@article {pmid42323864,
year = {2026},
author = {Cilloniz, C and Ho, A and Rhee, C},
title = {Human metapneumovirus: an underestimated cause of severe respiratory infection.},
journal = {Annals of the American Thoracic Society},
volume = {23},
number = {10},
pages = {1414-1426},
doi = {10.1093/annalsats/aaoag172},
pmid = {42323864},
issn = {2325-6621},
support = {MC_UU_00034/6//MRC/ ; },
mesh = {Humans ; *Metapneumovirus ; *Paramyxoviridae Infections/epidemiology/diagnosis/prevention & control/therapy ; *Respiratory Tract Infections/virology/epidemiology/diagnosis ; COVID-19/epidemiology ; SARS-CoV-2 ; Pandemics ; Pneumonia, Viral/epidemiology ; Hospitalization/statistics & numerical data ; },
abstract = {Since its identification in 2001, human metapneumovirus (hMPV) has been recognized as an important cause of acute respiratory tract infection in all age groups. Although infection is often mild in healthy adults, hMPV can cause severe lower respiratory tract disease, including pneumonia, in young children, older adults, individuals with chronic diseases and immunocompromising conditions, and residents of long-term care facilities. Accumulating evidence demonstrates that hMPV contributes substantially to hospitalization, intensive care unit admission, and mortality in these high-risk populations. Globally, hMPV circulates seasonally, most commonly in late winter and spring, contributing to both community- and healthcare-associated respiratory infections; however, the COVID-19 pandemic disrupted established epidemiology, resulting in shifts in epidemic timing, off-season resurgences, genotype replacement, and increased overlap with other respiratory viruses, while also providing insights into viral interference and multivirus cocirculation. Clinical manifestations of hMPV overlap with other respiratory viruses, including influenza virus and SARS-CoV-2, and selective diagnostic practices contribute to underrecognition and undertesting. Although no specific antiviral therapies or licensed vaccines are currently available, identification of hMPV has important implications for diagnostic accuracy, prognosis, antimicrobial stewardship, and infection prevention, particularly in hospital and long-term care settings. This review summarizes current evidence on the virology, epidemiology, post-COVID-19 trends, clinical manifestations, outcomes, diagnosis, and prevention of hMPV, with a particular focus on adults and other high-risk populations. We also review the current landscape of hMPV vaccine development and its potential implications for clinical practice and public health.},
}

Humans
*Metapneumovirus
*Paramyxoviridae Infections/epidemiology/diagnosis/prevention & control/therapy
*Respiratory Tract Infections/virology/epidemiology/diagnosis
COVID-19/epidemiology
SARS-CoV-2
Pandemics
Pneumonia, Viral/epidemiology
Hospitalization/statistics & numerical data

@article {pmid42403377,
year = {2026},
author = {Das, B and Moodley, M},
title = {Post-COVID paediatric dysautonomia: never the heart, always the brain-myth or maxim?.},
journal = {Cardiology in the young},
volume = {36},
number = {7},
pages = {1329-1339},
doi = {10.1017/S1047951126113900},
pmid = {42403377},
issn = {1467-1107},
mesh = {Humans ; *Primary Dysautonomias/diagnosis/physiopathology/therapy/etiology/epidemiology ; Child ; *COVID-19/complications/epidemiology ; Post-Acute COVID-19 Syndrome ; Adolescent ; SARS-CoV-2 ; },
abstract = {Paediatric dysautonomia has become increasingly recognised in children and adolescents, particularly in the post-COVID era. Affected patients commonly present with dizziness, palpitations, exercise intolerance, fatigue, and syncope, although reported prevalence varies widely because of evolving definitions and heterogeneous referral patterns. Contemporary evidence suggests that post-COVID dysautonomia arises from complex interactions among central autonomic network dysfunction, neurovascular dysregulation, impaired venous return, endothelial injury, hypovolemia, and altered cerebral perfusion, with tachycardia often representing a compensatory physiological response rather than a primary cardiac abnormality. Clinical phenotypes include postural orthostatic tachycardia syndrome, neurocardiogenic syncope, orthostatic hypotension, inappropriate sinus tachycardia, and undifferentiated orthostatic intolerance, frequently accompanied by fatigue, cognitive dysfunction, gastrointestinal symptoms, sleep disturbances, and post-exertional symptom exacerbation. Paediatric dysautonomia is best conceptualised as a distributed brain-heart-vascular network disorder that requires mechanistic understanding, standardised orthostatic assessment, and careful exclusion of structural heart disease and arrhythmia. The rapid expansion of specialised dysautonomia programmes and direct-to-consumer diagnostic pathways has also contributed to broader, and occasionally premature, application of autonomic diagnoses. Management should follow a stepwise, mechanism-guided approach emphasising patient education, trigger avoidance, hydration and salt optimisation, lower-body compression, individualised exercise rehabilitation, pacing strategies when post-exertional symptom exacerbation is present, school accommodations, and phenotype-directed pharmacotherapy for persistent functional impairment. Although post-COVID dysautonomia shares features with established paediatric autonomic disorders, important gaps remain in disease definitions, mechanistic understanding, and evidence-based treatment, underscoring the need for multidisciplinary care, standardised diagnostic frameworks, and prospective paediatric research.},
}

Humans
*Primary Dysautonomias/diagnosis/physiopathology/therapy/etiology/epidemiology
Child
*COVID-19/complications/epidemiology
Post-Acute COVID-19 Syndrome
Adolescent
SARS-CoV-2

@article {pmid42720199,
year = {2026},
author = {Januszewski, M and Ziuzia-Januszewska, L and Jakimiuk, AJ},
title = {COVID-19 and pregnancy: is a "forgotten" disease still a threat?.},
journal = {Ginekologia polska},
volume = {97},
number = {9},
pages = {768-774},
doi = {10.5603/gpl.110960},
pmid = {42720199},
issn = {2543-6767},
mesh = {Humans ; Female ; Pregnancy ; *COVID-19/prevention & control/epidemiology/complications/transmission ; *Pregnancy Complications, Infectious/prevention & control/epidemiology/virology ; SARS-CoV-2 ; Infectious Disease Transmission, Vertical/prevention & control ; Pregnancy Outcome ; Maternal Mortality ; },
abstract = {Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has significantly affected global health, including maternal and perinatal outcomes. Although the acute phase of the pandemic has subsided, the continued emergence of new viral variants, waning population immunity, and suboptimal vaccination coverage among women of reproductive age suggest that COVID-19 in pregnancy may remain a clinically relevant problem. This review summarizes current evidence regarding the clinical course, complications, and prevention of SARS-CoV-2 infection during pregnancy, addressing whether COVID-19 should be considered a "forgotten" obstetric disease. Most pregnant women develop asymptomatic or mild infection; however, pregnancy is associated with an increased risk of severe disease, intensive care unit admission, mechanical ventilation, and maternal mortality, particularly among women of advanced maternal age, with obesity, comorbidities, or without vaccination. SARS-CoV-2 infection during pregnancy is consistently linked with a higher incidence of preeclampsia, including severe forms such as eclampsia and HELLP syndrome, increased rates of cesarean delivery and, in many populations, preterm birth. Vertical transmission is uncommon but documented. Severe placental involvement, referred to as COVID-19 placentitis, may result in placental insufficiency, fetal hypoxia, and stillbirth. Expression of angiotensin-converting enzyme 2 within the placenta provides a biological basis for viral tropism and potential disruption of placental defense mechanisms, contributing to adverse perinatal outcomes. COVID-19 vaccination before conception, during pregnancy, and throughout breastfeeding is safe and effective. Immunization significantly reduces the risk of severe maternal disease, preterm birth, emergency cesarean delivery, stillbirth, and neonatal hospitalization, while also conferring passive protection to infants. Maintaining up-to-date vaccination remains essential for preventing maternal and perinatal complications associated with SARS-CoV-2 infection.},
}

Humans
Female
Pregnancy
*COVID-19/prevention & control/epidemiology/complications/transmission
*Pregnancy Complications, Infectious/prevention & control/epidemiology/virology
SARS-CoV-2
Infectious Disease Transmission, Vertical/prevention & control
Pregnancy Outcome
Maternal Mortality

@article {pmid42800936,
year = {2026},
author = {Syailatussuraya, MS and Mutakin, M and Asman, S and Hasanah, AN},
title = {Piperine: From Green Extraction to Clinical Translation-A Review.},
journal = {Drug design, development and therapy},
volume = {20},
number = {},
pages = {639169},
pmid = {42800936},
issn = {1177-8881},
mesh = {*Benzodioxoles/pharmacology/isolation & purification/chemistry/pharmacokinetics ; *Alkaloids/pharmacology/isolation & purification/chemistry/pharmacokinetics ; *Polyunsaturated Alkamides/pharmacology/isolation & purification/chemistry/pharmacokinetics ; Humans ; *Piperidines/pharmacology/isolation & purification/chemistry/pharmacokinetics ; Animals ; *Green Chemistry Technology ; },
abstract = {BACKGROUND: Piperine has diverse pharmacological and bioenhancing activities, but poor aqueous solubility, variable exposure, interaction liability, and discontinuity across production, formulation, and clinical evaluation limit translation. This review integrates these frequently separated stages.

METHODS: A structured narrative PubMed search covered English-language studies published from 1 January 2021 to 27 April 2026, supplemented by ClinicalTrials.gov records checked through 13 June 2026, backward citation searching, and selected earlier seminal studies. Evidence was synthesized by experimental level, methodological limitations, and translational relevance.

KEY FINDINGS: In one solvent-circulation study, response surface methodology optimization increased the reported piperine yield from 3.87% to 5.20% of dry material, although external batch or production-scale validation was not reported. In rats, a solid piperine self-nanoemulsifying drug delivery system produced 4.92-fold higher relative oral bioavailability than pure piperine dispersion, without human pharmacokinetic validation. Preclinical studies reported anticancer, anti-inflammatory, neuroprotective, anti-infective, and metabolic effects. Head-and-neck cancer-cell IC50 ranges were 102.8-176.0 µM in HEp-2 cells and 121.0-249.9 µM in SCC-25 cells, without exposure-matched in vivo confirmation. Published trials included COVID-19 (n=140), sepsis (n=66), and ischemic stroke (66 randomized; 56 completed); these trials evaluated curcumin-piperine combinations. A 2025 meta-analysis of 18 curcuminoid-piperine trials reported pooled reductions in AST and IL-6 but not ALT, ALP, CRP, or TNF-α.

