@article {pmid42780769,
year = {2026},
author = {Amiri, M and Cheraghi, M and Khalili, F and D'Ambrosio, L and Centis, R and Dinh-Xuan, AT and Venketaraman, V and Nasiri, MJ and Migliori, GB},
title = {Clinical effects of N-acetylcysteine in ICU patients with respiratory disease: a systematic review and meta-analysis.},
journal = {Respiratory research & clinical practice},
volume = {52},
number = {1},
pages = {e20250438},
pmid = {42780769},
issn = {3086-3910},
support = {R15 HL143545/HL/NHLBI NIH HHS/United States ; },
mesh = {Humans ; *Acetylcysteine/therapeutic use ; *Intensive Care Units/trends ; Hospital Mortality/trends ; Length of Stay ; Respiration, Artificial ; Randomized Controlled Trials as Topic/methods ; *Expectorants/therapeutic use ; Critical Illness ; *Respiratory Tract Diseases/drug therapy/mortality ; },
abstract = {OBJECTIVE: Critically ill patients with respiratory disease often experience impaired airway clearance, which contributes to adverse clinical outcomes. N-acetylcysteine (NAC) has mucolytic and antioxidant properties, and may have therapeutic potential in this setting. This study evaluated the impact of NAC on clinical outcomes in ICU patients with underlying respiratory disease.

METHODS: A systematic literature search was conducted in PubMed/MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, Scopus, and Web of Science from January of 2000 to July of 2025 in order to identify randomized controlled trials evaluating NAC in ICU patients with respiratory conditions. Primary outcomes included hospital mortality, duration of mechanical ventilation, ICU length of stay (LOS), and hospital LOS. Data were synthesized using fixed- or random-effects models based on heterogeneity. Subgroup analyses were performed based on the route of NAC administration.

RESULTS: Five randomized controlled trials comprising 340 patients were included. Hospital mortality was 44.76% in the NAC group and 47.61% in the control group (OR = 0.87; 95% CI: 0.49-1.53). No significant differences were observed in ventilation duration (mean difference [MD] = 0.79 days; 95% CI: -2.87 to 4.44) or ICU LOS (MD = 0.21 days; 95% CI: -3.75 to 4.17). However, NAC was associated with a shorter hospital stay (MD = -3.84 days; 95% CI: -7.44 to -0.24). Subgroup analysis suggested variability in mortality outcomes based on administration route.

CONCLUSIONS: NAC may reduce hospital LOS in critically ill patients with respiratory disease, although its effects on mortality and ventilation duration remain inconclusive. These findings may inform future research, particularly in patients with post-infectious lung damage such as that seen in COVID-19 or tuberculosis.},
}

Humans
*Acetylcysteine/therapeutic use
*Intensive Care Units/trends
Hospital Mortality/trends
Length of Stay
Respiration, Artificial
Randomized Controlled Trials as Topic/methods
*Expectorants/therapeutic use
Critical Illness
*Respiratory Tract Diseases/drug therapy/mortality

@article {pmid42780929,
year = {2026},
author = {Mokwele, ML and Van Niekerk, A},
title = {Organisational change and employee mental health: a conceptual framework integrating conservation of resources theory and the job demands-resources model.},
journal = {Frontiers in public health},
volume = {14},
number = {},
pages = {1925071},
pmid = {42780929},
issn = {2296-2565},
mesh = {Humans ; *Organizational Innovation ; *Mental Health ; COVID-19/epidemiology ; Working Conditions ; *Workplace/psychology ; Psychological Safety ; Leadership ; *Occupational Health ; *Workload/psychology ; SARS-CoV-2 ; },
abstract = {Organisational change has intensified in recent years in response to shifting workplace expectations, rapid technological developments, the effects of COVID-19, and evolving work patterns. While such transformation is often necessary for organisational sustainability, it can increase uncertainty, alter job demands, and place emotional pressure on employees. Drawing on Conservation of Resources theory, this article suggests that employees may view change as a threat to valued personal and work resources, heightening stress responses. The Job Demands-Resources model further illustrates how increased demands such as digital overload and rising performance pressures can affect wellbeing unless balanced with appropriate resources, including autonomy, clarity, and supportive work relationships. A range of organisational factors can shape how employees experience these changes. Leadership behaviours, communication practises, opportunities for involvement, and levels of engagement all influence how employees interpret and respond to shifting demands. These factors interact with job demands and resources by shaping perceptions of fairness, predictability, psychological safety, and support during periods of transition. Rather than functioning independently, these elements combine to influence employee wellbeing and adjustment. The article presents a framework in which the impact of organisational change on wellbeing is understood through the interplay between demands, available resources, and the broader relational and communicative environment. It highlights the enduring effects of recent disruptions, which have increased the need to understand how employees adapt to continuous change. The paper concludes by identifying future research directions aimed at improving organisational practises that support employee wellbeing throughout ongoing transformation.},
}

Humans
*Organizational Innovation
*Mental Health
COVID-19/epidemiology
Working Conditions
*Workplace/psychology
Psychological Safety
Leadership
*Occupational Health
*Workload/psychology
SARS-CoV-2

@article {pmid42781593,
year = {2026},
author = {Tapchaisri, P and Theeraroungchaisri, A},
title = {Regulatory evolution and service delivery models of telepharmacy in Thailand: a review of pandemic responses and future policy directions.},
journal = {Journal of pharmaceutical policy and practice},
volume = {19},
number = {1},
pages = {2731648},
pmid = {42781593},
issn = {2052-3211},
abstract = {BACKGROUND: The COVID-19 pandemic accelerated digital health adoption in Thailand, disrupting traditional healthcare delivery and prompting rapid pharmaceutical system reforms. Prior to 2020, telepharmacy was virtually non-existent due to strict regulations mandating in-person dispensing at licensed premises; however, the public health crisis prompted policy changes, leading to regulatory relaxation and the formal establishment of telepharmacy standards. To understand these transformative shifts, this review examines the regulatory evolution of telepharmacy in Thailand, classifies diverse service delivery models implemented across hospital and community pharmacy settings, and synthesises effectiveness evidence to inform future pharmaceutical policy and sustainable system integration.

METHODS: An integrative narrative review using documentary analysis of official policy and regulatory documents was conducted. Studies evaluating telepharmacy or medication delivery services were identified through PRISMA-guided searches of Thai-Journal Citation Index (TCI), PubMed, and Google Scholar (2020-2025).

RESULTS: Thailand implemented a phased policy response progressing from emergency regulatory flexibility toward institutionalised governance. Seven hospital-based telepharmacy models were identified. Synthesis of 31 included studies (14 pharmacist-led and 17 telemedicine with medication delivery or medication delivery without pharmacist counselling studies) suggested that telepharmacy and medication delivery services generally supported continuity of care for chronic diseases. Studies involving pharmacist interventions more frequently reported favourable outcomes, although findings varied across service models. Implementation relied largely on social media platforms and proprietary applications, though independent pharmacies faced financial barriers to accessing certified platforms.

CONCLUSION: While telepharmacy has been integrated into routine care under the Universal Coverage Scheme (UCS), an institutionalisation gap remains regarding sustainable public financing and digital infrastructure. Addressing regulatory clarity, reimbursement mechanisms, digital equity, and platform interoperability will be essential for the long-term and equitable integration of telepharmacy.},
}

@article {pmid42781939,
year = {2026},
author = {Sällberg, M},
title = {Exploring the Development of Vaccine Platforms, With a Particular Focus on the COVID-19 Pandemic.},
journal = {Acta paediatrica (Oslo, Norway : 1992)},
volume = {},
number = {},
pages = {},
doi = {10.1111/apa.70762},
pmid = {42781939},
issn = {1651-2227},
support = {23-3071//Cancerfonden/ ; 2025-06729//Vetenskapsrådet/ ; },
abstract = {Vaccines have been a cornerstone of human health for more than 200 years and one of the most important tools to reduce childhood deaths caused by pathogens. The concept of vaccines is basically to take something safe, make it immunogenic and induce an immune response in the host that will protect it against something dangerous. Live attenuated vaccines were the only option two centuries ago. These are excellent, and possibly the best vaccine platform, but they have limitations as they cannot always be given to everyone safely, for example due to deficient immunity or pregnancy. That is why newer platforms, such as killed or inactivated vaccines, were developed. These provide better all-round safety, but are often less immunogenic and require additional doses. Subcomponent vaccines were then developed in the 1980s. These only used parts of the virus, further improving safety and introducing the possibility of producing vaccines using gene technology. Adding genetic vaccines to the toolbox revolutionized the way that we handled the COVID-19 pandemic. The host became the producer of the vaccine, which better mimicked the immune responses induced by the live attenuated vaccines. All these platforms will be discussed in this mini-review.},
}

@article {pmid42782353,
year = {2026},
author = {Diederich, NJ and Pauly, C},
title = {Stress and Parkinson's disease: from dysfunctional detection to impaired handling: a narrative review.},
journal = {Journal of neural transmission (Vienna, Austria : 1996)},
volume = {},
number = {},
pages = {},
pmid = {42782353},
issn = {1435-1463},
abstract = {Stress can precipitate Parkinson's disease (PD), and conversely, PD imposes substantial stress on affected individuals. Controlled studies support this bidirectional relationship. Recent observations during the Covid‑19 pandemic suggested that PD patients may sometimes display an unexpected resilience to stressful events (SE), in particular in terms of missing motor deterioration. However, this "favorable" interpretation can be misleading as PD is characterized by dysfunctional stress detection and stress processing. Furthermore, reduced stress‑related cardiac morbidity has not been demonstrated uncontestably. Indeed, detailed analyses indicate that involvement of non‑dopaminergic systems modifies-rather than mitigates-stress responses. Lewy body pathology already compromises activation of the hypothalamic-pituitary-adrenal (HPA) axis, while autonomic cardiac responses are blunted. Dysfunction of the superior colliculi impairs instant detection of stress events (SE); degeneration of the pedunculopontine nucleus disrupts appropriate motivational appraisal of the SE. Impaired contrast discrimination and olfaction hinder immediate perceptual SE assessment. Locus coeruleus involvement reduces alertness, further limiting SE evaluation. Finally, at the nexus of stress handling, dysfunctional amygdalar networks contribute to diminished autonomic reactivity and altered emotional processing. This review synthesizes current knowledge on peripheral and central stress‑related systems affected by PD pathophysiology. It outlines established, emerging, and theoretical therapeutic strategies, including approaches informed by the Stress Reduction Theory and the Attention Restoration Theory. It underscores the need for systematic investigation into stress mechanisms in PD, an area that remains insufficiently explored.},
}

@article {pmid42782808,
year = {2026},
author = {Santos, P and Almeida, F},
title = {Hijacking Host Communication: The Central Role of Extracellular Vesicles in Infectious Disease Pathogenesis.},
journal = {Cells},
volume = {15},
number = {18},
pages = {},
pmid = {42782808},
issn = {2073-4409},
support = {2021/06794-5//Fundação de Amparo à Pesquisa do Estado de São Paulo/ ; },
mesh = {*Extracellular Vesicles/metabolism/immunology ; Humans ; *Host-Pathogen Interactions/immunology ; Animals ; *Communicable Diseases/immunology/parasitology ; *Cell Communication ; Immune Evasion ; },
abstract = {Extracellular vesicles (EVs) have emerged as fundamental mediators of intercellular communication during infectious diseases, acting as vehicles for proteins, lipids, and nucleic acids that profoundly influence host-pathogen interactions. In recent years, accumulating evidence has revealed that pathogens from distinct biological kingdoms, including protozoan parasites, viruses, and bacteria, either release their own EVs or exploit host-derived EVs to manipulate immune responses, promote infection, and sustain chronic disease. This review provides a comprehensive and integrative overview of the roles of EVs in infectious diseases, with particular emphasis on immune modulation, immune evasion, pathogenesis, and translational applications. We summarize current knowledge on EV-mediated communication in infections caused by major protozoan parasites (Trypanosoma cruzi, Plasmodium spp., Toxoplasma gondii, and Leishmania spp.), highlighting how parasite- and host-derived EVs regulate inflammatory responses, facilitate intracellular survival, and shape disease outcomes. We further examine viral infections, including HIV, HPV, HCV, and airborne respiratory viruses such as SARS-CoV-2, where EVs contribute to viral persistence, immune dysfunction, oncogenesis, and long-term sequelae. In addition, we discuss bacterial infections, focusing on Mycobacterium tuberculosis, Streptococcus pneumoniae, and Helicobacter pylori, illustrating how EVs can function both as vectors of virulence factors and as components of host defense mechanisms. Finally, we explore the emerging translational potential of EVs as non-invasive biomarkers for disease diagnosis and prognosis, as well as their application as therapeutic and vaccine platforms. By integrating findings across diverse pathogens, this review highlights extracellular vesicles as widely implicated and dynamic contributors of infectious disease biology and underscores their relevance as targets and tools for next-generation diagnostic and therapeutic strategies.},
}

*Extracellular Vesicles/metabolism/immunology
Humans
*Host-Pathogen Interactions/immunology
Animals
*Communicable Diseases/immunology/parasitology
*Cell Communication
Immune Evasion

@article {pmid42783445,
year = {2026},
author = {Minoretti, P and Emanuele, E},
title = {COVID-19 mRNA Vaccines as Antigen-Agnostic Immunomodulators: A Repurposing Perspective.},
journal = {Medical sciences (Basel, Switzerland)},
volume = {14},
number = {5},
pages = {},
doi = {10.3390/medsci14050572},
pmid = {42783445},
issn = {2076-3271},
mesh = {Humans ; *COVID-19/prevention & control/immunology ; *COVID-19 Vaccines/immunology/therapeutic use ; SARS-CoV-2/immunology ; *Drug Repositioning ; *Immunologic Factors/therapeutic use ; mRNA Vaccines/immunology ; RNA, Messenger/immunology ; Vaccines, Synthetic/immunology ; Pandemics ; },
abstract = {Since 2020, billions of doses of COVID-19 messenger RNA (mRNA) lipid nanoparticle vaccines have been administered worldwide, generating one of the largest pharmacovigilance databases for a modern therapeutic class. Intriguingly, their immunopharmacologic profile-including the engagement of innate nucleic acid sensors, systemic type I interferon signaling, dendritic cell-mediated cross-priming of CD8+ T cells, and upregulation of programmed cell death ligand 1 (PD-L1)-may extend beyond COVID-19 prophylaxis. Retrospective evidence from six independent cohorts, one of which is a multinational health-data network, indicated that vaccination within 100 days of immune checkpoint inhibitor (ICI) initiation may improve survival of patients with malignancies, including in immunologically cold tumors, although a substantial fraction of the original effect may be attributed to pandemic-era selection bias. Here, we examine the mechanistic basis and available evidence for the repurposing of licensed COVID-19 mRNA vaccines as antigen-agnostic immunomodulators. We identified five candidate contexts for prospective evaluation-namely, (1) PD-L1-negative non-small cell lung cancer initiating ICI therapy, (2) perioperative immune dysfunction in major cardiac surgery, (3) chronic hepatitis B, (4) chronic HIV with persistent immune exhaustion, and (5) sepsis-induced immunoparalysis. Methodological foundations for confirmatory assessment-comprising target trial emulation, Mendelian randomization, and pragmatic trial design-are now sufficiently developed to enable implementation. Prospective evaluation of the antigen-agnostic repurposing hypothesis is operationally feasible, albeit constrained by residual confounding and uncertainty about the durability of vaccine-induced innate reprogramming.},
}

Humans
*COVID-19/prevention & control/immunology
*COVID-19 Vaccines/immunology/therapeutic use
SARS-CoV-2/immunology
*Drug Repositioning
*Immunologic Factors/therapeutic use
mRNA Vaccines/immunology
RNA, Messenger/immunology
Vaccines, Synthetic/immunology
Pandemics

@article {pmid42783492,
year = {2026},
author = {Śliwiński, W and Pura, W and Matecka, D and Kosowski, M and Chołuj, D and Marciniak, J and Mazur, J and Zarówna, K and Damodaran, L and Szejko, N},
title = {Neurological and Neuropsychiatric Manifestations of Pediatric Inflammatory Multisystem Syndrome (PIMS/MIS-C): A Narrative Review.},
journal = {Journal of personalized medicine},
volume = {16},
number = {9},
pages = {},
doi = {10.3390/jpm16090461},
pmid = {42783492},
issn = {2075-4426},
abstract = {Background: Pediatric inflammatory multisystem syndrome (PIMS), also referred to as multisystem inflammatory syndrome in children (MIS-C), is a rare but serious post-infectious complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection characterized by systemic hyperinflammation and multiorgan involvement. New-onset neurological and psychiatric symptoms have emerged as critical clinical features, occurring in approximately 12-27% of pediatric patients aged 2-15 years (median age, 10 years) and often indicating a more severe disease course. This narrative review aims to provide a comprehensive overview of the current literature regarding the neurological and psychiatric manifestations of PIMS/MIS-C, focusing on epidemiology, pathophysiology, clinical presentation, neuroimaging findings, biomarkers, treatment strategies, and outcomes. Methods: A narrative literature review was conducted to synthesize current evidence on the neurological and psychiatric spectrum of PIMS/MIS-C. Evaluated parameters included clinical presentations ranging from common symptoms (such as headache, encephalopathy, altered mental status, and seizures) to rare complications (such as ischemic stroke, acute disseminated encephalomyelitis, Guillain-Barré syndrome, and cerebral edema), alongside associated psychiatric disturbances, diagnostic findings, and therapeutic approaches. Results: Neurological and psychiatric manifestations significantly impact the clinical trajectory of PIMS/MIS-C. Acute symptoms include headache, encephalopathy, seizures, and psychiatric disturbances like behavioral changes, hallucinations, delirium, anxiety, and sleep disorders. Neuroimaging in many cases reveals reversible lesions of the splenium of the corpus callosum, while electroencephalography typically demonstrates diffuse slowing consistent with encephalopathy. Early recognition and prompt administration of immunomodulatory therapy-primarily intravenous immunoglobulin and corticosteroids-correlate with favorable neurological recovery in the majority of patients. However, current evidence remains largely observational and heterogeneous, precluding definitive causal conclusions regarding this treatment-outcome relationship. Affected children more frequently require intensive care unit admission and remain at risk for persistent cognitive, behavioral, and psychiatric sequelae. Conclusions: Neurological and psychiatric complications in PIMS/MIS-C are clinically significant indicators of disease severity that require vigilant monitoring and early immunomodulatory intervention. Continued multidisciplinary follow-up and prospective studies are essential to elucidate the long-term neurodevelopmental and psychiatric consequences and to optimize therapeutic strategies for these patients.},
}

@article {pmid42786345,
year = {2026},
author = {Stengel, S and Lindner, N},
title = {[Diagnosis of Long Covid/Post Covid in Primary Care Settings - Recognition, Classification, and Differentiation].},
journal = {MMW Fortschritte der Medizin},
volume = {168},
number = {16},
pages = {38-41},
doi = {10.1007/s15006-026-6215-1},
pmid = {42786345},
issn = {1613-3560},
}

@article {pmid42786507,
year = {2026},
author = {Kim, DY and Hong, JJ},
title = {Rethinking non-human primate models for emerging viral infections after COVID-19.},
journal = {Laboratory animal research},
volume = {42},
number = {1},
pages = {},
pmid = {42786507},
issn = {1738-6055},
support = {RS-2022-NR067509//Bio & Medical Technology Development Program of the National Research Foundation (NRF)/ ; KGM 4572431//Korea Research Institute of Bioscience and Biotechnology (KRIBB) Research Initiative Programs/ ; },
abstract = {Non-human primates (NHPs) retain particular value in emerging viral infection research when questions require integrated analysis of systemic viral kinetics, protective immunity, tissue pathology, or longitudinal outcomes. However, their cost, limited availability, specialized husbandry, and ethical constraints preclude their routine use as default screening platforms. Using severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as a case study, we compare how rhesus macaques, cynomolgus macaques, African green monkeys, baboons, and marmosets have contributed to studies of pathogenesis, vaccine protection, therapeutic efficacy, immune memory, and post-acute outcomes. We emphasize that these species-question relationships cannot be transferred uncritically to future pathogens; model suitability must be re-established according to receptor usage, tissue tropism, disease phenotype, and experimental objective. AI-guided prediction, human organoids, and organ-on-chip systems can support this process by prioritizing variants and candidates, identifying tissue-specific mechanisms, and refining endpoints before NHP studies begin. We therefore propose a question-driven workflow in which computational and human-relevant platforms narrow the evidence gap before fit-for-purpose NHP validation. This strategy can improve interpretability, reproducibility, and alignment with the 3Rs while preserving NHP use for questions that require intact organism-level biology.},
}

@article {pmid42787466,
year = {2026},
author = {Geza, W and Dirwai, TL and Dlamini, N and Sobratee-Fajurally, N and Mabhaudhi, T},
title = {Enhancing youth resilience to agri-food system shocks: a pathway to climate justice.},
journal = {Environmental research. Food systems},
volume = {3},
number = {4},
pages = {042001},
pmid = {42787466},
issn = {2976-601X},
abstract = {Meaningful youth engagement in climate policy, resilience-building, and agrifood system transformation is vital to ensuring that young people are prioritised in national and global agendas. This review situates youth resilience within the context of climate justice, recognising that those in low- and middle-income countries (LMICs) disproportionately experience climate-related shocks due to systemic inequalities. Guided by the Preferred Reporting Items for Systematic and Meta-Analyses Protocol framework, a scoping review was undertaken to examine how youth in LMICs experience and respond to agrifood system vulnerabilities arising from climate change, economic disruptions (including COVID-19), and conflict, with a focus on education and employment outcomes. Systems thinking served as the central analytical approach to identify interdependencies, feedback loops, leverage points, and resilience pathways. The findings reveal limited research quantifying youth-specific vulnerabilities and resilience strategies within agrifood systems. While broad impacts are recognised, youth agency and adaptive capacities remain underexplored. The interactions among climate impacts, contextual vulnerability, health-productivity constraints, food insecurity and governance conditions create compounding risks that exacerbate food insecurity and social inequity among rural and urban youth. To address these gaps, the study proposes a conceptual framework that integrates climate justice principles into resilience-building strategies, promoting equitable access to resources, inclusive governance, and youth-led adaptation. By mapping interconnections across agrifood systems, climate, equity, education, and employment, the study charts resilience pathways toward socially inclusive, climate-adaptive, and economically sustainable food systems, underscoring the need for policies and research that centre youth agency and lived experiences.},
}

@article {pmid42787611,
year = {2026},
author = {Gulubova, MV and Ignatova, MK and Dimitrova, DN and Ananiev, JR},
title = {Immune cell interactions and lung damage in SARS-CoV-2 special attention on monocytes/macrophages, T and B lymphocytes, dendritic cells and Toll-like receptors in SARS-CoV-2.},
journal = {American journal of clinical and experimental immunology},
volume = {15},
number = {4},
pages = {290-306},
pmid = {42787611},
issn = {2164-7712},
abstract = {Coronavirus disease 2019 (COVID-19) is caused by a novel human virus - SARS-CoV-2, is characterized in severe cases by dysregulated innate and adaptive immune responses leading to lung injury and systemic hyperinflammation. This review summarizes the roles of monocyte/macrophages, T and B lymphocytes, dendritic cells, and Toll-like receptor signaling in the immunopathogenesis of severe COVID-19. Severe COVID-19 is characterized by light neutrophilia, reduced numbers of transitional and non-classical monocytes, lymphopenia and diminished conventional and plasmacytoid dendritic cells (DCs). Inflammatory monocytes/macrophage activation and excessive cytokine production contribute to alveolar damage and cytokine storm. Alveolar macrophages (AMs) are abortively infected by the virus in an ACE2-dependent manner, but still no virus replication has been detected. AMs produce high quantities of IL-6 TNF-α, and IL-1β promoting cytokine storm. T lymphocytes dysregulation is associated with lymphopenia, impaired antiviral responses, and T-cell exhaustion. Severe COVID-19 infection causes a disproportionate decrease of CD4[+] T cells, reduced CD8[+] T cells and alteration of T cell subsets i.e. Tregs decrease and stimulation of Th1, Th2 and Th17. TLR3 and TLR7 are broadly expressed on human immune cells and recognize dsRNA and ssRNA in the endosome. Since TLR7 duplicated genes are localized on the X-chromosome, the disease is more expressed in men. B cell responses are characterized by impaired germinal center formation and extrafollicular antibody production. B cells produce neutralizing antibodies having little somatic hypermutations (SHM) that block the virus in the extra-follicular space. The activation of B cells via contact with Tfh cells antigen and BCR antigen is described. The reduction of germinal centers in thoracic lymph nodes and spleen is discussed. DCs depletion and dysfunction reduce antigen-presentation and interferon responses. A significant reduction of conventional DCs1 and DCs2 and of pDCs in blood is detected. Simultaneously, CD1c[+] DCs are recruited and increased in the lung in severe COVID-19. Toll-like receptor pathways further amplify inflammatory signaling and immune imbalance. Collectively, these immune alterations contribute to defective viral clearance and progressive lung injury. Understanding the interactions between innate and adaptive immune responses in COVID-19 may support the development of targeted immunomodulatory therapies and provide broader insights into viral immunopathology.},
}

@article {pmid42787723,
year = {2026},
author = {Roberts, K and Goodman, A and Ferguson, A and Kaminski, A and Spellman, T and Luba, R},
title = {De-implementation of inequitable methadone policy and treatment: lessons learned from COVID-19 to support a more just methadone treatment system in the United States.},
journal = {Frontiers in public health},
volume = {14},
number = {},
pages = {1951510},
pmid = {42787723},
issn = {2296-2565},
mesh = {*Methadone/therapeutic use ; Humans ; United States ; *Opiate Substitution Treatment ; *Opioid-Related Disorders/drug therapy ; *COVID-19/epidemiology ; *Health Policy ; SARS-CoV-2 ; },
abstract = {Despite decades of evidence supporting methadone as a life-saving treatment for opioid use disorder, its delivery in the US has been stymied by stigmatizing dispensation policies that are neither evidence-based nor person-centered. Implementation failures and regulatory challenges have resulted in a significant treatment gap in the US and less than 30% of people with OUD enter and remain in treatment. In this article, we provide a historical overview of the methadone treatment (MT) system in the US and outline why it requires de-implementation. We present the COVID-19 public health emergency as a naturalistic experiment in de-implementation, outline evidence from this period on how COVID-19 related flexibilities influenced treatment outcomes and patient experiences and present a de-implementation framework to contextualize these changes while imagining further expansion of de-implementation efforts to support sustained change. We highlight how patient advocacy can shape further de-implementation while noting current threats to progress.},
}

*Methadone/therapeutic use
Humans
United States
*Opiate Substitution Treatment
*Opioid-Related Disorders/drug therapy
*COVID-19/epidemiology
*Health Policy
SARS-CoV-2

@article {pmid42788521,
year = {2026},
author = {Rolim, M and Leite, AB and Perdigão Neto, LV and Levin, AS},
title = {COVID-19 AND IBD: LOOK BEYOND THE VIRUS. A SYSTEMATIC REVIEW AND META-ANALYSIS FOCUSED ON BIOLOGIC THERAPY CONTINUITY.},
journal = {Arquivos de gastroenterologia},
volume = {63},
number = {},
pages = {e25147},
doi = {10.1590/S0004-2803.24612025-147},
pmid = {42788521},
issn = {1678-4219},
mesh = {Humans ; *Inflammatory Bowel Diseases/complications/drug therapy/therapy ; *COVID-19/complications ; *Biological Therapy ; Biological Products/therapeutic use ; },
abstract = {BACKGROUND/OBJECTIVE: Whether COVID-19 worsens the longterm course of inflammatory bowel disease (IBD) remains uncertain. We synthesized comparative cohorts to assess IBD outcomes after SARS-CoV-2 infection versus noninfected IBD controls and to evaluate the impact of biologic discontinuation.

