@article {pmid41758637,
year = {2026},
author = {Kozdrowicki, M and Szczepaniak, P and Kyslyi, V and Carnevale, L and Carnevale, D and Lembo, G and Guzik, TJ and Mikołajczyk, TP},
title = {The impact of inflammation, neuromodulation, and gut microbiota on developing cardiac fibrosis and hypertension.},
journal = {Cardiovascular research},
volume = {122},
number = {6},
pages = {681-706},
doi = {10.1093/cvr/cvag054},
pmid = {41758637},
issn = {1755-3245},
support = {ERA-CVD/NEMO/7/2019//Polish National Centre for Research and Development/ ; ERA-CVD/Gut-brain/8/2021//Polish National Centre for Research and Development/ ; ERA-CVD/JTC2020/25/ImmuneHyper/Cog/2022//Polish National Centre for Research and Development/ ; //Ministry of Health/ ; },
mesh = {Humans ; *Hypertension/physiopathology/metabolism/microbiology/immunology/therapy/pathology ; Fibrosis ; *Gastrointestinal Microbiome ; Animals ; COVID-19 ; *Myocardium/pathology/metabolism/immunology ; *Inflammation/physiopathology/metabolism/immunology ; Myofibroblasts/metabolism/pathology ; Inflammation Mediators/metabolism ; },
abstract = {Cardiovascular diseases (CVD) are the leading cause of premature mortality worldwide. Due to pressure overload and cardiac fibrosis, CVD often begin with hypertension and gradually progress to heart failure. Cardiac fibrosis reduces the number of functional cardiomyocytes and the force of contraction while increasing oxygen demand. It has been noted that myofibroblasts, which produce excessive amounts of extracellular matrix in the failing heart, express specific proteins such as periostin, tenascin C, thrombospondin, and osteopontin. Their activation involves immune cells that have a well-documented effect on the pathogenesis of hypertension. Moreover, dysregulation of the autonomic nervous system and sympathetic hyperactivity heightens peripheral inflammation and fosters fibrosis. In this review, we outline and summarize the most significant and recent findings concerning the molecular pathways of immune activation, neuromodulation, epigenetic modifications, and the impact of gut microbiota on myofibroblast activation and fibrosis in the heart, as well as potential therapeutic options (e.g. experimental anti-inflammatory treatments, epigenetic modulators, and vagus nerve stimulation). We will also highlight how current heart failure treatments, including renin-angiotensin-aldosterone system (RAA) inhibitors, β-adrenergic receptor (β-AR) antagonists, sodium-glucose co-transporter 2 (SGLT2) inhibitors, the Dietary Approaches to Stop Hypertension (DASH), and the Mediterranean diet, affect these processes at a molecular level. A comprehensive understanding of the neuroimmune mechanisms involved in the pathogenesis of heart failure and hypertension is particularly crucial in light of the increased risk of CVD following the COVID-19 pandemic, which resulted from the 'cytokine storm' during SARS-CoV-2 infection.},
}

Humans
*Hypertension/physiopathology/metabolism/microbiology/immunology/therapy/pathology
Fibrosis
*Gastrointestinal Microbiome
Animals
COVID-19
*Myocardium/pathology/metabolism/immunology
*Inflammation/physiopathology/metabolism/immunology
Myofibroblasts/metabolism/pathology
Inflammation Mediators/metabolism

@article {pmid41851644,
year = {2026},
author = {Doran, C and Sheku, M and Nakada, Y and Lopman, B and Nelson, K},
title = {Relevance of social contact definitions for use in infectious disease transmission modeling: a systematic review and recommendations.},
journal = {BMC infectious diseases},
volume = {26},
number = {1},
pages = {},
pmid = {41851644},
issn = {1471-2334},
support = {CDC-RFA-FT-23-0069//Insight Net Cooperative Agreement, CDC Center for Forecasting and Analytics/ ; K01AI166093-01A1//NIH/NIAID/ ; },
abstract = {BACKGROUND: Social mixing studies provide crucial evidence for parameterizing mathematical models of infectious disease transmission, and their validity for use in models is dependent on their study design and how well the contacts they capture map to the transmission routes of the pathogen of interest. This systematic review aims to catalogue contact definitions used in social mixing studies from 2005 to 2024 and evaluate their conceptual alignment to three archetypal pathogens.

METHODS: We searched Ovid Medline, Embase, Scopus, and Global Index Medicus for studies of human-to-human interactions that collected data via survey, diary, or interview published between January 2005 and August 2024. We excluded studies that focused on sexually-transmitted or food/water/vector-borne pathogens or used only GPS or sensor data. We excluded studies of contact tracing as a public health effort. Screening and data collection were conducted in Covidence. Contact definitions were presented verbatim and qualitatively coded to identify key elements. Results were stratified by prospective or retrospective design. We used the Mixed Methods Appraisal Tool to evaluate risk of bias.

RESULTS: We included 112 eligible studies, half (52.7%) of which began during pandemic periods (H1N1 [2009] or COVID-19 [2020]), commonly in the United States (18%) or United Kingdom (16%). Most (68%) had a retrospective design in which participants were asked to recall contacts that occurred prior to survey administration and 73% used a single-survey cross sectional design using random (16%) or stratified random (44%) sampling. Relevant contacts were often defined by an exchange of words (77%) or physical touch (59%). A minority of studies differentiated between contacts that occurred outdoors vs. indoors (28%) or allowed participants to report large group contacts separately from individually named contacts (28%). Contact definitions and attributes conceptually aligned with the transmission biology of influenza, tuberculosis, and norovirus in 77%, 6%, and 50% of studies respectively.

CONCLUSIONS: Contact studies were limited in their global scope and non-pandemic representativeness. Critical modifiers of transmission risk such as location, household membership, and shared space with large numbers of people were under-measured. Future modeling and social mixing studies should align measured contact rates to the target transmission routes by incorporating these elements.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-026-12938-y.},
}

@article {pmid41949759,
year = {2026},
author = {Kleinert, S},
title = {[Cardiovascular risk in inflammatory rheumatic diseases : Evidence-based strategies for risk reduction in rheumatologic practice].},
journal = {Zeitschrift fur Rheumatologie},
volume = {85},
number = {4},
pages = {307-316},
pmid = {41949759},
issn = {1435-1250},
mesh = {Humans ; *Cardiovascular Diseases/prevention & control/mortality/diagnosis ; Evidence-Based Medicine ; *Rheumatic Diseases/drug therapy/mortality ; Antirheumatic Agents/therapeutic use/adverse effects ; Heart Disease Risk Factors ; *Risk Reduction Behavior ; Rheumatology/standards ; Comorbidity ; Risk Assessment ; },
abstract = {Patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA) have a persistently increased cardiovascular (CV) risk and higher mortality, independently of traditional CV risk factors. Effective control of inflammation reduces CV events, whereas glucocorticoids increase the risk in a dose- and duration-dependent manner, even at ≤ 5 mg prednisolone/day. Disease-modifying antirheumatic drugs especially tumor necrosis factor (TNF) inhibitors, are largely protective through the reduction of systemic inflammation. For patients receiving Janus kinase (JAK) inhibitors or long-term glucocorticoid therapy, a structured CV risk assessment and guideline-based management of modifiable risk factors (including lipid optimization/statin therapy) are essential. Primary prevention should be based on the cardiovascular prevention guidelines of the European Society of Cardiology (ESC). Vaccinations (influenza, COVID-19, pneumococcus, respiratory syncytial virus, zoster) represent an effective pillar of CV prevention in populations at cardiovascular risk; however, evidence in patients with inflammatory rheumatic diseases is still lacking. The main challenge for CV prevention remains implementation: digital clinical reminders/decision support systems and multicomponent strategies can improve the implementation of recommendations.},
}

Humans
*Cardiovascular Diseases/prevention & control/mortality/diagnosis
Evidence-Based Medicine
*Rheumatic Diseases/drug therapy/mortality
Antirheumatic Agents/therapeutic use/adverse effects
Heart Disease Risk Factors
*Risk Reduction Behavior
Rheumatology/standards
Comorbidity
Risk Assessment

@article {pmid42046671,
year = {2026},
author = {Hudu, SA and Jimoh, AO},
title = {Operational zoonotic containment of Middle East respiratory syndrome coronavirus in Saudi Arabia: An implementation-oriented One Health genomic framework.},
journal = {Veterinary world},
volume = {19},
number = {3},
pages = {1322-1341},
pmid = {42046671},
issn = {0972-8988},
abstract = {Middle East respiratory syndrome coronavirus (MERS-CoV) remains a persistent zoonotic threat more than a decade after its first detection, with Saudi Arabia continuing to be the global epicenter of human infections and the main reservoir interface through dromedary camels. Despite ongoing surveillance, advances in molecular diagnostics, and research on vaccines and therapeutics, sporadic zoonotic spillovers and healthcare-associated outbreaks still occur, showing that current prevention strategies are still not enough. This review compiles current evidence from epidemiological studies, camel reservoir research, genomic monitoring, and public health reports published between 2012 and April 2025 to identify the key gaps preventing effective containment. Special focus is given to recent genomic discoveries, including post-2022 clade B sublineages, recombination events, and spike protein changes that might affect transmission and the effectiveness of countermeasures. Available data suggest that MERS-CoV epidemiology is driven by repeated camel-to-human transmission, followed by occasional amplification in healthcare settings rather than sustained community spread. High seroprevalence and frequent detection of viral RNA in juvenile camels, seasonal gathering in markets, and extensive animal movement networks contribute to ongoing viral circulation at the animal-human interface. Genomic studies consistently show close phylogenetic relationships between camel and human isolates, confirming recurrent zoonotic transmissions. However, fragmented surveillance systems, delayed genomic data integration, inconsistent biosecurity practices, and limited field evidence for camel vaccination pose major barriers to control. Additionally, hospital outbreaks continue to occur due to delayed diagnosis, overcrowding, and incomplete adherence to infection-prevention protocols, underscoring the need for improved clinical preparedness. Based on the integrated synthesis of epidemiological, veterinary, and genomic evidence, this review proposes an implementation-focused One Health genomic framework tailored to the Saudi context. The proposed roadmap highlights real-time connection of human and camel surveillance, expands genomic sequencing capacity, targets vaccination strategies in camels and high-risk human populations, standardizes biosecurity measures in markets and abattoirs, and strengthens infection control systems in healthcare facilities. Alignment with national governance structures and Saudi Vision 2030 offers a practical pathway for coordinated multi-sectoral action. This review concludes that MERS-CoV is unlikely to be eradicated soon, but it can be effectively managed through a genomics-enabled, operational One Health approach that combines surveillance, vaccination, clinical preparedness, and policy coordination. The model outlined here provides a scalable way to reduce zoonotic spillover risk and strengthen readiness against future coronavirus and emerging zoonotic threats.},
}

@article {pmid42046765,
year = {2026},
author = {Matenga-Ikihele, A and Asafo, F and Tuesday, R and Netzler, N and Puliuvea, C and Percival, T},
title = {Pacific-Led Responses to COVID-19: Lessons for Future Pandemic Preparedness.},
journal = {Journal of the Royal Society of New Zealand},
volume = {56},
number = {2},
pages = {e70049},
pmid = {42046765},
issn = {1175-8899},
abstract = {The COVID-19 pandemic exposed deep inequities in health systems globally and in Aotearoa New Zealand, with Pacific communities experiencing a disproportionate burden of illness, economic hardship, and social disruption. Despite these challenges, Pacific communities demonstrated resilience, culturally grounded leadership, and the ability to meet community needs through collective action. This qualitative review of peer-reviewed literature, government reports, and community-led research identified five interconnected themes: (1) community partnerships; (2) Pacific-centred approaches; (3) clear and trusted communication; (4) digital inclusion and literacy skills; and (5) economic support and sustainability. From these themes, key enablers were identified, which included community leadership, trusted communication strategies, and agile local systems, alongside barriers such as underinvestment, digital exclusion, reliance on unpaid labour, and limited inclusion of Pacific leadership in early planning. The findings highlight that Pacific-led systems are not supplementary but an essential public health infrastructure. Embedding these approaches within national emergency planning, through sustainable funding, formal governance roles, and strengthened digital inclusion, offers a pathway to a more equitable, trusted, and resilient pandemic response.},
}

@article {pmid42047168,
year = {2026},
author = {Uzer, F and Erendor, F and Sanlioglu, S},
title = {SARS-CoV-2 Variants and Immune Evasion: Mapping the Future of Vaccine Design.},
journal = {Reviews in medical virology},
volume = {36},
number = {3},
pages = {e70157},
doi = {10.1002/rmv.70157},
pmid = {42047168},
issn = {1099-1654},
mesh = {Humans ; *SARS-CoV-2/immunology/genetics ; *Immune Evasion ; *COVID-19 Vaccines/immunology ; *COVID-19/immunology/prevention & control/virology ; Spike Glycoprotein, Coronavirus/genetics/immunology/chemistry ; Antibodies, Neutralizing/immunology ; Mutation ; Vaccine Development ; Evolution, Molecular ; Antibodies, Viral/immunology ; },
abstract = {The evolutionary trajectory of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has progressed through several distinct phases since its zoonotic emergence, transitioning from initial human adaptation to an era of rapid antigenic drift and complex immune evasion. As of early 2026, the global landscape is dominated by highly evolved sublineages of the Omicron (B.1.1.529) variant, including the JN.1-descendent subvariants NB.1.8.1 and XFG. This review provides a comprehensive overview of the molecular mechanisms driving viral fitness, with a primary focus on the structural transformations within the spike (S) protein's receptor-binding domain (RBD), N-terminal domain (NTD), and S2 subunit. We examine the biophysical impacts of pivotal mutations, such as E484 K, K417 N, and F486P, alongside the phenomenon of convergent evolution and epistatic compensation. Furthermore, we provide an integrated analysis of current knowledge regarding the evolving dynamics of humoral and cellular immunity, exploring the challenges posed by immune imprinting and the decline of neutralizing antibody titers against antigenically distant strains. A comparative discussion of SARS-CoV-2 and seasonal influenza highlights divergent evolutionary paces but converging regulatory frameworks for annual vaccine updates. Finally, the current status of next-generation vaccine platforms is evaluated, specifically mosaic nanoparticles and mucosal delivery systems, which aim to provide pan-sarbecovirus protection and interrupt transmission. These insights are integrated into a policy framework focused on annual strain selection and enhanced genomic surveillance for sustainable long-term pandemic management.},
}

Humans
*SARS-CoV-2/immunology/genetics
*Immune Evasion
*COVID-19 Vaccines/immunology
*COVID-19/immunology/prevention & control/virology
Spike Glycoprotein, Coronavirus/genetics/immunology/chemistry
Antibodies, Neutralizing/immunology
Mutation
Vaccine Development
Evolution, Molecular
Antibodies, Viral/immunology

@article {pmid42047233,
year = {2026},
author = {Bashir, HM and Ciftci, D},
title = {Impact of COVID-19 on female reproductive health and communication post-pandemic: A scoping review.},
journal = {African journal of reproductive health},
volume = {30},
number = {8},
pages = {102-118},
doi = {10.29063/ajrh2026/v30i8.10},
pmid = {42047233},
issn = {1118-4841},
mesh = {Humans ; Female ; *COVID-19/epidemiology/psychology ; *Reproductive Health ; SARS-CoV-2 ; Adult ; Adolescent ; Young Adult ; Middle Aged ; *Communication ; *Health Communication ; *Women's Health ; },
abstract = {The COVID-19 pandemic significantly affected Female Reproductive Health (FRH), intensifying physiological and psychological conditions such as amenorrhea and postpartum related issues. While clinical studies have well-documented these impacts on FRH, no studies empirically tested health communication interventions, revealing a significant research gap. This scoping review bridges this gap, mapping evidence on the impact of COVID-19 on FRH and probing the untapped potential of communication strategies to mitigate these impacts. Following PRISMA-ScR guidelines, we systematically searched PubMed, PsycINFO, BMJ Global Health, and Frontiers (2021-2024) for peer-reviewed studies. The 13 included studies documented menstrual irregularities in 50-67% of women post-infection/vaccination, fertility rate declines of 18 per 100,000 women, and postpartum depression prevalence of 25.27%. Eligibility criteria included Women of reproductive age (15-49 years) affected by COVID-19's impact and implemented strategies addressing these impacts post-pandemic. We proposed integrating robust trauma-informed communication road map such as digital health literacy programs and community-led strategic initiatives.},
}

Humans
Female
*COVID-19/epidemiology/psychology
*Reproductive Health
SARS-CoV-2
Adult
Adolescent
Young Adult
Middle Aged
*Communication
*Health Communication
*Women's Health

@article {pmid42047332,
year = {2026},
author = {Paik, S and Um, S and Kim, IS and Park, EJ and Kim, KT and Basu, J and Oh, DC and Jo, EK},
title = {Exploiting autophagy-targeting natural compounds for potential antimicrobial actions.},
journal = {Autophagy},
volume = {},
number = {},
pages = {1-26},
doi = {10.1080/15548627.2026.2662426},
pmid = {42047332},
issn = {1554-8635},
abstract = {Natural products are biologically active compounds used for therapeutic interventions for various diseases, particularly infections. Autophagy is an intracellular catabolic pathway involving lysosomal degradation and is closely associated with immunological pathways, effectively combating bacterial, viral, fungal, and parasitic infections. Accumulating evidence suggests that autophagy activation or inhibition by natural products promotes antimicrobial responses against various pathogens. Numerous natural products can modulate autophagy through diverse signaling pathways, suggesting their potential as a host-directed therapeutic strategy that may complement conventional drug regimens or help mitigate drug resistance in various infectious diseases. However, it remains largely unclear whether these effects are mediated by direct modulation of autophagy or indirectly through associated mechanisms, including enhanced immune defense, attenuation of pathological inflammation, or crosstalk with other organelle functions. Additionally, multiple pathogens can evade host responses; thus, autophagy activation may inadvertently create favorable conditions for certain pathogens. This review discusses the current knowledge of natural products in terms of their antimicrobial actions through autophagy regulation, particularly the roles of distinct natural product classes, such as polyphenols, alkaloids, terpenoids, quinones, peptides, and macrolides in modulating autophagy for potentially contributing to control various infectious diseases. Exploring the intricate molecular interplay between natural products and autophagy in limiting infections may provide valuable insights that could inform the development of innovative host-directed antimicrobial treatments based on autophagy regulation.Abbreviations: 3-MA: 3-methyladenine; AM: alveolar macrophages; AMP: antimicrobial peptides; AMPK: 5' adenosine monophosphate-activated protein kinase; ARDS: acute respiratory distress syndrome; ART: artemisinin; ASFV: African swine fever virus; ATG: autophagy related; AZM: azithromycin; BafA1: bafilomycin A1; BECN1: beclin 1; BMDM: bone marrow-derived macrophage; BNIP3: BCL2 interacting protein 3; BNIP3L: BCL2 interacting protein 3 like; CALCOCO2/NDP52: calcium binding and coiled-coil domain 2; CAMKK2: calcium/calmodulin-dependent protein kinase kinase 2; CBD: cannabidiol; CF: cystic fibrosis; CGA: chlorogenic acid; CGAS: cyclic GMP-AMP synthase; CHUK/IKKα: component of inhibitor of nuclear factor kappa B kinase complex; CLP: cecal ligation and puncture; CLR: clarithromycin; CMA: chaperone-mediated autophagy; CoV: coronavirus; DHT: dihydrotanshinone I; EGCG: epigallocatechin-3-gallate; EIF2A: eukaryotic translation initiation factor 2A; EIF2AK2: eukaryotic translation initiation factor 2 alpha kinase 2; ESKAPE: Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.; ESRRA: estrogen related receptor alpha; FOXO1: forkhead box O1; FUNDC1: FUN14 domain containing 1; HBV: hepatitis B virus; HCV: hepatitis C virus; HDT: host-directed therapy; HIV: human immunodeficiency virus; HMGB1: high mobility group box 1; HSV: herpes simplex virus; IAV: influenza A virus; ICT: isocryptotanshinone; IFN: interferon; IKBKB/IKKβ: inhibitor of nuclear factor kappa B kinase subunit beta; IL: interleukin; INH: isoniazid; IRF3: IFN regulatory factor 3; KEAP1: kelch like ECH associated protein 1; LAMP: lysosomal associated membrane protein; LAP: LC3-associated phagocytosis; LPS: lipopolysaccharide; MAP1LC3/LC3: microtubule associated protein 1 light chain 3; MAPK: mitogen-activated protein kinase; MDM: monocyte-derived macrophage; MDR: multidrug-resistant; MON: monotropein; Mtb: Mycobacterium tuberculosis; MTOR: mechanistic target of rapamycin kinase; mtROS: mitochondrial ROS; NET: neutrophil extracellular trap; NFE2L2/Nrf2: NFE2 like bZIP transcription factor 2; NFKB/NF-κB: nuclear factor kappa B; NLRP3: NLR family pyrin domain containing 3; NLRX1: NLR family member X1; NOTCH1: notch receptor 1; NTM: nontuberculous mycobacteria; OMS: ohmyungsamycin; PAK1: p21 (RAC1) activated kinase 1; PINK1: PTEN induced kinase 1; PKM/PKM2: pyruvate kinase M1/2; PLD: phospholipase D; PM: peritoneal macrophage; PPM1A: protein phosphatase, Mg2+/Mn2+ dependent 1A; PRKN/parkin: parkin RBR E3 ubiquitin protein ligase; PtdIns3K: phosphatidylinositol 3-kinase; PtdIns3P: phosphatidylinositol-3-phosphate; PTEN: phosphatase and tensin homolog; RB1CC1/FIP200: RB1 inducible coiled-coil 1; RELA/p65: RELA proto-oncogene, NF-kB subunit; RIF: rifampicin; ROS: reactive oxygen species; RSV: resveratrol; RUBCN/rubicon: rubicon autophagy regulator; SAR: selective autophagy receptor; SIRT: sirtuin; STING1: stimulator of interferon response cGAMP interactor 1; STX17: syntaxin 17; Tat: trans-activator of transcription; TB: tuberculosis; TBK1: TANK binding kinase 1; TFEB: transcription factor EB; TLR: toll like receptor; TNA: tanshinone IIA; TNF: tumor necrosis factor; UA: ursolic acid; ULK1/Atg1: unc-51 like autophagy activating kinase 1; UPR: unfolded protein response; UVRAG: UV radiation resistance associated; VAMP8: vesicle associated membrane protein 8; VDR: vitamin D receptor; WIPI2: WD repeat domain, phosphoinositide interacting 2; ZFYVE1/DFCP1: zinc finger FYVE-type containing 1; ZIKV: Zika virus.},
}

@article {pmid42048372,
year = {2026},
author = {Braga, A and Fialho, SCAV and Martins, CAO and Duvivier, KM and Callado, GY and Araujo Júnior, E and de Rezende-Filho, J},
title = {Maternal vaccination in the immunization era: implementation, uptake, and emerging vaccines.},
journal = {Journal of perinatal medicine},
volume = {},
number = {},
pages = {},
pmid = {42048372},
issn = {1619-3997},
abstract = {Maternal immunization has ascended as a cornerstone of contemporary strategies aimed at safeguarding pregnant women, fetuses, and children in early childhood against vaccine-preventable diseases. The profound physiological and immunological adaptations inherent to gestation heighten maternal susceptibility to infectious morbidity, while several pathogens, including influenza, pertussis, COVID-19, rubella, and respiratory syncytial virus (RSV), pose significant risks of adverse maternal, fetal, and neonatal outcomes. Although an extensive body of evidence attests to the safety and effectiveness of maternal vaccines, global uptake among pregnant people remains markedly uneven and, in many settings, critically suboptimal. A nuanced understanding of national and international immunization programs, along with their structural and sociocultural challenges, is imperative to strengthen perinatal health protection. This narrative review synthesizes evidence drawn from peer-reviewed scientific literature, global health agency publications, and official national immunization guidelines. Extracted data were complemented by analyses of the immunological landscape of pregnancy, current vaccine recommendations, established safety profiles, and maternal immunization schedules across high-, middle-, and low-income countries. Particular emphasis was placed on the vaccines most consistently recommended during pregnancy, namely influenza, Tdap, COVID-19, and RSV, as well as on contextual determinants influencing vaccine hesitancy, access barriers, and global disparities in coverage.},
}

@article {pmid42048529,
year = {2026},
author = {Ventriglio, A and Torales, J and Castaldelli-Maia, JM and Caycho-Rodríguez, T and Hualparuca-Olivera, L and Bhugra, D},
title = {The past, present and future of Social Psychiatry.},
journal = {International review of psychiatry (Abingdon, England)},
volume = {38},
number = {1-3},
pages = {6-16},
doi = {10.1080/09540261.2025.2523454},
pmid = {42048529},
issn = {1369-1627},
mesh = {Humans ; *Community Psychiatry/trends/history ; *Social Determinants of Health ; COVID-19/psychology ; *Mental Disorders/therapy ; },
abstract = {In psychiatry, tensions have often arisen between biological and social approaches, despite their interconnection. Social psychiatry has evolved alongside changing understandings of mental health and its ties to broader social and geopolitical determinants. Global factors such as economic inequality, migration, and social exclusion are increasingly recognized as key influences on mental health outcomes. Nonetheless, challenges like stigma, lack of access, and resource limitations persist. The Biopsychosocial Model remains central to social psychiatry, offering an integrated framework that considers biological, psychological, and social dimensions. This comprehensive perspective ensures that interventions target not only symptoms but also contextual factors contributing to mental illness. The future of social psychiatry will be shaped by heightened awareness of social determinants, particularly amid global crises like war or COVID-19. Consistent application of the biopsychosocial model in clinical settings is essential. Policy advocacy focused on housing, employment, and inclusive care-alongside cultural sensitivity and the use of digital tools-will be vital. Moreover, enhancing psychiatric education and fostering interdisciplinary collaboration will be key to addressing social determinants across all levels of mental health care.},
}

Humans
*Community Psychiatry/trends/history
*Social Determinants of Health
COVID-19/psychology
*Mental Disorders/therapy

@article {pmid42048993,
year = {2026},
author = {Amiral, J and Seghatchian, J},
title = {An in-depth synthetic wrap on the immune-hemostatic axis in human disease.},
journal = {Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis},
volume = {65},
number = {3},
pages = {104441},
doi = {10.1016/j.transci.2026.104441},
pmid = {42048993},
issn = {1473-0502},
abstract = {Human defense systems (immunity, inflammation, hemostasis, fibrinolysis, and the renin-angiotensin-aldosterone system) have co-evolved to provide multilayered protection against infections, trauma, malignancies, and metabolic disturbances. In humans, these systems reach exceptional regulatory sophistication and are coordinated through integrated immunological and hemostatic mechanisms forming the frontline of defense. While highly efficient under physiological conditions, these networks can become dysregulated when challenged by overwhelming pathological stimuli. The COVID-19 pandemic exemplified these vulnerabilities, revealing profound inter-individual variability in immune activation that shaped susceptibility, disease progression, and outcomes. Similar variability extends to autoimmune disorders, cancer, and neurodegenerative diseases, where immunity and hemostasis govern detection, response, and chronicity. Artificial-intelligence models now propose an "immunological age," reflecting cumulative immune behavior and predictive disease risk. Nevertheless, pathologies may escape immune-hemostatic control and become refractory to therapy, leading to severe complications or fatal outcomes, as emphasized previously. This review synthesizes current understanding of the molecular, cellular, and systemic interplays linking immunity, inflammation, hemostasis, fibrinolysis, and RAAS. We highlight how these interdependent pathways shape disease expression across infections, autoimmunity, sepsis, malignancy, and cardiometabolic syndromes. In addition, we examine emerging laboratory biomarkers, such as NETs, Annexin A1, micro-RNAs, sACE2, and procoagulant platelets, that now provide unprecedented insights into immunothrombosis and thrombo-inflammation. By integrating mechanistic biology with diagnostic innovation, this narrative presents a unified perspective on immune-hemostatic interactions and outlines how these insights may reshape therapeutic strategies and precision medicine.},
}

@article {pmid42049130,
year = {2026},
author = {de la Mota, S and Suchet, L and van Wijk, M and Stibbs, DJ and Couto, PS and Rafiq, QA},
title = {On the road to in vivo CAR-T success: Comparing promising viral and non-viral vectors.},
journal = {Biotechnology advances},
volume = {},
number = {},
pages = {108907},
doi = {10.1016/j.biotechadv.2026.108907},
pmid = {42049130},
issn = {1873-1899},
abstract = {Chimeric antigen receptor (CAR)-T-cell therapies have demonstrated substantial efficacy in haematological malignancies, with multiple products approved for clinical use. However, broader application remains limited by severe toxicities, reduced efficacy toward solid tumours, and the high cost and complexity of ex vivo manufacturing. The autologous nature of most current therapies contributes to variable product quality, lengthy vein-to-vein times, and restricted patient access. In vivo CAR-T therapy has emerged as a potential solution, aiming to generate functional CAR-T-cells within the patient, with several platforms progressing into early Phase I clinical trials. This approach eliminates reliance on patient-derived starting material, reduces manufacturing failure rates, and offers the prospect of off-the-shelf availability at lower cost. Central to in vivo CAR-T development is selecting an appropriate gene delivery platform. Viral vectors, including lentiviral, adenoviral, and adeno-associated viral systems, have an established role in ex vivo CAR-T manufacturing and in vivo gene therapies. Non-viral vectors, such as lipid nanoparticles (LNP) and polyplexes, have garnered increasing attention due to their high packaging capacity, potential for redosing, and validation in large-scale production, as exemplified by mRNA-LNP vaccines against COVID-19. Recently, the in vivo CAR-T engineering toolbox has expanded with DNA-based LNP platforms capable of stably integrating CAR transgenes via transposon systems, fourth-generation T-cell-targeted lentiviral systems that minimise CAR display on vector particles and aberrant splicing, and emerging genome-editing technologies. This review compares viral and non-viral vectors for in vivo CAR-T therapy, evaluating their relative advantages and limitations in terms of safety, efficacy, scalability, analytical methods, regulatory implementation and commercial feasibility.},
}

@article {pmid42049507,
year = {2026},
author = {Morello, CM and Mnatzaganian, CL and Painter, NA},
title = {Emerging and Off-Label Uses Of Glucagon-Like Peptide-1 Receptor Agonists (GLP1-RA) and Dual GIP/GLP1-RAs.},
journal = {Journal of the American Board of Family Medicine : JABFM},
volume = {39},
number = {1},
pages = {},
doi = {10.3122/jabfm.2025.250158R1},
pmid = {42049507},
issn = {1558-7118},
mesh = {Humans ; *Glucagon-Like Peptide-1 Receptor Agonists ; *Diabetes Mellitus, Type 2/drug therapy ; *Off-Label Use ; *Obesity/drug therapy ; *Gastric Inhibitory Polypeptide/therapeutic use ; *Hypoglycemic Agents/therapeutic use ; },
abstract = {BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP1-RAs) and the glucagon-dependent insulinotropic polypeptide (GIP)/GLP1-RA are approved for type 2 diabetes (T2D) and obesity given their profound impact on glycemic weight management. Additional indications include reducing cardiovascular disease risk and progression of chronic kidney disease (CKD) in T2D as well as obstructive sleep apnea in patients with obesity. These enhanced effects are likely due to their pleiotropic effects, leading to decreased inflammation and other benefits. This review explored emerging evidence for uses of GLP1-RAs and GIP/GLP1-RA that have been researched but not yet approved. Clinicians may use this information to guide treatment decisions.