CHALLENGES: Extraction comparisons were limited by differences in botanical material, process conditions, and analytical methods. Other gaps included production-to-formulation continuity, stand-alone human exposure-response data, substrate-dependent interactions, long-term safety, and predominantly small or combination-based clinical studies.

CONCLUSION: Current evidence supports further development but not established stand-alone pharmaceutical efficacy. Translation requires standardized materials, scalable production, exposure-guided formulations, longer-term safety and interaction studies, and adequately powered trials with piperine-specific comparators.},
}

*Benzodioxoles/pharmacology/isolation & purification/chemistry/pharmacokinetics
*Alkaloids/pharmacology/isolation & purification/chemistry/pharmacokinetics
*Polyunsaturated Alkamides/pharmacology/isolation & purification/chemistry/pharmacokinetics
Humans
*Piperidines/pharmacology/isolation & purification/chemistry/pharmacokinetics
Animals
*Green Chemistry Technology

@article {pmid42800997,
year = {2026},
author = {Far, SST and Alizadeh, M and Kharazmi, E and Kavosi, Z},
title = {An Investigation of the Factors Reducing the Use of Hospital Services: A Systematic Review.},
journal = {Health science reports},
volume = {9},
number = {10},
pages = {e73220},
pmid = {42800997},
issn = {2398-8835},
abstract = {BACKGROUND AND AIMS: Hospital service utilization has declined in many health systems due to policy shifts, limited resources, and alternative care approaches. This study aimed to systematically review the factors contributing to a reduction in the use or volume of hospital services.

METHODS: In this systematic review, articles published from 2018 to 2023 were reviewed by searching relevant keywords based on the PRISMA guidelines. The systematic search was conducted using English-language texts related to the research question, "What are the factors reducing hospital services?" and electronic databases such as PubMed, Scopus, Science Direct, ProQuest, and Web of Science. The CASP checklist was used to evaluate the methodological quality of the included studies. Two researchers performed all the stages; finally, the selected articles were summarized in tables.

RESULTS: The database search yielded a total of 3705 articles, of which 30 were included in the review. The results of extracting the findings from the articles indicated four main concepts of factors reducing hospital services: "therapeutic factors," "administrative-support factors," "preventive factors," and "technological factors." The studies assessed the impact of medications, treatment pathways, guidelines and standards, and treatment methods as effective therapeutic factors. Regulations were considered administrative or support factors, while health measures to control the spread of COVID-19 and various vaccines were shown as preventive factors. Additionally, remote care and the use of new tools were categorized as technological factors influencing the reduction of hospital services.

CONCLUSION: Therapeutic factors such as medications, managerial factors like regulations, preventive factors like vaccines, and factors related to new tools such as artificial intelligence were shown to be among the factors which reduce the use of hospital services. Therefore, if the focus on reducing services is hospital-centered, these factors should be considered in policy-making related to health service delivery.},
}

@article {pmid42801203,
year = {2026},
author = {Ardila Jara, AR and Barbosa Malagon, C and Castillo Moreno, LD and Rojas, FA and Beltrán Rojas, GC and Medina Adam, A and Romero Troya, MJ and Aguiar Martinez, LG},
title = {Left Without Being Seen: A Scoping Review of a Silent Crisis in Emergency Departments.},
journal = {Open access emergency medicine : OAEM},
volume = {18},
number = {},
pages = {604937},
pmid = {42801203},
issn = {1179-1500},
abstract = {BACKGROUND: Left Without Being Seen (LWBS) rates are widely recognized as a key quality indicator in Emergency Departments (ED) worldwide. Their clinical relevance is substantial, given the documented association between LWBS and increased morbidity and mortality among patients presenting to the ED. However, the available evidence is extensive and highly heterogeneous; therefore, a scoping review represents a more appropriate approach for synthesizing the evidence than a systematic review or meta-analysis.

OBJECTIVE: This scoping review aims to synthesize current evidence regarding population characteristics, underlying determinants, and potential interventions associated with LWBS rates, pondering the need to strengthen strategies for identifying and reducing these events.

DESIGN: Scoping review conducted according to PRISMA-ScR guidelines. We searched four databases (PubMed, Scopus, Oxford Academic, and EBSCO) between Jan 01, 2020 - Dec 31,2025. To meet the eligibility criteria, studies were required to be observational analytical, interventional, or evidence synthesis, given the limited evidence found, posters involving studies of human participants in ED settings.

RESULTS: Ninety-four publications were included with de eligibility criteria Most studies were interventional and conducted in North America; however, systematic reviews and additional studies from Europe, Asia, Australia, South America, and the Middle East were also identified. Reported LWBS rates varied widely across settings and were influenced by both community-level and individual-level factors, including demographic characteristics, EDs staffing, time of presentation, chief complaint, and facility resources, as well as contextual factors such as the COVID-19 pandemic. The available evidence demonstrated considerable heterogeneity in the definition and characterization of LWBS causes, largely due to differences in reporting practices, documentation, and descriptions of events related to this outcome. Numerous interventions aimed at reducing LWBS rates were described.

CONCLUSION: LWBS is a key emergency care quality indicator driven by waiting times, crowding, and temporal factors. It predominantly affects low-acuity, socioeconomically vulnerable adults. Physician-in-triage reduces LWBS, while predictive models identify high-risk patients. Associated with revisits and mortality, LWBS requires flow optimization and context-adapted strategies. Standardized frameworks are needed to strengthen evidence.},
}

@article {pmid42803424,
year = {2026},
author = {McGannan, M and Barber-Fleming, V and Fearon, D and Grant, L},
title = {A decade of palliative care needs in humanitarian settings: A systematic scoping review of literature between 2012 and 2022.},
journal = {Palliative & supportive care},
volume = {24},
number = {},
pages = {e238},
doi = {10.1017/S1478951526103617},
pmid = {42803424},
issn = {1478-9523},
mesh = {Humans ; *Palliative Care/trends/methods ; *Altruism ; *Health Services Needs and Demand/trends ; COVID-19 ; },
abstract = {OBJECTIVES: To better understand the palliative care needs of people with serious and/or chronic conditions, and their families, in humanitarian settings in low-and middle-income countries between 2012 and 2022.

METHODS: A systematic scoping review methodology was employed to enable a wide-ranging search of this under-researched area. Databases and websites were systematically searched, in addition to correspondence to key experts.

RESULTS: Eighty-eight documents were included, comprising 63 publications in peer-reviewed journals, 5 conference abstracts, 4 conference posters, 7 case reports, 5 reports, 2 research snapshots, 1 survey report, and 1 master's thesis. The majority of literature was from the Public Health Emergency setting including 42 documents related to COVID and 30 to Ebola. Significantly less literature was identified from other settings: refugee populations (n = 10), multiple settings (n = 3), natural disaster contexts (n = 2), and conflict settings (n = 1). Sixty-four documents considered patient needs, 17 considered combined patient/family needs and 7 focused on family needs. Forty-six documents focused on adults, 25 on adults/children, 6 on children with 11 having no age specification. Findings from individual humanitarian contexts were mapped to palliative care domains and themes presented narratively.

SIGNIFICANCE OF RESULTS: The literature from Public Health Emergencies (Ebola and COVID) overshadowed other humanitarian contexts, demonstrating the comparative paucity of research in refugee, natural disaster, and conflict settings. The voice of children appeared under-represented, as did the perspective of family/caregivers. While there was strong research on pain and physical symptoms, holistic needs were also identified, highlighting the diversity of palliative care needs in humanitarian settings.},
}

Humans
*Palliative Care/trends/methods
*Altruism
*Health Services Needs and Demand/trends
COVID-19

@article {pmid42804114,
year = {2026},
author = {Wu, Z and Lou, J and Cheng, Y and Li, M and Wang, Z and Liu, N and Gao, X and Zheng, A and Zhang, H},
title = {mRNA lipid nanoparticle vaccines: current status, challenges and future prospects.},
journal = {Molecular biomedicine},
volume = {7},
number = {1},
pages = {},
pmid = {42804114},
issn = {2662-8651},
support = {82473861//Innovative Research Group Project of the National Natural Science Foundation of China/ ; },
mesh = {Humans ; *COVID-19 Vaccines/immunology ; *Lipids/chemistry ; *Nanoparticles/chemistry ; Nanovaccines ; *RNA, Messenger/chemistry/immunology/genetics ; Animals ; *COVID-19/prevention & control/immunology ; SARS-CoV-2/immunology ; Vaccines, Synthetic/immunology ; Liposomes ; },
abstract = {mRNA vaccines have become a clinically validated vaccine platform, as demonstrated by the success of COVID-19 vaccines such as Comirnaty and Spikevax, owing to their rapid design, manufacturing scalability, and capacity to induce in situ antigen expression. A key factor underlying this success is the lipid nanoparticle (LNP) delivery system, which protects mRNA from degradation and promotes efficient cellular uptake and cytoplasmic delivery, thereby enabling the full potential of mRNA technology. The continued advancement of mRNA-LNP vaccines requires integrated optimization of mRNA design, LNP composition, and delivery strategies to achieve improved stability, efficient intracellular delivery, and balanced immune responses. Despite remarkable progress, challenges related to formulation stability, long-term storage stability, safety and reactogenicity concerns, and durability of immune protection continue to hinder the broader application of mRNA-LNP vaccine platforms. This review provides an integrated overview of recent advances in mRNA-LNP vaccines, covering mRNA molecular engineering, LNP composition and delivery mechanisms, immune responses, clinical progress, and current developmental challenges. Furthermore, emerging strategies, including thermostable formulations, next-generation LNPs with improved targeting capability, emerging RNA platforms, and artificial intelligence-assisted optimization of RNA sequences and lipid materials, are discussed. By summarizing current achievements and future opportunities, this review highlights key principles guiding the rational design of safer, more stable, and more precise mRNA-LNP vaccine platforms and provides insights into accelerating their clinical translation.},
}