METHODS: Systematic review (PRISMA 2020). Adult IBD cohorts with vs without prior SARS-CoV-2. Databases: MEDLINE (PubMed), Web of Science, and Scopus; reference lists screened. Time window: Jan 2020 to Dec 2024. Risk of bias: Newcastle-Ottawa. Randomeffects Mantel-Haenszel with REML variance and Hartung-Knapp adjustment; heterogeneity by I2/τ2/Q. Zero events handled via 0.5 continuity correction; sensitivity analyses reported risk differences (percentage points) and studylevel effects for sparse outcomes. Certainty graded with GRADE.

RESULTS: Four matched cohorts (n≈1.3k; Italy/USA). Prior SARS-CoV-2 did not worsen IBD clinical course (OR: 1.06; 95%CI: 0.76-1.49), nor alter UC extent (OR: 1.26; 95%CI: 0.33-4.83) or CD location/behavior (OR: 1.00; 95%CI: 0.06-16.15 / OR: 1.00; 95%CI: 0.46-2.18). Conversely, COVID-19 associated with biologic delay/discontinuation (OR: 10.44; 95%CI: 3.56-30.62). Across studies, flares were more frequent when biologics were delayed/stopped (~52% vs ~18%; RD ≈ +34 p.p.).

CONCLUSION: COVID-19 per se does not appear to aggravate IBD outcomes; the clinically actionable signal is treatment continuity. In IBD patients without highrisk features for severe COVID-19, maintaining biologics should be considered to prevent flares.},
}

Humans
*Inflammatory Bowel Diseases/complications/drug therapy/therapy
*COVID-19/complications
*Biological Therapy
Biological Products/therapeutic use

@article {pmid42789649,
year = {2026},
author = {Ebell, MH and Grad, R},
title = {Top 20 Research Studies of 2025 for Primary Care Physicians.},
journal = {American family physician},
volume = {114},
number = {2},
pages = {175-183},
pmid = {42789649},
issn = {1532-0650},
mesh = {Humans ; Female ; *Primary Health Care ; COVID-19/prevention & control ; Male ; },
abstract = {This article summarizes the top 20 research studies of 2025 identified as POEMs (patient-oriented evidence that matters). Treating male sex partners of female patients with oral and topical medication reduces recurrence of bacterial vaginosis. Anti-influenza drugs do not reduce hospitalizations or mortality. COVID-19 vaccines still improve mortality and reduce hospitalizations. Influenza vaccines are safe in pregnancy. Vaginal estrogen appears to be safe in breast cancer survivors. Women with normal bone density given zoledronic acid every 5 years have fewer fractures. Early post-partum insertion of a long-acting reversible contraceptive is associated with fewer pregnancies vs delayed insertion. Early medication abortion before pregnancy confirmation is safe and effective. After stent placement in patients with atherosclerotic coronary vascular disease who are taking an anticoagulant, adding aspirin worsens outcomes. After catheter ablation for atrial fibrillation, discontinuing anticoagulants after 1 year is safe if atrial arrhythmia does not recur, whereas left atrial appendage closure is superior to oral anticoagulation. For patients with provoked venous thromboembolism and at least one ongoing risk factor, 12 months of apixaban is better than 3 months. Clopidogrel is slightly more effective than aspirin for the secondary prevention of myocardial infarction and stroke over 3 years. Intensive blood pressure lowering decreases cardiovascular events but increases rates of hypotension and syncope, and there are concerns about the applicability of the data to the United States. Duloxetine, milnacipran, and pregabalin provide meaningful pain reduction in adults with fibromyalgia. Amyloid-directed monoclonal antibodies do not provide clinically meaningful cognitive benefits and may cause harms. Bright light therapy is effective for nonseasonal depression. Water exposure 6 hours after cutaneous surgery does not increase the risk of complications. A meta-analysis of platelet-rich plasma injections for knee osteoarthritis concluded that high-quality studies found no meaningful pain improvement. Using an oral challenge to rule out sulfonamide allergy is safe when used with a risk assessment tool.},
}

Humans
Female
*Primary Health Care
COVID-19/prevention & control
Male

@article {pmid42790130,
year = {2026},
author = {Schaffner, W and Gravenstein, S and Kissler, S and Cornely, OA and Mehta, D and Cenoz, MG and Vicic, N and Rudin, D},
title = {Multicomponent vaccination against seasonal influenza and COVID-19: a strategy to address the continued global burden of disease in adults.},
journal = {Vaccine},
volume = {93},
number = {},
pages = {129082},
doi = {10.1016/j.vaccine.2026.129082},
pmid = {42790130},
issn = {1873-2518},
abstract = {Seasonal influenza and SARS-CoV-2 are respiratory viruses that represent a global health concern, causing substantial numbers of hospitalizations and mortality, particularly among high-risk groups, including infants and older adults. Together these associated respiratory diseases and related complications are among the leading causes of morbidity and mortality. Although effective vaccines are available for protection against influenza and COVID-19, vaccine uptake remains below the levels recommended by the World Health Organization (WHO). Increasing vaccination coverage is critical for protecting vulnerable populations and reducing strain on healthcare systems. To improve vaccine uptake, the WHO recommends co-administering influenza and COVID-19 vaccines when epidemiologically justified. A multicomponent vaccine approach in adults could go beyond the current co-administration approach, as it has the potential to streamline delivery, reduce missed vaccination opportunities, and enhance vaccine coverage among individuals at risk. This manuscript reviews the current evidence on multicomponent vaccination for protection against seasonal influenza and COVID-19. We summarize published literature on the potential public health impacts of a multicomponent vaccination approach, discuss associated challenges, and review multicomponent vaccines currently in development. The studies in this review highlight various potential benefits of a multicomponent approach, including simplified dosing, greater vaccination coverage, and reduced disease burden and costs. Healthcare workers expressed a preference for a combination vaccine over standalone influenza or COVID-19 vaccines, indicating a high likelihood of recommending it to patients. Consumers also showed strong interest. For multicomponent vaccination to succeed, key considerations include the optimal timing of administration and appropriate strain selection for both the influenza and SARS-CoV-2 viruses. Promising multicomponent influenza-COVID-19 vaccine candidates currently being evaluated in clinical trials may represent an important advancement in adult immunization strategy, and a meaningful opportunity to strengthen protection against two of the most consequential respiratory pathogens worldwide.},
}

@article {pmid42791422,
year = {2026},
author = {Khalil, M and Bannout, Z and Jaber, N and Obeid, D and Mhanna, Z and Madani, A and Srour, D and Arzouni, A and Abdallah, H and Mahdi, L and Karaki, H and Safa, L and Mchiek, A and Lakiss, H and Di Ciaula, A and Portincasa, P},
title = {The 2024 Lebanon conflict: a multidimensional assessment of syndemic impacts on public health and sustainable development goals.},
journal = {Internal and emergency medicine},
volume = {},
number = {},
pages = {},
pmid = {42791422},
issn = {1970-9366},
abstract = {Lebanon entered the 2024 armed conflict with health, environmental, and social systems already weakened by successive crises, including the COVID-19 pandemic, prolonged economic collapse, and the 2020 Beirut Port explosion. This narrative review aimed to synthesize evidence on the documented and anticipated effects of the conflict on public health, healthcare services, the environment, food security, education, and progress toward the Sustainable Development Goals (SDGs). Evidence was drawn from peer-reviewed studies and reports issued by governmental institutions and international organizations. Documented damage to hospitals and primary healthcare facilities, together with disruptions to medical supply chains, affected routine and emergency care and complicated the management of chronic diseases. Population displacement, overcrowding, and interruptions to essential services also increased the risk of infectious disease transmission and created conditions that may facilitate the spread and emergence of antimicrobial resistance, particularly in displaced and otherwise vulnerable populations. Concurrently, explosive weapons, fires, and infrastructure damage affected air, water, soil, agricultural land, and ecosystems. These environmental and agricultural impacts created plausible pathways linking conflict-related damage to food security, livelihoods, and long-term population health, although direct epidemiological evidence remains limited. Overall, the conflict generated interconnected pressures across health, environmental, and social systems and compounded pre-existing vulnerabilities. Coordinated recovery efforts should restore healthcare capacity, protect environmental and agricultural resources, strengthen surveillance, and support essential social services to reduce long-term harm and promote sustainable recovery.},
}

@article {pmid42791937,
year = {2026},
author = {Elhanashi, A and Saponara, S},
title = {Intelligent Real-Time Healthcare and Biomedical Monitoring Systems: A Narrative Review of AI, IoT, and Emerging Technologies.},
journal = {Bioengineering (Basel, Switzerland)},
volume = {13},
number = {9},
pages = {},
doi = {10.3390/bioengineering13091065},
pmid = {42791937},
issn = {2306-5354},
abstract = {BACKGROUND: Chronic disease management, an ageing global population, and the aftermath of the COVID-19 pandemic have pushed real-time, continuous health monitoring from a research curiosity toward routine clinical practice. Artificial intelligence (AI), the Internet of Medical Things (IoMT), edge computing, and next-generation wireless networks are converging to enable systems that sense, interpret, and act on physiological data outside the traditional hospital setting.

METHODS: This is a narrative review, not a PRISMA-guided systematic or scoping review; it synthesises 75 sources (a mixture of primary studies, systematic/scoping reviews, and meta-analyses), individually verified against their published record. The topics span IoMT system architecture and security, wearable and implantable sensing, deep learning for electrocardiogram (ECG), fall-related and human-activity signal analysis, edge and TinyML deployment, federated learning, blockchain-based health-record security, medical imaging diagnostics, explainable AI (XAI), continuous glucose monitoring, 5G/6G-enabled telemonitoring, digital twins, consumer-grade and contactless cardiac sensing, neurological and mental health monitoring, and the materials, regulatory, and acute care infrastructure surrounding real-time deployment. Studies were organised into a five-layer architectural taxonomy spanning perception, edge, network, cloud, and application layers.

RESULTS: Reported accuracies for deep learning models on ECG arrhythmia classification range from 91% to 99.5% across the reviewed studies, but the figures come from different datasets, class definitions, and validation protocols and are therefore not directly comparable; within this heterogeneous evidence, edge-deployed models report accuracies in the 85-96% range at substantially reduced power budgets. Deep-learning-based fall detection and chest radiograph classification are each reported, in the individual studies reviewed, to outperform threshold-based or classical alternatives, though this has not been established through head-to-head comparison across the full evidence base. Federated learning and blockchain are discussed as technical mechanisms that can contribute to data privacy and record integrity; neither constitutes regulatory compliance with frameworks such as HIPAA or the GDPR on its own. Persistent obstacles identified across the reviewed literature include dataset heterogeneity, limited external clinical validation, energy-constrained edge hardware, low clinician trust in opaque models, and fragmented interoperability standards.

CONCLUSIONS: The evidence reviewed here is consistent with, but does not by itself establish, a layered, privacy-preserving, and explainable architecture that couples lightweight on-device inference with federated or blockchain-secured cloud learning as a design direction for future real-time healthcare monitoring systems. Future work should prioritise standardised benchmarking, prospective clinical validation, and regulatory-aligned data-governance frameworks.},
}

@article {pmid42792830,
year = {2026},
author = {Aladag, E and Karakulak, UN and Haznedaroglu, IC},
title = {Spike Protein at the Crossroads of Long-COVID and Vaccine-Induced Immune Thrombotic Thrombocytopenia Syndromes: A Cardio-Hematological Perspective.},
journal = {Biomedicines},
volume = {14},
number = {9},
pages = {},
doi = {10.3390/biomedicines14092090},
pmid = {42792830},
issn = {2227-9059},
abstract = {The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike (S) protein is central to viral infectivity, host-pathogen interactions, and immune recognition. Beyond its indispensable role in viral entry, accumulating experimental and clinical evidence indicates that spike protein may exert pleiotropic biological effects involving endothelial, cardiovascular, hematological, neurological, and immunological pathways. During natural infection, these effects occur in the context of active viral replication, additional viral antigens, and systemic inflammation, whereas vaccination induces a fundamentally different, transient exposure to a prefusion-stabilized spike antigen without viral propagation. In this review, we critically examine the molecular and clinicopathological properties of the SARS-CoV-2 spike protein and the biological differences between infection-derived and vaccine-derived spike exposure. Particular emphasis is placed on endothelial dysfunction, platelet and complement activation, immune-thrombosis, persistent viral antigens and tissue reservoirs in Long-COVID, and the distinct anti-PF4-mediated pathophysiology of vaccine-induced immune thrombotic thrombocytopenia (VITT). Emerging evidence suggests that persistent or dysregulated spike-related antigen exposure may contribute to chronic multisystem manifestations in a subset of individuals following SARS-CoV-2 infection; however, evidence linking persistent vaccine-derived spike to chronic clinical syndromes remains substantially more limited and does not currently establish causality. Integrating these observations, we propose the 'Long-Spike' hypothesis as a hypothesis-generating conceptual framework rather than a defined clinical syndrome. Further prospective studies integrating ultrasensitive antigen detection, tissue-based analyses, immunophenotyping, and cardiovascular and hematological biomarkers are required to determine the clinical relevance and causal significance of persistent spike-related antigens.},
}

@article {pmid42793280,
year = {2026},
author = {Dutta, S and Dutta, S and Han, Y and Zhu, Y and Almuntashiri, S and Somanath, PR and Narayanan, SP and Islam, S and Wang, X and Zhang, D},
title = {Extracellular Vesicles as Molecular Regulators of Viral Infection: Implications for COVID-19 and Future Viral Pandemics.},
journal = {Current issues in molecular biology},
volume = {48},
number = {9},
pages = {},
doi = {10.3390/cimb48090924},
pmid = {42793280},
issn = {1467-3045},
support = {R56HL163607//National Heart Lung and Blood Institute/ ; },
abstract = {Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), exposed critical gaps in global preparedness for rapidly evolving viral pandemics. Though current antiviral treatments have shown some efficacy in managing COVID-19, substantial limitations, such as inefficient targeted drug delivery, aberrant host immune responses, and inadequate preparedness for future viral pandemics, were also evident. These challenges underscore the urgent need for target-specific, precise and efficient therapeutic strategies to modulate viral entry and immune dysregulation. Extracellular vesicles (EVs), cell-released cargo-carrying nanoscale vesicles, can both facilitate and inhibit viral infection depending on their cargo composition. Thus, endogenous EVs can promote or inhibit COVID-19 pathogenesis by modulating critical pathways, including angiotensin-converting enzyme 2 (ACE2)-mediated viral entry, transmembrane protease serine 2 (TMPRSS2)- dependent spike protein activation, nuclear factor kappa B (NF-κB)-driven inflammatory signaling, and NLRP3 inflammasome activation. In contrast, engineered EVs, such as ACE2-expressing EVs, mesenchymal stem cell-derived EVs and microRNA-enriched EVs, have therapeutic potential as they can facilitate antiviral defense through immune modulation, viral neutralization and suppression of cytokine storm. Moreover, EV-associated nucleic acids, proteins and lipids can act as biomarkers for disease detection and severity stratification. A deeper understanding of EV-virus mechanistic insights can enhance preparedness for similar viral diseases. In this review, we provide a comprehensive analysis of the molecular mechanisms underlying EV-virus interactions highlighting the therapeutic and diagnostic potential of EVs in tackling COVID-19 and future viral pandemics.},
}

@article {pmid42794587,
year = {2026},
author = {Bizerea-Moga, TO and Chișavu, F and Chișavu, L and Pitulice, L and Moga, TV and Bugi, MA and Foghiș, CF and Isac, R and Mărginean, O and Balica, NC},
title = {Obesity, Oxidative Stress, and Inflammation in Precocious Puberty: Do All Roads Lead to the Hypothalamus?.},
journal = {International journal of molecular sciences},
volume = {27},
number = {18},
pages = {},
doi = {10.3390/ijms27188159},
pmid = {42794587},
issn = {1422-0067},
mesh = {Humans ; *Puberty, Precocious/metabolism/pathology/etiology ; *Oxidative Stress ; Animals ; *Inflammation/metabolism/complications ; *Hypothalamus/metabolism/pathology ; *Obesity/metabolism/complications ; Hypothalamic-Pituitary-Gonadal Axis ; Female ; },
abstract = {Childhood obesity is consistently associated with earlier pubertal timing, particularly in girls, whereas its relationship with true central precocious puberty (CPP), defined by premature activation of the hypothalamic-pituitary-gonadal (HPG) axis, is less clearly established. An increased frequency of CPP diagnoses and referrals was reported during the COVID-19 pandemic, alongside changes in body weight, lifestyle, sleep, and psychosocial exposures. Human studies link excess adiposity to hyperleptinemia, insulin resistance, reduced adiponectin, altered sex-steroid bioavailability, and systemic low-grade inflammation, and associate these features with earlier pubertal development-consistently in girls, less so in boys. However, such associations do not establish that obesity directly induces premature hypothalamic activation. Mechanistic understanding of how these peripheral signals may influence pubertal timing derives predominantly from experimental models. The arcuate nucleus kisspeptin/neurokinin B/dynorphin (KNDy) network, a key component of the gonadotropin-releasing hormone (GnRH) pulse generator, interacts with hypothalamic metabolic circuits. In animal models of obesity and overnutrition, altered leptin and insulin signaling, mitochondrial reactive oxygen species generation, and activation of microglia and astrocytes remodel the mediobasal hypothalamus through inflammatory and stress-responsive pathways, including IKKβ/NF-κB and JNK signaling and altered Nrf2-mediated antioxidant defenses. At the molecular level, metabolic status interacts with the epigenetic machinery governing Kiss1 expression: in rodent models of overnutrition, accelerated loss of SIRT1-mediated repression at the Kiss1 promoter facilitates pubertal activation. Human genetic evidence establishes MKRN3 and DLK1 as causes of familial CPP, but evidence that obesity modifies these pathways to induce sporadic CPP is insufficient. Similarly, gut microbial metabolites have been linked experimentally to pubertal timing, and antioxidant micronutrients such as selenium, zinc, and vitamins C and E may be altered in pediatric obesity, yet a specific role in CPP remains unproven. Collectively, current evidence supports a working model in which metabolic, inflammatory, redox, glial, and epigenetic pathways may converge on hypothalamic reproductive circuits to influence pubertal timing in susceptible children. Direct evidence in children with CPP-of hypothalamic oxidative stress, glial activation, Nrf2 dysfunction, SIRT1 remodeling, or microbiome-mediated activation-remains limited or absent. Lifestyle optimization is appropriate for improving metabolic health in children with obesity, whereas antioxidant, micronutrient, and microbiome-targeted interventions should be considered investigational with respect to CPP. Longitudinal pediatric studies that distinguish earlier pubertal timing from true CPP, and that integrate metabolic phenotyping with validated measures of HPG-axis activation, are needed to test this framework.},
}

Humans
*Puberty, Precocious/metabolism/pathology/etiology
*Oxidative Stress
Animals
*Inflammation/metabolism/complications
*Hypothalamus/metabolism/pathology
*Obesity/metabolism/complications
Hypothalamic-Pituitary-Gonadal Axis
Female

@article {pmid42795466,
year = {2026},
author = {Onodera, T and Seo, S and Sakudo, A and Toniolo, A},
title = {Hyperglycemia in Cats Infected by SARS-CoV-2: Pancreatic Alterations and Potential Antiviral Therapeutics.},
journal = {Microorganisms},
volume = {14},
number = {9},
pages = {},
doi = {10.3390/microorganisms14091884},
pmid = {42795466},
issn = {2076-2607},
abstract = {Cats represent a susceptible host and a possible translational model for investigating coronavirus pathogenesis and therapeutics. Recent immunohistochemical (IHC) and histopathological studies in both human and feline tissues have demonstrated SARS-CoV-2 nucleocapsid protein (NP) and spike protein expression within pancreatic islet cells, following a classic temporal infection course. Notably, IHC analysis also reveals NP expression within exocrine ductal epithelial cells. Given that ductal epithelium functions as an islet progenitor pool during tissue injury or metabolic stress, pancreotropic coronaviruses may gain access to the endocrine compartment by exploiting this intrinsic cellular differentiation pathway. Although the precise mechanisms governing intra-islet viral entry remain to be elucidated, this review highlights the capacity of SARS-CoV-2 to compromise both the exocrine (digestive) and endocrine functions of the pancreas. Finally, we evaluate the therapeutic potential of direct-acting antivirals-specifically RNA-dependent RNA polymerase (RdRp) and protease inhibitors-as monotherapies and in synergistic combination to limit pancreatic injury and mitigate the diabetogenic effects of coronaviruses across both acute infection and post-acute sequelae, such as human long-COVID syndrome.},
}

@article {pmid42795472,
year = {2026},
author = {Feng, Z and Qiu, C and Zhou, Z and Yang, M and Wang, H and Zhou, Y},
title = {The Interplay Between Autophagy and Porcine Epidemic Diarrhea Virus: From Molecular Mechanisms to Therapeutic Perspectives.},
journal = {Microorganisms},
volume = {14},
number = {9},
pages = {},
doi = {10.3390/microorganisms14091890},
pmid = {42795472},
issn = {2076-2607},
support = {26CXNH001//Gansu Provincial Science and Technology Department/ ; GSXM‑2026‑KYTD‑08//the Key Scientific and Technological Innovation Team Project of Gansu Polytechnic College of Animal Husbandry and Engineering/ ; 25KJA180004//the Basic Science (Natural Science) Research Project of Higher Education Institutions in Jiangsu Province/ ; },
abstract = {Autophagy is a highly conserved degradation and recycling process in eukaryotic cells that plays a critical role in maintaining cellular homeostasis and responding to external stress. During viral infection, autophagy exhibits a classic "double-edged sword" effect-it can act as a host defense mechanism by directly degrading viral components, but it can also be hijacked by viruses to promote their own replication. Porcine epidemic diarrhea virus (PEDV), an important enteric coronavirus that severely affects the global swine industry, engages in a complex and sophisticated interplay with the host autophagy system. This review systematically dissects the dual regulatory mechanisms of autophagy during PEDV infection and reveals two intertwined functional axes. On one hand, PEDV utilizes multiple viral proteins to cooperatively manipulate the autophagic pathway-inducing mitophagy to suppress innate immune responses, utilizing autophagic membranes to construct replication platforms, and blocking autophagic flux to evade degradation-thereby establishing a multi-level pro-viral network. On the other hand, host cells deploy a unified molecular axis of "ubiquitination-autophagy receptor-lysosome" by mobilizing a broad array of restriction factors to target and degrade viral proteins, forming a coordinated defense system. These two axes converge at the oxidative stress-endoplasmic reticulum stress-autophagy hub, where PEDV NSP1 and NSP2 synergistically inhibit the NRF2 antioxidant system to trigger this cascade, while host factors such as DDX6 and ACE2 finely regulate the process. Based on this mechanistic framework, we discuss the therapeutic implications of targeting autophagy for PEDV intervention, with particular emphasis on the development of selective autophagy modulators as potential antiviral agents. We also identify key knowledge gaps and propose future research directions to translate these mechanistic insights into clinical or field applications. This review synthesizes the peer-reviewed literature published between 2013 and 2026, identified through systematic searches of PubMed, Web of Science, and Scopus databases. Notably, the majority of mechanistic findings discussed are derived from in vitro cell culture models, and their translation to in vivo settings remains a significant challenge. Bridging this gap will require validation in physiologically relevant models, such as porcine intestinal organoids and controlled piglet challenge studies, to assess the efficacy and safety of autophagy-targeting interventions in the context of intestinal homeostasis and mucosal immunity.},
}

@article {pmid42795534,
year = {2026},
author = {Crispino, P and Viceconti, A and Camardo, V},
title = {Increase in Healthcare-Associated Infections: Is COVID-19 Responsible? A Narrative Review.},
journal = {Microorganisms},
volume = {14},
number = {9},
pages = {},
doi = {10.3390/microorganisms14091952},
pmid = {42795534},
issn = {2076-2607},
abstract = {During the COVID-19 pandemic, healthcare-associated infections (HAIs) showed a significant increase, exacerbated by the prevalence of multidrug-resistant (MDR) organisms. Antibiotic overuse and infection control practices influenced HAI incidence rates, alongside the rising prevalence of resistant pathogens such as methicillin-resistant Staphylococcus aureus. Antibiotic-resistant pathogens causing healthcare-associated infections in COVID-19 patients include-in addition to methicillin-resistant Staphylococcus aureus-metallo-β-lactamase-producing carbapenem-resistant Enterobacteriaceae, carbapenem-resistant Acinetobacter baumannii, extended-spectrum β-lactamase-producing Klebsiella pneumoniae, and vancomycin-resistant enterococci. COVID-19 impacted bacterial healthcare-associated infections in various ways, with an increase in the incidence of metallo-β-lactamase-producing, carbapenem-resistant organisms-a trend already noted prior to the pandemic. Furthermore, the pandemic laid the groundwork for future challenges in HAI management, highlighting the need for rigorous infection prevention and control protocols. Poorer outcomes were observed in hospitalized COVID-19 patients with antibiotic-resistant infections. Although increased infection prevention and control (IPC) measures led to a reduction in certain site-specific hospital-acquired infections, in other contexts, COVID-19 was associated with an increased incidence of bacterial hospital-acquired infections. Further research is needed to determine the cost-benefit ratio of maintaining COVID-19-related infection prevention and control protocols beyond the pandemic in order to reduce the impact of hospital-acquired infections. Furthermore, it is necessary to assess the long-term impact of the high usage of certain broad-spectrum antibiotics during the COVID-19 pandemic.},
}

