," "SARS-CoV-2," "fecal/urine," and "surveillance/survey/detection." A narrative review was conducted based on the search results.Results A total of 2,108 articles were identified in PubMed, of which 19 were included in this review. In addition, six academic articles were retrieved from Google Scholar, and two government reports and guidelines were included in this review. The sampling methods and environmental factors such as wastewater temperature, transit time, and composition can be potential sources of error in wastewater surveillance. Furthermore, the standardization of these factors is difficult. The prevalence of COVID-19, population size, and population mobility in the target area also influence data interpretation. Additionally, because wastewater surveillance often lacks detailed patient background information such as age, sex, and exact locations of affected individuals, data interpretation can be more challenging than clinical testing-based surveillance, thus potentially limiting its applicability. However, compared to large-scale clinical screening, wastewater surveillance is significantly more cost-effective, rapid, and suitable for continuous monitoring. With regard to statistical analysis, sample normalization is crucial for accurate comparisons across samples, regions, and time periods. A low signal-to-noise ratio during COVID-19 wastewater surveillance requires significant smoothing procedures to extract meaningful signals.Conclusion Wastewater surveillance for COVID-19 is subject to errors from several sources. Nevertheless, it offers advantages over clinical surveillance that include lower expected costs and capacity for continuous monitoring across broad geographic areas. In conclusion, it is essential to understand the advantages and limitations of both clinical and wastewater surveillance and appropriately integrate both approaches for optimal utilization.},
}

*COVID-19/epidemiology
Humans
Japan/epidemiology
*Wastewater/virology
*SARS-CoV-2

@article {pmid41581920,
year = {2026},
author = {Morimoto, Y and Higashi, H and Izumi, H and Tomonaga, T and Nishida, C and Yamato, H and Eguchi, H and Kawanami, S and Suzuki, K and Yatera, K and Nakata, A},
title = {[Factors that contribute to the death/severity and onset of COVID-19 infection in working generation: Investigation of general health examination items by narrative review].},
journal = {Sangyo eiseigaku zasshi = Journal of occupational health},
volume = {68},
number = {2},
pages = {39-54},
doi = {10.1539/sangyoeisei.2025-023-A},
pmid = {41581920},
issn = {1349-533X},
mesh = {Humans ; *COVID-19/mortality/epidemiology/prevention & control/etiology ; Male ; Risk Factors ; Female ; *SARS-CoV-2 ; *Occupational Health ; Severity of Illness Index ; Smoking/adverse effects ; Workplace ; Japan/epidemiology ; Alcohol Drinking/adverse effects ; Obesity/complications ; Pandemics ; Sex Factors ; Exercise ; Hypertension/complications ; },
abstract = {The coronavirus disease 2019 (COVID-19) pandemic that affected Japan remains vivid in our collective memory. Currently classified as a Category 5 virus (for which medical institutions and individuals primarily implement preventive measures independently, without significant administrative intervention such as isolation), COVID-19 infections continue to peak biannually, currently driven by the Nimbus variant, a derivative of the Omicron strain. This situation necessitates ongoing vigilance in infection prevention efforts. While it is well-established that environmental factors, such as proper ventilation, are crucial in mitigating the risk of COVID-19 transmission, it has become evident that variations in individual susceptibility exist; some individuals contract the virus while others do not, even in identical environments. Personal factors, including pre-existing medical conditions, influence this disparity. This narrative review examines personal factors related to general health assessments within the workplace, incorporating data from systematic reviews and meta-analyses, as well as insights from both international and domestic academic societies. Although the strength of evidence varies, factors such as male gender, smoking, alcohol consumption, obesity, inadequate sleep, insufficient physical activity, hypertension, hyperlipidemia, diabetes, and chronic obstructive pulmonary disease have been identified as contributors to the severity and onset of COVID-19, as well as its associated mortality.},
}

Humans
*COVID-19/mortality/epidemiology/prevention & control/etiology
Male
Risk Factors
Female
*SARS-CoV-2
*Occupational Health
Severity of Illness Index
Smoking/adverse effects
Workplace
Japan/epidemiology
Alcohol Drinking/adverse effects
Obesity/complications
Pandemics
Sex Factors
Exercise
Hypertension/complications

@article {pmid41733130,
year = {2026},
author = {Tang, JW},
title = {The landscape of aerosol transmission after COVID-19.},
journal = {Current opinion in pulmonary medicine},
volume = {32},
number = {3},
pages = {182-187},
doi = {10.1097/MCP.0000000000001263},
pmid = {41733130},
issn = {1531-6971},
mesh = {Humans ; COVID-19/transmission ; SARS-CoV-2 ; Aerosols ; *Pandemics/prevention & control ; *Infection Control/methods/organization & administration ; *Coronavirus Infections/transmission/prevention & control/epidemiology ; *Pneumonia, Viral/transmission/prevention & control/epidemiology ; *Betacoronavirus ; },
abstract = {PURPOSE OF REVIEW: This review describes how the COVID-19 pandemic stimulated a radical shift around the concepts and definitions of aerosol transmission, and how this new understanding led to a rethink around related infection control interventions that were vital to reduce the spread of SARS-CoV-2, and, potentially, other respiratory viruses.

RECENT FINDINGS: A revision of the terminology for aerosol-transmitted pathogens by the WHO, together with its accompanying open access platform (ARIA), to allow users to define their own exposure scenarios and calculate related transmission risks, are just two of many multidisciplinary collaborations that have paved the way for a more effective pandemic response in the future, for aerosol-transmitted, novel pathogens.

SUMMARY: A multipronged approach is needed for any next pandemic, including expertise from laboratory microbiologists and virologists, clinical infectious diseases and infection control teams, public health physicians and epidemiologists, aerosol scientists and engineers. We need to develop a rapid evidence pipeline to collate robust scientific data about any new pathogen, how it is transmitted, how it infects and affects humans, and how to control, treat and prevent it. This article briefly outlines how far we have come and proposes some options to better prepare for the next pandemic.},
}

Humans
COVID-19/transmission
SARS-CoV-2
Aerosols
*Pandemics/prevention & control
*Infection Control/methods/organization & administration
*Coronavirus Infections/transmission/prevention & control/epidemiology
*Pneumonia, Viral/transmission/prevention & control/epidemiology
*Betacoronavirus

@article {pmid41765774,
year = {2026},
author = {Andoh, JE and Fu, J and Nwanyanwu, KH},
title = {Impact of United States federal funding on equity and vision research: lessons from history, justice, and politics, 1968-2025.},
journal = {Current opinion in ophthalmology},
volume = {37},
number = {3},
pages = {162-167},
doi = {10.1097/ICU.0000000000001212},
pmid = {41765774},
issn = {1531-7021},
mesh = {Humans ; United States ; *Politics ; *Biomedical Research/economics ; *Ophthalmology/economics ; COVID-19/epidemiology ; SARS-CoV-2 ; History, 20th Century ; *Financing, Government/history ; History, 21st Century ; *Health Equity ; National Institutes of Health (U.S.) ; *Research Support as Topic ; },
abstract = {PURPOSE OF REVIEW: Federal policy has long shaped the scope and inclusivity of vision research in the United States. This narrative review and opinion article evaluates the evolution of equity in vision research over time, from the landmark National Institutes of Health Revitalization Act of 1993 to the direct impact of federal policies in today's political landscape.

RECENT FINDINGS: Equity in vision research originated from early epidemiologic studies identifying social and behavioral determinants of health in the 1970s. The post-2020 period accelerated attention to structural disparities in healthcare, catalyzed by the COVID-19 pandemic and a national conversation on race. However, recent executive orders have reversed equity oriented federal policies, restricted terminology and data access, and changed research funding operations. These ongoing developments pose risks to progress in all areas of research.