Humans
*COVID-19 Vaccines/immunology
*Lipids/chemistry
*Nanoparticles/chemistry
Nanovaccines
*RNA, Messenger/chemistry/immunology/genetics
Animals
*COVID-19/prevention & control/immunology
SARS-CoV-2/immunology
Vaccines, Synthetic/immunology
Liposomes

@article {pmid42804126,
year = {2026},
author = {Murugan, AK and Afnan, R and Alzahrani, AS},
title = {COVID-19 vaccine-associated autoimmune thyroid eye disease: Graves' orbitopathy.},
journal = {Endocrine},
volume = {91},
number = {1},
pages = {},
pmid = {42804126},
issn = {1559-0100},
mesh = {Humans ; *Graves Ophthalmopathy/etiology/immunology/chemically induced/epidemiology ; *COVID-19 Vaccines/adverse effects ; *COVID-19/prevention & control ; Risk Factors ; SARS-CoV-2 ; Autoimmune Diseases ; },
abstract = {Thyroid eye disease (TED) is an autoimmune disorder commonly associated with hyperthyroidism of Graves' disease. The global outbreak of SARS-CoV-2 resulted in an unparalleled public health emergency. The rapid development and widespread administration of COVID-19 vaccines were instrumental in controlling viral transmission and decreasing severe disease outcomes and deaths. Although these vaccines have demonstrated strong safety and effective prevention, isolated cases of uncommon adverse events have been reported. Notably, instances of new-onset or worsening autoimmune disorders, including TED, after vaccination have drawn considerable research interest. In this review, we describe the common risk factors (age, sex, genetics, ethnicity, dysthyroid status, high serum cholesterol, oxidative stress, pregnancy, psychological stress, radioiodine therapy, trauma, systemic disease, and virus) of TED and outline the constituents of COVID-19 vaccines and the current global vaccination scenario. We further explain autoimmune mechanisms as central drivers of classical TED, particularly through the activation of autoreactive T-cells and the production of autoantibodies targeting shared antigens in orbital fibroblasts, leading to inflammation, tissue remodeling, and orbital expansion. Besides, we discuss molecular signaling (MAPK, PI3K/Akt, NF-κB, and JAK/STAT) implicated in TED. Moreover, we critically examine published case reports (n = 30) to identify shared features and potential factors associated with the onset of this autoimmune condition. We delineate the autoimmune-mediated molecular mechanisms in the development of COVID-19 vaccine-associated TED. The therapeutic management approaches and clinical outcomes related to COVID-19 vaccine-associated TED are also thoroughly examined and discussed. Improved understanding of these mechanisms may refine patient risk stratification, optimize clinical management, and inform vaccination strategies.},
}

Humans
*Graves Ophthalmopathy/etiology/immunology/chemically induced/epidemiology
*COVID-19 Vaccines/adverse effects
*COVID-19/prevention & control
Risk Factors
SARS-CoV-2
Autoimmune Diseases

@article {pmid42804450,
year = {2026},
author = {Johnson, G and Edwards, S and Jarman, H and Peel, E and Pino, M},
title = {Understanding delivery of bad news in the emergency department: A scoping review.},
journal = {PloS one},
volume = {21},
number = {9},
pages = {e0358343},
pmid = {42804450},
issn = {1932-6203},
mesh = {Humans ; *Emergency Service, Hospital ; *Truth Disclosure ; Communication ; *COVID-19 ; },
abstract = {BACKGROUND: Breaking bad news is a core component of emergency care, but the emergency department (ED) environment of urgency, crowding, and limited privacy presents challenges for sensitive communication. Many communication frameworks originate from other specialities, but the ED has limited evidence and guidance tailored to its context.

OBJECTIVE: This scoping review aimed to map the extent, nature, and characteristics of the literature on delivery of bad news in EDs, including terminology, frameworks, stakeholder perspectives, barriers and facilitators, educational resources, reported metrics, and evidence gaps.

METHODS: The review followed Joanna Briggs Institute (JBI) methodology and was prospectively registered on the Open Science Framework (OSF https://osf.io/f6q59/overview). Four databases (MEDLINE, EMBASE, EMCARE, CINAHL) and grey literature sources were searched in July 2025. Eligible sources included empirical studies, training evaluations, reviews, guidelines, consensus statements, editorials, commentaries, opinion pieces, educational articles, conference abstracts, and relevant grey literature reporting on adult patients, relatives, or clinicians in ED contexts. Data were charted and synthesised narratively.

RESULTS: From 7985 records, 156 publications were included. Studies originated from 26 countries, though the United States of America (USA) (n = 85) and United Kingdom (UK) (n = 18) dominated the literature. There was a rise in publications from 2010, particularly post-COVID-19. Twenty-five communication frameworks were identified; most were adapted from oncology (with SPIKES most frequently cited). Three frameworks developed specifically for ED practice (GRIEV_ING, 8S, EMTalk) were identified. Stakeholder perspectives were unevenly represented, with a predominance of healthcare professional perspectives. Reported metrics centred on clinician confidence; patient- and family-centred studies were uncommon. Barriers to effective communication consistently included time scarcity, lack of privacy, and insufficient training.

CONCLUSIONS: Research on delivering bad news in EDs is dominated by educational and simulation-based studies, and is largely clinician-centred, with limited evidence of patient and family perspectives, with no studies examining long-term outcomes. Reliance on frameworks from other specialties risks overlooking the contextual specifics of emergency care. Future research should prioritise ED-centred frameworks, patient outcomes, and systemic enablers to support compassionate, effective communication in this demanding environment.},
}

Humans
*Emergency Service, Hospital
*Truth Disclosure
Communication
*COVID-19

@article {pmid42805095,
year = {2026},
author = {Malik, ZK and Ahmad, K and Ahmed, S},
title = {AI-driven drug repurposing: Methods, platforms, and translational applications.},
journal = {Computational biology and chemistry},
volume = {126},
number = {Pt 1},
pages = {109444},
doi = {10.1016/j.compbiolchem.2026.109444},
pmid = {42805095},
issn = {1476-928X},
abstract = {The conventional drug discovery pipeline is resource-intensive, time-consuming, and characterized by high attrition rates, often requiring more than a decade and billions of dollars to bring a single therapeutic agent to market. Drug repurposing identifying new therapeutic indications for approved or investigational drugs offers a pragmatic alternative by leveraging established safety profiles and known pharmacokinetics. Despite growing interest, comprehensive syntheses that span the full spectrum of artificial intelligence (AI) methodologies from classical machine learning (ML) through deep learning (DL), graph neural networks (GNNs), and generative AI while also critically evaluating platforms, validation status, and translational readiness remain limited. This review addresses that gap. A narrative review methodology was employed. Literature was searched across PubMed, Scopus, Web of Science, and Google Scholar using a structured keyword strategy (terms: drug repurposing, AI drug discovery, machine learning, deep learning, graph neural networks, generative AI, reinforcement learning, clinical translation combined with Boolean operators). Studies published between 2018 and 2025 were prioritized, with foundational works included regardless of date. Inclusion criteria encompassed primary research articles, systematic reviews, and platform descriptions reporting AI-based drug repurposing methods or outcomes. Non-English publications, conference abstracts without full text, and purely theoretical works without empirical validation were excluded. We identified and synthesized evidence across six thematic domains: (1) classical ML strategies, including target-based and phenotypic screening; (2) DL architectures, including convolutional and recurrent networks; (3) GNNs for biological network modeling; (4) generative AI and reinforcement learning for de novo molecular design; (5) disease-specific applications in oncology, neurology, and COVID-19; and (6) bioinformatics databases underpinning model development. We explicitly compared ML, DL, GNN, and generative AI approaches in terms of data requirements, interpretability, scalability, and translational readiness and summarized these dimensions in a comparative table. Key platforms reviewed RepurposeDrugs, NeuroCADR, and COVID-19 repurposing frameworks were selected using predefined criteria that emphasized methodological transparency, accessibility, and reported validation. Across approaches, AI models frequently demonstrate strong internal predictive performance in silico, with graph-based and transformer models representing the current state of the art on benchmark datasets. However, external validation, reproducibility, and successful clinical implementation remain comparatively scarce. We therefore place particular emphasis on external cohort validation, prospective and experimental follow-up, and the distinction between computational promise and realized clinical benefit. Persistent challenges include dataset bias, limited model interpretability, regulatory uncertainty, and infrastructure gaps in low-resource settings. AI-driven drug repurposing holds considerable translational promise, but many claims remain preliminary. Interdisciplinary collaboration, shared benchmarks, transparent reporting of negative results, and prospective clinical validation frameworks are essential for realizing the full therapeutic potential of these approaches.},
}

@article {pmid42805654,
year = {2026},
author = {Dankers, A and Yildirim, D and Dijkstra, S and Ngongalah, L and Connolly, MA and Duggan, J and Zander, A and van Loenen, T and Boucherie, RJ and Timen, A},
title = {Performance indicators for evaluating and optimising hospital services during COVID-19: a scoping review.},
journal = {BMJ open},
volume = {16},
number = {9},
pages = {e122362},
doi = {10.1136/bmjopen-2026-122362},
pmid = {42805654},
issn = {2044-6055},
mesh = {*COVID-19/epidemiology/therapy ; Humans ; Pandemics ; *Quality Indicators, Health Care ; SARS-CoV-2 ; *Hospitals/standards ; *Delivery of Health Care/standards ; },
abstract = {OBJECTIVES: To identify which logistical and clinical healthcare key performance indicators (KPIs) were applied in hospitals during the COVID-19 pandemic and how frequently they were used when evaluating and optimising hospital care services.

DESIGN: Scoping review reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) framework.

DATA SOURCES: The search was performed in PubMed, CINAHL, EMBASE, Scopus and Web of Science and included articles published from the beginning of the COVID-19 pandemic, that is, 1 January 2020, until 11 November 2024, the date of the final search. The search strategy combined terms related to (1) COVID-19/pandemic, (2) performance and (3) hospital care.

ELIGIBILITY CRITERIA: Eligible studies were peer-reviewed, English-language publications that reported measurable performance indicators evaluating or optimising hospital care services during the COVID-19 pandemic. Studies had to explicitly define or evaluate KPIs and focus on inpatient hospital settings (≥1 overnight stay) in countries within the European Union, the European Economic Area, the Schengen area or the UK. Multicountry or global studies were included when they contained relevant European data or when the geographical context was not determinant (eg, modelling studies). Exclusion criteria included non-peer-reviewed publications, conference abstracts, organisational reports, literature reviews, studies without original results, studies without accessible full text and non-English publications.