@article {pmid42795536,
year = {2026},
author = {Akhmedova, N and Kholov, G and Ochilov, U and Shonazarova, N and Yuldashev, O and Olimova, G and Istamova, S and Mukhammadiyeva, S and Kenjayeva, N and Sharipov, J},
title = {Airway and Gut Dysbiosis, Infectious Exacerbations and Pulmonary Vascular Remodelling in COPD-Associated Pulmonary Hypertension: Microbial Mechanisms, Causal Uncertainty and Therapeutic Implications.},
journal = {Microorganisms},
volume = {14},
number = {9},
pages = {},
doi = {10.3390/microorganisms14091954},
pmid = {42795536},
issn = {2076-2607},
abstract = {Pulmonary hypertension complicating chronic obstructive pulmonary disease (COPD-PH) has a worse prognosis than airflow limitation alone but its pathogenesis is thought to be primarily due to alveolar hypoxia affecting pulmonary circulation. Two observations are not fully explained by this model. First, the majority of exacerbations of COPD are infectious and there is a stable frequent-exacerbator phenotype that is not fully accounted for by spirometric severity. Second, the airways of COPD are not sterile. They are home to a resident microbial community that changes as the disease progresses and the gut microbial community also undergoes disease-associated changes. This review examines whether microbial factors actively contribute to pulmonary vascular remodelling or merely reflect advanced disease. Three candidate exposures are considered: chronic airway colonisation, dysbiosis of the airway and gut communities and recurrent infectious exacerbation. We then examine the virulence mechanisms and host-recognition pathways of non-typeable Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis, Pseudomonas aeruginosa, rhinovirus, influenza viruses, respiratory syncytial virus and SARS-CoV-2. We then trace the pathways linking microbial recognition to vascular injury: Toll-like receptor signalling and NF-κB activation; interleukin-6, tumour necrosis factor-α and interleukin-1β; endothelin-1 upregulation against nitric oxide depletion; reactive oxygen species and hypoxia-inducible factor signalling converging with hypoxic pulmonary vasoconstriction; and, along the gut-lung axis, lipopolysaccharide translocation, trimethylamine N-oxide and depletion of short-chain fatty acid-producing taxa. Therapeutically, there is evidence and a vascular rationale for interventions that decrease exacerbation frequency. Pulmonary vasodilators have a sound physiological rationale, although their clinical efficacy is frequently limited by worsening ventilation-perfusion mismatch. Current evidence supports biological plausibility rather than demonstrated causality: no direct longitudinal human study has established that microbial alterations or microbial exposure cause pulmonary vascular remodelling in COPD-PH. We identify study designs capable of directly testing this hypothesis.},
}

@article {pmid42795935,
year = {2026},
author = {Bralic, M and Silconi, FI and Vuletic, V and Kovacic, S},
title = {Neurological Manifestations of Long COVID: Current Evidence, Emerging Concepts, and Future Perspectives.},
journal = {Journal of clinical medicine},
volume = {15},
number = {18},
pages = {},
doi = {10.3390/jcm15187163},
pmid = {42795935},
issn = {2077-0383},
abstract = {Six years after the onset of the COVID-19 pandemic, many individuals continue to experience persistent neurological symptoms that extend beyond the acute phase of infection, affecting daily life, work, and overall functioning, thereby representing a substantial long-term health burden. Cognitive impairment, fatigue, headache, and autonomic dysfunction are among the most frequently reported neurological features, often persisting despite the absence of clear diagnostic findings. Although Long COVID is recognized as a distinct clinical entity, the underlying pathophysiological mechanisms remain incompletely understood. This narrative review provides a critical synthesis of current literature regarding the clinical presentations, potential mechanisms, and biomarkers associated with neurological involvement in Long COVID. Reflecting the high heterogeneity of the available evidence, it is important to note that no neurological biomarker or disease-modifying therapy has yet been clinically validated. Ultimately, characterizing these pathways may help define disease heterogeneity, support patient stratification, and guide future personalized therapeutic approaches.},
}

@article {pmid42796374,
year = {2026},
author = {Runzer-Colmenares, FM and Cahuapaza-Gutierrez, NL and Calderon-Hernandez, CC and Umeres-Bravo, MM and Rojas-De la Cruz, RA and Villavicencio-Escudero, TV and Pajuelo-Vasquez, R and Enciso, N},
title = {Rhabdomyolysis Reported in Association with SARS-CoV-2 Infection and COVID-19 Vaccination: A Systematic Review.},
journal = {Medicina (Kaunas, Lithuania)},
volume = {62},
number = {9},
pages = {},
doi = {10.3390/medicina62091769},
pmid = {42796374},
issn = {1648-9144},
mesh = {Humans ; *Rhabdomyolysis/etiology/epidemiology ; *COVID-19 Vaccines/adverse effects ; *COVID-19/prevention & control/complications/epidemiology ; Male ; Middle Aged ; *Vaccination/adverse effects ; Adult ; SARS-CoV-2 ; Female ; },
abstract = {Background and Objectives: The association between SARS-CoV-2 infection, COVID-19 vaccination, and the development of rhabdomyolysis remains unclear. This systematic review aimed to comprehensively synthesize and analyze the available evidence on the occurrence of rhabdomyolysis in the context of SARS-CoV-2 infection and COVID-19 vaccination. Materials and Methods: A literature search was conducted in PubMed, Scopus, EMBASE, and Web of Science. The review followed PRISMA 2020 guidelines, assessing methodological quality. Statistical analyses were performed using STATA v18. Results: A total of 133 patients with rhabdomyolysis associated with SARS-CoV-2 infection were identified from 93 case reports and 7 case series; the median age was 45.5 years (IQR: 24-62), with a predominance of males (72.9%). Additionally, 13 observational studies comprising 818 patients with rhabdomyolysis associated with SARS-CoV-2 infection were included. Among cases associated with SARS-CoV-2 vaccination, 20 patients were identified from 20 case reports; the median age was 52.5 years (IQR: 22.5-76.5), with a predominance of males (75%). These cases were primarily associated with mRNA-based vaccines, particularly Pfizer-BioNTech BNT162b2 (50%) and Moderna (20%), and occurred predominantly after the first and second doses. The most frequent clinical manifestations in both groups were fever, myalgia, and dark urine. Clinical outcomes were favorable in most patients, both among infection-associated cases (72.2%) and vaccination-associated cases (80%). Conclusions: Rhabdomyolysis has been documented during SARS-CoV-2 infection, although its true frequency remains uncertain, whereas cases following COVID-19 vaccination do not establish causality or platform-specific risks.},
}

Humans
*Rhabdomyolysis/etiology/epidemiology
*COVID-19 Vaccines/adverse effects
*COVID-19/prevention & control/complications/epidemiology
Male
Middle Aged
*Vaccination/adverse effects
Adult
SARS-CoV-2
Female

@article {pmid42796658,
year = {2026},
author = {Prezioso, C and Frezza, F and Aquaro, S and Nencioni, L and Mariconda, A and Amantea, D and Catalano, A and Longo, P and Sinicropi, MS and Checconi, P},
title = {Investigating the Role of microRNA in Host-Influenza A and Other Respiratory RNA Virus Interactions.},
journal = {Pathogens (Basel, Switzerland)},
volume = {15},
number = {9},
pages = {},
doi = {10.3390/pathogens15090889},
pmid = {42796658},
issn = {2076-0817},
mesh = {*MicroRNAs/genetics/metabolism ; Humans ; *Influenza, Human/virology/genetics/immunology ; *Host-Pathogen Interactions/genetics ; *Influenza A virus/genetics/physiology ; Virus Replication ; SARS-CoV-2/genetics ; RNA, Viral/genetics ; Signal Transduction ; Animals ; RNA Replication ; },
abstract = {Respiratory RNA viruses extensively reprogram host regulatory networks, thereby influencing viral replication, immune evasion, and disease severity. This review examines microRNAs (miRNAs) as regulatory interfaces in host-virus interactions, focusing on influenza A virus as a paradigmatic model while integrating evidence from other respiratory RNA viruses as SARS-CoV-2 and respiratory syncytial virus. After outlining canonical miRNA biogenesis and its manipulation during infection, we discuss how respiratory RNA viruses converge on shared miRNA-regulated pathways, including interferon and NF-κB signaling, apoptosis, autophagy, cellular metabolism, and redox homeostasis. Within these networks, host miRNAs can directly target viral RNAs and modulate antiviral defenses and inflammation, whereas viruses can reshape miRNA expression to facilitate replication, influencing immunopathology. The possibility that RNA viruses encode authentic miRNAs is also critically evaluated; current evidence indicates that manipulating host miRNA biogenesis machinery and remodeling miRNA networks are more prevalent than producing canonical viral miRNAs. Finally, the potential of circulating miRNAs as diagnostic and prognostic biomarkers is considered, as well as the capability of miRNA mimics and antagomiRs to function as host-directed therapeutic strategies. Their clinical translation, however, will require standardized validation, cell- and time-resolved studies, efficient delivery systems, and a careful assessment of specificity, safety, and context-dependent effects.},
}

*MicroRNAs/genetics/metabolism
Humans
*Influenza, Human/virology/genetics/immunology
*Host-Pathogen Interactions/genetics
*Influenza A virus/genetics/physiology
Virus Replication
SARS-CoV-2/genetics
RNA, Viral/genetics
Signal Transduction
Animals
RNA Replication

@article {pmid42796662,
year = {2026},
author = {Vincenzi, F and Crobu, MG and Tonello, S and Vercellino, N and Grossini, E and Ravanini, P and Minisini, R and Boglione, L and Pirisi, M and Sainaghi, PP and Smirne, C},
title = {The Modulatory Role of Vitamin D in the Molecular Mechanisms of Sepsis and Infections with Focus on Viral Pathogenesis: A Narrative Review.},
journal = {Pathogens (Basel, Switzerland)},
volume = {15},
number = {9},
pages = {},
doi = {10.3390/pathogens15090894},
pmid = {42796662},
issn = {2076-0817},
mesh = {Humans ; *Vitamin D/immunology/therapeutic use ; *Sepsis/immunology/virology ; Vitamin D Deficiency/immunology/complications ; *Virus Diseases/immunology/virology ; Immunity, Innate ; Animals ; COVID-19 ; Adaptive Immunity ; },
abstract = {Viral infections are a widely recognized cause of mortality. Recently it has been demonstrated that vitamin D plays an important immuno-modulatory role in both innate and adaptive immune responses against infections, by reducing excessive inflammation and enhancing defense mechanisms. Specifically, exacerbation of infections may cause sepsis, characterized by a dysregulated immune response with hyperinflammation and immune exhaustion. Vitamin D can modulate these processes through various mechanisms, such as enhancing antiviral protection, promoting anti-inflammatory responses, protecting endothelial barriers, and modulating T-cells. This has been demonstrated for various viral infections, including influenza viruses, respiratory syncytial virus, and severe acute respiratory syndrome coronavirus. Although vitamin D deficiency has been associated with increased susceptibility to viral infections and immune cells of infected patients are highly responsive to vitamin D, the clinical benefits of its supplementation to vitamin D-deficient infected individuals are uncertain and, most importantly, direct evidence linking vitamin D to viral sepsis specifically remains particularly limited, with most mechanistic inference extrapolated from non-septic viral infection and bacterial sepsis literature. Based on these assumptions, this review will outline the present understanding about vitamin D regulatory effects on immune system and the possible connection between its serum levels and viral infections, while also addressing controversial issues.},
}

Humans
*Vitamin D/immunology/therapeutic use
*Sepsis/immunology/virology
Vitamin D Deficiency/immunology/complications
*Virus Diseases/immunology/virology
Immunity, Innate
Animals
COVID-19
Adaptive Immunity

@article {pmid42796669,
year = {2026},
author = {Sole, E and Montalbano, G and Motta, G and Pansera, MM and Midiri, A and Iacopino, M and Liotta, P and Mancuso, G and Biondo, C},
title = {Drivers of Viral Spillover: An Examination of How Pathogens Spread.},
journal = {Pathogens (Basel, Switzerland)},
volume = {15},
number = {9},
pages = {},
doi = {10.3390/pathogens15090901},
pmid = {42796669},
issn = {2076-0817},
mesh = {Humans ; Animals ; *Viral Zoonoses/transmission/virology/epidemiology ; *Zoonoses/transmission/virology ; SARS-CoV-2 ; COVID-19/transmission ; Pandemics ; Disease Reservoirs/virology ; *Coronavirus Infections/transmission ; },
abstract = {The occurrence of viral zoonotic spillover (the transmission of viruses from animals to humans) has attracted worldwide attention due to mounting concerns regarding viral threats such as avian influenza, Hendra, monkeypox, Nipah and bat coronaviruses. It is evident that these events deviate significantly from natural occurrences, being the conflation of ecological, environmental and social factors that are profoundly altering the boundaries between the animal and human domains. Consequently, in order to comprehend both the contemporary and prospective drivers of zoonotic viral spillover, a coordinated, comprehensive global One Health response is essential. The purpose of the present review is to analyze prevailing pathways of transmission between animal reservoirs and human populations. This examination involves the analysis of historical cases, including those of SARS and Ebola, as well as recent occurrences, such as the global pandemic of SARS-CoV-2 (COVID-19). A secondary objective of this review is to comprehend the fundamental mechanisms of cross-species transmission. The development of effective strategies to mitigate the emergence of zoonotic viruses and prevent future pandemics is contingent on a robust understanding of these mechanisms. This analysis is key to identifying pandemic pathogens and preventing the spread of zoonotic viruses. In conclusion, the review provides a thorough evaluation of current global strategies to prevent the spread of zoonotic viruses, highlighting gaps in our understanding and areas for further research.},
}

Humans
Animals
*Viral Zoonoses/transmission/virology/epidemiology
*Zoonoses/transmission/virology
SARS-CoV-2
COVID-19/transmission
Pandemics
Disease Reservoirs/virology
*Coronavirus Infections/transmission

@article {pmid42796671,
year = {2026},
author = {Samrat, SK and Srivastava, G and Zhang, R and Li, Z and Li, H},
title = {Target-Based Antiviral Drug Development Against Human Respiratory Viruses.},
journal = {Pathogens (Basel, Switzerland)},
volume = {15},
number = {9},
pages = {},
doi = {10.3390/pathogens15090903},
pmid = {42796671},
issn = {2076-0817},
support = {AI177149 and AI175435//University of Arizona/ ; },
mesh = {Humans ; *Antiviral Agents/pharmacology/therapeutic use/chemistry ; *Drug Development ; Drug Discovery/methods ; *Respiratory Tract Infections/drug therapy/virology ; Viral Proteins/antagonists & inhibitors ; Coronavirus/drug effects ; Drug Design ; },
abstract = {Human respiratory viruses represent a major global health burden, causing millions of severe infections and deaths annually. Despite the central role of vaccines in prevention, their limitations, such as incomplete coverage, waning immunity, and vulnerability to viral evolution, underscore the urgent need for effective antiviral therapeutics. This review examines the principles and applications of target-based antiviral drug development against human respiratory viruses, emphasizing the identification and exploitation of conserved viral and host targets. Key viral proteins, including RNA-dependent RNA polymerases, proteases, and fusion glycoproteins, are analyzed across major virus families such as coronaviruses, paramyxoviruses, and adenoviruses, highlighting their structural features, functional constraints, and therapeutic potential. We further explore the integration of high-throughput screening and rational drug design, supported by advances in structural biology, cryo-electron microscopy, and computational approaches, including artificial intelligence-driven drug discovery. These methodologies collectively enhance the precision and efficiency of antiviral development. However, significant challenges remain, particularly the conflict between viral mutation and target conservation, the rapid emergence of drug resistance, and the safety limitations of host-targeted therapies. Finally, we discuss emerging strategies to overcome these barriers, including combination therapies and the development of broad-spectrum antivirals targeting conserved molecular mechanisms. This paper highlights a framework for the rational design of durable antiviral interventions capable of addressing both existing and emerging respiratory viral threats.},
}

Humans
*Antiviral Agents/pharmacology/therapeutic use/chemistry
*Drug Development
Drug Discovery/methods
*Respiratory Tract Infections/drug therapy/virology
Viral Proteins/antagonists & inhibitors
Coronavirus/drug effects
Drug Design

@article {pmid42796724,
year = {2026},
author = {Joan, J and Chandra, C and Wibisono, CA and Gunawan, HD and Chang, V and Sumarpo, A},
title = {Complete Blood Count-Derived Inflammatory Markers in Pediatric Lower Respiratory Tract Infection: A Narrative Review.},
journal = {Pathogens (Basel, Switzerland)},
volume = {15},
number = {9},
pages = {},
doi = {10.3390/pathogens15090956},
pmid = {42796724},
issn = {2076-0817},
mesh = {Humans ; *Respiratory Tract Infections/blood/diagnosis/microbiology ; Biomarkers/blood ; Child ; Blood Cell Count ; Infant ; Child, Preschool ; Neutrophils ; *Inflammation/blood ; Adolescent ; Infant, Newborn ; },
abstract = {Lower respiratory tract infections (LRTIs) are a leading infectious cause of death in children worldwide. Complete blood count (CBC)-derived inflammatory ratios are low-cost and widely available, yet their reported performance varies. We reviewed 46 PubMed-indexed studies (2016-2026) in children aged 0-18 years with viral, bacterial, or mycobacterial LRTI. The findings were mapped across diagnosis, etiological differentiation, severity, and outcome prediction. The neutrophil-to-lymphocyte ratio (NLR) was the most investigated marker, with the broadest evidence base for severity assessment and for separating bacterial from viral disease, although its performance remained pathogen-, population-, and endpoint-dependent; it was elevated in severe pertussis, tuberculosis, Mycoplasma pneumoniae, Streptococcus pneumoniae, and SARS-CoV-2 infection, whereas findings in respiratory syncytial virus infection were conflicting. The platelet-to-lymphocyte ratio had the next broadest evidence base for severity, and the systemic immune-inflammation index was consistently elevated in Mycoplasma pneumoniae and SARS-CoV-2 infection. No single ratio performed consistently across all etiologies. Ratios governed by one dominant immunopathogenic mechanism behaved predictably; those whose numerator and denominator respond to the same process did not. Cut-offs were neither standardized, age-specific, nor externally validated, and most estimates derived from retrospective cohorts in few countries; reported values therefore represent association and discrimination rather than validated prediction. Standardized, age-specific thresholds are needed before these markers can support routine risk stratification.},
}

Humans
*Respiratory Tract Infections/blood/diagnosis/microbiology
Biomarkers/blood
Child
Blood Cell Count
Infant
Child, Preschool
Neutrophils
*Inflammation/blood
Adolescent
Infant, Newborn

@article {pmid42797547,
year = {2026},
author = {Runzer-Colmenares, FM and Cahuapaza-Gutierrez, NL and Calderon-Hernandez, CC and Hilares-Jorge, CM},
title = {Association Between Respiratory Vaccines and Risk of Cognitive Impairment, Dementia and Alzheimer's Disease: A Scoping Review.},
journal = {Vaccines},
volume = {14},
number = {9},
pages = {},
doi = {10.3390/vaccines14090726},
pmid = {42797547},
issn = {2076-393X},
abstract = {Background/Objectives: Neurocognitive disorders represent a growing burden among older adults. Although respiratory vaccines have demonstrated efficacy and safety in preventing acute respiratory events, their potential impact on the development of chronic neurocognitive disorders, such as cognitive impairment, dementia, and Alzheimer's disease (AD), has not been extensively explored. The objective of this scoping review was to synthesize and analyze the available evidence on the association between respiratory vaccination and the risk of developing cognitive impairment, dementia, and Alzheimer's disease. Methods: A scoping review was conducted in accordance with the PRISMA-ScR guidelines. A literature search was performed in the PubMed, Scopus, and Web of Science databases through 15 June 2026. Studies involving older adults (≥60 years), irrespective of their baseline neurocognitive status, were included. Observational studies (cohort and case-control studies) were considered. Editorials, narrative reviews, and other non-original articles were excluded. Results: Eighteen studies were included, with cohort studies being the predominant design. Four main categories of respiratory vaccines were evaluated: influenza, COVID-19, respiratory syncytial virus (RSV), and pneumococcal vaccines, in relation to the risk of cognitive impairment, dementia, and AD. Influenza vaccination was associated with a lower risk of dementia and AD, with a potential dose-response relationship observed, whereby a greater number of vaccinations was associated with a greater reduction in risk. Pneumococcal vaccination was also associated with a lower risk of dementia and AD, particularly among individuals who received a greater number of vaccine doses. In contrast, the evidence regarding COVID-19 and RSV vaccines was limited and yielded heterogeneous findings. Conclusions: Influenza and pneumococcal vaccination maybe associated with a lower risk of Alzheimer's disease and dementia. However, the evidence regarding COVID-19 and RSV vaccines remains limited, and additional studies are needed to clarify their impact on the risk of developing neurocognitive disorders.},
}

@article {pmid42797552,
year = {2026},
author = {Hou, J and Li, Y and Tao, M},
title = {COVID-19 Vaccination and Pulmonary Nodules: A Narrative Review of Causality, Detection Bias and Thoracic Imaging Pitfalls.},
journal = {Vaccines},
volume = {14},
number = {9},
pages = {},
doi = {10.3390/vaccines14090731},
pmid = {42797552},
issn = {2076-393X},
abstract = {Background/Objectives: Concern that COVID-19 vaccination causes pulmonary nodules persists because vaccination coincided with expanded computed tomography (CT), low-dose CT (LDCT) screening, post-COVID imaging and artificial intelligence (AI)-assisted detection. This review asks whether the current literature supports causality and how vaccination history should inform thoracic imaging. Methods: A focused search of PubMed, PubMed Central and the Cochrane Library was performed through 15 July 2026. Evidence was classified as direct or contextual; no PRISMA screening, risk-of-bias scoring or quantitative synthesis was performed. Results: Direct evidence remains sparse. One case report was too confounded for inference. A two-sample Mendelian randomization study found no broad lung disease risk signal, but nodules were not modeled and the heterogeneous endpoints were exploratory. An ecological study of 1,616,750 samples linked rising detection to SARS-CoV-2 infection waves and AI-assisted reading; lacking individual vaccination data, it cannot establish whether vaccination affected detection. Screening interruption produced the opposite pattern: Lung-RADS 4 nodules rose from 8% to 29%. The most reproducible post-vaccination thoracic finding is regional lymph-node activation on [18F]fluorodeoxyglucose positron emission tomography/computed tomography ([18F]FDG-PET/CT), an expected immune response rather than a parenchymal nodule. Conclusions: Current evidence is insufficient to establish vaccination as an independent, population-level cause of pulmonary nodules. Vaccination history should guide [18F]FDG-PET/CT interpretation; CT-detected parenchymal nodules warrant standard risk stratification.},
}

@article {pmid42165881,
year = {2026},
author = {Di Stadio, A and Brenner, MJ and De Luca, P and D'Ascanio, L and Patel, ZM},
title = {Regenerating smell in neurodegenerative disease -translating theory into therapy.},
journal = {European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery},
volume = {283},
number = {9},
pages = {6103-6108},
pmid = {42165881},
issn = {1434-4726},
mesh = {Humans ; *Olfaction Disorders/therapy/etiology/physiopathology ; *Neurodegenerative Diseases/complications/therapy/physiopathology ; COVID-19/complications ; *Platelet-Rich Plasma ; Olfactory Training ; SARS-CoV-2 ; *Smell/physiology ; },
abstract = {PURPOSE: Quantitative and qualitative olfactory dysfunction are one of the earliest and most prevalent symptoms across neurodegenerative diseases, notably Parkinson's and Alzheimer's disease. These pathologies may spread bidirectionally between the peripheral olfactory system and central brain regions, supporting a model in which the olfactory system represents both an early marker and a conduit for disease propagation. This short communication aims to investigate the potential of Platelet Rich Plasma (PRP) to treat smell alteration in the neurodegenerative diseases.

METHOD: We conducted a review of the literature to extract articles that discussed PRP use in the context of olfactory disorders.

RESULTS: 12 studies were identified; 7 studies on COVID-19, 2 on unspecific smell loss, 1 on traumatic anosmia, 1 on nasal polyposis and 1 illustrated the use of PRP in long-term persistent anosmia (> 25 years).