SUMMARY: Equity in vision research in the United States remains vulnerable to federal priorities that serve to support or destabilize. The current political environment underscores the need for the ophthalmologic research community to safeguard data integrity, sustain diverse participation, and continue methodologically rigorous protocols to ensure continued progress toward equitable vision health.},
}

Humans
United States
*Politics
*Biomedical Research/economics
*Ophthalmology/economics
COVID-19/epidemiology
SARS-CoV-2
History, 20th Century
*Financing, Government/history
History, 21st Century
*Health Equity
National Institutes of Health (U.S.)
*Research Support as Topic

@article {pmid41766448,
year = {2026},
author = {Taxiarchis, A and Pruner, I},
title = {Messengers of coagulopathy: complement-carrying extracellular vesicles in SARS-CoV-2 infection.},
journal = {Current opinion in hematology},
volume = {33},
number = {3},
pages = {105-112},
doi = {10.1097/MOH.0000000000000916},
pmid = {41766448},
issn = {1531-7048},
mesh = {Humans ; *COVID-19/immunology/complications/blood/pathology ; *Extracellular Vesicles/metabolism/immunology ; *SARS-CoV-2/immunology ; Complement Activation ; *Complement System Proteins/metabolism/immunology ; Blood Coagulation ; *Blood Coagulation Disorders/etiology/immunology ; Blood Platelets/metabolism ; },
abstract = {PURPOSE OF REVIEW: SARS-CoV-2 disease (COVID-19) is increasingly recognized as a thromboinflammatory vascular disorder characterized by dysregulated complement activation, endothelial injury, and sustained hypercoagulability. This review examines emerging evidence that extracellular vesicles act as key intermediaries linking complement activation to coagulation in acute and postacute COVID-19 infection.

RECENT FINDINGS: Recent studies demonstrate that extracellular vesicles released from platelets, endothelial cells, and neutrophils are markedly increased in COVID-19 and exhibit a combined procoagulant and complement-active phenotype. Sub-lytic complement attack, particularly membrane attack complex (MAC) deposition, triggers phosphatidylserine exposure and extracellular vesicle shedding, generating vesicles that support thrombin generation and propagate complement activity in the circulation. Extracellular vesicle-associated complement components, including C1q, C3 fragments, MASP2, and preassembled MACs, promote tissue factor decryption, platelet activation, and assembly of the prothrombinase complex, establishing a self-amplifying thromboinflammatory loop. Proteomic profiling further reveals compartment-specific extracellular vesicle signatures, with systemic extracellular vesicles enriched in complement and coagulation pathways. Importantly, complement-bearing and tissue factor-bearing extracellular vesicles persist beyond acute infection and are increasingly implicated in postacute sequelae of COVID-19.

SUMMARY: Extracellular vesicles serve as mobile platforms integrating complement activation with coagulation, providing a mechanistic framework for acute and chronic immunothrombosis in COVID-19. Targeting extracellular vesicle-mediated complement-coagulation crosstalk may offer novel diagnostic and therapeutic opportunities.},
}

Humans
*COVID-19/immunology/complications/blood/pathology
*Extracellular Vesicles/metabolism/immunology
*SARS-CoV-2/immunology
Complement Activation
*Complement System Proteins/metabolism/immunology
Blood Coagulation
*Blood Coagulation Disorders/etiology/immunology
Blood Platelets/metabolism

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

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

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

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

@article {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 {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 = {},
number = {},
pages = {e0007726},
doi = {10.1128/jvi.00077-26},
pmid = {41870078},
issn = {1098-5514},
abstract = {The ever-present threat of new viral epidemics makes the scientific community relentlessly work on the development of universal methods of antiviral therapy. The development of broad-spectrum antivirals (BSAs) focuses either on substances acting directly on viral proteins (direct-acting antivirals [DAA]) or on substances directed at the cell's own proteins (host-targeting antivirals [HTA]). Decades of development have led to the market entry of a number of DAAs with a wide range of antiviral activities; however, their clinical approval has been obtained for individual infections. HTAs have a number of advantages over DAAs, such as a wider range of antiviral activities and a high genetic barrier to viral resistance, which is undoubtedly important when preparing for a battle with an unknown pathogen. The COVID-19 pandemic has allowed for multiple clinical trials for repurposed HTAs, previously licensed for the treatment of other diseases, including cancer. Despite the enormous work done, the arsenal of BSAs capable of protecting against future pandemics caused by pathogen X is very limited. In this review, we described data on the most studied DAAs and HTAs, effective against at least two unrelated viral pathogens, focusing on those that have been studied in late preclinical and clinical trials. In the end, we highlighted alternative new approaches such as CRISPR-Cas therapy.},
}

@article {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},
doi = {10.5603/cj.111624},
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 {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 = {},
doi = {10.1136/bmjgh-2024-017216},
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 Puetz, 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 = {},
number = {},
pages = {1-29},
doi = {10.1017/S0950268826101241},
pmid = {41873169},
issn = {1469-4409},
}

@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 {pmid41559816,
year = {2026},
author = {Ahmad, A and Gundeti, MS and R, M and Wilson, E and Itrat, M and Javed, G and Quamri, MA and Chalia, DS and Yadav, P and P, AT and P, KK and S, AC and S, MH and Dileep, A and P, SS and R, G},
title = {Status of evidence on efficacy and safety of Indian traditional medicine (Ayush) for COVID-19: a qualitative review and evidence map synthesis.},
journal = {Systematic reviews},
volume = {15},
number = {1},
pages = {},
pmid = {41559816},
issn = {2046-4053},
mesh = {Humans ; *COVID-19/therapy ; *Medicine, Ayurvedic/methods ; India ; SARS-CoV-2 ; COVID-19 Drug Treatment ; Treatment Outcome ; },
abstract = {BACKGROUND: The novel coronavirus (COVID-19), caused by SARS-CoV-2, was first reported in Wuhan, China, in December 2019. Its rapid spread, high mutation rate, and challenges in containment led the WHO to declare it a global pandemic on March 11, 2020. Traditional medicine played a supportive role during the COVID-19 pandemic by offering immune-boosting and symptom-relieving remedies, especially in regions with limited access to conventional healthcare. Several countries, including India, have integrated traditional therapies with modern treatment protocols to enhance patient outcomes and reduce disease burden.

OBJECTIVES: This review aims to critically synthesize the existing evidence on the efficacy and safety of Ayush interventions in the management of COVID-19 in India. It seeks to qualitatively analyze published literature and clinical trial data, and to develop an evidence map categorizing interventions by type and associated clinical outcomes.

METHODS: A comprehensive literature search was conducted across seven electronic databases, including the National Repository on R&D Initiatives of the Ministry of Ayush, WHO COVID-19 dashboard for clinical trials, AYUSH Research Portal, PubMed, Cochrane Library, WHO ICTRP, and CTRI. Studies published between 2019 and June 2024 were considered. A total of 3626 records were identified (2572 from indexed databases and 1054 from trial registries). After removing 640 duplicates, 2986 studies were screened for title and abstract. Following exclusion of 802 records, full-text assessment was performed on the remaining studies. After screening, 304 studies were included in the final review (178 Ayurveda, 22 Siddha, 31 Homeopathy, 22 Unani, and 51 Yoga). Risk of bias was assessed using the ROB 2 and ROBINS-I tools. Data extraction and collation were performed in accordance with the PRISMA guidelines. The study protocol was registered in PROSPERO.

RESULTS: A total of 304 studies were included, comprising 58 (19.1%) prophylaxis studies, 151 (49.7%) treatment studies, and 17 (5.6%) post-COVID rehabilitation studies across different Ayush systems. Ayurveda accounted for the largest proportion of publications (n = 178), followed by Yoga (n = 51). Among the randomized controlled trials, approximately half were assessed as having low-to-moderate risk of bias, whereas the remaining studies exhibited high or unclear risk of bias, primarily due to inadequate reporting of randomization procedures, allocation concealment, and blinding. Considerable methodological variability was observed across studies, including differences in intervention type, duration, outcome measures, and quality assessment scores.

CONCLUSION: While there is significant data on Ayush and COVID-19, current studies vary too widely to be definitive. Future research must prioritize rigorous scientific standards if these systems are to be effectively integrated into public health responses.},
}

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

@article {pmid41800915,
year = {2026},
author = {Kato, TA},
title = {Hikikomori in the urban digital era: a psychodynamic, transdiagnostic model and multimodal interventions.},
journal = {Current opinion in psychiatry},
volume = {39},
number = {3},
pages = {234-241},
doi = {10.1097/YCO.0000000000001081},
pmid = {41800915},
issn = {1473-6578},
mesh = {Humans ; *Social Isolation/psychology ; Urban Population ; *Mental Disorders/therapy/psychology ; Object Attachment ; *COVID-19/psychology ; },
abstract = {PURPOSE OF REVIEW: Hikikomori (prolonged social withdrawal) was first described in Japan and was initially regarded as culture-bound. It is now recognized as a global mental health concern, more prevalent in urban settings and frequently comorbid with psychiatric disorders. In the post - COVID - 19 era, home - centered lifestyles have become increasingly normative, prompting a reconceptualization of hikikomori beyond reduced outing frequency. Drawing on over two decades of clinical and research experience, we propose a psychodynamic (developmental and attachment-informed), transdiagnostic, and multidimensional framework and outline assessment and intervention strategies for urban digital societies.