DATA EXTRACTION AND SYNTHESIS: Titles, abstracts and full texts were screened independently by three reviewers. Disagreements were resolved through discussion and consultation with two additional reviewers. Relevant study characteristics and KPI-related information were extracted using a predefined data extraction form. KPIs were categorised inductively into thematic categories. Structured data were analysed at both the study and KPI-category level. Data without a predefined structure, such as KPI definitions and key findings, were analysed manually at the KPI-category level.

RESULTS: Across 94 included studies, 459 distinct KPIs were extracted. Given substantial heterogeneity, KPIs were grouped inductively into six main categories: (1) clinical outcomes, (2) resources and capacity, (3) care delivery volumes, (4) care delivery performance, (5) access time and sojourn time and (6) other indicators. KPIs were reported in diverse formats, including volumes, percentages, scores, scales, characteristics and binary outcomes. Identical KPIs were sometimes defined differently across studies, while similar measures were reported under different terminology. The most common reason for KPI use was for the comparison between pre-COVID-19 and COVID-19 periods, followed by supporting optimisation and exploring quality of care during the pandemic. Most studies emphasised either clinical or logistical indicators, with limited integration of both perspectives within a single performance assessment. The majority of KPIs were not pandemic-specific but reflected indicators already used in routine hospital performance monitoring.

CONCLUSIONS: Hospital performance during COVID-19 was evaluated using a wide range of heterogeneous KPIs, with substantial variation in definitions and reporting practices. Greater transparency and standardisation in KPI definitions may improve comparability, reproducibility and preparedness for future health crises. Integrating clinical and logistical performance perspectives may provide a broader view of hospital performance and support decision-making during pandemics.},
}

*COVID-19/epidemiology/therapy
Humans
Pandemics
*Quality Indicators, Health Care
SARS-CoV-2
*Hospitals/standards
*Delivery of Health Care/standards

@article {pmid42807192,
year = {2026},
author = {Wu, M and Rahman, A and Lim, EG and Yan, R},
title = {The impact of social support on anxiety and depression under the context of COVID-19 pandemic: a systematic review and meta-analysis.},
journal = {Frontiers in psychology},
volume = {17},
number = {},
pages = {1836327},
pmid = {42807192},
issn = {1664-1078},
abstract = {INTRODUCTION: The COVID-19 pandemic created an extreme and prolonged context of collective stress while simultaneously disrupting ordinary sources of interpersonal support. Although social support is widely associated with better mental health, it remains unclear how consistently this association was observed across populations and contexts during the pandemic and what the findings may imply for future crisis preparedness.

METHODS: This systematic review and meta-analysis followed PRISMA 2020 guidelines. Six databases (PubMed, Web of Science, PsycINFO, Taylor & Francis Online, ScienceDirect, and ERIC) were searched for studies published between February 2020 and June 2022. Eligible studies quantitatively examined the association between social support and anxiety and/or depression using validated measures. Study quality was assessed with the Newcastle-Ottawa Scale. Random-effects models were applied to calculate pooled correlations, with subgroup, sensitivity, and publication bias analyses conducted.

RESULTS: Sixty studies comprising 64,693 participants met inclusion criteria. Social support was significantly associated with lower anxiety (ρ = -0.30, 95% CI [-0.33, -0.26]) and lower depression (ρ = -0.33, 95% CI [-0.37, -0.27]). Subgroup analyses showed consistent protective effects across age groups and occupations, particularly among college students and medical workers. Family support demonstrated the strongest associations. Heterogeneity was high (I[2] > 90%), and publication bias was detected, though trim-and-fill analyses did not alter overall results.

CONCLUSION: Higher social support was consistently associated with lower anxiety and depression during the COVID-19 pandemic. Viewed as evidence from an extreme and prolonged context of collective stress, these findings may inform mental health preparedness for future public health emergencies and other large-scale crises. However, substantial heterogeneity indicates that the magnitude of the association varies across populations and contexts. Because the pooled estimates were based on bivariate correlations, the findings should not be interpreted as evidence that social support causally was associated with lower symptoms of specific pandemic-related stressors.},
}

@article {pmid39223825,
year = {2026},
author = {Clausen, TM and Fargen, KM and Primiani, CT and Sattur, M and Amans, MR and Hui, FK},
title = {Post-acute sequelae of COVID infection and cerebral venous outflow disorders: Overlapping symptoms and mechanisms?.},
journal = {Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences},
volume = {32},
number = {5},
pages = {2314-2321},
pmid = {39223825},
issn = {2385-2011},
mesh = {Humans ; *COVID-19/complications ; Post-Acute COVID-19 Syndrome ; *Cerebral Veins/diagnostic imaging/physiopathology ; *Cerebrovascular Disorders/diagnostic imaging/etiology ; Jugular Veins/diagnostic imaging ; Diagnosis, Differential ; },
abstract = {Neurological long Covid (NLC) is a major post-acute sequela of SARS-CoV-2 infection, affecting up to 10% of infected patients. The clinical presentation of patients with NLC is varied, but general NLC symptoms have been noted to closely mimic symptoms of cerebral venous outflow disorders (CVD). Here we review key literature and discuss evidence supporting this comparison. We also aimed to describe the similarity between CVD symptomatology and neuro-NLC symptoms from two perspectives: a Twitter-distributed survey for long covid sufferers to estimate nature and frequency of neurological symptoms, and through a small cohort of patients with long covid who underwent CVD work up per our standard workflow. Over 700 patients responded, and we argue that there is a close symptom overlap with those of CVD. CVD workup in a series of 6 patients with neurological long COVID symptoms showed jugular vein stenosis by CT venography and varying degrees of increased intracranial pressure. Finally, we discuss the potential pathogenic association between vascular inflammation, associated with COVID-19 infection, venous outflow congestion, and its potential involvement in NLC.},
}

Humans
*COVID-19/complications
Post-Acute COVID-19 Syndrome
*Cerebral Veins/diagnostic imaging/physiopathology
*Cerebrovascular Disorders/diagnostic imaging/etiology
Jugular Veins/diagnostic imaging
Diagnosis, Differential

@article {pmid42448200,
year = {2026},
author = {Murugan, AK},
title = {Oral disease-associated proteins implicated in neuronal disorders: Emerging roles in diagnosis and treatment.},
journal = {International journal of biological macromolecules},
volume = {377},
number = {},
pages = {153500},
doi = {10.1016/j.ijbiomac.2026.153500},
pmid = {42448200},
issn = {1879-0003},
mesh = {Humans ; *Neurodegenerative Diseases/diagnosis/metabolism/therapy ; COVID-19/metabolism ; SARS-CoV-2 ; *Mouth Diseases/metabolism/therapy/diagnosis ; Animals ; },
abstract = {Oral health plays a crucial role in maintaining cognitive functions, reflecting a complex interplay between the oral cavity and brain health. Emerging evidence indicates that various oral disease-associated protein molecules are implicated in the pathogenesis of diverse neuronal disorders, including neurodegenerative diseases. This review comprehensively summarizes oral disease-related protein molecules involved in several neuronal disorders, including Alzheimer's disease, Parkinson's disease, neurodegeneration, neuroinflammation, dementia, cognitive decline, and brain fog in two different contexts. Firstly, it describes protein molecules under the classical oral disease condition [Aβ42, total-Tau, phosphorylated-Tau, α-synuclein, DJ-1, lactoferrin, MMP-2/8/9, IL-6, IL-1β, TNF-α, CRP, S100A8, S100A9, S100B, RAGE, LCN2, cathepsin B/L, HSP70/90, NfL, CXCL2/8, C3/4, defensins (α and β), and lysozyme]. Secondly, it explains in COVID-19 context [ACE2, TMPRSS2, furin-1, NRP1, spike, T1R, and T2R]. The review explores oral proteins implicated in neuronal disorders, highlighting their roles in activating inflammatory pathways, contributing to memory impairment, and mediating taste dysfunction in the context of COVID-19. Furthermore, the review delineates the mechanisms underlying the oral-brain axis, highlighting the roles of systemic inflammation, microbial interactions, and blood-brain barrier dysfunction in mediating these effects. It also highlights the innovative diagnostic potential of oral disease-associated proteins as non-invasive biomarkers for early detection and monitoring of neuronal disorders in both classical and COVID-19 contexts. In addition, the emerging therapeutic significance of these proteins is discussed, emphasizing their potential as molecular targets for the prevention and treatment of neurological diseases. Understanding oral disease-associated protein molecules provides novel insights into early diagnosis and progression of neuronal disorders.},
}

Humans
*Neurodegenerative Diseases/diagnosis/metabolism/therapy
COVID-19/metabolism
SARS-CoV-2
*Mouth Diseases/metabolism/therapy/diagnosis
Animals

@article {pmid42473775,
year = {2026},
author = {Olabosipo, J and Zhu, C and Telischi, J and Aston, SA and Cheng, H and Hoa, M},
title = {Uncommon Hearing Instability Disorders: A Scoping Review.},
journal = {The Annals of otology, rhinology, and laryngology},
volume = {135},
number = {11},
pages = {880-886},
doi = {10.1177/00034894261470539},
pmid = {42473775},
issn = {1943-572X},
mesh = {Humans ; *Hearing Loss/etiology/diagnosis ; *Hearing Loss, Sudden/etiology ; Auditory Acuity ; Neoplasms/complications ; },
abstract = {OBJECTIVE: The aim of this scoping review is to identify and categorize uncommon disorders of hearing instability, enabling a better understanding of their clinical presentations and treatments.

METHODS: The framework for the review was developed using the PRISMA-ScR. Literature was pulled from Medline, Web of Science, Embase, and Cochrane Central and screened independently by 3 reviewers with an extended inclusion and exclusion criteria. Once included, data extraction included etiological category of the disease, hearing loss type (sudden, fluctuating, or both), associated symptoms, comorbidities, treatments administered, and hearing recovery outcomes.