REVIEW PROCESS: PubMed and Embase literature searches were conducted using Medical Subject Heading terms. Studies referencing GLP1-RAs and GIP/GLP1-RA were included if they were published in approximately the last decade, included adults, and were either a randomized controlled trial, meta-analysis, or observational study. Of 319 articles reviewed, 27 met inclusion criteria.

EMERGING AND COMPELLING USES: Initial positive impacts have been noted for the following conditions: liver disease/liver transplant, CKD/kidney transplant, Alzheimer's disease, Parkinson's disease, substance use disorders, osteoarthritis, rheumatoid arthritis, psoriasis, COVID-19 virus, asthma, chronic obstructive pulmonary disorder, polycystic ovarian syndrome, and short bowel syndrome.

CONSIDERATIONS: Large randomized controlled trials may lead to approvals of these conditions and are encouraged. Safety and adverse effects of these medications must be assessed when initiating or modifying doses.

CONCLUSION: GLP1-RAs and GIP/GLP1-RA have demonstrated early benefits to several conditions beyond their current approved indications. Clinicians can use this information to determine treatment options for patients, particularly in those with T2D, cardiovascular disease, and/or obesity.},
}

Humans
*Glucagon-Like Peptide-1 Receptor Agonists
*Diabetes Mellitus, Type 2/drug therapy
*Off-Label Use
*Obesity/drug therapy
*Gastric Inhibitory Polypeptide/therapeutic use
*Hypoglycemic Agents/therapeutic use

@article {pmid38476083,
year = {2026},
author = {Abugamza, A and Kaskirbayeva, D and Charlwood, A and Nikolova, S and Martin, A},
title = {Impact of the COVID-19 pandemic on employment and inequalities: a systematic review of international evidence and critical appraisal of statistical methods.},
journal = {Perspectives in public health},
volume = {146},
number = {2},
pages = {85-94},
pmid = {38476083},
issn = {1757-9147},
mesh = {Humans ; *COVID-19/epidemiology ; *Employment/statistics & numerical data ; Socioeconomic Factors ; SARS-CoV-2 ; Pandemics ; *Health Status Disparities ; Female ; },
abstract = {AIMS: To assess the impact of the COVID-19 pandemic on individual labour market outcomes and how these vary over time and between different groups of individuals.

METHODS: Searches were conducted using Medline, Scopus and EconLit. Grey literature searches used Google Scholar and Econpapers. Study quality was assessed using the risk of bias in non-randomised studies of exposure tool (ROBINS-E), accompanied by a directed acyclic graph (DAG) to identify relevant mediators, moderators and confounders.

RESULTS: A total of 85 studies (77 peer-reviewed articles, 8 working papers) were included. The ROBINS-E showed that the overall risk of bias varied between studies from low (n = 14), moderate (n = 56) to serious (n = 15). Studies also varied in terms of outcome measures, study designs and the academic disciplines of researchers. Generally, studies using data collected before and during the pandemic showed large negative effects on employment, working hours and income. Studies that assessed moderators (e.g. by industry, occupation, age, gender, race and country of birth) indicated the pandemic has likely worsened pre-existing disparities in health and work. Generally, women, less educated, non-whites and young workers were affected the most, perhaps due to their jobs involving high levels of personal contact (e.g. hospitality, sales and entertainment) and being less amenable to remote working. The DAG highlighted methodological challenges in drawing robust inferences about COVID-19's impact on employment, including the lack of an unexposed control group.

CONCLUSIONS: The COVID-19 health crisis caused unanticipated and unprecedented changes to employment opportunities around the world, with potential long-term health consequences. Further research should investigate the longer-term impact of COVID-19, with greater attention given to low- and middle-income countries. Our study provides guidance on the design and critical appraisal of future studies.},
}

Humans
*COVID-19/epidemiology
*Employment/statistics & numerical data
Socioeconomic Factors
SARS-CoV-2
Pandemics
*Health Status Disparities
Female

@article {pmid39087388,
year = {2026},
author = {Zhang, J and Bloom, I and Westbury, LD and Bevilacqua, G and Ward, KA and Barker, M and Lawrence, W and Cooper, C and Dennison, EM},
title = {A Healthy Conversation Skills intervention to support changes to physical activity and dietary behaviours in community-dwelling older adults during the COVID-19 pandemic.},
journal = {Perspectives in public health},
volume = {146},
number = {2},
pages = {104-112},
pmid = {39087388},
issn = {1757-9147},
mesh = {Humans ; *COVID-19/epidemiology ; Female ; Male ; *Exercise/psychology ; Aged ; Aged, 80 and over ; *Independent Living ; *Diet ; SARS-CoV-2 ; *Health Behavior ; United Kingdom ; Surveys and Questionnaires ; *Health Promotion/methods ; Pandemics ; },
abstract = {AIMS: Physical activity (PA) and nutrition are important determinants of health in late adulthood. However, low levels of PA and poor nutrition are common in older adults and have become more prevalent during the COVID-19 pandemic. We hypothesised that Healthy Conversation Skills could be used to support health behaviour changes beneficial for health in older adults and thus conducted a study nested within the UK Hertfordshire Cohort Study.

METHODS: Between November 2019 and March 2020, 176 participants were visited at home. A trained researcher administered a questionnaire and undertook anthropometric and physical performance tests. A total of 89 participants were randomised to the control group and received a healthy living leaflet; 87 participants in the intervention group were interviewed using Healthy Conversation Skills at the initial visit with follow-up telephone calls at 1, 3, 6 and 9 months. Follow-up at 1 year by postal questionnaire assessed change in PA and diet. In total, 155 participants (79 control and 76 intervention) completed the baseline and 1-year follow-up.

RESULTS: At baseline, median (lower quartile, upper quartile) age (years) was 83.1 (81.5, 85.5) and median PA time (min/day) from walking, cycling and sports was 30.0 (15.0, 60.0). In total, 95% of participants completed the intervention; the total response rate for postal questionnaires was 94%. There were no statistically significant differences in outcomes between the trial arms. In women, there was a tendency for greater increases in diet quality in the intervention group compared to the control group (p = 0.075), while among men, there was a tendency for reduced decline in self-reported physical function in the intervention group compared to the control group (p = 0.081).

CONCLUSION: We have shown that it is viable to utilise Healthy Conversation Skills via telephone to promote healthier lifestyles in older adults. Larger appropriately powered studies to determine the efficacy of such an intervention are now warranted.},
}

Humans
*COVID-19/epidemiology
Female
Male
*Exercise/psychology
Aged
Aged, 80 and over
*Independent Living
*Diet
SARS-CoV-2
*Health Behavior
United Kingdom
Surveys and Questionnaires
*Health Promotion/methods
Pandemics

@article {pmid39899304,
year = {2025},
author = {Hanlon, P and Butterly, E and Wei, L and Wightman, H and Almazam, SAM and Alsallumi, K and Crowther, J and McChrystal, R and Rennison, H and Hughes, K and Lewsey, J and Lindsay, R and McGurnaghan, S and Petrie, J and Tomlinson, LA and Wild, S and Adler, A and Sattar, N and Phillippo, DM and Dias, S and Welton, NJ and McAllister, DA},
title = {Age and Sex Differences in Efficacy of Treatments for Type 2 Diabetes: A Network Meta-Analysis.},
journal = {JAMA},
volume = {333},
number = {12},
pages = {1062-1073},
pmid = {39899304},
issn = {1538-3598},
support = {MR/W016648/1/MRC_/Medical Research Council/United Kingdom ; },
mesh = {Aged ; Female ; Humans ; Male ; Middle Aged ; Age Factors ; Cardiovascular Diseases/epidemiology/etiology/prevention & control ; *Diabetes Mellitus, Type 2/blood/complications/drug therapy ; *Dipeptidyl-Peptidase IV Inhibitors/administration & dosage/adverse effects ; *Glucagon-Like Peptide-1 Receptor Agonists/administration & dosage/adverse effects ; Glycated Hemoglobin/analysis ; Randomized Controlled Trials as Topic ; Sex Factors ; *Sodium-Glucose Transporter 2 Inhibitors/administration & dosage/adverse effects ; Treatment Outcome ; Glycemic Control/adverse effects/methods/statistics & numerical data ; Adult ; Aged, 80 and over ; Drug Therapy, Combination/adverse effects/methods ; Incidence ; },
abstract = {IMPORTANCE: Sodium-glucose cotransporter 2 (SGLT2) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and dipeptidyl peptidase 4 (DPP4) inhibitors improve hyperglycemia, and SGLT2 inhibitors and GLP-1 receptor agonists reduce the risk of major adverse cardiovascular events (MACEs) among individuals with type 2 diabetes. It is not clear whether efficacy varies by age or sex.

OBJECTIVE: To assess whether age or sex are associated with differences in the efficacy of SGLT2 inhibitors, GLP-1 receptor agonists, and DPP4 inhibitors.

The MEDLINE and Embase databases and US and Chinese clinical trial registries were searched for articles published from inception to November 2022; in August 2024, the search was updated to capture the trial results. Two reviewers screened for randomized clinical trials of SGLT2 inhibitors, GLP-1 receptor agonists, or DPP4 inhibitors vs a placebo or active comparator in adults with type 2 diabetes.

DATA EXTRACTION AND SYNTHESIS: Individual participant data and aggregate data were used to estimate age × treatment interactions and sex × treatment interactions in multilevel network meta-regression models.

MAIN OUTCOME AND MEASURES: Hemoglobin A1c (HbA1c) and MACEs.

RESULTS: Of the 601 eligible trials identified (592 trials with 309 503 participants reported HbA1c; mean age, 58.9 [SD, 10.8] years; 42.3% were female and 23 trials with 168 489 participants reported MACEs; mean age, 64.0 [SD, 8.6] years; 35.3% were female), individual participant data were obtained for 103 trials (103 reported HbA1c and 6 reported MACEs). The use of SGLT2 inhibitors (vs placebo) was associated with less HbA1c lowering with increasing age for monotherapy (absolute reduction [AR], 0.24% [95% credible interval {CrI},
0.10% to 0.38%] per 30-year increment in age), for dual therapy (AR, 0.17% [95% CrI, 0.10% to 0.24%]), and for triple therapy (AR, 0.25% [95% CrI, 0.20% to 0.30%]). The use of GLP-1 receptor agonists was associated with greater HbA1c lowering with increasing age for monotherapy (AR, -0.18% [95% CrI, -0.31% to -0.05%] per 30-year increment in age) and for dual therapy (AR, -0.24% [95% CrI, -0.40% to -0.07%]), but not for triple therapy (AR, 0.04% [95% CrI, -0.02% to 0.11%]). The use of DPP4 inhibitors was associated with slightly better HbA1c lowering in older people for dual therapy (AR, -0.09% [95% CrI, -0.15% to -0.03%] per 30-year increment in age), but not for monotherapy (AR, -0.08% [95% CrI, -0.18% to 0.01%]) or triple therapy (AR, -0.01% [95% CrI, -0.06% to 0.05%]). The relative reduction in MACEs with use of SGLT2 inhibitors was greater in older vs younger participants per 30-year increment in age (hazard ratio, 0.76 [95% CrI, 0.62 to 0.93]), and the relative reduction in MACEs with use of GLP-1 receptor agonists was less in older vs younger participants (hazard ratio, 1.47 [95% CrI, 1.07 to 2.02]). There was no consistent evidence for sex × treatment interactions with use of SGLT2 inhibitors and GLP-1 receptor agonists.

CONCLUSIONS AND RELEVANCE: The SGLT2 inhibitors and GLP-1 receptor agonists were associated with lower risk of MACEs. Analysis of age × treatment interactions suggested that SGLT2 inhibitors were more cardioprotective in older than in younger people despite smaller reductions in HbA1c; GLP-1 receptor agonists were more cardioprotective in younger people.},
}

Aged
Female
Humans
Male
Middle Aged
Age Factors
Cardiovascular Diseases/epidemiology/etiology/prevention & control
*Diabetes Mellitus, Type 2/blood/complications/drug therapy
*Dipeptidyl-Peptidase IV Inhibitors/administration & dosage/adverse effects
*Glucagon-Like Peptide-1 Receptor Agonists/administration & dosage/adverse effects
Glycated Hemoglobin/analysis
Randomized Controlled Trials as Topic
Sex Factors
*Sodium-Glucose Transporter 2 Inhibitors/administration & dosage/adverse effects
Treatment Outcome
Glycemic Control/adverse effects/methods/statistics & numerical data
Adult
Aged, 80 and over
Drug Therapy, Combination/adverse effects/methods
Incidence

@article {pmid40720955,
year = {2026},
author = {Miglani, A and Manchanda, RK and Rutten, L},
title = {Prognostic Factor Research in Homeopathy: Overview of the Method, with Insights from Condition-Confined Studies.},
journal = {Homeopathy : the journal of the Faculty of Homeopathy},
volume = {115},
number = {2},
pages = {60-70},
doi = {10.1055/a-2562-8734},
pmid = {40720955},
issn = {1476-4245},
mesh = {Humans ; *Homeopathy/methods ; *COVID-19/therapy ; Prognosis ; SARS-CoV-2 ; Research Design ; },
abstract = {BACKGROUND: A prognostic factor (PF) refers to any feature of a disease or a characteristic of a patient that can be used to predict the likely outcome or course of a disease in an individual. Prognostic factor research (PFR), which is relatively new in homeopathy, focuses on investigating PFs and helps in therapeutic decision-making. The main challenge is the large number of eligible symptoms, but these can be reduced by condition-confined assessment, in which PFR is restricted to sub-populations of patients suffering from the same disease or condition. Condition-confined PFR (CC-PFR) identifies useful medicines for a given disease and compares with great precision different medicines regarding their relationship with common symptoms.

OBJECTIVE: To overview PFR and the findings from CC-PFR studies in homeopathy to date.

METHODS: A review of PFR, followed by a summary of six CC-PFR studies in homeopathy for coronavirus disease 2019 (COVID-19) was performed, outlining the methods, the challenges, the interpretation of outcomes and the lessons learned from each of the six studies in considering the further development of this model.

FINDINGS: The six CC-PFR studies during COVID-19 identified PFs for the 10 most frequently used medicines: Bry, Ars, Puls, Gels, Bell, Hep, Nux-v, Phos, Puls and Rhus-t. These PFs usually contain common symptoms, which in combination become 'specific' enough to select a medicine. These PFs or symptoms also helped to differentiate between these 10 medicines. This model was reproducible and the outcomes were verifiable in the subsequent waves of COVID-19. The outcomes of CC-PFR studies were mostly generalisable and resulted in the preparation of a mini-repertory and repertorisation app. However, these studies revealed key issues. The main problems were the reliability of observations, identification of biases and assessing causality. The quality of PFR data depends on the scientific skills of practitioners, who are typically not trained researchers. Thus, they require additional training in data collection, methods, management of bias and causal analysis.

CONCLUSION: CC-PFR improves the reliable use of common symptoms and thus reduces the inappropriate use of peculiar symptoms based on confirmation bias. CC-PFR studies may be helpful in diseases where rare and peculiar symptoms are difficult to find, for example in one-sided ailments, and in epidemic diseases. PFR, however, requires reliable observations by the participating practitioners. Hence, training and encouragement of clinicians is needed to develop the existing data and integrate research into everyday clinical practice.},
}

Humans
*Homeopathy/methods
*COVID-19/therapy
Prognosis
SARS-CoV-2
Research Design

@article {pmid41744170,
year = {2026},
author = {Domnich, A and Pariani, E},
title = {Beyond the laboratory: how COVID-19 reshaped specimen collection, testing workflows, and diagnostic algorithms.},
journal = {Expert review of molecular diagnostics},
volume = {26},
number = {2},
pages = {127-139},
doi = {10.1080/14737159.2026.2638743},
pmid = {41744170},
issn = {1744-8352},
mesh = {Humans ; *COVID-19/diagnosis/virology/epidemiology ; *Specimen Handling/methods ; SARS-CoV-2/isolation & purification ; Algorithms ; Workflow ; *COVID-19 Testing/methods ; Pandemics ; },
abstract = {INTRODUCTION: The SARS-CoV-2 pandemic forced a radical expansion of essential public health laboratory services that went beyond basic testing. This perspective highlights key shifts in laboratory function, specifically toward decentralized testing, self-sampling, less invasive specimen types, point-of-care devices, and novel surveillance strategies.

AREAS COVERED: The surge in testing demand favored decentralized solutions, including rapid lateral flow tests, due to their flexibility, speed, and affordability. However, several challenges arose from the variable diagnostic accuracy of rapid self-tests and alternative specimen types when compared to reference laboratory-based molecular assays using nasopharyngeal swabs. For instance, the use of self-collected saliva, which is often preferred by patients, was hindered by a lack of internationally standardized processing protocols. A post-pandemic rebound in the circulation of respiratory pathogens other than SARS-CoV-2 was likely driven by both immunity debt and increased testing, including of less severe cases, commonly performed through more costly multiplex respiratory panels.

EXPERT OPINION: Moving forward, while over-the-counter self-tests for common respiratory viruses are now common, stricter regulatory oversight and improved data connectivity are essential. Local decision-makers must weigh the trade-offs between broad testing access and clinical performance, and implement robust diagnostic stewardship programs for acute respiratory infections.},
}

Humans
*COVID-19/diagnosis/virology/epidemiology
*Specimen Handling/methods
SARS-CoV-2/isolation & purification
Algorithms
Workflow
*COVID-19 Testing/methods
Pandemics

@article {pmid42038565,
year = {2026},
author = {Baldo, KAT and King, RAN and San Juan, FGF and Dungog, CC and Solidum, JGN and Ceriales, JA and Dela Cruz, MCP and Ho, FDV and Picart, N and Plantado, ANR and Perez, J and Garcia, JP and Lapeña, JFF and Paz-Pacheco, E and Tantengco, OAG},
title = {Epidemiology, Diagnosis, and Management of Thyroid Cancer in the Philippines.},
journal = {Indian journal of surgical oncology},
volume = {17},
number = {3},
pages = {484-498},
pmid = {42038565},
issn = {0975-7651},
abstract = {Thyroid cancer incidence is rising in the Philippines, warranting attention due to unique risk factors and growing economic implications. This review examines the epidemiological trends, diagnosis, treatment, impact of COVID-19, and economic burden associated with thyroid cancer in the Philippines. We conducted a literature search in Scopus and HERDIN to synthesize the existing data on the epidemiology, diagnosis, and management of thyroid cancer in the Philippines. Filipinos exhibit a higher prevalence of BRAFV600E mutations, and thyroid cancer is more common among females and older individuals. Diagnostic procedures include risk assessment, family history evaluation, neck examination, hormone tests, neck ultrasonograms, thyroid scans, and biopsies guided by the Bethesda System. Treatment primarily involves surgery, which is determined by risk classification and disease extent. Total or near-total thyroidectomy is recommended for most cases, followed by postoperative management tailored to individual patient factors. Anaplastic thyroid cancer may require multimodal approaches. The COVID-19 pandemic disrupted healthcare access, leading to delays in thyroid cancer treatment and challenges in monitoring, prompting the adoption of telemedicine. However, the pandemic's psychological impact on thyroid cancer survivors is concerning. The economic burden remains substantial despite health insurance programs. In conclusion, thyroid cancer in the Philippines necessitates enhanced prevention, early detection, determination of risk factors, risk stratification, and treatment strategies. The COVID-19 pandemic emphasized the need for adaptable healthcare systems. This study summarized the epidemiology, diagnosis, and management of thyroid cancer in the Philippines. Implementation of existing policies and further research on the Filipino population is vital to address this growing health concern and ensure improved outcomes for thyroid cancer patients.},
}

@article {pmid42038922,
year = {2025},
author = {Kiran, MA and Saeed, S and Bin Nafisah, A and Alqarni, A and Alotaibi, AH and Alqahtan, AS and Aljadaan, H and Osayl, HB and Alsane, M and Alsuhail, N and Alrawaf, N and Albalawi, RS and Alanazi, SA and Aloufi, R},
title = {Impact of The COVID-19 Pandemic on Salivary Gland-related Healthcare Interventions; A Systematic Review And Meta-analysis :.},
journal = {Galen medical journal},
volume = {14},
number = {},
pages = {e3970},
pmid = {42038922},
issn = {2322-2379},
abstract = {BACKGROUND: The emergence of SARS-CoV-2 variants has raised concerns regarding their potential impact on perioperative outcomes. Its effect on patients undergoing surgery for salivary gland diseases remains unclear. This systematic review and meta-analysis aimed to evaluate the impact of the COVID-19 pandemic on salivary gland-related healthcare interventions, including cancer treatments, sialendoscopy procedures, and parotid surgery outcomes.

MATERIALS AND METHODS: Following PRISMA guidelines, a systematic search was conducted in PubMed, Embase, and Web of Science (2019-2025) for studies reporting pre- and during-COVID data. Two reviewers independently screened records, extracted data, and assessed risk of bias using the Newcastle-Ottawa Scale. A random-effects meta-analysis was performed to pool odds ratios (ORs) for intervention outcomes.

RESULTS: Four studies (n=7,740 participants) were included. The pooled OR for salivary gland interventions during versus pre-COVID was 1.08 (95% CI: 0.88-1.33, P=0.45), indicating no significant change, with moderate heterogeneity (I²=46%). Subgroup analyses revealed increased odds of wound dehiscence post-parotid surgery (OR=4.40, 95% CI: 1.18-16.40) but no significant differences in delayed cancer diagnosis or urgent sialendoscopy.