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

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

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

@article {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 = {},
number = {},
pages = {},
doi = {10.1186/s12985-025-02991-5},
pmid = {41862909},
issn = {1743-422X},
abstract = {Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a major global health burden in terms of acute infection and long-term consequences. Approximately 10% of infected experience autonomic dysfunction, cardiovascular complications, and neurological impairments. While immune dysregulation, persistent viral reservoirs, chronic inflammation, gut dysbiosis, and vascular dysfunction are implicated, the exact pathophysiological mechanisms of Long COVID remain unclear. Additionally, treatment options are limited and challenging to prescribe due to symptom heterogeneity. Non-pharmacological interventions such as increased salt intake, elimination diets for gastrointestinal symptoms, and cognitive pacing for fatigue may not be sufficient for severe symptoms. Moreover, pharmacological interventions such as β-blockers, calcium channel blockers, pyridostigmine, antihistamines, and low-dose naltrexone can improve tachycardia, fatigue, and brain fog but there are no standardized guidelines. In light of evidence supporting a strong association of Long COVID with gut dysbiosis, probiotics have emerged as a promising intervention. Clinical studies have shown that Bacillus coagulans, Bacillus subtilis, Lactobacillus acidophilus, and Bifidobacterium species can improve fatigue, gastrointestinal health, and overall physical and mental well-being in Long COVID patients. Large-scale randomized controlled trials are warranted to validate probiotic efficacy in Long COVID and reduce burden on individual health and healthcare institutions.},
}

@article {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},
abstract = {Post-acute sequelae of COVID-19 (PASC) affect millions of people worldwide and are increasingly recognized as a disorder of failed innate immune resolution rather than a persistent viral infection. Emerging evidence shows that residual SARS-CoV-2 antigens, host-derived alarmins, reactivated latent viruses, and mucosal microbiome-derived products from oral-nasopharyngeal and gut reservoirs sustain the chronic activation of pattern-recognition receptors, inflammasomes, and complement pathways. In parallel, deficits in specialized pro-resolving mediators, impaired efferocytosis, and persistent tissue injury prevent physiological termination of inflammation. These unresolved cues drive long-lasting epigenetic and metabolic reprogramming of hematopoietic stem cells and myeloid lineages, creating maladaptive trained immunity states characterized by hyper-responsiveness or exhaustion of these cells. Thromboinflammatory processes, including aberrant NETosis and sustained interface signalingling, further reinforce self-perpetuating inflammatory circuits. Together, these pathways give rise to reproducible molecular endotypes, including thromboinflammatory, interferon-driven, and neuroinflammatory phenotypes, which explain clinical heterogeneity. Framing PASC as a disorder of impaired immune resolution within a mucosal microbial viral context provides a unifying mechanistic scaffold for biomarker identification and host-directed therapies. This review proposes that restoring active resolution programs, rebalancing metabolic-epigenetic networks, and dismantling pathogenic innate feedback loops are promising strategies for reversing the chronic immune imprint of PASC.},
}

@article {pmid41865876,
year = {2026},
author = {Prichett, LM and Young, AS and Wu, EG and Yolken, RH and Severance, EG and Prandovszky, E and Carmichael, D and Badio, J and Kumra, T},
title = {Uneven Recovery: Intersectional Disparities in Youth Mental Health After COVID-19.},
journal = {Academic pediatrics},
volume = {},
number = {},
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 = {},
number = {},
pages = {},
doi = {10.1186/s12877-026-07088-4},
pmid = {41866483},
issn = {1471-2318},
}

@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 = {},
number = {},
pages = {},
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/ ; },
abstract = {A tremendous and painful price has been paid in the fight against pandemic viruses in the global health field. Emerging and re-emerging viruses serve as primary drivers of severe pandemics, such as influenza virus (IV), respiratory syncytial virus (RSV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Viral polymerases are highly conserved among viruses of the same genus. Inhibitors targeting polymerases often exhibit broad-spectrum antiviral activity against these same genus viruses, playing a crucial role in antiviral therapies. Non-nucleoside polymerase inhibitors demonstrate their superiority in terms of safety and anti-mutation ability out of nucleoside/nucleotide polymerase inhibitors. This review presents an overview of non-nucleoside polymerase inhibitors along with their relative antiviral activities and mechanisms of action, providing a reference for the development of novel antiviral drugs with broad-spectrum activities.},
}

@article {pmid41867155,
year = {2026},
author = {Valero-Gaspar, T and Garriga, C and Unim, B and Feteira-Santos, R and Palmieri, L and Díaz, A and Rodríguez-Blázquez, C and Forjaz, MJ},
title = {Indirect impact of COVID-19 pandemic on health and wellbeing: a narrative review.},
journal = {Annali dell'Istituto superiore di sanita},
volume = {62},
number = {1},
pages = {53-66},
doi = {10.4415/ANN_26_01_08},
pmid = {41867155},
issn = {2384-8553},
mesh = {Humans ; *COVID-19/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 {pmid36866647,
year = {2023},
author = {Tronco Hernandez, YA and Julian, A and Weekes, EC and Murphy, J and Frost, G and Hickson, M},
title = {Developing a consensus to support health and social care professionals and patients manage nutrition in the context of COVID-19 recovery.},
journal = {Journal of human nutrition and dietetics : the official journal of the British Dietetic Association},
volume = {36},
number = {4},
pages = {1242-1252},
doi = {10.1111/jhn.13163},
pmid = {36866647},
issn = {1365-277X},
mesh = {Humans ; *COVID-19 ; Delivery of Health Care ; Health Personnel ; Nutritional Status ; Social Support ; },
abstract = {BACKGROUND: The long-term effects on people who have had COVID-19 affect nutrition and can be influenced by diet conversely. Specific nutritional guidelines, however, were scarce at the beginning of 2020, and empirical literature was also lacking. Conventional research methodologies needed to be adapted to review the available literature that could be relevant to the United Kingdom and policy documents as well as collect the views of health and care staff. The aim of this paper is to describe the method to develop consensus statements from experts to address the necessary nutritional support and what emerged from this.

METHODS: A nominal group technique (NGT) was adapted to the virtual world; we purposefully selected a range of professionals (dietitians, nurses, occupational therapists, etc.) and patients with long-term effects of COVID to present them with the most updated evidence and aim to reach key guidelines to address COVID-19 recovery.

RESULTS: We were able to reach consensus statements that were developed and reviewed by relevant healthcare staff at the front line to address the nutritional needs of patients recovering from COVID-19 and those suffering from its long-term effects. This adapted NGT process led us to understand that a virtual repository of concise guidelines and recommendations was needed. This was developed to be freely accessed by both patients recovering from COVID-19 and health professionals who manage them.

CONCLUSIONS: We successfully obtained key consensus statements from the adapted NGT, which showed the need for the nutrition and COVID-19 knowledge hub. This hub has been developed, updated, reviewed, endorsed and improved across the subsequent 2 years.},
}

Humans
*COVID-19
Delivery of Health Care
Health Personnel
Nutritional Status
Social Support

@article {pmid37734889,
year = {2023},
author = {Harris, S and Mills, E and Venables, RH and Bradley, F and White, S},
title = {Developing consensus on the principles and key actions for collaborative working between general practices and community pharmacies: a modified eDelphi study.},
journal = {BMJ open},
volume = {13},
number = {9},
pages = {e074023},
pmid = {37734889},
issn = {2044-6055},
mesh = {Humans ; Consensus ; COVID-19 ; *General Practice ; Pandemics ; *Pharmacies ; *Intersectoral Collaboration ; },
abstract = {OBJECTIVES: To develop consensus on the principles and key actions for collaborative working in practice between general practice, community pharmacy and patients and their carers.

DESIGN: Three-round modified eDelphi study, starting from an established conceptual model of collaboration between general practitioners (GPs) and community pharmacists.

SETTING: Community pharmacies and general practices in England, UK.

PARTICIPANTS: A panel of 123 experts: 43% from a community pharmacy background; 36% from a GP background; 13% patients, carers or patient representatives and 8% from academic or commissioner backgrounds. Panellist numbers reduced by approximately 30% in rounds 2 and 3.

Consensus between expert panellists, defined as at least 75% agreement.