RESULTS: A total of 334 studies were included after screening, and data from 2247 patients was extracted. The most common etiologies per study were infectious (30.2%, n = 101 studies), neoplastic (29.6%, n = 99 studies), and vascular (28.1%, n = 94 studies). Average age across cases was 45.9 years (range: 0-90). Among patients, 89.8% exhibited sudden hearing loss, while 8.18% experienced fluctuating hearing loss. Neoplastic-related hearing instability had the highest number of total patients (n = 1101 patients), predominantly involving vestibular schwannomas (n = 582 patients) while infectious diseases had the second highest number of patients (n = 493 patients), with COVID-19 as the most reported infection (n = 146 patients). Causes identified without a known association with hearing loss in other literature include acute or chronic myeloid leukemia (n = 24), metastatic tumor disease (n = 10), or infective endocarditis (n = 3).

CONCLUSION: Hearing instability can arise from a variety of uncommon causes. Increased awareness of these conditions may help clinicians initiate appropriate treatment sooner, potentially improving patient outcomes.},
}

Humans
*Hearing Loss/etiology/diagnosis
*Hearing Loss, Sudden/etiology
Auditory Acuity
Neoplasms/complications

@article {pmid42679879,
year = {2026},
author = {Oliveira, NC and Sanesi, G and Paiva, TCB and Alvim, DS and Bargos, DC and Fontana, CF and Aranha, S and Lafortezza, R and Ferreira, ML},
title = {Urban green spaces: lessons from COVID-19 for future public health crises.},
journal = {Environmental research},
volume = {308},
number = {Pt 1},
pages = {125585},
doi = {10.1016/j.envres.2026.125585},
pmid = {42679879},
issn = {1096-0953},
mesh = {*COVID-19/epidemiology/prevention & control ; Humans ; *Public Health ; *Pandemics ; SARS-CoV-2 ; *Parks, Recreational ; },
abstract = {The COVID-19 pandemic constituted a global socioeconomic crisis with long-lasting consequences. In response to the rapid spread of the virus, governments implemented containment measures such as social distancing, mask mandates, and mobility restrictions, which also affected access to urban green spaces (UGS). This systematic review aimed to identify key lessons from the pandemic regarding the role of UGS during public health crises. The analysis included 155 studies published between 2020 and 2025, grouped into four main research domains: visitation patterns (n = 88), planning and management of UGS (n = 15), associations with viral transmission (n = 11), and health benefits (n = 41). The findings indicated substantial geographical disparities in scientific production and showed that the pandemic reshaped UGS visitation patterns, with proximity to residential areas becoming an important determinant of outdoor activities such as physical exercise and recreation. The literature also revealed persistent inequalities in access to urban nature, particularly among low-income communities, ethnic minorities, and other socially vulnerable groups. Drawing on different forms of evidence, five policy recommendations emerge: i) ensuring equitable access to UGS; ii) improving their quality and spatial distribution; iii) integrating UGS into emergency preparedness strategies; iv) implementing context-sensitive visitation and management protocols; and v) actively supporting health-promoting behaviors compatible with safe use of green environments. The applicability of these lessons to future crises will depend on pathogen characteristics, transmission routes, urban form, restriction policies, and governance capacity. The findings reinforce that equitable access to high-quality UGS should be recognized as a strategic priority for urban governance and public health resilience.},
}

*COVID-19/epidemiology/prevention & control
Humans
*Public Health
*Pandemics
SARS-CoV-2
*Parks, Recreational

@article {pmid42798114,
year = {2026},
author = {Li, J and Ai, F and Li, Y and Cheng, B and Chen, Z},
title = {1000 highly cited articles in depression research (2016-2026): A bibliometric and scoping review (global depression research: 2016-2026).},
journal = {Medicine},
volume = {105},
number = {39},
pages = {e50921},
pmid = {42798114},
issn = {1536-5964},
mesh = {*Bibliometrics ; Humans ; COVID-19 ; *Depression/therapy/epidemiology ; *Biomedical Research/statistics & numerical data ; SARS-CoV-2 ; Pandemics ; },
abstract = {BACKGROUND: Depression is one of the world's leading causes of disability, creating significant challenges for individuals and society. Although research in this field has grown rapidly, we still lack a complete understanding of how depression research has evolved globally over the past decade, especially regarding the long-term effects of the Coronavirus disease 2019pandemic.

METHODS: We collected data from the Web of Science Core Collection as of April 28, 2026. After careful screening, we included 1000 highly cited articles. Using bibliometric methods and visualization tools, we analyzed collaboration networks, keyword patterns, emerging topics, and timeline developments.

RESULTS: Our analysis shows that the United States produces more than half of the world's high-impact depression research. Research focus has shifted from traditional theories to new areas like brain-immune connections and gut bacteria, leading to comprehensive treatment approaches that combine digital technology. The Coronavirus disease 2019 pandemic served as a major turning point, significantly reshaping research priorities and accelerating the integration of medicine and data science.

CONCLUSIONS: Over the past decade, depression research has dynamically evolved in response to external challenges. Exploring basic biological mechanisms and combining knowledge from different fields have become central trends. Our comprehensive analysis provides valuable insights for planning future research, developing policies, and understanding the direction toward "multimodal integration" in depression treatment.},
}

*Bibliometrics
Humans
COVID-19
*Depression/therapy/epidemiology
*Biomedical Research/statistics & numerical data
SARS-CoV-2
Pandemics

@article {pmid42798382,
year = {2026},
author = {Pu, J and Chen, W and Jiang, H and Yang, H},
title = {A dual-database bibliometric analysis of post-COVID-19 condition and cognitive dysfunction (2021-2025).},
journal = {Frontiers in neurology},
volume = {17},
number = {},
pages = {1844317},
pmid = {42798382},
issn = {1664-2295},
mesh = {*Bibliometrics ; Humans ; *COVID-19/complications ; *Cognitive Dysfunction/etiology/epidemiology ; Post-Acute COVID-19 Syndrome ; },
abstract = {BACKGROUND: Coronavirus disease 2019 (COVID-19), caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has posed a substantial global health challenge. Cognitive dysfunction is a prevalent and disabling manifestation of post-COVID-19 condition (PCC). This study aims to conduct a comprehensive bibliometric analysis of research on PCC and cognitive dysfunction.

METHODS: Publications on PCC and cognitive dysfunction published between 2021 and 2025 were retrieved from the Web of Science Core Collection (WoSCC) and Scopus. After screening according to inclusion criteria, Bibliometrix (R package), VOSviewer, and CiteSpace were employed for bibliometric and visualization analysis.

RESULTS: 746 publications from the WoSCC and 1,117 publications from Scopus were included. Over the past 5 years, the number of publications on PCC-related cognitive dysfunction has exhibited a gradual upward trend. The United States showed the highest publication output, while the University of London demonstrated the highest number of publications among institutions in this network. The Journal of Clinical Medicine showed prominent publication and citation-related indicators in this field. Keyword analysis revealed three primary theme domains, including psychological factors, oxidative stress and neuroinflammation. Keyword burst detection revealed that blood-brain barrier, choroid plexus, and endothelial cells represent emerging research frontiers.

CONCLUSION: This bibliometric analysis systematically maps the global research landscape and evolving trends in PCC-related cognitive dysfunction. Our findings provide a broad overview of research development, collaboration patterns, and emerging topics, which may help generate hypotheses for future mechanistic investigations and clinical research.},
}

*Bibliometrics
Humans
*COVID-19/complications
*Cognitive Dysfunction/etiology/epidemiology
Post-Acute COVID-19 Syndrome

@article {pmid42798424,
year = {2026},
author = {Slaunwhite, A and Hoolsema, S and Ogiral, A and Roth, K and Smith, S and Krishnamoorthy, A and Mead, A and Martin, RE},
title = {The health status of incarcerated people in Canada: a narrative review.},
journal = {Frontiers in public health},
volume = {14},
number = {},
pages = {1902956},
pmid = {42798424},
issn = {2296-2565},
mesh = {Humans ; Canada/epidemiology ; *Prisoners/statistics & numerical data ; *Health Status ; COVID-19/epidemiology ; Health Services for Prisoners ; Patient Acceptance of Health Care/statistics & numerical data ; Mental Disorders/epidemiology ; },
abstract = {BACKGROUND: People who experience incarceration in Canada have been historically more likely to experience poor health than community-based populations. Although incarcerated people are entitled to health care equivalent to community standards, evidence suggests this is inconsistently achieved in Canada. We conducted a narrative review to synthesize contemporary evidence on health status and health care utilization by incarcerated people in Canada, including changes observed during and after the COVID-19 pandemic.

METHODS: We searched MEDLINE, PsycINFO, CINAHL, Scopus, and Web of Science for peer-reviewed literature published between January 1, 2014 and July 22, 2026 on the health of adults incarcerated in Canadian provincial, territorial, and federal correctional centers. Both title/abstract and full-text screening were completed independently by two reviewers, and findings were extracted and synthesized thematically across major health domains.

RESULTS: Across the 167 included articles, incarcerated people in Canada experience significantly higher rates of mental illness, substance use disorders, chronic disease, hepatitis C virus infection, and HIV. Mental health and substance use disorders were highly prevalent and often concurrent. Access to reproductive health care and maternal care in custody was limited compared to community care. Health care continuity was disrupted at admission, transfer, and release from correctional centers. These disparities were closely tied to community-based social determinants of health such as poverty, unstable housing, and systemic racism, and mortality risk was highest during transitions in and out of custody, when the risk of overdose death in the weeks following release was greatest.

INTERPRETATION: Incarceration is an important structural determinant of health in Canada that intersects with community-based social determinants of health, contributing to health inequities. To reduce preventable death among people who experience incarceration in Canada, efforts are required to strengthen continuity of care, evaluate the quality of services in correctional centers, and address the social determinants of health and structural inequities that contribute to premature mortality.},
}

Humans
Canada/epidemiology
*Prisoners/statistics & numerical data
*Health Status
COVID-19/epidemiology
Health Services for Prisoners
Patient Acceptance of Health Care/statistics & numerical data
Mental Disorders/epidemiology

@article {pmid42798495,
year = {2026},
author = {Al Mahtab, M and Akbar, SM and Rubido, JC and Yoshida, O and Huq, AKMF and Khan, S and Mahtab, M and Nieto, GE},
title = {Preventive and Therapeutic Vaccination for COVID-19 Using NASVAC.},
journal = {Euroasian journal of hepato-gastroenterology},
volume = {16},
number = {1},
pages = {124-130},
pmid = {42798495},
issn = {2231-5047},
abstract = {AIMS AND BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which belongs to the coronavirus family, suddenly emerged in China and neighboring regions towards the end of 2019. It disrupted the entire world within weeks to months, and finally became a pandemic that continued for about 3 years.