CONCLUSION: Post COVID-19 olfactory impairment has provided insights into mechanisms of smell loss and therapeutic strategies. While olfactory training remains the best studied intervention, its benefits are modest, inconsistent, and often limited in cases with central nervous system involvement. PRP has emerged as a promising candidate due to its growth factors and immunomodulatory properties. Preclinical studies demonstrate that intranasal PRP can enhance neurogenesis, reduce neuroinflammation, and improve olfactory and cognitive outcomes in animal models of Parkinson's and Alzheimer's disease. Early clinical observations also suggest potential benefit in longstanding anosmia of diverse etiologies. Future research should define optimal delivery routes, dosing, and long-term efficacy, with well-designed clinical trials needed to translate these experimental findings into therapeutic applications.},
}

Humans
*Olfaction Disorders/therapy/etiology/physiopathology
*Neurodegenerative Diseases/complications/therapy/physiopathology
COVID-19/complications
*Platelet-Rich Plasma
Olfactory Training
SARS-CoV-2
*Smell/physiology

@article {pmid42304586,
year = {2026},
author = {Gibson, M and Carlson, K},
title = {Big Bill, Bigger Consequences: One Big Beautiful Bill Act (OBBBA) and Opioid Use Disorder Treatment-A Critical Review.},
journal = {Policy, politics & nursing practice},
volume = {27},
number = {4},
pages = {252-257},
doi = {10.1177/15271544261458768},
pmid = {42304586},
issn = {1552-7468},
mesh = {Humans ; *Opioid-Related Disorders/drug therapy/therapy/epidemiology ; United States/epidemiology ; *Medicaid/legislation & jurisprudence/economics ; *Health Services Accessibility/legislation & jurisprudence ; Opiate Substitution Treatment ; COVID-19/epidemiology ; Health Policy ; },
abstract = {The United States continues to struggle with the opioid crisis, exacerbated by shifting political priorities and the aftermath of the COVID-19 pandemic. This critical review analyzes the One Big Beautiful Bill Act (OBBBA) and its implications for opioid use disorder (OUD) treatment through the lens of the Multiple Streams Framework. Drawing on Medicaid data, and evidence from state-level implementation, most notably Arkansas, this article evaluates how work requirements and administrative restructuring threaten access to medications for opioid use disorder (MOUD), harm reduction services, and continuity of care. Medicaid expansion has been influential in increasing treatment availability, reducing overdose deaths, and supporting rural health systems; however, OBBA's mandated community engagement requirements threaten the progress made in combatting this epidemic. These restrictions are projected to cause 11.8 million Americans to lose health insurance, disproportionately affecting individuals with OUD who already encounter significant barriers to care. Prior evidence demonstrates that similar policies failed to increase employment, generated widespread confusion, and produced significant losses in coverage. The losses in coverage lead to delayed care, medication interruptions, and worsened health outcomes. There are also substantial financial and operational burdens associated with national implementation, including an estimated $200 million in administrative costs, diversion of resources away from clinical services, and reduced capacity for evidence-based treatment. This analysis concludes that OBBBA is likely to undermine progress in reducing overdose mortality, amplify health disparities, and place added strain on healthcare systems, particularly in rural communities, which have experienced the most significant effects of the opioid epidemic.},
}

Humans
*Opioid-Related Disorders/drug therapy/therapy/epidemiology
United States/epidemiology
*Medicaid/legislation & jurisprudence/economics
*Health Services Accessibility/legislation & jurisprudence
Opiate Substitution Treatment
COVID-19/epidemiology
Health Policy

@article {pmid42772154,
year = {2026},
author = {Lee, S and Batule, BS and Seok, Y},
title = {A review of portable molecular diagnostics: Paper and smartphone synergy for pathogen detection.},
journal = {Biosensors & bioelectronics},
volume = {315},
number = {},
pages = {119238},
doi = {10.1016/j.bios.2026.119238},
pmid = {42772154},
issn = {1873-4235},
abstract = {Molecular diagnostics (MDx) enables sensitive and specific pathogen detection, but conventional laboratory-based methods require specialized instruments, trained personnel, and centralized infrastructure, limiting their accessibility in resource-limited settings. Paper-based MDx platforms offer low-cost, portable, and user-friendly alternatives for decentralized point-of-care testing (POCT); however, many systems still rely on subjective visual readout, partial workflow integration, and limited standardization. This review summarizes representative paper-based molecular diagnostic platforms for pathogen detection and critically examines how smartphone integration can support signal acquisition, quantitative or semi-quantitative analysis, data processing, and field deployability when imaging conditions and calibration strategies are appropriately controlled. We discuss paper-compatible nucleic acid amplification and molecular detection strategies, including loop-mediated isothermal amplification (LAMP), recombinase polymerase amplification (RPA), CRISPR-assisted assays, and amplification-free strand-displacement systems. Emphasis is placed on colorimetric and fluorescence-based readouts, smartphone-assisted image acquisition, app-based interpretation, and optical setup design. Representative examples demonstrate sensitive and rapid detection of pathogens such as SARS-CoV-2, MRSA, HIV-1, and Escherichia coli across diverse human-derived, food, environmental, and agricultural sample matrices. Rather than solely reporting analytical sensitivity, we compare platforms in terms of detection modality, smartphone role, data-processing strategy, workflow integration, real-sample validation, and practical deployment constraints. Remaining challenges include incomplete sample-to-answer integration, sample preparation bottlenecks, smartphone-to-smartphone variability, calibration robustness, reagent stability, and limited field validation. Overall, smartphone-integrated paper-based MDx provides a promising route toward accessible POCT, but future progress will depend on system-level co-optimization of paper architecture, molecular assay chemistry, optical acquisition, software analysis, and user-centered workflow design.},
}

@article {pmid42772206,
year = {2026},
author = {Greaves, PJ and Erfani, G and Simpson, D and Hill, B and Conner, T and Nemeckova, M and McCerery, A and Rolf, F and Monk, D and Steven, A},
title = {Nursing in adult critical care services - safe staffing evidence: A rapid review.},
journal = {Intensive & critical care nursing},
volume = {98},
number = {},
pages = {104585},
doi = {10.1016/j.iccn.2026.104585},
pmid = {42772206},
issn = {1532-4036},
abstract = {AIM: This rapid review was conducted for the NHS England Safer Staffing Programme (2024) England (2024) [1] to evaluate the evidence base for adult critical care nurse staffing. The review addressed four objectives: 1) identifying current staffing decision-making processes; 2) evaluating the impact of staffing models on patient outcomes and service efficiency; 3) assessing effects on burnout and staff retention; 4) identifying effective staffing responses during the COVID-19 pandemic.

METHODS: A rapid systematic review following PRISMA guidelines was conducted across MEDLINE, CINAHL Plus, PsycINFO, and Scopus (2012-2024). Studies examining quantitative, qualitative, and mixed-methods research on registered nurse staffing in adult intensive care were included.

FINDINGS: Eighty-six studies met the inclusion criteria. Current staffing guidelines predominantly rely on expert consensus (Level 7 evidence) with day-to-day adaptation by senior nurse managers. Emerging empirical data (Level 4-5) suggest an association between nurse-to-patient ratios of 1:1 or higher and reduced mortality and nosocomial infections, though heterogeneity across studies precludes defining an optimal ratio. Workload intensity may be a more sensitive predictor of outcomes than static ratios. High nursing workloads are associated with increased burnout and turnover. Pandemic responses demonstrated that while "upskilling" non-ICU nurses supported surge capacity, it increased the psychological burden on experienced ICU staff.

CONCLUSIONS: While current guidelines rely heavily on expert opinion, there is some evidence from the literature to suggest that moving toward objective, workload-based frameworks might address limitations in current consensus-based models. However, the existing evidence base is largely observational, necessitating further high-quality research to confirm these associations.

Healthcare organisations should consider integrating objective workload measurement tools to supplement the professional judgement of the Nurse in Charge. Such an approach may provide a more defensible basis for workforce planning and help mitigate the impact of rising patient acuity on staff retention.},
}

@article {pmid42775578,
year = {2026},
author = {Cristancho, SM},
title = {Brittle threshold: When adaptive success is the warning sign.},
journal = {Medical education},
volume = {},
number = {},
pages = {},
doi = {10.1111/medu.70322},
pmid = {42775578},
issn = {1365-2923},
abstract = {CONTEXT: What happens when a system keeps working-not because it is well designed but because people keep absorbing the strain? That question stayed with me after studying a community-led vaccination clinic during the COVID-19 pandemic. It delivered hundreds of vaccinations a day, with no formal chain of command or protocols. By any measure, it was a success. What it cost to sustain that success was never examined. Across my empirical work, I kept encountering the same pattern: systems functioning because people stretched roles, coordinated through workarounds and relied on relationships that were not designed to carry the full load. These adaptations were effective. Yet they were also hiding strain.

CONCEPTUAL CONTRIBUTION: In this paper, I introduce Brittle Threshold as a concept for attending to this condition. Rather than treating adaptive action as evidence of success, Brittle Threshold frames adaptive action as diagnostic information: evidence of how a system is coping and how close it may be operating to its limits. Drawing on resilience engineering and on empirical patterns from studies of team adaptation and community crisis response, I argue that adaptive success and vulnerability regularly coexist. The more smoothly work appears to run, the more it may depend on fragile support.

IMPLICATIONS: Brittle Threshold offers three contributions. It translates what adaptive success conceals in health professions education, it shifts what counts as evidence of system strain and it unsettles the moralisation of endurance as professional virtue. The question it opens is not why systems fail, but when is endurance no longer enough?},
}

@article {pmid42776600,
year = {2026},
author = {Nakachwa, SM and Okorobe, PM and Onama, J},
title = {Vaccination coverage among migrant and refugee populations in Uganda: A narrative review of challenges and recommendations.},
journal = {Global public health},
volume = {21},
number = {1},
pages = {2735676},
doi = {10.1080/17441692.2026.2735676},
pmid = {42776600},
issn = {1744-1706},
mesh = {Humans ; Uganda/epidemiology ; *Refugees/statistics & numerical data ; *Transients and Migrants/statistics & numerical data ; *Vaccination Coverage/statistics & numerical data ; Health Services Accessibility ; COVID-19/epidemiology ; },
abstract = {Uganda hosts one of Africa's largest refugee populations, yet displaced and migrant communities face persistent barriers to routine immunisation. Despite commitments to vaccine equity, many remain unprotected against preventable diseases. This narrative review synthesises evidence from peer-reviewed studies, national surveys, and institutional reports up to September 2025 to assess immunisation coverage, challenges, and potential solutions among refugees and migrants in Uganda. The findings indicate that vaccination rates in refugee communities are generally lower than national averages due to administrative barriers, vaccine shortages, long distances to health facilities, language difficulties, misinformation, and challenges intensified during the COVID-19 pandemic. Economic hardship further limits healthcare access. However, several strategies show promise: integrating refugees into national immunisation systems, simplifying registration processes, strengthening mobile outreach, engaging community health workers, and improving cross-border data coordination. Addressing these inequities requires both technical and social commitment through adequate financing, inclusive policies, and meaningful community engagement. Achieving equitable immunisation for refugees in Uganda is essential for public health protection and the realisation of universal health coverage.},
}

Humans
Uganda/epidemiology
*Refugees/statistics & numerical data
*Transients and Migrants/statistics & numerical data
*Vaccination Coverage/statistics & numerical data
Health Services Accessibility
COVID-19/epidemiology

@article {pmid42776863,
year = {2026},
author = {Heijkoop, MLA and Phan, TA and Woltman, AM and Versmissen, J and van Rosse, F},
title = {Audio-podcasts as a teaching tool in undergraduate health professions education - a scoping review.},
journal = {Medical teacher},
volume = {},
number = {},
pages = {1-18},
doi = {10.1080/0142159X.2026.2733141},
pmid = {42776863},
issn = {1466-187X},
abstract = {INTRODUCTION: Audio podcasts are increasingly popular, leading to increased use in health professions education (HPE), offering flexible, asynchronous learning. Their adoption accelerated during the COVID-19 pandemic, yet guidance on how to purposefully integrate podcasts into undergraduate curricula remains limited. This review aims to map the existing literature on the integration, design and evaluation of audio podcasts as instructor-delivered teaching tools for undergraduate students in HPE.

METHODS: We conducted a scoping review following PRISMA-ScR guidelines. Eligible studies included empirical research on instructor-delivered audio podcasts for undergraduate students in HPE programmes. Studies were excluded if they focused on video podcasts, if the creation of a podcast by students was the learning activity, or when the article lacked data evaluating the podcast. We searched 5 databases without date limits. Data were charted using a structured Excel form capturing study characteristics, podcast design, integration approach, and evaluation outcomes. All interventions were classified according to the PICRAT model to classify student interaction and pedagogical impact.

RESULTS: Our search identified 3395 records, of which 54 studies met inclusion criteria, spanning 13 HPE disciplines, predominantly medicine and nursing. Podcast formats ranged from lecture recordings to radio documentaries. Integration was mainly Passive-Replaces (n = 24) or Passive-Amplify (n = 17), with fewer Interactive (n = 3) or Creative (n = 8) uses. We identified four categories of learning activities in which podcasts were used, with listening as a standalone learning activity and listing as part of an assignment being most common. Podcasts were able to amplify and transform teaching by creating insights into the lives and experiences of patients and their families or into clinical practice.

DISCUSSION: Podcasts can supplement or replace traditional teaching and address challenges in HPE. Their greatest potential lies in providing learning experiences that are difficult to recreate through conventional teaching. Purposeful integration guided by educational theory is essential to maximize impact.},
}

@article {pmid42778035,
year = {2026},
author = {Qaid, EYA and Long, I},
title = {The Gut-Lung Axis in Respiratory Diseases: Mechanisms, Microbiome Dysbiosis, and Therapeutic Implications. A Comprehensive Review.},
journal = {Respiratory medicine},
volume = {},
number = {},
pages = {109167},
doi = {10.1016/j.rmed.2026.109167},
pmid = {42778035},
issn = {1532-3064},
abstract = {The gut and lung, though anatomically distinct, are connected through a dynamic, bidirectional communication network known as the gut-lung axis, whereby intestinal microbiota, immune cells, and microbial metabolites regulate pulmonary immunity and homeostasis, while pulmonary perturbations reciprocally alter gut microbial composition and barrier integrity. This narrative review synthesises current evidence on the mechanisms underlying this crosstalk, including immune cell trafficking, short-chain fatty acid and other microbial metabolite signalling, vagal neuroimmune communication, and epigenetic regulation of gut and lung tissues. A structured literature search was conducted across PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Library from inception to March 2025, supplemented by manual reference screening, yielding 146 included studies. We examine disease-specific patterns of gut dysbiosis and altered gut-lung signalling across asthma, chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, respiratory infections, COVID-19 and post-COVID sequelae, obstructive sleep apnoea, and lung cancer, alongside the reverse pathway by which pulmonary disease and critical illness disrupt intestinal homeostasis. We further review microbiome-targeted therapeutic strategies, including probiotics, prebiotics, dietary interventions, faecal microbiota transplantation, and vagus nerve stimulation, and discuss their current evidentiary limitations. Persistent challenges include predominantly observational study designs, inconsistent methodology, limited multi-omics integration, and a paucity of human mechanistic data. We conclude that the gut-lung axis represents a central, bidirectional framework for understanding respiratory disease pathogenesis, and that future progress will depend on longitudinal, multi-omics, and microbiome-stratified interventional studies to enable precision, microbiome-informed respiratory therapeutics.},
}

@article {pmid42778265,
year = {2026},
author = {Xiang, Y and Zhu, Q and Mou, C and Shi, K and Chen, Z},
title = {Commandeering the controller: The ubiquitin-proteasome tug-of-war between coronavirus and host.},
journal = {Advances in virus research},
volume = {125},
number = {},
pages = {29-67},
doi = {10.1016/bs.aivir.2026.07.001},
pmid = {42778265},
issn = {1557-8399},
mesh = {*Proteasome Endopeptidase Complex/metabolism/immunology ; *Ubiquitin/metabolism ; Humans ; Ubiquitination ; Immunity, Innate ; Interferons/metabolism/immunology ; *Host-Pathogen Interactions ; Animals ; Signal Transduction ; Immune Evasion ; *SARS-CoV-2/immunology ; Virus Replication ; *Coronavirus/immunology ; Viral Proteins/metabolism ; COVID-19/immunology/virology ; },
abstract = {The ubiquitin-proteasome system (UPS) plays a pivotal role in the precise regulation of innate immunity. Within the spatiotemporal framework of coronavirus (CoV) infection, the UPS emerges as a critical arena and a molecular switch, dynamically mediating the balance between host antiviral defense and viral replication alongside immune evasion. The host leverages the UPS to activate interferon (IFN) signaling pathways and to directly target viral proteins for degradation. Conversely, CoVs have developed sophisticated mechanisms to exploit this system, either by degrading antiviral proteins or by encoding viral deubiquitinases (DUBs) to counteract host ubiquitination signals. Notably, CoV proteins themselves undergo ubiquitination, which can lead to either their functional activation or proteasomal degradation, underscoring the dual-edged nature of the UPS. In this review, we initially examined the mechanisms by which the UPS regulates the IFN system. Subsequently, we highlighted the strategies employed by CoVs to inhibit the IFN system through the manipulation of the UPS. Thirdly, we synthesized findings regarding how the UPS specifically targets and degrades the principal virulence proteins of CoVs. Finally, we investigated the potential of the UPS as a therapeutic target for developing resistance against CoV infections.},
}

*Proteasome Endopeptidase Complex/metabolism/immunology
*Ubiquitin/metabolism
Humans
Ubiquitination
Immunity, Innate
Interferons/metabolism/immunology
*Host-Pathogen Interactions
Animals
Signal Transduction
Immune Evasion
*SARS-CoV-2/immunology
Virus Replication
*Coronavirus/immunology
Viral Proteins/metabolism
COVID-19/immunology/virology

@article {pmid42779283,
year = {2026},
author = {Safi, D and Toutounji, K and Arabi, M},
title = {Serious cardiac events in the COVID-19 era in the paediatric population: what did we learn?.},
journal = {Cardiology in the young},
volume = {},
number = {},
pages = {1-17},
doi = {10.1017/S1047951126123956},
pmid = {42779283},
issn = {1467-1107},
abstract = {BACKGROUND: Serious cardiac events, which are frequently associated with myocarditis or arrhythmias, pose serious public health concerns. COVID-19 can increase cardiovascular risks by causing cardiac damage, arrhythmias, and multisystem inflammatory syndrome in children. However, important knowledge gaps about the long-term cardiac effects of COVID-19 still exist. These lead to the possibility of unusual or delayed cardiac consequences and the requirement for specialised monitoring techniques to reduce potential risks, particularly in high-risk populations. This narrative review compares serious cardiac event incidence, mechanisms, and outcomes in adults and children.

METHODS: Data were gathered from peer-reviewed studies between 2019 and 2025, such as systematic reviews, clinical reports, and cohort analyses. Focus was placed on the potential contribution of COVID-19-related cardiac events. Key research and clinical practice gaps were identified by analysing paediatric and adult populations in terms of diagnostic methods, management techniques, and long-term results.

RESULTS: While vaccine-related cardiac complications are still uncommon, COVID-19 infection is linked to an increased risk of serious cardiac events in adults. Paediatric serious cardiac events, on the other hand, are rare but frequently associated with multisystem inflammatory syndrome in children, and there have been rare, documented vaccine-associated deaths in this population.

CONCLUSION: Significant findings reveal clear patterns in serious cardiac events mechanisms, with age-dependent differences in the severity and prognosis of COVID-19-related myocarditis, arrhythmias, and long QT syndrome, among others. These variations highlight the necessity of age-appropriate risk assessment and management techniques. In the context of COVID-19, these findings highlight distinct risk profiles for serious cardiac events, underscoring the need for targeted screening methods and focused public health initiatives.},
}

@article {pmid42766785,
year = {2026},
author = {Kao, S and Metaxa, AM and Soliman, R},
title = {Effectiveness of Telehealth Care Interventions for Women's Mental Health During and After the COVID-19 Pandemic: Systematic Review and Meta-Analysis.},
journal = {Journal of medical Internet research},
volume = {28},
number = {},
pages = {e85494},
pmid = {42766785},
issn = {1438-8871},
mesh = {Humans ; *COVID-19/psychology ; Female ; *Telemedicine ; Anxiety/therapy ; Depression/therapy ; Pandemics ; *Mental Health ; Stress, Psychological/therapy ; *Women's Health ; Mental Health Teletherapy ; SARS-CoV-2 ; Adult ; },
abstract = {BACKGROUND: The COVID-19 pandemic has increased telemental health interventions. However, evidence of effectiveness in improving women's mental health outcomes, acceptability, and user satisfaction remains fragmented.

OBJECTIVE: This study examined the effectiveness of telehealth interventions in alleviating depression, anxiety, and stress in women during and after the pandemic and descriptively summarized the acceptability of and satisfaction with these interventions.

METHODS: This systematic review and meta-analysis compared telemental health interventions with control conditions (waitlists or standard care) for women experiencing anxiety, depression, or stress. Databases (PubMed/MEDLINE, Embase, Web of Science, PsycINFO, and Cochrane Central Register of Controlled Trials) were searched through March 19, 2026. Eligible studies evaluated interventions in women aged 18 to 64 years (≥80% female participants and female-specific outcomes) and included randomized controlled trials (RCTs), nonrandomized trials, and observational studies with ≥5 participants using outcome measures. Random-effects meta-analyses were conducted for depression, anxiety, and stress using RCT data. Risk of bias was assessed using Cochrane tools and certainty of evidence using Grading of Recommendations, Assessment, Development and Evaluation.

RESULTS: Fifty-seven studies (N=13,457) from 24 countries, reported the effectiveness, acceptability, and satisfaction with telehealth interventions. Meta-analysis of 23 studies (n=3269) demonstrated significant benefits of telehealth interventions for depression, anxiety, and stress. Depression showed the greatest improvements, with a moderate reduction in symptoms (Hedges g=-0.56, 95% CI -0.86 to -0.26; P<.001), followed by anxiety (small to moderate reduction; Hedges g=-0.45, 95% CI -0.62 to -0.28; P<.001). Stress showed a smaller effect (Hedges g=-0.25, 95% CI -0.47 to -0.04; P=.02), indicating modest benefits. Heterogeneity was high, with 95% prediction intervals of -1.97 to 0.84, -1.11 to 0.21, and -0.98 to 0.40 for depression, anxiety, and stress, respectively. Subgroup analyses favored telehealth over waitlist and standard care for depression (waitlist: Hedges g=-0.60, 95% CI -0.86 to -0.33; standard care: Hedges g=-0.57, 95% CI -1.11 to -0.02; both P<.001) and anxiety (waitlist: Hedges g=-0.47, 95% CI -0.68 to -0.25; standard care: Hedges g=-0.52, 95% CI -0.80 to -0.25; both P<.001). Insufficient studies were available to evaluate stress in subgroup analyses. Treatment effects remained significant in female-only and predominantly female samples. Evidence certainty was downgraded due to heterogeneity, risk of bias, and methodological limitations.

CONCLUSIONS: This is the first systematic review and meta-analysis focused on telemental health interventions for women. Telehealth was associated with moderate, small to moderate, and modest reductions in depression, anxiety, and stress, respectively, with benefits across female-only and predominantly female samples. Moderate to high heterogeneity in average effects (CIs), wide distributions of effects across settings (prediction intervals), and risk of bias resulted in moderate certainty of evidence. Overall, telehealth is a scalable approach for improving access to mental health care for women, although high-quality research is needed to strengthen the evidence base.},
}

Humans
*COVID-19/psychology
Female
*Telemedicine
Anxiety/therapy
Depression/therapy
Pandemics
*Mental Health
Stress, Psychological/therapy
*Women's Health
Mental Health Teletherapy
SARS-CoV-2
Adult

@article {pmid42767409,
year = {2026},
author = {Costa, T and Ditadi, B and Premi, E and Manuello, J and Crocetta, A and Cauda, F and Duca, S and Liloia, D},
title = {The Post-Acute Effects of COVID-19 Are Not Associated with Robust Long-Term Regional or Global Brain Volumetric Changes: A Bayesian Meta-Analytic Evidence.},
journal = {Neuroscience and biobehavioral reviews},
volume = {},
number = {},
pages = {106986},
doi = {10.1016/j.neubiorev.2026.106986},
pmid = {42767409},
issn = {1873-7528},
abstract = {Acute respiratory and systemic manifestations associated with SARS-CoV-2 infection have been extensively investigated, including their potential effects on brain structure. However, whether structural magnetic resonance imaging (MRI) studies converge towards reproducible long-term neuroanatomical alterations following COVID-19 remains unclear, mostly due to high variability in methods and reported results across neuroimaging investigations. The present study applied a Bayesian meta-analytic approach to quantify the strength of the evidence supporting the presence or absence of reproducible brain volumetric alterations following COVID-19 infection. The systematic literature search identified nine independent magnetic resonance imaging (MRI) experiments reporting whole-brain volumetric measures and 12 MRI experiments reporting regional volumetric measures (i.e., for specific regions of interest), including a total of 1107 subjects with a history of COVID-19 disease and 609 control participants. The results reported in the selected studies were quantitatively synthesized using the Rouder-Morey common-effect Bayesian meta-analytic framework. Bayes' Factors (BF) were computed to quantify how strongly the available evidence supported the alternative hypothesis of volumetric differences relative to the null hypothesis of no differences. Global analyses provided limited evidence of volumetric differences, with BF10 = 3.286 for whole-brain volume and BF10 = 1.206 for total gray matter volume, corresponding to moderate and anecdotal evidence in favor of the alternative hypothesis, respectively. Regional analyses did not identify reproducible volumetric alterations in any of the 26 examined regions of interest. Overall, the present findings indicate that although several studies reported brain abnormalities detectable by MRI following COVID-19, the available volumetric evidence does not support a consistent pattern.},
}

@article {pmid42767650,
year = {2026},
author = {Lau, G},
title = {Translational Hepatology From Bedside to Global Policy: How Robust Clinical and Translational Research Reshapes Global Practice Guidelines and Patient Outcomes.},
journal = {Journal of gastroenterology and hepatology},
volume = {},
number = {},
pages = {},
doi = {10.1111/jgh.70742},
pmid = {42767650},
issn = {1440-1746},
support = {//Humanity and Health Clinical Trial Center, Hong Kong SAR, China/ ; },
abstract = {Over four decades, translational hepatology has evolved from empirical observations into an evidence-driven discipline. This review synthesizes key bedside discoveries, mechanistic studies, prospective cohorts, cross-regional health-economic evaluations, and landmark randomized controlled trials (RCTs) by our team that have helped to reshape regulatory drug approvals, Boxed Warnings, and international practice guidelines across APASL, AASLD, and EASL. First, clinical trials established the biphasic model and risk predictors of immunosuppression-induced hepatitis B virus (HBV) reactivation, proving that pre-emptive nucleos(t)ide analogue (NUC) prophylaxis prevents liver failure and antineoplastic disruptions. Second, multinational Phase III registration trials of finite 48-week pegylated interferon alfa-2a (Peg-IFN α-2a) in chronic hepatitis B (CHB)-combined with intrahepatic cccDNA kinetics, adoptive immunity transfer, and 30-year Asia-Pacific Markov health-economic modeling-established response-guided rules and validated finite Peg-IFN switch/add-on strategies as clinically dominant and cost-effective. Third, prospective cohorts uncovered direct-acting antiviral (DAA)-induced HBV reactivation during HCV clearance, establishing mandatory regulatory Boxed Warnings and pre-DAA screening. Fourth, the Phase III HIMALAYA study and pooled Greater China (Mainland China, Hong Kong, Taiwan) cohorts validated the STRIDE regimen (single-dose tremelimumab plus regular durvalumab) as frontline dual immunotherapy for unresectable hepatocellular carcinoma (uHCC), establishing marked survival benefit in HBV-predominant populations (median OS 25.26 vs. 14.09 months) alongside a vascular endothelial growth factor (VEGF)-free standard for cirrhotic portal hypertension within APASL guidelines. Finally, translational insights across metabolic dysfunction, COVID-19, ACLF, artificial intelligence (AI), and functional cure frameworks inform the APASL 2026 "treat-all" CHB paradigm.},
}

@article {pmid42769092,
year = {2026},
author = {Li, S and Bai, R},
title = {Lipid droplet-mitochondria contact sites as druggable spatial-pharmacology targets in respiratory disease: cross-cell-type mechanisms and translational strategies.},
journal = {Frontiers in cell and developmental biology},
volume = {14},
number = {},
pages = {1935993},
pmid = {42769092},
issn = {2296-634X},
abstract = {Lipid droplets and mitochondria form regulated contact sites whose molecular composition, phosphorylation state and spatial geometry now behave as measurable, druggable variables in living cells. The molecular toolkit has been mapped in liver, muscle and adipose tissue, yet its application to respiratory disease has lagged despite a lung-specific dependence on lipid biology that spans surfactant biogenesis, alveolar-macrophage lipid handling and fibroblast-driven remodelling. This review argues that the lipid-droplet-mitochondria contact site is an emerging spatial-pharmacology target in respiratory medicine, and organises the evidence into a three-way matrix with explicit grading of direct, indirect and cross-tissue evidence. A common molecular toolkit built around perilipin-family scaffolds, mitochondrial-outer-membrane tethers, an endoplasmic-reticulum bridging apparatus and the PFKL-PLIN2-CPT1A flux node (mechanistically established in hepatocellular carcinoma and inferred in lung) is rewired into cell-type-specific configurations across alveolar type 2 cells, macrophages, fibroblasts, endothelium and lung adenocarcinoma. That toolkit acquires a distinct disease role across idiopathic pulmonary fibrosis, chronic obstructive pulmonary disease, asthma, acute respiratory distress syndrome, tuberculosis, severe acute respiratory syndrome coronavirus two infection and lung cancer, generating a matrix of cell-type-by-disease configurations that no prior review has systematized. Four target axes, namely, tether occupancy, lipid flux, redox coupling and cell-type-precise delivery, converge geometrically at the interface and motivate combination strategies rather than pan-mitochondrial single-agent approaches. Inhaled lipid nanoparticles, mucus-penetrating carriers and engineered extracellular vesicles bring these targets within reach with cell-type precision. Endothelial contact-site biology is identified as the largest evidence gap and discussed candidly. The framework is offered as a roadmap for tether-axis compound development, contact-site engagement biomarkers and dual-axis inhaled therapeutics.},
}