CONCLUSION: The COVID-19 pandemic did not significantly alter overall salivary gland intervention rates or adverse events, though some procedural complications increased non-significantly. Limited evidence underscores the need for larger, standardized studies. While this shows that surgeons maintained quality of practice in this era during the COVID-19.},
}

@article {pmid42039182,
year = {2026},
author = {Lap, CR and van Houten, M and Bogaert, D and Biesbroek, G},
title = {A perfect storm: the immunological and pathophysiological landscape of pediatric post-COVID-19 condition.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1794596},
pmid = {42039182},
issn = {1664-3224},
mesh = {Humans ; *COVID-19/immunology/complications/virology/epidemiology ; *SARS-CoV-2/immunology ; Child ; Gastrointestinal Microbiome/immunology ; Dysbiosis/immunology ; Adolescent ; Immunity, Innate ; Post-Acute COVID-19 Syndrome ; },
abstract = {Pediatric Post-COVID Condition (PPCC) represents a significant and complex long-term sequela of SARS-CoV-2 infection, affecting a subset of children and adolescents even after mild acute disease. While acute COVID-19 is generally milder in children due to a more robust innate immune response, the mechanisms driving the persistence of symptoms in PPCC remain incompletely understood and likely multifactorial. This narrative review synthesizes current epidemiological data and explores the "perfect storm" of immunological and pathophysiological alterations underpinning the condition. We examine critical hypotheses including a dysregulated immune response characterized by altered T-cell subsets, monocyte activation, and autoantibody production. We discuss the potential role of persistent SARS-CoV-2 viral reservoirs in "sanctuary sites" like the gastrointestinal tract and the reactivation of latent viruses such as Epstein-Barr virus (EBV). Furthermore, the review details downstream pathogenic pathways, including vascular endothelial inflammation (thrombo-inflammation), neuroinflammation, and metabolic dysfunctions affecting the mitochondria and tryptophan-kynurenine pathway. Finally, we address the role of microbiome dysbiosis in perpetuating systemic inflammation and the gut-lung axis dysfunction. Given the heterogeneity of clinical presentations, we conclude that PPCC is likely a syndrome of overlapping biological phenotypes. Future research must prioritize identifying these specific biological endotypes to develop targeted diagnostic and therapeutic strategies for the pediatric population.},
}

Humans
*COVID-19/immunology/complications/virology/epidemiology
*SARS-CoV-2/immunology
Child
Gastrointestinal Microbiome/immunology
Dysbiosis/immunology
Adolescent
Immunity, Innate
Post-Acute COVID-19 Syndrome

@article {pmid42040795,
year = {2022},
author = {Najafi Kashkooli, A and Jooya, P and Navari, F and Gorjizadeh, N and Poudineh, M and Pouralimohamadi, N and Asadian, A and Sabet, H},
title = {Digestive System Involvement During Coronavirus Disease 2019; the Newest Clinical Features and Potential Mechanisms : Digestive System Involvements and COVID-19.},
journal = {Galen medical journal},
volume = {11},
number = {},
pages = {e2569},
pmid = {42040795},
issn = {2322-2379},
abstract = {The coronavirus disease 2019 (COVID-19), which is caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has been recognized as a worldwide pandemic and mostly affects the respiratory system. A considerable proportion of patients; however, might also experience gastrointestinal (GI) manifestations. Several investigations have assessed GI and hepatic involvement in this disease, although the mechanisms of these involvements in relation to the progression of COVID-19 remain unclear. This review summarized the clinical observations and the main mechanisms behind GI, liver, and pancreatic involvement among COVID-19 patients.},
}

@article {pmid42040796,
year = {2022},
author = {Bagheri Lankarani, K and Akbari, M and Homayounfar, R and Tabrizi, R and Vali, M and Zakeri, MR and Farjam, M and Khodadost, M and Ahmadizar, F},
title = {Therapeutic Efficacy of Melatonin in Patients with Coronavirus 2019: A Systematic Review and Meta-Analysis of Randomized Controlled Trials : Melatonin in COVID-19 Patients.},
journal = {Galen medical journal},
volume = {11},
number = {},
pages = {e2562},
pmid = {42040796},
issn = {2322-2379},
abstract = {The efficacy of melatonin in the treatment of patients with coronavirus 2019 (COVID-19) is controversial. This review has summarized the evidence on the efficacy of oral melatonin compared to placebo in patients with mild to moderate COVID-19 infection. We searched four international online databases and all randomized clinical trials (RCTs) that investigated the effects of melatonin compared with the placebo on clinical outcomes, including mortality, discharge time, O2 saturation (SaO2), and c-reactive protein (CRP) levels in patients with COVID-19 infection, were included. The standard random-effects model with hybrid continuity correction was used to pool the risk ratio (RR), weighted mean difference (WMD), and the I2 index to assess the heterogeneity. A total of 272 patients from five RCTs were included. Our meta-analysis showed melatonin compared to placebo, decreased discharge time (WMD=-0.93 days; 95% confidence interval [CI]:-2.94 to 1.07, P=0.36; I2=56.78%) and the risk of mortality (RR=0.72; 95% CI:0.25 to 2.13, P=0.56; I2=0.0%) in COVID-19 patients. Melatonin intake compared to placebo significantly increased SaO2 (WMD=1.38%; 95% CI:0.09 to 2.68, P=0.04; I2=49.82%) and decreased the CRP levels (WMD=-7.24 mg/l; 95% CI:-11.28 to -3.21, P0.001) in a sensitivity analysis. Our findings showed the efficacy of melatonin compared to placebo in patients with mild to moderate COVID-19 infection.},
}

@article {pmid42041273,
year = {2026},
author = {Silveira, JM and Nakaishi, APM and da Silva, MG and Dos Santos, DO and Gastaldi, AC},
title = {Effects of Exercise-Based Pulmonary Rehabilitation in Patients with Long COVID: A Systematic Review and Meta-Analysis.},
journal = {Advances in respiratory medicine},
volume = {94},
number = {2},
pages = {},
doi = {10.3390/arm94020025},
pmid = {42041273},
issn = {2543-6031},
mesh = {Humans ; *COVID-19/rehabilitation/complications/physiopathology ; *Exercise Therapy/methods ; Quality of Life ; Exercise Tolerance ; SARS-CoV-2 ; Randomized Controlled Trials as Topic ; },
abstract = {Background/Objective: A substantial proportion of infected individuals develop persistent symptoms after the acute phase of COVID-19, regardless of initial disease severity. Long COVID (LC) remains a public health challenge characterized by impaired functional exercise capacity (FEC) and quality of life (QoL). We systematically synthesized evidence on the effects of in-person outpatient pulmonary rehabilitation (OPR) with individualized and supervised exercise in adults with LC. Methods: Following PROSPERO (CRD42023389365), this study reviewed randomized controlled trials (RCTs) and observational cohort studies (OCSs) published between November 2019 and January 2026 in MEDLINE/PubMed, Web of Science, PEDro, and EMBASE. Results: Fifteen studies (n = 803) were included. OPR improved FEC (6MWT; MD: 53.72 m, 95% CI 43.69-63.75) and 30″SST (MD: 4.68, 95% CI 3.59-5.77) and reduced exertional dyspnea. RCTs showed benefits in physical (MD: 8.04, 95% CI 3.02-13.05) and mental QoL (MD: 6.60, 95% CI 2.01-11.18) and dyspnea impact, with inconsistent PF findings. Fatigue showed a trend toward improvement but was measured using heterogeneous patient-reported tools in RCTs and OCSs. Conclusions: Supervised PR improves FEC, QoL, and dyspnea in individuals with LC. In patients with fatigue/PEM, systematic assessment and continuous symptom monitoring are essential. High-quality controlled studies are needed to strengthen evidence and clinical guide.},
}

Humans
*COVID-19/rehabilitation/complications/physiopathology
*Exercise Therapy/methods
Quality of Life
Exercise Tolerance
SARS-CoV-2
Randomized Controlled Trials as Topic

@article {pmid42041392,
year = {2026},
author = {Markwitz, M and Welc, N and Kępińska, K and Bowszyc-Dmochowska, M and Dmochowski, M},
title = {Non-COVID-19 Vaccinations and the Induction of Autoantibodies in Pemphigus Diseases: A Review of the Speculative Issue and Our Clinical-Laboratory Experience.},
journal = {Antibodies (Basel, Switzerland)},
volume = {15},
number = {2},
pages = {},
doi = {10.3390/antib15020033},
pmid = {42041392},
issn = {2073-4468},
abstract = {Background: Pemphigus diseases are rare autoimmune blistering disorders mediated by pathogenic autoantibodies directed mainly against desmoglein 1 and desmoglein 3. Although most cases are considered idiopathic, external triggers that can disrupt immune tolerance have been described. Vaccination has been discussed as a potential precipitating factor in autoimmune skin diseases. However, the relationship between vaccination and the induction of pemphigus-related autoantibodies has not been comprehensively summarized. Methods: We conducted a narrative review of all available studies published in the last 25 years identified through medical databases, excluding studies on COVID-19 vaccinations. Reports describing either new-onset pemphigus or exacerbation of preexisting pemphigus with a temporal association to vaccination were included. Clinical characteristics, vaccine type, latency period, direct immunofluorescence findings, and ELISA results for desmoglein autoantibodies were analyzed. In addition, we present our own clinical-laboratory experience illustrating this issue. Results: The current evidence consists predominantly of case reports and small case series. Published cases describe pemphigus vulgaris and pemphigus foliaceus occurring after vaccinations against influenza, hepatitis B, tetanus, diphtheria, pertussis, rabies, and other routinely administered immunizations. The latency period most often ranged from several days to a few weeks. Immunopathological findings were consistent with classical pemphigus diseases, including intercellular IgG deposits in the epidermis and circulating autoantibodies against desmoglein 1 and/or desmoglein 3. Our patient was a 78-year-old woman who developed cutaneous form of pemphigus vulgaris, diagnosed with direct immunofluorescence (DIF) and multiplex ELISA, 10 days after diphtheria-tetanus-pertussis vaccination. The patient had a positive family history of autoimmune blistering disease, namely mucous membrane pemphigoid. Conclusions: Based on the currently available evidence, a direct causal relationship between vaccination and pemphigus diseases cannot be established. Nevertheless, accumulated clinical and serological observations suggest that vaccination may act as a triggering factor in genetically or immunologically predisposed individuals, possibly by amplifying pre-existing subclinical autoreactive immune responses. Further population-based and mechanistic studies are required to clarify this association, while the overall benefits of vaccination remain substantial.},
}

@article {pmid42041609,
year = {2026},
author = {Breaux, AM and Miller, GR and Cooper, HD and Bembenick, KN and Reddy, A and Ahmadzadeh, S and Shekoohi, S and Kaye, AD},
title = {Critical Care Sedation: Emerging Clinical Considerations and Risks of Volatile Anesthetics for Sedation: A Narrative Review.},
journal = {Diseases (Basel, Switzerland)},
volume = {14},
number = {4},
pages = {},
doi = {10.3390/diseases14040117},
pmid = {42041609},
issn = {2079-9721},
abstract = {Volatile anesthetics have steadily become more popular in intensive care units for sedation for reasons related to their beneficial pharmacokinetic and pharmacodynamic properties. Common anesthetics such as isoflurane and sevoflurane rapidly reach sedative levels in the body, but they are also rapidly eliminated, allowing for quick recovery. These agents have minimal impact on the liver and kidneys, which makes them attractive options when compared to other agents including opioids, benzodiazepines, ketamine, and propofol. Use of delivery systems like AnaConDa[®] (Anaesthetic Conserving Device; Sedana Medical AB, Danderyd, Sweden) has enabled providers to easily use these agents in the Intensive Care Unit (ICU). In this regard, they have recently provided additional beneficial consideration during intravenous drug shortages seen during the COVID-19 pandemic and at other times. These agents have shown organ-protective effects in the kidneys and lungs, which may even reduce the total time spent in the ICU. Pharmacodynamically, these anesthetics mediate their effects through central nervous system ion channels to exert analgesic and anxiolytic actions, thereby minimizing effects in the kidneys and lungs. These agents are primarily eliminated via exhalation, which makes them potential options for those with liver or kidney failure. This narrative review examines current efficacy and risks of using volatile anesthetics for sedation in the ICU setting and clinical roles for the future.},
}

@article {pmid42041712,
year = {2026},
author = {Vo, AH and Libmann, M and Carson, D and Wang, K and Puri, S and Butowski, N and Winters-Stone, K},
title = {A Scoping Review of Exercise Oncology in the Primary Brain Tumor Patient-Caregiver Dyad.},
journal = {Current oncology (Toronto, Ont.)},
volume = {33},
number = {4},
pages = {},
doi = {10.3390/curroncol33040193},
pmid = {42041712},
issn = {1718-7729},
mesh = {Humans ; *Brain Neoplasms/therapy/psychology ; *Caregivers/psychology ; *Exercise Therapy/methods ; *Exercise ; Quality of Life ; },
abstract = {BACKGROUND: Primary malignant brain tumors (PBT) impose substantial burdens on patients and caregivers. Caregivers are essential in the delivery of outpatient care for patients with PBT but experience high levels of fatigue, distress, and health decline. Although exercise is known to improve outcomes in cancer patients, interventions tailored specifically to the PBT patient-caregiver dyad remain limited. Dyadic intervention, as well as exercise oncology, are emerging areas of active research in neuro-oncology. This scoping review incorporates both principles to evaluate the existing literature on exercise interventions on primary brain tumor patient-caregiver dyads.

METHODS: We conducted a comprehensive search of MEDLINE (PubMed), Embase, CINAHL (EBSCO), Rehabilitation & Sports Medicine (EBSCO), and Cochrane Central (Ovid) in December 2025 for studies involving exercise interventions that included adult PBT patients and caregivers.

RESULTS: Of the 1126 records screened, eight studies were included: four yoga-based interventions (three feasibility trials and one ongoing multicenter RCT), one pilot ski-based intervention, and three aerobic and resistance training-based interventions (two qualitative and one ongoing trial). The interventions were safe and feasible, with high adherence and retention. The preliminary reported benefits included improvements in fatigue, sleep, quality of life, and caregiver distress for the dyads. Videoconference delivery was effective, particularly during the COVID-19 pandemic. The eight included studies comprised 5-67 dyads, with four being single-arm feasibility studies.

CONCLUSIONS: Current literature on dyadic exercise intervention in neuro-oncology consists primarily of small-scale feasibility and pilot studies. Initial findings have demonstrated that such interventions are safe. However, preliminary efficacy remains limited due to the risk of bias and lack of statistical power. Larger randomized clinical trials with objective endpoints are needed to define efficacy and guide evidence-based protocols.},
}

Humans
*Brain Neoplasms/therapy/psychology
*Caregivers/psychology
*Exercise Therapy/methods
*Exercise
Quality of Life

@article {pmid42041941,
year = {2026},
author = {Ramos-Nino, ME},
title = {Triple Latency as a Driver of Chronic Inflammation: An Integrative View of HSV, EBV, and CMV Persistence in Immunocompetent Hosts.},
journal = {Clinics and practice},
volume = {16},
number = {4},
pages = {},
doi = {10.3390/clinpract16040064},
pmid = {42041941},
issn = {2039-7275},
abstract = {Background: Herpes simplex virus (HSV), Epstein-Barr virus (EBV), and cytomegalovirus (CMV) establish lifelong latency in sensory neurons, lymphoid tissue, and myeloid-endothelial cells, respectively. A substantial proportion of adults worldwide are infected with all three viruses and may experience concurrent herpesvirus latency, yet they have largely been studied independently. This review examined whether latent and intermittently reactivating herpesviruses share overlapping inflammatory signatures and whether their combined presence contributes to chronic inflammatory burden. Methods: A narrative integrative review was conducted using MEDLINE, Embase, and Google Scholar (inception-October 2025). Evidence from thirty-one cohort studies and mechanistic investigations spanning virology, immunology, neurology, and clinical medicine was synthesized. Results: Herpesvirus reactivation rates ranged from 23% in general Intensive Care Unit (ICU) populations to 85% in severe COVID-19. Concurrent reactivation of multiple viruses occurred in 34-63% of critically ill patients and was associated with worse clinical outcomes. Notably, simultaneous CMV and EBV reactivation independently predicted mortality (adjusted hazard ratio, 3.17; 95% CI, 1.41-7.13). Across infections, overlapping inflammatory biomarkers, including IL-6, TNF-α, CRP, and PGE2, were consistently elevated, reflecting convergent activation of IFN and NF-κB signaling pathways. Mechanistic studies suggest cross-compartment immune priming, where CMV-driven T-cell exhaustion facilitates EBV reactivation, and viral cytokine signaling enhances HSV-associated neuroinflammation. Conclusions: HSV, EBV, and CMV triple latency may represent an underrecognized contributor to chronic inflammation in immunocompetent hosts. Understanding this multi-virus inflammatory network may inform mechanistic research, biomarker-guided risk stratification, and therapeutic strategies targeting convergent inflammatory pathways. Prospective interventional studies incorporating concurrent multi-virus monitoring are needed to clarify causal relationships.},
}

@article {pmid42041954,
year = {2026},
author = {Liu, Y and Khatchadourian, C and Sanders, L and Eweroke, Q and Warner-McCutcheon, C and Lewis, J and Santos, J and Venketaraman, V},
title = {Systematic Review: The Impact of COVID-19 Vaccination on Myocarditis Risk and Recovery.},
journal = {Clinics and practice},
volume = {16},
number = {4},
pages = {},
doi = {10.3390/clinpract16040077},
pmid = {42041954},
issn = {2039-7275},
abstract = {Background: Myocarditis is an uncommon but recognized adverse event following mRNA COVID-19 vaccination, with risk varying by age, sex, dose number, and vaccine product. Clarifying the magnitude of risk, clinical course, and recovery-relative to myocarditis following SARS-CoV-2 infection-is essential for risk-benefit assessment and public health guidance. Methods: We performed a systematic PubMed and Embase search (January 2020-December 2024) and synthesized cohort, registry, and surveillance data on myocarditis incidence and outcomes following mRNA COVID-19 vaccination. Outcomes included incidence, observed-to-expected (OE) or incidence rate (IRRs) ratios, hospitalization, and short-term recovery. Study selection followed PRISMA 2020 systematic review guidelines. Results: Myocarditis following mRNA COVID-19 vaccination was identified as a rare adverse event, most commonly occurring after the second dose and in younger male individuals. Across multiple cohort and registry-based studies, cases were generally mild and self-limited, with most patients recovering without complication. In contrast, myocarditis following SARS-CoV-2 infection was consistently associated with more severe outcomes, including higher rates of hospitalization and mortality. Conclusions: Vaccine-associated myocarditis is rare, typically mild, and self-limited, with excellent short-term recovery; vaccinated individuals also exhibit lower odds of in-hospital death and intubation. In contrast, infection-associated myocarditis is more frequent and severe. Overall, the benefit-risk profile of mRNA vaccination remains strongly favorable.},
}

@article {pmid42042039,
year = {2026},
author = {Chang, H and Wu, CS and Yeh, TY and Ko, WC},
title = {Tea Polyphenols in the COVID-19 Era: Mechanistic Insights and Translational Challenges.},
journal = {Current issues in molecular biology},
volume = {48},
number = {4},
pages = {},
doi = {10.3390/cimb48040379},
pmid = {42042039},
issn = {1467-3045},
support = {Not applicable//Renal Care Research and Health Promotion Association, New Taipei City/ ; },
abstract = {The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has driven the global COVID-19 pandemic, imposing a tremendous burden on public health. As the virus continually evolves through rapid mutations, the pandemic has transitioned into a prolonged endemic phase. Despite the development of novel drugs and vaccines, clinical outcomes remain suboptimal for vulnerable populations, including the elderly and those with comorbidities or compromised immunity. Tea polyphenols, a class of structurally diverse and bioactive nutraceuticals, may modulate viral entry, replication, and host inflammatory pathways implicated in disease progression through pleiotropic effects on viral attachment, membrane fusion, intracellular replication, and proteolytic processing. Here, we provide an updated chemo-biological perspective on the antiviral and immunomodulatory mechanisms of tea polyphenols against SARS-CoV-2. Current evidence highlights their potential to serve as promising candidates for further mechanistic and translational investigation as adjunctive strategies and nutraceuticals for COVID-19 management. Importantly, no large-scale randomized controlled trials have yet demonstrated clinical benefit of tea polyphenols in COVID-19.},
}

@article {pmid42042775,
year = {2026},
author = {Damnjanović, K and Djurov, K and Galic, M and Lisul, B and Mocanu, IV and Shukla, S and Enstone, A and Dai, L and Vrdelja, M and Batselova, H and Drăgănescu, A and Tešović, G},
title = {Vaccine Confidence and Vaccine Hesitancy in Several Countries in Southeastern Europe in Past 10 Years: A Structured Review of Published Literature.},
journal = {Vaccines},
volume = {14},
number = {4},
pages = {},
doi = {10.3390/vaccines14040299},
pmid = {42042775},
issn = {2076-393X},
support = {N/A//Merck Sharp & Dohme LLC/ ; },
abstract = {OBJECTIVES: Despite vaccination being the most effective way of preventing infections and vaccination rates recovering worldwide after the COVID-19 pandemic, vaccine hesitancy persists. Some factors, such as psychological and social barriers, can negatively impact views on vaccines and can contribute to vaccine hesitancy. The primary objective of this structured literature review is to investigate the available evidence relating to factors affecting vaccine hesitancy within several countries in Southeastern Europe.

METHODS: An electronic database search was conducted to identify studies assessing the public and healthcare professionals' (HCPs) attitudes towards vaccination in Southeastern Europe. These searches were supplemented with grey literature searches. Included studies were conducted in Bulgaria, Croatia, Romania, Serbia, and Slovenia between 1 January 2012 and 31 December 2022.

RESULTS: Of the 35 studies identified from the database searches, the most prominent theme observed across Romania, Croatia, and Bulgaria was low confidence in COVID-19 vaccines. Across all age groups, COVID-19 vaccine confidence in these regions was highly dependent on whether individuals thought vaccines were safe and effective, as well as their general trust in vaccines. Confidence in COVID-19 vaccines was seen as relatively high, with attitudes towards routine and elective vaccines being generally positive amongst the general public and HCPs, in Romania, Croatia, Serbia and Slovenia. However, uncertainty around the effectiveness of the vaccine still exists. In Bulgaria, trust in routine and elective vaccines remained low in the general public. Complacency and financial constraints were also identified as underlying causes of vaccine hesitancy.

CONCLUSIONS: The main cause behind vaccine hesitancy in several countries in Southeastern Europe is distrust in vaccine effectiveness and safety. These key findings can be utilised to support evidence-based decisions regarding where to focus resources to improve public and HCP perception of vaccines in Southeastern Europe.},
}

@article {pmid42042784,
year = {2026},
author = {Runzer-Colmenares, FM and Cahuapaza-Gutierrez, NL and Calderon-Hernandez, CC and Umeres-Bravo, MM},
title = {Effects of Respiratory Vaccines in Older Adults with Cardiovascular Diseases: A Scoping Review.},
journal = {Vaccines},
volume = {14},
number = {4},
pages = {},
doi = {10.3390/vaccines14040308},
pmid = {42042784},
issn = {2076-393X},
abstract = {Background/Objectives: Vaccination against respiratory viruses-such as respiratory syncytial virus (RSV), pneumococcal disease, influenza, and COVID-19-may reduce the risk of adverse outcomes in older adults with cardiovascular disease. This study conducted a scoping review of the effects of respiratory vaccines in older adults with cardiovascular disease. Methods: We included studies evaluating adults aged ≥ 60 years with cardiovascular disease who received different types of respiratory vaccines. Eligible designs comprised clinical trials, observational cohort studies, and other relevant studies. Editorials, commentaries, and non-original publications were excluded. A comprehensive and targeted literature search was conducted in PubMed, Scopus, EMBASE, and Web of Science from database inception through January 2026. Results: A total of 25 studies were included, encompassing 1,782,787 adults aged ≥ 60 years with cardiovascular disease who received various respiratory vaccines. RSV vaccines were associated with a lower incidence of cardiorespiratory hospitalization and stroke among vaccinated individuals. Pneumococcal vaccines showed that sequential dual vaccination strategies were associated with a lower risk of cardiovascular events. Influenza vaccination was associated with improved cardiovascular outcomes, lower mortality, and reduced adverse events. COVID-19 vaccines were associated with reductions in mortality and hospitalizations. These benefits are particularly relevant in an older population with a high burden of comorbidities; therefore, complete vaccination schedules, including booster doses, should be considered a central strategy for prevention and comprehensive management in this high-risk group. Conclusions: Vaccination against respiratory viruses in older adults with cardiovascular disease demonstrates an overall favorable/acceptable profile of efficacy and safety, with reductions in mortality, hospitalizations, and cardiovascular events, without a significant increase in serious adverse events.},
}

@article {pmid42042800,
year = {2026},
author = {Lopes de Abreu, AJ and Mpande, CAM and Song, Y and Nicholson, MW and Nannei, C and Friede, M},
title = {Unpacking the mRNA Supply Chain: Challenges and Opportunities for Global Health.},
journal = {Vaccines},
volume = {14},
number = {4},
pages = {},
doi = {10.3390/vaccines14040324},
pmid = {42042800},
issn = {2076-393X},
abstract = {The COVID-19 pandemic highlighted both the transformative potential of mRNA vaccines and the structural challenges associated with their supply chains. Unlike traditional vaccine platforms, mRNA vaccines depend on highly specialized raw materials, including plasmid DNA (pDNA), nucleotides, enzymes, and lipid nanoparticles (LNP), that are produced by a limited number of global suppliers. These dependencies, combined with platform-specific manufacturing processes and stringent cold chain requirements, introduce vulnerabilities across production, distribution, and regulatory oversight. This narrative review examines the distinctive features of mRNA vaccine supply chains and identifies key challenges and opportunities across three interconnected domains: manufacturing systems, logistics and distribution, and regulatory governance. Drawing on literature published between January 2021 and March 2026, the review synthesizes evidence on supply chain bottlenecks revealed during the COVID-19 pandemic, including upstream raw-material dependencies, limitations in manufacturing scale-up, cold chain constraints, and regulatory fragmentation. Particular attention is given to the implications of these challenges for low- and middle-income countries, where infrastructure, technical capacity, and regulatory resources may limit participation in mRNA vaccine production and deployment. The review also highlights emerging strategies to strengthen supply chain resilience, including diversification of input suppliers, development of regional manufacturing hubs, improvements in vaccine thermostability, regulatory harmonization initiatives, and the use of digital technologies for supply chain management. By integrating insights from manufacturing, logistics, and regulatory perspectives, this study contributes to a better understanding of the structural characteristics shaping mRNA vaccine supply chains and identifies priority areas for strengthening global preparedness for future health emergencies.},
}

@article {pmid42042827,
year = {2026},
author = {Aljohani, M},
title = {Seasonal Influenza Vaccine Uptake, Acceptance and Willingness to Vaccinate in Post-COVID-19 Vaccine Era Among Adult High-Risk Groups in Gulf Cooperation Council Countries (GCC): A Narrative Review of the Literature.},
journal = {Vaccines},
volume = {14},
number = {4},
pages = {},
doi = {10.3390/vaccines14040351},
pmid = {42042827},
issn = {2076-393X},
abstract = {BACKGROUND/OBJECTIVES: Reports on seasonal influenza vaccine (SIV) coverage in Gulf Cooperation Council (GCC) countries showed lower than targeted coverage among high-risk populations both before and after the COVID-19 pandemic and subsequent COVID-19 vaccine release. This narrative review aims to synthesise SIV coverage following the introduction of COVID-19 vaccines among at-risk groups in the GCC region.

METHODS: Database searches included PubMed and Google Scholar for articles assessing SIV uptake, acceptance, hesitancy, and intention to vaccinate among adults in high-risk groups in GCC countries, with data collected after the introduction of COVID-19 vaccines.

RESULTS: SIV uptake ranged from 1.8% among pregnant women to 64.1% among dialysis patients in Saudi Arabia. Healthcare workers (HCWs) demonstrated the highest overall coverage, reaching 64.5% for annual uptake in Bahrain, with 79% of HCWs in Saudi Arabia intending to vaccinate. Prevalent barriers included low risk perception and consideration of influenza as a mild disease not necessitating SIV uptake, as well as vaccine effectiveness and safety concerns. Previous vaccination, physician advice, and policy or mandates for HCWs were identified as frequent facilitators of uptake.