PATIENTS AND METHODS: One year after the commencement of infection, a vaccine surfaced on a global basis that imparted its effect on the progression of the infection. At the same time, symptomatic treatment was initiated to treat the patients and prevent progression to severe forms. Subsequently, antiviral drugs of different paradigms were used with mixed outcomes. Finally, immune modulators were mainly used to delay complications and reduce mortality.

RESULTS: Despite all these approaches, there have been nearly one billion infections and almost one million fatalities due to the pandemic of COVID-19. Two years after the containment of the virus, if the entire episode is considered holistically, it becomes evident that more insights are required to develop preventive and therapeutic measures against the sudden appearance of some microbe.

CONCLUSION: This is the initial theological approach, and more sophisticated drugs may be developed based on this principle.},
}

@article {pmid42798753,
year = {2026},
author = {Yerkenova, S and Lokshin, V and Aldangarova, G and Skakova, R and Koshkimbayeva, G and Mireeva, A and Nurseitova, L and Dzhardemaliyeva, N and Akhmentayeva, D and Maimakova, A and Suieubekov, B and Moiynbayeva, S},
title = {COVID-19 and female reproductive health: pathophysiological mechanisms and clinical reproductive outcomes.},
journal = {Frontiers in medicine},
volume = {13},
number = {},
pages = {1911269},
pmid = {42798753},
issn = {2296-858X},
abstract = {Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has raised important concerns regarding its potential effects on female reproductive health. This review aimed to synthesize current evidence on the biological mechanisms, clinical manifestations, ovarian reserve, fertility potential, and assisted reproductive technology (ART) outcomes associated with COVID-19. A comprehensive literature search of PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar was conducted for studies published between January 2020 and March 2026. Current evidence suggests that SARS-CoV-2 may affect female reproductive tissues through multiple interconnected pathways, including ACE2/TMPRSS2-mediated tissue susceptibility, immune dysregulation, oxidative stress, endothelial dysfunction, neuroendocrine disturbances, and potentially autoimmune mechanisms. Menstrual disturbances, such as changes in cycle length, menstrual flow, and dysmenorrhea, are among the most frequently reported reproductive manifestations, although most appear transient and reversible. Several studies have reported reductions in anti-Müllerian hormone (AMH) and hormonal alterations, particularly following severe infection; however, findings remain inconsistent. Importantly, most investigations demonstrate preserved ovarian reserve, fertility potential, and ART outcomes, including ovarian response, embryo development, clinical pregnancy, and live birth rates. Overall, current evidence suggests that COVID-19 may cause temporary reproductive alterations rather than permanent impairment of female fertility. Nevertheless, large prospective longitudinal studies are required to clarify long-term reproductive consequences and identify women at increased risk of persistent reproductive dysfunction.},
}

@article {pmid42799123,
year = {2026},
author = {Rakhimzhanova, AS and Pustolaikina, IA and Kurmanova, AF and Muzaparov, RA and Kapishnikova, DD and Stalinskaya, AL and Kulakov, IV},
title = {The Epoxybenzooxocine Core of Integrastatins and Analogs: A Comprehensive Review of Structure, Synthetic Approaches, and Biological Applications.},
journal = {ACS omega},
volume = {11},
number = {37},
pages = {54847-54869},
pmid = {42799123},
issn = {2470-1343},
abstract = {Integrastatins and their biogenetic counterparts possess a rare heterotetracyclic framework containing an unprecedented [6/6/6/6]-tetracyclic skeleton and a central [3/3/1]-bicyclic ketal core with high pharmaceutical potential, particularly due to their potent anti-HIV-1 integrase activity. Despite their promising scaffolds, a systematic consolidation of their chemistry and biology has been entirely lacking, creating a critical gap between the complex architecture of these natural polyketides and the targeted design of drug-like inhibitors. Herein, we present the first comprehensive review of this field, systematically analyzing 42 peer-reviewed publications from 1999 to 2025 retrieved from the Scopus, Web of Science, PubMed, and PubChem databases. Structural analysis confirms that while these rigid, nonplanar V-shaped molecules comply with Lipinski's Rule of Five as a baseline filter for drug-likeness, deeper ADMET profiling further highlights their high predicted human intestinal absorption (HIA) alongside a low risk of cardiotoxicity. Synthetically, we detail how the field has fundamentally evolved from an arduous 11-step sequence in 2003 to highly streamlined, atom-economical one-step protocols in 2008 and 2021, culminating in the 2025 total syntheses that successfully resolved long-standing structural misinterpretations of epicoccolide A and epicocconigrone A. Furthermore, a comparative assessment across eight critical synthetic parameters highlights the operational trade-offs between step efficiency, scalability, and functional group tolerance in current cascade cyclizations. Biologically, we evaluate the extensive in vitro and in silico profiling of over 30 synthetic derivatives, highlighting their antimicrobial (M. bovis, S. aureus, P. carotovorum, C. albicans), antitubercular, and antiviral (SARS-CoV-2 and HIV-1 integrase inhibition) potencies. Integrating pharmacophore mapping with in silico ADMET profiling demonstrates that despite favorable absorption and cardiac safety, predicted liabilities such as human hepatotoxicity, carcinogenicity, and skin sensitization highlight critical areas for targeted structural modification. Ultimately, by bridging synthetic methodology with in silico and experimental bioactivity evaluation, this review establishes epoxybenzooxocine-based heterocycles as viable early-stage lead platforms and outlines strategic directions to advance these scaffolds in targeted drug discovery.},
}

@article {pmid42799772,
year = {2026},
author = {Filippatos, F and Venieri, D and Tsigkrou, E and Karava, V and Miliaraki, M and Kakleas, K},
title = {Infectious triggers in IgA vasculitis in children: current evidence, causal attribution and immunopathogenic mechanisms.},
journal = {Rheumatology international},
volume = {46},
number = {10},
pages = {},
pmid = {42799772},
issn = {1437-160X},
mesh = {Humans ; Child ; *IgA Vasculitis/immunology/microbiology/epidemiology ; *Immunoglobulin A/immunology ; },
abstract = {IgA vasculitis (IgAV) is the most common systemic vasculitis in childhood. Its seasonal distribution and frequent respiratory or gastrointestinal prodromes implicate environmental exposures. However, microbiological detection temporally proximate to disease onset is insufficient to establish causality in an individual patient. To critically evaluate infectious exposures associated with pediatric IgAV, we distinguished epidemiological associations from incidental detection and infectious mimics, and separate direct IgAV evidence from mechanisms extrapolated from IgA nephropathy or general mucosal immunology. PubMed and MEDLINE were searched from inception through 6 August 2026 and supplemented by backward and forward citation tracking. Controlled-vocabulary and free-text terms addressed IgAV, pediatric populations, infection, specific pathogens, microbiota, vaccination, and immune mechanisms. The broad query retrieved 1,174 records before deduplication. Because screening was not prospectively logged, deduplicated screening and full-text counts could not be reconstructed; accordingly, no systematic-review or PRISMA completeness claim is made. Comparative evidence was most consistent for group A streptococcal exposure and population-level circulation of seasonal respiratory bacteria. Evidence for Mycoplasma pneumoniae, Helicobacter pylori in selected phenotypes, SARS-CoV-2, and specific enteric or parasitic infections was of lower certainty and was frequently case-based. Pediatric vaccine studies did not demonstrate a consistent excess risk. Evidence supports convergence of mucosal IgA induction, IgA1-containing immune complexes, complement activation, FcαRI-mediated myeloid signaling, neutrophil extracellular traps, and endothelial injury. Causal attribution requires integrated assessment of temporality, anatomical source, microbiological specificity, background exposure prevalence, and alternative diagnoses. Infectious investigations should be restricted to circumstances in which identification of a treatable infection, persistent antigen source, or immunosuppression-related hazard would alter management.},
}

Humans
Child
*IgA Vasculitis/immunology/microbiology/epidemiology
*Immunoglobulin A/immunology

@article {pmid37018525,
year = {2024},
author = {Bawand, R and Ghiasian, M and Samadyan, M},
title = {Concurrent Diffuse Dural and Leptomeningeal Enhancements in Brain Magnetic Resonance Imaging Following a Mild COVID-19 Infection: A Novel Case Report and Review of Literature.},
journal = {Current medical imaging},
volume = {20},
number = {},
pages = {e280323215040},
doi = {10.2174/1573405620666230328110847},
pmid = {37018525},
issn = {1573-4056},
mesh = {Humans ; Female ; Middle Aged ; *COVID-19/complications/diagnostic imaging ; *Magnetic Resonance Imaging/methods ; *Dura Mater/diagnostic imaging ; *Headache/etiology/diagnostic imaging ; SARS-CoV-2 ; *Meninges/diagnostic imaging ; Pandemics ; *Brain/diagnostic imaging ; *Coronavirus Infections/complications/diagnostic imaging ; *Pneumonia, Viral/complications/diagnostic imaging ; Betacoronavirus ; },
abstract = {INTRODUCTION: During the COVID-19 pandemic, various complications have been reported in patients with this infection worldwide, including a wide range of neurological disorders. In this study, we have reported a novel neurological complication in a 46-years-old woman who was referred due to a headache following a mild COVID-19 infection. Also, we have had a quick review of previous reports of dural and leptomeningeal involvements in COVID-19 patients.

CASE REPORT: The patient's headache was persistent, global, and compressive with radiation to the eyes. The severity of the headache was increased during the disease course and was exacerbated by walking, coughing, and sneezing but decreased with rest. The high severity of the headache disrupted the patient's sleep. Neurological examinations were completely normal, and laboratory tests did not have abnormal findings except for an inflammatory pattern. Finally, in the brain MRI, a concurrent diffuse dural enhancement and leptomeningeal involvement were observed, which is a new finding in COVID-19 patients and has not been reported so far. The patient was hospitalized and treated with Methylprednisolone pulses. After completing the therapeutic course, she was discharged from the hospital in good condition and with an improved headache. A repeated brain MRI was requested 2 months after discharge, which was completely normal and showed no evidence of dural and leptomeningeal involvements.