RESULTS: A high level of consensus (>80%) was achieved on all components of a model of collaboration composed of Fundamental Principles of Collaboration and Key Activities for Action, supported by a series of aspirational statements and suggested practical actions. The fundamental principles and key activities are appended by contextual points. The findings indicate that collaboration in practice involves team members other than just GPs and community pharmacists and recognises that patients often want to know how each professional team is involved in their care. This study also provides insights into how collaboration between general practice and community pharmacy settings appears to have shifted during the COVID-19 pandemic, especially through opportunities for virtual collaboration and communication that can transcend the need for close geographical proximity.

CONCLUSION: A consensus-based model of collaboration between general practice teams, community pharmacy teams, and patients and their carers has been developed. It is practically focused, values the patient voice and incorporates general practice and community pharmacy team members. While developed in England, the model is likely to also have applicability to other countries with similar health systems that include general practices and community pharmacies.},
}

Humans
Consensus
COVID-19
*General Practice
Pandemics
*Pharmacies
*Intersectoral Collaboration

@article {pmid41160239,
year = {2026},
author = {Krassnig, K and Bauer, R and Glasl, S and Haubenberger, P and Evanzin, HJ and Schneider, K and Margotti, D},
title = {[Herbal treatment options for post-viral symptoms and long COVID].},
journal = {Wiener medizinische Wochenschrift (1946)},
volume = {176},
number = {5-6},
pages = {130-148},
pmid = {41160239},
issn = {1563-258X},
mesh = {Humans ; *Phytotherapy/methods ; *COVID-19/complications ; *COVID-19 Drug Treatment ; Post-Acute COVID-19 Syndrome ; Fatigue Syndrome, Chronic/drug therapy ; *Plant Preparations/therapeutic use ; },
abstract = {BACKGROUND: Long COVID and post-viral symptom complexes have become a significant focus in medical practice. There is an urgent need to provide evidence-based treatment options to those patients. The aim of the literature review was to summarize herbal medicinal products as a treatment option for post-viral conditions, particularly long COVID.

METHODS: A working group of the Austrian Society for Phytotherapy conducted a narrative review between 2022 and 2024, based on external literature from the PubMed, PubPharm and Scopus databases and clinical experience from practice. The review identified the most relevant medicinal plants and their preparations for the most common symptom complexes of long COVID.

RESULTS: A total of 98 publications and 24 monographs were included in the literature review. The symptom complexes (+ relevant phytopharmaceuticals) include neurological complaints, such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) (Ginseng radix, Panax quinquefolii radix, Eleutherocci radix, Rhodiolae rhizoma et radix, Schisandrae fructus), nootropics (Ginkgo folium, Lavandulae flos), irritations of the respiratory tract (Liquiritiae radix, Nigellae semen, Eucalypti folium), gastrointestinal complaints (Gentianae radix, Centauri herba, Artemisii herba, Galangae rhizoma, Zingiberis rhizoma, Boswellia serrata, Curcuma longae rhizoma), circulatory weakness (Crataegi folium cum flore, Rosmarini folium, Salviae officinalis folium) and loss of smell (Rosae flos, Citri pericarpium, Caryophylli flos, Eucalypti folium). External evidence and clinical experience in medical practice show that many important symptoms of post-viral conditions can be successfully treated with herbal preparations.

CONCLUSION: Phytopharmaceuticals can provide evidence-based support for the therapeutic portfolio for viral diseases and their consequences in current and future viral epidemics.},
}

Humans
*Phytotherapy/methods
*COVID-19/complications
*COVID-19 Drug Treatment
Post-Acute COVID-19 Syndrome
Fatigue Syndrome, Chronic/drug therapy
*Plant Preparations/therapeutic use

@article {pmid41776658,
year = {2026},
author = {Oh, E and Mueller-Alcazar, A and Kottysch, S and Groth, N and Mahlke, CI},
title = {Effects of digital communication tools on patients, family members and health care professionals in adult ICUs: a mixed-methods systematic review.},
journal = {Critical care (London, England)},
volume = {30},
number = {1},
pages = {},
pmid = {41776658},
issn = {1466-609X},
abstract = {OBJECTIVE: The COVID-19 pandemic accelerated the rapid adoption of digital communication tools in clinical settings. This review aims to identify, synthesize, and critically appraise evidence on digital communication methods or interventions in adult intensive care units (ICUs) intended to promote the psychological and physical well-being of patients and their families, and to explore the associated impacts on healthcare professionals.

DESIGN: Mixed-methods systematic review (MMSR).

INFORMATION SOURCES: A systematic search was conducted in MEDLINE, CINAHL, PsycINFO, PSYNDEX, the Cochrane Library, and PROSPERO from 2010 to September 2023 and updated to July 2025. Reference lists and trial registries were screened for additional and ongoing studies.

METHODS: Following the JBI convergent integrated approach and PRISMA 2020 guidelines, quantitative data from randomized controlled trials (RCTs) were pooled in random-effects meta-analyses for family satisfaction and patient anxiety. Numerical findings from non-RCTs were qualitized and synthesized narratively. The qualitative data were subjected to thematic synthesis. All results were integrated into a single line of argument.

RESULTS: Fifty-four studies were included, comprising 22 qualitative, 25 quantitative, and 7 mixed-methods designs from 19 countries; 92% were conducted during the COVID-19 pandemic. Over half of the studies examined virtual visiting or video communication (57%, n = 31), whereas the others evaluated structured patient-status updates, family support teams, dynamic interaction platforms, or interventions for mechanically ventilated or delirious patients. Methodological quality was moderate to high in 96% of the studies. The meta-analysis of three RCTs demonstrated a moderate to strong improvement in family satisfaction (standardized mean difference = 0.76, 95% CI 0.45–1.06, p < .001) with virtual communication compared with usual care. Pooled effects on patient anxiety (mean difference = -2.19, 95% CI -4.62 to 0.23) and depression were nonsignificant, although qualitative findings consistently described perceived reductions in anxiety, loneliness, and emotional distress. Across study types, digital communication enhanced information sharing, supported shared decision-making, and increased family involvement. Key barriers included technical difficulties, privacy concerns, and staff workload, whereas facilitators comprised user-friendly technology, structured preparation, and continuity through a dedicated contact person.

CONCLUSIONS: Digital communication in adult ICUs is feasible, acceptable, and beneficial for patients, relatives, and healthcare professionals. Virtual tools improve family satisfaction and complement patient- and family-centred care, but sustainable integration requires clear protocols, staff training, and ethical frameworks beyond pandemic conditions.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13054-025-05826-5.},
}

@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 ; *Artificial Intelligence ; *Public Health ; *Decision Making ; COVID-19/prevention & control/epidemiology ; },
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
*Artificial Intelligence
*Public Health
*Decision Making
COVID-19/prevention & control/epidemiology

@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 {pmid41854286,
year = {2026},
author = {Phukuntsi, MA and Monyama, MC and Taioe, MO and Tsotetsi-Khambule, AM},
title = {A systematic review of experimental evidence on microbial pathogen transmission by Stomoxys spp.},
journal = {Parasite (Paris, France)},
volume = {33},
number = {},
pages = {13},
pmid = {41854286},
issn = {1776-1042},
mesh = {Animals ; *Muscidae/microbiology/parasitology/virology ; *Insect Vectors/microbiology/virology ; },
abstract = {Vector-borne microbial pathogens previously isolated from Stomoxys spp. are currently considered to be emerging or re-emerging threats to public health and the veterinary sector. Transmission of pathogens by flies in the Stomoxys genus is largely mechanical, indicating that they can transmit a wide range of pathogens to a variety of hosts. This study evaluated the diversity of pathogens demonstrably transmitted by a variety of Stomoxys flies, concerning species diversity, host diversity, and geographic distribution. Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were applied to screen studies based on pathogen type, host species, and experimental transmission outcomes. Journal articles published from 1973 to 2025 were sourced from six electronic databases. After evaluation, 30 studies were eligible for this review. Of these studies, 20% (6/30) reported negative outcomes. Three pathogens (Middle East respiratory syndrome coronavirus, Neorickettsia risticii, and Escherichia coli) were not transmitted by the flies in the experiments. Stomoxys spp. transmitted pathogens to a wide range of hosts (9 mammals) and substrates (blood and tissue culture), but the recorded experiments in camels failed. Three out of ten Stomoxys spp. reported in the studies (S. transvittatus, S. inornatus, and S. omega) failed to transmit pathogens in all attempts. The majority of experimental studies were on S. calcitrans, with very limited studies on other Stomoxys species, highlighting the dearth of information on other species occurring in Africa and Asia. Our study has consolidated the evidence regarding the experimental pathogen transmission by Stomoxys spp., highlighting and demonstrating their epidemiological significance and the need for surveillance and control/prevention strategies.},
}

Animals
*Muscidae/microbiology/parasitology/virology
*Insect Vectors/microbiology/virology

@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},
doi = {10.1016/j.ijheh.2026.114786},
pmid = {41855953},
issn = {1618-131X},
abstract = {BACKGROUND: Environmental health services in healthcare facilities-including water, sanitation, hygiene, waste management, cleaning, and infection control-prevent disease and strengthen healthcare delivery. Yet environmental health services are inadequate in many low- and middle-income countries (LMICs). Despite the importance of monitoring and improving services, no comprehensive evidence map exists to describe knowledge and gaps for action. The study objective was to comprehensively catalog published literature on environmental health services in healthcare facilities in LMICs by service domain, study type, and relevance to policy and practice.