CONCLUSION: Suboptimal uptake was reported among most high-risk groups in GCC countries. Health Belief Model components and physician involvement appear to have a significant impact on vaccine uptake among the intended population. More emphasis should be directed toward effective risk communication and action cues methods to enhance uptake among high-risk groups. Future research is needed to cover understudied areas like the elderly aged ≥ 65 years, cancer and other high-risk groups, in addition to further studies for GCC countries other than Saudi Arabia in the post-COVID-19 vaccine period.},
}

@article {pmid42042830,
year = {2026},
author = {Bellavite, P and Di Fede, G and Mantovani, M and Zanolin, E},
title = {Autoimmune Features of Post-COVID-19 Vaccination Syndrome and Their Impacts on the Renin-Angiotensin System.},
journal = {Vaccines},
volume = {14},
number = {4},
pages = {},
doi = {10.3390/vaccines14040354},
pmid = {42042830},
issn = {2076-393X},
abstract = {One of the most critical aspects of post-acute COVID-19 syndrome (PACS) and post-acute COVID-19 vaccination syndrome (PACVS) is the presence of autoantibodies. These autoantibodies are directed against various receptors in the autonomic and cardiovascular systems, including those targeting proteins of the renin-angiotensin system (RAS). The RAS plays a central role in regulating vascular homeostasis, inflammation, and endothelial function. During SARS-CoV-2 infection, the interaction of the spike (S) protein with angiotensin-converting enzyme 2 (ACE2) can alter the balance of the RAS, favoring an imbalance towards the ACE/Angiotensin II/AT1R axis, known for its pro-inflammatory, pro-thrombotic, and vasoconstrictive properties. Similar pathological mechanisms also come into play in response to vaccinations that use the S protein as an antigen. Studies conducted by other groups and us on patients with PACS and PACVS have revealed the presence of autoantibodies directed against these RAS components and the mechanisms by which these antibodies can worsen the clinical situation. In particular, anti-ACE2, presumably formed by the anti-idiotype network or molecular mimicry, is correlated with PACVS symptoms in many patients. Furthermore, the presence of anti-MAS1 antibodies can reduce the efficiency of the ACE2/Angiotensin-(1-7)/MAS1 axis, which normally acts as a counter-regulator. Considering this evidence, an analysis of RAS molecules and the autoantibodies implicated in reactions to them may be useful for evaluating a state of persistent dysregulation associated with post-vaccination symptoms such as asthenia, headache, skin edema and bruising, cardiovascular alterations, and neurovegetative manifestations. Finally, we offer insights into diagnosing these multifaceted syndromes and working hypotheses to guide research into possible therapeutic approaches.},
}

@article {pmid42043214,
year = {2026},
author = {Natarajan, M and Jayashankar, B and Nataraj, R},
title = {Placental Vulnerability to SARS-CoV-2: Viral Entry Pathways and Immune Activation.},
journal = {Viruses},
volume = {18},
number = {4},
pages = {},
doi = {10.3390/v18040426},
pmid = {42043214},
issn = {1999-4915},
mesh = {Humans ; Pregnancy ; *COVID-19/immunology/virology/transmission ; Female ; *Placenta/virology/immunology ; *SARS-CoV-2/physiology/immunology ; *Virus Internalization ; *Pregnancy Complications, Infectious/immunology/virology ; Angiotensin-Converting Enzyme 2/metabolism ; Infectious Disease Transmission, Vertical ; Serine Endopeptidases ; },
abstract = {Pregnancy represents a distinct immunological and physiological state that modifies maternal susceptibility to SARS-CoV-2 and influences the clinical and biological course of COVID-19. Accumulating evidence indicates that the interaction between viral entry determinants, gestation-specific immune modulation, placental endocrine-angiogenic pathways, and systemic inflammatory responses underlies the characteristic manifestations of SARS-CoV-2 infection during pregnancy. This review consolidates current understanding of SARS-CoV-2 viral structure, receptor biology, and the gestational regulation of key entry cofactors, including ACE2, TMPRSS2, NRP1, CTSL and FURIN, within reproductive and placental tissues. The review further integrates documented mechanisms of cytokine-mediated immune dysregulation, endothelial injury, thrombo-inflammation, and steroidogenic alteration observed in affected pregnancies, and examines their contribution to placental malperfusion, preeclampsia-like presentations, fetal growth abnormalities and preterm birth. Published molecular and computational studies characterising trophoblast antiviral defenses, receptor expression patterns, and structural determinants of Spike-ACE2 affinity are synthesised to contextualise the biological basis of placental susceptibility and the rarity of confirmed transplacental transmission. Current evidence on maternal clinical outcomes, fetal and neonatal consequences, vaccination efficacy, therapeutic considerations and contemporary management guidelines is also critically reviewed. By integrating molecular, immunological, pathological and clinical insights, this article provides a comprehensive framework for understanding the interaction between SARS-CoV-2 infection and pregnancy-specific physiology, with implications for risk assessment, preventive strategies and maternal-fetal care.},
}

Humans
Pregnancy
*COVID-19/immunology/virology/transmission
Female
*Placenta/virology/immunology
*SARS-CoV-2/physiology/immunology
*Virus Internalization
*Pregnancy Complications, Infectious/immunology/virology
Angiotensin-Converting Enzyme 2/metabolism
Infectious Disease Transmission, Vertical
Serine Endopeptidases

@article {pmid42043241,
year = {2026},
author = {Tasker, S and Spiri, AM and Hartmann, K and Addie, DD and Belák, S and Bergmann, M and Egberink, H and Frymus, T and Hofmann-Lehmann, R and Marsilio, F and Pennisi, MG and Thiry, E and Truyen, U and Boucraut-Baralon, C and Möstl, K and Hosie, MJ},
title = {Update on Treatment of Feline Infectious Peritonitis: European Advisory Board on Cat Diseases (ABCD) Guidelines.},
journal = {Viruses},
volume = {18},
number = {4},
pages = {},
doi = {10.3390/v18040452},
pmid = {42043241},
issn = {1999-4915},
mesh = {Animals ; Cats ; *Antiviral Agents/therapeutic use/administration & dosage ; *Feline Infectious Peritonitis/drug therapy/virology ; Adenosine Monophosphate/analogs & derivatives/therapeutic use/administration & dosage ; Coronavirus, Feline/drug effects ; Alanine/analogs & derivatives/therapeutic use/administration & dosage ; Europe ; Adenosine/analogs & derivatives/therapeutic use ; Hydroxylamines/therapeutic use ; Cytidine/analogs & derivatives/therapeutic use ; Morpholines/therapeutic use ; },
abstract = {Feline infectious peritonitis (FIP) is a disease arising as a result of feline coronavirus infection. It used to be regarded a fatal disease, with euthanasia commonly recommended following diagnosis due to its very poor prognosis. The availability of effective antiviral therapies, particularly nucleoside analogues such as oral GS-441524, has fundamentally changed the outlook for cats with FIP. FIP is now a treatable and frequently curable disease. In these revised guidelines, the European Advisory Board on Cat Diseases (ABCD) presents an update on the treatment of FIP, incorporating the findings of new studies including the range of available treatments (such as GS-441524, remdesivir and molnupiravir (EIDD-2801) and its active metabolite EIDD-1931), which varies globally, as well as suggestions for monitoring and prognostic indicators. Tables are used to present easy-to-find information on antiviral and supportive treatments for cats with FIP. GS-441524 is the most extensively studied antiviral for FIP with treatment success rates often exceeding 90%. Remdesivir is primarily reserved as an injectable antiviral for severely affected cats unable to tolerate oral medication; it is usually replaced by oral medication as soon as, and when, possible. Although 84-day treatment courses have historically been used, emerging evidence suggests that shorter regimens of 42 days can be equally effective.},
}

Animals
Cats
*Antiviral Agents/therapeutic use/administration & dosage
*Feline Infectious Peritonitis/drug therapy/virology
Adenosine Monophosphate/analogs & derivatives/therapeutic use/administration & dosage
Coronavirus, Feline/drug effects
Alanine/analogs & derivatives/therapeutic use/administration & dosage
Europe
Adenosine/analogs & derivatives/therapeutic use
Hydroxylamines/therapeutic use
Cytidine/analogs & derivatives/therapeutic use
Morpholines/therapeutic use

@article {pmid42043247,
year = {2026},
author = {Mahajan, S and Mahajan, S and Kaushik, N},
title = {Integrative Insights into the Immunopathogenesis and Organ-Specific Immunological Mechanisms of Long COVID: A Narrative Review.},
journal = {Viruses},
volume = {18},
number = {4},
pages = {},
doi = {10.3390/v18040458},
pmid = {42043247},
issn = {1999-4915},
mesh = {Humans ; *COVID-19/immunology/pathology/complications/virology ; *SARS-CoV-2/immunology ; Post-Acute COVID-19 Syndrome ; Immunity, Innate ; Adaptive Immunity ; Organ Specificity ; Autoimmunity ; },
abstract = {Long COVID (LC), also referred to as post-acute sequelae of SARS-CoV-2 infection, is characterized by persistent symptoms originating 3 months following acute COVID-19, lasting for at least two months and frequently affecting individuals who initially experienced mild to moderate disease. The clinical spectrum is heterogeneous, involving respiratory, cardiovascular, neurological, renal, gastrointestinal, and endocrine systems, thereby posing substantial diagnostic and therapeutic challenges. Despite extensive investigation, the precise immunopathogenic mechanisms underlying LC remain incompletely defined. Accumulating evidence suggests that LC is driven by a multifactorial interplay of persistent viral antigen reservoirs, chronic immune activation, dysregulated innate and adaptive immune responses, autoimmunity, endothelial dysfunction, microvascular injury, and aberrant tissue repair. These systemic immune perturbations manifest variably across different organs, contributing to the diverse clinical phenotypes observed. However, mechanistic clarity is hindered by heterogeneity in study designs, limited longitudinal data, and the absence of standardized immunological profiling. This narrative review provides integrative insights into the immunopathogenesis of LC, synthesizing current evidence on systemic immune dysregulation and organ-specific immunological mechanisms. A conceptual framework is proposed to facilitate a structured understanding of this complex syndrome and to guide future research toward targeted immunomodulatory strategies.},
}

Humans
*COVID-19/immunology/pathology/complications/virology
*SARS-CoV-2/immunology
Post-Acute COVID-19 Syndrome
Immunity, Innate
Adaptive Immunity
Organ Specificity
Autoimmunity

@article {pmid42044369,
year = {2026},
author = {Banerjee, P and Holly, L},
title = {Everyday Digital Technology Use and Youth Health: Scoping Review of Longitudinal Studies.},
journal = {JMIR public health and surveillance},
volume = {12},
number = {},
pages = {e85094},
doi = {10.2196/85094},
pmid = {42044369},
issn = {2369-2960},
mesh = {Humans ; Adolescent ; Longitudinal Studies ; *Digital Technology/statistics & numerical data ; COVID-19/epidemiology ; Social Media/statistics & numerical data ; Young Adult ; *Adolescent Health/statistics & numerical data ; Child ; },
abstract = {BACKGROUND: Everyday digital technologies such as social media, gaming, and internet use are deeply integrated into the lives of children, adolescents, and young adults. While these platforms can foster connection, learning, and entertainment, concerns have grown about their potential to influence mental, physical, and social well-being. Research on this topic has expanded rapidly over the past decade, yet much of it remains cross-sectional, limiting insights into long-term outcomes. Longitudinal studies are essential to capture evolving patterns of digital engagement, identify causal relationships, and guide effective policies and interventions that support youth in navigating digital environments. In particular, evidence is needed to distinguish between beneficial and harmful forms of digital engagement, such as social connection versus problematic use, and to understand how these impacts differ across diverse populations and contexts. The COVID-19 pandemic further accelerated young people's technology use, underscoring the urgency of examining both risks and opportunities. This review, therefore, synthesizes longitudinal research to map trends, identify knowledge gaps, and inform future directions.

OBJECTIVE: The study aimed to systematically identify and map longitudinal studies examining associations between everyday digital technology use (eg, social media, gaming, and internet use) and the health and well-being of youth (25 years or younger) and to chart the types of evidence available by technology category, outcomes, and geographical setting in order to highlight key gaps for future research.

METHODS: A systematic search of PubMed, Embase, and PsycArticles (2014-2024) was conducted and reported in accordance with PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). Data extraction covered demographics, digital technology categories, and health outcomes. Studies were grouped into 6 key themes: social media use and mental health, digital addiction and behavioral outcomes, physical activity and digital technology, digital health technologies and cognitive development, parental influence and digital technology, and digital well-being and risk behaviors.

RESULTS: Of the 456 studies identified, 267 were longitudinal studies relevant to our research aims. Internet use (n=201 studies), social media (n=140 studies), and gaming (n=83 studies) dominated the themes. Mental health was the most frequently assessed outcome, with a focus on anxiety and depression. Geographically, 15% (40/267) of studies originated from low- and middle-income countries, with the majority from high-income settings such as the United States (n=76 studies) and Australia (n=15 studies). Nearly half (131/267, 49%) were published post 2020, reflecting heightened interest during the COVID-19 pandemic.

CONCLUSIONS: Longitudinal evidence on everyday digital technology use and youth health is growing but remains concentrated in mental health outcomes and high-income settings, with notable gaps in physical health, educational outcomes, and equity-focused research. These findings highlight the need for more diverse, methodologically robust longitudinal studies to inform context-sensitive policies and interventions that balance the risks and benefits of digital engagement for young people.},
}

Humans
Adolescent
Longitudinal Studies
*Digital Technology/statistics & numerical data
COVID-19/epidemiology
Social Media/statistics & numerical data
Young Adult
*Adolescent Health/statistics & numerical data
Child

@article {pmid42044651,
year = {2026},
author = {Agyemang, C and Tetteh, J and Mbaye, MN and Lamptey, R and Seidu, S and Khunti, K and Kengne, AP},
title = {Burden and determinants of diabetes in sub-Saharan Africa.},
journal = {The lancet. Diabetes & endocrinology},
volume = {},
number = {},
pages = {},
doi = {10.1016/S2213-8587(26)00065-3},
pmid = {42044651},
issn = {2213-8595},
abstract = {The prevalence of type 2 diabetes is rising rapidly across sub-Saharan Africa; however, its epidemiology, clinical phenotypes, and underlying mechanisms remain insufficiently characterised. This first paper in a Series on diabetes in sub-Saharan Africa synthesises current evidence on the burden, distribution, and determinants of diabetes, including emerging phenotypes and the roles of early life adversity, psychosocial stress, and interactions with infectious disease. We also identify major gaps in surveillance systems, research capacity, prevention, and clinical management across the region. Sub-Saharan Africa is experiencing one of the fastest global increases in diabetes, with the highest proportion of undiagnosed cases and a projected steep rise in intermediate hyperglycaemia and diabetes by 2050. Urbanisation, ageing, obesity, and lifestyle transitions are major contributors; however, a substantial proportion of type 2 diabetes occurs in lean individuals (BMI <25 kg/m[2]), particularly in rural settings, suggesting distinct metabolic and developmental pathways not captured by models derived from high-income countries. Bidirectional interactions between diabetes and malaria, tuberculosis, HIV, or COVID-19 make disease trajectories complex. Persistent gaps in surveillance, a reliance on modelled estimates, low genomic representation, and constrained access to modern diabetes medications hinder progress. Strengthening health system capacity, improving data infrastructure, and investing in regionally driven research are essential to develop effective, context-specific interventions and advance precision medicine tailored to sub-Saharan African populations.},
}

@article {pmid42045685,
year = {2026},
author = {Mehdizadeh, M and Zhang, FW and Yu, LC and Li, JH and Posso, AN and Mustoe, AK and Escobar-Domingo, MJ and Foppiani, J and Karinja, S and Lee, BT},
title = {Telemedicine in Plastic Surgery: A Systematic Review and Meta-analysis of Utilization and Outcomes Pre- and Post-pandemic.},
journal = {Aesthetic plastic surgery},
volume = {},
number = {},
pages = {},
pmid = {42045685},
issn = {1432-5241},
abstract = {BACKGROUND: Telemedicine revolutionized healthcare post-COVID-19 by expanding virtual care across consultations, post-operative care, and inter-physician collaboration. However, its impact on adoption and effectiveness in plastic surgery remains underexplored. This study systematically compares pre- and post-pandemic telemedicine in plastic surgery, focusing on outcomes, accessibility, and patient satisfaction to inform best practices.

METHODS: A systematic review was conducted using PubMed, Medline, and Web of Science, following PRISMA guidelines, for articles published through November 2024. Extracted data included author, year, country, subspecialty, pandemic classification, sample size, demographics, utilization, barriers, travel time/distance, satisfaction, complications, and appointment duration. Meta-analyses calculated pooled estimates with 95% confidence intervals. Meta-regression and Welch's t-test assessed pre- versus post-pandemic differences. Analyses were performed in R 4.4.1.

RESULTS: Of 450 identified publications, 72 met inclusion criteria, encompassing 9435 subjects (mean age: 47.99). 89.3% (95% CI 59.3-96.2%) of patients reported willingness to reuse telemedicine, and the pooled satisfaction rate was 83.9% (95% CI 79.4-88.5; p < 0.05). Meta-analysis showed significant reductions in travel time (120 min; p < 0.05) and distance (187.1 km; p < 0.05). Five studies reported a mean appointment duration of 16.07 min. Complications were rare (7.7%; 95% CI 2.9-18.6%; p < 0.05). Post-pandemic satisfaction score was lower (81.1 vs. 91.2; p = 0.0315), likely reflecting increased utilization and technological barriers. Other outcomes, including complication rates and willingness to reuse telemedicine, showed no significant difference (p > 0.05).

CONCLUSION: Telemedicine plays an evolving role in plastic surgery, reducing travel burden and maintaining safety. However, lower post-pandemic satisfaction highlights the need to improve accessibility and technology to optimize outcomes.

LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .},
}

@article {pmid41486438,
year = {2025},
author = {Seo, JW and Seo, YB and Kim, SE and Kim, Y and Kim, EJ and Kim, T and Kim, T and Lee, SH and Lee, E and Lee, J and Jeong, YH and Jung, YH and Choi, YJ and Song, JY},
title = {Clinical Practice Guideline Recommendations for Post-Acute Sequelae of COVID-19.},
journal = {Infection & chemotherapy},
volume = {57},
number = {4},
pages = {478-521},
pmid = {41486438},
issn = {2093-2340},
support = {HD22C2045//Korea Health Industry Development Institute/Republic of Korea ; },
abstract = {The guidelines presented herewith are based on the "Clinical Practice Guideline Recommendations for Post-Acute Sequelae of COVID-19 (PASC)" published in Infection & Chemotherapy in March 2024; these guidelines have been refined by incorporating the most recent Korean and international research findings and clinical evidence published since then. In the context of patients experiencing various physical and mental symptoms that persist long after the acute phase of coronavirus disease 2019 (COVID-19) infection, the diagnosis and management of PASC has emerged as a novel public health challenge. These guidelines are intended to provide standardized diagnostic and management recommendations applicable to the Korean healthcare setting and were developed through a comprehensive review of existing guidelines from organizations such as the World Health Organization, the United States National Institutes of Health, the United Kingdom National Institute for Health and Care Excellence, and the European Society of Clinical Microbiology and Infectious Diseases, along with the latest meta-analyses and Korean cohort studies. PASC is defined as the persistent presence of symptoms and signs lasting more than 3 months after COVID-19 diagnosis for which the symptoms cannot be explained by alternative diagnoses. The revised guidelines emphasize the importance of integrated management for patients with PASC, including a multidisciplinary approach considering risk groups, symptom-specific assessment, and rehabilitation and psychological interventions, based on a total of 32 key questions. This revision reflects rapidly evolving research trends regarding the long-term effects of COVID-19 and is expected to serve as an evidence-based standard guideline for future patient care, clinical research, and health policy development in Korea.},
}

@article {pmid41486819,
year = {2026},
author = {Gupta, T and Verma, JK},
title = {Critical appraisal of methodological rigor in a systematic review on post-COVID-19 vaccination-associated olfactory dysfunction.},
journal = {Rhinology},
volume = {64},
number = {2},
pages = {285-286},
doi = {10.4193/Rhin25.440},
pmid = {41486819},
issn = {0300-0729},
mesh = {Humans ; *Olfaction Disorders/etiology ; *COVID-19 Vaccines/adverse effects ; *COVID-19/prevention & control ; SARS-CoV-2 ; *Vaccination/adverse effects ; },
abstract = {We read with keen interest the article by Kawabata et al. titled "Olfactory disorder after COVID-19 vaccination" which explores 16 cases of olfactory dysfunction temporally associated with vaccination. The paper addresses an important and under-recognized topic; however, several methodological aspects warrant clarification to aid accurate interpretation. First, the inclusion of five institutional cases within a review otherwise presented as PRISMA-compliant raises questions regarding methodological consistency. Under PRISMA, all included studies should be identified through transparent and reproducible database searches. Clarifying whether institutional data were processed separately from literature-derived cases would strengthen transparency and avoid confusion about the evidence level.},
}

Humans
*Olfaction Disorders/etiology
*COVID-19 Vaccines/adverse effects
*COVID-19/prevention & control
SARS-CoV-2
*Vaccination/adverse effects

@article {pmid41487586,
year = {2025},
author = {Fan, H and Wang, L and Zhai, L and Deng, S and Li, Y and Niu, H and Zhao, B and Gao, J and Gao, X},
title = {Mapping three decades of air pollution-lung cancer research: trends, hotspots, and networks (1990-2025).},
journal = {Frontiers in oncology},
volume = {15},
number = {},
pages = {1698246},
pmid = {41487586},
issn = {2234-943X},
abstract = {BACKGROUND: The relationship between air pollution and lung cancer has attracted considerable attention from researchers worldwide. To systematically assess the scholarly landscape and pinpoint research fronts, this study employs bibliometric analysis to delineate global trends, collaborative networks, and key publications within this field.

METHODS: Publications from 1990 to 2025 were extracted from Web of Science Core Collection and Scopus databases. Bibliometric tools including VOSViewer, Citespace, and Bibliometrix R were used to examine trends, key contributors, research themes, and prominent journals.

RESULTS: Among 4,238 publications, citation rates rose significantly. China produced the most publications, with leading institutions such as Harvard University and the Chinese Academy of Sciences. Key researchers included Lan Q, Rothman N, and Vermeulen R. Major journals were Environmental Health Perspectives and Atmospheric Environment. Frequently used keywords like "Lung Cancer" and "Particulate Matter" indicate core themes, while emerging terms such as "Covid-19" and "Machine Learning" reflect evolving interests.

CONCLUSION: Fine particulate matter is an established environmental risk factor for lung cancer, and research on polycyclic aromatic hydrocarbons and asbestos remains active. The field has shifted from exposure assessment to mechanistic investigations focusing on oxidative stress, gene expression, and machine learning applications, defining key future research directions.},
}

@article {pmid41488032,
year = {2026},
author = {Suresh, RR and Abuduani, T and Kasthuri, M and Chen, Z and Tber, Z and Loubidi, M and Zhang, H and Zhou, L and Zhou, S and Li, C and Kumari, A and Tao, S and Wiseman, JM and Hurwitz, SJ and Amblard, F and Schinazi, RF},
title = {Prodrug strategies in developing antiviral nucleoside analogs.},
journal = {RSC medicinal chemistry},
volume = {17},
number = {1},
pages = {105-131},
pmid = {41488032},
issn = {2632-8682},
support = {P30 AI050409/AI/NIAID NIH HHS/United States ; },
abstract = {Prodrug strategies are used to enhance the physicochemical and pharmaceutical properties of drug candidates that may not be suitable for specific delivery or are limited by formulation options. A prodrug derivative is converted into its active pharmaceutical ingredient (drug) through enzymatic or chemical reactions within the body. Antiviral nucleoside prodrugs have garnered considerable interest in drug discovery, leading to the approval of key drugs such as remdesivir (SARS-CoV-2), Sovaldi (hepatitis C virus, HCV), and tenofovir disoproxil fumarate [hepatitis B virus (HBV) and human immunodeficiency viruses (HIV)]. Their success lies in improving the oral bioavailability and delivering the parent drug to the targeted tissues. This review focuses on the prodrugs of antiviral nucleosides evaluated in humans (approved, in development or terminated), providing an overview of the different approaches utilized and discussing their in vitro and in vivo benefits.},
}

@article {pmid41488148,
year = {2025},
author = {Shitaye, G and Getie, M and Mekonnen, Z and D'Abrosca, G and Fattorusso, R and Isernia, C and Amuamuta, A and Malgieri, G},
title = {Molecular analysis of long COVID and new-onset diabetes mellitus: pathobiological relationships and current mechanistic views.},
journal = {Frontiers in endocrinology},
volume = {16},
number = {},
pages = {1737894},
pmid = {41488148},
issn = {1664-2392},
mesh = {Humans ; *COVID-19/complications/metabolism/pathology/epidemiology ; *SARS-CoV-2 ; *Diabetes Mellitus, Type 2/epidemiology/etiology/virology/metabolism/pathology ; *Diabetes Mellitus, Type 1/epidemiology/metabolism/etiology/virology ; Renin-Angiotensin System ; Post-Acute COVID-19 Syndrome ; Insulin Resistance ; },
abstract = {Long COVID, or post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC), refers to a range of persistent health effects associated with SARS-CoV-2 infection. Long COVID is a complex, multisystem disorder that can affect nearly every organ system and is strongly linked with the incidence of diabetes and other chronic conditions. Increasing evidence also connects persistent SARS-CoV-2 infection with the development of new-onset diabetes and other metabolic disorders. In this review, we assess the current evidence and discuss the incidence of new-onset diabetes, along with the pathobiological mechanisms by which SARS-CoV-2 may contribute to the progression of both new-onset type 1 and type 2 diabetes mellitus (T1DM and T2DM). We summarize the latest understanding of the molecular and cellular mechanisms underlying SARS-CoV-2-associated new-onset diabetes. Potential mechanisms include direct damage to pancreatic β-cells, inflammation, insulin resistance, and autoimmune responses. Dysregulation of the ACE2/renin-angiotensin system (RAS) pathway has been linked to multiple inter-organ pathologies, and increased inflammatory cytokines together with dysregulation of interferon regulatory factors (IRFs)-such as overexpression of IRF1-appear to represent key mechanistic links to widespread tissue damage and metabolic alterations. Moreover, the presence of viral RNA or viral RNA fragments may directly damage pancreatic islets, contributing to insulin resistance and β-cell dysfunction that, in turn, may promote the development of new-onset diabetes. In light of these findings, this review further examines evidence supporting the persistence of SARS-CoV-2 RNA in PASC reservoir tissues, including the pancreas, and its potential association with the development of new-onset diabetes mellitus.},
}

Humans
*COVID-19/complications/metabolism/pathology/epidemiology
*SARS-CoV-2
*Diabetes Mellitus, Type 2/epidemiology/etiology/virology/metabolism/pathology
*Diabetes Mellitus, Type 1/epidemiology/metabolism/etiology/virology
Renin-Angiotensin System
Post-Acute COVID-19 Syndrome
Insulin Resistance

@article {pmid41488264,
year = {2025},
author = {Kumar, C and Akhileshwar, and Kumar Neeraj, R and Hameed, S and Husain, N and Roy, SS and Mohan, L and Anantsaznam, },
title = {Systematic Review and Meta-Analysis of the Incidence of Myocarditis and Guillain-Barré Syndrome in Adolescents Receiving COVID-19 mRNA Vaccine.},
journal = {Cureus},
volume = {17},
number = {11},
pages = {e98208},
pmid = {41488264},
issn = {2168-8184},
abstract = {This study aimed to evaluate the incidence and risk of rare long-term adverse events, specifically myocarditis and Guillain-Barré syndrome (GBS), in adolescents (12-19 years) following COVID-19 mRNA vaccination. We systematically searched MEDLINE, Embase, Cochrane CENTRAL, and Scopus, supplemented by trial registries and reference lists (PROSPERO: CRD420251045173). Eligible studies included randomized controlled trials (RCTs), cohort studies, case-control studies, self-controlled case series, and pharmacovigilance database analyses reporting myocarditis or GBS outcomes in adolescents receiving BNT162b2 or mRNA-1273. The search was conducted in June 2025, and all published studies were included. Risk of bias was assessed using the Cochrane RoB-2 tool, Newcastle-Ottawa Scale, or adapted criteria for pharmacovigilance studies. Effect measures were expressed as incidence rate or incidence rate ratios (IRRs) with 95% confidence intervals (CIs). Meta-analyses were conducted using random-effects models. Ten studies met the inclusion criteria. Myocarditis incidence was elevated in adolescent and young adult males, particularly after the second dose. Pooled analyses indicated a higher risk with mRNA-1273 compared to BNT162b2 (pooled IRR ≈ 3.9), although heterogeneity was very high (I[2] > 95%). For GBS, global pharmacovigilance data suggested only a modest association with mRNA vaccines (ROR 9.66), substantially weaker than for adenoviral vector or influenza vaccines. COVID-19 mRNA vaccination in adolescents is associated with a small but measurable increased risk of myocarditis, particularly in males, after the second dose, with a higher incidence following mRNA-1273. No consistent evidence of increased GBS risk was observed. Absolute risks remain low, and outcomes are generally favorable compared to SARS-CoV-2 infection. Continued surveillance and long-term follow-up are warranted.},
}

@article {pmid41488437,
year = {2025},
author = {Pluetrattanabha, N and Direksunthorn, T},
title = {Mobile Health Clinics and Telehealth Outreach in Thailand: A Focus on Elderly Care and NCDs.},
journal = {Journal of multidisciplinary healthcare},
volume = {18},
number = {},
pages = {8321-8331},
pmid = {41488437},
issn = {1178-2390},
abstract = {BACKGROUND: Thailand faces a rapidly aging population alongside a high burden of non-communicable diseases (NCDs). Ensuring equitable healthcare access for older adults with NCDs is a pressing challenge. Mobile health clinics and telehealth services have emerged as key strategies to reach underserved elderly populations and maintain continuity of NCD care in remote or resource-limited settings.

OBJECTIVE: To examine current mobile clinic initiatives and telehealth outreach in Thailand focused on elderly care and NCD management, and to evaluate their impact on healthcare access and outcomes for older adults.

METHODS: We conducted a narrative review of published literature, policy reports, and program descriptions on mobile health clinics and telehealth interventions in Thailand, with emphasis on applications for older adults and chronic disease care (eg, diabetes, hypertension). A comprehensive search (2010-2025) of PubMed, Google Scholar, and Thai government/organization websites identified relevant sources. Data on intervention models, settings, target populations, and reported outcomes were extracted. In total, 15 key publications and reports were reviewed, from which 8 major mobile clinic or telehealth initiatives were identified.

RESULTS: Mobile health clinics have expanded primary care access for vulnerable elderly in both urban and rural areas. The Thai Red Cross Society's mobile clinic serves remote mountainous communities and provides primary care, NCD screenings, vaccinations, and medications to about 5,000 underserved people annually. Past mobile outreach programs have uncovered many untreated cases-in one survey, 58% of hypertensive and 75% of diabetic elderly were first diagnosed via a mobile unit. Telehealth services have likewise grown substantially. During the COVID-19 pandemic, telemedicine was rapidly adopted for routine consultations and chronic disease follow-ups. The National Health Security Office (NHSO) introduced a nationwide telemedicine service under the Universal Coverage Scheme, enabling remote consultations and medication deliveries for stable chronic NCD patients, ensuring continuity of care during lockdowns. Numerous telehealth applications emerged (public and private); for example, smartphone apps like MorDee ("Good Doctor") gained wide usage in Thailand. In an urban pilot "Dusit Telemedicine" model, integrating community clinics with a tertiary hospital, over 300 elderly patients received teleconsultations, reducing overcrowding. An acceptance study in this Bangkok pilot found older generations significantly less likely to adopt telemedicine than younger people - perceived ease of use was a strong predictor of acceptance (adjusted OR 3.95 for usability). Community-based telehealth pilots in rural areas, such as a Chiang Mai program using Community Health Leaders, demonstrated high satisfaction (≥90%) and successful NCD risk screenings, but also highlighted the need for training and support for both health workers and patients.