CONCLUSION: Inflammatory complications of the central nervous system caused by COVID-19 can occur in different forms and types, and clinicians should consider them.},
}

Humans
Female
Middle Aged
*COVID-19/complications/diagnostic imaging
*Magnetic Resonance Imaging/methods
*Dura Mater/diagnostic imaging
*Headache/etiology/diagnostic imaging
SARS-CoV-2
*Meninges/diagnostic imaging
Pandemics
*Brain/diagnostic imaging
*Coronavirus Infections/complications/diagnostic imaging
*Pneumonia, Viral/complications/diagnostic imaging
Betacoronavirus

@article {pmid42797632,
year = {2026},
author = {Georgakopoulou, VE and Pitiriga, VC},
title = {Complementary Roles of RT-PCR and Next-Generation Sequencing in Post-Vaccination SARS-CoV-2 Infection: Clinical Diagnosis, Genomic Characterization, and Surveillance.},
journal = {Vaccines},
volume = {14},
number = {9},
pages = {},
pmid = {42797632},
issn = {2076-393X},
abstract = {SARS-CoV-2 infection after vaccination remains a clinical and public-health challenge because protection against infection may vary with time since vaccination, host factors, previous infection, and ongoing viral evolution. Although vaccination substantially reduces the risk of severe COVID-19, post-vaccination infections may still occur and may be mild, atypical, or asymptomatic. This narrative review examines the complementary roles of reverse-transcription polymerase chain reaction (RT-PCR) and next-generation sequencing (NGS) in the diagnosis, genomic characterization, and surveillance of post-vaccination SARS-CoV-2 infection. RT-PCR remains the first-line method for confirming acute infection because it is rapid, widely available, and clinically actionable, although its clinical performance depends on appropriate specimen collection and timing. NGS complements RT-PCR by providing viral genomic characterization, including lineage assignment, mutation detection, investigation of suspected transmission clusters, and population-level surveillance. Sequencing may provide additional value in selected settings, particularly suspected reinfection, persistent infection in selected immunocompromised patients, outbreak investigations, and representative or event-triggered genomic surveillance. Its use should therefore be guided by a predefined clinical, epidemiological, or surveillance objective rather than applied routinely to all post-vaccination infections. An integrated strategy combining first-line RT-PCR with objective-driven sequencing can preserve diagnostic efficiency while providing genomic information when it is most likely to influence patient-level investigation, infection-control assessment, or public-health surveillance.},
}

@article {pmid42797646,
year = {2026},
author = {Jiang, S and Liu, Y and Cui, R},
title = {Immunogenicity and Safety of RSVPreF3 OA Coadministration Versus Sequential Administration in Adults: A Systematic Review and Meta-Analysis.},
journal = {Vaccines},
volume = {14},
number = {9},
pages = {},
pmid = {42797646},
issn = {2076-393X},
support = {NJ2028YB080//The 2025 Municipal Philosophy and Social Sciences Planning Project of Neijiang City/ ; Project No. 39//This work was supported by the Neijiang Municipal Science and Technology Bureau under the 2025 Second Batch Science and Technology Program Project/ ; },
abstract = {BACKGROUND/OBJECTIVES: Adults eligible for respiratory syncytial virus (RSV) vaccination may also receive influenza, COVID-19, pneumococcal, or herpes zoster vaccines. We compared immunogenicity and safety between coadministration and sequential schedules.

METHODS: We searched PubMed, Embase, Web of Science, Scopus, and CENTRAL from inception to 3 August 2026 for randomized trials in adults aged 50 years or older. Eligible trials compared RSVPreF3 OA coadministration with sequential administration of the partner vaccine followed by RSVPreF3 OA. Random-effects models pooled neutralizing-antibody geometric mean ratios (GMRs; coadministration/sequential) separately for RSV-A and RSV-B and risk ratios for safety outcomes. Risk of bias and certainty were assessed using RoB 2 and GRADE, respectively.

RESULTS: Six trials randomized 5455 participants. Pooled RSV-A and RSV-B GMRs were 0.895 (95% CI 0.816-0.983) and 0.922 (95% CI 0.837-1.016), respectively. In trial-specific per-protocol analyses, non-inferiority criteria were met for recombinant zoster vaccine (RZV) and 20-valent pneumococcal conjugate vaccine (PCV20) antibody endpoints, but non-inferiority was not demonstrated for SARS-CoV-2 XBB.1.5 neutralizing antibodies (GMR 0.763, 95% CI 0.662-0.885) or the adjuvanted quadrivalent influenza vaccine A/H3N2 response. The pooled risk ratio for serious adverse events was 0.831 (95% CI 0.530-1.303), with limited precision. Certainty was low for RSV-A and very low for RSV-B, mainly reflecting risk of bias and inconsistency.

CONCLUSIONS: In adults aged 50 years or older, same-day RSVPreF3 OA coadministration was associated with lower RSV-neutralizing antibody responses than sequential administration, while partner-vaccine immunogenicity varied by product and antigen. Non-inferiority was not demonstrated for the SARS-CoV-2 XBB.1.5 and adjuvanted-QIV A/H3N2 antibody endpoints. No clear safety difference between schedules was identified, and the clinical significance of the antibody differences remains uncertain.

REGISTRATION: PROSPERO CRD420261470812.},
}

@article {pmid42797648,
year = {2026},
author = {Poddine, G and Bellinato, F and Gisondi, P and Girolomoni, G},
title = {New-Onset Pemphigus Following Drug Exposure and Vaccination: A Systematic Review of Reported Cases.},
journal = {Vaccines},
volume = {14},
number = {9},
pages = {},
pmid = {42797648},
issn = {2076-393X},
abstract = {BACKGROUND: Although an increasing number of cases of new-onset pemphigus have been reported following drug exposure or vaccination, the available evidence remains fragmented and distinguishing true trigger-associated disease from coincidental onset continues to represent a major clinical challenge. We performed a systematic review to evaluate the available evidence on drug- and vaccine-associated new-onset pemphigus and to compare their clinical characteristics, management, and outcomes.

METHODS: This systematic review was conducted according to the PRISMA 2020 statement and prospectively registered in PROSPERO (CRD420261307622). PubMed was searched from database inception to 30 April 2026. Studies reporting individual patients with new-onset pemphigus temporally associated with drug exposure or vaccination were included. Demographic, clinical, immunopathological, therapeutic, and outcome data were extracted and synthesized descriptively because of the anticipated heterogeneity of the available evidence.

RESULTS: A total of 20 drug-associated and 26 vaccine-associated cases identified from primary reports were included in the descriptive synthesis. Drug-associated cases demonstrated marked heterogeneity in the implicated agents, broader clinical variability, and a longer median latency, with frequent clinical improvement following withdrawal of the suspected drug when reported. In contrast, vaccine-associated cases occurred predominantly after SARS-CoV-2 vaccination, displayed a substantially shorter latency, and were mainly represented by pemphigus vulgaris and pemphigus foliaceus. Across both groups, systemic corticosteroids constituted the mainstay of treatment, with generally favorable outcomes among patients with available follow-up. However, the available evidence consisted almost exclusively of case reports and small case series, precluding reliable assessment of incidence or causality.

CONCLUSIONS: Current evidence suggests that drugs and vaccines may act as potential triggers of new-onset pemphigus in susceptible individuals; however, the strength of evidence differs substantially between the two settings. Drug-associated cases generally provide more convincing clinical support for a trigger-related mechanism, whereas vaccine-associated cases require more cautious interpretation because temporal association alone cannot establish causality. Standardized case reporting, prospective pharmacovigilance, and mechanistic studies are needed to strengthen causal inference and improve the recognition and management of trigger-associated pemphigus.},
}

@article {pmid42797823,
year = {2026},
author = {Shaw, M and Fehr, AR},
title = {SARS-CoV-2 Drug-Resistant Mutations in Non-Structural Proteins.},
journal = {Viruses},
volume = {18},
number = {9},
pages = {},
pmid = {42797823},
issn = {1999-4915},
support = {2515959//U.S. National Science Foundation/ ; },
mesh = {Humans ; *Viral Nonstructural Proteins/genetics/metabolism ; *Drug Resistance, Viral/genetics ; *Antiviral Agents/pharmacology/therapeutic use ; *Mutation ; *SARS-CoV-2/genetics/drug effects ; Virus Replication/drug effects ; COVID-19 Drug Treatment ; RNA-Dependent RNA Polymerase/genetics ; RNA Replication ; COVID-19/virology ; },
abstract = {Various antiviral drug therapies have been developed for the treatment of coronaviruses, particularly SARS-CoV-2. However, the emergence of drug-resistant mutations is detrimental to clinical efficacy and global public health. Antiviral usage exerts selective pressures on viruses that manufacture an environment for resistant strains to emerge, in some cases at a fitness cost. However, the appearance of a compensatory mutation can restore or improve viral fitness, allowing the strain to persist and spread in a population. Here we evaluate the drug resistance mechanisms of multiple SARS-CoV-2 non-structural proteins, including the main protease (Mpro) and the RNA-dependent RNA polymerase (RdRP), which drive polyprotein processing and viral RNA replication, as well as PLPro, EndoU, and Mac1, which contribute to viral replication and counter host innate immune responses. We also discuss several methods that could be used to avoid drug resistance in the future. By integrating the understanding of molecular mechanisms of antiviral treatment with surveillance of resistance-associated mutations and new drug therapies, appropriate clinical approaches can be developed to reduce the impact of drug resistance.},
}

Humans
*Viral Nonstructural Proteins/genetics/metabolism
*Drug Resistance, Viral/genetics
*Antiviral Agents/pharmacology/therapeutic use
*Mutation
*SARS-CoV-2/genetics/drug effects
Virus Replication/drug effects
COVID-19 Drug Treatment
RNA-Dependent RNA Polymerase/genetics
RNA Replication
COVID-19/virology