@article {pmid42769528,
year = {2026},
author = {Kamb, A and Welch, JS},
title = {The transformative potential of lipid nanoparticles tailored for acute myeloid leukemia immunotherapy.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1799525},
pmid = {42769528},
issn = {1664-3224},
mesh = {Humans ; *Nanoparticles/chemistry/administration & dosage ; *Leukemia, Myeloid, Acute/therapy/immunology ; *Immunotherapy/methods ; Animals ; *Lipids/chemistry ; COVID-19 Vaccines/immunology/administration & dosage ; RNA, Messenger/administration & dosage ; T-Lymphocytes/immunology ; COVID-19/immunology/prevention & control ; Liposomes ; },
abstract = {T-cell engagers and engineered cell therapies have yet to deliver the same spectacular results in acute myeloid leukemia (AML) that they have in other hematologic malignancies. In this review, we analyze the challenges with AML immunotherapy development, including on-target, off-tumor toxicity, cytokine release syndrome (CRS), and the "myeloid sink." We then discuss the emergence of two technologies that could address the major challenges with investigational AML therapeutics: targeted, lipid nanoparticles (LNPs) loaded with specific mRNAs and a type of synthetic logic gate (a NOT gate). This approach builds on recent advancements of mRNA-loaded LNPs that developed with the COVID19 vaccines and evolved into vehicles for delivery to T cells. The LNP modality offers a new opportunity for effective treatment of patients with AML.},
}

Humans
*Nanoparticles/chemistry/administration & dosage
*Leukemia, Myeloid, Acute/therapy/immunology
*Immunotherapy/methods
Animals
*Lipids/chemistry
COVID-19 Vaccines/immunology/administration & dosage
RNA, Messenger/administration & dosage
T-Lymphocytes/immunology
COVID-19/immunology/prevention & control
Liposomes

@article {pmid42769543,
year = {2026},
author = {Calderón-Sandate, DN and Huerta-Garza, MJ and Márquez-Reyna, BA and Cañedo-Figueroa, DM and Hernández-Rodríguez, X and Lira-Hernández, FI and Osuna-Ramos, JF and Cardoso-Ortiz, J and Del Ángel, RM and Santos-Mena, AO and De Jesús-González, LA},
title = {The kynurenine pathway in RNA virus infection: immunometabolic control of antiviral defense and viral persistence.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1923351},
pmid = {42769543},
issn = {1664-3224},
mesh = {Humans ; *Kynurenine/metabolism/immunology ; Animals ; *RNA Virus Infections/immunology/metabolism/virology ; Indoleamine-Pyrrole 2,3,-Dioxygenase/metabolism/immunology ; Tryptophan/metabolism/immunology ; Signal Transduction/immunology ; *RNA Viruses/immunology/physiology ; Receptors, Aryl Hydrocarbon/metabolism ; Immunity, Innate ; Tryptophan Oxygenase/metabolism/immunology ; Host-Pathogen Interactions/immunology ; Virus Replication ; Protein Serine-Threonine Kinases ; },
abstract = {RNA virus infections are shaped by the interplay among viral replication, innate immune sensing, and host metabolism, which together determine the magnitude, duration, and quality of antiviral responses. The tryptophan-kynurenine (Trp-Kyn) pathway has emerged as an important immunometabolic axis linking interferon-driven inflammation, amino acid availability, immune-cell function, tissue homeostasis, and viral persistence. This review examines the roles of indoleamine 2,3-dioxygenase 1 (IDO1), IDO2, tryptophan 2,3-dioxygenase (TDO), Trp depletion, general control nonderepressible 2 (GCN2) signaling, mechanistic target of rapamycin complex 1 (mTORC1), Kyn-derived metabolites, and aryl hydrocarbon receptor (AhR) activation in host responses to RNA virus infection. We integrate genetic, pharmacological, cellular, animal, and clinical evidence across positive-sense and negative-sense single-stranded RNA viruses, double-stranded RNA viruses, and reverse-transcribing RNA viruses, including SARS-CoV-2, dengue virus, Zika virus, hepatitis C virus, influenza A virus, respiratory syncytial virus, rotavirus, reovirus, HIV-1, and SIV. Across these systems, the Trp-Kyn-AhR axis can influence interferon responses, viral replication, immune-cell function, tissue injury, and disease outcome. EMCV myocarditis provides causal proof of principle, whereas other RNA-virus models provide complementary functional and clinical evidence. Importantly, pathway activation does not confer a uniform antiviral or pathogenic phenotype; its biological consequences depend on viral class, tissue tropism, viral burden, inflammatory intensity, cell type, and disease stage. On this basis, we propose a time-phase model in which early or excessive IDO1-Kyn-AhR signaling may impair type I interferon responses, NK-cell function, CD8+ T-cell expansion, and viral clearance, whereas appropriately regulated activation during later inflammatory or resolution phases may limit immunopathology, support epithelial repair, and preserve tissue homeostasis. Persistent or dysregulated activation may instead contribute to exhaustion-like immune states, chronic inflammation, neuroimmune dysfunction, and post-acute viral sequelae. Finally, we discuss phase-adapted therapeutic strategies, including IDO1 inhibition, AhR agonism or antagonism, KMO-directed modulation, Trp-based entry inhibitors, and biomarker-guided combination approaches. Together, these findings position the Trp-Kyn-AhR axis as a dynamic, context-dependent target for precision host-directed antiviral immunometabolism.},
}

Humans
*Kynurenine/metabolism/immunology
Animals
*RNA Virus Infections/immunology/metabolism/virology
Indoleamine-Pyrrole 2,3,-Dioxygenase/metabolism/immunology
Tryptophan/metabolism/immunology
Signal Transduction/immunology
*RNA Viruses/immunology/physiology
Receptors, Aryl Hydrocarbon/metabolism
Immunity, Innate
Tryptophan Oxygenase/metabolism/immunology
Host-Pathogen Interactions/immunology
Virus Replication
Protein Serine-Threonine Kinases

@article {pmid42769913,
year = {2026},
author = {Mammas, IN and Kramvis, A and Stouraiti, A and Dalianis, T and Koletsi, P and Papaioannou, G and Papatheodoropoulou, A and Koutsaftiki, C and Korovessi, P and Drysdale, SB and Theodoridou, M and Spandidos, DA},
title = {Promoting expertise knowledge sharing in paediatric virology: An update (Review).},
journal = {Experimental and therapeutic medicine},
volume = {32},
number = {4},
pages = {293},
pmid = {42769913},
issn = {1792-1015},
abstract = {Knowledge sharing in medical education is a continuous exchange of skills and expertise between scientists. Paediatric virology is a rapidly developing, new scientific field of medicine, which enhances multidisciplinary, expertise knowledge sharing between paediatric health professionals and scientists of different subspecialties. The present review discusses the recent core topics in paediatric viral infectious diseases discussed during the 11th Workshop on Paediatric Virology organised by the Institute of Paediatric Virology and presents its key messages, including: i) The history of smallpox vaccination; ii) the role of viral co-infections triggering invasive bacterial diseases; iii) the surge of invasive group A streptococcal disease during the post-coronavirus disease 2019 (COVID-19) era; iv) foetal brain imaging findings in maternal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection; v) the diabetogenic role of Coxsackie viruses in childhood; vi) adenovirus-related central nervous system manifestations in the paediatric population; vii) new challenges and opportunities of hepatis D virus infection in children; viii) the Swedish up-to-date human papillomavirus vaccination experience in childhood.},
}

@article {pmid42770643,
year = {2026},
author = {Khawandi, J and Patel, K and Azzam, M and Nazzal, J and Lam, GY and Al Khader, A and Kawtharany, H and Al Zabibi, MA and Ahmad, J and Kivan, H and Al Hussein, S and Rehman, AU and Piché, A and Vasquez Camargo, A and McNaughton, C and Oudit, GY and Kamrul, R and Afzal, S and Schunemann, H and Wiercioch, W and Nieuwlaat, R and Brignardello-Petersen, R and Falcone, EL and Mustafa, RA},
title = {The role of 6-minute walk test and pulmonary function testing in patients with post COVID-19 condition: a systematic review and meta-analysis.},
journal = {Family practice},
volume = {43},
number = {5},
pages = {},
pmid = {42770643},
issn = {1460-2229},
support = {//Public Health Agency of Canada/ ; },
mesh = {Humans ; *COVID-19/complications/physiopathology ; *Walk Test/methods ; *Respiratory Function Tests/methods ; Post-Acute COVID-19 Syndrome ; Oximetry ; SARS-CoV-2 ; Pandemics ; },
abstract = {BACKGROUND AND OBJECTIVE: Post-COVID-19 condition (PCC) is a complication of acute COVID-19 infection, which often presents with respiratory symptoms. This review aimed to assess the prevalence of abnormal pulmonary function test (PFTs) and 6-minute walk test (6MWT) with oximetry findings, and their respective prevalence and magnitude of abnormalities in patients with PCC, compared to patients without PCC.

METHODS: We searched three databases. Two reviewers independently screened articles using LASER Al and extracted relevant data using a piloted Excel sheet. We performed meta-analysis using OpenMeta and RevManWeb and a subgroup analysis based on patients' settings during acute COVID-19. We assessed the risk of bias using the Hoy et al. tool and the certainty using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.

RESULTS: We included 30 studies that reported on the prevalence of abnormal PFTs and/or 6MWT in patients with PCC. Outcomes within PFTs and 6MWT showed that patients with PCC have a higher probability of having abnormal tests, with those hospitalized during their acute COVID-19 infection showing a higher probability of having abnormal tests. The overall certainty of the evidence was very low due to the high risk of bias, indirectness, and imprecision.

CONCLUSION: This review provides insight into the utilization of PFTs and 6MWT and the frequency of test abnormalities in patients with PCC. Despite existing evidence, there is a need for future studies to assess the diagnostic test accuracy of these tests in PCC.},
}

Humans
*COVID-19/complications/physiopathology
*Walk Test/methods
*Respiratory Function Tests/methods
Post-Acute COVID-19 Syndrome
Oximetry
SARS-CoV-2
Pandemics

@article {pmid42771023,
year = {2026},
author = {Pohl, EE and Groschner, K},
title = {Biophysics Austria: 65 years history.},
journal = {European biophysics journal : EBJ},
volume = {},
number = {},
pages = {},
pmid = {42771023},
issn = {1432-1017},
abstract = {The Austrian Biophysical Society (Biophysics Austria) was founded in 1961, making it one of the oldest national biophysical societies in Europe. It hosted the first European Meeting in Biophysics in Baden near Vienna in 1971 and celebrated its 60th anniversary by hosting the 13th European Biophysics Congress in Vienna as a hybrid event during the COVID-19 pandemic in 2021. In 2026, the society is celebrating its 65th anniversary. This review reflects on the society´s history and highlights events, milestones, and people who have contributed to its development.},
}

@article {pmid42669998,
year = {2026},
author = {Yiannakopoulou, E},
title = {Targeting Immunomodulation by Glutathione: A Possible Therapeutic Strategy against COVID-19.},
journal = {Endocrine, metabolic & immune disorders drug targets},
volume = {26},
number = {},
pages = {e18715303400155},
doi = {10.2174/0118715303400155251202063218},
pmid = {42669998},
issn = {2212-3873},
mesh = {Humans ; *Glutathione/therapeutic use/metabolism/pharmacology ; COVID-19/immunology ; SARS-CoV-2/drug effects ; *Immunomodulation/drug effects/physiology ; Oxidative Stress/drug effects ; Antioxidants/therapeutic use ; *COVID-19 Drug Treatment ; Animals ; Pandemics ; Antiviral Agents ; *Coronavirus Infections/drug therapy/immunology ; *Betacoronavirus/drug effects/immunology ; *Pneumonia, Viral/drug therapy/immunology ; Immunomodulating Agents ; },
abstract = {The severe acute respiratory syndrome coronavirus SARS-CoV-2, which causes COVID-19, has attracted the interest of the scientific community since 2019. In fact, in the majority of cases, COVID-19 results in a mildly symptomatic disease that needs no treatment. However, patients with comorbidities have an increased risk of severe manifestations of COVID-19. Although research progress in the field has been successfully accomplished, novel therapeutic strategies are still required. Treatment efforts are needed against the severe manifestations of the disease, such as the severe respiratory distress syndrome. The tripeptide glutathione could be a promising therapeutic approach against COVID-19. Glutathione is a multitarget agent that exhibits antiviral activity against SARS-CoV-2 and modulates the host response to SARS-CoV-2. Oxidative stress and glutathione deficiency have been implicated in the pathophysiology of severe COVID-19 disease. Thus, a possible therapeutic strategy could be the enhancement of the antioxidant defenses of the host through the treatment with nonenzymatic antioxidants. Apart from functioning as a scavenging agent, glutathione plays a central role in cellular signalling. As a redox regulator, glutathione also acts as a signalling molecule, thus modulating innate and T cell immunity, with implications for SARS-CoV-2 infection. Existing clinical data, although limited, provide evidence that the modulation of glutathione levels could be a preventive or adjunctive therapeutic strategy against SARS-CoV-2 infection.},
}

Humans
*Glutathione/therapeutic use/metabolism/pharmacology
COVID-19/immunology
SARS-CoV-2/drug effects
*Immunomodulation/drug effects/physiology
Oxidative Stress/drug effects
Antioxidants/therapeutic use
*COVID-19 Drug Treatment
Animals
Pandemics
Antiviral Agents
*Coronavirus Infections/drug therapy/immunology
*Betacoronavirus/drug effects/immunology
*Pneumonia, Viral/drug therapy/immunology
Immunomodulating Agents

@article {pmid42765958,
year = {2026},
author = {Masotta, V and Azzellino, G and Paoli, I and Caponnetto, V and Laurenza, E and Palma, L and Ciangoli, A and Petrucci, C and Lancia, L and Dante, A},
title = {[Simulation in nursing education in Italy: a scoping review].},
journal = {Assistenza infermieristica e ricerca : AIR},
volume = {45},
number = {3},
pages = {113-134},
doi = {10.1702/4774.47961},
pmid = {42765958},
issn = {2038-1778},
mesh = {Italy ; Humans ; *Education, Nursing/methods ; *COVID-19/epidemiology ; *Simulation Training/methods ; },
abstract = {UNLABELLED: . Simulation in nursing education in Italy: a scoping review.

INTRODUCTION: Simulation represents a cornerstone in contemporary nursing education, yet no comprehensive synthesis is currently available describing how it is used, in which settings it is applied, and outcomes assessed in Italy.

OBJECTIVE: To map the available literature on simulation in Italian nursing education and practice, examining study designs, participant characteristics, simulation modalities, theoretical and evidence-based underpinnings, outcome measures, and key educational insights.

METHODS: The scoping review followed the Joanna Briggs Institute (JBI) methodology and was reported according to the PRISMA-ScR checklist. Searches were conducted in PubMed, Scopus, and EBSCOhost. Primary studies conducted in Italy, published in Italian or English, and focused on the use of simulation in nursing education, training, or practice were included.

RESULTS: Thirty-three studies were included. Scientific production increased over time, with a marked peak during the covid-19 pandemic. Most studies were observational, monocentric, and conducted in academic settings, mainly within undergraduate nursing programmes. High-fidelity simulation was the most frequently used modality, whereas digital, immersive, and hybrid technologies were less represented. Outcomes mainly addressed the first two levels of Kirkpatrick's model, while transfer to practice and patient or organizational outcomes were rarely investigated.

CONCLUSIONS: Italian research on nursing simulation is growing and shows signs of maturation but remains predominantly single-centre and academically focused. As in the international literature, transfer to practice and impact on patient outcomes remain poorly documented. Pedagogical design appears generally sound, whereas reporting and alignment among objectives, modalities, fidelity, and evaluation remain areas for improvement.},
}

Italy
Humans
*Education, Nursing/methods
*COVID-19/epidemiology
*Simulation Training/methods

@article {pmid42766407,
year = {2026},
author = {Jardín, I and Macias-Díaz, A and Jimenez-Velarde, V and Fuentes-Mateos, M and Smani, T and Rosado, JA},
title = {Targeting the Orai1 CRAC channel: translating molecular insights into therapeutic progress.},
journal = {Expert opinion on therapeutic targets},
volume = {},
number = {},
pages = {},
doi = {10.1080/14728222.2026.2738180},
pmid = {42766407},
issn = {1744-7631},
abstract = {INTRODUCTION: The Ca[2+] release-activated Ca[2+] (CRAC) channel, triggered by the interaction between the Ca[2+] sensor STIM1 and Orai1, is the primary mediator of store-operated calcium entry (SOCE). Dysregulation of this process drives numerous human pathologies, particularly immune disorders and cancer hallmarks. Due to its role, Orai1 has emerged as an attractive target for precision therapeutics.

AREAS COVERED: This review outlines the pharmacological evolution of CRAC channel modulators, tracing their development from early chemical tools, such as SKF-96365, that exhibits several off-target effects, to more selective second-generation pore blockers, including Synta66, RO2959 or GSK-7975A. Particular attention is paid to third-generation inhibitors, especially CM4620 (zegocractin), evaluating data from recent Phase 2 clinical trials in acute pancreatitis (CARPO), severe COVID-19 pneumonia (CARDEA), and acute kidney injury (KOURAGE). We describe emerging orally bioavailable candidates like CM5480 aimed at chronic cardiopulmonary remodeling.

EXPERT OPINION: Clinical experience reveals that targeting ubiquitous Ca[2+] pathways, such as SOCE, demands specific trial design, transitioning toward biomarker-driven stratification of patient cohorts. Over the coming years, the pharmacological design will diverge into acute intravenous critical care and chronic oral immunomodulation. Ultimately, the exploitation of tissue-specific Orai2 and Orai3 isoform profiles represents the next frontier to enhance therapeutic efficacy across distinct disorders.},
}

@article {pmid42766503,
year = {2026},
author = {Muthuka, J and Muthoni, A and Ng'eno, L and Chebungei, L and Mbari, D and Nabaweesi, R},
title = {Maternal Serum Hemoglobin Levels Relative to Anemia Interventions in the COVID-19 Era: A Systematic Review and Meta-Analysis.},
journal = {Journal of health care for the poor and underserved},
volume = {37},
number = {1},
pages = {24-43},
doi = {10.1353/hpu.2026.a982955},
pmid = {42766503},
issn = {1548-6869},
mesh = {Humans ; Female ; *Hemoglobins/analysis ; *COVID-19/epidemiology ; Pregnancy ; *Anemia/therapy/blood ; Dietary Supplements ; *Pregnancy Complications, Hematologic/therapy/blood ; },
abstract = {In this literature review, we examined the impact of maternal anemia interventions on serum hemoglobin levels during the COVID-19 pandemic. We identified studies from various databases, spanning January 2020 to December 2022, and performed statistical analysis using Rev-Man 5.4.1 and JASP 0.9.95.4.0 softwares, employing both random and fixed effect models. Heterogeneity was assessed using the Cochran Q statistic and Higgins test. Overall, maternal anemia interventions significantly improved serum hemoglobin levels, with a standardized mean difference (SMD) of 0.93 (95% CI: 0.57, 1.30). Specific intervention effects included dietary iron supplements (SMD 1.16; 95% CI: -0.97, 3.28), educational information (SMD 0.75; 95% CI: 0.12, 1.37), intravenous ferric carboxyl-maltose (SMD 1.33; 95% CI: 0.28, 2.38), intravenous iron sucrose (SMD 0.82; 95% CI: 0.56, 1.09), and herbal substances (SMD 0.42; 95% CI: 0.24, 0.61). Although parenteral (injected) maternal anemia interventions marginally improved serum hemoglobin levels, multifaceted randomized controlled trials (RCTs) are essential to validate these findings.},
}

Humans
Female
*Hemoglobins/analysis
*COVID-19/epidemiology
Pregnancy
*Anemia/therapy/blood
Dietary Supplements
*Pregnancy Complications, Hematologic/therapy/blood

@article {pmid42766504,
year = {2026},
author = {Komeiha, M and Artyukh, I and Ogundele, OJ and Zhao, QJ and Massaquoi, N and Straus, S and Razak, F and Hosseini, B and Eissa, A and Isabel, M and Pinto, AD},
title = {Unveiling the Impact: A Scoping Review of the COVID-19 Pandemic's Effects on Low-Income Populations in Canada.},
journal = {Journal of health care for the poor and underserved},
volume = {37},
number = {1},
pages = {44-72},
doi = {10.1353/hpu.2026.a982956},
pmid = {42766504},
issn = {1548-6869},
mesh = {Humans ; *COVID-19/epidemiology/mortality ; Canada/epidemiology ; *Poverty/statistics & numerical data ; Social Determinants of Health ; Mental Health ; Low Socioeconomic Status ; Socioeconomic Disparities in Health ; },
abstract = {OBJECTIVES: This scoping review examines the impact of the COVID-19 pandemic on low-income populations in Canada.

METHODS: We conducted the scoping review using the Joanna Briggs Institute (JBI) methodology and adhered to the PRISMA-ScR guidelines for reporting. The review included studies focusing on generally healthy, low-income populations residing in Canada. The definition of low income varied among the included articles.

RESULTS: A total of 7,054 citations were screened, resulting in six peer-reviewed studies selected for data extraction and analysis. The grey literature search produced ten reports that were included. Findings resulted in three categories: (1) COVID-19 morbidity and mortality rates, (2) impact on mental health, and (3) impact on social determinants of health.

CONCLUSION: Urgent policy interventions are needed to mitigate the negative impacts of future health care crises on low-income individuals. Implementing livable wage mandates and paid sick leave policies could facilitate equitable recovery.},
}

Humans
*COVID-19/epidemiology/mortality
Canada/epidemiology
*Poverty/statistics & numerical data
Social Determinants of Health
Mental Health
Low Socioeconomic Status
Socioeconomic Disparities in Health

@article {pmid42766505,
year = {2026},
author = {Shukor, A and Biotech, M and Majid, U and Jameel, B and Klazinga, N and Martins, DSK},
title = {The Impact of the COVID-19 Pandemic on Community Health Centers in Canada and the United States: A Scoping Review.},
journal = {Journal of health care for the poor and underserved},
volume = {37},
number = {1},
pages = {73-110},
doi = {10.1353/hpu.2026.a982957},
pmid = {42766505},
issn = {1548-6869},
mesh = {Humans ; *COVID-19/epidemiology ; United States/epidemiology ; Canada/epidemiology ; *Community Health Centers/organization & administration ; Health Services Accessibility/organization & administration ; Quality of Health Care ; Quality Indicators, Health Care ; },
abstract = {Community health centers (CHCs) play a critical role in addressing the health needs of diverse and underserved communities. However, there remains a significant gap in the literature examining their resilience, particularly in crises such as COVID-19. This scoping review analyzed 68 articles to identify which performance indicators have been used to assess the impact of the pandemic on CHCs, and to understand what these indicators reveal about the CHCs' performance and resilience. The findings revealed that most performance indicators focused on access, availability, and quality of care, highlighting CHCs' role in maintaining essential services for underserved communities. However, critical upstream primary care performance indicators related to governance, financing, workforce planning, and building resilience were largely absent in the literature reviewed. This gap indicates a need to broaden performance indicators to holistically address all key performance and resilience dimensions, including upstream factors essential for sustaining long-term resilience and equity.},
}

Humans
*COVID-19/epidemiology
United States/epidemiology
Canada/epidemiology
*Community Health Centers/organization & administration
Health Services Accessibility/organization & administration
Quality of Health Care
Quality Indicators, Health Care

@article {pmid42762709,
year = {2026},
author = {Zanette, M and Enns, B and Carter, A and Compton, M and Daly, P and Davison, C and Gustafson, R and Hedden, L and Kerr, T and Schnepel, K and Nosyk, B},
title = {A review of policy actions implemented during a toxic drug public health emergency in British Columbia, Canada (2016-2024).},
journal = {The International journal on drug policy},
volume = {157},
number = {Pt A},
pages = {105509},
doi = {10.1016/j.drugpo.2026.105509},
pmid = {42762709},
issn = {1873-4758},
abstract = {BACKGROUND: During a decade-long public health emergency, driven by a highly unpredictable unregulated drug supply, drug toxicity remains the leading cause of unnatural death in British Columbia (BC), Canada. In response, the province implemented a multi-faceted approach to prevent toxic drug harms and save lives. Our objective was to review all relevant provincial policy actions since the declaration of the emergency and identify evaluations of implementation and effectiveness.

METHODS: We identified provincial-level policy actions related to unregulated substance use between 04/2016-12/2024 through a list provided by the BC Ministry of Health and searches of peer-reviewed and grey literature. We classified actions into nine provincial response domains, summarized over time, and noted if the policy change was evaluated.

FINDINGS: We identified 146 policy actions concentrated primarily in three domains: treatment and recovery (n = 51 (35%)), overdose prevention services (n = 26 (18%)), and social stabilization (n = 21 (14%)). Actions slowed at the onset of the COVID-19 pandemic, resuming in 2021-24. Most actions (n = 85, 58%) have not yet undergone evaluations of implementation or effectiveness.

CONCLUSION: Despite a broad and innovative provincial response, the toxic drug crisis remains a significant challenge across BC. More evaluation is urgently needed to identify the effects of policy actions to date.},
}

@article {pmid42762925,
year = {2026},
author = {Carreras, F and Salvatici, M and Corrado, C and Sansico, FD and Drago, L},
title = {Macrotroponin and antibody-mediated interference: An underrecognized cause of discordant cardiac troponin results.},
journal = {International journal of cardiology},
volume = {},
number = {},
pages = {134783},
doi = {10.1016/j.ijcard.2026.134783},
pmid = {42762925},
issn = {1874-1754},
abstract = {BACKGROUND: High-sensitivity cardiac troponin (hs-cTn) assays have improved the detection of myocardial injury, but have also increased the recognition of clinically discordant results. Among the causes of such discrepancies, analytical interferences remain underrecognized. Macrotroponin, a complex formed between cardiac troponin and immunoglobulins, represents a circulating immunoreactive complex of uncertain biological significance that remains analytically detectable and may lead to persistently elevated and non-dynamic cTn concentrations in the absence of myocardial injury.