CONCLUSION: Mobile clinics and telehealth are complementary strategies for enhancing healthcare delivery to elderly Thais with NCDs. Mobile clinics physically bring essential services to those unable to travel, while telehealth connects patients to providers for continuous care and monitoring. The Thai experience illustrates that integrating these innovations into primary healthcare systems can enhance equity of care for aging populations. Continued support, digital literacy training for seniors, and policy integration of telehealth into the health system are recommended to ensure healthy aging under universal health coverage.},
}

@article {pmid41488438,
year = {2025},
author = {Maulana, I and Shalahuddin, I and Eriyani, T and Pebrianti, S},
title = {"Exploring Psychosocial Interventions to Improve Mental Health Outcomes Among Healthcare Workers": Scoping Review.},
journal = {Journal of multidisciplinary healthcare},
volume = {18},
number = {},
pages = {8293-8303},
pmid = {41488438},
issn = {1178-2390},
abstract = {BACKGROUND: Healthcare workers (HCWs) face heightened risks of stress, anxiety, depression, and burnout, particularly during and after the COVID-19 pandemic. Psychosocial interventions have been increasingly implemented, yet the evidence remains fragmented across diverse settings and modalities. This scoping review aimed to map current psychosocial interventions designed to improve mental health outcomes among HCWs.

METHODS: Guided by the PRISMA-ScR framework, five databases (PubMed, Scopus, ScienceDirect, EBSCOhost, Google Scholar) were searched from January 2000 to September 2025. Eligible studies involved HCWs, assessed psychosocial interventions, and reported mental health outcomes. The Joanna Briggs Institute (JBI) appraisal tool was applied, and only studies scoring ≥70% were retained. Although multiple designs were eligible, only randomized controlled trials (RCTs) met the quality threshold and were included. Data were synthesized descriptively and thematically.

RESULTS: Of 312 identified records, 15 RCTs (2021-2025) were included. Interventions were grouped into mindfulness and meditation programs (n=6), digital and mHealth approaches (n=5), and coaching or AI-assisted resilience training (n=4). Specifically, mindfulness interventions reduced stress and anxiety by up to 30% and consistently improved well-being. Notably, digital modalities-including mobile apps and internet-delivered cognitive behavioral therapy (CBT)-were widely used during the pandemic and demonstrated benefits for burnout, sleep quality, and resilience. Across all studies, coaching and AI-assisted interventions improved work engagement and reduced exhaustion, particularly in non-pandemic contexts.

CONCLUSION: Psychosocial interventions demonstrate strong potential to improve HCWs' mental health. Digital programs offer scalable support, while resilience-based approaches promote long-term well-being. Future research should examine implementation in low-resource settings, compare digital versus in-person modalities, and explore organizational-level strategies to complement individual interventions.},
}

@article {pmid41488474,
year = {2025},
author = {Yamin, M and Alsahafi, N and Abdulal, RH and Asad, M and Bosaeed, M and Zohaib, A},
title = {Non-coding RNAs in the viral host-pathogen interaction: molecular regulation and therapeutic potential.},
journal = {Frontiers in cellular and infection microbiology},
volume = {15},
number = {},
pages = {1734182},
pmid = {41488474},
issn = {2235-2988},
mesh = {Humans ; *Host-Pathogen Interactions/genetics ; *RNA, Untranslated/genetics ; COVID-19/virology ; SARS-CoV-2/genetics ; MicroRNAs/genetics/antagonists & inhibitors ; RNA, Circular/genetics ; Hepacivirus/genetics ; RNA, Long Noncoding/genetics ; Virus Replication ; *Virus Diseases/virology/genetics ; Antiviral Agents/therapeutic use ; Animals ; },
abstract = {Non-coding RNAs (ncRNAs), including microRNA (miRNA), long non-coding RNA (lncRNA) and circular RNA (circRNA), serve as key regulatory molecules in the context of viral infection. They play dual roles by modulating host immune responses and influencing viral replication, persistence, and disease progression. Numerous ncRNAs have been implicated in infections caused by viruses such as HCV, DENV and SARS-CoV. This review highlights the biogenesis and multifaceted functions of both host-encoded and virus-encoded ncRNAs in shaping host-pathogen interactions. It also examines their potential as novel biomarkers and therapeutic agents for viral infections. We discuss translational applications such as Miravirsen, a miRNA inhibitor that reached clinical trials for Hepatitis C Virus (HCV) and diagnostic relevance of lncRNA NEAT1 in SARS-CoV-2 infection. In the end, we have also addressed the current challenges and limitations involved in translating research observations of ncRNAs to clinical outcomes.},
}

Humans
*Host-Pathogen Interactions/genetics
*RNA, Untranslated/genetics
COVID-19/virology
SARS-CoV-2/genetics
MicroRNAs/genetics/antagonists & inhibitors
RNA, Circular/genetics
Hepacivirus/genetics
RNA, Long Noncoding/genetics
Virus Replication
*Virus Diseases/virology/genetics
Antiviral Agents/therapeutic use
Animals

@article {pmid41488618,
year = {2025},
author = {Rodrigues, T and Beltrão, GS and Girardi, H and Pinto, AR},
title = {Viral reprogramming of glial metabolism as a driver of neuroinflammation.},
journal = {Frontiers in immunology},
volume = {16},
number = {},
pages = {1686774},
pmid = {41488618},
issn = {1664-3224},
mesh = {Humans ; *Neuroinflammatory Diseases/metabolism/virology/immunology ; *SARS-CoV-2/immunology ; Animals ; *COVID-19/immunology/metabolism/virology ; *Neuroglia/metabolism/virology/immunology ; Astrocytes/virology/metabolism/immunology ; HIV-1 ; Microglia/metabolism/virology/immunology ; Glycolysis ; Zika Virus/immunology ; },
abstract = {Considerable attention has been recently devoted to the involvement of immune cells in the central nervous system (CNS) during infections with neurotropic viruses, such as SARS-CoV-2, HIV-1, and ZIKV. These viruses are capable of infecting astrocytes and microglia, the main glial cells in the CNS, responsible for regulating neuronal activity. Here, we discuss how viral infections lead to metabolic reprogramming toward aerobic glycolysis in these cells, enhancing pro-inflammatory pathways, such as inflammasome activation, resulting in the secretion of inflammatory cytokines that favor the development of neuroinflammation. In this mini review, we discuss the pivotal interplay between metabolism and immunity towards viral pathogenesis in the CNS, pointing out the relevance of therapeutic strategies targeting both metabolic and immunological pathways to enhance antiviral and neuroprotective responses.},
}

Humans
*Neuroinflammatory Diseases/metabolism/virology/immunology
*SARS-CoV-2/immunology
Animals
*COVID-19/immunology/metabolism/virology
*Neuroglia/metabolism/virology/immunology
Astrocytes/virology/metabolism/immunology
HIV-1
Microglia/metabolism/virology/immunology
Glycolysis
Zika Virus/immunology

@article {pmid41488628,
year = {2025},
author = {Yin, L and Sun, CY and Chen, GL and Xiang, Z and Hu, BQ and Zhou, F and Wang, Q},
title = {Modular mastery of inflammation: umbilical cord mesenchymal stem cells as a therapeutic frontier.},
journal = {Frontiers in immunology},
volume = {16},
number = {},
pages = {1721947},
pmid = {41488628},
issn = {1664-3224},
mesh = {Humans ; *Mesenchymal Stem Cells/immunology ; *Umbilical Cord/cytology ; *Mesenchymal Stem Cell Transplantation/methods ; *COVID-19/therapy/immunology ; *Inflammation/therapy/immunology ; SARS-CoV-2 ; *Inflammatory Bowel Diseases/therapy/immunology ; Graft vs Host Disease/therapy/immunology ; Animals ; },
abstract = {Inflammation operates as a dual-edged sword in physiological defense and pathological damage, driving conditions from diabetes to neurodegeneration. Current anti-inflammatory therapies-NSAIDs, corticosteroids, and biologics-face clinical bottlenecks including non-specific toxicity, therapeutic ceiling effects, and drug resistance. Umbilical cord mesenchymal stem cells (UC-MSCs) emerge as a transformative alternative, leveraging three synergistic modules: Immune reprogramming, Inflammasome inhibition, Intercellular communication. Clinical trials demonstrate efficacy in inflammatory bowel disease, COVID-19 ARDS, and graft-versus-host disease. UC-MSCs outperform conventional therapies by multi-pathway modulation and tissue-regenerative capacity, though challenges persist in cell heterogeneity and long-term safety. Future work must standardize dosing protocols and validate scalable production for clinical translation.},
}

Humans
*Mesenchymal Stem Cells/immunology
*Umbilical Cord/cytology
*Mesenchymal Stem Cell Transplantation/methods
*COVID-19/therapy/immunology
*Inflammation/therapy/immunology
SARS-CoV-2
*Inflammatory Bowel Diseases/therapy/immunology
Graft vs Host Disease/therapy/immunology
Animals

@article {pmid41488667,
year = {2025},
author = {Zheng, Y and Liu, C and Li, Y and Wang, W and Dou, Q},
title = {The dual role of thrombospondin-1 in inflammatory regulation during acute respiratory distress syndrome: a mini-review.},
journal = {Frontiers in immunology},
volume = {16},
number = {},
pages = {1699900},
pmid = {41488667},
issn = {1664-3224},
mesh = {Humans ; *Thrombospondin 1/metabolism/immunology ; *Respiratory Distress Syndrome/immunology/metabolism/pathology ; *COVID-19/immunology ; Animals ; *Inflammation/immunology/metabolism ; *SARS-CoV-2/immunology ; },
abstract = {Inflammation serves as a fundamental defense against tissue injury and infection, yet dysregulation can lead to pathological outcomes. Thrombospondin-1 (Thbs1/TSP1), a multifunctional glycoprotein significantly upregulated during inflammation, exemplifies a dualistic regulator with context-dependent roles. Through modulation of cytokine networks and inflammatory cell activity (notably macrophages), Thbs1 critically governs inflammatory responses. Acute respiratory distress syndrome (ARDS), a life-threatening condition fueled by systemic inflammation secondary to infection or trauma, presents complex pathophysiology requiring elucidation. COVID-19 research highlights elevated Thbs1 expression in severe patients, where it demonstrates protective effects against pulmonary damage primarily via extracellular matrix protection, inhibition of neutrophil serine proteases, and TGF-β-dependent repair pathways. However, paradoxical evidence indicates that dysregulated Thbs1 can also contribute to ARDS pathogenesis, potentially by amplifying inflammation, promoting thromboinflammation, or driving fibrosis. Mechanistic insights reveal Thbs1's influence on ARDS progression through ECM remodeling, serine protease inhibition, and TGF-β activation. While significant progress has been made in understanding Thbs1 signaling, the precise mechanisms dictating its context-dependent switch between protective and pathogenic functions in inflammatory pathways remain a critical area for future investigation.},
}

Humans
*Thrombospondin 1/metabolism/immunology
*Respiratory Distress Syndrome/immunology/metabolism/pathology
*COVID-19/immunology
Animals
*Inflammation/immunology/metabolism
*SARS-CoV-2/immunology

@article {pmid41488929,
year = {2025},
author = {Du, S and Cui, Z and Xu, X and Liu, T and Ye, J},
title = {Clinical efficacy of exercise in the treatment of post-COVID-19 syndrome: a systematic review and network meta-analysis.},
journal = {Frontiers in physiology},
volume = {16},
number = {},
pages = {1656713},
pmid = {41488929},
issn = {1664-042X},
abstract = {BACKGROUND: Post-COVID-19 syndrome (PCS) describes a constellation of persistent or new symptoms lasting beyond the acute phase of SARS-CoV-2 infection. Emerging evidence suggests that exercise is a cost-effective and accessible intervention that may enhance pulmonary function, improve cardiopulmonary circulation, regulate emotional status, and alleviate symptoms of PCS. However, robust evidence supporting the efficacy of exercise therapy in PCS remains limited. This systematic review and meta-analysis aimed to elucidate the therapeutic potential of exercise therapy in PCS.

METHOD: A search of the PubMed, Embase, Web of Science, and Ovid databases up to March 25, 2025 yielded 33 randomized controlled trials (with 2,895 participants) for meta-analysis.

RESULT: The results showed that exercise therapy significantly improved the multi-dimensional outcomes of patients with PCS. Bayesian network meta-analysis indicated that the combination of aerobic exercise and respiratory muscle training had the best effect on lung function. Multimodal exercise significantly improved the results of the six-minute walk test, the dyspnea score, and peak oxygen uptake. Mental Health and Mental Component Summary scores improved significantly in the group that received exercise therapy (P<0.01).

CONCLUSION: The results of this meta-analysis confirm that exercise can significantly improve quality of life and the emotional state of patients with PCS. They also provide evidence for a treatment strategy in patients with post-COVID-19 sequelae.

https://www.crd.york.ac.uk/PROSPERO/#myprospero, identifier CRD420251034187.},
}

@article {pmid41489056,
year = {2026},
author = {Boesen, K and Hemkens, LG and Janiaud, P and Hirt, J},
title = {Topic-specific living databases of clinical trials: A scoping review of public databases.},
journal = {Clinical trials (London, England)},
volume = {23},
number = {2},
pages = {198-209},
pmid = {41489056},
issn = {1740-7753},
mesh = {Humans ; *Clinical Trials as Topic ; COVID-19 ; *Databases, Factual ; SARS-CoV-2 ; Information Storage and Retrieval ; },
abstract = {INTRODUCTION: Conducting systematic reviews of clinical trials is time-consuming and resource-intensive. One potential solution is to design databases that are continuously and automatically populated with clinical trial data from harmonised and structured datasets. This scoping review aimed to identify and map publicly available, continuously updated, topic-specific databases of clinical trials.

METHODS: We systematically searched PubMed, Embase, the preprint servers medRxiv, arXiv, Open Science Framework, and Google. We characterised each database using seven predefined features (access model, database type, data input sources, retrieval methods, data-extraction methods, trial presentation, and export options) and narratively summarised the results.

RESULTS: We identified 14 continuously updated databases of clinical trials, seven related to COVID-19 (initiated in 2020) and seven non-COVID-19 databases (initiated as early as in 2009). All databases, except one, were publicly funded and accessible without restrictions. Most relied on traditional methods used in static article-based systematic reviews sourcing data from journal publications and trial registries. The COVID-19 databases and some non-COVID-19 databases implemented semi-automated features of data import, which combined automated and manual data curation, whereas the non-COVID-19 databases mainly relied on manual workflows. Most reported information was metadata, such as author names, years of publication, and link to publication or trial registry. Only two databases included trial appraisal information (such as risk of bias assessments). Six databases reported aggregate group-level results, but only one database provided individual participant data on request.

DISCUSSION: Continuously updated topic-specific databases of clinical trials remain limited in number, and existing initiatives mainly employ traditional static systematic review methodologies. A key barrier to developing truly living platforms is the lack of accessible, machine-readable, and standardised clinical trial data.},
}

Humans
*Clinical Trials as Topic
COVID-19
*Databases, Factual
SARS-CoV-2
Information Storage and Retrieval

@article {pmid41490687,
year = {2026},
author = {Sousa Almeida, PR and Sarmento, G and Gruner, H and Veríssimo, R and Duque, S},
title = {[Vaccination of Older Adults in Portugal: Recommendations from the Geriatrics Study Group of the Portuguese Society of Internal Medicine].},
journal = {Acta medica portuguesa},
volume = {39},
number = {3},
pages = {223-234},
doi = {10.20344/amp.23786},
pmid = {41490687},
issn = {1646-0758},
mesh = {Humans ; Aged ; Portugal ; Influenza Vaccines/administration & dosage ; *Vaccination/standards ; Middle Aged ; Pneumococcal Vaccines/administration & dosage ; Geriatrics ; *COVID-19 Vaccines/administration & dosage ; Aged, 80 and over ; COVID-19/prevention & control ; Influenza, Human/prevention & control ; },
abstract = {Older persons are more susceptible to infections and have a higher risk of serious complications, with a worse functional and vital prognosis. Vaccination is an effective strategy with a favorable safety profile for preventing infections and promoting healthy aging. In view of the clinical evidence and the vaccines available in Portugal in the first half of 2025, the Geriatrics Study Group of the Portuguese Society of Internal Medicine presents a proposal for vaccination of adults aged 65 years or older. The experts also point out the need to create a national lifelong vaccination program that includes older people to increase vaccination coverage and reduce the impact of infections in this population. Although the document focuses on people aged 65 years or older, vaccination against some diseases should start earlier. This article outlines five main recommendations: 1) Annual influenza and COVID-19 vaccination for all adults aged 50 years or older, with those aged 65 years or older receiving the high-dose trivalent influenza vaccine; 2) Respiratory syncytial virus vaccination for all adults aged 60 years or older and adults aged 18 - 59 years with risk factors, prioritizing people aged 75 years or older and those aged 50 years or older with risk factors; 3) Pneumococcal vaccination with the 20-valent or 21-valent pneumococcal conjugate vaccine for all adults aged 50 years or older and adults aged 18 - 49 years with risk factors; 4) Herpes zoster vaccination with the recombinant vaccine for all adults aged 50 years or older and adults aged 18 - 49 years at high risk of herpes zoster; 5) From the age of 65 years, booster vaccination against tetanus, diphtheria and pertussis every 10 years.},
}

Humans
Aged
Portugal
Influenza Vaccines/administration & dosage
*Vaccination/standards
Middle Aged
Pneumococcal Vaccines/administration & dosage
Geriatrics
*COVID-19 Vaccines/administration & dosage
Aged, 80 and over
COVID-19/prevention & control
Influenza, Human/prevention & control

@article {pmid41491167,
year = {2026},
author = {Liao, Y and Liu, Y and Xu, S and Yang, J and Chen, Y},
title = {Incomplete Kawasaki disease associated with acute icteric hepatitis and Torque teno virus infection: a case report and literature review.},
journal = {BMC pediatrics},
volume = {26},
number = {1},
pages = {14},
pmid = {41491167},
issn = {1471-2431},
support = {0102018005//the 2024 Guangdong Renowned Traditional Chinese Medicine Practitioner Inheritance Studio Construction Project- Xu Youjia/ ; E43729//the State Administration of Traditional Chinese Medicine, under the project "a project for Chinese Medicine on Ying Lv's Renowned Expert Inheritance Studio"/ ; 2023B1111020004//the Department of Science and Technology of Guangdong Province, under the project "Efficacy and safety of the Jianer Jiedu Formula for the treatment of novel coronavirus infections in children- a real-world and randomized controlled study"/ ; 2024A03J0125//Bureau of Science and Technology of Guangzhou Municipality, under the project "Mechanism Study on the Regulation of NLRP3-mediated Pyroptosis by Jianer Jiedu Formula for the Treatment of RSV Pneumonia in Children Based on the Lingnan DampHeat Theory"/ ; },
mesh = {Humans ; Male ; *Mucocutaneous Lymph Node Syndrome/complications/diagnosis ; Infant ; *Torque teno virus/isolation & purification ; *DNA Virus Infections/complications/diagnosis ; *Jaundice/etiology ; Acute Disease ; *Hepatitis/diagnosis/complications ; Immunoglobulins, Intravenous/therapeutic use ; },
abstract = {INTRODUCTION: Kawasaki disease (KD) is an acute, self-limiting vasculitis that primarily affects children under five years of age. Its classic clinical features include prolonged fever, bilateral conjunctival injection, changes in the lips and oral cavity, cervical lymphadenopathy, rash, and extremity changes. Acute jaundice and liver dysfunction are atypical manifestations of KD. Cases in which jaundice is the initial presenting symptom-especially when accompanied by Torque Teno Virus (TTV) infection-are rarely reported.

CASE PRESENTATION: We describe a 17-month-old boy diagnosed with incomplete Kawasaki disease (IKD), who initially presented with persistent fever, jaundice, and elevated liver enzymes. At disease onset, characteristic mucocutaneous signs of KD were absent. As the illness progressed, the patient developed dorsal foot edema, erythematous lips, and cervical lymphadenopathy. On the ninth day of illness, echocardiography revealed dilation of the left coronary artery, confirming a retrospective diagnosis of IKD. Additionally, high-throughput sequencing of peripheral blood identified TTV type 28. The patient was treated with intravenous immunoglobulin, methylprednisolone, and hepatoprotective agents. Following treatment, his fever resolved, jaundice subsided, liver function normalized, and coronary artery dimensions gradually returned to within the normal range.

CONCLUSIONS: This case highlights an atypical presentation of IKD, characterized by early-onset jaundice and later development of coronary artery dilation, in a patient also infected with TTV. To our knowledge, this is the first reported case of IKD associated with acute icteric hepatitis and TTV infection. This case may inform clinical evaluation in similar presentations and contribute to future research on the etiology of KD.},
}

Humans
Male
*Mucocutaneous Lymph Node Syndrome/complications/diagnosis
Infant
*Torque teno virus/isolation & purification
*DNA Virus Infections/complications/diagnosis
*Jaundice/etiology
Acute Disease
*Hepatitis/diagnosis/complications
Immunoglobulins, Intravenous/therapeutic use

@article {pmid41492414,
year = {2026},
author = {Govorchin, A and Leduc, M and Atleo, CG and Hoogeveen, D and Borgos, I and Patrick, L},
title = {The right to health: indigenous data sovereignty in Canada during and beyond the COVID-19 pandemic.},
journal = {Lancet regional health. Americas},
volume = {54},
number = {},
pages = {101335},
pmid = {41492414},
issn = {2667-193X},
abstract = {The COVID-19 pandemic disproportionately impacted Indigenous Peoples in Canada, highlighting preexisting health inequities. These disparities were exacerbated by inadequate data management policies across Canadian governments, which contribute to inaccurate health information and access challenges for Indigenous Nations. Indigenous data sovereignty, which recognizes the right of Indigenous Peoples to govern their own data, has been identified as essential for achieving self-determination and improving health outcomes. We focus on British Columbia (BC) given its unique health and data governance structure with First Nations. This policy paper examines the challenges related to health data management that arose during COVID-19 in BC, and the regulatory barriers hindering Indigenous health equity. We present four policy recommendations that address data issues as a promising avenue to reducing health inequities in Canada. This includes supporting research by and with Indigenous Peoples, promoting ethical responsibilities of non-Indigenous researchers, implementing anti-racism policies, and adopting Indigenous data management frameworks.},
}

@article {pmid41493182,
year = {2026},
author = {Oliveira, T and Naranjo-Zolotov, M and Martins, R and Karatzas, S},
title = {Adoption of Internet of Things in Health Care: Weighted and Meta-Analytical Review of Theoretical Frameworks and Predictors.},
journal = {Journal of medical Internet research},
volume = {28},
number = {},
pages = {e64091},
pmid = {41493182},
issn = {1438-8871},
mesh = {Humans ; COVID-19/epidemiology ; *Delivery of Health Care ; *Internet of Things ; SARS-CoV-2 ; Telemedicine ; *Bibliometrics ; },
abstract = {BACKGROUND: The integration of the Internet of Things (IoT) into health care is transforming the industry by enhancing disease care and management, as well as supporting self-health management. The COVID-19 pandemic has accelerated the adoption of IoT devices, particularly wearable medical devices, which enable real-time health monitoring and advanced remote health management. Globally, the increased adoption of IoT in health care has improved efficiency, enhanced patient care, and generated substantial economic value.

OBJECTIVE: This review aims to conduct a comprehensive meta- and weight analysis of quantitative studies to identify the most influential predictors and theoretical frameworks explaining the adoption of IoT in health care.

METHODS: We searched databases, including Web of Science and PubMed, for quantitative studies on IoT health care adoption, with the last search conducted in early July 2025. Inclusion criteria comprised peer-reviewed articles written in English that employed a quantitative approach to IoT health care technology adoption. Studies were excluded if they did not report the significance of relationships, involved technologies without IoT features or were outside the scope, or examined target variables irrelevant to the analysis. The weight analysis identified the pathways with the most significant effects. A meta-analysis using a random-effects model was conducted to estimate combined effect sizes and their statistical significance. The results from both methods were then integrated to visualize the most frequently used theoretical frameworks. Risk of bias and heterogeneity were assessed using a funnel plot, Egger regression test, the I2 statistic, and subgroup analysis, which indicated no strong evidence of publication bias but revealed a high level of heterogeneity.

RESULTS: Analysis of 115 datasets from 109 papers identified the Technology Acceptance Model and the Unified Theory of Acceptance and Use of Technology (UTAUT) as the primary frameworks for explaining IoT adoption in health care. Incorporating context-specific variables-such as health consciousness, innovativeness, and trust-into these traditional technology acceptance frameworks enhances the understanding of IoT adoption. Although high heterogeneity suggests a need to refine theoretical models to account for regional contexts, universal adoption drivers such as performance expectancy and effort expectancy remain consistent.

CONCLUSIONS: Behavioral intention is the most frequently studied variable in IoT health care adoption, whereas attitude, performance expectancy, effort expectancy, and task-technology fit remain underexplored. While adoption theories from the information systems field, such as the TAM, are predominantly used, integrating context-specific constructs and theories-such as trust and innovativeness-can provide deeper insights into IoT adoption in health care. The strongest and most consistent predictors of behavioral intention were attitude, performance expectancy, habit, self-efficacy, functional congruence, and benefits. Additionally, social influence, facilitating conditions, trust, and aesthetic appeal demonstrated promising or strong effects. By contrast, variables such as privacy and security, barriers, vulnerability, severity, compatibility, financial cost, health, and technology anxiety were generally inconsistent or not statistically significant.},
}

Humans
COVID-19/epidemiology
*Delivery of Health Care
*Internet of Things
SARS-CoV-2
Telemedicine
*Bibliometrics

@article {pmid41493556,
year = {2026},
author = {Pathak, R and Vandeliwala, M and Patel, P and Patel, N and Patel, K},
title = {Resurgence of human metapneumovirus: an overview of past and current trends.},
journal = {Archives of microbiology},
volume = {208},
number = {2},
pages = {93},
pmid = {41493556},
issn = {1432-072X},
mesh = {*Metapneumovirus/physiology/genetics/pathogenicity ; Humans ; *Paramyxoviridae Infections/epidemiology/virology/diagnosis/drug therapy ; Antiviral Agents/therapeutic use ; *Respiratory Tract Infections/virology/epidemiology ; Host-Pathogen Interactions ; },
abstract = {Human metapneumovirus (HMPV) is a major respiratory pathogen belonging to the Pneumoviridae family that primarily affects children, the elderly, and immunocompromised individuals. Since its discovery in 2001, HMPV has been recognized as a significant cause of acute respiratory infections (ARIs) worldwide, exhibiting seasonal peaks and recurring outbreaks. In recent years, the virus has shown an unusual resurgence, particularly in the post-COVID-19 era, emphasizing the need for renewed clinical and epidemiological attention. This review provides a comprehensive overview of HMPV, encompassing its epidemiology, virion structure, replication mechanisms, host-pathogen interaction, clinical manifestations, diagnostic strategies, and current therapeutic approaches. Special attention is given to recent epidemiological trends, molecular insights derived from structural studies of viral proteins, and the challenges faced in developing vaccines and antiviral agents. Additionally, the review discusses the potential of plant-derived bioactive compounds as alternative or complementary therapeutic options. By consolidating the latest global data and highlighting existing knowledge gaps, the work aims to facilitate a better understanding of HMPV pathogenesis and guide future research directions for improved surveillance, diagnosis, and management of HMPV infections.},
}

*Metapneumovirus/physiology/genetics/pathogenicity
Humans
*Paramyxoviridae Infections/epidemiology/virology/diagnosis/drug therapy
Antiviral Agents/therapeutic use
*Respiratory Tract Infections/virology/epidemiology
Host-Pathogen Interactions

@article {pmid41494094,
year = {2026},
author = {Cao-Lei, L and Vrantsidis, D and Giesbrecht, GF},
title = {Epigenetic Insights into the Impact of Disaster-Related Prenatal Stress: A Narrative Review.},
journal = {Harvard review of psychiatry},
volume = {34},
number = {1},
pages = {7-22},
doi = {10.1097/HRP.0000000000000446},
pmid = {41494094},
issn = {1465-7309},
mesh = {Humans ; Pregnancy ; *Prenatal Exposure Delayed Effects/genetics ; *Stress, Psychological/genetics ; Female ; *Epigenesis, Genetic ; *Disasters ; DNA Methylation ; *Pregnancy Complications/genetics ; },
abstract = {Disaster-related prenatal maternal stress, whether due to natural or human-made crises, can have profound effects on offspring health and development. This narrative review synthesizes research findings on the epigenetic mechanisms through which prenatal maternal stress influences long-term offspring health outcomes. Focusing primarily on DNA methylation, we examine how exposure to stress during gestation alters the epigenetic profile and may contribute to mental, cognitive, and physical health vulnerabilities. Studies were categorized based on disaster type, including time-limited events such as hurricanes, floods, and earthquakes, and stressors like the COVID-19 pandemic and famine. Key findings highlight the timing of exposure, sex-specific epigenetic effects, and the potential for epigenetic markers to mediate stress-induced health outcomes. While considerable progress has been made, our review emphasizes the need for further research on how epigenetics may mediate mental health outcomes and the development of interventions that target these molecular mechanisms.},
}

Humans
Pregnancy
*Prenatal Exposure Delayed Effects/genetics
*Stress, Psychological/genetics
Female
*Epigenesis, Genetic
*Disasters
DNA Methylation
*Pregnancy Complications/genetics

@article {pmid41494304,
year = {2026},
author = {Kung, PJ and Chen, CM and Lin, EC and Shu, BC and Tew, Y and He, J and Fang, CJ and Reynolds, NR and Ornstein, KA},
title = {Ethical challenges around mandatory vaccination among nurses: A systematic review of qualitative and quantitative evidence.},
journal = {International journal of nursing studies},
volume = {175},
number = {},
pages = {105313},
doi = {10.1016/j.ijnurstu.2025.105313},
pmid = {41494304},
issn = {1873-491X},
mesh = {Humans ; *COVID-19/prevention & control ; *Mandatory Vaccination/ethics ; *Nurses/psychology ; Qualitative Research ; *Vaccination/ethics ; },
abstract = {BACKGROUND: Mandatory vaccination policies have sparked global ethical debates, particularly in the context of COVID-19. Among healthcare workers, nurses-the largest segment of the frontline workforce-face distinct tensions between professional responsibilities and personal autonomy. Yet, the ethical challenges these policies pose from nurses' perspectives remain insufficiently examined.