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

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

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

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

@article {pmid41856461,
year = {2026},
author = {Farokhnia, A and Faro, LK and Tian, Y and Frischknecht, L and Eimer, J and Brosh-Nissimov, T and Nilsson, J},
title = {Extended Nirmatrelvir-Ritonavir for Persistent COVID-19: Systematic Review with Individual Patient Data.},
journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases},
volume = {},
number = {},
pages = {108558},
doi = {10.1016/j.ijid.2026.108558},
pmid = {41856461},
issn = {1878-3511},
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 1 January 2022 through 31 December 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 non-random 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 were rare (each 1/39; 2.6%).

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

PROSPERO REGISTRATION: CRD42025642455.},
}

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

@article {pmid41859113,
year = {2026},
author = {Devine, J and Jacobs, B and Leroux-Roels, I and Leroux-Roels, G and van der Most, R},
title = {Infection, vaccination and risk of dementia: a proposed immunological model.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1748535},
pmid = {41859113},
issn = {1664-3224},
mesh = {Humans ; *Dementia/immunology/epidemiology/etiology/prevention & control ; *Vaccination ; *Models, Immunological ; BCG Vaccine ; Alzheimer Disease/immunology ; Immunity, Innate ; Risk Factors ; SARS-CoV-2/immunology ; Adjuvants, Immunologic ; },
abstract = {With ageing populations, the prevalence of different types of dementias is increasing. The pathology of Alzheimer's disease (AD), the most common form of dementia, has been linked to the presence of plaques and neurofibrillary tangles in the central nervous system of patients. There are growing indications that risk of developing dementia correlates with several infectious agents, including human herpes viruses, flaviviruses and SARS-CoV-2. This has led to a proposition that AD and other dementias could be considered as having an infectious disease etiology. Whilst the mechanisms behind this remain unclear, intriguing epidemiological data suggest that several vaccinations are correlated with reduced risk for dementia. Intravesicular administration of the tuberculosis vaccine strain Bacille Calmette-Guérin (BCG) has been associated with decreased risk of dementia in bladder cancer patients. This has led to the hypothesis that non-specific effects of vaccinations, mediated through trained innate immunity, provide a mechanistic explanation. Over the last few years, the AS01-adjuvanted recombinant shingles vaccine has also been associated with reduced risk in several studies. Moreover, in a recent study, immunization with the adjuvanted RSV vaccine, also containing AS01, was shown to reduce risk of dementia. Integrating data on BCG and mechanistic hypotheses, recent findings on the AS01 adjuvant, and the role of trained innate immunity, we describe here an immunological model that connects vaccine and adjuvant mode of action with risk of dementia. This immunological model can help shape a research roadmap to further elucidate the mechanisms behind the collective epidemiological data.},
}

Humans
*Dementia/immunology/epidemiology/etiology/prevention & control
*Vaccination
*Models, Immunological
BCG Vaccine
Alzheimer Disease/immunology
Immunity, Innate
Risk Factors
SARS-CoV-2/immunology
Adjuvants, Immunologic

@article {pmid41860005,
year = {2026},
author = {Zou, H and An, WT and Huang, SL and Luo, G and Mu, ZP},
title = {Advances in the application of natural bioactive compounds for the prevention and control of porcine epidemic diarrhea virus via the oxidative stress pathway.},
journal = {Polish journal of veterinary sciences},
volume = {29},
number = {1},
pages = {165-174},
doi = {10.24425/pjvs.2026.158513},
pmid = {41860005},
issn = {2300-2557},
mesh = {Animals ; *Porcine epidemic diarrhea virus/drug effects ; Swine ; *Swine Diseases/prevention & control/virology ; *Coronavirus Infections/veterinary/prevention & control/virology ; *Oxidative Stress/drug effects ; Antiviral Agents/pharmacology ; *Biological Products/pharmacology/therapeutic use ; },
abstract = {The porcine epidemic diarrhea virus (PEDV) represents a critical challenge to the global swine industry due to its profound adverse effects on pig health and production efficiency. A key pathological outcome of PEDV infection is the induction of oxidative stress, which significantly exacerbates intestinal injury and accelerates disease progression. Natural bioactive compounds, sourced from plants, animals, and microorganisms, have been extensively studied for their diverse biological properties, including potent antioxidant, anti-inflammatory, and antiviral activities. These compounds demonstrate significant potential in alleviating oxidative stress and playing a pivotal role in the prevention and management of PEDV infections. This review provides a comprehensive analysis of the mechanisms by which natural bioactive compounds enhance the antioxidant defence system and suppress PEDV replication. Current evidence indicates that these compounds alleviate oxidative stress primarily through the modulation of antioxidant enzyme systems, such as superoxide dismutase (SOD) and glutathione peroxidase (GPx), and the activation of key signalling pathways, including the Nrf2/ARE axis. These actions collectively contribute to reduced viral loads and improved health outcomes in PEDV-infected pigs. Although these findings underscore the potential of natural bioactive compounds, several critical challenges persist, particularly the incomplete elucidation of their mechanisms of action and the substantial costs associated with large-scale applications. Addressing these challenges necessitates further research aimed at uncovering the precise molecular pathways underlying their effects and developing cost-effective strategies to facilitate their practical implementation in the swine industry.},
}

Animals
*Porcine epidemic diarrhea virus/drug effects
Swine
*Swine Diseases/prevention & control/virology
*Coronavirus Infections/veterinary/prevention & control/virology
*Oxidative Stress/drug effects
Antiviral Agents/pharmacology
*Biological Products/pharmacology/therapeutic use

@article {pmid41860269,
year = {2026},
author = {Slama Schwok, A},
title = {[Post-COVID neurological sequelae, proposed mechanisms and therapeutic approaches].},
journal = {Medecine sciences : M/S},
volume = {42},
number = {3},
pages = {280-289},
doi = {10.1051/medsci/2026036},
pmid = {41860269},
issn = {1958-5381},
mesh = {Humans ; *COVID-19/complications/epidemiology/therapy ; *Nervous System Diseases/therapy/etiology/epidemiology ; SARS-CoV-2 ; Adult ; Female ; Post-Acute COVID-19 Syndrome ; Middle Aged ; Male ; Cognitive Dysfunction/etiology/therapy ; Adolescent ; Young Adult ; Neuroinflammatory Diseases/etiology/therapy ; },
abstract = {Approximately 5 % of patients suffer from the sequelae of the COVID-19 pandemics, representing a considerable number of individuals, often young or middle-aged working adults (18-50 years). Among them, women are disproportionately affected. The most common neurological symptoms include persistent cognitive impairment, known as "brain fog", chronic fatigue syndrome, inflammation of the nervous system (motor or autonomous), anxiety and depression, all of which significantly reduce patients' quality of life. There is therefore an urgent societal need to identify appropriate treatments based on a clear understanding of the underlying pathological mechanisms. This review describes the state of the art in Long neuro-COVID, with an emphasis on neuroinflammation, alteration of neurotransmission, and immune, endothelial and microvascular dysfunctions.},
}

Humans
*COVID-19/complications/epidemiology/therapy
*Nervous System Diseases/therapy/etiology/epidemiology
SARS-CoV-2
Adult
Female
Post-Acute COVID-19 Syndrome
Middle Aged
Male
Cognitive Dysfunction/etiology/therapy
Adolescent
Young Adult
Neuroinflammatory Diseases/etiology/therapy