CONTENT: This narrative review summarizes current clinical evidence on macrotroponin-associated interference in cTn immunoassays, predominantly derived from selected cohorts, case reports, and analytical studies. We describe proposed mechanisms, including autoantibody formation and immune complex persistence, and discuss assay-dependent variability. We examine key clinical scenarios in which macrotroponin should be suspected, including post-inflammatory states, autoimmune diseases, SARS-CoV-2-related settings, and physiological stress such as endurance exercise. Finally, we outline practical laboratory approaches for detection, including polyethylene glycol precipitation, immunoglobulin depletion, and size-exclusion techniques, and propose a clinically oriented diagnostic workflow.

SUMMARY: Macrotroponin represents an important and often overlooked cause of persistent or discordant cTn elevation. Recognition of this phenomenon is essential to avoid misdiagnosis and unnecessary investigations. Integration of biomarker kinetics, clinical context, and targeted laboratory testing is critical for accurate interpretation. Further studies are needed to define its prevalence, biological determinants, and standardized diagnostic strategies.},
}

@article {pmid42763918,
year = {2026},
author = {Kwon, Y and Gang, M},
title = {Effects of suicide prevention programs on suicidal ideation and attempts in military personnel: a systematic review and meta-analysis.},
journal = {Journal of mental health (Abingdon, England)},
volume = {},
number = {},
pages = {1-12},
doi = {10.1080/09638237.2026.2732884},
pmid = {42763918},
issn = {1360-0567},
abstract = {BACKGROUND: Suicide among military personnel is a pervasive and urgent issue.

AIMS: This study analyzed the effects of suicide prevention programs on suicidal ideation and attempts among military personnel and identified program characteristics associated with greater efficacy.

METHODS: PsycINFO, PubMed, Web of Science, EMBASE, and Google Scholar were searched for randomized controlled trials involving active-duty or retired military personnel. Fourteen studies were included in the systematic review, and 10 in the meta-analysis. Primary outcomes were suicidal ideation and attempts. Data were analyzed using a random-effects model, with subgroup analyses based on program type, delivery method, and implementation site.

RESULTS: Suicide prevention programs significantly reduced suicidal ideation and suicide attempts (Hedges's g = -0.33, 95% CI: -0.62 to -0.03, p = .029; I[2] = 73). Cognitive behavioral therapy (CBT)-based interventions showed a small effect on ideation (Hedges's g = -0.33) and a moderate effect on attempts (Hedges's g = -0.67). Face-to-face and blended programs were the most effective, whereas non-face-to-face programs were ineffective. Furthermore, military base-based interventions outperformed those at healthcare institutions.

CONCLUSIONS: Suicide prevention programs, particularly CBT-based and multi-component interventions delivered face-to-face or blended within military units, are effective. Future research should optimize remote strategies and enhance long-term effectiveness.

PRISMA/PROSPERO: Regarding registration in PROSPERO, while we did attempt the registration for this systematic review, it was ultimately not possible for two primary reasons. First, the PROSPERO registration review at the time we applied prioritized COVID-19-related research. This, therefore, delayed the review process for this study's suicide-related topic. Second, a systematic review protocol with a similar title had already been registered. Consequently, we never received a registration number. Notably, while a similarly titled protocol exists, our study specifically employs a comprehensive meta-analysis approach to address this topic, thus ensuring a distinct methodology.},
}

@article {pmid42764017,
year = {2026},
author = {Calderón-Larrañaga, S and Bakhti, R and Etemadi, M and Fakih, L and Vandeskog, HO and Shrestha, P and He, S and Chua, AQ and Heymann, D and Tangcharoensathien, V and Mahendradhata, Y and Cook, AR and Engebretsen, E and Eshete, MT and García-Basteiro, AL and Rando, K and Adeyi, O and Fukuda-Parr, S and Lee, K and Wamoyi, J and Haldane, V and Jung, AS and Rahman-Shepherd, A and Schenck, M and Tian, M and Hsu, LY and Ng, ISL and Valderas, JM and Leo, YS and Lee, V and Nordström, A and Kazatchkine, M and Teo, YY and Clark, H and Legido-Quigley, H and , },
title = {The NUS-Lancet PRIME Commission: transforming pandemic readiness for equity.},
journal = {Lancet (London, England)},
volume = {},
number = {},
pages = {},
doi = {10.1016/S0140-6736(26)01146-3},
pmid = {42764017},
issn = {1474-547X},
}

@article {pmid42764130,
year = {2026},
author = {Podolsky, AS and Zhou, MH and Freeman, EE and Rosenbach, M and Tyring, SK and Wanat, KA and Lupi, O and Lipner, SR},
title = {Dermatological Manifestations of Emergent Viruses. Part I: Common and Vaccine-Preventable Viral Infections.},
journal = {Journal of the American Academy of Dermatology},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.jaad.2026.09.054},
pmid = {42764130},
issn = {1097-6787},
abstract = {Viral infections frequently present with mucocutaneous manifestations that may provide diagnostic clues and guide timely management. However, the expanding therapeutic landscape and evolving public health recommendations highlight the need for an updated evidence-based review for dermatologists. Herein, we summarize the epidemiology, clinical presentation, diagnosis, management, and prevention of common and vaccine-preventable viral infections with dermatologic relevance, including Coronavirus Disease-2019 (COVID-19), mpox, measles, and rubella. Advances in antiviral therapies, immunomodulators, vaccination, and post-exposure prophylaxis have improved outcomes for several infections. Recognition of characteristic skin findings, familiarity with current diagnostic approaches, and implementation of evidence-based prevention strategies are essential for early diagnosis, appropriate treatment, and limiting disease transmission.},
}

@article {pmid42764981,
year = {2026},
author = {Seger, F and Gutschi, LM and Seneff, S},
title = {Lipid nanoparticles as active biointerfaces: From membrane interaction to systemic dysregulation.},
journal = {Acta pharmaceutica Sinica. B},
volume = {16},
number = {9},
pages = {5674-5708},
pmid = {42764981},
issn = {2211-3835},
abstract = {Lipid nanoparticles (LNPs) are central to modern mRNA therapeutics, including COVID-19 vaccines. Far from passive carriers, their ionizable lipids actively interact with cellular membranes. Evidence from cellular, transcriptomic, and proteomic studies indicates that LNPs, with or without nucleic acid, alter gene and protein expression, thereby initiating inflammatory, detoxification, and stress responses at the membrane. Key pathways affected include lipid metabolism and detoxification, with roles for Peroxisome Proliferator-Activated Receptor Gamma (PPARγ) and cytochrome P450 enzymes. We hypothesize that the phosphatidylinositol (PI) cycle is the primary site of LNP-induced perturbations, regulating membrane restructuring and organelle trafficking during endocytosis. Disruption of this cycle triggers downstream signaling cascades, including nuclear factor kappa B (NF-κB), mitogen-activated protein kinases (MAPKs), Janus kinase/signal transducers and activators of transcription (JAK/STAT), and mechanistic target of rapamycin (mTOR). We term this systemic effect lipid-nanoparticle-driven membrane dysfunction (L-DMD), characterized by dysregulated cellular communication, stress responses, and energy balance. This review provides a mechanistic framework for understanding the persistent biological effects of modified modRNA-LNP exposure and emphasizes a systems-level intracellular perspective.},
}

@article {pmid42765443,
year = {2026},
author = {Dejen, GM},
title = {mRNA Therapeutics Beyond Infectious Diseases: Expanding Therapeutic Applications and Future Perspectives.},
journal = {Immunity, inflammation and disease},
volume = {14},
number = {9},
pages = {e70511},
pmid = {42765443},
issn = {2050-4527},
mesh = {Humans ; *RNA, Messenger/therapeutic use/genetics ; Animals ; Immunotherapy/methods ; Precision Medicine/methods ; COVID-19 ; Neoplasms/therapy/genetics ; Nanoparticles ; SARS-CoV-2 ; Communicable Diseases/therapy ; Drug Delivery Systems ; *Genetic Therapy/methods ; },
abstract = {BACKGROUND: Messenger RNA (mRNA) therapeutics have rapidly evolved from experimental nucleic acid constructs into a clinically validated therapeutic platform. Their successful application during the COVID-19 pandemic accelerated interest in broader therapeutic uses beyond infectious diseases.

AIMS: This review summarizes the expanding therapeutic applications of mRNA technologies, recent technological advances, translational progress, current challenges, and future prospects across diverse medical fields.

MATERIALS AND METHODS: A comprehensive review of the published literature was conducted, synthesizing evidence from preclinical investigations, clinical studies, and recent advances in mRNA engineering, delivery systems, and translational research.

RESULTS: Advances in mRNA design, nucleoside modification, codon optimization, and delivery platforms, particularly lipid nanoparticles and emerging organ-targeted carriers, have expanded applications to cancer immunotherapy, personalized vaccines, autoimmune and inflammatory diseases, protein replacement therapy, cardiovascular regeneration, neurological disorders, and rare genetic diseases. Emerging technologies, including self-amplifying and circular RNA systems, further enhance therapeutic potential.

DISCUSSION: Despite significant progress, challenges remain, including optimization of targeted delivery, long-term safety, repeat-dose tolerability, manufacturing complexity, cold-chain requirements, production costs, and equitable global access. Continued technological innovation and regulatory harmonization are critical for successful clinical translation.

CONCLUSION: mRNA therapeutics are transitioning from a vaccine-centered technology to a versatile platform for precision medicine. Advances in delivery systems, scalable manufacturing, and artificial intelligence-assisted sequence design are expected to accelerate their integration into the treatment of chronic, genetic, and regenerative diseases.},
}

Humans
*RNA, Messenger/therapeutic use/genetics
Animals
Immunotherapy/methods
Precision Medicine/methods
COVID-19
Neoplasms/therapy/genetics
Nanoparticles
SARS-CoV-2
Communicable Diseases/therapy
Drug Delivery Systems
*Genetic Therapy/methods

@article {pmid42753364,
year = {2026},
author = {Sardar, N and Manzoor, S},
title = {Self-amplifying RNA and circular RNA vaccines: mechanisms, delivery strategies, and prospects for long-lasting immunity.},
journal = {Human immunology},
volume = {87},
number = {11},
pages = {112083},
doi = {10.1016/j.humimm.2026.112083},
pmid = {42753364},
issn = {1879-1166},
abstract = {Messenger RNA vaccines have demonstrated extraordinary success during the COVID-19 pandemic, yet conventional mRNA platforms exhibit inherent limitations including modest molecular stability, stringent cold-chain requirements, waning antibody responses, and the necessity for relatively high doses to achieve protective immunity. Next-generation RNA technologies-specifically self-amplifying RNA (saRNA) and circular RNA (circRNA) vaccines-address these shortcomings through fundamentally distinct molecular designs that enhance antigen expression kinetics and prolong immunological persistence. Self-amplifying RNA vaccines incorporate viral replicase elements derived from alphaviruses, enabling intracellular amplification of the antigen-encoding sequence and sustained protein production at doses substantially lower than conventional mRNA. Circular RNA vaccines feature covalently closed loop structures that confer complete resistance to exonuclease-mediated degradation, extending translational half-life and maintaining antigen presentation over extended periods. This review provides a comprehensive examination of the molecular architecture, intracellular processing mechanisms, and immune activation pathways characteristic of both platforms. We critically evaluate formulation and delivery strategies, with particular emphasis on lipid nanoparticles and emerging carrier systems, and assess manufacturing challenges related to scalability, purity, and quality control. The preclinical and early clinical evidence supporting both platforms is synthesized and compared, highlighting the dose-sparing capacity of self-amplifying RNA and the exceptional durability of circular RNA-induced responses. Persistent obstacles-including reactogenicity modulation, circularization efficiency, replicase-associated innate suppression, and regulatory standardization-are analyzed in depth. We conclude by identifying priority research directions essential for clinical translation, including optimized delivery systems, refined safety profiling, and cold-chain-independent formulations that will enable global vaccine accessibility.},
}

@article {pmid42753425,
year = {2026},
author = {Orzeł, U and Wójcik, E and Filipek, S and Moreira, IS},
title = {ACE2 dysregulation and lipid metabolism: Mechanistic interplay between COVID-19 and neurodegeneration.},
journal = {Molecular aspects of medicine},
volume = {112},
number = {},
pages = {101519},
doi = {10.1016/j.mam.2026.101519},
pmid = {42753425},
issn = {1872-9452},
abstract = {Angiotensin-converting enzyme 2 (ACE2) is the primary cellular receptor of SARS-CoV-2. It is a key regulator of the renin-angiotensin system (RAS) and modulates blood pressure and inflammatory pathways. ACE2 converts pro-inflammatory angiotensin II into the vasoprotective peptide, angiotensin (1-7). This is strongly influenced by the lipid composition of the plasma membrane. Cholesterol-rich lipid rafts play an important role in determining receptor localisation and viral accessibility. Dyslipidaemia, which is common in obesity, diabetes, and metabolic syndrome, has been associated with an increased susceptibility to severe COVID-19 and may amplify systemic inflammation. Aberrant lipid metabolism also contributes to neurodegenerative disorders, including Alzheimer's and Parkinson's diseases, which drive neuroinflammation, synaptic dysfunction, and blood-brain barrier impairment. Notably, similar disturbances and systemic inflammation are increasingly recognised in patients with Long COVID, suggesting overlapping mechanisms that may exacerbate or accelerate neurodegenerative processes. This review explores the interplay between ACE2 regulation, lipid metabolism, and systemic inflammation in COVID-19, with a particular focus on their implications for neurological health. Uniquely, we highlighted the intersection of ACE2 and lipid-related alterations in patients with Long COVID and their potential contribution to the progression of neurodegenerative diseases. In addition, we reviewed therapeutic strategies targeting ACE2, including recombinant soluble ACE2, ACE2-based nanotherapeutics, and lipid-focused interventions, aimed at mitigating acute infection, systemic inflammation, and persistent neurological sequelae. Understanding these mechanisms is essential to prevent long-term neurological consequences of the COVID-19 pandemic.},
}

@article {pmid42753783,
year = {2026},
author = {Colombo, F and Cecchini, M and Elgar, K and Segal, AB and Sutherland, E},
title = {Fit for the future: from siloed to integrated public health systems.},
journal = {The Lancet. Public health},
volume = {},
number = {},
pages = {},
doi = {10.1016/S2468-2667(26)00161-1},
pmid = {42753783},
issn = {2468-2667},
abstract = {Despite compelling evidence on the value of prevention, public health remains chronically underfunded and structurally deprioritised. Spending on prevention has remained stable at around 3% of total health expenditure across Organisation for Economic Co-operation and Development countries for the past two decades, and despite a temporary doubling of spending during the COVID-19 pandemic, this trend has already reversed. The central challenge for the next decade lies not in the absence of evidence, but rather the absence of political will and systems capable of translating evidence into action. Three interconnected priorities stand out: (1) embedding public health in cross-sectoral governance frameworks so that prevention is assessed on equal terms with curative care; (2) strengthening data to support public health investment and budgeting, especially in a highly volatile fiscal environment for many countries; and (3) accelerating digital transformation to increase analytical ability, targeted public health intervention, and public trust. Progress in all three areas requires strong political leadership and rethinking current systems to ensure that they are fit for the future.},
}

@article {pmid42756063,
year = {2026},
author = {Castle, VE and Sideropoulos, V and Jones, C and Zhang, D and Van Herwegen, J and Palikara, O},
title = {The Impact of COVID-19 on the Mental Health and Wellbeing of Children with Special Education Needs and Disabilities: A Systematic Review.},
journal = {Review journal of autism and developmental disorders},
volume = {13},
number = {3},
pages = {607-631},
pmid = {42756063},
issn = {2195-7185},
abstract = {The COVID-19 pandemic has impacted greatly the mental health of children. We performed a systematic review to better understand the impact of the pandemic on children with special educational needs and disabilities (SEND) across different SEND categories. Following PRISMA guidelines, of 1699 search results, 66 studies were included in our analysis as they met our inclusion criteria concerning: a) children with SEND; b) focus on COVID-19; c) longitudinal or cross-sectional design; d) quantitative or qualitative measures; and e) mental health or well-being outcomes. Our review suggests that there was a typically negative impact on mental health and well-being for children with SEND, yet experiences varied on the basis of individual differences, rather than category of SEND. Findings highlight the need for interventions and policy implementations to improve the everyday mental well-being of this population.},
}

@article {pmid42756240,
year = {2026},
author = {Kou, Z and Liu, Y and Qian, W and Zhang, S and Lou, S and Shao, D},
title = {Mapping the research landscape of antibody therapy for Ebola virus disease: a bibliometric analysis.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1919677},
pmid = {42756240},
issn = {1664-3224},
mesh = {Humans ; *Hemorrhagic Fever, Ebola/therapy/immunology/epidemiology ; Bibliometrics ; *Ebolavirus/immunology ; *Antibodies, Monoclonal/therapeutic use ; Disease Outbreaks ; *Antibodies, Viral/therapeutic use ; },
abstract = {BACKGROUND: Antibody-based therapies have become a cornerstone of Ebola virus disease (EVD) treatment and prevention, particularly following the successful clinical development of monoclonal antibody therapeutics against Zaire ebolavirus. However, despite substantial advances, the global research landscape, collaboration patterns, and evolving thematic trends of Ebola antibody therapy have not been systematically characterized. The ongoing 2026 Bundibugyo ebolavirus outbreak, for which no licensed vaccines or therapeutics currently exist, further underscores the importance of understanding the development trajectory of this field.

METHODS: Publications related to antibody therapy for EVD published between 1990 and 2026 were retrieved from the Web of Science Core Collection, PubMed, and Scopus databases. Following data integration, format conversion, and deduplication, a total of 1,350 unique publications were included. Bibliometric analyses were conducted using CiteSpace, VOSviewer, and Bibliometrix, complemented by Google Trends data to evaluate public interest and outbreak-related attention.

RESULTS: The field exhibited dynamic outbreak-driven growth, with major publication surges corresponding to the 2014-2016 West African Ebola epidemic and the period surrounding 2020. Although annual publication output declined after 2020, renewed public attention emerged during the 2026 Bundibugyo outbreak. The United States dominated both publication productivity and citation impact, followed by China, the United Kingdom, and Canada. Harvard University, the University of Texas System, and Scripps Research Institute were identified as leading institutions. Keyword co-occurrence and clustering analyses revealed five major thematic domains: fundamental virology and glycoprotein research, immunity and vaccination, infection and therapeutic development, cross-viral research involving COVID-19 and HIV, and clinically oriented studies focused on neutralizing antibodies, clinical trials, and convalescent plasma. Temporal analyses demonstrated a clear evolution from basic virology toward translational and clinical applications.

CONCLUSIONS: Ebola antibody therapy research has undergone substantial expansion over the past three decades, driven largely by major outbreak events and advances in antibody engineering technologies. The current Bundibugyo outbreak highlights persistent vulnerabilities in existing countermeasure strategies and emphasizes the urgent need for broadly protective pan-ebolavirus antibody therapeutics. These findings provide a comprehensive overview of the intellectual structure, global collaborations, research hotspots, and future directions of antibody-based interventions against Ebola virus disease.},
}

Humans
*Hemorrhagic Fever, Ebola/therapy/immunology/epidemiology
Bibliometrics
*Ebolavirus/immunology
*Antibodies, Monoclonal/therapeutic use
Disease Outbreaks
*Antibodies, Viral/therapeutic use

@article {pmid42756354,
year = {2026},
author = {Kalinowski, O and Rössler, W},
title = {Gender differences in the effects of economic inequality on mental conditions: a multivariate meta-analysis of Gini index and relative income position in high-income OECD countries.},
journal = {Frontiers in psychiatry},
volume = {17},
number = {},
pages = {1835495},
pmid = {42756354},
issn = {1664-0640},
abstract = {BACKGROUND: Economic inequalities are established determinants of mental conditions, yet the role of gender remains insufficiently examined. In this article, we suggest that women experience a "double risk" in contexts of economic inequality: higher exposure to economic disadvantage and greater vulnerability to its mental health effects.

METHODS: We conducted a two-step synthesis. First, we analyzed sex differences in relative poverty across high-income OECD countries. Mean differences were assessed using Welch t-tests, with sensitivity analyses across COVID-19 periods. Second, we performed a systematic review and multivariate random-effects meta-analysis following PRISMA guidelines. We included 21 studies reporting gender-disaggregated associations between income rank and income inequality and ICD-/DSM-based mental conditions. Effect sizes were transformed to log odds ratios and analyzed using multilevel models accounting for within-study dependencies. Gender was examined as a moderator.

RESULTS: Women exhibited higher relative poverty rates than men (20.5% vs. 18.3%; mean difference: 2.2 percentage points; p < 0.001). The meta-analysis (46 effect sizes) showed a significant association between lower income and poorer mental health (log(OR)=0.55, 95% CI 0.26-0.85), with substantial heterogeneity. Gender did not moderate effects across all outcomes. However, in depression-specific analyses (k=17), gender significantly moderated the association (p=0.016), with stronger effects in women. Income inequality (Gini index) showed no overall association with mental health, but gender still emerged as a significant moderator, with effects concentrated among women in adjusted models.

CONCLUSIONS: Gender shapes both exposure to economic disadvantage and vulnerability to its mental health consequences. While income-related mental health inequalities affect both sexes, women appear disproportionately impacted, particularly regarding depression. These findings highlight the importance of integrating gender-sensitive approaches into research and policy addressing socioeconomic determinants of mental health.

https://www.crd.york.ac.uk/PROSPERO/view/CRD420251123692, identifier CRD420251123692.},
}

@article {pmid42760256,
year = {2026},
author = {de Lima Brum, R and Saes-Silva, E and Neves, RG and da Silva Freitas, L and da Silva Bonifácio, A and da Silva Júnior, FMR},
title = {Exploring climate, air pollution, and respiratory disease hospitalizations in Brazil: a scoping review.},
journal = {Expert review of respiratory medicine},
volume = {},
number = {},
pages = {},
doi = {10.1080/17476348.2026.2736890},
pmid = {42760256},
issn = {1747-6356},
abstract = {INTRODUCTION: Air pollution is the leading environmental risk factor for mortality worldwide, contributing to 7.9 million deaths in 2023. In Brazil, studies evaluating the combined relationship between air pollution, climate variables, and respiratory disease hospitalizations remain fragmented and regionally concentrated.

AREAS COVERED: This scoping review mapped the Brazilian literature on air pollution, climate, and respiratory hospitalizations across multiple scientific databases. A total of 1,179 studies were identified, of which 129 met the eligibility criteria after screening and full-text assessment. Respiratory infections, including pneumonia and COVID-19, followed by asthma, were the most frequently investigated outcomes, with children representing the main target population. The review also revealed geographical asymmetry, as a single federative unit concentrated more than one-third of all published studies. Overall, 117 studies (90.70%) reported positive associations between environmental exposures and hospitalizations, of which 112 reported significant results.

EXPERT OPINION: Environmental epidemiology in Brazil remains limited by methodological fragmentation, territorial inequalities, and insufficient local coverage, with only 42 municipalities (0.75% of the Brazilian municipalities) individually identified among municipal-scale studies. Although the literature establishes an important epidemiological baseline, substantial structural gaps still hinder advances in the field, reinforcing the urgent need for decentralized research strategies, methodological modernization, and integrated climate-health approaches.},
}

@article {pmid42761183,
year = {2026},
author = {Kim, J and Son, B and Yoo, W and Shin, H},
title = {Gut microbiome-immune-metabolic axis in fatigue: mechanistic insights and food science approaches.},
journal = {Food science and biotechnology},
volume = {35},
number = {12},
pages = {3449-3463},
pmid = {42761183},
issn = {2092-6456},
abstract = {Fatigue is a heterogeneous symptom associated with lifestyle, infection, exercise, and chronic disease, but its biological links with the gut microbiome remain incompletely defined. This review summarizes clinical and mechanistic evidence connecting gut microbiome alterations with fatigue-related phenotypes, focusing on myalgic encephalomyelitis/chronic fatigue syndrome, post-acute COVID-19 syndrome, general adult fatigue, and exercise-induced fatigue. Evidence was interpreted according to fatigue-related phenotype, microbiome function, microbial metabolite, gut barrier marker, inflammatory response, and food-based intervention. Current studies suggest that reduced short-chain fatty acid production, impaired butyrate-producing capacity, gut barrier dysfunction, microbial translocation, low-grade inflammation, altered tryptophan metabolism, host energy imbalance, and gut-brain/gut-muscle axis signaling may contribute to fatigue-related physiological vulnerability. Food components/ingredients, including dietary fiber, fermented food, prebiotic, probiotic, postbiotic, polyphenol, and polysaccharide, may support microbiome-mediated recovery pathways. Further controlled, phenotype-specific, multi-omics intervention studies are required.},
}

@article {pmid42761488,
year = {2026},
author = {Xu, S and Li, X and Li, W and Huang, R},
title = {A narrative discussion on the impact of respiratory infectious diseases on dental education in China: implications for curriculum design and student outcomes.},
journal = {Frontiers in dental medicine},
volume = {7},
number = {},
pages = {1897947},
pmid = {42761488},
issn = {2673-4915},
abstract = {OBJECTIVE: Recent outbreaks of respiratory infectious diseases, transmitted via aerosols, have placed dental healthcare workers at high risk. Traditional dental education, based on student-teacher-patient interactions, faces unprecedented challenges across all stages. From admissions to classroom teaching, laboratory instruction, clinical training, and final examinations, every aspect of dental education is undergoing significant challenges and is in urgent need of change.

METHODS: This narrative review with content analysis synthesized literature on the impact of respiratory infections on dental education. We systematically searched PubMed, Web of Science, and CNKI (2020-2026) using relevant keywords. Two reviewers independently screened and selected studies. Data were thematically analyzed into five core domains: classroom teaching, laboratory teaching, clinical teaching, student admissions/assessment, and licensing examinations.

RESULTS: In classroom teaching, online platforms and AI-augmented PBL/CBL were rapidly adopted, yet persistent issues included network instability, limited interaction, digital inequities, and heavy reliance on student self-discipline. In laboratory teaching, AR/VR and iLab-X enabled remote training, but were constrained by high costs, poor haptic realism, inability to replicate patient emotions, and equipment dependence. In clinical teaching, enhanced infection controls-including PPE, rubber dams, and HEPA filtration-were implemented, though bio-aerosol risks, reduced patient flow, and limited clinical exposure remained. In admissions, online exams with dual-camera proctoring, open-ended questions, AI-generated items, and virtual OSCEs were adopted, while challenges persisted in cheating prevention, subjective scoring, validity, and privacy. Licensing examinations remained in-person with strict protection; VSP showed promise but lacked robust evidence and incurred high costs. Overall, technological innovations enabled educational continuity, yet significant infrastructure gaps, inequities, and unresolved validity issues persist across all domains.