AIM: This review examines the ethical challenges of mandatory vaccination from nurses' perspectives, informs ethical policymaking, and provides insights to navigate similar future scenarios.

DESIGN: A mixed-methods systematic review guided by the Joanna Briggs Institute methodology.

DATA SOURCES: Final searches of five databases-Embase, MEDLINE, CINAHL, Web of Science, and Scopus-were conducted in September 2025. Additional records were identified through citation tracking and supplementary searches.

METHODS: Empirical studies published from 2019 onward were screened for relevance and assessed for methodological quality using standardized critical appraisal tools. Studies were included if they examined nurses' experiences, attitudes, or ethical perspectives regarding mandatory vaccination. A narrative synthesis approach was applied to integrate qualitative, quantitative, and mixed-methods findings.

RESULTS: Twenty-eight studies were included (19 quantitative, 5 qualitative, and 4 mixed methods). Four themes emerged: (1) Walking a Tightrope-Between Vaccine Safety and Effectiveness; (2) Silent Burden-Navigating Stigma in the Shadows; (3) Navigating the Fine Line-Balancing Rights and Public Health in Times of Crisis; and (4) Strengthening Leadership and Communication.

CONCLUSIONS: While mandatory vaccination policies may serve public health goals, they can also generate ethical distress, undermine trust, and increase stigmatization among nurses who remain unvaccinated. Future policies should move beyond enforcement toward fostering ethical alignment through education, open dialog, and respectful engagement.

REGISTRATION: PROSPERO registration number: CRD42024551112, registered 03/06/2024.},
}

Humans
*COVID-19/prevention & control
*Mandatory Vaccination/ethics
*Nurses/psychology
Qualitative Research
*Vaccination/ethics

@article {pmid41494305,
year = {2026},
author = {Pupillo, E and Leone, MA and Amato, A and Bianchi, E and Damian, MS and Dyck, J and Garcia-Azorin, D and Giussani, G and Guekht, A and Koike, H and Khadilkar, S and Lehmann, H and Pochigaeva, K and Povolnova, J and Tumurov, D and Vetrov, F and de Visser, M and Winkler, AS and Grisold, W},
title = {Prevalence and trajectories of post-COVID-19 neuromuscular conditions: A systematic-review and meta-analysis.},
journal = {Journal of the neurological sciences},
volume = {481},
number = {},
pages = {125710},
doi = {10.1016/j.jns.2025.125710},
pmid = {41494305},
issn = {1878-5883},
mesh = {Humans ; *COVID-19/complications/epidemiology ; Prevalence ; *Neuromuscular Diseases/epidemiology/etiology ; Guillain-Barre Syndrome/epidemiology ; },
abstract = {INTRODUCTION: Neuromuscular diseases (NMDs) are a significant component of the post-acute sequelae of COVID-19. However, their long-term prevalence and trajectories remain poorly defined. This systematic review and meta-analysis aimed to determine the long-term prevalence in COVID-19 survivors of fourteen specific NMDs and related symptoms: cranial nerve diseases, Guillain-Barré syndrome, small fiber neuropathy, (poly)radiculopathies, (poly)neuropathies, plexopathies, motor neuron disease, myasthenia gravis, Lambert-Eaton syndrome, neuropathic pain, sarcopenia, myalgia, myalgia associated with other symptoms, and of other muscle diseases.

METHODS: We searched MEDLINE, Embase, and the Cochrane Library (January 2020 through November 2024) for studies with at least 3 months of follow-up. Pooled prevalence estimates were calculated at multiple time points (acute phase to 24 months) using random effects models.

RESULTS: Among 180 unique studies representing 15,865,322 cases (54 % female, mean age 50.0 years), the pooled prevalence for individuals with at least one NMD or related symptoms decreased from 36 % in the acute phase to 8 % at 24 months. Myalgia prevalence steadily declined from 35 % to 8 % by two years. A trend towards lower prevalences across the time points was observed also for Guillain-Barré syndrome, and other muscle diseases, while other conditions showed a more erratic pattern. The prevalence of neuropathic pain remained high and persisted almost unchanged through the follow-up period (from 31 % in the acute phase to 25 % at 12 months).

CONCLUSIONS: NMDs and related symptoms are common following COVID-19, but their general prevalence decreases with time. However, trajectories varied depending on the type of NMD or symptom.},
}

Humans
*COVID-19/complications/epidemiology
Prevalence
*Neuromuscular Diseases/epidemiology/etiology
Guillain-Barre Syndrome/epidemiology

@article {pmid41494490,
year = {2026},
author = {Messina, A and Bella, F and Maccarone, G and Avincola, G and Signorelli, MS},
title = {Astrocyte-mediated hippocampal damage in the pathogenesis of dysexecutive syndrome following COVID-19: A narrative review.},
journal = {Journal of psychiatric research},
volume = {194},
number = {},
pages = {164-173},
doi = {10.1016/j.jpsychires.2026.01.007},
pmid = {41494490},
issn = {1879-1379},
mesh = {Humans ; *COVID-19/complications/immunology/pathology ; *Astrocytes/pathology/immunology/metabolism ; *Hippocampus/pathology/physiopathology/metabolism/virology/immunology ; SARS-CoV-2 ; *Neuroinflammatory Diseases ; *Cognitive Dysfunction/etiology ; *Executive Function/physiology ; },
abstract = {SARS-CoV-2 infection has been implicated in hippocampal damage, contributing to the pathogenesis of dysexecutive syndrome observed in post-COVID-19 patients. Given the growing prevalence of long-COVID worldwide, understanding how SARS-CoV-2 affects hippocampal structure and function has become an urgent scientific and clinical priority. The hippocampus-crucial for memory, emotional regulation, and executive functioning-is especially susceptible to viral-driven neuroinflammatory cascades. SARS-CoV-2 triggers astrocyte and microglia activation, disrupts blood-brain barrier integrity, and induces cytokine-mediated neurotoxicity, ultimately impairing neuroplasticity and neurogenesis. These mechanisms converge to produce cognitive and affective disturbances-most notably fatigue, apathy, low mood, and executive dysfunction-that typify dysexecutive syndrome in long-COVID. This review synthesizes current evidence from clinical and experimental studies, integrating findings on viral neurotropism, hippocampal hypometabolism, and astrocyte-mediated neurodegeneration. Distinctions between depressive symptoms driven by neuroinflammation and classical depressive disorders are clarified to improve diagnostic accuracy and guide personalized treatment. Emerging data on the neuroprotective role of COVID-19 vaccination-particularly its capacity to modulate microglial activation and support hippocampal neurogenesis-are also examined. Overall, the findings underscore the need for targeted therapeutic strategies aimed at modulating neuroinflammation and supporting hippocampal plasticity, including cognitive rehabilitation approaches. Longitudinal studies are essential to elucidate the enduring impact of SARS-CoV-2 on hippocampal function and to inform effective clinical interventions.},
}

Humans
*COVID-19/complications/immunology/pathology
*Astrocytes/pathology/immunology/metabolism
*Hippocampus/pathology/physiopathology/metabolism/virology/immunology
SARS-CoV-2
*Neuroinflammatory Diseases
*Cognitive Dysfunction/etiology
*Executive Function/physiology

@article {pmid41496808,
year = {2025},
author = {Woods, JA and Hutchinson, NT and Powers, SK and Gomez-Cabrera, MC and Radak, Z and Leeuwenburgh, C and Cacciatore, S and Marzetti, E and Zhang, T and Garza, R and Sidebottom, C and Anderson, E and Durstine, JL and Sun, J and Ji, LL},
title = {Physical activity during COVID-19 pandemic: A 5-year retrospect.},
journal = {Sports medicine and health science},
volume = {7},
number = {6},
pages = {405-418},
pmid = {41496808},
issn = {2666-3376},
abstract = {The purpose of this article is to provide a follow-up review of the impact of the SARS-CoV-2 Disease or Coronavirus Disease 2019 (COVID-19) pandemic on human health and the role of physical activity (PA) during the 5-year pandemic. We aim to cover the immune system, the cardiopulmonary system, the musculoskeletal system, and the central nervous system (brain function), particularly among older adults, college students, and individuals with post-acute sequelae of COVID-19 (Long-COVID). The COVID-19 pandemic has given us many lessons, learned from the death of six million lives and tremendous disturbance to human life. First, we need to continue to investigate cellular and molecular mechanisms that mediate various organistic failures resulting from the viral infection. Such investigations are the only way to completely understand the etiology of the diseases and to develop new drugs and vaccines. The molecular pathways that transmit the signals of viral infection to each organ system are different requiring both basic and clinical research. Available evidence suggests that mitochondrial dysfunction, reduced microcirculation and latent immune activation play a major role, eventually impairing cardiovascular tolerance and peripheral bioenergetics. Second, the COVID-19 pandemic has manifested major disturbances to human lifestyles with reduced PA and exercise standing out as a major factor. Conversely, physical inactivity due to social confinement and mental/psychological stresses has been clearly linked to intensified pathogenic symptoms and amplification of adverse effects on multiple physiological systems. If not intervened, this interaction can lead to Long-COVID, a dangerous futile circle to cause systemic failure. Finally, the COVID-19 pandemic has exerted differential impacts on different populations. Thus, the strategy to develop and conduct to cope with the negativity of pandemic needs to be specific, flexible and tailored to fit different patient populations.},
}

@article {pmid41497070,
year = {2026},
author = {Obeagu, EI},
title = {Immunomodulatory strategies for managing cytokine storms in chronic COVID: mechanisms, therapeutic targets, and clinical advances.},
journal = {Annals of medicine and surgery (2012)},
volume = {88},
number = {1},
pages = {653-659},
pmid = {41497070},
issn = {2049-0801},
abstract = {Chronic COVID, characterized by persistent symptoms following acute SARS-CoV-2 infection, is increasingly linked to sustained immune dysregulation, particularly cytokine storms that drive chronic inflammation and multi-organ complications. Understanding the mechanisms underlying cytokine dysregulation in chronic COVID is essential for developing effective therapeutic strategies aimed at restoring immune balance and mitigating long-term morbidity. This review critically examines current immunomodulatory strategies for managing cytokine storms in chronic COVID, including corticosteroids, cytokine-specific biologics, Janus kinase inhibitors, and emerging cell-based therapies. Additionally, the role of biomarker-guided precision medicine in personalizing treatment to optimize efficacy and safety is discussed. Challenges such as patient heterogeneity, timing and duration of therapy, and potential adverse effects are also addressed. Future research directions emphasize the need for robust clinical trials, novel therapeutic development, and integrated multidisciplinary care to improve patient outcomes. By tailoring immunomodulatory approaches based on individual immune profiles, it is possible to enhance the management of cytokine-driven inflammation in chronic COVID and advance the field toward more effective, personalized treatments.},
}

@article {pmid41497304,
year = {2025},
author = {Fadaei, MR and Fadaei, MS and Kheirieh, AE and Hatami, H and Rahmanian-Devin, P and Tayebi-Khorrami, V and Fathabadi, MF and Baradaran Rahimi, V and Askari, VR},
title = {Overview of dendrimers as promising drug delivery systems with insight into anticancer and anti-microbial applications.},
journal = {International journal of pharmaceutics: X},
volume = {10},
number = {},
pages = {100390},
pmid = {41497304},
issn = {2590-1567},
abstract = {Dendrimers are tree-like polymeric molecules that have three main compartments: the core, branching units, and functional end groups. They are nanosized and monodispersed, with an almost spherical shape. For the past few decades, dendrimers have been evaluated in numerous studies as a promising category of candidates for gene delivery and diagnostic applications. Nowadays, some advanced dendrimers are considered promising anticancer delivery systems due to the vast types and applicable modifications. They also showed their effectiveness as antibacterial and antiviral agents. Smart dendrimers with pH-, redox-, or directly tumor microenvironment-responsive properties are investigated. pH-sensitive dendrimers enhance drug release in the tumor's acidic environment and inhibit release at physiological pH, thereby increasing the hemocompatibility of these chemical agents. Dendrimers have been examined for years to prevent sexually transmitted diseases, such as HIV, HPV, HSV, etc. In this regard, some studies yielded encouraging results and opened new avenues. Following the onset of the COVID-19 pandemic, researchers have shifted their focus toward seeking remedies to prevent and treat this viral disease. Dendrimers have already demonstrated favorable efficacy in protection against COVID-19 and other respiratory viral diseases. Furthermore, they may mitigate the neuroinflammatory manifestations of COVID-19 in individuals experiencing a critical disease state.},
}

@article {pmid41497535,
year = {2025},
author = {Yang, Y and Wang, K and Chen, S},
title = {Effects of Hypoglycemic Agents on Pulmonary Diseases: A Comprehensive Narrative Review.},
journal = {Journal of inflammation research},
volume = {18},
number = {},
pages = {18053-18078},
pmid = {41497535},
issn = {1178-7031},
abstract = {Beyond glycemic control, hypoglycemic agents exhibit multifaceted effects that may influence pulmonary health in patients with diabetes mellitus. This narrative review synthesizes available evidence from preclinical and clinical studies on the impact of major hypoglycemic drug classes-including biguanides, sulfonylureas, thiazolidinediones, α-glucosidase inhibitors, DPP-4 inhibitors, SGLT-2 inhibitors, GLP-1 receptor agonists, and insulin-on pulmonary diseases. Evidence suggests that these agents exert class-specific, and often conflicting, effects: preclinical studies support their protective potential in acute lung injury, while clinical data indicate variable efficacy in asthma, COPD, and respiratory infections including COVID-19. Conversely, some agents may be associated with increased risks of lung cancer or COPD exacerbations, underscoring the need for context-specific prescribing. Mechanistic insights from animal models primarily involve modulation of inflammatory, oxidative, and immune pathways. This narrative review aims to provide a clinical framework for personalizing hypoglycemic therapy in patients with comorbid pulmonary conditions, while underscoring the need for well-designed prospective studies to resolve existing controversies.},
}

@article {pmid41497729,
year = {2025},
author = {Liu, T and Li, M and Zhu, L and Liang, R and Zhang, P and Liu, X},
title = {Ocular Lesions Related to COVID-19 and Its Vaccines.},
journal = {Journal of ophthalmology},
volume = {2025},
number = {},
pages = {7078264},
pmid = {41497729},
issn = {2090-004X},
abstract = {OBJECTIVE: To review COVID-19 infection and COVID-19 vaccine-related ocular lesions.

METHODS: We carried out a systematic search in PubMed, Web of Science, Embase, and the Cochrane Library on COVID-19 and ophthalmology and reviewed the incidence, specific manifestations, and risk factors for COVID-19-related eye diseases and the relationship between the detection of COVID-19 in the conjunctiva and tears and eye involvement.

RESULTS: Conjunctivitis was the most common ocular lesion caused by 2019-nCoV infection, followed by uveitis and retinopathy. Conjunctivitis can be the first manifestation of COVID-19 infection and may be clinically related to the severity of pneumonia caused by COVID-19. In particular, conjunctivitis that occurs after pneumonia suggests that the patient has severe systemic disease. COVID-19 infection can cause uveitis, but the infection rate of COVID-19 in patients with uveitis is similar to that of the general population. Patients with uveitis need to reduce the dosage of systemic hormones and discontinue biological agents after being infected with COVID-19. Retinopathy caused by COVID-19 infection is mainly manifested as retinal microvascular disease, and the prognosis is good. SARS-CoV-2 detection in the conjunctiva and tears has high sensitivity and is of great value for disease diagnosis. Eye lesions caused by the COVID-19 vaccine, similar to other vaccines, have a low incidence and a good prognosis.

CONCLUSION: COVID-19-related ocular lesions are mainly manifested as conjunctivitis, uveitis, and retinal microvascular changes. These diseases are somewhat self-limiting and have a good prognosis.},
}

@article {pmid41497937,
year = {2025},
author = {Idahor, CO and Ogunfuwa, O and Ogbonna, N and Ogbeide, OA and Abe, O and Oore-Ofe, O},
title = {Transforming Emergency Care Through Telemedicine: A Narrative Review.},
journal = {Cureus},
volume = {17},
number = {12},
pages = {e98481},
pmid = {41497937},
issn = {2168-8184},
abstract = {Telemedicine has fleetly evolved from a niche result to a central pillar in modern emergency and critical care systems. This narrative review delves into the multifaceted role of telemedicine in emergency settings, tracing its historical development, present applications, and future possibilities. It examines how telemedicine islands geographical and infrastructural gaps, particularly in underserved communities, by enabling timely access to specialist care similar to telestroke services and remote ferocious care. Substantiation highlights advancements in clinical outcomes, functional effectiveness, and patient satisfaction, with global case studies demonstrating successful perpetration across both high- and low-resource settings. Despite these advances, challenges persist. Technological restrictions, regulatory barriers, digital knowledge gaps, and unlikeness in assent continue to hamper wide relinquishment. This review discusses these obstacles and underscores the significance of strategic investment, cross-sector collaboration, and policy reform. Arising inventions, including artificial intelligence, wearable devices, and scalable telehealth platforms, signal promising directions for perfecting reach and adaptability in emergency systems. Additionally, this paper identifies crucial areas for unborn research, including long-term outgrowth assessment and telemedicine's part in disaster and pandemic response. By synthesizing current substantiation and practical perceptivity, this review aims to inform clinicians, health system leaders, and policymakers about the transformative eventuality and ongoing challenges of telemedicine in emergency care. Eventually, it calls for sustained invention, equity-concentrated perpetration, and cooperative sweats to completely realize telemedicine's pledge in erecting a more accessible, responsive, and flexible emergency care geography.},
}

@article {pmid41498242,
year = {2026},
author = {Kuperwasser, C and El-Deiry, WS},
title = {COVID vaccination and post-infection cancer signals: Evaluating patterns and potential biological mechanisms.},
journal = {Oncotarget},
volume = {17},
number = {},
pages = {1-29},
pmid = {41498242},
issn = {1949-2553},
mesh = {Humans ; *COVID-19/prevention & control/immunology/epidemiology/virology ; *Neoplasms/epidemiology/etiology/immunology ; *COVID-19 Vaccines/adverse effects ; SARS-CoV-2/immunology ; *Vaccination/adverse effects ; Incidence ; },
abstract = {A growing number of peer-reviewed publications have reported diverse cancer types appearing in temporal association with COVID-19 vaccination or infection. To characterize the nature and scope of these reports, a systematic literature search from January 2020 to October 2025 was conducted based on specified eligibility criteria. A total of 69 publications met inclusion criteria: 66 article-level reports describing 333 patients across 27 countries, 2 retrospective population-level investigations (Italy: ~300,000 cohort, and Korea: ~8.4 million cohort) quantified cancer incidence and mortality trends among vaccinated populations, and one longitudinal analysis of ~1.3 million US miliary service members spanning the pre-pandemic through post-pandemic periods. Most of the studies documented hematologic malignancies (non-Hodgkin's lymphomas, cutaneous lymphomas, leukemias), solid tumors (breast, lung, melanoma, sarcoma, pancreatic cancer, and glioblastoma), and virus-associated cancers (Kaposi and Merkel cell carcinoma). Across reports, several recurrent themes emerged: (1) unusually rapid progression, recurrence, or reactivation of preexisting indolent or controlled disease, (2) atypical or localized histopathologic findings, including involvement of vaccine injection sites or regional lymph nodes, and (3) proposed immunologic links between acute infection or vaccination and tumor dormancy, immune escape, or microenvironmental shifts. The predominance of case-level observations and early population-level data demonstrates an early phase of potential safety-signal detection. These findings underscore the need for rigorous epidemiologic, longitudinal, clinical, histopathological, forensic, and mechanistic studies to assess whether and under what conditions COVID-19 vaccination or infection may be linked with cancer.},
}

Humans
*COVID-19/prevention & control/immunology/epidemiology/virology
*Neoplasms/epidemiology/etiology/immunology
*COVID-19 Vaccines/adverse effects
SARS-CoV-2/immunology
*Vaccination/adverse effects
Incidence

@article {pmid41498334,
year = {2026},
author = {Azasi, E and Asamoah, PE and Diaconu, K},
title = {Understanding the needs and key determinants of maternal, newborn, and child health among migrants in transit: a scoping review.},
journal = {Global health action},
volume = {19},
number = {1},
pages = {2607905},
pmid = {41498334},
issn = {1654-9880},
mesh = {Humans ; Female ; Pregnancy ; *Transients and Migrants/statistics & numerical data ; Health Services Accessibility ; Infant, Newborn ; *Child Health ; *Maternal Health ; *Health Services Needs and Demand ; Child ; },
abstract = {The global surge in migration has exposed pregnant women and children in transit to heightened risk of maternal and child health (MCH) challenges, driven by systemic barriers and unstable conditions. Evidence on how these transitory factors influence MCH remains limited. This scoping review examined the health needs and key determinants affecting migrant populations in transit, specifically pregnant women and children travelling from their countries of origin to their intended destination countries, with the aim of identifying major barriers and proposing strategies for improved health outcomes. We screened 1202 sources of evidence using five databases (PubMed, Scopus, Europe PMC, CINAHL, and Medline) as well as grey literature. Seven studies met the inclusion criteria. Data were drawn from peer-reviewed literature, charted using a standardized framework, and analysed thematically. Key barriers included financial constraints, language obstacles, and limited access to healthcare services. Although humanitarian organizations offered some support, significant unmet needs remain, including exposure to transactional sex, absence of respectful maternity care, and restricted access to essential health services. These challenges are exacerbated in conflict and crisis settings. The review underscores the importance of addressing key determinants, including location, language, financial capacity, and community support, to improve health outcomes for pregnant women and children under five on the move. This review recommends strengthening community mobilization, leveraging technology, and ensuring equitable access irrespective of users' cultural or financial constraints.},
}

Humans
Female
Pregnancy
*Transients and Migrants/statistics & numerical data
Health Services Accessibility
Infant, Newborn
*Child Health
*Maternal Health
*Health Services Needs and Demand
Child

@article {pmid41498391,
year = {2026},
author = {Zhang, X and Han, X and Xu, J and Li, G},
title = {Disease-associated adipose browning: current evidence and perspectives.},
journal = {Adipocyte},
volume = {15},
number = {1},
pages = {2610540},
pmid = {41498391},
issn = {2162-397X},
mesh = {Humans ; *Adipose Tissue, Brown/metabolism/pathology ; Animals ; Thermogenesis ; COVID-19/metabolism ; Energy Metabolism ; Adipose Tissue, White/metabolism ; },
abstract = {Brown and beige adipose tissue represent evolutionary adaptations in mammals, functioning as specialized thermogenic organs to maintain body temperature. Over the past two decades, researches have demonstrated that white adipose tissue (WAT) browning is an effective strategy to enhance energy expenditure. However, a growing body of evidence indicates that the browning process frequently occurs in a variety of chronic disease states, though its pathophysiological significance remains unclear. This review summarized evidence of pathological browning observed in human diseases and animal models, including breast cancer, colorectal cancer (CRC), clear cell renal cell carcinoma (ccRCC), kidney health, burn injury, atherosclerotic, SARS-CoV-2 and sepsis. Despite distinct pathological contexts, adipose tissue browning is consistently observed. This suggests that browning may not simply serve its classical metabolically protective role, but instead reflect an atypical response to pathological stress. It is currently unclear whether this is a compensatory mechanism by the organism in a diseased state or merely a byproduct of the disease process. Whether this response is adaptive or a cause of disease progression remains unresolved. Future research should therefore focus on identifying the triggers and functional outcomes of pathological browning to better understand adipocyte plasticity and its role in disease progression.},
}

Humans
*Adipose Tissue, Brown/metabolism/pathology
Animals
Thermogenesis
COVID-19/metabolism
Energy Metabolism
Adipose Tissue, White/metabolism

@article {pmid41499907,
year = {2026},
author = {Ruan, T and Li, M},
title = {The inverse relationship between post-traumatic growth and job burnout among medical staff during the COVID-19 normalization period: A systematic review.},
journal = {Asian journal of psychiatry},
volume = {116},
number = {},
pages = {104814},
doi = {10.1016/j.ajp.2025.104814},
pmid = {41499907},
issn = {1876-2026},
mesh = {Humans ; *Burnout, Professional/psychology/epidemiology ; *COVID-19 ; *Medical Staff/psychology ; *Posttraumatic Growth, Psychological ; },
abstract = {OBJECTIVE: To synthesize empirical evidence on the association between post-traumatic growth (PTG) and job burnout among medical staff across varied healthcare settings during the COVID-19 normalization period (2022 onward).

METHODS: Following PRISMA guidelines, a database indexing over 126 million records was searched, yielding 499 records for screening, and 11 studies that measured both PTG and burnout in active healthcare professionals. Data on study design, setting, instruments, sample characteristics, and key findings were extracted.

RESULTS: Nine quantitative (seven cross-sectional, one longitudinal, one unspecified design) and two qualitative studies met inclusion criteria, encompassing nurses, physicians, psychiatrists, paramedics, and medical rescuers in eight countries. Standardized instruments (e.g., Post-Traumatic Growth Inventory variants; Maslach Burnout Inventory variants) were most common. Eight studies reported a significant inverse correlation between PTG and burnout (e.g., odds ratio= 0.653, 95 % CI= 0.525-0.812, p < 0.001; r = -0.276, p = 0.034). Five studies identified PTG as a mediator or moderator of stress-burnout pathways. Qualitative analyses described a trajectory from acute stress through cognitive restructuring to growth, with burnout linked to unresolved trauma.