@article {pmid42797853,
year = {2026},
author = {Galati, G and Pavan, G},
title = {Can Non-Thermal Microwave Irradiation Inactivate Viruses? A Review with Some Computations.},
journal = {Viruses},
volume = {18},
number = {9},
pages = {},
pmid = {42797853},
issn = {1999-4915},
mesh = {*Microwaves ; Humans ; *Virus Inactivation/radiation effects ; *Viruses/radiation effects ; SARS-CoV-2/radiation effects ; },
abstract = {The use of non-thermal, human-safe electromagnetic (e.m.) waves in the GHz range to inactivate viruses has been proposed by a few groups. It is allegedly based on a transformation of a microwave photon into a phonon, which would produce a so-called Structure Resonance Energy Transfer (SRET) strong enough to break the capsid due to Confined Acoustic Vibration (CAV) at virus-specific frequencies. However, it is well known that e.m. photons' absorption in water or in organic media does not generate single phonons at the same frequency. Rather, it generates many thermal phonons across a wide frequency spectrum according to the widely known microwave heating effect, as exploited, inter alia, in the microwave oven. However, there remains interest in proposed usages of non-thermal microwave fields to inactivate respiratory viruses for air sanitization purposes. Hence, this paper poses the question: can human-safe microwave irradiation inactivate viruses?},
}

*Microwaves
Humans
*Virus Inactivation/radiation effects
*Viruses/radiation effects
SARS-CoV-2/radiation effects

@article {pmid42797858,
year = {2026},
author = {Alousi, FF and Alli, AA},
title = {Role of Ion Channels in the Pathophysiology of SARS-CoV-2.},
journal = {Viruses},
volume = {18},
number = {9},
pages = {},
pmid = {42797858},
issn = {1999-4915},
mesh = {Humans ; *Ion Channels/metabolism ; *SARS-CoV-2/physiology ; *COVID-19/physiopathology/virology ; Virus Replication ; Viroporin Proteins/metabolism ; Immune Evasion ; *Betacoronavirus/physiology ; Viral Proteins/metabolism ; Animals ; },
abstract = {In the pathophysiology of SARS-CoV-2, the critical role of ion channels has become increasingly evident during the COVID-19 crisis. This review offers a comprehensive analysis of the functions of ion channels, including viroporins, in both the viral life cycle and the host immune response. It explores how ion channels facilitate viral replication, assembly, and immune evasion. Moreover, this review critically examines the molecular mechanisms underpinning SARS-CoV-2 infection, with a particular emphasis on the integral role of viral proteins exhibiting membrane-interacting properties, collectively named viroporins, in promoting viral survival and triggering host defense mechanisms, highlighting their potential as therapeutic targets. By unraveling these complex interactions, this review aims to increase our understanding of COVID-19 pathophysiology.},
}

Humans
*Ion Channels/metabolism
*SARS-CoV-2/physiology
*COVID-19/physiopathology/virology
Virus Replication
Viroporin Proteins/metabolism
Immune Evasion
*Betacoronavirus/physiology
Viral Proteins/metabolism
Animals

@article {pmid42797597,
year = {2026},
author = {Lo Moro, G and Butnaru, AM and Toffanin, C and Cataldo, A and Mazzeo, S and Martella, M and Scaioli, G and Bert, F and Siliquini, R},
title = {Guidelines on Immunization of People with Chronic Neurological Disorders: A Systematic Review.},
journal = {Vaccines},
volume = {14},
number = {9},
pages = {},
doi = {10.3390/vaccines14090777},
pmid = {42797597},
issn = {2076-393X},
abstract = {BACKGROUND: People with chronic neurological disorders may be vulnerable to severe outcomes from vaccine-preventable infections. However, immunization recommendations for these patients may be difficult to identify and apply. This systematic review aimed to identify and describe official guidelines on preventive active immunization for individuals with chronic neurological disorders.

METHODS: This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 and registered in the PROSPERO International prospective register of systematic reviews (CRD420251005848). Bibliographic databases (PubMed, Embase, Scopus) and grey literature sources were searched to identify official national or international clinical practice guidelines or comparable structured guidance documents providing recommendations relevant to chronic neurological disorders. The search was restricted to countries with a Human Development Index greater than 0.8, to allow comparison across broadly comparable healthcare and socioeconomic contexts. Data were extracted on document characteristics, neurological conditions addressed, vaccines covered, and vaccination-related recommendations.

RESULTS: Overall, 12 unique documents were included. Four were vaccination-focused documents including recommendations for neurological disorders, four were disease-management guidelines including vaccination-related recommendations, and four specifically addressed vaccination in selected neurological diseases. Guidance was unevenly distributed across countries, neurological conditions, and document types. Influenza and COVID-19 vaccination were the most consistently addressed vaccines. Multiple sclerosis was the condition with the most detailed guidance, especially regarding vaccination before disease-modifying therapies, live attenuated vaccines, vaccine timing in relation to immunosuppression or relapse, and protection of close contacts.

CONCLUSIONS: Official immunization guidance for people with chronic neurological disorders remains limited and heterogeneous. Future guidelines should provide clearer and regularly updated recommendations to support vaccination assessment, treatment-sensitive planning, and multidisciplinary coordination.},
}

@article {pmid42797601,
year = {2026},
author = {Cai, D and Li, X and Wang, R and Lin, C and Wen, J and Tian, B},
title = {Research Progress, Application, and Industrialization Prospects of Circular RNA Vaccines in Viral Diseases.},
journal = {Vaccines},
volume = {14},
number = {9},
pages = {},
doi = {10.3390/vaccines14090781},
pmid = {42797601},
issn = {2076-393X},
support = {No. S202610626016//the Sichuan Provincial College Students Innovation and Entrepreneurship Training Program/ ; 2521993028/2025//Sichuan University/ ; },
abstract = {RNA vaccines-comprising linear mRNA, self-amplifying RNA, and circular RNA (circRNA)-constitute a core next-generation platform for the prevention and control of viral diseases; among these, circRNA vaccines possess notable structural stability, yet their technical bottlenecks and application prospects in veterinary medicine have not been systematically reviewed. This review synthesizes current research on circRNA vaccine design, circularization strategies, translation mechanisms, delivery systems, and immunological outcomes, and compares their antiviral performance with that of linear mRNA vaccines. Owing to their covalently closed circular conformation, circRNA vaccines exhibit enhanced resistance to nucleases and superior thermal stability, enabling sustained transfection activity at ambient temperatures without reliance on strict cold chains; through cap-independent translation driven by internal ribosome entry sites or N[6]-methyladenosine modifications, and in conjunction with optimized circularization protocols and lipid nanoparticle carriers, circRNA vaccines elicit substantially higher antiviral IgG titers and durable antigen-specific T-cell memory relative to linear mRNA vaccines. These vaccines have been deployed against COVID-19, monkeypox, influenza, and livestock viral diseases, demonstrating strong adaptability to viral variants and compatibility with mucosal or needle-free administration routes. CircRNA vaccines are well suited for both emergency outbreak response and routine immunization programs; nevertheless, challenges persist, including low circularization efficiency for long sequences, elevated manufacturing costs, and inadequate quality control standards. Addressing these issues through improved production workflows and delivery technologies adapted to resource-limited settings will be critical to establishing circRNA vaccines as a pillar of livestock disease management and as a strategic reserve for emerging zoonotic threats.},
}

@article {pmid42797619,
year = {2026},
author = {Dillard, JA and Saldivar, RA and Heise, MT and Baxter, VK},
title = {Vaccine-Associated Enhanced Respiratory Disease: From Animal Models to Human Health.},
journal = {Vaccines},
volume = {14},
number = {9},
pages = {},
doi = {10.3390/vaccines14090799},
pmid = {42797619},
issn = {2076-393X},
support = {1P01AI158571-01/NH/NIH HHS/United States ; 3U19AI100625-10/NH/NIH HHS/United States ; 5R01AI157253-05/NH/NIH HHS/United States ; 5U19AI109680-05/NH/NIH HHS/United States ; 7K01OD026529-06/NH/NIH HHS/United States ; 5T32AI007419-30/NH/NIH HHS/United States ; 5T32GM008719-25/NH/NIH HHS/United States ; 4P30CA016086-50/NH/NIH HHS/United States ; 5U01AI149644-05/NH/NIH HHS/United States ; 3U54CA260543-02/NH/NIH HHS/United States ; Infectious Disease Drug Discovery Program (ID3)//University of North Carolina System/ ; Rapidly Emerging Antiviral Drug Development Initiative (READDI)//Rapidly Emerging Antiviral Drug Development Initiative (READDI)/ ; North Carolina Translational Clinical Sciences Institute (NCTraCS)//University of North Carolina System/ ; Emerging Challenges in Biomedical Research COVID Pilot Award//University of North Carolina System/ ; Junior Investigator Development Award//University of North Carolina System/ ; Contract #95928//American Cancer Society/ ; },
abstract = {Vaccines are a safe and highly effective tool for protecting both humans and animals against infectious diseases. Although vaccines currently in use in humans have robust safety records, historical examples show that some vaccines have resulted in adverse outcomes, including vaccine-associated enhanced respiratory disease (VAERD). VAERD occurs when preexisting vaccine-induced immunity worsens respiratory disease, rather than conferring protection during infection. Enhanced disease in the lower respiratory tract characteristic of VAERD includes worsened clinical manifestations such as pneumonia and bronchiolitis, as well as increased pulmonary pathology in vaccinated, infected individuals compared with their unvaccinated, infected counterparts. Mechanistically, VAERD has been associated with TH2-mediated immunopathology or antibody-dependent enhancement and is primarily associated with specific virus families, including Pneumoviridae, Orthomyxoviridae and Coronaviridae. Notable cases of VAERD have been associated with a respiratory syncytial virus vaccine candidate evaluated in clinical trials in the 1960s, experimental coronavirus vaccines in animal models, and in veterinary vaccines for influenza virus in swine. Existing approved vaccines are safe and highly effective tools for protecting both humans and animals against respiratory pathogens. However, as new respiratory vaccines are developed, they must also undergo careful testing for VAERD or other adverse outcomes. This review aims to provide the field with an overview of VAERD as a resource to support vaccine development and safety studies.},
}

@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