@article {pmid41860271,
year = {2026},
author = {Cracowski, JL and Molimard, M and Richard, V and Roustit, M and Khouri, C},
title = {[Assessing the risk-benefit balance of medicines: Some lessons from Covid-19].},
journal = {Medecine sciences : M/S},
volume = {42},
number = {3},
pages = {295-305},
doi = {10.1051/medsci/2026040},
pmid = {41860271},
issn = {1958-5381},
mesh = {Humans ; COVID-19/epidemiology ; Pharmacovigilance ; *COVID-19 Drug Treatment ; Risk Assessment/methods ; SARS-CoV-2 ; *Drug-Related Side Effects and Adverse Reactions/epidemiology/prevention & control ; Pharmacoepidemiology/methods ; Drug Interactions ; Clinical Trials as Topic ; },
abstract = {The efficacy of medications is evaluated by clinical trials. However, such trials are not designed to assess adverse effects, particularly when those are rare. A robust pharmacovigilance system is therefore required to assess risks, supplemented as requested by pharmacoepidemiology studies. The benefits of medications are expressed in either relative or absolute terms and they vary depending on the baseline risk of the disease (its severity, potential complications, progression, and its incidence for the population-level benefits). This is not the case for adverse effects, which are influenced by the drug characteristics and the population receiving the treatment. In this context, can we truly balance the benefits and risks of medications? The experience of Covid-19 illustrates the complexity of this concept. It clearly highlights the need for a comprehensive approach, integrating analysis of clinical trials, pharmacovigilance monitoring, pharmacoepidemiology studies, and the detection of potential drug interactions. Finally, it is essential to inform and educate the general public about medications. This empowers individuals to accurately understand the complex concept of benefit-risk balance, prevents misleading over simplifications, and helps effectively counter misinformation.},
}

Humans
COVID-19/epidemiology
Pharmacovigilance
*COVID-19 Drug Treatment
Risk Assessment/methods
SARS-CoV-2
*Drug-Related Side Effects and Adverse Reactions/epidemiology/prevention & control
Pharmacoepidemiology/methods
Drug Interactions
Clinical Trials as Topic

@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 = {},
number = {},
pages = {114839},
doi = {10.1016/j.jconrel.2026.114839},
pmid = {41862100},
issn = {1873-4995},
abstract = {The human microbiome has emerged as a key player in health and disease, including cancer, which remains one of the leading causes of mortality worldwide. Although advances in understanding the tumor immune microenvironment and the development of immunotherapies have transformed cancer treatment, clinical efficacy remains limited by suboptimal response rates and severe side effects. Recent integrative research in cancer biology, immune-oncology, and cancer microbiome research, enabled by omics technologies and advanced bioinformatics, has begun to reveal intricate links between the microbiome, cancer progression, and immune modulation. These findings underscore the microbiome's pivotal role in shaping both therapeutic efficacy and resistance mechanisms. Currently, nanotechnology, propelled into mainstream success through the development of COVID-19 mRNA vaccines, is offering new tools for precision oncology. Nanomaterials are now being explored not only for targeted drug delivery but also for monitoring and modulating the microbiome, with significant potential for biomarker discovery and personalized medicine. In this article, we explore the role of the microbiota in tumorigenesis and cancer therapy, with a particular focus on its crosstalk with the immune system. We highlight emerging microbiota-targeted therapeutic strategies and discuss how nanotechnology-based systems are being designed to modulate the microbiome-immune-cancer axis. Finally, we discuss future directions in leveraging the convergence of microbiome science, nanotechnology, and immunotherapy to advance cancer treatment.},
}

@article {pmid37421651,
year = {2023},
author = {Brînzac, MG and Kuhlmann, E and Dussault, G and Ungureanu, MI and Cherecheș, RM and Baba, CO},
title = {Defining medical deserts-an international consensus-building exercise.},
journal = {European journal of public health},
volume = {33},
number = {5},
pages = {785-788},
pmid = {37421651},
issn = {1464-360X},
mesh = {Humans ; Consensus ; COVID-19/epidemiology ; *Delivery of Health Care ; Delphi Technique ; *Health Services Accessibility ; Pandemics ; SARS-CoV-2 ; Surveys and Questionnaires ; },
abstract = {BACKGROUND: Medical deserts represent a pressing public health and health systems challenge. The COVID-19 pandemic further exacerbated the gap between people and health services, yet a commonly agreed definition of medical deserts was lacking. This study aims to define medical deserts through a consensus-building exercise, explaining the phenomenon to its full extent, in a manner that can apply to countries and health systems across the globe.

METHODS: We used a standard Delphi exercise for the consensus-building process. The first phase consisted of one round of individual online meetings with selected key informants; the second phase comprised two rounds of surveys when a consensus was reached in January 2023. The first phase-the in-depth individual meetings-was organized online. The dimensions to include in the definition of medical deserts were identified, ranked and selected based on their recurrence and importance. The second phase-the surveys-was organized online. Finally, external validation was obtained from stakeholders via email.

RESULTS: The agreed definition highlight five major dimensions: 'Medical deserts are areas where population healthcare needs are unmet partially or totally due to lack of adequate access or improper quality of healthcare services caused by (i) insufficient human resources in health or (ii) facilities, (iii) long waiting times, (iv) disproportionate high costs of services or (v) other socio-cultural barriers'.

CONCLUSIONS: The five dimensions of access to healthcare: (i) insufficient human resources in health or (ii) facilities, (iii) long waiting times, (iv) disproportionate high costs of services and (v) other socio-cultural barriers-ought to be addressed to mitigate medical deserts.},
}

Humans
Consensus
COVID-19/epidemiology
*Delivery of Health Care
Delphi Technique
*Health Services Accessibility
Pandemics
SARS-CoV-2
Surveys and Questionnaires

@article {pmid37937672,
year = {2023},
author = {Cheng, AL and Anderson, J and Didehbani, N and Fine, JS and Fleming, TK and Karnik, R and Longo, M and Ng, R and Re'em, Y and Sampsel, S and Shulman, J and Silver, JK and Twaite, J and Verduzco-Gutierrez, M and Kurylo, M},
title = {Multi-disciplinary collaborative consensus guidance statement on the assessment and treatment of mental health symptoms in patients with post-acute sequelae of SARS-CoV-2 infection (PASC).},
journal = {PM & R : the journal of injury, function, and rehabilitation},
volume = {15},
number = {12},
pages = {1588-1604},
doi = {10.1002/pmrj.13085},
pmid = {37937672},
issn = {1934-1563},
mesh = {Humans ; *COVID-19 ; Disease Progression ; *Mental Health ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; },
}

Humans
*COVID-19
Disease Progression
*Mental Health
Post-Acute COVID-19 Syndrome
SARS-CoV-2

@article {pmid40354688,
year = {2025},
author = {Ortiz-de-Lejarazu, R and Sagué, M and Eiros, JM and de la Flor, J and Villar-Álvarez, F and Fernández-Prada, M and Jiménez-Jiménez, AB and Sanz, F and Gamazo, JJ and Yáñez, L and Gómez, A and Rodríguez-Ledo, P and Ortega, J and Molero, JM and Reina, J and Solà-Morales, O},
title = {Viral respiratory tract infections diagnosis: a Spanish survey and consensus approach.},
journal = {Diagnostic microbiology and infectious disease},
volume = {113},
number = {1},
pages = {116831},
doi = {10.1016/j.diagmicrobio.2025.116831},
pmid = {40354688},
issn = {1879-0070},
mesh = {Humans ; Consensus ; COVID-19/diagnosis ; Delphi Technique ; Molecular Diagnostic Techniques ; *Respiratory Tract Infections/diagnosis/virology ; SARS-CoV-2/isolation & purification ; Spain/epidemiology ; Surveys and Questionnaires ; *Virus Diseases/diagnosis/virology ; },
abstract = {BACKGROUND: Respiratory tract infections (RTI) rank second cause of adult and paediatric morbidity and mortality worldwide. Clinical symptoms of acute respiratory infections (ARIs) do not allow to differentiate one from another. The etiological diagnosis of viral respiratory infections has undergone changes throughout the 21st century pandemics. In Spain there is still no consensus on the use of molecular tools for the diagnosis of viral RTI.

METHODS: A panel of specialists from various Spanish Scientific Societies was gathered to discuss about the application of diagnostic techniques for respiratory viruses. A Delphi panel was conducted throughout 3 rounds, respondents being asked to rate their agreement level to provide evidence-based consensus methods to enable rapid and accurate diagnosis of viral RTI.