CONCLUSIONS: Consistent evidence indicates that higher PTG protects against burnout in medical staff post-pandemic peak. Psychological resources-resilience, self-compassion, adaptive coping, meaning in work, and job satisfaction-emerge as key mediators or moderators. Interventions fostering PTG and its correlates may mitigate burnout in healthcare workers.},
}

Humans
*Burnout, Professional/psychology/epidemiology
*COVID-19
*Medical Staff/psychology
*Posttraumatic Growth, Psychological

@article {pmid41499962,
year = {2026},
author = {Wang, B and Fu, Y and Duan, F and Pan, S and Zheng, Y},
title = {Decoding emerging viral sepsis: Molecular crosstalk, dysregulation, and precision strategies.},
journal = {Molecular aspects of medicine},
volume = {107},
number = {},
pages = {101442},
doi = {10.1016/j.mam.2025.101442},
pmid = {41499962},
issn = {1872-9452},
mesh = {Humans ; *Sepsis/virology/immunology/therapy ; SARS-CoV-2 ; COVID-19/virology/complications ; Host-Pathogen Interactions ; *Virus Diseases/virology ; Animals ; },
abstract = {Emerging and re-emerging viral pathogens pose a major challenge to global public health systems. One of the most significant complications associated with these viruses is viral sepsis, a severe condition characterized by organ dysfunction resulting from an unregulated host response to a viral infection. The present review comprehensively describes the molecular mechanisms underlying viral sepsis induced by emerging and re-emerging viral pathogens, such as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), influenza virus, dengue virus (DENV), Ebola virus (EBOV), and human immunodeficiency virus (HIV). It discusses the complex molecular interactions between particular viral factors and host cellular pathways, highlighting significant dysregulations in various immune responses, metabolic reprogramming, and endothelial integrity that induce sepsis development. Furthermore, this review thoroughly addresses nascent precision strategies, including advanced diagnostics, targeted therapeutics, and immunomodulatory interventions, carefully tailored to distinct viral etiologies and host endotypes. By shedding light on the intricate molecular landscape of viral sepsis, this review aims to provide a robust framework for future mechanistic research and accelerate the development of effective, personalized interventions to combat this challenging complication.},
}

Humans
*Sepsis/virology/immunology/therapy
SARS-CoV-2
COVID-19/virology/complications
Host-Pathogen Interactions
*Virus Diseases/virology
Animals

@article {pmid41501207,
year = {2026},
author = {Murata, A and Tanaka, M and Takayoshi, M and Matsuyama, Y and Sato, R and Ishida, Y and Teragaki, M and Iwanari, S and Ikeda, M and Takeoka, H},
title = {Osmotic nephropathy as a potentially underrecognized cause of acute kidney injury during SGLT2 inhibitor therapy: a case report and literature review.},
journal = {CEN case reports},
volume = {15},
number = {1},
pages = {16},
pmid = {41501207},
issn = {2192-4449},
mesh = {Humans ; Male ; *Sodium-Glucose Transporter 2 Inhibitors/adverse effects/therapeutic use ; *Acute Kidney Injury/chemically induced/therapy/diagnosis ; Aged ; *Diabetes Mellitus, Type 2/drug therapy/complications ; *Benzhydryl Compounds/adverse effects/therapeutic use ; COVID-19/complications ; *Glucosides/adverse effects ; *Renal Insufficiency, Chronic/drug therapy/complications ; Renal Dialysis ; SARS-CoV-2 ; },
abstract = {In recent years, sodium-glucose cotransporter 2 (SGLT2) inhibitors have become essential therapeutic agents in the management of chronic kidney disease (CKD), owing to their established renoprotective effects. Although acute kidney injury (AKI) may occasionally occur during SGLT2 inhibitor therapy, its pathological features remain incompletely understood. Here, we report a case of AKI caused by osmotic nephropathy in a patient with underlying CKD following the initiation of an SGLT2 inhibitor. We also review previously reported cases of SGLT2 inhibitor-associated osmotic nephropathy. A 71-year-old man with type 2 diabetes and CKD developed oliguric AKI, with his serum creatinine level increasing from 2.0 to 8.3 mg/dL, one month after initiating dapagliflozin. During this period, he experienced transient appetite loss associated with a COVID-19 infection. Despite initial management for presumed prerenal AKI, his renal function did not improve with intravenous fluid therapy, and he required hemodialysis. Kidney biopsy revealed characteristic features of osmotic nephropathy, including numerous isometric vacuoles within the epithelial cells of proximal tubules with preserved brush borders. His renal function began to improve approximately two weeks after discontinuation of the SGLT2 inhibitor, and eventually returned to baseline. This case and literature review highlight the potential for osmotic nephropathy as a rare but reversible complication of SGLT2 inhibitor therapy, which may be triggered by volume depletion, particularly in diabetic patients with pre-existing renal dysfunction. Recognition of this underdiagnosed entity is crucial for timely diagnosis and appropriate management.},
}

Humans
Male
*Sodium-Glucose Transporter 2 Inhibitors/adverse effects/therapeutic use
*Acute Kidney Injury/chemically induced/therapy/diagnosis
Aged
*Diabetes Mellitus, Type 2/drug therapy/complications
*Benzhydryl Compounds/adverse effects/therapeutic use
COVID-19/complications
*Glucosides/adverse effects
*Renal Insufficiency, Chronic/drug therapy/complications
Renal Dialysis
SARS-CoV-2

@article {pmid41502328,
year = {2026},
author = {Gimmon, Y and Gordon, CR},
title = {Neuro-vestibular rehab: new developments.},
journal = {Current opinion in neurology},
volume = {39},
number = {1},
pages = {83-87},
doi = {10.1097/WCO.0000000000001441},
pmid = {41502328},
issn = {1473-6551},
mesh = {Humans ; *Vestibular Diseases/rehabilitation/physiopathology ; *Reflex, Vestibulo-Ocular/physiology ; *Neurological Rehabilitation/methods/trends ; *Vestibule, Labyrinth/physiology ; Adaptation, Physiological/physiology ; Exercise Therapy/methods ; Telemedicine ; COVID-19 ; },
abstract = {PURPOSE OF REVIEW: This review highlights recent advances in neuro-vestibular rehabilitation, with emphasis on vestibular adaptation and emerging mobile technologies. It summarizes developments in promoting vestibular plasticity and discusses novel tools such as virtual reality, wearable sensors, and telehealth platforms that enhance access, engagement, and outcomes. The scope is broad, focusing on general principles rather than specific populations.

RECENT FINDINGS: New methods to enhance vestibulo-ocular reflex (VOR) adaptation include incremental adaptation devices and gamified exercises. Inducing VOR gain-down adaptation temporarily increases postural sway, which normalizes via sensory reweighting, demonstrating central compensation. Portable tools like StableEyes show promise in boosting VOR gain with brief sessions. Concurrently, technology-driven approaches are gaining traction. Gamified mobile applications and wearable sensors allow home-based rehabilitation with remote supervision and monitoring, showing promising results in conditions like multiple sclerosis. Virtual reality interventions and telehealth models accelerated during the COVID-19 era, expanding therapy delivery to underserved populations. Adjunctive methods such as vibrotactile feedback and galvanic vestibular stimulation are emerging as complementary therapies.

SUMMARY: Recent developments are advancing vestibular rehabilitation by refining adaptive training techniques and leveraging digital tools to overcome barriers in access and adherence. These innovations point to a more personalized, technology-enabled approach to optimizing neuro-vestibular recovery.},
}

Humans
*Vestibular Diseases/rehabilitation/physiopathology
*Reflex, Vestibulo-Ocular/physiology
*Neurological Rehabilitation/methods/trends
*Vestibule, Labyrinth/physiology
Adaptation, Physiological/physiology
Exercise Therapy/methods
Telemedicine
COVID-19

@article {pmid41502909,
year = {2026},
author = {El Rassi, C and El Darzi, R and Abou Mansour, M and Arabi, M},
title = {MIS-C: Diagnosis, Management, and Outcomes.},
journal = {Open forum infectious diseases},
volume = {13},
number = {1},
pages = {ofaf762},
pmid = {41502909},
issn = {2328-8957},
abstract = {Multisystem inflammatory syndrome in children (MIS-C) is an emergent postinfectious hyperinflammatory disorder predominantly affecting the pediatric population following COVID-19 infection. Clinically, it is characterized by persistent fever, shock, multiorgan involvement, and potentially severe cardiovascular involvement. This comprehensive review synthesizes current evidence on the epidemiology, pathophysiology, clinical presentation, diagnostic criteria, with particular emphasis on the management of MIS-C. We also stress on the importance of distinguishing MIS-C from phenotypically similar entities. Acute-phase management centers on supportive care, hemodynamic stabilization, and targeted immunomodulation, with intravenous immunoglobulin, corticosteroids, and biologic forming the therapeutic cornerstone. Thromboprophylaxis is frequently warranted due to the elevated thromboembolic risk, and long-term follow-up is essential to monitor for cardiac, gastrointestinal, and neurologic complications. Additional considerations include postrecovery vaccination protocols and the use of extracorporeal membrane oxygenation in cases of refractory cardiorespiratory failure. Despite advancements in clinical outcomes, diagnostic ambiguity and heterogeneous management guidelines continue to pose significant challenges.},
}

@article {pmid41503324,
year = {2025},
author = {Dameche, K and Shams, S and AlMesallam, MS},
title = {Herpes Zoster (HZ) Over the Past 10 Years: A Systematic Review on Trends, Triggers, and Post-COVID-19 Impact.},
journal = {Cureus},
volume = {17},
number = {12},
pages = {e98556},
pmid = {41503324},
issn = {2168-8184},
abstract = {Herpes zoster (HZ) is a reactivation of varicella-zoster virus (VZV), which has been traditionally associated with aging and immunosuppression. However, new data indicate that the coronavirus disease 2019 (COVID-19) pandemic has changed HZ epidemiology, with a higher incidence of HZ in post-COVID-19 patients and vaccinated subjects. This systematic review assesses the trends and triggers of HZ as well as the impact after the pandemic, focusing on the changes in the incidence rate among adult and pediatric patients during the last 10 years. All studies published between the years of 2014 and 2024 were accrued, based on a systematic review conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant articles were identified from searches of databases and other sources. Eligibility criteria of studies were applied, and qualitative and quantitative syntheses of studies were performed. A total of 11 studies were included in the review, which examined the association between COVID-19, vaccination, and HZ risk. Several studies suggested that psychological stress and immune dysfunction could be risk factors for HZ incidence. HZ cases after COVID-19 vaccination have been reported, although causation is not established. Based on countries in which COVID-19 was diagnosed, hospitalizations are estimated at 14.4 per 100,000 inhabitants (0.6 to 32.9 per 100,000), and mortality was 1.3 per 100,000, points in this IR Batch (assuming that these are of all diagnosed cases). The risk of HZ reactivation may be increased following COVID-19 infection and vaccination. Higher hospitalization rates with higher mortality risks and neurological consequences were also observed in some populations. Strengthening HZ vaccination programs and studying post-COVID-19 immune responses further can be essential for reducing long-term health risks.},
}

@article {pmid41504094,
year = {2025},
author = {Galuia, M and Hussain, A and Ahmad, S},
title = {Biosimilars in Gynecologic Cancers: Basic Principles and New Horizons.},
journal = {Frontiers in bioscience (Elite edition)},
volume = {17},
number = {4},
pages = {33415},
doi = {10.31083/FBE33415},
pmid = {41504094},
issn = {1945-0508},
mesh = {Humans ; *Biosimilar Pharmaceuticals/therapeutic use/economics ; *Genital Neoplasms, Female/drug therapy ; Female ; Cost-Benefit Analysis ; *Antineoplastic Agents/therapeutic use ; },
abstract = {Biological therapies have transformed cancer treatment by targeting the molecular mechanisms involved in carcinogenesis. However, higher costs, limited accessibility, and supply chain disruptions-such as those caused by COVID-19 in recent years-underscore the need for cost-effective alternatives. Biosimilars, which are drugs that are highly similar to their reference biologics in terms of safety, efficacy, and quality, offer a viable solution (as these demonstrate clinically meaningful outcomes). This review article examines the role of biosimilars, mainly in gynecological cancers. The primary focus of this article is to compare the efficacy, safety, and cost-effectiveness of biosimilars, as well as to explore the barriers that restrict their widespread adoption. A comprehensive literature review was conducted, analyzing various studies, regulatory guidelines, and the latest data on biosimilars for the treatment of gynecological cancers. Pivotal trials, such as the GOG-0218, ICON7, and RUBY, were reviewed to assess the efficacy, safety, and cost-effectiveness of these biosimilars. This review highlights key oncologic therapies, including bevacizumab, trastuzumab, pembrolizumab, and their biosimilars, mainly for gynecological cancers. Additionally, this review considers the challenges of immunogenicity, interchangeability, and clinician awareness. After reviewing the latest peer-reviewed literature and related online materials, we found that biosimilars demonstrate comparable efficacy and safety to their reference biologics while also being more cost-effective. Recent clinical trials support the role of biosimilars in limiting the progression of disease and improving overall survival while reducing the financial burden of cancer treatments.},
}

Humans
*Biosimilar Pharmaceuticals/therapeutic use/economics
*Genital Neoplasms, Female/drug therapy
Female
Cost-Benefit Analysis
*Antineoplastic Agents/therapeutic use

@article {pmid41504442,
year = {2026},
author = {Masters, PS},
title = {Coronavirus genome packaging and nucleocapsid assembly.},
journal = {Journal of virology},
volume = {100},
number = {2},
pages = {e0133025},
pmid = {41504442},
issn = {1098-5514},
support = {R01 AI064603/AI/NIAID NIH HHS/United States ; },
mesh = {*Nucleocapsid/metabolism/genetics ; Humans ; *Virus Assembly ; RNA, Viral/genetics/metabolism ; *Viral Genome Packaging ; SARS-CoV-2/genetics/physiology ; *Genome, Viral ; COVID-19/virology ; *Coronavirus/physiology/genetics ; Animals ; Coronavirus Nucleocapsid Proteins/metabolism/genetics ; Nucleocapsid Proteins/metabolism ; },
abstract = {Coronaviruses are a family of positive-strand RNA viruses that exhibit highly selective packaging of their genomic RNA (gRNA) into assembled virions, despite the presence of a large excess of subgenomic viral RNA species and host RNA in infected cells. While this high selectivity is critical to evading host innate immune responses, surprisingly, it is not essential for virion assembly. This review focuses on four main topics: (i) coronavirus genome packaging signals (PSs)-how they are found and the function they serve; (ii) the viral components that recognize the PS in order to bring about selective gRNA packaging; (iii) coronavirus nucleocapsid structure and assembly; and (iv) the relationship between nucleocapsid protein phosphorylation and nucleocapsid assembly versus RNA synthesis. Current understanding of these areas has benefited immensely from advances made by recent studies, most of which were performed in response to the emergence of the coronavirus responsible for the COVID-19 pandemic. Throughout this review, emphasis is placed on the counterintuitive distinction between coronavirus selective gRNA packaging and nucleocapsid assembly.},
}

*Nucleocapsid/metabolism/genetics
Humans
*Virus Assembly
RNA, Viral/genetics/metabolism
*Viral Genome Packaging
SARS-CoV-2/genetics/physiology
*Genome, Viral
COVID-19/virology
*Coronavirus/physiology/genetics
Animals
Coronavirus Nucleocapsid Proteins/metabolism/genetics
Nucleocapsid Proteins/metabolism

@article {pmid41504868,
year = {2026},
author = {Khan, S and Tang, P and Yang, P and Li, J and Wu, H},
title = {Dual-function cytokines as modulators of autophagy: reprogramming inflammatory resolution in severe COVID-19.},
journal = {Inflammation research : official journal of the European Histamine Research Society ... [et al.]},
volume = {75},
number = {1},
pages = {11},
pmid = {41504868},
issn = {1420-908X},
mesh = {Humans ; *Autophagy/immunology ; *COVID-19/immunology ; *Cytokines/immunology/physiology ; *Inflammation/immunology ; SARS-CoV-2 ; Endoplasmic Reticulum Stress ; Animals ; Cytokine Release Syndrome/immunology ; },
abstract = {BACKGROUND: Acute respiratory distress syndrome (ARDS) and systemic immune-mediated damage are two of the severe COVID-19 outcomes that are primarily caused by cytokine storms triggered by dysregulated immune responses. The limited benefits of current immunosuppressive treatments highlight the need for mechanistic understanding to direct focused interventions.

OBJECTIVE: The dual functions of cytokines in controlling autophagy during SARS-CoV-2 infection are examined in this review, along with the potential for autophagy modulation to limit hyperinflammation and restore immune homeostasis.

KEY FINDINGS: Emerging evidence suggests that autophagy critically modulates the balance between pro- and anti-inflammatory cytokines in COVID-19. Through anti-inflammatory feedback mechanisms, cytokines contribute to resolution while promoting inflammation in the early stages. The IRE1α-XBP1 axis is activated by SARS-CoV-2-induced endoplasmic reticulum stress, which increases cytokine production and modifies autophagic flux. Concurrently, extracellular vesicles containing cytokines, damage-associated molecular patterns, and viral components are released as secretory autophagy reroutes cytoplasmic cargo toward multivesicular bodies and amphisomes, increasing paracrine immune activation. Suppressed degradative autophagy and increased secretory autophagy-mediated inflammatory signaling are the hallmarks of this pathological state.

CONCLUSIONS: In severe COVID-19, targeted autophagy restoration is a promising therapeutic approach to restore immune responses, reduce excessive inflammation, and encourage the resolution of cytokine storms. Restoring immune homeostasis through more targeted immunointerventions may be made possible by modifying autophagy pathways.},
}

Humans
*Autophagy/immunology
*COVID-19/immunology
*Cytokines/immunology/physiology
*Inflammation/immunology
SARS-CoV-2
Endoplasmic Reticulum Stress
Animals
Cytokine Release Syndrome/immunology

@article {pmid41506147,
year = {2026},
author = {Huai, Y and Wang, X and Yan, J and Li, S and Zhao, H and Liao, B},
title = {Emerging viroporins, RBP dynamics, and skeletal remodeling: Targeting liquid-liquid phase separation for dual antiviral and bone-protective therapies.},
journal = {Molecular aspects of medicine},
volume = {107},
number = {},
pages = {101445},
doi = {10.1016/j.mam.2026.101445},
pmid = {41506147},
issn = {1872-9452},
mesh = {Humans ; *Antiviral Agents/pharmacology/therapeutic use ; SARS-CoV-2/metabolism ; *Bone Remodeling/drug effects ; COVID-19/metabolism/virology ; *RNA-Binding Proteins/metabolism ; Animals ; Zika Virus/metabolism/pathogenicity ; Chikungunya virus ; Zika Virus Infection/virology/metabolism/drug therapy ; Phase Separation ; },
abstract = {Emerging and re-emerging viral pathogens, particularly Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), Zika virus (ZIKV), and Chikungunya virus (CHIKV), are currently recognized as a significant global public health issue, commonly leading to devastating persistent complications including inflammatory bone disorders and long-lasting arthralgia. Although systemic cytokine storm has been reported as a significant factor, the particular intracellular processes through which these viruses affect bone homeostasis are still poorly understood. Recent studies underscore Liquid-Liquid Phase Separation (LLPS) and RNA-Binding Proteins (RBPs) as significant regulatory mechanisms manipulated by these viruses. Particularly, the SARS-CoV-2 Nucleocapsid protein exploits its intrinsically disordered regions to promote LLPS, facilitating viral assembly by the active inhibition of a key host anti-viral mechanism, known as host Stress Granules. Studies suggest that this biophysical interaction can affect the stability of the HuR RBD, impairing the nuclear β-catenin localization and then Wnt-mediated osteogenesis. Despite increasing recognition of post-viral musculoskeletal complications, the mechanistic links between viral persistence, host RBP dysfunction, and impaired bone remodeling remain poorly defined. This review incorporates viral LLPS, stress granule impairment, and osteogenic signaling into a unified 'Two-Hit' pathogenic framework. It also addresses key knowledge gaps, including the lack of longitudinal clinical validation and in vivo evidence associating LLPS impairment to skeletal disorders. Interestingly, this framework represents translational opportunities for dual-action therapeutic strategies that simultaneously impair viral condensates and recover host RBP-associated osteogenic signaling. Targeting the virus-host phase interface can introduce a potential approach not only for antiviral therapies but also for inhibiting post-viral musculoskeletal complications.},
}

Humans
*Antiviral Agents/pharmacology/therapeutic use
SARS-CoV-2/metabolism
*Bone Remodeling/drug effects
COVID-19/metabolism/virology
*RNA-Binding Proteins/metabolism
Animals
Zika Virus/metabolism/pathogenicity
Chikungunya virus
Zika Virus Infection/virology/metabolism/drug therapy
Phase Separation

@article {pmid41506494,
year = {2026},
author = {Tran, MT and Doan, TD and Wu, HC and Chu, CY},
title = {Vaccine development for porcine epidemic diarrhea virus and porcine Deltacoronavirus: Updated progress, challenges, and future perspectives.},
journal = {Microbial pathogenesis},
volume = {212},
number = {},
pages = {108286},
doi = {10.1016/j.micpath.2026.108286},
pmid = {41506494},
issn = {1096-1208},
mesh = {Animals ; *Porcine epidemic diarrhea virus/immunology ; Swine ; *Coronavirus Infections/prevention & control/veterinary/immunology ; *Viral Vaccines/immunology ; *Swine Diseases/prevention & control/virology/immunology ; *Vaccine Development/trends ; *Deltacoronavirus/immunology ; Vaccine Efficacy ; Antibodies, Viral/immunology ; Adjuvants, Vaccine ; Adjuvants, Immunologic/administration & dosage ; Cross Protection ; },
abstract = {Porcine Epidemic Diarrhea Virus (PEDV) and Porcine Deltacoronavirus (PDCoV) are considered the greatest threats to the world swine industry since they cause a very high morbidity rate in piglets. Although vaccines with various formulations have been tested and validated in different settings, they still cannot be considered to provide long-lasting, comprehensive protection against these pathogens under real-world conditions. This review provides a comprehensive and critical overview of parallel efforts to develop vaccines against PEDV and PDCoV, with particular emphasis on vaccine formulation strategies, virus strains used in challenge studies, and the geographical applicability of these vaccines. Recent advances in vaccine development are discussed, highlighting the use of newly developed adjuvants and advanced delivery systems to enhance vaccine efficacy, especially in terms of inducing mucosal immune responses. Rather than merely summarizing progress in vaccine development to date, this review presents challenges, including viral diversity, lack of cross-protection, and maternal antibody interference, which reduce vaccine efficacy. Additionally, we discuss novel directions for future research on broadly protective next-generation antigen-detection systems and integrated approaches targeting different porcine coronaviruses. Thus, this review offers an up-to-date, in-depth overview of the current state of PEDV and PDCoV vaccine research, while also outlining future perspectives to drive innovation toward practical and sustainable disease control.},
}

Animals
*Porcine epidemic diarrhea virus/immunology
Swine
*Coronavirus Infections/prevention & control/veterinary/immunology
*Viral Vaccines/immunology
*Swine Diseases/prevention & control/virology/immunology
*Vaccine Development/trends
*Deltacoronavirus/immunology
Vaccine Efficacy
Antibodies, Viral/immunology
Adjuvants, Vaccine
Adjuvants, Immunologic/administration & dosage
Cross Protection

@article {pmid41506930,
year = {2026},
author = {He, WT and Jiang, ZW and Veit, M and Merits, A and Zhang, FN and Wang, D and Su, S},
title = {Multiscale imaging of RNA virus: bridging structural mapping and functional insights.},
journal = {Trends in microbiology},
volume = {34},
number = {3},
pages = {305-317},
doi = {10.1016/j.tim.2025.12.002},
pmid = {41506930},
issn = {1878-4380},
mesh = {Cryoelectron Microscopy/methods ; Humans ; *RNA Viruses/ultrastructure/physiology ; SARS-CoV-2/ultrastructure ; COVID-19/virology ; Electron Microscope Tomography/methods ; Animals ; },
abstract = {RNA viruses, exemplified by the COVID-19 pandemic, pose a significant threat to global health. Their rapid mutation and host adaptability highlight the need for advanced tools for efficient viral studies and timely countermeasure development. Imaging technologies, such as cryo-electron microscopy and super-resolution microscopy, have been pivotal in advancing our understanding of viral structures, infection mechanisms, and virus-host interactions. However, each technique has limitations in the field of view or resolution. Recent advancements have focused on developing integrated multiscale imaging to better understand RNA virus pathogenesis. In this review, we examine recent progress in RNA virus imaging across molecular, cellular, and tissue scales, including cryo-electron tomography and correlative multiscale imaging, which link structural mapping with functional insights.},
}

Cryoelectron Microscopy/methods
Humans
*RNA Viruses/ultrastructure/physiology
SARS-CoV-2/ultrastructure
COVID-19/virology
Electron Microscope Tomography/methods
Animals

@article {pmid41509876,
year = {2026},
author = {Ärlebrant, L and Schimmer, R and Edin-Liljegren, A},
title = {Patients' experiences of video consultations: A qualitative systematic review.},
journal = {Digital health},
volume = {12},
number = {},
pages = {20552076251404513},
pmid = {41509876},
issn = {2055-2076},
abstract = {INTRODUCTION: Video consultation (VC) became vital for improving healthcare access during COVID-19 pandemic and remains so. Despite evidence of effectiveness, concerns including technology literacy and inconsistencies in experience highlight the need for larger, patient-focused studies. While patients appreciate the convenience of VC, challenges during complex issues and patients' preferences for in-person care persists. Synthesising qualitative studies offers insights into the fragmented understanding of patient experiences with VC. This review explores adult patients' experiences of VC.

METHODS: A systematic literature search was conducted for studies published between 2011 and 2024 and reported according to the PRISMA statement. Study quality was assessed using the CASP checklist, and data were analysed through thematic synthesis. Confidence in the findings was evaluated using GRADE-CERQual.

RESULTS: In total, 3203 unique studies were retrieved; 13 were included in the final synthesis, resulting in four main themes: (1) suitable for less complex issues when technical problems can be solved; (2) feeling secure, relaxed, and having mutual focus in an equitable partnership; (3) limitations regarding personal needs and practical help; and (4) increased vulnerability and lack of emotional feedback.