CONCLUSION: China's dental education rapidly adapted to respiratory epidemics through online teaching, simulation, and enhanced infection control, yet persistent challenges remain in digital equity, cost, validity, and infrastructure. These innovations are important primarily because they directly influence student learning outcomes-including knowledge acquisition, clinical reasoning, and skill retention-while also shaping curriculum design. Future preparedness requires sustained investment, faculty development, equitable access, and rigorous longitudinal research to validate skill transfer to clinical practice, ensuring that technological advances ultimately translate into measurable improvements in student competency and patient safety.},
}

@article {pmid42761556,
year = {2026},
author = {Abdi, YH and Issack, ZI},
title = {Converging infectious disease threats in the post-COVID era: surveillance fragility, pandemic risk, and global preparedness.},
journal = {Frontiers in public health},
volume = {14},
number = {},
pages = {1916865},
pmid = {42761556},
issn = {2296-2565},
mesh = {Humans ; *COVID-19/epidemiology ; Pandemic Preparedness ; *Pandemics ; *Global Health ; Zoonoses/epidemiology ; Animals ; Public Health Infrastructure ; SARS-CoV-2 ; *Communicable Diseases/epidemiology ; },
abstract = {The COVID-19 pandemic exposed profound weaknesses in global infectious disease surveillance yet, in its aftermath, pandemic-prone threats have intensified rather than receded. This narrative review synthesizes contemporary evidence on three converging drivers of pandemic risk zoonotic emergence, antimicrobial resistance, and climate-sensitive disease expansion and examines how structural failures in surveillance and global health governance amplify their impact. Drawing on recent epidemiological analyses, policy reports, and One Health evaluations, the review maps post-COVID surges in zoonotic outbreaks, drug-resistant infections, and vector and water-borne diseases, and links these trends to fragmented laboratory networks, inequitable genomic capacity, and weak integration across human, animal, and environmental systems. It further interrogates the geopolitical and socioeconomic determinants of vulnerability, including conflict-related surveillance collapse, vaccine inequity, and the political economy of pandemic financing. Emerging digital tools from AI-enabled forecasting to wastewater and social media surveillance are assessed not only for their technical promise but also for risks related to data bias, extractives, and governance gaps. The review argues that without redistributive investment in One Health integration, regional genomic platforms, community-based surveillance, and enforceable IHR-based accountability, the world will continue to detect converging threats late and respond inequitably, leaving pandemic preparedness structurally fragile in the post-COVID era.},
}

Humans
*COVID-19/epidemiology
Pandemic Preparedness
*Pandemics
*Global Health
Zoonoses/epidemiology
Animals
Public Health Infrastructure
SARS-CoV-2
*Communicable Diseases/epidemiology

@article {pmid42751133,
year = {2026},
author = {Zarbatan, FA and Alawam, K and Hakamy, A},
title = {Pulmonary sequelae of SARS-CoV-2 infection: a narrative review of long-term functional, radiological, and clinical outcomes in COVID-19 survivors, with a regional focus on Saudi Arabia.},
journal = {Frontiers in physiology},
volume = {17},
number = {},
pages = {1916914},
pmid = {42751133},
issn = {1664-042X},
abstract = {The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has left an enduring legacy of pulmonary morbidity among millions of survivors worldwide. While the acute phase of COVID-19 has been extensively characterized, the long-term pulmonary sequelae collectively termed post-acute sequelae of SARS-CoV-2 infection (PASC) or long COVID remain incompletely understood, particularly across diverse geographic and demographic populations. This narrative review synthesizes current evidence on the long-term pulmonary consequences of SARS-CoV-2 infection, with emphasis on functional, radiological, and clinical outcomes in survivors. Literature was identified through systematic searches of PubMed, Scopus, and Google Scholar covering publications from January 2020 to September 2025, using pre-specified search terms related to long COVID pulmonary outcome; studies involving adult survivors with objectively assessed pulmonary outcomes were prioritized. This review addresses the pathophysiological mechanisms underlying pulmonary injury, the definition and clinical spectrum of long COVID, the trajectory of pulmonary function test (PFT) abnormalities-particularly reductions in diffusing capacity for carbon monoxide (DLCO) and radiological findings detected on high-resolution computed tomography (HRCT). Risk factors for persistent pulmonary dysfunction, the impact on health-related quality of life (HRQoL) and functional capacity, emerging evidence supporting structured pulmonary rehabilitation, and the specific context of Saudi Arabia and the Jizan region are also examined. A particular focus on the Arabian Peninsula is warranted given that regional populations carry a high burden of metabolic comorbidities including obesity, diabetes mellitus, and hypertension that may amplify pulmonary vulnerability to SARS-CoV-2 yet remain substantially underrepresented in the current literature. The available evidence suggests that impaired gas exchange most consistently reflected by reduced DLCO may represent the most prevalent long-term pulmonary consequence of COVID-19, with restrictive ventilatory patterns predominating over obstructive defects. Significant gaps persist regarding the long-term trajectory of these abnormalities, population-specific risk stratification, and the efficacy of targeted rehabilitation. Structured, longitudinal, multicenter research incorporating standardized PFT protocols is urgently needed to address these unresolved questions and guide evidence-based post-COVID pulmonary care.},
}

@article {pmid42751188,
year = {2026},
author = {Xu, Q and Zhang, J and Hou, Y and Tan, Z and Gao, H and Silva-Júnior, EF and Gao, S and Zhan, P and Liu, X},
title = {The substrate envelope strategy: Structural basis for resistance mitigation in antiviral drug design.},
journal = {Pharmaceutical science advances},
volume = {4},
number = {},
pages = {100147},
pmid = {42751188},
issn = {2773-2169},
abstract = {Drug resistance remains a major hurdle in antiviral drug development. This review highlights the "substrate envelope hypothesis", a structure-based drug design (SBDD) paradigm that constrains the spatial boundaries and binding footprint of inhibitors within the conserved active site volume defined by natural viral substrates. By restricting inhibitor interactions to evolutionarily conserved residues, this approach ensures that mutations abrogating drug binding simultaneously impair natural substrate processing. This imposes an insurmountable fitness cost on the virus, thereby mitigating resistance. Through the analysis of viral enzyme-substrate co-crystal structures, we systematically review the application of this framework in human immunodeficiency.virus (HIV) protease, hepatitis C virus (HCV) NS3/4A protease, influenza virus (IFV) neuraminidase (NA), and severe acute respiratory Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) main protease, illustrating how substrate envelope-guided design achieves high potency while circumventing resistance. Additionally, we extend this strategy from traditional protease targets to non-protease enzymes. By integrating molecular dynamics and structural biology, this framework offers a rational approach for developing next-generation antivirals.},
}

@article {pmid42751394,
year = {2026},
author = {Chan, KK},
title = {Narrative Review: Telemedicine for Reducing Travel-Related Out-of-Pocket Costs Among Hong Kong Urological Patients and a Customized Tiered Consultation Pathway.},
journal = {Research and reports in urology},
volume = {18},
number = {},
pages = {645326},
pmid = {42751394},
issn = {2253-2447},
abstract = {PURPOSE: The COVID-19 pandemic disrupted routine urological outpatient services in Hong Kong, imposing disproportionate travel burdens on outlying island and cross-border patients who rely on multi-stage ferry and bus journeys. Globally, existing teleurology cost evidence is dominated by Western private-vehicle models, and to date no peer-reviewed review has investigated teleurology cost outcomes in Hong Kong. This narrative review addresses this regional research gap by synthesizing international evidence and proposing a tiered workflow aligned with the Hospital Authority's 2022-2027 Smart Care strategy.

PATIENTS AND METHODS: PubMed, CINAHL Complete and MEDLINE were searched for primary quantitative studies published between January 2012 and December 2022. Studies were screened following standard PRISMA protocols, and methodological quality was appraised using CASP and JBI checklists. Findings were aggregated via narrative thematic synthesis.

RESULTS: Eleven eligible studies (9 cohort studies, 1 randomized controlled trial, 1 cross-sectional survey) were included in the final analysis. Four core patient cost themes were identified by evidence strength: travel time savings (81.8% of studies), direct transport expenditure reduction (72.7%), travel distance reduction (54.5%), and lost work opportunity cost (45.5%). Western mileage-based cost frameworks have limited applicability to Hong Kong's ferry-dominated public transit ecosystem.

CONCLUSION: Evidence drawn predominantly from Western populations suggests that teleurology may reduce travel-related time and financial burdens for urology patients, with potential applicability to Hong Kong's remote island and cross-border patient groups. The proposed tiered consultation pathway represents a theoretically evidence-informed framework aligned with local digital healthcare policy, to support future telehealth pilot implementation and service optimization. As all included studies were conducted in North America and the United Kingdom, and the pathway has not been locally validated, its real-world effectiveness and cost-saving magnitude in Hong Kong remain to be confirmed in future primary research. Although this study focuses on the public healthcare setting in Hong Kong, the proposed telemedicine consultation pathway may serve as a reference clinical and operational blueprint for other highly urbanized regions with outlying islands or cross-border patient demographics.},
}

@article {pmid42735469,
year = {2026},
author = {Li, A and Ren, J and Guyatt, GH and Busse, JW and Sadeghirad, B and Patwardhan, B and Chaturvedi, S and Cheung, AM and Ge, L and Hao, Q and Thabane, L and Vohra, S and Brinkhaus, B and Chu, DK and Witt, CM and Li, Y and Krishnan, G and Kong, L and Wieland, LS and Agoritsas, T and Kothari, KU and Lee, MS and Okwen, PM and Ang, L and Zeng, Z and Gao, J and Wang, S and Cui, M and Zhai, C and Lozano, LEC and Fang, F and Pan, W and Yang, P and Wen, C and Rugolo, JM and Ren, Y and Kang, YK and Yong, NB and Fang, M and He, Q and Zhang, YQ},
title = {Traditional, complementary, and integrative medicine therapies for mild/moderate acute COVID-19: a systematic review and network meta-analysis.},
journal = {Phytomedicine : international journal of phytotherapy and phytopharmacology},
volume = {161},
number = {},
pages = {158764},
doi = {10.1016/j.phymed.2026.158764},
pmid = {42735469},
issn = {1618-095X},
mesh = {Humans ; *Integrative Medicine/methods ; *Complementary Therapies/methods ; COVID-19/therapy ; *COVID-19 Drug Treatment ; SARS-CoV-2 ; Phytotherapy ; Randomized Controlled Trials as Topic ; },
abstract = {BACKGROUND: Although the use of Traditional, Complementary, and Integrative Medicine (TCIM) interventions to treat coronavirus disease 2019 (COVID-19) is common, the effectiveness of these interventions is unclear.

OBJECTIVE: To compare different TCIM interventions for the treatment of mild/moderate acute COVID-19.

DATA SOURCES: EMBASE (Elsevier), Medline (OVID), VHL TCIM database, Cochrane Central, ClinicalTrials.gov, ICTRP, as of April 29th, 2025, as well as eight Chinese and four Korean databases.

STUDY SELECTION: Randomized controlled trials comparing a TCIM intervention with another, the standard of care (SoC), placebo, or conventional medicine in participants with suspected, probable, or confirmed mild/moderate acute COVID-19.

DATA EXTRACTION: Reviewers worked in pairs and independently extracted data and assessed the risk of bias and rated the certainty of the evidence for each outcome.

RESULTS: One hundred fifty-five trials evaluating 142 TCIM therapies were eligible for review, of which 69 (45%) trials enrolling 18,627 patients met criteria for analysis, contributing at least 80 participants or 20 events to one intervention. All the following estimates come from direct evidence, as networks were sparse. Compared with SoC or placebo, high to moderate certainty evidence showed that three TCIM add-on interventions probably reduced time to symptom resolution: Lianhua Qingwen (mean difference [MD] -2.82 days, 95% confidence interval -3.14 to -2.50, high certainty); Kovir capsule (MD -3.14 days, -3.67 to -2.61, moderate certainty); and honey and Nigella sativa (MD -3.00 days, -4.12 to -1.88, moderate certainty). Using conversion to severe cases as a proxy for hospitalization, Andrographis paniculata extract probably reduced hospital admission (risk difference -15 per 1000, -24.9 to 12.3, moderate certainty) for patients at moderate risk of hospitalization. No compelling evidence supports that any TCIM intervention reduced hospital admissions for patients at low or high risk of hospitalization, or reduced mortality and mechanical ventilation requirement across all patients. High to moderate certainty evidence showed that Lianhua Qingwen, Kovir capsule, COROPROTECT kit, and Shen Cao Gan Jiang likely did not increase adverse events leading to drug discontinuation; evidence for other TCIM interventions was insufficient to inform adverse events leading to discontinuation. High to moderate certainty evidence supported that Lianhua Qingwen was effective in resolving cough (MD -1.62 days, -1.80 to -1.45, high certainty) and probably effective in resolving fatigue (MD -1.41 days, -1.73 to -1.08, moderate certainty), honey and Nigella sativa was probably effective in resolving fever (MD -4.00 days, -4.72 to -3.28, moderate certainty), and Jinghua Jiedu was probably effective in resolving cough (MD -1.72 days, -2.23 to -1.21, moderate certainty). Other TCIM interventions were either ineffective, or of uncertain effectiveness.

CONCLUSION: Adding Lianhua Qingwen, Kovir capsule, or honey and Nigella sativa to SoC likely reduces symptomatic duration of mild/moderate acute COVID-19. Andrographis paniculata extract probably decreases hospital admissions among patients at moderate risk of hospitalization. Replication of positive findings is warranted.

REGISTRATION: PROSPERO (CRD42024517321).},
}

Humans
*Integrative Medicine/methods
*Complementary Therapies/methods
COVID-19/therapy
*COVID-19 Drug Treatment
SARS-CoV-2
Phytotherapy
Randomized Controlled Trials as Topic

@article {pmid42750687,
year = {2026},
author = {Harrison, ML},
title = {Breaking Trust: How Covid-19 Communication Failures Undermined Public Confidence in US Health Officials-A Narrative Review.},
journal = {Public health challenges},
volume = {5},
number = {3},
pages = {e70373},
pmid = {42750687},
issn = {2769-2450},
abstract = {National polling shows US citizens increasingly distrust those tasked with making our public health decisions. This dilemma appears to have been driven in part by evolving policy recommendations, communications from health officials and medical agencies that were confusing to some, and seemingly hypocritical behavior among US political leaders during the Covid-19 pandemic. The following review provides a chronological timeline of multiple pandemic-era events as well as communication and behavior missteps potentially responsible for the growing public distrust. It also suggests possible solutions to ameliorate the problem going forward.},
}

@article {pmid42750745,
year = {2026},
author = {Al Qaf'an, E and Alford, S and Mack, HA and Lim, D},
title = {Decision-Making in Public Health Crises: A Qualitative Systematic Review and Meta-Ethnography.},
journal = {Public health challenges},
volume = {5},
number = {3},
pages = {e70358},
pmid = {42750745},
issn = {2769-2450},
abstract = {INTRODUCTION: Decision-making (DM) during public health crises occurs under uncertainty, time pressure and resource constraints. Although numerous studies examine leadership and governance during crises, evidence remains fragmented and has not been systematically synthesised to integrate the DM models used in practice with the factors that shape those decisions. This qualitative systematic review addresses this gap by examining how health system leaders make decisions during public health crises.

METHODS: A qualitative systematic review using a meta-ethnographic approach was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. The protocol was registered in PROSPERO (CRD42023475382). PubMed, Medline, Embase, Scopus, Business Source, CINAHL and ProQuest were searched for English-language qualitative studies published since 1962.

RESULTS: Twenty-one studies were included with seven DM models and eight prioritised decision factors identified. Adaptive and evidence-based models predominated, reflecting the need to act under conditions of urgency while continuously incorporating emerging information. Knowledge and urgency emerged as key, interdependent drivers shaping model selection, highlighting that effective crisis DM depends not only on the choice of model but also on how the tension between rapid action and informed judgement is managed.

LIMITATIONS: Non-English literature was excluded, and the evidence base was dominated by COVID-19 studies and developed-country settings, which may limit transferability to lower resource contexts.

CONCLUSION: This review provides an integrated synthesis of DM models and prioritised decision factors during public health crises. The findings underscore the importance of strengthening real-time evidence systems and adaptive decision capacity to support timely, accountable and context-sensitive crisis decisions.},
}

@article {pmid42750993,
year = {2026},
author = {Phan, TP and Dinh, A and Dinh-Xuan, AT},
title = {Mechanisms of Mycobacterium tuberculosis disease and the impact of co-infections and post-TB complications.},
journal = {Breathe (Sheffield, England)},
volume = {22},
number = {3},
pages = {260060},
pmid = {42750993},
issn = {1810-6838},
abstract = {BACKGROUND: Mycobacterium tuberculosis (Mtb) remains a leading cause of global morbidity and mortality. Viral, bacterial, fungal, and parasitic co-infections substantially modify tuberculosis (TB) pathogenesis, and an increasingly recognised population of TB survivors develops post-TB lung disease (PTLD), which predisposes them to recurrent respiratory infections.

OBJECTIVES: To summarise current evidence on 1) Mtb pathophysiology and immunopathogenesis; 2) mechanisms by which major viral, bacterial, fungal, and parasitic co-infections alter TB progress; and 3) infectious complications associated with PTLD.

CONTENT: Mtb exploits innate immune evasion, altered macrophage activation, and granuloma remodelling in order to persist. Viral co-infections, particularly HIV, influenza, and severe acute respiratory syndrome coronavirus 2, impair T-helper 1 immunity, disrupt cytokine signalling, increase bacterial load, and drive progression to severe or disseminated TB. Bacterial pathogens (e.g. Streptococcus pneumoniae, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa) complicate diagnosis, increase severity, and contribute to antimicrobial resistance. Fungal and parasitic infections skew immunity and can delay diagnosis or reduce vaccine efficacy. PTLD results from sustained inflammation, matrix metalloproteinase activation, fibrosis, bronchiectasis, and cavitation; these structural changes favour chronic colonisation by opportunistic bacteria and long-term functional impairment.

CONCLUSIONS: TB pathogenesis is profoundly influenced by co-infections, and PTLD is an under-recognised driver of chronic respiratory morbidity. Integrated diagnostics, coordinated management of multimorbidity, and tailored strategies for PTLD are essential to reduce TB-related burden.},
}

@article {pmid42751000,
year = {2026},
author = {Frazier, K and Pulsipher, A and Orlandi, RR and Smith, KA},
title = {Temporal and Geographic Variations and Patient Factors in Acute Invasive Fungal Sinusitis: A Scoping Review.},
journal = {Therapeutic advances in allergy and rhinology},
volume = {17},
number = {},
pages = {27534030261450420},
pmid = {42751000},
issn = {2753-4030},
abstract = {BACKGROUND: The relationship between temporal and geographical variations and the incidence of acute invasive fungal sinusitis (AIFS) remains unclear. Furthermore, the impact of social determinants of health on AIFS outcomes is poorly understood. The objective of this scoping review was to summarize the literature on these topics using the Preferred Reporting Items for Systematic and Meta-Analyses Extension for Scoping Reviews guidelines.

METHODS: A scoping review was conducted using PubMed, Elsevier, and Wiley Online Library during August 2023 for articles that included the following variables related to AIFS: (1) temporal/geographic variations and (2) patient factors.

RESULTS: Sixteen studies were identified for inclusion. Associations between AIFS and COVID-19 were observed in certain geographic regions, particularly during the onset of the pandemic when high-dose oral corticosteroids were frequently used. No studies specifically examined the impact of geographic location on the incidence or outcomes in AIFS. Two studies reviewed the relationship between AIFS incidence and season, producing varied results. While both demonstrated seasonal variation in the incidence of AIFS, the findings appeared to be dependent on local climate conditions. Female sex and Black and Hispanic race appeared to be significant prognostic indicators for worse AIFS outcomes. A predominant number of studies included did not report the social determinants of health.

CONCLUSION: This review identifies a lack of comprehensive research on the role of geographic, temporal, and social determinants in AIFS and calls for further studies to bridge these knowledge gaps.},
}

@article {pmid42751095,
year = {2026},
author = {Hui, X and Gao, S and Ding, S and Li, M and Tian, X},
title = {N6-methyladenosine as a potential epitranscriptomic immune rheostat during SARS-CoV-2 infection.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1878455},
pmid = {42751095},
issn = {1664-3224},
mesh = {Humans ; *Adenosine/analogs & derivatives/immunology/metabolism/genetics ; *SARS-CoV-2/immunology ; *COVID-19/immunology/genetics ; Epitranscriptome ; Immunity, Innate/genetics ; Epitranscriptomics ; RNA Methylation ; Animals ; Signal Transduction ; Interferon Type I ; },
abstract = {N6-methyladenosine (m[6]A), the most abundant internal RNA modification in eukaryotic cells, has emerged as a critical regulator of antiviral host defense. Increasing evidence indicates that m[6]A functions beyond conventional post-transcriptional regulation by dynamically coordinating the magnitude, timing, and duration of immune responses during viral infection. In SARS-CoV-2 infection, dysregulated antiviral immunity is characterized by delayed interferon activation together with sustained inflammatory responses, suggesting the existence of regulatory mechanisms that continuously calibrate immune signaling rather than simply switching it on or off. In this review, we propose the concept of m6A as a potential "epitranscriptomic immune rheostat," representing a conceptual framework in which m6A may fine-tune antiviral immunity through coordinated regulation of RNA stability, translational efficiency, and transcript turnover. We summarize how m[6]A shapes multiple layers of innate immune responses, including pattern recognition receptor sensing, type I interferon signaling, inflammatory buffering, and immune resolution. We further discuss emerging evidence suggesting that SARS-CoV-2 infection is associated with dynamic modulation of the m[6]A regulatory machinery and viral RNA methylation landscapes, while emphasizing that many mechanistic insights remain to be experimentally validated in SARS-CoV-2 models. In addition, we highlight the interplay between m[6]A regulation and immunometabolic remodeling, while distinguishing direct SARS-CoV-2 evidence from findings derived from other viral systems or broader m[6]A biology. Selected comparisons with Influenza A virus are discussed as complementary evidence to explore potentially conserved principles of m[6]A-mediated immune regulation among RNA viruses rather than as direct evidence for SARS-CoV-2 infection. Finally, we discuss the therapeutic implications of targeting the m[6]A regulatory network to recalibrate immune responses with temporal and cellular precision, while noting that current m[6]A-targeting strategies remain at the preclinical proof-of-concept stage and require further evaluation regarding specificity, safety, and translational feasibility. Collectively, this review provides a hypothesis-driven conceptual framework for understanding how m[6]A integrates RNA fate control with antiviral immunity and immunopathology during SARS-CoV-2 infection.},
}

Humans
*Adenosine/analogs & derivatives/immunology/metabolism/genetics
*SARS-CoV-2/immunology
*COVID-19/immunology/genetics
Epitranscriptome
Immunity, Innate/genetics
Epitranscriptomics
RNA Methylation
Animals
Signal Transduction
Interferon Type I

@article {pmid42643057,
year = {2026},
author = {Henry, R and Collins, ME and Connor, KA and Gronvall, GK and Sell, TK},
title = {US Public School Operations During the COVID-19 Pandemic: A Scoping Review.},
journal = {Health security},
volume = {24},
number = {4},
pages = {311-321},
doi = {10.1177/23265094261475505},
pmid = {42643057},
issn = {2326-5108},
mesh = {Humans ; *COVID-19/prevention & control/epidemiology ; *Schools/organization & administration ; United States/epidemiology ; Quarantine ; SARS-CoV-2 ; Contact Tracing ; Education, Distance/organization & administration ; Pandemics ; },
abstract = {The COVID-19 pandemic forced the sudden closure of schools and a transition to remote learning across the United States. The suspension of in-person education not only altered the delivery of education for millions of students, but it effectively separated many students from vital services and functions that supported their ability to learn and develop. Given the unique role that schools play in educating children and young adults, as well as providing important nonacademic services, their closures led to disruptions in learning, added familial responsibilities, and reduced access to critical social services for students. The reopening of schools for in-person learning or the continuation of remote learning during a public health emergency requires careful planning and consideration to not only ensure the health and safety of students and staff, but also ensure equitable continuation of education and access to nonacademic services. We conducted a scoping review to identify and characterize the literature related to the implementation and impact of interventions and policies used to operate K-12 public schools in the United States during the first 2 years of the COVID-19 pandemic. Through thematic analysis, we found that masking, ventilation, physical distancing, testing, contact tracing, quarantine and isolation, and vaccination interventions allowed schools to safely conduct in-person learning during the pandemic. Findings from the literature suggest that there are suitable mitigation measures that allowed for the safe operation of public schools during the COVID-19 pandemic. The effective implementation of these measures required adequate resources, leadership commitment, and community buy-in.},
}

Humans
*COVID-19/prevention & control/epidemiology
*Schools/organization & administration
United States/epidemiology
Quarantine
SARS-CoV-2
Contact Tracing
Education, Distance/organization & administration
Pandemics

@article {pmid42750060,
year = {2026},
author = {Zhou, Z and Liu, Y and Yang, M and Qiu, C and Xia, J and Huang, Y and Zhou, Y},
title = {Mechanisms of antibody-dependent enhancement and its research progress in animal coronaviruses.},
journal = {Veterinary research},
volume = {57},
number = {1},
pages = {},
pmid = {42750060},
issn = {1297-9716},
support = {No.25KJA180004//Basic Science (Natural Science) Research Project of Universities in Jiangsu Province/ ; },
mesh = {Animals ; *Coronavirus Infections/veterinary/immunology/virology ; *Coronavirus/immunology ; *Antibody-Dependent Enhancement ; *Antibodies, Viral/immunology ; SARS-CoV-2 ; COVID-19/immunology ; *Betacoronavirus/immunology ; },
abstract = {Animal coronaviruses are associated with serious diseases in livestock and poultry, resulting in substantial economic losses worldwide. Antibody-dependent enhancement (ADE) is a phenomenon whereby pre‑existing pathogen specific antibodies may paradoxically exacerbate viral infections. In this review, we synthesize current classifications of ADE mechanisms, presenting a unified framework comprising two major categories subdivided into five distinct mechanistic subsets. Given the limited research on ADE in animal coronaviruses, we use SARS‑CoV‑2 as a case study to explore five potential ADE mechanisms associated with coronavirus infection. This review aims to provide a valuable reference for elucidating ADE mechanisms in animal coronaviruses.},
}

Animals
*Coronavirus Infections/veterinary/immunology/virology
*Coronavirus/immunology
*Antibody-Dependent Enhancement
*Antibodies, Viral/immunology
SARS-CoV-2
COVID-19/immunology
*Betacoronavirus/immunology

@article {pmid42750070,
year = {2026},
author = {Meyer, S and Liwanag, HJ and Schürch, K and Minder, B and von Groote, P and Schlaufer, C and Frahsa, A},
title = {Formal and informal science-policy interaction during public health emergencies of international concern: a scoping review.},
journal = {BMC global and public health},
volume = {4},
number = {1},
pages = {},
pmid = {42750070},
issn = {2731-913X},
abstract = {BACKGROUND: Interaction between science and policy might be a crucial asset for policy decisions during public health emergencies. Much work has been published about processes and forms of science-policy interaction on the one hand and challenges of public health emergency contexts on the other. However, more knowledge is needed to understand the challenges that arise when these two issues intersect.