RESULTS: The Delphi panel of experts reached a strong consensus that viral infections are the main cause of ARI, with Influenza, RSV, and SARS-CoV-2 identified as the most significant pathogens. These viruses are also the leading cause of ARI-related complications in vulnerable patients with risk factors for severe disease. In hospital settings, all symptomatic ARI patients should undergo rapid PCR testing for these three viruses, a measure of critical importance for immunocompromised individuals, the very elderly, and those with comorbidities that may worsen clinical outcomes.

CONCLUSION: Experts main concern was directed towards the need to inform and familiarize non-specialists about the relevance of specific viral diagnosis result of this diagnostic approach would be the reduction of antibiotic use for hospital and primary health providers.},
}

Humans
Consensus
COVID-19/diagnosis
Delphi Technique
Molecular Diagnostic Techniques
*Respiratory Tract Infections/diagnosis/virology
SARS-CoV-2/isolation & purification
Spain/epidemiology
Surveys and Questionnaires
*Virus Diseases/diagnosis/virology

@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.

SUMMARY: 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.

GRAPHICAL ABSTRACT: Created in BioRender by Dimitra Petropoulou (January 20, 2026) BioRender.com/rd3udxs. [Image: see text]},
}

@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 = {},
number = {},
pages = {},
pmid = {41849116},
issn = {1179-1888},
abstract = {BACKGROUND: Vitiligo is a multi-factorial autoimmune skin disorder often triggered by environmental exposures. Although the exposome has gained attention, no systematic review has fully assessed its role in vitiligo.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

@article {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 {pmid41644038,
year = {2026},
author = {Ogoti, B and Riitho, V and Wildemann, J and Mutono, N and Mureithi, M and Oyugi, J and Rodon, J and Corman, VM and Drosten, C and Thumbi, SM and Müller, MA},
title = {Epidemiology and genomic features of MERS coronavirus in Africa: a systematic and meta-analysis review.},
journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases},
volume = {165},
number = {},
pages = {108456},
doi = {10.1016/j.ijid.2026.108456},
pmid = {41644038},
issn = {1878-3511},
mesh = {Humans ; *Middle East Respiratory Syndrome Coronavirus/genetics ; Africa/epidemiology ; Camelus/virology ; *Coronavirus Infections/epidemiology/virology/veterinary ; Animals ; Genome, Viral ; Seroepidemiologic Studies ; RNA, Viral ; Prevalence ; Phylogeny ; },
abstract = {OBJECTIVES: We explored factors contributing to the low human MERS-CoV prevalence in Africa by assessing MERS-CoV epidemiological and genomic features.

METHODS: We followed the PRISMA guidelines. We searched for articles on epidemiological and virological MERS-CoV characteristics in humans and camels in Africa until August 2025. We used a generalised linear mixed-effects model to calculate pooled proportions. We identified relevant polymorphisms in African MERS-CoV lineages compared with the prototypic EMC/2012 and contemporary Arabian MERS-CoV (clade B5).

RESULTS: We included 53 articles, with 31 used in the meta-analysis. Kenya, Egypt, and Ethiopia contributed to 66.03% of all included studies. Pooled MERS-CoV RNA positivity in African dromedaries was 6.09%, with juveniles (15.29%) having a higher incidence than adults (4.51%). The pooled MERS-CoV seroprevalence was 73.67%, with adults (80.96%) higher than juveniles (36.02%). In human-focused studies, only nine PCR-confirmed MERS cases were reported, six travel-associated and three autochthonous cases, despite a pooled seroprevalence of 2.4%. Genomic analyses identified MERS-CoV clade C-specific polymorphisms in the Spike and accessory genes with putative phenotypic impact.

CONCLUSION: We found the highest MERS-CoV RNA positivity in young dromedaries. Elevated MERS-CoV seroprevalence in mainly asymptomatic camel-exposed humans suggests an underestimation of MERS-CoV infections in Africa. The ongoing MERS-CoV evolution emphasises the need for active genomic surveillance to monitor signatures of human adaptation.},
}

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

@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 {pmid41848128,
year = {2025},
author = {Hajji, H and Kalai, A and Chaabeni, A and Migaou, H and Jebali, B and Ben Salah Frih, Z and Ben Saad, H and Jellad, A},
title = {Beyond the basics: exploring non-conventional treatment for fatigue in post-acute COVID-19 syndrome.},
journal = {La Tunisie medicale},
volume = {103},
number = {9},
pages = {1265-1271},
doi = {10.62438/tunismed.v103i9.5926},
pmid = {41848128},
issn = {2724-7031},
mesh = {Humans ; *COVID-19/complications/therapy ; Post-Acute COVID-19 Syndrome ; *Fatigue/therapy/etiology ; SARS-CoV-2 ; Dietary Supplements ; Acupuncture Therapy/methods ; },
abstract = {INTRODUCTION: Post-acute 2019 coronavirus disease syndrome (PACS) is a multifaceted, multisystem disorder affecting an estimated 75 million individuals globally (in May 2024). Defined by symptoms persisting beyond four weeks post-infection, PACS manifests in subacute (4-12 weeks) and chronic (>12 weeks) phases, with fatigue being a prominent and debilitating feature. Comprehensive management of PACS-associated fatigue needs diverse therapeutic strategies extending beyond conventional rehabilitation.

AIM: This narrative review explored non-conventional interventions for PACS-related fatigue, focusing on treatments involving nutritional rehabilitation, physical modalities, and other innovative therapies.

METHODS: Narrative review.

RESULTS: Treatments reported in the literature include melatonin, QingjinYiqi, nutritional supplements, aromatherapy, antioxidants, Tai Chi, acupuncture, yoga, singing, hyperbaric oxygen therapy (HBOT), pulsed electromagnetic field therapy, and whole-body vibration. Melatonin and QingjinYiqi have shown notable improvements in fatigue and overall health. Nutritional supplements such as vitamin-minerals combinations have demonstrated enhancements in muscle strength, physical performance, and quality of life. Tai Chi, acupuncture, and yoga have shown positive effects on fatigue, muscle strength, and overall well-being. Aromatherapy, singing, HBOT, pulsed electromagnetic field therapy, and whole-body vibration effectively reduce fatigue while enhancing physical and cognitive functions.

CONCLUSION: These non-conventional treatments offer promising supplementary benefits to conventional rehabilitation.},
}

Humans
*COVID-19/complications/therapy
Post-Acute COVID-19 Syndrome
*Fatigue/therapy/etiology
SARS-CoV-2
Dietary Supplements
Acupuncture Therapy/methods

@article {pmid41848189,
year = {2026},
author = {Shrewsbury, SB},
title = {DHE - past, present, and future: a narrative review.},
journal = {Pain management},
volume = {},
number = {},
pages = {1-15},
doi = {10.1080/17581869.2026.2644524},
pmid = {41848189},
issn = {1758-1877},
abstract = {Dihydroergotamine (DHE) was first approved in 1946 for the acute treatment of migraine. Its efficacy when administered as an intravenous (IV) injection explains its enduring use in the management of migraine today. More recently, attention has been focused on the development of formulations delivered by the inhalational route to either the nasal mucosa or lung with the objective of providing a product that enables easy, needle-free, "at-home" use that is rapidly effective. Three new DHE products for migraine (two administered by nasal delivery) have been Food and Drug Administration (FDA) approved in the past five years with two others using pulmonary delivery in clinical development attempting to optimize outcomes for subjects requiring "at-home" migraine treatment. This narrative review describes those DHE development programs, and others that have failed, with the objective of providing a broad perspective on various approaches, including those that may be more likely to achieve the goals of high efficacy rates, rapid relief, and convenience of use. In addition, DHE has been investigated for potential repurposing of other indications. These too are described.},
}