CONCLUSION: VC is experienced as ideal for managing less complex issues but is challenging for emotional topics due to technical concerns. It empowers patients by providing a neutral place for focused conversations but can create vulnerability and distance that can challenge the patient-professional relationship. Success requires technological adaptation, sufficient time during VC, and emotional support. VC should complement - not replace - traditional care, with its use determined in dialogue with patients.},
}

@article {pmid41510348,
year = {2025},
author = {Tachibana, S and Bourgeois Yoshioka, CK},
title = {Take Fatigue or Fatigues into Account in Physiotherapy Interventions? A Rapid Scoping Review.},
journal = {Physical therapy research},
volume = {28},
number = {3},
pages = {157-173},
pmid = {41510348},
issn = {2189-8448},
abstract = {Fatigue is one of the most common symptoms encountered in rehabilitation and during physical therapy interventions. Although this phenomenon is known and experienced by everyone, its assessment is not straightforward. The lack of consensus on its definition, complex etiology, and multidimensional nature means that a large number of outcomes exist and continue to be reviewed. However, it seems essential that its assessment be better defined and standardized to understand the effects of physical therapy. To provide an initial exploratory overview, we conducted a rapid scoping review of the various fatigue assessments used in physiotherapy interventions or performed by physical therapists. A total of 139 articles published between 2020 and July 31, 2025 were included and explored. We found 43 different outcomes used across 46 population groups. While the most well-known chronic conditions such as cancer, multiple sclerosis (MS), and coronavirus disease 2019 (COVID-19) are representative, their assessment methods do not appear to be harmonized. These findings from the study support the idea that fatigue remains a complex phenomenon to assess. However, it appears that the lack of justification for the choice of an outcome prevents a better understanding of the reproducible effects on fatigue in physiotherapy interventions.},
}

@article {pmid41512080,
year = {2026},
author = {Lee, D and Malathi, K and Okano, T and Nakajima, K and Cobat, A and Morio, T and Casanova, JL and Zhang, SY},
title = {The OAS-RNase L pathway: Insights from experiments of nature.},
journal = {Science immunology},
volume = {11},
number = {115},
pages = {eads9407},
pmid = {41512080},
issn = {2470-9468},
support = {/HHMI/Howard Hughes Medical Institute/United States ; R21 AI160576/AI/NIAID NIH HHS/United States ; UL1 TR001866/TR/NCATS NIH HHS/United States ; },
mesh = {Humans ; *2',5'-Oligoadenylate Synthetase/genetics/metabolism/immunology ; *Endoribonucleases/metabolism/immunology/genetics ; *COVID-19/immunology ; *SARS-CoV-2/immunology/physiology ; Animals ; Signal Transduction ; },
abstract = {The 2'-5' oligoadenylate synthetases (OASs) are type I interferon-inducible enzymes that, with ribonuclease L (RNase L), have been studied in the context of their coupled action as antiviral effectors. RNase L degrades host and viral ssRNA, affecting diverse cellular processes including translational arrest, interferon response, and apoptosis, all of which are thought to restrict viral replication. Recent studies of recessive inborn errors of human OAS1, OAS2, and RNase L, however, revealed that for SARS-CoV-2 infection, the main protective action of this pathway in natura may be through restricting phagocyte-driven postviral inflammation rather than restricting early viral replication in the respiratory tract. This finding is consistent with the identification of gain-of-function OAS1 mutations in humans with autoinflammation also driven by myeloid cells. Here, we retrace the investigation of the OAS-RNase L pathway, focusing on these recent in natura studies in humans that reposition the pathway as a determinant of the inflammatory response under natural conditions of infection.},
}

Humans
*2',5'-Oligoadenylate Synthetase/genetics/metabolism/immunology
*Endoribonucleases/metabolism/immunology/genetics
*COVID-19/immunology
*SARS-CoV-2/immunology/physiology
Animals
Signal Transduction

@article {pmid41512436,
year = {2026},
author = {Chau, MT and Spuur, KM and Vu, H},
title = {Health human resources shortages in radiography and sustainable workforce development in Australia.},
journal = {Radiography (London, England : 1995)},
volume = {32},
number = {2},
pages = {103319},
doi = {10.1016/j.radi.2025.103319},
pmid = {41512436},
issn = {1532-2831},
mesh = {Humans ; Australia ; *Health Workforce ; COVID-19/epidemiology ; *Radiography/statistics & numerical data ; Technology, Radiologic ; SARS-CoV-2 ; *Radiology ; },
abstract = {OBJECTIVES: Health Human Resources (HHR) are critical for the effective functioning of healthcare systems, yet significant shortages exist, particularly in radiography. The increasing demand for diagnostic radiography services, driven by advancements in medical technology, an aging population, and the prevalence of chronic diseases, exacerbates these shortages. The COVID-19 pandemic further highlighted workforce vulnerabilities, increasing workloads and burnout. This review examines HHR shortages in radiography in Australia and proposes strategies for sustainable workforce development.

KEY FINDINGS: The aging radiography workforce, with a significant portion nearing retirement, intensifies HHR shortages. The pandemic disrupted education and training, delaying the entry of new professionals and increasing turnover intentions among existing staff. The result being delayed imaging services, increased wait times, and potentially compromised patient outcomes. To address these challenges, a multifaceted strategy is proposed. Policy changes and government initiatives, including funding educational programs and recognizing internationally trained radiographers, can provide immediate relief. Expanding enrolment capacities and developing new training programs are essential. Retention strategies, including improving working conditions and career advancement opportunities, are crucial for workforce stability. Promoting advanced practice models can optimize task distribution and better utilize specialized skills. Leveraging technology, such as artificial intelligence and telehealth, can enhance productivity and extend service reach.

CONCLUSION: A comprehensive approach combining policy changes, educational initiatives, retention strategies, technology integration, international recruitment, and awareness campaigns is essential for addressing HHR shortages in radiography. By implementing these strategies, the radiography workforce can be better equipped to meet the growing demands of healthcare, ensuring optimal patient outcomes and the sustainability of health services.

IMPLICATIONS FOR PRACTICE: Strengthening the radiography workforce will ensure timely and effective healthcare delivery, support health interventions, and progress towards universal health coverage and Sustainable Development Goals.},
}

Humans
Australia
*Health Workforce
COVID-19/epidemiology
*Radiography/statistics & numerical data
Technology, Radiologic
SARS-CoV-2
*Radiology

@article {pmid41512680,
year = {2026},
author = {Daneshi, K and Mitchell, S and Lewis, V and Bompolas, P and Karagah, K and Gokani, VJ},
title = {Trends and costs of plastic surgery claims in the NHS: A national analysis (2006-2025).},
journal = {Journal of plastic, reconstructive & aesthetic surgery : JPRAS},
volume = {113},
number = {},
pages = {678-686},
doi = {10.1016/j.bjps.2025.12.023},
pmid = {41512680},
issn = {1878-0539},
mesh = {Humans ; *State Medicine/economics/legislation & jurisprudence/trends ; *Malpractice/economics/trends/legislation & jurisprudence/statistics & numerical data ; *Surgery, Plastic/economics/legislation & jurisprudence/trends ; United Kingdom ; COVID-19/epidemiology ; *Plastic Surgery Procedures/economics/legislation & jurisprudence ; },
abstract = {BACKGROUND: Litigation within surgical specialties continues to impose a growing financial burden on the National Health Services (NHS). Plastic surgery may be especially vulnerable to claims arising from clinical complications and unmet patient expectations. However, national trends in plastic surgery litigation have not been well characterised. To analyse the national trends, causes and costs associated with NHS plastic surgery litigation from 2006/07 to 2024/25 were assessed.

METHODS: We analyzed anonymized clinical negligence claim data related to plastic surgery obtained from NHS Resolution (NHSR). Structured fields included Specialty, administrative year (notification/closure), primary cause, and paid amounts (damages, claimant legal costs, and NHS legal costs). We defined three windows: Baseline (to 2019/20), Pandemic/Recovery (2020/21-2022/23) and Recent (2023/24-2024/25; right-censored). Costs are reported as median (IQR) with mean (SD) and range. Only primary cause was analysable and sub-causes were not used.

RESULTS: Over 2006/07-2024/25, 1455 plastic-surgery claims were notified to NHSR (Baseline 1120; Pandemic/Recovery 208 and Recent 127; 2024/25 partial). Among 54 closed claims with damages (component data consistently available from 2018/19), the median total paid amount was £665,757 (IQR £386,570-£899,071), wherein aggregate payments across these claims exceeded £38.8 million. Within this subset, damages represented approximately 38-45% of the total payments by window, claimant legal costs 45-53%, and NHS legal costs 9-12%. The share of 'Fail/Delay Treatment' increased during and after the pandemic within a smaller pool of notifications.

CONCLUSION: This is the first national analysis of NHS plastic surgery litigation, offering insights into the specialty's unique medico-legal risks. Data showed declining notifications since 2019/20 and persistently high legal costs, with delay-related causes being prominent. Systemic delays and communication failures are the key drivers of claims. Enhancing perioperative care pathways, informed consent and early dispute resolution could reduce patient harm and financial impact.},
}

Humans
*State Medicine/economics/legislation & jurisprudence/trends
*Malpractice/economics/trends/legislation & jurisprudence/statistics & numerical data
*Surgery, Plastic/economics/legislation & jurisprudence/trends
United Kingdom
COVID-19/epidemiology
*Plastic Surgery Procedures/economics/legislation & jurisprudence

@article {pmid41513512,
year = {2026},
author = {Llanes, AC and Bandhlish, A and Pipavath, S and Lima, APS},
title = {Refining the Radiologic Recognition of Pulmonary Alveolar Proteinosis: A Crazy-Paving Pattern Approach.},
journal = {Seminars in roentgenology},
volume = {61},
number = {},
pages = {150961},
doi = {10.1053/j.ro.2025.09.004},
pmid = {41513512},
issn = {1558-4658},
mesh = {Humans ; *Pulmonary Alveolar Proteinosis/diagnostic imaging ; *Tomography, X-Ray Computed/methods ; Diagnosis, Differential ; Lung/diagnostic imaging ; COVID-19/diagnostic imaging ; Lung Diseases, Interstitial/diagnosis ; },
abstract = {Pulmonary alveolar proteinosis (PAP) is a rare airspace disease classically associated with the crazy-paving pattern on high-resolution computed tomography (HRCT). While highly suggestive, this imaging pattern is not pathognomonic and appears across a wide spectrum of pulmonary pathologies. In this review, we adopt a phenotype-first approach, using representative imaging cases to walk the reader through the differential diagnosis of crazy-paving, with attention to radiologic distribution, clinical context, and disease acuity. We emphasize distinguishing features between PAP and its mimics-including pulmonary edema, diffuse alveolar hemorrhage, organizing pneumonia, mucinous adenocarcinoma, exogenous lipoid pneumonia, acute fulminant PAP, and COVID-19 pneumonia-using side-by-side imaging and contextual pearls. Special attention is given to the radiologic clues favoring autoimmune versus secondary PAP, including geographic distribution of ground-glass opacities, subpleural sparing, and lower lobe predominance. The review concludes with a summary of diagnostic strategies, pathologic correlation, and treatment options, including insights from post-pandemic diagnostic pitfalls. This pattern-based framework is designed for the radiologist and serves as a practical guide for recognizing PAP within the broader spectrum of airspace diseases.},
}

Humans
*Pulmonary Alveolar Proteinosis/diagnostic imaging
*Tomography, X-Ray Computed/methods
Diagnosis, Differential
Lung/diagnostic imaging
COVID-19/diagnostic imaging
Lung Diseases, Interstitial/diagnosis

@article {pmid41513611,
year = {2026},
author = {Nunes, M and Kell, L and Slaghekke, A and Wüst, RC and Fielding, BC and Kell, DB and Pretorius, E},
title = {Virus-induced endothelial senescence as a cause and driving factor for ME/CFS and long COVID: mediated by a dysfunctional immune system.},
journal = {Cell death & disease},
volume = {17},
number = {1},
pages = {16},
pmid = {41513611},
issn = {2041-4889},
support = {NNF20CC0035580//Novo Nordisk Fonden (Novo Nordisk Foundation)/ ; },
mesh = {Humans ; *COVID-19/immunology/virology/pathology/complications ; SARS-CoV-2 ; *Cellular Senescence ; *Fatigue Syndrome, Chronic/immunology/virology/pathology ; *Endothelial Cells/pathology/virology/immunology ; *Immune System/pathology ; *Endothelium, Vascular/pathology/virology ; },
abstract = {Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long COVID are two post-viral diseases, which share many common symptoms and pathophysiological alterations. Yet a mechanistic explanation of disease induction and maintenance is lacking. This hinders the discovery and implementation of biomarkers and treatment options, and ultimately the establishment of effective clinical resolution. Here, we propose that acute viral infection results in (in)direct endothelial dysfunction and senescence, which at the blood-brain barrier, cerebral arteries, gastrointestinal tract, and skeletal muscle can explain symptoms. The endothelial senescence-associated secretory phenotype (SASP) is proinflammatory, pro-oxidative, procoagulant, primed for vasoconstriction, and characterized by impaired regulation of tissue repair, but also leads to dysregulated inflammatory processes. Immune abnormalities in ME/CFS and long COVID can account for the persistence of endothelial senescence long past the acute infection by preventing their clearance, thereby providing a mechanism for the chronic nature of ME/CFS and long COVID. The systemic and tissue-specific effects of endothelial senescence can thus explain the multisystem involvement in and subtypes of ME/CFS and long COVID, including dysregulated blood flow and perfusion deficits. This can occur in all tissues, but especially the brain as evidenced by findings of reduced cerebral blood flow and impaired perfusion of various brain regions, post-exertional malaise (PEM), gastrointestinal disturbances, and fatigue. Paramount to this theory is the affected endothelium, and the bidirectional sustainment of immune abnormalities and endothelial senescence. The recognition of endothelial cell dysfunction and senescence as a core element in the aetiology of both ME/CFS and Long COVID should aid in the establishment of effective biomarkers and treatment regimens.},
}

Humans
*COVID-19/immunology/virology/pathology/complications
SARS-CoV-2
*Cellular Senescence
*Fatigue Syndrome, Chronic/immunology/virology/pathology
*Endothelial Cells/pathology/virology/immunology
*Immune System/pathology
*Endothelium, Vascular/pathology/virology

@article {pmid41514815,
year = {2026},
author = {Vasinioti, VI and Lucente, MS and Catella, C and Buonavoglia, C and Decaro, N and Pratelli, A and Capozza, P},
title = {Feline Infectious Peritonitis: A Challenging Diagnostic and Therapeutic Labyrinth.},
journal = {Animals : an open access journal from MDPI},
volume = {16},
number = {1},
pages = {},
pmid = {41514815},
issn = {2076-2615},
abstract = {Feline coronaviruses (FCoVs) are ubiquitous pathogens, exhibiting high prevalence across feline populations worldwide. Although the virulent mutated biotype feline infectious peritonitis virus (FIPV) is observed in only a small percentage of cats, it causes a systemic and often fatal disease. Diagnosis of feline infectious peritonitis (FIP) is challenging due to its non-specific clinical signs and the difficulty in differentiating between the two biotypes, feline enteric coronavirus (FECV) and FPIV. Currently, veterinarians rely on a combination of diagnostic methods, integrating laboratory tests, anamnesis and clinical signs to improve the diagnostic accuracy of FIP. Once considered untreatable, FIP now benefits from recent pharmacological advances that suggest promising therapeutic options, including antiviral drugs and immunomodulatory therapies. Despite these developments, the lack of an effective vaccine and definitive curative treatment highlights the need for continued research. This review provides a comprehensive analysis of the current literature on diagnostic and treatment approaches for FIP. The aim is to improve understanding of the available options and strategies for FIP to mitigate its severe consequences.},
}

@article {pmid41515644,
year = {2026},
author = {Azman, SA and Kennedy, MP},
title = {Single-Use Flexible Bronchoscopy: Advances in Technology and Applications.},
journal = {Diagnostics (Basel, Switzerland)},
volume = {16},
number = {1},
pages = {},
pmid = {41515644},
issn = {2075-4418},
abstract = {With advances in scope and imaging technology, the use of single-use flexible bronchoscopy (SUFB) has broadened beyond intensive care units and operating rooms to bronchoscopy units, with an expanding body of literature suggesting adequate and comparable procedure outcomes, including airway inspection, bronchoalveolar lavage, endobronchial brushing and endobronchial biopsy, in comparison to standard reusable flexible bronchoscopy (RFB). Advantages such as mobility, ease of use and lack of requirement for cleaning staff during the COVID-19 pandemic led to a global increase in usage, with many companies developing SUFB as part of their bronchoscopy portfolio. In parallel, there has been more attention and initiatives to minimise the risk of infection transmission related to bronchoscopy. RFB requires maximum adherence to manufacturer-recommended cleaning protocols. However, evidence of transmissible organisms after cleaning is reported in healthcare settings of all types. After initial benchtop, retrospective and single-arm studies, comparative bronchoscopy studies are identifying that SUFB are as versatile and non-inferior to RFB. However, cost-effectiveness and sustainability factors have to be included in deciding the use of SUFB in routine practice.},
}

@article {pmid41516024,
year = {2025},
author = {Cuppen, JJM and Savelkoul, HFJ},
title = {Immune Delay, Beyond Immune Evasion, as a Driver of Pathogen Propagation Competence Through Neutrophil Dysregulation, to be Mitigated by Low-Frequency Electromagnetic Fields (LF-EMF).},
journal = {International journal of molecular sciences},
volume = {27},
number = {1},
pages = {},
pmid = {41516024},
issn = {1422-0067},
mesh = {Humans ; *Neutrophils/immunology/radiation effects ; *Immune Evasion/radiation effects ; *Electromagnetic Fields ; *Bacterial Infections/immunology ; Animals ; *Virus Diseases/immunology ; Neutrophil Activation/immunology/radiation effects ; },
abstract = {This paper proposes that immune delay, beyond immune evasion, is key in the propagation competence of major viral and bacterial infections, and that the dynamics of infection and immune response suggest possibilities for mitigating the ensuing infectious diseases. Recent data show a critical role of neutrophils at various stages of viral and bacterial infections, revealing how early activation of neutrophils could help mitigate infectious diseases. It could prevent the gradual overactivation of subclasses of neutrophils and probably not induce it. In respiratory virus infections, an immune delay of several days allows the development of a high viral load supporting infectivity towards further hosts when a delayed and increased immune response takes place. Virus variants will optimize immune delay towards highest infectivity, supporting pandemic potential. The influenza virus, coronavirus, and several major bacterial infections exhibit such immune delay capability. Recurrent urinary tract infections (rUTI) are common, often associated with the causative uropathogenic E. coli (UPEC) that has this capability, suggesting that immune delay is crucial in the pathogenesis of rUTI and other widespread bacterial infections. Counteracting immune delay, therefore, is a promising approach for mitigating infectious diseases with epidemic and pandemic presence or potential. Previously proven low-frequency electromagnetic field (LF-EMF)-induced neutrophil activation is such an approach.},
}

Humans
*Neutrophils/immunology/radiation effects
*Immune Evasion/radiation effects
*Electromagnetic Fields
*Bacterial Infections/immunology
Animals
*Virus Diseases/immunology
Neutrophil Activation/immunology/radiation effects

@article {pmid41516027,
year = {2025},
author = {Yang, J and Qu, Y and Yuan, Z and Lun, Y and Kuang, J and Shao, T and Qi, Y and Li, Y and Zhu, L},
title = {Targeting Host Dependency Factors: A Paradigm Shift in Antiviral Strategy Against RNA Viruses.},
journal = {International journal of molecular sciences},
volume = {27},
number = {1},
pages = {},
pmid = {41516027},
issn = {1422-0067},
mesh = {Humans ; *Antiviral Agents/pharmacology/therapeutic use ; *RNA Viruses/drug effects/physiology ; SARS-CoV-2/drug effects ; Virus Replication/drug effects ; *Host-Pathogen Interactions/drug effects ; *RNA Virus Infections/drug therapy/virology/metabolism ; Animals ; COVID-19/virology ; },
abstract = {RNA viruses, such as SARS-CoV-2 and influenza, pose a persistent threat to global public health. Their high mutation rates undermine the effectiveness of conventional direct-acting antivirals (DAAs) and facilitate drug resistance. As obligate intracellular parasites, RNA viruses rely extensively on host cellular machinery and metabolic pathways throughout their life cycle. This dependency has prompted a strategic shift in antiviral research-from targeting the mutable virus to targeting relatively conserved host dependency factors (HDFs). In this review, we systematically analyze how RNA viruses exploit HDFs at each stage of infection: utilizing host receptors for entry; remodeling endomembrane systems to establish replication organelles; hijacking transcriptional, translational, and metabolic systems for genome replication and protein synthesis; and co-opting trafficking and budding machinery for assembly and egress. By comparing strategies across diverse RNA viruses, we highlight the broad-spectrum potential of HDF-targeting approaches, which offer a higher genetic barrier to resistance, providing a rational framework for developing host-targeting antiviral therapies.},
}

Humans
*Antiviral Agents/pharmacology/therapeutic use
*RNA Viruses/drug effects/physiology
SARS-CoV-2/drug effects
Virus Replication/drug effects
*Host-Pathogen Interactions/drug effects
*RNA Virus Infections/drug therapy/virology/metabolism
Animals
COVID-19/virology

@article {pmid41516190,
year = {2025},
author = {Mcmillan, P and Turner, AJ and Uhal, BD},
title = {The Central Role of Macrophages in Long COVID Pathophysiology.},
journal = {International journal of molecular sciences},
volume = {27},
number = {1},
pages = {},
pmid = {41516190},
issn = {1422-0067},
mesh = {Humans ; *COVID-19/immunology/physiopathology/pathology/virology ; *Macrophages/immunology/metabolism ; SARS-CoV-2/immunology ; Macrophage Activation/immunology ; Immunity, Innate ; Epigenesis, Genetic ; Spike Glycoprotein, Coronavirus/metabolism/immunology ; Animals ; },
abstract = {This review article attempts to provide a unifying hypothesis to explain the myriad of symptoms and predispositions underlying the development of PASC (Postacute Sequelae of COVID), often referred to as Long COVID. The hypothesis described here proposes that Long COVID is best understood as a disorder of persistent immune dysregulation, with chronic macrophage activation representing the fundamental underlying pathophysiology. Unlike transient post-viral syndromes, Long COVID involves a sustained innate immune response, particularly within monocyte-derived macrophages, driven by persistent spike protein (peripherally in MAIT cells and centrally in Microglial cells), epigenetic imprinting, and gut-related viral reservoirs. These macrophages are not merely activated temporarily but also become epigenetically "trained" into a prolonged inflammatory state, as demonstrated by enduring histone acetylation markers such as H3K27acDNA Reprogramming. It is proposed that recognizing macrophage activation as the central axis of Long COVID pathology offers a framework for personalized risk assessment, targeted intervention, and therapeutic recalibration.},
}

Humans
*COVID-19/immunology/physiopathology/pathology/virology
*Macrophages/immunology/metabolism
SARS-CoV-2/immunology
Macrophage Activation/immunology
Immunity, Innate
Epigenesis, Genetic
Spike Glycoprotein, Coronavirus/metabolism/immunology
Animals

@article {pmid41516301,
year = {2025},
author = {Stojanovic, M and Djuric, M and Nenadic, I and Bojic, S and Andrijevic, A and Popovic, A and Pesic, S},
title = {Vascular Complications of Long COVID-From Endothelial Dysfunction to Systemic Thrombosis: A Systematic Review.},
journal = {International journal of molecular sciences},
volume = {27},
number = {1},
pages = {},
pmid = {41516301},
issn = {1422-0067},
mesh = {Humans ; *COVID-19/complications/pathology ; *Thrombosis/etiology/pathology ; *Endothelium, Vascular/physiopathology/pathology ; SARS-CoV-2 ; },
abstract = {Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated not only with respiratory illness but also with profound vascular and coagulation disturbances. Long COVID (LC) is characterized by persistent symptoms such as fatigue, dyspnea, cognitive impairment, and palpitations. Mechanistically, SARS-CoV-2 induces direct endothelial injury, promotes a pro-inflammatory cytokine milieu, and activates platelets, leading to immunothrombosis and impaired fibrinolysis. Consequently, patients exhibit microthrombosis, elevated plasma D-dimer, fibrinogen dysregulation, and persistent hypercoagulability. Clinically, this translates into an increased risk of venous thromboembolism, including deep vein thrombosis and pulmonary embolism, as well as arterial thrombotic events such as myocardial infarction and stroke, which may persist months after acute infection. Understanding the interplay between endothelial injury, inflammation, and coagulation is crucial for risk stratification and the development of preventive and therapeutic strategies. We conducted a systematic narrative review of the literature, including human clinical and mechanistic studies identified through PubMed, Scopus and Web of Science up to 30 September 2025. This review synthesizes current evidence on vascular complications in LC, highlighting endothelial dysfunction as a central pathophysiological nexus linking the acute phase of SARS-CoV-2 infection with chronic LC manifestations.},
}

Humans
*COVID-19/complications/pathology
*Thrombosis/etiology/pathology
*Endothelium, Vascular/physiopathology/pathology
SARS-CoV-2

@article {pmid41516418,
year = {2026},
author = {Barajas, A and Riquelme-Alacid, G and Vera-Montecinos, A and Ramos, B},
title = {Cognition, Cytokines, Blood-Brain Barrier, and Beyond in COVID-19: A Narrative Review.},
journal = {International journal of molecular sciences},
volume = {27},
number = {1},
pages = {},
pmid = {41516418},
issn = {1422-0067},
support = {PI21/00059//Instituto de Salud Carlos III/ ; },
mesh = {Humans ; *Blood-Brain Barrier/metabolism ; *COVID-19/complications/psychology/metabolism/immunology ; *Cytokines/metabolism/blood ; *Cognitive Dysfunction/etiology ; SARS-CoV-2 ; *Cognition/physiology ; },
abstract = {Numerous studies report cognitive impairment in COVID-19 patients from the acute to post-acute phases, linked to blood inflammation affecting blood-brain barrier (BBB) permeability and causing leakage of glial and neuronal proteins. However, a clear classification of these cognitive deficits and molecular blood events over time is still lacking. This narrative review summarizes the neuropsychological consequences of COVID-19 and evidence of altered cytokines and BBB disruption as potential mediators of cognitive impairment across post-infection phases. Post-COVID-19 cognitive dysfunction appears to follow a temporal course, evolving from acute focal deficits in attention, working memory, and executive function to more persistent multidomain impairments. We reviewed key cytokines released into the blood during COVID-19 infection, including antiviral (IFNγ, CXCL1, CXCL10), inflammatory (IL-1β, IL-2, IL-4, IL-6, IL-7, IL-8, IL-10, GM-CSF, TNFα), and monocyte chemoattractants (MCP1/CCL2, MCP3/CCL7, MIP-1α/CCL3, GM-CSF, G-CSF). This analysis shows that several inflammatory and viral cytokines remain elevated beyond the acute phase and are associated with cognitive deficits, including IL-6, IL-13, IL-8, IL-1β, TNFα, and MCP1 in long-term post-COVID-19 patients. In addition, we examined studies analyzing changes over time in neurovascular unit proteins as biomarkers of BBB disruption, including extracellular matrix proteins (PPIA, MMP-9), astrocytes (S100β, GFAP), and neurons (NFL). These proteins are elevated in acute COVID-19 but generally return to control levels within six months, suggesting BBB restoration. However, in patients followed for over a year, BBB disruption persists only in those with cognitive impairment and is associated with systemic inflammation, with TGFβ as a related biomarker. Although cognitive sequelae can persist for over 12 months after SARS-CoV-2 infection, further studies are needed to investigate long-term neurocognitive outcomes and their link to sustained proinflammatory cytokine elevation and brain impact.},
}

Humans
*Blood-Brain Barrier/metabolism
*COVID-19/complications/psychology/metabolism/immunology
*Cytokines/metabolism/blood
*Cognitive Dysfunction/etiology
SARS-CoV-2
*Cognition/physiology

@article {pmid41516981,
year = {2025},
author = {Huang, WH and Ho, YF and Yeh, JY and Liu, PY and Huang, PH},
title = {Hospital Influenza Outbreak Management in the Post-COVID Era: A Narrative Review of Evolving Practices and Feasibility Considerations.},
journal = {Healthcare (Basel, Switzerland)},
volume = {14},
number = {1},
pages = {},
pmid = {41516981},
issn = {2227-9032},
abstract = {Background: Hospital-acquired influenza remains a persistent threat that amplifies morbidity, mortality, length of stay, and operational strain, particularly among older and immunocompromised inpatients. The COVID-19 era reshaped control norms-normalizing N95 use during surges, ventilation improvements, and routine multiplex PCR-creating an opportunity to strengthen hospital outbreak management. Methods: We conducted a targeted narrative review of WHO/CDC/Infectious Diseases Society of America (IDSA) guidance and peer-reviewed studies (January 2015-August 2025), emphasizing adult inpatient care. This narrative review synthesizes recent evidence and discusses theoretical implications for practice, rather than establishing formal guidelines. Evidence was synthesized into pragmatic practice statements on detection, diagnostics, isolation/cohorting, antivirals, chemoprophylaxis, vaccination, surveillance, and communication. Results: Early recognition and test-based confirmation are pivotal. For inpatients, nucleic-acid amplification tests are preferred; negative antigen tests warrant PCR confirmation, and lower-respiratory specimens improve yield in severe disease. A practical outbreak threshold is ≥2 epidemiologically linked, laboratory-confirmed cases within 72 h on the same ward. Effective control may require immediate isolation or cohorting with dedicated staff, strict droplet/respiratory protection, and daily active surveillance. Early oseltamivir (≤48 h from onset or on admission) reduces mortality and length of stay; short-course post-exposure prophylaxis for exposed patients or staff lowers secondary attack rates. Integrated vaccination efforts for healthcare personnel and high-risk patients reinforce workforce resilience and reduce transmission. Conclusions: A standardized, clinician-led bundle-early molecular testing, do-not-delay antivirals, decisive cohorting and Personal protective equipment (PPE), targeted chemoprophylaxis, vaccination, and disciplined communication- could help curb transmission, protect vulnerable patients and staff, and preserve capacity. Hospitals should codify COVID-era layered controls for seasonal influenza and rehearse unit-level outbreak playbooks to accelerate response and recovery. These recommendations target clinicians and infection-prevention leaders in acute-care hospitals.},
}