METHODS: We conducted a scoping review informed by the Johanna-Briggs-Institute protocol and searched seven databases to identify formal and informal approaches to organising science-policy interaction. The original search was conducted in April 2022 and updated in March 2026. The searches included Embase.com, Medline, the Cochrane Library, Web of Science Social Science Citation Index, ERIC, Global Health, and Google Scholar. Systematic reviews, articles related to endemic diseases, on clinical and hospital contexts, and impact evaluations of research evidence in decision-making processes were excluded. Information on defined procedures for science policy interaction, form of interaction, selection process of interaction participants, perception of interaction, and barriers and facilitators of the interaction was extracted. Inclusion criteria were a) describe interaction/s of researcher/s and policymaker/s, and b) describe the study setting of a public health emergency. Data analysis followed qualitative content analysis.

RESULTS: 87 relevant studies were identified. Most included studies focused on the COVID-19 pandemic, with Scientific Advisory Committees (hereafter SACs) as the dominant mode of interaction. Informal mechanisms, such as committees without formal remit and unclear or undisclosed practices, were less frequently reported but played key roles. Common challenges included unclear roles, political interference, and limited communication. Key requirements are role transparency, formalisation, and institutionalisation of science-policy interaction.

CONCLUSIONS: Science-policy interactions during public health emergencies are shaped by dominant formal structures and underexplored informal practices. Strengthening inclusive, transparent, and interdisciplinary advisory systems is key to improving preparedness for future crises.},
}

@article {pmid42750274,
year = {2026},
author = {Ghafari, M and Watson, OJ and Dascalu, S and Mon, SHH and Abeler-Dörner, L and Rezaee-Zavareh, MS and Pley, C and Kordasti, S and Abbas, K and Madani, K and Panovska-Griffiths, J},
title = {Global vaccine readiness: equity-by-design in pandemic preparedness and response.},
journal = {Expert review of vaccines},
volume = {25},
number = {1},
pages = {2732508},
doi = {10.1080/14760584.2026.2732508},
pmid = {42750274},
issn = {1744-8395},
mesh = {Humans ; Pandemic Preparedness ; *COVID-19/prevention & control ; *Pandemics/prevention & control ; *Vaccine Development ; Global Health ; *Vaccines/administration & dosage ; *COVID-19 Vaccines/administration & dosage ; Public Health ; SARS-CoV-2 ; },
abstract = {INTRODUCTION: COVID-19 showed that rapid vaccine development and roll-out, while lifesaving, can still yield large, avoidable harms when equity is not considered from the outset. Disparities in vaccine timing and coverage, especially in low-resource settings, amplified health and economic burdens, highlighting the need for preparedness frameworks that combine speed with fairness.

AREAS COVERED: We synthesize evidence from literature and policy reports regarding global vaccine roll-out, focusing on avertable mortality under alternative sharing scenarios, procurement design, pooled mechanisms such as COVAX, and the role of distributed manufacturing and delivery capacity. We also examine how transparent data-sharing, effective public communication, genomic surveillance, adaptive trial designs, and modeling hubs can support more responsive and equitable vaccine deployment. Across six reflection points, we translate these lessons into practical priorities for future pandemic readiness, including strengthening healthcare infrastructure, equitable procurement, data transparency, and safeguarding public health decision-making from political and commercial distortion.

EXPERT OPINION: We argue that equity-by-design is essential if vaccine innovation is to deliver equitable public health impact. This requires geographically distributed manufacturing, transparency, equity-conditioned advance purchase agreements, and pre-agreed, epidemiology-triggered allocation of vaccines. We recommend institutionalizing disaggregated reporting, standardized data-sharing, greater pathogen genomic sequencing capacity, and communication strategies that support public health protection while countering misinformation.},
}

Humans
Pandemic Preparedness
*COVID-19/prevention & control
*Pandemics/prevention & control
*Vaccine Development
Global Health
*Vaccines/administration & dosage
*COVID-19 Vaccines/administration & dosage
Public Health
SARS-CoV-2

@article {pmid42750333,
year = {2026},
author = {Fan, Z and Chai, Y and Li, Q and Chen, Y and Gao, Z and Shi, T and Niu, J and Pu, X},
title = {[Advances in the mechanistic researches of neutrophil extracellular trap in pulmonary diseases].},
journal = {Xi bao yu fen zi mian yi xue za zhi = Chinese journal of cellular and molecular immunology},
volume = {42},
number = {9},
pages = {837-843},
pmid = {42750333},
issn = {1007-8738},
mesh = {Humans ; *Extracellular Traps/metabolism/immunology ; *Lung Diseases/immunology/metabolism ; *Neutrophils/metabolism/immunology ; Animals ; Autophagy ; Immunity, Innate ; Blood Platelets/metabolism ; },
abstract = {Neutrophil extracellular trap (NET), as an important effector mechanism of innate immunity, plays a critical regulatory role in various pulmonary diseases, including coronavirus disease-associated acute respiratory distress syndrome, bacterial pneumonia, sepsis, pulmonary fibrosis (PF), and chronic obstructive pulmonary disease. NET can be released by activated neutrophils through multiple mechanisms. Among them, classical suicidal NETosis represents one of the major pathways and contributes substantially to host defense against infection. However, the excessive accumulation of NET can lead to tissue damage, immunothrombosis, and chronic inflammation. By amplifying inflammatory cascades, disrupting tissue homeostasis, and triggering immunothrombotic processes, aberrant NET formation can also promote the development and progression of lung diseases. This review systematically summarizes the mechanisms of NET formation, metabolic regulation, autophagy, and their interactions with platelets. It provides an in-depth discussion of the roles and clinical significance of NET in both acute and chronic pulmonary diseases. Furthermore, potential therapeutic strategies targeting NET are highlighted. These strategies aim to offer new theoretical foundations and interventional perspectives for the prevention and treatment of pulmonary diseases.},
}

Humans
*Extracellular Traps/metabolism/immunology
*Lung Diseases/immunology/metabolism
*Neutrophils/metabolism/immunology
Animals
Autophagy
Immunity, Innate
Blood Platelets/metabolism

@article {pmid42739898,
year = {2026},
author = {Choudhury, S and Nawaar, N and Chowdhury, WR and Roy, P and Khan, AS and Ali, S and Zaki, RM and Raihan, T and Mishra, M and Rabbee, MF and Baek, KH},
title = {COVID-19-Associated Fungal Co-Infections: Pathogenesis, Diagnostics, Biomarkers, and Therapeutic Strategies.},
journal = {Journal of clinical medicine},
volume = {15},
number = {17},
pages = {},
pmid = {42739898},
issn = {2077-0383},
support = {PSAU/2026/R/1447//Prince Sattam Bin Abdulaziz University/ ; KFU26//King Faisal University/ ; RS-2025-02223124//Rural Development Administration/ ; },
abstract = {From a health perspective, the 21st century has witnessed the emergence and global impact of several major viral diseases, most notably coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2, which has been associated with a substantial burden of secondary fungal infections. Patients suffering from COVID-19 illnesses frequently developed fungal co-infections, which can worsen clinical outcomes and complicate therapeutic efforts. Hospitalized individuals with viral infections are particularly susceptible to invasive fungal pathogens, including Aspergillus, Candida, and Mucorales species. The co-pathogenesis between respiratory virus and fungi is complex, involving dynamic interactions among the pathogens and the host immune system. Opportunistic fungal infections were found to be more prevalent in COVID-19-infected individuals, who require mechanical ventilation, have diabetes, or exhibit neutropenia. This review aims to provide a comprehensive overview of fungal co-infections associated with COVID-19 disease, with a focus on their pathogenesis, biomarkers, diagnostic approaches, and potential treatment strategies. Overall, the available evidence indicates that viral-induced immune dysregulation, epithelial barrier damage, and clinical risk factors contribute to the development and severity of fungal co-infections in COVID-19 patients. Early recognition using reliable biomarkers and standardized diagnostic approaches, together with timely and pathogen-directed antifungal therapy, are essential for improving clinical outcomes.},
}

@article {pmid42741467,
year = {2026},
author = {Tasnim, S and Shammy, SS and Haider, N and Uddin, MJ},
title = {Epidemiology of Human Metapneumovirus Infection-A Systematic Review and Meta-Analysis.},
journal = {Health science reports},
volume = {9},
number = {9},
pages = {e73234},
pmid = {42741467},
issn = {2398-8835},
abstract = {BACKGROUND: Human metapneumovirus (hMPV) is a globally circulating respiratory pathogen. The objective of this systematic review is to evaluate the prevalence, case fatality rate, age-related severity, and seasonality of hMPV in the group of Acute Respiratory Infections (ARIs) and Community-Acquired Pneumonia (CAP).

METHODS: We conducted a systematic review and meta-analysis of articles on hMPV published from January 2001 to June 2025. Following PRISMA 2020 guidelines, we systematically searched PubMed and ScienceDirect for eligible articles using strict inclusion and exclusion criteria. Random-effects meta-analysis was performed to estimate pooled prevalence, and subgroup analyses were conducted by study group, geographic region, COVID-19 period, and age group.

RESULTS: One hundred one studies met the inclusion criteria, of which 96 contributed to the meta-analysis. The pooled global prevalence of hMPV was 6% (95% CI: 5%-7%). Prevalence estimates were highest in patients with respiratory tract infections (RTIs) patients (6%) and in South America (10%). Age-stratified analysis showed a high prevalence in children under 5 years (7%). Seroprevalence studies demonstrated low hMPV antibody prevalence in young children less than 1 year. The case fatality rate ranged from 2.5% in elderly populations to 4.4% in severe pediatric cases. hMPV mainly affects children under 2 years, with a smaller burden in older adults. Seasonal peaks were typically observed in late winter to early spring.

CONCLUSION: hMPV remains an important cause of respiratory disease worldwide, with a disproportionate burden on children. The significant heterogeneity across studies and evidence of publication bias highlight the need for standardized surveillance.},
}

@article {pmid42741759,
year = {2026},
author = {Effraimidis, G and Kasotas, A and Markantes, GK and Karapanou, O and Saltiki, K and Michalaki, M},
title = {How to manage subacute thyroiditis.},
journal = {Drugs in context},
volume = {15},
number = {},
pages = {},
pmid = {42741759},
issn = {1745-1981},
abstract = {Subacute thyroiditis (SAT) is a self-limited inflammatory thyroid disorder classically characterized by anterior neck pain, an enlarged tender thyroid, fever, fatigue, malaise, elevated inflammatory markers and a triphasic course from thyrotoxicosis through hypothyroidism to recovery. It can cause substantial morbidity and remains a frequent diagnostic challenge because it must be distinguished from acute suppurative thyroiditis, Graves' disease, painless thyroiditis, haemorrhage into a nodule and, rarely, malignant 'pseudothyroiditis' (rapidly growing carcinoma). In recent years, the recognized spectrum of triggers has expanded beyond the classical post-viral setting to include SARS-CoV-2 infection or vaccination. This review summarizes current understanding of SAT pathogenesis, including viral and post-viral mechanisms, and HLA-linked susceptibility. We outline the typical and variant clinical phenotypes, emphasising painful classical SAT, painless presentations, pregnancy-associated disease and therapy-related destructive thyroiditis. We then present a practical diagnostic framework based on clinical features, inflammatory markers, thyroid function tests, radionuclide imaging, ultrasound and fine-needle aspiration, when indicated. Management is discussed in a stepwise fashion, including NSAIDs and glucocorticoids for pain and inflammation, β-blockers for symptomatic thyrotoxicosis, selective levothyroxine replacement during the hypothyroid phase, and structured follow-up to detect recurrence and permanent hypothyroidism. Special attention is given to pregnancy and SARS-CoV-2-related SAT cases. Finally, we review long-term outcomes, recurrence risk and future research priorities. The aim is to provide a concise, clinically oriented guide to the contemporary management of SAT and to support rational, evidence-informed decision-making in routine endocrine practice.},
}

@article {pmid42741870,
year = {2026},
author = {Feige, J and Hauer, L and Sellner, J},
title = {SARS-CoV-2 management strategies in B-Cell-depleted people with multiple sclerosis: from prevention to antiviral treatment.},
journal = {Expert review of clinical immunology},
volume = {},
number = {},
pages = {1-19},
doi = {10.1080/1744666X.2026.2731966},
pmid = {42741870},
issn = {1744-8409},
abstract = {INTRODUCTION: Multiple sclerosis (MS) is a leading cause of neurological disability in young adults, necessitating early high-efficacy disease-modifying therapies (DMTs). Monoclonal antibodies targeting the CD20 antigen are a cornerstone of effective disease control, but depletion of peripheral B-cells blunts the humoral immune response. This review synthesizes current evidence on COVID-19 risk, prevention and treatment in anti-CD20-treated people with multiple sclerosis (pwMS).

AREAS COVERED: A PubMed literature search through June 2026 identified relevant studies on anti-CD20 therapies and COVID-19 in pwMS. While MS itself does not increase COVID-19 susceptibility, anti-CD20-induced immunosuppression predisposes patients to severe COVID-19 outcomes and protracted or relapsing infections. Furthermore, B-cell depletion severely impairs vaccine efficacy, leaving patients with markedly diminished or absent neutralizing antibody responses.

EXPERT OPINION: To mitigate COVID-19 risks, future strategies should focus on three pillars. First, strategic switching among anti-CD20 antibodies to improve vaccine efficacy. Second, variant-targeted monoclonal antibodies for pre- and post-exposure prophylaxis in patients lacking robust humoral responses. Finally, early administration of direct-acting small-molecule antivirals to halt viral replication before hyperinflammation. Moving forward, integrating real-world data, identifying immunogenetic risk biomarkers, and evaluating long-term combinations of vaccine-passive immunizations will help safely sustain high-efficacy MS treatments.},
}

@article {pmid42743107,
year = {2026},
author = {Valença-Pereira, F and Johnson, B and DeGregori, J and Rincon, M},
title = {Does acute inflammation triggered by infection promote cancer progression?.},
journal = {PLoS biology},
volume = {24},
number = {9},
pages = {e3003962},
pmid = {42743107},
issn = {1545-7885},
mesh = {Humans ; *Inflammation/immunology/virology/pathology/complications ; *Neoplasms/immunology/pathology/virology ; Disease Progression ; Animals ; COVID-19 ; SARS-CoV-2 ; Acute Disease ; Tumor Microenvironment/immunology ; *Coronavirus Infections/complications/immunology ; *Pneumonia, Viral/complications/immunology ; Betacoronavirus ; },
abstract = {Chronic infections are associated with cancer incidence and progression in human epidemiological data, but less is known about how such infections might promote cancer progression. Recent data implicate acute infection with common respiratory viruses, such as influenza and SARS-CoV-2, in cancer progression, providing evidence that infection-driven inflammation can promote tumor expansion and dissemination in experimental systems. The resulting acute inflammatory cascade and dynamic immune cell reprogramming can rapidly remodel the tissue microenvironment to favor cancer cell survival, growth, and evasion of immune elimination. However, acute infections can also elicit anti-tumor immune responses. Defining how infections differentially skew immune programs to promote or restrain cancer progression will therefore be essential for developing future strategies to target this disease.},
}

Humans
*Inflammation/immunology/virology/pathology/complications
*Neoplasms/immunology/pathology/virology
Disease Progression
Animals
COVID-19
SARS-CoV-2
Acute Disease
Tumor Microenvironment/immunology
*Coronavirus Infections/complications/immunology
*Pneumonia, Viral/complications/immunology
Betacoronavirus

@article {pmid42744113,
year = {2026},
author = {Persoff, J and Devereaux, A and Maves, R and Mehta, AB and Burry, L and Chakravarti, A and Levy, D and Feldman, HJ and Baez, AA and Felzer, JR and Baum, KD and Dries, DJ and Mukherjee, V and Persson, D and Conrad, TS and Hossain, T and Ghazipura, M and Anesi, GL and Ornoff, D and Freels, N and Sprung, CL and Dichter, JR},
title = {Social Media and Crisis Care Principles During Pandemics and Disasters: A Consensus Report From a Subgroup of the Task Force for Mass Critical Care.},
journal = {Chest},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.chest.2026.08.049},
pmid = {42744113},
issn = {1931-3543},
abstract = {BACKGROUND: Effective communication and coordination are fundamental determinants of the healthcare system's performance during disasters. Failures in these domains during COVID-19 contributed to disrupted care delivery, strained staff, resource shortages, and adverse patient outcomes.

RESEARCH QUESTION: Drawing on pandemic lessons, the Task Force for Mass Critical Care (TFMCC) conducted a comprehensive assessment of peer-reviewed literature, gray sources, and firsthand experience using a modified Delphi process to develop consensus-based suggestions to strengthen communication strategies and operational coordination.

STUDY DESIGN AND METHODS: Methodological frameworks from the World Health Organization and Guidelines International Network-McMaster Guideline Development Checklist for rapid guidelines were merged to establish a consensus development process, integrating evidence synthesized from the literature with expert opinions. The previously described process used a three-round modified Delphi approach to synthesize published evidence, collect anecdotal evidence, and develop suggestions.

RESULTS: A total of 147 evidence statements were evaluated, resulting in 22 suggestions substantiated by other supporting literature and anecdotal experiences. The TFMCC identified transparent, timely, and scientifically grounded public communication with proactive engagement through social media as indispensable for information dissemination and misinformation mitigation. Planning and coordination across federal, state, regional, and hospital systems are critical for effective disaster response, which depends on standardized crisis care frameworks, Medical Operations Coordination Centers, and interoperable health information systems enabling real-time situational awareness. Important findings include community engagement, equitable resource allocation, accessible communication strategies, and processes to avoid restrictive visitation policies that can impede surrogate decision-making. Finally, integrating emergency department expertise into hospital incident command and strengthening the "last mile" of supply-chain distribution are necessary to sustain clinical operations.

INTERPRETATION: Communication and coordination are core operational priorities during disaster response, emphasizing their impact on patient outcomes, system performance, and public trust. Communication and coordination systems require sustained investments in interorganizational relationships and public engagement.},
}

@article {pmid42744165,
year = {2026},
author = {Aashaq, S and Rakhshan, R and Rafiq, A and Ali, M and Beigh, MA},
title = {Multifaceted signaling of the cell surface receptor neuropilin-1 (NRP1): pathophysiological roles and therapeutic potential.},
journal = {Gene},
volume = {},
number = {},
pages = {150400},
doi = {10.1016/j.gene.2026.150400},
pmid = {42744165},
issn = {1879-0038},
abstract = {Neuropilin-1 (NRP1) is a developmentally conserved cell surface receptor that functionally acts to bind various ligands like class 3 semaphorins and several members of the VEGF family to engage in different signaling pathways that control cell migration and motility. Due to its widespread expression, NRP1 is implicated in immune function, axonal guidance, viral entry, tumor progression and angiogenesis. NRP1 is dysregulated across multiple cancer types and promotes tumor progression in a context-dependent manner in tumor cells and the tumor microenvironment, including endothelial, stromal, and immune-cell compartments. NRP1 is also involved in different autoimmune disorders, anosmia, and cardiovascular disorders. Phage display studies revealed that peptides containing C-terminal CendR motifs engage NRP1 for tissue penetration. Apart from cell-penetrating peptides, monoclonal antibodies against NRP1 also present a promising target for cancer therapeutics. Importantly, NRP1 in SARS-CoV-2 infection act as an auxiliary host factor, and furin cleavage of the viral spike protein exposes a C-terminal CendR motif that can bind NRP1, thereby facilitating viral entry. However, NRP1 is not an independent receptor comparable to ACE2, thus, NRP1-targeted antiviral strategies need further investigations. Given the above, the review provides comprehensive narrative of different signaling mechanisms of NRP1 in different diseases and how this cell surface receptor can be utilized in various therapeutic approaches to combat these diseases.},
}

@article {pmid42744480,
year = {2026},
author = {Lehmann, K and Wang, YF and Mamri, A and Brown, TG and Vanlaar, W and Batomen, B and Ouimet, MC and Nazif-Munoz, JI},
title = {Enhancing crisis resilience for future emergencies: A rapid review of road safety outcomes and reported measures during the COVID-19 pandemic.},
journal = {Journal of safety research},
volume = {98},
number = {},
pages = {265-275},
doi = {10.1016/j.jsr.2026.07.007},
pmid = {42744480},
issn = {1879-1247},
mesh = {Humans ; *Accidents, Traffic/prevention & control/statistics & numerical data ; *COVID-19/epidemiology ; Emergencies ; Pandemics ; *Safety ; },
abstract = {BACKGROUND AND OBJECTIVES: The COVID-19 pandemic disrupted mobility patterns and road usage, raising significant road safety concerns. It remains unclear whether governments worldwide implemented effective road safety measures (RSMs) to address the resulting fluctuations in traffic collisions, injuries, and fatalities. This study aims to: (a) identify global RSMs implemented, discussed or proposed during the pandemic to mitigate traffic-related incidents, and (b) explore their relevance, precision, and applicability in future crises.

METHODS: A systematic search of public health, transportation, and multidisciplinary databases (PubMed and Scopus) was conducted for studies published between 2019 and the present. This rapid review followed PRISMA and Cochrane Collaboration rapid review guidelines and was registered with PROSPERO (CRD420250599564). Inclusion criteria encompassed observational and quasi-experimental studies examining road safety measures implemented or proposed during the COVID-19 pandemic to address traffic-related incidents. Study selection and data extraction were conducted systematically, and findings were synthesized narratively.

RESULTS: Twenty-nine studies (published between 2020 and 2024) were included in the review. Findings highlight five key research clusters: (1) changes in crash frequency and severity, (2) risky driving behaviors, (3) regional variation in RSMs, (4) innovative measurement methods, and (5) crisis-responsive interventions. RSMs identified during the pandemic include speed control, traffic flow management, and protection of vulnerable road users, with a strong focus on data-driven approaches. However, some measures, especially behavioral interventions, remain underdeveloped and need further evaluation.

CONCLUSION: This review highlights the need for a comprehensive, crisis-resilient road safety approach integrating enforcement, behavioral interventions, and infrastructure improvements. This approach should not only address immediate crises but also support long-term road safety enhancements and preparedness for future public health emergencies.},
}

Humans
*Accidents, Traffic/prevention & control/statistics & numerical data
*COVID-19/epidemiology
Emergencies
Pandemics
*Safety

@article {pmid42745337,
year = {2026},
author = {Rossanese, A and Tomasi, A},
title = {Travel vaccination in senior travelers: current evidence, challenges, and prevention.},
journal = {Tropical diseases, travel medicine and vaccines},
volume = {12},
number = {1},
pages = {},
pmid = {42745337},
issn = {2055-0936},
abstract = {The substantial number of older adults undertaking international travel has increased the relevance of pre-travel prevention in this population. However, vaccination strategies in this group require consideration of immune aging, baseline status, medication use, and travel-related exposure. This narrative review summarizes the current evidence on vaccination in senior travelers, with particular attention to the vaccines most relevant to this population, the differences in the strength of evidence across vaccines, and the clinical factors that should guide pre-travel decision-making. Routine vaccines, including influenza, COVID-19, pneumococcal, respiratory syncytial virus, herpes zoster, and tetanus-diphtheria vaccines, constitute an essential part of pre-travel assessment, whereas travel-specific vaccines, such as hepatitis A, hepatitis B, typhoid, rabies, Japanese encephalitis, tick-borne encephalitis, and cholera, should be considered according to the destination, itinerary, expected exposure, and time before departure. Yellow fever vaccination represents a particular clinical challenge because advancing age is associated with a greater risk of serious vaccine-associated adverse events, making individualized risk‒benefit assessment essential. Recently introduced dengue and chikungunya vaccines should also be considered on an individualized basis, taking into account exposure risk, potential benefits, comorbidities, and the current limitations of the available evidence. The review also highlights the importance of integrating vaccination with non-vaccine preventive strategies, including food and water precautions, vector avoidance, and hygiene measures. Although the evidence base has expanded, important uncertainties remain, particularly because age-specific data are limited and frail older adults remain underrepresented in clinical studies. Overall, pre-travel care for senior travelers should be comprehensive, exposure-based, and individualized according to the clinical profile and travel characteristics of each traveler.},
}

@article {pmid42745812,
year = {2026},
author = {Tieu, KDB and Agyapong-Opoku, F and Agyapong, B},
title = {The use of chatbots as interventions for mental health conditions: scoping review of systematic reviews and meta-analyses.},
journal = {Frontiers in digital health},
volume = {8},
number = {},
pages = {1789599},
pmid = {42745812},
issn = {2673-253X},
abstract = {BACKGROUND: During the COVID-19 pandemic, the use of mental health chatbots received potential attention as a means of addressing the increase in demand for mental healthcare, which has become inaccessible due to a shortage of healthcare workers and lockdown. Even after the pandemic, chatbot versatility holds the potential to address the ongoing limited accessibility of mental healthcare due to a shortage of professionals, geographical challenges, cost, or stigma.

OBJECTIVE: This review examines the scope and nature of the systematic review and meta-analysis evidence on chatbot interventions for mental health.

METHOD: This scoping review follows Arksey and O'Malley's five-step guide and was reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for scoping reviews (PRISMA-ScR). The following databases were used to conduct all systematic literature searches: PubMed, Scopus, Medline, and Web of Science. Inclusion criteria include systematic reviews and meta-analyses, written in English, that focus on the use of chatbots as an intervention for mental conditions, with all primary articles being relevant. A total of 14 articles were relevant and included in the data extraction and analysis.

RESULTS: It was found that although current review-level evidence suggests potential short-term benefits, there was a discrepancy regarding the specific conditions under which chatbots are effective. Moreover, the use of chatbots for symptom improvement is still inconclusive, since there are issues with important aspects such as unclear risk of bias, lack of longitudinal studies, and lack of comparison with traditional therapy.

CONCLUSION: There is potential for chatbot implementation as an intervention for mental conditions. However, this is still at its early stages of development and requires more research to improve communication quality and ensure safety, which is paramount when communicating with vulnerable patients. The findings of the review provide a useful foundation for informing clinical practice, policy, and future research.},
}