@article {pmid41784841,
year = {2026},
author = {Wang, C and Evangelista, JF and Vidal, AKN and Islamuddin, M and Chen, Y and Xu, D and Qin, X},
title = {The emerging role of TLR7-mediated signaling in respiratory viral infections and autoimmune diseases.},
journal = {Cellular and molecular life sciences : CMLS},
volume = {83},
number = {1},
pages = {},
pmid = {41784841},
issn = {1420-9071},
support = {165265/HL/NHLBI NIH HHS/United States ; 962950//American Heart Association/ ; 165265/HL/NHLBI NIH HHS/United States ; },
abstract = {Toll-like receptor 7 (TLR7) is a key endosomal sensor that detects single-stranded RNA, linking innate and adaptive immunity through the induction of type I interferons and proinflammatory cytokines. Recent studies have underscored the pivotal role of TLR7 in shaping immune responses to respiratory viral infections, including SARS-CoV-2, influenza A virus, and respiratory syncytial virus (RSV), as well as in the pathogenesis of systemic autoimmune diseases such as systemic lupus erythematosus (SLE), which can be triggered by the respiratory viral infections. In COVID-19, TLR7 deficiency is associated with severe disease, particularly in males, due to impaired interferon responses and antibody production. In influenza, TLR7 enhances humoral and cytotoxic responses, though its overactivation may contribute to immunopathology. The role of TLR7 in RSV remains controversial, with both protective and detrimental effects reported depending on host and experimental context. In contrast, TLR7 plays a pathogenic role in SLE by amplifying type I interferon signaling and promoting autoreactive B cell activation. This review synthesizes current knowledge on TLR7-mediated signaling across these diseases, highlighting its context-dependent functions and dualistic nature in immunity and disease. We will discuss mechanistic insights, clinical relevance, and emerging therapeutic strategies targeting TLR7, emphasizing the need for precision modulation of this pathway in the treatment of viral infections and autoimmune disorders.},
}

@article {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 {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},
doi = {10.14814/phy2.70832},
pmid = {41846399},
issn = {2051-817X},
mesh = {Humans ; *Lung/physiology/physiopathology ; *Respiration, Artificial/methods ; *COVID-19/physiopathology/therapy ; *Models, Biological ; Airway Resistance ; Respiratory Mechanics ; Functional Residual Capacity ; },
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
*Respiration, Artificial/methods
*COVID-19/physiopathology/therapy
*Models, Biological
Airway Resistance
Respiratory Mechanics
Functional Residual Capacity

@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 {pmid41329126,
year = {2026},
author = {Siciliani, L},
title = {Waiting times for health services, health, and labour market outcomes.},
journal = {European journal of public health},
volume = {36},
number = {Supplement_2},
pages = {ii3-ii7},
doi = {10.1093/eurpub/ckaf213},
pmid = {41329126},
issn = {1464-360X},
mesh = {Humans ; *Waiting Lists ; *COVID-19/epidemiology ; *Employment/statistics & numerical data ; Sick Leave/statistics & numerical data ; SARS-CoV-2 ; Time Factors ; },
abstract = {Waiting times for health care is a significant health policy concern across many health systems, which has been exacerbated by the COVID-19 pandemic. Long waiting times for non-emergency care generate health losses to patients because health benefits are postponed. They can increase the risk of mortality or morbidity and reduce patient ability to benefit from health care. Waiting times can also generate negative spill-over effects on labour market outcomes. For individuals in the working age, employed individuals might end up on sick leave and claim sickness benefits, or experience reduced productivity if they continue to work. Individuals looking for a job may find it harder to find employment or become economically inactive. We conduct a narrative review of the literature on the effect of waiting times on health losses and labour market outcomes. There is growing literature documenting the effect of longer waiting times on labour market outcomes. Although limited, the literature identifies potentially harmful effects in particular when patients are waiting for mental health services and orthopaedic treatment. The findings have implications for prioritization of patients on the list and for allocation of resources within the health sector and across sectors.},
}

Humans
*Waiting Lists
*COVID-19/epidemiology
*Employment/statistics & numerical data
Sick Leave/statistics & numerical data
SARS-CoV-2
Time Factors

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

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

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

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

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

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

@article {pmid41837342,
year = {2026},
author = {Yilmaz, S and Göktaş, B and Ateş, İ and Çelik, M},
title = {Ivermectin Toxicity in Humans and Animals: Clinical Spectrum, Mechanisms, and Management.},
journal = {Journal of applied toxicology : JAT},
volume = {},
number = {},
pages = {},
doi = {10.1002/jat.70166},
pmid = {41837342},
issn = {1099-1263},
abstract = {Ivermectin is a widely used macrocyclic lactone with established efficacy against a broad range of parasitic infections in humans and animals and a long-standing reputation for clinical safety. However, increasing evidence indicates that ivermectin can produce clinically relevant toxicity under specific conditions, particularly involving the central nervous system. This review integrates findings from controlled human trials, pharmacovigilance data, clinical case reports, experimental animal studies, and environmental investigations to comprehensively characterize the toxicological profile of ivermectin. Early randomized, placebo-controlled studies in healthy volunteers demonstrated that ivermectin is generally well tolerated, even at doses substantially exceeding approved therapeutic levels, with predominantly mild and transient adverse events and no significant neurological toxicity under controlled conditions. In contrast, post-marketing surveillance and real-world clinical reports have identified rare but severe neurotoxic events, including encephalopathy, seizures, coma, and death, occurring after supratherapeutic exposure and, in susceptible individuals, even at standard therapeutic doses. Converging human and animal evidence highlights impairment or saturation of blood-brain barrier protection, particularly dysfunction of P-glycoprotein (ABCB1/MDR1)-mediated efflux, as a central determinant of ivermectin neurotoxicity. Animal studies further demonstrate marked species-, breed-, age-, dose-, and route-dependent susceptibility, with neonatal animals, genetically predisposed dog breeds, and models exposed to transporter inhibition or repeated high-dose regimens showing pronounced vulnerability. While neurotoxicity is often functional and reversible at lower exposures, high or cumulative dosing can lead to structural neuropathology and multi-organ injury. The COVID-19 pandemic amplified these risks through widespread off-label use, especially of veterinary formulations, resulting in a substantial increase in toxic exposures without demonstrated clinical benefit. Overall, ivermectin toxicity emerges as a predictable consequence of interactions between pharmacokinetics, transporter biology, exposure patterns, and host-specific factors rather than an inherent contradiction of its therapeutic value.},
}

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

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

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

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

@article {pmid41842771,
year = {2025},
author = {Diaz, F},
title = {[Kawasaki Disease and Pediatric Multisystem Inflammatory Syndrome in the Aftermath of the Pandemic].},
journal = {Andes pediatrica : revista Chilena de pediatria},
volume = {96},
number = {4},
pages = {447-456},
doi = {10.32641/andespediatr.v96i4.5361},
pmid = {41842771},
issn = {2452-6053},
mesh = {Humans ; *Mucocutaneous Lymph Node Syndrome/diagnosis/therapy/physiopathology/epidemiology ; *COVID-19/diagnosis/therapy/epidemiology/complications ; *Systemic Inflammatory Response Syndrome/diagnosis/therapy/physiopathology/epidemiology ; Child ; Pandemics ; },
abstract = {Following the initial months of the COVID-19 pandemic, Multisystem Inflammatory Syndrome in Children (MIS-C) was identified as an entity associated with SARS-CoV-2 infection. In addition to the viral epidemiological shift, many factors contributed to MIS-C being exceptionally rare today. The similarities to other diseases previously described in the pediatric population have made its clinical management challenging in the post-pandemic era. However, given its potential severity, it is essential to incorporate the different phenotypes into the diagnostic and therapeutic approach to common pediatric diseases and syndromes to minimize both underdiagnosis and overtreatment. The Kawasaki disease phenotype of MIS-C (fKD/MIS-C) and Kawasaki disease (KD) require special attention, as they share multiple clinical and pathophysiological characteristics. While the current evidence on KD is robust regarding treatment, severity, and outpatient follow-up, MIS-C management relies predominantly on expert recommendations. It is crucial to recognize the key common and distinctive features of these entities to optimize diagnosis, identify at-risk groups, and improve therapy during the acute phase and outpatient follow-up. Nonetheless, the long-term implications of fKD/MIS-C have not yet been fully elucidated.},
}

Humans
*Mucocutaneous Lymph Node Syndrome/diagnosis/therapy/physiopathology/epidemiology
*COVID-19/diagnosis/therapy/epidemiology/complications
*Systemic Inflammatory Response Syndrome/diagnosis/therapy/physiopathology/epidemiology
Child
Pandemics

@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 ; *COVID-19/prevention & control ; *Influenza Vaccines/economics/administration & dosage ; *Influenza, Human/prevention & control ; Middle Aged ; Adult ; Aged ; Adolescent ; Vaccines, Combined/economics ; Young Adult ; Seasons ; SARS-CoV-2 ; },
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
*COVID-19/prevention & control
*Influenza Vaccines/economics/administration & dosage
*Influenza, Human/prevention & control
Middle Aged
Adult
Aged
Adolescent
Vaccines, Combined/economics
Young Adult
Seasons
SARS-CoV-2

@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},
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.},
}